CN105212981A - 手持式手术手柄组件、在手术手柄组件和手术末端执行器间使用的手术接合器及其使用方法 - Google Patents

手持式手术手柄组件、在手术手柄组件和手术末端执行器间使用的手术接合器及其使用方法 Download PDF

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CN105212981A
CN105212981A CN201510364981.2A CN201510364981A CN105212981A CN 105212981 A CN105212981 A CN 105212981A CN 201510364981 A CN201510364981 A CN 201510364981A CN 105212981 A CN105212981 A CN 105212981A
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厄尔·M·策吉贝尔
戴维·乔瓦尼克
瑞安·威廉斯
戴维·福勒
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Abstract

本发明公开了一种手持式手术手柄组件、在手术手柄组件和手术末端执行器间使用的手术接合器及其使用方法。本发明提供了用于将被配置执行至少一对功能的手术末端执行器和被配置为致动所述末端执行器的手术装置选择性地相互连接的接合器组件，其中，所述末端执行器包括第一可轴向平移的驱动构件和第二可轴向平移的驱动构件，并且其中，所述手术装置包括第一可旋转驱动轴和第二可旋转驱动轴。

Description

手持式手术手柄组件、在手术手柄组件和手术末端执行器间使用的手术接合器及其使用方法
相关申请的交叉引用
本申请要求于2014年6月26日提交的、序列号为62/017,599的美国临时专利申请的权益和优先权，其全部内容通过引用结合于此。
技术领域
本公开涉及手术装置和/或系统、手术接合器以及它们的使用方法。更具体地，本公开涉及手持式动力手术装置、手术接合器和/或接合器组件，所述手术接合器和/或接合器组件在动力的、旋转和/或关节式运动的手术装置或手柄组件与用于夹紧、切割和/或吻合组织的末端执行器之间使用并且用于将它们相互连接。
背景技术
有一种类型的手术装置是一种直线型夹紧、切割和吻合装置。在外科手术中，可以使用这样的装置来切除胃肠道中癌变的或异常的组织。传统的直线型夹紧、切割和吻合器械包括具有细长轴和远侧部的手枪握柄样式的结构。远侧部包括一对剪刀样式的夹持元件，夹紧闭合结肠的开口端部。在本装置中，两个剪刀样式的夹持元件中的一个元件(如砧座部)相对于整个结构移动或枢转，而另一个夹持元件相对于整个结构保持固定。该剪切装置的致动(砧座部的枢转)是由保持在手柄中的握柄扳机来控制。
除了剪切装置以外，远侧部还包括吻合机构。剪切机构的固定夹持元件包括吻合钉钉仓接纳区域和用来驱动吻合钉紧靠砧座部向上穿过组织的被夹紧端部从而密封先前开口端部的机构。剪切元件可以与所述轴一体形成或者是可以拆卸的使得各种剪切元件和吻合元件可以互换。
许多手术装置的生产商已经开发出具有适用于操作和/或操纵所述手术装置的专用驱动系统的产品线。在许多实例中，所述手术装置包括：可重复使用的手柄组件；以及一次性末端执行器或类似物，在使用前，其可以选择性地被连接到所述手柄组件上，然后，在使用后，再从所述末端执行器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。
与许多现有的手术装置和/或手柄组件一起使用的许多现有的末端执行器都是由线性力来驱动。例如，适合于执行腔内胃肠吻合术操作、端对端吻合术操作以及横向吻合术操作的末端执行器通常均需要线性驱动力以便于被操作。因此，这些末端执行器与利用旋转运动来传递动力等的手术装置和/或手柄组件无法配合使用。
另外，在末端执行器的吻合机构发射期间传递至手术装置和/或手柄组件的作用力会导致不期望的过度关节式运动。
为了使所述线性驱动的末端执行器与利用旋转运动来传递动力的手术装置和/或手柄组件互相配合使用并且在吻合钉发射期间减少不期望的关节式运动的量，对于在所述线性驱动的末端执行器和旋转驱动的手术装置和/或手柄组件之间进行交接并且将其足够刚性地相互连接以在发射期间将过度关节式运动最小化的接合器和/或接合器组件存在需求。
发明内容
本公开涉及手持式动力手术装置、手术接合器和/或接合器组件，所述手术接合器和/或接合器组件在动力的、旋转的和/或关节式运动的手术装置或手柄组件与用来夹紧、切割和/或吻合组织的末端执行器之间使用并用于将它们相互连接。
根据本公开的一个方案，提供了一种用来将手术末端执行器选择器地相互连接的接合器。所述接合器被配置为执行功能并且包括被配置为致动末端执行器的手柄组件。所述末端执行器包括至少一个可轴向平移的驱动构件，并且所述手柄组件包括至少一个可旋转驱动轴。接合器壳体被配置为并且适于与所述手柄组件相连接并且能够与所述手柄组件的每个可旋转驱动轴进行可操作连通。所述接合器壳体进一步包括限定空腔的内壁表面，其中凸缘在所述接合器壳体的远侧端上从所述内壁表面向内径向地突出。所述接合器壳体还包括外管，其从较大直径朝远侧渐缩成较小直径。所述外管由所述接合器壳体的凸缘可旋转地且可平移地支撑，并且所述外管的远侧端构造成并且适于连接所述末端执行器以及同所述末端执行器的每个可轴向平移的驱动构件进行可操作连通。
所述接合器进一步包括内壳，其具有外表面和限定空腔的内壁表面，其中环形沟槽被限定在所述内壁表面的近侧端中。所述内壳的外表面的直径小于所述接合器壳体的内壁表面的直径，使得所述内壳被可旋转地支撑在所述接合器壳体中。所述接合器壳体进一步包括至少一个驱动转换器组件，其用于将所述手柄组件的相应一个可旋转驱动轴与所述末端执行器的一个可轴向平移的驱动构件相互连接。所述至少一个驱动转换器组件包括能够连接到所述手柄组件的可旋转驱动轴的第一端和能够连接到所述末端执行器的可轴向平移的驱动构件的第二端，使得其中所述至少一个驱动转换器组件将所述手柄组件的可旋转驱动轴的旋转转换并传递成所述末端执行器的可轴向平移的驱动构件的轴向平移。另外，所述至少一个驱动转换器组件被构造成被可旋转地且可平移地支撑在所述内壳的环形沟槽中。
所述接合器的内壳可以与所述外管机械配合。
所述接合器可以包括多个臂，所述多个臂沿着所述纵向轴线从所述内壳朝远侧延伸并且与所述外管机械配合。
所述接合器的多个臂可以包括一对平行臂。
所述接合器的至少一个驱动转换器组件的驱动转换器组件还可以包括第一驱动转换器组件，所述第一驱动转换器组件包括第一远侧驱动轴，其可旋转地支撑在所述接合器壳体中，其中所述第一远侧驱动轴的近侧端能够连接至所述手柄组件的可旋转驱动轴。所述第一驱动转换器组件进一步包括驱动联接螺母，其螺纹连接到所述第一远侧驱动轴的螺纹远侧部，其中所述驱动联接螺母抗旋转地被锁定在所述接合器壳体内。所述第一驱动转换器组件还包括驱动管，其具有近侧端和远侧端，所述近侧端被连接到所述驱动联接螺母，所述远侧端被配置用来选择性地与所述末端执行器的所述至少一个可轴向平移的驱动构件相接合。所述手柄组件的可旋转驱动轴的旋转引起所述远侧驱动轴的旋转，并且所述远侧驱动轴的旋转引起所述驱动联接螺母、所述驱动管和所述末端执行器的至少一个可轴向平移的驱动构件的轴向平移。
所述接合器的第一驱动转换器组件可以包括：正齿轮，其被键联接到所述远侧驱动轴的近侧端；近侧可旋转驱动轴，其具有被支撑在其远侧端上的正齿轮和能够连接到所述手柄组件的可旋转驱动轴的近侧端；以及复合齿轮，其将被键联接到所述远侧驱动轴的近侧端上的所述正齿轮与被支撑在所述近侧可旋转驱动轴的远侧端上的所述正齿轮相互接合。
在使用时，所述末端执行器的至少一个可轴向平移的驱动构件的平移引起所述末端执行器的闭合和所述末端执行器的击发。
所述接合器的所述至少一个驱动转换器组件还可以包括第二驱动转换器组件，所述第二驱动转换器组件包括：第二近侧驱动轴，其可旋转地支撑在所述接合器壳体中，其中所述第二近侧驱动轴的近侧端能够连接到所述手柄组件的第二可旋转驱动轴；联接封套，其可旋转地并且可平移地支撑在所述接合器壳体中，所述联接封套限定了内环形槽道；联接滑块，其可旋转地布置在所述联接封套的所述环形槽道内，所述联接滑块螺纹连接到所述第二近侧驱动轴的螺纹远侧部；以及驱动杆，其具有近侧端和远侧端，所述近侧端被连接到所述联接封套，所述远侧端被配置用来选择性地与所述末端执行器的另一个可轴向平移的驱动构件相接合。所述手柄组件的所述第二可旋转驱动轴的旋转引起所述第二近侧驱动轴的旋转，并且所述第二近侧驱动轴的旋转引起所述联接滑块、所述联接封套、所述驱动杆和所述末端执行器的另一个可轴向平移的驱动构件的轴向平移。
所述第一远侧驱动轴可以延伸穿过所述联接封套，使得所述联接封套能够绕所述第一远侧驱动轴旋转。
在使用时，所述末端执行器的另一个可轴向平移的驱动构件的平移引起所述末端执行器相对于所述接合器的关节式运动。
所述接合器可以进一步包括驱动传递组件，所述驱动传递组件包括：第三近侧可旋转驱动轴，其可旋转地支撑在所述接合器壳体中并且具有支撑在其远侧端的正齿轮以及能够连接到所述手柄组件的第三可旋转驱动轴的近侧端；环形齿轮，其可旋转地支撑在所述接合器壳体中，所述环形齿轮限定了与所述第三近侧可旋转驱动轴的正齿轮相接合的内部齿轮齿阵列，其中所述环形齿轮被键联接到所述内壳；以及至少一个旋转传递杆，其具有连接到所述内壳上的近侧端和连接到远侧联接组件上的远侧端，其中所述远侧联接组件被配置为选择性地与所述末端执行器连接。所述手柄组件的所述第三可旋转驱动轴的旋转引起所述第三近侧驱动轴的旋转，并且所述第三近侧驱动轴的旋转引起所述环形齿轮、所述内壳、所述至少一个旋转传递杆和所述远侧联接组件的旋转，从而相对于所述接合器并且绕着由所述接合器限定的纵向轴线来旋转所述末端执行器。
所述接合器的外管可以被配置为将内窥镜插入目标手术部位。所述接合器壳体可以被抑制插入所述目标手术部位。
所述第一驱动转换器组件、所述第二驱动转换器组件或所述驱动传递组件中的至少一个被布置在所述接合器壳体中。
在实施例中，所述末端执行器和所述接合器的外管限定了为内窥镜插入目标手术部位而配置的内窥镜部。
在实施例中，所述末端执行器和所述外管限定了为内窥镜插入目标手术部位而配置的内窥镜部。所述第一驱动转换器组件和所述第二驱动转换器组件中的每一个组件或驱动传递组件均可被布置在所述内窥镜的外部。
根据本公开的又一个方案，提供接合器组件以选择性地将被配置用来执行功能的手术末端执行器与被配置用来致动所述末端执行器的手柄组件相互连接。所述末端执行器包括至少一个可轴向平移的驱动构件，且所述手柄组件包括至少一个可旋转驱动轴。所述接合器组件包括：接合器壳体，其被配置为并且适于与所述手柄组件相连接并且能够与所述手柄组件的每个可旋转驱动轴进行可操作连通，所述接合器壳体具有限定空腔的内壁表面；以及外管，其具有近侧端和远侧端，其中所述近侧端由所述接合器壳体支撑，其中所述远侧联接组件被配置为并且适于连接所述末端执行器以及与所述末端执行器的每个可轴向平移的驱动构件进行可操作连通。
所述接合器进一步包括内壳，其具有限定纵向轴线的近侧端和远侧端，所述内壳具有外表面和限定空腔的内壁表面，其中所述内壳的外表面的直径小于所述接合器壳体的内壁表面的直径，其中所述内壳被可旋转地支撑在所述接合器壳体中；以及至少一个驱动转换器组件，其用于将所述手柄组件的相应一个可旋转驱动轴与所述末端执行器的一个可轴向平移的驱动构件相互连接。
所述至少一个驱动转换器组件包括：第一端部，其能够连接到所述手柄组件的可旋转驱动轴；以及第二端部，其能够连接到所述末端执行器的可轴向平移的驱动构件，其中，所述至少一个驱动转换器组件将所述手柄组件的可旋转驱动轴的旋转转换并传递成所述末端执行器的可轴向平移的驱动构件的轴向平移，其中至少一个驱动转换器组件配置成由所述内壳可旋转地支撑；中间壳体，其具有限定纵向轴线的近侧端和远侧端，所述中间壳体由接合器壳体固定地支撑，其中所述中间壳体具有外表面，所述外表面具有周向沟槽，其中所述外表面的直径小于所述接合器壳体的内表面的直径；以及至少一个联接杆，其具有近侧端和远侧端，其中，所述至少一个联接杆的近侧端由所述中间壳体中的沟槽和连接至所述远侧联接组件的远侧端可旋转地且可平移地支撑，其中所述至少一个联接杆的近侧端还与所述内壳机械配合。
所述接合器的至少一个联接杆可以包括两个平行的联接杆。
所述至少一个联接杆可以包括位于其近侧端上的凸台以由所述中间壳体中的沟槽接合。
所述接合器的至少一个驱动转换器组件可以包括：第一驱动转换器组件，其包括可旋转地支撑在所述接合器壳体中的第一远侧驱动轴，其中所述第一远侧驱动轴的近侧端能够连接至所述手柄组件的可旋转驱动轴；驱动联接螺母，其螺纹连接到所述第一远侧驱动轴的螺纹远侧部，其中所述驱动联接螺母抗旋转地被锁定在所述接合器壳体内；以及驱动管，其具有近侧端和远侧端，所述近侧端被连接到所述驱动联接螺母，所述远侧端被配置用来选择性地与所述末端执行器的所述至少一个可轴向平移的驱动构件相接合。所述手柄组件的可旋转驱动轴的旋转引起所述远侧驱动轴的旋转，并且所述远侧驱动轴的旋转引起所述驱动联接螺母、所述驱动管和所述末端执行器的至少一个可轴向平移的驱动构件的轴向平移。
所述接合器的第一驱动转换器组件可以包括：正齿轮，其被键联接到所述远侧驱动轴的近侧端；近侧可旋转驱动轴，其具有被支撑在其远侧端上的正齿轮和能够连接到所述手柄组件的可旋转驱动轴的近侧端；以及复合齿轮，其将被键联接到所述远侧驱动轴的近侧端上的所述正齿轮与被支撑在所述近侧可旋转驱动轴的远侧端上的所述正齿轮相互接合。
在使用时，所述末端执行器的至少一个可轴向平移的驱动构件的平移引起所述末端执行器的闭合和所述末端执行器的击发。
所述接合器的至少一个驱动转换器组件可以包括第二驱动转换器组件，其包括：可旋转地支撑在所述接合器壳体中的第二近侧驱动轴，其中所述第二近侧驱动轴的近侧端能够连接至所述手柄组件的第二可旋转驱动轴；联接封套，其可旋转地并且可平移地支撑在所述接合器壳体中，所述联接封套限定了内环形槽道；联接滑块，其可旋转地布置在所述联接封套的环形槽道内，所述联接滑块螺纹连接到所述第二近侧驱动轴的螺纹远侧部；以及驱动杆，其具有近侧端和远侧端，所述近侧端被连接到所述联接封套，所述远侧端被配置用来选择性地与所述末端执行器的另一个可轴向平移的驱动构件相接合。所述手柄组件的所述第二可旋转驱动轴的旋转引起所述第二近侧驱动轴的旋转，并且所述第二近侧驱动轴的旋转引起所述联接滑块、所述联接封套、所述驱动杆和所述末端执行器的另一个可轴向平移的驱动构件的轴向平移。
所述接合器可以进一步包括连接器套筒，其将装置的第二可旋转驱动轴与所述接合器的第二近侧驱动轴相互连接。
在使用时，所述末端执行器的另一可轴向平移的驱动构件的平移引起所述末端执行器相对于所述接合器的关节式运动。
所述接合器可以进一步包括驱动传递组件，所述驱动传递组件包括：第三近侧可旋转驱动轴，其可旋转地支撑在所述接合器壳体中并且具有支撑在其远侧端的正齿轮以及能够连接到所述手柄组件的第三可旋转驱动轴的近侧端；环形齿轮，其可旋转地支撑在所述接合器壳体中，所述环形齿轮限定了与所述第三近侧可旋转驱动轴的正齿轮相接合的内部齿轮齿阵列，其中所述环形齿轮被键联接到所述内壳；以及至少一个联接杆，其具有连接至所述内壳的近侧端、位于所述近侧端以便与所述中间壳体中的沟槽机械配合的凸台以及连接至远侧联接组件的远侧端，其中所述远侧联接组件配置成与所述末端执行器选择性连接。所述手柄组件的所述第三可旋转驱动轴的旋转引起所述第三近侧驱动轴的旋转，并且所述第三近侧驱动轴的旋转引起所述环形齿轮、所述内壳、所述至少一个联接杆和所述远侧联接组件的旋转，从而相对于所述接合器并且绕着由所述接合器限定的纵向轴线来旋转所述末端执行器。
所述外管可以被配置为将内窥镜插入目标手术部位。所述接合器壳体可以被抑制插入所述目标手术部位。
所述第一驱动转换器组件、所述第二驱动转换器组件和所述驱动传递组件中的至少一个可以被布置在所述接合器壳体中。
在实施例中，所述末端执行器和所述接合器的外管限定了为内窥镜插入目标手术部位而配置的内窥镜部。
附图说明
这里参照附图描述了本公开的各种实施例，其中：
图1是根据本公开实施例的部件分离的手术装置和接合器的立体图，图示了其与末端执行器的连接；
图2是图1中的手术装置的立体图；
图3是部件分离的图1和图2中的手术装置的立体图；
图4是用于图1至图3的所述手术装置中的蓄电池的立体图；
图5是去除壳体的图1至图3中所述手术装置的立体图；
图6是所述手术装置和所述接合器中每一个的连接端部的立体图，图示了其间的连接；
图7是通过图2的7-7取得的图1至图3中所述手术装置的剖视图；
图8是通过图2的8-8取得的图1至图3中所述手术装置的剖视图；
图9是部件分离的图1至图3中所述手术装置的扳机壳体的立体图；
图10是图1中所述接合器的立体图；
图11是图1和图10中所述接合器的部件分离的立体图；
图11A是内壳半部的替代实施例的立体图；
图11B是手柄壳体半部的替代实施例的平面图；
图12是图1和图10中的接合器的驱动联接组件的部件分离的立体图；
图13是图1和图10中所述接合器的远侧部的部件分离的立体图；
图13A是旋转传递杆的替代实施例的立体图；
图13B是中间壳体的替代实施例的立体图；
图14是通过图10的14-14取得的图1和图10中所述接合器的剖视图；
图15是通过图10的15-15取得的图1和图10中所述接合器的剖视图；
图16是图14中所述细部指示区域的放大图；
图16A是图14中所述细部指示区域的替代实施例放大图，其包括图13A的旋转传递杆的替代实施例和图13B的中间壳体的替代实施例；
图17是图15中所述细部指示区域的放大图；
图17A是图15中所述细部指示区域的替代实施例放大图，其包括图11A的内壳的替代实施例和图11B的手柄壳体半部的替代实施例；
图18是图14中所述细部指示区域的放大图；
图19是图15中所述细部指示区域的放大图；
图20是图1和图10中所述接合器的联接封套的部件分离的立体图；
图21是与本公开的手术装置和接合器一起使用的示例性的末端执行器的部件分离的立体图；以及
图22是LED输出的示意图；电动机选择示意图(选择夹紧/切割，旋转或关节式运动)；以及执行所选定功能的所述驱动电动机选择示意图。
具体实施方式
现在将参照附图详细描述本公开的手术装置，以及适用于手术装置和/或手柄组件的接合器组件的实施例，其中在几幅附图的每幅附图中相同附图标记指代相同的或对应的元件。在本文中使用时，术语“远侧”是指较远离用户的所述接合器或手术装置的部分或其部件，而术语“近侧”是指较接近用户的所述接合器或手术装置的部分或其部件。
根据本公开的实施例，手术装置总体被指定为100，且被配置为一种动力手持式机电器械的形式，用来选择性地将多个不同的末端执行器附接于此，配置每一个末端执行器是为了使用所述动力手持式机电手术器械来实现致动和操纵。
如图1所图示，手术装置100被配置为用来选择性地连接接合器200，然后，依次地，接合器200被配置为选择性地连接末端执行器或单次使用装载单元300。
如图1至图3所图示，手术装置100包括手柄壳体102，手柄壳体102包括下壳体部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被分成远侧半体110a和近侧半体110b，其中，远侧半体110a是从下壳体部104延伸出且与其整体形成，近侧半体110b能够通过采用多个紧固件而与远侧半体110a相连接。当接合时，远侧半体110a与近侧半体110b限定了手柄壳体102，手柄壳体102内有空腔102a，电路板150和驱动机构160被设置在空腔102a中。
远侧半体110a与近侧半体110b沿着横切如图1所示的上壳体部108的纵向轴线“X”的平面被划分开。
手柄壳体102包括垫圈112，垫圈112完全地围绕远侧半体110a和/或近侧半体110b的边缘延伸且介于在远侧半体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的功能是在远侧半体110a和近侧半体110b之间形成气密密封以便于在消毒和/或清洗操作时保护电路板150和驱动机构160。
以这种方式，手柄壳体102的空腔102a沿着远侧半体110a和近侧半体110b的周边密封并且还被配置为使得能够更轻松、更高效地将电路板150和驱动机构160装配在手柄壳体102中。
手柄壳体102的中间壳体部106提供了电路板150被设置在其中的壳体。将在下面额外详细阐明，电路板150配置为控制手术装置100的各种操作。
手术装置100的下壳体部104限定了在其上表面形成的孔隙(未显示)并且孔隙位于中间壳体部106的下方或内部。下壳体部104的孔隙提供了一通道，导线152穿过通道以将位于下壳体部104中的电气部件(如图4中所图示的蓄电池156，如图3中所图示的电路板154等)与位于中间壳体部106和/或上壳体部108中的电气部件(电路板150，驱动机构160等)互相电气连接。
手柄壳体102包括被布置在下壳体部104(未显示)的孔隙内的垫圈103，因而在允许导线152穿过下壳体部104的孔隙的同时还堵塞或密封下壳体部104的孔隙。垫圈103的功能是在下壳体部106和中间壳体部108之间形成气密密封以便于在消毒和/或清洗操作时保护电路板150和驱动机构160。
正如图所示，手柄壳体102的下壳体部104提供了壳体，可再充电蓄电池156可拆卸地位于壳体中。蓄电池156被配置为给手术装置100的电气部件中的任何一个部件提供电力。下壳体部104限定了蓄电池156被插入其中的空腔(未显示)。下壳体部104包括枢转地连接于其上的门105，用来封闭下壳体部104的空腔并将蓄电池156保持在空腔中。
参照图3和图5，上壳体部108的远侧半体110a限定了鼻部或连接部108a。鼻锥114被支撑在上壳体部108的鼻部108a上。鼻锥114是由透明材料制造的。照明构件116被布置在鼻锥114内，使得透过鼻锥114可见照明构件116。照明构件116采用发光二极管印刷电路板(LEDPCB)的形式。照明构件116被配置为照射多个颜色，特定彩色图案与独特的离散事件相关联。
手柄壳体102的上壳体部108提供了驱动机构160被安置于其中的壳体。如图5所示，驱动机构160配置为驱动轴和/或齿轮部件以便于执行手术装置100的各种操作。特别地，驱动机构160配置为驱动轴和/或齿轮部件，以便于相对于末端执行器300的近侧主体部302选择性地移动末端执行器300的工具组件304(参照图1和图20)，使得末端执行器300相对于手柄壳体102绕纵向轴线“X”(参照图3)旋转，使得砧座组件306相对于末端执行器300的钉仓组件308移动，和/或击发在末端执行器300的钉仓组件308内的吻合与切割钉仓。
驱动机构160包括相对接合器200在紧邻近侧的选择式齿轮箱组件(selectorgearboxassembly)162。在选择式齿轮箱组件162近侧的是具有第一电动机164的功能选择模块163，第一电动机164的功能为选择性地移动选择式齿轮箱组件162内的齿轮元件来与具有第二电动机166的输入驱动部件165相接合。
如图1至图4所示，且如上所述，上壳体部108的远侧半体110a限定了连接部108a，连接部108a配置为接受接合器200的对应的驱动联接组件210。
如图6至图8所示，当接合器200与手术装置100匹配时，手术装置100的连接部108a具有用来接纳接合器200的驱动联接组件210的筒状的凹槽108b。连接部108a容纳三个可旋转的驱动连接器118、120、122。
当接合器200与手术装置100匹配时，手术装置100的可旋转的驱动连接器118、120、122中的每一个驱动连接器与接合器200对应的可旋转的连接器套筒218、220、222相联接。(参照图6)。在这点上，对应的第一驱动连接器118和第一连接器套筒218之间的交接，对应的第二驱动连接器120和第二连接器套筒220之间的交接，以及对应的第三驱动连接器122和第三连接器套筒222之间的交接都是键联接，以便于手术装置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的对应的连接器套筒218、220、222的对应的旋转。
手术装置100的驱动连接器118、120、122与接合器200的连接器套筒218、220、222的匹配允许经由三个对应的连接器交接中的每一个独立地传递旋转力。手术装置100的驱动连接器118、120、122被配置为通过驱动机构160来独立旋转。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来驱动手术装置100的驱动连接器118、120、122中的哪一个或哪几个。
因为手术装置100的驱动连接器118、120、122中的每一个驱动连接器都是与接合器200的相应的连接器套筒218、220、222进行键联接和/或基本上非旋转的交接，当接合器200被联接到手术装置100时，会选择性地将旋转力从手术装置100的驱动机构160传递给接合器200。
手术装置100的驱动连接器118、120和/或122的选择性的旋转允许手术装置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，手术装置100的第一驱动连接器118的选择性的且独立的旋转对应于末端执行器300的工具组件304的选择性的且独立的打开和闭合操作，以及对应于末端执行器300的工具组件304的吻合/切割部件的驱动。同样，手术装置100的第二驱动连接器120的选择性的且独立的旋转对应于末端执行器300的工具组件304的横向于纵向轴线“X”(参照图3)的选择性的且独立的关节式运动。另外，手术装置100的第三驱动连接器122的选择性的且独立的旋转对应于末端执行器300相对于手术装置100的手柄壳体102绕纵向轴线“X”(参照图3)的选择性的且独立的旋转。
如上所述且如图5和图8所图示，驱动机构160包括：选择式齿轮箱组件162；在选择式齿轮箱组件162近侧定位的功能选择模块163，功能选择模块163的功能为选择性地移动选择式齿轮箱组件162内的齿轮元件来与第二电动机166相接合。这样，驱动机构160就在给定时间选择性地驱动手术装置100的驱动连接器118、120、122中的一个驱动连接器。
如图1至图3和图9所示，手柄壳体102在中间壳体部108的远侧表面或侧面上支撑扳机壳体107。与中间壳体部108配合的扳机壳体107支撑一对手指致动的控制按钮124、126和摇杆装置128、130。特别地，扳机壳体107限定了上孔隙124a以用于可滑动地接纳第一控制按钮124，以及下孔隙126b以用于可滑动地接纳第二控制按钮126。
控制按钮124、126和摇杆装置128、130中的每一个均包括由操作者的致动来移动的相应的磁体(未显示)。此外，对于控制按钮124、126和摇杆装置128、130中的每一个，电路板150都包括靠控制按钮124、126和摇杆装置128、130中磁体的移动来致动的相应的霍尔效应开关150a-150d。特别地，位置在控制按钮124紧邻近侧的是第一霍尔效应开关150a(参照图3和图7)，当操作者致动控制按钮124时，控制按钮124中的磁体就会移动，就会致动第一霍尔效应开关150a。对应于控制按钮124的第一霍尔效应开关150a的致动会引起电路板150给驱动机构160的功能选择模块163和输入驱动部件165提供适当的信号来闭合末端执行器300的工具组件304和/或击发末端执行器300的工具组件304内的吻合/切割钉仓。
同样，位置在摇杆装置128紧邻近侧的是第二霍尔效应开关150b(参照图3和图7)，当操作者致动摇杆装置128时，摇杆装置128中的磁体(未显示)就会移动，就会致动第二霍尔效应开关150b。对应于摇杆装置128的第二霍尔效应开关150b的致动会引起电路板150给驱动机构160的功能选择模块163和输入驱动部件165提供适当的信号来使得工具组件304相对于末端执行器300的主体部302进行关节式运动。有利的是，摇杆装置128在第一方向上的移动会引起工具组件304相对于主体部302在第一方向上进行关节式运动，而摇杆装置128在相反方向(如第二方向)上的移动会引起工具组件304相对于主体部302在相反方向(如第二方向)上进行关节式运动。
此外，位置在控制按钮126紧邻近侧的是第三霍尔效应开关150c(参照图3和图7)，当操作者致动控制按钮126时，控制按钮126中的磁体(未显示)就会移动，就会致动第三霍尔效应开关150c。对应于控制按钮126的第三霍尔效应开关150c的致动会引起电路板150给驱动机构160的功能选择模块163和输入驱动部件165提供适当的信号来打开末端执行器300的工具组件304。
此外，位置在摇杆装置130紧邻近侧的是第四霍尔效应开关150d(参照图3和图7)，当操作者致动摇杆装置130时，摇杆装置130中的磁体(未显示)就会移动，就会致动第四霍尔效应开关150d。对应于摇杆装置130的第四霍尔效应开关150d的致动会引起电路板150给驱动机构160的功能选择模块163和输入驱动部件165提供适当的信号来使得末端执行器300相对于手术装置100的手柄壳体102旋转。特别地，摇杆装置130在第一方向上的移动会引起末端执行器300相对于手柄壳体102在第一方向上旋转，而摇杆装置130在相反方向(如第二方向)上移动会引起末端执行器300相对于手柄壳体102在相反方向(如第二方向)上旋转。
如图1至图3所示，手术装置100包括被支撑在中间壳体部108和上壳体部之间且被定位于扳机壳体107上方的击发按钮或安全开关132。在使用中，根据需要和/或要求，末端执行器300的工具组件304在打开状态和闭合状态之间致动。当末端执行器300的工具组件304处于闭合状态时，为了击发末端执行器300，从其中发射出紧固件，按压下安全开关132，从而指示手术装置100：末端执行器300准备从其中发射出紧固件。
如图1和图10至图20所示，手术装置100被配置为用来选择性地与接合器200相连接，然后，依次地，接合器200被配置为用来选择性地与末端执行器300相连接。
接合器200配置为用来将手术装置100的驱动连接器120和122中任何一个驱动连接器的旋转转换成用于操作末端执行器300的驱动组件360和关节式运动连杆366的轴向平移，如图21所示且将在下面更详细地讨论。
接合器200包括用于将手术装置100的第三可旋转驱动连接器122与末端执行器300的第一可轴向平移的驱动构件相互连接的第一驱动传递/转换组件，其中，第一驱动传递/转换组件将手术装置100的第三可旋转驱动连接器122的旋转转换并传递成用来发射的末端执行器300的第一可轴向平移的驱动组件360的轴向平移。
接合器200包括用于将手术装置100的第二可旋转驱动连接器120和末端执行器300的第二可轴向平移的驱动构件相互连接的第二驱动传递/转换组件，其中，第二驱动传递/转换组件将手术装置100的第二可旋转驱动连接器120的旋转转换并传递成用来关节式运动的末端执行器300的关节式运动连杆366的轴向平移。
现在转向图10和图11，接合器200包括旋钮壳体202和从旋钮壳体202的远侧端延伸出的外管206。旋钮壳体202和外管206被配置和定尺寸为容纳接合器200的部件。外管206被定尺寸为用于内窥镜插入，特别地，外管可通过典型的套管针口、插管或类似物。旋钮壳体202的尺寸无法进入套管针口、插管或类似物。
旋钮壳体202被配置且适于连接到手术装置100的远侧半体110a的上壳体部108的连接部108a。
如图10至图12所示，接合器200包括在其近侧端处的手术装置驱动联接组件210和在其远侧端处的末端执行器联接组件230。驱动联接组件210包括远侧驱动联接壳体210a和可旋转地至少部分地支撑在旋钮壳体202中的近侧驱动联接壳体210b。驱动联接组件210在其中可旋转地支撑第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214以及第三可旋转近侧驱动轴216。
近侧驱动联接壳体210b被配置为分别可旋转地支撑第一连接器套筒218、第二连接器套筒220和第三连接器套筒222。如上所述，连接器套筒218、220、222中的每个都配置为分别与手术装置100相应的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122匹配，如上所述。连接器套筒218、220、222进一步配置为分别与相应的第一近侧驱动轴212、第二近侧驱动轴214和第三近侧驱动轴216的近侧端匹配。
近侧驱动联接组件210包括布置在相应的第一连接器套筒218、第二连接器套筒220和第三连接器套筒222的远侧的第一偏置构件224、第二偏置构件226和第三偏置构件228。围绕相应的第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214和第三可旋转近侧驱动轴216分别布置偏置构件224、226、228。当接合器200被连接到手术装置100时，偏置构件224、226、228作用在相应的连接器套筒218、220、222上从而有助于保持连接器套筒218、220、222与手术装置100的相应的可旋转的驱动连接器118、120、122的远侧端相接合。
特别地，第一偏置构件224、第二偏置构件226和第三偏置构件228的功能是沿近侧方向偏置相应的连接器套筒218、220、222。以这种方式，在装配接合器200到手术装置100的过程中，如果第一连接器套筒218、第二连接器套筒220和/或第三连接器套筒222与手术装置100的驱动连接器118、120、122不对准，则第一偏置构件224、第二偏置构件226和/或第三偏置构件228被压缩。因此，当手术装置100的驱动机构160被接合时，手术装置100的驱动连接器118、120、122将旋转，并且第一偏置构件224、第二偏置构件226和/或第三偏置构件228将引起相应的第一连接器套筒218、第二连接器套筒220和/或第三连接器套筒222向近侧向后滑动，有效地将手术装置100的驱动连接器118、120、122联接到近侧驱动联接组件210的第一近侧驱动轴212、第二近侧驱动轴214和/或第三近侧驱动轴216。
当校准手术装置100时，手术装置100的各个驱动连接器118、120、122就会旋转，并且当达到正确对准时，在连接器套筒218、220、222上的偏置会使连接器套筒218、220、222正确就位于手术装置100相应的驱动连接器118、120、122上。
接合器200包括分别被布置在手柄壳体202和外管206内的第一驱动传递/转换组件240、第二驱动传递/转换组件250和第三驱动传递/转换组件260。各个驱动传递/转换组件240、250、260被配置且适于将手术装置100的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122的旋转传递或转换成接合器200的驱动管246和驱动杆258的轴向平移，从而实现末端执行器300的闭合、打开、关节式运动和发射；或者将手术装置100的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122的旋转传递或转换成接合器200的环形齿轮266的旋转运动，从而实现接合器200的旋转。
如图13至图19所示，第一驱动传递/转换组件240包括被可旋转地支撑在壳体202和外管206内的第一远侧驱动轴242。第一远侧驱动轴242的近侧端部242a被键联接到正齿轮242c上，正齿轮242c被配置为经由复合齿轮243连接到正齿轮212a，正齿轮212a被键联接到第一可旋转近侧驱动轴212。第一远侧驱动轴242还包括具有螺纹外轮廓或表面的远侧端部242b。
第一驱动传递/转换组件240还包括驱动联接螺母244，驱动联接螺母244可旋转地联接到第一远侧驱动轴242的螺纹远侧端部242b，且将驱动联接螺母244可滑动地布置在外管206中。驱动联接螺母244被键联接到外管206的内壳管206a上，从而防止其随第一远侧驱动轴242旋转而旋转。如此，随着第一远侧驱动轴242旋转，驱动联接螺母244会平移通过外管206的内壳管206a和/或沿着外管206的内壳管206a平移。
第一驱动传递/转换组件240还包括驱动管246，驱动管246围绕第一远侧驱动轴242且具有被连接到驱动联接螺母244的近侧端部和延伸超出第一远侧驱动轴242的远侧端的远侧端部。驱动管246的远侧端部支撑连接构件247(参照图13)，连接构件247被配置和定尺寸为选择性地接合末端执行器300的驱动组件360的驱动构件374。
在操作中，随着第一可旋转近侧驱动轴212旋转，由于第一连接器套筒218的旋转，作为手术装置100的相应的第一驱动连接器118旋转的结果，第一可旋转近侧驱动轴212的正齿轮212a接合复合齿轮243的第一齿轮243a而引起复合齿轮243旋转。随着复合齿轮243旋转，复合齿轮243的第二齿轮243b旋转，并因而引起被键联接到第一远侧驱动轴242且与之相接合的正齿轮242c也旋转，从而致使第一远侧驱动轴242旋转。随着第一远侧驱动轴242旋转，引起驱动联接螺母244沿着第一远侧驱动轴242轴向平移。
随着引起驱动联接螺母244沿着第一远侧驱动轴242轴向平移，引起驱动管246相对于外管206的内壳管206a轴向平移。随着驱动管246轴向平移，由于连接构件247与驱动管246连接且被连接到末端执行器300的驱动组件360的驱动构件374，驱动管246会引起末端执行器300的驱动构件374同时进行轴向平移，从而实现末端执行器300的工具组件304的闭合以及工具组件304的击发。
参照图13至图19，接合器200的第二驱动转换器组件250包括被可旋转地支撑在驱动联接组件210内的第二可旋转近侧驱动轴214。第二可旋转近侧驱动轴214包括被配置为与第二连接器220相连接的非圆形的或定形的近侧端部214a，将第二连接器220与手术装置100的相应的第二连接器120相连接。第二可旋转近侧驱动轴214还包括具有螺纹外轮廓或表面的远侧端部214b。
如图20所示，第二驱动转换器组件250还包括被可旋转地且可平移地支撑在旋钮壳体202中成形的环形槽道或凹槽内的联接封套254。联接封套254限定了贯通其中的管腔254a以及在管腔254a表面中成形的环形槽道或凹槽。第二驱动转换器组件250还包括延伸穿过联接封套254的管腔254a并被可滑动布置在联接封套254的槽道内的联接滑块256。联接滑块256螺纹连接到第二可旋转近侧驱动轴214的螺纹远侧端部214b。如此被配置后，联接封套254能够绕第二可旋转近侧驱动轴214旋转，从而保持第二可旋转近侧驱动轴214相对于第一可旋转近侧驱动轴242的径向位置。
第二可旋转近侧驱动轴214限定了旋转轴线，而联接封套254限定了与第二可旋转近侧驱动轴214的旋转轴线间隔一径向距离的旋转轴线。联接滑块256限定了与联接封套254的旋转轴线相重合的旋转轴线。
第二驱动转换器组件250还包括驱动杆258，驱动杆258被可平移地支撑以轴向平移穿过外管206。驱动杆258包括被联接到联接封套254的近侧端部258a，以及限定了联接钩258c的远侧端部258b，联接钩258c被配置和定尺寸为选择性地与末端执行器300的关节式运动连杆366的钩状近侧端部366a相接合。(参照图21)。
在操作中，如图10至图19所示，随着驱动轴214由于第二连接器套筒220的旋转而旋转，作为手术装置100的第二驱动连接器120的旋转的结果，引起联接滑块256沿着第二可旋转近侧驱动轴214的螺纹远侧部214b轴向平移，这样依次地会引起联接封套254相对于旋钮壳体202轴向平移。随着联接封套254轴向平移，引起驱动杆258轴向平移。相应地，随着驱动杆258轴向平移，由于驱动杆258的钩258c被连接到末端执行器300的关节式运动连杆366的钩状近侧端366a(参照图21)，驱动杆258引起末端执行器300的关节式运动连杆366同时进行轴向平移，从而实现工具组件304的关节式运动。
如图10至图19所示且如上所述，接合器200包括被支撑在旋钮壳体202中的第三驱动传递/转换组件260。第三驱动传递/转换组件260包括被分别旋转地支撑在旋钮壳体202中的第一旋转壳体半体262和第二旋转壳体半体264，以及被支撑在且介于第一旋转壳体半体262和第二旋转壳体半体264之间的内部旋转环形齿轮266。第一旋转壳体半体262和第二旋转壳体半体264分别包括从其向远侧延伸的、且彼此平行的以及彼此间隔一横向距离的臂262a、264b。臂262a、264b分别包括在其远侧端附近径向向内延伸的凸台262b、264b。
第三驱动传递/转换组件260还包括一对旋转传递杆268、270，一对旋转传递杆268、270中的每个均在其近侧端处被连接到臂262a、264a的凸台262b、264b并且在其远侧端处被连接到被支撑在外管206远侧端处的远侧联接组件230。
第三驱动传递/转换组件260包括限定了齿轮齿266a内部阵列的环形齿轮266。环形齿轮266包括从其外边缘突出的一对完全对置的、径向延伸的突出件266b。在第一旋转壳体半体262和第二旋转壳体半体264的内表面中限定的凹槽262c、264c中布置突出件266b，使得环形齿轮266的旋转引起第一旋转壳体半体262和第二旋转壳体半体264的旋转。
第三驱动传递/转换组件260还包括被可旋转地支撑在壳体202和外管206内的第三可旋转近侧驱动轴216。第三可旋转近侧驱动轴216的近侧端部被键联接到接合器200的第三连接器222。第三可旋转近侧驱动轴216包括被键联接到其远侧端的正齿轮216a。齿轮组274将第三可旋转近侧驱动轴216的正齿轮216a与环形齿轮266的齿轮齿266a相互啮合。齿轮组274包括：与第三可旋转近侧驱动轴216的正齿轮216a相啮合的第一齿轮274a；以及与环形齿轮266的齿轮齿266a相啮合的第二齿轮274b。
在操作中，如图10至图19所示，随着第三可旋转近侧驱动轴216旋转，由于第三连接器套筒222的旋转，作为手术装置100的相应的第三驱动连接器122旋转的结果，第三可旋转近侧驱动轴216的正齿轮216a与齿轮组274的第一齿轮274a相啮合，引起齿轮组274旋转。随着齿轮组274旋转，齿轮组274的第二齿轮274b旋转并且从而引起环形齿轮266也旋转，因此会引起第一旋转壳体半体262和第二旋转壳体半体264旋转。随着第一旋转壳体半体262和第二旋转壳体半体264旋转，都会引起旋转传递杆268、270和被连接于其的远侧联接组件230绕接合器200的纵向轴线“X”旋转。随着远侧联接组件230旋转，同样也会引起被连接到远侧联接组件230上的末端执行器300绕接合器200的纵向轴线旋转。
参照图10、图11、图13和图18，接合器200还包括锁定机构280，锁定机构280固定驱动管246的轴向位置和径向方位以用于末端执行器300与其连接和分离。锁定机构280包括被可滑动地支撑在旋钮壳体202上的按钮282。锁定按钮282连接到纵向延伸穿过外管206的致动杆284。致动杆284介于外管206和内壳管206a之间。当锁定按钮282移动时，致动杆284移动。致动杆284包括在其中限定窗口284b的远侧部284a。如图18所示，窗口284b的远侧端限定了凸轮面284c。
如图13和图18所图示，锁定机构280还包括闭锁件286，闭锁件286被支撑在远侧联接组件230上与致动杆284的远侧部284a的窗口284b配准的位置处。闭锁件286包括朝向驱动管246的连接构件247延伸的凸块286a。闭锁件286的凸块286a被配置和定尺寸为选择性地与在驱动管246的连接构件247中形成的切口部247a相接合。锁定机构280还包括偏置构件288，偏置构件288趋于保持闭锁件286及其凸块286a与在驱动管246的连接构件247中形成的切口部247a分隔开。
在操作中，为了锁定驱动管246的位置和/或方位，用户将锁定按钮282从远侧位置移动到近侧位置，从而引起致动杆284的凸轮面284c与锁定臂286接合并抵抗偏置构件288的偏置而朝向驱动管246推动闭锁件286，使得闭锁件286的凸块286a被接纳到在驱动管246的连接构件247中形成的切口部247a中。
以这种方式，防止驱动管246向远侧移动和/或向近侧移动。当锁定按钮282从近侧位置移动到远侧位置时，凸轮面284c脱离闭锁件286，从而允许偏置构件288将闭锁件286及其凸块286a从在驱动管246的连接构件247中形成的切口部247a推出。
如图6和图12所示，接合器200包括一对电触销290a、290b，一对电触销290a、290b电连接到被布置在手术装置100的连接部108a中的对应的电插头190a、190b。电触销290a、290b用来允许经由被电连接到电路板150上的电插头190a、190b校准和传送必要的生命周期信息给手术装置100的电路板150。接合器200还包括被支撑在旋钮壳体202中且与电触销290a、290b进行电连通的电路板292。
当用户激活按钮时，软件会核对预定义的条件。如果符合条件，则软件会控制电动机并且将机械驱动输送给附接的手术吻合器，然后根据按下的按钮的功能，手术吻合器能够进行打开、闭合、旋转、做关节式运动或击发。软件还通过按照定义的方式打开或熄灭彩色灯来给用户提供反馈，从而指示出手术装置100、接合器200和/或末端执行器300的状态。
在如下示意图“A”中显示了系统的高级电气架构视图，并且显示了至各个硬件和软件接口的连接情况。在示意图“A”左侧上，显示了来自按钮124、126的按压和驱动轴的电动机编码器的输入。微型控制器包含操作手术装置100、接合器200和/或末端执行器300的装置软件。微型控制器接收微型局域网(MicroLAN)、超级ID芯片(UltraIDchip)、蓄电池ID芯片(BatteryIDchip)以及接合器ID芯片的输入并发送输出给它们。微型局域网、超级ID芯片、蓄电池ID芯片以及接合器ID芯片如下控制手术装置100、接合器200和/或末端执行器300：
微型局域网---用于读/写系统部件ID信息的串行1-导线总线通信；
超级ID芯片---识别手术装置100并且记录使用信息
蓄电池ID芯片---识别蓄电池156并且记录使用信息
接合器ID芯片---识别接合器200的类型，记录末端执行器300的存在并且记录使用信息
在图22中呈现的示意图的右侧指示了：至LED的输出；电动机的选择(选择夹紧/切割、旋转或关节式运动)；以及执行所选择功能的驱动电动机的选择。
参照图11A、图11B和图17A，根据本公开提供的接合器200的另一实施例示出并且通常表示为200'。接合器200'构造成类似于接合器200并且因此出于简化考虑，下文仅仅描述其另外的或替代的部件。
接合器200'可包括替代的旋钮壳体202'(参见图11B)。替代的旋钮壳体202'构造成同上面详细描述的旋钮壳体202类似，并且因此，出于简化考虑，下文仅仅描述其另外的或替代的特征。替代的旋钮壳体202'包括构造成接受外管206的纵向孔207'。外管206包括较大近侧直径204'，其朝向较小远侧直径205'向远侧地锥化。替代的旋钮壳体202'的纵向孔207'构造成接受外管206的较大近侧直径204'，使得较大近侧直径204'由纵向孔207'可旋转地支撑。壳体202'包括凸缘203'，其从纵向孔207'的远侧端向内径向延伸。凸缘203'构造成接收外管206的较小远侧直径205'，使得外管206的较小直径205'由凸缘203'支撑。凸缘203'在某位置处从旋钮壳体202'延伸出，使得外管206的较大近侧直径205'布置在纵向孔207'中并且被防止朝远侧平移经过凸缘203'。
接合器200'可进一步包括第一旋转壳体半体262'和第二旋转壳体半体264'。第一旋转壳体半体262'和第二旋转壳体半体264'构造成同上面的第一旋转壳体半体262和第二旋转壳体半体262类似，并且因此，出于简化考虑，下面仅仅描述其另外的或替代的特征。
第一旋转壳体半体262'和第二旋转壳体半体264'均限定了内壁表面208'，其中环形沟槽201'(图11A)被限定在内壁表面208'的近侧端。环形沟槽201'构造成接收驱动联接件210，使得第一旋转壳体半体262'和第二旋转壳体半体264'可相对于驱动联接件210绕着接合器200的纵向轴线“X”旋转，但不相对于驱动联接件210沿着接合器200的纵向轴线“X”轴向平移。驱动联接件210可采用本领域已知的任意合适的方式支撑在环形沟槽201'中，诸如通过轴套、滚珠轴承等。在一个非限制性实施例中，环形沟槽201'通过滚珠轴承207'接收驱动联接件210。滚珠轴承207'可通过本领域已知的任意合适的方式固定至驱动联接件210，诸如焊接、摩擦配合、粘合剂等。在一个非限制性实施例中，滚珠轴承207'通过焊接固定至驱动联接件210。结合在先前的实施例中已经公开的特征，增添环形沟槽201'和滚珠轴承207'用以轴向定位驱动联接件210，使得驱动联接件210被防止沿着接合器200的纵向轴线“X”(图10)轴向推进，从而在吻合钉发射期间减少由通过接合器200传递的作用力所导致的过度关节式运动的量。
参照图13A、图13B和图16A，根据本公开提供的接合器的另一实施例被示出并且通常表示为接合器200”。接合器200”构造成类似于接合器200和200'，并且因此，出于简化考虑，下文仅仅描述了其另外的或替代的部件。
接合器200”可包括一对替代旋转传递杆268”和270”。除近侧凸台271”(参见图13A)从旋转传递杆268”和270”的内表面272”延伸出之外，旋转传递杆268”和270”构造成同上面的旋转传递杆268和270类似。
接合器200”可进一步包括外管206的内壳管206a的替代的近侧端273”(参见图13和图13B)。近侧端273”的外表面274”在其中限定了环形沟槽275”。环形沟槽275”向内朝向接合器200的纵向轴线“X”径向延伸并且构造成接收替代的旋转传递杆268”和270”的近侧凸台271”(参见图16A)。当与已经在先前的实施例中公开的特征结合使用时，近侧端273”以及旋转传递杆268”和270”的组合用以轴向定位第一远侧驱动轴242，使得第一远侧驱动轴242被防止沿着接合器200的纵向轴线“X”轴向推进，从而在末端执行器300发射期间减少由通过接合器200传递的作用力所导致的过度关节式运动的量。
如图1和图21所示，末端执行器被指示为300。末端执行器300被配置和定尺寸为通过插管、套管针或类似物实现内窥镜插入。特别地，在图1和图21所图示的实施例中，当末端执行器300处于闭合状态时，末端执行器300可以穿过插管或套管针。
末端执行器300包括近侧主体部302和工具组件304。近侧主体部302被可释放地附接到接合器200的远侧联接组件230，而工具组件304可枢转地附接到近侧主体部302的远侧端。工具组件304包括砧座组件306和钉仓组件308。钉仓组件308相对于砧座组件306可枢转并且能在打开或未夹紧位置与闭合或夹紧位置之间移动以便于插入通过套管针的插管。
近侧主体部302包括至少驱动组件360和关节式运动连杆366。
参照图21，驱动组件360包括挠性驱动梁364，挠性驱动梁364具有近侧接合部368以及被固定到动力夹紧构件365的远侧端。接合部368包括限定台肩370的梯状部。接合部368的近侧端包括完全对置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牢固地固定到驱动梁364的近侧端上。驱动构件374限定近侧孔口376，近侧孔口376用来当末端执行器300被附接到接合器200的远侧联接组件230时接纳接合器200的第一驱动转换器组件240的驱动管246的连接构件247。
当驱动组件360在工具组件304内被向远侧推进时，夹紧构件365的上梁在砧座板312和砧座盖310之间限定的通道内移动，而且下梁移动到托架316外表面的上方来闭合工具组件304并从其中发射吻合钉。
末端执行器300的近侧主体部302包括关节式运动连杆366，关节式运动连杆366具有从末端执行器300的近侧端延伸出的钩状近侧端366a。当末端执行器300被固定到接合器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的驱动杆258的联接钩258c相接合。当接合器200的驱动杆258如上所述被推进或缩回时，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得工具组件304相对于近侧主体部302的远侧端枢转。
如图21所图示，工具组件304的钉仓组件308包括可支撑在托架316中的吻合钉钉仓305。吻合钉钉仓305限定中央纵向狭槽305a，以及被安置在纵向狭槽305a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。在操作手术装置100期间，驱动组件360与致动滑块邻接并推动致动滑块通过钉仓305。随着致动滑块移动通过钉仓305，致动滑块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并从其中顺序地发射单个吻合钉307以抵靠着砧座板312成形。
对于末端执行器300的结构和操作的详细讨论，可以参考名称为“TOOLASSEMBLYFORASURGICALSTAPLINGDEVICE(用于手术吻合装置的工具组件)”，序列号为7,819,896的美国专利。
将要理解的是，可以对这里公开的接合器组件的实施例做出各种修改。因此，上述说明不应该视为限制，而仅仅是一些特定实施例的例证。本领域的技术人员将在本公开的范围和精神内想到其他的修改。

Claims (18)

1.一种接合器，用来将被配置为执行功能的手术末端执行器和被配置为致动所述末端执行器的手柄组件选择性地相互连接，所述末端执行器包括至少一个可轴向平移的驱动构件，并且所述手柄组件包括至少一个可旋转驱动轴，所述接合器包括：
接合器壳体，其被配置为并且适于与所述手柄组件相连接并且能够与所述手柄组件的每个可旋转驱动轴进行可操作连通，所述接合器壳体具有限定空腔的内壁表面，其中凸缘在所述接合器壳体的远侧端上从所述内壁表面向内径向地突出；
外管，其具有近侧端和远侧端，所述外管从较大直径朝远侧渐缩成较小直径，所述外管由所述接合器壳体的凸缘可旋转地且可平移地支撑，其中所述外管的远侧端构造成并且适于连接所述末端执行器且与所述末端执行器的每个可轴向平移的驱动构件进行可操作连通；
内壳，其具有限定纵向轴线的近侧端和远侧端，所述内壳具有外表面和限定空腔的内壁表面，其中环形沟槽被限定在所述内壁表面的近侧端中，其中所述内壳的外表面的直径小于所述接合器壳体的内壁表面的直径，其中所述内壳被可旋转地支撑在所述接合器壳体中；以及
至少一个驱动转换器组件，其用于将所述手柄组件的相应一个可旋转驱动轴与所述末端执行器的一个可轴向平移的驱动构件相互连接，其中所述至少一个驱动转换器组件包括能够连接到所述手柄组件的可旋转驱动轴的第一端和能够连接到所述末端执行器的可轴向平移的驱动构件的第二端，其中所述至少一个驱动转换器组件将所述手柄组件的可旋转驱动轴的旋转转换并传递成所述末端执行器的可轴向平移的驱动构件的轴向平移，其中所述至少一个驱动转换器组件构造成被可旋转地且可平移地支撑在所述内壳的环形沟槽中。
2.根据权利要求1所述的接合器，其中，所述内壳与所述外管机械配合。
3.根据权利要求2所述的接合器，其中，多个臂沿着所述纵向轴线从所述内壳朝远侧延伸并且与所述外管机械配合。
4.根据权利要求3所述的接合器，其中，所述多个臂包括一对平行臂。
5.根据权利要求1所述的接合器，其中，所述接合器的至少一个驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括：
第一远侧驱动轴，其可旋转地支撑在所述接合器壳体中，其中所述第一远侧驱动轴的近侧端能够连接至所述手柄组件的可旋转驱动轴；
驱动联接螺母，其螺纹连接到所述第一远侧驱动轴的螺纹远侧部，其中所述驱动联接螺母被抗旋转地锁定在所述接合器壳体内；以及
驱动管，其具有近侧端和远侧端，所述近侧端被连接到所述驱动联接螺母，所述远侧端被配置用来与所述末端执行器的所述至少一个可轴向平移的驱动构件选择性地接合；
其中所述手柄组件的可旋转驱动轴的旋转引起所述远侧驱动轴的旋转，并且其中所述远侧驱动轴的旋转引起所述驱动联接螺母、所述驱动管和所述末端执行器的至少一个可轴向平移的驱动构件的轴向平移。
6.根据权利要求5所述的接合器，其中，所述第一驱动转换器组件包括：
正齿轮，其被键联接到所述远侧驱动轴的近侧端；
近侧可旋转驱动轴，其具有被支撑在其远侧端上的正齿轮和能够连接到所述手柄组件的可旋转驱动轴的近侧端；以及
复合齿轮，其将被键联接到所述远侧驱动轴的近侧端上的所述正齿轮与被支撑在近侧可旋转驱动轴的远侧端上的所述正齿轮相互接合。
7.根据权利要求6所述的接合器，其中，所述末端执行器的至少一个可轴向平移的驱动构件的平移引起所述末端执行器的闭合和所述末端执行器的击发。
8.根据权利要求5所述的接合器，其中，所述末端执行器的至少一个可轴向平移的驱动构件的平移引起所述末端执行器的闭合和所述末端执行器的击发。
9.根据权利要求5所述的接合器，其中，所述接合器的至少一个驱动转换器组件包括第二驱动转换器组件，所述第二驱动转换器组件包括：
第二近侧驱动轴，其可旋转地支撑在所述接合器壳体中，其中所述第二近侧驱动轴的近侧端能够连接到所述手柄组件的第二可旋转驱动轴；
联接封套，其可旋转地并且可平移地支撑在所述接合器壳体中，所述联接封套限定了内环形槽道；
联接滑块，其可旋转地布置在所述联接封套的环形槽道内，所述联接滑块螺纹连接到所述第二近侧驱动轴的螺纹远侧部；以及
驱动杆，其具有近侧端和远侧端，所述近侧端被连接到所述联接封套，所述远侧端被配置用来与所述末端执行器的另一个可轴向平移的驱动构件选择性地接合；
其中，所述手柄组件的所述第二可旋转驱动轴的旋转引起所述第二近侧驱动轴的旋转，并且其中，所述第二近侧驱动轴的旋转引起所述联接滑块、所述联接封套、所述驱动杆和所述末端执行器的另一个可轴向平移的驱动构件的轴向平移。
10.根据权利要求9所述的接合器，其中，所述第一远侧驱动轴延伸穿过所述联接封套，使得所述联接封套能够绕所述第一远侧驱动轴旋转。
11.根据权利要求9所述的接合器，其中，所述末端执行器的另一个可轴向平移的驱动构件的平移引起所述末端执行器相对于所述接合器的关节式运动。
12.根据权利要求9所述的接合器，其中，所述接合器进一步包括驱动传递组件，所述驱动传递组件包括：
第三近侧可旋转驱动轴，其可旋转地支撑在所述接合器壳体中并且具有支撑在其远侧端的正齿轮以及能够连接到所述手柄组件的第三可旋转驱动轴的近侧端；
环形齿轮，其可旋转地支撑在所述接合器壳体中，所述环形齿轮限定了与所述第三近侧可旋转驱动轴的正齿轮相接合的内部齿轮齿阵列，其中所述环形齿轮被键联接到所述内壳；
至少一个旋转传递杆，其具有连接到所述内壳的近侧端和连接到远侧联接组件上的远侧端，其中所述远侧联接组件被配置为选择性地与所述末端执行器连接；
其中，所述手柄组件的所述第三可旋转驱动轴的旋转引起所述第三近侧驱动轴的旋转，并且其中，所述第三近侧驱动轴的旋转引起所述环形齿轮、所述内壳、所述至少一个旋转传递杆和所述远侧联接组件的旋转，从而相对于所述接合器并绕着由所述接合器限定的纵向轴线来旋转所述末端执行器。
13.根据权利要求12所述的接合器，其中，所述接合器的外管被配置为将内窥镜插入目标手术部位。
14.根据权利要求13所述的接合器，其中，所述接合器壳体被抑制插入所述目标手术部位。
15.根据权利要求14所述的接合器，其中，所述第一驱动转换器组件、所述第二驱动转换器组件和所述驱动传递组件中的至少一个被布置在所述接合器壳体中。
16.根据权利要求15所述的接合器，其中，所述末端执行器和所述接合器的外管限定了为内窥镜插入目标手术部位而配置的内窥镜部。
17.根据权利要求1所述的接合器，其中，所述末端执行器和所述外管限定了为内窥镜插入目标手术部位而配置的内窥镜部。
18.根据权利要求17所述的接合器，其中，所述第一驱动转换器组件、所述第二驱动转换器组件和所述驱动传递组件中的每一个均被布置在所述内窥镜部的外部。
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