CN105232105B - 包括运送组件的装载单元 - Google Patents

包括运送组件的装载单元 Download PDF

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CN105232105B
CN105232105B CN201510379396.XA CN201510379396A CN105232105B CN 105232105 B CN105232105 B CN 105232105B CN 201510379396 A CN201510379396 A CN 201510379396A CN 105232105 B CN105232105 B CN 105232105B
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保罗·西里卡
贾斯汀·威廉斯
帕特里克·莫泽尔兹
克里斯托弗·彭纳
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Covidien LP
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Abstract

提供了包括运送组件的装载单元。所述运送组件邻近钉仓组件被操作性地接纳以将吻合钉保持在钉仓组件内。运送组件包括：运送构件，其选择性地紧固至装载单元；以及锁定构件，其可滑动地布置在所述运送构件内。所述锁定构件在近侧位置和远侧位置之间是能移动的，其中，在所述近侧位置，运送构件紧固到壳体，而在所述远侧位置，运送构件是能从壳体移除的。

Description

包括运送组件的装载单元
技术领域
本公开涉及包括能够替换的装载单元的手术吻合装置。更具体地，本公开涉及包括运送组件的能够替换的装载单元。
背景技术
用于将吻合钉、夹子或其它紧固件施加至组织的手术装置是众所周知的。用于施加手术紧固件的内窥镜检查手术装置包括：用于致动所述装置的手柄组件；用于内窥镜进入的轴；以及布置在轴的远侧端的工具组件。这些装置中的一些被设计成与包括工具组件并且容纳吻合钉或紧固件的能够替换的装载单元一起使用。能够替换的装载单元可以包括具有各种尺寸的吻合钉，并且吻合钉可以被排列为一种或多种构造。在使用能够替换的装载单元发射吻合器之后，用户可以移除空的装载单元，选择另外的装载单元并将其附接至吻合器，并再次发射吻合器。在手术操作期间可以反复执行这个过程。
许多装载单元通常包括吻合钉钉仓、吻合钉推动器组件以及刀具组件。在一些装载单元中，吻合钉推动器组件和刀具组件被包括在单个组件中。吻合钉推动器组件和刀具组件主要包括一个或多个被定位为接合致动单元的一个或多个驱动构件的活动部。如果在装载单元附接至致动单元之前和在装载单元附接至致动单元的过程中，活动部没有保持在恰当的位置，则装载单元可能不会准确地接合致动单元。一些装载单元具有自动锁定系统，所述自动锁定系统阻止装载单元的部件在装载单元附接至致动单元之前就移动，并且在装载单元已经附接至致动单元上时允许装载单元的活动部自由移动。然而，这些自动锁定系统不被构造为在致动装载单元之前将吻合钉保持在吻合钉钉仓内。此外，这些锁定系统不被构造为利于装载单元在装载单元已经附接至致动单元之后的定位。
因此，具有被构造为保持装载单元的活动部并且将吻合钉保持在吻合钉钉仓内的运送构件将是有益的。具有被构造为利于在装载单元附接至致动单元之后定位装载单元的运送构件也将是有益的。
发明内容
因此，提供了一种包括运送组件的装载单元。所述装载单元包括：壳体；吻合钉推动器组件，其操作性地保持在壳体内；刀具组件，其操作性地保持在壳体内；钉仓组件，其布置在壳体的远侧端上并且支撑环形阵列的吻合钉。所述运送组件操作性地布置为与所述钉仓组件相邻。所述运送组件包括：运送构件，其选择性地紧固至所述壳体；以及锁定构件，其可滑动地布置在所述运送构件内。所述锁定构件在近侧位置和远侧位置之间是能移动的，其中，在所述近侧位置，运送构件紧固到壳体，而在所述远侧位置，运送构件是能从壳体移除的。
在实施例中，运送构件包括基部，其具有定位成与钉仓组件相邻的用于将多个吻合钉保持在所述钉仓组件内的吻合钉保持表面。所述运送构件可以包括内环形延伸部，其具有一对支腿，每个支腿都构造为选择性地接合所述壳体以将运送组件紧固至所述壳体。所述运送构件可以包括外环形延伸部，其具有至少一个架状物和至少一个支腿，其中所述至少一个架状物接合所述刀具组件以防止刀具组件的移动，所述至少一个外支腿接合所述推动器组件以防止所述推动器组件的移动。所述运送构件可以包括凸缘部，其构造用于能由用户操作性的接合。
在一些实施例中，运送组件包括选择性地能紧固至所述凸缘部的导引构件。所述导引构件可以包括圆锥形形状。所述导引构件可以包括用于接纳取回用绳的通孔。导引构件可以构造为利于所述装载单元穿过管腔插入。所述运送构件可以包括导引部。
还提供了一种用于装载单元的运送组件。所述运送组件包括：运送构件，其具有基部、从所述基部向远侧延伸的凸缘以及从所述基部向近侧延伸的内环形延伸部；以及锁定构件，其可滑动地布置在所述环形延伸部内并且在近侧位置和远侧位置之间是能移动的，其中，在所述近侧位置，所述运送构件紧固到装载单元，而在所述远侧位置，运送构件是能从装载单元移除的。
运送组件可以进一步包括外环形延伸部，其具有至少一个架状物以及超过架状物延伸的至少一个支腿。所述基部可以包括用于将多个吻合钉保持在装载单元的钉仓内的吻合钉保持表面。运送组件还可以包括选择性地能紧固至所述凸缘的导引构件。所述导引构件可以包括圆锥形形状。在一些实施例中，所述导引构件包括用于接纳取回用绳的通孔。
附图说明
被并入本说明书中并构成本说明书的一部分的附图，图示出本公开的实施例并且与上文给出的本公开的概括描述以及下文给出的实施例的详细描述一起，用于解释本公开的原理，其中：
图1是根据本公开的实施例的装载单元的立体侧视图，该装载单元包括根据本公开的实施例的运送帽组件；
图2是图1中所示的装载单元和运送帽组件的立体图，其中，导引构件被移除；
图3是图1中所示的装载单元和运送帽组件的部分地部件分解的立体图；
图4是图1中所示的装载单元的部件分解的立体图；
图5是图1中所示的装载单元的剖视侧视图；
图6是图1中所示的运送帽组件的立体图；
图7是图1中所示的运送帽组件的部件分解的立体图；
图8是运送帽组件的端视立体图；
图9是沿图7中所示的线9-9截取的剖视侧视图；
图10是沿图8中所示的线10-10截取的剖视侧视图；
图11是图7中所示的细节指示区域的放大视图；
图12是图10中所示的细节指示区域的放大视图；
图13是沿图10中所示的线13-13截取的剖视侧视图；
图14是图1中所示的装载单元和运送帽组件在运送帽组件附接到装载单元之前的剖视侧视图；
图15是图14中所示的在运送帽组件附接到装载单元之后的剖视侧视图；
图16是图15中所示的关注指示区域的放大视图；
图17是图1中所示的装载单元和运送帽组件的立体图，其中外壳和推动器组件被移除；
图18是沿图17中所示的线18-18截取的剖视端视图；
图19是沿图18中所示的线19-19截取的剖视侧视图；
图20是沿图18中所示的线20-20截取的剖视侧视图；
图21是图14中所示的在运送帽组件从装载单元分离之前的剖视侧视图；
图22是根据本公开的替代实施例的装载单元的立体图，该装载单元包括根据本公开的替代实施例的运送帽组件；
图23是图22中所示的运送帽组件的立体图；
图24是根据本公开的另一个实施例的装载单元的立体图，该装载单元包括根据本公开的另一个实施例的运送帽组件；
图25是图24中所示的运送帽组件的立体图；以及
图26是图24中所示的装载单元和运送帽组件的剖视侧视图。
具体实施方式
现在将参照附图详细描述本公开的包括运送构件的装载单元的实施例，其中在几个视图的每一个视图中，相同的附图标记指代相同或相应的元件。如本领域通用的，术语“近侧”指的是较靠近用户或操作者(即，外科医生或临床医师)的部分或者部件，术语“远侧”指的是较远离用户的部分或者部件。
参照图1至图3，根据本公开的实施例的能够替换的装载单元总体显示为装载单元100，并且其包括根据本公开的实施例的总体作为运送帽组件200显示的运送组件。装载单元100被构造用于能操作性的连接到手术吻合装置(未显示)并且被构造为发射和形成环形阵列的手术吻合钉。运送帽组件200被选择性地接纳在装载单元100的远侧端102上，并且运送帽组件200进行操作以将吻合钉“S”(图4)保持在装载单元100的吻合钉钉仓120内。运送帽组件200还进行操作以防止装载单元100的吻合钉推动器组件130(图4)和装载单元100的刀具组件140(图4)在装载单元100附接至接合器组件(未显示)(接合器组件连接至吻合装置(未显示)的致动单元(未显示))或吻合装置(未显示)的致动单元(未显示)之前或在该过程中过早推进。
尽管将参照运送帽组件200来描述装载单元100，并且将参照装载单元100来描述运送帽组件200，但是能预想到的是，本公开的方案可以被改进以与具有不同构造的装载单元和运送帽组件一起使用。装载单元100将仅描述到能够完全公开本公开的方案所必需的程度。对于示例性装载单元的更详细描述，请参考公开号为2013/0181035的共有美国专利申请，该专利的全部内容通过引用合并于此。
现在参照图4和图5，装载单元100包括：壳体110；吻合钉钉仓120，其紧固至壳体110的远侧端110b；吻合钉推动器组件130，其被操作性地接纳在壳体110内；刀具组件140，其被操作性地接纳在壳体110内；套管构件150，其被接纳在壳体110的近侧端110a中；芯片组件160，其围绕套管构件150安装；以及盖构件170，其选择性地能紧固到壳体110的近侧端110a。
装载单元100的壳体110包括外筒部112和内筒部114。多个肋部(未显示)将外筒部112和内筒部114相互连接。壳体110的内筒部114和外筒部112是同轴的并且在其间限定了被构造为操作性地接纳吻合钉推动器组件130和刀具组件140的凹槽113(图5)。壳体110的内筒部114包括沿着其内表面延伸的多个纵向凸脊116(图5)，其构造用于在吻合操作期间将砧座组件(未显示)对准装载单元100。如将在下文更详细描述的，纵向凸脊116的近侧端116a构造为利于运送帽组件200与装载单元100的选择性紧固。环形凸脊118(图5)形成在内筒部114的外表面上并且构造为帮助将刀具组件140保持在缩回位置。
壳体110的近侧端110a被构造用于选择性的连接至接合器组件(未显示)或吻合装置(未显示)的致动单元(未显示)，其中接合器组件连接至吻合装置(未显示)的致动单元(未显示)。装载单元100的壳体110可以被构造用于卡口联接至致动单元和/或接合器组件，或构造用于以任何其他适合的方式连接至致动单元和/或接合器组件。
装载单元100的吻合钉钉仓120布置在壳体110的远侧端110b上并且包括构造为选择性地保持吻合钉“S”的多个吻合钉凹穴121。吻合钉钉仓120可以选择性地紧固至壳体110以允许替换吻合钉钉仓120，从而允许重复使用装载单元100。可替代地，吻合钉钉仓120紧固地固定到壳体110，从而仅允许装载单元100的单次使用。
继续参照图4和图5，装载单元100的吻合钉推动器组件130包括推动器接合器132和推动器134。尽管显示为独立的部件，但是能够预想到的是，推动器接合器132和推动器134可以一体地形成。推动器接合器132的近侧端132a被构造用于能操作性的连接至驱动机构(未显示)，该驱动机构用于在致动吻合器装置(未显示)的过程中将推动器接合器132和推动器134从第一或近侧位置(图5)推进至第二或远侧位置(未显示)。推动器134包括多个推动器构件136，推动器构件136对准被接纳在吻合钉钉仓120的吻合钉凹穴121内的吻合钉“S”。推动器134相对于吻合钉钉仓120的推进引起吻合钉从吻合钉钉仓120射出。
仍参照图4和图5，装载单元100的刀具组件140包括刀杆142和围绕刀杆142的远侧端142b紧固的圆形刀具144。刀杆142的近侧端142a被构造用于与驱动机构(未显示)能操作性的连接，该驱动机构将刀杆142和圆形刀具144从第一或近侧位置(图5)移动至第二或或推进位置(未显示)以引起布置为与吻合钉钉仓120相邻并且在吻合钉钉仓120的吻合钉线内的组织(未显示)的切割。刀杆142限定一对开口145(图5)。如将在下文更详细描述的，开口145构造为接纳运送帽组件200的运送构件202的外环形延伸部240的第一外支腿246和第二外支腿248。架状突出物(ledge)146(图5)布置成邻近刀杆142的远侧端142b。如将在下文更详细描述的，架状突出物146与运送帽组件200的运送构件202的外环形延伸部240的第一和第二架状物242、244的肋部242a、244a的分别接合防止了刀具组件140的远侧推进。
仍然参照图4和图5，芯片组件160的环形凸缘162围绕套管构件150的远侧端150b被接纳。套管构件150的远侧端150b通过形成在套管构件150的远侧端150b上的多个凸脊152而被紧固在壳体110的内筒部114的近侧端114a中。装载单元100的盖构件170选择性地紧固到壳体110的近侧端110a。盖构件170是一种能够使再装载器/装载单元与接合器的附接紧固的锁圈类型。通过这个盖构件/锁圈，不再需要操纵锁定件来附接。凸轮表面153使得构件170轻微上提然后很快恢复。为了卸载，有必要提起锁圈170离开再装载器的外壳，从而使一次性的再装载器从可重复使用的接合器(未显示)脱离。
现在转向图6至图13，运送帽组件200包括：运送构件202；导引构件204，其选择性地紧固到运送构件202；以及锁定构件206，其操作性地接纳在运送构件202中。运送构件202包括：基部210；凸缘部220，其从基部210向远侧延伸；以及内环形延伸部230和外环形延伸部240，它们从基部210向近侧延伸。尽管显示为一件式构造，即，一体地或整体地形成，但是能够预想到的是，基部210、凸缘部220以及内环形延伸部230和外环形延伸部240中的任何一个或全部可以独立地形成并且通过粘合剂、焊接或任何其他适合的方式紧固在一起。
如图所示，运送帽组件200的运送构件202的基部210包括具有圆形形状的大致为扁平的或平面的主体。尽管显示为具有圆形形状，但是能预想到的是，基部210可以包括与装载单元100的横截面形状对应的任何形状(图3)。基部210的吻合钉保持表面212形成在外环形延伸部240的径向外侧，并且构造为在装载单元100的运送期间、在装载单元100附接到吻合装置(未显示)的致动单元(未显示)期间以及在将装载单元100定位在患者体内期间，当运送帽组件200被接纳在装载单元100的远侧端102(图3)上时抵接装载单元100的吻合钉钉仓120从而将吻合钉“S”保持在吻合钉钉仓120的吻合钉凹穴121(图3)中。尽管显示为环形以对应吻合钉钉仓120的形状，但能够预想到的是，吻合钉保持表面212可以改进为对应其他构造的吻合钉钉仓。
运送帽组件200的运送构件202的基部210限定了一对通孔或开口213，其构造为选择性地接纳导引构件204的凸出部252。基部210包括围绕一对开口213的倾斜部或斜角部213a(图9)，以利于在其中接纳凸出部252。基部210还限定了布置在凸缘部220的任一侧上的一对狭槽215。如将在下文更详细描述的，狭槽215构造为接纳锁定构件206的支腿部262。
运送帽组件200的运送构件202的凸缘部220从基部210向远侧延伸并且构造为选择性地接纳在导引构件204中。凸缘部220还可以构造为利于由用户接合运送帽组件200的运送构件202。如图所示，运送构件202的凸缘部220大致是平坦的并且包括大致三角形的截面轮廓；然而，凸缘部220可以包括适合于接纳在运送帽组件200的导引构件204内的和/或利于由用户接合运送构件202的任何构造。例如，在一些实施例中，凸缘部220包括凸脊(未显示)和/或槽口(未显示)。
继续参照图6至图13，运送帽组件200的运送构件202的内环形延伸部230构造为选择性地接纳在装载单元100的壳体110的内筒部114内(图19)。内环形延伸部230包括圆筒状主体232和从圆筒状主体232向近侧延伸的第一支腿234和第二支腿236。圆筒状主体232和第一支腿234以及第二支腿236限定了构造用于接纳锁定构件206的纵向孔233。第一和第二内支腿234、236各自分别包括自由端234a、236a，其构造为朝向彼此径向向内弯曲。突起238从相应的第一和第二支腿234、236的各自的自由端234a、236a径向向外地延伸。如将在下文更详细描述的，突起238构造为当运送组件200接纳在装载单元100的远侧端102上时选择性地接合形成于装载单元100的壳体110的内筒部114的内表面上的凸脊116的近侧端116a(图5)。
运送帽组件200的运送构件202的外环形延伸部240与内环形延伸部230径向分隔并且构造为围绕装载单元100的壳体110的内筒部114被选择性地接纳。外环形延伸部240与内环形延伸部230是同轴的。外环形延伸部240包括第一架状物242和第二架状物244以及第一外支腿246和第二外支腿248。尽管第一架状物242显示为与第一外支腿246一体地形成并且第二架状物244显示为与第二外支腿248一体地形成，但是第一架状物242和第一外支腿246以及第二架状物和第二外支腿248可以形成为外环形延伸部240的分离的部分。此外，尽管外环形延伸部240显示为具有两个架状物242、244以及两个外支腿246、248，但是能够预想到的是，外环形延伸部240可以包括环形架状物、单个架状物或多个架状物，并且可以包括单个支腿或多个支腿。
第一和第二架状物242、244各自包括肋部242a、244a，肋部242a、244a构造为接合布置成邻近装载单元100的刀具组件140的刀杆142的远侧端142a的架状突出物146(图20)。尽管显示为各自具有一对肋部242a、244a，但是能够预想到的是，第一和第二架状物242、244中的每一个可以仅具有单个肋部或多个肋部。能进一步预想到的是，第一和第二架状物242、244可以替代地包括沿第一和第二架状物242、244的部分或全部的加厚部，用于接合刀具组件140的刀杆142的架状突出物146。第一和第二外支腿246、248中的每个都构造成使得：当运送帽组件200接纳在装载单元100的远侧端102上时，第一和第二外支腿246、248的自由端246a、248a接合装载单元100的推动器组件130(图19)的推动器接合器132。
仍然参照图6至图13，运送帽组件200的导引构件204包括大致圆锥形主体250。凸出部252从圆锥形主体250的近侧端250a向近侧延伸。凸出部252的近侧端252a是逐渐变细的，以利于凸出部252接纳在基部210中的开口213内。每个凸出部252包括凸起254，其构造为当凸出部252被接纳通过基部210中的开口213时摩擦地接合运送构件202的基部210，以将导引构件204选择性地紧固到运送构件202。暂时转向图12，每个凸出部252的中心线“C1”与运送构件202的基部210中的每个开口213的中心线“C2”横向隔开。这样，导引构件204的凸出部252在运送构件202的基部210中的开口213内的接纳，将凸出部252径向向外偏置，从而确保凸出部252上的凸起254与基部210的接合。导引构件204与运送构件202的分离需要克服由中心线“C1”、“C2”的横向隔开产生的偏置力，从而允许凸起254从运送构件202的基部210脱离。
运送帽组件200的导引构件204在圆锥形主体250的近侧端250a中限定了纵向狭槽253以及环形孔255。纵向狭槽253构造为当导引构件204接合运送构件202时接纳运送构件202的凸缘部220，而环形孔255构造为当锁定构件206处于远侧位置时(图3)接纳锁定构件206的支腿262。导引构件204还在圆锥形主体250的远侧端250b中限定了通孔257，其构造为接纳用于在运送帽组件200与装载单元100分离之后将运送帽组件200从体腔(未显示)内取回的缝合线、线“W”(图21)、绳或其他工具。
仍然参照图6至图13，运送帽组件200的锁定构件206包括大致圆筒状主体260，圆筒状主体260在近侧端260a中限定了槽口261并且具有从远侧端260b延伸出的一对支腿262。每个支腿262包括从每个自由端262a径向向外延伸的突起264，突起264构造为：当支腿262已经接纳在狭槽215中时防止支腿262的自由端262a穿过运送构件202的基部210中的狭槽215缩回。接合表面266形成在支腿262的连接端262b之间，并且接合表面266构造为当锁定构件206处于远侧位置时接合运送帽202的基部210。纵向肋部268(图11)沿着圆筒状主体260的外表面延伸并且构造为与运送构件202的内环形延伸部230的圆筒状主体232的内表面产生摩擦，以帮助相对于内环形延伸部230保持锁定构件206。
运送帽组件200的锁定构件206可滑动地接纳在由运送构件202的内环形延伸部230的第一内支腿234、第二内支腿236以及圆筒状主体232限定的纵向孔233中。当锁定构件206接纳在纵向孔233中时，锁定构件206的支腿262的自由端262a延伸穿过基部210中的狭槽215。如上所述，形成在支腿262的自由端262a上的突起264防止支腿262穿过狭槽215缩回。在第一或未锁定位置(图3)，锁定构件206处于近侧位置。在第二或锁定位置(图6)，锁定构件206处于远侧位置，其中形成在圆筒状主体260的近侧端260a中的槽口261布置成邻近运送构件202的内环形延伸部230的第一和第二臂234、236的自由端234a、236a。
现在将参照图14至图20描述运送帽组件200附接到装载单元100。首先参照图14，显示了运送帽组件200的运送构件202和锁定构件206，其中锁定构件206处于第一或未锁定位置。在未锁定位置，锁定构件206在由运送构件202的内环形延伸部230形成的纵向通道233内处于远侧位置，并且锁定构件206的支腿262穿过运送构件202的基部210中的狭槽215被完全接纳，使得锁定构件206的形成在锁定构件206的支腿262的连接端262b之间的接合表面266接合基部210。在运送帽组件200的运送构件202附接到装载单元100之前，导引构件204与运送构件202分离。
仍然参照图14，运送帽组件200的运送构件202和锁定构件206定位在装载单元100中，使得运送构件202的内环形延伸部230的第一和第二内支腿234、236以及接纳在内环形延伸部230的通道233内的锁定构件206的圆筒状主体260，与装载单元100的壳体110的内筒部114轴向对准。然后，如箭头“A”所示，运送构件202相对于装载单元100被纵向推进，使得运送构件202的内环形延伸部230的第一和第二内支腿234、236以及锁定构件206的圆筒状主体260被接纳在装载单元100的壳体110的内筒部114内。随着运送构件202的第一和第二内支腿234、236在装载单元100的内筒部114内向近侧推进，相应的第一和第二支腿234、236的自由端234a、236a，具体地，形成在自由端234a、236a上的突起238，与形成在壳体110的内筒部114内的凸脊116的接合，引起相应的第一和第二内支腿234、236的自由端234a、236a朝向彼此径向向内弯曲，如箭头“B”所示。
转向图15至图20，显示了运送帽组件200附接到装载单元100。当附接到装载单元100时，运送构件202的基部210的吻合钉保持表面212抵接吻合钉钉仓120以将吻合钉“S”保持在吻合钉凹穴121内，第一和第二架状物242、244(图20)围绕壳体110的内筒部114被接纳，并且外环形延伸部240的第一和第二外支腿246、248(图19)穿过形成于刀杆142中的开口145而被接纳。此外，相应的第一和第二支腿234、236的自由端234a、236a超过形成在壳体110的内筒部114内的凸脊116的近侧端116a向近侧延伸。如此，相应的第一和第二支腿234、236的自由端234a、236a能够回到未弯曲状态。
特别参照图15和图16，当运送构件202的内环形延伸部230的相应的第一和第二支腿234、236的自由端234a、236a回到未弯曲状态时，形成在每个自由端234a、236a上的突起238接合装载单元100的壳体110的内筒部114的凸脊116的近侧端116a。通过锁定构件206的圆筒状主体260沿近侧方向(如箭头“D”所示)的纵向移动，促进相应的第一和第二支腿234、236的自由端234a、236a如图16中的箭头“C”所示地回到未弯曲位置。锁定构件206通过圆筒状主体260的支腿262的自由端262a的接合而沿近侧方向移动。尽管能够预想到，运送帽组件200的导引构件206可以构造为当导引构件206紧固到运送构件202时接合支腿262的自由端262a，但是在实施例中，锁定构件206在导引构件206附接到运送构件202之前移动到近侧位置。
锁定构件206沿近侧方向的移动将运送构件202紧固到装载单元100。具体地，锁定构件206的圆筒状主体260的近侧端260a与内环形延伸部230的相应的第一和第二支腿234、236的自由端234a、236a的接合，确保相应的支腿234、236的自由端234a、236a回到未弯曲位置，从而进一步确保形成在每个自由端234a、236a上的突起238接合凸脊116的近侧端116a。突起238与形成在壳体110的内筒部114中的凸脊116的近侧端116a的接合将运送构件202紧固到装载单元100。
只要锁定构件206的圆筒状主体260的近侧端260a保持定位在相应的支腿234、236的自由端234a、236a之间，就能防止相应的第一和第二支腿234、236的自由端234a、236a径向向内弯曲。由于防止了支腿234、236的自由端234a、236a向内弯曲，所以形成在自由端234a、236a上的突起238保持与凸脊116的近侧端116a接触，从而确保运送构件202保持紧固到装载单元100。形成在锁定构件206的圆筒状主体260的支腿262的自由端262a上的突起264接合运送构件202的基部210以相对于运送构件202保持锁定构件206的圆筒状主体260。
特别参照图17，如上所述，当运送帽组件200的运送构件202附接到装载单元100时，运送帽组件200的运送构件202的外环形延伸部240的第一和第二外支腿246、248穿过形成在装载单元100的刀具组件140的刀杆142中的开口145而被接纳。转向图19，当穿过刀杆142的开口145被接纳时，外支腿246、248中的每个外支腿接合推动器组件130的推动器构件132。只要运送构件202紧固到装载单元100，推动器构件132与外支腿246、248的接合就能防止推动器构件132的纵向移动。
现在参照图20，如上所述，当运送帽组件200的运送构件202附接到装载单元100时，第一和第二架状物242、244围绕壳体110的内筒部114被接纳。形成在相应的第一和第二架状物242、244上的肋部242a、244a接合布置为与装载单元100的刀具组件140的刀杆142的远侧端142b相邻的架状突出物146。只要运送构件202紧固到装载单元100，第一和第二架状物242、244的肋部242a、244a与刀杆142的接合就能防止刀杆142的纵向移动。
当运送帽组件200的运送构件202紧固到装载单元100时，导引构件204可以紧固到运送构件202。替代地，装载单元100可以在没有导引构件204的情况下使用。导引构件204以上述方式紧固到运送构件202。特别地，导引构件204相对于运送构件202定位使得运送构件202的凸缘220对准形成在导引构件204的主体250中的纵向狭槽253。然后导引构件204相对于运送构件202纵向推进，使得凸缘220接纳在纵向狭槽253中。随着导引构件204相对于运送构件202被推进，从导引构件204的圆锥形主体250的近侧端250a延伸的凸出部252被接纳在形成于运送构件202的基部210中的开口213内。基部210的斜部213a以及凸出部252的逐渐变细的近侧端252a利于凸出部252接纳在开口213内。形成在每个凸出部252上的凸起254以及凸出部252和开口213的中心线“C1”、“C2”(图12)的偏移定位，确保导引构件204保持紧固到运送构件202。
能够预想到的是，装载单元100在预先附接了运送帽组件200的情况下被提供给临床医师，然而，运送帽组件200可以与装载单元100分离地提供给临床医师。如上所述，运送帽组件200的导引构件204可以附接到运送构件202或可能需要附接到运送构件202。能够预想到的是，运送帽组件200可以作为具有一个或多个有替代构造的导引构件(参见，例如，图24)的成套工具来提供。还能预想到的是，运送帽组件可以不具有导引构件(图26)。
装载单元100可以以任何传统方式紧固到接合器组件(未显示)或吻合装置(未显示)的致动单元(未显示)，其中，接合器组件连接到吻合装置(未显示)的致动单元(未显示)。如上所述，在一个实施例中，装载单元100利用卡口联接紧固到接合器组件。当附接到致动单元时，装载单元100以传统方式定位在患者的体腔内。装载单元100的定位可以是穿过切口或进入端口，或以任何其他方式。运送帽组件200的导引构件204利于装载单元100的定位。用于取回运送帽组件200的线“W”(图21)、绳、缝合线或其他工具可以在定位装载单元100之前使用形成在导引构件204的圆锥形主体250的远侧端250b上的通孔257来紧固到运送帽组件200。
注意的是，运送帽组件具有带凸缘220的运送构件202。凸缘220具有与导引构件204的圆锥形主体250的内部空间对应的逐渐变细的形状。可以设置狭槽253，用于接纳凸缘220以及将运送构件连接到导引构件。此外，运送构件具有可移动的锁定构件206，将运送构件紧固到装载单元100。例如，锁定构件206可以沿近侧方向是能移动的，以锁定运送构件在装载单元上的位置。在本文公开的任何实施例中，考虑具有预先附接的装载单元、导引构件以及运送构件的成套工具。可以提供不同尺寸的装载单元；更具体地，吻合钉线具有不同直径。导引构件和运送构件可以设置成预先附接以用于在肥胖治疗手术操作中频繁使用的尺寸，而不设置在不同尺寸的装载单元中，例如那些频繁用于结肠直肠手术操作的装载单元。运送构件的另一个潜在的益处是装载安全性。再装载器的过度操纵可以引起吻合钉和/或刀具的过早移动，但是运送构件使得能够在没有吻合钉或刀具被用户接触的危险的情况下，实现用户的手在再装载器/装载单元的顶部上方的人体工程学的放置。
现在参照图21，当定位在患者的体腔内时，运送帽组件200在砧座组件(未显示)可以附接到装载单元100并且组织(未显示)可以被吻合之前从装载单元100分离。通过套管针“T”的如箭头“E”所示的远侧推进至接合锁定构件206的近侧端260，实现了运送帽组件200与装载单元100的分离。套管针“T”的继续远侧推进引起锁定构件206向远侧位置移动。当锁定构件206处于远侧位置时，锁定构件206的圆筒状主体260的近侧端260a不再定位在运送构件202的内环形延伸部230的相应的第一和第二支腿234、236的自由端234a、236a之间。如此，相应的第一和第二支腿234、236的自由端234a、236a能够径向向内弯曲。
当形成在锁定构件206的圆筒状主体260的连接端262b之间的槽口266接合运送构件202的基部210时，套管针“T”的相对于装载单元100的继续远侧移动抵靠运送帽组件200的运送构件202施加一力。由于不再防止相应的第一和第二支腿234、236的自由端234a、236a径向向内弯曲，通过套管针“T”的远侧移动施加在运送构件202上的力引起相应的第一和第二支腿234、236的自由端234a、236a径向向内弯曲。相应的第一和第二支腿的自由端234a、236a的弯曲引起形成在自由端234a、236a中的每个自由端上的突起238与形成在装载单元100的壳体110的内筒部114上的凸脊116的近侧端116a脱离。这样，运送帽组件200的运送构件202不再紧固到装载单元100。套管针“T”的继续远侧移动引起运送构件202与装载单元100分离。
当运送帽组件200的运送构件202与装载单元100完全分离时，可以以传统方式使用装载单元100来吻合组织。可以使用线“W”或以任何其他适合的方式将运送帽组件200从体腔(未显示)内取回。
导引构件与运送帽一起使用，以有助于装置插入体腔。如上所述，当器械头部处于操作空间中时，导引构件和运送构件可以从装置射出。导引构件和运送构件通过用于移出的缝合线保持。
参照图22和图23，根据本公开的运送组件的替代实施例总体显示为运送帽组件300。运送帽组件300与上文所述的运送帽组件200大致相似，然而，运送帽组件300不包括导引组件。这样，运送帽组件300的运送构件302的基部310不包括用于接纳导引组件的凸出部的开口。运送帽组件300以与运送帽组件200附接到装载单元100以及从装载单元100分离的方式相同的方式而附接到装载单元100以及从装载单元100分离。
现在参照图24至图26，根据本公开的运送组件的另一个实施例总体显示为运送帽组件400。运送帽组件400与运送帽组件200大致相同，因此将仅描述关于其间的区别。与包括运送构件202(图3)和分离的导引构件204(图3)的运送帽组件200不同，运送帽组件400的运送构件402包括与基部410一体地形成的导引部404。尽管显示为与运送构件402的基部410一体地形成，但能够预想到的是，导引部404可以使用粘合剂、机械紧固件或以任何其他适合的方式牢固地紧固到基部410。
继续参照图24至图26，运送构件402的导引部404限定了大致圆锥形主体450，圆锥形主体450限定了贯通其中延伸的一对纵向狭槽451和沿其外表面形成的多个切口453。纵向狭槽451构造为接纳形成在锁定构件406的圆筒状主体460的远侧端460b上的支腿462。纵向狭槽451完全延伸穿过导引部404的圆锥形主体450以允许支腿462的进入，从而使锁定构件406在运送帽组件400附接到装载单元100期间能从远侧位置(未显示)向近侧位置(图26)移动。导引组件404的圆锥形主体450中的切口453可以构造为利于由用户操作性接合。替代地，和/或除此之外，切口453可以构造为利于装载单元100插入体腔(未显示)。
运送帽组件400以与运送帽组件200附接到装载单元100大致相同的方式而附接到装载单元100，然而，如上所述，导引部450与运送构件402的基部410一体地形成，因此，导引部450不是必须独立地紧固到基部410。此外，锁定构件406的圆筒状主体460的支腿462的进入以使锁定构件406从远侧位置(未显示)向近侧位置(图26)移动从而将运送构件402紧固到装载单元100，是通过形成在导引部404的圆锥形主体450内的纵向狭槽451。
尽管在此处已经参照附图描述了本公开的示例性的实施例，但是，需要理解的是，本公开不限于那些具体的实施例，而是，本领域的技术人员可以在不偏离本公开的范围或主旨的条件下，于此处实现各种其他变化和改进。

Claims (14)

1.一种装载单元，包括：
壳体；
吻合钉推动器组件，其操作性地保持在所述壳体内；
刀具组件，其操作性地保持在所述壳体内；
钉仓组件，其布置在所述壳体的远侧端上并且支撑环形阵列的吻合钉；以及
运送组件，其操作性地布置为与所述钉仓组件相邻，其中所述运送组件包括：
运送构件，其选择性地紧固至所述壳体；以及
锁定构件，其可滑动地布置在所述运送构件内并且在近侧位置和远侧位置之间是能移动的，其中，在所述近侧位置，所述运送构件紧固到所述壳体，而在所述远侧位置，所述运送构件是能从所述壳体移除的，
其中所述运送构件包括外环形延伸部，所述外环形延伸部具有至少一个架状物和至少一个外支腿，其中所述至少一个架状物接合所述刀具组件以防止刀具组件的移动，所述至少一个外支腿接合所述吻合钉推动器组件以防止所述吻合钉推动器组件的移动。
2.根据权利要求1所述的装载单元，其中所述运送构件包括基部，所述基部具有定位成与所述钉仓组件相邻以将多个吻合钉保持在所述钉仓组件内的吻合钉保持表面。
3.根据权利要求1所述的装载单元，其中所述运送构件包括内环形延伸部，其具有一对支腿，每个支腿都构造为选择性地接合所述壳体以将所述运送组件紧固至所述壳体。
4.根据权利要求1所述的装载单元，其中所述运送构件包括构造用于能由用户操作性接合的凸缘部。
5.根据权利要求4所述的装载单元，其中所述运送组件进一步包括选择性地能紧固至所述凸缘部的导引构件。
6.根据权利要求5所述的装载单元，其中所述导引构件包括圆锥形形状。
7.根据权利要求5所述的装载单元，其中所述导引构件包括用于接纳取回用绳的通孔。
8.根据权利要求5所述的装载单元，其中所述导引构件构造为利于所述装载单元穿过管腔插入。
9.根据权利要求1所述的装载单元，其中所述运送构件包括导引部。
10.一种用于手术吻合器的装载单元的运送组件，所述运送组件包括：
运送构件，其包括基部、从所述基部向远侧延伸的凸缘以及从所述基部向近侧延伸的内环形延伸部；以及
锁定构件，其可滑动地布置在所述内环形延伸部内并且在近侧位置和远侧位置之间是能移动的，其中，在所述近侧位置，所述运送构件紧固到装载单元，而在所述远侧位置，运送构件是能从装载单元移除的，
进一步包括外环形延伸部，其具有至少一个架状物以及超过架状物延伸的至少一个支腿。
11.根据权利要求10所述的运送组件，其中所述基部包括将多个吻合钉保持在装载单元的钉仓内的吻合钉保持表面。
12.根据权利要求10所述的运送组件，进一步包括选择性地能紧固至所述凸缘的导引构件。
13.根据权利要求12所述的运送组件，其中所述导引构件包括圆锥形形状。
14.根据权利要求12所述的运送组件，其中所述导引构件包括用于接纳取回用绳的通孔。
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JP2016013437A (ja) 2016-01-28
CA2893172C (en) 2024-01-02
US10709445B2 (en) 2020-07-14
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EP2962648A1 (en) 2016-01-06
AU2019204994A1 (en) 2019-08-01
JP6567899B2 (ja) 2019-08-28
US20170333036A1 (en) 2017-11-23
AU2015202932A1 (en) 2016-01-21
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US9730694B2 (en) 2017-08-15
AU2019204994B2 (en) 2020-10-29

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