CN103876799A - 低位前切除术用90度器械 - Google Patents
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Abstract
本发明公开了低位前切除术用90度器械。公开了一种关节式运动手术器械，包括末端执行器和可操作地联接末端执行器的驱动组件。末端执行器包括：第一驱动轴，其限定了第一轴线；和第二驱动轴，其可操作地接合第一驱动轴并且远离第一驱动轴而延伸。第二驱动轴可操作地联接末端执行器并限定了第二轴线，第二轴线不同于第一轴线。第一驱动轴和第二驱动轴可枢转地被布置为使得第一驱动轴和第二驱动轴被配置为在第一大致直线布置方式和第二大致垂直布置方式之间转换。
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/或系统及其使用方法。更特别地，本公开涉及一种与手术器械一起使用的并且被配置为在不同布置方式之间转换以方便于在不同类型手术操作过程中使用的驱动组件。
背景技术
在本技术领域中众所周知用于手术地连结组织的各种类型的手术器械，且它们常用于，例如，在执行手术、切除术和吻合术中闭合组织或器官，用于在胸部操作和腹部操作中闭塞器官，以及用于在电外科手术中熔融或密封组织。
一种这样的手术器械是手术吻合器械，其可以包括工具组件，所述工具组件包括砧座组件、用于支撑手术吻合钉阵列的钉仓组件、用于使钉仓组件和砧座组件接近的接近机构以及用于从钉仓组件射出手术吻合钉的发射机构。
在微创手术操作中，例如，腹腔镜和/或内窥镜操作中，通过小切口或通过经由患者中的小进入伤口或自然存在的孔口插入的窄套管来执行操作。因为减少了患者损伤、缩短了患者恢复期并显著地降低了总费用，所以微创操作优于传统的、开放式操作。在一些微创手术操作中，期望获得对与切口点或自然存在的孔口点间隔开的位置的介入。因此，将期望提供一种关节式运动机构以保持工具组件相对于驱动组件处于偏移位置。因而，需要改进关节式运动机构和/或枢转机构，其允许外科医生以各种配置操纵工具构件。
发明内容
在下文中参照附图更详细地描述本发明的示例性实施例的进一步细节和方案。
公开了一种关节式运动手术器械，所述关节式运动手术器械包括末端执行器和可操作地与末端执行器联接的驱动组件。末端执行器包括：第一驱动轴，其限定了第一轴线；和第二驱动轴，其可操作地与第一驱动轴接合并且远离第一驱动轴而延伸。第二驱动轴可操作地与末端执行器联接并限定了第二轴线，第二轴线不同于第一轴线。第一驱动轴和第二驱动轴可枢转地被布置为使得第一驱动轴和第二驱动轴被配置为在第一大致直线布置方式和第二大致垂直布置方式之间转换。根据一个实施例，第二驱动轴与第一驱动轴在横向上偏移。根据另一个实施例，第一驱动轴和第二驱动轴中的每一个驱动轴都结合有锥齿轮。第一驱动轴的锥齿轮和第二驱动轴的锥齿轮被配置为相互啮合。
根据本公开的另一个方案，驱动组件结合有被配置为与第二驱动轴在圆周上接合的摩擦齿轮。根据本公开另外的方案，第一驱动壳体和第二驱动壳体可枢转地布置。
根据本公开的另外的方案，第一驱动轴和第二驱动轴从近侧至远侧地通过一对相互啮合的锥齿轮、驱动销以及摩擦齿轮组件来相互连接。摩擦齿轮组件可以包括摩擦齿轮和摩擦小齿轮。根据本公开的另一个方案，驱动组件被配置为将第一驱动轴中的旋转运动转变为第二驱动轴中的旋转运动。在本公开的又一个方案中，第一驱动轴限定了第一纵向长度，而第二驱动轴限定了不同的第二纵向长度。第二驱动轴可以长于第一驱动轴。在本公开的另一个方案中，末端执行器被配置用于相对于第一轴线选择性的径向定向。
还公开了一种使用关节式运动手术器械的方法，并且包括提供末端执行器和提供可操作地与末端执行器联接的驱动组件。驱动组件包括第一驱动轴和可枢转地并可操作地与第一驱动轴联接的第二驱动轴。第二驱动轴从第一驱动轴以平行关系延伸出并与第一驱动轴在横向上偏移。所述方法进一步包括枢转第二驱动轴，使得第二驱动轴被布置成相对于第一驱动轴呈180度以外的角度。在本公开的另一个方案中，所述方法包括提供驱动组件，提供驱动组件包括在第一驱动轴和第二驱动轴的每一个驱动轴上提供锥齿轮。在本公开的又一个方案中，所述方法包括提供驱动组件，提供驱动组件包括提供与第二驱动轴在圆周上接合的摩擦齿轮。在本公开的另一个方案中，所述方法包括在第二驱动轴被布置成相对于第一驱动轴呈180度以外的角度时致动末端执行器。在本公开的又一个方案中，所述方法包括以选定的径向定向布置末端执行器。
附图说明
这里参照附图描述了本公开的实施例，其中：
图1是包括驱动组件和末端执行器的手术用关节式运动装置的立体图；
图2是沿着图1的剖面线2-2所截取的驱动组件的侧剖视图；
图3是没有末端执行器的驱动组件的立体图；
图4是组装后的驱动组件的内部部件的立体图；
图5是驱动组件的后部立体图；
图6是图示出驱动组件的内部部件的后部立体图；
图7是在工作中组装后的驱动组件的若干部分的立体图；
图8是在工作中组装后的驱动组件的若干部分的侧视图；
图9是驱动组件的部件分解图；
图10是末端执行器和驱动组件一部分的部件分解图；
图11是在工作中组装后的驱动组件的若干部分的立体图；
图12是手术用关节式运动装置的立体图，其中末端执行器正被旋转；
图13是可替换结构中的驱动组件的立体图；和
图14是可替换结构中的驱动组件的若干部分的侧视图。
具体实施方式
参照附图详细描述本公开的手术用关节式运动装置的实施例，其中在几幅附图的每幅附图中相似的附图标记指代相同的或相应的元件。如在本文中所使用的，术语“远侧”是指手术用关节式运动装置的较远离使用者的部分或其部件，而术语“近侧”是指手术用关节式运动装置的较接近使用者的部分或其部件。
首先参照图1，手术用关节式运动装置1000包括驱动组件100，驱动组件100操作地与末端执行器400相连接。末端执行器400和驱动组件100被配置为通过手动或电动手术器械进行致动和操纵。在国际申请号为PCT/US2008/077249、公开号为WO2009/039506的国际申请，和序列号为12/622,827且被公开为公开号为2011/0121049的美国专利申请中公开了一种这样适合的手术器械，其每一个申请的全部内容通过引用合并于此。在实施例中，驱动组件100和末端执行器400彼此是可分离的，使得驱动组件100被配置用来选择性地与多个不同的末端执行器中的任何一个末端执行器连接。可以设想到，末端执行器可以包括弯曲的钳夹构件以方便于执行特定类型的手术操作，例如，在低位前切除术（“LAR”）或其他结肠-直肠外科手术期间。
末端执行器400包括一对钳夹构件，一对钳夹构件包括钉仓组件432和砧座434。钉仓组件432容纳布置在其内的一个以上紧固件433（图10），并被配置为当发射手术用关节式运动装置1000时部署（deploy）紧固件433。砧座434可活动地，例如，可枢转地安装至末端执行器400并能够在打开位置和闭合位置之间活动从而夹持组织，其中在打开位置，砧座434与钉仓组件432分隔开，在闭合位置，砧座434与钉仓组件432处于紧密配合对齐。正如将在下面进一步描述的，末端执行器400经由通过驱动组件100传递的机械力而被操作。
如图所示，驱动组件100包括远侧部300和限定了纵轴线“A”的近侧部200。正如将在下面进一步描述的，驱动组件100的近侧部200和远侧部300是可枢转地附接。
目前转向图9，在部件分解图中示出了驱动组件100的部件。如上所述，驱动组件100的近侧部200包括壳体210。壳体210为大致圆柱形件，其限定了穿过其中的通道212。如图所示，通道212可以具有不规则的结构，例如，θ形状，以方便于插入驱动组件100的近侧部200的其他部件来进行组装。正如将在下面进一步描述的，一对纵向延伸槽214沿着壳体210的在直径上相对的外表面而被限定，并被配置为方便于驱动组件100的远侧部300的枢转。正如将在下面进一步描述的，壳体210的远侧部限定了凹部216，凹部216被定尺寸为容纳驱动组件100的各种不同的部件，以及方便于驱动组件100的近侧部200和远侧部300的相对枢转。
驱动组件100的近侧部200进一步包括驱动轴220、轴环230、安装支架240、盖构件250、锥齿轮260和驱动接合器270。正如将在下面进一步描述的，尽管上述公开的驱动组件100的近侧部200的特定部分将被描述为物理地定位在驱动组件的远侧部300内，但这些部分将被理解为与驱动组件100的近侧部200在功能上相关联。
如图所示，驱动轴220为大致直的细长构件，其与纵轴线A同轴地布置（图1）。驱动轴220包括远侧部222，远侧部222具有由多个相交的平侧面所限定的结构，例如，六边形结构。正如将在下面进一步描述的，驱动轴220的远侧部222被配置为与驱动组件100的其他部分相互接合。因此，驱动轴220为被配置为沿着其传递旋转力的大致刚性的构件。在实施例中，驱动轴220可以由诸如金属材料或复合材料制成。
正如将在下面进一步描述的，轴环230为大致直的管状构件，其限定了穿过其中的通道232用来接纳驱动轴220的一部分，并被定尺寸为与安装支架240的一部分对齐和邻接。正如将在下面进一步描述的，轴环230具有大致光滑的结构，其被配置为在其工作过程中将驱动轴220与壳体210的通道212的内壁相隔离。
安装支架240包括桥接部242，桥接部242限定了穿过其中的孔243用来接纳驱动轴220的一部分。桥接部242被配置为相对于纵轴线A（图1）垂直地定向。正如将在下面进一步描述的，一对平行臂244从桥接构件240的相对侧向远侧延伸出，且平行臂244中的每一个都限定了孔以接纳一对栓钉246中的一个。
如图所示，盖构件250为大致扁平构件，其限定了一对侧向孔254以及用来接纳驱动轴220的一部分的中央孔252。正如将在下面进一步描述的，盖构件250被配置为联接驱动组件100的近侧部200和远侧部300。
锥齿轮260为大致圆形构件，其限定了穿过其中的孔262。正如将在下面进一步描述的，孔262包括平坦部263，平坦部263被配置为接合驱动接合器270的一部分。多个齿264围绕锥齿轮260的远侧部在圆周上布置，且相对于孔262呈倾斜关系地布置。
驱动接合器270布置在锥齿轮260的远侧，且包括通过凸缘275分开的联接部272和轴部278。联接部272具有大致圆形的结构且包括在其外表面上形成的平坦部273。正如将在下面进一步描述的，联接部272被配置为装配在锥齿轮260的孔262内，使得联接部272的平坦部273接合锥齿轮260的孔262内的平坦部263。正如将在下面进一步描述的，联接部272还限定了穿过其中的孔274，其具有大致六边形结构以接合驱动轴220的远侧部222。正如将在下面进一步描述的，驱动接合器270的轴部278的远侧部还限定了平坦部279，平坦部279被配置为接合驱动组件100的远侧部300的一部分。
现在重点是驱动组件100的远侧部300，远侧部300包括锥齿轮320、驱动销330、定向机构340、颈部350、支架360、摩擦齿轮组件370、驱动轴380和驱动壳体390。
锥齿轮320具有与上述驱动组件100的近侧部200的锥齿轮260大致相似的结构。因此，锥齿轮320为限定了穿过其中的孔322的大致圆形构件。正如将在下面进一步描述的，孔322包括平坦部323，平坦部323被配置为接合驱动销330。多个齿324围绕锥齿轮320的近侧部而在圆周上布置，且相对于锥齿轮320的孔322呈倾斜关系地布置。正如将在下面进一步描述的，在驱动组件100的一个定向上，孔322被配置为接纳驱动组件100的近侧部200的驱动接合器270的一部分。
如图所示，驱动销330为大致圆形的细长构件，其具有通过圆形凸缘335分开的近侧部332和远侧部336。近侧部332被定尺寸为通过在锥齿轮320中所限定的孔322装配，且包括被配置为与孔322的平坦部323接合的平坦部333。正如将在下面进一步描述的，驱动销330的远侧部336还包括用来接合摩擦齿轮组件370的平坦部337。
定向机构340包括一对棘轮板342，每一个棘轮板限定了穿过其中的孔344用于驱动销330的一部分的穿过，且每一个棘轮板具有形成在其上的槽形面346。棘轮板342可以被配置作为诸如平面齿轮。因此，每一个棘轮板342的槽形面346可以被配置作为从孔344向外延伸的一系列径向延伸的脊。正如将在下面进一步描述的，棘轮板342被布置为使得每一个相应的棘轮板342的槽形面346是相对的且被配置为相互接合。定向机构340还包括弹簧348，弹簧348具有穿过其中的孔349以容纳驱动销330的一部分。弹簧348被配置为邻接远侧的棘轮板342。
如图所示，颈部350为大致圆柱形构件，其限定了穿过其中的通路352用来接纳驱动销330的一部分。正如将在下面进一步描述的，在手术用关节式运动装置1000的一个布置方式中，颈部350还限定了在其后表面上的孔354（图5）以容纳驱动接合器270的插入。一对在直径上相对的槽356形成于颈部350的外表面上用来接纳与上述安装支架240相关联的栓钉246。颈部350在其外表面上还限定了凹部358用来接纳盖构件250。正如将在下面进一步描述的，颈部350的通路352被配置为容纳驱动组件100的远侧部300的各种部件。
支架360为大致圆柱形构件，其限定了穿过其中的通路362用来接纳驱动销330的一部分。支架360包括：近侧轴环364，其被配置为装配在颈部350的通路352内；中央部364；和从中央部364延伸出的一对臂366。正如将在下面进一步描述的，臂366从中央部364的在直径上相对的部分延伸出，且每一个臂限定了被配置为与驱动壳体390的一部分相接合的外槽367，且每一个臂366限定了径向向内的座368以容纳末端执行器400（图1）的一部分。
如图所示，摩擦齿轮组件370包括摩擦齿轮372和摩擦小齿轮374。正如将在下面进一步描述的，摩擦齿轮372包括孔372a，孔372a具有平坦部372b用来接合驱动销330的平坦部333。摩擦齿轮372还包括外摩擦表面372c，外摩擦表面372c被配置为摩擦地接合摩擦小齿轮374的一部分。因此，摩擦齿轮372的摩擦表面372c可以由提高摩擦性的材料，例如，聚合物材料制成。
摩擦小齿轮374限定了穿过其中的孔374a用来接纳驱动轴380的一部分，并具有外摩擦表面374b，外摩擦表面374b被配置为与摩擦齿轮372的外摩擦表面372c摩擦接合。因此，摩擦小齿轮374的摩擦表面374b也可以由提高摩擦性的材料，例如，聚合物材料制成。
驱动轴380限定了相对于纵轴线A（图1）垂直的轴线“B”并被配置作为具有近侧联接部382、中央螺纹部384和远侧联接部386的细长构件。近侧联接部382被配置为固定地布置（例如，压配合或干涉配合）到摩擦小齿轮374的孔374a中。驱动轴380可以具有与驱动轴220相似的结构，但是具有不同的长度，例如，驱动轴380可以比驱动轴220更长。正如将在下面进一步描述的，驱动轴380被配置为沿着其传递旋转力。在实施例中，驱动轴220可以由诸如金属材料或复合材料制成。
驱动壳体390是细长构件，其限定了在其中的槽道392。正如将在下面进一步描述的，槽道392包括槽394，槽394被配置为支撑驱动轴380，以及末端执行器400的一部分。驱动壳体390还包括一对耳片394，该对耳片被配置为与支架360的外槽367接合。
转向图2至图6，在组装图、剖视图和立体图中分别示出了驱动组件100。首先参照驱动组件100的近侧部200，轴环230和安装支架240布置在壳体210的通道212内。通过轴环230的通道232和安装支架240的孔243插入驱动轴220的近侧部222。通过平行臂244中的孔将栓钉246插入并且将栓钉246插到颈部350的槽356中（在图5中最佳显示）以将安装支架240固定在适当的位置上。因为轴环230在近侧靠在安装支架240的桥接部242上，所以轴环230被保持在壳体200的通道212内。盖构件250就位于颈部350的凹部358内，且可以被压配合到凹部358中或通过颈部350的侧向孔354使用紧固件（图9）来固定。如图所示，驱动轴220的远侧部222通过盖构件250的中央孔252插入以接合驱动接合器270的联接部272的内表面。驱动轴220的远侧部222可以按这种方式与驱动接合器270牢固地联接（例如，压配合、钎焊、焊接等）。因为驱动接合器270以垂直定向安置在颈部350的通路352内，所以驱动接合器在壳体210的通道212内支撑轴环230、安装支架240和驱动轴220。
参照驱动组件100的远侧部300，驱动销330被示出安装在颈部350的通路352内。颈部350的通路352可以定尺寸为使得驱动销330在通路352内被保持基本不动的位置。通过锥齿轮320的孔322插入驱动销330的近侧部332，因而其被支撑在颈部350的通路352内。锥齿轮320被布置在驱动销330上，以使得锥齿轮320的齿324保持与锥齿轮260的齿264（图2）啮合。
如图所示，支架360的近侧轴环364被装配在颈部350的通路352内，使得支架360被颈部350支撑。支架360的臂366从中央部364延伸出并经由形成于每一个臂366上的槽367而与驱动壳体390接合。
如图所示，将定向机构340布置于在颈部350和支架360的中央部364之间所限定的内腔中，其中驱动销330的一部分延伸通过支架360的近侧轴环364。因为定向机构340布置在封闭空间内，所以弹簧348偏压棘轮板342成摩擦接合，使得每一个棘轮板的槽形面346（图9）以预定压缩力“F”相互接合。
如图所示，摩擦齿轮组件370也被支撑在支架360的内部中。摩擦齿轮372接纳在驱动销330的近侧部372上的平坦部373（图9）。摩擦小齿轮374以邻接关系在远侧布置在摩擦齿轮372的下方，并通过孔374a接纳驱动轴380的近侧联接部382（图2）。以这种方式，摩擦齿轮372在圆周上接合驱动轴380。驱动轴380延伸通过驱动壳体390的槽道392（图2），使得驱动轴380被支架360和驱动壳体390支撑。以这种方式，驱动轴380可操作地接合驱动组件100的近侧部200的驱动轴220并远离驱动组件100的近侧部200的驱动轴220而延伸。此外，驱动组件100的远侧部300的驱动轴380相对于驱动组件100的近侧部200的驱动轴220在横向上偏移。
现在将描述驱动组件100的操作。转向图7和图8，示出了在工作中的驱动组件100的内部部件。当驱动轴220如图所示地旋转时，与驱动接合器270的联接部272（图9）接合的驱动轴220的远侧部222，引起环绕其布置的锥齿轮260旋转。因为驱动组件100的远侧部300的锥齿轮320保持与驱动组件的近侧部200的锥齿轮260操作性啮合，即，相应锥齿轮260、320的齿264、324相互啮合，所以锥齿轮260的旋转引起锥齿轮320的旋转。锥齿轮320的旋转由于驱动销330的平坦部333与锥齿轮320的孔322上的平坦部323的接合（图9），而引起驱动销330旋转。以这种方式，驱动销330的平坦部333与锥齿轮320的孔322的平坦部323的相互接合阻止了锥齿轮320相对于驱动销330旋转，并确保了驱动销330和锥齿轮320共同旋转。驱动销330的旋转，依次又引起摩擦齿轮372的旋转。因为摩擦齿轮372保持与摩擦小齿轮374的摩擦、邻接关系（图2），所以摩擦齿轮372的旋转引起摩擦小齿轮374的旋转。由于驱动轴380通过摩擦小齿轮374的孔374a而被固定插入，所以驱动轴380也随着摩擦小齿轮374的旋转而旋转。以这种方式，驱动轴220的旋转在驱动组件100内沿着垂直路径传递力，使得驱动组件100的近侧部200的驱动轴220的旋转运动被转变为驱动组件100的远侧部300的驱动轴380的旋转运动。因此，在驱动轴380以与驱动轴220成垂直关系布置时，可以致动末端执行器400（图1）。
转向图10至图12，驱动壳体390的槽道392支撑钉仓组件432，钉仓组件432包含多个手术用紧固件433和多个相应的射出器或推进器437。正如下文更详细地描述的，末端执行器400包括致动滑板440，致动滑板440具有被配置为对推进器437施加紧固件驱动力的直立凸轮楔444，推进器437从钉仓组件432驱动紧固件433。这些结构用于限制钉仓组件432在驱动壳体390的槽道392内的横向、纵向和上升运动。
多个间隔开的纵向槽（未显示）延伸通过钉仓组件432且容纳致动滑板440的直立凸轮楔444。该槽与多个穴连通，多个紧固件433和推进器437分别被支撑在该多个穴内。推进器437由布置在钉仓组件432下方的推进器保持器（未显示）来固定，推进器保持器在推进器437通过致动滑板440接合之前支撑和对齐推进器437。工作中，随着致动滑板440平移通过钉仓组件432，凸轮楔444的成角度的前缘连续地接触推进器437，引起推进器在槽446内竖直平移，从而从其中推动紧固件433。钉仓组件432还包括纵向槽485以允许刀片474移动穿过其中。
继续参照图10至图12，末端执行器400包括布置在砧座434上方的砧座盖435。砧座盖435保护组织免受沿着砧座434的外部移动的部件的损害。砧座盖435包括被定尺寸和配置为接合砧座434的相对的安装翼450和452。安装翼450和452起在闭合过程中将砧座434与钉仓组件432对齐的功能。
继续参照图10至图12，末端执行器400进一步包括布置在驱动壳体390内的驱动梁462。驱动梁462包括竖直支撑柱472和接合致动滑板440的中央支撑楔445的邻接面476。驱动梁462还包括布置在竖直支撑柱472顶部上的凸轮构件480。凸轮构件480被定尺寸和配置为相对于砧座434的外凸轮表面482接合和平移，以在发射过程中逐渐地抵靠着身体组织夹紧砧座。
纵向槽484延伸通过砧座434以容纳竖直支撑柱472的平移。这允许凸轮构件480在发射过程中在盖435和砧座434之间移动。在实施例中，砧座盖435还可以包括形成于其下侧上的相应的纵向槽（未示出）并被固定至砧座434的上表面以在其之间形成通路。
驱动梁462包括远侧保持脚488a和近侧保持脚488b，每一个保持脚都具有穿过其所限定的洞孔489a和489b。洞孔489a和489b可以是有螺纹的或者是光滑的以提供沿着穿过其中的驱动螺杆460的移动。具有穿过其中的螺纹孔490a的移动螺母（travel nut）490布置在远侧保持脚488a和近侧保持脚488b之间。驱动组件100的远侧部300的驱动轴380（图9）通过螺纹孔490a可螺纹地联接至移动螺母490，使得随着驱动轴380旋转，移动螺母490沿着由驱动轴380所限定的纵轴线在纵向上移动并且还接合脚488a和脚488b（未示出）。
在使用中，随着驱动螺杆460在顺时针方向上旋转，由于凸轮构件480对砧座434的凸轮表面482向下推压，所以移动螺母490和驱动梁462在闭合砧座434的远侧方向上移动。驱动梁462还在远侧方向上推动滑板440，滑板440然后经由凸轮楔444接合推进器437以射出紧固件433。驱动梁462可以由任何适合的第一材料制成，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材料制成，也包括但不限于，塑料、金属及其组合物。第一材料和第二材料可以是相同的或者是不同的。在实施例中，驱动梁462可以包括具有穿过其中所限定的螺纹孔的单个保持脚，其可螺纹地联接至驱动轴380。
转向图11和图12，且另外参照图9，将描述定向机构340的操作。如上所述，棘轮板342被布置为使得相应的槽形面346彼此面对并被弹簧348压缩在一起。弹簧348对远侧棘轮板342施加预定力，使得在大致不变的径向定向上保持槽形面346的相互接合。然而，超过由弹簧348所保持的摩擦力的被施加在棘轮板342上的旋转力将引起远侧棘轮板342相对于近侧棘轮板342旋转。以这种方式，远侧棘轮板342的槽形面346将在近侧棘轮板346的槽形面346的上方形成凸轮状或“棘轮”状。由于定向机构340布置在颈部350和支架360之间所限定的腔中（图2中最佳示出），支架360可以相对于颈部350旋转。特别地，支架360的近侧轴环362在颈部350的通路352内旋转。由于末端执行器400由支架360支撑，支架360的这种方式的旋转允许末端执行器400相对于横向轴线B选择性的径向定向。
在本文中已经讨论了处于垂直布置方式，即，90度布置方式下的驱动组件100和末端执行器400，其中驱动组件100的近侧部200相对于驱动组件100的远侧部300和附接于此的末端执行器400垂直地布置。转向图12和图13，将描述驱动组件100从90度布置方式（在本文中，“第二布置方式”）至第一、大致线性（即，180度）布置方式的转换。
如上所述，驱动组件100的近侧部200的驱动轴220被配置为可滑动地布置在壳体210内并且相对于轴环230和安装支架240可滑动地布置。例如，通过将相关联的手术器械的手柄部远离驱动组件100向近侧撤回，驱动轴220可以通过壳体210的通道212向近侧撤回。因此，驱动轴的远侧222与锥齿轮260和盖构件250脱离并与其间隔开。然后，驱动组件100的远侧部300可以旋转远离驱动组件100的近侧部200。特别地，延伸通过安装支架240的臂244中的孔并且进入颈部350的槽356的栓钉246提供了驱动组件100的远侧部300绕着其旋转的枢转点。
在驱动组件100的近侧部200和远侧部300现在被布置在第一布置方式，即，180度布置方式的条件下，可以将驱动轴220和驱动接合器270通过壳体210的通道212向远侧插入以直接接合锥齿轮320，即，驱动接合器270的轴部278的远侧部上的平坦部279被插入锥齿轮320的孔322（图2）中，使得驱动轴220的旋转将以上述方式引起锥齿轮320的旋转以及驱动轴380的随后旋转。驱动组件100以基本上相反的顺序在第一布置方式和第二布置方式之间进行转换，即，驱动轴220和驱动接合器270与锥齿轮320脱离并向近侧撤回，驱动组件100的远侧部300相对于驱动组件100的第一部200枢转至90度布置方式，然后驱动轴220和驱动接合器270通过盖构件250中的中央孔252插入，使得锥齿轮260啮合锥齿轮320（参见图4）。
将要理解的是，可以对这里公开的实施例进行各种修改。因此，上述说明书不应该视为限制性的，而是仅仅作为优选实施例的示例。本领域的技术人员将在所附于此的权利要求书的范围和精神内设想到其他的修改。
Claims (17)
1.一种关节式运动手术器械，包括：
末端执行器；
驱动组件，其可操作地与所述末端执行器联接并包括；
第一驱动轴，其限定了第一轴线；
第二驱动轴，其可操作地接合所述第一驱动轴并且远离所述第一驱动轴而延伸，且可操作地联接所述末端执行器，所述第二驱动轴限定了第二轴线，所述第二轴线不同于所述第一轴线；
其中，所述第一驱动轴和所述第二驱动轴可枢转地被布置为使得所述第一驱动轴和所述第二驱动轴被配置为在第一大致直线布置方式和第二大致垂直布置方式之间转换。
2.根据权利要求1所述的关节式运动手术器械，其中，所述第二驱动轴与所述第一驱动轴在横向上偏移。
3.根据权利要求1所述的关节式运动手术器械，其中，所述第一驱动轴和所述第二驱动轴中的每一个驱动轴都结合有锥齿轮。
4.根据权利要求3所述的关节式运动手术器械，其中，所述第一驱动轴的锥齿轮和所述第二驱动轴的锥齿轮被配置为相互啮合。
5.根据权利要求1所述的关节式运动手术器械，其中，所述驱动组件结合有被配置为在圆周上接合所述第二驱动轴的摩擦齿轮。
6.根据权利要求1所述的关节式运动手术器械，其中，第一驱动壳体和第二驱动壳体以销和槽结构可枢转地布置。
7.根据权利要求1所述的关节式运动手术器械，其中，所述第一驱动轴和所述第二驱动轴从近侧至远侧地通过一对相互啮合的锥齿轮、驱动销和摩擦齿轮组件来相互连接。
8.根据权利要求7所述的关节式运动手术器械，其中，所述摩擦齿轮组件包括摩擦齿轮和摩擦小齿轮。
9.根据权利要求1所述的关节式运动手术器械，其中，所述驱动组件被配置为将所述第一驱动轴中的旋转运动转变为所述第二驱动轴中的旋转运动。
10.根据权利要求1所述的关节式运动手术器械，其中，所述第一驱动轴限定了第一纵向长度，而所述第二驱动轴限定了不同的第二纵向长度。
11.根据权利要求10所述的关节式运动手术器械，其中，所述第二驱动轴长于所述第一驱动轴。
12.根据权利要求1所述的关节式运动手术器械，其中，所述末端执行器被配置用于相对于所述第一轴线选择性的径向定向。
13.一种使用关节式运动手术器械的方法，包括：
提供末端执行器；
提供驱动组件，其可操作地与所述末端执行器联接，所述驱动组件包括；
第一驱动轴；
第二驱动轴，其可枢转地且可操作地联接所述第一驱动轴，所述第二驱动轴从所述第一驱动轴以平行关系延伸出并与所述第一驱动轴在横向上偏移；并且
枢转所述第二驱动轴，使得所述第二驱动轴被布置成与所述第一驱动轴呈180度以外的角度。
14.根据权利要求13所述的方法，其中，提供驱动组件包括在所述第一驱动轴和第二驱动轴中的每一个驱动轴上提供锥齿轮。
15.根据权利要求13所述的方法，其中，提供驱动组件包括提供在圆周上接合所述第二驱动轴的摩擦齿轮。
16.根据权利要求13所述的方法，进一步包括在所述第二驱动轴被布置成与所述第一驱动轴呈180度以外的角度时，致动所述末端执行器。
17.根据权利要求13所述的方法，进一步包括以选定的径向定向布置所述末端执行器。
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| US8556151B2 (en) * | 2007-09-11 | 2013-10-15 | Covidien Lp | Articulating joint for surgical instruments |
| US7954685B2 (en) * | 2007-11-06 | 2011-06-07 | Tyco Healthcare Group Lp | Articulation and firing force mechanisms |
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| US8469254B2 (en) * | 2010-01-22 | 2013-06-25 | Covidien Lp | Surgical instrument having a drive assembly |
| US9017314B2 (en) | 2011-06-01 | 2015-04-28 | Covidien Lp | Surgical articulation assembly |
| AU2013206807A1 (en) | 2012-07-18 | 2014-02-06 | Covidien Lp | Apparatus for endoscopic procedures |
| US9470297B2 (en) | 2012-12-19 | 2016-10-18 | Covidien Lp | Lower anterior resection 90 degree instrument |
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2012
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2013
- 2013-12-04 AU AU2013266999A patent/AU2013266999A1/en not_active Abandoned
- 2013-12-17 JP JP2013259795A patent/JP6355918B2/ja not_active Expired - Fee Related
- 2013-12-18 EP EP13197948.6A patent/EP2745782B1/en not_active Not-in-force
- 2013-12-19 CN CN201310706778.XA patent/CN103876799A/zh active Pending
- 2013-12-19 CA CA2837455A patent/CA2837455A1/en not_active Abandoned
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2016
- 2016-09-22 US US15/272,466 patent/US10024407B2/en active Active
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Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107405148A (zh) * | 2014-12-10 | 2017-11-28 | 伊西康有限责任公司 | 能够关节运动的外科器械系统 |
| JP2020073012A (ja) * | 2014-12-10 | 2020-05-14 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | 外科用器具アセンブリ |
| CN106337881A (zh) * | 2015-07-15 | 2017-01-18 | 季德贵 | 用于互相垂直轴的联轴器 |
| CN106337881B (zh) * | 2015-07-15 | 2019-06-18 | 季德贵 | 用于互相垂直轴的联轴器 |
| CN106438901A (zh) * | 2016-09-01 | 2017-02-22 | 宁波天弘电力器具有限公司 | 一种可弯折的旋转动力机构 |
| CN106438901B (zh) * | 2016-09-01 | 2018-10-30 | 宁波天弘电力器具有限公司 | 一种可弯折的旋转动力机构 |
| US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
Also Published As
| Publication number | Publication date |
|---|---|
| JP6355918B2 (ja) | 2018-07-11 |
| JP2014121603A (ja) | 2014-07-03 |
| EP2745782A1 (en) | 2014-06-25 |
| US9470297B2 (en) | 2016-10-18 |
| US10024407B2 (en) | 2018-07-17 |
| EP2745782B1 (en) | 2017-10-25 |
| CA2837455A1 (en) | 2014-06-19 |
| AU2013266999A1 (en) | 2014-07-03 |
| US20140165756A1 (en) | 2014-06-19 |
| US20170009861A1 (en) | 2017-01-12 |
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