JP2008504051A - 外科手術用ハンドアクセス装置 - Google Patents
外科手術用ハンドアクセス装置 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00265—Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
- A61B2017/3464—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
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Abstract
Description
本出願は、2004年4月5日に出願された仮出願番号60/559,548に対する利益を主張し、この内容は、本明細書中において参考として援用される。
本開示は、一般的に、体壁を横切る、体腔内へのシール状態でのアクセスを容易にするための外科手術用デバイス、より詳細には、腹腔鏡外科手術処置および内視鏡外科手術処置の間、外科医の手および/または外科手術用機器のシール状態での挿入を可能にするのに適合し得る外科手術用アクセス装置に関する。
内視鏡処置および腹腔鏡処置の両方を含む低侵襲性の外科手術処置によって、外科手術が、組織内の開口部から離れた器官、組織および脈管において実行され得る。腹腔鏡処置および内視鏡外科処置は、一般的に、身体内に挿入される任意の機器がシールされることを必要とする。すなわち、例えば、外科手術領域がガス注入される外科手術処置などの場合、切開部を通って身体内に気体が入らず、気体が出ないことを確実にするための用意がなされなければならない。これらの処置は、代表的に、カニューレを通して身体内に導入される外科手術用機器を使用する。カニューレは、それに関連するシールアセンブリを有する。シールアセンブリは、実質的に流体密なシールをこの機器の周りに提供して、確立された気腹術の完全性を保つ。
従って、本開示は、腹腔鏡外科手術処置および内視鏡外科手術処置の間、外科医の手および/または外科手術用機器のいずれかのシール状態での挿入を可能にするように適合可能な外科手術用アクセス装置に関する。このアクセス装置は、中心長手軸を規定し、物体の通過を可能にするように構成された寸法の第1の内部寸法を備える第1の内部通路を有するアクセスハウジング;第1の内部通路を横切ってハウジングに取り付けられ、実質的に流体密な関係で物体を受容するように適合されたシール(例えば、ゲルシール);およびこのハウジングに取り付け可能なアダプターを備える。アダプターは、アクセスハウジングの第1の内部寸法よりも小さい第2の内部寸法を規定する第2の内部通路を有するアクセス部材を備える。好ましくは、アクセスハウジングの第1の内部通路は、外科医の手の通過を可能にする寸法であり、一方アダプターの第2の内部通路は、外科手術用機器の通過を可能にする寸法である。アダプターは、第2の内部通路に対して配置され、機器との実質的な流体密な関係を確立するために適合された弁を備え得る。アクセスハウジングのシールは、アダプターのアクセス部材の周りに実質的な流体密なシールを形成するように適合される。アダプターは、アクセスハウジングに取り外し可能に取り付けられ得る。
本開示の外科手術用アクセス装置は、物体をこの装置を通して挿入する前、挿入の間、および挿入後において、患者の体腔と外側の大気との間に実質的なシールを提供する。この装置は、切開部を開創するために、可撓性ライナーおよび膨張可能部材を有し、その結果、この装置は、切開部を裏から覆い(line)、切開部を開創するために使用され得、外科手術部位にアクセスを提供する。
手で補助する腹腔鏡外科手術処置とともにアクセス装置100を使用することについて考察する。腹膜腔は、ガス注入され、例えば、トロカールを用いて、腔内に切開が作製され、当該分野で従来の通りに腔に対するアクセスを提供する。その後、開創器基部104は、第1の部材128を収縮させ、そして第1の部材128を切開部を通して体腔内に進めることによって、切開部内に導入される。第1の部材128は、腔内において、(その固有の弾性の影響下で)第1の部材128が、その通常の状態に戻り得るように開放される。ライナー部材126は、第1の部材128から切開部を通って延び、以前に考察されるように、切開部を裏から覆う。
Claims (27)
- 外科手術用アクセス装置であって、該装置が、以下:
中心長手軸を規定し、物体の通過を可能にするように構成された寸法の第1の内部寸法を規定する第1の内部通路を有するアクセスハウジング;
該第1の内部通路を横切って該ハウジングに取り付けられたシールであって、該シールが、実質的に流体密な関係で物体を受容するように適合されている、シール;および
該アクセスハウジングに取り付け可能なアダプターであって、該アダプターが、該アクセスハウジングの第1の内部寸法よりも小さい第2の内部寸法を規定する第2の内部通路を有するアクセス部材を備える、アダプター、
を備える、外科手術用アクセス装置。 - 請求項1に記載の外科手術用アクセス装置であって、前記アクセスハウジングの第1の内部通路が、外科医の手の通過を可能にする寸法である、外科手術用アクセス装置。
- 請求項1に記載の外科手術用アクセス装置であって、前記アダプターの第2の内部通路は、外科手術用機器の通過を可能にするような寸法である、外科手術用アクセス装置。
- 請求項3に記載の外科手術用アクセス装置であって、前記アダプターが、第2の内部通路に対して配置される弁を備え、該弁が、該機器との実質的な流体密な関係を確立するために適合されている、外科手術用アクセス装置。
- 請求項4に記載の外科手術用アクセス装置であって、前記アクセスハウジングのシールが、前記アダプターのアクセス部材の周りに実質的に流体密なシールを形成するように適合されている、外科手術用アクセス装置。
- 請求項1に記載の外科手術用アクセス装置であって、前記アダプターが、前記アクセスハウジングに取り外し可能に取り付けられている、外科手術用アクセス装置。
- 請求項1に記載の外科手術用アクセス装置であって、前記シールが、ゲル材料を含む、外科手術用アクセス装置。
- 外科手術用アクセス装置であって、以下:
物体を受容するための第1の通路を有するアクセスハウジング;および
アクセスハウジングに取り付け可能な基部であって、該基部が、以下:
切開部を少なくとも部分的に裏から覆うように患者の切開部内に位置付け可能な可撓性ライナー部材;
該ライナー部材の1つの端部に接続され、身体の内部表面に係合するように該身体内に位置付けるために適合された第1の部材;
該ライナー部材の他の端部に接続される第2の部材;および
該基部の第2の部材を係合するためのアクセスハウジングに隣接して配置された膨張可能部材であって、該膨張可能部材が、第2の部材を変位させるように膨張可能であり、これによって、該ライナー部材が、切開部を形成する組織に係合し、少なくとも部分的に該切開部を開創する、膨張可能部材、
を備える、基部、
を備える、外科手術用アクセス装置。 - 請求項8に記載の外科手術用アクセス装置であって、前記基部の第1の部材が弾性である、外科手術用アクセス装置。
- 請求項9に記載の外科手術用アクセス装置であって、前記基部が、前記アクセスハウジングに取り付けられ、前記膨張可能部材に隣接して配置されるハウジングマウントを備え、該ハウジングマウントが、該基部の第2の部材に連結され、かつ該第2の部材を変位させるために該膨張可能部材の膨張の際に該アクセスハウジングに対して移動可能である、外科手術用アクセス装置。
- 請求項9に記載の外科手術用アクセス装置であって、前記膨張可能部材が、バルーン部材を備える、外科手術用アクセス装置。
- 請求項9に記載の外科手術用アクセス装置であって、前記第1の部材および第2の部材が、それぞれ、弾性環状部材である、外科手術用アクセス装置。
- 請求項12に記載の外科手術用アクセス装置であって、前記バルーン部材が、環状形状を規定する、外科手術用アクセス装置。
- 請求項8に記載の外科手術用アクセス装置であって、前記アクセスハウジングが、外側トラフを備え、前記膨張可能部材が、該外側トラフに少なくとも部分的に収容される、外科手術用アクセス装置。
- 請求項14に記載の外科手術用アクセス装置であって、前記基部が、第2の部材に連結され、前記外側トラフに隣接して配置されるハウジングマウントを備え、該ハウジングマウントが、前記アクセスハウジングに対して移動するように適合され、これによって、膨張可能部材の膨張の際に、該ハウジングマウントが、前記第1の部材から変位する、外科手術用アクセス装置。
- 請求項8に記載の外科手術用アクセス装置であって、前記アクセスハウジングが、実質的に流体密な関係で前記物体を受容するために適合されたシールを有する、外科手術用アクセス装置。
- 請求項16に記載の外科手術用アクセス装置であって、前記アクセスハウジングに取り付け可能であるアダプターを備え、該アダプターが、前記シールを通る第2の通路を規定するアクセス部材を有する、外科手術用アクセス装置。
- 請求項17に記載の外科手術用アクセス装置であって、前記アダプターが、前記第2の通路を横切って配置される弁を有し、該弁が、実質的に流体密な関係で外科手術用機器を受容するように適合されている、外科手術用アクセス装置。
- 請求項8に記載の外科手術用アクセス装置であって、前記膨張可能部材が、バルーンである、外科手術用アクセス装置。
- 外科手術用アクセス装置であって、以下:
アクセスハウジングであって、該アクセスハウジングが、中心長手軸を規定し、外科医の手の通過のために該アクセスハウジングの中を延びる長手方向開口部を有するアクセスハウジング;
該アクセスハウジングに取り付けられた開創器基部であって、該開創器基部が、切開部を規定する組織部分に係合するように該切開部内に位置付けるための可撓性ライナーを有する、開創器基部;および
該アクセスハウジングに取り外し可能に取り付けられたトロカールアダプターであって、該トロカールアダプターが、該長手方向開口部内に受容するように位置付けられたトロカールスリーブ、および流体密な関係で外科手術用機器を受容するように適合されたトロカール弁を備える、トロカールアダプター、
を備える、外科手術用アクセス装置。 - 請求項20に記載の外科手術用アクセス装置であって、前記アクセスハウジングが、外科医の腕および前記トロカールスリーブのそれぞれの周りにシールを形成するように適合されたシールを備える、外科手術用アクセス装置。
- 請求項21に記載の外科手術用アクセス装置であって、前記シールが、外科医の腕の非存在下または前記トロカールスリーブの非存在下において閉鎖するように適合されている、外科手術用アクセス装置。
- 請求項22に記載の外科手術用アクセス装置であって、前記シールが、ゲル材料を含む、外科手術用アクセス装置。
- 請求項20に記載の外科手術用アクセス装置であって、前記開創器基部が、前記ライナーのそれぞれの端部に接続される第1の環状部材および第2の環状部材を備え、該第1の環状部材が、体腔内の内側組織部分に係合するように、切開部を通して位置付け可能であり、該第2の環状部材は、前記アクセスハウジングに関して取り付けられる、外科手術用アクセス装置。
- 請求項24に記載の外科手術用アクセス装置であって、前記開創器基部が、前記アクセスハウジングに取り付けられ、かつ前記第2の環状部材に係合可能な膨張可能部材を備え、該膨張可能部材が、前記第1の環状部材に対して該第2の環状部材を変位するように膨張して、前記ライナーが、切開部を規定する組織を少なくとも部分的に引き出すように適合されている、外科手術用アクセス装置。
- 請求項25に記載の外科手術用アクセス装置であって、前記膨張可能部材が、環状バルーンを備える、外科手術用アクセス装置。
- 請求項26に記載の外科手術用アクセス装置であって、前記開創器基部が、第2の環状部材に結合され、かつ前記環状バルーンによって係合されるように前記アクセスハウジングに対して位置付けられる環状マウントを備え、該環状マウントが、第1の環状部材に対して該第2の環状部材を変位させるために、該環状バルーンの膨張の際に該アクセスハウジングに対してより適合される、外科手術用アクセス装置。
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US55954804P | 2004-04-05 | 2004-04-05 | |
PCT/US2005/011562 WO2005097234A2 (en) | 2004-04-05 | 2005-04-05 | Surgical hand access apparatus |
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JP2010259598A Division JP2011092745A (ja) | 2004-04-05 | 2010-11-19 | 外科手術用ハンドアクセス装置 |
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JP2010259598A Pending JP2011092745A (ja) | 2004-04-05 | 2010-11-19 | 外科手術用ハンドアクセス装置 |
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US (3) | US7717847B2 (ja) |
EP (1) | EP1732623B1 (ja) |
JP (2) | JP2008504051A (ja) |
AU (1) | AU2005231843B2 (ja) |
CA (1) | CA2560158C (ja) |
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JP2009534085A (ja) * | 2006-04-19 | 2009-09-24 | アトロポス・リミテッド | 器具アクセス装置 |
JP2016209625A (ja) * | 2011-12-23 | 2016-12-15 | イーオン サージカル リミテッド | 腹腔鏡検査用シールブリッジ |
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US20100145152A1 (en) | 2010-06-10 |
JP2011092745A (ja) | 2011-05-12 |
AU2005231843B2 (en) | 2010-09-16 |
CA2560158C (en) | 2014-06-17 |
WO2005097234A3 (en) | 2009-04-30 |
US8485971B2 (en) | 2013-07-16 |
EP1732623B1 (en) | 2014-07-16 |
CA2560158A1 (en) | 2005-10-20 |
EP1732623A4 (en) | 2012-08-08 |
AU2005231843A1 (en) | 2005-10-20 |
EP1732623A2 (en) | 2006-12-20 |
US7717847B2 (en) | 2010-05-18 |
US20050267419A1 (en) | 2005-12-01 |
US20130281786A1 (en) | 2013-10-24 |
WO2005097234A2 (en) | 2005-10-20 |
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