CN105640609B - 腹腔镜手术结扎施夹器 - Google Patents

腹腔镜手术结扎施夹器 Download PDF

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CN105640609B
CN105640609B CN201510868226.8A CN201510868226A CN105640609B CN 105640609 B CN105640609 B CN 105640609B CN 201510868226 A CN201510868226 A CN 201510868226A CN 105640609 B CN105640609 B CN 105640609B
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clip module
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克里斯托弗·A·托卡扎
诺文·阿西多
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122Clamps or clips, e.g. for the umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004(bio)absorbable, (bio)resorbable or resorptive
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477Coupling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B2017/12004Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft

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Abstract

本发明提供了一种结扎施夹器,该结扎施夹器包括:手柄组件,其支撑推进机构,推进机构可移除地以及可滑动地支撑在手柄组件的圆筒壳体内;以及夹模块,其可移除地以及选择性地连接至手柄组件。夹模块包括:壳体,壳体限定了近侧端部、远侧端部以及贯通其中的腔室,夹模块壳体包括沿径向延伸进其腔室的环形凸缘;以及钳夹刀片,其可滑动地支撑在夹模块壳体的腔室内。钳夹刀片包括布置在夹模块壳体的远侧端部内的一对钳夹,一对钳夹偏置至打开状态,其中,每个钳夹均包括从其中突出的相应的凸轮齿,其中,凸轮齿与夹模块壳体的环形凸缘可操作地对准并且在夹模块壳体的环形凸缘的近侧。

Description

腹腔镜手术结扎施夹器
相关申请的交叉引用
本申请要求提交于2014年12月2日的美国临时专利申请序号62/086,250的利益以及优先权,其整个内容通过引用方式并入此处。
技术领域
本公开通常涉及一种与手术结扎夹一起使用的医疗器械。尤其,本公开针对用于在待闭塞的脉管周围定位、稳固以及闭合手术结扎夹(来自装载至夹仓(clip cartridge)或者夹包(clip pack)中的多个结扎夹)的模块化施夹器。
背景技术
内窥镜吻合器以及施夹器在本领域中是公知的,用于许多不同的以及有用的手术操作。在腹腔镜手术操作的情形下,进入腹部的内部是通过将窄管或者插管插入皮肤中的小的入口切口而实现的。在身体的其它地方执行的微创操作通常一般称为内窥镜操作。典型地,管或者插管设备通过入口切口延伸进患者的身体以提供进入口件。该口件允许外科医生使用套管针插入通过其中的许多不同的手术器械并且用于执行远离切口的手术操作。
在大多数这些操作期间,外科医生必须经常终止血或者另一流体流动通过一个或多个脉管。外科医生将经常施加手术夹至血管或者另一导管以防止在操作期间体液流动通过其中。在本领域中公知的内窥镜施夹器是用于在进入体腔期间施加单个夹。这种夹典型地由生物相容材料制备并且通常被压缩在整个脉管上。一旦施加至脉管,压缩夹终止流体流动通过其中。
内窥镜施夹器包括活动钳夹,它们能够在单次进入体腔期间在内窥镜或者腹腔镜操作中施加多个夹,在Green等人的共同转让的美国专利5,084,057和5,100,420中描述了该内窥镜施夹器,这两个专利的全部内容都通过引用方式并入此处。另一多内窥镜施夹器公开于Pratt等人共同转让的美国专利5,607,436中,其内容全部通过引用方式并入此处。尽管不是必要的,但是这些设备典型地使用在单次手术操作期间。其公开通过引用方式并入此处的Pier等的美国专利5,695,502公开了可重复消毒的手术施夹器。施夹器在单次插入体腔期间推进多个夹并且使多个夹成形。该可重复消毒的施夹器构造为接收可互换的夹盒(clip magazine)并且与可互换的夹盒协作以便在单次进入体腔期间推进多个夹并且使多个夹成形。
其他施夹器包括固定钳夹,它们在内窥镜或者腹腔镜操作中施加单个夹,然后必须从体腔撤回以便装载另外的单个夹,用于在体腔内进一步施加。Allen等人的美国专利5,354,304的公开通过引用方式并入此处,其公开了这种固定钳夹式手术施夹器。通常,使用这些施夹器包括:由施夹器的外科医生致动以发射单个夹;从患者体腔撤回施夹器;从施夹器的手柄组件移除已耗尽的夹仓(曾经收容单个夹);以及为了发射另一手术夹而装载新的夹仓至手柄组件上。
因此,对于如下的腹腔镜手术施夹器存在需要:该腹腔镜手术施夹器包括可重复使用的手柄组件,可重复使用的轴组件;以及一次性使用的夹仓组件,其中每个夹仓组件装载有多个手术结扎夹。
发明内容
本公开涉及一种能够在待闭塞的脉管周围定位、稳固以及闭合手术结扎夹(来自装载至夹仓或者夹包中的多个结扎夹)的腹腔镜模块化手术施夹器。
根据本公开的方案提供了一种结扎施夹器。结扎施夹器包括手柄组件以及夹模块。
手柄组件包括:圆筒壳体,在其中限定空腔;固定手柄,其从圆筒壳体延伸;扳机,其枢转地连接至固定手柄,扳机包括延伸进圆筒壳体的空腔内的近侧端部;细长颈部,其支撑在圆筒壳体上并且从圆筒壳体延伸出,细长颈部包括限定贯通其中的腔室的管状轴,其中,颈部的管状轴的腔室延伸进圆筒壳体的空腔;以及推进机构,其可移除地并且可滑动地支撑在圆筒壳体内以及颈部的管状轴的腔室内,其中,推进机构能由扳机致动。
推进机构包括:推进轴,其具有近侧端部和远侧端部;致动器,其支撑在推进轴的远侧端部处;以及偏置构件,其沿近侧方向推动推进轴。
夹模块可移除地并且选择性地连接至颈部的管状轴的远侧端部。夹模块包括:壳体,其限定了近侧端部、远侧端部以及通过其中的腔室;夹模块壳体的近侧端部构造为用于选择性地连接至颈部的管状轴的远侧端部;夹模块壳体包括沿径向延伸进其腔室的环形凸缘。
夹模块包括可滑动地支撑在夹模块壳体的腔室内的钳夹刀片。钳夹刀片包括布置在夹模块壳体的远侧端部内的一对钳夹,所述一对钳夹偏置至打开状态,其中,每个钳夹均包括从其突出的相应的凸轮齿,其中,凸轮齿与夹模块壳体的环形凸缘可操作地对准并且在夹模块壳体的环形凸缘的近侧;以及杆部,其从一对钳夹向近侧延伸,其中,杆部的近侧端部能够由推进机构的致动器的远侧端部接合。
夹模块可以进一步包括偏置构件,其构造为保持钳夹刀片相对于夹模块壳体处于缩回位置。
夹模块的钳夹刀片可以在推进位置和缩回位置之间移动,其中,在推进位置,钳夹刀片的一对钳夹的凸轮齿接合夹模块壳体的环形凸缘,其中,一对钳夹接近至闭合状态;在缩回位置,钳夹刀片的一对钳夹的凸轮齿脱离于夹模块壳体的环形凸缘,其中,一对钳夹处于打开状态。
夹模块的偏置构件可以是盘簧,其包括:第一端部,其稳固至钳夹刀片的较远侧部分;以及第二端部,其稳固至夹模块壳体的较近侧端部。
在使用中,在手柄组件的扳机致动期间,扳机的近侧端部可以接合推进机构的推进轴的近侧端部以向远侧推进该推进轴。
在使用中,在推进轴的向远侧推进期间,推进组件的致动器可以接合钳夹刀片的杆部的近侧端部以向远侧推进钳夹刀片。
夹模块壳体可以限定形成在其外表面中的径向凹槽,其中,径向凹槽定位成邻近夹模块壳体的近侧端部。
细长颈部的管状轴可以包括枢转地支撑而邻近其远侧端部的卡掣(latch),其中,卡掣包括近侧端部和远侧端部,其中,卡掣的远侧端部包括沿径向向内延伸的棘爪。
管状轴的卡掣的棘爪可以构造为选择性地接合夹模块壳体的径向凹槽以选择性地稳固夹模块至细长轴。
在使用中,在致动扳机时,扳机的近侧端部可以作用于推进机构的致动器的近侧端部上以向远侧推进致动器。
依然在使用中,在向远侧推进致动器时,致动器的远侧端部可以作用于钳夹刀片的杆部的近侧端部上以向远侧推进钳夹刀片。
此外,在使用中,在向远侧推进钳夹刀片时,钳夹刀片的一对钳夹的凸轮齿可以接合夹模块壳体的环形凸缘,由此一对钳夹接近至闭合状态。
根据本公开的另一方案,提供了一种夹模块,其用于选择性地连接至手柄组件以及能够由手柄组件的推进机构致动。夹模块包括壳体,壳体限定了近侧端部、远侧端部以及贯通其中的腔室,夹模块壳体的近侧端部构造为用于选择性地连接至手柄组件的管状轴的远侧端部,夹模块壳体包括沿径向延伸进其腔室的环形凸缘。
夹模块还包括可滑动地支撑在夹模块壳体的腔室内的钳夹刀片。钳夹刀片包括:布置在夹模块壳体的远侧端部内的一对钳夹,一对钳夹偏置至打开状态,其中,每个钳夹均包括从其突出的相应的凸轮齿,其中,凸轮齿与夹模块壳体的环形凸缘可操作地对准并且在夹模块壳体的环形凸缘的近侧;以及从一对钳夹向近侧延伸的杆部。杆部的近侧端部能够由手柄组件的推进机构接合。
夹模块可以进一步包括偏置构件,偏置构件构造为保持钳夹刀片相对于夹模块壳体处于缩回位置。
夹模块的钳夹刀片可以在推进位置和缩回位置之间移动,其中,在推进位置,钳夹刀片的一对钳夹的凸轮齿接合夹模块壳体的环形凸缘,其中,一对钳夹接近至闭合状态;在缩回位置,钳夹刀片的一对钳夹的凸轮齿脱离于夹模块壳体的环形凸缘,其中,一对钳夹处于打开状态。
夹模块的偏置构件可以是盘簧,其包括:第一端部,其稳固至钳夹刀片的较远侧部分;以及第二端部,其稳固至夹模块壳体的较近侧端部。
在使用中,在致动手柄组件的推进机构期间,钳夹刀片的杆部可以被作用以向远侧推进钳夹刀片。
夹模块壳体可以限定形成在其外表面中的径向凹槽,其中,径向凹槽定位成邻近夹模块壳体的近侧端部。
附图说明
此处参考附图公开了腹腔镜手术施夹器的特定实施例,其中:
图1是根据本公开的结扎手术施夹器的侧视图;
图2是图1的结扎手术施夹器的手柄组件和颈部的近侧端部的部件分离的立体图;
图3是图1的结扎手术施夹器的推进机构的立体图;
图4是图1的结扎手术施夹器的颈部的远侧端部的示意性侧视图,装载后的腹腔镜夹模块附接于其上;
图5是图4所示的结扎手术施夹器的颈部的远侧端部和腹腔镜夹模块的示意性截面侧视图;
图6是结扎手术施夹器的近侧端部的剖视图,示出手柄组件处于三个不同的位置;
图7是图1的结扎手术施夹器的颈部的远侧端部的示意性侧视图,示出附接至其上的装载后的腹腔镜夹模块的发射;以及
图8是图1的结扎手术施夹器的颈部的远侧端部的示意性侧视图,示出附接至其上的耗尽的腹腔镜夹模块。
具体实施方式
现在将参考附图详细描述根据本公开的结扎手术施夹器的实施例,其中,类似附图标记识别类似或者相同结构元件。如附图所示以及正如整个说明书描述的,作为传统,当提及在手术器械上的相对定位时,术语“近侧”指的是更靠近用户的装置的端部,术语“远侧”指的是更远离用户的装置的端部。
如图1所示,根据本公开的实施例的结扎手术施夹器通常指代为100。施夹器100包括:手柄组件110;细长的圆形或者柱形颈部或者组件120,其从手柄组件110突出或者从手柄组件110延伸出;以及结扎夹模块140,其能够可移除地以及选择性地安装在颈部120的远侧端部上。正如以下将更详细描述的,多个手术结扎夹“C”(图5和图7)装载至结扎夹模块140中。而且,正如以下将更详细描述的,在操作中,当手柄组件110被致动时,单个结扎夹“C”被发射并且在待被结扎的脉管周围成形。
如图1和图2所示,手柄组件110包括固定手柄112和在枢轴116处枢转地附接至固定手柄112的可压挤扳机114。可压挤扳机114包括近侧致动端部114a。
手柄组件110包括壳体,壳体呈圆筒118的形式并且支撑在固定手柄112上。圆筒118构造为接收颈部120的近侧端部。螺纹端盖119封闭圆筒118的近侧端部。如图2所示,圆筒118由具有逐渐减小直径的第一圆筒部分118a、第二圆筒部分118b和第三圆筒部分118c形成,第一圆筒部分118a、第二圆筒部分118b和第三圆筒部分118c一起形成望远镜状的外观结构。第三圆筒部分118c在其远侧端部包括沿径向突出的唇缘。
如图2所示,细长颈部或者组件120的近侧端部包括中空管或者轴122以及稳固至其上且在其近侧端部敞开的套圈(collar)124。中空轴122的近侧端部具有两个对置布置的J形凹口122a(例如,“卡销(bayonet lock)”或者通道)以将细长颈部120稳固至手柄组件110。
轴122和套圈124以及整个手柄组件110可以由例如不锈钢的高级手术钢制成,或者由高强度可热压聚合物等制成。
为了组装颈部120和手柄组件110,有弹力的波形垫圈和第一衬套(bushing)放置在轴122的近侧端部上。如图6图示的,轴122插入圆筒组件118的敞开的远侧端部,直到第一衬套上的边缘抵接第三圆筒部分118c上的周向唇缘。具有柱形部分以及周向边缘的第二衬套以及卡口环锁然后插入圆筒118的敞开的近侧端部并且插到轴122的近侧端部上。暂时参考图6,第二衬套被插入,直到其边缘抵接形成在圆筒118的第二圆筒部分118b和第三圆筒部分118c之间的径向突出脊。卡口环锁可以包括一对从其内柱形表面向内突出的一对对置的销,该一对对置的销构造为装配至J状凹口122a中并且锁定手柄组件110中的细长颈部120。
参考图3和图6,颈部120包括可滑动地布置在其中空轴122内的推进机构130。推进机构130包括推进轴132,推进轴132在其远侧端部处支撑致动器134。如图3所示,致动器134具有柱形部分134a,并且逐渐变细为具有大致矩形截面轮廓的扁平刀片状部分134b。
推进轴132通过压缩复位弹簧136被朝向颈部120的近侧端部推动。弹簧136的近侧端部可以抵接轴适配器138。
在颈部120连接至手柄组件110的圆筒118的情况下,通过将推进轴132插入圆筒118的近侧端部中而将推进轴132组装在颈部120中。如图6所示,短止动销122a从中空轴122的内表面在其中间区域向内延伸。当推进轴132通过中空轴132插入时,滑动衬套抵接止动销122a并且停留在该位置。推进轴132的进一步插入将致使弹簧136接合轴适配器138,从而在逆着可压挤扳机114的近侧致动端部114a的向后方向上偏置推进轴132。当推进轴132完全插入颈部120中时,螺纹端盖119可以放置在或者螺接在圆筒118的近侧端部上。
参考图6,当可压挤扳机114沿逆时针方向绕着枢轴116枢转时,可压挤扳机114的顶部或者致动端部114a接合轴适配器138的近侧端部,从而逆着弹簧136的偏置力向远侧推动推进轴132。
图5图示了结扎夹模块140如何附接至中空轴122的远侧端部。具体地,弹簧加载的卡掣126枢转地安装在中空轴122的壁中。卡掣126的远侧端部设置有棘爪126a。结扎夹模块140具有直径减小的壳体段142b,壳体段142b装配进中空轴122的敞开的远侧端部。为了将结扎夹模块140稳固于中空轴122上,卡掣126的近侧端部被向下压(沿箭头“A”的方向)以提升棘爪126a。然后,将结扎夹模块140的直径减小的壳体段142b插入中空轴122的敞开的远侧端部,卡掣126的近侧端部被释放,使得棘爪126a卡住结扎夹模块140的直径减小的壳体段142b中的横向或者径向凹槽142c以将结扎夹模块140可靠地锁定在颈部120中。有利地,卡掣126的棘爪126a可以设置有凸轮表面,凸轮表面安置于结扎夹模块140的直径减小的壳体段142b的近侧末端上。以该方式,当结扎夹模块140插入颈部120时,棘爪126a的凸轮表面被自动引导至结扎夹模块140的凹槽142c。
作为安全特征,当卡掣126枢转至打开位置时,卡掣126的近侧端部抵接致动器134的扁平刀片状部分134b并且防止推进轴132在中空轴122中向前移动更远。
类似地,当结扎夹模块140适当地安装在颈部120上并且推进轴132被推进以施加结扎夹时,如下所述,致动器134的柱形段134a防止卡掣126的近侧端部被按压而释放结扎夹模块140。
参考图4、图5、图7和图8,示出了结扎夹模块140的各个部件。结扎夹模块140包括壳体142,壳体142具有第一直径的远侧壳体段142a以及具有从第一直径减小的第二直径的近侧壳体段142b。近侧壳体段142b在其中限定外环形凹槽或者凹进部142c。腔室142d纵向延伸通过壳体142。壳体142包括环形凸缘142e,环形凸缘142e在壳体142的远侧端部限定沿径向向内延伸的凸轮表面。
结扎夹模块140包括可滑动地支撑在壳体142的腔室142d内的钳夹刀片144。钳夹刀片144包括:一对钳夹144a,其从壳体142内突出或者从壳体142内向远侧延伸;以及近侧杆部144b,其向近侧延伸通过壳体142的腔室142d。钳夹刀片144由诸如不锈钢的有弹力的材料制成,并且形成为使得一对钳夹144a彼此隔开或者偏置而彼此分开。每个钳夹144a包括从其中突出的凸轮齿144c,凸轮齿144c构造为当钳夹刀片144被向远侧推进时接合壳体142的环形凸缘142e。在操作中,参考图7和图8,随着钳夹刀片144向远侧推进,一对钳夹144a的凸轮齿144c接合壳体142的环形凸缘142e,从而导致一对钳夹144的闭合或者接近。
结扎夹模块140进一步包括偏置构件146,偏置构件146起到保持钳夹刀片144相对于壳体142处于缩回位置的作用,由此由于其自然弹簧偏置而将一对钳夹144a保持在打开状态。可替换地,偏置构件146可以用来作用于钳夹刀片144上,使得一对钳夹144a的外表面抵着壳体142的环形凸缘142e的远侧边缘进行凸轮运动。在实施例中,例如,偏置构件146可以是绕着钳夹刀片144的杆部144b布置的盘簧,并且可以包括第一端部和第二端部,第一端部稳固至钳夹刀片144的较远侧部分(例如,稳固至套圈或者钳夹刀片144的凸缘),第二端部稳固至壳体142的较近侧部分。
正如能够认识到的,结扎夹模块140是一次性使用的。此外,通过使用壳体142的标准尺寸的直径减小的近侧段142b,用于安装各种尺寸结扎夹的不同尺寸的模块能够易于连接至同一中空轴122上。
参考图5-图8,描述了施夹器100的示范操作。如图5图示的,当结扎夹模块140稳固至颈部120时,结扎夹“C”(图5和图7)被装载在结扎夹模块140的一对钳夹144a中并且准备好被发射。当施夹器100装载有保持结扎夹“C”于一对钳夹144a之间的结扎夹模块140并且准备好被发射时,结扎夹“C”可以定位在待被结扎的脉管周围。
参考图6和图7,在结扎夹“C”处于待被结扎的脉管周围的位置的情况下,扳机114的压挤或者致动将引起向远侧推进颈部120的推进轴132(图3和图6),正如图7的箭头“B”指示的。随着颈部120的推进轴132向远侧推进,致动器134的扁平刀片状部分134b被推进以抵接钳夹刀片144的杆部144b。此外,随着颈部120的推进轴132向远侧推进,推进机构130的复位弹簧136被压缩。
致动器134的扁平刀片状部分134b沿远侧方向推动钳夹刀片144,从而逆着结扎夹模块140的壳体142的环形凸缘142e驱动一对钳夹144a的凸轮齿144c,从而使一对钳夹144a逆着其弹簧偏置而闭合或者接近以使结扎夹“C”成形。随着钳夹刀片144向远侧推进,偏置构件146伸展或者伸长。
参考图8,在结扎夹“C”成形之后,扳机114被释放,由此复位弹簧136自由展开,因而撤回颈部120的推进轴132。随着颈部120的推进轴132被撤回,致动器134的扁平刀片状部分134b缩回而不与钳夹刀片144的杆部144b接触。随着致动器134从钳夹刀片144的杆部144b缩回,偏置构件146自由地再压缩或者缩回,从而从结扎夹模块140的壳体142的环形凸缘142e撤回一对钳夹144a的凸轮齿144c,从而由于其弹簧偏置而允许一对钳夹144a打开。
继续参考图8,在致动器134缩回时,致动器134的扁平刀片状部分134b与颈部120的卡掣126的近侧端部对准。当这样定位时,卡掣126的近侧端部可以被向下压(沿图5的箭头“A”的方向)以从结扎夹模块140的直径减小的近侧壳体段142b的横向或者径向凹槽142c将棘爪126a升高以及脱离,从而允许用尽的结扎夹模块140与颈部120断开连接。可替换地,在结扎夹模块140从颈部120断开连接并且将其丢弃之前,用尽的结扎夹模块140可以重新装载有新的结扎夹(包含在夹包中)。
新的结扎夹模块140然后能够被插入以及稳固在颈部120的中空轴122中,施夹器100再次准备好发射另一结扎夹“C”。
结扎夹“C”可以包含在含有多个夹(诸如六(6)个夹等)的夹包中。夹包可以装载有整组金属夹(例如,钛、不锈钢或者金属合金)、整组聚合物夹(例如,生物相容或者生物可吸收的)或者它们的组合。
虽然上文已经详细描述了本公开的具体实施例,但是应该理解的是,该说明书仅仅是为了示意目的。除了上文描述的优选实施例之外,本领域的技术人员可以对与优选实施例的公开方案对应的等同结构进行各种修改,这并不偏离随附权利要求中所限定的本公开的精神,随附权利要求的范围与最广义的阐释相一致从而包含这种修改以及等同结构。

Claims (17)

1.一种结扎施夹器,包括:
手柄组件,其包括:
圆筒壳体,在其中限定空腔;
固定手柄,其从所述圆筒壳体延伸;
扳机,其枢转地连接至所述固定手柄,所述扳机包括延伸进所述圆筒壳体的所述空腔的近侧端部;
细长颈部,其支撑在所述圆筒壳体上并且从所述圆筒壳体延伸出,所述细长颈部包括限定贯通其中的腔室的管状轴,其中,所述细长颈部的所述管状轴的所述腔室延伸进所述圆筒壳体的所述空腔;以及
推进机构,其可移除地以及可滑动地支撑在所述圆筒壳体和所述细长颈部的所述管状轴的所述腔室内,其中,所述推进机构能由所述扳机致动,所述推进机构包括:
推进轴,其具有近侧端部和远侧端部;
致动器,其支撑在所述推进轴的远侧端部处;以及
偏置构件,其沿近侧方向推动所述推进轴;以及
夹模块,其可移除地以及选择性地连接至所述细长颈部的所述管状轴的远侧端部,所述夹模块包括:
壳体,其限定了近侧端部、远侧端部以及贯通其中的腔室,所述夹模块壳体的近侧端部构造为用于选择性地连接至所述细长颈部的所述管状轴的远侧端部,所述夹模块壳体包括沿径向延伸进其腔室的环形凸缘;以及
钳夹刀片,其可滑动地支撑在所述夹模块壳体的所述腔室内,所述钳夹刀片包括:
一对钳夹,其布置在所述夹模块壳体的远侧端部内,所述一对钳夹偏置至打开状态,其中,每个钳夹均包括从其上突出的相应的凸轮齿,其中,所述凸轮齿与所述夹模块壳体的所述环形凸缘可操作地对准并且在所述夹模块壳体的所述环形凸缘的近侧;以及
杆部,其从所述一对钳夹向近侧延伸,其中所述杆部的近侧端部由所述推进机构的所述致动器的远侧端部接合,
其中所述钳夹刀片可滑动地支撑在所述夹模块壳体的所述腔室内,使得在向远侧推进所述钳夹刀片时,所述钳夹刀片的所述一对钳夹的所述凸轮齿接合所述夹模块壳体的所述环形凸缘,由此所述一对钳夹接近至闭合状态。
2.根据权利要求1所述的结扎施夹器,其中,所述夹模块进一步包括偏置构件,所述偏置构件构造为保持所述钳夹刀片相对于所述夹模块壳体处于缩回位置。
3.根据权利要求2所述的结扎施夹器,其中,所述夹模块的所述钳夹刀片能够在推进位置和缩回位置之间移动,其中:
在推进位置,所述钳夹刀片的所述一对钳夹的所述凸轮齿接合所述夹模块壳体的所述环形凸缘,其中,所述一对钳夹接近至闭合状态;以及
在缩回位置,所述钳夹刀片的所述一对钳夹的所述凸轮齿脱离于所述夹模块壳体的所述环形凸缘,其中,所述一对钳夹处于打开状态。
4.根据权利要求3所述的结扎施夹器,其中,所述夹模块的所述偏置构件是盘簧,所述盘簧包括稳固至所述钳夹刀片的较远侧部分的第一端部和稳固至所述夹模块壳体的较近侧端部的第二端部。
5.根据权利要求3所述的结扎施夹器,其中,在所述手柄组件的所述扳机致动期间,所述扳机的近侧端部接合所述推进机构的所述推进轴的近侧端部以向远侧推进所述推进轴。
6.根据权利要求5所述的结扎施夹器,其中,在向远侧推进所述推进轴期间,所述推进组件的所述致动器接合所述钳夹刀片的所述杆部的近侧端部以向远侧推进所述钳夹刀片。
7.根据权利要求1所述的结扎施夹器,其中,所述夹模块壳体限定形成在其外表面中的径向凹槽,其中,所述径向凹槽定位成邻近所述夹模块壳体的近侧端部。
8.根据权利要求7所述的结扎施夹器,其中,所述细长颈部的所述管状轴包括枢转地支撑而邻近其远侧端部的卡掣,其中,所述卡掣包括近侧端部和远侧端部,其中,所述卡掣的远侧端部包括沿径向向内延伸的棘爪。
9.根据权利要求8所述的结扎施夹器,其中,所述管状轴的所述卡掣的所述棘爪构造为选择性地接合所述夹模块壳体的所述径向凹槽以选择性地稳固所述夹模块至所述细长颈部的所述管状轴。
10.根据权利要求1所述的结扎施夹器,其中,在所述扳机致动时,所述扳机的近侧端部作用于所述推进机构的所述致动器的近侧端部上以向远侧推进所述致动器。
11.根据权利要求10所述的结扎施夹器,其中,在向远侧推进所述致动器时,所述致动器的远侧端部作用于所述钳夹刀片的所述杆部的近侧端部上以向远侧推进所述钳夹刀片。
12.一种夹模块,用于选择性地连接至手柄组件并且能够通过所述手柄组件的推进机构致动,所述夹模块包括:
壳体,其限定了近侧端部、远侧端部以及贯通其中的腔室,所述夹模块壳体的近侧端部构造为用于选择性地连接至所述手柄组件的管状轴的远侧端部,所述夹模块壳体包括沿径向延伸进其腔室的环形凸缘;
钳夹刀片,其可滑动地支撑在所述夹模块壳体的所述腔室内,所述钳夹刀片包括:
一对钳夹,其布置在所述夹模块壳体的远侧端部内,所述一对钳夹偏置至打开状态,其中,每个钳夹包括从其中突出的相应的凸轮齿,其中,所述凸轮齿与所述夹模块壳体的所述环形凸缘可操作地对准并且在所述夹模块壳体的所述环形凸缘的近侧;以及
杆部,其从所述一对钳夹向近侧延伸,其中,所述杆部的近侧端部能够由所述手柄组件的所述推进机构接合,
其中所述钳夹刀片可滑动地支撑在所述夹模块壳体的所述腔室内,使得在向远侧推进所述钳夹刀片时,所述钳夹刀片的所述一对钳夹的所述凸轮齿接合所述夹模块壳体的所述环形凸缘,由此所述一对钳夹接近至闭合状态。
13.根据权利要求12所述的夹模块,进一步包括偏置构件,所述偏置构件构造为保持所述钳夹刀片相对于所述夹模块壳体处于缩回位置。
14.根据权利要求13所述的夹模块,其中,所述夹模块的所述钳夹刀片能够在推进位置和缩回位置之间移动,其中:
在推进位置,所述钳夹刀片的所述一对钳夹的所述凸轮齿接合所述夹模块壳体的所述环形凸缘,其中,所述一对钳夹接近至闭合状态;以及
在缩回位置,所述钳夹刀片的所述一对钳夹的所述凸轮齿脱离于所述夹模块壳体的所述环形凸缘,其中,所述一对钳夹处于打开状态。
15.根据权利要求14所述的夹模块,其中,所述夹模块的所述偏置构件是盘簧,所述盘簧包括稳固至所述钳夹刀片的较远侧部分的第一端部和稳固至所述夹模块壳体的较近侧端部的第二端部。
16.根据权利要求15所述的夹模块,其中,在所述手柄组件的所述推进机构致动期间,所述钳夹刀片的所述杆部被作用以向远侧推进所述钳夹刀片。
17.根据权利要求12所述的夹模块,其中,所述夹模块壳体限定形成在其外表面中的径向凹槽,其中,所述径向凹槽定位成邻近所述夹模块壳体的近侧端部。
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