CN104042285B - 外科器械的多功能马达 - Google Patents
外科器械的多功能马达 Download PDFInfo
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- CN104042285B CN104042285B CN201410097776.XA CN201410097776A CN104042285B CN 104042285 B CN104042285 B CN 104042285B CN 201410097776 A CN201410097776 A CN 201410097776A CN 104042285 B CN104042285 B CN 104042285B
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Abstract
一种多功能马达。所述多功能马达可以在不同操作状态下操作以执行不同的功能。例如,所述马达可以在第一操作状态期间推进击发元件,在第二操作状态期间回缩击发元件,并在第三操作状态期间产生放大的触觉反馈。所述电动马达可以在第一方向旋转以推进击发元件,可以在第二方向旋转以回缩击发元件,并可以在第一方向和第二方向之间振荡以产生放大的触觉反馈。共振器可以固定至所述马达。所述共振器的质心可以是关于所述共振器的轴线平衡的。此外,所述共振器可以包含自然频率,并且可以在所述第三操作状态期间在含有所述自然频率的放大频率的范围内振荡。
Description
背景技术
本发明涉及外科器械,并且在各种实施例中涉及外科切割和缝合器械以及为此被设计用于切割和缝合组织的钉仓。
附图说明
当参考以下具体实施方式并结合附图时,本发明的特征和优点以及获得它们的方式将变得更加显而易见,并且本发明自身也更易于理解,其中:
图1为包括柄部、轴和可关节运动的端部执行器的外科器械的透视图;
图2为图1的外科器械的正视图;
图3为图1的外科器械的平面图;
图4为图1的外科器械的端部执行器和轴的剖视图;
图5为可旋转地连接图1的轴和端部执行器的关节运动接头的详细视图,其示出了处于中间或居中位置的端部执行器;
图6为图1的外科器械的关节运动控制器处于中间或居中位置的剖视图;
图7为图1的外科器械的端部执行器、细长轴和关节运动接头的分解图;
图8为图1的外科器械的端部执行器、细长轴和关节运动接头的剖视图;
图9为图1的外科器械的端部执行器、细长轴和关节运动接头的透视图;
图10示出了围绕关节运动接头关节运动的图1的外科器械的端部执行器;
图11为被致动以移动如图12中所示的端部执行器的图6的关节运动控制器的剖视图;
图12为包括柄部、轴和可关节运动的端部执行器的外科器械的透视图;
图13为图12的外科器械的侧视图;
图14为定位在图12的柄部内的击发构件和小齿轮的透视图;
图15为图14的击发构件和小齿轮以及可操作地与小齿轮接合的齿轮减速器组件的透视图;
图16为图12的柄部的透视图,其部分已移除以示出图14的击发构件和小齿轮、图15的齿轮减速器组件以及电动马达,其能够根据电动马达转动的方向而向远侧和/或近侧驱动击发构件;
图17为包括柄部、轴、端部执行器以及将端部执行器连接到轴的关节运动接头的外科器械的透视图,为了便于图示以柄部的部分被移除示出;
图18为图17的外科器械的剖视图;
图19为图17的外科器械的分解图;
图20为图17的外科器械的剖视详细视图,其示出为端部执行器处于开式构造,关节运动接头处于解锁构造,并且外科器械柄部的关节运动锁致动器以解锁构造示出;
图21为图17的外科器械的剖视详细视图,其示出了处于关节运动的开式构造的端部执行器、处于解锁构造的关节运动接头以及与图17的外科器械的击发构件接合的关节运动驱动器,其中击发构件的运动可促动关节运动驱动器并使端部执行器关节运动;
图22为图17的外科器械的剖视详细视图,其示出了处于闭式构造的端部执行器、处于解锁构造的关节运动接头以及被致动以关闭端部执行器并将关节锁定致动器移至锁定构造的端部执行器关闭驱动装置;
图22A为图17的外科器械的柄部的剖视详细视图,其以参照图22所述的构造示出;
图23为图17的外科器械的剖视详细视图,其示出了处于闭式构造的端部执行器、处于锁定构造的关节运动接头,其中致动的关闭驱动装置防止关节运动锁定致动器被移至图20-22中所示的其解锁构造;
图24A为以锁定构造示出的图17的外科器械的关节运动接头的平面图;
图24B为以解锁构造示出的图17的外科器械的关节运动接头的平面图;
图25为图17的外科器械的柄部的剖视详细视图,其示出了通过闭合驱动装置从击发构件断开的关节运动驱动器;
图26为图17的外科器械的剖视详细视图,其示出了处于至少部分击发位置的击发构件和通过闭合驱动装置从击发构件断开的关节运动驱动器;
图27为图17的外科器械的剖视详细视图,其示出了处于闭式构造的端部执行器、处于锁定构造的关节运动接头和关节运动接头致动器以及处于回缩位置的击发构件;
图28为图17的外科器械的剖视详细视图,其示出了处于开式构造的端部执行器、处于回缩位置的端部执行器关闭驱动装置以及处于锁定构造的关节运动接头;
图29为图17的外科器械的剖视详细视图,其示出了处于开式构造的端部执行器和处于解锁构造的关节运动接头和关节运动接头致动器,其中可将所述关节运动驱动器再次连接到击发驱动装置并用于使端部执行器再次关节运动;
图30为包括替代的关节运动锁结构的外科器械的轴和端部执行器的分解图;
图31为图30的外科器械的端部执行器和轴的剖视正视图,其示出了处于解锁构造的端部执行器;
图32为图30的外科器械的端部执行器和轴的剖视正视图,其示出了处于锁定构造的端部执行器;
图33为包括外科器械和多个可互换轴组件的外科系统的一种形式的装配视图;
图34为联接到可互换轴组件的外科器械柄部的透视图;
图35为图34的外科器械柄部的分解透视图;
图36为图35的柄部的侧正视图,其中柄部外壳的一部分已移除;
图37为可互换轴组件的分解透视图;
图38为图34的柄部和可互换轴组件的一部分的侧正视装配视图,其示出了那些部件在被联接到一起之前的对齐,并且为了清楚起见其部分被省去;
图39为可互换轴组件在附接至外科器械的柄部之前的一部分的透视图;
图40为联接到柄部的可互换轴组件的一部分的侧视图,其中锁轭处于与柄部的框架附接模块的一部分的锁定或接合位置;
图41为图40的可互换轴组件和柄部的另一个侧视图,其中锁轭处于脱离或解锁位置;
图42为可互换轴组件和柄部的一部分在被联接到一起之前的俯视图;
图43为图42的可互换轴组件和柄部联接到一起的另一个俯视图;
图44为可互换轴组件与外科器械柄部在被联接到一起之前对齐的侧正视图;
图45为图44的可互换轴组件和外科器械柄部的前透视图,为了清楚起见其部分被移除;
图46为可互换轴组件的一部分与外科器械柄部的一部分在被联接到一起之前对齐的侧视图,并且为了清楚起见其部分被省去;
图47为图46的可互换轴组件和柄部的另一个侧正视图,其中轴组件部分联接地接合柄部;
图48为图46和47的可互换轴组件和柄部在被联接到一起之后的另一个侧正视图;
图49为可互换轴组件的一部分与柄部的一部分在开始联接过程之前对齐的另一个侧正视图;
图50另一个可互换轴组件的一部分和另一个外科器械框架结构的一部分的俯视图;
图51为图50的可互换轴组件和框架部分在被联接到一起之后的另一个俯视图;
图52为图50的可互换轴组件和框架部分的分解透视图;
图53为图52的可互换轴组件和框架部分的另一个分解透视图,其中轴组件的轴附接模块与框架部分的框架附接模块在联接之前对齐;
图54为图52的可互换轴组件和框架部分的侧正视图;
图55为图53和54的可互换轴组件和框架部分在被联接到一起之后的透视图;
图56为图55的可互换轴组件和框架部分的侧正视图;
图57为图55和56的可互换轴组件和框架部分的另一个透视图,为了清楚起见其部分被省去;
图58为外科器械的另一个可互换轴组件的一部分和框架部分在被联接到一起之前的俯视图;
图59为图58的可互换轴组件和框架部分在被联接到一起之后的另一个俯视图;
图60为图58和59的可互换轴组件和框架在被联接到一起之前的透视图;
图61为图58-60的可互换轴组件和框架部分在被联接到一起之后的另一个透视图;
图62为图58-60的可互换轴组件和框架部分在被联接到一起之后的另一个透视图,其中轴组件的部分以横截面示出;
图63为外科器械的另一个端部执行器轴组件和框架部分的分解透视装配视图;
图64为图63的端部执行器轴组件和框架部分的顶部分解装配视图;
图65为图63和64的端部执行器轴组件和框架部分的另一个分解透视装配视图;
图66为图63-65的端部执行器轴组件和框架部分在被联接到一起之后的透视图;
图67为图66的端部执行器轴组件和框架部分的侧正视图,为了清楚起见其部分被省去;
图68为另一个外科器械的另一个端部执行器轴组件和框架部分的顶部分解装配视图;
图69为图68的端部执行器轴组件和框架部分的透视分解装配视图;
图70为图68和69的端部执行器轴组件和框架部分的另一个透视装配视图,其中端部执行器轴组件在被锁闭之前与框架部分联接地接合;
图71为图70的端部执行器轴组件和框架部分的俯视图;
图72为图68-71的端部执行器轴组件和框架部分在被联接到一起之后的俯视图;
图73为图72的端部执行器轴组件和框架部分的侧正视图;
图74为图72和73的端部执行器轴组件和框架部分的透视图;
图75为可互换轴组件和对应柄部的分解装配视图,其一些部件以横截面示出;
图76为图75的端部执行器轴组件和柄部的部分的局部剖视透视图;
图77为图75和76的端部执行器轴组件和柄部联接在一起的局部透视图,为了清楚起见多个部件被省去;
图78为图77的端部执行器轴组件和柄部的侧正视图;
图79为图75-78的端部执行器轴组件和柄部联接在一起的侧正视图,其中闭合驱动装置处于未致动位置并且其中一些部件以横截面示出;
图80为图79的端部执行器轴组件和柄部的另一个侧正视图,其中闭合驱动装置处于完全致动位置;
图81为可互换轴组件和对应柄部的分解装配视图,为了清楚起见一些部件被省去,并且其中闭合驱动系统处于锁定取向;
图82为图81的端部执行器轴组件和柄部联接在一起的侧视图,为了清楚起见多个部件被省去,并且其中闭合驱动系统处于解锁和未致动位置;
图83为图82的端部执行器轴组件和柄部的侧视图,为了清楚起见多个部件以横截面示出;
图84为图81-83的端部执行器轴组件和柄部联接在一起的侧视图,为了清楚起见多个部件被省去,并且其中闭合驱动系统处于致动位置;
图85为图84的端部执行器轴组件和柄部的侧视图,为了清楚起见多个部件以横截面示出;
图86为可互换轴组件的一部分和外科器械的柄部的一部分的分解透视装配视图;
图87为图86的可互换轴组件的部分和柄部的侧正视图;
图88为图86和87的可互换轴组件和柄部的另一个分解透视装配视图,为了清楚起见可互换轴组件的部分以横截面示出;
图89为图86-88的可互换轴组件的部分和柄部的另一个侧正视图,为了清楚起见其部分以横截面示出;
图90为图86-89的可互换轴组件的部分和柄部在可互换轴组件可操作地联接到柄部之后的侧正视图,并且为了清楚起见其部分以横截面示出;
图91为可互换轴组件的部分和联接到其的柄部的另一个侧正视图,其中闭合驱动系统处于完全致动位置;
图92为另一个可互换轴组件的一部分和另一个外科器械的柄部的一部分的分解透视装配视图;
图93为图92的可互换轴组件的部分和柄部在被联接到一起之前对齐的侧正视图;
图94为图92和93的可互换轴组件和柄部的另一个分解透视图,其中其一些部分以横截面示出;
图95为图92-94的可互换轴组件和柄部以可操作的接合方式联接到一起的另一个透视图;
图96为图95的可互换轴组件和柄部的侧正视图;
图97为图96的可互换轴组件和柄部的另一个侧正视图,其中其一些部件以横截面示出;
图98为图92-96的可互换轴组件和柄部的另一个侧正视图,其中闭合触发器处于完全致动位置;
图99为包括轴锁定组件结构的另一个可互换轴组件的一部分的透视图;
图100为图99中示出的轴锁定组件结构的透视图,其处于与可互换轴组件的击发构件的中间击发轴部分的锁定位置;
图101为轴锁定组件和中间击发构件部分的另一个透视图,其中轴锁定组件处于解锁位置;
图102为示意图,其示出了,其一,用于可操作地将外科器械的关节运动驱动装置连接到击发驱动装置的离合器组件,以及其二,能够以可脱开的方式将外科器械的关节运动驱动装置和端部执行器的关节运动锁保持在适当位置,其中图102示出了处于接合位置的离合器组件和处于锁定状况的关节运动锁;
图103为示意图,其示出了处于其接合位置的图102的离合器组件和处于第一解锁状况的图102的关节运动锁,所述关节运动锁允许图102的端部执行器在第一方向进行关节运动;
图104为示意图,其示出了处于其接合位置的图102的离合器组件和处于第二解锁状况的图102的关节运动锁,所述关节运动锁允许图102的端部执行器在第二方向进行关节运动;
图104A为图102的离合器组件和关节运动锁的分解图;
图105为包括处于其接合位置的图102的离合器组件的轴组件的局部透视图,为了便于图示轴组件的部分已移除;
图106为图105的轴组件的局部俯视平面图,其示出了处于其接合位置的图102的离合器组件;
图107为图105的轴组件的局部仰视平面图,其示出了处于其接合位置的图102的离合器组件;
图108为图105的轴组件的局部透视图,其示出了处于其接合位置的图102的离合器组件,为了便于图示另外的部分已移除;
图109为图105的轴组件的局部透视图,其示出了处于脱离位置的图102的离合器组件,为了便于图示另外的部分已移除;
图110为图105的轴组件的局部透视图,其示出了通过轴组件的闭合驱动装置移至脱离位置的图102的离合器组件;
图111为图105的轴组件的局部平面图,其示出了处于其接合位置的图102的离合器组件,为了便于图示另外的部分已移除;
图112为图105的轴组件的局部平面图,其示出了处于脱离位置的图102的离合器组件,为了便于图示另外的部分已移除;
图113为以锁定状况示出的关节运动锁的可供选择的实施例的平面图;
图114为图113的关节运动锁的分解图;
图115为以锁定状况示出的关节运动锁的另一个可供选择的实施例的剖视图;
图116为图114的关节运动锁的分解图;
图117为以锁定状况示出的关节运动锁的另一个可供选择的实施例的透视图;
图118为图117的关节运动锁的分解图;
图119为图117的关节运动锁的正视图,其示出了以锁定状况示出的关节运动锁;
图120为图117的关节运动锁的正视图,其示出了处于第一解锁状况以使端部执行器沿第一方向进行关节运动的关节运动锁;
图121为图117的关节运动锁的正视图,其示出了处于第二解锁状况以使端部执行器沿第二方向进行关节运动的关节运动锁;
图122为图117的关节运动锁的另一个分解图;
图123为图117的关节运动锁的第一锁凸轮的透视图;
图124为图117的关节运动锁的第二锁凸轮的透视图;
图125为以锁定状况示出的关节运动锁的另一个可供选择的实施例的透视图;
图126为图125的关节运动锁的分解图;
图127为图125的关节运动锁的剖视正视图,其示出了处于第一解锁状况以用于使端部执行器沿第一方向进行关节运动的关节运动锁;
图128为图125的关节运动锁的剖视正视图,其示出了处于锁定状况的关节运动锁;
图129为图125的关节运动锁的剖视正视图,其示出了处于第二解锁状况以用于使端部执行器沿第二方向进行关节运动的关节运动锁;
图130为图125的关节运动锁的剖视正视图,其示出了处于锁定状况的关节运动锁;
图131为轴组件的透视图;
图132为图131的轴组件的分解图,其示出了用于可操作地连接轴组件的关节运动驱动装置与击发驱动装置的离合器组件的可供选择的实施例;
图133为图131的轴组件的另一个分解图;
图134为图131的轴组件的局部分解图,为了便于图示以部分被移除示出;
图135为图131的轴组件的端视图,为了便于图示以部分被移除示出;
图136为图131的轴组件的另一个端视图,为了便于图示以部分被移除示出;
图137为图131的轴组件的局部剖视正视图;
图138为图131的轴组件的局部剖视透视图;
图139为图131的轴组件的另一个局部剖视图;
图140为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器,而离合器套管、切换筒、近侧关节运动驱动器和闭合管未示出;
图141为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器和离合器套管,而切换筒、近侧关节运动驱动器和闭合管未示出;
图142为图131的轴组件的透视图,其示出了处于脱离位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器和离合器套管,而切换筒、近侧关节运动驱动器和闭合管未示出;
图143为图131的轴组件的透视图,其示出了处于脱离位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器、离合器套管和闭合管,而切换筒和近侧关节运动驱动器未示出;
图144为图131的轴组件的透视图,其示出了处于脱离位置的离合器组件;示出了离合器致动器、离合器套管、闭合管、切换筒和近侧关节运动驱动器;
图145为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器、离合器套管和近侧关节运动驱动器,而切换筒和闭合管未示出;
图146为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器、离合器套管、近侧关节运动驱动器和闭合管,而切换筒未示出;此外,轴组件的关节运动驱动系统以居中或未进行关节运动的状况示出;
图147为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器、离合器套管和近侧关节运动驱动器,而切换筒和闭合管未示出;此外,轴组件的关节运动驱动系统以其中轴组件的端部执行器将关节运动到轴组件的纵向轴线左侧的状况示出;
图148为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器、离合器套管和近侧关节运动驱动器,而切换筒和闭合管未示出;此外,轴组件的关节运动驱动系统以其中轴组件的端部执行器将关节运动到轴组件的纵向轴线右侧的状况示出;
图149为图131的轴组件的透视图,其示出了处于接合位置的离合器组件,并且为了清楚起见以部分被移除示出;具体地讲,示出了离合器致动器、离合器套管、闭合管和近侧关节运动驱动器,而切换筒未示出;
图150为根据本文所述某些实施例的外科器械的透视图;
图151为根据本文所述某些实施例的外科器械的控制系统的示意性框图;
图152为根据本文所述某些实施例的外科器械的界面的透视图;
图153为图152的界面的俯视图;
图154为根据本文所述某些实施例的图152的界面处于未启动或空档构造的剖视图;
图155为根据本文所述某些实施例的图152的界面被启动以使端部执行器进行关节运动的剖视图;
图156为根据本文所述某些实施例的图152的界面被启动以使端部执行器返回到关节运动本位状态位置的剖视图;
图157为根据本文所述某些实施例的类似于图152的界面的界面处于未启动或空档构造的剖视图;
图158为根据本文所述某些实施例的图152的界面被启动以使端部执行器进行关节运动的剖视图;
图159为根据本文所述某些实施例的图152的界面被启动以使端部执行器返回到关节运动本位状态位置的剖视图;
图160为概述根据本文所述某些实施例的图150的外科器械的控制器对复位输入信号的响应的示意性框图;
图161为概述根据本文所述某些实施例的图150的外科器械的控制器对本位状态输入信号的响应的示意性框图;
图162为概述根据本文所述某些实施例的图150的外科器械的控制器对本位状态输入信号的响应的示意性框图;
图163为概述根据本文所述某些实施例的图150的外科器械的控制器对击发本位状态输入信号的响应的示意性框图;
图164为根据本文所述各种实施例的包括与轴分离的柄部的外科器械的侧正视图;
图165为根据本文所述各种实施例的包括联锁开关的柄部部分和包括锁定构件的轴部分的侧正视图;
图166为图150中外科器械的局部剖视图,其示出了根据本文所述各种实施例的处于锁定构造的锁定构件和开式开关;
图167为图150中外科器械的局部剖视图,其示出了根据本文所述各种实施例的处于解锁构造的锁定构件和被锁定构件按压的闭式开关;
图167A为图150中外科器械的局部剖视图,其示出了根据本文所述各种实施例的推进的击发驱动装置;
图167B为图150中外科器械的局部剖视图,其示出了根据本文所述各种实施例的处于回缩或默认位置的击发驱动装置;
图168为概述根据本文所述某些实施例的图150的外科器械的控制器对输入信号的响应的示意性框图;
图169为概述根据本文所述某些实施例的图150的外科器械的控制器对输入信号的响应的示意性框图;
图170为根据本公开各种实施例的电动马达和共振器的仰视图;
图171为图170的共振器的透视图;
图172为图170的共振器的仰视图;
图173为外科器械的柄部的局部透视图,其示出了根据本公开各种实施例的图170的电动马达和定位在柄部内的共振器;
图174为图173的电动马达和共振器的仰视图;
图175为图173的共振器的透视图;
图176为图173的共振器的仰视图;
图177为图173的柄部的局部透视图,其示出了根据本公开各种实施例的图170的电动马达和定位在柄部内的共振器;
图178为图177的电动马达和共振器的仰视图;
图179为图177的共振器的第一透视图;
图180为图177的共振器的第二透视图;
图181为图173的柄部的透视图,其示出了根据本公开各种实施例的图170的电动马达和定位在柄部内的共振器和保持环;
图182为在根据本公开各种实施例的外科手术期间外科器械的操作的流程图;
图183为根据一个实施例的图34的外科器械柄部的分解透视图,其示出了绝对定位系统的传感器结构的一部分;
图184为根据一个实施例的柄部外壳的一部分已移除的图34和183的柄部的侧正视图,其示出了绝对定位系统的传感器结构的一部分;
图185为根据一个实施例的包括微控制器控制的马达驱动电路结构的绝对定位系统的示意图,所述马达驱动电路结构包括传感器结构;
图186为根据一个实施例的绝对定位系统的传感器结构的详细透视图;
图187为根据一个实施例的绝对定位系统的传感器结构的分解透视图,其示出了控制电路板组件和传感器结构元件的相对对齐;
图188为根据一个实施例的绝对定位系统的传感器结构的侧透视图,其示出了控制电路板组件;
图189为根据一个实施例的绝对定位系统的传感器结构的侧透视图,其中控制电路板组件已移除以示出传感器元件夹持器组件;
图190为根据一个实施例的绝对定位系统的传感器结构的侧透视图,其中控制电路板和传感器元件夹持器组件已移除以示出传感器元件;
图191为根据一个实施例的绝对定位系统的传感器结构的俯视图,其以控制电路板被移除但电子部件仍然可见示出,以示出位置传感器和电路部件之间的相对位置;
图192为根据一个实施例的包括磁旋转绝对定位系统的绝对定位系统的位置传感器的一个实施例的示意图;
图193示出了根据一个实施例的处于竖直位置的关节运动接头,即相对于纵向成零度角;
图194示出了根据一个实施例的图193的关节运动接头,其以限定在纵向轴线L-A和关节运动轴线A-A之间的第一角度沿一个方向进行关节运动;
图195示出了根据一个实施例的图193的关节运动接头,其以限定在纵向轴线L-A和关节运动轴线A’-A之间的第二角度沿另一个方向进行关节运动;
图196示出了补偿柔性刀带的展开对横断长度的作用的方法的逻辑图的一个实施例;
图197为用于当轴组件未联接到外科器械柄部的电连接器时使电连接器断电的系统的示意图;
图198为示出了用于控制本文所公开的外科器械的马达的速度和/或可驱动构件的速度的系统的示意图;以及
图199为示出了用于控制本文所公开的外科器械的马达的速度和/或可驱动构件的速度的另一个系统的示意图。
贯穿多个视图,对应的参考符号指示对应的零件。本文示出的范例以一种形式示出了本发明的某些实施例,并且不应将此类范例理解为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有提交于2013年3月1日的以下专利申请,并且其中每一个各自全文以引用的方式并入本文:
-美国专利申请No.13/782,295,名称为ARTICULATABLE SURGICAL INSTRUMENTSWITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION;
-美国专利申请No.13/782,323,名称为ROTARY POWERED ARTICULATION JOINTSFOR SURGICAL INSTRUMENTS;
-美国专利申请No.13/782,338,名称为THUMBWHEEL SWITCH ARRANGEMENTS FORSURGICAL INSTRUMENTS;
-美国专利申请No.13/782,499,名称为ELECTROMECHANICAL SURGICAL DEVICEWITH SIGNAL RELAY ARRANGEMENT;
-美国专利申请No.13/782,460,名称为MULTIPLE PROCESSOR MOTOR CONTROL FORMODULAR SURGICAL INSTRUMENTS;
-美国专利申请No.13/782,358,名称为JOYSTICK SWITCH ASSEMBLIES FORSURGICAL INSTRUMENTS;
-美国专利申请No.13/782,481,名称为SENSOR STRAIGHTENED END EFFECTORDURING REMOVAL THROUGH TROCAR;
-美国专利申请No.13/782,518,名称为CONTROL METHODS FOR SURGICALINSTRUMENTS WITH REMOVABLE IMPLEMENT PORTIONS;
-美国专利申请No.13/782,375,名称为ROTARY POWERED SURGICAL INSTRUMENTSWITH MULTIPLE DEGREES OF FREEDOM;以及
-美国专利申请No.13/782,536,名称为SURGICAL INSTRUMENT SOFT STOP,全部申请均据此全文以引用方式并入。
本申请的申请人还拥有与上述申请同一天提交的以下专利申请,并且其中每一个各自全文以引用的方式并入本文:
-美国专利申请,名称为CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF ASURGICAL INSTRUMENT,代理人案卷号END7261USNP/130029;
-美国专利申请,名称为INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH ASURGICAL INSTRUMENT,代理人案卷号END7259USNP/130030;
-美国专利申请,名称为ARTICULATABLE SURGICAL INSTRUMENT COMPRISING ANARTICULATION LOCK,代理人案卷号END7260USNP/130031;
-美国专利申请,名称为SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONINGSYSTEM FOR SURGICAL INSTRUMENTS,代理人案卷号END7262USNP/130032;
-美国专利申请,名称为DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULARSURGICAL INSTRUMENTS,代理人案卷号END7254USNP/130034;
-美国专利申请,名称为ARTICULATION CONTROL SYSTEM FOR ARTICULATABLESURGICAL INSTRUMENTS,代理人案卷号END7258USNP/130035;
-美国专利申请,名称为DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULARSURGICAL INSTRUMENTS,代理人案卷号END7255USNP/130036;
-美国专利申请,名称为METHOD AND SYSTEM FOR OPERATING A SURGICALINSTRUMENT,代理人案卷号END7256USNP/130037;以及
-美国专利申请,名称为ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AFIRING DRIVE,代理人案卷号END7263USNP/130079。
现在将描述某些示例性实施例,以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途。附图中示出了这些实施例的一个或多个例子。本领域的普通技术人员将理解文中具体描述并用附图示出的装置和方法为非限制性示例性实施例,并且本发明的多个实施例的范围仅由权利要求书限定。结合一个实施例示出或描述的特征可与其他实施例的特征结合。这种修改形式和变型形式旨在包括在本发明的范围之内。
本说明书通篇引用的“各种实施例”、“一些实施例”、“一个实施例”或“实施例”等,是指结合所述实施例描述的具体特征、结构或特性包括在至少一个实施例中。因此,本说明书通篇出现的短语“在各种实施例中”、“在一些实施例中”、“在一个实施例中”或“在实施例中”等并不一定都指相同的实施例。此外,在一个或多个实施例中,具体特征、结构或特性可按任何合适的方式组合。因此,在无限制的情况下,结合一个实施例示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施例的特征、结构或特性结合。这种修改形式和变型形式旨在包括在本发明的范围之内。
本文所用术语“近侧”和“远侧”是相对于操纵外科器械柄部部分的临床医生而言的。术语“近侧”是指最靠近临床医生的部分,术语“远侧”则是指远离临床医生的部分。还应当理解,为简洁和清楚起见,空间术语诸如“竖直”、“水平”、“上”和“下”可在本文中结合附图使用。然而,外科器械在许多方向和位置中使用,并且这些术语并非限制性的和/或绝对的。
提供了各种示例性装置和方法以执行腹腔镜式和微创外科手术操作。然而,本领域中的普通技术人员将容易理解,本文所公开的各种方法及装置可用于许多外科手术操作及应用(包括例如与开放式外科手术操作相结合的应用)中。继续参阅本具体实施方式,本领域中的普通技术人员将进一步理解,本文所公开的各种器械可以任何方式插入体内,例如通过自然腔道、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可被直接插入患者体内或可通过具有工作通道的进入装置插入,外科器械的端部执行器及伸长轴可通过所述工作通道而推进。
图1-3示出了可包括柄部103、轴104和在关节运动接头110处可枢转地连接到轴104的关节运动端部执行器102的示例性外科器械100。提供关节运动控制器112以实现端部执行器102围绕关节运动接头110的旋转。端部执行器102示出为能够充当用于夹紧、切断和缝合组织的直线切割器,然而应当理解,各种实施例可包括能够充当其他外科装置的端部执行器,所述其他外科装置包括例如抓紧器、切割器、缝合器、施夹钳、进入装置、药物/基因治疗递送装置、超声、RF和/或激光能量装置等。器械100的柄部103可包括用于致动端部执行器102的闭合触发器114和击发触发器116。应当理解,具有涉及不同手术任务的端部执行器的器械可具有不同数量或类型的触发器或用于操作端部执行器的其他合适控制器。端部执行器102通过轴104连接至柄部103。临床医生可通过利用关节运动控制器112使端部执行器102相对于轴104进行关节运动,如下文更详细的描述。
应当理解,空间术语例如垂直、平行、右、左等在这里结合附图给出,假设外科器械100的纵向轴线与轴104的中心轴线共轴,并且触发器114、116以锐角从柄部103的底部向下延伸。然而在实际应用中,外科器械100可以成各种角度被定向,并且同样地,这些空间术语相对于外科器械100自身被使用。另外,近侧用于表示在柄部103后面并将端部执行器102向远侧或者远离他或她自身放置的医生的视角。如本文所用的短语“基本横向于纵向轴线”是指几乎垂直于纵向轴线的方向,其中“纵向轴线”是轴的轴线。然而,应当理解,与纵向轴线的垂直方向有一些偏差的方向也基本横向于纵向轴线。
本发明所公开的各个实施例是针对具有由弯曲缆线或带驱动的关节运动接头的器械。图4和5示出了伸长轴104和包括带205的端部执行器102的俯视剖视图,带205机械地联接到从端部执行器102延伸的凸台206上。带205可包括沿着伸长轴104从凸台206向近侧延伸并穿过关节运动控制器112的带部分202和204。带205和带部分202、204可具有固定的长度。可使用包括例如胶粘、焊接等的任何合适的紧固方法将带205机械地联接到凸台206上,如图所示。在各种实施例中,每个带部分202、204可作为单独的带提供,并且每个单独的带的一端机械地联接到凸台206,并且另一端延伸穿过轴104和关节运动控制器112。单独的带可如上所述机械地联接到凸台206。
除上述之外,带部分202、204可从凸台206穿过关节运动接头110并沿着轴104延伸至关节运动控制器112,如图6所示。关节运动控制器112可包括关节运动滑块208、框架212和壳体218。带部分202、204可通过狭槽210或其他孔穿过关节运动滑块208,但应当理解,带部分202、204可通过任何合适的方法联接到滑块208。关节运动滑块208可以是一件式的,如图6所示,或可包括两个件,两个件之间的界面限定狭槽210。在一个非限制性实施例中,关节运动滑块208可例如包括多个狭槽,每个狭槽均能够容纳带部分202、204中的一个。壳体218可覆盖关节运动控制器112的各种部件,以防止碎片进入关节运动控制器112。
再次参见图6,带部分202、204可分别在位于狭槽210近侧的连接点214、216处锚固到框架212。应当理解,带部分202、204可锚固在器械10中任何位于狭槽210近侧的地方,包括柄部103。图6的非限制性实施例示出了带部分202、204可包括在连接点214、216和位于轴104的纵向轴线附近的狭槽210之间的弯曲构造。预期其他的实施例中带部分202、204是直的。
图7-9示出了图5中示出的包括关节运动接头110的器械100的端部执行器102和伸长轴104的视图。图7示出了包括各种内部部件的端部执行器102和伸长轴104的分解图。在至少一个实施例中,端部执行器框架150和轴框架154能够在关节运动接头110处连接。凸台206与端部执行器框架150形成一体,并且带205与凸台206交接,如图所示。轴框架154可包括限定孔304的指向远侧的柄脚302。孔304可定位成与包括在端部执行器框架150中的关节运动销(未示出)交接,以允许端部执行器框架150相对于轴框架154枢转,并因此允许端部执行器102相对于轴104枢转。当组装好时,各个部件可围绕关节运动接头110在图9和10示出的关节运动轴线306处枢转。
图7还示出了砧座120。在该非限制性实施例中,砧座120联接到伸长通道198。例如,孔199可限制在伸长通道198中,孔199可容纳从砧座120延伸的销152并允许砧座120相对于伸长通道198和钉仓118从打开位置枢转至闭合位置。另外,图7示出了击发杆172,其能够纵向地平移穿过轴框架154,穿过柔性闭合装置和枢转框架的关节运动接头110,并穿过远侧框架150中的击发狭槽176进入端部执行器102。击发杆172可由一个实心部分构成,或在各种实施例中,可包括层压材料,该层压材料包括(例如)一叠钢板。应当理解,由层压材料制成的击发杆172可降低使端部执行器102关节运动所需的力。在各种实施例中,可将弹簧夹158安装在端部执行器框架150中以向下偏置击发杆172。在端部执行器框架150的顶部形成的远侧和近侧正方形孔164、168可限定在其间的夹杆170,夹杆170容纳弹簧夹158的上臂162,弹簧夹158的下部、朝远侧延伸的臂160对击发杆172的凸起部分174施加向下的力,如下所述。
击发杆172的远侧突出端可附接到E型横梁178,此外,当砧座120位于闭合位置时,E型横梁178可有助于将砧座120与定位在伸长通道198中的钉仓118间隔开。E型横梁178还可包括锋利刀刃182,当通过击发杆172向远侧推进E型横梁178时,刀刃182可用于切断组织。在操作中,E型横梁178还可以致动或击发钉仓118。钉仓118可包括模塑的仓体194,仓体194容纳多个钉191,钉191靠在钉驱动器192上,钉驱动器192在分别向上打开的钉腔195中。楔形滑动件190通过E型横梁178向远侧驱动,并在仓托盘196上滑动,仓托盘196使可替换的钉仓118的各种部件保持在一起。楔形滑动件190使钉驱动器192向上凸轮运动,以挤出钉191,使其变形并与砧座120接触,同时E型横梁178的切割表面182切断夹紧的组织。
除上述之外,E型横梁178可包括在击发过程中接合砧座120的上部销180。E型横梁178还可包括中间销184和底脚186,其可接合仓体194、仓托盘196和伸长通道198的各个部分。当钉仓118定位在伸长通道198内时,限定在仓体194中的狭槽193可与限定在仓托盘196中的狭槽197以及限定在伸长通道198中的狭槽189对齐。在使用中,E型横梁178可滑动穿过对齐的狭槽193、197和189,如图7所示,其中E型横梁178的底脚186可沿着狭槽189的长度接合沿着通道198的底面延伸的沟槽,中间销184沿着纵向狭槽197的长度接合仓托盘196的顶面,并且上部销180接合砧座120。在这种情况下,当击发杆172向远侧运动以击发来自钉仓118的钉和/或切割砧座120和钉仓118之间捕集的组织时,E型横梁178可分开或限制砧座120和钉仓118之间的相对运动。然后,击发杆172和E型横梁178可向近侧回缩,从而允许砧座120打开,释放两个缝合和切割的组织部分(未示出)。
图7-9还示出了根据各种实施例的双枢轴闭合套管组件121。具体参照图7,双枢轴闭合套管组件121包括轴闭合管部分128,轴闭合管部分128具有朝远侧突出的上部和下部柄脚146、148。端部执行器闭合管部分126包括用于结合砧座120上打开的插片122的马蹄形孔124和插片123。当砧座120打开时马蹄形孔124和插片123结合插片122。闭合管部分126显示具有朝近侧突出的上部柄脚144和下部柄脚(未示出)。上部双枢轴连接件130包括向上突出的远侧和近侧枢轴销134、136,远侧和近侧枢轴销134、136分别接合朝远侧突出的上部柄脚144中的远侧上部销孔138和朝远侧突出的上部柄脚146中的近侧上部销孔140。下部双枢轴连接件132包括向下突出的远侧和近侧枢轴销(图7中未示出,参见图8),远侧和近侧枢轴销分别接合朝近侧突出的下部柄脚中的远侧下部销孔和朝远侧突出的下部柄脚148中的近侧下部销孔142。
在使用中,闭合套管组件121向远侧平移,以例如响应于闭合触发器114的致动而闭合砧座120。通过向远侧平移闭合管部分126,并因此平移套管组件121,使套管组件121撞击在砧座120的在图9A中位于插片122的左侧的近侧表面上,从而闭合砧座120。如图8和9中更清楚地显示,通过向近侧平移管部分126,并因此平移套管组件121来打开砧座120,从而使插片123和马蹄形孔124接触并推挤插片122以抬起砧座120。在砧座的打开位置,双枢轴闭合套管组件121运动到其近侧位置。
在操作中,临床医生可通过横向推动控制器112使器械100的端部执行器102相对于轴104围绕枢轴110进行关节运动。从空档位置,临床医生可通过向控制器112的左侧提供横向力使端部执行器102相对于轴104关节运动到左侧。响应于力,关节运动滑块208可至少部分地推动至框架212中。当将滑块208推动至框架212中时,狭槽210和带部分204可沿着横向(例如基本上横向于或垂直于轴104的纵向轴线的方向)平移穿过伸长轴104。因此,力施加到带部分204上,使得带部分204弹性地弯曲和/或从其初始预弯曲位置朝着轴104的相对侧移动。同时,带部分202从其初始预弯曲位置松弛。带部分204的此类运动,加上带部分202的拉直,可在凸台206上施加逆时针的旋转力,这继而使凸台206和端部执行器102围绕关节运动枢轴110枢转到左侧,从而相对于轴104的轴线成所需的角度,如图12所示。带部分202的松弛减少了该带部分上的张力,允许带部分204使端部执行器102进行关节运动,而基本不会受到来自带部分202的干扰。应当理解,临床医生也可以通过对控制器112的右侧提供侧向力,从而使端部执行器102相对于轴104关节运动到右侧。这会使缆线部分202弯曲,从而使顺时针的力作用在凸台206上,这继而使凸台206和端部执行器围绕关节运动枢轴110枢转到右侧。与上文相似,带部分204可同时松弛以允许此类运动。
图12和13示出了马达驱动的外科切割和紧固器械310。该图示实施例示出了内窥镜式器械,并且,总的来说,这里所描述的器械310为内窥镜式外科切割和紧固器械;然而,应该指出的是,本发明并不限于此,而且根据发明的其他实施例,本文所公开的任何器械均可包括非内窥镜式外科切割和紧固器械。图12和13示出的外科器械310包括柄部306、轴308和连接至轴308的端部执行器312。在各种实施例中,端部执行器312可相对于轴308围绕关节运动接头314进行关节运动。用于使端部执行器312进行关节运动的各种装置和/或用于允许端部执行器312相对于轴308进行关节运动的各种装置在公布于2010年7月13日、名称为SURGICAL STAPLING INSTRUMENTS的美国专利No.7,753,245,以及公布于2010年3月2日、名称为SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR的美国专利No.7,670,334中有所公开,所述专利的公开内容全文以引用的方式并入本文。用于使端部执行器312进行关节运动的各种其他装置在下文中进行更详细的描述。与上文相似,端部执行器312能够充当用于夹紧、切断和/或缝合组织的直线切割器,但在其他实施例中,可以使用不同类型的端部执行器,例如用于抓紧器、切割器、缝合器、施夹钳、进入装置、药物/基因治疗装置、超声、RF和/或激光装置等其他类型外科装置的端部执行器。若干RF装置可在公布于1995年4月4日、名称为ELECTROSURGICAL HEMOSTATIC DEVICE的美国专利No.5,403,312,以及提交于2008年2月14日、名称为SURGICAL CUTTING AND FASTENING INSTRUMENT HAVINGRF ELECTRODES的美国专利申请序列号12/031,573中找到,所述专利申请的公开内容全文均以全文引用的方式并入。
应当理解,术语“近侧”和“远侧”在这里是参照握持器械310的柄部306的临床医生使用的。因此,端部执行器312相对于更近侧的柄部306是处于远侧的。可以进一步理解,为简洁和清楚起见,诸如“垂直”和“水平”的空间术语在这里是相对于附图来使用的。然而,外科器械可以多种方向和位置来使用,并且这些术语并非旨在成为限制性的和绝对的。
此外,端部执行器312可包括钉通道322和诸如砧座324的可枢转地平移的夹紧构件。器械310的柄部306可包括用于致动端部执行器312的闭合触发器318和击发触发器320。应当理解,具有针对不同外科任务的端部执行器的器械可具有不同数量或不同类型的触发器或用于操作端部执行器312的其他合适的控制器。柄部306可包括向下延伸的手枪式握把326,闭合触发器318被临床医生枢转地拉向手枪式握把326,促使砧座324朝着端部执行器312的钉通道322夹紧或闭合,由此夹紧位于砧座324和通道322之间的组织。在其他实施例中,除了砧座324之外或替代砧座324可以使用不同类型的夹紧构件。柄部306还可包括能够可释放地使闭合触发器318保持在其闭合位置的锁。在公布于2006年2月21日、名称为SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRINGSYSTEMS的美国专利No.7,000,818,公布于2008年9月10日、名称为MOTOR-DRIVEN SURGICALCUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK的美国专利No.7,422,139,以及公布于2008年12月16日、名称为ELECTRO-MECHANICAL SURGICALINSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS的美国专利No.7,464,849中提供了关于用于通过使闭合触发器318回缩来闭合(或夹紧)端部执行器312的砧座324的示例性闭合系统的实施例的更多细节,所述专利的公开内容全文以引用的方式并入本文。
一旦临床医生对端部执行器312的定位满意,临床医生就可以将闭合触发器318向后拉到邻近手枪式握把326的完全闭合、锁定的位置。然后,击发触发器320可被致动或击发。在至少一个此类实施例中,击发触发器320可位于闭合触发器318的更远的外侧,其中闭合触发器318的闭合可使击发触发器320朝向手枪式握把326运动或旋转,使得击发触发器320可在各种情况下被操作者用一只手够到。然后,操作者可枢转地将击发触发器320拉向手枪式握把312,使得在端部执行器312中缝合和切割被夹紧的组织。然后,在临床医生放松或释放掉施加到击发触发器320上的力时,击发触发器320可返回到未致动、或未击发的位置(示于图1和2中)。柄部306上的释放按钮在被压下时可释放被锁定的闭合触发器318。释放按钮可以多种形式实现,例如在已公开的提交于2006年1月31日、名称为SURGICALCUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM的美国专利申请公开号2007/0175955中公开的那样,所述专利申请的公开内容全文以全文引用的方式并入本文。
除上述之外,端部执行器312可包括切割器械,例如刀,以用于在使用者回缩击发触发器320时切割夹持在端部执行器312中的组织。另外除上述之外,端部执行器312还可包括用于紧固被切割器械切断的组织的装置,例如缝合器、RF电极和/或粘合剂。位于器械310的轴308内的可纵向活动的驱动轴可驱动/旋转端部执行器312中的切割器械和紧固装置。位于器械310的柄部306中的电动马达可用于驱动驱动轴,如本文进一步描述。在各种实施例中,马达可为DC有刷驱动马达,最大转速为例如大约25,000RPM。在其他实施例中,马达可包括无刷马达、无绳马达、同步马达、步进马达或任何其他合适的电动马达。诸如锂离子电池的电池(或“功率源”或“电源组”)例如可设置在邻近马达的柄部6的手枪式握把26中,其中电池可经由马达控制电路为马达供电。根据各种实施例,串联连接的多个电池单元可用作功率源来给马达供电。另外,功率源可是可替换的和/或可充电的。
如上文概述,在器械310的柄部306的电动马达可操作地与定位在轴308内的可纵向运动的驱动构件接合。现在参加图14-16,电动马达342可安装到并定位在柄部306的手枪式握把部326内。电动马达342可包括可操作地联接齿轮减速器组件370的旋转轴,其中齿轮减速器组件370可包括外壳374和输出小齿轮372。在某些实施例中,输出小齿轮372可直接可操作地接合可纵向运动的驱动构件382,或者作为另外一种选择,通过一个或多个中间齿轮386可操作地接合驱动构件382。在至少一个此类实施例中,中间齿轮386可与限定在驱动构件382中的一组或一齿条驱动齿384啮合。在使用中,电动马达342按箭头D的方向(图15)向远侧驱动驱动构件,和/或按箭头D的方向(图16)向近侧驱动驱动构件,这取决于电动马达342旋转中间齿轮386的方向。在使用中,由电池提供的电压极性可在顺时针方向上操作电动马达342,其中由电池施加到电动马达上的电压极性可以是相反的以在逆时针方向上操作电动马达342。柄部306可包括能够使电池施加到电动马达342上的极性反向的开关。柄部306还可包括能够检测驱动构件382的位置和/或驱动构件382运动的方向的传感器330。
如上所述,外科器械310可包括关节运动接头314,端部执行器312可围绕关节运动接头314进行关节运动。器械310还可包括关节运动锁,其可被配置并操作以选择性地将端部执行器312锁定在适当的位置。在至少一个此类实施例中,关节运动锁可从轴308的近端延伸至轴308的远端,其中关节运动锁的远端可接合端部执行器312以将端部执行器312锁定在适当的位置。再次参见图12和13,器械310还可包括关节运动控制器316,其可与关节运动锁接合并能够在锁定状态和解锁状态之间操作关节运动锁。在使用中,可向近侧牵拉关节运动控制器316以解锁端部执行器312并允许端部执行器312围绕关节运动接头314旋转。在端部执行器312已适当地进行关节运动之后,关节运动控制器316可向远侧运动以将端部执行器312重新锁定在适当的位置。在至少一个此类实施例中,柄部306还可包括弹簧和/或能够向远侧偏置关节运动控制器316并能够与端部执行器312一起使关节运动锁偏置至锁定构造的其他合适的偏置元件。如果临床医生需要,临床医生可再一次向后或向近侧牵拉关节运动控制器316,以解锁端部执行器312,使端部执行器312进行关节运动,并且然后使关节运动控制器316向后运动至其锁定状态中。在此类锁定状态中,端部执行器312不可相对于轴308进行关节运动。
如上所述,外科器械310可包括能够使端部执行器312相对于轴308保持在适当的位置的关节运动锁。另外如上所述,当关节运动锁处于解锁状态时,端部执行器312可相对于轴308旋转或进行关节运动。在此类解锁状态中,端部执行器312可定位在并推挤(例如)患者手术部位周围的软组织和/或骨骼,以使得端部执行器312相对于轴308进行关节运动。在某些实施例中,关节运动控制器316可包括关节运动开关或能够操作关节运动开关,该关节运动开关可选择性地允许和/或防止击发触发器320操作电动马达342。例如,此类关节运动开关可放置为与电动马达342和可操作地与击发触发器320相连的击发开关串联,其中当关节运动控制器316处于锁定状态时,关节运动开关可处于闭合状态。当关节运动控制器316运动至解锁状态时,关节运动控制器316可打开关节运动开关,从而使击发触发器320的操作和电动马达342的操作电力地分离。在这种情况下,器械310的击发驱动装置不可被击发,同时端部执行器312处于解锁状态并且相对于轴308进行关节运动。当关节运动控制器316回到锁定状态时,关节运动控制器316可重新闭合关节运动开关,然后这可使击发触发器320的操作与电动马达342电力地联接在一起。一个或多个外科缝合器械的各种细节在提交于2009年12月24日、名称为MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITHELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY的专利申请序列号12/647,100,以及公布于2011年6月30日的美国专利申请公布No.2011/0155785中有所公开,所述专利申请的公开内容全文以引用的方式并入本文。
现在转到图17-29,外科器械400可包括柄部403、从柄部403延伸的轴404、以及从轴404延伸的端部执行器402。读者将会注意到,为了举例说明,已移除了柄部403的一部分;然而,柄部403可包括与图1中示出的闭合触发器114和击发触发器116相似的闭合触发器和击发触发器。如将在下文中更详细地描述,击发触发器116可操作地联接包括延伸穿过轴404的击发构件470的击发驱动装置,其中击发触发器116的操作可朝着端部执行器402向远侧推进击发构件470。如将在下文中更详细地描述,外科器械400还可包括关节运动驱动装置,该关节运动驱动装置可选择性地与击发构件470联接,使得当击发构件470被(例如)击发触发器116和/或单独的关节运动触发器和/或按钮促动时,关节运动驱动装置可被击发构件470驱动,并且关节运动驱动装置可继而使端部执行器402围绕关节运动接头410进行关节运动。
现在返回图17,读者将会注意到,外科器械400的端部执行器402以开式构造示出。更具体地讲,包括砧座420的端部执行器402的第一钳口相对于端部执行器402的第二钳口的通道498以开式构造示出。与上文相似,通道498能够容纳并固定钉仓在其中。现在转到图20,其还示出了为开式构造的端部执行器420,外科器械400的柄部403可包括关节运动锁致动器409,关节运动锁致动器409可在远侧(或锁定)位置与近侧(或解锁)位置中运动,在远侧位置中端部执行器402相对于轴404锁定在适当的位置处,在近侧位置中端部执行器402可相对于轴404围绕关节运动接头410进行关节运动。虽然端部执行器402和轴404在图20中示出为以直的构造对齐,但关节运动锁致动器409以其回缩的解锁位置示出,因此端部执行器402可相对于轴404进行关节运动。参见图19、24A和24B,关节运动锁致动器409(图21)可操作地联接关节运动锁443,其中关节运动锁致动器409可使关节运动锁443在远侧位置和近侧位置之间运动,在远侧位置(图24A)中关节运动锁443与端部执行器402的近侧锁定构件407接合,在近侧位置(图24B)中关节运动锁443与端部执行器402分离。读者将会知道,关节运动锁致动器409的远侧锁定位置与关节运动锁443的远侧位置一致,并且关节运动锁致动器409的近侧解锁位置与关节运动锁443的近侧位置一致。现在转到图19,关节运动锁443通过关节运动锁杆440联接到关节运动锁致动器409,关节运动锁杆440包括与关节运动锁443接合的远端442,如图24A更好的示出,以及与关节运动锁致动器409接合的近端441,如图22更好的示出。例如,如图24A和24B所示,关节运动锁443可包括能够与限定在近侧锁定构件407的周边周围的一个或多个齿446啮合的一个或多个齿445。首先参见图19,轴404还可包括偏置构件,例如弹簧444,其能够将关节运动锁443的齿445偏置到与端部执行器402的近侧锁定构件407的齿446接合。相似地,柄部403还可包括定位在腔488中的偏置构件,腔488(图23)限定在关节运动锁致动器409和框架480之间,使得偏置构件可朝着其远侧锁定位置推动关节运动锁致动器409。
如图17所示,关节运动锁致动器409可由两个喷嘴半部或部分411a和411b构成,其中读者应当注意到,为了举例说明,已从图18-27中移除了喷嘴部分411b。另外如图17所示,关节运动锁致动器409可包括多个手指挂钩413,外科医生或其他临床医生可抓持该手指挂钩413以使关节运动锁致动器409回缩至其近侧解锁构造。再次参见图20,关节运动锁致动器409还可包括能够抵靠着轴404的框架或柄部403的框架偏置棘爪构件457的棘爪组件452。更具体地讲,轴404可包括从柄部框架480延伸的轴框架454,其中棘爪组件452能够抵靠着轴框架454偏置棘爪构件457。参见图19,轴框架454可包括限定在其中的棘爪通道453,棘爪通道453可与棘爪构件457对齐,使得当关节运动锁致动器409在其上述锁定和解锁位置中滑动时,棘爪构件457可在棘爪通道453内滑动。再次参见图20,棘爪组件452可包括固定框架部分458,固定框架部分458可限定能够容纳可调式螺纹构件459的螺纹孔。可调式螺纹构件459可包括内部孔,其中至少一部分棘爪构件457可定位在内部孔中,并且其中可通过(例如)定位在棘爪构件457和内部孔的闭合端之间的弹簧将棘爪构件457偏置到内部孔的末端。如图19所示,棘爪通道453的近端可包括棘爪座455,当关节运动锁致动器409到达其近侧解锁位置时,棘爪座455能够可释放地容纳棘爪构件457。在各种情况下,棘爪构件457、棘爪座455和定位在可调式螺纹构件459中的偏置弹簧的尺寸和配置设置成使得棘爪组件452可释放地将关节运动锁致动器409保持在其近侧解锁位置中。如将在下文中更详细地描述,关节运动锁致动器409可保持在其近侧解锁位置中直至端部执行器402已适当地进行关节运动。此时,可向前推动关节运动锁致动器409以使棘爪构件457与棘爪座455分离。读者将会知道,首先参见图20,可调式螺纹构件459可朝着轴框架454向下旋转,以增加使棘爪构件457脱离棘爪座455所需的力,同时可调式螺纹构件459可远离轴框架454向上旋转,以降低使棘爪构件457脱离棘爪座455所需的力。另外如图20所示,关节运动锁致动器409可包括可用于使螺纹构件459进入和旋转的入口418。
如上所述,关节运动锁致动器409处于图20示出的回缩解锁位置,并且端部执行器402处于图24B示出的解锁构造。现在参见图19和20,外科器械400还包括关节运动驱动器460,可向远侧推动关节运动驱动器460以使端部执行器402在第一方向上围绕关节运动接头410旋转,并可向近侧推动关节运动驱动器460以使端部执行器402在第二或相反的方向上围绕关节运动接头旋转,如图21所示。在比较图20和21时,读者将会注意到,已通过击发构件470向近侧推动关节运动驱动器460。更具体地讲,击发构件470的中间部分475可包括限定在其中的凹口或狭槽476,凹口或狭槽476能够容纳关节运动驱动器460的近端461,使得当向近侧推动击发构件470时,击发构件470也可向近侧推动关节运动驱动器460。相似地,当向远侧推动击发构件470时,击发构件470可向远侧推动关节运动驱动器460。另外如图20和21所示,关节运动驱动器460可包括(例如)与从近侧锁定构件407延伸的突出414接合的远端462,其能够将关节运动驱动器460的近侧和远侧关节运动动作传播到端部执行器102。首先参见图18-20,柄部404还可包括击发构件470的近侧击发构件部分482,其包括与击发机构470的中间构件475的近端477接合的远端481。与上文相似,柄部403可包括电动马达,该电动马达包括输出转轴和可操作地与输出转轴接合的齿轮,其中齿轮可操作地与限定在击发构件部分482的表面中的一组纵向齿484接合。在使用中,除上述之外,可在第一方向上操作电动马达以向远侧推进击发构件470,以及在第二或相反的方向上操作电动马达以向近侧回缩击发构件470。虽然未示出,柄部403还可包括开关,该开关可定位在第一状态中以在其第一方向上操作电动马达,定位在第二状态中以在其第二方向上操作电动马达,和/或定位在不在任何方向上操作电动马达的空档状态中。在至少一个此类实施例中,开关可包括至少一个偏置构件,例如弹簧,其能够将开关偏置到其空档状态中。另外,在至少一个此类实施例中,关节运动开关的第一状态可包括空档位置的第一侧面上的拨动开关的第一位置,并且关节运动开关的第二状态可包括空档位置的第二或相对侧面上的拨动开关的第二位置。
在各种情况下,除上述之外,关节运动开关可用于对端部执行器402的位置进行小的调整。例如,外科医生可在第一方向上运动关节运动开关以使端部执行器402围绕关节运动接头在第一方向上旋转,然后通过在第二方向上运动关节运动开关,和/或任何其他合适的在第一和第二方向上的运动的组合来使端部执行器402的运动反向,直至端部执行器402定位在所需的位置。首先参见图19、24A和24B,关节运动接头410可包括从轴框架构件451延伸的枢轴销405,以及限定在近侧锁定构件407中的孔408,孔408能够将枢轴销405紧密地容纳在其中,使得端部执行器402的旋转被限制为围绕关节运动轴线406旋转。首先参见图19,轴框架454的远端可包括能够将轴框架构件451容纳在其中的凹槽456。如将在下文中更详细地描述,轴404可包括外部套管,该外部套管可相对于轴框架454滑动以闭合砧座420。首先参见图19-21,轴410的外部套管可包括可通过关节运动连接件430和432彼此连接的近侧部分428和远侧部分426。当外部套管相对于关节运动接头410滑动时,关节运动连接件430可在端部执行器402已进行关节运动时调节外部套管的远侧部分426和近侧部分428之间的成角度的相对运动,如图21所示。在各种情况下,关节运动连接件430和432可在关节运动接头410处形成两个或多个自由度,以调节端部执行器402的关节运动。读者将会注意到,关节运动接头410还可包括引导件401,引导件410能够将击发构件470的远侧切割部分472容纳在其中,并在远侧切割部分472在关节运动接头410内和/或相对于关节运动接头410向远侧推进或向近侧回缩时引导远侧切割部分472。
如上所述,可向远侧推进击发构件470以向远侧推进关节运动驱动器460,并因此使端部执行器402在第一方向上旋转,相似地,击发构件470可向近侧回缩以向近侧回缩关节运动驱动器460,并因此使端部执行器402在相反的方向上旋转。然而,在一些情况下,当击发构件470用于使端部执行器402进行关节运动时,运动或至少基本上运动击发构件470的远侧切割部分472是不可取的。现在转到图19-21,击发构件470的中间部分475可包括限定在其远端中的纵向狭槽474,纵向狭槽474能够容纳远侧切割部分472的近端473。纵向狭槽474和近端473的尺寸和配置被设置成允许其间的相对运动,并可包括滑动接头471。滑动接头471可允许击发驱动装置470的中间部分475运动以使端部执行器402进行关节运动,而无需运动或至少基本上运动远侧切割部分472。一旦端部执行器402已被适当地取向,可向远侧推进中间部分475直至纵向狭槽474的近侧侧壁与近端473接触,从而推进远侧切割部分472并击发定位在通道498中的钉仓,如将在下文中更详细地描述。首先参见图19,轴框架454可包括限定在其中的纵向狭槽469,纵向狭槽469能够滑动地容纳关节运动驱动器460,相似地,外部轴套管的近侧部分428可包括能够调节上述关节运动驱动器460和轴404的外部套管之间的相对运动的纵向开口425。
除上述之外,当关节运动锁致动器409位于其近侧解锁位置中时,关节运动锁致动器409能够朝着驱动构件470偏置关节运动驱动器460的近侧部分461。更具体地讲,在至少一个此类实施例中,关节运动锁致动器409的内表面可包括凸轮,该凸轮可接合近侧部分461的横向侧466,并偏置近侧部分461至与限定在驱动构件470的中间部分475中的狭槽476接合。当关节运动锁致动器409运动回到其远侧锁定位置时,关节运动锁致动器409不可再朝着驱动构件470向内偏置近侧部分461。在至少一个此类实施例中,柄部403和/或轴404可包括有回弹力的构件,例如弹簧,其能够远离击发构件470向外偏置近侧部分461,使得近侧部分461不与狭槽476可操作地接合,除非在关节运动锁致动器409向近侧运动至其解锁位置时,有回弹力的构件的偏置力被关节运动锁致动器409克服,如上所述。在各种情况下,近侧部分461和狭槽476可包括限制力的离合器。
一旦端部执行器402已关节运动至期望方向,除上述之外,可致动闭合触发器114以使砧座420朝着其闭合位置运动,如图22所示。更具体地讲,闭合触发器114可向远侧推进轴410的外部套管,使得外部套管的远侧部分426可向远侧并向下推动砧座420。砧座420可包括从砧座420的相对侧延伸的突出497,每个突出均能够在限定在仓通道498中的伸长狭槽499内滑动并旋转。砧座420还可包括从其向上延伸的突出496,其可定位在限定在外部套管的远侧部分426中的孔495内,其中当将远侧部分426向远侧推进至使砧座420朝着仓通道498运动时,孔495的侧壁可接触突出496。除上述之外,闭合驱动装置的关节运动还可使关节运动锁致动器409从其近侧解锁位置(图20-22)运动至其远侧锁定位置(图23)。更具体地讲,闭合驱动装置能够向远侧推进闭合驱动仓盒415,闭合驱动仓盒415可接触安装在关节运动致动器409内的衬圈450,如图22所示。如图19和22所示,衬圈450可包括相对的部分或半部,可将该相对的部分或半部组装在一起使得衬圈450的相对部分可围绕轴404。衬圈450还可支撑上述棘爪组件452,并可包括与上述关节运动锁杆440的近端441接合的安装部分。在任何情况下,闭合驱动仓盒415可接触衬圈450并向远侧滑动关节运动锁致动器409,除上述之外,参见图19,使棘爪构件457从棘爪座455中移位至棘爪通道453,使得可将关节运动锁致动器409推动到其锁定位置中,并且关节运动锁443可运动至与近侧锁定位置407接合,从而将端部执行器402锁定在适当的位置,如图23所示。此时,闭合驱动仓盒415可防止端部执行器402解锁和进行关节运动,直至闭合驱动装置和砧座420重新打开并且闭合驱动仓盒415向近侧运动,如将在下文中更详细地描述。
现在参见图25,经由闭合驱动致动器114的闭合驱动装置的致动以及轴410的外部套管428的远侧推进也可以可操作地将关节运动驱动器460从击发驱动装置470脱离。当再次回顾图20和21时,读者将注意到,外部套管428包括限定在其中的窗口424,可旋转的凸轮构件465可以定位在该窗口内。凸轮构件465可以包括可旋转地销接至或联接到轴框架454的第一端和能够相对于凸轮构件465的销接端旋转的第二端,而在其他实施例中,凸轮构件465可以包括任何合适的形状。当外部套管428处于其近侧位置并且砧座420处于其开式构造时,凸轮构件465可以处于第一位置,该第一位置允许关节运动驱动器460的近端461与限定在击发构件470中的狭槽476接合;然而,当外部套管428朝远侧推进时,窗口424的侧壁可以接合凸轮构件465,并且将凸轮构件465的第二端抬离轴框架454并进入第二位置。在该第二位置中,凸轮构件465可以将关节运动驱动器460的近端461移动离开击发驱动装置470,使得近端461不再定位在限定于击发驱动装置470中的狭槽476内。因此,当闭合驱动装置已被致动为将砧座420闭合时,闭合驱动装置可将关节运动锁致动器409推动至其远侧的锁定构造,关节运动锁致动器409可将关节运动锁445推动至锁定构造,且端部执行器402,此外闭合驱动装置,可以可操作地使关节运动驱动器460从击发驱动装置470分离。在操作外科器械400中的此时,对击发驱动装置470的致动将不会使端部执行器402进行关节运动,并且击发驱动装置470可以独立于关节运动驱动器460运动。
现在转到图26,如上所述,击发驱动装置470可以朝远侧推进,以将钉从定位在端部执行器402的通道498内的钉仓弹出并且使钉抵靠着砧座420变形。如上所述,击发驱动装置470可另外包括可以能够切割捕集在端部执行器402内的组织的切割构件。也如上所述,柄部403内的电动马达可以被击发致动器116操作,以便将击发构件470朝远侧推进,其中在各种情况下,可对电动马达进行操作,直到击发构件470的远侧切割部分472到达钉仓的远端和/或钉仓内的任何其他合适的位置。在任何情况下,电动马达的旋转可逆向进行,以将击发构件470朝近侧缩回,如图27所示。在各种情况下,电动马达可将近侧驱动部分482和中间部分475缩回,直到限定在中间部分475中的纵向狭槽474的远侧侧壁与远侧切割构件472的近端473接触为止。此时,近侧驱动部分482和中间部分475的进一步回缩将使远侧切割构件472朝近侧缩回。在各种情况下,可对电动马达进行操作,直到限定在击发构件470的中间部分475内的狭槽476与关节运动驱动器460的近侧部分461重新对齐;然而,当闭合套管428仍处于朝远侧推进的位置时,凸轮构件465可以仍将关节运动驱动器460偏置为与击发构件470脱离接合。为了使关节运动驱动器460能够与击发构件470重新接合,在这种情况下,闭合驱动装置将必须被再次打开,以使限定在外部套管部分428中的窗口424与凸轮构件465对齐,使得凸轮构件465可以朝着轴框架454向内枢转并到达其第一位置。在各种情况下,关节运动驱动器460可发生弹性挠曲,以与击发构件470脱离接合,使得当允许凸轮构件465移动回到其第一位置时,关节运动驱动器460可以朝向轴框架454向内发生弹性挠曲,以使关节运动驱动器460的近侧部分461与限定在驱动构件470的中间部分475内的狭槽476重新接合。在各种实施例中,外科器械400还可以包括可以能够将近侧部分461偏置回到与中间部分475接合的偏置构件。
读者将注意到,在图27中击发构件470的中间部分475已被朝近侧缩回,使得限定在中间部分475内的狭槽476相对于关节运动驱动器460的近侧部分461朝近侧定位。在这种情况下,因此,近侧部分461可能不会可操作地重新连接至击发构件470,直到中间部分475朝远侧推进至将狭槽476与近侧部分461对齐。此类情形可能由于击发构件470的中间部分475与切割构件部分472之间的相对滑动而出现,该相对滑动是由滑动接头471产生的,并且其可能例如通过沿第一方向暂时地重新致动电动马达而解决。
再次参见图27,击发构件470可以处于回缩或复位位置,然而,闭合驱动装置仍处于致动或闭合构造,该构造可以防止砧座420被再次打开并防止端部执行器402再次进行关节运动。当闭合驱动装置被释放时,现在参见图28,闭合驱动仓盒415可被回缩至近侧位置,在该位置中,包括部分426和428的闭合套管也被朝近侧拉动。再次参见图19,近侧套管部分428可以包括可与闭合驱动仓盒415接合的近端417,使得近侧套管部分428和闭合驱动仓盒415一起朝远侧方向和/或近侧方向移动。在任何情况下,除上述之外,远侧套管部分426的近侧运动可能导致孔495的远侧侧壁与从砧座420延伸的突起496接合,以便使砧座420枢转至其打开位置,如图29所示。此外,闭合驱动仓盒415的近侧运动可能使关节运动锁致动器409解锁,使得关节运动锁致动器409可以移动至其近侧的解锁位置,这可能导致将关节运动锁443朝近侧牵拉,从而将弹簧444压缩并将端部执行器402解锁。如上所述,随后可将端部执行器402围绕关节运动接头410进行关节运动,并且可重复上述的对外科器械400的操作。首先参见图18-20,柄部404还可以包括安装到柄部框架480的开关408,该开关可以能够检测关节运动锁致动器409是否处于其近侧的解锁位置。在一些实施例中,开关408可以可操作地与柄部404内的指示器(诸如光指示器)联接,该指示器例如可以向外科器械400的操作者指示端部执行器402是否处于解锁状态,并且操作者可以利用关节运动开关以使端部执行器402进行关节运动。
如上结合图17的实施例所述,外科器械400可以包括能够将端部执行器402锁定和解锁的关节运动锁系统,以及能够将端部执行器402的砧座420打开和闭合的闭合驱动装置。尽管外科器械400的这两种系统在如上所述的若干方面相互作用,但是所述系统可以在其他方面彼此独立地被致动。例如,关节运动锁致动器409和端部执行器锁443可以不闭合砧座420而致动。在外科器械400的该实施例中,闭合驱动装置被独立地操作以将砧座420闭合。现在转到图30-32,外科器械400可以包括其中闭合驱动装置被致动以:其一,将砧座420闭合就位;其二,将端部执行器402锁定就位的替代结构。首先参见图31和32,轴404可以包括关节运动锁杆540,该关节运动锁杆可以在近侧的解锁位置(图31)和远侧的锁定位置(图32)之间运动,其中在所述近侧的解锁位置中,端部执行器402可以围绕关节运动接头410进行关节运动,并且在所述远侧的锁定位置中,端部执行器402可被锁定就位。与关节运动锁杆440类似,关节运动锁杆540可包括可操作地与关节运动锁443接合的远端542,使得当关节运动锁杆540被朝近侧拉动时,关节运动锁443可以被朝近侧拉动。类似地,当关节运动锁杆540被朝远侧推动时,关节运动锁443也可以被朝远侧推动。与如上所述的被关节运动锁致动器409朝远侧推动且朝近侧拉动的关节运动锁杆440形成对比,关节运动锁杆540可被闭合套管428朝远侧推动且朝近侧拉动。更具体地讲,关节运动锁杆540的近端541可包括吊钩547,当闭合套管428被朝近侧拉动时,该吊钩可以钩住闭合套管428的一部分并且与闭合套管428一起被朝近侧拉动。在这种情况下,套管428可以将关节运动锁杆540拉动至解锁状态。如读者将注意到,闭合套管428可包括关节运动锁杆540的近端541可定位在其中的窗口549。当闭合套管428被朝远侧推动时,除上述之外,窗口549的近侧侧壁548可以接触近端541并将关节运动锁杆540和关节运动锁443朝远侧推动,从而将端部执行器402锁定就位。
如本文所述,可能期望采用可包括可重复使用部分的外科系统,所述可重复使用部分能够与可互换外科部件一起使用。参见图33,例如,示出了通常表示为1000的外科系统,其在至少一种形式中,包括可以重复使用或不可以重复使用的外科器械1010。外科器械1010可以采用多个可互换轴组件1200、1200’、1200”。可互换轴组件1200、1200’、1200”可以具有可操作地联接至其的外科端部执行器1300、1300’、1300”,所述外科端部执行器能够执行一种或多种手术任务或程序。例如,外科端部执行器1300、1300’、1300”中的每一个可以包括能够可操作地支撑其中的外科钉仓的外科切割和紧固装置。轴组件中的每一个可以采用适于支撑不同尺寸和类型的钉仓的端部执行器,并具有不同的轴长度、尺寸和类型等等。尽管本发明的图示出了能够切割和缝合组织的端部执行器,但外科系统1000的各个方面还可以有效地采用能够将其他运动和形式的能量(诸如射频(RF)能量、超声能量和/或运动)施加至在各种外科应用和程序中使用的安装了可互换轴的端部执行器结构的外科器械。此外,端部执行器、轴组件、柄部、外科器械和/或外科器械系统可以利用任何合适的一个或多个紧固件以将组织紧固。例如,包括多个可移除地储存在其中的紧固件的紧固件仓可以可移除地插入和/或附接至轴组件的端部执行器。在各种情况下,可将轴组件选择为附接至外科器械的柄部,并且可将紧固件仓选择为附接至轴组件。
图33中示出的外科器械1010包括外壳1040,其由能够被临床医生抓握、操纵和致动的柄部1042组成。继续参阅本具体实施方式,然而,应当理解,本文公开的各种形式的可互换轴组件的各种独特且新型的结构也可以有效地与机器人控制的外科系统一起使用。因此,术语“外壳”也可以涵盖机器人系统的容纳或换言之可操作地支撑至少一个驱动系统的外壳或类似部分,其中所述至少一个驱动系统能够生成并施加可用于致动本文所公开的可互换轴组件及其相应的等同物的至少一种控制运动。术语“框架”可以指手持外科器械的一部分。术语“框架”还可以代表机器人控制的外科器械的一部分和/或可用于可操作地控制外科器械的机器人系统的一部分。例如,本文公开的可互换轴组件可以与美国专利申请公布No.US2012/0298719中公开的各种机器人系统、器械、部件和方法一起使用。名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利申请公布No.2012/0298719)全文以引用方式并入本文。
图34示出了具有可操作地联接至其的可互换轴组件1200的外科器械1010。在示出的形式中,外科器械包括柄部1042。在至少一种形式中,柄部1042可包括一对可互连的外壳片段1044、1046,它们可通过螺钉、按扣结构、粘合剂等互连。参见图35。在示出的结构中,柄部外壳片段1044、1046配合形成可被临床医生抓握和操纵的手枪式握把部1048。如将在下文进一步详细地讨论,柄部1042可操作地支撑其中的多个驱动系统,所述驱动系统能够生成各种控制运动并将该控制运动施加到可操作地附接至其的可互换轴组件的相应部分。
柄部1042还可以包括可操作地支撑多个驱动系统的框架1080。例如,框架1080可以可操作地支撑通常表示为1050的第一或闭合驱动系统,该第一或闭合驱动系统可用于将闭合和打开动作施加至可操作地附接或联接至其的可互换轴组件1200。在至少一种形式中,闭合驱动系统1050可以包括被框架1080可枢转地支撑的闭合触发器1052形式的致动器。更具体地讲,如图35所示,闭合触发器1052可以被框架1080可枢转地支撑,使得当临床医生抓握柄部1042的手枪式握把部1048时,闭合触发器1052可以轻松地从起始或未致动位置枢转至致动位置,并更具体地讲,枢转至完全压缩或完全致动的位置。闭合触发器1052可被弹簧或其他偏置结构(未示出)偏置到未致动位置。在各种形式中,闭合驱动系统1050还包括可枢转地联接到闭合触发器1052的闭合连杆组件1060。如可在图35中看到,闭合连杆组件1060可以包括可枢转地联接到闭合连杆1064的闭合触发器1052,所述闭合连杆具有一对侧向延伸的附接耳或从其突起的部分1066。闭合连杆1064在本文中也可以称作“附接构件”。
仍参见图35,可以观察到闭合触发器1052可以具有位于其上的锁定壁1068,该锁定壁能够与可枢转地联接到框架1080的闭合释放组件1070相配合。在至少一种形式中,闭合释放组件1070可以包括具有在其上形成的朝远侧突起的凸轮从动臂1074的释放按钮组件1072。释放按钮组件1072可以被释放弹簧1076沿逆时针方向枢转。当临床医生将闭合触发器1052从其未致动位置朝向柄部1042的手枪式握把部1048按压时,闭合连杆1062向上枢转至某个点,凸轮从动臂1072落入该点,与闭合连杆1062上的锁定壁1068保持接合,从而防止闭合触发器1052回到未致动位置。因此,闭合释放组件1070有助于将闭合触发器1052锁定在完全致动位置。当临床医生希望将闭合触发器1052解锁以允许其被偏置到未致动位置时,临床医生简单地枢转闭合释放按钮组件1072,使得凸轮从动臂1074被移动为与闭合触发器1052上的锁定壁1068脱离接合。当凸轮从动臂1074已被移动至与闭合触发器1052脱离接合时,闭合触发器1052可以枢转回到未致动位置。也可以采用其他闭合触发器锁定和释放结构。
在至少一种形式中,柄部1042和框架1080可以可操作地支撑在本文中被称为击发驱动系统1100的另一个驱动系统,该驱动系统能够将击发动作施加于可互换轴组件的附接至其的相应部分。击发驱动系统在本文中也可称作“第二驱动系统”。击发驱动系统1100可以采用位于柄部1042的手枪式握把部1048中的电动马达1102。在各种形式中,马达1102可以是例如具有大约25,000RPM的最大转速的直流刷式驱动马达。在其他结构中,马达可以包括无刷马达、无绳马达、同步马达、步进马达,或任何其他合适的电动马达。电池1104(或“功率源”或“电源组”),诸如锂离子电池,可以联接到柄部1042,以向控制电路板组件1106并最终向马达1102提供电力。图34示出了能够可释放地安装到柄部1042以便向外科器械1010提供控制电力的电源组外壳1104。可将多个串联的电池单元用作对马达供电的功率源。此外,功率源可以是可更换和/或可充电的。
如上文相对于其他各种形式所述,电动马达1102可以包括可操作地交接安装为与在可纵向移动的驱动构件1110上的一组或一齿条驱动齿1112啮合的齿轮减速器组件1108的可旋转轴(未示出)。在使用中,由电池提供的电压极性可以沿顺时针方向操作电动马达1102,其中由电池施加至电动马达的电压极性可被反转,以便沿逆时针方向操作电动马达1102。当电动马达1102沿一个方向旋转时,驱动构件1110将在远侧方向“D”上被轴向驱动。当马达1102被沿相反的旋转方向驱动时,驱动构件1110将在近侧方向“P”上被轴向驱动。参见例如图35。柄部1042可以包括开关,所述开关可以能够反转由电池施加至电动马达1102的极性。就本文所述的其他形式而言,柄部1042还可以包括能够检测驱动构件1110的位置和/或驱动构件1110正移动的方向的传感器。
马达1102的致动可通过可枢转地支撑在柄部1042上的击发触发器1120进行控制。击发触发器1120可在未致动位置和致动位置之间枢转。击发触发器1120可被弹簧(未示出)或其他偏置结构偏置到未致动位置(未示出),使得当临床医生释放击发触发器1120时,其可被弹簧或偏置结构枢转至或换言之返回未致动位置。在至少一种形式中,击发触发器1120可以定位在闭合触发器1052“外侧”,如上文所讨论。在至少一种形式中,击发触发器安全按钮1122可以可枢转地安装到闭合触发器1052。如在图35和36中可见,例如,安全按钮1122可以定位在击发触发器1120和闭合触发器1052之间,并具有从其突起的枢转臂1124。如图38所示,当闭合触发器1052处于未致动位置时,安全按钮1122被容纳在柄部外壳中,此时临床医生可能无法轻易地触及所述按钮并将其在防止对击发触发器1120致动的安全位置与其中击发触发器1120可被击发的击发位置之间移动。当临床医生按压闭合触发器1052时,安全按钮1122和击发触发器1120向下枢转,其中它们随后可被临床医生操纵。
如上所述,在至少一种形式中,可纵向移动的驱动构件1110具有在其上形成的一齿条的齿1112,用于与齿轮减速器组件1108的相应驱动齿轮1114啮合。至少一种形式还可以包括可手动致动的“救助”组件1130,该组件能够使临床医生在马达可能失能的情况下可以手动地缩回可纵向移动的驱动构件1110。救助组件1130可以包括能够被手动地枢转至与驱动构件1110中的齿1112棘轮接合的杠杆或救助柄部组件1132。因此,临床医生可以通过使用救助柄部组件1132而手动地缩回驱动构件1110,以将驱动构件沿近侧方向“P”缩回。美国专利申请公布No.US2010/0089970公开了救助结构和还可以与本文所公开的各种器械一起使用的其他部件、结构和系统。名称为“POWERED SURGICAL CUTTING AND STAPLINGAPPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117(现为美国专利申请公布No.2010/0089970)全文以引用方式并入。
图34和37示出了具有(例如)可操作地附接至其的外科端部执行器1300的一种形式的可互换轴组件1200。如那些图中所示的端部执行器1300可以能够以本文所公开的多种方式切割和缝合组织。例如,端部执行器1300可以包括能够支撑外科钉仓1304的通道1302。钉仓1304可以包括可移除的钉仓1304,使得其可以在耗尽时进行更换。然而,其他结构中的钉仓可以能够使得一旦安装在通道1302内,便不旨在将其从通道移除。通道1032和钉仓1304可以统称为端部执行器1300的“第一钳口部分”。在各种形式中,端部执行器1300可具有砧座1310形式的“第二钳口部分”,其以本文讨论的多种方式可移动地或可枢转地支撑在通道1302上。
可互换轴组件1200还可以包括轴1210,该轴包括联接到轴附接模块或轴附接部分1220的轴框架1212。在至少一种形式中,轴框架1212的近端1214可以延伸穿过在轴附接模块1220上形成且可旋转地附接至其的中空衬圈部1222。例如,可在轴框架1212的近端1214中提供环形沟槽1216,以接合延伸穿过轴附接模块1220中的狭槽1224的U形保持器1226。此类结构使得轴框架1212能够相对于轴附接模块1220旋转。
轴组件1200还可以包括轴框架1212延伸穿过的中空外部套管或闭合管1250。外部套管1250在本文中也可称作“第一轴”和/或“第一轴组件”。外部套管1250具有能够可旋转地联接到闭合管附接轭1260的近端1252。如可在图37中所见,外部套管1250的近端1252能够容纳在闭合管附接轭1260中的架1262内。U形连接器1266延伸穿过闭合管附接轭1260内的狭槽1264,以便容纳在外部套管1250的近端1252中的环形沟槽1254内。这种结构有助于将外部套管1250可旋转地联接到闭合管附接轭1260,使得外部套管1250可以相对于其旋转。
如可在图38和39中所见,轴框架1214的近端1214朝近侧突起离开外部套管1250的近端1252,并通过U形保持器1226(图38中所示)可旋转地联接到轴附接模块1220。闭合管附接轭1260能够可滑动地容纳在轴附接模块1220中的通路1268内。这种结构允许外部套管1250沿近侧方向“P”和远侧方向“D”在轴框架1212上相对于轴附接模块1220轴向移动,如下文将进一步详细讨论。
在至少一种形式中,可互换轴组件1200还可以包括关节运动接头1350。然而,其他可互换轴组件可能无法进行关节运动。如可在图37中所见,例如,关节运动接头1350包括双枢轴闭合套管组件1352。根据各种形式,双枢轴闭合套管组件1352包括具有朝远侧突出的上柄脚1356和下柄脚1358的轴闭合套管组件1354。端部执行器闭合套管组件1354包括用于以上述方式接合砧座1310上的开口插片的马蹄形孔1360和插片1362。如上所述,当砧座1310打开时,马蹄形孔1360和插片1362接合砧座插片。上部双枢轴连杆1364包括向上突出的远侧和近侧枢轴销,所述枢轴销分别接合外部套管1250上的朝近侧突出的上柄脚1356中的上部远侧销孔以及朝远侧突出的上柄脚1256中的上部近侧销孔。下部双枢轴连杆1366包括向下突出的远侧和近侧枢轴销,所述枢轴销分别接合朝近侧突出的下柄脚1358中的下部远侧销孔以及朝远侧突出的下柄脚1258中的下部近侧销孔。
在使用中,闭合套管组件1354朝远侧(方向“D”)平移,以便(例如)响应于闭合触发器1052的致动而将砧座1310闭合。砧座1310通过朝远侧平移外部套管1250而闭合,因此,轴闭合套管组件1354导致其以上述的方式冲击砧座1310上的近侧表面。还如上文所述,砧座1310通过朝近侧平移外部套管1250和轴闭合套管组件1354而打开,导致插片1362和马蹄形孔1360接触并推挤砧座插片以将砧座1310抬起。在砧座打开位置,轴闭合套管组件1352被移至其近侧位置。
在至少一种形式中,可互换轴组件1200还包括击发构件1270,其被支撑以便在轴框架1212内轴向行进。击发构件1270包括能够附接到远侧切割部分1280的中间击发轴部分1272。击发构件1270在本文中也可称作“第二轴”和/或“第二轴组件”。如可在图37中所见,中间击发轴部分1272可以包括在其远端中的纵向狭槽1274,其可以能够容纳远侧切割部分1280的近端1282。纵向狭槽1274和近端1282的尺寸可以被设定成能够允许在其之间的相对运行,并可以包括滑动接头1276。滑动接头1276可以允许击发驱动装置1270的中间击发轴部分1272被移动为使端部执行器1300进行关节运动,而无需移动或至少大体移动远侧切割部分1280。一旦端部执行器1300已合适地取向,中间击发轴部分1272便可朝远侧推进,直到纵向狭槽1272的近侧侧壁与近端1282发生接触,以便推进远侧切割部分1280并击发定位在通道1302内的钉仓,如本文所述。如可在图37中进一步所见,轴框架1212在其中具有伸长的开口或窗口1213,以利于将中间击发轴部分1272组装和插入到轴框架1212中。一旦中间击发轴部分1272已被插入其中,顶部框架片段1215便可以与轴框架1212接合,以包封住其中的中间击发轴部分1272和远侧切割部分1280。读者还将注意到,关节运动接头1350还可以包括可以能够在其中容纳击发构件1270的远侧切割部分1280并且在远侧切割部分1280在关节运动接头1350内和/或相对于关节运动接头1350朝远侧推进和/或朝近侧回缩时对所述远侧切割部分1280进行引导的引导件1368。
如可在图37所见,轴附接模块1220还可以包括闩锁致动器组件1230,其可以通过有头螺钉(未示出)或其他合适的紧固件可移除地附接至轴附接模块。闩锁致动器组件1230能够与可枢转地联接到轴附接模块1220(以便有选择地相对于其枢转行进)的锁轭1240配合。参见图41。参见图39,锁轭1240可以包括能够可释放地接合在框架1080的框架附接模块部分1084中形成的相应锁棘爪或沟槽1086的两个朝近侧突起的锁耳1242(图37),如下文将进一步详细讨论。锁轭1240呈大致U形,并且在闩锁致动器组件1230已联接到轴附接模块1220之后被安装在闩锁致动器组件1230上。闩锁致动器组件1230可以具有弓形主体部分1234,该弓形主体部分为相对于其在闩锁位置和未闩锁位置之间枢转的锁轭1240提供充足的空隙。
在各种形式中,锁轭1240被弹簧或偏置构件(未示出)沿近侧方向偏置。换句话说,锁轭1240被偏置到闩锁位置(图40)并且可被可移动地支撑在闩锁致动器组件1230上的闩锁按钮1236枢转至未闩锁位置(图41)。在至少一种结构中,例如,闩锁按钮1236可滑动地保持在闩锁外壳部分1235中,并被闩锁弹簧或偏置构件(未示出)沿近侧方向“P”偏置。如将在下文进一步详细地讨论,闩锁按钮1236具有朝远侧突起的释放耳1237,该释放耳被设计成接合锁轭1240并在致动闩锁按钮1236时将锁轭从闩锁位置枢转至图41中所示的未闩锁位置。
可互换轴组件1200还可以包括可旋转地支撑在轴附接模块1220上的喷嘴组件1290。在至少一种形式中,例如,喷嘴组件1290可以由两个喷嘴半部或部分1292、1294组成,所述两个半部或部分可以通过螺钉、按扣结构、粘合剂等互相连接。当喷嘴组件1290安装在轴附接模块1220上时,其可以与外部套管1250和轴框架1212配合,以使临床医生能够有选择地将轴1210围绕轴线SA-SA相对于轴附接模块1220旋转,所述轴线SA-SA可被限定为(例如)击发构件组件1270的轴线。具体地讲,喷嘴组件1290的一部分可以延伸穿过外部套管中的窗口1253,以接合轴框架1212中的凹口1218。参见图37。因此,喷嘴组件1290的旋转将导致轴框架1212和外部套管1250围绕轴线A-A相对于轴附接模块1220旋转。
现在参见图42和43,读者将观察到框架1080的框架附接模块部分1084与两个面朝里的燕尾接纳狭槽1088一起形成。每个燕尾接纳狭槽1088可以逐渐缩小,或换句话讲可以呈略微V形。参见例如图36和38(仅示出了狭槽1088之一)。所述燕尾接纳狭槽1088能够可释放地容纳轴附接模块1220的朝近侧延伸连接器部分1228的相应逐渐缩小的附接或耳部分1229。如可在图37-39中进一步所见,轴附接耳1278在中间击发轴1272的近端1277上形成。如将在下文进一步详细地讨论,当可互换轴组件1200联接到柄部1042时,轴附接耳1278容纳在形成于纵向驱动构件1110的远端1111中的击发轴附接架1113内。此外,闭合管附接轭1260包括朝近侧延伸的轭部分1265,该轭部分包括两个向下打开以捕获闭合附接杆1064上的附接耳1066的捕获狭槽1267。
现在将参照图44-48对将可互换轴组件1220附接到柄部1042进行描述。在各种形式中,框架1080或至少一个驱动系统限定致动轴线AA-AA。例如,致动轴线AA-AA可通过可在纵向上移动的驱动构件1110的轴线进行限定。因此,当中间击发轴1272可操作地联接到可纵向移动的驱动构件1110时,致动轴线AA-AA与如图48所示的轴线SA-SA同轴。
为了开始联接过程,临床医生可将可互换轴组件1200的轴附接模块1220定位在框架1080的框架附接模块部分1084上方或附近,使得形成在轴附接模块1220的连接器部分1228上的附接耳1229与附接模块部分1084中的燕尾狭槽1088对齐,如图45所示。临床医生随后可以将轴附接模块1220沿着大致横向于致动轴线AA-AA的安装轴线IA-IA移动。换句话说,轴附接模块1220沿着大致横向于致动轴线AA-AA的安装方向“ID”移动,直到连接器部分1228的附接耳1229坐置为与相应燕尾接纳狭槽1088“可操作地接合”。参见图44和46。图47示出了在中间击发轴1272上的轴附接耳1278进入可纵向移动的驱动构件1110中的架1113且闭合附接杆1064上的附接耳1066进入闭合管附接轭1260的轭部分1265中的相应狭槽1267之前,轴附接模块1220的位置。图48示出了在附接过程完成之后轴附接模块1220的位置。如可在该图中所见,耳1066(仅示出了一个)坐置为可操作地接合在闭合管附接轭1260的轭部分1265中它们的相应狭槽1267内。如本文所用,在两个部件的背景下的术语“可操作地接合”是指所述两个部件彼此充分地接合,使得一旦向其施加致动运动,所述部件便可以执行其预期活动、功能和/或程序。
如上所讨论,再次参见图44-49,可互换轴组件1200的至少五个系统可以可操作地与柄部1042的至少五个相应系统联接。第一系统可以包括将轴组件1200的框架与柄部1042的框架联接和/或对齐的框架系统。如上文概述,轴组件1200的连接器部分1228可以接合柄部框架1080的附接模块部分1084。第二系统可以包括闭合驱动系统,该闭合驱动系统能够将柄部1042的闭合触发器1052与轴组件1200的闭合管1250和砧座1310可操作地连接。如上文概述,轴组件1200的闭合管附接轭1260可以接合柄部1042的附接耳1066。第三系统可以包括击发驱动系统,该击发驱动系统能够将柄部1042的击发触发器1120与轴组件1200的中间击发轴1272可操作地连接。如上文概述,轴附接耳1278能够可操作地与纵向驱动构件1110的架1113连接。第四系统可以包括电气系统,该电气系统可以:其一,发送诸如轴组件(诸如轴组件1200)已与柄部1042可操作地接合的信号到柄部1042中的控制器,诸如微控制器7004;和/或其二,在轴组件1200和柄部1042之间传导电力和/或通信信号。例如,轴组件1200可以包括六个电触点,并且电连接器4000还可以包括六个电触点,其中轴组件1200上的每个电触点可以是成对的,并且当将轴组件1200组装到柄部1042时,与电连接器4000上的电触点配合。轴组件1200还可以包括闩锁1236,该闩锁可以是第五系统(诸如可以将轴组件1200可释放地锁定到柄部1042的锁系统)的零件。在各种情况下,例如当闩锁1236与柄部1042接合时,闩锁1236可以将柄部1042中的电路闭合。
除上述之外,可将轴组件1200的框架系统、闭合驱动系统、击发驱动系统和电气系统例如沿横向(即,沿轴线IA-IA)组装到柄部1042的相应系统。在各种情况下,轴组件1200的框架系统、闭合驱动系统和击发驱动系统可以同时地联接到柄部1042的相应系统。在某些情况下,轴组件1200的框架系统、闭合驱动系统和击发驱动系统中的两者可以同时地联接到柄部1042的相应系统。在至少一种情况下,框架系统可以在闭合驱动系统和击发驱动系统联接前至少初始地联接。在这种情况下,框架系统可以能够在闭合驱动系统和击发驱动系统的相应部件如上所述联接前将它们对齐。在各种情况下,外壳组件1200和柄部1042的电气系统部分可以能够在框架系统、闭合驱动系统和/或击发驱动系统最终或完全坐置的同时进行联接。在某些情况下,外壳组件1200和柄部1042的电气系统部分可以能够在框架系统、闭合驱动系统和/或击发驱动系统最终或完全坐置之前进行联接。在一些情况下,外壳组件1200和柄部1042的电气系统部分可以能够在框架系统已至少部分地联接之后,且在闭合驱动系统和/或击发驱动系统已被联接之前进行联接。在各种情况下,锁定系统可以能够使得其为待接合的最后一个系统,即,在框架系统、闭合驱动系统、击发驱动系统和电气系统全部被接合之后。
如上文概述,再次参见图44-49,柄部1042的电连接器4000可以包括多个电触点。现在转到图197,电连接器4000可以包括例如第一触点4001a、第二触点4001b、第三触点4001c、第四触点4001d、第五触点4001e和第六触点4001f。尽管所示的实施例利用了六个触点,但是设想了可以利用不止六个触点或不到六个触点的其他实施例。如图197所示,第一触点4001a可以与晶体管4008电连通,触点4001b-4001e可以与微控制器7004电连通,并且第六触点4001f可以与地面电连通。下文将对微控制器7004进行更为详细地讨论。在某些情况下,电触点4001b-4001e中的一个或多个可以与微控制器7004的一个或多个输出通道电连通,并且当柄部1042处于通电状态时可以通电,或具有施加至其的电压电势。在一些情况下,电触点4001b-4001e中的一个或多个可以与微控制器7004的一个或多个输入通道电连通,并且当柄部1042处于通电状态时,微控制器7004可以能够检测电压电势何时被施加至此类电触点。当轴组件(诸如轴组件1200)被组装到柄部1042时,电触点4001a-4001f可能不会彼此连通。然而,当轴组件未组装到柄部1042时,电连接器4000的电触点4001a-4001f可能暴露,并且在一些情况下,触点4001a-4001f中的一个或多个可以意外地彼此电连通。当触点4001a-4001f中的一个或多个与例如导电材料接触时,此类情况可能发生。当这种情况发生时,例如,微控制器7004可能接收到错误的输入和/或轴组件1200可能接收到错误的输出。要解决这个问题,在各种情况下,当轴组件(诸如轴组件1200)未附接到柄部1042时,柄部1042可能未通电。在其他情况下,当轴组件(诸如轴组件1200)未附接到柄部1042时,柄部1042可能通电。在这种情况下,微控制器7004可以能够忽视例如施加至与微控制器7004电连通的触点(即,触点4001b-4001e)的输入或电压电势,直到轴组件附接至柄部1042为止。虽然在这类情况下微控制器7004可以被供电以操作柄部1042的其他功能,但是柄部1042可以处于断电状态。在某种程度上,当施加至电触点4001b-4001e的电压电势可能不会影响对柄部1042的操作时,电连接器4000可以处于断电状态。读者将认识到,即便触点4001b-4001e可以处于断电状态,但是未与微控制器7004电连通的电触点4001a和4001f可能处于或可能不处于断电状态。例如,无论柄部1042是处于通电还是断电状态,第六触电4001f均可以保持与地面电连通。此外,无论柄部1042是处于如上所述的通电还是断电状态,晶体管4008和/或晶体管(诸如晶体管4010)的任何其他合适的结构和/或开关均可以能够控制来自柄部1042内的功率源4004(诸如电池1104)例如到第一电触点4001a的电力供应。在各种情况下,例如,当轴组件1200的闩锁1236与柄部1042接合时,闩锁1236可以能够改变晶体管4008的状态。在各种情况下,如本文别处所述,当闩锁1236接合柄部1042时,其可以能够将电路闭合,从而影响晶体管4008的状态。在某些情况下,除下述之外,霍尔效应传感器4002可以能够转换晶体管4010的状态,因此可以转换晶体管4008的状态,并最终将来自功率源4004的电力供应给第一触点4001a。通过这种方式,除上述之外,当轴组件未安装到柄部1042时,联接至连接器4000的电源电路和信号电路均可被断电,并且当轴组件安装到柄部1042时,这两者均可被通电。
在各种情况下,再次参见图197,柄部1042可包括例如霍尔效应传感器4002,该霍尔效应传感器在例如轴组件联接至柄部1042时,能够检测诸如磁性元件之类的可检测元件,例如位于诸如轴组件1200之类的轴组件之上的磁性元件。霍尔效应传感器4002可由诸如电池之类的功率源4006供电,例如,其实际上可放大霍尔效应传感器4002的检测信号,并通过图197所示的电路与微控制器7004的输入通道通信。一旦微控制器7004接收到指示轴组件已至少部分地联接到柄部1042的输入,并且作为结果,电触点4001a-4001f不再裸露,微控制器7004可进入其正常或通电的工作状态。在此类工作状态中,微控制器7004将对从轴组件传输至一个或多个触点4001b-4001e的信号进行评估,和/或通过处于其正常使用状态的一个或多个触点4001b-4001e将信号传输至轴组件。在各种情况下,在霍尔效应传感器4002可检测磁性元件之前,可能必须使轴组件1200完全坐置。虽然可利用霍尔效应传感器4002来检测轴组件1200是否存在,但也可利用例如传感器和/或开关的任何合适系统来检测是否已将轴组件组装到柄部1042。这样,除上述之外,当轴组件未安装到柄部1042时,联接至连接器4000的电源电路和信号电路均可被断电,当轴组件安装到柄部1042时,这两者被通电。
在各种实施例中,例如,可采用任何数量的磁感测元件来检测是否已将轴组件组装到柄部1042。例如,用于磁场感测的技术包括探测线圈、磁通门、光泵、核旋、超导量子干涉仪(SQUID)、霍尔效应、各向异性磁电阻、巨磁电阻、磁性隧道结、巨磁阻抗、磁致伸缩/压电复合材料、磁敏二极管、磁敏晶体管、光纤、磁光,以及基于及微机电系统的磁传感器等。
在将可互换轴组件1200可操作地联接至柄部1042之后,闭合触发器1052的致动将导致外部套管1250和联接于其上的轴闭合套管组件1354的远侧轴向行进,以通过本文所述的各种方式致动砧座1310。也可如图48所示,将可互换轴组件1200中的击发构件1270联接至柄部1042中的纵向可移动驱动构件1110。更具体地讲,将形成在中间击发轴1272的近端1277上的轴附接耳1278容纳于形成在纵向可移动驱动构件1110中的远端1111内的击发轴附接架1113之内。从而,击发触发器1120的致动(其导致马达1102的动力轴向推动纵向可移动驱动构件1110)也将导致击发构件1270在轴架1212内轴向地运动。此类动作将导致以本文所公开的各种方式推动远侧切割部分1280使其穿过夹在端部执行器1300中的组织。虽然未在图48中示出,但本领域的普通技术人员仍将理解,当处于该图所示的联接位置时,轴附接模块1220的附接耳部分1229坐置在框架1080的附接模块部分1084中的其各自的燕尾容纳槽1088内。从而,轴附接模块1220联接至框架1080。此外,虽然未在图48中示出(但其可在图40中看到),当轴附接模块1220联接至框架1080时,锁轭1240上的锁耳1242坐置在框架1080的附接模块部分1084中的其各自的锁槽1086(图40中仅示出了一个)内,以可释放地使所联接的轴附接模块1220可操作地接合框架1080。
要从框架1080上拆下可互换轴组件1220,临床医生在远侧方向“D”推动锁按钮1236以使锁轭1240枢转,如图41所示。锁轭1240的此类枢转运动使得其上的锁耳1242脱离与锁槽1086保持的接合。临床医生可于之后移动轴附接模块1220使其以分离方向“DD”远离柄部,如图49所示。
本领域的普通技术人员将会理解,轴附接模块1220也可保持固定,并且柄部1042沿着基本上横向于轴线SA-SA的安装轴线IA-IA移动,以使连接器部分1228上的耳1229与燕尾狭槽1088坐置接合。还将理解到,轴附接模块1220和柄部1042可沿着基本上横向于轴线SA-SA和致动轴线AA-AA的安装轴线IA-IA同时朝向彼此移动。
如本文所用,短语“基本上横向于致动轴线和/或横向于轴线”是指几乎垂直于致动轴线和/或轴线的方向。然而,应当理解,从垂直于致动轴线和/或轴线的方向偏离一些的方向也基本上横向于这些轴线。
图50-57示出了用于将可互换轴组件1600联接至柄部(未示出)的框架1480的另一种结构,所述柄部在其他方面的功能与本文详细讨论的柄部1042相同。因此,仅将进一步详细地讨论了解轴组件1600的独特和新颖的联接特征所必需的那些细节。然而,本领域的普通技术人员应当了解,可在机器人系统的外壳内支撑框架,所述机器人系统以其他方式支撑或容纳多个驱动系统。在其他结构中,框架可包括用于将可互换的轴组件可操作地附接于其上的机器人系统的一部分。
在至少一种形式中,轴组件1600包括轴1610,所述轴可包括上述轴1210的所有其他部件,并且可具有可操作地附接于其上的上述类型的端部执行器(未示出)。转到图57,在所示结构中,轴组件1600包括闭合管附接轭1660,所述闭合管附接轭可以如下方式可旋转地联接至外部套管1650:其中闭合管轭组件1260可旋转地联接至外部套管1250。
在各种形式中,轴组件1600包括具有开口的底部1621的轴附接模块或轴附接部分1620。轴1610通过插入轴1610的近端使其穿过轴附接模块1620的开口1622而联接至轴附接模块1620。可将闭合管附接轭1660插入轴附接模块1620使其穿过开口的底部部分1621,使得外部套管1650的近端1652容纳在闭合管附接轭1660中的架1662内。在上述方式中,U形连接器1666穿过轴附接模块1620中的狭槽1624以接合外部套管1250的近端1652中的环形沟槽1654,并穿过闭合管附接轭1660中的狭槽1664以将外部套管1650附连至闭合管附接轭1660。如上所述,此类结构允许外部套管1650相对于轴附接模块1620旋转。
在至少一种形式中,闭合管附接轭1660能够支撑在轴附接模块1620内,使得闭合管轭附接轭1660可在远侧和近侧方向于其中轴向运动。在至少一种形式中,闭合弹簧1625设置在轴附接模块内以在近侧方向“P”偏置闭合管轭组件1660。参见图57。就上述轴组件1210而言,轴框架1612的近端1614朝近侧从外部套管1650的近端1652延伸。如可在图57中看到的那样,可在轴框架1612的近端1614上形成挡圈1617。U形保持器构件1627插入穿过轴附接模块1620中的侧向狭槽1633,以在使外部套管1650相对于轴附接模块1620旋转时,将外部套管的近端1652保持在该轴向位置。这种结构允许临床医生相对于轴附接模块1620围绕轴线SA-SA旋转轴1610。本领域的普通技术人员应当理解,轴1610可通过相同或类似的上述喷嘴结构进行旋转。例如,喷嘴部分(未示出)可围绕外部套管1650组装并通过外部套管1650中的窗口1653接合轴框架1612中的凹口1618。参见图53。
在至少一种形式中,框架1480具有框架附接模块或形成于其上或附接于其上的框架附接部分1484。可形成具有相对的燕尾容纳槽1488的框架附接模块1484。每个燕尾容纳槽1488可以是锥形的,或者换句话讲,可以是稍微V形的。狭槽1488能够可释放地容纳从轴附接模块1620的近端延伸的燕尾连接器1629的相应部分。如可在图52中看到的那样,中间击发轴1672的近端1677朝近侧从轴附接模块1620中延伸并具有形成于其上的轴附接耳1678。中间击发轴1672的近端1677可延伸穿过框架附接模块1484的端壁1485之间的空间,以允许形成于其上的轴附接耳1678容纳在击发轴附接架1513中,该击发轴附接架形成在纵向可移动驱动构件1510的远端1511中。参见图57。当可互换轴组件1600联接到外科器械、装置、机器人系统等的柄部或外壳或框架上时,轴附接耳1678容纳在击发轴附接架1513中,该击发轴附接架形成在纵向可移动驱动构件1510的远端1511中。
如可在图52-55中看到的那样,框架附接模块1484可具有朝远侧延伸的底部构件1490,该底部构件适于在将轴附接模块1620可操作地联接到框架附接模块1484时,封闭轴附接模块1620的开口的底部1621的至少一部分。在一种形式中,闭合管附接轭1660具有一对从其中延伸并朝近侧延伸的间隔的轭臂1661。横向轭附接销1663可在其间延伸。参见图57。当使轴附接模块1620可操作地与框架附接模块1484接合时,轭附接销1663能够由在闭合驱动系统1450的闭合连接件1467上形成的吊钩1469吊挂地接合。闭合驱系统1450可类似于上述的闭合驱系统1050并且包括闭合触发器1452和闭合连杆组件1460。闭合连杆组件1460可包括可枢转地联接到闭合附接杆1464的闭合连接件1462。闭合附接杆1464可枢转地联接到闭合连接件1467。参见图54。
可结合图53和54来理解用于将轴组件1600联接到框架1480的方法。就本文所公开的其他结构而言,轴组件1600可限定轴线SA-SA,框架1480可限定致动轴线AA-AA。例如,轴线SA-SA可通过击发构件1670限定,致动轴线AA-AA可通过纵向可移动驱动构件1510限定。要开始联接过程,临床医生可将可互换轴组件1600的轴附接模块1620定位在框架1480的框架附接模块1484上方或其附近,使得轴附接模块1620的燕尾连接器1629与框架附接模块1484的燕尾狭槽1488对齐,如图53所示。临床医生可于之后沿着基本上横向于致动轴线AA-AA的安装轴线IA-IA移动轴附接模块1620。换句话讲,轴附接模块1620以基本上横向于致动轴线AA-AA的安装方向“ID”移动,直到燕尾连接器1629坐置在框架模块1484中的燕尾狭槽1488内。参见图55-57。当轴附接模块1620可操作地接合框架附接模块1484时,闭合管附接轭1665将可操作地接合闭合驱系统1450,并且闭合触发器1452的致动将导致外部套管1650和联接于其上的轴闭合管组件的远侧轴向行进,以通过本文所述的各种方式致动砧座。同样,击发构件1270将可操作地接合纵向可移动驱动构件1510。参见图57。从而,击发驱动系统1500的马达(未示出)的致动将导致纵向可移动驱动构件1510和击发构件1670的轴向行进。此类动作将导致以本文所公开的各种方式推动击发构件(未示出)的远侧切割部分使其穿过夹在端部执行器中的组织。
图58-62示出了用于将可互换轴组件1900联接至柄部(未示出)的框架1780的另一种结构,所述柄部在其他方面的功能与本文详细讨论的柄部1042相同。因此,仅将进一步详细地讨论了解轴组件1900的独特和新颖的联接特征所必需的那些细节。然而,本领域的普通技术人员应当了解,可在机器人系统的外壳或其他部分内支撑框架,所述机器人系统以其他方式支撑或容纳多个驱动系统。在其他结构中,框架可包括用于将可互换的轴组件可操作地附接于其上的机器人系统的一部分。
在至少一种形式中,轴组件1900包括轴1910,所述轴可包括上述轴1210的所有其他部件,并且可具有例如可操作地附接于其上的上述类型的端部执行器(未示出)。转到图62,在所示结构中,轴组件1900包括闭合管附接轭1960,所述闭合管附接轭可以如下方式可旋转地联接至外部套管1950:其中闭合管轭组件1260可旋转地联接至外部套管1250。
在各种形式中,轴组件1900可包括具有开口的底部1921的轴附接模块或轴附接部分1920。轴1910通过插入轴1910的近端使其穿过轴附接模块1920的开口1922而联接至轴附接模块1920。可将闭合管附接轭1960插入轴附接模块1920使其穿过开口的底部部分1921,使得外部套管1950的近端1952容纳在闭合管附接轭1660中的架1962内。在上述方式中,U形连接器1966接合外部套管1950的近端1952中的环形沟槽(未示出)和闭合管附接轭1960中的狭槽1964以将外部套管1950附连至闭合管附接轭1960。如上所述,此类结构允许外部套管1950相对于轴附接模块1920旋转。
在至少一种形式中,闭合管附接轭1960能够支撑在轴附接模块1920内,使得闭合管轭组件1960可在远侧(“D”)和近侧(“P”)方向于其中轴向运动。就上述轴组件1210而言,轴框架的近端朝近侧从外部套管1950的近端1952延伸。如可在图62中看到的那样,可在轴框架的近端上形成挡圈1917。U形保持器构件1927可用于在使轴框架相对于轴附接模块1920旋转时,将轴框架的近端保持在该轴向位置。这种结构允许临床医生相对于轴附接模块1920围绕轴线SA-SA旋转轴1910。可在本文所述的各种方式中使用喷嘴组件1990,以有利于轴1910相对于轴附接模块1920的旋转。
可互换轴组件1900还可包括喷嘴组件1990,该喷嘴组件可旋转地支撑在轴附接模块1920上。在至少一种形式中,例如,喷嘴组件1990可由可用螺钉、按扣结构、粘合剂等互连的两个喷嘴半部或部分构成。当安装在轴附接模块1920上时,喷嘴组件1990可与轴旋转适配器1995(其能够接合外部套管1950和轴框架1912)交接,以允许临床医生有选择地相对于轴附接模块1920围绕轴线SA-SA旋转轴1910,轴线SA-SA可由例如击发构件组件的轴线限定。从而,喷嘴组件1990的旋转将导致轴框架和外部套管1950相对于轴附接模块1920围绕轴线A-A旋转。
在至少一种形式中,框架1780具有框架附接模块或形成于其上或附接于其上的框架附接部分1784。可形成具有面朝外的燕尾容纳槽1788的框架附接模块1784。每个燕尾容纳槽1788可以是锥形的,或者换句话讲,可以是稍微V形的。参见图60。狭槽1788能够以可释放的方式可操作地接合形成在轴附接模块1920上的相应面朝内的燕尾连接器部分1929。如可在图60中看到的那样,中间击发轴1972的近端1977朝近侧从轴附接模块1920中延伸并具有形成于其上的轴附接耳1978。轴附接耳1978能够容纳在击发轴附接架1813中,该击发轴附接架形成在纵向可移动驱动构件1810的远端1811中。参见图62。当可互换轴组件1900可操作地接合外科器械、装置、机器人系统等的框架或外壳时,轴附接耳1978容纳在击发轴附接架1813中的可操作接合装置中,该击发轴附接架形成在纵向驱动构件1810的远端1811中。
在至少一种形式中,闭合管附接轭1960具有从其中延伸的朝近侧延伸的轭臂1961,该轭臂具有形成于其上的向下开口的吊钩1963以接合形成在闭合驱系统1750的闭合附接杆1764上的附接耳1766。参见图62。当使轴附接模块1920与框架附接模块1784联接接合时,附接耳1766由在闭合管轭臂1961上形成的吊钩1963吊挂地接合。闭合驱系统1750可类似于上述的闭合驱系统1050并且包括闭合触发器1752和闭合连杆组件1760。闭合连杆组件1760可包括可枢转地联接到闭合附接杆1764的闭合连接件1762。参见图62。闭合触发器1752的致动将导致闭合附接杆1764在远侧方向“D”轴向运动。
就本文所公开的其他结构而言,轴组件1900可限定轴线SA-SA,框架1780可限定致动轴线AA-AA。例如,轴线SA-SA可通过击发构件1970限定,致动轴线AA-AA可通过可操作地由框架1780支撑的纵向可移动驱动构件1810限定。要开始联接过程,临床医生可将可互换轴组件1900的轴附接模块1920定位在框架1780的框架附接模块1784上方或其附近,使得轴附接模块1920的燕尾连接器部分1929与其在框架附接模块1784中的相应燕尾狭槽1788彼此对齐。临床医生可于之后沿着基本上横向于致动轴线AA-AA的安装轴线移动轴附接模块1920。换句话讲,轴附接模块1920在基本上横向于致动轴线AA-AA的安装方向上移动,直到燕尾连接器1929坐置在其在框架模块1784的相应燕尾狭槽1788中的可操作接合装置中。当轴附接模块1920附接到框架附接模块1784时,闭合管附接轭1960将可操作地联接到闭合驱系统1750,并且闭合触发器1752的致动将导致外部套管1950和联接于其上的轴闭合管组件的远侧轴向行进,以通过本文所述的各种方式致动砧座。同样,击发构件将以可操作的接合方式与纵向可移动驱动构件1810联接。参见图62。从而,击发驱动系统1800的马达(未示出)的致动将导致纵向可移动驱动构件1810和击发构件1970的轴向行进。此类动作将导致以本文所公开的各种方式推动击发构件(未示出)的远侧切割部分使其穿过夹在端部执行器中的组织。
图63-66示出了用于将可互换轴组件2200联接至柄部(未示出)的框架2080的另一种结构,所述柄部的功能与本文详细讨论的柄部1042相同。因此,仅将进一步详细地讨论了解轴组件2200的独特和新颖的联接特征所必需的那些细节。然而,本领域的普通技术人员应当了解,可在机器人系统的外壳或其他部分内支撑框架,所述机器人系统以其他方式支撑或容纳多个驱动系统。在其他结构中,框架可包括用于将可互换的轴组件可操作地附接于其上的机器人系统的一部分。
在至少一种形式中,轴组件2200包括轴2210,所述轴可包括上述轴1210的所有其他部件,并且可具有可操作地附接于其上的上述类型的端部执行器(未示出)。这些结构的各种构造和操作如上所述。在所示结构中,轴组件2200包括闭合管附接轭2260,所述闭合管附接轭可以如下方式可旋转地联接至外部套管2250:其中闭合管轭附接轭1260可旋转地联接至外部套管1250。然而,轴组件2200不包括如上所述的轴附接模块。
如可在图63-65中看到的那样,框架2080可在第一框架部分2080A和第二框架部分2080B中形成。在其中框架2080与柄部一起使用的那些应用中,第一和第二框架部分2080A和2080B可彼此与柄部外壳部分相关联。从而,当临床医生希望附接不同的轴组件2200时,临床医生可能必须从彼此上拆下柄部外壳部分。在此类结构中,例如,可通过可移除的紧固件或有利于轻松拆卸外壳部分的其他结构将外壳部分连接在一起。在其他实施例中,轴组件2200可能够用于单次使用。在所示结构中,第一框架部分2080A可以可操作地支撑其中的各种驱动系统,第二框架部分2080B可包括框架部分,所述框架部分以可操作的接合方式将轴组件2200的各个部件保持在由第一框架部分2080A支撑的其相应驱动系统部件中。
在至少一种形式中,闭合管附接轭2260能够支撑在框架2080的通道2081内,使得闭合管附接轭2260可在远侧和近侧方向于其中轴向运动。就上述轴组件1210而言,轴框架2212的近端2214朝近侧从外部套管2250的近端2252延伸。如可在图63中看到的那样,可在轴框架2212的近端2214上形成挡圈2217。挡圈2217可适于可旋转地容纳在形成在框架2080中的环形沟槽2083内。此类结构用于可操作地将轴框架2212联接到框架2080以在使轴框架2212相对于框架2080旋转时,防止这些部件之间的任何相对轴向运动。这种结构还允许临床医生相对于框架围绕轴线SA-SA旋转轴2210。本领域的普通技术人员应当了解,上述的喷嘴结构可用于相对于框架2080围绕轴线SA-SA旋转轴2210。例如,喷嘴部分(未示出)可围绕外部套管2250组装并通过外部套管2250中的窗口2253接合轴框架2212中的凹口2218。参见图64。
如可在图64中看到的那样,中间击发轴2272的近端2277朝近侧从轴框架2212的近端2214延伸并具有形成于其上的轴附接耳2278。形成在纵向可移动驱动构件2110的远端2111中的击发轴附接架2113被形成为允许击发轴附接耳2278从侧面装入。为有助于临床医生在组装期间使轴组件2220以及第一和第二框架部分2080A和2080B的部件对齐,第二框架部分2080B可设置有耳2090,所述耳能够容纳在形成在第一框架部分2080A中的相应孔或凹坑2091内,反之亦然。在其中不期望使轴组件2200从框架2080上拆下的那些应用中,凹坑2090可能够永久地夹持或接合插入其中的耳2090。
第一框架部分2080A和/或可活动地由第一框架部分2080A支撑的纵向可移动驱动构件2110可以限定致动轴线A-A,轴组件2200限定轴线SA-SA。如可在图64中看到的那样,要开始联接过程,轴组件2200和第一框架部分2080A可相对于彼此取向,使得轴线SA-SA基本上平行于致动轴线AA-AA,并且使得环2217沿着基本上横向于致动轴线的安装轴线IA侧向地对齐,其中环形沟槽2083和轴附接耳2278沿着也基本上横向于致动轴线AA-AA的另一条安装轴线IA-IA侧向地对齐。然后,轴组件2200在基本上横向于致动轴线AA-AA的安装方向“ID”移动,直到闭合管附接轭2260坐置在形成在第一框架部分2080A中的通道2081的一部分内,环2217坐置在形成在第一框架部分2080A中的环形沟槽2083的一部分内,轴附接耳2278坐置在形成在纵向可移动驱动构件2110中的轴附接架2113内。在另一个结构中,轴组件2200和第一框架部分2080A可以类似的方式放在一起,方法是保持轴组件2200固定并朝柄部组件2200移动第一框架部分2080A,直到上述部件部分可操作地坐置在一起,或柄部组件2200和第一框架部分2080A可每者朝彼此移动,直到其坐置在一起。一旦柄部组件2200如图63所示可操作地坐置在第一框架部分2080A内,第二框架部分2080B即可与第一框架部分2080A连接,方法是使柱2090与其相应的孔或凹坑2091对齐并将部件连接在一起。第一和第二框架部分2080A和2080B可通过紧固件(如,螺钉、螺栓等)、粘合剂和/或按扣结构固定在一起。在其他结构中,当第一框架部分2080A和第二框架部分2080B的各自的外壳段连接在一起时,其可以联接接合的方式固定在一起。
一旦第一和第二框架部分2080A、2080b已如图65和66所示连接在一起,然后临床医生便可将闭合驱动系统2050联接至闭合管附接轭2260。闭合驱动系统2050可类似于上文所述的闭合驱动系统1050且包括闭合触发器2052和闭合连杆组件2060。闭合连杆组件可包括枢转地联接至闭合附接杆2064的闭合连接件2062。此外,另一闭合连接件2067枢转地联接至闭合附接杆2064。闭合连接件2067可能够用于闭合管附接轭2260通过销轴2269的至臂2261的枢转附接。参见图66。
图68-74示出用于将可互换轴组件2500联接至框架2380的另一结构。框架2380可与本文所述的柄部一起使用或者可与机器人系统结合使用。在至少一种形式中,轴组件2500包括轴2510,轴2510可包括上文所述的轴1210的其他部件的全部且可具有上文所述的可操作地附接至轴2510的类型的端部执行器(未示出)。这些结构的各种构造和操作如上所述。如可在图68-74中看到,轴组件2500包括轴附接模块或轴附接部分2520,轴附接模块或轴附接部分2520能够枢转地接合如将在下文进一步详细地讨论的框架2380的框架附接模块部分2384。轴附接模块2520例如可具有轴2510的近端穿过其延伸的衬圈部2522。轴附接模块2520与框架2380的框架附接模块部分2384协作以于其中形成通道2581以用于可移动地支撑其中的闭合管附接轭2560。闭合管轭组件2560可支撑在轴附接模块2520的一部分上且能够支撑在通道2581内使得闭合管轭组件2560可于其中在远侧和近侧方向上轴向地移动。就上文所述的轴组件而言,轴框架2512的近端可旋转地联接至轴附接模块2520使得其可相对于轴附接模块2520旋转。外部套管2550的近端以上文所述的方式可旋转地联接至闭合管附接轭2560使得其可相对于闭合管附接轭2560旋转。在各种形式中,喷嘴2590可以上文所述的方式使用以绕着轴线SA-SA相对于框架轴附接模块2520旋转轴2510。
如可在图68-70中进一步看到,中间击发轴2572的近端2577向近侧从闭合管附接轭2560延伸且具有形成于其上的轴附接耳2578。形成在纵向可移动驱动构件2410的近端2411中的击发轴附接架2413被形成为允许击发轴附接耳2578从侧面装入。
如可在图69中看到,框架附接模块部分2384具有一对形成于其中适用于容纳形成在轴附接模块2520上的对应枢转耳2529的枢转架2385。当耳2529支撑在枢转架2385内时,轴附接模块2520可枢转成与如图70所示的框架附接模块2384的可操作接合。具体地讲,耳2529可限定可基本上横向于致动轴线AA-AA的枢转轴线PA-PA。参见图73。轴附接模块2520可具有侧向延伸的锁销2591,锁销2591能够锁闭地接合框架附接模块2384中的锁坑2387。为启动联接过程,使中间击发轴2572可操作地在基本上横向于致动轴线AA-AA的方向上与纵向可移动驱动构件接合。
一旦轴附接模块2520已锁闭至如图72和73所示的框架附接模块2384,然后临床医生便可将闭合驱动系统(其可类似于本文所述的闭合驱动系统)联接至闭合管附接轭2560。
本文公开的各种可互换轴结构代表对采用专用轴的先前外科器械结构的巨大改进。例如,一个轴结构可用在多个柄部结构上和/或与机器人控制的外科系统一起使用。联接轴结构的方法也不同于先前的轴结构,先前的轴结构采用卡口连接以及在联接过程期间需要对轴和/或柄部或外壳施加旋转运动的其他结构。本文公开的轴组件所采用的联接过程的各种示例性描述包括使可互换轴组件的一部分在基本上横向于致动轴线的方向或取向上与外壳、柄部和/或框架的对应部分联接接合。这些联接过程意在涵盖轴组件及外壳、柄部和/或框架中的一者或两者的在联接过程期间的运动。例如,一种方法可涵盖在将轴组件移动至与柄部、外壳和/或框架联接接合的同时使所述柄部、外壳和/或框架保持固定。另一种方法可涵盖在将柄部、外壳和/或框架移动至与轴组件联接接合的同时使所述轴组件保持固定。又另一种方法可涉及将轴组件和柄部、外壳和/或框架同时一起移动至形成联接接合。应当理解,为联接本文所公开的各种轴组件结构所采用的联接程序可涵盖此类变型形式的一者或多者(包括全部)。
参见图75-80,示出了可与上文所述的柄部1042基本上相同的柄部2642,但是框架2680的框架附接模块或框架附接部分2684包括锁定组件2690用于防止闭合驱动系统1750的意外致动。如可在图75和76中看到,例如,近侧锁定狭槽段2692形成在框架附接模块2684中使得,在可互换轴组件1900’附接至其上之前,闭合附接杆1764上的对应附接耳1066可滑动地容纳在其中。因此,当闭合附接杆1764在该位置中时,临床医生不能致动闭合驱动系统。换句话讲,当致动耳1766容纳在近侧锁定狭槽段2692中时,临床医生不能致动闭合触发器1752。在各种形式中,仅可采用一个近侧锁定狭槽段2692。在其他形式中,提供两个近侧锁定狭槽段2692使得每个附接耳1766可容纳在对应的近侧锁定狭槽段2692中。在各种形式中,可使用锁定弹簧2695来偏置连杆组件1760,使得当闭合触发器1752在未致动位置中时,闭合附接杆1764被偏置至一位置,在该位置中,附接耳1766的至少一者容纳在近侧锁定狭槽段2692中。
如可在图77和78中看到,锁定组件2690还可包括远侧耳狭槽2694,远侧耳狭槽2694形成在轴附接模块1920’中且被定位使得当轴附接模块1920’已完全附接至框架2680时,远侧耳狭槽2694打开通向如图77和78所示的近侧锁定狭槽段2692。
通过参考图76-80可理解闭合锁定组件2690的操作。图76示出在闭合触发器1752未致动时闭合附接杆1764的位置。如可在该图中看到,当在该位置中时,附接耳1766容纳在对应的近侧锁定狭槽段2692中。因此,如果临床医生试图当在该位置中时(即,在以可操作接合的方式将可互换轴组件1900’可操作地附接至框架2680之前)致动闭合触发器1752,则临床医生将不能致动闭合驱动系统1750。在临床医生已将可互换轴组件1900’附接至框架2684使得可互换轴组件1900’以可操作接合的方式充分坐置且完全附接之后,轴附接模块1920”中的远侧锁定狭槽段2694将打开通向如图77和78所示的近侧锁定狭槽段2692。在轴附接模块1920”插入至与框架附接模块2684可操作地接合时,向近侧从闭合管附接轭1960延伸的轭臂1961将使附接耳1766卡在向下打开的狭槽1963中并驱动附接耳1766至如图79所示的近侧锁定狭槽2692的底部。然后,当临床医生需要通过致动闭合触发器1752来致动闭合驱动系统1750时,闭合连杆组件1760将在远侧方向“D”上被驱动。由于闭合附接杆1764向远侧推进,因此允许附接耳1766向远侧推进到远侧锁定狭槽2694中以获得必要的距离,例如,以导致砧座的闭合或者向可操作地联接至端部执行器轴组件1900’的端部执行器施加对应的致动运动。图80示出了当闭合驱动系统1750已充分致动时,例如当闭合触发器1752已充分按压时,闭合附接杆1764的位置。
图81-85示出了用于防止闭合驱动系统1750的意外致动直至可互换轴组件1900’已以可操作接合的方式与框架2680联接的另一锁定组件2690’。在至少一种形式中,锁定肩部2696形成在框架附接模块或框架附接部分2684’上使得当可互换轴组件1900’未以可操作接合的方式与框架2680联接时,由肩部2696防止闭合附接杆1764在远侧方向“D”上运动。参见图81。由于轴附接模块1920’插入至与框架附接模块2684’可操作地接合,因此向近侧从闭合管附接轭1960延伸的轭臂1961将使附接耳1766卡在闭合附接杆1764中并驱动闭合附接杆1764至如图82和83所示的“解锁”位置。如可在图82中具体地看到,当在解锁位置中时,闭合附接杆1764位于低于框架附接模块2684’上的肩部2696下方。当闭合附接杆在解锁位置中时,其可在通过按压致动触发器1752来致动闭合驱动系统1750时向远侧推进。
图86-91示出了另一可互换轴组件1900”以及采用锁定组件2700来防止闭合驱动系统1750”的意外致动的柄部2642。如可在图88和89中看到,锁定组件2700的一种形式包括致动器滑动构件2720,致动器滑动构件2720可滑动地轴接到形成在框架附接模块或框架附接部分2684”上的向远侧延伸的锁定底脚2710中。具体地讲,在至少一种形式中,致动器滑动构件2720具有容纳在形成在锁定底脚2710中的对应狭槽2712中的两个向侧向延伸的滑动插片2722。参见图86。致动器滑动构件2720枢转地联接至闭合驱动系统1750”的闭合附接杆1764”并具有形成于其中适用于容纳闭合管附接轭1960’上的向下延伸的致动器插片2702的致动器凹坑2724。就上文所述的闭合管附接轭1960而言,闭合管附接轭1960’以本文所述的各种方式可旋转地附设至在轴附接模块1920’内轴向可移动的外部套管1950。
如可在图88-89中看到,锁定组件2700还可包括容纳在形成在锁定底脚2710中的空腔2714中的可移动锁定构件2730。锁定构件2730具有锁定部分2732,锁定部分2732经定尺寸以延伸到致动器凹坑2724中使得当在“锁定”位置中时,锁定构件2730防止致动器滑动构件2720相对于锁定底脚2710的远侧运动。如可在图89中最具体地看到,锁簧2734提供在空腔2714中以将锁定构件2730偏置到锁定位置中。
图89示出了在锁定位置中的锁定组件2700。当在该位置中时,锁定部分2732位于致动器凹坑2724中且从而防止滑动构件2720的远侧运动。因此,如果临床医生试图通过按压闭合触发器1752来致动闭合驱动系统1750”,则锁定部分2732将防止滑动构件2720的推进。图90示出了在闭合管轭1960’上的致动器插片2702已插入致动器凹坑2724中并且已将锁定构件2730偏置到空腔2714的底部中的“解锁”位置中之后锁定构件2370的位置,在所述“解锁”位置中,致动器滑动构件2720可向远侧推进。图91示出了在闭合触发器1752已完全按压以从而轴向地推进闭合管附接轭1960’和附接至闭合管附接轭1960’的外部套管1950之后致动器滑动构件2720的位置。
图92-98示出了另一可互换轴组件1900”以及采用锁定组件2800来防止闭合驱动系统1750”的意外致动的柄部2642”。闭合驱动系统1750”可类似于上文所述的闭合驱动系统1050和1750且包括闭合触发器1752和闭合连杆组件1760’。闭合连杆组件1760’可包括枢转地联接至闭合附接杆1764的闭合连接件1762’。此外,致动器滑动构件2720可枢转地附接至闭合附接杆1764并且还可以可滑动地轴接在形成在框架附接模块2684”上的向远侧延伸的锁定底脚2710中。具体地讲,在至少一种形式中,致动器滑动构件2720具有容纳在形成在锁定底脚2710中的对应狭槽2712中的两个向侧向延伸的滑动插片2722。参见图92。致动器滑动构件2720枢转地联接至闭合驱动系统1750”的闭合附接杆1764并具有形成于其中适用于容纳闭合管附接轭1960’上的向下延伸的致动器插片2702的致动器凹坑2724。就上文所述的闭合管附接轭1960而言,闭合管附接轭1960’以本文所述的各种方式可旋转地附设至在轴附接模块1920”内轴向可移动的外部套管1950。
在各种形式中,锁定组件2800还可包括枢转地附接至框架附接模块2684”的可移动锁棒或锁定构件2802。例如,锁棒2802可枢转地安装到框架附接模块2684”上的向侧向延伸的销轴2804。锁棒2802还可具有从其近侧部分延伸的、能够当闭合驱动系统1750”未致动时延伸进入提供在闭合连接件1762’中的锁定狭槽2808中的锁销2806。参见图94。锁销2806可延伸穿过提供在附接至框架2680’的侧板2810中的锁定狭槽2812。锁定狭槽2812可用来在锁定位置(图92-94)与解锁位置(图95-98)之间引导锁销2806。
当锁定组件在锁定位置中时,锁销2806容纳在闭合连接件1762’中的锁定狭槽2808中。当在该位置中时,锁销防止闭合连杆组件1760’的运动。因此,如果临床医生试图通过按压闭合触发器1752来致动闭合驱动系统1750”,则锁销2806将防止闭合连接件1762的运动并最终防止滑动构件2720的推进。图95-98示出了在轴附接模块1920”已以可操作接合的方式与框架附接模块2684”联接之后锁棒2602的位置。当在该位置中时,框架附接模块2684”上的锁释放部分2820接触锁棒2802并导致其枢转以从而将锁销2806从闭合连接件1762’中的锁定狭槽2808中移出。如还可在图97和98中看到,当轴附接模块1920”已以可操作接合的方式与框架附接模块2684”联接时,闭合管轭1960’上的致动器插片2702坐置在致动器滑动构件2720中的致动器凹坑2724中。图98示出了在闭合触发器1752已完全按压以从而在远侧方向“D”上轴向地推进闭合管附接轭1960’和附接至闭合管附接轭1960’的外部套管1950之后致动器滑动构件2720的位置。
现在参见图99-101,示出了轴锁定组件2900,轴锁定组件2900能够防止击发构件1270的轴向运动,除非可互换轴组件已以可操作接合的方式与外科器械联接。更具体地讲,除非击发构件已以可操作接合的方式与纵向可移动驱动构件1110(纵向可移动驱动构件1110可在图88中看到)联接,否则轴锁定组件2900便可防止击发构件1270的轴向运动。在至少一种形式中,轴锁定组件2900可包括轴锁定构件或具有轴锁板2902,轴锁板2902具有穿过轴锁板2902的轴隙孔2904且由轴附接框架或模块1920”的一部分支撑以在基本上横向于轴线SA-SA的方向“LD”上可滑动地行进。参见图99。轴锁板2902可例如在图100所示的锁定位置之间运动,其中轴锁板2902延伸进入附接耳1278与中间击发轴部分1272的近端1277之间的凹陷区域1279中。当在该锁定位置中时,轴锁板2902防止中间击发轴部分1272的任何轴向运动。可由锁簧2906或其他偏置结构将轴锁板2902偏置到锁定位置中。注意,清楚起见,图99示出了处于解锁构造的锁板2902。当可互换轴组件未附接至外科器械时,锁板2902被偏置到如图100所示的锁定位置中。应当理解,当可互换轴组件未以可操作接合的方式与外科器械(例如,手持式器械、机器人系统等)附接时,此类结构防止击发构件1270的任何意外轴向运动。
如上文详细的描述,在可互换轴组件联接至外科器械期间,中间击发轴部分1272的端部上的附接耳1278进入纵向可移动驱动构件1110的远端中的支架1113。参见图88。由于附接耳1278进入支架1113,因此纵向可移动驱动构件1110的远端接触轴锁板2902并将其移动至解锁位置(图101),其中纵向可移动驱动构件1110的远端和中间击发轴部分1272的近端1277可响应于施加至纵向可移动驱动构件1110的致动运动而在轴隙孔2904内轴向地运动。
现在转到图102-112,外科器械,诸如外科器械10000,和/或任何其他外科器械,诸如外科器械系统1000,例如可包括轴10010和端部执行器10020,其中端部执行器10020可相对于轴10010做关节运动。除上述之外,外科器械10000可包括轴组件,轴组件包括轴10010和端部执行器10020,其中轴组件可以可移除地附接至外科器械10000的柄部。主要参见图102-104,轴10010可包括轴框架10012,且端部执行器10020可包括端部执行器框架10022,其中端部执行器框架10022可围绕关节运动接头10090可旋转地联接至轴框架10012。就关节运动接头10090而言,在至少一个实例中,轴框架10012可包括可容纳在限定在端部执行器框架10022中的枢轴孔10024内的枢轴销10014。端部执行器框架10022还可包括从其延伸的可与关节运动驱动器可操作地接合的驱动销10021。驱动销10021可能够接收对其施加的力,并且根据对驱动销10021施加力的方向,在第一方向或第二相反方向上旋转端部执行器10020。更具体地讲,当由关节运动驱动器在远侧方向上对驱动销10021施加力时,关节运动驱动器可围绕枢轴销10014推动驱动销10021,并且类似地,当由关节运动驱动器在近侧方向上对驱动销10021施加力时,关节运动驱动器可围绕枢轴销10014,例如,在相反方向上拉动驱动销10021。考虑到驱动销10021将放置在,例如,关节运动接头10090的相反侧上,因此关节运动驱动器的远侧和近侧运动将对端部执行器10020产生相反的作用。
除上述之外,再次参加图102-104,外科器械10000可包括关节运动驱动器系统,该关节运动驱动器系统包括近侧关节运动驱动器10030和远侧关节运动驱动器10040。当驱动力传输至近侧关节运动驱动器10030时,无论其在近侧方向上还是在远侧方向上,驱动力均可穿过关节运动锁10050而传输至远侧关节运动驱动器10040,如下文更详细的描述。在各种情况下,除上述之外,可利用外科器械10000的击发构件10060来将此类驱动力传递至近侧关节运动驱动器10040。例如,主要参见图102-112,外科器械10000可包括离合器系统10070,离合器系统10070可能够选择性地将近侧关节运动驱动器10030连接至击发构件10060使得击发构件10060的运动可传递至近侧关节运动驱动器10030。在使用时,离合器系统10070可以是在接合状态(图102-108和111)与脱离状态(图109、110和112)之间可运动的,在接合状态中,近侧关节运动驱动器10030与击发构件10060可操作地接合,在脱离状态中,近侧关节运动驱动器10030不与击发构件10060可操作地接合。在各种情况下,离合器系统10070可包括可能够将近侧关节运动驱动器10030直接连接至击发构件10060的接合构件10072。接合构件10072可包括至少一个驱动齿10073,当离合器系统10070在其接合状态中时,所述至少一个驱动齿10073容纳在限定在击发构件10060中的驱动凹陷10062中。在某些情况下,主要参见图28和31,接合构件10072可包括延伸至近侧关节运动驱动器10030的一侧的第一驱动齿10073以及延伸至近侧关节运动驱动器10030的另一侧以便接合限定在击发构件10060中的驱动凹陷10062的第二驱动齿10073。
除上述之外,再次参见图102-112,离合器系统10070还可包括致动器构件10074,致动器构件10074可能够围绕安装到近侧关节运动驱动器10030的近端10039(图104A)的枢轴销10071旋转或枢转接合构件10072。致动器构件10074可包括第一或外突起10076以及第二或内突起10077,在这两者之间可限定能够容纳限定在接合构件10072中的控制臂10079的凹陷10078。当致动器构件10074旋转远离击发构件10060时,即远离轴10010的纵向轴线时,内突起10077可接触接合构件10072的控制臂10079并将接合构件10072旋转远离击发构件10060以将驱动齿10073移出驱动凹口10062并且因此将接合构件10072从击发构件10060中脱离。同时,接合构件10072还可从近侧关节运动驱动器10030中脱离。在至少一种情况下,近侧关节运动驱动器10030可包括限定在其中的驱动凹口10035,驱动凹口10035还能够当接合构件10072在接合位置中时容纳驱动齿10073的一部分,其中类似于上文,当接合构件10072运动进入其脱离位置中时,驱动齿10073可从驱动凹口10035中移除。在某些其他情况下,主要参见图108,驱动齿10073可在其间限定可容纳在驱动凹口10035中的凹陷10083。在任一事件中,在某种程度上,接合构件10072可能够,其一,当接合构件10072在其接合位置中时同时接合近侧关节运动驱动器10030中的驱动凹口10035以及击发构件10060中的驱动凹口10062,以及其二,接合构件10072运动进入其脱离位置中时同时从驱动凹口10035和驱动凹口10062中脱离。通过继续参见图102-104,致动器构件10074可以可旋转或可枢转地安装到经由枢轴销10075至少部分地围绕轴10010的外壳。在一些情况下,枢轴销10075可安装到柄部框架10001和/或围绕柄部框架10001的柄部外壳,诸如包括,例如,如图131所示的部分11002和11003的柄部外壳。外科器械10000还可包括至少部分地围绕所述枢轴销10075的扭转弹簧10080,扭转弹簧10080可能够将旋转偏置传递至致动器构件10074以便朝着击发构件10060偏置致动器10074和接合构件10072以及将接合构件10072偏置到其接合位置中。为此,致动器构件10074的外突起10076可接触接合构件10072的控制臂10079并围绕枢轴销10071向内枢转接合构件10072。
当比较图108和109时,除上述之外,读者将注意到,离合器系统10070已在其接合状态(图108)与其脱离状态(图109)之间运动。可在图111与112之间进行类似比较,其中读者应理解,轴10010的闭合管10015已从近侧位置(图111)推进至远侧位置(图112)以使离合器系统10070在其接合状态(图111)与其脱离状态(图112)之间运动。更具体地讲,致动器构件10074可包括凸轮从动臂10081,凸轮从动臂10081可由闭合管10015接触并且当闭合管10015向远侧推进以关闭例如端部执行器10020的砧座时位移进入其脱离位置中。闭合管与砧座的相互作用在本申请的其他地方讨论,为了简洁起见,不再重复。在各种情况下,主要参见图107,致动器构件10074的凸轮从动臂10081可定位在限定在闭合管10015中的窗口10016内。当离合器系统10070在其接合状态中时,窗口10016的边缘或侧壁10017可接触凸轮从动臂10081并围绕枢轴销10075枢转致动器构件10074。实际上,窗口10016的侧壁10017可在闭合管10015运动进入其远侧或闭合位置中时充当凸轮。在至少一种情况下,致动器构件10074可包括从其延伸的止挡件,止挡件可能够,例如,接合柄部的外壳,并限制致动器构件10074的行进。在某些情况下,轴组件可包括定位在轴组件的外壳与从致动器构件10074延伸的凸缘10082中间的弹簧,凸缘10082可能够将致动器构件10074偏置到其接合位置中。在上文所讨论的闭合管10015的远侧闭合位置中,闭合管10015可保持定位在凸轮从动臂10081下面以将离合器系统10070固定在其脱离状态中。在此类脱离状态中,击发构件10060的运动不传送至近侧关节运动驱动器10030,和/或关节运动驱动器系统的任何其他部分。当闭合管10015回缩到其近侧或打开位置中时,闭合管10015可从致动器构件10074的凸轮从动臂10081下面移除,使得弹簧10080可将致动器构件10074偏置回到窗口10016中并允许离合器系统10070重新进入其接合状态中。
当近侧关节运动驱动器10030经由离合器系统10070与击发构件10060可操作地接合时,除上述之外,击发构件10060可使近侧关节运动驱动器10030向近侧和/或向远侧运动。例如,击发构件10060的近侧运动可使近侧关节运动驱动器10030向近侧运动,并且类似地,击发构件10060的远侧运动可使近侧关节运动驱动器10030向远侧运动。主要参见图102-104,近侧关节运动驱动器10030的运动,无论其为近侧或远侧,可解锁关节运动锁10050,如下文更详细的描述。通过主要参见图102,关节运动锁10050可包括与远侧关节运动驱动器10040的框架10042共同存在的框架。共同地,关节运动锁10050的框架和框架10042可在后文统称为框架10042。框架10042可包括限定在其中的第一或远侧锁腔10044和第二或近侧锁腔10046,其中第一锁腔10044和第二锁腔10046可通过中间框架构件10045分离。关节运动锁10050还可包括至少部分地定位在第一锁腔10044内的至少一个第一锁元件10054,所述至少一个第一锁元件10054可能够抑制或防止远侧关节运动驱动器10040的近侧运动。就图102-104所示的特定实施例而言,在第一锁腔10044内定位有可全部以类似、平行的方式作用并且可以可协作地充当单个锁元件的三个第一锁元件10054。预期可利用多于三个或少于三个第一锁元件10054的其他实施例。类似地,关节运动锁10050还可包括至少部分地定位在第二锁腔10046内的至少一个第二锁元件10056,所述至少一个第二锁元件10056可能够抑制或防止远侧关节运动驱动器10040的远侧运动。就图102-104所示的特定实施例而言,在第二锁腔10046内定位有可全部以类似、平行的方式作用并且可以可协作地充当单个锁元件的三个第二锁元件10056。预期可利用多于三个或少于三个第二锁元件10056的其他实施例。
除上述之外,主要参见图104A,每个第一锁元件10054可包括锁孔10052和锁定柄脚10053。锁定柄脚10053可设置在第一锁腔10044内,锁孔10052可与安装到轴框架10012的框架导轨10011可滑动地接合。再次参见图102,框架导轨10011延伸穿过第一锁元件10054中的孔10052。如读者将注意到,通过进一步参见图102,第一锁元件10054不以与框架导轨10011垂直的结构取向;相反,第一锁元件10054以关于框架导轨10011的非垂直的角度设置和对齐,使得锁孔10052的边缘或侧壁与框架导轨10011接合。此外,锁孔10052的侧壁与框架导轨10011的相互作用可在其之间形成抵抗或摩擦力,该抵抗或摩擦力可抑制第一锁元件10054与框架导轨10011之间的相对运动,并且因此抑制施加至远侧关节运动驱动器10040的近侧推力P。换句话讲,第一锁元件10054可防止或至少部分地抑制端部执行器10020在箭头10002指示的方向上旋转。如果在箭头10002的方向上向端部执行器10020施加扭矩,近侧推力P将从自端部执行器10024的框架10022延伸的驱动销10021传递至远侧关节运动驱动器10040的框架10042。在各种情况下,驱动销10021可紧密容纳在限定在远侧关节运动驱动器10040的远端10041中的销狭槽10043内,使得驱动销10021可抵靠销狭槽10043的近侧侧壁并将近侧推力P传递至远侧关节运动器10040。但是,除上述之外,近侧推力P将仅用来支持第一锁元件10054与框架导轨10011之间的锁定接合。更具体地讲,近侧推力P可传输至第一锁元件10054的柄脚10053,这可导致第一锁元件10054旋转并减小限定在第一锁元件10054与框架导轨10011之间的角度,并且因此增强锁孔10052的侧壁与框架导轨10011之间的咬合。最后,第一锁元件10054可将远侧关节运动驱动器10040的运动锁定在一个方向上。
为了释放第一锁元件10054并允许端部执行器10020以箭头10002指示的方向旋转,现在参见图103,可将近侧关节运动驱动装置10030朝近侧拉动以使第一锁元件10054伸直或至少基本上伸直成垂直或至少基本上垂直的位置。在这一位置,锁孔10052的侧壁和框架导轨10011之间的咬合或阻力可充分减小或消除,使得远侧关节运动驱动装置10040可朝近侧运动。为了使第一锁元件10054伸直成图103所示的位置,可将近侧关节运动驱动装置10030朝近侧拉动,使得近侧关节运动驱动装置10030的远侧臂10034接触第一锁元件10054,从而将第一锁元件10054拉动并旋转至其伸直位置。在各种情况下,可将近侧关节运动驱动装置10030继续朝近侧拉动,直到从那里延伸的近侧臂10036接触或邻接框架10042的近侧驱动壁10052并将框架10042朝近侧拉动,以使端部执行器10002进行关节运动。本质上,可将近侧拉力从近侧关节运动驱动装置10030通过近侧臂10036和近侧驱动壁10052之间的相互作用施加至远侧关节运动驱动装置10040,其中这一拉力可通过框架10042传递至驱动销10021以使端部执行器10020以箭头10002指示的方向进行关节运动。在端部执行器10020已在箭头10002的方向适当进行关节运动之后,在各种情况下,可将近侧关节运动驱动装置10040释放,以允许关节运动锁10050将远侧关节运动构件10040和端部执行器10020重新锁定就位。在各种情况下,关节运动锁10050可包括弹簧10055,其定位在第一锁元件10054组和第二锁元件10056组中间,可在第一锁元件10054伸直以解锁远侧关节运动驱动装置10040的近侧运动时压缩,如上所讨论。释放近侧关节运动驱动装置10030时,弹簧10055可以弹性地重新伸展以将第一锁元件10054推动至图102中所示的倾斜位置。
同时,再次参见图102和103,当第一锁元件10054如上所述锁定和解锁时,第二锁元件10056可保留在倾斜位置。读者将理解,尽管第二锁元件10056相对于轴导轨10011以倾斜位置布置和对齐,但第二锁元件10056不能够阻碍或至少基本上不能够阻碍远侧关节运动驱动装置10040的近侧运动。当远侧关节运动驱动装置10040和关节运动锁10050如上所述朝近侧滑动时,在各种情况下,第二锁元件10056可沿框架导轨10011朝远侧滑动而不会更改或至少基本上不会更改其相对于框架导轨10011的倾斜对齐。当第二锁元件10056允许远侧关节运动驱动装置10040和关节运动锁10050的近侧运动时,第二锁元件10056可以能够有选择地阻止或至少抑制远侧关节运动驱动装置10040的远侧运动,如下文更详细地讨论。
与上文相似,主要参见图104A,每个第二锁元件10056可以包括锁孔10057和锁柄10058。锁柄10058可以设置在第二锁腔10046内,并且锁孔10057可与安装在轴框架10012上的框架导轨10011可滑动地接合。再次参见图102,框架导轨10011延伸穿过第二锁元件10056中的孔10057。另外参见图102,读者将注意到,第二锁元件10056没有取向为与框架导轨10011垂直布置;而是第二锁元件10056相对于框架导轨10011以非垂直角度布置和对齐,使得锁孔10057的边缘或侧壁与框架导轨10011接合。此外,锁孔10057的侧壁与框架导轨10011之间的相互作用可以在它们之间产生阻力或摩擦力,这可以抑制第二锁元件10056与框架导轨10011之间的相对运动,从而抵抗施加至远侧关节运动驱动装置10040的远侧力D。换句话说,第二锁元件10056可以阻止或至少抑制端部执行器10020在箭头10003指示的方向旋转。如果在箭头10003指示的方向向端部执行器10020施加扭矩,远侧拉力D将从自端部执行器10024的框架10022延伸的驱动销10021传递至远侧关节运动驱动装置10040的框架10042。在各种情况下,驱动销10021可以紧密容纳在远侧关节运动驱动装置10040的远端10041中限定的销狭槽10043内,使得驱动销10021可以抵靠销狭槽10043的远侧侧壁并将远侧拉力D传递至远侧关节运动驱动装置10040。然而,除上述之外,远侧拉力D将仅用来支持第二锁元件10056和框架导轨10011之间的锁定接合。更具体地讲,远侧拉力D可以传送至第二锁元件10056的柄10058,这可以导致第二锁元件10056旋转并减少第二锁元件10056和框架导轨10011之间限定的角度,从而增强锁孔10057的侧壁与框架导轨10011之间的咬合。最后,第二锁元件10056可以将远侧关节运动驱动装置10040的运动锁定在一个方向。
为了释放第二锁元件10056并允许端部执行器10020在箭头10003指示的方向旋转,现在参见图104,可将近侧关节运动驱动装置10030朝远侧推动以使第二锁元件10056伸直或至少基本上伸直成垂直或至少基本上垂直的位置。在这一位置,锁孔10057的侧壁和框架导轨10011之间的咬合或阻力可充分减小或消除,使得远侧关节运动驱动装置10040可朝远侧移动。为了使第二锁元件10056伸直成图104所示的位置,可将近侧关节运动驱动装置10030朝远侧拉动,使得近侧关节运动驱动装置10030的近侧臂10036接触第二锁元件10056,从而将第二锁元件10056推动并旋转至其伸直位置。在各种情况下,可将近侧关节运动驱动装置10030继续朝远侧推动,直到从那里延伸的远侧臂10034接触或邻接框架10042的远侧驱动壁10051并将框架10042朝远侧推动,以使端部执行器10020进行关节运动。本质上,可将远侧推力从近侧关节运动驱动装置10030通过远侧臂10034和远侧驱动壁10051之间的相互作用施加至远侧关节运动驱动装置10040,其中这一推力可通过框架10042传递至驱动销10021以使端部执行器10020以箭头10003指示的方向进行关节运动。在端部执行器10020已在箭头10003的方向适当进行关节运动之后,在各种情况下,可将近侧关节运动驱动装置10040释放,以允许关节运动锁10050将远侧关节运动构件10040和端部执行器10020重新锁定就位。与上文相似,在各种情况下,定位在第一锁元件10054组和第二锁元件10056组中间的弹簧10055可以在第二锁元件10056伸直以解锁远侧关节运动驱动装置10040的远侧运动时压缩,如上所讨论。释放近侧关节运动驱动装置10040时,弹簧10055可以弹性地重新伸展以将第二锁元件10056推动至图102中所示的倾斜位置。
同时,再次参见图102和104,当第二锁元件10056如上所述锁定和解锁时,第一锁元件10054可保留在倾斜位置。读者将理解,尽管第一锁元件10054相对于轴导轨10011以倾斜位置布置和对齐,但第一锁元件10054不能够阻碍或至少基本上不能够阻碍远侧关节运动驱动装置10040的远侧运动。当远侧关节运动驱动装置10040和关节运动锁10050如上所述朝远侧滑动时,在各种情况下,第一锁元件10054可沿框架导轨10011朝远侧滑动而不会更改或至少基本上不会更改其相对于框架导轨10011的倾斜对齐。当第一锁元件10054允许远侧关节运动驱动装置10040和关节运动锁10050的远侧运动时,第一锁元件10054可以能够有选择地阻止或至少抑制远侧关节运动驱动装置10040的近侧运动,如上文所讨论。
根据上文,锁定状态下的关节运动锁10050可以能够阻止远侧关节运动驱动装置10040的近侧和远侧运动。在阻力方面,关节运动锁10050可以能够阻止或至少基本上阻止远侧关节运动驱动装置10040的近侧和远侧运动。总的来说,当第一锁元件10054为锁定取向时,远侧关节运动驱动装置10040的近侧运动被第一锁元件10054阻止,当第二锁元件10056为锁定取向时,远侧关节运动驱动装置10040的远侧运动被第二锁元件10056阻止,如上所述。换句话说,第一锁元件10054包括第一单向锁,第二锁元件10056包括以相反方向锁定的第二单向锁。
再次参见图102和如上所讨论,当第一锁元件10054处于锁定构造时,尝试将远侧关节运动驱动装置10040朝近侧运动可能只会进一步减小第一锁元件10054和框架导轨10011之间的角度。在各种情况下,第一锁元件10054可以弯曲,而在至少一些情况下,第一锁元件10054可以邻接第一锁腔10044中限定的远侧肩部10047。更准确地说,最外面的第一锁元件10054可以邻接远侧肩部10047,而其它第一锁元件10054可以邻接相邻的第一锁元件10054。在一些情况下,远侧肩部10047可以阻止第一锁元件10054的运动。在某些情况下,远侧肩部10047可以提供应变消除。例如,一旦远侧肩部10047接触第一锁元件10054,远侧肩部10047可以在邻近或至少基本上邻近锁导轨10011的位置支撑第一锁元件10054,使得只有小杠杆臂或扭矩臂将通过第一锁元件10054在其不同位置传递的相反力分离。在这些情况下,实际上通过第一锁元件10054的柄10053传递的力可以减小或消除。
与上文相似,再次参见图102和如上所讨论,当第二锁元件10056处于锁定构造时,尝试将远侧关节运动驱动装置10040朝远侧运动可能只会进一步减小第二锁元件10056和框架导轨10011之间的角度。在各种情况下,第二锁元件10056可以弯曲,而在至少一些情况下,第二锁元件10056可以邻接第二锁腔10046中限定的近侧肩部10048。更准确地说,最外面的第二锁元件10056可以邻接近侧肩部10048,而其它第二锁元件10056可以邻接相邻的第二锁元件10056。在一些情况下,近侧肩部10048可以阻止第二锁元件10056的运动。在某些情况下,近侧肩部10048可以提供应变消除。例如,一旦近侧肩部10048接触第二锁元件10056,近侧肩部10048可以在邻近或至少基本上邻近锁导轨10011的位置支撑第二锁元件10056,使得只有小杠杆臂或扭矩臂将通过第二锁元件10056在其不同位置传递的相反力分离。在这些情况下,实际上通过第二锁元件10056的柄10058传递的力可以减小或消除。
结合图102-112所示的示例性实施例进行讨论,近侧关节运动驱动装置10030的初始近侧运动可以解锁远侧关节运动驱动装置10040和关节运动锁10050的近侧运动,而近侧关节运动驱动装置10030的进一步近侧运动可以朝近侧驱动远侧关节运动驱动装置10040和关节运动锁10050。相似地,近侧关节运动驱动装置10030的初始远侧运动可以解锁远侧关节运动驱动装置10040和关节运动锁10050的远侧运动,而近侧关节运动驱动装置10030的进一步远侧运动可以朝远侧驱动远侧关节运动驱动装置10040和关节运动锁10050。结合以下公开的多个其它示例性实施例讨论了这种一般概念。根据结合图102-112中公开的示例性实施例提供的讨论,考虑到这类讨论是重复性的或大体累积性的,为了简洁起见,不会重复这类讨论。
现在转到图113和114,一种外科器械,诸如外科器械10000,和/或例如任何其它外科器械系统,可以包括近侧关节运动驱动装置10130、远侧关节运动驱动装置10140和关节运动锁10150。关节运动锁10150可以包括框架10152,此框架可以包括限定在其中,能够容纳近侧关节运动驱动装置10130的至少一部分和远侧关节运动驱动装置10140的至少一部分的狭槽或锁通道10151。关节运动锁10150还可以包括定位在第一或远侧锁腔10144内的第一锁元件10154,以及定位在第二或近侧锁腔10146内的第二锁元件10155。与上文相似,第一锁元件10154可以能够阻止通过远侧关节运动驱动装置10140传递的近侧推力P。为此,远侧关节运动驱动装置10140可以包括其中限定的锁凹陷10145,此锁凹陷可以包括能够接合第一锁元件10154并阻止远侧关节运动驱动装置10140相对于锁框架10152运动的一个或多个锁表面。更具体地讲,锁凹陷10145的侧壁可以包括第一或远侧锁表面10141,此锁表面可以能够靠着锁通道10151的侧壁或锁壁10153楔入第一锁元件10154,并且由于其楔入关系,远侧关节运动驱动装置10140可能不能在第一锁元件10154和锁通道10151的相对侧壁10157之间通过。读者将理解,锁凹陷10145为波状外形,使得它的深度朝锁凹陷10145的远端逐渐减小,其中相应地,远侧关节运动驱动装置10140的厚度朝锁凹陷10145的远端逐渐增大。因此,施加至远侧关节运动驱动装置10140的近侧推力P可能只用于进一步增大使远侧关节运动驱动装置10140保持就位的阻力或楔入力。
为了将远侧关节运动驱动装置10140朝近侧拉动,近侧关节运动驱动装置10130可以能够一,使远侧锁元件10154朝近侧移动以在近侧方向解锁关节运动锁10150,二,直接接合远侧关节运动驱动装置10140并向其施加近侧拉力。更具体地讲,除上述之外,近侧关节运动驱动装置10130可以包括能够初始接合第一锁元件10154的远侧臂10134,以及可以能够随后接合在锁凹陷10145的近端限定的近侧驱动壁10147并将远侧关节运动驱动装置10140朝近侧拉动的近侧臂10136。与上文相似,远侧关节运动驱动装置10140的近侧运动可以能够使外科器械的端部执行器进行关节运动。一旦端部执行器已适当进行关节运动,在各种情况下,近侧关节运动驱动装置10130即可释放,以允许定位在第一锁元件10154和第二锁元件10156中间的弹簧10155伸展并使第一锁元件10154相对于第一锁表面10141重新充分定位并将远侧关节运动驱动装置10140和端部执行器重新锁定就位。
同时,第二锁元件10156可以不阻止或至少基本上不阻止远侧关节运动驱动装置10140的近侧运动。当关节运动锁10150处于锁定状态时,第二锁元件10156可以定位在锁凹陷10145的第二或近侧锁表面10143与锁通道10151的锁壁10153之间。随着远侧关节运动驱动装置10140被近侧关节运动驱动装置10130朝近侧拉动,除上述之外,锁凹陷10145的停顿部分10142可以在第二锁元件10156上方运动。在各种情况下,锁凹陷10145的停顿部分10142可以包括凹陷10145的最宽部分,因此可以在远侧关节运动驱动装置10140朝近侧拉动时允许远侧关节运动驱动装置10140和第二锁元件10156之间的相对滑动运动。在一些情况下,第二锁元件10156可以能够在停顿部分10142内滚动,从而减小远侧关节运动驱动装置10140和第二锁元件10156之间的阻力。如读者将理解的,第二锁元件10156可以允许远侧关节运动驱动装置10140的近侧运动,但能够有选择地阻止远侧关节运动驱动装置10140的远侧运动,如下文更详细地讨论。
与上文相似,第二锁元件10156可以能够阻止通过远侧关节运动构件10140传递的远侧拉力D。为此,锁凹陷10145的第二锁表面10143可以能够靠着锁通道10151的锁壁10153楔入第二锁元件10156,并且由于其楔入关系,远侧关节运动驱动装置10140可能不能在第二锁元件10156和锁通道10151的相对侧壁10157之间通过。读者将理解,锁凹陷10145为波状外形,使得它的深度朝锁凹陷10145的近端逐渐减小,其中相应地,远侧关节运动驱动装置10140的厚度朝锁凹陷10145的近端逐渐增大。因此,施加至远侧关节运动驱动装置10140的远侧推力D可能只用于进一步增大使远侧关节运动驱动装置10140保持就位的阻力或楔入力。
为了将远侧关节运动驱动装置10140朝远侧推动,近侧关节运动驱动装置10130可以能够一,使第二锁元件10156朝远侧移动以在远侧方向解锁关节运动锁10150,二,直接接合远侧关节运动驱动装置10140并向其施加远侧推力。更具体地讲,除上述之外,近侧关节运动驱动装置10130的近侧臂10136可以能够初始接合第二锁元件10156,其中远侧臂10134随后可以接合在锁凹陷10145的远端限定的远侧驱动壁10148并将远侧关节运动驱动装置10140朝远侧推动。与上文相似,远侧关节运动驱动装置10140的远侧运动可以能够使外科器械的端部执行器进行关节运动。一旦端部执行器已适当进行关节运动,在各种情况下,近侧关节运动驱动装置10130即可释放,以允许弹簧10155伸展并使第二锁元件10156相对于第二锁表面10143重新充分定位并将远侧关节运动驱动装置10140和端部执行器重新锁定就位。
同时,第一锁元件10154可以不阻止或至少基本上不阻止远侧关节运动驱动装置10140的远侧运动。当关节运动锁10150处于锁定状态时,第一锁元件10154可以定位在锁凹陷10145的第一锁表面10141与锁通道10151的锁壁10153之间。随着远侧关节运动驱动装置10140被近侧关节运动驱动装置10130朝远侧推动,除上述之外,锁凹陷10145的停顿部分10142可以在第一锁元件10154上方运动。在各种情况下,在远侧关节运动驱动装置10140朝远侧推动时,停顿部分10142可以允许远侧关节运动驱动装置10140和第一锁元件10154之间的相对滑动运动。在一些情况下,第一锁元件10154可以能够在停顿部分10142内滚动,从而减小远侧关节运动驱动装置10140和第一锁元件10154之间的阻力。如读者将理解的,第一锁元件10154可以允许远侧关节运动驱动装置10140的远侧运动,但能够有选择地阻止远侧关节运动驱动装置10140的近侧运动,如上文所讨论。
除上述之外,锁凹陷10145的第一锁表面10141、停顿10142和第二锁表面10143可以限定合适的轮廓。这一轮廓可以由分别构成第一锁表面10141、停顿10142和第二锁表面10143的第一、第二和第三平坦表面限定。在这些情况下,可以识别第一锁表面10141、停顿10142和第二锁表面10143之间的确定性中断。在各种情况下,第一锁表面10141、停顿10142和第二锁表面10143可以构成连续表面,例如弓形表面,其中第一锁表面10141、停顿10142和第二锁表面10143之间的确定性中断可不存在。
现在转到图115和116,一种外科器械,诸如外科器械10000,和/或例如任何其它外科器械系统,可以包括轴10210、包括近侧关节运动驱动装置10230和远侧关节运动驱动装置10240的关节运动驱动系统,和能够可释放地将远侧关节运动驱动装置10240保持就位的关节运动锁10250。关节运动驱动系统的一般操作与结合图113和114中公开的实施例讨论的关节运动驱动系统相同或至少基本上类似,因此,为简洁起见,本文没有重复此类讨论。如读者将理解的,参见图115和116,关节运动锁10250可以包括第一锁元件10254和第二锁元件10256,其中第一锁元件可以提供能够可释放地抑制远侧关节运动驱动装置10240的近侧运动的单向锁,第二锁元件可以提供能够可释放地抑制远侧关节运动驱动装置10240的远侧运动的第二单向锁。与上文相似,第一锁元件10254和第二锁元件10256可以定位在远侧关节运动驱动装置10240中限定的锁凹陷10245内,并且可以被偏置构件或弹簧例如10255偏置成锁定状态。为了解锁第一锁元件10254,与上文相似,可将近侧关节运动驱动装置10230朝近侧拉动,使得远侧吊钩10234接触第一锁元件10254并将第一锁元件10254朝近侧拉动。然后,与上述实施例相似,可将近侧关节运动驱动装置10230进一步朝近侧拉动,直到远侧吊钩10234接触远侧关节运动驱动装置框架10242,将远侧关节运动驱动装置10240朝近侧拉动并使端部执行器10020进行关节运动。为了解锁第二锁元件10256,与上文相似,可将近侧关节运动驱动装置10230朝远侧推动,使得近侧吊钩10236接触第二锁元件10256并将第二锁元件10256朝远侧推动。然后,与上述实施例相似,可将近侧关节运动驱动装置10230进一步朝远侧推动,直到近侧吊钩10236接触远侧关节运动驱动装置框架10242,将远侧关节运动驱动装置10240朝远侧推动并使端部执行器10020进行关节运动。在各种情况下,第一锁元件10254和第二锁元件10256可各自包括可旋转的球形元件或例如轴承,其可以能够减小锁元件10254、10256、轴框架10212、近侧关节运动驱动装置10230和/或远侧关节运动驱动装置10240之间的滑动摩擦。
现在转到图125-130,一种外科器械,诸如外科器械10000,和/或例如任何其它外科器械系统,可以包括能够可释放地将远侧关节运动驱动装置10340保持就位的关节运动锁10350,和包括近侧关节运动驱动装置10330和远侧关节运动驱动装置10340的关节运动驱动系统。在许多方面,关节运动驱动系统的一般操作与结合上文公开的实施例讨论的关节运动驱动系统相同或至少基本上类似,因此,为简洁起见,本文没有重复这些方面。如读者将理解的,主要参见图125和126,关节运动锁10350可以包括第一锁元件10354和第二锁元件10356,其中第一锁元件可以提供能够可释放地抑制远侧关节运动驱动装置10340的近侧运动的单向锁,第二锁元件可以提供能够可释放地抑制远侧关节运动驱动装置10340的远侧运动的第二单向锁。与上文相似,第一锁元件10354可以定位在第一或远侧锁凹陷10344内,第二锁元件10356可以定位在远侧关节运动驱动装置10340中限定的第二或近侧锁凹陷10346内,并且可以被偏置构件或弹簧例如10355偏置成锁定状态。为了解锁第一锁元件10354,大体参见图129,可将近侧关节运动驱动装置10330朝近侧拉动,使得远侧吊钩10334接触第一锁元件10354并将第一锁元件10354朝近侧拉动。然后,如图129所示,与上述实施例相似,可将近侧关节运动驱动装置10330进一步朝近侧拉动,直到第一锁元件10354接触从关节运动驱动框架10340的框架10342延伸的中间肩部10345,并将远侧关节运动驱动装置10340朝近侧拉动以使端部执行器进行关节运动。一旦端部执行器已充分进行关节运动,近侧关节运动驱动装置10330即可释放,它可以允许偏置弹簧10355将锁元件10354和10356彼此移开,并将锁元件10354和10356坐置成锁定状态,如图130所示。为了解锁第二锁元件10356,大体参见图127,可将近侧关节运动驱动装置10330朝远侧推动,使得近侧吊钩10336接触第二锁元件10356并将第二锁元件10356朝远侧推动。然后,与上述实施例相似,可将近侧关节运动驱动装置10330进一步朝远侧推动,直到第二锁元件10356接触远侧关节运动驱动装置框架10342的中间肩部10345并将远侧关节运动驱动装置10340朝远侧推动,以使端部执行器以相反方向进行关节运动。与上文相似,一旦端部执行器已充分进行关节运动,近侧关节运动驱动装置10330即可释放,它可以允许偏置弹簧10355将锁元件10354和10356彼此移开,并将锁元件10354和10356坐置成锁定状态,如图128所示。
除上述之外,在各种情况下,第一锁元件10354和第二锁元件10356可各自包括楔形物,其可以能够将远侧关节运动驱动装置10340锁定就位。再次主要参见图125和126,关节运动锁10350可以包括框架10352,此框架包括限定在其中,能够容纳近侧关节运动驱动装置10330的至少一部分和远侧关节运动驱动装置10340的至少一部分的锁通道10351。除上述之外,第一锁腔10344可以限定在远侧关节运动驱动装置10340和锁通道10351的锁壁10353之间。当近侧负载P从端部执行器传递至远侧关节运动驱动装置10340时,远侧关节运动驱动装置10340可以接合第一锁元件10354的楔形部分10358并将第一锁元件10354靠着锁壁10353偏置。在此类情况下,近侧负载P可只增大将第一锁元件10354保持就位的楔入力。实际上,第一锁元件10354可以包括单向锁,此单向锁可以抑制远侧关节运动驱动装置10340的近侧运动,直到第一锁元件10354解锁,如上所述。当第一锁元件10354解锁并且远侧关节运动驱动装置10340朝近侧运动时,第二锁元件10356可以不阻止或至少基本上不阻止远侧关节运动驱动装置10340的近侧运动。与上文相似,除上述之外,第二锁腔10346可以限定在远侧关节运动驱动装置10340和锁壁10353之间。当远侧负载D从端部执行器传递至远侧关节运动驱动装置10340时,远侧关节运动驱动装置10340可以接合第二锁元件10356的楔形部分10359并将第二锁元件10356靠着锁壁10353偏置。在此类情况下,远侧负载D可只增大将第二锁元件10356保持就位的楔入力。实际上,第二锁元件10356可以包括单向锁,此单向锁可以抑制远侧关节运动驱动装置10340的远侧运动,直到第二锁元件10356解锁,如上所述。当第二锁元件10356解锁并且远侧关节运动驱动装置10340朝远侧运动时,第一锁元件10354可以不阻止或至少基本上不阻止远侧关节运动驱动装置10340的远侧运动。
现在转到图117-124,一种外科器械,诸如外科器械10000,和/或例如任何其它外科器械系统,可以包括能够可释放地将远侧关节运动驱动装置10440保持就位的关节运动锁10450,和包括近侧关节运动驱动装置10430和远侧关节运动驱动装置10440的关节运动驱动系统。如读者将理解的,主要参见图117和118,关节运动锁10450可以包括第一锁凸轮10454和第二锁凸轮10456,其中第一锁凸轮可以提供能够可释放地抑制远侧关节运动驱动装置10440的远侧运动的单向锁,第二锁凸轮可以提供能够可释放地抑制远侧关节运动驱动装置10440的近侧运动的第二单向锁。第一锁凸轮10454可以可旋转地安装到远侧关节运动驱动装置10440,并且可以包括突出10457,此突出可旋转地定位在远侧关节运动驱动装置10440中限定的枢轴孔10447内。相似地,第二锁凸轮10456可以可旋转地安装到远侧关节运动驱动装置10440,并且可以包括突出10458,此突出可旋转地定位在同样在远侧关节运动驱动装置10440中限定的枢轴孔10448内。关节运动锁10450还可以包括框架10452,此框架具有限定在其中的锁通道10451,此锁通道可以能够容纳近侧关节运动驱动装置10430的至少一部分、远侧关节运动驱动装置10440的至少一部分、第一锁凸轮10454和第二锁凸轮10456。锁通道10451可以包括第一锁壁10453和第二锁壁10459,其中当关节运动锁10450处于锁定状态时,第一锁凸轮10454可以偏置成与第一锁壁10453接合,第二锁凸轮10456可以偏置成与第二锁壁10459接合。在第一锁凸轮10454处于锁定位置时,第一锁凸轮10454可以能够将远侧关节运动驱动装置10440的第一支承点10445靠着第二锁壁10459偏置。相似地,当第二锁凸轮10454处于锁定位置时,第二锁凸轮10456可以能够将远侧关节运动驱动装置10440的第二支承点10446靠着第一锁壁10453偏置。图119中示出了这种锁定状态。也如图119所示,关节运动锁10450可以被弹簧10455偏置成锁定状态。弹簧10455可以能够使第一锁凸轮10454围绕其突出10457旋转,使得第一锁凸轮10454的凸角接合第一锁壁10453,相似地,此弹簧可以能够使第二锁凸轮10456围绕其突出10458旋转,使得第二锁凸轮10456的凸角接合第二锁壁10459。在各种情况下,第一锁凸轮10454和第二锁凸轮10456可各自包括其中限定的弹簧孔10449,此弹簧孔可以能够容纳弹簧10455的末端,使得弹簧10455可以施加以上讨论的偏置力。
为了解锁第一锁凸轮10454,大体参见图120,可将近侧关节运动驱动装置10430朝远侧推动,使得近侧关节运动驱动装置10430的远侧驱动肩部10434接触第一锁凸轮10454并将第一锁凸轮10454朝远侧推动。在各种情况下,第一锁凸轮10454可以包括从其延伸的驱动销10437,此驱动销可以被远侧驱动肩部10434接触,使得在将近侧关节运动驱动装置10430朝远侧推动时,第一锁凸轮10454和远侧关节运动驱动装置10440可以相对于第一锁表面10451朝远侧滑动。在一些情况下,第一锁凸轮10454可围绕其突出10447旋转以调整此类运动。与上文相似,在任何情况下,远侧关节运动驱动装置10440的远侧运动可以使端部执行器进行关节运动。与上文相似,一旦端部执行器已充分进行关节运动,近侧关节运动驱动装置10430即可释放,它可以允许偏置弹簧10455使锁凸轮10454和10456移动成分别与锁表面10453和10459接合,并将关节运动锁10450放置为其锁定状态,如图119所示。为了解锁第二锁凸轮10456,大体参见图121,可将近侧关节运动驱动装置10430朝近侧拉动,使得近侧驱动肩部10436接触第二锁凸轮10456并将第二锁凸轮10456朝近侧拉动。在各种情况下,第二锁凸轮10456可以包括从其延伸的驱动销10438,此驱动销可以被近侧驱动肩部10436接触,使得在将近侧关节运动驱动装置10430朝近侧拉动时,第二锁凸轮10456和远侧关节运动驱动装置10440可以相对于第二锁表面10459朝近侧滑动。在一些情况下,第二锁凸轮10456可围绕其突出10458旋转以调整此类运动。与上文相似,在任何情况下,远侧关节运动驱动装置10440的近侧运动可以使端部执行器以相反方向进行关节运动。与上文相似,一旦端部执行器已充分进行关节运动,近侧关节运动驱动装置10430即可释放,它可以允许偏置弹簧10455使锁凸轮10454和10456移动成分别与锁表面10453和10459接合,并将关节运动锁10450放置为其锁定状态,如图119所示。
除上述之外,当近侧负载P从端部执行器传递至远侧关节运动驱动装置10440时,如果关节运动锁10450处于锁定状态,第二锁凸轮10456将进一步偏置为与锁壁10459接合。在此类情况下,近侧负载P可只增大将第二锁凸轮10456保持就位的楔入力。实际上,第二锁凸轮10456可以包括单向锁,此单向锁可以抑制远侧关节运动驱动装置10440的近侧运动,直到第二锁凸轮10456解锁,如上所述。当第二锁凸轮10456解锁并且远侧关节运动驱动装置10440朝近侧运动时,第一锁凸轮10454可以不阻止或至少基本上不阻止远侧关节运动驱动装置10440的近侧运动。当远侧负载D从端部执行器传递至远侧关节运动驱动装置10440时,如果关节运动锁10450处于锁定状态,第一锁凸轮10454将进一步偏置为与锁壁10453接合。在此类情况下,远侧负载D可只增大将第一锁凸轮10454保持就位的楔入力。实际上,第一锁凸轮10454可以包括单向锁,此单向锁可以抑制远侧关节运动驱动装置10440的远侧运动,直到第一锁凸轮10454解锁,如上所述。当第一锁凸轮10454解锁并且远侧关节运动驱动装置10440朝远侧运动时,第二锁凸轮10454可以不阻止或至少基本上不阻止远侧关节运动驱动装置10440的远侧运动。
如上所讨论,一种外科器械可以包括:用于处理外科器械端部执行器内捕集的组织的击发驱动装置,用于使端部执行器围绕关节运动接头进行关节运动的关节运动驱动装置,以及可用于有选择地将关节运动驱动装置与击发驱动装置接合的离合器组件。上文讨论了示例性离合器组件10070,而下文将讨论另一个示例性离合器组件,即离合器组件11070。在各种情况下,本文公开的外科器械可以利用任一离合器组件。
现在转到图131-149,一种外科器械可以利用轴组件11010,此轴组件可以包括端部执行器10020、关节运动接头10090,以及可以能够可释放地将端部执行器10020保持就位的关节运动锁10050。读者将理解,为了便于图示,端部执行器10020的部分已在图131-133中移除;然而,端部执行器10020可以包括定位在其中的钉仓,和/或可旋转地联接到支撑钉仓的通道的砧座。上文已经讨论了端部执行器10020、关节运动接头10090和关节运动锁10050的操作,为简洁起见,本文不再重复。轴组件11010还可以包括由例如外壳部分11002和11003组成的近侧外壳,此近侧外壳可以将轴组件11010连接至外科器械的柄部。轴组件11010还可以包括闭合管11015,此闭合管可用于关闭和/或打开端部执行器10020的砧座。现在主要参见图132-134,轴组件11010可以包括脊11004,此脊可以能够可固定地支撑轴框架部分10012,此轴框架部分已在上文结合关节运动锁10050进行了讨论。脊11004可以能够一,可滑动地支撑其中的击发构件11060,二,可滑动地支撑围绕脊11004延伸的闭合管11015。脊11004还可以能够可滑动地支撑近侧关节运动驱动装置11030。在各种情况下,脊11004可以包括由框架部分11001支撑的近端11009,其中框架部分可以能够允许脊11004围绕其纵轴旋转。
除上述之外,轴组件11010可以包括离合器组件11070,此离合器组件可以能够有选择地和可释放地将近侧关节运动驱动装置11030联接到击发构件11060。离合器组件11070可以包括定位在击发构件11060周围的锁衬圈或套筒11072,其中锁套筒11072可以在锁套筒11072将近侧关节运动驱动装置11030联接到击发构件11060的接合位置和近侧关节运动驱动装置11030未可操作地联接到击发构件11060的脱离位置之间旋转。当锁套筒11072处于接合位置时(图135、136、138、139、141和145-149),除上述之外,击发构件11060的远侧运动可以使近侧关节运动驱动装置11030朝远侧运动,相应地,击发构件11060的近侧运动可以使近侧关节运动驱动装置11030朝近侧运动。当锁套筒11072处于脱离位置时(图142-144),击发构件11060的运动不会传递至近侧关节运动驱动装置11030,因此,击发构件11060可以独立于近侧关节运动驱动装置11030运动。在各种情况下,当击发构件11060没有使近侧关节运动驱动装置11030在近侧或远侧方向运动时,近侧关节运动驱动装置11030可以被关节运动锁11050保持就位。
主要参见图134,锁套筒11072可以包括圆柱形或至少基本上圆柱形的主体,其包括其中限定的能够容纳击发构件11060的纵向孔。锁套筒11072可以包括第一向内锁构件11073和第二向外锁构件11078。第一锁构件11073可以能够有选择地与击发构件11060接合。更具体地讲,当锁套筒11072处于接合位置时,第一锁构件11073可以定位在击发构件11060中限定的驱动槽口11062内,使得远侧推力和/或近侧拉力可以从击发构件11060传递至锁套筒11072。当锁套筒11072处于接合位置时,第二锁构件11078可以定位在近侧关节运动驱动装置11035中限定的驱动槽口11035内,使得施加至锁套筒11072的远侧推力和/或近侧拉力可以传递至近侧关节运动驱动装置11030。实际上,当锁套筒11072处于接合位置时,击发构件11060、锁套筒11072和近侧关节运动驱动装置11030将一起运动。另一方面,当锁套筒11072处于接合位置时,第一锁构件11073可以不定位在击发构件11060的驱动槽口11062内,因此,远侧推力和/或近侧拉力可以不从击发构件11060传递至锁套筒11072。相应地,远侧推力和/或近侧拉力可以不传递至近侧关节运动驱动装置11030。在此类情况下,击发构件11060可以相对于锁套筒11072和近侧关节运动驱动装置11030朝近侧和/或朝远侧滑动。为了调整这种相对运动,在此类情况下,击发构件11060可以包括其中限定的纵向狭槽或沟槽11061,当锁套筒11072处于脱离位置时,此纵向狭槽或沟槽可以能够容纳锁套筒11072的第一锁构件11073,并且调整击发构件11060相对于锁套筒11072的纵向运动。在各种情况下,第二锁构件11078可以保持与近侧关节运动驱动装置11030中的驱动槽口11035接合,无论锁套筒11072处于接合位置还是脱离位置。
除上述之外,离合器组件11070还可以包括可旋转的锁致动器11074,其可以能够使锁套筒11072在接合位置和脱离位置之间旋转。在各种情况下,锁致动器11074可以包括可围绕锁套筒11072的衬圈、穿过衬圈延伸的纵向孔,以及主要参见图135,与锁套筒11072接合的向内延伸驱动元件11077。再次参见图134,锁套筒11072可以包括其中限定的纵向狭槽11079,锁致动器11074的驱动元件11077可容纳在此纵向狭槽内。与上文相似,锁致动器11074可以在接合位置与脱离位置之间运动,在接合位置,锁致动器11074可以将锁套筒11072定位在其接合位置,在脱离位置,锁致动器11074可以将锁套筒11072定位在其脱离位置。为了使锁套筒11072在其接合位置与脱离位置之间运动,可将锁致动器11074围绕其纵轴旋转,使得从其延伸的驱动元件11077接合狭槽11079的侧壁以赋予锁套筒11072旋转力。在各种情况下,可约束锁致动器11074,使得它不会和锁套筒11072一起纵向运动。在此类情况下,锁致动器11074可以在轴脊11004中限定的至少部分周边窗口11089内旋转。为了调整当锁套筒11072处于接合位置时锁套筒11072的纵向运动,锁套筒11072还可以包括纵向开口11079,驱动元件11077可以在此纵向开口内行进。在各种情况下,纵向开口11079可以包括中央槽口11076,此中央槽口可以与端部执行器10020未进行关节运动的位置一致。在此类情况下,中央槽口11076可以充当能够可释放地保持或指示例如端部执行器10020中心取向的棘爪。
除上述之外,主要参见图134,锁致动器11074还可以包括从其向外延伸的凸轮从动件11081,此凸轮从动件可以能够容纳向其施加的力以使锁套筒11072如上所述旋转。在各种情况下,轴组件11010还可以包括切换筒11075,此切换筒可以能够向凸轮从动件11081施加旋转力。切换筒11075可以围绕锁致动器11074延伸,并且包括其中限定的纵向狭槽11083,凸轮从动件11081可以设置在此纵向狭槽内。当切换筒11075旋转时,狭槽11083的侧壁可以接触凸轮从动件11081并使锁致动器11074旋转,如上所概述。参见图137,切换筒11075还可以包括其中限定的至少部分周边开口11085,这些开口可以能够容纳从包括外壳半部11002和11003的外壳延伸的周边底座11007,并且允许切换筒11075和轴外壳之间的相对旋转而不是相对平移。再次参见图134,切换筒11075可用于使锁致动器11074和锁套筒11072在其接合位置与脱离位置之间旋转。在各种情况下,轴组件11010还可以包括偏置构件,诸如弹簧11080,它可以能够在将锁致动器11074和锁套筒11072偏置成其接合位置的方向偏置切换筒11075。因此,本质上,弹簧11080和切换筒11075可以能够使关节运动驱动系统偏置成与击发驱动系统有效接合。也如图134所示,切换筒11075可以包括滑环组件11005的部分,这些部分可以能够将电力传导至端部执行器10020和/或从其传导电力,和/或将信号发送至端部执行器10020和/或从其接收信号。滑环组件11005可以包括其相对侧面上的多个同心或至少基本上同心的导体11008,这些导体可以能够允许滑环组件11005的半块之间的相对旋转,同时仍保持它们之间的传导通路。2013年3月13日提交的名称为“STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067全文以引用方式并入本文。2013年3月13日提交的名称为“STAPLE CARTRIDGE TISSUE THICKNESSSENSOR SYSTEM”的美国专利申请序列号13/800,025全文以引用方式并入本文。
除上述之外,在各种情况下,轴组件11010的闭合机构可以能够使离合器组件11070偏置成脱离状态。例如,主要参见图134和144-147,如上所述,闭合管11015可以朝远侧推进以使端部执行器10020砧座闭合,并且这样来使锁致动器11074以及相应地锁套筒11072凸轮转动至脱离位置。为此,闭合管11015可以包括凸轮窗口11016,从锁致动器11074延伸的凸轮从动件11081可以穿过该凸轮窗口延伸。凸轮窗口11016可以包括倾斜侧壁或凸轮边缘11017,其可以能够在闭合管11015在打开或非闭合位置(图145-149)与闭合位置(图142-144)之间朝远侧运动时接合凸轮从动件11081,并使锁致动器11074从接合位置(图145-149)旋转至脱离位置(图142-144)。对比图144和149之后,读者将理解,当凸轮从动件11081和锁致动器11074凸轮转动至脱离位置时,凸轮从动件11081可以使切换筒11075旋转,并使弹簧11080在切换筒11075和轴外壳之间压缩。只要闭合管11015保持在推进闭合位置,关节运动驱动装置将从击发驱动装置断开。为了使关节运动驱动装置重新接合击发驱动装置,闭合管11015可被回缩至未致动位置,它还可以打开端部执行器10020,并且可以因此将凸轮边缘11017朝近侧拉动并允许弹簧11080将锁致动器11074和锁套筒11072重新偏置成接合位置。
如其它地方更详细描述的,外科器械1010可包括若干可操作系统,其至少部分地延伸穿过轴1210并且与端部执行器1300可操作地接合。例如,外科器械1010可包括可使端部执行器1300在开式构造和闭式构造之间转变的闭合组件、可使端部执行器1300相对于轴1210进行关节运动的关节运动组件、和/或可固定和/或切割由端部执行器1300捕集的组织的击发组件。此外,外科器械1010可包括外壳,例如柄部1042,其可分离地联接至轴1210并且可包括完整的闭合、关节运动和/或击发驱动系统,当柄部1042联接到轴1210时,这些系统可分别可操作地联接到轴1210的闭合、关节运动和击发组件。
在使用中,外科器械1010的操作者可希望使外科器械1010复位并使外科器械1010的一个或多个组件返回默认位置。例如,操作者可将端部执行器1300通过入口插入患者体内的手术部位,并且可随后使端部执行器1300进行关节运动和/或使端部执行器闭合以捕集腔内的组织。随后操作者可选择撤消之前的一些或全部动作,并且可选择从腔移除外科器械1010。外科器械1010可包括一个或多个系统,其能够有利于使上述一个或多个组件在操作者的最少输入下可靠返回本位状态,从而允许操作者从腔移除外科器械。
参见图150,外科器械1010可包括关节运动控制系统3000。手术操作者可利用关节运动控制系统3000使端部执行器1300相对于轴1210在关节运动本位状态位置和关节运动位置之间进行关节运动。此外,手术操作者可利用关节运动控制系统3000使进行关节运动的端部执行器1300复位或返回关节运动本位状态位置。可将关节运动控制系统3000定位在或至少部分地定位在柄部1042中。此外,如图151中的示例性示意框图所示,关节运动控制系统3000可包括控制器,例如控制器3002,它可以能够接收输入信号,并响应以启动马达,例如马达1102,使得端部执行器1300根据这一输入信号进行关节运动。合适的控制器的例子在本文的其它地方有所描述,包括但不限于微控制器7004(参见图185)。
除上述之外,端部执行器1300可在关节运动本位状态位置,本文也称为未进行关节运动的位置被定位为充分对齐轴1210,使得端部执行器1300和轴1210的至少一部分可通过入口,例如定位在患者内腔的壁上而不会损坏轴端口的套管针被插入患者内腔或从其缩回。在某些实施例中,当端部执行器1300处于关节运动本位状态位置时,端部执行器1300可以对齐或至少基本上对齐穿过轴1210的纵轴“LL”,如图150所示。在至少一个实施例中,关节运动本位状态位置可以在纵轴的任一侧与纵轴成最大且包括5°的任何角度。在另一个实施例中,关节运动本位状态位置可以在纵轴的任一侧与纵轴成最大且包括3°的任何角度。在又一个实施例中,关节运动本位状态位置可以在纵轴的任一侧与纵轴成最大且包括7°的任何角度。
关节运动控制系统3000可被操作以使端部执行器1300在与纵轴相交的平面相对于轴1210以第一方向例如顺时针方向和/或与第一方向相反的第二方向例如逆时针方向进行关节运动。在至少一个实例中,关节运动控制系统3000可被操作以使端部执行器1300在顺时针方向从关节运动本位状态位置进行关节运动至例如在纵轴右侧与纵轴成10°角的关节运动位置。又如,关节运动控制系统3000可被操作以使端部执行器1300在逆时针方向从定位在与纵轴成10°角的关节运动位置进行关节运动至关节运动本位状态位置。再如,关节运动控制系统3000可被操作以使端部执行器1300相对于轴1210在逆时针方向从关节运动本位状态位置进行关节运动至在纵轴右侧与纵轴成10°角的关节运动位置。读者将理解,端部执行器可响应操作者的命令,在顺时针方向和/或逆时针方向进行关节运动至不同角度。
参见图150,外科器械1010的柄部1042可包括界面3001,此界面可包括可由操作者利用以部分地使端部执行器1300相对于轴1210进行关节运动的多个输入,如上所述。在某些实施例中,界面3001可包括多个开关,它们可通过例如电路联接到控制器3002。在图151中示出的实施例中,界面3001包括三个开关3004A-C,其中开关3004A-C中的每一个分别通过三条电路3006A-C中的一条联接到控制器3002。读者将理解,通过界面3001可以利用开关和电路的其它组合。
除上述之外,控制器3002可包括处理器3008和/或一个或多个存储器单元3010。通过执行存储器3010中存储的指令码,处理器3008可控制外科器械1的各种部件,例如马达1102和/或用户显示器。控制器3002可使用集成和/或离散硬件元件、软件元件和/或它们的组合实现。集成硬件元件的例子可包括处理器、微处理器、微控制器、集成电路、专用集成电路(ASIC)、可编程逻辑器件(PLD)、数字信号处理器(DSP)、现场可编程门阵列(FPGA)、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、片上系统(SoC)和/或封装系统(SIP)。离散硬件元件的例子可包括电路和/或电路元件(例如逻辑门、场效应晶体管、双极型晶体管、电阻、电容、电感、继电器等)。在其它实施例中,控制器3002可包括混合电路,例如在一个或多个基底上包括离散和集成电路元件或部件。
再次参见图151,外科器械1010可包括与控制器3002可操作地通信的马达控制器3005。马达控制器3005可以能够控制马达1102的旋转方向。例如,马达1102可由电池,例如电池1104供电,并且马达控制器3002可能够根据控制器3002的输入确定电池1104向马达1102施加的电压极性,继而确定马达1102的旋转方向。例如,当电池1104施加至马达1102的电压极性被马达控制器3005根据控制器3002的输入反转时,马达1102可将其旋转方向从顺时针方向反转为逆时针方向。合适的马达控制器的例子在本文的其它地方有所描述,包括但不限于驱动器7010(图185)。
此外,如本文其它地方更详细描述的,马达1102可以被可操作地联接到关节运动驱动装置,例如近侧关节运动驱动装置10030(图37)。在使用中,马达1102可以根椐马达1102旋转的方向将近侧关节运动驱动装置10030朝远侧或朝近侧驱动。此外,近侧关节运动驱动装置10030可以被操作地联接到端部执行器1300,使得例如近侧关节运动驱动装置10030朝近侧的轴向平移可导致端部执行器1300在例如逆时针方向进行关节运动,和/或近侧关节运动驱动装置10030朝远侧的轴向平移可导致端部执行器1300在例如顺时针方向进行关节运动。
除上述之外,再次参见图151,界面3001可以能够使得开关3004A可专用于端部执行器1300的顺时针关节运动,并且开关3004B可专用于端部执行器1300的逆时针关节运动。例如,操作者可通过闭合可向控制器3002发信号的开关3004A使马达1102在顺时针方向旋转,从而因此导致近侧关节运动驱动装置10030朝远侧推进并导致端部执行器1300在顺时针方向进行关节运动,来使端部执行器1300在顺时针方向进行关节运动。又如,操作者可通过闭合可向控制器3002发信号的开关3004B使马达1102在例如逆时针方向旋转,并使近侧关节运动驱动装置10030朝近侧回缩以使端部执行器1300在逆时针方向进行关节运动,来使端部执行器1300在逆时针方向进行关节运动。
除上述以外,开关3004A-C还可包括开放偏置的圆顶开关,如图154所示。也可采用其他类型的开关,例如电容式开关。在图154中所示的实施例中,圆顶开关3004A和3004B通过摇臂3012控制。在本公开的范围内还可以想到用于控制开关3004A和3004B的其他装置。在图154中所示的空档位置中,开关3004A和3004B两者都偏置在打开位置中。操作者例如可通过朝前摆动摇臂从而按压圆顶开关3004A使端部执行器1300以顺时针方向进行关节运动,如图155中所示。结果,可闭合电路3006A(图151)向控制器3002发送信号以启动马达1102使端部执行器1300以如上所述的顺时针方向进行关节运动。马达1102可继续使端部执行器1300进行关节运动直到操作者释放摇臂3012,从而允许圆顶开关3004A返回至打开位置且摇臂3012返回至空档位置。在一些情况下,控制器3002可能够识别端部执行器1300何时达到预定最大程度的关节运动,并且在此时中断马达1102的电源,而不管是否按压圆顶开关3004A。在某种程度上,当达到最大程度的安全关节运动时,控制器3002可能够无视操作者的输入而停止马达1102。或者,例如,操作者可通过朝后摆动摇臂从而按压圆顶开关3004B使端部执行器1300以逆时针方向进行关节运动。结果,电路3006B可闭合而向控制器3002发送信号以启动马达1102使端部执行器1300以如上所述的顺时针方向进行关节运动。马达1102可继续使端部执行器1300进行关节运动直到操作者释放摇臂3012,从而允许圆顶开关3004B返回至打开位置且摇臂3012返回至空档位置。在一些情况下,控制器3002可能够识别端部执行器1300何时达到预定最大程度的关节运动,并且在此时中断马达1102的电源,而不管是否按压圆顶开关3004B。在某种程度上,当达到最大程度的安全关节运动时,控制器3002可能够无视操作者的输入而停止马达1102。
在某些实施例中,关节运动控制系统3000可包括虚拟棘爪,在端部执行器到达其关节运动本位状态位置时可警示操作者。例如,操作者可摆动摇臂3012以使端部执行器1300从关节运动的位置关节运动至关节运动本位状态位置。在到达关节运动本位状态位置后,控制器3002可停止端部执行器1300的关节运动。为了继续经过关节运动本位状态位置,操作者可释放摇臂3012,然后再次摆动它以重新开始关节运动。或者,机械棘爪还可用于为操作者提供这样的触觉反馈:端部执行器已到达关节运动本位状态位置。可采用其他形式的反馈,例如声频反馈。
除上述之外,关节运动控制系统3000还可包括复位输入,如果端部执行器1300位于关节运动的位置,复位输入可使端部执行器1300复位或返回至关节运动本位状态位置。例如,如图160所示,在接收到复位输入信号后,控制器3002可确定端部执行器1300的关节运动位置,并且如果端部执行器1300位于关节运动本位状态位置,控制器3002可不采取任何动作。然而,如果端部执行器1300在接收复位输入信号时位于关节运动的位置,控制器可启动马达1102以使端部执行器1300返回至关节运动本位状态位置。如图156所示,操作者可朝下按压摇臂3012以彼此同时或至少短时间段内闭合圆顶开关3004A和3004B,这可向控制器3002传输复位输入信号以使端部执行器1300复位或返回至关节运动本位状态位置。操作者然后可释放摇臂3012,从而允许摇臂3012返回至空档位置且开关3004A和3004B返回至打开位置。或者,关节运动控制系统3000的界面3001可包括单独的复位开关,例如另一个圆顶开关,其可由操作者独立地闭合以向控制器3002传输复位输入信号。
参见图157-159,在某些实施例中,外科器械1010的界面3001可包括界面摇臂3012A,该界面摇臂可包括能够帮助摇臂3012A处于其空档位置的接触构件3013,如图157所示。接触构件3013可包括弓形表面3017,该弓形表面可通过偏置构件和/或通过由圆顶开关3004A和3004B施加至其上的偏置力而偏置抵靠界面外壳3011。当操作者如图158所示朝前或朝后摆动摇臂3012A以使端部执行器1300分别以顺时针方向或逆时针方向进行关节运动时,接触构件3013可能够摇动或旋转。当释放摇臂3012A时,摇臂3012A的弓形表面可通过施加至其上的偏置力旋转回到其空档位置中抵靠在界面外壳3011上。在各种情况下,当操作者如图159所示朝下按压摇臂3012A以彼此同时或至少短时间段内按压圆顶开关3004A和3004B而可向控制器3002传输复位输入信号以使端部执行器1300复位或返回至如上讨论的关节运动本位状态位置时,接触构件3013可远离界面外壳3011位移。
如上文所述,控制器3002可能够确定端部执行器1300的关节运动位置。端部执行器1300的关节运动位置的了解可允许控制器3002确定马达1102是否需要启动以使端部执行器1300返回至关节运动本位状态位置,并且如果需要启动,则确定使端部执行器1300返回至关节运动本位状态位置所需的马达1102的旋转方向和旋转量。在某些实施例中,控制器3002可跟踪端部执行器1300的关节运动并将端部执行器1300的关节运动位置存储在例如存储器3010中。例如,当马达1102用于使端部执行器1300进行关节运动时,控制器3002可跟踪马达1102的旋转方向、旋转速度和旋转时间。在一些情况下,控制器3002可能够在击发系统用于驱动关节运动系统时评价击发系统的位移。更具体地讲,当关节运动驱动装置联接到击发驱动装置时,控制器3002可监控击发驱动装置以确定关节运动驱动装置的位移。处理器3008可基于这些参数计算端部执行器1300的关节运动位置并将关节运动驱动装置的位移位置存储在例如存储器3010中。读者将认识到可跟踪其他参数并且处理器3010可采用其他算法来计算端部执行器1300的关节运动位置,所有这些均可被本公开想到。当端部执行器1300进行关节运动时,端部执行器1300的存储的关节运动位置可连续更新。或者,例如当操作者在按压圆顶开关3004A或开关3004使端部执行器1300进行关节运动之后释放所述开关时,可在离散点更新存储的关节运动位置。
在任何情况下,在接收到复位输入信号后,处理器3008可访问存储器3010以恢复端部执行器1300的最后存储的关节运动位置。如果最后存储的关节运动位置不是关节运动本位状态位置,则处理器3008可基于最后存储的关节运动位置来计算使端部执行器1300返回至关节运动本位状态位置所需的马达1102的旋转方向和时间。在一些情况下,处理器3008可计算击发驱动装置需要位移的距离和方向以将关节运动驱动装置设置在其本位状态位置。在任何一种情况下,控制器3002可启动马达1102使之相应旋转以使端部执行器1300返回至关节运动本位状态位置。此外,处理器3008还可更新存储的关节运动位置以指示关节运动本位状态位置。然而,如果最后存储的关节运动位置是关节运动本位状态位置,则控制器3002可不采取任何动作。在一些情况下,控制器3002可通过一些形式的反馈警示使用者,端部执行器和关节运动系统位于其本位状态位置。例如,控制器3002可能够启动声和/或光信号以警示操作者,端部执行器1300位于关节运动本位状态位置。
在某些实施例中,外科器械1010可包括能够检测端部执行器1300的关节运动位置并将该位置传送至控制器3002的传感器。与上述类似,所检测的端部执行器1300的关节运动位置可存储在存储器3010中并且可在端部执行器1300进行关节运动时连续更新或可在操作者释放圆顶开关3004A时或在按压该开关使例如端部执行器1300进行关节运动之后更新。
在某些实施例中,可能期望在使端部执行器1300复位或返回至关节运动本位状态位置之前包括警告步骤以使操作者有机会纠正复位开关的错误启动。例如,控制器3002可能够通过启动警示操作者摇臂3012已按压的光和/或声信号,对复位输入信号对控制器3002的第一传输作出反应。此外,控制器3002还可能够通过启动马达1102以使端部执行器1300返回至关节运动本位状态位置,在离第一传输的预定时间段内对复位输入信号对控制器3002的第二传输作出反应。换句话讲,摇臂3012的第一朝下按压可产生对操作者的警告,并且在离第一朝下按压的预定时间段内的摇臂3012的第二朝下按压可使控制器3002启动马达1102以使端部执行器1300返回至关节运动本位状态位置。
除上述之外,界面3001可包括显示器,响应于摇臂3012的第一朝下按压,控制器3002可使用该显示器向操作者传送警告消息。例如,响应于摇臂3012的第一朝下按压,控制器3002可通过显示器提示操作者确认操作者希望使端部执行器1300返回至关节运动本位状态位置。如果在预定时间段内操作者第二次以按压摇臂3012的方式响应,控制器3012可以如下方式作出反应:启动马达1102以使端部执行器1300返回至关节运动本位状态位置。
如本文其他地方更详细描述的,外科器械1010的端部执行器1300可包括第一钳口和第二钳口,所述第一钳口具有砧座,例如砧座1310,所述第二钳口具有能够容纳钉仓(例如可包括多个钉的钉仓1304)的通道。此外,端部执行器1300可在开式构造与闭式构造之间转变。另外,外科器械1010可包括闭合锁并且柄部1042可包括闭合锁的释放构件,例如释放构件1072,其可由操作者按压以释放闭合锁,从而使端部执行器1300返回至开式构造。此外,控制器3002可联接到传感器3014,所述传感器能够检测释放构件1272对闭合锁的释放。另外,外科器械1010可包括击发驱动装置,例如击发驱动装置1110,其可操作地联接到击发构件,例如击发构件10060。控制器3002可联接到传感器3015,所述传感器能够检测击发驱动装置1110的位置。击发驱动装置1110可轴向移动以将击发构件10060从击发本位状态位置推进到击发位置,从而从钉仓1304部署钉和/或对在端部执行器1300处于闭式构造时捕集在砧座1310与钉仓1304之间的组织进行切割。
另外,如其他地方更详细描述的,外科器械1010的近侧关节运动驱动装置10030可选择性地与击发驱动装置1110联接,使得当击发驱动装置1110被马达1102驱动时,近侧关节运动驱动装置10030可被击发驱动装置1110驱动并且近侧关节运动驱动装置10030可继而使端部执行器1300相对于轴1210进行关节运动,如上文所述。另外,当端部执行器1300处于闭式构造时,击发驱动装置1110可从近侧关节运动驱动装置10030分离。该结构允许马达1102驱动击发驱动装置1110使击发构件10060在击发本位状态位置与击发位置之间移动,而与近侧关节运动驱动装置10030无关。
除上述之外,如本文其他地方更详细描述的,外科器械1010可包括离合器系统10070(参见图37),其可在端部执行器1300从开式构造转变为闭式构造时接合,并且在端部执行器1300从闭式构造转变为开式构造时脱离。在接合时,离合器系统10070可将击发驱动装置1110操作地联接至近侧驱动构件10030,并且在离合器构件脱离时,击发驱动装置1110可从近侧关节运动驱动装置分离。由于击发驱动装置1110可独立地从近侧关节运动驱动装置10030分离和移动,控制器3002可能够引导击发驱动装置1110以定位近侧关节运动驱动装置10030并再次将近侧关节运动驱动装置10030重新联接到击发驱动装置1110。当击发驱动装置1110联接到近侧关节运动驱动装置10030时,控制器3002可跟踪马达1102的旋转方向、旋转速度和旋转时间,以确定近侧关节运动驱动装置10030的位置并将该位置存储在例如存储器3010中。控制器3002可如本文其他地方所述的那样监控用于驱动关节运动系统的击发系统的位移。可采用其他参数和算法以确定近侧关节运动驱动装置10030的位置。在某些实施例中,击发驱动装置1110可包括传感器,所述传感器能够检测击发驱动装置1110何时联接到近侧关节运动驱动装置10030并将此传送至控制器3002,以确认击发驱动装置1110与近侧关节运动驱动装置10030之间的联接接合。在某些实施例中,当控制器3002不能够存储和访问端部执行器1300的关节运动位置时,控制器可启动马达1102以驱动击发驱动装置1110沿着其运动全程行进,直到击发驱动装置1110与近侧关节运动驱动装置10030联接布置。
除上述之外,在某些实施例中,击发构件10060的击发本位状态位置可位于端部执行器1300的近侧部分。或者,击发构件10060的击发本位状态位置可位于端部执行器1300的远侧部分。在某些实施例中,击发本位状态位置可限定于这样的位置,其中击发构件10060相对于端部执行器1300充分回缩,使得端部执行器1300可在开式构造与闭式构造之间自由移动。在其他情况下,击发构件10060的击发本位状态位置可认定为使关节运动驱动系统和端部执行器定位在其关节运动的本位状态位置的击发构件的位置。
再次参见图151,外科器械1010的界面3001可包括本位状态输入。操作者可采用本位状态输入将本位状态输入信号传输至控制器3002以使外科器械1010返回至本位状态,其可包括使端部执行器1300返回至关节运动本位状态位置和/或使击发构件10060返回至击发本位状态位置。如图154所示,本位状态输入可包括开关,例如开关3004C,其可经由电路3006C联接到控制器3002。如图152和153所示,本位状态输入可包括帽或盖,例如盖3014,其可由操作者按压以闭合开关3004C并将本位状态输入信号通过电路3006C传输至控制器3002。
再次参见图161,控制器3002在接收到本位状态输入信号后可通过传感器3015检查击发驱动装置1110的位置,并且可检查存储器3010的最后更新的关节运动位置。如果控制器3002确定端部执行器1300位于关节运动本位状态位置并且击发驱动装置1110被定位成使得其联接到近侧关节运动驱动装置10030,则控制器3002可不采取任何动作。或者,控制器3002可向操作者提供反馈,外科器械1010处于本位状态。例如,控制器3002可能够启动声和/或光信号或通过显示器传输消息以警示操作者外科器械1010处于本位状态。然而,如果控制器3002确定端部执行器1300不位于关节运动本位状态位置并且击发驱动装置1110被定位成使得其联接到近侧关节运动驱动装置10030,则控制器3002可启动马达1102以驱动击发驱动装置1110移动近侧关节运动驱动装置10030,其可继而使端部执行器1300相对于轴1210关节运动回到关节运动本位状态位置。然而,如果控制器3002确定端部执行器1300位于关节运动本位状态位置但击发驱动装置1110不被定位成使得其联接到近侧关节运动驱动装置10030,则控制器3002可启动马达1102以将击发驱动装置1110移动至适当位置,在该位置处,击发驱动装置1110联接至关节运动驱动装置10030。这样,马达1102可使击发构件10060回缩至击发本位状态位置。
在某些实施例中,参见图162,控制器3002在接收到本位状态输入信号后,可通过传感器3016检查端部执行器1300是否处于开式构造。可采用用于确定端部执行器1300是否处于开式构造的其他装置。如果控制器3002确定端部执行器1300处于开式构造,则控制器3002可如上所述继续进行。然而,如果控制器3002在接收到本位状态输入信号后,确定端部执行器1300处于闭式构造,则控制器3002可提示操作者确认操作者希望使外科器械1010返回至本位状态。该步骤可为预防步骤以防止操作者例如在外科手术过程中意外打开端部执行器1300。在某些实施例中,控制器3002可通过如下方式提示操作者:在联接到控制器3002的显示器上显示消息,例如,要求操作者通过按压释放构件1072使端部执行器1300返回至开式构造。如果操作者不将端部执行器1300释放成开式构造,则控制器3002可不采取任何动作。在其它实施例中,控制器3002可通过如下方式警示操作者:显示出错消息或启动声或光。然而,如果操作者将端部执行器1300释放成开式构造,则控制器3002可复位如上所述的外科器械。
参见图163,击发构件10060可包括单独的击发复位输入,其可包括开关和将开关联接至控制器3002的电路,其中开关可能够闭合电路并将击发复位输入信号传输至控制器3002。控制器3002在接收到击发复位输入信号后,可检查击发构件10060是否位于击发本位状态位置。如其他地方更详细描述的,击发构件10060可操作地联接到击发驱动装置1110,所述击发驱动装置可包括传感器,例如传感器3015(参见图151),其可将击发驱动装置1110的位置传输至控制器3002。因此,控制器3002可通过监控击发驱动装置1110的位置来确定击发构件10060的位置。在任何情况下,如果控制器3002确定击发构件10060位于击发本位状态位置,则控制器可不采取任何动作或可通过启动声和/或光来警示操作者击发构件10060已位于击发本位状态位置。在这方面,如果控制器3002确定击发构件10060不位于击发本位状态位置,则控制器3002可启动马达1102以驱动击发驱动装置1110使击发构件10060返回至击发本位状态位置。
如其他地方更详细描述的,外科器械1010可包括若干组件,其至少部分地延伸穿过轴1210并且可与端部执行器1300可操作地接合。例如,外科器械1010可包括可使端部执行器1300在开式构造和闭式构造之间转变的闭合组件、可使端部执行器1300相对于轴1210进行关节运动的关节运动组件、和/或可固定和/或切割由端部执行器1300捕集的组织的击发组件。此外,外科器械1010可包括外壳,例如柄部1042,其可分离地联接至轴1210并且可包括完整的闭合、关节运动和/或击发驱动系统,当柄部1042联接到轴1210时,这些系统可分别操作地联接到轴1210的闭合、关节运动和/或击发组件。
在使用中,上述组件及其对应驱动系统可操作地连接。试图在外科器械1010的操作过程中将柄部1042从轴1210分离,可以一定方式切断组件及其对应驱动系统之间的连接,所述方式可使这些组件及其对应驱动系统中的一者或多者不对齐。在另一方面,单是阻止使用者在操作过程中将柄部1042从轴1210分离就可导致困惑、沮丧和/或错误认为外科器械未正确操作。
外科器械1010可包括安全释放系统3080,其可能够使外科器械1010的组件和/或对应驱动系统中的一者或多者返回至本位状态,从而允许操作者将柄部1042从轴1210安全地分离。本文所用的术语本位状态可指默认状态,其中外科器械1010的组件和/或对应驱动系统中的一者或多者可位于或可返回至其默认位置,例如它们在柄部1042与轴1210联接之前的位置。
参见图150,外科器械1010的安全释放系统3080可包括锁定构件,例如锁定构件3082,其可在锁定构造与未锁定构造之间移动。如图164所示和如其他地方更详细描述的,轴1210可与外科器械1010的柄部1042对齐和联接。此外,锁定构件3082可从未锁定构造移动至锁定构造以在与轴1210的联接接合中锁定柄部。锁定构件3082可定位在轴1210的近侧部分,如图166所示,并且可包括闩锁构件3083,当锁定构件3082移动至锁定构造并且柄部1042联接到轴1210时,闩锁构件可推进到定位在柄部1042中的容纳狭槽3085中。此外,当锁定构件3082移动至未锁定构造从而允许柄部1042从轴1210分离时,闩锁构件3083可回缩出容纳狭槽3085,如图167所示。
参见图151,安全释放系统3080还可包括联锁开关3084,所述联锁开关经由电路3086联接到控制器3002,所述电路可能够将本位状态输入信号传输至控制器3002。此外,联锁开关3084可操作地联接到锁定构件3082。例如,当锁定构件移动至未锁定构造时,开关3086可移动以闭合电路3086,如图167所示,并且当锁定构件3082移动至锁定构造时,开关可移动至使电路3086成开路,如图166所示。在该例子中,控制器3002可能够将电路3086的闭合识别为本位状态输入信号的传输。或者,又如,当锁定构件移动至未锁定构造时,开关3086可移动以使电路3086成开路,并且当锁定构件3082移动至锁定构造时,开关可移动以闭合电路3086。在该例子中,控制器3002可能够将电路3086的开路识别为本位状态输入信号的传输。
再次参见图166和图167,锁定构件3082可包括第一表面3090和第二表面3092,它们可通过滑道3094分隔开,其中锁定构件3082可相对于开关3084定位成使得当柄部1042联接到轴1210时,第一表面3090和第二表面3092可相对于开关3084可滑动地移动。另外,如图166所示,第一表面3090可在第一平面中延伸并且第二表面3092可在第二平面中延伸,其中相比第二平面,开关3084可更靠近第一平面。另外,如图166所示,当锁定构件3082处于锁定构造并且闩锁构件3083容纳在容纳狭槽3085中时,第一表面3090可按压开关3084,从而闭合电路3086(图151)并将本位状态输入信号传输至控制器3002。然而,当锁定构件3082移动至未锁定构造并且闩锁构件3083从容纳狭槽3085回缩时,开关3084可沿着滑道3094滑动以面向第二表面3092,第二表面可为偏置开关3084提供足够的空间以返回至打开位置,如图166所示。
在某些实施例中,如图151和165中所示,开关3084的第一末端3084a可定位在柄部1042中,例如在其远侧部分,并且开关3084的第二末端3084b可定位在轴1210中,例如在其近侧部分,并且可与锁定构件3082操作地联接。在这些实施例中,开关3084可不闭合电路3086,直到柄部1042联接到轴1210以允许锁定构件3082使开关3084的第二末端3084b与第一末端3084a接触,从而闭合电路3086并将本位状态输入信号传输至控制器3002。在其它实施例中,开关3084的锁定构件3082、第一末端3084a和第二末端3084b可设置在柄部1042中以在联接柄部1042之前允许闭合电路3086并将本位状态输入信号传输至控制器3002,例如以在轴1210联接到柄部1042时,使击发驱动系统返回至其默认位置,从而确保与击发组件的正确对齐。
如本文其他地方更详细描述的,外科器械1010的端部执行器1300可包括第一钳口和第二钳口,所述第一钳口具有砧座,例如砧座1310,所述第二钳口具有能够容纳钉仓(例如可包括多个钉的钉仓1304)的通道。此外,端部执行器1300可在开式构造与闭式构造之间转变。例如,外科器械1010可包括用于将端部执行器1300锁定在闭合构造中的闭合锁并且柄部1042可包括闭合锁的释放构件,例如释放构件1072,其可由操作者按压以释放闭合锁,从而使端部执行器1300返回至开式构造。此外,控制器3002可联接到传感器3014,所述传感器能够检测释放构件1072对闭合锁的释放。另外,外科器械1010可包括击发驱动装置,例如击发驱动装置1110,其可操作地联接到击发构件,例如击发构件10060。控制器3002可联接到传感器3015,所述传感器能够检测击发驱动装置1110的位置。此外,击发驱动装置1110可轴向推进,如图167A所示,以使击发构件10060在未击发位置与击发位置之间推进,从而部署钉仓1304的钉和/或对在端部执行器1300处于闭式构造时捕集在砧座1310与钉仓1304之间的组织进行切割。另外,当锁定构件3082从闭式构造移动至开式构造时,马达1102可使击发驱动装置从推进位置例如图167A中所示的位置回缩至如图167B所示的默认或回缩位置。
除上述之外,如其他地方更详细描述的,外科器械1010的近侧关节运动驱动装置10030可选择性地与击发驱动装置1110联接,使得当击发驱动装置1110被马达5驱动时,近侧关节运动驱动装置10030可被击发驱动装置1110驱动并且近侧关节运动驱动装置10030可继而使端部执行器1300相对于轴1210在关节运动本位状态位置与关节运动位置之间进行关节运动,如上文所述。另外,例如当端部执行器1300处于闭式构造时,击发驱动装置1110可从近侧关节运动驱动装置10030分离。该结构允许马达1102驱动击发驱动装置1110使击发构件10060在未击发位置与击发位置之间移动,而与近侧关节运动驱动装置10030无关。由于击发驱动装置1110可独立地从近侧关节运动驱动装置10030分离和移动,控制器3002可能够引导击发驱动装置1110以定位近侧关节运动驱动装置10030并与其重新连接。在某种程度上,控制器3002可记住其在何处离开近侧关节运动驱动装置10030。更具体地讲,控制器3002可其一,评价近侧关节运动驱动装置10030从击发驱动装置1110分离时击发驱动装置1110的位置,以及其二,记住命令控制器3002将击发驱动装置1110与近侧关节运动驱动装置10030重新连接时近侧关节运动驱动装置10030位于何处。在此类情况下,控制器3002可将击发驱动装置1110移动至适当位置,在该位置中,离合器组件10070例如可将近侧关节运动驱动装置10030重新连接至击发驱动装置1110。当击发驱动装置1110联接到近侧关节运动驱动装置10030时,控制器3002可跟踪马达1102的旋转方向、旋转速度和旋转时间,以确定近侧关节运动驱动装置10030的位置并将该位置存储在例如存储器3010中。可采用其他参数和算法以确定近侧关节运动驱动装置10030的位置。在某些实施例中,击发驱动装置1110可包括传感器,所述传感器能够检测击发驱动装置1110何时联接到近侧关节运动驱动装置10030并将此传送至控制器3002,以确认击发驱动装置1110与近侧关节运动驱动装置10030之间的联接接合。在某些实施例中,当控制器3002不能够存储和访问近侧关节运动驱动装置10030时,控制器可启动马达1102以驱动击发驱动装置1110沿着其运动全程行进,直到击发驱动装置1110与近侧关节运动驱动装置10030联接布置。
现在参见图151和165,安全释放系统3080可通过如下方式对操作者将柄部1042从轴1210分离的尝试作出反应:例如操作者一将锁定构件3082从锁定构造移动至未锁定构造,就使外科器械1010复位至本位状态。如上所述,开关3084可操作地联接到锁定构件3082,使得当锁定构件3082从锁定构造移动至未锁定构造时,开关3084可移动至使电路3086成开路,从而将本位状态输入信号传输至控制器3002。或者,开关3084从其锁定构造移动至其未锁定构造可允许电路3086闭合,从而将本位状态输入信号传输至控制器3002。
再次参见图168,控制器3002在接收到本位状态输入信号后可通过传感器3015检查击发驱动装置1110的位置,并且可检查存储器3010的最后更新的端部执行器的关节运动位置和相应地近侧关节运动驱动装置10030的最后位置。如果控制器3002确定端部执行器1300位于关节运动本位状态位置并且击发驱动装置1110被定位成使得其联接到近侧关节运动驱动装置10030,则控制器3002可不采取任何动作并且使用者可从柄部移除轴组件。或者,控制器3002可向操作者提供反馈,外科器械1010处于本位状态和/或可安全地将柄部1042从轴1210分离。例如,控制器3002可能够启动声和/或光信号和/或通过联接到控制器3002的显示器(未示出)传输消息以警示操作者外科器械1010处于本位状态和/或可安全地将柄部1042从轴1210分离。然而,如果控制器3002确定端部执行器1300不位于关节运动本位状态位置并且击发驱动装置1110被定位成使得其联接到近侧关节运动驱动装置10030,则控制器3002可启动马达1102以驱动击发驱动装置1110移动近侧关节运动驱动装置10030,其可继而使端部执行器1300相对于轴1210关节运动回到关节运动本位状态位置。然而,如果控制器3002确定端部执行器1300位于关节运动本位状态位置但击发驱动装置1110不被定位成使得其联接到近侧关节运动驱动装置10030,则控制器3002可启动马达1102以将击发驱动装置1110移动至适当位置,在该位置处,击发驱动装置1110可联接至关节运动驱动装置9。这样,击发构件9可使击发构件10060回缩至击发本位状态位置。如上所述,控制器3002可任选地向操作者提供反馈,外科器械1010处于本位状态和可安全地将柄部1042从轴1210分离。
在某些实施例中,参见图169,控制器3002在接收到本位状态输入信号后,可通过传感器3016检查端部执行器1300是否处于开式构造。可采用用于确定端部执行器1300处于开式构造的其他装置。如果控制器3002确定端部执行器1300处于开式构造,则控制器3002可继续进行以将外科器械1010复位至本位状态。然而,如果控制器3002在接收到本位状态输入信号后,确定端部执行器1300处于闭式构造,则控制器3002可提示操作者确认操作者希望将柄部1042从轴1210分离。该步骤可为预防步骤以便例如在端部执行器1300正在使用并夹紧组织时,若操作者意外移动锁定构件3082从而将本位状态输入信号错误地传输至控制器3002,可防止外科器械1010复位。在某些实施例中,控制器3002可通过如下方式提示操作者:在联接到控制器3002的显示器上显示消息,例如,要求操作者通过按压释放构件1072使端部执行器1300返回至开式构造。除机械锁定构件3082之外,安全释放系统3080还可包括可由控制器3002控制的电子锁(未示出)。电子锁可能够防止操作者分离柄部1042和轴1210,直到操作者按压释放构件1072。如果操作者不将端部执行器1300释放成开式构造,则控制器3002可不采取任何动作。在其它实施例中,控制器3002可通过如下方式警示操作者:显示出错消息或启动声或光信号。另一方面,如果操作者将端部执行器1300释放成开式构造,则控制器3002可复位如上所述的外科器械1010。如果使用电子锁,则控制器3002可释放电子锁以允许操作者将柄部1042从轴1210分离。此外,控制器3002可进而警示操作者已可安全地将柄部1042从轴1210移除,如上文所述。
在某些实施例中,可能期望在响应于本位状态输入信号使外科器械1010复位至本位状态之前包括警告步骤以使操作者有机会纠正锁定构件3082的意外解锁。例如,控制器3002可能够通过如下方式对本位状态输入信号的第一传输作出反应:要求操作者例如通过显示器确认操作者希望复位外科器械1010。在某些实施例中,操作者可通过第二次锁定和解锁锁定构件3082,在离第一本位状态输入信号的预定时间段内将第二本位状态输入信号传输至控制器3002。控制器3002可能够通过使外科器械1010复位至本位状态对本位状态输入信号的第二传输作出反应(如果在离第一传输的预定时间段内传输)。
本文所述的外科器械的电动马达可执行多种功能。例如,多功能电动马达可在击发序列过程中推进和回缩击发元件。为执行多种功能,多功能电动马达可在不同操作状态之间切换。电动马达可例如在第一操作状态中执行第一功能,并且可例如随后切换至第二操作状态以执行第二功能。在各种情况下,电动马达可在第一操作状态(如,推进状态)过程中朝远侧驱动击发元件,并且可在第二操作状态(如,回缩状态)过程中朝近侧回缩击发元件。在某些情况下,电动马达在第一操作状态过程中可在第一方向旋转并且在第二操作状态过程中可在第二方向旋转。例如,电动马达的顺时针旋转可朝远侧推进击发元件并且电动马达的逆时针旋转可朝近侧回缩击发元件。电动马达可在第一和第二操作状态过程中平衡或基本上平衡,使得电动马达产生的背景触觉反馈或“噪音”最小化。虽然触觉反馈在第一和第二操作状态过程中可最小化,但在某些情况下不可完全消除。事实上,在外科器械的正常操作过程中操作者可预料到此类“噪音”,因此此类“噪音”可能不会构成指示外科器械的具体状况的反馈信号。
在各种情况下,多功能电动马达可在附加操作状态过程中执行附加功能。例如,在第三操作状态(如,反馈状态)过程中,电动马达可产生放大的触觉或触感反馈以将外科器械的具体状况传送至其操作者。换句话讲,多功能电动马达可在击发序列,如分别在第一操作状态和第二操作状态过程中朝远侧和近侧驱动击发元件,并且还可如在第三操作状态过程中产生放大的触觉反馈以与外科器械的操作者通信。在第三操作状态过程中产生的放大的触觉反馈可大幅超过在第一和第二操作状态过程中产生的背景触觉反馈或“噪音”。在各种实施例中,在第三操作状态过程中产生的放大的触觉反馈可构成对操作者的反馈信号,该信号指示外科器械的具体状况。例如,当在击发元件上检测预定的阈值力时,电动马达可产生放大的触觉反馈。在此类实施例中,放大的触觉反馈可构成对操作者的警告信号,例如潜在过载警告。在其它实施例中,放大的触觉反馈可将状态更新传送至操作者,例如击发元件已到达最远侧位置和/或成功完成击发冲程的信号。在各种实施例中,电动马达可在第三操作状态过程中在顺时针旋转与逆时针旋转之间振荡。如本文所述,安装在电动马达上的共振器或放大器可随电动马达而振荡以优化或放大电动马达所产生的触觉反馈。虽然共振器可在第三操作状态过程中放大触觉反馈,共振器可相对于其旋转轴线平衡,例如使得在第一和第二操作状态过程中背景触觉反馈或“噪音”保持最低。
在各种情况下,多功能电动马达可在不同操作状态之间切换。例如,电动马达可从第一操作状态切换至第二操作状态以将击发元件从端部执行器的远侧位置回缩。另外,电动马达可切换至第三操作状态以将指示外科器械的具体状况的信号传送至操作者。例如,当检测到临床重要的状况,电动马达可从第一操作状态切换至第三操作状态以将临床重要的状况传送至操作者。在某些实施例中,电动马达可产生放大的触觉反馈以将临床重要的状况传送至操作者。当电动马达切换至第三操作状态,可暂停击发元件的推进。在各种实施例中,在接收到放大的触觉反馈后,操作者可决定是否(A)要恢复第一操作状态或(B)启动第二操作状态。例如,当临床重要的状况为施加在击发元件上的较高力,其可指示潜在医疗器械过载,操作者可决定(A)恢复朝远侧推进击发元件,或(B)注意到潜在过载警告并朝近侧回缩击发元件。如果即使存在器械过载的可能,操作者也决定恢复第一操作状态,那么器械可能有故障风险。在各种实施例中,不同电动马达可产生反馈以将临床重要的状况传送至操作者。例如,第二电动马达可产生感觉反馈,例如噪音、光和/或触感信号,例如以将临床重要的状况传送至操作者。
现在参见图170,外科器械的电动马达5002(其他地方示出)可包括马达外壳5004和从马达外壳5004延伸的轴5006。虽然电动马达5002在本文作为一个例子描述,但其他电动马达,例如马达1102,可结合本文所公开的教导内容。轴5006可固定到定位在马达外壳5004内的转子(未示出),并且轴5006可随着转子旋转而旋转。轴5006可例如在第一操作状态过程中在一个方向旋转,并且可例如在第二操作状态过程中在第二方向旋转。另外,电动马达5002在一个方向的旋转可执行第一外科功能,并且电动马达5002在另一个方向的旋转可执行第二外科功能。在各种实施例中,电动马达5002和/或其轴5006可操作地联接到击发元件(其他地方示出),并且可在击发序列过程中驱动击发元件。例如,电动马达5002的顺时针旋转可朝远侧驱动击发元件并且电动马达5002的逆时针旋转可朝近侧驱动击发元件。或者,电动马达5002的逆时针旋转可朝远侧驱动击发元件并且电动马达5002的顺时针旋转可朝近侧驱动击发元件。换句话讲,电动马达可在第一操作状态过程中推进击发元件并且可在第二操作状态过程中回缩击发元件,或反之亦然。在其它实施例中,电动马达5002可操作地联接到关节运动机构(其他地方示出)并且可使端部执行器相对于外科器械的柄部进行关节运动。例如,电动马达5002的顺时针旋转可使端部执行器在第一方向进行关节运动,并且电动马达5002的逆时针旋转可使端部执行器在第二方向进行关节运动。
在各种实施例中,共振器或放大器5020可安装在电动马达5002的轴5006上。垫圈5008可例如相对于轴5006固定共振器5020。另外,共振器5020可稳定地固定至轴5006,使得共振器5020随轴5006而旋转和/或移动。在各种实施例中,共振器5020和/或其各个部分可例如紧固至轴5006和/或可与其一体成型。
现在参见图170-172,共振器5020可包括主体5022,所述主体包括用于容纳轴5006(图170)的安装膛孔5040(图171和172)。例如,当共振器5020固定至轴5006时,轴5006可延伸穿过安装膛孔5040。安装膛孔5040和轴5006可例如同轴。在各种实施例中,共振器5020的主体5022可相对于安装膛孔5040平衡和/或对称,并且主体5022的质心可例如沿着安装膛孔5040的中心轴线定位。在此类实施例中,主体5022的质心可沿着轴5006的旋转轴线定位,并且主体5022可例如相对于轴5006平衡。
在各种情况下,共振器5020还可包括从主体5022延伸的摆动件5030。例如,摆动件5030可包括从主体5022延伸的弹簧或杆5032以及从弹簧5032延伸的砝码5034。在某些情况下,共振器5020和/或其摆动件5030可设计成具有优化的自然频率。如本文所述,优化的自然频率可放大电动马达5002在顺时针和逆时针旋转之间振荡时,如在第三操作状态过程中产生的触觉反馈。在各种情况下,共振器5020还可包括从主体5022延伸的平衡物5024。主要参见图172,摆动件5030可在第一方向X上从主体5022延伸,并且平衡物5024可在第二方向Y上从主体5022延伸。第二方向Y可例如与第一方向X不同和/或相对。在各种实施例中,平衡物5024可设计成通过主体5022相对于安装膛孔5040(图171和172)平衡摆动件5030的质量。例如,平衡物5024的几何形状和材料可选择成使得整个共振器5020的质心5028(图172)沿着主体5022的安装膛孔5040的中心轴线从而沿着共振器5020和轴5006的旋转轴线(图170)定位。
共振器5020的质心5028(CMR)可根据下列关系式确定:
其中mR为共振器5020的总质量,CMB为主体5022的质心,CMC为平衡物5024的质心,CMS为弹簧5032的质心,CMW为砝码5034的质心,mB为主体5022的质量,mC为平衡物5024的质量,mS为弹簧5032的质量,并且mW为砝码5034的质量。在主体5022的质心沿着安装膛孔5040的中心轴线定位并且共振器5020包括均匀厚度和均匀密度的情况下,共振器5020可根据下列简化关系式相对于安装膛孔5040的中心轴线平衡:
AC·CMC=AS·CMS+AW·CMW,
其中AC为平衡物5024的面积,AS为弹簧5032的面积,并且AW为砝码5034的面积。
在各种情况下,当共振器5020的质心5028沿着安装孔5040的中心轴线从而沿着轴5006(图170)的旋转轴线居中时,共振器5020可相对于其旋转轴线平衡。在此类实施例中,因为平衡了共振器5020,背景触觉反馈可在第一和第二操作状态过程中最小化。在各种情况下,共振器5020可包括附加或更少的组件。共振器5020的各种组件可平衡成使得整个共振器5020的质心5028相对于共振器5020的旋转轴线平衡。另外,在一些实施例中,共振器5020的各种组件的材料和/或密度可不同于共振器5020的各种其他组件。可选择各种组件的材料和/或密度以相对于旋转轴线平衡共振器5020的质量和/或以优化共振器5020和/或其摆动件5030的自然频率,如本文所述。
仍然参见图170-172,摆动件5030的弹簧5032可偏转和/或可变形。例如,共振器5020的旋转可使摆动件5030的弹簧5032偏转。弹簧5032可在共振器5020的初始旋转时偏转,并且可在共振器5020继续在同一方向以相同旋转速度旋转时保持偏转。因为在共振器5020在一个方向上持续的基本上恒定旋转过程中弹簧5032的偏转度保持至少基本上恒定,在第一和第二操作状态过程中背景触觉反馈可保持最小化。当共振器5020的旋转方向改变时,弹簧5032可在不同方向上偏转。例如,弹簧5032可在共振器5020顺时针旋转时在第一方向上偏转,并且可在共振器5020逆时针旋转时在第二方向上偏转。第二方向可例如与第一方向相对。换句话讲,当电动马达5020在顺时针旋转与逆时针旋转之间振荡时,响应于旋转方向的变化,弹簧5032可反复在不同方向上偏转。弹簧5032在不同方向上的反复偏转,即偏转振荡,可产生放大的触觉反馈。例如,由振荡马达5002(图170)驱动的振荡共振器5020产生的触觉反馈可充分放大,使得其向操作者提供指示外科器械的具体状况的信号。振荡共振器5020和马达5002产生的放大的触觉反馈可大幅大于在共振器5020和马达5002在相同方向上的持续旋转过程中产生的背景触觉反馈。
在使用中,摆动件5030的旋转可对砝码5034产生离心力,并且摆动件5030的弹簧5032可响应于离心力而伸长。在各种实施例中,共振器5020和/或马达5002可包括用于限制弹簧5032的径向伸长的保持器。此类保持器可将摆动件5030保持在预定的径向边界5050(图170)内。在各种情况下,在第三操作状态过程中施加于砝码5034的离心力可不足以使摆动件5030伸长超过重新限定的径向边界5050。
在各种情况下,共振器5020可设计成放大电动马达5002(图170)在第三操作状态过程中产生的触觉反馈。换句话讲,共振器5020可设计成使得共振器5020的自然频率得以优化,并且电动马达5002可在一定频率处振荡,从而使共振器5020在其优化的自然频率处振荡。在各种实施例中,共振器5020的优化的自然频率可与电动马达5002的振荡频率相关。共振器5020的优化的自然频率可例如符合和/或对应于电动马达5002的振荡频率。在某些实施例中,共振器5020的优化的自然频率可例如与电动马达5002的振荡频率偏离。
在某些实施例中,共振器5020的自然频率可接近于摆动件5030的自然频率。例如,在自然频率近似值中可忽略基本上非振荡的组件。在某些实施例中,主体5022和平衡物5024可被认为是共振器5020的基本上非振荡的组件,从而被认为对共振器5020的自然频率具有可忽略的或无关紧要的作用。因此,共振器5020的振荡组件,如摆动件5030,可设计成放大电动马达5002(图170)在第三操作状态过程中产生的触觉反馈。在弹簧5032的质量基本上小于砝码5034的质量的情况下,摆动件5030的自然频率(fP)可接近于下列关系式:
其中kS为弹簧5032的弹簧常数并且mW为砝码5034的质量。弹簧5032的弹簧常数(kS)可根据下列关系式确定:
其中ES为弹簧5032的弹性模量,IS为弹簧5032的二次惯性矩,并且LS为弹簧5032的长度。在各种实施例中,可选择弹簧5032的弹簧常数(kS)和/或砝码5034的质量(mW),使得摆动件5030的自然频率(fP)与第三操作状态过程中电动马达5002的振荡频率相关。例如,摆动件5030的自然频率可通过改变弹簧5032的弹簧常数和/或砝码5034的质量来优化。
仍然参见图170-172,共振器5020和/或其摆动件5030的自然频率可优化为向操作者提供最佳触觉反馈的频率。例如,共振器5020的自然频率可优化为在大约50Hz与大约300Hz之间以增强操作者体验到的反馈。在一些实施例中,共振器5020的自然频率可优化为例如小于大约50Hz的频率,并且在其它实施例中,共振器5020可优化为例如大于大约300Hz的频率。另外,电动马达5002(图170)可在一定频率下振荡,从而驱动共振器5020在或接近其自然频率下振荡。在某些实施例中,电动马达5002可驱动共振器5020在包括共振器5020的自然频率在内的放大频率的范围内振荡。
在各种实施例中,电动马达5002的振荡频率可符合和/或对应于共振器5020的自然频率以在或接近其自然频率下驱动共振器5020。在某些实施例中,电动马达5002的振荡频率可接近或处于共振器5020的自然频率,并且在其它实施例中,电动马达5002的振荡频率可偏离共振器5020的自然频率。在各种实施例中,电动马达5002的振荡频率可优化为符合共振器5020的自然频率。另外,在某些实施例中,电动马达5002的振荡频率和共振器5020的自然频率可协同选择、设计和/或优化以放大电动马达5002在第三操作状态过程中产生的触觉反馈。
主要参见图170,当在第三操作状态过程中电动马达5002在顺时针方向与逆时针方向之间振荡时,电动马达5002可产生放大的触觉反馈。另外,电动马达5002在第一和第二操作状态过程中的旋转可在击发冲程过程中驱动击发构件(其他地方示出)。例如,电动马达5002的顺时针旋转可朝远侧推进击发元件并且电动马达5002的逆时针旋转可朝近侧回缩击发元件。因此,当电动马达5002在顺时针方向与逆时针方向之间振荡时,击发元件的远端可在稍微更远侧位置与稍微更近侧位置之间移动。然而,电动马达5002可明显减速,使得电动马达5002在第三操作状态过程中的振荡将击发元件的远端移动不明显和/或难以察觉的距离。在各种实施例中,齿轮齿数比可为例如大约200:1至大约800:1。在某些实施例中,击发元件在第三操作状态过程中可保持静止。例如,马达5002与击发元件的远端之间的松弛可吸收电动马达5002的振荡。例如,参见图102-104,此类松弛存在于击发构件10060与刀杆10066之间。在各种情况下,刀杆10066可包括延伸进击发构件10060中限定的驱动狭槽10064中的驱动插片10065,其中驱动狭槽10064在其远端10067与近端10069之间的长度可长于驱动插片10065。在使用中,击发构件10060的充分行进必须在远端10067或近端10069接触驱动插片10065之前发生。
现在参见图173-176,电动马达5002(图173和174)可定位在外科器械5100(图173)的柄部5101(图173)内。在各种实施例中,共振器或放大器5120可安装在电动马达5002的轴5006上。轴5006可固定到定位在马达外壳5004内的转子(未示出),并且轴5006可随着转子旋转而旋转。垫圈5008可例如相对于轴5006固定共振器5120。另外,共振器5120可固定至轴5006,使得共振器5120随轴5006而旋转和/或移动。在一些情况下,可例如采用键以将轴5006的旋转运动传输至共振器5120。在各种情况下,共振器5120和/或其各个部分可例如紧固至轴5006和/或可与其一体成型。
主要参见图175和176,与共振器5020类似,共振器5120可包括主体5122,所述主体包括用于容纳电动马达5002(图173和174)的轴5006(图173和174)的安装膛孔5140。例如,当共振器5120固定至轴5006时,轴5006可延伸穿过安装膛孔5140。在各种实施例中,共振器5120的主体5122可相对于安装膛孔5140平衡和对称,并且主体5122的质心可例如沿着安装膛孔5140的中心轴线定位。另外,主体5122的质心可沿着共振器5120和轴5006的旋转轴线定位,使得主体5122可例如相对于轴5006平衡。
在各种实施例中,共振器5120还可包括从主体5122延伸的摆动件5130。例如,摆动件5130可包括从主体5122延伸的弹簧或杆5132以及从弹簧5132延伸的砝码5134。在某些实施例中,弹簧5132可沿着限定主体5122与砝码5134之间的至少一条轮廓线的轴线延伸。弹簧5132可例如盘绕、弯曲、扭转、转动、交叉和/或交错。弹簧5132的几何形状可例如影响其弹簧常数。在至少一个实施例中,弹簧5132可形成共振器5120的第一横向侧上的第一环5137和共振器5120的第二横向侧上的第二环5138。弹簧5132的中间部分5139可例如横贯第一环5137与第二环5138之间。与弹簧5032类似,弹簧5132可偏转,并且可响应于共振器5120的旋转和/或振荡而偏转。另外,在某些实施例中,砝码5134可包括销5136,其可例如为砝码5134提供附加质量。如本文所述,砝码5134的质量以及弹簧5132的几何形状和性质可选择为例如优化摆动件5130的自然频率,从而优化整个共振器5120的自然频率。
仍然参见图175和176,共振器5120还可包括从主体5122延伸的平衡物5124。在某些实施例中,销5126可从平衡物5124延伸,并且可例如为平衡物5124提供附加质量。摆动件5130可在第一方向X上从主体5122延伸,并且平衡物5124可在第二方向Y上从主体5122延伸。第二方向Y可例如与第一方向X不同和/或相对。在各种实施例中,平衡物5124可设计成通过主体5120相对于安装膛孔5140平衡摆动件5130的质量。例如,平衡物5124的几何形状和材料可选择成使得共振器5120的质心5128沿着主体5122的安装膛孔5140的中心轴线从而沿着共振器5120的旋转轴线A(图173)定位。
与共振器5020类似,共振器5120可设计成放大电动马达5002(图173和174)在第三操作状态过程中产生的触觉反馈。换句话讲,共振器5120可设计成使得共振器5120的自然频率得以优化,并且电动马达5002可在一定频率处振荡,从而驱动共振器5120在其优化的自然频率处或附近振荡。例如,电动马达5002可驱动共振器5120在包括共振器5120的自然频率在内的放大频率的范围内振荡。在某些实施例中,共振器5120的自然频率可接近于摆动件5130的自然频率。在此类实施例中,摆动件5130可设计成放大电动马达5002在第三操作状态过程中产生的触觉反馈。例如,摆动件5130可设计成具有优化的自然频率,并且电动马达5002可驱动共振器5120在或接近摆动件5130的优化的自然频率下振荡以放大在第三操作状态过程中产生的触觉反馈。
现在参见图177-180,电动马达5002(图177和178)可定位在外科器械5100(图177)的柄部5101(图177)中。在各种实施例中,共振器或放大器5220可安装在电动马达5002的轴5006(图170)上。轴5006可固定到定位在外壳5004内的转子(未示出),并且轴5006可随着转子旋转而旋转。垫圈5008(图170)可例如相对于轴5006固定共振器5220。另外,共振器5220可固定至轴5006,使得共振器5220随轴5006而旋转和/或移动。在各种实施例中,共振器5220和/或其各个部分可例如紧固至轴5006和/或可与其一体成型。
主要参见图179和180,与共振器5020、5120类似,共振器5220可包括主体5222,所述主体包括用于容纳电动马达5002(图176和177)的轴5006(图176和177)的安装膛孔5240。例如,当共振器5220固定至轴5006时,轴5006可延伸穿过安装膛孔5240。在各种实施例中,共振器5220的主体5222可相对于安装膛孔5240平衡和对称,并且主体5222的质心可例如沿着安装膛孔5240的中心轴线定位。另外,主体5222的质心可沿着轴5006的旋转轴线定位,使得主体5222可例如相对于轴5006平衡。
在各种实施例中,共振器5220还可包括从主体5222延伸的摆动件5230。例如,摆动件5230可包括从主体5222延伸的弹簧或杆5232以及从弹簧5232延伸的砝码5234。在各种实施例中,弹簧5232可在主体5222与砝码5234之间弯折、盘绕、弯曲、扭转、转动、交叉和/或交错。另外,在某些实施例中,砝码5234可包括销5236,其可例如为砝码5234提供附加质量。如本文所述,砝码5234的质量以及弹簧5232的几何形状和性质可选择为例如优化摆动件5230的自然频率,从而优化整个共振器5220的自然频率。
在各种实施例中,保持器可限制或约束弹簧5232和/或摆动件5230在旋转和/或振荡过程中的径向伸长。例如,保持器可包括摆动件5230的至少一部分周围的阻挡件或保持壁。在第一和第二操作状态过程中,例如,弹簧5232可变形并使砝码5234朝阻挡件延伸,所述阻挡件可防止弹簧5232的进一步伸长。例如,主要参见图179和180,共振器5220可包括保持器5244。保持器5244可包括第一腿部5246,其可固定至主体5222和/或共振器5220的平衡物5224。第一腿部5246可固定至共振器5220,并且可例如与其形成为一体件和/或紧固于其上。保持器5244还可包括第二腿部或阻挡件腿部5248,其可在弹簧5232未变形时延伸经过摆动件5230的砝码5234。阻挡件腿部5248可限定摆动件5230不会延伸超出的径向边界5050。换句话讲,阻挡件腿部5248可阻止摆动件5230的径向延伸。例如,当弹簧5232未变形时,阻挡件腿部5248可不与摆动件5230接触,因为摆动件5230可定位在径向边界5050内。换句话讲,当弹簧5234未变形时,间隙5249(图180)可限定在砝码5234与阻挡件腿部5248之间。另外,当共振器5220在第三操作状态过程中振荡时,阻挡件腿部5248可保持不与摆动件5230接触。例如,在第三操作状态过程中对振荡摆动件5230的离心力可不足以将摆动件5230的砝码5234延伸超过马达5002的预定径向边界5050。虽然在第三操作状态过程中间隙5249可减小,砝码5234可例如保持不与阻挡件腿部5248接触。在此类实施例中,在第三操作状态过程中,摆动件5230的自然频率可基本上不受保持器5244的影响。
在各种实施例中,当共振器5220在第一和第二操作状态过程中旋转时,摆动件5230的弹簧5232可大幅变形和/或伸长。例如,共振器5220的旋转可对弹簧5232产生离心力,并且弹簧5232可响应于离心力而伸长。在某些实施例中,摆动件5230的砝码5234可移向且移入与保持器5244的阻挡件腿部5248邻接接触。在此类实施例中,阻挡件5248可限制或约束弹簧5232在第一和第二操作状态过程中进一步径向伸长。
在各种实施例中,保持器5244可基本上为刚性的,使得保持器5244抵抗变形和/或伸长。在某些实施例中,保持器5244可与共振器5220一体成型和/或相对于其固定。在一些实施例中,保持器5244可固定至马达5002(图177和178I)。例如,保持器5244可相对于马达5002的转子和/或轴5006(图177和178)并且可与其一起旋转和/或移动。在此类实施例中,保持器5244可例如与共振器5220一起旋转。在各种实施例中,保持器5244可例如紧固至马达5002和/或可与其一体成型。在某些实施例中,保持器5244可例如相对于旋转轴5008和/或共振器5220保持静止。
仍然参见图179和180,共振器5220还可包括从主体5222延伸的平衡物5224。在某些实施例中,销5226可从平衡物5224延伸,并且可例如为平衡物5224提供附加质量。摆动件5230可在第一方向上从主体5222延伸,并且平衡物5224可在第二方向上从主体5222延伸。第二方向可例如与摆动件5230的第一方向不同和/或相对。在各种实施例中,平衡物5224可设计成通过共振器5220的主体5220相对于安装膛孔5240平衡摆动件5230和保持器5244的质量。例如,平衡物5224的几何形状和材料可选择成使得共振器5220的质心5228沿着主体5222的安装膛孔5240的中心轴线从而沿着轴5008(图177和178)和共振器5220的旋转轴线A(图177)定位。
与共振器5020、5120类似,共振器5220可设计成放大电动马达5002在第三操作状态过程中产生的触觉反馈。换句话讲,共振器5220可设计成使得共振器5220的自然频率得以优化,并且电动马达5002可在一定频率处振荡,从而驱动共振器5220在其优化的自然频率处或附近振荡。例如,电动马达5002可驱动共振器5220在包括共振器5220的自然频率在内的放大频率的范围内振荡。在某些实施例中,共振器5220的自然频率可接近于摆动件5230的自然频率。在此类实施例中,摆动件5230可设计成放大电动马达5002在第三操作状态过程中产生的触觉反馈。例如,摆动件5230可设计成具有优化的自然频率,并且电动马达5002可驱动共振器5220在或接近摆动件5230的优化的自然频率下振荡以放大在第三操作状态过程中产生的触觉反馈。
现在参见图181,电动马达5002可定位在外科器械5100的柄部5101内。在各种实施例中,共振器或放大器5320例如与共振器5220类似,可安装在电动马达5002的轴5006(图170)上。共振器5320可包括主体5322,所述主体包括例如安装膛孔5340,例如包括弹簧5332、砝码5334和销5336的摆动件5330,以及例如包括销5326的平衡物5324。在各种实施例中,共振器5320的质心可沿着旋转轴线A设置,并且共振器5230的几何形状和材料可选择成优化其自然频率。
在各种实施例中,保持环5344与保持器5244类似,可限制或约束弹簧5332和/或摆动件5230在旋转和/或振荡过程中的径向伸长。在各种实施例中,保持环5344可包括摆动件5330的至少一部分周围的阻挡件或保持壁。在某些实施例中,保持环5344可例如包括环绕共振器5320的环。在各种实施例中,保持环5344可例如附接至电动马达5002,例如马达外壳5004。在其它实施例中,保持环5344可例如附接至外科器械5100的柄部5101。在其他实施例中,保持环5344可例如附接至电动马达5002的转子和/或轴5006(图170)使得保持环5344与轴5006和/或共振器5320一起旋转。在各种实施例中,保持环5344可基本上为刚性的,使得其抵抗变形和/或伸长。
保持环5344可限定摆动件5330不会延伸超出的径向边界。例如,当弹簧5332未变形时,摆动件5330可不与保持环5344接触。换句话讲,当弹簧5334未变形时,间隙可限定在摆动件5330的砝码5334与保持环5344之间。另外,当共振器5320在第三操作状态过程中振荡时,摆动件5330可保持不与保持环5344接触。例如,在第三操作状态过程中对振荡摆动件5330的离心力可不足以将摆动件5330的砝码5334延伸超过预定径向边界。虽然在第三操作状态过程中砝码5334与保持环5344之间限定的间隙可减小,砝码5334可例如保持不与保持环5344接触。在此类实施例中,在第三操作状态过程中,摆动件5330的自然频率可基本上不受保持环5344的影响。
在各种实施例中,当共振器5320在第一和第二操作状态过程中旋转时,摆动件5330的弹簧5332可大幅变形和/或伸长。例如,共振器5320的旋转可对弹簧5332产生离心力,并且弹簧5332可响应于离心力而伸长。在某些实施例中,摆动件5330的砝码5334可移向且移入与保持环5344邻接接触。在此类实施例中,保持环5344可限制或约束弹簧5332在第一和第二操作状态过程中进一步径向伸长。
在各种实施例中,外科器械5100(图177)可包括控制系统(未示出),其可控制电动马达5002。在各种实施例中,控制系统可例如包括一个或多个计算机、处理器、微处理器、电路、电路元件(如,晶体管、电阻器、电容器、电感器等等)、集成电路、专用集成电路(ASIC)、可编程逻辑器件(PLD)、数字信号处理器(DSP)、现场可编程门阵列(FPGA)、逻辑门、寄存器、半导体器件、芯片、微芯片和/或芯片组。控制系统可启动、暂停、恢复和/或终止电动马达5002的各种操作状态。例如,电动马达5002可在第一操作状态过程执行第一功能,如朝远侧推进击发元件,并且可随后切换成第二操作状态以执行第二功能,如朝近侧回缩击发元件。击发元件可例如朝远侧推进以横断预定长度的组织,和/或逐出和/或形成预定数量的钉(其他地方所示)。在各种实施例中,当已横断预定长度的组织和/或已逐出和/或形成预定数量的钉时,控制器可控制电动马达5002切换至第二操作状态。击发元件可在第二操作状态过程中朝近侧回缩以例如准备随后的击发冲程。在某些实施例中,电动马达5002可在击发元件完成预定横断长度和/或逐出和/或形成预定数量的钉之前切换至第三操作状态。例如,电动马达5002可过早地从第一操作状态切换至第三操作状态以将指示外科器械的状况的信号传送至操作者。在各种实施例中,电动马达5002可切换至第三操作状态以将潜在过载警告信号传送至操作者。在其它实施例中,放大的触觉反馈可将状态更新传送至操作者,例如击发元件已到达最远侧位置和/或成功完成击发冲程的信号。
在各种实施例中,外科器械5100可设计成克服最大阈值力以横断组织。当施加至击发元件的力超过最大阈值力时,外科器械5100可不按预期那样执行。例如,当击发元件试图横断更厚和/或更坚硬的组织时,更厚和/或更坚硬的组织可对击发元件施加超过最大阈值力的力。因此,击发元件可能无法横断更厚和/或更坚硬的组织。在此类实施例中,电动马达5002可切换至第三操作状态以警告操作者可能存在外科器械5100过载和/或故障。在各种实施例中,外科器械5100可包括传感器(未示出)。传感器可定位在例如端部执行器(其他地方示出)中,并且可能够检测在击发序列过程中施加至击发元件的力。在某些实施例中,传感器和控制系统可进行信号通信。在此类实施例中,当传感器所检测的力超过最大阈值力时,控制系统可将电动马达5002切换至第三操作状态。在第三操作状态中,如本文所述,击发元件的推进可暂停并且电动马达可产生放大的触觉反馈以将潜在过载警告传送至操作者。
响应于放大的触觉反馈,操作者可决定是否要恢复第一操作状态或启动第二操作状态。例如,操作者可决定恢复击发元件朝远侧的推进,即,使外科器械以警告的操作状态操作,或注意到潜在过载警告而使击发元件朝近侧回缩,即,使外科器械以修改的操作状态操作。如果操作者决定以警告的操作状态操作外科器械,那么外科器械5100可能有故障风险。在各种实施例中,外科器械5100可例如包括输入键(未示出),例如多个杠杆和/或按钮。在各种实施例中,输入键可与控制系统进行信号通信。操作者可经由输入键键入输入来控制外科器械。例如,操作者可选择输入键的第一按钮以恢复击发元件的推进,即,键入警告的操作状态,或可选择输入键的第二按钮以回缩击发元件,即,键入修改的操作状态。在各种实施例中,操作者可选择另外的按钮和/或杠杆以选择又一种不同的操作状态。
虽然外科器械5100在以警告的操作状态操作时可能出现故障,但外科器械5100的操作者可判断外科功能的必要性和/或紧迫性超过了故障风险。例如,当时间至关重要时,操作者可判断关键需要超过了器械故障的风险以迅速完成(或试图完成)外科横断和/或缝合。另外,通过允许操作者确定动作过程,可将操作者的全面了解应用于外科手术,并且操作者不太可能因外科器械5100而困惑和/或沮丧。
在各种实施例中,不同马达可产生反馈以与操作者通信。例如,第一马达可在击发序列过程中驱动击发构件,并且第二马达可产生反馈。在各种实施例中,第二马达可产生感觉反馈,例如噪音、光和/或触感信号以与操作者通信。另外,在某些实施例中,控制系统可控制外科器械的多个马达。
主要参见图180,操作外科系统或外科器械的方法可包括外科器械的多种操作状态。例如,外科器械可首先以初始操作状态5402操作,并且可随后以第二操作状态5412或5414之一操作。第二操作状态可为例如警告的操作状态5412,或例如修改的操作状态5414。当外科器械以初始操作状态5402操作时,可在步骤5404处启动初始外科功能。初始外科功能可为外科器械的各种功能中的一种或多种,例如将组织夹紧在端部执行器的钳口之间,使端部执行器进行关节运动,推进击发构件,回缩击发构件,打开端部执行器钳口,和/或重复和/或组合各种功能。在初始外科功能启动之后,外科器械可在步骤5406处检测外科器械的状况。例如,在初始外科功能正推进击发构件的情况下,传感器可检测临床重要的状况,例如对推进的击发构件施加的力超过了例如阈值力。
仍然参见图180,响应于所检测的状况,外科器械可在步骤5408处暂停初始外科功能。另外,在步骤5410处,外科器械可向外科器械的操作者提供反馈。反馈可为感觉反馈,例如噪音、光和/或触感信号。在某些实施例中,第一马达可暂停初始外科功能并且第二马达可产生感觉反馈。或者,如本文所述,多功能电动马达例如电动马达5002可从第一操作状态或推进状态切换至第三操作状态或反馈状态,其中电动马达振荡以产生放大的触觉反馈。当多功能电动马达振荡以产生放大的触觉反馈时,由于电动马达与击发构件之间的高齿轮齿数比,击发元件的推进和/或回缩可暂停和/或减小至不明显和/或难以察觉的量。在此类实施例中,在多功能马达从第一操作状态切换至第三操作状态的情况下,可例如同时或几乎同时发生步骤5408处初始外科功能的暂停和步骤5410处向操作者提供反馈。
在某些实施例中,外科器械将指示特定状况的反馈传送至操作者之后,操作者可确定如何继续。例如,操作者可在多种可能的操作状态之间做出决定。在各种实施例中,操作者可决定是进入警告操作状态5412还是修改的操作状态5414。例如,仍参见图180,操作者可在步骤5416处选择初始外科功能,或可在步骤5418处选择修改的外科功能。在各种实施例中,操作者可与(例如)键、按钮和/或杠杆交接,以选择辅助操作状态中的一者。如果操作者在步骤5416处选择初始外科功能,则外科器械可在步骤5418处恢复初始外科功能。如果操作者在步骤5420处选择修改的外科功能,则外科器械可在步骤5422处启动修改的外科功能。
图183-192示出了用于旋转或线性驱动直线切割器上的绝对位置感测的设备、系统和方法的各种实施例。微控制器控制的直线切割器需要位置和速率值以能够适当控制关节运动、击发和其他外科功能。在过去一直是使用附接到驱动马达的旋转编码器来实现这一点的,其使得微控制器能够通过对马达向后和向前所采取的步骤数进行计数来推断位置。在各种情况下,优选的是用紧凑结构替代该系统,所述紧凑结构向驱动棒或刀的每个可能位置的微控制器提供独特位置信号。现在结合图183-192对旋转或线性驱动直线切割器的此类绝对位置传感器结构的各种示例性具体实施进行详述。
图183为根据一个实施例的图34的外科器械柄部1042的分解透视图,其示出了绝对定位系统7000的传感器结构7002的一部分。已结合图34对图34的外科器械柄部1042进行了详述。因此,为了公开简洁和清楚起见,除了描述与绝对定位系统7000的传感器结构7002相关联的元件之外,图34的外科器械柄部1042的此类详述将不在此重复。因此,如图183所示,外壳1040的外科器械柄部1042可操作地支撑击发驱动系统1100,该驱动系统能够向可互换轴组件的对应部分施加击发动作。击发驱动系统1100可采用电动马达1102。在各种形式中,马达1102可(例如)为旋转最大值为大约25,000RPM的直流有刷驱动马达。在其他结构中,马达可包括无刷马达、无线马达、同步马达、步进马达或任何其他合适的电动马达。电池1104(或“功率源”或“电源组”),例如锂离子电池,可联接到柄部1042以向控制电路板组件1106并且最终向马达1102提供电力。电池组外壳1104可能够可释放地安装到柄部1042,以用于向外科器械1010(图33)提供控制电力。可使用串联连接的多个电池作为功率源来为马达供电。此外,功率源可为可置换的和/或可充电的。
如上面相对于其他各种形式所概述,电动马达1102可包括可操作地与齿轮减速器组件1108交接的可旋转轴(未示出),所述齿轮减速器组件与一组或一齿条的驱动齿1112啮合安装在纵向可移动驱动构件1110上。在使用中,电池所提供的电压极性可沿顺时针方向操作电动马达1102,其中电池施加于电动马达的电压极性可反转,以便沿逆时针方向操作电动马达1102。当沿一个方向旋转电动马达1102时,将沿远侧方向“D”轴向驱动驱动构件1110。当沿相对的旋转方向驱动马达1102时,将沿近侧方向“P”轴向驱动驱动构件1110。柄部1042可包括开关,该开关可能够使电池施加于电动马达1102的极性反转。与本文所述的其他形式一样,柄部1042还可包括传感器,该传感器能够检测驱动构件1110的位置和/或驱动构件1110移动的方向。
图184为根据一个实施例的图183的柄部的侧正视图,其示出了绝对定位系统7000的传感器结构7002的一部分,其中柄部外壳的一部分被移除。柄部1042的外壳1040支撑控制电路板组件1106,其包括执行绝对定位系统7000所必需的必要逻辑和其他电路部件。
图185为根据一个实施例的绝对定位系统7000的示意图,所述系统包括微控制器7004控制的马达驱动电路结构,该结构包括传感器结构7002。与绝对定位系统7000和/或传感器结构7002相关联的电动和电子电路元件由控制电路板组件1106支撑。微控制器7004通常包括可操作地联接的存储器7006和微处理器7008(“处理器”)。处理器7008控制马达驱动器7010电路以控制马达1102的位置和速率。马达1102可操作地联接到传感器结构7002和绝对位置传感器7012结构,以向外科器械1010(图33)的驱动棒或刀的每个可能位置的微控制器7004提供独特位置信号。经由反馈元件7024向微控制器7004提供独特位置信号。应当理解,独特位置信号可为基于位置传感器7012和微控制器7004之间的界面的模拟信号或数字值。在下文所述的一个实施例中,位置传感器7012和微控制器7004之间的界面为标准串联外围界面(SPI),并且独特位置信号为数字值,该数字值表示传感器元件7026经过一次旋转的位置。可将表示传感器元件7026经过一次旋转的绝对位置的值存储在存储器7006中。传感器元件7026的绝对位置反馈值对应于关节运动和刀元件的位置。因此,传感器元件7026的绝对位置反馈值提供关节运动和刀元件的位置反馈控制。
电池1104或其他能量源为绝对定位系统7000提供电力。此外,可提供其他传感器7018以测量与绝对定位系统7000相关联的其他参数。另外可提供一个或多个显示指示器7020,其可包括发声部件。
如图185所示,传感器结构7002提供对应于纵向可移动驱动构件1110的位置的独特位置信号。电动马达1102可包括可操作地与齿轮组件7014交接的可旋转轴7016,所述齿轮组件与一组或一齿条的驱动齿1112(图183)啮合安装在纵向可移动驱动构件1110上。传感器元件7026可以可操作地联接到齿轮组件7104,使得传感器元件7026的单一旋转对应于纵向可移动驱动构件1110的某个线性纵向平移,如下文更详细所述。在一个实施例中,齿轮传动装置和传感器的结构可经由齿条和小齿轮结构连接至线性致动器,或者经由直齿齿轮或其他连接连接至旋转致动器。对于包括旋转螺杆驱动构造的实施例而言,其中将需要较大数量的转动,可在驱动构件和传感器之间采用高减速齿轮传动装置结构,比如蜗杆与蜗轮。
根据本公开的一个实施例,绝对定位系统7000的传感器结构7002提供更稳固的位置传感器7012以用于与外科装置一起使用。通过为每个可能的致动器位置提供独特位置信号或值,此类结构无需进行归零或校正步骤并且会减少以下情况下消极设计影响的可能性,其中噪音或电源掉电状况可如常规旋转编码器构造中一样产生位置感测错误。
在一个实施例中,绝对定位系统7000的传感器结构7002替换通常附接到马达转子的常规旋转编码器并且将其替换为位置传感器7012,该传感器在与位置传感器7012相关联的传感器元件的单一旋转中针对每个可旋转位置生成独特位置信号。从而,与位置传感器7012相关联的传感器元件的单一旋转等同于纵向可移动驱动构件1110的纵向线性位移d1。换句话讲,d1为联接到纵向可移动驱动构件1110的传感器元件的单一旋转之后纵向可移动驱动构件1110从点a向点b移动的纵向线性距离。可经由齿轮减速连接传感器结构7002,其使得位置传感器7012针对纵向可移动驱动构件1110的全冲程仅完成单一转动。利用合适的齿轮齿数比,纵向可移动驱动构件1110的全冲程可用位置传感器7012的一次旋转表示。
可单独或结合齿轮减速采用一系列开关7022a至7022n(其中n为大于一的整数)以针对位置传感器7012的不止一次旋转提供独特位置信号。开关7022a-7022n的状态被馈送回微控制器7004,该微控制器应用逻辑以确定对应于纵向可移动驱动构件1110的纵向线性位移d1+d2+…dn的独特位置信号。
因此,绝对定位系统7000在器械通电时提供纵向可移动驱动构件1110的绝对位置,并且不使纵向可移动驱动构件1110回缩或推进至如常规旋转编码器可需要的复位(清零或本位)位置,所述编码器仅对马达向前或向后采取的步骤数进行计数以推断装置致动器、驱动棒、刀等等的位置。
在各种实施例中,传感器结构7002的位置传感器7012可包括(例如)一个或多个磁性传感器、模拟旋转传感器(比如电位差计)、模拟霍尔效应元件阵列等,所述霍尔效应元件输出位置信号或值的独特组合。
在各种实施例中,可对微控制器7004进行编程以执行各种功能,例如对刀和关节运动系统的速度和位置的精确控制。使用已知的物理特性,微控制器7004可设计成模拟实际系统在控制器7004的软件中的响应。将所模拟响应与实际系统的(嘈杂离散)所测量响应进行比较以获得“观测到的”响应,其用于实际反馈判决。观测到的响应为有利的调谐值,该值使模拟响应的平滑连续性质与测量响应均衡,其可感测对系统的外部影响。
在各种实施例中,绝对定位系统7000还可包括和/或被编程为执行下列功能。反馈控制器,其可为任何反馈控制器中的一者,包括但不限于:
PID、状态反馈和自适应。功率源将来自反馈控制器的信号转换为对系统的物理输入,在这种情况下为电压。其他例子包括但不限于脉宽调制(PWMed)电压、电流和力。马达1102可为有刷直流马达,其具有齿轮箱以及至关节运动或刀系统的机械链接。除了位置传感器7012所测量的位置之外,可提供其他传感器7018以测量物理系统的物理参数。由于其为数字信号(或连接至数字数据采集系统),其输出将具有有限的分辨率和取样频率。可提供比较和合并电路以使用算法(诸如,在无限制的情况下,加权平均数和理论控制回路)将所模拟响应与所测量响应合并,其使得朝所测量响应驱动所模拟响应。物理系统的模拟将比如质量、惯性、粘性摩擦、电感电阻等性能考虑在内,以通过得知输入预测物理系统的状态和输出。
在一个实施例中,微控制器7004可为(例如)LM4F230H5QR,其可得自德州仪器(Texas Instruments)。在一个实施例中,德州仪器(Texas Instruments)LM4F230H5QR为ARM Cortex-M4F处理器芯,其包括:256KB的单循环快闪式存储器或其他非易失性存储器(最多至40MHZ)的片上存储器7006、用以使性能改善超过40MHz的预取缓冲器、32KB的单循环串行随机访问存储器(SRAM)、装载有StellarisWare软件的内部只读存储器(ROM)、2KB电可擦编程只读存储器(EEPROM)、两个脉宽调制(PWM)模块,包括针对运动和能量应用的16种先进PWM输出、两种正交编码器输入(QEI)模拟、具有12个模拟输入通道的两个12位模数转换器(ADC),以及对于产品数据表而言易得的其他特征。可容易地取代其他微控制器以用于绝对定位系统7000中。因此,本公开不应限于这一上下文。
在一个实施例中,驱动器7010可为可得自Allegro微系统公司(AllegroMicrosystems,Inc)的A3941。A3941驱动器7010为全桥控制器,其用于与针对电感负载特别设计的外部N通道功率金属氧化物半导体场效应晶体管(MOSFET)一起使用,例如有刷直流马达。驱动器7010包括独特的电荷泵调节器,为低至7V的电池电压提供完整的(>10V)门极驱动并且允许A3941在低至5.5V的减速门极驱动下工作。可采用自举电容器提供N通道MOSFET所需的上述电池供电电压。高边驱动器的内部电荷泵允许直流(100%占空比)操作。可使用二极管或同步整流在快衰减模式或慢衰减模式下驱动全桥。在慢衰减模式下,电流再循环可穿过高边或低边FET。通过电阻器可调式空载时间保护功率FET不被击穿。整体诊断指示欠压、过热和功率桥故障,并且可能够在大多数短路情况下保护功率MOSFET。可容易地取代其他马达驱动器以用于绝对定位系统7000中。因此,本公开不应限于这一上下文。
描述总体架构以用于针对传感器结构7002执行绝对定位系统7000的各种实施例之后,本公开现在转向图186-192以获取绝对定位系统7000的传感器结构的一个实施例的描述。在图186中示出的实施例中,传感器结构7002包括磁性位置传感器7100、双极性磁体7102传感器元件、纵向可移动驱动构件1110(图183-185)每进行一个全冲程时就转动一次的磁体夹持器7104以及用以提供齿轮减速的齿轮组件7106。提供了结构元件(例如托架7116)以支撑齿轮组件7106、磁体夹持器7104和磁体7102。磁性位置传感器7100包括一个或多个磁性感测元件(例如,霍尔元件)并且被设置成邻近磁体7102。因此,当磁体7102旋转时,磁性位置传感器7100的磁性感测元件确定经过一次旋转的磁体7102的绝对角位置。
在各种实施例中,可在绝对定位系统7000上采用任何数量的磁性感测元件,例如根据其测量整个磁场还是磁场的矢量分量归类的磁性传感器。用于产生上述两种类型磁性传感器的技术涵盖物理学和电子学的多个方面。用于磁场感测的技术包括探测线圈、磁通门、光泵、核旋、超导量子干涉仪(SQUID)、霍尔效应、各向异性磁电阻、巨磁电阻、磁性隧道结、巨磁阻抗、磁致伸缩/压电复合材料、磁敏二极管、磁敏晶体管、光纤、磁光,以及基于微机电系统的磁传感器等。
在示出的实施例中,齿轮组件7106包括第一齿轮7108和第二齿轮7110,其啮合在一起以提供3:1齿轮齿数比连接。第三齿轮7112绕轴7114旋转。第三齿轮与纵向可移动驱动构件1110啮合,在纵向可移动驱动构件1110沿远侧方向D(图183)推进时沿第一方向旋转,并且在纵向可移动驱动构件1110沿近侧方向P(图183)回缩时沿第二方向旋转。第二齿轮7110绕相同轴7114旋转,因此第二齿轮7110绕轴7114的旋转对应于纵向可移动驱动构件1110的纵向平移。从而,纵向可移动驱动构件1110沿远侧方向D或近侧方向P的一个全冲程对应于第二齿轮7110的三次旋转和第一齿轮7108的单一旋转。由于磁体夹持器7104联接到第一齿轮7108,磁体夹持器7104随着纵向可移动驱动构件1110的每个全冲程进行一次完整旋转。
图187为根据一个实施例的绝对定位系统7000的传感器结构7002的分解透视图,其示出了控制电路板组件1106和传感器结构7002的元件的相对对齐方式。位置传感器7100(本视图中未示出)由位置传感器夹持器7118支撑并且与下面的旋转磁体7102精确对齐,所述夹持器限定适于包含位置传感器7100的小孔7120。夹具7120联接到托架7116以及控制电路板组件1106,并且在磁体7102随磁体夹持器7104旋转时保持静止。提供了一种轮毂7122以与第一齿轮7108/磁体夹持器7104组件配合。
图188-190提供根据一个实施例的传感器结构7002的额外视图。具体地讲,图188示出了定位在可操作模式中的整个传感器结构7002。位置传感器夹持器7118位于控制电路板组件1106下方并且包封磁体夹持器7104和磁体7102。图189示出了磁体7102,其位于在位置传感器夹持器7118中限定的小孔7120的下方。为了清楚起见,未示出位置传感器7100和控制电路板组件1106。图190示出了传感器结构7002,其中移除了控制电路板组件1106、位置传感器夹持器7118、位置传感器7100和磁体7102,以示出容纳磁体7102的小孔7124。
图191为根据一个实施例的传感器结构7002的俯视图,该结构示为控制电路板1106被移除但电子元件仍可见以示出位置传感器7100和电路元件7126之间的相对位置。在结合图186-191示出的实施例中,由第一齿轮7108和第二齿轮7110构成的齿轮组件7106具有3:1齿轮齿数比,使得第二齿轮7110的三次旋转提供第一齿轮7108以及从而提供磁体夹持器7104的单一旋转。如此前所述,在磁体夹持器7104/磁体7102组件旋转时位置传感器7100保持静止。
如上所述,可利用齿轮组件驱动磁体夹持器7104和磁体7102。由于可以可靠地预测齿轮组件中的一个齿轮和齿轮组件中的另一个齿轮之间的相对旋转,因此齿轮组件可用于各种情况。在各种其他情况下,只要可以可靠地预测马达的输出和磁体7102的旋转之间的关系,就可利用任何合适的驱动装置驱动夹持器7104和磁体7102。此类装置可包括(例如)轮组件,该组件包括至少两个接触轮,例如塑性轮和/或弹性轮,其可在两者间传输运动。此类装置还可包括(例如)轮和皮带组件。
图192为根据一个实施例的绝对定位系统7000的位置传感器7100的一个实施例的示意图,所述绝对定位系统包括磁性旋转绝对定位系统。在一个实施例中,位置传感器7100可作为AS5055EQFT单片磁性旋转位置传感器执行,其可得自奥地利微电子公司(austriamicrosystems,AG)。位置传感器7100与微控制器7004交接以提供绝对定位系统7000。位置传感器7100为低电压和低功率部件,并且在位于磁体7104(图186、187)上方的位置传感器7100的区域7130中有四个一体化的霍尔效应元件7128A、7128B、7128C、7128D。在芯片上也提供了高分辨率ADC7132和智能型电源管理控制器7138。提供了CORDIC处理器7136(针对坐标旋转数字计算机(COordinate Rotation DIgital Computer)),也称为逐位法和Volder算法,以执行简单有效的算法来计算双曲线函数和三角函数,其仅需要加法、减法、位位移和表格查找操作。经由标准SPI界面7134将角位置、报警位和磁场信息传输至宿主处理器、微控制器7004。位置传感器7100提供12或14位分辨率。在图191中示出的实施例中,位置传感器7100为在小型QFN16-销4×4×0.85mm包装件中提供的AS5055芯片。
霍尔效应元件7128A、7128B、7128C、7128D位于旋转磁体正上方。霍尔效应为熟知效应,为了本公开简洁和清楚起见,在本文中将不进行详述。一般来讲,霍尔效应为电导体范围内的电压差值(霍尔电压)的产生,所述电导体横向于导体中的电流和垂直于电流的磁场。霍尔效应由埃德温霍尔(Edwin Hall)发现于1879年。霍尔系数被限定为感应电场与电流密度和所施加磁场的产物的比率。其为从中制备导体的材料的特性,因为其值取决于构成电流的电荷载体的类型、数量和性能。在AS5055位置传感器7100中,霍尔效应元件7128A、7128B、7128C、7128D能够产生电压信号,其指示根据磁体7104经过单一旋转之后的角度的磁体7104(图186、187)的绝对位置。由CORDIC处理器7136计算角度的这个值(其为独特位置信号),并且将其以机载方式存储在寄存器或存储器中的AS5055位置传感器7100上。在多种技术中,如在通电时或在宿主处理器7004发出请求时,向宿主处理器7004提供角度的值,其指示经过一次旋转的磁体7104的位置。
AS5055位置传感器7100在连接至宿主微控制器7004时仅需要几个外部部件就可操作。使用单一电源的简单应用需要六根电线:两根电线用于电力,四根电线7140用于与宿主微控制器7004的SPI串行通信界面7134。可加入第七连接以便向宿主微控制器7004发送中断以通知可读取新的有效角度。
在通电时,AS5055位置传感器7100执行完全通电序列,包括一个角度测量。在输出销7142处将这一循环的完成指示为INT请求并且将角度值存储在内部寄存器中。一旦设定了这一输出,AS5055位置传感器7100就暂停为休眠模式。外部微控制器7004可通过经由SPI界面7134读取来自AS5055位置传感器7100的角度值来响应7142处的INT请求。一旦微控制器7004读取了角度值,就再次清除INT输出7142。由微控制器7004通过SPI界面7134向位置传感器7100发送“读取角度”指令也会自动使芯片通电并且启动另一个角度测量。微控制器7004一完成角度值的读取,就清除INT输出7142并且将新的结果存储在角度寄存器中。通过设定INT输出7142和状态寄存器中的对应标志再次指示角度测量的完成。
由于AS5055位置传感器7100的测量原理,每个通电序列之后,在非常短的时间(~600μs)内仅执行单一角度测量。一个角度的测量一完成,AS5055位置传感器7100就暂停为断电状态。未执行根据数字平均化的角度值的片上过滤,因为这将需要不止一个角度测量并且因此需要更长通电时间,在低功率应用中不希望这样。可通过在外部微控制器7004中对数个角度样品平均化来减少角度抖动。例如,4种样品的平均化使抖动减少6dB(50%)。
如上所述,可利用定位在外科器械系统1000的柄部1042内的马达1102使(例如)轴组件1200(包括击发构件1272和1280)的击发系统相对于轴组件1200的端部执行器1300推进和/或回缩,以便缝合和/或切割在端部执行器1300内捕集到的组织。在各种情况下,可能期望使击发构件1272和1280以所需速度或在所需速度范围内推进。同样,可能期望使击发构件1272和1280以所需速度或在所需速度范围内回缩。在各种情况下,例如柄部1042的微控制器7004和/或任何其他合适的控制器可能够控制击发构件1272和1280的速度。在一些情况下,控制器可能够基于(例如)向马达1102提供的电力的各种参数(诸如电压和/或电流)和/或马达1102的其他操作参数预测击发构件1272和1280的速度。控制器也可能够基于向马达1102提供的电流和/或电压的先前值和/或系统的先前状态(比如速度、加速度和/或位置)预测击发构件1272和1280的当前速度。此外,控制器也可能够利用(例如)上述的绝对定位传感器系统来感测击发构件1272和1280的速度。在各种情况下,控制器可能够对击发构件1272和1280的预测速度与击发构件1272和1280的感测速度进行比较,以确定是否应当增加马达1102的电力以便增加击发构件1272和1280的速度和/或减小电力以便减小击发构件1272和1280的速度。美国专利申请No.12/235,782,名称为MOTOR-DRIVEN SURGICALCUTTING INSTRUMENT,现在为美国专利No.8,210,411,全文以引用方式并入。美国专利申请No.11/343,803,名称为SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES,全文以引用方式并入。
使用本文所公开的器械的物理特性,现在转向图198和199,例如控制器(诸如微控制器7004)可被设计成模拟器械的实际系统在控制器的软件中的响应。将所模拟响应与实际系统的(嘈杂离散)所测量响应进行比较以获得“观测到的”响应,其用于实际反馈判决。观测到的响应为有利的调谐值,该值使所模拟响应的平滑连续性质与所测量响应均衡,其可感测对系统的外部影响。参见图198和199,可按照或接近目标速率(或速度)移动轴组件1200的端部执行器1300中的击发元件,或切割元件。可利用图198和199中所公开的系统以目标速率移动切割元件。系统可包括反馈控制器4200,其可为任何反馈控制器中的一者,包括但不限于例如PID、状态反馈、LQR和/或自适应控制器。系统还可包括功率源。功率源可将来自反馈控制器4200的信号转换为(例如)系统的物理输入,在这种情况下为电压。其他例子包括但不限于(例如)脉宽调制(PWM)电压、频率调制电压、电流、扭矩和/或力。
继续参见图198和199,其中提到的物理系统为能够驱动击发构件或切割构件的器械的实际驱动系统。一个例子为有刷直流马达,其具有齿轮箱以及至关节运动和/或刀系统的机械链接。另一个例子为本文所公开的马达1102,其操作(例如)可互换轴组件的击发构件10060和关节运动驱动器10030。图198和199中提到的外部影响4201(例如)为事物(比如组织、周围物体和摩擦)对物理系统的未测量的、不可预测的影响。此类外部影响可称为阻力并且可(例如)由马达4202表示,该马达与马达1102行为相反。在各种情况下,外部影响(例如阻力)为物理系统的模拟偏离实际物理系统的主要原因。图198和199中示出的以及下文进一步所述的系统可解决击发构件(或切割构件)的预测行为与击发构件(或切割构件)的实际行为之间的差异。
继续参见图198和199,其中提到的离散传感器对实际物理系统的物理参数进行测量。此类离散传感器的一个实施例可包括本文所述的绝对定位传感器7102和系统。由于此类离散传感器的输出可为数字信号(或连接至数字数据采集系统),其输出可具有有限的分辨率和取样频率。可向(例如)微控制器提供离散传感器的输出,诸如微控制器7004。在各种情况下,微控制器可将所模拟或所估计响应与所测量响应合并。在某些情况下,可能有用的是使用足够所测量响应以确保将外部影响考虑在内,并且不使观测到的响应无用地嘈杂。执行该操作的算法的例子包括加权平均数和/或理论控制回路,其(例如)朝所测量响应驱动所模拟响应。最终,除上述之外,物理系统的模拟将(例如)质量、惰性、粘性摩擦和/或电感电阻之类的特性考虑在内,以通过得知输入预测物理系统的状态和输出。图199示出了额外对操作实际系统所提供的电流进行评估和测量,其为又一个参数,可对其进行评估以用于控制(例如)轴组件1200的切割构件或击发构件的速度。在某些情况下,除了测量电压之外或代替测量电压,通过测量电流,可使物理系统更精确。尽管如此,本文所公开的想法可延伸为其他物理系统的其他状态参数的测量。
对绝对定位系统7000的各种实施例进行描述以确定对应于与关节运动和击发相关联的元件的独特绝对位置的传感器元件的绝对位置信号/值之后,本公开现在转向对数种技术的描述,以用于在位置反馈系统中利用绝对位置/值来控制关节运动和刀的位置,以补偿通电的进行关节运动外科器械1010(图33)中的刀带展开。绝对定位系统7000向沿着钉仓长度的驱动棒或刀的每个可能位置的微控制器提供独特位置信号/值。
已结合图37对关节运动接头1350的操作进行了描述,为了本公开简洁和清楚起见,在这一部分中将不进行详细重复。已结合图102对关节运动接头10090的操作进行了描述,为了本公开简洁和清楚起见,在这一部分中将不进行详细重复。图193示出了根据一个实施例的处于竖直位置的关节运动接头8000,即相对于示为纵向轴线L-A的纵向成零度角θ0。图195示出了根据一个实施例的图193的关节运动接头8000,其以限定在纵向轴线L-A和关节运动轴线A-A之间的第一角度θ1沿一个方向进行关节运动。图195示出了根据一个实施例的图194的关节运动接头8000,其以限定在纵向轴线L-A和关节运动轴线A’-A之间的第二角度θ2沿另一个方向进行关节运动。
根据本公开的外科器械利用多个柔性刀带8002将压缩力转移至端部执行器1300(图37)的仓内的平移式刀元件。柔性刀带8002允许端部执行器1300(图33)通过多种角度θ进行关节运动。然而,进行关节运动的行为导致柔性刀带8002展开。柔性刀带8002的展开改变纵向的有效横断长度Tl。从而,当使柔性刀带8002进行关节运动经过角度θ=0时,难以确定刀经过关节运动接头8000的精确位置。如此前所述,当关节运动角度为零度θ0(如图194所示)时,可直接使用来自绝对定位系统7000的绝对位置反馈信号/值确定关节运动和刀元件的位置。然而,当柔性刀带8002从纵向轴线L-A偏离零度角θ0时,如果不知道关节运动角度θ,则无法基于由绝对定位系统7000向微控制器7004提供的绝对位置信号/值精确确定仓内的刀的绝对位置。
在一个实施例中,可基于外科器械的击发驱动装置相当精确地确定关节运动角度θ。如上所概述,击发构件10060的运动可由绝对定位系统7000跟踪,其中当关节运动驱动装置通过(例如)离合器系统10070可操作地联接到击发构件10060时,绝对定位系统7000可实际上通过击发构件10060跟踪关节运动系统的运动。作为跟踪关节运动系统的运动的结果,外科器械的控制器可跟踪端部执行器(例如,端部执行器10020)的关节运动角度θ。在各种情况下,作为结果,可根据柔性刀带8002的纵向位移DL来确定关节运动角度θ。由于可基于绝对定位系统7000所提供的绝对位置信号/值精确确定柔性刀带8002的纵向位移DL,可采用算法以补偿刀随关节运动接头8000进行位移过程中的错误。
在另一个实施例中,可通过在关节运动接头8000远侧D的柔性刀带8002上定位传感器来确定关节运动角度θ。传感器可能够感测进行关节运动的柔性刀带8002中的张力或压缩量。向微控制器7004提供所测量的张力或压缩结果以基于在刀带8002中所测量的张力或压缩量计算关节运动角度θ。合适的传感器,例如微电子机械系统(MEMS)装置和应变仪可容易地能够进行此类测量。其他技术包括在关节运动接头8000中定位倾角传感器、倾斜仪、加速计或用于测量角度的任何合适装置以测量关节运动角度θ。
在各种实施例中,下文在通电外科器械1010的上下文中对补偿柔性刀带8002在通电的可关节运动外科器械1010(图33)中的展开的数种技术进行了描述,所述外科器械包括绝对定位系统7000和具有数据存储能力的微控制器7004,例如存储器7006。
图196示出了补偿柔性刀带8002的展开对横断长度Tl的作用的方法的逻辑图8100的一个实施例。将结合图185和192-196对方法进行描述。因此,在补偿柔性刀带8002的展开对横断长度Tl的作用的方法8100的一个实施例中,初始对(例如)端部执行器1300(图37)或端部执行器10020(图102)的关节运动角度θ与关节运动接头8000远侧的有效横断长度Tl之间的关系进行了表征,并且将表征数据存储在外科器械1010(图33)的存储器7006中。在一个实施例中,存储器7006为非易失性存储器,例如快闪式存储器、EEPROM等等。微控制器7004的处理器7008部分对存储在存储器7006中的表征数据进行访问8102。在外科器械1010的使用过程中处理器7008跟踪8104端部执行器1300的关节运动角度。处理器7008通过外科器械1010调节8106目标横断长度Tl,其基于已知的关节运动角度θM以及表示关节运动角度θS与横断长度Tl之间的关系的存储表征数据。
在各种实施例中,制造过程中可针对外科器械1010(图33)的轴来完成表示端部执行器1300(图37)的关节运动角度θ与有效横断长度Tl之间关系的表征数据。在一个实施例中,表征8102过程的输出为在存储器7006中执行的查找表。因此,在一个实施例中,处理器7008对在存储器7006中执行的查找表的表征数据进行访问。在一个方面,查找表包括阵列,该阵列用更简单的阵列索引操作取代运行时间计算。在处理时间方面的节约可能很明显,因为处理器7008从存储器7006检索值一般要比经历“昂贵”计算或输入/输出操作快。查找表可预先计算并且存储在静态程序存储中,作为程序初始化阶段(记忆)的一部分计算(或“预取”),或甚至存储在应用程序特定平台中的硬件中。在本专利申请中,查找表存储端部执行器1300(图37)的关节运动角度和有效横断长度之间的关系表征的输出值。查找表将这些输出值存储在阵列中并且在一些编程语言中可包括指针函数(或至标签的偏移量)来处理匹配输入。从而,对于限定位移DL的每个独特值而言,存在对应的关节运动角度θ。使用关节运动角度θ计算(例如)关节运动接头8000、关节运动接头1350或关节运动接头10090远侧的对应横断长度Tl位移。对应的横断长度Tl位移存储在查找表中,微控制器7004使用该位移确定经过关节运动接头的刀的位置。在本公开的范围内可想到其他查找表技术。
在一个实施例中,表征8102过程的输出为最佳曲线拟合公式,线性或非线性。因此,在一个实施例中,处理器7008可操作以执行计算机可读指令,从而基于表征数据执行最佳曲线拟合公式。曲线拟合为构造曲线(或与一系列数据点具有最佳拟合的数学函数)的过程,可能受到限制。曲线拟合可涉及任一内推法,其中需要对数据精确拟合。在本公开中,曲线表示基于关节运动角度θ的进行关节运动的关节运动接头8000(图37)远侧的柔性刀带8002的横断长度Tl位移,其取决于邻近P关节运动接头1350的柔性刀带8002的线性位移DL。可对数据点(例如邻近关节运动接头1350的柔性刀带8002的线性位移DL、进行关节运动的关节运动接头1350远侧的柔性刀带8002的位移Tl以及关节运动角度θ)进行测量并且用来生成n次多项式形式的最佳拟合曲线(3次多项式将提供适合所测量数据的合适曲线)。可对微控制器7004进行编程以执行n次多项式。在使用中,输入n次多项式为衍生自绝对定位系统7000提供的独特绝对位置信号/值的柔性刀带8002的线性位移。
在一个实施例中,表征8102过程对关节运动角度θ和刀带8002上的压缩力作出了说明。
在一个实施例中,有效横断长度为刀片的最远侧表面对外科器械1010的柄部中的预定基准之间的距离。
在各种实施例中,用于存储表征的存储器7006可为位于外科器械1010(图33)的轴、柄部或两者上的非易失性存储器。
在各种实施例中,关节运动角度θ可由位于外科器械1010(图33)的轴上的传感器跟踪。在其他实施例中,关节运动角度θ可由外科器械1010的柄部上的传感器跟踪或关节运动角度θ可由外科器械1010的控制软件内的变量跟踪。
在一个实施例中,微控制器7004的控制软件利用表征,其与非易失性存储器7006连通以访问表征。
本文所述的各种实施例在缝钉的上下文中有所描述,所述缝钉可释放地存储在钉仓内以用于与外科缝合器械一起使用。在一些情况下,缝钉可包括电线,所述电线在其接触外科缝合器的砧座时变形。此类电线可(例如)由金属构成,例如不锈钢,和/或任何其他合适的材料。此类实施例以及其教导内容可应用于包括紧固件的实施例中,所述紧固件可释放地与紧固件仓一起存储以用于与任何合适的紧固器械一起使用。
本文所述的各种实施例在线性端部执行器和/或线性紧固件仓的上下文中有所描述。此类实施例以及其教导内容可应用于非线性端部执行器和/或非线性紧固件仓,例如,圆形和/或波状外形端部执行器。例如,各种端部执行器,包括非线性端部执行器,在提交于2011年2月28日、名称为SURGICAL STAPLING INSTRUMENT的美国专利申请No.13/036,647(现在为美国专利申请No.2011/0226837)中有所公开,该专利申请据此全文引入以供参考。另外,提交于2012年9月29日、名称为STAPLE CARTRIDGE的美国专利申请No.12/893,461(现在为美国专利申请公开No.2012/0074198)据此全文引入以供参考。提交于2008年2月15日、名称为END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT的美国专利申请No.12/031,873(现在为美国专利No.7,980,443)也据此全文引入以供参考。公布于2013年3月12日、名称为SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE的美国专利No.8,393,514也据此全文引入以供参考。
实例
用于治疗组织的外科器械可包括具有触发器的柄部、从柄部延伸的轴、端部执行器和关节运动接头,其中端部执行器通过关节运动接头可旋转地联接到轴。外科器械还可包括可操作地与触发器联接的击发构件,其中触发器的操作能够朝端部执行器推进击发构件,以及可操作地与端部执行器联接的关节运动构件。关节运动构件可选择性地与击发构件接合,使得关节运动构件可操作地与处于接合构造的击发构件接合,并且使得关节运动构件可操作地脱离处于未接合构造的击发构件,其中当关节运动构件和击发构件处于接合构造时击发构件能够朝端部执行器推进关节运动构件以使端部执行器绕关节运动接头旋转。外科器械还可包括偏置构件,例如弹簧,其可能够在端部执行器进行关节运动之后,使端部执行器重新居中并且使端部执行器沿纵向轴线与轴重新对齐。
用于治疗组织的外科器械可包括电动马达、轴、端部执行器和关节运动接头,其中端部执行器通过关节运动接头可旋转地联接到轴。外科器械还可包括可与电动马达可操作地接合的击发驱动装置,其中击发驱动装置能够通过电动马达朝端部执行器推进以及远离端部执行器回缩。外科器械还可包括与端部执行器可操作地联接的关节运动驱动装置,其中在将关节运动驱动装置朝远侧推向端部执行器时关节运动驱动装置能够沿第一方向旋转端部执行器,其中在将关节运动驱动装置朝近侧推离端部执行器时关节运动驱动装置能够够沿第二方向旋转端部执行器,其中击发驱动装置可选择性地与关节运动驱动装置接合并且能够在击发驱动装置可操作地接合关节运动驱动装置时进行将关节运动驱动装置朝远侧推向端部执行器和将关节运动驱动装置推离端部执行器中的至少一者,并且其中当击发驱动装置可操作地脱离关节运动驱动装置时击发驱动装置可独立于关节运动驱动装置进行操作。
用于治疗组织的外科器械可包括轴、可旋转联接到轴的端部执行器和能够相对于端部执行器移动的击发构件。外科器械还可包括与端部执行器可操作地联接的关节运动构件,其中关节运动构件可选择性地与击发构件接合,使得关节运动构件可操作地与处于接合构造的击发构件接合,并且使得关节运动构件可操作地脱离处于未接合构造的击发构件,并且其中击发构件能够使关节运动构件相对于端部执行器移动,以在关节运动构件和击发构件处于接合构造时旋转端部执行器。外科器械还可包括端部执行器锁,该锁可构造为锁定构造和未锁定构造,其中当端部执行器锁处于未锁定构造时端部执行器锁能够使关节运动构件与击发构件可操作地接合。
可包括至少一个驱动系统的外科器械,所述驱动系统能够生成控制运动并且限定致动轴线。外科器械还可包括至少一个可互换轴组件,该组件能够沿基本上横向于致动轴线的方向可释放地联接到至少一个驱动系统,并且将控制运动从至少一个驱动系统传输至可操作地联接到可互换轴组件的外科端部执行器。此外,外科器械还可包括闭锁组件,该组件与至少一个驱动系统交接以用于防止驱动系统的致动,除非所述至少一个可互换轴组件已经可操作地联接到所述至少一个驱动系统。
包括轴组件的外科器械,该轴组件包括端部执行器。端部执行器可包括外科钉仓和相对于外科钉仓可移动地支撑的砧座。轴组件还可包括可移动的闭合轴组件,该组件能够向砧座施加打开运动和闭合运动。轴附接框架可以可操作地支撑其上的可移动闭合轴组件的一部分。外科器械还可包括框架构件,该构件能够可释放地与轴附接框架可操作地接合,以及闭合驱动系统,该系统由框架构件可操作地支撑并且限定致动轴线。当轴附接框架与框架构件可操作地接合时,闭合驱动系统可能够沿基本横向于致动轴线的方向与闭合轴组件可操作地接合。闭锁组件可与闭合驱动系统交接以用于防止闭合驱动系统的致动,除非闭合轴组件与闭合驱动系统可操作地接合。
可包括框架的外科系统,所述框架可操作地支撑至少一个驱动系统以用于在致动控制致动器时生成控制运动。驱动系统中的至少一者限定致动轴线。外科系统还可包括多个可互换轴组件,其中每个可互换轴组件可包括轴附接框架,该框架能够沿着基本横向于致动轴线的方向以可释放方式可操作地接合所述框架的一部分。第一轴组件可由轴附接框架可操作地支撑并且能够沿着基本横向于致动轴线的方向与所述至少一个驱动系统中的对应驱动系统可操作地接合。闭锁组件可机械地接合所述至少一个驱动系统的对应驱动系统的一部分并且与控制致动器配合以防止控制致动器的致动,直至轴附接框架与框架部分可操作地接合并且第一轴组件与所述至少一个驱动系统中的所述一个驱动系统可操作地接合。
可互换轴组件可与外科器械一起使用。在至少一种形式中,外科器械包括框架,该框架可操作地支撑多个驱动系统并且限定致动轴线。在一种形式中,轴组件包括第一轴线,该第一轴线能够向可操作地联接到其上的外科端部执行器施加第一致动运动,其中第一轴线的近端能够沿着基本横向于致动轴线的方向以可释放方式可操作地联接到由框架支撑的驱动系统中的第一者。
可互换轴组件可与外科器械一起使用。在至少一种形式中,外科器械可包括框架,其限定致动轴线并且可操作地支撑多个驱动系统。轴组件的各种形式可包括轴框架,其具有附接到其近端的轴附接模块并且能够沿着基本横向于致动轴线的方向可释放地联接到框架的一部分。轴组件还可包括端部执行器,其可操作地联接到轴框架的远端。在至少一种形式中,端部执行器包括外科钉仓以及相对于外科钉仓可移动地支撑的砧座。轴组件还可包括外部轴组件,其包括能够向砧座施加控制运动的远端。外部轴组件可包括近端,该近端能够沿着基本横向于致动轴线的方向以可释放方式可操作地联接到由框架支撑的驱动系统中的第一者。轴组件还可包括击发轴组件,其包括远侧切割部分,所述部分能够在端部执行器内的起始位置和结束位置之间移动。击发轴组件可包括近端,该近端能够沿着基本横向于致动轴线的方向以可释放方式可操作地联接到由框架支撑的击发驱动系统。
外科系统可包括支撑多个驱动系统并且限定致动轴线的框架。系统还可包括多个可互换轴组件。每个可互换轴组件可包括伸长轴,该伸长轴能够向可操作地联接到其上的外科端部执行器施加第一致动运动,其中伸长轴的近端能够沿着基本横向于致动轴线的方向以可释放方式可操作地联接到由框架支撑的驱动系统中的第一者。每个可互换轴组件还可包括控制轴组件,该控制轴组件可操作地支撑在伸长轴内并且能够向端部执行器施加控制运动,并且其中控制轴组件的近端能够沿着基本横向于致动轴线的方向以可释放方式可操作地联接到由框架支撑的驱动系统中的第二者,并且其中外科端部执行器中的至少一者不同于外科端部执行器中的另一者。
本领域的普通技术人员将会理解,本文所公开的各种外科器械结构包括多种机制和结构,以用于对可互换轴组件与外科器械对应部分进行有效对齐以及有效锁定和解锁,无论该外科器械为手持式器械还是机器人式控制器械。例如,可能期望器械能够在器械制备过程中的错误时刻或在外科手术中使用时防止驱动系统中的一者或多者(包括全部)进行关节运动。
与外科器械一起使用的外壳,其包括轴和端部执行器,其中外科器械包括能够使端部执行器相对于轴移动的关节运动组件。外壳包括由外壳可操作地支撑的马达、能够将至少一个关节运动动作传输至关节运动组件以使端部执行器在关节运动本位状态位置和关节运动位置之间移动的关节运动驱动装置、与马达通信的控制器、能够将第一输入信号传输至控制器的第一输入(其中控制器能够响应于第一输入信号启动马达以生成所述至少一个关节运动动作以使端部执行器移至关节运动的位置)以及能够将复位输入信号传输至控制器的复位输入(其中控制器能够响应于复位输入信号启动马达以生成至少一个复位动作以使端部执行器移至关节运动本位状态位置)。
外科器械包括轴、从轴朝远侧延伸的端部执行器,其中端部执行器可相对于轴在关节运动本位状态位置和关节运动位置之间移动。端部执行器包括钉仓,其包括多个缝钉和能够击发多个缝钉的击发构件,其中击发构件可在击发本位状态位置和击发位置之间移动。此外,外科器械包括从轴朝近侧延伸的外壳。外壳包括由外壳可操作地支撑的马达、与马达通信的控制器以及能够将本位状态输入信号传输至控制器的本位状态输入,其中控制器能够响应于本位状态输入信号启动马达以使端部执行器返回到关节运动本位状态位置以及使击发构件返回到击发本位状态位置。
外科器械包括端部执行器、从端部执行器朝近侧延伸的轴、关节运动组件,所述关节运动组件能够使端部执行器相对于轴在未进行关节运动的位置、未进行关节运动位置的第一侧面上的第一关节运动位置以及未进行关节运动位置的第二侧面上的第二关节运动位置之间移动,其中第一侧面与第二侧面相对。此外,外科器械还包括马达、与马达通信的控制器、能够将第一输入信号传输至控制器的第一输入(其中控制器能够启动马达以使端部执行器响应于第一输入信号移至第一关节运动位置)、能够将第二输入信号传输至控制器的第二输入(其中控制器能够启动马达以使端部执行器响应于第二输入信号移至第二关节运动位置)以及能够将复位输入信号传输至控制器的复位输入(其中控制器能够启动马达以使端部执行器响应于复位输入信号移至未进行关节运动的位置)。
外科器械包括端部执行器、从端部执行器朝近侧延伸的轴、能够击发多个缝钉的击发组件、能够相对于轴致动端部执行器的关节运动组件、可在锁定构造和未锁定构造之间移动的锁定构件以及从轴朝近侧延伸的外壳,其中当锁定构件处于未锁定构造时外壳可释放地联接到轴。外壳包括能够驱动击发组件和关节运动组件中至少一者的马达以及与马达通信的控制器,其中控制器能够启动马达以在锁定构件在锁定构造和未锁定构造之间移动时使击发组件和关节运动组件之中的至少一者复位至本位状态。
外科器械包括端部执行器、从端部执行器朝近侧延伸的轴、能够击发多个缝钉的击发组件、能够相对于轴致动端部执行器的关节运动组件、可在锁定构造和未锁定构造之间移动的锁定构件以及从轴朝近侧延伸的外壳,其中当锁定构件处于未锁定构造时外壳可释放地联接到轴。外壳包括能够驱动击发组件和关节运动组件中至少一者的马达、与马达通信的控制器以及可操作地联接到锁定构件的本位状态输入信号,其中本位状态输入能够将本位状态输入信号传输至控制器,并且其中控制器能够启动马达以使击发组件和关节运动组件中的至少一者响应于本位状态输入信号复位至本位状态。
外科器械包括端部执行器、从端部执行器朝近侧延伸的轴、能够使端部执行器相对于轴在本位状态位置与关节运动位置之间进行关节运动的关节运动组件、可在锁定构造与未锁定构造之间运动的锁定构件,以及从轴朝近侧延伸的壳体,其中当锁定构件为未锁定构造时,壳体可释放地联接到轴上。壳体包括能够驱动关节运动组件的马达和与马达通信的控制器,其中当锁定构件在锁定构造与未锁定构造之间移动时,控制器能够启动马达,使端部执行器返回本位状态位置。
用于外科器械的绝对位置传感器系统可包括其一,操作地联接到外科器械的可移动驱动构件上的传感器元件,以及其二,操作地联接到传感器元件上的位置传感器,位置传感器能够感测传感器元件的绝对位置。
外科器械可包括其一,绝对位置传感器系统,其包括操作地联接到外科器械的可移动构件上的传感器元件和操作地联接到传感器元件上的位置传感器,位置传感器能够感测传感器元件的绝对位置,以及其二,操作地联接到可移动驱动构件上的马达。
用于外科器械的绝对位置传感器系统可包括其一,操作地联接到外科器械的可移动构件上的传感器元件,其二,夹持传感器元件的夹持器,其中夹持器和传感器元件旋转联接,其三,操作地联接到传感器元件上的位置传感器,位置传感器能够感测传感器元件的绝对位置,其中位置传感器相对于夹持器和传感器元件的旋转是固定的。
补偿柔性刀带的展开对包括处理器和存储器的外科器械的横断长度的作用的方法,其中外科器械包括存储代表端部执行器的关节运动角度与关节运动接头远侧的有效横断长度之间的关系的特性数据的存储器,所述方法包括以下步骤:其一,用处理器从外科器械的存储器获取特性数据,其二,用处理器跟踪外科器械使用期间端部执行器的关节运动角度,以及其三,用处理器根据跟踪的关节运动角度和存储的特性数据调整外科器械的目标横断长度。
外科器械可包括微控制器和联接到微控制器上的存储器,其中微控制器包括能够执行计算机可读指令的处理器,其中处理器操作地其一,从存储器获取代表端部执行器的关节运动角度与关节运动接头远侧的有效横断长度之间的关系的特性数据,其二,跟踪外科器械使用期间端部执行器的关节运动角度,以及其三,根据跟踪的关节运动角度和存储的特性数据调整目标横断长度。
外科器械可包括具有关节运动接头的端部执行器、能够从关节运动接头近侧的位置平移至关节运动接头远侧的位置的柔性刀带、具有操作地执行计算机可读指令的处理器的微控制器,以及联接到微控制器上的存储器。处理器操作地其一,从存储器获取代表端部执行器的关节运动角度与关节运动接头远侧的有效横断长度之间的关系的特性数据,其二,跟踪外科器械使用期间端部执行器的关节运动角度,以及其三,根据跟踪的关节运动角度和存储的特性数据调整目标横断长度。
与外科器械一起使用的轴组件可包括轴、端部执行器、将端部执行器连接到轴上的关节运动接头、可相对于端部执行器移动的击发驱动装置、能够使端部执行器围绕关节运动接头进行关节运动的关节运动驱动器,以及能够选择性地将关节运动驱动器与击发驱动装置接合以使得击发驱动装置向关节运动驱动器移动的离合器衬圈。
外科器械可包括柄部、定位在柄部中的电动马达、可附接到柄部上的轴、端部执行器、将端部执行器连接到轴上的关节运动接头、可朝端部执行器移动的击发驱动装置(其中电动马达能够赋予击发驱动装置击发动作)、能够使端部执行器围绕关节运动接头进行关节运动的关节运动驱动器,以及能够选择性地将关节运动驱动器与击发驱动装置接合以赋予关节运动驱动器击发动作的可旋转离合器。
与外科器械一起使用的轴组件可包括轴、端部执行器、将端部执行器连接到轴上的关节运动接头、可相对于端部执行器移动的击发驱动装置、能够使端部执行器围绕关节运动接头进行关节运动的关节运动驱动器,以及能够选择性地将关节运动驱动器与击发驱动装置接合以使得击发驱动装置向关节运动驱动器移动的纵向离合器。
可附接到外科器械的柄部上的轴组件,轴组件包括具有能够操作地将轴连接到柄部上的连接器部分的轴、端部执行器、将端部执行器连接到轴上的关节运动接头、在向击发驱动装置施加击发动作时可相对于端部执行器移动的击发驱动装置、能够在向关节运动驱动器施加关节运动动作时使端部执行器围绕关节运动接头进行关节运动的关节运动驱动器,以及能够可释放地将关节运动驱动器保持在适当位置的关节运动锁,其中关节运动动作能够将关节运动锁解锁。
可附接到外科器械的柄部上的轴组件,轴组件包括轴,其中轴包括其一,能够操作地将轴连接到柄部上的连接器部分以及其二,近端;具有远端的端部执行器;将端部执行器连接到轴上的关节运动接头;可通过击发动作相对于端部执行器运动的击发驱动装置;能够在向关节运动驱动器施加关节运动动作时使端部执行器围绕关节运动接头进行关节运动的关节运动驱动器;以及关节运动锁,其包括其一,能够可释放地抵抗关节运动驱动器的近侧运动的第一单向锁,以及其二,能够可释放地抵抗关节运动驱动器的远侧运动的第二单向锁。
可附接到外科器械的柄部上的轴组件,轴组件包括轴,其中轴包括其一,能够操作地将轴连接到柄部上的连接器部分以及其二,近端;具有远端的端部执行器;将端部执行器连接到轴上的关节运动接头;可通过击发动作相对于端部执行器运动的击发驱动装置;关节运动驱动器系统,其包括其一,近侧关节运动驱动器以及其二,操作地与端部执行器接合的远侧关节运动驱动器;以及能够可释放地将远侧关节运动驱动器保持在适当位置的关节运动锁,其中近侧关节运动驱动器的运动能够将关节运动锁解锁并驱动远侧关节运动驱动器。
可附接到外科器械的柄部上的轴组件,轴组件包括轴,其中轴包括其一,能够操作地将轴连接到柄部上的连接器部分以及其二,近端;具有远端的端部执行器;将端部执行器连接到轴上的关节运动接头;可通过击发动作相对于端部执行器运动的击发驱动装置;和关节运动驱动器系统,其包括其一,第一关节运动驱动器以及其二,操作地与端部执行器接合的第二关节运动驱动器;以及能够可释放地将第二关节运动驱动器保持在适当位置的关节运动锁,其中第一关节运动驱动器的初始运动能够将第二关节运动驱动器解锁,并且第一关节运动驱动器的后续运动能够驱动第二关节运动驱动器。
外科缝合器可包括柄部、击发构件和电动马达。电动马达可在第一操作状态期间推进击发构件,在第二操作状态期间收回击发构件,并在第三操作状态期间向柄部传送反馈。此外,电动马达可包括轴和安装在轴上的共振器。共振器可包括主体,主体可包括安装膛孔。安装膛孔和轴可与共振器的中轴同轴,共振器的质心可沿着中轴定位。共振器还可包括从主体延伸的弹簧、从弹簧延伸的重物以及从主体延伸的平衡物。
用于切割和缝合组织的外科器械可包括柄部、从柄部延伸的击发构件、定位在柄部中的电动马达,以及具有质心的放大器。电动马达能够在多种状态下操作并可以包括马达轴。此外,可在质心处将放大器安装到马达轴上。当电动马达处于击发状态时,放大器可以第一方向旋转,当电动马达处于反馈状态时,放大器可在第一方向与第二方向之间摆动。
用于切割和缝合组织的外科器械可包括用于保持外科器械的保持装置、击发构件和用于在多种操作状态下操作的马达装置。多种操作状态可包括击发状态和反馈状态。马达装置可在击发状态期间以第一方向旋转,并可在反馈状态期间在第一方向与第二方向之间摆动。外科器械还可以包括用于生成触觉反馈的反馈生成装置。可将反馈生成装置安装到马达装置上。
用于切割和缝合组织的外科器械可包括柄部、从柄部延伸的击发构件,以及定位在柄部中的电动马达。电动马达能够在多种状态下操作,并且电动马达可包括马达轴。外科器械还可以包括具有质心的共振器。可在质心处将共振器安装到马达轴上。此外,当电动马达位于推进状态时,共振器可以是平衡的,当电动马达处于反馈状态时,共振器可以是不平衡的。
用于操作外科缝合器的方法可包括启动初始操作状态。初始操作状态期间可朝远侧驱动切割元件。该方法还可以包括检测切割元件处的阀值条件,将阀值条件传达给外科缝合器的操作者,以及接收来自操作者的多个输入之一。多个输入可包括第一输入和第二输入。该方法还可以包括响应来自操作者的输入启动次级操作状态。可响应第一输入朝远侧驱动切割元件,并可响应第二输入朝近侧收回切割元件。
用于操作外科器械的方法可包括启动初始外科功能,检测临床重要的状况,将临床重要的状况传达给外科器械的操作者,接收来自操作者的输入,以及根据来自操作者的输入执行次级外科功能。次级外科功能可包括继续初始外科功能或启动修改的外科功能中的一种。
用于控制外科器械的系统可包括马达,马达可在击发冲程期间驱动击发构件。系统还可包括用于控制马达的控制器,控制器能够在击发冲程期间在多种操作状态下操作。多种操作状态可包括推进状态和回缩状态。该系统还可以包括能够检测击发构件上的力的传感器,其中传感器和控制器可以信号通信。当传感器检测到击发构件上的力超过阀值力时,控制器可中止击发冲程。该系统还可以包括多个输入键,其中输入键和控制器可以信号通信。当第一输入键被激活时,控制器可恢复推进状态,当第二输入键被激活时,控制器可启动回缩状态。
外科器械可包括击发构件、能够驱动击发构件的马达,和用于控制马达的控制器。控制器能够在多种操作状态下操作外科器械,所述多种操作状态可包括驱动击发构件的击发状态和用于驱动击发构件的警告击发状态。外科器械还可以包括用于在警告击发状态下操作外科器械的装置。
外科器械可包括柄部、从柄部延伸的轴、端部执行器和将端部执行器连接到轴上的关节运动接头。外科器械还可以包括在向击发驱动装置施加击发动作时可相对于端部执行器运动的击发驱动装置、能够在向关节运动驱动器施加关节运动动作时使端部执行器围绕关节运动接头进行关节运动的关节运动驱动器,以及能够可释放地将关节运动驱动器保持在适当位置的关节运动锁,其中关节运动动作能够将关节运动锁解锁。
外科器械可包括至少一个能够在致动后产生控制运动并限定致动轴的驱动系统;至少一个可互换的轴组件,其能够以基本上横向于致动轴的方向可释放地联接到所述至少一个驱动系统上并将控制运动从所述至少一个驱动系统传送至操作地联接到所述可互换的轴组件上的外科端部执行器;以及锁定组件,其包括用于交接所述至少一个驱动系统的交接装置,并防止驱动系统的致动,除非所述至少一个可互换的轴组件已经可操作地联接到所述至少一个驱动系统上。
包括轴组件的外科器械可包括具有外科钉仓和砧座的端部执行器,其中在施加打开运动和闭合运动时砧座和外科钉仓中的一者可相对于砧座和外科钉仓中的另一者运动。外科器械还可以包括能够施加打开运动和闭合运动的可移动的闭合轴组件、操作地支承其上面的可移动闭合轴组件的一部分的轴附接框架;能够可释放地可操作地与轴附接框架接合的框架构件;由框架构件操作地支承并限定致动轴的闭合驱动系统,当轴附接框架可操作地与框架构件接合时,闭合驱动系统能够以基本上横向于致动轴的方向操作地与闭合轴组件接合;以及交接闭合驱动系统的锁定组件,其用于防止闭合驱动系统的致动,除非闭合轴组件可操作地与闭合驱动系统接合。
外科器械可包括端部执行器、从端部执行器朝近侧延伸的轴,以及关节运动组件,它能够使端部执行器相对于所述轴在非关节运动位置、非关节运动位置第一侧的关节运动位置的第一范围和非关节运动位置第二侧的关节运动位置的第二范围之间运动,其中第一侧与第二侧相对。外科器械还可以包括马达;与马达通信的控制器;能够将第一输入信号传送至控制器的第一输入,其中控制器能够响应第一输入信号而启动马达,使端部执行器向关节运动位置的第一范围内的关节运动位置移动;能够将第二输入信号传送至控制器的第二输入,其中控制器能够响应第二输入信号而启动马达,使端部执行器向关节运动位置的第二范围内的关节运动位置移动;以及能够将复位输入信号传送至控制器的复位输入,其中控制器能够响应复位输入信号而启动马达,使端部执行器向非关节运动位置移动。
虽然上述具体实施方式中列出了多个细节,但可以在没有这些具体细节的情况下实施多个实施例。例如,为简洁和清楚起见,以框图的形式示出了选择的方面,而不是详细地示出。本文提供的详细描述的某些部分可以呈现为对存储在计算机存储器中的数据进行操作的指令。本领域的技术人员用此类描述和表达向本领域的其他技术人员描述和传达他们的工作要旨。通常,算法是指导致所需结果的步骤的自相容序列,其中“步骤”是指物理量的操纵,物理量可以(但不一定)采用能被存储、传送、组合、比较以及以其他方式操纵的电或磁信号的形式。常用于指这些信号,如比特、值、元素、符号、字符、术语、数字等。这些和类似的术语可与适当的物理量相关联并且仅仅是应用于这些量的方便的标签。
除非上述讨论中另外明确指明,否则可以理解的是,在上述描述中,使用术语如“处理”或“估算”或“计算”或“确定”或“显示”的讨论是指计算机系统或类似的电子计算设备的动作和处理,其操纵表示为计算机系统的寄存器和存储器内的物理(电子)量的数据并将其转换成相似地表示为计算机系统存储器或寄存器或其他此类信息存储、传送或显示设备内的物理量的其他数据。
在一般意义上,本领域的技术人员将会认识到,可以用多种硬件、软件、固件或它们的任何组合单独和/或共同实施的本文所述的多个方面可以被看作是由多种类型的“电子电路”组成。因此,如本文所用,“电子电路”包括但不限于具有至少一个分立电路的电子电路、具有至少一个集成电路的电子电路、具有至少一个专用集成电路的电子电路、形成由计算机程序配置的通用计算设备的电子电路(如,至少部分地实施本文所述的方法和/或设备的由计算机程序配置的通用计算机,或至少部分地实施本文所述的方法和/或设备的由计算机程序配置的微处理器)、形成存储器设备(如,形成随机存取存储器)的电子电路,和/或形成通信设备(如,调制解调器、通信开关或光电设备)的电子电路。本领域的技术人员将会认识到,可以模拟或数字方式或它们的一些组合实施本文所述的主题。
上述具体实施方式已通过使用框图、流程图和/或例子阐述了设备和/或方法的多个实施例。只要此类框图、流程图和/或例子包含一个或多个功能和/或操作,本领域的技术人员就要将其理解为此类框图、流程图或例子中的每个功能和/或操作都可以单独和/或共同地通过多种硬件、软件、固件或实际上它们的任何组合来实施。在一个实施例中,本文所述的主题的若干部分可以通过专用集成电路(ASIC)、现场可编程门阵列(FPGA)、数字信号处理器(DSP)或其他集成格式来实施。然而,本领域的技术人员将会认识到,本文所公开的实施例的一些方面可以作为在一台或多台计算机上运行的一个或多个计算机程序(如,作为在一个或多个计算机系统上运行的一个或多个程序),作为在一个或多个处理器上运行的一个或多个程序(如,作为在一个或多个微处理器上运行的一个或多个程序),作为固件,或作为实际上它们的任何组合全部或部分地在集成电路中等效地实现,并且根据本发明,设计电子电路和/或编写软件和/或硬件的代码将在本领域技术人员的技术范围内。另外,本领域的技术人员将会认识到,本文所述主题的机制能够作为多种形式的程序产品进行分布,并且本文所述主题的示例性实施例适用,而不管用于实际进行分布的信号承载介质的具体类型是什么。信号承载介质的例子包括但不限于下列:可记录型介质,如软盘、硬盘驱动器、光盘(CD)、数字视频光盘(DVD)、数字磁带、计算机存储器等;和传输型介质,如数字和/或模拟通信介质(如,光纤电缆、波导、有线通信链路(如,发射器、接收器、传输逻辑、接收逻辑等)等)。
本领域技术人员将会认识到,本文所述的组成部分(如,操作)、设备、对象和它们随附的讨论是为了概念清楚起见而用作例子,并且可以设想多种构型修改形式。因此,如本文所用,阐述的具体例子和随附的讨论旨在代表它们更一般的类别。通常,任何具体例子的使用旨在代表其类别,具体组成部分(如操作)、设备和对象的未纳入部分不应采取限制。
对于本文中使用的基本上任何复数和/或单数术语,本领域技术人员可从复数转换成单数和/或从单数转换成复数,只要适合于上下文和/或应用就可以。为清楚起见,各种单数/复数置换在本文中没有明确表述。
本文所述的主题有时阐述了包含在其他不同组件中的不同组件或与其他不同组件连接的不同组件。应当理解,这样描述的结构仅是示例性的,并且事实上可以实现获得相同功能性的多种其他结构。在概念意义上,获得相同功能性的组件的任何布置方式都是有效“相关联的”,从而获得所需的功能性。因此,本文中为获得特定功能性而结合在一起的任何两个组件都可被视为彼此“相关联”,从而获得所需的功能性,而不论结构或中间组件如何。同样,如此相关联的任何两个组件也可被视为彼此“操作地连接”或“操作地联接”,以获得所需的功能性,并且能够如此相关联的任何两个组件都可被视为彼此“可操作地联接”,以获得所需的功能性。可操作地联接的具体例子包括但不限于可物理匹配的和/或物理交互组件,和/或无线交互式,和/或无线交互式组件,和/或逻辑交互式,和/或逻辑交互式组件。
在一些情况下,一个或多个组件在本文中可被称为“能够”、“可配置为”、“可操作地”、“适于”、“能”、“适合”等。本领域的技术人员将会认识到,除非上下文另有所指,否则“能够”通常可涵盖活动状态的组件和/或失活状态的组件和/或待机状态的组件。
对于所附的权利要求,本领域的技术人员将会理解,其中列出的操作通常可以任何顺序进行。另外,尽管以一定顺序列出了多个操作流程,但应当理解,可以不同于所示顺序的其他顺序进行所述多个操作,或者可以同时进行所述多个操作。除非上下文另有规定,否则此类替代排序的例子可包括重叠、交错、中断、重新排序、增量、预备、补充、同时、反向,或其他改变的排序。此外,除非上下文另有规定,否则像“响应于”、“相关”这样的术语或其他过去式的形容词通常不旨在排除此类变体。
虽然本文描述了多个实施例,但可以实现那些实施例的多种修改形式、变型形式、替代形式、变化形式和等同形式,这些形式是本领域技术人员将会想到的。另外,如果公开了用于某些组件的材料,那么也可以使用其他材料。因此,应当理解,上述具体实施方式和所附的权利要求旨在涵盖属于本发明所公开的实施例范围内的所有此类修改形式和变型形式。以下权利要求旨在涵盖所有此类修改形式和变型形式。
名称为SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE ENDEFFECTOR、提交于2010年4月22日的美国专利申请公开No.2010/0264194的公开内容全文以引用方式并入本文。序列号为No.13/524,049、名称为ARTICULATABLE SURGICALINSTRUMENT COMPRISING A FIRING DRIVE、提交于2012年6月15日的美国专利申请的公开内容全文以引用方式并入本文。
本文所公开的设备可被设计为单次使用后丢弃,或者它们可被设计为多次使用。然而,在任一种情况下,都可以在至少一次使用后对所述设备进行修复,以供再次使用。修复可包括以下步骤的任何组合:设备的拆卸、然后清洗或更换特定部件,以及后续的重新组装。具体地讲,可将设备拆卸,可以有选择地以任何组合更换或移除任何数量的特定部件或零件。清洗和/或更换特定零件之后,可以在修理厂或在外科手术之前由手术团队重新组装设备以供后续使用。本领域的技术人员将会认识到,设备的修复可以利用多种技术进行拆卸、清洗/更换和重新组装。此类技术的使用和所得的修复设备均在本发明范围内。
优选地,本文所述的发明将在手术前进行处理。首先,获得新的或用过的器械,如果必要的话,进行清洗。然后可对器械进行消毒。在一种消毒技术中,将器械放置在闭合且密封的容器中,如塑料袋或TYVEK袋。然后将容器和器械放置在可穿透容器的辐射场中,如γ辐射、x射线或高能量电子。辐射将器械和容器中的细菌杀死。然后可以将消毒的器械保存在无菌容器中。在医疗设施中打开之前,密封的容器使器械保持无菌。
被说成是以引用方式并入本文的任何专利、出版物或其他公开资料仅以不与本公开中所述的现有定义、陈述或其他公开资料冲突的程度并入本文中。因此,在必要的程度上,本文明确阐述的公开内容取代以引用方式并入本文的任何冲突资料。被说成是以引用方式并入本文但与本文中所述的现有定义、陈述或其他公开资料冲突的任何资料或它们的一部分将仅以不会在并入的资料与本公开资料之间引起冲突的程度并入。
总之,描述了通过采用本文所述的概念而获得的多种有益效果。上述一个或多个实施例的具体实施方式是为了说明和描述的目的而示出的。它并不旨在穷尽或限制于所公开的精确形式。根据上述教导内容的修改或变型也是可以的。选择和描述的一个或多个实施例是为了说明原理和实际应用,从而使本领域的普通技术人员能够利用适用于预期的特定用途的所述多个实施例和多种修改形式。其旨在用与本文一起提交的权利要求限定整体范围。
Claims (32)
1.一种外科缝合器,包括:
柄部;
击发构件;和
电动马达,其中所述电动马达在第一操作状态期间推进所述击发构件以执行钉击发冲程,在第二操作状态期间回缩所述击发构件,并在第三操作状态期间向所述柄部传送反馈而不执行所述钉击发冲程,并且其中所述电动马达包括:
轴;和
共振器,其安装在所述轴上,其中所述共振器包括:
主体,其包括安装孔,其中所述安装孔和所述轴与所述共振器的中心轴线同轴,并且其中所述共振器的质心沿着所述中心轴线定位;
从所述主体延伸的弹簧;
从所述弹簧延伸的重物;和
从所述主体延伸的平衡物。
2.根据权利要求1所述的外科缝合器,其中所述电动马达在所述第一操作状态期间沿第一方向旋转。
3.根据权利要求2所述的外科缝合器,其中所述电动马达在所述第二操作状态期间沿第二方向旋转,并且其中所述第二方向不同于所述第一方向。
4.根据权利要求3所述的外科缝合器,其中所述电动马达在所述第三操作状态期间在所述第一方向和所述第二方向之间振荡。
5.根据权利要求4所述的外科缝合器,其中所述共振器包括含有所述共振器的自然频率的放大频率范围,并且其中所述共振器在所述第三操作状态期间在所述放大频率范围内振荡。
6.根据权利要求1所述的外科缝合器,其中在所述第三操作状态期间向所述柄部传送的反馈包括所述柄部的触觉振动运动。
7.根据权利要求6所述的外科缝合器,其中所述电动马达安装在所述柄部内。
8.根据权利要求1所述的外科缝合器,其中基准线垂直于所述中心轴线延伸穿过所述共振器,并且其中所述弹簧在沿着所述基准线的至少一个位置处横跨所述基准线。
9.根据权利要求8所述的外科缝合器,其中所述弹簧沿着一轴线从所述主体延伸,并且其中所述轴线限定至少一个轮廓。
10.根据权利要求1所述的外科缝合器,其中所述柄部还包括轴向限制器,并且其中所述共振器被限制在所述轴向限制器内。
11.根据权利要求1所述的外科缝合器,还包括端部执行器,其中所述端部执行器还包括钉仓,所述钉仓包含多个钉。
12.一种用于切割和缝合组织的外科器械,所述外科器械包括:
柄部;
从所述柄部延伸的击发构件;
电动马达,其定位于所述柄部中,其中所述电动马达能够在多个状态下操作,并且其中所述电动马达包括马达轴;和
放大器,其包含质心,其中所述放大器在所述质心处安装到所述马达轴,其中当所述电动马达处于击发状态时,所述放大器沿第一方向旋转以引起钉击发冲程,并且其中当所述电动马达处于反馈状态时,所述放大器在所述第一方向和第二方向之间振荡,其中所述钉击发冲程在所述反馈状态期间不出现。
13.根据权利要求12所述的外科器械,其中所述击发构件在所述击发状态期间朝远侧前进。
14.根据权利要求13所述的外科器械,其中所述多个状态还包括回缩状态,其中当所述电动马达处于所述回缩状态时,所述放大器沿所述第二方向旋转,并且其中所述击发构件在所述回缩状态期间朝近侧回缩。
15.根据权利要求12所述的外科器械,其中所述柄部在所述反馈状态期间响应于所述放大器的振荡而振动。
16.根据权利要求12所述的外科器械,其中所述放大器还包括:
主体,其包括穿过所述放大器的质心的安装膛孔;
从所述主体延伸的摆动件;和
从所述主体延伸的平衡物。
17.根据权利要求16所述的外科器械,其中所述放大器还包括自然频率,并且其中当所述电动马达处于所述反馈状态时,所述放大器在含有所述自然频率的范围内振荡。
18.根据权利要求16所述的外科器械,其中所述摆动件沿着一轴线从所述主体延伸,并且其中所述轴线限定至少一个轮廓。
19.根据权利要求12所述的外科器械,其中所述放大器还包括轴向限制器,并且其中所述放大器被所述轴向限制器限制。
20.根据权利要求12所述的外科器械,还包括端部执行器,其中所述端部执行器还包括钉仓,所述钉仓包含多个钉。
21.一种用于切割和缝合组织的外科器械,所述外科器械包括:
保持装置,其用于保持所述外科器械;
击发构件;和
马达装置,其用于在多个操作状态下操作,其中所述多个操作状态包括击发状态和反馈状态,其中钉击发冲程在所述击发状态期间出现,其中所述钉击发冲程在所述反馈状态期间不出现,并且其中所述马达装置在所述击发状态期间沿第一方向旋转,并在所述反馈状态期间在所述第一方向和第二方向之间振荡;和
反馈生成装置,其用于生成触觉反馈,其中所述反馈生成装置安装到所述马达装置。
22.根据权利要求21所述的外科器械,其中所述第二方向与所述第一方向相反。
23.根据权利要求21所述的外科器械,其中所述多个操作状态还包括回缩状态,并且其中所述马达装置在所述回缩状态期间沿所述第二方向旋转。
24.根据权利要求21所述的外科器械,其中所述反馈生成装置在所述反馈生成装置的质心处安装到所述马达。
25.根据权利要求21所述的外科器械,其中所述反馈生成装置包括振荡装置,所述振荡装置用于在所述反馈状态期间在含有所述反馈生成装置的自然频率的范围内振荡。
26.根据权利要求21所述的外科器械,还包括缝合装置,所述缝合装置用于在所述击发状态期间缝合组织。
27.一种用于切割和缝合组织的外科器械,所述外科器械包括:
柄部;
从所述柄部延伸的击发构件;
电动马达,其定位于所述柄部中,其中所述电动马达能够在多个状态下操作,并且其中所述电动马达包括马达轴;和
共振器,其包含质心,其中所述共振器在所述质心处安装到所述马达轴,其中当所述电动马达处于推进状态时,所述共振器是平衡的,其中钉击发冲程在所述推进状态期间出现,其中当所述电动马达处于反馈状态时,所述共振器是不平衡的,并且其中所述钉击发冲程在所述反馈状态期间不出现。
28.根据权利要求27所述的外科器械,其中当所述电动马达处于所述推进状态时,所述电动马达沿第一方向旋转。
29.根据权利要求28所述的外科器械,其中当所述电动马达处于所述反馈状态时,所述电动马达在所述第一方向和第二方向之间振荡。
30.根据权利要求27所述的外科器械,其中所述共振器还包括:
主体,其包括穿过所述共振器的质心的安装膛孔;
从所述主体延伸的摆动件;和
从所述主体延伸的平衡物。
31.根据权利要求30所述的外科器械,其中所述共振器还包括自然频率,并且其中当所述电动马达处于所述反馈状态时,所述共振器在含有所述自然频率的范围内振荡。
32.一种外科缝合器,包括:
柄部;
端部执行器;
可移位构件,其能够相对于所述端部执行器移动;和
电动马达,其中所述电动马达在第一操作状态期间推进所述可移位构件,以提供钉击发冲程,在第二操作状态期间回缩所述可移位构件,并在第三操作状态期间向所述柄部传送反馈,其中所述钉击发冲程在所述第三操作状态期间不出现,并且其中所述电动马达包括:
轴;和
共振器,其安装在所述轴上,其中所述共振器包括:
主体,其包括安装孔,其中所述安装孔和所述轴与所述共振器的中心轴线同轴,并且其中所述共振器的质心沿着所述中心轴线定位;
从所述主体延伸的弹簧;
从所述弹簧延伸的重物;和
从所述主体延伸的平衡物。
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