CN101664331A - Endoscope operation applicator with a fastener - Google Patents

Endoscope operation applicator with a fastener Download PDF

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Publication number
CN101664331A
CN101664331A CN200910171616A CN200910171616A CN101664331A CN 101664331 A CN101664331 A CN 101664331A CN 200910171616 A CN200910171616 A CN 200910171616A CN 200910171616 A CN200910171616 A CN 200910171616A CN 101664331 A CN101664331 A CN 101664331A
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China
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clip
plate
distal
shaft assembly
pusher
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CN200910171616A
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Chinese (zh)
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CN101664331B (en
Inventor
格雷戈里·索伦蒂诺
肯尼斯·H·惠特菲尔德
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Tyco医疗健康集团
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Priority to US9280608P priority Critical
Priority to US61/092,806 priority
Priority to US12/539,204 priority patent/US8267944B2/en
Priority to US12/539,204 priority
Application filed by Tyco医疗健康集团 filed Critical Tyco医疗健康集团
Publication of CN101664331A publication Critical patent/CN101664331A/en
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Publication of CN101664331B publication Critical patent/CN101664331B/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery

Abstract

An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws. The invention relates to an endoscope operation applicator with a fastener.

Description

具有闭锁器的内窥镜手术施夹器 With endoscopic surgical clip applier closure

相关申请的引用 REFERENCE TO RELATED APPLICATIONS

[0001]本申请要求于2008年8月29日提交的序列号为61/092, 806的美国临时申请的权益和优先权,该临时申请的全部内容通过引用合并于此。 [0001] This application claims the serial number on August 29, 2008, filed the benefit of and priority to US provisional application 61/092, 806, the entire disclosure of which is hereby incorporated herein by reference.

技术领域 FIELD

[0002]本公开涉及手术施夹器,尤其是涉及一种新型的内窥镜手术施夹 [0002] The present disclosure relates to surgical clip appliers, more particularly, to a novel endoscopic surgical clip applier

器° Device °

背景技术 Background technique

[0003]内窥镜缝合器和施夹器在本领域中是公知的并且用于许多不同且有用的手术程序。 [0003] Endoscopic staplers and clip appliers are known and used in many different and useful surgical procedures in the art. 在腹腔镜手术程序的情况下,通过插入皮肤中的小进入切口的窄的管子或套管来获得到腹部内部的通道。 In the case of laparoscopic surgical procedure, the abdomen is obtained to the interior of the passage through a narrow tube is inserted into a small incision into the skin or casing. 而在身体上的其它部位执行的微创程序通常一般被称作内窥镜程序。 Minimally invasive procedures performed elsewhere in the body are often generally referred to as endoscopic procedures. 典型地,管子或者套管装置通过进入切口伸入患者的身体中,以便提供入口。 Typically, a tube or cannula device by entering the patient's body extending into the cutout in order to provide access. 此种入口允许外科医生利用套管针插入多个不同的手术器械并且用于在远离切口的地方执行手术程序。 The port allows the surgeon to use the cannula needle is inserted and a plurality of different surgical instruments for performing surgical procedures far removed from the incision.

[0004]在大多数的这些程序中,外科医生经常必须终止血液或另一种液体通过一根或多根脉管的流动。 [0004] In most of these procedures, the surgeon must often terminate the blood or another fluid through one or more vessels to flow. 在程序中,外科医生经常会将手术夹子施加到血管或另一种导管上,以防止体液流过这些导管。 In the procedure, the surgeon will often apply a surgical clip to a blood vessel or another duct to prevent fluid flow through the conduits. 内窥镜施夹器用于在进入体腔时施加单个夹子,这在本领域中是公知的。 Endoscopic clip applier for applying a single clip into the body cavity while, in the art which are well known. 典型地,这样的单个施夹器由生物相容性材料制成并且通常被压布在脉管上。 Typically, such a single clip applier made of a biocompatible material and are usually compressed over a vessel. 一旦施加到脉管上,该被压布的夹子就终止了液体通过导管的流动。 Once applied to the vessel, the compressed clip which terminates the flow of liquid through the conduit.

[0005]在共有的转让给格林(Green)等人的第5, 084, 057和5, 100, 420 [0005] In the common transfer to Green (Green) et al., 5, 084, 057 and 5, 100, 420

号美国专利中描述了在单独进入体腔中时能够在内窥镜或腹腔镜程序中施加多个夹子的内窥镜施夹器,上述两项专利的全部内容通过引用合并于此。 Described in U.S. Patent No. endoscope capable of applying a plurality of clips in endoscopic or laparoscopic procedure into the body cavity when used alone in the clip applier, the entire contents of these two patents is incorporated herein by reference. 在共有的转让给布拉德(Pratt)等人的第5, 607, 436号美国专利中公开了另一种复合内窥镜施夹器,该专利的全部内容同样通过引用合并于此。 In a common transfer Brad (Pratt) et al., 5, 607, 436 disclosed in U.S. Pat. Another multiple endoscopic clip applier, the entire disclosure of which is also incorporated herein by reference. 这些装置被典型地用在单个手术程序中,但这不是必须的。 These devices are typically used in a single surgical procedure, this is not essential. 在序列号为08/515,341 Serial No. 08 / 515,341

4的美国专利申请,即现在授予给皮埃尔(Pier)等人的第5,695,502号美国专利中公开了一种可重新消毒的手术施夹器,该专利所公开的内容通过引用合并于此。 U.S. Patent Application 4, i.e., now granted to Pierre (Pier) et al., U.S. Patent No. 5,695,502 discloses a re-sterilization of the surgical clip applier, the disclosed contents of which patent by reference incorporated herein. 该施夹器在单独插入体腔中时推进并形成多个夹子。 The clip applier advances and forms multiple clips during a single insertion in a body cavity. 所述可重复消毒的施夹器被配置成容纳并与可交换的弹夹合作,以便在单独进入体腔时推进和形成多个夹子。 This resterilizable clip applier is configured to receive and cooperate with exchangeable magazines, so as to advance and form multiple clips during a single into the body cavity. 一个重要的设计目标是,在不对来自装载程序的夹子进行任何压縮的情况下将手术夹子装在钳口之间。 An important design goal is carried out at any compression in the case where the surgical clip between the jaws in the clip from the loader not. 在装载过程中的夹子的这些弯曲或扭转经常会有许多意想不到的后果。 The bending or twisting often has a number of unintended consequences during loading of the clip. 在装载时的这种压縮可能会略微地改变夹子在钳口之间的对准。 Such compression during loading may alter slightly the alignment of the clip between the jaws. 这会使外科医生将夹子从钳口之间移除以便丢弃夹子。 This will cause the surgeon to remove the clip from between the jaws for discarding the clip. 另外,这种预载压缩可能会略微地压縮夹子的某些部分而改变其几何。 Additionally such preloading compression may slight compress parts of the clip to change its geometry. 这会使外科医生将夹子从钳口之间移除以便丢弃夹子。 This will cause the surgeon to remove the clip from between the jaws for discarding the clip.

[0006]经常在远离切口的地方执行内窥镜或者腹腔镜程序。 [0006] endoscopic or laparoscopic procedures are often performed remotely from the incision in. 因此,对于位于装置近端的用户而言,视野或者触觉反馈的减小可能使夹子的施加复杂化。 Thus, for a user device located at the proximal end of the field of view or reduced tactile feedback application of clips may be complicated. 因此希望通过向用户提供单个夹子被发射的指示、包含在装载单元中的夹子的损耗或者任何其它手术事件的指示来改善器械的操作。 It is therefore desirable to provide an indication by the clip to be transmitted to a single user, or loss of any indication of the clip other surgical event is contained in the loading unit to improve the operation of the instrument. 还希望提供这样一种手术施夹器:其促进了夹子的成功负载并且分开该手术施夹器的钳口,然后将夹子装在钳口之间以防止夹子的任何损坏或者过度压縮,并在发射前防止钳口压在夹子上。 It is also desirable to provide a surgical clip applier: the clip which facilitates the successful load and separated from the jaws of surgical clip applier, and then loads the clip between the jaws to prevent any damage or excessive compression of the clip, and preventing the pressure jaws on the clip before firing.

发明内容 SUMMARY

[0007]本公开涉及新型的内窥镜手术施夹器。 [0007] The present disclosure relates to novel endoscopic surgical clip applier.

[0008]根据本公开的一个方案,提供了一种用于将手术夹子施加到体组织上的装置。 [0008] According to an embodiment of the present disclosure, there is provided an apparatus for the application of surgical clips to body tissue. 本装置包括:手柄组件;轴组件,其从手柄组件向远侧延伸,并且限定了纵轴;布置在轴组件中的多个手术夹子;钳口,其邻近轴组件的远端部安装,该钳口可在隔开的打开状态和接近的闭合状态之间运动;以及推杆,其可往复运动地布置在轴组件中,该推杆被配置成在钳口处于打开状态时将最远侧手术夹子装入钳口中,并在钳口的接近期间时与被装入的夹子保持接触。 This apparatus comprising: a handle assembly; a shaft assembly extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; jaw mounted adjacent a distal end portion of the shaft assembly, the jaws movable between an open state and spaced close to a closed state; and a push rod, which can be reciprocally disposed within the shaft assembly, the jaw push rod is configured to open when the distal-most surgical clip loaded into the jaws, and remain in contact with the loaded clip during an approximation of the jaws upon.

[0009]推杆可包括形成在其远端处的推动器。 [0009] The pusher bar may include a pusher formed at a distal end thereof. 推动器可具有狭窄轮廓以在单个位置上接触被装入的手术缝合钉。 The pusher may have a narrow profile for contacting the loaded surgical staple at a single location. 推动器可以限定与被装入的手术缝合钉的平面大体正交的平面。 The pusher may define a plane of the loaded surgical staple is substantially perpendicular to the plane. [0010]所述装置可进一步包括可往复运动地布置在轴组件中的连接板。 [0010] The apparatus may further include a connecting plate reciprocally disposed in the shaft assembly.

连接板可以连接到推杆上。 Webs can be connected to the pusher. 在使用中,在连接板的最初远侧运动期间,推杆可以向着远侧推进,而在连接板的进一步远侧运动期间,连接板可以从推杆脱开。 In use, the plate during an initial distal movement of the push rod can be advanced distally, and during a further distal movement of the plate, the plate may be disconnected from the putter.

[0011]推杆可包括支撑在其上的第一弹簧夹子,该第一弹簧夹子用于在 [0011] The pusher bar may include a support on which a first spring clip, the spring clip used in the first

推杆处于推进位置时选择性地与轴组件的部件接合,以选择性地将推杆保持在该推进位置。 Selectively engaging member of the shaft assembly when the plunger is in the advanced position, to selectively push rod held in this advanced position. 推杆可进一步包括支撑于其上的第二弹簧夹子,第二弹簧夹子用于选择性地与连接板的第一部件接合。 The pusher bar may further include a second spring clip supported thereon promoter and the second snap clip for selectively engaging the first member of the connecting plate. 在连接板的最初远侧运动之后,连接板的第一部件可以选择性地从第二弹簧夹子脱离。 After the initial distal movement of the web, the first web member may selectively disengage from the second spring clip.

[0012]所述装置可进一步包括可往复运动地布置在轴组件中的推进板。 The [0012] apparatus can further include an advancer plate disposed within the shaft assembly is reciprocally. 推进板可包括能被推杆的肩部选择性地接合的至少一个翼片。 The advancer plate may include at least one shoulder of the pusher tab can be selectively engaged. 在使用中,在推杆的远侧和近侧运动期间,推杆的肩部可与推进板的至少一个翼片接合,以实现推进板的远侧和近侧运动中的一个。 In use, distal and proximal movement of the pusher during the push rod shoulder engageable with at least one propulsion fin plate, to achieve a distal and proximal movement of advance of the plate.

[0013]所述装置可进一步包括可滑动地支撑在轴组件中的夹子输出器,夹子输出器用于向远侧方向推动多个手术夹子。 [0013] The apparatus may further include a clip follower slidably supported in the shaft assembly, clip follower for urging the plurality of surgical clips in a distal direction. 夹子输出器包括从其第一表面突出的第一凸起以及从其第二表面突出的第二凸起。 The clip includes a first surface protruding from a first projection and a second projection projecting from its second surface. 在使用中,随着推进板向远侧运动,夹子输出器的第一凸起可与推进板接合,从而使该夹子输出器向远侧运动以推进多个手术夹子,并且其中,随着推进板向近侧运动,夹子输出器的第二凸起可与固定部件接合,从而使夹子输出器保持固定。 In use, as the advancer plate, clip follower engages a first protrusion plate may be moved distally to advance, so that the clip follower is moved distally to advance the plurality of surgical clips, and wherein, with the advance of plate, clip follower may engage a second protrusion and the fixing member is moved proximally such that the clip follower remains stationary.

[0014]所述装置可进一步包括布置在轴组件中的夹子载体,其中,该夹子载体被配置成保持多个手术夹子以及夹子输出器,并且其中,夹子输出器的第二凸起可与形成在夹子载体中的部件接合。 [0014] The apparatus may further include a clip carrier disposed in the shaft assembly, wherein the clip carrier is configured to retain the plurality of surgical clips and the clip follower, and wherein the second protrusion may be formed in the clip engaging the clip carrier member.

[0015]可逐步推进夹子输出器通过轴组件。 [0015] The shaft assembly may be incrementally advanced through the clip. 夹子输出器可包括从其表面伸出的窗钩(catch),其中,在最后一个手术夹子被发射之后,该窗钩可与推杆接合并可防止推杆向近侧方向运动。 The clip follower may include a catch therefrom (the catch) projecting surface, wherein, after a last surgical clip is fired, the catch may engage the pusher may prevent movement of the plunger in a proximal direction.

[0016]所述装置可进一步包括布置在手柄组件中的棘轮组件。 [0016] The apparatus may further include a ratchet assembly disposed in the handle assembly. 当推杆没有返回到近侧位置时,可以防止该棘轮组件复位。 When the push rod does not return to a proximal position, the ratchet assembly may be prevented reset.

[0017]所述装置可进一步包括支撑在壳体组件中的计数器。 The [0017] The apparatus may further comprise a housing supported in a counter assembly. 当手术夹子己经被发射之后,该计数器可提供指示。 When a surgical clip has been emitted, the counter may provide an indication. [0018]所述装置可进一步包括支撑在壳体组件中的指示器。 [0018] The apparatus may further include a support in the housing assembly indicator. 当至少一个手术夹子被装入钳口中、手术夹子被发射以及所述装置被复位时,指示器可提供听觉和触觉指示中的至少一个。 When at least one of a surgical clip is loaded into the jaws, a surgical clip is fired and the apparatus is reset, the indicator provides an audible and tactile indication of at least one.

[0019]所述装置可进一步包括可往复运动地布置在轴组件中的楔形板。 [0019] The apparatus may further include a wedge plate disposed in the shaft assembly reciprocally. 楔形板可以在其远端布置在钳口中的位置和其远端不在所述钳口中的位置之间运动。 Wedge plate may be disposed in its distal end position and its jaws distally between the jaws in the location is not. 楔形板可进一步包括支撑在其上用于选择性地与连接板的第二部件接合的第三弹簧夹子,其中,在连接板的最初远侧运动之后,连接板的第二部件选择性地从该第三弹簧夹子脱离。 Wedge plate may further include a support on which the third spring clip for selectively engaging the second web member, wherein, following an initial distal movement of the connector plate, the connector plate selectively from the second member the third spring clip from.

[0020]所述装置可进一步包括由手柄组件致动并连接到连接板的驱动杆,驱动杆用于实现连接板的运动。 [0020] The apparatus may further include an actuator handle assembly and a drive rod connected to the web, the drive rod to effect movement of the connector plate. 所述装置可进一步包括可往复运动地布置在轴组件中的驱动通道,其中,驱动杆选择性地与驱动通道接合以实现该驱动通道的平移。 The apparatus may further include a drive channel may be disposed in the shaft assembly reciprocally, wherein the drive bar selectively engages the drive channel to effect translation of the drive channel. 当驱动通道向远侧推进时,其远端可与钳口的表面接合,以实现钳口的接近。 When the drive channel is advanced distally its distal end surface engageable with the jaws to effect approximation of the jaws.

[0021]驱动通道在其向远侧推进时可致动楔形锁释放装置以使楔形板向近侧运动从而使楔形板的近端从钳口退回,并允许驱动通道接近钳口。 [0021] The drive channel may be advanced distally its wedge lock release actuator means to cause movement of the wedge plate so that the proximal end of the proximally retracted wedge plate from the jaws and permit the drive channel to approximate the jaws.

[0022]轴组件可以相对于手柄组件围绕纵轴旋转。 [0022] The shaft assembly relative to the handle assembly about the longitudinal axis. 轴组件可包括支撑在其内的保护装置。 The shaft assembly may include a protection device supported therein. 其中,该保护装置可在第三弹簧夹子平移通过该保护装置时防止第三弹簧夹子向外张开。 Wherein, the protection device can be translated in a third spring clip prevent the third spring clip from splaying outwardly through the protector.

[0023]楔形板和/或驱动通道可被偏置到近侧位置。 [0023] The wedge plate and / or drive channel may be biased to a proximal position.

[0024]根据本公开的另一个方案,提供了一种用于将手术夹子施加到体组织上的装置。 [0024] According to another aspect of the present disclosure, there is provided an apparatus for the application of surgical clips to body tissue. 该装置包括:手柄组件;轴组件,其从手柄组件向远侧延伸,并且限定了纵轴;布置在轴组件中的多个手术夹子;钳口,其邻近轴组件的远端部安装,该钳口可以在隔开的打开状态和接近的闭合状态之间运动;以及夹子输出器,其可滑动地支撑在轴组件中,用于向远侧推动多个手术夹子。 The apparatus comprising: a handle assembly; a shaft assembly extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; jaw mounted adjacent a distal end portion of the shaft assembly, the the jaws can be moved between an open state and a close spaced a closed state; and a clip follower slidably supported in the shaft assembly for urging the plurality of surgical clips distally. 该夹子输出器包括从其第一表面突出的第一凸起以及从其第二表面突出的第二凸起。 The clip includes a first surface protruding from a first projection and a second projection projecting from its second surface. 随着推进板向远侧推进,夹子输出器的第一凸起与推进板接合,从而使该夹子输出器向远侧运动以推进多个手术夹子,并且,随着推进板向近侧运动,夹子输出器的第二凸起与固定部件接合,从而使夹子输出器保持固定。 Advance distally as the advancer plate, clip follower engages the advancer plate and a first protrusion, such that the clip follower is moved distally to advance the plurality of surgical clips, and, as the advancer plate is moved proximally, the second protrusion engages with the fixed member of the clip so that the clip follower remains stationary. [0025]所述装置可进一步包括可往复运动地布置在轴组件中的推进板。 The [0025] apparatus can further include an advancer plate disposed within the shaft assembly is reciprocally. 推进板可限定沿其长度形成的多个窗口。 The advancer plate may define a plurality of windows formed along its length. 在使用中,随着推进板往复运动,夹子输出器的第一凸起可与多个窗口中的一个窗口选择性地接合。 In use, as the advancer plate reciprocates, a first clip projections may be selectively engageable with the plurality of windows in a window.

[0026]所述装置可进一步包括可往复运动地布置在轴组件中的推杆。 The [0026] apparatus can further include a plunger reciprocally disposed in the shaft assembly. 该推杆被配置成可以在钳口处于打开状态时将最远侧手术夹子装入钳口中,并在钳口的接近期间与被装入的手术夹子保持接触。 The push rod is configured so as to be in a distal-most surgical clip be loaded into the jaws when the jaws open state, and remain in contact during approximation of the jaws with the loaded surgical clip.

[0027]推进板可包括能与推杆的肩部选择性地接合的至少一个翼片。 [0027] The advancer plate may include at least one fin selectively engageable with the shoulder of the push rod. 在推杆的远侧和近侧运动期间,推杆的肩部可与推进板的至少一个翼片接合,以实现推进板的远侧和近侧运动中的一个。 During the push rod at the distal and proximal movement of the push rod shoulder engageable with at least one propulsion fin plate, to achieve a distal and proximal movement of advance of the plate.

[0028]推杆可包括形成在其远端处的推动器,其中,推动器具有狭窄轮廓以在单个位置上接触装入的手术缝合钉。 [0028] The pusher bar may include a pusher formed at a distal end thereof, wherein the pusher has a narrow profile for contacting the loaded surgical staple at a single location. 推动器可以限定与被装入的手术缝合钉的平面大体正交的平面。 The pusher may define a plane of the loaded surgical staple is substantially perpendicular to the plane.

[0029]所述装置可进一步包括可往复运动地布置在轴组件中的连接板。 [0029] The apparatus may further include a connecting plate reciprocally disposed in the shaft assembly. 连接板可以选择性地连接到推杆上。 Web may be selectively connected to the pusher. 在使用中,在连接板的最初远侧运动期间,推杆可向远侧推进,而在连接板的进一步远侧运动期间,该连接板可以从推杆脱开。 In use, the plate during an initial distal movement of the push rod can be distally advanced and during a further distal movement of the plate, the plate may be disconnected from the putter.

[0030]推杆可包括支撑在其上的第一弹簧夹子,该第一弹簧夹子用于在推杆处于推进位置时可拆卸地连接到轴组件的部件上,从而将推杆保持在该推进位置。 [0030] The pusher bar may include a first spring clip supported thereon on which a first spring clip used in the advanced position of the push rod is detachably connected to the upper part of the shaft assembly, thereby maintaining the push rod in the advancing position. 推杆可进一步包括支撑于其上的第二弹簧夹子,第二弹簧夹子用于可拆卸地连接到连接板的第一部件,其中,在连接板的最初远侧运动之后,连接板的第一部件从第二弹簧夹子脱开。 The pusher bar may further include a second spring clip supported thereon, and a second spring clip for detachably connecting plate connected to the first member, wherein, following an initial distal movement of the webs, a first web the second member is disengaged from the spring clip.

[0031]所述装置可进一步包括布置在轴组件中的夹子载体。 [0031] The apparatus may further include a clip carrier disposed in the shaft assembly. 夹子载体可被配置成保持多个手术夹子以及夹子输出器。 The clip carrier may be configured to retain the plurality of surgical clips and the clip follower. 夹子输出器的第二凸起可与形成在夹子载体中的部件接合。 A second clip member engageable with a projection formed in the clip carrier. 可逐步推进夹子输出器通过轴组件。 The clip follower may be incrementally advanced through the shaft assembly. 夹子输出器可包括从其表面伸出的窗钩。 The clip follower may include a catch extending from a surface. 在最后一个手术夹子被发射之后,窗钩可与推杆接合,并可防止推杆向近侧方向运动。 After the last surgical clip is fired, the catch can be engaged with the push rod, the push rod can be prevented from moving in a proximal direction.

[0032]所述装置可进一步包括布置在手柄组件中棘轮组件。 [0032] The apparatus may further include a ratchet assembly disposed in the handle assembly. 当推杆没有返回到近侧位置时,可防止该棘轮组件复位。 When the push rod does not return to a proximal position, the ratchet assembly is prevented reset.

[0033]所述装置可进一步包括支撑在壳体组件中的计数器,其中,当手术夹子已经被装入或者发射之后,该计数器可提供指示。 [0033] The apparatus may further include a counter supported in the housing assembly, wherein, when a surgical clip has been loaded or emitted, the counter may provide an indication. 所述装置可进一步包括支撑在壳体组件中的指示器,其中,当至少一个手术夹子被装入钳口中、手术夹子被发射以及所述装置被复位时,该指示器可提供听觉和触觉指示中的至少一个。 The apparatus may further include a support in the housing assembly indicator, wherein, when the at least one surgical clip is loaded into the jaws, a surgical clip is fired and the apparatus is reset, the indicator provides an audible and tactile indication at least one of.

[0034]所述装置可进一步包括可往复运动地布置在轴组件中的楔形板。 [0034] The apparatus may further include a wedge plate disposed in the shaft assembly reciprocally. 楔形板可以在其远端布置在钳口中的位置和其远端不在所述钳口中的位置之间运动。 Wedge plate may be disposed in its distal end position and its jaws distally between the jaws in the location is not. 该钳口可进一步包括支撑在其上用于与连接板的第二部件选择性地接合的第三弹簧夹子,其中,在连接板的最初远侧运动之后,连接板的第二部件可以选择性地从该第三弹簧夹子脱离。 The jaws may further include a support on which a third spring clip and a second member selectively engage the connecting plate, wherein, following an initial distal movement of the web, a second web member may be selectively disengage from the third spring clip.

[0035]所述装置可进一步包括驱动杆,驱动杆由手柄组件致动并连接到连接板上用于实现连接板的运动。 [0035] The apparatus may further include a drive rod, the drive lever actuated by the handle assembly and connected to the connecting plate to effect movement of the connector plate. 所述装置可进一步包括可往复运动地布置在轴组件中的驱动通道,其中,驱动杆可以与驱动通道选择性地接合以实现该驱动通道的平移,并且其中,当驱动通道向远侧推进时,其远端可与钳口的表面接合以实现钳口的接近。 The apparatus may further include a drive channel reciprocally disposed in the shaft assembly, wherein the drive bar may selectively engage the drive channel to effect translation of the drive channel, and wherein the drive channel when advanced distally , which may engage the distal end surface of the jaws to achieve close the jaws. 驱动通道在其向远侧推进时可致动楔形锁板以使楔形板向近侧运动从而使楔形板的远端从钳口退回,并且可以允许驱动通道接近钳口。 Drive channel when it is advanced distally actuatable wedge lock plate so that movement of the wedge plate so that the distal end proximally retracted wedge plate from the jaws and may permit the drive channel to approximate the jaws.

[0036]轴组件可以相对于手柄组件围绕纵轴旋转。 [0036] The shaft assembly relative to the handle assembly about the longitudinal axis. 轴组件可包括支撑在其内的套箍(cuff),其中,该套箍可在第三弹簧夹子平移跨过该套箍时防止第三弹簧夹子向外张开。 The shaft assembly may include a support therein ferrule (Cuff), wherein the cuff may prevent the third spring clip translates thereacross third spring clip from splaying outwardly as the ferrule.

[0037]楔形板和/或驱动通道可被偏置到近侧位置。 [0037] The wedge plate and / or drive channel may be biased to a proximal position.

[0038]根据本公开的又一个方案,提供了一种用于将手术夹子施加到体组织上的装置,其中,所述装置包括手柄组件以及从该手柄组件向远侧延伸并且限定了纵轴的轴组件。 [0038] According to still another embodiment of the present disclosure, there is provided an apparatus for the application of surgical clips to body tissue, wherein said apparatus includes a handle assembly and extending distally from the handle assembly and defining a longitudinal axis shaft assembly. 手柄组件包括扳机以及驱动杆,该驱动杆在扳机致动时可通过扳机往复平移。 The handle assembly includes a trigger and a drive rod, the driving rod can be reciprocally translatable by the trigger upon actuation of the trigger. 轴组件包括:壳体;布置在壳体中的多个手术夹子;钳口,其邻近壳体的远端部安装,该钳口可在隔开的打开状态和接近的闭合状态之间运动;可往复运动地布置在壳体中的推杆,该推杆被配置成在钳口处于打开状态时将最远侧手术夹子装入钳口中,并在钳口的接近期间与被装入的手术夹子保持接触;邻近推杆可往复运动地布置在壳体中的推进板,推进板包括选择性地与推杆的肩部接合的至少一个翼片,其中,在推杆的远侧和近侧运动期间,推杆的肩部与推进板的至少一个翼片接合,以实现推进板的远侧和近侧运动中的一个;邻近推进板布置在壳体中的夹子载体,其中,该夹子载体被配置成保持多个手术夹子;夹子输出器,其可滑动地支撑在夹子载体中最多个手术夹子的近侧位置上,该夹子输出器被配置成向远侧方向推动多个手术夹子,该夹子输 Shaft assembly comprising: a housing; a plurality of surgical clips disposed in the housing; jaw, a distal end portion which is mounted adjacent the housing, the jaw can be moved between an open state and a close spaced closed state; may be arranged reciprocally in the housing of the push rod, the push rod being configured to open when the jaws are in a distal-most surgical clip loaded into the jaws, the jaws close and during the loaded surgical the clip is held in contact; ram reciprocally disposed adjacent the advancing plate within the housing, the advancer plate including at least one fin selectively shoulder engaged with the push rod, wherein the push rod in the distal and proximal during the movement, at least one tab shoulder engages the plunger pusher plates to achieve advancing a distal and proximal plate movement; advancing a clip adjacent the carrier plate is arranged in the housing, wherein the clip carrier is configured to hold a plurality of surgical clips; clip follower slidably supported in the clip carrier at a proximal position of maximum of the surgical clips, the clip follower being configured to urge the plurality of surgical clips in a distal direction, the input clip 器包括从其第一表面突出的第一凸起以及从其第二表面突出的第二凸起,其中,随着推进板向远侧运动,夹子输出器的第一凸起与推进板接合,从而使该夹子输出器向远侧运动以推进多个手术夹子,并且其中,随着推进板向近侧运动,夹子输出器的第二凸起与夹 Includes a first protrusion protruding from a first surface and a second projection projecting from a second surface, wherein, as the advancer plate, clip follower and the pusher plate engages the first protrusion to move distally, such that the clip follower is moved distally to advance the plurality of surgical clips, and wherein, as the advancer plate is moved proximally, clip and second clip projections

子载体接合,从而使夹子输出器保持固定;邻近夹子载体可往复运动地布置在壳体中的驱动通道,其中,驱动杆与驱动通道选择性地接合以实现该驱动通道的平移,其中,当驱动通道向远侧推进时,其远端与钳口的表面接合以实现钳口的接近;以及邻近驱动通道可往复运动地布置在壳体中的楔形板, 该楔形板在其远端布置在钳口中的位置和其远端不在所述钳口中的位置之间运动。 Engaging the sub-carrier, such that the clip follower remains stationary; clip carrier may be disposed adjacent the drive channel reciprocally housing, wherein the drive bar selectively engages the drive channel to effect translation of the drive channel, wherein, when when the drive channel advanced distally, the distal end surface which engages the jaw to achieve a close jaws; and adjacent the drive channel may be arranged in the housing of the wedge plate reciprocally, the wedge plate disposed at its distal end moves between the jaws and the jaws in a position which is not the distal end.

[0039]推杆可包括形成在其远端处的推动器。 [0039] The pusher bar may include a pusher formed at a distal end thereof. 推动器可以具有狭窄轮廓以在单个位置上接触被装入的手术缝合钉。 The pusher may have a narrow profile for contacting the loaded surgical staple at a single location. 推动器可以限定与被装入的手术缝合钉的平面大体正交的平面。 The pusher may define a plane of the loaded surgical staple is substantially perpendicular to the plane. 推杆可包括支撑在其上的第一弹簧夹子,该第一弹簧夹子可以在推杆处于推进位置时与轴组件的壳体的部件选择性地接合,以选择性地将推杆保持在该推进位置。 Pusher bar may include a support on which a first spring clip, the spring clip may be in a first selectively engageable with parts of the housing of the shaft assembly when the pusher in the advanced position, to selectively held in the plunger the advanced position. 推杆可进一步包括支撑于其上的第二弹簧夹子,第二弹簧夹子用于与连接板的第一部件选择性地接合,其中, 在连接板的最初远侧运动之后,连接板的第一部件选择性地从第二弹簧夹子脱离。 The pusher bar may further include a second spring clip supported thereon, and a second spring clip for engagement with the first member for selectively connecting plate, the first of which, following an initial distal movement of the web, the web member selectively disengage from the second spring clip.

[0040]可逐步推进夹子输出器通过轴组件。 [0040] The shaft assembly may be incrementally advanced through the clip. 夹子输出器可包括从其表面伸出的窗钩。 The clip follower may include a catch extending from a surface. 在使用中,在最后一个手术夹子被发射之后,窗钩可与推杆接合,并且可防止推杆向近侧方向运动。 In use, after the last surgical clip is fired, the catch may engage the pusher, and may prevent movement of the plunger in a proximal direction.

[0041]手柄组件可进一步包括布置于其内的棘轮组件。 [0041] The handle assembly may further include a ratchet assembly disposed therein. 在使用中,当推杆没有返回到近侧位置时,可以防止该棘轮组件复位。 In use, when the plunger does not return to a proximal position, the ratchet assembly may be prevented reset. 手柄组件可进一步包括支撑在壳体组件中的计数器,其中,当手术夹子已经被发射之后,该计数器可提供指示。 The handle assembly may further include a counter supported in the housing assembly, wherein, when a surgical clip has been fired, the counter may provide an indication. 更进一步地,手柄组件可包括支撑在其内的指示器。 Still further, the handle assembly may include an indicator supported therein. 指示器可提供指示事件的听觉和触觉指示中的至少一个。 An audible and tactile indication indicating an event indicator may provide at least one. 例如,所述事件可以是至少一个手术夹子被装入钳口中、手术夹子被发射以及所述装置被复位。 For example, the event may be at least one of a surgical clip is loaded into the jaws, a surgical clip is fired and the apparatus is reset.

[0042]楔形板可进一步包括支撑在其上用于与连接板的第二部件选择性地接合的第三弹簧夹子。 [0042] The wedge plate may further include a support on which a third spring clip and a second member for selectively engaging the web. 在使用中,在连接板的最初远侧运动之后,连接板的第二部件可以选择性地从该第三弹簧夹子脱离。 In use, after the initial distal movement of the web, a second web member may selectively disengage from the third spring clip.

10[0043]轴组件可包括楔形板锁。 10 [0043] The shaft assembly may include a wedge plate lock. 在使用中,驱动通道可以在其向远侧推进后致动楔形板锁以使楔形板向近侧运动从而使楔形板的远端从钳口退回, 并且允许驱动通道接近钳口。 In use, the drive channel may actuate the wedge plate lock upon distal advancement thereof to cause proximal movement of wedge plate such that the distal end of the wedge plate from the jaws retracted, and permit the drive channel to approximate the jaws.

[0044]轴组件可以相对于手柄组件围绕纵轴旋转。 [0044] The shaft assembly relative to the handle assembly about the longitudinal axis. 轴组件可包括支撑在壳体内的套箍,其中,该套箍在第三弹簧夹子平移跨过该套箍时防止第三弹簧夹子向外张开。 The shaft assembly may include a support within the housing of the ferrule, wherein the ferrule in the third spring clip translates thereacross prevent the third spring clip from splaying outwardly as the ferrule.

[0045]楔形板和/或驱动通道可被偏置到近侧位置。 [0045] The wedge plate and / or drive channel may be biased to a proximal position.

附图说明 BRIEF DESCRIPTION

[0046]通过结合附图的下列详细描述,本施夹器将被更全面地认识并变得更好理解,在附图中: [0046] the following detailed description in conjunction with the accompanying drawings, the present clip applier will be more fully appreciated and become better understood, the accompanying drawings in which:

[0047]图1是根据本公开的一个实施方式的手术施夹器的前视立体图; [0047] FIG. 1 is a front perspective view of the surgical clip applier according to one embodiment of the disclosed embodiment;

[0048]图2是图1所示的施夹器的后视立体图,图示了其轴组件的旋转; [0048] FIG. 2 is a rear perspective view of the clip applier shown in FIG. 1, which illustrates a rotating shaft assembly;

[0049]图3是图1和图2所示的施夹器的轴组件的远端的前视立体图; [0049] FIG. 3 is a front perspective view of the distal end of shaft assembly of the clip applier shown in FIGS. 1 and 2;

[0050]图4是图l和图2所示的施夹器的俯视图; [0050] FIG. 4 is a plan view and FIG. L clip applier shown in FIG. 2;

[0051]图5是图l和图2所示的施夹器的侧面正视图; [0051] FIG. 5 is a side clip applier shown in Figure l and Figure 2 a front view;

[0052]图6是图1至图5所示的施夹器的手柄组件的立体图,图示了左 [0052] FIG. 6 is a perspective view of the handle assembly of the clip applier shown in FIG. 1 to FIG. 5, a left

半壳体被从其中移走的情况; Wherein half shells are removed from the case;

[0053]图7是图1至图5所示的施夹器的手柄组件的立体图,图示了右 [0053] FIG. 7 is a perspective view of the handle assembly of the clip applier shown in FIG. 1 to FIG. 5, illustrating the right

半壳体被从其中移走的情况; Wherein half shells are removed from the case;

[0054]图8是图1至图5所示的施夹器的手柄组件的部件分解的立体 [0054] FIG. 8 is an exploded perspective view of the handle assembly of FIGS. 1 to 5 of the clip applier

图; Figure;

[0055]图8A是图6至图8所示的手柄组件在扳机被从其中移走的情况下的立体图; [0055] FIG. 8A is a perspective view in the case of FIG. 6 to FIG. 8, the handle assembly shown in which the trigger from being removed;

[0056]图8B是图6至图8所示的手柄组件的反馈构件的立体图; [0057]图9是图1至图5所示的施夹器的轴组件的部件分解的立体图; [0058]图10是图9所示的轴组件的右侧前视立体图,示出了装配的情 A perspective view [0056] FIG 8B is a 6 to FIG. 8 a feedback member of the handle assembly; [0057] FIG. 9 is a perspective view of the exploded shaft assembly of the clip applier shown in Figures 1 to 5; [0058 right front perspective view] FIG. 10 is shown in FIG. 9 of the shaft assembly showing the assembled situation

况; condition;

[0059]图11是图10中显示的细节表示区域的放大视图; [0060]图12是图9至图11所示的轴组件的右侧前视图,示出了上壳体被从其中移走的情况;[0061]图13是图12中显示的细节表示区域的放大视图; [0062]图14是图12中显示的细节表示区域的放大视图; [0063]图15是图12中显示的细节表示区域的放大视图; [0064]图16是图9至15所示的轴组件的推杆的近端以及弹簧夹子(snap clip)的部件分解的立体图; [0059] FIG 11 is a detail shown in FIG. 10 shows an enlarged view of a region; [0060] FIG. 12 is a right side view of the front axle assembly shown in FIG. 9 to FIG. 11, showing the upper housing is removed from, case of walking; [0061] FIG 13 is a detail of FIG. 12 shows an enlarged view of a region; [0062] FIG 14 is a detail of FIG. 12 shows an enlarged view of a region; [0063] FIG. 15 is shown in figure 12 shows an enlarged detail view of a region; [0064] FIG. 16 is an exploded perspective view of the proximal end of the pusher member of the shaft assembly shown in FIGS. 9 to 15 and a spring clip (snap clip); and

[0065]图17是图9至图15所示轴组件的仰视图,图示了推杆的近端以 [0065] FIG. 17 is shown in FIGS. 9 to 15 a bottom view of the shaft assembly, illustrating the proximal end of the push rod to

及布置在上壳体中的弹簧夹子; Disposed in the housing and the spring clip;

[0066]图18是图9至图17所示的轴组件的右侧前视立体图,示出了上 [0066] FIG. 18 is a right front perspective view of the shaft assembly shown in FIG. 9 to FIG. 17, showing the upper

壳体和推杆被从其中移走的情况; Wherein the housing and the plunger are removed from the case;

[0067]图19是图18中显示的细节表示区域的放大视图; [0068]图20是图18中显示的细节表示区域的放大视图; [0069]图21是图9至图20所示的轴组件的右侧前视立体图,示出了上 [0067] FIG 19 is a detail shown in FIG. 18 shows an enlarged view of a region; [0068] FIG 20 is a detail shown in FIG. 18 shows an enlarged view of a region; [0069] FIG. 21 is shown in FIGS. 9 to 20 in right front perspective view of the shaft assembly showing the

壳体、推杆和推进板被从其中移走的情况; Housing, push rod, and wherein the pusher plate is removed from the case;

[0070]图22是图21中显示的细节表示区域的放大视图; [0070] FIG. 22 is a view of detail 21 shown in an enlarged view of the area;

[0071]图23是夹子输出器以及闭锁板的部件分解的立体图; [0071] FIG. 23 is a clip member and an exploded perspective view of the latch plate;

[0072]图23A是图23所示的夹子输出器以及闭锁板装配完毕后的俯视 [0072] FIG 23A is a plan view of the FIG clip and the latch plate assembly 23 is completed as shown in

立体图; FIG perspective;

[0073]图24是图23所示的夹子输出器的仰视立体图; [0073] FIG. 24 is a bottom perspective view of the clip shown in FIG 23;

[0074]图25是图9至图23所示的轴组件的远端的右侧前视立体图,示 [0074] FIG. 25 is a right front perspective view of the distal end of the shaft assembly shown in FIG. 9 to FIG. 23, a

出了上壳体、推杆、推进板以及夹子载体被从其中移走的情况; An upper housing, the push rod, plate, and to promote the situation wherein the clip carrier is removed;

[0075]图26是图25所示的轴组件的远端的右侧前视立体图,示出了上 Right front perspective view of the distal end [0075] FIG. 26 is shown in FIG. 25 of the shaft assembly showing the

壳体、推杆、推进板、夹子载体以及驱动通道被从其中移走的情况; Housing, push rod, and Advance plate, the clip carrier and a drive channel is removed from wherein;

[0076]图27是图9至图26所示的轴组件的左侧前视立体图,示出了上 Left front perspective view [0076] FIG. 27 is shown in FIGS. 9 to 26 of the shaft assembly showing the

壳体、推杆、推进板、夹子载体、驱动通道以及楔形板被从其中移走的情况; [0077]图28是图27中显示的细节表示区域的放大视图; [0078]图29是图27中显示的细节表示区域的放大视图; [0079]图30是图9至29所示的轴组件的下壳体的左侧前视立体图; [0080]图31是图30中显示的细节表示区域的放大视图; [0081]图31A是图30中显示的细节表示区域的放大视图; [0082]图32是图1至31A所示的施夹器的纵向截面图,图示了处于未 Housing, push rod, and Advance plate, the clip carrier, the drive channel and the wedge plate removed therefrom; and [0077] FIG 28 is a detail shown in FIG. 27 shows an enlarged view of a region; [0078] FIG. 29 is a view 27 shows an enlarged view of the detail display area; [0079] FIG. 30 is a left front perspective view of the lower housing of the shaft assembly shown in FIGS. 9-29; [0080] FIG 31 is a detail shown in FIG. 30 represents an enlarged view of an area; [0081] FIG 31A is a detail of FIG. 30 illustrates an enlarged view of a region; [0082] FIG. 32 is a longitudinal sectional view through FIG clip applier shown in FIG. 1 31A, is illustrated in the non-

致动状态下的施夹器; Clip applier in the actuated state;

12[0083]图33是图32中显示的细节表示区域的放大视图; 12 [0083] FIG 33 is a detail shown in FIG. 32 shows an enlarged view of the area;

[0084]图34是图1至图31A所示的施夹器的轴组件的远端的纵向截面 [0084] FIG. 34 is a longitudinal cross section of the distal end of shaft assembly of Figures 1 to 31A of the clip applier shown in FIG.

图; Figure;

[0085] 图 35 是沿图34中的35-35截取的截面图; [0085] FIG. 35 is a sectional view taken along 35-35 of FIG 34 taken;

[0086] 图 36 是图34中显示的细节表示区域的放大视图; [0086] FIG. 36 is shown in detail in FIG. 34 shows an enlarged view of the area;

[0087] 图 37 是沿图36中的37-37截取的截面图; [0087] FIG. 37 is a sectional view taken 37-37 in FIG. 36 along;

[0088] 图 38 是图34中显示的细节表示区域的放大视图; [0088] FIG. 38 is shown in detail in FIG. 34 shows an enlarged view of the area;

[0089] 图 39 是沿图38中的39-39截取的截面图; [0089] FIG. 39 is a sectional view taken along 39-39 of FIG 38;

[0090] 图 40 是图34中显示的细节表示区域的放大视图; [0090] FIG. 40 is shown in detail in FIG. 34 shows an enlarged view of the area;

[0091] 图 41 是沿图40中的41-41截取的截面图; [0091] FIG. 41 is a sectional view taken 41-41 in FIG. 40 along;

[0092] 图 42 是图34中显示的细节表示区域的放大视图; [0092] FIG. 42 is shown in detail in FIG. 34 shows an enlarged view of the area;

[0093] 图 43 是沿图42中的43-43线截取的截面图; [0093] FIG. 43 is a cross-sectional view along the line taken 4243-43;

[0094] 图 44 是图1至43所示的施夹器在最初致动期间的纵向截面图; [0094] FIG. 44 is a longitudinal sectional view of the clip applier shown in FIG. 1-43 during initial actuation;

[0095] 图 45 是图44中显示的细节表示区域的放大视图; [0095] FIG 45 is a detail shown in FIG. 44 shows an enlarged view of a region;

[0096] 图 46 是图34中显示的细节表示区域36的在施夹器的最初致动 [0096] FIG. 46 is shown in detail in FIG. 34 in the first region represents the actuator of the clip applier 36

期间的放大视图; An enlarged view of the period;

[0097]图47是图34中显示的细节表示区域40的在施夹器的最初致动期间的放大视图; [0097] FIG 47 is a detail shown in FIG. 34 shows an enlarged view of the actuator during the initial region of the clip applier 40;

[0098]图47A是推杆的俯视图,图示了推杆在施夹器的最初致动期间的运动; [0098] FIG 47A is a plan view of the plunger, illustrating a first push rod movement during actuation of the clip applier;

[0099]图47B和图47C均是轴组件的纵向截面图,图示了在施夹器的最 [0099] FIGS. 47B and 47C are longitudinal sectional view of the shaft assembly, illustrating the clip applier in the most

初致动期间楔形板的运动; First wedge plate during movement of the actuator;

[00100]图48和图49是在施夹器的最初驱动期间轴组件沿图40中41-41截取的截面的放大视图; [00100] FIG 48 FIG 49 is an enlarged cross-sectional view of the shaft assembly during the initial driving direction of the clip applier of FIG. 40 and taken at 41-41;

[00101]图50是在施夹器的最初致动期间图34中显示的细节表示区域42的放大视图; During [00101] FIG. 50 is a first actuator clip applier shown in FIG. 34 shows an enlarged detail view of area 42;

[00102]图51是在施夹器的最初致动期间轴组件的远端的左侧仰视立体图; [00102] FIG. 51 is a left side of the distal end of the shaft assembly during the initial actuation of the clip applier bottom perspective view;

[00103]图52至图54均是轴组件的纵向截面图,图示了在施夹器的最初致动期间楔形板的进一步运动,以及连接板的杆从楔形板的弹簧夹子的脱离;[00104]图55是图1至图54所示的施夹器的纵向截面图,图示了在进 [00103] Figures 52 through 54 are longitudinal cross-sectional view of the shaft assembly, illustrating a further movement of the movable wedge plate during the initial actuation of the clip applier, and a connection plate lever disengaged from the spring clip of the wedge plate; [ 00104] FIG. 55 is a longitudinal cross-sectional view of FIG. 1 to 54 shown in FIG clip applier, illustrating intake

一步致动期间的施夹器; Step during actuation of clip applier actuator;

[00105]图56是图55中显示的细节表示区域的放大视图; [00105] FIG. 56 is a view of detail 55 shown in an enlarged view of the area;

[00106]图56A是移去上壳体的轴组件的右视立体图,图示了在施夹器的进一步致动期间推杆的运动; [00106] FIG. 56A is a right side perspective view of the shaft assembly housing removed, illustrating a further actuation during clip applier push rod movement;

[00107]图56B和图56C均是推进板的仰视图,图示了在施夹器的进一步致动期间推进板的运动; [00107] FIGS. 56B and 56C are a bottom view of a plate advancing, illustrating pusher plate during the further actuation of the clip applier of movement;

[00108]图57是在施夹器的进一步致动期间图34中显示的细节表示区域36的放大视图; During [00108] FIG. 57 is a further actuation of the clip applier shown in FIG. 34 shows an enlarged detail view of area 36;

[00109]图58是在施夹器的进一步致动期间图34中显示的细节表示区域40施夹器的放大视图; During [00109] FIG. 58 is a further actuation of the clip applier shown in FIG. 34 shows an enlarged detail view of area 40 of the clip applier;

[00110]图59和图60是轴组件的纵向截面图,图示了在施夹器的进一步致动期间推杆的运动以及支撑在推杆上的夹子与上壳体的凸台的连接; [00110] FIG. 59 and FIG. 60 is a longitudinal sectional view of the shaft assembly, illustrating a further actuation of the clip applier during plunger movement is supported on the push rod and the clip connecting the boss of the upper housing;

[00111]图61是在施夹器的进一步致动期间图34中显示的细节表示区域40的放大视图; During [00111] FIG. 61 is a further actuation of the clip applier shown in FIG. 34 shows an enlarged detail view of region 40;

[00112]图62是在施夹器的进一步致动期间图34中显示的细节表示区域42的放大视图; During [00112] FIG. 62 is a further actuation of the clip applier shown in FIG. 34 shows an enlarged detail view of area 42;

[00113]图63是轴组件的纵向截面图,图示了在施夹器的进一步致动期间驱动杆的运动; [00113] FIG. 63 is a longitudinal sectional view of the shaft assembly, illustrating a further movement during actuation of the clip applier of the drive rod;

[00114]图64和图65是在施夹器的进一步致动期间轴组件沿图40中41-41截取的截面的放大视图; [00114] FIG. 64 and FIG. 65 is a time further actuation of the clip applier shaft assembly taken along 41-41 in FIG. 40 is an enlarged cross-sectional view;

[00115]图66是在施夹器的进一步致动期间轴组件的远端的俯视左侧立体图; [00115] FIG. 66 is a top left perspective view of the distal shaft assembly during a further actuation of the clip applier;

[00116]图67至图69是轴组件的纵向截面图,图示了在施夹器的进一 [00116] FIG. 67 through FIG. 69 is a longitudinal sectional view of the shaft assembly, illustrating the clip applier into a

步致动期间连接板的运动; Step induced during movement of the movable web;

[00117]图67A至图69A是根据本公开的另一可选实施方式的轴组件的纵向截面图,图示了在施夹器的进一步致动期间连接板的运动; [00117] FIGS. 67A to FIG. 69A is a longitudinal sectional view of the shaft assembly of the present disclosure further alternative embodiment, illustrated during a further actuation of the clip applier of web movement;

[00118]图70是图1至图69所示的施夹器在最后的致动期间的纵向截面图; [00118] FIG. 70 is a longitudinal sectional view of the clip applier shown in FIG. 1 to FIG. 69 during the final actuation;

[00119]图71是图70中显示的细节表示区域的放大视图;[00120]图72是在施夹器的最后致动期间图34中显示的细节表示区域42的放大视图; [00119] FIG 71 is a detail shown in FIG. 70 shows an enlarged view of a region; during [00120] FIG. 72 is the last actuator in the clip applier shown in FIG. 34 shows an enlarged detail view of area 42;

[00121]图73和图74是轴组件的远端的前视立体图,图示了在施夹器 [00121] FIG. 73 and FIG. 74 is a front perspective view of the distal end of the shaft assembly, illustrating the clip applier

的最后致动期间钳口的致动; The jaws during the final actuation of the actuator;

[00122]图75是图示了施加到脉管上的手术夹子的立体图; [00122] FIG. 75 is a perspective view illustrating a surgical clip applied to a vessel on;

[00123]图76是在施夹器的扳机被松开时图70中显示的细节表示区域 [00123] FIG 76 is a detail of the trigger of the clip applier is released when the display indicates 70 in FIG region

71的放大视图; 71 is an enlarged view;

[00124]图76A是在扳机在其完全致动后松开时手柄组件的侧面正视 [00124] FIG. 76A is released after it is full actuation of the trigger of the handle assembly side elevational

图; Figure;

[00125]图77是轴组件的纵向截面图,图示了在扳机松开期间连接板的运动; [00125] FIG. 77 is a longitudinal sectional view of the shaft assembly, illustrating a release web during movement of the trigger;

[00126]图78是轴组件的纵向截面图,图示了在扳机的松开期间推杆的运动以及支撑在推杆上的夹子从上壳体的凸台的脱开; [00126] FIG. 78 is a longitudinal sectional view of the shaft assembly, illustrating the trigger is released during movement of the pusher and a clip supported on the push rod is disengaged from the boss of the upper housing;

[00127]图79是移去上壳体的轴组件的右视立体图,图示了在扳机的松 Perspective view of the right [00127] FIG. 79 is a shaft assembly housing removed, illustrating the trigger in a pine

开期间推杆的运动; Putter during the opening movement;

[00128]图80是在扳机松开期间图34中显示的细节表示区域40的放大 [00128] FIG 80 is a detail of Figure 34 during release of the trigger shown in an enlarged area 40

视图; view;

[00129]图81是轴组件的纵向截面图,图示了在扳机松开期间连接板的杆再次连接到推杆的弹簧夹子上; [00129] FIG. 81 is a longitudinal sectional view of the shaft assembly, illustrating the trigger lever during the release push rod connecting plate is connected to the spring clip again;

[00130]图82至图83均是轴组件的纵向截面图,图示了在扳机松开期 [00130] FIGS. 82 to 83 are longitudinal cross-sectional view of the shaft assembly, illustrating a release of the trigger

间楔形板的进一步运动以及连接板的杆与楔形板的弹簧夹子上的再次接合; [00131]图84是当施夹器处于闭锁状态时轴组件的远端的前视立体图; [00132]图85是当施夹器处于闭锁状态时图34显示的细节表示区域42 Further movement between the wedge plate and engages again on the lever and the spring clip web wedge plate; a front perspective view of the distal end of the shaft assembly when [00131] FIG. 84 when the clip applier is in a locked state; [00132] FIG. 85 when the clip applier is in a locked state shown in FIG. 34 shows details of region 42

的放大视图;以及 An enlarged view; and

[00133]图86是当施夹器处于闭锁状态时图70显示的细节表示区域71 [00133] FIG. 86 is a time when the detail in a lockout state clip applier shown in FIG. 70 indicates an area 71

的放大视图。 An enlarged view.

具体实施方式 Detailed ways

[00134]现将参照附图详细说明根据本公开的手术施夹器的实施方式, 附图中相似的附图标记表示相似或相同的部件。 [00134] will now be described in detail with reference to the accompanying drawings of the present disclosure surgical clip applier according to an embodiment, the drawings in which like reference numerals refer to similar or identical parts. 如图所示及以下说明书通篇的相对位置时,术语"近侧"指装置的靠近用户的一端,术语"远侧"指装置的远离用户的一端。 Relative position as shown throughout the following specification and the term "proximal" refers to the end closer to the user apparatus, the term "distal" refers to the end away from the user apparatus.

[00135]现参照图1至图5,根据本公开的一个实施例的手术施夹器总体上用100来指代。 [00135] Referring now to FIG. 1 to FIG. 5, one embodiment of the surgical clip applier with the present disclosure to refer to a device 100 generally. 施夹器100包括手柄组件102和内窥镜部,该内窥镜部包括从手柄组件102向远侧延伸的轴组件104。 Assembly 100 includes a handle portion and the endoscopic clip applier 102, the endoscopic portion 102 includes a shaft assembly 104 extending distally from the handle assembly.

[00136]轴组件104具有约10mm的外径。 [00136] The shaft assembly 104 has an outer diameter of about 10mm. 取决于预计的用途诸如肥胖病手术,轴组件104可以具有各种伸长的或縮短的长度。 Depending on the intended use, such as obesity surgery, shaft assembly 104 may have various elongated or shortened lengths.

[00137]如图1至图5所示,手术施夹器100包括安装在轴组件104的远端并可由手柄组件102的扳机108致动的一对钳口106。 [00137] As shown in FIGS. 1 to 5, surgical clip applier 100 includes a mounting assembly 104 at the distal end of the shaft and a pair of jaws by a trigger 108 of handle assembly 102 of the actuator 106. 一对钳口106由合适的生物相容的材料诸如不锈钢或钛制成,该一对钳口限定了在其之间用于将手术夹子"C"容纳在其中的通道106a。 A pair of jaws 106 compatible with a suitable biological material such as stainless steel or titanium, the pair of jaws defining therebetween a surgical clip "C" therein a passage 106a. 当一对钳口106处于相对于彼此打开或非接近的状态时,测得一对钳口106的宽度大于轴组件104的外径。 When a pair of jaws 106 is open with respect to each other or a state close to the measured width of the outer diameter of one pair of jaws 106 is larger than the shaft assembly 104.

[00138] —对钳口106安装于轴组件104的远端以使它们相对该处纵向固定。 [00138] - pair of jaws 106 mounted to the distal end of shaft assembly 104 such that they are longitudinally fixed relative to the premises. 旋钮110可以可旋转地安装在手柄组件102的远端,并连接于轴组件104以向轴组件104和一对钳口106传输和/或提供绕其纵轴的360°旋转(参见图2)。 Knob 110 may be rotatably mounted at a distal end of the handle assembly 102, and is connected to the shaft assembly 104 to shaft assembly 104 and a pair of jaws 106 transmit and / or provide 360 ​​° about its longitudinal axis of rotation (see FIG. 2) .

[00139]现参照图1至图8,示出了手术施夹器100的手柄组件102。 [00139] Referring now to FIG. 1 to FIG. 8, there is shown a surgical clip applier 100 of handle assembly 102. 手柄组件102包括壳体103,该壳体具有第一或右侧半部103a和第二或左侧半部103b。 Handle assembly 102 includes a housing 103, the housing having a first or right side half-section 103a and a second or left side half portion 103b. 手柄组件102包括可枢转地支撑在右侧半部103a和左侧半部103b 之间的扳机108。 Handle assembly 102 includes a pivotable trigger 108 supported between the right half-section 103a and left side half portion 103b. 如以下将更详细讨论的,手柄组件102限定了形成于壳体103中的用于支撑和显示计数机构的窗口103c。 For example, the handle assembly 102 as discussed below in greater detail defining formed in the housing 103 for supporting the counter mechanism and a display window 103c. 手柄组件102的壳体103可由合适的塑料制成。 The handle assembly 102 housing 103 by a suitable plastic material.

[00140]壳体103将驱动组件120支撑在右侧半部103a和左侧半部103b 之间。 [00140] The housing 103 supports a drive assembly 120 between right side half-section 103a and left side half portion 103b. 驱动组件120包括叉形连杆122,该叉形连杆具有枢转地连接于扳机108的第一端和枢转地连接于曲柄板124的第二端。 The drive assembly 120 includes a wishbone link 122, which link has a fork pivotally connected to the first end 108 of the trigger and pivotally connected to the second end 124 of the crank plate. 如图6至图9所示,驱动组件120进一步包括可旋转地连接于曲柄板124的驱动连接器134、与驱动连接器134相互连接的柱塞135和支撑在驱动连接器134上的弹簧136。 The plunger 135 and the support shown in FIG. 6 to FIG, further comprising a drive assembly 120 rotatably connected to crank plate 124 of drive coupling 9134 with the drive connector 134 interconnecting the drive spring 136 of the connector 134 . 柱塞135限定了纵向狭槽135a,该纵向狭槽配置成并适于将驱动杆140的近端容纳在其中。 The plunger 135 defines a longitudinal slot 135a, the longitudinal slot configured and adapted to the proximal end of the drive rod 140 therein. [00141]驱动杆140通过整体销135b连接于柱塞135 (参见图9)。 [00141] The drive rod 140 is connected to a plunger 135 (see FIG. 9) by an integral pin 135b. 设置了帽144,柱塞135贯穿该帽。 The cap 144 is provided, plunger 135 extends through the cap. 设置密封件(seal)(未示出)来建立柱塞135 和外管150之间的气密性密封。 A seal (Seal) (not shown) to create an airtight seal between the plunger 135 and outer tube 150.

[00142]如图6至图8所示,手柄组件102进一步包括形成于曲柄板124 中/上的齿条124a以便齿条124a可随曲柄板124运动。 [00142] As shown in FIG. 6 to FIG. 8, handle assembly 102 further includes a rack 124a formed in the crank plate 124 / 124a may be on the order of the rack 124 with the crank plate movement. 齿条124a包括置于曲柄板124中限定的远侧凹槽124b和近侧凹槽124c之间的多个齿。 The rack 124a comprises a plurality of teeth disposed between the crank plate 124 defines a distal recess 124b and a proximal recess 124c. 设置凹槽124b和124c以允许棘爪224翻转并当曲柄板124在近侧和远侧运动之间变化时提升至齿条124a的齿上。 124b and 124c disposed on the groove 224 to allow the pawl to lift and flip when the rack 124a between the proximal and distal motion of crank plate 124 teeth.

[00143]手柄组件102进一步包括棘爪224,在棘爪224与曲柄板124 的齿条124a大体上操作的接合的位置处,棘爪224通过棘爪销226枢转地连接于壳体103。 [00143] The handle assembly 102 further includes a pawl 224, the engaging position, the pawl 224 and the pawl rack 124a of crank plate 124 is generally operated through 224 attached to the housing 103 of the pawl pin 226 pivotally. 棘爪224包括棘爪齿224a,该棘爪齿可选择地与曲柄板124 的齿条124a的齿接合。 Pawl 224 includes pawl teeth 224a, 124a of the rack teeth of the pawl and crank plate 124 selectively engage teeth. 棘爪齿224a可与齿条齿接合以限制齿条124a并且依次地限制曲柄板124在手柄组件102内的纵向运动。 Pawl tooth 224a is engageable with the rack teeth of the rack 124a and to limit longitudinal movement limit sequentially crank plate 124 within handle assembly 102. 设置爪簧228以使棘爪224偏入到与曲柄板124的齿条124a操作的接合。 Pawl spring 228 is provided to allow pawl 224 to bias the rack into engagement with the crank plate 124 in operation 124a.

[00144]如图6至图8所示,曲柄板124通过销123可枢转地连接于叉形连杆122。 [00144] As shown in FIG. 6 to FIG. 8, crank plate 124 by a pin 123 is pivotally coupled to wishbone link 122. 曲柄板124限定了形成于其中的一系列棘轮齿124a以与棘爪224 选择的接合。 Defining a crank plate 124 joined to form therein a series of ratchet teeth 124a of the pawl 224 with the selection.

[00145]如图8、图8A和图8B所示,手柄组件102进一步包括听觉/触觉反馈构件126,该反馈构件与扳机108操作地相关以便与其一起旋转并且当扳机108致动时绕着共同的轴旋转。 [00145] 8, 8A, and as shown in FIG. 8B handle assembly 102 further includes an audible / tactile feedback member 126, the feedback member is operatively associated with trigger 108 and rotation therewith about a common actuator when the trigger 108 the rotation of the shaft. 反馈构件126限定了滚道126a,滚道126a限定了多个棘轮齿或梯级126b。 Feedback member 126 defines a race 126a, 126a define a plurality of raceways of ratchet teeth or steps 126b. 设置有可偏转臂127,该可偏转臂包括操作的连接或布置在反馈元件126的滚道126a中并与梯级126b接触的第一端和连接于壳体103的第二端。 Is provided with a deflectable arm 127, the deflectable arm includes a first end 103 connected to the housing and a second end connected or arranged to operate in a feedback element in race 126a 126 and in contact with the step 126b. 在操作中,当致动扳机108时,臂127通过和/或沿着形成于反馈构件126中的滚道126a运动。 In operation, when the actuator when the trigger 108, through arm 127 and / or along race 126a formed in feedback member 126 moving in. 如以下将更详细讨论的, 随着臂127在反馈构件126的梯级126b上运动,臂127弹锁住梯级126b, 并产生可听到的声音/咯哒声和/或可感觉到的振动。 , As arm 127 moves in the steps 126b of feedback member 126, arm 127 snaps over steps 126b as discussed below in greater detail, and generates an audible sound / click sound slightly and / or perceptible vibration.

[00146]听觉/触觉反馈构件126包括足够的梯级126b以便在夹子已经被完全装入手术施夹器100的钳口中后、在装入的夹子己经由手术施夹器100 钳口形成后、并且当手术施夹器100被复位到原位并准备发射/形成另一夹子时产生听觉/触觉指示。 [00146] audible / tactile feedback member 126 includes sufficient steps 126b so as has been completely loaded surgical clip applier jaws after the clip 100, the clip has loaded jaws 100 are formed through the surgical clip applier, and generating an audible / tactile indication when a surgical clip applier 100 is reset to the home position and ready to transmit / form another clip.

17[00147]如图6、图7、图8和图8A所示,手术施夹器100的手柄组件102进一步包括支撑在壳体103中并通过限定在壳体103中的窗口103c可见的计数机构132。 17 [00147] 6, 7, 8 and 8A, handle assembly of surgical clip applier 100 further includes a support 102 in the housing 103 and visible through a window defined in the housing 103 counts 103c 132 institutions. 计数机构132包括显示器132a、处理器132b和使用电池等形式的能源(未示出)。 Counter mechanism 132 includes a display 132a, a processor 132b, and the use of forms of energy such as a battery (not shown).

[00148]显示器132a可以是本领域已知的任何器件以提供事件的指示。 [00148] Display 132a may be any device known in the art to provide an indication of an event. 事件可以涉及施夹器100的程序或操作。 Events may involve clip applier 100 or a program operation. 显示器132a是液晶显示器(LCD)。 Display 132a is a liquid crystal display (LCD).

[00149]显示器132a向外科医生显示施夹器100的一个或多个操作参数。 [00149] Display 132a displays a 100 or more operating parameters of clip applier the surgeon. 由显示器132a显示的操作参数包括剩下的夹子的数量(amount)或数目(number)、已经使用的夹子的数目、位置参数、使用的手术时间或程序的任何其它参数。 Operating parameter displayed by display 132a includes a number of clips remaining (amount) or number (Number), the number of clips that have been used, a position parameter, time or any other parameter of the surgical procedure used.

[00150]在电池或能源和处理器132b的触头之间布置聚酯薄膜(Mylar) 或另一聚合绝缘材料,该材料防止电池或能源在存储过程中被耗尽。 [00150] contacts disposed between battery or energy processor 132b and a polyester film (a Mylar), or another polymeric insulating material which prevents the battery or energy source is depleted during storage. 凸起从手术施夹器100的壳体103伸出以允许凸起易于从那里移开。 Projection from housing 103 of surgical clip applier 100 extending therefrom to permit easy removal of the projections. 一旦凸起被移开,电池或能源与处理器132b的触头电接触,而使显示器132a通电。 Once the protrusion is removed, battery or energy in electrical contact with the contact of processor 132b, the power monitor 132a.

[00151]如图6、图7、图8和图8A所示,手术施夹器100的手柄组件102进一步包括计数致动机构,该机构包括具有配置成并适于操作地、选择性地接合计数机构132的处理器132b的计数致动杠杆130。 [00151] 6, 7, 8 and 8A, handle assembly of surgical clip applier 100 further includes a counter 102 actuating mechanism that includes a configured and adapted to operatively, selectively engage the processor 132b of counter mechanism 132 of counter actuation lever 130. 计数致动杠杆130 进一步包括第二臂130b,该臂配置成并适于操作地、可滑动地接合形成在致动板128中的狭槽128a,致动板128可滑动地支撑在壳体103中。 Counter actuation lever 130 further includes a second arm 130b, the arm is configured and adapted to operate, the slot in the actuator plate 128 slidably engaged 128a is formed, the actuator plate 128 slidably supported in the housing 103 in.

[00152]在操作中,如以下将更详细说明的,随着扳机108被挤压,扳机108使得叉形连杆122向远侧推进,使得曲柄板124向远侧推进。 [00152] In operation, as described in greater detail below, as trigger 108 is squeezed, trigger 108 causes wishbone link 122 is advanced distally, crank plate 124 such that distal advancement. 当曲柄板124的臂124d推进预定距离时,臂124d接合或接触致动板128的指部128b。 When arm 124d of crank plate 124 advancing a predetermined distance, arm 124d engages or contacts finger 128b of actuator plate 128 is. 随着曲柄板124进一步向远侧推进,曲柄板124向远侧方向推动或拉动触发板128,从而致动计数致动杠杆130以致动计数机构132。 As crank plate 124 is further advanced distally, crank plate 124 push or pull on the trigger plate 128 in a distal direction thereby actuating counter actuation lever 130 to activate counter mechanism 132.

[00153]特别地,当致动板128向远侧运动足够的距离时,在其狭槽128b 内用凸轮带动计数致动杠杆130的第二臂130b并使计数致动杠杆130旋转导致第一臂130a旋转。 [00153] In particular, when actuator plate 128 is moved distally a sufficient distance, 128b in its slot count driven actuation lever cam 130 and a second arm 130b of counter actuation lever 130 resulting in rotation of the first rotation of the arm 130a. 当致动板128向近侧运动足够的距离时,计数致动杠杆130的第二臂130b返回原位,导致计数致动杠杆130的第一臂130a脱离计数机构132。 When actuator plate 128 is moved proximally a sufficient distance, counter actuation lever 130 of the second arm 130b to return in situ, resulting in counter actuation lever 130 of the first arm 130a of counter mechanism 132 disengaged.

[00154]现转至图9至图31A,手术施夹器100的轴组件104被示出并在下文中加以描述。 [00154] Turning now to FIGS. 9 to FIG. 31A, the surgical clip applier shaft assembly 104 and 100 is illustrated hereinafter be described. 轴组件104及其组件可由合适的生物相容的材料诸如不 Shaft assembly 104 and its components may be made of suitable biocompatible material such as no

18锈钢、钛、塑料等制成。 18 stainless steel, titanium, plastic or the like. 轴组件104包括外管150,外管150具有支撑在壳体103内的近端150a、远端150b和贯穿其中的内腔150c。 Shaft assembly 104 includes an outer tube 150, outer tube 150 having a proximal end supported within the housing 103 150a, 150b and the distal end of a lumen therethrough 150c. 外管150通过从其外表面突出的凸缘被固定在壳体103内。 Outer tube 150 by an outer surface of the projecting flange is secured within the housing 103 thereof. 轴组件104进一步包括均布置在外管150的内腔150c内的上壳体152a和下壳体152b。 Further comprising a shaft assembly 104 are disposed within upper housing 152a lumen 150c of outer tube 150 and the lower housing 152b. 后部上壳体154布置在外管150内和上壳体152a的近侧。 Rear upper housing 154 is disposed within outer tube 150 and proximal of upper housing 152a.

[00155]如图9、图12和图13所示,轴组件104进一步包括可滑动地布置在上壳体152a和后部上壳体154内的推杆156。 [00155] As shown in FIG. 9, FIGS. 12 and 13, shaft assembly 104 further includes a pusher bar 156 slidably disposed on the upper housing 152a and a rear inner housing 154. 推杆156包括限定了窄形推动器156c的远端156a,推动器156c配置成并适于选择性地接合/运动(即向远侧推进) 一堆夹子"C"的最远侧的夹钳"C1",并在其最初形成期间与最远侧的夹钳"C1"保持接触。 The pusher 156 includes a Narrow defining the distal end 156c of the pusher 156a, pusher 156c configured and adapted to selectively engage / motion (i.e., distally advance) a stack of clips "C" of the distal-most clip "C1", and the distal-most clip "C1" is kept in contact during its initial formation. 推杆156进一步包括近端156b。 Push rod 156 further includes a proximal end 156b. 推杆156 限定了具有窗钩156e的远侧窗口156d、位于远侧窗口156d的近侧并形成在其每侧边缘的一对凹槽156f 、位于侧凹槽156f的近侧的细长狭槽156g和位于狭槽156g的近侧的最近侧窗口156h。 Ram 156 defines a distal window 156d having a catch 156e located proximal distal window 156d and formed in a pair of recesses 156f each side edge, located in the elongated slot in the proximal side recesses 156f 156g located proximal of slot 156g most window 156h.

[00156]如图9和图14所示,推杆156在侧凹槽156f的远侧位置处沿着推杆156的上表面支撑第一弹簧夹子157a。 Illustrated, pusher bar 156 supports a first snap clip 157a [00156] FIGS. 9 and 14 at a location distal of side recesses 156f of pusher bar 156 along the upper surface. 第一弹簧夹子157a以这样的方式配置:其尖头突出或与推杆156的上表面间隔一定量。 A first snap clip 157a arranged in such a manner: a certain amount of its pointed protrusion or plunger 156 with the upper surface of the spacer.

[00157]如图9和图15所示,推杆156在其最近侧窗口156h的近侧位置处沿着推杆156的下表面支撑第二弹簧夹子157b。 As shown in [00157] FIGS. 9 and 15, the push rod 156 at a position which is proximal-most window 156h of pusher bar 156 supported along the lower surface of the second snap clip 157b. 第二弹簧夹子157b以这样的方式定位:其尖头突出足以压在推杆156的最近侧窗口156h上的量。 The second clip 157b is positioned in such a manner that: it is sufficient to press the protruding tip on the push rod 156 most window 156h amount. 第二弹簧夹子157b的尖头彼此隔开一定量,该量小于推杆156的最近侧窗口156h的宽度。 The second clip 157b tip spaced from each other a certain amount, the amount is less than the width of the push rod 156 of the proximal-most window 156h.

[00158]如图9和图16至图20所示,轴组件104进一步包括可往复运动地支撑在推杆156下方的推进板162。 [00158] As shown in FIG. 9 and FIGS. 16 to 20, further comprising a shaft assembly 104 reciprocally supported beneath pusher bar 156 pusher plate 162 如图16和图17所示,第四弹簧夹子157d支撑在推进板162的近端。 As shown in FIGS. 16 and 17, a fourth snap clip 157d is supported at a proximal end of advancer plate 162. 弹簧夹子157d包括一对尖头,该尖头可拆卸地连接于形成于上壳体152a中的近侧保持槽152m和远侧保持槽152n。 The spring clip 157d includes a pair of prongs, the prongs 152a is detachably connected to the housing in a proximal retaining grooves 152m and distal retaining grooves formed on 152n. 这样,在使用中,弹簧夹子157d可拆卸地接合保持槽152m和远侧保持槽152n 以使推进板162保持在近侧或远侧位置。 Thus, in use, snap clip 157d detachably engage retaining grooves 152m and distal retaining grooves 152n to allow advancer plate 162 in a proximal or distal position. 在推进板162向远侧推进时,用凸轮向内带动弹簧夹子157d的尖头并使得推进板162继续向远侧运动。 When advancer plate 162 is advanced distally, snap clip 157d cam driven inwardly such that the prongs advancer plate 162 to continue to move distally.

[00159]如图18至图20所示,推进板162包括形成于其中并沿着其长度延伸的一系列窗口162a。 [00159] FIG. 18 to FIG. 20, the pusher plate 162 includes a series of windows formed therein and extending along its length 162a. 如图19所示,每个窗口162a限定了近侧边缘, 该边缘在推进板162的表面下方延伸以便限定唇缘或凸耳162c。 19, each window 162a defines a proximal edge, the edge surface of advancer plate 162 below the extension so as to define a lip or ledge 162c. 推进板162进一步包括一对侧翼片162b,该侧翼片从其侧边缘在朝着上壳体152a的方向上延伸。 Advancer plate 162 further includes a pair of side plate 162b, the flap extends in a direction toward upper housing 152a from its side edges. 如图15所示, 一对侧翼片162b可滑动地布置在推杆156的侧凹槽156f中。 As shown in FIG 15, the pair of flap 162b may be slidably disposed within side recesses 156f of pusher bar 156. [00160]如图9和图21至图22所示,轴组件104进一步包括布置在上壳体152a中并位于推进板162下方的夹子载体164。 [00160] As shown in FIG. 9 and FIGS. 21 to 22, further comprising a shaft assembly 104 disposed in the upper housing 152a and beneath advancer plate 162 of clip carrier 164 夹子载体164 —般是具有上壁、 一对侧壁和限定通过其的通道的下壁的盒状结构。 Clip carrier 164. - as is having an upper wall, a pair of side walls and a box-like structure defined by the lower wall of the passage thereof. 夹子载体164包括形成于下壁中并沿着其长度纵向延伸的多个隔开的窗口164a (参见图9)。 Clip carrier 164 includes a plurality of spaced windows are formed in the lower wall and extending longitudinally along the length thereof 164a (see FIG. 9). 夹子载体164包括形成于上壁中并沿着其长度纵向延伸的细长窗口。 Clip carrier 164 includes an elongate window formed in the upper wall and extending longitudinally along the length thereof. [00161]如图9和图21所示, 一堆手术夹子"C"被以便于在其中和/ 或沿其滑动的方式装入和/或保持在夹子载体164的通道中。 [00161] FIG. 9 and FIG bunch of surgical clips "C" 21 so as to be in and / or along slidably loaded and / or retained in the channels 164 in the clip carrier. 夹子载体164 的通道配置并定尺寸成以头对尾的方式可滑动地保持一堆或多个手术夹子"C"。 Channel of clip carrier 164 is configured and dimensioned in a head-to-tail fashion slidably retain a stack or plurality of surgical clips "C". [00162]如图19所示,夹子载体164的远端包括一对隔开的弹性柄脚164b。 As shown in [00162] FIG. 19, the distal end of clip carrier 164 includes a pair of spaced resilient tangs 164b. 柄脚164b配置成并适于可拆卸地接合保持在夹子载体164内的该堆手术夹子"C"的最远侧手术夹子"C1"的后跨部(backspan)。 After tangs 164b configured and adapted to engage removably retained within clip carrier 164 in the stack of surgical clips "C" in a distal-most surgical clip "C1" of the cross section (backspan). [00163]如图9和图21至图24所示,施夹器100的轴组件104进一步包括可滑动地布置在夹子载体164的通道内的夹子输出器166。 [00163] As shown in FIG. 9 and FIG. 21 to FIG. 24, shaft assembly 104 of clip applier 100 further comprises a slidably disposed within the channel of clip carrier 164 clip 166. 如以下将更详细说明的,夹子输出器166位于该堆手术夹子"C"的后方并设置为在施夹器100的致动期间向前推动该堆夹子"C"。 As described in greater detail below, clip follower 166 is positioned behind the stack of surgical clips "C" and is provided to urge the stack of clips "C" during an actuation of clip applier 100 forwardly. 如将在下文中更详细说明的,夹子输出器166通过推进板162的向前和向后往复运动来致动。 As will be described in more detail below, clip follower 166 is actuated by the reciprocating forward and backward motion of the plate 162. [00164]如图23、图23A和图24所示,夹子输出器166包括主体部166a、 大体上从主体部166a向上和向后延伸的远侧凸起166b、及大体上从主体部166a向下和向后延伸的近侧凸起166c。 [00164] FIG. 23, 23A and 24, clip follower 166 includes body portion 166a, 166a is generally upwardly and rearwardly extending distally from the body portion of the projections 166b and 166a to substantially from the body portion the proximal and rearwardly extending projections 166c. [00165]夹子输出器166的远侧凸起166b配置并定尺寸成选择性地接合推进板162的窗口162a的凸耳162c。 [00165] 166 distal clip tab 166b is configured and dimensioned to selectively engage ledges 162c projecting into windows 162a of plate 162. 在使用中,随着推进板162向远侧方向推进或运动,夹子输出器166的远侧凸起166b面向推进板162的窗口162a 的凸耳162c的接合使得夹子输出器166朝着远侧方向逐步推进或行进。 In use, the engagement, or to promote the movement, clip follower 166 distally facing projection 166b into windows 162a of plate 162 in a distal direction as the advancer plate 162 so that the lugs 162c of the clip 166 in the distal direction step by step or travel. [00166]近侧凸起166c配置并定尺寸成选择性地接合形成在夹子载体164中的窗口164a。 Window [00166] Proximal tab 166c is configured and dimensioned to selectively engage formed in the clip carrier 164 164a. 在使用中,夹子输出器166的近侧凸起166c在形成夹子载体164的窗口164a中的接合防止夹子输出器166向近侧方向行进或运动。 In use, the proximal clip 166 engages protrusion 166c in a window 164a formed clip carrier 164 prevents clip follower 166 traveling or moving in a proximal direction. [00167]夹子输出器166包括支撑在其上或可选择地与其整体形成的闭锁板165。 [00167] The clip 166 includes a latching plate 165 supported thereon or alternatively, integrally formed therewith. 闭锁板165包括以从夹子输出器166的主体部166a向上和向后的方向从闭锁板165延伸的弹性尾部165a,该弹性尾部限定了窗口165b。 A resilient latch plate 165 includes a tail 165 extending from the latch plate 166a and backward directions from the clip body portion 166 is upwardly 165a, the resilient tail portion defining a window 165b. [00168]如图9、图25和图38所示,轴组件104进一步包括在夹子载体164下方的位置处可往复运动地支撑在通道组件104中的驱动通道168。 [00168] 9, 25 and 38, shaft assembly 104 further includes a clip carrier at a location below 164 reciprocally supported in channel assembly 104 drive channel 168. 驱动通道168是大体U形的通道,该通道包括从其后跨部168c在离开夹子载体164并朝着下壳体152b的方向上延伸的一对隔开的侧壁168b。 Drive channel 168 is a generally U-shaped channel, the channel comprising a pair of spaced apart side walls 168b and 168c subsequently cross-section extending in a direction toward the lower housing 152b of clip carrier 164 away. 驱动通道168进一步包括在狭槽168a的近侧的位置处从后跨部168c突出并在侧壁168b的方向上延伸的凸起168d。 Drive channel 168 further comprises a slot at a location proximal 168a projecting from the rear cross portions 168c and 168b extend in the direction of the side wall of the projection 168d. 如图41所示,驱动通道168限定了形成于侧壁168b中的一个侧壁中的狭槽或窗口168e以选择性地容纳楔形板释放装置194的齿194c。 As shown, drive channel 168 defines a tooth 194c 168e release means 194 to selectively receive wedge plate 168b is formed on one of the sidewalls of a slot or window 41. [00169]如图9和图25所示,施夹器100的轴组件104包括固定到驱动通道168上的驱动通道带箍167。 [00169] As shown in FIGS. 9 and 25, clip applier 100 includes a shaft assembly 104 secured to drive channel 168 in the drive channel strap 167. 带箍167固定到驱动通道168的侧壁168b 上以便横跨驱动通道168的侧壁168b横向延伸。 Strap 167 is secured to the side wall 168b of drive channel 168 so as to span the side wall 168b of drive channel 168 extends transversely. 带箍167在细长槽168a的远侧位置处固定到驱动通道168上。 Band 167 at a location distal of elongate slot 168a of drive channel 168 is fixed to the. 带箍167固定到驱动通道168上以使楔形板172在驱动通道168的后跨部168c和钳口106之间延伸。 Strap 167 is secured to drive channel 168 such that wedge plate 172 extends between the rear cross-section of drive channel 168 and jaws 106 168c. [00170]如图9、图26和图27所示,施夹器100包括安装在轴组件104 上或安装在轴组件104的远端处并可由扳机108致动的一对钳口106。 [00170] As shown in FIG. 9, 26 and 27, clip applier 100 includes a shaft assembly 104 mounted on or can be mounted at the distal end of shaft assembly 104 by a pair of jaws actuated trigger 108 106. 钳口106由合适的生物相容性材料诸如不锈钢或钛形成。 Jaws 106 such as stainless steel or a suitable biocompatible material formed of titanium. [00171]通过形成于下壳体152b中的与形成于钳口106中的容纳狭槽接合的凸台,将钳口106安装在邻近驱动通道168的远端,以使钳口106相对于驱动通道168保持固定。 [00171] By forming the lower housing 152b is formed in the boss 106 of the jaws engage the receiving slot, the jaws 106 are mounted adjacent the distal end of drive channel 168 so that the jaws 106 relative to the drive channel 168 remains fixed. 如图25所示,钳口106限定了在其之间用于将手术夹子"C"容纳在其中的通道106a。 As shown, jaws 106 define a channel therebetween for a surgical clip "C" contained therein 106a 25. [00172]如图9、图25和图26所示,施夹器100的轴组件104进一步包括楔形板172,楔形板172具有置于驱动通道168和钳口106之间的远端和贯穿轴组件104的近端。 [00172] FIG. 9, FIG. 25 and FIG. 26, shaft assembly 104 of clip applier 100 further includes a wedge plate 172, wedge plate 172 having a distal end interposed between drive channel 168 and jaws 106 and the penetrating shaft proximal end 104 of the assembly. 楔形板172包括大体锥形的远端172a以在钳口106之间选择性的操作的插入。 Wedge plate 172 includes a substantially tapered distal end 172a between the jaws 106 to selectively inserting operation. 如图26所示,楔形板172限定了从其下表面突出的翼片或凸起172b。 26, wedge plate 172 defines a protruding from a lower surface of the wings or protrusions 172b. 如图22所示,楔形板172限定了形成在其中的最远侧狭槽172c以将连接板174的第二杆174c可滑动地容纳在其中。 22, wedge plate 172 defines the distal-most slot 172c formed therein to the connecting plate 174c of the second rod 174 slidably received therein. [00173]如图22所示,第三弹簧夹子157c支撑在楔形板172的近端处。 [00173] 22, a third snap clip 157c is supported at the proximal end 172 of the wedge plate. 第三弹簧夹子157c以这样的方式定位:其尖头突出足以压在形成于楔形板172中的最近侧窗口172c上的量。 Third snap clip 157c is positioned in such a way that: in its tip projecting amount sufficient pressure on the wedge plate 172 is formed on the most window 172c. 第三弹簧夹子157c的尖头彼此隔开一定量,该量小于楔形板172的最近侧窗口172c的宽度。 Third snap clip 157c tines spaced from one another a certain amount, the amount is less than the width of the wedge plate 172 of most window 172c of. [00174]如图9、图18、图20和图36所示,施夹器100的轴组件104 进一步包括连接板174,连接板174可滑动地置于推杆156和楔形板172之间并且可拆卸地可连接于推杆156和楔形板172中的每一个。 [00174] FIG 9, FIG 18, FIG 20 and FIG 36, shaft assembly 104 of clip applier 100 further includes a web 174, connector plate 174 slidably interposed between pusher bar 156 and wedge plate 172 and detachably connectable to the pusher bar 156 and wedge plate 172 each. 连接板174包括锥形远端174a、从其上表面延伸的第一杆174b和从其下表面延伸的第二杆174c。 Connector plate 174 includes a tapered distal end 174a, 174b of the first lever and a second stem 174c extending from a lower surface extending from the upper surface. 杆174b、 174c中的每一个均具有大体泪珠形的轮廓,其中杆174b、 174c中的每一个的远端均大于其近端。 Rod 174b, 174c each of which has a generally teardrop-shaped profile, wherein the rod 174b, 174c in the distal end of each proximal end thereof are large. [00175]在操作中,连接板174的第一杆174b配置并定尺寸成与固定到推杆156上的第二弹簧夹子157b可拆卸的连接,连接板174的第二杆174c 配置并定尺寸成与固定到楔形板172上的第三弹簧夹子157c可拆卸的连接。 [00175] In operation, the first lever 174b of connector plate 174 is configured and dimensioned to the second snap clip 157b detachably connected to the push rod 156 fixed to the second rod 174c of connector plate 174 is configured and dimensioned as the third spring clip 172 secured to the wedge plate 157c of the detachable connection. [00176]如图22、图36和图37所示,连接板174的第二杆174c延伸到限定在驱动杆140的窗口140b中。 [00176] 22, 36 and 37, the second rod 174c of connector plate 174 extends into a window 140b defined in drive bar 140. 这样,随着驱动杆140往复运动,连接板174随其往复运动。 Thus, as the drive rod 140 reciprocated, connector plate 174 is reciprocated therewith. [00177]如图31A所示,保护装置198被支撑在下壳体152b中在其最初远侧推进期间在便于保持第三弹簧夹子157c的尖头之间的相对距离的位置处。 [00177] FIG 31A, a guard 198 is supported in lower housing 152b at the distal advancement during its initial holding position to facilitate the relative distance between the tines of the third snap clip 157c. 这样,连接板174的第二杆174b不能过早地脱离第三弹簧夹子157c直到第三弹簧夹子157c已经越过保护装置198。 Thus, the second rod 174b of connector plate 174 can not prematurely from third snap clip 157c until third snap clip 157c has crossed the guard 198. [00178]如图9、图27、图29和图41所示,施夹器100的轴组件104 进一步包括可滑动地支撑在下壳体152b的通道中的滑动接头180。 [00178] 9, 27, 29 and 41, shaft assembly 104 of clip applier 100 further includes a lower housing 152b slidably supported in the channel 180 of the slip joint. 滑动接头180包括主体部182和从其延伸的杆184。 Slip joint 180 includes a body portion 182 and a lever 184 extending therefrom. 当合适地定位在下壳体152b的通道中时,滑动接头180的杆184在大体远侧的方向上延伸。 When properly positioned in the lower housing 152b of the channel, the rod 180 of slider joint 184 extends in a substantially distal direction. 滑动接头180的杆184可滑动地通过形成在下壳体152b中并从下壳体152b的通道延伸的短轴152d (参见图29)。 Rod 180 of slider joint 184 slidably 152d by forming the minor axis (see FIG. 29) in the lower housing 152b and 152b extending from the lower housing passage. 轴组件104进一步包括偏置构件186,该偏置元件以压縮弹簧的形式支撑在杆184上并置于下壳体152b的短轴152d和滑动接头180的主体部182之间。 Shaft assembly 104 further includes a biasing member 186, the biasing spring element is supported in a compressed form on the rod 184 and interposed between lower housing 152b and 152d sliding joint minor axis 182 180 of the main body portion. [00179]滑动接头180的主体部182包括凸台182a,该凸台靠近主体部182的近端形成,且配置成并适于在驱动杆140的细长狭槽140a中可滑动的接合(参见图29)。 Main body portion 182 [00179] The slider joint 180 includes a boss 182a, the projection 182 near the proximal end of the body portion is formed, and is configured and adapted to the elongated slot in the drive lever 140a 140 in slidable engagement (see Figure 29). 滑动接头180的主体部182进一步包括窝眼182b,该窝眼靠近主体部182的远端形成,且配置成并适于将驱动通道168的凸起168d 容纳在其中(参见图38和图39)。 Main body portion 180 of slider joint 182 further includes indented 182b, the pocket adjacent the distal end of the body portion 182 is formed, and configured and adapted projection 168d of drive channel 168 therein (see FIGS. 38 and 39) . 22[00180]如图9、图27和图28所示,施夹器100的轴组件104进一步包括可滑动地支撑在下壳体152b的通道中和驱动通道168中的楔形板锁190。 22 [00180] 9, 27 and 28, shaft assembly 104 of clip applier 100 further includes a lower housing 152b slidably supported in the channel 168 and drive channel 190 of wedge plate lock. 楔形板锁190包括主体部190a、从主体部190a向远侧延伸的杆190b、 从主体部190a向近侧延伸的尾部190c、形成于主体部190a的上表面中的窝眼190d和从尾部190c延伸的杆或齿190e。 Wedge plate lock 190 includes a body portion 190a, 190b from the stem main body portion 190a extending distally from body portion 190a tail portion extending proximally 190c, 190d formed on the upper surface of the pocket in the main body portion 190a and a tail portion 190c from a rod extending teeth or 190e. 轴组件104进一步包括偏置构件192,该偏置构件以压縮弹簧的形式支撑在杆190b上并置于下壳体152b和楔形板锁190的主体部190a之间。 Shaft assembly 104 further includes a biasing member 192, the biasing member is a compressed form of a spring supported on rod 190b and interposed between the main body portion 190a and lower housing 152b of wedge plate lock 190. [00181]施夹器100的轴组件104进一步包括可旋转地支撑在下壳体152b的通道中的楔形板释放装置194。 [00181] shaft assembly 104 of clip applier 100 further includes a rotatably supported lower housing 152b of wedge plate release passage means 194. 楔形板释放装置194包括杆194a,该杆配置为与从楔形板锁190的尾部190c延伸的齿190e接合;槌194b,该槌在朝着楔形板锁190的尾部190c的方向上从杆194a向外延伸;及齿194c, 该齿在离开楔形板锁190的尾部190c的方向上从杆194a向外延伸。 Wedge plate release 194 includes a rod 194a, the lever configured to engage the tooth 190e extending from tail 190c of wedge plate lock 190; hammer 194b, the hammer in a direction toward the tail of wedge plate lock 190 from the rod 194a to 190c extending outwardly; and teeth 194c, the teeth extending outwardly from stem 194a in a direction away from tail 190c of wedge plate lock 190 is. [00182]现将对操作手术施夹器100以在诸如脉管的目标组织的周围形成或巻曲手术夹子进行描述。 [00182] Reference will now be operating in a surgical clip applier 100 around the target tissue, such as a vessel or Volume forming curved surgical clip will be described. 参照图32至图43,表示在任何操作或使用之前的手术施夹器100。 Referring to FIGS. 32 to 43, showing operation prior to any operation or use of the clip applier 100. 如图32和图33所示,在使用或发射施夹器100之前, 扳机108 —般处于非承压或非致动状态。 As shown in FIGS. 32 and 33, prior to use or transmitter clip applier 100, trigger 108 - as in the non-pressurized or non-actuated state. 这样,驱动组件120的曲柄板124 处于縮回或最近侧的位置,因此,柱塞135和驱动杆140也处于縮回位置。 As such, crank plate 120 of drive assembly 124 in a retracted or proximal-most position, and therefore, plunger 135 and drive bar 140 are also at a retracted position. 当曲柄板124处于縮回位置时,棘爪224布置在限定在曲柄板124中的远侧凹槽124b中。 When crank plate 124 is in the retracted position, pawl 224 is disposed in the distal recess 124b defined in crank plate 124 in. [00183]如图35至图37所示,当驱动组件120和驱动杆140处于縮回位置时,连接板174位于縮回或最近侧位置。 [00183] As shown in FIG. 35 to FIG. 37, when drive assembly 120 and drive bar 140 are in the retracted position, the connecting plate 174 in a retracted or proximal-most position. 当连接板174位于縮回或最近侧位置时,推杆156也处于縮回或最近侧位置,连接板174的第一泪珠形杆174b布置在推杆156的最近侧窗口156h的近端并保持与第二弹簧夹子157b 的尖头搭扣配合的接合。 When the link plate 174 is located in a retracted or proximal-most position, pusher bar 156 is also at a retracted or proximal-most position, the first tear-bar 174b of connector plate 174 is disposed at the proximal end of the push rod 156 and a proximal-most window 156h of the holder mating engagement with second snap clip 157b tip. 并且,当连接板174位于縮回或最近侧位置时,楔形板172也位于縮回或最近侧位置,且连接板174的第二泪珠形杆174c布置在楔形板172的最近侧窗口172c的近端,并保持与第三弹簧夹子157c的尖头搭扣配合的接合。 And, when the web 174 in the retracted or proximal-most position, wedge plate 172 is also located at a retracted or proximal-most position, and 174c arranged almost at the most window 172c of wedge plate 172 of the teardrop-shaped second connecting plate 174 of the rod end, and remains engaged with third snap clip 157c of the prongs snap fit. [00184]如图36和图37所示,当驱动组件120和驱动杆140处于縮回位置时,滑动接头182的凸起182a位于驱动杆140的细长狭槽140a中的最远侧位置处。 [00184] FIG 36 and, when drive assembly 120 and drive bar 140 are in the retracted position, slider joint 182 of FIG projection 37 distal-most position 182a is located in elongate slot 140a of drive bar 140 . 23[00185]如图38和图39所示,当驱动组件120和驱动杆140处于縮回位置时,夹子输出器166位于夹子载体164的通道的最近端,其中夹子输出器166的远侧凸起166b操作地布置在推进板162的最近侧窗口162a中,近侧凸起166c操作地布置在夹子载体164的最近侧窗口164a中。 23 [00185] 38 and 39, when drive assembly 120 and drive bar 140 are in the retracted position, clip follower 166 is located nearest end of the channel of clip carrier 164, wherein distal side clip 166 from operation 166b disposed most window 162a advancing plate 162, proximal tab 166c is operatively disposed within clip carrier 164 in a proximal-most window 164a of. [00186]继续参照图38和图39,当驱动组件120和驱动杆140处于縮回位置时,滑动接头180位于最近侧位置,并且因为驱动通道168的凸起168d 布置在滑动接头180的窝眼182b中,所以驱动通道168也位于最近侧位置。 [00186] With continued reference to FIGS. 38 and 39, when drive assembly 120 and drive bar 140 are in the retracted position, slider joint 180 is located proximal-most position, and since the projections 168d of drive channel disposed in the pocket 168 of slider joint 180 in 182b, the drive channel 168 is also located proximal-most position. 如图38和图39所示,滑动接头180紧靠从下壳体152b突出的物理止挡152e (参见图30)。 Shown in FIGS. 38 and 39, slider joint 180 abuts against the projection 152b of the lower case physical stop 152e (see FIG. 30). [00187]如图40和图41所示,当驱动组件120和驱动杆140处于縮回位置时,楔形板锁190位于最近侧位置以使从其尾部190c延伸的齿190e布置在形成于下壳体152b中的倾斜凸耳152f的近侧(参见图30和图31)。 [00187] FIGS. 40 and 41, when drive assembly 120 and drive bar 140 are in the retracted position, wedge plate lock 190 is located proximal-most position such that tooth 190e extending from tail 190c formed in the lower case disposed ramped ledge 152f of the proximal body 152b (see FIG. 30 and FIG. 31). 如图41所示,楔形板锁190紧靠从下壳体152b突出的物理止挡152g。 As shown, wedge plate 190 abuts against lock 41 from lower housing 152b protrudes physical stop 152g. 同样如图41所示,楔形板释放装置194布置在第一位置处以便其齿194c突入到形成于驱动通道168的侧壁168b中的窗口168e中。 Shown, wedge plate release means also shown 41,194 at a first position disposed so that tooth 194c thereof projects into window 168e formed in side wall 168b of drive channel 168 in the middle. [00188]如图42和图43所示,当驱动组件120和驱动杆140处于縮回位置时,推杆156的推动器156c布置在保持在夹子载体164中的最远侧夹子"C"的后跨部的近侧。 [00188] FIG. 42 and 43, when drive assembly 120 and drive bar 140 are in the retracted position, pusher 156c of pusher bar 156 is disposed in the holding clip carrier 164 in a distal-most clip "C", after the inter-proximal portion. 最远侧夹子"C"通过其柄脚164b保持在夹子载体164的通道中。 Distal-most clip "C" by tangs 164b of clip carrier 164 held in the channels of. 并且,如上所述,在此位置处,楔形板172位于最近侧位置以便其远端172a位于钳口106的近侧。 Further, as described above, at this position, wedge plate 172 is located so that its distal-most position 172a is located proximal jaw 106. [00189]如图43所示,当驱动通道168位于最近侧位置时,其远端从钳口106的近侧凸轮表面106b脱离。 [00189] As shown in FIG 43, when drive channel 168 is located proximal-most position, its distal end from the proximal camming surface 106b of jaws 106 disengaged. [00190]现转到图44至图54,在初始行程的第一阶段中,随着扳机108 从初始位置被挤压或致动,扳机108使得叉形连杆122向着远侧方向运动曲柄板124,而这将使得驱动连接器134和柱塞135向远侧运动并使得驱动杆140向远侧运动。 [00190] Turning now to FIGS. 44 to 54, in a first stage of the initial stroke, as the trigger 108 is squeezed or actuated from the initial position, trigger 108 causes wishbone link 122 in a distal direction toward the crank plate 124, which will cause the drive connector 134 and plunger 135 to move distally and drive bar 140 distally. 当随着柱塞135向远侧运动,弹簧136被压縮初始量。 When the plunger 135 is moved distally as the spring 136 is compressed an initial amount. [00191]与此同时,随着曲柄板124向远侧运动,齿条124a的齿与棘爪224的齿224a接合,棘爪224移出或旋转出曲柄板124的远侧凹槽124a。 [00191] Meanwhile, as crank plate 124 is moved distally the teeth of rack 124a and 224a pawl tooth 224 engages the pawl 224 to rotate out of or out of distal recess 124a of crank plate 124 is. 这样,在没有完成完整的远侧行程的情况下,曲柄板124不能回到最近侧位置。 Thus, in the case where there is no complete distal stroke complete, crank plate 124 can not return to a proximal-most position. [00192]如图44所示,随着扳机108被挤压初始量,臂127开始平移通过反馈构件126的滚道126a。 [00192] FIG. 44, as trigger 108 is squeezed an initial amount, arm 127 begins to translate through the feedback member 126 raceway 126a. 24[00193]如图46所示,随着驱动杆140向着远侧方向运动,驱动杆140 向着远侧方向推动连接板174。 24 [00193] As shown in FIG 46, as drive bar 140 is moved in a distal direction, drive bar 140 push connector plate 174 in a distal direction. 因为推杆156通过第二弹簧夹子157b选择性地连接于连接板174,推杆156被向着远侧方向推进或拉动。 Since pusher bar 156 is selectively connected to connector plate 174 via second snap clip 157b, pusher bar 156 is advanced or pulled in a distal direction. 并且,因为楔形板172通过第三弹簧夹子157c选择性地连接于连接板174,楔形板172也被向着远侧方向推进或拖动。 Also, since wedge plate 172 is selectively connected to the connecting plate 157c through the third spring clip 174, wedge plate 172 is also advanced or dragged in a distal direction.

[00194]随着驱动杆140向着远侧方向运动,其细长狭槽140a也向着远侧方向运动以使滑动接头182的凸起182a在相对于其的近侧方向上平移。 [00194] 140 in a distal direction as the movement of the drive rod, elongate slot 140a thereof is also moved in a distal direction so that the projection 182a of slider joint 182 is translated in the proximal direction relative thereto.

[00195]如图47至图49所示,随着楔形板172向着远侧方向运动,因为楔形板172的凸起172b保持在楔形板锁190的窝眼190d中,楔形板锁190 被向着远侧方向运动或拖动,这使得其尾部190c的齿190e被用凸轮带动越过形成于下壳体152b中的倾斜凸耳152f,从而从倾斜凸耳152f的近侧位置运动到倾斜凸耳152f的远侧位置。 [00195] FIG. 47 to FIG. 49, as wedge plate 172 is moved in a distal direction, since the projection 172 of wedge plate 172b held in the pocket 190D wedge plate lock 190, a wedge plate lock 190 is toward the far side or drag direction, which teeth 190e 190c tail portion such that it is driven cam formed in lower housing 152b across the ramped ledge 152f, so that from a proximal ramped ledge 152f to a position inclined ledge 152f distal position. 随着楔形板锁190向着远侧方向运动,偏置构件192被压縮初始量。 As wedge plate lock 190 is moved in a distal direction, biasing member 192 is compressed an initial amount. 如图49所示,楔形板锁190向着远侧方向运动直至楔形板锁190紧靠形成于下壳体152b中的物理止挡。 As shown in FIG physical, wedge plate lock 190 is moved in a distal direction until wedge plate lock 190 abuts against the lower housing 49 is formed in the stopper 152b.

[00196]如图47A所示,随着推杆156向着远侧方向运动,推进板162 的翼片162b在推杆156的侧凹槽156f中平移预定距离,直到翼片162b接触或接合推杆156的侧凹槽156f的近端。 [00196] As shown in FIG. 47A, as pusher bar 156 is moved in a distal direction, fins advancer plate 162 translate 162b a predetermined distance in side recesses 156f of pusher bar 156 until fins 162b contact with or engage the plunger side recesses 156f of the proximal end 156.

[00197]如图47B和图47C所示,随着楔形板172向着远侧方向运动, 由于连接板174的第二杆174c与第三弹簧夹子157c的连接,通过保护装置防止了连接板174的第二杆174c过早地从第三夹钳157c脱离。 [00197] As shown in FIG. 47B and FIG. 47C, 172 as the wedge plate in a distal direction, since the second stem 174c of connector plate 174 with third snap clip 157c is connected through the protective means prevents the connection plate 174 second stem 174c 157c prematurely disengaged from the third clamp. 特别地,随着连接板174向着远侧方向运动,保护装置198作用于第三弹簧夹子157c 的尖头的尖端以防止尖头由于第二杆174c所产生的远侧力作用于其上的力而向外张开。 In particular, as the connector plate 174 is moved in a distal direction, guard 198 acts on the tip of a third snap clip 157c to prevent the force of the distal tip of the tip due to the force generated by second stem 174c thereon for The flare outward.

[00198]如图50所示,随着推杆156向着远侧方向运动,其推动器156c 接合最远侧夹子"C"的后跨部并开始向着远侧方式推动最远侧夹子"C"。 [00198] FIG. 50, as pusher bar 156 is moved in a distal direction, pusher 156c thereof engages the distal-most clip "C" cross-section and starts pushing a distal manner distal most clip "C" . 随着推杆156向着远侧方向运动最远侧夹子"C",最远侧夹子"C"从夹子载体164的柄脚164b的后方脱离并开始进入到钳口106的通道106a中。 With the plunger 156 in a distal direction toward the distal-most clip "C", distal-most clip "C" disengaged from the rear tangs 164 of clip carrier 164b and the jaws 106a entered into the passage 106.

[00199]如图51所示,随着楔形板172向着远侧方向运动,其远端172a 进入钳口106之间,使得钳口106向外张开。 [00199] As shown in FIG 51, as wedge plate 172 is moved in a distal direction, distal end 172a thereof enters between jaws 106 causing jaws 106 to open outwardly.

[00200]如图52至图54所示, 一旦楔形板锁190紧靠形成于下壳体152b 中的物理止挡,则防止了楔形板172向着远侧方向进一步运动。 [00200] As shown in FIG. 54 to FIG. 52, once wedge plate lock 190 abuts against the lower housing 152b is formed in the physical stop, wedge plate 172 is prevented from further movement in the distal direction. 然而,驱动杆140继续向着远侧方向运动连接板174。 However, drive bar 140 continues to move connector plate 174 in a distal direction. 因为连接板174被继续向远侧推动,所以一旦第三弹簧夹子157c的尖头的尖端向远侧运动到超过保护装置198,则作用于第二杆174c上的力足够使得第三弹簧夹子157c的尖头向外张开并使得第二杆174c从其间脱开,从而使得连接板174继续向着远侧方向运动。 Since connector plate 174 to continue to be pushed distally, once the third snap clip 157c of the pointed tip beyond guard 198, the distal movement acting on the second lever 174c sufficient force such that the third snap clip 157c and such that the outwardly flared prongs 174c is disengaged from the second rod therebetween, so that the connector plate 174 to continue to move in a distal direction.

[00201]现转到图55至图69,随着扳机108从初始行程的第一阶段被进一步挤压或致动通过初始行程的第二阶段,扳机108使得叉形连杆122进一步向着远侧方向运动曲柄板124,而这使得驱动连接器134并随后使得柱塞135进一步向远侧运动且进一步向着远侧运动驱动杆140。 [00201] Turning now to FIGS. 55 to 69, as trigger 108 is further squeezed from the first stage of the initial stroke through a second stage or actuation of the initial stroke, trigger 108 causes wishbone link 122 to further distally the direction of movement of the crank plate 124, causes drive connector 134 and subsequently plunger 135 such that further and further towards the distal movement of the drive rod 140 to move distally. 随着柱塞135 向远侧运动,弹簧136被压縮进一步的量。 As the plunger 135 is moved distally, spring 136 is compressed a further amount.

[00202]与此同时,随着曲柄板124向着远侧运动,其齿条124a的齿相对于棘爪224的齿224a进一步向着近侧运动。 [00202] Meanwhile, as crank plate 124 toward the distal movement of the teeth of the rack 124a which is further towards the proximal movement of the tooth 224a of pawl 224. 这样,在没有完成完整的远侧行程的情况下,曲柄板124仍不能返回到最近侧位置。 Thus, in the absence of completion of a full distal stroke, crank plate 124 still can not return to a proximal-most position.

[00203]如图55所示,随着曲柄板124向着远侧运动预定距离之后,其臂124d接合或接触致动板128的指部128b。 [00203] As shown in FIG 55, as crank plate 124 after a predetermined distance toward the distal movement, arm 124d thereof engages or contacts finger actuator plate 128 of the portion 128b. 随着曲柄板124进一步向着远侧推进,曲柄板124向着远侧方向推动或拉动致动板128,从而致动计数致动杠杆130以激活计数机构132。 As crank plate 124 is further advanced distally, crank plate 124 in a distal direction pushes or pulls actuator plate 128, thereby actuating counter actuation lever 130 to activate counter mechanism 132.

[00204]特别地,当致动板128向着远侧运动足够距离时,在其槽128b 中用凸轮带动计数致动杠杆130的第二臂130b并促使其旋转,导致计数致动杠杆130的第一臂130a接合计数机构132,从而实现其显示器中的变化。 [00204] In particular, when actuator plate 128 is moved distally a sufficient distance, in its cammed within slot 128b of counter actuation lever 130 of the second arm 130b and causes its rotation, causing the first counter actuation lever 130 engaging arm 130a counter mechanism 132, in order to achieve a change in the display thereof. 特别地,显示手术施夹器100中剩余的夹子的数目的显示器将减少一个。 Specifically, the display device 100 the number of clips remaining in surgical clip applier will display a decrease. 可选择地,夹子计数机构将增加一个或产生某些其他变化。 Alternatively, the clip counter mechanism will increase or produce a certain other changes.

[00205]随着扳机108被进一步挤压时,臂127继续平移通过反馈构件126的滚道126a。 [00205] As the trigger 108 is squeezed further, arm 127 continues to translate through race 126 of feedback member 126a. 在这一点上,在扳机108的挤压中,手术夹子被装入钳口106中。 At this point in the squeezing of trigger 108, a surgical clip is loaded into the jaws 106. 相应地,臂127将与形成于反馈构件126的滚道126a中的梯级126b Accordingly, the track 126a, the arm 127 of the feedback member 126 formed in steps 126b

相互作用并产生告知用户夹子己被装入钳口中的听觉/触觉指示。 Inform the user interaction and to generate a clip has been loaded into the jaws of the audible / tactile indication.

[00206]如图57所示,随着驱动杆140向着远侧方向进一步运动,驱动杆140继续向着远侧方向推动连接板174。 As shown in [00206] FIG. 57, with further movement of the drive rod 140 in a distal direction, drive bar 140 continues to push connector plate 174 in a distal direction. 因为推杆156仍通过第二弹簧夹子157b选择性地连接于连机板174,所以推杆156被进一步向着远侧方向推进或拖动。 Since pusher bar 156 is still selectively by a second snap clip 157b connected to the connected board 174, the plunger 156 is further advanced or dragged in a distal direction. 然而,因为楔形板172的第三弹簧夹子157c被从连接板174的第二杆174c脱离,所以楔形板172不被向着远侧方向进一步推进或拖动。 However, since third snap clip 157c of wedge plate 172 is disengaged from the second shaft 174c of connector plate 174, so that wedge plate 172 is not further advanced or dragged in a distal direction. [00207]如图56A至图56C所示,随着推杆156向着远侧方向继续运动, 推杆156的侧凹槽156f的近端接合推进板162的一对翼片162b,推杆156 向着远侧方向推进或拖动推进板162。 [00207] As shown in FIGS. 56A to 56C, as pusher bar 156 continues to move in a distal direction, pusher pair of fins 162b side recesses 156f of the proximal end 156 engages the advancer plate 162, pusher bar 156 toward the advanced or dragged in a distal direction pusher plate 162.

[00208]如图56B和图56C所示,随着推动板162向着远侧推进,弹簧夹子157d脱离近侧保持槽152m并接合形成于上壳体152a中的远侧保持槽152n。 [00208] As shown in FIG. 56B and FIG. 56C, as advancer plate 162 advanced distally, snap clip 157d departing from the proximal retaining grooves 152m and engages distal formed on the housing 152a of the retaining grooves 152n.

[00209]如图57所示,驱动杆140向着远侧方向运动,直到滑动接头182的凸起182a选择性地平移至驱动杆140的细长狭槽140a中的最近侧位置。 As shown in [00209] FIG. 57, 140 in a distal direction movement of the drive rod, the position of the nearest side 140 of the elongated slot 140a until the projection 182a of slider joint 182 is selectively move the drive rod horizon.

[00210]随着推杆156继续向着远侧方向运动,推杆156通过翼片162b 继续向着远侧方向推动推进板162。 [00210] As the plunger 156 continues to move in a distal direction, pusher bar 156 continues to move through the fins 162b of advancer plate 162 in a distal direction pushed. 如图58所示,随着推进板162向着远侧方向运动,夹子输出器166的远侧凸起166b被容纳夹子输出器166的远侧凸起166b的窗口162a的近侧边缘接合以便相对于夹子载体164向着远侧方向推动夹子输出器166,从而使该堆夹钳"C"推进增加的量。 As illustrated, as advancer plate 162 toward the distal direction, distal clip 166 is raised projections 58 166b 166b receive a distal window 166 of clip follower engages the proximal edge 162a with respect to clip carrier 164 in a distal direction push clip 166, so that the stack of clips "C" to promote increased amount. 随着夹子输出器166向着远侧方向运动,使得其近侧凸起166c从夹子载体164的相对近侧窗口164a到夹子载体164的相对远侧窗口164a向远侧推进一个窗口164a。 As clip follower 166 is moved in a distal direction, such that proximal tab 166c of clip carrier opposite from the proximal window 164 of clip carrier 164 to 164a of a relatively distal window 164a advance distally window 164a.

[00211]如图58至图60所示,随着推杆156向着远侧方向运动,支撑于推杆156上的第一弹簧夹子157a弹锁在上壳体152a的凸台152h上,因而将推杆156保持在向前的位置处。 [00211] FIG. 58 to FIG. 60, as pusher bar 156 is moved in a distal direction, pusher bar 156 is supported on a first snap clip 157a snap on the boss 152h of upper housing 152a, thus the push rod 156 is held at the position forward.

[00212]此外,如图61所示,随着推杆156继续向着远侧方向运动,使得该堆夹钳"C"向着远侧方向运动。 [00212] Further, as shown in FIG. 61, as pusher bar 156 continues to move in a distal direction, so that the stack of clips "C" in a distal direction.

[00213]如图62所示,随着推杆156向着远侧方向运动,其推动器156c 继续向着远侧方向运动最远侧夹子"C1"直到最远侧夹子"C1"完全进入到钳口106的通道106a中。 [00213] FIG. 62, as pusher bar 156 is moved in a distal direction, pusher 156c thereof continues to move in a distal direction distal-most clip "C1" until distal-most clip "C1" into jaws fully 106 of the channel 106a. 在操作中,推杆156的推动器156c在所述夹子"C" 的形成期间与装入的夹子"C"的后跨部保持接触以便为其提供稳定性并将其保持在合适的位置。 In operation, pusher 156c of pusher bar 156 remains in contact with the clip "C" cross-section is charged during the forming of the clip "C" in order to provide stability and to hold it in place.

[00214]如图63所示,随着驱动杆140进一步向着远侧方向运动,其肩部140c接触驱动通道168的最近端。 [00214] As shown in FIG 63, 140 as further movement of the drive rod in a distal direction, shoulders 140c thereof contact with the nearest end 168 of the drive channel. 这样,随着驱动杆140进一步向着远侧方向运动,驱动杆140向着远侧方向运动或推动驱动通道168。 Thus, as drive bar 140 is further moved in a distal direction, drive bar 140 in a distal direction or push drive channel 168.

[00215]如图64所示,随着驱动通道168向着远侧方向运动,形成于驱动通道168的侧壁168b中的窗口168e的近侧边缘接触楔形板释放装置194的齿194c,使得楔形板释放装置194旋转。 Window [00215] As shown in FIG. 64, as drive channel 168 toward the distal direction, is formed on the side wall 168b of drive channel 168 in a proximal edge 168e of wedge plate release 194 contacting the teeth 194c, wedge plate such that release means 194 rotation. 随着楔形板释放装置194旋转, 其槌194b挤压楔形板锁190的齿190e以将齿190e从倾斜凸耳152f的后方推出或撞出。 With the rotation of the wedge plate release 194, which hammer 194b pressing teeth 190e of wedge plate lock 190 to the tooth 190e out of the rear inclined ledge 152f or knocked. 在这种情况下,如图65所示,允许偏置构件192减压,从而向着近侧方向运动楔形板锁190。 In this case, as shown in Figure 65, the biasing member 192 allows the reduced pressure to a proximal direction toward wedge plate lock 190. 如图66所示,随着楔形板锁190向着近侧方向运动,因为楔形板172连接到楔形板锁190上,所以楔形板172向着近侧方向运动以使其远端172a从与钳口106退出脱离接合。 Shown in Figure 66, as wedge plate lock 190 is moved in a proximal direction, as wedge plate 172 is connected to the wedge plate lock 190, wedge plate 172 so that movement in a proximal direction from its distal end 172a of the jaw 106 exit disengaged.

[00216]如图58和图67至图69所示,因为推杆156通过第一弹簧夹子157a与凸台152h的连接而保持在远侧位置,所以随着驱动杆140进一步向着远侧方向运动,作用于连接板174的力使得第二弹簧夹子157b从连接板174的第一杆174b脱离,从而允许连接板174继续向着远侧方向运动。 [00216] As shown in FIG. 58 and FIGS. 67 to 69, since the push rod 156 157a with boss 152h of the connector is held in position by a first spring clip distally, so as drive bar 140 is further moved in a distal direction , the forces acting on connector plate 174 such that the second snap clip 157b from first stem 174b of connector plate 174 disengaged, thereby allowing the connector plate 174 to continue to move in a distal direction.

[00217]如图67A至图69A所示,在一个实施方式中,第二弹簧夹子157b 的尖头的尖端可以配置成向外突出以便接合后上部壳体154的表面(参见图9),从而防止第二弹簧夹子157b从连接板174的第一杆174b的过早脱离。 [00217] FIG. 67A to FIG. 69A, in one embodiment, the tip of the second sub-spring clip prong 157b may be configured to project outwardly so as to engage the rear surface of the upper housing 154 (see FIG. 9), thereby prevents the second snap clip 157b from first stem 174b of connector plate 174 is disengaged prematurely. 在该实施方式中,凹槽可以形成于后部上壳体154的表面中,与第二弹簧夹子157b的尖头可能向外张开的位置一致,从而允许连接板174的第一杆174b In this embodiment, the grooves may be formed on the rear surface of the housing 154 in accordance with the second clip 157b outwardly flared prongs possible position, thus allowing the connection plate 174b of the first lever 174

脱离并继续向着远侧方向运动。 Out and continue to move in a distal direction.

[00218]如图70至图75所示,随着扳机108被致动进入初始行程的最后阶段,扳机108使得叉形连杆122进一步向着远侧方向运动曲柄板124, 而这使得驱动连接器134和柱塞135进一步向着远侧运动并进一步向着远侧运动驱动杆140。 [00218] As shown in FIG. 70 to FIG. 75, as trigger 108 is actuated in the final stage of the initial stroke, trigger 108 causes wishbone link 122 further towards the crank plate 124 in a distal direction, and this causes drive connector 134 and a plunger 135 moving further and further towards the distal movement of the drive bar 140 is moved distally. 随着驱动连接器134向着远侧运动,弹簧136被压缩进一步的量。 As drive connector 134 distally toward the spring 136 is compressed a further amount.

[00219]与此同时,随着曲柄板124向着远侧运动,其齿条124a的齿相对于棘爪224的齿224a进一步向着近侧运动至这样一个位置:在该位置处, 随着棘爪224的齿224a进入曲柄板124的近侧凹槽124c,齿条124a的齿从棘爪224的齿224a脱离,从而使其本身复位。 [00219] Meanwhile, as crank plate 124 toward the distal movement of the teeth of the rack 124a which further movement towards the proximal to the teeth 224a of the pawl 224 for such a position: in this position, with the pawl teeth 224a crank plate 224 enters proximal recess 124c 124 of the rack teeth 124a of the pawl 224 is disengaged from the teeth 224a thereby reset itself. 这样,当扳机108松开时,曲柄板124可以返回至最近侧位置。 Thus, when the trigger 108 is released, the crank plate 124 may return to a proximal-most position.

[00220]如图72至图74所示,在扳机108的初始行程的最后阶段期间, 驱动通道168和带箍167相对于钳口106向着远侧方向运动,以使驱动通道168的远侧边缘接合钳口106的凸轮表面106b,使得钳口106关闭并形成位于其间的夹钳"C1"。 [00220] FIG 72 through FIG 74, during the final stage of the initial stroke of trigger 108, drive channel 168 and strap 167 relative to the jaw 106 in a distal direction, drive channel 168 such that the distal edge jaws 106 engaging cam surface 106b, so that the jaws 106 to close and form a clamp therebetween "C1". 如图74所示,推杆156的推动器156c保持在远侧位置处,在所述夹子"C"的形成期间与所述夹子"C"的后跨部接触。 As shown, pusher 156c of pusher bar 156 remains at a distal position, the contact 74 shown in cross-section during the forming of the clip "C" and after the clip "C",. [00221]如图55所示,随着扳机108被挤压最后的量,臂127继续平移通过反馈构件126的滚道126a。 [00221] As shown in FIG 55, as trigger 108 is squeezed a final amount, arm 127 continues to translate through race 126a of feedback member 126 is. 在这一点上,在扳机108的挤压中,手术夹子"C1"已经由钳口106完全形成。 At this point in the squeezing of trigger 108, surgical clip "C1" has been fully formed by the jaws 106. 相应地,臂127将与形成于反馈构件126的滚道126a中的另一梯级126b相互作用,并产生告知用户手术夹子"C1"已由钳口106形成的听觉/触觉指示。 Accordingly, the arm 127 at another step 126b formed interactions race 126a of feedback member 126 and inform the user to generate a surgical clip "C1" auditory formed by the jaws 106 / tactile indication.

[00222]如图75所示,手术夹子"C1"可以形成或巻曲到脉管"V"或任何其他生物组织上。 [00222] 75, surgical clip "C1" may be formed or bent to the Volume vessel "V" or any other biological tissue.

[00223]现转到图76至图84,表示随着扳机108返回至未挤压或未致动位置时的施夹器100的操作。 [00223] Turning now to FIG. 76 to FIG. 84, showing the operation when the clip applier 100 as trigger 108 is returned to the un-squeezed or unactuated position. 如图76所示,随着扳机返回到未挤压位置,弹簧被允许解除压縮,从而推动曲柄板124向着近侧方向运动,而这使得柱塞向着近侧运动并向着近侧运动驱动杆。 As shown in FIG. 76, as the trigger returns to the un-squeezed position, the spring is released to allow compressed, thus promoting the crank plate 124 toward the proximal direction, toward which the plunger proximally toward the proximal movement of the drive rod and . 因为棘爪224已经复位,现允许曲柄板124向近侧运动直到棘爪224的齿224a再次进入曲柄板124的远侧凹槽。 Since pawl 224 has been reset, crank plate 124 is now allowed to move proximally until tooth 224a of pawl 224 enters the distal recess of crank plate 124 again.

[00224]如图76A所示,随着曲柄板124向着近侧运动,其臂124d脱离致动板128的指部128b,使得致动板128向着近侧方向运动。 [00224] As shown in FIG 76A, as crank plate 124 is moved proximally movement, which arm 124d departing finger 128b of actuator plate 128 such that the actuator plate 128 toward the proximal direction. 随着致动板128向着近侧运动,在其槽128b中用凸轮带动计数致动杠杆130的第二臂130b,并促使第二臂130b旋转,导致计数致动杠杆130的第一臂130a从计数机构132脱离。 As actuator plate 128 is moved proximally, the cam slot 128b of counter actuation lever 130 driven by a second arm 130b, 130b and causes rotation of the second arm, causing the first counter actuation lever 130a from the arm 130 counter mechanism 132 disengaged.

[00225]如图77所示,随着驱动杆140向着近侧方向运动,驱动杆140通过第一杆174b拉动连接板174。 [00225] As shown in FIG. 77, as drive bar 140 is moved in a proximal direction, drive bar 140 pulls web 174 by the first lever 174b. 随着连接板174向着近侧方向运动,第一杆174b与第二弹簧夹子157b的尖头接合并且通过第二弹簧夹子157b向着近侧方向推动推杆156。 With connector plate 174 toward the proximal direction, first stem 174b engages the tines of the second snap clip 157b and pushes the push rod 156 in a proximal direction by a second snap clip 157b.

[00226]如图78所示,随着力作用于推杆156上以向着近侧方向运动推杆156,所述力克服了第一弹簧夹子157a与上壳体152a的凸台152h的保持力,从而从凸台152h释放第一弹簧夹子157a并使得推杆156向着近侧方向运动。 [00226] FIG. 78, as the force acts on the plunger 156 toward the push rod 156 in the proximal direction, said forces overcome the retention force of first snap clip 157a with boss 152h of upper housing 152a, and thereby releasing boss 152h and a first snap clip 157a such that the push rod 156 from moving towards the proximal direction.

[00227]如图79所示,随着推杆156继续向着近侧方向运动,其侧凹槽156f的远端接合推进板162的翼片162b并使得推进板162向着近侧方向运动。 [00227] As shown in FIG. 79, as pusher bar 156 continues to move in a proximal direction, the distal end of side recesses 156f thereof engage fins 162b advancing plate 162 and plate 162 so that advancing toward the proximal direction. 随着推杆156向着近侧方向运动,推杆鼻部156c咬在余留的该堆夹子"C"的最远侧夹子的后方,从而变成新的最远侧夹子"C1"。 As the push rod 156 toward the proximal direction, pusher 156c bite behind the nose of the remaining stack of clips "C" in a distal-most clip, thereby becomes the new distal-most clip "C1".

[00228]如图80所示,随着推进板162向着近侧方向运动,夹子输出器166的近侧凸起166c接合夹子载体164的窗口164a的近侧边缘以便保持夹 [00228] FIG. 80, as advancer plate 162 is moved in a proximal direction, proximal clip 166 protrusions 166c engage the proximal edge of a window 164a of clip carrier 164 in order to maintain clip

29子输出器166在夹子载体164中的相对位置。 29 relative positions in the sub-output 166 of clip carrier 164. 当推进板162向着近侧方向运动,使得其远侧凸起166b从推进板162的相对近侧窗口162a到推进板162的相对远侧窗口162a向远侧推进一个窗口162a。 When the advancer plate 162 toward the proximal direction, distal tab 166b so that the pusher plate 162 is relatively proximal window 162a of advancer plate 162 to a relatively distal window 162a distally advance a window 162a.

[00229]如图81所示,当推杆156停止其近侧运动时,当其与从上半壳体152a的内表面突出的凸台接合时,连接板174的持续的近侧运动将使得第一杆174b与第二弹簧夹子157b再次接合。 [00229] As shown in FIG 81, when pusher bar 156 stops its proximal movement, when it is engaged with the upper housing half 152a from the protruding surface of the boss, continued proximal movement of the connecting plate 174 will cause the first stem 174b to re-engage the second snap clip 157b. 随着推杆156的近侧运动停止,连接板174的持续的近侧运动将使得第一杆174b与第二弹簧夹子157b再次接合。 With proximal movement of pusher bar 156 stopped, continued proximal movement of the connecting plate 174 will cause first stem 174b to re-engage with second snap clip 157b.

[00230]如图82和图83所示,随着连接板174向着近侧方向运动,由于驱动杆140的近侧运动,第二杆174c与第三弹簧夹子157c的尖头接合并通过第三弹簧夹子157c向着近侧方向推动楔形板172。 [00230] As shown in FIGS. 83 and 82, as connector plate 174 toward the proximal direction, since the proximal movement of drive bar 140, second stem 174c of third snap clip 157c by a third tines engage snap clip 157c pushed toward the wedge plate 172 in a proximal direction. 随着楔形板172向着近侧方向运动,楔形板锁190向着近侧方向运动直到楔形板锁190接触下半壳体152b中的物理止挡,从而阻止楔形板172的近侧运动。 As wedge plate 172 is moved in a proximal direction, wedge plate lock 190 is moved in a proximal direction until wedge plate lock 190 in contact with the lower housing half 152b a physical stop to prevent proximal movement of wedge plate 172. 一旦第三弹簧夹子157c的尖头的尖端向着远侧运动超过保护装置198,则当楔形板172停止其近侧运动时,连接板174的持续的近侧运动将使得第二杆174c与第三弹簧夹子157c再次接合。 Once the tip of third snap clip 157c move distally toward tip over protective device 198, when wedge plate 172 stops its proximal movement, continued proximal movement of the connecting plate 174 such that the second lever and the third 174c snap clip 157c to re-engage.

[00231]当扳机108返回至未致动位置时,臂127将平移通过反馈构件126的滚道126a并与形成于反馈构件126的滚道126a中的另一梯级126b相互作用,且产生告知用户手术施夹器100已被复位并准备再次发射的听觉/触觉指示。 [00231] When the trigger 108 is returned to the unactuated position, arm 127 will interact with the other pan and the step 126b formed in race 126a of feedback member 126 via a feedback member 126a of the race 126, and generates the user informed surgical clip applier 100 has been reset and is ready to re-emitted audible / tactile indication.

[00232]现转到图84至图85,表示手术施夹器100的构造其后是最后一个手术夹子"C"的应用。 [00232] Turning now to FIGS. 84 to 85, followed by showing the last surgical clip "C", the application builder 100 of surgical clip applier. 如图84和图85所示,当最后一个手术夹子已经被推进和形成时,推杆156仍处于推进或远侧位置,夹子输出器166已经通过刻度盘158被逐步推进足够的量,其闭锁板165向上偏置通过推进板162的窗口162a,并进入到推杆156的远侧窗口156d中。 As shown in FIG. 84 and FIG. 85, when the last surgical clip has been advanced and formed, pusher bar 156 still in an advanced or distal position, clip follower 166 has been step by step by an amount sufficient dial 158, which latch plate 165 is biased upward by advancing plate 162 window 162a, and into distal window 156d of pusher bar 156 in. 闭锁板165在推杆156的远侧窗口156d中的定位使得近侧窗口156d的窗钩156e进入并接合闭锁板165的窗口165b。 Locating the latch plate 165 in distal window 156d of pusher bar 156 such that the proximal window 156d of the catch 156e enters and engages the window 165 of the latch plate 165b. 这样,因为夹子输出器166通过在夹子载体164的远侧窗口164a中接合的其远侧凸起166c来保持在远侧位置,闭锁板165接合推杆156的窗钩156e,并防止推杆156返回到最近侧位置从而使棘爪224复位。 Thus, since clip follower 166 in clip carrier by engaging distal window 164a 164 in its distal protrusion 166c is held in the distal position, the pusher plate 165 engages the latch hook 156e window 156 and prevent the pusher 156 Back to the proximal-most position such that pawl 224 is reset.

[00233]如图86所示,因为推杆156不能或被防止运动到其完全近侧位置,棘爪224与曲柄板124的齿条124a保持接合并且不被允许进入近侧凹槽124c从而使其本身复位。 [00233] As shown in FIG 86, since the plunger 156 does not prevent movement of the rack or its fully proximal position, the pawl 224 and 124a of crank plate 124 remains engaged and is not allowed to enter proximal recess 124c so that reset itself. 因为棘爪224不能使其本身复位,所以曲柄板124被锁住或停止向远侧或近侧运动。 Since pawl 224 can not reset itself, crank plate 124 is locked so stopped or moving distally or proximally.

[00234]应该理解,以上描述仅仅是本公开的说明。 [00234] It should be understood that the foregoing description is only illustrative of the present disclosure. 本领域技术人员可以在不背离本公开的情况下做出各种替换和改进。 Those skilled in the art that various substitutions and modifications may be made without departing from the present disclosure. 相应地,本公开意在包含所有这些替换、改进和变化。 Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variations. 参照附图所描述的实施方式仅为证明本公开的某些示例而出现。 The embodiment described with reference to the accompanying drawings are merely some examples of the present disclosure demonstrate occur. 与上述的和/或所附权利要求无实质上不同的其它元件、步骤、方法和技术也在本公开的范围之内。 Substantially free of other elements different from the above-described and / or claimed in the appended claims, within the scope of the steps, methods and techniques are also present disclosure.

Claims (11)

1、一种用于将手术夹子施加到体组织上的装置,所述装置包括: 手柄组件,其包括扳机和驱动杆,所述驱动杆在扳机致动时通过扳机往复平移; 轴组件,其从所述手柄组件向远侧延伸并且限定了纵轴,所述轴组件包括: 壳体; 布置在所述壳体内的多个手术夹子; 钳口,其邻近所述壳体的远端部安装,所述钳口能够在隔开的打开状态和接近的闭合状态之间运动; 推杆,其可往复运动地布置在所述轴组件的壳体内,所述推杆配置为在远侧运动时将最远侧的手术夹子装入所述钳口; 夹子输出器,其滑动地支撑于所述轴组件中用于向远侧方向推动多个手术夹子;以及夹子载体,其布置在所述轴组件中,其中所述夹子载体配置成保持多个手术夹子和夹子输出器; 其中所述夹子输出器包括从其表面延伸的窗钩,其中在发射最后的手术夹子之后,所述窗钩 1. An apparatus for the application of surgical clips to body tissue, the apparatus comprising: a handle assembly including a trigger and a drive rod, said drive rod when the trigger is actuated by the trigger reciprocating translation; shaft assembly the handle assembly extends distally from and defines a longitudinal axis, the shaft assembly comprising: a housing; a plurality of surgical clips disposed within the housing; jaw, a distal end portion of the housing adjacent the mounting the spaced jaws movable between an open state and a closed approximated condition; plunger, which reciprocally disposed within the housing of the shaft assembly, the pusher is configured to move distally when the distal-most surgical clip into said jaws; clip, which is slidably supported for urging the plurality of surgical clips in a distal direction within the shaft assembly; and a clip carrier disposed in the shaft assembly, wherein the clip carrier is configured to hold a plurality of surgical clips and the clip follower; wherein said clip includes a catch surface extending therefrom, wherein after transmission of the last surgical clip, a window hook 合所述推杆并防止所述推杆向近侧方向运动。 The combined push rod and preventing movement of the push rod in a proximal direction.
2、 根据权利要求1所述的装置,其中所述推杆包括形成在其远端处的推动器,其中所述推动器具有狭窄轮廓用于在单个位置上接触被装入的手术缝合钉。 2. The apparatus according to claim 1, wherein said pusher comprises a pusher formed at a distal end thereof, wherein said surgical staple pusher has a narrow profile for contacting the loaded for a single position.
3、 根据权利要求2所述的装置,其中所述推动器限定了定位为与被装入的手术缝合钉的平面基本正交的平面。 3. The apparatus according to claim 2, wherein the pusher defines a plane positioned with the plane of the loaded surgical staple substantially orthogonal.
4、 根据权利要求1所述的装置,进一步包括可往复运动地布置在所述轴组件内的连接板,其中所述连接板可拆卸地连接到所述推杆上,其中在所述连接板的最初远侧运动期间所述推杆向远侧推进,而在所述连接板的进一步的远侧运动期间,所述连接板从所述推杆脱开。 4. The apparatus of claim 1, further comprising a connecting plate may be reciprocally disposed within the shaft assembly, wherein the connecting plate is removably coupled to said push rod, wherein the web during the initial distal movement of the push rod distally advanced and during a further distal movement of the connector plate, the web is disengaged from the pusher.
5、 根据权利要求4所述的装置,其中所述推杆进一步包括支撑在所述推杆上的第一弹簧夹子,所述第一弹簧夹子用于在所述推杆处于推进位置时连接到设置在所述轴组件的壳体中的固定部件上,以将所述推杆保持在所述推进位置。 5. The apparatus as claimed in claim 4, wherein said ram further comprises a push rod supported on said first spring clip, the spring clip for connection to a first advanced position when the plunger is in the a fixed shaft member disposed in said housing assembly in order to maintain the plunger in the advanced position.
6、 根据权利要求1所述的装置,其中所述推杆进一步包括支撑于所述推杆上用于与所述连接板的第一部件接合的第二弹簧夹子,其中在所述连接板的最初远侧运动之后,所述连接板的第一部件从所述第二弹簧夹子脱离。 6. The apparatus of claim 1, wherein said pusher further comprises a push rod supported on a second snap clip on the first member of the connecting plate joined, wherein in the connecting plate after initial distal movement of the first member of the second web is disengaged from the spring clip.
7、 根据权利要求4所述的装置,进一步包括可往复运动地布置在所述轴组件内的推进板,所述推进板包括可拆卸地连接到所述推杆的肩部的至少一个翼片,其中在所述推杆的远侧运动和近侧运动期间,所述推杆的肩部与所述推进板的至少一个翼片接合,以实现推进板的远侧运动和近侧运动中的一个。 7. The apparatus as claimed in claim 4, further comprising an advancer plate reciprocally disposed within the shaft assembly, the advancer plate including at least one tab removably attached to the push rod shoulder wherein during movement of the push rod distal and proximal movement of the push rod shoulder of said at least one propulsion fin plate joined to effect distal movement of advance of the plate and proximal movement One.
8、 根据权利要求7所述的装置,其中所述夹子输出器包括从所述夹子输出器的第一表面突出的第一凸起和从所述夹子输出器的第二表面突出的第二凸起,其中随着所述推进板向远侧运动,所述夹子输出器的第一凸起与所述推进板接合,从而使所述夹子输出器向远侧运动以推进所述多个手术夹子, 并且其中,随着所述推进板向近侧运动,所述夹子输出器的第二凸起与部件接合,从而使所述夹子输出器保持固定。 8. The apparatus of claim 7, wherein said clip comprises a projection from the first surface of the first clip and the projections projecting from the second surface of the second clip projections since, wherein as the advancer plate is moved distally, the first protrusion and the pusher plate engages the clip so that the clip follower is moved distally to advance the plurality of surgical clips and wherein, as the advancer plate, the clip member engages with the second protrusion moved proximally such that the clip follower remains stationary.
9、 根据权利要求8所述的装置,其中所述夹子输出器的第二凸起与形成在夹子载体中的部件接合。 9. The apparatus of claim 8, wherein said second projection is engaged with the clip member is formed in the clip carrier.
10、 根据权利要求8所述的装置,其中逐步推进所述夹子输出器通过所述轴组件。 10. The apparatus of claim 8, wherein the clip advancing stepwise through the shaft assembly.
11、 根据权利要求l所述的装置,进一步包括布置在所述手柄组件中的棘轮组件,其中当所述推杆没有返回到近侧位置时,防止所述棘轮组件复位。 11. The apparatus of claim according to claim l, further comprising a ratchet assembly disposed in the handle assembly, wherein when said pusher does not return to a proximal position, the ratchet assembly to prevent reset.
CN 200910171616 2008-08-29 2009-08-31 Endoscope operation applicator with a fastener CN101664331B (en)

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US61/092,806 2008-08-29
US12/539,204 US8267944B2 (en) 2008-08-29 2009-08-11 Endoscopic surgical clip applier with lock out
US12/539,204 2009-08-11

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US9717505B2 (en) 2010-07-28 2017-08-01 Covidien Lp Articulating clip applier cartridge
US9642627B2 (en) 2010-11-02 2017-05-09 Covidien Lp Self-centering clip and jaw
US9775623B2 (en) 2011-04-29 2017-10-03 Covidien Lp Surgical clip applier including clip relief feature
US9855043B2 (en) 2011-12-19 2018-01-02 Covidien Lp Jaw closure mechanism for a surgical clip applier
US9968362B2 (en) 2013-01-08 2018-05-15 Covidien Lp Surgical clip applier
US9848886B2 (en) 2013-01-08 2017-12-26 Covidien Lp Surgical clip applier
US9750500B2 (en) 2013-01-18 2017-09-05 Covidien Lp Surgical clip applier
US9775624B2 (en) 2013-08-27 2017-10-03 Covidien Lp Surgical clip applier
US9931124B2 (en) 2015-01-07 2018-04-03 Covidien Lp Reposable clip applier
WO2016112509A1 (en) * 2015-01-15 2016-07-21 Covidien Lp Endoscopic reposable surgical clip applier
US10159491B2 (en) 2015-03-10 2018-12-25 Covidien Lp Endoscopic reposable surgical clip applier
WO2016206015A1 (en) * 2015-06-24 2016-12-29 Covidien Lp Surgical clip applier with multiple clip feeding mechanism
US10271854B2 (en) 2016-05-11 2019-04-30 Covidien Lp Articulating endoscopic surgical clip applier

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ES2363582T3 (en) 2011-08-09

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