JP5855584B2 - 部分的に回転するブレード及び固定パッドの配設を伴う超音波手術器具 - Google Patents
部分的に回転するブレード及び固定パッドの配設を伴う超音波手術器具 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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
- A61B10/0275—Pointed or sharp biopsy instruments means for severing sample with sample notch, e.g. on the side of inner stylet
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320093—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing cutting operation
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
- A61B2017/320791—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter with cutter extending outside the cutting window
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Description
名称が「ULTRASONICALLY POWERED SURGICAL INSTRUMENTS WITH ROTATING CUTTING IMPLEMENT」、代理人整理番号END6688USNP/090341の米国特許出願第____号、
名称が「METHODS OF USING ULTRASONICALLY POWERED SURGICAL INSTRUMENTS WITH ROTATABLE CUTTING IMPLEMENTS」、代理人整理番号END6689USNP/090342の米国特許出願第____号、
名称が「SEAL ARRANGEMENTS FOR ULTRASONICALLY POWERED SURGICAL INSTRUMENTS」、代理人整理番号END6690USNP/090343の米国特許出願第____号、
名称が「ULTRASONIC SURGICAL INSTRUMENTS WITH ROTATABLE BLADE AND HOLLOW SHEATH ARRANGEMENTS」、代理人整理番号END6691USNP/090344の米国特許出願第____号、
名称が「ROTATABLE CUTTING IMPLEMENT ARRANGEMENTS FOR ULTRASONIC SURGICAL INSTRUMENTS」、代理人整理番号END6692USNP/090345の米国特許出願第____号、
名称が「DUAL PURPOSE SURGICAL INSTRUMENT FOR CUTTING AND COAGULATING TISSUE」、代理人整理番号END6694USNP/090347の米国特許出願第____号、
名称が「OUTER SHEATH AND BLADE ARRANGEMENTS FOR ULTRASONIC SURGICAL INSTRUMENTS」、代理人整理番号END6695USNP/090348の米国特許出願第____号、
名称が「ULTRASONIC SURGICAL INSTRUMENTS WITH MOVING CUTTING IMPLEMENT」、代理人整理番号END6687USNP/090349の米国特許出願第____号、及び
名称が「ULTRASONIC SURGICAL INSTRUMENT WITH COMB−LIKE TISSUE TRIMMING DEVICE」、代理人整理番号END6686USNP/090367の米国特許出願第____号も所有する。
(1) 超音波手術器具であって、
ハウジングと、
前記ハウジングによって支持され、かつ前記ハウジングから突出する外側シースであって、前記外側シースが、少なくとも1つの切断面を画定する、遠位ブレード開口部をその中に有し、前記外側シースが、前記遠位ブレード開口部と連通する、前記外側シースを通る少なくとも1つの吸引内腔を有する、外側シースと、
前記ハウジングによって支持される超音波トランスデューサアセンブリと、
前記超音波トランスデューサアセンブリに連結されたブレードであって、前記ブレードが、前記ブレードの遠位先端が前記遠位ブレード開口部内に延在するように前記外側シースを通って延在し、前記ブレードの組織切断部分が、前記遠位ブレード開口部から半径方向に突出する、ブレードと、
前記ハウジングによって支持され、かつ前記超音波トランスデューサアセンブリ及び前記外側シースのうちの1つに連結されたモータであって、前記ブレードの前記組織切断部分が前記外側シース上の前記少なくとも1つの切断面と接触するように、前記超音波トランスデューサアセンブリ及び前記外側シースのうちの1つに回転運動を適用するための、モータと、
を備える、超音波手術器具。
(2) それぞれの前記少なくとも1つの切断面に取り付けられた組織パッドを更に備える、実施態様1に記載の超音波手術器具。
(3) それぞれの前記組織パッドが、組織把持面をその上に有する、実施態様2に記載の超音波手術器具。
(4) 前記少なくとも1つの吸引内腔が、
前記外側シースを通って延在する主吸引内腔と、
前記外側シースを通って延在し、かつ前記少なくとも1つの切断面のうちの対応する1つを通る少なくとも1つの吸引穴と連通する、パッド内腔と、
を備える、実施態様1に記載の超音波手術器具。
(5) 前記少なくとも1つの切断面のうちの前記対応する1つの上に組織パッドを更に備え、前記組織パッドが、前記切断面を通る前記少なくとも1つの吸引穴のうちの対応する1つと連通する別の吸引穴を有する、実施態様4に記載の超音波手術器具。
(6) 前記少なくとも1つの切断面が、
前記ブレード開口部の一方の側面上の第1の切断面と、
前記ブレード開口部の別の側面上の第2の切断面と、
を備え、
前記超音波トランスデューサ及び前記外側シースのうちの1つへの回転運動の前記適用が、前記ブレードの前記組織切断部分を、前記第1及び第2の切断面のそれぞれと接触させる、実施態様1に記載の超音波手術器具。
(7) 前記第1及び第2の切断面のそれぞれの上に組織パッドを更に備える、実施態様6に記載の超音波手術器具。
(8) 前記少なくとも1つの吸引内腔が、
前記外側シースを通って延在し、かつ前記第1の切断面を通る少なくとも1つの第1の吸引穴と連通する第1のパッド内腔と、
前記外側シースを通って延在し、かつ前記第2の切断面を通る少なくとも1つの第2の吸引穴と連通する第2のパッド内腔と、
前記外側シースを通って延在し、かつ前記ブレード開口部と連通する主吸引内腔と、
を備える、実施態様6に記載の超音波手術器具。
(9) 前記第1及び第2のパッド内腔並びに前記主吸引内腔と連通する吸引制御システムを更に備える、実施態様8に記載の超音波手術器具。
(10) 前記吸引制御システムが、
吸引源と、
前記吸引源と連通する収集容器と、
前記収集容器及び前記第1のパッド内腔に連結された第1の吸引供給ラインと、
前記収集容器及び前記第2のパッド内腔に連結された第2の吸引供給ラインと、
前記収集容器及び前記主吸引内腔に連結された主吸引供給ラインと、
前記第1の吸引供給ライン内の第1の弁と、
前記第2の吸引供給ライン内の第2の弁と、
前記主吸引供給ライン内の第3の弁と、
を備える、実施態様9に記載の超音波手術器具。
(12) 前記ブレードの前記組織切断部分が、前記第1の切断面に対応する第1の組織切断縁部と、前記第2の切断面に対応する第2の組織切断縁部と、を有する、実施態様6に記載の超音波手術器具。
(13) 前記第1及び第2の組織切断縁部が鈍縁部である、実施態様12に記載の超音波手術器具。
(14) 組織を切断する方法であって、
手術器具のブレードを患者に挿入することであって、前記ブレードが、超音波運動源に取り付けられ、中空外側シースを通って延在し、前記ブレードの組織切断先端が、前記外側シース内のブレード開口部を通って露出され、前記ブレード及び外側シースのうちの一方が、他方に対して選択的に回転可能である、ことと、
前記ブレード開口部が前記患者内の標的組織に隣接するように、前記ブレード及び外側シースを位置付けることと、
標的組織を前記ブレード開口部に引き込むために、前記外側シースを通して吸引を適用することと、
前記ブレードの前記組織切断先端が、前記切断先端と前記外側シース上の切断面との間の前記ブレード開口部に引き込まれた前記標的組織の一部分に接触し、それを捕捉するように、前記ブレード及び外側シースのうちの一方を他方に対して振動させることと、
を含む、方法。
(15) 前記ブレードの前記切断先端を、前記切断先端と前記切断面との間に捕捉された前記標的組織と所定のドウェル時間接触させて保持することを更に含む、実施態様14に記載の方法。
(16) 前記ドウェル時間が終了すると、前記ブレードの前記切断先端と前記外側シース上の別の切断面との間の他の組織に接触し捕捉するように、前記ブレード及び外側シースのうちの一方を他方に対して回転させることを更に含む、実施態様15に記載の方法。
(17) 超音波手術器具であって、
ハウジングと、
前記ハウジングによって支持され、かつ前記ハウジングから突出する外側シースであって、前記外側シースが、少なくとも1つの切断面を画定する、遠位ブレード開口部をその中に有する、外側シースと、
前記ハウジングによって回転可能に支持される、超音波トランスデューサアセンブリと、
前記超音波トランスデューサアセンブリに連結されたブレードであって、前記ブレードが、前記ブレードの遠位先端が前記ブレード開口部内に延在するように前記外側シースを通って延在し、前記ブレードの組織切断部分が、前記ブレード開口部から半径方向に突出する、ブレードと、
前記ハウジングによって支持され、かつ前記超音波トランスデューサアセンブリに連結されたモータであって、前記ブレードの前記組織切断部分が前記少なくとも1つの切断面と接触するように、前記超音波トランスデューサアセンブリに回転運動を適用するための、モータと、
前記切断面と接触している際に、前記ブレードの前記組織切断部分が経験するねじれ量を制限するための手段と、
を備える、超音波手術器具。
(18) 前記制限するための手段が、前記モータ及び前記超音波トランスデューサアセンブリに動作可能に連結されたねじりバネを備える、実施態様17に記載の超音波手術器具。
(19) 前記制限するための手段が、前記モータ及び前記超音波トランスデューサに動作可能に連結されたねじりロードセルを備える、実施態様17に記載の超音波手術器具。
(20) 前記モータが、エンコーダが動作可能に連結されたステッピングモータを備える、実施態様17に記載の超音波手術器具。
Claims (16)
- 超音波手術器具であって、
ハウジングと、
前記ハウジングによって支持され、かつ前記ハウジングから突出する外側シースであって、前記外側シースの遠位部には遠位ブレード開口部が形成され、前記外側シースの前記遠位部における前記遠位ブレード開口部との境界部分は、少なくとも1つの切断面となっており、前記外側シースが、前記遠位ブレード開口部と連通する、前記外側シースを通る少なくとも1つの吸引内腔を有する、外側シースと、
前記ハウジングによって支持される超音波トランスデューサアセンブリと、
前記超音波トランスデューサアセンブリに連結されたブレードであって、前記ブレードが、前記ブレードの遠位先端が前記遠位ブレード開口部内に延在するように前記外側シースを通って延在し、前記ブレードの組織切断部分が前記ブレードの前記遠位先端に形成されている、ブレードと、
前記ハウジングによって支持され、かつ前記超音波トランスデューサアセンブリ及び前記外側シースのうちの1つに連結されたモータであって、前記ブレードの前記組織切断部分が前記外側シース上の前記少なくとも1つの切断面と接触するように、前記超音波トランスデューサアセンブリ及び前記外側シースのうちの1つに回転運動を適用するための、モータと、
を備え、
前記外側シースの前記少なくとも1つの切断面と前記ブレードの前記組織切断部分との間に組織を捕捉し、前記少なくとも1つの切断面および前記組織切断部分が協働して前記組織を切断するようになっている、超音波手術器具。 - それぞれの前記少なくとも1つの切断面に取り付けられた組織パッドを更に備える、請求項1に記載の超音波手術器具。
- それぞれの前記組織パッドが、組織把持面をその上に有する、請求項2に記載の超音波手術器具。
- 前記少なくとも1つの吸引内腔が、
前記外側シースを通って延在する主吸引内腔と、
前記外側シースを通って延在し、かつ前記少なくとも1つの切断面のうちの対応する1つを通る少なくとも1つの吸引穴と連通する、パッド内腔と、
を備える、請求項1に記載の超音波手術器具。 - 前記少なくとも1つの切断面のうちの前記対応する1つの上に組織パッドを更に備え、前記組織パッドが、前記切断面を通る前記少なくとも1つの吸引穴のうちの対応する1つと連通する別の吸引穴を有する、請求項4に記載の超音波手術器具。
- 前記少なくとも1つの切断面が、
前記ブレード開口部の一方の側面上の第1の切断面と、
前記ブレード開口部の別の側面上の第2の切断面と、
を備え、
前記超音波トランスデューサ及び前記外側シースのうちの1つへの回転運動の前記適用が、前記ブレードの前記組織切断部分を、前記第1及び第2の切断面のそれぞれと接触させる、請求項1に記載の超音波手術器具。 - 前記第1及び第2の切断面のそれぞれの上に組織パッドを更に備える、請求項6に記載の超音波手術器具。
- 前記少なくとも1つの吸引内腔が、
前記外側シースを通って延在し、かつ前記第1の切断面を通る少なくとも1つの第1の吸引穴と連通する第1のパッド内腔と、
前記外側シースを通って延在し、かつ前記第2の切断面を通る少なくとも1つの第2の吸引穴と連通する第2のパッド内腔と、
前記外側シースを通って延在し、かつ前記ブレード開口部と連通する主吸引内腔と、
を備える、請求項6に記載の超音波手術器具。 - 前記第1及び第2のパッド内腔並びに前記主吸引内腔と連通する吸引制御システムを更に備える、請求項8に記載の超音波手術器具。
- 前記吸引制御システムが、
吸引源と、
前記吸引源と連通する収集容器と、
前記収集容器及び前記第1のパッド内腔に連結された第1の吸引供給ラインと、
前記収集容器及び前記第2のパッド内腔に連結された第2の吸引供給ラインと、
前記収集容器及び前記主吸引内腔に連結された主吸引供給ラインと、
前記第1の吸引供給ライン内の第1の弁と、
前記第2の吸引供給ライン内の第2の弁と、
前記主吸引供給ライン内の第3の弁と、
を備える、請求項9に記載の超音波手術器具。 - 前記ブレードの前記遠位先端が弓形状を有する、請求項1に記載の超音波手術器具。
- 前記ブレードの前記組織切断部分が、前記第1の切断面に対応する第1の組織切断縁部と、前記第2の切断面に対応する第2の組織切断縁部と、を有する、請求項6に記載の超音波手術器具。
- 前記第1及び第2の組織切断縁部が鈍縁部である、請求項12に記載の超音波手術器具。
- 超音波手術器具であって、
ハウジングと、
前記ハウジングによって支持され、かつ前記ハウジングから突出する外側シースであって、前記外側シースの遠位部には遠位ブレード開口部が形成され、前記外側シースの前記遠位部における前記遠位ブレード開口部との境界部分は、少なくとも1つの切断面となっており、遠位ブレード開口部をその中に有する、外側シースと、
前記ハウジングによって回転可能に支持される、超音波トランスデューサアセンブリと、
前記超音波トランスデューサアセンブリに連結されたブレードであって、前記ブレードが、前記ブレードの遠位先端が前記ブレード開口部内に延在するように前記外側シースを通って延在し、前記ブレードの組織切断部分が前記ブレードの前記遠位先端に形成されている、ブレードと、
前記ハウジングによって支持され、かつ前記超音波トランスデューサアセンブリに連結されたモータであって、前記ブレードの前記組織切断部分が前記少なくとも1つの切断面と接触するように、前記超音波トランスデューサアセンブリに回転運動を適用するための、モータと、
前記切断面と接触している際に、前記ブレードの前記組織切断部分が経験するねじれ量を制限するための手段と、
を備え、
前記制限するための手段が、前記モータ及び前記超音波トランスデューサアセンブリに動作可能に連結されたねじりバネを備え、
前記外側シースの前記少なくとも1つの切断面と前記ブレードの前記組織切断部分との間に組織を捕捉し、前記少なくとも1つの切断面および前記組織切断部分が協働して前記組織を切断するようになっている、超音波手術器具。 - 超音波手術器具であって、
ハウジングと、
前記ハウジングによって支持され、かつ前記ハウジングから突出する外側シースであって、前記外側シースの遠位部には遠位ブレード開口部が形成され、前記外側シースの前記遠位部における前記遠位ブレード開口部との境界部分は、少なくとも1つの切断面となっており、遠位ブレード開口部をその中に有する、外側シースと、
前記ハウジングによって回転可能に支持される、超音波トランスデューサアセンブリと、
前記超音波トランスデューサアセンブリに連結されたブレードであって、前記ブレードが、前記ブレードの遠位先端が前記ブレード開口部内に延在するように前記外側シースを通って延在し、前記ブレードの組織切断部分が前記ブレードの前記遠位先端に形成されている、ブレードと、
前記ハウジングによって支持され、かつ前記超音波トランスデューサアセンブリに連結されたモータであって、前記ブレードの前記組織切断部分が前記少なくとも1つの切断面と接触するように、前記超音波トランスデューサアセンブリに回転運動を適用するための、モータと、
前記切断面と接触している際に、前記ブレードの前記組織切断部分が経験するねじれ量を制限するための手段と、
を備え、
前記制限するための手段が、前記モータ及び前記超音波トランスデューサアセンブリに動作可能に連結されたねじりロードセルを備え、
前記外側シースの前記少なくとも1つの切断面と前記ブレードの前記組織切断部分との間に組織を捕捉し、前記少なくとも1つの切断面および前記組織切断部分が協働して前記組織を切断するようになっている、超音波手術器具。 - 前記モータが、エンコーダが動作可能に連結されたステッピングモータを備える、請求項14または15に記載の超音波手術器具。
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-
2010
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2011
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- 2011-02-09 JP JP2012552954A patent/JP5855584B2/ja active Active
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BR112012020296B1 (pt) | 2020-06-02 |
CN102843981B (zh) | 2015-05-27 |
EP2533709A1 (en) | 2012-12-19 |
WO2011100332A8 (en) | 2012-09-13 |
JP2013519439A (ja) | 2013-05-30 |
AU2011215920B2 (en) | 2015-09-03 |
CA2789428A1 (en) | 2011-08-18 |
US20110196401A1 (en) | 2011-08-11 |
EP2533709B1 (en) | 2015-03-25 |
AU2011215920A1 (en) | 2012-08-23 |
CN102843981A (zh) | 2012-12-26 |
WO2011100332A1 (en) | 2011-08-18 |
BR112012020296A2 (pt) | 2016-05-03 |
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