CN103565489A - 手术设备 - Google Patents
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- A61B17/072—Surgical 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
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- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
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- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F04—POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
- F04C—ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS
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Abstract
本发明公开了一种手术设备。所述手术设备具有带有第一钳夹和第二钳夹的钳夹组件、枢转连接件、以及被配置为枢转所述钳夹组件的凸轮组件。具有第一部分、第二部分以及第三部分的凸轮狭槽可以具有Y型构造。挠性轴允许所述钳夹组件的进一步枢转。
Description
技术领域
本公开涉及用于执行内窥镜手术操作的手术装置、设备和/或系统,以及其使用方法。更特别地,本公开涉及机电的、手持式手术装置、设备和/或系统,其被配置为与可拆卸的一次性装载单元和/或单次使用装载单元一起使用,用来夹紧、切割和/或吻合组织。
背景技术
用于在工具组件的相对的钳夹结构之间抓取或夹紧组织并且此后紧固所夹紧的组织的手术设备在本领域是公知的。这些设备可以包括用于切割紧固的组织的刀具。这些紧固件典型地为手术吻合钉的形式,但是由适于手术使用的材料制成的两部件式紧固件也是公知的。
典型地,工具构件包括吻合钉钉仓以及砧座,其中,吻合钉钉仓容纳设置为至少两个横向间隔的排的多个吻合钉,砧座包括多个吻合钉成形凹处,其用于在这些吻合钉从钉仓被驱出时接纳这些吻合钉的钉腿成形并且使这些吻合钉的钉腿成形。通常,利用凸轮杆作用在吻合钉推动器上以从吻合钉钉仓顺序地射出这些吻合钉,通过纵向地穿行通过吻合钉钉仓的凸轮杆完成吻合操作。刀具可以在吻合钉排之间穿行以纵向地切割和/或打开吻合钉排之间的吻合组织。
在腹腔镜检查和/或内窥镜手术操作中,手术操作通过小的切口或插通患者中的小的进入创伤的窄的插管执行。由于减少患者外伤、缩短患者恢复周期以及总体成本的实质性降低,腹腔镜检查操作优选于开放式操作。为了解决内窥镜和/或腹腔镜检查手术操作的具体需要,已经开发了使外科医生更容易进入手术部位的内窥镜手术吻合设备。典型地,这些吻合设备包括可关节式运动的工具构件,所述可关节式运动的工具构件被支撑在吻合设备的远侧端的附近。工具构件可以被选择性地被操纵以允许外科医生在限定的空间中操纵工具组件。存在对允许外科医生以各种构造操纵工具构件的改进的关节式运动和/或枢转机构的需要。
发明内容
参照附图,以下会更详细地描述本发明示例性实施例的更多细节和方案。
在本公开的一个方案中,手术设备包括:钳夹组件,所述钳夹组件包括第一钳夹和能够相对于所述第一钳夹移动的第二钳夹。枢转连接件联接至所述钳夹组件的近侧端,所述枢转连接件包括远侧连结构件和近侧连结构件。所述钳夹组件和所述远侧连结构件限定了在所述钳夹组件的近侧端和所述远侧连结构件的远侧端之间延伸的第一纵向轴线,并且所述近侧连结构件限定了第二纵向轴线。所述设备包括凸轮组件,所述凸轮组件被配置为使所述钳夹组件相对于所述近侧连结构件绕与所述第一纵向轴线和第二纵向轴线垂直的枢转轴线枢转。
所述设备可以包括手柄组件和被配置为将所述手柄组件和所述钳夹组件相互连接的细长主体。所述细长主体可以包括:挠性轴,其联接至所述近侧连结构件的所述近侧端;以及刚性轴部,其联接至所述挠性轴的所述近侧端,其中所述刚性轴部限定了第三纵向轴线并且所述挠性轴被配置为所述钳夹组件和所述枢转连接件相对于所述刚性轴的第三纵向轴线做关节式运动。
在一些实施例中,所述远侧连结构件具有在所述远侧连结构件的近侧端处的凸轮狭槽并且所述设备进一步包括布置在所述凸轮狭槽中的凸轮销。所述凸轮狭槽具有第一部分、第二部分、以及第三部分,所述第一部分、第二部分、以及第三部分相对于彼此成角度地延伸。在一些实施例中,所述凸轮狭槽具有Y形构造。所述设备可以包括具有所述凸轮销的活动U形夹。
在一些实施例中,所述远侧连结构件包括一对相对的凸轮狭槽并且所述近侧连结构件具有与其相关联的U形夹,所述U形夹具有布置在所述一对相对的凸轮狭槽内的一对凸轮销,使得所述U形夹的移动使所述钳夹组件相对于所述近侧连结构件绕所述枢转轴线枢转。
所述设备可以进一步包括:驱动螺杆,其布置在所述钳夹组件内;以及驱动轴,其布置在所述枢转连接件内,所述驱动轴被配置为接合所述驱动螺杆并且在第一方向上旋转以使所述第二钳夹相对于所述第一钳夹移动。
在一些实施例中,所述设备进一步包括:旋转连杆,其布置在所述近侧连结构件内,所述旋转连杆限定贯通其中的管腔,所述驱动轴布置在所述管腔中。
所述枢转连接件可以进一步包括初级齿轮组件。所述初级齿轮组件包括:初级第一齿轮,其联接至所述钳夹组件,所述初级第一齿轮被配置为使所述钳夹组件绕所述第一纵向轴线旋转;以及初级第二齿轮,其联接至所述驱动轴。所述枢转连接件可以包括次级齿轮组件,所述次级齿轮组件具有:次级第一齿轮,其联接至所述初级第一齿轮,所述次级第一齿轮被配置为当所述钳夹组件和所述远侧连结构件处于枢转构造时使所述钳夹组件绕第一纵向轴线旋转;以及次级第二齿轮,其联接至所述初级第二齿轮,所述次级第二齿轮被配置为使所述第二钳夹相对于所述第一钳夹移动。
所述旋转连杆能够通过所述U形夹在远侧方向上移动并且被配置为当所述钳夹组件和所述远侧连结构件处于所述枢转构造时接合所述次级第一齿轮。在一些实施例中,所述驱动轴被配置为当处于近侧位置时接合所述旋转连杆并且当所述钳夹组件和所述远侧连结构件处于所述枢转构造时在第一方向上旋转以使所述钳夹组件绕所述第一纵向轴线旋转。
所述驱动轴可以被配置为在远侧位置上接合所述次级第二齿轮并且在所述第一方向上旋转以使所述第二钳夹相对于所述第一钳夹移动。
在本公开的另一个方案中,手术设备包括:钳夹组件,其具有第一钳夹和能够相对于所述第一钳夹移动的第二钳夹;以及驱动螺杆,其被配置为使所述第二钳夹相对于所述第一钳夹移动。所述设备具有枢转连接件,其联接至所述钳夹组件的近侧端,所述枢转连接件包括远侧连结构件和近侧连结构件,其中所述钳夹组件和所述远侧连结构件限定了在所述钳夹组件的近侧端和所述远侧连结构件的远侧端之间延伸的第一纵向轴线,并且所述近侧连结构件限定了第二纵向轴线。所述设备包括:凸轮组件,其联接至所述远侧连结构件和所述近侧连结构件,所述凸轮组件被配置为使所述钳夹组件相对于所述近侧连结构件绕与所述第一纵向轴线和第二纵向轴线垂直的枢转轴线从所述第一纵向轴线和第二纵向轴线基本上彼此平行的对准构造枢转至所述第一纵向轴线和所述第二纵向轴线基本上彼此垂直的枢转构造。
所述设备可以包括:驱动轴,其布置在所述枢转连接件内,所述驱动轴被配置为当所述钳夹组件处于所述对准构造和所述枢转构造中的一种构造时接合所述驱动螺杆并且在第一方向上旋转以使所述第二钳夹相对于所述第一钳夹移动。在一些实施例中,在对准构造中,所述驱动轴被配置为直接接合所述驱动螺杆。
在一些实施例中,枢转连接件进一步包括初级齿轮组件,所述初级齿轮组件具有:初级第一齿轮,其联接至钳夹组件,所述初级第一齿轮被配置为使所述钳夹组件绕所述第一纵向轴线旋转;以及初级第二齿轮,其联接至被配置为使所述第二钳夹相对于所述第一钳夹移动的驱动螺杆。所述枢转连接件可以具有次级齿轮组件,所述次级齿轮组件包括:次级第一齿轮,其联接至所述初级第一齿轮,所述次级第一齿轮被配置为当所述钳夹组件和所述远侧连结构件处于枢转构造时使所述钳夹组件绕第一纵向轴线旋转;以及次级第二齿轮,其联接至所述初级第二齿轮,所述次级第二齿轮被配置为使所述第二钳夹相对于所述第一钳夹移动。
在一些实施例中,在枢转构造中,所述驱动轴被配置为通过所述次级第二齿轮接合所述驱动螺杆。
在本公开的另一个方案中,手术设备包括:钳夹组件,所述钳夹组件包括第一钳夹和能够相对于所述第一钳夹移动的第二钳夹;枢转连接件,其联接至所述钳夹组件的近侧端,所述枢转连接件包括远侧连结构件和近侧连结构件,其中所述钳夹组件和所述远侧连结构件限定了在所述钳夹组件的近侧端和所述远侧连结构件的远侧端之间延伸的第一纵向轴线,并且所述近侧连结构件限定了第二纵向轴线,所述钳夹组件能够相对于所述近侧连结构件绕与所述第一纵向轴线和第二纵向轴线垂直的枢转轴线枢转。所述设备包括在所述枢转连接件近侧的挠性轴,挠性部分具有容纳多个根线缆的多个开口以实现所述挠性部分的挠曲。
所述挠性轴可以包括多个段,每个段均具有在其远侧端处的球窝接头以及限定承窝的近侧端。所述远侧连结构件可以具有在所述远侧连结构件的近侧端处的凸轮狭槽并且进一步包括布置在所述凸轮狭槽中的凸轮销。
所述凸轮狭槽可以具有第一部分、第二部分以及第三部分,所述第一部分、第二部分以及第三部分相对于彼此成角度地延伸。所述凸轮狭槽可以具有Y形构造。在一些实施例中,所述设备包括具有所述凸轮销的活动U形夹。
在一些实施例中,所述远侧连结构件包括一对相对的凸轮狭槽并且所述近侧连结构件具有与其相关联的U形夹,所述U形夹具有布置在所述一对相对的凸轮狭槽内的一对凸轮销,使得所述U形夹的移动使所述钳夹组件相对于所述近侧连结构件绕所述枢转轴线枢转。
附图说明
这里参照附图描述了本公开的各种实施例,其中:
图1是根据本公开的机电手术系统的立体图;
图2是根据本公开的图1的机电手术系统的手术器械、细长构件、以及末端执行器的分解立体图;
图3是根据本公开的沿图1的3-3截取的图1的手术器械的侧剖视图;
图4是根据本公开的沿图1的4-4截取的图1的手术器械的俯视剖视图;
图5是根据本公开的图1的手术器械的正视立体图,其中图2中的细长构件与所述手术器械分离;
图6是根据本公开的处于关节式运动和枢转构造的图1的细长构件和末端执行器的正视立体图;
图7是根据本公开的图1的末端执行器的侧剖视图;
图8是根据本公开的图1的末端执行器的放大的侧剖视图;
图9是根据本公开的图1的末端执行器的放大的后视立体图;
图10是根据本公开的驱动联接组件的局部分解侧视图;
图11是根据本公开的图1的末端执行器的分解立体图;
图12是根据本公开的图1的末端执行器的侧剖视图;
图13是根据本公开的图1的末端执行器的枢转连接件的仰视立体图;
图14是根据本公开的图13的枢转连接件的俯视立体图;
图15是根据本公开的图13的枢转连接件的分解立体图;
图16是根据本公开的在驱动轴脱离情况下的处于对准构造的图13的枢转连接件的立体剖面图;
图17是根据本公开的在驱动轴接合情况下的处于对准构造的图13的枢转连接件的立体剖面图;
图18是根据本公开的在驱动轴脱离情况下的处于枢转构造的图13的枢转连接件的立体剖面图;
图19是根据本公开的在驱动轴接合情况下的处于枢转构造的图13的枢转连接件的立体剖面图;
图20是根据本公开的处于对准构造的图13的枢转连接件的侧视部分分解图;
图21是根据本公开的在凸轮销接合凸轮狭槽的第二部分的情况下的图13的枢转连接件从对准构造转换至枢转构造的侧视图;
图22是根据本公开的在凸轮销接合在凸轮狭槽的第二部分中的情况下的图13的枢转连接件从对准构造转换至枢转构造的侧视图;
图23是根据本公开的在凸轮销接合凸轮狭槽的第三部分的情况下的图13的枢转连接件从对准构造转换至枢转构造的侧视图;以及
图24是根据本公开的在凸轮销接合在凸轮狭槽的第三部分中的情况下的处于枢转构造的图13的枢转连接件的侧视图。
具体实施方式
现在将参照附图详细描述本公开的机电手术系统、装置和/或设备的实施例,其中在多幅附图的每幅附图中相同附图标记表示相同的或对应的元件。在本文中使用时,术语“远侧”是指所述机电手术系统、装置和/或设备或其部件的较远离用户的部分,而术语“近侧”是指所述机电手术系统、装置和/或设备或其部件的较接近用户的部分。术语“左侧”和“右侧”分别是指,当所述手术系统、装置和/或设备定向在非旋转形态下时,从近侧端、从面向所述机电手术系统、装置和/或设备远侧端的用户角度来看,所述机电手术系统、装置和/或设备、或其部件的在左侧(如左边)和右侧(如右边)的部分。
首先参照图1至图5,根据本公开的一个实施例,显示了一种机电的、手持式、电动手术系统且一般由附图标记10表示。机电手术系统10包括一种手术装置或设备,为机电的、手持式、电动手术器械100的形式,其被配置用于经由轴组件200选择性地将多个不同的末端执行器400附接于此。末端执行器400和轴组件200配置为通过机电的、手持式、电动手术器械100来进行致动和操纵。特别地,手术器械100、轴组件200以及末端执行器400都是彼此可分离的,以便配置手术器械100来选择性地连接轴组件200,并且反过来,轴组件200配置为选择性地连接多个不同的末端执行器400中的任何一个末端执行器。
为了详细地说明示例性的机电的、手持式、电动手术器械100的结构和操作,可以参考于2008年9月22日提交、申请号为PCT/US2008/077249的国际申请(国际公开号为WO2009/039506)和于2009年11月20日提交的序列号为12/622,827的美国专利申请,每个申请的全部内容通过引用合并于此。
如图1至图4所示,通常,手术器械100包括手柄壳体102,手柄壳体102包括下壳体部分104、中壳体部分106以及上壳体部分108,其中,中壳体部分106从下壳体部分104延伸出和/或被支撑在下壳体部分104上,上壳体部分108从中壳体部分106延伸出和/或被支撑在中壳体部分106上。中壳体部分106和上壳体部分108被分离成远侧半部110a和近侧半部110b,其中,远侧半部110a从下壳体部分104延伸出且与下壳体部分104整体地形成,近侧半部110b通过采用多个紧固件(图3和图4)能够与远侧半部110a相连接。当接合时,远侧半部110a与近侧半部110b共同限定了手柄壳体102,手柄壳体102内有空腔102a,控制组件150和驱动机构160被布置在空腔102a中。器械100还包括被联接到控制组件150和驱动机构160的电源(未显示)。如在下面进一步详细讨论,控制组件150可以包括一个或多个逻辑控制器和/或用户接口(例如,开关、按钮、扳机、触摸屏等),并被配置用来控制器械100,特别是驱动机构160的各种操作。
器械100的下壳体部分104限定了形成在其上表面的小孔(未显示),它位于中壳体部分106的下方或内部。下壳体部分104的小孔提供了通道,可供电线和其他各种电导线穿过以将位于下壳体部分104中的电气部件(例如,电源和任何对应的功率控制电路)与位于中壳体部分106和/或上壳体部分108中的电气部件(例如,控制组件150、驱动机构160等)互相连接。
参照图3和图4,上壳体部分108的远侧半部110a限定了鼻部分或连接部分108a。鼻锥114被支撑在上壳体部分108的鼻部分108a上。手柄壳体102的上壳体部分108提供了壳体,其中布置驱动机构160。为了实现器械100的各种操作,配置驱动机构160来驱动轴和/或齿轮部件。特别地,驱动机构160被配置为驱动轴和/或齿轮部件,以便使得末端执行器400相对于手柄壳体102选择性地绕着由轴组件200的刚性部分204限定的纵向轴线A-A(图6)旋转,以使得末端执行器400的钳夹构件相对于彼此运动和/或发射紧固件,以便切断末端执行器400内抓取的组织。
如图3和图4所示,驱动机构160包括相对于轴组件200紧邻近侧定位的选择变速箱组件162。在选择变速箱组件162近侧的是具有第一电机164的功能选择模块163,其起到选择性地移动选择变速箱组件162内的齿轮元件来与具有第二电机166的输入驱动部件165相啮合的作用。特别参照图5,上壳体部分108的远侧半部110a限定了连接部分108a,连接部分108a被配置为用来接受轴组件200对应的驱动联接组件210。
继续参照图5,器械100的连接部分108a包括用来接收轴组件200的驱动联接组件210的筒状凹部108b。连接部分108a容纳三个可旋转的驱动连接器118、120、122。当轴组件200与器械100配合时,三个可旋转的驱动连接器(即,器械100的第一驱动连接器118、第二驱动连接器120以及第三驱动连接器122)中的每一个驱动连接器都可以机械地与其对应的可旋转的连接器套管相接合,对应的连接器套管即:轴组件200的第一连接器套管218、第二连接器套管220以及第三连接器套管222。
器械100的驱动连接器118、120、222与轴组件200的连接器套管218、220、222的配合允许经由三个对应的连接器接口中的每一个连接器接口独立地传递旋转力。器械100的驱动连接器118、120、122被配置为通过驱动机构160独立地旋转。在这点上,驱动机构160的功能选择模块163选择器械100的驱动连接器118、120、122中的哪一个或多个驱动连接器由驱动机构160的输入驱动部件165来驱动。
继续参照图3和图4,驱动机构160包括选择变速箱组件162和功能选择模块163,其中功能选择模块163被定位在选择变速箱组件162的近侧处,其功能为选择性地移动选择变速箱组件162内的齿轮元件来与第二电动机166相接合。这样,驱动机构160就可以在给定时间选择性地驱动器械100的驱动连接器118、120、122中的一个或多个。
因为器械100的驱动连接器118、120、122中的每一个驱动连接器都具有与轴组件200的相应的连接器套管218、220、222的键和/或基本上非可旋转的接口,所以当轴组件200被联接到器械100上时,会选择性地将旋转力从器械100的驱动机构160传递给轴组件200。
器械100的驱动连接器118、120和/或122选择性的旋转允许器械100选择性地致动末端执行器400的不同功能。在一些实施例中,可以使用任意数量的驱动连接器118、120和/或122来操作末端执行器400。如以下更详细地讨论所述,器械100的第一驱动连接器118的选择性的且独立的旋转对应于末端执行器400的钳夹构件的选择性的且独立的打开和闭合,以及对应于末端执行器400的致动滑块440(图8)的驱动。器械100的第三驱动连接器120、122的选择性的且独立的旋转对应于末端执行器400相对于轴组件200的选择性的且独立的枢转。
图6显示了轴组件200以及末端执行器400。轴组件200包括在其近侧端部处的刚性部分204,刚性部分204将驱动联接组件210和挠性部分或挠性轴202相互连接。轴组件200还包括将挠性部分202与末端执行器400相互连接的枢转连接件500。如图7和图8所示,刚性部分204容纳了第一连接器套管218,第一连接器套管218被联接到延伸穿过挠性轴202的挠性驱动轴119上。轴119可以由任何适合的的挠性和扭转硬质材料制成,其可随着挠性轴202一起进行关节式运动以允许末端执行器400相对于刚性部分204在非关节式运动位置与关节式运动位置之间进行关节式运动,其中,在所述非关节式运动位置上,由末端执行器400所限定的纵向轴线B-B基本上与由刚性部分204所限定的纵向轴线A-A对准,而在所述关节式运动位置上,末端执行器400的纵向轴线被设置成相对于刚性部分204的纵向轴线A-A成基本非零角度。轴119可以由不锈钢等材料制成。
如图8所示,挠性轴202包括多个联锁段206,每个联锁段都限定了贯穿其中的开口206a。如图8所示,轴119布置在开口206a内。联锁段206中的每一个均包括在其近侧端处的承窝206b以及在其远侧端处都包括球窝接头206c。一个段206的球窝接头206c被构造和定尺寸为与远侧的邻近段206的承窝206b相接,从而允许整个挠性轴202挠曲,并且从而可以绕刚性部分204的纵向轴线在整个360°空间里的任何需要的方向上进行关节式运动。特别地,挠性轴202的关节式运动允许末端执行器400和枢转连接件500相对于轴线A-A的关节式运动。
参照图9和图10,挠性部分202的关节式运动可以通过张紧线缆205a、205b、205c、205d来实现。在一些实施例中,可以使用被联接到末端执行器400上且穿过挠性轴202的四根径向等距间隔开的线缆。特别地,如图9和图10所示,每根线缆205a、205b、205c、205d可以布置在段206的各自的开口206d内。因此,施加在一根或多根线缆上的张力将可以调整挠性轴202的关节式运动方向。在共同拥有的于2011年7月21日提交的名称为“Articulating Links With Middle LinkControl System(具有中间链接控制系统的关节式运动链接)”、申请号为61/510,091的美国临时专利申请中,公开了一种线缆关节式运动器械,其全部内容通过引用合并于此。
参照图10,示出了驱动联接组件210,线缆205a、205b、205c、205d中的各个线缆分别联接到锚筋207a、207b、207c、207d。线缆205a、205b、205c、205d可以通过任何合适的方式包括但不限于粘合剂、打结等等被紧固到筋207a、207b、207c、207d。筋207a、207b、207c、207d以径向等距间隔开的构造联接到附接环209以维持线缆205a、205b、205c、205d的径向对准。筋207a、207b、207c、207d固定地联接到附接环209,而筋207d滑动地联接到环209,使得筋207d能够相对于附接环209纵向地移动。筋207d包括布置在柱体213的狭槽215内的止动器211。狭槽215被限定相对于轴线A-A对角地贯通柱体213。
环209可以螺纹联接到一个或多个螺纹驱动轴220a和螺纹驱动轴222a。随着驱动轴220a和驱动轴222a旋转,环209沿着驱动轴220a和驱动轴222a所限定的纵向轴线在纵向方向上穿行。驱动轴220a和驱动轴222a的旋转通过如上所述的连接套管220和连接套管222传递。随着环209在纵向方向上向远侧穿行,筋207a、207b、207c也向远侧移动,由此张紧线缆205a、205b、205c。
独立于线缆205a、205b、205c,线缆205d被张紧,允许末端执行器400通过挠性轴202相对于纵向轴线A-A进行关节式运动。具体地,因为施加到线缆205d上的张力高于施加在线缆205a、205b、205c上的张力,所以挠性轴202在线缆205d的方向上弯曲。经由被柱体213致动的筋207d将不同的张力施加在线缆205d上。随着柱体213绕纵向轴线A-A旋转,由于筋207d的止动器211和柱体213的狭槽215的接合,纵向移动被传递到筋207d。特别地,随着柱体213绕轴线A-A在顺时针方向上旋转,筋207d向近侧移动,从而增加了作用在线缆205d上的张力。反过来说,随着柱体213在逆时针方向上旋转,筋207d向远侧移动,从而松弛了作用在线缆205d上的张力。
图11和图12图示了末端执行器400的部件和操作。末端执行器400包括一对钳夹构件,其包括钉仓组件432和砧座434。钉仓组件432容纳一个或多个被布置在其内部的紧固件433(图11),并且钉仓组件432配置为在器械100发射时配置紧固件433。砧座434可运动地(例如,可枢转地)安装到末端执行器400上且能够在打开位置和闭合位置之间移动,其中,在打开位置上,砧座434与钉仓组件432彼此间隔开,在闭合位置上,砧座434与钉仓组件432密切配合对准从而夹紧组织。
参照图11,显示出末端执行器400的分解图。末端执行器400还包括具有细长通道411、底座412和两个平行直立壁414、416的承载器431,所述平行直立壁包括几个安装结构(诸如凹口439)以用来支撑钉仓组件432和砧座434。纵向狭槽413延伸穿过细长通道411。
承载器431还包括被布置在其底面上的板盖415。板盖415配置为与承载器431的通道411相摩擦地接合,其功能是保护组织免受沿承载器431外部移动的部件的损坏。承载器431还包括被布置在相应的壁414、416的近侧端处且被配置用来与末端执行器400的壳体构件410联接的一对翼件407和409。
继续参照图11,通道411的远侧部分支撑包括多个手术紧固件433和多个对应的发射器或推进器437的钉仓组件432。如以下更详细地描述,末端执行器400包括具有直立凸轮楔444的致动滑块440,直立凸轮楔444被配置以施加紧固件驱动力在推进器437上,这会从钉仓组件432中驱动出紧固件433。通过与在通道壁414和416的上表面中形成的对应凹口439摩擦接合的横向支柱436,将钉仓组件432保持在通道411内。这些结构用来限制钉仓组件432在通道411内的横向、纵向以及高程移动。
多个间隔开的纵向狭槽(未显示)延伸穿过钉仓组件432并容纳致动滑块440的直立凸轮楔444。所述狭槽与多个凹处相通,在凹处内分别支撑有多个紧固件433和推进器437。通过配置在钉仓组件432下方的推进器保持器(未显示)来固定推进器437,所述推进器保持器在推进器437通过致动滑块440接合之前,支撑并对准推进器437。在操作过程中,随着致动滑块440平移通过钉仓组件432,凸轮楔444的成角度前缘会顺序地接触推进器437,导致所述推进器在狭槽446内垂直地平移,从而从那推动紧固件434。如下面更详细的描述,钉仓组件432还包括纵向狭槽485以允许刀片474移动贯穿其中。
继续参照图11,末端执行器400包括被布置在砧座434上方的砧座盖435。砧座盖435保护组织免受沿砧座434外部移动的部件的损坏。砧座盖435包括相对的安装翼450和452,其尺寸和结构可分别与砧座434的定位凹部454和456相接合。安装翼450和452的功能是在闭合过程中使砧座434与钉仓组件432对准。如下面更详细的描述,砧座434和盖435配置为保持在打开形态下直到闭合。
砧座434可枢转地联接到承载器431上。承载器431包括形成在各自的翼件407、409中的一对开口421和422。砧座盖435还包括形成于其中的一对相对的开口457和459。枢轴销417(或一对销)穿过开口421、422、457和459,以允许砧座434枢转联接到承载器431。
如图11所示,末端执行器400进一步包括轴向驱动螺杆460,用来在吻合手术操作中将由挠性驱动轴119施加的旋转驱动力传递给致动滑块440。驱动螺杆460可旋转地支撑在承载器431中并包括螺纹部分460a和近侧端461。驱动螺杆460可旋转地固定在钉仓组件432的远侧端处并包括通过摩擦配合在近侧端461周围的一个或多个轴承466。这允许驱动螺杆460相对于承载器431旋转。末端执行器400的近侧壳体构件410经由一个或多个螺栓412和间隔件410a联接到承载器431的近侧端。壳体构件410包括限定贯穿其中的镗孔414,在镗孔414中可以容纳近侧端461。
参照图11和图12,末端执行器400进一步包括被布置在承载器431内的驱动梁462。驱动梁462包括垂直支柱472和与致动滑块440的中央支撑楔445相接合的抵接表面476。驱动梁462还包括被布置在垂直支柱472顶部上的凸轮构件480。凸轮构件480的尺寸和结构可以相对于砧座434的外凸轮面482接合和平移,从而在发射过程中逐步夹紧砧座434使其紧靠身体组织。
纵向狭槽484延伸穿过砧座434以适应垂直支柱472的平移。这允许凸轮构件480在发射过程中可以在盖435和砧座434之间穿行。在一些实施例中,砧座盖435还可以包括在其内面上形成的对应的纵向狭槽(未显示)并且砧座盖435固定在砧座434的上表面,从而在它们之间形成通道。
驱动梁462包括远侧保持底脚488a和近侧保持底脚488b,远侧保持底脚488a和近侧保持底脚488b各自具有限定为贯通的镗孔489a和489b。孔489a和489b可以是有螺纹的或者光滑的,以供穿过其中的驱动螺杆460穿行。具有贯通的螺纹孔490a的移动螺母490被布置在远侧保持底脚488a和近侧保持底脚488b之间。驱动螺杆460通过镗孔490a螺纹联接到移动螺母490,使得随着驱动螺杆460旋转,移动螺母490沿着由驱动螺杆460限定的纵向轴线沿纵向方向移动且还与底脚488a和488b相接合。
在使用中,随着驱动螺杆460沿顺时针方向旋转,移动螺母490和驱动梁462沿远侧方向移动,随着凸轮构件480向下推压在其凸轮面482上而闭合砧座434。驱动梁462也沿远侧方向推动滑块440,然后,经由凸轮楔444与推进器437相接合,从而射出紧固件433。驱动梁462可以由任何适合的第一原料制成,包括但不限于塑料、金属及其组合物。移动螺母490可以由任何适合的第二原料制成,同样包括但不限于塑料、金属及其组合物。第一原料和第二原料可以相同或不同。在一些实施例中,驱动梁462可以包括具有限定为贯通其中的螺纹镗孔的单个保持底脚,单个保持底脚可通过螺纹联接到驱动螺杆460上。
参照图11,驱动梁462还包括用来切割被紧固的组织的刀片474。在吻合手术操作中,刀片474在致动滑块440后面稍微移动,从而在紧固件的排之间形成切口。随着驱动梁462向远侧方向被驱动,垂直支柱472的抵接表面476会向远侧方向推动滑块440以射出紧固件433,且同时用刀片474切割组织。刀片474和驱动梁462移动穿过纵向狭槽484和485。随着驱动梁462向远侧方向被驱动,驱动梁462会闭合砧座,并还推动滑块440,而滑块440依次在移动刀片474之前射出紧固件433。随着紧固件433被射出,它们会紧靠着具有多个砧座凹处(未显示)的砧座434的组织接触表面(例如,下侧)发生变形。
关于图13至图16,枢转连接件500包括刚性近侧连结构件502以及联接到末端执行器400的刚性远侧连结构件504。近侧连结构件502和远侧连结构件504枢转地彼此联接。参照图15,显示出枢转连接件500的分解图。近侧连结构件502还包括两个平行的直立壁514和516,在其远侧端限定细长通道511,细长通道511转接至在其近侧端处的纵向空管腔512。壁514和516中的每一个均分别包括在其内限定的细长狭槽514a和细长狭槽516a以及开口514b和516b。近侧连结构件502还包括布置在其近侧端处的锚定点518a、518b、518c、518d。锚定点518a、518b、518c、518d联接到线缆205a、205b、205c、205d的远侧端,从而将挠性轴202的段206紧固在近侧连结构件502和刚性部分204之间。
远侧连结构件504包括被限定为贯穿其中的纵向管腔520,纵向管腔520连接至与纵向管腔520横向的横向管腔522。远侧连结构件504可以包括一对相对的壁523和525,壁523和525被配置为装配在近侧连结构件502的壁514和516之间。远侧连结构件504具有在远侧连结构件的近侧端处的壁523和525中限定的至少一个凸轮狭槽。例如,凸轮狭槽524和526被限定在远侧连结构件504的近侧端处的壁523和525内。远侧连结构件504进一步包括贯穿远侧连结构件504的一对开口523a和525a。一对机械紧固件(诸如销、铆钉等)穿过远侧连结构件504的开口523a、525a和近侧连结构件502的对应的开口514b和516b中的每一个,从而允许远侧连结构件504枢转联接至近侧连结构件502(例如,经由铆钉、冲压、卷曲加工等等)。
继续参照图15和图16,壳体构件410进一步包括外旋转接合部分411。外旋转接合部分411具有限定贯通其中的纵向管腔413的大致筒状形状。接合部分411还包括布置在其近侧端并且在管腔413内的内旋转接合部分415。类似于接合部分411,接合部分415具有限定贯通其中的纵向管腔417的大致筒状形状。驱动螺杆460的近侧端461延伸穿过壳体构件410,使得驱动螺杆460的近侧端461分别延伸穿过外旋转接合部分411和内旋转接合部分415的管腔413和管腔417以及远侧连结构件504的管腔520。驱动螺杆460的近侧端461包括具有互补的配套表面的内开口(female opening)461a,所述互补的配套表面被构造并且定尺寸为与如下进一步详细描述的驱动轴530机械交接。
壳体构件410的接合部分415固定地联接至驱动螺杆460的近侧端461并且包括限定在其筒状壁中的一对开口415a、415b。驱动螺杆460包括贯穿其中的近侧横向管腔461b。近侧横向管腔461b与接合部分415的开口415a、415b对准,使得销528摩擦配合贯穿其中,从而将驱动螺杆460紧固到接合部分415。在实施例中,使用任何合适的方法诸如机械紧固件、粘合剂等等将接合部分415紧固到驱动螺杆460的近侧端461。在进一步实施例,接合部分415可以与驱动螺杆460一体地形成。内旋转接合部分415可以在外旋转接合部分411内自由地旋转。这种构造允许驱动螺杆460与接合部分415一起相对于外旋转接合部分411并且相对于壳体构件410旋转。
末端执行器400包括初级齿轮组件419。初级齿轮组件419包括分别限制在接合部分411和415的近侧端处的第一齿轮419a和第二齿轮419b。齿轮419a和齿轮419b被配置为并且定尺寸为等径伞齿轮或锥齿轮并且分别通过将接合部分411和415的近侧边缘倒角而形成。
如以下进一步详细描述的,齿轮419a的接合允许接合部分411与壳体构件410和末端执行器400一起相对于枢转连接件500绕纵向轴线B-B的旋转。此外,如上所述,齿轮419b的接合允许接合部分415与驱动螺杆460一起旋转以闭合砧座434、射出紧固件433、和/或切割组织。
在实施例中,末端执行器400可移除地联接至枢转连接件500。如图15和图16所示,远侧连结构件504包括闩锁组件530,闩锁组件530适于接合外旋转接合部分411的表面上的凹槽411b。闩锁组件530包括经由销533枢转联接至远侧连结构件504的外表面的杠杆532。杠杆532包括被配置为并且定尺寸为与外旋转接合部分411的凹槽411b接合的球形柄534以及用于容纳弹簧538的空腔536,弹簧538将杠杆532以及依次球形柄534偏置而使其与外旋转接合部分411的凹槽411b接合。凹槽411b沿着外旋转接合部分411的整个外周延伸,使得在球形柄534布置在凹槽411b内时,末端执行器534被固定到枢转连接件500,同时依然允许末端执行器400相对于枢转连接件500的旋转。在末端执行器400从枢转连接件500插入和/或射出期间,压下杠杆532以拉动球形柄534脱离与外旋转接合部分411的凹槽411b的接合。
继续参照图15和图16,远侧连结构件504还分别包括次级外接合构件550和次级内接合构件552。次级外接合构件550可旋转地布置在远侧连结构件504的管腔522内。次级外接合构件550限定贯穿其中的管腔550a并且次级内接合构件552被配置为并且定尺寸为在其内旋转。垫圈556绕次级内接合构件552的外周而布置,充当接合构件550和552之间的缓冲件,从而允许次级外接合构件550和次级内接合构件552相对于彼此的以及相对于远侧连结构件504的旋转。
参照图16,如下面进一步详细描述的,次级外接合构件550包括配合表面550b,配合表面550b被构造并且定尺寸为与旋转连杆564机械交接。如下面进一步详细描述的,次级内接合构件552还包括配合表面552a,配合表面552a被构造并且定尺寸为与驱动轴530机械交接。
继续参照图15和图16,远侧连结构件504还包括次级齿轮组件540。次级齿轮组件540包括第一齿轮540a和第二齿轮540b。第一齿轮540a和第二齿轮540b被构造并且定尺寸为等径伞齿轮或锥齿轮,用于分别接合第一齿轮419a和第二齿轮419b。第一齿轮540a和第二齿轮540b分别布置在与次级外接合构件550和次级内接合构件552的配合表面550a和552a的相对的端上。
如图16所示,壳体构件410的接合部分415的近侧端被布置在外旋转接合部分411的近侧端的近侧,使得在内部布置的第二齿轮419b延伸到第一齿轮419a的外部。类似地,次级内接合构件552的在内部布置的齿轮540b延伸越过次级外接合构件550的齿轮540a。次级外接合构件550和次级内接合构件552通过一个或多个垫圈553被固定在远侧连结构件504的管腔522内。特别地,垫圈553抵接次级外接合构件550,次级外接合构件550进而抵接次级内接合构件552,从而将第一齿轮540a和第二齿轮540b分别与第一齿轮419a和第二齿轮419b互锁。
继续参照图15和图16,近侧连结构件502包括被布置在连结构件502的管腔512内的推杆560。推杆560被配置为在连结构件502的管腔512内滑动地移动并且被构造为并且定尺寸为接合连结构件502的最远侧段206。在实施例中,如图18和图19所示,连结构件502的远侧段206可以包括被构造为并且定尺寸为接合推杆560的近侧端的空腔。推杆560通过张紧线缆205a、205b、205c、205d而向远侧方向移动以使枢转连接件500接近远侧段206,远侧段206进而将推杆560推进至连结构件502的管腔512中。
推杆560限定了纵向管腔561以允许驱动轴119贯穿通过。推杆560的管腔561还包括远侧部分561a和近侧部分561b。驱动轴530联接至推杆560的管腔561内的挠性驱动轴119。特别地,驱动轴119被布置在推杆560的管腔561的近侧部分561b内并且驱动轴530被布置在管腔561的远侧部分561a内,在两者之间建立联接。
管腔561的远侧部分561a具有比近侧部分561b更大的直径并且足够容纳布置在驱动轴530上的弹簧562。弹簧562在推杆560和旋转连杆564之间偏置。旋转连杆564具有大致筒状形状并且限定了纵向管腔566以允许驱动轴530贯穿通过。类似于推杆560,旋转连杆564也被配置为在管腔512内滑动地移动以及在其内旋转。旋转连杆564的管腔566还包括远侧部分566a和近侧部分566b。管腔566的远侧部分566a和近侧部分566b包括在远侧部分566a和近侧部分566b之间的脊状件568,脊状件568为弹簧562提供台座。旋转连杆564还包括在其远侧端的齿轮569,齿轮569被构造成并且定尺寸为与接合构件550的配合表面550b机械交接。
驱动轴530被布置在旋转连杆564的管腔566内并且被构造为在其内滑动地移动和/或旋转。驱动轴530也被布置弹簧562内,而不接触弹簧562,允许驱动轴530独立地在其内部移动。驱动轴119的远侧端和驱动轴530的近侧端包括互补的配合表面,使得驱动轴119的旋转和纵向移动被传递至驱动轴530。
驱动轴530还包括为脊状件568提供互补的配合表面的中间部分570。这允许将驱动轴530的旋转运动传递至旋转连杆564。驱动轴530的中间部分570还包括垫圈572,垫圈572绕接合中间部分570的外周被布置,充当驱动轴530与旋转连杆564的内壁之间的缓冲件,从而当驱动轴530的中间部分570和旋转连杆564的脊状件568分离时允许驱动轴530在旋转连杆564内的旋转。垫圈572还充当止挡构件,防止驱动轴530相对于旋转连杆564的向近侧移动,因为随着驱动轴530向近侧方向移动,垫圈572被构造为并且定尺寸为与旋转连杆564的脊状件568接触。
存在与枢转连接件关联的凸轮机构。参照图14至图16,大致U形的U形夹580与近侧连结构件502关联。U形夹580具有从开口586向远侧延伸的第一纵向臂582和第二纵向臂584。U形夹580被布置在近侧连结构件502的管腔512内。在实施例中,如图13和图14所示,臂582和臂584可以延伸到近侧连结构件502的外部。U形夹580的U形结构与开口586一起允许贯穿其中的驱动轴530的纵向穿行。
纵向臂582和纵向臂584中的每一个臂都在其远侧端处包括凸轮销582a和凸轮销584a。凸轮销582a和凸轮销584a分别被布置在近侧连结构件502的狭槽514a和狭槽516a内。在U形夹580通过远侧段206接合时,所以U形夹580被推杆560向远侧移动。近侧连结构件502的狭槽514a和狭槽516a保持U形夹580沿着纵向轴线B-B的穿行。
如图15和图18所示,凸轮销582a和凸轮销584a还分别被布置在远侧连结构件504的凸轮狭槽524和凸轮狭槽526内。远侧连结构件504的凸轮狭槽524和凸轮狭槽526中的每个都分别包括第一部分524a、526a、第二部分524b、526b以及第三部分524c、526c。为了简化,因为凸轮狭槽524和第一部分524a、第二部分524b以及第三部分524c的结构和操作基本上类似于凸轮狭槽526和第一部分526a、第二部分526b、以及第三部分526c的结构和构造,所以下面仅仅讨论凸轮狭槽526和第一部分526a、第二部分526b以及第三部分526c。
[0099]凸轮狭槽526的第一部分526a基本上与由末端执行器400限定的纵向轴线“B-B”对准。凸轮狭槽526的第三部分526c基本上垂直于纵向轴线“B-B”延伸。凸轮狭槽526的第二部分526b相对于第一部分526a(例如,纵向轴线“B-B”)和第二部分524b的夹角为钝角。在实施例中,第二部分526b相对于纵向轴线“B-B”大约成45°的角度。凸轮狭槽的第一部分相对于凸轮狭槽的第二部分和第三部分成一角度延伸。例如,如图20至图24所示,凸轮狭槽的第一部分、第二部分和第三部分具有Y形状的构造。设想凸轮狭槽可以具有相对于彼此成角度的两个部分或相对于彼此成角度的多于三个的部分。
如图6所示,末端执行器400可经由挠性轴202相对于轴组件200的刚性部分204进行关节式运动以及相对于挠性轴202分别经由连结构件502和504绕开口514b、516b和523a、525a枢转。末端执行器400可以在对准(例如,不枢转)构造与枢转构造之间枢转,其中在对准构造中,如图1所示,由末端执行器400限定的纵向轴线“B-B”与由近侧连结构件502限定的纵向轴线“C-C”对准,而在枢转构造中,如图6所示,纵向轴线“B-B”垂直于纵向轴线“C-C”。
挠性驱动轴119允许末端执行器400的操作而不考虑施加在挠性轴202上的关节式运动。如上文关于图7至图10所描述的,挠性轴202可以在任何期望的方向上进行关节式运动。末端执行器400可以在对准(例如,不枢转)构造或枢转构造中被致动(例如,钉仓组件432和砧座434的接近和/或射出紧固件433)。
现在转向图16和图17,示出并且描述了在对准构造中的末端执行器400的操作,例如连结构件502和504沿着纵向轴线“B-B”对准。如下相对于图18至图24所描述,在对准构造中,推杆560未通过远侧段206接合,因为远侧段206会经由连结构件502和504实现末端执行器400的关节式运动。
一旦末端执行器400在期望的位置相对于轴组件200做关节式运动,末端执行器400可被致动以夹紧和/或密封组织。为了实现致动,挠性驱动轴119向远侧方向延伸,挠性驱动轴119进而推动驱动轴530而使其与驱动螺杆460的开口461a接合。如上所述,驱动轴530独立于推杆560、弹簧562以及旋转连杆564向远侧方向移动。一旦驱动轴530与驱动螺杆460接合,挠性驱动轴119根据其关节式运动的角度而绕纵向轴线“A-A”和/或“C-C”旋转。如上文关于图11和图12所述,驱动轴119在顺时针方向上的旋转引起驱动轴530在相同方向上的旋转,这进而旋转驱动螺杆460,从而夹紧和/或压缩钉仓组件432与砧座434之间的组织。
现在转向图20至图24,示出并且描述了末端执行器400经由连结构件502和504相对于挠性轴202分别绕开口514b、516b和523a、525a的枢转。
首先,如上文关于图7至图11所述,挠性轴202的远侧段206经由线缆205a、205b、205c、205d的张力朝近侧连结构件502被推进,这进而纵向地向远侧方向推进推杆560。推杆560接合U形夹580,U形夹580然后接合弹簧562,从而使旋转连杆564偏置。
如图20和图21所示,U形夹580的纵向移动纵向地移动凸轮销582a、584a通过近侧构件502的细长狭槽514a、516a以及通过远侧构件504的凸轮狭槽524和526的第一部分524a、526a。如图21所示,凸轮销582a、584a纵向地移动通过凸轮狭槽524和526的第一部分524a、526a直到凸轮销582a、584a接触或以其它方式可操作地接合凸轮狭槽524和526的第一部分524a、526a与第二部分524b、526b之间的肩部。这造成近侧连结构件502开始绕开口514b、516b和523a、525a旋转,如箭头“P”所指示。
结合图22,在凸轮销582a、584a连续纵向移动通过细长狭槽514a、516a时,凸轮销582a、584a进入凸轮狭槽524和526的第二部分524b、526b并且造成近侧连结构件502处于半枢转构造。
结合图23,凸轮销582a、584a连续纵向移动通过细长狭槽514a、516a使得凸轮销582a、584a从凸轮狭槽524和526的第二部分524b、526b移动,直到凸轮销582a、584a接触或以其它方式可操作地接合凸轮狭槽524和526的第二部分524b、526b与第三部分524c、526c之间的肩部。这使得近侧连结构件502继续绕开口514b、516b和523a、525a旋转,如箭头“P”所指示。
如图24所示,凸轮销582a、584a连续纵向移动通过细长狭槽514a、516a,使得远侧部分504与末端执行器400一起绕开口514b、516b和523a、525a旋转至枢转构造。凸轮销582a、584a通过细长狭槽514a、516a的连续纵向移动接合凸轮狭槽524和526的第三部分524c、526c。当施药器末端执行器400已经旋转至枢转构造时,凸轮狭槽524和526的第二部分524b、526b与细长狭槽514a、516a的纵向轴线基本上轴向地对准。因此,在末端执行器400处于枢转构造的情况下,凸轮销582a、584a可以移动通过凸轮狭槽524、526的第二部分524b、526b。
参照图18,一旦末端执行器400和远侧连结构件504处于关节式运动构造,旋转连杆564与末端执行器400接合。在关节式运动构造中,末端执行器400可以绕纵向轴线“B-B”旋转。如上所述,推杆560向远侧方向移动以接合U形夹580以便使远侧连结构件504和末端执行器400一起相对于近侧连结构件502枢转。推杆560的远侧移动还接合使旋转连杆564偏置的弹簧562,这将旋转连杆564与外接合构件550接合。特别地,旋转连杆564的齿轮569与外接合构件550的配合表面550b啮合。
驱动轴530经由中间部分570与旋转连杆564机械接合,中间部分570为脊状件568提供互补的配合表面,使得驱动轴530的旋转进而使旋转连杆564旋转。驱动轴119在顺时针方向上的旋转引起驱动轴530在相同方向上的旋转,驱动轴530然后使旋转连杆564旋转。因为接合构件550联接至旋转连杆564,所以接合构件550也被旋转并且然后传递至接合部分411。特别地,接合构件550的第一齿轮540a与接合部分411的第二齿轮419a互锁。因为驱动螺杆460经由轴承466可旋转地联接至末端执行器400,所以接合部分411的旋转还使末端执行器400相对于驱动螺杆460绕纵向轴线“B-B”旋转。
如图19所示,结合图11和图12,如上所述,驱动轴530可以向远侧方向推进以接合驱动螺杆460从而夹紧和/或密封在钉仓组件432与砧座434之间的组织。特别地,为了实现致动,挠性驱动轴119向远侧方向延伸。这使驱动轴530向远侧方向移动,使驱动轴530的中间部分570与旋转连杆564的脊状件568的互补的配合表面分离。这允许驱动轴530在旋转连杆564内旋转,使得驱动轴530的旋转用于使驱动螺杆460旋转以夹紧和/或密封钉仓组件432和砧座434之间的组织而不是如上所述使末端执行器400旋转。
随着驱动轴530向远侧方向延伸,驱动轴530从旋转连杆564脱离并且转而与接合构件552的配合表面552a接合。接合构件552机械连接至接合部分415,接合部分415进而联接至驱动螺杆460。特别地,接合构件552的第二齿轮540b与接合部分415的第二齿轮419b互锁。
一旦驱动轴530与接合构件552接合,挠性驱动轴119就旋转。驱动轴119在顺时针方向上的旋转引起驱动轴530在相同方向上的旋转,驱动轴530然后使接合构件552旋转。接合构件552的旋转被传递至接合部分415,接合部分415使驱动螺杆460与接合部分415一起旋转。如上结合图11和图12所述,驱动螺杆460的旋转实现组织的夹紧和/或压缩。
可以逆反枢转过程以便将末端执行器400和远侧连结构件504一起返回而与近侧连结构件502对准。首先,旋转连杆564和驱动轴530与末端执行器400分离。挠性驱动轴119向近侧方向退回,从而一起拉动驱动轴530和挠性驱动轴119。垫圈572被构造为并且定尺寸为与脊状件568接触使得随着驱动轴530向近侧方向移动,旋转连杆564也与其一起退回。同时地或按顺序地,远侧连结构件504返回至对准构造。这通过松弛线缆205a、205b、205c和205d的张力从近侧连结构件502缩回远侧段206来实现,线缆205a、205b、205c和205d的张力然后使推杆560向近侧方向纵向地缩回。凸轮销582a、584a向近侧移动以便将末端执行器400返回至对准构造。
将要理解的是,可以对这里公开的所述实施例进行各种修改。例如,器械100不需要使用吻合钉,而是可以使用本领域公知的两件式紧固件。此外,可以修改吻合钉或紧固件线性排的长度来满足特殊手术操作的要求。于是,致动轴的单个行程的长度和/或一次性装载单元内的吻合钉和/或紧固件的线性排的长度可以相应地改变。因此,上述说明书不应该视为限制,仅仅是一些优选实施例的例证。本领域的技术人员将在这里所附的权利要求书的范围和精神内构想出其他的修改。
Claims (27)
1.一种手术设备,包括:
钳夹组件,其包括第一钳夹和能够相对于所述第一钳夹移动的第二钳夹;
枢转连接件,其联接至所述钳夹组件的近侧端,所述枢转连接件包括远侧连结构件和近侧连结构件,其中所述钳夹组件和所述远侧连结构件限定了在所述钳夹组件的近侧端和所述远侧连结构件的远侧端之间延伸的第一纵向轴线,并且所述近侧连结构件限定了第二纵向轴线;以及
凸轮组件,其被配置为使所述钳夹组件相对于所述近侧连结构件绕与所述第一纵向轴线和所述第二纵向轴线垂直的枢转轴线枢转。
2.根据权利要求1所述的手术设备,进一步包括:
手柄组件;以及
细长主体,其被配置为将所述手柄组件和所述钳夹组件相互连接,所述细长主体包括:
挠性轴,其联接至所述近侧连结构件的所述近侧端;以及
刚性轴部,其联接至所述挠性轴的所述近侧端,其中所述刚性轴部限定了第三纵向轴线并且所述挠性轴被配置为使得所述钳夹组件和所述枢转连接件相对于所述刚性轴的所述第三纵向轴线做关节式运动。
3.根据权利要求1所述的手术设备,其中所述远侧连结构件具有在所述远侧连结构件的近侧端处的凸轮狭槽并且进一步包括布置在所述凸轮狭槽中的凸轮销。
4.根据权利要求3所述的手术设备,其中所述凸轮狭槽具有第一部分、第二部分以及第三部分,所述第一部分、所述第二部分以及所述第三部分相对于彼此成角度地延伸。
5.根据权利要求3所述的手术设备,其中所述凸轮狭槽具有Y形构造。
6.根据权利要求3所述的手术设备,进一步包括具有所述凸轮销的活动U形夹。
7.根据权利要求1所述的手术设备,其中所述远侧连结构件包括一对相对的凸轮狭槽并且所述近侧连结构件具有与其相关联的U形夹,所述U形夹具有布置在所述一对相对的凸轮狭槽内的一对凸轮销,使得所述U形夹的移动使所述钳夹组件相对于所述近侧连结构件绕所述枢转轴线枢转。
8.根据权利要求7所述的手术设备,进一步包括:
驱动螺杆,其布置在所述钳夹组件内;以及
驱动轴,其布置在所述枢转连接件内,所述驱动轴被配置为接合所述驱动螺杆并且在第一方向上旋转以使所述第二钳夹相对于所述第一钳夹移动。
9.根据权利要求8所述的手术设备,进一步包括:
旋转连杆,其布置在所述近侧连结构件内,所述旋转连杆限定贯通其中的管腔,所述驱动轴布置在所述管腔中。
10.根据权利要求9所述的手术设备,其中所述枢转连接件进一步包括:
初级齿轮组件,其包括:
初级第一齿轮,其联接至所述钳夹组件,所述初级第一齿轮被配置为使所述钳夹组件绕所述第一纵向轴线旋转;以及
初级第二齿轮,其联接至所述驱动轴。
11.根据权利要求10所述的手术设备,其中所述枢转连接件进一步包括:
次级齿轮组件,其包括:
次级第一齿轮,其联接至所述初级第一齿轮,所述次级第一齿轮被配置为在所述钳夹组件和所述远侧连结构件处于枢转构造时使所述钳夹组件绕所述第一纵向轴线旋转;以及
次级第二齿轮,其联接至所述初级第二齿轮,所述次级第二齿轮被配置为使所述第二钳夹相对于所述第一钳夹移动。
12.根据权利要求11所述的手术设备,其中所述旋转连杆能够通过所述U形夹在远侧方向上移动并且被配置为当所述钳夹组件和所述远侧连结构件处于枢转构造时接合所述次级第一齿轮。
13.根据权利要求12所述的手术设备,其中所述驱动轴被配置为当处于近侧位置时接合所述旋转连杆并且当所述钳夹组件和所述远侧连结构件处于枢转构造时在第一方向上旋转以使所述钳夹组件绕所述第一纵向轴线旋转。
14.根据权利要求13所述的手术设备,其中所述驱动轴被配置为在远侧位置上接合所述次级第二齿轮并且在所述第一方向上旋转以使所述第二钳夹相对于所述第一钳夹移动。
15.一种手术设备,包括:
钳夹组件,其包括:
第一钳夹和能够相对于所述第一钳夹移动的第二钳夹;以及
驱动螺杆,其被配置为使所述第二钳夹相对于所述第一钳夹移动;
枢转连接件,其联接至所述钳夹组件的近侧端,所述枢转连接件包括远侧连结构件和近侧连结构件,其中所述钳夹组件和所述远侧连结构件限定了在所述钳夹组件的近侧端和所述远侧连结构件的远侧端之间延伸的第一纵向轴线,并且所述近侧连结构件限定了第二纵向轴线;以及
凸轮组件,其联接至所述远侧连结构件和所述近侧连结构件,所述凸轮组件被配置为使所述钳夹组件相对于所述近侧连结构件绕与所述第一纵向轴线和所述第二纵向轴线垂直的枢转轴线从所述第一纵向轴线和第二纵向轴线基本上彼此平行的对准构造枢转至所述第一纵向轴线和所述第二纵向轴线基本上彼此垂直的枢转构造。
16.根据权利要求15所述的手术设备,进一步包括:
驱动轴,其布置在所述枢转连接件内,所述驱动轴被配置为当所述钳夹组件处于所述对准构造和所述枢转构造中的一种构造时接合所述驱动螺杆并且在第一方向上旋转以使所述第二钳夹相对于所述第一钳夹移动。
17.根据权利要求16所述的手术设备,其中在所述对准构造中,所述驱动轴被配置为直接接合所述驱动螺杆。
18.根据权利要求16所述的手术设备,其中所述枢转连接件进一步包括:
初级齿轮组件,其包括:
初级第一齿轮,其联接至所述钳夹组件,所述初级第一齿轮被配置为使所述钳夹组件绕所述第一纵向轴线旋转;以及
初级第二齿轮,其联接至所述驱动螺杆,所述初级第二齿轮被配置为使所述第二钳夹相对于所述第一钳夹移动。
19.根据权利要求17所述的手术设备,其中所述枢转连接件进一步包括:
次级齿轮组件,其包括:
次级第一齿轮,其联接至所述初级第一齿轮,所述次级第一齿轮被配置为当所述钳夹组件和所述远侧连结构件处于枢转构造时使所述钳夹组件绕第一纵向轴线旋转;以及
次级第二齿轮,其联接至所述初级第二齿轮,所述次级第二齿轮被配置为使所述第二钳夹相对于所述第一钳夹移动。
20.根据权利要求19所述的手术设备,其中在所述枢转构造中,所述驱动轴被配置为通过所述次级第二齿轮接合所述驱动螺杆。
21.一种手术设备,包括:
钳夹组件,其包括第一钳夹和能够相对于所述第一钳夹移动的第二钳夹;
枢转连接件,其联接至所述钳夹组件的近侧端,所述枢转连接件包括远侧连结构件和近侧连结构件,其中所述钳夹组件和所述远侧连结构件限定了在所述钳夹组件的近侧端和所述远侧连结构件的远侧端之间延伸的第一纵向轴线,并且所述近侧连结构件限定了第二纵向轴线,所述钳夹组件能够相对于所述近侧连结构件绕与所述第一纵向轴线和所述第二纵向轴线垂直的枢转轴线枢转;以及
挠性轴,其在所述枢转连接件的近侧,所述挠性部分具有容纳多根线缆的多个开口以实现所述挠性部分的挠曲。
22.根据权利要求21所述的手术设备,其中所述挠性轴包括多个段,每个段均具有在其远侧端处的球窝接头以及限定承窝的近侧端。
23.根据权利要求22所述的手术设备,其中所述远侧连结构件具有在所述远侧连结构件的近侧端处的凸轮狭槽并且进一步包括布置在所述凸轮狭槽中的凸轮销。
24.根据权利要求23所述的手术设备,其中所述凸轮狭槽具有第一部分、第二部分以及第三部分,所述第一部分、所述第二部分以及所述第三部分相对于彼此成角度地延伸。
25.根据权利要求23所述的手术设备,其中所述凸轮狭槽具有Y形构造。
26.根据权利要求23所述的手术设备,进一步包括具有所述凸轮销的活动U形夹。
27.根据权利要求21所述的手术设备,其中所述远侧连结构件包括一对相对的凸轮狭槽并且所述近侧连结构件具有与其相关联的U形夹,所述U形夹具有布置在所述一对相对的凸轮狭槽内的一对凸轮销,使得所述U形夹的移动使所述钳夹组件相对于所述近侧连结构件绕所述枢转轴线枢转。
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US13/921,890 | 2013-06-19 | ||
US13/921,890 US9480492B2 (en) | 2011-10-25 | 2013-06-19 | Apparatus for endoscopic procedures |
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JP (1) | JP2014018667A (zh) |
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JP2014018667A (ja) | 2014-02-03 |
EP2687164A2 (en) | 2014-01-22 |
AU2013206807A1 (en) | 2014-02-06 |
EP2687164A3 (en) | 2014-04-23 |
EP2687164B1 (en) | 2017-05-10 |
CA2821017A1 (en) | 2014-01-18 |
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