CN105105814A - 自定心夹子和钳夹 - Google Patents
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Abstract
本发明公开了一种自定心夹子和钳夹。一种对组织施加手术夹子的装置，所述装置包括具有扳机的手柄组件和从手柄组件延伸出的轴。所述轴中包含至少一个手术夹子。每个夹子包括通过横杆连接的一对夹腿。一对夹腿中的每个具有朝内的表面和朝外的表面，所述朝外的表面具有从其突出并沿其纵向延伸的凸起轮廓。钳夹组件布置在所述轴的远侧端处，并且包括能够在分隔位置与接近位置之间运动的第一和第二相对的钳夹。每个钳夹限定沿其相对的内表面纵向延伸的凹口。每个凹口限定纵向延伸的凹槽，所述凹槽具有与夹子的所述夹腿的凸起轮廓大致互补的轮廓。每个夹子的夹腿能够至少部分定位于所述钳夹的凹口的相应凹槽内。
Description
本申请是申请日为2011年9月8日，申请号为201110276088.6，发明名称为“自定心夹子和钳夹”的发明专利申请的分案申请。
相关专利申请的引用
本申请要求于2010年11月2日提交的序列号为61/409,131、名称为“自定心夹子和钳夹”的美国临时专利申请的优先权和权益，所述申请的全部内容通过引用合并于此。
技术领域
本公开涉及手术器械。本公开尤其涉及内窥镜手术施夹器以及对应的手术夹子。
背景技术
内窥镜吻合器和施夹器在本技术领域中是已知的，它们用于多种不同的有用的手术操作。在腹腔镜手术操作中，通过插通皮肤中的小进入切口的小直径管或插管，实现腹腔内部的进入。在身体中其他部位进行的微创手术操作通常称为内窥镜手术操作。通常，将管或插管装置经由进入切口伸入患者体内，以提供进出端口。外科医生可以使用套管针经由所述端口插入多种不同的手术器械，从而在远离切口的部位进行手术操作。
在大多数这些手术操作过程中，外科医生经常必须终止血液或其他流体通过一条或多条脉管的流动。在所述手术操作过程中，外科医生经常会将手术夹子施加到血管或其他导管上，以防止体液流过血管或其他导管。内窥镜施夹器用于在手术操作过程中施加单个或多个夹子，这在本领域中是公知的。这种夹子通常由生物相容性材料制成，它们经常被压布在脉管上。一旦施加到脉管上，这些压布的夹子就会终止流体流过所述脉管。
在格林(Green)等人的共同转让的美国专利第5,084,057号和第5,100,420号中描述了在单次进入体腔的过程中能够在内窥镜或腹腔镜手术操作中施加多个夹子的内窥镜施夹器，上述两项专利的全部内容通过引用合并于此。布拉德(Pratt)等人的共同转让的美国专利第5,607,436号中公开了另一种能够施加多个夹子的内窥镜施夹器，该专利的全部内容同样通过引用合并于此。这些装置通常但不必须地使用在单次手术操作中。在序列号为08/515,341的美国专利申请，现在由皮埃尔(Pier)等人所有的美国专利第5,695,502号中公开了一种可重复消毒的手术施夹器，该专利的全部内容通过引用合并于此。所述施夹器在单次插入体腔过程中推进并且成形多个夹子。所述可重复消毒的施夹器被配置为容纳并与可更换的夹子匣(clipmagazine)配合工作，以便在单次进入体腔过程中推进并且成形多个夹子。
在施夹器的制造中，一个重要的设计目标是在钳夹之间对准手术夹子，并且在身体组织或脉管上成形夹子的过程中保持夹子的夹腿对准。因此，提供的手术夹子和手术施夹器的理想情况是：在钳夹内以及在夹子成形到身体组织或脉管上的过程中，促使夹子的夹腿的正确对准。
发明内容
根据本公开，提供了一种对身体组织施加手术夹子的装置。所述装置包括具有手柄和能够相对于所述手柄运动的扳机的手柄组件。细长轴从所述手柄组件向远侧延伸并且包括一个或多个布置于其中的手术夹子。每个手术夹子包括通过横杆在一端处彼此连接的一对夹腿。一对夹腿中的每个具有朝内的表面和朝外的表面。每个夹腿的朝外的表面具有从其突出并沿其纵向延伸的凸起轮廓。钳夹组件布置在所述细长轴的远侧端处并且包括能够在分隔位置与接近位置之间运动的第一和第二相对的钳夹。每个钳夹限定沿其相对的内表面纵向延伸的凹口。每个凹口限定纵向延伸的凹槽，所述凹槽具有与一个或多个所述手术夹子的夹腿的凸起轮廓大致互补的轮廓。每个手术夹子的夹腿能够至少部分定位于所述钳夹的凹口的相应凹槽内。
在一个实施例中，每个手术夹子的夹腿的朝外的表面具有大体三角形的横截面轮廓。钳夹的每个凹口中限定的凹槽也可以具有大体三角形的横截面轮廓。
在另一个实施例中，每个手术夹子的每个夹腿具有人字形(chevron)横截面轮廓。每个手术夹子的横杆也可具有人字形横截面轮廓。
在另一个实施例中，每个钳夹的每个凹槽由朝向彼此成角度并且在二者之间限定角度的第一壁和第二壁限定。类似地，每个手术夹子的每个夹腿的朝外的表面可以由朝向彼此成角度并且在二者之间限定角度的第一壁和第二壁限定。此外，由每个手术夹子的每个夹腿的外表面的第一壁和第二壁限定的角度可小于由钳夹的凹槽的第一壁和第二壁限定的角度。
在另一个实施例中，在所述凹槽的相对侧处每个钳夹的凹口和凹槽之间的交界面处限定有台肩(shoulder)。
依据本公开的另一个实施例，提供了一种在构造为对身体组织施加手术夹子的手术施夹器中使用的钳夹组件。手术夹子中的每个包括一对相对的夹腿，每个夹腿具有向外突出的、纵向延伸的凸起轮廓。所述钳夹组件包括能够在分隔位置和接近位置之间运动的第一和第二相对的钳夹。钳夹中的每个限定沿其相对的内表面纵向延伸的凹口。凹口中的每个限定纵向延伸的凹槽，并且钳夹中的每个构造为用于将手术夹子的夹腿至少部分定位于所述钳夹的凹口内并且用于将手术夹子的每个夹腿的凸起部分容纳到相应钳夹的凹槽中。
在一个实施例中，钳夹组件包括限定在所述凹槽的相对侧处每个钳夹的凹口和凹槽之间的交界面处的台肩。此外，每个钳夹的凹口中限定的凹槽可以具有大体三角形横截面轮廓或人字形横截面轮廓。
依据本公开的另一个实施例，每个手术夹子包括通过横杆在一端处彼此连接的一对夹腿。每个夹腿包括朝内的表面和朝外的表面。每个夹腿的朝外的表面包括形成在其上的多个间隔布置的突出部，每个突出部限定从夹腿的朝外的表面上突出的凸起轮廓。该手术夹子可以与上述任何钳夹组件一起使用。
附图说明
下面将参照附图描述本公开器械的各个实施例，其中：
图1为手术施夹器的立体图；
图2为图1的手术施夹器的进一步的立体图，示出了手术施夹器的细长管状构件的旋转；
图3为图1和图2的手术施夹器的钳夹结构的放大立体图；
图4为在图1的手术施夹器中使用的钳夹组件的前视立体图；
图5为图4的钳夹组件的一个钳夹的远侧端视图；
图6为图5的钳夹的前视立体图，显示了手术夹子的一部分支撑在钳夹中；
图7为在图1的手术施夹器中使用的手术夹子的前视立体图；
图8为图7的手术夹子的一个夹腿的横向剖视图；
图8A为根据本公开的另一个实施例的手术夹子的一个夹腿的横向剖视图；
图8B为根据本公开的手术夹子的另一实施例的前视立体图；
图9为图7的手术夹子的俯视平面图；以及
图10为成形在脉管上的图7的手术夹子的立体图。
具体实施方式
下面将参照附图详细说明依据本公开的手术施夹器的实施例，其中，相似的附图标记表示相似或相同的结构部件。如附图所示和下面的说明书中描述的，在涉及手术器械的相对定位时，按照惯例，术语“近侧”是指装置的较靠近使用者的一端，而术语“远侧”是指装置的较远离使用者的一端。
参照图1-3，依据本公开的手术施夹器通常用100表示。手术施夹器100通常包括手柄组件102和内窥镜部，所述内窥镜部包括从手柄组件102向远侧延伸的轴组件104，并且在轴组件104的远侧端处布置有钳夹组件120。一叠手术夹子典型地以在轴组件104内滑动和/或沿着轴组件104滑动的方式装载和/或保持在轴组件104内。有关手术施夹器100的内部工作机制和操作的完整描述，请参阅惠特菲尔德(Whitfield)等人的共同转让的序列号为12/055,446的美国专利申请，该申请的全部内容通过引用合并于此。
继续参照图1-3，钳夹组件120安装在轴组件104的远侧端处，以使钳夹120a和120b相对于轴组件104纵向固定。旋钮110可转动地安装在手柄组件102的远侧端上并且结合到轴组件104上，从而为轴组件104及钳夹120a、120b传输和/或提供绕着纵轴线“x”的360°旋转。下文将进一步详细说明，钳夹组件120的钳夹120a和120b在其朝内的表面中分别限定凹口122a、122b，以及在相应凹口122a、122b内分别限定凹槽124a、124b。凹口122a和122b与凹槽124a和124b被构造为用于引导手术夹子(参见图6-10)通过其中。
现在参照图4-6，显示了钳夹120a、120b分别具有沿其纵向延伸的相应凹口122a、122b。更具体地，凹口122a和122b分别限定在钳夹120a和120b的朝内的表面121a和121b内。每个凹口122a和122b均限定宽度“w”(图5)，并且可具有大体矩形的横截面轮廓。可以理解的是，宽度“w”足够大以允许夹子“C”穿过其中(图6)。换言之，宽度“w”大于夹子“C”的直径“d”(图8)，以使夹子“C”可至少部分定位于钳夹120a和120b的相应凹口122a和122b内并能够滑动而通过钳夹120a和120b的相应凹口122a和122b。通过机械加工或任何其他适合的加工方法，可分别在钳夹120a、120b内形成凹口122a、122b。
继续参照图4-6，凹槽124a和124b分别限定在钳夹120a和120b的凹口122a和122b内。与凹口122a和122b相似，凹槽124a和124b分别沿钳夹120a和120b纵向延伸。钳夹120a的凹口122a的宽度“w”大于凹槽124a的最大直径，以使一对台肩125a限定在凹口122a和凹槽124a之间的交界面处。与钳夹120a相似，钳夹120b的凹口122b的宽度大于凹槽124b的最大直径，以使一对台肩限定在凹口122b和凹槽124b之间的交界面处。
凹槽124a和124b分别由第一壁126a、127a与第二壁126b、127b限定。每对壁126a、127a与126b、127b彼此成角度“α”相向延伸，最后分别会合于凹槽124a和124b的最低点128a和128b。从而，凹槽124a和124b限定大体三角形或V形的横截面轮廓，如图4-6中最佳所示。还可以设想的是第一壁和第二壁126a、126b与127a、127b为如弯曲或弓形的非线性形状(如图5-6所示)，以因此限定人字形横截面轮廓。此外，凹槽124a、124b和/或凹口122a、122b可以分别相对于钳夹120a和120b的高度居中，或者相对于凹口122a、122b的宽度“w”居中。而且，凹槽124a和124b可以分别相对于在钳夹120a和120b内限定的凹口122a和122b居中。
现在参照图7-9，每个夹子“C”都包括通过拱顶、夹冠(backspan)或横杆220c相互连接的一对夹腿220a和220b。每个夹腿220a和220b的朝内的表面222a和222b分别限定大致扁平的几何形状，以使得在围绕身体组织或脉管成形夹子“C”时，夹腿220a和220b的朝内的表面222a和222b一致且均匀地夹住身体组织或脉管。夹腿220a和220b的相应的朝外的表面224a和224b可以限定大致圆形的横截面轮廓，并且可以包括从相应的朝外的表面224a和224b突出并沿其纵向延伸的凸起轮廓226a和226b。类似地，横杆220c可以包括从其突出并且将夹腿220a的凸起轮廓226a和夹腿220b的凸起轮廓226b相互连接的凸起轮廓226c，以大致沿着夹子“C”的整个朝外的表面形成不间断的凸起轮廓。
如图8所示，更特别地，凸起轮廓226a由分别从夹腿220a的朝外的表面224a向外延伸的第一壁和第二壁227a和228a限定。相应地，第一壁和第二壁227a和228a以角度“β”朝向彼此成角度至最高点229a，以限定大体三角形、V形或人字形横截面轮廓。与夹腿220a相似，夹腿220b的凸起轮廓226b由从夹腿220b的朝外的表面向外延伸的第一壁和第二壁限定。第一壁和第二壁彼此也以角度“β”朝向彼此成角度至最高点。
角度“β”是凸起轮廓226a的壁227a和228a限定的角度，类似地也是凸起轮廓226b的第一壁和第二壁限定的角度，可以设想该角度大约等于或小于分别由钳夹120a和120b的凹槽124a和124b的第一壁和第二壁126a、126b与127a、127b之间限定的角度“α”，以使得凸起轮廓226a可至少部分定位于钳夹120a的凹槽124a内，并且使得凸起轮廓226b可至少部分定位于钳夹120b的凹槽124b内。
此外，设想夹腿220a的第一壁227a和第二壁228a与夹腿220b的第一壁和第二壁均为如弯曲或弓形的非线性形状。此外，夹腿220a、220b的第一壁和第二壁的非线性形状分别类似于钳夹120a和120b的凹槽124a和124b的非线性壁126a、127a与126b、127b的形状。相应地，如果角度“α”等于角度“β”，则凸起轮廓226a和226b的形状因此分别与凹槽124a和124b互补。然而，还可以设想的是，如果角度“α”和“β”不同，例如“α”大于“β”，则凸起轮廓226a和226b的形状分别与凹槽124a和124b的形状大致互补或准互补。
现在参照图8A，其中示出了可选夹子“C1”的外部轮廓。如图8A所示，夹子“C1”的夹腿220a′的朝外的表面224a′包括大体平坦的第一壁227a′和第二壁228a′，第一壁227a′和第二壁228a′以角度“β”朝向彼此成角度至最高点229a′，以限定大体三角形、V形或人字形的横截面轮廓226a′。
参照图8B，构造为与手术施夹器100(图1-3)一起使用的夹子“C2”的另一个实施例包括通过横杆220c″相互连接的一对夹腿220a″和220b″。夹子“C2”类似于夹子“C”(图7、图8和图9)，并且可以包括与上述夹子“C”相关的任何特征。但是，不同于夹子“C”(图7、图8和图9)，夹子“C2”包括从夹腿220a″的朝外的表面224a″突出的多个离散、分隔的凸起突出部226a″。夹子“C2”还可以包括类似地从夹腿220b″朝外的表面和/或从横杆220c″的朝外的表面延伸出的突出部(图中未示出)。可以采用模压或任何其他适合的制造方法形成突出部，如突出部226a″。
继续参照图8B，每个突出部226a″包括朝向彼此成角度的一对相对成角度的表面227a″、228a″，在一对表面之间限定角度“β”(参见图8)，并且最终相交以限定最高点229a″。换言之，成角度的表面227a″、228a″与最高点229a″共同限定大体三角形、V形或人字形的横截面轮廓。此外，虽然图中示出两个突出部226a″，但是可以设想提供多于或少于两个的突出部226a″，和/或突出部226a″相对于彼此间隔得更远或更加靠近到一起。夹子“C2”也可以配置为类似于上述的夹子“C”(图7、图8和图9)或夹子“C1”(图8A)。
现在将参照图1-10描述手术施夹器100围绕目标身体组织(如脉管)(参见图10)压平或成形手术夹子“C”的操作。
首先，定位施夹器100，以使要夹住的组织或脉管“V”被布置于钳夹120a和120b之间。挤压或致动扳机108，扳机108会使夹子“C”向远侧平移到钳夹120a和120b的相应凹口122a和122b中，从而使夹腿220a至少部分定位于钳夹构件120a的凹口122a内，并且使夹腿220b至少部分定位于钳夹构件120b的凹口122b内。因此，与钳夹120a和120b相似，现在也将夹子“C”的夹腿220a和220b定位于要被夹住的组织或脉管“V”的周围。
在此位置上，将分别从夹腿220a和220b突出的凸起轮廓226a和226b定位于钳夹120a和120b的相应凹槽124a和124b内。这种配置可确保夹子“C”的夹腿220a和220b相对于彼此正确对准，并且接下来确保相应的钳夹120a、120b内的夹子“C”的正确对准。换言之，凹口122a和122b与凹槽124a和124b共同用作夹子“C”的夹腿220a和220b在其中纵向平移的“轨道”，但充分抑制夹子“C”的夹腿220a和220b相对于彼此的旋转、垂直和/或横向的运动和/或倾斜，从而有助于确保钳夹120内的夹子“C”正确对准。
此时，夹子“C”的夹腿220a和220b分别定位于凹口122a、122b内，且凸起轮廓226a和226b分别定位于钳夹120a、120b的凹槽124a、124b内。如图7-9所示，夹子“C”最初限定未成形的配置，其中夹腿220a和220b相对于彼此分隔开。随着进一步挤压扳机108，钳夹120a和120b从打开位置朝向接近位置运动，从而使位于它们之间的手术夹子“C”开始成形。如图10所示，手术夹子“C”可以成形或压到脉管“V”或任何其他生物组织上。在夹子“C”成形期间，夹腿220a和220b的扁平的、朝内的表面222a和222b彼此相互接近，以因此实现脉管“V”的夹紧。可选择地，朝内的表面222a和222b可以包括一个或多个特征以促进围绕组织或脉管“V”的安全且有效的夹紧。
在夹子“C”成形过程中，夹子“C”的夹腿220a和220b的互补形状的凸起轮廓226a和226b保持在钳夹120a、120b的凹槽124a和124b内，更特别地，夹子“C”的夹腿220a和220b保持在钳夹120a、120b的凹口122a和122b内，从而充分抑制夹子“C”相对于钳夹组件120的旋转、垂直和/或横向的运动。相应地，在钳夹120a和120b运动到一起以使夹子“C”成形时，类似地使夹腿220a和220b在基本对准的共面方位接合到一起以夹住脉管“V”。换言之，钳夹120a、120b的凹口122和凹槽124及包括凸起轮廓226的夹子“C”的对应配置，能够在夹子“C”成形过程中减少意外事件和/或阻止夹腿220a和220b的剪切运动。提高夹腿220a和220b的正确对准事件有助于夹子“C”的正确成形。
如图10所示，一旦夹子“C”已经夹住脉管“V”，可以释放扳机108，以允许钳夹组件120返回到分隔位置。然后，可以重复手术施夹器100的上述操作，以便于随后夹子“C”夹紧组织。
依据本公开，在实施例中，通过在钳夹中设置与夹子的凸起轮廓226c相互作用和配合工作的凹槽124a、124b，凹口122a和122b的宽度“w”可相对于夹子的夹腿的最大宽度充分大，以适应相对于夹子的夹腿的宽度尺寸、相对于夹子的夹腿的线性度、相对于钳夹的凹口的宽度尺寸以及相对于钳夹的凹口的线性度的制造公差变化。
应该理解的是，之前的描述仅仅是本公开示意性的描述。在不脱离本公开的情况下，所属领域技术人员可设计多种替换和修改。因此，本公开旨在包含所有这些替换、修改和变化。参考随附的附图描述的实施例仅仅展示了本公开的特定示例。其他非实质性不同于以上描述的和/或随附的权利要求中的元件、步骤、方法和技术也被包括在本公开的范围内。
Claims (11)
1.一种用于对身体组织施加手术夹子的钳夹组件，所述手术夹子包括在一端处通过横杆相互连接的一对夹腿，所述一对夹腿具有朝内的表面和朝外的表面，所述朝外的表面具有从其突出并沿其纵向延伸的凸起轮廓，所述凸起轮廓由第一壁和第二壁限定，所述第一壁和第二壁朝向彼此成角度以在二者之间限定第一角度，所述钳夹组件包括：
能够在分隔位置和接近位置之间运动的第一和第二相对的钳夹，所述钳夹中的每个限定沿其相对的内表面纵向延伸的凹口，所述凹口中的每个限定纵向延伸的凹槽，所述凹槽具有由第一壁和第二壁限定的轮廓，所述第一壁和第二壁朝向彼此成角度以在二者之间限定第二角度，所述第一角度小于所述第二角度，
其中手术夹子的夹腿能够至少部分定位于所述钳夹的所述凹口的相应凹槽内。
2.根据权利要求1所述的钳夹组件，其中，所述手术夹子的夹腿的朝外的表面具有大体三角形的横截面轮廓。
3.根据权利要求1所述的钳夹组件，其中，所述钳夹的每个凹口中限定的所述凹槽具有大体三角形的横截面轮廓。
4.根据权利要求1所述的钳夹组件，其中，所述手术夹子的每个夹腿具有人字形横截面轮廓。
5.根据权利要求1所述的钳夹组件，其中，在所述凹槽的相对侧处每个钳夹的所述凹口和所述凹槽之间的交界面处限定有台肩。
6.根据权利要求1所述的钳夹组件，其中，所述手术夹子的横杆具有人字形形状的横截面轮廓。
7.一种用于对身体组织施加手术夹子的钳夹组件，所述手术夹子包括在一端处通过横杆相互连接的一对夹腿，所述一对夹腿具有朝内的表面和朝外的表面，所述朝外的表面包括形成在其上的多个分隔的突出部，每个突出部限定从夹腿的朝外的表面突出并且由第一壁和第二壁限定的凸起轮廓，所述第一壁和第二壁朝向彼此成角度以在二者之间限定第一角度，所述钳夹组件包括：
能够在分隔位置和接近位置之间运动的第一和第二相对的钳夹，所述钳夹中的每个限定沿其相对的内表面纵向延伸的凹口，所述凹口中的每个限定纵向延伸的凹槽，所述凹槽具有由第一壁和第二壁限定的轮廓，所述第一壁和第二壁朝向彼此成角度以在二者之间限定第二角度，所述第一角度小于所述第二角度，
其中手术夹子的夹腿能够至少部分定位于所述钳夹的所述凹口的相应凹槽内。
8.根据权利要求7所述的钳夹组件，其中，每个所述突出部具有大体三角形的横截面轮廓。
9.根据权利要求7所述的钳夹组件，其中，所述钳夹的每个凹口中限定的凹槽具有大体三角形的横截面轮廓。
10.根据权利要求7所述的钳夹组件，其中，每个突出部具有人字形横截面轮廓。
11.根据权利要求7所述的钳夹组件，其中，在所述凹槽的相对侧处每个钳夹的所述凹口和所述凹槽之间的交界面处限定有台肩。
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- 2011-08-12 CA CA2748839A patent/CA2748839A1/en not_active Abandoned
- 2011-08-15 AU AU2011211463A patent/AU2011211463B2/en not_active Expired - Fee Related
- 2011-08-26 JP JP2011184521A patent/JP2012096008A/ja not_active Ceased
- 2011-09-08 CN CN201110276088.6A patent/CN102462525B/zh not_active Expired - Fee Related
- 2011-09-08 CN CN201510419902.3A patent/CN105105814B/zh not_active Expired - Fee Related
- 2011-09-09 EP EP16185465.8A patent/EP3130295B1/en not_active Not-in-force
- 2011-09-09 ES ES11250754.6T patent/ES2605987T3/es active Active
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2015
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Also Published As
| Publication number | Publication date |
|---|---|
| EP2446838B1 (en) | 2016-11-02 |
| US9011464B2 (en) | 2015-04-21 |
| US9642627B2 (en) | 2017-05-09 |
| ES2605987T3 (es) | 2017-03-17 |
| US20120109158A1 (en) | 2012-05-03 |
| EP2446838A2 (en) | 2012-05-02 |
| JP2012096008A (ja) | 2012-05-24 |
| CA2748839A1 (en) | 2012-05-02 |
| CN102462525B (zh) | 2015-08-12 |
| EP3130295A1 (en) | 2017-02-15 |
| CN105105814B (zh) | 2018-08-28 |
| EP2446838A3 (en) | 2012-11-28 |
| AU2011211463A1 (en) | 2012-05-17 |
| EP3130295B1 (en) | 2019-02-20 |
| CN102462525A (zh) | 2012-05-23 |
| AU2011211463B2 (en) | 2015-06-04 |
| US20150190139A1 (en) | 2015-07-09 |
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