JP6771961B2 - アンビルアセンブリおよび送達システム - 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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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
- A61B2017/0046—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
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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
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00818—Treatment of the gastro-intestinal system
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Description
技術分野
本開示は、外科手術用ステープル留めデバイスと一緒に使用するためのアンビルアセンブリに関する。より特定すると、本開示は、これらのアンビルアセンブリの経口送達のための送達システムに関する。
アンビルアセンブリを外科手術部位(例えば、胃)に送達するための経口送達システムは、代表的に、このアンビルアセンブリの経口挿入を容易にするために、このアンビルアセンブリのヘッドの1つまたはより多くの開口部に通された、ガイド用縫合糸を備える。患者の口の外側に残る端部を備えるこのガイド用縫合糸は、このアンビルアセンブリの経口送達中にこのアンビルアセンブリが動かなくなった場合に、このアンビルアセンブリを取り外すため、および/または患者の緊急(例えば、心拍停止)の場合に、このアンビルアセンブリを回収するために、外科医によって使用され得る。一旦、このアンビルアセンブリが外科手術部位まで送達され、そして/またはステープル留め手順が行われたら、このアンビルアセンブリからのガイド用縫合糸の取り外しを容易にするように、このガイド用縫合糸をこのアンビルアセンブリに固定するための改善された方法が、望ましい。
(項目1)
送達アセンブリ;
該送達アセンブリに選択的に固定可能なアンビルアセンブリであって、該アンビルアセンブリは:
該送達アセンブリに選択的に固定可能である中心棒アセンブリ;および
該中心棒アセンブリに、第一の傾斜位置と作動可能位置との間で旋回的に固定されるヘッドアセンブリ
を備える、アンビルアセンブリ;ならびに
該アンビル送達システムから該ヘッドアセンブリを通って該ヘッドアセンブリの遠位に延びる縫合糸であって、該縫合糸は、該ヘッドアセンブリを該第一の傾斜位置に保持する、縫合糸
を備える、アンビル送達システム。
(項目2)
上記ヘッドアセンブリは、第一の近位開口部および第二の近位開口部を規定するハウジングを備え、上記縫合糸は、該第一の近位開口部および該第二の近位開口部の各々を通って延びる、上記項目に記載のシステム。
(項目3)
上記送達アセンブリは、可撓性部材およびアダプタを備える、上記項目のいずれかに記載のシステム。
(項目4)
上記縫合糸は、上記アダプタを通って延びる、上記項目のいずれかに記載のシステム。
(項目5)
上記縫合糸は、上記可撓性部材と上記アダプタとの間に、摩擦により固定される、上記項目のいずれかに記載のシステム。
(項目6)
上記縫合糸は、上記第一の近位開口部から上記アダプタを通って、上記第二の近位開口部まで延びる、上記項目のいずれかに記載のシステム。
(項目7)
上記縫合糸の第一の部分は、上記ヘッドアセンブリと上記アダプタとの間で、該縫合糸の第二の部分と交差する、上記項目のいずれかに記載のシステム。
(項目8)
上記縫合糸は、上記ヘッドアセンブリの遠位に延びるループを備える、上記項目のいずれかに記載のシステム。
(項目9)
上記ヘッドアセンブリは、上記第一の傾斜位置と逆の第二の傾斜位置まで移動可能である、上記項目のいずれかに記載のシステム。
(項目10)
アンビルアセンブリを第一の傾斜位置に固定する方法であって、該方法は:
縫合糸の第一の端部を、アンビルアセンブリのヘッドアセンブリの第一の開口部に通して受容する工程;
該縫合糸の該第一の端部を、該アンビルアセンブリの中心棒アセンブリに固定されたアダプタのボアに通して受容する工程;
該縫合糸の該第一の端部を戻して、該ヘッドアセンブリの第二の開口部に通して受容する工程;および
該ヘッドアセンブリに隣接する位置で、該縫合糸の該第一の端部を該縫合糸の該第二の端部に結ぶ工程
を包含する、方法。
(項目11)
上記縫合糸の上記第一の端部を該縫合糸の上記第二の端部に結ぶ工程の前に、上記ヘッドアセンブリを上記中心棒アセンブリに対して移動させる工程をさらに包含する、上記項目に記載の方法。
(項目12)
上記ヘッドアセンブリを上記中心棒アセンブリに対して移動させる工程が、該ヘッドアセンブリを第一の傾斜位置まで旋回させることを包含する、上記項目のいずれかに記載の方法。
(項目13)
上記縫合糸の上記第一の端部を第一の開口部に通して受容する工程が、該縫合糸の該第一の端部を第一の遠位開口部に入れ、そして第一の近位開口部から出して受容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14)
上記縫合糸の上記第一の端部を第二の開口部に通して受容する工程が、該縫合糸の該第一の端部を第二の近位開口部に入れ、そして第二の遠位開口部から出して受容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15)
アンビルアセンブリを第一の傾斜位置に固定する方法であって、該方法は:
縫合糸の第一の端部を、アンビルアセンブリのヘッドアセンブリの第一の開口部に通して受容する工程;
該縫合糸の第二の端部を、該ヘッドアセンブリの第二の開口部に通して受容する工程;
該縫合糸の該第一の端部および該第二の端部を、アダプタのボアに通して受容する工程;ならびに
該縫合糸が該ボア内に固定されるように、該アダプタを可撓性部材に固定する工程
を包含する、方法。
(項目16)
上記縫合糸の上記第一の端部および上記第二の端部を、ボアに通して受容する工程は、該縫合糸の該第一の端部を第一のボアに第一の方向の方向に通して受容し、そして該縫合糸の該第二の端部を該第一のボアの第二の方向に通して受容すること、次いで、該縫合糸の該第一の端部を第二のボアに通して第二の方向に受容し、そして該縫合糸の該第二の端部を該第二のボアに該第一の方向に通して受容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17)
上記アダプタを上記可撓性部材に固定する工程は、該アダプタの第一の端部を該可撓性部材の開口端に受容することを包含する、上記項目のいずれかに記載の方法。
摘要
経口送達に適したアンビルアセンブリは、縫合糸を受容するように構成されたアンビルヘッドを備え、この縫合糸は、このアンビルヘッドを送達位置に固定し、そしてこのアンビルアセンブリの送達後に、このアンビルヘッドから分離可能である。アンビル送達アセンブリは、このアンビルアセンブリ、このアンビルアセンブリに固定された送達アセンブリ、およびこのアンビルアセンブリに選択的に固定される縫合糸を備え、この縫合糸は、このアンビルアセンブリを送達位置に固定するため、およびこのアンビルアセンブリを回収するためのものである。
要旨
アンビル送達システムが提供される。このアンビル送達システムは、送達アセンブリ、この送達アセンブリに選択的に固定可能なアンビルアセンブリであって、この送達アセンブリに選択的に固定可能である中心棒アセンブリを備える、アンビルアセンブリ、およびこの中心棒アセンブリに、第一の傾斜位置と作動可能位置との間で旋回的に固定されるヘッドアセンブリを備える。このアンビル送達システムは、縫合糸をさらに備え、この縫合糸は、このアンビル送達システムからこのヘッドアセンブリを通ってこのヘッドアセンブリの遠位に延び、この縫合糸は、このヘッドアセンブリをこの第一の傾斜位置に保持する。
本開示のアンビルアセンブリ送達システムの実施形態が、図面を参照しながらここで詳細に記載される。図面において、同じ参照番号は、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。本明細書全体にわたって、用語「近位」とは、その器具の、操作者に最も近い部分をいい、そして用語「遠位」とは、その器具の、操作者から最も遠い部分をいう。
Claims (17)
- 送達アセンブリと、
前記送達アセンブリに選択的に固定可能なアンビルアセンブリであって、前記アンビルアセンブリは、
前記送達アセンブリに選択的に固定可能である中心棒アセンブリと、
第一の傾斜位置と作動可能位置との間で前記中心棒アセンブリに旋回的に固定されているヘッドアセンブリと
を含む、アンビルアセンブリと、
前記送達アセンブリから前記ヘッドアセンブリを通って前記ヘッドアセンブリの遠位に延びる縫合糸であって、前記縫合糸は、前記ヘッドアセンブリに隣接する結び目を形成するように結ばれており、前記縫合糸は、前記ヘッドアセンブリを前記第一の傾斜位置に保持する、縫合糸と
を備える、アンビル送達システム。 - 前記ヘッドアセンブリは、第一の近位開口部および第二の近位開口部を規定するハウジングを備え、前記縫合糸は、前記第一の近位開口部および前記第二の近位開口部の各々を通って延びる、請求項1に記載のシステム。
- 前記送達アセンブリは、可撓性部材およびアダプタを備える、請求項2に記載のシステム。
- 前記縫合糸は、前記アダプタを通って延びる、請求項3に記載のシステム。
- 前記縫合糸は、前記可撓性部材と前記アダプタとの間に摩擦により固定されている、請求項3に記載のシステム。
- 前記縫合糸は、前記第一の近位開口部から前記アダプタを通って前記第二の近位開口部まで延びる、請求項3に記載のシステム。
- 前記縫合糸の第一の部分は、前記ヘッドアセンブリと前記アダプタとの間で、前記縫合糸の第二の部分と交差する、請求項6に記載のシステム。
- 前記縫合糸は、前記ヘッドアセンブリの遠位に延びるループを含む、請求項1に記載のシステム。
- 前記ヘッドアセンブリは、前記第一の傾斜位置と逆の第二の傾斜位置まで移動可能である、請求項1に記載のシステム。
- アンビルアセンブリのヘッドアセンブリを第一の傾斜位置に固定する方法であって、前記方法は、
縫合糸の第一の端部をアンビルアセンブリのヘッドアセンブリの第一の開口部を通して受容することと、
前記縫合糸の前記第一の端部を前記アンビルアセンブリの中心棒アセンブリに固定されたアダプタのボアを通して受容することと、
前記縫合糸の前記第一の端部を前記ヘッドアセンブリの第二の開口部を通して戻るように受容することと、
前記ヘッドアセンブリが第一の傾斜位置にあるとき、前記ヘッドアセンブリに隣接する前記縫合糸の第二の端部に前記縫合糸の前記第一の端部を結ぶことにより、前記ヘッドアセンブリを前記第一の傾斜位置に固定することと
を含む、方法。 - 前記縫合糸の前記第二の端部に前記縫合糸の前記第一の端部を結ぶ前に、前記ヘッドアセンブリを前記中心棒アセンブリに対して移動させることをさらに含む、請求項10に記載の方法。
- 前記ヘッドアセンブリを前記中心棒アセンブリに対して移動させることは、前記ヘッドアセンブリを前記第一の傾斜位置まで旋回させることを含む、請求項11に記載の方法。
- 前記縫合糸の前記第一の端部を第一の開口部を通して受容することは、前記縫合糸の前記第一の端部を第一の遠位開口部に入れ、第一の近位開口部から出して受容することを含む、請求項10に記載の方法。
- 前記縫合糸の前記第一の端部を第二の開口部に通して受容することは、前記縫合糸の前記第一の端部を第二の近位開口部に入れ、第二の遠位開口部から出して受容することを含む、請求項13に記載の方法。
- アンビルアセンブリのヘッドアセンブリを第一の傾斜位置に固定する方法であって、前記方法は、
縫合糸の第一の端部をアンビルアセンブリのヘッドアセンブリに隣接する前記縫合糸の第二の端部に結ぶことと、前記結ぶことの後に、
前記縫合糸の前記第一の端部を前記ヘッドアセンブリの第一の開口部を通して受容することと、
前記縫合糸の前記第二の端部を前記ヘッドアセンブリの第二の開口部を通して受容することと、
前記縫合糸の前記第一の端部および前記第二の端部をアダプタのボアを通して受容することと、
前記ヘッドアセンブリが第一の傾斜位置にあるとき、前記縫合糸が前記ボア内に固定されるように前記アダプタを可撓性部材に固定することにより、前記ヘッドアセンブリを前記第一の傾斜位置に維持することと
を含む、方法。 - 前記縫合糸の前記第一の端部および前記第二の端部をボアを通して受容することは、前記縫合糸の前記第一の端部を第一の方向に第一のボアを通して受容し、かつ、前記縫合糸の前記第二の端部を第二の方向に前記第一のボアを通して受容することと、その後、前記縫合糸の前記第一の端部を前記第二の方向に第二のボアを通して受容し、かつ、前記縫合糸の前記第二の端部を前記第一の方向に前記第二のボアを通して受容することとを含む、請求項15に記載の方法。
- 前記アダプタを前記可撓性部材に固定することは、前記アダプタの第一の端部を前記可撓性部材の開口端に受容することを含む、請求項15に記載の方法。
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US14/790,227 | 2015-07-02 | ||
US14/790,227 US9974536B2 (en) | 2015-07-02 | 2015-07-02 | Anvil assemblies and delivery systems |
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EP (2) | EP3189794B1 (ja) |
JP (1) | JP6771961B2 (ja) |
AU (1) | AU2016203703B2 (ja) |
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US9974536B2 (en) | 2015-07-02 | 2018-05-22 | Covidien Lp | Anvil assemblies and delivery systems |
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