JP6640235B2 - 導体ストレインリリーフ付き外科用装置 - Google Patents

導体ストレインリリーフ付き外科用装置 Download PDF

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JP6640235B2
JP6640235B2 JP2017543779A JP2017543779A JP6640235B2 JP 6640235 B2 JP6640235 B2 JP 6640235B2 JP 2017543779 A JP2017543779 A JP 2017543779A JP 2017543779 A JP2017543779 A JP 2017543779A JP 6640235 B2 JP6640235 B2 JP 6640235B2
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assembly
surgical device
electrical conductor
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ケネス カッポラ，
ケネス カッポラ，
アーニー アラーニ，
アーニー アラーニ，
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コヴィディエン リミテッド パートナーシップ
コヴィディエン リミテッド パートナーシップ
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    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90—Identification means for patients or instruments, e.g. tags
    • A61B90/98—Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
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    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
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Description

関連出願の相互参照
本出願は、その内容の全体が参照により本明細書に組み込まれる、２０１５年２月２６日に出願された米国仮特許出願第６２／１２１，０４９号の利益及び優先権を主張する。
背景
本開示は、関節運動ツール組立体を有する外科用装置に関する。より具体的には、本開示は、ツール組立体の関節運動中に、外科用装置の本体とツール組立体との間の電気接続におけるストレインを解放するためのストレインリリーフを含む外科用装置に関する。
組織の手術用の外科用装置は、当技術分野ではよく知られており、通常、動力付きハンドル組立体と、ハンドル組立体から遠位に延在する本体部と、及び本体部の遠位端上に支持され、かつ本体部に対して関節運動可能であるツール組立体とを含む。ツール組立体は、非接近位置と接近位置との間で互いに関して移動可能である、第１及び第２のジョーを含む。外科用ステープリング装置では、第１のジョーが、アンビル組立体を支持し、第２のジョーが、カートリッジ組立体を支持する。カートリッジ組立体は、取り替え可能であり、外科的処置中にツール組立体の再使用を可能にし得る。取り替え可能なカートリッジ組立体は、様々な特性、すなわち、厚さ、密度を有する組織における使用に多様な構成で提供され得る。例えば、様々なカートリッジ組立体が、様々なサイズのステープルを有し得、かつ／またはステープルが、様々な構成で配置され得る。
多くのカートリッジ組立体は、外科用ステープリング装置の本体部を貫通して延在する導体によってハンドル組立体に電気的に結合される識別チップを含み、取り付けられたカートリッジ組立体とともに動作するようにハンドル組立体がプログラムされるのを確実にする。装填ユニットの関節運動中、本体部を貫通してツール組立体まで延在する導体は、ストレインを受けることがある。関節運動中、ハンドル組立体をツール組立体に接続する導体への損傷を防止するには、ストレインリリーフ付き電気導体を提供することが有益であるだろう。
したがって、ストレインリリーフ付き電気導体を含む外科用装置が提供される。外科用装置は、近位端及び遠位端を有する本体部を含み、また近位端に支持された接続組立体を含む。外科用装置は、本体部の遠位端に支持され、かつ本体部に対して関節運動可能であるツール組立体をさらに含み、ツール組立体は、識別組立体を含む。加えて、外科用装置は、接続組立体から識別組立体まで延在する電気導体を含む。電気導体は、本体部に対するツール組立体の関節運動に適応するためのストレインリリーフ部を含む。
実施形態において、ストレインリリーフ部は、複数のコイルを含む。複数のコイルの高さは、複数のコイルの近位部から複数のコイルの遠位部に減少してもよい。代替的に、複数のコイルの高さは、複数のコイルの近位部から遠位部まで均一である。複数のコイルは、互いに対して等しく離間し得る。
いくつかの実施形態において、本体部は、電気導体を受容するためのチャネルを画定する。チャネルは、電気導体のストレインリリーフ部を受容するための中央部を含み得る。外科用装置は、動力付きハンドル組立体を含み得、電気導体は、識別組立体をハンドル組立体に電気的に結合させる。ツール組立体は、ステープリング組立体を含み得る。ステープリング組立体は、取り外し可能なカートリッジ組立体を含み得る。電気導体は、可撓ケーブルを含み得る。可撓ケーブルは、近位部及び遠位部を含み得る。可撓ケーブルの近位部は、例えば、接着剤を使用して、本体部に軸方向に添着され得る。
実施形態において、ストレインリリーフ部は、電気導体の伸長を可能にするように構成される。代替的に、または加えて、ストレインリリーフ部は、電気導体の短縮を可能にするように構成される。本体部、ツール組立体、及び電気導体は、動力付きハンドル組立体に解放可能に結合されるように構成される装填ユニットを形成し得る。
本開示の様々な実施形態が、以下の図面を参照して本明細書に説明される。
接近位置におけるツール組立体を含む、ここに開示された外科用ステープリング装置の実施形態の側面斜視図である。 図１に示された外科用ステープリング装置の使い捨て装填ユニットの側面斜視図である。 部品が分解された状態での、図２に示された装填ユニットの側面斜視図である。 部品が分解された状態での、図２に示された装填ユニットの取り付け組立体及び発射ロックアウト組立体の拡大側面斜視図である。 図２に示された指示細部領域の側面斜視図である。 図２に示された装填ユニットの近位端の拡大斜視図である。 上部ハウジング半体が取り外された状態での、図２に示された装填ユニットの近位端の側面斜視図である。 部品が分解された状態での、図２に示された装填ユニットの識別組立体の側面斜視図である。 図８に示された識別組立体の側面斜視図である。 部品が分解された状態での、図８に示された識別組立体の接続組立体、及び図２に示された装填ユニットのジョー部材の近位端の斜視図である。 図１０に示された接続組立体及びジョー部材の代替的な斜視図である。 図３に示された指示細部領域の拡大図である。 図２に示された装填ユニットのカートリッジ本体に固定された、図８に示された識別組立体のチップ組立体の側面斜視図である。 図１３に示されたチップ組立体を含む、図２に示された装填ユニットのカートリッジ組立体の斜視端面図である。 図２に示された装填ユニットに装填される、図１４に示されたカートリッジ組立体の側面斜視図である。 アンビル組立体が取り外された状態での、図２に示された装填ユニットの上面斜視図である。 図１６に示された指示細部領域の拡大図である。 部品が分解された状態での、図２に示された装填ユニットのロック機構及び取り付け組立体の斜視図である。 図１８に示されたロック機構のラッチ部材の拡大斜視図である。 図１８に示されたロック機構及び取り付け組立体、ならびに図２に示された装填ユニットの駆動組立体の遠位端の底面斜視図である。 第１の構成、すなわちロック解除された構成における、図２０に示された駆動組立体の遠位端、及び図１９に示されたラッチ部材の側面断面図である。 第２の構成、すなわちロックされた構成における、図２１に示された駆動組立体の遠位端及びラッチ部材の断側面図である。 図２に示された線２３−２３に沿ってとられた断側面図である。 図２３に示された指示細部領域の拡大図である。 図１８に示されたロック機構及び駆動組立体の側面斜視図である。 図２５に示された線２６−２６に沿ってとられた側面断面図である。 アンビルプレートが取り外された状態での、図２に示された装填ユニットのツール組立体の上面図である。 第１の関節運動した位置における図２７に示されたツール組立体の近位端の拡大図である。 図２に示された装填ユニットのカートリッジ組立体、及び本開示の実施形態によるシッピングウェッジの側面斜視図である。 図２９に示されたシッピングウェッジの底面斜視図である 可撓ケーブルを含む、本開示の別の実施形態による装填ユニットの側面斜視図である。 図３１に示された、装填ユニットの可撓ケーブルの概略図である。
ここで、同様の参照番号がいくつかの図のそれぞれにおいて同一または対応する要素を指し示す図面を参照して、ここに開示された外科用装置の実施形態が詳細に説明される。この発明を実施するための形態では、「ｐｒｏｘｉｍａｌ（近位の）」という用語は、一般に、装置の、臨床医により近い部分を指すのに使用される一方、「ｄｉｓｔａｌ（遠位の）」という用語は、一般に、装置の、臨床医からより遠い部分を指すのに使用される。
外科用装置のツール組立体が関節運動させられるに従って、本体部からツール組立体まで延在するいずれのケーブルも、ストレイン、すなわち、圧縮または引張を受ける。ツール組立体の関節運動中、１つ以上のケーブルが受けたストレインは、ケーブルに損傷を与えるか、またはケーブルを外れさせることがある。本開示の実施形態は、ツール組立体の関節運動中に１つ以上のケーブルが受けたストレインを解放するためのストレインリリーフを提供することに取り組む。
図１は、ここに開示された、全体として外科用ステープラ１０として示される外科用装置の実施形態を図示する。外科用ステープラとして図示されているが、装置には、鉗子、開創器、クリップアプライヤなどを含む、他のタイプのエンドエフェクタが含まれ得る。外科用ステープラ１０は、動力付きハンドル組立体１２、本体部１４、及び装填ユニット１００を含む。ハンドル組立体１２及び本体部１４は、装填ユニット１００の動作をもたらすように構成される。ハンドル組立体１２及び本体部１４の構造及び機能の詳細説明については、その内容の全体が参照により本明細書に組み込まれる、共同所有される米国特許出願公開第２０１２／０２５３３２９号（‘３２９公開）を参照されたい。装填ユニット１００は、外科用ステープラ１０の本体部１４に選択的に固定されるように示され説明されるが、装填ユニット１００が本体部１４の遠位端に直接支持され得ることが想定される。
図１及び２を参照すると、装填ユニット１００は、近位本体部１０２及びツール組立体１０４を含む。ツール組立体１０４を近位本体部１０２に枢動可能に固定するのに、取り付け組立体１７０が、ツール組立体１０４に固定され、また装填ユニット１００の近位本体部１０２に枢動可能に結合される。装填ユニット１００は、発射ロックアウト機構が変更され、動力付きハンドル組立体と協働するための構成要素、すなわち識別組立体及び可撓ケーブル、ならびにシッピングウェッジが加えられたことを除き、米国特許出願公開第２０１３／００９８９６５号（‘９６５公開）に説明されているのとほぼ同じである。‘９６５公開は、その全体が参照により本明細書に組み込まれる。したがって、‘９６５公開に開示されているそれらに共通である装填ユニット１００の構成要素は、本明細書では簡単な説明のみとなる。その一方、接続組立体１９０（図５〜７）、識別組立体２００（図８〜１７）、発射ロックアウト機構２２０（図１９〜２８）、シッピングウェッジ３００（図２９及び３０）、可撓ケーブル「Ｒ２」（図３１及び３２）、ならびにそれらの動作方法を含む、本明細書において新たに提示される構成要素は、本明細書において詳細に説明されることになる。
図３を参照すると、装填ユニット１００の近位本体部１０２は、外側スリーブ１１２内に含まれる上部ハウジング半体１１０ａ及び下部ハウジング半体１１０ｂを含む。上部ハウジング半体１１０ａは、第１の結合部材１１４ａの第１の端を受容するための凹部１１１ａを画定し、下部ハウジング半体１１０ｂは、第２の結合部材１１４ｂの第１の端を受容するための凹部１１１ｂを画定する。外側スリーブ１１２が上部ハウジング半体１１０ａ及び下部ハウジング半体１１０ｂの周りに位置付けられると、第１の結合部材１１４ａと第２の結合部材１１４ｂは、外側スリーブ１１２によって、それぞれの凹部１１１ａ、１１１ｂ内に保持される。
上部ハウジング半体１１０ａの近位端は、バヨネットタイプの結合配置において、ステープリング装置１０（図１）の本体部１４（図１）の遠位端に解放可能に係合するための係合小隆起部１１６を含む。上部ハウジング半体１１０ａと下部ハウジング半体１１０ｂはそれぞれ、以下にさらに詳細に説明されるような駆動組立体１８０の駆動部材１８２を摺動可能に受容するためのそれぞれのチャネル１１３ａ、１１３ｂを画定する。近位本体部１０２に関するツール組立体１０４の関節運動を容易にするのに、関節運動リンク１１８が、上部ハウジング１１０ａと下部ハウジング１１０ｂとの間に摺動可能に位置付けられ、また外科用ステープラ１０（図１）の関節運動機構（図示せず）に係合するように適合される。ツール組立体１０４の関節運動及び発射中に、駆動部材１８２の外向きの座屈及び／または膨出を防止するのに、一対の吹き出し板組立体１２０ａ、１２０ｂが、上部ハウジング半体１１０ａ及び下部ハウジング半体１１０ｂの遠位端に隣接して位置付けられる。
チャネル１１７は、導体、例えば、電気リボンまたはケーブル「Ｒ１」または電線を受容するために上部ハウジング半体１１０ａの長さに延在する。以下にさらに詳細に説明されるように、電気リボン「Ｒ１」は、装填ユニット１００の近位本体部１０２の近位端に配置された接続組立体１９０を、装填ユニット１００のツール組立体１０４内に配置された識別組立体２００（図８）と電気的に結合させる。近位本体部１０２の構成要素のより詳細な説明は、それの内容の全体が、参照により本明細書に組み込まれる、共同所有される米国特許第７，１４３，９２４号（‘９２４特許）に提供されている。
なお図３を参照すると、ツール組立体１０４は、非接近位置と接近位置との間で互いに関して移動可能であるアンビル組立体１３０及び取り替え可能なカートリッジ組立体１５０を含む。アンビル組立体１３０は、アンビル本体１３２と、アンビル本体１３２の下側に固定されるアンビルプレート１３４を含み、チャネル１３１（図２４）を画定する。アンビル本体１３２の近位端は、取り付け組立体１７０の上部取り付け部１７２の円筒形枢動部材１７２ａを受容するための穴１３３を画定するブラケット１３２ａを含む。アンビルプレート１３４は、以下にさらに詳細に述べられるような駆動部材１８２の作業端１８４の一部を摺動可能に受容するように寸法設定される長手方向溝１３５を画定する。アンビルプレート１３４の組織接触面１３４ａは、複数のステープル受容窪み（図示せず）を画定する。
カートリッジ組立体１５０は、支持板１５２、カートリッジ本体１５４、複数のステープル「Ｓ」、及び作動スレッド１６２を含み、かつ以下にさらに説明されるステープル発射組立体１６０を含む。カートリッジ組立体１５０は、ジョー部材１５６に受容可能である。カートリッジ本体１５４及び支持板１５２は、参照により本明細書に組み込まれている‘９６５公開に説明されているようなスナップ嵌め接続によってジョー部材１５６に取り付けられる。他の接続形態が考えられ、スナップ嵌め接続の代わりに、またはそれに加えて使用され得る。
チャネル部材１５６は、アンビル本体１３２に形成された開口部１３９、及びチャネル部材１５６に形成された開口部１５１を貫通して延在する枢動ピン１３８によってアンビル本体１３２に枢動可能に固定される。カートリッジ本体１５４は、長手方向溝１５３ａと、アンビルプレート１３４の組織接触面１３４ａにおけるステープル受容窪み（図示せず）と整合して位置付けられる、横方向に離間した複数のステープル保持溝１５３ｂとを画定する。作動スレッド１６２は、カートリッジ本体１５４中を移動させられるように構成される。カートリッジ本体１５４の長手方向溝１５３ａは、作動スレッド１６２に形成された突出部１６２ａを受容し、作動スレッド１６２をカートリッジ本体１５４に通させる。カートリッジ本体１５４は、作動スレッド１６２の突出部１６２ａに形成された凹部１６３ａ（図１４）に受容される長手方向溝１５３ａ内に延在する戻り止め１５４ａ（図１４）を含み、カートリッジ組立体１５０の配送中、作動スレッド１６２を所定位置に固定する。各保持溝１５３ｂは、留め具、すなわちステープル「Ｓ」及びプッシャ１６４を受容する。作動スレッド１６２は、カートリッジ本体１５４を長手方向に通過してプッシャ１６４と係合し、続いて、カートリッジ本体１５４からステープル「Ｓ」を押し出すように、カートリッジ本体１５４内に位置付けられる。カートリッジ本体１５４は、組織（図示せず）が、ステープル保持溝１５３ｂの遠位に位置付けられるのを防止する一対の組織止め部材１５４ｂ（図１４）をさらに含む。支持板１５２を含むカートリッジ組立体１５０のより詳細な考察については、参照により本明細書に組み込まれている‘９６５公開を確認されたい。
図３及び４を参照すると、取り付け組立体１７０は、上部取り付け部１７２及び下部取り付け部１７４、ならびに保持ブレード１７６を含む。示されるように、上部取り付け部１７２と下部取り付け部１７４は、上部取り付け部１７２から延在する支柱１７８に互いに固定される。上部取り付け部１７２及び下部取り付け部１７４のそれぞれは、それぞれ、枢動部材１７２ａ（図３）、１７４ａ（図４）を含む。上に説明されたように、上部取り付け部１７２をアンビル本体１３２に固定するのに、上部取り付け部１７２上の枢動部材１７２ａが、アンビル本体１３２のブラケット１３２ａの穴１３３（図３）内に受容される。近位本体部１０２の第１の結合部材１１４ａ（図３）は、枢動部材１７２ａも受容する開口部１１５ａを画定する第２の端を有する。下部取り付け部１７４上の枢動部材１７４ａは、近位本体部１０２の第２の結合部材１１４ｂ（図３）の開口部１１５ｂに受容される。アンビル本体１３２をジョー部材１５６に固定する枢動ピン１３８は、アンビル本体１３２に形成された開口部１３９、及びジョー部材１５６に形成された開口部１５１を貫通して延在し、下部取り付け部１７４に形成された開口部１７３に受容され、下部取り付け部１７４をジョー部材１５６（図３）に固定する。下部取り付け部１７４は、保持ブレード１７６を受容するための溝１７７を画定する。以下にさらに詳細に説明されるように、保持ブレード１７６は、湾曲した遠位接面１７６ａ（図４）及び一対の制限部材１７６ｂ（図４）を含む。
駆動組立体１８０は、本体を有する駆動部材１８２、及び作業端１８４を含む。作業端１８４は、上部フランジ１８６ａ、下部フランジ１８６ｂ、上部フランジ１８６ａと下部フランジ１８６ｂとを相互接続させる垂直突っ張り１８６ｃ、及び垂直突っ張り１８６ｃに支持された、またはその中に形成されたナイフ１８７を含む。上部フランジ１８６ａは、アンビル組立体１３０のチャネル１３１（図２４）内に摺動可能に受容されるように位置付けられ、下部フランジ１８６ｂは、ジョー部材１５６の外側表面１５６ａ（図２４）に沿って摺動可能に位置付けられるように位置付けられる。使用中、駆動部材１８２の遠位への移動は、最初、上部フランジ１８６ａをアンビルプレート１３４に形成されたカム面１３４ｂに前進させ、下部フランジ１８６ｂを、ジョー部材１５６に形成されたカム面１５６ｂと係合するように前進させ、カートリッジ組立体１５０をアンビル組立体１３０に向かって、接近位置、すなわち閉位置に枢動させる。駆動部材１８２の継続的な前進は、作業端１８４がツール組立体１０４中を移動するのに従い、駆動組立体１８０の作業端１８４に隣接する、アンビル組立体１３０とカートリッジ組立体１５０との間の最小の組織間隙を漸進的に維持する。
駆動部材１８２の本体の遠位端は、駆動部材１８２の作業端１８４を支持し、止め面１８４ａを画定する。作動スレッド１６２（図３）は、作業端１８４の遠位の位置においてカートリッジ組立体１５０（図３）内に配置される。作業端１８４がその最近位位置にあり、ツール組立体１０４が開位置、すなわち非接近位置（図２４）にあるとき、スレッド１６２及び作業端１８４は、それらの初期位置にある。スレッド１６２は、カートリッジ本体１５４のステープル保持溝１５３ｂ内のプッシャ１６４に係合し、それを持ち上げるように位置付けられる、複数のカム面１６６ａを含む。プッシャ１６４（図３）は、スレッド１６２がツール組立体１０４中を前進させられるときに、カートリッジ本体１５４からステープル「Ｓ」を押し出すように、カートリッジ組立体１５０内に位置付けられる。スレッド１６２の近位端は、より詳細に以下に説明される、開口部、すなわち溝１６３（図４）を画定する１つ以上のフィンガー１６６ａを含む。
ある実施形態において、駆動部材１８２の本体は、複数の積み重ねシート１８２ａ〜ｄの材料、例えばステンレス鋼から形成される。ロック部材１８８（図３）が、装填ユニット１００の近位端の周りに支持され、装填ユニット１００がステープリング装置１０（図１）に取り付けられるまで、駆動部材１８２の軸方向移動を防止する。装填ユニット１００の上記で特定された構成要素のより詳細な考察は、その全体が参照により本明細書に組み込まれている‘９２４特許に説明されている。
図５〜７を参照すると、接続組立体１９０が、上部ハウジング半体１１０ａの近位端に支持され、装填ユニット１００と外科用ステープラ１０（図１）との間に電気接続をもたらす。接続組立体１９０は、コネクタハウジング１９２、接触部材１９４、及びリレー／スペーサ部材１９６を含む。接触部材１９４は、コネクタ１９２の凹部１９３内に受容される一対の接触部１９４ａを含む。接触部１９４ａは、外科用ステープラ１０（図１）の細長本体１４（図１）内に配置された接触部材（図示せず）の対応する接触部（図示せず）に係合するように位置付けられる。接触部材１９４は、接触部１９４ａ間に延在するコネクタ部１９４ｂを含む。上に説明されたように、導体、例えば、電気リボンまたはケーブル「Ｒ」または電線は、装填ユニット１００の近位本体部１０２を貫通して、かつツール組立体１０４中に延在し、接続組立体１９０を識別組立体２００（図８）と電気的に結合させる。
外科用ステープラ１０（図１）の細長本体１４（図１）への装填ユニット１００の取り付け中、接続組立体１９０の接触部材１９４の接触部１９４ａは、外科用ステープラ１０（図１）の細長本体１４（図１）の遠位端内に支持されたコネクタ組立体（図示せず）の接触部（図示せず）に係合するように位置付けられる。外科用ステープラ１０のコネクタ組立体の接触部材との接続組立体１９０の接触部材１９４ａの係合は、装填ユニット１００の識別組立体２００（図８）を外科用ステープラ１０（図１）のハンドル組立体１２（図１）と接続させる。上に示されたように、装填ユニット１００は、バイヨネット結合を用いて、または任意の他の好適な様態で、細長本体１４に取り付けられ得る。
ここで図８〜１７を参照すると、装填ユニット１００の識別組立体２００は、コネクタ組立体２０２及びチップ組立体２１２を含む。コネクタ組立体２０２は、コネクタハウジング２０４及びタブ２０４ｂを含む。コネクタハウジング２０４は、ツール組立体１０４のチャネル部材１５６における開口部１５７ａ（図１０）内に受容されるフランジ部材２０４ａを有する。タブ２０４ｂは、コネクタ組立体２０２をチャネル部材１５６に固定するように、チャネル部材１５６における溝１５７ｂ（図１０）内に受容される。コネクタハウジング２０４は、接続組立体１９０（図６）から延在する導体、例えば電気リボン「Ｒ」（図１１）の遠位端を受容し、接続組立体１９０（図７）の接触部材１９４を第１及び第２の接触部材２０６ａ、２０６ｂと電気連通させる。実施形態において、コネクタハウジング２０４が、電気リボン「Ｒ１」を第１及び第２の接触部材２０６ａ、２０６ｂで固定するように、電気リボン「Ｒ１」の遠位端の周りに成形される。接触部材２０６ａ、２０６ｂは、コネクタハウジング２０４がジョー部材１５６に固定されると、コネクタハウジング２０４から遠位に延在する。
チップ組立体２１２は、チップハウジング２１４及び識別チップ２１８を含む。突出部２１４ａが、チップハウジング２１４から延在し、カートリッジ組立体１５０のカートリッジ本体１５４（図１２）の近位端に形成された凹部１５５（図１２）内に受容され、チップ組立体２１２をカートリッジ本体１５４に固定する。チップ組立体２１２は、チップハウジング２１４から延在し、かつ識別チップ２１８と連通する、第１及び第２の接触部材２１６ａ、２１６ｂをさらに含む。
第１及び第２の接触部材２１６ａ、２１６ｂは、カートリッジ本体１５４がジョー部材１５６（図１６）内に受容されると、コネクタ組立体２０２のそれぞれの第１及び第２の接触部材２０６ａ、２０６ｂに係合する。実施形態において、また示されるように、コネクタ組立体２０２の第１及び第２の接触部材２０６ａ、２０６ｂ、ならびにチップ組立体２１２の第１及び第２の接触部材２１６ａ、２１６ｂは、第１の接触部材２０６ａ、２１６ａ間、また第２の接触部材２０６ｂ、２１６ｂ間のスナップ係合を可能にするように、それぞれのコネクタハウジング２０４、チップハウジング２１４に片持ち状に支持される。コネクタ組立体２０２の第１及び第２の接触部材２０６ａ、２０６ｂ、ならびにチップ組立体２１２の第１及び第２の接触部材２１６ａ、２１６ｂは、実質的に球形の形状を含み、コネクタ組立体２０２とチップ組立体２１２との間の係合を容易にし得る。
識別チップ２１８は、カートリッジ組立体１５０の仕様、例えば、カートリッジサイズ、ステープル配置、ステープル長、クランプアップ距離、製造日、型式番号、ロット番号、使用期限などを含む情報を格納し、情報の少なくともいくつかをハンドル組立体１２（図１）に伝送する能力がある、任意の市販のチップを含み得る。一実施形態において、識別チップ２１８には、消去可能なプログラマブル読み取り専用メモリ（ＥＰＲＯＭ：Ｅｒａｓａｂｌｅ Ｐｒｏｇｒａｍｍａｂｌｅ Ｒｅａｄ Ｏｎｌｙ Ｍｏｍｅｏｒｙ）チップが含まれる。このように、取り付けられたカートリッジ組立体１５０の構成は、例えば、ハンドル組立体１２の発射ストロークの発射力及び／または長さが、特定のカートリッジ組立体１５０に適応するよう調整され得るように、ハンドル組立体１２に中継され得る。ＥＰＲＯＭの代わりに、識別チップ２１８が、読み取り／書き込みＲＡＭなどの読み取り／書き込みメモリチップであり得、データが識別チップ２１８に書き込まれ得るようにすることが想定される。例えば、空のまたは部分的に発射された装填ユニット１００の再使用を防止するために、または何か他の目的で、装填ユニットが完全にまたは部分的に発射されたことを識別する識別チップ２１８に使用情報が書き込まれ得る。
特に図１６〜１８を参照すると、チャネル部材１５６内へのカートリッジ組立体１５０の装填中、チップ組立体２１２の第１及び第２の接触部材２１６ａ、２１６ｂは、コネクタ組立体２０２の第１及び第２の接触部材２０６ａ、２０６ｂに係合する。チップ組立体２１２の第１及び第２の接触部材２１６ａ、２１６ｂが、コネクタ組立体２０２のそれぞれの第１及び第２の接触部材２０６ａ、２０６ｂと係合させられると、チップ組立体２１２の識別チップ２１８に格納された情報が、外科用ステープラ１０の本体部１４への装填ユニット１００の接続時点で、ハンドル組立体１２に中継され得る。上に説明されたように、識別組立体２００は、装填ユニット１００を貫通して延在する導体、例えば、電気リボンまたはケーブル「Ｒ１」（図７及び１１）を介して、また装填ユニット１００の近位端内に配置される接続組立体１９０（図６）によって、外科用ステープラ１０（図１）に接続される。
ここで、図１８〜２８を参照して、発射ロックアウト組立体２２０が説明される。発射ロックアウト組立体２２０は、２０１４年３月３１日出願の米国特許出願第１４／２３０，５１６号（‘５１６出願）に説明されている発射ロックアウト組立体とほぼ同様であり、それら間の違いのみに関連して詳細に説明されることになる。したがって、‘５１６出願の内容の全体が参照により本明細書に組み込まれる。
発射ロックアウト組立体２２０は、下部取り付け部１７４の遠位端に枢動可能に支持されるラッチ部材２２２を含む。ラッチ部材２２２は、近位ベース部材２２４及び２つの離間した遠位に延在する脚２２６を有する、Ｕ字形の本体（図１９）を含む。示されるように、ベース部材２２４には、閉塞面を画定し、かつベース部材２２４に追加の支持をもたらすようにベース部材２２４に溶接または固定される、閉塞部材２２４ａが備えられる。代替的に、ベース部材２２４の近位端が閉塞面を画定することができる。ラッチ部材２２２は、第１の位置（図２１）から第２の位置（図２２）に枢動可能である。図２１に示された第１の位置では、ラッチ部材２２２の閉塞部材２２４ａが、駆動部材１８２の止め面１８４ａと整合され、ツール組立体１０４内への駆動部材１８２の前進を防止する。図２２に示された第２の位置では、閉塞部材２２４ａが、駆動部材１８２の止め面１８４ａと不整合にされ、ツール組立体１０４内への駆動部材１８２の前進を可能にする。
特に図１８〜２０を参照すると、ラッチ部材２２２の脚２２６のそれぞれは、中央に位置する枢動部材２２８及び当接面２３０を有する。枢動部材２２８は、取り付け組立体１７０の下部取り付け部１７４のカギ状アーム１７４ｂ（図２０）に支持され、ラッチ部材２２２を下部取り付け部１７４に枢動可能に支持する。偏倚部材は、下部取り付け部１７４の遠位面に形成されたそれぞれのボア１７５ａ（図１８）内に支持される一対のバネ２３２（図１８）を含み、ラッチ部材２２２を第１の位置に向けて付勢する。各バネ２３２は、ラッチ部材２２２のそれぞれの当接面２３０に形成された小隆起部２３０ａに係合するように位置付けられ、図２４に見られるような反時計回り方向にラッチ部材２２２を偏倚させる。各脚２２６の遠位端は、スレッド１６２が退避位置にあり、ラッチ部材２２２が第１の位置にあり、またアンビル組立体１３０とカートリッジ組立体１５０とが接近位置にあるときに、スレッド１６２に画定された開口部１６３（図２０）を貫通して延在するように位置付けられる、下向きに延在する突出部２３４を含む。
一対のバネ２３６は、ジョー部材１５６の内部表面１５６ｂ（図１０）と、下部取り付け部１７４の底面に画定されたそれぞれのボア１７５ｂ（図２０）との間に位置付けられ、ツール組立体１０４を非接近位置（図２）に付勢する。ジョー部材１５６は、バネ２３６に係合するための一対の円柱体１５８（図１０及び１１）を含む。
図２３及び２４を参照すると、駆動部材１８２が完全退避位置にあり、ツール組立体１０４が非接近位置、すなわち開位置にあるとき、駆動部材１８２の作業端１８４の上部フランジ１８６ａ、下部フランジ１８６ｂは、スレッド１６２の近位に、また、アンビルプレート１３４、チャネル部材１５６にそれぞれ形成された、カム面２３８ａ、２３８ｂの近位に離間する。ツール組立体１０４の非接近位置では、ラッチ部材２２２は、バネ２３２によって、反時計回り位置に向けて付勢される。下部取り付け部１７４は、ベース部材２２４または閉塞部材２２４ａに係合するように位置付けられる表面２４０を含む。閉塞部材２２４ａと、下部取り付け部１７４の表面２４０との間の係合は、ラッチ部材２２２のさらなる反時計回り回転を防止し、ラッチ部材２２２を第１の位置に保持する。図２５に示されるように、閉塞部材２２４ａは、発射ロックアウト組立体２２０がロックされた構成にあるとき、ラッチ部材２２２の遠位への移動を防止するように、下部取り付け部１７４のガセット１７４ｃに係合する。
発射ロックアウト組立体２２０の動作は、‘５１６出願に詳細に説明されている。手短に言えば、装填ユニット１００の発射中、発射ロックアウト組立体２２０のラッチ部材２２２は、下部取り付け部１７４の枢動部材１７４ｂの周りに枢動される。上に説明されたように、保持ブレード１７６は、下部取り付け部１７４における溝１７７内に受容される。図２６に図示されるように、保持ブレード１７６の曲面１７６ａは、ラッチ部材２２２の閉塞部材２２４ａの円弧運動に適応し、装填ユニット１００の発射中、ラッチ部材２２２の近位への移動を防止する。ラッチ部材２２２の近位への移動は、枢動部材２２８を下部取り付け部１７４のカギ状アーム１７４ｂから離脱させる可能性がある。装填ユニット１００の発射中の下部取り付け部１７４からのラッチ部材２２２の離脱は、装填ユニット１００の不発をもたらすことがあり、かつ／または発射ロックアウト組立体２２０が正しく機能するのを妨げることがある。
装填ユニット１００の発射の前に、ツール組立体１０４は、近位本体部１０２に対して関節運動させられ得る。ツール組立体１０４の関節運動中、保持ブレード１７６の制限部材１７６ｂは、装填ユニット１００の近位本体部１０２から延在する第２の結合部材１１４ｂに係合し、近位本体部１０２に対するツール組立体１０４の関節運動を制限する。
図２９及び３０を参照すると、カートリッジ組立体１５０のシッピングウェッジ３００は、取り外しの前に、カートリッジ本体１５４のステープル保持溝１５３ｂ内にステープル「Ｓ」（図３）を維持し、かつ装填ユニット１００のツール組立体１０４の作動を防止するように構成される。シッピングウェッジ３００は、細長本体の底面に沿って細長凹部３０３（図３０）を画定する細長本体３０２を含む。フランジ３０４は、細長凹部３０３内から延在し、カートリッジ本体１５４（図２９）の細長溝１５３ａ（図１４）内にフランジ３０４を固定するための複数の突起部３０４を含む。細長本体３０２の近位端は、カートリッジ組立体１５０が、ツール組立体１０４のジョー部材１５６（図２）内に装填された時点で、またシッピングウェッジ３００の取り外しの前に、アンビル組立体１３０（図２）へのカートリッジ組立体１５０（図２）の接近を防止するように構成された隆起部３０６（図２９）を含む。細長本体３０２の遠位端は、臨床医によって把持されるように位置付けられ、構成される突出部３０８を含み、カートリッジ組立体１５０からのシッピングウェッジ３００の離脱を容易にする。複数のタブ３１０が、カートリッジ組立体１５０のカートリッジ本体１５４に係合するために、細長本体３０２から延在し、シッピングウェッジ３００をカートリッジ組立体１５０のカートリッジ本体１５４に解放可能に固定する。
ここで図３１及び３２を参照すると、本開示の別の実施形態による装填ユニットが、全体として装填ユニット４００として示される。装填ユニット４００は、本明細書の上に説明された装填ユニット１００とほぼ同様であり、それら間の違いのみに関して説明されることになる。
装填ユニット４００は、電気導体、すなわち、装填ユニット４００の近位本体部４０２の近位端に配置された接続組立体１９０を、装填ユニット４００のツール組立体４０４内に配置された識別組立体２００（図８）と電気的に結合させるための可撓ケーブルまたは電気リボン「Ｒ２」を含む。可撓ケーブル「Ｒ２」は、複数のコイル「ｃ」を含むストレインリリーフ部を含む。示されるように、可撓ケーブル「Ｒ２」は、可撓ケーブル「Ｒ２」の近位部から、可撓ケーブル「Ｒ２」の遠位部に高さが減少する７つのコイル「ｃ」を含む。可撓ケーブル「Ｒ２」が、７つより多いまたは少ないコイル「ｃ」を含み得、かつ／またはコイルの高さが、近位部から遠位部に増加し得ることが想定される。代替的に、コイル「ｃ」の高さは、均一であっても、または無作為もしくは均一の様態で変わってもよい。コイル「ｃ」間で均一の間隔を有するように示されているが、コイル「ｃ」間の間隔がバラバラであり得ることが想定される。
装填ユニット４００の近位本体部４０２に対する装填ユニット４００のツール組立体４０４の関節運動中、可撓ケーブル「Ｒ２」は、ストレインを受ける。可撓ケーブル「Ｒ２」が受けたストレインは、ツール組立体４０４が近位本体部４０２に対して関節運動するのに従って変化する、近位本体部４０２の接続組立体１９０と、ツール組立体４０４内に配置された識別組立体２００との間の距離の結果である。具体的には、ツール組立体４０４が、図３１において矢印「Ｄ」によって示されるような第１の方向に関節運動するのに従って、接続組立体１９０と識別組立体２００との間の距離が増加し、ツール組立体３０４が、図３１において矢印「Ｅ」によって示されるような第２の方向に関節運動するのに従って、接続組立体１９０と識別組立体２００との間の距離が減少する。
可撓ケーブル「Ｒ２」のコイル「ｃ」は、可撓ケーブル「Ｒ２」が、可撓ケーブル「Ｒ２」上のストレインに反応して変形することによる、可変長を有することを可能にする。具体的には、図３２において矢印「Ａ」によって示されるような引張が可撓ケーブル「Ｒ２」の遠位端にかけられると、図３２において矢印「ａ１」によって示されるような各コイル「ｃ」の撓み、及び／または互いに対するコイル「ｃ」の外向きの撓みは、可撓ケーブル「Ｒ２」を伸長させ、それにより、可撓ケーブル「Ｒ２」上のストレインを解放する。図３２において矢印「Ｂ」によって示されるような圧縮が可撓ケーブル「Ｒ２」にかけられると、矢印「ｂ１」によって示されるような各コイル「ｃ」の内向きの撓み、及び／または、図３２において矢印「ｂ２」によって示されるような、互いに対するコイル「Ｒ２」の内向きの撓みは、可撓ケーブル「Ｒ２」を短縮させ、それにより、可撓ケーブル「Ｒ２」上のストレインを解放する。
装填ユニット４００の近位本体部４０２は、上部ハウジング半体４１０ａ及び下部ハウジング半体４１０ｂを含む。チャネル４１７は、上部ハウジング半体４１０ａの長さに延在し、可撓ケーブル「Ｒ２」を受容する。チャネル４１７は、可撓ケーブル「Ｒ２」の近位部及び遠位部を受容するための近位部４１７ａ及び遠位部４１７ｂと、可撓ケーブル「Ｒ２」のコイル「ｃ」を受容し、かつ可撓ケーブル「Ｒ２」がストレインを受けているときにコイル「ｃ」の撓みに適応するための中央部４１７ｃと、を含む。
可撓ケーブル「Ｒ２」は、装填ユニット４００の近位本体部４０２の長さに、かつ装填ユニット４００のツール組立体４０４中に延在する。可撓ケーブル「Ｒ２」は、装填ユニット４００の近位本体部４０２とともに配置された接続組立体１９０を、装填ユニット４００のツール組立体４０４内に配置された識別組立体２００（図８）と電気的に結合させる。可撓ケーブル「Ｒ２」は、可撓ケーブル「Ｒ２」の長手方向移動を可能にするように、チャネル４１７内に緩く受容され得る。一実施形態において、可撓ケーブル「Ｒ２」の近位端は、例えば、接着剤、オーバーモールディングを使用して、チャネル４１７の近位部４１７ａ内に軸方向に固着される。
上に説明されたように、可撓ケーブル「Ｒ２」は、装填ユニット４００の本体部４０２の近位端と装填ユニット４００のツール組立体４０４との間に延在する。装填ユニット４００の近位本体部４０２に対する装填ユニット４００のツール組立体４０４の関節運動中、可撓ケーブル「Ｒ２」は、ストレイン、すなわち、引張または圧縮を受ける。具体的には、図３１において矢印「Ｄ」によって示されるような第１の方向における、近位本体部４０２に対するツール組立体４０４の関節運動が、図３２において矢印「Ａ」によって示されるような引く力を可撓ケーブル「Ｒ２」の遠位端に生み出し、図３１において矢印「Ｅ」によって示されるような第２の方向における、近位本体部４０２に対するツール組立体４０４の関節運動が、図３２において矢印「Ｂ」によって示されるような押す力を可撓ケーブル「Ｒ２」の遠位端に生み出す。上に説明されたように、ツール組立体４０４の関節運動中に可撓ケーブル「Ｒ２」が受けたストレインに適応し、それにより、可撓ケーブル「Ｒ２」の破損及び／または座屈を防止するために、可撓ケーブル「Ｒ２」のコイル「ｃ」は、個々に、また互いに対して撓むように構成される。コイル「ｃ」が外向きに撓むのに従って、可撓ケーブル「Ｒ２」は伸び、コイル「ｃ」が内向きに撓むのに従って、可撓ケーブル「Ｒ２」は縮む。非関節運動位置へのツール組立体４０４の戻りは、可撓ケーブル「Ｒ２」のコイル「ｃ」を非ストレイン構成に戻らせる。
装填ユニット４００に組み込まれるとして示され、説明されたが、可撓ケーブル「Ｒ２」が、関節運動ツール組立体を有し、かつハンドル組立体への関節運動ツール組立体の電気的結合を必要とする、いずれのデバイスにも組み込まれ得ることが想定される。
本明細書において明確に説明され、添付図面に図示されたデバイス及び方法が、非限定の代表的な実施形態であることを当業者であれば、理解するであろう。１つの代表的な実施形態に関連して図示または説明された要素及び特徴が、本開示の範囲を逸脱することなく、別の要素及び特徴と組み合わされ得ることが想定される。同様に、当業者であれば、上に説明された実施形態に基づき、本開示のさらなる特徴及び利点を察知するであろう。したがって、本開示は、添付の特許請求の範囲により示されるものを除き、具体的に示され、説明されたものによって限定されるべきではない。

Claims (16)

  1. 外科用装置であって、
    近位端及び遠位端を有し、前記近位端上に支持された接続組立体を含む、本体部と、
    前記本体部の遠位端上に支持され、前記本体部に対して関節運動可能であるツール組立体であって、識別組立体を含む、ツール組立体と、
    前記接続組立体から前記識別組立体まで延在する電気導体であって、前記本体部に対する前記ツール組立体の前記関節運動に適応するためのストレインリリーフ部を含む、電気導体と、を備える、外科用装置。
  2. 前記ストレインリリーフ部が、複数のコイルを含む、請求項１に記載の外科用装置。
  3. 前記複数のコイルの高さが、前記複数のコイルの近位部から前記複数のコイルの遠位部に減少する、請求項２に記載の外科用装置。
  4. 前記複数のコイルの高さが、前記複数のコイルの近位部から遠位部まで均一である、請求項２に記載の外科用装置。
  5. 前記複数のコイルが互いに対して等しく離間する、請求項２に記載の外科用装置。
  6. 前記本体部が、前記電気導体を受容するためのチャネルを画定する、請求項１に記載の外科用装置。
  7. チャネルが、前記電気導体の前記ストレインリリーフ部を受容するための中央部を含む、請求項１に記載の外科用装置。
  8. 前記外科用装置が、動力付きハンドル組立体を含み、前記電気導体が、前記識別組立体を前記動力付きハンドル組立体に電気的に結合させる、請求項１に記載の外科用装置。
  9. 前記ツール組立体が、ステープリング組立体を含む、請求項１に記載の外科用装置。
  10. 前記ステープリング組立体が、取り外し可能なカートリッジ組立体を含む、請求項９に記載の外科用装置。
  11. 前記電気導体が、可撓ケーブルを含む、請求項１に記載の外科用装置。
  12. 前記可撓ケーブルが、近位部及び遠位部を含み、前記近位部が前記本体部に軸方向に添着される、請求項１１に記載の外科用装置。
  13. 前記電気導体が、接着剤を使用し、前記本体部に軸方向に添着される、請求項１に記載の外科用装置。
  14. 前記ストレインリリーフ部が、前記電気導体の伸長を可能にするように構成される、請求項１に記載の外科用装置。
  15. 前記ストレインリリーフ部が、前記電気導体の短縮を可能にするように構成される、請求項１に外科用装置。
  16. 前記本体部、前記ツール組立体、及び前記電気導体が、動力付きハンドル組立体に解放可能に結合されるように構成される装填ユニットとして形成される、請求項１に記載の外科用装置。

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