JPH04256745A - 分離式アンビルを有する管腔内吻合用の外科用ステープラー - Google Patents
分離式アンビルを有する管腔内吻合用の外科用ステープラーInfo
- Publication number
- JPH04256745A JPH04256745A JP3271924A JP27192491A JPH04256745A JP H04256745 A JPH04256745 A JP H04256745A JP 3271924 A JP3271924 A JP 3271924A JP 27192491 A JP27192491 A JP 27192491A JP H04256745 A JPH04256745 A JP H04256745A
- Authority
- JP
- Japan
- Prior art keywords
- anvil
- head
- trocar
- tip
- sleeve
- 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.)
- Pending
Links
- 230000003872 anastomosis Effects 0.000 title abstract description 3
- 238000000926 separation method Methods 0.000 title 1
- 238000005452 bending Methods 0.000 claims description 3
- 238000000034 method Methods 0.000 description 6
- 230000008878 coupling Effects 0.000 description 4
- 238000010168 coupling process Methods 0.000 description 4
- 238000005859 coupling reaction Methods 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 230000013011 mating Effects 0.000 description 3
- 238000005520 cutting process Methods 0.000 description 2
- 230000000717 retained effect Effects 0.000 description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 238000007373 indentation Methods 0.000 description 1
- 238000005304 joining Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000003860 storage Methods 0.000 description 1
- 230000003874 surgical anastomosis Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- 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
-
- 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
-
- 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
- A61B2017/07257—Stapler heads characterised by its anvil
Abstract
(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。
め要約のデータは記録されません。
Description
【0001】
【発明の分野】本発明は外科用ステープル作業に関する
。より特別には、本発明は内部吻合ステープル作業に関
する。最も特別には、本発明は管腔、特に腸管の内部吻
合ステープル作業に関し、この場合、ステープルの円形
リングが所望の管腔に適用される。
。より特別には、本発明は内部吻合ステープル作業に関
する。最も特別には、本発明は管腔、特に腸管の内部吻
合ステープル作業に関し、この場合、ステープルの円形
リングが所望の管腔に適用される。
【0002】
【発明の背景】一般に、外科用ステープル作業は過去数
十年間に相当に進歩した。特に、内部吻合ステープル作
業の分野における進歩は劇的であった。本発明の譲受人
エチコン、インク(Ethicon,Inc.)、ニュ
ージャージー州サマービル、により製造されるプロキシ
メート(Proximate、商品名)ILSステープ
ラーのような用具は、これまで不可能ではないが困難で
あると認識されてきた手術及び処置を外科医が比較的容
易に行えるようにした。
十年間に相当に進歩した。特に、内部吻合ステープル作
業の分野における進歩は劇的であった。本発明の譲受人
エチコン、インク(Ethicon,Inc.)、ニュ
ージャージー州サマービル、により製造されるプロキシ
メート(Proximate、商品名)ILSステープ
ラーのような用具は、これまで不可能ではないが困難で
あると認識されてきた手術及び処置を外科医が比較的容
易に行えるようにした。
【0003】外科的吻合用ステープル作業においては、
一般に、2個の管腔組織がステープルのリングにより接
合される。この処置中に、環状リング内に保持された組
織を分離させるために環状のナイフ刃が使用される。次
いで環状リングがステープラーと共に除去され、管腔内
の環状開口が外科的ステープル作業線に沿って完成され
る。
一般に、2個の管腔組織がステープルのリングにより接
合される。この処置中に、環状リング内に保持された組
織を分離させるために環状のナイフ刃が使用される。次
いで環状リングがステープラーと共に除去され、管腔内
の環状開口が外科的ステープル作業線に沿って完成され
る。
【0004】しかし、これらの外科的処置を行うときは
、ステープルの端部を曲げるアンビルヘッドをステープ
ルが打ち出されるステープル作業部分から分離すること
が望ましいことがある。この方針に沿った進歩が過去に
なされた。過去においては、組織を巾着(きんちゃく)
状に集めるので、機構のステープル作業する側にアンビ
ル部分のヘッドを取り付けることが普通であった。
、ステープルの端部を曲げるアンビルヘッドをステープ
ルが打ち出されるステープル作業部分から分離すること
が望ましいことがある。この方針に沿った進歩が過去に
なされた。過去においては、組織を巾着(きんちゃく)
状に集めるので、機構のステープル作業する側にアンビ
ル部分のヘッドを取り付けることが普通であった。
【0005】更に、ステープラーのヘッド部分に収容さ
れた組織がステープラーのアンビル部分に収容された組
織に接合されたときに、アンビル側に備えられたアンビ
ルにステープルが適正に揃うようにして、アンビルとヘ
ッドとを連結することが困難であることが見出だされた
。
れた組織がステープラーのアンビル部分に収容された組
織に接合されたときに、アンビル側に備えられたアンビ
ルにステープルが適正に揃うようにして、アンビルとヘ
ッドとを連結することが困難であることが見出だされた
。
【0006】更に、ヘッド寸法を、外側で最小であり、
かつより多くの組織が吻合ステープル内に集められるよ
うに最大の内部空間に保つような円形ステープラー内で
、ステープル作業を行うことが困難であることが見出だ
された。
かつより多くの組織が吻合ステープル内に集められるよ
うに最大の内部空間に保つような円形ステープラー内で
、ステープル作業を行うことが困難であることが見出だ
された。
【0007】また、集められ、ステープラーヘッドの比
較的鋭い套管針先端部で穿孔される組織を有することが
本発明の一部として望ましいが、鋭い套管針先端部を常
に露出させることはステープラーヘッドにとって常に望
ましいことではない。そうではなくて、より望ましい特
徴は接合処置の際にのみ、鋭い先端部が露出されること
である点が見出だされた。
較的鋭い套管針先端部で穿孔される組織を有することが
本発明の一部として望ましいが、鋭い套管針先端部を常
に露出させることはステープラーヘッドにとって常に望
ましいことではない。そうではなくて、より望ましい特
徴は接合処置の際にのみ、鋭い先端部が露出されること
である点が見出だされた。
【0008】
【発明の概要】従って、ステープル作業部分に連結可能
な分離可能式のアンビル部分及び用具のステープル作業
部分における用具と一体式の套管針がある、吻合ステー
プル作業用の外科用ステープラーを提供することが本発
明の目的である。
な分離可能式のアンビル部分及び用具のステープル作業
部分における用具と一体式の套管針がある、吻合ステー
プル作業用の外科用ステープラーを提供することが本発
明の目的である。
【0009】組織の巾着吻合に有利なように延長管を有
するアンビル部分を提供することが本発明の別の目的で
ある。
するアンビル部分を提供することが本発明の別の目的で
ある。
【0010】アンビル部分とヘッドのステープル又は軸
のステープル作業部分とを揃える整列機構を提供するこ
とが本発明の更に別の目的である。
のステープル作業部分とを揃える整列機構を提供するこ
とが本発明の更に別の目的である。
【0011】一体式套管針の先端部により軸のアンビル
部分を組み合わせる手段を提供することが本発明のなお
別の目的である。
部分を組み合わせる手段を提供することが本発明のなお
別の目的である。
【0012】軸のアンビル部分への連結時、又は巾着縫
合中を除いて套管針先端部を遮蔽する手段を提供するこ
とが本発明のなお別の目的である。
合中を除いて套管針先端部を遮蔽する手段を提供するこ
とが本発明のなお別の目的である。
【0013】本発明のこれ等及びその他の目的は、ステ
ープルが用具のヘッド部分からアンビル部分内に射出さ
れる外科用ステープル用具において説明される。アンビ
ル部分はヘッド部分から取り外し可能であり、ヘッド部
分は套管針先端部を収容し、その上にアンビルが取り付
けられる。アンビル部分は細長いスリーブを備え、これ
は套管針先端部が通過する開口を持つ。アンビル部分の
鎖錠機構と組み合わせうる手段が套管針先端部上にある
。アンビル部分を用具のヘッド部分のステープルと揃え
る整列手段が備えられる。巾着状に集められた組織への
挿入、又は套管針先端部上へのアンビル軸の挿入の際に
先端部が露出するように、後退可能なばね負荷式のスリ
ーブを套管針先端部に備えることもできる。
ープルが用具のヘッド部分からアンビル部分内に射出さ
れる外科用ステープル用具において説明される。アンビ
ル部分はヘッド部分から取り外し可能であり、ヘッド部
分は套管針先端部を収容し、その上にアンビルが取り付
けられる。アンビル部分は細長いスリーブを備え、これ
は套管針先端部が通過する開口を持つ。アンビル部分の
鎖錠機構と組み合わせうる手段が套管針先端部上にある
。アンビル部分を用具のヘッド部分のステープルと揃え
る整列手段が備えられる。巾着状に集められた組織への
挿入、又は套管針先端部上へのアンビル軸の挿入の際に
先端部が露出するように、後退可能なばね負荷式のスリ
ーブを套管針先端部に備えることもできる。
【0014】本発明の目的は、本発明の詳細な説明に関
連して図面を考慮したとき、より明らかとなるであろう
。
連して図面を考慮したとき、より明らかとなるであろう
。
【0015】
図1に見られるように、ヘッド20、アンビル30、調
整ねじ40、及びトリガー50を備えたステープラー1
0が明らかにされる。トリガー50は、安全装置55が
解除されたとき、ステープラー10を機能させるように
作用する。トリガー50が作動させられると、図示され
ない作動開始機構が軸25内で作動し、ヘッド20から
ステープルが発射される。これ等ステープルはアンビル
30のヘッド31の回りに周囲方向に配されたアンビル
34により端部が曲げられる。 同時に、ヘッド20内に保持されたナイフがアンビル3
4間で縫合された組織の周囲の内部に保たれた組織を切
断するように作動する。この方法において、環状の管腔
は軸により引っ張られ、そしてステープラー10の回り
に閉鎖組織を残す。次いで、ステープラー10は、縫合
された組織を残して適正な位置に組織を通って引かれる
。
整ねじ40、及びトリガー50を備えたステープラー1
0が明らかにされる。トリガー50は、安全装置55が
解除されたとき、ステープラー10を機能させるように
作用する。トリガー50が作動させられると、図示され
ない作動開始機構が軸25内で作動し、ヘッド20から
ステープルが発射される。これ等ステープルはアンビル
30のヘッド31の回りに周囲方向に配されたアンビル
34により端部が曲げられる。 同時に、ヘッド20内に保持されたナイフがアンビル3
4間で縫合された組織の周囲の内部に保たれた組織を切
断するように作動する。この方法において、環状の管腔
は軸により引っ張られ、そしてステープラー10の回り
に閉鎖組織を残す。次いで、ステープラー10は、縫合
された組織を残して適正な位置に組織を通って引かれる
。
【0016】図1、2及び7に見えるように、この環状
管腔用ステープラーには本発明を形成する種々の機構が
ある。より特別には、図1及び2に見られるように、套
管針先端部26を収容している套管針軸22が明らかに
される。この套管針軸22は、ヘッド部分20に一体式
に収容され、組織の穿刺ができる。この套管針軸22は
、往復してヘッド20に出入りするスリーブ24により
囲まれる。スリーブ24はばね23によりヘッド20上
に保持され、このばねは弾性を有し套管針軸22の回り
でのスリーブ24の往復を許す。
管腔用ステープラーには本発明を形成する種々の機構が
ある。より特別には、図1及び2に見られるように、套
管針先端部26を収容している套管針軸22が明らかに
される。この套管針軸22は、ヘッド部分20に一体式
に収容され、組織の穿刺ができる。この套管針軸22は
、往復してヘッド20に出入りするスリーブ24により
囲まれる。スリーブ24はばね23によりヘッド20上
に保持され、このばねは弾性を有し套管針軸22の回り
でのスリーブ24の往復を許す。
【0017】図3及び11に見られるように、套管針軸
22は全体的にスリーブ24で覆われ、従って巾着状に
された組織はスリーブ24の上に置かれる。それにもか
かわらず、套管針先端部26は、圧力が加えられると組
織を通して穿孔できる。これは、巾着状にされた組織の
接合の際に特に有利である。この方法で、露出先端部2
6を有する套管針スリーブ24は、巾着状組織を破断し
ないように巾着状組織を強制通過できる。套管針スリー
ブが組織に圧入された後で、それ以上に損害を与えない
ように、スリーブ24は套管針先端部26を取り囲み、
管腔はスリーブ24上に適切に付着できる。
22は全体的にスリーブ24で覆われ、従って巾着状に
された組織はスリーブ24の上に置かれる。それにもか
かわらず、套管針先端部26は、圧力が加えられると組
織を通して穿孔できる。これは、巾着状にされた組織の
接合の際に特に有利である。この方法で、露出先端部2
6を有する套管針スリーブ24は、巾着状組織を破断し
ないように巾着状組織を強制通過できる。套管針スリー
ブが組織に圧入された後で、それ以上に損害を与えない
ように、スリーブ24は套管針先端部26を取り囲み、
管腔はスリーブ24上に適切に付着できる。
【0018】套管針部分24に対応してアンビル部分3
0がある。アンビル30上には、アンビルヘッド31の
回りに周囲方向に配されたアンビル34が設けられる。 これ等アンビル34は、ヘッド20内に周囲方向に保持
されたステープルに対応する。図3において注意される
ように、アンビル30は組織の管腔内に置くことができ
、このとき組織は軸32の回りで巾着状にされる。
0がある。アンビル30上には、アンビルヘッド31の
回りに周囲方向に配されたアンビル34が設けられる。 これ等アンビル34は、ヘッド20内に周囲方向に保持
されたステープルに対応する。図3において注意される
ように、アンビル30は組織の管腔内に置くことができ
、このとき組織は軸32の回りで巾着状にされる。
【0019】アンビル30内に、図8に更に明らかにさ
れる整列機構が収容される。図8に見られるように、ア
ンビルヘッド31内にセレーション29がある。これら
のセレーションは套管針26の先端部内の刻み目又は凹
み28に対応する。アンビル30が套管針軸22上に置
かれたとき、セレーション29は対応する凹み28を見
出だし、従ってヘッド20の回りに周囲方向に置かれた
ステープルとアンビル34とを揃えることができる。
れる整列機構が収容される。図8に見られるように、ア
ンビルヘッド31内にセレーション29がある。これら
のセレーションは套管針26の先端部内の刻み目又は凹
み28に対応する。アンビル30が套管針軸22上に置
かれたとき、セレーション29は対応する凹み28を見
出だし、従ってヘッド20の回りに周囲方向に置かれた
ステープルとアンビル34とを揃えることができる。
【0020】更に、ヘッドにアンビルを鎖錠及び解除さ
せる独特の方法が明らかにされる。より特別には、図2
及び7に見られるように、レリーズ36は、アンビル3
0のヘッド31に解除ばね36aにより保持されたボタ
ン状のレバーより形成される。このレリーズはくさび3
5を有し、これは図10に見られるように中央の整列固
定用クリップ39bを強制開口させる。この固定用クリ
ップは整列用クリップ39aの間に押し込まれる。これ
等クリップ39a、39bの各は、中央部に丸く空けら
れた套管針用の孔37b、及びヘッド31のピン37と
適合する穴37aを持つ。
せる独特の方法が明らかにされる。より特別には、図2
及び7に見られるように、レリーズ36は、アンビル3
0のヘッド31に解除ばね36aにより保持されたボタ
ン状のレバーより形成される。このレリーズはくさび3
5を有し、これは図10に見られるように中央の整列固
定用クリップ39bを強制開口させる。この固定用クリ
ップは整列用クリップ39aの間に押し込まれる。これ
等クリップ39a、39bの各は、中央部に丸く空けら
れた套管針用の孔37b、及びヘッド31のピン37と
適合する穴37aを持つ。
【0021】套管針22の套管針先端部26は、中央に
設けられた穴37bに通過適合できる。アンビル30を
ヘッド20上に固定したいときは、全体的にばねにされ
た固定用クリップ39bが強制開口され、次いで套管針
先端部22の刻み目又はリッジ21の回りで閉鎖される
。これは図8及び10に最もよく見られる。アンビル3
0を開口しこれを套管針軸から分離したいときは、くさ
び35が固定用クリップ39bの股を開くようにレリー
ズ36の力を加える。クリップ39bの穴37bは、整
列クリップ39aの各の穴37bと同じ寸法になる。 この方法で軸をアンビル軸32から滑り出させることが
できる。
設けられた穴37bに通過適合できる。アンビル30を
ヘッド20上に固定したいときは、全体的にばねにされ
た固定用クリップ39bが強制開口され、次いで套管針
先端部22の刻み目又はリッジ21の回りで閉鎖される
。これは図8及び10に最もよく見られる。アンビル3
0を開口しこれを套管針軸から分離したいときは、くさ
び35が固定用クリップ39bの股を開くようにレリー
ズ36の力を加える。クリップ39bの穴37bは、整
列クリップ39aの各の穴37bと同じ寸法になる。 この方法で軸をアンビル軸32から滑り出させることが
できる。
【0022】しかし、通常は、固定用クリップ39bを
形成するばねは、一般に、これが刻み目又はリッジ21
内に適合する小さな位置又は「閉鎖」位置にあるように
強制される。刻み目21は固定用クリップ39bを保持
し、アンビル30はヘッド20内に収容された套管針2
2に適切に固定される。
形成するばねは、一般に、これが刻み目又はリッジ21
内に適合する小さな位置又は「閉鎖」位置にあるように
強制される。刻み目21は固定用クリップ39bを保持
し、アンビル30はヘッド20内に収容された套管針2
2に適切に固定される。
【0023】従って、手術の際は、図3、4、5及び6
に見られるように、それぞれ軸22及び筒状のアンビル
延長部32の両者に取り付けられた2個の管腔が外科処
置のため準備される。図4に見られるように、套管針先
端部26が露出されアンビル延長部32内に適合するよ
うにアンビル30が軸22上に置かれる。スリーブ24
は、露出位置に押され、ヘッド20内に差し込まれる。 整列クリップ39a及び固定用クリップ39bの穴37
bが、套管針を延長部32を通してアンビルヘッド31
内に案内する。套管針がアンビルヘッド31内に適切に
置かれると、くさび状のばねを備えた固定用クリップ3
9bが開かれ刻み目21の回りをつかむ。凹み28は軸
31のセレーション29とそれ自体で一致するので、ア
ンビル34はヘッド20に収容されたステープルと確実
に揃えられる。図7によく見られるように、アンビルヘ
ッド31が延長部32に連結されたときボス31aは穴
32a内に正確に置かれるので、製造中、セレーション
29はアンビル34と揃う。本装置は、図5におけるよ
うに、2個の類似した管腔片のように見える。調整ねじ
40が組織を互いに近付けるように引っ張る。
に見られるように、それぞれ軸22及び筒状のアンビル
延長部32の両者に取り付けられた2個の管腔が外科処
置のため準備される。図4に見られるように、套管針先
端部26が露出されアンビル延長部32内に適合するよ
うにアンビル30が軸22上に置かれる。スリーブ24
は、露出位置に押され、ヘッド20内に差し込まれる。 整列クリップ39a及び固定用クリップ39bの穴37
bが、套管針を延長部32を通してアンビルヘッド31
内に案内する。套管針がアンビルヘッド31内に適切に
置かれると、くさび状のばねを備えた固定用クリップ3
9bが開かれ刻み目21の回りをつかむ。凹み28は軸
31のセレーション29とそれ自体で一致するので、ア
ンビル34はヘッド20に収容されたステープルと確実
に揃えられる。図7によく見られるように、アンビルヘ
ッド31が延長部32に連結されたときボス31aは穴
32a内に正確に置かれるので、製造中、セレーション
29はアンビル34と揃う。本装置は、図5におけるよ
うに、2個の類似した管腔片のように見える。調整ねじ
40が組織を互いに近付けるように引っ張る。
【0024】図6に見られるように、ステープルは組織
を貫いてアンビル内に打ち込まれる。ステープルの端部
が曲げられると、組織を切断するナイフがステープルの
周囲内を保持する。この切断が行なわれると、ステープ
ラー10は管腔を通ってヘッド20の方向に引かれ、内
側に筒状開口を有し周囲の閉鎖された管腔が創成される
。
を貫いてアンビル内に打ち込まれる。ステープルの端部
が曲げられると、組織を切断するナイフがステープルの
周囲内を保持する。この切断が行なわれると、ステープ
ラー10は管腔を通ってヘッド20の方向に引かれ、内
側に筒状開口を有し周囲の閉鎖された管腔が創成される
。
【0025】ステープラー10の除去後に、ステープラ
ー10内に保持された余分の管腔が処分される。図2及
び10に見られるように、アンビル30のレリーズ36
が押される。これにより、図9に見られるような固定さ
れた機構は図7に示されるように開かれる。この時、固
定用クリップ39bが開口し、使用者はアンビル軸32
をステープラーヘッド20から滑らせることができる。 この方法で、アンビル30及びヘッド20内に保持され
た組織を除去できる。
ー10内に保持された余分の管腔が処分される。図2及
び10に見られるように、アンビル30のレリーズ36
が押される。これにより、図9に見られるような固定さ
れた機構は図7に示されるように開かれる。この時、固
定用クリップ39bが開口し、使用者はアンビル軸32
をステープラーヘッド20から滑らせることができる。 この方法で、アンビル30及びヘッド20内に保持され
た組織を除去できる。
【0026】この方法により、適正な巾着縫合と套管針
22による穿孔、凹み28とセレーション29との整列
、アンビルヘッド31の引っ張り、刻み目21の回りの
クリップ39bの固定、及び組織の適正なクリップ作業
と切断が行なわれた。従って、以下の実施態様及びこれ
らに相当する事項が本発明の範囲を包含することが現実
化された。
22による穿孔、凹み28とセレーション29との整列
、アンビルヘッド31の引っ張り、刻み目21の回りの
クリップ39bの固定、及び組織の適正なクリップ作業
と切断が行なわれた。従って、以下の実施態様及びこれ
らに相当する事項が本発明の範囲を包含することが現実
化された。
【0027】本発明の実施態様につき説明すれば次の通
りである。
りである。
【0028】1.ステープルがヘッド部分からアンビル
部分に推進され、前記アンビル部分は前記ヘッド部分よ
り取り外し可能であり、前記ヘッド部分は上に前記アン
ビルが取り付けられる套管針先端部を有する外科用ステ
ープル作業用具。
部分に推進され、前記アンビル部分は前記ヘッド部分よ
り取り外し可能であり、前記ヘッド部分は上に前記アン
ビルが取り付けられる套管針先端部を有する外科用ステ
ープル作業用具。
【0029】2.前記アンビル部分が細長いスリーブを
有し、前記スリーブは前記套管針先端部が通過して置か
れる開口を有する実施態様1の用具。
有し、前記スリーブは前記套管針先端部が通過して置か
れる開口を有する実施態様1の用具。
【0030】3.前記アンビル部分は前記套管針先端部
と組み合いうる鎖錠機構を有する実施態様1の用具。
と組み合いうる鎖錠機構を有する実施態様1の用具。
【0031】4.前記鎖錠機構は更に前記アンビル部分
を前記套管針先端部から解放させうる解除機構を有する
実施態様3の用具。
を前記套管針先端部から解放させうる解除機構を有する
実施態様3の用具。
【0032】5.前記套管針先端部は前記鎖錠機構と組
み合いうる結合手段を有する実施態様3の用具。
み合いうる結合手段を有する実施態様3の用具。
【0033】6.前記鎖錠機構は前記套管針の回りに組
み合いうるばね負荷式のクリップである実施態様3の用
具。
み合いうるばね負荷式のクリップである実施態様3の用
具。
【0034】7.前記套管針は周囲に前記鎖錠機構が組
み合いうる刻み目の付けられたリッジを有する実施態様
3の用具。
み合いうる刻み目の付けられたリッジを有する実施態様
3の用具。
【0035】8.前記套管針先端部がばね負荷式のスリ
ーブにより保護され、前記スリーブは前記アンビル部分
の細長いスリーブが前記套管針の上に挿入されたとき前
記先端部を露出するように後退しうる実施態様2の用具
。
ーブにより保護され、前記スリーブは前記アンビル部分
の細長いスリーブが前記套管針の上に挿入されたとき前
記先端部を露出するように後退しうる実施態様2の用具
。
【0036】9.前記アンビル部分は前記細長いスリー
ブに連結されたアンビルヘッドを有し、前記アンビルヘ
ッドは内径の回りに半径方向に配された多数のリブを有
し、更に前記套管針は前記先端部の回りに半径方向に配
された多数の溝を有し、前記細長いスリーブ及び前記ヘ
ッド内への前記先端部の挿入時には前記溝が前記リブと
揃う実施態様2の用具。
ブに連結されたアンビルヘッドを有し、前記アンビルヘ
ッドは内径の回りに半径方向に配された多数のリブを有
し、更に前記套管針は前記先端部の回りに半径方向に配
された多数の溝を有し、前記細長いスリーブ及び前記ヘ
ッド内への前記先端部の挿入時には前記溝が前記リブと
揃う実施態様2の用具。
【0037】10.ステープルがヘッド部分からアンビ
ル部分に推進され、前記アンビル部分は前記ヘッド部分
より取り外し可能であり、前記ヘッド部分は上に前記ア
ンビルが取り付けられる套管針先端部を有しかつ前記套
管針先端部は細長いスリーブにより保護され、前記スリ
ーブは前記套管針に前記アンビルを取り付けるために前
記スリーブに力を加えたときに前記先端部が露出するよ
うにばねに連結される外科用ステープル作業用具。
ル部分に推進され、前記アンビル部分は前記ヘッド部分
より取り外し可能であり、前記ヘッド部分は上に前記ア
ンビルが取り付けられる套管針先端部を有しかつ前記套
管針先端部は細長いスリーブにより保護され、前記スリ
ーブは前記套管針に前記アンビルを取り付けるために前
記スリーブに力を加えたときに前記先端部が露出するよ
うにばねに連結される外科用ステープル作業用具。
【0038】11.前記套管針先端部は前記套管針に連
結された前記アンビルと共に前記用具のヘッド部分内に
後退可能である実施態様10の用具。
結された前記アンビルと共に前記用具のヘッド部分内に
後退可能である実施態様10の用具。
【0039】12.前記アンビル部分は細長いスリーブ
を有し、前記スリーブは前記套管針先端部が通過して置
かれる開口を有する実施態様11の用具。
を有し、前記スリーブは前記套管針先端部が通過して置
かれる開口を有する実施態様11の用具。
【0040】13.前記アンビル部分は前記套管針先端
部と組み合いうる鎖錠機構を有する実施態様11の用具
。
部と組み合いうる鎖錠機構を有する実施態様11の用具
。
【0041】14.前記鎖錠機構は更に前記アンビル部
分を前記套管針先端部から解放するようにできる解除手
段を有する実施態様13の用具。
分を前記套管針先端部から解放するようにできる解除手
段を有する実施態様13の用具。
【0042】15.前記套管針先端部は前記鎖錠機構と
組み合いうる結合手段を有する実施態様13の用具。
組み合いうる結合手段を有する実施態様13の用具。
【0043】16.前記鎖錠機構は前記套管針の回りと
組み合いうるばね負荷式のクリップである実施態様13
の用具。
組み合いうるばね負荷式のクリップである実施態様13
の用具。
【0044】17.前記套管針は周囲に前記鎖錠機構が
組み合いうる刻み目の付けられたリッジを有する軸を備
える実施態様13の用具。
組み合いうる刻み目の付けられたリッジを有する軸を備
える実施態様13の用具。
【0045】18.前記アンビル部分は前記細長いスリ
ーブに連結されたアンビルヘッドを有し、前記アンビル
ヘッドは内径の回りに半径方向に配された多数のリブを
有し、更に前記套管針は前記先端部の回りに半径方向に
配された多数の溝を有し、前記先端部が前記細長いスリ
ーブ及び前記ヘッドの中に挿入されたとき前記溝と前記
リブとが揃う実施態様13の用具。
ーブに連結されたアンビルヘッドを有し、前記アンビル
ヘッドは内径の回りに半径方向に配された多数のリブを
有し、更に前記套管針は前記先端部の回りに半径方向に
配された多数の溝を有し、前記先端部が前記細長いスリ
ーブ及び前記ヘッドの中に挿入されたとき前記溝と前記
リブとが揃う実施態様13の用具。
【0046】19.ステープルがヘッド部分からアンビ
ル部分に推進され、前記アンビル部分は前記ヘッド部分
より取り外し可能であり、前記ヘッド部分は上に前記ア
ンビルが取り付けられる套管針先端部を有し、更に前記
アンビル部分は前記套管針先端部と組み合うことができ
かつ前記アンビルを前記先端部に解放可能に組み合わせ
て保持するように機能する鎖錠手段を有し、前記鎖錠機
構が解放せず前記先端部に取り付けられた前記アンビル
を前記ヘッド内に保持するように前記アンビル及び先端
部が一緒に前記ヘッドに後退できる外科用ステープル作
業用具。
ル部分に推進され、前記アンビル部分は前記ヘッド部分
より取り外し可能であり、前記ヘッド部分は上に前記ア
ンビルが取り付けられる套管針先端部を有し、更に前記
アンビル部分は前記套管針先端部と組み合うことができ
かつ前記アンビルを前記先端部に解放可能に組み合わせ
て保持するように機能する鎖錠手段を有し、前記鎖錠機
構が解放せず前記先端部に取り付けられた前記アンビル
を前記ヘッド内に保持するように前記アンビル及び先端
部が一緒に前記ヘッドに後退できる外科用ステープル作
業用具。
【0047】20.前記アンビル部分は細長いスリーブ
を有し、前記スリーブは前記套管針先端部が通過して置
かれる開口を有する実施態様19の用具。
を有し、前記スリーブは前記套管針先端部が通過して置
かれる開口を有する実施態様19の用具。
【0048】21.前記鎖錠機構は更に前記アンビル部
分を前記套管針先端部から解放しうる解除機構を有する
実施態様19の用具。
分を前記套管針先端部から解放しうる解除機構を有する
実施態様19の用具。
【0049】22.前記套管針先端部は前記鎖錠機構と
組み合いうる結合手段を有する実施態様19の用具。
組み合いうる結合手段を有する実施態様19の用具。
【0050】23.前記鎖錠機構は前記套管針の回りと
組み合いうるばね負荷式のクリップである実施態様19
の用具。
組み合いうるばね負荷式のクリップである実施態様19
の用具。
【0051】24.前記套管針は周囲に前記鎖錠機構が
組み合いうる刻み目の付けられたリッジを有する軸を備
える実施態様19の用具。
組み合いうる刻み目の付けられたリッジを有する軸を備
える実施態様19の用具。
【0052】25.前記套管針先端部はばね負荷式のス
リーブにより保護され、前記スリーブは前記アンビル部
分の細長いスリーブが前記套管針の上に挿入されたとき
前記先端部を露出させるように後退しうる実施態様19
の用具。
リーブにより保護され、前記スリーブは前記アンビル部
分の細長いスリーブが前記套管針の上に挿入されたとき
前記先端部を露出させるように後退しうる実施態様19
の用具。
【0053】26.前記アンビル部分は前記細長いスリ
ーブに連結されたアンビルヘッドを有し、前記アンビル
ヘッドは内径の回りに半径方向に配された多数のリブを
有し、更に前記套管針は前記先端部の回りに半径方向に
配された多数の溝を備え、前記先端部が前記細長いスリ
ーブ及び前記ヘッドの中に挿入されたとき前記溝と前記
リブとが揃う実施態様13の用具。
ーブに連結されたアンビルヘッドを有し、前記アンビル
ヘッドは内径の回りに半径方向に配された多数のリブを
有し、更に前記套管針は前記先端部の回りに半径方向に
配された多数の溝を備え、前記先端部が前記細長いスリ
ーブ及び前記ヘッドの中に挿入されたとき前記溝と前記
リブとが揃う実施態様13の用具。
【0054】27.前記先端部は前記ヘッド部分を通っ
て前記先端部と連結された後退手段の作動により前記ヘ
ッド内に後退しうる実施態様19の用具。
て前記先端部と連結された後退手段の作動により前記ヘ
ッド内に後退しうる実施態様19の用具。
【0055】28.前記後退手段は前記アンビルを前記
ヘッドにねじ止めするために取り付けられたねじ機構を
回転させる実施態様27の用具。
ヘッドにねじ止めするために取り付けられたねじ機構を
回転させる実施態様27の用具。
【0056】29.前記解除機構は前記ばね負荷式のク
リップのグループを前記套管針の回りから解放するよう
に作動しうる手動操作式のくさびを有する実施態様21
の用具。
リップのグループを前記套管針の回りから解放するよう
に作動しうる手動操作式のくさびを有する実施態様21
の用具。
【0057】30.ステープルがヘッド部分からステー
プルの端部を曲げるアンビルを有するアンビル部分に推
進され、前記アンビル部分は前記ヘッド部分より取り外
し可能であり、前記ヘッド部分は整列手段を有しかつ上
に前記アンビルが取り付けられる套管針先端部を有し、
更に前記アンビル部分は細長いスリーブに取り付けられ
たアンビルヘッドを有し、更に前記アンビルヘッドは前
記アンビルヘッド内の半径方向位置に置かれた多数のリ
ブを有し、前記リブは前記套管針先端部の整列手段と揃
う外科用ステープル作業用具。
プルの端部を曲げるアンビルを有するアンビル部分に推
進され、前記アンビル部分は前記ヘッド部分より取り外
し可能であり、前記ヘッド部分は整列手段を有しかつ上
に前記アンビルが取り付けられる套管針先端部を有し、
更に前記アンビル部分は細長いスリーブに取り付けられ
たアンビルヘッドを有し、更に前記アンビルヘッドは前
記アンビルヘッド内の半径方向位置に置かれた多数のリ
ブを有し、前記リブは前記套管針先端部の整列手段と揃
う外科用ステープル作業用具。
【0058】31.前記整列手段は前記リブが前記溝の
中に挿入されたとき前記ステープルが前記アンビル部分
の前記アンビルと揃えられるように前記リブと組み合い
うる多数の溝を有する実施態様30の用具。
中に挿入されたとき前記ステープルが前記アンビル部分
の前記アンビルと揃えられるように前記リブと組み合い
うる多数の溝を有する実施態様30の用具。
【0059】32.前記スリーブは前記套管針先端部が
通過して置かれる開口を有する実施態様31の用具。
通過して置かれる開口を有する実施態様31の用具。
【0060】33.前記アンビル部分は前記套管針先端
部と組み合いうる鎖錠機構を有する実施態様31の用具
。
部と組み合いうる鎖錠機構を有する実施態様31の用具
。
【0061】34.前記鎖錠機構は更に前記アンビル部
分を前記套管針先端部から解放しうる解除機構を有する
実施態様33の用具。
分を前記套管針先端部から解放しうる解除機構を有する
実施態様33の用具。
【0062】35.前記套管針先端部は前記鎖錠機構と
組み合いうる結合手段を有する実施態様33の用具。
組み合いうる結合手段を有する実施態様33の用具。
【0063】36.前記鎖錠機構は前記套管針の回りと
組み合いうるばね負荷式のクリップである実施態様33
の用具。
組み合いうるばね負荷式のクリップである実施態様33
の用具。
【0064】37.前記套管針は周囲に前記鎖錠機構と
組み合いうる刻み目の付けられたリッジを持った軸を有
する実施態様33の用具。
組み合いうる刻み目の付けられたリッジを持った軸を有
する実施態様33の用具。
【0065】38.前記套管針先端部はばね負荷式のス
リーブにより保護され、前記スリーブは前記アンビル部
分の細長いスリーブが前記套管針の上に挿入されたとき
前記先端部を露出させるように後退しうる実施態様31
の用具。
リーブにより保護され、前記スリーブは前記アンビル部
分の細長いスリーブが前記套管針の上に挿入されたとき
前記先端部を露出させるように後退しうる実施態様31
の用具。
【0066】39.前記套管針先端部は前記套管針に連
結された前記アンビルのヘッド部分内に後退しうる実施
態様31の用具。
結された前記アンビルのヘッド部分内に後退しうる実施
態様31の用具。
【0067】40.前記先端部は前記ヘッド部分を通っ
て前記先端部に連結された後退手段の作動により前記ヘ
ッド内に後退しうる実施態様31の用具。
て前記先端部に連結された後退手段の作動により前記ヘ
ッド内に後退しうる実施態様31の用具。
【0068】41.前記後退手段は前記アンビルを前記
ヘッドにねじ止めするために取り付けられたねじ機構を
回転させる実施態様40の用具。
ヘッドにねじ止めするために取り付けられたねじ機構を
回転させる実施態様40の用具。
【0069】42.前記解除機構は前記ばね負荷式のク
リップを前記套管針の回りから解放するように作動しう
る手動操作式のくさびを備える実施態様21の用具。
リップを前記套管針の回りから解放するように作動しう
る手動操作式のくさびを備える実施態様21の用具。
【図1】本発明の外科用ステープラーの斜視図である。
【図2】本発明の外科用ステープラーのヘッド部分及び
アンビル部分の斜視図である。
アンビル部分の斜視図である。
【図3】本発明の閉鎖及びステープル作業の側面図であ
る。
る。
【図4】本発明の閉鎖及びステープル作業の側面図であ
る。
る。
【図5】本発明の閉鎖及びステープル作業の側面図であ
る。
る。
【図6】本発明の閉鎖及びステープル作業の側面図であ
る。
る。
【図7】本発明のアンビル、アンビル軸及び套管針の分
解斜視図である。
解斜視図である。
【図8】図2の線8−8に沿って得られたアンビルの部
分断面の側面図である。
分断面の側面図である。
【図9】本発明に説明されたように套管針先端部上に置
かれた閉鎖アンビル軸の部分断面の側面図である。
かれた閉鎖アンビル軸の部分断面の側面図である。
【図10】図9の線10−10に沿って得られたアンビ
ル軸の断面の平面図である。
ル軸の断面の平面図である。
【図11】本発明のヘッド部分に収容される套管針収納
機構の部分切取り図である。
機構の部分切取り図である。
Claims (4)
- 【請求項1】ステープルがヘッド部分からアンビル部分
に推進され、前記アンビル部分は前記ヘッド部分より取
り外し可能であり、前記ヘッド部分は上に前記アンビル
が取り付けられる套管針先端部を有する外科用ステープ
ル作業用具。 - 【請求項2】ステープルがヘッド部分からアンビル部分
に推進され、前記アンビル部分は前記ヘッド部分より取
り外し可能であり、前記ヘッド部分は上に前記アンビル
が取り付けられる套管針先端部を有しかつ前記套管針先
端部は細長いスリーブにより保護され、前記スリーブは
前記套管針に前記アンビルを取り付けるために前記スリ
ーブに力を加えたときに前記先端部が露出するようにば
ねに連結される外科用ステープル作業用具。 - 【請求項3】ステープルがヘッド部分からアンビル部分
に推進され、前記アンビル部分は前記ヘッド部分より取
り外し可能であり、前記ヘッド部分は上に前記アンビル
が取り付けられる套管針先端部を有し、更に前記アンビ
ル部分は前記套管針先端部と組み合うことができかつ前
記アンビルを前記先端部に解放可能に組み合わせて保持
するように機能する鎖錠手段を有し、前記鎖錠機構が解
放せず前記先端部に取り付けられた前記アンビルを前記
ヘッド内に保持するように前記アンビル及び先端部が一
緒に前記ヘッドに後退できる外科用ステープル作業用具
。 - 【請求項4】ステープルがヘッド部分からステープルの
端部を曲げるアンビルを有するアンビル部分に推進され
、前記アンビル部分は前記ヘッド部分より取り外し可能
であり、前記ヘッド部分は整列手段を有しかつ上に前記
アンビルが取り付けられる套管針先端部を有し、更に前
記アンビル部分は細長いスリーブに取り付けられたアン
ビルヘッドを有し、更に前記アンビルヘッドは前記アン
ビルヘッド内の半径方向位置に置かれた多数のリブを有
し、前記リブは前記套管針先端部の整列手段と揃う外科
用ステープル作業用具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US590404 | 1990-09-28 | ||
US07/590,404 US5104025A (en) | 1990-09-28 | 1990-09-28 | Intraluminal anastomotic surgical stapler with detached anvil |
Publications (1)
Publication Number | Publication Date |
---|---|
JPH04256745A true JPH04256745A (ja) | 1992-09-11 |
Family
ID=24362122
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP3271924A Pending JPH04256745A (ja) | 1990-09-28 | 1991-09-25 | 分離式アンビルを有する管腔内吻合用の外科用ステープラー |
Country Status (13)
Country | Link |
---|---|
US (1) | US5104025A (ja) |
EP (1) | EP0481619B1 (ja) |
JP (1) | JPH04256745A (ja) |
AU (1) | AU654673B2 (ja) |
BR (1) | BR9104179A (ja) |
CA (1) | CA2052207C (ja) |
DE (1) | DE69108836T2 (ja) |
DK (1) | DK0481619T3 (ja) |
ES (1) | ES2071232T3 (ja) |
GR (1) | GR1000991B (ja) |
IE (1) | IE67958B1 (ja) |
PT (1) | PT99075B (ja) |
ZA (1) | ZA917765B (ja) |
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GB1121673A (en) * | 1965-08-26 | 1968-07-31 | N Isseldovatelsky Iex Khirurgi | Improvements in or relating to a surgical instrument for suturing hollow organs |
US3593903A (en) * | 1968-07-12 | 1971-07-20 | Vnii Khirurgicheskoi Apparatur | Surgical instrument for suturing hollow organs in infants |
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NL7711347A (en) * | 1977-10-17 | 1979-04-19 | Carl Robert Erik Daantje | Stapling instrument for joining intestine ends - has head coupling rod in two parts screwing together with hand grip |
DE2947107A1 (de) * | 1978-12-07 | 1980-06-26 | United States Surgical Corp | Genau fluchtende patrone und instrument zum klammern von anastomosen |
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US4654030A (en) * | 1986-02-24 | 1987-03-31 | Endotherapeutics | Trocar |
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US5119983A (en) * | 1987-05-26 | 1992-06-09 | United States Surgical Corporation | Surgical stapler apparatus |
WO1990006085A1 (en) * | 1988-11-29 | 1990-06-14 | Gingold Bruce S | Surgical stapling apparatus |
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- 1990-09-28 US US07/590,404 patent/US5104025A/en not_active Expired - Lifetime
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- 1991-09-19 GR GR910100390A patent/GR1000991B/el not_active IP Right Cessation
- 1991-09-25 JP JP3271924A patent/JPH04256745A/ja active Pending
- 1991-09-25 CA CA002052207A patent/CA2052207C/en not_active Expired - Lifetime
- 1991-09-26 PT PT99075A patent/PT99075B/pt not_active IP Right Cessation
- 1991-09-27 BR BR919104179A patent/BR9104179A/pt not_active Application Discontinuation
- 1991-09-27 ZA ZA917765A patent/ZA917765B/xx unknown
- 1991-09-27 DE DE69108836T patent/DE69108836T2/de not_active Expired - Lifetime
- 1991-09-27 ES ES91308868T patent/ES2071232T3/es not_active Expired - Lifetime
- 1991-09-27 AU AU84840/91A patent/AU654673B2/en not_active Expired
- 1991-09-27 DK DK91308868.8T patent/DK0481619T3/da active
- 1991-09-27 IE IE342891A patent/IE67958B1/en not_active IP Right Cessation
- 1991-09-27 EP EP91308868A patent/EP0481619B1/en not_active Expired - Lifetime
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
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JP2007522910A (ja) * | 2004-02-23 | 2007-08-16 | パワー メディカル インターヴェンションズ インコーポレーテッド | 外科用の切断およびステープル留めの装置 |
JP2011101812A (ja) * | 2004-02-23 | 2011-05-26 | Tyco Healthcare Group Lp | 外科用の切断およびステープル留めの装置 |
JP4782767B2 (ja) * | 2004-02-23 | 2011-09-28 | タイコ ヘルスケア グループ リミテッド パートナーシップ | 外科用の切断およびステープル留めの装置 |
US11172930B2 (en) | 2005-07-26 | 2021-11-16 | Cilag Gmbh International | Electrically self-powered surgical instrument with manual release |
JP2014060166A (ja) * | 2006-05-19 | 2014-04-03 | Ethicon Endo-Surgery Inc | 圧力スイッチ |
JP2017060747A (ja) * | 2015-09-25 | 2017-03-30 | コヴィディエン リミテッド パートナーシップ | 取り外し可能トロカールアセンブリを含むアダプタアセンブリ |
US11278314B2 (en) | 2015-09-25 | 2022-03-22 | Covidien Lp | Adapter assembly including a removable trocar assembly |
Also Published As
Publication number | Publication date |
---|---|
CA2052207A1 (en) | 1992-03-29 |
CA2052207C (en) | 2001-05-08 |
DE69108836D1 (de) | 1995-05-18 |
GR1000991B (el) | 1993-03-31 |
ZA917765B (en) | 1993-03-29 |
AU654673B2 (en) | 1994-11-17 |
IE913428A1 (en) | 1992-04-08 |
IE67958B1 (en) | 1996-05-15 |
BR9104179A (pt) | 1992-06-02 |
PT99075B (pt) | 1999-01-29 |
GR910100390A (en) | 1992-09-11 |
EP0481619B1 (en) | 1995-04-12 |
PT99075A (pt) | 1993-10-29 |
US5104025A (en) | 1992-04-14 |
DE69108836T2 (de) | 1995-11-23 |
DK0481619T3 (da) | 1995-07-03 |
ES2071232T3 (es) | 1995-06-16 |
EP0481619A1 (en) | 1992-04-22 |
AU8484091A (en) | 1992-04-02 |
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