JPH08173437A - 外科用ファスナ付け装置 - Google Patents

外科用ファスナ付け装置

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Publication number
JPH08173437A
JPH08173437A JP7198897A JP19889795A JPH08173437A JP H08173437 A JPH08173437 A JP H08173437A JP 7198897 A JP7198897 A JP 7198897A JP 19889795 A JP19889795 A JP 19889795A JP H08173437 A JPH08173437 A JP H08173437A
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JP
Japan
Prior art keywords
cartridge housing
anvil member
cartridge
piston
actuation mechanism
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.)
Granted
Application number
JP7198897A
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English (en)
Other versions
JP3828183B2 (ja
Inventor
Wayne P Young
ピー ヤング ウェイン
Daniel E Alesi
イー アレッシー ダニエル
Kenneth E Toso
イー トーソ ケニス
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United States Surgical Corp
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United States Surgical Corp
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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
    • A61B17/068—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
    • A61B17/07207—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 the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • 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
    • A61B17/068—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
    • A61B2017/07285—Stapler heads characterised by its cutter
    • 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

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  • 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)

Abstract

(57)【要約】 【課題】 本発明の課題は、アンビルとカートリッジ付
随物を徐々に接近させ、カートリッジから複数のファス
ナを次々に出すように構成された作動構造を有する内視
鏡ステープル留め装置を提供することである。 【解決手段】 体の組織に外科用ファスナを付ける装置
が提供される。装置は、ハンドル組立体及びハンドル組
立体から遠位に延びる細長い本体を有する。ファスナ付
け組立体は、細長い本体の遠位端に作動的に関連し、カ
ートリッジハウジング、複数のステープル及び開位置と
閉位置との間を移動可能なアンビルを含む。作動組立体
は、アンビルを徐々に閉じ、同時に、カートリッジから
ステープルを次々に出すために、ファスナ付け組立体内
を移動するように構成される。

Description

【発明の詳細な説明】
【０００１】
【発明の属する技術分野】本発明は、外科用ステープル
装置に関し、さらに特定すると、体の組織に複数の外科
用ファスナを次々に付け、任意に、ファスナで留められ
た組織を切開する装置に関する。
【０００２】
【従来の技術】組織が、対向するジョー構造の間で先ず
掴まれ、又はクランプされ、それから、外科用装置によ
って接合される外科用装置が、この分野で良く知られて
いる。いくつかの器具では、ファスナによって接合され
た組織を切るためのナイフが設けられている。ファスナ
は、典型的には、外科用ステープルの形態であるが、２
部ポリマ(two part polymeric)ファスナも利用される。
この目的のための器具は、組織を掴み、又はクランプす
るために、それぞれ使用される２つの細長い部材を備え
る。典型的には、一方の部材が、少なくとも２つの横列
に配置された複数のステープルを収容する使い捨てカー
トリッジを支持し、他方の部材が、カートリッジから出
されたときにステープルの脚を形成する表面を構成する
アンビルを備える。一般に、ステープル留め操作は、カ
ートリッジ支持部材の中を長手方向に移動する押し子に
よって行われ、押し子は、ステープルをカートリッジか
ら次々に出すようにステープルに作用する。ナイフが、
ステープル列の間を押し子と共に移動し、ステープルの
間でステープル留めされた組織を長手方向に切り、そし
て／又は、開いてもよい。そのような器具が、ボブロブ
等(Bovrov et al)の米国特許第3,079,606 号明細書、グ
リーン(Green) の米国特許第3,490,675 号明細書に開示
されている。
【０００３】米国特許第3,499,591 号明細書で開示され
ているその後のステープラは、２列のステープルを切開
の各側に付ける。これは、２組の互い違いにされたステ
ープル支持溝の間の細長い案内通路の中をカム部材が動
くカートリッジ組立体を設けることによって達成され
る。ステープル押しつけ部材は、溝内に配置され、そし
て、長手方向に動くカムに接触されるように位置決めさ
れ、ステープルを出す。このようなステープラの他の例
が、米国特許第4,429,695 号に開示されている。上述の
各器具は、外科医が外科部位に手で直接アクセスする従
来の外科のために設計されたものである。しかしなが
ら、内視鏡又は腹腔鏡を用いた外科では、外科は、小さ
な切開部を通して又は皮膚に明けられた小さな入口を通
して投入された狭いカニューレを通して行われる。内視
鏡外科及び／又は腹腔鏡外科における特有な要求に応え
るために、内視鏡外科用ステープル留め用器具が開発さ
れており、米国特許第5,040,715 号、5,312,023 号、5,
318,221 号、5,318,221 号に開示されている。一般に、
これらの器具は、アンビルの接近を行うためのクランプ
用構造部材と、その間に組織を固定するカートリッジ
と、組織を固定した後にカートリッジから複数のファス
ナを次々に出すステープル押出構造部材とを備える。
【０００４】
【発明が解決しようとする課題】アンビルとカートリッ
ジ付随物を徐々に接近させ、カートリッジから複数のフ
ァスナを次々に出すように構成された作動構造を有する
内視鏡ステープル留め装置を提供することは有益であ
る。
【０００５】
【課題を解決するための手段】体の組織に複数の外科用
ファスナを次々に付ける外科用装置が提供される。装置
は、ハンドル部分、ハンドル部分から延びる本体部分、
本体部分の遠位端部分に支持され、複数の外科用ファス
ナを収容し、組織接触面を構成するカートリッジハウジ
ング及びカートリッジ組立体から出されたファスナが押
しつけられるファスナ形成面を構成するアンビル部材を
含む。アンビル部材は、ハンドル部分から離れた位置に
取り付けられ、ファスナ形成面が組織接触面から離れて
いる第一位置と、ファスナ形成面と組織接触面がより接
近して協働的に整列した閉位置との間を移動することが
できる。装置は、アンビル部材を開位置から閉位置へ徐
々に動かし、同時に、複数の外科用ファスナを、アンビ
ルに対して形成させるために、カートリッジから出すよ
うにするアクチュエータをさらに含む。アクチュエータ
を駆動する駆動機構が設けられる。駆動機構は、ハンド
ル部分から操作可能であり、本体部分を通って、アンビ
ル部材に延びる。
【０００６】外科用装置の好ましい実施形態において、
カートリッジハウジング及びアンビル部材の各々は、ア
クチュエータの移動に順応するために、各々の中に形成
された対応する長手方向に延びるスロットを有する。好
ましくは、アクチュエータは、上カムビーム、横向き中
央部分及び上カムビームに平行な下カムビームを含む。
間隔を隔てた複数のカムプレートが、アクチュエータに
設けられ、カートリッジハウジングから外科用ファスナ
を出すために、カートリッジハウジング内に配置された
複数のステープル押し子に係合するように構成される。
一つの実施形態において、切断刃が、アクチュエータが
ファスナ付け組立体を通って移動すると、ステープルさ
れた組織を切開するために、アクチュエータに取り付け
られる。切断刃は、好ましくは、アクチュエータの中央
部分の先縁に形成される。
【０００７】一つの実施形態において、駆動機構は、ハ
ンドル部分内に配置された圧縮流体のキャニスタ、ハン
ドル部分内に構成される、長手方向に延びるピストンチ
ャンバ、ピストンチャンバを通って移動するように構成
されたピストン及びピストンからアクチュエータに延び
る駆動シャフトを有する空気圧式駆動装置を含む。トリ
ガ機構が、好ましくは、流体をキャニスタからピストン
チャンバに解放し、ピストンをチャンバ内で動かすよう
に、空気圧式駆動装置と関連している。別の実施形態に
おいて、ハンドル部分と関連し、アクチュエータに延び
る細長い駆動シャフトと作動的に連結している、回動す
る作動ハンドルを有する手動駆動装置が設けられる。本
外科用装置のさらなる特徴が、図面とともに以下の詳細
な説明から、当業者にとって、より容易に明らかにな
る。
【０００８】
【実施形態】図面及び以下の説明において、「近位」と
は装置の操作者に最も近い端を指し、「遠位」とは、装
置の操作者から最も遠い端を指す。本装置は、内視鏡に
よる処置と装置の両方について論じられる。しかし、
「内視鏡」、「内視鏡的に」及び「内視鏡部分」などの
用語のここでの使用は、とりわけ、内視鏡管と関連して
の使用のみに限定するものと解釈されるべきではない。
むしろ、装置は、アクセスが、関節鏡処置及び／又は腹
腔鏡処置を含むが、これに限定されるものでない小さな
切開に限定されるような処置における用途を見い出すか
もしれないということが考えられる。今、同じ参照番号
が同じ構造要素を特定する図面を参照すると、図１に
は、好ましい実施形態によって構成され、全体的に、参
照番号１０で指定された外科用ステープラが例示されて
いる。簡単に説明すると、外科用ステープラ１０は、ハ
ンドル部分１２、ハンドル部分１２から遠位側に延びる
細長い管状本体部分１４及び本体部分１４の遠位端と作
動的に関連したファスナ付け組立体１６を含む。
【０００９】ファスナ付け組立体１６は、複数の外科用
ファスナを収容するステープルカートリッジ１８及びス
テープルカートリッジ１８と回動可能に関連し、カート
リッジ１８から出されたとき、ステープルを打ち当てる
形成表面を構成するアンビル部材２０を含む。 図１に
最も良く見られるように、回転制御ノブ２２が、本体部
分１４の近位端に設けられ、本体部分１４によって構成
される長手方向軸線を中心とする本体部分１４及びファ
スナ付け組立体１６の回転を容易にするような方法で取
り付けられる。図２に示すように、内視鏡処置の間、外
科用装置１０の本体部分１４は、トロカール１５を通し
て、患者の腹腔に延びる。組織は、カートリッジ１８と
アンビル２０の間に掴まれ、ステープルが、組織に付け
られる。外科用装置１０の操作は、以下に詳しく説明さ
れる。
【００１０】図３を参照すると、ステープルカートリッ
ジ１８は、向かい合った側壁２６及び２８と床部３０を
有する、細長いカートリッジハウジング２４内に支持さ
れる。図４に最も良くわかるように、カートリッジハウ
ジング２４は、本体部分１４の遠位端で支持される。ノ
ッチ２６ａ及び２８ａが、側壁２６及び２８にそれぞれ
形成され、アンビル部材２０から外方に延びる一対の対
応するウイングレット３６及び３８を回動可能に支持す
る。図３及び５に示すように、バネ４０及び４２が、ア
ンビル部材と関連し、アンビルをカートリッジ１８に対
して、開位置に付勢する。別の実施形態では、アンビル
部材２０を、本体部分１４に直接取り付けてもよい。い
ずれの実施形態においても、アンビル部材２０は、ハン
ドル部分の遠位側に位置決めされ、ファスナ付け組立体
は、ハンドル部分によって、遠隔的に作動される。
【００１１】変形例として、アンビルを閉位置に付勢す
るバネを設けれもよい。例えば、バネは、アンビル部材
２０の近位部分から延び、本体部分１４又はハウジング
２４に連結される。体の組織がアンビルとカートリッジ
との間に挿入されたとき、体の組織は、アンビルをカー
トリッジ１８から遠ざける。それから、アンビルは、組
織に緩くクランプされ、ファスナが押し出されると、以
下に説明される作動機構が作動され、よりしっかり、そ
して徐々に、組織をクランプする。図３及び４を参照す
ると、作動機構５０は、ファスナ付け組立体１６に関連
し、アンビル２０とカートリッジ１８を、徐々に接近さ
せて、それらの間に組織をクランプし、同時に、カート
リッジ１８から複数の外科用ステープル３４を次々に出
す。さらに、作動機構５０は、ファスナ付け組立体１６
の中、すなわち、アンビル部材２０及びカートリッジ１
８の中を、遠位方向に移動するように構成され、カムア
ンビル部材２０を閉位置（完全クランプ位置）へ、漸次
移動させ、同時に、複数のステープル押し子を作動して
カートリッジ１８からステープル３４を押す。適当なス
テープル押し子の例が、米国特許第4,978,049 号に開示
され、その開示を、ここに援用する。
【００１２】作動機構５０は、上カムプレート５４及び
下カムプレート５６を、遠位端に配置し、近位端に取付
けブロック５８を配置した細長い支持ビーム５２を含
む。アンビル部材２０には、ステープル留め処置の間、
作動機構５０の移動に順応する細長いスロット６０が形
成される。対応するスロット６２が、カートリッジハウ
ジング２４の床部３０に形成される。使用中、作動機構
５０が、ファスナ付け組立体１６の中を、移動すると
き、上カムプレート５４は、アンビル部材２０の上面
（外面）２０ａに係合して、アンビル部材をカートリッ
ジ１８の方へ押し、下カムプレート５６は、床部３０の
下面（外面）30ａに係合して、上カムプレートによって
アンビルに及ぼされた圧縮力をバランスさせる。図示さ
れるように、上カムプレート５４及び下カムプレート５
６は、実質的に平らである。
【００１３】作動機構５０は、ステープル押し子３５と
作動するように構成されたステープル押出バー７０ａ乃
至７０ｄをさらに含む。押出バーは、それらのそれぞれ
の近位端が、対応する係合スロット７６に受け入れられ
る係合フック７４によって取付けブロック５８に係合さ
れる。各押し子の遠位端は、くさび形カム面７８を有
し、該カム面は、作動機構５０が、ファスナ付け組立体
１６の中を移動するとき、ステープル押し子３５に係合
する。支持ビーム５２の先縁は、組立体１６によって付
けられるステープルの平行な列の間に位置した組織に切
開を形成するために作られた切断刃８０を構成する。図
６を参照すると、空気圧式駆動装置９０が、ハンドル部
分１２に作動的に関連し、ステープル留め処置の間、フ
ァスナ付け組立体１６の中での作動機構５０の移動を制
御する。特に、駆動装置９０は、ハンドル部分１２か
ら、本体部分１４を通して、ファスナ付け組立体１６ま
で延びる駆動シャフト９２の長手方向移動を行わせるの
に役立つ。駆動シャフト９２の遠位端は、取付けブロッ
ク５８の対応する受け入れスロット９６ａ及び９６ｂに
係合するように構成された二股フック部分９４を含む
（図２及び３に示す）。
【００１４】駆動シャフト９２の近位端はピストン９８
から延びる。ピストン９８は、ハンドル部分１２内に構
成された細長いピストンチャンバ１００の中を移動する
ように構成されている。ピストンチャンバ１００は、可
撓管１０４を介してバルブ組立体１０２と連通してい
る。バルブ組立体１０２は、比較的低圧の圧縮ガス供給
源を収容する、円筒形キャニスタ１０６と関連してい
る。回動するトリガ１０８がハンドル部分１１２と関連
し、かつバルブ組立体１０２と相互作用するように構成
され、供給キャニスタ１０６からピストンチャンバ１０
０へのガスの放出を制御する。空気圧式装置の構造及び
作用は、米国特許第5,312,023 号に詳細に記載されてお
り、その開示を、ここに援用する。操作中、図５に示す
ような、矢印Ａで指示した方向にトリガ１０８を操作す
ると、バルブ組立体１０２により、圧縮ガスをキャニス
タ１０６から、管１０４を通って、ピストンチャンバ１
００へ流入させる。チャンバ１００内での圧縮ガスの膨
張の結果、ピストン９８は、矢印Ｂで指示したように遠
位方向に駆動される。そのとき、駆動シャフト９２は、
遠位方向に押され、作動機構５０をファスナ付け組立体
１６の中へ押し入れる。作動機構５０の、遠位方向の移
動により、カムプレート５４は、アンビル部材２０を、
カートリッジ１８の方へ付勢し、アンビル部材２０のフ
ァスナ形成面をカートリッジ１８の組織接触面と、より
接近して協働的に整列させ、その間に配置された体の組
織１１０をクランプする。同時に、ステープル押し子３
５は、各ステープル押出バー７０ａ乃至７０ｄのくさび
形カム面７８によって作動され、ステープル３４を、掴
まれた体の組織１１０に押し通す。加えて、切断刃８０
が、ステープル押出バーにおくれて移動して、ステープ
ル留めされた組織を切開する。
【００１５】図７に例示されるように、ピストンチャン
バ１００内での圧縮ガスの膨張により、ピストン９８及
び作動機構５０を、各ステープルがカートリッジ１８か
ら出されるまで、遠位側に移動させる。その後、ピスト
ンチャンバ１００内に配置され、ピストン９８の遠位側
への移動によって圧縮されたコイル状戻りバネ１１２
が、ピストンを近位側に押して、駆動シャフト９２及び
作動機構５０を、最も遠位の位置に戻す。それによっ
て、使用済みステープルカートリッジは、カートリッジ
ハウジング２４から取り出され、完全に装填されたカー
トリッジで置き換えられ、装置１０を、再度、利用する
ことができる。本装置を、好ましい実施形態について説
明したが、特許請求の範囲によって定められる如き精神
又は範囲から逸脱することなく、これに変更や修正がな
されることを含むことは、当業者にとって、容易に明ら
かになるであろう。
【図面の簡単な説明】
【図１】好ましい実施形態に従って作られた外科用ステ
ープル留め装置の斜視図である。
【図２】体の組織をステープル留めするために、トロカ
ールを通して患者の腹腔に、延びる、図１の外科用装置
の斜視図である。
【図３】図１に図示する外科用装置のファスナ付け組立
体の分解斜視図である。
【図４】装置の作動構造を示すために、カートリッジを
カートリッジハウジングから取り外した、図１の外科用
装置のファスナ付け組立体の斜視図である。
【図５】ステープル付け操作前の図１の外科用装置の側
面図である。
【図６】ステープル付け操作の初期段階中の図１の装置
の部分断面の側面図である。
【図７】ステープル付け操作終了後の図１の装置の部分
断面の側面図である。
【符号の説明】
１０ 外科用ステープラ １２ ハンドル部分 １４ 本体部分 １６ ファスナ付け組立体 １８ ステープルカートリッジ ２０ アンビル部材 ２２ 回転制御ノブ ２４ カートリッジハウジング ２６ 側壁 ２８ 側壁 ３０ 床部 ３４ ステープル ３５ ステープル押し子 ５０ 作動機構 ５２ 支持ビーム ５４ 上カムプレート ５６ 下カムプレート ５８ 取付けブロック ７０ ステープル押出バー ７８ くさび形カム面 ８０ 切断刃 ９０ 空気圧式駆動装置 ９２ 駆動シャフト ９８ ピストン １００ ピストンチャンバ １０２ バルブ組立体 １０６ キャニスタ １１２ コイル形戻りバネ
─────────────────────────────────────────────────────
【手続補正書】
【提出日】平成７年１０月９日
【手続補正１】
【補正対象書類名】図面
【補正対象項目名】全図
【補正方法】変更
【補正内容】
【図１】
【図２】
【図４】
【図３】
【図５】
【図６】
【図７】
───────────────────────────────────────────────────── フロントページの続き (72)発明者 ダニエル イー アレッシー アメリカ合衆国 コネチカット州 06784 シャーマン ルート 39 ノース 38 (72)発明者 ケニス イー トーソ アメリカ合衆国 コネチカット州 06897 ウィルトン オールド ハイウェイ 32

Claims (16)

    【特許請求の範囲】
  1. 【請求項１】 a)ハンドル部分と、 b)ハンドル部分から遠位側に延びる細長い本体部分と、 c)本体部分の遠位端部分で支持され、組織接触面を構成
    し、かつ複数の外科用ファスナを収容するカートリッジ
    ハウジングと、 d)カートリッジハウジングから出されたファスナが押し
    つけられるファスナ形成面を構成するアンビル部材とを
    有し、アンビル部材とカートリッジハウジングは、ハン
    ドル部分から間隔を隔てた位置において、第一位置と、
    ファスナ形成面及び組織接触面がより接近して協働的に
    整列する第二位置との間で相対運動可能に取り付けら
    れ、 e)さらに、アンビル部材とカートリッジハウジングを、
    第一位置から第二位置まで徐々に接近させ、カートリッ
    ジから複数の外科用ファスナをアンビルに向かって形成
    されるべく押し出すために、アンビル部材及びカートリ
    ッジハウジングの中を移動するように構成された作動機
    構と、 f)ハンドル部分から操作可能で、本体部分を通して延
    び、作動機構をアンビル部材の中に駆動する駆動機構と
    を有する体の組織に外科用ファスナ付け装置。
  2. 【請求項２】 カートリッジハウジング及びアンビル部
    材の各々には、作動機構の移動に順応するための長手方
    向に延びるスロットが形成されている請求項１に記載の
    装置。
  3. 【請求項３】 作動機構は、上カムビーム、中央部分及
    び上カムビームと平行な下支持ビームを含む前記請求項
    のいずれかに記載の装置。
  4. 【請求項４】 作動機構は、アンビルの第二位置への移
    動と同時に、カートリッジハウジングから外科用ファス
    ナを出すために、カートリッジハウジング内に配置され
    た複数のステープル押し子に係合するように構成された
    複数の間隔を隔てたカムバーを含む前記請求項のいずれ
    かに記載の装置。
  5. 【請求項５】 ハンドル組立体と作動的に関連し、ファ
    スナ付け組立体の中にアクチュエータを駆動するように
    作動される空気圧式駆動装置をさらに備える前記請求項
    のいずれかに記載の装置。
  6. 【請求項６】 空気圧式駆動装置は、ハンドル部分内に
    配置された圧縮流体のキャニスタ、ハンドル部分内に構
    成された長手方向に延びるピストンチャンバ、ピストン
    チャンバの中を移動するように構成されたピストン及び
    ピストンからアクチュエータまで延びる駆動シャフトを
    含む前記請求項のいずれかに記載の装置。
  7. 【請求項７】 流体をキャニスタからピストンチャンバ
    に解放して、ピストンをチャンバの中を駆動するため
    に、空気圧式駆動装置と関連したトリガ機構をさらに備
    え、ピストンは、ピストンチャンバの中を一般的に遠位
    方向に移動するように構成され、ピストンを近位方向に
    付勢するために、ピストンチャンバ内に配置されたコイ
    ル状戻りバネをさらに備える請求項７に記載の装置。
  8. 【請求項８】 作動機構がアクチュエータ部材及びカー
    トリッジハウジングの中を移動するとき、ステープル留
    めされた組織を切開するために、作動機構に取り付けら
    れた切断刃をさらに備える前記請求項のいずれかに記載
    の装置。
  9. 【請求項９】 切断刃は、作動機構がアクチュエータ部
    材及びカートリッジハウジングの中を移動するとき、ス
    テープル留めされた組織を切開するために、作動機構の
    中央部分の先縁に形成される請求項８に記載の装置。
  10. 【請求項１０】 アンビル部材は、第二位置にバネ付勢
    される前記請求項のいずれかに記載の装置。
  11. 【請求項１１】 作動機構は、遠位端に上カムプレート
    と下カムプレートを、近位端に少なくとも一つのファス
    ナ押出バーを受け入れる取付けブロックを含む前記請求
    項のいずれかに記載の装置。
  12. 【請求項１２】 アンビル部材は、ファスナ形成面と反
    対側の外面部分を有し、作動機構は、該外面部分に係合
    する前記請求項のいずれかに記載の装置。
  13. 【請求項１３】 アンビル部材は、長手方向に延びるス
    ロットを含み、前記作動機構は、前記外面部分に係合す
    るように前記スロットを通して延び、前記作動機構は、
    アンビルを第二位置に徐々に移動させるために、前記ア
    ンビル部材の前記外面部分に係合するカムプレートを遠
    位端に有する請求項１２に記載の装置。
  14. 【請求項１４】 カートリッジハウジング組織接触面と
    反対側の外面部分及び長手方向に延びるスロットを含
    み、前記作動機構は、前記スロットを通って延び、前記
    カートリッジハウジングの前記外面部分に係合する前記
    請求項のいずれかに記載の装置。
  15. 【請求項１５】 前記作動機構は、前記カートリッジハ
    ウジングの外面部分に係合するカムプレートを遠位端に
    含む請求項１４に記載の装置。
  16. 【請求項１６】 アンビル部材及びカートリッジハウジ
    ングに係合するカムプレートは、実質的に平らである請
    求項１３又は１５に記載の装置。
JP19889795A 1994-08-05 1995-08-04 外科用ファスナ付け装置 Expired - Fee Related JP3828183B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/286851 1994-08-05
US08/286,851 US5507426A (en) 1994-08-05 1994-08-05 Apparatus for applying surgical fasteners

Publications (2)

Publication Number Publication Date
JPH08173437A true JPH08173437A (ja) 1996-07-09
JP3828183B2 JP3828183B2 (ja) 2006-10-04

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Country Link
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EP (2) EP0699417B1 (ja)
JP (1) JP3828183B2 (ja)
AU (1) AU692572B2 (ja)
CA (1) CA2155477C (ja)
DE (2) DE69535085T2 (ja)
ES (2) ES2264065T3 (ja)

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JP2006501955A (ja) * 2002-10-04 2006-01-19 タイコ ヘルスケア グループ エルピー 外科用ステープリングデバイスのためのツールアセンブリ
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US5657921A (en) 1997-08-19
ES2218533T3 (es) 2004-11-16
CA2155477C (en) 2006-07-11
US5507426A (en) 1996-04-16
AU692572B2 (en) 1998-06-11
EP1459687A2 (en) 2004-09-22
ES2264065T3 (es) 2006-12-16
EP1459687A3 (en) 2005-07-20
EP0699417B1 (en) 2004-05-12
EP1459687B1 (en) 2006-06-21
AU2831995A (en) 1996-02-15
DE69535085T2 (de) 2007-01-04
DE69533016D1 (de) 2004-06-17
EP0699417A1 (en) 1996-03-06

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