CN106232026B - 具有能够关节运动的轴构造的外科器械 - Google Patents
具有能够关节运动的轴构造的外科器械 Download PDFInfo
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Abstract
一种外科器械(10)可包括外科端部执行器(100)，所述外科端部执行器(100)被构造成能够在至少一个控制动作施加到其时执行至少一个外科手术。所述外科器械还可包括细长轴组件(50)，所述细长轴组件(50)限定纵向工具轴线并且可操作地联接到所述外科端部执行器。所述细长轴组件可操作地支撑至少一个控制部件并且包括柔性关节运动部分(260)以用于有利于所述外科端部执行器相对于所述纵向工具轴线进行关节运动。所述柔性关节运动部分可包括纵向延伸的、细长的关节运动脊(262)，所述纵向延伸的、细长的关节运动脊(262)包括从所述关节运动脊的每个侧面延伸的多个肋(510,520)。每个肋可包括至少一个抗扭曲特征结构(530)以用于在外科端部执行器的关节运动期间阻止所述柔性关节运动部分围绕所述纵向工具轴线扭曲。
Description
技术领域
本发明涉及外科器械，并且在各种实施方案中，涉及被设计成用于切割和缝合组织的外科切割和缝合器械及其钉仓。
附图说明
通过结合附图来参考本发明实施方案的以下说明，本发明的各种形式的特征和优点以及其获取方法将会变得更加明显，并可更好地理解发明本身，其中：
图1为本发明的外科器械的一种形式的透视图；
图2为本发明的外科端部执行器的一种形式的分解透视图；
图3为图1的外科器械的一部分的分解透视图；
图4为图1的外科器械的另一部分的分解透视组件图；
图5为图1的外科器械的细长轴组件的一部分的分解透视组件图；
图6为远侧闭合管段和图2的外科端部执行器的透视图；
图7为砧座实施方案的一部分的后透视图；
图7A为另一个外科端部执行器组件的分解透视组件图；
图7B为另一个砧座组件实施方案和另一个闭合管段实施方案的一部分的后透视图；
图7C为另一个砧座组件和另一个远侧闭合管段的一部分的透视图；
图7D为另一个外科端部执行器实施方案的分解透视组件图；
图7E为另一个外科端部执行器实施方案的分解透视组件图；
图8为外科端部执行器和远侧闭合管段的侧剖视图，其中砧座组件处于打开位置；
图9为图8的外科端部执行器和远侧闭合管段的另一个侧剖视图；
图10为图1的外科器械的一部分的透视图，其中柄部外壳的一部分被移除；
图11为击发驱动系统的一部分的透视图；
图12为细长轴组件实施方案的中间部分的透视图；
图13为图12的中间轴部分的远侧端部的正视图；
图14为图12和图13的中间轴部分的侧正视图；
图15为图12-14的中间轴部分的平面图；
图16为图12-15的中间轴部分的相邻肋的部分的放大侧正视图；
图17为另一个中间轴部分实施方案的平面图；
图18为图17的中间轴部分的侧正视图；并且
图19为关节运动成基本上U形的图17和图18的中间轴部分的剖视平面图。
在所有这些视图中，对应的参考符号指示对应的部件。本文示出的范例以一种形式示出本发明的某些实施方案，并且此类范例不应被理解为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人还拥有以下专利申请，所述专利申请与本申请同一天提交并且全文各自以引用方式并入本文：
-名称为“Surgical Staples and Staple Cartridges”的美国专利申请，代理人案卷号END7341USNP/130301；
-名称为“Surgical Staples and Staple Cartridges”的美国专利申请，代理人案卷号END7331USNP/130304；
-名称为“Surgical Staples and Methods For Making the Same”的美国专利申请，代理人案卷号END7335USNP/130305；
-名称为“Surgical Staples,Staple Cartridges and Surgical EndEffectors”的美国专利申请，代理人案卷号END7332USNP/130306；
-名称为“Surgical Fastener”的美国外观设计专利申请，代理人案卷号END7338USDP/130307；
-名称为“Fastener Cartridge Comprising an Extendable Firing Member”的美国专利申请，代理人案卷号END7344USNP/130308；
-名称为“Fastener Cartridge Comprising a Firing Member Configured toDirectly Engage and Eject Fasteners From the Fastener Cartridge”的美国专利申请，代理人案卷号END7339USNP/130309；
-名称为“Fastener Cartridge Comprising a Firing Member IncludingFastener Surfaces”的美国专利申请，代理人案卷号END7340USNP/130310；
-名称为“Articulatable Surgical Instruments With Separate and DistinctClosing and Firing Systems”的美国专利申请，代理人案卷号END7333USNP/130322；
-名称为“Surgical Cutting and Stapling Instruments With IndependentJaw Control Features”的美国专利申请，代理人案卷号END7336USNP/130303；
-名称为“Surgical Cutting and Stapling Instruments With ArticulatableEnd Effectors”的美国专利申请，代理人案卷号END7334USNP/130312；
-名称为“Surgical Cutting and Stapling Methods”的美国专利申请，代理人案卷号END7330USNP/130313；和
-名称为“Modular Surgical Instruments”的美国专利申请，代理人案卷号END7342USNP/130311。
现在将描述某些示例性实施方案，以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途的原理。这些实施方案的一个或多个示例已在附图中示出。本领域的普通技术人员将会理解，在本文中具体描述并示出于附图中的装置和方法为非限制性的示例性实施方案，并且本发明的多个实施方案的范围仅由权利要求书限定。结合一个示例性实施方案进行图解说明或描述的特征可与其他实施方案的特征进行组合。这些修改和变型旨在涵盖于本发明的范围之内。
本说明书通篇提及的“各种实施方案”、“一些实施方案”、“一个实施方案”或“实施方案”等，意味着结合该实施方案描述的具体特征、结构或特性包括在至少一个实施方案中。因此，本说明书通篇出现的短语“在各种实施方案中”、“在一些实施方案中”、“在一个实施方案中”或“在实施方案中”等并不一定都指相同的实施方案。此外，在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式组合。因此，在无限制的情形下，结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。这些修改和变型旨在涵盖于本发明的范围之内。
本文所用术语“近侧”和“远侧”是相对于操纵外科器械的柄部部分的临床医生而言的。术语“近侧”是指最靠近临床医生的部分，并且术语“远侧”则是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可以结合附图使用空间术语诸如“竖直”、“水平”、“上”和“下”。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以执行腹腔镜式和微创外科手术操作。然而，本领域的普通技术人员将容易理解，本文所公开的各种方法和装置可用于许多外科手术和应用中，包括例如与开放式外科手术相结合。继续参阅本具体实施方式，本领域中的普通技术人员将进一步理解，本文所公开的各种器械可以任何方式插入体内，诸如通过自然腔道、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可被直接插入患者体内或可通过具有工作通道的进入装置插入，外科器械的端部执行器及细长轴可通过所述工作通道而推进。
图1示出了可包括外壳20、细长轴组件50的示例性外科器械10，所述细长轴组件50从外壳20可操作地伸出并且可操作地联接到外科端部执行器100。图1所示的外科器械10包括外壳20，所述外壳20由被构造成能够被临床医生抓握、操纵和致动的柄部22组成。继续参阅本具体实施方式，然而，应当理解，本文所公开的各种形式的轴构造和端部执行器构造的各种独特且新型的构造也可以有效地与机器人控制的外科系统一起使用。因此，术语“外壳”也可涵盖机器人系统的容纳或以其他方式可操作地支撑至少一个驱动系统的外壳或类似部分，所述至少一个驱动系统被构造成能够产生并施加可用于致动与其附接的各种形式的外科端部执行器的至少一种控制动作。术语“框架”可指手持式外科器械的一部分。术语“框架”还可表示机器人控制的外科器械的一部分和/或机器人系统的可用于可操作地控制外科器械的一部分。例如，2012年6月28日提交的名称为ROBOTICALLY-POWERED SURGICALDEVICE WITH MANUALLY ACTUATABLE REVERSING SYSTEM的美国专利申请序列No.13/536,323公开了也可有效地使用的各种机器人系统构造，该专利申请的全部公开内容以引用方式并入本文。此外，如将在下文更详细地论述，示于至少一些附图中的外科器械10使用马达来产生控制动作，以用于致动外科端部执行器的各种部件和特征结构。然而，继续参阅本具体实施方式，本领域中的普通技术人员将会理解，本发明的某些特征和优点也可结合配备有手动产生的(即，非马达产生的)致动和控制动作的外科器械来有效地获得。
如图1和图3所示，柄部22可包括一对可互连的外壳片段24、26，所述可互连的外壳片段24、26可通过螺钉、按扣特征结构、粘合剂等进行互连。如本文所用，术语“按扣特征结构”包括但不限于例如其上具有突起的凸块，所述突起被构造成能够保持性地接合另一个部件的对应配合部分。此类特征结构可被设计成可释放地接合配合部分或者其可被设计成或旨在不能被移除。在示出的构造中，柄部外壳片段24、26配合以形成可被临床医生抓握和操纵的手枪式握把部28。如将在下文更详细地论述，柄部22可操作地支撑其中的多个驱动系统或控制系统，所述驱动系统或控制系统被构造成能够产生各种控制动作并将控制动作施加到可操作地附接至外科端部执行器100的细长轴组件50的对应部件部分。在例示的实施方案中，外科端部执行器100被构造成能够例如切割和紧固组织。
图2示出了可采用的外科端部行器100的一种形式。如在此图中可见，外科端部执行器100可包括其中被构造成能够接收外科紧固件仓110的细长通道102。外科紧固件仓110可包括仓体112，所述仓体112在其中具有居中设置的细长狭槽114。仓体112还可包括成排的紧固件凹坑116，所述紧固件凹坑116位于细长狭槽114的每一侧并且被构造成能够在其中支撑对应的外科紧固件120。细长通道102还可在其中可操作地支撑组织切割构件或刀组件150，所述组织切割构件或刀组件150在安装于细长通道102中时被构造成能够在仓体112的狭槽114中轴向地行进。刀组件150可被构造为具有组织切割刃152，所述组织切割刃152居中地设置在下支脚154与上支脚或凸块156之间。如将在下文更详细地论述，刀组件150被构造成能够响应于击发驱动系统300对其施加的动作而在细长通道102和外科紧固件仓110内被轴向地驱动。
另外如在图2中可见，外科端部执行器100还可包括可运动地支撑在细长通道102上的砧座组件130。砧座组件130可例如响应于从闭合驱动系统200传送到其的闭合和打开动作来相对于外科紧固件仓110运动。然而，在其他构造中，砧座组件可为固定的并且外科紧固件仓可被构造成能够响应于对其施加的闭合动作来相对于砧座组件运动。在一种构造中，例如，砧座组件130包括砧座主体部分132，所述砧座主体部分132具有形成于其下侧的紧固件成形表面134。紧固件成形表面134可包括一系列成形凹坑(未示出)，所述成形凹坑对应于支撑在外科紧固件仓110中的外科紧固件120。当外科紧固件120的腿被驱动成与砧座组件130中的对应成形凹坑成形接触时，它们成形为期望的组织保持构型。砧座组件130还可包括砧座安装部分136，所述砧座安装部分136具有从其突出的一对凸耳138，所述凸耳138被接收在形成于细长通道102的近侧安装部分104中的对应弧形狭槽106内。在各种构造中，外科紧固件120被滑动件组件160和170驱动离开其在外科紧固件仓110中的对应紧固件凹坑116，所述滑动件组件160和170可运动地支撑在细长通道102内并且能够响应于击发驱动系统300对其施加的击发动作而运动。
现在参见图3，柄部22还可包括框架30，所述框架30可操作地支撑闭合驱动系统200和击发驱动系统300的各种部件。在至少一种形式中，闭合驱动系统200可包括被框架30可枢转地支撑的闭合触发器202形式的致动器。闭合触发器202可被框架30可枢转地支撑，使得当临床医生抓握柄部22的手枪式握把部28时，闭合触发器202可轻松地从起始或未致动位置枢转到致动位置，并且更具体地讲，枢转到完全压缩或完全致动的位置。闭合触发器202可被弹簧或其他偏置结构(未示出)偏置到未致动位置。有关闭合驱动系统200的构造和操作的某些方面的各种细节可见于2013年3月14日提交的名称为ARTICULATABLE SURGICALINSTRUMENT COMPRISING A FIRING DRIVE的美国专利申请序列No.13/803,097中，该专利申请的全部公开内容引用方式并入本文。如该参考文献所论述并且如本文的图3所示，闭合触发器202可被构造成能够与闭合释放组件220配合，所述闭合释放组件220可枢转地联接到框架30。在至少一种形式中，闭合释放组件220可包括释放按钮组件222，所述释放按钮组件222可通过释放弹簧(未示出)而沿着逆时针方向进行枢转。当临床医生将闭合触发器202从其未致动位置朝柄部22的手枪式握把部28按压时，闭合释放组件220用于将闭合触发器202锁定在完全致动位置。当临床医生期望将闭合触发器202解锁以允许其被偏置到未致动位置时，临床医生简单地枢转闭合释放按钮组件220，以使其脱离闭合触发器构造并且由此允许闭合触发器202枢转返回到未致动位置。也可采用其他闭合触发器锁定和释放构造。
参见图3和图4，闭合驱动系统200还可包括具有近侧端部212的近侧闭合管段210，所述近侧端部212被构造成能够可旋转地联接到闭合管附接托架230。近侧闭合管段210的近侧端部212被构造成能够接收在闭合管附接托架230的支架232(图3)内以允许相对其的相对旋转。近侧闭合管段210可通过U形连接器236可旋转地附接到闭合管附接托架230，所述U形连接器236被构造成能够接收在近侧闭合管段210的近侧端部212中的环形狭槽214中并且安置在闭合管附接托架230中的狭槽234(图3)中。此类构造用于将近侧闭合管段210可旋转地联接到闭合管附接托架230，使得近侧闭合管段210可相对其旋转。更具体地讲，此类构造有利于细长轴组件50相对于柄部22围绕由细长轴组件50限定的纵向工具轴线“LT-LT”的手动旋转，以使得临床医生能够按照由图1中的箭头“R”表示的方式来旋转外科端部执行器100。
在各种构造中，闭合管附接托架230可运动地安装在关节运动系统400的近侧关节运动管402上，所述关节运动系统400将在下文进行更详细地讨论。此类构造允许闭合管附接托架230响应于闭合触发器202的致动而在近侧关节运动管402上轴向地运动。具体地讲，闭合管附接托架230可通过闭合连接杆240可枢转地联接到闭合触发器202。参见图3。因此，当临床医生朝柄部22的手枪式握把部28向内枢转闭合触发器202时，闭合管附接托架230将沿远侧方向“D”推进。当击发触发器202返回到未致动位置时，闭合管附接托架230将在近侧关节运动管402上朝近侧(方向“P”)推进到起始位置。
闭合驱动系统200还可包括被构造成能够附接到近侧闭合管段210的远侧端部218的中间柔性管段250。如在图5中可见，中间管段250可包括柔性关节运动部分260和附接杆部分252。附接杆部分252的尺寸可设定成延伸到近侧闭合管段210的开口远侧端部218内以与其摩擦接合。柔性关节运动部分260可与附接杆部分252一体形成并且包括具有近侧端部部分264(仅一个部分可见于图5中)的关节运动脊262，所述近侧端部部分264被构造成能够接收在近侧闭合管段210的远侧端部218中的对应凹口219中以阻止近侧闭合管段210和中间管段250之间的相对旋转。中间管段250可通过例如螺杆、止动器、粘合剂等不可旋转地(即，被附接以阻止这些部件之间的相对旋转)附接到近侧闭合管段210。
闭合驱动系统200还可包括远侧闭合管段280，所述远侧闭合管段280被构造成能够轴向地接合砧座组件130并且对其施加打开动作和闭合动作。远侧闭合管段280可附接到中间管段250的远侧端部以用于与其一起轴向行进。关节运动脊262还可包括远侧端部部分266，所述远侧端部部分266被构造成能够接收在远侧闭合管段280的近侧端部282中的对应凹口284中以阻止远侧闭合管段280和中间管段250之间的相对旋转。参见图5。远侧闭合管段280的近侧端部282可具有向内延伸的附接凸块286，所述附接凸块286能够弯曲到中间管段250中的对应凹口266内。参见图5和图6。此类构造用于有利于将远侧闭合管段280附接到中间管段250，以用于与其一起轴向行进。
远侧闭合管段280被构造成能够对砧座组件130施加打开动作和闭合动作。如在图7中可见，砧座安装部分136的一种形式可与限定砧座凸块142的沟槽140一起形成。如在图6和图8中可见，远侧闭合管段280的远侧端部288具有形成于其中的向内延伸的致动凸块290，所述致动凸块290被构造成能够与砧座凸块142进行交互。例如，当远侧闭合管段280处于打开位置(图6和图8)时，致动凸块290与砧座凸块142偏置接触，所述砧座凸块142用于将砧座组件130枢转到打开位置。如图9所示，当砧座组件130处于打开位置时，凸耳138位于细长通道102的近侧安装部分104中的凸耳狭槽106的底部中。当远侧闭合管段280朝远侧推进时，远侧端部288接触砧座主体132上的直立端壁144，以导致砧座组件130朝外科紧固件仓110枢转或以其他方式运动。当被组装时，凸耳138各自延伸到远侧闭合管段280中的对应开口292内。参见图6。
现在将描述闭合驱动系统200的操作。可通过朝向和远离柄部22的手枪式握把部28枢转闭合触发器来使砧座组件130相对于外科紧固件仓110运动。因此，致动闭合触发器202导致近侧闭合管段210、中间管段250和远侧闭合管段280沿着远侧方向“DD”轴向地运动，以接触砧座主体部分132的端壁144，从而使得砧座130朝外科紧固件仓110枢转或以其他方式运动。临床医生可通过打开和闭合砧座组件130来抓持和操纵砧座组件130和紧固件仓110之间的组织。一旦靶组织被捕获在砧座组件130和紧固件仓110之间，临床医生就可将闭合触发器202枢转到完全致动位置，在该位置中其被锁定在适当位置以用于击发。
如上文所指出的那样，框架30还可被构造成能够可操作地支撑击发驱动系统300，所述击发驱动系统300被构造成能够将击发动作施加到细长轴组件50的对应部分并且最终施加到刀组件150和滑动件组件160、170。如在图3和图10中可见，击发驱动系统300可采用支撑在柄部22的手枪式握把部28中的电动马达302。在各种形式中，马达302可为例如具有大约25,000RPM的最大转速的直流有刷驱动马达。在其他构造中，马达302可包括无刷马达、无绳马达、同步马达、步进马达或任何其他合适的电动马达。电池304(或“电源”或“电源组”)，例如锂离子电池，可联接到柄部22以向控制电路板组件306并且最终向马达302提供功率。图3示出了被构造成能够可释放地安装到柄部22以便向外科器械10提供控制功率的电池组外壳305。可将多个串联的电池单元用作对马达302供电的电源。此外，电源可为可更换的和/或可充电的。
如上文相对于其他各种形式所概述，电动马达302可包括与齿轮减速器组件310可操作地交接的可旋转轴308，所述齿轮减速器组件310与一组或一齿条的驱动齿322啮合安装在纵向可移动驱动构件320上。齿轮减速器组件310可包括(除了别的以外)外壳312和输出小齿轮314。参见图11。在某些实施方案中，输出小齿轮314可直接与能够纵向运动的驱动构件320可操作地接合，或者另选地，通过一个或多个中间齿轮316与驱动构件320可操作地接合。在至少一个此类实施方案中，中间齿轮316可与限定在驱动构件320中的一组或一齿条驱动齿322啮合。在使用中，电动马达302可使驱动构件朝由箭头“DD”指示的远侧运动，和/或朝由箭头“PD”指示的近侧运动，这取决于电动马达302旋转中间齿轮316的方向。在使用中，电池所提供的电压极性可沿顺时针方向操作电动马达302，其中由电池施加到电动马达的电压极性可被反向，以便沿逆时针方向操作电动马达302。当电动马达302沿一个方向旋转时，驱动构件320将沿远侧方向“DD”被轴向地驱动。当马达302被沿相反的旋转方向驱动时，驱动构件320将沿近侧方向“PD”被轴向地驱动。柄部22可包括开关，所述开关被构造成能够使由电池施加到电动马达302的极性反向。柄部22还可包括被构造成能够检测可运动的驱动构件320的位置和/或可运动的驱动构件320正在运动的方向的传感器。
马达302的致动可通过可枢转地支撑在柄部22上的击发触发器330进行控制。击发触发器330可在未致动位置和致动位置之间枢转。击发触发器330可被弹簧(未示出)或其他偏置构造偏置到未致动位置，使得当临床医生释放击发触发器330时，其可被弹簧或偏置结构枢转到或以其他方式返回未致动位置。在至少一种形式中，击发触发器330可定位在闭合触发器202“外侧”，如此前全文以引用方式并入本文的美国专利申请序列No.13/803,097中更详细所述。在至少一种形式中，击发触发器安全按钮332可枢转地安装到闭合触发器202。安全按钮332可定位在击发触发器330和闭合触发器202之间，并且具有从其突出的枢转臂(未示出)。当闭合触发器202处于未致动位置时，安全按钮332被容纳在柄部外壳中，此时临床医生可能无法轻易地触及所述按钮并将其在防止对击发触发器330致动的安全位置与其中击发触发器330可被击发的击发位置之间移动。当临床医生按压闭合触发器202时，安全按钮332和击发触发器330向下枢转到其中它们随后可被临床医生操纵的位置。
如上所述，在至少一种形式中，能够纵向运动的驱动构件320具有在其上形成的一齿条的齿322，以用于与齿轮减速器组件310的对应驱动齿轮312啮合接合。至少一种形式还可包括可手动致动的“救助”组件，所述组件被构造成能够允许临床医生在马达变得失能的情况下手动地回缩能够纵向运动的驱动构件320。美国专利申请序列No.13/803,097包含可采用的救助组件的一种形式的其他细节。美国专利申请公布No.US 2010/0089970也公开了“救助”构造以及也可与本文所公开的各种器械一起使用的其他部件、构造和系统。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLEFIRING SYSTEM”的美国专利申请序列No.12/249,117(现为美国专利申请公布No.2010/0089970)全文以引用方式并入本文。
参见图4和图5，细长轴组件50的各种形式可包括击发构件组件60，所述击发构件组件60被支撑以用于在关节运动轴组件430内轴向行进，所述关节运动轴组件430为关节运动系统400的一部分并且基本上用作轴框架或脊。击发构件组件60还可包括具有近侧端部部分64的近侧击发轴62，所述近侧端部部分64被构造成能够可旋转地接收在设置于可运动驱动构件320的远侧端部324中的远侧支架326内。此类构造允许近侧击发轴62相对于可运动驱动构件320旋转同时还与其一起轴向运动。近侧击发轴62还可具有形成于其远侧端部66中的狭槽68，以用于在其中接收柔性远侧击发轴组件70的近侧端部72。参见图5。如在此图中可见，远侧击发轴组件70的近侧端部72可接收在远侧击发轴62中的狭槽68内并且可利用销73与其销接。
远侧击发轴组件70可包括位于右滑动件推动器梁76和左滑动件推动器梁78之间的中央击发梁74。中央击发梁74和推动器梁76、78可例如各自由以下金属制成，所述金属在端部执行器100进行关节运动时有利于外科端部执行器100中的滑动件组件160、170的轴向致动同时还有利于其挠曲，如将在下文更详细地论述。在至少一种构造中，中央推动器梁74、右滑动件推动器梁76和左滑动件推动器梁78可延伸穿过砧座安装部分136中的狭槽146。右滑动件推动器梁76对应于右滑动件组件160并且左滑动件推动器梁78对应于运动地支撑在细长通道102内的左滑动件组件170。右滑动件推动器梁76和左滑动件推动器梁78的轴向运动将分别导致右滑动组件160和左滑动件组件170在细长通道102内的轴向推进。当右滑动件组件160在细长通道102内轴向推进时，其驱动支撑在狭槽114右侧的仓体112中的外科紧固件120离开其相应的凹坑116，并且当左滑动件组件170在细长通道102内轴向推进时其驱动支撑在狭槽114左侧的仓体112内的外科紧固件120离开其相应的凹坑116。
中央击发梁74具有远侧端部80，所述远侧端部80被构造成能够接收在设置于刀组件154中的狭槽152内并且通过例如摩擦配合、粘合剂、焊接等保持在其中。底部窗口105可形成于细长通道102的远侧端部103中，以使得刀组件150能够穿过其插入。在至少一种形式中，细长通道102被形成为具有限定居中设置的通道狭槽109的右直立壁107和左直立壁108。一旦将刀组件150插入细长通道102中的底部窗口105内，刀组件150的主体部分151就可插入通道狭槽109内并且在细长通道102中朝近侧推进以与中央击发梁74的远侧端部180联接。下通道覆盖件111可附接到细长通道102的底部，以阻止组织、体液等进入细长通道102内，所述组织、体液等可阻碍刀组件150在细长通道内的运动。
在一种形式中，砧座组件130可按照如下方式安装到细长通道102上。为了开始安装过程，将砧座组件130定位在细长通道102上方，使得凸耳138可插入细长通道102的近侧安装部分104中的凹口113内，所述凹口113使得凸耳138能够进入细长通道102中的对应凸耳狭槽106。参见图2。这种安装可在远侧闭合管段280已附接到中间管段250之前或远侧闭合管段280已充分朝近侧运动以允许砧座被如此定位之后来执行。一旦凸耳138接收在其相应的凸耳狭槽106内，就可将远侧闭合管段280移动到图8和图9所示的位置，其中远侧闭合管段280将凸耳138保持在其相应的凸耳狭槽106中并且致动凸块290与用于将砧座组件130枢转到打开位置的砧座凸块142偏置接触。当处于该位置时，每个凸耳138突出到远侧闭合管段280中的对应开口192内。参见图6。如图2和图8所示，当砧座组件130处于打开位置时，刀组件150的上端进入砧座主体部分132中的窗口133。此类窗口133提供了间隙以在刀组件150保持在未致动位置时使砧座组件130运动到闭合位置。一旦砧座组件130已与处于适当位置的刀组件150安装在一起，就可将砧座覆盖件135附接到砧座主体134，以阻止组织、体液等进入砧座主体134内，所述组织、体液等可阻碍刀组件150在砧座主体中的运动。当刀组件150在端部执行器100中朝远侧推进时，刀组件150的上凸块156接合砧座主体中的凸缘，并且下支脚154接合细长通道102的部分115并且用于将砧座组件130保持在闭合位置并基本上维持砧座组件130和紧固件仓110之间的间距。
图7A和图7B示出了可与砧座组件130’一起工作的另选的远侧闭合管构造280’，所述砧座组件130’可与砧座组件130基本上相同，不同的是砧座组件130’不含砧座凸块。在此类构造中，例如，每个凸耳138延伸到远侧闭合管段280’中的对应开口292’内。远侧闭合管段280还包括向内延伸的鳃形凸块294，所述鳃形凸块294向内突出以用于与对应的砧座凸耳138接触。当沿近侧方向“PD”牵拉远侧闭合管段280’时，每个鳃形凸块294接触对应的凸耳138，以导致凸耳在细长通道102中的其对应的凸耳狭槽106中向下运动，从而使砧座组件130’枢转或以其他方式运动到打开位置。图7C示出了另一个远侧闭合管构造280”，其中致动凸块由远侧闭合管段280”中的凹痕290”形成，所述凹痕290”用于按照上述方式与砧座凸块142进行交互。
图7D示出了另选的砧座组件130”，其中砧座凸块142’可移除地附接到砧座安装部分136。在一种构造中，例如，砧座凸块142’被构造成具有被布置成保持接合砧座安装部分136中的开口141的按扣凸块143。砧座组件130”可在其他方面与上述砧座组件130相同并且可通过远侧闭合管段280以类似的方式打开和闭合。图7E示出了另一个砧座组件130”，其中砧座凸块由能够可移除地附接到砧座安装部分138的螺钉148形成。此类可移除的砧座凸块/螺钉构造可有利于砧座组件130’的安装的方便性。
参见图4和图5，关节运动系统400的一种形式包括关节运动轴组件430，所述关节运动轴组件430可由关节运动控制系统460来可操作地控制。在一种形式中，例如，关节运动轴组件430可包括右关节运动轴段440和左关节运动轴段450。右关节运动轴段440包括其中形成有右通道段444的近侧端部442。同样，左关节运动轴段450包括其中形成有左通道段454的近侧端部部分452。当右关节运动轴段440和左关节运动轴段450安装在近侧闭合管段210内时，它们形成关节运动轴组件430。右通道段444和左通道段454配合以在其中接收近侧击发轴62的一部分。右关节运动轴段440和左关节运动轴段450可由例如由塑料(尤其是以商品名Grivory GV-6H购自EMS-American Grilon的玻璃纤维增强型无定形聚酰胺)构成。
在各种构造中，例如，关节运动控制系统460可包括被支撑以用于相对于柄部22旋转行进的喷嘴组件462。如在图4中可见，喷嘴组件462可包括通过一系列紧固件(例如，螺钉)468附接到在一起的上喷嘴段464和下喷嘴段466。上喷嘴段464被构造成能够在其上可旋转地支撑关节运动控制旋钮470。在一种构造中，例如，关节运动控制旋钮470延伸穿过上喷嘴段464中的开口(未示出)并且通过螺钉474联接到关节运动齿轮构件472。关节运动齿轮构件472可包括关节运动正齿轮476，所述关节运动正齿轮476延伸到近侧闭合管段210的近侧端部部分212中的开口216内。如在图4中进一步可见，关节运动系统400还包括右致动管适配器478和左关节运动管适配器480。右关节运动管适配器478具有形成于其中的右凹槽479，所述右凹槽479能够接收形成于右关节运动轴段440的近侧端部442上的右适配器耳状物446。同样，左关节运动管适配器480包括左凹槽482，所述左凹槽482能够接合形成于左关节运动轴段450的近侧端部452上的左适配器耳状物456。右关节运动管适配器478还具有一系列右关节运动驱动齿轮481，所述右关节运动驱动齿轮481被构造成能够与关节运动正齿轮476啮合接合。左关节运动管适配器480具有形成于其中的一系列左关节运动驱动齿轮484，所述左关节运动驱动齿轮484能够与关节运动正齿轮476互相啮合。因此，当关节运动控制旋钮470相对于柄部22(图1)围绕横向于纵向工具轴线LT-LT的控制轴线CA-CA旋转时，左关节运动轴段450例如在近侧闭合管段210内沿远侧方向“DD”被轴向驱动并且右关节运动轴段440同时沿近侧方向“PD”被轴向驱动。
仍然参见图5，关节运动轴组件430还可包括右关节运动带490和左关节运动带500。在一种形式中，右关节运动带490的近侧端部部分492可附接到右关节运动轴段的远侧部分448，使得右关节运动带490的远侧部分494突出到其中的右通道449之外。右关节运动带490的近侧端部部分492可包括孔或腔体493，所述孔或腔体493被构造成能够接收右关节运动轴段440中的对应耳状物(未示出)以有利于将右关节运动带490附接到右关节运动轴段440。同样，左关节运动带500的近侧端部部分502可在其中具有孔或腔体503，所述孔或腔体503被构造成能够接收左关节运动轴段450的远侧部分458中的耳状物(未示出)以有利于将左关节运动带500附接到关节运动轴段450。关节运动带490和500可由金属构成，有利地由全硬301不锈钢或其等同物构成。
现在参见图12-15，如上文所简要论述，中间管段250可具有附接杆部分252和柔性关节运动部分260。在各种构造中，中间管段250可由例如以ISOPLAST等级2510购自DowChemical Company的刚性热塑性聚氨酯制成并且包括居中设置的、竖直延伸的关节运动脊262。关节运动脊262包括有利于分别附接到近侧闭合管段210和远侧闭合管段280的近侧脊端部264和远侧脊端部266，如上所述。关节运动脊262还包括居中设置的部件或刀狭槽270，以有利于各种控制部件从中穿过。在例示的构造中，狭槽270可运动地支撑中央击发梁74、右推动器梁76和左推动器梁78。在各种形式中，居中设置的狭槽270被基本上包封，以阻碍或阻止体液和组织渗入其中，所述体液和组织可以其他方式阻碍控制部件可操作地穿过其的运动。
如在图15中最具体可见，柔性关节运动部分260还包括可与关节运动脊262一体形成并且从其侧向地突出的多个右肋510和多个左肋520。在各种形式中，例如，每个右肋510可包括通过对应的右肋颈部部分516与关节运动脊262间隔开的肋主体部分512。同样，每个左肋520可包括通过左肋颈部部分526与关节运动脊262间隔开的左肋主体部分522。如在图13中可见，右肋主体部分512和左肋主体部分522具有弧形形状，以提供具有基本上圆形横截面形状的中间管段250的柔性关节运动部分260。此类形状可有利于中间管段250穿过圆形通道，例如，适当尺寸的套管针。
在各种构造中，右肋颈部部分516中的每一个用于限定右关节运动通道518以用于可运动地接收穿过其的右关节运动带490。右关节运动带490可延伸穿过右关节运动通道518并且联接到细长通道102的近侧安装部分104。例如，右关节运动带490的远侧端部494可具有能够联接到细长通道102的右附接部分497的右钩部分496。参见图2。相似地，左肋颈部部分526中的每一个用于限定左关节运动通道528以用于可运动地接收穿过其的左关节运动带500。左关节运动带500可延伸穿过左关节运动通道528并且联接到细长通道102的近侧安装部分104。例如，左关节运动带500的远侧端部504可具有能够联接到细长通道102的左附接部分507的左钩部分506。
现在将描述操作关节运动系统400的一个方法。当临床医生希望使端部执行器100相对于纵向工具轴线LT-LT(右侧方向由图15中的箭头“RD”表示)向右侧进行关节运动时，临床医生仅沿适当方向旋转关节运动控制旋钮470。例如，沿顺时针方向旋转控制旋钮470(当从上方观察时)导致沿远侧方向“DD”推动左关节运动带并且沿近侧方向“PD”牵拉右关节运动带490，由此用于对细长通道102施加关节运动动作。当对细长通道102施加关节运动动作时，柔性关节运动部分260挠曲，以允许外科端部执行器100沿“右侧”方向运动。反之，如果临床医生希望使端部执行器100沿左侧方向“LD”进行关节运动，则临床医生仅沿逆时针方向旋转控制旋钮470，从而导致沿远侧方向“DD”推动右关节运动带490并且沿近侧“PD”方向牵拉左关节运动带500，由此导致外科端部执行器100向左侧运动。还可通过被构造成能够对关节运动带490、500施加控制动作的机器人系统(未示出)来使端部执行器100进行关节运动。
在对外科端部执行器100施加上述关节运动动作时，可期望避免扭曲或扭转中间管段250的柔性关节运动部分260。如果发生这种扭转或扭曲，则可能阻碍，或者在严重扭曲的情况下可能完全阻止中央击发梁74以及右滑动件推动器梁76和左滑动件推动器梁78的操作。为了避免该问题，右肋510和左肋520可被独特地构造成能够阻止肋之间的扭曲。
在至少一种构造中，例如，每个肋主体512具有侧向端部，所述侧向端部被布置成与相邻肋的肋主体的侧向端部呈间隔开的、面对关系。再次参见图15，例如，每个右肋510的肋主体512具有第一右侧向端部513和第二右侧向端部514。除了最近侧右肋510P和最远侧右肋510D之外，一个右肋510的第一右侧向端部513与相邻的右肋510的第二右侧向端部514呈面对关系。当中间管段250的柔性关节运动部分260未进行关节运动(例如，柔性关节运动部分260沿纵向工具轴线LT-LT基本上轴向对齐)时，每个右肋510的第一右侧向端部513与相邻右肋510的第二右侧向端部514间隔开右肋间距515。在图15所示的构造中，例如，全部右肋间距515具有基本上相同的间距宽度“SWR”。同样，每个左肋520的肋主体522具有第一左侧向端部523和第二左侧向端部524。除了最近侧左肋520P和最远侧左肋520D之外，一个左肋520的第一左侧向端部523与相邻左肋520的第二左侧向端部524呈面对关系。当中间管段250的柔性关节运动部分260未进行关节运动时，每个左肋520的第一左侧向端部523与相邻左肋520的第二左侧向端部524间隔开左肋间距525。在图15所示的构造中，例如，全部左肋间距525具有基本上相同的间距宽度“SWL”。在至少一种形式中，右肋间距宽度SWR与左肋间距宽度SWL基本上相同。然而，右肋间距宽度和左肋间距宽度可彼此不同。
仍然参见图15，每个肋可具有大体标定为530的抗扭曲构造。在至少一种构造中，例如，抗扭曲突起532可形成于右肋主体512的第一右侧向端部513中的每一个上和每个左肋主体522的第一左侧向端部523的每一个上。每个抗扭曲突起532可与形成于紧邻并且成面对关系的肋中的基本上互补形状的凹槽534相对应。图14示出了左肋520上的这种构造。在至少一种构造中，右肋510采用相同的构型。在至少一种形式中，突起532可沿着侧向轴线基本上对齐。即，形成于右肋510上的突起532可在关节运动脊262的右侧沿着右侧向轴线RLA-RLA基本上对齐，并且形成于左肋520上的突起532可在关节运动脊262的左侧沿着左侧向轴线LLA-LLA基本上对齐。当柔性部分260未进行关节运动时，右侧向轴线RLA-RLA、左侧向轴线LLA-LLA和纵向工具轴线LT-LT可彼此基本上平行。如在图15中可见，右侧向轴线RLA-RLA和左侧向轴线LLA-LLA与纵向工具轴线LT-LT间隔开。
当柔性关节运动部分260沿右侧方向“RD”进行关节运动时，右肋510上的突起532中的至少一些将摩擦接合相邻右肋510中的对应凹槽532中的一部分，以阻止柔性部分260扭曲。相似地，当柔性关节运动部分260沿左侧方向“LD”进行关节运动时，左肋520上的突起532中的至少一些将以“抗扭曲取向”接合相邻左肋520中的凹槽532中的一部分，以阻止柔性部分260扭曲。突起532与相邻左肋520中的腔体534的底部之间的这种接合/取向例如示于图16中。如在此图中可见，在该示例中，第二肋520中的一个的第一左侧向端部523邻接相邻左肋520的第二左向侧端部524，由此阻止或阻碍中间管段250的柔性部分260的扭曲。
还可以想到各种另选的抗扭曲构造。例如，抗扭曲特征结构可不设置在例如最近侧的四个肋上。在其他构造中，抗扭曲特征结构可设置在构成柔性段的中心区域的多个肋中，但不设置在最近侧肋和最远侧肋中。在其他构造中，可沿着柔性段的长度每隔一对肋使用抗扭曲特征结构。例如，最近侧对的相邻肋可具有抗扭曲特征结构，然后紧邻的一个或多个肋(上述肋的远侧)可不具有抗扭曲特征结构并且随后紧邻肋(上述肋的远侧)可具有抗扭曲特征结构等等。这些另选的构造可仅应用到关节运动脊的一侧的肋，或者它们可用于关节运动脊的两侧的肋上。通过改变具有抗扭曲特征结构的肋的数量、位置和/或间距，以及肋(具有和不具有扭曲特征结构)之间的间距宽度，以及关节运动脊的几何形状，可有利地调节柔性段的整体柔性、其关节运动程度、其刚性程度及其关节运动速率。
参见图12和图13，在例示的构造中，关节运动脊262为细长的并且具有大体标定为“H”的高度。在至少一种构造中，高度“H”对于关节运动脊262的长度“L”而言为基本上一致的。此外，关节运动脊262可从近侧端部部分264到远侧端部部分266逐渐减小。更具体地讲，如在图12中可见，近侧端部部分262具有近侧宽度“PW”并且远侧端部部分266具有远侧宽度“DW”。在例示的实施方案，“PW”大于远侧宽度“DW”并且关节运动脊的宽度沿着长度“L”从近侧端部264到远侧端部266逐渐减小(如与高度形成对照)。此类逐渐减小的关节运动脊构造还用于在外科端部执行器的关节运动期间阻碍扭曲，同时有利于相对于柔性部分260的近侧端部增加柔性部分260的远侧端部的关节运动并且有利于各种控制部件(例如，中央击发梁74、右滑动件推动器梁76、左滑动件推动器梁78等)从其可运动地穿过。
另外，在一种构造中，当柔性部分260处于未关节运动或挠曲位置时，右肋间距515和左肋间距525的全部具有相同的起始宽度。因此，在这构型中，SWR＝SWL。图17和图18示出了另一个中间管段250’，其可与上述中间管段250’基本上相同，不同的是右肋间距515’和左肋间距525’在从柔性关节运动部分260’的近侧端部行进到柔性关节运动部分260的远侧端部期间具有递减的量值。即，最近侧右肋间距515P’为最宽的右肋间距并且最远侧右肋间距515D’为最窄的右肋间距，其中右肋间距515’沿着远侧方向“DD”逐渐变窄。相似地，最近侧左肋间距525P’为最宽的左肋间距并且最远侧左肋间距525D’为最窄的左肋间距，其中左肋间距525’沿着远侧方向逐渐变窄。在此类构造中，当对外科端部执行器施加关节运动动作时，柔性部分260’将在其远侧端部具有更快的挠曲速率。即，当对端部执行器施加关节运动动作时，柔性段260’的远侧部分将进行弯曲或关节运动的速率大于在该远侧段近侧的260’的另一部分将进行关节运动的速率。换句话讲，远侧端部上的肋之间的相对运动将在更近侧肋之间的相对运动停止之前停止，因为远侧肋之间的间距小于近侧肋之间的间距。在例示的构造中，彼此侧向对齐的右肋间距515’和左肋间距525’的宽度可在量值上相等。此类肋间距宽度构造可使得柔性关节运动部分260’能够根据需要呈现基本上“U”形。参见例如图19。然而，应当理解，可使用各种其他狭槽宽度构造、尺寸和构型以实现所需的关节运动量/范围，同时阻止中间管围绕纵向工具轴线不经意地扭曲。
本发明的各种形式可与外科端部执行器的各种不同形式结合使用，以在不引起扭曲的情况下实现此类端部执行器的关节运动和操作，所述扭曲可阻碍交接在端部执行器和各种控制系统之间的控制部件的操作。在一种形式中，例如，提供了一种外科器械，所述外科器械可包括外科端部执行器和限定纵向工具轴线的细长轴组件。细长轴组件可操作地联接到外科端部执行器并且包括具有近侧端部和远侧端部的柔性段。在对外科端部执行器施加关节运动动作时，柔性段被构造成能够使得其远侧部分进行关节运动的关节运动速率快于在远侧部分近侧的柔性段的另一部分的另一关节运动速率。
根据另一种一般形式，提供了一种包括外科端部执行器的外科器械，所述外科端部执行器被构造成能够在由至少一个控制部件对其施加至少一个控制动作时执行至少一个外科手术。细长轴组件可限定纵向工具轴线并且可操作地联接到外科端部执行器。细长轴组件可操作地支撑控制部件中的至少一个并且包括柔性关节运动部分，所述柔性关节运动部分用于在对外科端部执行器施加关节运动动作时有利于外科端部执行器相对于纵向工具轴线进行关节运动。在至少一种形式中，柔性关节运动部分可包括具有两个侧面的纵向延伸的、细长的关节运动脊。多个肋可从关节运动脊的每个侧面沿其长度延伸。每个肋可包括形成于其中的至少一个抗扭曲特征结构以用于在外科端部执行器相对于工具轴线进行关节运动期间阻止柔性关节运动部分围绕纵向工具轴线扭曲。
根据至少一种其他一般形式，提供了一种外科器械，所述外科器械可包括外壳，所述外壳可操作地支撑被构造成能够选择性地产生至少一个控制动作的至少一个控制系统。所述外科器械还可包括外科端部执行器，所述外科端部执行器被构造成能够在至少一个控制动作施加到其时执行至少一个外科手术。细长轴组件可操作地联接到外壳和外科端部执行器，并且限定纵向工具轴线。细长轴组件可包括柔性关节运动部分，所述柔性关节运动部分包括具有两个侧面的纵向延伸的、细长的关节运动脊。多个肋可从关节运动脊的每个侧面沿其长度延伸。每个肋可包括至少一个抗扭曲特征结构以用于在外科端部执行器相对于工具轴线进行关节运动期间阻止柔性关节运动部分围绕纵向工具轴线扭曲。
根据至少一种其他一般形式，提供了一种外科器械，所述外科器械可包括端部执行器，所述端部执行器包括细长通道，所述细长通道被构造成能够支撑包括组织切割构件和多个外科紧固件的外科紧固件仓。砧座组件相对于细长通道可被支撑。所述外科器械还可包括外壳，所述外壳可操作地支撑被构造成能够选择性地产生击发动作的击发驱动系统的至少一部分。外壳还可支撑用于产生闭合和打开动作的闭合系统的至少一部分。外壳还可支撑被构造成能够产生关节运动动作的关节运动系统的至少一部分。细长轴组件可操作地联接到外壳和外科端部执行器，并且限定纵向工具轴线。细长轴组件可与闭合系统可操作地交接，以对端部执行器选择性地施加打开动作和闭合动作。细长轴组件还可包括柔性关节运动部分，所述柔性关节运动部分包括具有长度和沿长度逐渐减小的宽度的纵向延伸的、细长的关节运动脊。细长的关节运动脊还可具有贯穿延伸的部件通道。多个肋可从关节运动脊的每个侧面沿其长度延伸。每个肋可包括形成于其中的至少一个抗扭曲特征结构以用于在外科端部执行器相对于工具轴线进行关节运动期间阻止柔性关节运动部分围绕纵向工具轴线扭曲。所述外科器械还可包括柔性击发梁，所述柔性击发梁可运动地支撑在部件通道内并且与击发控制系统和组织切割构件可操作地交接。右关节运动梁可由右肋可操作地支撑并且与关节运动系统和细长通道可操作地交接。左关节运动梁可由左肋可操作地支撑并且与关节运动系统和细长通道接合。
本领域技术人员将会认识到，本文所述的部件(例如，操作)、装置、对象和它们随附的讨论是为了概念清楚起见而用作示例，并且可以设想多种构型修改形式。因此，如本文所用，阐述的具体示例和随附的讨论旨在代表它们更一般的类别。通常，任何具体示例的使用旨在代表其类别，并且具体部件(例如，操作)、装置和对象的未纳入部分不应采取限制。
对于本文中使用的基本上任何复数和/或单数术语，本领域技术人员可从复数转换成单数和/或从单数转换成复数，只要适合于上下文和/或应用就可以。为清楚起见，各种单数/复数置换在本文中没有明确表述。
虽然本文描述了多个实施例，但可以实现那些实施例的多种修改形式、变型形式、替代形式、变化形式和等同形式，这些形式是本领域技术人员将会想到的。另外，凡是公开了用于某些部件的材料的，均可使用其他材料。因此，应当理解，上述具体实施方式和所附的权利要求旨在涵盖属于本发明所公开的实施例范围内的所有此类修改形式和变型形式。以下权利要求旨在涵盖所有此类修改形式和变型形式。
可将本发明所公开的装置设计成单次使用后即进行处理，或者可将它们设计成是多次使用的。然而，在任一种情形下，所述装置均可进行修复，以在至少一次使用后再次使用。修复可包括拆卸装置、清洗或更换具体部件以及后续重新组装的其中任意几个步骤的组合。具体地，所述装置可以拆卸，而且可以任意组合选择性地更换或移除所述装置的任意数目的特定零件或部件。清洗和/或置换特定部分后，该装置可以在修复设施处重新组装以便随后使用，或者在即将进行外科手术前由外科队重新组装。本领域的技术人员将会知道，装置的重新修复可利用多种用于拆卸、清洗/更换和重新组装的技术。这些技术的用途以及得到的重新修复装置均在本发明的范围内。
优选的是，在手术前处理本文所述的发明。首先，获取新的或用过的器械，并根据需要进行清洗。然后可对器械进行灭菌。在一种消毒技术中，将所述器械放置在闭合且密封的容器中，例如塑料或TYVEK袋中。然后将容器和器械置于可穿透该容器的辐射场，例如γ辐射、x-射线或高能电子。辐射杀死器械上和容器中的细菌。然后可将灭菌后的器械储存在无菌容器中。该密封容器使器械保持无菌直到在医疗设施中打开该容器为止。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本公开所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。同样地并且在必要的程度下，本申请明确阐述的公开内容取代了以引证方式并入本申请的任何冲突材料。据称以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
概括地说，已经描述了由采用本文所述的概念产生的许多有益效果。为了举例说明和描述的目的，已经提供了一个或多个实施例的上述具体实施方式。这些具体实施方式并非意图为详尽的或限定到本发明所公开的精确形式。可以按照上述教导对本发明进行修改或变型。所选择和描述的一个或多个实施例是为了示出本发明的原理和实际用途，从而允许本领域的普通技术人员能够利用多个实施例，并且在适合设想的具体应用的情况下进行各种修改。与此一同提交的权利要求书旨在限定全部范围。
Claims (9)
1.一种外科器械，包括：
外科端部执行器；以及
细长轴组件，所述细长轴组件限定纵向工具轴线并且可操作地联接到所述外科端部执行器，所述细长轴组件包括柔性段，所述柔性段包括：
包括两个侧面的纵向延伸的、细长的关节运动脊，所述脊包括长度和沿所述长度逐渐减小的宽度；和
多个肋，所述多个肋从所述关节运动脊的每个侧面沿其长度侧向地延伸，其中当对所述外科端部执行器施加关节运动动作时所述柔性段的远侧部分进行关节运动的关节运动速率快于在所述远侧部分近侧的所述柔性段的另一部分的另一关节运动速率；
其中所述关节运动脊的两个侧面包括：
右侧面；和
左侧面，并且其中所述多个肋包括：
至少三个右肋，所述至少三个右肋从所述关节运动脊的右侧面突出，使得第一间距设置于所述右肋之间，所述第一间距中的每一个具有第一间距宽度；以及
至少三个左肋，所述至少三个左肋从所述关节运动脊的左侧面突出，使得第二间距设置于所述左肋之间，所述第二间距中的每一个具有第二间距宽度；
其特征在于，所述第一间距宽度在从所述柔性段的近侧端部出发到所述柔性段的远侧端部期间具有连续减小的量值，并且其中所述第二间距宽度在从所述柔性段的近侧端部出发到所述柔性段的远侧端部期间具有连续减小的量值。
2.根据权利要求1所述的外科器械，其中所述关节运动脊包括近侧端部、远侧端部和高度，并且其中所述近侧端部具有近侧宽度，并且其中所述远侧端部具有与所述近侧宽度不同的远侧宽度。
3.根据权利要求2所述的外科器械，其中所述近侧宽度大于所述远侧宽度。
4.根据权利要求1所述的外科器械，其中所述第一间距宽度中的至少一者不同于所述第一间距宽度中的至少另一者，并且其中所述第二间距宽度中的至少一者不同于所述第二间距宽度中的至少另一者。
5.根据权利要求1所述的外科器械，其中所述第一间距宽度中的至少一者等于所述第二间距宽度中的至少一者。
6.根据权利要求1所述的外科器械，其中在所述关节运动脊的右侧面上侧向延伸的所述多个肋中的至少两个各自包括右抗扭曲突起，所述右抗扭曲突起被构造成能够接合所述右侧面上的对应的其他肋中的右抗扭曲止动器，并且其中所述关节运动脊的左侧面上的所述多个肋中的至少两个各自包括左抗扭曲突起，所述左抗扭曲突起被构造成能够接合所述左侧面上的对应的其他肋中的左抗扭曲止动器。
7.根据权利要求6所述的外科器械，其中每个所述右抗扭曲突起和每个所述右抗扭曲止动器在所述柔性部分未进行关节运动时沿着右侧向轴线对齐，并且其中每个所述左抗扭曲突起和每个所述左抗扭曲止动器在所述柔性关节运动部分未进行关节运动时沿着左侧向轴线基本上对齐。
8.根据权利要求1所述的外科器械，其中：
所述端部执行器包括：
细长通道，所述细长通道被构造成能够支撑其中的外科紧固件仓，所述外科紧固件仓包括组织切割构件和多个外科紧固件；
和
相对于所述细长通道被支撑的砧座，并且其中所述外科器械还包括：
外壳；
被构造成能够选择性地产生击发动作的击发驱动系统，其中所述击发驱动系统的至少一部分由所述外壳可操作地支撑；
用于产生闭合动作和打开动作的闭合系统，并且其中所述闭合系统的至少一部分由所述外壳可操作地支撑；
被构造成能够产生关节运动动作的关节运动系统，其中所述关节运动系统的至少一部分由所述外壳可操作地支撑；
所述细长轴组件可操作地联接到所述外壳和所述外科端部执行器并且限定纵向工具轴线，所述细长轴组件与所述闭合系统可操作地交接以对所述端部执行器选择性地施加所述打开动作和闭合动作，
所述柔性段包括柔性关节运动部分，并且所述细长的关节运动脊包括穿过其的部件通道；
所述关节运动脊的每个侧面上的至少一个所述肋包括从所述肋向外朝相邻的所述肋突出的抗扭曲突起，并且其中所述相邻的所述肋包括对应于所述抗扭曲突起的抗扭曲止动器，使得当对所述柔性关节运动部分施加扭曲动作时，所述抗扭曲突起接合所述对应的抗扭曲止动器；所述细长轴组件还包括：
柔性击发梁，所述柔性击发梁能够运动地支撑在所述部件通道内并且与所述击发驱动系统和所述组织切割构件可操作地交接；
右关节运动梁，所述右关节运动梁由所述右肋可操作地支撑并且与所述关节运动系统和所述细长通道可操作地交接；以及
左关节运动梁，所述左关节运动梁由所述左肋可操作地支撑并且与所述关节运动系统和所述细长通道交接。
9.根据权利要求8所述的外科器械，还包括：
右滑动件推动器梁，所述右滑动件推动器梁能够运动地支撑在所述部件通道中并且与所述击发驱动系统和所述外科端部执行器交接；
和
左滑动件推动器梁，所述左滑动件推动器梁能够运动地支撑在所述部件通道中并且与所述击发驱动系统和所述外科端部执行器交接。
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Also Published As
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| JP6517214B2 (ja) | 2019-05-22 |
| RU2016130055A3 (zh) | 2018-07-02 |
| WO2015100100A3 (en) | 2015-08-06 |
| MX2016008381A (es) | 2017-01-09 |
| PL2886068T3 (pl) | 2019-04-30 |
| BR112016014836A2 (pt) | 2020-09-24 |
| EP2886068A2 (en) | 2015-06-24 |
| EP2886068A3 (en) | 2015-09-30 |
| WO2015100100A2 (en) | 2015-07-02 |
| BR112016014836B1 (pt) | 2021-12-28 |
| EP2886068B1 (en) | 2018-07-18 |
| JP2017500148A (ja) | 2017-01-05 |
| RU2016130055A (ru) | 2018-01-30 |
| US20150173789A1 (en) | 2015-06-25 |
| CN106232026A (zh) | 2016-12-14 |
| RU2677918C2 (ru) | 2019-01-22 |
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