PT99075B - Agrafador cirurgico anastomotico intraluminal com bigorna separada - Google Patents
Agrafador cirurgico anastomotico intraluminal com bigorna separada Download PDFInfo
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- PT99075B PT99075B PT99075A PT9907591A PT99075B PT 99075 B PT99075 B PT 99075B PT 99075 A PT99075 A PT 99075A PT 9907591 A PT9907591 A PT 9907591A PT 99075 B PT99075 B PT 99075B
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single 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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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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
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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
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
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Description
DESCRIÇÃO
Domínio da invenção
A presente invenção refere-se a um processo cirúrgico para agrafar. Mais especificamente, a presente invenção refere-se a um processo interno de agrafamento anastomotico. Ainda mais especificamente, a presente invenção refere-se a um processo de agrafamento interno anastomótico do lumen, particularmente dos intestinos, em que se aplica um anel circular de agrados à parte desejada do lumen.
Antecedentes da invenção
Genericamente os processos de agrafamento cirúrgico fizeram progressos substanciais nas últimas décadas. Específicamente» no domínio do agrafamento anastomoti— co interno os avenços foram realmente extraordinários. Determinados dispositivos tais como o agrafador Proximate ILS produzido pelo requerente da presente invenção» Ethicon» Inc.» Somerville» New Jersey, têm permitido aos cirurgiões efectuar operações e praticar procedimentos que até então eram conside- 1 rados difíceis, se não mesmo impossíveis com relativa facilidade.
Áo efectuar-se o agrafamento anastomõtico cirúrgico, procede-se genericamente à ligação de duas partes do lúmen com um anel de agrafes. Durante a pratica deste procedimento utiliza-se uma faca de lâmina circular para separar o tecido mantido no interior do anel circular. 0 anel circular á depois removido do agrafador de modo a comple tar-se uma abertura circular no interior do lumen ao longo da linha de agrafamento cirúrgico.
Todavia, ao praticar-se este procedimento cirúrgico, torna-se desejável separar a cabeça da bigorna, sobre a qual os agrafes são dobrados, da parte de agrafamento de onde os agrafos são expelidos. Ko passado foram efectuados progressos de acordo com estas linhas orientadoras. Era típico, no passado, que o lado de agrafamento do mecanismo ligasse a cabeça ã bigorna através de uma prega de tecido de tipo bolsa de cordão.
Por outro lado, descobriu-se que no caso de o tecido contido sobre a cabeça do agrafador estar ligado ao tecido contido na bigorna do agrafador, era difícil ligar a bigorna e a cabeça com um alinhamento adequado dos agrafos nas bigornas contidas no lado correspondente da bigorna
Alem disso, descobriu-se que era difícil executar esse agrafamento no interior de um agrafador circular de modo a que a dimensão da cabeça fosse mantida num valor mínimo na parte exterior com um valor máximo na cavidade interior, de tal modo que mais tecido pudesse ser reunido no interior do agrafo da anastomose.
Alãm disso, embora possa ser desejável como parte da presente invenção possuir um tecido que seja reunido a perfurado por uma ponta de trocarte relativamen— te aguçada na cabeça do agrafador, nem sempre ê desejável que a cabeça do agrafador esteja continuamente exposta com uma ponta de trocarte aguçada. Em vez disso, verificou-se que um aspecto mais desejável consiste em possuir uma ponta
- 2 aguçada exposta apenas durante uma parte do procedimento de ligação.
Sumário da invenção
Em consequência constitui um objectivo da presente invenção proporcionar um agrafador cirúrgico para agrafamento anastomõtico, no qual exista uma bigorna separável que se pode ligar a parte de agrafamento e um trocarte que constitua parte integrante do instrumento na parte de agrafamento do instrumento.
Constitui outro objectivo da presente Invenção proporcionar a bigorna com um prolongamento tubular no sentido de facilitar o preguiamento do tecido.
Além disso, constitui outro objectivo da presente invenção proporcionar um mecanismo de alinhamento para alinhar a bigorna e os agrafos sobre a cabeça ou sobre a parte de agrafamento do veio.
Constitui ainda outro objectivo da presente invenção proporcionar um sistema para acopolar a bigorna ao veio através da ponta do trocarte integrante.
Constitui também outro objectivo da presente invenção proporcionar um sistema em que a ponta do trocarte esteja protegida excepto para uma ligação â bigorna do veio ou durante o pregueamento.
Estes e outros objectivos da presente invenção são descritos para um dispositivo de agrafamento cirúrgico em que os agrafos são provenientes de uma cabeça dirigindo-se para a bigorna do dispositivo. A bigorna é destacável da cabeça e essa cabeça contém uma ponta de trocarte a qual se liga a bigorna. A bigorna contem um casquilho alongado que possui uma abertura através da qual se coloca a ponta de trocarte. Sobre a ponta de trocarte existe um sistema que engrena com o mecanismo de bloqueamento da Bigorna. Existe também um sistema de alinhamento que alinha a bigorna com os agrafos sobre a cabeça do instrumento. Na ponta de trocarte pode existir também um casquilho forçado por uma mola que ** pode ser submetido a retracção para expor a ponta ao fazer-se a inserção através do tecido pregueado, ou a fazer-se a inserção do veio da bigorna sobre a ponta de trocarte.
Os objectivos da presente invenção são mais evidentes quando ilustrados pelos desenhos anexos em conjunto com a descrição pormenorizada da invenção.
Descrição dos desenhos
A Figura 1 representa uma perspectiva de um agrafador cirúrgico da presente invenção;
A Figura 2 representa uma perspectiva da cabeça e da bigorna de um agrafador cirúrgico da presente invenção;
As Figuras 3, 4, 5 e 6 são alçados laterais de uma operação de fecho e de agrafamento da presente invenção;
A Figura 7 representa uma perspectiva expandida de uma bigorna, de um veio da bigorna e de um trocarte da presente invenção;
A Figura 8 representa uma secção transversal parcial de um alçado Lateral da bigorna ao longo das linhas 8-8 da Figura 2;
A Figura 9 representa uma secção transversal parcial de um alçado lateral de um veio da bigorna fechada ajustada sobre uma ponta de trocarte conforme descrito na presente invenção;
A Figura 10 representa uma vista de topo da secção recta de um veio da bigorna segundo as linhas
10-10 da Figura 9; e
A Figura 11 representa uma vista lateral segundo um corte parcial de um mecanismo de protecção do trocarte contido na cabeça em conformidade com a presente invenção»
Descrição pormenorizada da invenção
Conforme se observa na Figura 1, descreve-se um agrafador 10 que possui uma cabeça 20,
- 4 uma
bigorna 30, am parafuso de afinaçao 40 e um gatilho 50. 0 gatilho 50 acciona o agrafador 10 quando o mecanismo de segurança 55 é libertado. Quando o gatilho 50 ê activado, o mecanismo de disparo não representado actua no interior do veio 25 de modo a expelir os agrafos a partir da cabeça 20, Esses agrafos são dobrados nas bigornas 34 dispostas circularmente em torno da cabeça 31 da bigorna 30. Simultâneamente, uma lâmina cortante existente no interior da cabeça 20 actua de modo a cortar o tecido mantido no interior da circunferência do tecido agrafado entre as bigornas 34. por este processo ê possível puxar um lumen circular através do veio e libertar o tecido fechado próximo do agrafador 10. 0 agrafador 10 é depois puxado através do tecido libertando o tecido agrafado no seu lugar.
Conforme se observa nas Figuras 1, 2 e 7 existem vários mecanismos que constituem o objecto da invenção neste agrafador anastomótíco circular. Mais específicamente» conforme se observa nas Figuras 1 e 2, mostra-se um veio de trocarte 22 que poesui uma ponta de trocar te 26· Este veio de trocarte 22 é parte integrante da cabeça 2Q e é susceptível de perfurar tecidos. Este veio de trocarte 22 está rodeado por um casquilho 24 dotado de um movimento alternado para dentro e para fora da cabeça 20. 0 casquilho 24 estã mantido sobre a cabeça 20 pela mola 23 que cria a sua reziliência e permite o movimento alternado do casquilho 24 em torno do vnio de trocarte 22.
Conforme se observa nas Figuras 3 e 11, o veio de trocarte 22 encontra-se geralmente coberto pelo casquilho 24 de tal modo que o tecido pregueado pode ser colocado sobre o casquilho 24. Apesar disso, a ponta de trocarte 26 é susceptível de penetrar através do tecido quando se aplica pressão. Isto é especialmente útil quando se pretende ligar tecido pregueado. Desta forma» o casquilho 24 do trocarte com a ponta 26 exposta é susceptível de ser forçado através de uma prega de tal modo que não haja rotura dessa prega. Depois de o casquilho do trocarte ser forçado através do tecido» o casquilho 24 envolve a ponta do trocarte 26 de tal modo
K
que não haverã outros danos ficando ainda o lumen adequadamente ajustado sobre o casquilho 24.
Coresspondendo ao trocarte 24 existe uma bigorna 30* Sobre a bigorna 30 existem as bigornas 34 dispostas circularmente em torno da cabeça da bigorna 31. Essas bigorna· 34 correspondem aos agrafos mantidos circularmente no interior da cabeça 20. Conforme se observa na Figura 3, a bigorna 30 pode ser colocada no interior de um tecido de lumen sendo depois o tecido pregueado em torno do veio 32.
Contido no interior da bigorna 30 existe um mecanismo de alinhamento que se encontra representado na Figura 8. Conforme se observa na Figura 8 existe um denteado 29 contido no interior da cabeça da bigorna. Esse denteado corresponde a dentes ou reentrâncias 28 contidas na ponta do trocarte 26» Quando a bigorna 30 estã colocada sobre o veio do trocarte 22, o denteado 29 encontra as correspondentes reentâncias 28 o que lhe permite alinhar as bigornas 34 com os agrafos colocados circularmente em torno da cabeça 20.
Alem disso, revela-se um método único para bloquear ou desbloquear a bigorna e a cabeça mais especificamente conforme se observa nas Figuras 2 e 7, o dispositivo de libertação 36 é formado a partir de uma alavanca em forma de botão que estã contida por uma mola de libertação 36 a na cabeça 31 da bigorna 30. Este dispositivo de libertação possui uma lingueta 35, conforme se mostra na Figura 10, que força a abertura do grampo 39 b de bloqueio do alinhamento central. Este grampo de bloqueio encontra-se introduzido entre os grampos 39 a de alinhamento. Cada um destes grampos 39 a e 39 b possui uma perfuração 37 b no trocarte aberta centralmente e perfurações 37 a que ajustam no pino 37 na cabeça 31*
A ponta 26 do trocarte 22 é susceptível de se ajustar através de perfurações 37 b dispostas central mente. No caso de se desejar bloquear a bigorna 30 sobre a cabeça 20, o grampo 39 b de bloqueio geralmente accionado pela mola é forçado a abrir e depois fecha-se em torno dos
dentes ou das nervuras 21 da ponta 22 do trocarte. Isto observa—se melhor nas Figuras 8 e 10« No caso de se pretender abrir a bigorna 30 e separá-la do veio do trocarte, exerce-se força sobre o dispositivo de libertação 36 de tal modo que a lingueta 35 obriga a levantar os dentes do grampo de bloqueio 39 b permitindo a abertura. A perfuração 37 b no grampo 39 b posaui as mesmas dimensões das perfurações 37 b em cada um dos grampos 39 a de alinhamento. Desta forma o veio pode deslizar para fora do velo 32 da bigorna.
Contudo, a mela que forma o grampo 39b do bloqueio estã normalmente enviesada de tal modo que está geralmente numa posição cerrada ou fechada”, ajustando-se deste modo aos dentes ou as nervuras 21, Os dentes 21 retêm o grampo 39 b do bloqueio e a bigorna 30 fica adequadamente presa ao trocarte 22 contido na cabeça 20.
Quando estã em funcionamento, conforme se observa pelas Figuras 3, 4, 5 e 6, a bigorna com duas secções de lumen ligadas simultaneamente ao veio 22 e ao proloii gamento tubular da bigorna 32 respectivamente, encontra-se pronta para a cirurgia. Conforme se observa na Figura 4, a bigorna 30 estã colocada sobre o veio 22 de tal modo que a ponta de trocarte 26 fica exposta e se ajusta ao interior do prolongamento 32 da bigorna, 0 casquilho 24 é empurrado para uma posição exposta de tal modo que se encaixa, qual telescópio, no interior da cabeça 20. As perfurações 37 b nos grampos 39 a de alinhamento e no grampo 39 b de bloqueio orientam o trocarte através da extensão 32 para o interior da cabeça 31 da bigorna* Quando o trocarte estã adequadamente ajustado ao interior da cabeça 31 da bigorna, o grampo 39 b de bloqueio que contém a mola com a configuração de lingueta ê forçado a abrir e depois prende-se em torno dos recortes denteados 21. Uma vez que as reentrâncias 28 ficaram alinhadas por si próprias com o denteado 29 no veio 31, fica garantido que as bigornas 34 ficam alinhadas com os agrafos contidos na cabeça 20. Conforme se observa melhor na Figura 7, o denteado 29 foi alinhado com as bigornas 34 durante o fabrico através da colocação exacta de cravos 31 1 no interior das perfurações
a ao estabelecer-se a ligação da cabeça 31 da bigorna â extensão 32. 0 instrumento assemelha-se agora a duas peças de lumen próximas conforme se observa na Figura 5. 0 parafuso 40 de afinação e ajustamento puxou os tecidos para mais próximo um do outro.
Conforme se observa na Figura 6» os agrafos foram disparados para outras bigornas através do tecido. Logo que os agrafos são dobrados, uma lâmina cortante corta o tecido mantido no interior da circunferência dos agrafos. Uma vez efectuado este corte , o agrafador 10 ó puxado no sentido da cabeça 20 e através do lumen de modo a criar-se o lumen fechado circularmente com uma abertura tubular interior.
Após a remoção do agrafador 10, elimina-se o lumen em excesso mantido no agrafador 10. 0 dispositivo de libertação 36 da bigorna 30 ê pressionado conforme se observa nas figuras 2 e 10. Isto origina a abertura do mecanismo de bloqueio que se observa na Figura 9, conforme sugerido na Figura 7. 0 grampo 39 b de bloqueio abre permitindo ao utilizador fazer deslizar o veio 32 da bigorna a partir da cabeça 20 do agrafador, por este processo remove-se o tecido que fica contido no interior da bigorna 30 e da cabeça 20.
Por este processo foi possível cosse guir um pregueamento e uma perfuração adequados pelo trocarte 22, um alinhamento adequado entre as reentrâncias 28 e o denteado 29, uma tracçao adequada através da cabeça 31 da biborna um ajustamento do grampo do bloqueio 39 ea torno dos recortes denteados 21 e um agrafamento e um corte adequado do tecido. Em consequência, faz-se observar que as reivindicações anexas e seus equivalentes englobam o âmbito da presente invenção.
Claims (1)
- Dispositivo cirugico para agrafar caracterizado pelo facto de os agrafos serea orientados a partir de una cabeça ea direcção a uma bigorna, sendo a bigorna separável daquela cabeça, contendo essa cabeça una ponta da tipo trocarte a qual está acoplada àquela bigorna.- 2« Dispositivo de acordo com a reivindicação 1 caracterizada pelo facto de a bigorna conter ua casquilho alongado, possuindo esse casquilho uma abertura através da qual é colocada a ponta de trocarte.- 3a Dispositivo de acordo coa a reivindicação 1 caracterizado pelo facto de a bigorna conter uaa lingueta de fecho que engrena coa a ponta de trocarte.- 4» Dispositivo de acordo coa a reivindicação 3 caracterizado pelo facto de a referida lingueta conter ainda um mecanismo de libertação que permite que a referida bigorna seja libertada da ponta de trocarte.- 5« Dispositivo de acordo com a reivindicação 3 caracterizado pelo facto de a referida ponta de trocarte possuir um sistema de aclopamento que engrena com a referida lingueta de fecho.- 6» Dispositivo de acordo com a reivindicação- 9 3 caracterizada pelo facto de a referida lingueta ser um grampo forçado por uma mola, ajustável em torno do referido trocarte.- 7* Dispositivo de acordo com a reivindicação 3 caracterizado pelo facto de o referido trocarte conter um veio que possuí um aulco de recorte denteado em torno do qual é ajustado a referida lingueta de fecho.- 8a Dispositivo de acordo com a reivindicação 2 caracterizado pelo facto de a referida ponta de trocarte ser protegida por um casquilho forçado por uma mola, podendo esse casquilho sofrer uma retracção para expâr a referida ponta ao fazer-se a inserção do referido casquilho alongado da bigorna sobre o referido trocarte.- 9» Dispositivo de acordo com a reivindicação 2 caracterizado pelo facto de a referida bigorna possuir uma cabeça de bigorna ligada ao referido casquilho alongado, possuindo essa cabaça de bigorna uma diversidade de nervuras dispostas radialmente em torna de um diâmetro interno, e por o referido trocarte possuir uma diversidade de sulcos dispostas radialmente am torno da referida ponta, ficando os sulcos alinhados com as nervuras ao fazer-se a inserção daquela ponta no casquilho alongado e na referida cabeça.- 10« Dispositivo cirúrgico para agrafar caracterizado pelo facto de os agrafos serem orientados a partir de uma cabeça em direcção â bigorna, sendo essa bigorna separável da referida cabeça, possuindo essa cabeça uma ponta de trocarte â qual e acoplada a referida bigorna, sendo essa ponta de trocarte protegida por um casquilho alongado, estando esse casquilho alongado ligado a uma mola de tal modo que a referida ponta fica exposta quando se exerce uma força sobre o referido casquilho no sentido de acoplar a bigorna ao trocarte.- 11® Dispositivo de acordo co» a reivindicação10 caracterizsdo pelo facto de a ponta de trocarte poder sofrer uma retracção para o interior da cabeça do referido dispositivo co» a bigorna acoplada ao trocarte.- 12* Dispositivo de acordo co» a reivindicação11 caracterizado pelo facto de a bigorna possuir u» casquilho alongado, possuindo esse casquilho uma abertura através da qual ê colocada a referida ponta de trocarte.- 13® Dispositivo de acordo com a reivindicação 11 caracterisado pelo facto de a referida bigorna possuir uma lingueta de fecho que engrena com a ponta de trocarte.- 14« Dispositivo de acordo com a reivindicação 13 caracterizado pelo facto de a referida lingueta possuir ainda um mecanismo de libertação que permite que a refeida bigorna seja libertada da ponta de trocarte.- 15â »Dispositivo de acordo com a reivindicação 13 caracterizado pelo facto de a referida ponta de trocarte possuir um sistema de acoplamento que engrena co» a referida lingueta de fecho.- 16® - 11Dispositivo de acordo coe a reivindicação 13 caracterizado pelo facto de a referida lingueta ser um grampo forçado por ama mola, ajustável em torno do referido trocarte.- 17« Dispositivo de acordo com a reivindicação 13 caracterizado pelo facto de o referido trocarte conter «m veio que possui um sulco de recorte denteado em torno do qual e ajustada a referida lingueta de fecho.ig» Dispositivo de acordo com a reivindicação 13 caracterizado pelo facto de a referida bigorna possuir uma cabeça de bigorna ligada ao referido casquilho alongado, possuindo essa cabeça de bigorna uma diversidade de nervuras dispostas radialmente em torno de um diâmetro interno, e por o referido trocarte possuir uma diversidade de sulcos dispostos radialmente em torno da referida, ponta, ficando os sulcos alinhados com as nervuras ao fazer-se a inserção daquela ponta no casquilho alongado e na referida cabeça.- iqi „Dispositivo cirúrgico para agrafar caracterizado pelo facto de os agrafos serem orientados a partir de uma cabeça em direcção â bigorna, sendo essa bigorna separável da referida cabeça, possuindo essa cabeça uma ponta de trocarte ã qual ê acoplada a referida bigorna e em que a referida bigorna possui uma lingueta que engrena com a referida ponta de trocarte e pode ser acclonada de modo a manter a referida bigorna livremente ajustada â referida ponta, podendo a bigorna e a ponta conjuntameate sofrer uma retracção em direcção ã cabeça de tal modo que a referida lingueta não possa ser libertada com a bigorna acoplada ã referida ponta mantida no interior daquela cabeça.12 - 20#Dispositivo de acordo com a reivindicação 19 caracterizado pelo facto de a bigorna conter um casqui lho alongado, possuindo esse casquilho uma abertura através da qual é colocada a ponta de trocarte.- 21a Dispositivo de acordo co» a reivindicação 19 caracterizado pelo facto de a referida lingueta conter ainda um mecanismo de libertação que permita que a referida bigorna seja libertada da ponta de trocarte.- 22a Dispositivo de acordo com a reivindicação 19 caracterizado pelo facto de a referida ponta de trocai: te possuir um sistema de acoplamento que engrena coa a referida lingueta de fecho.- 23a Dispositivo de acordo com a reivindicação 19 caracterizado pelo facto de a referida lingueta ser um grampo forçado por uma mola, ajustãvel em torno do referido trocarte._ 24a Dispositivo de acordo com a reivindicação 19 caracterizado pelo facto de o referido trocarte conter um veio que possui um sulco de recorte denteado em torno do qual é ajustada a referida lingueta de fecho.- 25a Dispositivo de acordo co» a reivindicação 19 caracterizado pelo facto de a referida ponta de trocajr te ser protegida por um casquilho forçado por uma mola, podendo esse casquilho sofrer uma retracção para expôr a referida ponta ao fazer-se a inserção do referido casquilho alongado da bigorna sobre o referido trocarte.- 26 a Dispositivo de acordo com a reivindicação 19 caracterizado pelo facto de a referida bigorna possuir uma cabeça da bigorna ligada ao referido casquilho alongado, possuindo essa cabeça de bigorna uma diversidade de nervuras dispostas radialmente em torno de um diâmetro interno, e por o referido trocarte possuir uma diversidade de sulcos dispostas radialmente em torno da referida ponta, ficando os sulcos alinhados com as nervuras ao fazer-se a inserção daquela ponta no casquilho alongado e na referida cabeça.- 27« Dispositivo de acordo com a reivindicação 19 caracterizado pelo facto de a referida ponta poder sofrer uma retracção para o interior da referida cabeça através do accionamento de um sistema de retracção associado ã referida ponta através da referida cabeça.- 28 « Dispositivo de acordo com a reivindicação 27 caracterizado pelo facto de o sistema de retracção fazer rodar ua mecanismo de parafuso que se lhe encontra associado no sentido de apertar a referida bigorna contra a referida cabeça.- 29« Dispositivo de acordo com a reivindicação 21 caracterizado pelo facto de o referido mecanismo de libertação possuir uma chaveta accionével manualmente destinada a libertar do referido trocarte um grupo do referido grampo forçado pela mola.- 30« Dispositivo cirúrgico para agrafar caracterizado pelo facto de os agrafos serem orientados a partir de uma cabeça em direcção a uma bigorna que possui dobradores de agrafos, sendo essa bigorna separável da referida cabeça, possuindo essa cabeça uma ponta de trocarte que dispõe de meios de alinhamento e estando ligada â referida bigorna, e por a referida bigorna conter uma cabeça de bigorna associada a um casqilho alongado, possuindo ainda essa cabeça de bigorna uma diversidade de nervuras dispostas em posição radial no interior dessa cabeça de bigorna, estando essas nervuras alinha das com meios de alinhamento na referida ponta de trocarte.- 31a Dispositivo de acordo com a reivindicação 30 caracterizado pelo facto de o referido sistema de alinhamento aer constituído por uma diversidade de sulcos que se ajustam ãs referidas nervuras de tal modo que os referidos agrafos ficam alinhados com os referidos dobradores de agrafos sobre aquela bigorna quando as referidas nervuras são inseridas no interior daqueles sulcos*- 32a Dispositivo de acordo com a reivindicação 31 caracterizado pelo facto de o referido casquilho possuir uma abertura através da qual é colocado a referida ponta de trocarte.- 33a Dispositivo de acordo com a reivindicação 31 caracterizado pelo facto de a bigorna conter uma lingueta de facto que engrena com a ponta de trocarte.- 34a Dispositivo de acordo com a reivindicação 33 caracterizado pelo facto de a referida lingueta conter ainda um mecanismo de libertação que permite que a referida bigorna seja libertada da ponta de trocarte.- 35a 15 -Dispositivo de acordt» com a reivindicação 33 caracterizado pelo facto de a referida ponta de trocajr te possuir ua sistema de acoplamento que engrena com a referida lingueta de facho·- 36a Dispositivo de acordo com a reivindicação 33 caracterizado pelo facto de a referida lingueta ser um grampo forçado por uma mola, ajustável em torno do referido trocarte.- 37« Dispositivo de acordo com a reivindicação 33 caracterizado pelo facto de o referido trocarte conter um veio que possui um sulco de recorte denteado em torno do qual e ajustada a referida lingueta de fecho.- 38a Dispositivo de acordo com a reivindicação 31 caracterizado pelo facto de a referida ponta de trocar te ser protegida por um casquilho forçado por uma mola, podendo esse casquilho sofrer uma retracção para expor a referida ponta ao fazer-se a inserção do referido casquilho alongado da bigorna sobre o referido trocarte.- 39a Dispositivo de acordo com a reivindicação 31 caracterizado pelo facto de a ponta de trocarte poder sofrer uma retracção para o interior da cabeça do referido dispositivo com a bigorna acoplada ao trocarte.- 40a _Dispositivo de acordo com a reivindicação 31 caracterizado pelo facto de a referida ponta poder sofrer uma retracçao para o interior da referida cabeça através do accionamento de um sistema de retracção associado á referida ponta através da referida cabeça.Dispositivo de acordo com a reivindicação 41 caracterizado pelo facto de o sistema de retracção fazer rodar ttl mecanismo de parafuso que se lhe encontra associado no sentido de apertar a referida bigorna contra a referida cabeça.- 42* Dispositivo de acordo com a reivindicação 41 caracterizado pelo facto de o referido mecanismo de libertação possuir uma chaveta accionável sanualmente destinada a libertar do referido trocarte um grupo do referido grampo forçado pela mola.A requerente reivindica a prioridade do pedido norte-americano apresentado em 28 de Setembro de 1990, sob o número de serie 590,404.
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US07/590,404 US5104025A (en) | 1990-09-28 | 1990-09-28 | Intraluminal anastomotic surgical stapler with detached anvil |
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PT99075A PT99075A (pt) | 1993-10-29 |
PT99075B true PT99075B (pt) | 1999-01-29 |
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PT99075A PT99075B (pt) | 1990-09-28 | 1991-09-26 | Agrafador cirurgico anastomotico intraluminal com bigorna separada |
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US (1) | US5104025A (pt) |
EP (1) | EP0481619B1 (pt) |
JP (1) | JPH04256745A (pt) |
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BR (1) | BR9104179A (pt) |
CA (1) | CA2052207C (pt) |
DE (1) | DE69108836T2 (pt) |
DK (1) | DK0481619T3 (pt) |
ES (1) | ES2071232T3 (pt) |
GR (1) | GR1000991B (pt) |
IE (1) | IE67958B1 (pt) |
PT (1) | PT99075B (pt) |
ZA (1) | ZA917765B (pt) |
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US4319576A (en) * | 1980-02-26 | 1982-03-16 | Senco Products, Inc. | Intralumenal anastomosis surgical stapling instrument |
US4654030A (en) * | 1986-02-24 | 1987-03-31 | Endotherapeutics | Trocar |
US4817847A (en) * | 1986-04-21 | 1989-04-04 | Finanzaktiengesellschaft Globe Control | Instrument and a procedure for performing an anastomosis |
US5119983A (en) * | 1987-05-26 | 1992-06-09 | United States Surgical Corporation | Surgical stapler apparatus |
AU4742190A (en) * | 1988-11-29 | 1990-06-26 | Bruce S. Gingold | Surgical stapling apparatus |
-
1990
- 1990-09-28 US US07/590,404 patent/US5104025A/en not_active Expired - Lifetime
-
1991
- 1991-09-19 GR GR910100390A patent/GR1000991B/el not_active IP Right Cessation
- 1991-09-25 CA CA002052207A patent/CA2052207C/en not_active Expired - Lifetime
- 1991-09-25 JP JP3271924A patent/JPH04256745A/ja active Pending
- 1991-09-26 PT PT99075A patent/PT99075B/pt not_active IP Right Cessation
- 1991-09-27 ZA ZA917765A patent/ZA917765B/xx unknown
- 1991-09-27 DK DK91308868.8T patent/DK0481619T3/da active
- 1991-09-27 BR BR919104179A patent/BR9104179A/pt not_active Application Discontinuation
- 1991-09-27 AU AU84840/91A patent/AU654673B2/en not_active Expired
- 1991-09-27 EP EP91308868A patent/EP0481619B1/en not_active Expired - Lifetime
- 1991-09-27 DE DE69108836T patent/DE69108836T2/de not_active Expired - Lifetime
- 1991-09-27 IE IE342891A patent/IE67958B1/en not_active IP Right Cessation
- 1991-09-27 ES ES91308868T patent/ES2071232T3/es not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
DK0481619T3 (da) | 1995-07-03 |
EP0481619B1 (en) | 1995-04-12 |
IE913428A1 (en) | 1992-04-08 |
BR9104179A (pt) | 1992-06-02 |
GR1000991B (el) | 1993-03-31 |
CA2052207A1 (en) | 1992-03-29 |
ZA917765B (en) | 1993-03-29 |
CA2052207C (en) | 2001-05-08 |
AU8484091A (en) | 1992-04-02 |
DE69108836D1 (de) | 1995-05-18 |
ES2071232T3 (es) | 1995-06-16 |
GR910100390A (en) | 1992-09-11 |
IE67958B1 (en) | 1996-05-15 |
DE69108836T2 (de) | 1995-11-23 |
US5104025A (en) | 1992-04-14 |
JPH04256745A (ja) | 1992-09-11 |
PT99075A (pt) | 1993-10-29 |
EP0481619A1 (en) | 1992-04-22 |
AU654673B2 (en) | 1994-11-17 |
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