DE3106490C2 - Chirurgisches Klammerinstrument zum Verbinden von schläuchförmigen Körperorganen - Google Patents
Chirurgisches Klammerinstrument zum Verbinden von schläuchförmigen KörperorganenInfo
- Publication number
- DE3106490C2 DE3106490C2 DE3106490A DE3106490A DE3106490C2 DE 3106490 C2 DE3106490 C2 DE 3106490C2 DE 3106490 A DE3106490 A DE 3106490A DE 3106490 A DE3106490 A DE 3106490A DE 3106490 C2 DE3106490 C2 DE 3106490C2
- Authority
- DE
- Germany
- Prior art keywords
- anvil
- carrier
- adjustment
- working gap
- cavity
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
- 210000000056 organ Anatomy 0.000 title claims abstract description 10
- 239000012780 transparent material Substances 0.000 claims 1
- 230000003872 anastomosis Effects 0.000 abstract description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 abstract 1
- 230000000007 visual effect Effects 0.000 abstract 1
- 238000000034 method Methods 0.000 description 3
- 229920003023 plastic Polymers 0.000 description 3
- 238000013459 approach Methods 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 230000003444 anaesthetic effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000007373 indentation Methods 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
Abstract
Das erfindungsgemäße wegwerfbare chirurgische Klammerninstrument zum Verbinden von rohrförmigen Körperorganen, wie z.B. den Organen des Verdauungskanals miteinander, besteht also im wesentlichen aus einem langgestreckten Körper mit einem rohrförmigen Gehäuseteil und einem ko axialen zylindrischen Handgriffteil. Der rohrförmige Gehäuseteil trägt an seinem freien Ende einen koaxialen zylindrischen Klammernträger, der mindestens eine ringförmige Reihe chirurgischer Klammern enthält. Eine Justierstange ist koaxial und nicht drehbar in dem Instrumentenkörper gelagert; sie besitzt ein erstes über den Klammernträger hinausragendes Ende. Ein Amboß mit zur leichteren Entfernung von der Anastomosestelle verbesserten Konfiguration ist dem Klammernträger gegenüberliegend mittels einer Amboßmutter auf dem ersten Ende der Justierstange befestigt. Mittels eines am freien Ende des Handgriffteiles des Instrumentenkörpers angeordneten Justierknopfes lassen sich der Amboß und die Justierstange axial relativ zum Instrumentenkörper zwischen einer Position, in der der Amboß dem Klammernträger benachbart ist, und einer Position, in der der Amboß mit Abstand vom Klammernträger angeordnet ist, verschieben. Der Amboß hat mehrere Amboßtaschen, um die Klammern in einem Abstandsbereich zwischen dem Amboß und dem Klammernträger, der einen Arbeitsspalt bildet, zu stauchen. Ein zweites Ende der Justierstange trägt einen mit dem Justierknopf derart zusammenwirkenden Anzeiger, daß er sowohl eine visuelle als
Description
Die Erfindung betrifft ein chirurgisches Klammerinstrument zum Verbinden von schlauchförmigen Körperorganen,
das einen Handgriff mit Betätigungshebel, an seinem einen Ende einen Klammernträger, axial vor
diesem einen Amboß sowie eine Justierstange aufweist, die an ihrem einen Ende mit dem Amboß verbunden, an
einen Justierknopf angeschlossen und von diesem unter Mitnahme des Ambosses und zur Einstellung eines Arbeitsspaltes
zwischen Amboß und Klemmernträger axial im Instrument verstellbar ist.
Klamnicrinstrumente dieser Art sind in den zurückliegenden
Jahren zunehmend in der inneren Chirurgie eingesetzt worden, weil sie die verschiedenen Anastomoseverfahren
wesentlich vereinfachen.
Klammerinstrumente der hier interessierenden Art sind in verschiedenen Ausführungen bekannt. Details
sind den US-PS 31 93 165,35 52 626 oder beispielsweise
der DE-OS 28 51 144 zu entnehmen. Alle diese Geräte ermöglichen eine mehr oder weniger drastische Reduzierung
der Operationsdauer gegenüber manuellen Verfahren, so daß auch die Zeitspanne entsprechend
reduziert wird, während der der Patient unter Narkose gehalten werden muß.
Bei dem in der US-PS 31 93 165 beschriebenen Klammergerät werden die Klammern von Hand in einen einzelnen
ringförmigen Klammerträger geladen. Der Aufbau des Gerätes ist kompliziert, es ist teuer in der Herstellung,
großvolumig und schwer. Da es sich hier um ein wiederverwendbares Klammerinstrument handelt, muß
es nach jedem Gebrauch auseinandergenommen und gereinigt sowie vor jedem Einsatz zusammengesetzt
und steriEsiert werden.
Ein Klammerinstrument für den Einmalgeb, auch ist der US-PS 35 52 626 zu entnehmen, das bereits austauschbare
Klammerträgerköpfe unterschiedlicher Durchmesser aufweist
Bei der Arbeit mit den genannten und anderen bekannten
Klammerinstrumenten wird ein axial zum Instrument verschiebbarer Amboß zunächst in einem
möglichst großen Abstand von der verbleibenden Stirnfläche des Gerätes gebracht und die mit einer Ringnaht
zu verbindenden Stirnenden von zwei Seiten her über den Amboß bzw. die äußere umlaufende Kante der erwähnten
Stirnfläche herum nach innen gezogen und dort auf einer zum Verstellen des Ambosses dienenden
Stange axial verschiebbar festgelegt Anschließend wird der Amboß unter Bildung eines umlaufenden Arbeitsspaltes in Richtung auf die erwähnte Stirnfläche zurückgezogen.
Dieser Arbeitsspalt muß unter Berücksichtigung der Dicke des zu verbindenden Gewebes und der
Länge der zu setzenden Klammern recnt genau dimensioniert werden. Da ein falsch eingestellter Arbeitspalt
zu erheblichen operativen und postoperativen Komplikationen führen kann, ist bei der Einstellung eine große
Sorgfalt erforderlich, die eine entsprechende Arbeitsund damit Narkosezeit erfordert
Der Erfindung lag deshalb die Aufgabe zugrunde ein chirurgisches Klammerinstrument mit Merkmalen der
vorgenannten US-Patentschrift so auszubilden, daß die Einstellung des Arbeitsspaltes erleichtert wird.
Gelöst wird diese Aufgabe bei einem chirurgischen Klammerinstrument der einleitend genannten Art dadurch,
daß der Justierkopf eine an seinem freien Ende offene Aushöhlung aufweist, in die das freie Ende der
Justierstange hineinragt, welches m;t einer Anzeigeeinrichtung versehen ist. die der Axialbewegung der Justierstange
folgt und deren Position relativ zu dei Aushöhlung sieht- und ertastbar ist.
Vorteilhafte Ausgestaltungen der Erfindung sind in den Unteransprüchen angegeben.
Die Lösung erfüllt die Zicivorstellungen dadurch, daß
sich der Arbeicsspalt von der anfänglich weiten Öffnungsstellung schnell und ohne Nachdenken auf einen
Grundwert zurückstellen läßt, von dem aus dann die Feineinstellung möglich ist. Der Operateur braucht deshalb
nur noch tastend und optisch die relative Position von Anzeigeeinrichtung und Aushöhlung zu beobachten.
Die Feineinstellung ist dann in vergleichbar schneller Weise anhand einer Skalierung vornehmbar.
Die Erfindung ist nachstehend anhand des in der Zeichnung dargestellten Ausführungsbeispieles näher
erläutert. In der Zeichnung zeigt
Fig. 1 eine Seitenansicht des Klammerinstrumentes und
Fig.2 einen Längsschnitt durch das Instrument gemäß
Fig. 1.
Das beispielhaft dargestellte Klammerinstrument 1 weist einen länglichen Körper 2 mit einem rohrförmigen
Gehäuseteil 3 und einen koaxialen zylindrischen Handgriffteil 4 von geringfügig größerem Durchmesser auf.
Der Körper 2 besteht aus zwei spiegelbildlich Kunststoff-Formteilen,
die miteinander verschweißt sind. Eines dieser Formteile 2b ist in F i g. 2 erkennbar.
Das rohrformige Gehäuseteil 3 trägt an seinem distaten
Ende einen zylindrischen Klammernträger 5. Eine Justierstange 6 durchsetzt den Körper 2 in axialer Richtung
und erstreckt sich an ihrem distalen Ende über den Klammernträger 5 hinaus bis zu einer Amboßeinheit 7,
die an der Justierstange 6 beftstigt ist.
Am proximalen Ende des Handgriffsteils 4 ist ein Justierknopf
8 drehbar befestigt, der als hohles zylindrisches Element mit einem ersten Teil 8a ausgebildet ist
welcher sich über das proximale Ende des Handgriffsteils 4 hinaus erstreckt. Ein zweiter Teil Sb des Justierknopfes
8 weist einen geringeren Außendurchmesser auf. Dieser Außendurchmesser ist so gewählt, daß das
Teil 86 des Justierknopfes vom Handgriffteil 4 aufgenommen werden kann und darin verdrehbar ist Ein dritter
Teil 8c des Justierknopfes 8 besitzt einen weiter verringerten Durchmesser mit einer Gewindebohrung
9.
Um den Justierknopf 8 im Handgriffteil 4 in seiner verdrehbaren Stellung zu sichern, sind die beiden Formteile
des Körpers 2 mit zusammenwirkenden ringförmigen inneren Flanschen ausgerüstet Ein solcher Flansch
10 des Formteils 2b ist in F i g. 2 zu sehen. Der dazugehörige gleiche und fluchtende Flansch des anderen
Formteils ist nicht erkennbar. Die Flansche 10 liegen an einer vorderen, zwischen den Teilen 8b und 8c gebildeten
Schulter 11 des Justierknopfes 8 an. Eine zwischen den Teilen 8a und 86 des Justierknopfes befindliche
Schulter 12 liegt in gleicher Weise am proximaien Ende des Handgriffteils 4 an. Schließlich weist der Justierknopf
8 eine ringförmige Nut 13 auf, und der Innenraum des Handgriffteils 4 ist mit einer entsprechenden Nut 14
versehen. In den Nuten 13 und 14 ist eine Arretierscheibe 51 untergebracht, die ein axiales Verschieben des
Justierknopfes 8 unterbindet.
Der Justierknopf 8 besteht im Ausführungsbeispiel aus durchsichtigem Kunststoff und trägt an seiner, dem
proximalen Ende des Handgriffteils 4 benachbarten äußeren Umfangsfläche eine Ringskala 16. Dieser benachbart
ist das rlandgriffteil 4 mit einer Indexmarke 17 versehen.
Die Justierstange 6 ist an ihrem hinteren oder proximalen Ende mit einem Gewinde 18 versehen, das die
Gewindebohrung 9 im Teil 8cdes Justierknopfes durchsetzt.
Die beiden Formteile des Körpers 2 sind an ihren Innenflächen mit einer sich in Längsrichtung erstrekkenden
Nut 19 versehen, die im Formteil 2b (Fig. 2)
gestrichelt dargestellt ist. Nach dem Verschweißen der beiden Formteile des Körpers 2 stehen sich somit zwei
Nuten 19 diametral im Inneren des Körpers 2 gegenüber.
Die Justierstange β wird von einer Querbohrung 20 durchsetzt, durch die ein Stift 21 hindurchgeführt ist. Die
freien Enden des Stiftes 21 stehen in gleitendem Eingriff mit den beiden Nuten 19 in den Formteilen des Körpers
2. Der Stift 21 verhindert dadurch ein Verdrehen der Justierstange 6. Gleichzeitig wird durch diese Konstruktion
erreicht, daß ein Verdrehen des Justierknopfes 8 wegen seiner Gewindebohrung mit der Justierstange 6
zu einer axialen Verschiebung der Justierstange führt. Die sich verschiebende Justierstange 6 nimmt dabei die
Amboßeinheit 7 mit. Folglich kann durch ein Verdrehen des Justierknopfes 8 eine Einstellung des noch zu beschreibenden
Arbeit?"ipaltes bewirkt werden. b5
Auf der lustierstange 6 ist ein zylindrisches hohles
Treiberrohr 22 gleitend gelagert, das an seinem distalen
Ende einen Kiammerntreiber 56 und ein zylindrisches Skalpell 59 tragt An seinem proximalen Ende ist das
Treiberrohr 22 mit einer ringförmigen Reihe von nach innen gerichteten Vertiefungen 23 versehen, von denen
nur eine dargestellt ist Eine entsprechende ringförmige Reihe von Vertiefungen 24 befindet sich am distalen
Ende des Treiberrohres 22. Diese Vertiefungen 23, 24 stellen für das axial gegenüber der Justierstange 6 verschiebbare
Treiberrohr 22 eine Führungseinrichtung mit niedrigem Reibungskoeffizienten dar.
Am proximalen Ende des Treiberrohres 22 ist ein Spulenkörper 25 mit stirnseitigen Ringflanschen 25a,
256 befestigt. Zwei gabelförmig angeordnete Nocken 30 am freien Ende eines um einen Stift 29 schwenkbaren
Hebels 28 greifen zwischen die Ringflansche 25a, 256 des Spulenkörpers 25. Wenn der Hebel 28 von dem
Chirurgen gegen das Handgriffteil 4 des Klammerinstrumentes 1 gezogen wird, drücken die Nocken 30 folglich
das Treiberrohr 22 axial gegenüber der Justierstange 6 nach -orn. Der Stift 29 ist in Ansätzen 26 (F i g. 1)
und 27 (F i g. 2) des Körpers 2 gel age5 ...
Zum Vorspannen νοπ Treiberrohr 22 und Handgriff
28 in die in der Zeichnung gezeigte Stellung dient eine Druckfeder 34, die sich unter 21wischenschaltung von
zwei lose auf dem Treiberrohr 22 angeordneten Unterlegscheiben 32, 33 einerseits an einem inneren ringförmigen
Flansch 31 des Körpers 2 und andererseits am Ringflansch 25a des Spulenkörpers 25 abstützt.
Zum Unterbinden einer unbeabsichtigten Betätigung von Hebel 28 und Treiberrohr 22 weist das Klammerinstrument
1 einen verstellbaren Sicherungshebel 35 auf, der in Axialrichtung verschiebbar in einem Schlitz 36
des Körpers 2 angeordnet und <an einem Herausfallen aus dem Körper 2 durch eine Schulter 37 gehindert ist.
Eine der Schulter 37 entsprechende Schulter befindet sich auf der in F i g. 2 nicht sichtbaren Seite des Sicherungshebels
35.
An seinem vorderen Ende ist der Sicherungshebel 35 mit einer Nase 39 versehen, die in der gezeichneten
Stellung eine Schulter 40 des Hebels 28 untergreift und dadurch eine Hebelbewegung unterbindet. Zum leichteren
Zurückziehen des Sicherungshebels 35 in die nicht gezeichnete Freigabestellung dient ein keilförmiger
Vorsprung 38 des Hebels 35.
Die am freien Vorderende der Justierstange 6 angeordnete Amboßeinheit 7 besteht aus dem eigentlichen
Amboß 60, der mit einer Amboßschraube 73 versehen ist und in seinem Inneren einen Ring 71 zur Bildung
einer Schneidfläche für das Skalpell 59 aufweist.
In F i g. 2 ist schließlich zu erkemnen, daß sich am proximalen
Ende der Justierstange 6 ein gewindeloser Zapfen 81 befindet, der eine Anzeigekappe 82 trägt. Diese
im hohlen Innenraum des Justierknopfes 8 befindliche Anze;";ckappe 82 stellt eine mit der rückwärtigen Fläche
des Justierknopfes 8 zusammenwirkende Anzeigeeinrichtung dar, wL nachstehend noch deuJrch werden
wird.
Zum Durchführen eines Anastromose-Verfahren wird das distale Ende des Klammerinstrumentes nach
Möglichkeit durch eine natürliche öffnung des Patientenkörpers
oder durch einen von der Anastomosestelle entfernten seitlichen Einschnitt in e;n rohrförmigss Körperorgan,
beispielsweise den Darm eingeführt. Der Klammernträger 5 und die Amboßeinheit 7 haben dabei
zunächst die in F i g. 1 gezeigte relative Stellung. Wenn das Klammerinstrurrient die richtige Position innerhalb
des Körperorgans hat, wird der Chirurg den Justierknopf 8 so verdrehen, daß sich der Amboß 60 vom
Klammernträger 5 entfernt. Die zu verbindenden Enden
des Körperorganes werden dann mit einem Faden eingeschnürt,
bis sie auf dem dann freiliegenden Teil der Justierstange 6 zwischen Amboß 60 und Klammernträger
5 aufliegen.
Anschließend muß der Arbeitsspalt zwischen den sich gegenüberliegenden Stirnflächen des Ambosses 60 und
des Klammernträgers 5 eingestellt werden, damit die beiden freien Enden des Körperorgans mittels des
Klammerinstrumentes verklammert werden können. Die Größe des benötigten Arbeitsspaltes entspricht regelmäßig
der Summe der Wandstärken der beiden zu verbindenden Teile des Körperorgans. Diese Wandstärken
wurden von dem Chirurgen vor dem Einführen des Klammerinstrumentes gemessen, so daß nun der Justierknopf
8 in diejenige Richtung verdreht werden kann, in der sich die Amboßeinheit 7 bzw. der Amboß 60
dem Klammernträger 5 nähert. Die Drehung des Justierknopfes 8 wird solange fortgesetzt, bis das hintere
Ende der Anzeigekappe 82 weitgehend koplanar mit dem hinteren Ende des Justierknopfes 8 liegt. Diese Position
kann visuell oder durch Tasten mühelos festgestellt werden. Wenn der |ustierknopf 8 aus einem durchsichtigen
Kunststoff besteht, kann der Chirurg außerdem leicht beobachten, wie sich die Anzeigekappe 82
dieser koplanaren Position nähert.
Die Länge der Justierstange ist so gewählt, daß der für das Klammerinstrument maximale Arbeitsspalt eingestellt
ist, wenn das hintere Ende der Anzeigekappe 82 in derselben Ebene wie die rückwärtige Fläche des Justierknopfes
8 liegt. Von dieser Position der beiden Teile jo an steht dem Chirurgen für die Einstellung des tatsächlichen
Arbeitsspaltes die in Fig. 1 ersichtliche Ringskala 16 am Justierknopf 8 nebst Marke 17 am Handgriffteil 4
zur Verfügung. Aufgrund der zuvor gemessenen Wandstärken kann der Chirurg also nun durch Verdrehen des J5
Justierknopfes 8 und unter Benutzung der Ringskala den notwendigen Arbeitsspalt einstellen. Sobald dies
geschehen ist, wird der Sicherungshebel 35 in seine nicht gezeichnete rückwärtige Stellung verschoben, worauf
der Hebel 28 gegen das Handgriffteil 4 gezogen, dadurch überschüssiges Gewebe im Arbeitsspalt mittels
des Skalpells 59 abgetrennt werden kann und die Klammern gesetzt werden können.
Hierzu 2 Blatt Zeichnungen
50
60
65
Claims (4)
1. Chirurgisches KJammerinstrument zum Verbinden
von schlauchförmigen Körperorganen, das einen Handgriff mit Betätigungshebel, an seinem einen
Ende einen Klammernträger, axial vor diesem einen Amboß sowie eine Justierstange aufweist, die
an ihrem einen Ende mit dem Amboß verbunden, an einen Justierkopf angeschlossen und von diesem unter
Mitnahme des Ambosses und zur Einstellung eines Arbeitsspaltes zwischen Amboß und Klammernträger
axial im Instrument verstellbar ist, dadurch
gekennzeichnet, daß der Justierkopf (8) eine an seinem freien Ende (Sa) offene Aushöhlung aufweist,
in die das freie Ende der Justierstange (6) hineinragt, welches mit einer Anzeigeeinrichtung (82)
versehen ist, die der Axialbewegung der Justierstange folgt und deren Position relativ zu der Aushöhlung
sieht- und ertastbar ist
2. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß die Anzeigeeinrichtung (82) eine rückwärtige
freie Fläche aufweist, die in der rückwärtigen Begrenzungsebene der Aushöhlung des Justierknopfes
(8) liegt, wenn der Arbeitsspalt seine maximale Größe hat, die sich innerhalb der Aushöhlung
befindet, wenn der Arbeitsspalt über seine maximale Größe hinaus geöffnet ist und die außerhalb der
Ebene liegt, wenn der Arbeitsspalt eine geringere als seine maximale Größe aufweist.
3. Instrument nach Anspruch I oder 2, dadurch
gekennzeichnet, daß der Jusw.'rkopf (8) im Bereich seiner Aushöhlung aus «ransparentem Material besteht.
4. Instrument nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, daß der Justierkopf (8) mit
einer Ringskala (16) und der Handgriff teil (4) benachbart
zur Ringskala mit einer Marke (17) zur Endeinstellung des Arbeitsspaites versehen ist.
40
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US06/124,954 US4319576A (en) | 1980-02-26 | 1980-02-26 | Intralumenal anastomosis surgical stapling instrument |
Publications (2)
Publication Number | Publication Date |
---|---|
DE3106490A1 DE3106490A1 (de) | 1982-02-18 |
DE3106490C2 true DE3106490C2 (de) | 1984-05-10 |
Family
ID=22417584
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE3153034A Expired DE3153034C2 (de) | 1980-02-26 | 1981-02-21 | Amboß für ein chirurgisches Klammerinstrument |
DE3106490A Expired DE3106490C2 (de) | 1980-02-26 | 1981-02-21 | Chirurgisches Klammerinstrument zum Verbinden von schläuchförmigen Körperorganen |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE3153034A Expired DE3153034C2 (de) | 1980-02-26 | 1981-02-21 | Amboß für ein chirurgisches Klammerinstrument |
Country Status (19)
Country | Link |
---|---|
US (1) | US4319576A (de) |
JP (2) | JPS56121543A (de) |
AR (1) | AR225654A1 (de) |
AT (1) | AT393616B (de) |
AU (1) | AU542542B2 (de) |
BE (1) | BE887286A (de) |
BR (1) | BR8101154A (de) |
CA (1) | CA1156116A (de) |
DD (1) | DD160036A5 (de) |
DE (2) | DE3153034C2 (de) |
ES (1) | ES498160A0 (de) |
FR (1) | FR2476477B1 (de) |
GB (2) | GB2070499B (de) |
HK (1) | HK69886A (de) |
IT (1) | IT1144115B (de) |
MX (1) | MX151314A (de) |
NL (1) | NL187559C (de) |
SE (2) | SE458739B (de) |
ZA (1) | ZA807910B (de) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE4309569C1 (de) * | 1993-03-24 | 1994-08-04 | Martin Storz | Griff für ein chirurgisches Rohrschaftinstrument |
Families Citing this family (955)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
AU575624B2 (en) * | 1980-02-26 | 1988-08-04 | Senco Products Inc. | Anastomsis surgical stapler |
US4289133A (en) * | 1980-02-28 | 1981-09-15 | Senco Products, Inc. | Cut-through backup washer for the scalpel of an intraluminal surgical stapling instrument |
US4345600A (en) * | 1980-08-04 | 1982-08-24 | Senco Products, Inc. | Purse-stringer |
US4351466A (en) * | 1980-10-16 | 1982-09-28 | United States Surgical Corporation | Disposable instrument for surgical fastening |
US4576167A (en) * | 1981-09-03 | 1986-03-18 | United States Surgical Corporation | Surgical stapler apparatus with curved shaft |
US4442964A (en) * | 1981-12-07 | 1984-04-17 | Senco Products, Inc. | Pressure sensitive and working-gap controlled surgical stapling instrument |
US4473077A (en) * | 1982-05-28 | 1984-09-25 | United States Surgical Corporation | Surgical stapler apparatus with flexible shaft |
US4485817A (en) * | 1982-05-28 | 1984-12-04 | United States Surgical Corporation | Surgical stapler apparatus with flexible shaft |
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CA736256A (en) * | 1962-08-27 | 1966-06-14 | S. Kasoolin Viacheslav | Instrument for suturing esophagus to intestine or stomach |
GB942122A (en) * | 1962-09-11 | 1963-11-20 | Mikhail Gueorguievich Akhalaya | A surgical instrument |
GB1121673A (en) * | 1965-08-26 | 1968-07-31 | N Isseldovatelsky Iex Khirurgi | Improvements in or relating to a surgical instrument for suturing hollow organs |
US3494533A (en) * | 1966-10-10 | 1970-02-10 | United States Surgical Corp | Surgical stapler for stitching body organs |
US3490675A (en) * | 1966-10-10 | 1970-01-20 | United States Surgical Corp | Instrument for placing lateral gastrointestinal anastomoses |
CH470170A (de) * | 1968-02-02 | 1969-03-31 | Vnii Khirurgicheskoi Apparatur | Gerät zum Anbringen von Rundanastomosen |
US3593903A (en) * | 1968-07-12 | 1971-07-20 | Vnii Khirurgicheskoi Apparatur | Surgical instrument for suturing hollow organs in infants |
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BE758685A (fr) * | 1970-10-14 | 1971-05-10 | Vnii Khirurgicheskoi Apparatur | Appareil chirurgical pour la suture de tissus par des agrafes |
CA988803A (en) * | 1972-10-16 | 1976-05-11 | Raymond Grunwald | Suturing instrument anvil bushing part |
US3822818A (en) * | 1973-02-20 | 1974-07-09 | A Strekopytov | Surgical instrument for joining osseous tissues by staples |
CH574010A5 (de) * | 1975-08-14 | 1976-02-15 | Kramlehner Karl | |
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-
1980
- 1980-02-26 US US06/124,954 patent/US4319576A/en not_active Expired - Lifetime
- 1980-12-17 AU AU65482/80A patent/AU542542B2/en not_active Expired
- 1980-12-18 ZA ZA00807910A patent/ZA807910B/xx unknown
- 1980-12-19 SE SE8008996A patent/SE458739B/sv unknown
- 1980-12-24 ES ES498160A patent/ES498160A0/es active Granted
- 1980-12-29 CA CA000367659A patent/CA1156116A/en not_active Expired
- 1980-12-31 GB GB8041628A patent/GB2070499B/en not_active Expired
-
1981
- 1981-01-05 NL NLAANVRAGE8100004,A patent/NL187559C/xx not_active IP Right Cessation
- 1981-01-14 FR FR8100575A patent/FR2476477B1/fr not_active Expired
- 1981-01-23 AR AR284063A patent/AR225654A1/es active
- 1981-01-26 JP JP913281A patent/JPS56121543A/ja active Granted
- 1981-01-29 BE BE0/203635A patent/BE887286A/fr not_active IP Right Cessation
- 1981-02-18 MX MX186025A patent/MX151314A/es unknown
- 1981-02-19 AT AT0074981A patent/AT393616B/de not_active IP Right Cessation
- 1981-02-21 DE DE3153034A patent/DE3153034C2/de not_active Expired
- 1981-02-21 DE DE3106490A patent/DE3106490C2/de not_active Expired
- 1981-02-25 IT IT67261/81A patent/IT1144115B/it active
- 1981-02-25 BR BR8101154A patent/BR8101154A/pt not_active IP Right Cessation
- 1981-02-26 DD DD81227900A patent/DD160036A5/de unknown
-
1983
- 1983-08-04 GB GB08321054A patent/GB2133735B/en not_active Expired
-
1986
- 1986-09-12 SE SE8603834A patent/SE8603834D0/xx not_active Application Discontinuation
- 1986-09-18 HK HK698/86A patent/HK69886A/xx not_active IP Right Cessation
-
1990
- 1990-05-28 JP JP2138160A patent/JPH039740A/ja active Granted
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE4309569C1 (de) * | 1993-03-24 | 1994-08-04 | Martin Storz | Griff für ein chirurgisches Rohrschaftinstrument |
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