JP6556896B2 - 組織切断及び封止装置 - Google Patents
組織切断及び封止装置 Download PDFInfo
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Description
本出願は、2012年9月26日に出願された米国仮特許出願第61/705,721号明細書に対する優先権を主張し、その内容は、全体としてかつすべての目的で参照により本明細書に組み込まれる。
図1を参照すると、1つの例示的な実施形態による電気手術デバイス100が示されている。デバイス100は細長いシャフト102を含む。細長いシャフト102は、上部つかみ具120及び下部つかみ具ハウジング130を特徴とする遠位端(先端)部分110を有している。下部つかみ具ハウジング130は下部つかみ具132を収容している。上部つかみ具120と下部つかみ具132との間で、図2及び図3に示す切刃160が組織を切断するように変位可能である。
デバイス100における電極構成は、サイズを低減しつかみ具の剛性を増大させる必要のバランスをとる別の特徴である。多くの既知の電気手術デバイスは、つかみ具に配置された1つ又は複数の独立した電極を使用する。独立した電極は、つかみ具内で電極を捕捉し、絶縁し、収容するための空間を必要とし、つかみ具における剛性を犠牲にする。この問題に対処するために、デバイス100は、独立した電極なしに設計されている。電力は、上部つかみ具120及び下部つかみ具ハウジング130に直接供給される。
既知の電気手術デバイスは、つかみ具を通って延在する専用の送電ワイヤを用いて電極に電力を供給する。多くの場合、これらの専用送電ワイヤは、固定された編組ワイヤ又はジャケット付きワイヤの形態である。専用送電ワイヤは、著しい量の空間を占有し、つかみ具から材料を除去する貫通ボア、通路等を必要とする。したがって、専用送電ワイヤ及びそれらの貫通ボアによりつかみ具の剛性が低減し、それにより、封止中につかみ具の間に印加することができる圧縮力の量が低減する。専用送電ワイヤが、器具が移動する際に移動するか又は伸びるために十分なたるみ又は弾性を有していない場合、専用送電ワイヤにより、器具の移動も制限される可能性がある。
下部つかみ具ハウジング130及び下部つかみ具132と連結する上部つかみ具120の表面を電気的に絶縁しなければならない。これに対処するために、デバイス100は、上部つかみ具120の上にプラスチック覆い180を含む。上部つかみ具120は、プラスチック覆い180とオーバーモールドされて、下部つかみ具ハウジング130と連結する表面を絶縁する。オーバーモールドでは構成要素の間に隙間が不要であり、それにより、つかみ具がより多くの材料質量を有することを可能にする空間が保持される。上部つかみ具120をオーバーモールドすることにより、次のセクションで説明するように、上部つかみ具にオフセット特徴を生成することも可能になる。
オーバーモールドされる覆い180は複数の機能を有している。オーバーモールドされる覆いの第1機能は、上述したように、下部つかみ具ハウジング130から上部つかみ具120を電気的に絶縁することである。オーバーモールドされる覆いの第2機能は、つかみ具が閉じられた時、電極、すなわち上部つかみ具120と下部つかみ具132との間の間隙空間をもたらすオフセット特徴を生成することである。図4において、デバイスの実施形態は、上部つかみ具120を横切って横方向に延在するストラップ150の形態で示されるオフセット特徴を含む。ストラップ150は、オーバーモールド工程中に製造される。オーバーモールドされる覆いの第3機能は、組織燃焼のリスクを低減するように、組織と接触するつかみ具の背面の温度を低下させることである。
下部つかみ具132は、下部つかみ具旋回接続部190によって下部つかみ具ハウジング130に旋回接続されている。下部つかみ具132と下部つかみ具ハウジング130との間の旋回接続部190は、十分な圧縮力を提供するために下部つかみ具において剛性及び強度を最大限にしなければならない最も重要な領域のうちの1つを表す。ピン接続部及び貫通ボアは、上述したように、下部つかみ具からの材料の除去を必要とし、つかみ具の剛性及び強度を低減する。したがって、旋回接続部190は、一対のボス136の形態である「ピンなし」接続部を特徴とする。ボス136は、下部つかみ具132から外側に突出し、下部つかみ具ハウジング130の小さい開口部138内にスナップ式に嵌まる。この構成により、旋回接続部190の位置においてつかみ具の幅を横切って下部つかみ具132から材料は除去されない。
関節運動デバイスの難題のうちの1つは、関節運動部材を通して動きを伝達することである。デバイスが屈曲した時、継手を通る弧の長さは、中心線から離れるように移動するに従って変化する。これには、概して、デバイスの中心線に沿って移動する(強度のため)縦長のかつ(可撓性のため)薄い作動部材の使用が必要である。左及び右の関節運動により、関節運動面に対して垂直に配置された、短くかつ平坦な作動部材又は対になったワイヤ部材の使用が阻止される。それは、それら部材又はワイヤが座屈しかつ/又は動き及び力を不均一に伝達するためである。
図8を参照すると、上部つかみ具120は、下部つかみ具132と嵌合する嵌合面131を有している。下部つかみ具132は、上部つかみ具120と嵌合する嵌合面133を同様に有している。嵌合面131及び133は、各々、平面嵌合面に対していくつかの利点を提供する、図示するようなV字型輪郭を有している。
再び図1を参照すると、下部つかみ具ハウジング130は、下部つかみ具ハウジングと下部つかみ具132との間に下部つかみ具ばね134を収容している。下部つかみ具ばね134は、下部つかみ具ハウジング130の内側に当接して、下部つかみ具132を旋回させる。この構成では、下部つかみ具ばね134は、下部つかみ具132の遠位部137を上部つかみ具120に向かって付勢する。
図9〜図12は、本発明による関節運動機構200を示す。関節運動機構200は、手首部170における屈曲運動又は回転運動を制御する。それにより、上部つかみ具120及び下部つかみ具132は左又は右に屈曲することができる。より具体的には、関節運動機構200は、関節運動ワイヤ部172及び174のうちの一方に引張力を印加して手首部170においてデバイスを屈曲させるように動作可能である。
実施形態は、「非円形」旋回インタフェースを有する構成要素を備えた手首機構を含むことができる。たとえば、構成要素の間の旋回インタフェースは、放物線形状、段形状又はV字切欠き形状を有することができ、それにより、球状又は円筒状インタフェース形状等、厳密に「円形」形状に関連する従来の固定された回転軸以外の移動回転軸がもたらされる。移動回転軸は、自動的にまっすぐになるか又は自動的に中心合せする結合の利益を提供する。そこでは、隣接する椎体は、関節運動した後にまっすぐな形態に戻るように促進される。このまっすぐな形態に向かう付勢により、つかみ具の位置が安定化し、つかみ具が係止されるか又は他の物体と接触している時における微動に対する抵抗が提供される。
以下の項目は、国際出願時の特許請求の範囲に記載の要素である。
(項目1)
組織を切断及び封止するための電気手術デバイスであって、
前記電気手術デバイスは、
前記電気手術デバイスの遠位端に位置する上部つかみ具と、
前記上部つかみ具に対向する下部つかみ具であって、旋回接続部によって前記上部つかみ具に旋回接続されている前記下部つかみ具と、を備え、
前記旋回接続部は、前記上部つかみ具の一部を収容する通路を備え、
前記上部つかみ具は、相対的開放状態と相対的閉鎖状態との間で、前記上部つかみ具を前記下部つかみ具に対して旋回させるように、前記通路を通って軸方向に変位可能であり、
前記上部つかみ具及び前記下部つかみ具は、前記相対的閉鎖状態で組織にRFエネルギーを送達するように動作可能である、電気手術デバイス。
(項目2)
前記上部つかみ具は、前記上部つかみ具の外側縁に隣接して位置する旋回点を中心に前記下部つかみ具に対して旋回可能であり、
前記旋回点は、前記電気手術デバイスの中心線からずれている、項目1に記載の電気手術デバイス。
(項目3)
前記旋回接続部は、前記上部つかみ具の第1面と係合する凸状面を有する半円筒状要素を備える、項目1に記載の電気手術デバイス。
(項目4)
前記旋回接続部は、さらに、前記上部つかみ具の第2面と係合する凹状面を備える、項目3に記載の電気手術デバイス。
(項目5)
前記凸状面及び前記凹状面は、前記通路の対向する壁を画定する、項目4に記載の電気手術デバイス。
(項目6)
前記凸状面及び前記凹状面は、共通する1点を中心として同心である円形輪郭に従う、項目4に記載の電気手術デバイス。
(項目7)
前記電気手術デバイスは、さらに、前記下部つかみ具を収容する下部つかみ具ハウジングを備え、
前記下部つかみ具は、前記下部つかみ具ハウジングの遠位部分に配置されている、項目1に記載の電気手術デバイス。
(項目8)
前記下部つかみ具は、下部つかみ具旋回接続部によって前記下部つかみ具ハウジングに旋回接続されている、項目7に記載の電気手術デバイス。
(項目9)
前記下部つかみ具旋回接続部が、前記下部つかみ具から外側に突出する一対のボスを備えるピンなし接続部を備え、
前記ボスは、前記下部つかみ具ハウジングの一対の開口部と係合している、項目8に記載の電気手術デバイス。
(項目10)
前記電気手術デバイスは、前記下部つかみ具ハウジングと前記下部つかみ具との間に配置された下部つかみ具ばねを備える、項目7に記載の電気手術デバイス。
(項目11)
前記下部つかみ具ばねは、前記下部つかみ具の遠位部分に位置し、
前記下部つかみ具ばねは、前記下部つかみ具の遠位部分を前記上部つかみ具に向かって付勢する、項目10に記載の電気手術デバイス。
(項目12)
前記上部つかみ具は、前記上部つかみ具を前記下部つかみ具から電気的に絶縁するように前記上部つかみ具の上に成形されたプラスチック覆いを備える、項目1に記載の電気手術デバイス。
(項目13)
前記電気手術デバイスは、さらに、前記電気手術デバイスの細長いシャフトと、前記上部つかみ具及び前記下部つかみ具と、の間に手首部を備え、
前記上部つかみ具及び前記下部つかみ具は、前記上部つかみ具及び前記下部つかみ具が前記細長いシャフトに対して屈曲するのを可能にするように、前記手首部において変位可能である、項目1に記載の電気手術デバイス。
(項目14)
前記電気手術デバイスは、さらに、前記手首部の通路を通してループ状にされた関節運動ワイヤを備える、項目13に記載の電気手術デバイス。
(項目15)
前記関節運動ワイヤを通して前記上部つかみ具及び前記下部つかみ具に電力が供給される、項目14に記載の電気手術デバイス。
(項目16)
前記手首部は、
椎体と、
ブッシュと、
前記椎体と前記ブッシュとの間の自動的にまっすぐになる結合部であって、前記上部つかみ具及び前記下部つかみ具を中心位置に向かって付勢する前記結合部と、を備える、項目13に記載の電気手術デバイス。
(項目17)
前記電気手術デバイスは、さらに、前記上部つかみ具及び前記下部つかみ具のうちの一方の通路を通ってループ状にされた作動ワイヤを備える、項目1に記載の電気手術デバイス。
(項目18)
前記作動ワイヤは、
第1作動ワイヤ部と、
第2作動ワイヤ部と、を備え、
前記第1作動ワイヤ部は、前記第2作動ワイヤ部と交差し、それにより、前記第1作動ワイヤ部と前記第2作動ワイヤ部とが、前記作動ワイヤがループ状にされている前記上部つかみ具及び前記下部つかみ具のうちの前記一方に等しい力をかける、項目17に記載の電気手術デバイス。
(項目19)
前記作動ワイヤを通して前記上部つかみ具及び前記下部つかみ具に電力が供給される、項目17に記載の電気手術デバイス。
(項目20)
前記上部つかみ具は、第1嵌合面を備え、
前記下部つかみ具は、前記第1嵌合面と嵌合する第2嵌合面を備え、
前記第1嵌合面及び前記第2嵌合面のそれぞれは、V字型輪郭を備える、項目1に記載の電気手術デバイス。
(項目21)
前記電気手術デバイスは、さらに、前記上部つかみ具及び前記下部つかみ具の屈曲運動又は回転運動を制御する関節運動機構をさらに具備する、項目1に記載の電気手術デバイス。
(項目22)
前記関節運動機構は、
ハウジングと、
前記ハウジング内で回転可能に変位可能な割出ディスクと、を備える、項目21に記載の電気手術デバイス。
(項目23)
前記ハウジングは、複数のラチェット切欠きを備え、
前記割出ディスクは、前記ラチェット切欠きと係合して、前記上部つかみ具及び前記下部つかみ具の位置を割り出す割出アームを備える、項目22に記載の電気手術デバイス。
(項目24)
前記関節運動機構は、前記上部つかみ具及び前記下部つかみ具に対する外部の力が前記上部つかみ具及び前記下部つかみ具を割出位置から移動させるのを防止する自動係止機構を備える、項目22に記載の電気手術デバイス。
Claims (10)
- 組織を切断及び封止するための電気手術デバイスであって、
前記電気手術デバイスは、
前記電気手術デバイスの遠位端に位置する上部つかみ具と、
前記上部つかみ具に対向する下部つかみ具であって、旋回接続部によって前記上部つかみ具に旋回接続されている前記下部つかみ具と、
前記上部つかみ具及び前記下部つかみ具のうちの一方の通路を通ってループ状にされた作動ワイヤと、を備え、
前記作動ワイヤは、
第1作動ワイヤ部と、
第2作動ワイヤ部と、を備え、
前記第1作動ワイヤ部は、交差点において前記第2作動ワイヤ部と交差し、
前記交差点は、前記上部つかみ具及び前記下部つかみ具の関節運動中、前記第1作動ワイヤ部及び前記第2作動ワイヤ部の旋回点として作用し、それにより、前記第1作動ワイヤ部及び前記第2作動ワイヤ部が、ループ状にされている前記作動ワイヤを介して前記上部つかみ具及び前記下部つかみ具のうちの前記一方に等しい力をかける、
電気手術デバイス。 - 前記第1作動ワイヤ部と前記第2作動ワイヤ部とは、前記交差点において、約180°ねじられている、請求項1に記載の電気手術デバイス。
- 前記作動ワイヤは、前記上部つかみ具に電力を供給する送電ワイヤである、請求項1又は2に記載の電気手術デバイス。
- 前記作動ワイヤは、前記上部つかみ具を前記下部つかみ具に対して、開放位置と閉鎖位置とに旋回させるように動作可能である、請求項1〜3のいずれか一項に記載の電気手術デバイス。
- 前記上部つかみ具及び前記下部つかみ具を前記開放位置又は前記閉鎖位置に旋回させるために、前記第1作動ワイヤ部及び前記第2作動ワイヤ部を通して押込み力又は引張力が印加される、請求項4に記載の電気手術デバイス。
- 前記押込み力は、前記上部つかみ具を前記開放位置に旋回させるために、前記上部つかみ具に印加される、請求項5に記載の電気手術デバイス。
- 前記引張力は、前記上部つかみ具を前記閉鎖位置に旋回させるために、前記上部つかみ具に印加される、請求項5又は6に記載の電気手術デバイス。
- 前記交差点における前記第1作動ワイヤ部及び前記第2作動ワイヤ部の交差により、前記上部つかみ具及び前記下部つかみ具が関節運動するときに、前記第1作動ワイヤ部及び前記第2作動ワイヤ部の弧の長さが、互いに鏡像となり同じ長さのまま維持される、請求項1〜7のいずれか一項に記載の電気手術デバイス。
- 前記作動ワイヤは、前記上部つかみ具のピンに接続されている、請求項1〜8のいずれか一項に記載の電気手術デバイス。
- 前記作動ワイヤは、前記上部つかみ具の基礎部分に形成されたU字型溝穴を通してループ状にされている、請求項1〜9のいずれか一項に記載の電気手術デバイス。
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