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1.发明授权
公开(公告)号：US6024748A
公开(公告)日：2000-02-15
申请号：US877701
申请日：1997-06-17
IPC分类号： A61B17/08 , A61B17/11 , A61B17/115 , A61B17/128 , A61B17/04
CPC分类号： A61B17/11 , A61B17/1152 , A61B17/1285 , A61B17/08 , A61B17/083 , A61B2017/1107 , A61B2017/1135
摘要： There is disclosed a surgical instrument and loading unit for performing an anastomosis of first and second blood vessels. The surgical instrument includes a handle assembly and a body portion extending distally from the handle assembly. The detachable loading unit includes an anvil releasably engagable with a distal end of the body portion and having a plurality of fasteners disposed in channels about the circumference of a distal end of the anvil. A pusher is slidably mounted over the anvil such that distal movement of the pusher in response to actuation of the handle assembly cams the fasteners between the anvil and a distal end of the pusher to simultaneously crimp the fasteners about tissue. A method of performing an anastomosis is also disclosed and includes positioning a first vessel in the loading unit and partially inserting the first vessel through an opening in a second vessel. The surgical instrument is subsequently attached to the loading unit and the handle assembly is actuated to crimp fasteners about the first and second vessels to form an anastomosis.
摘要翻译： 公开了用于进行第一和第二血管的吻合的手术器械和装载单元。 手术器械包括手柄组件和从手柄组件向远侧延伸的主体部分。 可拆卸的装载单元包括可释放地与主体部分的远端接合的砧座，并且具有围绕砧座的远端的圆周的通道设置的通道中的多个紧固件。 推动器可滑动地安装在砧座上，使得响应于手柄组件的致动而推动器的远端移动凸现砧座和推动器的远端之间的紧固件，以同时在组织周围压紧紧固件。 还公开了进行吻合的方法，并且包括将第一容器定位在装载单元中并且将第一容器部分地插入通过第二容器中的开口。 手术器械随后附接到装载单元并且手柄组件被致动以围绕第一和第二容器卷曲紧固件以形成吻合。
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公开(公告)号：US08464924B2
公开(公告)日：2013-06-18
申请号：US11803817
申请日：2007-05-16
申请人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
发明人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
IPC分类号： A61B17/06816
CPC分类号： A61B17/1155 , A61B17/115 , A61B17/34 , A61B2017/00128 , A61B2017/07257 , A61B2017/2905
摘要： This application is directed to a surgical stapling device for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The handle portion includes a rotatable approximation knob for approximating the anvil and shell assemblies and a firing trigger for actuating a firing mechanism for ejecting staples positioned within the shell assembly. The firing trigger forms one link of a two bar linkage provided to actuate the firing mechanism. The anvil assembly includes a tiltable anvil which will tilt automatically after firing of the device and unapproximating the anvil and shell assemblies. The head portion also includes a retractable trocar assembly which is slidably positioned within an anvil retainer and is automatically advanced and retracted upon attachment and detachment of the anvil assembly onto the anvil retainer, and a lockout tube.
摘要翻译： 该应用涉及用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 手柄部分包括用于近似砧座和壳体组件的可旋转近似旋钮，以及用于致动用于排出位于壳体组件内的缝钉的击发机构的击发触发器。 击发触发器形成两个连杆的一个连杆，用于致动击发机构。 砧座组件包括可倾斜的砧座，该砧座将在装置点火之后自动倾斜并且使砧座和壳体组件不接近。 头部还包括可伸缩的套针套组件，其可滑动地定位在砧座保持器内，并且在将砧组件安装和拆卸到砧座保持器上时自动前进和缩回，以及锁定管。
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公开(公告)号：US20120010611A1
公开(公告)日：2012-01-12
申请号：US13167876
申请日：2011-06-24
IPC分类号： A61B18/14
CPC分类号： A61B18/1445 , A61B34/30 , A61B90/04 , A61B2018/00083
摘要： A cover for an electrosurgical instrument having a wrist structure and an end effector is provided. The cover includes a hollow elongated structure, which includes a tip cover portion and a base cover portion integrally connected to the tip cover portion. The tip cover portion has a distal end with an opening therethrough sized to receive the end effector of the electrosurgical instrument and is composed of a first, electrically insulative material having a flexibility sufficient to allow the end effector to be manipulated while the end effector is received in the opening. The base cover portion is composed of a second material having a higher tear strength than the first material. The tip cover portion and the base cover portion overlap at an overlap region configured to receive the wrist structure of the electrosurgical instrument when the end effector is received in the opening.
摘要翻译： 提供具有手腕结构和末端执行器的电外科器械的盖子。 所述盖包括中空细长结构，其包括顶端盖部分和与所述末端盖部分整体连接的底盖部分。 尖端盖部分具有远端，其具有穿过其开口的开口，其尺寸适于接收电外科器械的端部执行器，并且由第一电绝缘材料构成，该第一电绝缘材料具有足以允许末端执行器在末端执行器被接收时被操纵的柔性 在开幕 底盖部分由具有比第一材料更高的撕裂强度的第二材料构成。 顶端盖部分和基部覆盖部分在重叠区域处重叠，当重叠区域被配置为当末端执行器被接收在开口中时接纳电外科器械的腕部结构。
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公开(公告)号：US07234624B2
公开(公告)日：2007-06-26
申请号：US11208667
申请日：2005-08-22
申请人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
发明人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
CPC分类号： A61B17/1155 , A61B17/115 , A61B17/34 , A61B2017/00128 , A61B2017/07257 , A61B2017/2905
摘要： This application is directed to a surgical stapling device for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The handle portion includes a rotatable approximation knob for approximating the anvil and shell assemblies and a firing trigger for actuating a firing mechanism for ejecting staples positioned within the shell assembly. The firing trigger forms one link of a two bar linkage provided to actuate the firing mechanism. The anvil assembly includes a tiltable anvil which will tilt automatically after firing of the device and unapproximating the anvil and shell assemblies. The head portion also includes a retractable trocar assembly which is slidably positioned within an anvil retainer and is automatically advanced and retracted upon attachment and detachment of the anvil assembly onto the anvil retainer. A lockout tube is provided and is positioned about an anvil retainer for releasably engaging an anvil assembly. The lockout tube prevents inadvertent detachment of the anvil assembly from the anvil retainer. The surgical stapling device also includes a firing lockout assembly which prevents actuation of the firing trigger until an anvil has been attached to the device and the anvil has been approximated. In one preferred embodiment, the firing lockout assembly includes a trigger lock and a safety bracket which prevents movement of the trigger lock from a locked to an unlocked position until an anvil has been attached to the device and approximated and returns the trigger lock to a locked position after the device has been fired. A tactile indication mechanism is also provided for notifying a surgeon that the device has been fired and for notifying a surgeon that the anvil head has been unapproximated a distance sufficient to permit the anvil head to tilt.
摘要翻译： 该应用涉及用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 手柄部分包括用于近似砧座和壳体组件的可旋转近似旋钮，以及用于致动用于排出位于壳体组件内的缝钉的击发机构的击发触发器。 击发触发器形成两个连杆的一个连杆，用于致动击发机构。 砧座组件包括可倾斜的砧座，该砧座将在装置点火之后自动倾斜并且使砧座和壳体组件不接近。 头部还包括可伸缩套管针组件，其可滑动地定位在砧座保持器内，并且在将砧组件附接和拆卸到砧座保持器上时自动前进和缩回。 锁定管被设置并且围绕砧座保持器定位以可释放地接合砧座组件。 锁定管防止砧组件从砧座保持器的意外脱离。 外科缝合装置还包括击发锁定组件，其防止触发触发器的致动，直到砧已经附接到装置并且砧已被近似。 在一个优选实施例中，击发锁定组件包括触发锁和安全支架，其防止触发锁从锁定位置移动到解锁位置，直到砧座已经附接到装置并近似并且将触发器锁定回锁定 设备启动后的位置。 还提供了一种触觉指示机构，用于通知外科医生该装置已经被点燃，并且通知外科医生砧座头未被近距离足以允许砧头倾斜的距离。
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公开(公告)号：US09204923B2
公开(公告)日：2015-12-08
申请号：US12173938
申请日：2008-07-16
CPC分类号： A61B18/1445 , A61B17/32 , A61B34/30 , A61B34/71 , A61B2017/003 , A61B2017/2927 , A61B2017/2945 , A61B2018/00345 , A61B2018/00404 , A61B2018/00595 , A61B2018/00601 , A61B2018/00619 , A61B2018/1432 , A61B2018/146 , A61B2034/305
摘要： An electrically energized medical instrument uses one or more drive cables to both actuate mechanical components of a wrist mechanism or an effector and to electrically energize the effector. Electrical isolation can be achieved using an insulating main tube through which drive cables extend from a backend mechanism to the effector, an insulating end cover that leaves only the desired portions of the effector exposed, and one or more seals to prevent electrically conductive liquid from entering the main tube. Component count and cost may be further reduced using a pair of pulleys that are shared by four drive cables.
摘要翻译： 电动医疗器械使用一个或多个驱动电缆来致动手腕机构或效应器的机械部件并且使效应器电通电。 电绝缘可以使用绝缘主管，驱动电缆从后端机构延伸到效应器，绝缘端盖，其仅留下被暴露的效应器的期望部分，以及一个或多个密封件，以防止导电液体进入 主管。 使用由四个驱动电缆共享的一对滑轮可以进一步减少部件数量和成本。
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公开(公告)号：US09138284B2
公开(公告)日：2015-09-22
申请号：US13167876
申请日：2011-06-24
CPC分类号： A61B18/1445 , A61B34/30 , A61B90/04 , A61B2018/00083
摘要： A cover for an electrosurgical instrument having a wrist structure and an end effector is provided. The cover includes a hollow elongated structure, which includes a tip cover portion and a base cover portion integrally connected to the tip cover portion. The tip cover portion has a distal end with an opening therethrough sized to receive the end effector of the electrosurgical instrument and is composed of a first, electrically insulative material having a flexibility sufficient to allow the end effector to be manipulated while the end effector is received in the opening. The base cover portion is composed of a second material having a higher tear strength than the first material. The tip cover portion and the base cover portion overlap at an overlap region configured to receive the wrist structure of the electrosurgical instrument when the end effector is received in the opening.
摘要翻译： 提供具有手腕结构和末端执行器的电外科器械的盖子。 所述盖包括中空细长结构，其包括顶端盖部分和与所述末端盖部分整体连接的底盖部分。 尖端盖部分具有远端，其具有穿过其开口的开口，其尺寸适于接收电外科器械的端部执行器，并且由第一电绝缘材料构成，该第一电绝缘材料具有足以允许末端执行器在末端执行器被接收时被操纵的柔性 在开幕 底盖部分由具有比第一材料更高的撕裂强度的第二材料构成。 顶端盖部分和基部覆盖部分在重叠区域处重叠，当重叠区域被配置为当末端执行器被接收在开口中时接纳电外科器械的腕部结构。
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公开(公告)号：US20080142566A1
公开(公告)日：2008-06-19
申请号：US11803817
申请日：2007-05-16
申请人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
发明人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
IPC分类号： A61B17/115
CPC分类号： A61B17/1155 , A61B17/115 , A61B17/34 , A61B2017/00128 , A61B2017/07257 , A61B2017/2905
摘要： This application is directed to a surgical stapling device for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The handle portion includes a rotatable approximation knob for approximating the anvil and shell assemblies and a firing trigger for actuating a firing mechanism for ejecting staples positioned within the shell assembly. The firing trigger forms one link of a two bar linkage provided to actuate the firing mechanism. The anvil assembly includes a tiltable anvil which will tilt automatically after firing of the device and unapproximating the anvil and shell assemblies. The head portion also includes a retractable trocar assembly which is slidably positioned within an anvil retainer and is automatically advanced and retracted upon attachment and detachment of the anvil assembly onto the anvil retainer. A lockout tube is provided and is positioned about an anvil retainer for releasably engaging an anvil assembly. The lockout tube prevents inadvertent detachment of the anvil assembly from the anvil retainer. The surgical stapling device also includes a firing lockout assembly which prevents actuation of the firing trigger until an anvil has been attached to the device and the anvil has been approximated. In one preferred embodiment, the firing lockout assembly includes a trigger lock and a safety bracket which prevents movement of the trigger lock from a locked to an unlocked position until an anvil has been attached to the device and approximated and returns the trigger lock to a locked position after the device has been fired. A tactile indication mechanism is also provided for notifying a surgeon that the device has been fired and for notifying a surgeon that the anvil head has been unapproximated a distance sufficient to permit the anvil head to tilt.
摘要翻译： 该应用涉及用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 手柄部分包括用于近似砧座和壳体组件的可旋转近似旋钮，以及用于致动用于排出位于壳体组件内的缝钉的击发机构的击发触发器。 击发触发器形成两个连杆的一个连杆，用于致动击发机构。 砧座组件包括可倾斜的砧座，该砧座将在装置点火之后自动倾斜并且使砧座和壳体组件不接近。 头部还包括可伸缩套管针组件，其可滑动地定位在砧座保持器内，并且在将砧组件附接和拆卸到砧座保持器上时自动前进和缩回。 锁定管被设置并且围绕砧座保持器定位以可释放地接合砧座组件。 锁定管防止砧组件从砧座保持器的意外脱离。 外科缝合装置还包括击发锁定组件，其防止触发触发器的致动，直到砧已经附接到装置并且砧已被近似。 在一个优选实施例中，击发锁定组件包括触发锁和安全支架，其防止触发锁从锁定位置移动到解锁位置，直到砧座已经附接到装置并近似并且将触发器锁定回锁定 设备启动后的位置。 还提供了一种触觉指示机构，用于通知外科医生该装置已经被点燃，并且通知外科医生砧座头未被近距离足以允许砧头倾斜的距离。
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公开(公告)号：US06945444B2
公开(公告)日：2005-09-20
申请号：US10472402
申请日：2002-04-03
申请人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
发明人： Richard D. Gresham , Scott E. Manzo , Ernest Aranyi , Robert J. Geiste , Bruce K. Jankowski , Keith Milliman
IPC分类号： A61B17/00 , A61B17/115 , A61B17/34 , A61B17/068
CPC分类号： A61B17/1155 , A61B17/115 , A61B17/34 , A61B2017/00128 , A61B2017/07257 , A61B2017/2905
摘要： This application is directed to a surgical stapling device for performing circular anastomoses. The stapling device includes a retractable trocar which is slidably supported by an anvil retainer and movable from a retracted position located within the anvil retainer to an advanced position extending from the anvil retainer. The trocar defines a sensor and is operatively connected to an indicator assembly. The indicator assembly is operatively associated with an anvil assembly such that the indicator will not move from a fire-not ready position to a fire-ready position until an anvil assembly has been mounted to the anvil retainer.
摘要翻译： 该应用涉及用于执行圆形吻合的外科缝合装置。 缝合装置包括可伸缩套针，其可滑动地由砧座保持器支撑并且可以从位于砧座保持器内的缩回位置移动到从砧座保持器延伸的前进位置。 套管针定义传感器并且可操作地连接到指示器组件。 指示器组件与砧座组件操作地相关联，使得指示器将不会从未准备就绪的位置移动到就绪位置，直到砧座组件已经安装到砧座保持器。
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公开(公告)号：US07546940B2
公开(公告)日：2009-06-16
申请号：US11978345
申请日：2007-10-29
申请人： Keith L. Milliman , Bruce K. Jankowski , Douglas J. Cuny , Kevin Sniffin , Anthony Dato , Richard D. Gresham
发明人： Keith L. Milliman , Bruce K. Jankowski , Douglas J. Cuny , Kevin Sniffin , Anthony Dato , Richard D. Gresham
IPC分类号： A61B17/068
CPC分类号： A61B17/068 , A61B17/115 , A61B17/1155 , A61B17/32053 , A61B2017/00371 , A61B2017/07257 , A61B2017/2905 , A61B2090/0811 , A61B2090/3616
摘要： A surgical stapling device is disclosed for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The anvil assembly includes a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The anvil assembly of the stapling device also includes a retainer clip positioned on the anvil head. The retainer clip includes at least one resilient arm which is positioned to engage a cutting ring during unapproximation of the stapling device.
摘要翻译： 公开了用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 砧座组件包括可倾斜的砧座，该砧座将在装置被点火并且未被近似之后自动倾斜。 钉钉装置的砧座组件还包括定位在砧头上的保持夹。 保持夹包括至少一个弹性臂，定位成在缝合装置的未近似期间接合切割环。
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公开(公告)号：US08348122B2
公开(公告)日：2013-01-08
申请号：US11515660
申请日：2006-09-05
申请人： Keith L. Milliman , Bruce K. Jankowski , Douglas J. Cuny , Kevin Sniffin , Anthony Dato , Richard D. Gresham
发明人： Keith L. Milliman , Bruce K. Jankowski , Douglas J. Cuny , Kevin Sniffin , Anthony Dato , Richard D. Gresham
IPC分类号： A61B17/064
CPC分类号： A61B17/068 , A61B17/115 , A61B17/1155 , A61B17/32053 , A61B2017/00371 , A61B2017/07257 , A61B2017/2905 , A61B2090/0811 , A61B2090/3616
摘要： A surgical stapling device is disclosed for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The stapling device includes an approximation mechanism including a rotatable knob, a screw having a helical channel and an anvil retainer. The helical channel includes a dwell portion for providing a tactile indication to a surgeon that the anvil retainer has been advanced to a position wherein the anvil assembly can be removed from the anvil retainer. A removable trocar for attachment to the anvil assembly is also disclosed which includes a rib positioned proximally of a mounting projection. The rib is positioned to align the mounting projection with associated engagement structure of the anvil assembly.
摘要翻译： 公开了用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 头部包括砧座组件，该砧组件包括可倾斜的砧座，该砧座将在该装置被点火并且未被近似之后自动倾斜。 可倾斜的砧座提供减小的砧座轮廓，以在执行吻合过程之后减少在装置移除期间的创伤。 缝合装置包括近似机构，其包括可旋转旋钮，具有螺旋通道的螺钉和砧座保持器。 所述螺旋通道包括用于向外科医生提供触觉指示的停留部分，所述砧座保持器已经前进到其中所述砧座组件能够从所述砧座保持器移除的位置。 还公开了一种用于连接到砧组件的可拆卸的套针针，其包括位于安装突起的近侧的肋。 肋被定位成使安装突起与砧组件的相关接合结构对准。
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