JPH0363376B2 - - Google Patents

Info

Publication number
JPH0363376B2
JPH0363376B2 JP60504501A JP50450185A JPH0363376B2 JP H0363376 B2 JPH0363376 B2 JP H0363376B2 JP 60504501 A JP60504501 A JP 60504501A JP 50450185 A JP50450185 A JP 50450185A JP H0363376 B2 JPH0363376 B2 JP H0363376B2
Authority
JP
Japan
Prior art keywords
fastener
assembly
component
actuator
shaft
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
JP60504501A
Other languages
English (en)
Other versions
JPS61501826A (ja
Inventor
Deiuitsudo Toomasu Guriin
Aanii Aranii
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
United States Surgical Corp
Original Assignee
United States Surgical Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by United States Surgical Corp filed Critical United States Surgical Corp
Publication of JPS61501826A publication Critical patent/JPS61501826A/ja
Publication of JPH0363376B2 publication Critical patent/JPH0363376B2/ja
Granted legal-status Critical Current

Links

Classifications

    • 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
    • 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
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2904—Details of shaft curved, but rigid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

請求の範囲 １ 最初は少なくとも１つの外科用留め具を収容
した留め具保持部品と、該留め具保持部品に対し
て移動でき、留めるべき組織を留め具保持部品か
ら少なくとも一部、クランプした組織を貫通して
アンビル部品まで押し進めるための第１の装置と
を有する末端に近い方の留め具付け組立体と、 第１の装置を作動するのに必要な仕事を行なう
第２の装置を有する基部に近い方の作動器組立体
と、 留め具付け組立体と作動器組立体とを連結し、
留め具付け組立体に対して支持し、そして、第２
の装置の行なう仕事を第１の装置に作動的に伝え
るための長さ方向シヤフト組立体と、 を有し、長さ方向シヤフト組立体は留め具付け組
立体を作動器組立体に対し、３本の互いに直交し
た軸線の各々のまわりに回転させるための継手を
有し、継手を除き、このシヤフト組立体は横方向
に剛性である、 ことを特徴とする外科用留め具付け装置。 ２ ３本の軸線は互いに共通点で交差することを
特徴とする請求の範囲第１項記載の外科用留め具
付け装置。 ３ 継手はボールを有し、該ボールはそれと補足
し合うソケツトの中に回転自在に設けられている
ことを特徴とする請求の範囲第２項記載の外科用
留め具付け装置。 ４ ボールおよびソケツトは、作動器組立体及び
留め具付け組立体が、これら組立体の移動相対位
置を保とうとするように互いに摩擦係合すること
を特徴とする請求の範囲第３項記載の外科用留め
具付け装置。 ５ 第２装置の行なう仕事は、シヤフト組立体の
第１の部材の基部に近い方の運動によつて第１の
装置に伝えられることを特徴とする請求の範囲第
１項記載の外科用留め具付け装置。 ６ 継手に長さ方向に隣接した第１の部材の部分
は、シヤフト組立体の長さ方向軸線に対して横に
撓むことができることを特徴とする請求の範囲第
５項記載の外科用留め具付け装置。 ７ 第１の装置留め具を末端の方向へ押し進め、
第１の装置は、第１の部材の基部に近い方の運動
をそれと釣り合つた留め具の末端の運動に変換す
るための第３の装置を有することを特徴とする請
求の範囲第５項記載の外科用留め具付け装置。 ８ 作動器組立体は、組織をクランプするために
アンビル部品を少なくとも一部留め具保持部品に
対して移動させるのに必要な仕事を行なう第４の
装置をさらに有し、シヤフト組立体は、アンビル
部品を留め具保持部品に対して移動させて組織ク
ランプするために第４の装置の行う仕事を留め具
付け組立体に作動的に伝えるための第２の部材を
有することを特徴とする請求の範囲第１項記載の
外科用留め具付け装置。 ９ 第４の装置の行なう仕事は、第２の部材の基
部に近い方の運動によつて留め具付け組立体に伝
えられることを特徴とする請求の範囲第８項記載
の外科用留め具付け装置。 １０ シヤフトが長さ方向に湾曲していることを
特徴とする請求の範囲第１項記載の外科用留め具
付け装置。 発明の背景 本発明は外科用留め具付け装置に関し、特に相
対的に動くことのできる留め具保持部品とアンビ
ル部品との間でクランプした身体組織に留め具を
付けるための装置に関する。 外科用留め具を相対的動くことのできる留め具
保持部品とアンビル部品との間でクランプした身
体組織に付けるための外科用留め具付け器具は、
種々知られている。例えばヒルシユ氏等の米国特
許第3275211号を参照されたい。外科用留め具は
ヒルシユ氏等の特許を示すように金属製外科用ホ
チキス針の形態を取つても良いし、或は、例えば
グリーン氏の米国特許4402445号に示すように最
初２つの部分の非金属製樹脂材料であつても良
い。金属製ホチキス針の場合、代表的にはホチキ
ス針の脚部を組織に打ち込みアンビルによつてこ
れら脚部を折り曲げてホチキス針を組織に留め
る。非金属製留め具の場合には、各留め具は当
初、２の別々の部品から成り、留め具部品は装置
の留め具保持部品の中に配置され、保持部品は装
置のアンビル部品の中に配置されている。留め具
部品の脚部は組織に打ち込まれて保持部品と相互
に係止し、それによつて留め具を組織に留める。
たいてい金属製外科用ホチキス針は生物学的には
不活性であり、したがつて組織内に恒久的にとど
まるけれども、生物学的に吸収性の金属製外科用
ホチキス針が知られている。非金属性樹脂材料の
外科用ホチキス針も又、生物学的に吸収性にする
か、或いは非吸収性にするかのどちらかにするこ
とができる。 採用する留め具の型式又は形態は本発明の一部
をなさない。種々の型式の留め具については、本
明細書で使用する「外科用留め具」という用語が
これら種々の型式の留め具の全てを総称するもの
とし、同様に本明細書で使用する「留め具保持部
品」、「アンビル部品」という用語が、これら種々
の型式の留め具の全てを付けるための器具を総称
するものとする。 留め具保持部品とアンビル部品との間でクラン
プした組織に外科用留め具を付けるための公知の
たいていの器具では、器具の末端の留め具付け組
立体（この留め具付け組立体は留め具保持部品及
びアンビル部品を有している）は、器具の基部に
近い方の作動器部分にしつかりと連結されてい
る。これは例えば、上記米国特許第3275211号及
び第4402445号に示す器具についてもあてはまる。 しかしながら、最近、留め具付け組立体と作動
器組立体との間の連結部が完全にはしつかりとし
ていないような器具に関心が高まつた。例えば、
ノイル氏等の米国特許第4473077号は、留め具付
け組立体と作動器組立体との間に連結されたシヤ
フト組立体が一平面（すなわち、ノイル氏等の米
国特許の第５図の紙面）において、横に撓むこと
ができるような外科用ホチキス針を示している。
これは、管状の身体器管の中に挿入されるように
なつたノイル氏等の米国特許に示す型式の器具で
は望まれる特徴である。かかる用途では、器具の
可撓性シヤフトは周囲の身体器管の曲率に順応す
る。しかしながら、通常、周囲の身体構造では支
持されない器具では（例えばヒルシユ氏等の米国
特許及びグリーン氏の米国特許に示す型式の器具
では）、留め具付け組立体と作動器組立体との間
の器具の可撓性が過度であると、留め具付け組立
体の位置を作動器組立体からは調節できず、ま
た、これら組立体の各々を、留められるべき組織
に器具を配置している間、別々に支持しなければ
ならない。これが意味することは、配置の際及び
取外しの際に器具を取り扱うためには２人の人間
が必要であるということである。 上記のことを考慮して、本発明の目的は、留め
具付け組立体が作動器組立体にしつかりとは連結
されていないけれども、留め具付け組立体の位置
を実質的に作動器組立体から調節することができ
るような上述の型式の外科用留め具付け装置を提
供することにある。 本発明のもう一つの目的は、留め具付け組立体
が作動器組立体にしつかりとは連結されていない
ような上述の型式の外科用留め具付け装置を改良
しかつ簡単にすることにある。 発明の概要 本発明のこれらの目的及びその他の目的は、本
発明の原理に従つて、留め具付け組立体が、ソケ
ツト内に回転自在に設けられたボールのような関
節部又は継手を有するシヤフト組立体により作動
器組立体に連結されているような外科用留め具付
け装置を提供することによつて達成される。継手
は好ましくは、留め具付け組立体の作動器組立体
とを３本の互いに直交した軸線の各々のまわりで
相対的に回転させることができる。継手を除き、
シヤフト組立体は好ましくは横方向に剛性であ
る。上記相対的な回転が可能ではあるけれども、
留め具保持組立体及び作動器組立体が、使用者に
より器具の形状が慎重に変えられるときを除い
て、それらの相対的な回転の向きを保とうとする
ほど継手を剛性にするのが良い。かくして、留め
具付け組立体の慎重な回転を除き、作動器組立体
を操作するだけで装置全体を位置決めすることが
できる。留め具付け組立体を別個に支持する必要
はない。 好ましい実施例では、作動器組立体は、留めら
れるべき組織を留め具保持部品とアンビル部品と
の間でクランプするように留め具保持部品とアン
ビル部品とを相対的に移動させるのに必要な少な
くとも或る種の仕事を行なう手動操作可能な装置
と、留め具をクランプされた組織に打ち込むのに
必要な仕事を行なう手動操作可能な装置とを有す
る。これらの装置の行なう仕事は、シヤフト組立
体の横に撓むことのできる部材（たとえばケーブ
ル）の基部に近い方の運動によつて留め具付け組
立体に伝えられる。これらの部材は好ましくは、
これらの部材が継手の作動を妨害しないようにシ
ヤフト組立体の継手を貫通する。 また、好ましい実施例では、留め具は留め具保
持部品から末端の方向へ押し進められ、留め具付
け組立体は、留め具を押し進めるのに必要な仕事
を伝えるシヤフト組立体部材の基部に近い方の運
動をそれと釣り合つた留め具の末端の運動に変換
するための装置を有する。 本発明の一層の特徴、その性質、および種々の
利点は添附図面および本発明の以下の詳細な説明
からもつと明らかになろう。
【図面の簡単な説明】
第１図は本発明の原理に沿つて変更しうる外科
用留め具付け装置の斜視図である。 第２図は第１図の装置の操作サイクルの最初の
段階を示す第１図の装置の一部断面の部分立面図
である。 第３図は操作サイクルの次の段階を示す第２図
と同様な図である。 第４図は第１図乃至第３図の装置の一部の分解
斜視図である。 第５図乃至第７図は第１図乃至第４図の装置の
種々の部分の分解斜視図である。 第８図は第１図乃至第７図の装置の操作サイク
ルの最初の段階を示す、装置の一部分の部分断面
立面図である。 第９図乃至第１２図は装置の操作サイクルの
次々の段階を示す第８図と同様な図である。 第１３図は本発明の変形例の斜視図である。 第１４図は本発明のもう１つの変形例を示す第
１０図と同様な図である。
【発明の詳細な説明】
第１図に示すように、本発明の変形しうる外科
用留め具付け器具１０の例示の実施例は基部に近
い方の作動器組立体２０と、末端の方の留め具付
け組立体２００と、中間のシヤフト組立体１００
とを有する。 留め具付け組立体２００は基部に近い方の留め
具保持部品２１０および末端の方のアンビル部品
２８０を有する。アンビル部品２８０は、留め具
保持部品２１０に対して一定の回動および並進運
動可能に取付けられ、従つてアンビル部品２８０
を第１図に実線で示すように、留め具保持部品２
１０から並進かつ回動させ、留めるべき組織１２
を留め具保持部品２１０の末端の方の表面とアン
ビル部品２８０の基部に近い方の表面との間に挿
入することができる。 留め具保持部品２１０は、シヤフト組立体の関
節即ち継手１５０をちようど越したところでシヤ
フト組立体１００の末端の方の端部に連結されて
いる。図示の実施例では、継手１５０は、球形ボ
ール１５２（第２図）を補足し合うソケツト１６
０に回転自在に取付けたものからなる。継手１５
０により、留め具付け組立体２００を、すべてボ
ール１５２の中心で交差する互に直交の３軸線１
０２，１０４，１０６の各々を中心に回転させ
る。留め具付け組立体２００のいくつかのありう
る位置を第１図に仮想線で示す。シヤフト組立体
１００の基部に近い膨の端部を、器具の長手方向
軸線である軸線１０２を中心に組立体１００およ
び２００が更に回転運動できるように作動器組立
体２０に回転自在に取付けても良い。継手１５０
および作動器組立体２０におけるシヤフト組立体
１００の回転取付け部以外、シヤフト組立体１０
０はその長手方向軸線に対して横方向に実質的に
剛性である。シヤフト組立体１００は又軸線１０
２の平行に実質的に剛性である。 作動器組立体２０は、基部に近い方のハンドル
３０と、手動操作可能なクランプ作動器レバー４
０と、手動操作可能な留め具作動器レバー６０と
を有する。作動器レバー４０を作動器組立体２０
の中へ下方に回動させると、アンビル部品２８０
の下方部分留め具保持部品２１０に向つて引張
る。留め具作動器レバー６０をハンドル３０に向
つて強く握ると、留め具保持部品２１０はこの部
品の中に収容されている外科用留め具をアンビル
部品２８０に向つて末端の方向に打ち込む。安全
掛け金９０を第３図に仮想線で示すように、レバ
ー６０から下方に回動させるまでは、留め具作動
器レバー６０を操作することができない。 本装置の構造をより詳細に考える前に、装置の
操作全体を概略的に説明することにする。装置の
最初の状態を第１図、第２図および第８図に示
す。留め具付け組立体２００を、所望ならば、軸
線１０２，１０４，１０６のうちの任意の１つを
中心に希望量だけ回転させて、留め具付け組立体
２００が作動器組立体２０に対して希望の角度向
きをもつようにする。継手１５０およびシヤフト
組立体１００と作動器組立体２０との間の回転連
結部は好ましくは十分に堅いから、装置の次の操
作中、組立体２０，２００は、これらが取るどん
な相対的角度向きをも維持する。 留めるべき組織１２はアンビル部品２８０と留
め具保持部品２１０との間に置かれる。アンビル
部品２８０の上方部分を第９図に示すように、留
め具保持部品２１０の対向した上方部分に向つて
手で移動させ、掛け金ボタン２１２を末端の方向
に手で押し、その結果、掛け金２１４がアンビル
部品２８０のキヤツチ２８２に係合する。これは
アンビル部品２８０の上方端を留め具保持部品２
１０の上方端に対して保持して組織をこれらの部
品間に締付け始める。 次の操作段階はクランプ作動器レバー４０を第
３図に示すように作動器組立体２０の中へ下向に
回動させることである。これは第３図および第１
０図に示すように、アンビル部品２８０の下方端
を留め具保持組立体２１０の下方端に向つて引き
込む。今や、部品２１０と２８０は互に実質的に
平行になつて組織１２をこれらの部品の対向表面
間にしつかりと締付ける。今や、組織は留められ
ようとしている。 留め具を付けるときには、安全掛け金９０を第
３図に仮想線で示すように下方に回動させる。次
いで、留め具作動器レバー６０を、これ又第３図
に仮想線で示すように、ハンドル３０に向つて回
動させる。これにより、留め具保持組立体２１０
は第１１図に示すように、複数の金属製外科用ホ
チキス針２０２の脚部を組織１２にそしてアンビ
ル部品２８０に向つて同時に或は実質的に同時に
打ち込む。アンビル部品２８０はホチキス針の脚
部の端を折り曲げてホチキス針を組織に固定す
る。（金属製ホチキス針がこの装置に採用されて
いるが、グリーンの米国特許第4402445号に示す
もののような２部品形プラスチツク留め具を変形
例として使用しうることは理解されよう）。今や、
組織留め手順は完了である。 留めた組織は第１２図に示すように、掛け金ボ
タン２１２を手で押し上げることによつて装置か
ら取り出される。これにより、掛け金２１４はキ
ヤツチ２８２を解放し、これにより、アンビル部
品２８０を留め具保持部品２１０から回動させ
る。今や、留めた組織を装置から取り出すことが
できる。 今、装置の内部構造および操作を先ず、第２図
を参照して説明すると、クランプ作動器レバー４
０は、ピボツトピン４２によつて作動器組立体フ
レーム２２に回動自在に連結されている。トグル
リンク４４の一端はピン４６によつてレバー４０
に回動自在に連結され、他端はピン４８によつて
スライド５０に回動自在に連結されている。スラ
イド５０はフレーム２２のスロツト２４に長手方
向往復運動可能に取付けられている（第４図も参
照）。レバー４０を第２図および第４図に示すよ
うに、作動器組立体２０の残部から外に回動させ
るときには、スライド５０はスロツト２４内の末
端の方の位置にある。レバー４０を第３図に示す
ように、作動器組立体２０の残部に向つて下方に
回動させるときには、スライド５０は、スロツト
２４の中で基部に近い方に移動する。レバー４０
を完全操作位置では、ピン４６はピン４２，４８
を通る直線を僅かに通り過ぎているから、レバー
４０は完全操作位置にとどまるようになる。 第１の横方向に撓む部材１１０の基部に近い方
の端はスライド５０に連結される。部材１１０は
金属ワイヤでも良いし或はケーブルでも良く、こ
こでは便宜上、部材１１０をケーブル１１０と稱
する。ケーブル１１０は、シヤフト組立体１００
の長さのほとんどの外側部材である中空管状シヤ
フト１２０を通過する。ケーブル１１０は又ボー
ル１５２の長手方向孔１５４（第７図）を通して
留め具付け組立体２００の中へ通る。ケーブル１
１０の末端の方の端はアンビル部品２８０に連結
される（第５図も参照）。従つて、レバー４０を
作動器組立体２０の残部に向つて下方に回動させ
るときには、ケーブル１１０はアンビル部品２８
０の下方端を留め具保持部品２１０に向つて引き
入れる。ケーブル１１０は横方向に撓むことがで
きるから、ケーブル１１０は継手１５０の回動を
干渉しない。又、ケーブル１１０は軸線１０２，
１０４，１０６の交点（第１図）を通過するか
ら、レバー４０の操作によつて張力状態を取ると
きでも、ケーブル１１０は組立体２０および２０
０の相対的な回転向きを変えない。 第２図に戻ると、留め具作動器レバー６０はピ
ン２６によつてフレーム２２に回動自在に連結さ
れている。安全掛け金９０もピン２８によつてハ
ンドル３０に回動自在に連結されている。第２の
横方向に撓む部材１１２の基部に近い方の端はア
ンカー１１４でフレーム２２に固定的に取付けら
れている。部材１１２はケーブル１１０と同様で
あるのが良く、従つてこれをケーブル１１２と稱
する。ケーブル１１２の基部に近い方の部分は、
軸６４によつてレバー６０に回転自在に取付けら
れているローラ６２のまわりを通る。ローラ６２
を通過した後、ケーブル１１２はシヤフト１２０
および継手１５０を末端方向に通過して留め具保
持部品２１０の中へ通る。第５図および第８図で
最も良くわかるように、ケーブル１１２が留め具
保持部品２１０に入るとき、ケーブル１１２はロ
ーラ２２０のまわりを通る。ローラ２２０はケー
ブル１１２をアンカー２２２まで向き変えし、こ
のアンカー２２２はケーブル１１２の末端の方の
端をカムバー２３０に連結する。従つて、レバー
６０をハンドル３０に向つて回動させるときに
は、ケーブル１１２はカムバー２３０を引き下げ
る。ケーブル１１０と同じように、ケーブル１１
２は軸線１０２，１０４，１０６の交点を通過
し、そして十分に横方向に撓むことができるの
で、ケーブル１１２は、レバー６０の操作によつ
て張力状態を取るときでも継手１５０の回動を干
渉せず、即ち、組立体２０と２００の相対的な回
転向きを変える。 カムバー２３０は、プツシヤ作動器部材２４０
の基部に近い方に向いた溝の中に配置されている
（第６図参照）。カムバー２３０の末端の方の面は
部材２４０のこの溝の底に当つてこの底に沿つて
摺動できる。プツシヤ作動器部材２４０は留め具
保持部品２１０の２つの平行な側方に間隔をへだ
てたフレーム部材２５０（第５図）間に配置され
ている。プツシヤ作動器部材２４０の末端の方の
表面はプツシヤ部材２６０の基部に近い方の端に
当り、プツシヤ部材２６０は、ホチキス針２０２
の後で、留め具ホルダ２７０の孔２７２の中へ延
びるプツシヤフインガ２６２を有している。プツ
シヤ作動器部材２４０は、プツシヤ部材２６０に
よつてホチキス針２０２が打ち込まれる軸線と実
質的に平行に移動するように構成されている。こ
の拘束は、部材２４０からフレーム部材２５０の
ガイドスロツト２５２の中へ側方かつ外方に延び
るガイドピン２４２によつて行なわれる。プツシ
ヤ作動器部材２４０も又ピン２４２を中心に回動
することができる。 カムバー２３０がケーブル１１２によつて引き
下げられると、カムバー２３０を貫通してフレー
ム部材２５０のカムスロツト２５４の中へ側方に
突出するカムホロワーピン２３２の作動でカムバ
ー２３０を末端の方向に強制的に移動させる。カ
ムスロツト２５４は傾斜しているから、カムバー
２３０がケーブル１１２の運動に応答して下方に
移動すると、カムバー２３０は末端方向にも移動
する。カムバー２３０はプツシヤ作動器部材２４
０に沿つて長手方向に摺動するから、カムバー２
３０の末端方向の運動だけが部材２４０に及ぼさ
れる。部材２４０が末端方向に移動すると、部材
２４０はプツシヤ部材２６０、従つてホチキス針
２０２を末端の方向に駆動する。かくして、要素
２３０，２３２，２４０，２４２，２５０，２５
２，２５４および２６０はケーブル１１２の末端
の方の端の下方運動をホチキス針２０２の末端方
向の運動に変換するための装置を構成する。 シヤフト組立体１００と作動器組立体２０の相
対的回転を可能にするこれらの組立体間の連結部
は第４図で最も良くわかる。シヤフト１２０の基
部に近い方の端は、作動器組立体２０の外側シエ
ルの２つの対象の半部７０ａ，７０ｂに形成され
ている円筒形ソケツト８０に回転自在に取付けら
れている。シエル半部７０は、リベツト、接着剤
等のような任意適当な手段で互に保持されてい
る。シヤフト１２０の環状カラー１２２はソケツ
ト８０の環状拡大部８２に受け入れられてシヤフ
ト１２０を作動器組立体２０に対して適確な長手
方向位置に保持する。所望ならば、作動器組立体
２０に対するシヤフト１２０の回転量をシヤフト
１２０のストツプ１２４と作動器組立体のシエル
７０のストツプ８４とによつて制限するのが良
い。シエル半部７０は好ましくは、シヤフト１２
０に十分な力で係合して装置の使用者が確立した
シヤフト１２０と作動器組立体２０の相対的な角
度向きを摩擦的に維持する。 継手１５０の詳細な構造を第７図に示す。中空
の一般的な截頭円錐形の脚部１５６の末端の方の
端にはボール１５２が形成されている。中空の円
筒形シヤンク１５８が脚部１５６の基部から基部
の方向に延びている。シヤンク１５８はシヤフト
１２０の末端の方の端に圧力嵌めされている。ボ
ール１５２はソケツト１６０にぴつたりと嵌り、
この構造は第９図でもつとも良くわかる。ソケツ
ト１６０は末端の方の座部材１６２を有し、座部
材１６２は軸２２４でローラ２２０を支持し、か
つピン１６４によつてフレーム部材２５０に固定
的に取付けられている（第７図）。座部材１６２
は中空であり、そして、ボール１５２の末端の方
の端部分を受け入れるための基部に近い方に向い
た環状座面１６６を有している。座部材１６２の
円筒形外表面の基部に近い方の部分はねじ山をも
つていてカラー１７０を受け入れる。カラー１７
０は環状保持リング１７２をボール１５２の表面
の基部に近い方の部分に押しつける。従つて、ボ
ール１５２は座表面１６６と保持リング１７２と
の間に保持されるが、軸線１０２，１０４，１０
６の各々を中心にこれらの部材に対して回転する
ことができる。表面１６６および１７２は好まし
くは、ボール１５２に十分な力で係合して組立体
２０と２００の相対的な角度向きが装置の使用者
によつてどんなに確立されても摩擦的に維持す
る。特に好ましい実施例では、ボール１５２はス
チールであり、部材１６２および１７２はナイロ
ンのような熱可塑性材料で作られる。 アンビル部品２８０は、フレーム部材２５０の
細長いスロツト２５６の中にあるピン２９０によ
つて留め具保持部品２１０に回動自在に連結され
ている。スロツト２５６は装置の長手方向軸線と
平行に細長く、従つて、アンビル部品２８０はピ
ン２９０を中心に回動することができるとともに
スロツト２５６と平行に並進することができる。
アンビル部品２８０は、アンビル部品２８０と留
め具保持部品２１０との間で圧縮される圧縮コイ
ルばね２９２によつて留め具保持部品２１０から
遠ざかるように弾性的に付勢されている。掛け金
２１４は、掛け金２１４と留め具保持部品２１０
の本体とに作用する圧縮コイルばね２１６によつ
て、例えば第８図に示すように、基部の方向に弾
性的に付勢されている。 第１３図は、シヤフト１２０が長さ方向に弯曲
している変形例を示す。その他の面では、第１３
図に示す実施例は第１図乃至第１２図に示す実施
例と同一であるのが良い。 第１４図は、シヤフト組立体１００が、第１図
乃至第１３図の実施例におけるように留め具付け
部品２１０の底ではなく留め具付け部品２１０の
ほぼ中心で終わつているもう１つの変形例を示し
ている。この実施例では、留め具付け部品２１０
に、ケーブル１１０をシヤフト組立体１００の長
さ方向軸線から留め具保持部品２１０の底に移送
するためのローラ２２６，２２８がさらに設けら
れている。その他の面では全て、第１４図の実施
例は第１図乃至第１２図の実施例か又は第１３図
の実施例のいづれかと同一であるのが良い。
JP60504501A 1984-10-19 1985-09-30 関節式外科用留め具付け装置 Granted JPS61501826A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/662,677 US4566620A (en) 1984-10-19 1984-10-19 Articulated surgical fastener applying apparatus
US662677 2000-09-15

Publications (2)

Publication Number Publication Date
JPS61501826A JPS61501826A (ja) 1986-08-28
JPH0363376B2 true JPH0363376B2 (ja) 1991-09-30

Family

ID=24658717

Family Applications (1)

Application Number Title Priority Date Filing Date
JP60504501A Granted JPS61501826A (ja) 1984-10-19 1985-09-30 関節式外科用留め具付け装置

Country Status (9)

Country Link
US (1) US4566620A (ja)
EP (1) EP0198874B1 (ja)
JP (1) JPS61501826A (ja)
AU (1) AU569403B2 (ja)
BR (1) BR8507001A (ja)
CA (1) CA1236745A (ja)
DE (1) DE3581199D1 (ja)
GB (1) GB2182882B (ja)
WO (1) WO1986002255A1 (ja)

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EP0198874A1 (en) 1986-10-29
GB2182882A (en) 1987-05-28
BR8507001A (pt) 1987-01-06
DE3581199D1 (de) 1991-02-07
JPS61501826A (ja) 1986-08-28
GB2182882B (en) 1988-05-25
AU569403B2 (en) 1988-01-28
EP0198874B1 (en) 1990-12-27
US4566620A (en) 1986-01-28
CA1236745A (en) 1988-05-17
WO1986002255A1 (en) 1986-04-24
EP0198874A4 (en) 1988-04-18
GB8615610D0 (en) 1986-07-30

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