CN102247177B - 手术控制台和手持式手术装置 - Google Patents

手术控制台和手持式手术装置 Download PDF

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CN102247177B
CN102247177B CN201110097438.2A CN201110097438A CN102247177B CN 102247177 B CN102247177 B CN 102247177B CN 201110097438 A CN201110097438 A CN 201110097438A CN 102247177 B CN102247177 B CN 102247177B
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唐纳德·马利诺思卡斯
戴维·A·泽伊奇勒
迈克尔·P·惠特曼
戴维·A·尼古拉斯
陈兴瑞
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Covidien LP
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    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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Abstract

本发明涉及一种手术控制台和手持式手术装置,本发明的手术系统和方法包括:手术器械,其被配置为以无线方式发送专属于所述手术器械的识别数据;以及控制台,其被配置为接收所述识别数据。所述控制台被配置为:基于所述识别数据注册所述手术器械,在所述手术器械和控制台之间建立无线双路通信链路,从所述手术器械接收运行数据和命令中的至少一个,并且基于运行数据和命令中的至少一个在手术器械运行期间向所述手术器械的用户提供运行反馈数据。

Description

手术控制台和手持式手术装置
相关申请的交叉引用
本申请为部分继续申请,要求于2009年11月20日提交的序列号为12/622,827的美国申请的利益和优先权,该申请的全部内容通过引用合并于此。
技术领域
本发明通常涉及一种手术控制台和手持式手术装置。
背景技术
例如,在申请号为2009/0101692的美国公开的专利申请中描述了一种电池供电的、手持式、整装式手术装置,其全部内容通过引用专门地合并于此,并且用附图标记800图示于此。该装置包括电路板,所述电路板响应于来自装置的操作者(例如,外科医生)的手动输入来控制各种功能,例如,作关节式运动、转动以及闭合钳夹并致动吻合切割机构。由于未物理地连接到任何外部驱动系统上,该装置在手术操作期间提供可动性。
公认的是期望提供这样一种双路通信装置:其不会降低或者不会实质上降低由诸如上述手术装置的装置所提供的可动性。此外,公认的是期望注册一个或多个手术装置并保持注册的和/或未经注册的装置的列表。
还公认的是期望提供用于追踪信息的机构,所述信息与例如存货量、装置和/或附加装置或装置部件的使用次数、故障、清洁/卫生处理状态、和/或维修之间的使用次数相关。这些信息还可包括通过成像装置获取的图像和/或在既定手术操作期间运行的装置控制的记录,例如,操作者使用了什么输入或控制、他们何时使用和/或使用了多长时间、和/或最终的状态和/或例如电动机力、部件位置和/或由传感器获得的数据的参数的记录。而且,期望基于接收到的信息向操作者提供视觉和/或听觉反馈。
而且,公认的是期望一种防止使用特定装置系统,例如在之前使用之后还未清洁的装置和/或未注册的装置。
还公认的是期望提供一种智能驱动单元,该智能驱动单元为可执行哪种手术操作提供可动性和灵活性。
发明内容
根据本发明的示例性实施例,手术系统包括:手术器械,所述手术器械被配置为以无线方式发送专属于手术器械的识别数据;以及控制台,其被配置为接收所述识别数据。该控制台进一步被配置为:基于所述识别数据注册所述手术器械,在所述手术器械和控制台之间建立无线双路通信链路,接收来自所述手术器械的运行数据和命令中的至少一个,以及基于运行数据和命令中的至少一个在手术器械运行期间向所述手术器械的用户提供运行反馈数据。
控制台可具有显示屏,所述显示屏被配置为直观地显示所述反馈数据的至少一部分。
所述显示器屏可为被配置为接收用户命令的触摸屏显示器。
所述控制台可具有扬声器,所述扬声器被配置为提供作为音频信号的反馈数据的至少一部分。
所述反馈数据可包括指令和查询中的至少一个。
所述反馈数据可包括所述手术器械的运行参数。
所述手术装置被配置为当所述手术装置还未向控制台注册时至少部分地不能运行。
所述手术器械可以为手持式电池供电的手术装置。
所述手持式电池供电的手术装置可包括被配置为接收不同类型的手术附加装置的智能驱动单元。
不同类型的手术附加装置中的一个可以为手术切割器/吻合器。
控制台可具有直观显示屏,所述直观显示屏被配置为完成a)传达运行数据和b)接收用户命令中的至少一项。
手术装置和控制台中的一个或两个可被配置为如同在工业、科学和医疗(ISM)无线电频带的一个或多个中的FCC注册装置一样运行。
所述控制台可被配置为向所述手术器械上载操作软件,所述手术器械被配置为执行所述操作软件。
所述手术器械可被配置为对应于手术操作分流视频数据。
所述手术器械和控制台可被配置为如同在工业、科学和医疗(ISM)无线电频带中的一个或多个中的FCC注册装置一样运行。
工业、科学和医疗无线电频带可包括2.400GHz至2.500GHz的ISM频带。
根据本发明的示例性实施例,手术装置包括手持式电池供电的驱动单元,所述驱动单元具有壳体和被配置为接受手术附加装置的对应部分的安装部。所述驱动单元还包括被配置为致动至少一个连接构件的致动器,当所述附加装置安装到所述安装部上时,所述连接构件与所述附加装置的对应构件配合,以允许致动所述至少一个连接构件以驱动所述附加装置。所述驱动单元进一步包括用户控制元件和处理器,所述用户控制元件被配置为注册用户命令,所述处理器布置在所述壳体中并被配置为从所述用户控制元件接收对应于所述用户命令的用户输入信号,所述处理器被配置为根据作为所述用户输入信号的函数的操作程序来控制所述连接构件的致动。所述驱动单元还包括收发器,所述收发器被配置为经由无线双路通信链路向远程控制台传达运行数据和命令中的至少一个并且从远程控制台接收运行数据和命令中的至少一个。
所述处理器可被配置为通过调节驱动所述致动器的输出电压来控制所述至少一个连接构件的致动。
所述驱动单元可被配置为确定对应于所述附加装置的序列号。
所述驱动单元可被配置为确定对应于所述附加装置的附加装置类型。
所述处理器可被配置为从软件数据库中选择操作软件,所述软件数据库包括对应于多种不同的附加装置类型的软件。
所述装置可包括存储器,所述软件数据库存储在所述存储器中。
所述装置可包括用于接收更新软件的接口。
所述驱动单元可被配置为在所述至少一个连接构件的致动期间将运行数据分流到所述远程控制台。
所述驱动单元可被配置为从所述附加装置接收视频数据流并且向所述远程控制台发送所述视频数据流。
所述驱动单元可被配置为:如果所述双路通信链路还未建立,则防止所述致动器的致动。
动力单元可被配置为如同在工业、科学和医疗(ISM)无线电频带的一个或多个中的FCC注册装置一样运行。
所述工业、科学和医疗无线电频带包括2.400GHz至2.500GHz的ISM频带。
所述装置可包括联接到驱动单元上的多个手术附加装置。
根据本发明的示例性实施例,控制台包括存储器,被配置为处理存储在存储器上的数据的处理器,以及被配置为与远程手术器械通信的收发器。所述控制台被配置为:从所述手术器械接收识别数据,基于所述识别数据注册所述手术器械,并在所述手术器械和控制台之间建立无线双路通信链路。控制台还被配置为:从所述手术器械接收运行数据和命令中的至少一个,并且基于运行数据和命令中的至少一个在手术器械运行期间向所述手术器械的用户提供运行反馈数据。
控制台可包括显示屏,所述显示屏被配置为显示经由所述双路通信链路从所述手术器械接收到的运行数据。
控制台可具有直观显示屏,其被配置为实现a)传达所述运行数据和b)接收所述用户命令中的至少一个。
控制台可被配置为从所述手术器械接收视频数据流。
控制台可被配置为向外部显示器输出对应于所述视频数据的视频信号。
控制台可被配置为向所述手术器械传送a)操作程序和b)固件中的至少一个。
控制台可包括编程端口,所述编程端口被配置为将a)所述操作程序和b)所述固件中的至少一个输出到所述手术器械。
控制台可被配置为将从所述手术器械接收到的所述运行数据记录到所述存储器中。
控制台可被配置为利用有线连接器向远程装置传达存储的数据。
控制台可被配置为经由因特网传达存储的数据。
根据本发明的示例性实施例,一种方法包括:以无线方式从手术器械向控制台发送识别数据,向控制台注册所述手术器械,并且在所述手术器械和控制台之间建立双路无线通信链路。所述方法还包括:在所述手术器械和控制台之间传送运行数据和命令中的至少一个,并且基于运行数据和命令中的至少一个在手术器械运行期间从控制台向所述手术器械的用户提供运行反馈数据。
所述方法可包括:判定以无线方式发送的识别数据的信号强度是否在预定阈值以下,如果判定出所述信号强度在所述预定阈值以下,则在注册之前要求用户确认。
所述方法可包括保持已经由控制台注册的手术装置的控制台上的列表。
在下面,结合附图更详细地说明本发明的示例实施例的进一步的细节和方案。
附图说明
图1a至图1c为根据本发明的示例性实施例的控制台的前视图。
图2为控制台的仰视图。
图3为控制台的后视图。
图4为根据本发明的示例性实施例的系统的示意图。
图5a和图5b示出了根据本发明的示例性实施例的智能驱动单元和手术附加装置。
图6示出了当手术附加装置连接到智能驱动单元上时的智能驱动单元和手术附加装置。
图7a和图7b示出了智能驱动单元。
图8a至图8c示出了驱动单元的内部部件。
图9示出了驱动单元的连接部分。
图10示出了手术附加装置的连接部分。
图11示出了根据本发明的示例性实施例的手术附加装置和附加装置轴。
图12为根据本公开的另一实施例的智能驱动单元在零件分离的情况下的立体图。
图13为根据又一实施例的智能驱动单元的立体图。
具体实施方式
结合图4,示意地图示了根据本发明的示例性实施例的系统10。系统10包括与医疗和/或手术器械200a、200b和200c通信的电子控制台100,所述医疗和/或手术器械200a、200b和200c布置在与控制台100相同的区域150中,例如布置在与控制台100相同的医疗护理或手术室中。应该理解的是,控制台100可与更多的器械例如八个以上的器械通信,和/或与更少的器械例如单个器械通信。然而,为了说明的目的示出了三个器械200a、200b和200c。这些器械可以例如为手持式手术器械(例如,带有可更换手术附加装置的电池供电的手术智能驱动单元)或在控制台100的通信范围内的任意其它的医疗和/或手术器械。控制台100可被配置为在指定的时间内与一个手术器械200a、200b或200c通信,和/或同时与两个以上的手术器械200a、200b和/或200c通信。
控制台100向一个或多个器械200a、200b和200c的操作者提供反馈,器械200a、200b和200c可以为例如为在下面更详细地描述的无线智能动力或驱动单元500。控制台100还能够识别语音并向一个或多个手术器械200a、200b和/或200c发送无线命令。当接收到来自手术器械的无线命令时,可例如以多种语言来显示口头(verbal)和视觉提示。控制台100可接收来自手术器械的分流视频,并且将视频输出到例如在手术室监控器上用于显示的独立的视频接口窗口(videointerfacepod)上,其中,手术器械具有摄像机。控制台100具有一个电路板或多个电路板,所述电路板包括处理器104(例如ARM9级微处理器)、微控制器、序号识别集成电路(IC)、音频IC和/或扩音器、图形显示器110(例如LCD显示器)、以太网接口140、USB接口145、手术装置编程接口(包括例如图3中图示的收发器102和/或USB接口145)。控制台100从外部UL/CE认证的AC壁式适配器接收供电,但是应该理解的是,代替壁式适配器或者除了壁式适配器之外,还可提供其它的电源,如下所述。
此外,例如,当由手术器械200a、200b、200c以无线方式给出命令时,控制台100可在显示器110上例如以多种语言来显示提示。当由手术器械200a、200b、200c以无线方式给出命令时,控制台100能够例如以多种语言发出提示。控制台100包括使用例如适配器电缆或无线连接器或链路来更新手术装置的软件的电路。控制台可通过网路例如因特网和/或局域网或者任意其它适当的机构例如经由USB端口145或存储器卡来接收这些更新。控制台100能够发送装置信息,例如关于使用诸如下面详细描述的附加装置600的手术附加装置的信息。此处,例如,附加装置600、吻合器、吻合钉重载和附加装置使用的数据可由控制台100通过因特网来传输。
在一个示例中,控制台包括能够以例如400MHz的频带接收手术装置发送信号的射频(RF)接收器和能够以900MHz至5.8GHz的频带双路通信和/或视频分流的RF收发器。控制台100能够处理接收到的分流视频、参数和/或提示信息,并将分流视频、参数和/或提示信息输出到例如独立的视频窗口以用于显示(覆盖)在例如手术室监控器的外部显示器上。示例性的控制台100包括语音识别能力,其能够处理语音命令并且无线传输命令以操作手术装置,例如下面描述的智能动力或驱动单元400。
此外,如下面更详细地阐述的,无线通信可使用一个或多个工业、科学和医疗(ISM)无线电频带,例如2.400GHz至2.500GHz的ISM频带,并且控制台100和/或手术器械200a、200b和200c可以经FCC认证以在该频带中工作。一种或多种ISM频带可用于手术器械200a、200b、200c和控制台100之间的单向和/或双路或双向通信。然而,应该理解的是,控制台100和/或手术器械200a、200b、200c可使用任意适当的频带。而且,尽管该示例使用从手术器械200a、200b、200c到控制台100的单向频道和手术器械200a、200b、200c之间的双路频道二者,但是应该理解的是,可省略单向频道,从而,例如所有的通信发生在一个或多个双路通信频道或链路上。
如上面所指出的,控制台100经由双路无线链路与器械200a、200b和200c中的每一个进行无线通信。在这点上,控制台100包括有包括收发器102的无线通信装置或布置106,以通过在无线收发器102和分别对应于器械200a、200b和200c的相应的无线通信装置或布置206a、206b和206c的无线收发器202a、202b和202c中的每一个之间发送和接收通信数据,而允许控制台100和器械200a、200b和200c之间的双路无线通信。该示例的无线通信布置106还可包括除了收发器之外的接收器。接收器可被配置为从可设置到器械200a、200b和200c上的无线发送器接收单向无线发送信号。单向链路可使用与双向或双路通信链路的频率不同的例如400MHz频带的频率,所述双向或双路通信链路可在所讨论的一个或多个ISM频带或其它的频带上工作。
可以以不同的方式使用该单向链路。例如,器械200a、200b、200c可在单向链路上向控制台100的接收器发送识别信息,并且一旦在控制台100上进行电子注册,器械200a、200b、200c就通过双路通信链路与控制台100通信。可选择地或者此外,可提供单向通信链路以允许器械200a、200b、200c和控制台100之间更大的通信带宽。
为了利于实现各种功能,例如存储、处理和/或发送/接收数据,控制台100和器械200a、200b和200c中的每一个包括用于存储数据的存储器103、203a、203b和203c,例如固态和/或以磁盘为基础的内部存储器,以及用于例如处理数据并启动数据的发送/接收的处理器104、204a、204b和204c。
如上面所指出的,无线链路可使用一个或多个工业、科学和医疗(ISM)的无线电频带,例如,2.400GHz至2.500GHz的ISM频带。控制台100和/或器械200a、200b和200c可以经FCC认证,以在该频带或任意其它适当的ISM频带上工作。然而,应当理解的是,控制台100和/或器械200a、200b和/或200c可作为可在任意适当的频带上运行的未经认证的装置运行。此外,无线协议可遵照802.11b、802.11g和/或任意其它适当的协议、标准或修订。应当注意的是,在例如2.400GHz至2.500GHz的ISM频带上的经认证的运行可以有利于限制其它装置例如小的电子装置的干扰。而且,对于已注册的装置,与其它的一些ISM频带相比,允许通信的动力级别和数据类型在2.400GHz至2.500GHz的ISM频带上可受到更少的限制。
结合图1a至图1c,控制台100包括壳体105。该示例的壳体105由ABS塑料形成并具有小于3.25英寸的高度、小于5.75英寸的宽度、小于1.75英寸的厚度,以及小于1.5镑的重量。然而,应当理解的是,壳体可为任意适当的大小、尺寸和重量。然而,为了加强控制台100的便携性和/或装载性,以及如何安装控制台100和何处安装控制台100的灵活性、和/或为了减少例如在手术室里的空间的使用量,壳体105的紧凑尺寸和重量是有利的。
显示器110布置在壳体的前面以向一个或多个手术器械的操作者(例如,外科医生)提供视觉的指示。尽管显示器110为一体的触摸屏液晶显示器(LCD),但是应该理解的是,可提供其它的显示器,例如有机发光二极管(OLED)显示器和/或非触摸屏显示器。显示器可以为例如彩色320乘240行分辨率的QVGA显示器,或任意其它适当的彩色或非彩色显示器。而且,应该理解的是,不必提供集成的直观显示器。例如,控制台可仅依赖于与操作者的听觉通信(例如,经由连接到集成扬声器125上的音频集成电路或向外部扬声器的音频输出信号)和/或可将视觉图像和/或视频输出到诸如手术室中的监控器的外部显示器上。
如下面指出的,除了集成显示器之外,示例控制台100还包括集成扬声器和视频输出连接器,从而提供与操作者通信的灵活性。如上面所指出的,视频输出连接器可用来连接到外部窗口和/或显示器上,以示出由控制台100从手术装置200a、200b和200c接收到的例如分流视频信号。
显示器的前部还包括备用开关112,可按下备用开关112以使控制台100置于备用模式或给控制台断电。例如,短时按压可指示控制台100进入备用状态或者退出备用状态,而长时按压可指示控制台100通电或断电。备用开关112由备用符号113表示。
为了调节听觉指示的音量,例如来自例如扬声器125的发音或音调指示和/或到外部扬声器的音频引出线,音量级显示控制件114显示在显示器110的下部。音量符号109向用户表明,当显示控制件114的条的填充部分向右移动时,音量增加,反之亦然。例如,通过轻敲音量控制件114的条上的特定位置以使填充部分移动到所述位置,和/或通过触摸控制件114附近的屏幕并在对应于期望的音量变化的方向上执行滑动,用户可以调节音量级。例如,如果用户用例如食指触摸控制件114并沿着屏幕向右滑动食指,则条的填充部分可扩大对应于滑动距离的量。同样,向左滑动或敲击可使得填充部分缩短,使得更低的音量输出。根据示例,在敲击的距离和填充部分或其它指示器的边缘移动的距离之间存在一对一或基本上一对一的对应关系。其它的设定,包括例如关于运行手术器械200a、200b、200c的设定和/或关于控制台的运行的设定,可以以模拟方式或任意其它适当的方式调节,例如,利用虚拟的数字小键盘或键盘输入数值的方式调节。
结合图2,控制台100的底部包括用于闪存或固态存储器卡(例如SD卡或任意其它适当的存储器)的插槽115和两个固定架连接器或孔120,以接收一个或多个固定架的对应的连接器以牢固地将控制台100保持在适当的位置处,例如在显示器可由手术室中的操作者看见的位置处。
结合图3,控制台的后部包括封闭的扬声器125,用于向操作者输出听觉信息。控制台的后部还包括合成视频连接器130和S视频连接器135,例如4引脚微型DIN,用于将视频信号输出到例如外部显示器和/或记录装置中。控制台100的后部还具有网络连接器140。尽管网络连接器140为以太网插口(在该示例中,RJ-45,IEEE802.3),但是应该理解的是,可使用任意适当的网络连接器,例如同轴电缆连接器。尽管可使用无线网络连接器,但是有线连接器可允许经由网络连接器的更安全的通信。
控制台100还具有编程端口145。在该示例中,编程端口被布置为通用串行总线(USB)连接器145。更具体地,示例端口145为USB微型AB端口。然而,应当理解的是,编程端口可以为被配置为发送和/或接收数据的任意类型的端口,例如,同轴电缆、专用连接器和/或接收器,所述接收器诸如为例如红外线接收器和/或其它的无线协议接收器例如蓝牙接收器。编程端口145被配置为经由数据电缆和手术器械上的对应的连接端口将软件或其它数据上载到一个或多个手术器械中。应该理解的是,USB端口可用作例如通用数据端口和/或被配置为接收手术器械数据,包括用来控制手术器械200a、200b、200c的软件。除了接收数据之外,编程端口145还可用来将数据从控制台100传送到外部装置,例如,外部硬盘驱动器、计算机和/或固态存储器装置。
软件和/或数据可上载到控制台100上,以便安装在控制台100和/或手术器械200a、200b、200c上。接收到的数据和软件可经由网络280、任意适当的端口例如USB端口145和/或利用例如收发器102的无线通信系统传送到控制台100中。
接收到的数据和软件可包括例如运算和控制算法、校准数据、显示信息和/或任意其它的软件,以有利于运行手术器械200a、200b和200c。此外,编程端口145可用来使控制台固件安装或升级到控制台100上和/或使手术器械固件传送到控制台100上,以使手术器械固件传送或安装到手术器械200a、200b、200c上。
电力经由电连接器150提供给控制台100,所述电连接器150接收插入到壁式插座中的AC适配器的对应的连接器。然而,应当理解的是,控制台100可设置有内部AC/DC转换器和/或可设置有电池例如再充电的内部或外部电池以供电。此外,应该理解的是,可通过诸如USB端口的端口例如编程端口145供电。
尽管特定的特征件被示出为布置在壳体105的特定面上或在控制台100的特定位置处,但是应该理解的是,任意特征件或特征件的组合可布置在壳体105的任意适当的位置上或面上。
在通电时,控制台100执行自测和配置,并且之后等待接收来自从例如一个或多个器械200a、200b和200c的一个或多个器械的通信信号。控制台100可提示用户或操作者对手术器械通电以便开始通信。
各个器械200a、200b和200c具有可存储在例如存储器203a、204b、204c中的序列号。在器械通电时,例如,在插入电池组和/或启动电源开关或按钮时,器械就开始发送对应于其各自序列号的数据。器械利用例如无线收发器202a、202b、202c或上述的单向通信发送器来发送该信息。
在控制台100接收到对应于各自器械200a、200b或200c的序列号发送的识别数据时,控制台100就会经由显示器110和/或外部显示器来显示器械的类型和器械标识符,例如,序列号的最后三个数字或整个序列号。除了信息的直观显示之外或作为信息直观显示的可选方案,听觉指示例如来自扬声器125的数字化或预先录制的声音可向用户或操作者传送信息。控制台100经由例如无线收发器102或单向接收器接收识别数据。控制台之后可关于是否注册了被识别的装置对用户进行提示,或者控制台可自动地注册装置。如果控制台100提示用户,则用户可例如触摸触摸屏显示器110(例如触摸标签为″是″或″否″的工具框或图标)来回应提示。
应该理解的是,此处所讨论的从控制台100到用户或操作者的任意通信可经由视觉和/或听觉来发生,例如,口头表达、利用例如显示器装置100、外部显示器、集成扬声器125、外部扬声器和/或任意其它适当的机构中的任意一个、一些或全部的指示。
当例如由控制台100从器械接收到的信号为临界预定阈值或位于预定阈值以下时,控制台可提示用户请求关于是否注册特定器械的指示或输入。用户可通过例如触摸触摸屏显示器110(例如,触摸标签为″是″或″否″的对话框或图标)来回应该提示。如果没有接收到响应,则控制台100可默认为″否″的响应,从而不再识别和/或承认例如来自所述特定器械的进一步的通信。
除了注册输入之外,触摸屏还可用于输入其它的控制台参数,包括例如音量和语言。
应该理解的是,代替触摸屏显示器110或除了触摸屏显示器110之外,对于此处描述的到控制台100的任意用户输入或命令可使用适当的用户输入机构来执行,诸如,例如按下单个按钮和/或发音(例如,此处控制台100具有扩音器和语音和/或声音识别软件)。
控制台100例如在存储器103中保持哪台器械已向控制台100进行了注册以及哪台装置已经拒绝向控制台100注册的记录。该记录可包括例如对应于已注册器械的序列号的列表和对应于未注册器械的序列号的另一列表。
已注册器械的列表和/或未注册器械的列表可在控制台100断电时清除或可保持到例如输入用户的删除命令时、例如从接收到来自特定器械的信号以后已经过了特定的时间量时和/或占用了指定量的插槽时。例如,已注册装置的列表和/或未注册装置的列表可具有例如八个条目,并且当后来的条目被录入时最早的条目被删除。有利的是,保持未注册用户的列表,例如以便至少当接收到的信号为临界值时避免对于这些装置的进一步提示。例如,当将装置断电或重启时,可清除已注册装置的列表,而存储未注册装置的列表以用于将来参考。
当向控制台100注册一个器械例如器械200a、200b和200c中的一个时,控制台100建立双路无线通信链路。控制台的通信范围可为任意适当的范围,例如十五英尺的半径或更大。该双路通信链路允许控制台100从已注册的一个或多个手术器械200a、200b和/或200c接收包括例如命令的数据并且将包括例如命令的数据发送到已注册的一个或多个手术器械200a、200b和/或200c。此外,该通信链路允许控制台100提供与用户例如外科医生的接口,以显示关于装置运行的信息并允许用户输入命令。
例如,上述信息为装置的一个或多个部件的参数和/或状态,例如手术切割器和吻合器的夹钳的闭合比率(closingrate)和/或作用的夹紧力,从传感器和成像装置获得的数据例如从安装到内窥镜上的一个或多个摄像机获得的图像或视频显示,和/或任意其它数据。
用户可例如经由触摸屏显示器110的按压部分来输入命令。这些命令可以为例如关于一个或多个手术器械200a、200b和/或200c的运行参数。例如,对于组织夹紧操作,用户可输入待施加到组织上的最大力、功率和/或闭合比率。控制台之后将依照命令与一个或多个手术器械通信。例如,控制台100可设定和/或指示手术装置来设定手术器械的运行参数以获得依照用户输入的操作。这些参数可通过增加、改变和/或校验在手术装置运行中使用的一个或多个值或参数来设定,例如在存储在存储器203a、203b和/或203c中的软件或运算算法中使用的一个或多个值或参数,并且在运行各自手术器械200a、200b、和/或200c期间由各自处理器204a、204b和/或204c执行。
用户还可请求关于手术器械200a、200b和200c的特定数据。在手术器械包括多个摄像机的情况下,或者在多个手术器械已注册的情况下,每个手术器械具有一个摄像机,用户可例如选择在指定的时间显示哪一幅视图或哪些幅视图。
此外,对应于正在执行的特定手术操作和/或手术操作的当前阶段或者其它条件,设置在存储器103、203a、203b和/或203c中并且由控制台100的处理器和/或手术器械200a、200b和/或200c执行的运行算法可以使显示器110和/或一个以上外部显示器显示数据(例如,图像、数值数据和/或指示手术器械或者患者的状态的数据等)、命令提示和/或菜单结构。
此外,根据示例,屏幕具有虚拟按钮以生成菜单,此处菜单和/或次级菜单下面的可选项根据下列条件变化:特定操作、操作的进程、操作条件(例如基于来自手术部位处的传感器的数据)、手术器械的类型和/或手术器械的一个或多个部件的状态或位置。
手术器械200a、200b和/或200c可被配置为仅当手术器械已向控制台100注册时能够进行手术上的操作。这可以例如通过将软件或固件安装到存储器203a、203b和/或203c上来实现,当由处理器203a、203b和/或203c运行所述软件或固件时,禁止执行一个或多个功能。例如,处理器204a、204b和/或204c可被配置为:仅当软件和/或固件确定装置已经由控制台100注册并且已经建立了双路通信链路时,才向电机和/或电机控制器输出控制信号和/或电压。例如可基于由无线接收器202a、202b、202c接收到的通信信号来作出所述判定。
手术器械200a、200b和/或200c可周期地或连续地监控与控制台100的通信链路的状态,以确保通信链路仍然是适当的。在这点上,手术器械可例如向控制台100周期地发送查询信号。如果由控制台100接收到查询信号,则控制台100发送响应信号以指示查询信号被接收到。在接收到响应信号时,手术器械将确认存在双路通信链路。查询的频率可以变化,例如如果手术器械由于例如休止状态期间而进入备用状态,则使得在特定期间内查询不太频繁或完全不发送询问。此外,在手术器械和控制台之间的数据通信期间不需要这种查询。而且,当手术器械和控制台中的任一个接收到诸如运行数据、软件数据、图像数据或其它数据的数据时,发送响应信号以指示数据被接收到。这可进一步确保通信链路得以保持。响应信号可包括例如标识符,从而可识别和确认特定通信信号(例如特定查询信号或数据传送)的接收。
如果手术器械200a、200b和/或200c确定通信链路已被切断(例如由于在发送一个或多个查询或数据传输之后没有接收到响应信号),则手术器械可禁用某些或全部功能、部分地禁用某些或全部功能和/或许可特定功能继续直到例如达到预定的时间或预定的事件发生。在这点上,可对手术装置的软件或固件进行编程,以使得通信链路的丢失不会防止用户例如外科医生完成特定手术操作,例如,在中断这种手术操作可能会引起并发症的情形下。
在确定通信链路已经丢失时,手术器械200a、200b、200c可发布信号,例如通信链路已经丢失的听觉或视觉信号。这样,用户将被警示并可尝试重新建立通信链路。手术器械可继续发送例如对应于手术器械的序列号的查询信号,直到从控制台接收到响应为止。
双路通信链路可使用任意适当的安全或加密协议,例如Wi-Fi保护访问(例如WPA或WPA2)或无线等效加密(WEP)。
除了与手术器械200a、200b和/或200c的无线通信链路之外,控制台100可被配置为通过第二网络280发送和接收数据。控制台可向远程装置300发送信息和从远程装置300接收信息,所述远程装置例如为场外计算机或服务器、或例如在同一家医院内的同一设备内的计算机或服务器,例如服务器100。远程装置300包括存储器303和处理器304,所述被存储器303配置为存储从控制台100接收到的和/或发送到控制台100的数据,所述处理器304处理接收到的数据。远程装置可包括任意其它适当的特征件,例如显示装置,以查看发送和/或接收到的数据,以及包括输入装置以允许例如手动输入(例如,经由键盘)和电子数据输入。网络280可包括例如因特网和/或局域网。应该理解的是,控制台100可通过控制台100和远程装置300之间的中间装置,例如计算机或服务器(计算机或服务器在传递数据之前可处理或不可处理数据)来发送和接收数据。此外,应该理解的是,控制台100可被配置为与装置300直接通信,而不用通过因特网和/或局域网来传递数据。
尽管图4中仅示出了一台远程装置,但是应该理解的是,可提供任意适当数量的远程装置。例如,一个或多个装置300可与控制台100布置在同一设备处和/或一个或多个装置可场外布置,例如布置在手术装备管理者的位置处。
在图4图示的示例中,控制台100通过安全的有线连接器250连接到装置300上。尽管有线连接器250基于以太网,但是应该理解的是,可提供任意适当的有线连接器。还应当理解的是,尽管图示的示例仅使用有线连接器,但是根据某些示例,可使用至少一个无线连接器。然而,仅使用有线连接器是有利的,这是由于可建立更安全的连接以更好地确保传输数据的保密性。数据可利用例如数据加密协议来传输,所述数据加密协议提供在控制台100和远程装置300之间通信的足够安全的线路。
控制台100可向远程装置300发送关于手术装置200a、200b和/或200c的运行和/或状态的数据。例如,控制台100可将通过通信网络从一个或多个手术器械接收到的数据记录到存储器103上并向远程装置300发送例如经处理或未经处理的数据。数据可包括例如联接到手术装置上的手术附加装置的类型、手术附加装置的序列号、手术附加装置的最后使用的日期和时间、何时运行特定功能、特定功能已运行多长时间、何时启动例如触发器或按钮的用户输入和/或启动例如触发器或按钮的用户输入多长时间、异常运行的任何错误信号和/或指示、传感器数据(例如图像传感器、温度传感器、压力传感器等)、特定插入件和/或钉仓(例如手术吻合器的吻合钉仓)的识别和/或序列号、最后使用特定插入件和/或钉仓的日期和/或时间、手术器械的电池电量(batterylevel)和/或电池健康状况、和/或关于手术器械和/或手术操作的任何其它数据。
数据可传输到手术装置管理者的远程装置300上,所述手术装置管理者可以位于例如手术操作场地之外的位置处。在控制台100断电之前,和/或一旦由控制台100从远程装置100接收到请求或查询信号时,远程装置300可通过以规则间隔的周期性传输和/或通过特定事件(例如完成一个或多个操作)触发的发送从控制台100获得数据。
控制台100、远程装置300和/或管理者可将接收到数据用于多种目的。根据示例,可判定手术装置或手术装置的部件(例如,手术附加装置)的清洁或卫生处理状态。在这点上,可保持关于一组手术器械和/或附加装置清洁和/或卫生处理状态的记录或数据库。
该数据可从远程装置300例如在清洁站的计算机接收,用来记录特定的手术装置何时被清洁或进行卫生处理。在从手术器械200a、200b、200c接收到指示特定手术装置和/或附加装置的数据,例如对应于手术器械的序列号和/或附加装置的序列号的数据,控制台可使该识别数据与清洁状态的数据相互对照以判定特定手术装置和/或附加装置自上次使用过之后是否已经得到清洁和/或消毒。可选择地或此外,控制台可向远程装置300例如服务器发送数据,之后远程装置300将对数据进行处理以作出特定装置或部件自上次使用之后是否已经进行消毒的判定,并且之后将结果送回到控制台100,控制台100之后可继续进行以允许运行手术器械200a、200b、200c或禁止运行。
如果运行受到禁止,则控制台100和/或手术器械可发布听觉、视觉和/或其它的警告或通知以指示在当前状态下不能运行手术器械。这样,控制台100可防止手术器械运行,直到清洁和/或消毒信息被更新为指示已经对手术器械的所有适当部分进行了清洁和/或消毒。
此外,通过追踪手术器械或手术器械的部件例如附加装置的使用和/或故障历史,可便于维护和维修装置。例如,在使用了特定次数和/或过了特定的时间之后,可确定手术器械200a、200b、200c或手术器械的附加装置或部件需要维修或更换。如果特定错误或故障被记录或者在器械或部件使用期间记录下错误或故障的一定数量和/或频率之后,则可由例如软件程序判定出需要修理。如果手术器械或手术器械的部件到了维修期或过了维修期或者需要进行修理,则控制台100可防止运行手术器械和/或可由控制台或手术器械警告用户。
控制台100还可通过例如记录由手术器械200a、200b、200c使用的吻合钉、钉仓或其它的装置的数量追踪存货量。在一个示例中,控制台可使吻合钉仓的序列号与特定的患者相关联。这可允许追踪吻合钉并且可识别特定吻合钉批号或类型的趋势和问题,例如,与其它的吻合钉的批号和/或类型相比,大致高数量的患者患有由于使用特定批号和/或类型的吻合钉进行操作的并发症。尽管在该示例中提及了吻合钉,但是该追踪操作可用来识别使用其它装置的趋势。
根据某些示例,通过追踪命令和/或其它的数据信号的顺序、时刻和持续时间(例如图像、传感器信号等),控制台100记录给定操作的精确记录。可将该记录用于例如训练的目的和/或医疗失当的反驳申辩,此处例如将记录链接到特定患者上。
应该理解的是,可在指定场所例如在指定医院使用多个控制台。在这种情况下,每个控制台100记录的数据可与每个其它控制台100记录的数据整合或组合,以使得例如尽管手术器械200a、200b和/或200c已向不同的控制台注册了给定的次数,但是仍可精确地追踪手术器械200a、200b和/或200c。例如,如果手术器械为手持式手术切割器/吻合器,则例如可在两个手术室的任意一个手术室中使用所述器械,其中每个手术室具有自己的控制台100。数据的这种整合或组合还可利于其它的追踪,例如手术器械的位置的追踪、追踪库存(例如吻合钉)的存货量以用于例如自动再订货等。
来自不同的控制台100的数据的整合可由远程装置300例如手术装置管理者或医院的计算机或服务器来执行,和/或由一个或多个控制台100来执行(例如,此处控制台100通过网络280通信)。
除了经由连接器250取回记录的数据之外,还可通过从插槽115访问可移动存储器例如闪存或固态存储器卡来取回数据,控制台100配置为自动或根据例如用户命令将数据写到存储器上。之后,可通过将存储器插入到存储器卡读出器中而由计算机例如远程装置300和/或便携式计算机读出可移动存储器。应当进一步理解的是,可经由USB或其它的数据端口例如编程端口145来取回信息。
图5a、图5b和图6示出了手术器械400,其包括上述手术器械200a、200b和200c的所有特征件。手术器械400由智能动力或驱动单元500以及可移动附加装置600构成。在该示例中,可移动附加装置600为用于夹紧、切割和吻合组织的手术附加装置。因此,如图6所图示的,附加装置600安装到驱动单元500上,从而手术器械400被配置为用于夹紧、切割和吻合组织的手持式、电池供电的、转动和/或作关节式运动的装置。
尽管附加装置600可从智能驱动单元500拆卸,但是应该理解的是,附加装置600可形成为不能从智能驱动单元500拆卸。
手术器械400被配置为特别适合于经由例如插管插入到患者的身体中。如上面所指出的,在示出的实施例中,手术器械400为夹紧、切割和吻合装置。手术器械400的可移动附加装置600包括钳夹部611a,所述钳夹部611a通过铰链部611c可枢转地联接到轴部611b上。钳夹部611a包括具有远端和近端的第一钳夹650以及具有远端和近端的第二钳夹680。第一钳夹650和第二钳夹680在它们相应的近端处或附近相对于彼此可枢转地联接。如图所示,第一钳夹650和第二钳夹680可绕枢轴线A相对于彼此枢转。在这种布置中,钳夹被配置为使得:当相对于第二钳夹680打开和闭合第一钳夹650时并且在第一钳夹650相对于第二钳夹680移动的点处,第一钳夹650和第二钳夹680例如它们的纵轴线保持在一个平面内。然而,应当理解的是,附加装置600可代替地布置为使得第一钳夹650和第二钳夹680可绕与示出的枢轴线定向不同的枢轴线相对于彼此枢转。
如上面所提及的,钳夹部611a通过铰链部611c可枢转地联接到轴部611b上。特别地,钳夹部611a可绕枢轴线B相对于轴部611b枢转,所述枢轴线B可位于钳夹部611a和轴部611b的任意位置上或在钳夹部611a和轴部611b之间的任意位置上,以及在相对于钳夹部611a和轴部611b在任意圆周位置处。如图5b所图示的,枢轴线B垂直定向,并在垂直于图5示出的侧视图的观察角的平面内。在这种布置中,钳夹部611a和轴部611b被配置为使得:当钳夹部611a相对于轴部611b作关节式运动时并且在钳夹部611a相对于轴部611b移动的任意点处,钳夹部611a和轴部611b保持在垂直于枢轴线B的一个平面内。应该意识到的是,在其它的示例性实施例中,枢轴线B可具有不同的取向,以使得钳夹部611a能够在不同的平面内枢转。钳夹部611a可枢转到相对于轴部611b的任意角度处以及任意角度之间,从而在使用期间能够按照期望选择地定位钳夹部611a。
此外,手术装置400可提供各种部件绕附加装置600的纵轴线的转动。例如,在各个实施例中,钳夹部611a和/或轴部611b可绕智能驱动单元500的纵轴线D相对于智能驱动单元500转动,如图6中所图示的,智能驱动单元500连接至附加装置600的轴部611b的近端处或附近,所述智能驱动单元500的纵轴线D例如为在智能驱动单元联接到附加装置600的点处的智能驱动单元500的纵轴线D。轴部611b可包括远侧部和近侧部,钳夹部611a连接至所述远侧部,并且在附加装置600安装到智能驱动单元500上时所述近侧部朝向智能驱动单元500。
通常,如例如在图7a和图7b所图示的,操作者可握住智能驱动单元500的手柄状的外形以操作手术装置400。智能驱动单元500具有下部502,在所示的实施例中,所述下部502形成了基座。此外,智能驱动单元500具有中间部504,所述中间部504包括几个手指致动的控制按钮507和508以及摇杆装置517。
图8a至8c示出了驱动单元500的内部部件,并示出了智能驱动单元500的内部部件的另外的细节。例如电池506的电源可位于由智能驱动单元500的近侧部502提供的壳体中。电池506可被配置为向手术器械400的任一部件供给电力。该布置可提供的优于其它的手术装置的优点在于,可免除手术器械400到独立的机电手术系统的电源的联接。然而,应当理解的是,其它的示例的手术器械可连接到独立的机电手术器械上以接收机械和/或电动力。
同样,智能驱动单元500的中间部504提供了放置电路板509的壳体。电路板509可被配置为控制手术器械400的各种操作。
位于智能驱动单元500的中间部504前面位置处的是控制按钮507、508和摇杆装置517。控制按钮507、508和摇杆装置517中的每一个包括由用户或操作者的致动而移动的相应磁体。此外,电路板509包括用于控制按钮507、508和摇杆装置517中的每一个的相应的霍尔效应开关,这些霍尔效应开关通过控制按钮507、508和摇杆装置517中的磁体的移动而被致动。例如,紧靠近控制按钮507定位的是霍尔效应开关,该霍尔效应开关在操作者致动控制按钮507时在控制按钮507内的磁体移动时被致动。霍尔效应开关的致动使得电路板509向功能选择模块5210和致动器或者输入驱动部件5310提供适当的信号,以相对于第二钳夹680闭合第一钳夹650和/或启动第二钳夹680内的吻合/切割钉仓。例如,下压按钮507可起动第一钳夹650相对于第二钳夹680的闭合或夹紧,并且下压按钮508可启动吻合/切割钉仓,或者反之亦然。
而且,紧靠近摇杆装置517定位的是霍尔效应开关,该霍尔效应开关在操作者致动摇杆装置517时在摇杆装置517内的磁体移动时被致动。霍尔效应开关的致动使得电路板509向功能选择模块5210和输入驱动部件5310提供适当的信号,以使钳夹部611a相对于附加装置600的轴部611b作关节式运动。有利的是,摇杆装置517在第一方向上的移动可使得钳夹部611a在第一方向上相对于轴部611b绕轴线B作关节式运动,而摇杆装置517在第二方向例如相反的方向上移动可使得钳夹部611a相对于轴部611b在第二方向例如相反的方向上作关节式运动。
应该理解的是,例如,根据由能联接到智能驱动单元500上的各种附加装置所执行的功能的数量和/或类型,可提供任意适当的数量的按钮和/或摇杆。
另外,智能驱动单元500的上部提供放置驱动机构5110(其包括例如功能选择模块5210和输入驱动部件5310)的壳体。为了执行如上面所列出的手术器械400的各种操作,驱动机构5110可被配置为驱动轴和/或齿轮部件。例如,为了使钳夹部611a相对于轴部611b选择性地移动,驱动机构5110可被配置为驱动轴和/或齿轮部件,以使轴部611b(或者手术附加装置600到远侧的部分)相对于智能驱动单元500绕纵轴线D转动,以使第一钳夹650相对于第二钳夹680移动,和/或以使启动第二钳夹680内的吻合和切割钉仓。
结合图9和图10,智能驱动单元500的远侧部包括附加装置接口或连接部分590,所述附加装置接口或连接部分590被配置为接受可移动附加装置600的对应接口或连接部分690。智能驱动单元500的连接部分590具有筒形凹进部591,当附加装置与智能驱动单元500配合时,所述筒形凹进部591接收附加装置600的筒形凸起691。然而,应当理解的是,附加装置的连接部分690可设置有凹进部,以接收智能驱动单元500的连接部分590的凸起。而且,应该理解的是,接口无需是筒形并且可以为任意适当的形状或几何形状。
当附加装置600与智能驱动单元500配合时,多个可转动的连接器592a、592b和592c中的每个与对应的可转动的连接器692a、692b、692c联接。在这点上,对应的连接器592a和692a之间的接口、对应的连接器592b和692b之间的接口、以及592c和692c之间的接口部被锁上,以使得连接器592a、592b和592c中的每一个的转动引起对应的连接器692a,692b、692c的相应转动。尽管图示的接口外形接近三角形,但是应该理解的是,可提供任意适当的几何形状以允许将来自第一连接器592a、592b和592c的转动传输给相应的连接器692a、692b和692c。应该进一步理解的是,尽管连接器592a、592b和592c被设置为被插入到内连接器692a、692b和692c中的外连接器,但是连接器692a、692b和/或692c可被配置为外连接器,外连接器被配置为容纳在相应的内连接器592a、592b和/或592c中。
连接器592a、592b和592c与连接器692a、692b和692c的配合允许转动力经由三个相应的连接器接口中的每一个单独地传输。连接器592a、592c和592c被配置为由驱动机构5110单独地转动。在这点上,功能选择模块5210选择由输入驱动部件5310(例如电动机)驱动哪一个连接器或哪些连接器592a、592b和/或592c。然而,应当理解的是,一个或多个连接器592a、592b和/或592c可设置有专用的驱动部件或电动机。
由于当附加装置600联接到智能驱动单元500上时,连接器592a、592b和592c中的每一个具有与相应的连接器692a、692b和692c的锁着的和/或基本上不可转动的接口,因此可将一个或多个转动力从智能驱动单元500的驱动机构5110选择性地传输到附加装置600上。
可将转动力从附加装置600的近端处的连接器692a、692b和692c经由沿着轴部611b布置的多个可转动的驱动轴传输到钳夹部611a上。可转动的驱动轴可在近端处不转动地联接或基本上不转动地联接到相应的连接器692a、692b或692c上,并且在远端处不转动地联接或基本上不转动地联接到钳夹部件或驱动器的输入上,所述驱动器被配置为致动钳夹部611a或钳夹部611a的部分或部件。这样,可转动的驱动轴可允许一对一或基本上一对一地在连接器692a、692b和/或692c和钳夹部611a之间传输转动。
连接器592a、592b和/或592c的选择性地转动允许智能驱动单元500选择性致动附加装置的不同的功能。在该示例中,三个连接器的选择性且独立的转动对应于钳夹部611a绕轴线B的选择性且独立的关节式运动、通过绕轴线A转动上钳夹650来打开和闭合钳夹650和680、以及驱动钳夹部611a的吻合/切割部件。
附加装置600可通过任意适当的机构联接到智能动力单元500上。例如,附加装置可利用可滑动的闭锁机构(例如,此处动力单元500的径向向外部被径向地向后或向前拉动以释放闭锁)或卡盘闭锁到适当位置处。尽管可提供需要单独的工具的附加装置,但是有利的是提供不用工具或手动操作的连接机构,例如上述的滑动闭锁、无键卡盘等。
驱动机构5110可包括选择器变速箱组件550。靠近选择器变速箱组件550的是功能选择模块5210,功能选择模块5210起到选择性地将在选择器变速箱组件550内的齿轮元件移动到与输入驱动部件5310啮合的作用。因此,驱动机构在给定的时间内可选择性地驱动一个或多个连接器592a、592b和/或592c。尽管连接器592a、592b和592c中的每一个基于选择器变速箱组件550的啮合状态被选择性地驱动,但是应该理解的是,连接器592a、592b和/或592c中的一个或多个可设置有专用的驱动部件或电动机。
通常,关于选择器变速箱组件550或手术器械400的进一步的细节,手术器械400包括许多与美国公开的专利申请第2009/0101692号中描述的部件基本上相同或相似的特征件,该申请全部内容通过引用特意合并于此。
智能驱动单元500还包括收发器,所述收发器连接到电路板509上并被配置为如上所述相对于手术器械200a、200b和200c向控制台100发送数据传输以及从控制台100接收数据传输。电路板509被配置为不准许例如钳夹部611b的各种功能的运行,除非确定已经与控制台100建立了双路通信链路。
智能驱动单元500的连接部分590还包括电连接器593a和593b,所述电连接器593a和593b与对应的电连接器693a和693b配合,以允许在智能驱动单元500和附加装置600之间传输电信号和/或动力。电连接器593a和593b电联接到包括例如电路板509的电路上,以允许电路经由电连接器593a和593b接收和/或发送信息和/或电力。电信号可以例如为手术附加装置数据,所述手术附加装置数据对应于例如手术附加装置类型和/或序列号、钉仓或插入件标识符、传感器数据和/或任意其它适当的通信信号。该数据可存储在手术附加装置和/或钉仓(例如,吻合钉钉仓)的电子芯片中。例如,吻合钉钉仓可包括有包含序列号和/或批号的电子芯片。该信息可经由连接器593a、693a、593b、693b的接口从芯片中读取并可转送到智能驱动单元500的电路。之后,电路板509可经由收发器将数据通过双路通信链路发送到控制台100,此处控制台100可存储和追踪数据。
此外,可将附加装置类型和序列号转送到智能驱动单元500中。该信息可存储在例如附加装置600的电子芯片上。之后,智能驱动单元500的包括例如电路板509的电路可将该数据传达到控制台100,控制台100可选择包括例如运算程序、算法或参数的数据,并且经由双路通信链路将所述数据发送到智能驱动单元500的电路中。然而,应当理解的是,驱动单元的包括例如存储器的电路,可包括多个预先安装的程序、算法和/或其它的参数,处理器509可从所述多个预先安装的程序、算法和/或其它的参数中作出选择以操作附加装置600。
如关于手术器械200a、200b和200c在上面所指出的,智能驱动单元500可将由操作手术器械400的用户例如外科医生输入的命令的记录发送到控制台100。例如,智能驱动单元500可向控制台100发送与如下信息对应的信号:在操作期间,控制按钮507和508以及摇杆装置517中的每一个何时运行、如何运行、和/或已经运行了多长时间。控制台100之后可将该信息存储在例如存储器103上。该信息可与特定患者和/或操作链接,并且可如上面指出的例如由管理者收集。智能驱动单元500可在预定的间隔内和/或在特定事件或状况(例如,程序结束或程序的一部分结束)时在手术操作期间连续地发送该数据。
智能驱动单元500还可被配置为监控输入驱动部件5310的参数。例如,可测量驱动输入驱动部件5310的一个或多个电动机的电流,以例如确定由手术器械400施加的力,例如夹紧力。在这点上,智能驱动单元500和/或控制台100可包括控制单元或系统,诸如,例如在序列号为12/430,780的美国专利申请中所描述的,该申请全部内容通过引用特意合并于此。在这点上,智能驱动单元500可包括测量驱动输入驱动部件5310的电流的电流传感器、确定输入驱动部件5310的转速的速度传感器、以及确定输入驱动部件5310(例如电动机的输出轴)的输出位置和/或部件(例如附加装置600的上钳夹650)的位置中的至少一个的位置传感器。之后,例如通过利用调节对输入驱动部件5310所施加的电压来调节输入驱动部件5310的驱动速度,控制单元可基于来自这些传感器的输入来控制输入驱动部件5310。此处,例如手术器械包括如图示的切割器/吻合器附加装置600,控制系统可被配置为:在例如用户压下按钮507的同时,将钳夹650和680施加到夹紧的组织上的夹紧力限制到预定的最大限值。
基于例如在手术操作期间获得的感知到和/或确定的数据和参数,手术器械400可通过双路无线链路将数据发送到控制台100,以便例如存储、处理和/或用于向器械400的用户提供信息。例如,可将钳夹650和680的闭合比率发送到控制台100并且在显示器110上显示给用户,如图1b所图示的。在操作期间,控制台100还可基于例如通过双路无线通信链路从手术器械400发送给控制台100的信息向用户传达警告和/或错误信号。
手术器械400(更具体地,智能驱动单元500)向控制台100传达运行数据和/或命令数据,以允许控制台提供包括例如指令、查询和/或警告的反馈。运行数据可包括例如测量到或确定的值、参数、状态等,而命令数据可为传送到控制台100的任意适当的指令,例如查询用户、显示状态或参数和/或发布警告的指令。
而且,用户可通过将命令输入到控制台100中来设定手术器械400的参数,控制台100之后基于用户命令通过双路无线通信链路与手术器械400通信。例如,基于来自用户的输入,控制台可发送数据以更改使用特定参数的运算算法。例如,用户可将力的限值输入到控制台100上以用于夹紧操作。之后,控制台100可设定例如上述控制系统的运行参数以使得手术器械400限制在夹紧操作期间施加到被夹紧组织上的力。
控制台100可被配置为接收用户命令和/或为了适当的目的提示用户发出命令。例如,用户可从一组操作程序、模式和/或算法中作出选择。基于这样的命令或输入,控制台100通过无线通信链路与手术器械400通信,以便例如安装操作软件和/或设定运行参数。根据一个示例,对于被选择的手术操作,可将程序可以从控制台100传送到和安装到手术装置400上,此处程序要求以特定顺序和/或在特定条件下执行特定功能。例如,当确定例如钳夹之间的组织间隙不在可接受的预定范围内时,手术器械400的电路可忽略来自按钮的输入信号或用于致动吻合钉驱动器的其它输入(有效地禁止按钮的功能)。
当电池电量和/或健康状况在特定阈值以下时,控制台100还可以警告用户。此外,控制台100和/或手术器械400可被配置为:当控制台100和/或手术装置400确定电池电力可能不足以完成所述操作时,防止特定操作的开始。例如,当用户经由例如触摸屏显示器110选择操作程序或模式,并(例如通过控制台100)作出电池电量和/或健康状况不充足(基于例如通过无线通信链路线路从手术器械400发送到控制台100的电池和/或健康状况信息)的判定时,控制台可向用户指示基于电池的当前状态不允许操作、和/或可指示用户在手术操作可继续进行之前更换电池。
此外,如图7a所图示的,智能驱动单元500的中间部504由手柄部分504a和触发器部分504b形成。手柄部分504a整体形成(例如通过注塑成型)为一整件,包括接收用户较靠下的手指的管状部。触发器部分504b随后以适当的方式(例如用粘合剂、焊接和/或紧固件)接合到手柄部分504a上。类似地,上壳体510和电池壳体515各自整体形成为一整件并接合到手柄部分504a上。电池506通过电池门520被约束在电池壳体515内,所述电池门520闭锁到闭合位置上并且通过按下释放按钮525使电池门520解除闭锁。与沿着接缝(例如近似平行于图7b的视图中的纸面的接缝)接合两个近似对称的半部的结构相对照,该结构可提供增强的强度并且可利于部件壳体零件504a、504b、510、515和/或520的密封。
智能驱动单元500被配置为作为一个整体经受高压灭菌(autoclavable),无需拆卸。在这点上,包括电池506的智能驱动单元500可被高压灭菌,不会损坏智能驱动单元500的任何部分。为了利于这种高压灭菌,智能驱动单元500可包括密封件或诸如密封垫570的密封垫(例如在图8c中示出的),所述密封件或诸如密封垫570的密封垫被配置为在电池门520和电池壳体515之间形成足以防止潮气在高压灭菌器的压力和温度下进入智能驱动单元壳体的气密密封。此外,当附加装置600连接到驱动单元500上时,智能驱动单元500和附加装置600可在需要时一起进行高压灭菌。
图11示出了根据本发明的示例性实施例的手术附加装置600和手术附加装置轴800。示出的附加装置800不具有可联接到其远端810上的钳夹或其它的器械部分。附加装置轴800与附加装置600的轴的不同之处在于,细长轴部811被弯曲成一角度。这可允许轴的远端810(以及连接到其上的器械)例如在一些内窥镜操作期间更容易地进入患者身体的部分。尽管附加装置600和800包括刚性轴,但是应该理解的是可以提供柔性轴。
提供了具有动力单元500的手术装置,该动力单元500在其上可拆卸地联接不同的附加装置以被驱动,这提供了相同的驱动单元可与不同的附加装置和/或附加装置类型一起使用的灵活性。在这点上,可以想象到的是,操作者例如外科医生可在单次操作期间使用多个附加装置。例如,对于肠切割、切除和吻合操作,外科医生可首先连接线切割器/吻合器诸如附加装置600以在待切除组织的癌变部分的相对端处切割和吻合。为了再次接合肠的保留部分的两个密封端,外科医生可通过从动力单元500拆开并移出线切割器/吻合器附加装置(例如,通过拉、推、和/或翻转闭锁机构或卡盘),用环状的切割器/吻合器附加装置更换出线吻合器/切割器附加装置,并且之后连接环状吻合器/切割器附加装置。
当插入附加装置时,动力单元500可例如通过经由电连接器693a和693b从布置在附加装置中的电子芯片中读取所述数据来判定手术附加装置类型和/或特定的手术附加装置。基于该信息,智能动力单元500和/或控制台100可选择适当的操作程序和/或设定一个或多个运行参数。
动力单元500和/或控制台100可交叉引用与特定附加装置相关的校准数据。例如,如果已经预先确定出具有特定序列号的特定附加装置需要校正因数来调节该附加装置的特质(idiosyncrasy),则所述校正因数可并入到用于所述附加装置的运行算法或程序中。例如,对于特定的附加装置类型,可期望连接器692a、692b、692c中的一个的全程360度转动以与在附加装置的远端处的元件例如钳夹650的期望的移位或转动(或其它的可量化的状态变化)相关联。可将该期望的关联构建到用于所述特定类型的每个附加装置的操作程序中。然而(例如,测试期间),如果确定特定单元需要比360度转动稍多或稍少的转动以获得期望的效果,则可提供校正因数以说明当附加装置运行时单个附加装置的这种特性。
现在转到图12,智能驱动单元的另一实施例通常表示为900。智能驱动单元900基本上类似于智能驱动单元500,因此此处仅详细描述到识别其结构和/或操作的差别所必需的程度。
如图12所示,智能驱动单元900包括从下部902延伸出和/或支撑在下部902上的中间部904。中间部904包括与下部902整体地形成并从下部902延伸出的远侧半部分904a,以及可由多个紧固件连接到远侧半部分904a上的近侧半部分904b。远侧半部分904a和近侧半部分904b限定了其中具有空腔的壳体,电路板509置于所述空腔中。
远侧半部分904a和近侧半部分904b沿着如图5a所示的基本上与纵轴线″D″正交的平面被分割。
中间部904进一步包括密封垫905,所述密封垫905完全围绕近侧半部分904b的边缘延伸并且被插入在远侧半部分904a和近侧半部分904b之间。密封垫905密封远侧半部分904a的周边和近侧半部分904b的周边。
这样,中间部904的空腔沿着远侧半部分904a的周边被密封,并且近侧半部分904b仍被配置为使得智能驱动单元900更容易和更有效地装配,以及使得智能驱动单元900更容易且更有效地维护、维修或修理。
智能驱动单元900的下部902限定了形成在其上表面上的孔902a,并且所述孔902a位于中间部904下面。孔902a提供了通道,电线(未示出)穿过所述通道以使置于下部902中的电部件(电池、电路等)与置于中间部904中的电部件(电动机、电路等)相互电连接。下部902包括布置在孔902a中从而堵塞或密封孔902a同时允许电线穿过其中的密封垫903。可以预想的是,可将电线装入密封垫903内以有助于保持电线在其中的位置。
中间部904限定了前端部或连接部990。前端部990包括支撑在中间部904的远端上的前锥体990a。前锥体990a由透明、半透明和/或半透材料制成。前端部990包括照明构件994,所述照明构件994布置在前锥体990a内以使得可通过前锥体990a看到照明构件994或前锥体990a通过照明构件994可见。照明构件994可以为发光二极管印刷电路板(LEDPCB)等形式。照明构件994可被配置为照亮至少一种和期望的多种颜色,并且每种颜色与唯一的个别的事件关联。
如图12所示,智能驱动单元900包括置于中间部904的近端处的发射按钮或安全开关910。在使用中,手术附加装置600可按照需要和/或期望在打开和闭合状态之间被致动。然而,为了发射手术附加装置600,并且为了从手术附加装置600中逐出紧固件,在手术附加装置处于闭合状态下,安全开关910被按下,从而指示智能驱动单元900可发射手术附加装置600以从其中逐出紧固件。
如图13所示,安全开关910可位于中间部904的远端附近。特别的是,安全开关910被示出为紧靠控制按钮507、508布置并且可从中间部904的任一侧致动。
为了最小化累积误差,预期的是,还可校准选择器开关的初始位置,以及任何适配器在被联接时插入在智能驱动单元900和附加装置600之间的初始位置。
尽管手术吻合器/切割器在此被描述为示例性的手术附加装置,但是应该理解的是,可提供多种类型的手术附加装置并且所述手术附加装置可由驱动单元500供电。
为了连接附加装置,对于附加装置来讲有利的是,通过将附加装置轴向地压入到驱动单元中将附加装置锁入到驱动单元500中。此外,如上面所指出的,不带工具的连接件和拆卸机构可特别有利于简化了从驱动单元500联接、拆卸和更换手术附加装置。
尽管已经结合特定的示例和示例性实施例对本发明进行了说明,但是应该理解的是,前面的说明绝不是限制。而且,本文所描述的特征件可以任意组合来使用。

Claims (10)

1.一种手术装置,包括:
手持式电池供电的驱动单元,其包括:
壳体,所述壳体包括:
基座部;
中间部,其包括从所述基座部延伸出的远侧半部分和可选择性地固定到所述远侧半部分上的近侧半部分;以及
密封垫,其插入在所述中间部的所述远侧半部分和所述近侧半部分之间;以及
安装部,其设置在所述中间部的所述远侧半部分中,所述安装部被配置为接受手术附加装置的对应部分。
2.根据权利要求1所述的手术装置,其中,所述驱动单元的所述壳体包括被配置为致动至少一个连接构件的致动器,当所述手术附加装置安装到所述安装部上时,所述连接构件与所述手术附加装置的对应构件配合,以允许致动所述至少一个连接构件而驱动所述附加装置。
3.根据权利要求2所述的手术装置,其中,所述驱动单元的所述壳体包括处理器,所述处理器布置在所述壳体内并且被配置为从用户控制元件接收对应于用户命令的用户输入信号,所述处理器被配置为根据作为所述用户输入信号的函数的操作程序来控制所述连接构件的致动。
4.根据权利要求1所述的手术装置,其中,所述壳体的所述中间部的所述远侧半部分与所述基座部一体地形成。
5.根据权利要求1所述的手术装置,其中,所述壳体的所述中间部的所述远侧半部分和所述近侧半部分沿着横向于支撑在所述中间部中的驱动构件的转动轴线的方向延伸的平面被分开。
6.根据权利要求1所述的手术装置,其中,所述基座部包括形成于其中的孔,所述孔形成在所述中间部下面的位置处。
7.根据权利要求6所述的手术装置,其中,所述壳体包括布置在形成在所述基座部中的所述孔内的密封垫。
8.根据权利要求1所述的手术装置,其中,所述驱动单元包括支撑在所述壳体上的安全开关,其中所述手术装置仅能够在所述安全开关被致动之后发射。
9.根据权利要求1所述的手术装置,进一步包括紧靠所述安装部布置的照明构件,其中所述照明构件在所述手术装置运行中发生预定事件时照亮。
10.根据权利要求9所述的手术装置,其中,所述照明构件被配置为对应于在所述手术装置运行中的多个不同的预定事件照亮多种不同的颜色。
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