CN101951843A - 一种改进的手术器械的末端执行机构 - Google Patents
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Abstract
一种改进的手术器械的末端执行机构，用于微创手术器械或普通手术器械中，或者为自动控制的末端执行器的一部分。这些末端执行机构包括多个抓紧元件以及与各抓紧元件相配的驱动杆。每个抓紧元件也作为相对于其处于更末端的抓紧单元的固定连接物，并迫使更末端抓紧元件其相邻抓紧元件之间保持与所要抓取物品来确定相应角度。
Description
相关共同申请的交叉参考：
本申请要求于2007年3月20日提交的序列号为60/895,760且题为“一种改进的手术器械的末端执行机构”的美国临时申请的权益，其内容通过参考的方式清楚地合并在此。
技术领域
本发明涉及一种改进的手术器械的末端执行机构，特别是涉及多个组件的手术器械的末端执行机构，该机构可用来紧握任何形状的大型物体。
背景技术
末端执行机构为手术器械的一部分，用于接触并控制病人的肌体组织。现有技术中，末端执行器包括，紧握钳，可抓紧但不能用于切割或穿透组织。这种装置可在传统的手术中代替医生的手。但是现有的紧握钳经常出现无法适当的夹紧物体的情况。由于该设备缺乏合适的保持力，导致医生的工作复杂化。手术过程中，需要被控制的组织的形状和表面结构都很复杂，并且表面很滑很难抓紧，另外，现有装置缺少必要的保持力，所以，医生不得不施加很大的力来夹紧组织，以便使手术可以进行下去。过大的夹紧力会增加组织长期创伤的发生。
如图2所示，典型的手术器械25带有一个空心圆柱杆32，其内包含有实心的驱动杆(图中未示出)。驱动杆远端与执行机构31相连，近端与手柄装置30的一个元件相连。当操纵手柄时，驱动杆滑动穿过空心杆来操纵末端执行机构。锯齿边和其他特征表面能够使末端执行机构实现多种手术功能，例如夹紧或切割。很多创造性的连锁装置被设计用来转化外科医生的操作，在器械手柄的末端，用于打开或闭合器械的夹爪。典型的，手柄装置30带有一个与空心杆32刚性连接的固定元件35，和一个枢接于(通过枢轴销33)驱动杆上的活动元件34，驱动杆设置在空心杆中并可在其中往复运动。当外科医生挤压固定元件和活动元件使其合并到一起，在驱动杆的作用下，将使夹爪闭合。当外科医生释放固定元件和活动元件，这个相反的动作将使夹爪分开。
现有技术中，许多器械的末端执行机构31包括延伸的上、下夹爪元件45、46，两夹爪相互之间、以及与空心杆32和驱动杆之间通过枢钉90枢接。当操纵典型器械上的夹爪45、46时，外科医生通常很难夹紧光滑组织，这是因为夹爪首先关闭其后端，所以就对组织造成一个推力，将组织推向夹爪外，如图1A中显示的。接下来，由于重复的夹持和为了夹紧而增加的夹持力会对组织造成创伤。
美国专利6,238,414公开了一种手术器械，通过在打开后使两个夹爪相互之间保持平行状态的方法，来解决夹持大的圆筒状的物体的问题，如图1B、2A和2B所示。然而，夹爪不会总被用来夹紧大型物体，特别是圆柱状的物体，所以，需要改进末端执行机构使其能够更好地夹持任意形状的大型物体。
发明内容
本发明公开了一种用于微创手术器械的改进的末端执行机构，该机构也可以用于普通手术或作为机械控制末端执行器的一部分。
通常，一方面，本发明的特征在于一种包括一个改进的末端执行机构的手术器械。所述改进的末端执行机构包括一个外壳，一个设置在外壳中并可沿纵向往复运动的枢转驱动器，和从外壳延伸的第一和第二夹紧单元。第一夹紧单元包括一个第一夹爪元件，一个第二夹爪元件和一个驱动元件。第一夹爪元件带有一个枢接于外壳的第一位置的第一末端，和一个枢接于第二夹爪的第一末端的第一位置的第二末端。驱动元件带有一个枢接于枢转驱动器的第一位置的第一末端，和一个枢接于第二夹爪的第一末端的第二位置的第二末端。第一外壳位置和第一枢转驱动器位置之间间隔有一可调节距离，并且通过调节这个距离可在第一夹爪与第二夹爪之间建立任意角度方向。
本发明在这方面的实施例可包括下列特征中的一个或多个。手术器械进一步包括用于驱动第一夹紧单元相对第二夹紧单元运动的第一驱动装置。所述第一驱动装置包括一个可在所述外壳和所述枢转驱动器内沿轴线往复运动的第一驱动杆。所述第一夹紧单元驱动元件旋转的与第一驱动杆的第一末端的第一位置啮合，第一驱动杆的直线运动被转化成为第一夹紧单元驱动元件的旋转动作，并且通过第一夹紧单元驱动元件的旋转驱动第一夹紧单元相对于第二夹紧单元运动。所述手术器械进一步包括调整第一外壳位置和第一枢转驱动器位置之间距离的装置。所述用于调整第一外壳位置与第一枢转驱动器位置之间距离的装置驱动枢转驱动器沿纵向运动，并且枢转驱动器的直线运动被转化成第一夹紧单元驱动元件的旋转运动，随着第一夹紧单元驱动元件的旋转运动，驱动第一夹紧单元第二夹爪元件相对第一夹紧单元第一夹爪元件运动。所述第二夹紧单元包括一个第一夹爪元件，一个第二夹爪元件和一个驱动元件。所述第二夹紧单元第一夹爪元件带有一个枢接于所述外壳第一位置的第一末端，和一个枢接于第二夹紧单元第二夹爪元件的第一末端的第一位置的第二末端。所述第二夹紧单元驱动元件带有一个枢接于所述枢转驱动器第一位置的第一末端，和一个枢接于第二夹紧单元第二夹爪元件的第一末端的第二位置的第二末端。所述用于调整第一外壳位置与第一枢转驱动器位置之间距离的装置驱动枢转驱动器沿纵向运动，并且枢转驱动器的直线运动被转化成第二夹紧单元驱动元件的旋转运动，随着第二夹紧单元驱动元件的旋转运动，驱动第二夹紧单元第二夹爪元件相对第二夹紧单元第一夹爪元件运动。所述第二夹紧单元驱动元件旋转的与第一驱动杆的第一末端的第二位置啮合，第一驱动杆的直线运动被转化成第二夹紧单元驱动元件的旋转动作，并且通过第二夹紧单元的驱动元件的旋转运动驱动第二夹紧单元相对于第一夹紧单元运动。所述第一驱动装置可进一步包括一个设置在所述外壳内沿轴向往复运动的第二驱动杆，并且第二夹紧单元驱动元件与第二驱动杆的第一末端的第一位置啮合。所述第二驱动杆的直线运动被转化为第二夹紧单元驱动元件的旋转运动，并且通过第二夹紧单元驱动元件的旋转运动驱动第二夹紧单元相对第一夹紧单元运动。所述第一驱动杆的第一末端包括从第一末端伸出的第一和第二指端，第一和第二指端上设置有分别与所述第一和第二夹紧单元驱动元件的第一和第二连接轭相啮合的第一和第二轭销。所述第一和第二驱动杆的第一末端包括分别与第一和第二夹紧单元驱动元件的第一和第二连接轭相啮合的第一和第二轭销。所述枢转驱动器可以为空心管。所述手术器械可进一步包括用于操纵第一驱动装置和用于调整第一外壳位置和第一旋转驱动器位置之间距离的装置的手柄装置。所述手术器械可进一步包括一个杆组件，该杆组件包括一个空心外套，所述第一驱动装置，和所述用于调整第一外壳位置和第一旋转驱动器位置之间距离的装置。所述第一夹紧单元可进一步包括第三夹爪元件和第二驱动元件，并且第三夹爪元件包括枢接于第二夹爪元件的第二末端的第一位置的第一末端，并且第二驱动元件包括枢接于第二夹爪元件的第一末端的第二位置的第一末端，和枢接于第三夹爪元件的第一末端的第二位置的第二末端。所述手术器械可进一步包括分别用于第一和第二夹紧单元的附加夹爪元件和附加驱动元件。所述夹爪元件包括带有锯齿、锐齿(aggressive teeth)、无损伤齿、肘状物或凸起其中之一的内表面，所述夹紧单元也可以是一次性的。所述第二夹紧单元可与外壳固定相连。所述末端执行机构可为自动控制。所述末端执行机构可用于微创手术中。
通常，另一方面，本发明的特征在于一种包括如上面所述的改进的末端执行机构的假肢。另一方面，本发明的特征在于一种包括如上面所述的改进的末端执行机构的机械化组装系统。
另一方面，本发明描述了一种在末端执行机构的第一夹紧单元的第一和第二夹爪元件之间建立任意角度方向方法。所述方法包括提供一个外壳，提供一个设置在外壳中并可沿纵向往复运动的枢转驱动器，同时还提供第一夹紧单元和一个第二夹紧单元。所述第一夹紧单元包括第一和第二夹爪元件和一个驱动元件。进一步，第一夹爪元件的第一末端枢接于所述外壳的第一位置上，第一夹爪元件的第二末端枢接于第二夹爪元件的第一末端的第一位置上。进一步，驱动元件的第一末端枢接于枢转驱动器的第一位置，驱动元件的第二末端枢接于第二夹爪元件的第一末端的第二位置上。第一外壳位置和第一枢转驱动器位置之间留有一段可调节间距。进一步，提供了一种装置，该装置可用来调整第一外壳位置和第一枢转驱动器位置之间的距离，并通过对第一外壳位置和第一枢转驱动器位置之间距离的调整，从而可以在第一和第二夹爪元件之间建立任意角度方向。
下面结合实施例及其附图详细说明本发明。本发明其他特征，目的和优点将体现在以下的具体实施例和附图以及权利要求中。
附图说明
参照附图，不同附图中的相同标记代表相同部件：
图1A为现有技术中典型的末端执行机构的结构示意图；
图1B为现有技术中带有平行的夹爪元件的末端执行机构的示意图；
图2A为带有图1B中所示末端执行机构的手术器械的透视图，图中两个平行夹爪是处于合并状态；
图2B为带有图1B中所示末端执行机构的手术器械的透视图，图中两个平行夹爪处于打开状态；
图3为第一实施例中改进的末端执行机构的透视侧视图；
图4A为图3中所示第一实施例的侧视图，其中上端夹爪呈打开状态；
图4B为图3中所示第一实施例的侧视图，其中上端夹爪呈关闭状态；
图5A为带有图3中所示的末端执行机构的手术器械；
图5B为图5A中手术器械的俯视图；
图6为图5B中沿A-A的横截面视图；
图7为图3中所示末端执行机构的分解图；
图8为改进的末端执行机构的第二实施例的侧面透视图；
图9A为图8中的末端执行机构的侧视图，图中上端的夹爪与下端固定夹爪之间形成了第一角度；
图9B为图8中的末端执行机构的侧视图，图中上端的夹爪与下端固定夹爪之间形成了第二角度；
图9C为图8中的末端执行机构的侧视图，图中上端的夹爪与下端固定夹爪之间形成了第三角度；
图9D为图8中的末端执行机构的侧视图，图中上端的夹爪与下端固定夹爪之间合并在一起；
图10A为带有图8中末端执行机构的手术器械的侧视图；
图10B为图10A中手术器械的俯视图；
图10C为图10B中手术器械沿A-A的横截面视图；
图11为图8中末端执行机构的分解图；
图12为第三实施例中改进的末端执行机构的透视侧视图。；
图13A为图12中所示第三实施例的侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第一角度；
图13B为图12中的末端执行机构的侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第二角度；
图13C为图12中的末端执行机构的侧视图，其中上端夹爪相对下端夹爪呈部分关闭状态；
图13D为图12中的末端执行机构的侧视图，其中上端夹爪相对下端夹爪呈关闭状态；
图14为图12中所示的末端执行机构的分解图；
图15为第四实施例中改进的末端执行机构的透视侧视图；
图16A为图15中末端执行机构侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第一角度；
图16B为图15中末端执行机构侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第二角度；
图16C为图15中的末端执行机构的侧视图，其中上端夹爪相对下端夹爪呈关闭状态；
图17为图15中所示的末端执行机构的分解图；
图18A为带有图15中所示的末端执行机构的手术器械的侧视图；
图18B为图18A中手术器械的俯视图；
图19为沿图18中沿A-A的部分横截面视图；
图20为第五实施例中改进的末端执行机构的透视侧视图；
图21A为图20中末端执行机构侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第一角度；
图21B为图20中末端执行机构侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第二角度；
图21C为图10中的末端执行机构的侧视图，其中上端夹爪相对下端夹爪呈部分关闭状态；
图21D为图20中的末端执行机构的侧视图，其中上端夹爪相对下端夹爪呈关闭状态；
图22为图20中所示的末端执行机构的分解图；
图23为第六实施例中改进的末端执行机构的透视侧视图；
图24A为图20中末端执行机构侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第一角度；
图24B为图23中末端执行机构侧视图，其中上端夹爪相对下端夹爪呈打开状态，其间形成第二角度；
图24C为图23中末端执行机构侧视图，其中上端夹爪相对下端夹爪之间形成第三角度；
图25为图23中所示的末端执行机构的分解图；
图26为第七实施例中改进的末端执行机构的分解图；
图27为图26中所示的末端执行机构的关闭状态；
图28为第八实施例中改进的末端执行机构的透视图；
图29为图28中所示的末端执行机构的部分分解透视图；
图30为图28中所示的末端执行机构的侧视图；
图31为图28中末端执行机构的侧面透视图。
具体实施方式
详细说明本发明：
如图5A和5B所示，手术器械25包括带有一个末端执行机构100的一个前端组件90和一个手柄装置30。手柄装置30包括一个固定手柄35和一个活动手柄34，活动手柄34通过枢轴销33枢接于固定手柄35。固定手柄35上端为管状部分36，该部分大体为空心，并且与杆组件32的远端相连。杆组件32包括一个空心套37和一个设置在外套内部与之同轴的实心驱动杆130。如图6所示，驱动杆130的第一末端99a通过传动销40与活动手柄34连接，并且随着使用者操纵活动手柄34，在空心套37内沿轴向做往复运动。如图7所示，驱动杆130的第二末端99b与执行器132相连接，执行器132与末端执行机构100顺序相接。驱动杆130将活动手柄34的动作传递给末端执行机构100。执行器132具有一个延伸部分133，一个上指端134和一个下指端136。上指端134和下指端136之间形成一开口138。上指端134上还设置有一轭销135，该轭销135从上指端134的一个外表面向外延伸。在一个例子中，执行器132与驱动杆130之间参照美国专利US 6,238,414中所描述的方式进行连接。
如图3和图7所示，在第一个实施例中，端部执行组件90包括外壳140和末端执行机构100。外壳140包括一个空心管，该空心管一端140a与空心套37的远端连接，空心管第二末端140b与末端执行机构100连接。外壳末端140b还包括通孔142和144。执行器132设置在外壳140中。末端执行机构100包括一个从外壳140的第二末端140b纵向延伸出的固定夹爪110和一个枢接于外壳140的第二末端140b的活动夹爪120。活动夹爪120包括第一夹爪元件122，第二夹爪元件124和驱动元件126。驱动元件126的一个末端126a通过插入外壳140上的通孔144和驱动元件126上的通孔146的枢轴销125枢接于外壳140的第二末端140b。驱动元件126的第二末端126b通过插入驱动元件126上的通孔148和第二夹爪元件124上的通孔149中的枢轴销127枢接于第二夹爪元件124的第一末端124a。驱动元件126的末端126a还包括一个与从执行器132的上指端134延伸出的轭销135相啮合的连接轭131。第一夹爪元件122的第一末端122a通过插入外壳140的通孔142和第一夹爪元件122的通孔147的枢轴销128枢接于外壳的140的第二末端140b。第一夹爪元件122的第二末端122b通过分别插入第一夹爪元件122和第二夹爪元件124的通孔141和143中的枢轴销129枢接于第二夹爪元件124的第一末端124a。第一和第二夹爪元件122、124和固定夹爪110都带有具有圆滑边界的平直内表面，适于在对器官和组织不造成伤害的情况下抓紧它们。固定夹爪110的内表面，第一夹爪元件122和第二夹爪元件124也可以具有适于抓紧而不会损伤组织或器官的锯齿或齿111。正如上面提到过的，驱动元件126的末端126a通过连接轭131与枢轴销135相啮合枢转接于执行器上指端134，并由此使驱动杆130的线性直线运动被转化为驱动元件126向下的旋转运动。如图4B所示，驱动元件126向下的旋转运动使得第二夹爪元件124的第一末端124a和与之枢连的第一夹爪元件122的第二末端122b向下旋转，从而使第一和第二夹爪元件122、124与固定夹爪110合并。类似的，如图4A所示，驱动杆130向后的直线运动被转化成驱动元件126的向上转动，并且驱动元件126的向上旋转使得第一和第二夹爪元件122、124相对固定夹爪110打开。第一夹爪元件122与第二夹爪元件124之间的角度150取决于轴孔142和144之间的相对位置，在本实施例中其相对位置是固定的。在本实施例中，轴孔142和144以及与之相对应的枢轴销125和128之间的距离，使第二夹爪元件124的内表面与固定夹爪110的内表面相平行。
根据图28至31中所示的实施例，夹爪110也是可动的，并包括一个第一夹爪元件112，第二夹爪元件114和驱动元件116。驱动元件116的一个末端116a通过插入外壳140上的通孔144和驱动元件116上的通孔146b的枢轴销125枢接于外壳140的第二末端140b。驱动元件116的第二末端116b通过插入驱动元件116的通孔148b和第二夹爪元件114上的通孔149b的枢轴销127b枢接于第二夹爪元件114的第一末端114a。驱动元件116的末端116a也包括连接轭131b，连接轭131b与从执行器132的下指端136延伸出的轭销137相啮合。第一夹爪元件112的第一末端122a通过插入第一夹爪元件112上的通孔147b和外壳140上的通孔142中的枢轴销128枢接于外壳末端140b。第一夹爪元件122的第二末端122b通过分别插入第一夹爪元件112和第二夹爪元件114上的通孔141b和143b的枢轴销129b枢接于第二夹爪元件114的第一末端114a。
如图8和图11所示，在末端执行机构100的第二种实施方式中，枢轴销125和128的相对位置是可变的，因此第一夹爪元件122和第二夹爪元件124之间的夹角150也是可变的，所以，如图9A-9D所示，第二夹爪元件124的内表面与固定夹爪元件110的内表面之间可排列成任意形式。在第二实施例中，驱动元件126控制着第一夹爪元件122的张开和闭合，第二驱动元件160控制着第二夹爪元件124相对第一夹爪元件122的方向，并且第二驱动元件独立于驱动元件126。如图8和图11所示，本实施例中的端部执行组件90除了外壳140和末端执行机构100，还包括枢转驱动器160。根据图10C所示，枢转驱动器160包括设置在外壳140中的用于容纳驱动杆130的空心管。扳手60通过枢轴销161枢接于枢转驱动器160的第一末端160a。沿着箭头80的方向向后扳动扳手60，可使枢转驱动器160沿与箭头80相反方向向前移动。枢转驱动器160的第二末端160b包括凸缘162a、162b，并且凸缘162b上设置有通孔164。凸缘162b通过插入凸缘162b上的通孔164和驱动元件126上的通孔146的销125枢接于驱动元件126。向前移动枢转驱动器160，使枢轴销125向靠近枢轴销128的方向移动，并且使驱动元件126进一步向上移动。由于驱动元件126的第二末端126b通过枢轴销127枢接于第二夹爪元件124的第一末端124a，枢轴销125的向前移动使得夹爪元件124的第一末端124a也同时向上运动，并且夹爪元件124的第二末端124b向下运动。通过这种方法，第二夹爪元件124初始方向通过活动手柄34操纵驱动杆130来确定，并且接下来进一步通过扳手60作用于枢转驱动器160的运动来控制。
如图12和图14a所示，在末端执行机构100的第三种实施方式中，包括第一和第二组合活动夹爪110、120。第一组合活动夹爪110包括第一和第二夹爪元件112、114，和驱动元件116。第二组合活动夹爪120包括第一和第二夹爪元件122、124，和驱动元件126。两个驱动元件116和126均由驱动杆130驱动，驱动杆130设置在空心套37内并可沿轴向往复运动，并随着活动手柄34的动作而动作。如图10C中所示，向着远离固定手柄35的方向移动活动手柄34，推动驱动杆130沿着箭头80所示方向向后移动，并且，随着驱动杆130向后运动，使驱动元件116和126分别向下、向上旋转，由此打开第一和第二组合活动夹爪110，120。如上所述，在附加枢转驱动器160的驱动下，用于连接驱动元件116、126与外壳140的枢轴销125的位置是可变的。附加枢转驱动器160允许组合夹爪110、120中的第二夹爪元件114、124相对与其相对应的第一夹爪元件112、122运动。图13A至图13D描述了两个组合活动夹爪110、120的几种相对位置，以及相对应夹爪元件之间的相对位置。在本实施例中，组合活动夹爪110和120的移动是相互对称的。
根据图15和图17所示，在本发明第四种实施方式中，末端执行机构100包括第一和第二组合活动夹爪110和120。第一组合活动夹爪110包括第一和第二夹爪元件112、114，和驱动元件116。第二组合活动夹爪120包括第一和第二夹爪元件122、124，和驱动元件126。如图18A和图19所示，驱动元件116、126由两个不同的驱动杆130a和130b驱动，两个驱动杆设置在空心套37中，并可沿轴向往复运动，使用者通过两个独立的活动手柄34a、34b分别操纵两个驱动杆。向远离固定手柄35的方向移动手柄34a、34b，推动驱动杆130a、130b沿着箭头80的方向向后运动，如图18A所示，驱动杆130a和130b的向后运动使得驱动元件116和126分别向下和向上转动，由此打开第一和第二组合活动夹爪110和120。因为两个独立的手柄34a、34b可相对于对方单独运动，所以，两个组合夹爪能够被单独控制。如上所述，将驱动元件116和126连接到外壳140上的枢轴销125的位置在枢转驱动机构160的驱动下是可变的。通过沿箭头80所示方向扳动扳手60，附加枢转驱动机构160可使第二夹爪元件114、124相对于其对应的第一夹爪元件112和114运动。图16A至16C所示的是两个组合活动夹爪110、120之间以及相应的夹爪元件之间的几种相对位置，在本实施例中，组合活动夹爪110和120的动作是独立的，并不对称于对方。
如图20和图22所示，在本发明第五种实施方式中，末端执行机构100包括第一和第二组合活动夹爪110、120。第一组合活动夹爪110包括第一、第二和第三夹爪元件112、114、118，驱动元件116和连接元件115。第二组合活动夹爪120包括第一、第二和第三夹爪元件122、124、172，驱动元件126和连接元件171。驱动元件116、126的第二末端116b和126b通过枢轴销175a、175b枢接于连接元件113和171的末端115a、171a。连接元件115、171的第二末端115b、171b通过枢轴销174a、174b枢接于第三夹爪元件118、172。第一夹爪元件112、122也通过枢轴销129a、129b枢接于第二夹爪元件114、124，并且第二夹爪元件122和124也分别通过枢轴销173a、173b枢接于第三夹爪元件118、172。第一夹爪元件112、124也通过枢轴销128枢接于外壳140，并且驱动元件116、126也通过枢轴销125枢接于外壳140。两个驱动元件116、126还通过轭销135、137分别与连接轭131a、131b啮合枢接于执行器132，并且通过一个驱动杆130驱动，该驱动杆130由手柄34操纵，设置在空心套37内并可沿其轴向往复运动。移动手柄34使其远离固定手柄35，推动驱动杆130沿着80方向向后移动，如图10C所示，驱动杆130的向后运动将使得驱动元件116、126分别向下和向上转动，由此分别打开第一和第二组合活动夹爪110、120的第一夹爪元件112、122。第一夹爪元件112、122的运动分别通过连接元件115和171传递给第二夹爪元件114、124和第三夹爪元件118、172。因为只有一个驱动杆130，所以第一组合活动夹爪110的动作与第二组合活动夹爪120呈镜像。如上面提到的，用于连接驱动元件116、126与外壳140的枢轴销125的位置可在附加枢转驱动机构160的作用下变化。附加的枢转驱动机构160可使组合活动夹爪110、120的第二夹爪元件114、124相对于其相应的第一夹爪元件112、122运动，图21A至图21D所示的是，两个可移动的组合活动夹爪110、120之间及其所对应的夹爪元件之间的几种相对位置。
如图23和图25所示，本发明的第六种实施方式中，末端执行机构100包括第一和第二组合活动夹爪110、120。第一组合活动夹爪110包括第一、第二和第三夹爪元件112、114、118，驱动元件116和连接元件115。第二组合活动夹爪120包括第一、第二、第三夹爪元件122、124、172，驱动元件126和连接元件171。驱动元件116、126的第二末端116b和126b通过枢轴销175a、175b枢接于连接元件115、171的第一末端115a、171a。连接元件115、171的第二末端115b、171b通过枢轴销174a、174b枢接于第三夹爪元件118、172。第一夹爪元件112、122也通过枢轴销129a、129b枢接于第二夹爪元件114、124，第二夹爪元件122、124也通过枢轴销173a、173b分别枢接于第三夹爪元件118、172。如上所述，第一夹爪元件112、124也通过枢轴销128枢接于外壳140。驱动元件116、126也通过枢轴销125枢接于外壳140。驱动元件126、116也分别通过轭销135、137与连接轭131a、131b相啮合而分别枢接于执行器132a、132b，并且分别由两个相互独立的驱动杆130a、130b驱动，两驱动杆130a、130b设置在空心套37内并可沿轴向往复运动，两驱动杆分别由使用者通过活动手柄34a、34b来操纵。向远离固定手柄35的方向移动活动手柄34a、34b，推动驱动杆130a、130b沿着80所示方向向后运动，如图10C所示，驱动杆130a和130b的向后运动将导致驱动元件126、116向上或向下转动，由此分别打开第一和第二组合活动夹爪110、120的第一夹爪元件112、122。第一夹爪元件112和122的运动分别通过连接元件115、171传递给第二夹爪元件114、124和第三夹爪元件118、172。因为设置有两个驱动杆130a、130b，所以第一组合活动夹爪110的运动独立于第二组合活动夹爪120，并且他们之间的动作可以是不对称的。如上所述，在附加枢转驱动器160的作用下，连接驱动元件116、126与外壳140的枢轴销125的位置是可变的。枢转驱动器160可使组合活动夹爪110、120的第二夹爪元件114、124相对于其相应的第一夹爪元件112、122运动。图24A至图24C中显示了两个组合活动夹爪之间以及相应夹爪元件之间的几种不同的相对位置。
如图26和图27所示，在本发明的第七种实施方式中，组合活动夹爪120的第一夹爪元件122的一个顶部表面上设置有长沟槽202。如图26和27所示，沟槽202贯穿第一夹爪元件全长，其尺寸与驱动元件126相匹配。同样，组合活动夹爪110的第一夹爪元件112上设置有与驱动元件116相匹配的沟槽(图中未示出)。第一夹爪元件122的第一末端122a带有两个凸缘204、206，两凸缘通过插入外壳上的通孔142和凸缘204和206上的通孔203、205中的枢轴销125枢接于外壳末端140b。第一夹爪元件122的第二末端122b上设置有一个凸缘208，凸缘208通过插入第二夹爪元件上的通孔143和凸缘208上的通孔207中的枢轴销129枢接于第二夹爪元件124。
在一个实施例中，典型的夹爪尺寸为0.500×0.175英寸，典型的手柄尺寸为0.230×4.5×1.75英寸。内镜仪器的材质为生物相容性质的不锈钢，陶瓷，塑料或复合材料。末端执行机构可以是一次性的或非一次性的，并且其材质可以为生物相容性质的不锈钢，金属，铝合金，塑料或复合材料。如上所述，改进的末端执行机构可用于微创手术器械中，也可以用于普通手术器械中，或为自动控制末端执行机构的一部分。也可以用于假肢中，比如，人造手指关节，或其他非医疗的机械装置中。
在另一个实施例中，末端执行机构包括多组夹爪元件和与之配套的驱动元件和连接元件。每个夹爪元件也作为与之邻近的并更接近末端的夹爪元件的固定连接物，迫使他与其相对的夹爪元件保持相应的角度。夹爪元件可带有圆滑表面，锐型或防损伤齿，或者包括肘部或宽握表面。末端执行机构的双重作用结构包括每侧带有两个或三个夹爪元件。单一作用结构包括两个或三个与固定的下端夹爪对应的夹紧单元。通过增加用于调整外壳上的主枢轴销和枢转驱动器之间的距离的装置，末端夹爪之间的相对角度是可以同时或单独变化的。独立控制的扳手能够用来调整枢转中心的距离，或可以通过使用重载弹簧来限定主要驱动机构。另一种调整枢转中心距离的方法为可以通过使用在管结构中的管，其中外管内有凸轮槽通过管子的旋转推动枢轴销向前或向后运动。本发明中通过夹爪角度的控制，可使夹爪的末端折叠在一起或平直的伸出。单独的主驱动器可同时控制处于相对位置的夹爪元件。同时，独立的驱动杆能够单独的驱动每个夹爪元件组。如上所述，夹爪的顶端和末端相对于对方既可对称的运动，也可以不对称的运动。
以上简述了本发明中的几个实施例，然而，已经描述了本发明的一些实施方案。但是应该理解，还可以进行各种不背离本发明的实质和范围的改变。
Claims (24)
1.一种手术器械，包括一个改进的末端执行机构，该机构包括：一个外壳；一个设置在所述外壳中的枢转驱动器，枢转驱动器可在所述外壳内沿纵向往复运动；第一和第二夹紧单元从所述外壳伸出；其中，所述第一夹紧单元包括一个第一夹爪元件，一个第二夹爪元件和一个驱动元件，并且，其中所述的第一夹爪元件包括一个枢接于所述外壳的第一位置的第一末端，和一个枢接于所述第二夹爪元件的一个第一末端的一个第一位置的第二末端；其中，所述驱动元件包括一个枢接于所述枢转驱动器的第一位置的第一末端，和一个枢接于所述第二夹爪元件的一个第一末端的一个第二位置的第二末端；其中所述第一外壳位置和所述第一枢转驱动器位置之间间隔一可调节距离，并且调节所述间隔距离可以在第一和第二夹爪元件之间建立任意角度方向。
2.如权利要求1中所述的手术器械，进一步包括用于驱动所述第一夹紧单元相对所述第二夹紧单元运动的第一驱动装置。
3.如权利要求2中所述的手术器械，其中，所述第一驱动装置包括一个第一驱动杆，该驱动杆设置在所述外壳中并可沿纵向往复运动，并且所述枢转驱动器和其中所述第一夹紧单元驱动元件可转动地与所述第一驱动杆的一个第一末端的一个第一位置啮合连接，其中所述第一驱动杆的线性运动被转化成所述第一夹紧单元驱动元件的旋转运动，并且随着所述第一夹紧单元驱动元件的旋转，驱动所述第一夹紧单元相对所述第二夹紧单元运动。
4.如权利要求3中所述的手术器械，进一步包括用于调整所述第一外壳位置和所述第一枢转驱动器位置之间间隔距离的装置。
5.如权利要求4中所述的手术器械，其中，所述用于调整所述第一外壳位置和所述第一枢转驱动器位置之间间隔距离的装置驱动所述枢转驱动器沿纵向直线运动，其中所述枢转驱动器的所述的直线运动被转化成所述第一夹紧单元驱动元件的旋转运动，并且随着所述第一夹紧单元驱动元件旋转，驱动所述第一夹紧单元第二夹爪元件相对所述第一夹紧单元第一夹爪元件运动。
6.如权利要求5中所示的手术器械，其中，所述第二夹紧单元包括一个第一夹爪元件，一个第二夹爪元件和一个驱动元件，并且其中所述第二夹紧单元第一夹爪元件包括一个枢接于所述外壳的所述第一位置的第一末端，和一个枢接于所述第二夹紧单元第二夹爪元件的一个第一末端的一个第一位置的第二末端，并且其中所述第二夹紧单元驱动元件包括一个枢接于所述枢转驱动器的所述第一位置的第一末端，和一个枢接于所述第二夹紧单元第二夹爪元件的所述第一末端的所述第二位置的第二末端。
7.如权利要求6中所述的手术器械，其中，所述用于调整所述第一外壳位置和所述的第一枢转驱动器位置之间间隔距离的装置驱动所述枢转驱动器沿纵向直线运动，其中所述枢转驱动器的所述直线运动被转化成所述第二夹紧单元驱动元件的旋转运动，并且随着所述第二夹紧单元驱动元件旋转，驱动所述第二夹紧单元第二夹爪元件相对所述第二夹紧单元第一夹爪元件运动。
8.如权利要求7中所述的手术器械，其中，所述第二夹紧单元驱动元件可转动地与所述第一驱动杆的所述第一末端的第二位置啮合连接，其中所述第一驱动杆的直线运动被转化成所述第二夹紧单元驱动元件的旋转运动，并且随着所述第二夹紧单元驱动元件旋转，驱动所述第二夹紧单元相对第一夹紧单元运动。
9.如权利要求7中所述的手术器械，其中，所述第一驱动装置进一步包括一个第二驱动杆，该驱动杆设置在所述外壳内并可沿纵向往复运动，其中所述第二夹紧单元驱动元件与所述第二驱动杆的第一末端的第一位置啮合连接，所述第二驱动杆的直线运动被转化成所述第二夹紧单元驱动元件的旋转运动，并且随着所述第二夹紧单元驱动元件旋转，驱动所述第二夹紧单元相对所述第一夹紧单元运动。
10.如权利要求8中所述的手术器械，其中，所述第一驱动杆的所述第一末端包括由所述第一末端伸出的第一和第二指端，其中所述第一和第二指端包括分别可转动地与第一和第二夹紧单元驱动元件上的第一和第二连接轭相啮合的第一和第二轭销。
11.根据权利要求9中所述的手术器械，其中，所述第一和第二驱动杆的所述第一末端包括分别可转动地与第一和第二夹紧单元驱动元件上的第一和第二连接轭相啮合的第一和第二轭销。
12.根据权利要求1中所述的手术器械，其中，所述枢转驱动器包括一个空心管。
13.根据权利要求5中所述的手术器械，其中，所述手术器械进一步包括一个用于驱动所述第一驱动装置的手柄装置，所述第一驱动装置用于调整所述第一外壳位置和所述第一枢转驱动器位置之间间隔的距离。
14.根据权利要求13中所述的手术器械，其中，所述手术器械进一步包括一个杆组件，该杆组件包括一个空心套，所述第一驱动装置，和所述用于调整所述第一外壳位置和所述第一枢转驱动器位置之间间隔距离的驱动装置。
15.根据权利要求1中所述的手术器械，其中，所述第一夹紧单元进一步包括一个第三夹爪元件，和一个第二驱动元件，并且其中所述第三夹爪元件包括一个枢接于所述第二夹爪元件的所述第二末端的第一位置的第一末端，其中所述第二驱动元件包括一个枢接于所述第二夹爪元件的所述第一末端的第二位置的第一末端，和一个枢接于所述第三夹爪元件的所述第一末端的第二位置的第二末端。
16.根据权利要求15中所述的手术器械，其中，所述手术器械进一步包括分别用于所述第一和第二夹紧单元的附加夹爪元件和附加驱动元件。
17.根据权利要求1中所述的手术器械，其中，任意一个所述夹爪元件包括带有锯齿、锐齿(aggressive teeth)、无损伤齿、肘状物或凸起中之一形状的内表面。
18.根据权利要求1中所述的手术器械，其中，任意一个所述夹紧单元均为一次性的。
19.根据权利要求1中所述的手术器械，其中，所述第二夹紧单元与所述外壳固定连接。
20.根据权利要求1中所述的手术器械，其中，所述末端执行机构是自动控制的。
21.根据权利要求1中所述的手术器械，其中，所述末端执行机构可用于微创手术中。
22.一种包括权利要求1中所述的末端执行机构的假肢。
23.一种包括权利要求1中所述的末端执行机构的机械化组装系统。
24.一种在手术器械的末端执行机构的第一夹紧单元的第一和第二夹爪元件之间预设角度方向的方法，所述方法包括：
提供一个外壳；
提供一个设置在所述外壳中的枢转驱动器，该枢转驱动器设置在外壳中并可沿纵向往复运动；
提供所述第一夹紧单元和一个第二夹紧单元，其中，所述第一夹紧单元包括所述第一和第二夹爪元件和一个驱动器元件；
将所述第一夹爪元件的第一末端枢接于所述外壳的第一位置，并将所述第一夹爪元件的第二末端枢接于所述第二夹爪元件的第一末端的第一位置；
将所述驱动元件的第一末端枢接于所述枢转驱动器的第一位置上，
将所述驱动元件的第二末端枢接于所述第二夹爪元件的第一末端的第二位置，其中，所述第一外壳位置和所述的第一枢转驱动器位置之间间隔一可调节距离；
提供用于调整所述第一外壳位置和所述第一枢转驱动器位置之间间隔距离的装置；并且
调整所述第一外壳位置和所述第一枢转驱动器位置之间间隔的距离，由此在所述第一和第二夹爪元件之间建立任意的角度方向。
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- 2007-09-24 US US11/859,856 patent/US7776065B2/en not_active Expired - Fee Related
- 2007-10-19 KR KR1020097021284A patent/KR20100015516A/ko not_active Application Discontinuation
- 2007-10-19 WO PCT/US2007/081909 patent/WO2008115288A1/en active Application Filing
- 2007-10-19 CA CA2680258A patent/CA2680258C/en not_active Expired - Fee Related
- 2007-10-19 JP JP2010500900A patent/JP5156089B2/ja not_active Expired - Fee Related
- 2007-10-19 CN CN2007800522194A patent/CN101951843B/zh not_active Expired - Fee Related
- 2007-10-19 EP EP20070854219 patent/EP2129305A4/en not_active Withdrawn
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108814693A (zh) * | 2018-04-19 | 2018-11-16 | 刘陈邦 | 一种高性能远端操作的产钳 |
| CN110575227A (zh) * | 2019-10-09 | 2019-12-17 | 郑州大学 | 一种医疗手术钳 |
| CN110575227B (zh) * | 2019-10-09 | 2021-07-09 | 郑州大学 | 一种医疗手术钳 |
| CN115813456A (zh) * | 2022-12-09 | 2023-03-21 | 沈阳医学院附属第二医院 | 一种心内膜心肌活组织钳及其使用方法 |
Also Published As
| Publication number | Publication date |
|---|---|
| EP2129305A4 (en) | 2015-05-20 |
| CA2680258A1 (en) | 2008-09-25 |
| WO2008115288A1 (en) | 2008-09-25 |
| KR20100015516A (ko) | 2010-02-12 |
| CA2680258C (en) | 2012-03-20 |
| JP5156089B2 (ja) | 2013-03-06 |
| JP2010522056A (ja) | 2010-07-01 |
| CN101951843B (zh) | 2013-05-01 |
| US7776065B2 (en) | 2010-08-17 |
| EP2129305A1 (en) | 2009-12-09 |
| US20080234725A1 (en) | 2008-09-25 |
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Effective date of registration: 20160303 Address after: Tennessee Patentee after: Specialty surgical instruments Address before: Massachusetts, USA Patentee before: Symmetry Medical Tnco Patentee before: Griffiths Jerry R Patentee before: Difrancesco Francis J. |
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