CN101138483B - 医疗驱动系统 - Google Patents
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Abstract
公开了医疗驱动系统，每个系统包括适于接合医疗设备的至少一部分并使医疗设备的至少一部分运动的驱动系统组件。每个医疗驱动系统组件在多个表达形式中进行了各种各样的描述，例如：适于与导管接合并在导管上滑动的组件；适于围绕并接合到导管上的组件；适于与内窥镜的工作通道入口接合并在该工作通道入口上滑动的组件，其中医疗设备可以插入到该工作通道入口中；包括正齿轮和螺母式齿轮的组件，其中螺母式齿轮包括被正齿轮啮合的外齿；可插入内窥镜的柔性插管的工作通道中的组件；和/或包括驱动轴和固定接合到该驱动轴的螺母式齿轮的组件，驱动轴具有至少一个中空部分，医疗设备可以设置在该中空部分中。
Description
相关专利申请的交叉引用
本专利申请通过引用而结合了2005年11月17日公布的公开号为2005/0256505的美国专利申请。
技术领域
本申请整体涉及一种医疗设备，更具体地说，涉及一种为医疗设备的至少一部分提供运动的医疗驱动系统。
背景技术
医生通常使用长的柔性内窥镜来访问和观察患者消化道内的组织。对于上消化道，医生可以将胃窥镜插入到服用了镇静剂的患者的口腔内来检查和处理食道、胃和近侧十二指肠中的组织。对于下消化道，医生可以经过服用了镇静剂的患者的肛门插入结肠镜来检查直肠和结肠。一些内窥镜具有从机头中的端口向柔性插管的远侧部分延伸的工作通道，该工作通道的直径通常大约为2.5-3.5毫米。医生可以将医疗器械插入该工作通道内来帮助诊断或者处理患者体内的组织。医生通常使用柔性的活检钳穿过内窥镜的工作通道从消化道的粘膜层中获取活检组织。
插入柔性内窥镜，尤其是插入结肠内，对于患者来说是一个非常耗时和不舒服的过程，即使患者服用了镇静剂。医生常常需要数分钟沿结肠的错综复杂的乙状的、向下的、横向的和向上的部分推进柔性内窥镜。医生可以在内窥镜的插入期间或者取出期间诊断和/或处理结肠中的组织。柔性内窥镜可能会在结肠内“成圈”，比如在乙状结肠处或者在结肠脾曲处，从而沿结肠进一步推进内窥镜将变得困难。当形成圈时，推进内窥镜的作用力会拉伸肠系膜，导致患者疼痛。取决于根据患者的身体构造以及医生操纵柔性内窥镜的技能，结肠的一些部分可能没有检查到，因此增加了未确诊疾病的风险。
导丝已经被用来辅助导管和其它器械进入患者体内的多个部位。导丝的多种医疗应用和特殊设计一直用于心血管方面的用途。但是，与血管系统相反，在消化道中使用导丝存在一些特殊的挑战。例如，肠更加曲折、柔软且通常具有更大的直径。此外，对于小肠和结肠来说，它们要比大多数动脉或者静脉更长。
发明内容
本发明的第一实施方式的第一表现形式是一种包括机械式驱动系统组件的医疗驱动系统。该驱动系统组件适于与柔性导管接合并在柔性导管上滑动，并且围绕该柔性导管。该导管具有可插入患者体腔内的远端。该驱动系统组件适于接合医疗设备的至少一部分并使所述医疗设备的至少一部分运动。
本发明的第一实施方式的第二表现形式是一种包括机械式驱动系统组件的医疗驱动系统。该驱动系统组件适于围绕并接合到柔性导管以及从该柔性导管上分离，该柔性导管具有可插入患者体腔内的远端。该驱动系统组件适于接合医疗设备的至少一部分并使所述医疗设备的至少一部分运动。
本发明的第二实施方式的第一表现形式是一种包括机械式驱动系统组件的医疗驱动系统。该驱动系统组件适于与内窥镜的工作通道入口接合并在内窥镜的工作通道入口上滑动并围绕该工作通道入口。该驱动系统组件适于接合医疗设备的至少一部分并使所述医疗设备的至少一部分运动，其中所述医疗设备可插入到所述工作通道入口中。
本发明的第二实施方式的第二表现形式是一种包括正齿轮和螺母式齿轮的医疗驱动系统。所述正齿轮适于被驱动轴旋转驱动。所述螺母式齿轮包括与所述正齿轮啮合的外齿，并且包括内部特征，其适于啮合医疗设备的外部表面特征，以便使该医疗设备的至少一部分运动。
本发明的第三实施方式的第一表现形式是一种包括机械式驱动系统组件的医疗驱动系统。该驱动系统组件可插入到内窥镜的柔性插管的工作通道内以及从该工作通道内缩回。该驱动系统组件包括可旋转的柔性驱动轴以及固定地接合到该驱动轴的螺母式齿轮。所述螺母式齿轮具有内螺纹，所述驱动轴具有至少一个中空部分。当医疗设备设置在所述中空部分中时，所述内螺纹适于可操作地啮合该医疗设备的外螺纹，以便当所述螺母式齿轮被所述驱动轴旋转驱动时，移动所述设置的医疗设备的至少一部分穿过所述螺母式齿轮并延伸越过所述插管的远端。
本发明的第三实施方式的第二表现形式是一种包括机械式驱动系统组件的医疗驱动系统。该驱动系统组件包括可旋转的柔性驱动轴以及固定地接合到该驱动轴的螺母式齿轮。所述螺母式齿轮具有内螺纹，所述驱动轴具有至少一个中空部分。当医疗设备设置在所述中空部分中时，所述内螺纹适于可操作地啮合该医疗设备的外螺纹，以便当所述螺母式齿轮被所述驱动轴旋转驱动时，移动所述设置的医疗设备的至少一部分穿过所述螺母式齿轮。
从本发明的实施方式的一种或者多种表现形式可以得到若干优点。当医疗设备是医疗导丝(或者，例如医疗针)时，具有机械式驱动系统组件将容许导丝(或者针)具有更长的长度，这是本领域技术人员能够认识到的。当驱动系统组件适于在导管上滑动时，现有的导管能够与驱动系统组件一起使用，而不需要制造专门的具有驱动系统组件的导管。当驱动系统组件适于在内窥镜的工作通道入口上滑动或者在内窥镜的柔性插管的工作通道中滑动时，当不从患者身上拔出插管且其它内窥镜检查程序需要工作通道时，可以除去驱动系统组件。
本发明具体涉及如下方面：
(1)、一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件能够与柔性导管接合并在柔性导管上滑动，并且所述驱动系统组件围绕所述柔性导管，所述柔性导管具有可插入患者体腔内的远端，并且所述驱动系统组件能够与医疗设备的至少一部分接合并使医疗设备的至少一部分运动。
(2)、根据第(1)项所述的医疗驱动系统，其中，所述驱动系统组件能够被设置在所述导管的所述远端附近。
(3)、根据第(2)项所述的医疗驱动系统，其中，所述导管是内窥镜插管。
(4)、根据第(3)项所述的医疗驱动系统，其中，所述驱动系统组件能够使所述医疗设备的所述至少一部分线性运动越过所述导管的远端，并且所述医疗设备具有外螺纹。
(5)、根据第(4)项所述的医疗驱动系统，其中，所述医疗设备包括能够医学处理患者组织的医疗器械。
(6)、根据第(4)项所述的医疗驱动系统，其中，所述医疗设备包括医疗导丝。
(7)、根据第(4)项所述的医疗驱动系统，其中，所述驱动系统组件包括螺母式齿轮，所述螺母式齿轮具有从动外齿，并具有能够可操作地啮合所述外螺纹的主动内螺纹。
(8)、根据第(7)项所述的医疗驱动系统，其中，所述驱动系统组件包括正齿轮，所述正齿轮设置成与所述螺母式齿轮的外齿啮合。
(9)、根据第(1)项所述的医疗驱动系统，其中，所述驱动系统组件包括滑动式离合器，当运动的所述医疗设备受到的阻力超过预定阀值时，所述滑动式离合器中断所述医疗设备的所述机械式驱动系统组件的运动。
(10)、一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件能够围绕柔性导管、与柔性导管接合以及从所述柔性导管分离，所述柔性导管具有可插入患者体腔内的远端，并且所述驱动系统组件能够接合医疗设备的至少一部分并使所述医疗设备的至少一部分运动。
(11)、根据第(10)项所述的医疗驱动系统，其中，所述驱动系统组件包括滑动式离合器，当运动的所述医疗设备受到的阻力超过预定阀值时，所述滑动式离合器中断所述医疗设备的所述机械式驱动系统组件的运动。
(12)、一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件能够与内窥镜的工作通道入口接合并在所述内窥镜的工作通道入口上滑动，并且围绕所述工作通道入口，所述驱动系统组件能够接合医疗设备的至少一部分并使所述医疗设备的至少一部分运动，其中所述医疗设备可插入到所述工作通道入口中。
(13)、根据第(12)项所述的医疗驱动系统，其中，所述驱动系统组件能够使所述医疗设备的所述至少一部分线性运动，并且所述医疗设备具有外螺纹。
(14)、根据第(13)项所述的医疗驱动系统，其中，所述医疗设备包括能够医学处理患者组织的医疗器械。
(15)、根据第(13)项所述的医疗驱动系统，其中，所述医疗设备包括医疗导丝。
(16)、根据第(13)项所述的医疗驱动系统，其中，所述驱动系统组件包括螺母式齿轮，所述螺母式齿轮具有从动外齿，并具有能够可操作地啮合所述外螺纹的主动内螺纹。
(17)、根据第(16)项所述的医疗驱动系统，其中，所述驱动系统组件还包括正齿轮，所述正齿轮设置成与所述螺母式齿轮的外齿啮合。
(18)、一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件包括正齿轮和螺母式齿轮，其中所述正齿轮能够被驱动轴旋转驱动，其中所述螺母式齿轮包括与所述正齿轮啮合的外齿，并且包括内部特征，所述内部特征能够啮合医疗设备的外部表面特征，以便使所述医疗设备的至少一部分运动。
(19)、根据第(18)项所述的医疗驱动系统，其中，所述医疗设备包括能够医学处理患者组织的医疗器械。
(20)、一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件可插入到内窥镜的柔性插管的工作通道内以及从所述工作通道内缩回，并且所述驱动系统组件包括可旋转的柔性驱动轴以及固定地接合到所述驱动轴上的螺母式齿轮，其中，所述螺母式齿轮具有内螺纹，所述驱动轴具有至少一个中空部分，并且当医疗设备设置在所述中空部分中时，所述内螺纹能够可操作地啮合所述医疗设备的外螺纹，以便当所述螺母式齿轮被所述驱动轴旋转驱动时，移动所述设置的医疗设备的至少一部分穿过所述螺母式齿轮并延伸越过所述插管的远端。
(21)、根据第(20)项所述的医疗驱动系统，其中，所述驱动系统组件包括围绕所述驱动轴的护套，所述驱动轴可相对于所述护套旋转，并且所述护套包括多个径向向外的凸起。
(22)、根据第(20)项所述的医疗驱动系统，其中，所述医疗设备包括能够医学处理患者组织的医疗器械。
(23)、根据第(20)项所述的医疗驱动系统，其中，所述医疗设备包括医疗导丝。
(24)、一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件包括可旋转的柔性驱动轴以及固定地接合到所述驱动轴上的螺母式齿轮，其中，所述螺母式齿轮具有内螺纹，所述驱动轴具有至少一个中空部分，并且当医疗设备设置在所述中空部分中时，所述内螺纹能够可操作地啮合所述医疗设备的外螺纹，以便当所述螺母式齿轮被所述驱动轴旋转驱动时，移动所述设置的医疗设备的至少一部分穿过所述螺母式齿轮。
(25)、根据第(24)项所述的医疗驱动系统，其中，所述驱动系统组件包括围绕所述驱动轴的护套，所述驱动轴可相对于所述护套旋转。
(26)、根据第(24)项所述的医疗驱动系统，其中，所述医疗设备包括能够医学处理患者组织的医疗器械。
附图说明
图1是本发明医疗驱动系统的第一实施方式以及柔性导管的远端部分的立体图，其中该医疗驱动系统已经在所述导管上滑动并且围绕该导管，该医疗驱动系统使第一实施方式的医疗设备运动，该医疗设备包括医学处理超声换能器组件形式的医疗器械，并且已经除去了该医疗驱动系统的顶盖；
图2是图1中医疗驱动系统的视图，其中该医疗驱动系统已经离开了导管，并且已经从医疗驱动系统上除去了医疗设备；
图3是图1至图2中医疗驱动系统的螺母式齿轮的侧面横截面图，显示了螺母式齿轮的内螺纹，该螺母式齿轮适于可操作地啮合图1中医学处理超声换能器组件的外螺纹；
图4是医疗设备的第二实施方式的一部分的侧视图，该医疗设备包括医疗导丝，并且能够由图1至图2中的医疗驱动系统所移动；
图5是本发明医疗驱动系统的第二实施方式、具有工作通道入口的内窥镜的近侧部分、内窥镜插管的远端部分以及可操作地接合到医疗驱动系统的马达组件(示意性地显示为切除了一部分以露出驱动轴)的立体图，其中该医疗驱动系统已经在所述工作通道入口上滑动并且围绕该工作通道入口，该医疗驱动系统移动第一实施方式的医疗设备，该医疗设备可插入到工作通道中并包括医学处理超声换能器组件形式的医疗器械，并且已经除去了该医疗驱动系统的侧盖和马达组件的侧盖；
图6是沿图5中的线6-6获取的图5中插管的横截面图；
图7是图5中医疗驱动系统的视图，其中该医疗驱动系统已经离开了工作通道入口，并且已经从医疗驱动系统上除去了医疗设备；
图8是图5和图7中医疗驱动系统的螺母式齿轮的侧面横截面图，显示了螺母式齿轮的内螺纹，该螺母式齿轮适于可操作地啮合图5中医学处理超声换能器组件的外螺纹；
图9是医疗设备的第二实施方式的一部分的侧视图，该医疗设备包括医疗导丝，并且能够由图5和图7中的医疗驱动系统移动；
图10是本发明医疗驱动系统的第三实施方式、显示了部分横截面且具有柔性插管(包括工作通道)的内窥镜的近侧部分、以横截面显示的内窥镜插管的远端部分以及可操作地接合到医疗驱动系统的马达组件的实施方式的示意性侧视图，其中驱动系统组件已经插入到工作通道内，为了清楚已经省略了驱动系统组件的护套，并且其中该医疗驱动系统移动第一实施方式的医疗设备，该医疗设备包括医学处理超声换能器组件形式的医疗器械(以外部视图显示)；
图11是从工作通道中取出的图10中的医疗驱动系统以及医疗器械的视图，其中医疗驱动系统而不是医疗器械以横截面显示；
图12是图11中医疗驱动系统的视图，增加了护套，并除去了医疗器械；
图13是沿图12中的线13-13获取的图12中的护套和驱动轴的横截面图；以及
图14是医疗设备的第二实施方式的一部分的侧视图，该医疗设备包括医疗导丝，并且能够由图10至图13中的医疗驱动系统所移动。
具体实施方式
在详细解释本发明若干实施方式之前，请注意每个实施方式的应用或用途并不局限于在附图和说明书中所说明的部件和步骤的具体结构和安排。本发明的示例性实施方式可以应用或者结合到其它的实施方式、变例和修改中，并且可以通过各种方式进行实践或者实施。此外，除非另有说明，这里使用的术语和表现形式是为了描述本发明的示例性实施方式而选择的，目的是为了方便读者，而不是为了限制本发明。
还需理解的是，下述表现形式、实施方式、实施例等中的任意一个或者多个能够与下述其它表现形式、实施方式、实施例等中的任意一个或者多个进行组合。
本发明的医疗驱动系统10的第一实施方式显示于图1至图3中。图1至图3中医疗驱动系统10的第一表现形式包括机械式驱动系统组件12。该驱动系统组件12适于与柔性导管14接合并在柔性导管14上滑动，并围绕该柔性导管14。导管14具有可插入患者体腔内的远端16。驱动系统组件12适于接合医疗设备18的至少一部分并使医疗设备18的至少一部分运动。
导管的实施例包括但不限于：心血管导管、肺导管以及内窥镜插管如胃窥镜插管和结肠镜插管。患者体腔的实施例包括但不限于：上消化道、下消化道以及血管。导管和/或体腔的其它实施例留给技术人员。在一种表现形式中，驱动系统组件12包括弹性护套部分13，用于围绕并滑动接合到导管14上以及从导管14上滑动分离。
在图1至图3中的实施方式的第一表现形式的一种应用中，驱动系统组件12适于设置在导管14的远端16附近。在一种变例中，导管14是一种内窥镜插管。在一种变例中，驱动系统组件12适于紧挨着关节式内窥镜插管的关节部分的近侧设置。
在图1至图3中的实施方式的第一表现形式的一种设计中，驱动系统组件12包括滑动式离合器19，当移动的医疗设备受到的阻力超过预定阀值时，该滑动式离合器19中断医疗设备的机械式驱动系统组件的运动。
在图1至图3中的实施方式的第一表现形式的一种布置中，驱动系统组件12适于使医疗设备18的至少一部分作线性运动并越过导管14的远端16，其中医疗设备18具有外螺纹19。在未显示的其它布置中，驱动系统组件适于使医疗设备的至少一部分作旋转运动。其它运动类型，包括线性和旋转组合式运动，留给本领域技术人员。
在图1至图3中的实施方式的第一表现形式的一种应用中，医疗设备18包括医疗器械20，该医疗器械20适于医学处理患者组织，且有一部分带外螺纹19。在一种实施例中，医疗器械20是一种医学处理超声换能器组件。医疗器械的其它实施例包括但不限于：钳组件、注射针、医用圈套器、针刀以及括约肌切开器。其它实施例留给技术人员。
适于和驱动系统组件12一起使用的医疗设备22的第二实施方式显示于图4中，其中该医疗设备22包括医疗导丝24，该导丝24具有带外螺纹19的第一段26。在一种变例中，医疗导丝24具有不带外螺纹的远侧的第二段30。在未显示的一种修改中，该第二段被接合的光滑护套覆盖，该护套具有低摩擦表面以便容易通过体腔。在未显示的一种实施例中，医疗导丝是一种环形医疗导丝，其中所述第二段的远端位于患者体外。在材料的一种选择中，除了任意的光滑护套以外，医疗导丝24主要包括超弹性合金，比如可以从Nitinol Devices & Components(地址：加利福尼亚的弗里蒙特)获得的镍钛诺合金；光滑护套28的光滑护套材料实施例主要包括聚四氟乙烯(PTFE)，比如可以从Zeus，Inc(地址：南卡罗来纳州Orangeburg)获得的Striped Teflon
PTFE。在一种实施方式中，光滑护套通过本领域熟知的热缩性工艺加以应用。在一种构造方法中，将镍钛诺螺旋弹簧熔接或者激光焊接到镍钛诺合金丝上。在另一种方法中，较大直径的镍钛诺合金丝被加工成具有外螺纹。
在图1至图3中的实施方式的第一表现形式的一种结构中，驱动系统组件12包括螺母式齿轮32，该螺母式齿轮32具有从动外齿34和主动内螺纹36，该主动内螺纹36适于可操作地啮合医疗设备18或22的外螺纹19。在一种变例中，驱动系统组件12还包括与螺母式齿轮32的外齿34啮合的正齿轮38。在一种修改中，滑动式离合器19包括六角形轴40和联轴器42。六角形轴40的远端连接到正齿轮38。联轴器42包括：近端，该近端可以连接到由马达(或者手动曲柄)驱动的柔性驱动轴44；远端，该远端为指针46形式，该指针46围绕六角形轴40的近端；以及至少一个0形环48，该O形环48围绕所述指针46。当正在运动的医疗设备18或22受到阀值阻力时，六角形轴40停止旋转，指针46则滑到六角形轴40的角落上。当医疗设备18或22所受到的阻力下降到阀值阻力以下时，旋转的指针46将停留在六角形轴40的平面上。在一个示例中，第一护套50围绕驱动轴44，第二护套52围绕驱动系统组件12近侧的医疗设备18。当前进的医疗设备18或22开始受到阀值以上的阻力时，驱动系统组件12将中断医疗设备18或22的机械式转动，以便有效限制在其前进时所能作用于组织上的力的大小。在一个实施例中，阀值阻力在2.5磅至3.5磅的范围内。用于旋转运动的滑动式离合器的其它设计实例以及用于线性运动的滑动式离合器的其它设计实例留给技术人员。
未显示的其它结构包括这样的医疗设备，该医疗设备具有与外螺纹不同的表面高度特征，比如可以被驱动系统组件可操作地接合的周期性齿、周期性孔和/或周期性槽。医疗设备上不具有表面高度特征的结构留给本领域技术人员。
图1至图3中的实施方式的第二表现形式是包括机械式驱动系统组件12的医疗驱动系统10。该驱动系统组件12适于围绕地接合到柔性导管14以及从该柔性导管14上分离，该柔性导管14具有可以插入到患者体腔内的远端16。该驱动系统组件12适于接合并移动医疗设备18的至少一部分。
在图1至图3中的实施方式的第二表现形式的一种设计中，驱动系统组件12包括滑动式离合器19，当正在运动的医疗设备受到的阻力超过预定阀值时，该滑动式离合器19中断该医疗设备的机械式驱动系统组件的运动。
在未显示的一种说明中，驱动系统组件包括两个护套部分，它们在护套周围机械地螺纹接合在一起。
图1至图3中的实施方式的第三表现形式是医疗组件54，该医疗组件54包括柔性导管14、医疗驱动系统10以及医疗设备18。医疗驱动系统10包括机械式驱动系统组件12。该驱动系统组件12围绕并连接到导管14。该导管14具有可以插入到患者体腔内的远端16。驱动系统组件12接合并适于移动医疗设备18的至少一部分。
本发明的医疗驱动系统110的第二实施方式显示于图5至图8中。图5至图8中的医疗驱动系统110的第一表现形式包括机械式驱动系统组件112。该驱动系统组件112适于与内窥镜116的工作通道入口114接合并在内窥镜116的工作通道入口114上滑动并围绕该工作通道入口。该驱动系统组件112适于接合并移动医疗设备118的至少一部分，其中该医疗设备118可以插入到工作通道入口114中。
在一个示例中，驱动系统组件112包括弹性的护套部分113，用于围绕并滑动接合到工作通道入口114上以及从该工作通道入口114上滑动分离。其它说明如夹持接合留给本领域技术人员。在图5至图8中的实施方式的第一表现形式的一种未显示的设计中，驱动系统组件包括滑动式离合器，当正在运动的医疗设备受到的阻力超过预定阀值时，该滑动式离合器中断该医疗设备的机械式驱动系统组件的运动。
在图5至图8中的实施方式的第一表现形式的一种布置中，驱动系统组件112适于使医疗设备118的至少一部分作线性运动，其中该医疗设备118具有外螺纹119。在未显示的其它布置中，驱动系统组件适于使医疗设备的至少一部分作旋转运动。其它运动类型，包括线性和旋转组合式运动，留给本领域技术人员。
在图5至图8中的实施方式的第一表现形式的一种实施方式中，医疗设备118包括医疗器械120，该医疗器械120适于医学处理患者组织，且有一部分带外螺纹119。在一种实施例中，医疗器械120是一种医学处理超声换能器组件。医疗器械的其它实施例留给技术人员。
适于和驱动系统组件112一起使用的医疗设备122的第二实施方式显示于图9中，其中该医疗设备122包括医疗导丝124，该导丝124具有带外螺纹119的第一段126。在一种变例中，医疗导丝124具有不带外螺纹的远侧的第二段130。
在图5至图8中的实施方式的第一表现形式的一种结构中，驱动系统组件112包括螺母式齿轮132，该螺母式齿轮132具有从动外齿134和主动内螺纹136，该主动内螺纹136适于可操作地啮合医疗设备118的外螺纹119。在一种变例中，驱动系统组件112还包括与螺母式齿轮132的外齿134啮合的正齿轮138。
图5至图8中的实施方式的第二表现形式是包括机械式驱动系统组件112的医疗驱动系统110。该驱动系统组件112包括正齿轮138和螺母式齿轮132。正齿轮138适于被驱动轴140旋转驱动。螺母式齿轮132包括外齿134，该外齿134被正齿轮138啮合，并且包括适于啮合医疗设备118的外部表面特征(如外螺纹119)的内部特征(如内螺纹136)，以便移动该医疗设备118的至少一部分。
在一个示例中，马达145用于旋转驱动轴140。在未显示的其它说明中，手动曲柄用于旋转驱动轴。用于旋转驱动轴的其它装置留给技术人员。在图5至图8中的实施方式的第一表现形式的一种未显示的设计中，驱动系统组件包括滑动式离合器，当正在运动的医疗设备受到的阻力超过预定阀值时，该滑动式离合器中断该医疗设备的机械式驱动系统组件的运动。
在图5至图8中的实施方式的第二表现形式的一种实施方式中，医疗设备118包括医疗器械120，该医疗器械120适于医学处理患者组织。在一种实施例中，医疗器械120是一种医学处理超声换能器组件。在一种程序中，医疗驱动系统112没有与内窥镜一起使用。在一种变例中，医疗驱动系统112没有与任何其它具有导管的医疗器械一起使用。
图5至图8中的实施方式的第三表现形式是医疗组件146，该医疗组件146包括具有工作通道入口114的内窥镜116、医疗驱动系统110以及医疗设备118。医疗设备118插入到工作通道入口114中。医疗驱动系统110包括机械式驱动系统组件112，该驱动系统组件112围绕并接合到工作通道入口114。驱动系统组件112接合并适于移动医疗设备118的至少一部分。请注意，图5还显示了内窥镜116的柔性插管148，图6显示了插管148的工作通道150，医疗器械120的一部分置于该工作通道150内。还请注意，医疗器械120的导丝152显示于图5中的驱动系统组件112内。
本发明的医疗驱动系统210的第三实施方式显示于图10至图13中。图10至图13中的医疗驱动系统210的第一表现形式包括机械式驱动系统组件212。该驱动系统组件212可以插入到内窥镜218的柔性插管216的工作通道214中以及从该工作通道214中缩回。驱动系统组件212包括可旋转的、柔性的驱动轴220以及固定接合到驱动轴220的螺母式齿轮222。螺母式齿轮222具有内螺纹224，驱动轴220具有至少一个中空部分226。当医疗设备228位于中空部分226中时，内螺纹224适于可操作地啮合医疗设备228的外螺纹227，以便当螺母式齿轮222被驱动轴220旋转驱动时，移动所设置的医疗设备228的至少一部分穿过螺母式齿轮222并延伸越过插管216的远端230。
在一个示例中，马达组件232设置在内窥镜218和患者的外侧，并且可操作地连接到驱动轴220的近端234。请注意，工作通道214从内窥镜218的工作通道入口236向插管216的远端230延伸。在未显示的其它说明中，手动曲柄用于旋转驱动轴。用于旋转驱动轴的其它装置留给技术人员。
在图10至图13中的实施方式的第一表现形式的一种结构中，驱动系统组件212包括围绕驱动轴220的护套252，其中驱动轴220可以相对于护套252旋转，并且其中护套252包括多个径向向外的凸起253。在一种变例中护套252是多腔护套，从驱动轴220的近端234延伸并经过螺母式齿轮222的远端254。在此变例中，护套252径向覆盖螺母式齿轮222的远端254，并且非弹力金属丝256如镍钛诺合金丝紧固地设置在护套252的较小腔内并沿护套252的长度延伸，以便防止驱动轴220伸长，这对于本领域技术人员是可以理解的。请注意，当护套252插入到工作通道214内时，在护套252周围仍然具有间隔的空间(比如距离图13中的护套252的“凸耳”的外侧的空间以及“凸耳”的外侧之间的空间)，从而流体和小型装置可以在工作通道214内穿过而不会受到旋转的柔性驱动轴220的干扰。
在图10至图13中的实施方式的第一表现形式的一种实施方式中，医疗设备228包括医疗器械240，该医疗器械240适于医学处理患者组织，并且有一部分带外螺纹227。在一种实施例中，该医疗器械240是一种医学处理超声换能器组件。医疗器械的其它实施例留给技术人员。
适于和驱动系统组件212一起使用的医疗设备242的第二实施方式显示于图14中，其中该医疗设备242包括医疗导丝244，该医疗导丝244具有带外螺纹227的第一段246。在一种变例中，该医疗导丝244具有不带外螺纹的远侧的第二段248。
申请人通过实验发现，内螺纹224与外螺纹227之间的相对松的啮合会使医疗设备228在平移时基本上不会旋转。在未显示的一种设计中，医疗设备228的近端具有键合表面特征，其允许医疗设备在手柄的匹配腔内平移而不旋转。其它防旋转技术留给本领域技术人员。
在图10至图13中的实施方式的第一表现形式的一种未显示的布置中，螺母式齿轮是一种接合到齿轮壳的两件式螺母式齿轮，该齿轮壳接合到驱动轴的远端。在此布置中，管的近端可旋转地接合到螺母式齿轮壳，并且弹性的末端夹持器固定接合到管的远端。当这种装配件全部插入到工作通道内时，末端夹持器的远端位于插管的远端附近，管的近端位于插管的关节部分的近端的附近。
图10至图13中的实施方式的第二表现形式是一种包括机械式驱动系统组件212的医疗驱动系统210。驱动系统组件212包括可旋转的、柔性的驱动轴220以及固定接合到驱动轴220的螺母式齿轮222。螺母式齿轮222具有内螺纹224，驱动轴220具有至少一个中空部分226。当医疗设备228位于中空部分226中时，内螺纹224适于可操作地啮合医疗设备228的外螺纹227，以便当螺母式齿轮222被驱动轴220旋转驱动时，移动该医疗设备228的至少一部分穿过螺母式齿轮222。
在图10至图13中的实施方式的第二表现形式的一种结构中，驱动系统组件212包括围绕驱动轴220的护套252，其中驱动轴220可相对于护套252旋转。
在图10至图13中的实施方式的第二表现形式的一种实施方式中，医疗设备218包括医疗器械240，该医疗器械240适于医学处理患者组织，并且有一部分带外螺纹227。在一种实施例中，医疗器械240是一种医学处理超声换能器组件。在一种程序中，医疗驱动系统210没有与内窥镜一起使用。在一种变例中，医疗驱动系统210没有与任何其它具有导管的医疗器械一起使用。
图10至图13中的实施方式的第三表现形式是医疗组件250，该医疗组件250包括具有柔性插管216和工作通道214的内窥镜218、医疗驱动系统210以及医疗设备228。医疗驱动系统210包括机械式驱动系统组件212，该驱动系统组件212可以插入到工作通道214中以及从该工作通道214中缩回。驱动系统组件212包括可旋转的、柔性的驱动轴220以及固定接合到该驱动轴220的螺母式齿轮222。螺母式齿轮222具有内螺纹224，驱动轴220具有至少一个中空部分226。内螺纹224可操作地啮合被置于中空部分226中的医疗设备228的外螺纹227。当螺母式齿轮222被驱动轴220旋转驱动时，内螺纹224适于移动所设置的医疗设备228的至少一部分，使之穿过螺母式齿轮222并延伸越过插管216的远端230。
从本发明的实施方式的一种或者多种表现形式可以得到若干优点。当医疗设备是医疗导丝(或者，例如医疗针)时，具有机械式驱动系统组件将容许导丝(或者针)具有更长的长度，这是本领域技术人员能够认识到的。当驱动系统组件适于在导管上滑动时，现有的导管能够与驱动系统组件一起使用，而不需要制造专门的具有驱动系统组件的导管。当驱动系统组件适于在内窥镜的工作通道入口上滑动或者在内窥镜的柔性插管的工作通道中滑动时，当不从患者身上拔出插管且其它内窥镜检查程序需要工作通道时，可以除去驱动系统组件。
虽然本发明已经通过对其多个表达形式、实施方式以及实施例的描述进行了说明，但是申请人的目的不是为了将所附的权利要求的精神和范围限制于这些细节。在不背离本发明的范围的前提下，多种其它的变例、改变和替换对于本领域技术人员来说将是已知的。将会理解，前面的描述是通过实施例的方式提供的，在不背离后附的权利要求的范围和精神的前提下本领域技术人员可以作出其它修改。
Claims (9)
1.一种医疗驱动系统，包括机械式驱动系统组件，所述驱动系统组件能够与柔性导管接合并在柔性导管上滑动，并且所述驱动系统组件围绕所述柔性导管，所述柔性导管具有可插入患者体腔内的远端，并且所述驱动系统组件能够与医疗设备的至少一部分接合并使医疗设备的至少一部分运动，其中，所述驱动系统组件包括护套部分，所述护套部分包括用于围绕并滑动地接合到所述导管上的内表面以及与所述内表面相对的外表面，在所述外表面上，所述驱动系统组件能够接合并使所述医疗设备运动。
2.根据权利要求1所述的医疗驱动系统，其中，所述驱动系统组件能够被设置在所述导管的所述远端附近。
3.根据权利要求2所述的医疗驱动系统，其中，所述导管是内窥镜插管。
4.根据权利要求3所述的医疗驱动系统，其中，所述驱动系统组件能够使所述医疗设备的所述至少一部分线性运动越过所述导管的远端，并且所述医疗设备具有外螺纹。
5.根据权利要求4所述的医疗驱动系统，其中，所述医疗设备包括能够医学处理患者组织的医疗器械。
6.根据权利要求4所述的医疗驱动系统，其中，所述医疗设备包括医疗导丝。
7.根据权利要求4所述的医疗驱动系统，其中，所述驱动系统组件包括螺母式齿轮，所述螺母式齿轮具有从动外齿，并具有能够可操作地啮合所述外螺纹的主动内螺纹。
8.根据权利要求7所述的医疗驱动系统，其中，所述驱动系统组件包括正齿轮，所述正齿轮设置成与所述螺母式齿轮的外齿啮合。
9.根据权利要求1所述的医疗驱动系统，其中，所述驱动系统组件包括滑动式离合器，当运动的所述医疗设备受到的阻力超过预定阀值时，所述滑动式离合器中断所述医疗设备的所述机械式驱动系统组件的运动。
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-
2006
- 2006-09-08 US US11/518,606 patent/US20080064920A1/en not_active Abandoned
-
2007
- 2007-09-03 AU AU2007214375A patent/AU2007214375B2/en not_active Ceased
- 2007-09-07 CA CA2600664A patent/CA2600664C/en not_active Expired - Fee Related
- 2007-09-07 EP EP07253560A patent/EP1905346B1/en not_active Expired - Fee Related
- 2007-09-07 DE DE602007007028T patent/DE602007007028D1/de active Active
- 2007-09-07 ES ES07253560T patent/ES2344366T3/es active Active
- 2007-09-07 JP JP2007233073A patent/JP5138321B2/ja not_active Expired - Fee Related
- 2007-09-10 CN CN2007101492639A patent/CN101138483B/zh not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| CA2600664A1 (en) | 2008-03-08 |
| US20080064920A1 (en) | 2008-03-13 |
| CN101138483A (zh) | 2008-03-12 |
| AU2007214375A1 (en) | 2008-04-03 |
| ES2344366T3 (es) | 2010-08-25 |
| AU2007214375B2 (en) | 2012-09-06 |
| EP1905346B1 (en) | 2010-06-09 |
| JP2008080119A (ja) | 2008-04-10 |
| DE602007007028D1 (de) | 2010-07-22 |
| JP5138321B2 (ja) | 2013-02-06 |
| EP1905346A2 (en) | 2008-04-02 |
| EP1905346A3 (en) | 2008-04-09 |
| CA2600664C (en) | 2016-01-12 |
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