ES2567046T3 - Conexión de contrafuerte de instrumento quirúrgico - Google Patents
Conexión de contrafuerte de instrumento quirúrgico Download PDFInfo
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- ES2567046T3 ES2567046T3 ES12158861.0T ES12158861T ES2567046T3 ES 2567046 T3 ES2567046 T3 ES 2567046T3 ES 12158861 T ES12158861 T ES 12158861T ES 2567046 T3 ES2567046 T3 ES 2567046T3
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- slrm
- staple
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis, e.g. 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
- A61B17/32—Surgical cutting instruments
- A61B17/3209—Incision instruments
- A61B17/3211—Surgical scalpels, knives; Accessories therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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
- A61B2017/07271—Stapler heads characterised by its cartridge
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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)
Abstract
Un instrumento de grapado quirúrgico (10), que comprende: un conjunto de asidero (12); una parte de cuerpo (20) que se extiende desde el conjunto de asidero; mordazas de grapado quirúrgico que incluyen un conjunto de cartucho (22, 122) de grapas y un conjunto de yunque (30, 130) dispuestos en un extremo distal de la parte de cuerpo; un material de refuerzo (50, 150) de línea de grapas; un sujetador (32) para dicho material de refuerzo (50, 150) de línea de grapas; y caracterizado por dicho sujetador (32, 132) que tiene dos partes, las dos partes incluyen una hoja (45a, 145a) que tiene una pluralidad de ganchos (35, 135) en un primer lado y un adhesivo (43, 143) en un segundo lado, el adhesivo se conecta a al menos una de las mordazas de grapadora quirúrgica, y el material de refuerzo de línea de grapas tiene una pluralidad de bucles (37, 137) dispuestos para acoplarse a la pluralidad de ganchos.
Description
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endoscópico 140. Un conjunto de asidero 101 incluye un asidero pivotable 103 que impulsa el movimiento de un miembro impulsor a través del conjunto de cartucho 122 de grapas. El miembro impulsor (no se muestra) pasa a través del canal 139 y empuja una corredera o barra de leva a través del cartucho de grapas para empujar empujadores de grapa, y las grapas, a través de las ranuras 136 hacia los rebajes de formación de grapa del miembro de yunque 126. Un instrumento quirúrgico de este tipo se describe en la patente de EE.UU. nº 6.241.139 de Milliman et al.
El instrumento de grapado tiene un material de refuerzo de línea de grapas 150 sujetado al mismo. El conjunto de cartucho 122 de grapas y el conjunto de yunque 130 tienen cada uno una superficie de contacto con tejido que se acopla al tejido. La superficie de contacto con tejido 141 del conjunto de cartucho 122 de grapas define las ranuras 136 de recepción de grapa, mientras que la superficie de contacto con tejido 142 del conjunto de yunque 130 define rebajes 131 de formación de grapa.
Un SLRM 150 se puede conectar a la superficie 141, la superficie 142, o a ambas. Véase la figura 12. Deseablemente, el SLRM 150 se conecta a una o más superficies de contacto con tejido antes de que el instrumento de grapado quirúrgico sea empaquetado, de modo que el cirujano y/o el personal de la sala de operaciones no tengan que instalar el SLRM sobre el instrumento de grapado quirúrgico antes de la cirugía. Sin embargo, también se contempla la instalación del SLRM justo antes de la cirugía.
El SLRM 150 y el instrumento de grapado quirúrgico 110 definen un sujetador 132 que tiene dos partes. La primera parte es un gancho, o una pluralidad de ganchos 135, y la segunda parte es un bucle, o una pluralidad de bucles
137. El gancho o ganchos 135 se pueden proporcionar sobre la mordaza de grapadora quirúrgica y el bucle o bucles 137 se pueden proporcionar sobre el SLRM 150. Como alternativa, el gancho o ganchos se proporcionan sobre el SLRM y el bucle o bucles se proporcionan sobre las mordazas de grapadora quirúrgica.
En ciertas realizaciones preferidas, el SLRM 150 comprende un material que tiene una pluralidad de poros 152 y los ganchos 135 comprenden ganchos de fibra que se aplican a la superficie 141 del conjunto de cartucho 22 de grapas y/o a la superficie 142 del conjunto de yunque 130. Los ganchos se pueden formar de un polímero, un material metálico tal como acero, etc. Una hoja 145, que tiene una pluralidad de ganchos de fibra 135 en un primer lado 146 y un material adhesivo 143 en un segundo lado 148, se aplica a la superficie de contacto con tejido 141 del conjunto de cartucho 122 de grapas. La hoja 145 es generalmente de forma rectangular u oblonga y se encuentra fuera de las filas 137 de ranuras de recepción de grapa. Por ejemplo, al menos una primera hoja 145a se dispone en un extremo distal de la superficie de trabajo 141 y al menos una segunda hoja 145b se dispone en un extremo proximal de la superficie de trabajo 141. Las hojas 145 se adhieren a la superficie de trabajo 141 de modo que no se superponen a las ranuras 136 de recepción de grapa. Véase la figura 10.
Al menos una primera hoja 155a, que tiene un primer lado con un material adhesivo y un segundo lado que tiene una pluralidad de ganchos de fibra, se conecta a la superficie de contacto con tejido 142 del conjunto de yunque 130 en un extremo distal de la superficie 142. Al menos una segunda hoja 155b también se conecta en el extremo proximal de la superficie 142. Las hojas se encuentran hacia fuera de los rebajes 131 de formación de grapa. Véase la figura 11.
El SLRM 150 es generalmente un pedazo rectangular de material poroso. Un SLRM 150 se aplica a cada una de la superficie 141 y la superficie 142 presionando un SLRM 150 contra los ganchos 135 en la superficie de contacto con tejido 141 y presionando otro SLRM contra los ganchos en la superficie de contacto con tejido 142. Los ganchos 135 se acoplan al SLRM 150 en los poros 152 reteniendo de ese modo el SLRM 150 contra la superficie de trabajo 141 del conjunto de cartucho 122 de grapas y la superficie de trabajo 142 del conjunto de yunque 130. El SLRM 150 tiene un tamaño para superponerse a las superficies de trabajo del conjunto de cartucho 122 de grapas y del conjunto de yunque 130. El SLRM 150 y las hojas 145, 155 no interfieren con el funcionamiento del empujador o la cuchilla. La cuchilla, que es llevada por el miembro impulsor del instrumento de grapado 100, divide el SLRM, separando el SLRM en dos partes.
En otra realización, el SLRM 150 se conecta a la superficie 141, la superficie 142, o a ambas utilizando una hoja (145, 155) que es de forma alargada y se extiende al lado de las filas 137 de ranuras 136 de recepción de grapa, los rebajes 131 de formación de grapa, o ambos. Una o más hojas alargadas se pueden aplicar a la superficie 141 y/o la superficie 142. Ganchos 135 en la hoja u hojas conectan el SLRM a la superficie 141 y/o a la superficie 142.
El SLRM 150 comprende un material que tiene una pluralidad de poros 152. Como alternativa, el SLRM 150 comprende un material que tiene una pluralidad de fibras, o cualquiera de los otros materiales tratados anteriormente. Los ganchos 135 que se conectan a la superficie 141 y a la superficie 142 acoplan el SLRM en los poros o las fibras del SLRM, como se ha tratado anteriormente.
Se contempla que el área de conexión, densidad de ganchos, fortaleza de fibra de gancho, longitud de fibra de gancho y la presión del SLRM sobre los ganchos se puedan optimizar para asegurar la retención del SLRM y también la fácil liberación del SLRM después de que el instrumento de grapado quirúrgico sea disparado.
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En una realización adicional, el instrumento de grapado quirúrgico 100 tiene mordazas de grapado quirúrgico, un material de refuerzo de línea de grapas, y una hoja de conexión 245 que tiene un primer lado 246 y un segundo lado 248 con un adhesivo en el mismo. El SLRM 50 se conecta al primer lado 246 mediante el adhesivo y el segundo lado 248 se conecta a la superficie de contacto con tejido de al menos una de las mordazas de grapado quirúrgico circular. Las mordazas de grapado quirúrgico incluyen un conjunto de yunque y un conjunto de cartucho. En ciertas realizaciones, el conjunto de yunque y el conjunto de cartucho se disponen para formar una línea de grapas circular. En otras realizaciones, el conjunto de yunque y el conjunto de cartucho se disponen para formar una línea de grapas lineal.
La hoja de conexión 245, como se representa en la figura 14, tiene una forma rectangular u oblonga y una o más hojas de conexión 245 se pueden colocar en la superficie de trabajo 41 del conjunto de cartucho 22 de grapas para conectar el SLRM a la superficie de trabajo 41. En ciertas realizaciones, la hoja u hojas 245 se colocan hacia fuera de las filas 37 de ranuras 36 de recepción de grapa definidas por la superficie 41 y también se pueden colocar hacia dentro de las filas 37 de ranuras 36 de recepción de grapa. En otras realizaciones, la hoja de conexión es de forma circular, con un orificio que se dimensiona para ser más grande que las ranuras de retención de grapas o rebajes de formación de grapa. Se puede utilizar otra hoja dimensionada para ser más pequeña de las ranuras y/o las filas.
Una o más hojas de conexión se pueden colocar en la superficie de contacto con tejido 42 del conjunto de yunque 30 para conectar el SLRM a la superficie 42. En ciertas realizaciones, la hoja u hojas 245 se colocan hacia fuera de los rebajes 31 de formación de grapa definidos por la superficie de trabajo 42 y también se pueden colocar hacia dentro de los rebajes 31 de formación de grapa para conectar un SLRM al conjunto de yunque.
En una realización adicional, la hoja 245 que tiene un primer lado 246 y un segundo lado 248 con un adhesivo en la misma se puede conectar a la superficie de trabajo 141 y/o a la superficie de trabajo 142. El SLRM 150 se conecta al primer lado 246 mediante el adhesivo y el segundo lado 248 se conecta a la superficie de trabajo de al menos una de las mordazas de grapado quirúrgico. El adhesivo en el primer lado 246 se selecciona para permitir que el SLRM sea liberado del instrumento después del disparo de grapas y el corte de tejido de modo que el SLRM permanezca con el tejido grapado y el instrumento se pueda retirar. Por el contrario, el segundo lado tiene un adhesivo que se selecciona para mantener la hoja 245 conectada al instrumento a medida que se retira el instrumento. La hoja de adhesivo 245 se puede utilizar con el instrumento 10 o el instrumento 100 tratados anteriormente, u otros instrumentos de grapado quirúrgico.
En otra realización, el SLRM 150 se conecta a la superficie de trabajo 141, la superficie de trabajo 142, o a ambas utilizando una hoja (145, 155) que es de forma alargada y se extiende al lado de las filas 137 de ranuras 136 de recepción de grapa, los rebajes 131 de formación de grapa, o ambos. Una o más hojas alargadas se pueden conectar a la superficie de trabajo 142 y/o a la superficie de trabajo 142 mediante adhesivo y el SLRM se puede conectar a la hoja u hojas mediante adhesivo.
En una realización adicional, el instrumento de grapado quirúrgico 10 o el instrumento de grapado quirúrgico 100, u otro instrumento de grapado, tiene un conjunto de asidero, una parte de cuerpo que se extiende desde el conjunto de asidero, mordazas de grapado quirúrgico que incluyen un conjunto de cartucho de grapas y un conjunto de yunque dispuestos en un extremo distal de la parte de cuerpo, y un material de refuerzo de línea de grapas (SLRM). Al menos una de una superficie de contacto con tejido del conjunto de cartucho de grapas y una superficie de contacto con tejido del conjunto de yunque incorpora ganchos u otras características de acoplamiento formadas en el conjunto de cartucho de grapas y/o en el conjunto de yunque de modo que los ganchos o características de acoplamiento se extienden desde, o retroceden dentro de, la superficie de contacto con tejido del conjunto de cartucho de grapas y/o del conjunto de yunque. Las figuras 15a a 15e ilustran diversas formas para características que se pueden utilizar como ganchos o características de acoplamiento para acoplar un SLRM y retener el SLRM sobre el instrumento de grapado. Los ganchos o características de acoplamiento se forman como parte de las superficies de yunque y/o de cartucho como características moldeadas o estampadas y/o mecanizadas. Típicamente, el conjunto de cartucho de grapas incluye un cuerpo moldeado de un material polimérico, mientras que el conjunto de yunque se forma de una o más partes que se estampan y/o mecanizan de metal. Los ganchos o características de acoplamiento tendrían geometrías que podrían hacerse a través de estos métodos de formación de partes. Se pueden utilizar otros métodos de fabricación.
El SLRM 350 comprende un material que tiene una pluralidad de poros 352 o fibras 353 que se acoplan mediante los ganchos o características de acoplamiento 335 en la superficie de contacto con tejido 341 del conjunto de cartucho de grapas 322 y en la superficie de contacto con tejido 342 del conjunto de yunque 330. Los poros se pueden formar como aberturas en una hoja de material, o rebajes, o los poros pueden comprender aberturas definidas entre fibras, alambres de hilo, etc., que componen el SLRM.
Los ganchos o características de acoplamiento 335 se forman a través de la superficie de contacto con tejido 341 y/o la superficie de contacto con tejido 342. Como alternativa, los ganchos o características de acoplamiento 335 se forman de modo que los ganchos o características de acoplamiento 335 se disponen hacia fuera de líneas de grapas circulares lineales, o hacia fuera y/o hacia dentro de líneas de grapas circulares. El SLRM 350 puede ser un pedazo
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Claims (1)
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imagen1
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US13/044,623 US8479968B2 (en) | 2011-03-10 | 2011-03-10 | Surgical instrument buttress attachment |
| US201113044623 | 2011-03-10 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| ES2567046T3 true ES2567046T3 (es) | 2016-04-19 |
Family
ID=45894127
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| ES12158861.0T Active ES2567046T3 (es) | 2011-03-10 | 2012-03-09 | Conexión de contrafuerte de instrumento quirúrgico |
Country Status (6)
| Country | Link |
|---|---|
| US (3) | US8479968B2 (es) |
| EP (1) | EP2497431B1 (es) |
| JP (2) | JP5999925B2 (es) |
| AU (1) | AU2012200850B2 (es) |
| CA (1) | CA2767589C (es) |
| ES (1) | ES2567046T3 (es) |
Families Citing this family (923)
| Publication number | Priority date | Publication date | Assignee | Title |
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| US5865361A (en) | 1997-09-23 | 1999-02-02 | United States Surgical Corporation | Surgical stapling apparatus |
| EP2228019B1 (en) | 2002-06-17 | 2013-08-14 | Covidien LP | Annular support structures |
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| US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
| US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
| US11998198B2 (en) | 2004-07-28 | 2024-06-04 | Cilag Gmbh International | Surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
| US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
| US7845536B2 (en) | 2004-10-18 | 2010-12-07 | Tyco Healthcare Group Lp | Annular adhesive structure |
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| US9364229B2 (en) | 2005-03-15 | 2016-06-14 | Covidien Lp | Circular anastomosis structures |
| US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
| US7673781B2 (en) | 2005-08-31 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with staple driver that supports multiple wire diameter staples |
| US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
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2011
- 2011-03-10 US US13/044,623 patent/US8479968B2/en not_active Expired - Fee Related
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2012
- 2012-02-14 CA CA2767589A patent/CA2767589C/en active Active
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| US9107665B2 (en) | 2015-08-18 |
| JP5999925B2 (ja) | 2016-09-28 |
| US20130277411A1 (en) | 2013-10-24 |
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| JP2012187400A (ja) | 2012-10-04 |
| US20120228360A1 (en) | 2012-09-13 |
| US20150001276A1 (en) | 2015-01-01 |
| CA2767589A1 (en) | 2012-09-10 |
| CA2767589C (en) | 2019-08-27 |
| EP2497431A1 (en) | 2012-09-12 |
| US9055944B2 (en) | 2015-06-16 |
| AU2012200850B2 (en) | 2014-07-03 |
| AU2012200850A1 (en) | 2012-09-27 |
| US8479968B2 (en) | 2013-07-09 |
| EP2497431B1 (en) | 2016-03-09 |
| JP6285471B2 (ja) | 2018-02-28 |
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