CN104027149A - 包括支撑件释放机构的圆形吻合装置 - Google Patents
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Abstract
本发明公开了一种包括支撑件释放机构的圆形吻合装置。圆形吻合装置包括手柄组件、细长体、末端执行器和一个或多个支撑件。所述细长体从所述手柄组件延伸。所述末端执行器安装于所述细长体的远端并且支承所述一个或多个支撑件。支撑件释放机构可操作地连结到所述末端执行器,并选择性地将所述一个或多个支撑件固定至所述末端执行器。
Description
相关申请的交叉引用
本申请主张于2013年3月7日提交的美国临时专利申请第61/774,071号的权益和优先权,该申请的全部内容通过引用结合在此。
技术领域
本公开涉及手术吻合装置。更具体地,本公开涉及支承支撑件的圆形吻合装置。
背景技术
在各种身体结构(如肠或支气管)连接时,紧固件通常被用来替代缝合。用来施加这些紧固件的手术吻合装置通常设计成同时切割和密封组织,以减少吻合过程的时间和风险。
圆形手术吻合装置由外科医生使用,来顺序地或同时地施加一个或多个手术紧固件(如钉或两部分式紧固件)到身体组织,以便将身体组织的片段连接在一起和/或实现吻合。圆形手术吻合装置通常包括:环形的紧固件钉仓组件,其用来支承多个环形排的紧固件;可操作地与所述紧固件钉仓组件相关联的环形砧座组件,所述紧固件钉仓组件提供一表面,在所述圆形吻合装置击发时,这些紧固件紧靠所述表面成形;以及用来切割组织的环形刀片。
对大多数过程而言,使用裸露的紧固件,即与患者的组织直接接触的紧固件,通常是可以接受的。在出现愈合之前,组织的完整性通常会防止紧固件从该组织撕裂出来而损害密封。然而,在一些手术操作中,外科医生用支撑材料与圆形吻合装置组合,来桥接、修复和/或加固患者体内的组织缺损。特别是,支撑材料减少患者所遭受的创伤,减少渗漏的情况,减少出血的情况,并在相邻的身体组织之间创建一个较强的结合。
因此,需要可靠地和可移除地将支撑材料附着在圆形吻合装置上,以使该支撑材料不干扰该装置的操作,保持在该装置上直到紧固件被发射,并且方便且易于安装和使用。
发明内容
根据一个方面,本发明提供了一种圆形吻合装置包括手柄组件、细长体、钉仓组件以及钉仓支撑件。
所述细长体从所述手柄组件延伸。所述钉仓组件安装在所述细长体的远端,并且可在第一位置和第二位置之间相对于所述细长体的远端移动。所述钉仓组件被定位成在所述第一位置与所述细长体的远端相邻,且在所述第二位置与所述细长体的远端隔开。所述钉仓组件包括延伸至环形边缘的组织接合表面。
所述钉仓支撑件具有主体部和延伸部。该延伸部从所述钉仓支撑件的主体部延伸。当所述钉仓组件被布置在所述第一位置时,所述主体部被支承在所述钉仓组件的组织接合表面上,并且所述延伸部延伸经过所述环形边缘,从而使所述延伸部被固定在所述细长体和所述钉仓组件之间,以保持所述支撑件被支承在所述钉仓组件上。
弹簧组件固定在所述钉仓组件和所述细长构件的远端之间。所述弹簧组件适于将所述钉仓组件拉向所述细长构件的远端,以便当所述钉仓组件被布置在所述第一位置时,保持所述钉仓组件与所述细长构件的远端非常接近。所述弹簧组件包括一个或多个弹簧,当所述钉仓组件被布置在所述第一位置时,所述一个或多个弹簧提供足以将所述钉仓支撑件的延伸部捕获于所述细长构件和所述钉仓组件之间的弹簧力。当所述钉仓组件被移向所述第二位置时,所述一个或多个弹簧允许所述钉仓组件的运动,以将所述钉仓支撑件的延伸部从所述细长构件和所述钉仓组件之间释放。
所述钉仓组件包括一个或多个推进器,在所述圆形吻合装置击发时,所述一个或多个推进器朝向所述第二位置驱动所述钉仓组件并且抵抗所述一个或多个弹簧的弹簧力。所述钉仓组件移动到所述第二位置,并将所述钉仓支撑件的延伸部从所述细长构件和所述钉仓组件之间释放。在支承于在所述钉仓组件的组织接合表面内限定的紧固件保持槽内的紧固件成形时,所述钉仓支撑件的主体部从所述钉仓组件的组织接合表面分离。
在实施方式中,所述钉仓组件包括刀具组件。该刀具组件包括刀具。所述一个或多个推进器可操作地连结到第一驱动器上。所述刀具组件可操作地连结到第二驱动器上。所述第一和第二驱动器是分开的,且可彼此独立地操作。
在某些实施方案中,所述圆形吻合装置包括砧座组件,所述砧座组件选择性地在接近位置和非接近位置之间可相对于所述钉仓组件移动。砧座支撑件被支承在所述砧座组件的组织接合表面上。所述砧座支撑件具有主体部和从其主体部延伸的延伸部。所述砧座组件包括夹紧组件,所述夹紧组件将砧座支撑件的延伸部固定至砧座组件,以使所述砧座支撑件的主体部被支承在所述砧座组件的组织接合表面之上。所述夹紧组件包括夹具,其是弹簧加载的,以保持所述砧座支撑件的延伸部被固定到所述砧座组件上。
所述夹具包括锁定组件,所述锁定组件将所述夹具保持于锁定配置,以保持所述砧座支撑件的延伸部被固定到所述砧座组件上。所述刀具可移动以将所述锁定组件定位于解锁配置,以便来自弹簧加载的夹具的弹簧力移动所述夹具,以将所述砧座支撑件的延伸部释放。
根据另一个方面,提供了一种圆形吻合装置,其包括手柄组件、从该手柄组件延伸的细长体、安装在所述细长体的远端的末端执行器以及支承在所述砧座组件上的砧座支撑件。
所述末端执行器包括砧座组件和钉仓组件。所述砧座组件可选择性地在接近位置和非接近位置间相对于所述钉仓组件移动。
所述砧座支撑件具有主体部和从该主体部延伸的延伸部。所述砧座组件包括弹簧加载的夹具,所述夹具将所述砧座支撑件的延伸部固定至所述砧座组件,从而所述砧座支撑件的主体部被支承于所述砧座组件的组织接合表面之上。
在实施方式中,所述圆形吻合装置包括具有刀具的刀具组件。所述弹簧加载的夹具包括锁定组件,所述锁定组件将所述弹簧加载的夹具保持在锁定配置,以保持所述砧座支撑件的延伸部被固定到所述砧座组件上。所述刀具可移动以将所述锁定组件定位于解锁配置。当所述锁定组件被布置在所述解锁配置时,所述弹簧加载的夹具被配置以释放所述砧座支撑件的延伸部。
所述钉仓组件可于第一位置和第二位置之间相对于所述细长体的远端移动。所述钉仓组件被定位成在所述第一位置与所述细长体的远端相邻,且在所述第二位置与所述细长体的远端隔开。
所述钉仓组件支承钉仓支撑件,当所述钉仓组件被布置在所述第一位置时,所述钉仓支撑件被固定在所述细长体和所述钉仓组件之间。所述钉仓组件的至所述第二位置的移动将所述钉仓支撑件从所述细长体和所述钉仓组件之间释放。
根据另一个方面,砧座组件包括砧座头、砧座盖和支撑件。所述砧座头限定了开口。所述砧座盖包括盖体和从该盖体延伸的突起。该突起可固定于限定在所述砧座头内的开口内,以将砧座盖固定至砧座头。所述支撑件包括主体部和从该主体部延伸的延伸部。当所述突起定位于限定在所述砧座头内的开口内时,所述延伸部可固定于所述砧座盖和所述砧座头之间。所述砧座头支承与所述突起相邻的垫圈。该垫圈可与所述突起接合,以将所述砧座盖和所述砧座头分开,并从所述砧座盖和所述砧座头之间释放所述延伸部。所述垫圈可移动而与所述突起接合,以将所述砧座盖和所述砧座头分离,使得所述延伸部从所述砧座盖和所述砧座头之间释放。所述突起在所述一个或多个开口内被打平(peened)或熔化(或者打平和熔化两种方式),以防止所述砧座盖从所述砧座头脱离。
根据又一个方面,本公开针对一种用于将钉仓支撑件从圆形吻合装置的钉仓组件释放的方法。该方法包括以下步骤:提供圆形吻合装置,其包括具有安装在所述细长体的远端的钉仓组件的细长构件,所述钉仓组件包括钉仓支撑件,所述钉仓支撑件被支承在所述钉仓组件的组织接合表面上且被捕获在所述细长构件和所述钉仓组件之间;以及相对于所述细长构件来移动所述钉仓组件,以将所述钉仓支撑件从所述圆形吻合装置释放。
根据一个方面,所述方法包括以下步骤:在足以将所述钉仓支撑件的延伸部捕获于所述细长构件和所述钉仓组件之间的弹簧力下,选择性地保持所述钉仓支撑件的延伸部夹置在所述钉仓组件的近侧表面和所述细长构件的远侧表面之间;驱动所述钉仓组件抵抗所述弹簧力以使得所述钉仓组件和所述细长构件相对于彼此分开;将被捕获在所述细长构件和所述钉仓组件之间的所述钉仓支撑件的延伸部释放;以及成形被支承在限定于所述钉仓组件的所述组织接合表面的紧固件保持槽内的紧固件,以将所述钉仓支撑件从所述钉仓组件的组织接合表面分离。
从以下描述、附图及权利要求书中,其他方面、特征和优点将是显而易见的。
附图说明
被并入说明书中并构成其中的一部分的、阐述本公开的实施方式的附图,连同上面给出的本公开的一般描述,以及下面给出的详细描述,用来解释本公开的原理,其中:
图1为根据本公开的圆形吻合装置的立体图;
图2为图1的圆形吻合装置的末端执行器的实施方式的剖视图;
图3和4为图2所示的细节的指示区域的渐进的、放大的剖视图;
图5和6为图1的圆形吻合装置的末端执行器的另一个实施方式的一部分的渐进的、放大的剖视图;
图7-9为示例性的砧座和/或钉仓手术支撑件的俯视图;和
图10为被配置来操作本公开的末端执行器的示例性的机电的、动力手柄的示例性立体图。
具体实施方式
如本文中所使用的术语“临床医生”指的是医生、护士、或任何其他保健提供者,并且可以包括辅助人员。本公开的具体实施方式将在此参照附图进行说明。如附图中所示并在整个下面的描述中所描述的,按照传统,当涉及物体上的相对定位时,术语“近侧”指的是设备离临床医生较近的端,而术语“远侧”指的是设备的离临床医生较远的端。在下面的描述中,公知的功能或结构没有详细描述,以避免在不必要的细节上模糊本公开。
首先参照图1,与支撑材料一起使用的圆形手术吻合装置在本文中公开,并通常指定为10。手术吻合装置10包括手柄组件20、管状的细长体30以及末端执行器40。手柄组件20包括可转动的推进构件22和可枢转的触发构件24。细长体30从手柄组件20的远端部向远侧延伸至末端执行器40的近端部,从而细长体30设置在手柄组件20和末端执行器40之间。在一些实施方式中,细长体30具有沿细长体30的长度的直线形状,并且在某些实施方式中,细长体30具有沿细长体30的长度的弯曲形状。
壳构件32被支承在细长体30的远端部处。壳构件32将末端执行器40的近端部连接至细长体30的远端部。末端执行器40可以与细长体30是一体的或是可拆卸的。细长体30可以与手柄20是一体的或是可拆卸和可替换的。可以配置细长体30和末端执行器40与机电的动力手柄500(参见图10)和/或控制台或手术机器人一起使用。
末端执行器40包括紧固件钉仓组件100、砧座组件200以及具有适于切割组织的基本上圆柱形的刀具400(图4)的刀具组件。在实施方式中,紧固件钉仓组件100和/或砧座组件200可被替换,并且圆形吻合装置10可以重复使用。
在实施方式中,圆形吻合装置10适于单次使用,并且可以是一次性的。圆形吻合装置10可包括任何数量的驱动器,以实现吻合装置10的击发,包括,例如,一个驱动器,其可操作以成形由末端执行器40支承的紧固件,以及另一个驱动器,其可操作以推进刀具400,分离和/或独立于其他的驱动器。
可以参见授权给Viola等人的美国专利第5,915,616号和共同拥有的于2010年11月15日提交的名为“用在手术手柄组件和手术末端执行器之间的适配器(Adapters for Use Between Surgical Handle Assembly and SurgicalEnd Effector)”的美国专利申请公开第2011/0174099号,该申请的全部内容在此通过引用并入本文,用于示例性的圆形吻合装置的结构和操作的详细讨论。
现在转到图2-4,紧固件钉仓组件100安装在细长体30的远端部处,且在包含任意中间位置的第一位置和一个或多个第二位置之间,可相对于细长体30的远端部移动。在所述第一位置处,钉仓组件100被定位成邻近于细长体30的远端部。在所述第二位置处,钉仓组件100从细长体30的远端部隔开。
紧固件钉仓组件100包括钉仓体110和推进器构件120。钉仓体110具有组织接合表面112,其延伸到外环形边缘112a且限定多个环绕组织接合表面112的呈环状的和/或同心排列的紧固件保持槽114。每个紧固件保持槽114的尺寸被设计为支承紧固件50,如手术吻合钉。
推进器构件120,其可操作地连结到适于驱动该推进器构件120的驱动器上,推进器构件120包括具有多个推进器122的大致圆筒状的主体,推进器122的尺寸设计为与保持在紧固件保持槽114内的紧固件50相接合。多个推进器122设置成环绕推进器构件120的圆筒状的主体的环形的和/或同心的排列。在圆形吻合装置10击发时,多个推进器122朝向所述第二位置驱动钉仓组件100。推进器构件120的尺寸设计为容纳穿过的刀具400。
弹簧组件130被固定在钉仓组件100和细长构件30的远端部之间。弹簧组件130适于将钉仓组件100拉向细长构件30的远端部,以保持钉仓组件100与细长构件30的远端部非常接近,例如,当钉仓组件100位于所述第一位置时。弹簧组件130包括一个或多个弹簧132,其通过任何合适的固定技术固定在钉仓体110的近端部和壳构件32的远端部之间。所述一个或多个弹簧132可具有任何合适的弹簧常数,适于将钉仓体110牵向或拉向壳构件32,以保持钉仓体110的近端部与壳构件32的远端部非常接近,如图4所示。所述一个或多个弹簧132适于从压紧状态伸长至扩张状态,以使钉仓体110的近端部非接近于壳构件32的远端部。所述一个或多个弹簧可以是螺旋形的,但其它配置是预期的。或者,其他的弹性装置可额外地被使用或者代替弹簧组件130。
参考图3、4和9,钉仓支撑件140具有主体部142和延伸部144,该延伸部144从钉仓支撑件140的主体部142延伸。延伸部144的尺寸被设计以延伸经过钉仓体110的组织接合表面112的环形边缘112a。延伸部144可固定于壳构件32的远端部和钉仓体110的近端部之间,以保持钉仓支撑件140被支承在钉仓体110上。例如,当钉仓组件100位于所述第一位置时,主体部142被支承在钉仓组件100的组织接合表面112上,且延伸部144延伸经过组织接合表面112的环形边缘112a,以致延伸部144被固定在细长体30和钉仓组件100之间,以保持钉仓支撑件140被支承在钉仓体110上。
弹簧组件130的一个或多个弹簧132提供足以将钉仓支撑件140的延伸部144捕获于细长构件30和钉仓组件100之间的弹簧力。如下面更详细地描述,所述一个或多个弹簧132可随钉仓组件100移动,并且当钉仓组件100被移向所述第二位置时,抵抗一个或多个弹簧132的弹簧力,以将钉仓支撑件140的延伸部144从细长构件30和钉仓组件100之间释放。在所述第二位置,在支承在紧固件保持槽114内的紧固件50成形之时或之后,钉仓支撑件140的主体部142与钉仓组件100的组织接合表面112分离。
圆形吻合装置10击发之后,砧座组件200可选择性地于接近位置和非接近位置之间可相对于钉仓组件100移动。砧座组件200包括砧座体210、砧座板220、夹紧组件230以及挤压组件240。砧座体210限定一个或多个开口210a并且被支承在夹紧组件230和砧座板220之间。砧座板220具有组织接合表面222,其延伸至环形边缘222a并限定多个紧固件成形凹穴224,这些紧固件成形凹穴224布置成环绕组织接合表面222的环形的和/或同心的排列。夹紧组件230包括一个或多个夹具232和一个或多个弹簧234,弹簧加载所述一个或多个夹具232。所述一个或多个夹具232限定凹槽232a。挤压组件240包括一个或多个刀具接合构件242、挤压环244和一个或多个夹具啮合指246。
参照图8,砧座支撑件250具有主体部252和延伸部254,其从砧座支撑件250的主体部252延伸。延伸部254的尺寸设计为延伸经过砧座板220的组织接合表面222的环形边缘222a。延伸部254可固定于夹紧组件230的近端部和砧座体210的远端部之间,以保持砧座支撑件250的延伸部254被固定于砧座组件200,以致砧座支撑件250被支承在砧座板220的组织接合表面222之上。例如,夹紧组件230包括锁定组件,所述锁定组件包括一个或多个夹具啮合指246的远端部和所述一个或多个夹具232的凹槽232a。如下面更详细地描述,所述一个或多个夹具啮合指246的远端部进行配合,来保持所述一个或多个夹具232处于选择性地锁定配置,以使砧座支撑件250的延伸部254抵靠砧座体210的远端部而锁定。
在操作中,在圆形吻合装置10击发之前,且在砧座组件200和紧固件钉仓组件100放置在目标手术部位之后,如在美国专利第5,915,616号或美国专利申请公开第2011/0174099号中所述,其公开内容整体地通过引用的方式并入在此,砧座组件200和紧固件钉仓组件100通过驱动组件(未示出)被定位在一接近状态,以将组织夹紧在其间。如图2和3所示,对于处于接近状态的钉仓组件100和砧座组件200,弹簧组件130促使钉仓组件100的钉仓体110朝向壳构件32的远端部,以将钉仓支撑件140的延伸部144的远端部捕获在壳构件32的远端部和钉仓体110的近端部之间,如上所述。类似地,在挤压组件240的一个或多个夹具啮合指246的远端部与一个或多个夹具232的凹槽232a的接触啮合的情况下,夹紧组件230的一个或多个夹具232将砧座支撑件250的延伸部254相对于砧座体210的远端部锁定,以保持砧座支撑件250的主体部252被支承在砧座板220的组织接合表面222之上。
再次参考图4,在圆形吻合装置10击发时,推进器构件120的推进器122向远侧推进通过紧固件保持槽114,以从紧固件保持槽114分配紧固件50。在紧固件50被从紧固件保持槽114分配时,在抵靠限定于砧座板220的组织接合表面222的紧固件成形凹穴224成形之前,紧固件50的腿部被驱动通过钉仓支撑件140、被夹紧的组织以及砧座支撑件250。随着推进器构件120向远侧推进,推进器构件120与钉仓体110接合且驱动钉仓体110向远侧离开壳构件32,抵抗所述一个或多个弹簧132的反向力。钉仓体110的从壳构件32的分离提供了介于钉仓体110和壳构件32之间的空间,该空间足够使得钉仓支撑件140的延伸部144从钉仓体110和壳构件32之间释放。
刀具400可通过驱动组件(未示出)的驱动器向远侧推进,通过钉仓组件,与挤压组件240的刀具接合构件242相接合。随着刀具400向远侧驱动刀具接合构件242,刀具接合构件242压紧挤压环244且驱动夹具啮合指246向远侧通过限定于砧座体210内的开口210a。夹具啮合指246的远侧运动将夹具啮合指246的远端部从夹具组件230的一个或多个夹具232的凹槽232a脱离,因而将锁定组件重新定位于解锁配置,以使得一个或多个夹具232完全地从夹具啮合指246脱离。在所述一个或多个弹簧243的弹簧力下,所述一个或多个弹簧243迫使所述一个或多个夹具232离开砧座体210的远端部,且使得砧座支撑件250的延伸部254的远端部自由,使得整个砧座支撑件250从砧座组件200脱离。
现在转到图5和6,砧座组件的另一个实施方式通常被称为砧座组件300。砧座组件300包括砧座盖310、砧座头320、偏置构件330(如弹簧)、垫圈340、切割环350和砧座支撑件360(图7)。
砧座盖310选择性地在接近和非接近位置之间可相对于砧座头320移动,且包括盖体312,盖体312具有一个或多个突起314,所述突起314从盖体312向近侧延伸。每个突起314包括臂构件314a和横向构件或头部314b。臂构件314a从盖体312的近端部向近侧延伸,且将横向构件314b支承在臂构件314a的近端部上。
砧座头320包括具有组织接合表面324的头主体322。组织接合表面324限定了多个紧固件成形凹穴324a。头主体322在头主体322的远端部限定一个或多个开口326,且在头主体322的近端部限定了中心开口326a。该中心开口326a的尺寸设计为容纳垫圈340和切割环350,且每个开口326的尺寸设计为在其中容纳砧座盖310的突起314,以将砧座盖310固定到砧座头320上。每个突起314可以在所述一个或多个开口326内被打平或熔化(或者打平和熔化两种方式),以防止砧座盖310从砧座头320脱离。当容纳在中心开口326a内时,垫圈340可以被定位成与砧座盖310的突起314相邻。偏置构件330在盖体322的肩328和突起314的横向构件314b之间关于突起314的臂构件314a定位,以迫使砧座盖310的近端部与砧座头320的远端部接近。从图7看到,砧座支撑件360包括主体部362和从主体部362延伸的延伸部364。当突起314定位于限定在砧座头320的一个或多个开口326内时,延伸部364可固定于砧座盖310和砧座头320之间。
在操作中,刀具400在远侧驱动力下向远侧推进以与切割环350接合。远侧驱动力驱动垫圈340与砧座盖310的一个或多个突起314的横向构件314b的远端部相接合,并将偏置构件330压紧在砧座盖310的横向构件314b的远端部和砧座头320的肩328的近端部之间。垫圈340与所述一个或多个突起314的接合将砧座盖310与砧座头320分离。随着砧座盖310与砧座头320分离,砧座盖310的近端部与砧座头320的远端部分离,以使得支撑件360的延伸部364从被夹置于砧座盖310的近端部和砧座头320的远端部之间释放,使得整个砧座支撑件360从砧座组件300分离。
如所理解的,本公开的任何支撑件可以具有任何合适的几何构型,并且可以被支承在砧座组件和/或钉仓组件上。进一步地,本公开的任何支撑件可以由手术用级别的生物相容的非吸收性材料(例如永久的)或可吸收的材料(即非永久的)网或材料制成,优选浸渍有粘合剂、密封剂和/或其它药物。还可以设想,每个部分可以是不可吸收和可吸收材料两者的复合材料。可以找到用于支撑件制造的合适的材料和浸渍于或涂抹于支撑件的合适的粘合剂、密封剂和/或药剂,例如,在美国专利第7,942,890号中,该申请的全部内容通过引用的方式并入本文中。
从图10看到,示出了一种与本公开的末端执行器40一起使用的机电的动力手术手柄500。机电的动力手术手柄500可以包括动力源(如电池等)、马达和电路板(未示出)或类似物。
本领域的技术人员将理解,本文具体描述的和在附图中图示的结构和方法是非限制性的示例性实施方式,并且该描述、公开和附图应当仅仅理解为特定实施方式的示例。但是应当理解,本公开并不限于所描述的具体实施方式,且各种不同的改变和修改可以由本领域技术人员在不脱离本公开的范围或构思的情况下进行。另外,可以预见的是一个示例性实施例所阐述或描述的要素和特征可以与其他实施例的要素和特征相结合,而不脱离本公开的范围,并且这样的修改和变化也意欲将其包含在本公开的保护范围之内。事实上,任何目前公开的要素和特征的任意组合是在本公开的保护范围之内。因此,本公开的主题并不被已经特别示出和描述的所限制。
Claims (20)
1.一种圆形吻合装置,包括:
手柄组件;
细长体,其从所述手柄组件延伸;
钉仓组件,其安装于所述细长体的远端且能够在第一位置和第二位置之间相对于所述细长体的远端移动,所述钉仓组件被定位成在所述第一位置与所述细长体的远端相邻,且在所述第二位置与所述细长体的远端隔开,所述钉仓组件包括延伸至环形边缘的组织接合表面;以及
钉仓支撑件,其具有主体部和从所述钉仓支撑件的主体部延伸的延伸部,其中当所述钉仓组件布置于所述第一位置时,所述主体部被支承在所述钉仓组件的组织接合表面上,且所述延伸部延伸经过所述环形边缘,以将所述延伸部固定在所述细长体和所述钉仓组件之间,来保持所述支撑件被支承在所述钉仓组件上。
2.如权利要求1所述的圆形吻合装置,其中弹簧组件被固定在所述钉仓组件与所述细长构件的远端之间,所述弹簧组件适于将所述钉仓组件拉向所述细长构件的远端,以便当所述钉仓组件布置于所述第一位置时,保持所述钉仓组件与所述细长构件的远端非常接近。
3.如权利要求2所述的圆形吻合装置,其中所述弹簧组件包括至少一个弹簧,当所述钉仓组件布置在所述第一位置时,所述至少一个弹簧提供足以将所述钉仓支撑件的延伸部捕获于所述细长构件和所述钉仓组件之间的弹簧力,当所述钉仓组件被移向所述第二位置时,所述至少一个弹簧允许所述钉仓组件的运动,以将所述钉仓支撑件的延伸部从所述细长构件和所述钉仓组件之间释放。
4.如权利要求3所述的圆形吻合装置,其中所述钉仓组件包括至少一个推进器,在所述圆形吻合装置击发时,所述至少一个推进器朝向所述第二位置驱动所述钉仓组件并且抵抗所述至少一个弹簧的弹簧力,其中所述钉仓组件移动到所述第二位置并将所述钉仓支撑件的延伸部从所述细长构件和所述钉仓组件之间释放,并且其中在支承于在所述钉仓组件的组织接合表面内限定的紧固件保持槽内的紧固件成形时,所述钉仓支撑件的主体部从所述钉仓组件的组织接合表面分离。
5.如权利要求4所述的圆形吻合装置,其中所述钉仓组件进一步包括刀具组件,所述至少一个推进器可操作地连结至第一驱动器,所述刀具组件可操作地连结至第二驱动器,所述第一和第二驱动器是分开的,且是能够彼此独立地操作。
6.如权利要求1所述的圆形吻合装置,进一步包括砧座组件,其可选择性地在接近位置和非接近位置之间相对于所述钉仓组件移动。
7.如权利要求6所述的圆形吻合装置,进一步包括砧座支撑件,其支承于所述砧座组件的组织接合表面。
8.如权利要求7所述的圆形吻合装置,其中所述砧座支撑件具有主体部和从其主体部延伸的延伸部,所述砧座组件包括夹紧组件,其将所述砧座支撑件的延伸部固定至所述砧座组件,以使所述砧座支撑件的主体部被支承在所述砧座组件的组织接合表面上。
9.如权利要求8所述的圆形吻合装置,其中所述夹紧组件包括夹具,其是弹簧加载的,以保持所述砧座支撑件的延伸部被固定至所述砧座组件。
10.如权利要求9所述的圆形吻合装置,进一步包括含有刀具的刀具组件;所述夹具包括锁定组件,所述锁定组件将所述夹具保持于锁定配置,以保持所述砧座支撑件的延伸部被固定到所述砧座组件上;所述刀具是能够移动的以将所述锁定组件定位于解锁配置,以便来自弹簧加载的夹具的弹簧力使所述夹具移动,以将所述砧座支撑件的延伸部释放。
11.一种圆形吻合装置,包括:
手柄组件;
细长体,其从所述手柄组件延伸;
末端执行器,其安装于所述细长体的远端,所述末端执行器包括砧座组件和钉仓组件,所述砧座组件可选择性地在接近位置和非接近位置之间相对于所述钉仓组件移动;以及
砧座支撑件,其支承于所述砧座组件上,所述砧座支撑件具有主体部和从所述主体部延伸的延伸部,所述砧座组件包括弹簧加载的夹具,所述夹具将所述砧座支撑件的延伸部固定至所述砧座组件,从而所述砧座支撑件的主体部被支承于所述砧座组件的组织接合表面上。
12.如权利要求11所述的圆形吻合装置,进一步包括含有刀具的刀具组件;所述弹簧加载的夹具包括锁定组件,所述锁定组件将所述弹簧加载的夹具保持于锁定配置,以保持所述砧座支撑件的延伸部被固定到所述砧座组件上;所述刀具是能够移动的以将所述锁定组件定位于解锁配置;所述弹簧加载的夹具配置为当所述锁定组件布置于所述解锁配置时将所述砧座支撑件的延伸部释放。
13.如权利要求11所述的圆形吻合装置,其中所述钉仓组件能够在第一位置和第二位置之间相对于所述细长体的远端移动,所述钉仓组件被定位成在所述第一位置与所述细长体的远端相邻,且在所述第二位置与所述细长体的远端隔开。
14.如权利要求13所述的圆形吻合装置,其中所述钉仓组件支承钉仓支撑件,当所述钉仓组件被布置在所述第一位置时,所述钉仓支撑件被固定在所述细长体和所述钉仓组件之间,其中所述钉仓组件的至所述第二位置的移动将所述钉仓支撑件从所述细长体和所述钉仓组件之间释放。
15.一种砧座组件,包括:
砧座头,其限定开口;
砧座盖,其包括盖体和从所述盖体延伸的突起,所述突起能够固定于限定在所述砧座头内的开口内,以将所述砧座盖固定至所述砧座头;
支撑件,其包括主体部和从所述主体部延伸的延伸部,当所述突起定位于限定在所述砧座头内的开口内时,所述延伸部能够固定在所述砧座盖和所述砧座头之间。
16.如权利要求15所述的砧座组件,其中所述砧座头支承与所述突起相邻的垫圈,所述垫圈能够与所述突起接合,以将所述砧座盖和所述砧座头分离,并将所述延伸部从所述砧座盖和所述砧座头之间释放。
17.如权利要求16所述的砧座组件,其中所述垫圈能够移动以与所述突起接合,以将所述砧座盖和所述砧座头分离,使得所述延伸部从所述砧座盖和所述砧座头之间释放。
18.如权利要求15所述的砧座组件,其中所述突起在所述开口中被打平和/或被熔化,以防止所述砧座盖从所述砧座头脱离。
19.一种用于将钉仓支撑件从圆形吻合装置的钉仓组件释放的方法,包括以下步骤:
提供圆形吻合装置,其包括具有安装于所述细长体的远端的钉仓组件的细长构件,所述钉仓组件包括钉仓支撑件,所述钉仓支撑件被支承在所述钉仓组件的组织接合表面且被捕获在所述细长构件和所述钉仓组件之间;以及
相对于细长构件来移动所述钉仓组件以将所述钉仓支撑件从所述圆形吻合装置释放。
20.如权利要求19所述的方法,进一步包括以下步骤:
在足以将所述钉仓支撑件的延伸部捕获于所述细长构件和所述钉仓组件之间的弹簧力下,选择性地保持所述钉仓支撑件的延伸部夹置在所述钉仓组件的近侧表面和所述细长构件的远侧表面之间;
驱动所述钉仓组件抵抗所述弹簧力以使得所述钉仓组件和所述细长构件相对于彼此分开;
将被捕获在所述细长构件和所述钉仓组件之间的所述钉仓支撑件的延伸部释放;
以及成形被支承在限定于所述钉仓组件的所述组织接合表面的紧固件保持槽内的紧固件,以将所述钉仓支撑件从所述钉仓组件的组织接合表面分离。
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CN108523956B (zh) * | 2017-02-28 | 2023-05-30 | 柯惠Lp公司 | 具有钉鞘的手术钉合设备 |
CN109381235A (zh) * | 2017-08-07 | 2019-02-26 | 柯惠Lp公司 | 具有可复位的倾斜砧座组件的缝合装置 |
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Also Published As
Publication number | Publication date |
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EP2984995B1 (en) | 2018-08-29 |
ES2635550T3 (es) | 2017-10-04 |
EP2774551A3 (en) | 2014-10-15 |
EP2984995A1 (en) | 2016-02-17 |
EP2774551B1 (en) | 2017-07-05 |
CN104027149B (zh) | 2018-02-27 |
AU2014201008B2 (en) | 2018-03-29 |
AU2014201008A1 (en) | 2014-09-25 |
EP2774551A2 (en) | 2014-09-10 |
US9782173B2 (en) | 2017-10-10 |
US20140252062A1 (en) | 2014-09-11 |
JP2014171880A (ja) | 2014-09-22 |
CA2843962A1 (en) | 2014-09-07 |
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