JP4154500B2 - 外科用針 - Google Patents
外科用針 Download PDFInfo
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- JP4154500B2 JP4154500B2 JP2006046945A JP2006046945A JP4154500B2 JP 4154500 B2 JP4154500 B2 JP 4154500B2 JP 2006046945 A JP2006046945 A JP 2006046945A JP 2006046945 A JP2006046945 A JP 2006046945A JP 4154500 B2 JP4154500 B2 JP 4154500B2
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0491—Sewing machines for 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06066—Needles, e.g. needle tip configurations
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0482—Needle or suture guides
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1125—Forceps, specially adapted for performing or assisting anastomosis
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- A—HUMAN NECESSITIES
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- 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
- A61B2017/1142—Purse-string sutures
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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
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/2833—Locking means
- A61B2017/2837—Locking means with a locking ratchet
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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Description
、管状組織の管壁の周囲の一連の縫合を作る。各針は縫合の付近で折られて取り出され、次いで装置のジョーが開かれ組織が解放される。次いで組織の良好な端部が吻合リング又は類似物の上に置かれる。次に、糸がきちんと引かれ、その端部が通常の巾着縫合の結紮方法で一緒に結ばれる。
られた2本の針が、各通路に1個の針で、通路及び組織を完通するように強制され、これにより管状組織を取り巻く一連の縫い目を作る。次いで、針が糸から外され身体から取り出され、これにより、管状組織内に巾着縫合を残し、きちんと引かれ結ばれる。
駆動用ロッドを備える。駆動用ロッドは、一方のジョーを第1の旋回中心軸と平行な第3の旋回中心軸の周りで上下させるように空転レバーを経てこのジョーに連結されることが好ましい。第1及び第3の旋回中心軸は、空転レバーの掴み力を増加させるように互いに食い違いにされることが好ましい。
り定められる通路と揃えられる。上方ジョー14が閉鎖位置にあるときは、案内26a、26bの上半部は上方ジョーと揃えられ、通路31の上方導管は上方ジョーの歯の溝27により定められる通路と揃えられる。通路31の上方導管と下方導管との間の間隔は、ジョーの溝26と27とが完全に閉じられたときのこれらの間の間隔よりもわずかに大きくして、ジョーが完全閉鎖に僅かに及ばないときに針が溝に確実に入るようにする。
を折り取れるように、針56の先端と主体部とが出会う位置にノッチ56cを設けることができる。各針の手元側端部56bは押し又は引く力を受けるために直角に曲げられる。縫合糸58は、歯の溝26、27のスロットの幅、及びドッグボーン通路30の真っすぐな溝の幅より小さい直径のものである。
を生じてジョー112、114を一緒に絞る位置へ、軸110に沿って端末方向に動くことができる。或いは、ジョーと梁との組立体が後退したときに、隠れていた部分110cを露出させるように手元側に軸に沿って動き得る。スリーブの端部付近の広げられたフランジ領域130aは、スリーブの手元側端部の一体部品として内側に固定された気密ダイヤフラム(図示せず)を備える。プッシャー136のフォーク状の端部136aと組み合うように、スリーブのフランジ領域に溝130bが設けられる。溝130bとプッシャー136のフォーク状端部136aとの間には十分な隙間があり、従ってプッシャーは、ピン146において旋回側端部を軸110に向け又はこれから離すように、フォークを溝の中で拘束することなしに合理的な距離を運動させることができる。上述のダイヤフラムは軸110に対する気密を提供する。縫合装置が挿入されるカニューレにも、気密具としてスリーブ130を払拭するダイヤフラムを設けるべきである。これは縫合手術中の加圧された腹部からの漏洩を防止する。
ーレ(図示せず)を通って出入するときはこの位置に留められる。スリーブ130は、図示のようにジョー112が入ったときのその最も後退した(手元側)位置において示される。強度のため、及び使用されるカニューレの細い内径に対してジョーに要求される大きさのため、スリーブ130は、ジョー112の上方に適合するようには設計されないが、カニューレの通過には適するように設計される。最末端のジョー114は、主軸110の部分である非回転支持梁110bの梁の端部にある。この状態においては、ジョー及びその支持梁は比較的小直径のカニューレを通って挿入できる。最手元側のジョー112(カニューレを通過する最後のジョー)がカニューレを通過し終わると、以下更に説明されるようにケーブル148aを進めるようにノブ150を押すことにより、このジョーはその支持梁120と共に旋回して凹所又は入れ子部分110cから出てピン128の周りで旋回する。ピン128は軸110と支持梁120とを通る横断方向の中心軸を有し、従ってジョー112が回転させられる。この回転は、支持梁とジョー112とが他方のジョー114の付近にきてこれと接触するまで、又はこれに対して閉じるまで続く。
ーブルによりピン120に対して加えられる押し又は引きの作用が支持梁120をジョー112と共に旋回ピン128の周りで回転させるように、旋回ピン128に関して位置決めされる。この方法で、梁及びジョーの組立体を、軸110を入れ子部分に出入させるために遠隔的に旋回させることができる。ケーブル148aは、これがプッシュプル棒148と結合するまで軸に沿い、又は軸を通って移動する。ケーブルを、これに加えられた軸方向の力に応答しかつ適正に撓むように、ケーブルを座屈しないように保持しかつピン120への適正な方向の力を与えさせるために、計画的に位置決めされた拘束具が必要である。この拘束部は、典型的には、ジョー入れ子凹所110cの底部において軸110を架橋するブリッジ110e、110fの形式である。
次に、レバー134がプッシャー136の旋回により定位置に組み合わせられ、プッシャー136のフォーク状端部136aがスリーブ130の溝130bと組み合う。
緒に連結された尖った針頭276を備える。針軸274の手元側端部は、使用者が針カートリッジと組織とを通して針を押すことを助けるために角度付きの部分280を持つ。針を押すためのその他の手段、例えば針軸の端部上のプラスチックキャップも予想される。破断可能な頸部は、部分図33Aに示された、例えば90°のノッチを形成するように角度を付けられた2個の角度部分278、280で形成された小直径部分を持つ。小直径部分は、縫合糸が組織を縫った後における針頭と縫合糸との針軸からの切離しを容易にするために設けられる。
プール312の滑りによりカムロッドが前方に摺動される。この作用により、カムロッドの端末が第2のジョーのカム面218と当たり、第1のジョーと第2のジョーを作動ピン254の周りで関節接合運動、又は旋回させる。ジョーは、これがスプールに当たるまでロッドの固定用ナット318の回転により図29に示された関節接合運動位置に固定される。ジョーを関節接合位置又は角度位置に置くことの利点は、掴まれる組織の部分の良好な観察を外科医−使用者に提供することである。この装置の別の利点は、体腔を横切る角度付けによる接近性の提供である。
けのものであることが理解されよう。上述のものに加えて好ましい実施例の開示された構造に相当する同等構造の種々の変更が、以下の請求項に定められる本発明の精神から離れることなく熟練技術者により行うことができる。本発明の精神は、かかる変更した構造及び同等の構造を含むように最も広い解釈を与えるべきである。
1.1対のジョー;
開いた位置と閉じた位置との間を第1の旋回中心軸の周りで相対旋回運動ができるように前記ジョーを一緒に連結しているヒンジ手段;及び
第1の端部と第2の端部とを有し、前記ジョーの一方と共に旋回運動できるようにこれと連結されたレバーを有するアクチュエーター手段;前記レバーの前記第2の端部に連結された関節接合リンク;及び前進位置と後退位置との間を往復運動できるように取り付けられ、前記リンクに連結された駆動用ロッド
を備え、
前記駆動用ロッドが前進位置に動かされたときに、前記レバーと前記リンクとによる前記駆動用ロッドと前記ジョーの一方との相互連結が前記ジョーを閉じた位置に動かし、更に前記駆動用ロッドが後退位置に動かされたときに前記ジョーを開いた位置に動かす
医用器具。
2.前記リンクを前記レバーの前記第1の端部に連結している第1のユニバーサルピン及び前記リンクを前記駆動用ロッドに連結している第2のユニバーサルピンを更に備え、前記第1及び第2のユニバーサルピンが前記リンクにその長手方向中心軸まわりでかつ前記レバーと前記駆動用ロッドとに関する回転を許す実施態様1による医用器具。
3.前記器具が管状組織に巾着縫合を置く外科用縫合装置であり;
前記1対のジョーがその間に管状組織を掴むためのものであり、各ジョーは1列の間隔を明けられた均一な大きさの歯を有し;更に
前記アクチュエーター手段は前記ジョーの対を、管状組織を受け入れる開いた位置と前記第1のジョーの歯列が前記第2のジョーの歯列と噛み合う掴み位置との間で作動させる実施態様1による医用器具。
4.各歯が基部と頂部とを有し、ジョーが閉じられたときに歯列が噛み合うように掴み位置において2列が対向しかつ互いに食い違いにされ、これにより歯列間の管状組織を2個の管壁の組織が歯列間の管状組織を各歯の頂部と重なっている状態で波状に曲げる実施態様3による外科用縫合装置。
5.前記ジョーの対を第1の旋回中心軸を横切る第3の旋回中心軸の周りで旋回させる関節接合手段
を更に有する実施態様1による医用器具。
6.前記関節接合手段が前記ジョーの一方と組み合うように摺動可能に配置されたカムロッドを有しかつ前記ジョーの対を第3の旋回中心軸まわりに旋回させる実施態様5による外科用縫合装置。
7.第1の旋回中心軸まわりに前記ジョーの対を作動させるように前記駆動用ロッドを滑らせ、かつ第3の旋回中心軸まわりに前記ジョーの対を関節運動させるように前記カムロッドを滑らせるためのハンドル手段を更に備えた実施態様6による外科用縫合装置。
8.前記カムロッドと前記駆動用ロッドとを摺動可能に収容する細長い軸を更に備え、前記軸が第1の端部において前記ハンドル手段に連結され第2の端部において前記ジョーの対に連結される実施態様7による外科用縫合装置。
9.前記軸が前記ジョーの対の関節運動を限定する停止手段を有する実施態様8による外科用縫合装置。
10.腸又は管状組織のその他の部分に巾着縫合を置くための外科用縫合装置にして、
少なくも約180°の平面円弧において揺動しかつ管状組織を横切って掴むために一方の端部において一緒に旋回可能に連結された1対の細長いジョー、
を備え、
各ジョーは1列の間隔を空けられた一様な寸法の歯を有し、各歯は基部と頂部とを有し、ジョーが閉じられたときに歯列が噛み合うように2列が互いに向かい合いかつ食い違いにされ、これにより前記組織の2個の管壁が各歯の頂部に重なった状態で歯列間の組織を波状に曲げ、
前記歯の各の頂部が列の方向と平行に走るこの中の溝を有し、各列の前記溝の総ては列の歯の総てを通る糸引きの針の移動用の実質的に真っすぐな通路をその底部において定めるように整列され、各溝の底部は、ジョーが組織を横切って把持されたときに通路を強制通過させられる針が組織の次の隣接管壁を貫くことなく各歯の頂部に接触しかつ重なっている組織の波状管壁だけを通って走り得るに十分に歯の基部に近い
外科用縫合装置。
11.各歯を通る溝の断面が、溝の底部の円形部分と前記円形部分から歯の頂部に延びている狭い幅のスロット部分を有する実質的に鍵穴状である実施態様10による外科用縫合装置。
12.更に各歯列に1本で2本の針を備え、各針は針により引かれる糸の端部をこれに取り付ける手段を有し、更に前記針の各は尖端及び通路を通って針を押すための鈍い後端を有し、前記針の各の直径はこれと組になった鍵穴形の溝の円形部分の直径より小さいが前記溝のスロット部分の幅より大きい実施態様11による外科用縫合装置。
13.細長い針軸;
尖端を有する針の頭部;及び
小断面部分を有し、前記針軸と前記針頭部とを連結する破断可能な頸部
を備え、前記頸部は前記針頭部が前記針軸から切り取られることを許す
外科用針。
14.前記針頭部がこれに縫合糸を固定するための固定用手段を有する実施態様13による外科用針。
15.外科用針を押すために前記細長い針軸の一方の端部の押し手段を更に備えた実施態様13による外科用針。
12 下方ジヨー
14 上方ジヨー
16 歯
18 歯
20 ヒンジ
22 ヒンジ
26 溝
30 カム部材
32 押し棒
34 ハンドル
36 ハンドル
38 レバー
54 カニューレ
56 針
58 縫合糸
Claims (6)
- 細長い針軸;
尖端を有する針の頭部;及び
小断面部分を有し、前記針軸と前記針頭部とを連結する破断可能な頸部を備え、前記頚部は前記針頭部が前記針軸から切り取られることを許す外科用針であって、前記針軸及び前記針頭部の中に長手方向に外科用糸を少なくとも部分的に受け入れるための溝;並びに
外科用針を押すために前記細長い針軸の一方の端部の押し手段を備え、前記押し手段が前記針軸の長手方向に関して或る角度で一端を彎曲させた針軸部分から成ることを特徴とする外科用針。 - 前記針頭部が前記尖端から半径方向外向きに延びる切断用刃を有する請求項1に外科用針。
- 前記針尖端に3個の切断用刃が互いに120°の間隔で設けられている請求項2に記載の外科用針。。
- 前記針頭部がこれに縫合糸を固定するための固定用手段を有する請求項1に記載の外科用針。
- 外科用針を押すために前記細長い針軸の一方の端部の押し手段を更に備えた請求項1に記載の外科用針。
- 細長い針軸;
尖端を有する針の頭部;及び
小断面部分を有し、前記針軸と前記針頭部とを連結する破断可能な頸部を備え、前記頚部は前記針頭部が前記針軸から切り取られることを許す外科用針であって、前記針軸及び前記針頭部の中に長手方向に外科用糸を少なくとも部分的に受け入れるための溝;並びに
外科用針を押すために前記細長い針軸の一方の端部の押し手段を備え、前記押し手段が前記針軸の一端にプラスチックキャップを有することを特徴とする外科用針。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/967,033 US5411481A (en) | 1992-04-08 | 1992-10-27 | Surgical purse string suturing instrument and method |
Related Parent Applications (1)
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JP2003157988A Division JP4071160B2 (ja) | 1992-10-27 | 2003-06-03 | 外科用巾着縫合装置及び外科用針 |
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JP2006181375A JP2006181375A (ja) | 2006-07-13 |
JP4154500B2 true JP4154500B2 (ja) | 2008-09-24 |
Family
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Application Number | Title | Priority Date | Filing Date |
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JP09651693A Expired - Lifetime JP3687683B2 (ja) | 1992-10-27 | 1993-04-01 | 医用器具 |
JP2003157988A Expired - Lifetime JP4071160B2 (ja) | 1992-10-27 | 2003-06-03 | 外科用巾着縫合装置及び外科用針 |
JP2006046945A Expired - Lifetime JP4154500B2 (ja) | 1992-10-27 | 2006-02-23 | 外科用針 |
JP2007297352A Withdrawn JP2008055227A (ja) | 1992-10-27 | 2007-11-15 | 外科用巾着縫合装置及び外科用針 |
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Application Number | Title | Priority Date | Filing Date |
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JP09651693A Expired - Lifetime JP3687683B2 (ja) | 1992-10-27 | 1993-04-01 | 医用器具 |
JP2003157988A Expired - Lifetime JP4071160B2 (ja) | 1992-10-27 | 2003-06-03 | 外科用巾着縫合装置及び外科用針 |
Family Applications After (1)
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JP2007297352A Withdrawn JP2008055227A (ja) | 1992-10-27 | 2007-11-15 | 外科用巾着縫合装置及び外科用針 |
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US (3) | US5411481A (ja) |
EP (1) | EP0598976B1 (ja) |
JP (4) | JP3687683B2 (ja) |
KR (1) | KR940008662A (ja) |
AT (1) | ATE194474T1 (ja) |
AU (1) | AU3681993A (ja) |
CA (1) | CA2093475A1 (ja) |
DE (1) | DE69329009T2 (ja) |
ES (1) | ES2149785T3 (ja) |
ZA (1) | ZA932497B (ja) |
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1993
- 1993-02-26 ES ES93103082T patent/ES2149785T3/es not_active Expired - Lifetime
- 1993-02-26 DE DE69329009T patent/DE69329009T2/de not_active Expired - Lifetime
- 1993-02-26 AT AT93103082T patent/ATE194474T1/de not_active IP Right Cessation
- 1993-02-26 EP EP93103082A patent/EP0598976B1/en not_active Expired - Lifetime
- 1993-04-01 JP JP09651693A patent/JP3687683B2/ja not_active Expired - Lifetime
- 1993-04-06 CA CA002093475A patent/CA2093475A1/en not_active Abandoned
- 1993-04-07 KR KR1019930005817A patent/KR940008662A/ko not_active Application Discontinuation
- 1993-04-07 ZA ZA932497A patent/ZA932497B/xx unknown
- 1993-04-07 AU AU36819/93A patent/AU3681993A/en not_active Abandoned
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1995
- 1995-05-01 US US08/432,354 patent/US5649938A/en not_active Expired - Lifetime
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1996
- 1996-12-10 US US08/763,113 patent/US5843098A/en not_active Expired - Lifetime
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2003
- 2003-06-03 JP JP2003157988A patent/JP4071160B2/ja not_active Expired - Lifetime
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2006
- 2006-02-23 JP JP2006046945A patent/JP4154500B2/ja not_active Expired - Lifetime
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JP4071160B2 (ja) | 2008-04-02 |
US5649938A (en) | 1997-07-22 |
EP0598976A3 (en) | 1994-10-12 |
JP2003310627A (ja) | 2003-11-05 |
DE69329009D1 (de) | 2000-08-17 |
EP0598976B1 (en) | 2000-07-12 |
KR940008662A (ko) | 1994-05-16 |
JPH06142107A (ja) | 1994-05-24 |
ES2149785T3 (es) | 2000-11-16 |
JP3687683B2 (ja) | 2005-08-24 |
ATE194474T1 (de) | 2000-07-15 |
JP2008055227A (ja) | 2008-03-13 |
JP2006181375A (ja) | 2006-07-13 |
EP0598976A2 (en) | 1994-06-01 |
ZA932497B (en) | 1993-11-01 |
CA2093475A1 (en) | 1994-04-28 |
AU3681993A (en) | 1994-05-12 |
DE69329009T2 (de) | 2001-03-29 |
US5843098A (en) | 1998-12-01 |
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