JPS58336B2 - 器官をステ−プル縫合するための外科器具 - Google Patents

器官をステ−プル縫合するための外科器具

Info

Publication number
JPS58336B2
JPS58336B2 JP54167710A JP16771079A JPS58336B2 JP S58336 B2 JPS58336 B2 JP S58336B2 JP 54167710 A JP54167710 A JP 54167710A JP 16771079 A JP16771079 A JP 16771079A JP S58336 B2 JPS58336 B2 JP S58336B2
Authority
JP
Japan
Prior art keywords
staple
jaws
surgical instrument
crankshaft
suturing
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
Application number
JP54167710A
Other languages
English (en)
Other versions
JPS55108348A (en
Inventor
イオシフ・レイボウイツチ・リポフスキー
ウラジミール・ミハイロウイツチ・フエドトフ
ゲンリフ・イリチ・ルコムスキー
ボリス・アンドレーエウイツチ・スミルノフ
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.)
FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA
Original Assignee
FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA
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 FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA filed Critical FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA
Publication of JPS55108348A publication Critical patent/JPS55108348A/ja
Publication of JPS58336B2 publication Critical patent/JPS58336B2/ja
Expired legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/0725Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots

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

【発明の詳細な説明】 本発明は医療器機に関し、特に器官のステープル縫合(
ステープル、即ち縫合針による縫合)を行うため、例え
ば胃腸の横吻合及び腸管の吻合または諸器官の縫合を行
うための外科器具に関し、この器具においては手術後に
残される器官の部分及び切除される部分の両者がともに
縫合され、同時に上記後の部分が切離される。
現在においてはソ連発明者証第571,948号に示さ
れた縫合器が知られ、この器具は顎及び握り部を有する
ステープル体を有し、上記ステープル体中には、ステー
プル溝を有する可変換マガジンが置かれ、上記ステープ
ル溝中にはステーブル押出し器が置かれる。
上記器具はさらに顎を有する保持体を有し、上記保持体
には、ステープルを曲げるための凹みが設けられる。
上記器具はさらにステーブル押出し器をナイフと3もに
進めるための手段及びステープル体と保持体とを相連結
するための機構を有する。
この器具は、主として狭くて深い手術側を通して器官を
縫合するために設計されたのであり、胃腸の横吻合及び
腸の吻合を行うためには用い得られないか、またはその
ような用い方を行うことは極めて困難である。
というのは、現在の技法においてはこの器具の両顎は、
相離れた時にしか手術側から器官中へ入れられないから
である。
この器具のステープル体及び保持体は連結機構により機
械的に連結されているから、手術中に相離すことができ
ず、さらにその全体長さが犬であるために、この器具を
手術剤中で取扱って胃腸吻合及び腸管吻合を行うことは
極めて困難である。
上記欠点は、米国特許第3,079,608号明細書に
示された器具により部分的に排除され得た。
この器具は、可脱にヒンジ連結された保持体及びステー
プル体を有し、上記画体はそれぞれステープルを曲げる
ための凹みを有する顎及びステープルマガジンを保持す
る顎を有し、さらにステーブル押出し器及び上記画体を
所定位置に固定するためのラック型ロック手段を有する
しかしこの器具も種種の欠点を有し、その主なるものは
、縫合間隙を調節し得ないことにある。
胃腸器官の壁厚は患者によって異り、従って縫合器に必
要とされる縫合間隙は0.4mmから2.7mmの間(
即ち2.3mmの範囲)において異ってくる。
縫合されるべき器官の壁厚がこのように大きく異るので
あるから、一定の(不変の)縫合間隙を有する縫合器は
、器官の壁を縫合するための最適圧縮力を与えることが
できないのである。
即ちこの縫合器により壁厚の大きな器官を縫合する場合
には、器官壁が不要に損傷され、従って行なわれた縫合
は屡々止血性が不充分である。
さらに上記器具の構造によっては、縫合間隙を(縫合さ
れる組織を圧縮する)顎がそれらの全長にわたって相互
に平行であるように保ちつゝ増すことができす、よって
縫合結果が極めて悪くなる。
つまり器具の両顎間の間隙が扇形になり、即ち両顎間の
距離が顎の両端におけるよりも顎の基部において小にな
り、この距離の差は間隙が大になる程犬になり、よって
縫合される組織が不適当に圧縮されるばかりでなく、得
られる縫合の高さが不均等になる。
つまり良好でない縫合が形成される結果になるのである
本発明の目的は縫合間隙の広い範囲にわたりその長さに
沿って均等な圧縮を保証し得るような顎を有する縫合器
を提供するにある。
本発明による縫合器は可脱に関節連結された保持体及び
ステープル体を有し、上記画体はそれぞれステープルを
曲げるための凹みを有する顎及びステープルマガジンを
保持するための顎を平行に有し、さらにステーブル押出
し器及び上記画体を定められた関係位置に保つための保
持器を有し、さらに本発明においては保持体の顎は摺動
体を有し、上記摺動体はステープル体に向けて可調節に
動かされた後、予設定位置にロックされ得、上記摺動体
はステープルを曲げるための多数の凹みを有し、さらに
上記摺動体に調節運動を与えるための手段が設けられる
上記摺動体を設けたことにより、縫合間隙の広い範囲に
わたり顎の全長に沿って均等な縫合圧力を与えるように
両顎間の間隙を調節することが可能にされ、よって良好
にして信頼性のある縫合が得られ、縫合される器官の組
織への損傷度合が減少され、よって手術後における組織
の順調な回復が可能にされる。
本発明の一実施例においては、顔中にバーを受入れるた
めの長手溝が作られ、上記バーは上記溝に沿って可調節
に摺動し得る。
さらに上記バーに運動を与えるためのクランク軸が設け
られ、このクランク軸の軸受端部は保持体に対して位置
を固定され、上記クランク軸のクランク腕軸は、上記バ
ー中に作られた溝中に受入れられる。
上記クランク軸の軸受端部の一つに、クランク軸を回し
た後に所定位置に固定するためのレバーが設けられるこ
とが望ましい。
以下添付図面を参照して本発明の実施例について説明す
る。
本発明による器官のステープル縫合を行うための外科器
具は、保持体1及びステープル体2を有しく第1,2及
び3図)、保持体1とステープル体2とは、ピボットピ
ン3(第1図及び2図)により可脱に相連結され、保持
体1及びステープル体2はそれぞれの一端に顎4及び5
を有し、他端にリング6を有する。
ステープル体2の顎5上には、ステーブル(縫合針)9
及びステーブル9のための押出し器10を保持するステ
ーブルマガジン7及び8が可脱に置かれる。
保持体1の顎4中には溝Aが作られ、溝A中に、ステー
ブル9を曲げるための凹み12を有するバー(摺動体)
11が入れられ、バー11は、上記溝A中において横方
向に(即ちステーブル体に向けて及びこれから遠ざかる
ように)動かされ得る。
バー11中には長手溝13が作られ、長手溝13は軸(
主軸)14のクランク腕軸(偏心軸)14′を受入れ、
軸14は軸受端部15及び16(第1,3及び4図)を
有し、ピン17により保持体1に対して固定された位置
に置かれる。
端部16はねじ端を有するレバー18を有し、上記ねじ
端上にローラ19が螺合し、ローラ19は保持体1上に
設けられた半円形突起20(第3図)に接触して、軸1
4が勝手に回転することを防ぐ役をする。
ステープル体2上には摺動体21が設けられ、摺動体2
1に板形ナイフ23及び楔形の斜端を有する条24がね
じ22により取付けられ、ナイフ23及び条24は狭い
溝25及び26(第3及び4図)に沿って動き得る。
前記ピン3は一端に爪27を有し、爪27は保持体1中
の溝28(第5図)に係合して保持体1及びステーブル
体2に対する固定支持点を形成する。
保持体1とステーブル体2とは、相合わされた時にラッ
ク型ロック29(第6図)によりその位置に固定される
ナイフ23により切られる時に組織が引張られることを
防ぐために、顎4及び5の圧縮面上に鋸歯状突起30(
第1及び4図)が作られる。
次に本発明による縫合器の作用について説明する。
まずローラ19がねじ戻された後に、クランク軸14の
レバー18が最右端位置に回され、よって凹み12を有
するバー11が保持体1の顎4中に引込まれ、これによ
り器具が最大縫合間隙に相当する位置に設定される。
次に保持体1とステーブル体2とが離され(脱連結され
)、ついで顎4及び5が縫合されるべき器官の壁中の適
当な切り口から上記器官の内腔中に入れられる。
例えば保持体1の顎4は胃の内腔中に入れられ、ステー
ブル体2の顎5は小腸の内腔中に入れられる。
ついで保持体1と2とが、各々のリング6を引き寄せて
ロック29を係合させることにより相連結される。
次にクランク軸14がレバー18により左に回わされ、
よって縫合される器官の壁を均等に圧縮して緊密な縫合
を行うに要する適当な間隙が与えられる。
ついでローラ19を回転して、その内面を突起20の表
面に堅く接触させることにより、クランク軸14が勝手
に回らないことが保証される。
ついでナイフ23及び条24を保持する摺動体21がス
テーブル体に沿って(第1図で見て上方へ)動かされ、
よって条2〜4の楔形斜端により押出し器10が作動さ
れ、押出し器10は合溝からステーブル9を押出す。
マガジン7及び8の溝から出された後、ステーブル9の
尖った脚は器官の壁を貫通した後バー11中の凹み12
の壁に押付けられてB形に曲げられ、よって縫合が形成
される。
条24の前進と同時にナイフ23が行われた縫合間の組
織を切断し、よって胃腔と腸管との連通が確立される。
これらのことが行われた後、摺動体21は最初の位置に
戻され、顎4と5とは離されて、縫合された器官の内腔
から引出される。
ついで切り口が手により適当な方法に従って巾着縫合さ
れる。
上記器具を次回の縫合に用いるには、空のマガジンをス
テーブルの入っているマガジンと代えることを要する。
縫合間隙を変えるためには、クランク軸を回転してバー
11とステーブル体の顎との間の距離を変えることを要
する。
本発明による器具は、取扱いが便利であり、その用法は
外科医により容易に習得され得、人体の如何なる柔軟組
織に対しても適用される程の範囲の縫合間隙を与え得、
さらに消化器官の縫合、血管の縫合、または種々な成形
及び再生手術に対して用いられ得る。
【図面の簡単な説明】
第1図は本発明による器具の一部断面を含む千体図、第
2図は第1図の側面図、第3図は第1図の■−■線によ
る断面図、第4図は第1図のIV−■線による断面図、
第5図は第2図の矢印V視による図、第6図は第1図の
■−■線による断面図である。 1・・・保持体、2・・・ステーブル体、9・・・ステ
ーブル、11・・・摺動体、12・・・凹み、13・・
・溝、14・・・クランク軸、14′・・・クランク腕
軸、15,16・・・クランク軸の軸受端部、18・・
・レバー、19・・・ローラ、A・・・長手溝。

Claims (1)

  1. 【特許請求の範囲】 1 ステープル縫合時において互いに平行に保持される
    顎がそれぞれ形成されている保持体とステープル体とを
    可脱に関節連結し、前記ステープル体にステープルマガ
    ジンおよびステープルマガジンからステープルを前記保
    持体に向けて押出すためのステープル押出し器を設けて
    なる、器官をステープル縫合するための外科器具におい
    て、前記保持体1の顎4中には長手方向溝Aが形成され
    、この溝A内にステープルを曲げるための凹み12の形
    成された摺動体11がステープル体2に向けて横方向に
    調節移動可能に配設され、さらに前記摺動体11中には
    、軸受端部15,16が保持体1に対して固定された位
    置に置かれた摺動体11に調節移動を与えるためのクラ
    ンク軸14のクランク腕軸14′が挿通配設されている
    ことを特徴きする外科器具。 2 クランク軸14の一方の軸受端部16にはレバー1
    8が連結され、このレバー18にはクランク軸14を調
    節位置に固定するための保持具が取付けられていること
    を特徴とする特許請求の範囲第1項記載の外科器具。
JP54167710A 1978-12-25 1979-12-25 器官をステ−プル縫合するための外科器具 Expired JPS58336B2 (ja)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
SU782714120A SU886897A1 (ru) 1978-12-25 1978-12-25 Хирургический аппарат дл наложени боковых желудочнокишечных анастомозов

Publications (2)

Publication Number Publication Date
JPS55108348A JPS55108348A (en) 1980-08-20
JPS58336B2 true JPS58336B2 (ja) 1983-01-06

Family

ID=20805759

Family Applications (1)

Application Number Title Priority Date Filing Date
JP54167710A Expired JPS58336B2 (ja) 1978-12-25 1979-12-25 器官をステ−プル縫合するための外科器具

Country Status (6)

Country Link
US (1) US4290542A (ja)
JP (1) JPS58336B2 (ja)
CA (1) CA1135144A (ja)
DE (1) DE2952284C2 (ja)
FR (1) FR2445132A1 (ja)
SU (1) SU886897A1 (ja)

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JPS55108348A (en) 1980-08-20
DE2952284A1 (de) 1980-07-03
US4290542A (en) 1981-09-22
DE2952284C2 (de) 1982-10-28
FR2445132A1 (fr) 1980-07-25
SU886897A1 (ru) 1981-12-07
CA1135144A (en) 1982-11-09
FR2445132B1 (ja) 1982-11-19

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