ES2259405T3 - Sujetador para tejidos y aplicador para el mismo. - Google Patents
Sujetador para tejidos y aplicador para el mismo.Info
- Publication number
- ES2259405T3 ES2259405T3 ES03253396T ES03253396T ES2259405T3 ES 2259405 T3 ES2259405 T3 ES 2259405T3 ES 03253396 T ES03253396 T ES 03253396T ES 03253396 T ES03253396 T ES 03253396T ES 2259405 T3 ES2259405 T3 ES 2259405T3
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- Prior art keywords
- fastener
- bra
- barrel
- applicator
- channel
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- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0684—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
-
- 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
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
-
- 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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- 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
Un aplicador de sujetadores quirúrgicos, que comprende: un cañón (22) alargado, que tiene un extremo distal y proximal; y al menos un sujetador (60) situado dentro de dicho cañón alargado, teniendo dicho sujetador un par de resaltes (62, 64) que se extienden lateralmente desde él, teniendo dicho sujetador una posición abierta y cerrada (90, 92); en el que el aplicador se usa para aplicar al menos un sujetador dentro del cuerpo de un paciente, insertando dicho extremo distal de dicho cañón en una posición objetivo dentro del cuerpo del paciente, haciendo avanzar dicho al menos un sujetador dentro de dicho cañón, de manera que sea adyacente a dicho extremo distal, y colocando dicho sujetador en contacto con el tejido; caracterizado porque: el cañón alargado de dicho aplicador comprende dos canales (32, 34) paralelos, siendo cada canal para recibir uno de los resaltes; y los canales comprenden también un canal (33, 35) curvado que se sitúa en abanico lejos del eje longitudinal en el extremo distal del aplicador, de manera que el sujetador es movido por el canal curvado desde la posición abierta hasta la posición cerrada para cerrar dicho sujetador, moviéndose dichos resaltes uno lejos del otro a medida que se hace avanzar de modo distal dicho sujetador.
Description
Sujetador para tejidos y aplicador para el
mismo.
En los últimos años, ha habido muchos avances en
los procedimientos quirúrgicos endoscópicos y laparoscópicos. En
estos procedimientos, el cirujano hace una incisión en la posición
deseada, en la que se ha de realizar el procedimiento quirúrgico.
Típicamente, se inserta entonces un trocar en la incisión hecha por
el cirujano. Aplicando presión contra el extremo proximal del
trocar, el obturador es empujado a través del tejido, hasta que
entra en una posición objetivo, tal como la cavidad abdominal o
cualquier otra víscera hueca deseada del cuerpo. La cánula se
inserta a través de la perforación hecha por el obturador y éste es
retirado, dejando la cánula como una vía de acceso a la cavidad
abdominal. Si se desea, se puede bombear un gas de compresión tal
como, por ejemplo, dióxido de carbono, a través de la cánula del
trocar para inflar el abdomen o la víscera hueca del cuerpo.
Entonces, cualquier número de instrumentos quirúrgicos tal como, por
ejemplo, un instrumento de sujeción de tejido, se puede insertar a
través de la cánula del trocar para realizar el procedimiento
quirúrgico.
Uno de tales instrumentos de sujeción de tejido
insertados a través de la cánula durante un procedimiento quirúrgico
es la grapadora quirúrgica. El cirujano emplea las grapadoras
quirúrgicas durante el procedimiento para aplicar secuencial o
simultáneamente uno o más sujetadores quirúrgicos tales como, por
ejemplo, grapas o sujetadores en dos piezas para tejido corporal,
con el fin de unir entre sí segmentos de tejido corporal. Un ejemplo
de una grapadora quirúrgica se describe en la patente de EE.UU.
número 5.725.554, expedida a Simon et al. Se describe una
grapadora quirúrgica y una grapa para unir tejido de un paciente. La
grapadora quirúrgica tiene un largo brazo endoscópico, un mecanismo
de accionamiento de grapado situado en el extremo del brazo
endoscópico y un mango con un mecanismo de disparo. La grapa, que
tiene forma en M redondeada, posee una sección transversal circular
con una superficie plana en el lado inferior. El funcionamiento del
mecanismo de disparo hace que una fuerza lineal se desplace a través
de la longitud del brazo hasta el mecanismo de accionamiento de
grapado, que forma la grapa para sujetar el tejido. Un inconveniente
del diseño de esta grapadora quirúrgica y esta grapa es que el largo
brazo endoscópico tiene una gran sección transversal, lo que
requiere un mayor orificio de acceso y una mayor incisión para
alcanzar la zona quirúrgica.
El aplicador de clips es otro de tales
instrumentos de sujeción de tejido insertados a través de la cánula
durante un procedimiento quirúrgico. El cirujano emplea los
aplicadores de clips durante el procedimiento para aplicar
secuencial o simultáneamente uno o más clips al tejido corporal con
el fin de aprisionar los vasos sanguíneos. Un ejemplo de un
aplicador de clips se describe en la patente de EE.UU. número
5.843.097, expedida a Mayenberger et al. Se describe un
aplicador quirúrgico para clips en forma de U, que comprende un
mango, un cañón tubular contiguo al mango, una herramienta
aplicadora de tipo pinzas en el extremo libre del cañón tubular, un
depósito de clips en el cañón tubular, un mecanismo de cierre, que
comprende mordazas en el extremo distal del cañón tubular, y un
mecanismo de avance dispuesto en el cañón tubular. El mecanismo de
avance empuja un clip hacia dentro de las mordazas del mecanismo de
cierre. Cuando se acciona el mango, las mordazas del mecanismo de
cierre aprisionan el clip alrededor del vaso sanguíneo. Un
inconveniente del diseño de este aplicador quirúrgico y su clip en
forma de U es que el cañón tubular tiene una gran sección
transversal, lo que requiere un mayor orificio de acceso y una mayor
incisión para alcanzar la zona quirúrgica.
La patente de EE.UU. número 5.222.961 describe
un sujetador quirúrgico y un aplicador de sujetadores según el
preámbulo de las reivindicaciones 1 y 4.
En cirugía mínimamente invasiva, en particular,
cirugía endoscópica o laparoscópica, ha llegado a ser deseable
proporcionar instrumentos más pequeños capaces de alcanzar las zonas
quirúrgicas a través de orificios de acceso más pequeños, pero
proporcionando todavía la capacidad para suministrar a su través
grapas y clips relativamente grandes. Unas incisiones más pequeñas
causan menos daño al acceder a la zona quirúrgica y las heridas de
acceso de tales incisiones cicatrizan más rápido. Los dispositivos
de sujeción quirúrgicos actualmente conocidos tales como, por
ejemplo, los aplicadores de clips y las grapadoras quirúrgicas
presentan todos el inconveniente de tener un cañón de instrumento
con una gran sección transversal, que está impuesta, en general,
por el tamaño del sujetador a medida que pasa a su través. Tener un
cañón de instrumento con una gran sección transversal requiere un
mayor orificio de acceso y una mayor incisión. Por lo tanto, lo que
se necesita es un instrumento de sujeción de tejido y un sujetador
de tejido que tenga un cañón con una sección transversal reducida,
capaces de alcanzar las zonas quirúrgicas a través de orificios de
acceso y de incisiones más pequeños.
Un procedimiento para aplicar un sujetador
quirúrgico incluirá las etapas de proporcionar un aplicador de
sujetadores según la presente invención que tenga un cañón alargado
con al menos un sujetador según la presente invención situado dentro
del mismo. El sujetador tiene un par de resaltes que se extienden
lateralmente desde él. El sujetador tiene una posición abierta y
cerrada. El procedimiento incluirá además la etapa de insertar el
extremo distal del cañón en una posición objetivo dentro del cuerpo
de un paciente. Después de ello, el procedimiento incluirá aplicar
al menos un sujetador dentro del cuerpo de un paciente. Esta etapa
implica los pasos de hacer avanzar el al menos un sujetador dentro
del cañón, de manera que sea adyacente al extremo distal, colocar
el sujetador en contacto con el tejido y cerrar el sujetador,
moviendo los resaltes lejos uno del otro a medida que se hace
avanzar el sujetador de modo distal.
Las nuevas propiedades de la invención se
exponen con particularidad en las reivindicaciones adjuntas. La
propia invención, sin embargo, tanto para la organización como para
los procedimientos de funcionamiento, junto con sus objetos y
ventajas adicionales, se pueden comprender mejor con referencia a la
descripción siguiente, tomada en unión con los dibujos que se
acompañan, en los que:
la figura 1 es una vista en perspectiva del
dispositivo sujetador de la presente invención.
La figura 2 es una vista en corte del conjunto
de cañón de la presente invención, que ilustra la superficie en
conexión con el cañón.
La figura 3 es una vista en perspectiva de la
superficie en el conjunto de cañón de la presente invención, que
incluye los canales primero y segundo.
La figura 4 es una vista desde un extremo del
extremo distal del conjunto de cañón de la presente invención.
La figura 5A es una vista en corte del sujetador
de la presente invención, que ilustra la posición abierta.
La figura 5B es una vista en corte del sujetador
de la presente invención, que ilustra la posición cerrada.
La figura 6 es una vista en corte del conjunto
de cañón de la presente invención, que ilustra cómo están montados
los sujetadores en la superficie.
La figura 7 es una vista en perspectiva desde
arriba del conjunto de cañón, que muestra el mecanismo de empuje
descansando contra la pared de retención, antes de accionar el
mecanismo de disparo.
La figura 8 es una vista en perspectiva desde
arriba del conjunto de cañón, que muestra el mecanismo de empuje
cargado contra el sujetador más distal después de accionar el
mecanismo de disparo.
La figura 9 es una vista en corte transversal
del dispositivo, que muestra el conjunto de cañón y el mecanismo de
empuje haciendo avanzar el sujetador de modo distal.
La figura 10 es una vista en corte transversal
del dispositivo, que muestra el conjunto de cañón y el mecanismo de
empuje haciendo avanzar el sujetador de modo distal hacia dentro de
los canales curvados.
La figura 11 es una vista en corte transversal
del dispositivo, que muestra el conjunto de cañón, el mecanismo de
empuje y el sujetador en transformación desde la posición abierta
hasta la cerrada en el tejido, durante la entrada distal en los
canales curva-
dos.
dos.
La figura 12 es una vista en corte transversal
del dispositivo, que muestra el conjunto de cañón, el mecanismo de
empuje y el sujetador en transformación desde la posición abierta
hasta la cerrada en el tejido, durante la entrada distal adicional
en los canales curvados.
La figura 13 es una vista en corte transversal
del dispositivo, que muestra el conjunto de cañón y el sujetador
después de que ha sido transformado a la posición cerrada alrededor
del tejido.
La figura 14 es una vista en corte de una
realización alternativa de la superficie de la presente invención,
conectada al cañón.
La figura 15A es una vista en perspectiva de una
realización alternativa del sujetador de la presente invención, que
ilustra la posición abierta.
La figura 15B es una vista en perspectiva de una
realización alternativa del sujetador de la presente invención, que
ilustra la posición cerrada.
La figura 15C es una vista desde un extremo de
una realización alternativa del sujetador de la presente invención,
tomada por la línea 15C-15C de la figura 15A.
La figura 16 es una vista en corte de una
realización alternativa del conjunto de cañón de la presente
invención, que ilustra cómo están montados los sujetadores en la
superficie.
La figura 17 es una vista en corte transversal
de una realización alternativa del dispositivo, que muestra el
conjunto de cañón y el mecanismo de empuje haciendo avanzar el
sujetador de modo distal.
La figura 18 es una vista en corte transversal
de una realización alternativa del dispositivo, que muestra el
conjunto de cañón y el mecanismo de empuje haciendo avanzar más el
sujetador de modo distal.
La figura 19 es una vista en corte transversal
de una realización alternativa del dispositivo, que muestra el
conjunto de cañón y el sujetador después de que se ha quitado del
cañón y transformado en la posición cerrada alrededor de un vaso
sanguíneo.
Se usan números de referencia en esta
descripción para designar los diversos componentes y elementos del
instrumento de esta invención. Los números de referencia idénticos
designados en los diversos dibujos hacen referencia al elemento o
componente idéntico del instrumento quirúrgico de penetración. Como
se usa en esta descripción, "proximal" o "de modo
proximal" hace referencia a esa porción del instrumento,
componente o elemento que se extiende hacia el usuario. Al
contrario, "distal" o "de modo distal" hace referencia a
esa porción del instrumento, componente o elemento que se extiende
lejos del usuario.
Haciendo referencia a la figura 1, se muestra un
dispositivo sujetador 2, que incluye un conjunto 20 de cañón y un
conjunto 10 de carcasa, de la presente invención. El conjunto 10 de
carcasa incluye una carcasa 12 y un mango 14. La carcasa 12, que
puede estar hecha de un termoplástico adecuado, rígido de clase
médica tal como, por ejemplo, polipropileno o policarbonato, está
fijada integralmente al mango 14, formando generalmente una forma de
pistola. La carcasa 12, que tiene una cavidad en su interior,
comprende un mecanismo de alimentación. Los mecanismos de
alimentación son bien conocidos en la técnica, y se puede
seleccionar uno de los muchos materiales adecuados tales como, por
ejemplo, de tipo elástico, para uso en el mecanismo de alimentación.
El conjunto 10 de carcasa incluye además un mecanismo de disparo 16,
que podría estar constituido por muchos materiales adecuados
conocidos en la técnica, la mayoría de los cuales son termoplásticos
rígidos tales como, por ejemplo, policarbonato. El mecanismo de
disparo 16 se extiende desde la carcasa 12 y está montado a
pivotamiento en la misma. El extremo proximal de la manilla de mando
18 está fijado al extremo distal de la carcasa 12. La manilla de
mando 18, que está hecha, preferiblemente, de un polímero rígido tal
como, por ejemplo, policarbonato, es generalmente cónica con una
cavidad a su través. La manilla de mando 18 permite una rotación de
360 grados del conjunto 20 de cañón con respecto al conjunto 10 de
carcasa.
Como se ilustra en las figuras 2, 3 y 4, el
conjunto 20 de cañón comprende un cañón 22, una superficie 30, un
mecanismo de empuje 40 y una pared de retención 50. El cañón 22, que
está hecho, preferiblemente, de un material de refuerzo tal como,
por ejemplo, acero inoxidable, aluminio o cualquier otro material
conocido para los expertos en la técnica, es generalmente una
estructura tubular que tiene un extremo proximal y un extremo
distal. El cañón 22 tiene una cavidad 24 a su través creada por su
diámetro interior, que forma una primera pared lateral 26 y una
segunda pared lateral 28. La superficie 30 está fijada a la segunda
pared lateral 28 del cañón 22, como se muestra en la figura 4. La
superficie 30 es generalmente una estructura semitubular hecha de un
polímero rígido tal como, por ejemplo, policarbonato, o cualquier
otro material conocido para los expertos en la técnica. La
superficie 30 tiene un primer canal 32 y un segundo canal 34 que se
extienden de modo generalmente longitudinal en ella. El primer canal
32 y el segundo canal 34 están moldeados integralmente a partir de
la superficie 30, usando procedimientos de fabricación tales como,
por ejemplo, moldeo por inyección.
Haciendo referencia a la figura 2, el primer
canal 32 y el segundo canal 34 incluyen un primer paso recto 37 y un
segundo paso recto 39 que se extienden paralelos al eje longitudinal
del cañón 22. El primer canal 32 y el segundo canal 34 incluyen
además un primer canal 33 curvado y un segundo canal 35 curvado. El
primer canal 33 curvado está fijado integralmente al extremo distal
del primer paso recto 37. El segundo canal 35 curvado está fijado
integralmente al extremo distal del segundo paso recto 39. El primer
canal 33 curvado y el segundo canal 35 curvado se sitúan en abanico
lejos del eje longitudinal en el extremo distal de la superficie 30.
La superficie 30 incluye además una primera pared 36 y una segunda
pared 38. La pared de retención 50 está fijada a la primera pared
36 y a la segunda pared 38 de la superficie 30, como se muestra en
la figura 4. La pared de retención 50, que es generalmente una
estructura rectangular alargada hecha de un polímero rígido tal
como, por ejemplo, policarbonato, o cualquier otro material conocido
para los expertos en la técnica, se extiende longitudinalmente a
través del cañón 22. La pared de retención 50 incluye un lado de
retención 52. El mecanismo de empuje 40 está cargado contra el lado
de retención 52 de la pared de retención 50. El mecanismo de empuje
40 es generalmente una estructura alargada formada, preferiblemente,
a partir de una única pieza de material elástico delgado tal como,
por ejemplo, acero inoxidable o cualquier otro material conocido
para los expertos en la técnica. El mecanismo de empuje 40, que se
extiende longitudinalmente a través del cañón 22 y hacia fuera de su
extremo proximal, tiene una curva en el extremo distal para formar
un brazo de empuje 42. Una pared de empuje 44 está situada en el
extremo distal del brazo de empuje 42, lo que se describirá con más
detalle posteriormente.
Haciendo referencia a la figura 5A y la figura
5B, se muestra un sujetador 60 de la presente invención. El
sujetador 60, que está hecho, preferiblemente, de un metal
biocompatible dúctil tal como, por ejemplo, titanio o tántalo,
incluye un primer resalte 62 y un segundo resalte 64 que se
extienden lateralmente desde él. El primer resalte 62 y el segundo
resalte 64 tienen generalmente secciones transversales circulares y
están fijados integralmente al sujetador 60. El sujetador 60
comprende además un extremo cerrado 66 y un extremo abierto 68. El
extremo abierto 68 está adyacente al extremo distal 23 del cañón 22,
cuando el sujetador 60 se está desplegando. El extremo cerrado 66
tiene un miembro de conexión 70 entre él. El miembro de conexión 70,
que es generalmente curvado, comprende un primer extremo 71 y un
segundo extremo 73. El primer extremo 71 puede estar fijado integral
o separadamente al extremo distal del primer resalte 62. El segundo
extremo 73 está fijado integralmente al extremo distal del segundo
resalte 64. El extremo cerrado 66 incluye una primera pata 72
alargada que se extiende longitudinalmente desde él. La primera pata
72 alargada es generalmente curvada, con un extremo distal y un
extremo proximal. El extremo proximal de la primera pata 72 alargada
puede estar fijado integral o separadamente al extremo proximal del
primer resalte 62. El extremo distal de la primera pata 72 alargada
incluye una primera punta 80, que es generalmente cónica y afilada
para facilitar la sujeción del tejido. El extremo cerrado 66
comprende además una segunda pata 74 alargada que se extiende
longitudinalmente desde él. La segunda pata 74 alargada es
generalmente curvada, con un extremo distal y un extremo proximal.
El extremo proximal de la segunda pata 74 alargada está fijado
integralmente al extremo proximal del segundo resalte 64. El extremo
distal de la segunda pata 74 alargada comprende una segunda punta
82, que es generalmente cónica y afilada para facilitar la sujeción
del tejido. El sujetador 60 tiene una posición abierta 90 y una
posición cerrada 92. La posición abierta 90 del sujetador 60 tiene
generalmente forma de W, como se muestra en la figura 5A. La
posición cerrada 92 del sujetador 60 tiene generalmente forma de
caja, como se muestra en la figura 5B. La posición abierta 90 y la
posición cerrada 92 se describirán con más detalle
posteriormente.
Haciendo referencia ahora a la figura 6, se
puede comprender cómo se monta el sujetador 60 en el conjunto 20 de
cañón. El primer resalte 62 y el segundo resalte 64 se deslizan
dentro de los extremos proximales del primer paso recto 37 del
primer canal 32 y del segundo paso recto 39 del segundo canal 34,
respectivamente, de manera que el primer resalte 62 permanece en el
primer canal 32 y el segundo resalte 64 permanece en el segundo
canal 34. El sujetador 60 se mueve entonces de modo distal en la
superficie 30 y se detiene antes de entrar en contacto con el primer
canal 33 curvado y el segundo canal 35 curvado. Una serie de
sujetadores 60 se pueden deslizar entonces dentro del primer canal
32 y el segundo canal 34, de manera que la primera punta y la
segunda punta de cada sujetador se sitúan contra el extremo cerrado
del sujetador, distales al mismo, en la serie.
El conjunto 20 de cañón, que incluye el
sujetador 60, está montado al conjunto 10 de carcasa que forma el
dispositivo sujetador 2 de la presente invención. El mecanismo de
empuje 40, que se extiende longitudinalmente dentro de y hacia fuera
del extremo proximal del cañón 22, está fijado con seguridad y
firmeza al mecanismo de disparo 16, de manera que cuando se acciona
éste, el mecanismo de empuje 40 se mueve de modo distal más allá de
la pared de retención 50. El extremo distal del mecanismo de
alimentación se cargará contra el extremo cerrado 66 del sujetador
más proximal 60 de una serie de sujetadores 60. El extremo distal de
la manilla de mando 18, que tiene una cavidad a su través, está
acoplado al extremo proximal del conjunto 20 de cañón.
Las figuras 7-13 muestran un
procedimiento endoscópico o laparoscópico que utiliza el dispositivo
sujetador 2 de la presente invención. Después de ganar acceso a la
zona quirúrgica a través de, por ejemplo, un trocar, el cirujano
inserta el dispositivo sujetador 2 a través de la vía de acceso
hasta la zona quirúrgica, de manera que los segmentos del tejido 101
corporal a unir se colocan contra el extremo distal del conjunto 20
de cañón. Se hace girar la manilla de mando 18 para permitir que el
cirujano consiga la orientación apropiada del sujetador en la
posición objetivo. Después de situar el dispositivo sujetador 2 en
la posición objetivo, el cirujano, agarrando el mango 14 del
conjunto 10 de carcasa, acciona el mecanismo de disparo 16. Durante
el accionamiento, el mecanismo de empuje 40, que está fijado con
seguridad y firmeza al mecanismo de disparo 16, es propulsado hasta
más allá de la pared de retención 50, como se muestra en las figuras
7 y 8. Después de la propulsión hasta más allá de la pared de
retención 50, la pared de empuje 44 del mecanismo de empuje 40 es
cargada contra el extremo proximal del primer resalte 62 y el
segundo resalte 64 del sujetador más distal 60 en el cañón 22. El
cirujano libera entonces el mecanismo de disparo 16. Durante la
liberación del mecanismo de disparo 16, el mecanismo de empuje 40
hace avanzar el sujetador más distal 60 hasta más allá del primer
paso recto 37 y del segundo paso recto 39, y hacia dentro de la
primera curva 33 y la segunda curva 35, respectivamente, como se
muestra en las figuras 10 y 11. El sujetador 60 se hace avanzar
continuamente de modo distal a través de la primera curva 33 y la
segunda curva 35. Durante el movimiento distal a través de la
primera curva 33 y la segunda curva 35, el sujetador 60 empieza a
transformarse desde la posición abierta 90 hasta la posición cerrada
92, mostradas por las figuras 11 y 12. Cuando el mecanismo de
disparo se libera completamente, el sujetador 60 se hace avanzar
hacia fuera del extremo distal del cañón 22, transformándolo
completamente en la posición cerrada 92. Como se muestra en la
figura 13, la posición cerrada 92 del sujetador 60 sujeta los
segmentos del tejido 101 corporal, que están colocados contra el
extremo distal del cañón 22.
Haciendo referencia a las figuras
14-19, se muestra una realización alternativa del
dispositivo sujetador 102 de la presente invención, que incluye un
sujetador 160 y una superficie 130. Como se muestra en las figuras
15A-15C, el sujetador 160, que está hecho,
preferiblemente, de un metal biocompatible de tipo elástico tal
como, por ejemplo, Nitinol, incluye un primer resalte 162 y un
segundo resalte 164 que se extienden lateralmente desde él. El
primer resalte 162 y el segundo resalte 164, que tienen generalmente
secciones transversales rectangulares alargadas, están fijados
integralmente al sujetador 160. El sujetador 160 comprende además un
extremo cerrado 166 y un extremo abierto 168. El extremo abierto
168 está adyacente al extremo distal 123 del cañón 122. El extremo
cerrado 166 tiene un miembro de conexión 170 entre él. El miembro de
conexión 170, que tiene generalmente forma de V, comprende un primer
extremo 171 y un segundo extremo 173. El primer extremo 171 está
fijado integralmente al extremo proximal del primer resalte 162. El
segundo extremo 173 está fijado integralmente al extremo proximal
del segundo resalte 164. El extremo cerrado 166 incluye una primera
pata 172 alargada que se extiende longitudinalmente desde él. La
primera pata 172 alargada es generalmente recta, con un extremo
distal y un extremo proximal. El extremo proximal de la primera pata
172 alargada está fijado integralmente al extremo distal del primer
resalte 162. El extremo cerrado 166 comprende además una segunda
pata 174 alargada que se extiende longitudinalmente desde él. La
segunda pata 174 alargada es generalmente recta, con un extremo
distal y un extremo proximal. El extremo proximal de la segunda pata
174 alargada está fijado integralmente al extremo distal del segundo
resalte 164. El sujetador 160 tiene una posición abierta 190 y una
posición cerrada 192. La posición abierta 190 del sujetador 160
tiene generalmente forma de V, como se muestra en la figura 15A. La
posición cerrada 192 del sujetador 160 tiene generalmente forma de
U, como se muestra en la figura 15B. El sujetador 160 empieza en la
posición cerrada 192 y es retenido en la posición abierta 190 por el
primer resalte 162, que permanece en el primer canal 132, y el
segundo resalte 164, que permanece en el segundo canal 134 de la
superficie 130, como se muestra en la figura 14. La superficie 130
es generalmente una estructura semitubular hecha de un polímero
rígido tal como, por ejemplo, policarbonato o cualquier otro
material conocido para los expertos en la técnica. La superficie 30,
como se muestra en la figura 16, comprende el primer canal 132 y el
segundo canal 134. El primer canal 132 y el segundo canal 134, que
son generalmente rectos, se extienden longitudinalmente desde el
extremo distal del cañón 122 hasta el extremo proximal del mismo,
discurriendo paralelos al eje longitudinal. El primer canal 132 y el
segundo canal 134 están moldeados integralmente a partir de la
superficie 130, usando procedimientos de fabricación tales como, por
ejemplo, moldeo por inyección. Las figuras 17-19
muestran un procedimiento endoscópico o laparoscópico que utiliza
la realización alternativa del dispositivo sujetador 2 de la
presente invención. En el procedimiento, el sujetador 160 es
retenido en la posición abierta 190 por el primer resalte 162, que
permanece en el primer canal 132, y el segundo resalte 164, que
permanece en el segundo canal 134. Después de que el mecanismo de
empuje 140 saque el sujetador 160 del extremo distal 123 del cañón
122, el sujetador 160 se cierra alrededor del vaso sanguíneo 201 y
vuelve hasta la posición cerrada 192.
Aunque se han mostrado y descrito en esta
memoria realizaciones preferidas de la presente invención, será
evidente para los expertos en la técnica que tales realizaciones se
proporcionan sólo a modo de ejemplo. Numerosas variaciones, cambios
y reemplazos se les podrán ocurrir ahora a los expertos en la
técnica sin salirse de la invención. En consecuencia, se pretende
que la misma sólo esté limitada por el alcance de las
reivindicaciones adjuntas.
Claims (6)
1. Un aplicador de sujetadores quirúrgicos, que
comprende:
un cañón (22) alargado, que tiene un extremo
distal y proximal; y
al menos un sujetador (60) situado dentro de
dicho cañón alargado, teniendo dicho sujetador un par de resaltes
(62, 64) que se extienden lateralmente desde él, teniendo dicho
sujetador una posición abierta y cerrada (90, 92);
en el que el aplicador se usa para aplicar al
menos un sujetador dentro del cuerpo de un paciente, insertando
dicho extremo distal de dicho cañón en una posición objetivo dentro
del cuerpo del paciente, haciendo avanzar dicho al menos un
sujetador dentro de dicho cañón, de manera que sea adyacente a dicho
extremo distal, y colocando dicho sujetador en contacto con el
tejido;
caracterizado porque:
el cañón alargado de dicho aplicador comprende
dos canales (32, 34) paralelos, siendo cada canal para recibir uno
de los resaltes; y
los canales comprenden también un canal (33, 35)
curvado que se sitúa en abanico lejos del eje longitudinal en el
extremo distal del aplicador, de manera que el sujetador es movido
por el canal curvado desde la posición abierta hasta la posición
cerrada para cerrar dicho sujetador, moviéndose dichos resaltes uno
lejos del otro a medida que se hace avanzar de modo distal dicho
sujetador.
2. El aplicador de la reivindicación 1, en el
que los resaltes (62, 64) tienen secciones transversales
circulares.
3. El aplicador de la reivindicación 1 o la
reivindicación 2, en el que el sujetador (60) está hecho de un metal
biocompatible dúctil.
4. Un aplicador de sujetadores quirúrgicos, que
comprende:
un cañón (122) alargado, que tiene un extremo
distal y proximal; y
al menos un sujetador (160) situado dentro de
dicho cañón alargado, teniendo dicho sujetador un par de resaltes
(162, 164) que se extienden lateralmente desde él, teniendo dicho
sujetador una posición abierta y cerrada (190, 192);
en el que el aplicador se usa para aplicar al
menos un sujetador dentro del cuerpo de un paciente, insertando
dicho extremo distal de dicho cañón en una posición objetivo dentro
del cuerpo del paciente, haciendo avanzar dicho al menos un
sujetador dentro de dicho cañón, de manera que sea adyacente a dicho
extremo distal, y colocando dicho sujetador en contacto con el
tejido;
caracterizado porque:
el cañón alargado de dicho aplicador comprende
dos canales (132, 134) paralelos, siendo cada canal para recibir uno
de los resaltes; y
el sujetador (160) está hecho de un metal
biocompatible de tipo elástico, cargado para empezar en la posición
cerrada (192) y ser retenido en la posición abierta (190) por los
resaltes que permanecen en los canales respectivos, y en el que el
sujetador se cierra sacando los resaltes del canal, de manera que el
sujetador puede recuperarse elásticamente hasta la posición
cerrada.
5. El aplicador de la reivindicación 5, en el
que los resaltes tienen secciones transversales rectangulares
alargadas.
6. El aplicador de una cualquiera de las
reivindicaciones precedentes, en el que los resaltes son integrales
con el resto del sujetador (60, 160).
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US38524802P | 2002-05-31 | 2002-05-31 | |
US385248P | 2002-05-31 |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2259405T3 true ES2259405T3 (es) | 2006-10-01 |
Family
ID=29420645
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES03253396T Expired - Lifetime ES2259405T3 (es) | 2002-05-31 | 2003-05-30 | Sujetador para tejidos y aplicador para el mismo. |
Country Status (8)
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---|---|
US (1) | US7056330B2 (es) |
EP (1) | EP1366719B1 (es) |
JP (1) | JP4425567B2 (es) |
AT (1) | ATE320218T1 (es) |
AU (1) | AU2003204424B2 (es) |
CA (1) | CA2430387C (es) |
DE (1) | DE60304007T2 (es) |
ES (1) | ES2259405T3 (es) |
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-
2003
- 2003-05-16 US US10/440,958 patent/US7056330B2/en not_active Expired - Lifetime
- 2003-05-28 AU AU2003204424A patent/AU2003204424B2/en not_active Ceased
- 2003-05-29 JP JP2003153246A patent/JP4425567B2/ja not_active Expired - Fee Related
- 2003-05-30 ES ES03253396T patent/ES2259405T3/es not_active Expired - Lifetime
- 2003-05-30 CA CA2430387A patent/CA2430387C/en not_active Expired - Fee Related
- 2003-05-30 DE DE60304007T patent/DE60304007T2/de not_active Expired - Lifetime
- 2003-05-30 EP EP03253396A patent/EP1366719B1/en not_active Expired - Lifetime
- 2003-05-30 AT AT03253396T patent/ATE320218T1/de not_active IP Right Cessation
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US7056330B2 (en) | 2006-06-06 |
AU2003204424B2 (en) | 2007-06-28 |
DE60304007D1 (de) | 2006-05-11 |
CA2430387A1 (en) | 2003-11-30 |
ATE320218T1 (de) | 2006-04-15 |
CA2430387C (en) | 2011-07-12 |
EP1366719B1 (en) | 2006-03-15 |
AU2003204424A1 (en) | 2003-12-18 |
JP4425567B2 (ja) | 2010-03-03 |
JP2004154544A (ja) | 2004-06-03 |
US20030233105A1 (en) | 2003-12-18 |
DE60304007T2 (de) | 2006-10-19 |
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