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DE537571T1 - Gerät zum Anbringen von chirurgischen Befestigungen. - Google Patents

Gerät zum Anbringen von chirurgischen Befestigungen.

Info

Publication number
DE537571T1
DE537571T1 DE92116882T DE92116882T DE537571T1 DE 537571 T1 DE537571 T1 DE 537571T1 DE 92116882 T DE92116882 T DE 92116882T DE 92116882 T DE92116882 T DE 92116882T DE 537571 T1 DE537571 T1 DE 537571T1
Authority
DE
Germany
Prior art keywords
jaw member
advancing
feed
tissue
jaw
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
Application number
DE92116882T
Other languages
English (en)
Inventor
Henry Bolanos
David T Green
Lisa W Heaton
Keith Ratcliff
Frank J Viola
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
United States Surgical Corp
Original Assignee
United States Surgical Corp
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by United States Surgical Corp filed Critical United States Surgical Corp
Publication of DE537571T1 publication Critical patent/DE537571T1/de
Pending legal-status Critical Current

Links

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
    • A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots

Landscapes

  • 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)

Claims (37)

EP-Anmeldung Nr. 92 116 882.9 57 866 p2/len Patentanspruchs
1. Vorrichtung zum Anbringen von chirurgischen Verbindungselementen an Körpergewebe, umfassend:
eine Gewebegreifeinrichtung zum Positionieren und Greifen von Gewebe, an das die Verbindungselemente angebracht werden sollen; wobei die Greifeinrichtung ein erstes Backenglied mit mehreren daran positionierten Verbindungselementen und ein zweites Backenglied aufweist;
eine erste Vorschubeinrichtung zum Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes;
eine zweite Vorschubeinrichtung zum schrittweisen Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes anschließend an das Vortreiben durch die erste Vorschubeinrichtung, um Gewebe dazwischen zu greifen;
eine Einrichtung zum Hineintreiben der Verbindungselemente in das Gewebe, nachdem die Backenglieder durch die Vorschubeinrichtungen im Verhältnis zueinander positioniert worden sind; eine Einrichtung zum Auslösen der Treibeinrichtung; und eine lösbare Einrichtung zum Halten der ersten und zweiten Vorschubeinrichtung, um wahlweise das erste Backenglied im Verhältnis zu dem zweiten Backenglied zu positionieren.
2. Vorrichtung nach Anspruch 1,
dadurch gekennzeichnet , daß die erste Vorschubeinrichtung das erste Backenglied in Richtung des zweiten Backengliedes weiter vorschiebt als die zweite Vorschubeinrichtung.
3. Vorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet , daß die Halteeinrichtung ein schwenkbares Klammerglied mit einer Mittelbohrung umfaßt, durch welche die erste Vorschubeinrichtung hindurchgeführt ist, wobei eine Kante der Mittelbohrung mit der Vorschubeinrichtung in Eingriff steht, um die erste Vorschubeinrichtung zurückzuhalten und wahlweise das erste Backenglied im Verhältnis zu dem zweiten Backenglied zu positionieren.
4. Vorrichtung nach Anspruch 1, 2 oder 3, dadurch gekennzeichnet , daß die erste und zweite Vorschubeinrichtung eine erste und eine zweite Ratschenschaltung umfassen, und daß die Halteeinrichtung die zweite Ratschenschaltung umfaßt.
5. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß diese ferner eine Löseeinrichtung umfaßt, die mit der Halteeinrichtung verbunden ist, um die Halteeinrichtung außer Eingriff mit der Vorschubeinrichtung zu bringen, um die Vorschubeinrichtung zu einer Ruheposition zurückzubringen.
6. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß diese ferner eine Kartusche zum Unterbringen der mehreren Verbindungselemente umfaßt, wobei die Kartusche lösbar an dem ersten Backenglied befestigt ist, und daß diese ferner eine mit der Vorschubeinrichtung verbundene Führungseinrichtung zum Führen und Ausrichten der Kartusche mit dem zweiten Backenglied umfaßt, wobei die Führungseinrichtung eine Gleitschiene umfaßt, die über eine
Verbindungsanordnung an einem proximalen Ende an der Vorschubeinrichtung befestigt ist, und die an einem distalen Ende mit einem Führungsstift verbunden ist, der durch die Kartusche und das zweite Backenglied hindurchgeführt ist, um die Kartusche und das zweite Backenglied miteinander auszurichten.
7. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß diese ferner eine Einrichtung zum Koppeln der Treibeinrichtung mit der Betätigungseinrichtung umfaßt, wobei die Treibeinrichtung die Verbindungselemente nur treibt, wenn das erste Backenglied sich um einen vorbestimmten Abstand in Richtung des zweiten Backengliedes genähert hat.
8. Vorrichtung nach Anspruch 7,
dadurch gekennzeichnet , daß die Koppeleinrichtung eine Lagerfläche an der Treibeinrichtung umfaßt, um mit einem Arm der Auslöseeinrichtung in Eingriff zu stehen, um die Verbindungselemente nur dann zu treiben, wenn das erste Backenglied sich um den vorbestimmten Abstand in Richtung des zweiten Backengliedes genähert hat, wobei die Lagerfläche eine Aussparung für einen Eingriff mit dem Arm umfaßt, wobei die Aussparung sich von einer Gleitfläche auf der Treibeinrichtung erstreckt, auf welcher der Arm vor dem Eingriff mit der Aussparung gleitet.
9. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß die erste und die zweite Vorschubeinrichtung mit der Treibeinrichtung gekoppelt sind, um die Treibeinrichtung in eine Feuerposition vorzuschieben.
10. Vorrichtung nach einem der vorstehenden Ansprüche,
dadurch gekennzeichnet , daß
die erste Vorschubeinrichtung einen Druckstangenmechanismus und die zweite Vorschubeinrichtung eine
Sperrhakeneinrichtung umfaßt, die an dem
Druckstangenmechanismus angeordnet ist, wobei der
Druckstangenmechanismus sich von einem Gehäuse der
Vorrichtung erstreckt und so ausgebildet ist, daß er in das Gehäuse gedrückt werden kann, um das erste -Backenglied in
Richtung des zweiten Backengliedes vorzuschieben, wobei die Sperrhakeneinrichtung mit der Halteeinrichtung in Eingriff
steht, die ein Ratschenglied umfaßt, das innerhalb des
Gehäuses positioniert ist, um mit der Sperrhakeneinrichtung in Eingriff zu gelangen, wenn der Druckstangenmechanismus
in das Gehäuse gedrückt wird.
11. Vorrichtung nach Anspruch 10,
dadurch gekennzeichnet , daß
das Ratschenglied und die Sperrhakeneinrichtung eine
Feinvorschubeinrichtung umfassen, um schrittweise
vorzuschieben und einen Abstand zwischen den Backengliedern einzustellen, um das Gewebe zu greifen.
12. Vorrichtung nach Anspruch 11,
dadurch gekennzeichnet , daß
das Ratschenglied und die Sperrhakeneinrichtung mindestens
zwei Ratschenschaltungen umfassen, wobei eine erste
Schaltung eine Einrichtung zum Halten des
Druckstangenmechanismus gegen eine Vorspannkraft umfaßt, um den Druckstangenmechanismus in eine Ruheposition
zurückzubringen, und eine zweite Schaltung eine Einrichtung vorsieht, um schrittweise das erste Backenglied in Richtung
des zweiten Backengliedes vorzuschieben, um Gewebe dazwischen zu greifen.
13. Vorrichtung nach Anspruch 12,
dadurch gekennzeichnet , daß die zweite Schaltung mehrere Sperrhaken zum schrittweisen Vorschieben des ersten Backengliedes in Richtung des zweiten Backengliedes umfaßt, wobei die zweite Schaltung sich um einen vorbestimmten Abstand vorschiebt, bevor die erste Schaltung sich vorschiebt, um der zweiten Schaltung zu folgen.
14. Vorrichtung nach Anspruch 13,
dadurch gekennzeichnet , daß die zweite Schaltung drei Sperrhakenglieder umfaßt, von denen sich jedes schrittweise jeweils aufeinanderfolgend vorschiebt, wobei die erste Schaltung sich nach jedem Sperrhakenglied der sich einmal vorschiebenden zweiten Schaltung vorschiebt.
15. Vorrichtung nach einem der Ansprüche 10 bis 14, dadurch gekennzeichnet , daß diese ferner eine Löseeinrichtung zum Lösen des Sperrhakens von dem Ratschenglied umfaßt, um den Druckstangenmechanismus in eine Ruhestellung zurückzubringen.
16. Vorrichtung nach Anspruch 15,
dadurch gekennzeichnet , daß die Löseeinrichtung einen Schwenkpunkt umfaßt, um den Druckstangenmechanismus relativ zu einer Längsachse der Vorrichtung zu schwenken, um den Sperrhaken außer Eingriff mit dem Ratschenglied zu bringen, wobei der Sperrhaken durch eine Feder gegen das Ratschenglied vorgespannt ist.
17. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß die Vorschubeinrichtung einen Schwenkstangenmechanismus umfaßt, der sich von einem Gehäuse der Vorrichtung erstreckt und in einer ersten Richtung relativ zu einer Längsachse der Vorrichtung hin und her geschwenkt werden kann, um das erste Backenglied in Richtung des zweiten Backengliedes vorzuschieben, wobei der Stangenmechanismus vorgespannt ist, um in eine Ruhestellung im wesentlichen in Ausrichtung mit der Längsachse zurückzukehren, wobei das Hin- und Herschwenken des Stangenmechanismus den Stangenmechanismus von der Längsachse nach unten ablenkt.
18. Vorrichtung nach Anspruch 17,
dadurch gekennzeichnet , daß der Schwenkstangenmechanismus mindestens eine Ratschenschaltung zum schrittweisen Vorschieben des ersten Backengliedes in Richtung des zweiten Backengliedes umfaßt.
19. Vorrichtung nach Anspruch 17 oder 18, dadurch gekennzeichnet , daß diese ferner eine Löseeinrichtung zum Außer-Eingriff-Bringen der Halteeinrichtung umfaßt, um die Vorrichtung in eine Ruhestellung zurückzuführen.
20. Vorrichtung nach Anspruch 17, 18 oder 19, dadurch gekennzeichnet , daß die Löseeinrichtung eine Lösestange umfaßt, welche die Halteeinrichtung berührt, um die Halteeinrichtung auf ein Schwenken des Schwenkstangenmechanismus in einer zweiten Richtung, entgegengesetzt zu der ersten Richtung, außer Eingriff zu bringen.
21. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß die Vorschubeinrichtung ein Stangenglied umfaßt, das sich distal von einem Gehäuse der Vorrichtung erstreckt und das durch einen Bediener mit dem Daumen betätigbar ist, um das erste Backenglied vorzuschieben.
22. Vorrichtung nach Anspruch 21,
dadurch gekennzeichnet , daß ein Abschnitt des Stangengliedes mit einem Schraubgewinde versehen ist, um in Eingriff mit der Halteeinrichtung zu stehen, wobei die Stange drehbar ist, um eine Feineinstellung eines Abstandsbereiches zwischen den Backengliedern durch Vorschieben des Gewindes über die Halteeinrichtung zu erlauben.
23. Vorrichtung nach einem der vorstehenden Ansprüche, dadurch gekennzeichnet , daß die erste und zweite Vorschubeinrichtung ein Stangenglied umfassen, das entlang eines Längsabschnitts ein Schraubgewinde aufweist, wobei das Stangenglied durch die Halteeinrichtung weg von dem Schraubgewinde für einen ersten Vorschub des ersten Backengliedes vorgeschoben wird, wobei das Stangenglied mittels des Schraubgewindes durch die Halteeinrichtung für einen zweiten Vorschub des ersten Backengliedes drehbar vorgeschoben wird.
24. Vorrichtung zum Anbringen von chirurgischen Verbindungselementen an Körpergewebe, umfassend eine Gewebegreifeinrichtung zum Positionieren und Greifen von Gewebe dazwischen, die ein erstes Backenglied und ein zweites Backenglied umfaßt, wobei das erste Backenglied mehrere daran positionierte Verbindungselemente umfaßt; und
0537
eine Vorschubeinrichtung zum Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes, wobei die Vorschubeinrichtung um eine Längsachse der Vorrichtung hin und her schwenkbar ist.
25. Vorrichtung nach Anspruch 24,
dadurch gekennzeichnet , daß die Vorschubeinrichtung eine Einrichtung zum Vorschieben des ersten Backengliedes um einen vorbestimmten Abstand und eine Einrichtung zum Vorschieben des ersten Backengliedes um einen zweiten vorbestimmten Abstand anschließend an den ersten vorbestimmten Abstand umfaßt.
26. Vorrichtung nach Anspruch 24 oder 25, dadurch gekennzeichnet , daß diese ferner eine lösbare Einrichtung zum Halten der Vorschubeinrichtung umfaßt, um wahlweise das erste Backenglied im Verhältnis zu dem zweiten Backenglied zu positionieren.
27. Vorrichtung nach Anspruch 24, 25 oder 26, dadurch gekennzeichnet , daß diese den Gegenstand eines oder mehrerer der vorstehenden Ansprüche umfaßt.
28. Vorrichtung nach einem der Ansprüche 24 bis 27, dadurch gekennzeichnet , daß diese ferner eine lösbare Einrichtung zum Außer-Eingriff-Bringen der Vorschubeinrichtung umfaßt, um das erste Backenglied von dem zweiten Backenglied weg zu bewegen, um das dazwischen positionierte Gewebe loszulassen.
29. Vorrichtung zum Anbringen von chirurgischen Verbindungselementen an Körpergewebe, umfassend:
eine Gewebegreifeinrichtung zum Positionieren und Greifen von Gewebe dazwischen, die ein erstes Backenglied und ein zweites Backenglied umfaßt, wobei an dem ersten Backenglied mehrere Verbindungselemente positioniert sind; und
eine Vorschubeinrichtung zum Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes, die eine linear betätigbare Vorschubeinrichtung zum Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes um einen vorbestimmten Abstand umfaßt, und eine schwenkbar betätigbare Vorschubeinrichtung, die relativ zu einer Längsachse der Vorrichtung schwenkbar ist, um das erste Backenglied in Richtung des zweiten Backengliedes vorzutreiben, um dazwischen Gewebe zu greifen.
30. Vorrichtung nach Anspruch 29,
dadurch gekennzeichnet , daß diese den Gegenstand eines oder mehrerer der vorstehenden Ansprüche umfaßt.
31. Vorrichtung zum Anbringen von chirurgischen Verbindungselementen an Körpergewebe, umfassend:
eine Gewebegreifeinrichtung zum Positionieren und Greifen von Gewebe dazwischen, die ein erstes Backenglied und ein zweites Backenglied umfaßt, wobei an dem ersten Backenglied mehrere Verbindungselemente positioniert sind; und
eine Vorschubeinrichtung zum Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes, die eine linear betätigbare Vorschubeinrichtung zum
Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes um einen vorbestimmten Abstand umfaßt, und eine drehbare Vorschubeinrichtung, um das erste Backenglied in Richtung des zweiten Backengliedes vorzutreiben, um dazwischen Gewebe zu greifen.
32. Vorrichtung nach Anspruch 31,
dadurch gekennzeichnet , daß diese ferner eine lösbare Einrichtung zum Halten der ersten und zweiten Vorschubeinrichtung umfaßt, um wahlweise das erste Backenglied im Verhältnis zu dem zweiten Backenglied zu positionieren.
33. Vorrichtung nach Anspruch 31 oder 32, dadurch gekennzeichnet , daß die linear betätigbare Vorschubeinrichtung das erste Backenglied in Richtung des zweiten Backengliedes um einen ersten vorbestimmten Abstand vortreibt, und daß die drehbare Vorschubeinrichtung schrittweise das erste Backenglied in Richtung des zweiten Backengliedes nach dem Vortreiben durch die linear betätigbare Vorschubeinrichtung vortreibt.
34. Vorrichtung nach Anspruch 31, 32 oder 33, dadurch gekennzeichnet , daß die linear betätigbare Vorschubeinrichtung ein Stangenglied umfaßt, das sich distal von einem Gehäuse der Vorrichtung erstreckt und das durch einen Bediener mit dem Daumen betätigbar ist, um das erste Backenglied vorzuschieben, und daß die drehbare Vorschubeinrichtung ein Schraubgewinde umfaßt, das einstückig mit dem Stangenglied ausgebildet ist, wobei das Schraubgewinde mit der Halteeinrichtung in Eingriff steht, um das erste Backenglied im Verhältnis zu dem zweiten Backenglied schrittweise vorzuschieben.
35. Vorrichtung zum Anbringen von chirurgischen Verbindungselementen an Körpergewebe, umfassend:
eine Gewebegreifeinrichtung zum Positionieren und Greifen von Gewebe dazwischen, die ein erstes Backenglied mit mehreren daran positionierten Verbindungselementen und ein zweites Backenglied umfaßt;
eine Einrichtung zum Hineintreiben der Verbindungselemente in das Gewebe, die eine Einrichtung zum Auslösen der Treibeinrichtung umfaßt; eine erste Vorschubeinrichtung zum Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes, um Gewebe dazwischen zu greifen/ eine zweite Vorschubeinrichtung zum schrittweisen Vortreiben des ersten Backengliedes in Richtung des zweiten Backengliedes anschließend an das Vortreiben durch die erste Vorschubeinrichtung; wobei die erste und zweite Vorschubeinrichtung die Treibeinrichtung weiter vorschieben; eine lösbare Einrichtung zum Halten der Vorschubeinrichtung, um wahlweise das erste Backenglied im Verhältnis zu dem zweiten Backenglied zu positionieren; und
eine Einrichtung zum Koppeln der Treibeinrichtung mit der Auslöseeinrichtung, wobei die Treibeinrichtung die Verbindungselemente nur dann treibt, wenn sich das erste Backenglied um einen vorbestimmten Abstand an das zweite Backenglied genähert hat.
36. Vorrichtung nach Anspruch 29,
dadurch gekennzeichnet , daß die Koppeleinrichtung eine Lagerfläche an der Treibeinrichtung umfaßt, um mit einem Arm in Eingriff zu
treten, um die Verbindungselemente zu treiben, wenn das erste Backenglied an dem vorbestimmten Abstand.
37. Vorrichtung nach Anspruch 30,
dadurch gekennzeichnet , daß die Lagerfläche eine Aussparung zum Eingriff mit dem Arm umfaßt, die sich von einer Gleitfläche an der Treibeinrichtung erstreckt, auf welcher der Arm vor dem Eingriff mit der Aussparung gleitet.
DE92116882T 1991-10-18 1992-10-02 Gerät zum Anbringen von chirurgischen Befestigungen. Pending DE537571T1 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US77909791A 1991-10-18 1991-10-18

Publications (1)

Publication Number Publication Date
DE537571T1 true DE537571T1 (de) 1993-10-14

Family

ID=25115316

Family Applications (2)

Application Number Title Priority Date Filing Date
DE69217808T Expired - Lifetime DE69217808T2 (de) 1991-10-18 1992-10-02 Gerät zum Anbringen von chirurgischen Befestigungen
DE92116882T Pending DE537571T1 (de) 1991-10-18 1992-10-02 Gerät zum Anbringen von chirurgischen Befestigungen.

Family Applications Before (1)

Application Number Title Priority Date Filing Date
DE69217808T Expired - Lifetime DE69217808T2 (de) 1991-10-18 1992-10-02 Gerät zum Anbringen von chirurgischen Befestigungen

Country Status (5)

Country Link
US (2) US5509596A (de)
EP (1) EP0537571B1 (de)
CA (1) CA2079756A1 (de)
DE (2) DE69217808T2 (de)
ES (1) ES2041610T3 (de)

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CA2079756A1 (en) 1993-04-19
ES2041610T1 (es) 1993-12-01
EP0537571A3 (en) 1993-06-30
EP0537571B1 (de) 1997-03-05
DE69217808D1 (de) 1997-04-10
US5509596A (en) 1996-04-23
US5706997A (en) 1998-01-13
EP0537571A2 (de) 1993-04-21
DE69217808T2 (de) 1997-07-24
ES2041610T3 (es) 1997-05-16

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