ES2589805T3 - Aparato de fijación quirúrgica de compresión variable - Google Patents
Aparato de fijación quirúrgica de compresión variable Download PDFInfo
- Publication number
- ES2589805T3 ES2589805T3 ES11005121.6T ES11005121T ES2589805T3 ES 2589805 T3 ES2589805 T3 ES 2589805T3 ES 11005121 T ES11005121 T ES 11005121T ES 2589805 T3 ES2589805 T3 ES 2589805T3
- Authority
- ES
- Spain
- Prior art keywords
- crimp
- pushers
- cartridge
- surgical fasteners
- surgical
- 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.)
- Active
Links
- 230000006835 compression Effects 0.000 title 1
- 238000007906 compression Methods 0.000 title 1
- 230000015572 biosynthetic process Effects 0.000 abstract description 3
- 238000002788 crimping Methods 0.000 description 2
- 238000010304 firing Methods 0.000 description 2
- 230000003872 anastomosis Effects 0.000 description 1
- 239000012636 effector Substances 0.000 description 1
Classifications
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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
-
- 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
-
- 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
- A61B17/07207—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 the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
- B25C—HAND-HELD NAILING OR STAPLING TOOLS; MANUALLY OPERATED PORTABLE STAPLING TOOLS
- B25C5/00—Manually operated portable stapling tools; Hand-held power-operated stapling tools; Staple feeding devices therefor
- B25C5/02—Manually operated portable stapling tools; Hand-held power-operated stapling tools; Staple feeding devices therefor with provision for bending the ends of the staples on to the work
- B25C5/0285—Hand-held stapling tools, e.g. manually operated, i.e. not resting on a working surface during operation
- B25C5/0292—Hand-held stapling tools, e.g. manually operated, i.e. not resting on a working surface during operation with the objects to be stapled together introduced perpendicularly to the longitudinal axis of the tool in an opening formed by an anvil and a plunger
-
- 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
- A61B2017/07228—Arrangement of the staples
-
- 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
- A61B2017/07235—Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
-
- 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
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (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)
- Mechanical Engineering (AREA)
- Surgical Instruments (AREA)
Abstract
Un aparato (1000) de aplicación de fijadores quirúrgicos que comprende: un conjunto de fijación que incluye una sección de yunque (1014) y una sección de cartucho (100), la sección de cartucho (100) y la sección de yunque (101) que pueden moverse desde una posición de no sujeción a una posición de sujeción para sujetar el tejido entre ellos, teniendo la sección de cartucho una multitud de ranuras (126) de retención; una multitud de fijadores quirúrgicos (130), teniendo cada uno de los fijadores quirúrgicos (130) un puente trasero y unas patas que se disponen en una ranura (126) de retención correspondiente; una multitud de empujadores (1132), teniendo cada empujador (1132) un empujadores de engarce (1132) y un empujador de rizado (1138); y un deslizador de actuación (1134) que se desplaza distalmente a través del cartucho (100) y que incluye cuñas excéntricas que entran en contacto con los empujadores (1132) y dirigen los empujadores (1132) y dirigen los fijadores (130) contra la sección de yunque (1014), teniendo cada cuña excéntrica una superficie (1135a) de cuña de engarce y una superficie (1135c) de cuña de rizado, las superficies (1135a) de cuña de engarce que entran en contacto con los empujadores de engarce (1132) cuando el deslizador de actuación (1014) se desplaza, y las superficies (1135c) de cuña de rizado que entran en contacto con los empujadores de rizado (1138) cuando el deslizador de actuación (1134) se desplaza, de tal manera que los empujadores de engarce (1132) dirigen los fijadores quirúrgicos (130) contra la sección de yunque (1014) y los empujadores de rizado (1138) forman los rebajes (116) en los puentes traseros de los fijadores quirúrgicos (130), en el que el conjunto de fijación y la multitud de fijadores quirúrgicos (130) se configuran para formar los fijadores quirúrgicos con diferentes configuraciones de formación para aplicar fuerzas de compresión variables al tejido.
Description
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despliegan en filas, por ejemplo, las filas interior y exterior en la realización de la FIG. 18, en los lados opuestos de la línea central 252 y se forman en fijadores que tienen una o más configuraciones de formación, por ejemplo, los fijadores quirúrgicos mostrados en las FIGS. 3a, 3b, 3c, 3d.
La FIG. 4 muestra un ejemplo de un cartucho 2220 de fijadores quirúrgicos que tienen las ranuras 2224, formadas en la superficie superior 2222 del cartucho. Las ranuras se extienden en general de forma perpendicular al eje longitudinal. Estas ranuras 2224 se disponen en columnas, tales como la columna 2227 y las filas 2228. Este cartucho 2220 no incluye una ranura longitudinal para una cuchilla. El cartucho 2220 incluye una multitud de empujadores como se discute en la presente memoria para formar determinados fijadores con un espacio interior relativamente grande, y otros fijadores con un espacio interior relativamente pequeño.
Aunque el cartucho 200 de fijadores quirúrgicos de la FIG. 10 se representa cuando incluye los pares de la primera y segunda filas 228a, 228b, respectivamente, se pueden incluir en realizaciones alternativas del cartucho 200 de fijadores quirúrgicos, filas adicionales de ranuras 226 de retención de fijadores, y en consecuencia, filas adicionales de fijadores quirúrgicos, como se discutió anteriormente con respecto al cartucho 100 de fijadores quirúrgicos. También, los fijadores se pueden disponer de diferentes maneras dentro del cartucho como se discute en la presente memoria con respecto a las otras realizaciones del cartucho.
Con referencia adicional a la FIG. 11, se ilustra un aparato 4000 de aplicación de fijadores quirúrgicos de cualquiera de la variedad reutilizable o desechable para su uso con el cartucho 200 de fijadores quirúrgicos. El aparato 4000 de aplicación de fijadores quirúrgicos incluye un conjunto de mango 4002, una parte alargada 4004 que se extiende distalmente desde el mango 4002, y un brazo 4006 que se extiende desde un extremo distal 4008 de la parte alargada 4004. El aparato 4000 de aplicación de fijadores quirúrgicos incluye además un extremo efector 4010 que incluye un yunque 4012 fijado de forma ortogonal al brazo 4006 y un receptor 4014 del cartucho de fijadores quirúrgicos acoplado operativamente al extremo distal 4008 de la parte alargada 4004 para sostener el cartucho 200 de fijadores quirúrgicos sobre el mismo.
En funcionamiento, el aparato 4000 de aplicación de fijadores quirúrgicos se dispara de forma similar a y según otros instrumentos de grapado quirúrgico conocidos. Para una discusión detallada de la aproximación y el disparo del instrumento 4000 de grapado quirúrgico, se hace referencia a la comúnmente cedida Patente de EE.UU. 5.964.394, asignada actualmente a Tyco Healthcare Group LP. El conjunto de mango 4002 incluye un alojamiento 4016, que incluye un elemento de mango estacionario 4018. Un mango móvil 4020 se sujeta de manera pivotante dentro del alojamiento 4016 y se desvía lejos del elemento de mango estacionario 4018. El movimiento del elemento de mango móvil 4020 en la dirección del elemento de mango estacionario 4018 imparte una fuerza de accionamiento a un eje de accionamiento dentro del alojamiento 4016 que a su vez imparte una fuerza a una barra de empuje dentro del cartucho 4014 de grapas, para de ese modo expulsar fijadores dispuestos dentro de las ranuras del cartucho 200 de grapas y para dirigir los fijadores quirúrgicos contra una superficie de formación de grapas del elemento de yunque 4012. Antes de hacer avanzar el cartucho 4014 de grapas hacia el yunque 4012, el médico mueve una palanca de aproximación 4017 hacia el alojamiento 4016 que provoca que el cartucho 4014 de grapas se mueva hacia el yunque 4012 antes de disparar las grapas y aproximar el cartucho 4014 de grapas con respecto al yunque 4012 con el tejido dispuesto entre ellos.
El aparato 4000 de aplicación de fijadores quirúrgicos se utiliza para aplicar una multitud de fijadores quirúrgicos, por ejemplo, los fijadores quirúrgicos 130 a cada lado de una sección de tejido objetivo (no mostrado), y puede ser cualquier aparato de aplicación de fijadores quirúrgicos adecuado para este propósito previsto, que incluye pero no se limita al instrumento de fijación de la anastomosis transversal que se describe en la Patente de EE.UU. Nº.
7.070.083.
El aparato de aplicación de fijadores tiene una multitud de empujadores que se hacen avanzar en la dirección distal para desplegar los fijadores quirúrgicos desde el cartucho, en la dirección distal, contra el yunque. Los fijadores quirúrgicos se despliegan y se forman en general simultáneamente. Para formar fijadores quirúrgicos con diferentes configuraciones de formación (por ejemplo, como se muestran en las FIGS. 3a, 3b, 3c, 3d), en comparación con otros fijadores quirúrgicos en el cartucho, algunos de los empujadores tienen un empujador de rizado y un empujador de engarce. El empujador de rizado y el empujador de engarce pueden ser móviles uno con respecto al otro, para cerrar por separado el fijador quirúrgico y luego formar una cavidad en el puente posterior del fijador quirúrgico, o el empujador de rizado y el empujador de engarce se pueden formar integralmente uno con el otro. A partir de entonces, se pueden utilizar un bisturí u otro elemento de corte similar para eliminar la sección objetivo de tejido. Se pueden obtener detalles adicionales sobre el uso y el funcionamiento del aparato 4000 de aplicación de fijaciones quirúrgicas mediante la referencia a la Patente de EE.UU. Nº. 7.070.083. En una realización alternativa, el aparato 4000 podría incluir un elemento de corte como en los otros cartuchos descritos en la presente memoria.
El aparato de aplicación de fijadores quirúrgicos según ciertas realizaciones de la presente descripción incluye una multitud de barras excéntricas para interactuar con los empujadores para desplegar los fijadores quirúrgicos. Por ejemplo, el aparato descrito en la Patente de EE.UU. Nº. 5.318.221, tiene un adaptador de barra excéntrica que tiene una multitud de barras excéntricas y una cuchilla. Se hace avanzar un canal a través del funcionamiento del mango del aparato, que dirige las barras excéntricas y la cuchilla hacia adelante. Se hace avanzar un tubo de sujeción que rodea el extremo proximal del yunque para sujetar el yunque y el cartucho juntos. En otro ejemplo, el
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Claims (1)
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imagen1
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US5191108P | 2008-05-09 | 2008-05-09 | |
| US51911P | 2008-05-09 | ||
| US417709 | 2009-04-03 | ||
| US12/417,709 US8186556B2 (en) | 2008-05-09 | 2009-04-03 | Variable compression surgical fastener apparatus |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| ES2589805T3 true ES2589805T3 (es) | 2016-11-16 |
Family
ID=41005235
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| ES11005121.6T Active ES2589805T3 (es) | 2008-05-09 | 2009-04-29 | Aparato de fijación quirúrgica de compresión variable |
| ES09251224.3T Active ES2622869T3 (es) | 2008-05-09 | 2009-04-29 | Aparato de fijación quirúrgica de compresión variable |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| ES09251224.3T Active ES2622869T3 (es) | 2008-05-09 | 2009-04-29 | Aparato de fijación quirúrgica de compresión variable |
Country Status (7)
| Country | Link |
|---|---|
| US (3) | US8186556B2 (es) |
| EP (2) | EP2116192B1 (es) |
| JP (3) | JP5431015B2 (es) |
| CN (2) | CN103371859B (es) |
| AU (2) | AU2009201688B2 (es) |
| CA (1) | CA2664874C (es) |
| ES (2) | ES2589805T3 (es) |
Families Citing this family (679)
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| US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
| US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
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| US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
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-
2009
- 2009-04-03 US US12/417,709 patent/US8186556B2/en active Active
- 2009-04-28 AU AU2009201688A patent/AU2009201688B2/en not_active Ceased
- 2009-04-29 EP EP09251224.3A patent/EP2116192B1/en not_active Not-in-force
- 2009-04-29 CA CA2664874A patent/CA2664874C/en not_active Expired - Fee Related
- 2009-04-29 ES ES11005121.6T patent/ES2589805T3/es active Active
- 2009-04-29 ES ES09251224.3T patent/ES2622869T3/es active Active
- 2009-04-29 EP EP11005121.6A patent/EP2371296B1/en active Active
- 2009-05-07 JP JP2009113091A patent/JP5431015B2/ja not_active Expired - Fee Related
- 2009-05-08 CN CN201310235090.8A patent/CN103371859B/zh active Active
- 2009-05-08 CN CN2009101364292A patent/CN101574273B/zh active Active
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2012
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- 2012-11-30 US US13/690,339 patent/US9113870B2/en active Active
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2013
- 2013-09-18 JP JP2013192614A patent/JP5729781B2/ja active Active
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2014
- 2014-09-16 AU AU2014227435A patent/AU2014227435B2/en not_active Ceased
- 2014-10-30 JP JP2014220977A patent/JP2015071042A/ja not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| CN103371859B (zh) | 2015-01-14 |
| CN101574273B (zh) | 2013-07-17 |
| US8342380B2 (en) | 2013-01-01 |
| EP2116192A1 (en) | 2009-11-11 |
| US8186556B2 (en) | 2012-05-29 |
| AU2009201688B2 (en) | 2014-06-26 |
| JP2014054544A (ja) | 2014-03-27 |
| US9113870B2 (en) | 2015-08-25 |
| EP2371296B1 (en) | 2016-08-10 |
| US20120228359A1 (en) | 2012-09-13 |
| JP2015071042A (ja) | 2015-04-16 |
| US20130087603A1 (en) | 2013-04-11 |
| AU2014227435A1 (en) | 2014-10-02 |
| CA2664874A1 (en) | 2009-11-09 |
| EP2116192B1 (en) | 2017-03-22 |
| JP2009268909A (ja) | 2009-11-19 |
| EP2371296A1 (en) | 2011-10-05 |
| AU2014227435B2 (en) | 2015-09-17 |
| US20090281554A1 (en) | 2009-11-12 |
| JP5431015B2 (ja) | 2014-03-05 |
| CN101574273A (zh) | 2009-11-11 |
| CN103371859A (zh) | 2013-10-30 |
| ES2622869T3 (es) | 2017-07-07 |
| JP5729781B2 (ja) | 2015-06-03 |
| AU2009201688A1 (en) | 2009-11-26 |
| CA2664874C (en) | 2016-09-20 |
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