JPH07108295B2 - 手術用ステ−プラ - Google Patents

手術用ステ−プラ

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Publication number
JPH07108295B2
JPH07108295B2 JP62057889A JP5788987A JPH07108295B2 JP H07108295 B2 JPH07108295 B2 JP H07108295B2 JP 62057889 A JP62057889 A JP 62057889A JP 5788987 A JP5788987 A JP 5788987A JP H07108295 B2 JPH07108295 B2 JP H07108295B2
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JP
Japan
Prior art keywords
staple
staples
trigger
shuttle
surgical stapler
Prior art date
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Expired - Lifetime
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JP62057889A
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English (en)
Other versions
JPS62243545A (ja
Inventor
カーティス・ウェイン・ソーントン
Original Assignee
エドワ−ド・ウエツク・アンド・カンパニ−，インコ−ポレ−テツド
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Publication of JPS62243545A publication Critical patent/JPS62243545A/ja
Publication of JPH07108295B2 publication Critical patent/JPH07108295B2/ja
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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
    • A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A61B17/0684—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Gripping Jigs, Holding Jigs, And Positioning Jigs (AREA)
  • Materials For Medical Uses (AREA)
  • Saccharide Compounds (AREA)

Description

【発明の詳細な説明】 【産業上の利用分野】
本発明は、けがや手術で開いた切開部を縫合するため
に、皮膚および／または組織にステープルを打ち込むた
めの手術用ステープラに関するものである。
【従来技術】
傷口を縫合するには、糸あるいはフィラメントで縫合す
るよりステープルを使って処置するほうが好ましいとさ
れるようになってきた。糸あるいはフィラメントでの縫
合にかかる時間と比較して、ステープルの方が切開部が
速く閉じられるため、外科医はステープルのほうを選ん
でいる。 ステープルを打ち込む間、外科医の視界を大きくするた
めに、ステープラの輪郭を改良したり、また、保有ステ
ープルが詰まることなく連続配送されることの信頼性を
改善する等、さまざまな特徴を有する手術用ステープラ
が設計されて来た。これらは、例えば、米国特許第4,01
4,492号、4,109,844号、4,179,057号、4,202,480号、4,
256,251号、4,375,866号、4,407,286号、4,489,875号並
びに4,527,725号に見られる。上記特許には、形成アン
ビルを備えず前以て形成したステープルを使用する型式
のステープラ、据え付けの形成アンビルを有するステー
プラ、並びにステープラが皮膚および／または組織に打
ち込まれる間に変形するところの配置地点にそれぞれの
ステープルを配送するための種々の供給機構や、可動あ
るいは進退自在の形成アンビルを有するステープラ、が
記載されている。 外科医の視界を改善するために、ステープルの底部と接
合すべき皮膚あるいは組織表面との間に形成される角度
を大きくするという努力の結果、ステープル詰まりなし
に配送を維持することはますます難しくなっている。特
に、ステープルが、カバー付き保持通路すなわちレール
上に貯蔵され、かつ、形成あご状部材及び形成アンビル
に連続的に供給されるようなステープラにおいてはそう
である。ステープラのそのような供給機構ひ保持される
ステープルの角度や、バネ付勢プッシャ等の付勢手段の
圧力が増大すると、ステープラの曲がりや詰まりを引き
起こす。 つまり、次のステープルが、くさびのように先行ステー
プルの下に押し込まれ、その結果、供給機構において詰
まりが生ずることになる。
【発明の目的】
本発明は、以下に詳細に述べるように、上述のごとき問
題点に鑑み、新規な構造のステープラを提供するべく創
案されたものである。
【発明の要旨】
本発明に係る手術用ステープラは、好ましくは使捨て型
であって、フレームに固着されたステープル供給機構及
びステープル形成機構を備える。作動引き金は、ステー
プル供給機構及びステープル形成機構の何れにも連繋さ
れている。ステープル供給機構は、保有ステープルをス
テープル成形位置へと連続的に案内するレールおよびシ
ャトルを有している。該シャトルは、可動ステープル保
持カバーとしてレールと協働している。上記シャトル
は、上記ステープルの動きと一致した方向及び時間に作
動するように引き金と連繋している。この構造は、ステ
ープルがステープル供給機構を詰まらせたりしないよう
な信頼性のある手術用ステープラを提供する。本発明
は、ステープル全体について述べているが、本発明の重
要な特徴は、ステープル供給機構において摩擦力を避け
るために可動ステープル保持カバーすなわちシャトルを
設けることに存する。そのような摩擦力が生じれば、供
給機構内でステープルが詰まってしまう。そのような可
動シャトルは、以下に詳細に述べる実施例のステープラ
に適用できる。そして、また、レール上に保持されるス
テープルのラックに基づく供給機構を使用するほとんど
のステープラに適応できる。 以上、述べたように、手術用ステープラの中にステープ
ラのラックを供給するための困難さは、ステープルがカ
バーによりレール上に保有されている時の角度が増大す
れば、大きくなる。つまり、ステープルの脚とレールの
縦軸と垂直な平面により形成される角度がより大きくな
るとき、保持通路すなわちレール上に位置するステープ
ルの頂部及び固定カバー間の摩擦力は増大し、その結
果、45度の角度で40本のステープルのラックを供給機構
内で詰まることなく供給することが不可能となる。
【発明の効果】
本発明に係る手術用ステープラの可動カバーすなわちシ
ャトルは、この問題点を完全に克服する。つまり、シャ
トルは、該シャトルがレール上に進むとき、ステープル
と共に動くように連結されているため、ステープル頂部
とシャトル底面との間の摩擦がなくなるからである。
【実施例】
以下に本発明の手術用ステープラの好適一実施例につい
て添付の図面に従ってより詳細に述べる。 第１図は、本発明に係る手術用ステープラ20の一実施例
を示し、切開部11を縫合するためにステープル10を打ち
込んだ後の使用状態を示す。手術用ステープラ20は、フ
レーム21及び引き金22を有している。 第２図、第３図及び第４図は、引き動作又は復帰動作に
より、引き金22を一方向に動かせるための部材の配置を
示す。ステープルが詰まる、またはステープルが十分に
変形して打ち込まれる前にステープルが解放される結果
ステープラが故障してしまうのを防止するという点か
ら、引き金の一方向の移動のみを許容するということは
重要である。第２図で、引き金22はフレーム21に対して
十分に復帰した状態にあり、矢印は、引き金22を引く動
作の方向を示す。つめ23はピボットピン26により引き金
22に装着されている。そして、つめ状バネ25は、つめ23
の耳部のどちらか一方に接触しているとき、つめ23を付
勢するように位置決めされている。つめ状バネ25は、図
中、引き金22に一体成形された部材として示されている
が、引き金22とは別体の板バネとして構成し、これを引
き金22に枢着してもよい。つめ当て24は弾性材料からで
きていて、フレーム21の一部分として形成されたり、あ
るいはフレーム21に枢着される別体部材で構成される。
そして、第３図に示すように、つめ当て24は、引き金22
の引き動作中、つめ23が接触するような位置にある。引
き金22のこの引き動作中、つめ23の接触点は、該つめ23
の耳部に対するつめバネ25の付勢力によって弾性つめ当
て24に対して押し付けられる。つめ23は、つめ当て24と
接触する地点で１つの接触点を有するように図示されて
いるが、多数の接触点、例えば、鋸歯の形状を有してい
てもよい。引き金22の引き動作は、つめ当て24に対して
つめ23が接触していても、何等支障がない。第３図から
明らかなように、反対方向の動きは、つめ当て24の表面
につめ23が突っ込むことにより、阻止されるようになっ
ている。第４図に点線で示すように、引き金22が十分引
かれた位置に達するとき、つめ23は、つめ当て24の段部
に達し、引き金22の復帰動作のためにピボットピン26の
回りに回転する。そして、その間、つめ23は復帰動作が
終了するまで引き動作ができないように付勢される。 第５図は、引き金22が十分復帰した位置にあるときの、
ステープル供給アセンブリ及びステープル形成アセンブ
リの各部材の相対位置を示している。また、第６図は、
引き金22が十分引かれた位置にあるとき第５図と同様の
部材の相対位置を示している。図に示すように、フレー
ム21は、該フレーム21の一体部材として付勢バネ28を備
えているが、これは別体の板バネ、すなわち、フレーム
21に固着されるようなものを設けてもよい。第５図に示
すように、付勢バネ28は、可動アンビル29をステープル
10の通過路から外れるように付勢する。アンビル29は、
１つの平面を構成しておらず、２つの平面部を連結した
ような構成となっており、その連結点が支点を構成して
いる。第６図に示すように、引き金22が十分引かれた位
置に動くとき、ステープルを形成又は変形させるための
あご状部材31（以下、ステープル形成用あご状部材とい
う。）のカム表面30は、アンビル29の支点の回りに該ア
ンビル29を揺動させてアンビルの形成端をステープル通
過路に位置せしめる。引き金22が再び十分復帰した位置
に動いたとき（第５図）、ステープル形成用あご状部材
31上のカム面32は、可動アンビル29をステープル10の通
路から外すために揺動させる際、付勢バネ28を補助す
る。アンビル29内の窓32aは、該アンビル29がカム表面3
0の影響下にあるとき、カム面32と反対の位置にある。 フレーム21は解放窓43を有し、該窓43は、カバーブロッ
ク34上の帯部44と協働してカバーブロック34をフレーム
21内に組み付けるために、設けられている。フレーム21
は、カバーブロック34と類似した輪郭に合うような切り
欠き部45′をその先端に有しているとともに、可動アン
ビル29のための間隙を有している。フレーム21は、特
に、手術用ステープラ20が一回限りの使い捨て装置とし
て作られるときには、好ましくは、プラスチック、例え
ば、透明なあるいは着色したポリカーボネイトで成形さ
れるのが良い。 引き金22は、フレーム21内でピボットピン27の回りを回
転する。引き金22の突出部22aは、ステープル形成用あ
ご状部材31の頂部に接触しており、カバーブロック34内
の空間に位置する圧縮コイルバネが、引き金22を上方す
なわち引き下がった退避位置にステープル形成用あご状
部材31を付勢し、それにより、引き金22を十分復帰した
位置（第５図）に持っていく。 カバーブロック34は、ステープル供給機構及びステープ
ル形成・打ち込み機構を構成するための個々の部材を組
み立てるためのベースとなる。第5,6,11,12図に示すよ
うに、カバーブロック34は、ステープル形成用あご状部
材31及び形成アンビル29に合うような輪郭を有する。そ
して、上記ステープル形成用あご状部材31及び形成アン
ビル29の何れも、帯部44によって保持されている。ま
た、カバーブロック34は、ステープル形成用あご状部材
31及び引き金22を付勢するための圧縮コイルバネ33を収
納するための空間を備えている。ステープル形成用あご
状部材31のステープル変形脚47はステープル形成用あご
状部材の一部であり、引き金22の引き動作の最終段階に
おいて、形成アンビル29の回りでステープル10を押すよ
うに形成されている（第8,9図参照）。ステープル供給
機構は、シャトル38、プッシャ40、サドル状バネ41、レ
ール39及び底部材42から成り（第10,12図参照）、カバ
ーブロック34と連繋するように構成されている。レバー
状の片持ちバネ48は、アンビル29の形成端が移動する前
に、レール39の一部として第１ステープルを保持してい
る。カバーブロック34は、一体部として、ステープル・
ストリッパ・ブロック45を有し、該ブロック45は、形成
されたステープル10がステープラ20内に引込まれること
を防止する。 カバーブロック34は、一対の穴38′を備えている（第12
図参照）。該穴38′は、ピボットピン27のためのベアリ
ングとして機能し、引き金22はピボットピン27の回りを
回る。引き金22のハブ35はキー溝36を備えており、該キ
ー溝36はシャトル38の突出部37に嵌合するようになって
いる。引き金22の回転運動が、キー溝36及び突出部37を
介して、シャトル38の直線運動となる。引き金22の引き
動作の間、ハブ35は時針回り方向に回転し（第5,6図参
照）、その結果、キー溝36は突出部37及びシャトル38を
手術用ステープラ20の後方に動かす。ステープラの動作
サイクルのこの段階、つまり、引き金22の引き状態、に
おいて、アンビル29は、供給される次のステープル10の
通過路に向いて揺動し、それから、下方に移動していく
ステープル形成用あご状部材31が、ステープル10に接触
するとともに該ステープルをアンビル29の回りに形成す
る。これがステープルの打ち込みである。引き金22が引
き状態にある間、レール39上のステープル10は動かな
い。つまり、ステープル10はステープラ20の前方に進ま
ない。ステープル10のそのような前進は、引き金22が復
帰する間、すなわち、その開き動作のときのみ生じる。
つまり、ステープル形成用あご状部材31が十分に引っ込
んで、アンビル29をステープル通過路から外れるように
揺動して、打ち込み済みステープル10を解放した後に始
めて、ステープル10は前進する。このようにアンビル29
がステープルを解放すると、プッシャ40は、プッシャの
耳部46に連結さたサドル状バネ41の影響下でレール39上
をステープル10の太さと等しい間隔だけステープル10の
列を動かす。その結果、次のステープル10が形成・打ち
込み位置に来ることになる。この復帰、すなわち引き金
22の開き動作の間、ハブ35は、第5,6図に示すように、
時針回りに回り、その結果、キー溝36は突出部37及びシ
ャトル38を手術用ステープラ20の前方に動かす。それ
故、引き金22が復帰する間、すなわち引き金22が開いて
いる間、そしてステープル10がプッシャによりレール39
上に動いている間、シャトル38は絶えずステープル10と
同じ方向に動いている。このため、ステープル10の詰ま
り現象は少なくなる。というのは、ステープル10の頂部
とカバーメンバー、つまり、シャトル38間の摩擦が取り
除かれるためである。更に、シャトル38がプッシャ40と
協働する結果、ステープル10が均一に移動する。 フレーム21、引き金22、つめ当て24、カバーブロック3
4、プッシャ40及び底部材42は、特に、一回限りの使捨
て装置として使用されるときは、すべてプラスチック例
えば、透明なあるいは着色したポリカーボネイトで成形
される。しかしながら、圧縮コイルバネ33及びサドル状
バネ41だけでなく、つめ23、アンビル29、あご状部材3
1、シャトル38並びにレール39はステンレス鋼で形成さ
れるほうがよい。 一方、本発明に係る手術用ステープラは、最初の供給品
が使い果たされた後、ステープルを再装填することによ
って再使用できる装置とすることもできるが、好ましく
は、一回限りの使捨て装置として使用するほうがよい。
従って、詳細な説明で述べられたいくつかの部材は再装
填しないものとして設計されている。 必要ならば、上述の手術用ステープラは解体してステー
プルを再装填できるように改良することもできる。本発
明は、上記実施例に限定されるものではなく、その他種
々の態様で実施できる。例えば、本発明に係る手術用ス
テープラ20を使捨て装置とする場合、ピボットピン27が
フレーム21の両側部の何れも貫通する代わりに、引き金
22のハブ35と、フレーム21内に接着したカバーブロック
34の穴38′とで支持されるようにしてもよい。このステ
ープラを再使用する場合には、ピボットピン27は、フレ
ーム21の両側部を貫通して適当な手段で位置決めされ
る。従って、カバーブロック34のアセンブリはフレーム
に接着しなくてもフレーム21内に保持され、かつ、ステ
ープル10を新しく再装填するため取り外したり、あるい
は、カートリッジとして予め組み立てられているカバー
ブロック34のアセンブリと取り替えることもできる。
【図面の簡単な説明】
図面は本発明の一実施例を示し、第１図は本発明に係る
手術用ステープラの斜視図で、切開部を縫合するための
手術用ステープルを打ち込んだ後の使用位置にある手術
用ステープラを示す図、第２図はつめ及びつめ当ての配
置を示すための手術用ステープラの部分断面側面図、第
３図はステープラの部分図で、ステープルが生理組織内
に変形しながら打ち込まれている間、つまり、引き金が
引かれている間、のつめとつめ当ての状態を示す図、第
４図はステープラの部分図で、引き金が十分に引かれた
地点（点線で示す）で引き金が復帰状態にある間のつめ
及びつめ当ての状態を示す図、第５図はステープラの拡
大部分断面図で、引き金が十分に復帰した位置にあると
きの各部材の位置を示す図、第６図はステープラの拡大
部分断面図で、引き金が十分に引かれた位置にあるとき
の各部材の位置を示す図、第７図はステープル形成用あ
ご状部材、アンビル及びステープルの断面側面図で、ス
テープルが変形開始位置にあるときのこれら３つの部分
の関係を示す図、第８図は、第７図と同じ状態にあると
きのステープル形成用あご状部材、アンビル及びステー
プルの部分断面正面図、第９図はステープル形成用あご
状部材、アンビル及びステープルの正面図で、ステープ
ルの変形が終了したときのこれら３つの部材の関係を示
す図、第10図は、底部材、レール、ステープル、シャト
ル及びステープルプッシャの組み合わせを示す斜視図、
第11図は、アンビル、ステープル形成用あご状部材、圧
縮コイルバネ及びカバーブロックの関係を示す部分分解
斜視図、第12図はステープラのステープル案内・供給部
材の分解斜視図である。 10……ステープル、11……切開部、20……手術用ステー
プラ、21……フレーム、22……引き金、22a……突出
部、23……つめ、24……つめ当て、25……つめ状バネ、
26,27……ピボットピン、28……付勢バネ、29……可動
アンビル、30……カム面、31……ステープル形成用あご
状部材、32……カム面、32a……窓、33……圧縮コイル
バネ、34……カバーブロック、35……ハブ、36……キー
溝、37……突出部、38……シャトル、38′……穴、39…
…レール、40……プッシャ、41……サドル状バネ、42…
…底部材、43……窓、44……帯部、45……ブロック、4
5′……切り欠き部、46……耳部、47……ステープル変
形脚、48……片持ちバネ。

Claims (3)

    【特許請求の範囲】
  1. 【請求項１】打ち込み位置に手術用ステープルを配送す
    るステープル配送手段と、ステープルを打ち込み位置で
    生理組織保持形状に変形させるための変形手段を作動す
    るための作動手段とを備え、 上記ステープル配送手段は、ステープルの動きを案内す
    るレール及び該レールに沿ってステープルを動かす付勢
    手段並びにレール上にステープルを保持するための保持
    手段を有してなる手術用ステープラにおいて、 上記保持手段としてシャトルを備え、該シャトルは、上
    記レール上に上記ステープルを覆うカバーとして配置さ
    れるとともに上記作動手段に連結され、かつ、シャトル
    が、打ち込み位置の方に向けてステープルとともに動く
    一方、各ステープル打ち込み動作の作動間に開始位置に
    復帰するようにしたことを特徴とする手術用ステープ
    ラ。
  2. 【請求項２】ステープル供給機構並びにステープル形成
    機構を備えた手術用ステープラであって、 上記ステープル供給機構並びにステープル形成機構のど
    ちらもフレームに固着され、かつ、作動引き金が上記ス
    テープル供給機構並びに上記ステープル形成機構の何れ
    にも連繋され、 さらに、上記ステープル供給機構は、保有ステープルを
    上記ステープル形成機構に連続的に案内するレールと、
    可動ステープル保持カバーとして上記レールと協働した
    シャトルとを有し、 また、上記シャトルは上記ステープルの動きと一致した
    方向及び時間に作動するように上記引き金と連繋してい
    ることを特徴とする特許請求の範囲第１項記載の手術用
    ステープラ。
  3. 【請求項３】上記ステープル形成機構は、上記引き金と
    連繋する可動アンビルを有しており、 引き金が次のステープルを形成するために復帰すると
    き、該可動アンビルが揺動してステープルの通過路から
    外れることを特徴とする特許請求の範囲第２項記載の手
    術用ステープラ。
JP62057889A 1986-03-11 1987-03-11 手術用ステ−プラ Expired - Lifetime JPH07108295B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/838,504 US4662555A (en) 1986-03-11 1986-03-11 Surgical stapler
US838504 1986-03-11

Publications (2)

Publication Number Publication Date
JPS62243545A JPS62243545A (ja) 1987-10-24
JPH07108295B2 true JPH07108295B2 (ja) 1995-11-22

Family

ID=25277255

Family Applications (1)

Application Number Title Priority Date Filing Date
JP62057889A Expired - Lifetime JPH07108295B2 (ja) 1986-03-11 1987-03-11 手術用ステ−プラ

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Country Link
US (1) US4662555A (ja)
EP (1) EP0240722B1 (ja)
JP (1) JPH07108295B2 (ja)
AT (1) ATE79525T1 (ja)
AU (1) AU604229B2 (ja)
BR (1) BR8701092A (ja)
CA (1) CA1275220C (ja)
DE (1) DE3781183T2 (ja)
ES (1) ES2033705T3 (ja)
GR (1) GR3006244T3 (ja)

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DE3781183T2 (de) 1993-01-14
ES2033705T3 (es) 1993-04-01
AU604229B2 (en) 1990-12-13
DE3781183D1 (de) 1992-09-24
BR8701092A (pt) 1988-09-20
ATE79525T1 (de) 1992-09-15
AU6980287A (en) 1987-09-17
US4662555A (en) 1987-05-05
EP0240722B1 (en) 1992-08-19
JPS62243545A (ja) 1987-10-24
EP0240722A1 (en) 1987-10-14
CA1275220C (en) 1990-10-16

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