JP2006255411A - 吻合複合材ガスケット - Google Patents
吻合複合材ガスケット Download PDFInfo
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- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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Abstract
【解決手段】隣接する腸管切断部の間に沈着するための構造体100である。構造体は、第1の材料の少なくとも1つの内側リング102、第2の材料の中央リング104および外側リング106を備える。第1の材料および第2の材料は、接着剤、封止剤および医薬のうちの少なくとも1つからなる創傷処置材料を含み、ここで、第1の材料は、第2の材料と異なる創傷処置材料である。
【選択図】図2
Description
(技術分野)
本開示は、ガスケットに関し、そしてより詳細には、種々の身体構造を吻合する場合に漏出、出血および/または狭窄の発生率を減少させるために、ステープルデバイスと併せて使用するための複合材ガスケットに関する。
ステープルは、種々の身体構造(例えば、腸または気管支)を連結または吻合する場合、縫合を置き換えるために従来から使用されている。これらのステープルを適用するために使用される外科用ステープルデバイスは、一般的に患者中の組織の長いセグメントを同時に切断かつシールするために設計され、従ってこのような手順の時間およびリスクを大いに減少させる。
本開示は、吻合手順において隣接する腸管切断部の間に配置するための構造体および/またはガスケットを提供する。この構造体は、少なくとも、1つの第1の材料の内側リング、および第2の材料の中間リングを所有する。上記第1の材料および第2の材料は、接着剤、封止剤および/または医薬のうちの少なくとも1つからなる創傷処置材料を含む。上記第1の材料は、第2の材料と異なる。
(項目1)
吻合手順において、隣接する腸管切断部の間に沈着するための構造体であって、該構造体は、
第1の材料の少なくとも1つの内側リング;および
第2の材料の中央リング
を備え、該第1の材料および該第2の材料は、接着剤、封止剤および医薬のうちの少なくとも1つからなる創傷処置材料を含み、ここで、該第1の材料は、該第2の材料と異なる、構造体。
(項目2)
前記構造体が、前記創傷処置材料に含浸されている、項目1に記載の構造体。
(項目3)
前記構造体が、メッシュ様材料である、項目1に記載の構造体。
(項目4)
前記構造体が、生体吸収性である、項目1に記載の構造体。
(項目5)
項目4に記載の構造体であって、該構造体は、外側リングをさらに備え、ここで該構造体の外側リングは、グリコリド、グリコール酸、ラクチド、乳酸、p−ジオキサノン、e−カプロラクトン、トリメチレンカーボネートからなる群より選択される少なくとも1つのモノマー、それらのホモポリマー、それらのコポリマー、およびそれらのブレンドを含む、構造体。
(項目6)
項目4に記載の構造体であって、該構造体は、外側リングをさらに備え、ここで該構造体の外側リングは、グリコリド、ラクチド、トリメチレンカーボネート、ジオキサノン、およびそれらの組み合わせからなる群より選択される第2の材料と組み合わせて編んだポリグリコール酸ヤーンのメッシュを含む、構造体。
(項目7)
前記構造体の中央リングが、グリコリド、グリコール酸、ラクチド、乳酸、p−ジオキサノン、e−カプロラクトン、トリメチレンカーボネートからなる群より選択される少なくとも1つのモノマー、それらのホモポリマー、それらのコポリマー、およびそれらのブレンドを含む、項目4に記載の構造体。
(項目8)
前記構造体の内側リングが、グリコリド、グリコール酸、ラクチド、乳酸、p−ジオキサノン、e−カプロラクトン、トリメチレンカーボネートからなる群より選択される少なくとも1つのモノマー、それらのホモポリマー、それらのコポリマー、およびそれらのブレンドを含む、項目4に記載の構造体。
(項目9)
前記構造体が、非吸収性である、項目1に記載の構造体。
(項目10)
前記構造体の外側リングが、ポリブテール(polybuther)、ポリエーテルエステル、ポリエチレン、ポリプロピレン、ナイロン、ポリエチレンテレフタレート、ポリテトラフルオロエチレン、フッ化ポリビニリデン、ステンレス鋼、およびチタンからなる群より選択される少なくとも1つの非吸収性材料を含む、項目9に記載の構造体。
(項目11)
前記構造体の中央リングが、ポリエチレン、ポリプロピレン、ナイロン、ポリエチレンテレフタレート、ポリテトラフルオロエチレン、フッ化ポリビニリデン、ステンレス鋼、およびチタンからなる群より選択される少なくとも1つの非吸収性材料を含む、項目9に記載の構造体。
(項目12)
前記構造体の内側リングが、ポリオレフィン、ナイロン、および絹からなる群より選択される少なくとも1つの非吸収性材料を含む、項目8に記載の構造体。
(項目13)
非吸収性材料と吸収性材料との両方の複合材を含む外側リングをさらに備える、項目1に記載の構造体。
(項目14)
前記構造体の中央リングが、非吸収性材料と吸収性材料との両方の複合材を含む、項目1に記載の構造体。
(項目15)
前記構造体の内側リングが、非吸収性材料と吸収性材料との両方の複合材を含む、項目8に記載の構造体。
(項目16)
前記構造体の内側リングが、該内側リングの長さに沿って形成される少なくとも1つのギャップをさらに備える、項目8に記載の構造体。
(項目17)
前記創傷治療材料が、ヒドロゲルを含有する少なくとも1種の接着剤を含む、項目1に記載の構造体。
(項目18)
前記創傷処置材料が、フィブリン封止剤、コラーゲンベースの封止剤、および合成ポリエチレングリコールベースのヒドロゲル封止剤からなる群より選択される少なくとも1種の封止剤を含む、項目1に記載の構造体。
(項目19)
前記創傷処置材料が、抗菌剤、鎮痛剤、解熱剤、麻酔剤、鎮痙剤、抗ヒスタミン剤、抗炎症剤、心臓血管薬、診断剤、交感神経作用剤、コリン作用剤、抗ムスカリン剤、抗痙攣剤、ホルモン、増殖因子、筋弛緩剤、アドレナリン作用性ニューロン遮断剤、抗腫瘍剤、免疫原性因子、免疫抑制剤、胃腸薬、利尿剤、ステロイド、脂質、リポ多糖類、多糖類、酵素およびこれらの組み合わせからなる群より選択される少なくとも1種の医薬を含む、項目1に記載の構造体。
(項目20)
前記構造体が、第1の層および第2の層を備える、項目1に記載の構造体。
(項目21)
前記構造体の第1の層が、2要素から構成される創傷処置材料の第1の要素を含み、そして該構造体の第2の層が、該2要素から構成される創傷処置材料の第2の要素を含む、項目20に記載の構造体。
(項目22)
前記内部リングが、非生体吸収性材料を含み、そして前記中央リングが、生体吸収性材料を含む、項目1に記載の構造体。
(項目23)
隣接する腸管切断部の間に構造体を配置する方法であって、該方法は、以下の工程を包含する方法:
円形外科用吻合デバイスを提供する工程であって、該円形外科用吻合デバイスは、
アンビル部材と第1の軸とを備えるアンビルアセンブリ;および
管状本体部分中に作動可能に配置された環状ナイフと該環状ナイフの半径方向内向きに配置された第2の軸とを備える環状本体部分
を備え、該アンビルアセンブリの第1の軸は、該管状本体の第2の軸に選択的に装着可能である、工程;
該アンビルアセンブリを第1の腸管切断部に挿入する工程;
該管状本体部分を第2の腸管切断部分に挿入する工程;
少なくとも1つの内側リングおよび中央リングを備える構造体を、該第1の腸管切断部と該第2の腸管切断部との間に配置する工程であって、該構造物は、接着剤、封止剤、および医薬のうちの少なくとも1つからなる創傷処置材料を保有する、工程;
該アンビルアセンブリと管状本体部分とを互いに接近させて、該第1の腸管切断部の端部分、該構造体、および該第2の腸管切断部の端部分を、該アンビル部材と該管状本体部分との間に配置するようにする工程であって、該構造体は、該第1の腸管切断部と該第2の腸管切断部との間に配置される、工程;ならびに
該外科用吻合デバイスを発射して、該環状ナイフの半径方向内向きに配置された該第1の腸管切断部および該第2の腸管切断部の部分を切断し、そして該構造体に対して、該環状ナイフの半径方向外向きに該第1の腸管切断部および該第2の腸管切断部の部分を押す工程。
(項目24)
前記アンビルアセンブリを前記管状本体部分に接近させる工程の前に、該アンビルアセンブリの第1軸を該管状本体部分の第2の軸に装着する工程をさらに包含する、項目23に記載の方法。
(項目25)
項目24に記載の方法であって、ここで:
前記構造体は、該構造体中に形成されたアパーチャを備え;そして
前記アンビルアセンブリの第1の軸を前記管状本体部分の第2の軸に装着する工程の前に、該アンビルアセンブリの第1の軸および該管状本体部分の第2の軸の一方を該構造体のアパーチャに挿入する工程をさらに包含する、方法。
(項目26)
前記構造体が、生体吸収性である、項目24に記載の方法。
(項目27)
前記構造体が、非吸収性である、項目24に記載の方法。
(項目28)
前記構造体が、少なくとも1つの非吸収性材料と組み合わせた少なくとも1つの生体吸収性材料の複合材を含む、項目24に記載の方法。
(項目29)
前記構造体が、メッシュ様材料である、項目24に記載の方法。
(項目30)
項目24に記載の方法であって、ここで前記管状本体部分は、円形構造中に複数の外科用ステープルを保有し、該外科用ステープルは、前記環状ナイフの半径方向外向きに配置され、ここで前記吻合デバイスを発射する際に、該複数のステープルは、第1の腸管切断部、前記構造体、次いで第2の腸管切断部を貫通する、方法。
(項目31)
項目30に記載の方法であって、ここで前記外科用吻合デバイスを発射する工程が、前記第2の腸管切断部を貫いて、前記構造体を貫いて、前記管状本体部分から、前記第1の腸管切断部を貫いて、そして前記アンビル部材に対して、前記複数のステープルを駆動する工程を包含する、方法。
(項目32)
前記構造体が、第1の層および第2の層を備える、項目24に記載の方法。
(項目33)
前記構造体の第1の層が、2要素から構成される創傷処置材料の第1の要素を含み、そして該構造体の第2の層が、該2要素から構成される創傷処置材料の第2の要素を含む、項目32に記載の方法。
(項目34)
項目24に記載の方法であって、ここで前記構造体は、2要素から構成される創傷処置材料の第1の要素を含み、そして、該2要素から構成される創傷処置材料の第2の要素を該構造体に適用する工程をさらに包含する、方法。
(項目35)
項目34に記載の方法であって、ここで前記構造体は、2要素から構成される接着剤の第1の要素を含み、そして、該2要素から構成される接着剤の第2の要素を、前記接近させる工程の前に支持体構造体に適用する工程を包含する、接着剤材料を分散させる工程をさらに包含する、方法。
(項目36)
前記中央リングが、生体吸収性材料を含み、そして前記内側リングが、非生体吸収性材料を含む、項目28に記載の方法。
(項目37)
前記環状ナイフが、前記生体吸収性材料から前記非吸収性材料を切断する、項目36に記載の方法。
(項目38)
前記ナイフが、前記第1の腸管切断部と前記第2の腸管切断部との間に非吸収性材料の部分が残るように前記構造体を切断する、項目36に記載の方法。
(項目39)
前記非吸収性材料が、前記生体吸収性材料を少なくとも部分的に吸収する際に、前記本体から通過されるように整えられる、項目38に記載の方法。
ここに開示される円形吻合構造体の実施形態は、本明細書中で円形吻合ガスケットとも称され、ここで図面を参照して詳細に記載される。図面において、同様の参照番号は、類似または同一の要素を同一視する。本明細書中で使用される場合、および慣用的に、用語「遠位」は、使用者から遠い部分をいい、一方用語「近位」は、使用者に対して近い部分をいう。
本開示は、吻合手順において、隣接する腸管切断部の間に配置するための構造体および/またはガスケットを提供する。この構造体は、少なくとも、第1の材料の内側リング、および第2の材料の中央リングを保有する。この第1の材料および第2の材料は、接着剤、封止剤および/または医薬のうちの少なくとも1つからなる創傷処置材料を含む。この第1の材料は、第2の材料と異なる。
Claims (22)
- 吻合手順において、隣接する腸管切断部の間に沈着するための構造体であって、該構造体は、
第1の材料の少なくとも1つの内側リング;および
第2の材料の中央リング
を備え、該第1の材料および該第2の材料は、接着剤、封止剤および医薬のうちの少なくとも1つからなる創傷処置材料を含み、ここで、該第1の材料は、該第2の材料と異なる、構造体。 - 前記構造体が、前記創傷処置材料に含浸されている、請求項1に記載の構造体。
- 前記構造体が、メッシュ様材料である、請求項1に記載の構造体。
- 前記構造体が、生体吸収性である、請求項1に記載の構造体。
- 請求項4に記載の構造体であって、該構造体は、外側リングをさらに備え、ここで該構造体の外側リングは、グリコリド、グリコール酸、ラクチド、乳酸、p−ジオキサノン、e−カプロラクトン、トリメチレンカーボネートからなる群より選択される少なくとも1つのモノマー、それらのホモポリマー、それらのコポリマー、およびそれらのブレンドを含む、構造体。
- 請求項4に記載の構造体であって、該構造体は、外側リングをさらに備え、ここで該構造体の外側リングは、グリコリド、ラクチド、トリメチレンカーボネート、ジオキサノン、およびそれらの組み合わせからなる群より選択される第2の材料と組み合わせて編んだポリグリコール酸ヤーンのメッシュを含む、構造体。
- 前記構造体の中央リングが、グリコリド、グリコール酸、ラクチド、乳酸、p−ジオキサノン、e−カプロラクトン、トリメチレンカーボネートからなる群より選択される少なくとも1つのモノマー、それらのホモポリマー、それらのコポリマー、およびそれらのブレンドを含む、請求項4に記載の構造体。
- 前記構造体の内側リングが、グリコリド、グリコール酸、ラクチド、乳酸、p−ジオキサノン、e−カプロラクトン、トリメチレンカーボネートからなる群より選択される少なくとも1つのモノマー、それらのホモポリマー、それらのコポリマー、およびそれらのブレンドを含む、請求項4に記載の構造体。
- 前記構造体が、非吸収性である、請求項1に記載の構造体。
- 前記構造体の外側リングが、ポリブテール(polybuther)、ポリエーテルエステル、ポリエチレン、ポリプロピレン、ナイロン、ポリエチレンテレフタレート、ポリテトラフルオロエチレン、フッ化ポリビニリデン、ステンレス鋼、およびチタンからなる群より選択される少なくとも1つの非吸収性材料を含む、請求項9に記載の構造体。
- 前記構造体の中央リングが、ポリエチレン、ポリプロピレン、ナイロン、ポリエチレンテレフタレート、ポリテトラフルオロエチレン、フッ化ポリビニリデン、ステンレス鋼、およびチタンからなる群より選択される少なくとも1つの非吸収性材料を含む、請求項9に記載の構造体。
- 前記構造体の内側リングが、ポリオレフィン、ナイロン、および絹からなる群より選択される少なくとも1つの非吸収性材料を含む、請求項8に記載の構造体。
- 非吸収性材料と吸収性材料との両方の複合材を含む外側リングをさらに備える、請求項1に記載の構造体。
- 前記構造体の中央リングが、非吸収性材料と吸収性材料との両方の複合材を含む、請求項1に記載の構造体。
- 前記構造体の内側リングが、非吸収性材料と吸収性材料との両方の複合材を含む、請求項8に記載の構造体。
- 前記構造体の内側リングが、該内側リングの長さに沿って形成される少なくとも1つのギャップをさらに備える、請求項8に記載の構造体。
- 前記創傷治療材料が、ヒドロゲルを含有する少なくとも1種の接着剤を含む、請求項1に記載の構造体。
- 前記創傷処置材料が、フィブリン封止剤、コラーゲンベースの封止剤、および合成ポリエチレングリコールベースのヒドロゲル封止剤からなる群より選択される少なくとも1種の封止剤を含む、請求項1に記載の構造体。
- 前記創傷処置材料が、抗菌剤、鎮痛剤、解熱剤、麻酔剤、鎮痙剤、抗ヒスタミン剤、抗炎症剤、心臓血管薬、診断剤、交感神経作用剤、コリン作用剤、抗ムスカリン剤、抗痙攣剤、ホルモン、増殖因子、筋弛緩剤、アドレナリン作用性ニューロン遮断剤、抗腫瘍剤、免疫原性因子、免疫抑制剤、胃腸薬、利尿剤、ステロイド、脂質、リポ多糖類、多糖類、酵素およびこれらの組み合わせからなる群より選択される少なくとも1種の医薬を含む、請求項1に記載の構造体。
- 前記構造体が、第1の層および第2の層を備える、請求項1に記載の構造体。
- 前記構造体の第1の層が、2要素から構成される創傷処置材料の第1の要素を含み、そして該構造体の第2の層が、該2要素から構成される創傷処置材料の第2の要素を含む、請求項20に記載の構造体。
- 前記内部リングが、非生体吸収性材料を含み、そして前記中央リングが、生体吸収性材料を含む、請求項1に記載の構造体。
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US11/080,854 US7942890B2 (en) | 2005-03-15 | 2005-03-15 | Anastomosis composite gasket |
US11/080,854 | 2005-03-15 |
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JP2013216068A Ceased JP2014076366A (ja) | 2005-03-15 | 2013-10-17 | 吻合複合材ガスケット |
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ES2353607T3 (es) | 2011-03-03 |
JP2012066097A (ja) | 2012-04-05 |
CA2538979C (en) | 2014-01-14 |
US9226754B2 (en) | 2016-01-05 |
DE602006017614D1 (de) | 2010-12-02 |
AU2006200753C1 (en) | 2013-01-17 |
EP1702570B1 (en) | 2010-10-20 |
EP2245997B1 (en) | 2012-11-14 |
EP2135563B1 (en) | 2012-01-25 |
US8167895B2 (en) | 2012-05-01 |
US20090287230A1 (en) | 2009-11-19 |
EP1702570A1 (en) | 2006-09-20 |
ES2380999T3 (es) | 2012-05-22 |
JP2014076366A (ja) | 2014-05-01 |
US20110184444A1 (en) | 2011-07-28 |
EP2135563A1 (en) | 2009-12-23 |
CA2538979A1 (en) | 2006-09-15 |
AU2006200753B2 (en) | 2011-10-13 |
EP2245997A1 (en) | 2010-11-03 |
JP2014193329A (ja) | 2014-10-09 |
AU2006200753A1 (en) | 2006-10-05 |
US20060212050A1 (en) | 2006-09-21 |
US7942890B2 (en) | 2011-05-17 |
JP4986207B2 (ja) | 2012-07-25 |
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