JP7374256B2 - 多機能手術用アクセスシステム - Google Patents
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Classifications
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
- A61B17/3496—Protecting sleeves or inner probes; Retractable tips
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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
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive 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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3431—Cannulas being collapsible, e.g. made of thin flexible material
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
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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
- A61B2017/00982—General structural features
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- A—HUMAN NECESSITIES
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- 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
- A61B2090/0801—Prevention of accidental cutting or pricking
Description
本願は、全体として、医療用デバイスに関し、更に詳細には、開創器を含む手術用アクセスシステムに関する。
本明細書中に開示した実施例と同様の手術用アクセスシステムが、米国特許公開第2005/0241647A1号、米国特許公開第2007/0185387A1号、米国特許公開第2007/0149859A1号、及び米国特許公開第2007/0088202A1号に開示されている。出典を明示することにより、これらの特許公開に開示された全ての内容は本明細書の開示の一部とされる。
ポリエステル編製布及び布の一方の面に積層した50μm(2ミル)のポリウレタン層を含むポリウレタン積層布(PUL-2ミル シーブライト)についての耐穿刺性をFED-STD-101/2065に従って計測した。試験では、3.175mm(0.125インチ)の円形のシャフトを7.6cm×7.6cm(3インチ×3インチ)の布サンプルと毎分7.6cm(毎分3インチ)で接触する。試験を、円形のシャフトを布のポリエステル面と接触させて15個のサンプルについて行い、61.07N(13.73ポンド)の平均耐穿刺性を得た。ポリウレタン側について行った15回の試験の平均耐穿刺性は、53.56N(12.04ポンド)であった。
本開創器シースで使用した76μm(4ミル)のポリエーテルポリウレタンフィルム(ペレタン(ペレタン(PELLETHANE)は登録商標である)2363、ルブリゾール)の耐穿刺性を上文中に説明したのと同様に計測した。15回の試験についての平均値は12.46N(2.80ポンド)であった。
幾つかの実施例では、布は、手術器具によって不時に刺されたり切られたりすることにより、又は以下に説明するようにシース150を意図的に穿刺することにより損傷を受けた場合、裂け目が拡がるのに抵抗する。このような布の例には、裂け止め布即ちリップストップ布、特定の編み生地、及び編みメッシュ生地が含まれる。幾つかの実施例では、布の配向により、シースに器具を通すときに器具を妨げる欠陥が生じる可能性を減少する。例えば、幾つかの実施例では、布の滑らかな表面がシースの長さ方向軸線に面し、即ちシースの内側に面する。幾つかの実施例では、布は斜行配置されているか或いは、縁がシースの長さ方向軸線とほぼ平行である。適当な布は、リップストップポリアミド(ナイロン(ナイロン(NYLON)は登録商標である)、オックスフォード織りの布、耐磨耗性ポリエステル及び/又はポリアミド布(コンジュラ(コンジュラ(Condura)は登録商標である)、編みモノフィラメント布、等である。
上述の内リングの幾つかの実施例では、シャフトは本体内に選択的に係止できる。これは、例えばラチェット及び爪を使用して、開口部及び/又は内腔/チャンネルを潰すことによって、ロックナットによって、ロックリングによって、摩擦によって、又はその他の方法によって行われる。図14に示す実施例では、内リング1430の平面図はほぼ円形である。他の実施例では、内リングは、上文中に説明した別の形状を有する。他の実施例は、複数の本体及びシャフトを含む。幾つかの実施例では、本体は二つの端部を持つ本体であり、即ち本体の各端は、シャフトを入れ子式に受け入れる寸法を備えている。シャフトもまた二つの端部を持つシャフトであり、即ちシャフトの各端を本体に挿入できる。外リングの幾つかの実施例は調節を同様に行うことができる。
102 近位端
104 遠位端
106 機器アクセスチャンネル
110 外アンカー即ち近位アンカー
130 内アンカー即ち遠位アンカー
150 可撓性シース
Claims (17)
- 組織開創器であって、
近位端から遠位端まで延びる器具アクセスチャンネルを形成する長さ方向軸線と、
外リングと、
閉ループを規定するように一緒に連結された複数の円弧状部材を備えている内リングであって、前記複数の円弧状部材の一又は二以上の角度が、前記内リングの局所的長手方向軸線周りの、前記複数の円弧状部材の一又は二以上の回転により調整可能であり、これによって前記内リングの形状が再成形される内リングと、
前記外リングと前記内リングとの間を延びる可撓性シースとを備え、
前記器具アクセスチャンネルが前記外リング、前記内リングおよび前記可撓性シースを通って延びている、
ことを特徴とする組織開創器。 - 前記複数の円弧状部材はリンク要素を使って連結され、前記リンク要素は、可撓性ポリマーで覆われた、リンクチェーン、ボールソケットチェーン、およびローラーチェーンの一又は二以上を含む、
請求項1に記載の組織開創器。 - 前記複数の円弧状部材の一又は二以上の配向が調整可能である、
請求項1に記載の組織開創器。 - 前記複数の円弧状部材の一又は二以上の調整は、前記複数の円弧状部材の一の配向を、隣接する円弧状部材に対して回転させて行われる、
請求項3に記載の組織開創器。 - 前記複数の円弧状部材の一又は二以上の調整は、前記複数の円弧状部材を、隣接する円弧状部材に対して所定各度に配置して行われる、
請求項1に記載の組織開創器。 - 前記複数の円弧状部材の各々が独立して調整可能である、
請求項1に記載の組織開創器。 - 前記複数の円弧状部材の各々が、他の円弧状部材に対して可変の長さを有している、
請求項1に記載の組織開創器。 - 前記内リングに張力又は圧縮力を加えることによって前記内リングの配座が固定可能である、
請求項1に記載の組織開創器。 - 前記内リングの閉ループが、前記複数の円弧状部材に連結された複数の直線状部材によって更に構成されている、
請求項1に記載の組織開創器。 - 前記複数の円弧状部材と前記複数の直線状部材とによって構成された前記閉ループが、凸区間および凹区間を有している、
請求項9に記載の組織開創器。 - 前記複数の円弧状部材と前記複数の直線状部材とが、交互に、端と端で連結されている、
請求項9に記載の組織開創器。 - 組織開創器であって、
近位端から遠位端まで延びる器具アクセスチャンネルを形成する長さ方向軸線と、
外リングと、
4以上の部材を有している複数の部材を備えている内リングであって、該複数の部材が円弧状部材を備え、前記円弧状部材が一緒に連結され凸区間と凹区間を有している閉ループを構成し、前記複数の部材の一又は二以上の角度が、前記内リングの局所的長手方向軸線回りの前記複数の円弧状部材の回転により調整可能であり前記内リングの閉ループの凸区間と凹区間の形状を再成形する内リングと、
前記外リングと前記内リングとの間を延びる可撓性シースとを備え、
前記器具アクセスチャンネルが前記外リング、前記内リングおよび前記可撓性シースを通って延びている、
ことを特徴とする組織開創器。 - 前記複数の部材が更に直線状部材を備え、前記円弧状部材および前記直線状部材が端と端で一緒に連結され凸区間と凹区間とを有する閉ループを形成している、
請求項12に記載の組織開創器。 - 前記複数の部材の各々の長さが異なっていてもよい、
請求項12または13に記載の組織開創器。 - 前記複数の部材の各々の調整が隣接する他の部材の調整とは独立している、
請求項12または13に記載の組織開創器。 - 前記複数の部材の一又は二以上の配向が調整可能である、
請求項12または13に記載の組織開創器。 - 前記内リングに張力又は圧縮力を加えることによって前記内リングの配座が固定可能である、
請求項12または13に記載の組織開創器。
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JP6643125B2 (ja) | 2020-02-12 |
EP2473124A1 (en) | 2012-07-11 |
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AU2010286353A1 (en) | 2012-03-01 |
AU2010286353B2 (en) | 2015-09-03 |
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EP4248881A3 (en) | 2023-11-08 |
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US11510695B2 (en) | 2022-11-29 |
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US20200085467A1 (en) | 2020-03-19 |
EP4248881A2 (en) | 2023-09-27 |
EP2473124B1 (en) | 2020-02-12 |
WO2011026124A1 (en) | 2011-03-03 |
CA2771337A1 (en) | 2011-03-03 |
JP2013503022A (ja) | 2013-01-31 |
CA2771337C (en) | 2018-05-01 |
JP2020044364A (ja) | 2020-03-26 |
US9717522B2 (en) | 2017-08-01 |
ES2956272T3 (es) | 2023-12-18 |
JP7069100B2 (ja) | 2022-05-17 |
JP2022107609A (ja) | 2022-07-22 |
US20150320441A1 (en) | 2015-11-12 |
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