JP4517170B2 - 遮蔽往復外科用器具 - Google Patents
遮蔽往復外科用器具 Download PDFInfo
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- JP4517170B2 JP4517170B2 JP2004540289A JP2004540289A JP4517170B2 JP 4517170 B2 JP4517170 B2 JP 4517170B2 JP 2004540289 A JP2004540289 A JP 2004540289A JP 2004540289 A JP2004540289 A JP 2004540289A JP 4517170 B2 JP4517170 B2 JP 4517170B2
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1659—Surgical rasps, files, planes, or scrapers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
- A61B1/00167—Details of optical fibre bundles, e.g. shape or fibre distribution
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/015—Control of fluid supply or evacuation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/3135—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for examination of the epidural or the spinal space
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1622—Drill handpieces
- A61B17/1624—Drive mechanisms therefor
-
- 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
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Molecular Biology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Radiology & Medical Imaging (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Neurology (AREA)
- Surgical Instruments (AREA)
Description
図8および図9に、遠位チップアセンブリ18を、さらに詳細に示す。ある実施態様では、複合チップ18は、約10cm(4インチ)〜約15cm(6インチ)の長さを持つ(全ての値とその間の部分範囲を含む)。ある実施態様では、複合チップ18は約5(2インチ)〜約30cm(12インチ)の長さを持つ(全ての値とその間の部分範囲を含む)。変更態様では、必要に応じて、または希望により、他の適切な長さを有効に利用することができる。
本発明の実施態様は、骨および/または組織精密除去用の往復切削ブレードを提供する。ある実施態様では、往復切削ブレードの5つの面を遮蔽または被覆または防護して、遮蔽外科用やすりを提供する。
ある実施態様によれば、外科用ヤスリ器具12は、既存の焼灼機器60への接続に対応することにより、切削または彫刻したばかりの骨または他の組織の少量の出血を停止させることができる。この実施態様において、システムが持つ特別な特徴は、導電性金属やすりブレード106を覆っている非導電性遮蔽材108である。
図22に、光ファイバープローブ124および126を含む光ファイバー視覚システム218を示す。一部の外科的実施態様では、光ファイバー視覚システム218により、外科医は、神経根圧迫と正常な身体機能に対する損傷とを引き起こしている不要な骨および軟骨沈着の存在を視覚的に見て、確認することが可能になる。不要な物質に関するこの情報は、視覚画像をコンピュータデータベースに保存し、参照および記録のために直ちにカラー画像を印刷することによって文書化し記録することができる。
トロイダルトランスミッションシステムまたはトロイダル動力変換システム98は、回転運動または回転動作を往復運動または往復動作に変換する機械的変換装置である。動力付きハンドピース20は、組織除去器具または組織除去ブレード106の切削動作に動力を供給するための回転原動機80を格納する。原動機80の回転機械動作は適切な往復ストローク長を持つ往復機械動作に変換される。機械的動作変換装置は単純であって部品数が少ないことが望しい。
拍動流水ポンプシステム290を使い捨て切削ブレードアセンブリ18に組込み、遠位カバー72内に格納する。拍動水ポンプ290は患者の体内に滅菌水を供給し、ある実施態様では、「患者間での」生物学的汚染が起こらないことを保証するために、1回使用後に処分される。本発明の実施態様の拍動流水ポンプシステムは、流体輸送が望まれる数多くの分野および用途に役立つ。ある実施態様では、各直線運動ストローク後に水のパルスがもたらされる。
図39は、カバーまたはハウジング74と、ビデオカメラ78と、原動機アセンブリ80と、遠位チップアセンブリ18のインターフェース部材102および継手104に連結するための遠位インターフェース部材322とを含む、動力付きハンドピース20を示す。インターフェース部材322は、インターフェース開口部158と実質的に揃うように調整された開口部324を持ち、ここに光ファイバープローブ124、126を通してカメラ78と接続することができる。
本明細書で説明し例示する方法は、記載した行為の順序に限定されず、また記載した行為を必ずしも全て実施するとも限らない。本発明の実施態様の実施においては、他の行為順序、または全ての行為のうちの一部だけ、または行為の同時進行も、利用することができる。
図43〜43は、整形外科用遮蔽往復運動外科用やすり器具または機械12aのさまざまな図である。外科用やすり器具12aは、一般に、ハンドピース20aにドッキングされてそこから動力を供給される遠位チップアセンブリ18aを備える。
Claims (21)
- ブレードと、
内部を前記ブレードが移動するハウジングであって、長軸を持つハウジングと、
回転運動を往復直線運動に変換するトランスミッションであって、前記ブレードが前記ハウジング内を往復運動するように前記トランスミッションが前記ブレードに連結されているトランスミッションと、
前記ハウジング内の第1開口部であって、それを通して前記ブレードの一部を露出させる第1開口部と、
前記ブレードの該露出部分上の切削面であって、組織の研削、やすり掛けおよび切削の少なくとも1つを行うように構成されている切削面とを備え、
前記トランスミッションが、実質的に固定された距離だけ離れている2つの面と、中心軸のまわりを回転するカムであって、前記中心軸が前記2つの面間に延在する平面に対してある角度を持っているカムとを備えており、
前記カムは厚さが一様でない曲線体を持ち、前記曲線体は、前記中心軸のまわりの前記カムの回転に応じて前記2つの面が直線的に移動する時に前記2つの面が実質的に固定された距離だけ離れた状態を保つように、カムが中心軸の周りを回転する時に前記2つの面と常に接触していることを特徴とする外科用器具。 - 前記ハウジングがその長軸の少なくとも一部にまわりに凹状である、請求項1の外科用器具。
- 前記ハウジングがその長軸の少なくとも遠位部分のまわりに凹状である、請求項2の外科用器具。
- 前記ハウジングがその長軸の少なくとも一部のまわりに凸状である、請求項1の外科用器具。
- 前記ハウジングがその長軸の少なくとも遠位部分のまわりに凸状である、請求項4の外科用器具。
- 前記第1開口部が前記ハウジング上の開口面にある、請求項1の外科用器具。
- 患者の体内に当該外科用器具を入れやすいように、前記ハウジングがその長軸に沿って湾曲している、請求項1の外科用器具。
- 前記ブレードが実質的に平坦である、請求項1の外科用器具。
- 前記ハウジングがその長軸に沿って前記開口面の方向に湾曲している、請求項6の外科用器具。
- 摩擦を減らすために少なくとも1つの軸受支持部をさらに備えている、請求項1の外科用器具。
- 該カムの中心軸が、前記2つの面の直線運動の方向に対して、実質的に平行である、請求項1の外科用器具。
- 該中心軸が、前記2つの面間に延在する平面に対して、実質的に垂直である、請求項1の外科用器具。
- 前記2つの面が、前記中心軸のまわりの前記カムの回転に応じて往復運動して、直線的に前後に移動する、請求項1の外科用器具。
- 前記曲線体が少なくとも2つのトーラスを備えた形状を持ち、それら少なくとも2つのトーラスは部分的に重なり合っており、該少なくとも2つのトーラスのそれぞれは中心軸を持ち、前記少なくとも2つのトーラスの中心軸は互いにある角度を持っている、請求項1の外科用器具。
- 少なくとも1つの軸受が前記2つの面を備えている、請求項1の外科用器具。
- 2つの軸受がそれぞれに前記2つの面を備えている、請求項15の外科用器具。
- 前記曲線体が、前記カムの前記中心軸に対して、ある角度を持って配置される、請求項1の外科用器具。
- 前記ハウジングに連結されたハンドピースをさらに備えている、請求項1の外科用器具。
- 前記回転運動に動力を供給するように構成された原動機を、前記ハンドピース内にさらに備えている、請求項1の外科用器具。
- 前記原動機がガスタービンを備えている、請求項19の外科用器具。
- 前記外科用器具の近位端に連結するように構成されたコードをさらに備え、該コードは、光ファイバ、電気線、灌注用導管、吸込み管、および当該外科用器具内のガスタービン原動機に動力を供給するためのガス管のうちの少なくとも1つを備えている、請求項1の外科用器具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US41469002P | 2002-09-27 | 2002-09-27 | |
PCT/US2003/030906 WO2004028351A2 (en) | 2002-09-27 | 2003-09-29 | Shielded reciprocating surgical file |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2006500998A JP2006500998A (ja) | 2006-01-12 |
JP4517170B2 true JP4517170B2 (ja) | 2010-08-04 |
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ID=32043401
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2004540289A Expired - Fee Related JP4517170B2 (ja) | 2002-09-27 | 2003-09-29 | 遮蔽往復外科用器具 |
Country Status (6)
Country | Link |
---|---|
US (6) | US7390330B2 (ja) |
EP (1) | EP1549199A4 (ja) |
JP (1) | JP4517170B2 (ja) |
AU (2) | AU2003283978C1 (ja) |
CA (1) | CA2500973C (ja) |
WO (1) | WO2004028351A2 (ja) |
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AU2009236031B2 (en) | 2012-06-28 |
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AU2003283978B2 (en) | 2009-08-13 |
US20040122459A1 (en) | 2004-06-24 |
CA2500973C (en) | 2012-05-15 |
WO2004028351A2 (en) | 2004-04-08 |
US8080011B2 (en) | 2011-12-20 |
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