JPH10506026A - 外科用螺旋ファスナ及びアプリケータ - Google Patents
外科用螺旋ファスナ及びアプリケータInfo
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- JPH10506026A JPH10506026A JP8506478A JP50647896A JPH10506026A JP H10506026 A JPH10506026 A JP H10506026A JP 8506478 A JP8506478 A JP 8506478A JP 50647896 A JP50647896 A JP 50647896A JP H10506026 A JPH10506026 A JP H10506026A
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Classifications
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
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- A—HUMAN NECESSITIES
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- 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
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic 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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips 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
- A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06066—Needles, e.g. needle tip configurations
- A61B2017/06076—Needles, e.g. needle tip configurations helically or spirally coiled
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- A—HUMAN NECESSITIES
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- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06166—Sutures
- A61B2017/06171—Sutures helically or spirally coiled
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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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0649—Coils or spirals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S227/00—Elongated-member-driving apparatus
- Y10S227/902—Surgical clips or staples
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
- Y10S606/91—Polymer
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/916—Tool for installing or removing orthopedic fastener
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T24/00—Buckles, buttons, clasps, etc.
- Y10T24/46—Pin or separate essential cooperating device therefor
- Y10T24/4693—Pin or separate essential cooperating device therefor having specific wire penetrating portion
- Y10T24/4695—Wire curved or bent
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
- Coating Apparatus (AREA)
- Pens And Brushes (AREA)
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1.組織を結紮するため、或いは埋め込み可能な装置を取り付けるためのファス ナであって、 遠位先端部及び近位端部を有する連続的な螺旋コイルと; 前記遠位端部の最初の螺旋コイル部と; 前記最初のコイル部に設けられた組織突き刺し手段と; 前記連続的な螺旋コイルが、組織を結紮して前記埋め込み可能な装置を位置 決めして取り付けるために、前記連続的な螺旋コイルを挿入するための手段と; よりなるファスナ。 2.前記組織突き刺し手段は前記最初の螺旋コイル部の端部に形成された先端で ある、請求項1記載のファスナ。 3.前記最初の螺旋コイル部の前記先端と隣接したコイルが間隙を構成し、 前記間隙は、前記ファスナの前記組織内への浸透深さ及びピッチ、並びに前記 組織に対する前記ファスナの保持強度を決定するようになっている、請求項2記 載のファスナ。 4.前記連続的な螺旋コイルは、コイル間に均一なピッチを有する、請求項1記 載のファスナ。 5.前記連続的な螺旋コイルは、コイル間に、アプリケータにより変えることが できる、ピッチを有する請求項1記載記載のファスナ。 6.前記連続的な螺旋コイルは、コイル間で組織を捕らえるのに十分なピッチを 有する、請求項1記載のファスナ。 7.前記連続的な螺旋コイルは、前記ファスナが前記組織内に挿入されるにつれ て増大するピッチを有する、請求項1記載のファスナ。 8.前記連続的な螺旋コイルは、0.050インチのピッチを有する、請求項1 記載のファスナ。 9.前記連続的な螺旋コイルは、自身の直径の0(ゼロ)倍から最大3.0倍ま での範囲のピッチを有する、請求項1記載のファスナ。 10.前記連続的な螺旋コイルを挿入するための手段は、前記近位端部がT形バー である、請求項1記載のファスナ。 11.前記連続的な螺旋コイルを回転させて組織内に挿入するアプリケータにより 、 前記T形バーに回転力及び長手方向の力が与えられる、請求項10記載のファ スナ。 12.前記連続的な螺旋コイルは、直径が少なくとも1mmのカニューレ内に入る寸 法である、請求項1記載のファスナ。 13.前記連続的な螺旋コイルの少なくとも一部は、前記ファスナの組織内への挿 入を容易にするために、生物学的適合性のある滑性材料で被覆されている、請求 項1記載のファスナ。 14.前記連続的な螺旋コイルは、吸収され得る材料で製造される、請求項1記載 のファスナ。 15.前記連続的な螺旋コイルは、実質的にチタン、チタン合金、ステンレス剛及 びニッケルクロム合金よりなる材料のグループから選択された金属材料で製造さ れる、請求項1記載のファスナ。 16.前記連続的な螺旋コイルは、実質的にプラスチック、液晶ポリマ、HDPE 、ポリグリコール酸及びポリグリコリドヒドロキシ酢酸よりなる材料のグループ から選択されたポリマ材料で製造される、請求項1記載記載のファスナ。 17.前記連続的な螺旋コイルは長手方向に伸縮できる、請求項1記載のファスナ 。 18.前記組織突き刺し手段とは反対方向に突出して該前記組織突き刺し手段の近 傍に配設された1つ或いはそれ以上のあごを更に有する、請求項1記載のファス ナ。 19.組織を結紮するため、或いは埋め込み可能な装置を取り付けるためのファス ナであって、 遠位端部及び近位端部を有する連続的な螺旋コイルと; 前記組織を突き刺すための前記遠位端部の先端と; 前記先端との間に間隙を有し、前記遠位端部に隣接した最初の螺旋コイル部 と; 前記埋め込み可能な装置を位置決めして取り付けるための前記螺旋コイルを 前記組織に挿入するアプリケータと係合できる、前記近位端部のT形バーと;よ りなる、ファスナ。 20.前記間隙は、前記ファスナの前記組織内への侵入深さ及びピッチ、並びに前 記組織に対する前記ファスナの保持強度を決定するようになっている、請求項1 9記載記載のファスナ。 21.前記連続的な螺旋コイルは、コイル間に均一なピッチを有する、請求項19 記載のファスナ。 22.前記連続的な螺旋コイルは、コイル間に前記アプリケータにより変えること ができるピッチを有する、請求項19記載記載のファスナ。 23.前記連続的な螺旋コイルは、前記ファスナが前記組織内に挿入されるにつれ て増大するピッチを有する、請求項19記載のファスナ。 24.前記連続的な螺旋コイルは、吸収され得る材料より製造される、請求項19 記載のファスナ。 25.前記連続的な螺旋コイルは、実質的にチタン、チタン合金、ステンレス剛及 びニッケルクロム合金よりなる材料のグループから選択された金属材料より製造 される、請求項19記載のファスナ。 26.前記連続的な螺旋コイルは、実質的にプラスチック、液晶ポリマ、HDPE 、ポリグリコール酸及びポリグリコリドヒドロキシ酢酸よりなる材料のグループ から選択されたポリマ材料で製造される、請求項19記載記載のファスナ。 27.前記連続的な螺旋コイルは長手方向に伸縮できる、請求項19記載のファス ナ。 28.前記組織突き刺し手段とは反対方向に突出して該前記先端の近傍に配設され た1つそれ以上のあごを更に有する、請求項19記載のファスナ。 29.組織を結紮するため、或いは埋め込み可能な装置を取り付けるためのファス ナであって、 遠位端部及び近位端部を有する連続的な2重螺旋コイルと; 前記遠位端部はそれぞれ前記組織を突き刺すための2つの先端と; それぞれ前記2つの先端の一方と関連すると共に、間に間隙を構成する、前 記遠位端部に隣接した2つの最初の螺旋コイル部と; 前記埋め込み可能な装置を位置決めして取り付けるために前記2重螺旋コイ ルを前記組織に挿入するアプリケータと係合できる、前記近位端部の連結バー 部と;よりなる、ファスナ。 30.前記間隙は、前記ファスナの前記組織内への侵入深さ及びピッチ、並びに前 記組織に対する前記ファスナの保持強度を決定するようになっている、請求項2 9記載記載のファスナ。 31.前記連続的な2重の螺旋コイルは、コイル間に均一なピッチを有する、請求 項29記載のファスナ。 32.前記連続的な2重の螺旋コイルは、コイル間に前記アプリケータにより変え ることができるピッチを有する、請求項29記載記載のファスナ。 33.前記連続的な2重の螺旋コイルは、前記ファスナが前記組織内に挿入される につれて増大するピッチを有する、請求項29記載のファスナ。 34.前記連続的な2重の螺旋コイルは、吸収され得る材料で製造される、請求項 29記載のファスナ。 35.前記連続的な2重の螺旋コイルは、実質的にチタン、チタン合金、ステンレ ス剛及びニッケルクロム合金よりなる材料のグループから選択された金属材料で 製造される、請求項29記載のファスナ。 36.前記連続的な2重の螺旋コイルは、実質的にプラスチック、液晶ポリマ、H DPE、ポリグリコール酸及びポリグリコリドヒドロキシ酢酸よりなる材料のグ ループから選択されたポリマ材料で製造される、請求項29記載記載のファスナ 。 37.前記連続的な2重の螺旋コイルは、長手方向に伸縮できる、請求項29記載 のファスナ。 38.前記連結バーから前記遠位端部に向って延びる旋回ポストを更に有し、該旋 回ポストは尖った端部を有する、請求項29記載のファスナ。 39.前記2つの先端とは反対方向に突出して該2つの先端に隣接して配設された 1つそれ以上のあごを更に有する、請求項29記載のファスナ。 40.ファスナを体の組織に取り付けるためのアプリケータであって: 細長いアウタチューブ、連結端部及び末端部を有する遠位端部と; ハンドル及びアクチュエータを有し、前記遠位端部の前記連結端部に取り付 けられた近位部分と、 1前記アウタチューブ内に収納されると共に、複数のファスナを受け入れ、前 記アクチュエータと協働するようになっている回転体と; 前記末端部から前記ファスナをねじ式に回転させて放出させるための手段と ;よりなるアプリケータ。 41.前記複数のファスナと係合するようになっているロック/クリップインジケ ータと; 前記ロック/クリップインジケータに長手方向の力を与えて、前記複数のフ ァスナを前記末端部に向けて付勢するようになっている、荷重ばね;を更に有す る、請求項40記載のアプリケータ。 42.前記ロック/クリップインジケータは、前記複数のファスナがアプリケータ から放出されると、前記アクチュエータの作動を防止する、請求項41記載アプ リケータ。 43.溝が実質的に前記回転体の長さ方向に沿って延び、該溝は前記複数のファス ナのコイルを受け入れるようになっている、請求項40記載のアプリケータ。 44.前記回転体は、D形に近い断面を有すると共に、複数のファスナのコイルを 受け入れるようになっている、請求項40記載のアプリケータ。 45.前記ねじ式に回転して放出させる手段は前記複数のファスナと係合するよう になっている前記末端部の内部に設けられたねじの形態である、請求項40記載 のアプリケータ。 46.前記ねじの形態は前記末端部の前記内部に固定された連動ばねである、請求 項45記載のアプリケータ。 47.前記ねじ式に回転して放出させる手段は前記端部に取り付けられたノーズ片 であり、該ノーズ片は前記アウタチューブの長手方向の軸線に向って垂直に突出 する構造を有し、前記複数のファスナに係合するようになっている、請求項40 記載のアプリケータ。 48.前記遠位部分及び近位部分は互いに解放自在に固定される、請求項40記載 のアプリケータ。 49.前記遠位部分は使い捨て可能であり、前記近位部分は再使用可能である、請 求項48記載のアプリケータ。 50.前記アクチュエータは、 手でつかまれるようになっている第1端部と、第2端部とを有し、中間点を 中心に前記ハンドルに枢動自在に取り付けられたレバーと; 前記ハンドルの内部に回転自在に取り付けられた親ねじと; ナットドライバと;を有し、 前記レバーの前記第2端部は前記ナットドライバに枢動自在に取り付けられ 、前記ナットドライバは前記親ねじに沿って走行するようになっており、これに より前記親ねじを回わし、 前記親ねじは前記回転体に取り付けられ、前記レバーが手で押し下げられる と、前記ナットドライバが前記親ねじに沿って前記回転体に向って走行して前記 回転体を回わす、請求項40記載のアプリケータ。 51.前記親ねじは高い螺旋親ねじである、請求項50記載のアプリケータ。 52.前記レバーは中間延長部を有する、請求項50記載のアプリケータ。 53.前記ハンドルの内部に形成された歯車歯を更に有する、請求項52記載のア プリケータ。 54.前記中間延長部に枢動自在に取り付けられ、前記歯車歯に係合するようにな っているばね付勢式爪を更に有する、請求項53記載のアプリケータ。 55.前記アクチュエータは、 前記ハンドルに回動自在に取り付けられた第1端部と、手でつかまれるよう になっている中間部と、第2端部と、を有するレバーと; 前記ハンドルの内部に回転自在に取り付けられた親ねじと; 前記第2端部が枢動自在に取り付けられると共に、前記親ねじに沿って走行 するようになっており、これにより前記親ねじを回わすナットドライバと; 前記親ねじを前記回転体に解放自在に係合させる手段と;を有し、 前記レバーが手で押し下げられると、前記ナットドライバは前記親ねじに沿 って前記回転体に向って走行し、これにより前記回転体を回動し、前記レバーが その押し下げられていない位置に戻ると、前記親ねじは不動のままの前記回転体 とは独立して逆方向に回転する、請求項40記載のアプリケータ。 56.前記親ねじは高い螺旋親ねじである、請求項55記載のアプリケータ。 57.前記解放自在な係合手段はラチェット機構である、請求項55記載のアプリ ケータ。 58.前記レバーは中間延長部を有し、該中間延長部の内部には複数の歯が形成さ れる、請求項55記載のアプリケータ。 59.前記レバーが完全に押し下げられるまで、該レバーが反対方向にストローク するのを防止するための、前記歯と協働するラッチ爪を更に有する、請求項58 記載のアプリケータ。
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US08/286,878 US5582616A (en) | 1994-08-05 | 1994-08-05 | Surgical helical fastener with applicator |
US08/286,878 | 1994-08-05 | ||
PCT/US1995/007270 WO1996003925A1 (en) | 1994-08-05 | 1995-06-07 | Surgical helical fastener with applicator |
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