CN105232102A - 用于手术吻合的复合驱动梁 - Google Patents

用于手术吻合的复合驱动梁 Download PDF

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CN105232102A
CN105232102A CN201510379275.5A CN201510379275A CN105232102A CN 105232102 A CN105232102 A CN 105232102A CN 201510379275 A CN201510379275 A CN 201510379275A CN 105232102 A CN105232102 A CN 105232102A
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戴维·A·尼古拉斯
约翰·W·比尔兹利
拉塞尔·普里巴尼奇
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Abstract

一种末端执行器，其包含安装至手术吻合装置的安装部、从安装部向远侧延伸的第一钳夹构件和第二钳夹构件、与第一钳夹构件和第二钳夹构件能够接合的驱动梁以及带螺纹的驱动螺杆。第一钳夹构件包含第一组织接合表面，且第二钳夹构件支撑紧固件仓。紧固件仓包含限定紧固件保持狭槽的第二组织接合表面，紧固件保持狭槽支撑紧固件。驱动梁包含由第一材料形成的保持足部。保持足部限定支撑由第二材料形成的带螺纹的插入部的螺纹孔。带螺纹的驱动螺杆与带螺纹的插入部可螺纹接合，且能够旋转以沿带螺纹的驱动螺杆向远侧推进驱动梁来发射紧固件且使紧固件成形。本发明还公开了一种用于手术吻合的复合驱动梁。

Description

用于手术吻合的复合驱动梁
相关申请的交叉引用
本申请要求于2014年7月1日提交的申请号为62/019,560的美国临时专利申请的权益和优先权，该申请的全部公开通过引用合并于此。
技术领域
本公开涉及一种用于执行内窥镜检查手术操作的手术装置、设备和/或系统以及其使用方法。更具体地，本公开涉及一种如下的机电的、手持式的手术装置、设备和/或系统：所述机电的、手持式的手术装置、设备和/或系统配置为与用于夹紧、切割和/或吻合组织的能移除的可置换的装载单元和/或单次使用装载单元一起使用。
背景技术
大量的手术设备制造商已经开发了具有用于操作和/或操纵机电手术设备的专利驱动系统的生产线。一些机电手术设备包含可再用的手柄组件、以及如下的可替换的装载单元和/或单次使用装载单元等：在使用之前选择性地连接至手柄组件，然后继使用之后与该手柄组件分离，以被处置或在一些实例中消毒以便再使用。这些装载单元可包含钳夹构件，该钳夹构件支撑可致动的驱动梁以实现组织的夹紧、切割和/或吻合。
许多的这些机电手术设备或其部件对于制造、购买和/或操作来说相对昂贵。制造商和终端用户存在发展对于制造、购买和/或操作相对便宜的机电手术设备的期望。
因而，对如下的机电手术装置、设备和/或系统存在需求：对于开发和制造、存储和运送来说相对经济，并且从终端用户的角度上，对于购买和使用来说经济且便利。
发明内容
依照本公开的一个方案，提供了一种手术吻合装置的末端执行器。所述末端执行器包含：适于选择性地安装至所述手术吻合装置的安装部、从所述安装部向远侧延伸的第一钳夹构件和第二钳夹构件、与所述第一钳夹构件和所述第二钳夹构件能够接合的驱动梁、以及带螺纹的驱动螺杆。
第一钳夹构件包含第一组织接合表面且限定斜面。第二钳夹构件适于支撑紧固件仓。紧固件仓包含限定紧固件保持狭槽的第二组织接合表面。紧固件保持狭槽支撑多个紧固件。
随着驱动梁沿第一钳夹构件和第二钳夹构件向远侧平移，驱动梁与第一钳夹构件的斜面能够接合以将第一钳夹构件和第二钳夹构件维持在接近状态。
驱动梁包含由第一材料形成的保持足部。在实施例中，第一材料包含金属材料。在一些实施例中，第一材料包含不锈钢。保持足部限定螺纹孔，螺纹孔支撑由第二材料形成的带螺纹的插入部。在实施例中，第二材料包含聚合材料。在一些实施例中，第二材料包含聚醚醚酮。螺纹孔包含从所述螺纹孔的内表面延伸的内螺纹。内螺纹接合从所述带螺纹的插入部的外表面延伸的外螺纹。所述带螺纹的插入部包含相反端。在实施例中，带螺纹的插入部的所述相反端中的每一个均包含从其延伸的锁定凸缘，以将所述带螺纹的插入部固定至所述保持足部。
在一些实施例中，带螺纹的插入部包含从所述带螺纹的插入部的内表面延伸的内螺纹。在实施例中，带螺纹的插入部的内螺纹中的每一个均限定内峰，且所述带螺纹的插入部的外螺纹中的每一个均限定外峰，每一个内峰邻近且纵向偏离所述外峰之一。
在实施例中，驱动梁支撑刀具，所述刀具适于随着所述驱动梁沿带螺纹的驱动螺杆平移而切割组织。在一些实施例中，驱动梁包含横向突出构件，其中所述横向突出构件的至少部分由聚合材料形成。
带螺纹的驱动螺杆与驱动梁的带螺纹的插入部能够螺纹接合。带螺纹的驱动螺杆能够旋转以沿带螺纹的驱动螺杆选择性地向远侧推进驱动梁，来从紧固件仓的紧固件保持狭槽发射多个紧固件且抵靠第一钳夹构件的第一组织接合表面使所述多个紧固件成形。
在本公开的另一方案中，动力手术吻合装置包含手柄组件、从所述手柄组件向远侧延伸的轴组件、以及从所述轴组件能够选择性地拆卸的末端执行器。
其它的方案、特征以及优势将通过随后的描述、附图和权利要求书而变得显而易见。
附图说明
并入且构成该说明书一部分的附图图示出本公开的实施例，且与上文给出的本公开的总体描述和下文给出的实施例的详细描述一起用来解释本公开的原理，其中：
图1是依照本公开原理的机电手术系统的立体图；
图2是图1的机电手术系统的部件分离的立体图；
图3是图1和图2的机电手术系统的末端执行器的正视立体图；
图4是图3的末端执行器的后视立体图；
图5是图3和图4的末端执行器的部件分离的立体图；
图6是沿图4的6-6截取的、图3至图5的末端执行器的侧面的、剖面的立体图，示出末端执行器处于非接近状态；
图7是图6所示的细节指示区域的放大图；
图8是末端执行器的侧剖面图，示出末端执行器的驱动梁处于部分推进位置；
图9是图8所示的细节指示区域的放大图；
图10是在示出末端执行器的驱动梁处于部分推进位置情况下的末端执行器处于接近状态的侧剖视图；
图11是图10所示的细节指示区域的放大图；
图12是末端执行器的放大的、部分的剖视图，示出驱动梁部分推进；
图13是在示出末端执行器的驱动梁处于远侧推进位置情况下的末端执行器处于接近状态的侧剖视图；
图14是根据本公开原理的驱动梁的实施例的后视立体图；
图15是沿图14的线15-15截取的图14的驱动梁的侧剖视图；以及
图16是沿图14的线16-16截取的图14的驱动梁的后视立体的剖视图。
具体实施方式
参考附图详细描述本公开的机电手术系统、装置和/或设备的实施例，其中在几幅视图的每一视图中，同样的附图标记指代同一的或对应的元件。如在此使用的术语“远侧”表示机电手术系统、装置和/或设备的离用户较远的部分或部件，而术语“近侧”表示机电手术系统、装置和/或设备的离用户较近的部分或部件。
首先参考图1和图2，机电的、手持式的、动力的手术系统示出且总体标示为10。机电手术系统10包含机电的、手持式的、动力的手术器械或手柄组件100形式的手术装置或设备，其中所述手术装置或设备被配置为经由轴组件200在其上选择性地附接多个不同的末端执行器400，其中，各个末端执行器400都配置为被机电的、手持式的、动力的手术器械100致动且操纵。具体地，手术器械100配置为与轴组件200的关节式运动组件300选择性的连接，并且依次，轴组件200构造为经由关节式运动组件300与多个不同的末端执行器400中的任何一个选择性连接。
关于典型的机电的、手持式的、动力的手术器械的构造和操作的详细描述，可参考公开号为2009/0101692的美国专利申请、公开号为2011/0121049的美国专利申请、以及公开号为2013/0098966的美国专利申请，这些申请中的每一个申请的全部内容通过引用合并于此，其中所述典型的机电的、手持式的、动力的手术器械的部件与在此描述的动力手术系统10的一个或多个部件可组合和/或可互换。
通常，如图1和图2所图示，手术器械100包含器械壳体102，该器械壳体具有下壳体部104、从下壳体部104延伸和/或被支撑在下壳体部104上的中间壳体部106、以及从中间壳体部106延伸和/或被支撑在中间壳体部106上的上壳体部108。手术器械100具有用于控制手术系统的特定功能、收集数据、以及执行其他功能的控制器(未示出)。器械壳体102在其中限定空腔(未示出)，电路板(未示出)和驱动机构(未示出)位于所述空腔中。
电路板配置为控制手术器械100的各种操作，这将在下文更详细阐述。根据本公开，器械壳体102提供壳体，可再充电的电池(未示出)可移除地位于所述壳体中。电池配置为向手术器械100的电气部件中的任何一个供给电力。
器械壳体102的上壳体部108具有鼻形部或连接部108a，所述鼻形部或连接部构造为接纳轴组件200的传动壳体202的对应的轴联接组件204。如图2所见，手术器械100的上壳体部108的连接部108a限定如下的圆筒状凹槽108b：当轴组件200与手术器械100配接时，所述圆筒状凹槽接纳轴组件200的传动壳体202的轴联接组件204。手术器械100的连接部108a具有至少一个可旋转驱动构件。在一些实施例中，连接部108a容置多个可旋转驱动构件或连接器(未示出)，多个驱动构件中的每一个驱动构件可通过容置在器械壳体102内的驱动机构(未示出)而独立地和/或从属地能够致动和能够旋转。
器械壳体102的上壳体部108提供了壳体，驱动机构(未示出)位于所述壳体中。驱动机构配置为驱动轴和/或齿轮部件，以执行手术器械100的各种操作。具体地，驱动机构配置为驱动轴/或齿轮部件，以使末端执行器400相对于轴组件200选择性地移动；以使轴组件200和/或末端执行器400相对于器械壳体102围绕纵轴线“X1”旋转(见图1和图2)；以使末端执行器400的第一钳夹构件/上钳夹构件或砧座组件410相对于末端执行器400的第二钳夹构件/下钳夹构件或仓组件420移动；和/或使轴组件200关节式运动和/或旋转；和/或以发射在末端执行器400的仓组件420内的紧固件仓420a。
根据本公开，驱动机构可包含：选择器齿轮箱组件(未示出)；邻近选择器齿轮箱组件设置的功能选择模块(未示出)，所述功能选择模块用于选择性地移动在选择式齿轮箱组件内的齿轮元件从而使其与第二电动机(未示出)接合。驱动机构可配置为在特定时间选择性地驱动手术器械100的驱动构件或连接器中的一个。
如图1和图2所图示，器械壳体102支撑一对手指致动的控制按钮124、126和/或摇杆设备130(仅仅示出一个摇杆设备)。控制按钮124、126和摇杆设备130中的每一个均包含通过操作者的致动而移动的相应的磁体(未示出)。另外，容置在器械壳体102内的电路板(未示出)包含控制按钮124、126以及摇杆设备130中的每一个所用的相应的霍耳效应开关(未示出)，其中所述霍耳效应开关通过在控制按钮124、126以及摇杆设备130中的磁体的运动来致动。对应控制按钮124、126的霍耳效应开关(未示出)的致动引起电路板向驱动机构的功能选择模块以及输入驱动部件提供适当的信号，以打开/闭合末端执行器400和/或以发射在末端执行器400内的吻合/切割仓。
相似地，对应摇杆设备130的霍耳效应开关的致动引起电路板向驱动机构的功能选择模块以及输入驱动部件提供适当的信号，以使末端执行器400相对于轴组件200旋转或使末端执行器400和轴组件200相对于手术器械100的器械壳体102旋转。具体地，摇杆设备130沿第一方向的运动引起末端执行器400和/或轴组件200相对于器械壳体102沿第一方向旋转，而摇杆设备130沿相反(例如，第二)方向的运动引起末端执行器400和/或轴组件200相对于器械壳体102沿相反(例如，第二)方向旋转。
现在返回到图3至图13，示出且描述末端执行器400。末端执行器400配置为且适于施加多个直线排的紧固件“F”(例如，吻合钉，见图5)。在一些实施例中，紧固件为各种尺寸，并且在一些实施例中，紧固件具有如大约30、45和60mm长度的各种长度或排。
如图3和图4所示，末端执行器400包含联接至钳夹组件415的安装部430。安装部430的近侧端部配置为选择性地连接至如下的轴组件200的远侧端部(例如，关节式运动组件300)：具有形成在其上的互补结构。钳夹组件415连接至安装部430且从安装部430向远侧延伸。如将在下文更详细论述的，钳夹组件415包含：下钳夹构件420，其配置为选择性地支撑在其中的紧固件仓420a；以及上钳夹构件410，所述下钳夹构件和上钳夹构件中的每一个均固定至安装部430，以使上钳夹构件410和下钳夹构件420之间能够相对运动。钳夹组件415枢转地可移动，以使上钳夹构件410和下钳夹构件420在接近状态和非接近状态之间定位。
参考图5，如由本领域的技术人员所了解的，上钳夹构件410包含砧座主体410a，所述砧座主体具有包含如下多个吻合钉形成凹穴(未示出)的组织接合表面/紧固件成形表面411：所述多个吻合钉形成凹穴布置成纵向延伸排且构造为基于末端执行器400的发射来使紧固件成形。砧座主体410a支撑片簧组件412和杆组件414，所述片簧组件和所述杆组件被支撑在主体410a的腔室410b内。片簧组件412和杆组件414由能从主体410a选择性地移除的盖410c封装在腔室410b内。同时，片簧组件412和杆组件414用作在非接近状态下偏置钳夹组件415，且能够使钳夹组件415在接近状态和非接近状态之间枢转运动，这将在下文更详细描述。
片簧组件412包含片簧412a，所述片簧412a在片簧412a的第一端处由安装板412b和紧固件412c安装至主体410a。片簧412a延伸至在片簧412a的第二端处的可具有任何合适构造(如曲线勺状物(curvilinearscoop))的接合末端412d。
杆组件414包含杆414a，所述杆414a限定在其一端的销孔414c和在其相反端的远侧末端414b。通过穿过杆414a的销孔414c且穿过限定在砧座主体410a中的销孔410d而被接纳的销414d来将杆141枢转地安装至砧座主体410a。
砧座主体410a在砧座主体410a的近侧端限定多个孔，所述多个孔包含接纳驱动组件416的驱动孔410e、接纳一对柱塞组件418的一对柱塞孔410f、以及接纳电接触器构件417的电接触器孔410g，其中当末端执行器400固定到轴组件200时，所述电接触器构件用来与器械壳体102电连通。驱动组件416包含驱动构件416a、联接至驱动构件416a的齿轮构件416b、以及支撑驱动构件416a和齿轮构件416b的安装板416c。一对柱塞组件418中的每一个柱塞组件包含接纳弹簧418b的柱塞418a，所述弹簧418b用作沿远侧方向弹簧偏置柱塞418a，以有助于将紧固件仓420a固定至仓组件420。柱塞418a限定销狭槽418c，其中当销418d被接纳在限定于砧座主体410a的销孔410h内时，所述销狭槽接纳销418d以将每一个柱塞组件固定在一对柱塞孔410f中的相应的一个内。
下钳夹构件420配置为且适于选择性地接纳紧固件仓420a。紧固件仓420a包含组织接合表面423a(以及多个吻合钉推进器，未示出，但是可由本领域的技术人员所了解到)，其中所述组织接合表面423a限定适于支撑多个紧固件“F”的多排紧固件保持狭槽423b。紧固件仓420a还包含布置在几对紧固件保持狭槽423b排之间的纵向延伸的刀具狭槽423c，其中所述刀具狭槽适于能够使驱动梁426贯穿其轴向地平移。
下钳夹构件420包含如下的沟槽形式的安装构件420b：其支撑能够联接至安装构件420b的紧固件仓420a和基座构件420c。安装构件420b包含安装主体421，所述安装主体具有从其向近侧延伸的一对翼状部421a。一对翼状部421a限定贯穿其中的紧固件孔421b，所述紧固件孔被定尺寸为接纳被推进到限定在上钳夹构件410中的一对通道410i内的紧固件440，用于将上钳夹构件410固定至下钳夹构件420。狭槽421c和螺杆通道421d限定在安装主体421的邻近一对翼状部421a定位的板421e中。
如本领域的技术人员将了解的，致动滑块422由下钳夹构件420支撑且适于穿过紧固件仓420a推进，以发射由紧固件仓420a所支撑的多个紧固件。下钳夹构件420可旋转地支撑在其中的驱动螺杆424，所述驱动螺杆基本上延伸下钳夹构件420的整个长度。如在下文更详细描述的，驱动螺杆424与驱动梁426螺纹接合，所述驱动梁响应于驱动螺杆424的旋转而在近侧位置和远侧位置之间轴向可滑动地支撑在下钳夹构件420中。驱动螺杆424包含：多面头部424a；一对保持构件424b，所述一对保持构件限定在其之间的环形沟槽424c；以及向远侧延伸的螺纹轴424d。驱动螺杆424延伸穿过螺杆通道421d，以便当支架428被接纳在狭槽421c中且定位在环形沟槽424c内时，支架428将驱动螺杆424固定至安装构件420b，其中所述支架限定贯穿其中的U形沟槽428a。当能使驱动螺杆424旋转的同时，支架428和安装构件420b协作来将驱动螺杆424轴向地且横向地固定在下钳夹构件420中。
驱动梁426具有配置为随着驱动梁426移动穿过紧固件仓420a内的刀具狭槽423c而逐渐接近下钳夹构件420和上钳夹构件410的大体I形横截面轮廓。驱动梁426用来轴向地移置致动滑块422通过下钳夹构件420，且所述驱动梁包含：保持足部426a，其具有内螺纹孔426f；竖直定向的支柱426b，其被支撑在保持足部426a上；以及横向突出构件426c，其形成在支柱426b的顶上。横向突出构件426c限定形成在其上表面的切口426d。竖直定向的支柱426b支撑在其上的适于切割组织的刀具426e。
图5图示出安装部430固定至上钳夹构件410的近侧端部。安装部430包含联接在一起且支撑弹簧组件438的第一构件432、第二构件434以及第三构件436。弹簧组件438包含柱塞438a和弹簧438b。
现在参考图6和图7，示出末端执行器400处于初始状态和/或非接近状态，其中相对于通过末端执行器400限定的纵轴线“X2”，上钳夹构件410与下钳夹构件420分隔开。在非接近状态下，下钳夹构件420相对于上钳夹构件410以锐角(例如，15度)形式定位，驱动螺杆424相对于安装部430以锐角形式布置，并且驱动螺杆424的头部424a以锐角形式被支撑在由驱动构件416a限定的孔416d内。
如图7所描述，当末端执行器400处于非接近状态时，通过与片簧412a的接合末端412d接触，杆414a因由片簧组件412施加至杆414a的弹簧偏置力而布置在延伸位置。驱动梁426布置在最近侧位置，而片簧组件412的片簧412a布置在非弯曲状态。在杆414a的延伸位置，杆414a的远侧末端414b布置在驱动梁426的横向突出构件426c的切口426d中。
参考图8和图9，驱动构件416a的旋转使驱动螺杆424的头部424a旋转，这将旋转传到驱动螺杆424。随着驱动构件416a将旋转运动传到驱动螺杆424，一对保持构件424b维持驱动螺杆424的纵向固定。通过驱动螺杆424与驱动梁426的保持足部426a螺纹接合，如箭头“A”所指明的，驱动螺杆424的旋转运动向远侧地平移驱动梁426。在这点上，杆414a的远侧末端414b接合驱动梁426的切口侧壁426g，防止驱动梁426的远侧平移，且引起下钳夹构件420相对于上钳夹构件410沿由箭头“B”指示的方向且围绕限定横向穿过驱动螺杆424的头部424a的枢轴线“P”枢转。随着下钳夹构件420朝向上钳夹构件410枢转，使上钳夹构件410和下钳夹构件420闭合和/或接近，驱动梁426接合杆414a的底部表面，以便杆414a克服如下的弹簧偏置力来沿箭头“B”指示的方向朝向上钳夹构件410逆时针(如图9所图示，尽管当从末端执行器400的相反侧观看时顺时针)枢转：所述弹簧偏置力通过片簧组件412的接合末端412d被施加至杆414a的顶部表面。响应于杆414a朝向上钳夹构件410的枢转运动，片簧412a开始沿由箭头“B”指示的方向向弯曲状态弯曲，以便片簧412a相对于紧固件412c朝向上钳夹构件410顺时针(如图9所图示，尽管当从末端执行器400的相反侧观看时逆时针)枢转。
如图10和图11所见，驱动螺杆424的进一步旋转运动使杆414a枢转，以便杆414a的远侧末端414b与切口426a分离，能够使杆414a朝向缩回位置枢转且能够使下钳夹构件420如由箭头“C”指示的那样继续朝向上钳夹构件410枢转，直到上钳夹构件410和下钳夹构件420定位在接近状态为止。当杆414a的远侧末端414b与驱动梁426的切口426a的分离时，驱动螺杆424的继续旋转运动使在杆414a下方的驱动梁426如由箭头“A”指示的那样沿杆414a或杆组件414的底部表面向远侧平移，直到驱动梁426安装至斜面410j。驱动梁426的远侧平移驱动杆414a至如下的缩回位置，使得接合末端412d与杆414a的顶部表面分离且能够使驱动梁426安装至斜面410j且沿斜面410j平移：在所述缩回位置处，远侧末端414b沿片簧412a在点412e处接合片簧412a的底部表面。
参考图12和图13，当上钳夹构件410和下钳夹构件420处于接近状态时，下钳夹构件420与上钳夹构件410平行地定位，且驱动螺杆424的头部424a被支撑在驱动构件416a的孔416d内，以便驱动螺杆424平行于上钳夹构件410。在接近状态下，驱动螺杆424的继续旋转使驱动梁426如由箭头“A”指示的那样朝向末端执行器400的远侧端部来向远侧平移穿过末端执行器400。当使驱动梁426向远侧平移经过杆组件414时，片簧组件412推动杆组件414到延伸位置。驱动螺杆424的继续旋转使致动滑块422穿过紧固件仓420a推进，以发射存储在紧固件仓420a内的多个紧固件，用于固定组织。
然后驱动螺杆424可沿相反方向旋转以使驱动梁426向近侧缩回至最近侧位置。更具体地，驱动梁426向近侧缩回，直到驱动梁426接合杆组件414为止，其中杆组件414在片簧组件412的弹簧偏置下促使上钳夹构件410和下钳夹构件420分隔开，以便上钳夹构件410和下钳夹构件420如图6所示的那样被布置在最初的或非接近状态。然后紧固件仓420a可按期望地被移除、处理掉和/或替换，且在必要时可通过装载在下钳夹构件420内的新的、未发射的紧固件仓420a重复上述的末端执行器400的操作。
在实施例中，末端执行器400支撑向手术器械100的控制器和/或电路板电传送信号或标识码的一个或多个计算机或微芯片(未示出)。信号或标识码可指示紧固件仓420a或其部分是否至少部分发射、未发射等。
现在返回到图14至图16，根据本公开的另一个实施例的驱动梁总体指定为500。驱动梁500基本上相似于驱动梁426，且由此，将在此仅仅详细描述到如下程度：描述与驱动梁426在构造和/或操作方面的不同所必需的。
驱动梁500包含复合主体510，所述复合主体由两种或多种材料形成，以在提供足以支撑夹紧厚组织且将紧固件发射在厚组织中所需要的负荷的强度的同时，减小用于推进驱动梁500的输入转矩。复合主体510具有I形横截面轮廓(见图16)且包含保持足部520、固定至保持足部520的带螺纹的插入部530、从保持足部520延伸的竖直定向的支柱540、以及在支柱540的顶上形成的横向突出构件550。竖直定向的支柱540支撑刀具542，所述刀具适于随驱动梁500沿带螺纹的驱动螺杆424平移而切割组织。
在一些实施例中，保持足部520、竖直定向的支柱540和/或横向突出构件550中的一个或多个中的至少部分可由第一材料(如不锈钢的金属材料)一体地和/或整体地形成，以提供如下的负荷支撑强度：所述负荷支撑强度用于通过当前描述的手术设备夹紧和发射紧固件“F”。在实施例中，带螺纹的插入部530和/或横向突出构件550中的一个或两者中的至少部分可由第二材料(例如聚醚醚酮(PEEK)的聚合材料)一体地和/或整体地形成，以减小如下文更详细描述的用于推进驱动梁500的输入转矩。如可了解到的，驱动梁500的任何部件或其部分中的一个或多个，可由包含聚合材料和/或金属材料的任何合适的材料形成。本领域的技术人员将理解的是，任何部件或其部分中的一个或多个，可使用已知的成形和/或紧固技术(如模塑、铸造、铣削、焊接等)来形成。例如，驱动梁500的金属材料可铸造和/或铣削，而聚合材料可喷射模塑在其中。
如图15所见，保持足部520限定具有内表面522a的螺纹孔522。螺纹孔522包含从螺纹孔522的内表面522a延伸的内螺纹524。保持足部520进一步包含从保持足部520的外表面的底部延伸的足跟526。足跟526在其中限定一个或多个沟槽526a且包含从所述一个或多个沟槽横向延伸的多个翼状部526b。
带螺纹的插入部530在相反端530a、530b之间延伸，且包含从其延伸的内螺纹532和外螺纹534。内螺纹532形成在带螺纹的插入部530的内部/内表面530c/从带螺纹的插入部530的内部/内表面530c延伸，而外螺纹534形成在带螺纹的插入部530的外部/外表面530d上/从带螺纹的插入部530的外部/外表面530d延伸。螺纹孔522的内螺纹524接合从带螺纹的插入部530的外表面530d延伸的外螺纹534。带螺纹的插入部530的每一内螺纹532限定内峰532a，而带螺纹的插入部530的每一外螺纹534限定外峰534a。在实施例中，每一个内峰532a邻近且纵向偏离外峰534a之一。如可了解到的是，保持足部520和/或带螺纹的插入部530的任何螺纹中的一个或多个可具有包含任何合适的形状和/或尺寸的任何合适的构造。
带螺纹的插入部530的相反端530a、530b中的每一个均包含从其径向向外延伸以固定和/或助于带螺纹的插入部530固定至保持足部520的锁定凸缘536。带螺纹的插入部530可包含从带螺纹的插入部530的底部表面延伸的一个或多个锁定凸起538。每一个锁定凸起538均被固定在足跟526的沟槽526a中的一个沟槽内，以固定和/或助于带螺纹的插入部530固定至保持足部520。带螺纹的插入部530可包含从在足跟526的一对翼状部526b上方的锁定凸起538延伸出的一对翼状部539。
如图15和图16所见，横向突出构件550包含中央部552以及从中央部552延伸的一对翼状部554。中央部552和/或一对翼状部554的部分可限定形成在横向突出构件550的上表面的切口556。中央部552可由如PEEK的聚合材料形成，而一对翼状部554可由如不锈钢的金属材料形成。中央部552的底部表面552a适于接合第一钳夹构件410的斜面410j且沿第一钳夹构件410的斜面410j滑动。
在操作中，带螺纹的驱动螺杆424与驱动梁500的带螺纹的插入部530螺纹接合。带螺纹的驱动螺杆424能够旋转来使驱动梁500沿带螺纹的驱动螺杆424选择性地向远侧推进。随着带螺纹的驱动螺杆424旋转，驱动梁500相似于上面关于驱动梁426描述的那样推进。随着驱动梁500沿第一钳夹构件410和第二钳夹构件420向远侧平移，横向突出构件500，即中央部552的底部表面552a与第一钳夹构件410的斜面410j(见图11)的顶部表面接合，且沿第一钳夹构件410的斜面410j(见图11)的顶部表面滑动，以将第一钳夹构件410和第二钳夹构件420维持在接近状态。随着驱动梁500向远侧平移，多个紧固件“F”从紧固件仓420a的紧固件保持狭槽423b发射，以抵靠第一钳夹构件410的组织接合表面411使多个紧固件“F”成形。
如上文所述的，带螺纹的插入部530或其部分可由如PEEK的任何合适的聚合材料形成，以在带螺纹的驱动螺杆424旋转时，减小在带螺纹的驱动螺杆424的外表面与驱动梁500的带螺纹的插入部530的内表面之间产生的摩擦力。相似地，横向突出构件550的中央部552也可由聚合材料形成以减小在横向突出构件550的底部表面552a与可为金属的第一钳夹构件410(例如，斜面410j的顶部表面)之间的摩擦力。同样地，带螺纹的插入部530的一对翼状部539可由聚合材料形成，以减小在一对翼状部539的上表面539a与第二钳夹构件420的表面(如金属的)之间的摩擦力。在带螺纹的驱动螺杆424与驱动梁500之间；在一对翼状部539的上表面539a与第二钳夹构件420之间；和/或在横向突出构件550的底部表面552a与第一钳夹构件410之间的摩擦力的减小使如下的输入转矩减小：沿带螺纹的驱动螺杆424推进驱动梁500所需要的所述输入转矩。例如，通过塑料对金属的接合所产生的摩擦力可比相似的金属对金属的接合小多达2.5倍。假定驱动梁500的部分可由金属材料形成，则驱动梁500的复合主体510提供足够的强度以支撑夹紧厚组织和将紧固件发射在厚组织中所需要的负荷，而同时减小沿带螺纹的驱动螺杆424推进驱动梁500所需要的输入转矩。
本领域的技术人员将理解的是，在此具体描述且示出在附图中的结构和方法是非限制性的示范实施例，且描述、公开以及附图仅仅解释为具体实施例的示范。因此，要理解的是，本公开没有限制于已描述的明确的实施例，且在不脱离公开的范围或精神的情况下，可由本领域的技术人员实现各种其他的改变和改进。另外，在不脱离本公开的范围的情况下，与一些实施例有关的所示出或描述的元件和特征可与一些其它实施例的元件和特征合并，且这种改进和变化也包含在本公开的范围内。因而，本公开的主旨没有被已经具体示出且描述的所限制。

Claims (20)

1.一种手术吻合装置的末端执行器，所述末端执行器包括：
安装部，其适于选择性地安装至所述手术吻合装置；
第一钳夹构件，其从所述安装部向远侧延伸，所述第一钳夹构件包含第一组织接合表面；
第二钳夹构件，其从所述安装部向远侧延伸且适于支撑紧固件仓，所述紧固件仓包含限定紧固件保持狭槽的第二组织接合表面，所述紧固件保持狭槽支撑多个紧固件；
驱动梁，其与所述第一钳夹构件和所述第二钳夹构件能够接合，所述驱动梁包含由第一材料形成的保持足部，所述保持足部限定螺纹孔，所述螺纹孔支撑由第二材料形成的带螺纹的插入部；以及
带螺纹的驱动螺杆，其与所述驱动梁的所述带螺纹的插入部螺纹接合，且能够旋转以沿所述带螺纹的驱动螺杆选择性地向远侧推进所述驱动梁，来从所述紧固件仓的所述紧固件保持狭槽发射所述多个紧固件且抵靠所述第一钳夹构件的所述第一组织接合表面来使所述多个紧固件成形。
2.根据权利要求1所述的末端执行器，其中所述第一材料包含金属材料，且所述第二材料包含聚合材料。
3.根据权利要求2所述的末端执行器，其中所述第一材料包含不锈钢。
4.根据权利要求2所述的末端执行器，其中所述第二材料包含聚醚醚酮。
5.根据权利要求1所述的末端执行器，其中所述第一钳夹构件限定斜面，随着所述驱动梁沿所述第一钳夹构件和所述第二钳夹构件向远侧平移，所述驱动梁与所述斜面能够接合以将所述第一钳夹构件和所述第二钳夹构件维持在接近状态。
6.根据权利要求1所述的末端执行器，其中所述驱动梁支撑刀具，所述刀具适于随着所述驱动梁沿所述带螺纹的驱动螺杆平移而切割组织。
7.根据权利要求1所述的末端执行器，其中所述螺纹孔包含内螺纹，所述内螺纹从所述螺纹孔的内表面延伸且接合从所述带螺纹的插入部的外表面延伸的外螺纹，且其中所述带螺纹的插入部包含相反端，所述带螺纹的插入部的所述相反端中的每一个均包含从其延伸的锁定凸缘，以将所述带螺纹的插入部固定至所述保持足部。
8.根据权利要求7所述的末端执行器，其中所述带螺纹的插入部包含从所述带螺纹的插入部的内表面延伸的内螺纹。
9.根据权利要求8所述的末端执行器，其中所述带螺纹的插入部的所述内螺纹中的每一个均限定内峰，且所述带螺纹的插入部的所述外螺纹中的每一个均限定外峰，每一个内峰邻近且纵向偏离所述外峰之一。
10.根据权利要求1所述的末端执行器，其中所述驱动梁包含横向突出构件，其中所述横向突出构件的至少部分由聚合材料形成。
11.一种动力手术吻合装置，包括：
手柄组件；
轴组件，其从所述手柄组件向远侧延伸；以及
末端执行器，其能够从所述轴组件选择性地拆卸，所述末端执行器包含：
第一钳夹构件，其具有第一组织接合表面；
第二钳夹构件，其适于支撑紧固件仓，所述紧固件仓包含限定紧固件保持狭槽的第二组织接合表面，所述紧固件保持狭槽支撑多个紧固件；
驱动梁，其与所述第一钳夹构件和所述第二钳夹构件能够接合，所述驱动梁包含由第一材料形成的保持足部，所述保持足部限定螺纹孔，所述螺纹孔支撑由第二材料形成的带螺纹的插入部；以及
带螺纹的驱动螺杆，其与所述驱动梁的所述带螺纹的插入部螺纹接合，且能够旋转以沿所述带螺纹的驱动螺杆选择性地向远侧推进所述驱动梁，从而从所述紧固件仓的所述紧固件保持狭槽发射多个紧固件且抵靠所述第一钳夹构件的所述第一组织接合表面使所述多个紧固件成形。
12.根据权利要求11所述的动力手术吻合装置，其中所述第一材料包含金属材料，且所述第二材料包含聚合材料。
13.根据权利要求12所述的动力手术吻合装置，其中所述第一材料包含不锈钢。
14.根据权利要求12所述的动力手术吻合装置，其中所述第二材料包含聚醚醚酮。
15.根据权利要求11所述的动力手术吻合装置，其中所述第一钳夹构件限定斜面，随着所述驱动梁沿所述第一钳夹构件和所述第二钳夹构件向远侧平移，所述驱动梁与所述斜面能够接合以将所述第一钳夹构件和所述第二钳夹构件维持在接近状态。
16.根据权利要求11所述的动力手术吻合装置，其中所述驱动梁支撑刀具，所述刀具适于随着所述驱动梁沿所述带螺纹的驱动螺杆平移而切割组织。
17.根据权利要求11所述的动力手术吻合装置，其中所述螺纹孔包含内螺纹，所述内螺纹从所述螺纹孔的内表面延伸且接合从所述带螺纹的插入部的外表面延伸的外螺纹，且其中所述带螺纹的插入部包含相反端，所述带螺纹的插入部的所述相反端中的每一个均包含从其延伸的锁定凸缘，以将所述带螺纹的插入部固定至所述保持足部。
18.根据权利要求17所述的动力手术吻合装置，其中所述带螺纹的插入部包含从所述带螺纹的插入部的内表面延伸的内螺纹。
19.根据权利要求18所述的动力手术吻合装置，其中所述带螺纹的插入部的所述内螺纹中的每一个均限定内峰，且所述带螺纹的插入部的所述外螺纹中的每一个均限定外峰，每一个内峰邻近且纵向偏离所述外峰之一。
20.根据权利要求11所述的动力手术吻合装置，其中所述驱动梁包含横向突出构件，其中所述横向突出构件的至少部分由聚合材料形成。
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