CN100337596C - 电动机械式手术装置 - Google Patents

电动机械式手术装置 Download PDF

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CN100337596C
CN100337596C CNB028165012A CN02816501A CN100337596C CN 100337596 C CN100337596 C CN 100337596C CN B028165012 A CNB028165012 A CN B028165012A CN 02816501 A CN02816501 A CN 02816501A CN 100337596 C CN100337596 C CN 100337596C
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surgical instrument
drive shaft
motor
coupling
rotatable
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CN1547454A (zh
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M·P·惠特曼
G·多罗斯
J·E·布尔班克
D·A·蔡希纳
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Covidien LP
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Powermed Inc
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Abstract

一种电动机械式手术装置，其包括：壳体；从壳体延伸的细长轴，细长轴的远端可拆卸地与手术器具联接；至少两个轴向可旋转的驱动轴，其设置细长轴内，每一驱动轴的远端构造成与手术器具联接；转向线缆组件构造成使细长轴的远端转向；以及设置在壳体内的马达系统，该马达系统构造成驱动该驱动轴和转向线缆组件。设置控制系统以便控制该马达系统。可设置遥控系统经由控制系统来控制该马达系统。设置例如霍耳效应器件的传感器，以便基于所检测到的驱动轴旋转来确定手术器具的元件的位置。存储器单元存储多个操作程序和算法，其中每一个对应于装接到电动机械式手术装置上的手术器具的类型。控制系统从多个操作程序和算法中读取或选择对应于装接到电动机械式手术装置上的手术器具的类型的操作程序和算法。

Description

电动机械式手术装置
技术领域
本发明涉及电动机械式手术装置。
背景技术
参考文献中有大量对手术装置的描述。例如，授权给Sjostrom的美国专利4705038描述了一种用于电动器具的手术装置。该系统包括一手柄，其包含马达并包括适于接受多个手术装置中的一个的凹部。一对簧片开关设置在凹部内，并且每一手术装置包括一个或两个适于当该器具与手柄组装时促动特别组合的簧片开关的磁体。由组装手柄的磁体促动的簧片开关和手术装置的组合为系统识别如此与手柄组装的手术装置。可由该系统识别的手术装置的数量限于两个磁铁的四个可能的组合形式。
授权给Ams的美国专利4995877描述了一种带有旋转驱动的手术装置的装置。该装置包括包含用于驱动工具插入件驱动马达的手持部件。该装置还包括具有存储单元的控制单元，该存储单元用于存储由装置的使用者手动设定的操作数据。这些数据可传输给编码载体，其可插入到插入式设备中。
授权给Mallaby的美国专利5249583描述了一种带有无刮擦定位传感器的活组织检查的电动器具。带槽口的盘和凸轮固定到由马达驱动的驱动轴上。布置一对传感器，以便在带槽口的盘的槽口位于该传感器上时激活每一传感器，由此确定器具的套管和管心针的位置。该传感器、带槽口的盘、凸轮、马达、和用于给该器具可充电电池包含在该器具的壳体内。
授权给Hooven的美国专利5383880描述了一种具有感测装置的内窥镜式的手术器具。该器具包括设置在手持壳体内的马达。传感器设置在用于感测邻近组织的血液氧含量的系统的器具的头部内。
授权给Byrne等人的美国专利5395033描述了一种具有一对爪的内窥镜式的手术器具。永久磁体设置在一个爪的远端中，并且磁阻传感器设置在另一爪的远端中。磁体在爪之间产生磁场，并且传感器测量在磁场中的变化，以便确定爪之间的距离。
授权给Tsuruta等人的美国专利5467911描述了一种用于纤维切断和固定身体组织的手术装置。该器具包括操作部段和可拆卸地装接到该操作部段上的插入部段。
授权给Hooven的美国专利5518163、5518164、5667517描述了一种内窥镜式的手术系统，其包括设置在手柄部分中的马达。用来感测邻近组织的血液氧含量的感测部件设置在该器具的头部中。触点也设置在该器具的头部中。当该系统的起动螺母朝向前移动到头部中以驱动并形成设置在其中的手术切断件，该起动螺母与触点接合，由此使得马达反向，以使起动螺母撤回。
授权给Young等人的美国专利5653374和授权给Alesi等人的美国专利5779130以及授权给Viola等人的美国专利5954259描述了一种整装的电动手术设备，其包括设置在手持器具体内的马达组件和电源。
以上所述的这些器具和系统存在许多缺点。例如，在几种上述的器具和系统中，马达设置在器具的手柄内。由于尺寸上的原因，这些马达通常只能提供有限的扭矩。在上述的器具和系统中，电池设置在手柄内以便向马达供电。然而，这些电池系统只能向马达提供有限的电力，这进一步地限制了由马达提供的扭矩输出。
此外，精确地确保上述的器具和系统的操作部件的位置通常是不可能的。
上述的器具和系统的另一优点在于，这些上述的器具和系统通常需要手动操纵和操作。当马达设置在这些器具的手柄中时，对于操作者来说手动操纵和操作是困难的且不方便的。
因此，本发明的一目的在于提供一种电动机械式手术装置，其中马达系统设置成远离该手术装置。
本发明的另一目的在于提供一种电动机械式手术装置，该手术装置可由遥控单元来操作。
本发明的又一目的在于提供一种电动机械式手术装置，其中该手术装置的部件的相对位置可精确地确定。
本发明的再一目的在于提供一种电动机械式手术装置，该手术装置包括多个操作程序或算法。每一操作程序或算法对应于相应的手术装置或可装接到该电动机械式手术装置上的装接件。
发明内容
通过提供一种本申请所述的电动机械式手术装置可最有效地实现本发明的以上的和其它的有利目的和优点。在一个示例实施例中，电动机械式手术装置包括：壳体，从该壳体延伸的细长轴，该细长轴的远端可拆卸地联接到手术器具上；至少两个设置在该细长轴内的可轴向旋转的驱动轴，每一该驱动轴的远端构造成与该手术器具联接；构造成控制该细长轴的该远端转向的转向线缆组件；以及设置在该壳体内的马达系统，该马达系统构造成以便驱动该驱动轴和该转向线缆组件。
在另一实施例中，该电动机械式手术装置包括控制系统和遥控单元，该遥控单元构造成与该控制系统通讯，以便借助该控制系统来控制该马达系统。遥控单元可包括有线连接的遥控单元和/或无线连接的遥控单元。
在又一实施例中，该电动机械式手术装置包括构造成检测该驱动轴旋转的传感器。该控制系统构造成基于该驱动轴被检测出的旋转来确定该手术器具的部件的位置。
在再一实施例中，该电动机械式手术装置包括构造成存储多个操作程序或算法的第一储存器，每一操作程序或算法对应于相应类型的手术器具。该控制系统构造成以便检测装接到该电动机械式手术装置上的该类型的手术器具，并且选择或读取对应于该装接的手术器具的操作程序或算法。
附图说明
图1示出了依据本发明的实施例的电动机械式手术装置10的透视图；
图2示出了图1所示的柔性轴的部分截取的侧视图；
图3是沿图2所示的线3-3截取的柔性轴的截面图；
图4示出了第一联接器的后端视图；
图5其示出了柔性轴的第二联接器前端视图；
图6示出了马达的一个可行的布置；
图7示出了电动机械式手术装置10的示意图；
图8是编码器106、108的示意图；
图9a示出了该圆形手术纤维切断器装接件的第一实施例的截面图；
图9b示出了该圆形手术纤维切断器装接件的第二实施例的截面图；
图9c示出了该圆形手术纤维切断器装接件的第二实施例的截面；
图10示意地示出了存储器单元；
图11示出了无线RCU的示意图；
图12示出了有线RCU的示意图；
图13示出了依据本发明的主操作程序的第一实施例的流程图；
图14a-14d示出了对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250特定的起动程序的第一实施例的流程图；
图15a和15b示出了对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250特定的夹持程序的第一实施例的流程图；
图16示出了对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250特定的松开夹持程序的第一实施例的流程图；
图17a-17d示出了用于操作图1所示的电动机械式手术装置的主操作程序的第二实施例的流程图；
图18a和18b示出了用于操作图1所示的电动机械式手术装置的自检程序的流程图；
图19a-19e示出了用于操作图1所示的电动机械式手术装置的现场检测操作程序的流程图；
图20a-20c示出了用于操作如图9a-c所示的圆形手术纤维切断器装接件250的主操作程序的流程图；
图21a-21d示出了如图9a-c所示的圆形手术纤维切断器装接件的起动程序的第二实施例的流程图；
图22a-22b示出了如图9a-c所示的圆形手术纤维切断器装接件的夹持程序的第二实施例的流程图；和
图23a-23b示出了如图9a-c所示的圆形手术纤维切断器装接件的松开夹持程序的第二实施例的流程图。
具体实施方式
本领域的普通技术人员可通过阅读以下的具体实施方式并结合参照附图1-23b来理解本发明。在所有的附图中独立的附图标记表示相同或相似的部件。
参照图1，其示出了依据本发明的实施例的电动机械式手术装置10的透视图。示例性的电动机械式手术装置10可包括例如远程电源控制台12，其包括具有前面板15的壳体14。其上面安装了以下将详细描述的显示设备16和指示器18a、18b。柔性轴20从壳体14伸出并且通过第一联接器22可拆卸地固定到其上。柔性轴20的远端24可包括第二联接器26，其用于可拆卸地将手术器具和/或装接件固定到柔性轴20的远端24上。手术器具或装接件可以是例如手术纤维切断器、手术切割器、手术纤维切断器-切割器、直线手术纤维切断器、直线手术纤维切断器-切割器、圆形手术纤维切断器、圆形手术纤维切断器-切割器、手术夹施加器、手术夹结扎器、手术夹紧装置、脉管扩张装置、内腔扩张装置、解剖刀、液体传输装置或者其它类型的医疗器具。这些医疗器具的某些在如下的专利和专利申请中被描述，例如，美国专利序号09/324,451的名为“A Stapling Device for Use with anElectromechanical Driver Device for Use with Anastomosing，Stapling，and Resecting Instruments”，美国专利申请序号09/324,452，名为“Electromechanical Driver Device for Use withAnastomosing，Stapling and Resecting Instruments”，美国专利申请序号09/351,534的名为“Automated Surgical StaplingSystem”，美国专利申请序号09/510,926的名为“A Vessel and LumenExpander Attachment for Use with an Electromechanical DriverDevice”，美国专利申请序号09/510,927名为“ElectromechanicalDriver and Remote Surgical Instruments Attachment HavingComputer Assisted Control Capabilities”，美国专利申请序号09/510,931名为“A Tissue Stapling Attachment for Use with anElectromechanical Driver Device”，美国专利申请序号09/510,932名为“A Fluid Deliver Mechanism for Use with Anastomosing，Stapling，and Resecting Instruments”，美国专利申请序号09/510,933名为“A Fluid Delivery Device for Use withAnastomosing，Stapling，and Resecting Instruments”，所有的这些申请都被特意地在此引入供参考。
参照图2，其示出了柔性轴20的部分截取的侧视图。依据一个实施例，柔性轴20包括管状护套28，其包括涂层和其它密封组件，以便在其内通道40和外界环境之间提供流体密封的密封件。护套28可由与组织相容的的无菌弹性体材料制成。护套28也可由能经受住压热器作用的材料制成，第一可旋转的驱动轴30、第二可旋转的驱动轴32、第一转向线缆34、第二转向线缆35、第三转向线缆36、第四转向线缆37、和数据传输线缆38设置在柔性轴20的内通道40内并沿其整个长度延伸。图3是沿图2所示的线3-3截取的柔性轴20的截面图，并且进一步示出了多个线缆30、32、34、35、36、37、38。转向线缆34、35、36、37的每一个远端固定到柔性轴20的远端24上。多个线缆30、32、34、35、36、37、38中的每一个容纳在相应的护套内。
第一可旋转的驱动轴30和第二可旋转的驱动轴32例如可构造成高柔性驱动轴，例如编织的或螺旋状的驱动线缆。应当理解，这种高柔性的驱动线缆具有有限的扭矩传递特性和能力。应当理解，例如图9a所示的圆形手术切断器装接件250和图9b和9c所示的圆形手术切断器装接件2250以及以下描述的手术器具或其它可拆卸地装接到柔性轴29上的装接件与由驱动轴30、32传递的扭矩相比需要更高的扭矩输入。驱动轴30、32由此构造成传递高速的低扭矩，通过传动组件将高速的低扭矩转变成低速的高扭矩，该传动组件设置在驱动柔性轴20的远端和/或近端，在手术器具或装接件中和/或在远程电源控制台12中。应当理解，这种传动组件可在壳体14中的马达和可拆卸地装接到柔性轴20上的手术器具或其它装接件之间沿动力系设置在任何适当的位置处。这种传动组件可包括例如直齿轮组件、行星齿轮组组件、调谐齿轮组件、摆线齿轮组件、外摆线齿轮组件等。图9b和9c示出了具有用于将高速的低扭矩转变成低速的高扭矩的传动组件的圆形手术切断器装接件2250的实施例，以下将进行描述。
现参照图4，示出了第一联接器22的后端视图。第一联接器22包括第一连接器44、第二连接器48、第三连接器52、第四连接器56，每一连接器可旋转地固定到第一联接器22上。连接器44、48、52、56中的每一个包括对应的凹部46、50、54、58。如图4所示，每一凹部46、50、54、58可以是六边形的。然而，应当理解凹部46、50、54、58可以是其它任何形状和结构，以便非旋转地联接并刚性地使连接器44、48、52、56装接到容纳在壳体12内的马达组件的对应驱动轴上，这将在下面详细描述。应当理解，互补的突出部设置在马达组件的对应驱动轴上，由此如下所述地驱动柔性轴20的驱动元件。还应当理解，凹部设置在驱动轴上，而互补的突出部设置在连接器44、48、52、56。可设置任何其它的构造成非旋转地并可松释地将连接器44、48、52、56与马达组件的驱动轴联接的联接组件。
连接器44、48、52、56中的一个非旋转地固定到第一驱动轴30上，连接器44、48、52、56中的另一个非旋转地固定到第二驱动轴32上。连接器44、48、52、56中的其余两个与传动元件接合，其构造成将拉力施加到转向线缆34、35、36、37上由此使得柔性轴20的远端24转向。数据传输线缆38与数据连接器60电连接并逻辑上连接。数据连接器60包括例如电触点，其对应于并在数量上等于在数据线缆38内包含的独立导线的数量。第一联接器22包括键结构42，其适当地使得第一联接器22朝向设置在壳体12上的匹配且互补的联接组件。这种键结构42可设置在第一联接器22和壳体12上的匹配且互补的联接组件中的任意一个或两个上。第一联接器22包括快速连接式连接器，其使用了例如简单推入动作以使第一联接器22与壳体12接合。密封件设置成与多个连接器44、48、52、56、60中的任一个结合，以便在第一联接器22的内部与外界环境之间提供流体密封的密封件。
现参照图5，其示出了柔性轴20的第二联接器26。第二联接器26包括第一连接器66和第二连接器68，每一连接器可旋转地固定到第二联接器26上并且每一连接器非旋转地固定到第一和第二驱动轴30、32中的相应一个轴的远端上。快速连接式装配件64可以是例如旋转快速连接式装配件、卡口式装配件等。键结构74设置在第二联接器26上，以便适当地对准装接到第二联接器26上的手术器具或装接件。用于适当地对准装接到柔性轴20上的手术器具或装接件的键结构或其它组件可设置在第二联接器26和手术器具或装接件中的任一个或两个上。此外，快速连接式装配件可设置在手术器具或装接件上。具有电触点72的数据连接器70也设置在第二联接器26中。第二联接器26的数据连接器70类似于第一联接器22的数据连接器60，该数据连接器70包括电连接并逻辑连接到数据传输线缆38的对应导线和数据连接器60的触点62上的电触点72。密封件设置成与连接器66、68、70中的任一个结合，以便在第二联接器26的内部与外界环境之间提供流体密封的密封件。
电动机械式驱动元件设置在远程电源控制台12内，该驱动元件构造成以便驱动驱动轴30、32和转向线缆34、35、36、37，由此操作该电动机械式手术装置10和装接到第二联接器26上的手术器具或装接件。在图6所示的示例性实施例中，五个电动马达76、80、84、90、96均通过电源来操作，它们设置在远程电源控制台12中。然而，应当理解，可设置任何适当数量的马达，并且马达可通过电池电源、线路电流、直流电源、电子控制的直流电源等来操作。还应当理解，马达可连接到直流电源上，该电源又连接到线路电流上，并向马达提供操作电流。
图6示出了马达的一个可行的布置。当第一联接器22和柔性轴20与壳体14接合时，第一马达76的输出轴78与第一联接器22的第一连接器44接合，由此驱动第一驱动轴30和第二联接器26的第一连接器66。相似地，当第一联接器22和柔性轴20与壳体14接合时，第二马达80的输出轴82与第一联接器22的第二连接器48接合，由此驱动第二驱动轴32和第二联接器26的第二连接器68。当第一联接器22和柔性轴20与壳体14接合时，第三马达84的输出轴86与第一联接器22的第三连接器52接合，由此借助第一滑轮组件88来驱动第一和第二转向线缆34、35。当第一联接器22和柔性轴20与壳体14接合时，第四马达90的输出轴92与第一联接器22的第四连接器56接合，由此借助第二滑轮组件94来驱动第三和第四转向线缆36、37。第三和第四马达84、90可固定到滑架100上，该滑架借助第五马达96的输出轴98选择性地在第一位置和第二位置之间移动，以便使得第三和第四马达84、90选择性地与对应的滑轮组件88、94接合或脱离接合，由此使得柔性轴20按需要地张紧和可转向或者具有柔性。应当理解，可使用其它机械、电动或电动机械式的机构，以便选择性地使得转向机构接合或脱离接合。所述的马达的布置和构形例如在美国专利序列号No.09/510923名称为“A CarrigeAssembly for Controlling a Steering Wire Mechanism Within aFlexible Shaft”中进行了描述，其的内容特意地在此全部引入作为参考。
应当理解，马达76、80、84、90、96中的任一个或多个马达可以是高速/低扭矩马达或低速/高扭矩马达。如上所述，第一可旋转驱动轴30和第二可旋转驱动轴32可构造成传递高速和低扭矩。因此，第一马达76和第二马达80可构造成高速/低扭矩的马达。或者，第一马达76和第二马达80可构造成低速/高扭矩的马达，其带有设置在第一马达76和第二马达80与第一可旋转驱动轴30和第二可旋转驱动轴32中的对应一个轴之间的扭矩减小/速度增大的传动组件。这种扭矩减小/速度增大的传动组件可包括例如直齿轮组件、行星齿轮组组件、调谐齿轮组件、摆线齿轮组件、外摆线齿轮组件等。应当理解，任何的此类的传动组件可设置在远程电源控制台12内或在柔性轴20的近端，例如在第一联接器22中。应当理解，该传动组件设置在第一可旋转驱动轴30和/或第二可旋转驱动轴32的远端和/近端处，以便防止其缠绕和破裂。
参照图7，其示出了电动机械式手术装置10的示意图。控制器122设置在远程电源控制台的壳体14中，且构造成控制电动机械式手术装置10以及装接在柔性轴20上的任何手术器具或装接件的功能和操作。设置存储器单元130，并且该存储器单元130可包括存储器装置，如ROM(只读存储器)部件132和/或RAM(随机存取存储器)部件134。ROM部件132通过线136与控制器122在电和逻辑方面上通信。RAM部件134通过线138与控制器122在电和逻辑方面上通信。RAM部件134可包括任何类型的随机存取存储器，例如，磁存储装置、光存储装置、磁光存储装置、电存储装置等。类似地，ROM部件132可包括任何类型的只读存储器，例如，可拆卸存储装置，如PC卡或PCMCIA类型的装置。应当理解，ROM组件132和RAM组件134可形成为单个单元或者单独的单元，ROM组件132和RAM组件134可设置成PC卡或PCMCIA类型的装置的形式。控制器122还连接到壳体14的前面板15上，并且尤其是经由线154连接到显示装置16上且经由相应的线156、158连接到指示器18a、18b上。线116、118、124、126、128将控制器122分别地电连接并逻辑连接到第一、第二、第三、第四、第五马达76、80、84、90、96。有线连接的遥控单元(“RCU”)150可以通过线150电连接地和逻辑地连接到控制器122。还可设置无线连接的遥控单元(“RCU”)148，并且该遥控单元(“RCU”)可通过无线电线路160与经由线144连接到收发器140的接收/发送单元146通信。收发器140可通过线142电连接地和逻辑地连接到控制器122。无线电线路160可以是光链路，例如红外线链路、无线电链路、或其它任何形式的无线通讯链路。
开关装置186可以是例如一排DIP开关，其经由线188连接到控制器122上。开关装置186可用于例如选择在显示装置16上显示的提示和信息使用的多种语言中的一种。该提示和信息例如是关于电动机械式手术装置10和/或装接到其上的任何手术器具或装接件的操作和/或状态。
依据本发明的实施例，第一编码器106设置在第二联接器26内并构造成根据和依据第一驱动轴30的旋转而输出一信号。第二编码器108也设置在第二联接器26内并构造成根据和依据第二驱动轴32的旋转而输出一信号。由每一编码器106、108输出的信号代表相应驱动轴30、32的旋转以及其旋转方向。这种编码器106、108可以是例如霍耳效应器件、光学器件等。尽管所述的编码器106、108设置在第二联接器26内，但是编码器106、108可设置在马达系统和手术器具或装接件之间的任何位置处。应当理解，在第二联接器26内或在柔性轴20的近端处设置编码器106、108使得可对驱动轴的旋转进行准确地确定。如果编码器106、108设置在柔性轴20的近端，则第一和第二可旋转的驱动轴30、32的缠绕可导致测量错误。
图8是编码器106、108的示意图，其包括霍耳效应器件。具有北磁极242和南磁极244的磁体240非旋转地安装在驱动轴30、32上。编码器106、108还包括第一传感器246和第二传感器248，它们相对于驱动轴30、32的纵向轴线或旋转轴线成间隔90度地设置。传感器246、248的输出是持续的，并且作为在传感器的方向范围中的磁场极性的变化的函数而改变其状态。因此，基于来自编码器106、108的输出信号，驱动轴30、32的角度位置可在四分之一转内被确定，并且可确定驱动轴30、32的旋转方向。每一编码器106、108的输出经由数据传输线缆38的相应线110、112传输给控制器122。控制器122通过基于来自编码器106、108的输出信号可跟踪驱动轴30、32的角度位置和旋转方向，由此可确定连接到电动机械式手术装置10上的手术器具或装接件的部件的位置和/或状态。也就是说，通过对驱动轴30、32的旋转圈进行记数，控制器122可确定连接到电动机械式手术装置10上的手术器具或装接件的部件的位置和/或状态。
例如，在圆形手术纤维切断器装接件250中，例如在图9a所示的截面中，该圆形手术纤维切断器装接件250包括适于在尺寸和结构上与柔性轴20的第二联接器26配合的联接器260，以便可拆卸地将圆形手术纤维切断器装接件250装接到其上。圆形手术纤维切断器装接件250包括砧部分254，其具有安装在砧杆258的远端上的砧256。砧杆258通过砧驱动轴262的操作可延伸出来和退回，该砧驱动轴可旋转地固定在圆形手术纤维切断器装接件250的主体部分252内。砧驱动轴262的近端包括第一连接器268，其适于在尺寸和结构上与第二联接器26的第一连接器66联接。圆形手术纤维切断器装接件250还包括纤维切断器驱动器/切割器264，其由切断器驱动器/切割器的驱动轴266的旋转来驱动。切断器驱动器/切割器的驱动轴266的近端包括第二连接器270，其在尺寸和结构上与第二联接器26的第二连接器68联接。因此，在图9a所示的圆形手术纤维切断器装接件250中，砧256的伸出和退回由第一马达76的操作来实现，该纤维切断器驱动器/切割器264的伸出和退回由第二马达80的操作来实现。砧驱动轴262的节距和纤维切断器驱动器/切割器驱动轴266的节距是预定的并且是已知量。即，砧256和纤维切断器驱动器/切割器264的前进距离是相应驱动轴30、32的旋转的函数并可基于相应驱动轴30、32的旋转来确定。通过在一时刻确定砧256和纤维切断器驱动器/切割器264在一点的绝对位置，基于来自编码器106、108的输出信号和砧驱动轴262和纤维切断器驱动器/切割器的驱动轴266的已知节距，砧256和纤维切断器驱动器/切割器264的相对位移可用于确定砧256和纤维切断器驱动器/切割器264在其后所有时刻的绝对位置。当圆形手术纤维切断器装接件250首次联接到柔性轴20上时，砧256和纤维切断器驱动器/切割器264的绝对位置是可以固定的并确定的。或者，砧256和纤维切断器驱动器/切割器264相对于例如主体部分252的相对位置可基于来自编码器106、108的输出信号来确定。
圆形手术纤维切断器装接件250还包括数据连接器272，其适于在尺寸和结构上与第二联接器26的连接器70电连接和逻辑连接。在实施例中，数据连接器272包括在数量上等于连接器70的导线72的数量的触点(未示出)。存储器单元174容纳在圆形手术纤维切断器装接件250中，其与数据连接器272电连接和逻辑连接。存储器单元174的形式可以是EEPROM(电可擦可编程只读存储器)、EPROM(可擦可编程只读存储器)等，并且可例如容纳在圆形手术纤维切断器装接件250的主体部分252中。
图9b示出了该圆形手术纤维切断器装接件2250的第二实施例的截面。圆形手术纤维切断器装接件2250包括适于在尺寸和结构上与柔性轴20的第二联接器26配合的联接器2260，以便可拆卸地将圆形手术纤维切断器装接件2250装接到其上。圆形手术纤维切断器装接件2250包括砧部分2254，其具有安装在砧杆2258的远端上的砧2256。砧杆2258可拆卸地固定到套针2274上。砧杆2258通过砧驱动轴2262的操作可延伸出来和退回，该砧驱动轴可旋转地固定在圆形手术纤维切断器装接件2250的主体部分2252内。砧驱动轴2262具有外螺纹，套针2274在其近端2276处具有内螺纹，因此砧驱动轴2262的旋转可使得砧驱动轴2262伸出和退回。砧驱动轴2262的近端包括第一连接器2268，其适于在尺寸和结构上与第二联接器26的第一连接器66联接。圆形手术纤维切断器装接件2250还包括纤维切断器驱动器/切割器2264，其由切断器驱动器/切割器的驱动轴2266的旋转来驱动。切断器驱动器/切割器的驱动轴2266的近端包括第二连接器2270，其适于在尺寸和结构上与第二联接器26的第二连接器68联接。传动组件2278设置在切断器驱动器/切割器的驱动轴2266和纤维切断器驱动器/切割器2264之间。传动组件2278可包括例如直齿轮组件、行星齿轮组组件、调谐齿轮组件、摆线齿轮组件、外摆线齿轮组件等，其构造成将由第二旋转驱动轴32传递的高速/低扭矩转变成低速/高扭矩，以便射出并形成纤维切断，以下将描述。图9c是传动组件2278的分解图，该传动组件2278包括行星齿轮组件，即四套行星齿轮2280a、2280b、2280c、2280d。圆形手术纤维切断器装接件2250的第二实施例的操作类似于以上所述的圆形手术纤维切断器装接件250的第一实施例的操作。
图10示意地示出了存储器单元174。如图10所示，数据连接器272包括触点，每一触点经由对应的线278电连接并逻辑连接到存储器单元174上。存储器单元174构造成可存储例如序列号数据180、装接件类型识别符(ID)数据182、以及使用数据184。存储器单元174可额外地存储其它数据。序列号数据180和识别(ID)数据182可构造成只读数据。在实施例中，序列号数据180是识别特殊的手术器具或装接件的独特数据，而ID数据182是识别装接件的类型(例如圆形手术纤维切断器装接件，线形手术纤维切断器装接件等)的数据。使用数据184代表特别装接件的使用，例如砧256和圆形手术纤维切断器装接件250推进的次数或圆形手术纤维切断器装接件250的纤维切断器驱动器/切割器264推进或起动的次数。
应当理解，每一类型的装接到柔性轴20的远端24上的手术器具或装接件可设计成并构造成单次使用或多次使用。手术器具或装接件还可设计成并构造成使用预定的次数。因此，使用数据184可用于确定手术器具或装接件是否已经使用以及手术器具或装接件的使用次数是否超过允许使用的最大次数。如上所述，在超过允许使用的最大次数之后试图使用手术器具或装接件将产生ERROR(错误)状况。
应当理解，图9a所示的圆形手术纤维切断器装接件250仅仅是与电动机械式手术装置10结合使用手术装接件的示例。还应当理解，可使用其它任何类型的(如上所列举的)手术器具或装接件与电动机械式手术装置10结合使用。在本发明的实施例中，无论手术器具或装接件的特殊类型如何，手术器具或装接件包括联接元件268、270、272，这是手术器具或装接件以及存储器单元174的适当操作所必需的。尽管在此所述的驱动轴和马达实现了圆形手术纤维切断器装接件250的特殊功能，但是应当理解，驱动轴和马达可实现其它类型的手术器具和装接件的同一或其它的功能。
再参照图7，依据本发明的实施例，控制器122构造成当手术器具或装接件首次连接到柔性轴20上时可从该手术器具或装接件的存储器单元174中读取ID数据182。该存储器单元174经由数据传输线缆38的线120电连接并逻辑连接到控制器122上。基于读取的ID数据182，控制器122构造成可从存储器单元130中读取或选择对应于连接到柔性轴20上的手术器具或装接件的类型的操作程序或算法。该存储器单元130构造成存储用于每一种可用类型的手术器具或装接件的操作程序或算法，依据从所装接的手术器具或装接件的存储器单元174中读取的ID数据182，该控制器122可从存储器单元130中选择和/或读取操作程序或算法。如上所述，存储器单元130可包括可拆卸的ROM部件132和/或RAM部件134。因此，存储在存储器单元130中的操作程序或算法可按需要进行更新、添加、删除、改进、或进行其它方式的修改。存储在存储器单元130中的操作程序或算法可基于例如使用者的特殊要求进行定制。例如键盘、鼠标、指点器、触摸屏等数据输入装置可经由例如数据连接器端口连接到存储器单元130上，以便有助于操作程序或算法的定制。另外或额外的是，操作程序或算法可从电动机械式手术装置10中遥控地定制并预编程到存储器单元130中。应当理解，序列号数据180和/或使用数据184还可使用确定多个操作程序或算法中的哪一个操作程序或算法从存储器单元130中被读取或选择。还应当理解，或者操作程序或算法可存储在手术器具或装接件的存储器单元174中，并且经由数据传输线缆38传输到控制器122。一旦适当的操作程序或算法由控制器122读取或选择，或传输到控制器，依据由使用者经由有线RCU150和/或无线RCU148执行的操作，控制器122可执行操作程序或算法。如上所述，控制器122经由相应线116、118、124、126、128电连接并逻辑连接到第一、第二、第三、第四、第五马达76、80、84、90、96上，并且依据所读取、选择、或经由相应线116、118、124、126、128传输的操作程序或算法来控制这些马达76、80、84、90、96。
参照图11，其示出了无线RCU148的示意图。无线RCU(遥控单元)148包括转向控制器300，其具有布置成四向摇杆310的多个开关302、304、306、308。开关302、304的操作借助摇杆310通过第四马达92来控制第三和第四转向线缆36、37。应当理解，摇杆310和开关302、304、306、308布置成以便开关302、304的操作使得柔性轴20沿北-南方向转向，并且开关306、308的操作使得柔性轴20沿北-南方向转向。在此参照的北、南、东、西是相对的坐标系统。或者，可设置数字操纵杆、模拟操纵杆等以代替摇杆310和开关302、304、306、308。可使用电位计或任何其它形式促动器来代替开关302、304、306、308。
无线RCU148还包括转向接合/脱开开关312，该开关的操作控制第五马达96的操作，以便选择性使得转向机构接合和脱离接合。无线RCU148还包括双向摇杆314，其具有由此可操作的第一和第二开关316、318。这些开关316、318的操作控制该电动机械式手术装置10和任何手术器具或装接件的特定功能，手术器具或装接件依据对应于装接的任何手术器具或装接件的操作程序或算法装接到柔性轴20上。例如，如果该手术器具是如图9a所示和以上所述的圆形手术纤维切断器装接件250，双向摇杆314的操作可控制砧256的推进和退回。无线RCU148还设置有另一开关320，该开关的操作还可控制该电动机械式手术装置10和任何手术器具或装接件的操作，手术器具或装接件依据对应于装接的任何手术器具或装接件的操作程序或算法装接到柔性轴20上。例如，当圆形手术纤维切断器装接件250装接到柔性轴20上时，开关320的操作启动纤维切断器驱动器/切割器264的推进或起动序列。
无线RCU148包括控制器322，其经由线324与开关302、304、306、308、经由线326与开关316、318、经由线328与开关312、经由线330与开关320电连接并逻辑连接。无线RCU148可包括指示器18a’和18b’，其对应于前面板15的指示器18a和18b；显示装置16’，其对应于前面板15的显示装置16。如果需要，指示器18a’和18b’可经由相应线332、334与控制器322电连接并逻辑连接，并且显示装置16’经由线336与控制器322电连接并逻辑连接。控制器322经由线340与收发器338电连接并逻辑连接，并且收发器338经由线344与接收器/发送器342电连接并逻辑连接。未示出的电源例如可设置在无线RCU148中，以便为其提供电力。因此，无线RCU148可用于经由无线电链路160来控制电动机械式手术装置10和装接到柔性轴20上的任何手术器具或装接件的操作。
无线RCU148可包括经由线348连接到控制器322上的开关346。开关346的操作将数据信号经由无线电链路160传输给接收器/发送器146。数据信号包括专用识别无线RCU148的识别数据。该识别数据由控制器122使用，以便防止电动机械式手术装置10的未授权的操作，并且防止由其它无线RCU引起的电动机械式手术装置10操作的干扰。在无线RCU148与电动机械式手术装置10之间的每一随后的通信包括识别数据。因此控制器122可辨别无线RCU并且由此仅允许单个可识别的无线RCU148来控制电动机械式手术装置10和装接到柔性轴20上的任何手术器具或装接件的操作。
基于装接到柔性轴20上的手术器具或装接件的部件位置，依据来自编码器106、108的输出信号进行确定，控制器122可选择性地使得由对应于装接的手术器具或装接件的操作程序或算法限定的电动机械式手术装置10的功能起作用或不起作用。例如，如果该手术器具或装接件是如图9a所示的圆形手术纤维切断器装接件250，由开关320的操作来控制的起动功能不起作用，除非确定砧256与主体部分252之间的空间或间隙在可接受的范围内。如上所述，基于来自编码器106、108的输出信号来确定砧256与主体部分252之间的空间或间隙。应当理解，开关320本身保持可操作，但是控制器122不能实施对应的功能，除非确定该空间或间隙在可接受的范围内。
参照图12，其示出了有线RCU150的示意图。在该实施例中，有线RCU(遥控单元)150包括与无线RCU148大致相同的控制元件，并且省去了这些元件的描述。在图12中相同的部件由标记来表示。应当理解，电动机械式手术装置10和装接到柔性轴20上的任何手术器具或装接件的功能可由有线RCU150和/或无线RCU148来控制。例如在电池故障的情况下，在无线RCU148中，有线RCU150可用于控制电动机械式手术装置10和装接到柔性轴20上的任何手术器具或装接件的功能。
如上所述，壳体14的前面板15包括指示器18a和18b以及显示装置16。显示装置16可包括字母数字显示装置，例如LCD显示装置。显示装置16还可包括声频输出装置，例如扬声器、蜂鸣器等。依据对应于装接到柔性轴20上的任何手术器具或装接件的操作程序或算法，显示装置16可由控制器122来操作和控制。如果没有装接手术器具或装接件，控制器122可读取或选择缺省的操作程序或算法，或传输到控制器122，由此控制显示装置16的操作以及电动机械式手术装置10的其它方面和功能。如果如图9a所示的圆形手术纤维切断器装接件250装接到柔性轴20上，显示装置16可显示例如代表如上所述的基于来自编码器106、108的输出信号来确定的砧256与主体部分252之间间隙的数据。
相似地，依据对应于装接到柔性轴20上的任何手术器具或装接件的操作程序或算法，指示器18a和18b可由控制器122来操作和控制。指示器18a和/或18b可包括声频输出装置，例如扬声器、蜂鸣器等，和/或视频输出装置，例如LED、灯、发光件等。如果如图9a所示的圆形手术纤维切断器装接件250装接到柔性轴20上，指示器18a可指示例如电动机械式手术装置10处于电源开的状态，并且指示器18b可指示例如如上所述的砧256与主体部分252之间间隙是否确定为处于可接受的范围内。应当理解，尽管仅描述了两个指示器18a和18b，但是可设置所需的任何数量的附加指示器。此外，应当理解，尽管仅描述了单个显示装置，但是可设置所需的任何数量的附加显示装置。
依据对应于装接到柔性轴20上的任何手术器具或装接件的操作程序或算法，有线RCU150的指示器18a’和18b’和显示装置16’以及无线RCU148的指示器18a”和18b”以及显示装置16”可由相应的控制器322、322’相似地操作和控制。
参照图13，其示出了依据本发明的主操作程序的第一实施例的流程图。该主操作程序在步骤1000处开始并进行到步骤1002，在该步骤中启动电动机械式手术装置10。步骤1002可包括启动步骤，例如存储器充值和启动、自检诊断等。在启动步骤1002之后，在步骤1004中确定是否存在手术器具或装接件(“DLU”)，即手术器具或装接件是否安装在柔性轴20的远端24上。如果在步骤1004中确定DLU不存在，则控制转移到回路1034。如果确定DLU存在，则操作程序进行到步骤1006，在其中确定FIRE键是否被按压。FIRE(起动)键在本文中指的是无线RCU148和/或有线RCU150的开关中的一个。更具体地说，FIRE键对应于RCU148的开关320和/或有线RCU150的开关320’。如果在步骤1006中确定了FIRE键被按压，则控制转移到在步骤1008中的程序A。程序A对于装接到柔性轴20上的任何DLU来说是特定的。程序A将在以下的图14a-d中详细描述。在步骤1008中执行程序A之后，控制转移到回路1034。
如果在步骤1006中确定了FIRE键没被按压，则在步骤1010中确定CLAMP键是否被按压。在本文中，CLAMP(夹持)键指的是无线RCU148和/或有线RCU150的开关中的一个。更具体地说，CLAMP键对应于RCU148的开关316和/或有线RCU150的开关316’。如果在步骤1010中确定了CLAMP键被按压，则控制转移到在步骤1012中的程序B。程序B对于装接到柔性轴20上的任何DLU来说是特定的。程序B将在以下的图15a-b中详细描述。在步骤1012中执行程序B之后，控制转移到回路1034。
如果在步骤1010中确定了CLAMP键没被按压，则在步骤1014中确定UNCLAMP(松开夹持)键是否被按压。在本文中，UNCLAMP键指的是无线RCU148和/或有线RCU150的开关中的一个。更具体地说，UNCLAMP键对应于RCU148的开关318和/或有线RCU150的开关318’。如果在步骤1014中确定了UNCLAMP键被按压，则控制转移到在步骤1016中的程序C。程序C对于装接到柔性轴20上的任何DLU来说是特定的。程序C将在以下的图16中详细描述。在步骤1016中执行程序C之后，控制转移到回路1034。
如果在步骤1014中确定了UNCLAMP键没被按压，则在步骤1018中确定一个或多个STEERING(转向)键是否被按压。在本文中，STEERING键指的是无线RCU148和/或有线RCU150的开关中的一个。更具体地说，STEERING键对应于RCU148的开关302、304、306、308和/或有线RCU150的开关302’、304’、306’、308’。如果在步骤1018中确定了一个或多个STEERING键被按压，则在步骤1020中执行相应转向马达的操作。转向马达对应于如上所述的第三马达84和第四马达92。在执行步骤1020之后，控制转移到回路1034。
如果在步骤1018中确定了没有STEERING键被按压，则在步骤1022中确定DISENGAGE(脱离接合)键是否被按压。在本文中，DISENGAGE键指的是无线RCU148和/或有线RCU150的开关中的一个。更具体地说，DISENGAGE键对应于RCU148的开关312和/或有线RCU150的开关312’。如果在步骤1022中确定了DISENGAGE键被按压，则在步骤1024中执行脱离接合的操作。在执行步骤1024之后，控制转移到回路1034。
如果在步骤1022中确定DISENGAGE键没被按压，则在步骤1026中执行IDLE(待机)程序。
在步骤1028中，确定是否到达主操作程序的操作末段。如果确定在步骤1028中没有到达主操作程序的末段，则控制转移到回路1034。然而，如果确定在步骤1028中到达了主操作程序的末段或终止了主操作程序，则在步骤1030中执行停机程序，并且主操作程序随后在步骤1032中终止。
应当理解，该主操作程序确定那些键以图13所示的顺序或以任何其它适当的顺序被按压。还应当理解，图13所示的主操作程序以及图14a-d、15a-b、16所示的程序是以基于信息、由事件驱动的、和/或轮询类型的软件应用来实现的。
参照图14a-d，其示出了对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250特定的起动程序的第一实施例的流程图。应当理解，图14a-d所示的第一程序代表图13所示的主操作程序的步骤1008的程序A，并且图14a-d所示的第一程序对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250是特定。应当理解，例如以上列举的其它手术器具或装接件可具有与它们相关的其它起动程序。
由步骤1008进行，在步骤1100中确定DLU即圆形手术纤维切断器装接件250是否已经完全打开。如上所述，基于由编码器106、108产生的信号来进行该确定。如果在步骤1100中确定该DLU没有完全打开，则在步骤1102中确定出错状态，DLU没有准备好起动。控制随后转移到步骤1120，在其中控制返回到图13所示的主操作程序中。
如果在步骤1100中确定该DLU已经完全打开，则在步骤1104中确定DLU是否完全夹持。如上所述，基于由编码器106、108产生的信号来进行该确定。如果在步骤1104中确定该DLU没有完全夹持，则在步骤1106中确定出错状态，DLU没有处于起动的可接受范围内。控制随后转移到步骤1120，在其中控制返回到图13所示的主操作程序中。
如果在步骤1104中确定该DLU已经完全夹持，则在步骤1108中确定DLU是否已经在先起动。如上所述，基于由编码器106、108产生的信号和/或使用数据184来进行该确定。如果在步骤1108中确定该DLU在先已经起动，则在步骤1110中确定出错状态，DLU已经被使用。控制随后转移到步骤1120，在其中控制返回到图13所示的主操作程序中。应当理解，在图13所示的主操作程序中可进行相似的使用确定，例如在启动步骤1002中或在DLU存在确定步骤1004中，作为确定步骤1108的替换和补充。
如果在步骤1108中确定该DLU没有在先起动，则在步骤1112中确定使用计数。如上所述该使用计数存储在使用数据184中。在步骤1112中多次尝试递减使用计数。然而，出现递减使用计数故障。在步骤1114中，确定该使用计数递减步骤1112是否失败。如果在步骤1114中确定使用计数递减失败，则在步骤1116中确定出错状态。随后，在步骤1118中执行等待回路，直到无线RCU148和/或有线RCU150的所有键被松释。在步骤1118中确定所有键被松释之后，控制转移到步骤1120，其后，控制返回到图13所示的主操作程序中。
如果在步骤1114中确定使用计数递减没有失败，则起动马达电流限定在步骤1122中设定。在本文中，如上所述该起动马达对应于第二马达80。该起动马达随后在步骤1124中起动，以便开始推进纤维切断器驱动器/切割器264。
参照图14b，定时器在步骤1126中设定。随后在步骤1128中确定对于起动操作经过的时间是否超过预定的门限。如果在步骤1128中确定超过起动时限，则该起动马达在步骤1130中停机，并且在步骤1132中确定出错状态。控制随后进行到步骤1136。然而，如果在步骤1128中确定起动时间没有超过起动时限，则在步骤1134中确定是否超过硬件当前限定。该硬件当前限定与该起动马达继续操作的阻力相关。超过硬件当前限定的状态表明了纤维切断操作已经成功完成。如果在步骤1134中确定没有超过硬件当前限定，则起动马达的操作继续，直到超过预定的起动时限或者超过硬件当前限定。在任一种情况下，控制随后进行到步骤1136。
步骤1136代表等待步骤，在其过程中，允许经过预定的等待时间。该等待时间允许电动机械式手术装置10和圆形手术纤维切断器装接件250的驱动和从动部件在进行到步骤1138之前重置，在步骤1138中该起动马达停机。
在步骤1138中该起动马达停机之后，在步骤1140中马达电流限定被设定为全范围，并且随后起动马达在步骤1142中被反向起动，使得纤维切断器驱动器/切割器264退回并使其返回到其初始位置。随后，一旦砧256与主体部分252之间的间隙超过可接受的范围，对应于IN-RANGE(在范围内)指示器的指示器18a和18b在步骤1144中关断。或者，当在步骤1142中马达反向起动时，该IN-RANGE(在范围内)指示器被关断。在IN-RANGE指示器在步骤1144中关断之后，定时器在步骤1146中重置。
参照图14c，在步骤1148中基于定时器在步骤1146中的重置，确定纤维切断器驱动器/切割器264完成退回的预定时限是否超时。如果在步骤1148中确定超过该预定时限，则在步骤1150中确定出错状态，即应在允许的预定时限内完成的退回操作失败。然而，如果在步骤1148中确定没有超过该预定时限，则在步骤1152中确定纤维切断器驱动器/切割器264的退回是否完成。如果在步骤1152中确定纤维切断器驱动器/切割器264的退回没有完成，则控制返回到步骤1148。继续进行纤维切断器驱动器/切割器264的退回，直到在步骤1148中确定预定时限超时或者在步骤1152确定经过完成退回。应当理解，在步骤1152中可基于由编码器106、108产生的信号来进行该确定。在确定纤维切断器驱动器/切割器264的退回已经完成(步骤1152)或者确定预定时限超时(步1148骤)之后，松开夹持马达的电流限定在步骤1154中被设定为全范围。在本文中，松开夹持马达对应于如上所述的第一马达76。
在步骤1156中，计算砧256的当前位置与砧256的最终松开夹持位置之间半程点。在步骤1158中将“假想”的目标点设定为预定设定点加预定偏置值，以确保松开夹持马达达到其最大电流或满电流，由此确保从松开夹持马达输出最大扭矩。在步骤1160中，开始该松开夹持马达的移动。在步骤1162中，设定定时器，并且在步骤1164中清除目标标记。
参照图14d，在步骤1166中确定砧256是否经过在步骤1156中确定的半程点。如果在步骤1166中确定砧256已经经过在步骤1156中确定的半程点，则在步骤1170中设定对于砧256的“真实”的最终目标位置，由此替代在步骤1158中设定的“假想”的最终目标点。控制随后转移到步骤1174。然而，如果在步骤1166中确定砧256没有经过在步骤1156中确定的半程点，则控制直接转移到步骤1174，绕过目标重置步骤1170。
在步骤1174中，确定砧256是否到达在步骤1170中设定的“真实”的最终目标。应当理解，砧256的位置可依据如上所述的由编码器106、108产生的信号来进行确定。如果在步骤1174中确定砧256到达其在步骤1170中设定的“真实”最终目标，则控制转移到步骤1180，以下将描述。然而，如果在步骤1174中确定砧256没有到达其“真实”最终目标，则在步骤1176中相对于在步骤1162中重置的定时器来确定预定时限是否经过超时。如果在步骤1176中确定该预定时限没有超时，则控制返回到步骤1166，并且松开夹持马达继续其操作以便进一步松开砧256。然而，如果在步骤1176中确定该预定时限超时，则在步骤1178中确定出错状态，即砧256在预定时限内移动到其“真实”最终目标。控制随后转移到步骤1180，其中转向机构脱离接合。在以上所述的电动机械式手术装置10是实施例中，转向机构包括如上所述的第五马达96和/或滑架100。在转向机构在步骤1180中脱离接合之后，在步骤1182中执行等待回路，直到无线RCU148和/或有线RCU150的所有键被松释。一旦所有键被松释，控制在步骤1184中返回到图13所示的主操作程序中。
参照图15a和15b，其示出了对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250特定的夹持程序的第一实施例的流程图。应当理解，图15a和15b所示的夹持程序代表图13所示的主操作程序的步骤1012的程序B，并且图15a和15b所示的夹持程序对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250是特定。应当理解，例如以上列举的其它手术器具或装接件可具有与它们相关的其它夹持程序。
由步骤1012进行，在步骤1200中确定是否设定DLU打开标记。如上所述，基于由编码器106、108产生的信号来进行该确定。如果在步骤1200中确定该DLU打开标记没有设定，则在步骤1202中确定出错状态，即DLU没有准备好夹持。随后在步骤1204中执行等待回路，并且一旦无线RCU148和/或有线RCU150的所有键被松释，控制在步骤1206中返回到图13所示的主操作程序中。
然而，如果在步骤1200中确定该DLU打开标记被设定，则在步骤1208中确定砧256与主体部分252之间的间隙大于预定门限G1，例如5mm。如上所述，可基于由编码器106、108产生的信号来进行该确定。如果砧256与主体部分252之间的间隙被确定成小于预定门限G1，则控制进行到步骤1220。然而，如果在步骤1208中砧256与主体部分252之间的间隙被确定成大于预定门限G1，则控制进行到步骤1210，在其中CLAMP(夹持)马达的速度和扭矩限定被设定成相应的最大值。在本文中，CLAMP(夹持)马达对应于如上所述的第一马达76。在步骤1212中重置定时器，并且执行步骤1214和步骤1218的控制回路，直到对于达到间隙小于该预定门限G1的预定时间段超时，或者该间隙被确定成小于预定门限G1。如果在步骤1214中确定该预定时间段超时，则在步骤1216中确定出错状态，即夹持操作被认为失败。在执行步骤1216之后，执行步骤1204，在步骤1204中执行等待回路，并且一旦无线RCU148和/或有线RCU150的所有键被松释，其后控制在步骤1206中返回到图13所示的主操作程序中。
如果在步骤1214中确定没有超过该预定时间段，则在步骤1218中确定是否完成这样的移动，即砧256移动到使得砧256与主体部分252之间的间隙小于预定门限G1的位置中。如果在步骤1218中没有完成该移动，夹持马达的操作继续进行，并且控制返回到步骤1214。然而，如果在步骤1218中确定完成了该移动，则控制进行到步骤1220。
在步骤1220中，对于夹持马达，设定一个低于最大速度设定的速度设定，并且对于夹持马达，设定一个低于最大扭矩限定的扭矩限定。其后，在步骤1222中，设定位置偏置，以便确保当砧256与主体部分252之间的该间隙接近该偏置值时，夹持马达输出最大扭矩。该偏置值可以是例如大约1.0mm，以便当该间隙大约等于1.0mm时夹持马达的满程扭矩输出。
参照图15b，控制进行到步骤1224，在该步骤中定时器被重置。在步骤1226中，砧256与主体部分252之间当前间隙的数值显示在显示装置16上。在步骤1228中确定砧256与主体部分252之间的间隙是否小于预定门限G2。如上所述，可基于由编码器106、108产生的信号来进行该确定。预定门限G2例如为2.0mm。如果在步骤1228中确定砧256与主体部分252之间的间隙小于预定门限G2，则控制进行到步骤1230，在该步骤中，IN-RANGE(在范围内)指示器被激活并且DLU就绪标记被设定。IN-RANGE指示器对应于指示器18a、18b，其中的任一个或两个可以是例如LED元件或其它声频或视频指示器。如果在步骤1228中确定砧256与主体部分252之间的间隙不小于预定门限G2，则控制进行到步骤1232，在该步骤中确定砧256与主体部分252之间的间隙是否小于或等于另一预定门限G3。如上所述，可基于由编码器106、108产生的信号来进行该确定。预定门限G3例如为1.0mm。如果在步骤1232中确定砧256与主体部分252之间的间隙小于或等于预定门限G3，则控制进行到步骤1238，如下所述。然而，如果在步骤1232中确定砧256与主体部分252之间的间隙大于预定门限G3，则在步骤1234中确定对于预定时限是否达到该夹持马达的电流限定。对于预定时限达到该夹持马达的电流限定表明了组织被完全地夹持在砧256与主体部分252之间。该预定时限例如为大约1.0秒。如果在步骤1234中确定对于预定时限已经达到该夹持马达的电流限定，则控制进行到步骤1238。然而，如果在步骤1234中确定对于预定时限没有达到该夹持马达的电流限定，则在步骤1236中确定CLAMP(夹持)键是否松释。如果在在步骤1236中确定夹持键没有松释，则控制返回到步骤1226。如果在步骤1236中确定夹持键已经松释，则控制进行到步骤1238。
在步骤1238中，夹持马达的操作被停止。其后，在步骤1240中，执行等待回路，并且一旦无线RCU148和/或有线RCU150的所有键被松释。在所有键被松释后，控制在步骤1242中返回到图13所示的主操作程序中。
参照图16，其示出了对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250特定的松开夹持程序的第一实施例的流程图。应当理解，图16所示的松开夹持程序代表图13所示的主操作程序的步骤1016的程序C，并且图16所示的松开夹持程序对于例如图9a所示的圆形手术纤维切断器装接件250或例如图9b和9c所示的圆形手术纤维切断器装接件2250是特定。应当理解，例如以上列举的其它手术器具或装接件可具有与它们相关的其它夹持程序。
由步骤1016进行，在步骤1300中对于松开夹持马达的扭矩限定被设定为其最大值。该松开夹持马达对应于如上所述的夹持马达。该松开夹持马达也可对应于如上所述的第一马达76。
在步骤1302中，对于砧256的目标位置设定为代表其完全松开夹持位置的数值。松开夹持马达的操作在步骤1304中起动。在步骤1306中，确定UNCLAMP(松开夹持)键是否已经松释。如果在步骤1306中确定松开夹持键已经松释，则控制进行到步骤1314。如果在步骤1306中确定松开夹持键没有松释，则在步骤1308中确定砧256与主体部分252之间的间隙是否大于或等于预定门限G4，该预定门限依据在步骤1302中设定的目标位置来限定。如上所述，可基于由编码器106、108产生的信号来进行该确定。如果在步骤1308中确定砧256与主体部分252之间的间隙大于或等于预定门限G4，则DLU打开标记在步骤1310中被设定。控制随后进行到步骤1312。如果在步骤1308中确定砧256与主体部分252之间的间隙小于预定门限G4，则在步骤1312中确定该松开夹持操作是否完成。即，确定是否到达在步骤1302中设定的对于砧256的目标位置。如果在步骤1312中确定松开夹持操作没有完成，则控制返回到步骤1306。如果在步骤1312中确定松开夹持操作已经完成，则松开夹持马达操作在步骤1314中被停止。控制随后在步骤1316中返回到图13所示的主操作程序中。
图17a-d示出了用于操作图1所示的电动机械式手术装置的主操作程序的第二实施例的流程图。图18a和18b示出了用于操作图1所示的电动机械式手术装置的自检程序的流程图。图19a-e示出了用于操作图1所示的电动机械式手术装置的现场检测操作程序的流程图。图20a-c示出了用于操作如图9a-c所示的圆形手术纤维切断器装接件250的主操作程序的流程图。图21a-d示出了如图9a-c所示的圆形手术纤维切断器装接件的起动程序的第二实施例的流程图。图22a-b示出了如图9a-c所示的圆形手术纤维切断器装接件的夹持程序的第二实施例的流程图。图23a-b示出了如图9a-c所示的圆形手术纤维切断器装接件的松开夹持程序的第二实施例的流程图。图17a-23b所示的操作程序是本领域普通技术人员容易理解的，并且在此不进行详细描述。
应当理解，相对于圆形手术纤维切断器装接件250、2250的如上所述的多个马达和开关元件的操作对于圆形手术纤维切断器装接件250或2250来说是特定。当其它手术器具或装接件装接到柔性轴20上时，该马达和/或开口可执行其它的功能。
应当理解，例如图9a所示的圆形手术纤维切断器装接件250或例如图9b所示的圆形手术纤维切断器装接件2250的手术器具或装接件可构造成在体外或体内装接到柔性轴20上。手术器具或装接件的体内装接可用于例如减小外伤并缩短恢复时间。例如，常规的线形切割装置和线形纤维切断器装置用于沿肠道执行功能端-端吻合处理。由于柔性轴20的长度、柔性、和可转向性，柔性轴20在没有装接任何手术器具或装接件的情况下可从嘴或直肠以最小外伤的方式插入到体内，例如胃肠道。应当理解，柔性轴20可经例如自然开口、切口、套管等进入体内。该柔性轴20随后可进一步插入体内并转向，如上所述，以便柔性轴20的远端24例如沿肠道传送到治疗位置。在柔性轴20的远端24传送到治疗位置之后，该手术器具或装接件可借助在原位的第二联接器26装接到柔性轴20上。该手术器具或装接件可经自然开口、切口、套管等插入体内以便装接到柔性轴20上。应当理解，柔性轴20可经第一开口进入体内，手术器具或装接件可经第二开口进入体内，该第一开口可与第二开口是同一开口或不同开口。
通过使用如此装接到柔性轴20上的手术器具或装接件，可执行端-端吻合处理，随后其上装接有手术器具或装接件的柔性轴20可从体内撤出。应当理解，手术器具或装接件的形状和结构使得在撤出过程中外伤最小化。此外，应当理解，柔性轴20可按如上所述的方式在撤出前变得更具柔性。
因此，可最有效地获得到本发明的上述多个目的和优点。本领域的普通技术人员应当理解，以上所述的实施例可在不脱离本发明的范围的情况下进行变型。尽管本发明在此仅描述并披露了单个实施例，但是应当理解，本发明决不限于此，而是由后附的权利要求来限定。

Claims (33)

1.一种包括手术器具的手术器具系统，该手术器具构造成便于完全插入到体内以便与电动机械式手术控制装置一起使用，其包括：
联接器，其构造成使该手术器具与电动机械式手术装置联接；
在该联接器内的可旋转的驱动轴，以便使得电动机械式手术装置操纵该手术器具；
检测该可旋转的驱动轴的旋转运动的传感器；和
容纳在该手术器具内的存储器单元，该存储器单元构造成存储代表与该手术器具相关的至少一个参数的数据，其包括代表使用该手术器具的使用数据，由该传感器检测到的所述旋转运动表现出该手术器具的使用；
其中，该联接器包括数据连接器，其构造成使该存储器单元与该电动机械式手术装置连接。
2.如权利要求1所述的手术器具系统，其特征在于，该手术装置包括：
马达组件，该马达组件构造成使得该至少一个可旋转的驱动轴从其近端旋转；并且
该手术器具系统包括第一传动组件，其设置在该可旋转驱动轴的远端处以便驱动该手术器具中的至少一个元件；
其中，该传动组件构造成将该可旋转驱动轴的高速旋转转变成以高扭矩驱动该至少一个从动元件。
3.如权利要求2所述的手术器具系统，其特征在于，该手术器具可装接到该可旋转驱动轴的该远端上，该手术器具包括该手术器具中的至少一个元件。
4.如权利要求3所述的手术器具系统，其特征在于，该第一传动组件设置在该手术器具中。
5.如权利要求3所述的手术器具系统，其特征在于，该手术器具包括圆形手术纤维切断器装接件。
6.如权利要求5所述的手术器具系统，其特征在于，该手术器具的该至少一个元件包括该圆形手术纤维切断器装接件的砧和该圆形手术纤维切断器装接件的纤维切断驱动器/切割器中的至少一个。
7.如权利要求2所述的手术器具系统，其特征在于，该至少一个可旋转的驱动轴至少包括第一可旋转驱动轴和第二可旋转驱动轴，该手术器具的该至少一个元件包括由该第一可旋转驱动轴驱动的第一元件和由该第二可旋转驱动轴驱动的第二元件，该传动组件包括第一传动系统和第二传动系统，第一传动系统构造成将该第一可旋转驱动轴的高速旋转转变成以高扭矩驱动该第一从动元件，第二传动系统构造成将该第二可旋转驱动轴的高速旋转转变成以高扭矩驱动该第二从动元件。
8.如权利要求7所述的手术器具系统，其特征在于，该马达组件包括构造成使该第一可旋转驱动轴旋转的第一马达和构造成使第二可旋转驱动轴旋转的第二马达。
9.如权利要求7所述的手术器具系统，其特征在于，该手术器具可拆卸地装接到该第一和第二可旋转驱动轴的远端上，并且该手术器具包括该第一和第二元件。
10.如权利要求9所述的手术器具系统，其特征在于，该第一元件包括砧，该第二元件包括纤维切断驱动器/切割器。
11.如权利要求2所述的手术器具系统，其特征在于，包括设置在该马达组件和该至少一个可旋转驱动轴之间的第二传动组件，该第二传动组件构造成将由马达组件传递的高扭矩转变成使得该至少一个可旋转驱动轴高速旋转。
12.如权利要求2所述的手术器具系统，其特征在于，该第一传动组件包括直齿轮组件、行星齿轮组组件、调谐齿轮组件、摆线齿轮组件、外摆线齿轮组件中的至少一种。
13.如权利要求11所述的手术器具系统，其特征在于，每一该第一传动组件和第二传动组件包括直齿轮组件、行星齿轮组组件、调谐齿轮组件、摆线齿轮组件、外摆线齿轮组件中的至少一种。
14.如权利要求1所述的手术器具系统，其特征在于，包括：
具有第一联接器的细长的柔性轴，该柔性轴包括可旋转的驱动轴；并且
其中，该手术器具包括第二联接器，该第二联接器与该第一联接器互补并构造成与该第一联接器联接；
其中，该细长的柔性轴构造成可经第一开口插入体内，并且该手术器具构造成经第二开口插入体内；和
其中，该细长的柔性轴构造成在该细长轴经该第一开口插入体内之后并且在该手术器具经该第一开口和该第二开口中的一个开口插入体内之后，借助第一联接器和第二联接器与该手术器具联接。
15.如权利要求14所述的手术器具系统，其特征在于，该第一开口包括自然开口、切口、套管中的至少一个。
16.如权利要求14所述的手术器具系统，其特征在于，该第二开口包括自然开口、切口、套管中的至少一个。
17.如权利要求14所述的手术器具系统，其特征在于，该第一开口和该第二开口中的每一个包括自然开口、切口、套管中的至少一个。
18.如权利要求14所述的手术器具系统，其特征在于，该第一开口不同于该第二开口。
19.如权利要求14所述的手术器具系统，其特征在于，该手术器具包括手术纤维切断器器具。
20.如权利要求14所述的手术器具系统，其特征在于，该手术器具包括手术纤维切断器/切割器器具。
21.如权利要求14所述的手术器具系统，其特征在于，该手术器具包括吻合处理器具。
22.如权利要求14所述的手术器具系统，其特征在于，该柔性轴和联接到该柔性轴上的手术器具构造成可从体内经该第一开口撤出。
23.如权利要求14所述的手术器具系统，其特征在于，该手术器具包括至少一个可移动元件，并且该可旋转的驱动轴构造成便于实现该手术器具的该至少一个可移动元件的移动。
24.如权利要求23所述的手术器具系统，其特征在于，第一联接器和第二联接器构造成联接该至少一个可移动元件和该至少一个可旋转驱动轴。
25.如权利要求23所述的手术器具系统，其特征在于，该电动机械式手术控制装置包括构造成驱动该可旋转驱动轴的电动机械式驱动器装置。
26.如权利要求25所述的手术器具系统，其特征在于，该电动机械式驱动器装置包括构造成驱动该驱动轴的马达系统。
27.如权利要求14所述的手术器具系统，其特征在于，该手术器具包括第一可移动元件和第二可移动元件，并且该可旋转的驱动轴包括构造成可实现该第一可移动元件的移动的第一可旋转驱动轴以及构造成可实现该第二可移动元件的移动的第二可旋转驱动轴。
28.如权利要求27所述的手术器具系统，其特征在于，第一联接器和第二联接器构造成联接该第一可移动元件和该第一可旋转驱动轴并联接该第二可移动元件和该第二可旋转驱动轴。
29.如权利要求28所述的手术器具系统，其特征在于，该电动机械式手术控制装置包括构造成驱动该第一可旋转驱动轴和第二可旋转驱动轴的电动机械式驱动器装置。
30.如权利要求29所述的手术器具系统，其特征在于，该电动机械式驱动器装置包括构造成驱动第一可旋转驱动轴和第二可旋转驱动轴的马达系统。
31.如权利要求30所述的手术器具系统，其特征在于，该马达系统包括构造成驱动该第一可旋转驱动轴的第一马达，和构造成驱动该第二可旋转驱动轴的第二马达。
32.如权利要求14所述的手术器具系统，其特征在于，该柔性轴包括转向装置，其构造成使得该细长轴的远端转向。
33.如权利要求14所述的手术器具系统，其特征在于，该细长轴构造成在该细长轴经该第一开口插入体内之后并且在该手术器具经该第一开口和第二开口中的一个开口插入体内之后，借助第一联接器和第二联接器与该手术器具联接。
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EP2316345B1 (en) 2016-12-21
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CA2814279A1 (en) 2003-01-03
EP1408843A2 (en) 2004-04-21
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AU2002320076A1 (en) 2003-01-08
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JP4268038B2 (ja) 2009-05-27
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EP3158942B1 (en) 2018-08-08
CA2451558C (en) 2013-08-06

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