JP4441402B2 - 外科処置のためのバルーン・タイプ・アクチュエータ - Google Patents
外科処置のためのバルーン・タイプ・アクチュエータ Download PDFInfo
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- JP4441402B2 JP4441402B2 JP2004517526A JP2004517526A JP4441402B2 JP 4441402 B2 JP4441402 B2 JP 4441402B2 JP 2004517526 A JP2004517526 A JP 2004517526A JP 2004517526 A JP2004517526 A JP 2004517526A JP 4441402 B2 JP4441402 B2 JP 4441402B2
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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
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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
- A61B17/07207—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 the staples being applied sequentially
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of 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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
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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
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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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
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
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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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
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Description
全層切除処置には、臓器の一部分の全層を摘出すること、周りの組織を集めて摘出によってできた穴を塞ぐこと、余分な組織を除去することを伴う。
様々な従来の装置及び処置が病斑の切除のために利用可能である。しかしながら、様々な切断、ステープリング及びこれら装置の他の機能の作動は、アクチュエータをかさばらせ及び/又は装置を過度に堅くする。
例えば、ワーキング・ヘッドに配される台とステープリング・ヘッドの間の隙間を開閉することが必要であり、一方切除される組織部は該隙間で保持されなければならない。次に切除される組織を摘出するためにステープルを発射し、切断ブレードを作動させなけばならない。
通常これら機能を実行する力は、軸長を延長し、装置の剛性を増す1又はそれ以上のケーブル又は駆動軸によって制御ハンドルからワーキング・ヘッドへ伝わる。
本発明は外科手術に用いられるアクチュエータであり、該アクチュエータが作動形状の時患者の体外にある、近端から遠端へと延長する膨張流体導管と、該膨張流体導管を介して膨張流体が膨張部材に提供される時、膨張部材が収縮形状から膨張形状へと膨張し、該収縮形状の時、前記膨張部材が縦軸に対し横向きに実質的に延長する折り目を含み、膨張流体が供給される時、前記膨張部材が縦軸に沿って実質的に膨張する、前記膨張流体導管の前記遠端に接続される膨張部材とからなる。
本発明は、外科装置部品を駆動するための手術セット、又は患者の組織又は臓器を直接動かすために用いられるアクチュエータである。正式な使用方法の例として、下記に全てが記載されるアクチュエータは、全層切除装置(FTRD)のステープリング及び切断機能を作動する。
しかしながら、当業者は本発明のアクチュエータが、内視鏡及び関節鏡装置等のような、低侵襲手術を最低限にするための装置の多種多様の機能を作動するために採用されることを理解する。
膨張部12は、空気が入れられた時膨張する伸縮性シェル14を含む。実施例の1つにおいて、シェル14はポリエチレン又は他の適切な材料から作られる。
更に面16は膨張形状の時、位置が変化するアイテムの形状に対応する表面16は、膨張部12を形成することにより特定の適用のための膨張力が最も良く適用されるために成形することができる。
すなわち、膨張圧が適用されない時は常に、アクチュエータ10の縦(軸方向)の長さを図1aで示すように収縮した形状にするために、アコーディオン状の折り目18のバイアスが互いに収縮を生じる。
折り目18はシェル14の材料で成型、又は膨張したシェル14に放射状の力を適用する個別の弾性リングにより成形することができる。更に、当業者に理解されるように、膨張部12の弾性特性は、アクチュエータ10を収縮形状へとバイアスをかけるために、シェル14の膨張のための膨張圧の供給により、適用される力とは反対方向への力を適用するために選択することができる。
この結果は図1a及び1bで示されるアコーディオンの様な設計によって達成することができ、膨張の大部分は実質的に縦方向である。当業者は他のアプローチで同様の結果が得られることを理解する。
例えば膨張部12のシェル14は、所望の方向への膨張を可能とするが、実質的に所望の方向の直角方向への膨張を防ぐファイバーから作ることができる。例えば当業者は、編み込みがケブラー(登録商標)のようなファイバーから行うことができ、該編み込みは、実質的に縦方向へは柔軟性がないが、横方向への所定量の膨張を可能とする。
導管22と関連して膨張部12を曲げることにより、所望の方向に力を適用するためにアクチュエータ10を用いることが可能である。前記の如くアクチュエータ10を、外科装置の部品を作動するために用いることができ、又は臓器又は組織の一部の位置を直接変えるために用いることができる。
後者の場合、膨張の間必要な位置付けを行い、アクチュエータ10の所望の位置を維持するため膨張部12に力を適用し、導管22を用いるために該導管が堅いことが必要であり、所望の力が適切な位置及び所望の方向に適用される。図2は、一度膨張部12が所望の位置に置かれたならば、導管22を回転させることにより、このことを達成するための配置を示す。
膨張部12及び12’は、1本の導管22を用いて同時に膨張し、代わりに個別の導管又は例えば接合部32に配される制御バルブを用いて個別に膨張する。
力を適用する方法により、同じ又は相違する方向に力を適用するため2つ以上の膨張部12がアクチュエータ10に用いられる。
特に該台部材56とステープル・スロット58の間の距離は、結合部60を延長又は短縮することにより制御される。
このことは、FTRDがヘッド部53を人体の組織を引き出すために開かれ、正確な位置で閉鎖することを可能とし、ステープルはステープル・スロット58から配置される。
このことは、力が適用されている場合に、アクチュエータ10が位置から外れて移動することを防ぐ。アクチュエータ10の力が適用される表面16は、ヨーク54と接続するように設計することができ、該ヨークはヘッド部53内を縦方向にスライドすることができる。
ヨーク54は、結合部60により台部材56に取り付けられ、ヨーク54が移動する時、台部材56はその上を移動するようにする。
圧力が解放された時、アクチュエータ10は収縮し、好ましくは収縮形状に戻る。もし力が適用される表面16がヨーク54に取り付けられたならば、アクチュエータ10は該ヨーク54を、収縮形状で元の位置へと動かす。
このことは、上記の様に収縮時に収縮形状に戻るようにアクチュエータ10を形成することにより、もしくは閉鎖位置に対し台部材56へバイアスをかけるためアクチュエータ10から分離するように追加の弾性部材を用いることにより更に促進することができる。
力が適用される面16は、ステープル・ドライブ72に隣接し、該ステープル・ドライブはヘッド部53にスライド可能なように配され、縦方向に形状が変化する。アクチュエータ10が導管22を介して膨張する時、ステープル・ドライブ72を押し、ステープル76を順にステープル・スロット58の外側へ押し出す。
この方法においてステープル76は、制御ハンドルからヘッド部53まで延長する機械的な結合のないFTRD51から発射することができる。代わりに、柔軟な導管22だけが制御ハンドルからヘッド部53まで延長する。
当業者は、ステープル・ドライブ72の既知の異なる設計が、各ステープル、カム表面又は他の力伝達部材を押すロッドのようなアクチュエータ10と共に用いることができることを理解する。
ガイド84をベース86の移動を制御するために用いてもよく、ガイド88がカム80の移動を制御する。代わりに、アクチュエータ10を刃82に周辺の方向に沿った力を直接供給するために位置付けることもできる。
より具体的には、例えばアクチュエータ10は実質的には円盤形状であり、該アクチュエータは膨張部12を含み、2本の脊椎64の間に挿入することができ、該脊椎は互いを所定距離で離す必要がある。
膨張部12は、軸方向に補強される導管22を介して膨張流体源に取り付けられる。導管22の軸補強は、操作者が軸に沿って力を適用することにより、膨張部12を脊椎64の間に位置付けることを可能とする。
代わりに、アクチュエータ10は、関節鏡が貫通する導管22と共に関節鏡又は同様の装置を用いて脊椎64の間の位置へ配置され操作される。
臓器又は組織に接する面66が更に提供され、該面は特定の臓器又は組織64の一部を、損傷を与えることなく元の位置に戻す形状を有する。
従って、本発明は添付の請求項及びこれと同等のものから提供される修正及び変更をカバーすることが意図される。
Claims (16)
- アクチュエータが作動形状の時患者の体外にある、近端から遠端へと延長する第1膨張流体導管と、
該第1膨張流体導管を介して膨張流体が第1膨張部材に供給される時、該第1膨張部材が収縮形状から膨張形状へと膨張するように、該第1膨張流体導管の該遠端に接続される第1膨張部材であって、該収縮形状のとき、該第1膨張部材が縦軸に対し横向きに実質的に延長する折り目を含み、膨張流体が供給されるとき、該第1膨張部材が縦軸に沿って実質的に膨張し、該第1膨張部材は、膨張力を構造へ適用するための力が適用される表面を備え、該力が適用される表面は、閉じた表面ならびに該第1膨張部材の残りの材料よりも柔軟性の低い材料を備え、そして該力が適用される表面は、該第1膨張部材と一体化する、第1膨張部材と、
を備える、外科手術に用いられるアクチュエータ。 - 前記第1膨張部材が、該膨張部材を収縮構造とするためにバイアスがかけられる弾力性のある側面を更に有することを特徴とする請求項1のアクチュエータ。
- 前記弾力性のある側面が成型された表面であることを特徴とする請求項2のアクチュエータ。
- 前記第1膨張部材の縦方向の傾向が実質的に近接部分から末端部分へ延長することを特徴とする請求項1のアクチュエータ。
- 前記第1膨張部材の縦方向の傾向が、近接部分から末端部分の方向に対し実質的に直角に延長することを特徴とする請求項1のアクチュエータ。
- 前記アクチュエータが作動形状の時、動かされるアイテムに隣接して位置付けられる、力が適用される面を、前記第1膨張部材が定義することを特徴とする請求項1のアクチュエータ。
- 前記動かされるアイテムが臓器の1つ及び組織の一部分であることを特徴とする請求項6のアクチュエータ。
- 前記動かされるアイテムが外科用装置の構成要素であることを特徴とする請求項6のアクチュエータ。
- 前記動かされるアイテムがステープリング機構を作動するカムを備えることを特徴とする請求項8のアクチュエータ。
- 前記動かされるアイテムが組織切断機構を作動するカムを備えることを特徴とする請求項8のアクチュエータ。
- 膨張流体源に対して選択的に連結可能である第2膨張部材を更に備える請求項1のアクチュエータ。
- 前記第2膨張部材が、膨張流体が更に供給された時、その拡大方向が前記第1膨張部材に対して実質的に直角となるように設計されることを特徴とする請求項11のアクチュエータ。
- 前記第1膨張流体導管の近端に接続される手動ポンプを更に備える請求項1のアクチュエータ。
- 第2膨張構成要素が前記第1膨張流体導管に接続されることを特徴とする請求項11のアクチュエータ。
- 前記第2膨張構成要素が第2膨張流体導管の遠端に接続され、該膨張流体導管は膨張流体源に接続される近端から延長することを特徴とする請求項11のアクチュエータ。
- 選択された前記第1及び第2膨張部材の内の1つに供給される膨張流体を導くための第1膨張流体導管に接続される制御バルブを更に備える請求項14のアクチュエータ。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US10/187,144 US8287561B2 (en) | 2002-06-28 | 2002-06-28 | Balloon-type actuator for surgical applications |
PCT/US2003/013102 WO2004002327A1 (en) | 2002-06-28 | 2003-04-28 | Balloon-type actuator for surgical applications |
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JP2005531360A JP2005531360A (ja) | 2005-10-20 |
JP4441402B2 true JP4441402B2 (ja) | 2010-03-31 |
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JP2004517526A Expired - Fee Related JP4441402B2 (ja) | 2002-06-28 | 2003-04-28 | 外科処置のためのバルーン・タイプ・アクチュエータ |
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US (1) | US8287561B2 (ja) |
EP (1) | EP1517641A1 (ja) |
JP (1) | JP4441402B2 (ja) |
AU (1) | AU2003232007A1 (ja) |
CA (1) | CA2457566A1 (ja) |
WO (1) | WO2004002327A1 (ja) |
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US6506196B1 (en) * | 1999-06-22 | 2003-01-14 | Ndo Surgical, Inc. | Device and method for correction of a painful body defect |
US6830174B2 (en) * | 2000-08-30 | 2004-12-14 | Cerebral Vascular Applications, Inc. | Medical instrument |
US20040030352A1 (en) * | 2000-09-20 | 2004-02-12 | Mcgloughlin Timothy Mary | Device for staunching vagina bleeding |
US20030111507A1 (en) * | 2001-12-14 | 2003-06-19 | George Nunez | Balloon actuator for use in a resectioning device |
-
2002
- 2002-06-28 US US10/187,144 patent/US8287561B2/en active Active
-
2003
- 2003-04-28 CA CA002457566A patent/CA2457566A1/en not_active Abandoned
- 2003-04-28 EP EP03761894A patent/EP1517641A1/en not_active Withdrawn
- 2003-04-28 JP JP2004517526A patent/JP4441402B2/ja not_active Expired - Fee Related
- 2003-04-28 WO PCT/US2003/013102 patent/WO2004002327A1/en active Application Filing
- 2003-04-28 AU AU2003232007A patent/AU2003232007A1/en not_active Abandoned
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AU2003232007A1 (en) | 2004-01-19 |
US20040002726A1 (en) | 2004-01-01 |
EP1517641A1 (en) | 2005-03-30 |
CA2457566A1 (en) | 2004-01-08 |
WO2004002327A1 (en) | 2004-01-08 |
US8287561B2 (en) | 2012-10-16 |
JP2005531360A (ja) | 2005-10-20 |
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