CN105682570B - 手术紧固件施加装置 - Google Patents
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Abstract
紧固件施加装置(20)包括砧座半部(100)和钉仓接收半部(200)，所述钉仓接收半部具有定尺寸为可释放地接收单次使用装载单元(“SULU”)(400)的远侧部和构造为支撑发射组件(500)的近侧部。发射组件包括静止壳体(502)和发射操作杆(516)，并且发射操作杆(516)具有一个或多个操作杆导向凸起(522)。发射操作杆能够从静止壳体的近侧端滑动到静止壳体的远侧端以限定发射行程。夹紧操作杆(300)能够从非夹紧位置向夹紧位置移动，以使远侧砧座部以与SULU紧密靠近的方式可释放地紧固。夹紧操作杆限定了一个或多个操作杆导向狭槽(316)。操作杆导向凸起定位成在发射行程开始时进入操作杆导向狭槽以抑制在发射行程期间夹紧操作杆向非夹紧位置移动。
Description
技术领域
本公开涉及一种手术紧固件施加装置，并且更具体地，涉及一种具有可重复使用的和一次性的部件的手术紧固件施加装置。
背景技术
如下的手术紧固件施加装置在本领域中是公知的：组织首先被抓握和夹紧在相对的钳夹结构之间，然后借助手术紧固件结合。在一些这样的装置中，提供刀具以切断通过紧固件结合的组织。尽管紧固件通常是手术吻合钉的形式，但是也可使用其它手术紧固件，诸如，例如，夹子或两部分聚合手术紧固件。
手术紧固件施加装置通常包括两个细长梁构件，所述两个细长梁构件用于捕获或夹紧其间的组织。通常情况下，梁构件中的一个承载有容纳布置为至少两个横排的多个吻合钉的一次性钉仓组件，而另一梁构件包括限定如下表面的砧座：所述表面用于当吻合钉被从钉仓组件驱动时形成吻合钉腿。在使用两部分紧固件的情况下，包括砧座的梁构件承载两部分紧固件的配合部件，例如接收器。
一般地，吻合钉形成过程受到由一个或多个纵向移动的凸轮构件和一系列单独的吻合钉推动器之间的相互作用的影响。由于凸轮构件纵向移动通过钉仓承载梁构件，单独的推动器构件向上偏置进入支撑在钉仓组件内的吻合钉的后跨部以从钉仓顺序地射出吻合钉。刀具可以设置为与凸轮构件一起在吻合钉排之间行进，以切割在形成的吻合钉排之间的组织。这种器械的例子公开在美国专利第7,631,794号中，上述专利的全部通过引用合并于此。
发明内容
本发明涉及一种将手术紧固件施加至组织的手术紧固件施加装置。在实施例中，手术紧固件施加装置包括：砧座半部，其包括远侧砧座部和近侧手柄部；以及钉仓接收半部，其限定细长通道构件。所述细长通道构件具有定尺寸为可释放地接收单次使用装载单元的远侧部以及构造为支撑发射组件的近侧部。所述发射组件包括静止壳体和发射操作杆，所述发射操作杆具有从所述发射操作杆延伸的至少一个操作杆导向凸起。发射操作杆能够从静止壳体的近侧端滑动到静止壳体的远侧端以限定发射行程。夹紧操作杆紧固至钉仓接收半部并包括近侧手柄部。所述夹紧操作杆与砧座半部和所述钉仓接收半部操作性地关联并且能够从非夹紧位置移动到夹紧位置，以使砧座半部的远侧砧座部以与单次使用装载单元紧密靠近的方式可释放地紧固。夹紧操作杆的近侧手柄部限定至少一个操作杆导向狭槽。至少一个操作杆导向凸起定位成在发射行程开始时进入所述至少一个操作杆导向狭槽从而在发射行程期间抑制夹紧操作杆向非夹紧位置移动。
在实施例中，夹紧操作杆可释放地紧固至钉仓接收半部。
在实施例中，所述砧座半部的近侧手柄部和夹紧操作杆的近侧手柄部中的至少一个限定了多个孔以利于砧座半部和/或所述夹紧操作杆的清洁和消毒。
在实施例中，所述砧座半部的远侧砧座部限定了贯通其延伸的纵向狭槽。所述纵向狭槽限定相对窄的底部和沿远离所述底部延伸的方向逐渐加宽的顶部。
在实施例中，发射组件包括静止壳体，静止壳体具有底表面和从底表面向下延伸的突起。所述钉仓接收半部的细长通道构件的近侧部限定孔，所述孔构造成接收静止壳体的突起以将发射组件在细长通道构件内可释放地紧固和对准。
在实施例中，发射组件构造成在单次使用装载单元可释放地紧固在细长通道构件内之前，可释放地紧固在钉仓接收半部内。
在实施例中，偏置构件支撑在发射组件的远侧端中。所述偏置构件构造成抑制单次使用装载单元在夹紧操作杆移动到夹紧位置之前，就完全安置在所述细长通道构件内。
在实施例中，所述砧座半部包括位于近侧的杆，并且钉仓接收半部包括一对位于近侧的支撑构件，每个支撑构件限定竖直狭槽。所述杆构造成接收在竖直狭槽内以相对于钉仓接收半部可枢转地支撑砧座半部。
在实施例中，夹紧操作杆包括一对向内延伸的凸起，并且所述钉仓接收半部限定一对凹窝。夹紧操作杆的凸起构造成接收在钉仓接收半部的凹窝内，以将夹紧操作杆可释放地保持在夹紧位置和非夹紧位置之间的中间位置。
在实施例中，所述至少一个操作杆导向狭槽具有口。至少一个操作杆导向凸起定位成当夹紧操作杆移动到夹紧位置时进入所述至少一个操作杆导向狭槽的口。
附图说明
现在将在此处参照附图描述本公开的手术紧固件施加装置的各种实施例，其中：
图1是本公开的手术紧固件施加装置的实施例的处于夹紧位置的侧视立体图；
图2是在夹紧操作杆和钉仓接收半部的组装期间，图1的手术紧固件施加装置的侧视立体图；
图3是图1的手术紧固件施加装置的部件分离的侧视立体图；
图4A是图1的手术紧固件施加装置的砧座半部的侧视立体图；
图4B是图4A的砧座半部的仰视立体图；
图5是图4A的砧座半部的近侧端部的仰视立体图；
图6A是图1的手术紧固件施加装置的彼此脱离的砧座半部和钉仓接收半部的近侧端的侧视图；
图6B是图6A砧座半部和钉仓接收半部的近侧端彼此接合的侧视图；
图7A是图1的手术紧固件施加装置的钉仓接收半部的仰视立体图；
图7B是图7A的钉仓接收半部的侧视图；
图8是图7A中的细节指示区域的放大侧视立体图；
图9是图1的手术紧固件施加装置的发射组件的侧视立体图；
图10是图9的发射组件的静止壳体的近侧端的仰视立体图；
图11A是图1的手术紧固件施加装置的钉仓接收半部的纵向剖视图，其中，单次使用装载单元(“SULU”)部分地接合在其中；
图11B是图11A的钉仓接收半部的纵向剖视图，其中SULU完全接合在其中；
图12A是图1的手术紧固件施加装置的砧座半部的远侧部的仰视立体图；
图12B是图12A的砧座半部的远侧部的俯视立体图；
图13是沿图12B的剖切线13-13截取的横剖视图；
图14A是图1的手术紧固件施加装置的夹紧操作杆的俯视立体图；和
图14B是图14A的夹紧操作杆的侧视图。
具体实施方式
现在将参照附图详细说明本公开的手术紧固件施加装置的实施例，在附图中，在几幅视图的每个中，相同附图标记指代相似或相同的结构元件。如本文所用，传统的，术语“近侧”指的是装置的较靠近用户的端，而术语远侧指的是装置的较远离用户的端。
图1至图2示出了本公开的总体示出为手术吻合器10的手术紧固件施加装置的实施例。手术吻合器10包括砧座半部100、钉仓接收半部200、夹紧操作杆300、单次使用装载单元400(以下简称“SULU”)，以及发射组件500。砧座半部100、钉仓接收半部200以及夹紧操作杆300可以构造为可重复使用的部件并且，如此，可以由适合于消毒和重复使用的生物相容性材料(例如，不锈钢)构成。如将在下面所述的，砧座半部100、钉仓接收半部200和夹紧操作杆300各自包括特征件以利于其有效的消毒。另一方面，SULU 400和发射组件500是一次性的部件并且可以从手术吻合器10的可重复使用的部件分离。SULU 400和发射组件500可从由任何合适的生物相容性材料(包括塑料、金属，或其组合)构成。此外，手术吻合器10可构造为接收或容纳SULU和/或用于发射不同吻合线的长度的吻合钉的发射组件，所述长度例如为60mm、80mm以及100mm。
参照图4A至图4B和图12A至图13，砧座半部100包括近侧手柄部102和远侧砧座部104。远侧砧座部104包括吻合钉变形部106(图4B)，吻合钉变形部106包括限定在其底表面110内的多个吻合钉变形凹槽108(图12B)。吻合钉变形部106可与砧座半部100一体形成，或者替代地，通过紧固工艺(例如焊接、钉合或压接(crimping)，或其它粘合剂)紧固至砧座半部100。限定吻合钉变形部106的远侧砧座部104的底表面110构造为当SULU 400(图3)定位在钉仓接收半部200(参见图2)的通道构件202中时面对SULU(图3)的顶表面400。远侧砧座部104限定了沿着砧座部104的长度的绝大部分延伸的中央纵向狭槽112(图12A至图13)。如图12A至图13最佳示出的，中央纵向狭槽112具有延伸通过吻合钉变形部106的底表面110的相对窄的底部114，用于当刀具406移动通过SULU 400(参见图3)时可滑动地接收SULU 400(参见图3)的刀具406，以切断吻合钉横向排115(图12B)之间的组织。如图13所示，中央纵向狭槽112的顶部116从底部114向远侧砧座部104的顶表面118逐渐变宽，其中中央纵向狭槽112限定了相对宽的开口。通过设置如图所示的加宽的中央纵向狭槽112，需要更少的材料来形成远侧砧座部104，从而减小了远侧砧座部104的重量。此外，加宽的狭槽112允许远侧砧座部104的更有效的清洁和消毒。
参照图1至5，并且特别参照图4A至图4B，砧座半部100的中央部120限定在远侧砧座部104的吻合钉变形部106的近侧端和砧座半部100的近侧手柄部102的远侧端之间。砧座半部100的中央部120包括两对圆柱形横向支撑构件124、126。砧座半部的中央部120还包括至少一个突起，例如朝向钉仓接收半部200向下延伸的一对支撑指状件125。在砧座半部100和钉仓接收半部200的组装期间，横向支撑构件124起到如下作用：当手术吻合器10(图1)处于夹紧位置时，设定SULU 400(图3)和砧座半部100的吻合钉变形部106之间的最小间隙。另一方面，当手术吻合器10(图1)处于夹紧位置时，横向支撑构件126支撑在限定在钉仓接收半部200的中央部210中的U形凹槽212中(参照图7A至图7B)，以相对于砧座半部100的吻合钉变形部106正确地对准SULU 400(图3)。另外，在夹紧位置，横向支撑构件126接收在形成在夹紧操作杆300的间隔开的突缘部308上的切口310中。当吻合器10移向夹紧位置时，支撑指状件125推动SULU 400(图3)完全进入钉仓接收半部200的通道构件202中的位置。
特别继续参照图4A至图4B，砧座半部100的近侧手柄部102形成为符合人体工程学并且包括主体部128和拇指接合抵接件130。主体部128可以限定利于近侧手柄部102的清洁和消毒的多个孔132。孔132在主体部128中的设置还减少了手术吻合器10的整体重量。
另外参照图5，近侧手柄部102的近侧端包括向下延伸的突起，即指状件134，指状件134限定将在下面进一步详细地讨论的后定位杆136(图6A至图6B)。后定位杆136可以采取多种构造，例如，圆柱形、泪滴形等。后定位杆136可包括从其横向延伸的至少一个凸起。如在图5中最佳示出的，杆136可以与砧座半部100的近侧手柄部102朝向其近侧端形成一体，例如整体地与砧座半部100的近侧手柄部102朝向其近侧端形成。
参照图7A至图8，钉仓接收半部200限定细长通道构件202，通道构件202限定具有定尺寸为可释放地接收SULU 400(图3)的远侧部206和定尺寸为可释放地接收发射组件500(图9)的近侧部208的大致U形通道204。钉仓接收半部200还包括中央部210，中央部210限定定位成支撑砧座半部100(参见图1至图3)的横向支撑构件126的间隔开的U形凹槽212，如上所述。钉仓接收半部200的中央部210还包括定位在凹槽212下面的一对向下延伸的指状件214。指状件214各自支撑圆柱形枢转构件216，圆柱形枢转构件216构造为接收在夹紧操作杆300的间隔突缘部308的相应的C形凹槽314内以利于手术吻合器10(参见图1至图3)的夹紧，这将在下面描述。限定在钉仓接收半部200的中央部210内的一对凹窝218中的每一个都构造成接收夹紧操作杆300(参照图1至图3)的凸起312以将夹紧操作杆300可释放地紧固在夹紧和非夹紧位置之间的中间位置，这将在下面描述。
另外参照图1至图3，细长通道构件202的近侧部208的基面220限定细长纵向狭槽222，其构造为容许下面将描述的发射组件500的偏置构件506(例如，板簧)(图3)的通过，以将夹紧操作杆300朝向非夹紧位置偏置。将偏置构件506(图3)定位在一次性发射组件500上而不是定位在可重复使用的钉仓接收半部200或夹紧操作杆300上省却了在使用后偏置构件506(图3)内及其周围的消毒的需求。换句话说，无论是钉仓接收半部200还是夹紧操作杆300都不需要包括构造成将偏置部件506(图3)保持在其中的复杂特征件，并且因此，它们容易被消毒。细长通道件202的基面220还限定了位于近侧的孔224，孔224构造成接收从发射组件500的静止壳体502的底表面向外延伸的突起504(图10)，以将发射组件500在细长通道构件202内紧固和对准，如将在下面描述的。
参照图6A至图6B，钉仓接收半部200的近侧端包括一对竖直支撑构件226。每个竖直支撑构件226限定细长竖直狭槽228，细长竖直狭槽228可具有圆形底表面，虽然可预想其它构造。竖直狭槽228各自定尺寸为接收指状件134的后定位杆136，指状件134与砧座半部100的近侧端一体并从其延伸，如上所述。在组装期间，后定位杆136插入每个竖直狭槽228以将砧座半部100可枢转地支撑在钉仓接收半部200上并且将钉仓接收半部200相对于砧座半部100轴向定位。通过定位杆136支撑在支撑构件226的竖直插槽228内，砧座半部100可以相对于钉仓接收半部200像剪刀那样的方式在打开和关闭位置之间枢转。
参照图1至图3和图7A至图10，发射组件500包括静止壳体502，静止壳体502具有包括突起504(图10)的近侧端。如上所讨论的，突起504从静止壳体502的底表面延伸，并且构造为用于接收在限定在细长通道构件202的基面220内的孔224内以将发射组件500的近侧端在细长通道构件202的近侧部208内可释放地紧固和对准。同样地，SULU 400(图3)包括一对远侧突起414(图3)，远侧突起414能够定位在形成在通道构件202的远侧端处的切口230内以将SULU400的远侧端可释放地紧固在通道构件202的远侧部206内。如将在下面参照图11A至图11B进一步详细描述的，发射组件500的静止壳体502包括偏置构件526，偏置构件526定位成在组装期间抑制SULU 400的近侧端完全安置在通道元件202内，从而用作抑制发射组件500的意外发射的锁定件。当吻合器10夹紧，SULU 400的近侧端才移动到通道构件202内的适当的操作位置，其中足够的力施加在SULU 400上以抵靠偏置构件526的偏置而使SULU 400完全安置在通道构件202内，这将在下面进一步详细讨论。
参照图9，发射组件500的静止壳体502构造成容纳发射组件500的工作部件。对于本文的目的，足以说，静止壳体502通常支撑刀具致动杆508、凸轮杆510、导块512、滑块514、发射操作杆516、以及其它相互协作部件(未明确示出)，上述所有部件起到当致动发射操作杆516时从SULU 400(图3)顺序地发射多个手术紧固件并且并推进刀具406(图3)通过SULU400(图3)从而随后分割吻合钉的横向排115(图12B)之间的组织的作用。与发射组件500类似的发射组件的更详细描述可以在美国专利第7,631,794号(下称“'794专利”)中找到，上述专利的整体通过引用并入本文。
发射组件500的发射操作杆516包括第一和第二手指接合构件518和520，其中任一个可选择性地从吻合器10的任一侧接合，以使发射操作杆516移动通过发射行程。发射组件500构造成使得发射操作杆516必须在发射操作杆516可以移动通过发射行程之前，首先枢转到发射组件500的一侧或另一侧。操作杆导向凸起522从每个接合构件518、520的底表面延伸。另外参照图1至图3和图14A至图14B，每个操作杆导向凸起522构造成并定尺寸为：当发射操作杆516致动，即，当发射行程开始，操作杆导向凸起522接收在限定在夹紧操作杆300的每一侧上的相应的操作杆导向狭槽316内。如将在下面描述的，夹紧操作杆300的适当的操作杆导向狭槽316接收发射操作杆516的对应的操作杆导向凸起522(取决于在发射之前哪一侧发射操作杆516枢转)，从而，一旦发射行程已经开始，即，一旦发射操作杆516已经从完全缩回位置向远侧移动，则既引导发射操作杆516的平移又抑制夹紧操作杆300的松开。如本文所使用的，发射行程定义为发射操作杆516的从完全缩回位置到完全推进位置的移动，而发射行程的开始定义为发射操作杆516的足以将操作杆导向凸起522中的一个定位在相应的操作杆导向狭槽316内的移动。
再次参照图1至图3，SULU 400包括容纳多个吻合钉推动器(未示出)的主体402、底盖404、具有倾斜锋利的前缘或刀片(未示出)的刀具406、可操作地布置在主体402内的多个吻合钉(未示出)以及可枢转地安装的安全锁定件408(图11A至图11B)，其在前面已通过引用合并于此的'794专利中有更详细的描述。主体402具有多排吻合钉保持狭槽410(例如，四排、六排等)和居中布置在主体402中的线性开槽的刀具轨道412。手术吻合器10可以定尺寸为接收或容纳不同吻合线长度的SULU，所述吻合线长度包括例如60毫米、80毫米与100毫米。刀具406可以包括构造为接合发射组件500的刀具致动杆508的上翘钩部524(图11A)的下翘钩部(未示出)，这同样在'794专利中有描述。特别参照图11A至图11B，如上所述，偏置构件526支撑在发射组件500(图9)的静止壳体502的远侧端中。偏置构件526定位为并构造成在组装期间抑制SULU 400的近侧端完全安置在通道元件202内以抑制发射组件500的意外发射。更具体地，偏置构件526防止SULU 400在吻合器10移动到夹紧位置之前就完全安置在通道元件202，从而防止发射组件500(图9)操作性地接合SULU400。当吻合器10夹紧且此时刀具406的下翘钩部(未示出)操作性地定位用于与刀具致动杆508(图9)的上翘钩部524(图11A)接合，SULU 400的近侧端才移动到通道构件202内的完全安置位置。在发射行程期间，凸轮杆510(图9)可滑动地移动通过主体402，以从SULU 400射出吻合钉。同时，但在预设延迟之后，刀具406经由刀具致动杆508(图9)的推进而被推进通过SULU 400，以分割吻合钉的横向排115之间的组织。类似于SULU 400的SULU的更详细描述可以在’794专利中找到。
现在参照图14A至图14B，结合图1至图3，夹紧操作杆300包括手柄部302，手柄部302包括抓握部304和拇指接合抵接件306。如上所述，一对隔开的突缘部308支撑在夹紧操作杆300的远侧端上。每个突缘部308限定切口310，切口310定尺寸为接收砧座半部100的相应的横向支撑构件126以利于手术吻合器10的从非夹紧位置向夹紧位置(图1)的移动。突缘部308各自还包括向内延伸的凸起312，凸起312构造成当夹紧操作杆300朝向夹紧位置枢转时以卡扣配合的方式接收在限定在钉仓接收半部200的中央部210内的凹窝218中，从而将夹紧操作杆300可释放地紧固在夹紧和非夹紧位置之间的中间位置。
如上所讨论的，每个突缘部308还限定C形凹槽314，C形凹槽314构造为接收钉仓接收半部200的圆柱形枢转构件216，以容许夹紧操作杆300相对于钉仓接收半部200在非夹紧和夹紧位置之间的枢转。通过从钉仓接收半部200的圆柱形枢转构件216周围移除夹紧操作杆300的突缘部308，夹紧操作杆300能够从钉仓接收半部200完全移除或分离。此构造允许更容易进入夹紧操作杆300和钉仓接收半部200两者并消除了两个部件的难以到达的区域，从而利于两个部件的清洁和消毒。
继续参照图14A至图14B，同样如上面讨论的夹紧操作杆300的手柄部302包括沿其每侧延伸的纵向操作杆导向狭槽316。操作杆导向狭槽316各自限定了构造成接收对应的手指接合构件518、520的操作杆导向凸起312的开口或口318。更具体地，当发射行程开始，操作杆导向凸起522从口518内移入相应的操作杆导向狭槽316。当操作杆导向凸起522布置在操作杆导向狭槽316内时，抑制了夹紧操作杆300松开。
夹紧操作杆300的手柄部302还限定了多个孔320，孔320利于夹紧操作杆300的清洁和消毒并减少手术吻合器10的整体重量。偏置构件506(图3)从发射组件500向下延伸通过限定在钉仓接收半部200内狭槽222(图7A)，偏置构件506构造为接合夹紧操作杆300的内表面以朝向非夹紧位置偏置夹紧操作杆300。
现在转向图1至图3，结合图4A至图14B，描述了吻合器10的组装和操作。最初，发射组件500，接着是SULU 400，装载入钉仓接收半部200。为了将发射组件500装载入钉仓接收半部200的通道构件202的近侧部208，发射组件500的静止壳体502插入通道构件202使得从发射组件500(见图10)的静止壳体502向下延伸的突起504(图10)定位在限定在通道构件202的基面220内的孔224内。一旦发射组件500装载到通道构件202，SULU 400可经由远侧突起414在切口部230内的接合而装载入通道构件202的远侧部206。然而，如上面提到的，在这一点上，由于偏置部件526(图11A至图11B)的从通道元件202推动SULU 400近侧端的偏置，因此SULU 400的近侧端将仅部分地安置在钉仓接收半部200的通道构件202内。
一旦SULU 400和发射组件500装载到通道构件202，砧座半部100可通过将杆136插入钉仓接收半部200的竖直支撑构件226的竖直狭槽228而组装至钉仓接收半部200(参见图6A至图6B)。此后，砧座半部100可朝钉仓接纳半部200向下旋转以将横向支撑构件126(图4A至图4B)定位在基本U形凹槽212(图7B)中。
随着砧座半部100和钉仓接收半部200可枢转地彼此接合，夹紧操作杆300可以接合到钉仓接收半部200。参照图2至图3和图14A至图14B，为将夹紧操作杆300接合至钉仓接收半部200，夹紧操作杆300的突缘部308关于钉仓接收半部200的中央部210接近从而使得钉仓接收半部200的圆柱形枢转构件216(图3)插入夹紧操作杆300的大致C形凹槽314。此后，夹紧操作杆300可以关于枢转构件216(图3)并且相对于钉仓接收半部200沿逆时针方向(根据图2所示的方位)向中间位置旋转。在中间位置，突起312(图14B)接收在孔或凹窝218(图3)内以将夹紧操作杆300相对于钉仓接收半部200保持在中间位置。
在使用中，为了抓住砧座半部100和SULU 400之间的组织，手术吻合器10定位成使得被抓住的组织布置在砧座半部100和SULU 400之间。此后，夹紧操作杆300沿逆时针方向从中间位置向图1中所示的夹紧位置旋转以使砧座半部100的吻合钉变形部106和SULU 400的顶表面接近从而抓住其间的组织。当夹紧操作杆300朝向夹紧位置旋转时，横向支撑构件126接收在夹紧操作杆300的突缘部308的切口310(图2)中，并且支撑指状件125接合SULU400从而逆着偏置构件526(图11A至图l1B)的偏置向下推动SULU 400以完全安置在钉仓接收半部200的通道构件202。当SULU 400完全安置在通道构件202中，SULU 400移动至与发射组件500操作性的接合，使得刀具致动杆508和刀具406彼此操作性地接合，以容许发射组件500的致动。
当手术吻合器10处于夹紧、未发射位置，发射操作杆516枢转至吻合器10的任一侧，以利于从吻合器10的任一侧致动手术吻合器10。随着发射操作杆516枢转至吻合器10的所需侧，发射操作杆516的手指接合构件518、520的对应的操作杆导向凸起522定位在夹紧操作杆300(图1)的导向狭槽316的对应的口318内。在这个位置，吻合器10仍然可以为松开的，但已准备好发射。
为了发射吻合器10，发射操作杆516的手指接合构件518、520沿图1中箭头“A”指示的方向沿着通道构件202向远侧推进。当手指接合构件518、520初始远侧推进时，操作杆导向凸起522从夹紧操作杆300的相应的狭槽316的口318移入操作杆导向狭槽316，以抑制在发射行程期间夹紧操作杆300松开并且引导发射操作杆516通过发射行程的平移。当发射操作杆516向远侧推进，滑块514在发射组件500的静止壳体502内向远侧移动，以实现凸轮杆510的相应的移动和刀具致动杆508的延迟移动。当凸轮杆510向远侧移动通过发射组件500的静止壳体502并进入SULU 400，凸轮杆510的凸轮表面顺序地接合布置在SULU 400中的推动器(未明确示出)以从主体402中穿过组织射出吻合钉(未明确示出)，并进入砧座半部100的吻合钉变形部106用于关于组织形成吻合钉。同时，由于刀具致动杆508的远侧端与刀具406接合，在预设延迟后，刀具406通过SULU 400推进以切割吻合钉(未示出)的横向排115(图12B)之间的组织。
当发射行程完成后发射操作杆516返回到其最近侧位置以缩回凸轮杆510和刀具406，操作杆导向凸起522从操作杆导向狭槽316移动回到相应的狭槽316的口318，从而容许夹紧操作杆300移回中间位置。此后，夹紧操作杆300可以从钉仓接收半部200脱离并移除，并且吻合器10可以移动到打开位置，以释放吻合和分割的组织。在打开位置处，砧座半部100从钉仓接收半部200间隔开从而使得偏置构件526(图11A至图11B)在通道构件202内从完全就座位置推动SULU 400的近侧端，从而利于从通道件202移除SULU 400。
在手术操作期间，SULU 400可以更换多次，以便于吻合器10在单个患者上的多次使用。例如，在从血管移除血管的病变部分的手术操作期间，手术吻合器10可用于吻合和切割在病变的血管部分的相对侧上的组织。在手术吻合器10的每个吻合和切割操作之后可以更换SULU 400。由于每个SULU 400设置有新刀具406，组织的撕裂最小化。在手术操作后，将使用过的SULU 400和发射组件500可以从通道构件202移除，并以适当的方式处置。如以上所提到的，砧座半部100、钉仓接收半部200和夹紧操作杆300然后可消毒(例如通过高压消毒)，并以上面讨论的方式通过新的SULU 400和发射组件500重新使用。
应理解的是，可以对本文所公开的手术紧固件施加装置的实施例进行各种修改。因此，上面的描述不应当解释为限制性的，而仅仅是作为实施例的范例。本领域技术人员将设想在本公开的范围和精神内的其它修改。
Claims (9)
1.一种手术紧固件施加装置，包括：
砧座半部，其包括远侧砧座部和近侧手柄部；
钉仓接收半部，其限定细长通道构件，所述细长通道构件具有定尺寸为可释放地接收单次使用装载单元的远侧部以及构造为支撑发射组件的近侧部，所述发射组件包括静止壳体和发射操作杆，所述发射操作杆具有从所述发射操作杆延伸的至少一个操作杆导向凸起，所述发射操作杆能够从静止壳体的近侧端滑动到静止壳体的远侧端以限定发射行程；以及
夹紧操作杆，其紧固至钉仓接收半部并包括近侧手柄部，所述夹紧操作杆与砧座半部和所述钉仓接收半部操作性地关联并且能够从非夹紧位置移动到夹紧位置，以使砧座半部的远侧砧座部以与单次使用装载单元紧密靠近的方式可释放地紧固，所述夹紧操作杆的近侧手柄部限定至少一个操作杆导向狭槽，其中所述至少一个操作杆导向凸起定位成在发射行程开始时进入所述至少一个操作杆导向狭槽以在发射行程期间抑制夹紧操作杆向非夹紧位置移动，
所述手术紧固件施加装置还包括支撑在所述发射组件的远侧端中的偏置构件，所述偏置构件构造成抑制单次使用装载单元在夹紧操作杆移动到夹紧位置之前，就完全安置在所述细长通道构件内。
2.根据权利要求1所述的手术紧固件施加装置，其中所述夹紧操作杆可释放地紧固至钉仓接收半部。
3.根据权利要求1所述的手术紧固件施加装置，其中所述砧座半部的近侧手柄部和夹紧操作杆的近侧手柄部中的至少一个限定了多个孔以利于砧座半部和/或所述夹紧操作杆的清洁和消毒。
4.根据权利要求1所述的手术紧固件施加装置，其中所述砧座半部的远侧砧座部限定了贯通其延伸的纵向狭槽，所述纵向狭槽限定相对窄的底部和沿远离所述底部延伸的方向逐渐加宽的顶部。
5.根据权利要求1所述的手术紧固件施加装置，其中，所述发射组件包括静止壳体，所述静止壳体具有底表面和从底表面向下延伸的突起，其中所述钉仓接收半部的细长通道构件的近侧部限定孔，所述孔构造成接收静止壳体的突起以将发射组件在细长通道构件内可释放地紧固和对准。
6.根据权利要求1所述的手术紧固件施加装置，其中所述发射组件构造成在单次使用装载单元可释放地紧固在细长通道构件内之前，可释放地紧固在钉仓接收半部内。
7.根据权利要求1所述的手术紧固件施加装置，其中所述砧座半部包括位于近侧的杆，并且钉仓接收半部包括一对位于近侧的支撑构件，每个支撑构件限定竖直狭槽，所述杆构造成接收在所述竖直狭槽内以相对于钉仓接收半部可枢转地支撑砧座半部。
8.根据权利要求1所述的手术紧固件施加装置，其中所述夹紧操作杆包括一对向内延伸的凸起，并且其中所述钉仓接收半部限定一对凹窝，所述夹紧操作杆的凸起构造成接收在钉仓接收半部的凹窝内以将所述夹紧操作杆可释放地保持在夹紧位置和非夹紧位置之间的中间位置。
9.根据权利要求1所述的手术紧固件施加装置，其中所述至少一个操作杆导向狭槽具有口，并且其中所述至少一个操作杆导向凸起定位成当所述夹紧操作杆移动到夹紧位置时进入所述至少一个操作杆导向狭槽的口。
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2013
- 2013-11-04 US US15/033,657 patent/US11033264B2/en active Active
- 2013-11-04 CN CN201380080702.9A patent/CN105682570B/zh active Active
- 2013-11-04 WO PCT/US2013/068247 patent/WO2015065485A1/en active Application Filing
- 2013-11-04 JP JP2016526350A patent/JP6366708B2/ja active Active
- 2013-11-04 CN CN201910027568.5A patent/CN110063762B/zh active Active
- 2013-11-04 CA CA2926750A patent/CA2926750A1/en not_active Abandoned
- 2013-11-04 EP EP13795344.4A patent/EP3065647A1/en not_active Withdrawn
- 2013-11-04 AU AU2013403915A patent/AU2013403915A1/en not_active Abandoned
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US5465896A (en) * | 1991-11-07 | 1995-11-14 | United States Surgical Corporation | Linear surgical stapling instrument |
| US5636779A (en) * | 1994-12-13 | 1997-06-10 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
Also Published As
| Publication number | Publication date |
|---|---|
| US20160310136A1 (en) | 2016-10-27 |
| CN105682570A (zh) | 2016-06-15 |
| JP6366708B2 (ja) | 2018-08-01 |
| JP2016534795A (ja) | 2016-11-10 |
| CA2926750A1 (en) | 2015-05-07 |
| CN110063762B (zh) | 2022-04-15 |
| WO2015065485A1 (en) | 2015-05-07 |
| EP3065647A1 (en) | 2016-09-14 |
| AU2013403915A1 (en) | 2016-04-28 |
| US11033264B2 (en) | 2021-06-15 |
| CN110063762A (zh) | 2019-07-30 |
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