BRPI0901477A2 - unidade de carga descartável acionada por motor para uso com um aparelho de corte e grampeamento cirúrgico - Google Patents
unidade de carga descartável acionada por motor para uso com um aparelho de corte e grampeamento cirúrgico Download PDFInfo
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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
- A61B17/068—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
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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
- A61B2017/00017—Electrical control of surgical instruments
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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
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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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
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
Abstract
UNIDADE DE CARGA DESCARTAVEL ACIONADA POR MOTOR PARA USO COM UM APARELHO DE CORTE E GRAMPEAMENTO CIRúRGICO. A presente invenção refere-se a uma unidade de carga descartável acionada por motor nela contido, para uso com um aparelho de corte e grampeamento cirúrgico. A unidade de carga descartável pode conter uma bateria que é retida em uma posição desconectada quando a unidade de carga descartável não está em uso e é movida para uma posição conectada quando a unidade de carga descartável é acoplada ao aparelho de corte e grampeamento cirúrgico para permitir o motor ser seletivamente acionado desse modo. Indicadores podem ser suportados na unidade de carga descartável para indicar quando a montagem de acionamento axial da mesma está em uma posição de partida e uma posição terminal. Outro indicador pode ser fornecido para indicar quando a montagem de bigorna está em uma posição fechada.
Description
Relatório Descritivo da Patente de Invenção para "UNIDADE DE CARGA DESCARTÁVEL ACIONADA POR MOTOR PARA USO COM UM APARELHO DE CORTE E GRAMPEAMENTO CIRÚRGICO".
INVENTORES
Kyle P. Moore, um cidadão americano residindo em 6518 Falling Leaves Ct., Mason, Ohio 45040;
Frederick E. Shelton, IV, um cidadão americano residindo em 245 East Main Street, Hillsboro, Ohio 45133;
William B. Weisenhburgh, II, um cidadão americano residindo em 974 Airymeadows Drive, Mainville, Ohio 45039;
Jerome R. Morgan, um cidadão americano residindo em 3275 S.Whitetree Circle, Cincinnati, Ohio 45236;
Mark H. Ransicj, um cidadão americano residindo em 7501 Nor-dan Dr., West Chester, Ohio 45069; e
Eugene L. Timperman, um cidadão americano residindo em 10639 Silverbrook Drive, Cincinnati, Ohio 45240. CAMPO DA INVENÇÃO
A presente invenção refere-se em geral a instrumentos cirúrgicos endoscópicos incluindo, mas não limitado a, a aparelhos de corte e grampeamento cirúrgicos que têm unidades de carga descartáveis que são capazes de aplicar linhas de grampos no tecido enquanto cortam o tecido entre aquelas linhas de grampo e, mais particularmente, a aperfeiçoamentos relacionados a tais unidades de carga descartáveis. ANTECEDENTES
Instrumentos cirúrgicos endoscópicos são freqüentemente preferidos sobre dispositivos cirúrgicos abertos desde que uma incisão menor tende a reduzir o tempo de recuperação pós-operatório e complicações. Consequentemente, desenvolvimento significante tem se dedicado a uma faixa de instrumentos cirúrgicos endoscópicos que são adequados para colocação precisa de um efetuador de extremidade distai em um local cirúrgico desejado através de uma cânula de um trocarte. Estes efetuadores de extremidade distai engatam o tecido em um número de maneiras para obterum efeito diagnóstico ou terapêutico (por exemplo, endocortador, garra, cortador, grampeadores, aplicador de grampo, dispositivo de acesso, dispositivo de distribuição de terapia de droga/gene, e dispositivo de energia usando ultrasom, RF, laser, etc).
Grampeadores cirúrgicos conhecidos incluem um efetuador terminal que simultaneamente faz uma incisão longitudinal no tecido e aplica linhas de grampos em lados opostos da incisão. O efetuador terminal inclui um par de elementos de mordente cooperando que, se o instrumento é pretendido para aplicações endoscópicas ou laparoscópicas, são capazes de passar através de uma passagem de cânula. Um dos elementos de mordente suporta um cartucho de grampos que tem pelo menos duas fileiras de grampos lateralmente espaçadas. O outro elemento de mordente define uma bigorna tendo bolsos formando grampos alinhados com as fileiras de grampos no cartucho. O instrumento inclui comumente uma pluralidade de cunhas alternadas que, quando acionadas distalmente, passam através das aberturas no cartucho de grampos e engatam acionadores suportando os grampos para efetuar o disparo dos grampos na direção da bigorna.
Um tipo de aparelho de grampeamento cirúrgico é configurado para operar com unidades de carga descartáveis (DLUs) que são construídas para suportar um cartucho de grampos e montagem de faca nas mesmas. Uma vez que o procedimento está completo, a DLU inteira é descartada. Tais instrumentos que são designados para acomodar o conteúdo da DLU pra oferecer a vantagem de uma lâmina de faca "nova" para cada disparo do instrumento. Exemplos de tais aparelhos de grampeamento cirúrgicos e DLUs são descritos na Patente U.S. N° 5.865.361 para Milliman e outros, a descrição da qual é incorporada aqui em sua totalidade.
Tais unidades de carga descartáveis anteriores, no entanto, exigem que o médico engatilhe continuamente o manipulo para disparar os grampos e cortar o tecido. Existe uma necessidade de um aparelho de grampeamento cirúrgico configurado para uso com uma unidade de carga descartável que é acionada por um motor contido na unidade de carga descartável.SUMÁRIO
Em um aspecto geral das várias modalidades da presente invenção, é fornecida uma unidade de carga descartável para fixação em um aparelho de corte e grampeamento cirúrgico. Em várias modalidades, a unidade de carga descartável pode compreender um transportador que suporta um cartucho de grampos na mesma. Uma montagem de bigorna pode ser acoplada de modo móvel no transportador para deslocamento móvel seletivo entre posições aberta e fechada com relação ao cartucho de grampos. Uma montagem de acionamento axial pode ser suportada dentro do transportador tal que pode se mover em uma direção distai de uma posição de partida para uma posição terminal através do transportador e do cartucho de grampos. A montagem de acionamento axial pode também ser retraída em uma direção proximal da posição terminal de volta para a posição inicial. Um motor pode ser suportado dentro do transportador e construído para acionar a montagem de acionamento axial nas direções distai e proximal. Uma bateria pode ser suportada dentro do transportador e ser acoplada no motor para fornecer energia ao mesmo.
Em ainda outro aspecto geral das várias modalidades da presente invenção, é fornecida uma unidade de carga descartável para fixação em um aparelho de corte e grampeamento cirúrgico. Em várias modalidades, a unidade de carga descartável inclui um transportador que suporta um cartucho de grampo no mesmo. Uma montagem de bigorna pode ser acoplada de modo móvel no transportador para deslocamento móvel seletivo entre as posições aberta e fechada com relação ao cartucho de grampos. Um alojamento pode ser acoplado no transportador e ser configurado para fixação operável removível no aparelho de grampeamento cirúrgico. Uma montagem de acionamento axial pode ser suportada dentro do transportador e o alojamento para mover em uma direção distai de uma posição de partida para uma posição final através do transportador e do cartucho de grampos. A montagem de acionamento axial pode também ser retraída em uma direção proximal da posição terminal para a posição de partida. Um motor pode ser suportado dentro do transportador e configurado para interfacear com amontagem de acionamento axial para acionar a montagem de acionamento axial nas direções distai e proximal. Uma bateria pode ser suportada dentro do transportador e ser acoplada no motor para fornecer energia ao mesmo. A bateria pode ser seletivamente móvel entre uma posição desconectada e posições conectadas em resposta aos movimentos aplicados na mesma por uma parte do aparelho de grampeamento cirúrgico.
Em outro aspecto geral das várias modalidades da presente invenção, é fornecido um aparelho de corte e grampeamento cirúrgico. Várias modalidades do instrumento podem incluir uma montagem de manipulo que suporta de modo operável uma montagem de acionamento na mesma, que é construída para conferir movimentos de acionamento e um movimento de retração. Uma parte de manipulo móvel pode ser suportada de modo operável na montagem de manipulo e configurada para interfacear com o sistema de acionamento tal que a manipulação do manipulo móvel faz o sistema de acionamento conferir movimentos de acionamento. Um corpo alongado pode se projetar da montagem de manipulo e ter uma extremidade distai que é acoplável a uma unidade de carga descartável. Em várias modalidades, a unidade de carga descartável pode compreender um transportador que tem um cartucho de grampos suportado na mesma. Uma montagem de bigorna pode ser acoplada de modo móvel no transportador para deslocamento móvel seletivo entre as posições aberta e fechada com relação ao cartucho de grampos. Uma montagem de acionamento axial pode ser suportada dentro do transportador tal que a montagem de acionamento axial pode se mover em uma direção distai a partir de uma posição de partida para uma posição terminal através do transportador e do cartucho de grampos e também em uma direção proximal da posição terminal para a posição de partida. Um motor pode ser suportado dentro do transportador e configurado para interfacear com a montagem de acionamento axial para acionar a montagem de a-cionamento axial nas direções distai e proximal. Uma bateria pode ser suportada dentro do transportador e ser acoplada ao motor para fornecer energia ao mesmo. A bateria pode ser configurada para interfacear com uma parte do corpo alongado para receber os movimentos de acionamento do mesmona manipulação do manipulo móvel.
Estes e outros objetivos e vantagens da presente invenção se tornarão evidentes a partir dos desenhos anexos e a descrição da mesma.
BREVE DESCRIÇÃO DAS FIGURAS
Os desenhos anexos, que são incorporados e constituem uma parte deste relatório, ilustram modalidades da invenção, e, junto com a descrição geral das várias modalidades da invenção dada acima, e a descrição detalhada das modalidades fornecida abaixo, servem para explicar vários princípios da presente invenção.
A figura 1 é uma vista em perspectiva de uma modalidade de unidade de carga descartável da presente invenção acoplada a um aparelho de corte e grampeamento cirúrgico convencional.
A figura 2 é uma vista em seção transversal da unidade de carga descartável da figura 1 com vários componentes mostrados em vista completa por clareza.
A figura 3 é uma vista em seção transversal de uma extremidade proximal da modalidade da unidade de carga descartável das figuras 1 e 2 com vários componentes mostrados em vista completa por clareza.
A figura 4 é um esquema de uma modalidade de circuito da unidade de carga descartável das figuras 1-3.
A figura 5 é uma vista em seção transversal da unidade de carga descartável das figuras 1-3 quando a unidade de carga descartável foi fixada no corpo alongado do instrumento cirúrgico.
A figura 6 é uma vista esquemática do circuito ilustrando a posição de vários componentes da unidade de carga descartável depois que foi fixada no instrumento cirúrgico.
A figura 7 é uma vista em seção transversal da unidade de carga descartável das figuras 1-6 quando a trave de acionamento foi movida para a posição fechada da bigorna.
A figura 8 é uma vista esquemática do circuito ilustrando a posição de vários componentes da unidade de carga descartável após a trave de acionamento ter sido movida para a posição fechada da bigorna.A figura 9 é uma vista em seção transversal da unidade de carga descartável das figuras 1-8 quando a trave de acionamento foi movida para sua posição disparada mais distai.
A figura 10 é uma vista esquemática do circuito ilustrando a po-sição de vários componentes da unidade de carga descartável depois que a viga de acionamento foi movida para sua posição disparada mais distai.
A figura 11 é uma vista em seção transversal da unidade de carga descartável das figuras 1-10 quando a trave de acionamento está sendo retornada para uma posição de partida.
A figura 12 é uma vista esquemática do circuito ilustrando a po-sição de vários componentes da unidade de carga descartável quando a trave de acionamento está sendo retornada para uma posição de partida.
DESCRIÇÃO DETALHADA
Voltando aos desenhos, em que numerais iguais indicam com-15 ponentes iguais por todas as várias vistas, a figura 1 representa uma unidade de carga descartável 16 da presente invenção que é acoplada a um aparelho de corte e grampeamento cirúrgico convencional 10. A construção e a operação geral de um aparelho de corte e grampeamento 10 são descritas na Patente U.S. N° 5.865.361, a descrição da qual foi aqui incorporada por referência. Assim, a presente Descrição Detalhada não discutirá os vários componentes do aparelho 10 e sua operação aqui, além do que é necessário para descrever a operação da unidade de carga descartável 16 da presente invenção.
Na medida em que a presente Descrição Detalhada prosseguir, será apreciado que os termos "proximal" e "distai" são usados aqui com referência a um médico agarrando uma montagem de manipulo 12 do aparelho de grampeamento cirúrgico 10 no qual a unidade de carga descartável 16 é fixada. Assim, a unidade de carga descartável 16 é distai com respeito à montagem de manipulo mais proximal 12. Será ainda apreciado que, por conveniência e clareza, os termos espaciais tais como "vertical", "horizontal", "para cima", "para baixo", "direita", e "esquerda" são usados aqui com respeito aos desenhos. No entanto, instrumentos cirúrgicos são usados em mui-tas orientações e posições, e estes termos não pretendem ser limitantes ou absolutos.
Como pode ser visto na figura 1, a unidade de carga descartável 16 pode em geral compreender uma montagem de ferramenta 17 para realizar procedimentos cirúrgicos tais como cortar tecido e aplicar grampos em cada lado do corte. A montagem de ferramenta 17 pode incluir uma montagem de cartucho 18 que inclui um cartucho de grampos 220 que é suportado em um transportador 216. Uma montagem de bigorna 20 pode ser acoplada de modo pivotante no transportador 216 em uma maneira conhecida para deslocamento pivotante seletivo entre as posições aberta e fechada. A montagem de bigorna 20 inclui uma parte de bigorna 204 que tem uma pluralidade de concavidades de deformação de grampos (não mostradas) formada na superfície inferior da mesma. O cartucho de grampos 220 aloja uma pluralidade de impulsores ou acionadores (não mostrados) que possuem um grampo ou grampos (não mostrados) suportados no mesmo. Um carrinho de atuação 234 é suportado dentro da montagem de ferramenta 17 e é configurado para acionar os impulsores e grampos no cartucho de grampos 220 na direção da montagem de bigorna 20 quando o carrinho de atuação 234 é acionado da extremidade proximal da montagem de ferramenta 17 para a extremidade distai 220. Ver figura 2.
A unidade de carga descartável 16 pode ainda incluir uma montagem de acionamento axial 212 que compreende uma trave de acionamento 266 que pode ser construída a partir de uma folha única de material ou, de preferência, de múltiplas folhas empilhadas. No entanto, a trave de acionamento 266 pode ser construída a partir de outras configurações de material adequadas. A extremidade distai da trave de acionamento 266 pode incluir um tirante de suporte vertical 271 que suporta uma lâmina de faca 280 e uma superfície de sustentação 283 que engata a parte central do carrinho de atuação 234 durante um procedimento de grampeamento. A lâmina de faca 280 pode ser em geral posicionada para transladar ligeiramente atrás do carrinho de atuação 234 através da fenda longitudinal central no cartucho de grampos 220 para formar uma incisão entre as fileiras de tecido corporalgrampeado. Um flange de retenção 284 pode se projetar distalmente a partir do tirante vertical 271 e suportar um pino ou pinos de carne 286 em sua extremidade distai. O pino de carne 286 pode ser dimensionado e configurado para engatar a superfície de carne 209 na parte de bigorna 204 para prender a parte de bigorna 204 contra o tecido corporal. Ver figuras 5 e 7. Em adição, um feixe de molas (não mostrado) pode ser fornecido entre a extremidade proximal da parte de bigorna 204 e a parte terminal distai do alojamento 200 para orientar a montagem de bigorna 20 para uma posição normalmente aberta. O transportador 216 pode também ter uma fenda de fundo alongada através da qual uma parte do tirante de suporte vertical 271 se estende para ter um elemento de suporte 287 fixado na mesma.
Como pode também ser visto na figura 1, a unidade de carga descartável 16 pode também ter uma parte de alojamento 200 que é adaptada para encaixar em ou de outro modo ser fixada no transportador 216. A extremidade proximal 500 do alojamento 200 pode incluir protuberâncias de engate 254 para engatar de modo liberável o corpo alongado 14 de um aparelho de grampeamento cirúrgico. As protuberâncias 254 formam um aco-plamento do tipo baioneta com a extremidade distai da parte de corpo alongada 14 do aparelho de grampeamento cirúrgico como descrito na Patente U.S. N°. 5.865.361.
O alojamento 200 pode ainda incluir uma parte de comutação 520 que aloja de modo móvel uma bateria 526 na mesma. Mais especificamente, e com referência à figura 3, a parte de comutação 520 do alojamento 200 define uma cavidade de bateria 522 que suporta de modo móvel um retentor de bateria 524 que aloja uma bateria 526 no mesmo. Como pode ser visto na figura 3, um primeiro contato de bateria 528 é suportado em contato elétrico com a bateria 526 e se projeta para fora através do retentor de bateria 524 para engate deslizante com a parede interna 523 da cavidade de bateria 522.
Similarmente, um segundo contato de bateria 530 é montado em contato elétrico com a bateria 526 e também se projeta para fora do retentor de bateria 524 para deslizar ao longo da parede interna 523 da cavidade de bateria 522. O retentor de bateria 524 tem um soquete de haste de controle532 configurado para receber a extremidade distai 276 da haste de controle 52 quando a extremidade proximal da unidade de carga descartável 16 é acoplada no corpo alongado 14 do aparelho de grampeamento cirúrgico 10. Como pode também ser visto na figura 3, uma série de contatos 540, 542, 544 pode ser orientada dentro da parede 523 para contato com os contatos de bateria 530. O propósito dos contatos 540, 542 e 544 será discutido em detalhe adicional abaixo. Como pode ser visto também na figura 3, um elemento de orientação ou mola de comutação 550 é posicionado dentro da cavidade de bateria 522 para orientar o retentor de bateria 524 na direção proximal "PD" tal que quando a recarga descartável 16 não é fixada no corpo alongado 14, o retentor de bateria 524 é orientado para sua posição mais proximal mostrada na figura 3. Quando retido nesta posição de "pré-uso" ou "desconectada" pela mola 550, os contatos de bateria 528 e 530 não contatam qualquer um dos contatos 540, 542, 544 dentro da cavidade de bateria 522 para impedir a bateria 526 de ser drenada durante o não uso.
Como pode também ser visto na figura 3, o alojamento 200 pode ainda ter uma cavidade de motor 560 no mesmo que aloja um motor 562 e uma caixa de engrenagem 564. A caixa de engrenagem 564 tem um eixo de saída 566 que se projeta através de um furo 572 em um anteparo proximal 570 formado no alojamento 200. Ver figura 5. O eixo de saída 566 é chavea-do ou de outro modo acoplado de modo não-rotativo em um disco propulsor 580. Como pode ser visto na figura 5, o disco propulsor 580 é rotativamente suportado dentro da cavidade do disco propulsor 582 formado entre o anteparo proximal 570 e um anteparo distai 590 formado no alojamento 200. Em adição, o disco impulsor 580 é rotativamente suportado entre um mancai de impulso proximal 583 e um mancai de impulsor distai 584 como mostrado. Como pode também ser visto na figura 5, o disco impulsor 580 pode ser formado em uma extremidade proximal de um parafuso de acionamento 600 que engata de modo roscado uma porca de acionamento 610 que é suportada dentro de uma seção de engate 270 formada na extremidade distai do tirante de acionamento 266. Em várias modalidades, a seção de engate 270 pode incluir um par de dedos de engate 270a e 270b que são dimensiona-dos e configurados para serem recebidos dentro de uma fenda na porca de acionamento 610 para fixar de modo não-rotativo a porca de acionamento 610 no tirante de acionamento 266. Assim, a rotação do parafuso de acionamento 600 dentro da porca de acionamento 610 acionará o tirante de a-cionamento 266 na direção distai "DD" ou na direção proximal "PD" dependendo da direção de rotação do parafuso de acionamento 600.
A unidade de carga descartável 16 pode ainda incluir um comu-tador de retorno 630 que é montado no alojamento 200 e é adaptado para ser atuado por uma porca de faca 610. Como pode também ser visto na figura 5, um comutador 640 é montado no alojamento 200 e é também orientado para ser atuado pela porca de faca 610 para indicar quando a montagem de bigorna 20 foi fechada. Um comutador 650 é montado no alojamento 200 e é também adaptado para ser atuado pela porca de faca 610 para indicar que a montagem de acionamento axial 212 se moveu para sua posição acabada. As operações específicas dos comutadores 630, 640, 650 serão discutidas em mais detalhes abaixo.
A figura 4 ilustra uma modalidade de circuito 700 da presente invenção que ilustra as posições dos vários componentes da unidade de carga descartável 16 da presente invenção quando em uma condição de "pré-uso". Por exemplo, os vários componentes da unidade de carga descartável 16 podem estar nesta orientação de pré-uso quando a unidade 16 está sendo armazenada ou expedida. Como pode ser visto nesta figura, quando nesta orientação, os contatos de bateria 528 e 530 não contatam qualquer um dos contatos 540, 542, 544 no alojamento 200 que impede a bateria 526 de ser drenada durante o não uso.
As figuras 5 e 6 ilustram as posições de vários componentes da unidade de carga descartável 16 depois que foi acoplada ao corpo alongado 14 do instrumento de corte e grampeamento cirúrgico 10. Em particular, como pode ser visto na figura 5, a extremidade distai 276 da haste de controle 52 foi acoplada no retentor de bateria 524. Quando a haste de controle 52 é fixada no retentor de bateria 524, o retentor de bateria 524 é movido na direção distai "DD" contra a mola 550 tal que os contatos de bateria 528, 530são colocados em contato com os contatos de retorno 540 no alojamento 200. Também, quando nesta posição, a porca de faca 610 atua o comutador de retorno 630 para uma orientação aberta. Será apreciado que o comutador de retorno 630 é um comutador normalmente fechado que é atuado para a posição aberta pela porca de faca 610. Como mostrado na figura 6, quando o comutador de retorno 630 é aberto, o motor 562 não é acionado.
As figuras 7 e 8 ilustram as posições de vários componentes da unidade de carga descartável 16 depois que o clínico atuou o manipulo móvel 24 (mostrado na figura 1) do instrumento de corte e grampeamento cirúrgico 10. Como discutido na Patente U.S. N° 5.865.361, quando o manipulo móvel 24 é inicialmente movido na direção do elemento de manipulo esta-cionário 22, a haste de controle 52 é feita se mover na direção distai "DD". Como pode ser visto na figura 7, quando a haste de controle 52 é inicialmente movida na direção distai durante o percurso de fechamento de bigorna, o retentor de bateria 524 move a bateria 526 para uma posição em que os contatos de bateria 528, 530 contatam os contatos de fechamento de bigorna 542. A energia é agora permitida fluir da bateria 526 para o motor 562 que roda o parafuso de acionamento 600 e faz o tirante de acionamento 266 se mover distalmente. Quando o tirante de acionamento 266 move distal-mente na direção "DD", o pino de carne 286 engata a parte de carne 209 da parte de bigorna 204 e faz a montagem de bigorna 20 pivotar para uma posição fechada como ilustrado na figura 7. Quando o tirante de acionamento 266 move distalmente para a posição fechada da bigorna, a porca de faca 610 se move para fora de contato com o comutador de retorno 630 que permite que o comutador de retorno reassuma sua posição normalmente aberta. A porca de faca 610 então atua o comutador de bigorna fechado 640 e move para uma posição aberta. Ver figura 8. Em várias modalidades, uma ou mais luzes de bigorna fechada 660 podem ser montadas no alojamento 200 para fornecer uma indicação visual para o médico que a montagem de bigorna 20 foi movida para a posição fechada.
Quando o médico deseja disparar o instrumento 10 (isto é, atuar o instrumento 10 para fazê-lo cortar e grampear o tecido), o médico primeiropressiona o embolo 82 da montagem de travamento de disparo 80 (figura 1) como discutido na Patente U.S. N° 5.865.361. Depois disto, o manipulo móvel 24 pode ser atuado. Quando o manipulo móvel 24 é pressionado, a haste de controle 52 move o retentor de bateria 524 e a bateria 526 para a posição ilustrada nas figuras 9 e 10. Como pode ser visto naquelas figuras, quando a bateria 526 é movida para esta posição, os contatos de bateria 528, 530 são colocados em contato com os contatos de disparo 544. O comutador 650 está normalmente fechado até que seja atuado pela porca de faca 610. Assim, quando os contatos da bateria 528, 530 contatam os contatos de disparo 544, a energia flui da bateria 526 para o motor 562 que aciona o parafuso de acionamento 600. Quando o parafuso de acionamento 600 é rodado, o tirante de acionamento 266 e a porca da faca 610 são acionados na direção distai "DD" para avançar o carrinho de atuação 234 através do cartucho de grampos 220 para efetuar a ejeção de grampos e cortar o tecido. Uma vez que o tirante de acionamento 266 atinge o fim do percurso de disparo (isto é, todos os grampos no cartucho de grampos 220 foram disparados), a porca de faca 610 é posicionada para atuar o comutador normalmente fechado 650 e movê-lo para uma posição aberta (ilustrada na figura 10) que para o fluxo de energia da bateria 526 para o motor 562. Em várias modalidades, uma luz de indicação distai ou luzes 670 podem ser montadas no alojamento 200 para fornecer uma indicação ao médico que o tirante de acionamento 266 atingiu sua posição disparada mais distai.
Para retrair o tirante de acionamento 266, o médico agarra os botões de retração 32 (mostrados na figura 1) na montagem de manipulo 12 e os puxa na direção proximal "PD". A operação e construção dos botões de retração 32 são discutidas na Patente U.S. N° 5.865.361. Uma vez que o médico move o tirante de acionamento 266 a uma distância suficiente na direção proximal "PD" de modo a mover a bateria para os contatos 540 (figura 11), a energia será suprida através do comutador 630 que inverte o motor 562. A porca de faca libera o comutador 650. O motor 562 então aciona o tirante de acionamento 266 distai ao comutador 630, que se abre. O comutador de retorno 630 está também em sua posição normalmente fechadadesse modo permitindo que a energia flua para o motor 562 e rode o parafuso de acionamento 610 em uma direção oposta para acionar o tirante de acionamento 266 na direção proximal "PD". Uma vez que a porca de faca 610 atua o comutador de retorno de faca 630, o comutador de retorno de faca 630 é movido para uma posição aberta desse modo parando o fluxo de energia da bateria 526 para o motor 562. Em várias modalidades, uma luz de partida 700 pode ser montada no alojamento 200 para fornecer uma indicação que o tirante de acionamento 266 está na posição de partida.
As figuras 11 e 12 ilustram as posições de vários componentes da unidade de carga descartável 16 da presente invenção quando a extremidade distai do tirante de acionamento 266 e a lâmina 280 inadvertidamente se tornam emperrados durante o percurso de disparo (isto é, quando a lâmina 280 está sendo avançada distalmente através do tecido preso na montagem de ferramenta 17). Para tratar de tal ocorrência, um limitador de corrente 680 pode ser fornecido como mostrado na figura 12. O limitador de corrente 680 serve para desligar o motor 562 quando a quantidade de corrente que é retirada excede um limite predeterminado. Será entendido que a quantidade de corrente que o motor 562 retira durante um emperramento aumentaria sobre a quantidade de corrente retirada durante as operações de disparo normais. Uma vez que o limitador de corrente 680 fecha o motor 562, o médico pode retrair o tirante de acionamento 266 agarrando os botões de retração 32 (mostrados na figura 1) na montagem de manipulo 12 e empurrando-os na direção proximal "PD" e o motor 562 acionará o parafuso de acionamento 600 em reverso na maneira descrita acima. Assim, o limitador de corrente 680 serve para parar o motor 562 quando a montagem de acionamento axial 212 encontra resistência que excede uma quantidade predeterminada de resistência que está associada com a quantidade máxima predeterminada de corrente que o motor 562 deve retirar sob circunstâncias de operação normal. Este aspecto também economiza energia da bateria de modo que o tirante de acionamento 266 pode ser retraído.
Assim, a unidade de carga descartável 16 da presente invenção compreende uma unidade de carga descartável acionada por motor autocon-tido que pode ser usada em conexão com os instrumentos de corte e gram-peamento cirúrgicos convencionais que tradicionalmente exigiam que o médico avançasse e retraísse manualmente a montagem de acionamento e a lâmina de corte de uma unidade de carga descartável acoplada no mesmo. Várias modalidades da unidade de carga descartável 16 podem ser construídas para facilitar a retração automática da montagem de acionamento axial se a lâmina encontrar uma quantidade predeterminada de resistência.
Enquanto várias modalidades da invenção foram descritas, deve ser evidente, no entanto, que várias modificações, alterações e adaptações naquelas modalidades podem ocorrer a pessoas versadas na técnica com a obtenção de algumas ou todas as vantagens da invenção. Por exemplo, de acordo com várias modalidades, um componente único pode ser substituído por múltiplos componentes, e múltiplos componentes podem ser substituídos por um componente único, para realizar uma dada função ou funções. Esta aplicação portanto pretende cobrir todas as tais modificações, alterações e adaptações sem se afastar do escopo e espírito da invenção descrita como definida pelas reivindicações anexas.
Qualquer patente, publicação ou outro material de descrição, no todo ou em parte, que é dito ser incorporado por referência aqui, é incorporado aqui somente na medida em que os materiais incorporados não confli-tam com definições, regulamentos ou outro material de descrição existentes apresentados nesta descrição. Como tal, e na extensão necessária, a descrição como explicitamente apresentada aqui substitui qualquer material conflitante incorporado aqui por referência. Qualquer material, ou parte do mesmo, que é dito ser incorporado aqui por referência, mas que conflita com definições, regulamentos ou outro material de descrição existente apresentado aqui somente será incorporado na medida em que não surge conflito entre este material incorporado e o material de descrição existente.
A invenção que pretende ser protegida não deve ser construída como limitada às modalidades particulares descritas. As modalidades devem portanto ser vistas como ilustrativas em vez de restritivas. Variações e mudanças podem ser feitas por outros sem se afastar do espírito da presenteinvenção. Consequentemente, é expressamente pretendido que todos os equivalentes, variações e mudanças que se encontram dentro do espírito e escopo da presente invenção como definida nas reivindicações sendo a-brangidas desse modo.
Claims (20)
1. Unidade de carga descartável para fixação em um aparelho de corte e grampeamento cirúrgico, a dita unidade de carga descartável compreendendo:um transportador;um cartucho de grampos suportado no dito transportador;uma montagem de bigorna acoplada de modo móvel no dito transportador para deslocamento móvel seletivo entre as posições aberta e fechada com relação ao dito cartucho de grampos;uma montagem de acionamento axial suportada dentro do dito transportador para mover em uma direção distai de uma posição de partida para uma posição terminal através do dito transportador e do dito cartucho de grampos e em uma direção proximal da dita posição terminal para a dita posição de partida;um motor suportado dentro do dito transportador e interfaceando com a dita montagem de acionamento axial nas ditas direções distai e proximal; euma bateria suportada dentro do dito transportador e acoplada no dito motor para fornecer energia ao mesmo.
2. Unidade de carga descartável, de acordo com a reivindicação-1, em que a dita bateria é móvel entre uma posição desconectada e posições conectadas dentro do dito transportador.
3. Unidade de carga descartável, de acordo com a reivindicação-2, em que a dita bateria é retida na dita posição desconectada antes da dita unidade de carga descartável ser acoplada no aparelho de grampeamento cirúrgico, e é movida para uma das ditas posições conectadas no acopla-mento da dita unidade de carga descartável no aparelho de grampeamento cirúrgico.
4. Unidade de carga descartável, de acordo com a reivindicação-3, em que a dita bateria é suportada em um retentor de bateria que é suportado de modo móvel no dito transportador e é fixável a uma haste de controle do aparelho de grampeamento cirúrgico.
5. Unidade de carga descartável, de acordo com a reivindicação-1, ainda compreendendo um indicador suportado na dita unidade de cargadescartável para indicar quando a dita montagem de acionamento axial estáem uma posição de partida.
6. Unidade de carga descartável, de acordo com a reivindicação-1, ainda compreendendo um indicador suportado na dita unidade de carre-gamento descartável quando a dita montagem de bigorna está na dita posi-ção fechada.
7. Unidade de carga descartável, de acordo com a reivindicação- 1, ainda compreendendo um indicador suportado na dita unidade de cargadescartável para indicar quando a dita montagem de acionamento axial estáem uma posição mais distai.
8. Unidade de carga descartável, de acordo com a reivindicação-1, ainda compreendendo meios para parar o dito motor de acionar a dita montagem de acionamento na dita direção proximaí quando a dita monta-gem de acionamento axial encontra resistência que excede uma quantidadepredeterminada de resistência.
9. Unidade de carga descartável, de acordo com a reivindicação-8, em que o dito meio para parar o dito motor compreende um limitador de corrente acoplado de modo operável ao dito motor.
10. Unidade de carga descartável para fixação em um aparelhode corte e grampeamento cirúrgico, a dita unidade de carga descartávelcompreendendo:um transportador;um cartucho de grampo suportado no dito transportador;uma montagem de bigorna acoplada de modo móvel no ditotransportador para deslocamento móvel seletivo entre as posições aberta efechada com relação ao dito cartucho de grampos;um alojamento acoplado no dito transportador e configurado pa-ra fixação operável removível no aparelho de corte e grampeamento cirúrgi-co;uma montagem de acionamento axial suportada dentro do ditotransportador e do dito alojamento para mover em uma direção distai de umaposição de partida para uma posição terminal através do dito transportador edo dito cartucho de grampos e em uma direção proximal da dita posiçãoterminal para a dita posição de partida;um motor suportado dentro do dito transportador e interfaceandocom a dita montagem de acionamento axial para acionar a dita montagemde acionamento axial nas ditas direções distai e.proximal; euma bateria suportada dentro do dito transportador e acopladano dito motor para fornecer energia ao mesmo, a dita bateria seletivamente móvel entre uma posição desconectada e posições conectadas em respostaaos movimentos aplicados na mesma por uma parte do aparelho de gram-peamento cirúrgico.
11. Unidade de carga descartável, de acordo com a reivindica-ção 10, em que a dita bateria é retida na dita posição desconectada antes do dito alojamento ser acoplado no aparelho de grampeamento cirúrgico e émovida para uma das ditas posições conectadas no acoplamento do ditoalojamento no aparelho de grampeamento cirúrgico.
12. Unidade de carga descartável, de acordo com a reivindica-ção 11, ainda compreendendo meios para parar o dito motor quando a dita montagem de acionamento axial encontra resistência que excede uma quan-tidade de resistência predeterminada.
13. Unidade de carga descartável, de acordo com a reivindica-ção 10, ainda compreendendo meios no dito alojamento para indicar quandoa dita montagem de acionamento axial está em uma posição de partida e uma posição terminal.
14. Unidade de carga descartável, de acordo com a reivindica-ção 10, ainda compreendendo meios no dito alojamento para indicar quandoa dita bigorna está na dita posição fechada.
15. Aparelho de corte e grampeamento cirúrgico compreendendo:uma montagem de manipulo;um sistema de acionamento suportado de modo operável na ditamontagem de manipulo e construído para conferir movimentos de aciona-mento e um movimento de retração;uma parte de manipulo móvel suportada de modo operável nadita montagem de manipulo e interfaceando com o dito sistema de aciona- mento tal que a manipulação do dito manipulo móvel faz o dito sistema deacionamento conferir os ditos movimentos de acionamento;um corpo alongado se projetando da dita montagem de manipu-lo e tendo uma extremidade distai acoplável a uma unidade de carga descar-tável, a dita unidade de carga descartável compreendendo:um transportador;um cartucho de grampos suportado no dito transportador;uma montagem de bigorna acoplada de modo móvel no ditotransportador para deslocamento móvel seletivo entre posições aberta e fe-chada com relação ao dito cartucho de grampos;uma montagem de acionamento axial suportada dentro do ditotransportador para mover em uma direção distai de uma posição de partidapara uma posição terminal através do dito transportador e do dito cartuchode grampos e em uma direção proximal da dita posição terminal para a ditaposição de partida;um motor suportado dentro do dito transportador e interfaceandocom a dita montagem de acionamento axial nas ditas direções distai e pro-ximal; euma bateria suportada dentro do dito transportador e acopladano dito motor para fornecer energia ao mesmo, a dita bateria interfaceando com uma parte do corpo alongado para receber os ditos movimentos de a-cionamento do mesmo na manipulação do dito manipulo móvel.
16. Aparelho de corte e grampeamento cirúrgico, de acordo coma reivindicação 15, em que a dita bateria é retida na dita posição desconec-tada antes da dita unidade de carga descartável ser acoplada na dita extre- midade distai do corpo alongado do dito aparelho de grampeamento cirúrgi-co, e é movida para uma das ditas posições conectada no acoplamento dadita unidade de carga descartável na dita extremidade distai do dito corpoalongado.
17. Aparelho de corte e grampeamento cirúrgico, de acordo coma reivindicação 16, em que o dito corpo alongado suporta de modo operáveluma haste de controle no mesmo interfaceando com o dito sistema de acio-namento e em que a dita bateria é suportada em um retentor de bateria queé suportado de modo móvel no dito transportador e é fixável a uma extremi-dade distai da dita haste de controle.
18. Aparelho de corte e grampeamento cirúrgico, de acordo coma reivindicação 15, ainda compreendendo meios para parar o dito motor quando a dita montagem de acionamento axial encontra resistência que ex-cede uma quantidade de resistência predeterminada.
19. Aparelho de corte e grampeamento cirúrgico, de acordo coma reivindicação 15, ainda compreendendo:um primeiro indicador na dita unidade de carga descartável para indicar quando a dita montagem de acionamento axial está em uma posiçãode partida;um segundo indicador na dita unidade de carga descartável paraindicar quando a dita bigorna está na dita posição fechada; eum terceiro indicador na dita unidade de carga descartável paraindicar quando a dita montagem de acionamento axial está na dita posiçãoterminal.
20. Aparelho de corte e grampeamento cirúrgico, de acordo coma reivindicação 18, em que o dito meio para parar o dito motor compreendeum limitador de corrente acoplado de modo operável ao dito motor.
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-
2008
- 2008-02-14 US US12/031,628 patent/US7793812B2/en active Active
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2009
- 2009-02-13 RU RU2009105069/14A patent/RU2506909C2/ru not_active IP Right Cessation
- 2009-02-13 BR BRPI0901477-2A patent/BRPI0901477B1/pt active IP Right Grant
- 2009-02-13 EP EP09250367A patent/EP2090240B1/en active Active
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- 2009-02-13 DE DE602009001003T patent/DE602009001003D1/de active Active
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HK1135870A1 (en) | 2010-06-18 |
JP5586856B2 (ja) | 2014-09-10 |
RU2506909C2 (ru) | 2014-02-20 |
US7793812B2 (en) | 2010-09-14 |
US20100301096A1 (en) | 2010-12-02 |
BRPI0901477B1 (pt) | 2021-04-27 |
CN101507625B (zh) | 2013-02-13 |
JP2009189821A (ja) | 2009-08-27 |
EP2090240A1 (en) | 2009-08-19 |
US8196795B2 (en) | 2012-06-12 |
RU2009105069A (ru) | 2010-08-20 |
US20090206136A1 (en) | 2009-08-20 |
EP2090240B1 (en) | 2011-04-13 |
DE602009001003D1 (de) | 2011-05-26 |
CN101507625A (zh) | 2009-08-19 |
US20110132965A1 (en) | 2011-06-09 |
US8540130B2 (en) | 2013-09-24 |
ATE505138T1 (de) | 2011-04-15 |
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