CN106999189A - 具有击发指示器的外科吻合装置 - Google Patents
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Abstract
本公开涉及一种外科吻合装置(10),其具有指示器机构,所述指示器机构能够在第一位置、第二位置和第三位置之间移动。指示器(26)的第一位置为临床医生指示外科吻合装置(10)的钳部还未接近。指示器(26)的第二位置为临床医生指示外科吻合装置(10)的钳部已接近。指示器(26)的第三位置为临床医生指示外科吻合装置(10)已经被击发并且用尽吻合钉。
Description
技术领域
本公开涉及一种外科吻合装置,并且更具体地涉及一种包括击发指示器的外科吻合装置,所述击发指示器用于为临床医生提供吻合装置已经击发的指示。
现有技术
具有端部执行器的外科吻合装置在医疗领域中是众所周知的,所述端部执行器构造为夹紧和缝合组织。通常,这些装置包括具有击发触发器的手柄组件、本体部分以及支撑在本体部分的远侧端部上的工具组件。工具组件包括第一钳部和第二钳部,所述第一钳部支撑砧座组件,所述第二钳部支撑容纳多个吻合钉的盒组件。在使用中,第一钳部和第二钳部能够相对于彼此在间隔位置和靠近位置之间移动,以将组织夹紧在钳部之间。在组织已经被夹紧在钳部之间之后,能够致动击发触发器以从盒组件内击发吻合钉穿过组织进入砧座组件内。
在一些实施例中,在外科吻合装置的手柄组件上设置指示器,以使临床医生确认外科吻合装置何时处于击发就位位置,即,所述击发就位位置为砧座组件和盒组件足够接近以允许来自盒组件的吻合钉抵靠砧座组件正确地形成的位置。
在已知的吻合装置中,在已经致动击发触发器并且吻合钉已经从盒中射出后,在装置上没有任何东西向临床医生指示外科吻合装置已经被击发以及已经用尽吻合钉。未意识到外科吻合装置已经用尽吻合钉的临床医生对外科吻合装置的操作可能对患者造成严重的损伤。
在外科吻合装置的领域中,需要一种简单、便宜的装置,所述装置用于使临床医生确认外科吻合装置已经被击发。
发明内容
本公开的一方面涉及一种外科吻合装置,所述外科吻合装置包括手柄组件,所述手柄组件包括限定了窗口的外壳、支撑在外壳上的击发触发器和指示器机构。击发触发器能够致动以击发吻合装置。本体从手柄组件向远侧延伸,并且壳体组件支撑在本体的远侧端部上。接近组件从手柄组件穿过本体延伸,并且包括支撑在手柄组件上的接近旋钮。砧座组件支撑在接近组件的远侧端部上。接近组件能够致动以将砧座从与壳体组件间隔开的未接近位置移动到与壳体组件相邻的接近位置。指示器机构包括指示器、滑板和指示器连接件,所述指示器与窗口相邻地枢转地支撑在壳体内。滑板与指示器可操作地相联,并且能够响应于砧座组件从未接近位置移动到接近位置而在外壳内移动以将指示器从第一位置移动到第二位置。指示器连接件定位在外壳内,并且与指示器可操作地相联,并且能够响应于击发触发器的致动而移动,以将指示器从第二位置移动至第三位置。
在实施例中,击发触发器枢转地支撑在外壳上。
在一些实施例中,吻合装置包括击发连接件,所述击发连接件具有第一端部和第二端部,所述第一端部可枢转地连接到击发触发器,所述第二端部可枢转地连接到外壳。
在某些实施例中,击发连接件包括侧向延伸部,所述侧向延伸部定位成接合指示器连接件以在外壳内移动指示器连接件,从而实现将指示器从第二位置移动到第三位置。
在实施例中,指示器连接件能够在沿外壳的内壁限定的槽内滑动。
在一些实施例中,指示器连接件包括中心本体部分、上部部分和下部部分。下部部分定位成接合击发连接件的侧向延伸部,并且上部部分定位成接合指示器。
在某些实施例中,指示器包括抵接表面,所述抵接表面定位成接合指示器连接件的上部部分。
在实施例中,滑动构件包括圆柱形连接件,并且指示器包括至少一个凹部。圆柱形连接件接收在至少一个凹部内,以将滑动构件连接到指示器。
在一些实施例中,圆柱形连接器形成在滑动构件的上翘唇部部分上。
在某些实施例中,指示器包括本体,所述本体的顶部表面包括标记以识别指示器的三个位置中的每一个。
在实施例中,标记包括定位在指示器的本体的顶部表面上的三种不同的颜色。
在一些实施例中,偏压构件定位成将滑动构件迫压到将指示器保持在第一位置的位置。
在某些实施例中,滑动构件包括限定了细长槽的本体部分、支撑连接器的上翘唇部部分、和近侧延伸部。
在实施例中,偏压构件围绕滑动构件的本体的近侧延伸部定位,并且在手柄组件的外壳和滑动构件的本体之间被压缩。
在一些实施例中,接近机构包括支撑螺杆止动件的传动螺杆,所述螺杆止动件具有突出部,所述突出部定位在滑动构件的细长槽内,其中,传动螺杆移动而将砧座组件移动到接近位置实现了将突出部移动穿过细长槽与滑动构件相接触,使得突出部与滑动构件的接触实现了移动滑动构件以将指示器从第一位置枢转至第二位置。
在一些实施例中,指示器机构包括限定了槽的透镜盖。透镜盖定位在指示器上方使得标记通过透镜盖的槽可见。
附图说明
本文参照附图描述了本公开所公开的外科吻合装置和击发指示器的多个实施例,其中:
图1是本公开的外科吻合装置的一个实施例的侧视透视图,其中,端部执行器处于接近位置并且击发触发器被致动;
图2是图1中所示的外科吻合装置的手柄组件的侧视透视图,其中,移除了一半本体并且击发触发器处于未致动位置;
图3是沿图2的剖面线3-3获取的剖视图;
图4示出了穿过手柄组件的一部分的侧视剖视图,其中,击发触发器处于致动位置;
图5是图4中所示细节的指示区域的放大视图;
图6是图4的外科吻合装置的指示器组件的指示器板的透视图;
图7是图4中所示的指示器组件的指示器构件的侧视透视图;
图8是图7中所示的指示器构件的俯视透视图;
图9是图1中所示的外科吻合装置的手柄组件的一半本体的内部表面的侧视透视图;
图10是图9中所示细节的指示区域的放大视图;
图11A是图1中所示的外科吻合装置的手柄组件的上部表面的俯视图,其示出了在外科吻合装置的接近和击发之前处于第一位置的指示器组件;
图11B是穿过图1中所示的外科吻合装置的指示器组件的横向剖视图,其中,指示器组件示出为处于第一位置;
图11C是沿图3的剖面线11C-11C获取的剖视图,其中,指示器组件处于第一位置;
图11D是沿图3的剖面线11C-11C获取的剖视图,其中,外科吻合装置处于部分接近位置;
图12A是图1中所示的外科吻合装置的手柄组件的上部表面的俯视图,其示出了在外科吻合装置接近之后但是击发之前处于第二位置的指示器组件;
图12B是穿过图1中所示的外科吻合装置的指示器组件的横向剖视图,其中,指示器组件示出为处于第二位置;
图12C是沿图3的剖面线11C-11C获取的剖视图,其中,指示器组件处于第二位置;
图13A是图1中所示的外科吻合装置的手柄组件的上部表面的俯视图,其示出了在外科吻合装置接近和击发之后处于第三位置的指示器组件;
图13B是穿过图1中所示的外科吻合装置的指示器组件的横向剖视图,其中,指示器组件示出为处于第三位置;以及
图13C是沿图3的剖面线11C-11C获取的剖视图,其中,指示器组件处于第三位置。
具体实施方式
本领域技术人员将理解,本文所具体描述并且在附图中示出的装置和方法是非限制性示例性实施例。可以想到,在不偏离本公开的范围的前提下,结合一个示例性实施例所示出或描述的元件和特征可以与其他实施例的元件和特征相组合。同样,本领域技术人员将基于上述实施例来理解本公开的其他特征和优点。因此,除了所附权利要求所指出的内容之外,本公开不受具体示出和描述的内容的限制。
如本文中所使用的,术语远侧指的是装置离临床医生最远的部分,而术语近侧指的是装置离临床医生最近的部分。此外,如本文所使用的,术语临床医生指的是包括医生、护士和辅助人员的医务人员。
本文公开的外科吻合装置包括枢转指示器,所述枢转指示器支撑在外科吻合装置的手柄组件上。所述指示器响应于外科吻合装置从未接近位置移动至接近位置而从第一位置枢转至第二位置,以向临床医生指示吻合装置处于击发就位位置。外科吻合装置还包括指示器连接件,所述指示器连接件定位成与指示器接合并且响应于外科吻合装置的击发触发器的致动而将指示器从第二位置移动至第三位置,以向临床医生指示外科吻合装置已经被击发。下文将详细描述外科吻合装置。
图1示出了本文公开的外科吻合装置(通常表示为附图标记10)的一个实施例。外科吻合装置10包括手柄组件12、本体14、盒组件或壳体组件16和砧座组件18,所述本体14从手柄组件12向远侧延伸,所述盒组件或壳体组件16支撑在本体14的远侧端部上,所述砧座组件18相对于壳体组件16被可移动地支撑在与壳体组件16间隔开的位置和与壳体组件16并列对准的位置之间。手柄组件12包括外壳20、击发触发器22、接近旋钮24和指示器26,所述击发触发器22枢转地支撑在外壳20上,所述接近旋钮24可旋转地支撑在外壳20上,所述指示器26通过形成为穿过外壳20的上壁的窗口28可见。如图所示,指示器26可以具有球形或凸形形状使得指示器26穿过窗口28突出。指示器26的球形形状允许从吻合装置10的相对两侧观察指示器26。美国专利No.7303106(“‘106专利”)公开了一种外科吻合装置,所述外科吻合装置包括进一步详细描述的许多相同的部件和机构,并且其全部内容通过引用并入本文。
还参照图2,手柄组件12支撑接近组件30。接近组件30包括接近旋钮24(图1)、中空套筒32、固定地紧固至中空套筒32的一端部的套环(collar)34、和传动螺杆36。传动螺杆36具有近侧端部和远侧端部,所述近侧端部延伸穿过套环34并且进入中空套筒32,所述远侧端部可操作地连接到砧座组件18。传动螺杆36包括螺旋凹槽(未示出),所述螺旋凹槽接收支撑在套环34上的销38。
接近旋钮24(图1)、套筒32和套环34可旋转地支撑在手柄组件12的外壳20的近侧端部上,其中销38接收在螺旋凹槽内。套环34限定了环形凹槽40,所述环形凹槽40接收形成在外壳20的内壁上的凸缘42,以将套环34轴向地固定在外壳20内。因此,当相对于外壳20的近侧端部致动或旋转接近旋钮24时,销38在传动螺杆36的螺旋凹槽(未示出)内移动,以实现传动螺杆36线性移动进入中空套筒32和线性移动离开中空套筒32。已经通过引用并入本文的‘106专利公开了与接近组件30基本上相类似的接近组件。
使用例如固定螺钉44将螺杆止动件42轴向地固定至传动螺杆36。螺杆止动件42包括向上指向的突出部46,所述突出部46将在下文进一步详细讨论。当接近旋钮24被致动并且传动螺杆36在手柄组件12的外壳20内线性移动时,包括突出部46的螺杆止动件42也在外壳20内线性移动。
击发触发器22通过枢转销50枢转地联接至推动器连接件48的近侧端部。如下文将详述的,如本领域中所已知的,推动器连接件48接合定位在壳体组件16(图1)中的推动器(未示出),以当击发触发器22被致动时将吻合钉从壳体组件16射出。击发触发器22的中心部分56通过枢转构件60枢转地联接至击发连接件58的远侧端部。击发连接件58的近侧端部支撑传动销62,所述传动销62定位成当击发触发器22被致动时接合形成在螺杆止动件42上的后挡部64(图4)。更具体地,当击发触发器22被致动时(即朝向手柄组件12的外壳20受压时),传动销62接合螺杆止动件42的后挡部64,而击发连接件58的远侧端部朝向外壳20枢转,以向远侧推进(advance)推动器连接件48。
参照图2-图5,击发连接件58包括侧向延伸部66。指示器连接件68可滑动地定位在槽70(图9和10)内,所述槽70限定在外壳20的内壁中。指示器连接件68包括中心本体部分72、上部部分74和下部部分76。中心本体部分72可滑动地接收在外壳20内的槽70中,使得当击发触发器22被致动时,上部部分74定位成接合指示器26的底部表面,而下部部分76定位成接合击发连接件58的侧向延伸部66。
还参照图6-图10,本文公开的外科吻合装置10包括指示器机构,所述指示器机构包括指示器26、透镜盖82(图5)和滑动构件84(图6)。指示器26围绕枢转构件86被枢转地支撑,所述枢转构件86可以一体地形成在外壳20的内壁上。可替代地,枢转构件86可以与外壳20分别形成。透镜盖82定位在指示器26上方并且限定了槽82a,指示器26可以通过所述槽82a而可视化。滑动构件84(图6)包括本体部分92、远侧抵接构件或上翘唇部部分96、和近侧延伸部98,所述本体部分92在其中形成有细长槽94。滑动构件84可滑动地定位在外壳20中。近侧延伸部98通过支撑结构100(图2)可滑动地支撑在外壳20中,所述支撑结构100可以与外壳20一体形成。偏压构件(例如螺旋弹簧102)定位成围绕近侧延伸部98在滑动构件84的支撑结构100和本体部分92之间处于压缩状态,以在外壳20内向远侧迫压滑动构件84。
还参照图7和图8,唇部部分96的上侧端部包括圆柱形连接器96a。指示器26包括一对间隔开的细长凹部106(图7,仅示出一个凹部),所述细长凹部106接收圆柱形连接器96a的相对的端部。如下文将详述的,在吻合装置10的未接近位置处,偏压构件102(图2)将滑动构件84迫压到其最远侧位置,以将指示器26枢转至第一位置,这为临床医生提供了吻合装置10还未接近并且未处于击发就位状态的指示。
如上所述,螺杆止动件42固定地附接到传动螺杆42(图2),并且包括突出部46。突出部46定位成延伸(travel)穿过滑动构件84的槽94,并且在吻合装置10接近期间接合槽94的近侧端部94a(图6)。当螺杆止动件42的突出部46抵接槽94的近侧端部94a时,吻合装置10的进一步接近抵抗弹簧102的偏压在外壳20内向近侧移动滑板84。随着滑板84在外壳20内向近侧移动,滑动构件84的圆柱形连接器96a(所述圆柱形连接器96a在与枢转构件86偏置的位置处定位在指示器26的细长凹部106内)实现了指示器26围绕枢转构件86从第一位置枢转移动到第二位置,从而为临床医生提供吻合装置10处于接近和击发就位位置的指示。
参照图7和图8,指示器26包括本体110(具有顶部表面112)、一对间隔开的铰接构件114、限定细长凹部106的内部表面116。铰接构件114从本体110向下延伸,并且限定了接收枢转构件86(图10)的开口118。本体110还限定了抵接表面120,所述抵接表面120定位在铰接构件114之间。如下文进一步详述,当击发触发器22被致动时,抵接表面120定位成接合指示器连接件68的上部部分74。指示器26的本体110的顶部表面112包括标记,所述标记指示指示器26的三个不同位置。如上所述,指示器26的第一位置为临床医生提供吻合装置处于未接近位置并且尚未击发就位的指示,而指示器26的第二位置为临床医生提供吻合装置已经接近并且处于击发就位位置的指示。如下所述,指示器26能够移动到第三位置,所述第三位置为临床医生提供吻合装置10已经被击发的指示。
设置在指示器本体110的顶部表面112上的标记可以包括各种不同颜色或字母数字标志,以区分或识别指示器的每个位置。在实施例中,标记包括设置在指示器26的顶部表面112上的三种不同颜色,例如红色(R)、绿色(G)和粉色(P)。颜色R、G和P定位在指示器26的顶部表面112上,使得当指示器26定位在其第一位置时,第一颜色(例如R)通过透镜盖82中的槽82a(图5)可见,当指示器26定位在其第二位置时,第二颜色(例如G)通过透镜盖82中的槽82a可见,而当指示器26定位在其第三位置时,第三颜色(例如P)通过透镜盖82中的槽82a可见。可替代地,颜色可以由各种不同的字母、数字或符号代替。
参照图11A-图11C,在致动外科吻合装置10之前(图1),在吻合装置10处于未接近位置的状态下(图1A),指示器26处于其第一位置,使得颜色R通过透镜盖82中的槽82a可见。此外,指示器连接件68的上部部分74定位成靠近指示器本体110的抵接表面120,并且下部部分76与击发连接件58的侧向延伸部66间隔开。如图所示,螺杆止动件42与接近机构的套环34远侧地间隔开,并且滑动构件84在偏压构件或弹簧102处于未压缩状态的情况下处于其最远侧位置。如图所示,螺杆止动件42的突出部46定位在滑动构件84的细长槽94的远侧端部中。
图11D示出了处于部分接近位置的吻合装置10,其中已经通过致动接近旋钮24(图1)使吻合装置10接近从而朝向盒组件16移动砧座组件18。在所示的部分接近位置中,定位在套环34的远侧的螺杆止动件42已经与传动螺杆36一起向近侧朝向套环34移动,使得传动螺杆36的突出部46已经从槽94的远侧端部移动到与槽94的近侧端部94a相邻的位置。如图所示,吻合装置10未处于完全接近位置。因此,螺杆止动件42的突出部46还没有在外壳20内向近侧移动滑动构件84,并且因此,滑动构件84仍然处于其最远侧位置。
参照图12A-图12C,当吻合装置10(图1)从图11D中所示的部分接近位置移动到完全接近位置以将砧座组件18移动到与盒组件16并列对准时,螺杆止动件42的突出部46在槽94的近侧端部94a(图12C)处接合滑动构件84,并且将滑动构件84在外壳20内缩回。如图12C中可视,随着滑动构件84在外壳20内向近侧移动,经由滑动构件84的唇部部分96的圆柱形连接器96a连接到指示器26的滑动构件84使得指示器26沿顺时针方向从其第一位置枢转至其第二位置。如上所述,在指示器26的第二位置处,第二颜色(例如G)通过透镜盖82中的槽82a可见,以为临床医生提供吻合装置10处于接近位置的指示。注意到,在传动螺杆36的完全缩回位置处,螺杆止动件42与套环34接合(图12C)。
参照图13A-图13C,在已经将吻合装置移动到完全接近位置之后,能够击发吻合装置以从盒组件16中射出吻合钉。通过朝向手柄组件12的外壳20枢转击发触发器22击发吻合装置10。如上所述,随着击发触发器22朝向手柄组件12的外壳20枢转,击发连接件58朝向外壳20枢转,使得形成在击发连接件58的至少一侧上的侧向延伸部66接合指示器连接件68的下部部分76,以在手柄组件12的外壳20内的槽70内向上移动指示器连接件68。随着指示器连接件68在槽70内向上移动,指示器连接件68的上部部分74压抵指示器26的抵接表面120,以将指示器26从其第二位置枢转到其第三位置。在第三位置处,第三颜色(例如P)通过透镜盖82中的槽82a可见,以为临床医生提供吻合装置10已经被击发的指示。
本领域技术人员将理解,本文所具体描述并且在附图中示出的装置和方法是非限制性示例性实施例。可以想到,在不偏离本公开的范围的前提下,结合一个示例性实施例所示出或描述的元件和特征可以与其他实施例的元件和特征组合。同样,本领域技术人员将基于上述实施例来理解本公开的其他特征和优点。因此,除了所附权利要求所指出的内容之外,本公开不受具体示出和描述的内容的限制。
Claims (16)
1.一种外科吻合装置,所述外科吻合装置包括:
手柄组件,所述手柄组件包括外壳、击发触发器和指示器机构,所述外壳限定了窗口,所述击发触发器支撑在外壳上,所述击发触发器能够被致动以击发吻合装置;
本体,所述本体从所述手柄组件向远侧延伸;
壳体组件,所述壳体组件支撑在所述本体的远侧端部上;
接近组件,所述接近组件从所述手柄组件穿过所述本体延伸,所述接近组件包括接近旋钮,所述接近旋钮支撑在所述手柄组件上;以及
砧座组件,所述砧座组件支撑在所述接近组件的远侧端部上,其中,所述接近组件能够致动以将砧座从与所述壳体组件间隔开的未接近位置移动到与所述壳体组件相邻的接近位置;
其中,所述指示器机构包括:
指示器,所述指示器与窗口相邻地枢转地支撑在所述外壳内;
滑板,所述滑板与所述指示器可操作地相联,响应于所述砧座组件从所述未接近位置移动到所述接近位置,所述滑板能够在所述外壳内移动以将所述指示器从第一位置移动到第二位置;以及
指示器连接件,所述指示器连接件定位在所述外壳中,所述指示器连接件与所述指示器可操作地相联,并且能够响应于所述击发触发器的致动移动以将所述指示器从所述第二位置移动至第三位置。
2.根据权利要求1所述的外科吻合装置,其中,所述击发触发器可枢转地支撑在所述外壳上。
3.根据权利要求2所述的外科吻合装置,所述外科吻合装置还包括击发连接件,所述击发连接件具有第一端部和第二端部,所述第一端部可枢转地连接到所述击发触发器,所述第二端部可枢转地连接到所述外壳。
4.根据权利要求3所述的外科吻合装置,其中,所述击发连接件包括侧向延伸部,所述侧向延伸部定位成接合所述指示器连接件以在所述外壳内移动所述指示器连接件,从而实现将所述指示器从所述第二位置移动至所述第三位置。
5.根据权利要求4所述的外科吻合装置,其中,所述指示器连接件能够在沿着所述外壳的内壁限定的槽内滑动。
6.根据权利要求5所述的外科吻合装置,其中,所述指示器连接件包括中心本体部分、上部部分和下部部分,其中,所述下部部分定位成接合所述击发连接件的所述侧向延伸部,并且所述上部部分定位成接合所述指示器。
7.根据权利要求6所述的外科吻合装置,其中,所述指示器包括抵接表面,所述抵接表面定位成接合所述指示器连接件的所述上部部分。
8.根据权利要求1所述的外科吻合装置,其中,所述滑动构件包括圆柱形连接器,并且所述指示器包括至少一个细长凹部,所述圆柱形连接器接收在所述至少一个细长凹部内,以将所述滑动构件连接至所述指示器。
9.根据权利要求8所述的外科吻合装置,其中,所述圆柱形连接器形成在所述滑动构件的上翘唇部部分上。
10.根据权利要求1所述的外科吻合装置,其中,所述指示器包括本体,所述本体具有包括标记的顶部表面,所述标记设置为识别所述指示器的三个位置中的每一个。
11.根据权利要求10所述的外科吻合装置,其中,所述标记包括三种不同的颜色,所述三种不同的颜色定位在所述指示器的所述本体的顶部表面上。
12.根据权利要求1所述的外科吻合装置,所述外科吻合装置还包括偏压构件,所述偏压构件定位成将所述滑动构件迫压到将所述指示器保持在所述第一位置处的位置。
13.根据权利要求1所述的外科吻合装置,其中,所述滑动构件包括本体部分、上翘唇部部分和近侧延伸部,所述本体部分限定了细长槽,所述上翘唇部部分支撑所述圆柱形连接器。
14.根据权利要求12所述的外科吻合装置,其中,所述偏压构件围绕所述滑动构件的所述本体的所述近侧延伸部定位,并且在所述手柄组件的所述外壳和所述滑动构件的所述本体之间被压缩。
15.根据权利要求13所述的外科吻合装置,其中,所述接近机构包括支撑螺杆止动件的传动螺杆,所述螺杆止动件包括突出部,所述突出部定位在所述滑动构件的所述细长槽内,其中,所述传动螺杆移动而将所述砧座组件移动到接近位置实现了将所述突出部移动穿过所述细长槽与所述滑动构件相接触,其中,所述突出部与所述滑动构件的接触实现了移动所述滑动构件以将所述指示器从所述第一位置枢转到所述第二位置。
16.根据权利要求10所述的外科吻合装置,所述外科吻合装置还包括限定了槽的透镜盖,所述透镜盖定位在所述指示器上方使得所述标记通过所述透镜盖的槽可见。
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- 2014-12-17 WO PCT/CN2014/094007 patent/WO2016095112A1/en active Application Filing
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US20170319206A1 (en) | 2017-11-09 |
JP2017537738A (ja) | 2017-12-21 |
EP3232946A1 (en) | 2017-10-25 |
CN106999189B (zh) | 2020-05-26 |
US10542985B2 (en) | 2020-01-28 |
WO2016095112A1 (en) | 2016-06-23 |
JP6518766B2 (ja) | 2019-05-22 |
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