CN102028509A - 用于手术器械的内部骨架结构底盘 - Google Patents

用于手术器械的内部骨架结构底盘 Download PDF

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CN102028509A
CN102028509A CN2010105894549A CN201010589454A CN102028509A CN 102028509 A CN102028509 A CN 102028509A CN 2010105894549 A CN2010105894549 A CN 2010105894549A CN 201010589454 A CN201010589454 A CN 201010589454A CN 102028509 A CN102028509 A CN 102028509A
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迈克尔·A·热姆洛克
斯坦尼斯瓦夫·马尔奇克
亚当·J·罗斯
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    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00464Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
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    • AHUMAN NECESSITIES
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Abstract

本发明公开一种用于手术器械的内部骨架结构底盘,也即一种用于安装手术器械的动力头的一组操作部件的底盘。动力头具有壳体,壳体使得能够进入被壳体包围的动力头的内部空间。一组操作部件具有当安装在被壳体包围的内部空间内时用于对准的恰当结构。底盘被构造为:如果底盘和原装的或替换的一组操作部件安装在壳体的内部空间内,则所述底盘给安装在底盘上的所述原装的或替换的一组操作部件提供所述用于对准的恰当结构。所述底盘可以由金属形成,所述壳体可以由聚合物形成。所述底盘被构造为使至少一个电气部件接地。

Description

用于手术器械的内部骨架结构底盘
相关申请的交叉引用
本申请要求由Zemlok等人于2009年10月6日提交的、题目为“用于手术器械的内部骨架结构底盘”的、申请号为61/248,971的美国临时专利申请和由Zemlok等人于2009年10月5日提交的、题目为“用于手术器械的电池弹出设计”的、申请号为61/248,504的美国临时专利申请和的优先权。本申请是由Zemlok等人于2008年8月8日提交的、题目为“动力手术吻合器械”的、申请号为12/189,834,公开号为US 2009/0090763A1的美国专利申请的部分连续案,该申请要求了由Zemlok等人于2007年10月5日提交的、题目为“动力手术吻合器”的、申请号为60/997854的美国临时专利申请的优先权,其全部内容合并于此作为参考。
技术领域
本申请涉及一种手术器械的动力头,更特别地,本发明涉及电池隔室和电池移除以及动力头的部件的安装。
背景技术
带有电池的手术器械和/或吻合器可能需要一种将电池移除以进行处置、回收或再充电目的的装置。如果接触或暴露于来自使用过的手术器械、手套或衣服的外表面的污染中,则电池组会被划分为危险医疗废弃物。这种分类使得处置废弃物的花费更高而且降低了医院回收或重复利用电池的能力。
在与废物产生相关的其他方面,手术器械的尺寸减小以及不断增加的功能需求不断地迫使需求更高性能的内部部件。这些部分可能要求稀有材料或精深的加工方法。另外,这些部件通常更加复杂,精确度更高且需要更严格的公差约束来制造。这些高成本部件也可导致设计趋于更高的重复利用性。为了正确地将所有的这些复杂部件和配件结合在一起形成精确的、耐用的高质量的器械,需要一个能够将这些部件精确定位、对准和放置到一起的底盘或组件平台。这个底盘还必须具有足够的强度和结构以抵抗变形和老化,变形和老化不利于组件的耐用性、精确对准和公差要求。
大部分底盘组件平台被合并到器械的壳体或手柄部组件盖(HSC)中。这些部件受限于特定材料、形状和工艺,从而限制了部件的精度和强度。
当手术器械动力头的壳部受到污染时,由于难以从受到污染的壳体中移出内部部件而不污染内部部件而使得对贵重的内部部件的重复使用和再加工经常受到阻碍。
发明内容
为了改进减少受污染的医疗废弃物的技术现状,本公开涉及一种用于安装手持式手术器械的动力头的一组操作部件的底盘。动力头具有壳体,壳体使得能够进入被壳体包围的动力头的内部空间。一组操作部件具有当安装在被壳体包围的内部空间内时用于对准的恰当结构(a proper configuration for alignment)。底盘被构造为:如果底盘和一组操作部件安装在壳体的内部空间内,则底盘给安装在底盘上的一组操作部件提供所述用于对准的恰当结构;或者如果底盘和替换的一组操作部件安装在壳体的内部空间内,则底盘给安装在底盘上的动力头的替换的一组操作部件提供所述用于对准的恰当结构。在一个实施例中,底盘由金属形成,壳体由聚合物形成。
附图说明
在此将参考附图对主题器械的各种实施例进行描述,其中:
图1为根据本公开的一个实施例的动力手术器械的立体图;
图2为根据图1中本公开的实施例的动力手术器械的局部放大立体图;
图2A为根据图1和图2中本公开的实施例的动力手术器械的变体的局部放大立体图;
图2B为图2A的动力手术器械的变体的近端视图;
图3为根据图1中本公开的实施例的动力手术器械的局部放大平面图;
图4为根据本公开的一个实施例的图1中动力手术器械的内部部件的局部立体剖视图;
图4A为图4的动力手术器械的变体的内部部件的局部立体图;
图5为根据本公开的一个实施例的图1中动力手术器械的零件分离的关节式运动机构的立体图;
图6为示出根据设置在第一位置的图1中本公开的一个实施例的动力手术器械的内部部件的局部剖视图;
图7为示出根据设置在第二位置的图1中本公开的实施例的动力手术器械的内部部件的局部剖视图;
图8为根据本公开的一个实施例的图1中动力手术器械的零件分离的装载单元的安装组件和近侧本体部(proximal body)的立体图;
图9为根据本公开的一个实施例的图1中动力手术器械的末端执行器的侧视剖视图;
图10为示出根据图1中本公开的实施例的动力手术器械的内部部件的局部放大侧视图;
图10A为图4A的动力手术器械的变体的内部部件的局部放大视图;
图11为根据本公开的一个实施例的图1中动力手术器械的单向离合器盘的立体图;
图12为示出根据图1中本公开的实施例的动力手术器械的内部部件的局部放大侧视图;
图13为根据图1中本公开的实施例的动力手术器械的电源的示意图;
图14为示出鉴定图1中动力手术器械的电源的方法的流程图;
图15A-15B为根据图1中本公开的实施例的动力手术器械的装载单元的局部立体后视图;
图16为示出鉴定根据图1中本公开的实施例的动力手术器械的装载单元的方法的流程图;
图17为根据图1中本公开的实施例的动力手术器械的装载单元的立体图;
图18为根据本公开的实施例的图1中动力手术器械的末端执行器的侧视剖视图;
图19为根据本公开的实施例的图1中动力手术器械的侧视剖视图;
图20为根据图1中本公开的实施例的动力手术器械的控制系统的示意图;
图21为根据本公开的反馈控制系统的示意图;
图22A-22B为根据本公开的实施例的反馈控制系统的反馈控制器的立体正视图和后视图;
图23为根据本公开的实施例的反馈控制器的示意图;
图24为根据本公开的一个实施例的动力手术器械的内部部件的局部剖视图;
图25为根据本公开的一个实施例的动力手术器械的内部部件的局部立体剖视图;
图26为根据本公开的一个实施例的动力手术器械的前端(nose)组件的局部立体图;
图27为根据本公开的一个实施例的动力手术器械的收缩杆的局部立体图;
图28为根据本公开的一个实施例的动力手术器械的局部立体图;
图29为根据本公开的一个实施例的动力手术器械的立体图;
图30为根据本公开的一个实施例的动力手术器械的模块收缩组件的立体图;
图31为根据本公开的一个实施例的动力手术器械的内部部件的局部放大剖视图;以及
图32为根据本公开的一个实施例的动力手术器械的内部部件的局部放大剖视图;
图33为根据本公开的一个实施例的动力手术器械的立体图,该器械具有围绕器械的动力头的一个或多个密封构件;
图34为图33中动力头的剖视图,显示动力头的内部元件和一个或多个密封构件。
图35为示出根据本公开的一个实施例的用于图33和图34中动力头的电池组或电源组的立体图;
图36为根据本公开的一个实施例的图35中具有密封构件的电池组或电源组的另一个立体图;
图37为依据本公开的手术器械的动力头的壳体的外部的立体图;
图38为图37中的动力头的剖视图,示出了一组操作部件安装在依据本公开的一个实施例的结构构件或底盘上;
图39为依据本公开的一个实施例的结构构件或底盘的一侧的视图,其显示了用于安装操作部件的特征;
图40为依据本公开的图36中动力头的分解立体图,显示了壳体部分和安装在结构构件或底盘上的一组操作部件;
图41为依据本公开的图36中动力头的另一分解立体图,显示壳体部分和安装在结构构件或底盘上的一组操作部件;
图42为显示在图39中的结构构件或底盘的一侧的视图,显示了安装在结构构件或底盘上的一组操作部件;以及
图43为结构构件或底盘的另一侧的视图,并显示了安装在结构构件或底盘上的一组操作部件。
具体实施方式
现在将参考附图详细描述目前公开的动力手术器械的实施例,其中相同的附图标记指代多幅视图中的每一幅图的相同或相应元件。如本文所使用的,术语“远侧”指的是动力手术器械较远离用户的部分或其部件,而术语“近侧”指的是动力手术器械较靠近用户的部分或其部件。
此外,在下文中和附图中出现的诸如“前部”、“后部”、“上部”、“下部”、“顶部”、“底部”等术语仅为了方便进行说明而使用而不是限定公开的内容。
根据本公开的诸如手术吻合器的动力手术器械在图中用附图标记10指代。先参考图1,动力手术器械10包括壳体110、限定了贯通其中的第一纵向轴线A-A的内窥镜部140,以及限定了贯通其中的第二纵向轴线B-B的末端执行器160。内窥镜部140从壳体110向远侧延伸,并且末端执行器160邻近内窥镜部140的远侧部设置。在一个实施例中,壳体110的部件被密封以抵抗颗粒的渗透和/或流体污染,并且有助于防止消毒处理对部件的损害。
根据本公开的一个实施例,末端执行器160包括:具有一个或多个手术紧固件的第一钳夹构件(例如,钉仓组件164);以及包括用来展开和成形手术紧固件的砧座部的与第一钳夹构件对置的第二钳夹构件(例如,砧座组件162)。在某些实施例中,吻合钉被容纳在钉仓组件164中以同时或连续的方式将吻合钉的线性排列施加到体组织。砧座组件162和钉仓组件164中的一个或两个相对于彼此能够在砧座组件162与钉仓组件164隔开的打开位置和砧座组件162与钉仓组件164并列对准的接近或夹紧位置之间移动。
可以进一步预想到末端执行器160联接到安装部166上,安装部166可枢转地联接到主体部168上。主体部168可以与动力手术器械10的内窥镜部140构成整体,或可以可拆卸地联接到器械10上以提供可替换的一次性装载单元(DLU)、或单次使用的装载单元(SULU)(例如,装载单元169)。在某些实施例中,可重复利用部分可以被构造为用来消毒并且在随后的手术过程中再次使用。
装载单元169可以通过卡扣连接器连接到内窥镜部140上。可以预想到,装载单元169具有连接到装载单元169的安装部166上的关节式运动连杆,并且该关节式运动连杆连接到联动杆以使末端执行器160随着联动杆沿第一纵向轴线A-A在远近方向上平移而作关节式运动。可以使用其它工具将末端执行器160连接到内窥镜部140以实现关节式运动,例如柔性管或包括多个可枢转构件的管。
装载单元169可以并入或被构造为并入各种末端执行器,例如脉管密封装置、直线吻合装置、旋转吻合装置、刀具等。这些末端执行器可以被接合到动力手术器械10的内窥镜部140上。装载单元169可以包括不做关节式运动的直线吻合末端执行器。中间柔性轴可以被包括在手柄部112和装载单元之间。可以预想柔性轴的并入可便于接近和/或进入患者身体的特定区域。
参考图2,根据本公开的一个实施例图示了壳体110的放大图。在图示实施例中,壳体110包括手柄部112,手柄部112上设置有主驱动开关114。开关114可以包括第一开关114a和第二开关114b,二者一起形成扳钮开关。限定了手柄轴线H-H的手柄部112被构造为由用户的手指来抓取。手柄部112具有提供了宽裕的手掌紧握杠杆机构的人体工程学的形状,该形状有助于防止手柄部112在操作中被挤出用户的手。每一个开关114a和114b被示为设置到手柄部112上合适的位置以便于由用户的一个或多个手指按压。在另一个实施例中,该器械10包括由肋元件分隔开的两个独立开关114a和114b。
另外,参考图1和图2,开关114a、114b可以用来启动和/或停止驱动电动机200(图4)的移动。在一个实施例中,开关114a被构造为在第一方向上启动驱动电动机200以在远侧方向上推进发射杆220(图6),从而夹紧砧座组件162与钉仓组件164。与之相反,开关114b可以被构造为收缩发射杆220以通过在相反方向上启动驱动电动机200来打开砧座组件162与钉仓组件164。在收缩模式期间,一旦启动吻合和切割模式,就会激活机械闭锁件(未显示),以防止装载单元169的吻合和切割的进一步进行。在已经预先展开吻合钉之后,该闭锁件通过软件执行冗余后退以防止切割组织。扳钮具有用来启动开关114a的第一位置,启动开关114b的第二位置,以及在第一位置和第二位置之间的中间位置。下面对器械10的驱动部件的详细操作进行更详细的讨论。
壳体110,尤其是手柄部112,包括开关护罩117a和开关护罩117b。开关护罩117a和开关护罩117b可以具有分别围绕开关114a的底部和开关114b的顶部的类肋状。开关护罩117a和开关护罩117b防止开关114的意外启动。此外,开关114a和开关114b具有需要增加压力以启动的高触觉反馈。
在一个实施例中,开关114a和开关114b被构造为多速(例如两个或更多个)开关、增量开关或变速开关,所述开关以非线性方式控制驱动电动机200和发射杆220的速度。例如,开关114、114b能够对压力敏感。这种控制接口允许驱动部件的速率从较慢或较精确的模式逐渐增加到较快的操作。为了防止收缩的意外启动,在故障安全开关被按压之前开关114b可以是非电子接通的。另外,第三开关114c也可以用于该目的。另外或可选择地,故障安全能够通过在从大约100毫秒到2秒的预定时间段内按压并且保持开关114b而得到克服。然后,除非开关114a和114b在收缩模式期间启动(例如,按压或释放)以停止收缩,否则发射杆220将自动收缩回其初始位置。在释放开关114b之后随后按压释放开关114b,收缩继续进行。可选择地,在其它实施例中,即使开关114b被释放,发射杆220的收缩能够继续直到完全收缩。其它实施例包括发射杆220的自动收缩模式,在该模式下,即使释放了开关114b,仍然全部收缩该发射杆220。如果开关114a或开关114b中的一个被启动,该模式可在任意时间被中断。
开关114a和开关114b接合到非线性速度控制电路115中,电路115能够实施为电压调节电路、可变电阻电路或微电子脉冲宽度调制电路。开关114a和开关114b可以通过移置或驱动可变控制装置与控制电路115相接,所述可变控制装置例如为变阻器、多档位开关电路(multiple position switch circuit)、线性和/或旋转可变位移传感器、线性和/或旋转电位计(potentiometer)、光学编码器、铁磁传感器和霍尔效应传感器。这就允许开关114a和开关114b基于按压开关114a和开关114b以多个速度模式操作驱动电动机200,速度模式例如取决于所使用的控制115的类型递增或逐步地逐渐增加驱动电动机200的速度。
在一个特定实施例中,还可以包括开关114c(图1、图2和图4),其中开关114c的按压可以机械地和/或电气地改变从夹紧到发射的操作模式。开关114c凹入在壳体110中并且具有高触觉反馈以防止错误启动。提供单独的控制开关以初始化发射模式,这允许末端执行器的钳夹重复地打开和关闭,因此器械10在按压开关114c前用作抓取器,从而启动吻合和/或切割模式。例如,开关114可以包括一个或多个微电子开关。例如,一种微电子薄膜开关提供触觉感觉、小的封装尺寸、人体工程学的尺寸和外形、薄轮廓、将字面模制在开关上的能力、符号、描绘和/或指示的能力以及低材料成本。另外,可以密封开关114(例如微电子薄膜开关)以便于器械10的消毒并且有助于防止颗粒和/或流体污染。
作为替代,或除了开关114之外,其它输入装置可以包括声音输入技术,该输入装置可以包括并入控制系统501(图20)中的硬件和/或软件,或连接到控制系统501的单独的数字模块。声音输入技术可以包括声音识别、声音启动、声音校正和/或嵌入语音。用户能够通过声音命令来整体或部分地控制器械的操作,因此解放出用户的一只或两只手以操作其它器械。也可以用声音或其它音频输出向用户提供反馈。
在对手术器械10继续说明之前,图2A和图2B示出手术器械10的变形。更具体地,手术器械10′包括壳体110′,其被构造为具有部分沙漏形的手柄112′。手术器械10′与手术器械10相比提供了可选的人体工程学结构。
再次回到对手术器械10的说明并参考图3,示出了具有用户接口120的壳体110的近侧区118。用户接口120包括屏幕122和多个开关124。用户接口120可以显示器械10的各种操作参数类型,例如:“模式”(例如,旋转、关节式运动或致动),其通过传感器可以传递至用户接口;“状态”(例如,关节式运动角度、转速或致动类型);和“反馈”,“反馈”例如吻合钉是否已经基于器械10中设置的传感器所报告的信息被发射;连同错误和其他代码(例如,不正确载入、更换电池、电池水平、估计剩余发射数量或任何非功能性的子系统)。
屏幕122可以为LCD屏,等离子屏、电致发光屏等。在一个实施例中,排除开关124的需要,屏幕122可以为触摸屏。触摸屏可以结合电阻的、表面声波、电容的、红外的、变形测量、光学的、分散的信号或声音脉冲识别触摸屏技术。触摸屏可以用来允许用户在观察操作反馈的同时提供输入。该方法可便于密封屏幕部件从而有助于对器械10进行消毒,并且可以防止颗粒和/或流体污染。在某些实施例中,屏幕122被可枢转或可旋转地安装到器械10以用来在使用或准备期间灵活地观察屏幕(例如,通过铰链或球窝式安装件)。
开关124可以用来开始和/或停止器械10的移动以及选择单次使用的装载单元(SULU)或一次性装载单元(DLU)的类型,以及选择枢轴方向、速度和/或扭矩。还可以预想到,至少一个开关124能被用来选择各设定值被超越的紧急模式。开关124还可以用来选择屏幕122上的各种选项,例如在用户接口菜单导航和选择各种设置的同时对提示作出响应,允许用户输入不同的组织类型以及吻合钉钉仓的各种尺寸和长度。
开关124可以由各种形状和尺寸的微电子触觉或非触觉薄膜、聚酯薄膜、合成橡胶、塑料或金属键形成。另外,可以将开关定位在相互不同的高度和/或可以包括凸起的标记或其它织构特征(例如凹陷或凸起)以使得用户不需要查看用户接口120就能够按压适当的开关。
除了屏幕124之外,用户接口120可以包括一个或多个可视化输出123,可视化输出123可以包括一个或多个彩色可见光源或发光二极管(“LED”)以将反馈传送给用户。可视化输出123可以包括各种形状、尺寸和颜色的相应的指示器,指示器具有识别可视化输出123的数字和/或文字。可视化输出123设置在壳体110的顶部以使输出123被抬起并相对于壳体110突出以提供更好的可见度。
多光源以特定的组合显示以向用户示出特定的操作模式。在一个实施例中,可视化输出123包括第一光源(例如黄色)123a、第二光源(例如绿色)123b和第三光源(例如红色)123c。这些光源以特定的组合操作,特定的组合如表1所列与特定的操作模式有关。
Figure BSA00000388761000101
表1
在另一个实施例中,可视化输出123可以包括显示与操作模式有关的特定颜色的单个多色LED,操作模式如上所述与表1中第一光源、第二光源和第三光源有关。
用户接口120还包括声音输出125(例如乐音、钟、蜂鸣器、集成扬声器等)以将例如电池能量不足、钉仓为空等的各种状态变化传达给用户。声音反馈可以与可视化输出123结合使用或可以替代可视化输出123。声音反馈可以按单个或多个脉冲顺序的嘀嗒声、劈啪声、嘟嘟声、敲钟声和嗡嗡声的形式被提供。在一个实施例中,模拟的机械声音可以被预先录制,模拟的机械声音由复制机械闭锁件和传统的无动力器械机构产生的嘀嗒声和/或劈啪声而预先录制。这样不再需要通过器械10的真实部件来产生这样的机械声音,并且也避免了嘟嘟声和其它通常与其它手术室设备有关的电子声音的使用,从而防止无关的声音反馈造成的混乱。器械10可以包括一个或多个麦克风或其他声音输入装置,该装置用于确定背景噪声水平并且相应地调整音频反馈音量以用于清楚的反馈识别。
器械10还可以通过壳体110内的触觉机构(未明确示出)来提供触觉或振动反馈。触觉反馈可以与听觉和视觉反馈结合使用或可以替代它们以避免与依赖于声音和视觉反馈的手术室设备发生混乱。触觉机构可以为以脉动的方式振动的异步电动机。在一个实施例中,振动处于大约20Hz或以上的频率,在一些实施例中为约20Hz到约60Hz的频率,这提供了具有2毫米或更低振幅的位移,在一些实施例中从约0.25毫米到约2毫米的振幅,以将振动效果限制为不会到达装载单元169。
还可以预想到,用户接口120包括在屏幕和/或开关上的不同颜色和/或亮度的文字以进一步区别显示项目。视觉、听觉或触觉反馈的强度能够增加或降低。例如,反馈强度可以用来表示器械上的力正变得过大。
图2、图3和图4图示了关节式运动机构170,其包括关节式运动壳体172、动力关节式运动开关174、关节式运动电动机132以及手动关节式运动旋钮176。该关节式运动开关174可以为在壳体110各侧具有臂174a和臂174b的摇杆和/或滑动开关,以允许左手或右手的使用。动力关节式运动开关174的平移启动关节式运动电动机132。手动关节式运动旋钮176的枢转将致动如附图5中显示的关节式运动机构170的关节式运动齿轮233。通过开关174或旋钮176致动关节式运动机构170会导致末端执行器160从其纵向轴线B-B大体与纵向轴线A-A成一直线的第一位置朝向纵向轴线B-B设置为相对于纵向轴线A-A有一角度的位置移动。优选地,可以到达多个关节式运动位置。动力关节式运动开关174还可以与由开关114a和开关114b控制的夹紧机构类似并入非线性速度控制器。
此外,壳体110包括具有翼状外形并且从壳体110的顶面延伸至开关174上面的开关护罩117c和开关护罩117d。开关护罩117c或开关护罩117d能够防止当器械10被放倒时开关174的意外启动,或者防止在使用时碰到物理障碍物,并且要求用户触到罩169下面以启动关节式运动机构170。
旋转旋钮182围绕第一纵向轴线A-A的旋转导致壳体组件180以及关节式运动壳体172和手动关节式运动旋钮176围绕第一纵向轴线A-A旋转,从而导致发射杆220的远侧部224和末端执行器160围绕第一纵向轴线A-A的相应旋转。关节式运动机构170机电接合到设置在壳体前端组件155上的第一导电圆环157和第二导电圆环159,如图4和图26所示。导电圆环157和导电圆环159可以被焊接、粘合、压紧配合、按扣配合或卷曲到前端组件155上并且与电源400电接触,从而向关节式运动机构170提供电力。前端组件155可以是模块化的(例如,独立于壳体110)并且可以在组装过程联接到壳体110以便于以上述方法安装圆环。关节式运动机构170包括与导电圆环157和导电圆环159接触的一个或多个刷子和/或弹簧负载触头,以使随着壳体组件180连同关节式运动壳体172一起旋转,关节式运动机构170与导电圆环157和导电圆环159连续接触,从而从电源400接收电力。
关节式运动壳体172、动力关节式运动开关174、手动关节式运动旋钮176的更多细节以及向末端执行器160提供关节式运动在于2007年3月15日提交的、申请序列号为11/724,733的共有美国专利申请中有详细的描述,其全部内容通过引用合并于此作为参考。可以预想到,可以设置在壳体110内的限位开关、近侧传感器(例如,光学的和/或铁磁的),线性可变位移传感器和转轴编码器的任意组合,可以用来控制和/或记录末端执行器160的关节式运动角度和/或发射杆220的位置。
图4、图5-图10以及图11-图12图示了器械10的各种内部部件,包括驱动电动机200、内螺纹驱动管210以及具有近侧部222和远侧部224的发射杆220。驱动管210能够围绕贯通其中的驱动管轴线C-C旋转。驱动电动机200设置为与驱动管210机械协作并且被构造为使驱动管210围绕驱动齿轮轴线C-C旋转。在一个实施例中,驱动电动机200可以为电动机或齿轮电动机,其可以包括并入其壳体内的齿轮装置。
壳体110可以由两个半部110a和110b形成,如图3所示。两个壳体半部110a和110b可以利用凸台定位器111处的螺杆彼此联接,凸台定位器111使壳体部110a和110b对准。在一个实施例中,可以使用超声焊接控制器将半部110a和110b联接在一起以密封该壳体免于外部污染。另外,壳体110可以由塑料形成并且可以包括通过两次模制处理施加到壳体110的内表面的橡胶支撑构件。橡胶支撑构件可以把驱动部件(例如,驱动电动机200)的振动与器械10的其余部分隔开。
壳体半部110a和110b可以通过塑料薄片彼此联接(例如,活动铰链),塑料薄片使半部110a和110b相互连接并且允许壳体110可以通过分离半部110a和110b而打开。
在一个实施例中,驱动部件(例如,包括驱动电动机200、驱动管210和发射杆220等)可以安装到支撑板上,以允许驱动部件在器械10已经使用后从壳体110上移走。与铰接壳体半部110a和110b一起安装的支撑板提供了对特定的内部部件的重复利用和循环利用,同时限制了其污染。
图4A图示了变体手术器械10′的内部部件。图4A用来与图4进行一般对比,在此不作详细讨论。
再次回到手术器械10的说明,并且参考图4、图5、图6和图7,图示了发射杆联轴器190。发射杆联轴器190提供了发射杆220的近侧部222和远侧部224之间的联接。具体地,发射杆联轴器190使发射杆220的远侧部224能相对于发射杆220的近侧部222旋转。因此,参考下面对关于对准板350的讨论,发射杆联轴器190使得发射杆220的近侧部222能够保持不旋转,同时允许发射杆220的远侧部224的旋转(例如,当旋转旋钮182旋转时)。
参考图6和图7,发射杆220的近侧部222包括贯通驱动管210的内螺纹部212的螺纹部226。发射杆220和驱动管210之间的这种关系引起:在驱动管210响应驱动电动机200的旋转而旋转时,发射杆220在箭头D和箭头E的方向上沿驱动管210的螺纹部212向远侧和/或近侧移动。随着驱动管210在第一方向上旋转(例如,顺时针方向),发射杆220向近侧移动,如图6所示,发射杆220位于其最近侧位置上。随着驱动管210在第二方向上旋转(例如,逆时针方向),发射杆220向远侧移动,如图6所示,发射杆220位于其最远侧位置上。
发射杆220能在特定的限度内向远侧和近侧平移。具体地,发射杆220的近侧部222的第一末端222a与对准板350结合作为机械停止装置。也就是说,在收缩时,当发射杆220向近侧平移时,第一末端222a接触对准板350的远侧表面351,从而防止发射杆220连续的近侧平移,如图6所示。另外,近侧部222的螺纹部226与对准板350结合作为机械停止装置。也就是说,当发射杆220向远侧平移时,螺纹部226接触对准板350的近侧表面353,从而防止发射杆220进一步向远侧平移,如图7所示。对准板350包括具有非圆形横截面的贯穿其中的孔。所述孔的非圆形横截面防止发射杆220的近侧部222的旋转,从而限制了发射杆220的近侧部222通过其中的轴向平移。此外,近侧轴承354和远侧轴承356至少部分地设置在驱动管210周围以便于驱动管210的旋转,同时有助于驱动管在壳体110内定位。驱动管210在其两端包括远侧径向凸缘210a和近侧径向凸缘210b,它们分别用于保持驱动管210使其位于远侧轴承356和近侧轴承354之间。
驱动管210在第一方向(例如,逆时针方向)上的旋转对应于发射杆220向远侧平移,发射杆220向远侧平移会致动末端执行器160的钳夹构件162或164(即砧座组件162与钉仓组件164)以抓取或夹紧其间夹持的组织。发射杆220追加的远侧平移通过致动凸轮杆和/或致动滑块74(图9)把手术紧固件从末端执行器160中弹射出以紧固组织。此外,发射杆220还可以被构造为致动刀具(未明确示出)以切断组织。发射杆220的近侧平移与驱动管210在第二方向(例如,顺时针方向)上的旋转对应,发射杆220的近侧平移致动砧座组件162与钉仓组件164和/或刀具收缩或恢复到相应的预发射位置。发射或其它的启动末端执行器160的进一步细节在由米利曼(Milliman)等人共有的专利号为6,953,139的美国专利(′139号米利曼专利)中有详细的描述,其公开通过引用合并于此作为参考。
图8所示为装载单元169的局部分解图。可以通过具有驱动梁或驱动构件266的轴向驱动组件213来致动末端执行器160。驱动梁213的远侧末端可以包括刀片。另外,驱动梁213包括具有一对凸轮构件40a的固定凸缘40,凸轮构件40a在驱动梁213纵向前进期间啮合砧座组件162和钉仓组件164。驱动梁213使致动滑块74纵向前进穿过吻合钉钉仓164。如图9中所示,滑块74具有凸轮楔,随着滑块74前进所述凸轮楔用来啮合设置在钉仓组件164的狭槽内的推动器68。设置在狭槽内的吻合钉66通过推动器68被驱动穿过组织并且抵靠砧座组件162。
参考图10,示出了驱动电动机轴202从联接到驱动电动机200上的变速器204处延伸出。驱动电动机轴202与离合器300机械协作。驱动电动机轴202由驱动电动机200旋转,从而引起离合器300的旋转。离合器300包括离合器盘302和弹簧304并且显示为具有设置在离合器盘302上的楔形部306,楔形部306被构造为与设置在驱动管210的近侧面216上的接口(例如,楔214)匹配。
弹簧304图示为位于变速器204和驱动管210之间。具体地,根据图10所示的实施例,弹簧304图示为位于离合面302和离合垫圈308之间。另外,驱动电动机200和变速器204安装在电动机支架310上。如图8所示,通过设置在电动机支架310内的狭槽312以及设置在壳体110上的突起314,电动机架310关于壳体110能够被向近侧或远侧调节。
在本公开的一个实施例中,离合器300被实施为滑动单向离合器以限定驱动部件上的扭矩和高惯性负载。离合器300的楔形部306被构造并且布置为关于驱动管210的近侧面216的楔214滑动,除非临界力通过离合器弹簧304施加到离合器盘302上。此外,当弹簧304施加使楔形部306和楔214在不滑动的情况下啮合所需的上述临界力时,驱动管210将在驱动电动机200旋转时旋转。可以预想到,楔形部306和/或楔214被构造为当发射杆220上获得发射力时在一个和/或两个方向(例如,顺时针方向和/或逆时针方向)上关于彼此滑动。
附图10A示出了关于图2A、图2B和图4A描述的手术器械10′的内部部件的局部放大图。此外,以类似的方式,提供图10A用来与图10进行比较且这里不再赘述。采用在手术器械10中相应的相同的附图标记来标记这些与手术器械10具有相同结构的部分。
再次返回到对手术器械10的描述并参考图11和图12,示出了带单向离合器盘700的离合器300。离合器盘700包括各自具有滑动面704和夹紧面706的多个楔形部702。滑动面704具有弯曲边缘,该弯曲边缘啮合驱动管210的楔214直至达到预定负载。夹紧面706具有完全啮合驱动管210并且防止滑动的扁平边缘。当离合器盘700反向(例如,逆时针方向)旋转时,楔形部702的夹紧面706无滑动地啮合楔214,从驱动电动机200供给完全扭矩。该特征有助于确保钳夹162、164在极度负载发生时由于收缩而打开。当离合器盘700正向(例如,顺时针方向)旋转时,楔形部702的滑动面704啮合楔214并且限制向驱动管210传递扭矩。因此,如果施加到滑动面704上的负载超过限值,则离合器300滑动并且驱动管210不旋转。这能够防止由于电动机和驱动部件而产生的对末端执行器160或组织的高负载损伤。更特别地,器械10的驱动机构能够以比反向驱动时较小的扭矩正向驱动驱动杆220。另外,还可以用电子离合器来增加或减少电动机势能(例如,连同驱动电动机200、驱动管210、离合器组件300、对准板350和发射杆220的任意部分一起驱动驱动杆220向前或向后),下面将对此进行更加详细的讨论。
可以进一步预想到,驱动电动机轴202包括D形或非圆形横截面708,横截面708包括大体上的扁平部710和圆形部712。因此,尽管驱动电动机轴202能够相对于离合器盘700平移,在驱动电动机轴202旋转时,驱动电动机轴202不会相对于离合器盘700“滑动”。也就是说,驱动电动机轴202的旋转将引起离合器盘700的无滑动旋转。
在根据本公开的某些实施例中,装载单元包括轴向驱动组件,其与发射杆220协作以使末端执行器160的砧座组件162和钉仓组件164接近,并且从吻合钉钉仓发射吻合钉。正如上述讨论和第139号米利曼专利的特定实施例中所公开的,该轴向驱动组件可以包括穿过吻合钉钉仓向远侧行进并且可以在吻合钉发射后收缩的梁。
参考图4,器械10包括电源400,电源400可以是可再充电池(例如,铅电池、镍电池、锂离子电池等)。还可以预想到电源400包括至少一个一次性电池。该一次性电池可以介于约9伏和约30伏之间。
取决于器械10的能量和电压电势的需要,电源400包括一个或多个电池单元401。此外,电源400可包括一个或多个超级电容器402,由于其比传统电容器更高的能量密度而用作补充储能器件。在高能提取期间,超级电容器402能够与电池单元401结合使用。因为电池单元401为不能快速流出电流的典型慢流装置,当所要求/所需的能量比电池单元401自身所能提供的更快时(例如,在夹紧厚组织、快速发射和夹紧等时),能够利用超级电容器402来产生电力冲击。该配置能够降低电池上的电流负载从而减少电池单元401的数量。超级电容器402还能够调节系统电压,以给电动机200和发射杆220提供更一致的速度。可以预想到,能够将电池单元401连接到超级电容器402上以对电容器充电。
电源400可以连同驱动电动机200一起被移除以提供这些部件的循环使用以及器械10的重复使用。在另一个实施例中,电源400可以是在使用中由用户佩戴在束带和/或挽带上并且用导线连接到器械10的外部电池组。
电源400可以封装在绝缘罩404中,绝缘罩404可以由吸收性的、耐火的和阻燃材料形成。罩404将该器械10的组件与电源400电绝缘和热绝缘。更具体地,罩404防止由电源400产生的热使器械10的其它部件变热。另外,罩404还可以被构造为在过度使用和/或损伤期间吸收从电池402中泄漏的任何化学物质或流体。
电源400可以接合到被构造为连接到外部电源(例如,DC变压器)的电源适配器406。外部电源可以用来为电源400再充电或供给另外的电力需求。电源适配器406还可以被构造为与电手术发电机相接,该电手术发电机可以随后为器械10供应电力。在该配置中,器械10还可以包括交直流电源,该电源转换来自电手术发电机的RF能量并且为器械10供电。
在另一个实施例中,电源400利用感应充电接口再次充电。电源400接合到设置在壳体110的近侧部内的感应线圈(未明确示出)。感应线圈在被放置到电磁场内后把能量转换为电流,然后电流用来为电源400充电。电磁场可以由基站(未明确示出)产生,该基站被构造为与壳体110的近侧部相接,以使感应线圈被电磁场包围。该配置消除了外部接触器的需要并且允许壳体110的近侧部将电源400和感应线圈密封在防止暴露在流体和污染物下的防水环境内。
参考图6,器械10还包括一个或多个安全电路,例如放电电路410以及电动机和电池操作模块412。为了显示清晰,使器械10的各种电子部件相互连接的导线和其它电路元件并未示出,但是本公开考虑到了该机电连接导线。器械10的某些部件无线地连通。
放电电路410接合到开关414和电阻负载417,并且开关414和电阻负载417依次接合到电源400。开关414可以为用户启动或自动(例如,定时器、计数器)开关,其在为了安全和低温处理而对电源400完全放电时(例如,在手术程序的最后)被启动。一旦开关414被启动,负载417电连接到电源400以使电源400的势能被导向负载417。自动开关可以为定时器或计数器,其在预定操作时间段或使用数量过后自动启动以为电源400放电。负载417具有足够的预定电阻以完全和安全地为所有电池单元401放电。
电动机和电池操作模块412接合到一个或多个热传感器413,该热传感器413确定驱动电动机200和电源400内的温度以确保器械10的安全操作。所述传感器可以为用来确定在电源400、电热调节器、热电堆、热电耦、热红外传感器等内引出电流的电流表。监测这些部件的温度以确定其上放置的负载。流过这些部件的电流的增加引起这些部件内部温度的升高。温度和/或电流引出数据可以随后用来以有效的方式控制电力消耗或保证操作的安全水平。
为了确保器械10的安全和可靠操作,理想的是保证电源400是可靠的和/或有效的(例如,遵照严格的质量和安全标准)以及在预定温度范围内的操作。对电源400有效性的鉴定使得病人和/或用户由于质量不佳可能受到伤害的危险降至最低。
参考图13,显示电源400具有一个或多个电池单元401、热传感器413以及接合于其上的嵌入式微控制器405。微控制器405通过有线和/或无线通信协议接合到器械10的微控制器500(图6、图13和图20)以鉴定(authenticate)电源400。在一个实施例中,热传感器413能够直接接合到微控制器500而不是接合到嵌入式微控制器405。热传感器413可以为电热调节器、热电堆、热电耦、热红外传感器、电阻温度检测器、线性主动电热调节器、温度响应变色带、双金属触头开关等。热传感器413将测量到的温度向微控制器405和/或微控制器500报告。
嵌入式微控制器405与微控制器500执行所谓的询问响应鉴定算法,如图13所示。在步骤630中,电源400被连接到器械10并且接通器械10。微控制器500向嵌入式微控制器405发送询问请求。另外,微控制器500可以向微控制器405请求从热传感器413接收的电池温度。在步骤632中,微控制器405对询问请求进行解析并且生成作为对请求的应答的响应。该响应可以包括标识符,例如存储在无线电频率识别标签中的或微控制器405的存储器中的唯一的序列号、电源400的唯一的电气测量值(例如,电阻、电容、电感等)。另外,该响应包括由热传感器413测量的温度。
在步骤634中,微控制器500解码所述响应以获得标识符以及测量的温度。在步骤636中,通过将标识符与认证(authentic)标识符的预先认可的列表进行比照,微控制器500基于标识符确定电源400是否可靠。如果标识符无效(not valid),则器械10将不会操作并且通过用户接口120显示错误代码或“鉴定电池失败”的信息。如果标识符有效,则处理继续进行到步骤640,在步骤640中,分析测量的温度以确定测量值是否在预定的操作范围内。如果温度超过界限,则器械10同样显示错误信息。这样,如果温度在预定的界限内并且标识符有效,则在步骤642中,器械开始操作,可能包括向用户提供“电池已鉴定”的信息。
返回参考图4和图6,图示了用来提供与器械10的功能有关的反馈信息的多个传感器。传感器的任意组合可以设置在器械10内以确定其操作阶段,例如,吻合钉钉仓负载检测以及其状态、关节式运动、夹紧、旋转、吻合、切割和收缩等。传感器能够通过旋转编码器、器械10的各种内部部件(例如,发射杆220、驱动电动机200等)的接近、位移或接触来启动。
在图示的实施例中,传感器能够为可变电阻器(例如,可变电阻装置)、电流监测器、电导传感器、电容传感器、感应传感器、热基传感器、限制启动开关、多位开关电路、压力传感器、线性和/或旋转可变位移传感器、线性和/或旋转电位计、光学编码器、铁磁传感器、霍尔效应传感器以及近程开关。传感器测量旋转、速度、加速度、减速度、线性和/或角位移、机械限制的检测(例如,停止)等。上述测量可以通过实施以线性或旋转的阵列安置在器械10的机械驱动部件上的多个指示器来实现。传感器随后将测量值传送给确定器械10的操作状态的微控制器500。另外,微控制器500还基于测量的反馈来调节器械10的电动机速度或扭矩。
如图11和图12所示,在离合器300实施为滑动离合器的实施例中,线性位移传感器(例如,线性位移传感器237,图4)位于离合器300的远侧以提供精确测量。在该配置中,离合器300的滑动量不影响传感器所记录的位置、速度和加速度测量值。
参考图4,负载开关230设置在壳体前端组件155内。开关230与电源400串连,防止微控制器500和器械10的启动,除非装载单元169正确装载到器械10内。如果装载单元169没有装载到器械10内,则与电源400的连接断开,从而防止器械10的任意的电子部件或电气部件的使用。这还防止从电源400引出任何可能的电流,使得电源400在其特定的储存寿命期间维持最大势能。
由于开关难以从外部操纵并且仅能够通过装载单元169的插入来启动,因此开关230作为防止器械10的错误启动的所谓“加电(power-on)”开关。在图18和图19中,随着装载单元169插入到内窥镜部140内通过使传感器板360移动到传感器管362而传感器管362使传感器帽364发生位移,开关230被启动。一旦开关230启动,来自电源400的电力供给到器械10的电子部件(例如,传感器、微控制器500等)以提供用户进入用户接口120和其它输入/输出设备的通路。这还启动可视化输出123以使其根据表示正确装载的装载单元169的光源组合来照亮,其中全部光源如表1所述关闭。
更特别地,如图18和图19所示,内窥镜部140包括在其中的传感器板360,该传感器板与也设置在内窥镜部140内且围绕发射杆220的远侧部224的传感器管机械接触。发射杆220的远侧部224穿过位于传感器帽364远侧末端的开口368。传感器帽364包括弹簧并且与开关230邻接。这使得传感器帽364相对传感器管362偏置,传感器管362位于传感器帽364的远侧末端而没有穿过开口368。因此,传感器管362的偏置随后将传感器板360推出。
当装载单元169被装载到内窥镜部140内时,近侧部171邻接传感器板360并且在近侧方向上移动板360。传感器板360随后在近侧方向上推动传感器管362,传感器管362随后施加压力到传感器帽364上,从而压缩弹簧366并且启动指示装载单元169已经正确插入的开关230。
一旦装载单元169被插入到内窥镜部中,开关230还基于装载单元169的位置来确定装载单元169是否正确装载。如果装载单元169没有正确装载,则没有开关会被启动并且错误代码通过用户接口120向用户传达(例如,如表1所述,全部光源关闭)。如果装载单元169已经被发射,则任意的机械闭锁件已经在之前启动或吻合钉仓已经被使用,器械10通过用户接口120传达错误,例如,第一光源123a闪烁。
在一个实施例中,接合到微控制器500(参见图6)的第二闭锁开关(未显示)可以在器械10中实施为设置在被构造为在用户抓取器械10时启动的手柄部112的顶面上或内部的生物电阻抗(bioimpedance)传感器、电容传感器或压力传感器。因此,除非器械10被正确抓取,否则所有开关被禁用。
参考图6,在一个实施例中,器械10包括用来确定和输出发射杆220的当前线性位置的位置计算器416。该位置计算器416电连接到线性位移传感器237,并且转速检测装置418被接合到驱动电动机200。装置418包括编码器420,该编码器420接合到电动机以产生两个或多个响应于驱动电动机200的旋转的编码脉冲信号。编码器420将脉冲信号发送给装置418,然后装置418确定驱动电动机200的转速。由于转速与发射杆220的线速度成正比,位置计算器416随后基于驱动电动机200的转速来确定发射杆的线速度和位置。位置计算器416和速度计算器422接合到微控制器500,微控制器500响应于来自计算器416和计算器422的感应反馈来控制驱动电动机200。下面将参考图20对该配置进行更加详细的讨论。
器械10包括设置在发射杆220上的第一指示器320a和第二指示器320b,所述指示器确定发射杆220的限度。线性位移传感器237确定发射杆220相对驱动管210和/或壳体110的位置。例如,限位开关(例如,轴开始位置传感器231和夹紧位置传感器232)可以通过感应第一指示器320a和/或第二指示器320b(例如,凸起、凹槽、锯齿痕等)穿过而启动,以确定发射杆220的限度和器械10的模式(例如,夹紧、抓取、发射、密封、切割、收缩)。此外,取决于联接在其中的特定装载单元的尺寸,从第一指示器320a和第二指示器320b接收到的反馈可以用来确定发射杆220应该在何时停止其轴向移动(例如,驱动电动机200应该何时中止)。
更特别地,随着发射杆220从其静止位置(例如,初始位置)在远侧方向上移动,位置传感器231的第一致动由指示器械10的操作已经开始的第一指示器320a来启动。随着操作的继续,发射杆220向更远侧移动以开始夹紧,从而移动第一指示器320a以与夹紧位置传感器232相接。发射杆220的进一步前进移动第二指示器320b以与指示器械10已经发射的位置传感器232相接。
如上所述,位置计算器416接合到邻近发射杆220设置的线性位移传感器237。在一个实施例中,线性位置传感器237可以为磁传感器。发射杆220可以包括磁铁或磁性特征件。磁传感器可以为铁磁传感器或被构造为检测磁场变化的霍尔效应传感器。随着发射杆220由于驱动电动机200的旋转而直线平移,由磁传感器记录磁场响应于平移运动的变化。磁传感器将与磁场变化相关的数据传输给位置计算器416,位置计算器416随后确定作为磁场数据的函数的发射杆220的位置。
在一个实施例中,发射杆220中的选定部可以是磁性材料,例如设置在发射杆220上的内螺纹部212的螺纹或其它凹槽(例如,指示器320a和/或指示器320b)可以包括磁性材料或由磁性材料制成。这使得随着发射杆220的磁化部直线平移,磁场内的周期变化与螺纹的每一次非连续平移相关。位置计算器416随后通过对磁场内的周期变化的数量求和来确定发射杆220的距离和位置,并且将该和与螺纹和/或凹槽之间的预定距离相乘。
在一个实施例中,线性位移传感器237可以为电位计或可变电阻器。发射杆220包括设置为与线性位移传感器237机电接触的触头(例如,弧刷端子)。随着驱动电动机200使发射杆220在远侧方向上移动,该触头沿着线性位移传感器237的表面滑动。随着触头滑动经过电位计和/或可变电阻器,电位计的电压和可变电阻器的电阻相应变化。因此,电压和电阻的变化被传输给位置计算器416,位置计算器随后推断发射杆220和/或发射杆联轴器190行进的距离及其位置。
在一个实施例中,位置计算器416接合到一个或多个开关421,随着发射杆220和发射杆联轴器190在远侧方向上移动,开关421由内螺纹部212的螺纹或指示器320a和/或指示器320b启动。位置计算器416计算启动开关421的螺纹的数量并且随后将该数量与螺纹或指示器320a和/或指示器320b之间的预定距离相乘。
器械10还包括速度计算器422,该速度计算器422确定线性移动发射杆220的当前速度和/或由驱动电动机200提供的扭矩。速度计算器422连接到线性位移传感器237,线性位移传感器237使得速度计算器422基于其位移变化的速率来确定发射杆220的速度。
速度计算器422接合到包括编码器426的转速检测装置424。编码器426传输与驱动电动机200的旋转相关的脉冲,速度计算器422随后使用所述脉冲来计算发射杆220的线速度。在另一个实施例中,速度计算器422接合到旋转传感器239,该旋转传感器239检测驱动管210的旋转,从而测量驱动管210的转速,使得可以确定发射杆220的线速度。
速度计算器422还接合到测量在驱动电动机200内感应的反电动势(“EMF”)的电压传感器428。驱动电动机200的反电动势电压与驱动电动机200的转速成正比,如上所述,驱动电动机200的转速用来确定发射杆220的线速度。
还能够通过在恒定电流条件下测量穿过其端子的电压来实现监测驱动电动机200的速度。驱动电动机200的负载的增加造成施加在电动机端子上的电压的降低,而电动机端子上电压的降低与电动机的速度的减小直接相关。因此,测量穿过驱动电动机200的电压提供了用于确定其上放置的负载。另外,通过监测电压随时间的变化(dV/dt),微处理器500能够检测与负载的大变化或驱动电动机200和/或电源400的温度增加相关的电压的快速下降。
在另一实施例中,速度计算器422接合到电流传感器430(例如,电流表)。电流传感器430与接合到驱动电动机200的分流电阻器432电连通。电流传感器430通过测量穿过电阻器432的电压降来测量驱动电动机200牵引的电流。由于用来为驱动电动机200提供动力的电压与驱动电动机200的转速成比例,因此与发射杆220的线速度成比例,速度计算器422基于驱动电动机200的电压势能来确定发射杆220的速度。
电流传感器430还可以接合到电源400来确定牵引的电流,牵引的电流可以用于分析在末端执行器160上的负载。这可能指示吻合组织的类型,因为不同的组织具有不同的拉伸特性,其影响施加在器械10和电源400和/或电动机200上的负载。
速度计算器422还可以接合到第二电压传感器(未明确示出)以确定电源400内的电压,从而计算从电源直接输出的功率。另外,电流随时间的变化(dI/dt)能够被监测以检测与通过驱动电动机200所施加的扭矩的大幅增加对应的测量中的快速尖峰脉冲。因此,电流传感器430用来确定驱动电动机200的扭距和负载。
另外,由速度计算器422测量的发射杆220的速度随后可以与驱动电动机200的牵引电流比较,以确定驱动电动机200是否正确操作。也就是说,如果牵引电流与发射杆220的速度(例如,低)不相称(例如,大),则电动机200处于故障中(例如,锁定、停转等)。如果检测到停转的情况,或牵引电流超过了预定的极限值,则位置计算器416确定发射杆220是否处于机械停止状态。如果发射杆处于机械停止状态,则微控制器500能够切断驱动电动机200或进入脉冲和/或暂停模式(例如,对驱动电动机200非连续供电),以防止电动机200、电池或电源400和微控制器500损坏,以将器械10解锁并且收缩发射杆220。
在一个实施例中,速度计算器422将由旋转传感器239检测到的驱动管210的转速和基于转速检测装置424的测量值的驱动电动机200的转速进行比较。如果在离合器300的旋转和驱动管210的旋转之间存在偏差,则所述对比使得速度计算器422可以确定是否存在离合器启动问题(例如,滑动)。如果检测到滑动,则位置计算器416确定发射杆220是否处于机械停止状态。如果发射杆处于机械停止状态,则微控制器500能够切断器械10或进入脉冲和/或暂停模式(例如,对驱动电动机200非连续供电),或者收缩发射杆220。
除发射杆220和其它驱动部件的线性和/或旋转位移之外,器械10还包括适于检测末端执行器160的关节式运动的传感器。参考图4,器械10包括旋转传感器241,旋转传感器241适于在由轴开始位置传感器231检测的程序开始时指示旋转壳体组件180的开始位置、旋转方向和角位移。指示器设置在旋转旋钮182的内表面上,旋转传感器241通过计算使旋转旋钮182发生了旋转的指示器的数量来操作。计算值随后被传输给微控制器500,微控制器500随后确定内窥镜部142的旋转位置。这可以无线地或通过内窥镜部上的电连接和连接到微控制器500的导线进行连通。
器械10还包括确定末端执行器160关节式运动的关节式运动传感器235。特征件263设置在关节式运动齿轮233上,该关节式运动传感器235计算使关节式运动旋钮176从其0°位置起旋转的特征件263的数量,该0°位置即关节式运动旋钮176的中心位置以及因此也是末端执行器160的中心位置,如图5所示。该0°位置能够由中心唯一指示器265指示,中心唯一指示器265也设置在与末端执行器160的第一位置对应的关节式运动齿轮233上,在第一位置处纵向轴线B-B与纵向轴线A-A大体成一直线。计算值随后传输给微控制器500,微控制器500随后确定末端执行器160的关节式运动位置并且通过接口120报告关节式运动角度。该特征件可包括凸起、磁性材料、发射器等。
另外,关节式运动角度能够用于所谓的“自动停止”模式。在该操作模式期间,在末端效应器160位于其中心第一位置时,器械10自动停止末端执行器160的关节式运动。也就是说,随着末端执行器160从纵向轴线B-B设置为与纵向轴线A-A成一角度的位置朝向第一位置作关节式运动,在纵向轴线B-B与纵向轴线A-A大体成一直线时关节式运动停止。该位置通过关节式运动传感器235基于中心指示器来检测。该模式使得内窥镜部140可以被取出,而无需用户不得不手动地对准末端执行器160。
参考图1,本公开提供了装载单元识别系统440,其允许器械10识别装载单元169及确定装载单元169的操作状态。识别系统440向器械10提供吻合钉尺寸、钉仓长度、装载单元169的类型、钉仓的状态、正确接合等信息。该信息允许器械调节夹紧力、夹紧及发射速度和用于不同长度吻合钉钉仓的行程的末端。
装载单元识别系统440也可以适于确定以及向器械10传达(例如,图20所示的控制系统501)各种信息,包括用于操作特定末端执行器160的速度、功率、扭矩、夹紧、行进长度及强度限制。控制系统501也可以确定操作模式以及调节用于部件的行进的电压、离合器弹簧负荷和停止点。更具体地说,识别系统可以包括设置在末端执行器160中的部件(例如,微芯片、发射机或发射器),所述末端执行器160与控制系统501或位于控制系统501内的接收器连通(例如,无线、经由红外线信号等)。还可以预想到,可以通过发射杆220发送信号,以使发射杆220作为用于在控制系统501与末端执行器160之间通信的管道。在另一实施例中,能够通过诸如反馈控制器603(图21-图23)的中间接口来发送该信号。
通过示例的方式,以上讨论的传感器可以用于确定吻合钉是否已经从吻合钉钉仓中发射、吻合钉是否被完全地发射、是否梁已经通过吻合钉钉仓向近侧收缩以及梁向近侧收缩的程度以及与装载单元的操作有关的其他信息。在本公开的特定实施例中,装载单元上装有用于识别装载单元的类型和/或装在器械10上的吻合钉钉仓的类型的部件,包括磁性的,光学的、红外线、细胞、射频或导体识别芯片。装载单元和/或吻合钉钉仓的类型可以由控制系统501中的相关接收器来接收,或由用于提供反馈、控制和/或库存分析的操作室中的外部设备来接收。
信息能够经由装载单元169与器械10之间的各种通信协议传输(例如,有线传输或无线传输)到器械10。所述信息能够存储在装载单元169内的微控制器、微处理器、非易失性存储器、射频识别标签及如光学、颜色、位移、磁、电、二进编码和格雷编码的各种类型的识别器中(例如,电导、电阻、电容、阻抗)。
在一实施例中,装载单元169和器械10分别包括对应的无线收发器、识别器442和询问机444。识别器442包括存储器或识别器442可以接合到用于存储与装载单元169有关的各种识别和状态信息的微控制器。一旦装载单元169接合到器械10,器械10经由询问机444向识别器442询问识别码。响应该询问,识别器442答复与装载单元169对应的识别码。在操作期间,一旦已发生识别,识别器442被构造为向器械10提供关于装载单元169的状态(例如,机械和/或电气故障、位置、关节式运动等)的更新。
识别器442和询问机444被构造为使用下列通信协议中的一个或多个来彼此通信,如蓝
Figure BSA00000388761000251
无线
Figure BSA00000388761000252
802.11 IEEE和其他无线电、红外线、UHF、VHF通信等。在一实施例中,收发器400可以是根据收发器402的询问能力而主动或被动的射频识别(RFID)标签。
图15A和图15B示出了具有各种类型的识别设备的装载单元169的另一实施例。参考图15A,示出了具有电识别器173的装载单元169的近侧端171。识别器173可以包括一个或多个电阻器、电容器、感应器,并与设置在内窥镜部140的远端上的对应的电触头181接合。该触头可以包括设置在内窥镜部中的集流环、电刷和/或固定触点。识别器173可以设置在装载单元169的任何位置上,并且可以形成在柔性电路或固定电路上,或可以直接位于装载单元169的表面上。
当装载单元169与内窥镜部140接合时,该触头施加小电流通过电识别器173。询问机触头也包括用来测量电阻、阻抗、电容和/或电识别器173的阻抗的对应的电传感器。电识别器173具有与装载单元169的识别码对应的独特的电气特性(例如,频率、波形等),因而,当装载单元169的电气特性被确定时,器械10基于该测定出的特性来确定装载单元169的特性。
在一个实施例中,识别器173可以是磁识别器,诸如格雷编码磁铁和/或具有预定的独特磁特性的铁节点,其通过识别码来识别装载单元169。磁识别器经由设置在内窥镜部140的远侧端的磁传感器(例如,铁磁传感器、霍尔效应传感器等)来读取。磁传感器将磁数据传输到器械10,器械10然后确定装载单元169的特性。还可以预见到,触头181表现为导电油墨或柔性电路的非接触天线,触头181激励电识别器173以发射频率识别信号。
图15B示出了具有一个或多个突起175的装载单元169的近侧端171。突起175可以为如各种尺寸的层状、凸起状、带状等任何形状。突起175与设置在内窥镜部140的近侧段内的对应的位移传感器183相接。当突起175插进内窥镜部时该传感器被移置。位移量由传感器来分析并被转变为识别数据,使得器械10确定吻合钉大小、钉仓长度、装载单元169的类型、正确接合等。位移传感器可以是能够被弹簧加载的开关、触头、磁传感器、光传感器、各种电阻器、线性和旋转可变位移传感器。开关被构造为基于它们的启动状态向器械10传输二进制编码。更具体地,一些突起175延伸出足以选择性地启动一些开关的距离,从而基于突起175的组合产生独特的编码。
在另一实施例中,突起175可以是颜色编码的。位移传感器183包括颜色传感器,该颜色传感器被构造为确定突起175的颜色以基于该颜色来测量装载单元169的一个或多个特性,并向器械10传输该信息。
图16示出了用于识别装载单元169和向器械10提供与装载单元169有关的状态信息的方法。在步骤650中,确定装载单元169是否正确地装载到器械10上。这可以通过检测是否已经与识别器173和/或突起175形成接触来确定。如果装载单元169被正确地装载,则在步骤652中,装载单元169向器械10传达就绪状态(例如,打开可视化输出123的第一光源)。
在步骤654中,器械10检验装载单元169是否已经在以前发射过。这可以通过在钉仓组件164(图9)内设置一个或多个发射传感器900来实现,该发射传感器900确定是否已经有吻合钉66发射。发射传感器900可以是开关或是熔丝,当滑块74向远侧方向推进时所述开关或熔丝被触发,滑块74向远侧方向推进表示末端执行器160正被使用。发射传感器900可以连接到识别器442,其存储指示以前发射状态的值。第二发射传感器900可放置在吻合钉66最后一排的远端,这样当该传感器900被触发时,则指示钉仓组件164的发射完成。
如果装载单元169被发射过,则在步骤656中,器械10提供错误响应(例如,闪烁可视化输出123的第一光源)。如果装载单元169没有被发射过,则在步骤658中装载单元169经由识别系统440向器械10提供识别和状态信息(例如,打开第一光源)。基于以下详述的步骤664中存储在识别器442的存储器中的已存储的“先前发射过”信号,做出装载单元169是否已经发射的判定。在步骤660中,器械10响应从装载单元169接收的信息来调节它的操作参数。
在步骤662中,用户通过器械10执行手术过程。一旦该手术过程完成且装载单元169已经被发射,器械10向装载单元169传输“先前发射过”信号。在步骤664中,装载单元169将“先前发射过”信号存储在识别器442的存储器中,用于以下讨论的步骤654中通过器械10的此后的询问。
参考图17,装载单元169包括设置在末端执行器160中用于检测被抓取对象的类型的一个或多个组织传感器,诸如识别非组织物体和组织类型物体。这些传感器也能够被构造为确定流过末端执行器160的钳夹构件之间的血量。更具体地,第一组织传感器177设置在砧座组件162的远侧部,第二组织传感器179设置在钉仓组件164的远侧部。传感器177和传感器179接合到识别器442,使得能向器械10的微控制器500传输传感器数据。
传感器177和传感器179适于在二者间产生呈一个或多个阵列或频率的场和/或波。传感器177和传感器179可以是声学、超声、铁磁、霍尔效应传感器、激光、红外线、射频或压电器件。传感器177和传感器179被校准用于忽略经常出现的如空气、体液和各种类型的人体组织的材料以及用于对特定的组织类型(例如疤痕组织、肺、胃、括约肌)分类,或者用于检测外来物质的特定类型。该外来物质可以是骨头、肌腱、软骨、神经、主动脉和如陶瓷、金属、塑料等非组织物质。
传感器177和传感器179基于由传感器产生的场信号的吸收、反射和/或滤波来检测经过砧座组件162与钉仓组件164之间的外来物质。如果材料减弱信号或反射信号,从而物质在校准范围外,因此是外来物质,则传感器177和传感器179向微控制器500传输干扰信息,微控制器500然后确定末端执行器160抓取的物质的类型。该确定可以通过比较干扰信号与查找表来做出,该查找表列出了各种类型的物质及它们的相关干扰范围。微控制器500然后警告用户抓取的外来物质以及外来物质的特性。这允许用户防止夹紧、切割或吻合通过含有外来物质的区域,或者控制系统501能够对于特定组织的情况改变驱动电动机200的执行方式。
图20示出了包括微控制器500的控制系统501,微控制器500接合到位置计算器416、速度计算器422、装载单元识别系统440、用户接口120、驱动电动机200和数据存储模块502。另外,微控制器500可以直接接合各种传感器(例如,第一组织传感器177、第二组织传感器179、负载开关230、轴开始位置传感器231、夹紧位置传感器232、关节式运动传感器235、线性位移传感器237、旋转传感器239、发射杆旋转传感器241、电动机和电池操作模块412、转速检测装置418、开关421、电压传感器428、电流传感器430、询问机444等)。
微控制器500包括存储用于控制器械10的操作和功能的一个或多个应用软件(例如,固件程序)的内置存储器。微控制器500处理来自用户接口120的输入数据并且响应该输入来调节器械10的操作。器械10的调节可以包括器械10的通电或断电、依靠电压调节或电压脉冲宽度调制来进行速度控制、通过减少占空比或脉冲式开启或关断电压以限制在预定时间段期间的平均传输电流来进行扭矩限制。
微控制器500经由用户反馈模块504接合到用户接口120,用户反馈模块504被构造为将器械10的操作参数通知用户。用户反馈模块504指示用户界面120在屏幕122上输出操作数据。特别地,来自传感器的输出被传输到微控制器500,微控制器500然后响应该输出向用户发送反馈来指示用户为器械10选择特定的模式、速度或功能。
装载单元识别系统440指示微控制器500哪个末端执行器位于装载单元上。在一实施例中,控制系统501能够存储与施加到发射杆220和/或末端执行器160上的力有关的信息,以使当装载单元169被识别时微控制器500自动为器械10选择操作参数。这使得能控制施加到发射杆220上的力,以便发射杆220能够驱动位于当时在使用中的装载单元上的特定末端执行器160。
在一个实施例中,微控制器500也分析来自位置计算器416和速度计算器422以及其他传感器的计算结果,以确定发射杆220的实际位置和/或速度以及器械10的部件的操作状态。该分析可以包括对来自计算器416和计算器422的感应反馈信号的解析,以响应该感应信号来控制发射杆220和器械10的其他部件的移动。微控制器500被构造为当位置计算器416报告发射杆220已经移动超过预定点时限制发射杆220的行进。可以由微控制器500使用来控制器械10的另外的参数包括电动机和/或电池温度、剩余循环以及已用循环的次数、剩余电池寿命、组织厚度、末端执行器的当前状态、传输和接收、外部设备连接状态等。
在一实施例中,器械10包括被构造为测量电流(例如安培计)、电压(例如电压计)、接近度(例如光学传感器)、温度(例如热电耦,热敏电阻等)和力(例如应变计,测力传感器等)以确定装载单元169上的负载状态的各种传感器。在器械10的操作期间,期望知道在接近处理期间和发射处理期间由器械10施加到目标组织上的力。对异常负载(例如超出预定负载范围)的检测指示出器械10和/或被夹紧组织遇到的问题,该问题被传达给用户。
负载状态的监测可以通过以下方法中的一个或多个来执行:监测驱动电动机200的速度、监测由电动机施加的扭矩、钳夹构件162和钳夹构件164的接近度、监测器械10的部件的温度、经由应变传感器185(图4)来测量发射杆220和/或器械10的其他负载承受部件上的负载。以上结合图6及速度计算器422讨论了速度和扭矩的监测。
测量钳夹构件162与钳夹构件164之间的距离也能够指示在末端执行器160和/或器械10上的负载状态。当大量的力施加到钳夹构件162和钳夹构件164上时,钳夹构件向外偏转。在正常操作期间,钳夹构件162和钳夹构件164彼此平行,但是在变形期间,钳夹构件彼此间成一角度。因而,测量钳夹构件162与钳夹构件164之间的角度使得能够确定由于施加在其上的负载所引起的所述钳夹构件的变形。钳夹构件可以包括图17所示的应变计187和应变计189以直接测量施加在钳夹构件上的负载。可选地,能够在钳夹构件162和钳夹构件164的远尖端上设置一个或多个接近度传感器191和接近度传感器193,以测量钳夹构件162和钳夹构件164之间的角度。然后,这些测量结果被传输到微控制器500,微控制器500分析该角度和/或应变测量结果并警告用户在末端执行器160上的应力。
在另一实施例中,发射杆220或其他负载承受部件包括设置在其上的一个或多个应变计和/或负载传感器。在高应变条件下,施加在器械10和/或末端执行器160上的压力被转移到发射杆220使得发射杆220偏转,导致其上的应变增加。然后,应变计向微控制器500报告应力测量结果。在另一实施例中,可以在离合器盘302上设置位置、应变或力传感器。
在接近处理期间,当末端执行器160夹紧组织时,设置在器械10和/或末端执行器160中的传感器向微控制器500指示末端执行器160围绕异常组织(例如,低或高负载条件)布置。低负载条件指示末端执行器160抓取少量组织,高负载条件指示抓取过量组织和/或外来物体(例如管、吻合线、夹子等)。此后,微控制器500经由用户接口120向用户指示应该选择更合适的装载单元169和/或器械10。
在发射处理期间,传感器能够警告用户各种错误。传感器可以向微控制器500传达吻合钉钉仓或器械10的一部分有错误。另外,传感器能够检测施加在刀具上的力的突发尖峰脉冲,这指示出碰到了外来物体。力的尖峰脉冲的监测能够用于检测发射行程的结束,例如,当发射杆220碰到吻合钉仓的末端并且进入硬停止时。硬停止产生比在器械10的正常操作期间观察到的力的尖峰脉冲相对更大的力的尖峰脉冲,并且能够用于向微控制器指示发射杆220已经到达装载单元169的末端。力的尖峰脉冲的测量可以与关于位置计算器416及速度计算器422讨论的位置反馈测量结果(例如来自编码器、线性可变位移传感器、线性电压计等的测量结果)相组合。这使得器械10不更改末端执行器160就可以使用各种类型的吻合钉钉仓(例如,多种长度)。
当遇到力的尖峰脉冲时,器械10通知用户该状态并通过进入以下将更详细地描述的所谓的“脉冲”,或脉冲宽度调制(PWM)或电子离合模式而采取预防措施。在该模式期间,驱动电动机200被控制为仅在短脉冲时运行,以使抓取的组织与末端执行器160之间的压力均衡。电子离合限制由驱动电动机200施加的扭矩并防止从电源400流出大量电流的情况。这依次防止了由于伴随着过载和高牵引电流情况而产生的过热引起的对电子部件和机械部件的损坏。
微控制器500经由脉冲宽度调制控制信号来通过电动机驱动器控制驱动电动机200。电动机驱动器被构造为在顺时针方向或逆时针方向上调节驱动电动机200的速度。电动机驱动器还被构造为在多个操作模式之间切换,多个操作模式包括电动机电子制动模式、恒速模式、电子离合模式和受控电流启动模式。在电子制动模式中,虑及紧固件停止以及调节发射杆220的线性位置有更高的位置精度,驱动电动机200的两个端子被缩短,产生的反电动势抵消驱动电动机200的旋转。
在恒速模式中,速度计算器422与微控制器500和/或电动机驱动器联合来调节驱动电动机200的转速,以保证发射杆220的恒定线速度。电子离合模式涉及响应来自位置计算器416和速度计算器422的感应反馈信号使离合器300与驱动电动机200反复接合和/或分离。在受控电流启动模式中,电流以斜线上升或下降以防止当在静态模式与动态模式之间转变时出现的过高的破坏电流和扭矩以提供所谓的“软启动”和“软停止”。
数据存储模块502记录来自与微控制器500接合的传感器的数据。另外,数据存储模块502记录在手术过程期间装载单元169的识别码、末端执行器100的状态、吻合循环的次数等。数据存储模块502还被构造为通过无线或有线数据端口503连接到外部设备,如个人计算机、PDA、智能手机、存储装置(例如,Secure
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card,Compact
Figure BSA00000388761000302
card,
Figure BSA00000388761000303
等)。这使得数据存储模块502传输执行数据到外部设备用于随后的分析和/或存储。数据端口503也允许微控制器500的固件的所谓“在场中(in the field)”的升级。
图21-图23示出了反馈控制系统601。该系统包括图22A-图22B示出的反馈控制器603。器械10经由有线(例如
Figure BSA00000388761000304
等)或无线(例如,蓝无线
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802.11 IEEE和其他无线、红外线、UHF、VHF通信等)的数据端口502连接到反馈控制器603。
参考图21,反馈控制器603被构造为存储由器械10传输到其的数据以及处理和分析所述数据。反馈控制器603还连接到其他设备,如视频显示器604、视频处理器605和计算装置606(例如,个人计算机、PDA、智能手机、存储装置等)。视频处理器605用于处理由反馈控制器603生成的输出数据以用于向视频显示器604输出。计算装置606用于另外处理反馈数据。在一实施例中,由微控制器600执行的传感器反馈分析的结果可以内部存储用于由计算装置606以后提取。
反馈控制器603包括接合到微控制器600的数据端口607(图22B),数据端口607使得反馈控制器603连接到计算装置606。数据端口607可以提供与计算装置606的有线和/或无线通信,计算装置606提供在计算装置606与反馈控制器603之间的接口,用于提取存储的反馈数据、反馈控制器603的操作参数的构造和反馈控制器603的固件和/或其他软件的升级。
在图22A-图22B中进一步示出了反馈控制器603。反馈控制器603包括壳体610和如视频输入614、视频输出616、平视(“HUD”)显示输出618的多个输入和输出端口。反馈控制器603还包括用于显示关于反馈控制器603的状态信息的屏幕620。
图23示出了反馈控制器603的部件。反馈控制器603包括微控制器600和数据存储模块602。微控制器600和数据存储模块602提供与器械10的微控制器500和数据存储模块502类似的功能。将这些部件设置在呈反馈控制器603形式的独立模块中,这减轻了在器械10中具有这些部件的需要。
数据存储模块602可包括一个或多个内部和/或外部存储设备,如磁性硬盘驱动器、闪存(例如Secure
Figure BSA00000388761000311
等)。反馈控制器603使用数据存储模块602以存储来自器械10的反馈数据,用于由计算装置606进行的随后的数据分析。反馈数据包括由设置在器械10中的传感器等供给的信息。
微控制器600被构造为代替和/或补充器械10的控制电路,如果该控制电路存在。微控制器600包括存储用于控制器械10的操作和功能的一个或多个应用软件(例如,固件)的内置存储器。微控制器600处理来自用户接口120的输入数据并响应该输入来调节器械10的操作。微控制器600经由用户反馈模块504接合到用户接口120,用户反馈模块504被构造为通知用户器械10的操作参数。更具体地,器械10被构造为经由数据端口407(图6)无线地或通过有线连接连接到反馈控制器603。
在公开的实施例中,微控制器600连接到驱动电动机200,并被构造和设置为监控电池阻抗、电压、温度和/或牵引电流(current draw)并且控制器械10的操作。确定电池400、变速器、驱动电动机200和器械10的驱动部件上的负载,如果所述负载指示达到或接近损坏限制则控制电动机速度。例如,可以确定电池400中剩余的能量、剩余发射次数、是否必须替换电池400或为电池400充电、和/或器械10的势能负载限制的接近。微控制器600还可以连接到器械10的上述一个或多个传感器上。
微控制器600还被构造为响应监控到的信息来控制驱动电动机200的操作。脉冲调制控制系统可以用于控制器械10,脉冲调整控制系统可以包括电子离合器。例如,微控制器600能够调节驱动电动机200的电压供给,或向驱动电动机200供给脉冲调制信号来调节功率和/或扭矩输出以防止系统损坏或优化能量使用。
在一实施例中,电力制动电路可以用于控制驱动电动机200,其使用旋转的驱动电动机200的现有的反电动势来抵消和大致减少驱动管210的动量。电力制动电路改善驱动电动机200和/或驱动管210的控制得到良好的停止精度和/或动力手术器械10的转移位置。用于监控动力手术器械10的部件及有助于防止动力手术器械10的过载的传感器可以包括如热传感器、热敏电阻器、热电堆、热电偶和/或热红外线成像的热型传感器,并且向微控制器600提供反馈。在达到或接近限制的情况下,微控制器600可控制动力手术器械10的部件,这种控制可以包括切断来自电源400的电力、暂时中断电力或进入暂停模式和/或脉冲调制以限制使用的能量。微控制器600也能够监控部件的温度以确定何时能够恢复操作。微控制器600的上述使用可以单独使用或以电流、电压、温度和/或阻抗测量值为因素来使用。
由微控制器600分析和处理数据的结果被输出到视频显示器604和/或HUD显示器622。视频显示器604可以是如LCD屏幕、等离子屏幕、电发光屏幕等的任何类型的显示器。在一实施例中,视频显示器604可包括触摸屏,并且可结合电阻的、表面波纹、电容的、红外的、应变计、光学的、离散信号或声音脉冲识别触摸屏技术。该触摸屏可以用于使得用户在观看操作反馈的同时提供输入。HUD显示器622可以突设在手术过程期间用户可以看到的任何表面上,如一副眼镜和/或护目镜的透镜、面罩等。这使得用户不用失去对程序的关注就可以看到来自反馈控制器603的重要反馈信息。
反馈控制器603包括屏幕显示模块(on-screen display module)624和HUD模块626。模块626处理微控制器600的输出用于分别显示在显示器604和显示器622上。更具体地,OSD模块624将来自反馈控制器603的文本和/或图形信息覆盖在经由设置在其中的摄像头从手术位置接收到的其他视频图像上。具有覆盖文本的修正后的视频信号被传输到视频显示器604,使得用户在仍然观察手术位置的同时看到来自器械10和/或反馈控制器603的有用的反馈信息。
图24-图25示出了器械10′的另一实施例。器械10′包括具有设置成直线构造的多个电池单元401的电源400′。电源400′垂直地插入位于手柄部112内的垂直电池室800中。电池室800包括位于其顶部的弹簧触头802以向下推动电源400′。在一实施例中,弹簧触头802可以包括与电源400′电接合的触头。电源400′经由电池盖804保持在电池室800中,电池盖804被构造为沿远侧方向滑动以锁止在适当位置。盖804和手柄部112可包括舌状物和槽接合器以防止盖804滑出。由于弹簧触头802向下的力使电源400′偏压盖804。当盖804在近侧方向上滑动时,电源400′被弹簧触头802从电池室800中弹出。
图25示出了检测驱动管210的旋转从而测量驱动管210的转速的旋转传感器239的另一实施例,测量驱动管210的转速使得能确定发射杆220的线速度。旋转传感器239包括光读取器812(例如光电断路器)和安装在驱动管210上的编码器轮810。光读取器812被构造为确定在两个相对的边缘814和816之间连续提供的光束的中断的次数。编码器轮810与驱动管210一起旋转,并包括通过其中的多个狭缝811。
编码器轮810的外边缘设置在光读取器812的相对的边缘之间,以使在边缘814与边缘816之间传输的光通过狭缝811传播。换句话说,当旋转驱动管210时,边缘814与边缘816之间的光束被编码器轮810中断。光读取器812测量光束中断的次数及其发生的速率并将这些测量结果传输到速度计算器422,速度计算器422然后确定上述发射杆220的速度。
图27-图32示出了具有用于将发射杆220从其发射位置收缩的收缩组件820的器械10′。收缩组件820为驱动管210提供手动从动机械接口,以使得通过该收缩组件820的齿合动作来手动收缩发射杆220。这在某些情况下有用,使得器械的用户手动控制发射杆220的位置(例如,电气故障、卡住末端执行器160等)。收缩组件820可被构造为能够插进器械10′中的模块组件。
参考图30,收缩组件820包括具有顶部823和底部825的收缩底盘822。收缩组件820经由驱动齿轮826和收缩齿轮824与驱动管210机械相接。第一正齿轮830刚性联接到收缩齿轮824上。驱动齿轮826联接到驱动管210上,并响应驱动管210的旋转平移。相反地,驱动齿轮826的旋转将旋转传给驱动管210。驱动齿轮826和收缩齿轮824可以是使得收缩齿轮824和驱动齿轮826以正交方式相接的锥齿轮。
收缩齿轮824接合到第一心轴828,第一心轴828以基本正交的方式设置在收缩底盘822的顶部823与底部825之间。第一心轴828能够围绕其限定的纵向轴线旋转。第一心轴828进一步包括联接到第一心轴828和收缩齿轮824上的第一正齿轮830。第一正齿轮830与设置在第二心轴834上的第二正齿轮832相接,第二心轴834也以基本垂直的方式设置在收缩底盘822的顶部823与底部825之间,并且能够围绕其限定的纵向轴线旋转。
第二正齿轮832与设置在第一心轴828上的第三正齿轮836机械相接。第三正齿轮836联接到单向离合器组件840的第一离合器部838上。如图31所示,离合器组件840进一步包括旋转地设置在第一心轴828上的第二离合器部842,第二离合器部842位于第一离合器部838上方,且弹簧843设置在第一离合器部838和第二离合器组件842之间,从而将第一离合器部838和第二离合器部842偏压向隆高的非互锁构造(例如,第一构造)。
驱动管210和/或驱动齿轮826的旋转将旋转传给收缩齿轮824和第一正齿轮830、第二正齿轮832和第三正齿轮836,以及第一离合器部838和各个心轴828和834。因为,第二离合器部842能够围绕心轴828旋转并通过弹簧843而与第一离合器部838分离,第一离合器部838的旋转不会转移到第二离合器部842。
第一离合器部838和第二离合器部842包括多个互锁齿844,互锁齿844具有扁平互锁面846和倾斜滑动面848(图30)。收缩组件820通过收缩杆845致动。如图32所示,第二离合器部842被收缩杆845向下推动从而与互锁齿844相接。滑动面848使得互锁面846彼此接触,从而使第二离合器部842旋转以旋转第一离合器部838和所有相接的齿轮。
收缩杆845包括联接到其上的凸轮部847和手柄849。凸轮部847包括开口853,开口853容纳单向打捆针传动离合器(needle needle)855,单向打捆针传动离合器855与可操作地接合到第一心轴828上的配合件856机械协作,从而使得收缩杆845围绕第一心轴828旋转。
参考图29,收缩杆845包括各自具有凸轮面852的一个或多个凸轮件850。在第一构造中,如图27所示,收缩杆845沿壳体110的杆容纳部(lever pocket)860设置。通过将收缩杆845嵌套在壳体110中,能使用更长的杆,这给予用户相比其它手动收缩系统更大的机械优势。收缩杆845被弹簧843上推动而抵靠在顶部823上,凸轮件850设置在对应的凸轮容纳部858中。收缩杆845也由安装在顶部823与凸轮部847之间的回拉弹簧862保持在第一构造中。凸轮件850和杆容纳部860限制了收缩杆845的旋转范围。
当收缩杆845被拉出杆容纳部860时,凸轮件850与对应的凸轮容纳部823相接并在向下的方向上推动收缩杆845的凸轮部847。该向下移动使弹簧843压缩并且推动第一离合器部838和第二离合器部842一起互锁齿844,从而啮合第二构造中的离合器部838和离合器部842。凸轮部847在逆时针方向上的旋转致动打捆针传动离合器855,打捆针传动离合器855与配合件856相接且轴向接合到第一心轴828上。收缩杆845的连续旋转使离合器组件840旋转,离合器组件840依次旋转配合件856,配合件856与此时与下离合器838匹配的上离合器842锁定。该下离合器838固定到第三正齿轮836上,然后驱动正齿轮836、832和830、收缩齿轮824和驱动齿轮826。这进一步旋转驱动管210并且收缩驱动杆220。
如图28所示,收缩杆845能够旋转直到手柄849抵接壳体110。此后,收缩杆845被跨坐在径向槽854内的回拉弹簧862带回到其第一构造。这使凸轮部847升高使得第二离合器部842也向上移动并与第一离合器部838分离。打捆针传动离合器855松开配合件856,允许收缩杆845返回第一构造,而不影响驱动管210的移动。一旦收缩杆845返回到第一构造,收缩杆845可以再次收缩以继续逐步移动(ratchet)驱动杆220。这样,该组件可被设置为使得收缩杆845一次或多次移动进而部分或完全地收缩发射杆220。
关于本公开的其它方面,为了改进将医疗垃圾最小化的技术现状,依据本发明,为防止电池供电的手术器械的电池污染,可以考虑采用一个密封的电池组隔室,和/或密封的器械壳体和/或密封的手柄组件作为手术器械的部分。这样,在一个实施例中,密封电池组的范围能够从电池组扩展到手柄组件甚至在另一实施例中扩展到器械壳体。
更特别地,参见图33-图36,图示了手术器械10″。除了手术器械10″包括例如与电池室或隔室800不同的电池室或隔室800′的至少一个电池保持结构外,手术器械10″和手术器械10′基本相同。另外,尽管手术器械10′也包括动力头,手术器械10″包括被构造为包含电池室或隔室800′的动力头900′。在此定义,动力头900′是手术器械10″的从壳体110的近侧部118延伸到壳体部分110的远侧部118′的部分。如下面关于图38和图4-图12所定义的,动力头900′包括一组操作部件,该组操作部件提供电力和操控手术器械10″并且被安装在壳部110内或附近。为了参考,电池室800′包括上端800′a和下端800′b。如图35和图36所示,形成电池组451的至少一个电池451′或多个单元或电池451′可以如图35中所示的并排结构451a定向,或者如图36中所示的端对端结构451b来定向。在此定义,除电池单元451′外,电池还可包括存储电荷的电容或感应线圈、或燃料电池或其它合适的电力供给机构。呈现结构451a和451b的电池单元451′提供了便于从电池室800′中弹出单元或电池组451′的单元分布/形状/结构,从而无论在弹出过程中或弹出过程后都避免了对单个电池单元451′或电池组451的医疗污染。并排结构451a中的电池组具有端子连接器条902,端子连接器条902可选择地在电池单元451′的正极端子和负极端子之间延伸并且连接电池单元451′的正极端子和负极端子。在结构451a中,电池组451包括上端452a′和下端452a″。
端对端结构451b中的电池组包括端子连接器条902,端子连接器条902仅布置在电池单元451′的纵端处。在结构451b中,电池组451包括上端452b′和下端452b″。对准柱和/或键920可位于电池组451的周边或外部,以确保电池组在配对/载入到电池室800′中时正确定向。正确定向还能够确保在电池室800′或装置的壳体内正确的电池端子极性。
电触头906可以布置在电池室800′的上端800′a处以与在特定电池组451上的对应电极端子匹配并且与电源电路(未示出)电连通。触头906可提供至少两种功能。
参见图34,在一个实施例中,触头906可为弹簧加载的正电接头和负电接头802。在通过电池室端口910将电池组451载入电池室800′的期间,电池组结构451a或者451b的上端452a′、452b′分别通过室端口910插入,直到其与由弹簧加载并且位于室800′的上端800′a的触头906形成接触,使得对准键920能够通过插座(未显示)正确地对准在室800′内。电池室800′在器械壳体110内具有肋条904,以便抓住、分离及容易地弹出电池组451。肋条904有助于容纳和对准电池组451并且在形成动力头900′的至少一个电池保持结构的电池室800′内限定电池弹出路径。
当触头906由于与电池组451接触而受压缩时,该触头906产生了趋向于在如箭头A所示的方向上朝向电池室800′的下端800′b向后通过室端口910而弹出电池组451的压缩力,从而进一步限定穿过室端口910的电池弹出路径。
电池室进入门912被构造成在室800′的下端800′b与室端口910密封相接。进入门912通过偏置铰链或者枢轴连接器914可旋转地安装在手柄部112上,所述偏置铰链或枢轴接头914被设置为能够使该进入门912如箭头B所示向下或向上,相应地远离室端口910或者靠近室端口910,旋转地摆动,以分别暴露或者密封室端口910。铰链或枢轴连接器914可包括弹簧(未显示)以平衡额外闭合力,如下文中说明的。进入门912包括如箭头B所示的向下和向上旋转摆动的自由端912a和安装在铰链或枢轴连接器914处的固定端912b。该自由端912a被构造为接收端916以与插锁上的倒钩接合或容纳倒钩,如下文中所述。如图34所示,在一个实施例中,铰链或枢轴连接器914安装于手柄部112的远侧112b。
如上所述,插锁930包括具有端部930a′的上臂930a和具有下端部930b′的下臂930b,枢轴连接器932被设置为使得该插锁930能够绕枢轴连接器932旋转摆动,插锁930通过枢轴连接器932被可移动地安装在手柄部112内邻近近侧112a,使得插锁930的端部930a和端部930b可选择地朝向或远离近侧112a摇动。插锁930的下臂930b被构造为接合端或倒钩934,接合端或倒钩934与进入门912的接收端916相接合或啮合,从而接合插锁930的端部或倒钩934。
在一个实施例中,能量储存机构936,例如压缩弹簧,也可被设置在手柄部112在近侧112a的内部,以限制该插锁930的上臂930a在近侧方向上朝向近侧112a的运动并且偏置上臂930a朝向远侧112b的运动。
电池室进入致动机构940,例如所示出的细长的按钮,可以设置在手柄部112的近侧112a的凹槽孔942中。电池室进入致动机构940被构造为由手术器械10″的用户致动。凹槽孔942穿透近侧112a并且实现电池室进入致动机构940和插锁930的下臂930b之间的接触。
当电池室进入致动机构940朝向远侧112b在远侧方向上受压时,电池室进入致动机构940在远侧方向上推进下臂930b,从而迫使插锁930抵抗弹簧936的压缩力而围绕枢轴连接器932可旋转地摆动,并且使得插锁930的接合端或倒钩934和进入门912的接收端916分离。插锁930的接合端或倒钩934和进入门912的接收端916的分离使得进入门912通过绕铰链或者枢轴连接器914枢转而可旋转地摆动或在箭头B的方向上向下旋转,从而将进入门912从如图所示的关闭位置改变到打开位置(未显示)并且至少部分暴露室端口910。将电池室进入致动机构940布置在凹槽孔942中减小了在手术程序期间对电池组451意外致动的可能性。联锁特征件(未显示),例如,诸如帽的机械特征件,可被设置为在手术过程期间将电池室进入致动机构940锁定。如果电池组451在手术过程期间不能适当地完成工作,可从操作区域中移走动力头900′以执行电池组451的弹出。
进入门912的旋转或摆动进一步通过由触头906产生的压缩力实现,如上所述,该压缩力趋向于在如箭头A显示的方向上朝向电池室的下端800′b向后通过室端口910而弹出电池组451。进入门912的旋转或摆动与压缩力结合再加上重力的帮助能够使电池组451克服约束摩擦力并在可以包括重力方向的方向上弹出,以进入用来充电的、无危险的废物处理或者回收的无菌环境或容器中。电池组451的流线型结构和电池室800′内提供的肋条904一起有助于电池组451从电池室800′的装载和弹出。这样,手术器械10″被构造为用户单手能够弹出电池组451中的至少一个电池单元451′,而不存在对电池单元451′的医疗污染。这样,进入致动机构940通过打开进入门912而提供进入电池室800′的入口。实际上,进入门912用作动力头900′的铰接壳体盖。更特别地,由于电池室800′形成动力头900′的至少一个电池保持结构,该电池保持结构进一步包括铰接盖或进入门912。当该铰接盖或进入门912处在关闭位置时,该铰接盖或进入门912防止接近至少一个电池451′,而当该铰接盖或进入门912处于打开位置时,该铰接盖或进入门912使得能够沿着电池弹出路径从至少一个电池保持结构弹出至少一个电池451′。
另外,触头906的弹簧加载的正电接头和负电接头802提供了如下的机构:该结构可切断或中断从电池组451到动力头900′内的所有外部触头(包括到至少一个电气部件)的电连接或电连通,以辅助处理和处置电池组451。在这里定义,电气部件包括电子部件。
可以预想,切断或中断与电池组451的电连接或电连通的结构可进一步包括易断的箔片或线桥。还可以预想,将缓慢放电的电阻或电路合并到动力头900′中,以在安全的低温率下使电池缓慢漏电以进一步有助于处理和处置。
在单独的实施例中,按钮可以是用来激活一个或多个螺线管来弹出电池的开关,其中该螺线管可平移输出轴以打开电池门和/或释放弹力。例如,能量储存机构936,例如压缩弹簧,还可以布置在手柄部112在近侧112a的内部以限制插锁930的上臂930a朝向近侧112a在近侧方向上的运动并且偏置该上臂930a朝向远侧112b的运动,能量储存机构936可以用被电池室进入致动机构940激活的螺线管(未显示)来代替。
通过销或插锁能够使用于电池组451的弹簧弹射力的全部或部分不影响电池组或与电池组隔离,使得电池组451在日常操作时一般不会受到弹簧802的压缩力。然后,弹簧802的合成潜在能量能够通过一个在电池弹出按钮被按下时启动的单独机构(未显示)来释放。
在一个实施例中,如图33-图34所示,手术装置或器械10″的动力头900′进一步包括至少一个密封构件950,该密封构件950围绕一个或多个电池保持结构(例如电池室800′)延伸,使得该密封构件950被构造为能够从例如电池室800′的一个或多个电池保持结构中,沿着如上所述的电池弹出路径弹出电池组451的至少一个电池单元451′、或者弹出整个电池组451,而不会有对电池单元451′(一个或多个)或电池组451的污染。密封构件950可合并形成在密封构件950的周界的O形圈或垫圈960,该O形圈或垫圈960可以从手柄部112的近侧112a的位置960a延伸到手柄部112的远侧112b的位置960b,以使进入门912在弹出电池单元451′(一个或多个)或电池组451期间打开。
在一个实施例中,手术装置或器械10″的动力头900′包括手柄组件,例如手柄部112,其中手柄组件或手柄部112包括例如电池室800′的一个或多个电池保持结构,并且其中至少一个密封构元件952围绕手柄组件或手柄部112或一个或多个电池保持结构(例如电池室800′)延伸,使得一个或多个密封构件952被构造为能够从例如电池室800′的一个或多个电池保持结构,沿着如上所述的电池弹出路径弹出至少一个电池单元451′或整个电池组451,而不会有对电池单元451′或电池组451的医疗污染。以与密封构件950类似的方式,密封构件952可合并O形圈或垫圈960,O形圈或垫圈960可以从手柄部112的近侧112a的位置960a延伸到手柄部112的远侧112b的位置960b,以使得在弹出电池单元451′(一个或多个)或电池组451期间能够打开进入门912。
在一个实施例中,手术装置或器械10″的动力头900′包括器械壳体,例如器械壳体110,其中该器械壳体110包括例如电池室800′的一个或多个电池保持结构,其中密封构件954围绕器械壳体110或例如电池室800′的一个或多个电池保持结构延伸,以使得一个或多个密封构件954被构造为能够从例如电池室800′的一个或多个电池保持结构弹出至少一个电池单元451′或整个电池组451,而不会有对电池单元451′(一个或多个)或电池组451的医疗污染。同样,如密封构件950和952,密封构件954可合并O形圈或垫圈960,O形圈或垫圈960可以从手柄部112的近侧112a的位置960a延伸到手柄部112的远侧112b的位置960b,以使得在弹出电池单元451′(一个或多个)或电池组451期间能够打开进入门912。
从上述对动力头900′的密封构件950、952和954的描述中能够理解,该密封构件950,952和954在电池组451和其他壳体部件之间提供了整体或分离的密封件或垫圈或粘合系统,同时允许在电池组451和可为弹簧加载的正电接头和负电接头802的触头906之间进行电连通。
同样可从上文中可知,本公开也涉及具有例如电池室800′的至少一个电池保持结构的动力头900′,所述电池保持结构被构造为保持至少一个电池单元451′。一个或多个电池保持结构被构造为能够,例如,沿着由电池室800′内的肋条904限定的电池弹出路径弹出电池单元451′(一个或多个),而不会有对电池单元的医疗污染。
在一个实施例中,例如电池室800′的至少一个电池保持结构,被构造为用户单手能够弹出电池单元451′(一个或多个)。例如,通过沿着电池室800′内的肋条904限定的电池弹出路径弹出而弹出电池单元451′(一个或多个),而不会有对电池单元的污染。
在一个实施例中,如图34所示,动力头900′包括至少一个能量储存机构(例如弹簧802),该能量储存机构可操作地接合到例如电池室800′的一个或多个电池保持结构,其中例如弹簧802的一个或多个能量储存机构的致动使得能够通过沿着由电池室800′内的肋条904限定的电池弹出路径的弹出来弹出电池单元451′(一个或多个),而不会有对电池单元的污染。
以与如上所述能量储存机构936类似的方式,弹簧802可以用由电池室进入致动机构940激活的螺线管(未显示)来代替。
在一个实施例中,同样如图34所示,该动力头900′包括例如弹簧802的至少一个能量储存机构,所述能量储存机构可操作地接合到例如电池室800′的一个或多个电池保持结构,并且能量储存机构被构造为:其中通过致动电池室进入致动机制940来致动例如弹簧802的一个或多个能量储存机构,使用户单手能够弹出电池单元451′(一个或多个),并且所述动力头900′被构造为:其中通过例如沿着由电池室800′内的肋条904限定的电池弹出路径弹出使得用户单手弹出电池单元451′(一个或多个)能够弹出电池单元451′(一个或多个),而不会有对电池单元的污染。
再返回到图4-图12,如上文所述,图4-图12示出了器械10的各种内部部件,包括驱动电动机200、驱动管210和具有近侧部222和远侧部224的发射杆220。该驱动管210能围绕贯通其中的驱动管轴线C-C旋转。驱动电动机200被设置为与驱动管210机械协作并且被构造为使驱动管210围绕驱动齿轮轴线C-C旋转。在一个实施例中,驱动电动机200可为电动电动机或齿轮电动机,其可以包括并入其壳体内的齿轮。
如图3所示,壳体110可以由两个半部110a和110b构成。两个壳体半部110a和110b可利用凸台定位器111处的螺杆彼此联接,凸台定位器111使壳体部110a和110b对准。在一个实施例中,可以使用超声焊接控制器将半部110a和110b联接在一起以密封该壳体使其免于外部污染。另外,壳体110可以由塑料形成并且可以包括通过两次(two-shot)模制处理施加到壳体110的内表面的橡胶支撑构件。橡胶支撑构件可以把驱动部件(例如,驱动电动机200)的振动与器械10的其余部分隔开。
壳体半部110a和110b可以通过塑料薄片(例如,活动铰链)彼此联接,塑料薄片使半部110a和半部110b相互连接,允许壳体110可以通过分离半部110a和半部110b而打开(见图3)。
在一个实施例中,驱动部件(例如,包括驱动电动机200、驱动管210和发射杆220等)可以安装到支撑板上,允许在器械10已经使用后从壳体110移走驱动部件。与铰接壳体半部110a和110b一起安装的支撑板提供了对特定内部部件的重复利用和循环利用,同时限制了对特定内部部件的污染。
更具体地,通过将用于手术器械或装置的单独的、内部的结构构件或底盘设置为支撑板,能够制造出更强大和更高精度的组件,其易于组装、维护、再加工、再使用或重复利用。
通常,与所有包含性手柄组件盖、例如具有至少第一壳体部110a和第二壳体部110b的壳体110相比,当使用类似的制造工艺来制造时,该结构构件或底盘能够更小,因此在尺寸上更加精确。能够将额外的基准面和定位特征件设计到结构构件或底盘中,因为结构元件和底盘的几何结构基本上独立于壳体110的外表面设计。壳体110的外表面几何形状会阻碍多方面的强度并且限制“净成形”模制特征件的多个方面。
对于结构构件或底盘,也能够采用更高精度的制造方法或工艺,从而相比于手柄组件盖能够提高精确度和降低所要求的公差。该结构构件或底盘与手柄组件盖相比,可由更高强度/性能的材料和/或附加结构形成,从而提高壳体110内包含的至少操作部件的坚固度和使用寿命。也就是说,额外的精度、对准和强度能够有益于手术器械10或10′的机构、轴承、齿轮、离合器和/或联轴器,特别是对于由在较高线性和/或旋转速度/负载下运行的机电或气缸子系统驱动和/或供以动力的器械。来自结构构件或底盘的附加结构能支撑极度或重复疲劳负载,从而防止变形,而变形会导致不对准和/或机械故障。
将紧固件安装点和/或特征件结合到结构构件或底盘的侧部使得壳体部110a和110b可在保持所有功能组件对准的同时容易地被移除或更换。部件可从多个接近平面组装,从而简化手术器械的整体组装、维修、再加工、再使用和回收。
参见图37-图43,手术器械10″的动力头900′包括限定了多个端口或凸台定位器111的第一壳体部110a和第二壳体部110b,如上面图3中所描述的,该凸台定位器111将两个壳体半部或部分110a和110b彼此对准并且被设置在第二壳体部110b中,以使第一壳体部110a和第二壳体部110b能联结。
特别参见图37-图38,依据本公开的一个实施例,手术器械10′″的动力头900′包括结构构件或底盘1001,用来安装动力头900′和/或手术器械10″的一组操作部件1000。由第一壳体部110a和第二壳体部110b构成的壳体110,使得能够进入手术器械10′″的动力头900′的由壳体110环绕的内部空间1002。如上面关于图4-图12所描述的,在内部空间1002中安装一组操作部件。更特别地是,一组操作部件1000包括:驱动电动机200(和相关齿轮组件);近侧轴承354和远侧轴承356;驱动管210;动力关节式运动开关174;和开关114的部分,该开关的部分可包括第一开关114a和和第二开关114b,第一开关114a和第二开关114b一起形成为在内部空间1002外部的扳钮开关并且具有大体设置在内部空间1002内的内部接触面114′;以及位置和限位开关(例如轴开始位置传感器231和夹紧位置传感器232),位置和限位开关被设置在内部空间1002内,一组操作部件1000也可以包括其它的部件。
如上所述,凸台定位器111使两个壳体半部110a和110b对准以联结在一起成为壳体110。另外,由于该组操作部件1000具有当安装在由壳体110包围的内部空间1002内时的用于对准的恰当结构,凸台定位器111还能够实现该组操作部件1000的所述用于对准的恰当结构。
在根据本公开的一个实施例中,该组操作部件1000可安装在底盘1001上而非直接安装在壳体半部或部分110a上,后一方案应用于手术器械10的动力头900′(见图4)。
如图39所示,该底盘1001包括凸台定位器端口111′,凸台定位器端口被构造为与壳体半部或部分110a和110b(见图38)的凸台定位器111对准。底盘1001被构造为为具有近侧部1010a、中心部1010b和远侧部1010c,其中近侧部分1010a、中心部分1010b和远侧部分1010c可操作地相互连接或相互整体形成以构成底盘1001。近侧部分1010a被构造为具有第一凹槽1012和第二凹槽1014,两个凹槽均形成于底盘1001内以容纳该组操作部件1000的特定部件。第二凹槽1014位于第一凹槽1012远侧。更特别地,第一凹槽1012被构造为容纳和对准驱动发动机200(及其相关齿轮组件),而第二凹槽1014被构造为容纳和对准近侧轴承354(见图38)。在图38中所示的示范性实施例中,近侧部分1010a具有呈部分椭圆形横截面的近侧部1011并且邻近具有梯形横截面的远侧部1013。第一凹槽1012形成于具有部分椭圆形横截面的近侧部1011中,而第二凹槽1014形成于具有梯形横截面的远侧部1013内。
中心部分1010b可为半圆柱形的并具有相应矩形横截面,其被构造为具有形成在底盘1001内的凹槽1016。该凹槽1016被构造为容纳和对准驱动管210。
在图39中并结合图38所示的示范性实施例中,远侧部分1010c具有梯形横截面,在其中形成有被构造为容纳和对准远侧轴承356的凹槽1017。远侧部分1010c具有在凹槽1017的远侧的通常为T形的孔1020。孔1020被构造为能够容纳、保持和对准位置和限位开关,例如轴开始位置传感器231和夹紧位置传感器232。远侧部分1010c进一步包括形成于其中并且被设置在凹槽1017和孔1020之间的狭缝1022。狭缝1022作为基准用来对准该组操作部件1000,并且被构造为和设置为保持和对准对准板350,对准板350将发射杆220同心定位,如上文关于图6和图7所描述的。此外,对准板350包括贯穿其的孔355,该孔具有非圆形横截面(见图7)。孔355的非圆形横截面防止发射杆220的近侧部222的旋转,从而限制发射杆220的近侧部222轴向平移穿过其中。对准板350还用作轴承座和机械止动装置。对准板350的远侧表面351还作为开始位置传感器231和夹紧位置传感器232的安装面和基准面。
远侧部分1010c进一步包括向下指向的突起或延伸部分1024,在突起或延伸部分1024中形成有被构造为容纳和对准扳钮开关114的内部接触面114′的凹槽1026,并且突起或延伸部分1024基本上位于内部空间1002内。
从上述说明能理解到,如果底盘1001及一组操作部件1000安装在壳体110的内部空间1002中,则底盘1001被构造为给安装在底盘1001上的该组操作部件1000提供用于对准的恰当结构。尽管在图37-图43中未明显示出,如果底盘1001和替换的一组操作部件安装在壳体110的内部空间1002内,则底盘1001被构造为给安装在底盘1001上的手术器械10′″的替换的一组操作部件(未明确显示)提供用于对准的恰当结构。这样,底盘1001被构造为给该组操作部件1000和/或替换的一组操作部件(包括该组操作部件1000或替换的一组操作部件)提供用于对准的恰当结构。本领域技术人员将认识到,尽管通常情况下替换的一组操作部件与由制造商首次向手术器械10′″的动力头900″提供的原装的一组操作部件1000相同,但是仅需要替换的一组操作部件与原装的一组操作部件1000相比能够达到在插入内部空间1002时保持对准、安装并合适地运行手术器械10′″的程度上相同即可。
参见图37,并如上文关于图4-图12的说明,壳体110具有至少第一壳体部110a和第二壳体部110b。至少可移除第一壳体部110a以暴露手术器械10′″的内部空间1002的至少一部分。第一壳体部110a限定多个端口111并且第二壳体部110b限定多个端口1010,如果第一壳体部110a和第二壳体部110b联结在一起,则该端口1010被设置为能够实现一组操作部件1000和替换的一组操作部件(未明确显示)的用于对准的恰当结构。
另外,如图39所示,底盘1001限定多个端口111′,如果或其中第一壳体部110a和第二壳体部110b联结在一起且如果或其中底盘1001和该组操作部件1000或替换的一组操作部件安装在壳体110的内部空间1002内,则端口111′被设置为能够实现该组操作部件1000和替换的一组操作部件(未明确显示)的用于对准的恰当结构。
可以预想,夹子、带扣、按扣、快速转动紧固件或其他适合的连接器可以并入分别位于第一壳体部110a和第二壳体部110b、和/或底盘1001上的适当位置处以提供拆卸的便易性。
底盘1001可由含铁的、导电的或磁性的金属制成,以对例如控制开关114或轴开始位置传感器231和夹紧位置传感器232的这些电子部件施加屏蔽,使它们免受射频(RF)噪声和电磁干扰(EMI)。结构构件/底盘1001还能够可操作地接合或可操作地连接到上述的部件(包括驱动电动机200),以作为用于直流电(DC)应用的共同接地端。
图40-图41显示了手术器械10′″的分解图,显示第一壳体部110a和第二壳体部110b,以及如上文关于图37-图39的描述的安装在底盘1001上的一组操作部件1000。
电动手术器械10′″包括可操作地接合到动力头900″以使动力头10″能够驱动和操控发射杆220(见图6)的旋转前端调换组件1050。该旋转前端调换组件1050包括接口连接器1052,以使得能够调换发射杆220的前端1054,图中显示了TycoHealthcare Model EGIA前端1054。调换组件1050被构造为容纳和操控其他前端1054,例如具有圆形横截面的Tyco Healthcare Model EEA、具有圆形横截面的ModelEEA、具有直角横截面的Model TA,或刀具、烧灼器、射频能源、或夹子或抓取器的前端。
图42是底盘1001的敞开侧1001a的视图,显示了一组操作部件1000安装在底盘1001上,其中敞开侧1001a面向观察者。图43是底盘1001的关闭侧1001b的视图,显示一组操作部件1000安装在底盘1001上,其中关闭侧1001b面向观察者。
在一个实施例中,底盘1001由金属制成,并且壳体110由聚合材料制成。一组操作部件1000或替换的一组操作部件(未显示)包括至少一个电气部件,例如,电池单元451′(一个或多个)(见图40-图41),并且底盘1001被构造为能够实现电气部件的电接地。
因此,从上述公开中能够理解到,手术器械例如手术器械10″的动力头900′,其中动力头900′包括底盘1001,通过在维持全部或大部分重要部件组件的对准和位置的同时能够更容易地去除/处理受到污染的壳体或盖提高了贵重部件的重新使用和再加工。另外,底盘1001提供如下优点:
●能为手术器械10″提供额外的稳定性、强度和结构支撑;
●能用作或者布置为用于安装部件、紧固件和可拆除的壳体盖的底盘平台;
●相对于单平面壳体盖组件结构,能够实现用于组装或维修部件的更简单的多平面可进入性;
●相对于标准塑料壳体紧固件凸台,实现了安装和移除紧固件的多次循环的更大耐用性以用于多次再加工、维修和/或检修循环;
●与净模制壳体组件方法相比,实现了用于精确支承和机构对准的更高公差的基准定位。
●能够用作或者布置为用于DC或微电子装置内的全部部件的电接地平台;
●为装置内的电子部件构建射频(RF)和电磁干扰(EMI)屏蔽。
应理解的是,可以对此处所示的实施例做出各种改进。因此,上述描述不应被解释为用于限制,而是仅仅作为优选实施例的范例。本领域的技术人员将预想到在所附的权利要求的范围和精神内的其他改进。

Claims (11)

1.一种用于安装手持式手术器械的动力头的一组操作部件的底盘,
动力头具有壳体,所述壳体使得能够进入被壳体包围的动力头的内部空间,
一组操作部件具有当安装在被壳体包围的内部空间内时用于对准的恰当结构,
其中,所述底盘被构造为:如果所述底盘和一组操作部件安装在壳体的内部空间内,则所述底盘给安装在底盘上的一组操作部件提供所述用于对准的恰当结构;或者如果所述底盘和替换的一组操作部件安装在壳体的内部空间内,则所述底盘给安装在底盘上的所述动力头的替换的一组操作部件提供所述用于对准的恰当结构。
2.根据权利要求1所述的底盘,其中,
所述底盘由金属形成,所述壳体由聚合物形成。
3.根据权利要求2所述的底盘,其中,
所述一组操作部件包括至少一个电气部件,其中所述底盘构造为能够实现所述至少一个电气部件的电接地。
4.根据权利要求1所述的底盘,其中,
所述动力头包括由两个半部形成的壳体,所述两个半部在每个壳体半部上的至少两个凸台定位器处彼此联接,所述凸台定位器设置为将两个壳体半部彼此对准,
所述底盘包括至少两个凸台定位器端口,所述端口被构造且设置成对准每个壳体半部上的所述至少两个凸台定位器。
5.根据权利要求4所述的底盘,其中,
所述动力头包括发射杆,通过发射杆的平移引起手术紧固件的射出,
所述底盘还包括形成于其中的狭缝,所述狭缝被构造且设置成作为所述发射杆关于所述动力头对准的基准。
6.一种用于手持式手术设备的动力头,包括
形成在所述动力头内的内部空间;和
用于安装所述动力头的一组操作部件的底盘,
所述内部空间被构造为容纳所述底盘。
7.根据权利要求6所述的动力头,动力头具有使得能够进入所述动力头的内部空间的壳体,所述内部空间被所述壳体包围,
一组操作部件具有当安装在被壳体包围的内部空间内时用于对准的恰当结构,
其中,所述底盘被构造为:如果所述底盘和一组操作部件安装在壳体的内部空间内,则所述底盘给安装在底盘上的一组操作部件提供所述用于对准的恰当结构;或者如果所述底盘和替换的一组操作部件安装在壳体的内部空间内,则所述底盘给安装在底盘上的所述动力头的替换的一组操作部件提供所述用于对准的恰当结构。
8.根据权利要求7所述的动力头,其中,所述底盘由金属形成,所述壳体由聚合物形成。
9.根据权利要求8所述的动力头,其中,所述一组操作部件包括至少一个电气部件,其中所述底盘构造为能够实现所述至少一个电气部件的电接地。
10.根据权利要求1所述的动力头,其中,
所述动力头包括由两个半部形成的壳体,所述两个半部在每个壳体半部上的至少两个凸台定位器处彼此联接,所述凸台定位器设置为将两个壳体半部彼此对准,
所述底盘包括至少两个凸台定位器端口,所述端口被构造且设置成对准每个壳体半部上的所述至少两个凸台定位器。
11.根据权利要求10所述的动力头,其中,
所述动力头包括发射杆,通过发射杆的平移引起手术紧固件的射出,
所述底盘还包括形成于其中的狭缝,所述狭缝被构造且设置成作为所述发射杆关于所述动力头对准的基准。
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