CN102090912B - Surgical clip applier - Google Patents

Surgical clip applier Download PDF

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Publication number
CN102090912B
CN102090912B CN 201010593698 CN201010593698A CN102090912B CN 102090912 B CN102090912 B CN 102090912B CN 201010593698 CN201010593698 CN 201010593698 CN 201010593698 A CN201010593698 A CN 201010593698A CN 102090912 B CN102090912 B CN 102090912B
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CN
China
Prior art keywords
distal
proximal
connector member
member
clip
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CN 201010593698
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Chinese (zh)
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CN102090912A (en
Inventor
雅罗斯洛娃·T·马尔科夫斯基
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柯惠Lp公司
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Priority to US28656909P priority Critical
Priority to US61/286,569 priority
Priority to US12/943,045 priority patent/US8545486B2/en
Priority to US12/943,045 priority
Application filed by 柯惠Lp公司 filed Critical 柯惠Lp公司
Priority claimed from CN201410655485.8A external-priority patent/CN104367363B/en
Publication of CN102090912A publication Critical patent/CN102090912A/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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2913Handles transmission of forces to actuating rod or piston cams or guiding means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2913Handles transmission of forces to actuating rod or piston cams or guiding means
    • A61B2017/2915Handles transmission of forces to actuating rod or piston cams or guiding means arcuate shaped guiding means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2913Handles transmission of forces to actuating rod or piston cams or guiding means
    • A61B2017/2916Handles transmission of forces to actuating rod or piston cams or guiding means pins in guiding slots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2913Handles transmission of forces to actuating rod or piston cams or guiding means
    • A61B2017/2917Handles transmission of forces to actuating rod or piston cams or guiding means with flexible part

Abstract

本发明提供了一种外科施夹器,所述外科施夹器包括:外壳;至少一个手柄,其可枢转地连接到所述外壳上;通道组件,其从所述外壳向远侧延伸出;夹子承载器,其配置在所述通道组件内且在其中限定了通道和多个窗口;以及多个夹子,它们可滑动地配置在所述夹子承载器的通道内。 The present invention provides a surgical clip applier, the surgical clip applier comprising: a housing; at least one handle pivotally connected to said housing; a channel assembly extending distally from the housing out ; clip carrier disposed within said channel assembly and defining a passageway therein and a plurality of windows; and a plurality of clips which are slidably disposed within the channel of said clip carrier. 所述外科施夹器进一步包括:驱动通道,其可往复地配置在所述外壳和所述通道组件中的至少一个内;楔板,其可往复地配置在所述通道组件内;推杆,其可往复地设置在所述外壳和所述通道组件内;以及运动倍增系统,其具有多个连接件,所述连接件被构造为基于所述手柄的初始致动而使所述推杆向远侧移动递增量,并且被构造为在手柄初始致动之后使推杆和楔板向近侧移动。 The surgical clip applier further comprising: at least one drive channel, which can be reciprocally arranged in the housing and the channel assembly in the interior; wedge plate reciprocally disposed within said channel assembly; ram, which reciprocally disposed within said channel assembly and said housing; and a motion multiplier system having a plurality of connecting members, said connecting member is configured based on the initial actuation of the handle to the push rod distal movement increment, and is configured as a wedge and push rod after the initial movement of the actuation handle proximally.

Description

外科施夹器 Surgical clip applier

[0001] 相关申请的交叉引用 CROSS [0001] REFERENCE TO RELATED APPLICATIONS

[0002] 本申请要求于2009年12月15日提交的、序列号为61/286, 569的美国临时申请的利益和优先权,将所述申请的全部内容通过引用并入到这里。 [0002] This application claims the December 15, 2009 submitted by the serial number for the benefit of and priority to US provisional application 61/286, 569, the entire contents of which are incorporated here by reference.

技术领域 FIELD

[0003] 本申请涉及外科器械,更特别地,涉及具有多个夹子的外科施夹器,所述外科施夹器用于在外科手术过程中将夹子施加到体组织和血管。 [0003] The present application relates to surgical instruments, and more particularly, relates to a surgical clip applier having a plurality of clips, the surgical clip applier to the clip during a surgical procedure is applied to the tissue and blood vessels.

背景技术 Background technique

[0004] 外科施夹器是现有技术已知的,并由于向体组织和血管的传统缝合提供了另一种选择而越来越受外科医生的欢迎。 [0004] Surgery is known in the prior art clip appliers, and by providing an alternative to conventional suturing to tissue and blood vessel by a surgeon more welcome. 专利号为5, 030, 226的格林(Green)等人的美国专利和专利号为5, 431,668的伯班克三世(Burbank III)等人的美国专利公开了典型的器械。 Patent No. 5, 030, 226 Green (Green) et al and U.S. Patent No. 5, 431,668 to Burbank III (Burbank III) et al., U.S. Patent discloses a typical instrument. 这些器械通常提供多个夹子,所述多个夹子存储在器械中并基于器械近端处手柄的开合而被相继送入器械远端处的钳夹机构。 These instruments generally provide a plurality of clips, and opening and closing of the handle on the proximal end of the instrument are successively fed to the jaw mechanism and the distal end of the instrument at a plurality of clips stored in the instrument. 当手柄闭合时,钳夹闭合以使位于钳夹构件之间的夹子变形,而当钳夹张开以释放变形的夹子时,将一个新的夹子从其序列送入钳夹之间的位置。 When the handles are closed, the jaws are closed to the clip positioned between the jaw member is deformed, when the jaws open to release the deformed clip, a new position between the jaws of a clip fed from the sequence. 这个过程重复执行直到将夹子序列中的所有夹子都已用过。 This process is repeated until all the clips series of clips have been used.

[0005] 典型地,外科施夹器可在从相对小的、相对中等的到相对大的多种尺寸和/或比例范围内获得。 [0005] Typically, a surgical clip applier may be relatively small, relatively medium to relatively large variety of sizes and or scale range / obtained from. 通常,每种特定尺寸的外科施夹器包括不同的零件。 Generally, each particular size of surgical clip appliers includes different components. 同样地,装配各种尺寸的外科施夹器的方法从一种尺寸到另一种尺寸而不同。 Likewise, the method of assembling the various sized surgical clip applier from one size to another size differ.

[0006] 因而,每种不同尺寸的施夹器需要外部零件(例如,施夹器致动)的不同的行程长度,这又影响内部零件(例如,夹子部署零件)的不同的时间选择。 Selecting different time [0006] Accordingly, each different size of clip applier requires external components (e.g., clip applier actuator) of different stroke lengths, which in turn affect the internal parts (e.g., the deployment of the clip part) of. 因此,存在可以将某些主要零件构造为仅仅通过改变几何结构无需改变功能性即可用于不同尺寸的施夹器的需求。 Thus, there may be some of the major components configured only by changing the geometry without altering the functional requirements can be used for different sizes of clip appliers.

[0007] 另外,因此存在对构造为容纳简单内部零件的外科施夹器的需求,仅仅改变所述零件的几何结构,就可使所述简单内部零件以相似的方式对所有不同尺寸的施夹器都起作用。 [0007] Further, there is need for a simple internal parts configured to receive a surgical clip applier, simply changing the geometry of the part, can be simply the internal parts in a similar manner for all the different sizes of clip appliers It is all work. 同时不会危及具有低驱动力的较高的夹子推动力。 While not endangering the high clip having a low driving force of the driving force. 运动和力特性更好,并且零件更简单,从而使得设备的性能更好。 Better motion and force characteristics, and simpler parts, so that the better the performance of the device.

发明内容 SUMMARY

[0008] 本申请涉及具有多个夹子的外科施夹器,所述外科施夹器用于在外科手术期间将所述夹子施加到体组织和血管中。 [0008] The present application relates to surgical clip appliers having a plurality of clips, the surgical clip applier during a surgical procedure for the clips to body tissues and blood vessels.

[0009] 根据本公开的一个方案,提供一种外科施夹器,其包括:外壳;至少一个手柄,其可枢转地连接到外壳上;通道组件,其从外壳向远侧延伸出;夹子承载器,其配置在通道组件内且在其中限定了通道和多个窗口;多个夹子,它们可滑动地配置在夹子承载器的通道内;驱动通道,其可往复地配置在外壳和通道组件中的至少一个内,所述驱动通道具有可操作地连接到至少一个手柄上的第一端和可操作地连接到通道组件的远端上的第二端;楔板,其可往复地配置在通道组件内,所述楔板可操作地连接到至少一个手柄上且包括多个沿其长度形成的孔;推杆,其可往复地设置在外壳和通道组件内,所述推杆具有可操作地连接到至少一个手柄上的近端和限定了推动器的远端,其中所述推杆的远端被构造为与多个夹子中的最远侧夹子相接合;以及运动倍增系 [0009] According to an embodiment of the present disclosure, a surgical clip applier, comprising: a housing; at least one handle which is pivotally connected to the housing; a channel assembly extending distally from the housing; clip a carrier which is disposed within the channel assembly and defining a passageway therein and a plurality of windows; a plurality of clips which are slidably disposed within the channel of clip carrier; drive channel, which can be reciprocally arranged in the housing and the channel assembly at least one inner, said drive channel having a second end operatively connected to the distal end of the at least a first end operatively connected to the channel assembly on a handle; a wedge plate reciprocally disposed in the channel assembly, said wedge plate operatively connected to the at least one handle and comprises a plurality of holes formed along its length; ram, which can be reciprocally disposed within the housing and the channel assembly, said pusher having operable coupled to the at least one handle on the proximal end and a distal end defining a pusher, wherein the pusher distal end is configured with a plurality of clips engage distal-most clip; and a motion multiplier system 统,其具有多个连接件,所述连接件被构造为基于手柄的初始致动而使推杆向远侧移动递增量,并且被构造为在手柄初始致动之后使推杆和楔板向近侧移动。 System, having a plurality of connecting members, said connecting member being configured to handle based on the initial actuation of the plunger moved distally increasing amounts, and is configured such that the push rod and the wedge plate following an initial actuation of handle proximal movement.

[0010] 运动倍增系统的多个连接件可以包括:近侧连接构件,其可枢转地支撑在外壳内且可操作地连接到驱动通道上;枢轴驱动臂,其使驱动通道和近侧连接构件相互连接;以及远侧连接构件,其使近侧连接构件和推杆相互连接,以使驱动通道向远侧的平移引起近侧连接构件经由枢轴驱动臂的枢轴旋转,其中近侧连接构件的枢轴旋转引起远侧连接构件的枢轴旋转。 [0010] a plurality of connectors motion multiplier system may include: a proximal connector member which is pivotally supported and operatively connected to the drive channel within the housing; pivot drive arm, which drive channel and a proximal connecting member interconnecting; and a distal connector member that proximal connector member and the push rod connected to each other, so that the drive channel causes the proximal pivoting member is connected via a pivot of the drive arm to translate distally, wherein the proximal It causes rotation of the pivot member pivotally connected to the distal connector member is rotated. 远侧连接构件的枢轴旋转引起推杆的远侧平移。 A pivot member connected to the distal push rod rotation causes distal translation. 近侧连接构件通过枢轴销可枢转地连接到外壳上。 Proximal connector member pivotably connected to the housing by a pivot pin. 远侧连接构件可枢转地连接到近侧连接构件上。 The distal connector member is pivotally connected to the proximal connector member.

[0011] 驱动通道的进一步远侧平移可引起近侧连接构件经由枢轴驱动臂的进一步枢轴旋转,其中近侧连接构件的进一步枢轴旋转可引起远侧连接构件的进一步枢轴旋转,并且其中远侧连接构件的进一步枢轴旋转引起推杆的近侧平移。 Further distal translation of [0011] the drive channel may cause the proximal connector member is rotated via a further pivot arm pivot drive, wherein the proximal connector member further rotation of the pivot may cause further pivotable connection of the distal member, and wherein further rotation of the pivot member connected to the distal push rod causes proximal translation.

[0012] 在实施例中,当近侧连接构件、远侧连接构件、枢轴驱动臂、驱动通道和推杆处于第一位置时,近侧连接构件和远侧连接构件限定了第一角度。 [0012] In an embodiment, when the proximal connector member, the distal connector member, the pivot drive arm, the drive channel and the push rod in the first position, the proximal and distal connector member defining a first angle connecting member. 驱动通道的近侧平移导致近侧连接构件和远侧连接构件经由枢轴驱动臂而枢轴地旋转,从而将第一角度增大到大约180度的第二角度,以使近侧连接构件和远侧连接构件相对于彼此成一直线,使得近侧连接构件、远侧连接构件、枢轴驱动臂、驱动通道和推杆处于第二位置。 The proximal translation of the drive channel lead proximal connector member and the distal member is pivotally connected via a pivot drive arm to rotate so as to increase the first angle to a second angle of approximately 180 degrees so that the proximal connector member and The distal connector member relative to each other in line, such that the proximal connector member, the distal connector member, the pivot drive arm, the drive channel and the push rod in the second position.

[0013] 进一步,当近侧连接构件、远侧连接构件、枢轴驱动臂、驱动通道和推杆处于第二位置时,驱动通道的进一步近侧平移导致近侧连接构件和远侧连接构件经由枢轴驱动臂而枢轴旋转,从而将大约180度的第二角度减小到第三角度,以使远侧连接构件、枢轴驱动臂和驱动通道处于第三位置,同时推杆处于第一位置。 When [0013] Further, when the proximal connector member, the distal connector member, the pivot drive arm, the drive channel and the push rod in the second position, further proximal translation of the drive channel lead proximal connector member and the distal member is connected via a the pivot drive arm pivot, so that the second angle of about 180 degrees to the third angle is reduced, so that the distal connector member, the pivot drive arm and the drive channel in the third position, while the plunger is in the first position.

[0014] 近侧连接构件经由枢轴驱动臂的旋转致使近侧连接构件和远侧连接构件相对于彼此成一直线且沿着由近侧连接构件的近端和远侧连接构件的远端之间的参考轴线限定的纵向轴线,以使远侧连接构件引起推杆的远侧平移。 [0014] between the proximal connector member by the distal end along a proximal end and a distal member connected to a proximal connecting member causes the distal member and the proximal connector member is connected via a drive arm pivotally rotated in line with respect to one another and reference axis defining a longitudinal axis, the distal connector member to the push rod causes distal translation.

[0015] 近侧连接构件经由枢轴驱动臂的进一步旋转致使近侧连接构件和远侧连接构件彼此成角度地偏移,以使远侧连接构件引起推杆的近侧平移。 [0015] The proximal connector member causes the proximal connector member and the distal member connected angularly offset to each other, to cause the distal connector member proximal translation of the push rod via a further rotary pivot drive arm.

[0016] 由近侧连接构件的近端和远侧连接构件的远端之间的参考轴线限定的纵向轴线和近侧连接构件限定了在纵向轴线的第一侧的第一锐角,并且推杆处于近侧位置。 [0016] The proximal connector member and the longitudinal axis defined by the reference axis between the proximal end and the distal end of the distal connector member proximal connector member defines a first acute angle at a first side of the longitudinal axis of the push rod and in a proximal position. 驱动通道的远侧平移可使近侧连接构件和远侧连接构件枢转,从而使在纵向轴线的第一侧的第一锐角增大,直到近侧连接构件和远侧连接构件相对于彼此成一直线,并且推杆经由远侧连接构件向远侧平移到远侧位置为止。 Distal translation of the drive channel may cause distal member and the proximal connector member is pivotally connected, such that the first acute angle at a first side of the longitudinal axis increases until the distal member and the proximal connector member is connected to each other with respect to a a straight line, and the push rod is moved distally through the distal position of the connecting member distally so far.

[0017] 驱动通道的进一步远侧平移致使近侧连接构件和远侧连接构件从纵向轴线的一侧枢转到纵向轴线的第二侧,从而使近侧连接构件和纵向轴线限定第二锐角,并且使推杆经由远侧连接构件向近侧平移到近侧位置。 Further distal [0017] The translation of the drive channel causes the distal member and the proximal connector member is connected from the pivot axis to a second side of the longitudinal sides of the longitudinal axis, such that the longitudinal axis of the proximal connector member and defining a second acute angle, and the push rod is moved proximally through the proximal position to the distal connecting member.

[0018] 夹子输出器(clip follower)被构造为接合楔板并且基于楔板的远侧平移向远侧移动,并且被构造为接合夹子承载器且基于楔板的近侧平移使其近侧移动停止。 [0018] The clip (clip follower) is configured to engage the wedge plate and the wedge plate distally based translational movement distally and is configured so as to move proximally to engage and clip carrier based proximal translation of the wedge plate stop.

[0019] 施夹器可进一步包括钳夹组件,所述钳夹组件具有一对从通道组件的与外壳反向的端部延伸出的钳夹。 [0019] The clip applier may further include a jaw assembly, said jaw assembly having a pair of jaws extending from the housing with the opposite end of the channel assembly. 钳夹组件可适于容纳多个夹子中的一个夹子于其中,并且是可操作的以便响应于手柄的运动来实现夹子的成型。 Jaw assembly may be adapted to receive a plurality of clips in a clip therein and are operable in response to movement of the handle so as to achieve the molding clip.

[0020] 当手柄在第一方向上接近初始量时,推杆可朝向钳夹运动以将最远侧夹子移动至所述钳夹之间。 [0020] When the handle close to the initial amount in the first direction, movement of the push rod movable toward the jaws to move to the distal most clip between the jaws. 当手柄在第一方向上接近附加量时,推杆可被构造且适于朝向外壳运动以将所述推动器移动到多个夹子中的最远侧夹子后面。 When the handle is attached near the amount in the first direction, and the plunger may be configured so as to move said pusher behind a distal most clip into a plurality of clips adapted for movement toward the housing.

[0021] 驱动通道可被构造且定尺寸为至少部分地围绕钳夹和楔板。 [0021] The drive channel may be configured and dimensioned to surround the jaws and the wedge plate at least partially. 驱动通道可包括带箍(strap),所述带箍横跨所述驱动通道的远端延伸,用于将钳夹和楔板保持在驱动通道内。 The drive channel may include a strap (Strap), said band across the distal end of said drive channel extends, and means for clamping wedge held in the drive channel.

[0022] 当至少一个手柄在第一方向上被致动而运动时,驱动通道可朝向钳夹组件运动, 以将驱动通道的第二端移动到抵靠钳夹以闭合钳夹,当至少一个手柄运动第二量时,驱动通道被移离钳夹,以使驱动通道的第二端移离钳夹以允许钳夹张开。 [0022] When at least one handle in a first direction of motion is actuated, drive channel may be moving towards the jaw assembly to the second end of the drive channel to move against the jaws to close the jaws, when at least one when the amount of movement of the second handle, the drive channel being moved away from the jaws, such that the second end of the drive channel to allow the jaw to move away from the jaw to open.

[0023] 在实施例中,施夹器可进一步包括运动反转机构,所述运动反转机构可操作地连接到楔板和驱动通道上。 [0023] In an embodiment, the clip applier may further include a motion reversing mechanism, the motion reversing mechanism operatively connected to the drive channel and the wedge plate. 在驱动通道的远侧移动期间,运动反转机构的旋转导致楔板的近侧移动。 During the distal movement of drive channel, results in rotational movement of the reversing mechanism of a proximal movement of the wedge plate.

[0024] 在实施例中,施夹器可进一步包括夹子输出器,所述夹子输出器可滑动地配置在夹子承载器的通道内,并且被配置在多个夹子的近侧,夹子输出器被构造为且适于与夹子承载器的窗口和楔板的孔可选择地接合。 [0024] In an embodiment, the clip applier may further include a clip, said clip follower slidably disposed within the channel of clip carrier, and is disposed proximally of the plurality of clips, the clip is configured and adapted to selectively engage with the aperture of the clip carrier and a wedge plate window. 夹子输出器可被构造为且适于基于楔板的往复运动在相对于夹子承载器的远侧方向上推进多个夹子。 The clip follower may be configured and adapted to reciprocate on the wedge plate in advance a plurality of clips in a distal direction relative to the clip carrier.

[0025] 在实施例中,施夹器可进一步包括运动反转机构,所述运动反转机构可操作地连接到驱动通道和楔板上,并且与推杆可选择地接合。 [0025] In an embodiment, the clip applier may further include a motion reversing mechanism, the motion reversing mechanism operatively connected to the drive channel and the wedge plate and selectively engageable with the push rod. 在驱动通道的远侧平移期间,运动反转机构的旋转导致楔板和推杆的近侧移动。 During distal translation of the drive channel, the rotational movement of the reversing mechanism causes proximal movement of the wedge plate and the push rod.

[0026] 在实施例中,施夹器可进一步包括棘轮机构。 [0026] In an embodiment, the clip applier may further include a ratchet mechanism. 棘轮机构可进一步包括:齿条,其具有多个棘轮齿,与驱动通道关联;以及棘爪,其具有至少一个齿,配置在可选择地接合齿条的位置处。 Ratchet means may further comprise: a rack having a plurality of ratchet teeth, associated with the drive channel; and a pawl, having at least one tooth, disposed at a location to selectively engage the rack. 棘爪可被偏压到与齿条接合,其中当驱动通道纵向往复运动时,多个齿越过棘爪。 Pawl may be biased into engagement with the rack, wherein the drive channel to reciprocate longitudinally, the plurality of teeth past the pawls. 棘爪可在至少一个手柄完全致动之前防止驱动通道的无意的返回。 Pawl may prevent inadvertent return of the drive channel before full actuation of the at least one handle.

[0027] 在实施例中,施夹器可进一步包括配置在通道组件的远端内的锁定件。 [0027] In an embodiment, the clip applier may further comprise a locking member disposed within the distal end of the channel assembly. 当将最后一个夹子从施夹器中射出时,可通过夹子输出器致动锁定件。 When the light emitted from the last clip in the clip applier, by actuating the locking clip member. 锁定件可由夹子输出器推进以横跨驱动通道的路径延伸,从而防止驱动通道向远侧移动。 Locking member to extend across the path of the drive channel may be advancing clip, thereby preventing the distal movement of drive channel.

[0028] 在实施例中,施夹器可进一步包括支撑在外壳和通道组件中的至少一个内的计数器显示机构。 [0028] In an embodiment, the clip applier may further include a counter supported in the housing at least one channel assembly and the display means. 计数器显示机构被构造为且适于基于至少一个手柄的每次致动而显示所述施夹器的状态的改变。 Counter display mechanism is configured and adapted to vary the display state of the clip applier at least one handle on each actuation.

附图说明 BRIEF DESCRIPTION

[0029] 由于从下述接合下列附图考虑时的详细描述中本发明的施夹器变得更好理解,因此将能够更充分地认识本施夹器。 [0029] Since the engagement clip applier following detailed description when considered in reference to the present invention will become better understood, and therefore will be more fully appreciated from the following of the present clip applier. 在附图中: In the drawings:

[0030] 图1为根据本公开的实施例的外科施夹器的立体图; [0030] FIG. 1 is a perspective view of a surgical clip applier according to an embodiment according to the present disclosure;

[0031] 图1A为图1的外科施夹器的后视立体图,图示装运楔在适当的位置; [0031] FIG 1A is a rear perspective view of the surgical clip applier of FIG. 1, illustrating the shipping wedge in position;

[0032] 图1B为通过图1A的1B-1B剖切的剖视图; [0032] FIG. 1B is a cross-sectional view taken through 1B-1B of FIG. 1A;

[0033] 图1C为通过图1A的1C-1C剖切的剖视图; [0033] FIG 1C is a cross-sectional view taken through 1C-1C of Figure 1A;

[0034] 图2为图1的外科施夹器的俯视图; [0034] FIG. 2 is a top plan view of the surgical clip applier of FIG 1;

[0035] 图3为图1和图2的外科施夹器的侧面正视图; [0035] FIG. 3 is a surgical FIGS. 1 and 2 applied clip side elevational view;

[0036] 图4为图1至3的外科施夹器的分解立体图; [0036] FIG. 4 is an exploded perspective view 1-3 of FIG surgical clip applier;

[0037] 图4A为图1至4的外科施夹器的运动倍增系统的立体图; [0037] Figure 4A a perspective view of a system multiplying the motion of the surgical clip applier of FIGS. 1-4;

[0038] 图4B为图1至4的外科施夹器的运动倍增系统的分解立体图; [0038] FIG. 4B an exploded perspective view of the motion multiplier system of the surgical clip applier of FIGS. 1-4;

[0039] 图4C为图1至4的外科施夹器的枢轴臂的俯视立体图; [0039] 4C a top perspective view of the pivot arm of Figures 1 to 4 of the surgical clip applier;

[0040] 图4D为图4C的枢轴臂的仰视立体图; [0040] Figure 4D is a bottom perspective view of the pivot arm of FIG. 4C;

[0041] 图4E为图1至4的外科施夹器的夹子输出器的俯视立体图; [0041] FIG. 4E is applied a top perspective view of the clip follower of the surgical clip applier of FIGS. 1 to 4;

[0042] 图4F为图1至4的外科施夹器的听觉/触觉指示器的立体图; [0042] FIG. 4F auditory perspective view of FIGS. 1 to 4, the surgical clip applier / tactile indicator;

[0043] 图4G为图1至4的外科施夹器的齿条构件的立体图; [0043] FIG 4G is a perspective view of a rack member of the surgical clip applier of FIG. 1 to 4 of;

[0044] 图4H为外科夹子的俯视立体图; [0044] FIG. 4H is a top perspective view of the surgical clip;

[0045] 图41为图4H的外科夹子的仰视立体图; [0045] FIG. 41 is a bottom perspective view of the surgical clip of Figure 4H;

[0046] 图4J为通过图4H的4J-4J剖切的图4H的外科夹子的前视剖视图; [0046] Figure 4J is taken through Figure 4J-4J 4H surgical clip a front sectional view of FIG. 4H;

[0047] 图5为图1至4的外科施夹器的纵视剖视图,图示外科施夹器处于未致动状态; [0047] FIG. 5 is a surgical Figures 1 to 4 a longitudinal sectional view of the clip applier, illustrating the surgical clip applier in an unactuated condition;

[0048] 图6为图5所指示细节区域的放大图; [0048] FIG. 6 is an enlarged view of a detail of FIG. 5 indicates the region;

[0049] 图7为图5所指示细节区域的放大图; [0049] FIG. 5 FIG. 7 is an enlarged view of a detail of the area indicated;

[0050] 图8为图5所指示细节区域的放大图; [0050] FIG. 8 is an enlarged view of a detail of FIG. 5 indicates the region;

[0051] 图9为通过图8的9-9剖切的图1至4的外科施夹器的剖视图; [0051] FIG. 9 is a cross-sectional view of the surgical clip applier taken through 9-9 in FIG. 8 is 1 to 4;

[0052] 图10为图1至4的外科施夹器的立体图,图示了从其移除了上半外壳; [0052] FIG. 10 is a view of a surgical clip applier 1 to 4, a perspective view illustrates an upper housing half removed therefrom;

[0053] 图11为如图10所示的图1至4的外科施夹器的放大图; [0053] FIG. 11 is an enlarged view of the surgical clip applier of FIGS. 1 to 4 shown in Figure 10;

[0054] 图12为图1至4的外科施夹器的通道组件的远端的俯视立体图,图示了从其移除了盖; [0054] FIG. 12 is 1 to 4, the surgical clip applier top perspective view of the distal end of the channel assembly of the device, illustrating the cap removed therefrom;

[0055] 图13为图1至4的外科施夹器的俯视立体图,图示了从其移除了上半外壳和推杆; [0055] FIG. 13 is a surgical FIGS. 1 to 4 is applied a top perspective view of the clip illustrating the upper housing half removed therefrom and the push rod;

[0056] 图14为图12的通道组件的远端的俯视立体图,图示从其移除了盖和推杆; [0056] FIG. 14 is a top perspective view of the distal end of the channel assembly of FIG. 12, illustrating the cap and the push rod is removed therefrom;

[0057] 图15为图12的通道组件的远端的俯视立体图,图示从其移除了推杆和夹子承载器; [0057] FIG. 15 is a top perspective view of the distal end of the channel assembly of FIG. 12, illustrating the pusher and the clip is removed from the carrier;

[0058] 图16为图12的通道组件的远端的俯视立体图,图示从其移除了盖、推杆、夹子承载器、外科夹子和夹子输出器; [0058] FIG. 16 is a top perspective view of the distal end of the channel assembly of FIG. 12, illustrating the lid removed therefrom, the push rod, the clip carrier, the surgical clips and the clip follower;

[0059] 图17为图16所指示细节区域的放大图; [0059] FIG 17 FIG 16 is an enlarged view of the detail area indicated;

[0060] 图18为图1至4的外科施夹器的俯视立体图,图示从其移除了上半外壳、推杆和楔板; [0060] FIG. 18 is applied a top perspective view of the surgical clip applier of FIGS. 1-4, the illustrated upper housing half removed therefrom, and the wedge pusher plate;

[0061] 图19为图12的通道组件的远端的俯视立体图,图示从其移除了盖、推杆、夹子承载器、外科夹子、夹子输出器和楔板; [0061] FIG. 19 is a top perspective view of the distal end of the channel assembly of FIG. 12, illustrating the lid removed therefrom, the push rod, the clip carrier, the surgical clips, the clip follower and the wedge plate;

[0062] 图20为图1至4的外科施夹器的俯视立体图,图示从其移除了上半外壳、推杆、楔板和驱动通道; [0062] FIG. 20 is a top perspective view of the clip applier surgical 1-4, illustrating the upper housing half removed therefrom, the push rod, the wedge plate and a drive channel;

[0063] 图21为图1至4的外科施夹器的仰视立体图,图示从其移除了下半外壳、驱动通道和楔板; [0063] FIG. 21 is 1 to 4, a surgical clip applier is a bottom perspective view illustrating a lower housing half removed therefrom, the drive channel and the wedge plate;

[0064] 图22为图1至4的外科施夹器的俯视图,图示从其移除了上半外壳且处于未致动状态; [0064] FIG. 22 is a plan view of a surgical clip applied 1 to 4, illustrating the upper housing half removed therefrom and in an unactuated state;

[0065] 图23为图22所指示细节区域的放大图; [0065] FIG. 23 is an enlarged view of a detail of the area indicated in FIG. 22;

[0066] 图24为图22所指示细节区域的放大图; [0066] FIG. 24 is an enlarged view of a detail of the area indicated in FIG. 22;

[0067] 图24A为图24的运动倍增系统的示意图; [0067] FIG 24A is a schematic view of the motion multiplier system of Figure 24;

[0068] 图25为图1至4的外科施夹器的俯视图,示出从其移除了上半外壳且在其初始致动期间; [0068] FIG. 25 is a plan view of a surgical clip applied 1 to 4, showing the upper housing half removed therefrom and during the initial actuation thereof;

[0069] 图26为图25所指示细节区域的放大图; [0069] FIG 26 FIG 25 is an enlarged view of the indicated area of ​​detail;

[0070] 图27为图25所指示细节区域的放大图; [0070] FIG 27 FIG 25 is an enlarged view of the detail area indicated;

[0071] 图27A为图27的运动倍增系统的示意图; [0071] FIG 27A is a schematic view of the motion multiplier system of Figure 27;

[0072] 图28为在外科施夹器的初始致动期间的通道组件的远端的放大、纵视剖视图; [0072] FIG. 28 is an enlarged distal end of the channel assembly during the initial actuation of the surgical clip applier, a longitudinal sectional view;

[0073] 图29为图1至4的外科施夹器的俯视立体图,示出了从其移除了上半外壳和推杆且在其初始致动期间; [0073] FIG. 29 is a surgical 1 to FIG. 4 a top perspective view of clip applier, illustrating the upper housing half removed therefrom and the push rod and, during initial actuation thereof;

[0074] 图30为在外科施夹器的进一步初始致动期间的通道组件的远端的放大、纵视剖视图; [0074] FIG. 30 is an enlarged distal end of the channel assembly during a further initial actuation of the surgical clip applier, a longitudinal sectional view;

[0075] 图31为示出在图1至4的外科施夹器的相应的初始致动期间的听觉/触觉指示器的操作的仰视立体图; Auditory bottom during [0075] FIG. 31 is a diagram illustrating the respective initial surgical clip applier of FIGS. 1-4 actuation / tactile indicator perspective view of an operation;

[0076] 图32为图1至4的外科施夹器的俯视图,示出了从其移除了上半外壳且在外科施夹器的进一步致动期间; [0076] FIG. 32 is a plan view of a surgical clip applied 1 to 4, it is shown during the further actuation of the surgical clip applier and the upper housing half removed therefrom;

[0077] 图33为图32所指示细节区域的放大图; [0077] FIG. 33 is an enlarged view of a detail of the region indicated in FIG 32;

[0078] 图34为示出图1至4的外科施夹器的计数器机构的致动的放大剖视图; [0078] FIG. 34 is a diagram illustrating an enlarged cross-sectional view of the actuator of FIG counter surgical clip applier mechanism 1 to 4;

[0079] 图35为图32所指示细节区域的放大图; [0079] FIG. 35 is an enlarged view of a detail of FIG. 32 indicates the region;

[0080] 图36为在图1至4的外科施夹器的最后一次致动期间所示出的齿条机构的放大图; [0080] FIG. 36 is an enlarged view of the rack mechanism during the final actuation of the surgical administered in Figures 1 to 4 of the clip is shown;

[0081] 图37和38为示出在图1至4的外科施夹器的最后一次致动期间的通道组件的远端的放大立体图; [0081] Figures 37 and 38 is an enlarged perspective view showing the distal end of the channel assembly during a surgical clip applier last actuation of Figures 1 to 4;

[0082] 图39为图1至4的外科施夹器的俯视图,示出了从其移除了上半外壳且处于外科施夹器致动后的最终状态; [0082] FIG. 39 is a plan view of a surgical clip applied 1 to 4, it shows the upper housing half removed therefrom and in a final state after actuation of the surgical clip applier;

[0083] 图40为图39所指示细节区域的放大图; [0083] FIG. 40 is an enlarged view of a detail of FIG. 39 indicates the region;

[0084] 图41为图39所指示细节区域的放大图; [0084] FIG. 41 is an enlarged view of a detail of FIG. 39 indicates the region;

[0085] 图41A为图41的运动倍增系统的示意图; [0085] FIG 41A is a schematic view of the motion multiplier system of Figure 41;

[0086] 图42为示出在图1至4的外科施夹器致动之后的听觉/触觉指示器的位置的放大图; [0086] FIG. 42 is a diagram illustrating an enlarged view of the position of the surgical clip applier after hearing the actuator of FIG. 1-4 / tactile indicator of;

[0087] 图43为示出在图1至4的外科施夹器致动之后的钳夹组件的位置的钳夹组件的俯视图; [0087] FIG. 43 is a plan view showing the jaw assembly in position after the jaw assembly of the surgical clip applier of FIGS. 1-4 actuation;

[0088] 图44为包括外科施夹器的一个夹子的体血管的立体图,示出夹子施加到体血管上; [0088] FIG. 44 is a perspective view of the vascular surgical clip comprising a clip applier, showing the clip to a blood vessel body;

[0089] 图45为图22、25、32和39所指示细节区域的放大图,示出了在外科施夹器完全致动之后的其张开或释放期间的枢轴臂的操作; [0089] FIG. 45 is an enlarged view of a detail of the region indicated in FIGS. 22,25,32 and 39, illustrating the operation of the pivot arm during its opening or release of the surgical clip applier following full actuation;

[0090] 图46为所示在图1至4的外科施夹器的张开或释放期间的齿条机构的放大图; [0090] FIG. 46 is an enlarged view of the rack mechanism shown during the opening or release of the surgical clip applier of FIGS. 1 to 4;

[0091] 图47为示出在图1至4的外科施夹器的张开或释放期间的听觉/触觉指示器的操作的放大图; [0091] FIG. 47 is a diagram illustrating the auditory during opening or release of the surgical clip applier of FIGS. 1-4 / tactile indicator is an enlarged view of an operation;

[0092] 图48和49为示出在图1至4的外科施夹器的张开或释放期间的夹子输出器的运动的通道组件的纵视剖视图; [0092] FIGS. 48 and 49 is shown in a longitudinal cross-sectional view of the channel assembly of the surgical clip applier motion of Figures 1 to 4 or the clip flared during release of view;

[0093] 图50和51为示出在图1至4的外科施夹器的张开或释放期间的推杆和楔板的运动的通道组件的远端的纵视剖视图;和 [0093] FIGS. 50 and 51 to the distal end of the channel assembly illustrating the movement of the push rod and the wedge plate during the opening or release of the surgical FIGS. 1 to 4 of the clip applier of a longitudinal sectional view; and

[0094] 图52为示出图1至4的外科施夹器在从其弹射出最后一个外科夹子之后的锁定状态下的通道组件的远端的纵视剖视图。 [0094] FIG. 52 is a diagram illustrating the surgical clip applier of FIGS. 1-4 in cross-sectional view from the distal end of the channel assembly in a locked state after the ejection of the last surgical clip longitudinally.

具体实施方式 Detailed ways

[0095] 现在将参照附图对依照本公开的外科施夹器的实施例进行详细描述,其中相同的附图标记代表类似或相同的结构构件。 [0095] Reference will now be described for embodiments in accordance with the present disclosure a surgical clip applier is described in detail, wherein identical structural member similar or identical reference numerals represent. 如附图所示以及如下贯穿全文所描述的,当涉及外科器械的相对位置时,跟传统的一样,术语"近侦『表示装置靠近用户的一端,而术语"远侧" 表示装置远离用户的一端。 As shown in the drawings and described throughout the following, when the relative position of the surgical instrument involves, as with the traditional, the term "proximal detect" indicating means near one end user, while the term "distal" means away from the user device end.

[0096] 图1至5示出的依照本公开的实施例的外科施夹器通常用100表示。 [0096] Figures 1 to 5 shows the surgical clip applier according to the present embodiment disclosed embodiments generally designated 100. 可以参考下述申请:于2008年8月25日提交的、申请号为61/091,467、名称为"Surgical Clip Applier (外科施夹器)"的美国临时申请和于2008年8月25日提交的、申请号为61/091,485、名称为"Surgical Clip Applier andMethod of Assembly (外科施夹器及其装配方法)"的美国临时申请,将所述每个申请的全部内容通过引用都并入于此,用于详细讨论外科施夹器100的结构、操作和装配方法。 Can refer to the following application: on August 25, 2008 filed Application No. 61 / 091,467, entitled "Surgical Clip Applier (surgical clip applier)," the US provisional application and on August 25, 2008 filed application Serial No. 61 / 091,485, entitled "surgical clip Applier andMethod of assembly (surgical clip applier and method of assembling)" U.S. provisional application, the entire contents of each are incorporated by reference and into this, for a detailed discussion structure, operation, and method of assembly 100 of surgical clip applier.

[0097] 外科施夹器100为包括手柄组件102的外科器械,所述手柄组件102包括具有上半外壳104a和下半外壳104b的外壳104。 [0097] Surgical clip applier 100 is a surgical instrument comprising a handle assembly 102, the handle assembly 102 includes an upper housing half 104a and lower housing half 104b of housing 104. 手柄组件102进一步包括一对手柄106,所述一对手柄106可枢转地固定在外壳104上并从外壳104向外延伸。 Handle assembly 102 further includes a pair of handles 106, the pair of handles 106 pivotably secured to housing 104 and extending outwardly from the housing 104. 通道组件108稳固地固定在外壳104上并从外壳104向外延伸,终止于钳夹组件110。 Channel assembly 108 firmly fixed and extends outwardly from the housing 104 in the housing 104, terminating in a jaw assembly 110.

[0098] 如在图1至4中可见,施夹器100的半外壳104a和104b彼此通过卡扣配合(snap fit)接合而装在一起。 [0098] As can be seen in FIGS. 14, clip applier 100 of housing half 104a and 104b by a snap-fit ​​(snap fit) engagement means to each other. 外壳104限定了形成于下半外壳104b内的用于支撑和显示计数器机构的窗口l〇4c,如在下文将更详细讨论的。 L〇4c housing 104 defines a window for supporting and displaying a counter mechanism is formed in the lower housing half 104b, as discussed in greater detail below. 外壳104由合适的塑性材料制成。 Housing 104 is made of a suitable plastic material.

[0099] 如在图4中可见,手柄106通过手柄枢轴支柱104d固定在外壳104上,所述手柄枢轴支柱l〇4d从下半外壳104b延伸出并进入到形成于手柄106上的相应的孔106a内。 [0099] As can be seen, the handle 106 104d fixed to the housing 104 by handle pivot strut in FIG. 4, the handle pivot l〇4d strut extending from lower housing half 104b and into the handle 106 is formed on the respective 106a of the hole. 手柄组件102包括连杆构件122,所述连杆构件122在形成于相应手柄106上的枢轴点106b 处可枢转地连接至每个手柄106。 Handle assembly 102 includes a link member 122, the link member 122 at pivot point 106b formed at the respective handle 106 is pivotally connected to each handle 106. 每个连杆构件122的远端122a通过驱动销124可枢转地连接到形成于驱动通道140内的枢轴点140a。 Each distal end 122a of the link member 122 by the driving pin 124 is pivotally connected to a pivot point 140a formed in a drive channel 140 within. 驱动销124的每端可滑动地容纳在形成于相应的上、下半外壳104a、104b内的细长通道104e中。 Each end of the drive pin 124 is slidably received in a respective formed on the upper and lower housing half 104a, 104b within the elongate channel 104e in. 使用时,如下文将更详细描述的,当扳动手柄106时,连杆构件122通过驱动销124向远侧推动驱动通道140。 In use, as will be described in detail, when the lever handle 106, the link member 122 by the driving pin 124 push drive channel 140 distally.

[0100] 通道组件108包括通道或仓盖130和外部或下部通道132,各自均具有保持在外壳组件102内并位于上、下半外壳104a、104b之间的近端。 [0100] channel assembly 108 includes a channel or cartridge cover 130 and an outer or lower channel 132 each having a held and positioned within the housing assembly 102, 104a, 104b between the proximal end of the lower casing half. 仓盖130包括至少一个保持元件130a,其被构造为且适于可选择地以卡扣配合接合的方式与设置在外部通道132上的互补或相应的保持元件132a相接合。 Cover 130 includes at least one retaining element 130a, which is configured and adapted to selectively engage a snap-fit ​​manner is provided on the exterior channels 132 complementary or corresponding retention element 132a engages.

[0101] 如在图4和图6至12中可见,施夹器100包括可滑动地配置在仓盖130下方的夹子推杆(push bar) 160。 [0101] As can be seen in FIGS. 4 to 6 and FIGS. 12, clip applier 100 includes a slidably disposed beneath cartridge cover 130 of the clip pusher (push bar) 160. 推杆160包括限定了推动器160c的远端160a,所述推动器160c 被构造为且适于可选择地接合/移动存放在外科施夹器100内的最远侧夹子"C/'。推杆160进一步包括近端160b,所述近端160b限定了其中的第一近侧窗口160d和第二近侧窗口160h。第一近侧窗口160d被构造为可滑动地容纳驱动销124于其中,并且第二近侧窗口160h被构造为可滑动地容纳固定杆154a于其中。推杆160还在其中限定了用于可操作地与稳定器162接合的远侧窗口160e和近侧窗口160g,如在下文将更详细讨论的。推杆160 进一步包括孔160f,所述孔160f被构造为容纳远侧连接构件158的滑动支柱158c,如在下文将更详细讨论的。 Pusher bar 160 includes a distal end defining a pusher 160c to 160a, the pusher 160c is configured and adapted to selectively engage / move stored within the surgical clip applier 100 of distal-most clip "C / '. Push bar 160 further includes a proximal end 160b, wherein the proximal end 160b defining a proximal window 160d of the first and second proximal window 160h. the first proximal window 160d is configured to slidably receive the drive pin 124 therein, 160h and the second proximal window is configured to slidably receive therein fixed rod 154a. pusher 160 which also defines a distal window 160e and 160g proximal window for operative engagement with a stabilizer 162, as discussed in more detail below. pusher 160 further includes a hole 160f, the hole 160f is configured to receive a sliding member connected to the distal struts 158c 158, as discussed in greater detail below.

[0102] 施夹器100进一步包括稳定器162,所述稳定器162被构造为覆于推杆160之上并与其接合。 [0102] clip applier 100 further includes a stabilizer 162, a stabilizer 162 configured to overlie and engage pusher bar 160. 稳定器162包括:远侧突起162a,其被构造为接合推杆160的远侧窗口160e ; 细长窗口162b和162d,所述细长窗口162b和162d在其中限定为位于基本覆于形成于推杆160中的近侧窗口160d和160h之上并与相应的近侧窗口160d和160h对准的位置处。 The stabilizer 162 comprises: distal tab 162a, which is configured to engage distal window 160e of pusher bar 160; elongate window 162b and 162d, 162d and the elongate window 162b defined therein is positioned substantially formed overlying the push at the top of rod 160 in the proximal window 160d and 160h and the corresponding proximal window 160d and 160h aligned position. 如在图4和6中可见,稳定器162进一步包括多个突起162e,它们从稳定器的顶表面延伸出, 位于近侧和远侧位置,并被构造且定尺寸为容纳在形成于上半外壳104a中的相应通道中。 As can be seen in FIGS. 4 and 6, stabilizer 162 further comprises a plurality of projections 162e, extending from a top surface of the stabilizer, located in the proximal and distal position, and is configured and dimensioned to be received is formed in the upper half housing 104a in the respective channel. 稳定器162进一步包括覆于推杆160的孔160f之上的孔162f。 Further comprising a stabilizer 162 above the hole 162f of pusher bar 160 overlies hole 160f. 孔160f和162f均被构造为容纳远侧连接构件158的滑动支柱158c。 Holes 160f and 162f are configured to receive the distal connector member of the sliding strut 158c 158.

[0103] 如在图4、4A、4B和24中可见,施夹器100进一步包括运动倍增系统155,所述运动倍增系统155为具有可枢转地支撑在外壳104内且通过枢轴驱动臂156可操作地连接到驱动通道140上的近侧连接构件154的三杆连接系统的形式。 [0103] The, 4B and 24 visible in FIG. 4,4A, clip applier 100 further includes a motion multiplier system 155, a motion multiplier system 155 having pivotally supported within the housing 104 and driven by a pivot arm 156 operatively connected to form a three connection system 140 proximal connector member 154 drive channel. 枢轴驱动臂156经由孔156b通过销156a可枢转地接合到外壳104上。 The pivot drive arm 156 pivotally joined to the housing 104 by a pin 156a via the hole 156b. 运动倍增系统155进一步包括将近侧连接构件154 和推杆160相互连接的远侧连接构件158。 Motion multiplier system 155 further comprises a distal connector member 158 connected to the proximal member 154 and the push rod 160 connected to each other. 纵向轴线"XI"限定为沿着穿过近侧连接构件154的固定杆154a和远侧连接构件158的滑动支柱158c延伸的轴线。 Longitudinal axis "XI" is defined as an axis extending in the sliding strut 158c 158 fixing bars 154a and the distal connection member 154 along through the proximal member. 纵向轴线"XI"的包括枢轴驱动臂156的一侧定义为第一侧,而纵向轴线"XI"的另一侧定义为第二侧。 Longitudinal axis "XI" includes the definition of one side of the pivot drive arm 156 is a first side, while the other side defines a longitudinal axis "XI" is a second side. 在第一侧上,近侧连接构件154可枢转地定向在相对于纵向轴线"XI"成角度" α "处(如图24所示)。 On the first side, proximal connector member 154 is pivotally oriented with respect to the longitudinal axis "XI" at an angle "α" at (Figure 24). 在第二侧上,近侧连接构件154可枢转地定向在相对于纵向轴线"XI"成角度α " 处(如图35所示)。实质上,当近侧连接构件154定向在角度" α "和角度α "之间,角度为〇度时,使得近侧连接构件154与纵向轴线"XI"成一直线(如图27所示)。 On a second side, a proximal connector member 154 may be pivotally oriented pivot with respect to the longitudinal axis "XI" at an angle [alpha] 'at a (FIG. 35). In essence, when the proximal connector member 154 is oriented at an angle " It is between α "and the angle α", square angle degrees, so that the proximal connector member 154 with the longitudinal axis "XI" in line (Figure 27). 在这种构造中,近侧连接构件154还与远侧连接构件158成一直线,如下文将更详细讨论的。 In this configuration, the proximal connector member 154 is also connected to the distal member 158 in a straight line, will be discussed in more detail below. 枢轴驱动臂156通过由驱动通道140固定且驱动的枢轴销156a被可枢转地支撑。 The pivot drive arm 156 is pivotally supported by the fixed drive channel 140 and drives the pivot pin 156a. 纵向轴线"Χ2" 限定为沿着驱动通道140延伸的轴线。 Longitudinal axis "Χ2" is defined as an axis extending along a drive channel 140. 如此,枢轴驱动臂156可枢转地定向在相对于纵向轴线"X2"成角度" β "处(如图24所示)。 Thus, the pivot drive arm 156 is pivotally oriented with respect to the longitudinal axis "X2" at an angle "β" at (Figure 24).

[0104] 近侧连接构件154包括毂(hub) 154b,所述毂154b被构造为容纳穿过其的固定杆154a,以便建立在近侧连接构件154和外壳104之间的枢转连接。 [0104] proximal connector member 154 comprises a hub (hub) 154b, 154b of the hub is configured to receive a fixation rod therethrough through 154a, in order to establish the connection between the proximal member 154 and the housing 104 is pivotally connected. 近侧连接构件154还包括近侧孔154c和远侧孔154d。 Proximal connector member 154 also includes proximal and distal bore hole 154c 154d. 近侧孔154c被构造为容纳枢轴驱动臂156的驱动支柱156c, 枢轴驱动臂156以旋转的方式可选择地驱动近侧连接构件154,如在下文将更详细讨论的。 The proximal hole 154c is configured to receive pivot arm 156 driving strut 156c of the pivot drive arm 156 so as to selectively drive rotation of proximal connector member 154, as discussed in more detail below. 远侧孔154d被构造为容纳通过远侧连接构件158的孔158b的接合销158a,接合销158a使近侧连接构件154可枢转地接合到远侧连接构件158上。 The distal hole 154d is configured to receive the distal connector member 158 through the hole of the engaging pin 158a 158b, so that the engagement pin 158a proximal connector member 154 may be pivotally engaged to the distal connection member 158. 远侧连接构件158进一步包括支柱158c,所述支柱158c可滑动地连接到推杆160的孔160f和稳定器162的孔162f中。 The distal connector member 158 further comprises a strut 158c, 158c of the strut slidably connected to the plunger 160 bore holes 160f and 162f 162 stabilizer in. 远侧连接构件158通过滑动支柱158c实现推杆160和稳定器162在近侧和远侧方向上的平移。 The distal connector member 160 and the plunger 158 158c achieve stabilizer 162 is translated in a proximal and distal direction by sliding strut.

[0105] 施夹器100进一步包括配置在通道组件108内且位于推杆160下方的夹子承载器170。 [0105] clip applier 100 further includes a component disposed within the channel 108 and is located below the ram 160 of clip carrier 170 夹子承载器170通常呈盒状结构,具有上壁170a、一对侧壁170b和下壁170c,限定了穿过其中的通道170d。 Clip carrier 170 is generally box-shaped structure having an upper wall 170a, a pair of sidewalls 170b and 170c lower wall, defining a passage therethrough 170d. 夹子承载器170包括多个间隔开的窗口172,所述窗口172形成于上壁170a内并沿其长度纵向延伸。 Clip carrier 170 includes a plurality of spaced-apart window 172, the window 172 formed in the upper wall 170a and extending longitudinally along its length. 夹子承载器170包括形成于下壁170c内并沿其长度纵向延伸的细长窗口170e (如图9所示)。 Clip carrier 170 includes an elongate window 170e formed in the lower wall 170c and extending longitudinally along its length (see Figure 9).

[0106] 如在图4H至4J中可见,外科夹子"C"包括第一腿部"C2"和第二腿部"C 4"。 [0106] As can be seen, surgical clips "C" in Figure 4H to 4J includes a first leg "C2" and second leg "C 4". 外科夹子"C"的腿部"C2"和"C4"中的每一个都连接到彼此上以形成顶点"C 14"。 The surgical clip "C" leg "C2" and "C4" are each connected to one another to form an apex "C 14". 外科夹子"C" 的顶点"C14"具有如图4H至41所示大致V形的构造。 The surgical clip "C" apex "C14" has a generally V-shaped configuration as shown in FIG 4H 41 to FIG. 外科夹子"C"的第一腿部"C 2"进一步包括位于内壁上且限定了多个凹槽"C8"的夹持图案(gripping pattern) "C6"。 The surgical clip "C" first leg "C 2" further includes an inner wall and defining a plurality of grooves "C8" holding pattern (gripping pattern) "C6". 外科夹子"C"的第二腿部"C4"包括在外壁上的多个凹入部"C 1(l"和在内壁上的多个凸出部"C12"。 当外科夹子"C"施加到组织上时,由于在下文将更详细地描述施加夹子"C"到组织上,腿部"C 2 "和"C4"会合到一起,以使多个凹入部"C1(l"和多个凸出部"C12 "将组织夹紧并保持在其间。为了更详细地讨论外科夹子"C",请参见于共有的由2006年1月23日提交的、名称为"SurgicalHemostatic Clip (外科止血夹)"、公布号为2007/0173866的美国文献,将其全部内容通过引用并入到此处。 The surgical clip "C" second leg "C4" includes a plurality of recessed portions of the outer wall of the "C 1 (l" and a plurality of projections on the inner wall of the "C12". When surgical clips "C" is applied to the when tissue, since described in more detail below is applied to a clip "C" to the tissue, leg "C 2" and "C4" to join together, so that a plurality of concave portions "C1 (l" and a plurality of projections the department "C12" will organize clamped and held therebetween. for more detailed discussion of surgical clips "C", refer seen in total submitted by the January 23, 2006, entitled "SurgicalHemostatic clip (surgical hemostatic clip) "American literature publication No. 2007/0173866, the entire contents of which are incorporated by reference herein to.

[0107] 如在图4、9和14中可见,一叠外科夹子"C"装载和/或保持在夹子承载器170的通道170d内,以在其内滑动和/或沿其滑动。 [0107] As can be seen in FIGS. 4, 9 and 14, a stack of surgical clips "C" loaded and / or retained within clip carrier channel 170d 170 to slide therein and / or slide along. 通道170d被构造且定尺寸为将一叠或多个外科夹子"C"以头尾相接的方式可滑动地保持于其中。 Channel 170d is configured and dimensioned to a stack or plurality of surgical clips "C" in a head to tail manner slidably retained therein.

[0108] 如在图12和14中可见,夹子承载器170的远端包括一对分隔开的弹性柄脚(tang) 171。 [0108] As can be seen in FIGS. 12 and 14, the distal end of clip carrier 170 includes a pair of spaced apart elastic tangs (tang) 171. 柄脚171被构造为适于可选择地接合保持在夹子承载器170内的一叠外科夹子"C"的最远侧外科夹子"C1"的后跨部(backspan)。 After the tang 171 is adapted to be selectively configured to engage the stack of surgical clips retained within clip carrier 170 "C" of the distal-most surgical clip "C1" of the cross section (backspan).

[0109] 如在图4、4E、7和15中可见,施夹器100进一步包括可滑动地配置在夹子承载器1-70的通道170d内的夹子输出器174。 [0109] The, 7 and 15 seen in FIG 4,4E, clip applier 100 further comprises a slidably disposed within the channel of clip carrier 170d 1-70 of the clip 174. 如下文将要更详细地讨论的,夹子输出器174位于这叠外科夹子"C"的后方,设置为在施夹器100致动期间将这叠夹子"C"向前推进。 As will be discussed in greater detail below, clip follower 174 is positioned behind the stack of surgical clips "C" is provided to the clip applier 100 during actuation of the stack of clips "C" forward. 如下文将要更详细地讨论的,通过楔板180的前后往复运动来致动夹子输出器174。 As will be discussed in greater detail, before and after the wedge plate 180 to reciprocate the actuator clip 174.

[0110] 如在图4E和7中可见,夹子输出器174包括:限定了一平面的主体部174a,从主体部174a基本上向上和向后延伸出的远侧突起175,以及从主体部174a基本上向下和向后延伸出的近侧突起176。 [0110] As can be seen, clip 174 includes 7 and in FIG. 4E: defining a planar body portion 174a, a substantially upward and rearwardly extending distally from the body portion 175 of the protrusion 174a, 174a, and from the main body portion extending substantially downwardly and rearwardly out of the proximal protrusion 176. 远侧突起175包括:在由主体部174a限定的所述平面下方向下延伸的远侧部175a ;和在由主体部174a限定的所述平面上方向上延伸的近侧部175b。 The distal projection 175 comprising: 175a by the distal portion of the lower body portion 174a defining a plane extending downwardly; and a proximal portion 175b extending in a direction on the plane defined by body portion 174a in.

[0111] 远侧突起175的近侧部175b被构造且定尺寸为可选择地与形成于夹子承载器170 的上壁170a内的窗口172接合。 The proximal portion [0111] 175b of distal tab 175 is configured and dimensioned to selectively engage the clip carrier formed in the upper wall 170a 170 a window 172. 使用时,夹子输出器174的远侧突起175的近侧部175b 接合在形成于夹子承载器170的上壁170a内的窗口172中,防止夹子输出器在近侧方向上平移或移动。 In use, the distal clip proximal portion 174 of the projection 175 engages in a window 175b formed in the clip carrier 172 on the wall 170a 170, the clip prevents translation or movement in the proximal direction.

[0112] 近侧突起176被构造且定尺寸为可选择地与形成于楔板180内的窗口180b接合。 [0112] The proximal protrusion 176 is engaged 180b configured and dimensioned to selectively formed in wedge plate 180 window. 使用时,夹子输出器174的近侧突起176接合在形成于楔板180内的窗口180b中,使得夹子输出器174基于楔板180的远侧移动而向远侧前进或移动。 In use, the proximal projection 174 of clip 176 engages in a window 180b formed in wedge plate 180 such that clip 174 on the distal movement of the wedge plate 180 is advanced or moved distally.

[0113] 如在图4、7至9、16和17中可见,施夹器100进一步包括可滑动地配置在手柄组件102和通道组件108内的楔板180。 [0113] As can be seen in FIGS. 4 and 7 to 9, 16 and 17, clip applier 100 further includes a wedge plate slidably disposed in the handle assembly 180 in the 108 and channel assembly 102. 楔板180定位或配置在夹子承载器170下方。 Wedge plate 180 is positioned or disposed below clip carrier 170. 楔板180包括用于选择性操作地插在钳夹120之间的基本锥形的远端180a。 Wedge plate 180 includes a distal end for selectively operatively interposed between the jaws 120 is substantially conical 180a. 楔板180限定了: 多个沿其长度纵向延伸并形成于其隆起部分中的间隔开的窗口或孔180b、位于孔180b远侧的远侧窗口或孔180c、以及定位在孔180c近侧的最近侧横向定向槽180d。 Wedge plate 180 defines: a plurality of longitudinally extending along the length thereof and forms a raised portion thereon spaced apart windows or apertures 180b, 180b distal of the aperture distal window or aperture 180c, and a positioning hole 180c in proximal recently transversely oriented grooves 180d side.

[0114] 如在图4、8、16和17中可见,施夹器100包括由仓盖130支撑的远侧锁定件178。 [0114] As can be seen in FIGS. 8, 16 and 17, clip applier 100 includes a cover 130 supporting the locking member 178 distally. 远侧锁定件178包括尾部或突起178a,所述尾部或突起178a基本上向后和向下延伸并构造且定尺寸为容纳在楔板180的远侧窗口或孔180c中。 The distal locking member 178 includes a tail or protrusion 178a, the protrusion 178a of the tail or rearward and extends substantially downwardly and configured and dimensioned to receive the distal window 180 of wedge plate or of the hole 180c.

[0115] 如在图4、4C、4D、6、11、13、18和20中可见,施夹器100包括楔板运动反转机构(motion reversing mechanism),其呈枢轴臂179的形式,可枢转地支撑在外壳104 的下半外壳l〇4b上,用于将驱动通道140的平移传递成楔板180的反转平移(reverse translation)。 [0115] As can be seen in FIG. 4,4C, 4D, 6,11,13,18 and 20, clip applier 100 includes a wedge plate motion reversing mechanism (motion reversing mechanism), which form the pivot arm 179, pivotally supported on the lower housing half l〇4b housing 104 for transmitting translation of drive channel 140 to translation of wedge plate 180 is inverted (reverse translation). 枢轴臂179包括:被构造为可枢转地连接到外壳104上的枢轴凸起部(pivot boss) 179a、设置在枢轴臂179的一端处并沿与枢轴凸起部179a相反的方向延伸的第一柱杆或指状部179b、以及设置在枢轴臂179的第二端处并在沿第一柱杆或指状部179b和枢轴凸起部179a的方向上延伸的第二柱杆或指状部179c。 Pivot arm 179 comprising: a configured to be pivotally connected to a pivot boss portion (pivot boss) 179a on the housing 104, provided at one end of the pivot arm 179 and the projection 179a opposite to the pivot portion along extending in a direction of the first stem or finger extending portion 179b, and disposed at the second end of the pivot arm 179 and along the first stem or finger 179b and a pivot portion 179a of the boss portion two posts or fingers 179c. 第一柱杆或指状部179b被构造为适于接合在楔板180的最近侧槽180d中。 First stem or finger 179b is configured as a recently adapted to engage the side grooves 180d of wedge plate 180. 第二柱杆或指状部179c被构造为接合在形成于驱动通道140中的槽140g中,其连接在限定于驱动通道140中的窗口140g中。 Second stem or finger 179c is configured to engage the groove 140g is formed in the driving passage 140, which is connected in a window 140g defined in a drive channel 140. 槽140g包括: 彼此轴向和横向偏离的纵向延伸远侧部和纵向延伸近侧部,以及使远侧部和近侧部相互连接的横向部。 140g groove comprising: a longitudinally extending and laterally offset from one another axially of the longitudinally extending distal portion and a proximal portion, a distal portion and a transverse portion and a proximal portion connected to each other.

[0116] 使用时,如在下文将详细讨论的,当驱动通道140向远侧移动时,在一停顿时间段(dwell period)之后(即,驱动通道140的槽140g的纵向延伸的远侧部的长度),第二柱杆或指状部179c在远侧方向上移动,使枢轴臂179旋转,从而使第一柱杆或指状部179b在第二方向上移动。 [0116] In use, when drive channel 140 is moved distally, after a pause period of time (dwell period) (i.e., longitudinally extending slot 140g of drive channel 140 of the distal portion, as will be discussed in more detail below length), second stem or finger 179c is moved in the distal direction, so that rotation of the pivot arm 179 so that first stem or finger 179b is moved in the second direction. 当第一柱杆或指状部179b在第二方向上移动时,第一柱杆或指状部179b 将楔板180从钳夹120之间拉出,推动楔板。 When the first stem or finger 179b is moved in the unit when the second direction, first stem or finger 179b of wedge 180 is pulled out from between the jaws 120, push wedge. 当楔板180在远侧方向上移动时,如在图17中可见,楔板180的远端180a凸靠(cam against)钳夹120的内表面,从而保持钳夹120彼此间隔开。 When the wedge 180 is moved in the distal direction, as can be seen, the distal end 180a projecting wedge 180 against the inner surface (cam against) the jaws 120, so as to maintain jaws 120 spaced apart from each other in FIG 17.

[0117] 如在图4、6至11、13、18和19中可见,施夹器100包括驱动通道140,所述驱动通道140可往复地支撑在手柄组件102的外壳104和通道组件108内并在二者之间延伸。 [0117] As can be seen in Figures 4, 6, 11,13,18 and 19, clip applier 100 includes a drive channel 140, a drive channel 140 reciprocally supported in the housing 104 within the handle assembly 102 and channel assembly 108 and extending therebetween. 驱动通道140的近端支撑在外壳104的上、下半外壳104a、104b之间,而驱动通道140的远端支撑在仓盖130和通道组件108的外部通道132之间,位于楔板180的下方一位置处。 The proximal end of drive channel 140 is supported on the housing 104, lower housing half 104a, between 104b, and the distal end of drive channel 140 is supported between cartridge cover 130 and outer channel 108 of channel assembly 132, a wedge plate 180 located at a location below.

[0118] 驱动通道140的远端是基本呈U形的通道,其包括在远离外部通道132且朝向仓盖130的方向上、从其后跨部140c延伸出的间隔开的一对侧壁140b。 The distal end [01] of drive channel 140 is substantially U-shaped channel, which includes a pair of side walls spaced apart in a direction away from outer channel 132 and toward cartridge cover 130 extending from backspan 140c 140b thereafter . 驱动通道140进一步限定了形成于后跨部140c内、用于可枢转地容纳驱动销124穿过其中的驱动销凹槽140a。 Drive channel 140 further defines an internal cross-section 140c formed in the rear, for pivotally receiving drive pin 124 through the drive pin recess 140a therein. 驱动通道140进一步限定了位于驱动销凹槽140a远侧的位置处、从后跨部140c突出的肋块(rib) 140e。 Drive channel 140 further defines a drive pin located at a distal recess 140a of the block from a rib projecting backspan 140c (rib) 140e. 驱动通道140进一步限定了形成于后跨部140c内、位于槽140e远侧的位置处的往复限制槽140f。 Drive channel 140 further defines an internal cross-section 140c formed in the rear, at a reciprocation limiting slot 140f located distally of the groove 140e.

[0119] 如在图4、8、9、12、14至16和19中可见,施夹器100包括固定到驱动通道140上的驱动通道带箍143。 [0119] As can be seen in FIGS. 4,8,9,12,14 to 16 19, clip applier 100 includes a drive channel secured to drive channel 140. Strap 143. 带箍143固定到驱动通道140的直立部140b上,以横向地横跨直立部140b延伸。 Strap 143 is secured to the upright portion 140b of drive channel 140, to laterally extend across the upstanding portion 140b. 带箍143固定到驱动通道140上、位于往复限制槽140f的远侧。 Strap 143 is secured to drive channel 140, located at a distal reciprocation limiting slot 140f. 带箍143 固定到驱动通道140上以使楔板180在带箍143下方和钳夹120上方延伸。 Strap 143 is secured to drive channel 140 such that wedge plate 180 extends beneath strap 143 and above jaws 120.

[0120] 如在图4、4F、6、10和21中可见,施夹器100进一步包括通过驱动销124连接到驱动通道140的听觉/触觉指示器148。 [0120] The 6, 10 and 21 seen in FIG. 4,4F, clip applier 100 further includes an audible connected to drive channel 140 via drive pin 124 / tactile indicator 148. 指示器148包括弹性指状部148a和一对凸起部148b。 Indicator 148 includes a resilient finger 148a and the convex portion 148b couple. 使用时,如在下面将更详细地描述的,当将施夹器100致动并使驱动通道140往复运动时,指示器148的第一弹性指状部148a与设置在施夹器100上的相应的互补结构或凸缘149相互作用,以给用户生成听觉和/或触觉反馈。 In use, as described in greater detail below, when the clip applier 100 is actuated and drive channel 140 reciprocated, first resilient finger portions 148 indicator 148a provided in the clip applier 100 corresponding complementary structure or ledge 149 interact to generate a user audible and / or tactile feedback. 指示器148的凸起部148b搭在形成于上半外壳104a的通道104e内并向指示器148提供支撑以防止指示器148旋转。 The projection portion 148b of indicator 148 ride within channel 104e formed in upper housing half 104a of indicator 148 to provide support to prevent rotation of the indicator 148.

[0121] 如在图4、6、10、11、13、18和20中可见,施夹器100进一步包括偏压构件146,其呈拉力弹簧的形式,可操作地固定到驱动通道140的近端和外壳104上并处于二者之间,趋向于保持驱动通道140处于缩回的或最近侧的位置。 [0121] As can be seen in FIG 4,6,10,11,13,18 and 20, clip applier 100 further includes a biasing member 146, which is in the form of a tension spring, operatively secured to drive channel 140 near the end and the housing 104 and between them, drive channel 140 tends to remain in a retracted or proximal-most position. 偏压构件146的作用在于在位于钳夹120之间的夹子"C"成型之后使驱动通道140缩回或便于驱动通道140缩回。 That the action of the biasing member 146 is located behind the drive channel jaw clip "C" shaped between 120 140 retract or facilitate retraction of drive channel 140.

[0122] 如在图4、4G、11、13、18和20中可见,驱动通道140的近端包括齿条构件141,其固定在驱动销124上并可与驱动通道140 -起移动。 [0122] e.g., 11,13,18, and 20 seen in FIG 4,4G, the proximal end of drive channel 140 includes a rack member 141, which is fixed to the drive pin and drive channel 124 and 140-- move together. 齿条构件141包括槽141b,以便可滑动地容纳固定杆154a。 Rack member 141 includes a slot 141b, so as to slidably receive the fixation rod 154a. 齿条构件141进一步包括从其近端延伸出的突起141c,其在下半外壳104b内可滑动地平移。 Further comprising a rack member 141 extending proximally therefrom out of the protrusion 141c, which slidably translate within lower housing half 104b. 齿条构件141被构造为且适于与支撑在外壳104内的棘爪142接合。 The rack member 141 is configured and adapted to engage within the housing 104 with the support pawl 142. 齿条构件141和棘爪142限定了棘轮机构144。 Rack member 141 and pawl 142 define a ratchet mechanism 144. 使用时,当驱动通道140轴向移动时, 齿条构件141也移动。 In use, when drive channel 140 is moved axially, rack member 141 is also moved. 齿条构件141限定了一系列具有一定长度的齿条齿141a,当随着驱动通道140到达最近或最远侧位置而使齿条构件141在近侧移动和远侧移动之间变化时, 所述长度允许棘爪142反向并在齿条构件141上返回。 Rack member 141 defines a series of rack teeth 141a having a length, when as drive channel 140 reaches the distal most position closest or rack member 141 changes between proximal and distal movement of the mobile, the the length of said reversed and allow the ratchet 142 to return the rack member 141.

[0123] 通过棘爪销147将棘爪142可枢转地连接到下半外壳104b上,在此处棘爪142基本上与齿条构件141可操作地接合。 [0123] The pawl 142 is pivotally connected by a pawl pin 147 on the lower housing half 104b, 141 where the pawl operably engaged with the rack member 142 substantially. 棘爪142能够与齿条构件141接合以限制齿条构件141 的纵向移动,并且接着限制驱动通道140的纵向移动。 The pawl 142 engages with the rack member 141 to restrict longitudinal movement of rack member 141, and then limiting the longitudinal movement of drive channel 140. 棘轮机构144进一步包括爪簧145, 所述爪簧145被构造且定位为将棘爪142偏压至与齿条构件141可操作的接合。 Ratchet mechanism 144 further includes a pawl spring 145, the pawl spring 145 configured and positioned to bias pawl 142 to 141 operably engaged with the rack member. 爪簧145 的作用在于保持棘爪142的齿与齿条构件141的齿141a啮合,以及保持棘爪142处于旋转或倾斜的位置。 Pawl spring 145 is to maintain the role of the teeth 142 of the pawl 141 and the teeth 141a of the rack member engaging pawl 142 and held at a position rotated or tilted.

[0124] 如在图1至4、8、10、12、14至17和19中可见,施夹器100包括一对安装在通道组件108的远端上或远端处的谢夹120,其能够通过手柄组件102的手柄106来致动。 [0124] As can be seen in FIGS. 17 through 4,8,10,12,14 and 1-19, clip applier 100 includes a pair of Xie channel assembly is mounted on the distal end or distal end 108 of clip 120, which can be actuated by the handle assembly 102 in handle 106. 谢夹120由例如不锈钢或钛的适合的生物相容性材料制成。 Xie clip 120 is adapted by, for example, stainless steel or titanium biocompatible material.

[0125] 通过一个或多个延伸穿过驱动通道140的往复限制槽140f的铆钉120c或类似物将钳夹120安装在驱动通道140的远端,以使得钳夹120相对于外部通道132和驱动通道140是纵向静止的。 [0125] through one or more passages extending through reciprocation limiting slot 140f drives the rivet 140 or the like, 120c of the jaws 120 mounted at a distal end of drive channel 140 such that jaws 120 with respect to outer channel 132 and drive 140 is a longitudinal channel stationary. 如在图12、14、17和19中可见,钳夹120在其间限定了用于容纳外科夹子"C/'于其中的通道120a。 As can be seen in FIGS. 12, 14 and 19, jaws 120 define a channel 120a therebetween for receiving a surgical clip "C / 'therein.

[0126] 如在图1至4、6、11、13和20中可见,施夹器100进一步包括支撑在手柄组件102 的外壳104中的计数器机构190。 [0126] As can be seen in FIGS. 1 to 4,6,11,13 and 20, clip applier 100 further includes a housing 104 supported on the handle assembly 102. Counter mechanism 190. 计数器机构190包括显示器192、处理器194和电池等形式的能源198。 Counter mechanism 190 includes a display 192, a processor 194 and a battery 198 and other forms of energy. 显示器192为向外科医生显示施夹器100的一个或多个操作参数的液晶显示器。 A liquid crystal display monitor 192 to display a clip applier 100 or more operating parameters of the surgeon. 所显示的操作参数可为剩余夹子的数量或数目、已经使用过的夹子的数目、位置参数、使用的手术时间、或者该过程的任何其它参数。 Any number of other parameters may be displayed operating parameters the number or the number of remaining clips, the clip has been used, a position parameter, a surgical time of usage, or the process.

[0127] 计数器机构190包括由PVC制成的翼片192a,翼片192a配置在电池或能源198和处理器194的触点194a之间或配置在处理器194的触点194a之间以防止电池或能源198 在存放过程中被耗尽。 [0127] Counter mechanism 190 includes a tab 192a made of PVC, flaps 192a disposed between the battery or energy source 198 and the contacts 194a 194 processor or a processor disposed between the contacts 194a 194 to prevent the battery or 198 energy is depleted during storage. 如在图1A和1B中可见,翼片192a从施夹器100的外壳104向外部延伸以允许所述翼片易于从外壳移除。 As can be seen in FIGS. 1A and 1B, tab 192a extends to the outside of the flap to allow easy removal of the housing from the housing 104 from the donor clamp 100. 一旦移除翼片192a,电池或能源198与处理器194 的触点194a电接触或在处理器194的触点194a之间形成电接触。 Once 192a, battery or energy source 198 with a processor 194 in electrical contact 194a of the contact wings or removing electrical contact between the processor 194 of the contacts 194a.

[0128] 可通过形成于驱动通道140中的突块(nub) 140e来致动计数器机构190。 [0128] may be formed on the bump by (NUB) 140e of drive channel 140 to actuate the counter mechanism 190. 使用时, 如在图36中可见,当向前驱动驱动通道140时,其突块140e与触点194a接合,使得触点194a形成一电路并触发处理器194执行功能(例如,将出现在显示器192上的数目减少给定的增量或数值)。 In use, as seen in FIG. 36, when drive channel 140 is driven forward, lugs 140e which engages with the contact 194a, contact 194a is formed such that a circuit and trigger processor 194 to perform the functions (e.g., the display appears in the reducing the number of 192 on a given increment or value).

[0129] 如在图1A和1C中可见,施夹器100包括支撑在外壳104上并插在手柄106之间的装运楔200。 [0129] As can be seen in FIGS. 1A and 1C, clip applier 100 includes a support 104 on the housing 106 and interposed between the handle 200 of the shipping wedge. 装运楔200的作用在于:在装运和/或存放施夹器100时保持手柄106间隔开或不被扳动。 Shipping wedge 200 is that the effect of: shipping and / or storage of clip applier 100 to maintain handles 106 spaced apart or may not be pulled. 装运楔200连接到计数器机构190的翼片192a上,以使得终端用户使用施夹器100时,终端用户必须移除装运楔200,从而也移除翼片192a来启动计数器机构190。 Shipping wedge 200 is connected to the counter means 190 of the flaps 192a, so that the end user to use clip applier 100, the end user must remove shipping wedge 200 thereby also removing tab 192a to activate counter mechanism 190.

[0130] 如在图1A和1C中可见,装运楔200包括卡圈形式的主体部202,主体部202限定了被构造且定尺寸为可容纳一部分外壳104于其中的通道204。 [0130] As can be seen, shipping wedge 200 includes a main body portion in the form of a collar 202, the body 202 defines a portion is configured and dimensioned to receive a portion of the housing 104 in which the channel 204 in FIGS. 1A and 1C. 装运楔200包括直立部206, 其从主体部202的相反两侧向外延伸出并被构造为容纳手柄106于其中。 Shipping wedge 200 includes an upright portion 206 which extends from opposite sides of the body portion 202 and an outward lever 106 is configured to receive therein. 装运楔200进一步包括从直立部206的相反两侧向内延伸的突起208。 Shipping wedge 200 further includes a projection 208 extending from opposite sides of the upright portion 206 inwardly. 装运楔200的突起208被构造且定尺寸为当装运楔200合适地固定到施夹器100上时与手柄106接合。 Shipping wedge 208 of the protrusion 200 is configured and dimensioned that when shipping wedge 200 is suitably secured to the clip applier 100 is engaged with the handle 106.

[0131] 参照图22至53,提供了施夹器100的操作。 [0131] Referring to FIGS. 22-53, clip applier is provided an operation 100. 在初始扳动施夹器100的手柄106之前,如在图22至24中可见,施夹器100的内部零件处于所谓的"原始"位置或"起动"位置。 , As seen in FIGS. 24 to 22 before the initial pulling handle 100 of clip applier 106, the internal parts of clip applier 100 is in a so-called "home" position or "START" position. 更具体地,在"原始"位置,驱动销124位于最近侧位置,棘爪142位于驱动通道140的齿条140d的远侧,枢轴臂179的第二指状部179c位于驱动通道140的窗口140g的远侧部内的最远侧位置,以使得楔板180位于最远侧位置,并且没有夹子"C"设置在钳夹120内。 More specifically, in the "home" position, the drive pin 124 is located at a proximal-most position, pawl 142 is located distal rack 140d of drive channel 140, second finger pivot arm 179 is located at the window portion 179c of drive channel 140 distal-most position in the distal portion 140g, so that the wedge 180 is located distal-most position, and no clips "C" is provided in the jaws 120. 由于驱动销124处于最近侧位置,因此推杆160、稳定器162和驱动通道140也处于最近侧位置。 Since drive pin 124 is in a proximal-most position, pusher bar 160, stabilizer 162, and drive channel 140 are also at a proximal-most position.

[0132] 如在图24中可见,当驱动通道140和推杆160位于最近侧位置时,枢轴驱动臂156 的驱动支柱156c位于最近侧位置,并且指示器148的第二弹性指状部148b配置在形成于下半外壳104b中的凸台(edge) 149的近侧。 [0132] As can be seen, when drive channel 140 and pusher bar 160 located at a proximal-most position, the pivot drive column 156c of the driving arm 156 is located proximal-most position in FIG. 24, the indicator 148 and the second resilient finger 148b disposed proximal (edge) 149 of the boss 104b is formed in the lower housing half. 在实施例中,在对指示器148略作修改后,凸台149可形成在上半外壳104a内。 In an embodiment, after a slight modification of the indicator 148, the boss 149 may be formed in upper housing half 104a. 在"原始"位置,近侧连接构件154的角度" α "可从大约45度到大约60度的范围变化,同时枢轴驱动臂156的角度" β "可从大约20度到大约25度的范围变化。 In the "home" position, the proximal member 154 of the connection angle "[alpha]" may vary range from about 45 degrees to about 60 degrees, while the angle of the pivot arm 156 drives the "beta]" may be from about 20 degrees to about 25 degrees range. 此外,在初始扳动施夹器100的手柄106之前,在楔板180位于最远侧位置时,其远端180a插在钳夹120之间。 Further, prior to the initial pulling handle 100 of clip applier 106, wedge plate 180 is located at the distal-most position, distal end 180a thereof is interposed between jaws 120.

[0133] 如在图22、24和24A中可见,同样是在"原始"位置,远侧连接构件158的接合销158a位于纵向轴线"XI"的第一侧。 The engagement pin 158a [0133] As can be seen, the same is in the "home" position, the distal connector member 158 in FIGS. 22, 24 and 24A located at a first side of the longitudinal axis "XI" is.

[0134] 下列的方程式用于计算处于"原始"位置的运动倍增系统155的动力学。 [0134] The following equation is used to calculate the dynamic motion multiplier system "home" position 155. 所述"原始"位置直接涉及到当推杆160处于"原始"位置(S卩,最近侧位置)时的情况,例如,当"α " 为大约60度时的情况。 The case when the "home" position when the push rod 160 directly involved in the "home" position (S Jie, proximal-most position), for example, when the "[alpha]" is the case about 60 degrees.

[0135] ΧΡ = (2) (LI) (cos a ) - (LI) (1) [0135] ΧΡ = (2) (LI) (cos a) - (LI) (1)

[0136] 其中,距离"ΧΡ"为由滑柱158c行进的距离,并且长度"L1"为近侧连接构件154 和远侧连接构件156的长度,如图24A所示。 [0136] wherein the spool 158c by the distance traveled distance "ΧΡ", and the length "L1" is the length of the proximal connector member 154 and distal connector member 156, as shown in FIG. 24A.

[0137] XD = (B) + (C) (cos α ) - (L2) (cos β ) (2) [0137] XD = (B) + (C) (cos α) - (L2) (cos β) (2)

[0138] 其中,距离"XD"为由枢轴驱动臂156的枢轴柱156a沿纵向轴线"Χ2"行进的距离,距离"Β"为沿着纵向轴线"XI"的枢轴驱动臂156的枢轴销156a和近侧连接构件154 的固定杆154a之间的距离,距离"C"为近侧连接构件154的固定杆154a和枢轴驱动臂156 的驱动支柱156c之间的距离,并且长度"L2"为枢轴驱动臂156从枢轴柱156a到驱动支柱156c的长度,如图24A所示。 [0138] wherein the distance traveled by the pivot post 156a of the pivot arm 156 driven along the longitudinal axis "Χ2" distance "XD", from "Β" is driven along the longitudinal axis "XI" of the pivot arm 156 pivot pin 156a and the proximal connector member 154 fixed to rod 154a of the distance between the distance "C" is connected to the proximal member 154 is fixed rod drive column 154a 156c and the distance between the pivot drive arm 156, and a length "L2" is the drive arm 156 pivots from 156a to the length of the drive pivot post pillar 156c, as shown in FIG. 24A.

[0139] 此外,在初始扳动之前,钳夹120内没有夹子"C"。 [0139] Further, before the initial pulled, the clamp jaws 120 is not "C". 在初始扳动手柄106期间首先将夹子"C"装载到钳夹120内。 During the initial toggle handle 106 first clip "C" is loaded into the jaws 120. 如在图25至33中可见,在初始扳动手柄106 (即,工作行程)期间,连杆构件122的远端122a相对于外壳104向远侧移动。 As seen in FIGS. 25 to 33, in an initial lever handle 106 (i.e., the working stroke), the distal end 122a of the link member 122 relative to the housing 104 is moved distally. 当连杆构件122的远端122a向远侧移动时,驱动销124向远侧移动,从而将远侧轴向运动传递给驱动通道140。 When the distal end of the link member 122 moves distally 122a, drive pin 124 is moved distally thereby transmitting distal axial movement to drive channel 140.

[0140] 随后,如在图25至31中可见,当驱动通道140向远侧移动时,运动倍增系统155 从"原始"位置移动到初始致动位置。 [0140] Subsequently, as seen in FIGS. 25 to 31, when drive channel 140 is moved distally, the motion multiplier system 155 is moved from the "home" position to the initial position of the actuator. 更确切地说,驱动通道140在远侧方向上前进,这又致使枢轴驱动臂156在远侧方向上移动。 More specifically, drive channel 140 proceeds in a distal direction, which in turn causes the pivot drive arm 156 moves in the distal direction. 就是说,枢轴驱动臂156枢转且驱动近侧连接构件154以便在一方向上旋转,以使角度" β "增大,例如,不限于从大约22度到大约45度变化。 That is, the pivot drive and the drive arm 156 is pivotally connected to the proximal member 154 so as to rotate in one direction, so that the angle "β" is increased, for example, is not limited to vary from about 22 degrees to about 45 degrees. 如此,当角度" β "增大时,近侧连接构件154关于近侧连接构件154的固定杆154a旋转,这又导致沿着稳定器162的槽162b和推杆160的近侧窗口160d向远侧驱动远侧连接构件158的驱动支柱158c。 Thus, when the angle "β" is increased, the proximal connection member 154 is fixed on the rotation shaft 154a of the proximal connector member 154, which in turn causes the stabilizer along the slot 162b 162 and proximal window 160d of pusher bar 160 distally the distal strut connecting the drive side of the drive member 158 158c. 当向远侧驱动远侧连接构件158的驱动支柱158c时,远侧连接构件158的驱动支柱158c在远侧方向上驱动推杆160。 When the drive member distally connected to the distal struts 158 of the drive 158c, the driving member 158 is connected to the distal strut 158c drive pusher 160 in the distal direction.

[0141] 如在图25、32和33中可见,在初始扳动手柄106期间,指示器148随着驱动通道140的远侧移动一起向远侧移动。 [0141] As can be seen, during the initial lever handle 106, the pointer 148 moves distally along with the distal movement of drive channel 140 in FIG. 25, 32 and 33. 使用时,指示器148的作用在于创建咔嗒听觉和/或触觉振动,从而向用户指示外科施夹器100的手柄106已经经历了至少一部分行程。 In use, the action indicator 148 is to create audible click and / or tactile vibration, thereby indicating to the user the surgical clip applier 100, the handle 106 has undergone at least a part of the journey. 特别地,如在图32和33中可见,当致动手柄106时,听觉/触觉指示器148的第一弹性臂148a搭跨在形成于上、下半外壳104a、104b的至少一个内的凸缘149上和/或沿着所述凸缘149搭跨,从而使第一弹性臂148a弯曲。 In particular, as can be seen, when the handle actuator 106 movable in FIGS. 33 and 32, an audible / tactile indicator 148, a first resilient arm 148a ride across the projection formed on at least one of the upper and lower housing half 104a, 104b of upper edge 149 and / or 149 along the flange engaging over, so that the first curved resilient arm 148a. 当听觉/触觉指示器148的臂148a到达凸缘149的近端时,弹性臂148a搭到(snap over)凸缘149的近端上并且与凸缘149的表面149a接触, 从而在弹性臂148a与凸缘149的表面149a接触时形成了第一可听声音和触觉振动。 When the audible / tactile indicator arm 148 to the proximal end 148a of the flange 149, resilient arm 148a to ride on the proximal end (snap over) of the flange 149 and in contact with the surface 149a of the flange 149, so that the resilient arm 148a forming a first audible sound and a tactile vibration when in contact with the surface 149a of the flange 149. 听觉/触觉指示器148的第一指示向用户指示夹子"C"已经被适当地装载。 Audible / tactile indicator 148 indicates the first indication clip "C" to the user has been properly loaded.

[0142] 如在图28和30中可见,同样在初始扳动手柄106期间,当推杆160在远侧方向上移动时,其推动器160c接合最远侧夹子"C/'的后跨部并且开始将最远侧夹子"C/'向远侧移动或推出夹子承载器170并进入到钳夹102中。 [0142] As can be seen in FIGS. 28 and 30, also during the initial lever handle 106, when the push rod 160 is moved in the distal direction, pusher 160c thereof engages distal-most clip "C / 'portion of the backspan and starts the distal-most clip "C / 'or mobile Release clip carrier 170 and into jaws 102. distally. 当最远侧夹子"C/'向远侧移动时,夹子承载器170的柄脚171偏转或做凸轮运动而脱离与最远侧夹子"C/'的接合并返回到它们未偏转或未做凸轮运动的状态,以获取一叠夹子"C"的下一个夹子。 When the distal-most clip "C / 'is moved distally, tangs 171 of clip carrier deflected or cammed 170 is disengaged from the distal-most clip" C /' then return to their undeflected combined or not done state of the cam movement, to obtain a stack of clips "C" of the next clip. 在初始扳动手柄106期间,推杆160前进足够的量以将最远侧夹子"C/'置于钳夹120的通道120a中。 During the initial toggle lever 106, pushrod 160 advances a sufficient amount of the distal-most clip "C / 'jaws 120a disposed channel 120.

[0143] 如在图27和31中可见,同样在初始扳动手柄106期间,当驱动通道140在远侧方向上移动时,棘轮机构144的齿条构件141向远侧移动,致使其齿141a移动到与棘爪142 的齿接合并且越过或横过棘爪142的齿。 [0143] As seen in FIGS. 27 and 31, also during the initial lever handle 106, when drive channel 140 is moved in the distal direction, rack member 144 of ratchet mechanism 141 is moved distally causing teeth 141a thereof moved into engagement with the teeth 142 of the pawl and the ratchet teeth crossing over or 142. 一旦棘轮机构144的齿条构件141移动到与棘爪142接合,则驱动通道140在齿条构件141跳过棘爪142之前不能返回到原始或最近侧位置。 Once rack member 144 of ratchet mechanism 141 moves into engagement with pawl 142, drive channel 140 in the rack member 141 is skipped or can not return to the original position before the nearest side 142 of the pawl.

[0144] 在初始扳动手柄106期间,如在图25至33中可见,驱动通道140向远侧移动直到枢轴臂179的指状部179c接合驱动通道140的槽140g的横向部分(即,停顿(dwell))。 [0144] During the initial lever handle 106, as can be seen, drive channel 140 in FIGS. 25 to 33 move distally until the lateral groove portion 140g of the pivot arm 179c of the finger engaging portion 179 of drive channel 140 (i.e., pause (dwell)). 一旦槽140g的横向部分与枢轴臂179的指状部179c邻接(即停顿已经结束之后),驱动通道140的进一步的远侧移动导致指状部179c移动并且使枢轴臂179旋转。 Once the transverse portion of slot 140g of the pivot arm portion 179c of the fingers 179 adjacent to (i.e., after the pause has ended), further distal movement of drive channel 140 causes finger 179c and the movement of the pivot arm 179 to rotate. 枢轴臂179的旋转导致指状部179b的移动,这又导致楔板180在近侧方向上被拖动,从而使其远端180a 从钳夹120之间缩回并允许钳夹120最终被闭合或接近,由此允许钳夹120最终被闭合或接近。 Rotation of the pivot arm 179 causes movement of finger portion 179b of the shape, which in turn causes wedge plate 180 is dragged in the proximal direction, distal end 180a so that it is retracted from between the jaws 120 allowing the jaws 120 and finally or nearly closed, thereby allowing jaws 120 closed or eventually close.

[0145] -旦实现枢轴臂179所需的旋转,当枢轴臂179的指状部179c通过驱动通道140 的槽140g的近侧部时,枢轴臂179就停止旋转,。 [0145] - Once the required rotation of pivot arm 179, the pivot arm 179 when finger portion 179c through the proximal portion of the groove 140g of drive channel 140, pivot arm 179 stops rotating. 枢轴臂179的指状部179c在驱动通道140的行程结束之前都保留在驱动通道140的槽140g的近侧部内。 The pivot arm 179 until the finger portion 179c at the end of the stroke of drive channel 140 are retained within the proximal portion of slot 140g of drive channel 140.

[0146] 如在图25至31中可见,在进一步扳动手柄106期间,推杆160与驱动通道140向远侧移动,如上所述,直到枢轴驱动臂156已经到达适当的位置为止,以使得角度" β "为45 度。 [0146] As seen in FIGS. 25 to 31, during the further lever handle 106, the push rod 160 and drive channel 140 is moved distally, as described above, until the pivot arm 156 has been driven reaches the proper position, to such that the angle "β" is 45 degrees. 在这种构造中,近侧连接构件154和远侧连接构件158沿着纵向轴线"XI"成一直线, 以使它们之间的角度" α "为0度。 In this configuration, the proximal connector member 154 and distal connector member 158 along the longitudinal axis "XI" in line, so that the angle between them is "α" is 0 degrees.

[0147] 下列的方程式用于计算运动倍增系统155处于"完全展开(fullyextended) "位置时的动力学。 [0147] The following equation is used to calculate the kinetic motion multiplier system 155 is at "fully deployed (fullyextended)" position. 所述"完全展开"位置直接涉及推杆160处于"完全展开"位置(即最远侧位置)的情况,例如,当角度"α "为大约0度时的情况。 The "fully extended" position of the push rod 160 directly relates to the case in a "fully extended" position (i.e., distal-most position), for example, when the angle "[alpha]" is about the case where 0 degrees.

[0148] XE = (B) + (C)-(L2) (cos β 〇) (3) [0148] XE = (B) + (C) - (L2) (cos β square) (3)

[0149] 其中,距离"ΧΕ"为沿着驱动通道140的纵向轴线"Χ2"的在枢轴驱动臂156的枢轴销156a的"原始"位置和枢轴驱动臂156的枢轴销156a的"完全展开"位置之间的距离, 距离"B"为沿着纵向轴线"XI"的枢轴驱动臂156的枢轴销156a和近侧连接构件154的固定杆154a之间的距离,距离"C"为远侧连接构件158的接合销158c和枢轴驱动臂156的驱动支柱156c之间的距离,长度"L2"为枢轴驱动臂156从枢轴柱156a到驱动支柱156c 的长度,并且角度" β /为当角度" α "为大约0度时的角度" β "的"完全展开"位置角度。 在这种情况下,枢轴驱动臂156的角度" β/大约为45度,如上所述且如图27Α所示。 [0149] wherein a distance "ΧΕ" to "X2" of the drive arm 156 of pivot pin 156a of the pivot drive channel 140 along the longitudinal axis of the "original" position of the drive and the pivot arm 156 pivot pin 156a of "fully expanded" distance between the position, the distance "B" is a driving pivot pin 156a and a proximal arm 156 along the "XI" is a distance between the longitudinal axis of the pivot 154a is connected to the fixed rod member 154, the distance " C "is connected to the distal struts 156 of the drive member 158 engaging the pivot pin 158c and 156c of the distance between the driving arm, the length" L2 "length, 156c of the driving arm 156 pivots from 156a to the driving strut and pivot post the angle "β / that when the angle" [alpha] "angle is about 0 degrees" beta] "is" fully expanded "position angle. in this case, the pivot angle of the driving arm 156" β / about 45 degrees, as described above and as the 27Α FIG.

[0150] 如在图31中可见,当驱动通道140进一步向远侧前进时,驱动通道140将指示器148的弹性指状部148a拉到凸缘149的近端上或者使弹性指状部148a在凸缘149的近端上弯曲。 [0150] As can be seen, when drive channel 140 is further advanced distally, drive channel 140 in FIG. 31 the indicator portion 148 of the resilient fingers 148a pulled over the proximal flange 149 or the resilient fingers 148a bent in the proximal flange 149. 如此,产生第一指示(即,听觉和/或触觉)以向用户指示外科夹子"C"已经适当地装载。 Thus, generating a first indication (i.e., audible and / or tactile) to indicate to a user of surgical clips "C" has been appropriately loaded.

[0151] 如在图25和27中可见,同样在"完全展开"位置,近侧连接构件154和远侧连接构件158与纵向轴线"XI"成一直线和/或与纵向轴线"XI"平行。 [0151] As can be seen in FIGS. 25 and 27 also in the "fully extended" position, the proximal connector member 154 and distal connector member 158 with the longitudinal axis "XI" in-line and / or the longitudinal axis "XI" parallel.

[0152] 现在参照图32至35,在进一步扳动手柄106期间,致使连杆构件122的远端122a 相对于外壳104进一步向远侧移动。 [0152] Referring now to FIGS. 32 through 35, during the further lever handle 106, so that the distal end 122a of the link member 122 relative to the housing 104 is moved further distally. 当连杆构件122的远端122a进一步向远侧移动时,导致驱动销124进一步向远侧移动,从而将远侧轴向移动传递给驱动通道140。 When the distal end 122a of the link member 122 is further moved distally, it causes the drive pin 124 is moved further distally thereby transmitting distal axial movement to drive channel 140.

[0153] 如在图32、33和35中可见,当继续扳动手柄106时,枢轴驱动臂156继续沿远侧方向移动,以使得随着驱动通道140沿远侧方向移动,枢轴驱动臂156和驱动通道140的纵向轴线"X2"之间的角度" β "继续增大到大约90度。 [0153] As can be seen in FIGS. 32, 33 and 35, as 106, pivotal movement of the drive arm continues in a distal direction to continue lever handle 156, so that as drive channel 140 in the distal direction movement, pivot drive the angle between the arm 156 and the longitudinal axis 140 of the drive channel "X2" "β" continues to increase to about 90 degrees. 这种移动还导致近侧连接构件154(即, 位于第一侧)相对于纵向轴线"XI"枢转或移动越过中心到达第二侧,以使近侧连接构件154之间的角度相对于纵向轴线"XI"被可枢转地定向在角度α "处(如图35所示)。 如此,当近侧连接构件154关于纵向轴线"XI"旋转时,角度α "从大约0度减小到大约60度,致使远侧连接构件158在近侧方向上移动。 This movement also causes proximal connector member 154 (i.e., first side) relative to the longitudinal axis "XI" over center pivot or move to the second side, so that the angle between the proximal connector member 154 with respect to the longitudinal axis "XI" is pivotally oriented "thus, when the proximal connector member 154 at about the longitudinal axis (FIG. 35)." XI "is rotated, the angle [alpha] 'decreases from about 0 degrees to an angle [alpha] may pivot about 60 degrees, so that the distal connector member 158 is moved in the proximal direction. 在这种构造中,远侧连接构件158的滑柱158c在近侧方向上滑动,这又使推杆160和稳定器162滑回到缩回位置或"安全"位置。 In this configuration, the distal connector 158 of the spool member 158c slides in the proximal direction, which in turn causes the push rod 160 and the stabilizer 162 is slid back to the retracted position or "safe" position. 在"安全"位置,诸如驱动杆140的施夹器100的其它零件仍然在远侧方向上移动,以使夹子"C"可形成在钳夹构件120之间。 In the "safe" position, as the other parts of the drive rod 140 of clip applier 100 is still moved in the distal direction, so that clips "C" may be formed between the jaw members 120. 然而,在"安全"位置,推杆160安全地缩回到近侧位置,以使得在钳夹构件120彼此接近时推杆160不干扰施夹器100。 However, in the "safe" position, the push rod 160 to the proximal position safely retracted, the push rod 160 so that the clip applier 100 does not interfere when the jaw member 120 approach each other.

[0154] 下列的方程式用于计算运动倍增系统155在"安全"位置时的动力学。 [0154] The following equation is used to calculate the kinetic motion multiplier system 155 in the "safe" position. 如上所述, 所述"安全"位置直接涉及推杆160在安全缩回位置(即,最近侧位置)的情况,而施夹器100的其它零件(例如手柄106)仍然在工作行程中。 As described above, the "safe" position of the push rod 160 directly relates to the case in a safe retracted position (i.e., proximal-most position), while other parts of clip applier 100 (e.g. handle 106) is still in the working stroke.

[0155] (L2)-(C) (sin(-a )) = A (4) [0155] (L2) - (C) (sin (-a)) = A (4)

[0156] 其中,长度"L2"为枢轴驱动臂156从枢轴柱156a到驱动支柱156c的长度,距离"C"为沿着纵向轴线"XI"的远侧连接构件158的接合销158c和枢轴驱动臂156的驱动支柱156c之间的距离,并且距离"A"为沿着与纵向轴线"XI"正交的参考轴线的近侧连接构件154的固定杆154a和枢轴驱动臂156的枢轴销156a之间的距离,如图41A所示。 [0156] wherein, the length "L2" is the length of the pivoting drive arm 156 from pivot post 156a to 156c of the drive column, the distance "C" along the longitudinal axis "XI" distal connector member and the engaging pin 158c 158 the distance between the pivot drive arm 156c drive column 156, and the distance "a" is connected and fixed to the lever member 154 proximally along a reference axis perpendicular to the longitudinal axis "XI" 154a of the driving arm 156 and the pivot the distance between the pivot pin 156a, as shown in FIG 41A.

[0157] 继续参照图32至38,在进一步扳动手柄106期间,在将翼片192a从计数器机构190移除的情况下,当驱动通道140向远侧前进时,其突块140e接合处理器194的触点194a,从而完成电路并且使处理器194执行功能,如上所述。 [0157] With continued reference to FIGS. 32-38, during the further lever handle 106, in a case where the tab 192a removed from counter mechanism 190, as drive channel 140 is advanced distally, which lugs engage processor 140e 194 contacts 194a, thereby completing the circuit and causing the processor 194 to perform the functions described above.

[0158] 现在参照图39至44,示出了在最后一次扳动手柄106时的施夹器100。 [0158] Referring now to FIGS. 39-44, shows a lever handle last clip applier 100 to 106. 在这种状态下,驱动通道140处于远侧位置,推杆160处于远侧位置,楔板180处于近侧位置,偏压构件146被拉伸,并且棘爪142位于齿条140d的近侧。 In this state, drive channel 140 in a distal position, pusher bar 160 in a distal position, wedge plate 180 in a proximal position, the biasing member 146 is stretched, and the pawl 142 is located proximal of rack 140d.

[0159] 另外,如在图43中可见,在将楔板180的远端180a从钳夹120之间移出的情况下, 当驱动通道140进一步向远侧移动时,驱动通道140和/或驱动通道带箍143的远侧边缘紧密接合钳夹120的凸起表面(cammingsurface) 120b,由此使得钳夹120接近彼此并且使插入其间的外科夹子"C/'成型。由于驱动通道带箍143固定在驱动通道140上且随其移动, 因此驱动通道带箍143发挥作用以覆盖驱动通道140,以便在钳夹120接近时将钳夹120保持在驱动通道140内,并且在施夹器100操作期间将楔板180保持在驱动通道140内。 [0159] Further, as can be seen, in the case where the distal end 180a of wedge plate 180 removed from between jaws 120, as drive channel 140 is further moved distally, drive channel 140 and / or drive 43 in FIG. channel strap 143 distal edge surfaces of the jaws tightly engaging projections 120 (cammingsurface) 120b, thereby causing the jaws 120 close to each other and the insertion therebetween of surgical clips "C / 'shaped fixed Since drive channel strap 143 and moves therewith, drive channel strap 143 thus play on drive channel 140 acts to cover the drive channel 140 so as to maintain jaws 120 within drive channel 140 at close jaws 120 and 100 during operation of clip applier in the wedge plate 180 within drive channel 140 remains.

[0160] 如在图44中可见,外科夹子"C/'可形成或压接到血管"V"上或任何其它生物组织上。 [0160] As can be seen in Figure 44, surgical clip "C / 'may be formed or crimped vessel" on V "or any other biological tissue.

[0161] 由于指示器148的凸起部148b穿过推杆160的槽160d平移,因此允许驱动通道140相对于推杆160向远侧移动。 [0161] Since the projection portion 148b of indicator 148 through slot 160d of pusher bar 160 is translated, drive channel 140 thereby allowing the plunger 160 to move distally.

[0162] 此外,当驱动通道140完全向远侧前进时,如在图41中可见,棘轮机构144的齿条构件141向远侧移动到超过棘爪142的位置,以使齿条构件141的齿141a移动到棘爪142 的齿的远侧,从而使齿条构件141和棘爪142彼此脱离。 [0162] Further, when drive channel 140 is fully advanced distally, as seen, rack member 144 of ratchet mechanism 141 moves distally in FIG. 41 to a position beyond the detent 142 so that the rack member 141 distal ratchet teeth 141a to move the teeth 142, so that the rack member 141 and pawl 142 disengaged from each other. 如此,驱动通道140被允许或能够自由返回到原始或最近侧位置。 As such, drive channel 140 is permitted or free to return to the original or proximal-most position.

[0163] 如在图42中可见,当驱动通道140向远侧移动时,听觉/触觉指示器148的弹性臂148a搭到凸缘149的远端并且与凸缘149的表面149a接触,从而产生可听声音和/或触觉振动。 [0163] As can be seen, when drive channel 140 is moved distally, audible / tactile indicator 148 of resilient arm 148a in FIG. 42 to ride the distal end of the flange 149 and in contact with the surface 149a of the flange 149, thereby generating audible sound and / or tactile vibration. 这种可听声音和/或触觉振动与外科夹子"C"的装载相符。 And / or tactile vibration and surgical clips "C" loaded matches that audible sound.

[0164] 现在参照图45至52,在张开或释放手柄106期间,促使连杆构件122的远端122a 相对于外壳104向近侧移动。 [0164] Referring now to FIGS. 45 to 52, during the opening or release of handles 106, 122 causes the distal end 122a of the link member relative to the housing 104 is moved proximally. 当连杆构件122的远端122a向近侧移动时,促使驱动销124 向近侧移动,从而将近侧轴向移动传递给驱动通道140,这又依次传递给推杆160。 When the distal end of the link member 122 moves proximally 122a, causes the drive pin 124 is moved proximally, thereby nearly axial movement is transmitted to the driving side of the channel 140, which in turn is transmitted to the push rod 160. 通过偏压构件146的收缩使得驱动通道140的近侧移动变得容易。 By contraction of the biasing member 146 causes proximal movement of drive channel 140 is facilitated. 可选择地,释放手柄106导致偏压构件146在近侧方向上缩回驱动通道140。 Alternatively, the release of handles 106 results in biasing member 146 is retracted in the proximal direction, drive channel 140.

[0165] 当驱动通道140向近侧移动时,驱动通道140的远侧凸台和/或驱动通道带箍143 脱离钳夹120的凸起表面120b,由此释放了钳夹120使它们彼此分离,以将楔板180的远端180a重新插入在所述钳夹120之间,并且将另一个外科夹子"C"容纳在其间。 [0165] When the drive channel 140 is moved proximally, drive channel 140 far side of the table and / or drive channel strap 143 from the convex surface 120 of the jaws 120b, thereby releasing the jaws 120 so that they are separated from each other to the distal end 180a of wedge plate 180 is reinserted between the jaws 120, and another surgical clip "C" received therebetween. 尤其,当驱动通道140向近侧移动时,槽140g的横向部分作用于指状部179c上,以使枢轴臂179旋转并且使枢轴臂179的指状部179b向远侧推动楔板180。 In particular, when drive channel 140 is moved proximally, the transverse portion of slot 140g of action refers to the portion 179c, so that rotation of the pivot arm 179 and the pivot arms 179 finger portion 179b pushes the wedge plate 180 distally . 当楔板180在远侧方向上移动时,如在图51和52中可见,楔板180的远端180a被重新插入或重新引入到钳夹120中,从而使钳夹120分开。 When the wedge 180 is moved in the distal direction, as seen in FIGS. 51 and 52, the distal end 180a of wedge plate 180 is reinserted or reintroduced into jaws 120, 120 so that the jaws apart.

[0166] 如在图48和49中可见,当楔板180向远侧移动时,夹子输出器174的近侧突起176 接合楔板180的窗口180b并且因此被向远侧推进给定的距离。 [0166] As can be seen in FIGS. 48 and 49, when the wedge plate 180 moves distally, the proximal projection 174 of clip 176 engages the window 180b of wedge plate 180 and thus is advanced distally a given distance. 当夹子输出器174被向远侧推进时,一叠夹子"C"也被向远侧推进。 When the clip 174 is advanced distally, stack of clips "C" is also advanced distally. 从图50中可见,当楔板180到达最远侧位置时, 夹子通道170邻接、接合、推进或凸靠远侧突起175的近侧部分175b,直到楔板180的腹板(web) 180f基本上搁置在远侧突起175的远侧部分175a下方。 It is seen, when the wedge plate 180 reaches the distal-most position, clip channel 170 abuts, engages in FIG. 50, by advancing distal protrusion or a convex proximal portion 175b 175 of wedge plate 180 until the web (web) 180f substantially resting on the lower projections of the distal portion 175a 175 distally. 这样进行时,远侧突起175 的近侧部分175b移动延伸进入夹子通道170的更远侧的窗口172。 By this configuration, the distal portion 175b of the protrusion 175 moves proximally extending into the clip channel 170 of the more distal window 172.

[0167] 如在图50和51中可见,当夹子输出器174被向前推进时,使得一叠夹子"C"向前移动,最远侧夹子"C/'通过在推杆160的推动器160c下方的凸轮运动而移动到推动器160c 的远侧,直到该最远侧夹子"C/'被施夹器170的柄脚171挡住。 [0167] As seen in FIGS. 50 and 51, when the clip 174 is advanced, so that the stack of clips "C" is moved forward, distal-most clip "C / 'through the push rod 160 of the pusher downward movement of the cam 160c is moved distally to the pusher 160c until the distal-most clip "C / 'by tangs 170 of clip applier 171 is blocked.

[0168] 暂时回到图47,当驱动通道140在近侧方向上移动时,听觉/触觉指示器148的臂148a越过凸缘149急速返回(snap back)并且使其自身复位以用于手柄106的下一次弹射行程或扳动。 [0168] Returning momentarily to FIG. 47, when drive channel 140 is moved in the proximal direction, an audible / tactile indicator of the arms 148a 148 149 snaps back over the rim (snap back) to reset itself and for the handle 106 next ejection stroke or pulled.

[0169] 当驱动通道140进一步在近侧方向上移动时,驱动通道140实现了枢轴驱动臂156 的近侧移动,这又使运动倍增系统的运动反向。 [0169] When the drive channel 140 is moved further in the proximal direction, drive channel 140 is moved proximally to achieve a pivoting of the driving arm 156, which in turn causes reverse movement of the motion multiplier system.

[0170] 如在图45至51中可见,当释放手柄106且通过偏压构件146在近侧方向上移动驱动通道140时(如图39所示),枢轴驱动臂156的接合销156a在近侧方向上移动,以使得当驱动通道140也在近侧方向上移动时,在枢轴驱动臂156和驱动通道140的纵向轴线"X2"之间的角度" β "继续减小。 [0170] As can be seen in FIG. 45 to 51, if and when the biasing member 106 by movement of drive channel 146 in a proximal direction release handle 140 (FIG. 39), the drive arm 156 engages the pivot pin 156a in moving the proximal direction, such that when moved, the angle between the pivot arm 156 and drive the longitudinal axis 140 of the drive channel "X2" to "β" the further reduction of drive channel 140 is also a proximal direction. 如此,远侧连接构件158的驱动支柱158c开始在远侧方向上移动,以使得推杆160和稳定器162通过滑柱158c向远侧移回到"完全展开"位置。 Thus, the distal connecting member 158c drive column 158 begins to move in the distal direction, so that the pusher bar 160 and stabilizer 162 via the spool 158c back to the far lateral "fully extended" position. 大体上同时,当远侧连接构件158的驱动支柱158c开始在远侧方向上移动时,位于纵向轴线"XI"的第二侧的近侧连接构件154的角度"-α "从大约-60度增大到大约0度。 Substantially simultaneously, when the driving strut distal connector member 158 begins to move in the distal direction 158c, a proximal side of the second longitudinal axis "XI" in the connection angle member 154 "-α" of from about -60 ° increases to approximately 0 degrees. 当驱动通道140进一步在近侧方向上移动时,近侧连接构件154从纵向轴线"XI"的第二侧枢转到第一侧,以使得在"完全展开"位置,近侧连接构件154和远侧连接构件158再次可枢转地定位在彼此成一直线的位置,从而使角度" α "为大约0度。 When drive channel 140 is moved further in the proximal direction, proximal connector member 154 from the second side to the first side of the longitudinal pivot axis "XI" so that the "fully extended" position, the proximal connector member 154 and the distal connector member 158 is pivotally positioned again at a position in line with each other, so that the angle "α" is about 0 degrees. 换句话说,近侧连接构件154和远侧连接构件158位于纵向轴线"XI"的第一侧和第二侧之间。 In other words, the proximal member 154 and distal connector member 158 is positioned between the connecting longitudinal axis "XI" first and second sides.

[0171] 在所述构造中,当驱动通道140进一步继续在近侧方向上移动时,推杆160与驱动通道140 -起向近侧移动,如上所述,直到枢轴驱动臂156已经到达适当的位置,以使得在枢轴驱动臂156和驱动通道140的纵向轴线"Χ2"之间的角度" β "为大约45度。 [0171] In the configuration, when drive channel 140 further continues to move in a proximal direction, drive channel and the pusher bar 160 140-- from moving proximally, as described above, until the pivot arm 156 has been driven to the appropriate position, so that the angle between the longitudinal axis of the pivot drive arm 156 and drive channel 140 of "Χ2" to "β" is about 45 degrees. 如此,近侧连接构件154移动到第一侧,以使角度" α "开始从大约〇度增大到大约60度。 Thus, proximal connector member 154 is moved to the first side, so that the angle "α" starts to increase from about square degrees to about 60 degrees.

[0172] 接着,当驱动通道140向近侧移动时,反向的运动倍增系统155从"完全展开"位置移动到"原始"位置。 [0172] Next, when drive channel 140 is moved proximally, the reverse motion multiplier system 155 from "fully extended" position to the "home" position. 更确切地,驱动通道140在近侧方向上前进,这又使得枢轴驱动臂156 在近侧方向上移动。 More specifically, drive channel 140 in a proximal direction, which in turn causes the pivot drive arm 156 moves in the proximal direction. 也就是说,枢轴驱动臂156在一方向上枢转并驱动近侧连接构件154, 以使在枢轴驱动臂156和驱动通道140的纵向轴线"Χ2"之间的角度" β "从大约45度减小到大约22度。 That is, the driving arm 156 pivots in one direction and the pivot driving proximal connector member 154, so that the angle between the pivot arm 156 and the drive axis 140 of the longitudinal drive channel "Χ2" to "β" of from about 45 degrees to about 22 degrees is reduced. 如此,近侧连接构件使得远侧连接构件沿着稳定器162的槽162b和推杆160的近侧窗口160d向近侧滑动。 Thus, proximal connector member such that the connecting member distally along the slot 162b 162 stabilizer and proximal window 160d of pusher bar 160 slides proximally. 在这种构造中,远侧连接构件158在近侧方向上驱动推杆160。 In this configuration, the distal connector member 158 in a proximal direction 160 of the drive ram.

[0173] 当驱动通道140和推杆160位于最远侧位置时,枢轴驱动臂156的滑柱156c位于最远侧位置并且指示器148的第二弹性指状部148b配置在凸台149的近侧。 [0173] When the drive channel 140 and pusher bar 160 located at a distal-most position, the pivot drive arm of the spool 156c 156 located at a distal-most position of the indicator 148 and the second resilient fingers 148b disposed bosses 149 proximally. 此外,当释放施夹器100的手柄106时,在楔板180位于最远侧位置的情况下,其远端180a插在钳夹120之间。 Further, when the handle 100 of the release clip applier 106, wedge plate 180 in a distal-most position of the case positioned, distal end 180a thereof is interposed between jaws 120. 另外,当驱动通道140在近侧方向上移动时,其突块140e脱离处理器194的触点194a。 Further, when drive channel 140 is moved in the proximal direction, which projection 140e contacts 194a 194 from the processor.

[0174] 现在参照图52,示出了在手柄106的完整行程或扳动之后且在从其射出最后一个夹子之后的施夹器100的远端。 After [0174] Referring now to FIG. 52, there is shown after a full stroke or lever handle 106 and is emitted from the last clip in the clip applier 100 to the distal end. 在弹射出最后一个夹子之后,如在图52中可见,夹子输出器的近侧突起176配置在楔板180的孔180b中的最远侧孔或窗口内。 After the ejection of the last clip, as seen, clip projections 176 disposed within the proximal distal-most aperture or window hole 180b of wedge plate 180 in FIG. 52. 如此,当在弹射出夹子之后楔板180向远侧移动时,以上述方式,夹子输出器174也向远侧移动。 Thus, when moved distally after wedge plate 180 ejecting the clip, in the manner described above, clip follower 174 is also moved distally. 因此,当夹子输出器174向远侧移动时,其远侧凸起175被移动到夹子承载器170的窗口172的最远侧窗口的远侧。 Thus, when the clip 174 is moved distally, distal tab 175 is moved distally clip carrier 170 to a distal-most window of windows 172. 如此,远侧突起175的近侧部分175b紧密接合夹子承载器170的顶壁的内表面并向下做凸轮运动或推进。 Thus, a proximal portion 175 of the distal tab 175b tightly engage the inner surface of the top wall of clip carrier 170 and is cammed or advancing the next.

[0175] 当远侧突起175的近侧部分175b向下做凸轮运动或推进时,远侧突起175的近侧部分175b紧密接合锁定件178的突起178a的上表面并且使锁定件178的突起178a向下做凸轮运动或推进而横跨带箍143的路径被支撑在驱动通道140上且进入到楔板180的远侧窗口180c内。 [0175] When the proximal portion 175 of the distal tab 175b do cammed downward or advance, the proximal portion 175 of distal tab 175b of the upper surface 178 of the locking member protrusion 178a and the close contact member 178 of the locking projections 178a do downward or advance movement of the cam across the strap path 143 is supported within drive channel 140 and into distal window 180 of wedge plate 180c. 如此,如果驱动通道140向远侧前进,以上述方式,带箍143将紧邻锁定件178的突起178a并且防止或阻碍带箍143并且依次防止或阻碍驱动通道140向远侧移动。 Thus, if drive channel 140 is advanced distally, in the manner described above, strap 143 adjacent to the protrusion 178a of the locking member 178 and strap 143 prevents or hinders and prevents or impedes sequentially drive channel 140 is moved distally. 此时,棘爪142停顿在齿条140d的远侧,并且手柄106布置在完全张开位置,因此不能被再进一步地张开。 At this time, pawl 142 distally pause rack 140d, and handles 106 are arranged in a fully open position, and therefore can not be re-opened further. 在这种构造中,施夹器被锁定且不能再使用。 In this configuration, clip applier is locked and can no longer be used.

[0176] 基于施夹器的尺寸,施夹器100的零件的尺寸必须是相应比例的。 [0176] Based on the size of clip applier, the clip applier dimensions of the part 100 must be appropriate proportions. 各种尺寸的施夹器的大部分零件彼此基本上是相同的。 Most parts of various sizes of clip applier are substantially identical to each other. 可相应地调节涉及夹子宽度的零件尺寸,例如钳夹120和楔板180,或者涉及夹子长度的零件尺寸,例如推杆160和枢轴臂179。 The clip can be adjusted accordingly relates to the width of the part size, e.g. jaws 120 and the wedge plate 180, or to a length of the clip part size, e.g. push rod 160 and pivot arm 179. 如此,基本以相同的方式装配各种尺寸的每一个施夹器,并且以基本相同的方式操作所述施夹器的内部机构。 Thus, in substantially the same manner as the assembly of the various sizes of each clip applier, and in substantially the same manner as the operation of the internal mechanism of the clip applier.

[0177] 例如,可提供相对小的、中等的和较大尺度的施夹器100,其中每一种尺寸的施夹器都存储且弹射相对小的、中等的或较大的外科夹子。 [0177] For example, it may provide a relatively small, medium and large scale clip applier 100, wherein each of the sizes of clip appliers are storing and ejecting relatively small, medium or large surgical clip. 基于外科夹子的相对尺寸,相应的施夹器及它们相应的零件必须是适当比例的。 Based on the relative dimensions of the surgical clips, the corresponding clip appliers, and their corresponding parts must be appropriate proportions. 然而,依据本公开,各种尺寸的施夹器中的每一种都包括相同的零件并且可以彼此相同的顺序装配。 However, according to the present disclosure clip applier, of various sizes in each of which comprises the same parts identical to each other and can be assembled in order. 如此,装配施夹器的技术人员仅仅需要学会装配一种尺寸的施夹器所需的顺序和/或步骤,这又使得技术人员同样能够装配其它尺寸的施夹器,无需学习新的装配顺序或步骤。 Thus, the assembly clip applier art only need to learn the sequence and / or steps required to assemble the clip applier of one size, which in turn makes the art can likewise be assembled clip applier other dimensions, without having to learn a new mounting order or steps.

[0178] 因此,用于相对小的、中等的或较大的施加器的装配方法和/或步骤彼此基本上是相同的。 [0178] Thus, for a relatively small, medium or large applicator assembly method and / or steps are substantially identical to each other.

[0179] 许多其它剩余的零件或部件在特征尺寸或比例方面是相同的或具有微小的变化。 [0179] Many other remaining components or parts in terms of size or scale features are identical or with a slight variation. 然而,如果需要,为了达到相同的结果,则可以修改下列部件的形状,即近侧连接构件154 的长度、枢轴驱动臂156的长度和/或远侧连接构件158的长度。 However, if necessary, to achieve the same results, you may be modified following the shape of the member, i.e. the length of the proximal connector member 154, the pivot 156 of the drive arm length and / or distal connector member 158.

[0180] 可以想到的是,改变角度" α "的起动角度,例如相对于大约60度,在大约45度处是更有效的,以使得角度差产生用于施夹器100的工作行程的更平滑的起动动作。 [0180] It is contemplated that variations in the angle "α" starting angle, about 60 degrees with respect to e.g., at about 45 degrees is more effective, so that the angle difference to produce a working stroke of clip applier 100 further smooth starting operation. 然而,当起动角度" α "为大约45度时,由于较长的近侧连接构件154和远侧连接构件158,使得比在大约60度的起动角度" α "时占据了施夹器100的外壳104内的更多面积。 However, when starting the angle "α" is about 45 degrees, due to the longer proximal connector member 154 and distal connector member 158, such that the ratio occupied at the time of starting the clip applier angle "α" of about 60 degrees to 100 more areas within the housing 104. 运动倍增系统155的全部参数都能够并且应该被单独设计,以用于特定设备的任何构造需要,其中所述运动倍增系统被认为是补充于所述特定设备中。 All parameters are motion multiplier system 155 can and should be designed separately, in any configuration required for a particular device, wherein the motion multiplier system is considered to be complementary to the specific device.

[0181] 应该理解的是,之前的描述仅仅是本公开示意性的描述。 [0181] It should be understood that the foregoing description is only illustrative of the present disclosure is described. 在不脱离本公开的情况下,所属领域技术人员可设计多种变形和修改。 Without departing from the present disclosure, those skilled in the art can design many variations and modifications. 因此,本公开旨在包含所有这些变形、修改和变化。 Accordingly, the present disclosure is intended to encompass all such variations, modifications, and variations. 参考随附的附图描述的实施例仅仅展示了本公开的特定实例。 Reference to the drawings appended examples only to demonstrate certain examples of the present disclosure. 其它非实质性不同于以上描述和/或附加的权利要求的元件、步骤、方法和技术也希望包括在本公开的范围内。 Other insubstantially different from those described above and / or additional claim elements, steps, methods and techniques are also intended to include within the scope of the present disclosure.

Claims (18)

1. 一种用于将外科夹子施加到体组织的外科施夹器,所述外科施夹器包括: 外壳; 至少一个手柄,其可枢转地连接到所述外壳上; 通道组件,其从所述外壳向远侧延伸出; 夹子承载器,其配置在所述通道组件内且在其中限定了通道和多个窗口; 多个夹子,它们可滑动地配置在所述夹子承载器的通道内; 驱动通道,其可往复地配置在所述外壳和所述通道组件中的至少一个内,所述驱动通道具有可操作地连接到至少一个手柄上的第一端和可操作地连接到通道组件的远端上的ΛΑ~ -•上山弟·~-¾ ; 楔板,其可往复地配置在所述通道组件内,所述楔板可操作地连接到至少一个手柄上且包括多个沿其长度形成的孔; 推杆,其可往复地设置在所述外壳和所述通道组件内,所述推杆具有可操作地连接到至少一个手柄上的近端和限定了推动器的远端,其中所述 1. A method for applying surgical clips to body tissue a surgical clip applier, the surgical clip applier comprising: a housing; at least one handle which is pivotally connected to the housing; channel assembly, from which a plurality of clips which are slidably disposed in the channel of said clip carrier; extending distally out of said housing; clip carrier disposed within said channel assembly and defining a passageway therein and a plurality of windows ; at least one drive channel, which is reciprocally disposed in said housing and within said channel assembly, said drive channel having at least one operatively connected to a first end operatively connected to the handle channel assembly on the distal end ΛΑ ~ - • uphill Di · ~ -¾; wedge plate reciprocally disposed within said channel assembly, said wedge plate operatively connected to the at least one handle and which include a plurality of the length of the hole is formed; ram which is reciprocally disposed within said housing and said channel assembly, said pusher having operatively connected to the at least one handle on the proximal end and a distal end defining a pusher, wherein said 推杆的远端被构造为与所述多个夹子中的最远侧夹子相接合; 运动倍增系统,其具有多个连接件,所述连接件被构造为基于所述手柄的初始致动而使所述推杆向远侧移动递增量,并且被构造为在手柄初始致动之后使推杆和楔板向近侧移动; 其中,所述运动倍增系统的多个连接件包括: 近侧连接构件,其可枢转地支撑在所述外壳内且可操作地连接到所述驱动通道上; 枢轴驱动臂,其使所述驱动通道和所述近侧连接构件相互连接;以及远侧连接构件,其使所述近侧连接构件和所述推杆相互连接; 其中,所述驱动通道的远侧平移引起所述近侧连接构件经由所述枢轴驱动臂枢轴旋转,以使得所述近侧连接构件促使所述远侧连接构件的第一端在第一方向上枢轴旋转且所述远侧连接构件的第二端使所述推杆在远侧方向上可滑动地移动。 The distal end of the plunger is configured with the plurality of clips in a distal-most clip engages; motion multiplier system having a plurality of connecting members, said connecting member being configured to be based on the initial actuation of the handle increasing amounts of the push rod to move distally and is configured such that the push rod and the wedge plate is moved proximally, after initial actuation of the handle; wherein a plurality of said connecting member movement multiplying system comprising: a proximal connector member, which is pivotally supported and operatively connected to said drive channel within the housing; pivot drive arm which causes said drive channel and said proximal member are connected to each other; and a distal connecting means that the proximal connector member and the push rod connected to each other; wherein distal translation of said drive channel causes the proximal connector member is rotated via the pivot drive arm pivot, so that the proximal connector member causes the distal end is pivotally connected to the first member in a first rotational direction and the second distal end of said push rod connecting member to slidably move in the distal direction.
2. 根据权利要求1所述的施夹器,其中,所述驱动通道的进一步远侧平移引起所述近侧连接构件经由所述枢轴驱动臂枢轴旋转,以使得所述近侧连接构件促使所述远侧连接构件的第一端在第二方向上枢轴旋转且所述远侧连接构件的第二端使所述推杆在近侧方向上可滑动地移动。 2. The clip applier according to claim 1, wherein said drive channel causes further distal translation of the proximal connector member is rotated via the pivot drive arm pivot, so that the proximal connector member causes the distal end of a first connecting member to pivot in the second direction and the second distal end of said push rod connecting member to slidably move in the proximal direction.
3. 根据权利要求1所述的施夹器,其中,所述运动倍增系统的多个连接件包括: 近侧连接构件,其可枢转地支撑在所述外壳内并且可操作地连接到所述驱动通道上; 枢轴驱动臂,其使所述驱动通道和所述近侧连接构件相互连接;以及远侧连接构件,其使所述近侧连接构件和所述推杆相互连接; 其中所述驱动通道的远侧平移引起所述近侧连接构件经由所述枢轴驱动臂的枢轴旋转,其中所述近侧连接构件的所述枢轴旋转引起所述远侧连接构件的枢轴旋转,并且其中所述远侧连接构件的所述枢轴旋转引起所述推杆的远侧平移。 The clip applier of claim 1, wherein the plurality of connectors motion multiplier system comprises: a proximal connector member pivotally supported within the housing and operatively connected to the the said drive channel; pivot drive arm which causes said drive channel and said proximal connector member is connected to each other; and a distal connector member and the proximal connector member interconnecting said push rod; wherein distal translation of said drive channel causes the proximal connector member via the pivoting of the pivot drive arm, wherein the pivot axis of the proximal connector member causes rotation of the distal pivoting member connected and wherein said pivot member connected to the distal push rod rotation causes the distal translation.
4. 根据权利要求3所述的施夹器,其中,所述驱动通道的进一步远侧平移引起所述近侧连接构件经由所述枢轴驱动臂的进一步枢轴旋转,其中所述近侧连接构件的所述进一步枢轴旋转引起远侧连接构件的进一步枢轴旋转,并且其中所述远侧连接构件的所述进一步枢轴旋转引起所述推杆的近侧平移。 4. The clip applier according to claim 3, wherein said further distal translation of the drive channel causes the proximal connector member is rotated via a further pivot of the pivot drive arm, wherein said proximal connector further rotation of said pivot member causes further rotation of the pivot member connected to the distal, and further wherein said pivot member connected to the distal push rod rotation causes the proximal translation.
5. 根据权利要求3所述的施夹器,其中当所述近侧连接构件、远侧连接构件、枢轴驱动臂、驱动通道和推杆处于所述驱动通道的近侧平移之前的第一位置时,所述近侧连接构件和所述远侧连接构件限定了小于大约180度的第一角度,其中所述驱动通道的近侧平移引起所述近侧连接构件和所述远侧连接构件经由所述枢轴驱动臂而枢轴旋转,从而将小于大约180度的第一角度增大到大约180度的第二角度,以使所述近侧连接构件和所述远侧连接构件相对于彼此成一直线,从而使得所述近侧连接构件、远侧连接构件、枢轴驱动臂、驱动通道和推杆处于所述驱动通道的近侧平移之后的第二位置。 5. The previous clip applier according to claim 3, wherein when the proximal connector member, the distal connector member, the pivot drive arm, the drive channel and the push rod in a proximal translation of the drive channel in a first position, the proximal connector member and the distal connector member defining a first angle of less than about 180 degrees, wherein the proximal translation of the drive channel causes the distal connector member and the proximal connector member driven via the pivot arm pivots so that the first angle is less than about 180 degrees is increased to a second angle of about 180 degrees, so that the proximal connector member and the distal member relative to the connection line with each other, so that the proximal connector member, the distal connector member, the pivot drive arm, the drive channel and the push rod in the second position after the proximal translation of the drive channel.
6. 根据权利要求5所述的施夹器,其中当所述近侧连接构件、远侧连接构件、枢轴驱动臂、驱动通道和推杆处于所述第二位置时,所述驱动通道的进一步近侧平移引起所述近侧连接构件和所述远侧连接构件经由所述枢轴驱动臂而枢轴旋转,从而将大约180度的第二角度减小到小于大约180度的第三角度,以使所述远侧连接构件、枢轴驱动臂和驱动通道处于所述驱动通道的进一步近侧平移之后的第三位置,同时所述推杆处于所述第一位置。 6. According clip applier 5, wherein when the proximal connector member, the distal connector member, the pivot drive arm, the drive channel and the push rod in the second position claim, said drive channel further proximal translation causes the proximal connector member and the distal member is connected via the pivot drive arm is pivotally rotated to a second angle of about 180 degrees to less than a third angle of about 180 degrees , so that the distal connector member, the pivot drive arm and the drive channel in a third position after said further proximal translation of the drive channel, while the plunger is in the first position.
7. 根据权利要求3所述的施夹器,其中,所述近侧连接构件经由所述枢轴驱动臂的旋转致使所述近侧连接构件和所述远侧连接构件相对于彼此成一直线并且沿着由所述近侧连接构件的近端和所述远侧连接构件的远端之间的参考轴线限定的纵向轴线,以使所述远侧连接构件引起所述推杆的远侧平移。 7. The clip applier according to claim 3, wherein the proximal connector member to cause the proximal connector member and the distal connector member relative to one another in a straight line through the rotation of the pivot drive arm and along the reference axis defining the longitudinal axis between the distal and proximal end of the distal member is connected by the connecting member proximally such that the distal connector member causes distal translation of the pusher.
8. 根据权利要求7所述的施夹器,其中,所述近侧连接构件经由所述枢轴驱动臂的进一步旋转致使所述近侧连接构件和所述远侧连接构件彼此成角度地偏移,以使所述远侧连接构件引起所述推杆的近侧平移。 8. The clip applier according to claim 7, wherein the proximal connector member to cause the proximal connector member and the distal member is connected via a further rotation of the pivot drive arm is angularly offset from each other shift, such that the distal connector member causes proximal translation of the push rod.
9. 根据权利要求3所述的施夹器,其中,由所述近侧连接构件的近端和所述远侧连接构件的远端之间的参考轴线限定的纵向轴线和所述近侧连接构件限定了在所述纵向轴线的第一侧的第一锐角,并且所述推杆处于近侧位置,其中所述驱动通道的远侧平移引起所述近侧连接构件和所述远侧连接构件枢转,从而使在所述纵向轴线的第一侧的所述第一锐角增大,直到所述近侧连接构件和所述远侧连接构件相对于彼此成一直线,并且所述推杆经由远侧连接构件向远侧平移到远侧位置为止。 9. The clip applier according to claim 3, wherein the reference axis is defined by a proximal end and a distal end between said distal member is connected to the proximal connector member and the longitudinal axis of said proximal connector member defines a first side of the longitudinal axis of the first acute angle, and the push rod in a proximal position, wherein the drive channel causes distal translation of the distal connector member and the proximal connector member pivot so that the first side of the longitudinal axis a first acute angle increases until the proximal connector member and the distal connector member relative to each other in line, and the push rod away via side connecting member is moved distally until the distal position.
10. 根据权利要求9所述的施夹器,其中,所述驱动通道的进一步远侧平移致使所述近侧连接构件和所述远侧连接构件从所述纵向轴线的所述一侧枢转到纵向轴线的第二侧,从而使所述近侧连接构件和所述纵向轴线限定第二锐角,并且使所述推杆经由所述远侧连接构件向近侧平移到近侧位置。 10. The application according to claim 9, clip, wherein further distal translation of said drive channel causes the proximal connector member and the distal member is connected from the longitudinal side of the pivot axis to the second side of the longitudinal axis so that the proximal connector member and defining a second acute angle to the longitudinal axis, the pusher and the proximal position to move proximally through the distal connecting member.
11. 根据权利要求1所述的施夹器,其中,夹子输出器被构造为接合所述楔板并且基于所述楔板的远侧平移而向远侧移动,并且被构造为接合夹子承载器且在所述楔板近侧平移时阻止夹子输出器的近侧移动。 11. The clip applier according to claim 1, wherein the clip is configured to engage the wedge plate and on the distal translation of the wedge plate is moved distally and is configured to engage the clip carrier and prevents proximal movement of the clip when the proximal translation of the wedge plate.
12. 根据权利要求1所述的施夹器,进一步包括钳夹组件,所述钳夹组件包括一对从所述通道组件的与所述外壳反向的端部延伸出的钳夹,所述钳夹组件适于容纳多个夹子中的一个夹子于其中,并且是可操作的以便响应于所述手柄的移动来实现夹子的成型。 12. The clip applier according to claim 1, further comprising a jaw assembly, the jaw assembly comprises a pair of jaws extending from the housing with the opposite end of the channel assembly, said jaw assembly is adapted to receive a plurality of clips in a clip therein and are operable in response to movement of the handle to achieve the molding clip.
13. 根据权利要求12所述的施夹器,其中,当使所述手柄在第一方向上接近初始量时, 所述推杆朝向钳夹移动以将最远侧夹子移动至所述钳夹之间,并且当使所述手柄在第一方向上接近附加量时,所述推杆被构造为且适于朝向外壳移动以将所述推动器移动到多个夹子中的最远侧夹子后面。 According to claim 12, wherein the clip applier, wherein, when the handle is close to the initial amount in the first direction, the jaws move toward the push rod to move the distal-most clip to said jaws between, and when the handle is attached near the amount in the first direction, and the push rod is configured to move said pusher behind a distal-most clip of the plurality of clips adapted to move toward the housing .
14. 根据权利要求13所述的施夹器,其中,所述驱动通道被构造且定尺寸为至少部分地围绕钳夹和楔板,其中所述驱动通道包括带箍,所述带箍横跨所述驱动通道的远端延伸, 用于将钳夹和楔板保持在驱动通道内。 14. The clip applier according to claim 13, wherein said drive channel is configured and dimensioned to at least partially surrounds the jaws and the wedge plate, wherein said drive channel includes a strap, the strap across the the distal end of drive channel extends, and means for clamping wedge held in the drive channel.
15. 根据权利要求13所述的施夹器,其中,当所述至少一个手柄在第一方向上被致动而移动时,所述驱动通道朝向钳夹组件移动,以将驱动通道的第二端移动到抵靠钳夹以闭合钳夹,当所述至少一个手柄移动第二量时,驱动通道被移离钳夹,以使驱动通道的第二端移离钳夹以允许钳夹张开。 To drive the second channel clip applier, wherein when the at least one handle in a first direction is actuated to move the drive passage toward the mobile jaw assembly, according to claim 13, end of the movable jaw to close the jaw abutment, when the amount of the at least one second handle is moved, the drive channel being moved away from the jaws, such that the second end of the drive channel to allow the jaw to move away from the jaw opening .
16. 根据权利要求15所述的施夹器,进一步包括运动反转机构,所述运动反转机构可操作地连接至所述楔板和所述驱动通道,其中在驱动通道的远侧移动期间,运动反转机构的旋转导致楔板的近侧移动。 16. The clip applier as claimed in claim 15, further comprising a motion reversing mechanism, the motion reversing mechanism operatively connected to said wedge plate and said drive channel, wherein during the distal movement of drive channel rotational movement of the reversing mechanism causes the proximal movement of the wedge plate.
17. 根据权利要求1所述的施夹器,进一步包括: 夹子输出器,其可滑动地配置在所述夹子承载器的通道内,并且被配置在多个夹子的近侧,所述夹子输出器被构造为且适于与所述夹子承载器的窗口和所述楔板的孔可选择地接合,其中所述夹子输出器被构造为且适于基于所述楔板的往复运动在夹子承载器的远侧方向上推进多个夹子。 17. The clip applier according to claim 1, further comprising: a clip follower slidably disposed within the channel of said clip carrier and disposed proximally is a plurality of clips, the clip is configured and adapted to selectively engage the clip carrier and a window hole of the wedge plate, wherein said clip follower is configured and adapted to reciprocate on said wedge carrier clip advancing a plurality of clips in a distal direction filter.
18. 根据权利要求1所述的施夹器,进一步包括: 运动反转机构,其可操作地连接至所述驱动通道和所述楔板,并且与所述推杆可选择地接合,其中在所述驱动通道的远侧平移期间,所述运动反转机构的旋转导致楔板和推杆的近侧移动。 18. The clip applier according to claim 1, further comprising: a motion reversing mechanism operatively connected to said drive channel and said wedge plate and selectively engageable with said plunger, wherein during distal translation of said drive channel, the rotational movement of the reversing mechanism causes the proximal movement of the wedge plate and the push rod.
CN 201010593698 2009-12-15 2010-12-15 Surgical clip applier CN102090912B (en)

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US4522207A (en) * 1981-02-06 1985-06-11 Charles H. Klieman Spring activated hemostatic clip applicator
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US8708213B2 (en) * 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US8465502B2 (en) * 2008-08-25 2013-06-18 Covidien Lp Surgical clip applier and method of assembly
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