CN104042277B - 手术吻合装置 - Google Patents

手术吻合装置 Download PDF

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CN104042277B
CN104042277B CN201410093895.8A CN201410093895A CN104042277B CN 104042277 B CN104042277 B CN 104042277B CN 201410093895 A CN201410093895 A CN 201410093895A CN 104042277 B CN104042277 B CN 104042277B
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jaw members
surgical stapling
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欧内斯特·奥拉尼
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07271Stapler heads characterised by its cartridge
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07278Stapler heads characterised by its sled or its staple holder
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07285Stapler heads characterised by its cutter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0814Preventing re-use

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  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

本发明提供一种手术吻合装置,也称为吻合器,所述手术吻合装置构造为联接到再装载器。再装载器包括第一钳夹构件,第一钳夹构件可释放地支撑钉仓,所述钉仓包括滑动偏转器,滑动偏转器能够从第一位置运动到第二位置。在再装载器的第一钳夹构件和所述第二钳夹构件中的一个上设置一个或多个闭锁台阶。驱动构件包括工作端,工作端被驱使朝向闭锁台阶运动。在第一位置,所述滑动偏转器被定位以防止驱动构件的所述工作端与所述闭锁台阶的接合,并且在第二位置,所述滑动偏转器被定位以允许所述工作端与闭锁台阶的接合,从而防止所述工作端的进一步推进。所述工作端的向远侧平移使得滑动偏转器从第一位置运动到第二位置。本发明还提供了一种再装载器。

Description

手术吻合装置
相关申请的交叉引用
本申请要求于2013年3月13日递交的序列号为61/779,669的美国临时专利申请的权益和优先权,该申请的全部内容通过引用合并于此。
技术领域
本公开涉及手术吻合装置。更特别地,本公开涉及包括刀具驱动闭锁机构的手术吻合装置。
背景技术
构造为吻合并且随后切断组织的手术吻合装置在该领域是已知的。这种吻合装置通常包括壳体或手柄以及细长构件,所述细长构件自壳体延伸出。在特定情况下,单次使用装载单元再装载器(reload)或多次使用装载单元(MULU)再装载器可以构造为可释放地联接到细长构件的远侧端。在上述任一的再装载器构造中,包括砧座和钉仓的工具组件可以被设置在再装载器的相应的钳夹上以吻合组织。所述工具组件能够包括刀具以切断吻合的组织。所述再装载器可以包括驱动构件,所述驱动构件具有工作端,所述工作端支撑所述刀具并且使致动滑块推进通过所述工具组件以吻合并且切断组织。
虽然上述的再装载器构造提供众多的优点,但是当吻合钉钉仓不存在于所述工具组件中或已经被发射时,期望的是所述再装载器可以防止所述再装载器的所述驱动构件的无意的推进。
发明内容
能够理解的是,可以证实包括刀具驱动闭锁机构的手术吻合装置在外科手术领域是有用的。
参照附图详细地描述根据本公开的实施例,其中,相似的附图标记表示相似或相同的结构元件。如在此使用的,术语“远侧”是指所描述的离用户较远的部分,而术语“近侧”是指所描述的离用户较近的部分。
本公开的一个方案提供一种手术吻合装置(吻合器)。所述吻合器包括壳体。细长构件从所述壳体延伸出。再装载器支撑在所述细长构件的远侧端上。所述再装载器包括:第一钳夹构件,其可释放地支撑钉仓;以及第二钳夹构件,其支撑砧座。所述钉仓包括滑动偏转器,滑动偏转器能够从第一位置运动到第二位置。一个或多个闭锁台阶设置在所述第一钳夹构件和所述第二钳夹构件中的一个上。驱动构件包括工作端,所述工作端构造为当所述第一钳夹构件和所述第二钳夹构件处于闭合构造时平移通过所述再装载器。所述工作端被驱使朝向所述闭锁台阶运动。在所述第一位置,所述滑动偏转器被定位以防止所述驱动构件的所述工作端与所述闭锁台阶的接合,并且,在所述第二位置,所述滑动偏转器被定位以允许所述驱动构件的所述工作端与所述闭锁台阶的接合,从而防止所述工作端的进一步推进。所述工作端的向远侧平移使得所述滑动偏转器从第一位置运动到第二位置。
所述驱动构件可以包括梁,所述梁包括远侧端,所述远侧端具有将所述工作端朝向所述闭锁台阶偏置的预先弯曲构造。一个或多个弹性构件可以构造为将所述工作端朝向所述闭锁台阶偏置。所述弹性构件可以联接到手术吻合装置的枢转构件。所述弹性构件可以包括大体弓形的接触部,其允许所述工作端滑动经过并且与所述滑动偏转器和所述闭锁台阶中的一个相接触。所述闭锁台阶可以设置在所述砧座和所述第一钳夹构件中的每个上。
所述滑动偏转器可移除地联接到所述钉仓的致动滑块。所述滑动偏转器可以在其上包括一个或多个凸起部(detent),所述凸起部可以构造为接合在所述工作端上的相应凹进部(indent)和布置在所述钉仓内的相应凹进部。所述滑动偏转器包括机械接口,所述机械接口构造为接合布置在所述钉仓内的相应的机械接口。布置在所述滑动偏转器上的所述机械接口和布置在所述钉仓内的所述机械接口形成燕尾形接合部。
本公开的一个方案提供一种手术吻合装置(吻合器)。所述吻合器包括壳体。细长构件从所述壳体延伸出。再装载器支撑在所述细长构件的远侧端上。所述再装载器包括:第一钳夹构件,其可释放地支撑钉仓;以及第二钳夹构件,其支撑砧座。所述钉仓包括滑动偏转器,滑动偏转器能够从第一位置运动到第二位置。一个或多个闭锁台阶设置在所述第一钳夹构件和所述第二钳夹构件中的一个上。驱动构件包括工作端,所述工作端构造为当所述第一钳夹构件和所述第二钳夹构件处于闭合构造时平移通过所述再装载器。所述工作端被驱使朝向所述闭锁台阶运动。一个或多个弹性构件被定位成将所述工作端朝向所述至少一个闭锁台阶偏置。在所述第一位置,所述滑动偏转器被定位以防止所述驱动构件的所述工作端与所述闭锁台阶的接合,并且,在所述第二位置,所述滑动偏转器被定位以允许所述驱动构件的所述工作端与所述闭锁台阶的接合,从而防止所述工作端的进一步推进。所述工作端的向远侧平移使得所述滑动偏转器从第一位置运动到第二位置。
所述弹性构件可以联接到所述手术吻合装置的枢转构件。所述弹性构件可以包括大体弓形的接触部,其允许所述工作端滑动经过并且与所述滑动偏转器和所述闭锁台阶中的一个相接触。所述闭锁台阶可以设置在所述砧座和所述第一钳夹构件中的每个上。
所述滑动偏转器可移除地联接到所述钉仓的致动滑块。所述滑动偏转器可以在其上包括一个或多个凸起部,所述凸起部可以构造为接合在所述工作端上的相应凹进部和布置在所述钉仓中的相应凹进部。所述滑动偏转器包括机械接口,所述机械接口构造为接合布置在所述钉仓内的相应的机械接口。布置在所述滑动偏转器上的所述机械接口和布置在所述钉仓内的所述机械接口形成燕尾形接合部。
本公开的一个方案提供一种再装载器,所述再装载器构造为联接到手术吻合装置。所述再装载器包括钉仓,所述钉仓被支撑在所述再装载器的第一钳夹构件上。所述钉仓包括滑动偏转器,所述滑动偏转器能够从第一位置运动到第二位置。一个或多个闭锁台阶设置在所述第一钳夹构件和所述第二钳夹构件中的一个上。驱动构件包括工作端,所述工作端构造为当所述第一钳夹构件和所述第二钳夹构件处于闭合构造时平移通过所述再装载器。所述工作端被驱使朝向所述闭锁台阶运动。在所述第一位置,所述滑动偏转器被定位以防止所述驱动构件的所述工作端与所述闭锁台阶的接合。并且,在所述第二位置,所述滑动偏转器被定位以允许所述驱动构件的所述工作端与所述闭锁台阶的接合,从而防止所述工作端的进一步推进。所述工作端的向远侧平移使得所述滑动偏转器从第一位置运动到第二位置。
附图说明
在下文中参照附图说明本公开的多种实施例,其中:
图1是动力手术吻合装置的侧视立体图,动力手术吻合装置支撑再装载器;
图2是手动手术吻合装置的侧视立体图,手动手术吻合装置支撑再装载器;
图3A是根据本公开实施例的图1和图2的再装载器的侧视立体图,再装载器包括驱动闭锁机构;
图3B是部件分开的再装载器的工具组件和驱动构件的俯视立体图,其示出通道组件,所述通道组件构造为提供刀具平移的通路;
图4是图3中所示的可与所述工具组件使用的部件分开的钉仓的分解图;
图5是图4中所示的钉仓的致动滑块的立体图;
图6是钉仓的俯视立体图;
图7是图6的指示细节区域的放大图;
图8是钉仓的近侧端的立体图,钉仓的致动滑块和滑动偏转器与钉仓的近侧端分开;
图9是钉仓的近侧端的立体图,钉仓的致动滑块和滑动偏转器支撑在钉仓中;
图10是再装载器的刀具和滑动偏转器的侧视立体图;
图11是图3B中所示的再装载器的工具组件的钳夹构件的立体图,与图4中所示的钉仓相互分开;
图12是图11的细节的区域的放大图;
图13是再装载器的远侧端的俯视立体图,示出了工具组件,钉仓联接到钳夹构件且钳夹构件处于接近位置;
图14是图13的指示细节区域的放大图;
图15是图13中所示的再装载器的远侧端的仰视立体图;
图16是图15的指示细节区域的放大图,移除了砧座;
图17是示出了工具组件的近侧端的正视图,驱动构件和滑动偏转器处于缩回构造;
图18是示出了工具组件的近侧端的剖面图,驱动构件和滑动偏转器处于缩回构造;
图19是示出了随着刀具和滑动偏转器开始向远侧移动,具有驱动构件和滑动偏转器的工具组件的近侧端的剖面图;
图20是示出了工具组件的近侧端的局部剖面图,在工具组件已经发射之后刀具缩回,滑动偏转器在最远侧位置,并且驱动构件处于闭锁构造;
图21是示出了图20中所示的工具组件的近侧端的俯视立视图,驱动构件处于闭锁构造;
图22是根据本公开的可替换的实施例的驱动构件的俯视正视图,其构造为与在图3中描述的再装载器一起使用;以及
图23是图22的指示细节区域的放大图。
具体实施方式
在此公开本公开的详细的实施例;然而,公开的实施例仅仅是本公开的范例,其可以被以各种形式实施。因此,在此公开的特别结构的和功能的细节不应该解释为限制,而仅仅是作为权利要求的根据以及作为典型的根据而教导本领域的技术人员,从而在几乎任意适当的详细结构中多样地使用本公开。
图1示出了动力手术吻合装置,通常表示为附图标记100。图2示出了手动的手术吻合装置,通常表示为附图标记200。动力装置包括一个或多个马达以及内部或外部电源,而手动装置200具有可动手柄236以及用于驱动装置功能的机构。参见专利号为5,865,361、5,782,396的美国专利;国际申请WO04/032,760;公开号为2010/0276741的美国专利申请;以及专利申请序列号为13/444,228的美国专利申请,这些公开的每个的全部的内容通过引用合并于此。
简要地,手术吻合装置100包括壳体或固定手柄102,壳体或固定手柄102具有致动器136以及细长构件104,细长构件104从壳体102延伸出(图1)。同样地,手术吻合装置200包括壳体202或固定手柄以及细长构件204,壳体202或固定手柄支撑可动手柄236,细长构件204从壳体202延伸出。手术吻合装置200包括收缩机构216(图2),其能够被手动地抓住并且近侧地拉动以缩回装置200的发射机构。各细长构件104,204构造为可移除地联接到再装载器106。
参照图3A,再装载器106包括轴部109和工具组件107,工具组件107支撑在轴部109的远侧端上。工具组件107包括第一钳夹构件108和第二钳夹构件110,它们能够从用于定位第一钳夹构件108和第二钳夹构件110之间的组织的分离构造(图2)运动到用于为后续的组织吻合而夹紧组织的接近构造(图13)。
图3B示出了具有分开的钳夹构件108,110以及驱动构件“D”的工具组件107,驱动构件“D”具有支撑工作端101的驱动梁103。工作端101具有I梁构造,该I梁构造具有顶部和底部凸缘118a,118b并且工作端101包括远侧抵接表面118c,远侧抵接表面118c与致动滑块115的中心支撑楔形件113a(图4)接合。工作端101构造为运动通过工具组件107,工具组件107包括通过砧座111限定的刀具通道部114a,114b,砧座111分别支撑在钳夹构件110和钳夹构件108上。特别地,驱动梁103的工作端101从缩回位置运动到延伸位置以推进刀具105和致动滑块115以吻合并且切断组织。在吻合操作期间,刀具105被定位以在致动滑块115后方略微地行进以在吻合组织排之间形成切口。
参照图3B,枢轴组件150设置在轴109的远侧端,枢轴组件150可枢转地将工具组件107联接到轴109。枢轴组件150包括底部151a和顶部151b,底部151a和顶部151b可操作地相互联接并且分别联接到钳夹构件108、110,从而允许钳夹构件108、110(图3B)绕横向于再装载器106的纵向轴线的轴线做关节式运动。
为了更详细的讨论再装载器106的构造和操作,可以参照专利号为5,865,361和专利号为7,225,963的美国专利,这些专利的全部的内容通过引用合并于此。
参照图3B至图5,工具组件107的钳夹构件108构造为将可移除的钉仓组件112(钉仓112)支撑在工具组件107上。钉仓112包括多个紧固件117a和多个推动构件117b,推动构件117b可操作地与一个或多个紧固件117a接合。钉仓112包括一个或多个固位狭槽119,其纵向地沿钉仓112的组织接触表面121定位并且构造为容纳紧固件117a。钉仓壳体123(图4)联接到钳夹构件108。在此公开的任意实施例中,可以使用凸起部125(图4)、闩锁、夹子等将钉仓112联接到钳夹108。在序列号是13/280,880的名称为Multi-Use loading Unit(多次使用装载单元)的美国专利申请中公开了可移除的且可代替的钉仓,该专利的全部的内容通过引用合并于此。
参照图3A至图12,再装载器106包括锁定机构,锁定机构构造为当钉仓112还没有安装在钳夹构件108中时或当安装在钳夹构件108中的钉仓112已经被发射时,闭锁驱动构件“D”从而防止装置的发射。锁定机构包括滑动偏转器130,滑动偏转器130设置在钉仓112的近侧端处,锁定机构构造为在吻合钉钉仓112发射之前当滑动偏转器130处于缩回位置时,防止驱动构件“D”的工作端101的偏转。滑动偏转器130包括分别具有近侧端和远侧端131a,131b的大体细长构造,并且滑动偏转器130可释放地联接到致动滑块115。在示出的实施例中,滑动偏转器130被支撑在致动滑块115的凸出的楔支撑部之间以可释放地将滑动偏转器130联接到致动滑块115。更特别地,滑动偏转器130在致动滑块115的中央楔形支撑部113a和右楔形支撑部113b之间被联接到致动滑块115(图5)。
参照图6和图7,在钉仓112的预先安装构造中,滑动偏转器130的近侧端131a向近侧延伸穿过致动滑块115的近侧边缘。滑动偏转器130的近侧端131a限定了成角度的平面,该平面被定位为当钉仓112安装在钳夹构件108中时,将驱动构件“D”的工作端101的抵接表面118c,118d偏转远离分别设置在砧座111和钉仓112上的各自的闭锁台阶120a、120b。通过如此偏转工作端101,驱动构件“D”被允许向远侧地平移经过闭锁台阶120a、120b并且穿过刀具通道114a,114b以实现组织的吻合和切断。
凸起部133与滑动偏转器130的远侧端131b相邻设置,并且凸起部133包括内侧部134a,内侧部134a构造为与设置在钉仓112的内侧壁137b上的相应的凹进部137a牢固地接合(图7)。凸起部133包括外侧部134b,外侧部134b构造为可释放地与设置在驱动构件“D”的工作端101上的相应的凹进部138接合。凹进部138被定位于邻近上凸缘118a。依照目前的公开,随着驱动构件“D”的工作端101向远侧地运动并且在钉仓112中推进致动滑块115,外侧部134b可释放地接合在工作端101的凹进部138以在钉仓112中向远侧推进滑动偏转器130。在凸起部133的内侧部134a接合在钉仓112的内壁137b上的凹进部137a之前,滑动偏转器130将与驱动构件“D”的工作端101向远侧移动。
滑动偏转器130包括侧壁140,侧壁140沿滑动偏转器130的一侧延伸并且限定了凹槽141,凹槽141构造为在其中接纳从钉仓112的内侧壁137b延伸出的相应的引导构件139(图8)。包括引导构件139的内侧壁137b被定位在钉仓112中以允许致动滑块115向远侧平移通过钉仓112。在一个实施例中,凹槽141具有燕尾形构造并且接纳相应形状的引导构件139。
参照图7至图9,依照目前的公开,当驱动构件“D”的工作端101被推进以接触和推进致动滑块115时,致动滑块115首先独立于滑动偏转器130运动。工作端101的持续远侧平移导致滑动偏转器130的凸起部133的外侧部134b可释放地接合工作端101的相应的凹进部138,以将滑动偏转器130联接到工作端101,使得滑动偏转器130和工作端101一起向远侧移动。工作端101的进一步的向远侧平移导致凹槽141接纳引导构件139。引导构件139引导滑动偏转器130与内壁145接合以防止滑动偏转器130的进一步的向远侧移动。当滑动偏转器130的远侧端131b接触内壁145时,滑动偏转器130的外侧部134b从驱动构件“D”的工作端101的相应的凹进部138脱离。在凹槽141与引导构件139接合的情况下,滑动偏转器130被紧固到内侧壁137b并且防止了在钉仓112中的进一步移动。更特别地,当工作端101运动回到缩回构造时,在远侧端131b与内壁145接触的情况下滑动偏转器130保持在推进位置上。
再次根据图3B,并且参照图11,弹性构件152与钳夹构件108的近侧端邻近设置,并且弹性构件152构造为将驱动构件“D”的工作端101朝向砧座111和钉仓112的各自的闭锁台阶120a、120b偏置。特别地,弹性构件152联接到枢轴组件150的底部151b的延伸部153(图3B)。在示出的实施例中,例如,一对铆钉155a,155b构造为延伸通过在弹性构件152的近侧联接端156a处设置的孔157a,157b和在延伸部153中限定的相应的孔158a,158b,以在工具组件107的近侧端处将弹性构件152紧固到枢轴组件150。可代替地,可以使用其它联接方法将弹性构件142紧固到钉仓112。在一些实施例中,弹性构件152可以被可操作地联接到钳夹构件108的内壁和/或钉仓112。
大体弓形的接触部156b设置在弹性构件152上并且从近侧联接端156a延伸出从而朝向滑动偏转器130(当滑动偏转器130处于缩回位置时)和/或闭锁台阶120a、120b偏置驱动构件“D”的工作端101。弓形的接触部156b构造为允许驱动构件“D”的工作端101运动经过接触部156b并且与滑动偏转器130和/或闭锁台阶120a、120b接触(图17至图21)。另外,弓形的接触部156b构造为许可在钉仓112已经被发射之后工作端101移动回到缩回构造。弓形的接触部156b构造为延伸进入刀具通道114a,114b(见图17至18)并且弓形的接触部156b包括弹簧常数,该弹簧常数能够使工作端101朝向滑动偏转器130偏置而不会施予将实质上改变工作端101的平移路径的过多的偏置力。
参照图11至图14,闭锁台阶120b邻近于刀具通道114b设置(图12和图14),并且闭锁台阶120b构造为接触工作端101的抵接表面118d(图21)。在闭锁台阶120b的制造过程期间,闭锁台阶120b可以形成在钳夹构件108中。在闭锁台阶120b和驱动构件“D”的工作端101的抵接表面118d之间的接触防止了驱动构件“D”的再次推进,下文中将对此详细的讨论。
图15至16示出了砧座111联接到其上的钳夹构件110。砧座111包括多个斗状部或凹陷107(例如,见图3A),斗状部或凹陷107构造为当紧固件117a从钉仓112展开时,在其中接纳相应的紧固件117a。闭锁台阶120a设置在砧座111的近侧端邻近于刀具通道114a并且以与闭锁台阶120b相似的方式起作用。特别地,闭锁台阶120a构造为接触工作端101的抵接表面118c以防止驱动构件“D”的再次推进。闭锁台阶120a被限定在砧座111中并且被钳夹构件110覆盖(图15)。闭锁台阶120a可以与闭锁台阶120b对准。可代替地,闭锁台阶120a和闭锁台阶120b可以偏移或以其它方式构造为适应多种手术操作和/或需求。
虽然包括各自闭锁台阶120b,120a的钉仓112和砧座111都已经被在此描述,但是砧座111或钉仓112中仅一个包括闭锁台阶也在目前的公开范围之中。然而,可以被了解的是,具有两个闭锁台阶120a、120b提供更多的保护以防止在钉仓112发射之后驱动构件“D”的再次推进。为此目的,假设在抵接表面118c接触闭锁台阶120a的几乎同一时间抵接表面118d接触闭锁台阶120b。
在使用中,当钉仓组件112没有安装在钳夹构件108上时,弹性构件152的刀具接触部156b延伸进入刀具通道114a、114b(图17)。当刀具接触部156b处于此构造的情况下,随着在钉仓112中向远侧推进驱动构件“D”,在刀具接触部156b和驱动构件“D”的工作端101之间的接合将抵接表面118c、118d偏置到各自的闭锁台阶120a、120b,以防止驱动构件“D”的进一步推进。
当钉仓112安装在钳夹构件108上时,滑动偏转器130的近侧端131a被定位为近侧地经过闭锁台阶120a、120b(图18)。在此位置,滑动偏转器130防止工作端101的抵接表面118c、118d接合各自的闭锁台阶120a、120b。其结果是,包括工作端101的驱动构件“D”被允许向远侧地平移经过滑动偏转器130(图19)并且以如上文所述的方式接合致动滑块115。
直到工作端101返回缩回构造,然后驱动构件“D”可以向近侧地运动经过滑动偏转器130和弹性构件152。在驱动构件“D”的工作端101处于缩回位置并且滑动偏转器130处于推进位置的情况下,滑动偏转器130不再定位成通过弹性构件152防止工作端101偏转到台阶120a、120b。一旦工作端101返回到缩回构造,弹性构件152的刀具接触部156b朝向台阶120a、120b偏转驱动构件“D”的工作端101以如上文所述的方式防止驱动构件“D”的进一步推进(图20至图21)。
包括滑动偏转器130和弹性构件152的锁定机构的独特构造克服了前述的通常地与常规的手术吻合装置关联的缺陷。特别地,当吻合钉钉仓不存在于所述工具组件107中或已经被发射时,包括弹性构件152的滑动偏转器130防止了驱动构件“D”的无意的推进。
从前述中并且参照多种附图,本领域的技术人员将会了解,本公开可以进行一些修改而不偏移本公开的范围。例如,如在此描述的手术吻合装置100、200包括弹性构件152,弹性构件152构造为朝向闭锁台阶120a、120b偏置工作端101,可以利用其它方法和/或设备以朝向闭锁台阶120a、120b偏置工作端101。
例如,参照图22至图23,示出了锁定机构的可替换的实施例。该实施例与前述的利用工作端101的实施例大致相似。因此,在此只描述在图22至图23中示出的独特的实施例的特征。
与构造为经由弹性构件152朝向闭锁台阶120a、120b偏置的工作端101不同,驱动梁203的远侧端203a朝向闭锁台阶120a、120b自偏置。特别地,远侧端203a在朝向闭锁台阶120a、120b的方向上预先弯曲。远侧端203a可以被弯曲以提供任意合适的弹簧常数,例如,与由弹性构件152提供的弹簧常数近似相等的弹簧常数。
在使用中,当钉仓组件112没有安装在钳夹构件108上时,驱动梁203的预先弯曲的远侧端203a偏置工作端201使其与前述的闭锁台阶120a、120b接合。因此,防止驱动构件“D”的工作端201向远侧推进。
当钉仓112安装在钳夹构件108上时,滑动偏转器130的近侧端131a被定位在闭锁台阶120a、120b的近侧。因此,滑动偏转器130使工作端201的抵接表面偏转而不接合各自的闭锁台阶120a、120b。其结果是,包括工作端201的驱动构件被允许向远侧平移经过滑动偏转器130并且如上文所述的方式接合致动滑块115。
然后,直到工作端201回到缩回构造,驱动构件可以向近侧地移动。一旦工作端201运动回到缩回构造并且滑动偏转器130处于其远侧位置(不再被定位以偏转工作端201经过闭锁台阶120a、120b),远侧端203a的预先弯曲构造如上文所述的方式闭锁驱动构件。
图中显示了手术吻合的可替换的装载单元和能够附接到手术吻合装置的轴(诸如轴109)。可以想到其它构造。例如,可替换的装载单元自身可以具有可移除的以及可替换的钉仓组件。可代替地,器械的钳夹能够被永久地附接并且构造为接纳可移除的以及可替换的钉仓。
进一步,在实施例中可以证明不利用外侧部134b和相应的凹进部138是有利的。在本实施例中,前述的上文与将滑动偏转器130和致动滑块125联接结合所述的凹进部/凸起部构造可以构造为在工作端101接触致动滑块125之后保持滑动偏转器130和致动滑块125的接合。可以被了解的是,可以需要对钉仓112、致动滑块115、滑动偏转器130和/或工作端101进行一些其他修改,使得锁定机构以与其一致的方式起作用。
虽然已经在图中显示了本公开的多个实施例,但是其并非旨在将本公开限制于此,而是旨在使本公开的范围如本领域所允许的那样宽泛并且旨在同样地解读说明书。因此,上文的说明不应该解释为限制,而是仅仅作为特别的实施例的范例。本领域的技术人员将预想到在本公开的范围和本文附加的权利要求的精神内的其他改进。

Claims (17)

1.一种手术吻合装置,包括:
壳体;
细长构件,其从所述壳体延伸出;
再装载器,其支撑在所述细长构件的远侧端上,所述再装载器包括:第一钳夹构件,其可释放地支撑钉仓;以及第二钳夹构件,其支撑砧座,所述钉仓包括滑动偏转器,所述滑动偏转器能够从第一位置运动到第二位置;
至少一个闭锁台阶,其设置在所述第一钳夹构件和所述第二钳夹构件中的一个上;
驱动构件,其包括工作端,所述驱动构件构造为当所述第一钳夹构件和所述第二钳夹构件处于闭合构造时平移通过所述再装载器,所述工作端被驱使朝向至少一个所述闭锁台阶运动;并且
其中,在所述第一位置,所述滑动偏转器的近侧端被定位在所述至少一个闭锁台阶的近侧以防止所述驱动构件的所述工作端与所述至少一个闭锁台阶的接合,并且,在所述第二位置,所述滑动偏转器被定位以允许所述驱动构件的所述工作端与所述至少一个闭锁台阶的接合,从而防止所述工作端的进一步推进,
其中,所述工作端的向远侧平移使得所述滑动偏转器从所述第一位置运动到所述第二位置。
2.根据权利要求1所述的手术吻合装置,其中所述驱动构件包括梁,所述梁包括远侧端,所述远侧端具有将所述工作端朝向所述至少一个闭锁台阶偏置的预先弯曲构造。
3.根据权利要求1所述的手术吻合装置,其中至少一个弹性构件联接到所述手术吻合装置的枢转构件。
4.根据权利要求3所述的手术吻合装置,其中所述至少一个弹性构件包括大体弓形的接触部,所述大体弓形的接触部允许所述工作端滑动经过并且与所述滑动偏转器和所述至少一个闭锁台阶中的一个相接触。
5.根据权利要求1所述的手术吻合装置,其中所述至少一个闭锁台阶设置在所述砧座和所述第一钳夹构件中的每个上。
6.根据权利要求2所述的手术吻合装置,其中所述滑动偏转器可移除地联接到所述钉仓的致动滑块。
7.根据权利要求1所述的手术吻合装置,其中所述滑动偏转器在其上包括至少一个凸起部,所述凸起部构造为接合在所述工作端上的相应凹进部和布置在所述钉仓内的相应凹进部。
8.根据权利要求1所述的手术吻合装置,其中所述滑动偏转器包括机械接口,所述机械接口构造为接合布置在所述钉仓内的相应的机械接口。
9.根据权利要求8所述的手术吻合装置,其中布置在所述滑动偏转器上的所述机械接口和布置在所述钉仓内的所述机械接口形成燕尾形接合部。
10.一种手术吻合装置,包括:
壳体;
细长构件,其从所述壳体延伸出;
再装载器,其支撑在所述细长构件的远侧端上,所述再装载器包括:第一钳夹构件,其可释放地支撑钉仓;以及第二钳夹构件,其支撑砧座,所述钉仓包括滑动偏转器,所述滑动偏转器能够从第一位置运动到第二位置;
至少一个闭锁台阶,其设置在所述第一钳夹构件和所述第二钳夹构件中的一个上;以及
驱动构件,其包括工作端,所述驱动构件构造为当所述第一钳夹构件和所述第二钳夹构件处于闭合构造时平移通过所述再装载器,所述工作端被驱使朝向所述至少一个闭锁台阶运动;以及
至少一个弹性构件,其被定为成将所述工作端朝向所述至少一个闭锁台阶偏置;并且
其中,在所述第一位置,所述滑动偏转器的近侧端被定位在所述至少一个闭锁台阶的近侧以防止所述驱动构件的所述工作端与所述至少一个闭锁台阶的接合;并且,在所述第二位置,所述滑动偏转器被定位以允许所述驱动构件的所述工作端与所述至少一个闭锁台阶的接合,从而防止所述工作端的进一步推进,
其中,所述工作端的向远侧平移使得所述滑动偏转器从所述第一位置运动到所述第二位置。
11.根据权利要求10所述的手术吻合装置,其中所述至少一个闭锁台阶设置在所述砧座和钉仓中的每个上。
12.根据权利要求10所述的手术吻合装置,其中所述至少一个弹性构件包括大体弓形的接触部,所述大体弓形的接触部允许刀具滑动经过并且与所述滑动偏转器和所述至少一个闭锁台阶中的一个相接触。
13.根据权利要求10所述的手术吻合装置,其中所述滑动偏转器可移除地联接到所述钉仓的致动滑块。
14.根据权利要求10所述的手术吻合装置,其中所述滑动偏转器在其上包括至少一个凸起部,所述凸起部构造为接合在所述工作端上的相应凹进部和布置在所述钉仓内的相应凹进部。
15.根据权利要求10所述的手术吻合装置,其中所述滑动偏转器包括机械接口,所述机械接口构造为接合布置在所述钉仓内的相应的机械接口。
16.根据权利要求15所述的手术吻合装置,其中布置在所述滑动偏转器上的所述机械接口和布置在所述钉仓内的所述机械接口形成燕尾形接合部。
17.一种再装载器,其构造为联接到手术吻合装置,所述再装载器包括:
钉仓,其支撑在所述再装载器的第一钳夹构件上,所述钉仓包括滑动偏转器,所述滑动偏转器能够从第一位置运动到第二位置;
砧座,其支撑在所述再装载器的第二钳夹构件上;
至少一个闭锁台阶,其设置在所述第一钳夹构件和所述第二钳夹构件中的一个上;
驱动构件,其包括工作端,所述驱动构件构造为当所述第一钳夹构件和所述第二钳夹构件处于闭合构造时平移通过所述再装载器,所述工作端被驱使朝向所述至少一个闭锁台阶运动;并且
其中,在所述第一位置,所述滑动偏转器的近侧端被定位在所述至少一个闭锁台阶的近侧以防止所述驱动构件的所述工作端与所述至少一个闭锁台阶的接合,并且,在所述第二位置,所述滑动偏转器被定位以允许所述驱动构件的所述工作端与所述至少一个闭锁台阶的接合,从而防止所述工作端的进一步推进,
其中,所述工作端的向远侧平移使得所述滑动偏转器从所述第一位置运动到所述第二位置。
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