JP6740140B2 - インプラントを固定するためのシステムおよび方法 - Google Patents
インプラントを固定するためのシステムおよび方法 Download PDFInfo
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- JP6740140B2 JP6740140B2 JP2016574967A JP2016574967A JP6740140B2 JP 6740140 B2 JP6740140 B2 JP 6740140B2 JP 2016574967 A JP2016574967 A JP 2016574967A JP 2016574967 A JP2016574967 A JP 2016574967A JP 6740140 B2 JP6740140 B2 JP 6740140B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0412—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from suture anchor body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0417—T-fasteners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
- A61B2017/0422—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor
- A61B2017/0425—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor the anchor or the separate member comprising threads, e.g. a set screw in the anchor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0429—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being expanded by a mechanical mechanism which also locks them in the expanded state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0437—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being resilient or spring-like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
- A61B2017/0441—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws the shaft being a rigid coil or spiral
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
- A61B2017/0443—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws the shaft being resilient and having a coiled or helical shape in the released state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
- A61B2017/0488—Instruments for applying suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
- A61F2/2457—Chordae tendineae prostheses
Description
12 近位ハブ
14 縫合糸
16 針
18 クロスピン、クロスバー
20 アンカー駆動装置
22 近位コントロールハンドル
24 トルクノブ
26 縫合糸係止ノブ
28 トルクシャフト、トルク駆動装置、縫合糸係止ノブ
30 遠位チューブ状本体部
32 インプラント
34 クリップ
34A、34B クリップ
36 ワイヤまたは撚り線
38 端圧着部
40 クリップ駆動装置
42 近位コントロールハンドル
44 コントロール部
46 細長い本体部
48 外側スリーブ
50 内側シャフト
52 スネア
54 装填縫合糸
56 アンカー駆動装置
58 トルクシャフト
60 遠位ハウジング
200 アンカー
202 アンカー
204 螺旋
206 鋭利な先端部
208 送達用カテーテル
210 先の尖った端部
212 接合補助デバイス
214 駆動シャフト開口
216 縫合糸またはテープ
218 タップ
220 上縁
222 アンカーカテーテル
224、226、228 アンカー
230 縫合糸
232 プッシャーチューブ
234 縫合糸またはテープ
236 上縁
238 アンカーカテーテル
240 アンカー
242 コイルセクション
244 先の尖った端部
246 アンカーヘッド
248 中心縫合糸
250 ボール
252 送達用カテーテル
254 アンカー
256 遠位係止タブ
258 ハブ
260 ポケット
262 アンカー
264 クリップ
266 縫合糸
268 アンカー
269 中空チューブ
270 クリップ
272 縫合糸
274 小穴
276 アンカー
278 クリップ
280 縫合糸
282 内腔
284 アンカー
286 クリップ
288 縫合糸
290 板バネ
292 アンカー
294 クリップ
296 縫合糸
298 ボール
300 内腔
302 可撓性側壁
304 アンカー
306、308 レバーアーム
310 支点
310 アンカー
312 バネ要素
312 チューブ状本体部
314 内腔
316 二次アーム
318 アンカー
320 クリップ
322 縫合糸
324 ネジ山付き内腔
326 ハブ
328 アンカー
330 クリップ
332 ノブ
334 アンカー
336 縫合糸
338 スロット
340 針状導入器
344 アンカー
346 針
348 鋭利な遠位端
350 縫合糸
352 近位段部
354 アンカー
356 針
358 縫合糸
360 アンカー
362 遠位のバーブまたはフック
364 導入器
364 アンカー
366 縫合糸
368 アンカー
370 近位小穴
372 縫合糸
374 バーブ
376 トグルボルト
378、380 クリップ
382 アンカー
384 アンカー
386 アンカー
390 補強部分
392 ハブ
394 形状記憶クリップ
396 アンカー
398 補強部分
400 ハブ
402 バネ
404 近位キャップ
406 T字型またはトレブルフック
408 バーブ
410 アンカー
412 補強部分
414 ハブ
416 バーブ付き特徴部
418 近位キャップ
420 T字型/トレブルフック特徴部
422 アンカー
424 補強部分、ハブ
426 アンカー
428 補強部分、ハブ
430 縫合糸
432 圧着特徴部
434 アンカー
436 アーム
525 心室突出部
530 遠位端
600 操縦可能なカテーテル
1200 接合補助デバイス
2240 アンカー
Claims (20)
- 患者の組織内に植え込み可能な医療デバイスを固定するためのシステムであって、
近位端および遠位端を備えるアンカーであって、前記遠位端は組織と係合するように構成されている、アンカーと、
前記アンカーの前記近位端に結合されている縫合糸と、
植え込み可能な医療デバイスであって、前記縫合糸は、前記植え込み可能な医療デバイスの少なくとも一部を通過するように構成される、植え込み可能な医療デバイスと、
少なくとも2本の撚り合わされた撚り線を備えるクリップであって、前記縫合糸は、前記植え込み可能な医療デバイスを通過した後に前記少なくとも2本の撚り合わされた撚り線を横断方向に通過するように構成される、クリップと、
外側スリーブ、内側シャフト、及び、前記内側シャフトを通って延在するループ先端部を備える送達用具であって、前記ループ先端部は前記縫合糸と係合するように構成されている、送達用具と、
を備えることを特徴とするシステム。 - 前記縫合糸の端部上に針をさらに備える、請求項1に記載のシステム。
- 前記少なくとも2本の撚り線はニチノールである、請求項1に記載のシステム。
- 前記少なくとも2本の撚り線は形状記憶材料を含む、請求項1に記載のシステム。
- 前記クリップは直線状である、請求項1に記載のシステム。
- 前記クリップは非直線状である、請求項1に記載のシステム。
- 前記アンカーは螺旋状部分を備える、請求項1に記載のシステム。
- 前記アンカーは、針を備える、請求項1に記載のシステム。
- 前記植え込み可能な医療デバイスは、心臓弁の弁尖接合を改善するように構成されている接合補助デバイスである、請求項1に記載のシステム。
- 前記縫合糸は、植え込み可能な医療デバイスの一方の表面から前記植え込み可能な医療デバイスの第2の対向する表面に通される、請求項1に記載のシステム。
- 前記縫合糸は、前記クリップの一方の側にループを形成する請求項1に記載のシステム。
- 外側スリーブおよび内側シャフトを備える送達用具であって、前記内側シャフトは前記外側スリーブに関して前記内側シャフトを移動するように構成されているコントロールハンドルに動作可能に結合される、送達用具と、
前記内側シャフトを貫通するループ先端部であって、縫合糸を係合するように構成されているループ先端部と、
前記内側シャフト上に配設されているクリップであって、前記コントロールハンドルは、前記内側シャフトの内側で前記ループ先端部および前記縫合糸を引くように構成され、前記ループ先端部および前記縫合糸が前記内側シャフトの内側に引かれた後に、前記外側スリーブは前記内側シャフトから前記クリップを押して離すように構成されている、クリップと、
をさらに備えることを特徴とする請求項1〜11のいずれか一項に記載のシステム。 - 前記アンカーは、中心針を備える、請求項12に記載のシステム。
- 前記ループ先端部および前記縫合糸が前記内側シャフトの内側に引かれた後に、前記縫合糸は前記クリップの一方の側にループを形成する請求項12に記載のシステム。
- 前記クリップが前記内側シャフトから押し離された後に、前記縫合糸は前記クリップの一方の側にループを形成する請求項12に記載のシステム。
- 前記アンカーが近位ハブ内にクロスピンを備え、縫合糸が前記クロスピンに操作可能に取り付け可能である請求項1〜15のいずれか一項に記載のシステム。
- トルクシャフトをさらに備え、前記トルクシャフトの回転が前記アンカーを回転させる請求項1〜16のいずれか一項に記載のシステム。
- 前記外側スリーブが前記内側シャフトから前記クリップを押して離すように構成されている請求項1に記載のシステム。
- 前記アンカーがハブ内にクロスピンを備える請求項1に記載のシステム。
- 前記縫合糸が前記クロスピンに結合される請求項19に記載のシステム。
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PCT/US2015/037451 WO2015200497A1 (en) | 2014-06-24 | 2015-06-24 | Systems and methods for anchoring an implant |
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