CN104135952A - 线性缝合器 - Google Patents
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Abstract
本发明公开了一种线性缝合器,所述线性缝合器包括具有近端和远端的支撑基部;位于支撑基部的近端处的触发器;位于支撑基部的远端处的端部执行器,所述端部执行器由触发器击发并且包括仓。所述仓包括仓体。所述仓体包括用于容纳钉的钉槽;以及仓闭锁件,当所述仓未被击发时,所述仓闭锁件被迫处于打开位置以抵接钉驱动器的外侧,并且在所述仓中的钉由钉驱动器击发之后,所述仓闭锁件朝仓体的内部方向回弹。公开了另一种线性缝合器,其包括具有近端和远端的支撑基部;位于支撑基部的近端处的触发器;位于支撑基部的远端处的端部执行器,所述端部执行器由触发器击发并且包括仓,所述仓包括仓体,所述仓体包括已空仓指示器。
Description
技术领域
本发明涉及一种外科缝合和切割器械。更具体地,本发明涉及一种结合了具有闭锁件的仓的线性缝合器,该闭锁件可防止已用仓或已空仓重新击发。本发明还涉及一种结合了具有已空仓指示器的仓的线性缝合器,该已空仓指示器可指示已空的仓。
背景技术
现有技术中已使用外科缝合和切割器械来同时在组织中制造切口并在切口的相对两侧上施加成排的钉。此类器械的端部执行器常常包括一对协同工作的钳口构件,如果器械旨在用于内窥镜式或腹腔镜式应用,这一对钳口构件能够穿过管道通道。钳口构件之一大体接收钉仓,该钉仓具有侧向间隔开的至少两排钉。另一钳口构件限定砧座,该砧座具有与仓中的钉排对准的钉成形凹坑。器械包括多个往复式楔形件;当朝远侧驱动时,该多个往复式楔形件穿过钉仓中的开口并接合支撑钉的驱动器以实现钉朝砧座击发。
构建可重复使用的用于外科缝合器的端部执行器通常是有利的。例如,一名患者可能需要一系列切断和缝合操作。针对每个操作替换整个端部执行器往往在经济上是低效的。如果端部执行器是针对进行重复操作的强度和可靠性而构建的,则尤为如此。为此,在外科缝合器的每个操作之前,将钉仓安装到端部执行器中。
虽然含有钉的钉仓提供许多优点,但希望能防止在不存在未击发的钉仓时器械的意外击发。否则,可能在没有钉来最小化出血的情况下发生组织的切断。尤其希望的是,以不受介入故障影响的可靠方式来实现对这种意外击发的防止。另外,为了易于制造和组装,还希望以最小数目的部件来实现闭锁特征。
因此,非常需要一种结合了具有闭锁件的仓的线性缝合器,该闭锁件可防止已用仓或已空仓重新击发;以及一种结合了具有已空仓指示器的仓的线性缝合器,该已空仓指示器可指示已空的仓。
发明内容
本发明涉及一种结合了具有闭锁件的仓的线性缝合器,该闭锁件可防止已用仓或已空仓重新击发。
根据本发明,一种线性缝合器包括:
具有近端和远端的支撑基部;
位于支撑基部的近端处的触发器;
位于支撑基部的远端处的端部执行器,该端部执行器由触发器击发并包括仓,该仓包括:
仓体,该仓体包括:
用于容纳钉的钉槽;以及
仓闭锁件,当仓未受击发时,仓闭锁件被迫处于打开位置以抵接钉驱动器的外侧,并且在仓中的钉由钉驱动器击发之后,仓闭锁件朝仓体的内侧方向回弹(这意味着,在仓闭锁件未被迫具有更大尺寸时,回到仓的常规尺寸和外部形状)。
优选地,仓闭锁件包括布置在仓体的壁上并朝近侧延伸的一个或多个偏转特征。
优选地,偏转特征与仓体整体地模制而成。
优选地,偏转特征单独制造并随后附接到仓体上。
优选地,偏转特征由聚合物制成。
优选地,偏转特征由金属制成。
优选地,偏转特征是片簧。
优选地,每个偏转特征都包括一个扩大的近端或突起。
根据本发明,一种线性缝合器包括:
具有近端和远端的支撑基部;
位于支撑基部的近端处的触发器;
位于支撑基部的远端处的端部执行器,该端部执行器由触发器击发并包括仓,该仓包括仓体,该仓体包括已空仓指示器。
优选地,已空仓指示器包括形成在仓体中的指示器窗口和形成在用于驱动仓中的钉的钉驱动器上的指示器特征,在仓被击发之后,该指示器窗口显示该指示器特征。
优选地,指示器特征是颜色或标记。
附图说明
以下将参照附图描述本发明的各实施例,在附图中:
图1是根据本发明各实施例的线性缝合器的透视图。
图2是处于未致动打开位置的线性缝合器的侧视图。
图3是处于已致动闭合位置的线性缝合器的侧视图。
图4是线性缝合器的端部执行器的局部剖视图。
图5A和图5B分别是图4中所示钉驱动器的示意图和剖面图。
图6A和图6B分别是图4中所示钉仓的示意图和剖面图。
图7是示出击发前仓与钉驱动器之间的关系的视图。
图8是示出击发后仓与钉驱动器之间的关系的视图。
实施例
为方便并易于理解,在上下文中,类似部分由类似参考标记指示。应当理解,本文参照抓握器械柄部的使用者来使用术语“近侧”和“远侧”。因此,端部执行器相对于更近侧的柄部位于远侧。还应理解,为简洁和清楚,本文参照附图使用空间术语诸如“竖直”和“水平”、“上”和“下”。然而,外科器械在多个取向和位置中使用,并且这些术语并非旨在进行限制,也并非是绝对的。
图1示出根据本发明的缝合器1的透视图。缝合器1包括具有近端和远端的支撑基部2、位于支撑基部2的远端处的端部执行器11、均位于支撑基部2的近侧的触发器3和柄部4、以及位于支撑基部2的近端处的旋钮5。端部执行器11由触发器3和旋钮5致动并击发,使得端部执行器11可缝合所夹紧的组织。图2示出处于未致动打开位置的缝合器1;并且图3示出处于已致动闭合位置的缝合器1,其中钉被射出以缝合组织。
将参照附图对缝合器1的部件进行详细描述。
如图1和图2所示,端部执行器11位于支撑基部2的远端处,并且具有与支撑基部2连接的基本U形的支撑结构12。U形支撑结构12通过以下方式形成:例如挤出铝,随后进行机加工以形成支撑结构12。这样,就不需要多个部分,并且显著降低与制造和组装相关的成本。另外,可以提高总体稳定性,并且因为钴照射可
有效地穿透所挤出的铝,易于对缝合器1进行消毒。此外,通过挤出获得平滑外表面,可对组织造成更少创伤。U形支撑结构12支撑固定钳口6和活动钳口8。固定钳口6继而支撑砧座7。活动钳口8含有用于容纳外科钉的仓9。保持销10被支撑在支撑基部2的上部上。如图所示,保持销10延伸穿过活动钳口8的上端中的通孔43和通孔27。保持销10可向前移位至砧座7中的孔71以确保砧座7和仓9完全对准,并且两者间所捕获的组织得以适当维持。
现在参照图4,其中示出活动钳口8和仓组件的剖面图。仓组件包括面向砧座7的仓9、邻近仓9的钉驱动器15、从近侧向远侧延伸的推杆17,以及包围仓9、驱动器15和一部分推杆17的壳体16。如图1至图3所示,壳体16形成有开口94以暴露仓9的一部分。这些部分的详细描述如下。
如图4所示,仓9的下端形成有具有引导功能的狭槽28。仓9的远侧表面(即,面向砧座的表面)设置有与通孔27相邻的向前延伸的垫片元件29和与狭槽28最外端相邻的向前延伸的垫片50。这些垫片与砧座协同工作以确定仓9的最远侧位置。当然,这些元件不是绝对必需的并可以被省略。
图6A和图6B分别是根据本发明实施例的钉仓的示意图和剖面图,其中为清楚,省略了垫片元件和垫片。如图6A所示,仓9包括可由聚合物制成的大体立方体形状的仓体91。仓体91在其远端表面中形成有用于容纳钉的钉槽34。每个钉槽34在其两端处设置有附加凹槽(图中未示出),这些凹槽旨在以摩擦方式接收外科钉的腿部。仓体91具有供驱动器15通过的开放近端。仓体91在左侧壁和右侧壁上设置有仓闭锁件。仓闭锁件可防止已空仓或已用仓在击发后重新击发或重新装载。图5A至图8还示出可指示已空仓的已空仓指示器。
如图6A所示,仓闭锁件包括设置在仓体91的左侧壁和右侧壁上的偏转特征92。当然,本领域的技术人员能够想到,偏转特征92可设置在仓的上壁和下壁上,或仅设置在仓的这些壁之一上。如图所示,偏转特征92是朝近侧(即,朝图6A或6B中图的右侧)延伸的条状元件,并且均在其近端处具有向仓内突出的突起。仓体91的侧壁的其它部分具有类似壁厚。偏转特征92可以是与通过模制等制成的仓体91成整体的聚合物元件,或是在制造之后附接到仓体91的单独金属元件。此外,偏转特征92可以是片簧、在其近端处具有附加的突出弹性抽头(tap)的金属线、或具有扩大近端的片簧等。简而言之,偏转特征92可采用任何合适形式,只要偏转特征在迫使它们处于打开位置的保持力被释放时能够回弹到其初始形状。当然,本领域的技术人员能够理解,金属的偏转特征92可提供更好的稳定性和强度。
此外,如图6A所示,已空仓指示器包括形成在仓体91中的指示器窗口93。在图6A所示的实施例中,指示器窗口93位于仓体91的上部上。然而,应当理解,指示器窗口93可位于其它位置处,只要壳体16的开口94布置在对应位置处以暴露指示器窗口93。作为另外一种选择,可省略壳体16,或壳体16仅封闭仓的一部分并且不会盖住指示器窗口93。同时,指示器窗口93的形状并不限于如图中示出的矩形,它可以是圆形、正方形、三角形、五角形等。
紧邻仓9设置的是驱动器15(如图5A和图5B中示出为两个示例性实施例)。驱动器15具有足够的强度并且是由适用于外科环境的适当塑性材料模制而成,并且优选地由可通过已知方法消毒的那些塑性材料制成。如图5A和图5B所示,驱动器15是整体的一体式元件,它包括驱动器主体21,多个驱动板24从驱动器主体21的远侧表面向前延伸。驱动板24在数目上与仓9中容纳的钉的数目相等。向前延伸的驱动板24被布置成平行间隔的两排,其中一排驱动板相对于另一排驱动板错开,这对应于仓9中钉槽34的布置。如图5A所示,驱动器主体21大体上是立方体形状,其中两个近侧边缘是斜切的,并且左侧和右侧均具有一个凹入部分。如图5B实施例的剖面图所示,驱动器主体21的剖面是呈大体上狗骨形状。在一个实施例中,驱动器主体21与驱动板24具有不同颜色以用作已空仓指示器的指示器特征。在另一个实施例中,驱动器主体21在其上具有标记95(图5A中的假想线),作为已空仓指示器的指示器特征。标记95可以是能吸引注意力的任何标记,诸如圆形、正方形、三角形、十字形标记等,或本领域的技术人员已知的不影响移动的凹坑、凹口或小突起。
如图4所示,驱动器15的驱动板24可插入到仓9的钉槽34内。应当理解,驱动器的叉齿24上覆于对应钉的冠部上。这样,当驱动器15相对于仓9朝远侧移位时,外科钉将从其钉槽34朝远侧被顶出。
图4还示出了壳体16。类似于驱动器15和仓9,壳体16也是整体的一体式模制而成的塑性构件。
推杆17(图4)的近端与触发器3和旋钮5(图1)相关联。旋钮5的转动使推杆17朝远侧移动,并且触发器3朝柄部4的转动(由图3的箭头D指示)击发仓9,从而导致推杆17驱动驱动器15以用于形成钉。推杆17的远端端接在板状结构49(图4)中。板状结构49的远端可与驱动器15的驱动器主体21的近端接触。当推杆17在远侧方向上移位时,它将通过板状结构49使驱动器15朝远侧移位。
图7是示出击发前仓与钉驱动器之间的关系的视图。如图7所示,驱动器15的驱动板24刚好位于仓9的钉槽34的近侧处,并且驱动器15的驱动器主体21的近端未越过位于偏转特征92的近端处的突起。此时,通过仓体91的指示器窗口93能够看到驱动板24的一部分。
图8是示出击发后仓与钉驱动器之间的关系的视图。
当仓9由推杆17致动时,推杆17的板状结构49与驱动器15的驱动器主体21的近端接触并使驱动器15朝远侧移动,驱动器15的驱动板24还被插入仓9的钉槽34中。随着驱动器15的驱动板24插入钉槽34中,偏转特征92的突起在驱动器主体21的近端上滑动、被迫打开并无法回弹到仓内(这意味着,无法回到偏转特征92未偏转时的仓的正常形状)。在击发后,如图8所示,推杆17缩回并且板状结构49一起缩回。此时,驱动器15的驱动板24保持完全处于钉槽34中。驱动器15的近端越过偏转特征92的突起并完全进入仓9。随后,驱动器15的驱动器主体21的近端不再约束偏转特征92。偏转特征92现在向内回弹到仓体91内或至少部分地回弹,只要偏转特征进入适当位置以阻止推杆17被朝远侧向前驱动而越过这些偏转特征。这样,偏转特征92停留在推杆17远端处的板状结构49与驱动器15之间。因此,当使用者试图重新装载已用仓或已空仓时,偏转特征92将会阻止向前驱动推杆17,由此防止重新击发。
如上所述,偏转特征可设置在仓的上壁和下壁上,或仅设置在左壁、右壁、上壁以及下壁之一上,只要驱动器的驱动器主体的近端设置有对应结构,以使得仓中的钉在由钉驱动器击发之后,在仓未被击发并回弹到仓体的大约常规尺寸或形状时,偏转特征被迫处于打开位置以抵接钉驱动器的外侧。偏转特征的近端无需具有突起,而是可在大约近端处具有朝仓内延伸的扩大部分。例如,扩大部分可以是从远端向近端在朝仓内延伸的方向上逐步扩大的部分。
在图8所示的位置中,驱动器15的驱动板24保持完全处于钉槽34内。通过仓体91的指示器窗口93仅能够看到驱动器主体21的一部分。在驱动器主体21和驱动板24具有不同颜色的实施例中,现在指示器窗口93中示出的颜色不同于仓击发前的颜色,从而向使用者指示仓已被击发。在驱动器主体21在其上具有标记95的实施例中,此时正好能够通过指示器窗口93看到标记95,从而向使用者指示仓已被击发。当然,这两种方式可进行组合,使得当在图8所示位置中时,通过指示器窗口93不仅可看到不同颜色还可看到标记,从而更可靠地指示被击发的仓。换句话说,在将仓击发后,通过指示器窗口93能够看到指示器特征,从而向使用者指示仓已被击发。
已在上文结合线性缝合器描述了本发明的各种实施例。然而,应当指出的是,在其它实施例中,本文所公开的本发明的外科器械无需是线性缝合器,而可以是弯曲缝合器等。本发明也可在传统的内窥镜式和开放式外科器械以及机器人辅助的手术中得到应用。
可将本文所公开的器械设计为单次使用后即丢弃,或将它们设计为可多次使用。然而,在任一种情况下,所述器械均可进行修复,以在至少一次使用后再次使用。修复可包括以下步骤的任何组合:拆卸器械、接着清洗或替换特定工件以及后续重新组装。具体地,可先拆卸器械,然后可以任何组合选择性地替换或移除器械的任何数目的特定工件或部件。在清洗和/或替换特定部件之后,可在修复设施处将器械重新组装以供后续使用,或者在即将进行外科手术之前由外科手术团队重新组装。本领域的技术人员应当理解,器械的修复可利用多种用于拆卸、清洗/替换以及重新组装的技术。此类技术的使用和所得到的已修复器械均在本发明的范围之内。
尽管本文已经结合某些公开的实施例描述了本发明,但是可对那些实施例实施多种修改和变型。例如,可采用不同类型的端部执行器。另外,在公开了用于某些部件的材料的情况下,均可使用其他材料。上述描述和以下权利要求旨在涵盖所有此类修改和变型。
Claims (10)
1.一种线性缝合器,包括:
具有近端和远端的支撑基部;
位于所述支撑基部的所述近端处的触发器;
位于所述支撑基部的所述远端处的端部执行器,所述端部执行器由所述触发器击发并包括仓,所述仓包括:
仓体,所述仓体包括:
用于容纳钉的钉槽;以及
仓闭锁件,当所述仓未被击发时,所述仓闭锁件被迫处于打开位置以抵接钉驱动器的外侧,并且在所述仓中的所述钉由所述钉驱动器击发之后,所述仓闭锁件朝所述仓体的内部方向回弹。
2.根据权利要求1所述的线性缝合器,其中所述仓闭锁件包括布置在所述仓体的壁上并朝近侧延伸的一个或多个偏转特征。
3.根据权利要求2所述的线性缝合器,其中所述偏转特征与所述仓体整体地模制而成。
4.根据权利要求2所述的线性缝合器,其中所述偏转特征单独制造并随后附接到所述仓体。
5.根据权利要求2所述的线性缝合器,其中所述偏转特征是由聚合物或金属制成的。
6.根据权利要求2所述的线性缝合器,其中所述偏转特征是片簧。
7.根据权利要求7所述的线性缝合器,其中所述偏转特征各自包括一个扩大的近端。
8.一种线性缝合器,包括:
具有近端和远端的支撑基部;
位于所述支撑基部的所述近端处的触发器;
位于所述支撑基部的所述远端处的端部执行器,所述端部执行器由所述触发器击发并且包括仓,所述仓包括仓体,所述仓体包括已空仓指示器。
9.根据权利要求8所述的线性缝合器,其中所述已空仓指示器包括形成在所述仓体中的指示器窗口和形成在用于驱动所述仓中的钉的钉驱动器上的指示器特征,在所述仓被击发后,所述指示器窗口显示所述指示器特征。
10.根据权利要求9所述的线性缝合器,其中所述指示器特征是颜色或标记。
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- 2013-02-06 RU RU2014137141A patent/RU2623130C2/ru not_active IP Right Cessation
- 2013-02-06 WO PCT/US2013/024841 patent/WO2013122792A2/en active Application Filing
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WO2013122792A3 (en) | 2014-03-06 |
RU2014137141A (ru) | 2016-04-10 |
BR112014020069A8 (pt) | 2017-07-11 |
JP6254100B2 (ja) | 2017-12-27 |
EP2814405B1 (en) | 2020-01-08 |
EP3685761B1 (en) | 2022-10-19 |
BR112014020069A2 (zh) | 2017-06-20 |
MX368375B (es) | 2019-09-30 |
CN104135952B (zh) | 2017-07-14 |
EP3685761A1 (en) | 2020-07-29 |
JP2015509393A (ja) | 2015-03-30 |
US20130206813A1 (en) | 2013-08-15 |
MX2014009791A (es) | 2014-09-12 |
WO2013122792A2 (en) | 2013-08-22 |
BR112014020069B1 (pt) | 2021-07-20 |
RU2623130C2 (ru) | 2017-06-22 |
EP2814405A2 (en) | 2014-12-24 |
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