JP2001046384A - 外科用器具 - Google Patents
外科用器具Info
- Publication number
- JP2001046384A JP2001046384A JP2000205637A JP2000205637A JP2001046384A JP 2001046384 A JP2001046384 A JP 2001046384A JP 2000205637 A JP2000205637 A JP 2000205637A JP 2000205637 A JP2000205637 A JP 2000205637A JP 2001046384 A JP2001046384 A JP 2001046384A
- Authority
- JP
- Japan
- Prior art keywords
- locking
- handle assembly
- plunger
- locking tab
- tab
- 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
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
-
- 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
- A61B2017/2946—Locking means
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Ophthalmology & Optometry (AREA)
- Heart & Thoracic Surgery (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
具を提供する。 【解決手段】 外科用器具は、ハンドルアセンブリ(4
0)、細長い軸部(85)、端部作動体(95)、作動
部材(105)、ロック用タブ(155)、ロック用ロ
ッド(108)、及び解除用トリガー(120)を備え
る。ロック用ロッドは、作動部材の近位端部に固定さ
れ、ロック用タブがロック解除位置にある場合、少なく
もロック用ロッドの遠位端部がロック用タブの開口部を
介して可動自在にロック用タブと係合し、作動部材がハ
ンドルアセンブリから遠ざかる方向及びハンドルアセン
ブリに近づく方向に移動することを可能とする。一方、
ロック用タブがロック位置にある場合、ハンドルアセン
ブリから遠ざかる方向の作動部材の動きが妨げられるよ
うに、ロック用タブにロック用ロッドが固定される。解
除用トリガーの往復運動によって、ロック用タブがロッ
ク位置とロック解除位置との間を交互する。
Description
ド型の外科用器具に関し、特に腹腔鏡用ハンドヘルド型
の外科用器具の作動部材を固定及び解除するための新規
かつ有用な往復式の解除自在ロック機構に関する。
ドヘルド(手持)型の外科用器具は外科分野でよく知ら
れており、古くから使用されてきた。そのような器具の
多くは、把持、切開、切断、結紮、又は身体に物体を固
定することに使用されてきた。外科的処置の間、組織を
把持したり或いは巧みに手動操作することによって組織
を処理したりするために使用されるハンドヘルド型の外
科用器具に対して関心が持たれている。また、腹腔鏡手
術すること、すなわち患者の大きな開口部又は切開部を
介するよりもむしろ少数かつ小口径の外科用アクセスポ
ートを介して手術が行われるような、僅かな侵襲による
外科的処置においては、腹腔鏡手術するためのハンドヘ
ルド型の外科用器具に対して特に関心が持たれている。
典型的な腹腔鏡手術では、腹腔を不活性ガスで通気し、
手術用アクセスポートを患者の体内に挿入する。腹腔鏡
外科用器具をアクセスポートに挿入し、該アクセスポー
トを介して外科的処置が施される。腹腔鏡手術は、しば
しば「鍵穴手術」とも呼ばれ、アクセスポートが「鍵
穴」(keyhole)で、それを通して手術が行われる。アク
セスポート(「鍵穴」)の寸法の結果として、腹腔鏡把
持器具は、一対のハサミ様ハンドルと、アクセスポート
と気密封止を形成する小径で細長い軸と、動作可能に少
なくとも一つのハンドルに動作可能に結合している。
巧みに手動操作することが可能な外科用器具を提供する
ことが重要である。長時間にわたって組織を把持及び保
持していることは疲労を招くものであり、また外科医が
疲労して掴んでいる組織を放してしまう場合は合併症が
生じるおそれがある。したがって、外科医のスタミナを
節約して他の外科的仕事に備えるために、外科用把持器
具に一方向の保持又はクランピング機構を設けることが
現在一般に行われている。多くのそのような把持器具は
ハサミのようなハンドルを介して端部作動体(end effe
ctor)に動作可能なかたちで連結された歯板(rack)及
び歯止め(pawl)によるクランピング機構を用いる。歯
板及び歯止めは、歯の傾斜面と歯のアンダーカット面と
を有する鋸歯状の歯部を備えている。把持器具の歯板は
一方のハンドルに動作可能に連結し、歯止めは他方のハ
ンドルに偏位して連結する。端部作動体が一緒に動いて
組織を掴もうとすると歯板及び歯止めの歯部の傾斜面が
滑り係合(sliding engagement)し、端部作動体が離れ
ようとするとアンダーカット面がロック係合(locking
engagement)する。歯止めは歯板から外されなければな
らず、また歯止めはカム又は他の手段によって外されて
端部作動体が再び開かなければならない。開く方法に関
するそのような器具の一例は、D. M. Litlejohnの米国
特許第1,659,112号に記述されている。歯板及
び歯止め機構が動作可能にハサミ様ハンドルに連結され
ている別の器具はBales らの米国特許第5,176,7
02号に開示されている。Bales らに記述された器具
は、腹腔鏡手術で使用される。
組織をクランプするとロックされるが、手術中に器具を
解除するための第2の手を用いなければならないので、
使用が難しい。器具を作動させる同一の手でロック及び
ロック解除が容易に行える歯板及び歯止め機構を持つ腹
腔鏡把持器具が求められていた。一対のハサミ様ハンド
ルとラチェットから歯止めを解除するために容易にアク
セス可能なトリガーとを持つ腹腔鏡把持器具がGreen ら
の米国特許第5,476,479号及びAranyiの米国特
許第5,483,952号に開示されている。
腔鏡検査用ロック器具の歯板及び歯止めロック機構は限
界がある。歯板及び歯止め機構は、閉じる際の位置が無
制限にあるわけではなく、歯板と歯止めとの間の距離に
応じて事前に定めたいくつかのロック位置に限定され
る。爪は2つのラック歯の間に固定されるので、ラック
歯の寸法は事前に定めたロック位置の数を限定する。も
し歯の形状が大きければ、外科医は非常に少ない数の離
散したロック位置の数に制限され、強すぎる力又は弱す
ぎる力で組織をクランプする可能性が増大する。もし歯
の形状が小さければ、事前に定めたロック位置の数を増
やすことで、噛み合わせによるロック機構の限界を減少
させることができるが、限界を排除することはできな
い。
無制限にあるロック機構が求められている。そのような
機構は、T. C. Hutcheson の米国特許第804,229
号、Nicholasの米国特許第5,314,424号、及び
Measamerらの米国特許第5,735,874号に開示さ
れている。Hutcheson、Nicholas、及びMeasamerによっ
て使用されるロック機構は、アパーチャ又は開口部が形
成され、該開口部を貫通する軸部を中心にして旋回可能
な平板である。端部作動体は動作可能に軸部によって作
動ハンドルに連結されている。軸部の軸線に対して平板
が傾いている場合、平板の開口部が軸に対して楕円状に
なって軸部との接触が生じ、軸部による一方向の摩擦ロ
ックが形成される。平板が軸部に対して直角である場
合、軸部に対して平板の開口部が円形となり、両方向に
軸部が開口部内を自由に滑動するので、作動ハンドルが
ロック解除される。
期的であったが、一方向滑動ロック機構を作動又は解除
する際の作動ボタンまたはトリガーの使用が煩わしかっ
た。Nicholasの作動機構もまた煩わしかった。これらの
従来技術のロック機構は使用者が直覚的に使用できるも
のではない。したがって、無制限に変化可能な一方向ロ
ック機構であって、ロック解除可能で直覚的に使用でき
るものが求められている。
びクランプするための外科用器具である。この外科用器
具は、ハンドルアセンブリと、近位端部及び遠位端部を
有する細長い軸部とを備える。細長い軸部の近位端部は
ハンドルアセンブリと接続している。少なくとも一つの
可動部材を有する端部作動体が細長い軸部の遠位端部に
位置している。
作動部材は近位端部を有し、ハンドルアセンブリから遠
ざかる方向及びハンドルアセンブリに近づく方向に移動
可能である。作動部材は、少なくとも一つの可動部材の
動作を始動させるために動作可能に端部作動体と接続し
ている。
え、ロック用タブはハンドルアセンブリ上に設けられ、
開口部が形成されている。ロック用タブは、ロック位置
とロック解除位置との間で移動可能である。
端部を有するロック用ロッドをさらに備える。ロック用
ロッドは、作動部材の近位端部で該作動部材に固定され
ている。作動部材がハンドルアセンブリから遠ざかる方
向及びハンドルアセンブリに近づく方向に移動すること
を可能とすべく、ロック用タブがロック解除位置にある
時に、ロック用ロッドの少なくとも遠位端部が開口部を
介して移動可能にロック用タブと係合する。また、ロッ
ク用ロッドは、ハンドルアセンブリから遠ざかる方向の
作動部材の移動を防止すべくロック用タブがロック位置
にある時にロック用タブに対して固定される。
トリガーがさらに設けられている。解除用トリガーはハ
ンドルアセンブリから延びており、またハンドルアセン
ブリから離れた第1の位置とハンドルアセンブリに近接
する第2の位置との間をハンドルアセンブリ内で移動可
能である。解除用トリガーは第1の位置に向けて付勢さ
れている。解除用トリガーは、最初にハンドルアセンブ
リに向けて第1の位置から第2の位置へ押し込まれ、続
いて第2の位置から解除されて第1の位置へ戻る時に往
復運動可能である。解除用トリガーが連続した往復運動
を行うことによってロック用タブをロック位置とロック
解除位置との間で交互させる。
プする本発明の新規な外科用器具により外科医に直覚的
に使用可能な解除自在ロック機構が提供されることであ
る。すなわち、この解除自在ロック機構は解除用トリガ
ーを押し込んだり解除したりすることでロック又は係合
され、また、解除用トリガーを再び押し込んだり再び解
除したりすることで解除自在ロック機構がロック解除又
は係合解除される。そのような機構は習熟が容易であ
り、またロック状態からロック解除状態への切換えが容
易である。したがって、直覚的で容易に使用できる解除
自在ロック機構が外科医に対して提供される。
係合した際に端部作動体が妨害されることなく閉じるこ
とを可能とし、該端部作動体を使用者が開こうとした際
にロックされる解除自在ロック機構を提供する。この種
の解除自在ロック機構は、開放式及び腹腔鏡式外科処置
の際に組織を把持又はクランプするのに特に適してい
る。そのような解除自在ロック機構は、外科用器具(把
持器、バブコック等)にとって理想的である。
具は、係合した際に外科医に対して閉じている間に無数
のロック位置を提供する解除自在ロック機構を提供す
る。この種の解除自在ロック機構によって、外科医に対
して組織の厚さや組織の圧縮性に関わりなく適当な把持
力又はクランプ力が与えれられる。
器具は、外科医に対して人間工学的なハンドルアセンブ
リを提供する。このハンドルアセンブリは小さく、外科
医の手に十分フィットして操作を容易にする。人間工学
的なハンドルアセンブリは、小指用の弓形フィンガーフ
ックと、中指用及び薬指用の中央フィンガーループと、
人差し指用のフィンガーレストとを有する。親指によっ
て作動する移動可能な作動部材は、親指が掛かる作動ル
ープを有する。また、本発明のハンドヘルド型の外科用
器具の解除自在ロック機構は、弓形の経路内で湾曲して
おり、操作を容易にするために人差し指に対して解除用
トリガーが人間工学的に配置され、またハンドルアセン
ブリ内でロック用ロッドに対してロック用タブが人間工
学的に配置されている。
器具は、異なる寸法、形状、及び用途の多種多様な端部
作動体と組み合わせることが可能な普遍的なハンドルア
センブリを提供する。また、本発明のハンドヘルド型の
外科用器具は、組立の際に端部作動体を作動させるため
に容易に変化可能なストローク又は変位を提供する。ス
トロークが変化可能であることによって、異なる端部作
動体のストローク要求に対して良好に一致するストロー
クを提供することができる。
求の範囲で指摘され、開示の一部を形成している。本発
明をより一層理解するために、本発明の好ましい実施の
形態例が例証される図面及び発明の詳細な説明にもとづ
いて本発明を説明する。
に開示されている。しかし、本発明の構成及び操作の方
法については、本発明のさらなる目的及び利点ととも
に、図面を参照しながら以下の説明にもとづいて最も良
く理解することができよう。
腹腔鏡を用いる外科的処置の際に組織を把持およびクラ
ンプするためのハンドヘルド型の外科用器具である。特
に、本発明は端部作動体に動作可能に取り付けられた新
規かつ有用な解除自在ロック機構を持つ腹腔鏡手術用把
持およびクランプ器具に関する。係合した場合、端部作
動体が閉じて組織を把持またはクランプしている間、解
除自在ロック機構はほとんど抗力を与えない。また、使
用者が端部作動体を開こうと試みるとクランプ又はロッ
クされる。解除自在ロック機構は必要な時に容易に係合
解除される。本発明の外科用器具30を図1乃至図24
に示す。
用器具30の等角図である。腹腔鏡検査器具は、外科医
が把持するため近位側にあるハンドルアセンブリ40
と、該ハンドルアセンブリ40に回転自在に接続された
細長い軸部アセンブリ80と、該細長い軸部アセンブリ
80の遠位端に取り付けられた端部作動体95とを備え
る。本発明の目的は、寸法、形状、及び使用目的が異な
る多種多様な端部作動体を組み付けることが可能な普遍
的な外科用器具を提供することである。ハンドルアセン
ブリ40は人間工学的に設計されており、小指用の弓形
のフィンガーフック41と、中指用及び薬指用の固定フ
ィンガーループ42と、人差し指用のフィンガーレスト
43とを有する。可動の作動部材105は、親指用の作
動ループ106を有し、動作可能に端部作動体95に接
続している。作動部材105を固定フィンガーループ4
2から遠ざかる方向及び近づく方向に動かすことで端部
作動体95の開閉が行われる。説明及び図示を容易かつ
理解し易くするために、以下の説明では組織を把持およ
びクランプするのに適した一対の端部作動体95、すな
わち可動な第1及の顎部材96び第2の顎部材97を使
用して説明する。作動部材105は、解除自在ロック機
構115(図2乃至図3及び図5乃至図16)の解除用
トリガー120によって解除自在なかたちでロックされ
たり、ロック解除される。解除用トリガー120は通
常、ハンドルアセンブリ40から遠ざかる方向に付勢さ
れている。またハンドルアセンブリ40に近づく方向及
び該ハンドルアセンブリ40から遠ざかる方向への解除
用トリガー120の往復運動を交互に行うことにより解
除自在ロック機構115をロック及びロック解除する。
解除自在ロック機構115を構成する要素の大部分は、
ハンドルアセンブリ40の中に位置しており、後で詳細
に説明する。細長い軸部アセンブリ80は固定自在及び
回転自在にハンドルアセンブリ40の遠位端部内に取り
付けられている。回転ノブ81は、細長い軸部アセンブ
リ80と第1の顎部材96及び第2の顎部材97とを回
転させるために設けられている。
把持又はクランプする際に腹腔鏡外科用器具30の使用
及び操作が容易である。すなわち、解除自在ロック機構
115をロック解除することで、外科医は可動の第1の
顎部材96及び第2の顎部材97を容易に開閉して組織
を把持したり、巧みに扱うことができる。外科用器具3
0で組織をクランプするために、ハンドルアセンブリ4
0に近づく方向及び遠ざかる方向へ解除用トリガー12
0を前後に往復運動させることにより、外科医は第1の
顎部材96及び第2の顎部材97を開き、解除自在ロッ
ク機構を作動させ、所望の組織上で第1の顎部材96及
び第2の顎部材97をクランプするか又は閉じる。作動
部材105が解除されると、解除自在ロック機構115
は第1の顎部材96及び第2の顎部材97をロックして
閉じた状態を保つ。解除用トリガー120の第2の往復
運動により解除自在ロック機構115をロック解除する
ことによって第1の顎部材96及び第2の顎部材97が
開かれる。
の分解等角図である。図中、ハンドルアセンブリ40の
内部構成要素を示すために、右側ハンドルカバー45と
左側ハンドルカバー50とが分離されている。右側ハン
ドルカバー45及び左側ハンドルカバー50は、一般に
鏡像関係にあり、これらの間に長手方向に沿う鏡像の対
称面が定まる。この鏡像の対称面の例外は、右側ハンド
ルカバー45に設けられた部分的ループ44、右側ハン
ドルカバー45の内側から左側に延びる一連のグリップ
ピン(図示せず)、及び左側ハンドルカバー45に設け
られた一連の対応するグリップピンが係合するグリップ
ピンソケット40a(図3)である。その他の違いにつ
いては後述する。グリップピン及びグリップピンソケッ
ト40aは押し嵌めることによって結合する構造となっ
ており、それによって右側ハンドルカバー45と左側ハ
ンドルカバー50とが一体に保持される。
0の遠位端は内側方向に延びるハンドルフランジ部52
を有し、また細長い軸部アセンブリ80は回転ノブ81
の近位端部近傍に溝部82が形成されている。細長い軸
部アセンブリ80の溝部82と左側ハンドルカバー50
のハンドルフランジ部52とを係合することによって細
長い軸部アセンブリ80を左側ハンドルカバー50に取
り付ける。これによって、細長い軸部アセンブリ80が
軸線に沿ってハンドルアセンブリ40内に固定される回
転継手が形成される。細長い軸部アセンブリ80の近位
端部は、回転自在かつ動作可能に作動ロッド83を介し
て作動部材105に連結されている。作動部材105の
動きによって作動ロッド83が近位方向及び遠位方向に
細長い軸部アセンブリ80内で移動し、第1の顎部材9
6と第2の顎部材97とが閉じたり、開いたりする。
の対向した軸ピン107を有する。これらの軸ピン10
7は、右側ハンドルカバー45及び左側ハンドルカバー
50に位置する一対の対向した軸ピン受穴51に旋回自
在に設けられている。作動部材105は、軸ピン107
を軸ピン受穴51に挿入することによって右側ハンドル
カバー45及び左側ハンドルカバー50に旋回自在に設
けられる。断面が矩形状である作動ロック用ロッド10
8は、作動部材105の作動ループ106から遠位方向
に延びる。作動ロック用ロッド108(同様に作動部材
105の残りの部分)は、エンジニアリングサーモプラ
スチック、例えばスチレン、ポリカーボネート、ポリエ
ーテルアミド、液晶ポリマー、又は医学用器具で一般に
使用されている他のいくつかのエンジニアリングサーモ
プラスチックのいずれかから作られる。
ー120を含む)が組み合わされ、作動部材105をロ
ック又はロック解除するために該作動部材105の作動
ロック用ロッド108に動作可能に連結し、また間接的
に第1の顎部材96及び第2の顎部材97に連結してい
る。解除自在ロック機構115は、解除用トリガー12
0の連続的な往復運動、すなわちハンドルアセンブリ4
0に近づく動き及びハンドルアセンブリ40から遠ざか
る動きに応答して、作動部材105の係合及び係合解除
を交互に行う。この点に関しては以下に詳細に説明す
る。
かたちで示す等角図であり、該外科用器具を構成する全
ての構成要素が示されている図である。細長い軸部アセ
ンブリ80の主軸は細長い軸部85である。この細長い
軸部85は、薄いシート状の外科用品質基準の金属から
形成されている。すなわち、この細長い軸部85は、ス
テンレス鋼管で細長い軸部85を作るというような従来
の方法によって形成されるものではなく、連続型抜き及
び板金成型等、一連の成型工程によって平坦なシートか
ら形成される。ステンレス鋼からなる平坦なシートを巻
いたり、或いは形作ることで断面が円筒状で、軸方向に
沿う継ぎ目87及び遠位端側Uリンク86を有する中空
の細長い軸部85にする。軸方向に沿う継ぎ目87は、
スチール鋼からなる平坦な帯(図示せず)の長手方向に
沿う縁部が一緒に巻かれて円筒状の細長い軸部85を形
成するところである。型抜き及び成型プロセスは、長手
方向の縁部をあらかじめ互いに合わせ、図3において細
長い軸部85の下部に位置していることから軸線に沿う
継ぎ目87は図示されていない。断熱材88で細長い軸
部85を覆うことで電気焼灼器使用の際に外科医及び患
者を保護する。細長い軸部85の近位端部と係合する一
対の軸アダプタ89は、回転ノブ81によって一緒に固
定される。軸アダプタ89は、既に述べたように、細長
い軸部アセンブリ80をハンドルアセンブリ40に挿入
した場合にハンドルフランジ部52と係合する溝部82
を有する。細長い軸部85の遠心端部には、ピボット部
材98がUリンク86内で第1の顎部材96及び第2の
顎部材97に可動なかたちで取り付けられている。
軸的に配置され、かつ可動である。端部作動体95の一
対のリンク99によって作動ロッド83の遠位端部が動
作可能に第1の顎部材96及び第2の顎部材97に接続
されている。作動ロッド83の近位端部上に、対向する
ノッチ84が2対形成されており、一方の対が近位側で
他方の対が遠位側となるようにして配置されている。な
お、組み立て方法を明確に与えるために、作動ロッド8
3の切断された近位端部が図3の分解図において2度出
現していることを留意しておく。一対の作動半球体90
が一対のノッチ84に取り付けられ、作動ロッド83の
遠位端部における球体状の回転及び作動継手となる(図
23乃至図24)。作動半球体90の各々は、ロックピ
ン91とロック用ソケット92とを有し、さらに一対の
作動半球体90同士を圧して接合させることによって球
体が形成される。組み立ての際に、ロック用ピン91と
対向するロック用ソケット92とが整合されるように作
動半球体90を配置することが重要である。図23及び
図24に示すように、作動半球体90は一対のノッチ8
4にある近位側又は遠位側の2つの位置のいずれか一つ
にロックすることができる。図23は近位側の取付位置
を示している図であり、一方、図24は第2の作動半球
体90の取付に先立して遠位端側の取付位置が示されて
いる図である。この2つの位置で作動半球体90が取付
けられることによって、端部作動体95において2通り
の異なったストローク(デュアルストローク)又は直線
往復運動形の出力が得られる。デュアルストローク機能
は、一般的なハンドルアセンブリ40及び細長い軸部ア
センブリ80に多種多様な寸法及び形態の端部作動体を
適用することを目的とした製造の過程で特に必要であ
る。
転及び作動継手が形成される。この継手は作動部材10
5の左片側部材110と右片側部材111の内側に位置
した球体ソケット109の中に据えられる。左片側部材
110と右片側部材111とが一緒にロックされて、組
み立てられた作動部材105内に組み合わせられた作動
半球体90が捕捉される。
除自在ロック機構115は、解除用トリガー120、ト
リガーバネ125、弾性部材(伝達部材)130、カム
ボタン135、プランジャー145、ロック用タブ15
5、及びロック用バネ165から構成される。解除用ト
リガー120、トリガーバネ125、伝達部材130及
びカムボタン135が一緒に結合してサブアセンブリを
形成する。解除自在ロック機構115の構成要素は、ハ
ンドルアセンブリ40の右側ハンドルカバー45及び左
側ハンドルカバー50の中に取り付けられる。
であり、ハンドルアセンブリ40の中に往復運動自在に
取付けられている。解除用トリガー120の連続的な往
復運動、すなわちハンドルアセンブリ40に近づく方向
への動き及びハンドルアセンブリ40から遠ざかる方向
への動きに応答して解除自在ロック機構115の係合及
び係合解除が行われる。解除用トリガー120は、指
(図示せず)を掛けるためのフィンガーパッド121と
遠位方向に延びるトリガー軸122とを有する。リブ1
23がトリガー軸122の軸線に沿って該トリガー軸1
22の底部に延びていることから、トリガー軸122の
断面形状が鍵穴形となり、それによってハンドルアセン
ブリ40内でのフィンガーパッド121の回転が防げ
る。保持リング124もまたトリガー軸122の近位端
部に設けられており、トリガーバネ125と係合してハ
ンドルアセンブリ40から解除用トリガー120が排除
されるのを防ぐ。ピン124a(図3)が保持リング1
24から近位方向に延びており、解除用トリガー120
の近位端部で弾性部材130に固定可能に取り付けられ
ている。
り、解除用トリガー120からの動力及び動作入力を弓
形経路に沿って解除自在ロック機構115の他の可動要
素へ伝達する。多くの他の伝達部材、例えば弾力性の
管、薄いワイヤ、ビーズのストリング、或いは多くの弾
性伝達部材のいずれも同様に動力及び動作を弓形経路に
沿って伝達可能であることは、当業者にとって明らかで
ある。
0の遠位端部に連結しており、ハンドルアセンブリ40
内で近位方向及び遠位方向に沿って往復運動する。カム
ボタン135は図20乃至図22に最もよく図示されて
おり、解除自在ロック機構115のロック及びロック解
除を行うためにプランジャー145と係合している。カ
ムボタン135は中心に位置したボタン状の円板136
と、弾性部材130と結合する近位端側ポスト137
と、遠位端側ガイド軸138とを有する。また、ハンド
ルアセンブリ40内でのカムボタン135の回転を防ぐ
ために、4枚の等間隔に離間したカムリブ139が円板
136から半径方向に沿って外側に延びている。さら
に、4枚のカム歯140がカムボタン135の近位端面
に位置し、各カムリブ139から半径方向に沿って内側
に延びている。これらのカム歯140の使用については
後述する。ガイド軸138は、プランジャー145の整
合及び誘導のために、カム歯140から近位方向に延び
ている。
ック機構115のロック及びロック解除を行うために、
ハンドルアセンブリ40内のいくつかの位置を通って往
復及び回転する。図17乃至図19に最も良く図示され
ているように、プランジャー145は、概ね中空の円柱
状であり、本体146と、ガイド軸138が係合する開
口部147(図19)とを有する。一対の対向したプラ
ンジャーリブ149が本体146の遠位端部近傍で半径
方向に沿って外側に延びている。傾斜したランプ面15
0が、各プランジャーリブ149の遠位端部に位置して
おり、右側ハンドルカバー45及び左側ハンドルカバー
50の特徴的な形状と係合する。傾斜したランプ面15
0及びピーク面152が、各プランジャーリブ149の
遠位端部でプランジャーピーク152を形成する。カム
ボタン135の4枚のカム歯140(図20)に対応し
て等間隔で離間した同一寸法及び同一ピッチの4枚の歯
153が本体146の遠位端側の面に位置するとともに
半径方向に沿って内側に延びている。ここで注意すべき
ことは、プランジャーリブ149はプランジャー歯15
3と直接整合されているものではないことである。この
ことの意義については後述する。また、このような傾斜
したランプ面150及びプランジャー歯153を用いて
作動部材105のロック及びロック解除を行うことにつ
いても詳細に後述する。ロック用タブ155と係合する
ために、プランジャー145の近位端部に丸みを帯びた
面148が形成されている。
ルカバー45及び左側ハンドルカバー50の中に旋回自
在に設けられており、作動部材105の矩形状のロック
用ロッド108と係合する。ロック用タブ155は、平
坦な片状の材料をZ字形に加工したものであり、ロック
用ロッド108を受けるために垂直方向に延びる脚部1
57にロック用開口部156を有する。任意の位置でロ
ック用ロッド108をグリップ又はクランプするため
に、ロック用開口部156の内側の上端面及び下端面が
滑面となっている。接点における接線に対して概ね垂直
な位置までロック用タブ155が旋回するとき、ロック
用ロッド108はロック用タブ155の開口部156内
を自由に滑動する。ロック用タブ155が適当な角度に
旋回するとき、一方向においてはロック用ロッド108
が摩擦によってロックされ、他方向においてはロック用
タブ155と滑動自在に係合する。例えば、図14に示
す配向では、作動部材105がハンドルアセンブリ40
から遠ざかる方向に動こうとする際に、ロック用タブ1
55がロック用ロッド108をロックする。ロック用タ
ブ155は通常、ロック用タブバネ165によってプラ
ンジャー145の丸みを帯びた面148に向けてロック
位置方向に付勢されている。ロック用ロッド108とと
もにロック用タブ155をロック及びロック解除するの
は、ハンドルアセンブリ40に対するプランジャー14
5の位置である。
要素を支持するとともに動作可能に係合する左側ハンド
ルカバー50の内部主要構造を示す拡大図である。解除
自在ロック機構115の可動要素は、内部主要構造の中
で弧を描くように形成された弓形の経路に設けられてお
り、大部分のものが右側ハンドルカバー45と鏡像の関
係にある(図3)。左側ハンドルカバー50と右側ハン
ドルカバー45とを組み合わせると、解除自在ロック機
構115の構成要素を保持する内部主要構造は一般に一
連の弓形の円筒又はスロットをハンドルアセンブリ40
の中心部分に相互接続する。解除自在ロック機構115
の弓形経路の略円筒状の構造は、ほとんどの場合、右側
ハンドルカバー45と左側ハンドルカバー50との間で
長手方向に沿って等しく分割される。
54が、左側ハンドルカバー50の固定フィンガールー
プ42上に位置している。トリガー開口部53及びトリ
ガースロット54は、ハンドルアセンブリ40内に鍵穴
形状の開口部を形成し、それによって解除用トリガー1
20及びリブ123を受ける(図3)。鍵穴形状の開口
部は、鍵穴形状のトリガー軸122及びリブ123の回
転を防ぐ。直径がトリガー開口部53よりも大きい円筒
状のトリガーバネ開口部55がトリガー開口部53と同
軸的に位置し、またトリガー開口部53よりも近位側に
位置している。トリガーバネ125(図3)及び解除用
トリガー120の近位端部は、円筒状のトリガーバネ開
口部55内に据えられ、解除用トリガー120はハンド
ルアセンブリ40から遠ざかる方向に付勢されている
(図6の矢印参照)。弓形スロット56がトリガーバネ
開口部55から近位方向に延びており、弾性部材130
(図3)を受けるとともに誘導する。
カムボタン開口部57に接続している。カムボタン開口
部57は、往復運動するカムボタン135を受ける。一
対の水平スロット58及び一対の垂直スロット59がカ
ムボタン開口部57の軸線から半径方向外側に向けて左
側ハンドルカバー50及び右側ハンドルカバー45の中
に延びている。水平スロット58及び垂直スロット59
は、カムボタン135のカムリブ139を受け、該カム
ボタン135の往復運動の際にカムボタン135が回転
するのを防ぐ。図5に示すように右側ハンドルカバー4
5と左側ハンドルカバー50との当接面を示す縦方向の
線に沿って、カムボタン開口部57及び垂直スロット5
9が等しく分割されている。一つの水平スロット58が
左側ハンドルカバー50の中に位置しており、一方それ
に対向するスロットはその鏡像として右側ハンドルカバ
ー45の中に位置している。ここで注意しておくべき点
は、一対の垂直面60によって垂直スロット59の左側
壁部及び右側壁部が形成されており、左側壁部は左側ハ
ンドルカバー50の中に位置し、右側壁部は右側ハンド
ルカバー45の中に位置していることである。
位端部、水平スロット58、及び垂直スロット59は、
より大きな円筒状のプランジャー開口部67に開いてい
る。図5では、プランジャー開口部67を横切る左側ハ
ンドルカバー50の断面図が示されている。ハンドルア
センブリ40のプランジャー開口部67は、一対のロッ
ク用歯62と一対のロック解除用歯64とを備え、これ
らは水平スロット58と垂直スロット59の各対の間か
ら遠位方向に延びている。図5に最も良く示されている
ように、ロック用歯62及びロック解除用歯64はプラ
ンジャー開口部67の内側円周に交互に設けられてい
る。図4では、左側ハンドルカバー50内のロック用歯
62及びロック解除用歯64は2通りの異なる歯形を持
つ。これらの歯形は解除自在ロック機構115を交互に
ロック及びロック解除する上で重要な役割を担う。
は、水平スロット58及び傾斜したロック用ランプ62
aから延びる停止面66から形成される。停止面66及
びロック用ランプ62aは、ロック用ピーク63で交差
する。ロック用ランプ62aはロック用ピーク63から
所定の角度で傾斜(図4)してロック用エッジ61で
(垂直スロット59の)垂直面60と交差する。ロック
解除用歯64の歯形は、停止面66及びプランジャー開
口部67の壁部(図4)から浅い角度で延びるロック解
除用ランプ65から形成される。右側ハンドルカバー4
5及び左側ハンドルカバー50の各々において、ロック
解除用ランプ65(図4)はロック解除用エッジ64a
で垂直スロット59の垂直面60と交差する。このよう
な構成の目的は後述する。円筒状ジャーナル68がプラ
ンジャー開口部67の近位端部に設けられており、プラ
ンジャー145を受ける。
ルカバー50内の円筒状ジャーナル68の上方かつ近位
側に位置しており、ロック用タブ155(図3)を受け
る。右側ハンドルカバー45にも左側ハンドルカバー5
0のロック用タブスロット69と同様のロック用タブス
ロット(図示せず)が形成されており、これらは互いに
鏡像の関係にある。バネポケット70がロック用タブス
ロット69の下に形成されており、ロック用タブバネ1
65を受ける。ロック用タブバネ165は、通常ロック
用タブ155をロック位置方向に、およびプランジャー
145の丸みを帯びた面148とは逆の方向に付勢す
る。
て、配置、及び動作をここで若干詳細に説明する。ここ
で、図3を再び見てみると、この図は解除自在ロック機
構115の個々の要素を示す分解図である。また、図1
1乃至図16は、カムボタン135及びプランジャー1
45をさらに詳細に説明するための図である。さらに図
4は、解除自在ロック機構115の要素を保持し、かつ
相互作用するハンドルカバーの特徴的構造を示す図であ
る。さらに、図6,図8,図10,図12,図14及び
図15では、内部構成要素の配置を示すために、右側ハ
ンドルカバー45が取り外されている。図5,図7,図
9,図11,図13及び図16の断面図では、切断した
左側ハンドルカバー50が断面線で示されており、右側
ハンドルカバー45は破線で示されている。
は、作動部材105が可動となるロック解除位置に解除
自在ロック機構115が置かれていることが示されてい
る。作動部材105は端部作動体95を開くためにハン
ドルアセンブリ40から遠ざかる方向に移動しているの
が図示されている。往復運動する解除用トリガー120
は、トリガーバネ125によってハンドルアセンブリ4
0から遠ざかる通常の位置に付勢されている。保持リン
グ124は、トリガーバネ開口部55の遠位端に対して
付勢され、解除用トリガー120が排除されるのを防
ぐ。解除用トリガー120の上に矢印が記されており、
付勢の方向を示している。
5は、左側ハンドルカバー50の弓形スロット56内で
往復運動する弾性部材130に動作可能なかたちで接続
されている。解除自在ロック機構115は、ロック解除
位置にあり、カムボタン135がトリガーバネ125に
よってカムボタン開口部57の遠位端部に対して付勢さ
れている。右側ハンドルカバー45及び左側ハンドルカ
バー50の両方にまたがる水平スロット58及び垂直ス
ロット59内にカムリブ139を捕捉することで、カム
ボタン135の回転が防げる。プランジャー145は、
カムボタン135から近位方向に離れたロック解除位置
にあるプランジャー開口部67の中に捕捉されている。
このロック解除位置ではプランジャー145のプランジ
ャーリブ149が概ね水平に配向されている。プランジ
ャー145は、ロック用タブバネ165及びロック用タ
ブ155によって遠位方向に付勢されている。また、プ
ランジャーリブ149の遠位側プランジャーピーク15
1は、停止面66(図4)とロック解除用ランプ65
(図4)との交線から形成される一対の水平方向に対向
した谷部の中に捕捉される。図7もまた、プランジャー
145及びプランジャー開口部67の断面図を示すもの
で、停止面66とロック解除用ランプ65とによって形
成された両方の谷部の中に両方のプランジャーピーク1
51が捕捉されるのを強調して示す。
は、左側ハンドルカバー50のロック用タブスロット6
9に旋回自在なかたちで取り付けられている。ロック用
タブ155は、ロック用開口部156を通過するロック
用ロッド108によってハンドルアセンブリ40内に垂
直に配向している。ロック用タブバネ165は、旋回す
るロック用タブ155を、往復運動するプランジャー1
45に対して遠位方向に常に付勢する。上記の通り、ロ
ック用タブ155をロック用ロッド108に係合又は係
合解除するのは、プランジャー145の(ハンドルアセ
ンブリ40に対する)位置である。ロック用タブバネ1
65は左側ハンドルカバー50のバネポケット70の中
に示されている。
の最初の往復運動によって解除自在ロック機構115を
ロック位置からロック解除位置に切り換えるプロセスを
説明するためのものである。図8は図6に類似している
が、解除自在ロック機構115をロック解除位置からロ
ック位置に切り換えるプロセスの第1のステップにおい
て解除用トリガー120が部分的に押し込まれて示され
ている。図9は、プランジャー開口部67の特徴ととも
にプランジャー145の配向を示す図8の一部断面図で
ある。図8において、解除用トリガー120は部分的に
押し込まれており、トリガーバネ125が矢印によって
示される動きの方向に圧縮されている。弓形スロット5
6によって形成される弓状の経路に沿って解除用トリガ
ー120からの力及び動作を弾性部材130が伝達し
て、カムボタン135がカムボタン開口部57の中を近
位方向に動いてプランジャー145と接触する。この動
作によって、プランジャー145はプランジャーピーク
151(プランジャーリブ149の遠位端にある)がロ
ック用歯62のロック用ピーク63を通過するためにバ
ランスがとれる位置に向けて遠位方向に動く。右側ハン
ドルカバー45のロック用ピーク63の小さな断面部分
が図8においてハッチングによって図示されている。こ
れによって、ロック用ピーク63に対するプランジャー
ピーク151の位置が明らかに示されている。
遠位方向に動かす際に、カム歯140はプランジャー歯
153と完全には噛み合っていない。この部分的な噛み
合いは、図8及び図9に示されるように、ハンドルアセ
ンブリ40に対するカム歯140の固定配向とプランジ
ャーの回転配向によって生ずる。プランジャー145の
回転配向は、プランジャーリブ149のピーク面152
と右左ハンドルカバー45及び50の停止面66との接
触によって生ずる。ロック用タブ155は、図8に示す
位置でロック用ロッド108によってロック解除され
る。
ロック解除状態からロック状態に切り換えるプロセスの
第2のステップにおいて解除自在ロック機構115の要
素を示す図である。図10において、解除用トリガー1
20の連続する近位方向への動きによってプランジャー
145のプランジャーピーク151が右左ハンドルカバ
ー45及び50のロック用ピーク63を遠位方向に通り
越し、その結果プランジャー145の回転が自在とな
る。プランジャー145が回転自由となることによっ
て、圧縮されたロック用タブバネ165の遠位方向の付
勢が図8の部分的に噛み合ったプランジャー歯153を
動かして、図10に示す位置にカムボタン135のカム
歯140を滑り込ませる。この滑り動作がプランジャー
145を遠位方向に動かし、プランジャー145をロッ
ク用ピーク63を通り越して図10乃至図11に示す位
置に回転させる(概ね上を向いている矢印を参照)。ひ
とたびカム歯140とプランジャー歯153とが完全に
噛み合うと、プランジャー145は方向を変えて右左ハ
ンドルカバー45及び50に対して解除用トリガー12
0が当接するまでカムボタン135に沿って近位方向に
移動する(図示せず)。この時点で、トリガーバネ12
5及びロック用タブバネ165の両方が完全に圧縮され
る。解除用トリガー120が解除されると、解除自在ロ
ック機構115がロック用タブバネ165の付勢下で遠
位方向に移動し、トリガーバネ125は図10及び図1
1に示す位置に戻る。この時点で、プランジャーピーク
151は、右左ハンドルカバー45及び50のロック用
ランプ62aに再び係合する。右側ハンドルカバー45
のロック用歯62の小さな断面部分は、プランジャー1
45のプランジャーピーク151とロック用ランプ62
aとの係合を明確に見せるためのものである。
は図10に示す第2の位置から図12に示す第3の位置
に向けて遠位方向に移動を続ける。プランジャーピーク
151とロック用ランプ62aとが接触することでプラ
ンジャー145が図12に示す位置に回転する。プラン
ジャー145上に示される矢印は回転の方向を示してい
る。プランジャー145が図10に示す位置から回転す
る際に、プランジャー歯153はカム歯140上を滑
り、遠位方向に移動しているカムボタン135からプラ
ンジャー145を分離する。この分離によってプランジ
ャー歯153がカム歯140の第1の組の面に乗り上げ
て、カム歯140の次の第2の組との噛み合わせに跳び
込むことが可能となる。この跳び込み及び回転によって
プランジャー145は図12に示す位置に移動する。
5のプランジャーリブ149は右左ハンドルカバー45
及び50の垂直スロット59と整合している。プランジ
ャーリブ149のピーク面152(図17乃至図19)
が右左ハンドルカバー45及び50の垂直面60と接し
ているので、プランジャー145のさらなる回転を防げ
る。この位置において、プランジャー145は、部分的
に圧縮されたロック用タブバネ165の付勢下で遠位方
向に沿って垂直スロット59への移動が自在となり、ロ
ック解除プロセスが完了する。ロック用タブバネ165
の付勢はまた、プランジャー歯153とカム歯140と
の部分的噛み合わせを強制する。プランジャー145の
プランジャーリブ149が垂直スロット59内に位置し
ている限り、カム歯140とプランジャー歯153は部
分的に噛み合った状態に留まる。
要素の遠位方向への移動が完了し、ロック位置にある解
除自在ロック機構115を有する外科用器具30が図示
されている。解除用トリガー120は通常の位置(ハン
ドルアセンブリ40から完全に延びきった位置)に戻
り、一回の完全な往復運動を完了して解除自在ロック機
構115をロックする。すなわち、解除用トリガー12
0は図6に示す通常の延長位置から右左ハンドルカバー
45及び50に近接又は当接する位置に移動し、再び図
14に示す位置に戻る。端部作動体95は完全に閉じた
位置にあり、端部作動体95を開こうとした時に解除自
在ロック機構115はロックされる。解除用トリガー1
20を再び往復運動させて解除自在ロック機構115を
係合解除しない限り、もはや閉じた作動部材105を開
くことは不可能である。
とロックされた係合状態で示されている。ロック用タブ
155及びプランジャー145はロック用タブバネ16
5によって遠位方向に付勢され、またプランジャー14
5は最も遠位方向にある位置へ移動してロック用タブ1
55を反時計方向に旋回させてロック位置にする(矢印
参照)。トリガーバネ125は解除用トリガー120を
図14に示す延長位置に付勢している。解除自在ロック
機構115の要素は作動部材105が再び往復運動を開
始するまでロック位置に留まる。
0が第2回目の往復運動を開始することで解除自在ロッ
ク機構115がロック位置からロック解除位置へ切り換
えられるプロセスを説明するためのものである。図15
において、ハンドルアセンブリ40に近接した位置まで
近位方向に沿って作動部材105が押し込まれる。作動
部材105の動作によってカムボタン135及び部分的
に係合したプランジャー145が近位方向に移動する。
カムボタン135及びプランジャー145が近位方向に
移動する際に、解除自在ロック機構115の要素が図1
2に既に示した位置に達するまでカム歯140はプラン
ジャー歯153(図14参照)に部分的に噛み合った状
態に留まる。解除自在ロック機構115の要素がさらに
遠位方向に動くことによって、プランジャー145の遠
位側プランジャーピーク151が近位方向に動いて右左
ハンドルカバー45及び50の垂直面60(図4)のロ
ック解除用エッジ64aを通り越すことが可能となる。
この動作によってプランジャー145が回転式にロック
解除され、プランジャー歯153がカム歯140上を滑
動し、図15及び図16に示す完全に係合した位置にプ
ランジャー145が回転する。この回転によって下の方
のプランジャーリブ149が動いて視界に入る。完全に
係合したプランジャー145及びカムボタン135はハ
ンドルアセンブリ40内で遠位方向に移動を続けて図1
5及び図16に示す位置に達する。ロック用タブ155
はプランジャー145によって時計方向(矢印参照)に
付勢されてロック解除される。ここで注意しておく点
は、図16において、プランジャー145のプランジャ
ーリブ149が上述した位置まで回転し、この位置でロ
ック解除用ランプ65に部分的に重なることである。
ような完全に押し込まれた位置から操作者によって解除
される時に、解除自在ロック機構115の移動可能な構
成要素はロック用タブバネ165の付勢下で遠位方向に
移動する。解除自在ロック機構115の遠位方向への移
動によって、プランジャー145のプランジャーピーク
151が右左ハンドルカバー45及び50の傾斜したロ
ック解除用ランプ65と滑り接触する。この滑り接触に
よってプランジャー145が図6のロック解除位置に回
転し、この位置においてプランジャーリブ149の遠位
側プランジャーピーク151が、停止面66とロック解
除用ランプ65との交差部分から形成された一対の水平
に対向する谷部の中に捕捉される。カムボタン135及
び作動部材105は図6の延長位置に戻り、第2のロッ
ク解除往復運動を完了する。
て説明したが、それらの実施形態例は本発明を説明する
ことのみを目的として提供されたものであるこは当業者
ならば容易に理解することができよう。数多くの変形、
改良、置換等が本発明から逸脱することなく可能である
ことは当業者にとって明らかとなろう。したがって、本
発明の範囲は特許請求の範囲にもとづいてのみ定めるこ
とができる。
弓形経路にある前記ロック用タブに動作可能に結合して
いる請求項1に記載の外科用器具。 (2)第1の位置に向けて解除用トリガーを付勢するた
めに、前記ハンドルアセンブリ上にトリガーバネがさら
に設けられている実施態様(1)に記載の外科用器具。 (3)前記解除用トリガーは遠位側フィンガーパッドを
有する実施態様(2)に記載の外科用器具。 (4)前記解除用トリガーは、前記遠位側フィンガーパ
ッドから前記ハンドルアセンブリの中に近位方向に延び
る細長いトリガー部材を有する実施態様(3)に記載の
外科用器具。 (5)前記解除用トリガーは、前記トリガー部材の周り
に前記ハンドルアセンブリ内で前記解除用トリガーが回
転するのを防ぐために、前記トリガー部材上に軸線方向
に沿って延びるリブを有する実施態様(4)に記載の外
科用器具。
ック用タブに動作可能に接続したロック用タブバネをさ
らに備え、該ロック用タブバネは前記ロック用タブを前
記ロック位置に向けて付勢し、前記ロック用タブがロッ
ク位置にある時に前記ロック用タブを前記ロック用ロッ
ドにロックする実施態様(5)に記載の外科用器具。 (7)前記ロック用タブは矩形状の開口部を有する実施
態様(6)に記載の外科用器具。 (8)前記ロック用ロッドは矩形状の断面を有し、前記
ロック用タブの前記矩形状の開口部が前記ロック用ロッ
ドを受ける実施態様(7)に記載の外科用器具。 (9)前記ロック用ロッドが湾曲している実施態様
(8)に記載の外科用器具。 (10)前記ロック用ロッドは、エンジニアリングサー
モプラスチックから作られる実施態様(9)に記載の外
科用器具。
部材の少なくとも一部分とともに一体的に形成される実
施態様(10)に記載の外科用器具。 (12)前記作動部材はフィンガーループを有する実施
態様(10)に記載の外科用器具。
具は多種多様な端部作動体に対応することができ、また
直覚的かつ容易に使用することが可能な解除自在ロック
機構が得られ、さらに組織の厚さや組織の圧縮性に関わ
りなく適当な把持又は把握力を与えることを可能とする
効果がある。
図であって、該ハンドヘルド型の外科用器具は作動部材
のロック及びロック解除を行うための解除自在ロック機
構を有する図である。
図であって、ハンドルアセンブリ内に設けられたサブア
センブリが示されている図である。
てを分解したかたちで示す分解等角図である。
部の一部を示す側面図であり、図1のハンドヘルド型の
外科用器具の解除自在ロック機構を保持及び係合する構
成が示されている図である。
し、右側ハンドルカバーの一部を破線で示す断面図であ
る。
た状態を示す側面図であって、解除自在ロック機構がロ
ック解除された時の要素の位置が分かるように右側ハン
ドルカバーが取り除かれている図である。
器具の断面図であって、解除自在ロック機構がロック解
除された時の、ハッチングで表された左側ハンドルカバ
ー及び破線で表された右側ハンドルカバーに対するプラ
ンジャーの位置を示す図である。
器具の側面図であって、解除自在ロック機構がロックさ
れ始める過程にある時の要素の第1の位置が分かるよう
に、右側ハンドルカバーが取り除かれている図である。
器具の一部の断面図であって、解除自在ロック機構がロ
ックされ始める過程にある時の、ハッチングで表された
左側ハンドルカバー及び破線で表された右側ハンドルカ
バーに対するプランジャーの位置を示す図である。
用器具の一部の断面図であって、解除自在ロック機構が
ロックされ始める過程にある時の要素の第2の位置が分
かるように、右側ハンドルカバーが取り除かれている図
である。
用器具の一部の断面図であって、解除自在ロック機構が
ロックされ始める過程にある時の、ハッチングで表され
た左側ハンドルカバー及び破線で表された右側ハンドル
カバーに対するプランジャーの位置を示す図である。
用器具の一部の断面図であって、解除自在ロック機構が
ロックされ始める過程にある時の要素の第3の位置が分
かるように、右側ハンドルカバーが取り除かれている図
である。
用器具の一部の断面図であって、解除自在ロック機構が
ロックされ始める過程にある時の、ハッチングで表され
た左側ハンドルカバー及び破線で表された右側ハンドル
カバーに対するプランジャーの位置を示す図である。
用器具の一部の断面図であって、解除自在ロック機構が
ロックされる時の要素が分かるように、右側ハンドルカ
バーが取り除かれている図である。
用器具の一部の断面図であって、解除自在ロック機構の
ロック解除が始まる過程にある時の要素が分かるよう
に、右側ハンドルカバーが取り除かれている図である。
用器具の一部の断面図であって、解除自在ロック機構の
ロック解除が始まる過程にある時の、ハッチングで表さ
れた左側ハンドルカバー及び破線で表された右側ハンド
ルカバーに対するプランジャーの位置を示す図である。
ランジャーの正面図である。
プランジャーの上面図である。
プランジャーの端面図である。
正面図である。
カムボタンの上面図である。
カムボタンの端面図である。
対する第1の位置に置かれた作動半球体の正面図であ
る。
対する第2の位置に置かれた作動半球体の正面図であ
る。
Claims (1)
- 【請求項1】 組織を把持及びクランプするための外科
用器具であって、 ハンドルアセンブリと、 近位端部及び遠位端部を有し、前記近位端部で前記ハン
ドルアセンブリと接続する細長い軸部と、 前記細長い軸部の前記遠位端部に位置した少なくとも一
つの可動部材を有する端部作動体と、 近位端部を有し、前記ハンドルアセンブリから遠ざかる
方向及び前記ハンドルアセンブリに近づく方向に移動可
能であり、前記少なくとも一つの可動部材の動作を始動
させるために動作可能に前記端部作動体に接続した作動
部材と、 前記ハンドルアセンブリ上に設けられ、開口部を有し、
ロック位置とロック解除位置との間で移動可能であるロ
ック用タブと、 近位端部及び遠位端部を有し、前記作動部材の前記近位
端部で前記作動部材に固定されており、前記作動部材が
前記ハンドルアセンブリから遠ざかる方向及び前記ハン
ドルアセンブリに近づく方向に移動することを可能とす
べく前記ロック用タブが前記ロック解除位置にある時に
少なくとも前記遠位端部が前記ロック用タブの前記開口
部を介して移動可能に前記ロック用タブと係合し、ま
た、前記ハンドルアセンブリから遠ざかる方向への前記
作動部材の移動を防止すべく前記ロック用タブが前記ロ
ック位置にある時に前記ロック用タブに対して固定され
るロック用ロッドと、 前記ロック用タブに動作可能に連結し、前記ハンドルア
センブリから離れた第1の位置と前記ハンドルアセンブ
リに近接する第2の位置との間を前記ハンドルアセンブ
リ内で移動可能であり、また、最初に前記第1の位置か
ら前記第2の位置に向けて前記ハンドルアセンブリに押
し込まれ、続いて第2の位置から解除されて前記第1の
位置へ戻る時に往復運動可能であり、連続した往復運動
を行うことで前記ロック用タブを前記ロック位置と前記
ロック解除位置との間で交互させる解除用トリガーとを
備えることを特徴とする外科用器具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/349,028 US6117158A (en) | 1999-07-07 | 1999-07-07 | Ratchet release mechanism for hand held instruments |
US349028 | 1999-07-07 |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2001046384A true JP2001046384A (ja) | 2001-02-20 |
JP4141623B2 JP4141623B2 (ja) | 2008-08-27 |
Family
ID=23370590
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000205637A Expired - Lifetime JP4141623B2 (ja) | 1999-07-07 | 2000-07-06 | 外科用器具 |
Country Status (7)
Country | Link |
---|---|
US (1) | US6117158A (ja) |
EP (1) | EP1066797B1 (ja) |
JP (1) | JP4141623B2 (ja) |
AU (1) | AU767258B2 (ja) |
CA (1) | CA2313424C (ja) |
DE (1) | DE60023068T2 (ja) |
ES (1) | ES2248020T3 (ja) |
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Also Published As
Publication number | Publication date |
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CA2313424C (en) | 2007-04-24 |
AU767258B2 (en) | 2003-11-06 |
EP1066797B1 (en) | 2005-10-12 |
AU4508900A (en) | 2001-01-11 |
EP1066797A1 (en) | 2001-01-10 |
ES2248020T3 (es) | 2006-03-16 |
US6117158A (en) | 2000-09-12 |
DE60023068D1 (de) | 2005-11-17 |
DE60023068T2 (de) | 2006-07-27 |
CA2313424A1 (en) | 2001-01-07 |
JP4141623B2 (ja) | 2008-08-27 |
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