CN104939883B - 用于组织厚度感测的仪器和方法 - Google Patents

用于组织厚度感测的仪器和方法 Download PDF

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CN104939883B
CN104939883B CN201510149368.9A CN201510149368A CN104939883B CN 104939883 B CN104939883 B CN 104939883B CN 201510149368 A CN201510149368 A CN 201510149368A CN 104939883 B CN104939883 B CN 104939883B
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CN104939883A (zh
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戴维·乔瓦尼克
马修·乔瓦尼奇
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Covidien LP
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Abstract

本发明提供了用于组织厚度感测的仪器和方法。还提供了一种手术器械。所述手术器械包括：测试末端执行器，其包括测试钳夹组件以及至少一个传感器，其中，所述测试钳夹组件具有配置为关于组织夹紧的一对钳夹，所述至少一个传感器配置为测量至少一个组织特性；以及手柄组件，其配置为联接到治疗末端执行器。所述手柄组件包括：驱动组件；电动机，其可操作地联接到驱动组件；以及控制器，其可操作地联接到所述电动机，所述控制器配置为控制电动机的操作以致动所述测试末端执行器，从而测量所述至少一个组织特性，并基于所述至少一个组织特性来确定至少一个适合的治疗末端执行器。

Description

用于组织厚度感测的仪器和方法
相关申请的交叉引用
本申请要求享有提交于2014年3月31日的序号为61/972,511的美国临时专利申请的利益和优先权，其整个公开通过引用合并于此。
技术领域
本公开涉及用于执行内窥镜手术操作的手术仪器、装置和/或系统以及其使用方法。更具体地，本公开涉及配置为用于与用于夹紧、切割和/或吻合组织的能够拆卸的、一次性的末端执行器和/或单次使用的末端执行器一起使用的机电的、手持式手术仪器、装置和/或系统。
背景技术
许多手术装置的生产商已经开发出具有适用于操作和/或操纵机电手术装置的专用驱动系统的产品线。在许多实例中，所述机电手术装置包括可重复使用的手柄组件，以及一次性末端执行器或单次使用的末端执行器。所述末端执行器可以在使用前选择性地连接至所述手柄组件上，并且然后，在使用后再从所述手柄组件断开连接以便于被处置或在一些实例中被消毒以重复使用。
许多这种机电手术装置包括复杂的驱动部件，其利用多种可接收用户输入的用户接口(例如，控制器)来控制装置并给用户提供反馈。为防止驱动机构的致动超过机械极限，多种开关和传感器被用来检测手术装置的运转状态。
各种末端执行器能够与可重复使用的手柄组件一起使用。然而，在一些应用中，对于医师而言，很难为特定的手术选择适合的末端执行器(例如，选择具有足够的长度以紧固组织的紧固件的末端执行器)。因此，需要如下的系统和仪器：其配置为确定组织特性从而为医师指示一个或多个适合的末端执行器来治疗所述组织。
发明内容
根据本公开的一个实施例提供了一种手术器械。所述手术器械包括：测试末端执行器，其包括测试钳夹组件以及至少一个传感器，所述测试钳夹组件具有配置为关于组织夹紧的一对钳夹，所述至少一个传感器配置为测量至少一个组织特性；以及手柄组件，其配置为联接到测试末端执行器。所述手柄组件包括：驱动组件；电动机，其可操作地联接到驱动组件；以及控制器，其可操作地联接到所述电动机，所述控制器配置为控制电动机的操作以致动测试末端执行器，从而测量至少一个组织特性并基于所述至少一个组织特性来确定至少一个适合的治疗末端执行器。
根据上述实施例的一个方案，所述至少一个传感器配置为测量施加在组织上的压力。所述至少一个传感器选自包括力传感器、压电元件、压阻元件、测压元件、金属薄膜应变计、半导体应变计、感应压力传感器、电容压力传感器、电位压力传感器及其组合的组。
根据上述实施例的另一个方案，手柄组件包括联接到控制器的用户接口装置。用户接口装置选自包括发光二极管、声频装置、显示器及其组合的组。用户接口装置输出对应至少一个适合的治疗末端执行器的标记。
根据本公开的一个实施例，提供了一种手术系统。所述手术系统包括：测试末端执行器，其包括配置为测量至少一个组织特性的至少一个传感器；多个治疗末端执行器，所述治疗末端执行器中的每个都包括钳夹组件，所述钳夹组件具有配置为关于组织夹紧的一对钳夹；以及手柄组件，其配置为选择性地联接到所述治疗末端执行器中的至少一个或所述测试末端执行器，所述手柄组件包括：驱动组件；电动机，其可操作地联接到驱动组件；以及控制器，其可操作地联接到电动机，所述控制器配置为控制所述电动机的操作以致动测试末端执行器，从而测量至少一个组织特性并基于所述至少一个组织特性指示从多个治疗末端执行器中选择出的至少一个适合的治疗末端执行器。
根据上述实施例的一个方案，所述至少一个传感器配置为测量施加在组织上的压力。所述至少一个传感器选自包括力传感器、压电元件、压阻元件、测压元件、金属薄膜应变计、半导体应变计、感应压力传感器、电容压力传感器、电位压力传感器及其组合的组。
根据上述实施例的另一个方案，手柄组件包括联接到控制器的用户接口装置。用户接口装置选自包括发光二极管、声频装置、显示器及其组合的组。用户接口装置输出对应至少一个适合的治疗末端执行器的标记。
根据上述实施例的另一个方案，提供了一种用于治疗组织的方法。所述方法包括：将测试末端执行器联接到手柄组件，所述测试末端执行器包括配置为测量至少一个组织特性的至少一个传感器；致动所述测试末端执行器以测量所述至少一个组织特性；以及基于所述至少一个组织特性确定至少一个适合的治疗末端执行器。
根据上述实施例的一个方案，所述方法进一步包括：在手柄组件的用户接口上指示至少一个适合的治疗末端执行器。在用户接口上指示包括输出对应至少一个适合的治疗末端执行器的标记，其中标记选自包括颜色、标识号、音调、及其组合的组。
根据上述实施例的另一个方案，所述方法进一步包括：将至少一个适合的治疗末端执行器联接到手柄组件；以及通过至少一个适合的治疗末端执行器夹紧组织。
根据上述实施例的另一个方案，所述方法进一步包括：致动测试末端执行器包括测量施加到所述组织上的压力。
附图说明
本文将通过参照附图描述本公开的实施例，其中：
图1是根据本公开的包括手术器械、接合器以及末端执行器的机电手术系统的分解的立体图；
图2是根据本公开的图1的手术器械的立体图；
图3是根据本公开的图1的手术器械的部件分开的立体图；
图4是根据本公开的图1的手术器械的电池的立体图；
图5是根据本公开的图1的手术器械的部分分解的俯视图；
图6是根据本公开的图1的手术器械的正视立体图，其中，所述接合器从所述手术器械分离；
图7是根据本公开的图1的手术器械沿着图2的7-7取得的侧剖视图；
图8是根据本公开的图1的手术器械沿着图2的8-8取得的俯视剖视图；
图9是根据本公开的图1的末端执行器的部件分开的立体图；
图10是根据本公开的图1的手术器械的示意图；以及
图11是根据本公开的测试末端执行器和测试钉仓的部件分开的立体图。
具体实施方式
根据本公开的实施例，手术系统总体被指定为10，并且所述手术系统呈动力手持式机电器械的形式，且所述动力手持式机电器械被配置为选择性地将多个不同的末端执行器附接至其上，所述末端执行器中的每一个均被配置为用于通过所述动力手持式机电手术器械来致动和操纵。
如图1所示，手术器械100被配置为选择性连接接合器200，并且，依次地，接合器200被配置为选择性连接末端执行器或单次使用的装载单元300。
如图1至图3所示，手术器械100包括手柄壳体102，手柄壳体102具有下壳体部104、中间壳体部106以及上壳体部108，其中，中间壳体部106从下壳体部104延伸出和/或被支撑在下壳体部104上，上壳体部108从中间壳体部106延伸出和/或被支撑在中间壳体部106上。中间壳体部106和上壳体部108被分离成远侧半体110a和近侧半体110b，其中，远侧半体110a与下壳体部104一体式形成并且从下壳体部104延伸，而近侧半体110b能够通过多个紧固件与远侧半体110a连接。当结合时，远侧半体110a和近侧半体110b限定手柄壳体102，在手柄壳体102内具有安置了电路板150和驱动机构160的空腔102a。
可从图2和图3看出，远侧半体110a和近侧半体110b沿着横切上壳体部108的纵向轴线“X”的平面被分割。手柄壳体102包括垫圈112，垫圈112完全地环绕远侧半体110a和/或近侧半体110b的边缘延伸并且被插入远侧半体110a和近侧半体110b之间。垫圈112密封远侧半体110a和近侧半体110b的周边。垫圈112的作用是在远侧半体110a和近侧半体110b之间建立气密的密封，使电路板150和驱动机构160在杀菌和/或清洁操作时被保护。
如此，手柄壳体102的空腔102a沿着远侧半体110a的周边被密封，而近侧半体110b被配置为使电路板150和驱动机构160在手柄壳体102内的组装变得更加容易且更加高效。
手柄壳体102的中间壳体部106提供了安置有电路板150的壳体。电路板150被配置为控制手术器械100的多种操作，这将在下文中更详细地介绍。
手术器械100的下壳体部104限定了孔隙(未显示)，此孔隙形成在下壳体部104的上表面并位于中间壳体部106之下或之内。下壳体部104的孔隙提供了通道，电线152穿过所述通道以将安置在下壳体部104内的电气部件(如图4所示的电源156，如图3所示的电路板154，等)与安置在中间壳体部106和/或上壳体部108内的电气部件(电路板150、驱动机构160等)电连通。
手柄壳体102包括布置在下壳体部104的孔隙(未显示)内的垫圈103，从而塞紧或密封下壳体部104的孔隙但是允许电线152从其中穿过。垫圈103的作用是在下壳体部106和中间壳体部108之间建立气密的密封，从而使电路板150和驱动机构160在杀菌和/或清洁操作时被保护。
如图所示，手柄壳体102的下壳体部104提供了壳体，可再充电的电源156(图4)被可拆卸地布置在所述壳体内。电源156被配置为向手术器械100的任何电气部件供给电力。下壳体部104限定了空腔(未显示)，电源156被插入所述空腔。下壳体部104包括门105，门105枢轴地连接到下壳体部104，用于闭合下壳体部104的空腔并且将电源156保持在所述空腔内。
参考图3和图5，上壳体部108的远侧半体110a限定了鼻形物或连接部108a。鼻椎体114被支撑在上壳体部108的鼻形部108a上。鼻椎体114由透明材料制成。器械100还包括用户接口装置，例如照明构件116，照明构件116被布置在鼻椎体114内，从而穿过其中可以看见照明构件116。照明构件116可以是发光二级管印刷电路板(LED PCB)。照明构件116被配置为以具有与独特的离散事件相关联的特定颜色图案的多种颜色照明。
器械100还可以包括一个或多个音频输出(例如，音调、铃、警报器、合成扬声器等等)，以将各种状态变化(例如电池电量过低，钉仓变空等等)传达给用户。听觉反馈可与照明构件116联合使用，或者代替照明构件116。听觉反馈可以设置成单脉冲或多脉冲顺序的咔哒声、劈啪声、哔哔声、铃声、嗡嗡声的形式。在一个实施例中，复制由传统的非动力器械的机械锁定器和机构产生的咔哒声和/或劈啪声的模拟的机械声音可以预先录制。这消除了通过器械100的实际部件产生这种机械声音的需求，并且避免了使用通常与其他手术室器械相联系的哔哔声或其他电子声，从而防止与不相干的听觉反馈混淆。
器械100还可以通过触觉机构(未明显示出)提供触觉反馈或振动反馈。触觉反馈可以与听觉反馈或视觉反馈联合使用，或者代替听觉反馈或视觉反馈，从而避免与依赖于听觉反馈或视觉反馈的手术室器械混淆。触觉机构可以是以脉冲方式振动的异步电动机。在一个实施例中，振动的频率为大约30Hz或之上，从而提供具有1.5mm或更低幅度的位移，以限制末端执行器300的振动效果。
在其他实施例中，器械100可以包括任何其他适合的用户接口装置，所述用户接口装置包括但不限于显示装置(例如，液晶显示器、有机发光显示器、电泳墨水显示器等等)。
手柄壳体102的上壳体部108提供了安置驱动机构160的壳体。如图5所示，驱动机构160被配置为驱动轴和/或齿轮部件来执行手术器械100的多种操作。特别地，驱动机构160被配置为驱动轴和/或齿轮部件从而选择性地使末端执行器300的工具组件304相对末端执行器300的近侧主体部302移动(参见图1和图9)，使末端执行器300相对手柄壳体102绕纵向轴线“X”(参见图2)旋转，使砧座组件306相对末端执行器300的钉仓组件308移动，和/或从末端执行器300的钉仓组件308内发射吻合和切割钉仓。
驱动机构160包括选择器变速箱组件162，其紧靠接合器200的近侧。选择器变速箱组件162的近侧具有功能选择模块163，功能选择模块163具有第一电动机164，第一电动机164的作用是选择性地移动选择器变速箱组件162内的齿轮元件使所述齿轮元件与具有第二电动机166的输入驱动部件165接合。电动机164可以是配置为致动一个或多个驱动器(例如，图6的可旋转驱动连接器118、120、122)的任何电动机。电动机164联接到电源156，电源156可以是DC电池(例如，能够再充电的铅基、镍基、锂离子基电池等等)、AC/DC变压器、或任何其他适合于向电动机164提供电能的电源。
如图1至图4所示，并且如上所提到的，上壳体部108的远侧半体110a限定了连接部108a，其被配置为接收接合器200的对应的驱动联接组件210。
如图6至图8所示，手术器械100的连接部108a具有圆柱形的凹槽108b，当接合器200与手术器械100配接时，凹槽108b接纳接合器200的驱动联接组件210。连接部108a容纳三个可旋转驱动连接器118、120、122。
如图6所示，当接合器200与手术器械100配接时，手术器械100的可旋转驱动连接器118、120、122中的每一个驱动连接器与接合器200的对应的可旋转连接器套管218、220、222相联接。在这点上，对应的第一驱动连接器118和第一连接器套管218之间的交接，对应的第二驱动连接器120和第二连接器套管220之间的交接，以及对应的第三驱动连接器122和第三连接器套管222之间的交接都是键联接，以便于手术器械100的驱动连接器118、120、122中的每一个驱动连接器的旋转都会引起接合器200的对应的连接器套管218、220、222的对应的旋转。
手术器械100的驱动连接器118、120、122与接合器200的连接器套管218、220、222的配接允许旋转力经由三个对应的连接器交接中的每一个连接器交接独立地传递。手术器械100的驱动连接器118、120、122被配置为被驱动机构160独立地旋转。在这点上，驱动机构160的功能选择模块163会选择由驱动机构160的输入驱动部件165来驱动手术器械100的驱动连接器118、120、122中的哪一个或哪几个。
因为手术器械100的驱动连接器118、120、122中的每一个驱动连接器与接合器200的对应的连接器套管218、220、222的交接都是键式的和/或基本上不可旋转的，当接合器200联接到手术器械100时，旋转力被选择性地从手术器械100的驱动机构160传递到接合器200。
手术器械100的驱动连接器118、120和/或122的选择性旋转允许手术器械100选择性地致动末端执行器300的不同功能。如下面更详细地讨论，手术器械100的第一驱动连接器118的选择性的且独立的旋转对应末端执行器300的工具组件304的选择性的且独立的打开和闭合，以及对应末端执行器300的工具组件304的吻合/切割部件的驱动。同样，手术器械100的第二驱动连接器120的选择性的且独立的旋转对应末端执行器300的工具组件304的横切纵向轴线“X”(参见图2)的选择性且独立的关节式运动。另外，手术器械100的第三驱动连接器122的选择性的且独立的旋转对应末端执行器300相对于手术器械100的手柄壳体102绕纵向轴线“X”(参见图2)的选择性的且独立的旋转。
如上所提到的并且如图5和图8所示，驱动机构160包括选择器变速箱组件162，以及安置在选择器变速箱组件162的近侧的功能选择模块163，功能选择模块163的作用是选择性地移动选择器变速箱组件162内的齿轮元件使所述齿轮元件与第二电动机166接合。这样，在特定时间，驱动机构160选择性地驱动手术器械100的驱动连接器118、120、122中的一个。
如图1至图3所示，手柄壳体102将控制组件107支撑在中间壳体部106的远侧表面或侧面上。控制组件107是功能完善的机械子组件，其在联接至器械100之前能够与器械100的其余部分分离地组装和测试。
控制组件107，与中间壳体部108协作，将一对手指致动的控制按钮124、126和一对摇杆装置128、130支撑在壳体107a内。控制按钮124、126分别被联接至延伸轴125、127。特别地，控制组件107限定了用于可滑动地接纳延伸轴125的上孔隙124a和用于可滑动地接纳延伸轴127的下孔隙126a。
对于手术器械100的构造和操作的详细讨论，可以参考序号为13/331，047的共有美国专利申请，上述专利的全部内容通过引用结合在此。
参照图9，末端执行器300的驱动组件360包括挠性驱动轴364，挠性驱动轴364具有紧固到驱动梁365的远侧端以及近侧接合体368。接合体368包括限定肩370的梯状部。接合体368的近侧端包括正相对的向内延伸的指状件372。指状件372与中空的驱动构件374接合从而将驱动构件374牢固地紧固到轴364的近侧端上。驱动构件374限定近侧孔口，近侧孔口在末端执行器300被附接到接合器200的远侧联接器230时接纳接合器200的驱动管246(图1)的连接构件。
驱动梁365包括分别布置在竖直支撑架(support strut)380的顶部和底部的凸轮构件382和抓住部(catch)384。凸轮构件382定尺寸并配置为在发射期间接合砧座板312的外凸轮表面312a并且相对于其平移，以抵靠身体组织逐步地夹紧砧座。
当驱动组件360在工具组件304内向远侧推进时，驱动梁365的凸轮构件380在限定在砧座板312内的沟槽312b以及形成在砧座盖310的下侧上的对应的纵向狭槽(未显示)内移动。支撑架380在吻合钉钉仓305的沟槽305a内移动，并且抓住部384在托架316的外表面上方移动，以闭合工具组件304并且从其中发射吻合钉。
末端执行器300的近侧主体部302包括封装上壳体部301a和下壳体部301b的鞘或外管301。上壳体部301a和下壳体部301b封装关节式运动连杆366，关节式运动连杆366具有从末端执行器300的近侧端延伸的钩状近侧端366a。当末端执行器300被紧固到接合器200的远侧壳体232时，关节式运动连杆366的钩状近侧端366a与接合器200的联接钩(未显示)相接合。如上所述，当接合器200的驱动杆(未显示)被推进或缩回时，末端执行器300的关节式运动连杆366会在末端执行器300内被推进或缩回以使工具组件304相对于近侧主体部302的远侧端枢转。
如上文图9所示，工具组件304的钉仓组件308包括能够支撑在托架316内的吻合钉钉仓305。吻合钉钉仓305限定了中央纵向狭槽305a，以及定位在纵向狭槽305a的每一侧上的三个线性排吻合钉保持狭槽305b。每一个吻合钉保持狭槽305b接纳单个吻合钉307和吻合钉推动器309的一部分。在操作器械100期间，驱动组件360与致动滑板350邻接并推动致动滑板350通过钉仓305。随着致动滑板移动通过钉仓305，致动滑板350的凸轮楔顺序地与吻合钉推动器309相接合，从而在吻合钉保持狭槽305b内竖直地移动吻合钉推动器309并从其中顺序地射出单个吻合钉307以靠着砧座板312成型。吻合钉钉仓305可以是能够替换的，从而允许具有多个吻合钉钉仓305的末端执行器300的重复使用和/或选择适当尺寸(其可以是从大约1mm到大约20mm)的紧固件。
参照图10，电源156和电动机164被联接至布置在电路板154上的电动机驱动电路404，电路板154控制电动机164的操作，包括电能从电源156流向电动机164。驱动电路404包括配置为测量电动机164和电源156的运转状态的多个传感器408a、408b、…408n。传感器408a-n可包括电压传感器、电流传感器、温度传感器、遥感传感器、光学传感器及其组合。传感器408a-408n可测量由电源156提供的电能的电压、电流以及其他电学特性。传感器408a-408n还可测量电动机164的按照每分钟的转数(RPM)的旋转速度、转矩、温度、电流消耗、以及其他运转特性。可通过测量电动机164的旋转来确定RPM。多种驱动轴(例如，图6的可旋转驱动连接器118、120、122)的位置可通过使用布置在轴内或邻近轴处的多种线性传感器来确定或从RPM测量值来推定。在实施例中，在恒定的RPM下，可以基于电动机164的额定电流消耗来计算转矩。在另外的实施例中，驱动电路404和/或控制器406可测量时间并作为其函数(包括例如积分和/或微分)处理上述数值以确定测量值的变化等。
驱动电路404还被联接至控制器406，控制器406可以是任何适合的逻辑控制电路，其适合于执行计算和/或根据一组指示运转，这将在下文中更详细地描述。控制器406可包括被可操作地连接至内存的中央处理单元，内存可包括临时类型内存(例如，RAM)和/或非临时类型内存(例如，可读取多种记忆卡、磁盘碟片、等)。控制器406包括多个用于交接驱动电路404的输入端和输出端。特别地，控制器406接收被测量的来自驱动电路404的关于电动机164和电源156的运转状态的传感器信号，并且依次地，基于传感器读数和特定的规则系统指示，输出控制信号至驱动电路404以控制电动机164的运转，这将在下文中更详细地描述。控制器406还配置为接收来自用户接口(例如，被联接至控制器406的控制组件107的开关、按钮、触摸屏等)的多个用户输入。
根据本公开的器械100和方法可以与任何其他动力手术器械一起使用，所述动力手术器械包括但是不局限于线性动力吻合器、圆形或弓形动力吻合器、抓紧器、电手术密封镊子、旋转组织混合装置等。提供了根据本公开的器械100和方法，用于确定一个或多个组织特性并且提供指示了用于治疗组织的适合的末端执行器的输出。器械100可以联接到测试单元，其可以是测试末端执行器400和/或测试钉仓405。测试钉仓405可以与末端执行器300或测试末端执行器400一起使用。测试单元配置为能够由器械100操作，以确定一个或多个组织特性，例如，厚度。器械100可以输出确定的组织特性和/或提供一个或多个适合的末端执行器300和/或吻合钉钉仓305，用于治疗被测试的组织。
参照图11，显示了具有测试钉仓505的测试末端执行器500。在实施例中，测试末端执行器500和测试钉仓505可以单独地或组合地用于测量组织特性。测试末端执行器500与末端执行器300大致相似，并且包括：砧座组件506，其相对于钉仓组件508可移动；以及驱动组件560，其具有挠性的驱动轴564。驱动轴564包括固定到驱动梁565的远侧端，以及近侧接合体568，其接合中空驱动构件574，依次地，当末端执行器500附接至接合器200的远侧联接件230时，中空驱动构件574接纳接合器200的驱动管246(图1)的连接构件。
驱动梁565包括分别布置在竖直支撑架580的顶部和底部的凸轮构件582和抓住部584。凸轮构件582定尺寸且配置为在发射期间接合砧座板512的外凸轮表面512a并且关于其平移，以抵靠身体组织逐步地夹紧砧座。
当驱动组件560在工具组件504内向远侧推进时，驱动梁565的凸轮构件580在限定在砧座板512内的沟槽512b以及形成在砧座盖510的下侧上的对应的纵向狭槽(未显示)内移动。支撑架580在测试钉仓505的沟槽505a内移动，并且抓住部584在托架516的外表面的上方移动，以闭合工具组件504。测试末端执行器500还包括封装上壳体部501a和下壳体部501b的鞘或外管501。
测试末端执行器500还包括钉仓组件508，其配置为容纳测试钉仓505，其能够支撑在托架516内。测试钉仓505还限定了中央纵向狭槽505a。
由于测试末端执行器500用于测量组织特性，所以其可以没有一些部件，例如关节式运动连杆366和/或致动滑块350(图9)，从而最小化末端执行器300的成本和复杂性。相似地，测试钉仓505可以没有任何组织紧固件，以防止组织的无意中的夹紧。在实施例中，限定在砧座板512内的沟槽512b和/或测试钉仓505的中央纵向狭槽505a可以比限定在砧座板312内的对应的沟槽312b和/或吻合钉钉仓305的中央纵向狭槽305a短。这是由于，驱动梁565为闭合工具组件504而移动的距离可以比为从吻合钉钉仓305射出吻合钉307而移动的距离短。
测试末端执行器500和/或测试钉仓505可以包括一个或多个传感器520，传感器520联接到被致动以闭合工具组件504的部件中的任何一个。在实施例中，传感器520可以布置在砧座组件506和/或钉仓组件508的内表面上。在其他实施例中，传感器520可以联接到驱动组件560。
传感器520可以是确定对应正施加在正被夹紧的组织上的力的量的正施加在传感器上的机械力的量的任何适合的传感器。特别地，传感器520检测正施加在组织上的力并且将指示所述力的电信号传输到控制器406，然后控制器406得到组织压缩。传感器520可以使用无线(例如，RFID、BluetoothTM、等等)或有线连接(例如，2线总线)而联接到器械100的控制器406。
适合的传感器520可以包括并且不限于：力传感器、压电元件、压阻元件、测压元件、金属薄膜应变计、半导体应变计、感应压力传感器、电容压力传感器、电位压力传感器、及其组合。
在实施例中，传感器520还可以包括用于确定砧座组件506和钉仓组件508之间的间隙距离的近侧传感器。适合的传感器520包括但不限于：分压计、线性可变差动变压器、抗磁元件、电容元件、电磁感应传感器、霍尔效应传感器、及其组合。
在其他实施例中，传感器520可以包括电传感器和/或光学传感器，用于确定其他特性，包括但不限于：组织阻抗、组织半透明性/不透明性、组织水文学、组织血管分布、封闭血管的爆破强度、组织密封融合、温度、通过施加的治疗能量而导致的组织刺入深度、热扩散、及其组合。适合的电传感器和/或光学传感器包括：电极；光发射机(例如，发光二极管)，其照射组织；感光器；等等。
在使用期间，测试末端执行器500经由接合器200联接到器械100。在实施例中，测试钉仓505可以联接到末端执行器300的托架316或测试末端执行器500的托架516。一旦测试末端执行器500和/或测试钉仓505联接到器械100，控制器406识别测试末端执行器500和/或测试钉仓505以及容纳在其内的传感器520。响应于检测到测试末端执行器500和/或测试钉仓505，控制器406将器械100配置成测试模式。然后器械100使用测试末端执行器500和/或测试钉仓505夹紧组织。如上所述，容纳在测试末端执行器500和/或测试钉仓505中的传感器520测量施加在末端执行器300或末端执行器500上的力以及任何其他组织特性。传感器测量结果传输到控制器406，然后，控制器406基于来自传感器520的测量结果确定施加在组织上的力以及任何其他组织特性。
控制器406进一步配置为基于所测量的组织特性而确定用于治疗组织的一个或多个适合的末端执行器300。控制器406的内存可以存储查找表格，其中，所述查找表格存储一列末端执行器300和对应的夹紧力或其他组织类型。控制器406基于测量的夹紧力或其他感测到的测量结果来选择末端执行器300。
如上所述，器械100可以通过照明构件116或其他反馈装置(例如，声调)输出适合的类型的末端执行器300。照明构件116可以通过使用与末端执行器300关联的预定的颜色、闪光图案及其组合来指示适合的末端执行器300。特别地，每个类型的末端执行器300可以由预定的颜色或标识号指定，从而使得照明构件116的输出用于指示适合类型的末端执行器300。在实施例中，可能有多个末端执行器300都适合治疗组织，从而使得照明构件116输出多个指示。这允许医师从多个适合的末端执行器300中选择。
应该理解的是，上述描述仅是本公开的例证性描述。可以在不脱离本公开的情况下由本领域技术人员提出多种选择和改进。例如，本发明的器械可以用在训练方法中，用于教导外科医生末端执行器选择，然后末端执行器用在手动型装置上，例如手术吻合器。因此，本公开意图包括所有这种选择、改进和变化。呈现参照附图描述的实施例仅是说明本公开的一些例子。与上述描述和/或所附权利要求在本质上没有区别的其他元件、步骤、方法和技术也意图包括在本公开的范围内。

Claims (12)

1.一种手术器械，包括：
测试末端执行器，其包括测试钳夹组件以及至少一个传感器，其中，所述测试钳夹组件具有配置为关于组织夹紧的一对钳夹，所述至少一个传感器配置为测量至少一个组织特性；以及
手柄组件，其配置为联接到所述测试末端执行器，所述手柄组件包括：
驱动组件；
电动机，其可操作地联接到驱动组件；
控制器，其可操作地联接到所述电动机，所述控制器配置为控制电动机的操作以致动所述测试末端执行器，从而测量至少一个组织特性并基于所述至少一个组织特性来从多个治疗末端执行器中确定并选择一组多个适合的治疗末端执行器；以及
联接到所述控制器的用户接口装置，所述用户接口装置配置为输出对应所述一组多个适合的治疗末端执行器的标记。
2.根据权利要求1所述的手术器械，其中所述至少一个传感器配置为测量施加在所述组织上的压力。
3.根据权利要求1所述的手术器械，其中所述至少一个传感器选自包括力传感器、压电元件、压阻元件、测压元件、金属薄膜应变计、半导体应变计、感应压力传感器、电容压力传感器、电位压力传感器及其组合的组。
4.根据权利要求1所述的手术器械，其中所述用户接口装置选自包括发光二极管、声频装置、显示器及其组合的组。
5.一种手术系统，包括：
测试末端执行器，其包括配置为测量至少一个组织特性的至少一个传感器；
多个治疗末端执行器，所述治疗末端执行器中的每个都包括钳夹组件，所述钳夹组件具有配置为关于组织夹紧的一对钳夹；以及
手柄组件，其配置为选择性地联接到所述治疗末端执行器中的至少一个或所述测试末端执行器，所述手柄组件包括：
驱动组件；
电动机，其可操作地联接到所述驱动组件；
控制器，其可操作地联接到所述电动机，所述控制器配置为控制所述电动机的操作以致动所述测试末端执行器，从而测量至少一个组织特性并基于所述至少一个组织特性从多个治疗末端执行器中选择一组多个适合的治疗末端执行器；以及
联接到所述控制器的用户接口装置，所述用户接口装置配置为输出对应所述一组多个适合的治疗末端执行器的标记。
6.根据权利要求5所述的手术系统，其中所述至少一个传感器配置为测量施加在所述组织上的压力。
7.根据权利要求5所述的手术系统，其中所述至少一个传感器选自包括力传感器、压电元件、压阻元件、测压元件、金属薄膜应变计、半导体应变计、感应压力传感器、电容压力传感器、电位压力传感器及其组合的组。
8.根据权利要求5所述的手术系统，其中所述用户接口装置选自包括发光二极管、声频装置、显示器及其组合的组。
9.一种用于测量组织的方法，包括：
将测试末端执行器联接到手柄组件，所述测试末端执行器包括配置为测量至少一个组织特性的至少一个传感器；
致动所述测试末端执行器以测量所述至少一个组织特性；
通过控制器，基于所述至少一个组织特性选择一组多个适合的治疗末端执行器；以及
在所述手柄组件的用户接口上指示所述一组多个适合的治疗末端执行器。
10.根据权利要求9所述的方法，其中在所述用户接口上指示包括输出对应所述一组多个适合的治疗末端执行器的标记，其中所述标记选自包括颜色、标识号、音调、及其组合的组。
11.根据权利要求9所述的方法，进一步包括：
将至少一个适合的治疗末端执行器联接到所述手柄组件；以及
通过所述至少一个适合的治疗末端执行器夹紧组织。
12.根据权利要求9所述的方法，其中致动所述测试末端执行器包括测量施加到所述组织上的压力。
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