JP4864371B2 - 電気的に作動する回動関節運動機構を含む外科器具 - Google Patents
電気的に作動する回動関節運動機構を含む外科器具 Download PDFInfo
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Description
図1に、細長いシャフト16によってハンドル14から離間したステープル止め組立体12のエンドエフェクタを先端部に有する外科用切断/ステープル止め器具10として外科器具が示されている。ステープル止め組立体12は、交換可能なステープルカートリッジ20を受容するためのステープル溝18を有する。ステープル止め及び切断のためにステープルカートリッジ20に対して組織をクランプするアンビル22が、ステープル溝18に回動可能に取り付けられている。ステープル止め組立体12が閉じると、その断面積及び細長いシャフト16が、トロカール(不図示)のカニューレなどを介して小さな切開部から挿入するのに適した大きさとなる。
図1に示されているステープル止め組立体12では、2つの異なった運動をシャフト16を介してシャフトフレーム(図1には示されていないが図7に詳細に示されている)に長手方向伝達し、組織をクランプし、ステープル止めし、組織を切断することができる。このシャフトフレーム組立体は、基端側がハンドル14に取り付けられ、回動ノブ30と共に回動できるよう結合されている。図1の外科用ステープル止め/切断器具10に用いられるマルチストロークハンドル14の例が、ジェフリー S.スウェイズ(Jeffrey S. Swayze)及びフレデリック E.シェルトン4世(Frederick E. Shelton IV)による同時係属中の自己の米国特許出願第10/674,026号(名称「マルチストローク発射位置表示器及び引き戻し機構を含む外科用ステープル止め器具(SURGICAL STAPLING INSTRUMENT INCORPORATING A MULTISTROKE FIRING POSITION INDICATOR AND RETRACTION MECHANISM)」、及びケビン・ドール(Kevin Doll)、ジェフリー S.スウェイズ(Jeffrey S. Swayze)、フレデリック E.シェルトン4世(Frederick E. Shelton IV)、及びダグラスB.ホフマン(Douglas B. Hoffman)による2005年2月7日出願の米国特許出願第11/052,632号(名称「発射運動の引き戻しが自動で終了するマルチストローク発射機構を含む外科用ステープル止め器具(SURGICAL STAPLING INSTRUMENT INCORPORATING A MULTI-STROKE FIRING MECHANISM WITH AUTOMATIC END OF FIRING TRAVEL RETRACTION)」に開示されている。これらの特許文献には、様々な別の特徴や形態が示されており、言及することを以ってその開示内容の全てを本明細書の一部とする。
電気活性ポリマー(EAPs)は、電圧が加えられると形状が変化する導電物質がドープされた一連のポリマーである。要するに、この導電ポリマーを、一定の形態のイオン流体またはゲル及び電極と組み合わせることができる。電圧を加えると、この流体/ゲルからのイオンが導電ポリマーに対して流入または流出し、このイオンの流れによりポリマーの形状が変化する。加える電圧は、使用するポリマー及びイオン流体によって1V〜4kVの範囲である。電圧が加えられると、ある種のEAPsは収縮し、別のEAPsは膨張する。EAPsをばねや可撓性プレートなどの機械手段に組み合わせて、電圧を加えた際のこれらの効果を変更することができる。
図6‐図13に示されているように、外科用切断/ステープル止め器具200が、細長いシャフト204に形成されたEAP作動関節運動接合部202をエンドエフェクタの基端側に有する。このエンドエフェクタは、細長いシャフト204によって長手方向に伝達される別々の閉止運動及び発射運動に有利に応答する外科用ステープル止め/切断組立体12として例示されている。EAP作動関節運動接合部202は、ステープル止め組立体12に関節運動に所望の臨床的柔軟性を有利に付与する。
図20‐図27に示されているように、EAP作動関節運動ロック700が、外科器具704の回動関節運動接合部702に設けられている。分かり易くするために、シングルピボットフレーム機構706が、先端側に延出した上下の回動タブ710及び712を有する基端フレームグランド708で示されている。これらの回動タブはそれぞれ、エンドエフェクタ720に取り付けられる先端フレームグランド718の基端側に延出した上下のタング714及び716のそれぞれに回動可能に係合する。上部回動タブ710の上部内側孔722が、上部タング714の上部外側孔724の下側に整合し、上部回動ピン726によって互いに回動可能にピンで止められる。下部回動タブ712の下部内側孔728が、下部タング716の下部外側孔730の上に整合し、下部回動ピン732によって互いに回動可能にピンで止められる。上下のモーメントアーム734及び736がそれぞれ、上下の回動タブ710及び712から先端側に延出している。上部モーメントアーム734は、概ね水平な左上部EAPファイバーアクチュエータ740によって先端フレームグランド718に形成された左上部取付け点738に向かって近づくことができる。上部モーメントアーム734はまた、概ね水平な右上部EAPファイバーアクチュエータ744によって先端フレームグランド718に形成された右上部取付け点742に向かって近づくことができる。下部モーメントアーム736は、概ね水平な左下部EAPファイバーアクチュエータ748によって先端フレームグランド718に形成された左下部取付け点746に向かって近づくことができる。下部モーメントアーム736はまた、概ね水平な右下部EAPファイバーアクチュエータ752によって先端フレームグランド718に形成された右下部取付け点750に向かって近づくことができる。
(1)外科器具であって、
エンドエフェクタと、
細長いシャフトと、
前記エンドエフェクタの選択された一つ及び前記細長いシャフトの先端部に取り付けられた第1のフレーム部材、前記エンドエフェクタの他の一つ及び前記細長いシャフトの先端部に取り付けられた第2のフレーム部材、及び前記第1のフレーム部材と前記第2のフレーム部材との間の回動連結部を含む、回動関節運動接合部と、
前記第1のフレーム部材と前記第2のフレーム部材との間に連結された電気活性ポリマーアクチュエータと、を含む、外科器具。
(2)前記第1のフレーム部材が、前記回動連結部及び前記第2のフレーム部材を向いた凹部開口を含み、
前記第2のフレーム部材が、前記凹部内に延びた第1のモーメントアームを含み、
前記電気活性ポリマーアクチュエータが、前記凹部に亘って前記モーメントアームと前記第1のフレーム部材との間に取り付けられている、実施態様(1)に記載の外科器具。
(3)前記電気活性ポリマーアクチュエータが、収縮するように機能的に構成された電気活性ポリマーファイバーアクチュエータを含む、実施態様(2)に記載の外科器具。
(4)前記第1のフレーム部材が、前記第2のフレーム部材の第2の上部タングに取り付けられた第1の上部タング、及び前記第2のフレーム部材の第2の下部タングに取り付けられた第1の下部タングを含み、
前記第1及び第2の上部タングが前記第1及び第2の下部タングから横方向に離間している、実施態様(1)に記載の外科器具。
(5)前記第1のフレーム部材が、前記第2のフレーム部材を受容する凹部を画定するチューブを含み、
前記第2の上部タング及び前記第2の下部タングの少なくとも一方が、前記凹部内に延びたモーメントアームを含み、
前記電気活性ポリマーアクチュエータが、前記モーメントアーム、及び前記第1のフレーム部材の横方向のそれぞれの内面に取り付けられた、互いに反対側を向いた一対の電気活性ポリマーアクチュエータを含む、実施態様(4)に記載の外科器具。
前記電気活性ポリマーアクチュエータが電気活性ポリマーファイバーアクチュエータを含み、この電気活性ポリマーファイバーアクチュエータが一端で前記円周状部分に取り付けられて配置され、そして前記他方のフレーム部材に取り付けられている、実施態様(4)に記載の外科器具。
(7)前記少なくとも1つのタングが、前記関節運動接合部の関節運動の軸を横断するカウンター円周状部分を含み、
前記外科器具が、前記カウンター円周状部分に取り付けられて配置されたカウンター電気活性ポリマーファイバーアクチュエータをさらに含む、実施態様(6)に記載の外科器具。
(8)選択された1つの前記上部タングと選択された1つの前記下部タングが共に、前記電気活性ポリマーファイバーに取り付けられた上側部分及び前記カウンター電気活性ファイバーアクチュエータに取り付けられた下側部分を含む丸い形状を有する、実施態様(7)に記載の外科器具。
(9)前記エンドエフェクタが、発射バーによって作動されるステープル止め/切断組立体を含み、
前記発射バーの基端側に前記ハンドル部分が取り付けられ、前記ハンドル部分が、前記発射バーに長手方向の発射運動を付与するように機能的に構成されており、
前記細長いシャフトが、関節運動した前記関節運動接合部を介して前記発射バーを支持する発射バーガイドをさらに含む、実施態様(4)に記載の外科器具。
(10)前記エンドエフェクタが、ステープルカートリッジを受容するように機能的に構成された下側溝、及び回動可能に取り付けられた上側アンビルをさらに含み、
前記ハンドル部分が、長手方向の閉止運動を提供するように機能的に構成されており、
前記細長いシャフトが、基端側が前記ハンドル部分に結合されて前記閉止運動を前記アンビルとの先端連結部に伝達する閉止スリーブ組立体をさらに含み、
前記閉止スリーブ組立体が、引き戻された位置及び先端側に延出した位置の両方で前記関節運動接合部の関節運動の軸を中心に回動するように機能的に構成されている、実施態様(9)に記載の外科器具。
(12)前記閉止スリーブ組立体が、回動リンクの第1の端部に回動可能に取り付けられた先端閉止チューブ、及び前記回動リンクの第2の端部に回動可能に取り付けられた基端閉止チューブを含む、実施態様(10)に記載の外科器具。
(13)前記先端閉止チューブが、基端側に延出した上部タング及び下部タングを有する先端閉止リングをさらに含み、
前記基端閉止チューブが、先端側に延出した上部タング及び下部タングを有する基端閉止リングをさらに含む、実施態様(12)に記載の外科器具。
(14)前記第1のフレーム部材が、前記第2のフレーム部材に向かって延出したモーメントアームを含み、
前記第2のフレーム部材が前記モーメントアームを受容する凹部を含み、前記モーメントアームは回動可能に前記凹部の後部に取り付けられ、前記凹部は前記第1のフレーム部材が関節運動可能な大きさに形成され、
前記電気活性ポリマーアクチュエータが、前記凹部の第1の側面と前記モーメントアームとの間に取り付けられた第1の電気活性ポリマーアクチュエータと、前記凹部の第2の側面と前記モーメントアームとの間に取り付けられた第2の電気活性ポリマーアクチュエータとをさらに含む、実施態様(1)に記載の外科器具。
(15)前記第1の電気活性ポリマーアクチュエータ及び前記第2の電気活性ポリマーアクチュエータが、作動すると前記モーメントアームを押すスタックアクチュエータを含む、実施態様(14)に記載の外科器具。
前記発射バーの基端側に前記ハンドル部分が取り付けられ、前記ハンドル部分が、前記発射バーに長手方向の発射運動を付与するように機能的に構成されており、
前記細長いシャフトが、前記発射バーを支持する発射バーガイドをさらに含み、
前記モーメントアームが、前記関節運動接合部を介して前記発射バーを案内するために前記発射バーガイドと連絡する発射バースロットを含む、実施態様(14)に記載の外科器具。
(17)関節運動固定機構をさらに含み、この関節運動固定機構が、
前記第1のフレーム部材及び前記第2のフレーム部材の選択された一方に取り付けられ、前記第1のフレーム部材及び前記第2のフレーム部材の他方に向かって延出して係合するように付勢された、長手方向に移動する固定部材と、
作動すると前記長手方向に移動する固定部材の付勢に打ち勝って前記関節運動接合部を固定解除するよう機能的に構成されて配置された電気活性ポリマーアクチュエータと、を含む、実施態様(1)に記載の外科器具。
(18)外科器具であって、
長手方向にスライド可能に受容された閉止スリーブ組立体によって覆われたフレーム組立体を含む細長いシャフトと、
細長い溝、その細長い溝に係合したステープルカートリッジ、及び前記ステープルカートリッジに対して形成面を提供する前記細長い溝に回動可能に取付けられたアンビルを含む、ステープル止め組立体と、
前記フレーム組立体に形成された関節運動接合部であって、前記フレーム組立体は、前記細長い溝に取り付けられた先端フレーム部分、及びその先端フレーム部分に回動可能にピンで止められた基端フレーム部分を含む、関節運動接合部と、
前記細長いシャフトの基端部に取り付けられ、前記細長いシャフトに電気信号を選択的に伝達するように機能的に構成されたハンドル部分と、
前記関節運動接合部に連結され、前記電気信号に応答して前記ステープル止め組立体を関節運動させる電気活性ポリマーアクチュエータと、を含む、外科器具。
(19)前記細長いシャフトが、マルチピボット接合部を有する長手方向にスライド可能に受容された閉止スリーブ組立体をさらに含み、前記マルチピボット接合部が前記関節運動接合部を覆い、そのマルチピボット接合部の先端側が上側ジョーを回動させるためにその上側ジョーに係合しており、
前記ハンドル部分が、前記閉止スリーブ組立体を移動させて前記上側ジョーを開閉できるように機能的に構成されている、実施態様(18)に記載の外科器具。
(20)外科器具であって、
エンドエフェクタと、
前記エンドエフェクタ及び基端フレーム部分に取り付けられた先端フレーム部分を含む細長いシャフトと、
前記先端フレーム部分と前記基端フレーム部分との間の回動取付け部と、
電気信号に応答して前記回動取付け部を中心に、前記基端フレーム部分に対して前記先端フレーム部分の回動を作動させるための手段と、を含む、外科器具。
12 ステープル止め組立体
14 ハンドル
16 シャフト
18 ステープル溝
20 ステープルカートリッジ
22 アンビル
30 回動ノブ
32 関節運動接合部
34 関節運動制御スイッチ
36 EAPアクチュエータ
38 電源
40 閉止トリガー
42 ピストルグリップ
44 発射トリガー
46 引き戻しレバー
48 閉止解除ボタン
100 ラミネートEAP複合材
102 プレート陽極層
104 EAP層
106 イオンセル層
108 プレート陰極層
110 接着層
120 EAPプレートアクチュエータ
140 収縮EAPファイバーアクチュエータ
142 プラチナ陰極ワイヤ
144、150 エンドキャップ
146 円柱キャビティ
148 プラスチック円柱壁
152 収縮ポリマーファイバー
200 外科用切断/ステープル止め器具
202 EAP作動関節運動接合部
204 シャフト
210 関節運動接合部
214 基端閉止チューブ
216 先端閉止リング
218 可撓性閉止チューブ
220、222 垂直スリット
224 長手方向バンド
226 馬蹄開口
228 アンビル閉止構造
230 回動ピン
234 シングルピボットフレーム組立体
238 上部回動タブ
240 下部回動タブ
242、252 上部回動ピンホール
244、254 下部回動ピンホール
246 上部回動タング
248 下部回動タング
250 先端フレームグランド
256 上部フレーム回動ピン
258 下部フレーム回動ピン
270 発射バー
272 発射スロット
274 矩形開口
278 クリップバー
280 上部アーム
282 クリップばね
284 アーム
286 ***部分
288 Eビーム
292 ステープルドライバ
296 ウェッジスレッド
298 カートリッジトレイ
300 切断面
302 上部ピン
304 中間ピン
306 下部脚
308 長手方向スロット
310 長手方向開口
312 垂直スロット
400 EAPアクチュエータシステム
402、404 EAPファイバーアクチュエータ
406 上部モーメントアーム
416 下部モーメントアーム
504 ダブルピボット閉止スリーブ組立体
506 シングルピボットフレーム組立体
514 上部タング
516 下部タング
518 先端閉止チューブ
522 先端閉止リング
528 上部ダブルピボットリンク
530 先端回動ピン
532 基端回動ピン
534 上部先端ピンホール
536 上部基端ピンホール
538 下部ダブルピボットリンク
540 先端回動ピン
542 基端回動ピン
544 下部先端ピンホール
550 基端フレームグランド
552 回動ピンホール
554 回動凹部
556、558 モーメントアーム
560 ドッグボーン型リンク
562 基端ピン
566 先端ピン
570 先端フレームグランド
572 先端横ガイド
574 基端ガイド
580 EAP作動システム
582、584 EAPスタックアクチュエータ
600 EAP作動関節運動接合部
602 外科器具
604 シングルピボットフレーム組立体
606 基端フレームグランド
608 タング
610 先端フレームグランド
612 回動ピン
614 半涙型プーリー
616 収縮EAPファイバーアクチュエータ
700 EAP作動関節運動ロック
702 回動関節運動接合部
704 外科器具
706 シングルピボットフレーム機構
708 基端フレームグランド
710 上部回動タブ
712 下部回動タブ
714 上部タング
716 下部タング
720 エンドエフェクタ
722 上部内側孔
724 上部外側孔
726 上部回動ピン
728 下部内側孔
730 下部外側孔
732 下部回動ピン
734 上部モーメントアーム
736 下部モーメントアーム
740、744 上部EAPファイバーアクチュエータ
748、752 下部EAPファイバーアクチュエータ
800 上部EAP作動関節運動固定機構
802 上部固定ボルト組立体
804 上部固定凹部
808 固定チップ
810 先端スロット
812 歯車の谷
814 歯車部分
816 クロスプレート
818 圧縮ばね
820、822 EAPスタックアクチュエータ
824 上部固定カバー
830 下部EAP作動関節運動固定機構
900 EAP関節運動システム
901 シングルピボット関節運動接合部
902、904 上部EAPファイバーアクチュエータ
906、908 下部EAPファイバーアクチュエータ
910 上部モーメントアーム
912 下部モーメントアーム
914 上部回動タブ
916 下部回動タブ
918 基端フレームグランド
920 左上部取付け点
924 右上部取付け点
926 左下部取付け点
928 右下部取付け点
1000 EAP関節運動システム
1001 シングルピボット関節運動接合部
1002、1004 上部EAPスタックアクチュエータ
1006、1008 下部EAPスタックアクチュエータ
1014 上部モーメントアーム
1016 上部回動タブ
1020、1030 チップピン
1022 先端フレームグランド
1024 下部モーメントアーム
1026 下部回動タブ
Claims (11)
- 外科器具であって、
エンドエフェクタと、
細長いシャフトと、
前記エンドエフェクタ及び前記細長いシャフトの先端部の選択された一方に取り付けられた第1のフレーム部材、前記エンドエフェクタ及び前記細長いシャフトの先端部の他方に取り付けられた第2のフレーム部材、及び前記第1のフレーム部材と前記第2のフレーム部材との間の回動連結部を含む、回動関節運動接合部と、
前記第1のフレーム部材と前記第2のフレーム部材との間に連結された電気活性ポリマーアクチュエータと、を含み、
前記第1のフレーム部材が、前記回動連結部及び前記第2のフレーム部材を向いた凹部開口を含み、
前記第2のフレーム部材が、前記凹部内に延びた第1のモーメントアームを含み、
前記電気活性ポリマーアクチュエータが、前記凹部に亘って前記モーメントアームと前記第1のフレーム部材との間に取り付けられている、外科器具。 - 前記電気活性ポリマーアクチュエータが、収縮するように機能的に構成された電気活性ポリマーファイバーアクチュエータを含む、請求項1に記載の外科器具。
- 前記第1のフレーム部材が、前記第2のフレーム部材の第2の上部タングに取り付けられた第1の上部タング、及び前記第2のフレーム部材の第2の下部タングに取り付けられた第1の下部タングを含み、
前記第1及び第2の上部タングが前記第1及び第2の下部タングから横方向に離間している、請求項1に記載の外科器具。 - 前記第1のフレーム部材が、前記第2のフレーム部材を受容する凹部を画定するチューブを含み、
前記第2の上部タング及び前記第2の下部タングの少なくとも一方が、前記凹部内に延びたモーメントアームを含み、
前記電気活性ポリマーアクチュエータが、前記モーメントアーム、及び前記第1のフレーム部材の横方向のそれぞれの内面に取り付けられた、互いに反対側を向いた一対の電気活性ポリマーアクチュエータを含む、請求項3に記載の外科器具。 - 前記少なくとも1つのタングが、前記関節運動接合部の関節運動の軸を横断する円周状部分を含み、
前記電気活性ポリマーアクチュエータが電気活性ポリマーファイバーアクチュエータを含み、この電気活性ポリマーファイバーアクチュエータが一端で前記円周状部分に取り付けられて配置され、そして他方のフレーム部材に取り付けられている、請求項3に記載の外科器具。 - 前記少なくとも1つのタングが、前記関節運動接合部の関節運動の軸を横断するカウンター円周状部分を含み、
前記外科器具が、前記カウンター円周状部分に取り付けられて配置されたカウンター電気活性ポリマーファイバーアクチュエータをさらに含む、請求項5に記載の外科器具。 - 選択された1つの前記上部タングと選択された1つの前記下部タングが共に、前記電気活性ポリマーファイバーに取り付けられた上側部分及び前記カウンター電気活性ファイバーアクチュエータに取り付けられた下側部分を含む丸い形状を有する、請求項6に記載の外科器具。
- 前記エンドエフェクタが、発射バーによって作動されるステープル止め/切断組立体を含み、
前記発射バーの基端側に前記ハンドル部分が取り付けられ、前記ハンドル部分が、前記発射バーに長手方向の発射運動を付与するように機能的に構成されており、
前記細長いシャフトが、関節運動した前記関節運動接合部を介して前記発射バーを支持する発射バーガイドをさらに含む、請求項3に記載の外科器具。 - 前記エンドエフェクタが、ステープルカートリッジを受容するように機能的に構成された下側溝、及び回動可能に取り付けられた上側アンビルをさらに含み、
前記ハンドル部分が、長手方向の閉止運動を提供するように機能的に構成されており、
前記細長いシャフトが、基端側が前記ハンドル部分に結合されて前記閉止運動を前記アンビルとの先端連結部に伝達する閉止スリーブ組立体をさらに含み、
前記閉止スリーブ組立体が、引き戻された位置及び先端側に延出した位置の両方で前記関節運動接合部の関節運動の軸を中心に回動するように機能的に構成されている、請求項8に記載の外科器具。 - 関節運動固定機構をさらに含み、この関節運動固定機構が、
前記第1のフレーム部材及び前記第2のフレーム部材の選択された一方に取り付けられ、前記第1のフレーム部材及び前記第2のフレーム部材の他方に向かって延出して係合するように付勢された、長手方向に移動する固定部材と、
作動すると前記長手方向に移動する固定部材の付勢に打ち勝って前記関節運動接合部を固定解除するよう機能的に構成されて配置された電気活性ポリマーアクチュエータと、を含む、請求項1に記載の外科器具。 - 細長いシャフトは、長手方向にスライド可能に受容された閉止スリーブ組立体によって覆われたフレーム組立体を含み、
前記エンドエフェクタはステープル止め組立体を含み、前記ステープル止め組立体は、細長い溝、その細長い溝に係合したステープルカートリッジ、及び前記ステープルカートリッジに対して形成面を提供する前記細長い溝に回動可能に取付けられたアンビルを含み、
前記電気活性ポリマーアクチュエータは、前記ステープル止め組立体を関節運動させ、
当該外科器具は前記細長いシャフトの基端部に取り付けられたハンドル部分をさらに含み、前記ハンドル部分は前記細長いシャフトに電気信号を選択的に伝達するように機能的に構成されている、請求項1に記載の外科器具。
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US59169404P | 2004-07-28 | 2004-07-28 | |
US60/591,694 | 2004-07-28 | ||
US11/096,158 | 2005-03-31 | ||
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JP4864371B2 true JP4864371B2 (ja) | 2012-02-01 |
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EP (1) | EP1621137B1 (ja) |
JP (1) | JP4864371B2 (ja) |
KR (1) | KR20060092848A (ja) |
AT (1) | ATE415873T1 (ja) |
AU (1) | AU2005203217B2 (ja) |
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2005
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- 2005-07-22 AU AU2005203217A patent/AU2005203217B2/en not_active Ceased
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CA2514214A1 (en) | 2006-01-28 |
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CA2514214C (en) | 2014-05-20 |
US20060025812A1 (en) | 2006-02-02 |
JP2006034976A (ja) | 2006-02-09 |
MXPA05008044A (es) | 2006-02-10 |
EP1621137A2 (en) | 2006-02-01 |
KR20060092848A (ko) | 2006-08-23 |
DE602005011368D1 (de) | 2009-01-15 |
AU2005203217B2 (en) | 2012-03-08 |
RU2005123980A (ru) | 2007-02-10 |
EP1621137A3 (en) | 2006-03-01 |
AU2005203217A1 (en) | 2006-02-16 |
EP1621137B1 (en) | 2008-12-03 |
ATE415873T1 (de) | 2008-12-15 |
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