CN1228687A - 动脉内膜切除术外科仪器和方法 - Google Patents
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Abstract
从选择长度动脉中去除动脉噬菌斑的动脉内膜切除术外科仪器和方法,及切割动脉噬菌斑积聚的外科仪器。动脉内膜切除术外科仪器具有显示手术位置影象的装置,以便能够观察动脉探查,而不需要沿待去除动脉噬菌斑积聚的选择长度切开动脉。
Description
技术领域
本发明整体涉及一种外科仪器和方法,特别涉及清理动脉以去除动脉噬菌斑积聚。
发明背景
常规操作是,切开待清除噬菌斑积聚的动脉的整个选择长度,繁琐地将内层(即“内壁”)从外膜上分离开以沿动脉长度去除动脉噬菌斑积聚,然后将整个切开长度缝合封闭,利用外膜作为封闭。由于这种切口例如可沿整个从腹股沟到脚的长度上延伸,这种方法是一种大规模的外科侵入。随着切口长度的增加,这种外科手术的难度也增加。
过去也使用另外一种方法去除动脉噬菌斑积聚,该方法涉及在待清理的动脉部分端部相对小的切口。在该方法中,使用镊子去除或松动动脉噬菌斑积聚,镊子从两个切口处插入以将动脉“去除内壁”。为了去除残余的噬菌斑,将一个“剥离器”(例如一种导管状元件)从上切口到下切口穿过整个闭塞的动脉,一定有限数量的噬菌斑残余就被从下切口推出来了。当导管状元件从下切口伸出时,将一个拭子固定在导管状元件的前端。当抽回导管状元件时,拭子将残余的噬菌斑带向并带出上切口。然后,将两个切口缝合。由于被清理的动脉部分不是切开和暴露的,该方法是“盲目的”,所以本质上是危险的。而且,第二个切口无论对于推出噬菌斑还是接近导管状元件以固定拭子都是必要的。
在另一个被称为气体动脉内膜切除术的去除动脉噬菌斑积聚的技术中,一个二氧化碳气体喷嘴插入到动脉壁中以产生一个“分离平面”。在动脉上切开一个小开口,把一个仔细设计不会损伤动脉的专用气体插入到分开平面,二氧化碳气体穿过专用气体刀进一步分离内壁的整个长度。然后通过横切动脉远端并将整个内壁从动脉近端切口拉出以去除内壁,然后将两个切口缝合。由于被清理的动脉部分不是切开和暴露的,该方法也是“盲目的”,所以本质上是危险的。而且,该方法至少需要两次外科切开以暴露要清理的动脉部分的两端和在动脉本身上的两个切口。
还可这样进行气体动脉内膜切除术,即首先用外科手术沿整个选择长度动脉切开身体部分,但不是待清理的动脉,然后通过观察透过足够透明的动脉壁探查动脉来进行气体动脉内膜切除术。这种方法也是一种大规模的外科侵入。随着切口长度的增加,这种外科方法的难度也增加。
由于这引起与上述外科方法相关的困难和危险,分流术外科方法变得受欢迎了。不是清除动脉中的动脉噬菌斑积聚,而是用外科手术将具有动脉噬菌斑积聚的动脉部分分流。这种分流术方法也是大规模的外科侵入。随着旁通管长度的增加,这种外科方法的难度也增加。
目前,存在一种减少外科方法中侵入程度的趋势。从而,人们对可减少外科侵入和缩短病人必须住院时间的气体动脉内膜切除术表现出越来越多的新兴趣。
发明综述
本发明是只通过一个较小的切口进行气体动脉切除术的新外科仪器和新外科方法。
根据本发明构造的一种动脉内膜切除术外科仪器,包括一个铲端,该铲端在其第一端具有一个光学开口和多个流体开口。该动脉内膜切除术外科仪器还具有第一弹性管状装置,该装置从铲端的光学开口穿过铲端,用于将光从第一弹性管状装置的远端通过光学开口传导到手术位置,并将手术位置的影象通过光学开口传导到第一弹性管状装置的远端。该动脉内膜切除术外科仪器还具有第二弹性管状装置,该装置从铲端的流体开口穿过铲端,用于将流体从第二弹性管状装置的远端通过流体开口传导到手术位置。该动脉内膜切除术外科仪器进一步具有适于连接到光源、影象形成元件和流体源的连接器装置,第一弹性管状装置的远端和第二弹性管状装置的远端连接到该连接器装置上,以便将光从光源传导到第一弹性管状装置,将手术位置的影象从第一弹性管状装置传导到影象形成元件,并将流体从流体源传导到第二弹性管状装置。
根据本发明进行的从选择长度动脉清除动脉噬菌斑积聚的动脉内膜切除术外科方法,包括只在选择长度动脉第一端做一个切口以暴露动脉,从该切口将动脉噬菌斑积聚去除。该动脉内膜切除术外科方法还包括将铲从动脉外膜和中膜间的切口处插入到动脉中,在使用流体增加动脉外膜和中膜间空间的同时,用铲探查选择长度动脉。动脉内膜切除术外科方法进一步包括探查动脉时连续显示铲周围的手术位置影象,和探查动脉时观察手术位置影象。在动脉内膜切除术外科方法中还包括在选择长度动脉的第二端终止探查动脉,抽回铲,并将铲通过切口从动脉抽出。其次,该动脉内膜切除术外科方法包括将动脉噬菌斑积聚从动脉中去除和处理选择长度动脉第二端的终止过渡。该动脉内膜切除术外科方法通过缝合切口结束。
如果有必要切下动脉噬菌斑积聚以将其去除,根据本发明构造的第一种外科仪器,包括一个细长弹性杆件,一个位于细长弹性杆件第一端的把手,一个位于与第一端相对的细长弹性杆件第二端的切割件。该切割件具有一内切割边和一弧形外钝边。
根据本发明构造的切割动脉噬菌斑积聚的第二种外科仪器,包括一个细长管状支撑件和一个切割金属丝件,该切割金属丝件从细长管状支撑件中伸出并可在细长管状支撑件中自由移动。切割金属丝件的自由端从细长管状支撑件的第一端伸出,切割金属丝件的封闭环部分从细长管状支撑件的第二端伸出。
附图简要描述
图1所示为根据本发明构造的动脉内膜切除术外科仪器部分剖面俯视图。
图2所示为图1动脉内膜切除术外科仪器的铲端部分的端视图。
图3所示为图1动脉内膜切除术外科仪器的光学部分的剖面图。
图4所示为部分填充动脉噬菌斑积聚的人体动脉剖面图。
图5所示为图1动脉内膜切除术外科仪器的铲端部分第二实施例的端视图。
图6所示为根据本发明构造的动脉内膜切除术外科仪器第三实施例的部分剖面图。
图7A和7B所示分别为根据本发明构造的用于切割动脉噬菌斑积聚的外科仪器第一实施例的俯视图和侧视图。
图7C所示为图7A和7B外科仪器切割件部分的替代形式。
图8所示为根据本发明构造的用于切割动脉噬菌斑积聚的外科仪器第二实施例的俯视图。
图9所示为根据本发明构造的用于切割动脉噬菌斑积聚的外科仪器第三实施例的打开的侧视图。
发明详细描述
参见图1、2和3,根据本发明构造的动脉内膜切除术外科仪器,包括一个铲端10,该铲端在其第一端具有一个光学(即光和影象)开口12和多个流体开口14。如下所述,光学开口12允许从光源传来的光被传导到手术位置,手术位置的影象被传导到影象形成元件。这样,外科医生可以观察在动脉中进行的手术过程,不需要切开被清理动脉的整个长度。如下所述,流体开口14允许流体,通常为二氧化碳,流向手术位置以增加动脉外膜和中膜间的空间(即“分离平面”)。这样,铲端10可以沿被清理的动脉长度推进。铲端10的主体最好为弧形,与动脉形状相似并尺寸适合于被清理的特定动脉。
更适宜的是,铲端10还在其第一端具有多个液体开口16a和16b,以允许液体流向和流出手术位置,以带走动脉噬菌斑积聚残余并清洁光学开口12。液体通过液体开口16a导向手术位置,通过液体开口16b导出手术位置。通常,液体可以是盐溶液。
根据本发明构造的动脉内膜切除术外科仪器还包括第一弹性管状装置18,其从铲端的光学开口12穿过铲端10延伸,用于将光从第一弹性管状装置远端通过光学开口传导到手术位置,将手术位置的影象通过光学开口传导到第一弹性管状装置远端。这种第一弹性管状装置18可以包括通过其将光传导到手术位置的第一纤维光学装置,和通过其传导手术位置影象的第二纤维光学装置。对于图3所示的本发明的实施例,第一纤维光学装置包括多个排列成环形的纤维光缆20,第二纤维光学装置包括单根纤维光缆22,其布置在第一纤维光学装置的多个光缆20的环形排列的中心。如图1和2所示,光学开口12和纤维光缆20和22最好位于铲端10弧形体内部,而不要位于铲端内外弧形表面的外侧,这样易于设计并能使铲端的尺寸最小。
根据本发明构造的动脉内膜切除术外科仪器进一步包括第二弹性管状装置24,其从铲端10的流体开口14穿过铲端10延伸,用于将流体从第二弹性管状装置的远端通过流体开口传导到手术位置。
尽管如图所示的第一弹性管状装置18和第二弹性管状装置24是被分开的,但也可将其同轴布置。
当要将液体输送到手术位置时,根据本发明构造的动脉内膜切除术外科仪器进一步包括第三弹性管状装置26,其从铲端的流体开口16a和16b穿过铲端10延伸,用于将流体从第三弹性管状装置的远端通过第一流体开口传导到手术位置,和将流体通过第二流体开口从手术位置传导到第三弹性管状装置的远端。
根据本发明构造的动脉内膜切除术外科仪器还包括适于连接到光源、影象形成元件和流体源的连接器装置28,第一弹性管状装置18的远端和第二弹性管状装置24的远端连接到该连接器装置上。当液体被输送到手术位置和从手术位置被抽出时,连接器装置28适于连接到液体源和液体排放容器,第三弹性管状装置26的远端连接到连接器装置上。这样,光源的光被传导到第二弹性管状装置18,手术位置的影象被从第一弹性管状装置18传导到影象形成元件,流体源的流体被传导到第二弹性管状装置24,液体被从液体源传导到第三弹性管状装置26和从第三弹性管状装置传导到液体排放容器。
连接器装置28可以包括传统的路厄氏锁连接器,流体源和第二弹性管状装置24连接到该路厄氏锁连接器上以通过流体,液体源、液体排放容器和第三弹性管状装置26连接到该路厄氏锁连接器上以通过盐溶液。相反,通过其将光传导到手术位置的第一纤维光学装置和通过其将手术位置的影象传导到影象形成元件的第二纤维光学装置是连续的,不间断的纤维光缆,其穿过连接器装置28,但被连接器装置锁住以防发生纵向和旋转滑动,并被密封以防止漏出二氧化碳气体和盐溶液。
更适宜的是,根据本发明构造的动脉内膜切除术外科仪器包括弹性套30,其在铲端10和连接器装置28之间延伸,并且第一弹性管状装置18、第二弹性管状装置24和第三弹性管状装置26穿过该套。弹性套30可以是管件,如图1所示,分开排列的第一弹性管状装置18、第二弹性管状装置24和第三弹性管状装置26穿过该管件,或者可将套和管状装置做成一个具有管道或通道的单一弹性挤出件,光、手术位置的影象、流体和盐溶液通过这些管道或通道传导。
刚才描述的外科仪器可用在动脉内膜切除术外科手术,以根据本发明将动脉噬菌斑积聚从选择长度动脉中去除。首先,开一个切口并将动脉在选择长度动脉的第一端切开,动脉噬菌斑积聚从该切口取出。然后,用一根针穿过动脉的外壁,针的规格通常为25,并将二氧化碳气体通过针导入以开始分离外膜和中膜(即“分离平面”)。将针抽出并在动脉壁上做一个切口。
参见图4,根据本发明进行的动脉内膜切除术外科方法的下一步是,将铲10从动脉外膜40和中膜42间的切口处插入到动脉中。然后,用铲探查选择长度动脉,同时通过铲端利用控制压力下的流体(例如二氧化碳气体)增加动脉外膜40和中膜42间的空间。二氧化碳气体还能减少手术位置的血液量。二氧化碳气体或者被吸收或者通过动脉壁上的切口流走。控制压力下的盐溶液可输送到手术位置以冲走从动脉噬菌斑积聚44上掉下的噬菌斑碎片,并清洁铲端的光学开口。当动脉中存在由动脉噬菌斑积聚造成的完全闭塞时,控制二氧化碳气体和盐溶液的压力以排除对动脉产生损伤的可能性是很重要的。
在对动脉探查时,连续显示动脉手术位置的影象,这样进行操作的外科医生可以在探查动脉时观察手术位置的影象。在探查动脉时,动脉的侧面分支被隔离开。动脉的探查在选择长度动脉的第二端结束,铲被抽回并通过切口从动脉取出。
然后,沿动脉内膜46和中膜42(即“内壁”)的动脉噬菌斑积聚44被从动脉中取出。如果在选择长度动脉的第二端动脉噬菌斑积聚已被破坏或削弱,可通过使用镊子把动脉噬菌斑积聚通过切口拉出来取出内壁。这可通过在铲沿动脉移动时观察手术位置的影象来确定。
如果必要,在铲抽回并从动脉中取出后,如图7A、7B、7C和8中所示的外科仪器,可通过切口插入到动脉中并推进到动脉噬菌斑积聚被切除的选择长度动脉的第二端。当外科切割仪器被抽回并从动脉中取出时,动脉噬菌斑积聚被外科切割仪器或镊子通过切口拉出。
当动脉噬菌斑积聚被取出后,处理选择长度动脉第二端处的终止过渡并缝合切口。如果铲具有液体开口,在探查动脉时,可把液体输送到手术位置并从手术位置抽走。在切口缝合前将动脉噬菌斑积聚残余取出是很重要的。
重要的是准备终止过渡,否则血流会使动脉噬菌斑积聚进一步剥落。如果过渡不连贯,还可能在终止处存在凝结和残余。终止过渡可通过一个激光仪器准备,该仪器可包括在根据本发明构造的动脉内膜切除术外科仪器中。如图5所示,铲端10可具有一个激光开口32,激光束可通过该开口发射出以准备终止过渡。
如图6所示,根据本发明构造的动脉内膜切除术外科仪器可带有一个气球,并按与使用气球导管相同的方法在外科方法中使用。弹性套34具有粘结在套外表面的气球36。当气球36放气时,其平放在弹性套34的外表面。在控制压力下的流体通过空气通道38导入气球时36,气球被充气,如图6所示。
参见图7A和7B,根据本发明构造的切割动脉噬菌斑积聚的外科仪器的第一实施例,包括一个细长弹性杆件50,一个位于细长弹性杆件第一端的把手52,一个位于与第一端相对的细长弹性杆件第二端的切割件54。切割件54具有内切割边56和弧形外钝边58。壁60位于内切割边56和弧形外钝边58间,其具有足够的宽度以带走当把手52被拉出或转动时切割下的物质。尽管所示切割边56是弧形的,其可以是其它形状,如一个直边。
更适宜的是,图7A和7B外科仪器的切割件54处于一个与细长杆件50成钝角的平面内。通过这样布置,在外科仪器通过切口插入后,切割件54可容易地沿将被从动脉中取出的内壁表面移动到切割件要切割动脉噬菌斑积聚的地方。当遇到动脉噬菌斑积聚的侧支时,可转动外科仪器以绕过这些侧支。对于切割动脉噬菌斑积聚的特定外科仪器,杆件50的弹性、切割件54和杆件间夹角和切割边56的形状、半径和长度取决于动脉的尺寸和状态。任何这种外科仪器设计的目的都是保证,当外科仪器转动以刺穿动脉噬菌斑积聚时,外科仪器不会刺穿动脉壁。希望的效果是当切割件54刺穿动脉噬菌斑积聚时,其包围该动脉噬菌斑积聚。当切割完成后,切割件54可保持与切割下来的内壁物质结合到某一程度,使得当抽回并通过切口取出外科仪器时足以通过切口取出内壁物质。位于内切割边56和外钝边58间的壁60在通过切口取出切割下来的内壁物质时也是有用的。
图7A和7B所示外科仪器的杆件50的希望弹性是由第一刚性件50a第一端和第二刚性件50b第一端间的弹簧62提供的。把手52附着在细长弹性杆件第一刚性件50a的第二端,切割件54附着在细长弹性杆件第二刚性件50b的第二端。弹簧62和切割件54的斜面提供了切割件的转动中心,其在把手52转动以切割动脉噬菌斑积聚时防止切割动脉壁。弹簧62设计成具有足够弹性以获得这种结果,但仍足够刚性以切割动脉噬菌斑积聚,并允许当把手52拉回或通过切口抽出时带出切割下的物质。
如图7C所示,切割件54可做成具有一个附着在细长杆件第二刚性件50b第二端的壳体64,该壳体具有一个弧形的外钝边58。切割刀片66位于壳体64中。在这种形式的切割件中有一个壁,其位于切割刀片66的内切割边56和壳体64的外钝边58间,并且具有足够的宽度以当拉出把手52时带走切割下来的物质。
应该注意,如图7A、7B和7C中所示切割动脉噬菌斑积聚的外科仪器可如上述动脉内膜切除术外科仪器一样,带有光学和冲洗功能。
图8和9所示为根据本发明构造的切割动脉噬菌斑积聚的外科仪器的第二和第三实施例。这些外科仪器中的每一个包括一个细长管状支撑件和一个穿过细长管状支撑件并在细长管状支撑件内自由移动的切割金属丝件。切割金属丝件的自由端从细长管状支撑件的一端伸出,切割金属丝件的封闭环部分从细长管状支撑件的第二端伸出。
参见图8,细长管状支撑件包括一个第一细长管70和第二细长管72。切割金属丝件包括第一和第二段长度的金属丝74和76,其分别穿过第一细长管70和第二细长管72。第一段长度金属丝的第一和第二自由端74a和74b从第一细长管的一端伸出,第一段长度金属丝的中间部分74c从第一细长管的相反端伸出。第二段长度金属丝的第一和第二自由端76a和76b从第二细长管的一端伸出,第二段长度金属丝的中间部分76c从第二细长管的相反端伸出,并且从第一段长度金属丝74和中间部分74c中穿过。
图8的外科仪器按下述方式使用。该外科仪器通过切口插入并沿动脉移动到要切割动脉噬菌斑积聚的地方,同时金属丝76的中间部分76c位于要切割的内壁材料外面。通过拉动金属丝74的自由端74a和74b及金属丝76的自由端76a和76b,金属丝76中间部分76c的松驰部分被收紧,内壁物质就被切割下来。如果金属丝76的中间部分76c穿过内壁物质移动而不通过切口拉出内壁物质时,内壁物质可或者通过拉出外科仪器或者通过使用镊子取出。
参见图9,细长管状支撑件包括一个细长管80和一个附着在细长管第一端的壳体82。切割金属丝件包括一定长度的金属丝84,其穿过细长管80和壳体82延伸,并且一定长度金属丝的第一和第二自由端84a和84b从与细长管第一端相对的细长管第二端伸出。一定长度金属丝的中间部分84c从细长管80的第一端伸出并从细长管绕过壳体82返回到细长管中。
图9的外科仪器的使用与图8外科仪器的使用相同。外科仪器通过切口插入并沿动脉移动到动脉噬菌斑积聚要被切除的地方,使金属丝84的中间部分84c位于要被切除的内壁物质外部。通过拉动金属丝84的自由端84a和84b,金属丝中部84c的松驰部分被收紧,内壁物质就被切割下来。内壁物质可或者通过拉出外科仪器或者通过使用镊子取出。当拉回并通过切口拉出外科仪器时,壳体82的作用与图7A、7B和7C中外科仪器的壁在拉出切下的内壁物质过程中起的作用相同。
尽管在前面描述了本发明的优选实施例,但应这样理解,对于本领域的普通技术人员来讲,在不偏离本发明的真正精神和范围的前提下,可以进行各种变形和改变。
Claims (20)
1.一种动脉内膜切除术外科仪器,包括:
一铲端,该铲端在其第一端部具有:
(a)一光学开口,
(b)多个流体开口;
从所述铲端内的所述光学开口穿过所述铲端延伸的第一弹性管状装置,用于:
(a)将光从所述第一弹性管状装置的远端通过所述光学开口传导到手术位置,
(b)将手术位置的影象通过所述光学开口传导到所述第一弹性管状装置的所述远端;
从所述铲端内的所述流体开口穿过所述铲端延伸的第二弹性管状装置,用于将流体从所述第二弹性管状装置远端通过所述流体开口传导到手术位置;
连接器装置,适于连接到:
(a)光源,
(b)影象形成元件,
(c)流体源,
下述装置连接于其上:
(a)所述第一弹性管状装置的所述远端,
(b)所述第二弹性管状装置的所述远端,
用于:
(a)将光从光源传导到所述第一弹性管状装置,
(b)将手术位置的影象从第一弹性管状装置传导到影象形成元件,
(c)将流体从流体源传导到所述第二弹性管状装置。
2.根据权利要求1所述的动脉内膜切除术外科仪器,进一步包括一位于所述铲端和所述连接器装置间的弹性套,所述第一弹性管状装置和所述第二弹性管状装置穿过该套。
3.根据权利要求2所述的动脉内膜切除术外科仪器,其特征在于,所述第一弹性管状装置包括:
(a)第一纤维光学装置,光通过该装置传导,
(b)第二纤维光学装置,手术位置的影象通过该装置传导。
4.根据权利要求3所述的动脉内膜切除术外科仪器,其特征在于:
(a)所述第一纤维光学装置包括环形排列的多根纤维光缆,
(b)所述第二纤维光学装置包括单根纤维光缆,其位于所述第一纤维光学装置所述多根纤维光缆环形排列的中心。
5.根据权利要求4所述的动脉内膜切除术外科仪器,其特征在于,所述铲端具有一弧形主体,所述光学开口、所述多根纤维光缆和所述单根纤维光缆位于所述铲端的所述弧形主体内。
6.根据权利要求2所述的动脉内膜切除术外科仪器,其特征在于:
(a)所述铲端在其所述第一端还具有多个液体开口,
(b)所述连接器装置还适于连接到液体源和液体排放容器,
(c)所述动脉内膜切除术外科仪器进一步包括从所述铲端液体开口穿过所述铲端延伸的第三弹性管状装置,用于将液体从连接到所述连接器装置的所述第三弹性管状装置远端通过第一所述液体开口传导到手术位置,并通过第二所述液体开口将液体从手术位置传导到所述第三弹性管状装置的所述远端。
7.根据权利要求6所述的动脉内膜切除术外科仪器,其特征在于,所述第三弹性管状装置穿过所述弹性套。
8.根据权利要求2所述的动脉内膜切除术外科仪器,其特征在于,所述铲端还在其第一端具有一激光开口,激光束通过该开口射出。
9.根据权利要求2所述的动脉内膜切除术外科仪器进一步包括:
(a)粘结在所述套上的气球,
(b)一流体通道,通过其将处于控制压力下的流体导入所述气球以为所述气球充气。
10.从选择长度的动脉中取出动脉噬菌斑积聚的动脉内膜切除术外科方法,包括如下步骤:
在选择长度动脉的第一端只开一个切口以暴露动脉,通过该切口取出动脉噬菌斑积聚;
在动脉外膜和中膜间的切口处将铲插入到动脉;
用铲探查选择长度动脉,同时使用流体增加动脉外膜和中膜间的空间;
探查动脉时,连续显示铲周围手术位置的影象;
探查动脉时,观察手术位置的影象;
在选择长度动脉的第二端终止动脉探查;
抽回铲并通过该切口将铲从动脉取出;
从动脉中取出动脉噬菌斑积聚;
处理选择长度动脉第二端的终止过渡;
缝合切口。
11.根据权利要求10所述的动脉内膜切除术外科方法,进一步包括在探查过程中将液体传导到手术位置,和在探查过程中将液体从手术位置导出。
12.根据权利要求10所述的动脉内膜切除术外科方法:(a)进一步包括如下步骤:
(1)在抽回并从动脉中取出铲后,将一切割仪器插入到动脉,
(2)将切割仪器推进到选择长度动脉的第二端,
(3)在选择长度动脉的第二端切割动脉噬菌斑积聚(b)其特征在于,从动脉取出动脉噬菌斑积聚的步骤包括:
(1)通过切口将动脉噬菌斑积聚拉出,
(2)抽回切割仪器并从动脉取出切割仪器,并在抽回和从动脉取出切割仪器时使用切割仪器将动脉噬菌斑积聚通过切口拉出。
13.外科仪器,包括:
细长弹性杆件;
位于所述细长杆件第一端的把手;
位于与所述第一端相反的长杆件第二端的切割件,其具有:
(a)一内切割边,
(b)一弧形外钝边,以及
(c)位于所述内切割边和所述弧形外钝边间的壁。
14.根据权利要求13所述的外科仪器,其特征在于,所述切割件位于与所述细长弹性杆件成钝角的平面内。
15.根据权利要求14所述的外科仪器,其特征在于:
(a)所述细长弹性杆件包括第一和第二刚性件,及位于所述第一刚件性第一端和所述第二刚性件第一端间的弹簧。
(b)所述把手附着在所述细长弹性杆件的所述第一刚性件的第二端,
(c)所述切割件附着在所述细长杆件的所述第二刚性件的第二端。
16.外科仪器,包括:
一细长弹性杆件,具有第一和第二刚性件,及位于所述第一刚件性第一端和所述第二刚性件第一端间的弹簧;
一把手,位于所述细长弹性杆件的所述第一刚性件的第二端;
一切割件,其具有:
(a)一壳体,附着在所述细长弹性杆件所述第二刚性件的第二端,并具有一弧形外钝边,
(b)一切割刀片,位于所述壳体内并具有一内切割边,
(c)一壁,位于所述内切割边和所述弧形外钝边间。
17.根据权利要求16所述的外科仪器,其特征在于,所述切割件位于与所述细长弹性杆件成钝角的平面内。
18.外科仪器,包括:
一细长管状支撑件;
一切割金属丝,其穿过所述细长管状支撑件并可在所述细长管状支撑件内自由移动:
a)所述切割金属丝的自由端从所述细长管状支撑件的第一端伸出,
b)所述切割金属丝的封闭环部分从所述细长管状支撑件的第二端伸出。
19.根据权利要求18所述的外科仪器,其特征在于:
(a)所述细长管状支撑件包括:
(1)第一细长管,
(2)第二细长管,
(b)所述切割金属件包括
(1)穿过所述第一细长管的第一段长度金属丝:
(ⅰ)所述第一段长度金属丝的第一和第二自由端从所述第一细长管的第一端伸出,
(ⅱ)所述第一段长度金属丝的中间部分从所述第一细长管的第二端伸出,
(2)穿过所述第一细长管的第二段长度金属丝:
(ⅰ)所述第二段长度金属丝的第一和第二自由端从所述第二细长管的第一端伸出,
(ⅱ)所述第二段长度金属丝的中间部分从所述第二细长管的第二端伸出,并环状穿过所述第一段长度金属丝的所述中间部分。
20.根据权利要求18所述的外科仪器,其特征在于:
(a)所述细长管状支撑件包括:
(1)一细长管
(2)一附着在所述细长管第一端的壳体
(b)所述切割金属丝件包括穿过所述细长管和所述壳体的一段长度金属丝:
(1)所述一段长度金属丝的第一和第二自由端从与所述细长管所述第一端相对的所述细长管第二端伸出,
(2)所述一段长度金属丝的中间部分从所述细长管所述第一端伸出,并从所述细长管绕过所述壳体返回到所述细长管。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US08/680,594 US5954713A (en) | 1996-07-12 | 1996-07-12 | Endarterectomy surgical instruments and procedure |
US08/680,594 | 1996-07-12 |
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CN1228687A true CN1228687A (zh) | 1999-09-15 |
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CN97197604A Pending CN1228687A (zh) | 1996-07-12 | 1997-07-11 | 动脉内膜切除术外科仪器和方法 |
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US (3) | US5954713A (zh) |
EP (1) | EP0917445B1 (zh) |
JP (2) | JP2000515402A (zh) |
KR (1) | KR20000023753A (zh) |
CN (1) | CN1228687A (zh) |
AT (1) | ATE260605T1 (zh) |
AU (1) | AU741165B2 (zh) |
CA (1) | CA2260019A1 (zh) |
DE (1) | DE69727938T2 (zh) |
IL (1) | IL128015A0 (zh) |
WO (1) | WO1998002102A2 (zh) |
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-
1996
- 1996-07-12 US US08/680,594 patent/US5954713A/en not_active Expired - Lifetime
-
1997
- 1997-07-11 AU AU36610/97A patent/AU741165B2/en not_active Ceased
- 1997-07-11 CA CA002260019A patent/CA2260019A1/en not_active Abandoned
- 1997-07-11 AT AT97933420T patent/ATE260605T1/de not_active IP Right Cessation
- 1997-07-11 DE DE69727938T patent/DE69727938T2/de not_active Expired - Fee Related
- 1997-07-11 IL IL12801597A patent/IL128015A0/xx unknown
- 1997-07-11 JP JP10506215A patent/JP2000515402A/ja active Pending
- 1997-07-11 CN CN97197604A patent/CN1228687A/zh active Pending
- 1997-07-11 WO PCT/US1997/012174 patent/WO1998002102A2/en not_active Application Discontinuation
- 1997-07-11 EP EP97933420A patent/EP0917445B1/en not_active Expired - Lifetime
-
1999
- 1999-01-12 KR KR1019990700217A patent/KR20000023753A/ko not_active Application Discontinuation
- 1999-04-20 US US09/294,566 patent/US6358244B1/en not_active Expired - Lifetime
-
2002
- 2002-02-04 US US10/067,630 patent/US20020120257A1/en not_active Abandoned
-
2007
- 2007-01-25 JP JP2007015568A patent/JP2007160125A/ja active Pending
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN100401994C (zh) * | 2002-10-18 | 2008-07-16 | 阿里耶·谢尔 | 配有成像导丝的动脉粥样硬化斑移除系统 |
CN108338812A (zh) * | 2018-04-17 | 2018-07-31 | 四川大学华西医院 | 一种冷光源引导缝合器 |
Also Published As
Publication number | Publication date |
---|---|
US5954713A (en) | 1999-09-21 |
KR20000023753A (ko) | 2000-04-25 |
CA2260019A1 (en) | 1998-01-22 |
DE69727938T2 (de) | 2005-07-07 |
US20020120257A1 (en) | 2002-08-29 |
EP0917445A2 (en) | 1999-05-26 |
AU741165B2 (en) | 2001-11-22 |
DE69727938D1 (de) | 2004-04-08 |
IL128015A0 (en) | 1999-11-30 |
WO1998002102A2 (en) | 1998-01-22 |
ATE260605T1 (de) | 2004-03-15 |
JP2000515402A (ja) | 2000-11-21 |
EP0917445B1 (en) | 2004-03-03 |
US6358244B1 (en) | 2002-03-19 |
WO1998002102A3 (en) | 1998-03-26 |
JP2007160125A (ja) | 2007-06-28 |
AU3661097A (en) | 1998-02-09 |
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