CN103181809A - 集成有夹子计数器的手术施夹器 - Google Patents
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Abstract
本发明提供了一种集成有夹子计数器的手术施夹器，尤其是提供了这样一种手术施夹器，其包括通道组件并且叠置有夹子承载器，所述夹子承载器具有被可滑动地支撑在所述通道组件中的夹子计数器板，其中，所述夹子计数器板被配置为且适用于在手柄被致动时显示施夹器的状态的变化。
Description
相关申请的交叉引用
本申请主张于2011年12月29日递交的序列号为61/581,116的美国临时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
本申请涉及手术器械，并且更特别地，本申请涉及具有多个夹子的手术施夹器，该手术施夹器用于在手术操作中将夹子施加到体组织和血管。
背景技术
手术施夹器在本领域中是已知的，并且手术施夹器通过提供对传统的体组织和血管的缝合的替代而在外科医生中日益流行。在格林(Green)等人的专利号为5,030,226的美国专利以及伯班克三世（BurbankIII）等人的专利号为5,431,668的美国专利中公开了典型的器械。通常，这些器械提供了多个夹子，这些夹子被存放在器械中并且在打开和闭合在器械的近端处的手柄时向在器械的远端处的钳夹机构连续地供应夹子。在手柄闭合时，钳夹闭合从而使得定位于钳夹构件之间的夹子变形，并且在打开钳夹以释放已变形的夹子时，从序列中将新的夹子供应到钳夹之间的位置。重复该过程直到夹子序列中的所有夹子用完。
许多的这些手术施夹器在制造、购买和/或操作上相对昂贵。因此，制造商和终端用户期望开发出在制造、购买和/或操作上相对便宜的手术施夹器。
此外，许多的这些手术施夹器是手动操作的，并且使这些手术施夹器发射所需的相对力可能较大。
因此，存在对在开发和制造上相对经济以及需要较小的发射力的手术施夹器的需求。
发明内容
本申请涉及具有多个夹子的手术施夹器，该手术施夹器用于在手术期间将夹子施加到体组织和血管。
根据本公开的一个方案，提供了一种手术施夹器，所述手术施夹器包括：壳体；至少一个手柄，所述至少一个手柄可枢转地连接到所述壳体；通道组件，所述通道组件从所述壳体向远侧延伸；夹子承载器，所述夹子承载器布置在限定了通道的通道组件内，所述夹子承载器包括多个朝向远侧并且延伸进入夹子通道中的坡道；多个夹子，所述多个夹子可滑动地布置在夹子承载器的通道内；步进梁，所述步进梁往复运动地布置在所述通道组件内并且叠置在所述夹子承载器上，所述步进梁操作地连接到所示至少一个手柄以用于在所述至少一个手柄被致动时进行往复运动，所述步进梁包括多个朝向远侧并且延伸进入夹子通道中的坡道；以及夹子从动件，所述夹子从动件可滑动地布置在夹子承载器的通道内并且布置在所述多个夹子的近侧，夹子从动件被配置为且适用于与夹子承载器的朝向远侧的坡道和步进梁的朝向远侧的坡道选择性接合，其中，夹子从动件被配置为且适用于在步进梁进行往复运动时驱使所述多个夹子相对于夹子承载器在远侧方向上运动。
步进梁的朝远侧定向的坡道可以被配置为选择性地接合在夹子从动件中限定的第一孔，并且在步进梁向远侧运动时驱使夹子从动件向远侧运动，并且夹子承载器的朝向远侧的坡道可以被配置为选择性地接合在夹子从动件中限定的第二孔，并且在步进梁向近侧运动时使得夹子从动件向近侧的运动停止。
施夹器还可以包括钳夹组件，所述钳夹组件包括一对钳夹，所述一对钳夹从所述通道组件的与壳体相反的端部延伸出。钳夹组件可以适用于在其中容纳夹子并且钳夹组件能够响应于至少一个手柄的运动而操作以实现夹子的成形。
施夹器还可以包括夹子推杆，夹子推杆往复运动地定位在壳体和通道组件两者中的至少一个内。推杆可以具有第一端部和第二端部，第一端部操作地连接到至少一个手柄，第二端部限定了推动器。在至少一个手柄以初始量被致动时，推杆可以运动离开所述一对钳夹，以使得推动器在存放在夹子承载器的通道中的最远侧夹子的后方运动。推杆可以被配置为且适用于在至少一个手柄返回到初始位置时朝向钳夹运动，以使得最远侧夹子在钳夹之间运动。
夹子推杆可以连接到步进梁，其中，夹子推杆的轴向平移导致伴随步进梁的轴向平移。
夹子推杆和步进梁可以被配置并且彼此连接，使得在夹子推杆的轴向平移和步进梁的轴向平移之间提供延迟。
施夹器还可以包括驱动联接系统，驱动联接系统被配置为在至少一个手柄被致动时使得推杆向近侧运动，并且被配置为在至少一个手柄随后被释放时使得推杆向远侧运动。
施夹器还可以包括驱动通道，驱动通道可平移且可滑动地布置在壳体和通道组件两者中的至少一个内。驱动通道可以具有第一端部和第二端部，第一端部操作地连接到至少一个手柄，第二端部被配置和定尺寸为选择性地接合所述一对钳夹以实现所述一对钳夹的闭合。在至少一个手柄在第一方向上运动时，驱动通道可以朝向钳夹组件运动，以使得驱动通道的第二端部面对所述一对钳夹运动从而闭合所述一对钳夹。在至少一个手柄在与第一方向相反的第二方向上运动时，驱动通道可以运动离开钳夹组件，以使得驱动通道的第二端部运动离开钳夹组件从而允许所述一对钳夹打开。
驱动联接系统可以包括：远侧联接构件，远侧联接构件具有第一端部，第一端部枢转地连接到推杆；以及曲柄构件，曲柄构件被枢转地支撑在壳体中。曲柄构件可以为基本上L形，并且可以具有第一腿部，第一腿部枢转地连接到远侧联接构件的第二端部，并且曲柄构件可以具有第二腿部，第二腿部可滑动地连接到在所述驱动通道中形成的致动通道中。在使用中，驱动通道的远侧运动可以使得曲柄构件的第二腿部可滑动地平移通过弓形槽，从而使得曲柄构件旋转，从而使得第一腿部旋转，从而使得远侧联接构件向近侧运动，并且从而使得推杆向近侧运动。
夹子从动件可以起到在夹子从动件由步进梁推进到所述一对钳夹之间的位置时锁闭的作用。在使用中，在夹子从动件定位于所述一对钳夹之间时，夹子从动件可以防止所述一对钳夹完全闭合，从而防止施夹器完成整个闭合行程。
施夹器还可以包括夹子计数器板，夹子计数器板被可滑动地支撑在通道组件中，其中，夹子计数器板被配置为且适用于在至少一个手柄每次被完全致动时显示施夹器的状态的变化。
夹子计数器板可以包括一系列离散的标记，其中，多个离散的标记中的一个选择出的标记相对剩余的离散的标记是可辨别的。多个离散的标记中的每个标记均可以涉及在所述施夹器中包含的多个夹子的相应的夹子的数量。
夹子计数器板可以限定一系列在其第一表面中形成的凹槽，其中，步进梁可以包括从其表面延伸出的凸起，凸起被定尺寸为被接收在夹子计数器板中形成的一系列凹槽中的每个凹槽中。在使用中，在步进梁运动时，凸起可以与夹子计数器板接合以使得夹子计数器板运动并且改变多个离散的标记中的所述一个选择出的标记，所述一个选择出的标记相对剩余的离散的标记是可辨别的。
可辨别的离散的标记可以是通过夹子通道可见的。
施夹器还可以包括夹子计数器板，夹子计数器板被可滑动地支撑在通道组件中。夹子计数器板可以包括通过通道组件可见的标记，其中标记对应于装载在施夹器中的夹子的数量，其中，在每次发射施夹器时，夹子计数器板运动使得标记减量，从而使得标记对应于所述施夹器被发射后剩余的多个夹子的夹子的数量。
根据本公开的另一个方案，提供了一种手术施夹器，所述手术施夹器包括：壳体；至少一个手柄，至少一个手柄枢转地连接到壳体；通道组件，通道组件从壳体向远侧延伸出；夹子承载器，夹子承载器布置在限定了通道的通道组件内，夹子承载器包括多个朝向远侧并且延伸进入所述夹子通道中的坡道；多个夹子，多个夹子可滑动地布置在夹子承载器的通道内；步进梁，步进梁往复运动地布置在通道组件内并且叠置在夹子施夹器上，步进梁操作地连接到至少一个手柄以用于在至少一个手柄被致动时进行往复运动；以及夹子推杆，夹子推杆往复运动地定位在壳体和通道组件两者中的至少一个内，推杆具有第一端部和第二端部，第一端部操作地连接到至少一个手柄，第二端部限定了推动器，在至少一个手柄以初始量被致动时，推杆可运动离开所述一对钳夹，以使得推动器在存放在夹子承载器的通道中的最远侧夹子的后方运动，并且所述推杆被配置为且适用于在至少一个手柄返回到初始位置时朝向钳夹运动，以使得最远侧夹子在钳夹之间运动。
施夹器可以还包括夹子从动件，夹子从动件可滑动地布置在夹子承载器的通道内并且布置在所述多个夹子的近侧，夹子从动件被配置为且适用于与夹子承载器和步进梁选择性接合，其中，夹子从动件被配置为且适用于在步进梁进行往复运动时驱使所述多个夹子相对于所述夹子承载器在远侧方向上运动。
步进梁可以包括多个朝向远侧并且延伸进入所述夹子通道中的坡道，其中，步进梁的朝向远侧的坡道被配置为选择性地接合在夹子从动件中限定的第一孔，并且在步进梁向远侧运动时驱使所述夹子从动件向远侧运动，并且其中，夹子承载器的朝向远侧的坡道被配置为选择性地接合在夹子从动件中限定的第二孔，并且在步进梁向近侧运动时使得夹子从动件向近侧的运动停止。
施夹器还可以包括钳夹组件，钳夹组件可以包括一对钳夹，所述一对钳夹从所述通道组件的与壳体相反的端部延伸出，所述钳夹组件适用于在其中容纳夹子并且所述钳夹组件能够响应于所述至少一个手柄的运动耳操作以实现夹子的成形。
夹子推杆可以连接到步进梁，其中，夹子推杆的轴向平移导致伴随步进梁的轴向平移。夹子推杆和步进梁可以被配置并且彼此连接，使得在夹子推杆的轴向平移和步进梁的轴向平移之间提供延迟。
施夹器可以还包括驱动联接系统，驱动联接系统被配置为在致动至少一个手柄时向近侧运动推杆，以及被配置为在接着释放至少一个手柄时向远侧运动推杆。
施夹器还可以包括驱动通道，驱动通道可平移且可滑动地布置在所述壳体和所述通道组件两者中的至少一个内。驱动通道可以具有第一端部和第二端部，第一端部可操作地连接到至少一个手柄，第二端部被配置和定尺寸为选择性地接合所述一对钳夹以实现所述一对钳夹的闭合。在至少一个手柄在第一方向上运动时，驱动通道可以朝向钳夹组件运动，以使得驱动通道的第二端部面对所述一对钳夹运动从而闭合所述一对钳夹。在至少一个手柄在与第一方向相反的第二方向运动时，所述驱动通道可以运动离开钳夹组件，以使得驱动通道的第二端部运动离开钳夹组件从而允许所述一对钳夹打开。
驱动联接系统可以包括：远侧联接构件，远侧联接构件具有第一端部，第一端部枢转地连接到推杆；以及曲柄构件，曲柄构件被枢转地支撑在壳体中。曲柄构件可以是基本上L形并且可以具有第一腿部，第一腿部枢转地连接到远侧联接构件的第二端部，并且所述曲柄构件具有第二腿部，第二腿部可滑动地连接到在驱动通道中形成的致动通道中。在使用中，驱动通道的远侧运动可以使得曲柄构件的第二腿部可滑动地平移通过弓形槽，从而使得曲柄构件旋转，从而使得第一腿部旋转，从而使得远侧联接构件向近侧运动，并且从而使得推杆向近侧运动。
夹子从动件可以起到在夹子从动件由步进梁推进到所述一对钳夹之间的位置时锁闭的作用。在使用中，在夹子从动件定位于所述一对钳夹之间时，夹子从动件可以防止所述一对夹子完全闭合，从而可以防止施夹器完成整个闭合行程。
施夹器还可以包括夹子计数器板，夹子计数器板被可滑动地支撑在通道组件中，其中夹子计数器板被配置为且适用于在所述至少一个手柄每次被完全致动时显示施夹器的状态的变化。夹子计数器板可以包括一系列离散的标记，其中多个离散的标记中的一个选择出的标记相对剩余的离散的标记是可辨别的。
多个离散标记中的每个标记均可以涉及在所述施夹器中包含的多个夹子的相应的夹子的数量。
夹子计数器板可以限定在其第一表面中形成的一系列凹槽，其中，步进梁可以包括从其表面延伸出的凸起，凸起被定尺寸为被接收在夹子计数器板中形成的一系列凹槽中的每个凹槽中。在使用中，在步进梁运动时，凸起可以与夹子计数器板接合以使得夹子计数器板运动并且改变多个离散的标记中的所述一个选择出的标记，所述一个选择出的标记相对剩余的离散的标记是可辨别的。
可辨别的离散的标记可以是通过夹子通道可见的。
施夹器还可以包括夹子计数器板，夹子计数器板被可滑动地支撑在通道组件中。夹子计数器板可以包括通过通道组件可见的标记，其中标记对应于装载在施夹器中的夹子的数量，其中，在每次发射施夹器时，夹子计数器板运动使得标记减量，从而使得所述标记对应于所述施夹器被发射后剩余的多个夹子的夹子的数量。
根据本公开的另一个方案，提供了一种手术施夹器，所述手术施夹器包括：壳体；至少一个手柄，至少一个手柄可枢转地连接到壳体；通道组件，通道组件从壳体向远侧延伸出；夹子承载器，夹子承载器布置在限定了通道的通道组件内，夹子承载器包括多个朝向远侧并且延伸进入夹子通道中的坡道；多个夹子，多个夹子可滑动地布置在夹子承载器的通道内；以及夹子计数器板，夹子计数器板被可滑动地支撑在所述通道组件中，其中夹子计数器板被配置为且适用于在所述至少一个手柄每次被完全致动时显示施夹器的状态的变化。
夹子计数器板可以包括一系列离散的标记，其中，多个离散的标记中的一个选择出的标记相对剩余的离散的标记是可辨别的。多个离散的标记中的每个标记均可以涉及在所述施夹器中包含的多个夹子的相应的夹子的数量。
施夹器还可以包括步进梁，步进梁往复运动地布置在通道组件内并且叠置在夹子承载器上，步进梁操作地连接到至少一个手柄以用于在至少一个手柄被致动时进行往复运动。
夹子计数器板可以限定在其第一表面中形成的一系列凹槽，其中步进梁可以包括从其表面延伸出的凸起，凸起被定尺寸为被接收在夹子计数器板中形成的一系列凹槽中的每个凹槽中。在使用中，在步进梁运动时，凸起可以与夹子计数器板接合以使得夹子计数器板运动并且改变多个离散的标记中的所述一个选择出的标记，所述一个选择出的标记相对剩余的离散的标记是可辨别的。
可辨别的离散的标记可以是通过夹子通道可见的。
施夹器可以还包括夹子推杆，夹子推杆往复运动地定位在壳体和通道组件两者中的至少一个内。推杆可以具有第一端部和第二端部，第一端部操作地连接到至少一个手柄，第二端部可以限定推动器。在至少一个手柄以初始量被致动时，推杆可以运动离开所述一对钳夹，以使得所述推动器在存放在所述夹子承载器的通道中的最远侧夹子的后方运动。所述推杆可以被配置为且适用于在所述至少一个手柄返回到初始位置时朝向所述钳夹运动，以使得所述最远侧夹子在所述钳夹之间运动。
施夹器还可以包括夹子从动件，夹子从动件可滑动地布置在夹子承载器的通道内并且可以布置在所述多个夹子的近侧。夹子从动件可以被配置为且适用于与夹子承载器和步进梁选择性接合，其中，夹子从动件可以被配置为且适用于在步进梁往复进行运动时驱使所述多个夹子相对于所述夹子承载器在远侧方向上运动。
步进梁可以包括多个朝向远侧并且延伸到夹子通道中的坡道，其中，步进梁的朝向远侧的坡道被配置为选择性地接合在夹子从动件中限定的第一孔，并且在步进梁向远侧运动时驱使所述夹子从动件向远侧运动，并且其中，夹子承载器的朝向远侧的坡道可以被配置为选择性地接合在夹子从动件中限定的第二孔，并且在步进梁向近侧运动时使得所述夹子从动件向近侧的运动停止。
施夹器还可以包括钳夹组件，所述钳夹组件包括一对钳夹，所述一对钳夹从所述通道组件的与壳体相反的端部延伸出。钳夹组件可以适用于在其中容纳钳夹并且所述钳夹组件可以响应于所述至少一个手柄的运动而操作以实现夹子的成形。
夹子推杆可以连接到步进梁，其中夹子推杆的轴向平移导致伴随步进梁的轴向平移。
推杆和步进梁可以被配置并且彼此连接，使得在夹子推杆的轴向平移和步进梁的轴向平移之间提供延迟。
施夹器还可以包括驱动联接系统，驱动联接系统被配置为所述至少一个手柄被致动时使得所述推杆向近侧运动，并且被配置为在所述至少一个手柄随后被释放时使得所述推杆向远侧运动。
施夹器还可以包括驱动通道，驱动通道可平移且滑动地布置在壳体和通道组件两者中的至少一个内。驱动通道可以具有第一端部和第二端部，第一端部操作地连接到至少一个手柄，第二端部被配置和定尺寸为选择性地接合所述一对钳夹以实现所述一对钳夹的闭合。在至少一个手柄在第一方向上运动时，驱动通道可以朝向钳夹组件运动，以使得驱动通道的第二端部面对所述一对钳夹运动从而闭合所述一对钳夹。在至少一个手柄在与第一方向相反的第二方向运动时，驱动通道可以运动离开所述钳夹组件，以使得所述驱动通道的第二端部运动离开所述钳夹组件从而允许所述一对钳夹打开。
驱动联接系统可以包括：远侧联接构件，远侧联接构件具有第一端部，第一端部枢转地连接到推杆；以及曲柄构件，曲柄构件被枢转地支撑在壳体中。曲柄构件可以是基本上L形并且可以具有第一腿部，第一腿部枢转地连接到远侧联接构件的第二端部，并且曲柄构件可以具有第二腿部，第二腿部可滑动地连接到在所述驱动通道中形成的致动通道中。在使用中，驱动通道的远侧运动可以使得曲柄构件的第二腿部可滑动地平移通过弓形槽，从而使得曲柄构件旋转，从而使得第一腿部旋转，从而使得远侧联接构件向近侧运动，并且从而使得推杆向近侧运动。
夹子从动件可以起到在所述夹子从动件由所述步进梁推进到所述一对钳夹之间的位置时锁闭的作用。在使用中，在夹子从动件定位于所述一对钳夹之间时，夹子从动件可以防止所述一对钳夹完全闭合，从而防止施夹器完成整个闭合行程。
附图说明
当结合下面的附图进行考虑时，通过下面的详细描述将更好地理解本发明的施夹器，从而将更加全面地了解本发明的施夹器，在附图中：
图1为根据本公开的一个实施例的手术施夹器的立体图；
图2为图1的手术施夹器的手柄组件的零件分解的立体图；
图3为图1的手术施夹器的通道组件的俯视立体图；
图4为图3的通道组件的仰视立体图；
图5为图3和图4的通道组件的零件分解的立体图；
图6为图3和图4的通道组件的推杆的俯视立体图；
图7为图6的推杆的仰视立体图；
图8为图6中的细节指示区域的推杆的放大视图；
图9为通过图6的9-9所截取的推杆的剖视图；
图10为图3和图4的通道组件的夹子承载器的俯视立体图；
图11为图10的夹子承载器的俯视立体图；
图12为图10的细节指示区域的夹子承载器的放大视图；
图13为通过图10的13-13所截取的夹子承载器的剖视图；
图14为图3和图4的通道组件的步进梁的俯视立体图；
图15为图14的步进梁的仰视立体图；
图16为图15的细节指示区域的步进梁的放大视图；
图17为图15的细节指示区域的步进梁的放大视图；
图18为通过图14的18-18所截取的步进梁的剖视图；
图19为图18的细节指示区域的步进梁的放大视图；
图20为图18的细节指示区域的步进梁的放大视图；
图21为图3和图4的通道组件的夹子计数器板的俯视立体图；
图22为图21的夹子计数器板的仰视立体图；
图23为通过图21的23-23所截取的夹子计数器板的剖视图；
图24为图23的指示细节区域的夹子计数器板的放大视图；
图25为图4的细节指示区域的通道组件的放大俯视立体图；
图26为图25的细节指示区域的通道组件的放大视图；
图27为通过图25的27-27所截取的通道组件的剖视图；
图28为通过图4的28-28所截取的通道组件的剖视图；
图29为图28的细节指示区域的通道组件的放大视图；
图30为图29的细节指示区域的通道组件的放大视图；
图31为图28的细节指示区域的通道组件的放大视图；
图32为图29的细节指示区域的通道组件的放大视图；
图33为图1和图2的手术施夹器的手柄组件的立体图，图中自手柄组件移除了上壳体半部；
图34为图1和图2的手术施夹器的手柄组件的放大立体图，图中自手柄组件移除了上壳体半部和推动器稳定器；
图35为图1和图2的手术施夹器的手柄组件以未致动状态示出的俯视立体图，图中自手柄组件移除了上壳体半部、推动器稳定器和推杆；
图36为图1和图2的手术施夹器的手柄组件以未致动状态示出的俯视平面视图，其中自手柄组件移除了上壳体半部；
图37为图1和图2的手术施夹器的通道组件的远端的俯视立体图，以未致动状态示出了推杆、驱动通道和步进梁；
图38为通过图37的38-38所截取的手术施夹器的通道组件的远端的剖视图；
图39为图1和图2的手术施夹器的手柄组件示出为在第一次完整的致动后的俯视立体图，其中自手柄组件移除了上壳体半部；
图40为图1和图2的手术施夹器的手柄组件示出为在第一次完整的致动后的俯视立体图，其中自手柄组件移除了上壳体半部和推动器稳定器；
图41为图1和图2的手术施夹器的手柄组件示出为在第一次完整的致动后的俯视平面图，其中自手柄组件移除了上壳体半部；
图42为图28的指示区域31的放大视图，图示出了推杆和步进梁的近侧运动；
图43为图29的指示区域32的放大视图，图示出了推杆、步进梁和夹子计数器板的运动；
图44为图1和图2的手术施夹器的通道组件的远端的俯视立体图，图示出了推杆、驱动通道和步进梁，其中推杆在近侧方向上移动夹子计数器板；
图45为图44的细节指示区域45的通道组件的远端的放大视图；
图46为通过图45的46-46所截取的通道组件的远端的剖视图；
图47为通过图45的46-46所截取的通道组件的远端的进一步的剖视图，图示出了在手柄组件的第一次完整的挤压后的推杆；
图48为图1和图2的手术施夹器的手柄组件示出为在返回行程期间的俯视平面图，其中自手柄组件移除了上壳体半部和推动器稳定器；
图49为图28的指示区域31的放大视图，图示出了推杆和步进梁的远侧运动；
图50为图29的指示区域32的放大视图，图示出了推杆、步进梁和夹子从动件的远侧运动；
图51为通道组件的远端的俯视立体图，图示出了推杆将最远侧夹子移动到钳夹中；
图52为通道组件的远端的俯视平面图，图示出了推杆将最远侧夹子移动到钳夹中；
图53为通过图52的53-53所截取的通道组件的远端的剖视图；
图54为通道组件的远端的俯视立体图，图示出了推杆将夹子从动件移动到钳夹中以便锁闭施夹器；以及
图55为通过图54的55-55所截取的通道组件的远端的剖视图。
具体实施方式
现在，将参照附图详细地描述根据本公开的手术施夹器的实施例，其中，相同的附图标记表示相似或相同的结构元件。如附图中所示和遍布于下文的说明中的描述，按照惯例，当涉及手术器械上的相对定位时，术语“近侧”是指装置的较靠近用户的端部，术语“远侧”是指装置的较远离用户的端部。
图1至图4图示出了根据本公开的一个实施例的手术施夹器，通常将该手术施夹器指定为100。
手术施夹器100是包括手柄组件102的手术器械，手柄组件102包括壳体104，壳体104具有上壳体半部104a和下壳体半部104b。手柄组件102还包括一对手柄106，手柄106可枢转地紧固到壳体104并且从壳体104中向外延伸。通道组件108固定地紧固到壳体104并且从壳体104中向外延伸，终止于钳夹组件110。
如图1和图2所示，利用相互搭扣配合式接合将施夹器100的壳体半部104a和104b装配在一起。壳体104由合适的塑性材料形成。
如图2所示，手柄106通过手柄枢转柱104d紧固到壳体104，手柄枢转柱104d从下壳体半部104b延伸出并且进入到在手柄106中形成的相应孔106a中。手柄组件102包括连杆构件122，连杆构件122在相应的手柄106中形成的枢转点106b处枢转地连接到各手柄106。每个连杆构件122的远端122a经由驱动销124枢转地连接到在驱动通道140中形成的枢转点140a。驱动销124的每个端部均被可滑动地接收在细长通道104e中，细长通道104e形成在相应的上壳体半部104a和下壳体半部104b中。在使用中，如下文中将更详细地描述的那样，当挤压手柄106时，连杆构件122经由驱动销124向远侧推动驱动通道140。
通道组件108包括管状主体130，管状主体130具有在上壳体半部104a和下壳体半部104b之间保留在手柄组件102中的近端。管状主体130限定了穿过其的腔体130a以及形成在管状主体130的外表面中的纵向延伸的通道130b。
如图2和图5至图9所示，施夹器100包括夹子推杆160，夹子推杆160可滑动地布置在手柄壳体104和通道组件108内。推杆160包括限定了推动器160c的远端160a，推动器160c被配置为且适用于选择性地接合/移动存放在手术施夹器100中的最远侧夹子“C1”。推杆160还包括在其中限定第一近侧窗口160d1和第二近侧窗口160d2的近端160b。第一近侧窗口160d1被配置为在其中可滑动地接收驱动销124，第二近侧窗口160d2被配置为在其中可滑动地接收枢转销154c。推杆160进一步在其中限定远侧窗口160e和近侧窗口160g以用于与稳定器162进行可操作地接合，这将在下文中更加详细地描述。推杆160还包括孔160f，孔160f被配置为枢转地连接到远侧联接构件158，这将在下文中更加详细地描述。
施夹器100的手柄组件102还包括稳定器162，稳定器162被配置为叠置在推杆160上并且接合推杆160。稳定器162包括被配置为接合推杆160的远侧窗口160e的远侧凸起162a，以及在其中限定的细长窗口162b和162d，细长窗口162b和162d位于基本上叠置在推杆160中形成的相应的近侧窗口160d1和160d2上并与它们对准的位置。如图2所示，稳定器162在近侧和远侧位置处还包括多个凸起162e，凸起162e自稳定器162的顶面延伸出，并且凸起162e被配置和定尺寸为被接收在形成于上壳体半部104a中的相应的通道（未示出）中。稳定器162还包括孔162f，孔162f叠置在推杆160的孔160f上。推杆160的孔160f和稳定器162的孔162f两者均被配置为枢转地接收枢转销158c，枢转销158c延伸通过远侧联接构件158。
如图2所示，施夹器100的手柄组件102还包括呈双杆联接系统形式的驱动联接系统155，驱动联接系统155具有远侧联接构件158和近侧曲柄构件154。近侧曲柄构件154经由枢转销154c被枢转地支撑在壳体104中。近侧曲柄构件154基本上为L形，包括第一腿部154a和第二腿部154b，第一腿部154a经由第一枢转销156a枢转地连接到远侧联接构件158的近端，第二腿部154b经由第二枢转销156b枢转并可滑动地连接到限定在驱动通道140中的弓形槽140g。可以预期的是，曲柄构件154的第一腿部154a定位为基本上垂直于曲柄构件154的第二腿部154b。
如上所述，驱动联接系统155包括远侧联接构件158，远侧联接构件158使近侧曲柄构件154和推杆160相互连接。纵向轴线“X1”由沿延伸通过驱动销124、远侧联接构件158的枢转销158c和枢转销154c的轴线限定。纵向轴线“X1”的包括曲柄构件154的第二腿部154b的一侧限定了第一侧，纵向轴线“X1”的与第一侧相反的另一侧限定了第二侧。
在手术施夹器100的未致动状态下，曲柄构件154的第二腿部154b布置在纵向轴线“X1”的第一侧处，并且曲柄构件154的第一腿部154a基本上沿纵向轴线“X1”布置。在手术施夹器100被致动时，曲柄构件154的第一腿部154a布置在纵向轴线“X1”的第二侧处，这将在下文中非常详细地描述。
如图4、图5和图10至图13所示，施夹器100的通道构件108包括夹子承载器170，夹子承载器170布置在管状主体130的通道130b内使得夹子承载器170介于管状主体130和推杆160之间。夹子承载器170通常为盒状结构，其具有上壁170a、一对侧壁170b和限定了通道170d通过的下壁170c。夹子承载器170包括多个向远侧延伸的、隔开的坡道172，坡道172在下壁170c中形成并且沿其长度纵向延伸，其中，坡道172朝向堆叠的夹子“C”突出。可以预期的是，为每个手术夹子“C”均设置坡道172。向远侧延伸的坡道172起到帮助维持堆叠的夹子“C”不向近侧运动的作用。夹子承载器170包括细长窗口170e（如图10所示），细长窗口170e形成在上壁170a中并且沿其整个长度纵向延伸。
如图5、图25至图30和图32所示，堆叠的手术夹子“C”以在其内滑动和/或沿其滑动的方式被装载和/或保留在夹子承载器170的通道170d内。通道170d被配置和定尺寸为使堆叠的或多个手术夹子“C”以头尾相接的方式保留在通道170d内。
如图12、图13和图26所示，夹子承载器170的远端包括一对隔开的弹性柄脚171。柄脚171被配置为且适用于选择性地接合保留在承载器170内的堆叠的手术夹子“C”的最远侧手术夹子“C1”的腿部或后跨部（backspan）。
如图5所示，施夹器100的通道组件108还包括夹子从动件174，夹子从动件174可滑动地布置在夹子承载器170的通道170d内。如下文中将更加详细地描述的，夹子从动件174定位在堆叠的手术夹子“C”之后并且设置为在手术施夹器100的致动期间驱使堆叠的手术夹子“C”运动。如下文中也将更加详细地描述的，通过步进梁180的前向后往复运动来致动夹子从动件174。夹子从动件174起到在发射堆叠的夹子“C”中的最后的手术夹子后锁闭的作用，这将在下文中更详细地描述。
如图5所示，夹子从动件174包括限定了平面的主体部174a、在主体部174a中限定的远侧窗口174b以及从主体部174a向近侧延伸的至少一个腿部174c，以便作为夹子从动件174的稳定特征。远侧窗口174被配置和定尺寸为选择性地接收坡道172，坡道172从夹子承载器170的上壁170a向远侧突出。在使用中，如由夹子从动件174的远侧窗口174限定的、夹子承载器170的坡道172抵靠主体部174a的远侧壁的接合，防止了夹子从动件174在近侧方向上行进或运动。
夹子从动件174的远侧窗口174b也被配置和定尺寸为选择性地接纳坡道180b，坡道180b从步进梁180向远侧突出和延伸。在使用中，当步进梁180在远侧方向上运动时，如由夹子从动件174的远侧窗口174b限定的、步进梁180的坡道抵靠主体部174a的远侧壁的接合在远侧方向上驱动夹子从动件174。
如图3至图5、图25和图26所示，施夹器100的通道组件108包括钳夹组件110，该钳夹组件110具有一对钳夹120，所述一对钳夹120安装在通道组件108的远端上或远端处并且能够通过手柄组件102的手柄106致动。钳夹120由合适的生物相容性材料例如不锈钢或钛形成。
钳夹120经由一个或多个铆钉或类似物安装在驱动通道140的远端中，使得钳夹120相对于外部通道132和驱动通道140纵向静止，所述铆钉或类似物延伸通过驱动通道140的往复运动限制槽140f。如图26所示，钳夹120之间限定了用于在其中接收手术夹子“C1”的通道120a。
如图5、图14至图20以及图27至图32所示，施夹器100的通道组件108还包括步进梁180，步进梁180可滑动地布置在手柄组件102和通道组件108内。特别地，步进梁180定位于或布置在夹子承载器170的通道170d内并且叠置在堆叠的夹子“C”上。步进梁180包括基本上锥形的远端或鼻端180a。步进梁180限定了多个隔开的、向远侧延伸的坡道180b，坡道180b在步进梁180中形成，沿步进梁180的长度纵向延伸并且向堆叠的夹子“C”突出。可以预期的是，为每个手术夹子设置坡道180b。向远侧延伸的坡道180b起到使堆叠的夹子“C”在步进梁180向远侧运动时向远侧运动并且帮助维持堆叠的夹子“C”不向近侧运动的作用。
步进梁180还包括向近侧延伸的坡道180c，坡道180c布置在坡道180b的近侧，并且沿步进梁180的相反侧突出。步进梁180的坡道180c延伸通过在推杆160中形成的窗口160g，以便与凹口192a接合（见图22和图24），凹口192a限定于夹子计数器板192的表面中，这将在下文中更详细地描述。
步进梁180还包括在其中形成的第一槽180d，第一槽180d用于接纳从推杆160突出的肋件或凸起160h。根据本公开，步进梁180的第一槽180d具有比推杆160的凸起160h的轴向长度短的轴向长度。以这种方式，当推杆160往复运动时，如下文中的描述，步进梁180在一定程度的空动后也随推杆160往复运动直到推杆160的凸起160h与步进梁180的第一槽180d的远端或近端接合。
步进梁180进一步在其中限定第二槽180e，第二槽180e被配置和定尺寸为收纳从管状主体130延伸出的止动柱130c。止动柱130c延伸通过夹子承载器170并且进入步进梁180的第二槽180e中。在使用中，当步进梁180在近侧或远侧方向上轴向往复运动时，止动柱130c与步进梁180的第二槽180e的远端或近端接合以便限制步进梁180的轴向行进的距离。
如图5和图21至图27所示，施夹器100还包括支撑在通道组件108中的计数器机构190。计数器机构190包括夹子计数器板192，夹子计数器板192被可滑动地支撑在推杆160的顶部。通过弹性指件170f接合形成于计数器板192的表面中的凹口192b使计数器板192相对于夹子承载器170选择性地保持在适当位置处。在使用中，当步进梁180由于推杆160向近侧运动并且推杆160的肋件160h接合在步进梁180的窗口180d中而向近侧运动时，由于步进梁180向近侧延伸的坡道180c抵靠凹口192a接合，夹子计数器板192向近侧运动，凹口192a形成在夹子计数器板192的下表面中。夹子计数器板192向近侧运动直到夹子承载器170的弹性指件170f接合夹子计数器板192的下一个最远侧凹口192b以便由此保持夹子计数器板192相对于夹子承载器170的轴向位置。然后，当步进梁180由于推杆160向近侧运动并且推杆160的肋件160h接合在步进梁180的窗口180d中而向远侧运动时，由于夹子承载器170的弹性指件170f接合在夹子计数器板192的下一个最远侧凹口192b中，夹子计数器板192继续保持在适当位置处。
当夹子计数器板192在近侧方向上运动时，在其表面上布置的标志或标记192c运动至与叠置并且固定到管状主体130的通道130b上的盖子中形成的窗口或指示器对准。在操作中，当夹子计数器板192在近侧方向上运动时，呈数字或类似的形式的标记192c递减以便指示在手术施夹器100中剩余的夹子“C”的总数。
如图2至图5所示，施夹器100包括驱动通道140，驱动通道140被往复运动地支撑在手柄组件102的壳体104和通道组件108中并且在手柄组件102的壳体104和通道组件108之间延伸。在步进梁180下方的位置处，驱动通道140的近端被支撑在壳体104的上壳体半部104a和下壳体半部104b之间，并且驱动通道140的远端被支撑在钉仓盖130和通道组件108的外通道132之间。
驱动通道140的远端基本上为U形通道，其包括一对隔开的侧壁140b，该一对侧壁140b从驱动通道140的后跨部140c沿远离外通道132并且朝向钉仓盖130的方向延伸。驱动通道140进一步限定了驱动销凹槽140a，驱动销凹槽140a形成在后跨部140c中，用于在其中枢转地接纳驱动销124。驱动通道140进一步限定了肋件140e，肋件140e在驱动销凹槽140a的远侧位置处从后跨部140c突出。驱动通道140在肋件140e的远侧位置处还限定了往复运动限制槽140f，往复运动限制槽140f形成在后跨部140c中。此外，驱动通道140限定了在其中形成的弓形槽140g，弓形槽140g被配置和定尺寸为可滑动地接纳第二枢转销156b，第二枢转销156b枢转地连接到曲柄构件154的第二腿部154b。
如图5和图27所示，施夹器100包括紧固到驱动通道140的驱动通道凸轮块143。特别地，凸轮块143紧固到驱动通道140的远端并且凸轮块143包括由一对侧壁限定的凸轮通道143a，该对侧壁被配置和定尺寸为布置钳夹120的外观。凸轮块143紧固到驱动通道140使得凸轮块143随驱动通道140的运动而往复运动。
可以预期的是，施夹器100还可以包括视觉/触觉指示器（未示出），视觉/触觉指示器经由驱动销124连接到驱动通道140。该指示器包括弹性指件和一对突起。在使用中，当致动施夹器100并且驱动通道140往复运动时，指示器的第一弹性指件与设置在施夹器100中的对应的互补结构或凸缘（未示出）相互作用，以便为用户提供视觉和/或触觉反馈。指示器的突起压靠（ride）在上壳体半部104a中形成的通道内并且向指示器提供支撑以防止指示器旋转。
如图2所示，施夹器100的手柄组件102还包括呈拉伸弹簧形式的偏置构件146，偏置构件146可操作地紧固到驱动通道140的近端和壳体104上并且位于驱动通道140的近端和壳体104之间，趋于将驱动通道140维持在缩回或最近侧位置处。偏置构件146起到在定位于钳夹120之间的夹子“C”的成形之后使驱动通道140缩回或便于缩回的作用。
如图33至图36所示，施夹器100的手柄组件102包括棘轮构件141，棘轮构件141经由驱动销124紧固到驱动通道140的近端，以便可与驱动通道140一起运动。棘轮齿条构件141被配置为且适用于与支撑在壳体104中的棘轮爪142接合。齿条构件141和棘轮爪142限定了棘轮机构144。在使用中，当驱动通道140轴向运动时，齿条构件141也运动。齿条构件141限定了具有以下长度的一系列齿条齿：当齿条构件141随着驱动通道140到达最近侧或最远侧位置而在近侧和远侧运动之间变化时，所述长度允许棘轮爪142越过齿条构件141回转并向后推进。
在棘轮爪142处于与齿条构件141基本上可操作接合的位置处，棘轮爪142通过棘轮爪销枢转地连接到下壳体半部104b。棘轮爪142可与齿条构件141接合以便限制齿条构件141的纵向运动，进而限制驱动通道140的纵向运动。棘轮机构144还包括棘轮爪簧，棘轮爪簧被配置和定位为使棘轮爪142偏置为与齿条构件141可操作接合。棘轮爪簧起到维持棘轮爪142的齿与齿条构件141的齿141a接合的作用，以及将棘轮爪142维持在旋转或斜置位置的作用。
参照图1至图32和图33至图55，提供了施夹器100的操作。在施夹器100的手柄106的任何初始挤压之前，如图33至图38所示，施夹器100的内部部件处在所谓的“初始”或“起始”或未致动位置。更特别地，在“初始”位置处，驱动销124位于最近侧位置，棘轮爪142位于驱动通道140的齿条140d的远侧，枢转臂179的第二指件179c位于驱动通道140的窗口140g的远侧部中的最远侧位置处，使得步进梁180位于最远侧位置处，没有夹子“C”定位在钳夹120内，并且推杆160的推动器160a布置在夹子“C”的远侧。此外，在驱动销124处于最近侧位置处时，推杆160布置在最远侧位置处并且驱动通道140布置在最近侧位置处。
在施夹器100的手柄106的初始挤压之前，在步进梁180位于最远侧位置处时，其远端180a介于钳夹120之间。同样在施夹器100的手柄106的初始挤压之前，没有夹子“C”存在于钳夹120内。在手柄106的初始挤压期间，首先，将夹子“C”装载到钳夹120中，以便将第一夹子“C1”填装到钳夹120中从而填装施夹器100。
如图39至图47所示，在手柄106完成初始挤压期间/在手柄106完成初始挤压之后（工作行程），为了填装手术施夹器100，连杆构件122的远端122a相对于壳体104向远侧运动。当连杆构件122的远端122a向远侧运动时，驱动销124向远侧运动从而将远侧轴向运动传递到驱动通道140。
随后，如图39至图41所示，当驱动通道140运动到最远侧位置时，驱动联接系统155从“初始”位置运动到致动位置。更特别地，驱动通道140在远侧方向上推进，进而由于第二枢转销156b在驱动通道140的弓形槽140g中的滑动接合使得曲柄构件154绕枢转销154c枢转，第二枢转销156b固装到曲柄构件154的第二腿部154b中。
当曲柄构件154在第一方向上旋转时，曲柄构件154的第一腿部154a作用在远侧联接构件158上，以使得远侧联接构件158在近侧方向上运动。由于通过枢转销158c将远侧联接构件158固装到推杆160，当远侧联接构件158在近侧方向上运动时，推杆160也在近侧方向上运动。
当推杆160在近侧方向上运动时，其凸起160h在一定程度的空动后与步进梁180的第一槽180d的近端接触，以使得步进梁180在近侧方向上与推杆160一起运动。当步进梁180在近侧方向上运动时，其坡道180b凸轮运动越过堆叠的夹子“C”，以便与堆叠的夹子“C”中的下一个近侧夹子可操作接合。而且，当步进梁180在近侧方向上运动时，其向近侧延伸的坡道180c与在计数器板192的底面中形成的凹口192a接合，通过将夹子承载器170的弹性指件170f从计数器板192的第一近侧凹口192b中释放使计数器板192在近侧方向上运动，直到弹性指件170f与计数器板192的下一个远侧凹口192b再次接合。当计数器板192向近侧运动时，标记192c运动至与在安装到计数器130b的远侧部的盖子中形成的窗口或标记对准，以便将可用于使用的夹子的总初始数量指示给用户。
此外，当推杆160在近侧方向上运动时，当推杆160到达最近侧位置时，推杆160的推动器160c运动到最远侧手术施夹器“C1”的近侧位置。通过这种方式，当释放手柄106时，在完全挤压后机构回转，其中，驱动通道140在近侧方向上运动并且推杆160在远侧方向上运动。当推杆160在远侧方向上运动时，推动器160c作用在最远侧夹子“C1”上，以使得最远侧夹子“C1”在远侧方向上运动出夹子承载器170之外，并且将最远侧夹子“C1”装载到钳夹120的通道120a中。当最远侧夹子“C1”向远侧运动时，夹子承载器170的柄脚171偏离或凸轮运动出与最远侧夹子“C1”的接合并且返回其未偏离或无凸轮运动状态以便捕获堆叠的夹子“C”中随后的夹子。
在手柄106的初始完全释放期间，推杆160向远侧运动足以将最远侧夹子“C1”放置在钳夹120的通道120a中的量。
在手柄106被完全释放后，推杆160仍然前进，使得其推动器160c基本上支撑或基本上仍然与现在装载的最远侧夹子“C1”中至少一个后跨部接触。
这种次序实质上完成了将手术夹子“C1”装填或装载到钳夹120中。此时，手术施夹器100准备好分别利用完成单次挤压和释放手柄106来向目标手术部位施加夹子。
在利用手术夹子“C1”对手术施夹器100初始装填后，如上所述，任何额外的或手柄106的进一步完全挤压均将使得向目标部位施加装载在钳夹120内的手术夹子“C1”，随后每次释放手柄106均将使得将新的手术夹子“C”装载到钳夹120中，这将在下文中更加详细地描述。
如图39至图41所示，仍然在手柄106的任何挤压期间，当驱动通道140在远侧方向上运动时，棘轮机构144的齿条构件141向远侧运动，使得其齿运动到与棘轮爪142接合并且越过或跨过棘轮爪142的齿。一旦棘轮机构144的齿条构件141运动至与棘轮爪142接合，驱动通道140不能返回初始或最近侧位置，直到齿条构件141由于手柄106的完全挤压而具有畅通的（cleared）棘轮爪142。
在手柄106的任何完全挤压期间，在初始装填手术施夹器100后，如图39至图47所示，驱动通道140向远侧运动以使得凸轮块143向远侧运动。当凸轮块143向远侧运动时，凸轮块143沿钳夹120的外凸轮表面作用以便接近钳夹120。由于手术夹子“C1”布置在钳夹120中，所以当凸轮块143运动到驱动通道140的行程的端部处的最远侧位置时，手术夹子“C1”完全成形。
伴随着驱动通道140的远侧运动，在手柄106的挤压期间，推杆160向近侧运动，如上所述。当推杆160向近侧运动时，推杆160作用在步进梁180上，如上所述，以使得步进梁180也在近侧方向上运动。
如上所述，当步进梁180运动到最近侧位置时，其坡道180b凸轮运动越过堆叠的夹子“C”以便与堆叠的夹子“C”中的下一个近侧夹子可操作地接合。
同样如上所述，当步进梁180向近侧运动时，步进梁180作用在计数器板192上，如上所述，以便使计数器板192同样在近侧方向上运动直到夹子承载器170的弹性指件170f再次接合在计数器板192的下一个远侧凹口192b中。
此外，如上所述，当步进梁180向最近侧位置运动时，其坡道180b凸轮运动越过夹子从动件174的远侧边缘，使得步进梁180的下一个远侧坡道180b布置在夹子从动件174的窗口174b中。由于夹子从动件174抵靠夹子承载器170的坡道172接合，所以防止了夹子从动件174向近侧滑动。
现在，参照图48至图53，在手柄106的打开或释放期间，使联接构件122的远端122a相对于壳体104向近侧运动。当联接构件122的远端122a向近侧运动时，使得驱动销124向近侧运动，从而将近侧轴向运动传递到驱动通道140，进而使得推杆160向远侧轴向地运动。通过偏置构件146的压缩，方便了驱动通道140的近侧运动。可选择地，手柄106的释放使得偏置构件146在近侧方向上退出驱动通道140。
当驱动通道140向近侧运动时，凸轮块143的远侧边缘缩回并且脱离抵靠钳夹120的凸轮表面的接合，因此使得钳夹120自由而相互分离从而在其间接收另一个手术夹子“C”。
此外，当驱动通道140向近侧运动时，在手柄106的释放期间（即返回行程），为了使得手术施夹器100再次装载新的/下一个手术夹子“C”，联接构件122的远端122a相对于壳体104向近侧运动。当联接构件122的远端122a向近侧运动时，驱动销124向近侧运动从而将近侧轴向运动传递到驱动通道140。
此后，如图48所示，当驱动通道140运动到最远侧位置时，驱动联接系统155从致动位置运动到“初始”位置。更特别地，驱动通道140在近侧方向上缩回，进而由于第二枢转销156b在驱动通道140的弓形槽140g中的滑动接合使得曲柄构件154绕枢转销154c枢转，第二枢转销156b固装到曲柄构件154的第二腿部154b。
当曲柄构件154在第二方向（与第一方向相反）上旋转，曲柄构件154的第一腿部154a作用在远侧联接构件158上，以使得远侧联接构件158在远侧方向上运动。由于远侧联接构件158通过枢转销158c固装到推杆160，当远侧联接构件158在远侧方向上运动时，推杆160也在远侧方向上运动。
当推杆160在远侧方向上运动时，其凸起160h在一定程度的空动后运动至与步进梁180的第一槽180d的前端接触，以使得步进梁180在远侧方向上与推杆160一起运动。当步进梁180在远侧方向上运动时，其坡道180b与堆叠的夹子“C”中相应的手术夹子接合，以便向远侧推进在堆叠的夹子“C”中剩余的手术夹子。此外，当步进梁180在远侧方向上运动从而向远侧推进在堆叠的夹子“C”中剩余的手术夹子时，手术夹子凸轮运动越过或通过夹子承载器170的坡道172。当向远侧推进堆叠的夹子“C”时，堆叠的夹子通过夹子承载器170的柄脚171保持在轴向位置处。
而且，当步进梁180向远侧运动时，步进梁180的坡道180b接合在夹子从动件174的窗口174b中，并且由此被驱使向远侧运动给定的距离。
而且，当步进梁180在远侧方向上运动时，其向近侧延伸的坡道180c凸轮运动越过在计数器板192的底面中形成的凹口192a以便与计数器板192的下一个远侧凹口192a可操作接合，其中，由于它们在计数器板192的下一个远侧凹口192b中的接合，夹子承载器170的弹性指件170f维持计数器板192的轴向位置。
而且，当推杆160在远侧方向上运动时，当推杆160到达最远侧位置时，其推动器160c已经使得堆叠的夹子“C”的下一个最远侧夹子“C1”向远侧运动出夹子承载器170之外，进入钳夹120的通道120a中。当下一个最远侧夹子“C1”向远侧运动时，夹子承载器170的柄脚171偏离或凸轮运动退出与最远侧夹子“C1”的接合，并且返回它们的未偏离或无凸轮运动状态以便捕获堆叠的夹子“C”的随后的夹子。
在手柄106被完全释放后，推杆160向远侧运动足以将最远侧夹子“C1”放置在钳夹120的通道120a中的量。而且在手柄106被完全释放后，推杆160仍然前进，使得其推动器160c基本上支撑或基本上仍然与现在装载的最远侧夹子“C1”的至少一个后跨部接触。
现在转向图54和图55，在堆叠的夹子“C”的最后夹子发射后，夹子从动件174已经通过步进梁180的往复轴向运动向远侧推进（如上所述），使得推杆160的推动器160c可能立刻与夹子从动件174的主体部174a接合，以便将夹子从动件174向远侧推进到钳夹120中。由于夹子从动件174布置在钳夹120内，当钳夹120在手柄106的任何随后的挤压下接近时，当驱动通道140和凸轮块143向远侧推进时，夹子从动件174防止钳夹120接近。然而，由于驱动通道140已经向远侧推进一定程度，棘轮机构144的齿条构件141也已经向远侧运动，使得其齿运动至与棘轮爪142的齿接合。如上所述，一旦棘轮机构144的齿条构件141运动至与棘轮爪142接合时，驱动通道140不能返回到初始或最近侧位置，直到齿条构件141已经由于手柄106的完全挤压使棘轮爪142畅通。然而，由于钳夹120中存在夹子从动件174，所以防止了手柄106完全挤压，由此有效地锁闭施夹器100。
应当理解的是：上述描述仅仅是对本公开的阐述。本领域的技术人员可能想出各种替换和改进而不背离本发明。因此，本公开意图包含所有的所述替换、改进和变型。示出的参照附图描述的实施例仅用来证明本发明的某些特定实例。与上文那些描述和/或所附权利要求无本质上不同的其它元件、步骤、方法和技术也意图包括在本公开的范围内。
Claims (17)
1.一种手术施夹器，包括：
壳体；
至少一个手柄，其可枢转地连接到所述壳体；
通道组件，其从所述壳体向远侧延伸；
夹子承载器，其布置在限定了通道的所述通道组件内，所述夹子承载器包括多个朝向远侧并且延伸进入夹子通道中的坡道；
多个夹子，它们可滑动地布置在所述夹子承载器的所述通道内；以及
夹子计数器板，其被可滑动地支撑在所述通道组件中，其中，所述夹子计数器板被配置为且适用于在所述至少一个手柄每次被完全致动时显示施夹器的状态的变化。
2.根据权利要求1所述的施夹器，其中，所述夹子计数器板包括一系列离散的标记，其中，多个离散的标记中的一个选择出的标记相对剩余的离散的标记是可辨别的。
3.根据权利要求2所述的施夹器，其中，多个离散的标记中的每个标记均涉及在所述施夹器中包含的多个夹子的相应的夹子的数量。
4.根据权利要求1所示的施夹器，还包括步进梁，所述步进梁往复运动地布置在所述通道组件内并且叠置在所述夹子承载器上，所述步进梁操作地连接到所述至少一个手柄以用于在所述至少一个手柄被致动时进行往复运动。
5.根据权利要求4所述的施夹器，其中，所述夹子计数器板限定了一系列在其第一表面中形成的凹槽，并且其中，所述步进梁包括从其表面延伸出的凸起，所述凸起被定尺寸为被接收在所述夹子计数器板中形成的一系列凹槽中的每个凹槽中，
其中，在所述步进梁运动时，所述凸起与夹子计数器板接合以使得夹子计数器板运动并且改变多个离散的标记中的所述一个选择出的标记，所述一个选择出的标记相对剩余的离散的标记是可辨别的。
6.根据权利要求5所述的施夹器，其中，所述可辨别的离散的标记是通过所述夹子通道可见的。
7.根据权利要求4所述的施夹器，还包括夹子推杆，所述夹子推杆往复运动地定位在所述壳体和所述通道组件两者中的至少一个内，所述推杆具有第一端部和第二端部，所述第一端部操作地连接到所述至少一个手柄，所述第二端部限定了推动器，在所述至少一个手柄以初始量被致动时，所述推杆能够运动离开所述一对钳夹，以使得所述推动器在存放在所述夹子承载器的通道中的最远侧夹子的后方运动，并且所述推杆被配置为且适用于在所述至少一个手柄返回到初始位置时朝向所述钳夹运动，以使得所述最远侧夹子在所述钳夹之间运动。
8.根据权利要求7所述的施夹器，还包括夹子从动件，所述夹子从动件可滑动地布置在所述夹子承载器的通道内并且布置在所述多个夹子的近侧，所述夹子从动件被配置为且适用于与所述夹子承载器和所述步进梁选择性接合，其中，所述夹子从动件被配置为且适用于在所述步进梁进行往复运动时驱使所述多个夹子相对于所述夹子承载器在远侧方向上运动。
9.根据权利要求8所述的施夹器，其中，所述步进梁包括多个朝向远侧并且延伸进入所述夹子通道中的坡道，其中，所述步进梁的朝向远侧的坡道被配置为选择性地接合在所述夹子从动件中限定的第一孔，并且在所述步进梁向远侧运动时驱使所述夹子从动件向远侧运动，并且其中，所述夹子承载器的朝向远侧的坡道被配置为选择性地接合在所述夹子从动件中限定的第二孔，并且在所述步进梁向近侧运动时使得所述夹子从动件向近侧的运动停止。
10.根据权利要求1所述的施夹器，还包括钳夹组件，所述钳夹组件包括一对钳夹，所述一对钳夹从所述通道组件的与壳体相反的端部延伸出，所述钳夹组件适用于在其中容纳夹子并且所述钳夹组件能够响应于所述至少一个手柄的运动而操作以实现夹子的成形。
11.根据权利要求7所述的施夹器，其中，所述夹子推杆连接到所述步进梁，其中，所述夹子推杆的轴向平移导致伴随所述步进梁的轴向平移。
12.根据权利要求11所述的施夹器，其中，所述夹子推杆和所述步进梁被配置并且彼此连接，使得在所述夹子推杆的轴向平移和所述步进梁的轴向平移之间提供延迟。
13.根据权利要求7所述的施夹器，还包括驱动联接系统，所述驱动联接系统被配置为在所述至少一个手柄被致动时使得所述推杆向近侧运动，并且被配置为在所述至少一个手柄随后被释放时使得所述推杆向远侧运动。
14.根据权利要求13所述的施夹器，还包括驱动通道，所述驱动通道可平移且可滑动地布置在所述壳体和所述通道组件两者中的至少一个内，所述驱动通道具有第一端部和第二端部，所述第一端部操作地连接到所述至少一个手柄，所述第二端部被配置和定尺寸为选择性地接合所述一对钳夹以实现所述一对钳夹的闭合；
在所述至少一个手柄在第一方向运动时，所述驱动通道朝向钳夹组件运动，以使得所述驱动通道的第二端部面对所述一对钳夹运动从而闭合所述一对钳夹；
在所述至少一个手柄在与所述第一方向相反的第二方向上运动时，所述驱动通道运动离开所述钳夹组件，以使得所述驱动通道的第二端部运动离开所述钳夹组件从而允许所述一对钳夹打开。
15.根据权利要求14所述的施夹器，其中，所述驱动联接系统包括：
远侧联接构件，其具有第一端部，所述第一端部枢转地连接到所述推杆；以及
曲柄构件，其被枢转地支撑在所述壳体中，所述曲柄构件为基本上L形并且具有第一腿部，所述第一腿部枢转地连接到所述远侧联接构件的第二端部，并且所述曲柄构件具有第二腿部，所述第二腿部可滑动地连接到在所述驱动通道中形成的致动通道中；
其中，所述驱动通道的远侧运动使得所述曲柄构件的第二腿部可滑动地平移通过弓形槽，从而使得所述曲柄构件旋转，从而使得所述第一腿部旋转，从而使得所述远侧联接构件向近侧运动，并且从而使得所述推杆向近侧运动。
16.根据权利要求8所述的施夹器，其中，所述夹子从动件起到在所述夹子从动件由所述步进梁推进到所述一对钳夹之间的位置时锁闭的作用。
17.根据权利要求16所述的施夹器，其中，在所述夹子从动件定位于所述一对钳夹之间时，所述夹子从动件防止所述一对钳夹完全闭合，从而防止所述施夹器完成整个闭合行程。
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| US13/674,141 US9364216B2 (en) | 2011-12-29 | 2012-11-12 | Surgical clip applier with integrated clip counter |
| US13/674,141 | 2012-11-12 |
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| CN103181809A true CN103181809A (zh) | 2013-07-03 |
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| EP (1) | EP2609875B1 (zh) |
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| Publication number | Publication date |
|---|---|
| US10349936B2 (en) | 2019-07-16 |
| EP2609875A1 (en) | 2013-07-03 |
| US20130172911A1 (en) | 2013-07-04 |
| AU2012258345A1 (en) | 2013-07-18 |
| US11278287B2 (en) | 2022-03-22 |
| CA2796695A1 (en) | 2013-06-29 |
| US20160256157A1 (en) | 2016-09-08 |
| CN103181809B (zh) | 2017-12-22 |
| US20190192139A1 (en) | 2019-06-27 |
| US9364216B2 (en) | 2016-06-14 |
| EP2609875B1 (en) | 2018-04-18 |
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