JP6766127B2 - 外科手術用ステープル留め装置、およびそれに外科手術用バットレスを接着する方法 - Google Patents
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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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
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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
- A61B17/068—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
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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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
- A61B2017/00526—Methods of manufacturing
- A61B2017/0053—Loading magazines or sutures into applying tools
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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
- A61B2017/00831—Material properties
- A61B2017/00884—Material properties enhancing wound closure
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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
- A61B2017/00831—Material properties
- A61B2017/00893—Material properties pharmaceutically effective
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B2017/0688—Packages or dispensers for surgical staplers
Description
技術分野
本開示は、バットレス材料が組み込まれた外科手術用装置に関する。より特定すると、本開示は、取り外し可能な外科手術用バットレスと、この外科手術用バットレスとともに取り外し可能に配置可能な弾力性のある多孔性材料とを含む外科手術用ステープル留め装置に関し、この多孔性材料は、この外科手術用ステープル留め装置の組織直面表面への、この外科手術用バットレスの接着を容易にするように働く。
対向する顎構造体の間に組織を把持またはクランプし、次いで外科手術用ファスナーによって組織を接合するための外科手術用デバイスは、当該分野において周知である。いくつかの器具において、これらのファスナーによって接合された組織を切断するためのナイフが提供される。これらのファスナーは、代表的には外科手術用ステープルの形態であるが、2部品のポリマー製ファスナーもまた利用され得る。
外科手術用ステープル留め装置は、ツールアセンブリ、少なくとも1つの外科手術用バットレス、および弾力性のある多孔性材料を備える。このツールアセンブリは、カートリッジアセンブリ、およびこのカートリッジアセンブリに旋回可能に接続されたアンビルアセンブリを備える。このカートリッジアセンブリは、ステープル保持スロットを規定する第一の組織直面表面を備える。このアンビルアセンブリは、このカートリッジアセンブリのステープル保持スロットから排出されたステープルを形成するためのステープルポケットを規定する第二の組織直面表面を備える。この少なくとも1つの外科手術用バットレスは、この第一の組織直面表面およびこの第二の組織直面表面のうちの少なくとも一方に取り外し可能に配置される。この弾力性のある多孔性材料は、この第一の組織直面表面とこの第二の組織直面表面との間で、この少なくとも1つの外科手術用バットレスと接触して取り外し可能に配置される。この弾力性のある多孔性材料は、このカートリッジアセンブリとこのアンビルアセンブリとの近接によるこの弾力性のある多孔性材料の圧縮のときに、この弾力性のある多孔性材料から液体を排出するように構成される。
好ましい実施形態において、本発明は、下記の項目を提供する。
(項目1)
外科手術用ステープル留め装置であって、該外科手術用ステープル留め装置は、
ステープル保持スロットを規定する第一の組織直面表面を備えるカートリッジアセンブリと、
該カートリッジアセンブリに旋回可能に接続されたアンビルアセンブリであって、該カートリッジアセンブリの該ステープル保持スロットから排出されたステープルを形成するためのステープルポケットを規定する第二の組織直面表面を備える、アンビルアセンブリと、
該第一の組織直面表面および該第二の組織直面表面のうちの一方に取り外し可能に配置された少なくとも1つの外科手術用バットレスと、
該第一の組織直面表面と該第二の組織直面表面との間に取り外し可能に配置された弾力性のある多孔性材料であって、該弾力性のある多孔性材料は、該少なくとも1つの外科手術用バットレスと接触し、該弾力性のある多孔性材料は、該カートリッジアセンブリと該アンビルアセンブリとの近接による該弾力性のある多孔性材料の圧縮のときに、該弾力性のある多孔性材料から液体を排出するように構成されている、弾力性のある多孔性材料とを備える、外科手術用ステープル留め装置。
(項目2)
上記弾力性のある多孔性材料はスポンジである、上記項目に記載の外科手術用ステープル留め装置。
(項目3)
上記スポンジは、細長い形状を有し、第一の端部および第二の端部を有し、該スポンジは、該第一の端部から該第二の端部に向かってテーパ状である、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目4)
上記弾力性のある多孔性材料は、上記少なくとも1つの外科手術用バットレスの長さに等しい長さ、および、該少なくとも1つの外科手術用バットレスの幅に等しい幅を有する、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目5)
上記弾力性のある多孔性材料は、上記第一の組織直面表面と上記第二の組織直面表面との間に規定される空間を占有するようなサイズおよび寸法にされている、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目6)
上記弾力性のある多孔性材料は、頂表面および底表面を有し、該頂表面は、上記第二の組織直面表面と当接係合しており、該底表面は、上記少なくとも1つの外科手術用バットレスと当接係合している、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目7)
上記カートリッジアセンブリと上記アンビルアセンブリとは、互いに対して、第一の離間位置から第二の近接位置まで選択的に移動可能であり、該第二の近接位置において、該カートリッジアセンブリと該アンビルアセンブリとは、協働することにより、該カートリッジアセンブリと該アンビルアセンブリとの間に組織を把持する、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目8)
上記弾力性のある多孔性材料は水溶性接着剤を含む、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目9)
上記少なくとも1つの外科手術用バットレスは、少なくとも1個のアンカーによって、上記アンビルアセンブリおよび上記カートリッジアセンブリのうちの少なくとも一方に固定される、上記項目のいずれかに記載の外科手術用ステープル留め装置。
(項目10)
外科手術用ステープル留めシステムであって、該外科手術用ステープル留めシステムは、
ツールアセンブリであって、
ステープル保持スロットを規定する第一の組織直面表面を備えるカートリッジアセンブリと、
該カートリッジアセンブリに旋回可能に接続されたアンビルアセンブリであって、該カートリッジアセンブリの該ステープル保持スロットから排出されたステープルを形成するためのステープルポケットを規定する第二の組織直面表面を備える、アンビルアセンブリと、
該カートリッジアセンブリの該組織直面表面と該アンビルアセンブリの該組織直面表面とのうちの少なくとも一方に取り外し可能に配置された外科手術用バットレスと
を備える、ツールアセンブリと、
該第一の組織直面表面と該第二の組織直面表面との間で取り外し可能に配置され、かつ、該外科手術用バットレスと接触するように構成された弾力性のある多孔性材料であって、該弾力性のある多孔性材料は、該カートリッジアセンブリと該アンビルアセンブリとの近接による該弾力性のある多孔性材料の圧縮のときに、該弾力性のある多孔性材料から液体を排出するように構成されている、弾力性のある多孔性材料と
を備える、外科手術用ステープル留めシステム。
(項目11)
上記弾力性のある多孔性材料はスポンジである、上記項目に記載の外科手術用ステープル留めシステム。
(項目12)
上記スポンジは、細長い形状を有し、第一の端部および第二の端部を有し、該スポンジは、該第一の端部から該第二の端部に向かってテーパ状である、上記項目のいずれかに記載の外科手術用ステープル留めシステム。
(項目13)
上記弾力性のある多孔性材料は、上記外科手術用バットレスの長さに等しい長さ、および、該外科手術用バットレスの幅に等しい幅を有する、上記項目のいずれかに記載の外科手術用ステープル留めシステム。
(項目14)
上記弾力性のある多孔性材料は、水溶性接着剤を含む、上記項目のいずれかに記載の外科手術用ステープル留めシステム。
(項目15)
外科手術用ステープル留め装置を準備する方法であって、該方法は、
ツールアセンブリを提供することであって、該ツールアセンブリは、
第一の組織直面表面を有するカートリッジアセンブリと、
第二の組織直面表面を有するアンビルアセンブリと
を備える、ことと、
該第一の組織直面表面または該第二の組織直面表面に取り外し可能に固定された少なくとも1つの外科手術用バットレスを提供することと、
弾力性のある多孔性材料が該少なくとも1つの外科手術用バットレスと当接係合するように、該弾力性のある多孔性材料を該第一の組織直面表面と該第二の組織直面表面との間に配置することと、
該弾力性のある多孔性材料を濡らすことと、
液体が該弾力性のある多孔性材料を出て該少なくとも1つの外科手術用バットレスに接触するように、該カートリッジアセンブリと該アンビルアセンブリとを近接させることにより、該カートリッジアセンブリと該アンビルアセンブリとの間で該弾力性のある多孔性材料を圧縮することと
を包含する、方法。
(項目16)
上記弾力性のある多孔性材料は、スポンジである、上記項目に記載の方法。
(項目17)
上記スポンジは、細長い形状を有し、第一の端部および第二の端部を有し、該スポンジは、該第一の端部から該第二の端部に向かってテーパ状である、上記項目のいずれかに記載の方法。
(項目18)
上記弾力性のある多孔性材料は、上記少なくとも1つの外科手術用バットレスの長さに等しい長さ、および、該少なくとも1つの外科手術用バットレスの幅に等しい幅を有する、上記項目のいずれかに記載の方法。
(項目19)
上記弾力性のある多孔性材料は、上記第一の組織直面表面と上記第二の組織直面表面との間に規定される空間を占有するようなサイズおよび寸法にされる、上記項目のいずれかに記載の方法。
(項目20)
上記弾力性のある多孔性材料は、頂表面および底表面を有し、該頂表面は、上記第二の組織直面表面と当接係合しており、該底表面は、上記少なくとも1つの外科手術用バットレスと当接係合している、上記項目のいずれかに記載の方法。
(項目21)
上記弾力性のある多孔性材料を濡らすことは、上記カートリッジアセンブリと上記アンビルアセンブリとを近接させる前に、該弾力性のある多孔性材料を生理食塩水溶液に挿入することを包含する、上記項目のいずれかに記載の方法。
(項目22)
上記弾力性のある多孔性材料は、水溶性接着剤を含む、上記項目のいずれかに記載の方法。
本開示によれば、外科手術用ステープル留め装置が提供される。この外科手術用ステープル留め装置は、ツールアセンブリ、外科手術用バットレス、および、弾力性のある多孔性材料を備える。このツールアセンブリは、カートリッジアセンブリ、および、このカートリッジアセンブリに旋回可能に接続されたアンビルアセンブリを備える。このカートリッジアセンブリは、ステープル保持スロットを規定する第一の組織直面表面を備える。このアンビルアセンブリは、このカートリッジアセンブリのステープル保持スロットから排出されたステープルを形成するためのステープルポケットを規定する第二の組織直面表面を備える。この外科手術用バットレスは、この第一の組織直面表面およびこの第二の組織直面表面のうちの少なくとも一方に取り外し可能に配置される。この弾力性のある多孔性材料は、この第一の組織直面表面とこの第二の組織直面表面との間で、この外科手術用バットレスと接触して取り外し可能に配置可能である。この弾力性のある多孔性材料は、このカートリッジアセンブリとこのアンビルアセンブリとの近接によるこの弾力性のある多孔性材料の圧縮のときに、この弾力性のある多孔性材料から液体を排出するように構成される。
本開示の外科手術用ステープル留め装置の実施形態が、ここで図面を参照しながら詳細に記載される。図面において、同様の参照番号は、数枚の図の各々において、同一の要素または対応する要素を表す。
Claims (20)
- 外科手術用ステープル留め装置であって、前記外科手術用ステープル留め装置は、
ステープル保持スロットを規定する第一の組織直面表面を含むカートリッジアセンブリと、
前記カートリッジアセンブリに旋回可能に結合されたアンビルアセンブリであって、前記カートリッジアセンブリの前記ステープル保持スロットから排出されたステープルを形成するためのステープルポケットを規定する第二の組織直面表面を含むアンビルアセンブリと、
少なくとも2つの外科手術用バットレスであって、前記少なくとも2つの外科手術用バットレスは、前記第一の組織直面表面に取り外し可能に配置された第一の外科手術用バットレスと、前記第二の組織直面表面に取り外し可能に配置された第二の外科手術用バットレスとを含む、少なくとも2つの外科手術用バットレスと、
前記第一の組織直面表面と前記第二の組織直面表面との間に取り外し可能に配置された弾力性のある多孔性材料であって、前記弾力性のある多孔性材料は、前記少なくとも2つの外科手術用バットレスに取り外し可能に接触し、前記弾力性のある多孔性材料は、前記カートリッジアセンブリおよび前記アンビルアセンブリを離間位置に向かって弾力的に付勢し、前記弾力性のある多孔性材料は、前記カートリッジアセンブリと前記アンビルアセンブリとが近接することによって前記弾力性のある多孔性材料が圧縮されるときに、前記弾力性のある多孔性材料から液体を排出するように構成されており、前記弾力性のある多孔性材料は、頂表面および底表面を含み、前記カートリッジアセンブリおよび前記アンビルアセンブリが前記離間位置にあるときに、前記頂表面の遠位部分は、前記第二の外科手術用バットレスの遠位部分に当接係合しており、前記底表面の遠位部分は、前記第一の外科手術用バットレスの遠位部分に当接係合している、弾力性のある多孔性材料と
を備え、
前記カートリッジアセンブリと前記アンビルアセンブリとは、互いに対して、前記離間位置から近接位置まで選択的に移動可能である、外科手術用ステープル留め装置。 - 前記弾力性のある多孔性材料は、スポンジである、請求項1に記載の外科手術用ステープル留め装置。
- 前記スポンジは、細長い形状を有し、かつ、第一の端部および第二の端部を有し、前記スポンジは、前記第一の端部から前記第二の端部に向かってテーパ状である、請求項2に記載の外科手術用ステープル留め装置。
- 前記弾力性のある多孔性材料は、前記少なくとも2つの外科手術用バットレスの長さに等しい長さを有し、かつ、前記少なくとも2つの外科手術用バットレスの幅に等しい幅を有する、請求項1に記載の外科手術用ステープル留め装置。
- 前記弾力性のある多孔性材料は、前記第一の組織直面表面と前記第二の組織直面表面との間に規定される空間を占有するようなサイズおよび寸法にされている、請求項1に記載の外科手術用ステープル留め装置。
- 前記カートリッジアセンブリと前記アンビルアセンブリとは、協働することにより、前記カートリッジアセンブリと前記アンビルアセンブリとの間に組織を把持する、請求項1に記載の外科手術用ステープル留め装置。
- 前記弾力性のある多孔性材料は、水溶性接着剤を含む、請求項1に記載の外科手術用ステープル留め装置。
- 前記少なくとも2つの外科手術用バットレスは、少なくとも1個のアンカーによって、前記アンビルアセンブリおよび前記カートリッジアセンブリのうちの少なくとも一方に固定される、請求項1に記載の外科手術用ステープル留め装置。
- 外科手術用ステープル留めシステムであって、前記外科手術用ステープル留めシステムは、
ツールアセンブリであって、
ステープル保持スロットを規定する第一の組織直面表面を含むカートリッジアセンブリと、
前記カートリッジアセンブリに旋回可能に結合されたアンビルアセンブリであって、前記カートリッジアセンブリの前記ステープル保持スロットから排出されたステープルを形成するためのステープルポケットを規定する第二の組織直面表面を含むアンビルアセンブリと、
前記カートリッジアセンブリの前記第一の組織直面表面に取り外し可能に配置された第一の外科手術用バットレスと、前記アンビルアセンブリの前記第二の組織直面表面に取り外し可能に配置された第二の外科手術用バットレスと
を備える、ツールアセンブリと、
前記第一の組織直面表面と前記第二の組織直面表面との間で取り外し可能に配置され、かつ、前記第一の外科手術用バットレスおよび前記第二の外科手術用バットレスに取り外し可能に接触するように構成された弾力性のある多孔性材料であって、前記弾力性のある多孔性材料は、前記カートリッジアセンブリおよび前記アンビルアセンブリを離間位置に向かって弾力的に付勢し、前記弾力性のある多孔性材料は、前記カートリッジアセンブリと前記アンビルアセンブリとが近接することによって前記弾力性のある多孔性材料が圧縮されるときに、前記弾力性のある多孔性材料から液体を排出するように構成されており、前記弾力性のある多孔性材料は、頂表面および底表面を含み、前記カートリッジアセンブリおよび前記アンビルアセンブリが前記離間位置にあるときに、前記頂表面の遠位部分は、前記第二の外科手術用バットレスの遠位部分に当接係合しており、前記底表面の遠位部分は、前記第一の外科手術用バットレスの遠位部分に当接係合している、弾力性のある多孔性材料と
を備え、
前記カートリッジアセンブリと前記アンビルアセンブリとは、互いに対して、前記離間位置から近接位置まで選択的に移動可能である、外科手術用ステープル留めシステム。 - 前記弾力性のある多孔性材料は、スポンジである、請求項9に記載の外科手術用ステープル留めシステム。
- 前記スポンジは、細長い形状を有し、かつ、第一の端部および第二の端部を有し、前記スポンジは、前記第一の端部から前記第二の端部に向かってテーパ状である、請求項10に記載の外科手術用ステープル留めシステム。
- 前記弾力性のある多孔性材料は、前記第一の外科手術用バットレスおよび前記第二の外科手術用バットレスの長さに等しい長さを有し、かつ、前記第一の外科手術用バットレスおよび前記第二の外科手術用バットレスの幅に等しい幅を有する、請求項9に記載の外科手術用ステープル留めシステム。
- 前記弾力性のある多孔性材料は、水溶性接着剤を含む、請求項9に記載の外科手術用ステープル留めシステム。
- 外科手術用ステープル留め装置を準備する方法であって、前記方法は、
ツールアセンブリを提供することであって、前記ツールアセンブリは、
第一の組織直面表面を有するカートリッジアセンブリと、
第二の組織直面表面を有するアンビルアセンブリと
を備える、ことと、
少なくとも2つの外科手術用バットレスを提供することであって、前記少なくとも2つの外科手術用バットレスは、前記第一の組織直面表面に取り外し可能に固定された第一の外科手術用バットレスと、前記第二の組織直面表面に取り外し可能に固定された第二の外科手術用バットレスとを含む、ことと、
弾力性のある多孔性材料が前記少なくとも2つの外科手術用バットレスに取り外し可能に当接係合し、かつ、前記カートリッジアセンブリおよび前記アンビルアセンブリを離間位置に向かって弾力的に付勢するように、前記弾力性のある多孔性材料を前記第一の組織直面表面と前記第二の組織直面表面との間に配置することであって、前記弾力性のある多孔性材料は、頂表面および底表面を含み、前記カートリッジアセンブリおよび前記アンビルアセンブリが前記離間位置にあるときに、前記頂表面の遠位部分は、前記第二の外科手術用バットレスの遠位部分に当接係合しており、前記底表面の遠位部分は、前記第一の外科手術用バットレスの遠位部分に当接係合している、ことと、
前記弾力性のある多孔性材料を濡らすことと、
液体が前記弾力性のある多孔性材料を出て前記少なくとも2つの外科手術用バットレスに接触するように、前記カートリッジアセンブリと前記アンビルアセンブリとを近接させることにより、前記カートリッジアセンブリと前記アンビルアセンブリとの間で前記弾力性のある多孔性材料を圧縮することと
を含み、
前記カートリッジアセンブリと前記アンビルアセンブリとは、互いに対して、前記離間位置から近接位置まで選択的に移動可能である、方法。 - 前記弾力性のある多孔性材料は、スポンジである、請求項14に記載の方法。
- 前記スポンジは、細長い形状を有し、かつ、第一の端部および第二の端部を有し、前記スポンジは、前記第一の端部から前記第二の端部に向かってテーパ状である、請求項15に記載の方法。
- 前記弾力性のある多孔性材料は、前記少なくとも2つの外科手術用バットレスの長さに等しい長さを有し、かつ、前記少なくとも2つの外科手術用バットレスの幅に等しい幅を有する、請求項14に記載の方法。
- 前記弾力性のある多孔性材料は、前記第一の組織直面表面と前記第二の組織直面表面との間に規定される空間を占有するようなサイズおよび寸法にされている、請求項14に記載の方法。
- 前記弾力性のある多孔性材料を濡らすことは、前記カートリッジアセンブリと前記アンビルアセンブリとを近接させる前に、前記弾力性のある多孔性材料を生理食塩水溶液に挿入することを含む、請求項14に記載の方法。
- 前記弾力性のある多孔性材料は、水溶性接着剤を含む、請求項14に記載の方法。
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2014
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- 2014-12-11 AU AU2014274574A patent/AU2014274574B2/en not_active Ceased
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- 2014-12-22 EP EP14199670.2A patent/EP2939608B1/en active Active
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2018
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2019
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JP2015208673A (ja) | 2015-11-24 |
JP2019213884A (ja) | 2019-12-19 |
AU2014274574A1 (en) | 2015-11-12 |
US9844378B2 (en) | 2017-12-19 |
US20150305743A1 (en) | 2015-10-29 |
CN105011978B (zh) | 2020-01-10 |
CN105011978A (zh) | 2015-11-04 |
EP2939608B1 (en) | 2019-02-06 |
CA2875285A1 (en) | 2015-10-29 |
JP2019069192A (ja) | 2019-05-09 |
AU2014274574B2 (en) | 2019-11-21 |
EP2939608A1 (en) | 2015-11-04 |
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