CN101401736A - 动力手术缝合装置 - Google Patents
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Abstract
本发明公开一种动力手术缝合器。该缝合器包括壳体,从壳体向远侧延伸并且限定了第一纵轴的内窥镜部,至少部分地设置在壳体内的驱动电动机,以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机围绕穿过其中延伸的第一纵轴旋转。该缝合器还包括邻近内窥镜部的远侧部设置的末端执行器。末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。该缝合器进一步包括控制系统,该控制系统包括接合到驱动电动机、发射杆和负载单元且检测其操作参数的多个传感器。该控制系统还包括微控制器,其接合到多个传感器且配置为在检测到的操作参数的作用下确定动力手术缝合器的操作状态。
Description
相关申请的引用
本申请要求2007年10月5日提交的题目为“动力手术缝合装置”的申请号为60/997,854的美国临时申请的利益和优先权,其全文被在此引用作为参考。
技术领域
本公开涉及一种用来将机械手术紧固件植入病人组织内的手术缝合器,尤其涉及一种由电动机提供动力的用来将手术紧固件发射到组织内的手术缝合器,以及一种用于响应一个或多个感觉反馈信号的控制所述缝合器的反馈控制器。
背景技术
目前已知的装置一般需要10-60磅的手腕力量来夹紧组织和在组织内展开以及形成手术紧固件,经过反复使用该装置会导致手术医生的手部变得疲劳。本领域公知的有将手术紧固件植入组织内的以气体为动力的气动缝合器。这些器械中的某些利用连接到触发机构的压缩气体供给。该触发机构在被压下时简单地释放压缩气体以将紧固件植入组织内。
本领域公知的还有以电动机为动力的手术缝合器。这些手术缝合器包括具有启动缝合钉发射机构(staple firing mechanism)的电动机的动力手术缝合器。但是,这些电动机动力装置仅提供缝合过程的有限的用户控制。用户仅能够触发单个开关和/或按钮来启动电动机,并且将相应的扭矩施加于缝合器的发射机构。在某些其它装置中,控制器用来控制缝合器。
对于包括各种传感器的新的和改进的动力手术缝合器有着持续的需求。这些传感器向反馈控制器提供相关的反馈,反馈控制器响应代表缝合器操作的感觉反馈信号自动调节动力缝合器的各种参数。
发明内容
根据本公开的一方面,公开了一种动力手术缝合器。该缝合器包括壳体、从壳体向远侧延伸并且限定了第一纵轴的内窥镜部、至少部分地设置在壳体内的驱动电动机以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机纵向平移并且可围绕从其延伸出的第一纵轴旋转。缝合器还包括邻近内窥镜部的远侧部设置的末端执行器。末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。缝合器此外还包括主驱动开关,该主驱动开关包括第一开关和第二开关,二者一起形成了触发开关。第一开关适于向第一方向启动驱动电动机以推动末端执行器的第一手术功能,而第二开关适于向第二方向启动驱动电动机以推动末端执行器的第二手术功能。
根据本公开的另一个方面,公开了一种动力手术缝合器。该缝合器包括壳体、从壳体向远侧延伸并且限定了第一纵轴的内窥镜部、至少部分地设置在壳体内的驱动电动机以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机纵向平移。缝合器还包括配置为可移动的附着在内窥镜部的负载单元。负载单元包括末端执行器,该末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。缝合器还包括负载单元识别系统和应答机,负载单元识别系统包括识别负载单元并且设置于其上的识别器。应答机配置为与识别器相接以获得与负载单元联系的独特的识别码。
根据本公开的进一步方面,公开了一种动力手术缝合器。该缝合器包括壳体、从壳体向远侧延伸并且限定了第一纵轴的内窥镜部、至少部分地设置在壳体内的驱动电动机以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机围绕从其延伸出的第一纵轴纵向平移。缝合器还包括邻近内窥镜部的远侧部设置的末端执行器。末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。缝合器此外还包括接合到驱动电动机的电源。该电源包括一个或多个电池以及一个或多个封入由吸收剂和缓速材料形成的绝缘罩内的超电容器。
根据本公开进一步的另一个方面,公开了一种动力手术缝合器。该缝合器包括壳体、从壳体向远侧延伸并且限定了第一纵轴的内窥镜部、至少部分地设置在壳体内的驱动电动机以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机纵向平移。缝合器还包括邻近内窥镜部的远侧部设置的末端执行器。该末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。缝合器此外还包括用来确定发射杆当前的线性位置的位置计算器。该位置计算器接合到邻近发射杆设置并且配置为检测发射杆的线性移动的线性位移传感器。此外缝合器还包括确定发射杆的线速度和驱动电动机的转速的至少一个的速度计算器。
根据本公开的一方面,公开了一种动力手术缝合器。该缝合器包括壳体、从壳体向远侧延伸并且限定了第一纵轴的内窥镜部、至少部分地设置在壳体内的驱动电动机以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机纵向平移。缝合器还包括邻近内窥镜部的远侧部设置的末端执行器。末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。缝合器此外还包括铰接装置,铰接装置包括配置为可以将末端执行器从第一铰接位置移动至第二铰接位置的铰接电动机,在第一铰接位置,第二纵轴与第一纵轴大体成一条直线,而在第二铰接位置第二纵轴设置为相对于第一纵轴有一角度。另外,缝合器还包括铰接传感器,其配置为确定在末端执行器在第一位置的铰接期间,接合到铰接电动机且配置为当末端执行器在第一位置时向铰接电动机发出信号以终止计算。
根据本公开的进一步方面,公开了一种动力手术缝合器。该缝合器包括壳体、从壳体向远侧延伸并且限定了第一纵轴的内窥镜部、至少部分地设置在壳体内的驱动电动机以及设置为与驱动电动机机械协作的发射杆。发射杆通过电动机围绕从其延伸出的第一纵轴纵向平移。缝合器还包括邻近内窥镜部的远侧部设置的末端执行器。末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能。缝合器此外还包括具有多个接合到驱动电动机、发射杆、负载单元和末端执行器的传感器,多个配置为检测其操作参数的传感器的控制系统。该控制系统还包括微控制器,其接合到多个传感器且配置为在检测的操作参数的作用下确定动力手术缝合器的操作状态。
附图说明
在此将参考附图对主要器械的各种实施例进行描述,其中:
图1为依照本公开的一个实施例的动力手术器械的立体图;
图2为依照图1中本公开的实施例的动力手术器械的局部放大立体图;
图3为依照图1中本公开的实施例的动力手术器械的局部放大平面图;
图4为依照本公开的一个实施例的图1中动力手术器械的内部部件的局部立体剖视图;
图5为依照本公开的一个实施例的图1中动力手术器械的部分分离的铰接机构的立体图;
图6为依照设置在第一位置的图1中本公开的一个实施例的动力手术器械的内部部件的局部横截面图;
图7为依照设置在第二位置的图1中本公开的实施例的动力手术器械的内部部件的局部横截面图;
图8为依照本公开的一个实施例的图1中动力手术器械的部分分离的负载单元的安装组件和近本体部(proximal body)的立体图;
图9为依照本公开的一个实施例的图1中动力手术器械的末端执行器的横截面侧视图;
图10为依照图1中本公开的实施例的动力手术器械的内部部件的局部放大侧视图;
图11为依照本公开的一个实施例的图1中动力手术器械的单向离合器片的立体图;
图12为依照图1中本公开的实施例的动力手术器械的内部部件的局部放大侧视图;
图13为依照图1中本公开的实施例的动力手术器械的电源的示意图;
图14为示出证明图1中动力手术器械的电源的方法的流程图;
图15A-B为依照图1中本公开的实施例的动力手术器械的负载单元的局部立体后视图;
图16为示出证明依照图1中本公开的实施例的动力手术器械的负载单元的方法的流程图;
图17为依照图1中本公开的实施例的动力手术器械的负载单元的立体图;
图18为依照本公开的实施例的图1中动力手术器械的末端执行器的横截面侧视图;
图19为依照本公开的实施例的图1中动力手术器械的横截面侧视图;
图20为依照图1中本公开的实施例的动力手术器械的控制系统的示意图;
图21为依照本公开的反馈控制系统的示意图;
图22A-B为依照本公开的实施例的反馈控制系统的反馈控制器的立体正视图和后视图;
图23为依照本公开的实施例的反馈控制器的示意图;
图24为依照本公开的一个实施例的动力手术器械的内部部件的局部剖视图;
图25为依照本公开的一个实施例的动力手术器械的内部部件的局部立体剖视图;
图26为依照本公开的一个实施例的动力手术器械的前端(nose)组件的局部立体图;
图27为依照本公开的一个实施例的动力手术器械的收缩杆的局部立体图;
图28为依照本公开的一个实施例的动力手术器械的局部立体图;
图29为依照本公开的一个实施例的动力手术器械的立体图;
图30为依照本公开的一个实施例的动力手术器械的模块收缩组件的立体图;
图31为依照本公开的一个实施例的动力手术器械的内部部件的局部放大剖视图;以及
图32为依照本公开的一个实施例的动力手术器械的内部部件的局部放大剖视图。
具体实施方式
现在将参考附图详细描述目前公开的动力手术器械的实施例,其中相同的附图标记指代多幅视图中的每一幅图的相同或相应元件。如本文所使用的术语“远侧”指的是动力手术器械远离用户的部分或其部件,而术语“近侧”指的是动力手术器械靠近用户的部分或其部件。
依照本公开的诸如手术缝合器的动力手术器械在图中用附图标记10指代。先参考图1,动力手术器械10包括壳体110、限定了穿过其延伸的第一纵轴A-A的内窥镜部140,以及限定了穿过其延伸的第二纵轴B-B的末端执行器160。内窥镜部140从壳体110向远侧延伸,并且末端执行器160邻近内窥镜部140的远侧部设置。在一个实施例中,密封壳体110的部件以防止颗粒的渗透和/或流体污染并且有助于防止消毒处理对部件的损害。
依照本公开的一个实施例,末端执行器160包括具有一个或多个手术紧固件(例如,钉仓组件164)的第一钳构件,以及包括用来展开和形成手术紧固件(例如,砧座组件162)的砧座部的第二反钳构件。在某些实施例中,缝合器被容纳在钉仓组件164中以同时或连续的方式将缝合器的线性排列应用到人体组织。砧座组件162和钉仓组件164中的一个或两个在砧座组件162隔开钉仓组件164的打开位置和砧座组件162与钉仓组件164并置的临近或夹紧的位置之间都可以相对彼此移动。
可以进一步预想到末端执行器160附着在安装部166上,安装部166可枢转地附着在主体部168上。主体部168可以与动力手术器械10的内窥镜部140构成整体,或可以可拆卸地附着在器械10上以提供可替代的一次性负载单元(DLU)或单独使用的负载单元(SULU)(例如,负载单元169)。在某些实施例中,可重复利用部可以配置为用来消毒并且在随后的手术程序中再次使用。
负载单元169可以通过卡口连接连接到内窥镜部140。可以预想到负载单元169具有连接到负载单元169的安装部166的铰链连杆,并且铰链连杆连接到联动杆以使末端执行器160随着联动杆沿第一纵轴A-A在远近方向平移而铰接。可以使用其它工具将末端执行器160连接到内窥镜部140以实现铰接,例如柔性管或包括多个可枢转构件的管。
负载单元169可以并入或配置为并入各种末端执行器,例如脉管密封装置、线性缝合装置、旋转缝合装置、刀具等。这些末端执行器可以被接合到动力手术器械10的内窥镜部140。负载单元169可以包括未铰接的线性缝合末端执行器。中间柔性轴可以被包括在手柄部112和负载单元之间。可以预想到柔性轴的并入便于接近和/或进入身体的特定区域。
参考图2,依照本公开的一个实施例图示了壳体110的放大图。在图式实施例中,壳体110包括手柄部112,手柄部112上设置有主驱动开关114。开关114可以包括第一开关114a和第二开关114b,二者一起形成触发开关。限定了手柄轴H-H的手柄部112配置为由用户的手指来抓取。手柄部112具有提供了宽敞的手掌紧握杠杆机构的人体工程学的形状,该形状有助于防止手柄部112在操作中被挤出用户的手。示出了每一个开关114a和114b设置到手柄部112上合适的位置以便于由用户的一个或多个手指按压。
另外,参考图1和图2,开关114a和114b可以用来启动和/或停止驱动电动机200(图4)的移动。在一个实施例中,开关114a配置为在第一方向触发驱动电动机200以在远侧方向推进发射杆220(图5),从而夹紧砧座组件162与钉仓组件164。与之相反,开关114b可以配置为收缩发射杆220以通过在相反方向启动驱动电动机200来张开砧座组件162与钉仓组件164。收缩模式启动机械锁止,通过负载单元169防止缝合和切割的进一步进行。触发器具有用来启动开关114a的第一位置,启动开关114b的第二位置,以及在第一位置和第二位置之间的中间位置。下面对器械10的驱动部件的详细操作进行更详细的讨论。
壳体110,尤其是手柄部112,包括开关罩117a和117b。开关罩117a和117b可以具有分别围绕开关114a的底部和开关114b的顶部的类肋状。开关罩117a和117b防止开关114的意外启动。此外,开关114a和114b具有需要增加压力以启动开关的高触觉反馈。
在一个实施例中,开关114a和114b配置为多速(例如两个或更多个)开关、增量开关或变速开关,所述开关以非线性方式控制驱动电动机200和发射杆220的速度。例如,开关114和114b可以是对压力敏感的。这种控制接口允许驱动部件的速率从较慢或较精确的模式向较快的操作逐渐增加。为了防止收缩的意外启动,开关114b在按压故障安全开关之前可以是电子非连通的。另外,第三开关114c也可以用于该目的。另外或可选择地,故障安全可以通过从预定的大约100毫秒到2秒的时间段内按压并且保持开关114b而得到克服。除非开关114b在收缩模式期间启动(例如,按压或释放)以停止收缩,发射杆220将自动收缩回其初始位置。释放开关114b后随后按压,收缩继续进行。可选择地,在其它实施例中,即使开关114b被释放,发射杆220的收缩可以继续直到完全收缩。
开关114a和114b接合到非线性速度控制电路115中,电路115可以实施为电压调节电路、可变电阻电路或微电子脉冲宽度调制电路。开关114a和114b可以通过置换或驱动可变控制装置与控制电路115相接,所述可变控制装置例如为变阻器、多档位开关电路(multipleposition switch circuit)、线性和/或旋转可变位移传感器、线性和/或旋转电位计(potentiometer)、光学编码器、铁磁传感器和霍尔效应传感器。这就允许开关114a和114b基于按压开关114a和114b以多个速度模式操作驱动电动机200,速度模式例如取决于所使用的控制电路115的类型逐渐或逐步地逐渐增加驱动电动机200的速度。
在一个特定实施例中,还可以包括开关114c(图1、2和4),其中开关114c的按压可以机械地和/或电子地改变从夹紧到发射的操作模式。开关114c凹入在壳体110中并且具有高触觉反馈以防止错误启动。提供分离的控制开关以初始化发射模式允许末端执行器的钳重复地打开和关闭,因此器械10在按压开关114c前用作抓取器,从而启动缝合器和/或刀具。例如,开关114可以包括一个或多个微电子薄膜开关。这样的微电子薄膜开关包括相对较低的致动力、小的封装尺寸、人体工程学的尺寸和外形、薄型、包括开关上的模制字母的能力、符号、描绘和/或指令以及低材料消耗。另外,可以密封开关114(例如微电子薄膜开关)以便于器械10的消毒并且有助于防止颗粒和/或流体污染。
作为替代物,或除了开关114之外,其它输入装置可以包括声音输入技术,该输入装置可以包括并入控制系统501(图14)中的硬件和/或软件,或连接到控制系统501的分离的数字模块。声音输入技术可以包括声音识别、声音启动、声音校正和/或嵌入语音。用户可以通过声音命令来整体或部分地控制器械的操作,因此解放出用户的一只或两只手以操作其它器械。声音或其它可听输出也可以被用来向用户提供反馈。
参考图3,示出了具有用户接口120的壳体110的近侧区118。用户接口120包括屏幕122和多个开关124。用户接口120可以显示器械10的各种操作参数,例如可以通过传感器与用户接口通信的“模式”(例如,旋转、铰接或致动)、“状态”(例如,铰接角度、转速或致动类型)和“反馈”,例如缝合钉是否已经基于器械10中设置的传感器所报告的信息被发射。
屏幕122可以为液晶屏,等离子屏、电致发光屏等类似屏。在一个实施例中,排除开关124的要求,屏幕122可以为触摸屏。触摸屏可以结合电阻的、表面声波、电容的、红外的、变形测量、光学的、分散的信号或声音脉冲识别触摸屏技术。触摸屏可以用来允许用户在观察操作反馈的同时提供输入。该方法可便于密封屏幕部件从而有助于对器械10进行消毒,并且可以防止颗粒和/或流体污染。在某些实施例中,屏幕被可枢转或可旋转地安装到器械10以用来在使用或准备期间灵活地观察屏幕(例如,通过铰链或球窝式安装)。
开关124可以用来开始和/或停止器械10的移动,以及选择枢轴方向、速度和/或扭矩。还可以预想到至少一个开关124能被用来选择各设定值被超越的紧急模式。开关124还可以用来选择屏幕122上的各种选项,例如在用户接口菜单导航和选择各种设置的同时对提示作出响应,允许用户输入不同的组织类型以及缝合钉仓的各种尺寸和长度。
开关124可以从各种形状和尺寸的微电子触觉或非触觉薄膜、聚酯薄膜、合成橡胶、塑料或金属键中形成。另外,可以将开关定位在相互不同的高度和/或可以包括凸起的标记或其它组织特征(例如凹陷或凸起)以使得用户不需要查看用户接口120就能够按压适当的开关。
除了屏幕124之外,用户接口120可以包括一个或多个可视化输出123,可视化输出123可以包括一个或多个彩色可见光源或发光二极管(LED)以将反馈传送给用户。可视化输出123可以包括各种形状、尺寸和颜色的相应的指示器,指示器具有识别可视化输出123的数字和/或文字。可视化输出123设置在壳体110的顶部以使输出123被抬起并相对于壳体110突出以提供更好的可见度。
多光源以特定的组合展示以向用户图示特定的操作模式。在一个实施例中,可视化输出123包括第一光源(例如黄色)123a、第二光源(例如绿色)123b和第三光源(例如红色)123c。这些光源以特定的组合操作,特定的组合如表1所列与特定的操作模式有关。
表1
在另一个实施例中,可视化输出123可以包括显示与操作模式有关的特定颜色的单个多彩LED,操作模式如上所述与表1中第一、第二和第三光源有关。
用户接口120还包括声音输出125(例如乐音、钟、蜂鸣器、集成扬声器等)以将例如电池能量不足、钉仓为空等的各种状态变化传达给用户。声音反馈可以与可视化输出123结合使用或可以替代可视化输出123。声音反馈可以嘀嗒声、劈啪声、嘟嘟声、敲钟声和嗡嗡声的形式,以单个或多个脉冲的顺序被提供。在一个实施例中,模拟的机械声音可以被预先录制,而模拟的机械声音由复制机械锁止和传统的无动力器械机构产生的嘀嗒声和/或劈啪声来得到。这样不再需要通过器械10的真实部件来产生这样的机械声音,并且避免了嘟嘟声和其它通常与其它手术室设备有关的电子声音的使用,从而防止无关的声音反馈造成的混乱。
器械10还可以通过壳体110内的触觉机构(未明确示出)来提供触觉或振动反馈。触觉反馈可以与听觉和视觉反馈结合使用或可以替代它们以避免依赖于声音和视觉反馈的手术室设备的混乱。触觉机构可以为以脉动的方式振动的异步电动机。在一个实施例中,振动处于大约30Hz或以上的频率,这提供了具有1.5毫米或更低振幅的位移以限定振动效果不会到达负载单元169。
还可以预想到用户接口120包括在屏幕和/或开关上的不同颜色和/或亮度的文字以进一步区别显示项目。视觉、听觉或触觉反馈的强度能够增加或降低。例如,反馈强度可以用来表示器械上的力正变得过大。
图2-4图示了铰接机构170,其包括铰接壳体172、动力铰接开关174、铰接电动机132以及手动铰接旋钮176。动力铰接开关174的平移或手动铰接旋钮176的枢转启动铰接电动机132,随后铰接电动机132启动铰接机构170的铰接齿轮233,如图C所示。铰接机构170的启动导致末端执行器160从其纵轴B-B大体与纵轴A-A成一直线的第一位置移至纵轴B-B设置为相对于纵轴A-A有一角度的位置。优选地,可以到达多个铰接位置。动力铰接开关174还可以在开关114a和114b控制时与夹紧机构类似并入非线性速度控制器。
此外,壳体110包括具有翼状外形并且从壳体110的顶面越过开关174延伸的开关罩169。开关罩169防止开关174的意外启动并且要求用户触到开关罩169下面以启动铰接机构170。
另外,铰接壳体172和动力铰接开关174安装在旋转壳体组件180上。旋转旋钮182围绕第一纵轴A-A的旋转导致壳体组件180以及铰接壳体172和动力铰接开关174围绕第一纵轴A-A的旋转,从而导致发射杆220的远侧部224和执行器160围绕第一纵轴A-A的相应旋转。铰接机构170机电接合到壳体前端组件155上设置的第一和第二导电圆环157和159,如图4和26所示。导电圆环157和159可以被焊接和/或卷曲到前端组件155上并且与电源400电接触,从而向铰接机构170提供电力。前端组件155可以是模块化的并且可以在组装过程附着到壳体110以更易焊接和/或卷曲圆环。铰接机构170包括一个或多个与导电圆环157和159接触的刷子和/或弹簧负载触头,以使随着壳体组件180沿铰接壳体172旋转,铰接机构170与导电圆环157和159连续接触从而从电源400接收电力。
铰接壳体172、动力铰接开关174、手动铰接旋钮176的更多细节以及向末端执行器160提供铰接在2007年3月15日提交的共有申请序列号为11/724,733的美国专利中有详细的描述,其全部内容通过引用合并于此作为参考。可以预想到可以设置在壳体110内的限位开关、近程传感器(例如,光学的和/或铁磁的),线性可变位移传感器和转轴编码器的任意组合,可以用来控制和/或记录末端执行器160的铰接角度和/或发射杆220的位置。
图4-8图示了器械10的各种内部部件,包括驱动电动机200、驱动管210以及具有近侧部222和远侧部224的发射杆220。驱动管210可以围绕穿过其延伸的驱动管轴C-C旋转。驱动电动机200设置为与驱动管210机械协作并且配置为使驱动管210围绕驱动齿轮轴C-C旋转。在一个实施例中,驱动电动机200可以为电动机或齿轮电动机,其可以包括并入其壳体内的齿轮装置。
壳体110可以从两个半部110a和110b形成,如图3所示。两个壳体半部110a和110b可以利用凸台定位器111处的螺杆彼此附着,凸台定位器111使壳体部110a和110b成一直线。另外,壳体110可以由塑料形成并且可以包括通过两次模制处理施加到壳体110的内表面的橡胶支承构件。橡胶支承构件可以把驱动部件(例如,驱动电动机200)的振动与器械的其余部分隔开。
壳体半部110a和110b可以通过塑料薄片(例如,活动铰链)彼此附着,塑料薄片与半部110a和110b相互连接并且允许壳体110可以通过分离半部110a和110b而打开。
在一个实施例中,驱动部件(例如,包括驱动电动机200、驱动管210和发射杆220等)可以安装到支承板上,支承板允许驱动部件在器械10已经使用后从壳体110移走。与铰接壳体半部110a和110b一起安装的支承板提供特定的内部部件的重复利用和循环利用同时限制了其污染。
参考图4-6,图示了发射杆接合器190。发射杆接合器190提供了发射杆220的近侧部222和远侧部224之间的链接。特定的,发射杆接合器190使发射杆220的远侧部224能相对于发射杆220的近侧部222旋转。因此,参考下面对关于定位板350的讨论,发射杆接合器190使得发射杆220的近侧部222能够保持不转,同时允许发射杆220的远侧部224的旋转(例如,当旋转旋钮182旋转时)。
参考图5和6,发射杆220的近侧部222包括贯穿驱动管210的内螺纹部212延伸的螺纹部226。发射杆220和驱动管210之间的这种关系导致发射杆220响应驱动电动机200的旋转在驱动管210旋转时,在箭头D和E的方向上沿驱动管210的螺纹部212向远侧和/或近侧移动。随着驱动管210在第一方向上旋转(例如,顺时针方向),发射杆220向近侧移动,如图5所示,发射杆220设置在其最近侧位置上。随着驱动管210在第二方向上旋转(例如,逆时针方向),发射杆220向远侧移动,如图6所示,发射杆220设置在其最远侧位置上。
发射杆220在特定的限定内向远侧和近侧平移。特别地,发射杆220的近侧部222的第一末端222a与定位板350结合作为机械停止装置。也就是说,在收缩时,当发射杆220向近侧平移时,第一末端222a接触定位板350的远侧表面351,从而防止发射杆220连续的近侧平移,如图5所示。另外,近侧部222的螺纹部226与定位板350结合作为机械停止装置。也就是说,当发射杆220向远侧平移时,螺纹部226接触定位板350的近侧表面353,从而防止发射杆220进一步向远侧平移,如图6所示。定位板350包括具有非圆形横截面的贯穿其的孔。所述孔的非圆形横截面防止发射杆220的近侧部222的旋转,从而限定了发射杆220的近侧部222贯穿其的轴向平移。此外,近侧轴承354和远侧轴承356至少部分地设置在驱动管210周围以便于驱动管210的旋转,同时有助于驱动管在壳体110内定位。
驱动管210在第一方向(例如,逆时针方向)上的旋转与发射杆220向远侧平移一致,发射杆220向远侧平移启动末端执行器160的钳构件162、164以抓取或夹紧其间夹持的组织。发射杆220另外的远侧平移通过启动凸轮杆和/或作用滑轮74(图9)把手术紧固件从末端执行器160中弹射出以紧固组织。此外,发射杆220还可以配置为启动刀片(未明确示出)以切割组织。发射杆220的近侧平移与驱动管210在第二方向(例如,顺时针方向)上的旋转一致,发射杆220的近侧平移启动钳构件162、164和/或刀片来收缩或恢复到相应的预发射位置。发射或其它的启动末端执行器160的细节在由米利曼(Milliman)等人共有的专利号为6,953,139的美国专利(第139号米利曼专利)中有详细的描述,其公开通过引用合并与此作为参考。
图X所示为负载单元169的分解图。末端执行器160可以通过具有驱动梁或驱动构件266的轴向驱动组件213来启动。驱动梁213的远侧末端可以包括刀片。另外,驱动梁213包括具有一对凸轮构件40a的固定凸缘40,凸轮构件40a在驱动梁213纵向前进时啮合砧座组件162和钉仓组件164。驱动梁213使得启动滑轮74纵向穿过缝合钉仓164前进。滑轮74具有凸轮楔,随着滑轮74前进所述凸轮楔用来啮合设置在钉仓组件164狭槽内的推动器68。设置在狭槽内的缝合钉66通过推动器68被驱动穿过组织并且对着砧座组件162。
参考图8,示出了驱动电动机轴202从附着在驱动电动机200上的行星齿轮204处延伸。驱动电动机轴202与离合器300机械协作。驱动电动机轴202通过驱动电动机200旋转,从而引起离合器300的旋转。离合器300包括离合器片302和弹簧304并且显示为具有设置在离合器片302上的楔形部306,楔形部306配置为与设置在驱动管210的近侧面216上的接口(例如,楔214)一致。
弹簧304图示为位于行星齿轮204和驱动管210之间。特别地,与图8所示的实施例一致,弹簧304图示为位于离合面302和离合垫圈308之间。另外,驱动电动机200和行星齿轮204安装在电动机架310上。如图8所示,通过设置在电动机架310内的狭槽312以及设置在壳体110上的突起314,电动机架310关于壳体110近侧或远侧可调。
在本公开的一个实施例中,离合器300实施为滑动单向离合器以限定驱动部件上的扭矩和高惯性负载。离合器300的楔形部306配置并且布置为关于驱动管210的近侧面216的楔214滑动,除非临界力通过离合器弹簧304施加到离合器片302上。此外,当弹簧304施加所需的临界力以使楔形部306和楔214在不产生滑动的情况下啮合,驱动管210将随着驱动电动机200的旋转而旋转。可以预想到楔形部306和/或楔214配置为在一个和/或两个方向(例如,顺时针方向和/或逆时针方向)关于彼此滑动直到获得临界力。
如图A和B,示出了离合器300与单向离合器片700。离合器片700包括多个具有滑动面704和夹紧面706的楔形部702。滑动面704具有啮合驱动管210的楔214直到预定负载的曲边。夹紧面706具有完全啮合驱动管210并且防止滑动的平边。当离合器片700在第一方向(例如,顺时针方向)旋转时,楔形部702的夹紧面706无滑动地啮合楔214,从驱动电动机200供给完全扭矩。当离合器片700在反方向(例如,逆时针方向)旋转时,楔形部702的滑动面704啮合楔214并且限定向驱动管210平移的扭矩。因此,如果施加到滑动面704上的负载超过限定,则离合器300滑动并且驱动管210不旋转。这防止了会由于驱动部件的动量和动力摩擦而产生的对末端执行器160或组织的高负载损伤。更特别地,器械10的驱动机构能够以与向后驱动时较小的扭矩向前驱动驱动杆220。单向离合器的使用消除了该问题。另外,电子离合器还可以用来在收缩时(例如,在相反方向驱动驱动杆220)增加电动机势能,下面将对此进行详细讨论。
可以进一步预想到驱动电动机轴202包括D形横截面708,D形横截面708包括大体上的平面部710和圆形部712。因此,当驱动电动机轴202相对于离合器片302平移时,随着驱动电动机轴202的旋转,驱动电动机轴202不会相对于离合器片302“滑动”。也就是说,驱动电动机轴202的旋转将引起离合器片302的无滑动旋转。
在依照本公开的某些实施例中,负载单元包括轴向驱动组件,其与发射杆220协作以接近末端执行器160的砧座组件162和钉仓组件164,并且从钉仓发射缝合钉。正如上述讨论和第139号米利曼专利的特定实施例中所公开的,该轴向驱动组件可以包括穿过钉仓向远侧移动并且可以在缝合钉发射后收缩的梁。
参考图4,器械10包括电源400,电源400可以是可再充电池(例如,铅电池、镍电池、锂离子电池等)。还可以预想到电源400包括至少一个一次性电池。该一次性电池可以介于9伏和30伏之间。
取决于器械10当前的负载需要,电源400包括一个或多个电池401。此外,电源400包括一个或多个超电容器402,由于其比传统电容器更高的能量密度而用作补充的电存储。在高能提取中,超电容器402能够与电池401结合使用。因为电池401为从中不能快速流出电力的典型慢流装置,当所要求/所需的能量比电池401自身所能提供的要快时(例如,在夹紧厚组织、快速发射和夹紧等时),能够利用超电容器402来产生电力冲击。该配置能够降低电池上的电流负载从而减少电池401的数量。可以预想到,能够将电池401连接到超电容器402上以对电容器充电。
电源400可以随着驱动电动机200移动以供给这些部件的循环使用以及器械10的重复使用。在另一个实施例中,电源400可以是在使用中被用户佩戴上传送带和/或导线并且用导线连接到器械10的外部电池组。
电源400可以封入绝缘罩404中,绝缘罩404可以从吸收、耐火和阻燃材料中形成。罩404防止由电源400产生的热使器械10的其它部件变热。另外,罩404还可以配置为在过度使用和/或损伤过程中吸收从电池402中泄漏的任何化学物质或流体。
电源400接合到配置为连接到外部电源(例如,DC变压器)的电源适配器406。外部电源可以用来为电源400再充电或供给另外的电力需求。电源适配器406还可以配置为与电手术发电机相接,该电手术发电机可以随后为器械10供应电力。在该配置中,器械10也可以包括AC到DC的电源,该电源转换来自电手术发电机的射频能量并且为器械10提供电力。
在另一个实施例中,电源400利用感应充电接口可再次充电。电源400接合到设置在壳体110的近侧部内的感应螺线管(未明确示出)。感应螺线管在被放置到电磁场内后把能量转换为电流,然后电流用来为电源400充电。电磁场可以由基站(未明确示出)产生,该基站配置为与壳体110的近侧部相接,以便感应螺线管被电磁场包围。该配置消除了外部接触器的需要并允许壳体110的近侧部来密封电源400和防止暴露在流体和污染物下的防水环境中的感应螺线管。
参考图5,器械10还包括一个或多个安全电路,例如放电电路410以及电动机和电池操作模块412。为了显示清晰,使器械10的各种电子部件相互连接的导线和其它电路元件并未示出,但是该机电连接导线可以通过本公开预想到。器械10的某些部件无线地连通。
放电电路410接合到开关414以及依次接合到电源400的抗阻负载417。开关414可以为用户启动或自动(例如,定时器、计数器)开关,其在为了安全和低温处理而对电源400完全放电时(例如,在手术处理的最后)被启动。一旦开关414被启动,负载417电连接到电源400以使电源400的势能被导向负载417。自动开关可以为定时器或计数器,其在预定操作时间段或使用数量过后自动启动以为电源400放电。负载417具有足够的预定电阻以完全和安全地为所有电池401放电。
电动机和电池操作模块412接合到一个或多个热传感器413,该热传感器413确定驱动电动机200和电源400内的温度以确保器械10的安全操作。所述传感器可以为用来确定在电源400、电热调节器、热电堆、热电耦、热红外传感器等内引出电流的电流表。监测这些部件的温度允许确定其上放置的负载。流过这些部件的电流的增加引起这些部件内部温度的升高。温度和/或电流牵引数据可以随后用来以有效的方式控制电力消耗或保证操作的安全电平。
为了确保器械10的安全和可靠操作,保证电源400是可靠的和/或有效的(例如,遵照严格的质量和安全标准)以及在预定温度范围内的操作是值得的。对电源400有效性的鉴定使得病人和/或用户由于质量不佳可能受到伤害的危险降至最低。
参考图9,电源400示出了具有一个或多个电池401、温度传感器403以及接合于其上的嵌入式微控制器405。微控制器405通过有线和/或无线通信协议接合到器械10的微控制器500(图14)以鉴定(authenticate)电源。在一个实施例中,温度传感器403可以直接接合到微控制器500而不是接合到嵌入式微控制器405。温度传感器403可以为电热调节器、热电堆、热电耦、热红外传感器、电阻温度检测器、线性主动电热调节器、温度响应变色带、双金属触头开关等。温度传感器403将测量到的温度向微控制器405和/或微控制器500报告。
嵌入式微控制器405与微控制器500执行所谓的回应询问鉴别算法,如图10所示。在步骤630中,电源400被连接到器械10并且接通器械10。微控制器500向嵌入式微控制器405传送询问请求。在步骤632中,微控制器405对询问请求进行解析并且生成作为对请求的应答的响应。该响应可以包括标识符,例如存储在无线电频率标识符标记或微控制器405的存储器中的唯一的序列号、电源400的唯一的电测量值(例如,电阻、电容、电感等)。另外,该响应包括由温度传感器403测量的温度。
在步骤634中,微控制器500解码所述响应以获得标识符以及测量温度。在步骤636中,通过将标识符与有效(authentic)标识符的预先认可的列表进行比照,微控制器500基于标识符确定电源400是否有效。如果标识符无效(not valid),器械10将不会操作并且通过用户接口120显示“鉴定电池失败”的信息。如果标识符有效,处理继续进行到步骤640,在步骤640中,分析测量的温度以确定测量是否在预定的操作范围内。如果温度超过限定值,则器械10同样显示故障信息。这样,如果温度在预定的限定值内并且标识符有效,则在步骤642中,器械开始操作,可能包括向用户提供“电池已鉴定”的信息。
返回参考图4和5,图示了多个用来提供与器械10的功能有关的反馈信息的传感器。传感器的任意组合可以设置在器械10内以确定其操作阶段,例如,缝合钉仓负载检测以及其状态、铰接、夹紧、旋转、缝合、切割和收缩及其它。传感器能够通过器械10的各种内部部件(例如,发射杆220、驱动电动机200等)的接近、位移或接触来启动。
在图示的实施例中,传感器能够为可变电阻器(例如,可变电阻装置)、电流监测器、电导传感器、电容传感器、感应传感器、热基传感器、限定启动开关、多位开关电路、压力传感器、线性和/或旋转可变位移传感器、线性和/或旋转电位计、光学编码器、铁磁传感器、霍尔效应传感器以及近程开关。传感器测量旋转、速度、加速度、减速度、线性和/或角位移、机械限定的检测(例如,停止)等。上述测量可以通过将多个指示器以线性或旋转的阵列安置在器械10的机械驱动部件上来达到。传感器随后将测量值传送给确定器械10的操作状态的微控制器500。另外,微控制器500还基于测量的反馈调节器械10的电动机速度或扭矩。
如图A和B所示,在离合器300实施为滑动离合器的实施例中,线性位移传感器(例如,线性位移传感器237)位于离合器300的远侧以提供精确测量。在该配置中,离合器300的滑动量不影响传感器所记录的位置、速度和加速度测量值。
参考图4,负载开关230设置在铰接壳体172内。开关230与开关114串连,防止器械10的启动,除非负载单元169正确负载到器械10内。如果负载单元169没有负载到器械10内,则主动力开关(例如,开关114)打开,从而防止器械10的任意的电子或电部件的使用。这还防止任何可能的来自电源400的电流使得电源400维持超过其特定的储存寿命的最大势能。
由于开关不能到达外部处理并且仅能够通过负载单元169的插入启动,因此开关230作为防止器械10的错误启动的所谓“锁止”开关。开关230随着负载单元169插入到内窥镜部140内通过插入物或传感器管的位移而启动。一旦开关230启动,来自电源400的电力供给器械10的电部件(例如,传感器、微控制器500等)以提供用户进入用户接口120和其它输入/输出设备。这还使得可视化输出123依照指出正确负载的负载单元169的光源组合点亮,其中全部光源如表1所示关闭。
更特别地,如图18和19所示,内窥镜部140包括在其中的传感器板360,该传感器板与传感器管机械接触并且也设置在内窥镜部140内且围绕发射杆220的远侧部224。发射杆220的远侧部224穿过位于传感器帽364远侧末端的开口368。传感器帽364包括弹簧并且与开关230邻接。这使得传感器帽364相对传感器管362偏置,传感器管362位于传感器帽364的远侧末端而没有穿过开口368。因此传感器管362的偏置随后将传感器板360推出。
当负载单元169负载到内窥镜部140内时,近侧部171邻接传感器板360并且在近侧方向安置板360。传感器板360随后在近侧方向推动传感器管362,传感器管362随后施加压力到传感器帽364上,从而压缩弹簧366并且启动指示负载单元169已经正确插入的开关230。
一旦负载单元169插入到内窥镜部,开关230还会确定负载单元169是否基于其位置正确负载。如果负载单元169没有正确负载,则开关114不会启动并且误差码通过用户接口120向用户传达(例如,如表1所示,全部光源关闭)。如果负载单元169已经发射,则任意的机械闭锁已经在之前启动或缝合钉仓已经使用,器械10通过用户接口120传达误差,例如,第一光源123a在闪烁中。
在一个实施例中,接合到主开关114的第二锁止开关259(图4)可以在器械10中实施为设置在配置为在当用户抓取器械10时启动的手柄部112的顶面上的生物电阻抗(bioimpedance)传感器、电容传感器或压力传感器。因此,除非器械10被正确抓取,否则开关114被禁用(disable)。
参考图5,器械10包括用来确定和输出发射杆220的当前线性位置的位置计算器416。该位置计算器416电连接到线性位移传感器237,并且转速检测器418被接合到驱动电动机200。检测器418包括编码器420,该编码器420接合到电动机以产生两个或多个响应于驱动电动机200的旋转的编码脉冲信号。编码器420将脉冲信号传输给检测器418,然后检测器418确定驱动电动机200的转速。由于转速与发射杆220的线速度直接成比例,位置计算器416随后基于驱动电动机200的转速确定发射杆的线速度和位置。位置计算器416和速度计算器422接合到微控制器500,微控制器500响应于来自计算器416和422的感觉反馈控制驱动电动机200。下面将参考图14对该配置进行详细讨论。
器械10包括设置在发射杆220上的第一指示器320a和第二指示器320b,所述指示器确定发射杆220的速度以及发射杆220关于驱动管210和/或壳体110的位置。例如,限位开关可以通过觉察第一指示器320a和第二指示器320b(例如,凸起、凹槽、锯齿痕等)穿过而启动(例如,轴启动位置传感器231和夹紧位移传感器232),从而确定发射杆220的位移、发射杆220的速度以及器械10的模式(例如,夹紧、抓取、发射、封装、切割、收缩)。此外,接收自第一指示器320a和第二指示器320b的反馈可以用来确定发射杆220取决于附着在其中的特定负载单元的尺寸应该在何时停止其轴向移动(例如,驱动电动机200应该何时中止)。
更特别地,随着发射杆220从其静止位置(例如,初始位置)在远侧方向移动,位置传感器231的第一启动由指示器械10的操作已经开始的第一指示器320a启动。随着操作的继续,发射杆220被更远地移至初始夹具,初始夹具移动第一指示器320a以与夹紧位置传感器232相接。发射杆220的进一步前进移动第二指示器320b以与指示器械10已经发射的位置传感器232相接。
如上所述,位置计算器416接合到邻近发射杆220设置的线性位移传感器237。在一个实施例中,线性位置传感器237可以为磁传感器。发射杆220可以是磁性的或可以在其中包括磁性材料。磁传感器可以为铁磁传感器或配置为检测磁场变化的霍尔效应传感器。随着发射杆220由于驱动电动机200的旋转而线性平移,由磁传感器记录磁场响应于平移的变化。磁传感器将与磁场变化相关的数据传输给位置计算器416,位置计算器416随后在磁场数据的作用下确定发射杆220的位置。
在一个实施例中,发射杆220的选取部可以是磁性的,例如设置在发射杆220上的内螺纹部212或其它凹槽(例如,指示器320a和/或320b)可以包括磁性材料或由磁性材料制成。这考虑到磁场内的周期变化随着发射杆220的磁部线性平移与螺纹的每一次非连续平移相关。位置计算器416随后通过对磁场内的周期变化的数目求和确定发射杆220的距离和位置,并且将该和与螺纹和/或凹槽的预定距离相乘。
在一个实施例中,线性位移传感器237可以为电位计或可变电阻器。发射杆220包括设置为与线性位移传感器237机电接触的触头(例如,凸轮端子)。随着发射杆220通过驱动电动机200在远侧方向移动,触头沿着线性位移传感器237的表面滑动。随着触头滑动穿过电位计和/或可变电阻器,电位计的电压和可变电阻器的电阻相应变化。因此,电压和电阻的变化被传输给位置计算器416,位置计算器随后推断发射杆220和/或发射杆接合器190平移的距离和其位置。
在一个实施例中,位置计算器416接合到一个或多个开关412,随着发射杆220和发射杆接合器190在远侧方向移动,开关412由内螺纹部212的螺纹或指示器320a和/或320b启动。位置计算器416计算启动开关421的螺纹的数量并且随后将该数字与螺纹或指示器320a和/或320b之间的预定距离相乘。
器械10还包括速度计算器422,该速度计算器422确定线性移动发射杆220的当前速度和/或由驱动电动机200提供的扭矩。速度计算器422连接到线性位移传感器237,线性位移传感器237使得速度计算器422基于其位移变化的速率确定发射杆220的速度。
速度计算器422接合到包括编码器426的转速检测仪424。编码器426传输与驱动电动机200的旋转相关的脉冲,速度计算器422随后使用所述脉冲来计算发射杆220的线速度。在另一个实施例中,速度计算器422接合到旋转传感器239,该旋转传感器239检测驱动管210的旋转,从而测量考虑到发射杆220的线速度的确定的驱动管210的转速。
速度计算器422还接合到测量在驱动电动机200内感应的反电动势(“EMF”)的电压传感器428。驱动电动机200的反电动势电压与驱动电动机200的转速直接成比例,如上所述,驱动电动机200的转速用来确定发射杆220的线速度。
在恒定电流情况下通过测量穿过其端子的电压来实现监测驱动电动机200的速度。驱动电动机200的负载的增加造成施加在电动机端子上电压的降低,而电动机端子上电压的降低与电动机的速度的减小直接相关。因此,测量穿过驱动电动机200的电压用于确定其上放置的负载。另外,通过监测电压随时间的变化(dV/dt),微处理器500能够检测与负载的较大变化或驱动电动机200和/或电源400的温度增加相关的电压的快速下降。
在另一实施例中,速度计算器422接合到电流传感器430(例如,电流表)。电流传感器430与接合到驱动电动机200的分流电阻器432电连通。电流传感器430通过测量穿过电阻器432的电压下降来测量驱动电动机200牵引的电流。由于用来为驱动电动机200提供动力的电流与驱动电动机200的转速成比例,因此与发射杆220的线速度成比例,速度计算器422基于驱动电动机200的牵引电流确定发射杆220的速度。
速度计算器422还可以接合到第二电压传感器(未明确示出)以确定电源400内的电压,从而计算直接来自电源的功率。另外,电流随时间的变化(dI/dt)能够被监测以检测与通过驱动电动机200所施加的扭矩的大幅增加对应的测量中的快速峰值。因此,电流传感器430用来确定驱动电动机200的速度和负载。
另外,由速度计算器422测量的发射杆220的速度则可以与驱动电动机200的牵引电流比照,以确定驱动电动机200是否正确操作。也就是说,如果牵引电流(例如,偏大)与发射杆220的速度(例如,偏小)不相称,则电动机200处于故障中(例如,锁定、失速等)。如果检测到失速,或牵引电流超过了预定的限定值,则位置计算器416确定发射杆220是否处于机械停止状态。如果发射杆处于机械停止状态,则微控制器500可以切断驱动电动机200或进入脉冲和/或暂停模式(例如,对驱动电动机200非连续供电)以开启器械10并且收缩发射杆220。
在一个实施例中,速度计算器422对比通过旋转传感器239检测的驱动管210的转速和基于测量转速检测仪424的驱动电动机200的转速。如果在离合器300的旋转和驱动管210的旋转之间不一致,则所述对比使得速度计算器422确定是否存在离合器启动问题(例如,滑动)。如果检测到滑动,则位置计算器416确定发射杆220是否处于机械停止状态。如果发射杆处于机械停止状态,则微控制器500可以切断器械10或进入脉冲和/或暂停模式(例如,对驱动电动机200非连续供电),又或收缩发射杆220。
除发射杆220和其它驱动部件的线性和/或旋转位移之外,器械10还可以包括适于检测末端执行器160的铰接的传感器。参考图4,器械10包括适于在由轴开始位置传感器231检测的程序开始时指示旋转壳体组件180的开始位置、旋转方向和角位移的旋转传感器241。旋转传感器241通过计算设置在旋转旋钮182的内表面上的指示器的数量来操作,旋转旋钮182通过指示器旋转。计算值则随后被传输给微控制器500,微控制器500随后确定内窥镜部142的旋转位置。这可以无线地或通过内窥镜部上的电连接和连接到微控制器500的导线进行连通。
器械10还可以包括确定末端执行器160铰接的铰接传感器235。该铰接传感器235计算设置在铰接齿轮233上的263的数字,通过所述数字,铰接旋钮176从其0°位置,即铰接旋钮176的中心位置以及因此是末端执行器160的中心位置旋转,如图C所示。该0°位置可以由中心唯一指示器265指定,中心唯一指示器265也设置在与末端执行器160的第一位置对应的铰接齿轮233上,第一位置处纵轴B-B与纵轴A-A大体成一直线。计算值则传输给微控制器500,微控制器500随后确定末端执行器160的铰接位置并且通过接口120报告铰接角度。
另外,铰接角度可以用于所谓的“自动停止”模式。在该操作模式下,在末端效应器160位于其中心第一位置时,器械10自动停止末端执行器160的铰接。也就是说,随着末端执行器160从纵轴B-B设置为与纵轴A-A成一角度的位置到第一位置铰接,在纵轴B-B与纵轴A-A大体成一直线时铰接停止。该位置通过铰接传感器235基于中心指示器检测。该模式使得内窥镜部140被取出,而无需用户不得不手动地对准末端执行器160。
结合图1,本公开设置有负载单元识别系统440,其使得器械10识别负载单元169及确定负载单元169的操作状态。识别系统440向器械10提供缝合钉尺寸、钉仓长度、负载单元169的类型、钉仓的状态、合适接合等信息。该信息使得器械调节夹紧力、夹紧及发射速度和用于不同长度钉仓的行程的末端。
负载单元识别系统440也可以适于确定以及向器械10传达(例如,图14所示的控制系统501)包括用于操作末端执行器160的速度、动力、转矩、夹紧、行驶长度及强度限制的各种信息。控制系统501也可以确定操作模式以及调节用于部件的行驶的电压、离合器弹簧负荷和停止点。更具体地说,识别系统可以包括设置在末端执行器160中的部件(例如,微芯片、发射机或发射器),所述末端执行器160与控制系统501或位于控制系统501内的接收器连通(例如,无线、经由红外线信号等)。也可以预想到可以通过发射杆220发射信号,以使发射杆220作为用于在控制系统501与末端执行器160之间连通的导管。在另一实施例中,能够通过如反馈控制器603(图15至图17)的中间接口来发射该信号。
通过示例的方式,以上讨论的传感器可以用于确定缝合钉是否已经从缝合钉仓中发射、缝合钉是否被完全地发射、是否有些束已经被收缩到缝合钉仓近端以及这些束被收缩的程度、以及与负载单元有关的其他信息。在本公开的特定实施例中,负载单元上装有用于识别负载单元的类型和/或装在器械10上的钉仓的类型的部件,包括红外线芯片、细胞芯片或射频识别芯片。负载单元和/或钉仓的类型可以由控制系统501中的相关接收器来接收,或由用于提供反馈、控制和/或总量分析的操作室中的外部设备来接收。
信息能够经由负载单元169与器械10之间的各种通信协议传输(例如,有线传输或无线传输)到器械10。所述信息能够存储在负载单元169内的微控制器、微处理器、非易失性存储器、射频识别接头及如光学、颜色、位移、磁、电、二进编码和格雷编码的各种类型的识别器中(例如,电导、电阻、电容、阻抗)。
在一实施例中,负载单元169和器械10包括对应的无线收发器,分别为识别器442和应答机444。识别器442包括存储器或识别器442可以接合到用于存储与负载单元169有关的各种识别和状态信息的微控制器。一旦负载单元169接合到器械10,器械10经由应答机444询问识别器442识别码。响应该询问,识别器442答复与负载单元169对应的识别码。在操作期间,一旦已发生识别,识别器442配置为向器械10提供关于负载单元169的状态(例如,机械和/或电故障、位置、铰接等)的更新。
识别器442和应答机444配置为使用一个或多个下列通信协议彼此通信,如蓝牙、ANT3、KNX、ZWave、X10、无线USBIrDA、Nanonet、TinyOS、ZigBee、802.11 IEEE和其他无线、红外线、UHF、VHF通信等。在一实施例中,收发器400可以是根据收发器402的询问能力而主动或被动的射频识别(RFID)接头。
图11A和图11B示出了具有各种类型的识别设备的负载单元169的额外实施例。结合图11A,示出了具有电识别器173的负载单元169的近侧端171。识别器173可以包括一个或多个电阻器、电容器、感应器,并与设置在内窥镜部140的远端的对应的电触头181接合。该触头可以包括设置在内窥镜部的集流环、电刷和/或静触头。识别器173可以设置在负载单元168的任何位置上,也可以形成在柔性电路或固定电路上,或可以直接位于负载单元169的表面。
当负载单元169接合到内窥镜部140时,该触头施加小电流通过电识别器173。应答机触头也包括用来测量电阻值、阻抗、电容值和/或电识别器173的阻抗的对应的电传感器。电识别器173具有与负载单元169的识别码对应的独特的电特性(例如,电阻值、电容值、感应值等),因而,当负载单元169的电特性被确定时,器械10基于该测定出的特性来确定负载单元169的特性。
在一实施例中,电识别器173可以是如格雷编码磁铁和/或具有预定的独特磁模式的铁节点的磁识别器,该磁模式通过识别码来识别负载单元169。磁识别器经由设置在内窥镜部140的远端的磁传感器(例如,铁磁传感器、霍尔效应传感器等)来读取。磁传感器将磁数据传输到器械10,器械10然后确定负载单元169的特性。
图11B示出了具有一个或多个突起175的负载单元169的近侧端171。突起175可以为如层状、凸起状、带状等的任何形状和各种尺寸。突起175与设置在内窥镜部140的近侧段的对应的位移传感器183相接。当突起175插进内窥镜部时该传感器被移置。位移量通过传感器来分析并被转变为识别数据,使得器械10确定缝合钉大小、钉仓长度、负载单元169的类型、合适接合等。位移传感器可以是能够被弹簧负载的开关、触点、磁传感器、光传感器、各种电阻器、线性和旋转可变位移传感器。这些开关配置为基于它们的启动状态向器械10传输二进编码。更具体地,一些突起175延伸足以选择地启动一些开关的距离,从而基于突起175的组合产生独特的编码。
在另一实施例中,突起175可以是颜色编码的。位移传感器183包括颜色传感器,该颜色传感器配置为确定突起175的颜色以基于该颜色来测量负载单元169的一个或多个特性,并向器械10传输该信息。
图12示出了用于识别负载单元169和向器械10提供与负载单元169有关的状态信息的方法。在步骤650中,确定负载单元169是否恰当地装载到器械10上。这可以通过检测触头是否由识别器173和/或突起175制成。如果负载单元169被恰当地装载,则在步骤652中,负载单元169向器械10传达就绪状态(例如,打开可视化输出123的第一光源)。
在步骤654中,器械10检验负载单元169是否已经提前发射。识别器442存储指示提前发射状态的值。如果负载单元169被发射,则在步骤656中,器械10提供误差响应(例如,闪动可视化输出123的第一光源)。如果负载单元169没有被发射,则在步骤658中负载单元169经由识别系统440向器械10提供识别和状态信息(例如,打开第一光源)。基于以下详述的步骤664中存储在识别器442的存储器中的已存储的“提前发射”信号,做出负载单元169是否已经发射的判断。在步骤660中,器械10响应从负载单元169接收的信息来调节它的操作参数。
在步骤662中用户通过器械10执行手术程序。一旦该程序完成且负载单元169已经被发射,器械10向负载单元169传输“提前发射”信号。在步骤664中,负载单元169将“提前发射”信号存储在识别器442的存储器中,用于以下讨论的步骤654中通过器械10的下一次询问。
结合图13,负载单元169包括设置在末端执行器160中用于检测抓住的物体的类型的一个或多个组织传感器,如识别非组织物体和物体的组织类型。这些传感器也配置为确定通过末端执行器160的钳构件之间的血量。更具体地,第一组织传感器177设置在砧座组件162的远端部,第二组织传感器179设置在钉仓组件164的末端部。传感器177和179接合到识别器442,使得向器械10的微控制器500传输传感器数据。
传感器177和179适于在二者间产生呈一个或多个排列或频率的场和/或波。传感器177和179可以是声学、超声速、铁磁、霍尔效应传感器、激光、红外线、射频或压电设备。传感器177和179被校准用于忽略经常出现的如空气、体液和各种类型的人体组织的材料,以及用于检测外部物质的特定类型。该外部物质可以是骨头、肌腱、软骨、神经、主动脉和如陶瓷、金属、塑料等非组织物质。
传感器177和179基于由传感器产生的场信号的吸收、反射和/或过滤来检测通过砧座组件162与钉仓组件164之间的外部物质。如果该物质减少信号或反射信号,以使物质在校准范围外,因此是外部物质,则传感器177和179向微控制器500传输干扰信息,微控制器500然后确定末端执行器160抓住的物质的类型。该确定可以通过比较干扰信息与查找表来做出,该查找表列出了各种类型的物质及它们的相关干扰范围。微控制器500然后警告用户抓住了外部物质以及外部物质的特征。这使得防止了用户夹紧、切断或缝合含有外部物质的区域。
图14示出了包括微控制器500的控制系统501,微控制器500接合到位置计算器416、速度计算器422、负载单元识别系统440、用户接口120、驱动电动机200和数据存储模块502。另外,微控制器500可以直接接合各种传感器(例如第一和第二组织传感器177和179、负载开关230、轴开始位置传感器231、夹紧位置传感器232、铰接传感器235、线性位移传感器237、旋转传感器239、发射杆旋转传感器241、电动机和电池操作模块412、转速检测装置418、开关421、电压传感器428、电流传感器430、应答机444等)。
微控制器500包括存储一个或多个用于控制器械10的操作和功能的应用软件(例如,固件程序)的内置存储器。微控制器500处理来自用户接口120的输入数据并响应该输入来调节器械10的操作。器械10的调节可以包括打开或关闭器械10的动力、通过电压调节或电压脉冲宽度调制来进行速度控制、通过减少占空比或脉冲打开或关闭电源以限制在预定时间段期间的平均传输电流来进行转矩限制。
微控制器500经由用户反馈模块504接合到用户接口120,用户反馈模块504配置为通知用户器械10的操作参数。用户反馈模块504指示用户接口(interface)120将操作数据输出到屏幕122上。尤其,传感器的输出被传输到微控制器500,微控制器500然后响应该输出向用户发送反馈来指示用户为器械10选择特定的模式、速度或功能。
负载单元识别系统440指示微控制器500哪个末端执行器在负载单元上。在一实施例中,控制系统501能够存储与施加到发射杆220和/或末端执行器160上的力有关的信息,以使当负载单元169被识别时微控制器500自动选择用于器械10的操作参数。这使得控制施加到发射杆220的力,以便发射杆220能够驱动位于当时在使用中的负载单元上的特定末端执行器160。
微控制器500也分析从位置计算器416和速度计算器422以及其他传感器的计算,以确定发射杆220的实际位置和/或速度以及器械10的部件的操作状态。该分析可以包括来自位置计算器416和速度计算器422的感觉反馈信号的中断,以响应该感觉信号来控制发射杆220和器械10的其他部件的移动。微控制器500配置为当位置计算器416报告发射杆220已经移动超过预定点时限制发射杆220的行驶。由微控制器500使用来控制器械10的其他参数包括电动机和/或电池温度、剩余循环以及已用循环的次数、剩余电池寿命、组织厚度、末端执行器的当前状态、传输和接收、外部设备连接状态等。
在一实施例中,器械10包括配置为测量电流(例如安培计)、电压(例如电压计)、近侧(例如光学传感器)、温度(例如热接合器)和力(例如)以确定负载单元169上的负荷状态的各种传感器。在器械10的操作期间,期望知道在接近处理期间和发射处理期间由器械10施加到目标组织上的力。异常负载(例如超出预定负载范围)的检测指示器械10和/或被夹紧的组织的问题,该问题被传达给用户。
负载状态的监测可以通过一个或多个以下方法来执行:监测驱动电动机200的速度、监测由电动机施加的转矩、钳构件162和164的近端、监测器械10的部件的温度、经由应变传感器185(图4)来测量发射杆220和/或器械10的其他负载承受部件上的负载。以上结合图5及速度计算器422讨论了速度和转矩监测。
测量钳构件162与164之间的距离也能够指示在末端执行器160和/或器械10上的负载状态。当给与钳构件162和164大量力时,钳构件向外变形。在正常操作期间,钳构件162和164彼此平行,但是在变形期间,钳构件彼此间成一角度。因而,测量钳构件162与164之间的角度能够确定由于施加在其上的负载所引起的所述钳构件的变形。钳构件可以包括图13所示的应变片187和189以直接测量施加在钳构件上的负载。可选地,可以在钳构件162和164的远尖端设置一个或多个近端传感器191和193,以测量钳构件162和164之间的角度。然后这些测量传输到微控制器500,微控制器500分析该角度和/或应变测量并警告用户在末端执行器160上的压力。
在另一实施例中,发射杆220或其他负载承受部件包括设置在其上的一个或多个应变片和/或负载传感器。在高应变情况下,施加在器械10和/或末端执行器160上的压力传递到发射杆220使得发射杆220偏转,导致其上增加的应变。然后应变片向微控制器500报告应力测量。在另一实施例中,可以在离合器板302上设置位置、应变或力传感器。
在接近处理期间,当末端执行器160夹紧组织时,设置在器械10和/或末端执行器160中的传感器向微控制器500指示末端执行器160围绕异常组织(例如,低或高负载情形)展开。低负载情形指示末端执行器160抓住了少量组织,高负载情形指示抓住了大量组织和/或外部物质(例如管、缝合线、芯片等)。因此微控制器500经由用户接口120向用户指示应该选择更合适的负载单元169和/或器械10。
在发射处理期间,传感器能够警告用户各种错误。传感器可以向微控制器500传达钉仓或一部分器械10的错误。另外,传感器能够检测在刀上施加的力的突发峰值,这指示出碰到了外部物质。力峰值的监测能够用于检测发射行程的结束,如当发射杆220碰到钉仓的端部并进入硬停止时。硬停止产生比在器械10的正常操作期间观察到的力峰值相对大的力峰值,并能够用于向微控制器指示发射杆220已经到达负载单元169的端部。力峰值的测量可以与结合位置计算器416及速度计算器422讨论的位置反馈测量(例如从编码器、线性可变位移传感器、线性电压计等)相组合。这使得器械10不改变末端执行器160就可以使用各种类型的钉仓(例如多长度)。
当遇到力峰值时,器械10通知用户该状态并通过进入以下将更详细地描述的所谓的“脉冲”或电离合器模式采取预防措施。在该模式期间,驱动电动机200被控制为仅在短脉冲时运行,以使抓住的组织与末端执行器160之间的压力相等。电离合器限制由驱动电动机200施加的转矩并防止来自电源400的高电流量的情况。这依次防止了由于伴随过载和高电流情况的过热而对电部件和机械部件的损坏。
微控制器500经由脉冲宽度调制控制信号来通过电动机驱动器控制驱动电动机200。电动机驱动器配置为在顺时针方向或逆时针方向调节驱动电动机200的速度。电动机驱动器也配置为在多个操作模式之间切换,多个操作模式包括电电动机制动模式、恒速模式、电离合器模式和受控电流致动模式。在电制动模式中,驱动电动机200的两个终端被缩短,产生的反电动势抵消驱动电动机200的旋转,使得紧固件停止以及使得调节发射杆220的线性位置的更高的位置精度。
在恒速模式中,速度计算器422与微控制器500和/或电动机驱动器联合来调节驱动电动机200的转速,以保证发射杆220的恒定线速度。电离合器模式涉及响应来自位置计算器416和速度计算器422的感觉反馈信号使离合器300与驱动电动机200反复接合和/或分离。在受控电流致动模式,电流升高或下降以防止当从静态模式转到动态模式以提供所谓的“软启动”和“软停止”时损坏电流和转矩过高。
数据存储模块502记录来自与微控制器500接合的传感器的数据。另外,数据存储模块502记录在程序期间负载单元169的识别码、末端执行器100的状态、缝合循环的次数等。数据存储模块502也配置为通过无线或有线数据端口503连接到外部设备,如个人计算机、PDA、智能手机、存储设备(例如,Secure Digitalcard、Compact flashcard、Memorystick)等。这使得数据存储模块502传输执行数据到外部设备用于随后的分析和/或存储。数据端口503也使得微控制器500的固件的所谓“在场中”的更新。
图15至图17示出了反馈控制系统601。该系统包括图16A和图16B示出的反馈控制器603。器械10经由有线(例如Firewire、USBSerial RS232、Serial RS485、USART、Ethernet等)或无线(例如,蓝牙、ANT3、KNX、ZWave、X10、无线USB、IrDANanonet、TinyOS、ZigBee、802.11 IEEE和其他无线、红外线、UHF、VHF通信等)的数据端口502连接到反馈控制器603。
结合图15,反馈控制器603配置为存储由器械10传输到其的数据以及处理和分析所述数据。反馈控制器603也连接到其他设备,如视频显示器604、视频处理器605和计算设备606(例如,个人计算机、PDA、智能手机、存储设备等)。视频处理器605用于处理由反馈控制器603产生的输出数据以用于向视频显示器604输出。计算设备606用于反馈数据的另外处理。在一实施例中,由微控制器600执行的传感器反馈分析的结果可以内部存储用于由计算设备606以后检索。
反馈控制器603包括接合到微控制器600的数据端口607(图16B)。数据端口607使得反馈控制器603连接到计算设备606。数据端口607可以提供与计算设备606的有线和/或无线连通,计算设备606提供在计算设备606与反馈控制器603之间的接口,用于存储的反馈数据的检索、反馈控制器603的操作参数的构造和反馈控制器603的固件和/或其他软件的更新。
在图16A和图16B中进一步示出了反馈控制器603。反馈控制器603包括壳体610和如视频输入614、视频输出616、平视(“HUD”)显示器输出618的多个输入和输出端口。反馈控制器603还包括用于显示关于反馈控制器603的状态信息的屏幕620。
图23示出了反馈控制器603的部件。反馈控制器603包括微控制器600和数据存储模块602。微控制器600和数据存储模块602提供与器械10的微控制器500和数据存储模块502类似的功能。将这些部件设置在独立模块中,以反馈控制器603的形式,减轻了器械10中具有这些部件的需要。
数据存储模块602可包括一个或多个内部和/或外部存储设备,如磁硬驱动机(magnetic hard drives)、闪存存储器(例如SecureDigitalcard、Compact flashcard、Memorystick等)。反馈控制器603使用数据存储模块602以存储来自器械10的反馈数据,用于由计算设备606进行的随后的数据分析。反馈数据包括由设置在器械10中的传感器等供给的数据。
微控制器600配置为代替和/或补充器械10的控制电路,如果存在的话。微控制器600包括存储一个或多个用于控制器械10的操作和功能的应用软件(例如,固件)的内部存储器。微控制器600处理来自用户接口120的输入数据并响应该输入数据来调节器械10的操作。微控制器600经由用户反馈模块504接合到用户接口120,用户反馈模块504配置为通知用户器械10的操作参数。更具体地,器械10配置为经由数据端口407(图5)通过无线或有线连接到反馈控制器603。
在公开的实施例中,微控制器600连接到驱动电动机200,并被构造和设置为监控电池阻抗、电压、温度和/或牵引电流(current draw)及控制器械10的操作。确定电池400、传输、驱动电动机200和器械10的驱动部件上的负荷,如果所述负荷指示到达或接近损坏限制则控制电动机速度。例如,可以确定电池400中剩余的能量、剩余发射次数、是否必须替换电池400或为电池400充电,和/或器械10的势能负载限制的接近。微控制器600也可以连接到器械10的一个或多个上述传感器。
微控制器600也配置为响应监控到的信息来控制驱动电动机200的操作。脉冲模块控制线路可以用于控制器械10,脉冲模块控制线路可以包括电离合器。例如,微控制器600能够调节驱动电动机200的电压供给,或向驱动电动机200供给脉冲调制信号来调节动力和/或转矩输出以防止系统损坏或最佳化能量使用。
在一实施例中,电制动电路可以用于控制驱动电动机200,其使用旋转的驱动电动机200的现有的反电动势来抵消和基本减少驱动管210的动力。电制动电路可以改善驱动电动机200的控制和/或驱动管210的停止精度,和/或动力手术器械10的变换位置。用于监控动力手术器械10的部件及有助于防止动力手术器械10的过载的传感器可以包括如热传感器、热敏电阻器、热电元件、热电偶和/或热红外线传感器的热型传感器,并向微控制器600提供反馈。在达到或接近限制的情况下,微控制器600可控制动力手术器械10的部件,这种控制可以包括切断来自电源400的动力、暂时中断动力或进入暂停模式和/或脉冲模块以限制使用的能量。微控制器600也能够监控部件的温度以确定何时能够恢复操作。微控制器600的上述使用可以单独使用或与电流、电压、温度和/或阻抗测量一起使用。
通过微控制器600的数据分析和处理的结果输出到视频显示器604和/或HUD显示器622。视频显示器604可以是如LCD屏幕、等离子屏幕、电发光屏幕等的任何类型的显示器。在一实施例中,视频显示器604可包括触摸屏,可结合电阻的、表面波纹、电容的、红外的、应变片、光学的、离散信号或声音脉冲识别触摸屏幕技术。该触摸屏可以用于在观看操作反馈时使得用户提供输出。HUD显示器622可以突设在手术程序期间用户可以看到的任何表面上,如一对眼镜和/或护目镜的透镜、面罩等。这使得用户不用放松对程序的关注就可以观察来自反馈控制器603的重要的反馈信息。
反馈控制器603包括屏幕显示模块(on-screen display module)624和HUD模块626。HUD模块626处理微控制器600的输出用于分别显示在显示器604和622上。更具体地,OSD模块624将来自反馈控制器603的文本和/或图形信息覆盖在经由设置在其中的摄像头从手术位置接收的其他视频图像。具有覆盖文本的修正后的视频信号被传输到视频显示器604,使得用户在仍然观察手术位置的同时观察来自器械10和/或反馈控制器603的有用的反馈信息。
图24至图25示出了器械10’的另一实施例。器械10’包括具有设置成直线构造的多个电池401的电源400’。电源400’垂直地插入位于手柄部112中的垂直的电池室800。电池室800包括位于其顶部的弹簧802以推下电源400’。在一实施例中,弹簧802可以包括触头以电接合电源400’。电源400’经由电池盖804保持在电池室800中,电池盖804配置为沿远侧方向滑动以锁止在适当位置。盖804和手柄部112可包括舌状物和槽以防止盖804滑出。由于弹簧802向下的力使电源400’压向盖804。当盖804在近端方向滑动时,电源400’通过弹簧802从电池室800中弹出。
图25示出了检测驱动管210的旋转从而测量驱动管210的转速的旋转传感器239的另一实施例。驱动管210使得确定发射杆220的线速度。旋转传感器239包括安装在驱动管210上的编码器轮810和光输入机812(例如光电断路器)。光输入机812配置为确定在相对的边缘814和816之间连续提供的光束的中断的次数。编码器轮810与驱动管210一起旋转,并包括通过其中的多个狭缝811。
编码器轮810的外边缘设置在光输入机812的相对的边缘之间,以使在边缘814与816之间传输的光通过狭缝811闪光。换句话说,当驱动管210被旋转时,边缘814与816之间的光束被编码器轮810中断。光输入机812测量光束中断的次数及其发生的速度并将这些测量传输到速度计算器422,速度计算器422然后确定上述发射杆220的速度。
图27至图32示出了具有用于将发射杆220从其发射位置收缩的收缩组件820的器械10’。收缩组件820为驱动管210提供手动驱动机械接口,使得在紧急情况下(例如,电故障、卡住末端执行器160等)通过收缩组件820的收缩运动使驱动管210手动收缩。收缩组件820可配置为能够插进器械10’的模块组件。
结合图30,收缩组件820包括具有顶部823和底部825的收缩底盘822。收缩组件820经由驱动齿轮826和收缩齿轮824与驱动管210机械相接。驱动齿轮826附着在驱动管210上,并响应驱动管210的旋转被平移。相反地,驱动齿轮826的旋转显示驱动管210上的旋转。驱动齿轮826和收缩齿轮824可以是使得收缩齿轮824和驱动齿轮826以垂直方式相接的斜齿轮。
收缩齿轮824接合到第一滑柱828,第一滑柱828以基本垂直的方式设置在收缩底盘822的顶部823与底部825之间,并围绕其限定的纵轴旋转。第一滑柱828进一步包括附着在第一滑柱828和收缩齿轮824上的第一正齿轮830。第一正齿轮830与设置在第二滑柱834上的第二正齿轮832相接,第二滑柱834也以基本垂直的方式设置在收缩底盘822的顶部823与底部825之间,并围绕其限定的纵轴旋转。
第二正齿轮832与设置在第一滑柱828上的第三正齿轮836机械相接。第三正齿轮836附着在单向离合器组件840的第一离合器部838。如图31所示,离合器组件840进一步包括旋转地设置在第一滑柱828上的第二离合器部840。第二离合器部840位于第一离合器部838上方,且弹簧843设置在第一离合器部838和第二离合器组件840之间,从而保持第一离合器部838和第二离合器部840处于升高的非互锁配置(例如,第一配置)。
驱动管210和/或驱动齿轮826的旋转显示分别同第一离合器部838和滑柱828和834一起旋转的收缩齿轮824、第一、第二和第三正齿轮830、832和836上的旋转。因为,第二离合器部842能够围绕第一滑柱828旋转并通过弹簧843与第一离合器部838分离,第一离合器部838的旋转不被改变。
第一离合器部838和第二离合器部842包括多个互锁齿844,互锁齿844具有扁平互锁面846和倾斜滑动面848。在图32所示的第二配置中,第二离合器部842被收缩杆845推下从而与互锁齿844相接。滑动面848使得互锁面846彼此接触,从而使第二离合器部842旋转以旋转第一离合器部838和所有相接的齿轮。
收缩杆845包括附着在其上的凸轮部847和手柄849。凸轮部847包括开口853,开口853包围单向打捆针传动离合器855,单向打捆针传动离合器855与附着在第一滑柱828上的配合件856机械协作,从而使得收缩杆845围绕第一滑柱828旋转。结合图29,收缩杆845包括一个或多个具有凸轮面852的凸轮件850。在第一配置中,如图27所示,收缩杆845沿壳体110的杆壳860设置。收缩杆845被弹簧843推上顶住顶部823,凸轮件850设置在对应的凸轮壳858中。收缩杆845由安装在顶部823与凸轮部847之间的回拉弹簧862维持在第一配置。凸轮件850和杆壳860防止收缩杆845的进一步旋转。
当收缩杆845被推出杆壳860时,凸轮件850与对应的凸轮壳823相接并向下推动收缩杆845的凸轮部847。该向下移动使弹簧843压缩并推动第一离合器部838和第二离合器部842一起互锁齿844,从而啮合第一离合器部838和第二离合器部842。在逆时针方向的凸轮部847的旋转制动打捆针传动离合器855,打捆针传动离合器855与配合件856和第一滑柱828相接。收缩杆845的连续旋转使离合器组件840旋转,离合器组件840依次旋转正齿轮836、832和830、收缩齿轮824和驱动齿轮826。这反过来旋转驱动管210和收缩发射杆220。
如图28所示,在手柄849邻接壳体110前收缩杆845能够旋转预定量。因此,收缩杆845被回拉弹簧862带回其第一配置。这使凸轮部847升高使得第二离合器部842也向上移动并与第一离合器部838分离。打捆针传动离合器855松开配合件856,使得没有影响驱动管210的移动而使收缩杆845返回第一配置。一旦收缩杆845返回到第一配置,收缩杆845可以再次收缩以继续松开驱动杆220。
应理解的是可以对此处所示的实施例做出各种改进。因此,上述描述不应被理解为用于限制,而是仅仅是优选实施例的示意。本领域的技术人员将想到在所附的权利要求的范围和精神内的其他改进。
Claims (51)
1、一种动力手术缝合器,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
驱动电动机,其至少部分地设置在所述壳体内;
发射杆,其设置为与所述驱动电动机机械协作;
末端执行器,其邻近内窥镜部的远侧部设置,该末端执行器与所述发射杆机械协作以使所述发射杆驱动末端执行器的手术功能;以及
主驱动开关,其包括一起构成触发开关的第一开关和第二开关,其中第一开关适于在第一方向启动所述驱动电动机以推动末端执行器的第一手术功能,第二开关适于在第二方向启动所述驱动电动机以推动末端执行器的第二手术功能。
2、根据权利要求1所述的动力手术缝合器,其中所述第一开关和第二开关接合到非线性速度控制电路,所述非线性速度控制电路适于在第一开关和第二开关的按压作用下控制所述驱动电动机的旋转速度。
3、根据权利要求2所述的动力手术缝合器,其中所述非线性速度控制电路是从由电压调节电路、可变电阻电路和微电子脉冲宽度调制电路构成的组中选择的。
4、根据权利要求2所述的动力手术缝合器,其中所述第一开关和第二开关以及非线性速度控制电路接合到可变控制装置。
5、根据权利要求4所述的动力手术缝合器,其中所述可变控制装置是从由变阻器、多档位开关、线性可变位移传感器、旋转可变位移传感器、线性电位计、旋转电位计、光学编码器、铁磁传感器和霍尔效应传感器构成的组中选择的。
6、根据权利要求1所述的动力手术缝合器,其中所述末端执行器包括用于使通过其的多个手术紧固件变形及用于紧固组织的一对相对的组织接合面,该对组织接合面相对彼此在打开位置与组织接合面彼此并列的接近位置之间移动。
7、根据权利要求6所述的动力手术缝合器,其中末端执行器的第一手术功能包括将发射杆沿远端方向推进以将所述一对相对的组织接合面移动到接近位置,末端执行器的第二手术功能包括将发射杆沿近端方向收缩以将所述一对相对的组织接合面移动到接近位置。
8、根据权利要求6所述的动力手术缝合器,进一步包括:
第三开关,其适于启动驱动电动机以驱动发射杆使手术紧固件展开及变形。
9、根据权利要求1所述的动力手术缝合器,进一步包括:
负载单元,其配置为可移动地附着到内窥镜部上,该负载单元包括末端执行器,末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能;以及
负载开关,其设置在内窥镜部中并接合到主驱动开关,其中在负载单元附着到内窥镜部而启动负载开关之前,所述主驱动开关被禁用。
10、根据权利要求1所述的动力手术缝合器,进一步包括:
锁止开关,其设置在壳体的手柄部的顶面并接合到主驱动开关,其中在手柄部被紧握而启动锁止开关之前,所述主驱动开关被禁用。
11、根据权利要求10所述的动力手术缝合器,其中所述锁止开关是从由生物电阻抗传感器、电容传感器和压力传感器构成的组中选择的。
12、一种动力手术缝合器,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
驱动电动机,其至少部分地设置在所述壳体内;
发射杆,其设置为与驱动电动机机械协作;
负载单元,其配置为可移动地附着到内窥镜部上,负载单元包括与发射杆机械协作的末端执行器,以使发射杆驱动末端执行器的手术功能;以及
负载单元识别系统,其包括识别负载单元且设置在负载单元上的识别器,以及配置为与识别器相接以获得与负载单元唯一相关的识别码的应答机。
13、根据权利要求12所述的动力手术缝合器,其中识别器和应答机配置为彼此无线通信的无线收发器。
14、根据权利要求12所述的动力手术缝合器,其中识别器是具有电阻器、电容器和感应器中至少一个的电识别器,所述电识别器具有至少一个与识别码唯一相关的电特性。
15、根据权利要求14所述的动力手术缝合器,其中应答机包括至少一个适于与电识别器相接且基于至少一个电特性来确定识别码的触头。
16、根据权利要求12所述的动力手术缝合器,其中识别器是具有至少一个识别器编码磁铁和以具有与识别码唯一相关的预定磁模式设置的铁节点的磁设备。
17、根据权利要求16所述的动力手术缝合器,其中应答机是适于与磁识别器相接且适于基于预定磁模式来确定识别码的磁传感器。
18、根据权利要求17所述的动力手术缝合器,其中所述磁传感器是从由铁磁传感器和霍尔效应传感器构成的组中选择的。
19、根据权利要求12所述的动力手术缝合器,其中识别器包括多个突起,所述多个突起配置为与位移传感器相接以使位移模式对应于识别码。
20、根据权利要求12所述的动力手术缝合器,进一步包括:
用户接口,其包括多个可视化输出,多个可视化输出配置为基于被启动的该多个可视化输出的至少一部分的组合来传达负载单元和动力手术缝合器中至少一个的操作状态。
21、根据权利要求20所述的动力手术缝合器,其中用户接口进一步包括触觉反馈机构,触觉反馈机构具有设置在壳体内的异步电动机并配置为在施加于动力手术缝合器上的力的作用下提供变化强度的振荡反馈。
22、根据权利要求12所述的动力手术缝合器,其中应答机确定负载单元是否已经被提前发射。
23、根据权利要求12所述的动力手术缝合器,其中末端执行器包括用于使通过其的多个手术紧固件变形及用于紧固组织的一对相对的组织接合面,该组织接合面相对彼此在打开位置与组织接合面彼此并列的接近位置之间移动。
24、根据权利要求23所述的动力手术缝合器,其中末端执行器包括分别设置在组织接合面的每一个中的第一组织传感器和第二组织传感器,第一组织传感器和第二组织传感器配置为在第一组织传感器与第二组织传感器之间产生场并检测该场中指示外部组织的变化。
25、根据权利要求24所述的动力手术缝合器,其中第一组织传感器和第二组织传感器被校准以忽略空气、体液和组织中的至少一个。
26、一种动力手术缝合器,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
驱动电动机,其至少部分地设置在所述壳体内;
发射杆,其设置为与驱动电动机机械协作;
末端执行器,其邻近内窥镜部的远侧部设置,末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能;以及
电源,其接合到驱动电动机,电源包括至少一个电池以及至少一个封入在由吸收剂和阻燃剂材料形成的绝缘罩内的超电容器。
27、根据权利要求26所述的动力手术缝合器,进一步包括:
动力适配器,其进一步配置为接合到电手术产生器以提供动力来为电源充电。
28、根据权利要求26所述的动力手术缝合器,进一步包括:
感应充电接口,其包括设置在所述壳体内的感应线圈,其中当将壳体及设置在壳体中的感应线圈放置在电磁场内时,感应线圈将电磁场能转变为直流电来为电源充电。
29、根据权利要求26所述的动力手术缝合器,进一步包括:
放电电路,其具有开关和接合到电源的电阻负载,其中当开关启动时电源被放电到电阻负载。
30、根据权利要求26所述的动力手术缝合器,进一步包括:
电动机和接合到至少一个热传感器的电池操作模块,电动机和电池操作模块配置为监控驱动电动机和电源中至少一个的温度。
31、根据权利要求30所述的动力手术缝合器,其中所述至少一个热传感器是从由热敏电阻器、热电元件、热电偶和热红外传感器构成的组中选择的。
32、根据权利要求26所述的动力手术缝合器,其中所述电源进一步包括用于测量所述电源内的温度的温度传感器,以及用于存储与所述电源相关的唯一识别器的嵌入式微控制器。
33、根据权利要求32所述的动力手术缝合器,进一步包括:
微控制器,其配置为与嵌入式微控制器相接以询问微控制器及从嵌入式微控制器获得所述电源的温度和唯一标识符,其中如果所述温度在预定操作范围内及所述唯一标识符有效,则微控制器鉴定所述电源。
34、一种动力手术缝合器,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
驱动电动机,其至少部分地设置在所述壳体内;
发射杆,其设置为与驱动电动机机械协作;
位置计算器,其用于确定发射杆的线性位置,该位置计算器接合到线性位移传感器上,所述线性位移传感器邻近发射杆设置且配置为检测发射杆的线性移动;以及
速度计算器,其用于确定发射杆的线速度和驱动电动机的转速中的至少一个。
35、根据权利要求34所述的动力手术缝合器,其中发射杆包括设置在其上的第一指示器和第一指示器。
36、根据权利要求36所述的动力手术缝合器,进一步包括:
轴开始位置传感器,其配置为当第一指示器与其相接时向位置计算器发出信号,其中第一指示器的位置指示发射杆开始移动处;以及
夹紧位置传感器,其配置为当第二指示器与其相接时向位置计算器发出信号,其中第二指示器的位置指示末端执行器的夹紧。
37、根据权利要求34所述的动力手术缝合器,其中发射杆的至少一部分被磁化或发射杆包括设置在其中的磁材料,且线性位移传感器配置为检测与发射杆的移动对应的磁场的变化。
38、根据权利要求37所述的动力手术缝合器,其中所述线性位移传感器是从由铁磁传感器和霍尔效应传感器构成的组中选择的。
39、根据权利要求34的动力手术缝合器,其中所述线性位移传感器是从由电位计和变阻器构成的组中选择的,且发射杆包括与线性位移传感器电磁接触的触头,其中线性位移传感器配置为基于其至少一个电特性的变化来检测发射杆的移动。
40、根据权利要求34所述的动力手术缝合器,其中速度计算器接合到线性位移传感器,速度计算器配置为基于发射杆位移的变化量来确定发射杆的线速度。
41、根据权利要求31所述的动力手术缝合器,其中速度计算器接合到旋转速度检测装置,旋转速度检测装置具有用于传输与驱动电动机的转速对应的脉冲的至少一个编码器。
42、根据权利要求34所述的动力手术缝合器,进一步包括电压传感器,其连接到驱动电动机并测量驱动电动机的反电动势,速度计算器接合到电压传感器并配置为基于测量出的电动势来确定发射杆的线速度和驱动电动机的旋转速度中的至少一个。
43、根据权利要求31所述的动力手术缝合器,进一步包括电流传感器,其接合到与驱动电动机连接的并联电阻器,电流传感器配置为测量驱动电动机的牵引电流,速度计算器接合到电流传感器并配置为基于牵引电流来确定发射杆的线速度和驱动电动机的旋转速度中的至少一个。
44、根据权利要求43所述的动力手术缝合器,其中速度计算器配置为比较发射杆的线速度与驱动电动机的牵引电流以确定驱动电动机的旋转是否完全传递到发射杆。
45、根据权利要求34所述的动力手术缝合器,其中速度计算器配置为比较发射杆的线速度与驱动电动机的转速以确定驱动电动机的旋转是否完全传递到发射杆。
46、根据权利要求31所述的动力手术缝合器,其中位置计算器和速度计算器接合到包括微控制器的控制系统。
47、一种动力手术缝合器,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
驱动电动机,其至少部分地设置在所述壳体内;
发射杆,其设置为与驱动电动机机械协作;
末端执行器,其邻近内窥镜部的远侧部设置,末端执行器限定了第二纵轴并且与发射杆机械协作以使发射杆驱动末端执行器的手术功能;
铰接机构,其包括配置为将末端执行器从第一铰接位置移动至第二铰接位置的铰接电动机,其中在第一铰接位置,第二纵轴基本对准第一纵轴,而在第二铰接位置,第二纵轴设置为与第一纵轴成一角度;以及
铰接传感器,其配置为在铰接期间确定末端执行器何时处于第一位置,铰接传感器接合到铰接电动机且配置为当末端执行器处于第一位置时向铰接电动机发出信号以停止铰接。
48、一种动力手术缝合器,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
驱动电动机,其至少部分地设置在所述壳体内;
发射杆,其设置为与驱动电动机机械协作;
负载单元,其配置为可拆卸地附着到内窥镜部上,负载单元包括末端执行器,末端执行器与发射杆机械协作以使发射杆驱动末端执行器的手术功能;
控制系统,其包括:
多个传感器,其与驱动电动机、发射杆和负载单元接合且配置为检测驱动电动机、发射杆和负载单元的操作参数;以及
与多个传感器接合的微控制器,其配置为在检测到的操作参数的作用下确定动力手术缝合器的操作状态。
49、根据权利要求47所述的动力手术缝合器,其中控制系统适于接合到外部反馈控制器上,外部反馈控制器配置为处理动力手术缝合器的操作状态以产生输出。
50、根据权利要求48所述的动力手术缝合器,其中反馈控制器适于接合到视频处理器、视频显示器、平视显示器和计算设备上。
51、根据权利要求49所述的动力手术缝合器,其中反馈控制器包括:
屏幕显示模块,其配置为将反馈控制器的输出覆盖在视频显示器上;以及
平视显示模块,其配置为将反馈控制器的输出覆盖在平视显示器上。
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- 2008-09-30 ES ES11178021.9T patent/ES2646491T3/es active Active
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2016
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