CN103584893A - 附接到可降解的聚合物区的支撑件 - Google Patents
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Abstract
本发明提供了一种与手术吻合器一起使用的末端执行器组件，所述末端执行器包括具有组织接触面的吻合钉钉仓组件和具有组织接触面的砧座组件。手术支撑件被配置并且定尺寸为大体上置于所述吻合钉钉仓组件和砧座组件中至少一个的所述组织接触面的至少一部分之上。多个附接垫，其被固定在所述吻合钉钉仓组件和砧座组件中至少一个的至少一个所述组织接触面上，所述吻合钉钉仓组件和砧座组件中至少一个被配置为将相应的支撑件材料保持在其上，其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。
Description
相关申请的交叉引用
本申请是于2011年12月14日提交的序列号为13/325,481的美国专利申请的部分继续申请，该公开通过引用合并于此。
技术领域
本公开涉及手术吻合装置，所述手术吻合装置包括能够可释放地附接到手术吻合装置上的手术支撑件，并且尤其涉及具有由与手术支撑件相同的材料制成的附接垫的手术吻合装置。附接垫将手术支撑件与手术吻合装置连结，使得在手术吻合装置发射时释放手术支撑件。
背景技术
外科医生使用手术吻合装置来依次或同时施加一排或多排紧固件（例如吻合钉或两部件紧固件）到身体组织用于将身体组织的多个段连结在一起。此类装置通常包括一对钳夹或类似指状物结构，待连结的身体组织被放置在所述一对钳夹或类似指状物结构之间。当致动或“发射”吻合装置时，纵向移动的发射杆接触在一个钳夹中的吻合钉驱动构件。吻合钉驱动构件推动手术吻合钉通过身体组织并且进入使吻合钉成形的对侧钳夹中的砧座中。如果要移除或分离组织，则可以将刀片设置在所述装置的钳夹中以切割吻合钉线之间的组织。
许多手术吻合装置依靠刀片切割下手术支撑件的一部分从而实现释放。这些方法典型地采用除手术支撑件之外的第二材料或安装结构（例如，缝合线）以提供手术支撑件至手术吻合装置的附接。典型地，随着必须被刀片横切的各个材料的增加而增加发射力以便释放手术支撑件。
会令人期望的是，提供能够可释放地固定到手术吻合装置的手术支撑件，而不需要第二材料或安装结构并且不需要刀片来切割支撑件和/或第二材料或安装结构从而将手术支撑件从手术吻合装置释放，从而可以使用更少的材料和更低的发射力。
发明内容
根据本公开的一个方案，本发明提供了一种与手术吻合器一起使用的末端执行器组件，其中所述末端执行器包括具有组织接触面的吻合钉钉仓组件和具有组织接触面的砧座组件。手术支撑件被配置并且定尺寸为大体上置于所述吻合钉钉仓组件和砧座组件中的至少一个的所述组织接触面的至少一部分之上。多个附接垫，其被固定在吻合钉钉仓组件和砧座组件中的至少一个的至少一个所述组织接触面上，吻合钉钉仓组件和砧座组件中的至少一个被配置为将相应的支撑件材料保持在其上，其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。至少一个所述附接垫由选自如下组群的材料制成，所述组群包括：乙交酯、三亚甲基碳酸酯、交酯、己内酯及其组合。
在实施例中，所述附接垫中的至少一个可以被放置在所述吻合钉钉仓组件和砧座组件的至少一个所述组织接触面的凹槽中。
所述吻合钉钉仓组件和砧座组件具有被配置为使刀片能够从其中通行的中央纵向延伸狭槽。在实施例中，至少一个附接垫被放置在所述中央纵向延伸狭槽附近。
所述吻合钉钉仓组件和砧座组件中的每个具有远侧端，使得至少一个远侧附接垫被放置在所述吻合钉钉仓组件和砧座组件中的每个的第一外边缘与所述中央纵向延伸狭槽的远侧端之间。此外，所述吻合钉钉仓组件和砧座组件中的每个具有近侧端，使得至少一个近侧附接垫被放置在所述吻合钉钉仓组件和砧座组件中的每个的第一外边缘与所述中央纵向延伸狭槽的近侧端之间。
在另一个实施例中，所述吻合钉钉仓组件、所述砧座组件和所述手术支撑件大体上是圆形的，其中所述圆形支撑件包括内部、外部以及在所述内部与所述外部之间延伸的中部，并且至少一个附接垫沿所述中部固定。
在本公开的另一个方案中，一种与手术吻合装置一起使用的吻合钉钉仓包括：钉仓本体，其包括限定多个吻合钉保持槽的组织接触面；以及吻合钉，其被布置在所述钉仓本体的各个吻合钉保持槽内。手术支撑件，被配置并且定尺寸为大体上置于所述钉仓本体的所述吻合钉保持槽的至少一部分之上。多个附接垫，其被固定到所述钉仓本体的所述组织接触面上，所述钉仓本体被配置为将相应的支撑件材料保持在其上，其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。
在本公开的又一个方案中，手术吻合装置包括壳体和末端执行器，所述末端执行器被固定至所述壳体和具有组织接触面的吻合钉钉仓组件以及具有组织接触面的砧座组件。手术支撑件被配置并且定尺寸为大体上置于所述吻合钉钉仓组件和砧座组件的至少一个的所述组织接触面的至少一部分之上。多个附接垫，其被固定在所述吻合钉钉仓组件和砧座组件中的至少一个的至少一个所述组织接触面上，所述吻合钉钉仓组件和砧座组件中的至少一个被配置为将相应的支撑件材料保持在其上，其中所述手术支撑件被超声焊接到所述多个附接垫中的每个垫上。
附图说明
参照附图，在这里公开了本公开的互锁支撑件保持系统的各种实施例，其中：
图1是根据本公开实施例的手术吻合装置的立体图；
图2是图1的手术吻合装置的吻合钉钉仓组件的部件分离的立体图，图示出与吻合钉钉仓组件相关联的手术支撑件；
图3是图1的手术吻合装置的砧座组件的部件分离的立体图，图示出与砧座组件相关联的手术支撑件；
图4是吻合钉钉仓组件的立体图，图示出附着到吻合钉钉仓的手术支撑件；
图5是砧座组件的立体图，图示出附着到砧座板的手术支撑件；
图6是图1的手术吻合装置的远侧端的立体图，示出围绕组织段放置使用；
图7是沿图6的线7-7截取的剖视图；
图8是图6的吻合后的并且分隔的组织段的立体图；
图9A是根据本公开另一个实施例的手术吻合装置的说明性实施例的立体图；
图9B是图9A的手术吻合装置的部分脱离的侧面正视图；
图10A是根据本公开实施例的包括手术支撑件的图9A的手术吻合装置的吻合钉钉仓组件的说明性实施例的立体图；
图10B是在图10A中图示的吻合钉钉仓组件和手术支撑件的俯视平面图；
图11是患者的肠区域的立体图，图示出将图9A、图9B和图10的手术吻合装置的砧座杆和吻合钉钉仓组件放置在肠区域内的方法；以及
图12是图11的肠区域的示意性立体视图，图示出安装到手术吻合装置的砧座杆。
具体实施方式
关于与手术吻合装置一起使用的支撑件，在下面讨论本公开的各种示例性实施例。通过接近位于包含至少一个手术支撑件的手术吻合装置的吻合钉钉仓与砧座板之间的伤口组织的边缘，可以在封闭伤口时使用在此描述的支撑件。将该至少一个手术支撑件通过至少一个附接垫连结到手术吻合装置。附接垫由与手术支撑件相同的材料制成并且放置在吻合钉钉仓和砧座板中的各个组织接触面与该至少一个手术支撑件之间。手术吻合装置的发射迫使至少一个吻合钉的钉腿穿过吻合钉钉仓上的开口、穿过组织然后进入砧座板上的凹槽中以便将手术支撑件固定到组织上、以便使邻近的组织彼此固定并且封闭所述组织。吻合钉的发射力冲击附接垫使其断开，从而将手术支撑件从组织接触面释放。因此，本公开描述手术支撑件、支撑所述手术支撑件的手术吻合装置及其使用方法和机理。
应该理解的是，各种各样的手术吻合装置可以与本公开的手术支撑件一起使用。例如，可以利用线性吻合器构造，诸如，例如，那些包括Duet TRSTM再装载器和带有Tri-StapleTM技术的吻合器，其可通过Covidien获得，Covidien的主要营业地在555Long Wharf Drive,NorthHaven,CT06511；以及横向吻合的吻合器，诸如，例如EEATM、CEEATM、GIATM、EndoGIATM、以及TATM，也可通过Covidien获得。还应当理解的是，本公开的原理等同地可应用于具有替代构造的手术吻合器，诸如，例如，具有环形钉仓和砧座的端对端吻合的吻合器（参见，例如共同拥有的、专利号为5,915,616的、名称为“Surgical FastenerApplying Apparatus（手术紧固件施加装置）”的美国专利，其全部内容通过引用合并于此）；腹腔镜检查的吻合器（参见，例如共同拥有的、专利号为6,330,965和6,241,139的、名称均为“Surgical StaplingApparatus（手术吻合装置）”的美国专利，其全部内容均通过引用合并于此）；以及横向吻合的吻合器（参见，例如共同拥有的、专利号为5,964,394和7,334,717的、名称均为“Surgical Fastener ApplyingApparatus（手术紧固件施加装置）”的美国专利，其全部内容均通过引用合并于此）。
现在将参照附图详细地描述本公开的手术支撑件和手术吻合装置的实施例，其中附图中相似的附图标记表示类似的或者相同的元件。在下面的讨论中，术语“近侧”和“尾部”可以相互交换采用，并且应该理解为指在正确使用时更靠近临床医师的结构部分。术语“远侧”和“引导部”可以相互交换使用，并且应该理解为指在正确使用时更远离临床医师的结构部分。如在此所使用的，术语“患者”应当理解为指人类对象或其他动物，并且术语“临床医师”应当理解为指医生、护士或者其他看护提供者并且可以包括支持人员。
现在参照图1，公开了用于吻合组织或将支撑件材料或手术支撑件施加到组织上的示例性的手术吻合装置或手术吻合器10。在专利号为7,128,253的美国专利中公开了这种类型的手术吻合器械的示例，其全部公开通过引用合并于此。
手术吻合装置10通常包括手柄12，具有从手柄12向远侧延伸的细长管状构件14。末端执行器组件16安装在细长管状构件14的远侧端18上。末端执行器组件16包括被配置为在其内接纳吻合钉钉仓32的第一钳夹或吻合钉钉仓组件200以及包括第二钳夹或砧座组件300。末端执行器组件16可以永久地固定在细长管状构件14上或可以是可拆卸的从而可替换为新的末端执行器组件16。还构想吻合钉钉仓能够是可移除的且可替换的。吻合钉钉仓组件200和砧座组件300中的一个被可移动地安装在末端执行器组件16的远侧端18处，并且能够在彼此间隔开的打开位置与彼此大致邻接的闭合位置之间移动。砧座组件300支撑砧座板302并且由包括但不限于不锈钢、钛、钛合金等等的金属材料制成。至少吻合钉钉仓32的组织接触面由除金属之外的包括但不限于塑料、热塑性塑料、树脂、聚碳酸酯等等的材料制成。
如图1所示，手术吻合装置10进一步包括可移动地安装在手柄12上的扳机33。初始时操作扳机33致动以使第一钳夹和第二钳夹在打开位置和闭合位置之间移动并且同时致动手术吻合装置10以将吻合钉线施加到组织上。为了相对于待吻合的组织正确地定向末端执行器组件16，手术吻合装置10另外设置有安装在手柄12上的旋转旋钮34。旋转旋钮34相对于手柄12的旋转使得细长管状构件14和末端执行器组件16相对于手柄12旋转从而相对于待吻合的组织正确地定向末端执行器组件16。
如图6和图7所示，设置驱动器36以将第一钳夹或吻合钉钉仓组件200和第二钳夹或砧座组件300从打开位置移动接近至闭合位置。驱动器36移动通过形成在砧座组件300的砧座板302中的纵向狭槽338（图3）。随着驱动器36穿过狭槽338，带有刀片31的刀具30与驱动器36相关联以切割被抓取在吻合钉钉仓组件200与砧座组件300之间的组织。
为了详细讨论示例性手术吻合装置10的构造和操作，可以参照上面引用的共同拥有的、专利号为5,915,616和6,330,965的美国专利。
吻合钉钉仓组件200和/或砧座组件300可以设置有手术支撑件500。设置手术支撑件500以加固并且封闭由手术吻合装置10施加到组织上的吻合钉线。手术支撑件500可以配置成适合与任何手术吻合装置、紧固装置或发射装置配合的任何形状、大小或尺寸。
吻合钉钉仓组件200设置有钉仓支撑件500a并且砧座组件300设置有砧座支撑件500b（以下面更详细描述的方式）。支撑件500a、500b可以由任何生物可兼容的天然或合成材料制成。制成支撑件500a、500b的材料可以是生物可吸收的或非生物可吸收的。应该理解的是，天然的、合成的、生物可吸收的和非生物可吸收的材料的任何组合可以用于形成支撑件材料。支撑件500a、500b可以是有孔的或者无孔的、或有孔和无孔的层的组合。可以使用无孔的支撑件500a、500b来阻止或者防止组织从周围组织向内生长，从而充当防粘连屏障并且防止不想要的疤痕组织的形成。
与在此公开的手术吻合装置一起使用的手术支撑件500a、500b的另外的示例性材料在共同转让的、专利号为5,542,594、5,908,427、5,964,774和6,045,560的美国专利以及共同转让的于2006年4月20日提交的公开号为2006/0085034的美国申请、于2006年6月22日提交的公开号为2006/0135992的美国申请中给出，各个专利的全部内容均通过引用合并于此。
如在当前实施例中所图示的并且如图2和图3所示，通过策略性地放置使手术支撑件500a、500b附着在吻合钉钉仓32和/或砧座板302的向内的面上或组织接触面220、320上的附接垫240、340（如下面详细描述的），手术支撑件500可释放地附接到吻合钉钉仓组件200和/或砧座组件300上。附接垫240、340由与手术支撑件500a、500b相同的可降解的聚合物制成。附接垫240、340和手术支撑件500a、500b由相同材料组成使得因附接垫240、340和手术支撑件500a、500b具有相同的熔化温度和化学特性而更易粘结。
参照图2，通过在组织接触面220的近侧端260和远侧端262两者上均放置至少一个附接垫240，吻合钉钉仓组件200的钉仓支撑件500a被可操作地固定或粘附到吻合钉钉仓32的组织接触面220上。附接垫240被布置在钉仓支撑件500a与组织接触面220之间。吻合钉钉仓组件200进一步包括第一外边缘248a和第二外边缘248b。如图2所示，远侧附接垫240a被布置在第一外边缘248a与吻合钉钉仓组件200的中央纵向狭槽238的远侧端之间。类似地，远侧附接垫240a被布置在第二外边缘248b与中央纵向狭槽238的远侧端之间。近侧附接区240b被布置在第一外边缘248a与中央纵向狭槽238的近侧端之间并且在第二外边缘248b与中央纵向狭槽238的近侧端之间。在这个实施例中，中央附接垫240c被布置在组织接触面220的近侧端260和远侧端262之间，组织接触面220在第一外边缘248a与中央纵向狭槽238之间并且在第二外边缘248b与中央纵向狭槽238之间。构想了其他实施例，其中多个附接垫240被布置在沿组织接触面220的不同的位置中。
参照图3，并且类似于钉仓支撑件500a，通过在组织接触面320的近侧端360和远侧端362两者上均放置至少一个附接垫340，砧座支撑件500b被可操作性地固定或粘附到砧座组件300的砧座板302的组织接触面320上。远侧附接垫340a被布置在外边缘348a、348b与中央纵向狭槽338的远侧端之间。近侧附接垫340b被布置在外边缘348a、348b与中央纵向狭槽338的近侧端之间。进一步，中央附接区340c被放置在近侧端360与远侧端362之间并且在外边缘348a、348b与中央纵向狭槽338之间。
在此公开的任何实施例中，附接垫可以是圆形、椭圆形、矩形的或者具有任何形状并且可以设置在末端执行器组件的至少一个组织接触面上。
在实施例中，构想附接垫240、340通过包覆模制、注射成型、或通过卡扣配合并且通过将预先成形的部件固定到相应的组织接触面220、320上而被布置在吻合钉保持腔52和吻合钉成形腔68中。图4和图5图示出分别被布置在吻合钉钉仓32和砧座板302上的支撑件500a、500b。如图4所示，附接垫240可以沿着吻合钉钉仓200的组织接触面220被布置在选择性放置的吻合钉保持腔52中。类似地，如图5所示，附接垫340沿着砧座板302的组织接触面320被布置在吻合钉成形腔68中。
在组装期间，支撑件500a、500b分别被放置在吻合钉钉仓组件200和砧座组件300的各个组织接触面220、320上。使用超声波焊接将支撑件500a、500b接合于相应的附接垫240、340上从而接合在相应的组织接触面220、320上。还设想其他的接合方法，诸如激光焊接、溶剂粘结、或热挤压。如上所述，因为支撑件500a、500b由与附接垫240、340相同的材料制成，所以平衡了支撑件与附接垫240、340之间的接合强度和释放力，使得支撑件材料在组织操纵和吻合钉定位期间保持固定到组织接触面220、320上。在此公开的任何实施例中，还构想附接区或附接垫可以被布置在砧座板的纵向狭槽中、吻合钉钉仓32中、或两者之中。
如图6所图示的，在手术吻合装置10的使用期间，在其上装载有手术支撑件500a、500b的第一钳夹或吻合钉钉仓组件200和第二钳夹或砧座组件300被放置在手术部位的任一面上。吻合钉钉仓组件200和砧座组件300的组织接触面220、320被放置在待彼此紧固的组织“T”的相邻层上。
如图7所示，吻合钉钉仓组件200包括被放置在吻合钉钉仓32的单独的吻合钉保持槽52内的手术吻合钉50。吻合钉50为常规类型并且包括钉冠54，钉冠54具有从钉冠54延伸的一对钉腿56和58。钉腿56和58分别终止于组织穿透尖端60和62。推动器64位于吻合钉保持槽52内并且被放置在吻合钉50和驱动杆36的路径之间。
在所图示的实施例中，初始时，手术吻合装置10被扳机33相对于手柄12（图1）的移动所致动，引起驱动器36在箭头“A”（图6）的方向上并且抵靠砧座板302的斜边21移动，由此引起砧座组件300相对于吻合钉钉仓组件200移动至闭合位置。随着驱动杆36在吻合钉钉仓32内向远侧推进，驱动杆36与楔形滑块66交互作用以推动推动器64向上抵靠吻合钉50的钉冠54，朝向砧座组件300的砧座板302中的吻合钉成形腔或凹槽68来驱动吻合钉50的钉腿56和58通过钉仓支撑件500a、组织“T”以及砧座支撑件500b。吻合钉钉腿56和58的组织穿透尖端60和62被弯折在砧座板302中的吻合钉成形腔68内，钉冠54使手术支撑件500抵靠组织“T”而固定。
如图7中的实施例所示，附接区240、340分别被安插在吻合钉钉仓32和砧座板302的相应的组织接触面220、320与钉仓支撑件500a和砧座支撑件500b之间。在发射后，打开末端执行器组件16释放了钉仓支撑件500a与附接区240之间的接合，从而将钉仓支撑件500a从吻合钉钉仓32的组织接触面220释放。类似地，砧座支撑件500b与附接区340之间的接合被破坏并且将砧座支撑件500b从砧座板302的组织接触面320释放。如上所述，因为支撑件500a、500b由相同的材料制成，所以在释放手术支撑件500a、500b与吻合钉钉仓32与砧座板302之间的接合时，存在更小的将任何非可降解的材料从吻合钉钉仓32或砧座板302移入身体的风险。还构想在此公开的任何实施例中，支撑件可以由不同于附接区或附接垫的材料制成并且可以是生物可降解的、生物可吸收的、生物再吸收的或非生物可吸收的。优选由生物可降解的、生物可吸收的、生物再吸收的或可植入的材料制成附接垫或附接区。在此公开的任何实施例中，支撑件、附接垫或附接区、或支撑件和附接垫或附接区均可以由会在身体内遇水、血液等等快速降解而允许支撑件与器械分离的材料制成。可以使用淀粉、糖或盐。
可以构想的是，在此公开的任何实施例中，支撑件和附接垫或附接区由相同或类似的材料制成以便使支撑件能够容易焊接在相同或类似的材料上。垫或区使用相同或类似的材料意味着避免了在支撑件分离期间可能脱离垫或钉仓的外来的、非可降解的材料进入身体的担忧。
在手术吻合装置10完全致动时，可以利用与手术吻合装置10相关联的并且由驱动器36承载的刀具30（图7）来切割组织“T”以及在现在成形的吻合钉50的各排之间的手术支撑件500a、500b。在砧座组件300移动至与吻合钉钉仓组件200间隔开的打开位置时，支撑件500a、500b被从相应的吻合钉钉仓组件200和砧座组件300的相应的组织接触面220、320拉开。
在图8中图示出由吻合钉50分隔并且吻合闭合而形成的组织“T”。具体地，手术支撑件500a、500b通过吻合钉50的钉腿56、58和钉冠54被抵靠组织“T”而固定。因此，手术支撑件500a、500b被吻合到组织“T”，从而封闭并且加固由吻合钉50产生的吻合钉线。
现在参照图9A和图9B，示出了与本公开的手术支撑件124一起使用的环形手术吻合装置110。手术吻合装置110包括具有至少一个可枢转的致动手柄构件133的手柄组件112以及推进构件135。设置从手柄构件112延伸的管状本体部114，可以将管状本体部114构造成具有沿其长度的弯曲形状。本体部114终止于吻合钉钉仓组件122，吻合钉钉仓组件122包括具有一对环形阵列的吻合钉保持槽152，在各个吻合钉保持槽152中布置吻合钉150。位于吻合钉钉仓122的远侧，设置有包括砧座构件121和与其操作性地相关联的轴123的砧座组件120，用于将砧座组件120可移除地连接至吻合装置110的远侧端部。
吻合钉钉仓组件122可以固定地连接至管状本体部114的远侧端并且可以被配置为同心地装配在管状本体部114的远侧端内。吻合钉钉仓组件122包括吻合钉推动器164，吻合钉推动器164包括具有通常呈截头圆锥形形状的近侧部和限定了在圆周上间隔开的指状物（未示出）的两个同心环的远侧部，指状物中的每一个被接纳在相应的吻合钉保持槽152内。
大致呈敞口杯形式的、其边缘限定刀片131的刀具130被布置在吻合钉钉仓组件122内并且被安装在吻合钉推动器164的远侧表面上。刀具130向一对环形阵列的吻合钉150的径向内部布置。因此，在使用中，随着推进吻合钉推动器164，刀具130也在轴向上向远侧推进。
如图10A所示，手术支撑件124在被布置在手术支撑件124与吻合钉钉仓组件122的组织接触面134之间的附接垫140处被可释放地附接到吻合钉钉仓组件122上。如上所述，附接垫140将手术支撑件124接合到组织接触面134上。手术支撑件124被设置成环形配置并且包括中央孔125以穿过其中接纳砧座组件120的轴123。
设想的是，手术支撑件124可以以类似于与被附接至吻合钉钉仓组件122的手术支撑件124的方式另外地或可替代地附接或粘附到砧座板121的组织接触面上。
如图10B所示，手术支撑件124可以沿着手术支撑件124的内部或内周缘160和外部或外周缘162被固定或粘结到吻合钉钉仓122。设想的是，可以利用其他配置来将手术支撑件124保持在吻合钉钉仓组件122，诸如与吻合钉钉仓300一起讨论的、附接垫140在吻合钉保持槽内的布置，或者改变在吻合钉保持槽152之间的附接区140、或者在本领域的普通技术人员的可知范围内的其他布置。
手术吻合装置110和可拆卸的砧座组件120被使用在吻合操作中以实现肠段50和肠段52的结合。典型地使用包括腹腔镜检查装置和仪器的最小侵入性的手术技术来执行吻合操作。如图11所示的操作点处，患病的肠段已经先被移除了，已经将砧座组件120（在其上可选择地包括手术支撑件124）通过手术切口或穿过肛门施加到操作部位上并且放置在肠段52内，并且手术吻合装置110的管状本体部114（在其上可选择地包括手术支撑件124）已经被经肛门插入至肠段50中。如图12所图示出，还示出了通过常规手段诸如钱包线形缝合线“P”围绕相应的部件（例如，砧座组件120的轴123以及管状本体部114的远侧端）临时地固定肠段50和肠段52。
此后，临床医师操纵砧座组件120直到将轴123的近侧端插入手术吻合装置110的管状本体部114的远侧端，其中在管状本体部114的远侧端内的安装结构（未示出）接合轴123以实现安装。然后接近砧座组件120和管状本体部114以便接近肠段50和肠段52。然后发射手术吻合装置110。刀具（未示出）切割组织的一部分并且手术支撑件124向刀具径向内部布置以完成所述吻合。砧座组件120和吻合钉钉仓组件122打开的力与吻合到肠段50和肠段52的手术支撑件124一起造成手术支撑件124在附接垫140处释放，从而将手术支撑件124从组织接触面134释放。
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装置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。例如，构思在此公开的任何实施例中手术器械可以是手动的或电动的。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，除了由所附的权利要求书所指明的之外，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 (19)
1.一种与手术吻合器一起使用的末端执行器组件，所述末端执行器包括：
吻合钉钉仓组件，其具有组织接触面；
砧座组件，其具有组织接触面；
手术支撑件，其被配置并且定尺寸为大体上置于所述吻合钉钉仓组件和砧座组件中至少一个的所述组织接触面的至少一部分之上；以及
多个附接垫，其被固定在所述吻合钉钉仓组件和砧座组件中至少一个的至少一个所述组织接触面上，所述吻合钉钉仓组件和砧座组件中至少一个被配置为将相应的支撑件材料保持在其上，
其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。
2.根据权利要求1所述的末端执行器组件，其中所述附接垫中的至少一个由选自以下群组的材料制成，所述群组包括：乙交酯、三亚甲基碳酸酯、交酯、己内酯及其组合。
3.根据权利要求2所述的末端执行器组件，其中所述附接垫中的至少一个被放置在所述吻合钉钉仓组件和砧座组件的至少一个所述组织接触面的凹槽中。
4.根据权利要求3所述的末端执行器组件，其中所述吻合钉钉仓组件和砧座组件具有被配置为使刀片能够从中通行的中央纵向延伸狭槽。
5.根据权利要求4所述的末端执行器组件，其中至少一个附接垫被放置在所述中央纵向延伸狭槽附近。
6.根据权利要求5所述的末端执行器组件，其中，所述吻合钉钉仓组件和砧座组件中的每个具有远侧端，使得至少一个远侧附接垫被放置在所述吻合钉钉仓组件和砧座组件中的每个的第一外边缘与所述中央纵向延伸狭槽的远侧端之间。
7.根据权利要求6所述的末端执行器组件，其中，所述吻合钉钉仓组件和砧座组件中的每个具有近侧端，使得至少一个近侧附接垫被放置在所述吻合钉钉仓组件和砧座组件中的每个的第一外边缘与所述中央纵向延伸狭槽的近侧端之间。
8.根据权利要求3所述的末端执行器组件，其中所述吻合钉钉仓组件、所述砧座组件和所述手术支撑件大体上是圆形的，其中所述圆形支撑件包括内部、外部以及在所述内部与所述外部之间延伸的中部，并且至少一个附接垫沿所述中部固定。
9.一种与手术吻合装置一起使用的吻合钉钉仓，所述吻合钉钉仓包括：
钉仓本体，其包括限定多个吻合钉保持槽的组织接触面；
吻合钉，其被布置在所述钉仓本体的各个吻合钉保持槽内；
手术支撑件，其被配置并且定尺寸为大体上置于所述钉仓本体的所述吻合钉保持槽的至少一部分之上；以及
多个附接垫，其被固定到所述钉仓本体的所述组织接触面上，所述钉仓本体被配置为将相应的支撑件材料保持在其上，
其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。
10.根据权利要求9所述的吻合钉钉仓，其中所述附接垫中的至少一个由选自以下群组的材料制成，所述群组包括：乙交酯、三亚甲基碳酸酯、交酯、己内酯及其组合。
11.根据权利要求10所述的吻合钉钉仓，其中所述钉仓本体具有被配置为使刀片能够从中通行的中央纵向延伸狭槽。
12.根据权利要求11所述的吻合钉钉仓，其中所述钉仓本体的至少一个附接垫被布置在所述中央纵向延伸狭槽附近。
13.根据权利要求12所述的吻合钉钉仓，其中所述吻合钉钉仓具有远侧端，使得至少一个远侧附接垫被放置在所述吻合钉钉仓的第一外边缘与所述中央纵向延伸狭槽的远侧端之间。
14.根据权利要求13所述的吻合钉钉仓，其中所述吻合钉钉仓具有近侧端，使得至少一个近侧附接垫被放置在所述吻合钉钉仓的第一外边缘与所述中央纵向延伸狭槽的近侧端之间。
15.根据权利要求10所述的吻合钉钉仓，其中所述吻合钉钉仓和所述手术支撑件大体上是圆形的，其中所述圆形手术支撑件包括内部、外部以及在所述内部与所述外部之间延伸的中部，并且至少一个附接垫沿所述中部固定。
16.一种手术吻合装置，包括：
壳体；
末端执行器，其被固定至所述壳体和具有组织接触面的吻合钉钉仓组件以及具有组织接触面的砧座组件；
手术支撑件，其被配置并且定尺寸为大体上置于所述吻合钉钉仓组件和砧座组件中至少一个的所述组织接触面的至少一部分之上；以及
多个附接垫，其被固定在所述吻合钉钉仓组件和砧座组件中至少一个的至少一个所述组织接触面上，所述吻合钉钉仓组件和砧座组件中至少一个被配置为将相应的支撑件材料保持在其上，
其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。
17.根据权利要求16所述的手术吻合装置，其中所述多个附接垫被布置在沿所述吻合钉钉仓组件和砧座组件的至少一个所述组织接触面的凹槽中。
18.根据权利要求17所述的手术吻合装置，其中所述附接垫中的至少一个由选自以下群组的材料制成，所述群组包括：乙交酯、三亚甲基碳酸酯、交酯、己内酯及其组合。
19.根据权利要求18所述的手术吻合装置，其中所述手术支撑件被超声焊接到所述多个附接垫中的每个上。
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Also Published As
| Publication number | Publication date |
|---|---|
| ES2645420T3 (es) | 2017-12-05 |
| CA2821619C (en) | 2020-07-14 |
| JP2018110929A (ja) | 2018-07-19 |
| JP2014036842A (ja) | 2014-02-27 |
| AU2013206804A1 (en) | 2014-03-06 |
| CA2821619A1 (en) | 2014-02-15 |
| AU2013206804B2 (en) | 2017-12-07 |
| JP6362307B2 (ja) | 2018-07-25 |
| CN103584893B (zh) | 2017-05-31 |
| EP2698118A1 (en) | 2014-02-19 |
| JP2020014881A (ja) | 2020-01-30 |
| EP2698118B1 (en) | 2017-10-04 |
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