JP5089944B2 - 移動防止機構を備えたクリップアプライヤ - Google Patents
移動防止機構を備えたクリップアプライヤ Download PDFInfo
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips 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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
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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
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/032—Automatic limiting or abutting means, e.g. for safety pressure limiting, e.g. hydrostatic
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- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S227/00—Elongated-member-driving apparatus
- Y10S227/901—Surgical clip appliers
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Description
本願は、2005年4月14日出願の米国特許出願第10/907,763号(名称:「外科クリップアプライヤの方法(Surgical Clip Applier Methods)」)、2005年4月14日出願の同第10/907,764号(名称:「医療器具用の力を制限する機構(Force Limiting Mechanism For Medical Instrument)」)、2005年4月14日出願の同第10/907,765号(名称:「外科クリップ前進機構(Surgical Clip Advancement Mechanism)」)、2005年4月14日出願の同第10/907,766号(名称:「外科クリップアプライヤのラチェット機構(Surgical Clip Applier Ratchet Mechanism)」)、および2005年4月14日出願の同第10/907,768号(名称:「外科クリップ前進/整合機構(Surgical Clip Advancement And Alignment Mechanism)」)の一部継続出願である。これらの特許出願は参照をもってその開示内容の全てを本明細書の一部とする。
本発明は、広義には外科装置に関し、詳細には、管、脈管、シャントなどに外科クリップを取り付けるための装置および方法に関する。
近年、胆嚢摘出術、胃瘻造設術、虫垂切除術、およびヘルニア修復術などの腹腔鏡外科手術および内視鏡外科手術の実施によって外科手術が著しく進歩した。このような外科手術は、体腔内に挿入するために用いられる外科器具であるトロカール組立体を介して行われる。このようなトロカールは、通常は、尖ったオブチュレータチップおよびトロカールチューブすなわちカニューレを含む。オブチュレータチップを用いて皮膚に刺入し、トロカールカニューレを、皮膚内に挿入して体腔内にアクセスする。挿入後、オブチュレータを取り外し、トロカールカニューレを体内に残す。このカニューレを介して、外科器具を配置する。
本発明は、血管、ダクト、シャントなどに外科クリップを取り付けるための方法および装置を提供する。例示的な一実施形態では、外科クリップアプライヤは、トリガーが移動可能に結合されたハウジングと、そのハウジングから延び、遠位端部に対向した顎部が形成されている細長いシャフトを有する外科クリップアプライヤを提供する。トリガーは、クリップを前進させて顎部間に配置し、顎部を開位置から閉止位置に移動させて、顎部間に配置されたクリップを圧縮形成するように構成されている。
本発明は、添付の図面を参照しながら以下の詳細な説明を読めば、より完全に理解できるであろう。
(1)互いに閉じてクリップすべき組織を近接させる顎部、およびこれらの顎部内に複数のクリップを連続的に前進させるように構成されたクリップ前進組立体を有する、改善された内視鏡外科クリップアプライヤにおいて、
前記クリップ前進組立体の一部が、前記顎部に向かって移動して前記顎部内に複数のクリップを連続的に前進させることができる、クリップトラック内に配置されたプッシャー機構であって、前記プッシャー機構が、前記クリップトラックとの間で摩擦を発生させて、前記クリップトラック内での前記プッシャー機構の不所望の移動を防止するように構成され、前記クリップ前進組立体が作動すると移動して前記プッシャー機構を遠位側に前進させるように構成されている、プッシャー機構、
を備える、内視鏡外科クリップアプライヤ。
(2)実施態様(1)に記載の内視鏡外科クリップアプライヤにおいて、
前記プッシャー機構が、前記クリップトラックと接触してそのクリップトラックとの間で摩擦を発生させる突出部を備えている、内視鏡外科クリップアプライヤ。
(3)実施態様(1)に記載の内視鏡外科クリップアプライヤにおいて、
前記プッシャー機構が、前記クリップトラックに対して付勢され、そのクリップトラックとの間で摩擦を発生させる可撓性タングを備えている、内視鏡外科クリップアプライヤ。
(4)実施態様(3)に記載の内視鏡外科クリップアプライヤにおいて、
前記可撓性タングが、前記クリップトラック内に形成された対応するリッジに係合するように構成されたリップを備えている、内視鏡外科クリップアプライヤ。
(5)実施態様(1)に記載の内視鏡外科クリップアプライヤにおいて、
前記プッシャー機構が、前記クリップトラックとの間で摩擦を発生させるカンチレバー構造を有する、内視鏡外科クリップアプライヤ。
前記クリップトラックが、支持面を備えており、この支持面はこの支持面に沿って延びた対向した側壁を有しており、前記プッシャー機構が、前記対向した側壁の間にスライド可能に配置されている、内視鏡外科クリップアプライヤ。
(7)実施態様(6)に記載の内視鏡外科クリップアプライヤにおいて、
前記対向した側壁が、実質的にV型の断面になるように前記プッシャー機構を付勢している、内視鏡外科クリップアプライヤ。
(8)外科クリップアプライヤにおいて、
ハウジングであって、このハウジングに移動可能に結合されたトリガー、および前記ハウジングから延び、遠位端部に対向した顎部が形成されているシャフトを有する、ハウジングと、
前記シャフト内に延在する、複数のクリップを保持するように構成されたクリップトラックと、
前記クリップトラック内にスライド可能に配置された、前記複数のクリップを前記クリップトラック内を前進させるように構成されたフィーダーシューであって、前記フィーダーシューの不所望の移動を妨げるために、前記クリップトラックとの間で摩擦を発生させるように構成されている、フィーダーシューと、
を含む、外科クリップアプライヤ。
(9)実施態様(8)に記載の外科クリップアプライヤにおいて、
前記フィーダーシューが、前記クリップトラックと接触してそのクリップトラックとの間で摩擦を発生させる少なくとも1つの突出部を備えている、外科クリップアプライヤ。
(10)実施態様(8)に記載の外科クリップアプライヤにおいて、
前記フィーダーシューが、前記クリップトラックとの間で摩擦を発生させるようにクリップトラックに対して付勢される可撓性タングを備えている、外科クリップアプライヤ。
前記可撓性タングが、前記クリップトラック内に形成された対応するリッジに係合するように構成されたリップを備えている、外科クリップアプライヤ。
(12)実施態様(10)に記載の外科クリップアプライヤにおいて、
前記クリップトラックが、前記フィーダーシューの前記可撓性タングに係合するように構成された少なくとも1つの表面突起を備えている、外科クリップアプライヤ。
(13)実施態様(8)に記載の外科クリップアプライヤにおいて、
前記フィーダーシューが、前記クリップトラックとの間で摩擦を発生させるカンチレバー構造を有する、外科クリップアプライヤ。
(14)実施態様(8)に記載の外科クリップアプライヤにおいて、
前記クリップトラックが、支持表面を備えており、この支持表面はこの支持表面に沿って延びる対向した側壁を有しており、前記フィーダーシューが、前記対向した側壁の間にスライド可能に配置されている、外科クリップアプライヤ。
(15)実施態様(14)に記載の外科クリップアプライヤにおいて、
前記対向した側壁が、実質的にV型の断面になるように前記フィーダーシューを付勢している、外科クリップアプライヤ。
ハウジングと、
前記ハウジングから延びたシャフトと、
前記シャフトの遠位端部に形成された第1の顎部および第2の顎部であって、これらの顎部間に組織を受容するように構成されている、第1の顎部および第2の顎部と、
複数のクリップを保持するように構成された、前記シャフト内に延在するクリップトラックと、
前記クリップトラック内に配置されたクリッププッシャーであって、前記複数のクリップを前記クリップトラック内を前進させて前記第1の顎部および第2の顎部に配置するように構成されており、前記クリッププッシャーに加えられる力が、前記クリッププッシャーと前記クリップトラックとの間に生成される付勢力よりも大きくない場合には、前記クリッププッシャーの移動が防止されるように、前記クリップトラック内で付勢されている、クリッププッシャーと、
を含む、外科クリップアプライヤ。
(17)実施態様(16)に記載の外科クリップアプライヤにおいて、
前記クリッププッシャーが、このクリッププッシャーを前記クリップトラック内で付勢するように構成された付勢機構を備えている、外科クリップアプライヤ。
(18)実施態様(17)に記載の外科クリップアプライヤにおいて、
前記付勢機構が、前記クリッププッシャーに形成された突出部を含む、外科クリップアプライヤ。
(19)実施態様(17)に記載の外科クリップアプライヤにおいて、
前記付勢機構が、前記クリッププッシャーに形成された可撓性タングを含む、外科クリップアプライヤ。
(20)実施態様(16)に記載の外科クリップアプライヤにおいて、
前記クリッププッシャーが、前記クリップトラック内で付勢されるように、前記クリップトラックの幅よりも大きい幅を有する、外科クリップアプライヤ。
前記クリップトラックが、このクリップトラックと前記クリッププッシャーとの間で付勢力が生成されるように前記クリッププッシャーを変形させる大きさである、外科クリップアプライヤ。
(22)実施態様(16)に記載の外科クリップアプライヤにおいて、
前記クリッププッシャーが、前記クリップトラックによって実質的にV型の形状から実質的に平坦な形状に撓む、外科クリップアプライヤ。
Claims (5)
- 互いに閉じてクリップすべき組織を近接させる顎部、およびこれらの顎部内に複数のクリップを連続的に前進させるように構成されたクリップ前進組立体を有する、改善された内視鏡外科クリップアプライヤにおいて、
前記クリップ前進組立体の一部は、前記顎部に向かって移動して前記顎部内に複数のクリップを連続的に前進させることができる、クリップトラック内に配置されたプッシャー機構を含み、
前記プッシャー機構は、前記クリップトラックとの間で摩擦を発生させて、前記クリップトラック内での前記プッシャー機構の不所望の移動を防止するように構成されると共に、前記クリップ前進組立体が作動すると移動して前記プッシャー機構を遠位側に前進させるように構成され、
前記プッシャー機構は、前記クリップトラックに対して付勢され、そのクリップトラックとの間で摩擦を発生させる可撓性タングを含み、
前記可撓性タングは、前記クリップトラック内に形成された対応するリッジに係合するように構成されたリップを含む、内視鏡外科クリップアプライヤ。 - 請求項1に記載の内視鏡外科クリップアプライヤにおいて、
前記プッシャー機構が、前記クリップトラックと接触してそのクリップトラックとの間で摩擦を発生させる突出部を備えている、内視鏡外科クリップアプライヤ。 - 請求項1に記載の内視鏡外科クリップアプライヤにおいて、
前記プッシャー機構が、前記クリップトラックとの間で摩擦を発生させるカンチレバー構造を有する、内視鏡外科クリップアプライヤ。 - 請求項1に記載の内視鏡外科クリップアプライヤにおいて、
前記クリップトラックが、支持面を備えており、この支持面はこの支持面に沿って延びる対向した側壁を有しており、前記プッシャー機構が、前記対向した側壁の間にスライド可能に配置されている、内視鏡外科クリップアプライヤ。 - 請求項4に記載の内視鏡外科クリップアプライヤにおいて、
前記対向した側壁が、実質的にV型の断面になるように前記プッシャー機構を付勢している、内視鏡外科クリップアプライヤ。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US11/162,584 | 2005-09-15 | ||
US11/162,584 US7740641B2 (en) | 2005-04-14 | 2005-09-15 | Clip applier with migrational resistance features |
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JP2007075620A JP2007075620A (ja) | 2007-03-29 |
JP5089944B2 true JP5089944B2 (ja) | 2012-12-05 |
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JP2006249638A Active JP5089944B2 (ja) | 2005-09-15 | 2006-09-14 | 移動防止機構を備えたクリップアプライヤ |
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US (5) | US7740641B2 (ja) |
EP (1) | EP1764044B2 (ja) |
JP (1) | JP5089944B2 (ja) |
KR (1) | KR101283901B1 (ja) |
CN (1) | CN1994236A (ja) |
AT (1) | ATE430520T1 (ja) |
AU (1) | AU2006213959B2 (ja) |
BR (1) | BRPI0604714B8 (ja) |
CA (1) | CA2560359C (ja) |
DE (1) | DE602006006627D1 (ja) |
HK (1) | HK1104438A1 (ja) |
MX (1) | MXPA06010632A (ja) |
RU (1) | RU2433792C2 (ja) |
SG (1) | SG131067A1 (ja) |
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US8038686B2 (en) | 2005-04-14 | 2011-10-18 | Ethicon Endo-Surgery, Inc. | Clip applier configured to prevent clip fallout |
US7288098B2 (en) * | 2005-04-14 | 2007-10-30 | Ethicon Endo-Surgery, Inc. | Force limiting mechanism for medical instrument |
US7740641B2 (en) | 2005-04-14 | 2010-06-22 | Ethicon Endo-Surgery, Inc. | Clip applier with migrational resistance features |
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US8523882B2 (en) * | 2005-04-14 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Clip advancer mechanism with alignment features |
US7552854B2 (en) | 2006-05-19 | 2009-06-30 | Applied Medical Resources Corporation | Surgical stapler with firing lock mechanism |
EP2314232B1 (en) | 2006-10-17 | 2015-03-25 | Covidien LP | Apparatus for applying surgical clips |
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US20060235442A1 (en) | 2006-10-19 |
AU2006213959B2 (en) | 2011-09-15 |
EP1764044B2 (en) | 2016-10-19 |
MXPA06010632A (es) | 2007-03-30 |
JP2007075620A (ja) | 2007-03-29 |
CN1994236A (zh) | 2007-07-11 |
ATE430520T1 (de) | 2009-05-15 |
SG131067A1 (en) | 2007-04-26 |
RU2006133127A (ru) | 2008-03-20 |
US7740641B2 (en) | 2010-06-22 |
US8246635B2 (en) | 2012-08-21 |
US20140343578A1 (en) | 2014-11-20 |
AU2006213959A1 (en) | 2007-03-29 |
RU2433792C2 (ru) | 2011-11-20 |
US20110218555A1 (en) | 2011-09-08 |
US20170273689A1 (en) | 2017-09-28 |
EP1764044A1 (en) | 2007-03-21 |
BRPI0604714A (pt) | 2007-08-28 |
BRPI0604714B8 (pt) | 2021-06-22 |
KR20070031820A (ko) | 2007-03-20 |
EP1764044B1 (en) | 2009-05-06 |
US8821516B2 (en) | 2014-09-02 |
US10639045B2 (en) | 2020-05-05 |
HK1104438A1 (en) | 2008-01-18 |
US20100249804A1 (en) | 2010-09-30 |
CA2560359C (en) | 2014-07-22 |
BRPI0604714B1 (pt) | 2018-05-29 |
DE602006006627D1 (de) | 2009-06-18 |
US9717504B2 (en) | 2017-08-01 |
KR101283901B1 (ko) | 2013-07-16 |
CA2560359A1 (en) | 2007-03-15 |
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