CN101141922B - 超声外科剪刀和用于超声外科剪刀的组织垫 - Google Patents

超声外科剪刀和用于超声外科剪刀的组织垫 Download PDF

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CN101141922B
CN101141922B CN2005800118074A CN200580011807A CN101141922B CN 101141922 B CN101141922 B CN 101141922B CN 2005800118074 A CN2005800118074 A CN 2005800118074A CN 200580011807 A CN200580011807 A CN 200580011807A CN 101141922 B CN101141922 B CN 101141922B
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凯文·L·豪泽
萨拉·A·诺斯钱格
史蒂文·诺恩费尔特
克雷格·N·法勒
杰弗里·J·韦特库纳斯
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Abstract

一种超声外科剪刀组织垫，具有组织垫主体，该组织垫主体包括基材和至少一种填料。一种替代的超声外科剪刀组织垫具有组织垫主体，该组织垫主体具有邻接的第一和第二区域，其中第一区域包括第一材料，第二区域包括第二材料。一种超声外科剪刀包括超声外科刀以及可操作地向着刀打开和闭合并具有可横向弹性变形的远尖端的夹钳臂。一种替代的超声外科剪刀包括超声外科刀、可操作地向着刀打开和闭合的夹钳臂以及与夹钳臂连接并具有夹钳表面的组织垫，至少一部分组织垫沿着与夹钳表面大致垂直的方向弹性变形。

Description

超声外科剪刀和用于超声外科剪刀的组织垫
相关申请的引用
本申请要求2004年2月27日提交的序列号为60/548,301的美国临时专利申请的优先权，该文献的内容结合入本申请中作为参考。
本申请包括涉及2004年10月8日提交的No.60/617,427的共同拥有的美国专利申请的主题，该文献的内容结合入本申请中作为参考。
技术领域
本发明总的涉及超声外科器械，更具体地，涉及一种超声外科剪刀，还涉及一种用于超声外科剪刀的组织垫。
背景技术
超声外科器械是已知的，其包括超声外科剪刀，该超声外科剪刀包括超声外科刀、可操作地向着所述刀打开和闭合的夹钳臂、以及与所述夹钳臂连接并包括夹钳表面的聚四氟乙烯组织垫。夹钳臂将夹钳力施加到定位于组织垫的夹钳表面和刀之间的血管上。超声外科刀的超声振动和血管上的夹钳压力使血管接合(将血管壁聚在一起)、横切(切割)接合的血管以及使血管的接合的切割末端凝固(封闭)。在组织横切完成时，进行超声振动的超声外科刀接触并切下一部分聚四氟乙烯组织垫，这是因为刀相对于组织垫产生摩擦损伤和摩擦热量。在序列号为5,322,055和6,325,811的美国专利中描述了示例性装置，该文献的内容结合入本申请中作为参考。
科学家和工程师们仍在继续探寻改进的超声外科剪刀和用于超声外科剪刀的改进的组织垫。
发明内容
本发明的超声外科剪刀组织垫的第一种实施方式包括超声外科剪刀组织垫主体，所述主体具有基材和至少一种与基材不同材料的填料。
本发明的超声外科剪刀组织垫的第二种实施方式包括超声外科剪刀组织垫主体，所述主体具有邻接的第一和第二区域，其中，第一区域包括第一材料，并且第二区域包括与第一材料不同的第二材料。
本发明的超声外科剪刀的第一种实施方式包括超声外科刀和夹钳臂，该夹钳臂可操作地向着所述刀打开和闭合并具有可横向弹性变形的远尖端。
本发明的超声外科剪刀的第二种实施方式包括超声外科刀，可操作地向着刀打开和闭合的夹钳臂，以及与夹钳臂连接并具有夹钳表面的组织垫。至少一部分组织垫可沿着大致与夹钳表面垂直的方向弹性变形。
从本发明的一个或多个实施方式和方法可获得多种益处和优点。使组织垫具有基材和至少一种填料允许基材和至少一种填料可被选择具有不同的硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度，和/或熔融温度，以便改善组织垫的耐用性，当采用大的夹钳力时这是很重要的，因为组织垫的磨损在大的夹钳力作用下比在小的夹钳力作用下更快。申请人发现，在一个试验中，填充15％石墨的聚四氟乙烯组织垫在7磅夹钳力的作用下的磨损大致与100％聚四氟乙烯组织垫在1.5磅夹钳力作用下的磨损相同。由于弹性构件能将负载更均匀地分布到组织垫的整个表面上，所以具有弹性夹钳臂和/或弹性组织垫也能改善组织垫的耐用性。
本发明没有局限性，可用于如在结合入本申请中作为参考的专利中公开的直或弯曲超声外科刀，而且进一步应用于用手致动的器械以及机器人辅助器械。
附图说明
图1是本发明的超声外科剪刀组织垫的第一种实施方式的一部分的剖视图；
图2是本发明的超声外科剪刀组织垫的第二种实施方式的一部分的剖视图；
图3是图2的组织垫的第一种替代实施方式的侧视图；
图4是图2的组织垫的第二种替代实施方式的侧视图；
图5是图2的组织垫的第三种替代实施方式的侧视图；
图6是本发明的超声外科剪刀的一种实施方式的一部分的示意性侧视图；
图7是本发明的超声外科剪刀的一种替代实施方式的一部分的示意性侧视图。
具体实施方式
在详细解释本发明之前，应注意，本发明不将其应用或使用限制为在附图和说明书中描述的构造和零部件的布置的细节。本发明的示例性实施方式可在其它实施方式、改变和变化中执行或包含在其它实施方式、改变和变化中，并可以多种方式实践或实施。此外，除非另外指明，为方便读者，这里采用的术语和表述是为描述本发明的示例性实施方式的目的而选，而不是出于限制本发明的目的。
应理解，下面描述的实施方式、方法、例子等的任何一个或多个可与下面描述的其它实施方式、方法、例子等的任何一个或多个组合。
现参见附图，其中相同的附图标记表示相同的元件，图1示出了本发明的超声外科剪刀组织垫10的第一种实施方式。该超声外科剪刀组织垫10具有超声外科剪刀组织垫主体12，该主体12包括基材14和至少一种与基材14材料不同的填料16。
在图1的超声外科剪刀组织垫10的实施方式的一个例子中，所述至少一种填料16具有至少一种特性，该特性的数值与基材14的所述至少一种特性的数值不同，其中，所述至少一种特性选自包括如下特性的组：硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度，和熔融温度。在一种变化中，对于基材14和该至少一种填料16来说，至少两个或更多或全部特性具有不同值。
在图1的超声外科剪刀组织垫10的一个例子中，基材14具有高于华氏500度的热挠曲温度。在相同或不同例子中，基材14具有高于华氏700度的熔融温度。在相同或不同例子中，在大于30,000磅/(英寸/秒)的压力-速度值下，基材14具有小于0.3的动摩擦系数。在图1的超声外科剪刀组织垫10的材料的一种选择中，基材14主要由热固性塑性材料构成。在一种变化中，基材14主要由聚酰亚胺材料构成。
在本发明的一种执行方式中，所述至少一种填料16具有与基材14的硬度不同的硬度。在相同或不同执行方式中，至少一种填料16具有与基材14的刚度不同的刚度。在相同或不同执行方式中，至少一种填料16具有与基材14的润滑能力不同的润滑能力。在相同或不同执行方式中，至少一种填料16具有与基材14的动摩擦系数不同的动摩擦系数。在相同或不同执行方式中，至少一种填料16具有与基材14的传热系数不同的传热系数。在相同或不同执行方式中，至少一种填料16具有与基材14的耐磨性不同的耐磨性。在相同或不同执行方式中，至少一种填料16具有与基材14的热挠曲温度不同的热挠曲温度。在相同或不同执行方式中，至少一种填料16具有与基材14的熔融温度不同的熔融温度。
在本发明的一个例子中，至少一种填料选自包括如下材料的组：玻璃、碳纤维、石墨、金属颗粒、二硫化钼、液体润滑剂、在温度升高时变成更多润滑粉末的固体材料、碳纳米管、聚砜、聚苯硫醚、sumifine(商品名称)粉末、氮化硼、聚四氟乙烯粉末、硅酮油和气凝胶。
在本发明的相同或另一例子中，基材14选自包括如下材料的组：塑性材料、多孔陶瓷材料、抛光陶瓷、自组装纳米复合物(当烘焙时，其自身结构形成预定阵列的两种或多种材料的组合物的材料)、高度交联的聚四氟乙烯、硬度至少与钽一样低的金属、氟化聚酰亚胺、填充有粘土的纳米复合物形成聚合物(这些是填充有少量粘土材料的材料，其中，粘土材料与聚合物分子结合产生具有比最初的聚合物材料特性更好的材料，例如填充了粘土的尼龙，其显示了至少比常规尼龙材料高华氏100度的热挠曲温度)，以及聚酰亚胺材料。在一种变化中，塑料选自包括聚四氟乙烯和聚酰亚胺的组。在一种改变中，大体上85％的超声外科刀组织垫主体12主要由基材14构成，大体上15％的超声外科刀组织垫主体12主要由所述至少一种填料16构成，其中，基材14主要由聚四氟乙烯构成，所述至少一种填料16主要由石墨构成。
在本发明的一种表现形式中，超声外科剪刀组织垫主体12包括基材14和至少一种填料16，其中，基材14选自包括如下材料的组：塑性材料、多孔陶瓷、抛光陶瓷、自组装纳米复合物、高度交联的聚四氟乙烯、硬度至少与钽一样低的金属、氟化聚酰亚胺、填充有粘土的纳米复合物形成聚合物、以及聚酰亚胺材料。
在本发明的一种未显示的构造中，超声外科剪刀组织垫主体主要包括选自如下组中的材料：塑性材料、多孔陶瓷、抛光陶瓷、自组装纳米复合物、高度交联的聚四氟乙烯、硬度至少与钽一样低的金属、氟化聚酰亚胺、填充有粘土的纳米复合物形成聚合物，以及聚酰亚胺。
在本发明的一种配置中，超声外科剪刀组织垫主体12包括基材14和至少一种填料16，其中，基材14主要包括多孔聚合物，至少一种填料16选自主要包括如下材料的组：固体润滑剂、液体润滑剂的组、以及在温度增加时变成液体润滑剂的固体润滑剂。
在本发明的一种未显示的设置中，超声外科剪刀组织垫主体主要包括多孔芯吸材料，所述多孔芯吸材料在接触时将患者体液吸到超声外科剪刀组织垫主体中，或者当浸入到含水溶液(诸如盐溶液)中时吸收水分。这些材料通过吸收一些热量使组织垫主体中夹杂的水分蒸发掉来改善组织垫主体的温度性能。
图2示出了本发明的超声外科剪刀组织垫18的第二种实施方式。超声外科剪刀组织垫18具有超声外科剪刀组织垫主体20，该主体20具有邻接的第一区域24和第二区域26，其中，第一区域24包括第一材料28，第二区域26包括与第一材料28不同的第二材料30。对图2的组织垫18的上述说明同样适用于图3-5，如本领域技术人员通过下面讨论的图3-5的组织垫所理解的那样。在图2的组织垫18的一种变化中，第一区域24主要包括第一材料28，第二区域26主要包括第二材料30。在另一种变化中，第一区域24包括基材和至少一种填充材料，其中，基材为第一材料28。在相同或不同变化中，第二区域26包括基材和至少一种填充材料，其中，基材为第二材料30。
在图2的组织垫18的一种构造中，组织垫主体20的第一区域24和第二区域26之间的界面与组织垫主体20的夹钳表面22大致垂直，如图所示。在另一种未显示的构造中，第一和第二区域之间的界面与夹钳表面大致平行(可以想象将图2中的组织垫18旋转90度而得到)。在另一种未显示的构造中，界面以大致在1度到89度之间的角度相对于夹钳表面倾斜，如本领域技术人员理解的那样。
应当注意，用于描述图1的超声外科剪刀组织垫10的实施方式的例子、说明、材料的选择等同样适用于图2的超声外科剪刀组织垫18的实施方式，其中，用“第一材料28”代替“基材14”，并用“第二材料30”代替“至少一种填充材料16”。
图3是作为图2的组织垫18的第一种替代实施方式的组织垫118的外部侧视图。如图所示，组织垫118包括具有邻接的第一区域124和第二区域126的组织垫主体120。第一区域124包括第一材料128，第二区域126包括与第一材料不同的第二材料130。在一种变化中，组织垫主体120的夹钳表面122主要由第一材料128构成，该第一材料128从夹钳表面122离开向着第二区域126延伸。在一种执行方式中，沿横向位于各第二区域126之间的材料是第一区域124的第一材料128。在另一种未显示的执行方式中，具有第三材料的第三区域沿横向设置于各第二区域之间。
图4是作为图2的组织垫18的第二种替代实施方式的组织垫218的外部侧视图。如图所示，组织垫218包括具有邻接的第一区域224和第二区域226的组织垫主体220。第一区域224包括第一材料228，第二区域226包括与第一材料不同的第二材料230。在一种变化中，组织垫主体220的夹钳表面222主要由从夹钳表面222离开向着第二区域226延伸的第一材料228构成。在一种执行方式中，沿横向位于各第二区域226之间的材料是第一区域224的第一材料228。在另一种未显示的执行方式中，具有第三材料的第三区域沿横向设置于各第二区域之间。
图5是作为图2的组织垫18的第三种替代实施方式的组织垫318的外部侧视图。如图所示，组织垫318包括具有邻接的第一区域324和第二区域326的组织垫主体320。第一区域324包括第一材料328，第二区域326包括与第一材料不同的第二材料330。在一种变化中，组织垫主体320的夹钳表面322主要由从夹钳表面322离开向着第二区域326延伸的第一材料328构成。在一种应用中，通过牺牲第一区域324、使其相对较快地被磨损或熔融但又具有某些特性(例如需要的润滑能力)来提高组织垫318的寿命。超声外科刀(在图5中未显示)运动穿过第一材料318然后与第二材料330接触。选择第二材料330，使其具有比第一材料318磨损或熔融得慢的特性。
应注意，用于描述图2的组织垫18的实施方式的例子、说明、材料的选择等同样适用于图3-5的组织垫118、218和318的实施方式，组织垫18的其它替代实施方式留给本领域技术人员处理。
图6示出了本发明的超声外科剪刀32的第一种实施方式。超声外科剪刀32包括超声外科刀34和夹钳臂36，该夹钳臂36可操作地向着刀34打开和闭合并具有可横向弹性变形的远尖端38。“弹性变形的远尖端”的意思是在夹钳臂36夹钳过程中远尖端38可弹性挠曲，所述的夹钳过程例如当超声外科剪刀32用于横切并封闭设置于夹钳表面42和超声外科刀34之间的血管(其中，血管壁已经由借助夹钳臂36施加的夹钳力接合在一起)时。在第一种表现方式的一种实现方式中，超声外科剪刀32还包括与夹钳臂36连接并具有夹钳表面42的组织垫40，其中，组织垫40沿着与夹钳表面42大致垂直的方向弹性变形。在超声外科剪刀32的实施方式的一个例子中，组织垫40包括如前所述的用于图1的组织垫10的基材和至少一种填料。在超声外科剪刀32的另一个例子中，组织垫40包括如前所述的用于图2-5的组织垫18、118、218或318的第一材料和第二材料。
图7示出了本发明的超声外科剪刀44的第二种实施方式。超声外科剪刀44包括超声外科刀46、可操作地向着刀46打开和闭合的夹钳臂48和组织垫50。组织垫50与夹钳臂48连接并具有夹钳表面52。至少一部分组织垫50沿着与夹钳表面52大致垂直的方向弹性变形。“弹性变形”的意思是在夹钳臂48的夹钳过程中组织垫50可弹性挠曲，所述夹钳臂48的夹钳过程例如当超声外科剪刀44用于横切并封闭设置于夹钳表面52和超声外科刀46之间的血管(其中，血管壁已经由借助夹钳臂48施加的夹钳力接合在一起)。在超声外科剪刀44的实施方式的一个例子中，组织垫50包括如前所述的用于图1的组织垫10的基材和至少一种填料。在超声外科剪刀44的另一个例子中，组织垫40包括如前所述的用于图2-5的组织垫18、118、218或318的第一材料和第二材料。
从本发明的一个或多个实施方式和方法可获得多种益处和优点。使组织垫具有基材和至少一种填料允许基材和至少一种填料可被选择具有不同的硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度，和/或熔融温度，以便改善组织垫的耐用性，当采用大的夹钳力时这是很重要的，因为组织垫的磨损在大的夹钳力作用下比在小的夹钳力作用下更快。申请人发现，在一个试验中，填充15％石墨的聚四氟乙烯组织垫在7磅夹钳力的作用下的磨损大致与100％聚四氟乙烯组织垫在1.5磅夹钳力作用下的磨损相同。由于弹性构件能将负载更均匀地分布到组织垫的整个表面上，所以具有弹性夹钳臂和/或弹性组织垫也能改善组织垫的耐用性。
虽然已经通过多种实施方式的描述对本发明进行了阐述，但本发明的申请人并不是想将所附的权利要求书的精神和范围限制得如此详细。许多其它改变、变化和替代可在不背离本发明的精神的前提下由本领域技术人员进行。例如，考虑将所述系统、元件和方法可想到地改变成与机器人系统兼容，本发明的超声外科剪刀和组织垫可用于机器人辅助的外科手术方面。应当理解，前面的描述仅仅作为例子提供，本领域技术人员在不背离所附的权利要求书的精神和范围下可进行其它修改。

Claims (16)

1.一种超声外科剪刀组织垫，包括：超声外科剪刀组织垫主体，所述超声外科剪刀组织垫主体包括基材和至少一种与所述基材的材料不同并散布在所述基材中的填料，
其中，所述至少一种填料具有至少一种特性，所述至少一种填料的所述至少一种特性具有与基材的该至少一种特性的值不同，所述至少一种特性选自包括如下特性的组：硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度和熔融温度。
2.如权利要求1所述的超声外科剪刀组织垫，其中，所述基材具有大于华氏500度的热挠曲温度。
3.如权利要求1所述的超声外科剪刀组织垫，其中，所述基材具有大于华氏700度的熔融温度。
4.如权利要求1所述的超声外科剪刀组织垫，其中，在大于30,000磅/英尺每秒的压力速度值下，所述基材具有小于0.3的动摩擦系数。
5.如权利要求1所述的超声外科剪刀组织垫，其中，所述基材主要包括热固性塑性材料。
6.如权利要求5所述的超声外科剪刀组织垫，其中，所述基材主要包括聚酰亚胺材料。
7.一种超声外科剪刀组织垫，包括：超声外科剪刀组织垫主体，该超声外科剪刀组织垫主体具有夹钳表面，超声外科剪刀组织垫主体具有之间有界面的邻接的第一和第二区域，其中，第一区域包括第一材料，第二区域包括与第一材料不同的第二材料，所述组织垫主体的第一、第二区域之间的界面大致垂直于所述组织垫主体的夹钳表面，
其中，所述第一材料具有至少一种特性，第一材料的所述至少一种特性与第二材料的该至少一种特性的值不同，所述至少一种特性选自包括如下特性的组：硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度、和熔融温度。
8.如权利要求7所述的超声外科剪刀组织垫，其中，所述第一区域主要包括第一材料，第二区域主要包括第二材料。
9.如权利要求7所述的超声外科剪刀组织垫，其中，所述第一材料具有大于华氏500度的热挠曲温度。
10.如权利要求7所述的超声外科剪刀组织垫，其中，所述第一材料具有大于华氏700度的熔融温度。
11.如权利要求7所述的超声外科剪刀组织垫，其中，在大于30,000磅/英尺每秒的压力速度值下，所述第一材料具有小于0.3的动摩擦系数。
12.如权利要求7所述的超声外科剪刀组织垫，其中，所述第一材料主要包括热固性塑性材料。
13.如权利要求12所述的超声外科剪刀组织垫，其中，所述第一材料主要包括聚酰亚胺材料。
14.如权利要求7所述的超声外科剪刀组织垫，其中，所述第一区域包括基材和至少一种填料，所述基材是第一材料。
15.一种超声外科剪刀，包括：
a)超声外科刀；
b)夹钳臂，该夹钳臂可操作地向着所述超声外科刀打开和闭合并具有可横向弹性变形的远尖端；
c)与夹钳臂连接并具有夹钳表面的组织垫，所述组织垫具有邻接的第一区域和第二区域，其中，第一区域包括第一材料，第二区域包括与第一材料不同的第二材料，第一区域和第二区域之间的界面大致垂直于所述夹钳表面，
其中，所述第一材料具有至少一种特性，第一材料的所述至少一种特性与第二材料的该至少一种特性的值不同，所述至少一种特性选自包括如下特性的组：硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度、和熔融温度。
16.一种超声外科剪刀，包括：
a)超声外科刀；
b)夹钳臂，该夹钳臂可操作地向着所述超声外科刀打开和闭合；和
c)组织垫，该组织垫与夹钳臂连接并具有夹钳表面，所述组织垫包括组织垫主体，所述组织垫主体包括基材和至少一种不同于所述基材并散布在所述基材中的填料，所述至少一种填料具有至少一种特性，所述至少一种填料的至少一种特性与基材的该至少一种特性的值不同，所述至少一种特性选自包括如下特性的组：硬度、刚度、润滑能力、动摩擦系数、传热系数、耐磨性、热挠曲温度和熔融温度。
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