JPH07404A - 受け器なし外科用フアスナー - Google Patents

受け器なし外科用フアスナー

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Publication number
JPH07404A
JPH07404A JP6034282A JP3428294A JPH07404A JP H07404 A JPH07404 A JP H07404A JP 6034282 A JP6034282 A JP 6034282A JP 3428294 A JP3428294 A JP 3428294A JP H07404 A JPH07404 A JP H07404A
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JP
Japan
Prior art keywords
tines
fastener
surgical fastener
end parts
surgical
Prior art date
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Pending
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JP6034282A
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English (en)
Inventor
Michael F Bregen
マイケル・エフ・ブレジエン
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Ethicon Inc
Original Assignee
Ethicon Inc
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Publication date
Application filed by Ethicon Inc filed Critical Ethicon Inc
Publication of JPH07404A publication Critical patent/JPH07404A/ja
Pending legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S411/00—Expanded, threaded, driven, headed, tool-deformed, or locked-threaded fastener
    • Y10S411/904—Fastener or fastener element composed of nonmetallic material
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S411/00—Expanded, threaded, driven, headed, tool-deformed, or locked-threaded fastener
    • Y10S411/92—Staple

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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)
  • Materials For Medical Uses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Slide Fasteners, Snap Fasteners, And Hook Fasteners (AREA)
  • Sheet Holders (AREA)

Abstract

(57)【要約】 【目的】 組織に確実に締結する。 【構成】 自動閉鎖する受け器なし外科用ファスナー
が、ブリッジ部材と、ブリッジ部材の対向側から延びて
いる少なくとも２つの尖叉とを具備する。尖叉は、尖叉
の遠位端部が相互の方を指す正常閉位置から尖叉の遠位
端部が組織に貫入するために相互にほぼ平行になる開位
置まで弾性変形可能である。尖叉は、尖叉の遠位端部が
ファスナー本体を組織に固定するために相互の方を指す
閉位置に弾力的に復帰することができる。

Description

【発明の詳細な説明】
【０００１】
【産業上の利用分野】本発明は、外科用ファスナーに関
し、さらに詳細には、内部身体組織へヘルニアパッチを
固定するために適合される生体適合性又は生体吸収性材
料の外科用ファスナーに関する。
【０００２】
【従来技術及びその課題】外科用ファスナー又はステー
プルが、外科用手順において一般に使用され、外科医は
時間消費する縫合手順の必要性なしに、身体組織を締結
することができる。外科用ファスナーは、一度に一つの
ファスナーを据え付け、又は順次あるいは同時に複数の
ファスナーを適用するために動作する外科用ステープラ
を使用することにより、身体組織に適用される。ステー
プラは、一般に、ファスナーが組織内に駆動されるファ
スナーカートリッジを含む。
【０００３】２部分外科用ファスナー装置が今までに公
知である。そのような装置は、一対の歯叉を具える一般
にＵ形状の構成のファスナー部材又はステープルと、歯
叉が係合掛止される孔を設けた受け器部材とを含む。フ
ァスナー歯叉は、一方の側から身体組織を刺通し、そし
て受け器部材は、組織の他方の側において歯叉を掛止す
る。外科用ファスナーは、いったん係止されると、分離
できず、その結果、身体組織内に挿入された後、ファス
ナーは容易に除去できない。従って、２部分外科用ファ
スナーは、通常、身体組織に吸収される生体吸収性材料
から成る。
【０００４】過去において、ヘルニア修復手順が、伸長
切開が修復される内部身体組織への接近のために身体壁
に為される開放手術によって行われてきた。そのような
開放手術は、患者にとって外傷性であり、そして長い回
復期間が切開の治癒のために必要とされる。一般に、ヘ
ルニア修復が、従来の縫合術によって行われる。ヘルニ
ア修復パッチは、使用されるならば、パッチの縁に沿っ
て適用された縫合によって、内部身体組織に固定され
る。
【０００５】最近では、内視鏡器械及び技術が、ヘルニ
ア修復を含む、内部身体組織において手術を行うために
開発された。そのような手順は、身体壁における小切開
に内視鏡管を据え付け、所望の手術を行うために内視鏡
管に外科用器械を挿入することにより行われる。内視鏡
手順は、患者に外傷性ではなく、そして開放手術と比較
して回復期間は短縮される。
【０００６】内視鏡手術によりヘルニア修復を行う際
に、内部身体組織を確実に一緒に保持することができる
外科用ファスナー又はステープルを使用することができ
る。また、ヘルニアパッチが据え付けられるならば、外
科用ファスナー又はステープルは、ヘルニアパッチを内
部身体組織に確実に締結することができなければならな
い。ヘルニア修復手順のために今まで使用された内視鏡
器械は、金属、例えば、チタン又はステンレス鋼製の外
科用ファスナー又はステープルを使用した。これらの器
械は、一般に、開位置から手術部位における組織に貫入
する閉位置に外科用ファスナーを形成するステープル形
成機構を含む。
【０００７】ヘルニア修復のために今まで使用された金
属ファスナー又はステープルは、患者内部に永久的に残
存し、内部身体組織によって吸収されない。そのような
金属ファスナー又はステープルは、Ｘ線に不透過性であ
り、患者のＸ線写真に現れる。こうして、ファスナー又
はステープルは究極的に身体組織に吸収され、患者のＸ
線写真に干渉しないために、ヘルニア修復のために生体
吸収性材料の外科用ファスナー又はステープルを使用す
ることが望ましい。以前の生体吸収性材料の２部分外科
用ファスナーは、修復される組織の両側へ接近すること
が難しいために、ヘルニア修復のために適切にならない
傾向がある。従って、生体吸収性材料の受け器なしファ
スナーが、内部身体組織におけるヘルニア修復と他の外
科用手順のために非常に望ましい。また、ファスナーを
内部身体組織を固定するための形成機構を具える外科用
器械を使用する必要を回避する自動閉鎖する受け器なし
ファスナーを設けることが都合が良い。
【０００８】従って、内部身体組織におけるヘルニア修
復と他の外科用手順のために使用される生体適合性又は
生体吸収性材料の外科用ファスナーを提供することが、
本発明の目的である。
【０００９】また、内部身体組織においてヘルニア修復
又は他の手術を行うために、内視鏡手順における使用の
ために適する生体適合性又は生体吸収性材料の受け器な
し外科用ファスナーを提供することが、発明の目的であ
る。
【００１０】発明の別の目的は、ヘルニアパッチを内部
身体組織に確実に締結することができる生体適合性又は
生体吸収性材料の受け器なし外科用ファスナーを提供す
ることである。
【００１１】自動閉鎖し、ステープル形成機構の必要性
なしに、内視鏡器械により内部身体組織に適用される弾
性の生体適合性又は生体吸収性材料の受け器なし外科用
ファスナー又はステープルを提供することが、発明の別
の目的である。
【００１２】発明の一層の目的は、単一外科用ファスナ
ー又は一連の外科用ファスナーを順次に身体組織に送り
出し適用することができるアプリケータにより、内部身
体組織に適用される受け器なし外科用ファスナーを提供
することである。
【００１３】
【課題を解決するための手段】本発明により、外科用フ
ァスナーは、ブリッジ部材と、ブリッジ部材の対向端部
から延びている少なくとも２つの尖叉とを具備し、尖叉
は、各々、組織に貫入するための遠位端部を有し、尖叉
は、尖叉の遠位端部が相互の方を指す正常閉位置から尖
叉の遠位端部が組織に貫入するために相互にほぼ平行に
なる開位置まで弾性変形可能であり、そして尖叉は、尖
叉の遠位端部がファスナー本体を組織に固定するため
に、相互の方を指す閉位置に弾力的に戻ることができ
る。
【００１４】好ましくは、尖叉の各々は、通常尖叉の遠
位端部を相互の方を指して維持する弾性ヒンジ状区分を
有する。弾性ヒンジ状区分により、尖叉の遠位端部は相
互の方を指す閉位置から相互にほぼ平行な開位置に旋回
することができる。
【００１５】発明の別の見地により、外科用ファスナー
は、ブリッジ部材と、ブリッジ部材の対向端部から同一
方向に延びている少なくとも２つの尖叉とを含むファス
ナー本体を具備し、尖叉は、ブリッジ部材から相互にほ
ぼ平行な近位部分と、近位部分から横方向に相互の方を
指している遠位部分とを含み、尖叉の遠位部分は、相互
にほぼ平行な定位まで、圧力に応答して可動であり、そ
して尖叉の遠位部分は、圧力が解放された時、相互の方
を指す横定位まで弾力的に戻り可能である。好ましく
は、ファスナー本体は、生体適合性又は生体吸収性であ
る弾性材料から成る。 外科用ファスナーの好ましい実
施態様において、ブリッジ部材は、湾曲形状であり、尖
叉の近位端部の間を架橋する。ブリッジ部材は、尖叉の
間でアクチュエータを滑り可能に収容し圧力を加えて尖
叉の遠位端部を旋回させるために、尖叉と比較して、縮
小された厚さである。代替的に、一対のブリッジ部材
が、併置され、圧力を加えて尖叉の遠位端部を旋回させ
るために、アクチュエータを滑り可能に収容するために
離間される。
【００１６】前述と他の目的、見地と利点は、図面を参
照して、発明の好ましい実施態様の次の詳細な説明から
より良く理解されるであろう。
【００１７】
【実施例】図１を参照すると、本発明が、一般に５０の
外科用ファスナーにおいて具現され、ブリッジ部材５２
と、ブリッジ部材５２の対向端部から同一方向に延びて
いる一対の尖叉５４とを含むファスナー本体５１を具備
する。尖叉（ｔｉｎｅ）５４は、ブリッジ部材５２から
相互にほぼ平行な近位端部５６と、近位端部５６から横
方向に相互の方を指す遠位端部５８とを含む。各尖叉５
４の遠位部分５８は、先鋭な組織貫入点６２において終
端する傾斜表面６０を有する。各尖叉５４は、尖叉５４
の遠位部分５８に近位部分５６を連結する弾性のヒンジ
状かど区分６４を有する。 図１〜図４の外科用ファス
ナー５０において、ファスナー本体５１の材料の弾力性
は、尖叉５４の所望のヒンジ状作用を設ける。ファスナ
ー材料は、組織の貫入のために相互にほぼ平行な定位
に、尖叉５４の内側における圧力に応答して、尖叉５４
の遠位部分５８を移動させるために十分に弾力性であ
る。ヒンジ状区分６４は、圧力が解放された時、尖叉５
４の遠位部分５８を、相互の方を指す横定位（図２）ま
で弾性的に復帰させる。
【００１８】図２に示された如く、尖叉５４は、尖叉５
４の遠位端部５８が相互の方を指す正常閉位置から、尖
叉５４の遠位端部５８が組織に貫入するために相互にほ
ぼ平行な開位置まで弾性変形可能である。尖叉５４は、
ファスナー本体５１を組織に固定するために、尖叉５４
の遠位端部５８が相互の方を指す閉位置まで弾性的に復
帰される。こうして、外科用ファスナー５０は、弾性フ
ァスナー材料がその原形状に復帰する傾向のために自動
閉鎖する。
【００１９】ファスナー５０の好ましい実施態様におい
て、ファスナー本体５１は、生体適合性又は生体吸収性
の弾性材料から成る。ここで考えられたように、生体適
合性とは、身体組織に外傷又は有害な影響なしに、人体
の内部に残ることができるファスナー材料を言及する。
生体適合性材料は、身体組織により吸収性又は非吸収性
である。非吸収性ファスナー材料が使用されるならば、
外科用ファスナーは、身体組織に永久的に移植されてい
る。生体吸収性とは、生体適合性であり、身体組織に次
第に吸収され、その結果、外科用ファスナーが究極的に
消失するファスナー材料を言及する。生体吸収性ファス
ナー材料の例としては、限定されるものではないが、ポ
リジオキシドン、ポリグリコール酸、ポリラクチドグリ
コロイド、及びポリグラクチン９１０の如く、吸収性ポ
リマー又はコポリマーがある。さらに、十分な強度及び
弾性の生体適合性又は生体吸収性材料が、ここで開示さ
れた外科用ファスナーのための材料として使用されるこ
とが考えられる。
【００２０】好ましくは、ブリッジ部材５２は、尖叉５
４と比較して、縮小された厚さである。図３と図４に示
された如く、各尖叉５４は、矩形断面を有し、そしてブ
リッジ部材５２の厚さは、各尖叉５４の厚さの約半分で
ある。ブリッジ部材５２は、下記のアプリケータを収容
するために尖叉５４の間に位置する浅い溝７０を設ける
ために、尖叉５４の前面６８から凹状にされた平坦前面
６６を有する。ブリッジ部材５２は、尖叉５４の後面７
４と同一面の平坦後面７２を有する。
【００２１】図１と図２に示された如く、ブリッジ部材
５２は、尖叉５４の近位部分５６の内側に対して対向端
部において連結してある。ブリッジ部材５２の中央部分
は、上方、すなわち、近位方向に湾曲され、ブリッジ部
材５２において下方凹状縁７６と上方凸状縁７８を設け
ている。
【００２２】代替的に、図５と図６に示された如く、外
科用ファスナー５０は、下記のアプリケータを収容する
ための溝７０′を設けるために併置かつ離間された前方
及び後方ブリッジ部材５２′と５２″をそれぞれ含む。
前方ブリッジ部材５２″は、尖叉５４の前面６８と同一
面の平坦前面６６′を有する。後方ブリッジ部材５２″
は、尖叉５４の後面７４と同一面の平坦後面７２″を有
する。
【００２３】図１と図２に示された如く、外科用ファス
ナー５０は、通常、尖叉５４の遠位部分５８が相互の方
を指す閉位置を取る。尖叉５４の間に挿入されたアクチ
ュエータによって加えられた圧力に応答して、遠位部分
５８は、図２の仮線によって示されたヒンジ状かど区分
６４の回りで、身体組織への挿入のために遠位部分５８
が相互にほぼ平行な定位にある開位置に旋回される。圧
力が解放される時、尖叉５４の遠位部分５８は、外科用
ファスナー５０を身体組織に固定するために閉位置に復
帰する。
【００２４】図７と図８を参照すると、外科用ファスナ
ー５０の修正実施態様において、湾曲又は三日月形状開
口８０が各尖叉５４のヒンジ状区分６４において形成し
てある。好ましくは、開口８０は、前方から後方に尖叉
５４を完全に貫通している。三日月形状開口８０は、ヒ
ンジ状区分６４の弾力性を高め、尖叉５４の遠位部分５
８がたわんで開き、身体組織に挿入された後に、外科用
ファスナー５０が閉位置に復帰する能力を高める。
【００２５】図９と図１０を参照すると、本発明はま
た、一対の尖叉１０４がブリッジ部材１０２の対向端部
から同一方向に延びている湾曲ブリッジ部材１０２を含
む、弾性の生体適合性又は生体吸収性材料のファスナー
本体１０１を具備する外科用ファスナー１００において
具現される。尖叉１０４は、ブリッジ部材１０２から相
互にほぼ平行な近位部分１０６と、近位部分１０６から
横方向に相互の方を指す遠位部分１０８とを含む。尖叉
１０４の各遠位部分１０８は、先鋭な組織貫入点１１２
において終端する傾斜表面１１０を有する。各尖叉１０
４は、尖叉１０４の遠位部分１０８に近位部分１０６を
連結する弾性ヒンジ状区分１１４を含む。尖叉１０４の
各遠位部分１０８は、ヒンジ状区分１１４を規定するノ
ッチを設けるために部分的に切欠きにされる。
【００２６】図９に示された如く、タブ１１８が、ヒン
ジ状区分１１４に隣接して各遠位部分１０８において形
成される。タブ１１８は、尖叉１０４の遠位部分１０８
が外科用ファスナー１００の閉位置において相互の方を
指している時、側方外側に突出する。図１０に示された
如く、圧力が加えられて尖叉１０４の遠位部分１０８を
ほぼ平行な定位に旋回させる時、タブ１１８は、尖叉１
０４の側部に形成されたノッチ１１６において収容され
る。また、外科用ファスナー１００が内視鏡管に挿入さ
れる時、タブ１１８は内視鏡管の内壁によって内側に押
され、尖叉１０４の遠位部分１０８を身体組織への貫入
のために開かせる。外科用ファスナー１００が身体組織
に固定され、閉位置に戻された後、側方に突出するタブ
１１８は、一方針として作用し、遠位部分１０８を内側
に押しやり、確実な閉鎖を設ける。
【００２７】図１１と図１２を参照すると、本発明はま
た、ブリッジ部材１５２と、ブリッジ部材１５２の対向
端部から同一方向に延びている一対の尖叉１５４とを含
む、弾性の生体適合性又は生体吸収性材料のファスナー
本体１５１を具備する外科用ファスナー１５０において
具現される。尖叉１５４は、ブリッジ部材１５２から相
互にほぼ平行な近位部分１５６と、近位部分１５６から
延びていて相互と内側のブリッジ部材１５２の方を指す
遠位部分１５８とを含む。尖叉１５６の各遠位部分１５
８は、先鋭な組織貫入点１６２において終端する傾斜表
面１６０を有する。各尖叉１５４は、尖叉１５４の遠位
部分１５８に近位部分１５６を連結する弾性ヒンジ状か
ど区分１６４を有する。
【００２８】図１１に示された如く、外科用ファスナー
１５０は、通常、尖叉１５４の遠位部分１５８が相互の
方を指し、組織貫入点１６２がブリッジ部材１５２の上
方凸状縁又は冠部１７８に係合する閉位置を取る。尖叉
１５４の間に挿入されたアクチュエータによって加えら
れた圧力に応答して、遠位部分１５８は、ヒンジ状区分
１６４の回りで、身体組織への挿入のために相互にほぼ
平行な定位（図１２）に旋回される。圧力が解放される
時、尖叉１５４の遠位部分１５８は、外科用ファスナー
１５０を身体組織に固定するために閉位置に復帰する。
【００２９】図１３と図１４を参照すると、外科用ファ
スナーを身体組織に適用するための一般に２００のアプ
リケータが、伸長溝形状押し部材２０２と相互に関して
縦方向に滑り可能な伸長平坦舌状物２０４とを具備す
る。図１４に示された如く、舌状物２０４は、押し部材
２０２の対向側に沿って縦方向の一対のフランジ２０６
の間にあり継ぎ様式に滑り可能に収容された台形断面を
有する。
【００３０】図１５に示された如く、アプリケータ２０
０に外科用ファスナー５０の一つを取り付けるために、
舌状物２０４が、押し部材２０２の遠位端部を越えて延
ばされ、舌状物２０４の遠位端部は、尖叉５４の間の浅
い溝７０に挿入され、尖叉５４の遠位部分５８を相互に
ほぼ平行な定位にある開位置に旋回させる。舌状物２０
４は、組織貫入点６２が相互に平行に方向付けられた開
位置において外科用ファスナー５０を維持する。アプリ
ケータ２００の遠位端部は、外科用ファスナー５０が固
定された身体組織２１０の区分に隣接して位置付けられ
る。それから、図１６に示された如く、押し部材２０２
は、舌状物２０４に関して遠位に移動され、尖叉５４の
近位部分５６に係合し、外科用ファスナー５０を舌状物
２０４から遠位に押し離す。外科用ファスナー５０が遠
位方向に押される時、組織貫入先端６２は、身体組織２
１０に貫入する。また、尖叉５４の遠位部分５８が舌状
物２０４から解き放される時、遠位部分５８は、相互の
方を指す閉位置に戻る。結果として、外科用ファスナー
５０は、尖叉５４の遠位部分５８により身体組織２１０
に固定される。
【００３１】図５と図６に示された外科用ファスナー５
０の実施態様に関して、アプリケータ２００の舌状物２
０４は、ブリッジ部材５２′と５２″の間に位置する溝
７０′に挿入され、圧力を加えて尖叉５４の遠位部分５
８を相互にほぼ平行な定位にある開位置に旋回させるこ
とができる。それから、押し部材２０２は、舌状物２０
４に関して遠位に移動され、尖叉５４の遠位部分５６に
係合し、外科用ファスナー５０を舌状物２０４から遠位
に押し離す。外科用ファスナー５０が遠位方向に押され
る時、組織貫入先端６２は、身体組織２１０に貫入す
る。また、尖叉５４の遠位部分５８が舌状物２０４から
解き放される時、遠位部分５８は、相互の方を指す閉位
置に戻り、ファスナー５０を身体組織２１０に固定す
る。
【００３２】図１７と図１８を参照すると、本発明の複
数の外科用ファスナーが、ヘルニアパッチ２２０を身体
組織２１０に締結するために、アプリケータ２００によ
って順次に適用される。好ましくは、外科用ファスナー
は、ヘルニアパッチ２２０の縁に沿って適用される。
【００３３】図１７に示された如く、一連の外科用ファ
スナー５０が、内視鏡管２１２に挿入されるアプリケー
タ２００の舌状物２０４の遠位端部に沿って端部を合わ
せて取り付けてある。アプリケータ２００と内視鏡管２
１２は、最前ステープル５０をヘルニアパッチ２２０の
縁と整合させするように、所望の手術部位において位置
付けられる。それから、図１８に示された如く、押し器
２０２は、最前ステープル５０を舌状物２０４に沿って
遠位方向に押すために進められる。最前ステープル５０
は、舌状物２０４から解き放され、そして尖叉５４の遠
位部分５８は、ヘルニアパッチ２２０の縁を身体組織２
１０に固定するために、閉位置に復帰する。その後、ア
プリケータ２１０と内視鏡管２１２は、ヘルニアパッチ
２２０の縁に沿って異なる位置に移動され、ここで、次
の外科用ファスナー５０を身体組織２１０に固定するた
めに、アプリケータ２００の動作が繰り返される。
【００３４】同様に、アプリケータ２００は、図７と図
８に示された外科用ファスナー５０の修正実施態様を適
用するために使用される。さらに、アプリケータ２００
は、図９〜図１０の外科用ファスナー１００と図１１〜
図１２の外科用ファスナー１５０を適用するために使用
される。
【００３５】広い見地において発明は、示され記載され
た好ましい実施態様の特定の詳細に限定されず、技術に
おける当業者は、発明が添付のクレイムの精神と範囲内
の修正により実施されることを認識するものである。
【００３６】本発明の主なる特徴及び態様は以下のとお
りである。
【００３７】１．ブリッジ部材と、該ブリッジ部材の両
側から延びている少なくとも２つの尖叉とを含み、該尖
叉は、各々、組織に貫入するための遠位端部を有する外
科用ファスナーであって、該尖叉は、該尖叉の該遠位端
部が相互の方を指す正常閉位置から該尖叉の該遠位端部
が組織に貫入するために相互にほぼ平行になる開位置ま
で弾性変形可能であり、該尖叉は、該尖叉の該遠位端部
が該ファスナー本体を組織に固定するために相互の方を
指す該閉位置に弾力的に復帰することができる外科用フ
ァスナー。
【００３８】２．該ファスナー本体が弾性材料から成る
上記１に記載の外科用ファスナー。 ３．該ファスナー本体が生体適合性材料から成る上記１
に記載の外科用ファスナー。
【００３９】４．該ファスナー本体が、生体吸収性材料
から成る上記１に記載の外科用ファスナー。
【００４０】５．該尖叉の各々が、通常該尖叉の該遠位
端部を相互の方に指して維持する弾力的なヒンジ状区分
を有する上記１に記載の外科用ファスナー。
【００４１】６．該弾性ヒンジ状区分が、該尖叉の該遠
位端部を、相互の方を指す閉位置から相互にほぼ平行な
開位置まで旋回させることを許容する上記５に記載の外
科用ファスナー。
【００４２】７．各尖叉が、該尖叉の該遠位端部が相互
の方を指している時、側方外側に突出する該ヒンジ状区
分に隣接するタブを有する上記５に記載の外科用ファス
ナー。
【００４３】８．各尖叉の部分が、該尖叉の弾力性を高
めるために、該ヒンジ状区分に隣接して除去される上記
５に記載の外科用ファスナー。
【００４４】９．該ブリッジ部材が湾曲形状であり、該
尖叉の近位端部の間を架橋する上記１に記載の外科用フ
ァスナー。
【００４５】１０．該ブリッジ部材が、該尖叉の間にア
クチェータを滑り可能に収容し圧力を加えて該尖叉の該
遠位端部を旋回させるために、該尖叉と比較して厚さが
縮小される上記１に記載の外科用ファスナー。
【００４６】１１．該ブリッジ部材が、アクチェータを
滑り可能に収容し圧力を加えて該尖叉の該遠位端部を旋
回させるために併置かつ離間された一対のブリッジ部材
を具備する上記１に記載の外科用ファスナー。
【００４７】１２．ブリッジ部材と、該ブリッジ部材の
両端部から同一方向に延びている少なくとも２つの尖叉
とを含むファスナー本体を具備する外科用ファスナーで
あって、該尖叉は、該ブリッジ部材から相互にほぼ平行
な近位部分と、該近位部分から横方向に相互の方を指し
ている遠位部分とを含み、該尖叉の該遠位部分は、相互
にほぼ平行な定位まで、圧力に応答して可動であり、そ
して該尖叉の該遠位部分は、該圧力が解放された時、相
互の方を指す横定位まで弾力的に復帰可能である外科用
ファスナー。
【００４８】１３．該ファスナー本体が弾性材料から成
る上記１２に記載の外科用ファスナー。
【００４９】１４．該ファスナー本体が生体適合性材料
から成る上記１２に記載の外科用ファスナー。
【００５０】１５．該ファスナー本体が生体吸収性材料
から成る上記１２に記載の外科用ファスナー。
【００５１】１６．該尖叉の各々が、通常該尖叉の該遠
位端部を相互の方を指して維持する弾性ヒンジ状区分を
有する上記１２に記載の外科用ファスナー。
【００５２】１７．該弾性ヒンジ状区分が、該尖叉の該
遠位端部を、相互の方を指す閉位置から相互にほぼ平行
な開位置に旋回させることを許容する上記１６に記載の
外科用ファスナー。
【００５３】１８．各尖叉が、該尖叉の該遠位端部が相
互の方を指している時、側方外側に突出する該ヒンジ状
区分に隣接してタブを有する上記１６に記載の外科用フ
ァスナー。
【００５４】１９．各尖叉の部分が、該尖叉の弾力性を
高めるために該ヒンジ状区分に隣接して除去される上記
１６に記載の外科用ファスナー。
【００５５】２０．該ブリッジ部材が湾曲形状であり、
該尖叉の近位端部の間を架橋する上記１２に記載の外科
用ファスナー。
【００５６】２１．該ブリッジ部材が、該尖叉の間のア
クチェータを滑り可能に収容し圧力を加えて該尖叉の該
遠位端部を旋回させるために、該尖叉と比較して厚さが
縮小される上記１２に記載の外科用ファスナー。
【００５７】２２．該ブリッジ部材が、アクチェータを
滑り可能に収容し圧力を加えて該尖叉の該遠位端部を旋
回させるために併置かつ離間された一対のブリッジ部材
を具備する上記１２に記載の外科用ファスナー。
【図面の簡単な説明】
【図１】本発明により構成された外科用ファスナーの斜
視図である。
【図２】図１の外科用ファスナーの前正面図である。
【図３】図１の外科用ファスナーの頂面図である。
【図４】図１の外科用ファスナーの底面図である。
【図５】図１の外科用ファスナーの修正実施態様の頂面
図である。
【図６】図５の外科用ファスナーの底面図である。
【図７】閉位置における外科用ファスナーの別の実施態
様の前正面図である。
【図８】開位置における図７の外科用ファスナーの前正
面図である。
【図９】閉位置における外科用ファスナーの別の実施態
様の前正面図である。
【図１０】開位置における図９の外科用ファスナーの前
正面図である。
【図１１】閉位置における外科用ファスナーの別の実施
態様の前正面図である。
【図１２】開位置における図１１の外科用ファスナーの
前正面図である。
【図１３】本発明の外科用ファスナーを据え付けるため
に使用されたアプリケータの斜視図である。
【図１４】図１３のアプリケータの遠位端面図である。
【図１５】アプリケータの遠位端部に取り付けた開位置
における図１の外科用ファスナーを示す。
【図１６】ファスナーがアプリケータの遠位端部から変
位された時、閉位置における図１の外科用ファスナーを
示す。
【図１７】ヘルニアパッチを身体組織に固定するため
に、内視鏡管に挿入されたアプリケータに取り付けた一
連の外科用ファスナーを示す部分切欠き側面図である。
【図１８】ヘルニアパッチを身体組織に固定するため
に、最前外科用ファスナーを変位させる図１７のアプリ
ケータの動作を示す部分切欠き側面図である。
【符号の説明】
５０ 外科用ファスナー ５１ ファスナー本体 ５２ ブリッジ部材 ５４ 尖叉

Claims (2)

    【特許請求の範囲】
  1. 【請求項１】 ブリッジ部材と、該ブリッジ部材の両側
    から延びている少なくとも２つの尖叉とを含み、該尖叉
    は、各々、組織に貫入するための遠位端部を有する外科
    用ファスナーであって、該尖叉は、該尖叉の該遠位端部
    が相互の方を指す正常閉位置から該尖叉の該遠位端部が
    組織に貫入するために相互にほぼ平行になる開位置まで
    弾性変形可能であり、該尖叉は、該尖叉の該遠位端部が
    該ファスナー本体を組織に固定するために相互の方を指
    す該閉位置に弾力的に復帰することができる外科用ファ
    スナー。
  2. 【請求項２】 ブリッジ部材と、該ブリッジ部材の両端
    部から同一方向に延びている少なくとも２つの尖叉とを
    含むファスナー本体を具備する外科用ファスナーであっ
    て、該尖叉は、該ブリッジ部材から相互にほぼ平行な近
    位部分と、該近位部分から横方向に相互の方を指してい
    る遠位部分とを含み、該尖叉の該遠位部分は、相互にほ
    ぼ平行な定位まで、圧力に応答して可動であり、そして
    該尖叉の該遠位部分は、該圧力が解放された時、相互の
    方を指す横定位まで弾力的に復帰可能である外科用ファ
    スナー。
JP6034282A 1993-02-09 1994-02-08 受け器なし外科用フアスナー Pending JPH07404A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US015707 1993-02-09
US08/015,707 US5304204A (en) 1993-02-09 1993-02-09 Receiverless surgical fasteners

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EP0611132B1 (en) 1997-01-08
DE69401364T2 (de) 1997-05-28
GR940100053A (el) 1994-10-31
CA2115131A1 (en) 1994-08-10
DE69401364D1 (de) 1997-02-20
EP0611132A1 (en) 1994-08-17
ES2096408T3 (es) 1997-03-01
AU668452B2 (en) 1996-05-02
ATE147248T1 (de) 1997-01-15
US5304204A (en) 1994-04-19
CA2115131C (en) 2004-06-22
AU5503794A (en) 1994-08-11

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