CN103690212B - 具有自换切割刀功能的外科线形吻合器 - Google Patents
具有自换切割刀功能的外科线形吻合器 Download PDFInfo
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- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- 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
- A61B17/07207—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 the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- 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
- A61B2017/07214—Stapler heads
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- 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
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
Abstract
一种具有自换切割刀功能的外科线形吻合器,实现在钉仓组件内的刀仓内安装的切割刀分为初装切割刀和多把备用切割刀,完成初装切割刀的切割操作后,将初装切割刀重新装入刀仓的刀槽内,将初装切割刀带离刀架,同时刀仓将与初装切割刀邻近的第一把备用切割刀安装在刀架上,依次完成更换切割刀的动作,达到钉仓的结构较简单、成本较低,在手术过程中切割刀的刀刃每次使用时能保持锋利,顺利执行切割各种组织的任务,甚至切割以前钉合在组织上的吻合钉的技术效果。
Description
技术领域
本发明涉及到各种外科线形吻合器中安装切割刀的,特别涉及到外科线形切割吻合器中安装的切割刀,还特别涉及到腔镜外科线形切割吻合器中安装的切割刀,也特别涉及到各种电动外科线形吻合器中安装的切割刀。
背景技术
各种外科线形吻合器用于代替外科手术中采用针线徒手吻合操作,正在被广泛地用于人体消化道器官、呼吸道器官和泌尿生殖器官等器官和组织的端端、端侧及侧侧吻合等手术,形成通道的手术、闭合切口的手术和夹紧或切割的手术,特别适用于显露和操作困难的器官和组织的吻合手术,可以减少手术时间,提高手术质量。
如美国专利公示20050222616的外科直形切割吻合器、美国专利公示20100200639的腔镜外科切割吻合器、美国专利公示20130018361的各种电动的外科线形吻合器和其他各种手动的、或电动的、或液动的、或气动的外科线形吻合器中所介绍的:外科线形吻合器由钉仓组件、钉砧组件和操作机构组成。钉仓组件内有钉仓和安装在钉仓内的吻合钉、推钉块和切割刀。钉砧组件内的钉砧的表面上有内凹后形成的钉砧成形槽。钉砧表面上的钉砧成形槽与钉仓内的吻合钉的位置相互对应。当操作机构将待吻合组织夹紧在相互靠拢的钉砧和钉仓之间后,操作机构通过推动推钉块将吻合钉从钉仓内推出,使吻合钉的钉尖穿透被夹紧的待吻合组织后,吻合钉在钉砧上的钉砧成形槽上弯曲成形,达到将组织吻合的手术目的。上述美国专利公示的内容通过引用并入本说明书。
在使用外科线形吻合器时,每次操作机构通过推动推钉块将吻合钉从钉仓内推出吻合组织后,由于钉仓内已无吻合钉,因此需要更换一只装有吻合钉的钉仓,才能继续下一次吻合组织的手术。这种外科线形吻合器的令人不满意处是,在手术过程中,外科线形吻合器内的切割刀经过几次切割组织后刀刃逐渐变钝,特别是切割刀的刀刃切割到以前钉合在组织上的吻合钉时刀刃已被损坏,如果继续使用,切割刀将无法正常切割组织,从而造成外科线形吻合器失效,甚至手术失败。美国专利公示20130056522介绍一种外科线形吻合器:采用更换一只装有吻合钉和切割刀的钉仓,此种钉仓的结构较复杂、成本较高。因此外科线形吻合器还需改进。
由上述显然可以看出,现在已经设计了大量不同式样的外科线形吻合器,并且新的外科线形吻合器的研制工作仍在继续,以便对每年世界上大量使用的外科线形吻合器作进一步的改进,既达到减少手术时间、术中污染、器械使用成本的目的,又达到避免发生更换错误的钉仓、更换曾经使用过的钉仓、忘了更换钉仓却又继续使用等引起医疗事故的差错的目的。
发明内容
本发明的目的在于提出一种具有自换切割刀功能的外科线形吻合器,实现在钉仓组件内的刀仓内安装的切割刀分为初装切割刀和多把备用切割刀,其中初装切割刀先被安装在刀架上。当驱动机构带动刀架完成初装切割刀的切割操作后,将初装切割刀重新装入刀仓的刀槽内,再带动刀仓在钉仓组件内向侧面移动,使得初装切割刀和备用切割刀跟随刀仓一起向侧面移动,将初装切割刀带离刀架,同时刀仓将与初装切割刀邻近的第一把备用切割刀安装在刀架上。安装在刀仓的刀槽内的备用切割刀以上述方式依次有一把邻近的备用切割刀被刀仓安装在刀架上,再次被刀架从刀仓的刀槽内推出、再次被刀架重新装入刀仓的刀槽内、再次被刀仓移动带离刀架,依次完成更换切割刀的动作。从而使得本发明的具有自换切割刀功能的外科线形吻合器的钉仓的结构较简单、成本较低,在手术过程中切割刀的刀刃每次使用时能保持锋利,顺利执行切割各种组织的任务,甚至切割以前钉合在组织上的吻合钉。
本发明的目的是通过下述技术方案实现的:
本发明的具有自换切割刀功能的外科线形吻合器中的钉仓组件由钉仓、钉仓架和驱动机构组成。钉仓和驱动机构安装在钉仓架内,钉仓呈线形。在钉仓中至少交错排列两排钉孔。在钉仓内安装有推钉块和吻合钉。吻合钉安装在钉仓的钉孔内。
在钉仓组件内安装有斜锲、刀仓、刀架和切割刀。斜锲和刀架被约束在钉仓组件内可前后移动。刀仓被约束在钉仓组件内可向侧面移动。刀仓上有分隔的刀槽。切割刀分为初装切割刀和备用切割刀。初装切割刀和备用切割刀安装在刀仓的刀槽内,其中初装切割刀此时安装在刀架上。
当驱动机构推动斜锲和刀架在钉仓组件内向前移动时,斜锲推动推钉块将吻合钉从钉仓的钉孔内推出,同时,初装切割刀被刀架从刀仓的刀槽内推出、跟随刀架一起前移。
当驱动机构带动刀架在钉仓组件内后移将初装切割刀重新装入刀仓的刀槽内后,驱动机构再带动刀仓在钉仓组件内向侧面移动,使得初装切割刀和备用切割刀跟随刀仓一起向侧面移动,将初装切割刀带离刀架,同时刀仓将与初装切割刀邻近的第一把备用切割刀安装在刀架上,完成首次更换切割刀的动作。
当驱动机构再次推动斜锲和刀架在钉仓组件内前移时,斜锲推动推钉块将吻合钉从钉仓的钉孔内推出,同时,刀架将第一把备用切割刀从刀仓的刀槽内推出,使得第一把备用切割刀跟随刀架一起前移。当驱动机构再次带动刀架在钉仓组件内后移将第一把备用切割刀重新装入刀仓的刀槽内后,驱动机构再次带动刀仓在钉仓组件内向侧面移动,使得初装切割刀和第一把备用切割刀跟随刀仓一起向侧面移动,将第一把备用切割刀带离刀架,同时刀仓将与第一把备用切割刀邻近的第二把备用切割刀安装在刀架上,再次完成更换切割刀的动作。安装在刀仓的刀槽内的备用切割刀以上述方式依次有一把邻近的备用切割刀被刀仓安装在刀架上,再次被刀架从刀仓的刀槽内推出、再次被刀架重新装入刀仓的刀槽内、再次被刀仓移动带离刀架,依次完成更换切割刀的动作。
本发明的刀仓上可以有螺旋机构。驱动机构通过驱动刀仓上的螺旋机构带动刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
刀仓上的螺旋机构可以由驱刀螺杆和螺母组成,其中螺母位于刀仓内。驱刀螺杆拧入刀仓的螺母内。驱动机构通过驱动刀仓上的螺旋机构的驱刀螺杆带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
驱刀螺杆上可以固定有齿轮。驱动机构通过转动驱刀螺杆上的齿轮,驱动刀仓上的螺旋机构的驱刀螺杆带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
本发明的驱动机构内可以有斜面推板转盘机构和槽轮间歇转位机构。斜面推板转盘机构由在钉仓组件内前后直线移动的斜块和在端面上分布凸块的转盘组成。槽轮间歇转位机构由被约束在钉仓组件内旋转的主动拨盘和从动槽轮组成。拨盘端面的周向分布有圆销。槽轮上有齿轮和周向分布的径向槽。
当驱动机构带动斜面推板转盘机构的斜块在钉仓组件内开始向前移动时,斜块推动拨盘端面上的凸块沿斜块的下斜面滑动,从而带动拨盘在钉仓组件内转动,拨盘再带动槽轮在钉仓组件内转动,槽轮通过转动驱刀螺杆上的齿轮,驱动刀仓上的螺旋机构的驱刀螺杆带动刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
当驱动机构带动斜块在钉仓组件内向后移动到靠近终点时,斜块推动拨盘端面上的凸块沿斜块的上斜面滑动,从而带动拨盘在钉仓组件内转动,拨盘再带动槽轮在钉仓组件内转动,槽轮再驱动所述刀仓上的螺旋机构的驱刀螺杆带动刀仓在钉仓组件内向侧面移动。
斜面推板转盘机构的转盘与槽轮间歇转位机构的拨盘可以组合成一体。
槽轮间歇运动机构的槽轮可以固定在刀仓上的螺旋机构的驱刀螺杆上。槽轮间歇运动机构的槽轮通过驱动刀仓上的螺旋机构的驱刀螺杆带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
在槽轮间歇运动机构的槽轮上可以固定有齿轮,在刀仓上的螺旋机构的驱刀螺杆上可以固定有齿轮。槽轮间歇运动机构的槽轮上的齿轮和刀仓上的螺旋机构的驱刀螺杆上的齿轮分别与同一根齿条相互啮合。槽轮间歇运动机构的槽轮上的齿轮通过齿条驱动刀仓上的螺旋机构的驱刀螺杆上的齿轮带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
在槽轮间歇运动机构的槽轮上可以固定有齿轮,在刀仓上的螺旋机构的驱刀螺杆上可以固定有齿轮。槽轮间歇运动机构的槽轮上的齿轮与驱刀螺杆上的齿轮相互啮合。槽轮上的齿轮通过转动驱刀螺杆上的齿轮,驱动刀仓上的螺旋机构的驱刀螺杆带动刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
本发明的驱动机构内可以有斜面推板转盘机构。斜面推板转盘机构由在钉仓组件内前后直线移动的斜块和在端面上分布凸块的转盘组成。在斜面推板转盘机构的转盘上可以固定有齿轮。在刀仓上的螺旋机构的驱刀螺杆上可以固定有齿轮。斜面推板转盘机构的齿轮与驱刀螺杆的齿轮相互啮合。
当驱动机构带动斜面推板转盘机构的斜块在钉仓组件内开始向前移动时,斜块推动转盘端面上的凸块沿斜块的下斜面滑动,从而带动转盘在钉仓组件内转动。斜面推板转盘机构的齿轮通过驱动所述刀仓上的驱刀螺杆的齿轮,带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
当驱动机构带动斜块在钉仓组件内向后移动到靠近终点时,斜块推动所述转盘端面上的凸块沿斜块的上斜面滑动,从而带动转盘在钉仓组件内转动。斜面推板转盘机构的齿轮通过驱动刀仓上的驱刀螺杆的齿轮,带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
附图说明
图1是表示本发明的具有自换切割刀功能的外科线形吻合器中的钉仓组件的外观图;
图2是表示图1的钉仓组件移去钉仓架后的外观图;
图3是表示图2的钉仓组件移去右爿钉仓及其内装零件后的外观图;
图4是表示图3的钉仓组件移去左爿钉仓、刀仓和斜锲后的外观图;
图5是表示左爿钉仓的外观图;
图6是表示右爿钉仓的外观图;
图7是表示吻合钉、驱钉螺杆和推钉块的局部安装外观图;
图8是表示单个驱钉螺杆的外观图;
图9是表示单个推钉块的外观图;
图10是表示同排推钉块的外观图;
图11是表示图4的钉仓组件准备第一击发操作时的右侧外观图;
图12是表示图11的钉仓组件准备第一击发操作时的左侧外观图;
图13是表示图4的钉仓组件完成第一击发操作时的右侧外观图;
图14是表示图13的钉仓组件完成第一击发操作时的左侧外观图;
图15是表示图4的钉仓组件准备第二击发操作时的右侧外观图;
图16是表示图15的钉仓组件准备第二击发操作时的左侧外观图;
图17是表示图4的钉仓组件完成第二击发操作时的右侧外观图;
图18是表示图17的钉仓组件完成第二击发操作时的左侧外观图;
图19是表示图11的斜面推板转盘机构和槽轮间歇转位机构的右侧外观图;
图20是表示图19的斜面推板转盘机构和槽轮间歇转位机构的左侧外观图;
图21是表示部分完成第一次装钉和换刀时斜面推板转盘机构和槽轮间歇转位机构的右侧外观图;
图22是表示图21的斜面推板转盘机构和槽轮间歇转位机构的左侧外观图;
图23是表示完成第一次装钉和换刀时斜面推板转盘机构和槽轮间歇转位机构的右侧外观图;
图24是表示图23的斜面推板转盘机构和槽轮间歇转位机构的左侧外观图;
图25是表示槽轮间歇转位机构的齿轮与驱钉螺杆的齿轮相互啮合的外观图;
图26是表示槽轮间歇转位机构的槽轮固定在驱钉螺杆上的外观图;
图27是表示槽轮间歇转位机构的齿轮与驱刀螺杆的齿轮相互啮合的外观图;
图28是表示槽轮间歇运动机构的槽轮固定在驱刀螺杆上的外观图;
图29是表示斜面推板转盘机构的齿轮与驱刀螺杆的齿轮相互啮合的外观图。
具体实施方式
下面用举例方式,结合附图陈述本发明的具有自换切割刀功能的外科线形吻合器的最佳实施例。本发明的范围将在权利要求中指出。应当认识到某些或全部附图都是为了说明本发明的最佳实施例的说明简图,而并未描绘出所示部分的真实尺寸。参考最佳实施例的详细叙述,将会更加清楚地理解达到本发明上述的和其它的目的和优点的实际方式。
为了便于图示说明本发明各种实施例的具有自换切割刀功能的外科线形吻合器的技术特征、技术方案和技术效果,以下各种实施例中仅主要图示外科线形吻合器中的钉仓组件和操作机构与钉仓组件相关的驱动机构部分,钉砧组件和操作机构在各种外科线形吻合器中的具体结构和功能可参考本说明书的背景技术中引用的各篇美国专利公示中的内容。
在附图和下面的描述中,术语“近端”是指外科线形吻合器靠近操作者的一端,而术语“远端”是指外科线形吻合器远离操作者的一端。其他方向性术语可根据附图和下面的描述来理解。如图1所示,方向1表示近或后,方向2表示远或前,方向3表示左,方向4表示右,方向5表示上或顶,方向6表示下或底。
图1至图5表示本发明的具有自换切割刀功能的外科线形吻合器中的钉仓组件7。钉仓组件7由钉仓8、钉仓架9和驱动机构10组成。钉仓8和驱动机构10安装在钉仓架9内。在钉仓8的走刀槽11的两侧各交错排列两排钉孔12。在钉仓8内安装有推钉块13和吻合钉14。
如图2至图12所示,钉仓8内安装的吻合钉14分为初装吻合钉15和三只备用吻合钉16、17和18。初装吻合钉15安装在钉仓8的钉孔12内、其钉梁19位于推钉块13的端面20上方。在钉仓8中的各个钉孔12的侧面内各有储钉孔21。在每个储钉孔21内各安装三只备用吻合钉16、17和18。在钉仓8内安装驱钉螺杆22。初装吻合钉15的钉腿23和24和备用吻合钉16、17和18的钉腿25、26、27、28、29和30分别插在各个驱钉螺杆22的螺纹的螺槽31内。
如图13至图18所示,当驱动机构10推动推钉块13将初装吻合钉15从钉仓8的钉孔12内推出后,驱动机构10先将推钉块13从钉仓8的顶部拉回到钉仓8的底部,然后带动驱钉螺杆22转动,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,将各个储钉孔21内与初装吻合钉15相邻的一只备用吻合钉16装在钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉17和18依次移动到前一备用吻合钉的原先位置。驱动机构10再先推动推钉块13将备用吻合钉16从钉仓8的钉孔12内推出,然后将推钉块13从钉仓8的顶部拉回到钉仓8的底部,再转动驱钉螺杆22,驱钉螺杆22的螺纹的螺槽31则再带动储钉孔21内的备用吻合钉17和18的钉腿27、28、29和30移动,将各个储钉孔21内的另一只备用吻合钉17装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉18则再依次移动到前一只备用吻合钉的原先位置。各个储钉孔21内的备用吻合钉16、17和18以上述方式每次各有一只备用吻合钉被装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,再依次被推钉块13从钉仓8的钉孔12内推出。
如图1至图8所示,钉仓8由左爿钉仓32和右爿钉仓33合拢组成。在左爿钉仓32和右爿钉仓33中各交错排列两排钉孔34和35。在左爿钉仓32和右爿钉仓33的两个侧面上分别排列多个直通各个钉孔34和35的侧面的储钉孔36和37。在每个储钉孔36或37内各安装三只备用吻合钉16、17和18。左爿钉仓32和右爿钉仓33合拢后安装在钉仓架9内,左爿钉仓32与右爿钉仓33之间有走刀槽11。
如图7和图8所示,驱钉螺杆22的螺纹的螺槽31位于相邻的两个吻合钉38和39的相邻的钉腿40和41之间,相邻的两个吻合钉38和39的相邻的钉腿40和41分别插在同一驱钉螺杆22两侧的双头螺纹的螺槽31内。
如图11至图18所示,驱钉螺杆22上固定有齿轮44。驱动机构10通过转动驱钉螺杆22上的齿轮44,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,每次将各个储钉孔21内的一只备用吻合钉装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉依次移动到前一备用吻合钉的原先位置。同排的各个驱钉螺杆22上的齿轮44与同一齿条45相互啮合。驱动机构10通过移动齿条45转动同排的驱钉螺杆22上的齿轮44,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,每次将各个储钉孔21内的一只备用吻合钉装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉依次移动到前一备用吻合钉的原先位置。
如图19至图24所示,驱动机构10内有斜面推板转盘机构46和槽轮间歇转位机构47。斜面推板转盘机构46由在钉仓组件7内前后直线移动的斜块48和在端面上分布凸块49、50和51的转盘52组成。槽轮间歇转位机构47由被约束在钉仓组件7内旋转的主动拨盘53和从动槽轮54组成。拨盘53端面的周向分布有圆销55、56和57和外凸圆弧58、59和60。槽轮52上有周向分布的径向槽61、62、63和64和锁止弧65、66、67和68和齿轮69。斜面推板转盘机构46的转盘52与槽轮间歇转位机构47的拨盘53组合成一体。
槽轮间歇运动机构47的槽轮54上的齿轮69和驱钉螺杆22上的齿轮44分别与同一根齿条45相互啮合。槽轮间歇运动机构47的槽轮54上的齿轮69通过齿条44驱动驱钉螺杆22上的齿轮44转动。
当驱动机构10带动斜面推板转盘机构46的斜块48在钉仓组件7内开始向前移动时,斜块48脱离转盘52的凸块51向前移动(见图19),此时,拨盘53的外凸圆弧58在槽轮54的锁止弧65内、拨盘53的圆销55留在槽轮54的径向槽61的出口处将槽轮54锁住(见图20)。驱动机构10推动推钉块13将初装吻合钉15从钉仓8的钉孔12内推出。
当驱动机构10推动推钉块13将初装吻合钉15从钉仓8的钉孔12内推出后,驱动机构10后移,先将推钉块13从钉仓8的顶部拉回到钉仓8的底部,然后带动斜块48在钉仓组件7内向后移动到靠近终点时,斜块48推动转盘52的凸块49沿斜块48的上斜面71滑动,从而带动拨盘53转动,带动转盘52端面上的凸块50转到备用状态(见图21)。当驱动机构10带动斜块48在钉仓组件7内向后移动到靠近终点时,拨盘53的外凸圆弧58留在槽轮54的锁止弧65内、拨盘53的圆销56进入槽轮54的径向槽62的进口处将槽轮54锁住(见图22)。
当驱动机构10带动斜面推板转盘机构46的斜块48在钉仓组件7内又开始向前移动时,斜块48推动转盘52的凸块50沿斜块48的下斜面70滑动(见图21和23),从而带动拨盘53在钉仓组件7内转动,拨盘53的外凸圆弧58松开槽轮54的锁止弧65,拨盘53的圆销56进入槽轮54的径向槽62带动槽轮54在钉仓组件7内转动(见图22)。槽轮54上的齿轮69通过转动驱钉螺杆22上的齿轮44,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,每次将各个储钉孔21内的一只备用吻合钉装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉依次移动到前一备用吻合钉的原先位置,
当斜块48脱离转盘52的凸块50又继续向前移动时,拨盘53的外凸圆弧59已进入槽轮54的锁止弧66内、拨盘53的圆销56留在槽轮54的径向槽62的出口处将槽轮54锁住(见图24)。
当驱动机构10带动斜块48在钉仓组件7内再向后移动到靠近终点时,斜块48推动转盘52的凸块51沿斜块48的上斜面71滑动,从而带动拨盘53转动,带动转盘52端面上的凸块49转到备用状态。当驱动机构10带动斜块48在钉仓组件7内向后移动到靠近终点时,拨盘53的外凸圆弧59留在槽轮54的锁止弧66内、拨盘53的圆销57进入槽轮54的径向槽63的进口处将槽轮54锁住。
如图25所示,槽轮间歇运动机构47的槽轮54上的齿轮69也可以通过中间齿轮42与驱钉螺杆22上的齿轮44啮合,相邻的驱钉螺杆22上的齿轮44也可以相互啮合。驱动机构10通过转动钉仓8近端的驱钉螺杆72上的齿轮72以带动相互啮合的驱钉螺杆22上的齿轮44一起转动,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,每次将各个储钉孔21内的一只备用吻合钉装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉依次移动到前一备用吻合钉的原先位置。
如图26所示,槽轮间歇运动机构47的槽轮54也可以固定在驱钉螺杆22上,相邻的驱钉螺杆22上的齿轮44也可以相互啮合。驱动机构10通过转动钉仓8近端的驱钉螺杆72上的齿轮72以带动相互啮合的驱钉螺杆22上的齿轮44一起转动,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,每次将各个储钉孔21内的一只备用吻合钉装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,其他备用吻合钉依次移动到前一备用吻合钉的原先位置。
如图11至图24所示,本发明的钉仓组件7内安装有斜锲74、刀仓75、刀架76和切割刀77。斜锲74和刀架76被约束在钉仓组件7内可前后移动。刀仓75被约束在钉仓组件7内可向侧面移动。刀仓75上有分隔的刀槽78。切割刀77分为初装切割刀79和备用切割刀80、81和82。初装切割刀79和备用切割刀80、81和82安装在刀仓75的刀槽78内,其中初装切割刀79此时安装在刀架76上。
当驱动机构10推动斜锲74和刀架76在钉仓组件8内向前移动时,斜锲74推动推钉块13将吻合钉14从钉仓8的钉孔12内推出,同时,初装切割刀79被刀架76从刀仓75的刀槽78内推出、跟随刀架76一起前移。
当驱动机构10带动刀架76在钉仓组件7内后移将初装切割刀79重新装入刀仓75的刀槽78内后,驱动机构10再带动刀仓75在钉仓组件7内向侧面移动,使得初装切割刀79和备用切割刀80、81和82跟随刀仓75一起向侧面移动,将初装切割刀79带离刀架76,同时刀仓75将与初装切割刀79邻近的第一把备用切割刀80安装在刀架76上,完成首次更换切割刀77的动作。
当驱动机构10再次推动斜锲74和刀架76在钉仓组件7内前移时,斜锲74推动推钉块13将吻合钉14从钉仓8的钉孔12内推出,同时,刀架76将第一把备用切割刀80从刀仓75的刀槽78内推出,使得第一把备用切割刀80跟随刀架76一起前移。当驱动机构10再次带动刀架76在钉仓组件7内后移将第一把备用切割刀80重新装入刀仓75的刀槽78内后,驱动机构10再次带动刀仓75在钉仓组件7内向侧面移动,使得初装切割刀79和备用切割刀80、81和82跟随刀仓75一起向侧面移动,将第一把备用切割刀80带离刀架76,同时刀仓75将与第一把备用切割刀80邻近的第二把备用切割刀81安装在刀架76上,再次完成更换切割刀的77动作。安装在刀仓75的刀槽78内的备用切割刀80、81和82以上述方式依次有一把邻近的备用切割刀被刀仓75安装在刀架76上,再次被刀架76从刀仓75的刀槽78内推出、再次被刀架76重新装入刀仓75的刀槽78内、再次被刀仓75移动带离刀架76,依次完成更换切割刀77的动作。
刀仓75上有螺旋机构83。驱动机构10通过驱动刀仓75上的螺旋机构83带动刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
刀仓75上的螺旋机构83由螺杆84和螺母85组成,其中螺母85位于刀仓75内。螺杆84拧入刀仓75的螺母85内。驱动机构10通过驱动刀仓75上的驱刀螺杆84带动刀仓75的螺母85,使得刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
在槽轮间歇运动机构47的槽轮54上固定有齿轮69,在刀仓75上的螺旋机构83的驱刀螺杆84上固定有齿轮86。槽轮间歇运动机构47的槽轮54上的齿轮69和刀仓75上的驱刀螺杆84上的齿轮86分别与同一根齿条44相互啮合。槽轮间歇运动机构47的槽轮54上的齿轮69通过齿条44驱动刀仓75上的驱刀螺杆84上的齿轮86带动刀仓75的螺母85,使得刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
当驱动机构10带动斜面推板转盘机构46的斜块48在钉仓组件7内开始向前移动时,斜块48推动转盘52端面上的凸块49沿斜块48的下斜面70滑动,从而带动拨盘53在钉仓组件7内转动,拨盘53再带动槽轮54在钉仓组件7内转动,槽轮54上的齿轮69通过转动驱刀螺杆84上的齿轮86,驱动刀仓75上的驱刀螺杆84带动刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
当驱动机构10带动斜块48在钉仓组件7内向后移动到靠近终点时,斜块48推动转盘52端面上的凸块50沿斜块48的上斜面71滑动,从而带动拨盘53在钉仓组件7内转动,拨盘53再带动槽轮54在钉仓组件7内转动,槽轮54再驱动刀仓75上的驱刀螺杆84带动刀仓75在钉仓组件7内向侧面移动。
如图27所示,在槽轮间歇运动机构47的槽轮54上可以固定有齿轮87,在刀仓75上的驱刀螺杆84上可以固定有齿轮88。槽轮间歇运动机构47的槽轮54上的齿轮87与驱刀螺杆84上的齿轮88相互啮合。槽轮54上的齿轮87通过转动驱刀螺杆84上的齿轮88,驱动刀仓75上的驱刀螺杆84带动刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
如图28所示,槽轮间歇运动机构47的槽轮54固定在刀仓75上的螺旋机构83的驱刀螺杆84上。槽轮间歇运动机构47的槽轮54通过驱动刀仓75上的驱刀螺杆84带动刀仓75的螺母85,使得刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
如图29所示,斜面推板转盘机构46的齿轮43与驱刀螺杆84的齿轮88相互啮合。斜面推板转盘机构46的齿轮43通过驱动刀仓75上的驱刀螺杆84的齿轮88,带动刀仓75的螺母85,使得刀仓75在钉仓组件7内向侧面移动,完成更换切割刀77的动作。
如图9和10所示,本发明的钉仓8内安装的推钉块13上有阶梯形凸块89。阶梯形凸块89在推钉块13的近端为阶梯形凸块89的下阶90、在推钉块13的远端为阶梯形凸块89的上阶91。阶梯形凸块89的上阶91向推钉块13的前端方向伸出。
当吻合钉14位于推钉块13的端面20上方时,各个推钉块13位于钉仓8的底部,各个推钉块13的阶梯形凸块89的上阶91的伸出部依次盖在前一相邻推钉块13的阶梯形凸块89的下阶90上。
如图13和14、图17和18所示,当驱动机构10带动斜锲74前移推动推钉块13将吻合钉14从钉仓8的钉孔12内依次推出时,各个推钉块13依次向上移动到钉仓8的顶部。
如图11至图18所示,驱动机构10内有压杆92。压杆92上有前臂93和后臂94。压杆92可在钉仓组件7内转动。斜锲74有前斜面95和后斜面96。
当吻合钉14位于推钉块13的端面20上方时,各个推钉块13位于钉仓8的底部,各个推钉块13的阶梯形凸块89的上阶91的伸出部依次盖在相邻推钉块13的阶梯形凸块89的下阶90上。
当驱动机构10带动斜锲74前移推动推钉块13将吻合钉14从钉仓8的钉孔12内依次推出后,各个推钉块13依次向上移动到钉仓8的顶部。
随后斜锲74后移到钉仓组件7的近端,驱动机构10内的压杆92将钉仓8的最近端的推钉块97的阶梯形凸块98的下阶99压回到钉仓8的底部,同时,最近端的推钉块97的阶梯形凸块98的上阶100的伸出部压在相邻推钉块101的阶梯形凸块102的下阶103上,将相邻的推钉块101的阶梯形凸块102的下阶103压回到钉仓8的底部,其余各个推钉块13的阶梯形凸块89的上阶91的伸出部也依次压在相邻推钉块13的阶梯形凸块89的下阶90上,使得钉仓8内的全部推钉块13都被驱动机构10内的压杆92从钉仓8的顶部压回到钉仓8的底部。
当吻合钉14位于推钉块13的端面20上方时,压杆92的前臂93将钉仓8的最近端的推钉块97的阶梯形凸块98的下阶99压到钉仓8的底部,各个推钉块13的阶梯形凸块89的上阶91的伸出部依次盖在相邻推钉块13的阶梯形凸块89的下阶90上,使得全部推钉块13位于钉仓8的底部。
当驱动机构10带动斜锲74开始前移时,斜锲74的前斜面95将压杆92的前臂93上抬,使得压杆92的前臂93脱离钉仓8的最近端的推钉块97的阶梯形凸块98的下阶99。然后斜锲74继续前移,推动推钉块13将吻合钉14从钉仓8的钉孔12内推出,使得各个推钉块13依次向上移动到钉仓8的顶部。
随后斜锲74后移到钉仓组件7的近端,斜锲74的后斜面96将压杆92的后臂94上抬,使得压杆92的前臂93将钉仓8的最近端的推钉块97的阶梯形凸块98的下阶99压到钉仓8的底部,同时,最近端的推钉块97的阶梯形凸块98的上阶100的伸出部压在相邻推钉块13的阶梯形凸块89的下阶90上,其余各个推钉块13的阶梯形凸块89的上阶91的伸出部也依次压在相邻推钉块13的阶梯形凸块89的下阶90上,使得钉仓8内的全部推钉块13都被驱动机构10内的压杆92从钉仓8的顶部压回到钉仓8的底部。
当驱动机构10推动推钉块13将初装吻合钉15从钉仓8的钉孔12内推出后,驱动机构10内的压杆92先将推钉块13从钉仓8的顶部压回到钉仓8的底部,然后带动驱钉螺杆22转动,使得驱钉螺杆22通过螺纹的螺槽31移动储钉孔21内的备用吻合钉16、17和18的钉腿25、26、27、28、29和30,将各个储钉孔21内与初装吻合钉15相邻的一只备用吻合钉16装在钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,备用吻合钉17和18依次移动到前一备用吻合钉的原先位置,驱动机构10再先推动推钉块13将备用吻合钉16从钉仓8的钉孔12内推出,然后将推钉块13从钉仓8的顶部压回到钉仓8的底部,再转动驱钉螺杆22,驱钉螺杆22的螺纹的螺槽31则再带动储钉孔21内的备用吻合钉17和18的钉腿27、28、29和30移动,将各个储钉孔21内的另一只备用吻合钉17装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,备用吻合钉18则再依次移动到前一只备用吻合钉17的原先位置。各个储钉孔21内的备用吻合钉16、17和18以上述方式每次有一只备用吻合钉被装入钉仓8的各个相应的钉孔12内的推钉块13的端面20上方,再依次被推钉块13从钉仓8的钉孔12内推出。
根据上述详细介绍可知,本发明的具有自换切割刀功能的外科线形吻合器,实现在钉仓组件内的刀仓内安装的切割刀分为初装切割刀和多把备用切割刀,其中初装切割刀先被安装在刀架上。当驱动机构带动刀架完成初装切割刀的切割操作后,将初装切割刀重新装入刀仓的刀槽内,再带动刀仓在钉仓组件内向侧面移动,使得初装切割刀和备用切割刀跟随刀仓一起向侧面移动,将初装切割刀带离刀架,同时刀仓将与初装切割刀邻近的第一把备用切割刀安装在刀架上。安装在刀仓的刀槽内的备用切割刀以上述方式依次有一把邻近的备用切割刀被刀仓安装在刀架上,再次被刀架从刀仓的刀槽内推出、再次被刀架重新装入刀仓的刀槽内、再次被刀仓移动带离刀架,依次完成更换切割刀的动作。从而使得本发明的具有自换切割刀功能的外科线形吻合器的钉仓的结构较简单、成本较低,在手术过程中切割刀的刀刃每次使用时能保持锋利,顺利执行切割各种组织的任务,甚至切割以前钉合在组织上的吻合钉。
于是可以看出,上述所陈述的目标,包括由前面说明所显示的那些目标被有效地达到了。这里所述的仅仅是本发明申请的典型的最佳实施形式,可以对上述结构作某些变化也不违背本发明的精神和范围。本发明不局限或被限止于这里所陈述的具体细节,而应如同权利要求的限定中陈述的那样保留对所属领域中等技术人员来说是显而易见的任何改进或改型。
Claims (10)
1.一种具有自换切割刀功能的外科线形吻合器,所述外科线形吻合器中的钉仓组件由钉仓、钉仓架和驱动机构组成,所述钉仓和驱动机构安装在所述钉仓架内,钉仓呈线形,在钉仓中至少交错排列两排钉孔,在所述钉仓内安装有推钉块和吻合钉,所述吻合钉安装在所述钉仓的钉孔内;
其特征在于:
在所述钉仓组件内安装有斜锲、刀仓、刀架和切割刀,所述斜锲和刀架被约束在钉仓组件内可前后移动,所述刀仓被约束在钉仓组件内可向侧面移动,所述刀仓上有分隔的刀槽,所述切割刀分为初装切割刀和备用切割刀,所述初装切割刀和备用切割刀安装在所述刀仓的刀槽内,其中初装切割刀此时安装在所述刀架上;
当所述驱动机构推动斜锲和刀架在钉仓组件内向前移动时,斜锲推动所述推钉块将吻合钉从钉仓的钉孔内推出,同时,初装切割刀被刀架从刀仓的刀槽内推出、跟随刀架一起前移;
当驱动机构带动刀架在钉仓组件内后移将初装切割刀重新装入刀仓的刀槽内后,驱动机构再带动刀仓在钉仓组件内向侧面移动,使得初装切割刀和备用切割刀跟随刀仓一起向侧面移动,将初装切割刀带离刀架,同时刀仓将与初装切割刀邻近的第一把备用切割刀安装在刀架上,完成首次更换切割刀的动作;
当驱动机构再次推动斜锲和刀架在钉仓组件内前移时,斜锲推动推钉块将吻合钉从钉仓的钉孔内推出,同时,刀架将第一把备用切割刀从刀仓的刀槽内推出,使得第一把备用切割刀跟随刀架一起前移;当驱动机构再次带动刀架在钉仓组件内后移将第一把备用切割刀重新装入刀仓的刀槽内后,驱动机构再次带动刀仓在钉仓组件内向侧面移动,使得初装切割刀和第一把备用切割刀跟随刀仓一起向侧面移动,将第一把备用切割刀带离刀架,同时刀仓将与第一把备用切割刀邻近的第二把备用切割刀安装在刀架上,再次完成更换切割刀的动作;安装在刀仓的刀槽内的备用切割刀依次有一把邻近的备用切割刀被刀仓安装在刀架上,再次被刀架从刀仓的刀槽内推出、再次被刀架重新装入刀仓的刀槽内、再次被刀仓移动带离刀架,依次完成更换切割刀的动作。
2.根据权利要求1所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述刀仓上有螺旋机构,所述驱动机构通过驱动所述刀仓上的螺旋机构带动刀仓在所述钉仓组件内向侧面移动,完成更换切割刀的动作。
3.根据权利要求2所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述刀仓上的螺旋机构由驱刀螺杆和螺母组成,其中所述螺母位于刀仓内、所述驱刀螺杆拧入刀仓的螺母内,所述驱动机构通过驱动所述刀仓上的驱刀螺杆带动刀仓的螺母,使得刀仓在所述钉仓组件内向侧面移动,完成更换切割刀的动作。
4.根据权利要求3所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述驱刀螺杆上固定有齿轮,所述驱动机构通过转动所述驱刀螺杆上的齿轮,驱动所述刀仓上的驱刀螺杆带动刀仓的螺母,使得刀仓在所述钉仓组件内向侧面移动,完成更换切割刀的动作。
5.根据权利要求4所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述驱动机构内有斜面推板转盘机构和槽轮间歇转位机构,所述斜面推板转盘机构由在所述钉仓组件内前后直线移动的斜块和在端面上分布凸块的转盘组成,所述槽轮间歇转位机构由被约束在钉仓组件内旋转的主动拨盘和从动槽轮组成,所述拨盘端面的周向分布有圆销,所述槽轮上有齿轮和周向分布的径向槽;
当驱动机构带动斜面推板转盘机构的斜块在钉仓组件内开始向前移动时,斜块推动所述转盘端面上的凸块沿斜块的下斜面滑动,从而带动拨盘在钉仓组件内转动,拨盘再带动槽轮在钉仓组件内转动,槽轮通过转动所述驱刀螺杆上的齿轮,驱动所述刀仓上的驱刀螺杆带动刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作;
当驱动机构带动斜块在钉仓组件内向后移动到靠近终点时,斜块推动所述转盘端面上的凸块沿斜块的上斜面滑动,从而带动拨盘在钉仓组件内转动,拨盘再带动槽轮在钉仓组件内转动,槽轮再驱动所述刀仓上的驱刀螺杆带动刀仓在钉仓组件内向侧面移动。
6.根据权利要求5所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述斜面推板转盘机构的转盘与槽轮间歇转位机构的拨盘组合成一体。
7.根据权利要求5所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述槽轮间歇运动机构的槽轮固定在所述刀仓上的螺旋机构的驱刀螺杆上,槽轮间歇运动机构的槽轮通过驱动所述刀仓上的驱刀螺杆带动刀仓的螺母,使得刀仓在所述钉仓组件内向侧面移动,完成更换切割刀的动作。
8.根据权利要求5所述的具有自换切割刀功能的外科线形吻合器,其特征是,在所述槽轮间歇运动机构的槽轮上固定有齿轮,在所述刀仓上的螺旋机构的驱刀螺杆上固定有齿轮,所述槽轮间歇运动机构的槽轮上的齿轮和所述刀仓上的驱刀螺杆上的齿轮分别与同一根齿条相互啮合,槽轮间歇运动机构的槽轮上的齿轮通过所述齿条驱动刀仓上的驱刀螺杆上的齿轮带动刀仓的螺母,使得刀仓在所述钉仓组件内向侧面移动,完成更换切割刀的动作。
9.根据权利要求5所述的具有自换切割刀功能的外科线形吻合器,其特征是,在所述槽轮间歇运动机构的槽轮上固定有齿轮,在所述刀仓上的螺旋机构的驱刀螺杆上固定有齿轮,所述槽轮间歇运动机构的槽轮上的齿轮与所述驱刀螺杆上的齿轮相互啮合,槽轮上的齿轮通过转动所述驱刀螺杆上的齿轮,驱动所述刀仓上的驱刀螺杆带动刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
10.根据权利要求3所述的具有自换切割刀功能的外科线形吻合器,其特征是,所述驱动机构内有斜面推板转盘机构,所述斜面推板转盘机构由在所述钉仓组件内前后直线移动的斜块和在端面上分布凸块的转盘组成,在斜面推板转盘机构的转盘上固定有齿轮,在所述刀仓上的螺旋机构的驱刀螺杆上固定有齿轮,所述斜面推板转盘机构的齿轮与所述驱刀螺杆的齿轮相互啮合;
当驱动机构带动斜面推板转盘机构的斜块在钉仓组件内开始向前移动时,斜块推动所述转盘端面上的凸块沿斜块的下斜面滑动,从而带动转盘在钉仓组件内转动,斜面推板转盘机构的齿轮通过驱动所述刀仓上的驱刀螺杆的齿轮,带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作;
当驱动机构带动斜块在钉仓组件内向后移动到靠近终点时,斜块推动所述转盘端面上的凸块沿斜块的上斜面滑动,从而带动转盘在钉仓组件内转动,斜面推板转盘机构的齿轮通过驱动刀仓上的驱刀螺杆的齿轮,带动刀仓的螺母,使得刀仓在钉仓组件内向侧面移动,完成更换切割刀的动作。
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US8365971B1 (en) * | 2009-09-23 | 2013-02-05 | Cardica, Inc. | True multi-fire linear cutter |
US9861361B2 (en) * | 2010-09-30 | 2018-01-09 | Ethicon Llc | Releasable tissue thickness compensator and fastener cartridge having the same |
CN107348981B (zh) * | 2011-10-26 | 2020-11-10 | 直观外科手术操作公司 | 具有整体的手术刀刀片的外科手术器械 |
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US5383880A (en) * | 1992-01-17 | 1995-01-24 | Ethicon, Inc. | Endoscopic surgical system with sensing means |
CN101507625A (zh) * | 2008-02-14 | 2009-08-19 | 伊西康内外科公司 | 用于外科切割和缝合设备的一次性电动装载单元 |
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