JP6830978B2 - 子宮マニピュレーターならびに関連する構成要素および方法 - Google Patents
子宮マニピュレーターならびに関連する構成要素および方法 Download PDFInfo
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- JP6830978B2 JP6830978B2 JP2019077531A JP2019077531A JP6830978B2 JP 6830978 B2 JP6830978 B2 JP 6830978B2 JP 2019077531 A JP2019077531 A JP 2019077531A JP 2019077531 A JP2019077531 A JP 2019077531A JP 6830978 B2 JP6830978 B2 JP 6830978B2
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- 210000004291 uterus Anatomy 0.000 claims description 35
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Description
[1]患者体内で子宮マニピュレーターをポジショニングする方法であって、以下の段階を含む方法:
該子宮マニピュレーターのコルポトマイザーカップ(colpotomizer cup)に変形力を印加して、該コルポトマイザーカップを公称幅構成から縮小幅構成に調整する段階;
該コルポトマイザーカップが該縮小幅構成になっている間に該コルポトマイザーカップを該患者の膣管内に挿入する段階;
該コルポトマイザーカップが該縮小幅構成から該公称幅構成に拡張できるよう、該コルポトマイザーカップから該変形力を除去する段階;および
該コルポトマイザーカップが該公称幅構成になっている間に該コルポトマイザーカップを該患者の子宮頚部の周りにポジショニングする段階;
[2]コルポトマイザーカップを患者の膣管内に挿入する段階が、子宮マニピュレーターのシャフトに沿って該コルポトマイザーカップを動かす段階を含む、[1]の方法;
[3]シャフトに沿った既定の位置でコルポトマイザーカップをロックする段階をさらに含む、[2]の方法;
[4]コルポトマイザーカップが縮小幅構成になっている間に、膣管内の該コルポトマイザーカップを患者の子宮頚部まで進める段階をさらに含む、[1]の方法;
[5]コルポトマイザーカップに変形力を印加する段階が、該コルポトマイザーカップを絞る段階を含む、[1]の方法;
[6]コルポトマイザーカップから変形力を除去する段階が、該コルポトマイザーカップを解放する段階を含む、[5]の方法;
[7]コルポトマイザーカップに変形力を印加する段階が、該コルポトマイザーカップをつぶす段階を含む、[1]の方法;
[8]コルポトマイザーカップを膣管内に挿入する段階が、該コルポトマイザーカップを患者の膣入口(vaginal entryway)内に挿入する段階を含む、[1]の方法;
[9]コルポトマイザーカップがポリウレタンを含む、[1]の方法;
[10]コルポトマイザーカップを形成する1つまたは複数の材料が、約5.5 MPa〜約171 MPaの範囲内の弾性率を有する、[1]の方法;
[11]コルポトマイザーカップを形成する1つまたは複数の材料が、85ショアA〜100ショアAの範囲内の硬さを有する、[1]の方法;
[12]コルポトマイザーカップの壁厚が約0.2 cm〜約0.7 cmの範囲内である、[1]の方法;
[13]コルポトマイザーカップを形成する1つまたは複数の材料が、約5.5 MPa〜約171 MPaの範囲内の弾性率と、85ショアA〜100ショアAの範囲内の硬さとを有する、[12]の方法;
[14]コルポトマイザーカップが、約2.5 cm、約3.0 cm、約3.5 cm、または約4.0 cmの最大内径を有する、[1]の方法;
[15]コルポトマイザーカップの複数の視界窓のうち1つまたは複数を通して、該コルポトマイザーカップ内の子宮頚部を可視化する段階をさらに含む、[1]の方法;
[16]前記複数の視界窓が、コルポトマイザーカップの外周の大部分にわたる、[15]の方法;
[17]患者の子宮頚部を受けるようサイズ決定される受け部を規定する、変形可能なコルポトマイザーカップであって、変形可能なコルポトマイザーカップを該患者の膣管内に挿入するために公称幅構成から縮小幅構成に調整可能であり、かつ、変形可能なコルポトマイザーカップを該子宮頚部の周りに配置するために該縮小幅構成から該公称幅構成に調整可能である該変形可能なコルポトマイザーカップを含む、子宮マニピュレーター;
[18]コルポトマイザーカップがポリウレタンを含む、[17]の子宮マニピュレーター;
[19]コルポトマイザーカップの壁厚が約0.2 cm〜約0.7 cmの範囲内であり、かつ、該コルポトマイザーカップが、約2.5 cm、約3.0 cm、約3.5 cm、または約4.0 cmの最大内径を有する、[17]の子宮マニピュレーター;ならびに
[20]コルポトマイザーカップを形成する1つまたは複数の材料が、約5.5 MPa〜約171 MPaの範囲内の弾性率と、85ショアA〜100ショアAの範囲内の硬さとを有する、[17]の子宮マニピュレーター。
図1に、女性の骨盤内外科手技において用いるため膣管内に挿入するよう適合された子宮マニピュレーター100を示す。子宮マニピュレーター100は、子宮の整復において用いるため子宮頚部内にわたるよう構成されたシャフト102と、シャフト102の周りに配されかつ子宮頚部を受けるよう構成されたコルポトマイザーアセンブリ104とを含む。子宮マニピュレーター100は、シャフト102の遠位先端108に固定され、かつ子宮内で遠位先端108のポジションを保つよう構成された、拡張可能バルーン106をさらに含む。シャフト102の遠位先端108に光源110がマウントされる;そして光源110は、子宮マニピュレーター100の挿入中に膣管および外子宮口(すなわち頚管口)を照明するために用いられてもよい。シャフト102の近位部分114にマニピュレーターハンドル112が接続される。
101 バルーンカフカテーテルチューブ
102 シャフト
103 カップフェース
104 コルポトマイザーアセンブリ
105 中心点
106 拡張可能バルーン
107 アーチ中心線
108 遠位先端
109 軸中心線
110 光源
111 チャネル
112 マニピュレーターハンドル
113 オフセット
114 近位部分
115 電源
116 中央部分
117 電線
118 収縮チューブ
119 ボタン
120 中央内腔
122 開口部
123 プラットフォーム
124 定規マーキング
125 近位端
126 雌部分
128 雄部分
130 受け部
132 指用凹部
134 指用凹部
136 指用凹部
138 一体型シリンジ
142 プランジャー
144 スライド式ボタン
146 コルポトマイザーカップ
148 スリーブ
150 膣閉鎖栓
152 輪状のボディ
154 リム
156 遠位端
158 基部
160 近位端
162 突起
164 視界窓
166 開口部
168 雌部分
170 雄部分
172 受け部
174 近位端
176 サムロック
178 受け部
180 突起
182 ガイド表面
184 カムローラー
186 ローラーマウント
188 ジョー
190 レンズ
192 リフトフランジ
194 本体
196 遠位カフ
198 拡張可能バルーンカフ
200 包装容器
202 基部
204 カバー
206 ポスト
300 腹膜腔
302 腹壁
304 膣管
306 子宮
308 子宮の底部
310 子宮頚部
314 腹腔鏡
318 膣円蓋
320 膣入口
Claims (13)
- 患者の子宮頚部を受けるようサイズ決定される受け部を規定する、単一構成要素として形成される変形可能なコルポトマイザーカップであって、
該変形可能なコルポトマイザーカップを該患者の膣管内に挿入するために公称幅構成から縮小幅折り畳み構成に調整可能であり、かつ、
該変形可能なコルポトマイザーカップを該子宮頚部の周りに配置するために該縮小幅折り畳み構成から該公称幅構成に調整可能である、該変形可能なコルポトマイザーカップ
を含み、
該変形可能なコルポトマイザーカップがポリウレタンを含有する材料配合を含み、
該変形可能なコルポトマイザーカップが、複数の視界窓を含み、
該材料配合は、該複数の視界窓によって提供される構成とともに、該変形可能なコルポトマイザーカップが対向する側部でそれ自体の上に手で折り畳まれて、該縮小幅折り畳み構成になることを可能にする、
子宮マニピュレーター。 - 前記変形可能なコルポトマイザーカップの壁厚が約0.2 cm〜約0.7 cmの範囲内である、請求項1記載の子宮マニピュレーター。
- 前記変形可能なコルポトマイザーカップを形成する1つまたは複数の材料が、約5.5 MPa〜約171 MPaの範囲内の弾性率を有する、請求項1記載の子宮マニピュレーター。
- 前記変形可能なコルポトマイザーカップを形成する1つまたは複数の材料が、85ショアA〜100ショアAの範囲内の硬さを有する、請求項1記載の子宮マニピュレーター。
- 前記変形可能なコルポトマイザーカップを形成する1つまたは複数の材料が、約5.5 MPa〜約171 MPaの範囲内の弾性率と、85ショアA〜100ショアAの範囲内の硬さとを有する、請求項2記載の子宮マニピュレーター。
- 前記変形可能なコルポトマイザーカップが、約2.5 cm、約3.0 cm、約3.5 cm、または約4.0 cmの最大内径を有する、請求項1記載の子宮マニピュレーター。
- シャフトをさらに含み、前記変形可能なコルポトマイザーカップが、該シャフトに沿って動かすことが可能である、請求項1記載の子宮マニピュレーター。
- 前記変形可能なコルポトマイザーカップがロック機構を含み、該ロック機構により、該変形可能なコルポトマイザーカップをシャフトに沿った既定の位置でロックすることが可能である、請求項7記載の子宮マニピュレーター。
- 前記複数の視界窓が、前記変形可能なコルポトマイザーカップの外周の大部分にわたる、請求項1記載の子宮マニピュレーター。
- 前記材料配合は、前記複数の視界窓によって提供される構成とともに、前記変形可能なコルポトマイザーカップが対向する側部でそれ自体の上に手で絞られて、前記縮小幅折り畳み構成になることを可能にする、請求項1記載の子宮マニピュレーター。
- 前記縮小幅折り畳み構成が、横長の断面形状を有する、請求項1記載の子宮マニピュレーター。
- 前記シャフトが、該シャフトの遠位先端を前記患者の子宮の底部にポジショニングするように構成されている、請求項7記載の子宮マニピュレーター。
- 前記変形可能なコルポトマイザーカップを含むコルポトマイザーアセンブリをさらに含み、該コルポトマイザーアセンブリは、該変形可能なコルポトマイザーカップを前記子宮頚部に置くために、前記シャフト上で運ばれ、かつ該シャフトに沿って移動可能である、請求項12記載の子宮マニピュレーター。
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