CN105935302A - 钳夹构件及制造方法 - Google Patents

钳夹构件及制造方法 Download PDF

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CN105935302A
CN105935302A CN201610125527.6A CN201610125527A CN105935302A CN 105935302 A CN105935302 A CN 105935302A CN 201610125527 A CN201610125527 A CN 201610125527A CN 105935302 A CN105935302 A CN 105935302A
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文卡塔·拉马纳·莫汉·皮雅拉
拉贾塞卡拉·努卡拉
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Abstract

本发明提供了钳夹构件及制造方法。与手术吻合器械一起使用的砧座组件包括均由热塑材料制造的砧座板和砧座罩。砧座板包括第一表面和与第一表面相对的第二表面。第一表面具有沿着其外周布置的多个焊道。砧座罩构造成与手术吻合器械的远侧端联接。砧座罩包括具有沿着其外周布置的至少一个细长表面结构件的表面。砧座板的焊道和砧座罩的细长表面结构件构造成在其组装时抵接接合。

Description

钳夹构件及制造方法
技术领域
本公开一般涉及手术器械，并且更具体地，涉及用于通过手术接合组织的手术器械以及制造/组装手术器械的钳夹构件的方法。
背景技术
用于将平行排的吻合钉施加穿过压缩的活体组织的手术吻合器械在本领域中已广为人知。这些手术器械常常用于在横切或切除之间将组织和器官闭合，用于在胸和腹的操作中使器官闭塞，以及用于在吻合中紧固组织。
通常地，这样的手术吻合器械包括砧座组件，用于支撑手术吻合钉阵列的钉仓组件，用于使砧座组件和钉仓组件接近的接近机构，以及用于将手术吻合钉从钉仓组件弹射的发射机构。
在使用中，外科医生起初使砧座组件和钉仓组件接近。然后，外科医生可以致动手术器械以在组织中放置吻合钉。此外，外科医生可使用同一手术器械或单独的器械以切割邻近吻合钉排的组织或吻合钉排之间的组织。
通常地，为了制造这些手术吻合器械的砧座组件和钉仓组件，会用到：板金加工，冲压，以及机械加工，尤其是用于组装的激光焊接。这些机械加工操作复杂且昂贵。因此，存在对更具有成本效益且简化的手术吻合器械的部件的制造工艺的需要。
发明内容
在本公开的一个实施例中，提供一种用于与手术吻合器械一起使用的砧座组件。所述砧座组件包括均由热塑材料制造的砧座板和砧座罩。砧座板具有纵向贯穿其而限定的刀具槽。砧座板包括第一表面和与第一表面相对的第二表面。第一表面具有沿着其外周布置的多个焊道(bead)。砧座罩构造成与手术吻合器械的远侧端联接。砧座罩包括具有沿着其外周布置的至少一个细长表面结构件的表面。砧座板的侧面焊道和砧座罩的细长表面结构件构造成在其组装时抵接接合。
在某些实施例中，砧座板的多个焊道是沿着其外周布置的多个侧面焊道。至少一个细长表面结构件可以是至少一个纵向焊道结构件。
在一些实施例中，焊道可以具有三角形构造，且细长表面结构件可以具有三角形的横截面构造。
可以预想，热塑材料可以为聚醚醚酮。
可以想到，砧座板的端部和砧座罩的端部可以分别限定贯通其的开口，以便在砧座板与砧座罩组装时，开口处于重叠对齐。
在一些实施例中，砧座板可以进一步包括从其第二表面的端部垂直延伸的一对立柱。砧座板可进一步包括与一对立柱接合的一对偏置构件。
可以预想，砧座板可进一步包括从砧座板的第一表面的外周垂直延伸的壁。
在一些实施例中，砧座板和砧座罩可均具有弓形的构造。
在本公开的另一个方案中，提供一种用于与手术吻合器械一起使用的末端执行器。所述末端执行器包括砧座组件和钉仓组件。砧座组件包括均由热塑材料制造的砧座板和砧座罩。砧座板具有纵向贯穿其而限定的刀具槽。砧座板包括第一表面和与第一表面相对的第二表面。第一表面具有沿着其外周布置的多个焊道。砧座罩构造成与手术吻合器械的远侧端联接。砧座罩包括具有沿着其外周布置的至少一个细长表面结构件的表面。砧座板的焊道和砧座罩的细长表面结构件构造成在其组装时抵接接合。砧座组件或钉仓组件的至少一个相对于另一个在间隔位置和接近位置之间能移动以接合并吻合其间的组织。砧座组件和钉仓组件可以均具有弓形的构造。
在本公开的又一个方案中，提供一种制造手术吻合器械的砧座组件的方法。所述方法包括：提供砧座板和砧座罩，以及在砧座板的焊道和砧座罩的细长表面结构件之间的交接面处，将砧座板超声焊接至砧座罩。
在一些实施例中，所述方法进一步包括：在将砧座板与砧座罩超声焊接之前，将限定在砧座板的端部中的开口与限定在砧座罩的端部中的开口对齐。
附图说明
本文参照附图公开了本公开的手术吻合器械的各种实施例，其中：
图1是包括根据本公开的实施例的末端执行器的手术吻合器械的立体图；
图2A是图1的末端执行器的砧座组件的砧座板的俯视立体图；
图2B是图2A的砧座板的仰视立体图；
图3A是图1的砧座组件的砧座罩的仰视立体图；
图3B是图3A的砧座罩的俯视立体图；
图4A是图1的砧座组件处于组装后的形式的仰视立体图；以及
图4B是图4A的砧座组件的俯视立体图。
具体实施方式
参照附图对本公开的手术吻合器械的实施例进行详细描述，其中相同的附图标记在若干视图中的每个中指代相似或相同的元件。在附图和接下来的描述中，术语“近侧”指的是手术吻合器械的最靠近操作者的端部或其部件；而术语“远侧”指的是手术吻合器械的最远离操作者的端部或其部件。如本领域内的技术人员预见到的，所描述的手术吻合器械发射吻合钉，但其可适于发射其他任何适合的紧固件，比如夹子和两部分式的紧固件。
如本文所使用的，术语平行和垂直被理解为包括相对真正的平行和真正的垂直多达+/-10度的大致平行和大致垂直的相对构造。
参见图1，附图标记10指代本公开的手术吻合器械的实施例。为了简要起见，本公开集中于器械10的末端执行器100的钳夹构件110、120，更具体地，集中于器械10的钳夹构件120的砧座组件112。序列号为8,899,461和7,565,993的美国专利以及于2013年10月17日提交的序列号为14/056,198的美国专利申请详细描述了其他手术末端执行器的结构和操作。这些专利和申请的全部内容通过引用的方式并入此处。
手术吻合器械10构造为夹紧、紧固、和/或切割组织。通常，器械10包括：手柄组件20；细长部或接合器组件30，其从手柄组件20向远侧延伸并且限定纵向轴线“X”；以及弯曲的末端执行器100，其适于夹紧并紧固组织。接合器组件30将手柄组件20和末端执行器100相互连接。接合器组件30包括：近侧壳体32，其可操作地联接至手柄组件20的远侧端；以及远侧细长部34，其可操作地联接至末端执行器100的近侧细长部102。可以预想的，手柄组件可以是诸如例如在图1中描绘的手柄的手动操作的手柄，由电机或其他某驱动器提供动力、构造为用于附接至自动系统的动力手柄，等等。
手柄组件20包括固定手柄22和可动手柄24。可动手柄24适于朝向或远离固定手柄22可枢转地移动。此外，可动手柄24通过如下机构可操作地联接至末端执行器100：所述机构适于将可动手柄24的至少部分致动转换成第一钳夹构件110或第二钳夹构件120中的至少一个的在间隔位置和接近位置之间的枢转运动。如本领域中的技术人员意识到的，任何常规的致动机构可用于可操作地将可动手柄24联接至末端执行器100。
在公开的实施例中，手柄组件20包含用于布置诸如例如来自末端执行器100的手术吻合钉的紧固件并且推进末端执行器100的刀具(图中未示出)的致动机构(图中未示出)。致动机构包括可操作地连接至可动手柄24的发射杆(图中未示出)。在操作中，使可动手柄24朝向固定手柄22枢转引起发射杆件向远侧推进。发射杆又可操作地联接至至少部分地定位在末端执行器100之内的轴向驱动组件(图中未示出)。所述轴向驱动组件构造为响应发射杆向远侧平移而向远侧移动。轴向驱动组件的向远侧平移引起第一钳夹构件110朝向第二钳夹构件120枢转。在某些实施例中，驱动组件具有带有远侧头部的细长梁。所述远侧头部具有用于接合钳夹构件中的一个的上部，以及用于接合另一个钳夹构件的下部。可替换地，管形构件能够用于闭合钳夹。此外，在致动滑块(未示出)平移穿过末端执行器100时，轴向驱动组件推动布置于第一钳夹构件110之内的致动滑块。随着致动滑块前进通过第一钳夹构件110，致动滑块将紧固件从限定在第一钳夹构件110中的紧固件保持槽推出。在一个实施例中，轴向驱动组件包括安装于其远侧部的刀片(图中未示出)。在操作中，当轴向驱动组件向远侧移动穿过末端执行器100以切断组织时，刀片移动通过末端执行器100。作为致动滑块的替换物，可提出一系列的凸轮杆以布置紧固件。
继续参见图1，末端执行器100包括近侧细长部102、第一钳夹构件110以及第二钳夹构件120。在一些实施例中，末端执行器100可以呈一次性装载单元的形式。在一些实施例中，钳夹构件110、120分别直接与接合器组件30的远侧细长部34的远侧端连接。第一钳夹构件110和第二钳夹构件120具有弓形形状(即，第一钳夹构件110和第二钳夹构件120相对于纵向轴线“X”弯曲)。可以想象，第一钳夹构件110和第二钳夹构件120可利于执行某些种类的手术操作。例如，与直的钳夹构件相比，第一钳夹构件110和第二钳夹构件120例如在低位前切术(“LAR”)或其他的结肠直肠手术期间，有助于实现接近低骨盆区域。第一钳夹构件110和第二钳夹构件120能移动，例如，在间隔开的位置和接近位置之间相对于彼此能枢转，以接合并吻合其间的组织。尽管以弓形的构造示出，但预期第一钳夹构件110和第二钳夹构件120可以是直线的。
第一钳夹构件110包括钉仓组件130，所述钉仓组件30构造成用于保持和排出吻合钉，而第二钳夹构件120包括砧座组件112，在末端执行器100的致动期间吻合钉抵靠砧座组件112而成形。钉仓组件130具有弓形构造并包括表面132，所述表面132构造成接合组织。钉仓组件130的表面132通常面对砧座组件112(见图1)，并且在操作期间，当砧座组件112朝向钉仓组件130接近时接合组织。
钉仓组件130包括在钉仓组件130的表面132中限定的多个紧固件保持槽134。紧固件保持槽134布置为沿着表面132的弓形排(例如，两个同心排)并且沿着钉仓组件130的曲线长度延伸。每个紧固件保持槽134适于保持紧固件(未示出)直到用户致动手柄组件20。如上所述，当可动手柄24朝向固定手柄22枢转时，紧固件从紧固件保持槽134弹射，并朝向砧座组件112移动。
钉仓组件130进一步包括限定于表面132中并且构造为用于刀具或其他合适的切割工具(未示出)能平移通过其中的刀具槽136。刀具槽136布置于紧固件保持槽134的相邻排之间，并沿着钉仓组件130的曲线长度延伸。在操作中，当可动手柄24朝向固定手柄22枢转时，刀具(图中未示出)滑动通过刀具槽136。替换地，也可以使用其他机构来驱动刀具通过刀具槽136。如上所述，致动手柄组件20不仅沿着刀具槽136驱动刀具以切割布置于砧座组件112和钉仓组件130之间的组织，而且将紧固件从紧固件保持槽134弹射(如，经由可动手柄24的单个行程或多个行程)到组织之中。
参考图2A-4B，第二钳夹构件120包括限定吻合钉成形穴113的钉砧组件112，所述吻合钉成形穴113构造成在钳夹构件110、120接近时将从钉仓组件130弹射的吻合钉变形。所述穴被定形为将紧固件变形成期望的形状，如典型的吻合钉的“B”形。可以预想可变形的紧固件的其他形状和类型。
砧座组件112通常包括砧座板140(图2A和图2B)和砧座罩180(图3A和图3B)，所述砧座板140和所述砧座罩180彼此联接并均由诸如例如热塑材料的塑料材料制造。在某些实施例中，砧座板140和/或砧座罩180的部件或整体可由各种塑料材料制造，比如，例如，包括聚醚醚酮(PEEK)、聚醚酮酮(PEKK)以及聚醚酮(PEK)的聚芳醚酮(PAEK)、碳-聚醚醚酮复合物、聚乙烯对苯二甲酸酯(PET)、硅酮、聚氨酯、硅酮-聚氨酯共聚物、半刚性材料和刚性材料。砧座板140和/或砧座罩180可具有包括上述材料的材料复合物，以实现各种期望的特性，诸如强度、刚度、弹性、柔顺度以及耐久度。砧座板140和/或砧座罩180还可由异质的材料制造，诸如上述材料中的两种或更多种的结合。
参考图2A和图2B，砧座板140具有弓形构造，所述弓形构造限定在砧座板140的第一端142a和第二端142b之间延伸的弯曲的中心轴线“C1”。砧座板140具有沿着弯曲的中心轴线“C1”穿过砧座板140而限定的刀具槽144。砧座板140的第二端142b具有穿过其厚度而限定的开口146。开口146与弯曲的中心轴线“C1”对齐。
砧座板140具有第一侧面148a和第二侧面148b，所述第一侧面148a和所述第二侧面148b在两者之间限定砧座板140的宽度。砧座板140的宽度在布置于第一端142a和第二端142b之间的接合点150处改变，以限定砧座板140的第一部分152a和砧座板140的第二部分152b。砧座板140的第一部分152a具有第一宽度“W1”(图2B)，且第二部分152b具有大于第一部分152a的第一宽度“W1”的第二宽度“W2”(图2B)，以便第二部分152b的外周“P”布置得比第一部分152a的外周“P”横向偏离轴线“C1”更大的距离。通过这样的方式，砧座板140在第二部分152b处增加的宽度为砧座板140提供了更大的区域以容纳将在下文详细描述的用于超声焊接的焊道。可以预想，宽度可以是锥形的、阶梯形的、或能够设置一些其他的过渡。
砧座板140包括具有平面构造的第一、顶部表面154a和与第一表面154a相对、也具有平面构造的第二、底部表面154b。在一些实施例中，表面154a、154b可呈现为各种构造，比如，例如，波浪形的、锥形的、或弯曲的。砧座板140的第一表面154a具有从其垂直地延伸的壁156。壁156沿着第二部分152b的外周“P”布置。在一些实施例中，壁156可沿着砧座板140的第一部分152a和第二部分152b的外周“P”延伸。如将在下文更加详细地描述的，壁56起到在组装期间引导砧座罩180布置成与砧座板140互补对齐的作用。
砧座板140的第一表面154a进一步包括布置在砧座板140的外周“P”与砧座板140的轴线“C1”之间的多个横向的焊道158。焊道158具有三角形构造。在一些实施例中，焊道158可呈现各种形状和构型，比如，例如，正方形、圆形、椭圆形、锥体、星形等。焊道158从砧座板140的第一表面154a延伸出小于壁156从第一表面154a延伸出的距离的距离。支撑于砧座板140的第二部分152b之上的焊道158布置得比支撑于砧座板140的第一部分152a之上的焊道158更加横向地远离弯曲的中心轴线“C1”。如此，如能够领会的，与支撑在第一部分152a上的焊道158交叉的虚线以及与支撑在第二部分152b上的焊道158交叉的虚线平行但不同轴。在一些实施例中，所有的焊道158可彼此对齐。可以预想，焊道158可由各种材料中制造，比如，例如，那些本文已经描述过的材料。
参见图2B，砧座板140的在末端执行器100的组装中面向钉仓组件130的第二表面154b具有从砧座板140的第一端142a垂直延伸的一对立柱160。立柱160以并排定向的方式布置，以便与立柱160交叉的虚线与砧座板140的弯曲的中心轴线“C1”(图2A)处于垂直关系。简要地参见图4A，砧座板140进一步包括一对偏置构件162，所述一对偏置构件162中的每一个与一对立柱160的相应的立柱接合。偏置构件162可以为盘簧的形式，所述盘簧构造成接合钉仓组件130以弹性地将砧座组件112朝向与钉仓组件130间隔开的位置偏置。偏置构件162可经由粘合剂和立柱160结合。
参见图3A和图3B，砧座罩180被定形和定尺寸为与砧座板140互补配合地接合。与砧座板140相似的，砧座罩180具有弓形的构造，所述弓形的构造限定在砧座罩180的第一端182a和第二端182b之间延伸的弯曲的中心轴线“C2”。砧座罩180的第一端182a具有从砧座罩180的侧面垂直延伸的一对凸缘184。凸缘184均限定用于接纳紧固件(未明确地示出)而贯穿构造的近侧开口185，该近侧开口利于将砧座罩180与近侧细长部102的远侧端联接。如此，在组装的状态下，砧座组件112与近侧细长部102经由砧座罩180联接。
砧座罩180的第一端182a具有从其向近侧延伸的指形件或凸起186。凸起186具有形成在其中的一对切口187。切口187定位在凸起186的每个侧面上以助于将砧座罩180固定至近侧细长部102。更特别地，近侧细长部102包括位于其中的通道(图中未示出)，并且所述通道包括一对突起(图中未示出)。砧座罩180的凸起186与近侧细长部102的通道机械地接合，以便切口187与突起对齐。外套筒(未明确示出)覆盖凸起186和通道。凸起186和通道的构造利于砧座罩186和近侧细长部102之间的稳固连接。此外，该连接导致相对于近侧细长部102不可移动的(例如，不可枢转的)砧座组件112。在一些实施例中，砧座组件112可以可枢转地与近侧细长部102联接。
砧座罩180的第二端182b具有贯通其厚度而限定的开口188。开口188与弯曲的中心轴线“C2”对齐，以便在砧座板140与砧座罩180组装时，砧座板140和砧座罩180的相应的开口146、188重叠对齐。
砧座罩180包括固定在砧座罩180的表面192上并且沿着砧座罩180的外周“P”布置的细长表面结构件190。如在下文中更加详细描述的，砧座罩180的细长表面结构件190和砧座板140的焊道158构造为在砧座罩180与砧座板140组装时彼此抵接接合。细长表面结构件190可与彼此整体地形成以限定一个整体式的细长表面结构件，或者如图3A所示可沿着外周“P”彼此间隔开。细长表面结构件190具有与砧座板140的三角形焊道158对应的三角形横截面构造。在一些实施例中，细长表面结构件190可以呈现与焊道158的相应的形状相对应的各种形状和横截面构造，比如，例如，正方形、圆形、椭圆形、锥体、星形、均匀的、不均匀的，等等。可以预想，细长表面结构件190可以由各种材料制造，比如，例如，那些已在本文描述的材料。
参见图2A-图4B，将描述制造/组装砧座组件112的方法。通过使用砧座板140的壁156作为引导，并且通过相对于彼此地操纵砧座板140和砧座罩180直到限定在砧座板140的第二端142b中的开口146与限定在砧座罩180的第二端182b中的开口188对齐，砧座板140和砧座罩180以彼此互补的关系被放置。进一步地操纵砧座板140和砧座罩180，直到砧座板140的第一表面154a的焊道158与砧座罩180的表面192的纵向焊道结构件190处于抵接接合。
在合适地将砧座罩180和砧座板140定位时，超声波能施加器(图中未示出)将超声波能引向限定在砧座板140的焊道158与砧座罩180的细长结构件190之间的交接面“I”(图4B)。如图4A和图4B所示，超声波能熔化交接面“I”以将砧座罩180超声焊接于砧座板140。这个过程消除了对通常用于制造砧座组件112的板金压制、激光焊接、和其他复杂的机械加工操作的需求。也可以使用其他的焊接形式。
砧座罩180与焊接至其的砧座板140然后可以与末端执行器100的剩余部分联接。
可以理解的是，可以对当前公开的手术吻合器械的实施例做出各种变型。因此，以上的描述不应该构成为限制，而仅仅作为实施例的范例。本领域技术人员能够想到本公开的范围和主旨内的其他变型。

Claims (20)

1.一种与手术吻合器械一起使用的砧座组件，包括：
砧座板，其由热塑材料制造，并且具有纵向贯穿其而限定的刀具槽，所述砧座板包括：
第一表面，其具有沿着其外周布置的多个焊道；以及
第二表面，其与所述第一表面相对；以及
砧座罩，其由热塑材料制造，并构造成与所述手术吻合器械的远侧端联接，所述砧座罩包括具有沿着其外周布置的至少一个细长表面结构件的表面，其中所述砧座板的所述多个焊道和所述砧座罩的所述至少一个细长表面结构件构造为在组装时抵接接合。
2.根据权利要求1所述的砧座组件，其中所述多个焊道中的至少一个焊道具有三角形的构造。
3.根据权利要求1所述的砧座组件，其中所述至少一个细长表面结构件具有三角形的横截面构造。
4.根据权利要求1所述的砧座组件，其中所述热塑材料为聚醚醚酮。
5.根据权利要求1所述的砧座组件，其中所述砧座板的端部和所述砧座罩的端部均限定贯通的开口，以便在所述砧座板与所述砧座罩组装时所述开口处于重叠对齐。
6.根据权利要求1所述的砧座组件，其中所述砧座板进一步包括从其所述第二表面的端部垂直延伸的一对立柱。
7.根据权利要求6所述的砧座组件，其中所述砧座板进一步包括与所述一对立柱接合的一对偏置构件。
8.根据权利要求1所述的砧座组件，其中所述砧座板进一步包括从所述砧座板的所述第一表面的外周垂直延伸的壁。
9.根据权利要求1所述的砧座组件，其中所述砧座板具有弓形的构造。
10.一种与手术吻合器械一起使用的末端执行器，包括：
砧座组件，其包括：
砧座板，其由热塑材料制造，并且具有纵向贯穿其而限定的刀具槽，所述砧座板包括：
第一表面，其具有沿着其外周布置的多个焊道；以及
第二表面，其与所述第一表面相对；以及
砧座罩，其由热塑材料制造，并构造成与所述手术吻合器械的远侧端联接，所述砧座罩包括具有沿着其外周布置的至少一个细长表面结构件的表面，其中所述砧座板的所述多个焊道和所述砧座罩的所述至少一个细长表面结构件构造为在其组装时抵接接合；以及
钉仓组件，其中所述砧座组件或所述钉仓组件中的至少一个相对于另一个在间隔位置和接近位置之间能移动以接合并吻合位于其间的组织。
11.根据权利要求10所述的末端执行器，其中所述多个焊道中的至少一个焊道具有三角形的构造。
12.根据权利要求10所述的末端执行器，其中所述至少一个细长表面结构件具有三角形的横截面构造。
13.根据权利要求10所述的末端执行器，其中所述热塑材料为聚醚醚酮。
14.根据权利要求10所述的末端执行器，其中所述砧座板的端部和所述砧座罩的端部均限定贯通的开口，以便在所述砧座板和所述砧座罩组装时所述开口处于重叠对齐。
15.根据权利要求10所述的末端执行器，其中所述砧座板进一步包括从其所述第二表面的端部垂直延伸的一对立柱。
16.根据权利要求15所述的末端执行器，其中所述砧座板进一步包括与所述一对立柱接合的一对偏置构件。
17.根据权利要求10所述的末端执行器，其中所述砧座板进一步包括从所述砧座板的所述第一表面的外周垂直延伸的壁。
18.根据权利要求10所述的末端执行器，所述砧座组件和所述钉仓组件具有弓形的构造。
19.一种制造手术吻合器械的砧座组件的方法，所述方法包括：
提供由热塑材料制造并且具有纵向贯穿其而限定的刀具槽的砧座板，所述砧座板包括：
第一表面，其具有沿着其外周布置的多个焊道；以及
第二表面，其与所述第一表面相对；
提供由热塑材料制造并构造为联接至手术吻合器械的远侧端的砧座罩，所述砧座罩包括具有沿着其外周布置的至少一个细长表面结构件的表面；以及
在所述砧座板的所述多个焊道与所述砧座罩的所述至少一个细长表面结构件之间的交接面处，将所述砧座板超声焊接至所述砧座罩。
20.根据权利要求19所述的方法，进一步包括：在将所述砧座板与所述砧座罩超声焊接之前，将限定在所述砧座板的端部中的开口与限定在所述砧座罩的端部中的开口对齐。
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US20160256159A1 (en) 2016-09-08
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