CN104622530A - 带有脆性保持构件的砧座组件 - Google Patents

带有脆性保持构件的砧座组件 Download PDF

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CN104622530A
CN104622530A CN201410641539.5A CN201410641539A CN104622530A CN 104622530 A CN104622530 A CN 104622530A CN 201410641539 A CN201410641539 A CN 201410641539A CN 104622530 A CN104622530 A CN 104622530A
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anvil
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assembly
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head assembly
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CN104622530B (zh
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贾斯汀·威廉斯
帕特里克·D·莫泽杰尔
史蒂文·乔伊丝
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Covidien LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Abstract

一种砧座组件，包括保持构件，所述保持构件具有本体部和连接到所述本体部的脆性部，其中所述脆性部被定位为与支撑构件接合并且在支撑构件从第一、近侧位置移动到第二、远侧位置期间从本体部分离。所述保持构件在吻合组件发射之前将垫片保持在近侧位置，在所述吻合组件发射期间，当所述脆性部分离时允许所述垫片移动到远侧位置。避免了所述吻合组件发射之后作用在所述垫片上的近侧力，因此有助于确保砧座组件的倾斜。

Description

带有脆性保持构件的砧座组件
技术领域
本公开主要涉及一种具有可倾斜的头部的砧座组件，其适于与圆形结合用吻合器一起使用。更具体地，本公开涉及一种具有脆性保持构件的可倾斜砧座组件。
背景技术
包括具有可倾斜砧座头部的砧座组件的圆形结合用吻合器在本领域中是已知的。这种圆形结合用吻合器和可倾斜砧座组件的例子公开于共有的美国专利7,364,060(“‘060专利”)中。可倾斜砧座组件的另一个例子公开于公开号为2008/0230581的共有的美国专利申请(“‘581公开”)中。‘060专利和‘581公开中的每一个的全部内容通过引用合并于此。描述于‘581公开中的砧座组件包括位于砧座组件内并定位为阻止砧座组件的砧座头部在吻合器发射之前倾斜的垫片。当吻合器发射的时候，吻合器的刀刃接合垫片并使垫片移动到允许砧座头部在刀刃缩回时倾斜的位置。如果当刀刃缩回时垫片粘附到刀刃上，垫片会回到其阻止砧座头部倾斜的位置。当这种情况发生时，砧座头部将不会倾斜。
为了将垫片保持在阻止砧座头部在发射前倾斜的近侧位置，描述于‘581公开中的砧座组件包括一定位于垫片远侧的保持构件。该保持构件包括多个可变形凸起，其阻止垫片的远侧移动直至足以使凸起变形的预定力被施加到垫片上为止，即通过在吻合钉成形期间与刀刃的接合。在可变形凸起的变形过程中产生有残留的近侧力。该力作用于垫片上，这会导致垫片朝其原始位置向近侧移动。如在‘581公开中所描述的，砧座组件的倾斜操作依赖于垫片随着吻合器发射的远侧定位。任何作用于垫片上的近侧力都会导致垫片返回其原始的近侧位置，因此阻止了砧座组件的倾斜。
因此，提供下述砧座组件是有益的：其具有在吻合组件发射之前将垫片保持在近侧位置的器件，该器件允许垫片在吻合组件发射期间移动到远侧位置，并在吻合组件发射之后不产生作用于垫片上和会阻止砧座组件倾斜的近侧力。
发明内容
因此，提供了一种砧座组件。所述砧座组件包括中心杆组件和头部组件。所述头部组件包括壳体、支撑构件和保持构件。所述头部组件在非倾斜位置和倾斜位置之间可枢转地支撑在所述中心杆组件上。所述支撑构件能从第一位置移动到第二位置，在所述第一位置所述支撑构件的一部分被定位为阻止所述头部组件从所述非倾斜位置枢转移动到倾斜位置，在所述第二位置所述支撑构件被定位为允许所述头部组件相对于所述中心杆组件从所述非倾斜位置枢转移动到倾斜位置。所述保持构件包括本体部和连接到所述本体部的脆性部。所述脆性部被定位为接合所述支撑构件，并被构造为在所述支撑构件从所述第一位置移动到所述第二位置期间从所述本体部分离。
在一个实施例中，所述保持构件被定位于所述头部组件内以阻止所述支撑构件从所述第一位置移动到所述第二位置直至预定的力已被施加到所述支撑构件上为止。所述保持构件可以在所述头部组件内定位于所述壳体和支撑构件之间，所述保持构件包括保持部和从所述保持部延伸出的本体部，所述脆性部与所述保持部间隔开地被支撑在所述本体部上。所述保持构件的所述保持部可以被定位为邻近所述壳体的内侧壁。所述头部组件可以进一步包括支柱，所述壳体和支柱限定了环形凹槽，并且所述保持构件被定位在所述环形凹槽内。所述保持构件可以包括形成于所述本体部的第一端上的保持部，所述脆性部在与所述保持部间隔的位置处被支撑在所述本体部上。所述保持构件的本体部可以限定有多个切口，所述多个切口被构造为容纳形成在所述支撑构件上的指部。所述保持构件可以在所述本体部和所述脆性部之间限定有弱化部。所述弱化部可以限定有孔。
在一些实施例中，所述头部组件可以进一步包括凸轮锁定构件，所述凸轮锁定构件被定位为阻止所述支撑构件从所述第二位置移动到所述第一位置。所述头部组件可以绕枢轴构件可枢转地固定到中心杆上，并且所述凸轮锁定构件可以绕所述枢轴构件可枢转地安装。所述凸轮锁定构件可以被构造为当所述头部组件从所述非倾斜位置移动到所述倾斜位置时保持与所述支撑构件的接合，使得所述支撑构件从其第二位置向其第一位置的移动被阻止。所述凸轮锁定构件可以被定位为当所述支撑构件处于其第一位置时接合所述支撑构件的内周缘。所述头部组件可以进一步包括柱塞，其被偏置构件推动至与所述凸轮锁定构件接合从而推动所述凸轮锁定构件到其被枢转的位置。所述凸轮锁定构件可以包括曲面，所述曲面被构造为在所述头部组件从所述第一位置移动到所述第二位置期间消除所述凸轮锁定构件和所述支撑构件之间的任何间隙。
在不同的实施例中，所述支撑构件可以包括切割环(cutting ring)和垫片。所述切割环可以被固定到所述垫片的近侧面。所述垫片可以包括至少一个指部，当所述支撑构件处于其第一位置时所述至少一个指部定位为与中心杆的表面接合以阻止所述头部组件相对于所述中心杆的枢转移动。所述切割环可以由比所述垫片软的材料形成。所述切割环可以由聚乙烯形成并且所述垫片由金属形成。所述中心杆可以限定有纵轴线并且所述头部组件的枢轴线与所述中心杆的纵轴线相交。
附图说明
这里参照附图来描述本公开的砧座组件的不同实施例，其中：
图1为从本公开的带有倾斜的砧座头部的砧座组件的一端的侧视立体图；
图2为从图1所示的砧座组件的另一端的侧视立体图；
图3为在图1和图2中所示的砧座组件的部件分离的侧视立体图；
图4为在图1-3中所示的砧座组件的凸轮锁定构件的侧视立体图；
图5为在图1-3中所示的砧座组件的脆性保持构件的侧视立体图；
图6为沿凸轮锁定构件所取得的砧座头部和中心杆组件远端的侧视截面图，其中砧座头部处于非倾斜或操作位置；
图7为砧座头部和中心杆组件的远端的侧视截面图，其中垫片和切割环在砧座头部壳体内处于它们的近侧位置；
图7A为图7中所示的指示区域7A的放大图；
图7B为图7中所示的指示区域7B的放大图；
图8为在砧座头部倾斜前沿凸轮锁定构件所取得的砧座头部和中心杆组件远端的侧视截面图，其中垫片和切割环在砧座头部壳体内处于它们的推进或远侧位置；
图8A为图8中所示的指示区域8A的放大图；
图8B为图8中所示的指示区域8B的放大图；以及
图9为砧座头部和砧座中心杆组件的远端的侧视截面图，其中垫片和切割环在砧座头部壳体内处于它们的推进位置且砧座头部处于倾斜位置。
具体实施方式
现在将参照附图对本公开的砧座组件的实施例进行详细描述，其中在几幅附图的每一幅中，相同的附图标记代表相同或相应的元件。与本技术领域中一样的是，术语“近侧”指的是较靠近用户或操作者(也就是外科医生或临床医生)的部分或部件，而术语“远侧”指的是较远离用户的部分或部件。
图1-9所示的砧座组件10适于与手术吻合装置一起使用用于执行例如中空组织器官和痔疮手术的圆形吻合术。参考图1-3，砧座组件10包括头部组件12和中心杆组件14。头部组件12包括支柱16、壳体18、支撑构件或垫片20、切割环22、切割环盖23、砧座板24、凸轮锁定构件26和脆性保持构件27。如图示，支柱16与头部18整体地形成并且支柱16定位于头部18的中心。可选择地，头部18和支柱16可以单独地形成并使用已知的紧固技术，例如粘合、焊接、摩擦配合等紧固在一起。砧座板24被支撑在壳体18的外环形凹槽28(图3)中，并包括多个用于容纳吻合钉和使吻合钉变形的吻合钉变形凹穴30。至少一个凸起24a从砧座板24径向地向外延伸并容纳在形成于壳体18的外边缘内的切口32内。凸起24a和切口32的功能是将砧座板24正确地对准或定位在壳体18的环形凹槽28内。
现在特别参考图3，垫片20包括中心开口34，其允许垫片20被定位为围绕支柱16。垫片20被构造为容纳在形成于支柱16和外环形凹槽28之间的壳体18的内环形凹槽36内。垫片20包括凸台20a。尽管凸台20a被显示为具有圆形，但也可以想到其它构造，例如方形、长方形、三角形等。垫片20包括一对向内延伸的指部38，其将会在下文中进一步描述。垫片20由相对硬的材料例如金属形成。可选择地，其它结构材料也可以用来构成垫片20。
切割环22包括开口22a，开口22a具有与垫片20的台20a基本相同的构造。切割环22包括构造为容纳在形成于壳体18中的环形槽36a内的外唇缘22b(图6)。如下文中将会进一步详细描述的，切割环22的外唇缘22b被构造为在吻合钉成形步骤之前保持切割环22和垫片20处于围绕支柱16的近侧位置并位于壳体18的内环形凹槽36内。切割环22可以由聚乙烯或其它合适的材料形成。切割环22使用例如粘合剂牢固地固定到垫片20上以形成垫片/切割环组件。在一个实施例中，切割环22通过底切与垫片20二次成型。可选择地，垫片20与切割环22可以形成为单一或一个整体结构。
继续参考图3，切割环盖23被构造为使用例如粘合剂固定到切割环22的面向外的或近侧的表面40上。在一个实施例中，切割环盖23由具有比切割环22的硬度更大的硬度的一种或多种材料形成，例如迈拉(Mylar)。在其它实施例中，切割环盖23包括用粘合剂和/或聚丙烯涂层连结在一起的两层迈拉(Mylar)(未显示)。可选择地，切割环22不必有盖。
垫片20和切割环22被构造为围绕支柱16可移动地安装。如下文中将会进一步详细描述的，垫片20和切割环22被构造为从围绕支柱16且位于壳体18的内环形凹槽36内的初始或近侧位置(图6和图7)移动到围绕支柱16且位于壳体18的内环形凹槽36内的推进或远侧位置(图8)。如下文中将会进一步详细讨论的，在近侧位置，垫片20阻止头部组件12相对于中心杆组件14旋转，在远侧位置，垫片20不阻止头部组件12相对于中心杆组件14旋转。
继续参考图1-3，中心杆组件14包括中心杆52、柱塞54和柱塞弹簧56。中心杆52的第一端包括限定了空腔59a(图3)的一对臂59。每一个臂59具有横向的通孔58，其与中心杆52的中心纵轴线对准。可选择地，通孔58可以与中心杆52的纵轴线偏离。砧座头部组件12的支柱16被定尺寸为定位于空腔59a中，并且砧座头部组件12的支柱16也包括横向的通孔60。枢轴构件62通过每一个臂59的通孔58和支柱16的通孔60将支柱16可枢转地固定到中心杆52上，以使得砧座头部组件12被可枢转地安装到中心杆组件14上。对于中心杆组件14的更详细描述，请参考‘581公开，其内容先前通过引用合并于此。
现在参考图3和图4，凸轮锁定构件26包括具有通孔26b的本体26a。通孔26b被定尺寸为容纳枢轴构件62，以使得凸轮锁定构件26绕枢轴构件62可枢转地安装在支柱16的横向狭槽72内(图3)。凸轮锁定构件26包括第一本体部26c，其被构造为部分地从支柱16的狭槽72延伸出并被定位为与柱塞54的指部66接合。凸轮锁定构件26还包括边缘26f，其被构造为当砧座头部12在其非倾斜或操作位置(图6)的时候被柱塞54的指部66推动至与垫片20的内周缘接合。
现在参考图5，脆性保持构件27具有第一端100a和第二端100b，并包括大体环形的本体部100，其具有形成在第一端100a附近的保持环或部102以及与保持部102间隔开且邻近第二端100b形成的脆性环或部104。保持环102被构造为将脆性保持构件27围绕头部组件12的支柱16固定。如下文中将会进一步详细描述的，脆性环104被构造为选择性地将垫片20和切割环22保持在近侧位置(图6和图7)。脆性环104可以包括布置在脆性环104和环形本体部100之间的应力集中点(stress riser)或槽104a、孔或其它弱化部以帮助脆性环104从环形部分100分离。脆性保持构件27限定了被构造为容纳垫片20的指部38(图7)和凸轮锁定构件26(图6)的多个切口101。
当脆性保持构件27围绕支柱16定位时，保持环102被定位为邻近壳体18的后壁18a。脆性环104被定位在垫片20和壳体18之间。脆性环104被构造为将垫片20和切割环22保持在近侧位置(图6和图7)直至一足以将脆性环104从环形本体部100断裂或分离的预定力施加到垫片/切割环组件上为止。该预定力可以接近于但小于当刀刃与垫片/切割环组件接合时由手术吻合装置(未显示)的环形切割刃(未显示)施加到垫片20(图3)上的力。在一个实施例中，该预定力在约十磅和约九十磅之间。在另一个实施例中，该预定力约为三十(30)磅。当达到预定的力时，例如在切割组织的过程中，脆性环104从环形本体100断裂或分离，因而允许垫片20在壳体18的内环形凹槽36内被推向远侧。在此所公开的任何一个实施例中，脆性保持构件27可以具有无切口101的连续环以便这些部分可以保持在一起。由切口101形成的四个部分可以被卡住，从而阻止砧座倾斜。
参考图6和图7，所示出的砧座组件10处于发射前的、操作位置。在该发射前的、操作位置，垫片20与壳体18的后壁18a间隔开，并且垫片20的指部38(图7)与邻近中心杆52的顶面52a形成的突起52b接合以阻止砧座头部组件12绕枢轴构件62倾斜。如图6所示，柱塞54的指部66被弹簧56推动至与凸轮锁定构件26的本体部26c接合从而沿顺时针方向绕枢轴构件62推动凸轮锁定构件26，使得凸轮锁定构件26的边缘26f与垫片20的内周缘20b接合。脆性保持构件27阻止垫片20在壳体18的内环形凹槽36内向远侧无意的或过早的移动从而阻止砧座头部组件12无意的或过早的倾斜。具体来说，并且特别参考图7A，垫片20接合脆性保持构件27的脆性环104，因而将垫片20保持在近侧位置。特别参考图7B，通过将切割环22的唇缘22b容纳在壳体18的环形槽36a内，垫片20被进一步保持在壳体18的内环形凹槽36内的近侧位置。
在吻合步骤期间，砧座组件10附接到手术吻合装置(未显示)上，手术吻合装置以描述于‘060专利中的方式被发射，其内容先前已通过引用合并于此。现在参考图8，在手术吻合装置发射期间，手术吻合装置的刀刃(未显示)与切割环22(或切割环盖23)接合并在垫片/切割环组件20/22上施加远侧力。如上所述，当预定的力被施加到垫片/切割环组件上时，该力通过垫片/切割环组件20/22被传递到脆性保持构件27的脆性环104。当施加预定的力到脆性环104上时，脆性环104从脆性保持构件27的环形本体部100分离，以允许垫片/切割环组件20/22沿箭头“W”表示的方向被向远侧推动，进入壳体18的内环形凹槽36内。垫片/切割环组件20/22的向远侧移动引起垫片20的指部38(图7)远离中心杆52的突起52b移动并脱离与中心杆52的突起52b(图7)的接合。随着垫片20的内周缘20b移动越过凸轮锁定构件26的边缘26f，凸轮锁定构件26通过柱塞54沿图8中由箭头“X”表示的方向被枢转到达如下位置：在该位置本体部26d定位于垫片20之前并与垫片20接合(图8A)。柱塞54与凸轮锁定构件26的接合以及随后与支柱16的接合，使得朝着倾斜位置推动砧座头部组件12。
特别参考图8A，在垫片/切割环组件20/22的向远侧移动期间，脆性保持构件27的脆性环104从脆性保持构件27的环形本体部100分离并向远侧移动。分离的脆性环104保持被困于壳体18的后壁18a和垫片/切割环组件20/22之间。
现在特别参考图8B，除了脆性环104从环形本体100分离之外，垫片/切割环组件20/22的向远侧移动还引起了形成于切割环22上的唇缘22b被从切割环22的本体部折断。唇缘22b保留在壳体18的槽36a内。可选择地，手术吻合装置(未显示)的刀刃(未显示)可以彻底地切割切割环22，由此使切割环22的包括唇缘22b的部分与切割环22的其余部分分离。切割环22的包括唇缘22b的部分保留在壳体18的槽36a内。
应当注意的是，当手术吻合装置(未显示)发射时砧座头部组件12不会立即倾斜，这是因为在发射时，砧座头部组件12处于被靠近的位置，即砧座头部组件12与手术吻合装置(未显示)的壳组件紧紧对准。这样，砧座头部组件12的倾斜因与手术吻合装置(未显示)的壳组件(未显示)的接合而被阻止，直至砧座头部组件12不被靠近为止。
参考图9，当砧座头部组件12向其倾斜位置枢转时，柱塞54的指部66保持凸轮锁定构件26的面26e与垫片20接触以阻止当刀刃缩回时垫片20粘附到手术吻合装置的刀刃(未显示)上。应当注意的是，凸轮锁定构件26的曲面26e被构造为消除任何间隙并确保凸轮锁定构件26的面26e与垫片20之间的接触以在刀刃缩回期间和缩回之后保持垫片20在适当的位置，以使得在砧座组件12倾斜期间，垫片/切割环组件20/22留在远侧位置。
可以理解，可以对本文公开的实施例进行各种修改。例如，尽管示出具有环形构造，但脆性保持构件可以具有其它构造，例如，方形、椭圆形、长方形等。因此，上面的描述不应理解为限定，而仅是优选实施例的示例。本领域技术人员可以想到在于此所附权利要求书的范围和宗旨内的其它修改。

Claims (20)

1.一种砧座组件，包括：
中心杆组件；以及
头部组件，其包括壳体、支撑构件和保持构件，所述头部组件在非倾斜位置和倾斜位置之间可枢转地支撑在所述中心杆组件上，其中所述支撑构件能从第一位置移动到第二位置，在所述第一位置所述支撑构件的一部分被定位为阻止所述头部组件从所述非倾斜位置枢转移动到倾斜位置，在所述第二位置所述支撑构件被定位为允许所述头部组件相对于所述中心杆组件从所述非倾斜位置枢转移动到倾斜位置，所述保持构件包括本体部和连接到所述本体部的脆性部，其中所述脆性部被定位为接合所述支撑构件，并被构造为在所述支撑构件从所述第一位置移动到所述第二位置期间从所述本体部分离。
2.根据权利要求1所述的砧座组件，其中所述保持构件被定位于所述头部组件内以阻止所述支撑构件从所述第一位置移动到所述第二位置直至预定的力已被施加到所述支撑构件上为止。
3.根据权利要求1所述的砧座组件，其中所述保持构件在所述头部组件内被定位在所述壳体和支撑构件之间，所述保持构件进一步包括形成在所述本体部的第一端上的保持部。
4.根据权利要求3所述的砧座组件，其中所述保持构件的所述保持部被定位为邻近所述壳体的内侧壁。
5.根据权利要求3所述的砧座组件，其中所述脆性部在与所述保持部间隔的位置处被支撑在所述本体部上。
6.根据权利要求1所述的砧座组件，其中所述头部组件进一步包括支柱，所述壳体和所述支柱限定了环形凹槽，并且所述保持构件被定位在所述环形凹槽内。
7.根据权利要求1所述的砧座组件，其中所述保持构件的本体部限定了多个切口，所述多个切口被构造为容纳形成于所述支撑构件上的指部。
8.根据权利要求1所述的砧座组件，其中所述保持构件在所述本体部和所述脆性部之间限定有弱化部。
9.根据权利要求8所述的砧座组件，其中所述弱化部限定有孔。
10.根据权利要求1所述的砧座组件，其中所述头部组件进一步包括凸轮锁定构件，所述凸轮锁定构件被定位为阻止所述支撑构件从所述第二位置移动到所述第一位置。
11.根据权利要求10所述的砧座组件，其中所述头部组件绕枢轴构件可枢转地固定到中心杆上，所述凸轮锁定构件绕所述枢轴构件可枢转地安装。
12.根据权利要求10所述的砧座组件，其中所述凸轮锁定构件被构造为当所述头部组件从所述非倾斜位置移动到所述倾斜位置时保持与所述支撑构件的接合，使得所述支撑构件从所述第二位置向所述第一位置的移动被阻止。
13.根据权利要求1所述的砧座组件，其中所述凸轮锁定构件被定位为当所述支撑构件处于所述第一位置时接合所述支撑构件的内周缘。
14.根据权利要求10所述的砧座组件，进一步包括柱塞，所述柱塞被偏置构件推动至与所述凸轮锁定构件接合从而推动所述凸轮锁定构件到被枢转的位置。
15.根据权利要求10所述的砧座组件，其中所述凸轮锁定构件包括曲面，所述曲面被构造为在所述头部组件从所述第一位置移动到所述第二位置期间消除所述凸轮锁定构件和所述支撑构件之间的任何间隙。
16.根据权利要求1所述的砧座组件，其中所述支撑构件包括切割环和垫片，所述切割环被固定到所述垫片的近侧面。
17.根据权利要求16所述的砧座组件，其中所述垫片包括至少一个指部，当所述支撑构件处于所述第一位置时所述至少一个指部定位为与中心杆的表面接合以阻止所述头部组件相对于所述中心杆的枢转移动。
18.根据权利要求17所述的砧座组件，其中所述切割环由比所述垫片软的材料形成。
19.根据权利要求18所述的砧座组件，其中所述切割环由聚乙烯形成，所述垫片由金属形成。
20.根据权利要求2所述的砧座组件，其中所述预定的力在约十磅和约九十磅之间。
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