CN103565488B - 包括手术支撑件的手术装置 - Google Patents

包括手术支撑件的手术装置 Download PDF

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CN103565488B
CN103565488B CN201310303690.3A CN201310303690A CN103565488B CN 103565488 B CN103565488 B CN 103565488B CN 201310303690 A CN201310303690 A CN 201310303690A CN 103565488 B CN103565488 B CN 103565488B
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anvil
surgical buttress
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CN103565488A (zh
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杰拉尔德·霍奇金森
蒂莫西·D·埃布纳
彼得·哈瑟维
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07292Reinforcements for staple line, e.g. pledgets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07257Stapler heads characterised by its anvil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07271Stapler heads characterised by its cartridge
    • FMECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F04POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
    • F04CROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS
    • F04C2270/00Control; Monitoring or safety arrangements
    • F04C2270/04Force
    • F04C2270/041Controlled or regulated
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00Metal working
    • Y10T29/49Method of mechanical manufacture
    • Y10T29/49826Assembling or joining

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Abstract

本发明提供了一种用于手术吻合装置的末端执行器,其包括砧座组件和手术支撑件。所述砧座组件包括砧座主体和砧座板,所述砧座板包括限定多个吻合钉成形腔的底面。所述砧座主体和所述砧座板能够选择性地相连接。所述手术支撑件包括支撑件主体和从所述主体延伸出的多个臂。所述臂能够布置在所述砧座板的顶面与所述砧座主体的底面之间,以在所述砧座板和所述砧座主体彼此连接时紧靠所述砧座板的所述底面支撑所述支撑件主体。本发明还公开了包括手术支撑件的手术装置。

Description

包括手术支撑件的手术装置
相关申请的交叉引用
本申请要求提交于2012年7月18日的申请号为61/672,888的美国临时专利申请的权益和优先权,该临时专利申请的全部公开内容通过引用合并于此。
技术领域
本申请涉及一种手术装置,尤其涉及一种在手术吻合装置的操作中与手术吻合装置一起使用以将多个手术吻合钉施加到身体组织上的手术支撑件。
背景技术
随着医疗和医院成本的持续增长,外科医生一直在努力开发先进的外科技术。外科领域的进步经常关系到手术技术的发展,涉及更少的侵入性手术操作并且整体上减少患者创伤。以这种方式,能够显著降低住院时间,并且因此也能够降低医院和医疗成本。
本公开包括但是不限于与内窥镜手术一同使用,内窥镜手术是近年来减少手术操作的侵入性的一种真正的巨大进步。一般而言,内窥镜手术涉及例如,切穿身体体壁,查看卵巢、子宫、胆囊、肠子、肾脏、阑尾等和/或在其上手术等。有许多普通的内窥镜手术操作,包括:仅举几例,关节镜、腹腔镜(盆腔镜检查)、胃肠镜检查、喉支气管镜检查。通常,利用套针来产生实施内窥镜手术所穿过的切口。将套针管或者插管装置伸进并且留在腹壁中合适位置上以提供内窥镜手术工具的进入通道。穿过相对较大直径的套针管插入摄像头或者内窥镜,套针管通常位于腹部切口(naval incision)处,并且允许视觉检查和扩大体腔。接着,外科医生能够在手术部位处借助诸如钳子、切割器、敷贴器等被设计为适合穿过附加的插管的特殊器械实施诊断和治疗操作。于是,代替切穿主要肌肉的较大的切口(通常12英寸以上),进行内窥镜手术的患者接受更加美观的切口,大小在5到10毫米之间。因此,和传统手术相比恢复更快并且患者需要更少的麻醉。此外,因为扩大了手术视野,所以外科医生能够更好地切开血管以及控制失血。由于更小的切口而导致大大降低热量损失和水分损失。为了解决内窥镜和/或腹腔镜手术操作的特殊需要,已经开发并且在例如美国专利No.5,040,715(Green等)、No.5,307,976(Olson,等)、No.5,312,023(Green等)、No.5,318,221(Green等)、No.5,326,013(Green等)以及No.5,332,142(Robinson等)中公开了内窥镜手术吻合装置。
在包括开放手术和内窥镜手术涉及的手术操作的许多手术操作中,经常需要吻合组织。由于必须实现组织的吻合所穿过的较小的开口,在内窥镜手术中尤其具有挑战性。用于此目的的器械可以包括两个细长构件分别用于获取或者夹紧组织。在现有技术中,首先在相对的钳夹结构之间抓取或者夹紧组织然后由手术紧固件连结组织的手术设备是众所周知的。通常,两个构件中的一个携带紧固件钉仓,紧固件钉仓容纳被布置成至少两横排的多个吻合钉,而另一个构件具有限定用于当吻合钉从吻合钉钉仓中驱出时使吻合钉钉腿成形的表面的砧座。紧固件通常为手术吻合钉的形式但是也可以使用两部分聚合紧固件。一般而言,吻合手术由纵向穿过吻合钉钉仓的凸轮条或者楔形体来执行,凸轮条作用在吻合钉推动器上以连续从吻合钉钉仓发射吻合钉。刀片可以在各排吻合钉之间行进以纵向切割和/或打开在各排吻合钉之间的吻合组织。在例如美国专利No.3,079,606和美国专利No.3,490,675中公开了这样的器械。
在美国专利No.3,499,591中公开的稍后的吻合器在切口的各侧上施加双排吻合钉。这通过设置可置换装载单元来实现,其中凸轮构件穿过在两排交错的吻合钉携带槽之间的细长的引导路径移动。吻合钉驱动构件位于槽内并且以这样的方式定位:使得吻合钉驱动构件被纵向移动的凸轮构件接触以执行从可置换装载单元的吻合钉钉仓中发射吻合钉。本申请的受让人美国外科公司(U.S.Surgical)数年来制造和销售内窥镜吻合器械。这样的器械示例包括Multifire ENDO GIATM30和Multifire ENDO GIATM60器械。在美国专利No.4,429,695和美国专利No.5,065,929中公开了这种吻合器的其他示例。
在上述一般类型的吻合器中,可以与这些器械组合使用手术支撑件材料作为对吻合线的加固以进一步促进适当地吻合钉成形同时减少由任何组织不对齐、组织异常或者组织不均匀导致的扭曲/变形。这些器械具有显著的临床效果。但是,仍然可以改进,例如降低制造和/或应用的复杂性。
发明内容
根据一个方案,本公开涉及一种用于手术吻合装置的末端执行器。所述末端执行器包括砧座组件和手术支撑件。所述砧座组件包括能够选择性地相连接的砧座主体和砧座板。所述砧座板包括限定多个吻合钉成形腔的底面。所述手术支撑件包括支撑件主体和从所述主体延伸出的多个臂。所述手术支撑件可以由无纺布材料形成并且可以由选自以下群组的材料制成,该群组包括:polyglytone6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
所述手术支撑件的所述臂可以从所述支撑件主体的侧边缘延伸出并且可以与所述支撑件主体一体形成。值得注意的是,所述手术支撑件的所述臂能够在所述支撑件主体的顶面和底面中的一个或者两者上折叠。如所能理解的,所述臂能够布置在所述砧座板的顶面与所述砧座主体的底面之间,以在所述砧座板和所述砧座主体彼此连接时紧靠所述砧座板的所述底面支撑所述支撑件主体。所述砧座主体在所述砧座主体的底面中限定一个或多个通道,用于接纳所述手术支撑件的一个或多个所述臂。
根据一个方案,一种手术吻合装置包括:第一钳夹组件、第二钳夹组件、多个紧固件以及手术支撑件。所述第一钳夹组件包括砧座主体和砧座板。所述砧座板在其底面中限定多个紧固件成形腔。所述第二钳夹组件包括限定多个紧固件保持槽的紧固件钉仓。所述多个紧固件布置在所述紧固件保持槽内,并且被配置和定尺寸为在发射所述手术吻合装置时被所述砧座板的所述紧固件成形腔成形。所述手术支撑件包括支撑件主体和从所述支撑件主体延伸出的多个臂。如所能理解的,所述手术支撑件可以由无纺布材料形成并且可以由选自以下群组的材料制成,该群组包括:polyglytone6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
所述手术支撑件的所述臂可以与所述支撑件主体一体形成并且可以从所述支撑件主体的侧表面延伸出。所述臂能够在所述支撑件主体的顶面和底面中的一个或者两者上折叠。所述臂能够布置在所述砧座板的顶面与所述砧座主体的底面之间,以紧靠所述砧座板的所述底面支撑所述支撑件主体。所述第一钳夹组件的所述砧座主体可以在其所述底面中限定一个或多个通道,用于接纳所述手术支撑件的一个或多个所述臂。在发射手术吻合装置时,可以从所述一个或多个通道中释放出一个或多个所述臂。
所述手术吻合装置可以包括刀具组件,所述刀具组件包括刀片,所述刀片能够穿过所述第一钳夹组件和第二钳夹组件中的一个或者两者移动,以切割所述手术支撑件的所述支撑件主体和所述臂中的一个或者两者,以有助于从所述砧座板的所述底面紧靠所述砧座板的所述底面释放至少所述支撑件主体。
根据又一个方案,一种将手术支撑件装设到手术吻合装置的末端执行器上的方法,包括:提供用于手术吻合装置的末端执行器。所述末端执行器包括:第一钳夹组件和第二钳夹组件。所述第一钳夹组件包括砧座主体和砧座板。所述砧座板在其底面中限定多个紧固件成形腔。所述第二钳夹组件包括限定多个紧固件保持槽的紧固件钉仓,用于保持多个紧固件,在所述吻合装置发射时所述紧固件被所述紧固件成形腔成形。所述方法涉及:提供手术支撑件,所述手术支撑件包括支撑件主体和从所述支撑件主体延伸出的多个臂;将所述手术支撑件的所述臂装设在所述砧座板的顶面与所述钳夹的底面之间,使得所述支撑件主体邻近于所述砧座板的所述底面布置。
所述方法可以包括将所述手术支撑件的所述臂定位在由所述砧座板的所述底面限定的通道内的步骤。一个步骤可以包括由无纺布材料形成所述手术支撑件的步骤。所述方法可以涉及由选自以下群组的材料形成所述手术支撑件,该群组包括:polyglytone6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
附图说明
通过下面结合附图的详细描述,本公开的上述和其他方案、特征以及优势将变得更加显而易见,附图中:
图1是根据本公开的内窥镜手术吻合装置的一个实施例的立体图;
图2是图示出在紧固件施加操作中正在连续发射紧固件时,当前公开的手术吻合装置的末端执行器的放大立体图;
图3是带有固定到其砧座组件的手术支撑件的末端执行器的另一立体图;
图4是图3中所示的手术支撑件的立体图;
图5是图3中所示的末端执行器的砧座组件的零件分离的仰视立体图;以及
图6是图5中所示的砧座组件的零件组装的仰视立体图。
具体实施方式
如此处所使用的,术语“临床医师”指医生、护士或者任何其他看护提供者并且可以包括支持人员。此处将参照附图来描述本公开的特定实施例。如在附图中所示和在下面整篇说明中所描述的,正如当表示物体上的相对定位时通常所用的,术语“近侧”指更靠近临床医师的装置的端部,而术语“远侧”指离临床医师更远的装置的端部。在下文的描述中,不再详细描述众所周知的功能或者结构以避免因不必要的细节使得本公开模糊不清。
一般而言,包括开放装置和内窥镜装置的线性吻合器,可以具有两个细长构件,其分别用于获取或者夹紧组织。通常,一个构件带有吻合钉钉仓,该吻合钉钉仓容纳被布置成至少两横排的多个吻合钉,而另一个构件具有砧座,该砧座限定当吻合钉被从吻合钉钉仓推出时用于使吻合钉钉腿成形的表面。一般而言,吻合手术由纵向穿过吻合钉钉仓行进的凸轮条来执行,凸轮条作用在吻合钉推动器上以从吻合钉钉仓中连续地射出吻合钉。刀片可在吻合钉排之间移动以纵向地切割和/或切开吻合钉排之间的被吻合的组织。在例如美国专利第6,202,914号中公开了这种器械,该专利的全部内容通过引用合并于此。
有些吻合器在切口的各侧上施加双排吻合钉。这通过设置可置换装载单元来实现,凸轮构件在该可置换装载单元中沿着在两组交错的吻合钉携带槽之间的细长引导路径移动。吻合钉驱动构件位于槽内并且以这样的方式定位:使得吻合钉驱动构件被纵向移动的凸轮构件接触以执行从可置换装载单元的吻合钉钉仓中发射吻合钉。美国专利第5,065,929号中公开了这样的吻合器的示例,该专利的全部内容通过引用合并于此。
上述的一些器械被设计用于外科医生可以徒手进入手术部位的常规手术操作。然而,在内窥镜或者腹腔镜操作中,穿过较小的切口或者穿过通过皮肤中较小的进入创口插入的狭窄的插管来实施手术。为了解决内窥镜或者腹腔镜操作的特殊需要,已经开发并且在例如美国专利第5,865,361号中公开了内窥镜手术吻合装置,该专利的全部内容通过引用合并于此。
现在参照附图,附图中相似的附图标记表示在几个视图中相同的或者大致类似的元件,图1图示出可以被布置为用于微创(即内窥镜或者腹腔镜等)或者开放的吻合操作的手术吻合装置10。手术吻合装置10包括外壳20以及从外壳20向远侧延伸的细长构件30。细长构件30的远侧端支撑末端执行器100的近侧端,在末端执行器100的近侧端和远侧端之间限定纵轴“L”。末端执行器100包括第一钳夹构件或者钉仓组件102以及第二钳夹构件或者砧座组件110,钉仓组件102被配置为选择性地接纳吻合钉钉仓104。钉仓组件102可以是单次使用装载单元。当然,吻合钉钉仓104容纳吻合钉和/或除吻合钉以外的其他手术紧固件。钉仓组件102和/或吻合钉钉仓104可以是选择性地单独可替换或者整体可替换。
参照图2,钉仓组件102的吻合钉钉仓104包括钉仓外壳106,其包括组织接触面106a,组织接触面106a具有形成于其中的容纳多个紧固件或者吻合钉70的多排吻合钉保持槽(此处也称为吻合钉槽和紧固件槽)108。参照图2和图6,当向远侧将凸轮条和/或滑板80推进到多个吻合钉推进器构件90时,在限定于砧座组件110的组织接触面120b中的紧固件成形腔124中可以连续成形多个吻合钉70,下文将更加详细地描述。
现在参照图3,末端执行器100的砧座组件110包括砧座板120、砧座主体130以及手术支撑件140(如此处所使用的,“手术支撑件”包括小拭子、密封垫、支撑件或者吻合钉线加固结构)。砧座组件110或者其各部分可以是可置换的或者可重用的。
如图4所示,手术支撑件140包括具有大致矩形形状的主体142,以及多个臂144。主体142和多个臂144可以整体形成或者为单独可附接的。尤其是,手术支撑件140包括在主体142的近侧区域处从主体142的相对侧边缘或者表面142a、142b侧向延伸的第一臂144a和第二臂144b。第三臂144c和第四臂144d在主体142的远侧区域处从主体142的相对侧表面142a、142b侧向延伸出。当然,可以沿主体142的侧表面142a、142b任何位置布置任何数量的臂144。
可以横向或者大致横向(即非垂直)于在主体142的近侧端与远侧端之间通过主体142延伸的纵轴“L”布置一个或多个臂144。如所能理解的,一个或多个臂144可以以相对于主体142的纵轴的任何合适的角度布置并且可以延伸到距主体142的侧表面142a、142b适当的距离。而且,臂144中的一个或多个可以具有任何合适的长度、宽度和/或厚度。任何数量的臂144可以和任何数量的其他臂144相偏离和/或对齐。
在实施例中,手术支撑件140或者其各部分可以由生物可降解材料制成,生物材料选自以下群组:天然胶原材料,羊肠线,和合成树脂,包括那些来自于碳酸亚烃酯,三亚甲基碳酸酯,四亚甲基碳酸酯,己内酯,戊内酯,二氧环己酮,聚酐,聚酯,聚丙烯酸酯,聚甲基丙烯酸甲酯,聚氨基甲酸乙酯,乙醇酸,乳酸,乙交酯,丙交酯,聚羟基丁酸酯,聚原酸酯,聚羟基链烷酸酯,其均聚物,及其共聚物。在实施例中,手术支撑件140或者其各部分可以由生物不可降解材料制成,生物不可降解材料选自以下群组:聚烯烃,聚乙烯,聚二甲基硅氧烷,聚丙烯,聚乙烯和聚丙烯的共聚物,聚乙烯和聚丙烯的混合物,超高分子量聚乙烯,聚酰胺,聚酯,聚对苯二甲酸乙二醇酯,聚四氟乙烯,聚醚-酯,聚丁烯酯,聚四亚甲基醚二醇,1,4-丁二醇,和聚氨酯。在实施例中,手术支撑件140或者其各部分可以由无纺布材料制成,无纺布材料选自以下群组:polyglytone6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
现在参照图5至图6,砧座主体130限定穿过砧座主体130的第一横向通道132和第二横向通道134,当手术支撑件140与砧座主体130适当地对齐时,第一横向通道132和第二横向通道134与手术支撑件140的一个或多个臂144对齐。第一通道132和第二通道134被定尺寸为接纳手术支撑件140的一个或多个臂144以在砧座主体130与砧座板120之间支撑手术支撑件140的臂144同时保持手术支撑件140的主体142邻近于砧座板120的底或者组织接触面120b而定位。尤其是,第一通道132和第二通道134从砧座主体130的底面130b凹进并且以沿砧座主体130纵向间隔开的关系布置。
砧座主体130可以包括砧座主体固定特征件136,砧座主体固定特征件136与砧座板固定特征件122相配合以在啮合时将砧座主体130和砧座板120固定在一起。如所能理解的,一个或多个固定特征件可以包括任何合适的机械特征件或者化学特征件。例如,如图6所图示的,销122a可以从砧座板120的顶面120a延伸以与限定在砧座主体130内的孔穴136a相啮合。其他机械配置可以包括钩环紧固件、摩擦配合啮合和/或卡扣啮合。在实施例中,可以在砧座主体130和/或砧座板120的任何合适的表面上包括粘性和/或磁性材料以有助于固定砧座主体130和砧座板120。
值得注意的是,手术支撑件140或者其各部分可以经由任何合适的化学特征件或者机械特征件(例如,粘性、磁性、钩环、卡扣、带子、线绳、焊接等)可操作地连接到砧座组件110或者其各部分。
为了组装,将手术支撑件140邻近于砧座板120定位,使得手术支撑件140的主体142紧靠/邻近于砧座板120的底面120b布置,并且使得手术支撑件140的臂144围绕砧座板120的侧面120c、120d折叠以沿砧座板120的顶面120a定位臂144。如此这样,砧座板120可以经由固定特征件122、136固定到砧座主体130,使得手术支撑件140的臂144布置在砧座主体130的底面130b与砧座板120的顶面120a之间的通道132、134内。在附接手术支撑件140之前,可以适宜地将砧座板120固定到砧座主体130。如此这样,手术支撑件140邻近于砧座板120定位,使得手术支撑件140的臂144可以插入通道132、134内以邻近于砧座板120的底面120b装设手术支撑件140的主体142,使得手术支撑件140的主体142被布置为与砧座板120的底面120b接触。
再次参照图5至图6,在适当地附接到砧座板120和/或砧座主体130上时,手术支撑件140的主体142可以在砧座板120的近侧部和远侧部之间延伸。尤其是,手术支撑件140的主体142可以大致覆盖限定在砧座板120中的紧固件成形腔124(图6)的部分或者全部。
在用手术吻合装置10的第一钳夹构件102和第二钳夹构件110夹紧患者的组织之时,可以接着发射手术吻合装置10以部署紧固件70穿过吻合钉钉仓104的紧固件槽108。发射时,紧固件70穿过紧固件槽108并且紧固件70的钉腿穿透被第一钳夹构件102和第二钳夹构件110以及手术支撑件140的主体142夹紧的组织。紧固件70接着紧贴砧座板120的紧固件成形腔124而成形,由此将手术支撑件140的主体142贴附在被夹紧的组织上。随之,可平移地布置在末端执行器100内的刀片(未示出)穿过手术支撑件140的主体142至少一部分,切穿夹紧在第一钳夹构件102和第二钳夹构件110之间的组织。在某些实施例中,刀片被构造和配置为在发射前切穿主体142。
手术支撑件140从吻合钉钉仓104的钉仓外壳106脱离,使得手术支撑件140的主体142和/或臂144可以保持经由紧固件70附接到组织上。可替代地,手术支撑件140的臂144和/或主体142能够用剪刀切割,或者可以包括用于将手术支撑件140的任何合适的部分(即臂144)从手术支撑件140的其他部分(即主体142)上分离的穿孔件或者易碎特征件。
如果需要进一步应用或者使用手术支撑件,则如上所述,可以将新的手术支撑件140装设到砧座组件110上。用户可以接着重复紧固程序。如果需要,可以进一步想到的是,临床医师可以在使用手术吻合装置10之前将手术支撑件140从砧座组件110上去除。
可替代地或者可附加地,如所能理解的,在发射之前或者之后可以在钉仓组件102上定位任何合适的手术支撑件。
本领域技术人员会理解的是,在此具体描述并图示在附图中的结构和方法为非限制性的示例性实施例,并且描述、公开和附图应仅构成特定实施例的示例。因此应该理解的是,本公开不限于所描述的精确实施例,本领域技术人员在不偏离本公开的范围或精神的前提下能够实现多种其他的改变和修改。另外,能想到的是,联系一个示例性实施例所说明或描述的元件和特征可以与另一示例性实施例的元件和特征进行组合而不偏离本公开的范围,而这种修改和变型也被有意包括在本公开的范围内。因此,本公开的主题不受已经具体示出和所描述的内容的限制。

Claims (20)

1.一种用于手术吻合装置的末端执行器,包括:
砧座组件,其包括砧座主体和砧座板,所述砧座板包括限定多个吻合钉成形腔的底面,所述砧座主体和所述砧座板能够选择性地相连接;
手术支撑件,其包括支撑件主体和从所述支撑件主体延伸出的多个臂,所述臂能够布置在所述砧座板的顶面与所述砧座主体的底面之间,以在所述砧座板和所述砧座主体彼此连接时紧靠所述砧座板的所述底面支撑所述支撑件主体,
其中,所述砧座主体包括砧座主体固定特征件,而所述砧座板包括砧座板固定特征件,所述砧座主体固定特征件与所述砧座板固定特征件相配合以在啮合时将所述砧座主体和所述砧座板固定在一起且将所述手术支撑件的臂布置在所述砧座主体的底面与所述砧座板的顶面之间。
2.根据权利要求1所述的末端执行器,其中所述砧座主体在所述砧座主体的底面中限定至少一个通道,用于接纳所述手术支撑件的所述臂中的至少一个。
3.根据权利要求2所述的末端执行器,其中所述手术支撑件由无纺布材料形成。
4.根据权利要求2所述的末端执行器,其中所述手术支撑件由选自以下群组的材料制成,该群组包括:polyglytone 6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
5.根据权利要求1所述的末端执行器,其中所述手术支撑件的所述臂与所述支撑件主体一体形成。
6.根据权利要求1所述的末端执行器,其中所述手术支撑件的所述臂从所述支撑件主体的侧边缘延伸出。
7.根据权利要求6所述的末端执行器,其中所述手术支撑件的所述臂能够在所述支撑件主体的顶面和底面中的至少一个面上折叠。
8.一种手术吻合装置,包括:
第一钳夹组件,其包括砧座主体和砧座板,所述砧座板在其底面中限定多个紧固件成形腔;
第二钳夹组件,其包括限定多个紧固件保持槽的紧固件钉仓;
多个紧固件,其布置在所述紧固件保持槽内,并且被配置和定尺寸为在发射所述手术吻合装置时由所述砧座板的所述紧固件成形腔成形;以及
手术支撑件,其包括支撑件主体和从所述支撑件主体延伸出的多个臂,所述臂布置在所述砧座板的顶面与所述砧座主体的底面之间,以紧靠所述砧座板的所述底面支撑所述支撑件主体,
其中,所述砧座主体包括砧座主体固定特征件,而所述砧座板包括砧座板固定特征件,所述砧座主体固定特征件与所述砧座板固定特征件相配合以在啮合时将所述砧座主体和所述砧座板固定在一起且将所述手术支撑件的臂布置在所述砧座主体的底面与所述砧座板的顶面之间。
9.根据权利要求8所述的手术吻合装置,其中所述砧座主体在其所述底面中限定至少一个通道,用于接纳所述手术支撑件的所述臂中的至少一个。
10.根据权利要求9所述的手术吻合装置,其中在发射手术吻合装置时,从所述至少一个通道中释放出至少一个所述臂。
11.根据权利要求8所述的手术吻合装置,其中所述手术支撑件由无纺布材料形成。
12.根据权利要求8所述的手术吻合装置,其中所述手术支撑件由选自以下群组的材料制成,该群组包括:polyglytone 6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
13.根据权利要求8所述的手术吻合装置,进一步包括刀具组件,所述刀具组件包括刀片,所述刀片能够穿过所述第一钳夹组件和第二钳夹组件中的至少一个移动,以切割所述手术支撑件的所述支撑件主体和所述臂中的至少一个,以有助于从所述砧座板的所述底面紧靠所述砧座板的所述底面释放至少所述支撑件主体。
14.根据权利要求8所述的手术吻合装置,其中所述手术支撑件的所述臂与所述支撑件主体一体形成。
15.根据权利要求8所述的手术吻合装置,其中所述手术支撑件的所述臂从所述支撑件主体的侧表面延伸出。
16.根据权利要求15所述的手术吻合装置,其中所述臂能够在所述支撑件主体的顶面和底面中的至少一个面上折叠。
17.一种将手术支撑件装设到手术吻合装置的末端执行器上的方法,所述方法包括以下步骤:
提供用于手术吻合装置的末端执行器,所述末端执行器包括:第一钳夹组件和第二钳夹组件,所述第一钳夹组件包括砧座主体和砧座板,所述砧座板在其底面中限定多个紧固件成形腔,所述第二钳夹组件包括限定多个紧固件保持槽的紧固件钉仓,用于保持多个紧固件,在所述吻合装置发射时所述紧固件由所述紧固件成形腔成形;
提供手术支撑件,所述手术支撑件包括支撑件主体和从所述支撑件主体延伸出的多个臂;
将所述手术支撑件的所述臂装设在所述砧座板的顶面与所述砧座主体的底面之间,使得所述支撑件主体邻近于所述砧座板的所述底面布置,
其中,所述砧座主体包括砧座主体固定特征件,而所述砧座板包括砧座板固定特征件,所述砧座主体固定特征件与所述砧座板固定特征件相配合以在啮合时将所述砧座主体和所述砧座板固定在一起且将所述手术支撑件的臂布置在所述砧座主体的底面与所述砧座板的顶面之间。
18.根据权利要求17所述的方法,进一步包括将所述手术支撑件的所述臂定位在由所述砧座板的所述底面限定的通道内的步骤。
19.根据权利要求17所述的方法,进一步包括由无纺布材料形成所述手术支撑件的步骤。
20.根据权利要求19所述的方法,进一步包括由选自以下群组的材料形成所述手术支撑件的步骤,该群组包括:polyglytone 6211、乙交酯、己内酯、三亚甲基碳酸酯、丙交酯及其组合物。
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US9572576B2 (en) 2017-02-21
AU2013206777B2 (en) 2017-04-20
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CA2820466A1 (en) 2014-01-18
US20170150967A1 (en) 2017-06-01
US10485540B2 (en) 2019-11-26
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US11399832B2 (en) 2022-08-02
JP6360286B2 (ja) 2018-07-18
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AU2013206777A1 (en) 2014-02-06
US20200085430A1 (en) 2020-03-19
US20140021242A1 (en) 2014-01-23
CN103565488A (zh) 2014-02-12

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