JP4717828B2 - 外科用開創器、照明カニューレ、および使用法 - Google Patents
外科用開創器、照明カニューレ、および使用法 Download PDFInfo
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Description
本願は、参照することを以って本明細書組み込まれる、2003年12月18日出願の米国仮特許出願第60/530,565号の優先権を主張するものである。
外科手術では、患者に対する外傷および組織に対する損傷を最小化または軽減するのが好ましい。このため、外科医は、切開部を可能な限り小さく維持しようとする。しかしながら、通常は、外科医が明確な手術野を確保する必要がある。
例えば、外科手術のための作業空間を作り出し、外科手術を行う外科医のために外科手術条件を改善して外科手術を改善する方法および装置をここに開示する。
本発明の好適な実施形態を以下に説明する。本発明は、本発明の好適な実施形態を用いて特に図示および説明するが、当業者であれば、添付の特許請求の範囲によって包含される本発明の範囲から逸脱することなく形態および細部を様々に変更できることを理解できよう。
(1)外科用開創器において、
フレームであって、
第1のベース要素と、
第2のベース要素と、
前記第1のベース要素と前記第2のベース要素を連結するコネクタと、を備え、前記第1のベース要素および前記第2のベース要素との少なくとも一方が、前記コネクタの長さに沿って移動可能であり、前記コネクタが前記第1のベース要素または前記第2のベース要素に対して移動すると、前記フレームが第1の位置から第2の位置に移動して、前記第1のベース要素と前記第2のベース要素との間の距離が変化する、前記フレームと、
前記フレームに取り付けられた少なくとも2つの開創器ブレードと、
を含む、外科用開創器。
(2)実施態様(1)に記載の外科用開創器において、
少なくとも1つのブレードが、クリップで前記フレームに取り付けられている、外科用開創器。
(3)実施態様(1)に記載の外科用開創器において、
少なくとも1つのブレードおよびベース要素が、1つの連続した材料部分から形成されている、外科用開創器。
(4)実施態様(1)に記載の外科用開創器において、
前記ブレードの1つに伸縮自在およびスライド可能に取り付けられているブレード延長部をさらに含む、外科用開創器。
(5)実施態様(1)に記載の外科用開創器において、
少なくとも2つのブレードの位置を互いに対して固定するロック機構をさらに含む、外科用開創器。
第2のコネクタと、
前記コネクタに取り付けられた第3のベース要素と、
前記コネクタに取り付けられた第4のベース要素と、をさらに含み、前記第3のベース要素および前記第4のベース要素の少なくとも一方が、前記コネクタの長さに沿って移動可能であって、この移動により、前記第3のベース要素と前記第4のベース要素との間の距離が変化するようになっており、前記第1のベース要素および前記第2のベース要素が前記第3のベース要素および前記第4のベース要素に対して移動可能である、外科用開創器。
(7)実施態様(1)に記載の外科用開創器において、
前記拡張可能なフレームが、外科用器具または開創器ブレードを支持するための少なくとも1つの取付け点をさらに含む、外科用開創器。
(8)実施態様(1)に記載の外科用開創器において、
前記第1のコネクタが弧状である、外科用開創器。
(9)実施態様(1)に記載の外科用開創器において、
前記第1のコネクタが直線状である、外科用開創器。
(10)実施態様(1)に記載の外科用開創器において、
前記フレームが前記第1の位置にあるときに、前記ブレードが導管を画定する、外科用開創器。
前記フレームが第2の位置にあるときに、前記ベース要素がアクセス口を画定する、外科用開創器。
(12)実施態様(11)に記載の外科用開創器において、
前記各ブレードが、前記フレームに取り付けられた基端部、およびその基端部の反対側の先端部を備えており、前記アクセス口が、前記拡張可能なフレームが前記第2の位置にあるときに、任意の2つのブレードの先端部間の最大距離よりも小さい平均直径を有する、外科用開創器。
(13)実施態様(1)に記載の外科用開創器において、
前記ベース要素が、実質的に主平面にある前記コネクタに沿って移動可能である、外科用開創器。
(14)実施態様(1)に記載の外科用開創器において、
前記フレームが前記第1の位置にあるときに、前記ブレードが互いに接触する、外科用開創器。
(15)外科用開創器において、
第1の開創器ブレードおよび第2の開創器ブレードと、
前記第1の開創器ブレードの基端部および前記第2の開創器ブレードの基端部に取り付けられた第1のコネクタであって、前記第1の開創器ブレードまたは前記第2の開創器ブレードの少なくとも一方が、前記第1のコネクタの長さに平行な線に沿って移動可能である、第1のコネクタと、
第3の開創器ブレードおよび第4の開創器ブレードと、
前記第3の開創器ブレードの基端部および前記第4の開創器ブレードの基端部に取り付けられた第2のコネクタであって、前記第3の開創器ブレードまたは前記第4の開創器ブレードの少なくとも一方が、前記第2のコネクタの長さに平行な線に沿って移動可能であり、前記第1のコネクタまたは前記第2のコネクタの少なくとも一方が、前記第1のコネクタと前記第2のコネクタを横断する線に沿って移動可能である、第2のコネクタと、
を具備する、外科用開創器。
前記第1のコネクタまたは前記第2のコネクタが湾曲している、外科用開創器。
(17)実施態様(15)に記載の外科用開創器において、
前記第1の開創器ブレードまたは前記第2の開創器ブレードがベース要素に取り付けられており、このベース要素が前記第1のコネクタに取り付けられている、外科用開創器。
(18)実施態様(15)に記載の外科用開創器において、
前記開創器ブレードが、これらのブレードが全体として導管を画定する位置まで移動可能である、外科用開創器。
(19)オブチュレータに取り付けられた外科用開創器を含む組立体。
(20)外科用開創器において、
中心軸を有するハウジング要素であって、
前記中心軸に対して垂直な内径を有する導管を画定する円筒状部分と、
前記円筒状部分の一端に隣接したブレード部分であって、少なくとも2つのブレードを含み、これらの各ブレードの先端部分が、前記中心軸に対して移動可能であり、第1の位置では、前記ブレード部分の先端部が近接し、前記中心軸に対して前記ブレードの先端部が移動すると、前記ブレードが前記第1の位置から第2の位置に移動して前記中心軸の長さに沿った導管を形成する、前記ブレード部分と、を備えた前記ハウジング要素と、
外径を有する円筒状拡張要素であって、前記外径が、前記円筒状部分の内径よりも小さく、前記ハウジング要素に移動可能に取り付けられている、前記円筒状拡張要素と、
を具備する、外科用開創器。
外径、内径、先端部、および基端部を有する外科用カニューレであって、前記内径、前記先端部、および前記基端部によって内部領域が画定されている、前記外科用カニューレと、
前記基端部に取り付けられたインターフェイスリングであって、光ファイバーワイヤのアレイと光子通信する光源インターフェイスを含み、前記アレイが、光を前記カニューレの先端部に向かって案内するように配置されている、前記インターフェイスリングと、を含む、外科用照明カニューレ。
(22)外科手術方法において、
哺乳動物の組織を切開して切開部を作り出すステップと、
前記切開部を拡張して前記切開部から手術部位に至る経路を作り出すステップと、
開創器を前記経路内に導入するステップと、
前記開創器を拡張させて作業通路を作り出すステップであって、この開創器の拡張が、
第1の開創器ブレードおよび第2の開創器ブレードの少なくとも一方を前記開創器の第1のコネクタに沿って移動させて、前記第1の開創器ブレードを前記第2の開創器ブレードから分離させるステップと、
第3の開創器ブレードおよび第4の開創器ブレードの少なくとも一方を、前記第1のコネクタに対して所定の角度に配置されている第2のコネクタに沿って移動させて、前記第3の開創器ブレードを前記第4の開創器ブレードから分離するステップと、によって行われる、前記作業通路を作り出すステップと、
前記作業通路を介して外科手術の少なくとも一部を行うステップと、
を含む、外科手術方法。
(23)実施態様(22)に記載の外科手術方法において、
前記開創器が、第1のベース要素、第2のベース要素、およびコネクタを有するフレームを含み、
前記コネクタが、前記第1のベース要素と前記第2のベース要素を連結し、前記第1のベース要素および前記第2のベース要素の少なくとも一方が、前記コネクタの長さに沿って移動可能であり、前記コネクタが前記第1のベース要素または前記第2のベース要素に対して移動すると、前記フレームが、第1の位置から第2の位置に移動して、前記第1のベース要素と前記第2のベース要素との間の距離が変化する、方法。
(24)実施態様(22)に記載の外科手術方法において、
前記経路が第1の椎骨まで延びており、前記外科手術の少なくとも一部が、前記第1の椎骨で行われ、前記方法が、少なくとも2つの開創器ブレードの間に器具またはインプラントを案内して、前記第1の椎骨に近接した第2の椎骨にアクセスするステップをさらに含む、外科手術方法。
(25)実施態様(22)に記載の外科手術方法において、
前記開創器が前記経路内に導入される前に、前記開創器がオブチュレータに取り付けられる、外科手術方法。
前記第1の開創器ブレードおよび前記第2の開創器ブレードの少なくとも一方が非線形の線に沿って移動する、外科手術方法。
(27)実施態様(22)に記載の外科手術方法において、
前記第1の開創器ブレードおよび前記第2の開創器ブレードの少なくとも一方が線形の線に沿って移動する、外科手術方法。
(28)実施態様(22)に記載の外科手術方法において、
前記第3の開創器ブレードおよび前記第4の開創器ブレードの少なくとも一方が非線形の線に沿って移動する、外科手術方法。
(29)実施態様(22)に記載の外科手術方法において、
前記第3の開創器ブレードおよび前記第4の開創器ブレードの少なくとも一方が線形の線に沿って移動する、外科手術方法。
(30)椎骨へのアクセスする方法において、
哺乳動物の組織を切開して切開部を作り出すステップと、
前記切開部を拡張して前記切開部から手術部位に至る経路を作り出すステップと、
開創器を前記経路内に案内するステップと、
少なくとも2つの開創器ブレードを分離させて、前記開創器を通じて作業通路を作り出すステップと、
前記作業通路を介して第1の椎骨で外科手術の少なくとも一部を行うステップと、
器具またはインプラントを2つの前記開創器ブレード間に案内して第2の椎骨に近接した組織を移動させて、前記第1の椎骨に近接した前記第2の椎骨を露出させるステップと、
前記作業通路を介して前記第2の椎骨で外科手術の少なくとも一部を行うステップと、を含む、方法。
前記開創器が前記経路内に導入される前に、前記開創器がオブチュレータに取り付けられる、方法。
(32)実施態様(30)に記載の方法において、
前記開創器が、第1のベース要素、第2のベース要素、およびコネクタを有するフレームを含み、
前記コネクタが、前記第1のベース要素と前記第2のベース要素を連結し、前記第1のベース要素および前記第2のベース要素の少なくとも一方が、前記コネクタの長さに沿って移動可能であり、前記コネクタが前記第1のベース要素または前記第2のベース要素に対して移動すると、前記フレームが、第1の位置から第2の位置に移動して、前記第1のベース要素と前記第2のベース要素との間の距離が変化する、方法。
(33)実施態様(32)に記載の方法において、
前記第1の開創器ブレードおよび前記第2の開創器ブレードの少なくとも一方が非線形の線に沿って移動する、方法。
(34)実施態様(32)に記載の方法において、
前記第1の開創器ブレードおよび前記第2の開創器ブレードの少なくとも一方が線形の線に沿って移動する、方法。
(35)実施態様(32)に記載の方法において、
前記第3の開創器ブレードおよび前記第4の開創器ブレードの少なくとも一方が非線形の線に沿って移動する、方法。
前記第3の開創器ブレードおよび前記第4の開創器ブレードの少なくとも一方が線形の線に沿って移動する、方法。
(37)キットにおいて、
外科用開創器と、
前記外科用開創器のフレームに取り付けることができる開創器挿入器と、
ブレード深さタワーと、
伸延器(distractor)と、
少なくとも1つのブレード調節器具と、を含む、キット。
(38)実施態様(37)に記載のキットにおいて、
前記ブレード調節器具がブレードリムーバー器具である、キット。
(39)実施態様(37)に記載のキットにおいて、
前記ブレード調節器具が、ブレードプッシャー器具である、キット。
(40)実施態様(37)に記載のキットにおいて、
オブチュレータをさらに含む、キット。
少なくとも2つの異なる拡張器をさらに含む、キット。
Claims (9)
- 外科用開創器において、
第1のベース要素であって、該第1のベース要素に結合された第1のブレードと該第1のベース要素から延在する第1のコネクタとを有する、第1のベース要素と、
第2のベース要素であって、該第2のベース要素に結合された第2のブレードと該第2のベース要素から延在する第2のコネクタとを有し、該第2のベース要素は前記第1のベース要素に対して移動動作するために前記第1のコネクタに結合されている、第2のベース要素と、
第3のベース要素であって、該第3のベース要素に結合された第3のブレードと該第3のベース要素から延在する第3のコネクタとを有し、該第3のベース要素は前記第2のベース要素に対して移動動作するために前記第2のコネクタに結合されている、第3のベース要素と、
第4のベース要素であって、該第4のベース要素に結合された第4のブレードを有し、該第4のベース要素は前記第3のベース要素に対して移動動作するために前記第3のコネクタに結合されている、第4のベース要素と、
を備え、
前記第1のベース要素、前記第2のベース要素および前記第3のベース要素は、主平面を画定し、前記主平面を通るアクセス口を画定し、アクセス口を通して外科手術が行なわれ得るように構成されている、外科用開創器。 - 請求項1に記載の外科用開創器において、
前記第1のコネクタおよび前記第2のコネクタの少なくとも一つは、前記主平面からずれて湾曲している、外科用開創器。 - 請求項1に記載の外科用開創器において、
前記第1のコネクタおよび前記第2のコネクタアームの各々は、前記主平面からずれて湾曲している、外科用開創器。 - 請求項1に記載の外科用開創器において、
前記第1のブレード、前記第2のブレードおよび前記第3のブレードをそれぞれのベース要素に結合するために、前記第1のベース要素、前記第2のベース要素および前記第3のベース要素の各々にそれぞれ設けられた第1のクリップ、第2のクリップおよび第3のクリップをさらに備える、外科用開創器。 - 請求項1に記載の外科用開創器において、
前記第1のコネクタは前記第1のベース要素に固定され、前記第2のコネクタは前記第2のベース要素に固定されている、外科用開創器。 - 請求項5に記載の外科用開創器において、
前記第1のコネクタに対する前記第2のベース要素の位置を固定する、前記第2のベース要素上の固定機構と、前記第2のコネクタに対する前記第3のベース要素の位置を固定する、前記第3のベース要素上の固定機構とをさらに備える、外科用開創器。 - 請求項6に記載の外科用開創器において、
前記第1のコネクタおよび前記第2のコネクタはラチェットアームであり、前記第2のベース要素上の前記固定機構および前記第3のベース要素上の前記固定機構はそれぞれのラチェットアームに係合するタブを備える、外科用開創器。 - 請求項7に記載の外科用開創器において、
前記第1のコネクタのラチェットアームおよび前記第2のコネクタのラチェットアームは前記第2のベース要素の内部および前記第3のベース要素の内部をそれぞれ通過し、前記固定機構のタブはそれぞれのベース要素の内部で前記ラチェットアームに係合する、外科用開創器。 - 請求項1から8のいずれかに記載の外科用開創器において、
前記第4のベース要素は該第4のベース要素から延在する第4のコネクタを有し、前記第1のベース要素は前記第4のベース要素に対して移動動作するために前記第4のコネクタに結合されている、外科用開創器。
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AU2009201497B2 (en) | 2012-01-19 |
WO2005060837A2 (en) | 2005-07-07 |
JP2011125733A (ja) | 2011-06-30 |
WO2005060837A3 (en) | 2006-10-05 |
EP1706041B1 (en) | 2015-11-18 |
AU2004303424C1 (en) | 2009-11-05 |
EP1706041A2 (en) | 2006-10-04 |
US20090018400A1 (en) | 2009-01-15 |
US10869657B2 (en) | 2020-12-22 |
US7491168B2 (en) | 2009-02-17 |
EP2332468B1 (en) | 2016-11-09 |
US20140058210A1 (en) | 2014-02-27 |
US20050159650A1 (en) | 2005-07-21 |
US8038611B2 (en) | 2011-10-18 |
AU2004303424A1 (en) | 2005-07-07 |
CN1913834B (zh) | 2010-12-01 |
EP2332468A1 (en) | 2011-06-15 |
CN1913834A (zh) | 2007-02-14 |
US8602984B2 (en) | 2013-12-10 |
CA2550605C (en) | 2012-05-08 |
AU2009201497A1 (en) | 2009-05-14 |
CA2550605A1 (en) | 2005-07-07 |
JP5313276B2 (ja) | 2013-10-09 |
AU2004303424B2 (en) | 2009-02-05 |
JP2007514501A (ja) | 2007-06-07 |
US20110313256A1 (en) | 2011-12-22 |
US8622897B2 (en) | 2014-01-07 |
US20050159651A1 (en) | 2005-07-21 |
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