JP5697321B2 - 保護要素を備えた外科用アクセス装置 - Google Patents
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
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Description
本発明は、体腔内への外科的アクセスをもたらす、外科用アクセス装置に関する。
腹部腹腔鏡手術は、胆嚢の腹腔鏡的除去の、従来(切開)手術に対する利点が明らかになってきた1980年代後半には好評を博した。術後の回復期間の減少、術後の痛みおよび創傷感染の著しい減少、ならびに、美容的結果(cosmetic outcome)の改善は、体腔壁のより小さな切開部を用いて手術を行う腹腔鏡外科医の能力から主に得られる、腹腔鏡手術の確立した利益である。
本発明は、概して、患者の身体の内部への外科的アクセスを可能にする装置を提供する。一実施形態では、外科用アクセス装置が提供され、この外科用アクセス装置は、開創器を含んでよく、開創器は、体腔内へと組織を貫通する通路を形成するため、この開創器を通って延びる開口部を有する。ハウジングが、開創器に連結されていてよく、また、ハウジングを通って延びる長さ方向軸を定めることができる。ハウジングは、開創器の開口部と連絡している、複数の剛性シールポートを含むことができる。いくつかの実施形態では、各シールポートは、シール要素を内部に有してよく、ハウジングの長さ方向軸と、ゼロより大きい角度を成す中心軸を有してよい。各シールポートの中心軸は、他のすべてのシールポートの中心軸と異なっていてよい。
本明細書に開示される装置および方法の構造、機能、製造、および使用の原理の総合的理解を提供するため、特定の例示的実施形態を説明する。これらの実施形態の1つ以上の例が、添付図面に示される。当業者は、本明細書で特に説明され添付図面に示される装置および方法が、非限定的な例示的実施形態であり、本発明の範囲が請求項によってのみ定められることを理解するであろう。例示的な一実施形態と関連して示されるかまたは説明される特徴は、他の実施形態の特徴と組み合わせられてよい。このような改変および変形体は、本発明の範囲内に含まれることを意図している。
〔実施の態様〕
(1) 外科用アクセス装置において、
開創器であって、体腔内へと組織を貫通する通路を形成するために、前記開創器を通って延びる開口部を有する、開創器と、
前記開創器に連結されており、外科器具を受容するために、複数のシールポートを有する、ハウジングと、
前記開創器内部に配されており、前記シールポートおよび前記開創器を通して外科器具が挿入されることにより引き起こされる損傷から、組織を保護するように構成された、可撓性シールドと、
を含む、外科用アクセス装置。
(2) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記開創器の長さと少なくとも同じ長さを有する、外科用アクセス装置。
(3) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記開創器の長さよりも長い長さを有する、外科用アクセス装置。
(4) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記ハウジングに連結されており、手術が行われる患者の体腔内へ前記ハウジングから延びるように構成されている、外科用アクセス装置。
(5) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドに連結されており、曲がりくねった通路に沿って前記可撓性シールドを操縦するように構成された、操縦ケーブル、
をさらに含む、外科用アクセス装置。
(6) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記ハウジングに取り外し可能に連結される、外科用アクセス装置。
(7) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドは、シリコーン、ウレタン、熱可塑性エラストマー、およびゴムから成る群から選択された材料で形成される、外科用アクセス装置。
(8) 実施態様1に記載の外科用アクセス装置において、
前記可撓性シールドは、ポリオレフィン、ポリエステル、ナイロン、およびフルオロポリマーから成る群から選択された材料で形成される、外科用アクセス装置。
(9) 実施態様1に記載の外科用アクセス装置において、
各シールポートは、互いに異なる中心軸であって、前記ハウジングの長さ方向中心軸とは異なる、中心軸を有する、外科用アクセス装置。
(10) 実施態様1に記載の外科用アクセス装置において、
前記ハウジングは、前記開創器に対して回転可能である、外科用アクセス装置。
(11) 実施態様1に記載の外科用アクセス装置において、
前記シールポートのうち少なくとも1つが、前記ハウジングに対して回転可能である、外科用アクセス装置。
(12) 実施態様1に記載の外科用アクセス装置において、
各シールポートは、前記中心軸の角度方向が調節可能となるように、前記ハウジングに対して自由に動くことができる、外科用アクセス装置。
(13) 実施態様1に記載の外科用アクセス装置において、
前記ハウジングを前記開創器に対して多軸的に動かすように、前記ハウジングと前記開創器との間に延在する、可撓性コネクタ、
をさらに含む、外科用アクセス装置。
(14) 実施態様13に記載の外科用アクセス装置において、
前記可撓性シールドは、前記可撓性コネクタおよび前記開創器を通って延びる、外科用アクセス装置。
(15) 実施態様1に記載の外科用アクセス装置において、
前記開創器との、前記ハウジングの選択的な係合および係合解除を可能にするように構成された、解放機構、
をさらに含む、外科用アクセス装置。
(16) 外科用アクセス装置において、
外科器具を受容するために、複数のシールポートを有するハウジングと、
患者の身体の開口部に位置付け可能であり、前記シールポートを通して挿入された外科器具を受容するために、前記ハウジングから遠位に延びる、開創器と、
前記ハウジングから近位に延びており、前記ハウジングの前記シールポート内へ進められる外科器具の挿入により引き起こされる損傷から、組織を保護するように構成された、カラーと、
を含む、外科用アクセス装置。
(17) 実施態様16に記載の外科用アクセス装置において、
前記カラーは、遠位開口部および近位開口部を備えた、実質的に円錐形の形状を有し、前記遠位開口部は、前記ハウジングの基部を受容する、外科用アクセス装置。
(18) 実施態様16に記載の外科用アクセス装置において、
前記カラーの少なくとも遠位部分が、実質的に剛性である、外科用アクセス装置。
(19) 実施態様18に記載の外科用アクセス装置において、
前記カラーの少なくとも前記遠位部分は、ポリカーボネート、および高密度ポリエチレンから成る群から選択された材料から形成される、外科用アクセス装置。
(20) 実施態様16に記載の外科用アクセス装置において、
前記カラーの少なくとも近位部分が、実質的に可撓性である、外科用アクセス装置。
(21) 実施態様20に記載の外科用アクセス装置において、
前記カラーの少なくとも前記近位部分は、シリコーン、ウレタン、熱可塑性エラストマー、およびゴムから成る群から選択された材料から形成される、外科用アクセス装置。
(22) 実施態様16に記載の外科用アクセス装置において、
前記カラーは、前記ハウジングに前記カラーを解放可能に固定するために、その遠位部分に解放可能な固定要素を含む、外科用アクセス装置。
(23) 実施態様22に記載の外科用アクセス装置において、
前記固定要素は、片持ち梁風に突き出た少なくとも1つのスナップを含む、外科用アクセス装置。
(24) 実施態様16に記載の外科用アクセス装置において、
前記カラーは、組織に前記カラーを固定するために、その近位部分の周りに配された複数の縫合糸用穴を有する、外科用アクセス装置。
(25) 実施態様16に記載の外科用アクセス装置において、
前記ハウジングは、前記開創器に対して回転可能であり、前記カラーの回転は、前記ハウジングを回転させるのに有効である、外科用アクセス装置。
(26) 実施態様16に記載の外科用アクセス装置において、
前記カラーは、前記ハウジングを方向付けるための、および外科器具を前記シールポート内へ導くための、誘導マークを含む、外科用アクセス装置。
(27) 外科用アクセス装置において、
近位に向いた表面および遠位に向いた表面を有する基部リングと、
前記基部リングの前記遠位に向いた表面から遠位に延びる開創器と、
前記基部リングの前記近位に向いた表面から近位に延びるハウジングであって、前記ハウジングは、複数のシールポートを有する、ハウジングと、
前記開創器の内部を通って前記基部リングから遠位に延びるシールドであって、前記シールドは、前記開創器を通して外科器具が挿入されることにより引き起こされる損傷から、前記開創器を保護するように構成されている、シールドと、
を含む、外科用アクセス装置。
(28) 実施態様27に記載の外科用アクセス装置において、
前記シールドは、前記基部リングに解放可能に連結される、外科用アクセス装置。
(29) 実施態様27に記載の外科用アクセス装置において、
前記シールドは、前記開創器の長さよりも長い長さを有する、外科用アクセス装置。
(30) 実施態様27に記載の外科用アクセス装置において、
前記可撓性シールドに連結されており、曲がりくねった通路に沿って前記可撓性シールドを操縦するように構成された、操縦ケーブル、
をさらに含む、外科用アクセス装置。
(31) 実施態様27に記載の外科用アクセス装置において、
前記基部リングから前記カラーを取り外すための解放機構、
をさらに含む、外科用アクセス装置。
(32) 実施態様27に記載の外科用アクセス装置において、
前記シールドは、シリコーン、ウレタン、熱可塑性エラストマー、およびゴムから成る群から選択された材料で形成される、外科用アクセス装置。
(33) 実施態様27に記載の外科用アクセス装置において、
前記複数のシールポートのそれぞれから遠位に延びる複数のシールド、
をさらに含む、外科用アクセス装置。
(34) 実施態様27に記載の外科用アクセス装置において、
前記シールドは、ポリオレフィン、ポリエステル、ナイロン、およびフルオロポリマーから成る群から選択された材料で形成される、外科用アクセス装置。
(35) 実施態様27に記載の外科用アクセス装置において、
前記ハウジングを前記開創器に対して多軸的に動かすように、前記ハウジングと前記開創器との間に延在する、可撓性コネクタ、
をさらに含む、外科用アクセス装置。
Claims (10)
- 外科用アクセス装置において、
開創器であって、体腔内へと組織を貫通する通路を形成するために、前記開創器を通って延びる開口部を有する、開創器と、
前記開創器に連結されており、外科器具を受容するために、複数のシールポートを有する、ハウジングと、
前記開創器内部に配されており、前記シールポートおよび前記開創器を通して外科器具が挿入されることにより引き起こされる損傷から、組織を保護するように構成された、可撓性シールドと、
を含み、
前記ハウジングが前記開創器に連結されている際に、前記ハウジングは、前記開創器に対して回転可能である、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記開創器の長さと少なくとも同じ長さを有する、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記開創器の長さよりも長い長さを有する、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記ハウジングに連結されており、手術が行われる患者の体腔内へ前記ハウジングから延びるように構成されている、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドに連結されており、曲がりくねった通路に沿って前記可撓性シールドを操縦するように構成された、操縦ケーブル、
をさらに含む、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドは、前記ハウジングに取り外し可能に連結される、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドは、シリコーン、ウレタン、熱可塑性エラストマー、およびゴムから成る群から選択された材料で形成される、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
前記可撓性シールドは、ポリオレフィン、ポリエステル、ナイロン、およびフルオロポリマーから成る群から選択された材料で形成される、外科用アクセス装置。 - 請求項1に記載の外科用アクセス装置において、
各シールポートは、互いに異なる中心軸であって、前記ハウジングの長さ方向中心軸とは異なる、中心軸を有する、外科用アクセス装置。 - 請求項1〜9の何れか1つに記載の外科用アクセス装置において、
前記ハウジングは、ハウジング本体、及び、前記ハウジング本体に取り外し可能に連結され、前記複数のシールポートが内部を通って延びるシール基部を備え、
前記可撓性シールドは、前記ハウジング本体に、取り外し可能に連結され、
前記シール基部が前記ハウジング本体から取り外されている際に、前記可撓性シールドを前記ハウジング本体に連結でき、前記ハウジング本体に連結されている前記可撓性シールドを前記ハウジング本体から取り外しでき、
前記シール基部が前記ハウジング本体に連結されている際に、前記可撓性シールドおよび前記ハウジング本体の連結部は前記ハウジング内に位置し、前記可撓性シールドを前記ハウジング本体から取り外しできないようになっている、外科用アクセス装置。
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2008
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CN101711688A (zh) | 2010-05-26 |
EP2168512A1 (en) | 2010-03-31 |
CA2680915A1 (en) | 2010-03-30 |
US8425410B2 (en) | 2013-04-23 |
EP2168512B1 (en) | 2014-11-12 |
BRPI0903942A2 (pt) | 2010-07-20 |
KR20100036988A (ko) | 2010-04-08 |
US20100081881A1 (en) | 2010-04-01 |
BRPI0903942B1 (pt) | 2019-07-16 |
CA2680915C (en) | 2017-02-07 |
AU2009222422A1 (en) | 2010-04-15 |
CN101711688B (zh) | 2013-02-27 |
AU2009222422B2 (en) | 2014-12-11 |
MX2009010638A (es) | 2010-04-29 |
JP2010082450A (ja) | 2010-04-15 |
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