CN106687052A - 手术紧固件施加装置 - Google Patents
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- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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Abstract
本公开涉及一种用于将紧固件施加至身体组织的手术紧固件施加装置。所述装置包括限定了细长沟槽构件的钉仓容纳半部，所述细长沟槽构件构造成可释放地容纳发射组件和单次使用装载单元。锁定结构防止了在发射组件安装至钉仓容纳半部之后单次使用装载单元插入沟槽构件中。可替换地，如果单次使用装载单元未与发射组件接合，则锁定结构防止发射组件完全插入钉仓容纳半部中。
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，涉及一种具有重复使用及一次性构件的手术紧固件施加装置。
背景技术
手术紧固件施加装置中，首先将组织在对置钳夹结构之间夹持或夹紧，然后通过手术紧固件联结在现有技术中是周知的。在一些此种装置中，刀设置为对已经被紧固件联结的组织进行切割。虽然还可以使用其他手术紧固件，诸如例如夹子或两部分的复合手术紧固件，但是紧固件一般为手术吻合钉的形式。
手术紧固件施加装置一般包括两个用于在其间捕捉或夹紧组织的细长梁构件。一般地，其中一个梁构件承载容纳多个布置成至少两横行的吻合钉的一次性钉仓组件，而另一个梁构件包括砧座，该砧座限定了当吻合钉由钉仓组件驱动对吻合钉腿成形的表面。在使用两部分的紧固件的情况下，包括砧座的梁构件承载两部分的紧固件的配合部，例如，接收器。通常，吻合钉成形过程受到一个或多个纵向运动的凸轮系统构件及一系列独立吻合钉推进器之间相互作用的影响。随着凸轮系统构件纵向地穿过钉仓承载梁构件行进，各个推进器构件被向上偏置至支撑在钉仓组件中的吻合钉的后节距(backspan)中，从而将吻合钉从钉仓中弹出。刀可以设置为随凸轮系统构件在吻合钉行之间行进，以切割成形后的吻合钉的行之间的组织。在专利号为No.7,631,794的美国专利中公开了该器械的一个实例，其全部公开通过引用以其全部并入本文。
由于与手术装置的不当杀菌相关的危险，紧固件施加装置一般是用后即弃。虽然可以替换钉仓组件以在一个患者身体上执行多种紧固件施加操作，但是吻合钉施加装置一般是在手术过程已经完成后即丢弃的。与手术过程相关的一次性使用性的要求可能增加成本。虽然已经开发了可再利用的紧固件施加装置，但是这种装置可能过于复杂并且难以杀菌。
本领域中存在如下需求：包括可再利用构件的紧固件施加装置，其不过度复杂，并且构造为使手术过程中使用后的适当的杀菌变得容易。
发明内容
本发明涉及一种用于将手术紧固件施加到组织的手术紧固件施加装置。在本公开的实施例中，手术紧固件施加装置包括砧座半部，限定了细长沟槽构件的钉仓容纳半部，以及单次使用装载单元和构造为容纳在所述沟槽构件中的发射组件。所述发射组件可以包括锁定结构，其在所述发射组件安装至所述沟槽构件中之后防止所述单次使用装载单元完全插入所述沟槽构件中。
在实施例中，当所述单次使用装载单元与所述发射组件接合时，所述单次使用装载单元和所述发射组件一起形成单一一次性单元。
在实施例中，所述锁定结构可以限定防止所述单次使用装载单元和所述发射组件配接的第一位置和允许所述单次使用装载单元和所述发射组件配接的第二位置。所述锁定结构构造为在在其第一位置和其第二位置之间运动。然而，当所述发射组件支撑在所述沟槽构件中时，阻止所述锁定结构从所述第一位置移动到所述第二位置。
在实施例中，所述锁定结构包括具有定位销的弹簧加载旋钮。所述定位销操作地连接至所述发射组件的凸轮杆。当所述锁定结构处于所述第一位置时，所述凸轮杆相对于所述发射组件处于前进位置，从而防止了所述单次使用装载单元的近侧端进入所述发射组件的远侧端。
在实施例中，所述锁定结构包括安装在所述发射组件的刀致动杆的顶部上的弹簧加载按钮，所述弹簧加载按钮构造为实现所述刀致动杆通过限定在所述发射组件的底表面上的凹槽的枢转运动。当所述锁定结构处于所述第一位置时，所述刀致动杆处于通常位置，这防止了所述单次使用装载单元的近侧端进入所述发射组件的远侧端。
在实施例中，本公开提供一种手术紧固件施加装置，其包括砧座半部，限定了细长沟槽构件的钉仓容纳半部，以及单次使用装载单元和构造为容纳在所述沟槽构件中的发射组件。所述发射组件可以包括锁定结构，如果所述单次使用装载单元没有安装至所述发射组件，其可以防止所述发射组件完全插入所述沟槽构件。
在实施例中，所述锁定结构可以限定防止所述发射组件完全插入所述沟槽构件的第一位置和允许所述发射组件完全插入所述沟槽构件的第二位置。所述锁定结构构造为在其第一位置和其第二位置之间运动。然而，当所述发射组件与所述单次使用装载单元接合时，阻止了所述锁定结构从所述第二位置运动到所述第一位置。
在实施例中，所述锁定结构包括可拆卸地安装至限定在所述沟槽构件的侧壁上的槽的旋钮。所述旋钮可通过所述槽运动至阻止所述单次使用装载单元进入所述沟槽构件的位置。
在实施例中，本公开提供一种手术紧固件施加装置，其包括砧座半部，限定了细长沟槽构件的钉仓容纳半部，以及单次使用装载单元和可安装至所述沟槽构件的发射组件。所述发射组件可以包括可安装至所述沟槽构件的锁定结构。如果所述发射组件紧固至所述钉仓容纳半部中，所述锁定结构可以防止所述单次使用装载单元插入所述沟槽构件。
在实施例中，所述锁定构件包括弹簧加载开关，其可滑动通过限定在所述发射组件的侧壁上的槽。当所述弹簧加载开关滑动通过所述槽时，所述锁定构件在所述第一位置和所述第二位置之间移动。
附图说明
在此将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是从本公开的处于夹紧位置的手术紧固件施加装置的实施例的远侧端观察的侧透视图；
图2是从图1所示的处于夹紧位置的手术紧固件施加装置的近侧端观察的侧透视图；
图2A是图1所示的手术紧固件施加装置的处于打开位置的侧透视图；
图2B是图2A所示的指示的细节区域的放大图；
图3是将图1所示的手术紧固件施加装置的各部分分离所得的侧透视图；
图3A是图1所示的紧固件施加装置的夹紧杆的侧视截面图；
图4是图1所示的手术紧固件施加装置的钉仓容纳半部的侧透视图，其中，单次使用装载单元和发射组件支持在所述钉仓容纳半部中；
图5是图4所示的指示的细节区域的放大图；
图6是从手术紧固件施加装置的钉仓容纳半部的上方观察的透视图，其具有SULU和发射组件支撑在其中；
图7是图6所示的指示的细节区域的放大图；
图8是从图3所示的手术紧固件施加装置的发射组件的上方观察的前端透视图；
图9是图8所示的指示的细节区域的放大图；
图9A是沟槽构件的俯视透视图，其具有可释放地紧固在其中的发射组件；
图9B是图9A所示的指示的细节区域的放大图；
图9C是沟槽构件的中央部的俯视透视图；
图10是从图8所示的发射组件的上方观察的后端透视图；
图11是图10所示的指示的细节区域的放大图；
图12是将各部分分离的图10所示的发射组件的侧透视图；
图12A是图12所示的发射组件的凸轮杆的仰视透视图；
图12B是图12所示的发射组件的发射杆的仰视透视图；
图13是图1所示的手术紧固件施加装置的SULU的侧透视图；
图14是图13所示的指示的细节区域的放大图；
图15是图13所示的SULU的正透视图；
图16是图15所示的指示的细节区域的放大图；
图17是图15所示的SULU在部件分离情况下的侧透视图；
图18是处于打开位置的图1所示的手术紧固件施加装置的侧视截面图；
图19是图18所示的指示的细节区域的放大图；
图20是图18所示的指示的细节区域的放大图；
图21是处于打开位置的图18所示的手术紧固件施加装置的近侧端的透视图；
图22是图18所示的指示的细节区域的放大图；
图23是从图1所示的手术紧固件施加装置的夹紧杆的近侧端的下方观察的透视图；
图24是处于夹紧位置的图1所示的手术紧固件施加装置的侧透视图；
图25是处于夹紧位置的图24所示的手术紧固件施加装置的侧视截面图；
图26是图25所示的指示的细节区域的放大图；
图27是图25所示的指示的细节区域的放大图；
图28是沿图26的截线28-28截取的截面图；
图29是当发射组件运动通过致动行程以从紧固件施加装置中弹出紧固件时图1所示的手术紧固件施加装置的俯视图；
图30是图29所示的手术紧固件施加装置的侧截面图，其具有处于致动位置的发射组件；
图31是图30所示的指示的细节区域的放大图；
图32是图30所示的指示的细节区域的放大图；
图33是在装置已被发射并运动至打开位置之后图1所示的手术紧固件施加装置的侧截面图；
图34是图33所示的指示的细节区域的放大图；
图35A是示出凸轮杆处于缩回位置的发射组件的替代实施例的侧视示意图；
图35B是凸轮杆处于前进位置的图35A的发射组件的侧视示意图；
图35C是凹部包括于其中的沟槽构件的替代实施例的侧视示意图；
图36A是具有处于正常非枢转位置的刀致动杆的发射组件的另一实施例的侧视示意图；
图36B是图36A的发射组件的俯视透视图；
图36C是示出了限定在其中的细长槽的图36B的发射组件的固定壳体的侧视剖视透视图；
图36D是图36A的发射组件的侧视示意图，其具有处于枢转位置的刀致动杆；
图36E是安装有单次使用装载单元的图36A的发射组件的侧视示意图；
图37A是具有安装到其上的旋钮的沟槽构件的替代实施例的侧视示意图；
图37B是图37A的旋钮的俯视透视图；
图37C是具有与沟槽构件中的槽对准的侧壁的图37B的旋钮的截面示意图；
图37D是在沟槽构件中的图37C的旋钮的俯视平面图；
图37E是图37D所示的指示的细节区域的放大图；
图37F是沟槽构件的截面图以及旋转到沟槽构件中的槽中的图37E的旋钮的端视图；
图37G是在沟槽构件中的图37F的旋钮的俯视平面图；
图37H是图37G所示的指示的细节区域的放大图；
图37I是当旋钮插入沟槽构件中时沟槽构件的截面图以及图37B的旋钮的视图；
图37J是图37I的沟槽构件的切除部的侧面图和旋钮的端视图；
图38A是其中安装有开关的发射组件的另一个替代实施例的侧面图；
图38B是图38A的具有限定在其中的凹坑以容纳图38A的开关的沟槽构件的替代实施例；
图38C是图38A的沟槽构件的侧壁的内表面的侧透视图。
具体实施方式
参考附图详细描述本公开的手术紧固件施加装置的实施例，其中，相同的附图标记标注同一或相应的元件。本文所用的术语“近侧”指的是装置离用户较近的部分，而术语“远侧”指的是装置进一步远离用户的部分。
参照图1至图3，手术吻合器10包括砧座半部12，钉仓容纳半部14，夹紧杆16，单次使用装载单元18(以下称为“SULU”)和发射组件20。在实施例中，砧座半部12、钉仓容纳半部14和夹紧杆16构成可再利用的部件，并且因此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。相反，SULU 18和发射组件20构成为一次性的，并且因此可以由具有必要强度特性的任意合适的生物相容性材料(例如塑料，金属，其组合)构造。
参照图3至图7，钉仓容纳半部14限定了细长沟槽构件22，细长沟槽构件22限定了具有定尺寸为可释放地容纳SULU 18的远侧部24a及定尺寸为可释放地容纳发射组件20的近侧部24b的U型沟槽24。U型沟槽可以具有平坦的底部和在截面中竖直的腿部，或者它可以具有稍微圆形的底部和/或至少一个弯曲的腿部。在截面中，U的底部可以通过尖角或至少一个稍微圆形的角部与腿连接。发射组件20包括固定壳体26(还参照图12)，固定壳体26具有包括容纳枢轴构件29(图12)的端部的开口28的近侧端。枢轴构件29枢转地支撑在固定壳体26的近侧端上的锁紧构件206，并且通过开口28延伸到形成在钉仓容纳半部14的近侧部中的凹槽30中，以将发射组件20的近侧端可释放地紧固在沟槽构件22的近侧部24b中，这将在下文中进一步详细讨论。发射组件20的远侧端限定了三角形切口部64d。三角形切口部64d可以是三角形或可以是具有尖角或至少一个圆角或倒角的三角形，并且可以不具有相等的边或两个或三个相等的边。切口部64d定位成容纳形成在沟槽构件22(见图9A至图9C)的内壁上的突起部65，以将发射组件20的远侧端可释放地紧固在沟槽构件22中。发射组件20的结构也将在下文中进一步详细讨论。同样地，SULU 18包括一对远侧突起部32，其定位在形成在沟槽构件22的远侧端处的切口部34中，以将SULU 18可释放地紧固在沟槽构件22的远侧部24a中。在组装期间，发射组件20必须在SULU 18插入沟槽构件22的远侧24a之前插入沟槽构件22的近侧部24b中，这将在下文中讨论。为了将SULU 18定位在沟槽构件22中，将SULU 18上的突起部32定位在切口部34内，同时将SULU 18定位在沟槽构件22上方并与其成一定角度。之后，能够将SULU 18向下旋转至U型的沟槽24的远侧部24a中。这允许发射组件20的驱动部件与SULU 18的部件恰当的排列，并且还使得发射组件20与支撑在SULU 18中的刀40(图17)的接合变得简单。SULU 18的近侧端包括向外延伸的锯齿状表面42(图7)以易于SULU 18的近侧端的夹紧，从而允许从沟槽构件22移走和/或替换SULU 18。如将在下文中讨论的，在吻合器10运动至夹紧位置之前，锯齿状夹紧表面42将不会完全置于沟槽构件22的远侧部24a中。
参照图8至图12，发射组件20包括固定壳体26，刀致动杆44，凸轮杆46，引导块48，发射杆50，滑块52，踏板54以及枢转锁紧构件206(图12)。在实施例中，固定壳体26包括具有下壁62和一对侧壁64的U型框60。各侧壁64的远侧端限定了近侧阶64b、远侧倾斜部64c(图9)和三角形切口部64d。如上文所述，定位三角形切口部64d以容纳形成于沟槽构件22的内壁上的突起部65(图9B)。各侧壁64的近侧端包括一对横向延伸的可变形壁部66(图11)，其与滑块52的近侧端隔开并且限定了壁部66和滑块52之间的区域，用于枢转地容纳锁紧构件206，这将在下文中进一步详细讨论。
引导块48包括限定了三个纵向槽70a、70b、70c及一对向外延伸的突起部72的主体。在实施例中，各突起部72呈圆柱形并且包括渐缩部72a(图9)。圆柱形突起部72可以是具有圆形横截面的圆柱体，或者可以具有稍微椭圆形的横截面。另外，圆柱形突起部72可以具有钝端或稍微圆形或锥形的端部。可替换地，还可以设想其它突起部的构造。突起部72定尺寸为被容纳在形成于固定壳体26的侧壁64中的开口74(图12)中，以将引导块48轴向地固定在固定壳体26的远侧端中。突起部72允许引导块48在U型框60内的一定程度的枢转运动。如将在下文进一步详细讨论的，响应于吻合器10运动至夹紧位置，引导块48从与刀致动杆44的凹口49和凹口51锁紧接合的第一位置(图19)枢转至与刀致动杆44的凹口49和凹口51脱离的第二位置(图26)。绕突起部72设置扭力弹簧以推动引导块48与凹口49和51锁紧接合。各槽70a和槽70c定尺寸为可滑动地容纳凸轮杆46的各自的侧壁114。相似地，槽70b定尺寸为可滑动地容纳刀致动杆44。
滑块52包括毂80，其包括构造为搭扣配合至形成于发射杆50中的枢转洞82中的弹性指形件80a。当滑块52在缩回位置时，发射杆50绕毂80枢转，从而使发射组件20从吻合器10的任一侧的致动变容易。踏板54往复地容纳在形成于滑块52中的洞84中。踏板54包括构造为横跨刀致动杆44的近侧端102的开槽主体部54a。在实施例中，开槽主体部54a包括倾斜的远侧表面86。销88从踏板54向上延伸通过滑块52中的洞84。偏置构件90定位于开槽主体部54a和滑块52之间，围绕销88以推动踏板向下地远离滑块52至延伸位置。在滑块52的缩回位置，踏板54被收纳于形成于沟槽构件22的下壁22a中的切口部55中(图20)。
发射杆50包括第一指接合构件50a和第二指接合构件50b，它们中的任一个能够被可选地接合，从而从吻合器10的任一侧移动发射杆50通过发射行程。弓形凹槽94(图12B)形成于发射杆50的底表面中，其可滑动地收纳踏板54的销88，从而限定发射杆50能够绕滑块52的毂80枢转所通过的旋转范围。如在此使用的，发射行程定义为发射杆50从完全缩回位置(图25)至完全推进位置(图30)的位移。止动凹槽94a形成于弓形凹槽94的各端。止动凹槽94a构造并定尺寸为收纳踏板54的销88的端部，从而防止在手术吻合器10的发射行程期间发射杆50绕毂80的枢转运动。更具体地，当发射组件20被致动以在固定壳体26中向远侧地推进滑块52时，踏板54的倾斜的远侧表面86接合沟槽构件22并且凸出(cammed out of)切口部55(图27)，以将销88向上地推动至止动凹槽94a中，从而防止在发射杆50通过发射行程的运动期间发射杆50的枢转运动。明显的，销88必须定位在止动凹槽94a之下，以允许踏板54从切口部55向上升起，以允许通过发射行程运动发射杆50。由此，发射杆50必须在能够通过发射行程运动发射杆50之前枢转至发射组件20的一侧或另一侧。
刀致动杆44包括具有阶梯部100的近侧端，阶梯部100包括具有第一高度的近侧第一阶102及具有高于第一高度的第二高度的第二阶104。致动杆44的远侧端包括上弯曲钩部106及上凹口49和下凹口51。指形件108从在第一阶102和第二阶104之间的刀致动杆44向上地突出。如图27所示，指形件108可滑动地容纳在形成于滑块52底侧中的凹槽110中。当滑块52在固定壳体26中向远侧地推进时，指形件108在凹槽110中运动，使得滑块52相对于刀致动杆44运动，直到指形件108与限定了凹槽110的近侧端的壁112(图32)接合为止。当指形件108与壁112接合，滑块52的进一步的向远侧运动也将实现刀致动杆44的向远侧运动。如下文中显而易见的，该布置允许在切割组织前将吻合钉从SULU 18中弹出。
参照图12和12A，凸轮杆46包括一对侧壁114和基壁116(图12A)。各侧壁114的近侧端114a包括凸起壁部118。各凸起壁部118构造为固定地容纳于形成于滑块52下侧中的槽(未示出)中，以将凸轮杆46的近侧端固定地紧固到滑块52。可替换地，滑块52可以围绕刀致动杆44的近侧端模制。各侧壁114的远侧端包括倾斜的凸轮表面114b。基壁116限定了向远侧延伸的细长槽123(图12A)及向近侧地延伸的纵向槽121，细长槽123从凸轮杆46的远侧端沿着凸轮杆46的大体长度延伸。当滑块52处于缩回位置时，槽121定位以易于踏板54通过沟槽构件22的切口部55。参见图27。
凸轮杆46的侧壁114可滑动地定位在引导块48的槽70a和槽70c中，并且刀致动杆44可滑动地定位在引导块48的纵向槽70b中。当发射组件20支撑在沟槽构件22中并且发射杆50枢转至固定壳体26的一侧并被向远侧地推动时，滑块52在固定壳体26中向远侧地运动。由于滑块52开始向远侧地运动，踏板54的渐缩表面86与限定了切口部55的沟槽构件22的远侧边缘接合，以推动踏板54向上离开切口部55，通过凸轮杆46的槽121，并且到达发射组件20的固定壳体26的内表面上(图27)。当这发生时，踏板54的销88运动至止动凹槽94a中，以防止发射杆50的进一步的枢转运动。如果发射杆50未枢转到销88定位在止动凹槽94a之下的位置，则将防止踏板54向上运动离开切口部55，并且将防止发射杆50运动通过发射行程。当发射杆50向远侧地运动时，指形件108在凹槽110中运动，使得随着凸轮杆46远侧地推进，刀致动杆44保持静止。当指形件108与限定了凹槽110的近侧壁112接合时，刀致动杆44随滑块52和凸轮杆46向远侧地运动。如将在下文中讨论的，当凸轮杆46和刀致动杆44在发射组件20的固定壳体26和沟槽构件22中向远侧地运动时，凸轮杆46的倾斜的凸轮表面114b运动通过SULU 18，以从SULU 18弹出紧固件。同时，尽管具有等于凹槽112(图32)的长度的预设延迟，刀致动杆杆44驱动刀片40通过SULU 18以剖割组织。
美国专利No.7,631,794(“‘794专利”)公开了包括与上文类似的发射组件的示例性的手术紧固件施加装置。‘794专利通过引用整体并入本文。
图13至图17示出了SULU 18。参照图17，SULU 18包括主体120，多个吻合钉推进器122(仅显示了一个)，底盖124，具有倾斜的锋利前缘或刀锋40a的刀40，多个吻合钉126(仅显示了一个)，以及枢转安装的安全锁定件128。主体120的近侧端包括略微突出超出限定主体120的外壁的挠性指形件120a。指形件120a摩擦地接合沟槽构件22的内壁，以在SULU 18可释放地定位于沟槽构件22中时将SULU 18的近侧端保持在沟槽构件22中。如本领域中已知的，主体120具有多排吻合钉保持槽130(例如四排，六排等)和居中地布置在主体120中的线性开槽刀轨道132。手术吻合器10可以定尺寸为容纳或收纳包括例如60mm、80mm和100mm的不同吻合线长度的SULU。刀40包括下弯曲钩部40b，其定位为当SULU 18定位在沟槽构件22中时，接合刀致动杆44的上弯曲钩部106(图12)。
在示出的实施例中，主体120包括形成在线性开槽刀轨道132的任一侧上的两行交错的槽130。交错成行的槽130延伸超过刀轨道132的远侧端，以便利超出刀片40的行程的远侧端将吻合钉成形。
吻合钉推进器122可以构造为延伸至一个或多个槽130中。在实施例中，单个推进器与各槽130相关联。可替换地，如图17所示，各推进器122能够构造为延伸至两个邻接的槽130中，并且定位于保持在槽130中的相应的吻合钉126之下。如本领域中已知的，各推进器122包括下凸轮表面122a，其定位以接合凸轮杆46的远侧端上的凸轮表面114b中的一个(图12)，使得凸轮杆46通过SULU 18的运动顺序地提升在其相应的一个或多个槽130中的各相应的推进器122，以从槽130弹出吻合钉。
底盖124部分地包围形成在钉仓主体120中的沟槽125(图18)。纵向脊部134形成在底盖124的上表面上，并且为紧固于刀40的底部边缘的刀支撑构件136提供支承表面。刀40可以经由销、焊接或其它已知的紧固技术紧固至支撑构件136。在发射行程期间，随着推进发射杆50通过沟槽构件22，刀40沿刀轨道132被引导。一对槽138限定在脊部134的侧面和钉仓主体120的外壁之间。纵向脊部134定位在主体120中并且定尺寸为可滑动地容纳在凸轮杆46的细长槽120(图12A)中，使得凸轮杆46可滑动地通过钉仓主体120关于纵向脊部134运动，以从SULU 18弹出吻合钉126。
安全锁定件128枢转地布置在主体120的上近侧端上，并且绕枢轴构件150从锁紧方位(图26)枢转至解锁方位(图34)。枢轴构件150容纳在主体120中的开口154中。偏置构件，例如弹簧152，定位在刀支撑构件136和安全锁定件128之间，以朝向解锁方位推动安全锁定件128。安全锁定件128包括近侧钩156，其定位以容纳形成在刀40上的接合构件158，以当刀40处于缩回位置时将安全锁定件128保持在锁紧方位(图19)。当在发射行程期间刀40朝向推进位置运动时，接合构件158远离近侧钩156运动，以允许安全锁定件128响应于弹簧152的推动而朝向解锁位置枢转。应当注意，由于安全锁定件128的顶表面128a接合砧座半部12的内表面从而防止了安全锁定件128的枢转，当砧座半部12和钉仓容纳半部14处于夹紧位置时，防止了安全锁定件128枢转至解锁位置。安全锁定件128限定了定尺寸为可滑动地容纳刀40的槽160。在刀40的缩回位置，刀40的前缘40a被限制在安全锁定件128的槽160中，以防止医生与刀40的前缘40a的意外接合和受伤。
再次参照图2和图3，砧座半部12包括近侧手柄部12a和远侧砧座部12b。砧座部12b包括吻合钉变形部198，如本领域已知的，吻合钉变形部198包括多个吻合钉变形凹槽，并且当SULU 18定位在沟槽构件22中时，吻合钉变形部198面向SULU 18的顶表面。还如本领域中已知的，吻合钉变形部198包括用于当刀40运动通过SULU 18时容纳刀40(图17)的中心纵向槽(未图示)。吻合钉变形部198能够与砧座半部12一体地形成，或可替换地，通过诸如焊接的紧固工序而紧固至砧座半部12。一对定位指形件170(图3)定位为与砧座部12b的吻合钉变形部198的近侧端邻近。将定位指形件170容纳在SULU 18的凹槽中，以在装置处于夹紧位置时将SULU 18与吻合钉变形部198适当地对准。
砧座半部12的中心部包括一对圆柱形横向支撑构件172。在砧座半部12和钉仓容纳半部14的组装期间，横向支撑构件172支撑在限定在钉仓容纳半部14的中心部173中的U型凹槽174中(图28)。中心部173的远侧壁173a限定组织止动件(图3)。当夹紧杆16运动到夹紧位置(图2B)时，横向支撑构件172也被定位成容纳于形成在夹紧杆16的间隔开的凸缘部178上的切口176中。近侧手柄部12a是人体工学地形成的，并且包括拇指接合支座180和抓握部182。手柄部12a的近侧端包括向下延伸的指形件184，其包括一对对立的泪滴形突起部186，将在下文中进一步对其描述。可替换地，突起部186可以呈现各种构造。
钉仓容纳半部14包括间隔开的中心布置的U型凹槽174，其定位成支撑砧座半部12的横向支撑构件172。钉仓容纳半部14的近侧端包括一对竖直支撑构件188。各竖直支撑构件188包括具有圆形底表面的细长竖直槽188a。竖直槽188a定尺寸为当砧座半部12在组装期间支撑在钉仓容纳半部14上时，容纳形成在砧座半部12(图21)的指形件184上的突起部186。通过将突起部186定位在竖直槽188a中，砧座半部12可以相对于钉仓容纳半部14在打开位置和闭合位置之间以剪刀状方式枢转。在实施例中，突起部186具有泪滴轮廓。钉仓容纳半部14的至少一个侧壁包括凹陷189(参见图3)，其将在下文中进一步详细讨论。
夹紧杆16还包括手柄部190，手柄部190包括抓握件190a和拇指接合支座192。如上所述，一对间隔开的凸缘部178支撑在夹紧杆16的远侧端上。各凸缘部178限定了切口176，切口176定尺寸为当吻合器10朝向夹紧位置(图2B)运动时容纳砧座半部12的相应的横向支撑构件172。夹紧杆16的远侧端还限定了定尺寸为容纳枢轴构件187的一对开口194。枢轴构件187定尺寸为延伸通过钉仓容纳半部14中的开口195及夹紧杆16中的开口194，以将夹紧杆16枢转地紧固至钉仓容纳半部14。
如图3A所示，夹紧杆16的内壁包括突起件201。突起件201定位在形成于钉仓容纳半部14的侧壁中的凹陷189(图2A)中，以将夹紧杆16可释放地保持在松开位置或打开位置(图2A)。
为了将发射组件20装载到沟槽构件22的近侧部24b中，发射组件20的固定壳体26通过沟槽构件22的近侧端滑动到沟槽构件22中，直到枢轴构件29被容纳在形成于沟槽构件22的近侧端中的凹槽30中为止。在发射组件20被装载之后，SULU 18可以以上述方式装载到远侧部24a中。
参照图2和图2B，在SULU 18和发射组件20被装载到沟槽构件22中之后，能够将砧座部12组装到钉仓容纳半部14。为了将砧座半部12附接到钉仓容纳半部14，指形件184的突起件186被定位在钉仓容纳半部14的竖直支撑构件188的竖直槽188a中。然后，砧座半部12朝向钉仓容纳半部14旋转，以将横向支撑构件172定位在U型凹槽174中。
为了将手术吻合器10定位在夹紧位置，夹紧杆16从图2A所示的位置沿逆时针方向旋转。随着夹紧杆16的旋转，横向支撑构件172被容纳在凸缘部178的切口176(图2)中并朝向钉仓容纳半部14配置凸轮。如图3所示，通过诸如焊接的方法在接合钉仓容纳半部14的位置将弹簧构件200紧固到夹紧杆16的内表面上，从而将夹紧杆16推动到图2A所示的松开位置。在图1所示的夹紧位置，吻合钉变形部198定位为与SULU 18的顶表面紧密接近。
参考图3、图3A和图12，如上所述，枢转锁紧构件206枢转地支撑在发射组件20的固定壳体26的近侧端上。枢转锁紧构件206包括枢轴构件29，其延伸通过限定在固定壳体26中的开口部28。手指接合构件212定位在锁紧构件206的一端上，并且锁定部210定位在锁紧构件206的另一端上。锁定部210包括钩构件210a。偏置构件214绕枢轴构件29定位以将锁定部210向着发动组件20的固定壳体26向内地推动。当锁紧构件206紧固在发射组件20上时，锁定部210向下延伸通过固定壳体26的近侧端中的开口216，到达沟槽构件22的底表面下方的位置(图20)。如上所述，枢轴构件29的端部容纳在形成在钉仓容纳半部14的近侧端中的切口部30中，以将发射组件20可释放地紧固在沟槽构件22的近侧沟槽部24b中(图21)。切口部30部分地由下弯的指形件220限定，以将发射组件26保持在沟槽构件22中(图3)。
参照图3A，夹紧杆16的近侧端包括例如圆柱218的接合构件，其定位成当夹紧杆16运动到夹紧位置时与锁定部210的钩构件210a接合(图27)。虽然示出了柱形件，但是可以想到其它接合构件的构造。通过观察图27可见，当夹紧杆16朝向夹紧位置运动时，锁定部210的倾斜面222与柱形件218接合。该接合使锁紧构件206绕枢轴构件29枢转，使得锁定部210的钩构件210a经过，并且然后与柱形件218卡扣接合。为了从柱形件218释放锁定部210，锁紧构件206的接合构件212被按压以使锁定部210枢转脱离与柱形件218的接合。当这种情况发生时，弹簧构件200将夹紧杆16推动至松开位置。
参照图3、图12、图19和图26，如上文所述，引导块48枢转地支撑在发射组件20的固定壳体26中。引导块48包括向远侧地延伸的鼻部220(图12和图26)，其当SULU 18支撑在沟槽构件22中时位于SULU 18之下。引导块48的内表面包括锁紧表面222(图19)，当吻合器10处于松开位置时，锁紧表面222被容纳在刀致动杆44的凹口49和凹口51中。如上文所述，当SULU 18定位在沟槽构件22中时，在将夹紧杆16运动到夹紧位置之前，SULU 18定位在鼻部220的顶部并且不完全置于沟槽构件22中。当吻合器10运动到夹紧位置时，定位指形件170(图3)接合SULU 18的主体120的顶表面，以使SULU 18完全置于沟槽构件22中。如上文所述，定位指形件170容纳在SULU 18中的凹槽中，以相对于砧座部分12b适当地定位SULU 18。当SULU 18完全置于沟槽构件22中时，SULU 18向下按压引导块48的鼻部220，以使引导块48绕突起件72枢转。当引导块48枢转时，锁紧表面222从凹口49和凹口51运动以解锁刀致动杆44(图26)。这种构造防止了刀致动杆44在夹紧之前相对于引导块48的运动，以确保刀致动杆44和SULU刀40在使用之前保持用于操作接合的适当地定位。
如图24至图28所示，当吻合器10处于夹紧、未发射位置时，发射组件20的滑块52在沟槽构件22和固定壳体26的近侧端处处于缩回位置。见图27。在该位置，踏板54定位在沟槽构件22的切口55中，并且踏板54的销88定位在止动凹槽94a下方的发射杆50的弓形凹槽94中。因此，发射杆50能够枢转以易于从吻合器10的任一侧致动吻合器10。此外，在滑块52在该位置中时，刀致动杆44的指形件108邻接滑块52的凹槽110的远侧壁定位。锁紧构件206的锁定部210也与柱形件218接合，以将夹紧杆16保持在夹紧位置。
如图26所示，当滑块52处于缩回位置时，刀40和凸轮杆46的凸轮表面114b定位在SULU 18的近侧端中，并且安全锁定件128的近侧钩156定位成与刀40的接合构件158接合，以将安全锁定件128保持在锁定方位。此外，刀40的下弯曲钩部40b与刀致动杆44的上弯曲钩部106接合，以将发射组件20连接到SULU 18的刀40。
参照图29至图32，当发射杆50沿图29中箭头“A”所示的方向向远侧地推进时，滑块52在发射组件20的固定壳体26中向远侧地运动，以实现凸轮杆46的相应的运动及刀致动杆44的延迟运动。如上所述，刀致动杆44的延迟运动等于滑块52的凹槽110的长度，并且由刀致动杆44的指形件108在滑块52的凹槽110中的运动引起。当指形件108接邻凹槽110的近侧壁112时，刀致动杆44随滑块52的运动开始。随着凸轮杆46通过发射组件20的固定壳体26向远侧地运动时，推进凸轮杆46的侧壁114上的凸轮表面114b通过SULU 18，以顺序地接合推进器122，以从主体120的槽130弹出吻合钉126。同时，由于刀致动杆44的远侧端与刀40接合，在预设延迟之后，推进刀40通过SULU 18以切割吻合线之间的组织。
如图32中的虚线所示，当滑块52在固定壳体26中向远侧地运动时，踏板54骑跨在沟槽构件22上并沿着发射组件20的固定壳体26的内表面运动。当这发生时，踏板54的销88运动到止动凹槽94a中以防止发射杆50的进一步的枢转运动。
参照图31和图32，当刀40在SULU 18中向远侧地运动时，刀40的接合构件158与安全锁定件128的近侧钩156脱开。
参照图33和图34，当发射杆50返回到其最近侧位置以缩回凸轮杆46和刀40，并且锁紧构件206被按压以使锁定部210与柱形件218脱开时，弹簧200将夹紧杆16推动到其松开位置，以允许吻合器10运动至打开位置。在打开位置，砧座半部12与钉仓容纳半部14分隔开，并且弹簧152(图17)沿图34中的箭头B所示的方向绕枢轴构件150将安全锁定件128枢转至其解锁位置，使得安全锁定件128从SULU 18向上地突出。在解锁位置，安全锁定件128防止吻合器10运动回到夹紧位置。为了重新使用吻合器10，必须用新的SULU 18替换使用过的SULU 18。
在外科手术期间，可以多次更换SULU 18以易于吻合器10在单个患者上的多次使用。由于各SULU 18设置有全新的刀40，因此最小化了组织的撕裂。在外科手术之后，可以以适当的方式从沟槽构件22移除使用过的(一个或多个)SULU 18和发射组件20并将它们丢弃处理。如上文讨论的方式，砧座半部12，钉仓容纳半部14和夹紧杆16现在可以通过诸如高压灭菌来消毒，并且可以与消过毒的SULU 18和发射组件20一起再次使用。由于锁紧构件206形成发射组件20的一部分并且是一次性的，所以在可再利用的部件上保留了更少的用于收集组织和流体的区域。因此，装置的可再利用的部件能够更容易地消毒。
在上述手术吻合器中，SULU 18和发射组件20独立地紧固至钉仓容纳半部14的沟槽构件22并且能够独立地从钉仓容纳半部14的沟槽构件22上拆卸。更具体地，在上述实施例中，首先能够将发射组件20安装到沟槽构件22中并紧固在沟槽构件22中，随后是SULU18。随着SULU 18进入沟槽构件22，SULU 18与发射组件20接合。在下面讨论的替代实施例中，在一次性单元能够被紧固在沟槽构件22中之前必须将SULU 18与发射组件20组装以形成单一一次性单元。在实施例中，锁定结构防止了SULU 18或发射组件20中的任何一个独立插入沟槽构件22中。在这些实施例中，在将单一一次性单元紧固在钉仓容纳半部14的沟槽构件22中之前，SULU 18必须与发射组件20组装以形成单一一次性单元。将在下文中讨论具体实施例。
图35A至图35B示出了发射组件320的替代实施例。与上述实施例类似，发射组件320包括具有构造为容纳SULU 318的近侧端319的远侧端321的固定壳体326。发射组件320还包括凸轮杆346和可动地定位在固定壳体326中的刀致动杆(未示出)。与前面描述的凸轮杆46类似，凸轮杆346构造为在发射组件320致动时运动通过SULU 318以从SULU 18弹出紧固件126(图17)。
为了简单起见，未在图35A至图35B中示出刀致动杆，但是其与图12所示的刀致动杆44大体相似。刀致动杆构造为可释放地接合SULU 318，并且可以包括在其远侧端处的上弯曲钩部106(图12)，上弯曲钩部106构造为可释放地接合SULU 318的刀40的下弯曲钩部40b(图17)。
发射组件320包括支撑在固定壳体326的近侧端323的弹簧加载旋钮330。旋钮330与凸轮杆346及刀致动杆操作性连接。旋钮330包括弹簧332，其可以直接抵接或接合凸轮杆346和刀致动杆的近侧端。弹簧332通常处于压缩状态，并且在固定壳体326中向远侧地推动凸轮杆346。可替换地，弹簧332可以经由滑块，例如图12中的滑块52，与凸轮杆346接合。
旋钮330包括与弹簧332操作性连接的定位销334。定位销334可以具有板状构造并且垂直于发射组件320的纵向轴线“A”定位。定位销334具有下端336，其延伸到发射组件320的固定壳体326的底表面352下方。固定壳体326的底表面352限定了细长槽354，其容纳定位销334的下端336，使得定位销334能够轴向地运动通过引导槽354。当定位销334位于引导槽354的近侧端时，弹簧332处于如图35A所示的压缩状态。相反地，当定位销334位于导向槽354的远侧端时，弹簧332处于如图35B所示的延伸状态。因此，通过操纵定位销334的位置，凸轮杆346和刀致动杆可以在缩回位置“R”(图35A)和前进位置“F”(图35B)之间移动。
在缺少任何外部影响的情况下，处于压缩状态的弹簧332将凸轮杆346推向前进位置“F”(图35B)。在前进位置，凸轮杆346防止SULU 318容纳在发射组件320的远侧端中。更具体地，当凸轮杆346和刀致动杆处于前进位置F时，SULU 318的近侧端不被构造为容纳或操作性接合凸轮杆346和刀致动杆的远侧端。
为了用发射组件320装载SULU 318，临床医生需要首先通过抵抗弹簧332的偏压而将定位销334滑动到槽354的近侧端来将凸轮杆346和刀致动杆缩回到图35A所示的缩回位置“R”。然后，临床医生将SULU 318的近侧端319放置到发射组件320的固定壳体326的远侧端321中。然后，临床医生释放定位销334，这允许凸轮杆346向前弹出到前进位置“F”，以操作性接合SULU 318。
为了使SULU 318与发射组件320脱离，临床医生必须首先通过将定位销334运动至引导槽354的近侧端来将凸轮杆346和刀致动杆缩回至缩回位置“R”。在此过程期间，凸轮杆从SULU 318脱离。然后，临床医生能够从发射组件320的远侧端321移除SULU 318的近侧端319。当临床医生释放定位销334时，凸轮杆346被弹簧332向前地推动，从而返回到前进位置“F”。
如图35C所示，沟槽构件322在其底表面326上限定了凹部324。凹部324定尺寸为当发射组件320定位在沟槽构件322中并且定位销334位于图35B所示的前进位置时容纳定位销334的下端336。将定位销334容纳在沟槽构件322的凹部324中防止了定位销334运动到图35A所示的其缩回位置，并且因此，当发射组件320容纳在沟槽构件322中时，防止了SULU318插入发射组件320的固定壳体326中。更具体地，定位销334和凹部324之间的接合防止了凸轮杆346的缩回。因此，如果发射组件320安装在不具有SULU 318的沟槽构件322中，则凸轮杆346将保持在前进位置“F”，从而防止了SULU 318与发射组件320随后的操作性接合。
相似地，如果发射组件320和SULU 318首先接合以形成单一一次性单元，由于凹部324防止了凸轮杆346的缩回，则一旦将发射组件320和SULU 318两者安装至沟槽构件322中，SULU 318就不能从发射组件320脱离。
在图36A至图36E所示的另一实施例中，发射组件420包括具有构造为接收SULU418(图36E)的近侧端419的远侧端421的固定壳体426。发射组件420还包括沿着发射组件420的纵向轴线“A”居中定位的刀致动杆444和包括间隔开的侧壁445a(图36B)的凸轮杆445。
刀致动杆444具有与前述刀致动杆44类似的构造。更具体地，刀致动杆444可以包括在其远侧端408处的上弯曲钩部406，该上弯曲钩部406构造为可释放地接合SULU 418的刀40的下弯曲钩部40b(图17)。
在该实施例中，刀致动杆444经由枢转连接件448枢转地连接至位于发射组件420的近侧端423处的保持构件446。发射组件420的固定壳体426进一步在其底表面452中限定了细长凹槽或槽450。槽450定尺寸为便利当刀致动杆444相对于保持构件446枢转时刀致动杆444的远侧端408通过槽450。在缺少任何外部影响的情况下，刀致动杆444平行于发射组件420的纵向轴线“A”而定位在固定壳体426的底表面452的上方。
发射组件420还包括安装在刀致动杆444的顶部上的按钮454，以实现刀致动杆444相对于枢转连接件448的枢转运动。按钮454可以定位为邻近刀致动杆444的远侧端408。当沿由图36D中箭头“D”所示的方向按下按钮454时，刀致动杆444相对于保持构件446以逆时针方向向下旋转。在此过程期间，刀致动杆444的远侧端408穿过槽450并延伸超过固定壳体426的底表面452。偏置构件或弹簧(未示出)可以设置为将按钮454推动到其非按压位置，使得在释放按钮454时，按钮454和刀致动杆444返回到它们的非按压位置或正常位置。因此，通过操纵按钮454，刀致动杆444能够可选地从固定壳体426中的正常位置运动到延伸通过槽450的枢转位置。
当刀致动杆444处于其正常位置(图36A)时，由于刀致动杆444的远侧端408抵靠SULU 418的近侧端419，因此SULU 418不能沿图36E中的箭头“E”所示的方向滑动到发射组件420中。因此，为了使SULU 418的近侧端419与发射组件420的固定壳体426的远侧端适当地接合，临床医生必须首先按下按钮454以使刀致动杆444向下枢转通过槽450。当这种情况发生时，SULU 418的近侧端419能够穿越刀致动杆444的远侧端408并进入发射组件420的远侧端421中。当SULU 418适当地定位在发射组件420的远侧端中时，临床医生释放按钮454以允许刀接合杆444与SULU 418接合。更具体地，当刀致动杆444的远侧端408向上运动时，刀致动杆444的上弯钩部406接合SULU 418的刀40的下弯钩部40b(图17)，以将发射组件420紧固至SULU 418。
为了使SULU 418与发射组件420脱离，刀致动杆444的上弯钩部406必须与SULU418的刀40(图17)的下弯钩部40b脱离。为了实现这一点，刀致动杆444的远侧端408通过按压按钮454而被向下推动通过槽450。当刀致动杆444的远侧端408向下运动时，向上弯钩406从SULU 418的下弯钩部40b(图17)脱离。在按压杆444的同时，临床医生从发射组件420的远侧端421移除SULU 418的近侧端419。此后，临床医生释放按钮454以将刀致动杆444恢复到其正常位置。
在该实施例中，当发射组件420安装在沟槽构件22(图3)中时，沟槽构件22的底表面覆盖槽450，以防止刀致动杆444通过槽450的枢转运动。相应地，如果发射组件420安装在沟槽构件22中而SULU 418还没有与发射组件420操作性地接合，由于刀致动杆444被限于其正常位置时防止SULU 418与发射组件420的适当接合，则SULU 418不能在随后被装载至发射组件420。
出于相似的原因，如果发射组件420和SULU 418接合以形成单一一次性单元，由于刀致动杆444被限于其正常位置时防止从发射组件420释放SULU 418，则一旦安装至沟槽构件22中之后，SULU 418不能从发射组件420脱离。
在图37A至图37J中所示的另一实施例中，旋钮570可拆除地联接到沟槽构件522。如图37B所示，旋钮570包括H型基部572，从H型基部572的上表面576向上延伸的抓握构件574，和从基部572的下表面579向下延伸的远侧构件578。基部572包括纵向侧壁572a和572c，各纵向侧壁限定了大于沟槽构件522的宽度“w”(也就是沟槽构件522的侧壁582之间的横向距离)的长度。基部572还包括前壁572b和后壁572d，各壁572b和572d限定了小于沟槽构件522的宽度“w”的长度。
沟槽构件522限定了对称地布置在沟槽构件522的侧壁582上的一对槽580。槽580定尺寸为容纳旋钮570的基部572的一部分。如图37A所示，槽580限定在沟槽构件522的侧壁582上，其处于紧邻SULU 528的近侧端和发射组件520的远侧端接合的区域560之上的位置处。
如图37C至图37E所示，旋转构件570可在沟槽构件522内从解锁位置运动到锁紧位置。在解锁位置中(图37C至图37E)，旋转构件570的基部572的侧壁572a、侧壁572c与槽580横向对准，并且前壁和后壁572b和572d跨限定在沟槽构件522的侧壁582之间的横向空间延伸。旋转构件570的抓握构件574的旋转实现了旋转构件570在沟槽构件522中的相应地旋转。当旋转构件570从解锁位置旋转到锁紧位置(图37F至图37H)时，侧壁572a、侧壁572c从与槽580对准的位置运动到横切槽580的位置。
图37F至图37H示出了处于锁紧位置的旋转构件570，其从解锁位置大约旋转90度。在锁紧位置，基部572的侧壁572a和侧壁572c跨限定在沟槽构件522的一对侧壁582之间的横向空间延伸，使得前壁572b和后壁572d定位在槽580中。在该位置，旋转构件570被锁紧在沟槽构件522中。旋转构件570可旋转约90度以将旋转构件570转移回解锁位置。
在使用中，为了将SULU 518和发射组件520紧固在沟槽构件522中，临床医生首先将SULU 518与发射组件520接合，以形成单一一次性单元。接下来，临床医生将单一一次性单元定位在沟槽构件522中，使得在SULU 518和发射组件520之间的接合区域560(图37A)置于紧邻限定于沟槽构件522中的一对槽580之下。然后，如图37I至图37J所示，临床医生以使得基部572平行于沟槽构件522的底表面526的方式将旋钮570定位在沟槽构件522上方。接下来，临床医生沿图37I中的箭头“G”所示的方向向下运动旋钮570至沟槽构件522中，直到旋钮570相对于槽580到达其解锁位置，如图37C所示。然后如图37F所示，临床医生将旋钮570旋转到其锁紧位置，以将旋钮570锁紧在槽580中。
当旋钮570处于锁紧位置时，旋钮570位于SULU 518和发射组件520各自的上表面之上，并且旋钮570的远侧构件578邻接SULU 518的近侧端及发射组件520的远侧端。这样，当旋钮570旋转至锁紧位置时，旋钮570经由与槽580的接合而将SULU 518和发射组件520紧固至沟槽构件522内。
可替换地，临床医生可以分别地将SULU 518和发射组件520引入沟槽构件522中，并且随后将旋钮570安装在沟槽构件522中，以将SULU 518和发射组件520紧固至沟槽构件522中。
为了从沟槽构件522卸下SULU 518和发射组件520，临床医生将旋钮570旋转到其解锁位置，并且然后从沟槽构件522向上提升旋钮570。然后临床医生可以从沟槽构件22移除作为单一单元的SULU 518和发射组件520，或分别地移除SULU 518和发射组件520。
在上述安装和卸载SULU 518和发射组件520的方法中，如果在将SULU 518引入沟槽构件522之前将旋钮570旋转到锁紧位置，旋钮570将防止随后SULU 518进入沟槽构件522。
如图38A至图38C所示的替代实施例中，发射组件620具有包括构造为容纳SULU618的近侧端619的远侧端621的固定壳体626。固定壳体626的远侧端621限定了细长的纵向槽670，其定尺寸为收纳可滑动通过槽670的弹簧加载开关672。开关672横向地跨过槽670突出，并且向内和向外延伸超过发射组件620的固定壳体626的侧壁664。SULU 618在其近侧端619上限定了在其侧壁682上的止动器680。止动器680定尺寸为接收并可释放地接合开关672的内表面。
在缺少任何外部影响的情况下，弹簧加载开关672定位在槽670的近侧端670a处。为了在SULU 618的近侧端619定位在发射组件620的远侧端621中之前将SULU 618紧固至发射组件620，开关672必须沿槽670的长度运动到槽670的远侧端670b。当将开关672定位在槽670的远侧端中时，止动器680定位成接收开关672。在该位置中，开关672的内表面能够滑动到形成在SULU 618上的止动器680中。当开关672的内表面接收在止动器680中时，SULU 618的近侧端619紧固至发射组件620的远侧端621，并且开关672保持在槽670的远侧端中。
沟槽构件622还在其侧壁626的内表面上限定凹部624。凹部624定尺寸为当开关672位于槽670的远侧端中时容纳开关672。
由于上述构造，为了将发射组件620定位在沟槽构件622中，发射组件620和SULU618首先必须在SULU 618和发射组件620能够插入沟槽构件622之前紧固在一起。如果发射组件620被引入沟槽组件622中而不首先与SULU 618接合，将处于其正常近侧位置的开关672将与沟槽构件622中的凹部624错开，并且因此，将防止开关672被容纳在沟槽622中。
可以理解，可以对本文公开的手术紧固件施加装置的实施例进行各种修改。因此，上述描述不应被解释为限制，而仅仅是作为实施例的示例。本领域技术人员将想到在本公开的范围和精神内的其它修改。
Claims (20)
1.一种手术紧固件施加装置，其包括：
砧座半部；
钉仓容纳半部，其限定了沟槽构件，所述沟槽构件构造为容纳单次使用装载单元和发射组件，
所述发射组件包括锁定结构，所述锁定结构构造为：在所述发射组件独立于所述单次使用装载单元安装至所述沟槽构件中之后，防止所述单次使用装载单元插入所述沟槽构件中以与所述发射组件操作性接合。
2.根据权利要求1所述的手术紧固件施加装置，其中，当所述单次使用装载单元安装为与所述发射组件操作性接合时，所述单次使用装载单元和所述发射组件一起形成单个一次性单元。
3.根据权利要求1所述的手术紧固件施加装置，其中，所述锁定结构可在第一位置和第二位置之间运动，所述第一位置防止所述单次使用装载单元和所述发射组件之间的操作性接合，并且所述第二位置允许所述单次使用装载单元和所述发射组件之间的操作性接合，其中，当将所述发射组件支撑在细长的沟槽构件内时，阻止所述锁定结构从所述第一位置运动到所述第二位置。
4.根据权利要求3所述的手术紧固件施加装置，其中，所述锁定结构通常处于所述第一位置。
5.根据权利要求3所述的手术紧固件施加装置，其中，所述锁定结构包括弹簧加载旋钮，所述弹簧加载旋钮具有操作地连接至所述发射组件的凸轮杆的定位销。
6.根据权利要求5所述的手术紧固件施加装置，其中，当所述锁定结构处于所述第一位置时，所述凸轮杆相对于所述发射组件处于前进位置，防止所述单次使用装载单元的近侧端进入所述发射组件的远侧端。
7.根据权利要求5所述的手术紧固件施加装置，其中，当所述锁定结构处于所述第二位置时，所述凸轮杆相对于所述发射组件处于缩回位置，允许所述单次使用装载单元的近侧端进入所述发射组件的远侧端。
8.根据权利要求3所述的手术紧固件施加装置，其中，所述沟槽构件限定了在其中的凹部，以当所述发射组件插入所述沟槽构件中时将所述锁定结构保持在所述第一位置。
9.根据权利要求3所述的手术紧固件施加装置，其中，所述锁定结构包括安装在所述发射组件的刀致动杆的顶部上的弹簧加载按钮，所述弹簧加载按钮定位成实现所述刀致动杆从所述第一位置至所述第二位置的枢转运动，其中，所述刀致动杆延伸通过限定在所述发射组件的固定壳体的底表面上的槽。
10.根据权利要求9所述的手术紧固件施加装置，其中，当所述锁定结构处于所述第一位置时，在该位置刀致动杆防止所述单次使用装载单元的近侧端进入所述发射组件的远侧端。
11.根据权利要求9所述的手术紧固件施加装置，其中，当所述刀致动杆枢转通过所述槽时，所述单次使用装载单元的近侧端可运动至与所述发射组件的远侧端操作性接合。
12.一种手术紧固件施加装置，其包括：
砧座半部；
钉仓容纳半部，其限定了细长沟槽构件；
单次使用装载单元和能够可操作地安装在所述沟槽构件内的发射组件；以及
锁定结构，其能够可拆卸地安装至所述沟槽构件，以将所述单次使用装载单元和所述发射组件紧固在所述沟槽构件中。
13.根据权利要求12所述的手术紧固件施加装置，其中，所述锁定结构包括能够可拆卸地安装至所述沟槽构件的旋转构件，所述旋转构件能够从与所述沟槽构件脱离的解锁位置运动到锁紧位置，其中，所述旋转构件的一部分被容纳在限定在所述沟槽构件的侧壁上一处的槽中，以将所述单次使用装载单元和所述发射组件紧固在所述沟槽构件中。
14.根据权利要求13所述的手术紧固件施加装置，其中，所述旋钮包括H型基部。
15.一种手术紧固件施加装置，其包括：
砧座半部；
钉仓容纳半部，其限定了细长的沟槽构件；
所述沟槽构件构造成容纳单次使用装载单元和发射组件，
所述发射组件包括锁定结构，所述锁定结构定位成当所述发射组件独立于所述单次使用装载单元插入所述沟槽构件中时，防止所述发射组件和所述单次使用装载单元之间的操作性接合。
16.根据权利要求15所述的手术紧固件施加装置，其中，所述锁定结构可在防止所述发射组件完全插入所述沟槽构件的第一位置和允许所述发射组件完全插入所述沟槽构件的第二位置之间运动，并且其中，当所述发射组件与所述单次使用装载单元接合时，阻止所述锁定结构从所述第二位置运动到所述第一位置。
17.根据权利要求16所述的手术紧固件施加装置，其中，所述锁定结构通常处于所述第一位置。
18.根据权利要求16所述的手术紧固件施加装置，其中，所述锁定结构包括弹簧加载开关，所述弹簧加载开关可滑动通过限定在所述发射组件的侧壁上的槽，以在所述第一位置和所述第二位置之间转移。
19.根据权利要求16所述的手术紧固件施加装置，其中，所述沟槽构件限定了在其中的凹部，以在所述锁定结构处于所述第二位置时收纳所述锁定结构。
20.一种手术紧固件施加装置，其包括：
砧座半部；
钉仓容纳半部，其限定了沟槽构件，所述沟槽构件构造为容纳单次使用装载单元和发射组件；
所述发射组件包括锁定结构，所述锁定结构构造为仅当所述单次使用装载单元与所述发射组件一体地连接时才许可所述单次使用装载单元插入所述沟槽构件中。
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2014
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- 2014-05-15 CN CN201480078861.XA patent/CN106687052B/zh active Active
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- 2014-05-15 CN CN201911101650.4A patent/CN110680437B/zh active Active
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2015174985A1 (en) | 2015-11-19 |
| EP3142569B1 (en) | 2023-12-27 |
| US11497497B2 (en) | 2022-11-15 |
| EP3142569A1 (en) | 2017-03-22 |
| CN110680437B (zh) | 2023-01-31 |
| JP2017518803A (ja) | 2017-07-13 |
| US10512461B2 (en) | 2019-12-24 |
| US20170143335A1 (en) | 2017-05-25 |
| CN106687052B (zh) | 2019-12-10 |
| US20200113563A1 (en) | 2020-04-16 |
| CN110680437A (zh) | 2020-01-14 |
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