JPS62117543A - 外科用留め具付け装置 - Google Patents
外科用留め具付け装置Info
- Publication number
- JPS62117543A JPS62117543A JP61241891A JP24189186A JPS62117543A JP S62117543 A JPS62117543 A JP S62117543A JP 61241891 A JP61241891 A JP 61241891A JP 24189186 A JP24189186 A JP 24189186A JP S62117543 A JPS62117543 A JP S62117543A
- Authority
- JP
- Japan
- Prior art keywords
- tissue
- fasteners
- fastener
- control member
- row
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 239000002184 metal Substances 0.000 description 7
- 210000004204 blood vessel Anatomy 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 238000001467 acupuncture Methods 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000001125 extrusion Methods 0.000 description 1
- 210000000744 eyelid Anatomy 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
Classifications
-
- 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
- A61B17/068—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
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Accommodation For Nursing Or Treatment Tables (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。
め要約のデータは記録されません。
Description
【発明の詳細な説明】
〔産業上の利用分野〕
本発明はりi科用留め具イ(1け装置に関し、より詳し
くは、装置の留め具保持部品とアンビル部品との間でク
ランプされた身体の組織に、実質的に長さ方向に整列し
た複数個の外科用留め具を付:jるための装置に関する
。
くは、装置の留め具保持部品とアンビル部品との間でク
ランプされた身体の組織に、実質的に長さ方向に整列し
た複数個の外科用留め具を付:jるための装置に関する
。
装置の留め具保持部品とアンビル部品との間でクランプ
された身体の組織に、長さ方向に整列しまた複数の外科
用留め具を付けるためのい<−)かのタイプの外科用留
め具材は装置が開発された。例えばヒルシュ等の米国特
許第3.275.211号は、ホチキス針保持カートリ
ッジとアンビルとの間でクランプされた身体の組織に、
平行な2列の金属製外科用ホチキス針を付けるための装
置を示しており、このアンビルは、ホチキス針がカート
リッジから押し出されて組織に途中まで突き刺されたJ
きホチキス針を折り曲げる。グリーンの米国特許第4.
506.671号は、金属製外科用ホチキス針の代わり
に2つの部品からなる樹脂製留め具を用いた類似のタイ
プの器具を示してる。2つの部品からなる留め具の各々
は、留め異部品と保持器部品とを有する。留め異部品は
、駆動されて組織を通して分離し、従って留め異部品の
プロングの端が、装置のアンビル部品内に解放自在に保
持された保持器部品と噛み合う。
された身体の組織に、長さ方向に整列しまた複数の外科
用留め具を付けるためのい<−)かのタイプの外科用留
め具材は装置が開発された。例えばヒルシュ等の米国特
許第3.275.211号は、ホチキス針保持カートリ
ッジとアンビルとの間でクランプされた身体の組織に、
平行な2列の金属製外科用ホチキス針を付けるための装
置を示しており、このアンビルは、ホチキス針がカート
リッジから押し出されて組織に途中まで突き刺されたJ
きホチキス針を折り曲げる。グリーンの米国特許第4.
506.671号は、金属製外科用ホチキス針の代わり
に2つの部品からなる樹脂製留め具を用いた類似のタイ
プの器具を示してる。2つの部品からなる留め具の各々
は、留め異部品と保持器部品とを有する。留め異部品は
、駆動されて組織を通して分離し、従って留め異部品の
プロングの端が、装置のアンビル部品内に解放自在に保
持された保持器部品と噛み合う。
本明細書において用いる“留め具”という用語は、金属
製ホチキス針、2つの部品からなる樹脂製ホチキス、及
びその類似物を包括するものである。同様に、“留め具
保持部品”という用語は、2つの部品からなる樹脂製留
め具の留め異部品や金属製ホチキスを最初に収容する構
造体を包括的に示すものである。“アンビル”という用
語は、金属製ホチキスを打ち曲げる構造体や、2つ部品
からなる締め具の保持器部品を解放自在に支持する構造
体を包括的に示すものである。
製ホチキス針、2つの部品からなる樹脂製ホチキス、及
びその類似物を包括するものである。同様に、“留め具
保持部品”という用語は、2つの部品からなる樹脂製留
め具の留め異部品や金属製ホチキスを最初に収容する構
造体を包括的に示すものである。“アンビル”という用
語は、金属製ホチキスを打ち曲げる構造体や、2つ部品
からなる締め具の保持器部品を解放自在に支持する構造
体を包括的に示すものである。
上述した形式の多くの公知の器具は、留められるべき組
織を全体的に、装置の留め具保持部品とアンビル部品と
の間に閉じ込めるための構造を有している。例、えば、
上述のグリーンの米国特許1、−示す装置は、内部で留
め具保持部品及びアンピノ1部品が長さ方向留め真列の
一端に隣接したところで互いに回動自在に連結されてい
るようなカーlリッジを有している。留め真列の他端に
隣接したところでは、カートリッジを閉じたときにピン
が留め具保持部品から延び出してアンビル部品の中に入
る。したがって、留められるべき組織は全体として装置
の留め具保持部品とアンビル部品との間に閉じ込められ
る。これは、留め真列の一端に隣接した回動連結部の作
用及び留め真列の他端に隣接したピンの作用に因る。
織を全体的に、装置の留め具保持部品とアンビル部品と
の間に閉じ込めるための構造を有している。例、えば、
上述のグリーンの米国特許1、−示す装置は、内部で留
め具保持部品及びアンピノ1部品が長さ方向留め真列の
一端に隣接したところで互いに回動自在に連結されてい
るようなカーlリッジを有している。留め真列の他端に
隣接したところでは、カートリッジを閉じたときにピン
が留め具保持部品から延び出してアンビル部品の中に入
る。したがって、留められるべき組織は全体として装置
の留め具保持部品とアンビル部品との間に閉じ込められ
る。これは、留め真列の一端に隣接した回動連結部の作
用及び留め真列の他端に隣接したピンの作用に因る。
上述の組織閉じ込め構造は少量の組織をホチキス針の両
端を越えて延ばすことができる。例えば、上述のグリー
ンの米国特許に示す装置では、カートリッジの留め具保
持部品とアンビル部品との間の回動連結部と、留め真列
の隣接端との間では少量の組織が留められないままにな
ることがある。
端を越えて延ばすことができる。例えば、上述のグリー
ンの米国特許に示す装置では、カートリッジの留め具保
持部品とアンビル部品との間の回動連結部と、留め真列
の隣接端との間では少量の組織が留められないままにな
ることがある。
同様に、留め真列の他端と、留め具保持部品から延びて
アンビル部品の中に入っているピンさの間でも少量の組
織が留められないままになることがある。このことは多
くの状況では問題とならない。
アンビル部品の中に入っているピンさの間でも少量の組
織が留められないままになることがある。このことは多
くの状況では問題とならない。
しかしながら、成る状況では留め具列が完全に組織全体
を横切るようにすることが望ましい。これは、例えば留
め具を太い血管を横切って付け、それによってかかる血
管を閉じるようにする際に重要である。血管の横方向軸
線の部分が僅かでも留められていなければ、留め具列を
通り越す許容できない血液の流れが生じる。
を横切るようにすることが望ましい。これは、例えば留
め具を太い血管を横切って付け、それによってかかる血
管を閉じるようにする際に重要である。血管の横方向軸
線の部分が僅かでも留められていなければ、留め具列を
通り越す許容できない血液の流れが生じる。
上記のことを考慮して、本発明の目的は、上述の形式の
外科用留め具材は装置を、かかる装置により付けられる
留め具列が装置で締めつけられた組織を完全に横切って
延びるようにすることによって改良することにある。
外科用留め具材は装置を、かかる装置により付けられる
留め具列が装置で締めつけられた組織を完全に横切って
延びるようにすることによって改良することにある。
本発明のもう一つの目的は、上述の形式の外科用留め具
材は装置で締めつけられた組織が留められないままにな
るような部分のないようにすることにある。
材は装置で締めつけられた組織が留められないままにな
るような部分のないようにすることにある。
本発明のこれらの目的及びその他の目的は、本発明の原
理にしたがって、上記の外科用留\う具材は装置におい
て、組織の縁制御部材を、留め具列の少なくとも一方の
端に、好ましくは両端jど隣接して、組織の隣接縁が留
め具列の関連した端の内側にあるようにすることによっ
て達成される。このようにして、留められていないまま
の組織の部分はない。
理にしたがって、上記の外科用留\う具材は装置におい
て、組織の縁制御部材を、留め具列の少なくとも一方の
端に、好ましくは両端jど隣接して、組織の隣接縁が留
め具列の関連した端の内側にあるようにすることによっ
て達成される。このようにして、留められていないまま
の組織の部分はない。
本発明の更に別の特徴、性質及び種々の利点は添付の図
面及び本発明についての以下の詳細な説明から明らかに
なろう。
面及び本発明についての以下の詳細な説明から明らかに
なろう。
第1図に示すように、本発明の実施例は、使い捨ての留
め具材はカートリッジ50を着脱自在に受け入れて作動
させる再使用可能な作動器20を含む。作動器20は、
グリーンの米国特許第4,383、634号の第1図な
いし第13図に示す作動器と実質的に同一であってもよ
い。したがって、本明細書においては、作動器20を極
く簡単に述べるに留める。カートリッジ50は、本発明
にしたがって変形されているが、カー) IJッジ50
はグ1−ンの米国特許第4.383.634号の前述の
図面に示すカートリッジに基本的に類似していてもよい
。
め具材はカートリッジ50を着脱自在に受け入れて作動
させる再使用可能な作動器20を含む。作動器20は、
グリーンの米国特許第4,383、634号の第1図な
いし第13図に示す作動器と実質的に同一であってもよ
い。したがって、本明細書においては、作動器20を極
く簡単に述べるに留める。カートリッジ50は、本発明
にしたがって変形されているが、カー) IJッジ50
はグ1−ンの米国特許第4.383.634号の前述の
図面に示すカートリッジに基本的に類似していてもよい
。
このため、本明細書においてはカートリッジ50の新規
な点だけを詳細に述べる。
な点だけを詳細に述べる。
前述のように、カートリッジ50は、作動器20の先端
のU形部分に着脱自在に取り付は可能である。カートリ
ッジ50が第2図に示すように作動器20の適所に配置
された状態で、組み立てられた機器は、カートリッジの
アンビル部品52が組織の片側にあり、カートリッジの
留め具保持部品54が組織の他の側にあるように、留め
るべき組織22に対して位置決めされる。次に、クラン
プ作動器24が、作動器20の先端−近端方向軸線に平
行になるまで、時計方向に枢動される。
のU形部分に着脱自在に取り付は可能である。カートリ
ッジ50が第2図に示すように作動器20の適所に配置
された状態で、組み立てられた機器は、カートリッジの
アンビル部品52が組織の片側にあり、カートリッジの
留め具保持部品54が組織の他の側にあるように、留め
るべき組織22に対して位置決めされる。次に、クラン
プ作動器24が、作動器20の先端−近端方向軸線に平
行になるまで、時計方向に枢動される。
このことにより、クランププッシャ26が先端方向に進
み、それによって、留め具保持部品54を枢動し進めて
、第3図および第4図に示すようにアンビル部品52に
対して組織クランピング(締め付け)関係にもたらす。
み、それによって、留め具保持部品54を枢動し進めて
、第3図および第4図に示すようにアンビル部品52に
対して組織クランピング(締め付け)関係にもたらす。
カートリッジ50は、クランププッシャ26が最初板ば
ね56を留め具保持部品54の近い方の表面に対して押
圧し、留め具保持部品54をピボットピン76を中心と
(1、て枢動させる。第3図に示すように、このことに
よって、留め具保持部品54の゛′上″′端は、留め具
保持部品54の“下”端がアンビル部品52に向かって
移動する前に、アンビル部品52に向かって移動する。
ね56を留め具保持部品54の近い方の表面に対して押
圧し、留め具保持部品54をピボットピン76を中心と
(1、て枢動させる。第3図に示すように、このことに
よって、留め具保持部品54の゛′上″′端は、留め具
保持部品54の“下”端がアンビル部品52に向かって
移動する前に、アンビル部品52に向かって移動する。
さらに、ピン58°の先端部分74は、装置の組織クラ
ンピングストロークの初期に、留め具保持部品54の上
端からアンビル部品52に入り込む。したがって、全ク
ランピング圧力が組織に加えられるかなり前に、組織が
装置内iこ完全に包囲される。このことによって、その
後全クランピング圧力が組織に加えられるときに、組織
が装置から押し出されることが防がれている。
ンピングストロークの初期に、留め具保持部品54の上
端からアンビル部品52に入り込む。したがって、全ク
ランピング圧力が組織に加えられるかなり前に、組織が
装置内iこ完全に包囲される。このことによって、その
後全クランピング圧力が組織に加えられるときに、組織
が装置から押し出されることが防がれている。
上述したようにして組織を装置に入れた後、クランププ
ッシャ26を末端側へ更に移動させることによって保持
部品54をアンビル部品52に対しほぼ平行に挿入し、
第4図に示すように、組織22を部品52と54の間に
完全にクランプ止めする。留め具保持部品54のこの段
階における移動中、ピボットピン76はスロット78に
沿って移動する。かくて組織22は完全にクランプ止め
され、留める準備ができた。
ッシャ26を末端側へ更に移動させることによって保持
部品54をアンビル部品52に対しほぼ平行に挿入し、
第4図に示すように、組織22を部品52と54の間に
完全にクランプ止めする。留め具保持部品54のこの段
階における移動中、ピボットピン76はスロット78に
沿って移動する。かくて組織22は完全にクランプ止め
され、留める準備ができた。
作動器ハンドル28を後方に回動して組織を留める。こ
れは、列をなす作動器20の留め具プッシャ要素30.
32とカートリッジ50の部品60.62を末端方向に
移動させる(第5図参照)。
れは、列をなす作動器20の留め具プッシャ要素30.
32とカートリッジ50の部品60.62を末端方向に
移動させる(第5図参照)。
作動器ハンドル28は、続いて、留め具64(本実施例
においては金属製外科用ホチキス針である)の全てを組
織22を通してアイビル52に打ちつける。アンビル5
2は、ホチキス針64の脚部を打ち曲げて組織を留める
。ハンドル28を放しクランプ作動器24を回転させて
装置フレームの外に出すことにより、留められた組織を
装置からはずす。これは、クランププッシャ26を手元
側に引き込むことによって留め具保持部品54を回動さ
せてアンビル部品52から外せるようにし、組織22を
装置から取り外し可能とする。クランプ作動器24を作
動器フレームの外へ回動させることによって、第1図に
示すように、クランププッシャ26も作動器フシ5・−
ムの外へ回動可能となり、再使用のための装置の清掃を
容易にする。
においては金属製外科用ホチキス針である)の全てを組
織22を通してアイビル52に打ちつける。アンビル5
2は、ホチキス針64の脚部を打ち曲げて組織を留める
。ハンドル28を放しクランプ作動器24を回転させて
装置フレームの外に出すことにより、留められた組織を
装置からはずす。これは、クランププッシャ26を手元
側に引き込むことによって留め具保持部品54を回動さ
せてアンビル部品52から外せるようにし、組織22を
装置から取り外し可能とする。クランプ作動器24を作
動器フレームの外へ回動させることによって、第1図に
示すように、クランププッシャ26も作動器フシ5・−
ムの外へ回動可能となり、再使用のための装置の清掃を
容易にする。
本実施例における留め具61は金属製外科用ホチキス針
であるが、これに代えて米国特許第4,506.671
号に開示すされた普通のタイプの、三部品からなる樹
脂製留め具を使用可能であることは当業者に容易に明ら
かなになるであろう。
であるが、これに代えて米国特許第4,506.671
号に開示すされた普通のタイプの、三部品からなる樹
脂製留め具を使用可能であることは当業者に容易に明ら
かなになるであろう。
第6図〜第8図で最も良く分かるように、図示の実施例
の装置は留め具64を66a、66b、66Cでそれぞ
れ示す平行な3本の列をなして付ける。外側の列66a
、66cは内側の列66bよりも幾分長い。本発明によ
れば、外科用留め真列の「下」端に隣接した組織22の
縁部22aが留め真列のその端部を越えることのないよ
うにするために、カー) IJッジ50は、内側留め真
列66bと整列し、且つ外側留め真列66a、66Cの
隣接端の間で留め真列と重なり或いはこの中に延びる第
1の組織縁部制御部材68を有している。図示の実施例
では、組織縁部制御部材68はカートリッジ50の部分
70から上方に突出したウェブ又はリブであり、外科用
留め具保持部品54とアンビル部品とを連結する。ウェ
ブ68はりI科用留め具を押し出す軸線と平行に延び、
且つ留め具保持部品54及びアンビル部品52の対向面
の間の空間全体に及んでいる。留め具保持部品、54を
アンビル部品52に向かって移動させて組織をクランプ
するために、留め具保持部品54は該部品54が部品5
2に向かって移動するときにウェブ68の近い方の端を
受け入れるための溝72を有している。したがって、装
置内での組織22の位置決め中及びクランプ中は常時、
ウェブ68の上縁部は組織22の下方の縁部22Hに作
用している。特に、ウェブ68は組織22の下縁部22
aを外側の留め真列66a、66a間に持ち上げ、それ
によって組織の下縁部が留め真列の下端を越えないよう
にする。内側の留め真列66bが外側の留め真列66a
、66cよりも短いということにより、ウェブ68を長
い外側の留め真列66a、66a間で留め真列と重ね、
或いはこの中に突出させることができる。
の装置は留め具64を66a、66b、66Cでそれぞ
れ示す平行な3本の列をなして付ける。外側の列66a
、66cは内側の列66bよりも幾分長い。本発明によ
れば、外科用留め真列の「下」端に隣接した組織22の
縁部22aが留め真列のその端部を越えることのないよ
うにするために、カー) IJッジ50は、内側留め真
列66bと整列し、且つ外側留め真列66a、66Cの
隣接端の間で留め真列と重なり或いはこの中に延びる第
1の組織縁部制御部材68を有している。図示の実施例
では、組織縁部制御部材68はカートリッジ50の部分
70から上方に突出したウェブ又はリブであり、外科用
留め具保持部品54とアンビル部品とを連結する。ウェ
ブ68はりI科用留め具を押し出す軸線と平行に延び、
且つ留め具保持部品54及びアンビル部品52の対向面
の間の空間全体に及んでいる。留め具保持部品、54を
アンビル部品52に向かって移動させて組織をクランプ
するために、留め具保持部品54は該部品54が部品5
2に向かって移動するときにウェブ68の近い方の端を
受け入れるための溝72を有している。したがって、装
置内での組織22の位置決め中及びクランプ中は常時、
ウェブ68の上縁部は組織22の下方の縁部22Hに作
用している。特に、ウェブ68は組織22の下縁部22
aを外側の留め真列66a、66a間に持ち上げ、それ
によって組織の下縁部が留め真列の下端を越えないよう
にする。内側の留め真列66bが外側の留め真列66a
、66cよりも短いということにより、ウェブ68を長
い外側の留め真列66a、66a間で留め真列と重ね、
或いはこの中に突出させることができる。
留め具の列の他端(上端)においては、ピン58の手元
から遠い方の端部は第2の組織縁部イ;1]御部材74
として作動する。ウェブ68の場合と同様に、この第2
の組織縁部制御部材74は内方の留め真列66bと整合
している。クランプ作動器24の操作に先立ち、第2の
組織縁部制御部(オフ4は、リーフスプリング56によ
って留め具保持部54の内側で手元に近い方に引っ込め
られていて、装置内の組織22の変位を妨げないように
なっている。しかしながら、クランプ作動器24が操作
されると、第2の組織縁部制御部材74はリーフスプリ
ング56の圧縮に応答して留め具保持部54からアンビ
ル部品52内に延入する。第2の組織縁部制御部材74
がこのように伸長するとき、もしも組織22の上縁82
2bがホチキス針の列の上端部にあるか上端部近くにあ
れば(第7図)、第2の組織縁部制御部材74は第8図
に示すように、留め具の外方の列66aおよび66Cの
最上方の留め具の間で組織縁部を下方に押し下げる。再
度述べるが、留め具の内方の列66bの方が外方の列よ
りも短いために第2の組織縁部制御部材74の操作を行
うことが可能となり、従って、列66aおよび66Cの
最上方の留め具の間で、第2の組織縁部制御部材74を
留め具の上端部に重ね合わせるか留め具の上端部に向か
って下方に伸長させることができる。従って、第2の組
織縁部制御部材74は、組織22の上縁部22bが留め
具の列の上端部を超えて伸長しないようにすることがで
きる。また、ウェブ68および第2の組織縁部制御部材
74は、留め具の列が完全に組織22を横切って伸長す
ること、および留め具64が駆動されるときに組織のい
かなる部分も留められない状態に残されないようにする
ことを保S圧する。
から遠い方の端部は第2の組織縁部イ;1]御部材74
として作動する。ウェブ68の場合と同様に、この第2
の組織縁部制御部材74は内方の留め真列66bと整合
している。クランプ作動器24の操作に先立ち、第2の
組織縁部制御部(オフ4は、リーフスプリング56によ
って留め具保持部54の内側で手元に近い方に引っ込め
られていて、装置内の組織22の変位を妨げないように
なっている。しかしながら、クランプ作動器24が操作
されると、第2の組織縁部制御部材74はリーフスプリ
ング56の圧縮に応答して留め具保持部54からアンビ
ル部品52内に延入する。第2の組織縁部制御部材74
がこのように伸長するとき、もしも組織22の上縁82
2bがホチキス針の列の上端部にあるか上端部近くにあ
れば(第7図)、第2の組織縁部制御部材74は第8図
に示すように、留め具の外方の列66aおよび66Cの
最上方の留め具の間で組織縁部を下方に押し下げる。再
度述べるが、留め具の内方の列66bの方が外方の列よ
りも短いために第2の組織縁部制御部材74の操作を行
うことが可能となり、従って、列66aおよび66Cの
最上方の留め具の間で、第2の組織縁部制御部材74を
留め具の上端部に重ね合わせるか留め具の上端部に向か
って下方に伸長させることができる。従って、第2の組
織縁部制御部材74は、組織22の上縁部22bが留め
具の列の上端部を超えて伸長しないようにすることがで
きる。また、ウェブ68および第2の組織縁部制御部材
74は、留め具の列が完全に組織22を横切って伸長す
ること、および留め具64が駆動されるときに組織のい
かなる部分も留められない状態に残されないようにする
ことを保S圧する。
第9図は本発明の別の実施例を示すものであり、この実
施例では、留め具64が4つの平行な列66d、66e
、66f、66gになっている。
施例では、留め具64が4つの平行な列66d、66e
、66f、66gになっている。
外方の列66d、66gは内方の列66e、66fより
も長くなっている。組織縁部制御部材80.82は、留
め具の内方の列66e、66fと整合していて、留め具
の外方の列66d、66gの端部留め具の間の留め真列
の各端部と重なり合うか、該各端部内に延入している。
も長くなっている。組織縁部制御部材80.82は、留
め具の内方の列66e、66fと整合していて、留め具
の外方の列66d、66gの端部留め具の間の留め真列
の各端部と重なり合うか、該各端部内に延入している。
従って、組織縁部制御部材80.82は、図示の列によ
って留められた組織の縁部が列の端部を超えて伸長しな
いように防止し、これにより、列が完全に組織を横切っ
て伸長すること、および組織のいがなる部分も留められ
ない状態に残ることがないように保証することができる
。
って留められた組織の縁部が列の端部を超えて伸長しな
いように防止し、これにより、列が完全に組織を横切っ
て伸長すること、および組織のいがなる部分も留められ
ない状態に残ることがないように保証することができる
。
第10図は、留め具64を、3本の平行な列66h、6
6i、66jで再び付ける本発明のもう一つの変形例を
示している。しかしながら、この変形例では内側の留め
真列66iは外側の留め真列66h、66jよりも長い
。組織の縁制御部材90.92は内側の列661の端の
留め具を部分的に取り囲むU形の部材であり、各LJ形
部材の平行な脚部は重なり、或いは外側の留め真列66
h、66jの端部に隣接した留め真列の両端内に延びて
いる。したが−って、組織の11 ’LTSが留め真列
の両端を越えて延びるのを防ぎ、それにょって、留め真
列は留められないままでいるような組織の部分が全く無
いように組織を完全に横切って延びるようにする。
6i、66jで再び付ける本発明のもう一つの変形例を
示している。しかしながら、この変形例では内側の留め
真列66iは外側の留め真列66h、66jよりも長い
。組織の縁制御部材90.92は内側の列661の端の
留め具を部分的に取り囲むU形の部材であり、各LJ形
部材の平行な脚部は重なり、或いは外側の留め真列66
h、66jの端部に隣接した留め真列の両端内に延びて
いる。したが−って、組織の11 ’LTSが留め真列
の両端を越えて延びるのを防ぎ、それにょって、留め真
列は留められないままでいるような組織の部分が全く無
いように組織を完全に横切って延びるようにする。
ここに図示して説明した実施例は本発明の原理の例示に
過ぎず、当業者であれば本発明の範囲及び精神から逸脱
することなく種々の修正を行えることは理解されよう。
過ぎず、当業者であれば本発明の範囲及び精神から逸脱
することなく種々の修正を行えることは理解されよう。
例えば、再使用可能な作動器に使用される使い捨てカー
トリッジに具体化する代わりに、グリーンの米国特許第
435.462号の第1図〜第8図に示すような使い捨
ての物品として装置全体を構成しても良い。
トリッジに具体化する代わりに、グリーンの米国特許第
435.462号の第1図〜第8図に示すような使い捨
ての物品として装置全体を構成しても良い。
第1図は本発明の例示の実施例の部分分解斜視図である
。 第2図は装置の操作サイクルの初期段階を示す第1図の
装置の部分断面立面図である。 第3図、第4図及び第5図は、装置の操作サイクルの連
続的段階を示す第1図の装置の遠い方の部分の断面立面
図である。 第6図は第4図の4−4線に沿った断面図である。 第7図は第2図の7−7線に沿った断面図である。 第8図は第4図の8−8線に沿った断面図である。 第9図及び第10図は本発明の2つの変形例の略図であ
る。 26・・・・・・プッシャ 50・・・・・・留め具保持カートリッジ52・・・・
・・アンビル部品 64・・・・・・留め具 68.74.80.82.
。 第2図は装置の操作サイクルの初期段階を示す第1図の
装置の部分断面立面図である。 第3図、第4図及び第5図は、装置の操作サイクルの連
続的段階を示す第1図の装置の遠い方の部分の断面立面
図である。 第6図は第4図の4−4線に沿った断面図である。 第7図は第2図の7−7線に沿った断面図である。 第8図は第4図の8−8線に沿った断面図である。 第9図及び第10図は本発明の2つの変形例の略図であ
る。 26・・・・・・プッシャ 50・・・・・・留め具保持カートリッジ52・・・・
・・アンビル部品 64・・・・・・留め具 68.74.80.82.
Claims (1)
- 【特許請求の範囲】 (1)複数の外科用留め具を身体組織に付けるための装
置であって、留め具保持カートリッジ (50)と、身体組織を締めつけるための前記カートリ
ッジ(50)と対向したアンビル部品(52)と、列を
なした留め具(64)を身体組織に付けるために、留め
具(64)を前記カートリッジ(50)から前記アンビ
ル部品に向かって押し出すためのプッシャ(26)とを
有する装置において、締めつけた組織の少なくとも一方
の側に、この側を前記留め具(64)の列内に制限する
組織の縁制御部材(68、74;80、82;90、9
2)を有することを特徴とする装置。 (2)前記制御部材は前記アンビル部品(52)から突
出するウェブ(68)からなる、特許請求の範囲第(1
)項に記載の装置。 (3)前記制御部材(74)はカートリッジ(50)に
引っ込み可能に取付けられている、特許請求の範囲第(
1)項に記載の装置。 (4)前記プッシャ(26)は前記制御部材を前記カー
トリッジ(50)から前記アンビル部品(52)に向か
って押し出すように配置されている、特許請求の範囲第
(3)項に記載の装置。 (5)前記アンビル部品(52)は前記制御部材(74
)を受け入れるための凹部を有している特許請求の範囲
第(1)項、第(2)項及び第(3)項のいずれか1つ
の項に記載の装置。 (6)前記留め具(64)の列は、前記少なくとも1つ
の制御部材(68、74;80、82)と長さ方向に整
列して配置された留め具の少なくとも1つの内側列(6
6b、66e、66f)と長さ方向に重なり関係をなし
て配置された留め具の一対の平行な外側列(66a、6
6c)を有する、特許請求の範囲第(1)項に記載の装
置。 (7)前記制御部材(90、92)は、一対の脚部を内
方に向けたU形状をなしている、特許請求の範囲第(1
)項に記載の装置。 (8)前記留め具(64)の列は、前記少なくとも1つ
の制御部材(90、92)の前記脚部と長さ方向に整列
して配置された留め具の一対の平行な外側列(66h、
66i)と、前記脚部と長さ方向に重なり関係をなして
配置された留め具の少なくとも1つの内側列(66h)
と、を有する、特許請求の範囲第(7)項に記載の装置
。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US06/785,992 US4715520A (en) | 1985-10-10 | 1985-10-10 | Surgical fastener applying apparatus with tissue edge control |
| US785992 | 1985-10-10 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JPS62117543A true JPS62117543A (ja) | 1987-05-29 |
Family
ID=25137266
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP61241891A Pending JPS62117543A (ja) | 1985-10-10 | 1986-10-11 | 外科用留め具付け装置 |
Country Status (8)
| Country | Link |
|---|---|
| US (1) | US4715520A (ja) |
| EP (1) | EP0220029B1 (ja) |
| JP (1) | JPS62117543A (ja) |
| AT (1) | ATE77224T1 (ja) |
| AU (1) | AU588382B2 (ja) |
| BR (1) | BR8604975A (ja) |
| CA (1) | CA1263579A (ja) |
| DE (1) | DE3685716T2 (ja) |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2005193043A (ja) * | 2003-12-30 | 2005-07-21 | Ethicon Endo Surgery Inc | 高度に制御された形態で組織をステープリングおよび切開するように適合された手術用器具 |
| JP2005193034A (ja) * | 2003-12-30 | 2005-07-21 | Ethicon Endo Surgery Inc | 体の組織に複数の手術用締結具を適用するように適合された手術用器具 |
| JP2007203058A (ja) * | 2006-01-31 | 2007-08-16 | Ethicon Endo Surgery Inc | 手術用切断/結合器具およびこれに用いるモジュラーエンドエフェクタに使用するための、組織ロケータを備えたアンビルを有する使い捨てカートリッジ |
| JP2010075690A (ja) * | 2008-09-23 | 2010-04-08 | Tyco Healthcare Group Lp | 外科用器具のための組織止め |
| JP2011050744A (ja) * | 2009-09-03 | 2011-03-17 | Tyco Healthcare Group Lp | 外科用器具およびその外科用器具と共に使用する装填ユニット |
| US9615829B2 (en) | 2008-09-23 | 2017-04-11 | Covidien Lp | Tissue stop for surgical instrument |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4941623A (en) * | 1987-05-12 | 1990-07-17 | United States Surgical Corporation | Stapling process and device for use on the mesentery of the abdomen |
| US4848637A (en) * | 1987-06-11 | 1989-07-18 | Pruitt J Crayton | Staple device for use on the mesenteries of the abdomen |
| US4930503A (en) * | 1987-06-11 | 1990-06-05 | Pruitt J Crayton | Stapling process and device for use on the mesenteries of the abdomen |
| US5027834A (en) * | 1987-06-11 | 1991-07-02 | United States Surgical Corporation | Stapling process for use on the mesenteries of the abdomen |
| US5071052A (en) * | 1988-09-22 | 1991-12-10 | United States Surgical Corporation | Surgical fastening apparatus with activation lockout |
| US5040715B1 (en) * | 1989-05-26 | 1994-04-05 | United States Surgical Corp | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
| US5413268A (en) * | 1989-05-26 | 1995-05-09 | United States Surgical Corporation | Apparatus and method for placing stables in laparoscopic or endoscopic procedures |
| US4978049A (en) * | 1989-05-26 | 1990-12-18 | United States Surgical Corporation | Three staple drive member |
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| JP2014061403A (ja) * | 2008-09-23 | 2014-04-10 | Covidien Lp | 外科用器具のための組織止め |
| US9615829B2 (en) | 2008-09-23 | 2017-04-11 | Covidien Lp | Tissue stop for surgical instrument |
| US10028799B2 (en) | 2008-09-23 | 2018-07-24 | Covidien Lp | Tissue stop for surgical instrument |
| US10786324B2 (en) | 2008-09-23 | 2020-09-29 | Covidien Lp | Tissue stop for surgical instrument |
| JP2011050744A (ja) * | 2009-09-03 | 2011-03-17 | Tyco Healthcare Group Lp | 外科用器具およびその外科用器具と共に使用する装填ユニット |
Also Published As
| Publication number | Publication date |
|---|---|
| US4715520A (en) | 1987-12-29 |
| AU588382B2 (en) | 1989-09-14 |
| DE3685716D1 (de) | 1992-07-23 |
| AU6368186A (en) | 1987-04-16 |
| CA1263579A (en) | 1989-12-05 |
| ATE77224T1 (de) | 1992-07-15 |
| DE3685716T2 (de) | 1993-01-21 |
| EP0220029B1 (en) | 1992-06-17 |
| EP0220029A1 (en) | 1987-04-29 |
| BR8604975A (pt) | 1987-07-14 |
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