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JP2002540835A - 動き動作が分離された堅固に結合された関節動きデバイス - Google Patents

動き動作が分離された堅固に結合された関節動きデバイス

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JP2002540835A
JP2002540835A JP2000608952A JP2000608952A JP2002540835A JP 2002540835 A JP2002540835 A JP 2002540835A JP 2000608952 A JP2000608952 A JP 2000608952A JP 2000608952 A JP2000608952 A JP 2000608952A JP 2002540835 A JP2002540835 A JP 2002540835A
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jaw
distal end
rod
motion
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JP4169142B2 (ja
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グレース，ケネス
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コンピュータ・モーション・インコーポレーテッド
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/75—Manipulators having means for prevention or compensation of hand tremors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2936—Pins in guiding slots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • 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
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    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T74/00—Machine element or mechanism
    • Y10T74/20—Control lever and linkage systems
    • Y10T74/20207—Multiple controlling elements for single controlled element
    • Y10T74/20305—Robotic arm
    • Y10T74/20317—Robotic arm including electric motor

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Abstract

(57)【要約】 本発明は、連節リストから分離される堅固に結合したジョー（５０）を有するデバイスである。このデバイスは、把持、切断、縫合等に使用することができる、連節運動ならびに作動を提供するために、以下のようなものを備える。すなわち、近位端（１４）および遠位端（１６）を有する細長いハウジング（１２）、ハウジングの内部に延在する、近位端（２２）および遠位端（２４）を有する関節ロッド（２０）、ハウジングの内部に延在する、近位端および遠位端を有する動作ロッド、動作ロッドとその遠位端で連接しているラック・ドライバ（１７０）であって、動作ロッドの運動を実質的に約９０度変化させるように円筒ラックと係合しているラック・ドライバ、円筒ラックと連接しており、それによって円筒ラックの運動がジョーを作動させるジョーであって、さらに関節ロッドの直線運動がジョーの回転運動を引き起こすように関節ロッドと回転可能に連接しているジョー。

Description

【発明の詳細な説明】
【０００１】 （関連出願の相互参照） 本出願は、１９９６年１１月２２日に出願し、係属中の出願番号０８／７５５
，０６３の一部継続出願である、１９９７年６月１１日に出願し、係属中の出願
番号０８／８７３，１９０の一部継続出願である、１９９９年３月３日に出願し
、現在米国特許第５，８５５，５８３号として発行されている出願番号０９／２
６２，１３４の一部継続出願である。
【０００２】 （発明の背景） （１．発明の分野） 本発明は一般に、外科用デバイスに関する。より詳細には、本発明は、侵襲の
少ない内視鏡外科処置を実施する際の縫合用デバイスに関し、より詳細には、内
視鏡による冠状動脈バイパス移植手術に使用する関節動きデバイスに関する。
【０００３】 （２．関連技術の説明） 冠状動脈が閉塞すると、生命を維持するために必要な血液および酸素が心臓か
ら失われる可能性がある。この閉塞は投薬または血管形成術により除去すること
ができる。重篤な閉塞には、冠状動脈バイパス移植（ＣＡＢＧ）を実施して、動
脈の閉塞部分にバイパスを形成する。ＣＡＢＧ処置は一般に、心臓にアクセスす
るために胸骨を切断し、胸腔を開けて実施する。閉塞部分に隣接した動脈を切開
する。次いで、内胸動脈（ＩＭＡ）または他の何らかの血流用の動脈のもとが切
開部位の動脈と結びつけられる。ＩＭＡは動脈の閉塞部分をバイパスして、心臓
に再び完全な血流を提供する。
【０００４】 胸骨を切断し、胸腔を開放することにより、患者に大きな外傷が生じる。さら
に、胸骨が破壊されたことで、患者の回復に要する期間が長くなる。したがって
、侵襲の少ないＣＡＢＧ処置を可能にするシステムが開発されてきた。これらの
システムでは、ハンド・ヘルドのツールと長さ３〜５インチ程度の小さな切開を
用いて、患者の胸部へアクセスする。
【０００５】 このような侵襲の小さな処置は、患者の皮膚の数インチ程度の小さな切開を通
して外科器具を挿入することにより実施する。このような機器の操作は、特に移
植したものを動脈に縫合する際に厄介となる可能性がある。これらのシステムで
は、手術部位を直接見て行っている。このようなシステムは、このように手術部
位の直接明視化を必要とするため、ＣＡＢＧ処置を完全に内視鏡で実施すること
はできない。さらに、このようなシステムでは、手術部位で外科器具を適切に操
作するために必要な切開サイズの理由から、完全に内視鏡的なアプローチで行え
ない。
【０００６】 完全に内視鏡的な方法では、胸腔に到達するために小さな穴を使用する。これ
らの穴はそれぞれ直径３〜１１ｍｍ程度である。完全に内視鏡的にＣＡＢＧ処置
を実施する（すなわち、３〜１１ｍｍの穴を使用する）ためには、外科医の手の
震えやスケール・モーションを除外するためにロボット・システムを使用しなけ
ればならない。
【０００７】 内視鏡による外科処置の性能を高めるためには、手術部位に操作できるだけで
はなく、組織または縫合糸を操作して吻合できる外科器具を使用することが有用
であろう。
【０００８】 患者のリスクを少なくし、手術時間を短縮するため当技術分野で必要とされて
いるのは、過度に複雑なデザインとなることなく、関節動きおよびその他の動き
が可能なロボットで動作する外科デバイスである。
【０００９】 （発明の概要） 本発明は、組織および針を操作のための関節動きデバイスであり、このデバイ
スは、 近位端および遠位端を有する細長いハウジングと、 ハウジングの内部に延び、近位端および遠位端を有する関節ロッドと、 ハウジングの内部に延び、近位端および遠位端を有する動作ロッドと、 動作ロッドとその遠位端で連接しているラック・ドライバであって、動作ロッ
ドの運動を実質的に約９０度変化させるよう円筒ラックと係合しているラック・
ドライバと、 円筒ラックと連接しているジョーであって、円筒ラックの運動がジョーを作動
させ、さらに関節ロッドの直線運動がジョーの回転運動を引き起こすように関節
ロッドと回転可能に連接しているジョーと を備えている。
【００１０】 （発明の詳細な説明） 参照番号により図面をより具体的に参照すると、図１、２および３は関節動き
デバイス１０の好ましい実施形態を示す。デバイス１０はハウジング１２を含む
。ハウジングは、実質的に器具１０の長さだけ延びており、近位端１４および遠
位端１６ならびに長手方向の軸Ｘを有している。ハウジング１２の内部には、関
節ロッド２０および動作ロッド３０が配置されている。関節ロッド２０および動
作ロッド３０はそれぞれ、近位端２２、３２および遠位端２４、３４を有してい
る。
【００１１】 ロッドの近位端２２、３２は、侵襲が少なく外科処置を実施するロボット・シ
ステムに取り付けられていてもよい。このようなシステムの１つは、本発明の譲
受人であるＣｏｍｐｕｔｅｒ Ｍｏｔｉｏｎ社で製造されており、参照により本
明細書にに組み込む米国特許第５，８５５，５８３号に記載されている。
【００１２】 ロッド２０、３０は、米国特許第５，８５５，５８３号に教示されている取付
手段を介してアクチュエータに取り付けられている。ロッドを取り外し可能にア
クチュエータに取り付ける他の手段は、ねじ、クリップ等の使用を含む技術で知
られている。このようにして、各ロッド２０、３０は、様々なユーザ・インター
フェースおよび電源に接続されているアクチュエータで駆動することができ、侵
襲の少ない外科処置の実施に役立つ。
【００１３】 関節ロッド２０は、長手方向の軸Ｘに沿って、実質的にハウジング１２の長さ
にわたって延びている。関節ロッド２０はジョー５０に回転可能に接続されてい
る。このような回転可能な接続は、関節ロッド２０とジョー５０の中間に取り付
けたヒンジ５２を使用して実施することができる。
【００１４】 ジョー５０は、ラック６０を使用して、ハウジング１２とその遠位端１６で回
転可能に連接している。このようにして、関節ロッド２０の運動によりジョー５
０が回転する。ラック６０はジョー５０が回転する回転軸となっている。
【００１５】 動作ロッド３０はジョー５０を作動させる。動作ロッドの遠位端３４にはピン
３６が配置されている。ピン３６はラック・ドライバ７０に配置されたラック・
チャンネル７２内にはまる。ラック・ドライバはピン７４等を介して、ハウジン
グ１２に回転可能に取り付けられている。ハウジングは、その遠位端１６にはラ
ック・ドライバ７０の横方向の運動用の２つの長手方向の開口１８、１９を有す
る。それらの開口は遠位端を通して形成されている。それらについては以下に詳
細に記述するを提供する。
【００１６】 動作ロッド３０の長手方向の運動により、ラックチャンネル７２内のピン３６
が動き、動作ロッド３０の長手方向の運動をラック・ドライバ７０の回転運動に
変換する。ラック・ドライバ７０は、ラック・ドライバ７０をハウジング１２に
取り付けているピン７４で規定される回転点の周りを回転する。ラック・ドライ
バ７０は、長手方向の開口１８、１９を通って、ハウジングの内部である空間か
ら外へと動くこともできる。
【００１７】 ラック・ドライバ７０は、ラック６０に係合するショルダ７６を有している。
ラック・ドライバ７０が回転すると、ショルダ７６はラック６０を横方向に動か
すが、これは動作ロッド３０の長手方向の運動に直交し、ハウジング１２の長手
方向の軸に直交する。ラック６０は、ハウジング１２内で、それを通して形成さ
れている２つの円筒状の開口部１３、１５を介して滑動可能である。ラック６０
が横方向に動くと、ジョー５０が動作させられる。ラック６０の横方向の運動は
第１ジョー部材５４に伝達される。第２ジョー部材５６はピン５８等を介して第
１ジョー部材５４に回転可能に接続されており、第１ジョー部材５４に対して静
置されている。このようにして、第１ジョー部材５４を動かすと、第２ジョー部
材５６は静止したままで、ジョー５０が作動される。各部材が鋭利な縁部を有し
ている場合、ジョーははさみとして機能することができる。
【００１８】 ジョー５０は、関節ロッド２０の運動を介して関節動きがなされても、常にラ
ック６０と連接している。これは、その中に形成された円周チャンネル６６を有
する円筒ラックを使用することにより実施できる。このチャンネル６６はラック
・ドライバ７０のショルダ７６ならびに第１ジョー部材５４上のショルダ５８を
受ける。
【００１９】 したがって、ジョー５０が関節運動されると、第１ジョー部材５４のショルダ
５８はラック６０内の円周チャンネル６６内で、連接を維持したまま回転し、関
節ロッド２０の動きにより生じるジョー５０の関節動きをした位置にかかわらず
ジョー５０を作動させる。
【００２０】 このように、ジョー５０の関節動きとジョー５０の作動は分離される。いくつ
かの理由から、このように分離される堅固に結合されたデバイスを提供すること
は非常に有利である。第一に、デバイスが簡単に滅菌でき、第二に、伸ばしたケ
ーブル等を使用しないため、デバイスは非常に安全に使用できる。
【００２１】 ある説明的な実施形態を記述し、添付の図面に示してきたが、当業者には様々
な他の変更も可能であることから、このような実施形態は単に例示的なものであ
り、広い発明を限定するものではないこと、本発明は図示および記述した具体的
な構成および配置に限定されるものではないことを理解されたい。
【図面の簡単な説明】
【図１】 閉じた、角度のある構成の本発明のデバイスの一部分離透視図である。
【図２】 開いた、角度のある構成の本発明のデバイスの一部分離透視図である。
【図３】 開いた、まっすぐな構成の本発明のデバイスの断面透視図である。
【手続補正書】
【提出日】平成１４年６月３日（２００２．６．３）
【手続補正１】
【補正対象書類名】明細書
【補正対象項目名】発明の名称
【補正方法】変更
【補正の内容】
【発明の名称】 動き動作が分離された堅固に結合された関節動きデバイス
───────────────────────────────────────────────────── フロントページの続き (81)指定国 ＥＰ(ＡＴ，ＢＥ，ＣＨ，ＣＹ， ＤＥ，ＤＫ，ＥＳ，ＦＩ，ＦＲ，ＧＢ，ＧＲ，ＩＥ，Ｉ Ｔ，ＬＵ，ＭＣ，ＮＬ，ＰＴ，ＳＥ)，ＯＡ(ＢＦ，ＢＪ ，ＣＦ，ＣＧ，ＣＩ，ＣＭ，ＧＡ，ＧＮ，ＧＷ，ＭＬ， ＭＲ，ＮＥ，ＳＮ，ＴＤ，ＴＧ)，ＡＰ(ＧＨ，ＧＭ，Ｋ Ｅ，ＬＳ，ＭＷ，ＳＤ，ＳＬ，ＳＺ，ＴＺ，ＵＧ，ＺＷ )，ＥＡ(ＡＭ，ＡＺ，ＢＹ，ＫＧ，ＫＺ，ＭＤ，ＲＵ， ＴＪ，ＴＭ)，ＡＥ，ＡＧ，ＡＬ，ＡＭ，ＡＴ，ＡＵ， ＡＺ，ＢＡ，ＢＢ，ＢＧ，ＢＲ，ＢＹ，ＣＡ，ＣＨ，Ｃ Ｎ，ＣＲ，ＣＵ，ＣＺ，ＤＥ，ＤＫ，ＤＭ，ＤＺ，ＥＥ ，ＥＳ，ＦＩ，ＧＢ，ＧＤ，ＧＥ，ＧＨ，ＧＭ，ＨＲ， ＨＵ，ＩＤ，ＩＬ，ＩＮ，ＩＳ，ＪＰ，ＫＥ，ＫＧ，Ｋ Ｐ，ＫＲ，ＫＺ，ＬＣ，ＬＫ，ＬＲ，ＬＳ，ＬＴ，ＬＵ ，ＬＶ，ＭＡ，ＭＤ，ＭＧ，ＭＫ，ＭＮ，ＭＷ，ＭＸ， ＮＯ，ＮＺ，ＰＬ，ＰＴ，ＲＯ，ＲＵ，ＳＤ，ＳＥ，Ｓ Ｇ，ＳＩ，ＳＫ，ＳＬ，ＴＪ，ＴＭ，ＴＲ，ＴＴ，ＴＺ ，ＵＡ，ＵＧ，ＵＺ，ＶＮ，ＹＵ，ＺＡ，ＺＷ

Claims (1)

    【特許請求の範囲】
  1. 【請求項１】 組織および針を操作するための関節動きデバイスであって、 近位端および遠位端を有する細長いハウジングと、 ハウジングの内部に延び、近位端および遠位端を有する関節ロッドと、 ハウジングの内部に延び、近位端および遠位端を有する動作ロッドと、 動作ロッドとその遠位端で連接しているラック・ドライバであって、動作ロッ
    ドの運動を実質的に約９０度変化させるよう円筒ラックと係合しているラック・
    ドライバと、 円筒ラックと連接しているジョーであって、円筒ラックの運動がジョーを作動
    させ、さらに関節ロッドの直線運動がジョーの回転運動を引き起こすように関節
    ロッドと回転可能に連接しているジョーと を備えるデバイス。
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US09/287,860 US6132441A (en) 1996-11-22 1999-04-07 Rigidly-linked articulating wrist with decoupled motion transmission
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DE60042301D1 (de) 2009-07-16
EP2016908A2 (en) 2009-01-21
CA2334458A1 (en) 2000-10-12
WO2000059384A1 (en) 2000-10-12
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US9402619B2 (en) 2016-08-02
WO2000059384A9 (en) 2001-11-15
US20130030449A1 (en) 2013-01-31
US6132441A (en) 2000-10-17
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EP1083830A1 (en) 2001-03-21
US20080103524A1 (en) 2008-05-01
ATE432656T1 (de) 2009-06-15
US8845681B2 (en) 2014-09-30
US8292916B2 (en) 2012-10-23
EP2016908A3 (en) 2009-11-25
USRE43049E1 (en) 2011-12-27

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