DE69108836T2 - Chirurgisches intraluminales Anastomosennähgerät mit abnehmbarem Amboss. - Google Patents
Chirurgisches intraluminales Anastomosennähgerät mit abnehmbarem Amboss.Info
- Publication number
- DE69108836T2 DE69108836T2 DE69108836T DE69108836T DE69108836T2 DE 69108836 T2 DE69108836 T2 DE 69108836T2 DE 69108836 T DE69108836 T DE 69108836T DE 69108836 T DE69108836 T DE 69108836T DE 69108836 T2 DE69108836 T2 DE 69108836T2
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- anvil
- trocar
- head
- tip
- sleeve
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- Expired - Lifetime
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- 230000003872 anastomosis Effects 0.000 title description 8
- 238000009958 sewing Methods 0.000 title 1
- 238000003780 insertion Methods 0.000 claims description 3
- 230000037431 insertion Effects 0.000 claims description 3
- 230000008878 coupling Effects 0.000 claims 1
- 238000010168 coupling process Methods 0.000 claims 1
- 238000005859 coupling reaction Methods 0.000 claims 1
- 210000003128 head Anatomy 0.000 description 28
- 238000000034 method Methods 0.000 description 7
- 210000001785 incus Anatomy 0.000 description 2
- 238000005304 joining Methods 0.000 description 2
- 241000208125 Nicotiana Species 0.000 description 1
- 235000002637 Nicotiana tabacum Nutrition 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 238000001356 surgical procedure Methods 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
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
- Die vorliegende Erfindung betrifft chirurgisches Klammern. Im engeren Sinne betrifft die Erfindung internes Klammern zum Erstellen von Anastomosen. Im noch engeren Sinne betrifft die Erfindung internes Klammern von Lumen, insbesondere des Darms, zum Erstellen von Anastomosen, wobei ein kreisförmiger Ring aus Klammern an dem gewählten Lumen angebracht wird.
- Im allgemeinen hat chirurgisches Klammern in den letzten Jahrzehnten erhebliche Fortschritte gemacht. Insbesondere im Bereich des internen Klammerns zum Erstellen von Anastomosen sind die Fortschritte recht dramatisch gewesen. Geräte wie das Klammergerät Proximate ILS, das von dem Rechtsinhaber der vorliegenden Erfindung, der Firma Ethicon, Inc., Somerville, New Jersey, hergestellt wird, haben es Chirurgen ermöglicht, Operationen und Behandlungsmethoden, die bis dahin als schwierig, wenn nicht als unmöglich angesehen wurden, mit relativer Leichtigkeit durchzuführen.
- Bei der Durchführung chirurgischen Klammerns zum Erstellen von Anastomosen werden im allgemeinen zwei Teile Lumen durch einen Ring aus Klammern miteinander verbunden. Während dieses Vorgangs wird eine kreisförmige Messerklinge dazu verwendet, innerhalb des kreisförmigen Ringes vorhandenes Gewebe auszustanzen. Der kreisförmige Ring wird dann zusammen mit dem Klammergerät entfernt, so daß innerhalb des Lumens entlang der chirurgischen Klammernaht eine kreisförmige Öffnung entsteht.
- Bei der Durchführung dieser chirurgischen Verfahren hat es sich allerdings als wünschenswert erwiesen, den Amboßkopf, auf dem die Klammern zusammengepreßt werden, von dem Klammerteil, aus dem die Klammern ausgestoßen werden, zu trennen. In der Vergangenheit wurden Fortschritte in diese Richtung gemacht. Eine chirurgische Klammervorrichtung nach dem Oberbegriff des Anspruchs 1 ist beispielsweise aus der GB-A-1241577 bekannt. Diese Druckschrift offenbart eine chirurgische Klammervorrichtung, die ein abnehmbares Amboßteil aufweist, das eine sich längs erstreckende Hülse umfaßt, wobei die Hülse eine Öffnung enthält, durch die die Trokarspitze während des Gebrauchs geführt wird. In der Vergangenheit ist es üblich gewesen, daß die Klammerseite der Vorrichtung mit dem Kopf am Amboßteil durch eine im Gewebe gesetzte "Tabaksbeutelnaht" verbunden ist.
- Zusätzlich ist festgestellt worden, daß, wenn am Kopfteil befindliches Gewebe des Klammergeräts mit am Amboßteil des Klammergeräts befindlichem Gewebe verbunden wird, es schwierig ist, den Amboß und den Kopf bei sauberer Ausrichtung der Klammern auf die auf der Amboßseite enthaltenen Ambosse miteinander zu verbinden.
- Weiter hat sich herausgestellt, daß es schwierig ist, ein derartiges Klammern innerhalb eines kreisförmigen Klammergeräts derart durchzuführen, daß die Größe des Kopfes an der Außenseite auf einem Minimum gehalten wird und dabei ein maximaler innerer Hohlraum vorliegt, so daß innerhalb der Anastomoseklammern mehr Gewebe angesammelt werden kann.
- Auch wenn es als Teil dieser Erfindung wünschenswert ist, daß das angesammelte Gewebe von einer relativ scharfen Trokarspitze am Kopf des Klammergeräts durchbohrt wird, so ist es nicht immer wünschenswert, daß der Kopf des Klammergeräts ständig mit einer scharfen Trokarspitze freiliegt. Es hat sich herausgestellt, daß es eher ein wünschenswertes Merkmal ist, eine scharfe Spitze zu haben, die nur während eines Teils des Befestigungsvorgangs frei liegt.
- Entsprechend ist es Aufgabe der Erfindung, eine chirurgische Klammervorrichtung zum Erstellen von Anastomosen zur Verfügüng zu stellen, die ein getrenntes Amboßteil aufweist, das mit einem Klammerteil und einem Trokar verbindbar ist, wobei der Trokar einteilig mit dem Gerät an dessen Klammerteil ausgeführt ist.
- Eine weitere Aufgabe der Erfindung ist es, den Amboßteil mit einer sich längs erstreckenden Hülse zu versehen, um das Setzen einer Tabaksbeutelnaht zu erleichtern.
- Darüber hinaus ist es eine weitere Aufgabe der Erfindung, eine Ausrichtvorrichtung zur Verfügung zu stellen, die den Amboßteil und die Klammern am Kopf oder dem Klammerteil des Schaftes aufeinander ausrichtet.
- Eine weitere Aufgabe der Erfindung ist es, eine Vorrichtung zur Verfügung zu stellen, die es ermöglicht, mit der Spitze des einteiligen Trokars in den Amboßteil des Schaftes einzugreifen.
- Eine weitere Aufgabe der Erfindung ist es, eine Vorrichtung zur Verfügung zu stellen, bei der die Trokarspitze abgeschirmt ist, außer bei einer Verbindung mit dem Amboßteil des Schaftes oder während des Legens einer Tabaksbeutelnaht.
- Diese und andere Aufgaben der Erfindung werden gelöst durch eine chirurgischen Klammervorrichtung, bei der Klammern vom Kopfteil in den Amboßteil der Vorrichtung getrieben werden. Der Amboßteil ist vom Kopfteil abnehmbar und der Kopfteil enthält eine Trokarspitze, auf welcher der Amboßteil angebracht ist. Der Amboßteil umfaßt eine sich längs erstreckende Hülse, die eine Öffnung enthält, durch die die Trokarspitze hindurch plaziert wird. Auf der Trokarspitze befinden sich Mittel, die mit einer Verriegelungsvorrichtung am Amboßteil in Eingriff gebracht werden können. Es ist eine Ausrichtvorrichtung vorhanden, die den Amboßteil gegenüber den Klammern des Kopfteils des Gerätes ausrichtet. Weiter befindet sich auf der Trokarspitze eine federbelastete Hülse, die zurückziehbar ist, um die Spitze bei Eindringen in mit einer Tabaksbeutelnaht versehenes Gewebe oder nach dem Einsetzen des Amboßschaftes auf die Trokarspitze freizulegen.
- Die Gegenstände dieser Erfindung werden deutlicher bei Berücksichtigung der folgenden Zeichnungen in Verbindung mit der ausführlichen Beschreibung der Erfindung.
- Fig. 1 zeigt eine perspektivische Ansicht einer erfindungsgemäßen chirurgischen Klammervorrichtung;
- Fig. 2 zeigt eine perspektivische Ansicht des Kopfteils und des Amboßteils einer erfindungsgemäßen chirurgischen Klammervorrichtung;
- Figuren 3, 4, 5 und 6 zeigen Seitenansichten eines erfindungsgemäßen Verschließ- und Klammervorgangs;
- Fig. 7 zeigt eine vergrößerte perspektivische Ansicht eines Ambosses, eines Amboßschafts und eines Trokars gemäß der vorliegenden Erfindung;
- Fig. 8 zeigt teilweise im Querschnitt eine Seitenansicht des Ambosses entlang den Linien 8-8 der Fig. 2;
- Fig. 9 zeigt teilweise im Querschnitt eine Seitenansicht eines geschlossenen Amboßschaftes, der auf einer Trokarspitze sitzt, wie in der vorliegenden Erfindung beschrieben;
- Fig. 10 zeigt von vorne eine Querschnittsansicht eines Amboßschaftes entlang den Linien 10-10 der Fig. 9; und
- Fig. 11 zeigt eine teilweise geschnittene Seitenansicht einer erfindungsgemäßen, im Kopfteil angeordneten Trokar-Ummantelvorrichtung.
- In Fig. 1 ist eine Klammervorrichtung 10 dargestellt, die ein Kopfteil 20, ein Amboßteil 30, eine Einstellschraube 40 und ein Auslöseteil 50 aufweist. Bei entriegeltem Sicherungsteil 55 dient der Auslöseteil 50 zur Betätigung der Klammervorrichtung 10. Wenn der Auslöseteil 50 aktiviert wird, wird im Schaft 25 eine nicht dargestellte Abdrückvorrichtung betätigt, so daß Klammern aus dem Kopfteil 20 ausgestoßen werden. Diese Klammern werden an Ambossen 34 zusammengedrückt, die entlang dem Umfang des Kopfes 31 des Amboßteils 30 angeordnet sind. Gleichzeitig dient ein innerhalb des Kopfteils 20 angeordnetes Messer dazu, Gewebe auszustanzen, das sich innerhalb des Umfangs des zwischen den Ambossen 34 geklammerten Gewebes befindet. Auf diese Weise kann ein kreisförmiges Lumen durch den Schaft gezogen werden und es bleibt geschlossenes Gewebe um die Klammervorrichtung 10 herum zurück. Die Klammervorrichtung 10 wird dann durch das Gewebe zurückgezogen, wobei das geklammerte Gewebe an seinem Platz zurückbleibt.
- In den Figuren 1, 2 und 7 sind verschiedene Vorrichtungen dargestellt, die bei dem vorliegenden kreisförmigen Anastomosen- Klammergerät die Erfindung bilden. Insbesondere ist in den Figuren 1 und 2 ein Trokarschaft 22 mit einer Trokarspitze 26 dargestellt. Dieser Trokarschaft 22 ist einstückig mit dem Kopfteil 20 ausgeführt und geeignet, Gewebe zu durchbohren. Dieser Trokarschaft 22 ist von einer Hülse 24 umgeben, die in den Kopfteil 20 hinein- und aus diesem herausbewegbar ist. Die Hülse 24 wird durch eine Feder 23 am Kopfteil 20 gehalten, wobei die Feder 23 das Federungsvermögen der Hülse 24 bewirkt und eine Hin- und Herbewegung der Hülse 24 entlang des Trokarschafts 22 ermöglicht.
- Wie in den Figuren 3 und 11 dargestellt, ist der Trokarschaft 22 im allgemeinen von der Hülse 24 bedeckt, so daß mit eirier Tabaksbeutelnaht versehenes Gewebe über der Hülse 24 plaziert sein kann. Nichtsdestotrotz ist die Trokarspitze 26 geeignet, bei Ausübung eines Druckes das Gewebe zu durchbohren. Dies ist insbesondere dann nützlich, wenn mit einer Tabaksbeutelnaht versehenes Gewebe miteinander verbunden wird. Auf diese Weise ist die Trokarhülse 24 mit freigelegter Spitze 26 dazu geeignet, durch die Tabaksbeutelnaht getrieben zu werden, ohne daß die Tabaksbeutelnaht zerrissen wird. Nachdem die Trokarhülse durch das Gewebe getrieben ist, umgibt die Hülse 24 die Trokarspitze 26, so daß kein weiterer Schaden bewirkt werden kann, wobei das Lumen dennoch angemessen über der Hülse 24 angefügt ist.
- Dem Trokarteil 24 entspricht der Amboßteil 30. Auf dem Amboßteil 30 befinden sich Ambosse 34, die um den Amboßkopf 31 entlang dessen Umfang angeordnet sind. Diesen Ambossen 34 entsprechen Klammern, die im Kopfteil 20 entlang dessen Umfang gehalten werden. Wie Fig. 3 zu entnehmen ist, kann der Amboßteil 30 innerhalb eines Lumen im Gewebe angeordnet und dann 'um den Schaft 32 eine Tabaksbeutelnaht gezogen werden.
- Innerhalb des Amboßteils 30 befindet sich eine Ausrichtvorrichtung, die näher in Fig. 8 beschrieben ist. Gemäß Fig. 8 befinden sich im Amboßkopf 31 Rippen 29. Diesen Rippen entsprechen Vertiefungen oder Aussparungen 28, die in der Spitze des Trokar 26 enthalten sind. Wenn das Amboßteil 30 über dem Trokarschaft 22 plaziert wird, finden die Rippen 29 entsprechende Aussparungen 28 und sind daher in der Lage, die Ambosse 34 auf die entlang dem Umfang des Kopfteiles 20 angeordneten Klammern auszurichten.
- Des weiteren ist ein einzigartiges Verfahren zum Verriegeln und Entriegeln des Amboßteiles mit dem Kopfteil offenbart. Insbesondere wird gemäß den Figuren 2 und 7 ein Entriegelungsteil 36 durch einen knopfförmigen Hebel gebildet, der von einer Entriegelungsfeder 36a auf dem Kopf 31 des Amboßteils 30 gehalten wird. Dieser Entriegelungsteil enthält gemäß Fig. 10 einen Keil 35, der einen Mittenausricht-Verriegelungsclip 39b aufdrückt. Dieser Verriegelungsclip ist zwischen Ausrichtclips 39a eingekeilt. Jeder dieser Clips 39a, 39b weist ein mittig durchbohrtes Trokarloch 37b und Löcher 37a auf, die auf den Dorn 37 des Kopfes 31 passen.
- Die Trokarspitze 26 des Trokars 22 paßt durch die mittig angeordneten Löcher 37b. Sofern es gewünscht ist, den Amboßteil 30 mit dem Kopfteil 20 zu verriegeln, wird der im allgemeinen gefederte Verriegelungsclip 39b aufgedrückt und rastet dann in die Vertiefung oder Rille 21 der Trokarspitze 22 ein. Dies ist am besten anhand der Figuren 8 und 10 zu sehen. Sofern es erwünscht ist, den Amboßteil 30 zu öffnen und vom Trokarschaft zu trennen, so wird auf den Entriegelungsteil 36 Kraft ausgeübt, so daß der Keil 35 die Zacken des Verriegelungsclips 39b aufstemmt. Das Loch 37b im Clip 39b besitzt nun dieselbe Größe wie die Löcher 37b in jedem der Ausrichtclips 39a. Auf diese Weise ist der Schaft aus dem Amboßschaft 32 herausschiebbar.
- Normalerweise ist die Feder, die den Verriegelungsclip 39b bildet, jedoch derart vorgespannt, daß dieser im allgemeinen in einer engeren oder "geschlossenen" Stellung ist, so daß er in die Vertiefung oder Rille 21 hineinpaßt. Die Vertiefung 21 hält den Verriegelungsclip 39b, so daß der Amboßteil 30 angemessen an dem im Kopfteil 20 enthaltenen Trokar 22 befestigt ist.
- Mit zwei sich jeweils sowohl an den Schaft 22 als auch an den röhrenförmigen Amboßfortsatz 32 anschließenden Lumina ist der Amboß bereit für einen chirurgischen Einsatz, wie in den Figuren 3, 4, 5 und 6 dargestellt ist. Gemäß Fig. 4 wird der Amboßteil 30 auf den Schaft 22 aufgesetzt, so daß die Trokarspitze 26 freiliegt und in den Amboßfortsatz 32 hineinpaßt. Die Hülse 24 wird in eine freiliegende Stellung gedrückt, so daß sie innerhalb des Kopfteils 20 verschoben wird. Die Löcher 37b der Ausrichtclips 39a und des Verriegelungsclips 39b führen den Trokar durch den Fortsatz 32 in den Amboßkopf 31. Wenn der Trokar im Amboßkopf 31 ausreichend aufliegt, wird der Verriegelungsclip 39b, der die keilförmige Feder enthält, aufgedrückt und greift dann in die Vertiefung 21 ein. Da die Aussparungen 28 sich auf die Rippen 29 im Schaft 31 ausgerichtet haben, ist gesichert, daß die Ambosse 34 auf die im Kopfteil 20 enthaltenen Klammern ausgerichtet sind. Wie besonders Fig. 7 zu entnehmen ist, wurden die Rippen 29 auf die Ambosse 34 während der Herstellung durch sorgfältiges Plazieren der Vorsprünge 31a in die Löcher 32a bei der Verbindung des Amboßkopfes 31 mit dem Fortsatz 32 ausgerichtet. Das Gerät erscheint nun gemäß Fig. 5 als zwei aneinandergebrachte Teile Lumen. Die Einstellschraube 40 hat das Gewebe näher aneinander gezogen.
- In Fig. 6 sind die Klammern durch das Gewebe in die Ambosse gedrückt worden. Sobald die Klammern zusammengepreßt sind, stanzt ein Messer innerhalb des Umfangs der Klammern vorhandenes Gewebe aus. Sobald dieser Schneidvorgang erfolgt ist, wird die Klammervorrichtung 10 in Richtung des Kopfteils 20 und durch das Lumen zurückgezogen, so daß nun ein an seinem Umfang geschlossenes Lumen mit einer inneren, röhrenartigen Öffnung geschaffen ist.
- Nach Entfernen der Klammervorrichtung 10 wird das überschüssige, in der Klammervorrichtung 10 gehaltene Lumen beseitigt. Der Entriegelungsteil 36 des Amboßteils 30 wird gemäß den Figuren 2 und 10 nach unten gedrückt. Dies bewirkt, daß die Verriegelungsvorrichtung sich gemäß Fig. 9 öffnet, wie in Fig. 7 angedeutet ist. Der Verriegelungsclip 39b öffnet sich nun, wodurch dem Benutzer ermöglicht wird, den Amboßschaft 32 vom Kopfteil 20 der Klammervorrichtung wegzuschieben. Auf diese Weise wird das zwischen dem Amboßteil 30 und dem Kopfteil 20 vorhandene Gewebe entfernt.
- Wie beschrieben, erfolgte in geeigneter Weise ein Versehen von Gewebe mit einer Tabaksbeutelnaht und ein Durchstechen des Gewebes mittels eines Trokars 22, eine Ausrichtung zwischen Aussparungen 28 und Rippen 29, ein Hindurchziehen des Amboßkopfes 31, ein Einrasten des Clips 39b in die Vertiefung 21 und ein geeignetes Klammern und Schneiden von Gewebe. Es ist somit erkennbar, daß die nachfolgenden Ansprüche und ihre Äguivalente dahin zu verstehen sind, daß sie den Schutzumfang der Erfindung umfassen.
Claims (14)
1. Chirurgische Klammervorrichtung (10), bei der Klammern
von einem Kopfteil (20) zu einem Amboßteil (30) bewegt
werden, wobei der Amboßteil (30) von dem Kopfteil (20)
abnehmbar ist, der Kopfteil (20) eine Trokarspitze (26)
enthält, auf welcher der Amboßteil (30) angebracht ist,
der Amboßteil (30) eine sich längs erstreckende Hülse
(32) umfaßt, die Hülse (32) eine Öffnung enthält, durch
die die Trokarspitze (26) hindurch plaziert wird, dadurch
gekennzeichnet, daß
die Trokarspitze (26) durch eine federbelastete Hülse
(24) geschützt ist, wobei die Hülse (24) zurückziehbar
ist, um die Spitze (26) nach dem Einsetzen der sich längs
erstreckenden Hülse (32) des Amboßteils über den Trokar
(22) freizulegen wird.
2. Vorrichtung nach Anspruch 1, wobei die federbelastete
Hülse (24) mit einer Feder (23) derart verbunden ist, daß
die Spitze (26) nach der Ausübung einer Kraft auf die
Hülse (24) freigelegt wird, um den Amboß (30) an dem
Trokar (22) zu befestigen.
3. Vorrichtung nach irgendeinem vorhergehenden Anspruch,
wobei der Amboßteil (30) Ambosse (34) zum Zusammenpressen
von Klammern hat und einen Amboßkopf (31) aufweist, der
an einer sich längs erstreckenden Hülse (32) befestigt
ist und der Amboßkopf (30) eine Mehrzahl von Rippen (29)
enthält, die in radialen Stellungen innerhalb des
Amboßkopfes (31) angeordnet sind, wobei die Rippen (29)
gegenüber einer Ausrichtvorrichtung (28) auf der Trokarspitze
(26) ausgerichtet sind.
4. Vorrichtung nach einem der Ansprüche 1 oder 2, wobei der
Amboßteil (30) einen Amboßkopf (31) enthält, der mit der
sich längs erstreckenden Hülse (32) verbunden ist, wobei
der Ambgßkopf (31) eine Mehrzahl von Rippen (29) hat, die
radial um einen inneren Durchmesser verteilt angeordnet
sind und der Trokar (26) eine Mehrzahl von Nuten (28)
enthält, die radial um die Spitze (26) herum verteilt
angeordnet sind, wobei die Nuten (28) mit den Rippen (29)
nach dem Einsetzen der Spitze (26) in die sich längs
erstreckende Hülse (32) und den Kopf (31) ausgerichtet
sind.
5. Vorrichtung nach einem vorhergehenden Anspruch, wobei der
Amboßteil (30) eine Verriegelungsvorrichtung (39b)
enthält, die mit der Trokarspitze (26) in Berührung bringbar
ist.
6. Vorrichtung nach Anspruch 5, wobei die
Verriegelungsvorrichtung (39b) ferner eine Entriegelungsvorrichtung (36)
enthält, durch welche der Amboßteil (30) von der
Trokarspitze (26) entriegelbar ist.
7. Vorrichtung nach Anspruch 5 oder Anspruch 6, wobei die
Trokarspitze (26) eine Kupplungsvorrichtung enthält, die
mit der Verriegelungsvorrichtung (39b) kuppelbar ist.
8. Vorrichtung nach einem der Ansprüche 5 bis 7, wobei die
Verriegelungsvorrichtung (39b) ein federbelasteter Clip
(39b) ist, der an dem Trokar (22) um diesen herum
anlegbar ist.
9. Vorrichtung nach Anspruch 8, umfassend eine
Entriegelungsvorrichtung (36), die einen handbetätigten Keil (35)
enthält, der zum Lösen des federbelasteten Clipses (39b)
aus seiner den Trokar (22) umgreifenden Stellung
betätigbar ist.
10. Vorrichtung nach einem der Ansprüche 5 bis 9, wobei der
Trokar (22) einen Schaft (22) mit einer vertieften Rille
(21) enthält, um die herum die Verriegelungsvorrichtung
(39b) anlegbar ist.
11. Vorrichtung nach einem der Ansprüche 5 bis 10, wobei der
Amboß (30) und die Spitze (26) zusammen zu dem Kopf (20)
derart zurückziehbar sind, daß die
Verriegelungsvorrichtung (39b) unlösbar ist, wobei der Amboß (30) mit der
Spitze (26) innerhalb des Kopfes (20) gehalten wird.
12. Vorrichtung nach einem der Ansprüche 1 bis 10, wobei die
Trokarspitze (26) in den Kopfteil (20) der Vorrichtung
zurückziehbar ist, wobei der Amboß (30) mit dem Trokar
(22) verbunden ist.
13. Vorrichtung nach irgendeinem vorhergehenden Anspruch,
wobei die Spitze (26) in den Kopf (20) durch Betätigung
einer Rückziehvorrichtung zurückziehbar ist, die mit der
Spitze (26) durch den Kopfteil (20) verbunden ist.
14. Vorrichtung nach Anspruch 13, wobei die
Rückziehvorrichtung einen daran angebrachten Schraubmechanismus dreht,
um den Amboß (30) mit dem Kopf (20) zu verschrauben.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/590,404 US5104025A (en) | 1990-09-28 | 1990-09-28 | Intraluminal anastomotic surgical stapler with detached anvil |
Publications (2)
Publication Number | Publication Date |
---|---|
DE69108836D1 DE69108836D1 (de) | 1995-05-18 |
DE69108836T2 true DE69108836T2 (de) | 1995-11-23 |
Family
ID=24362122
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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DE69108836T Expired - Lifetime DE69108836T2 (de) | 1990-09-28 | 1991-09-27 | Chirurgisches intraluminales Anastomosennähgerät mit abnehmbarem Amboss. |
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US (1) | US5104025A (de) |
EP (1) | EP0481619B1 (de) |
JP (1) | JPH04256745A (de) |
AU (1) | AU654673B2 (de) |
BR (1) | BR9104179A (de) |
CA (1) | CA2052207C (de) |
DE (1) | DE69108836T2 (de) |
DK (1) | DK0481619T3 (de) |
ES (1) | ES2071232T3 (de) |
GR (1) | GR1000991B (de) |
IE (1) | IE67958B1 (de) |
PT (1) | PT99075B (de) |
ZA (1) | ZA917765B (de) |
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- 1991-09-27 DK DK91308868.8T patent/DK0481619T3/da active
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- 1991-09-27 AU AU84840/91A patent/AU654673B2/en not_active Expired
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DK0481619T3 (da) | 1995-07-03 |
PT99075B (pt) | 1999-01-29 |
EP0481619B1 (de) | 1995-04-12 |
IE913428A1 (en) | 1992-04-08 |
BR9104179A (pt) | 1992-06-02 |
GR1000991B (el) | 1993-03-31 |
CA2052207A1 (en) | 1992-03-29 |
ZA917765B (en) | 1993-03-29 |
CA2052207C (en) | 2001-05-08 |
AU8484091A (en) | 1992-04-02 |
DE69108836D1 (de) | 1995-05-18 |
ES2071232T3 (es) | 1995-06-16 |
GR910100390A (en) | 1992-09-11 |
IE67958B1 (en) | 1996-05-15 |
US5104025A (en) | 1992-04-14 |
JPH04256745A (ja) | 1992-09-11 |
PT99075A (pt) | 1993-10-29 |
EP0481619A1 (de) | 1992-04-22 |
AU654673B2 (en) | 1994-11-17 |
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