CN102188268B - 内部增压的医疗装置 - Google Patents
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Abstract
本发明提供了一种内部增压的医疗装置,尤其提供了用在增压手术环境中的增压手术器械。所述增压手术器械包括增压系统,所述增压系统用于保持使用期间在手术器械内的中性压力流或正压力流。所述增压系统包括用于检测手术环境的压力的主传感器和用于使手术器械的压力和手术环境的压力相平衡的增压机构。所述增压机构包括:控制器,其接收从主传感器发送的信号并且将从主传感器发送的信号与环境或内部器械压力进行比较;以及压力输送系统,其响应于从控制器接收到的信号向手术器械的内部提供正压力。用于压力输送系统的压力源可以是外部的或手术器械内自备的。
Description
相关申请的交叉引用
本申请要求于2010年3月2日提交的、申请号为61/309,606的美国临时专利申请的优先权和权益,将其全部内容通过引用合并于此。
技术领域
本公开涉及增压手术器械。更特别地,本公开涉及结合增压机构的增压手术器械,其配置成内部平衡或超过被吹体腔内检测到的压力。
背景技术
在诸如腹腔镜手术过程的特定手术过程中,为了给手术器械建立工作空间通常有必要将患者的体壁与下层的组织分开。典型地,这通过穿过体壁形成切口并且通过切口插入进入口或插管来完成。提供扩充或吹入流体(insufflation fluid)或气体的来源。气体被迫通过插管并且进入体腔。当吹入流体进入体腔时,流体促使体壁远离下层组织以建立工作空间。这导致了工作空间具有的内压高于身体外部的环境压力。
一旦被吹的工作空间被建立,则手术器械就可通过插管插入并且进入被吹的体腔以执行手术过程。这些手术器械典型地包括:保持在患者体外的手柄或主体部;以及细长管状构件,其具有工作器械或末端执行器,所述细长管状构件通过插管插入并且进入增压的体腔。由于体腔的压力高于体腔外部的压力,因此吹入流体倾向于通过细长管状构件漏出并且通过手术器械的主体部中的空隙流出。吹入气体通过细长管状构件的漏出和流动在细长管状构件内产生了回吸(drawing)或虹吸作用,该回吸或虹吸作用牵引体液和组织通过末端执行器并且进入细长管状构件。体液和组织被引入末端执行器和手术器械的其余部分会污染且妨碍手术器械的工作部件。这除了造成污染物流过手术器械外,还造成操作手术器械的困难。
因此,期望提供一种防止体液和组织通过手术器械漏出的手术器械。还期望提供一种结合了增压机构以使手术器械内的压力和体腔内的压力相平衡来防止吹入流体通过手术器械漏出的手术器械。还期望提供一种能够用来增加通过插管提供至体腔内的吹入流体的增压手术器械。
发明内容
本发明公开了一种增压手术器械,其具有主体部和从主体部延伸出的细长管状构件。主传感器位于手术器械内以检测在工作环境中的压力。所述增压手术器械附加地包括位于手术器械的主体部内的增压机构,用于使手术器械的压力和工作环境的压力相平衡。所述增压机构包括连接到主传感器的控制器和连接到控制器的压力输送系统。所述压力输送系统响应于从控制器接收到的信号向手术器械的内部提供正压力,并且压力输送系统与手术器械的内部流体连通。特别地,压力输送系统与细长管状构件的内部流体连通。
控制器结合用于检测手术器械内的压力的第二传感器。所述控制器将工作环境中的压力与手术器械内的压力进行比较。
压力输送系统包括导管(tube)并且导管的远端连接到与细长管状构件的近端流体连通的套环(collar)。所述套环通过位于套环周围的一系列进口与细长管状构件的近端流体连通。
主传感器位于细长管状构件内。特别地,主传感器邻近细长管状构件的远端定位。主传感器通过传感器线缆连接到控制器。在特定的实施例中,主传感器和传感器线缆容纳在细长管状构件的壁内。
在一个实施例中,压力输送系统包括位于手术器械的主体部内的自备气罐(self-contained gas cartridge)。压力输送系统包括连接到自备气罐和连接到控制器的阀门,使得所述阀门响应于从控制器接收到的信号来调节由所述自备气罐释放的气体。
在可替代的实施例中,压力输送系统包括增压泵,所述增压泵与细长管状构件的内部流体连通并且连接到控制器。抽吸导管(draw tube)从所述增压泵延伸到主体部外部的位置以将低压吹入气体抽吸到泵内。
在又一个可替代的实施例中,压力输送系统包括阀门和从所述阀门延伸到连接配件的连接导管。所述阀门连接到控制器。在此实施例中,连接配件可释放地联接到吹入流体的外部源。
附图说明
这里,参照附图公开目前公开的增压手术器械的各个实施例,其中:
图1为部分以剖面示出的、通过体腔壁插入且进入被吹的或增压的体腔的现有技术的手术器械和现有技术的插管的侧视图;
图2为部分以剖面示出的、通过现有技术的插管插入且进入增压体腔的增压手术器械的第一实施例的侧视图;
图3为图示出位于增压手术器械的手柄或主体部内的自备增压机构的图2的细节区域的放大图;
图4为图示出邻近增压手术器械的细长管状构件的远端定位的主传感器的图2的细节区域的放大图;
图5为图示出启动自备增压机构来使细长管状构件内的压力相等的类似于图2的图;
图6为图示出启动自备增压机构以使在手术器械内产生比增压的体腔内的压力大的压力的类似于图2的图;
图7为部分以剖面示出的、通过现有技术的插管插入且进入增压的体腔的增压手术器械的可替代实施例的侧视图;
图8为图示出位于增压手术器械的手柄或主体部内的增压机构的可替代实施例的图7的细节区域的放大图;
图9为图示出启动增压机构来使增压手术器械的细长管状构件内的压力相等的类似于图7的图;
图10为图示出启动增压机构以使在手术器械内产生比增压的体腔内的压力大的压力的类似于图7的图;
图11为部分以剖面示出的、通过现有技术的插管插入且进入增压的体腔的增压手术器械的又一个可替代实施例的侧视图;
图12为图示出位于增压手术器械的手柄或主体部内的增压机构的又一个可替代实施例的图11的细节区域的放大图;
图13为图示出启动增压机构以使增压手术器械的细长管状构件内的压力相等的类似于图11的图;以及
图14为图示出启动增压机构以使在增压手术器械内产生比增压的体腔内的压力大的压力的类似于图11的图。
具体实施方式
现在将结合附图详细描述本公开的增压手术器械的实施例,其中在若干视图的每一个中,相似的附图标记表示相同或相应的元件。如现有技术中所常见的,术语“近侧”指靠近使用者或操作者(即外科医生或内科医生)的部分或部件,而术语“远侧”指更远离使用者的部分或部件。
首先参考图1,图示了现有技术的手术器械10和现有技术的插管12。现有技术的插管12图示为通过切口I插入且延伸进入体腔BC,切口I穿过体腔壁BCW形成。设置现有技术的插管12来容纳现有技术的手术器械10贯穿其中的一部分以便在体腔BC内进行手术操作。现有技术的插管12主要包括主体部14和从主体部14向远侧延伸的插管导管16。主体部14和插管导管16形成用于容纳现有技术的手术器械10的一部分的通孔18。通孔18从主体部14的近端20延伸到插管导管16的开口远端22。
诸如密封件24和26的一对密封件可设置在主体部14内以防止气体从体腔BC漏出并且对现有技术的手术器械10的周围进行密封。为了增压从而在体腔BC内建立工作空间,气体进口28设置在主体部14上以接收气体源或吹入流体源30。吹入流体源30提供诸如二氧化碳的惰性、无毒气体以在体腔BC内扩充并且建立工作空间。阀门32设置在气体进口28上以控制进入体腔BC的气流。
现有技术的手术器械10主要包括手柄或主体部34,细长管状构件36从主体部34向远侧延伸出。为了对位于体腔BC内的组织进行手术操作,将末端执行器40置于细长管状构件36的远端38上。在现有技术的手术器械10中,末端执行器40包括吻合钉钉仓42和相对于吻合钉钉仓42可移动地安装的砧座构件44。砧座构件44可在与吻合钉钉仓42间隔开的开启位置和其中砧座构件44与吻合钉钉仓42处于紧密协作对准的闭合位置之间移动。尽管末端执行器40被图示为包括吻合钉钉仓42和砧座构件44,但是也可考虑诸如切割器、抓取器、活组织切片检查装置、电烙装置等的其他类型的末端执行器以用于现有技术的手术器械10中。致动器或扳柄46设置在主体部34上并且是可操作的以使砧座构件44相对于吻合钉钉仓42在开启位置和闭合位置之间移动。旋转体封套(rotator cuff)48可旋转地安装在主体部34上并且固定到细长管状构件36上。为了使末端执行器40相对于将进行操作的组织适当地定位,设置旋转体封套48以使细长管状构件36旋转,并由此使末端执行器40也旋转。
在使用现有技术的手术器械10和现有技术的插管12以在体腔BC内进行手术操作时,通过体腔壁BCW形成切口I并且通过切口I插入插管导管16,以使得现有技术的插管12形成进入体腔BC的进入口。一旦现有技术的插管12被适当地定位,则打开阀门32以允许吹入气体从吹入流体源30流过通孔18并且沿箭头A的方向进入体腔BC,从而扩充体腔BC以建立工作空间。当吹入气体流入体腔BC时,体腔BC内的压力P1上升到大于体腔BC外侧的外部或环境压力P2的水平。
一旦体腔BC已适当地扩充且增压到压力P1,则操作现有技术的手术器械10使得末端执行器40和细长管状构件36通过现有技术的插管12中的密封件24和26以及通孔18插入。一旦末端执行器40已从插管导管16的远端22延伸出,则在体腔BC内进行期望的手术操作。
因为体腔BC内的压力P1大于体腔BC外侧的压力P2,因此在位于体腔BC内的末端执行器40和位于体腔BC外侧的诸如主体部34的现有技术的手术器械10的其余部分之间存在压力差。在一些情况下,位于体腔BC内的吹入气体会被迫沿箭头B的方向向近侧流过现有技术的手术器械10并且逸入主体部34并且在旋转体封套48和主体部34之间以及扳柄46和主体部34之间的空隙间漏出。尽管现有技术的手术器械10典型地包括多个密封件(未示出)以防止吹入气体的漏出,但这些密封件仍然可能泄漏,特别是在操作期间当现有技术的手术器械10的内部部件相对于密封件移动时。当吹入气体通过现有技术的手术器械10向近侧移动时,吹入气体倾向于将体液和组织微粒回吸或虹吸进入末端执行器40和细长管状构件36并且向近侧通过末端执行器40和细长管状构件36,从而污染且在一些情况下潜在地损坏现有技术的手术器械10的内部部件。另外地,现有技术的手术器械10可设置用于吹入气体漏出的路径从而降低体腔BC内的压力P1。
现在参考图2,公开了一种与现有技术的插管12一起使用以在体腔BC内进行手术操作的增压手术器械50。增压手术器械50被设计为防止吹入气体通过增压手术器械50漏出体腔BC。增压手术器械50主要包括手柄或主体部52,细长管状构件54从主体部52向远侧延伸出。末端执行器56安装在细长管状构件54的远端58上并且包括吻合钉钉仓60和相对于吻合钉钉仓60可移动地安装的砧座构件62。扳柄或致动器64设置成使砧座构件62从与吻合钉钉仓60间隔开的开启位置移动到邻近吻合钉钉仓60的闭合位置。尽管将增压手术器械50公开为包括末端执行器56,但可设置诸如在关于现有技术的手术器械10的上文中所提到的那些其他末端执行器。为了使末端执行器56相对于将进行操作的组织适当地定位,旋转体封套66可旋转地安装在主体部52的远端68上并且固定到细长管状构件54上。
为了防止吹入气体通过增压手术器械50漏出体腔BC,增压手术器械50包括增压机构70,增压机构70设置成在细长管状构件54内产生压力P3(图5),压力P3大于或等于体腔BC内的压力P1。在细长管状构件54内产生的压力P3防止吹入气体的漏出并且防止身体的流体和组织虹吸进入增压手术器械50。主传感器72邻近细长管状构件54的远端58定位并且被设置以检测压力P1。传感器线缆74以下文中更加详细描述的方式从主传感器72延伸出通过细长管状构件54到达增压机构70。
现在参考图3,如上文中所提到的,致动器64相对于主体部52可移动地安装。致动器64在枢轴76处安装到主体部52上。为了致动末端执行器56(图2),控制杆78从致动器64的内部端80延伸出并且通过细长管状构件54。控制杆78的近端82通过形成在内部端80上的柱螺栓84可移动地固定到内部端80上。控制杆78的远端(未示出)固定到末端执行器56以致动末端执行器56。如上文中进一步提到的,手术器械典型地包括多个密封件以有助于防止气体通过手术器械漏出。增压手术器械50包括位于细长管状构件54的近端88处的密封件86以密封控制杆78的周围。
增压机构70包括内部压力检测和调节电路或控制器90,其设置成接收由主传感器72发送的信号并且确定将由增压机构70产生的压力P3。尽管未特定示出,但控制器90包括比较传感器和微处理器或模拟控制电路以将由主传感器72检测到的体腔压力P1与由体腔BC外部的控制器90中的传感器检测到的环境压力P2进行比较。控制器90触发阀门或压力调节机构以产生内部手术器械压力P3并且将内部手术器械压力P3保持在大于或等于压力P1的水平。传感器线缆74的近端92连接到控制器90以传送从主传感器72接收到的信号。
增压机构70另外还包括位于主体部52内的自备气罐94。自备气罐94容纳二氧化碳吹入气体。阀门96设置在自备气罐94上以调节流出自备气罐94和通过增压手术器械50的气流。阀门线缆98从控制器90延伸到阀门96。控制器90比较由主传感器72检测到的压力P1并且触发阀门96打开,以便在增压手术器械50内提供气体压力P3。自备气罐94、阀门96和阀门线缆98形成增压机构70的压力输送系统100。
压力输送系统100另外还包括压力导管102,其具有第一端104和第二端106,第一端104连接到阀门96,而第二端106连接到细长管状构件54的近端108、密封件86的远侧。特别地,套环110通过形成在套环110上的多个进口112与细长管状构件54流体连通。压力导管102的第二端106固定到套环110上以将来自自备气罐94的增压气体或吹入流体传送到细长管状构件54。
现在参考图4,如上文中所提到的,主传感器72邻近细长管状构件54的远端58定位。传感器线缆74的远端114固定到主传感器72。主传感器72可固定到细长管状构件54的内表面116上,或者,可替代地,主传感器72可形成、模制或以其它方式定位在细长管状构件54的壁118的内部。另外地,传感器线缆74也可在壁118的内部从主传感器72向近侧延伸到细长管状构件54的近端88。应当注意的是,尽管将主传感器72公开为位于细长管状构件54内,但主传感器72也能位于增压手术器械50内的其它地方。
现在参考图2至图6,并且首先关于图2,现在将描述增压手术器械50的使用。现有技术的插管12通过切口I插入,以使得现有技术的插管12的远端22位于体腔BC内,所述切口I穿过体腔壁BCW形成。此后,打开阀门32以允许气体从吹入流体源30流过气体进口28并且流出现有技术的插管12的远端22。气体沿箭头A的方向流动以使体腔BC被吹到大于环境压力P2的压力P1并且在体腔BC内建立工作空间。类似于在上文所述的现有技术的手术器械10,当增压手术器械50处于静止或非致动状态时,吹入气体能够沿箭头B的方向向近侧流过增压手术器械50,从而将吹入流体和身体组织虹吸进入且通过增压手术器械50。
现在参考图3和图5,在增压机构70致动时,控制器90(图3)接收与由主传感器72检测到的压力P1成比例的信号并且将所述信号与增压手术器械50内的压力P3进行比较。如果压力P1大于P3,则控制器90向包括阀门96的压力输送系统100发信号,使其开启以允许高压气体从自备气罐94流动经过压力导管102到达在细长管状构件54的近端108处的套环110。这促使了气体沿箭头C的方向向远侧流动经过增压手术器械50。当气体沿箭头C的方向向远侧流过增压手术器械50时,增压手术器械50内的压力被补偿,使得增压手术器械50内的压力P3等于体腔BC内的压力P1,从而防止体液或组织的任何向近侧流动或虹吸通过增压手术器械50。应当注意的是,可对控制器90进行调整以提供等于压力P1或大于压力P1的压力P3。
现在参考图6,如上文中所提到的,可对控制器90进行调整以提供大于体腔BC内压力P1的压力P3。这在以下的情况下是可取的:额外的吹入流体是必须的以使体腔BC保持在被吹气状态和防止吹入气体通过额外的进入口或现有技术的插管12而损失。在此情况下,控制器90触发压力输送系统100以提供具有大于P1的压力P3的高压气体,所述高压气体沿箭头C的方向流动经过增压手术器械50并且流出细长管状构件54的远端58以及流入体腔BC。
以这种方式,增压手术器械50防止体液和组织虹吸返回通过增压手术器械50,并且能够被用来在体腔BC内提供额外的吹入流体以弥补通过其他进入口的任何损失。
现在参考图7至图10,并且首先对于图7,公开了增压手术器械的另一个可替代的实施例120,其与现有技术的插管12一起使用以便在体腔BC内进行手术操作。与上文中描述的增压手术器械50相似,增压手术器械120被设计成防止吹入气体漏出体腔BC并由此防止任何体液或组织虹吸通过增压手术器械120。增压手术器械120的操作结构类似于增压手术器械50的操作结构,并且主要包括手柄或主体部122,细长管状构件124从主体部122向远侧延伸出。末端执行器126安装在细长管状构件124的远端128上并且包括吻合钉钉仓130和砧座构件132。砧座构件132相对于吻合钉钉仓130可移动地安装。扳柄或致动器134设置成使砧座构件132从与吻合钉钉仓130间隔开的开启位置移动到邻近吻合钉钉仓130的闭合位置。旋转体封套136可旋转地安装在主体部132的远端138上以使末端执行器126相对于将进行操作的组织定位。
增压手术器械120包括增压机构140以防止吹入气体通过增压手术器械120而漏出体腔BC。增压机构140设置成在细长管状构件124内产生大于或等于体腔BC内的压力P1的压力P4(图9)。主传感器142邻近细长管状构件124的远端128定位并且被设置成以上文中描述的方式检测压力P1。传感器线缆144从主传感器142延伸出、通过细长管状构件124到达增压机构140。类似于增压手术器械50中的主传感器72和传感器线缆74,主传感器142和传感器线缆144可设置在细长管状构件124的内侧或可容纳在细长管状构件124的壁内。
现在参考图8,致动器134相对于主体部122可移动地安装在枢轴146处。控制杆148从致动器134的内部端150延伸通过细长管状构件124到达末端执行器126。控制杆148借助致动器134的致动而通过细长管状构件124的平移使得砧座构件132以已知方式相对于吻合钉钉仓130在开启和闭合位置之间移动。通过柱螺栓154将控制杆148的近端152固定到致动器134的内部端150。密封件156设置在细长管状构件124的近端158内以使吹入气体通过细长管状构件124从体腔BC的漏出最小化。
增压机构140另外包括结合增压泵162的压力输送系统160。增压泵162设置成产生大于或等于位于体腔BC内的压力P1的压力P4。压力输送系统160另外包括压力导管164,其具有近端166和远端168,近端166连接到增压泵162而远端168连接到设置在细长管状构件124的近端158上的套环170。套环170位于密封件156的远侧并且包括与细长管状构件124的内部流体连通的多个进口172。
增压泵162可由诸如内部电池、外部电源等的各种器件来提供动力。另外地,在压力P4等于压力P1的情况下,增压泵162可从外部的空气源吸入它的增压流体,或者当期望产生大于压力P1的压力P4时,增压泵162可连接到低压吹入流体的外部源。压力输送系统160另外包括抽吸导管174,抽吸导管174具有连接到增压泵162的第一端176和连接到吹入流体的外部源的第二端178。外部导管180被设置用于连接到吹入流体的外部源并且连接到第二端178。衬套(bushing)182可设置成将抽吸导管174的第二端178连接到外部导管180。
增压机构140另外包括控制器184,控制器184的功能基本与上文中所描述的、关于增压手术器械50的控制器90相同。传感器线缆144的近端186连接到控制器184以传送由主传感器142检测到的信号。泵线缆188在控制器184和增压泵162之间延伸。控制器184接收来自主传感器142的信号并且向增压泵162发送指示信号以便产生期望的压力P4。
现在参考图7至图10,现在将描述在增压手术器械120内产生压力的增压机构140的使用。插管12是以上文中描述的方式穿过体腔壁BCW定位并且体腔BC被吹气至压力P1以建立工作空间。此后,通过插管12操纵增压手术器械120使得末端执行器126在体腔BC内定位。
首先参考图7,在最初或非启动状态下,迫使吹入气体沿箭头A的方向通过现有技术的插管12进入体腔BC。当增压机构140未启动时,体腔BC内的压力P1大于体腔BC外侧的压力P2,从而允许吹入气体沿箭头B的方向流过增压手术器械120。如上文中所提到的,吹入气体沿箭头B的方向的漏出引起将体液和组织吹入增压手术器械120的回吸或虹吸作用。
现在参考图8和图9,当期望防止体液通过增压手术器械120的虹吸时,增压手术器械120被启动使得主传感器142检测体腔BC内的压力P1。由主传感器142检测到的信号通过传感器线缆144被发送到增压机构140。特别地,该信号被发送到增压机构140的控制器184,然后控制器184发送一信号到压力输送系统160。增压泵162被启动并且通过抽吸导管174抽吸流体并且迫使该流体通过压力导管164进入细长管状构件124。沿着箭头C的线路引导流体压力以在增压手术器械120的细长管状构件124内产生压力P4。如示出,产生的压力P4等于体腔压力P1,这使增压手术器械120内的压力相等从而防止体液或组织的任何虹吸或漏出。
现在参考图10,如果期望将额外的吹入流体提供到体腔BC中,从控制器184发送到增压泵162的信号使得增压泵162产生大于体腔压力P1的压力P4。如示出,由增压泵162产生的增压气体沿箭头C的方向行进经过增压手术器械120并且离开细长管状构件124的远端128并且进入体腔BC。
以这种方式,增压手术器械120结合在增压机构140的压力输送系统160内的内部增压泵162来使增压手术器械120内的压力平衡或者产生足够的压力以提供进入体腔BC的额外的吹入流体源。
现在参考图11至图14,公开了增压手术器械的另一个实施例190。增压手术器械190主要包括手柄或主体部192和从主体部192向远侧延伸出的细长管状构件194。末端执行器196设置在细长管状构件194的远端198上。末端执行器196包括吻合钉钉仓200和可移动地安装在吻合钉钉仓200上的砧座构件202。扳柄或致动器204可移动地安装在主体部192上并且设置成使砧座构件202从与吻合钉钉仓200间隔开的开启位置移动到邻近吻合钉钉仓200的闭合位置。旋转体封套206可旋转地安装在主体部192的远端208上并且可旋转以使末端执行器196相对于将进行操作的组织定位。
增压手术器械190包括增压机构210以防止吹入气体的漏出和防止体液通过增压手术器械190的虹吸。主传感器212邻近细长管状构件194的远端198定位,并且传感器线缆214在主传感器212和增压机构210之间延伸。应当注意的是,类似于以上的实施例,主传感器212和传感器线缆214可容纳在细长管状构件194的壁(未示出)内。
与前面公开的实施例形成对照,增压手术器械190使用高压吹入气体的外部源216。供给导管218被设置并且从外部源216延伸出,且以下面更详细描述的方式连接到设置在主体部192内的压力输送系统220。
参考图12,致动器204在枢轴222处可移动地安装到主体部192上。控制杆224延伸通过细长管状构件194并且控制杆224在其近端228处连接到致动器204的内部端226。形成在内部端226上的柱螺栓230将控制杆224的近端228固定到致动器204。密封件232设置在细长管状构件194的近端234中以有助于防止吹入气体的漏出。
在此实施例中,压力输送系统220主要包括阀门236,其结合配件238以可释放的联接在供给导管218上。压力导管240被设置并且在阀门236和细长管状构件234之间延伸。特别地,压力导管240的近端242连接到阀门236而压力导管240的远端244连接到环绕细长管状构件194的近端234设置的套环246上。套环246通过一系列进口248与细长管状构件194流体连通。
增压机构210包括控制器250,所述控制器250基本类似于关于增压手术器械50和120的上文中所描述的那些控制器。传感器线缆214的近端252连接到控制器250以传送与由主传感器212检测到的压力相当的信号。阀门线缆254被设置并且具有连接到控制器250的第一端256和连接到阀门236的第二端258。控制器250接收通过传感器线缆214发送的信号并且沿着阀门线缆254传送一信号来控制阀门236的操作。
现在参考图11至图14,并且首先对于图11,现在将描述增压手术器械190的操作。插管12通过切口I插入,并且体腔BC被吹至压力P1以在体腔BC内建立工作空间,切口I穿过体腔壁BCW而形成。此后,通过插管12操作增压手术器械190使得末端执行器196在体腔BC内定位。如在前的示例一样,在启动增压机构210之前,吹入流体可沿箭头B的方向流过增压手术器械190,从而产生虹吸作用,将体液和组织吸入增压手术器械190。
现在参考图12和图13,在启动增压机构210时,主传感器212检测压力P1并且沿着传感器线缆214发送信号至控制器250。然后控制器250经由阀门线缆254发送信号至阀门236。根据增压手术器械190的期望状态,打开阀门236以经由供给导管218接收高压吹入流体的外部源216且允许吹入流体流过压力导管240到达套环246。将阀门236打开到使等于体腔BC内的压力P1的压力P5通过且进入压力导管240的程度。高压吹入流体流过进口248且进入细长管状构件194。吹入流体沿箭头C的方向向远侧流动以使增压手术器械190内的压力相等。
参考图14,如果期望使用吹入流体的外部源216来将额外的吹入流体提供到体腔BC内,则将阀门236打开到使压力P5大于位于体腔BC内的压力P1的程度。在这种情况下,吹入流体沿箭头C的方向流动完全通过增压手术器械190并且进入体腔BC。
以这种方式,增压手术器械190能够等于包含在体腔BC内的压力P1或能够增压到大于体腔BC中的压力P1的程度,并且能够使用增压手术器械190来提供额外的吹入气体源。另外地,通过使用增压吹入流体的外部源216,增压手术器械190能够接收且实质上无限的供给增压气体。
如上所述,增压手术器械50、120和190结合设备来使各个手术器械内的压力相对于被吹的体腔BC内侧的压力相等,而且,增压手术器械50、120和190向体腔BC内提供额外的吹入流体源来弥补通过其他进入口的损失。
将理解的是,可对在此公开的实施例进行各种改进。例如,可将公开的增压机构、主传感器和传感器线缆结合到用在内窥镜和/或腹腔镜手术过程中的诸如内窥镜活组织切片检查装置、显影装置等的其他器械中。而且,如上文所提到的,主传感器可位于手术器械内的各个位置处以便检测手术器械内的各个点处的压力。另外地,密封件可设置在容纳致动器、旋转体封套和任何其他外部装置的手术器械主体部中的孔口处,并且包括主体部以及细长管状构件部的整体手术器械可被增压。因此,以上的描述不应当被解释为限制,而是应当仅被解释为对特定实施例的说明。本领域中的技术人员将会想到在此附加的权利要求的精神和范围内的其他的改进。
Claims (20)
1.一种增压手术器械,包括:
手术器械,其具有主体部和从所述主体部延伸出的细长管状构件;
主传感器,其位于所述手术器械内以检测在工作环境中的压力;以及
增压机构,其位于所述手术器械的所述主体部内,所述增压机构包括连接到所述主传感器上的控制器和连接到所述控制器上的压力输送系统,所述压力输送系统与所述手术器械的内部流体连通并且配置为响应于由所述主传感器检测到的压力而提供吹入流体以防止吹入气体通过手术器械漏出。
2.如权利要求1所述的增压手术器械,其中所述控制器结合用于检测所述手术器械内的压力的第二传感器,所述控制器将所述工作环境中的压力与所述手术器械内的压力进行比较。
3.如权利要求2所述的增压手术器械,其中所述压力输送系统与所述细长管状构件的内部流体连通。
4.如权利要求3所述的增压手术器械,其中所述压力输送系统通过导管与所述细长管状构件的内部流体连通。
5.如权利要求3所述的增压手术器械,其中所述压力输送系统包括位于所述手术器械的所述主体部内的自备气罐。
6.如权利要求5所述的增压手术器械,其中所述压力输送系统包括连接到所述自备气罐和连接到所述控制器的阀门,使得所述阀门响应于从所述控制器接收到的信号来调节由所述自备气罐释放的气体。
7.如权利要求3所述的增压手术器械,其中所述压力输送系统包括增压泵,所述增压泵与所述细长管状构件的内部流体连通并且连接到所述控制器。
8.如权利要求7所述的增压手术器械,其中所述压力输送系统另外包括抽吸导管,所述抽吸导管从所述增压泵延伸到所述主体部的外部的位置。
9.如权利要求7所述的增压手术器械,其中所述增压泵响应于从所述控制器接收到的信号来传送气体。
10.如权利要求3所述的增压手术器械,其中所述压力输送系统包括阀门和从所述阀门延伸到连接配件的连接导管,所述阀门连接到所述控制器。
11.如权利要求10所述的增压手术器械,其中所述连接配件能释放地联接到吹入流体的外部源。
12.如权利要求10所述的增压手术器械,其中所述阀门响应于从所述控制器接收到的信号来调节由所述增压泵释放的气体。
13.如权利要求4所述的增压手术器械,其中所述导管的远端连接到套环上,所述套环与所述细长管状构件的近端流体连通。
14.如权利要求13所述的增压手术器械,其中所述套环通过位于所述套环周围的一系列进口与所述细长管状构件的所述近端流体连通。
15.如权利要求1所述的增压手术器械,其中所述主传感器位于所述细长管状构件内。
16.如权利要求15所述的增压手术器械,其中所述主传感器邻近所述细长管状构件的远端定位。
17.如权利要求15所述的增压手术器械,其中所述主传感器容纳在所述细长管状构件的壁内。
18.如权利要求1所述的增压手术器械,其中所述主传感器通过传感器线缆连接到所述控制器。
19.如权利要求18所述的增压手术器械,其中所述传感器线缆容纳在所述细长管状构件的壁内。
20.如权利要求1所述的增压手术器械,其中所述细长管状构件结合密封件以防止吹入流体的损失。
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EP2363162A2 (en) | 2011-09-07 |
CN102188268A (zh) | 2011-09-21 |
EP2363162B1 (en) | 2020-04-29 |
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CA2730864A1 (en) | 2011-09-02 |
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AU2011200896A1 (en) | 2011-09-22 |
AU2011200896B2 (en) | 2014-06-12 |
US20170197045A1 (en) | 2017-07-13 |
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