JP5162707B2 - 半月板治療システム - Google Patents
半月板治療システム Download PDFInfo
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- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 1
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0482—Needle or suture guides
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0491—Sewing machines for 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0493—Protective devices for suturing, i.e. for protecting the patient's organs or the operator
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0477—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery with pre-tied sutures
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06004—Means for attaching suture to needle
- A61B2017/06042—Means for attaching suture to needle located close to needle tip
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06066—Needles, e.g. needle tip configurations
- A61B2017/06095—Needles, e.g. needle tip configurations pliable
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- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/036—Abutting means, stops, e.g. abutting on tissue or skin abutting on tissue or skin
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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
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
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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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Description
した結び目を持った片手装置の容易さを有したすべての縫合手法を含んでいる。それは、上で議論したインプラント処置の容易さを再現するが、硬質プラスチック製インプラントに伴うリスクを排除する。
合される。
で注記したように、図1では、装置10は、それが患者内への挿入前の構成として図示されている。施術者が針挿入箇所から隣接した針出口箇所までの深さを測定すると、本発明装置は、患者の膝に挿入されることが可能となる。シース16は、後退可能であり、本発明装置が患者に導入されているとき、針の先端による怪我から患者を保護する目的で移送針28および捕獲針30をシース16が覆っている。装置10は、カニューレまたは他の種類の導入チャネルなどの任意の適切な手段によって患者の膝に挿入されることができる。装置10が処置部位に挿入されると、施術者は、シース作動ボタン18を引き戻すことによってシース16を後退させ、所望の貫通深さでシースを停止させる。これは、ハンドル12上の摺動する深さゲージ22によって示される。深さゲージ22上のマーキングに対応する目盛り付きマーキングを有した別の深さゲージ37は、図3に示すように、捕獲針30の遠位端に配置される。この深さゲージは、処置中に関節鏡的に視認可能である。
するために力フィードバックの方法を利用することである。図14および図15は、そのような方法を連続して示している。圧縮力(プランジャ)要素54は、より短い移送針28の遠位端に配置されることが可能である。プランジャ54が半月板を出て被膜に入るときに、針上の力は減少し、その後、プランジャは、前方に飛び出し、半月板(図15)に対して深さリミッタ56を遠ざけるように駆動する機構を解放し、したがって針のさらに遠位への侵入を防止する。
Claims (15)
- 組織の一部における裂傷を治療する装置であって、
近位アクチュエータ部と、
該近位アクチュエータ部から遠ざかるように延び、組織を貫通する遠位先端を有した移送針と、
前記近位アクチュエータ部から遠ざかるように延び、組織を貫通する遠位先端を有した捕獲針と、
前記移送針に配置された縫合針であって、該縫合針が、前記移送針から前記捕獲針の方に延長可能であり、前記捕獲針から前記移送針の方に後退可能である、前記縫合針と、
前記捕獲針内に配置され、前記移送針から移送されるときに縫合糸を捕獲する延長可能な捕獲プランジャと、
前記裂傷治療装置が処置部位に挿入されるときに前記移送針および前記捕獲針を覆う後退可能な挿入シースとを備え、
前記近位アクチュエータ部は、
前記挿入シースを後退する挿入シース・アクチュエータと、
前記縫合針を前進させる縫合針前進アクチュエータと、
前記捕獲プランジャを遠ざけるように解放する捕獲プランジャ解放機構とを具備し、
前記縫合針前進アクチュエータは、さらに、前記捕獲プランジャ解放機構を作動させる位置を有している裂傷治療装置。 - 前記移送針は、その上に横方向に配置された窓を備え、該窓を通じて前記縫合針が延長または後退される請求項1記載の裂傷治療装置。
- 前記捕獲針は、その上に横方向に配置された窓を備え、該窓を通じて前記縫合針が延長または後退される請求項1記載の裂傷治療装置。
- 前記窓は第1窓であり、該第1窓が配置される側とは反対側で、前記捕獲針に配置された第2窓をさらに備え、前記縫合針が前記捕獲針内に完全に延長されるときに、前記第2窓を通じて前記縫合針の遠位端が延長する請求項3記載の裂傷治療装置。
- 前記縫合針は、十分な可撓性を有し、それによって、前記移送針内に収容されたときにそれは真っすぐな構成になり、前記縫合針の遠位端が前記移送針から延出したときに縫合針を前記捕獲針の方に向けるのを支援する屈曲を得る請求項1記載の裂傷治療装置。
- 前記処置部位への前記針の挿入深さを制限する深さ制限装置をさらに備える請求項1記載の裂傷治療装置。
- 前記深さ制限装置は、前記近位アクチュエータ部に配置された深さゲージを具備している請求項6記載の裂傷治療装置。
- 前記挿入シース・アクチュエータは、前記近位アクチュエータ部内のスロットに沿って軸方向に摺動するボタンを具備し、前記深さゲージは、前記スロットに沿って配置された目盛り付きマーキングを具備し、その結果、施術者は、前記裂傷治療装置の挿入深さを制御するために、前記スロットに沿って所定距離だけ前記挿入シース・アクチュエータのボタンを摺動させることによって、前記シースを後退することができる請求項7記載の裂傷治療装置。
- 前記深さ制限装置は、前記裂傷治療装置の遠位端に配置された力フィードバック・ユニットを具備している請求項6記載の裂傷治療装置。
- 前記力フィードバック・ユニットは、前記針のうちの1つの遠位端に配置された圧縮力要素を具備している請求項9記載の裂傷治療装置。
- 前記針のうちの1つは、前記針のうちの短い方である請求項10記載の裂傷治療装置。
- 前記針のうちの1つは、前記移送針である請求項11記載の裂傷治療装置。
- 前記圧縮力要素は、プランジャを具備している請求項10記載の裂傷治療装置。
- 前記深さ制限装置は、前記力フィードバック・ユニット上の力の減少に応じて、前記裂傷治療装置に沿って遠ざかるように移動可能な深さリミッタをさらに具備している請求項9記載の裂傷治療装置。
- 前記移送針および前記捕獲針は、それらの各々の長さに沿ってそれぞれ湾曲している請求項1記載の裂傷治療装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10726808P | 2008-10-21 | 2008-10-21 | |
US61/107,268 | 2008-10-21 | ||
PCT/US2009/061546 WO2010048333A2 (en) | 2008-10-21 | 2009-10-21 | Meniscal repair systems and methods |
Publications (3)
Publication Number | Publication Date |
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JP2012506299A JP2012506299A (ja) | 2012-03-15 |
JP2012506299A5 JP2012506299A5 (ja) | 2012-12-06 |
JP5162707B2 true JP5162707B2 (ja) | 2013-03-13 |
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Application Number | Title | Priority Date | Filing Date |
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JP2011533311A Active JP5162707B2 (ja) | 2008-10-21 | 2009-10-21 | 半月板治療システム |
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US (3) | US8177795B2 (ja) |
EP (1) | EP2375996B1 (ja) |
JP (1) | JP5162707B2 (ja) |
AU (1) | AU2009308484B2 (ja) |
WO (1) | WO2010048333A2 (ja) |
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EP2375996A2 (en) | 2011-10-19 |
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WO2010048333A3 (en) | 2010-08-12 |
AU2009308484A1 (en) | 2010-04-29 |
US8177795B2 (en) | 2012-05-15 |
US8435253B2 (en) | 2013-05-07 |
US20120035625A1 (en) | 2012-02-09 |
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