JP2017023720A - 内視鏡ステープラおよびステープル - Google Patents
内視鏡ステープラおよびステープル 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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
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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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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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
- A61B17/068—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
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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
- A61B17/068—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
- A61B2017/07228—Arrangement of the staples
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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
- A61B17/068—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
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
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Abstract
Description
本開示は、外科用ステープラ、そしてより特定すれば、内視鏡使用のための外科用ステープラに関する。本開示はまた、内視鏡外科用ステープラとの使用のための外科用ステープルに関する。
外科用ステープラは、代表的には、組織の切開および縫合を同時にもたらすために、複数のステープルを収容するカートリッジハウジング、ステープルがこのカートリッジから射出されるときステープルを成形するためのアンビルおよびナイフを含む。手動で通される縫合糸を付与することと比較したとき、組織を縫合および切開する外科用ステープラの使用は、外科的手順の速度を増加し、そしてそれ故、患者外傷を最小にする。
本開示は、アンビル、および一連のステープルを有するステープルカートリッジを含むツールアセンブリを有する外科用ステープラに関し、一連のステープルは、支持され、そして組織を縫合するためにステープルカートリッジからアンビル中に回転可能に射出されるように構成される。ステープルが支持され、そしてステープルカートリッジ内から射出される様式は、より厚い組織を縫合し得るステープルを含む小直径のツールアセンブリの使用を、そのような小直径を備えるツールアセンブリに通常付随するであろうより促進する。
(項目1)
外科用ステープラであって:
シャフト部分;
上記シャフト部分の遠位端上に支持されるツールアセンブリであって、上記ツールアセンブリがアンビルおよびカートリッジアセンブリを含み、上記カートリッジアセンブリが複数のステープルポケットを規定するカートリッジ本体を含み、プッシャが上記ステープルポケットの各々に回転可能に支持され、そしてステープルが上記プッシャの各々に支持される、ツールアセンブリ;および
上記ツールアセンブリを通って移動するように構成され、上記ステープルポケットの個々の1つ内の上記プッシャの各々の回転可能な移動をもたらす作業部材を有する駆動アセンブリ、を備え、上記プッシャの各々の回転可能な移動が、上記カートリッジ本体の個々のステープルポケットから上記ステープルを射出する、外科用ステープラ。
(項目2)
上記ステープルポケットの各々が旋回部材を含み、そして上記プッシャの各々が上記旋回部材の個々の1つに回転可能に支持される、上記項目に記載の外科用ステープラ。
(項目3)
上記ステープルポケットの各々が円形壁を含み、上記円形壁の各々が上記プッシャの個々の1つをスライド可能に支持する、上記項目のいずれかに記載の外科用ステープラ。
(項目4)
上記カートリッジ本体が少なくとも2つのステープルポケットの列、および上記少なくとも2つのステープルポケットの列の間に延びる少なくとも1つのチャネルを規定する、上記項目のいずれかに記載の外科用ステープラ。
(項目5)
上記少なくとも1つのチャネルを通って並進するように構成されたスレッドをさらに含み、上記スレッドが上記プッシャを逐次的に係合するように位置決めされる少なくとも1つのカムを含み、上記カートリッジ本体内の上記プッシャの回転可能な移動をもたらす、上記項目のいずれかに記載の外科用ステープラ。
(項目6)
上記スレッドが上記カートリッジ本体内に、上記駆動アセンブリの作業部材によって係合および進行されるように位置決めされる、上記項目のいずれかに記載の外科用ステープラ。
(項目7)
上記プッシャの各々が、上記カートリッジ本体の少なくとも1つのチャネル中に延びるように位置決めされており、上記少なくとも1つのチャネルを通る上記スレッドの並進が、上記少なくとも1つのカムを上記少なくとも2つのステープルポケットの列の2つの隣接する列でプッシャと接触させ、上記プッシャの回転をもたらす、上記項目のいずれかに記載の外科用ステープラ。
(項目8)
上記少なくとも2つのステープルポケットの列が、4つのステープルポケットの列を含み、そして上記少なくとも1つのカムが2つのカムを含む、上記項目のいずれかに記載の外科用ステープラ。
(項目9)
上記ステープルの各々が、単一の組織貫通脚部分を含む、上記項目のいずれかに記載の外科用ステープラ。
(項目10)
上記単一の組織貫通脚部分が、テーパー状のチップを規定する第1の端部および近位脚部分に接続される第2の端部を有し、上記近位脚部分が上記プッシャの1つに支持される、上記項目のいずれかに記載の外科用ステープラ。
(項目11)
上記プッシャの各々がチャネルを規定する本体を含み、上記ステープルの各々の近位脚部分が、上記チャネル内に支持される、上記項目のいずれかに記載の外科用ステープラ。
(項目12)
上記単一の組織貫通脚部分が湾曲し、そして上記ステープルポケットの円形壁に沿ってスライドするように構成される、上記項目のいずれかに記載の外科用ステープラ。
(項目13)
上記プッシャの各々が、上記プッシャが上記複数のステープルポケットの個々の1つ内に回転可能に支持されるように上記旋回部材を受容する寸法のスロットを規定する、上記項目のいずれかに記載の外科用ステープラ。
(項目14)
上記ステープルの各々の鈍い近位脚部分が湾曲部分を含み、そして上記チャネルが***を含み、上記***が、上記複数のステープルポケットの個々の1つ内に上記ステープルを保持するように上記湾曲部分と相互作用する、上記項目のいずれかに記載の外科用ステープラ。
(項目15)
上記駆動アセンブリの作業部材が、上ビームおよび下ビームを含むIビーム構成を有し、上記上ビームおよび上記下ビームが上記アンビルおよび上記カートリッジアセンブリと係合可能であり、上記作業部材が上記ツールアセンブリを通って移動するとき、組織を次第にクランプする、上記項目のいずれかに記載の外科用ステープラ。
(項目16)
上記カートリッジアセンブリがカートリッジチャネルを含み、上記カートリッジチャネルが上記カートリッジ本体を支持し、上記外科用ステープラがさらに第1の関節運動リンクおよび第2の関節運動リンクを含み、上記第1の関節運動リンクおよび上記第2の関節運動リンクの各々が上記カートリッジチャネルの近位端に作動可能に接続される遠位端を有し、上記第1の関節運動リンクおよび上記第2の関節運動リンクが軸方向で反対方向に移動可能であり、上記ツールアセンブリを上記シャフト部分に対して旋回させる、上記項目のいずれかに記載の外科用ステープラ。
(項目17)
上記第1の関節運動リンクを上記第2の関節運動リンクに相互接続する旋回可能な関節運動部材をさらに含み、上記関節運動部材の旋回可能な移動が、上記第1の関節運動リンクの1つの方向の移動を引き起こし、そして上記第2の関節運動リンクの反対方向の移動をもたらす、上記項目のいずれかに記載の外科用ステープラ。
(項目18)
外科用ステープルであって:
テーパー状のチップを有する第1の端部、湾曲した本体、および第2の端部を含む遠位組織貫通脚部分、ならびに上記組織貫通脚部分の第2の端部に接続される近位脚部分を備え、上記近位脚部分がプッシャ上に受容されるように構成され、上記遠位組織貫通脚部分および上記近位脚部分がD形状に変形された構成を有するように構成される、外科用ステープル。
(項目19)
ツールアセンブリであって:
アンビルおよびカートリッジアセンブリを備え、上記カートリッジアセンブリが複数のステープルポケットを規定するカートリッジ本体を含み、プッシャが上記ステープルポケットの各々に回転可能に支持され、そしてステープルが上記プッシャの各々に支持される、ツールアセンブリ。
(項目20)
上記ステープルポケットの各々が旋回部材を含み、そして上記プッシャの各々が上記旋回部材の個々の1つに回転可能に支持される、上記項目に記載のツールアセンブリ。
(項目21)
上記ステープルポケットの各々が円形壁を含み、上記円形壁の各々が上記プッシャの個々の1つをスライド可能に支持する、上記項目のいずれかに記載のツールアセンブリ。
(項目22)
上記カートリッジ本体が、少なくとも2つのステープルポケットの列、および上記少なくとも2つのステープルポケットの列の間に延びる少なくとも1つのチャネルを規定する、上記項目のいずれかに記載のツールアセンブリ。
(項目23)
上記少なくとも1つのチャネルを通って並進するように構成されたスレッドをさらに含み、上記スレッドが、上記プッシャを逐次的に係合するように位置決めされる少なくとも1つのカムを含み、上記カートリッジ本体内で上記プッシャの回転可能な移動をもたらす、上記項目のいずれかに記載のツールアセンブリ。
外科用ステープラは、アンビル、および一連のステープルを有するステープルカートリッジを含み、これら一連のステープルは、ステープルカートリッジに支持され、このステープルカートリッジからアンビル中に組織を縫合するために回転可能に射出されるように構成される。実施形態では、外科用ステープラは、複数の回転可能なプッシャを支持するカートリッジを含む。各プッシャは、単一の組織貫通遠位脚部分および近位脚部分を有する、湾曲した実質的にU形状のステープルを支持する。上記プッシャは、上記遠位脚部分をアンビル中に駆動し、上記ステープルを実質的にD形状の構成に変形するように回転可能である。
現在開示される、内視鏡使用のためのステープルを含む内視鏡外科用ステープラの実施形態は、ここで、図面を参照して詳細に記載され、図面において、同様の参照番号は、いくつかの図面の各々において同一または対応する要素を指定する。本説明において、用語「近位」は、一般に、臨床医により近い装置の部分をいうために用いられ、その一方、用語「遠位」は、一般に、臨床医からより遠い装置の部分をいうために用いられる。さらに、用語「内視鏡」は、一般に、内視鏡、腹腔鏡、または関節鏡の装置または手順、ならびに、小さな切開または患者の身体中に挿入されるカニューレを通って延びるか、または実施されるように構成されている、任意のその他の外科用装置または手順をいうために用いられる。最後に、用語「臨床医」は、一般に、医師、看護師、およびサポート要員を含む医療要員をいうために用いられる。
Claims (23)
- 外科用ステープラであって:
シャフト部分;
該シャフト部分の遠位端上に支持されるツールアセンブリであって、該ツールアセンブリがアンビルおよびカートリッジアセンブリを含み、該カートリッジアセンブリが複数のステープルポケットを規定するカートリッジ本体を含み、プッシャが該ステープルポケットの各々に回転可能に支持され、そしてステープルが該プッシャの各々に支持される、ツールアセンブリ;および
該ツールアセンブリを通って移動するように構成され、該ステープルポケットの個々の1つ内の該プッシャの各々の回転可能な移動をもたらす作業部材を有する駆動アセンブリ、を備え、該プッシャの各々の回転可能な移動が、該カートリッジ本体の個々のステープルポケットから該ステープルを射出する、外科用ステープラ。 - 前記ステープルポケットの各々が旋回部材を含み、そして前記プッシャの各々が前記旋回部材の個々の1つに回転可能に支持される、請求項1に記載の外科用ステープラ。
- 前記ステープルポケットの各々が円形壁を含み、該円形壁の各々が前記プッシャの個々の1つをスライド可能に支持する、請求項2に記載の外科用ステープラ。
- 前記カートリッジ本体が少なくとも2つのステープルポケットの列、および該少なくとも2つのステープルポケットの列の間に延びる少なくとも1つのチャネルを規定する、請求項1に記載の外科用ステープラ。
- 前記少なくとも1つのチャネルを通って並進するように構成されたスレッドをさらに含み、該スレッドが前記プッシャを逐次的に係合するように位置決めされる少なくとも1つのカムを含み、前記カートリッジ本体内の該プッシャの回転可能な移動をもたらす、請求項4に記載の外科用ステープラ。
- 前記スレッドが前記カートリッジ本体内に、前記駆動アセンブリの作業部材によって係合および進行されるように位置決めされる、請求項5に記載の外科用ステープラ。
- 前記プッシャの各々が、前記カートリッジ本体の少なくとも1つのチャネル中に延びるように位置決めされており、前記少なくとも1つのチャネルを通る前記スレッドの並進が、前記少なくとも1つのカムを前記少なくとも2つのステープルポケットの列の2つの隣接する列でプッシャと接触させ、該プッシャの回転をもたらす、請求項6に記載の外科用ステープラ。
- 前記少なくとも2つのステープルポケットの列が、4つのステープルポケットの列を含み、そして前記少なくとも1つのカムが2つのカムを含む、請求項5に記載の外科用ステープラ。
- 前記ステープルの各々が、単一の組織貫通脚部分を含む、請求項1に記載の外科用ステープラ。
- 前記単一の組織貫通脚部分が、テーパー状のチップを規定する第1の端部および近位脚部分に接続される第2の端部を有し、該近位脚部分が前記プッシャの1つに支持される、請求項9に記載の外科用ステープラ。
- 前記プッシャの各々がチャネルを規定する本体を含み、前記ステープルの各々の近位脚部分が、該チャネル内に支持される、請求項10に記載の外科用ステープラ。
- 前記単一の組織貫通脚部分が湾曲し、そしてステープルポケットの円形壁に沿ってスライドするように構成される、請求項10に記載の外科用ステープラ。
- 前記プッシャの各々が、該プッシャが前記複数のステープルポケットの個々の1つ内に回転可能に支持されるように前記旋回部材を受容する寸法のスロットを規定する、請求項2に記載の外科用ステープラ。
- 前記ステープルの各々の鈍い近位脚部分が湾曲部分を含み、そして前記チャネルが***を含み、該***が、前記複数のステープルポケットの個々の1つ内に該ステープルを保持するように該湾曲部分と相互作用する、請求項11に記載の外科用ステープラ。
- 前記駆動アセンブリの作業部材が、上ビームおよび下ビームを含むIビーム構成を有し、該上ビームおよび該下ビームが前記アンビルおよび前記カートリッジアセンブリと係合可能であり、該作業部材が前記ツールアセンブリを通って移動するとき、組織を次第にクランプする、請求項1に記載の外科用ステープラ。
- 前記カートリッジアセンブリがカートリッジチャネルを含み、該カートリッジチャネルが前記カートリッジ本体を支持し、前記外科用ステープラがさらに第1の関節運動リンクおよび第2の関節運動リンクを含み、該第1の関節運動リンクおよび該第2の関節運動リンクの各々が該カートリッジチャネルの近位端に作動可能に接続される遠位端を有し、該第1の関節運動リンクおよび該第2の関節運動リンクが軸方向で反対方向に移動可能であり、前記ツールアセンブリを前記シャフト部分に対して旋回させる、請求項1に記載の外科用ステープラ。
- 前記第1の関節運動リンクを前記第2の関節運動リンクに相互接続する旋回可能な関節運動部材をさらに含み、該関節運動部材の旋回可能な移動が、該第1の関節運動リンクの1つの方向の移動を引き起こし、そして該第2の関節運動リンクの反対方向の移動をもたらす、請求項16に記載の外科用ステープラ。
- 外科用ステープルであって:
テーパー状のチップを有する第1の端部、湾曲した本体、および第2の端部を含む遠位組織貫通脚部分、ならびに該組織貫通脚部分の第2の端部に接続される近位脚部分を備え、該近位脚部分がプッシャ上に受容されるように構成され、該遠位組織貫通脚部分および該近位脚部分がD形状に変形された構成を有するように構成される、外科用ステープル。 - ツールアセンブリであって:
アンビルおよびカートリッジアセンブリを備え、該カートリッジアセンブリが複数のステープルポケットを規定するカートリッジ本体を含み、プッシャが該ステープルポケットの各々に回転可能に支持され、そしてステープルが該プッシャの各々に支持される、ツールアセンブリ。 - 前記ステープルポケットの各々が旋回部材を含み、そして前記プッシャの各々が該旋回部材の個々の1つに回転可能に支持される、請求項19に記載のツールアセンブリ。
- 前記ステープルポケットの各々が円形壁を含み、該円形壁の各々が前記プッシャの個々の1つをスライド可能に支持する、請求項20に記載のツールアセンブリ。
- 前記カートリッジ本体が、少なくとも2つのステープルポケットの列、および該少なくとも2つのステープルポケットの列の間に延びる少なくとも1つのチャネルを規定する、請求項21に記載のツールアセンブリ。
- 前記少なくとも1つのチャネルを通って並進するように構成されたスレッドをさらに含み、該スレッドが、前記プッシャを逐次的に係合するように位置決めされる少なくとも1つのカムを含み、前記カートリッジ本体内で前記プッシャの回転可能な移動をもたらす、請求項22に記載のツールアセンブリ。
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EP3120780B1 (en) | 2019-01-23 |
AU2016204293A1 (en) | 2017-02-09 |
CA2934151A1 (en) | 2017-01-20 |
US20170020524A1 (en) | 2017-01-26 |
US20200121320A1 (en) | 2020-04-23 |
US11490893B2 (en) | 2022-11-08 |
JP2021035606A (ja) | 2021-03-04 |
AU2016204293B2 (en) | 2020-05-07 |
US10548599B2 (en) | 2020-02-04 |
EP3120780A2 (en) | 2017-01-25 |
EP3120780A3 (en) | 2017-04-05 |
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