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Publication numberCN101869496 B
Publication typeGrant
Application numberCN 201010167574
Publication date17 Oct 2012
Filing date15 Sep 2004
Priority date15 Sep 2003
Also published asCN1882370A, CN1882370B, CN101869496A, EP1662971A2, EP1662971A4, EP1662971B1, EP1662971B2, EP2311520A1, EP2311520B1, US7762998, US7892200, US8007465, US8496614, US20060190039, US20090259231, US20090318872, US20100286649, WO2005037055A2, WO2005037055A3
Publication number201010167574.X, CN 101869496 B, CN 101869496B, CN 201010167574, CN-B-101869496, CN101869496 B, CN101869496B, CN201010167574, CN201010167574.X
Inventors弗雷德里克L科, 罗伯特E小霍伊特, 雅内尔比尔克
Export CitationBiBTeX, EndNote, RefMan
External Links: SIPO, Espacenet
Implantable device fastening system and methods of use
CN 101869496 B
The invention relates to an implantable type access terminal port element and transferring tool system, which comprises an implantable type access terminal port element which comprises a base; a plurality of fasteners pivotally connected to the base and capable of moving between an arranging front position and an arranging position; a first rotatable component connected to the base, which is arranged into a plurality of fasteners arranged by rotating the first rotatable component; and a transferring tool system which is beneficial to implant the access terminal port element into a soft tissue. The transferring tool comprises a second rotatable component which is arranged to be jointed with the first rotatable component by the removing mode; and an actuating assembly which can effectively enable the fasteners to be moved into the arranging position. The actuating assembly has a driving member jointed to the second rotatable component by the operation mode.
Claims(21)  translated from Chinese
1. 一种可植入式进入端口元件,包括: 壳体; 由壳体固定的隔膜,所述隔膜的一端形成可植入式进入端口元件的上表面的至少一部分,所述隔膜能够由针刺穿; 位于隔膜下方的空间,流体可从刺穿隔膜的针输入到所述空间内; 被包括在可植入式进入端口元件中的紧固件,所述紧固件使得用户将可植入式进入端口元件附连到组织上,所述紧固件具有配设前位置和配设位置,紧固件在该配设前位置中缩回到可植入式进入端口元件中,紧固件在该配设位置在所述可植入式进入端口元件的下表面以下延伸。 An implantable access port device, comprising: a housing; fixed diaphragm housing, one end of said diaphragm forms at least a portion of the implantable access port on the surface of the diaphragm by the needle can be piercing; space located below the diaphragm, fluid can enter from the needle to pierce the membrane within the space; fasteners are included in implantable access port in the fastener so that the user will be planted -in access port is attached to tissue, said fastener having a pre-arranged position and the arrangement position, the fastener is disposed in the retracted position prior to an implantable access port device, fastening member is disposed in the extended position in the implantable access port under the surface or less.
2.如权利要求I所述的可植入式进入端口元件,其特征在于,所述紧固件从配设前位置可枢转地旋转至配设位置。 2. The implantable access port device as claimed in claim I, wherein said fastener is pivotally rotated from the front position to the disposed position disposed.
3.如权利要求2所述的可植入式进入端ロ元件,其特征在干,所述紧固件包括多个紧固件,所述多个紧固件同时从配设前位置枢转至配设位置。 3. The claim 2 implantable ro entry end element, characterized in that the dry, the fastener comprises a plurality of fasteners, the plurality of fasteners is provided simultaneously with the front position pivoted from to the arrangement position.
4.如权利要求I所述的可植入式进入端口元件,其特征在于,所述紧固件包括分布在所述可植入式进入端口元件的下表面周围的多个紧固件,每个紧固件为弯曲形钩子,所述多个紧固件同时从配设前位置枢转至配设位置。 As claimed implantable access port according to each claim I, wherein said fastener comprises a plurality of fasteners located in the implantable access port around the lower surface, fasteners for the curved hook, a plurality of fasteners disposed simultaneously transferred from a position disposed pivot the front position.
5.如权利要求4所述的可植入式进入端口元件,其特征在于,所述弯曲形钩子绕轴线枢转,所述轴线大致从所述可植入式进入端口元件的竖直轴线的中心向外径向定向。 5. The implantable access port device of claim 4, characterized in that the curved hook pivot about an axis, said axis from said substantially vertical axis into the implantable port element outward radial orientation center.
6.如权利要求4所述的可植入式进入端ロ元件,其特征在干,所述弯曲形钩子绕轴线枢转,所述轴线大致切向于其中心在所述可植入式进入端口元件的竖直轴线处的圆。 As claimed in claim 4, wherein the implantable member into the end of the ro, characterized in that the dry, the curved hook pivot about an axis, said axis is substantially tangential at the center thereof into the implantable round the vertical axis at the port element.
7.如权利要求4所述的可植入式进入端口元件,其特征在于,每个弯曲形钩子产生喀哒声,从而表示所述弯曲形钩子完全枢转至所述配设位置。 7. 4 claim implantable access port, wherein each of the curved hook produce a clicking sound, which indicates that the curved hook completely pivoted the arrangement position.
8.如权利要求4所述的可植入式进入端口元件,其特征在干,所述弯曲形钩子的锋利尖端旋转经过ー弧线并且在弧线的末端向回容纳在所述可植入式进入端口元件的下表面中或该下表面附近。 8. An implantable access port device of claim 4, wherein the dry, the curved hook ー sharpened tip through an arc of rotation and at the end of the arc to the back received in the implantable type access port in the lower surface or the lower surface nearby.
9.如权利要求4所述的可植入式进入端口元件,其特征在于,所述可植入式进入端ロ元件还包括旋转盘,用于将弯曲形钩子从配设前位置旋转至配设位置。 Implantable access port 9. claimed in claim 4, characterized in that said entry end ro implantable member further comprises a rotatable disk, is provided for the curved hook from the front position with rotation to distribution set position.
10.如权利要求9所述的可植入式进入端口元件,还包括单向挠性锁定凸块,在将所述弯曲形钩子从所述配设前位置枢转至配设位置之后,所述锁定凸块接合所述可植入式进入端口元件上的止挡件并阻止所述盘向回旋转。 Implantable access port 10. The element as claimed in claim 9, further comprising a flexible one-way locking projections, in the curved hook from the front position disposed after said pivoted position is disposed, the said locking lugs engage the implantable port into the stopper element and prevent the disc is rotating backward.
11. 一种由可植入式进入端口元件和配设工具组成的系统,包括: 根据权利要求I所述的可植入式进入端口元件; 配设工具,其包括: 远端罩体,所述远端罩体覆盖可植入式进入端口元件以使得所述可植入式进入端口元件的下表面暴露; 传动装置,用于将致动件的运动传递至可植入式进入端口元件,以将紧固件从其配设前位置移动至配设位置; 其中,所述配设工具通过致动件被致动,所述致动件包括笔式抓握致动件、手掌抓握致动件或手枪式抓握致动件。 11. An implantable access port by the elements and tools that are arranged, comprising: an implantable access port according to claim I; disposed tool comprising: a distal end cover, the said distal end cover covering the implantable access port such that the implantable member into the lower surface of the port is exposed; drive means for movement of the actuating member is transmitted to the implantable access port, In the fastener from the front position to the disposed position disposed; wherein said tool is disposed through the actuating member is actuated, said actuating member comprises a pen-grip actuator, a palm grip induced the movable member or pistol grip actuator.
12.如权利要求11所述的系统,其特征在于,所述紧固件在壳体中从配设前位置可枢转地旋转至配设位置。 12. The system of claim 11, wherein said fastener is disposed in the housing from the front position to the pivotally rotating arrangement position.
13.如权利要求12所述的系统,其特征在于,所述传动装置将致动件的直线运动转换为围绕所述可植入式进入端口元件的竖直轴线的旋转运动,以使得紧固件旋转。 13. The system according to claim 12, characterized in that said drive means to linear motion is converted to the actuating member surrounding the implantable member into the rotational movement of the vertical port axis, so that the fastening member rotation.
14.如权利要求11所述的系统,其特征在于,所述紧固件在壳体中从配设前位置可枢转地旋转至配设位置;且所述可植入式进入端口元件还包括旋转盘,用于将紧固件从配设前位置旋转至配设位置;且其中,配设工具接触并旋转旋转盘。 14. The system of claim 11, wherein said fastener is disposed in the housing from the front position to pivotally disposed rotating position; access port of the implantable device and also It includes a rotating disk for rotating the fastener is disposed from the front position to the arrangement position; and wherein the tool is arranged to contact and rotation of the rotary disk.
15.如权利要求14所述的系统,其特征在于,所述紧固件包括分布在所述可植入式进入端口元件的下表面周围的多个紧固件,每个紧固件为弯曲形钩子,所述多个紧固件同时从配设前位置枢转至配设位置。 15. The system of claim 14, wherein said fastener comprises a plurality of fasteners located in the implantable access port around the lower surface, each fastener is curved shaped hooks, while the plurality of fasteners disposed from the front position pivoted arrangement position.
16.如权利要求11所述的系统,其特征在于,所述传动装置包括将施加到手掌抓握致动件或手枪式抓握致动件上的力放大为施加到紧固件上的较大力的齿轮机构。 16. The system of claim 11, wherein said transmission means comprises applying to the actuating member or the palm gripping the pistol grip on the movable member caused by amplification applied to the fastener is relatively strong gear mechanism.
17.如权利要求11所述的系统,其特征在于,所述紧固件包括分布在所述可植入式进入端口元件的下表面周围的多个紧固件,所述多个紧固件同时从配设前位置枢转至配设位置;且其中,所述可植入式进入端口元件还包括旋转盘,用于将紧固件从配设前位置旋转至配设位置;且其中,配设工具接触并旋转旋转盘,传动装置将致动件的直线运动转换为围绕所述可植入式进入端口元件的竖直轴线的旋转运动以使得紧固件旋转。 17. The system of claim 11, wherein said fastener comprises a plurality of fasteners located in the implantable access port around the lower surface, said plurality of fasteners disposed from both the front position pivoted position disposed; and wherein said implantable access port member further comprises a rotatable disk for the fastener is disposed from the front position to the disposed position; and wherein, and the rotating tool contacts disposed rotating disk, the drive means actuating the linear motion converting member to surround the implantable member into the rotational movement of the vertical port axis such that rotation of the fastener.
18.如权利要求17所述的系统,还包括单向挠性锁定凸块,在将所述紧固件从所述配设前位置枢转至配设位置之后,所述锁定凸块接合所述可植入式进入端口元件上的止挡件并阻止所述盘向回旋转。 18. The system of claim 17, further comprising a flexible one-way locking projection in the fastener from the forward position disposed after said pivoted position is disposed, the engagement of the locking projections said implantable port into the stopper element and prevent the disc is rotating backward.
19.如权利要求17所述的系统,其特征在于,还包括单向挠性锁定凸块,在将所述紧固件从所述配设前位置枢转至配设位置之后,所述锁定凸块接合所述可植入式进入端口元件上的止挡件并阻止所述盘向回旋转。 19. The system according to claim 17, characterized in that, further comprising a flexible one-way locking projections, when the fastener is disposed from the front after the arrangement position pivoted position, the locking lugs engage the implantable port into the stopper element and prevent the disc is rotating backward.
20.如权利要求11所述的系统,其特征在于,所述紧固件包括分布在所述可植入式进入端口元件的下表面周围的多个紧固件,所述多个紧固件同时从配设前位置枢转至配设位置;且其中,所述致动件是手掌抓握致动件,所述手掌抓握致动件包括杠杆,所述杠杆连接到传动装置且相对于壳体可枢转地安装,以使得操作者用其手掌一起挤压所述杠杆和壳体并配设所述紧固件。 20. The system of claim 11, wherein said fastener comprises a plurality of fasteners located in the implantable access port around the lower surface, said plurality of fasteners disposed from both the front position pivoted position disposed; and wherein said actuating member is a palm grip actuated member, the palm-grip actuator including a lever connected to the transmission means with respect to housing is pivotally mounted, so that the operator, together with their palm squeezing the lever and the housing and disposed fastener.
21.如权利要求20所述的系统,其特征在于,所述配设工具包括柱塞,所述柱塞安装成直线地滑动且由所述手掌抓握致动件的所述杠杆偏移。 21. The system of claim 20, wherein said tool is arranged comprising a plunger slidably installed linearly and grasped by the palm of the shift lever actuating member.
Description  translated from Chinese

可植入装置的紧固系统和其使用方法 The implantable device and a fastening system using methods

[0001] 本申请是申请日为2004年9月15日、申请号为200480033641. I、发明名称为“可植入装置的紧固系统和其使用方法”的发明专利申请的分案申请。 [0001] The present application is filed on September 15, 2004, application No. 200480033641. I, titled "fastening systems implantable devices and their use," the divisional application patent application.

技术领域 Technical Field

[0002] 本发明涉及可植入医疗装置和手术器械以及紧固件的技术领域。 [0002] The present invention relates to the field of implantable medical devices and surgical instruments and fasteners. 本发明包括在外科手术中紧固装置或植入件的方法以及用于所述过程中的手术紧固件和器械。 The present invention includes a fastening device in surgery or implant methods and processes for the surgical fasteners and instruments.

背景技术 Background

[0003] 手术紧固件,如缝合钉、夹子、钳子、带子、钉子或其它伤ロ或切ロ封闭装置在手术过程中通常用于允许外科医生紧固、固定和/或修补身体组织。 [0003] The surgical fasteners, such as staples, clips, forceps, tape, nails or other wound closure devices ro ro or cut during surgery is generally used to allow the surgeon to fasten, fixed and / or repair body tissue. 在美国专利No. 4994073或4950284或4934364和4932960中说明了手术紧固件的ー些例子。 Description of the surgical fasteners ー Some examples in U.S. Patent No. 4994073 or 4950284 or 4934364 and 4932960 in.

[0004] 手术紧固件已经用于外科手术中以消除对缝合的需要,因为缝合既费时间又不方便。 [0004] Surgical fasteners have been used in surgical procedures to eliminate the need for suturing, stapling because time-consuming and inconvenient. 在这些应用场合中,外科医生经常使用装有一个或多个手术紧固件的紧固件植入装置以在几秒钟内完成采用缝合需要花费几分钟才能完成的工作。 In these applications, surgeons often use fitted with one or more surgical fasteners fastener implant device to be completed within a few seconds using suture takes a few minutes to complete the work. 这种手术时间的缩短减小了患者的失血和创伤。 This reduction in operating time reduces blood loss and trauma patients.

[0005] 通常,这种紧固系统已经主要用于封闭切ロ或伤ロ,或者用于将组织紧固在一起。 [0005] Typically, such fastening systems have been mainly used to close the cut ro ro or injury, or for the organization fastened together. 可以用于多种类型的可植入装置的手术紧固系统将非常利于外科医生。 It can be used for many types of implantable devices surgical fastening system will be very beneficial to the surgeon. 目前,结合有紧固系统的手术装置通常使用非常专业化的系统,这些系统可能过于复杂并且不适合用于其它应用场合。 Currently, surgical devices incorporating fastening systems typically use very specialized systems, which may be too complex and not suitable for other applications. 结果,大多数可植入装置仍然采用縫合方式固定。 As a result, most of the implantable device remains fixed suture. 例如,当插入胃带(gastricband)和相关进入端口元件(accessport)时,端口元件采用4至5道缝线在腹直肌鞘上被縫合就位。 For example, when inserting gastric band (gastricband) and associated access port (accessport), port components using 4-5 sutures on the rectus sheath is sutured in place. 这种缝线的位置经常很有挑战性,因为端口元件被设置在脂肪以下几英寸处,并且缝合端口元件经常要花费与放置胃带本身一样长的时间。 Such sutures often very challenging position, because the port element is arranged in the following few inches of fat, and suturing the port component often takes a long time and the same place the gastric band itself. 改进的紧固系统将允许以相当于缝合装置的安全性进行简单的单步连接。 Improved fastening system will allow the equivalent of stapling device security simple single-step connection.

[0006] 本发明将解决该技术领域中的这些问题。 [0006] The present invention is to solve the art of these issues.


[0007] 本发明包括手术紧固系统,其中可植入装置包括多个位于配设前位置的紧固件,或者其中可植入装置可包括装配在所述装置上的壳体,其中所述壳体包括多个位于配设前位置的紧固件。 [0007] The present invention comprises a surgical fastening systems wherein an implantable device comprising a plurality of fasteners arranged before the position, or wherein an implantable device may comprise means mounted on said housing, wherein said the housing includes a plurality of pre-arranged position of the fastener. 因此,本发明还包括可以随意地放置可植入装置并且导致紧固件运动进入配设后位置的配设系统。 Accordingly, the present invention can optionally further comprises placing the implantable device and cause movement of the fastener into the arrangement position after the system is disposed.

附图说明 Brief Description

[0008] 结合下面说明和附图将可以更完全地理解本发明的上述目的和优势,其中: [0008] The combination of the following description and drawings will be more fully understood from the above-mentioned objects and advantages of the present invention, wherein:

[0009] 图I是径向枢转紧固件的透视图,其中缝合钉位于配设前位置; [0009] Figure I is a perspective view of the radial pivot fastener of FIG, wherein the staple is disposed forward position is located;

[0010] 图2是图I所示径向枢转紧固件的透视图,其中缝合钉位于配设位置; [0010] Figure 2 is a perspective view of the radial pivot fastener shown in Fig. I, which is located in the staple position is disposed;

[0011] 图3是图I所示径向枢转紧固件的详细透视图,其中缝合钉位于配设前位置;、[0012] 图4是图2所示径向枢转紧固件的详细透视图,其中缝合钉位于配设位置; [0011] FIG. 3 is a detailed perspective view shown in Figure I a radial pivot fastener, wherein the staples are arranged is located in the front position;, [0012] FIG. 4 is shown in Figure 2 the radial pivot fastener a detailed perspective view, in which the staple position is located is disposed;

[0013] 图5是传递系统的透视图; [0013] FIG. 5 is a perspective view of the delivery system;

[0014] 图6是图5所示传递系统以及端口元件紧固件的剖切视图; [0014] FIG. 6 is a delivery system of Figure 5 cut-away view of the port member and the fastener;

[0015] 图7是图6所示传递系统的远端以及位于配设前位置中的端口元件紧固件的详细剖切透视图; [0015] FIG. 7 is a distal end of the delivery system shown in Figure 6, and a detailed cut-away perspective view of the front position located disposed port fastener element;

[0016] 图8是图6所示传递系统的远端以及位于配设位置中的端口元件紧固件的详细剖切透视图; [0016] FIG. 8 is a distal end of the delivery system shown in Figure 6, and a detailed cut-away perspective view of the arrangement position is located in the port fastener element;

[0017] 图9是用于传递系统的笔式握柄结构的透视图; [0017] FIG. 9 is a perspective view of a delivery system for pen grip structure;

[0018] 图10是示于开始位置中的图9所示传递系统手柄的详细剖切透视图; [0018] FIG. 10 is a detailed cutaway perspective view of FIG delivery system in the starting position of the handle shown in FIG. 9;

[0019] 图11是示于触发位置中的图9所示传递系统手柄的详细剖切透视图; [0019] FIG. 11 is shown in cut-away perspective view of the system passed a detailed handle trigger position shown in Figure 9;

[0020] 图12是用于传递系统的手枪式握柄结构的正视图; [0020] FIG. 12 is a system for transmitting pistol grip front view showing the structure;

[0021] 图13是示于开始位置中的图12所示传递系统手柄的详细正视图; [0021] FIG. 13 is shown in the start position in the handle of the delivery system of FIG elevational detail shown in FIG. 12;

[0022] 图14是示于触发位置中的图12所示传递系统手柄的详细正视图; [0022] FIG. 14 is a diagram illustrating the position of the trigger in the handle of the delivery system of FIG elevational detail shown in FIG. 12;

[0023] 图15是用于传递系统的另一个手枪式握柄结构的透视图; [0023] FIG. 15 is a perspective view of another delivery system for pistol grip configuration;

[0024] 图16是图15所示传递系统的齿轮传动机构的详细视图; [0024] FIG. 16 is a detailed view of the gear transmission mechanism of the delivery system shown in Figure 15;

[0025] 图17是示于开始位置中的图15所示传递系统的详细剖切正视图; [0025] FIG. 17 is a detailed cutaway delivery system 15 is shown in the start position shown in FIG front view;

[0026] 图18是示于弹簧完全回弹位置中的图15所示传递系统的详细剖切正视图; [0026] FIG. 18 is a detailed cutaway delivery system is shown in the full rebound position of the spring 15 as shown in FIG front view;

[0027] 图19是示于触发位置中的图15所示传递系统的详细剖切正视图; [0027] FIG. 19 is a detailed cutaway passed to the trigger system shown in FIG. 15 a front view of the position;

[0028] 图20是位于配设前位置中的连续NiTi丝式紧固件的透视图; [0028] FIG. 20 is a perspective view of the front located position disposed in a continuous NiTi wire type fastener;

[0029] 图21是位于配设后位置中的图20所示连续NiTi丝式紧固件的透视图; [0029] FIG. 21 is disposed on the rear position in the perspective view of FIG continuous NiTi wire fastener 20;

[0030] 图22是直腿、钝头连续金属丝式紧固件的底侧透视图; [0030] FIG. 22 is a straight leg and bottom side perspective view of the blunt tip continuous wire type fasteners;

[0031] 图23是弯曲腿、钝头连续金属丝式紧固件的底侧透视图; [0031] FIG. 23 is a curved leg, blunt bottom side perspective view of a continuous wire type fasteners;

[0032] 图24是模制尖端连续金属丝式紧固件的底侧透视图; [0032] FIG. 24 is a bottom side perspective view of a molded tip continuous wire type fasteners;

[0033] 图25是连续NiTi丝式紧固件的透视图,其中磨利尖端位于配设后外侧位置; [0033] FIG. 25 is a perspective view of a continuous NiTi wire fastener, wherein the sharpened tip located outside the rear position is disposed;

[0034] 图26是连续NiTi丝式紧固件的透视图,其中磨利尖端位于配设后内侧位置; [0034] FIG. 26 is a perspective view of a continuous NiTi wire fastener, wherein the sharpened tip is located inside the rear position is disposed;

[0035] 图27是连续NiTi丝式紧固件的底侧透视图,其中图26所示磨利尖端位于配设后内侧位置; [0035] FIG. 27 is a bottom side perspective view of a continuous NiTi wire fastener, wherein shown sharpened tip disposed on the inside position after 26;

[0036] 图28是带有直腿和縫合钉导向件的径向滑动紧固件的透视图; [0036] FIG. 28 is a perspective view with straight legs and a staple guide radial slide fastener;

[0037] 图29是图28所示径向滑动紧固件的透视图; [0037] FIG. 29 is a perspective view of a radial slide fastener of Figure 28;

[0038] 图30是带有弯曲腿的径向滑动紧固件的透视图; [0038] FIG. 30 is a perspective view of a radial slide fastener with curved legs;

[0039] 图31是安装之前的两部件式紧固系统的透视图; [0039] FIG. 31 is a perspective view of a two-part fastening system before installation;

[0040] 图32是安装之后的图31所示两部件式紧固系统的透视图; [0040] FIG. 32 is a perspective view of a mounting after the two-part fastening system of Figure 31;

[0041] 图33是安装之前的另ー个两部件式紧固系统的透视图; [0041] FIG. 33 is another perspective view ー installed before a two-part fastening systems;

[0042] 图34是安装之后的图33所示两部件式紧固系统的透视图; [0042] FIG. 34 is a perspective view of a mounting after the two-part fastening system of Figure 33;

[0043] 图35是结合在装置中的独立紧固件的透视图; [0043] FIG. 35 is incorporated in the apparatus in a perspective view of independent fasteners;

[0044] 图36是结合在装置中的另ー个独立紧固件的透视图; [0044] FIG. 36 is incorporated in devices other fasteners ー independent perspective;

[0045] 图37是结合在装置中的另ー个独立紧固件的透视图; [0045] FIG. 37 is incorporated in devices other fasteners ー independent perspective;

[0046] 图38是结合在装置中的另ー个独立紧固件的透视图; [0046] FIG. 38 is incorporated in devices other fasteners ー independent perspective;

[0047] 图39是结合在位于配设前位置的注射端口元件中的另ー个独立紧固件的透视图; [0047] FIG. 39 is a combination of elements are located in the injection port is disposed in the forward position other fasteners ー independent perspective;

[0048] 图40是位于配设后位置中的图39所示独立紧固件的透视图; [0048] FIG. 40 is disposed on the rear position in a perspective view of independent fasteners Figure 39;

[0049] 图41是螺旋线圈紧固件的透视图; [0049] FIG. 41 is a perspective view of a helical coil fastener;

[0050] 图42是另ー个螺旋线圈紧固件的透视图; [0050] FIG. 42 is a perspective view of another ー helical coil fastener;

[0051] 图43是水平线圈紧固系统底座的俯视图; [0051] FIG. 43 is a horizontal coil fastening system base plan view;

[0052] 图44是图43所不水平线圈紧固系统底座的侧视图; [0052] FIG. 44 is a diagram 43 is not horizontal coil fastening system base of the side view;

[0053] 图45是图43所示水平线圈紧固系统底座的仰视图; [0053] FIG. 45 is a view of the horizontal coil fastening system base of the bottom shown in Fig. 43;

[0054] 图46是用于图43所示水平线圈紧固系统的紧固系统驱动工具的透视图; [0054] FIG. 46 is a perspective view of the horizontal coil fastening system of the fastening system of Figure 43 driving tool;

[0055] 图47是图43所不水平线圈紧固系统底座的详细视图; [0055] FIG. 47 is a detailed view of the horizontal coil 43 without fastening system base;

[0056] 图48是结合在装置中的封闭金属圈紧固系统的侧视图; [0056] FIG. 48 is incorporated in the apparatus of the closed metal loop fastening system, a side view;

[0057] 图49是包括图48所示封闭金属圈紧固系统的装置的俯视图; [0057] FIG. 49 is shown in Fig. 48 includes a plan view of the closure device of FIG metal ring fastening systems;

[0058] 图50是两部件式咬扣配合紧固系统的侧视图; [0058] FIG. 50 is a two-part fastening system with bite buckle side view;

[0059] 图51是使用弯曲形销或钩子的另ー个封闭金属圈系统的透视图; [0059] FIG. 51 is a hook with a bent-shaped pin or another ー perspective view of a closed metal ring system;

[0060] 图52是结合在装置中的图51所示使用弯曲形销或钩子的封闭金属圈系统的侧视图; [0060] FIG. 52 is incorporated in the apparatus shown in Figure 51 using a side view of the curved pins or hooks closed metal ring system;

[0061] 图53显示了结合在装置中的弯曲形销紧固系统的俯视图和侧视图; [0061] Figure 53 shows a top view of the device in conjunction curved pin fastening system and a side view;

[0062] 图54显示了结合在装置中的另ー个弯曲形销紧固系统的俯视图和侧视图; [0062] Figure 54 shows the binding of another in the apparatus ー curved shaped pin fastening system plan view and a side view;

[0063] 图55显不了弹黃线圈紧固系统的俯视图和侧视图; [0063] FIG. 55 was not a plan view and a side view of the fastening system of the coil spring;

[0064] 图56显示了位于其打开和闭合位置中的带有弯曲式紧固件的折叠基板的侧视图; [0064] Figure 56 shows in its open and closed positions of the folding of the substrate with a side view of the curved fastener;

[0065] 图57显示了结合在装置中的旋转钩紧固件的俯视图和侧视图; [0065] Figure 57 shows the binding of the apparatus of the rotary hook fastener top and side views;

[0066] 图58是旋转盘紧固系统的顶侧透视图,其中紧固件位于配设前位置; [0066] FIG. 58 is a top side perspective view of the rotating disc fastening system, wherein the fastener is located in the front position disposed;

[0067] 图59是图58所示旋转盘紧固系统的底侧透视图,其中紧固件位于配设后位置; [0067] FIG. 59 is a perspective view of the bottom side of the rotating disc fastening system shown in 58, wherein the fastener is disposed in the posterior position;

[0068] 图60是图58所示旋转盘紧固系统的仰视图,其中紧固件位于配设后位置; [0068] FIG. 60 is a bottom view of the rotating disc fastening system shown in Figure 58, which is disposed after the fastener is located in the position;

[0069] 图61是图58所示旋转盘紧固系统的侧视图,其中紧固件位于部分配设位置;和 [0069] FIG. 61 is a side view of the rotating disc fastening system of Figure 58, which is located in parts of the distribution arrangement position fastener; and

[0070] 图62是图58所示旋转盘紧固系统的弯曲式紧固件的透视图,显示了旋转轴线。 [0070] FIG. 62 is a perspective view of the rotating disc fastening system shown in articulated fastener 58, showing the axis of rotation.


[0071] 本发明包括手术紧固系统,其中可植入装置包括多个位于配设前位置中的紧固件(例如,缝合钉),或者其中紧固件设置为适合于縫合装置上的孔,或者其中可植入装置可以包括安装在装置上的可分离壳体,其中所述壳体包括多个位于配设前位置中的紧固件。 [0071] The present invention comprises a surgical fastening systems wherein an implantable device comprising a plurality of pre-arranged position the fasteners (e.g., staples), or wherein the fastener is adapted to the hole provided on the stapling device , or wherein an implantable device may include a housing detachably mounted on the apparatus, wherein the housing includes a plurality of pre-arranged position of the fastener.

[0072] 可分离壳体和紧固件可以由本领域公知的用于制造手术紧固件和植入件的各种材料制成。 [0072] detachable housing and fasteners can be made surgical fasteners and implants made of various materials for well known in the art. 紧固件可以由金属、聚合物或其它合适的材料制成。 Fasteners may be made of metal, polymer, or other suitable material. 可分离壳体可以由金属、聚合物、陶瓷或复合材料制成;例如通常使用聚砜、醋酸基共聚物、钛、弾性体和不锈钢。 Detachable housing may be made of metal, polymer, ceramic, or composites; generally used e.g. polysulfone, acetate-based copolymers, titanium, and stainless steel body 弾 resistance.

[0073] 这些材料必须具有生物适应性,也就是说,它们不会负面影响活体周围环境,并且反过来,它们的性能不会受活体周围环境负面影响。 [0073] These materials must be biocompatible, i.e., they do not adversely affect the surrounding living environment, and conversely, their performance is not adversely affected by the surrounding environment affect the living body. 材料可以是惰性的、不可吸收的或者生物可降解的。 Material may be inert, non-absorbable or biodegradable. 惰性材料相当不容易被破坏并且在更长的时间内保持它们的形状和功能。 Inert material not easy to be destroyed and retain their shape and function over a longer period of time.

[0074] 金属和金属合金,具体地说钛和钛合金被用于各种不同的医疗应用场合的可植入制品中。 [0074] metals and metal alloys, in particular titanium and titanium alloys are used in a variety of medical applications implantable article. 所有可植入制品都具有一定程度的生物不适应性,这可能表现为组织发炎、坏死、增生、突变、中毒和其它反应,例如受到巨细胞、白细胞和巨噬细胞攻击。 Bio-implantable products all have a degree of flexibility, which may appear to tissue inflammation, necrosis, hyperplasia, mutation, poisoning and other reactions, such as by giant cells, leukocytes and macrophages attack. 虽然通常认为钛及其合金在植入时具有惰性,但是仍然可能出现ー些生物和生物化学相互作用,并且已经发现理想的是在钛和钛合金植入件的表面上提供各种不同的涂层以便用于特定用途。 Although titanium and its alloys generally considered inert when implanted, but still may appear ー some biological and biochemical interactions, and it has been found desirable to provide a variety of coating on the surface of titanium and titanium alloy implant layer to be used for a specific purpose. 对于很多其它的金属和金属合金也同样如此。 For many other metals and metal alloys are the same. 因此,本发明包括在紧固件、可分离壳体或装置的表面上使用这种涂层。 Accordingly, the present invention includes the use of such coatings on the surface fastener, separable housing or device.

[0075] 可以用于(不论是由钛制成或是由其它材料制成的)待植入材料中的一些涂层包括生物制剂(例如遗传物质或细胞材料)或化学制剂(例如抗增殖试剂或细胞生长因子)以减小与增生或发炎有关的问题。 [0075] may be used (whether it is made of titanium or made of other materials) to be implanted in some of the coating material include biological agents (such as genetic material or cellular material) or chemical agents (such as anti-proliferative agent or cell growth factor) to reduce the proliferation or inflammation-related issues. 这些制剂可以与粘合剂,如弾性体或生物可吸收聚合物混合到金属或聚合物体的表面上。 These preparations can be with a binder, such as 弾 of body or bioabsorbable polymer mixture onto the surface of a metal or polymer body.

[0076] 这里关注的、包括縫合钉的紧固件经常由丝线(wire)构成并因此对于它们的尺寸具有相对较大的表面积。 [0076] The concern here, fasteners including staples are often composed of filaments (wire) for their size and therefore have a relatively large surface area. 因此,允许将生物和生物化学制剂添加到植入件表面上的方法可有利于将植入件对身体组织的不良反应降至最低。 Therefore, allow adding biological and biochemical agents to the method on the surface of the implant may be beneficial to the implant side effects on the body tissue to a minimum. 这些可包括应用于不锈钢和钛合金(例如,NiTi合金)上以延缓组织反应的涂层。 These may include used in stainless steel and titanium alloys (for example, NiTi alloys) to retard tissue reactions on the coating. 这些涂层是基于稳定的生物适应性聚合物(例如苯こ烯一异丁烯一苯こ烯三嵌段共聚物(SIBS))和生物可吸收聚合物,例如聚羟基こ酸。 These coatings are based on stable biocompatible polymer (e.g., an isobutylene an alkenyl benzene ko ko alkenyl benzene triblock copolymer (SIBS)) and bio-resorbable polymer, e.g., poly-hydroxy acids ko. 在迄今为止公知的技术中,将活性化学或生物制剂与聚合物涂层材料混合,然后在将植入件放入体内之后从涂层中洗提制剂。 In so far known techniques, the active chemical or biological agent is mixed with the polymeric coating material, and then placed in the implant body after eluted from the coating formulation.

[0077] 本发明另外关注的是紧固件可以由形状记忆合金(SMA)制成。 [0077] The present invention is further concerned that the fastener can be made of a shape memory alloy (SMA). 与该应用场合中所使用的传统合金相比,由形状记忆合金制造金属医疗装置的主要原因在于它们对于永久变形的巨大抵抗力。 Compared with the conventional alloys used in the application, the main reason for the medical device from a shape memory metal alloy that their large resistance to permanent deformation. 用于各种医疗器械的合金一直依赖于不锈钢、诸如Elgiloy™的高镍合金和钛基合金,所有这些材料可以通过加工硬化获得很高的屈服強度。 Alloy used for a variety of medical devices have relied on stainless steel, such as high nickel alloys and titanium based alloys Elgiloy ™, all of these materials can be obtained by hardening a high yield strength. 普通金属,即使具有很高屈服強度的金属也不能承受远高于0. 2%的应变而不遭受永久变形。 Common metals, even though the metal has a high yield strength can not withstand much higher than the 0.2% strain without suffering permanent deformation. 由ー种上述传统合金制造的设备一旦遭受弯曲或扭曲,实际上就不可能消除。 Equipment consists of the above conventional alloys ー once suffered bend or twist, virtually impossible to eliminate. 形状记忆合金,如Au-Cd、Cu-Zn-Al、Ni-Ti和很多其它合金所显示的非同寻■常的拟弹性特性(pseudoelasticity)使得有可能实现高达10%的应变的完全“弾性”恢复。 Shape memory alloys, such as Au-Cd, Cu-Zn-Al, Ni-Ti alloy and many other unusual find displayed quasi elastic properties ■ normal (pseudoelasticity) makes it possible to achieve up to 10% strain of complete "弾 sex "Restore. 因为其很高的可恢复应变及其优秀的抗腐蚀性,用于医疗部件所首选的形状记忆合金属于Ni-Ti合金族。 Because of its high recoverable strain and its excellent corrosion resistance, used in medical components of the preferred shape memory alloy Ni-Ti alloys belonging to the family.

[0078] 形状记忆合金属于表现出热弹性马氏体相变的那类合金。 [0078] Shape memory alloys belong to exhibit thermoelastic martensitic transformation of that alloy. 术语“马氏体”表示钢在从高温进行淬火时所产生的晶相。 The term "martensite" means grain steel during quenching from high temperatures generated by the phase. 存在于升高温度中的相被称为奥氏体;这些术语已经被转而用于描述形状记忆合金中出现的相变。 At elevated temperature in the presence of a phase it is called austenite; these terms have been used to describe the shape memory alloy instead of the phase transition occurs. 当钢已经从奥氏体温度淬火为马氏体时,再次形成奥氏体需要将结构加热到非常高的温度,通常超过1400 T。 When the steel has been quenched martensite from austenite when, once again form austenite structure needs to be heated to very high temperatures, typically in excess of 1400 T.

[0079] 对比之下,热弹性形状记忆合金可以从马氏体转变为奥氏体并且在很小的温度范围内,通常在18到55 T之间反复加热和冷却。 [0079] In contrast, the thermoelastic shape memory alloys can change from martensite and austenite in a small temperature range, usually repeated heating and cooling between 18 and 55 T. 形状记忆合金的相变通常由滞后曲线描述,其中显示为在从经常称为母相的奥氏体相进行冷却时,马氏体在表示为Ms的温度处开始形成,并且在达到较低温度Mf之后,合金完全成为马氏体。 Phase change the shape memory alloy is usually described by a hysteresis curve, which shows when the austenite is often called the parent phase cooling phase, martensite is expressed as the temperature at the Ms begin to form, and, after reaching a low temperature After Mf, alloy fully become martensite. 在从温度Mf以下进行加热之后,马氏体在温度As处开始回复到奥氏体结构,并且当达到表示为Af的温度时,合金完全成为奥氏体。 After heating the temperature Mf below the martensite temperature As revert to the austenitic structure at the beginning, and when it reaches the temperature is represented as Af, the alloy becomes fully austenitic. 这两个相或晶体结构具有差异很大的力学特性:奥氏体的杨氏模量大约为 These two phases or crystalline structures have very different mechanical properties: Young's modulus of approximately austenite

12 X 106psi,而马氏体的杨氏模量大约为4X 106psi ;并且取决于赋予合金的冷加工量的屈服强度对于奥氏体在28至IOOksi之间,而对于马氏体在10至20ksi之间。 12 X 106psi, and the Young's modulus of martensitic about 4X 106psi; and depending on the yield strength given amount of cold work the alloy between the austenite to 28 IOOksi, and for martensite of 10 to 20ksi Room.

[0080] 形状记忆合金的独特特征在于它们能够恢复变形。 [0080] the unique characteristics of shape memory alloys is their ability to recover deformation. 当处于马氏体形态的形状记忆合金样品遭受应カ时,应变由各个马氏体变体的增长和收缩适应,而不是通过传统合金中常见的方式:滑动、晶界滑移和位错运动。 When the shape memory alloy is in the martensite form of sample grades suffer should, by the growth of each strain martensite variants and contraction adaptation, rather than through conventional alloys common way: sliding, grain boundary sliding and dislocation motion . 当变形的马氏体被加热到奥氏体完成温度Af吋,部件回复到其初始未变形状态。 When deformed martensite is heated to a temperature to complete the austenite Af inch, member returns to its initial undeformed state. 因此,对于医疗植入应用,有可能开发ー种结构,其中装置保持在体温以下而处于其未变形形状,并且在插入身体之后,装置的温度升高至体温,此时装置回复到奥氏体结构。 Thus, for medical implant applications, it is possible to develop ー kind of structure, in which the means to maintain the body temperature or less and is in its undeformed shape, and after insertion of the body, the device temperature was raised to body temperature, this time to return to the austenitic means structure. 在当前应用中,紧固件可以由诸如NiTi的SMA可选制成。 In the current application, the SMA such as NiTi fastener can be made optional.

[0081] 属于本发明范围内的是,能够在比将装置縫合就位所需更短的时间内,将这里说明的这种紧固系统紧固到身体组织中。 [0081] fall within the scope of the present invention is capable of more than the required device stitched into place within the shorter time, such fastening systems described herein is fastened to the body tissues. 在这里所述的情况下(放置胃带的进入端口元件),紧固系统的放置和固定应该花费不超过5分钟。 In the case where the lower (access port placed gastric band), positioning and fixing the fastening system should take no more than five minutes. 另外,为了便于重新定位装置或者完全取出已植入的装置,固定系统能够完全解开并且从组织中取出。 Further, in order to facilitate the re-positioning device or complete removal of the implanted device, the fastening system can be completely untied and removed from the organization. 这种植入和取出不会对患者造成更大的创伤,并且固定系统不会导致比传统缝合方法更多的粘连。 Such implants and removal without causing greater trauma to the patient, and fixed the system does not lead to more adhesions than the traditional suturing method. 普通外科医生或其它医疗专业人员能够可靠并且连贯地完成紧固系统的固定和取出。 General surgeon or other medical professionals to reliably and consistently in fixed and removing fastening systems.

[0082] 另外,在这里说明的这种固定系统的制作过程中,紧固件的尺寸决定紧固件将安装在身体组织内的深度。 [0082] Further, in the production process of such fixation systems described herein, the fastener size determines the fasteners installed in the body tissue depth. 在当前应用的情况下,进入端口元件应该固定在装置以下不超过3_的深度处。 In the case of the current application, the access port should not exceed the following fixed means of depth 3_. 而且,在这种应用中,安装紧固件的身体组织是筋膜(fascia)。 Further, in this application, is installed fastener body tissue fascia (fascia). 然而,属于本发明范围内的是,装置所连接的身体组织将取决于特定的装置而变化。 However, within the scope of the present invention is connected to the apparatus body tissue will vary depending upon the particular apparatus. 另外,紧固系统在组织内的连接不会导致在放置过程中或在身体运动过程中的组织损伤;例如,用于胃带的进入端口元件经常直接连接在腹直肌上。 In addition, the fastening system is connected within the organization does not result in the placement process, or tissue damage in the body during exercise; for example, the access port for the gastric band is often directly connected to the rectus abdominis. 此外,为了适应长期的植入,装置的固定具有与缝合相当或比其更大的強度并且抵抗移位或者分离。 In addition, in order to meet long-term implantation, the device has a suture fixation or separation rather than its greater strength and resistance to displacement or.

[0083] 这里所述本发明可以与任何类型的可植入装置一起使用。 [0083] The present invention described herein can be used with any type of implantable device. 这种实例包括内部监视器、端口元件、起搏器、治疗剂、投药系统、神经刺激器、外科整形装置、肌腱修复件等。 Such examples include internal monitors, ports element, pacemakers, therapeutics, drug administration systems, neurostimulators, orthopedic devices, tendon repair parts. 为了便于说明,现在将根据图I至图40所示说明本发明,其中本发明显示为与进入端口元件一起使用。 For convenience of explanation, according to the present invention will now be described as shown in FIG. I to 40, wherein the present invention is shown as used with the access port. 本领域的技术人员将会认识到,本发明可以与其它类型的可植入装置一起使用,并且本发明可以采取与图中所示类似的形式。 Those skilled in the art will recognize that the present invention may be used with other types of implantable devices, and in the present invention may take a form similar to that shown in FIG.

[0084] 另外,在附图中,壳体形成为圆环,因此可以如此进行说明。 [0084] Further, in the drawings, the housing is formed as a ring, it can be so described. 然而,本领域的技术人员将会认识到,壳体的形状取决于装置的形状,因此本发明不限于其中壳体为圆形的装置。 However, those skilled in the art will recognize that the shape of the housing depends on the shape of the apparatus, and therefore the present invention is not limited to a circular apparatus wherein the housing.

[0085] 图I显示了根据本发明一个实施例的进入端口元件紧固系统。 [0085] Figure I shows, according to an access port fastening system embodiment of the present invention. 进入端口元件10包括隔膜11,该隔膜在实践中由针刺穿以将流体,如盐水输入到进入端口元件中用干与例如液压操作的胃带一起使用。 Access port 10 includes a diaphragm 11, the diaphragm in practice acupuncture to wear by the fluid, such as saline input to the access port with dry and such as the stomach with a hydraulically operated together.

[0086] 进入端口元件10包括围绕进入端口元件外周的可分离壳体12。 [0086] the access port 10 includes an access port around the outer periphery of the separable housing 12. 壳体12包括切ロ或开ロ15。 Housing 12 includes a cut or open ro ro 15. 切ロ容纳紧固件14。 Cut ro receive a fastener 14. 切ロ或开ロ15可以采取适合容纳紧固件14同时允许紧固件14运动所需的任何形式。 Cut or open ro ro 15 adapted to receive a fastener 14 may take any form of fastener 14 while allowing movement required. 属于本发明范围内的是,为了使装置运动或移位的可能性降至最小而采用至少三个紧固件14。 Within the scope of the present invention is the possibility for movement or displacement of the apparatus is minimized and the use of at least three fasteners 14. 如图I至图4中所示,紧固件14通过穿过孔接合并由此枢转连接到环12上的垂直区段与环12连接。 As shown in FIG. I through, the fastener 14 is connected through a through hole 4 to engage and thereby pivotally connected to the vertical section 12 and the ring 12 on the ring. 紧固件14具有如图I和图3所示的第一位置以及如图2和图4所示的第二或固定位置。 Fastener 14 has a first position as shown in Figure I and shown in Figure 3 and a second or fixed position shown in FIG. 2 and FIG. 为了从第一位置运动到第二位置,紧固件绕其轴线旋转。 To a first position to a second position, the fastener about its axis of rotation. 切ロ15允许该旋转并且小锁定凸耳在紧固件旋转之后将其保持就位。 Cut ro 15 allows the rotation of the locking lug and a small rotation after the fastener to hold it in place. 在一个实施例中,紧固件14可以是两腿式縫合钉。 In one embodiment, the fastener 14 may be the staple legs style. 在另ー个实施例中,縫合钉为刚性的,以至于在旋转进入患者筋膜的过程中它们不会变形。ー In another embodiment, the staples are rigid, so that during the rotation into the fascia of a patient that they are not deformed. 对于这种应用,传统金属也适合。 For this application, also suitable for conventional metal. 此外,縫合钉可以形成为“U”形或者其改型,包括基本上形成为: In addition, the staple may be formed as a "U" shape, or modifications thereof, including substantially formed as follows:

[0087]<z [0087] <z

[0088] 当位于第二位置时,紧固件14通过锁定凸耳16被刚性保持就位。 [0088] When in the second position, the fastener 14 through the locking lug 16 is rigidly held in place. 锁定凸耳16的形成可以使得在紧固件14从第一位置运动到第二位置之后外科医生可以听到清晰的喀哒声以表示紧固件14完全由锁定凸耳16接合。 The locking lug 16 is formed so that the fastener 14 may be moved from the first position to the second position after the surgeon can hear a clear clicking sound to indicate that the fastener 14 entirely by the locking lug 16 is engaged. 当位于第二位置时,进入端口元件10由与患者筋膜连接的紧固件14固定在患者体内的壳体12内。 When in the second position, access port 10 is connected by the fastener with the fascia of the patient 12 is fixed in the housing 14 within the patient's body. 实质上,筋膜或其它身体组织被固定在紧固件14与壳体12或装置10之间。 Essentially, the fascia or other bodily tissue is secured between the fastening means 12 or 14 and the housing 10. 此外,壳体12可以包括与围绕装置10周边的缝合孔(未不出)接合的栓(未不出)。 In addition, the housing 12 may include suture holes 10 and around the periphery of the device (not not) engaging bolt (not not).

[0089] 图5至图8显示了图I所示的进入端口元件及其与进入端口元件传递系统20的相互作用。 [0089] Figures 5 to 8 show the interaction shown in Figure I with the access port and the access port delivery system 20. 如图5中所示,进入端口元件传递系统20可以包括手指凹陷25,该凹陷由操作者用于帮助将进入端口元件和传递系统保持就位并且准确对正。 Shown in Figure 5, the access port delivery system 20 may include a finger recess 25, the recess by the operator to help the access port and the delivery system remains in place and accurately aligned.

[0090] 传递系统20包括端口元件罩体21。 [0090] delivery system 20 comprises a port cover member 21. 端口元件罩体21容纳柱塞22、滑动推件24 和滑动组件26。 Port cover member 21 accommodating the plunger 22, the sliding member 24 and pushes the slide assembly 26. 端口元件罩体可以形成为基本上覆盖进入端口元件10所需的任何形状。 Port cover member may be formed in any shape substantially cover the access port 10 required.

[0091] 柱塞22为传递系统20提供操作装置并且与下面将要说明的触发装置连接。 [0091] delivery system 20 of the plunger 22 and is provided with the operating device will be described as a trigger device is connected. 在起动触发装置之后,柱塞22沿进入端口元件10的方向运动。 After the trigger assembly, the plunger 22 enters along the direction of movement 10 of the port member. 该运动导致滑动推件24被致动。 The campaign led to slide pusher 24 is actuated. 滑动推件24将运动柱塞22的能量传递给滑动组件26。 Pushing the sliding movement of the plunger 24 to pass energy 22 to the slide assembly 26. 滑动组件26具有基本上为圆形的形状并且包围进入端口元件10。 The slide assembly 26 has a substantially circular shape and enclosing the access port 10. 在其它应用中,滑动组件可以采取适合于待植入装置和壳体的形式。 In other applications, the slide assembly may take adapted to be implanted device and the housing form. 在致动之后,滑动组件26沿着进入端口元件10的方向被推动。 After actuation, the slide assembly 26 is pushed in the direction of the access port 10. 对正凸片30帮助对正滑动组件26。 Help for positive alignment tabs 30 slide assembly 26. 对正凸片30与端口元件罩体21连接并且与进入端口元件10相互作用以确保准确对正。 Alignment tabs 30 and the cover element 21 is connected to the port and the access port 10 interact to ensure accurate alignment. 滑动组件26的运动导致与滑动装置26连接的梁28作用于紧固件14上。 26 results in movement of the slide assembly 26 is connected with the slide beam 28 acts on the fastener 14. 施加于紧固件14上的力允许它们在环孔(未示出)内旋转并且适应基本上由切ロ15限定的弧线。 Applied to the fastener 14 allows them to force holes in the ring (not shown) is rotated by the interior and substantially adapted to define the arc cut 15 ro. 该旋转对应于上述从第一位置到第二位置的运动。 The rotation corresponding to the movement from the first position to the second position. 由于梁28继续朝向进入端口元件10运动,所以紧固件14到达第二位置并且通过锁定凸耳16被保持就位。 Since the beam 28 continues movement toward the access port 10, so the fastener 14 and reaches the second position by the locking lug 16 is held in place. 在该位置,进入端口元件10通过紧固件14及它们与患者的筋膜或其它组织的相互作用而被刚性保持就位。 In this position, the access port 10 by fasteners 14 and their interaction with the fascia or other tissue of the patient and are rigidly held in place.

[0092] 图9显示了包括触发装置40的进入端口元件传递系统。 [0092] Figure 9 shows the access port member includes a trigger transfer device 40 of the system. 图10显示了位于开始或加载位置的触发装置40的横截面图。 Figure 10 shows a triggering device located at the beginning or the loading position of the cross-section of FIG. 40. 在该位置,弹簧42被压缩,并且与杆46连接的栓销44通过肋部48固定以防止压缩弹簧42伸展。 In this position, the spring 42 is compressed and the rod 46 is connected with the plug pin 44 is fixed by a rib 48 to prevent the compression spring 42 extends. 触发装置包括与操纵杆52连接的触发件50。 Trigger means includes a trigger member 52 is connected with the lever 50. 如图10中所示,弹簧42和杆46位于壳体54中。 As shown in Figure 10, the spring 42 and the rod 46 is located in the housing 54.

[0093] 如图11中所不,在触发件50上施加预定カ之后,操纵杆52作用于壳体54上。 [0093] FIG. 11 is not as in the grades after applying a predetermined trigger member 50, the lever 52 acts on the housing 54. 壳体54在支点(未示出)上枢转,该枢转动作将栓销44抬高到肋部48的端部上方。 The pivot housing 54 (not shown) to pivot, the pivoting action will peg 44 raised to the upper end of the rib 48. 在抬高之后,压缩弹簧42的弹簧カ沿着进入端口元件方向驱动柱塞22并且如上所述致动其周围的装置。 After the elevation, compression springs spring 42 ka driving along the access port 22 and the direction of the plunger actuation means described above its surroundings. 在这种结构中,可以确定柱塞行程、速度和冲击カ以满足应用需要。 In such a configuration, it is possible to determine the piston stroke, the speed and impact grades to meet application needs. 根据测试,取决于实际应用中所使用的弹簧,柱塞行程在0. 25至0. 75英寸之间,并且可以在柱塞上产生高达50磅的力。 Between .25 to .75 inches, and can produce up to 50 pounds of force on the plunger according to the test, the spring depending on the application used, the piston stroke.

[0094] 弹簧驱动装置的可选形式示于图12中。 [0094] Optional form of a spring drive unit is shown in Figure 12. 图12显示了手掌抓握致动触发装置60。 Figure 12 shows a palm grip actuated trigger means 60. 手掌抓握是非常简单的设计,只需要单个运动部件来移动柱塞22。 Palm grip is a very simple design, only a single moving part to move the plunger 22. 在如图13所示的第一位置中,有活动手柄61、固定手柄62、枢转点64和致动尖端66。 In the first position shown in FIG. 13, there is a movable handle 61, stationary handle 62, pivot point 64 and an actuating tip 66.

[0095] 在操作中,使用者挤压活动手柄61,将其沿着固定手柄62的方向推动。 [0095] In operation, the user squeezes the movable handle 61, which is driven in the direction of the stationary handle 62. 该运动沿着与活动手柄61的运动方向相反的方向推动与活动手柄61和枢转点64连接性接合的致动尖端66。 The movement along the direction of movement of movable handle 61 in the opposite direction to promote and movable handle 61 and a pivot point 64 connected to the tip of the engagement of the actuator 66. 通过使用简单的杠杆作用,施加于活动手柄61上的相对较小的力通过枢转点64放大并且由致动尖端66施加于柱塞22上。 By using a simple leverage applied to the movable handle 61 by a relatively small force pivot point 64 and an enlarged tip 66 by the actuator 22 is applied to the plunger. 柱塞22通过致动尖端66沿着进入端口元件10的方向被移动并且如上所述致动其周围的装置。 22 by actuating the plunger tip 66 is moved in the direction of the access port 10 and the actuating means described above therearound. 手掌抓握致动装置所产生的カ只受使用者的力量限制,根据测试,该装置能够产生超过50磅的カ以及0. 25英寸的柱塞行程。 Palm grip actuator grades produced only by the user's power restrictions, according to the test, the device is capable of producing more than 50 pounds of grades and 0.25 inches of piston stroke. 作为选择,可以制造齿轮机构,其尽管需要活动手柄61更大的行进距离但是能够产生相等或更大的力。 Alternatively, a gear mechanism can be produced, even though their activities require a greater travel distance of the handle 61 but can produce equal or greater force. 由图12至图14中所示装置产生的力也可以根据需要通过以下方式而改变,即将枢转点64移动为更靠近柱塞22以产生更大的力,或者远离枢转点以产生更小的力。 Force generated by the apparatus shown in FIG. 12 to FIG. 14 may also be produced by the following methods vary according to need, is about pivot point 64 to move closer to the plunger 22 to produce more force, or away from the pivot point to produce less force.

[0096] 另ー个可选的触发装置示于图15至图19中。 [0096] Another ー optional trigger device shown in Figures 15 to 19. 手枪式抓握触发装置70包括在一端安置有齿轮传动齿73的触发件72、与齿轮传动齿73啮合的齿轮74、由齿轮74驱动的齿条75和弹簧76。 Pistol grip trigger device 70 includes gear teeth arranged with an end 73 of the trigger 72, the gear 73 engages the gear teeth 74, 74 driven by the gear rack 75 and spring 76. 齿条还可以包括用于握紧柱塞22的装置78。 Rack may further comprise means 78 for gripping the plunger 22.

[0097] 操作过程示于图17至图19中。 Process [0097] Operation is shown in FIG. 17 to FIG. 19. 在图17中,触发件伸出并且弹簧几乎没有或完全没有压力。 In FIG. 17, the trigger and the spring member extends little or no pressure. 齿轮传动齿73与齿轮74的对应齿和齿条75上的齿啮合。 Gear teeth 73 and the gear teeth 74 and corresponding to the rack teeth 75 on the engagement. 柱塞22位于伸出位置。 The plunger 22 is extended position. 当压下触发件72吋,齿轮传动齿73致动齿轮74并且转而导致齿条75压缩弹簧76,如图18中所示。 When pressing the trigger 72-inch, 73 tooth gear actuator gear 74 and rack 75 in turn leads to a compression spring 76, shown in Figure 18. 在预定距离处,齿轮传动齿73不再接合齿轮74。 At a predetermined distance, gear teeth 73 no longer engages the gear 74. 在该位置处,齿轮74自由旋转。 In this position, the gear 74 to rotate freely. 弹簧76中储存的能量推动齿条75朝向柱塞22运动。 The energy stored in the spring 76 push the plunger 22 is moved toward the rack 75. 自由旋转的齿轮74允许齿条75运动,而齿条75转而推动柱塞朝向进入端口元件10并且如上所述致动其周围的装置。 74 allows free rotation of the gear rack 75 movement, and the rack 75 in turn push the plunger toward the access port 10 and actuation means described above its surroundings.

[0098] 另ー个可以结合在手枪式抓握触发装置70中的结构是锁(未示出),该锁在弹簧76被压缩之后防止齿轮74旋转。 [0098] Another ー may join in the pistol grip trigger 70 structure means is a lock (not shown) after the lock spring 76 is compressed to prevent rotation of the gear 74. 然后在需要时,操作者可以释放锁,由此允许弹簧76如上所述伸展。 Then when necessary, the operator can release the lock, thereby allowing the spring 76 as described above extends.

[0099] 根据测试,手枪式抓握触发装置70允许柱塞行进大约0.4英寸并且可以产生超过50磅的力。 [0099] The test pistol allows the plunger to travel approximately 0.4 inches and can produce more than 50 pounds of force gripping device 70 is triggered. 例如,该实施例优于,例如上述活动抓握装置的明显优势在于具有很高冲击速度的瞬时配设。 For example, this embodiment is superior to, e.g., the above-mentioned activities of the gripping device having a clear advantage in that high impact velocity instantaneous disposed.

[0100] 在图20中,显示了本发明的另ー个实施例。 [0100] In FIG. 20, showing another ー embodiment of the present invention. 如上所述,NiTi或SMA合金材料的使用在医疗领域众所周知。 Described above is used, NiTi or SMA alloy materials is well known in the medical field. 如图20中所示,NiTi紧固件示于配设前状态中。 As shown in FIG. 20, NiTi fasteners are shown in a state prior disposed. 紧固件14是连续的并且与进入端口元件10连接而穿过其中的孔。 Fastener 14 is continuous and is connected with the access port 10 and apertures therethrough. 在操作中,紧固件14被压入患者的筋膜中以固定进入端口元件。 In operation, the fastener 14 is pressed into the fascia of the patient to secure the access port. NiTi紧固件14具有能够在例如加热至体温时改变其形状的独特能力。 NiTi fasteners 14 have to change its shape when heated to a temperature such as the unique capability. 如图21中所示,在安装紧固件后,它们可以改变形状以至在进入端口元件10下方弯曲并且将进入端ロ元件固定就位。 As shown in Figure 21, after installing the fasteners, which can change shape at or even below the access port 10 and the entry end bent ro element in place.

[0101] 在图22中,紧固件14显示为带有处于配设状态的直腿80。 [0101] In FIG. 22, the fastener 14 is shown as disposed in a state with the straight leg 80. 可选结构包括如图23所示的弯曲腿81。 Alternatively structure 81 comprises a curved leg 23 as shown in FIG. 使用弯曲腿81,可以将筋膜夹在紧固件与进入端口元件下侧之间。 With a bent leg 81 can be sandwiched between the lower fascia fastener and the access port side. 另ー个可选结构示于图24中,其中紧固件腿81的尖端覆盖有模制尖端82。 Another ー optional structure is shown in FIG. 24, in which the fastener leg tip 81 is covered with a molded tip 82. 模制尖端可以形成为帮助刺穿患者筋膜的形状。 Molded tip may be formed to help patients piercing fascia shape. 这样就不需要使紧固件14形成为用于刺穿的形状。 This eliminates the need to make the fastener 14 is formed in a shape for piercing. 另外,尖端82可以由生物可吸收材料形成。 Further, tip 82 may be formed of bio-absorbable material.

[0102] 在本发明的另ー个实施例中,NiTi紧固件可以连续形成于环84中。 [0102] In another embodiment of the present invention ー embodiment, NiTi fastener can be continuously formed in a ring 84. 环84的使用允许紧固件14形成有连续的结构。 The ring 84 allows the use of a continuous fastener structure 14 is formed. 在形成带有紧固件14的环84之后,可以磨掉腿80的端部以产生各个基本上为U形的紧固件14。 After forming the ring 84 with the fasteners 14, the ends of the legs 80 may be worn away to produce individual substantially U-shaped fastener 14. 环84确保紧固件14可以如上所述作为ー个整体插入,并且研磨腿确保具有足够刺穿筋膜的锋利尖端。 Ring 84 to ensure that the fasteners 14 can be used as described above ー full insertion, and ground has enough legs to ensure a sharp tip to pierce the fascia. 如图25和图27中所示,腿可以形成于环84中并且置于其中以至于在因为受热而弯曲之后,腿80向内朝向进入端口元件10或者向外朝向进入端口元件10。 As shown in FIG. 25 and 27, the legs 84 may be formed in a ring and positioned therein so as to heat and after a bend, the legs 80 inwardly toward the access port 10 or 10 outward toward the access port.

[0103] 本发明的另ー个实施例是如图28至图34中所示的两部件式紧固系统。 [0103] The present invention ー Another embodiment is shown in Fig. 28 to 34 as shown in a two-part fastening system. 图28显示了形成有多个单独紧固件14的导向件90。 Figure 28 shows the formation of a plurality of individual fastener guide 90 14. 紧固件14可以在导向件90中从第一位置滑动到第二位置。 Fastener 14 can be slid from the first position in the guide member 90 to the second position. 在操作中,将导向件90放在进入端口元件10之上并且与切ロ15对正。 In operation, the guide member 90 is placed into the port 10 and the cut on the 15 pairs of regular ro. 紧固件14由弹簧形材料形成并且成形为与进入端口元件10连接。 Shaped fastener 14 is formed of a spring material and shaped to the access port 10 is connected. 紧固件14从图28中所示的第一位置滑动到图29中所示的第二位置。 The slide fastener 14 from a first position shown in Figure 28 to a second position shown in FIG. 29. 紧固件14刺穿筋膜并且将进入端口元件10牢固保持于此。 The fasteners 14 pierce the fascia and securely holding the access port 10 thereto. 如前所述,紧固件可以具有直的或弯曲形的腿。 As previously mentioned, the fastener may have a straight or curved legs. 在所有紧固件从导向件90滑动到进入端口元件10上之后,如果导向件不是最终植入装置的部件就可以将其取出。 After the access port 10 in all the fasteners to slide from the guide member 90, if the guide is not part of the final implanted device can be removed. 作为选择,导向件90也可以是可植入装置的永久部件。 Alternatively, the guide member 90 may be a permanent part of the implantable device.

[0104] 另ー个两部件式紧固装置包括预成形环100 (图31和图32)。 [0104] Another ー a two-part fastening device includes a pre-formed ring 100 (Figures 31 and 32). 该环包括用于将环100连接到筋膜上的第一固定装置104。 The ring comprises a ring 100 connected to the first fixture 104 on the fascia. 该环还包括用于将进入端口元件10连接到固定环100上的第二固定装置102。 The ring further comprises means for access port 10 is connected to the second fixing means 102 on ring 100 is fixed. 在操作中,将环100放在筋膜上,然后扭动以将筋膜接合在第一固定装置104中。 In operation, the ring 100 on the fascia, the fascia and then twisted to engage the first securing means 104. 然后将进入端口元件10放在环100上并且通过进入端口元件中的孔106接合第二固定装置102。 The access port 10 is then placed on the ring 100 through the access port 106 in the engaging hole 102 of the second fixing means. 该结构允许正向连接和重新安装的可重复性,而不分离预成形环。 This structure allows positive connections and reinstall repeatability, without isolating the preformed ring.

[0105] 图33和图34显示了另ー个两部件式紧固装置,该装置包括置放装置112和具有NiTi紧固件114的环110。 [0105] FIG. 33 and FIG. 34 shows a two-part ー other fastening means, the apparatus includes a ring holding means 112 and 114 having NiTi fasteners 110. 在实际应用中,环110插入置放装置112中。 In practice, the ring 110 is inserted in the holding means 112. 置放装置112放在进入端口元件10上方,使紧固件14与切ロ15和孔106对正。 Placement device 112 on top of the access port 10, the fastener 14 and 15 and hole 106 cut ro alignment. 推动紧固件114穿过孔106并且接合进入端口元件10所坐靠的患者筋膜。 Push fastener 114 through the hole 106 and engages the access port 10 patients were sitting by the fascia. 通过加热过程,紧固件14改变形状并且将进入端口元件固定在筋膜上。 By the heating process, the fasteners 14 to change the shape and the access port is fixed to the fascia. 在预定时间之后,可以取出置放装置。 After a predetermined time, it can be removed placement device.

[0106] 本发明的另一个实施例涉及独立紧固件。 Another [0106] This embodiment of the invention relates to a separate fasteners. 如图35至图38中所示,可以使用各种不同的结构以将进入端口元件10固定在患者的筋膜上。 As shown in FIG. 35 to FIG. 38, a variety of structures can be used to enter the port member 10 is fixed in the patient's fascia. 紧固件可以采用NiTi以至于在施加预定热量之后紧固件改变形状。 NiTi so that the fasteners may be used after applying predetermined heat to change the shape of the fastener. 紧固件14可以单独插入,或者如上所述作为预成形环的部件插入。 Fastener 14 can be inserted individually, or as a pre-formed as described above member into the ring. 当単独插入时,紧固件14可以是直杆或者可以具有某些可以通过加热过程而显著变形(heightened)的预成形形状。 When radiolabeling single insert, fastener 14 may be straight rods or may have some heating process can be significantly deformed (heightened) pre-formed shape. 在图35中,紧固件14呈现卷曲发辫形状。 In Figure 35, the fastener 14 presenting curled tress shape. 在图36中,紧固件呈现基本上为C形的外形。 In Figure 36, the fastener presents a substantially C-shaped profile. 图37和图38使用U形紧固件14,其端部在加热时线性弯曲以至形成如图37所示的Q形,或者垂直弯曲成图38所示的形状。 37 and 38 use U-shaped fastener 14, which ends when heated curved linear Q-shaped form as well as shown in FIG. 37, or a vertical bent into shape shown in Figure 38. 这些形状可以针对特定的应用按需要选择。 These shapes can be selected as desired for a particular application.

[0107] 本发明的另ー个实施例示于图39中。 [0107] The present invention another ー a 39 embodiment is shown in FIG. 在图39中,紧固件14滑动安装在进入端ロ元件10中。 In Figure 39, the fastener 14 is mounted into the end of the slide member 10 ro. 这可以通过将NiTi紧固系统冷模制到装置中而实现,并且允许正向连接和可重复的重新安装。 This can be achieved by cold molding NiTi fastening system into the device is achieved, and allow the positive connection and repeatable reinstalled. 通过使用安装工具120,可以推动紧固件穿过进入端口元件10底部的孔并且接合筋膜。 By using the installation tool 120, can push the fastener through the hole at the bottom of the access port 10 and engage the fascia. 通过将紧固件安装为进入端口元件10的一体部件,不需要如上所述的环或壳体用于容纳紧固件。 By mounting the fastener elements integral to the access port member 10, a ring or housing as described above is not required for receiving a fastener. 安装工具120可以是这里所公开的触发装置的一部分。 Installation tool 120 may be part of a trigger device disclosed herein. 图40显示了位于接合位置中的紧固件14。 Figure 40 shows the fastener is located in the engaged position 14.

[0108] 如上所述并且如图I至图8中所示,径向枢转紧固件是采用直接驱动的简单传递系统。 [0108] As described above and as shown in Figure I-radial pivot fastener 8 is a simple direct drive transmission system. 相关传递系统启动枢转以径向进入。 Related transfer system startup pivoted radially enters. 缝合钉可以是不锈钢、钛、镍钛诺或Elgiloy™,或者包括其它金属或塑料的其它合适的材料。 The staple may be stainless steel, titanium, nitinol or Elgiloy ™, or other suitable materials including other metals or plastics. 模制枢转/锁闭系统可以设计为咬扣到可植入装置上的已有缝合孔中。 Molded pivot / locking system can be designed to bite buckle to implantable existing suture holes on the device. 另外,简单的缝合钉形状允许很容易地制造。 In addition, the simple staple shape allows easily manufactured. 这种系统为自刺穿系统,即不需要预先刺穿身体组织,例如筋膜。 This system is self-piercing system that does not require pre-pierced body tissue, such as fascia. 缝合钉的弯曲形结构允许预知縫合钉前进时刺入身体组织的深度;并且弯曲形縫合钉的枢转特征产生轻松穿过组织的路径。 Curved structure allows to predict the penetration of the staple when the staple advancing body tissue depth; and curved staples pivoting feature to generate easy path through the tissue. 拆卸紧固系统需要取出工具,并且缝合钉将伴随着向内生长的周围组织所产生的非常小的阻カ旋出初始进入路径。 Removing fastening systems need to remove the tool and staples will be accompanied by the surrounding tissue ingrowth generated very little initial resistance ka spin out into the path. 然而,除了拆卸过程之外,拆卸系统所需的力很适当以允许缝合钉保持锁定就位。 However, in addition to the demolition process, the force required to remove the system is adequate to allow the staples remain locked in place.

[0109] 这里关注的紧固系统的连续金属丝形状包括钝头、模制尖端和研磨或削锐尖端。 [0109] where the shape of the continuous metal wire fastening systems attention include blunt, molding and grinding or cutting edge sharp cutting edge. 如图20至图23中所示的钝头连续金属丝系统可能需要预刺穿以便插入钝头金属丝。 Blunt tip continuous wire system is shown in Fig. 20 to 23 may need to insert a pre-pierced blunt metal wire. 紧固组件可被制造成需要锁定结构以保持金属丝形状或包覆模制(overmolded)环。 The fastener assembly may be manufactured to require the locking structure to maintain the shape of the wire or overmolding (overmolded) ring. 简单金属丝形状可以由不锈钢、钛、Elgiloy™、NiTi,或者其它合适的材料制成。 Simple shapes can be made of stainless steel wire, titanium, Elgiloy ™, NiTi, or other suitable material. 因为钝头提供最小的组织损伤和创伤,因此可以很轻松地取出紧固装置。 Because blunt provide minimal tissue damage and trauma, so you can easily remove the fastening device. 另外,钝头减小取出装置所需的力。 In addition, to reduce blunt force required to remove the device. 如图20和图24中所示带有模制尖端的连续金属丝式装置不需要预先刺穿身体组织,并且这些尖端允许轻松进入身体组织。 20 and 24 shown in FIGS with a molded tip continuous wire type device does not require a pre-pierced body tissue, and these tips allow easy access to the body tissues. 此外,图25至图27中所示削锐或磨利尖端连续金属丝式装置也不需要预先刺穿身体组织,它们也允许轻松进入身体组织。 In addition, 27 shown in FIGS. 25 to cut sharp or sharpened tip continuous wire type device does not require a pre-pierced body tissue, they also allow easy access to the body tissues.

[0110] 这里所示带有平坦紧固件(图28和图29)和弯曲式紧固件(图30)的径向滑动紧固装置需要比其它紧固装置更大的进入位置。 Radial [0110] Here with flat fasteners (Figures 28 and 29) and curved fasteners (Figure 30) of the fastening means shown in slide requires more advanced position than other fastening means. 紧固件产生穿过身体组织的简单而可靠的路径,在使用弯曲式紧固件系统中将获得更大的保持力。 Fasteners produce simple and reliable path through body tissue, using curved fastener system will be in greater retention. 系统的拆卸采用将每个紧固件从其中心位置撤出的相关取出工具来实现。 Removing system uses each fastener withdrawal from its center position to achieve their removal tool. 作为选择,紧固件可被制造成:通过向上提装置,此时紧固件被弯曲到矫直位置以允许轻松取出紧固件,从而实现系统的拆卸。 Alternatively, the fastener can be manufactured: by providing means upwardly, when the fastener is bent into position to allow easy removal straightening fastener, in order to achieve disassembly of the system.

[0111] 图41显示了ー种螺旋线圈紧固件,该紧固件可选与包括从底座中心延伸的导管连接器的端ロ元件一起使用。 [0111] Figure 41 shows a spiral coil ー fastener optional and includes a central conduit extending from the base end of the connector elements with ro. 螺旋形结构被安装在咬扣端ロ元件的単独的盘上,或者可以安装在端口元件本身上,居中位于基板上。 Helical structure is mounted on the pin end bite ro radiolabeling disc alone element or elements may be installed on the port itself, the center is located on the substrate. 通过盘或端口元件的旋转而将盘或端口元件手动固定在组织上,这导致线圈沿穿过组织的螺旋路径前进。 The disc or port element fixed by manually rotating disk or port element in the organization, which leads to a spiral coil along the path of advancing through the tissue. 在一个实施例中,线圈可以具有锋利的尖端。 In one embodiment, the coil can have a sharpened tip.

[0112] 螺旋线圈紧固件的改型示于图42中。 [0112] modified helical coil fastener is shown in Figure 42. 图42显示了一种扁形螺旋弹簧,其向下偏转以开始其穿过组织的路径。 Figure 42 shows a flat coil spring, which deflect downward to begin its path through the tissue. 在植入之后撤出偏移装置,允许弹簧在康复过程中压缩。 Biasing means to withdraw after implantation, allowing the spring compression in the rehabilitation process. 弹簧的压缩将减小植入的线圈紧固件的轮廓并且可以减小产生疼痛的可能性。 The compression coil spring will reduce contour implantable fastener and can reduce the likelihood of pain.

[0113] 图43至图47显示了ー种水平线圈植入系统。 [0113] FIG 43 to FIG 47 shows ー kind horizontal coil implantation system. 在该水平线圈系统中,金属线圈被水平使用以将端口元件縫合到组织上。 In the horizontal coil system, a metal coil is used horizontally to the port element sewn to the organization. 众所周知,通过在侵入性最小的疝气手术过程中用作网钉(mesh tack),这种线圈可以刺穿组织并且保持在组织中。 As we all know, by acting as a network staple (mesh tack) hernia in minimally invasive surgical procedures, such coils can pierce tissue and remain in the organization. 在该情况下,如上述螺旋线圈紧固件(參见图55) —祥,线圈与组织表面平行而非垂直地前迸。 In this case, as the spiral coil fasteners (see Figure 55) - Andrew, rather than parallel to the surface coil and the organization before 迸 vertically. 期望小型工具以有助于驱动线圈穿过组织和底座中的配合孔(參见图46)。 We expect a small tool to help drive coil through tissue and the base of the mating hole (see Figure 46). 这种孔可以是穿过底座底部上的脊部的直孔(參见图44、图45和图47),或者是模制在具有平坦表面的底座中的弯曲形孔。 Such holes may be straight holes through a ridge on the bottom of the base (see FIG. 44, FIG. 45 and FIG. 47), or a molded base having a flat surface in the curved hole. 底座的俯视图示于图43中。 A plan view of the base shown in Figure 43. 期望的是,最后的孔将为盲孔,并且线圈的端部将形成于可以倾斜滑动并且锁定就位例如进入狭槽中的横杆中。 It is desirable that the last hole would be blind holes, and the coil end portion can be formed on the inclined sliding and locked in place, for example into the slot in the crossbar. 一种改型包括这样的线圈的路径,即其绕端ロ元件或底座边缘弯曲而有助于工具接触到线圈。 A modification includes a coil path, that is, its about the end of the ro edge of the base element or bending tool contacts contribute to the coil. 这也可以通过改变线圈的挠性而实现。 This change can also be realized flexible coil. 为了防止旋转线圈在前进穿过孔之前勾到组织纤维,可以在工具上增加导管作为遮蔽。 In order to prevent rotation of the coil hook through the hole before advancing to the tissue fibers can be added on as a tool catheter shelter.

[0114] 图48至图62显示了金属縫合系统的各种不同的实施例。 [0114] FIG 48 to FIG 62 shows a suturing system of various metals different embodiments. 该端口元件固定方法涉及通过使用底座本身作为封闭弯曲形金属构件形成的圈的装置(例如,參见图48和图52),而在端ロ元件底座之下形成ー个或多个封闭金属圏。 The port member fixing method relates to the use of the base itself as a means of closing ring-shaped metal member formed in a curved (e.g., see FIG. 48 and FIG. 52), and under the end of the base member is formed ー ro one or more closed rings of metal . 这可以用于单部件式系统和两部件式系统,由此两部件式系统可以具有采用图50所示系统与端口元件或其它装置连接的环。 This can be used for single-component systems and two-part system, whereby a two-part system may have a ring system and port elements or other connected device uses shown in Figure 50. 一个实施例包括偏移工具,所述偏移工具使金属构件尖端与底座的接触分离,从而允许构件尖端开始其向下穿过组织的路径。 One embodiment includes contacting tool offset, the offset tool tip and the metal member is separated from the base, allowing the member tip to begin its path downward through the tissue. 所述偏移工具可以是圆盘或端口元件本身。 The tool may be offset disc or port element itself. 在尖端已经前进一定距离之后,撤出工具,允许弯曲形构件然后遵循与底座相交的路径运动。 After the tip has advanced a certain distance, the withdrawal of the tool that allows the curved shape of the base member and then follow a path intersecting motion. 同样,另一个实施例包括在两个平面内弯曲的多个构件,以至于底座的旋转完成多个圈的形成。 Similarly, another example embodiment includes a plurality of members curved in two planes, so that the rotation of the completion of the formation of a plurality of base circle.

[0115] 获得这种圈的一种可选方法是采用弯曲形销,所述弯曲形销在到达其期望的组织位置之后被插入穿过底座,如图51、图53和图54中所示。 [0115] An alternative method of obtaining such a ring is shown in Figure 53 and Figure 54 is a curved shaped pin, the pin bent shape after reaching its desired tissue location is inserted through the base, as shown in Figure 51, . 这种销自然地具有穿过组织的弧形并且很容易指回端口元件底座。 This pin has a natural arc through tissue and can easily refer back to port element base. 这种销可以制造成:通过在咬扣于底座上的狭槽中的销上増加直角弯曲,或者通过其它此类公知的方式(參见图57),所述销在完全行程之后被锁定就位。 This pin may be manufactured: by biting buckle on the base of the slot in the pin to increase in a right angle bend, or by other such well-known manner (see FIG. 57), after the full stroke of the pin is locked on bit. 该设计思想的改型包括位于销的端部并且与弯曲形部分平行(图51)的附加直部分。 Modification of the design, including the ends and parallel with the curved portion (51) of the additional portion is straight pin. 杠杆臂被用于驱动弯曲形部分穿过底座并且完成其设计行程(參见图49和图58至图62)。 The lever arm is used to drive the curved section through the base and is designed to complete the stroke (see FIG. 49 and FIG. 58 to FIG. 62).

[0116] 在另ー个实施例中,可以使用两部件式系统,其中端口元件与带有锋利、弯曲延伸部(參见图56)的折叠基板连接。 [0116] In another embodiment ー, two-part system may be used wherein the port member connected to the substrate with a sharp folded, bent extending portion (see FIG. 56). 将折叠后的板放在组织上,使延伸部指向组织。 The folded sheet on the organization, so that point extension organization. 当基板展开(平坦)时,延伸部沿着旋转路径被驱动旋转90度(參见图56)。 When the substrate is expanded (flat), the extension is driven to rotate 90 degrees along the rotational path (see Figure 56). 端口元件然后咬扣到基板上,将延伸部锁定就位。 Port element then bite buckle to the substrate, the extension is locked in place. 在一个实施例中,延伸部的尖端将与另一半部的尖端重叠,从而半遮蔽这些尖端。 In one embodiment, the tip of the extending portion overlaps with the tip of the other half, so that the tip of the semi-shielding.

[0117] 图58至图62显示了一种优选的旋转盘紧固系统。 [0117] FIG. 58 through 62 show a preferred rotating disc fastening system. 在将待植入装置放入其期望的位置之后,使用多个弯曲形销或钩子501 (參见图62)将其固定到组织上,这些弯曲形销或钩子的尖端旋转经过ー弧线并且在它们行进的末端向回容纳在基板510中或其附近。 After the location of the device to be implanted into its desired, using a plurality of curved pins or hooks 501 (see Figure 62) to secure it to the organization, these curved pin or hook tip and the arc of rotation through ーAt the end of their travel at or near the back to accommodate the substrate 510. 基板510内的盘520旋转,由此导致杠杆臂525压在弯曲形钩子501上,而弯曲形钩子501反过来绕它们的固定轴线在基板中旋转经过ー弧线直到盘的旋转动作停止。 Rotation of the disc 520 within the substrate 510, thereby causing the lever arm 525 is pressed against the curved hooks 501, 501 and the curved hook turn about their fixed axis in the substrate through the rotary disc rotational operation ー arc until stop. 在完全配设位置中(图59和图60),优选的是,钩子501的尖端向回容纳在基板510中以形成封闭圈。 Fully disposed position (FIG. 59 and FIG. 60), it is preferable that the tip of the hook 501 is accommodated in the back of the substrate 510 to form a closed ring. 作为选择,尖端可以形成非封闭圈。 Alternatively, the tip may be formed of non-closed loop. 无论为何种情况,优选的是,旋转盘520在其行进的末端锁定就位以将钩子锁定就位。 Regardless of the circumstances, it is preferable that the rotating disc 520 locks in place to lock the hooks in place at the end of its travel. 与止挡件515接合的单向挠性锁定凸块527或其它锁定装置可以用于通过阻止盘的向回旋转而将钩子锁定就位。 Flexible way with the stopper 515 engages the lock projection 527 or other locking device can be used in turn by preventing the hook to swing the locking plate in place. 例如前面结合图5至图19所述的配设エ具或传递系统可用于将装置紧固就位。 For example, above in connection with Figures 5 to 19 are arranged according to Eito or delivery system may be used with the device secured in place. 柱塞22和滑动推件24的直线运动通过使用齿轮的传动系统或其它公知装置而转变为旋转运动。 Linear motion of the plunger 22 and slide pusher 24 by the use of transmission gears or other known means and converted into rotational motion.

[0118] 尽管已经结合某些优选实施例,具体地说结合进入端ロ元件或注射端ロ元件尤其显示并说明了本发明,但是本领域的普通技术人员很容易认识到,任何多个可植入医疗装置可以与本发明的紧固系统一起使用,并且在不脱离本发明的精神和范围的前提下,可以对进行各种变化和改型。 [0118] Although certain preferred embodiments have been incorporated, specifically incorporated into the end of the injection end ro ro element or elements in particular, the present invention is shown and described, those of ordinary skill in the art will readily recognize that any plurality of implantable the medical device may be used in conjunction with the fastening system of the invention, and without departing from the spirit and scope of the present invention, can make various changes and modifications.

International ClassificationA61M39/02, A61M39/04, A61B, A61B17/068, A61B17/064
Cooperative ClassificationA61M39/0208, A61M39/04, A61B17/064, A61B2017/0649, A61B2017/0647, A61F5/0056, A61M2039/0223, A61B17/0684
European ClassificationA61B17/064, A61B17/068B2
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