CN203564285U - 末端执行器、外科手术器械和荷包钳 - Google Patents

末端执行器、外科手术器械和荷包钳 Download PDF

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CN203564285U
CN203564285U CN201320589180.2U CN201320589180U CN203564285U CN 203564285 U CN203564285 U CN 203564285U CN 201320589180 U CN201320589180 U CN 201320589180U CN 203564285 U CN203564285 U CN 203564285U
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tong arm
band
end effector
purse
staple
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孙斌
刘刚
方云才
汪炬
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Tianjin Huanyi Sterilization Technology Co ltd
Reach Surgical Inc
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REACH SURGICAL INSTRUMENT (CHINA) CO Ltd
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    • 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
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • 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
    • A61B17/07207—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 the staples being applied sequentially
    • 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
    • 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
    • A61B2017/07228—Arrangement of the staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1142—Purse-string sutures

Abstract

本实用新型涉及医疗器械技术领域，公开了一种末端执行器、外科手术器械和荷包钳，以简化对管腔组织进行外科手术的操作过程，减少手术时间，减轻给手术病人带来的创伤。所述末端执行器包括：第一钳臂和第二钳臂；缝合机构，设置在第一钳臂和第二钳臂的纵向方向的一侧；荷包缝合机构，设置在第一钳臂和第二钳臂的纵向方向的另一侧；切割机构，设置在缝合机构和荷包缝合机构之间；荷包缝合机构包括：所述第一钳臂上沿纵向方向设置的扎带，所述扎带与所述第一钳臂可拆装连接，且所述扎带具有可与管腔组织粘接的粘接部，所述扎带与所述管腔组织之间的粘接作用力大于所述扎带与所述第一钳臂之间的连接作用力。

Description

末端执行器、外科手术器械和荷包钳
技术领域
本实用新型涉及医疗器械技术领域，特别是涉及一种末端执行器、一种外科手术器械和一种荷包钳。
背景技术
胃肠道手术通常需要切断闭合组织管腔，并在断开的一侧管腔处进行荷包缝合，荷包缝合处用于配合安装圆型缝合器的钉砧，以便使用圆型缝合器进行后续的缝合等操作。
荷包缝合是外科手术中一种常见的缝合技术，已知存在两种主要的荷包缝合的方式。一种方式是手工进行荷包缝合，如图1a、图1b所示，医生先围绕管腔组织59的切口用荷包针带着荷包线58穿过组织表面，再收紧荷包线58即可完成荷包缝合。手工缝合的方式操作复杂，操作精度较难把握，并且易因脱线导致缝合失败，目前在外科手术中已经很少被采用。
另一种方式是使用荷包钳辅助进行荷包缝合。如图2a所示，一种荷包钳同样是利用穿针（即荷包针）带线（即荷包线58）的方式进行荷包缝合。如图2b所示，还有一种荷包钳是通过荷包钉57将荷包线58附着到管腔组织59表面而进行荷包缝合，通常的方式是击发荷包钉57而使其刺入并固定到管腔组织59，而荷包线58或者与荷包钉57之间相互连接，或者被荷包钉57压在管腔组织59和荷包钉57之间，从而将荷包线58附着到管腔组织59，以实现荷包缝合。
通常在对管腔组织进行手术时，除需要对管腔组织的保留端切口进行荷包缝合外，还需要对其病变端进行切割、缝合。而现有荷包钳功能单一，只能完成对保留端的荷包缝合，无法实现对病变端的切割缝合。因此至少还需要配合使用其他切割缝合器等手术器械，更换手术器械的操作较为繁琐，这会导致手术时间较长，增加手术风险以及给手术病人带来的痛苦。
而且，二十世纪八十年代出现了腔镜手术，其为一种主要透过内窥镜及各种显像技术而使外科医生在无需对患者造成巨大伤口的情况下施行手术。相对于开放式手术而言，腔镜手术具有对组织破坏小、术后恢复快等显著的优势，从而成为发展的趋势。在这种情况下，出现了用于腔镜手术的荷包钳，现有的用于腔镜手术的荷包钳同样存在上述功能单一的问题。
实用新型内容
本实用新型的第一个目的是提供一种末端执行器，以简化对管腔组织进行外科手术的操作过程，减少手术时间、手术风险以及患者的痛苦，进一步还可以用于腔镜手术。
该末端执行器包括：第一钳臂和第二钳臂，第一钳臂和第二钳臂能够在张开闭合机构的作用下相对运动，以使第一钳臂和第二钳臂所形成的钳口张开或闭合；缝合机构，缝合机构设置在第一钳臂和第二钳臂的纵向方向的一侧；荷包缝合机构，荷包缝合机构设置在第一钳臂和第二钳臂的纵向方向的另一侧；切割机构，切割机构设置在缝合机构和荷包缝合机构之间；荷包缝合机构包括：所述第一钳臂上沿纵向方向设置的扎带，所述扎带与所述第一钳臂可拆装连接，且所述扎带具有可与管腔组织粘接的粘接部，所述扎带与所述管腔组织之间的粘接作用力大于所述扎带与所述第一钳臂之间的连接作用力。
在该技术方案中，末端执行器一侧的缝合机构可实现组织的缝合，另一侧的荷包缝合机构可实现组织的荷包缝合，而在缝合机构和荷包缝合机构之间的切割机构则可实现组织的切割，可见，使用本实用新型所提供的末端执行器可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，与现有技术相比，大大简化了对管腔组织进行外科手术的操作过程，减少了手术时间，减轻了给手术病人带来的创伤。
本实用新型的第二个目的是提供一种外科手术器械，包括：手柄和被手柄驱动的如前述技术方案的末端执行器。由于末端执行器具有上述效果，因此该外科手术器械可大大简化对管腔组织进行外科手术的操作过程，减少手术时间，减轻给手术病人带来的创伤。
本实用新型的第三个目的是提供一种荷包钳，荷包钳包括：第一钳臂和第二钳臂，第一钳臂和第二钳臂能够在张开闭合机构的作用下相对运动，以使第一钳臂和第二钳臂所形成的钳口张开或闭合；荷包缝合机构，包括：所述第一钳臂上沿纵向方向设置的扎带，所述扎带与所述第一钳臂可拆装连接，且所述扎带具有可与管腔组织保留端粘接的粘接部，所述扎带与所述管腔组织之间的粘接作用力大于所述扎带与所述第一钳臂之间的连接作用力。
当第一钳臂和第二钳臂所形成的钳口在张开闭合机构的作用下闭合时，扎带的粘接部与管腔组织粘接；当第一钳臂和第二钳臂所形成的钳口打开后，扎带与第一钳臂分离；将扎带环绕于管腔组织的表面并收紧，以实现管腔保留端组织的荷包缝合。采用该技术方案能够有效的降低因荷包钉脱落造成的荷包缝合失败的风险，因此，该荷包钳大大地提高了手术的安全性。
附图说明
图1a为管腔组织荷包缝合的截面示意图；
图1b为管腔组织在荷包线收紧后的主视图；
图2a为现有一种荷包钳荷包缝合原理示意图；
图2b为现有另一种荷包钳荷包缝合原理示意图；
图3a为本实用新型实施例的末端执行器立体结构示意图；
图3b为本实用新型实施例的末端执行器在手术操作时的结构示意图；
图3c为本实用新型实施例的末端执行器在手术操作时钳口闭合时的剖面结构示意图；
图3d为本实用新型实施例的末端执行器在手术操作时钳口闭合后示意图；
图4为本实用新型实施例中第一钳臂的结构示意图；
图5为进行切割、组织缝合和荷包缝合后的管腔组织示意图；
图6a为为荷包缝合后的管腔组织与圆形缝合器钉砧配合的三维示意图；
图6b为通过圆形缝合器进行管腔组织缝合的三维示意图；
图7为本实用新型实施例的外科手术器械结构示意图。
附图标记：
57-荷包钉           58-荷包线            59-管腔组织
10a-第一钳臂        10b-第二钳臂         11-缝合机构
12-荷包缝合机构     13-切割机构          14-扎带
15-粘接部           16-套扣              17-容置槽
18-缝钉钉砧         19-缝钉钉匣          20-缝钉
21-缝钉推钉滑块     22-缝钉推钉器        23-切割刀
24-刀槽             25-闭合凸缘          26-手柄
27-末端执行器       28-细长体            29-传动机构
30-圆形缝合器钉砧
具体实施方式
为了使用同一器械便能够完成荷包缝合、切割和缝合，简化对需要进行荷包缝合的组织（特别是管腔组织）进行外科手术的操作过程，减少手术时间、风险以及患者的痛苦，进一步地能够用于腔镜手术，本实用新型实施例提供了一种末端执行器和一种外科手术器械。在本实用新型技术方案中，末端执行器一侧的缝合机构可实现组织的缝合，另一侧的荷包缝合机构可实现组织的荷包缝合，而在缝合机构和荷包缝合机构之间的切割机构则可实现组织的切割，使用本实用新型实施例所提供的末端执行器或外科手术器械可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，大大简化了对管腔组织进行外科手术的操作过程，减少了手术时间，进一步还可用于腔镜手术。为使本实用新型的目的、技术方案和优点更加清楚，以下举实施例对本实用新型作进一步详细说明。
如图3a至图3d所示，本实用新型实施例的末端执行器，包括：
第一钳臂10a和第二钳臂10b，第一钳臂10a和第二钳臂10b能够在张开闭合机构的作用下相对运动，以使第一钳臂10a和第二钳臂10b所形成的钳口张开或闭合；
缝合机构11，缝合机构11设置在第一钳臂10a和第二钳臂10b的纵向方向的一侧；
荷包缝合机构12，荷包缝合机构12设置在第一钳臂10a和第二钳臂10b的纵向方向的另一侧；
切割机构13，切割机构13设置在缝合机构11和荷包缝合机构12之间；
荷包缝合机构12包括：
第一钳臂10a上沿纵向方向设置的扎带14，扎带14与第一钳臂10a可拆装连接，且扎带14具有可与管腔组织59粘接的粘接部15，扎带14与管腔组织59之间的粘接作用力大于扎带14与第一钳臂10a之间的连接作用力。
在本实用新型各实施例中，“远侧”指该器械被操作时远离使用者的一侧，“近侧”则指该器械被操作时靠近使用者的一侧。“前进”指向远离使用者的方向运动，“后退”则指向靠近使用者的方向运动。本实用新型实施例所提供的末端执行器可以配合驱动机构使用，由驱动机构来提供驱动力。驱动机构的具体结构形式不限，例如，可以直接将现有切割缝合器前端的末端执行器卸下，将本实用新型实施例所提供的末端执行器装上，由现有切割缝合器的驱动机构为张开闭合机构、缝合机构和切割机构提供驱动力。此外，也可以为本实用新型实施例所提供的末端执行器另外设计驱动机构。
本实用新型实施例所提供的末端执行器按照功能可划分为张开闭合机构、缝合机构、荷包缝合机构及切割机构四部分。其中，张开闭合机构用于实现末端执行器的两个钳臂所形成的钳口的张开和闭合，使用时可以驱动钳口张开以将待手术的管腔组织置于其中，然后驱动钳口闭合将管腔组织夹紧以进行荷包缝合、切割、缝合等手术动作，并且当手术动作结束后，可以驱动钳口再次张开以释放组织。切割机构用于实现对组织的切割功能，可以将管腔组织的病变端及保留端切割分离。缝合机构用于实现对组织的缝合功能，可以在管腔组织病变端的切口处进行缝合。荷包缝合机构用于实现对组织的荷包缝合功能，可以在管腔组织保留端的切口处进行荷包缝合，以在后续操作中配合安装圆型缝合器的钉砧，使用圆型缝合器进行缝合等操作。
在本实施例中，如图5～图6b所示，本领域技术人员通过相关器械将扎带环绕于管腔组织的表面并可后续通过手工收紧，以在管腔组织保留端的切口处进行荷包缝合，且将管腔组织病变端的病变组织切除后，使圆型缝合器钉砧30通过管腔组织59保留端的切口处进入管腔组织59保留端的内部，并配合圆型缝合器实现管腔组织的端端缝合，由于该技术为本领域技术人员所熟知，因此这里不再详细赘述。下面将分别进一步详细说明这四部分的结构。
在本实用新型实施例的末端执行器中，张开闭合机构、缝合机构和切割机构中可以至少两者被同步驱动；也可以是，张开闭合机构、缝合机构和切割机构被分别驱动。可以根据不同的驱动方式来设计末端执行器的具体结构。
张开闭合机构：
在本实用新型的各实施例中，第一钳臂10a和第二钳臂10b可相对运动，可以均为可转动的活动钳臂；或者，第一钳臂10a为不可转动的固定钳臂，第二钳臂10b为可转动的活动钳臂；或者，第二钳臂10b为不可转动的固定钳臂，第一钳臂10a为可转动的活动钳臂。无论是只有一个活动钳臂还是两个均为活动钳臂，只要两个钳臂能够被驱动使两个钳臂形成的钳口张开和闭合即可。
本实用新型的末端执行器的张开闭合机构可采用现有切割缝合器的末端执行器的张开闭合机构的各种技术方案来实现，例如，套管式张开闭合方案、工字梁式张开闭合方案等。
例如，张开闭合机构可包括闭合杆，闭合杆远侧端设置有闭合凸缘，第一钳臂和第二钳臂之间设置有压簧，当闭合杆被驱动而纵向向远侧运动时，闭合凸缘啮合第一钳臂和/或第二钳臂上的闭合面，使得钳臂克服压簧的弹力而闭合，当闭合杆回退时，钳口可在压簧的复位作用下张开。当闭合杆被驱动而纵向向远侧运动时，闭合凸缘可以仅啮合第一钳臂或第二钳臂上的闭合面，但为了获得较平衡的受力，优选的，闭合凸缘同时啮合第一钳臂和第二钳臂上的闭合面。
其中，闭合杆、用于击发缝钉的缝钉推钉杆或用于驱动切割刀的刀杆中的任意两者是为一体结构或者为不同部件相互连接；闭合杆、缝钉推钉杆或刀杆也可以分别是不同的部件；此外，也可以是闭合杆、刀杆和缝钉推钉杆为一体结构（可称为驱动杆）或者为不同部件相互连接。
请结合图3b和3d所示，在本实用新型的一个具体实施例中，切割刀23与刀杆是一体结构并作为张开闭合机构的闭合杆，第一钳臂10a和第二钳臂10b之间设置有压簧（图中未示出），闭合杆的远侧端在活动钳臂背离钳口的一侧固定有平行于切割方向的闭合凸缘25；当闭合杆前进时，闭合凸缘25推动活动钳臂转动至钳口闭合，当闭合杆后退时，压簧推动活动钳臂转动至钳口打开。这里需要说明的是，在关闭钳口时闭合凸缘25所走的行程并不需要很大。
切割机构：
本实用新型的末端执行器的切割机构可采用现有的切割缝合器的末端执行器的切割机构的各种技术方案来实现。
例如，结合图4、图3a和图3b所示，切割机构可包括切割刀23，切割刀23能够在推刀机构的作用下在缝合机构和荷包缝合机构之间运动，以将分别进行缝合的和荷包缝合的组织切割分离，推刀机构可以是推刀杆或其他部件,切割刀23与推刀机构可以是一体的也可以是分体的（此时，切割刀23设置在推刀机构的远侧）。第一钳臂和第二钳臂设置有容纳切割刀23运动的刀槽24（如图4所示），以为切割刀23的运动提供导向，使切割运动更加平稳、准确。
缝合机构：
本实用新型的末端执行器的缝合机构可采用现有切割缝合器的末端执行器的缝合机构的各种技术方案来实现。
例如，如图3c所示，缝合机构可设置在两个钳臂的纵向方向的一侧，一个钳臂设置缝钉钉砧18，另一个钳臂设置缝钉钉匣19，缝钉钉匣19中设置缝钉20，缝钉20可沿纵向方向设置为一排或多排，缝钉20能够由缝钉推钉机构击发。用于击发缝钉20的缝钉推钉机构可包括缝钉推钉杆(该实施例中，切割刀23的刀杆作为缝钉推钉杆)、缝钉推钉滑块21和缝钉推钉器22。击发过程可以是缝钉推钉杆向远侧纵向运动而驱动缝钉推钉滑块21，缝钉推钉滑块21的斜面作用于缝钉推钉器22而使其横向运动，继而由缝钉推钉器22将缝钉20推出缝钉钉匣19、穿过管腔组织59并抵压缝钉钉砧18，缝钉20在缝钉钉砧18的作用下成型为B字状，从而完成缝合。
缝钉20的排数不限，但至少应为一排，优选至少为两排，这样，可在管腔组织的病变端进行至少两道缝合，大大减少了缝合失败的风险。当缝钉20沿纵向设置为多排时，可以仅设置一个缝钉推钉滑块21推动前方的多个缝钉推钉器22。
结合图3b和3c所示，当切割刀23的刀杆作为缝钉推钉杆时，切割刀23的位置可设置为相对于缝钉推钉滑块21更加靠后（即更加靠近近侧），使得先缝合后切割，这样可以减少病变端内部组织外流，提高手术的成功率。在一实施例中，缝钉推钉滑块21被切割刀23的刀杆推动，在切割刀23的刀刃对组织进行切割之前，缝钉推钉滑块21的斜面已经推动前方的缝钉推钉器22将缝钉20击发，也就是先将前方的管腔组织缝合，因此，切割刀23总是在组织缝合之后才进行切割。
荷包缝合机构：
荷包缝合机构可设置在两个钳臂的纵向方向的另一侧，也就是与缝合机构相对的一侧。
如图3c并结合图4、图5所示，当第一钳臂10a和第二钳臂10b所形成的钳口闭合时，为了使扎带14与管腔组织59可靠地粘接，在本实施中优选的，粘接部15具有粘接刺或者粘结层。粘接刺在钳口闭合作用力下刺入管腔组织59，使扎带14与管腔组织59粘接，或者，粘结层在钳口闭合作用力下将扎带14与管腔组织59粘接。当然粘接刺的结构形式不限，例如，在第一钳臂10a和第二钳臂10b所形成的钳口张开时，为了使扎带14与第一钳臂10a分离且与管腔组织59可靠地粘接，粘接刺可以采用倒刺结构。
本实施例提供的荷包缝合机构是通过将扎带环绕于管腔组织的表面并收紧以实现荷包缝合，为了便于操作收紧扎带，如图4并结合图6a所示优选的实施例中，扎带14的近侧一端具有套扣16，扎带14的远侧一端可穿过套扣16将管腔组织59收紧，从而实现管腔保留端组织的荷包缝合。当然，还可以采用：扎带14的远侧一端具有套扣16，扎带14的近侧一端可穿过套扣16将管腔组织59收紧，从而实现管腔保留端组织的荷包缝合。
扎带14与第一钳臂10a可拆装连接方式不限，优选的，如图4所示，第一钳臂10a上具有与扎14形状相配合的容置槽17，扎带14卡设于所述容置槽17内，当第一钳臂和第二钳臂所形成的钳口张开时，扎带14粘接在管腔组织59的表面并与容置槽17分离。
扎带14与第一钳臂10a可拆装连接方式还可以粘结连接，扎带14与管腔组织59之间的粘接作用力大于扎带14与第一钳臂10a之间的连接作用力，当第一钳臂10a和第二钳臂10b所形成的钳口张开时，扎带14粘接在管腔组织59的表面并与第一钳臂10a分离。
在本实用新型实施例的技术方案中，闭合杆、缝钉推钉杆和刀杆可以为一体结构或者为不同部件相互连接以实现同步驱动，例如，在一实施例中，闭合杆、缝钉推钉杆、和刀杆为一体机构，可称为驱动杆。使用时，驱动杆向远侧运动以进行驱动，首先驱动张开闭合机构以闭合钳臂，荷包缝合机构的扎带粘接部与管腔组织粘接，随着驱动杆的进一步运动，缝合机构被驱动，缝钉被依次击发以实现缝合，同时切割刀在驱动杆的推动下在缝合机构和荷包缝合机构之间对组织进行切割，从而同时完成了切割、缝合和荷包缝合（进行切割、组织缝合和荷包缝合后的管腔组织如图5所示，其中，箭头所示方向为管腔组织的长度方向），这更加简化了对管腔组织进行外科手术的操作过程，减少了手术时间，从而进一步减轻了给手术病人带来的创伤。
综上，在本实用新型技术方案中，末端执行器一侧的缝合机构可实现组织的缝合，另一侧的荷包缝合机构可实现组织的荷包缝合，而在缝合机构和荷包缝合机构之间的切割机构则可实现组织的切割，可见，使用本实用新型实施例所提供的末端执行器可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，与现有技术相比，大大减少了更换手术器械的频率，简化了对管腔组织进行外科手术的操作过程，减少了手术时间，减轻了给手术病人带来的创伤。
需要说明的是，在本实用新型的各个实施例中，末端执行器的规格尺寸不限，可以根据具体手术需要进行设计。例如，当末端执行器为具有腔镜规格的末端执行器时，可以配合腔镜使用，使手术兼具安全性高、创面小、痛楚少、恢复快等优点。
如图7所示，本实用新型实施例还提供了一种外科手术器械，包括：手柄26和被手柄26驱动的如前述任一实施例的末端执行器27。
该实施例中还包括内部设置有传动机构29的细长体28，手柄26的远侧通过细长体28与末端执行器27连接，手柄26驱动传动机构29，传动机构29进而将驱动传递给末端执行器27，以为其张开闭合、缝合和切割提供驱动。具有该结构的外科手术器械可以配合腔镜使用，使手术兼具安全性高、创面小、痛楚少、恢复快等优点。
使用本实用新型实施例所提供的外科手术器械可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，与现有技术相比，大大简化了对管腔组织进行外科手术的操作过程，减少了手术时间，且能够有效的降低因荷包钉脱落造成的荷包缝合失败的风险，提高了手术的安全性，减轻了给手术病人带来的创伤，进一步还可以用于腔镜手术。
本实用新型实施例还提供了一种荷包钳，包括：
第一钳臂和第二钳臂，第一钳臂和第二钳臂能够在张开闭合机构作用下相对运动，以使第一钳臂和第二钳臂所形成的钳口张开或闭合；
荷包缝合机构，包括：第一钳臂上沿纵向方向设置的扎带，扎带与第一钳臂可拆装连接，且扎带具有可与管腔组织保留端粘接的粘接部，扎带与管腔组织之间的粘接作用力大于扎带与第一钳臂之间的连接作用力。
当第一钳臂和第二钳臂所形成的钳口在张开闭合机构的作用下闭合时，扎带的粘接部与管腔组织粘接；当第一钳臂和第二钳臂所形成的钳口在张开闭合机构的作用下打开后，扎带与第一钳臂分离；将扎带环绕于管腔组织的表面并收紧，以实现管腔保留端组织的荷包缝合。因此，该荷包钳能够有效的降低因荷包钉脱落造成的荷包缝合失败的风险，大大地提高手术的安全性。
优选的，粘接部具有粘接刺或者粘结层。扎带的近侧一端具有套扣，扎带的远侧一端可穿过套扣将管腔组织收紧，或者，所述扎带的远侧一端具有套扣，所述扎带的近侧一端可穿过所述套扣将所述管腔组织收紧。第一钳臂上具有与扎带形状相配合的容置槽，扎带卡设于容置槽内。第一钳臂与扎带还可以粘结连接。各实施例的有益效果如前，这里不再重复说明。
本实用新型实施例所提供的荷包钳，钳臂张开闭合机构的具体形式不限，例如，可采用与前述末端执行器类似的结构形式，也可采用普通手术钳的结构形式，第一钳臂和第二钳臂铰接，通过操作者手动操作两个握柄将钳口闭合。
显然，本领域的技术人员可以对本实用新型进行各种改动和变型而不脱离本实用新型的精神和范围。这样，倘若本实用新型的这些修改和变型属于本实用新型权利要求及其等同技术的范围之内，则本实用新型也意图包含这些改动和变型在内。

Claims (19)

1.一种末端执行器，其特征在于，包括：
第一钳臂(10a)和第二钳臂(10b)，所述第一钳臂(10a)和所述第二钳臂(10b)能够在张开闭合机构的作用下相对运动，以使所述第一钳臂(10a)和所述第二钳臂(10b)所形成的钳口张开或闭合；
缝合机构(11)，所述缝合机构(11)设置在所述第一钳臂(10a)和所述第二钳臂(10b)的纵向方向的一侧；
荷包缝合机构(12)，所述荷包缝合机构(12)设置在所述第一钳臂(10a)和所述第二钳臂(10b)的纵向方向的另一侧；
切割机构(13)，所述切割机构(13)设置在所述缝合机构(11)和所述荷包缝合机构(12)之间；
所述荷包缝合机构(12)包括：所述第一钳臂(10a)上沿纵向方向设置的扎带(14)，所述扎带(14)与所述第一钳臂(10a)可拆装连接，且所述扎带(14)具有可与管腔组织(59)粘接的粘接部(15)，所述扎带(14)与所述管腔组织(59)之间的粘接作用力大于所述扎带(14)与所述第一钳臂(10a)之间的连接作用力。
2.如权利要求1所述的末端执行器，其特征在于，所述粘接部(15)具有粘接刺或者粘结层。
3.如权利要求1所述的末端执行器，其特征在于，所述扎带(14)的近侧一端具有套扣(16)，所述扎带(14)的远侧一端可穿过所述套扣(16)将所述管腔组织(59)收紧，或者，所述扎带(14)的远侧一端具有套扣(16)，所述扎带(14)的近侧一端可穿过所述套扣(16)将所述管腔组织(59)收紧。
4.如权利要求1所述的末端执行器，其特征在于，所述第一钳臂(10a)上具有与所述扎带(14)形状相配合的容置槽(17)，所述扎带(14)卡设于所述容置槽(17)内。
5.如权利要求1所述的末端执行器，其特征在于，所述第一钳臂(10a)与所述扎带(14)粘结连接。
6.如权利要求1所述的末端执行器，其特征在于，所述缝合机构(11)包括：
所述第一钳臂(10a)上设置的缝钉钉匣(19)，所述第二钳臂(10b)在钳口闭合时与所述缝钉钉匣(19)对应的位置处设置的缝钉钉砧(18)，所述缝钉钉匣(19)中设置有缝钉(20)，所述缝钉(20)能够由缝钉推钉机构击发，其中：
所述缝钉推钉机构包括：缝钉推钉杆、缝钉推钉滑块(21)和缝钉推钉器(22)，当所述缝钉推钉杆向远侧纵向驱动所述缝钉推钉滑块(21)时，所述缝钉推钉滑块(21)的斜面横向驱动所述缝钉推钉器(22)，使所述缝钉推钉器(22)将所述缝钉(20)推出所述缝钉钉匣(19)并在所述缝钉钉砧(18)的作用下成型。
7.如权利要求1所述的末端执行器，其特征在于，所述切割机构(13)包括：能够在推刀机构的作用下在所述缝合机构(11)和所述荷包缝合机构(12)之间运动的切割刀(23)。
8.如权利要求7所述的末端执行器，其特征在于，所述第一钳臂(10a)和所述第二钳臂(10b)具有容纳所述切割刀(23)运动的刀槽(24)。
9.如权利要求1所述的末端执行器，其特征在于，所述第一钳臂(10a)和所述第二钳臂(10b)均为可转动的活动钳臂；或者，所述第一钳臂(10a)为不可转动的固定钳臂，所述第二钳臂(10b)为可转动的活动钳臂；或者，所述第二钳臂(10b)为不可转动的固定钳臂，所述第一钳臂(10a)为可转动的活动钳臂。
10.如权利要求9所述的末端执行器，其特征在于，所述张开闭合机构包括闭合杆，所述闭合杆远侧端设置有闭合凸缘(25)，所述第一钳臂(10a)和所述第二钳臂(10b)之间设置有压簧，当所述闭合杆被驱动而纵向向远侧运动时，所述闭合凸缘(25)啮合第一钳臂(10a)和/或第二钳臂(10b)上的闭合面并使所述钳口克服所述压簧的弹力而闭合，当所述闭合杆回退时，所述钳口可在所述压簧的复位作用下张开。
11.如权利要求1～10任一项所述的末端执行器，其特征在于，
所述张开闭合机构、所述缝合机构(11)和所述切割机构(13)中至少两者被同步驱动；或者，
所述张开闭合机构、所述缝合机构(11)和所述切割机构(13)被分别驱动。
12.如权利要求11所述的末端执行器，其特征在于，所述末端执行器为具有腔镜规格的末端执行器。
13.一种外科手术器械，其特征在于，包括：手柄(26)和被所述手柄(26)驱动的如权利要求1～12任一项所述的末端执行器(27)。
14.如权利要求13所述的外科手术器械，其特征在于，还包括内部设置有传动机构(29)的细长体(28)，所述手柄(26)的远侧通过所述细长体(28)与所述末端执行器(27)连接，所述手柄(26)通过所述传动机构(29)为所述末端执行器(27)的张开闭合、缝合、切割和荷包缝合提供驱动。
15.一种荷包钳，其特征在于，包括：
第一钳臂和第二钳臂，所述第一钳臂和所述第二钳臂能够在张开闭合机构的作用下相对运动，以使所述第一钳臂和所述第二钳臂所形成的钳口张开或闭合；
荷包缝合机构，包括：所述第一钳臂上沿纵向方向设置的扎带，所述扎带与所述第一钳臂可拆装连接，且所述扎带具有可与管腔组织粘接的粘接部，所述扎带与所述管腔组织之间的粘接作用力大于所述扎带与所述第一钳臂之间的连接作用力。
16.如权利要求15所述的荷包钳，其特征在于，所述粘接部具有粘接刺或者粘结层。
17.如权利要求15所述的荷包钳，其特征在于，所述扎带的近侧一端具有套扣，所述扎带的远侧一端可穿过所述套扣将所述管腔组织收紧，或者，所述扎带的远侧一端具有套扣，所述扎带的近侧一端可穿过所述套扣将所述管腔组织收紧。
18.如权利要求15所述的荷包钳，其特征在于，所述第一钳臂上具有与所述扎带形状相配合的容置槽，所述扎带卡设于所述容置槽内。
19.如权利要求15所述的荷包钳，其特征在于，所述第一钳臂与所述扎带粘结连接。
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