CN107049400B - 用于手术装置的接合器、延伸件和连接器组件 - Google Patents
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Abstract
本发明涉及一种用于手术装置的接合器、延伸件和连接器组件。一种用于将末端执行器可操作地连接至手术器械的接合器组件。所述接合器组件包括第一近侧轴、第二近侧轴、第一远侧轴和第二远侧轴。所述第一近侧轴包括第一齿轮组件。所述第二近侧轴限定纵向轴线并且包括第二齿轮组件。所述第一远侧轴沿着所述纵向轴线布置并且包括第三齿轮组件。所述第一齿轮组件被机械地接合于所述第三齿轮组件。第二远侧轴包括第四齿轮组件。所述第二齿轮组件被机械地接合于所述第四齿轮组件。所述第二远侧轴的远侧部至少部分地布置在所述第三齿轮组件的内腔中。
Description
技术领域
本公开涉及用在手术系统中的接合器组件。更具体地，本公开涉及与机电手术装置和手术装载单元一起使用并且将它们机械地和电气地互连的接合器组件，并且涉及包括手持式机电手术装置和用于将手术装载单元连接至该手持式机电手术装置的接合器组件的手术系统。
背景技术
诸多手术装置制造商已经开发出了具有用于操作和/或操纵机电手术装置的专有驱动系统的生产线。在很多情况下，该机电手术装置包括可重复使用的手柄组件，以及一次性装载单元和/或单次使用装载单元等，该一次性装载单元和/或单次使用装载单元在使用之前选择性地连接至手柄组件并且在使用之后与手柄组件断开以便被处理或者在一些情况下消毒后重新使用。
在某些情况下，接合器组件被用以将机电手术装置同多个手术装载单元中任一个互连以在它们之间建立机械和/或电气连接。由于接合器组件和机电手术装置的复杂性，确保它们之间的全部电气和机械连接都能够容易地、可靠地且重复地完成是很重要的。
因此，存在对于提供与该手术装置机电的稳健互连方式的接合器组件的需求。
发明内容
本公开涉及一种用于将末端执行器可操作地连接至手术器械的接合器组件。所述接合器组件包括第一近侧轴、第二近侧轴、第一远侧轴和第二远侧轴。所述第一近侧轴包括第一齿轮组件。所述第二近侧轴限定纵向轴线并且包括第二齿轮组件。所述第一远侧轴沿着所述纵向轴线布置并且包括第三齿轮组件。所述第一齿轮组件被机械地接合于所述第三齿轮组件。所述第一齿轮组件的旋转引起所述第三齿轮组件的旋转。第二远侧轴包括第四齿轮组件。所述第二齿轮组件被机械地接合于所述第四齿轮组件。所述第二齿轮组件的旋转引起所述第四齿轮组件的旋转。所述第二远侧轴的远侧部至少部分地布置在所述第三齿轮组件的内腔中。
在所公开的实施例中，所述第二远侧轴相对于所述第三齿轮组件能够关于所述纵向轴线旋转。
进一步公开的是，所述第一齿轮组件、所述第二齿轮组件、所述第三齿轮组件和所述第四齿轮组件中的每个布置在壳体内。所述接合器组件的实施例包括布置在所述壳体内的支撑板。所述支撑板相对于所述壳体被可旋转地固定。在实施例中，所述支撑板包括延伸穿过其中的孔。所述支撑板的第一孔关于所述纵向轴线布置并且与所述第二远侧轴的部分轴向对准。进一步公开的是，所述第一孔与所述第三齿轮组件的部分轴向对准。还公开的是，所述第二齿轮组件包括在所述支撑板的近侧布置的多个齿轮齿。在实施例中，所述第三齿轮组件包括在所述支撑板的远侧布置的多个齿轮齿，并且所述第一近侧轴的部分延伸穿过所述支撑板的第二孔。进一步公开的是，所述第二近侧轴的部分延伸穿过所述支撑板的第三孔。
在所公开的实施例中，所述第二远侧轴的与所述支撑板的所述第一孔轴向对准的那部分包括比所述第一孔的直径略小的直径，使得所述第二远侧轴相对于所述支撑板能够旋转并且使得所述支撑板支撑所述第二远侧轴。
进一步公开的是，所述接合器包括可操作地连接至所述第一远侧轴的第一组件，用于将来自所述第一远侧轴的旋转运动转变成纵向移动来执行第一功能(例如，使套管针构件相对于所述第一远侧轴轴向移动)。另外，公开的是，所述接合器包括可操作地连接至所述第二远侧轴的第二组件，用于将来自所述第二远侧轴的旋转运动转变成纵向移动来执行第二功能(例如，使砧座相对于所述第二远侧轴轴向移动)。
本公开还涉及一种手术器械，其包括第一近侧轴、第二近侧轴、第一远侧轴和第二远侧轴。所述第一近侧轴布置成与第一齿轮组件机械协作。所述第二近侧轴限定纵向轴线并且被布置成与第二齿轮组件机械协作。所述第二齿轮组件相对于所述第一近侧轴能够关于所述纵向轴线旋转。第一远侧轴沿着所述纵向轴线并且被布置成与第三齿轮组件机械协作。所述第三齿轮组件相对于所述第一近侧轴能够关于所述纵向轴线旋转。所述第一齿轮组件被机械地接合于所述第三齿轮组件，使得所述第一齿轮组件的旋转引起所述第三齿轮组件的旋转。第二远侧轴包括第四齿轮组件。所述第二齿轮组件被布置成与所述第四齿轮组件机械协作，使得所述第二齿轮组件的旋转引起所述第四齿轮组件的旋转。所述第二远侧轴的远侧部被至少部分地布置在所述第三齿轮组件的内腔中。
在所公开的实施例中，所述第二近侧轴能够相对于所述第三齿轮组件旋转。
进一步公开的是，所述手术器械包括可操作地连接至所述第一远侧轴的第一组件，用于转变来自所述第一远侧轴的旋转运动以使套管针构件相对于所述第一远侧轴轴向移动。还公开的是，所述手术器械包括可操作地连接至所述第二远侧轴的第二组件，用于转变来自所述第二远侧轴的旋转运动以使砧座相对于所述第二远侧轴轴向移动。
附图说明
在此参照附图描述本公开的实施例，其中：
图1是根据本公开的实施例的接合器组件、根据本公开的实施例的延伸组件和示例性手持式机电手术装置的立体分离视图；
图2是图1的示例性手持式机电手术装置的立体侧视图；
图3是图1的接合器组件的立体侧视图；
图4是图3的接合器组件去除了外套筒时的立体侧视图；
图5是图3和图4的接合器组件在去除了第一推进器组件和第二推进器组件的近侧壳体和远侧壳体时的立体侧视图；
图6是图2至图4的接合器组件沿着图3中的线6-6截取的剖面侧视图；
图7是图2至图5的接合器组件沿着图5中的线7-7截取的剖面侧视图；
图8是图2至图7的接合器组件的联接组件和传递组件的放大立体图；
图9是图2至图7的接合器组件在去除了壳体组件时的立体侧视图；
图10是图9的标示的细节区域的放大图；
图11是图6的标示的细节区域的放大图；
图12是图7的标示的细节区域的放大图；
图13是图8的传递组件的立体端视图；
图14是图6的标示的细节区域的放大图；
图15是图7的标示的细节区域的放大图；
图16是图9的标示的细节区域的放大图；
图17是图1的延伸组件的立体侧视图；
图18是图17的延伸组件的内柔性带组件的立体侧视图；
图19是图17的延伸组件的外柔性带组件的立体侧视图；
图20是图18和图19的内柔性带组件和外柔性带组件的立体侧视图以及图17的延伸组件的框架组件的分解图；
图21是图20的内柔性带组件和外柔性带组件以及框架组件的立体侧视图；
图22是图21的标示的细节区域的放大图；
图23是图20的内柔性带组件和外柔性带组件以及框架组件的前视立体图；
图24是图23的标示的细节区域的放大图；
图25是沿着图17的线25-25截取的剖面端视图；
图26是沿着图17的线26-26截取的剖面端视图；
图27是包括近侧密封构件以及第一和第二远侧密封构件的图20的内柔性带组件和外柔性带组件以及框架组件的远侧端的放大立体侧视图；
图28是图27的近侧密封构件以及第一和第二远侧密封构件的分解立体图；
图29是图17的延伸组件的套管针组件的分解图；
图30是图29的套管针组件的立体侧视图；
图31是沿着图30的线31-31截取的剖面侧视图；
图32是沿着图17的线32-32截取的剖面俯视图；
图33是图17的延伸组件的远侧端的放大剖视图；
图34是连接至图17的延伸组件的图3的接合器组件以及联接至延伸组件的末端执行器和砧座组件的立体侧视图；
图35是图34的标示的细节区域的放大剖面侧视图；
图36是根据本公开的另一实施例的接合器组件的后视立体图；
图37是图36的接合器组件在去除了外套筒和手柄构件时的立体侧视图；
图38是图37的接合器组件在去除了基部和壳体构件时的立体侧视图；
图39是图38的接合器组件在去除了支撑结构时的立体侧视图；
图40是沿着图36的线40-40截取的剖面侧视图；
图41是沿着图40的线41-41截取的剖面侧视图；
图42是根据本公开的又一实施例的接合器组件的后视立体图；
图43是沿着图42的线43-43截取的剖面侧视图；
图44是沿着图42的线44-44截取的剖面侧视图；
图45是根据本公开的实施例的连接器组件的立体图；
图46是图45的连接器组件的分解立体图；
图47是图45的连接器组件在去除了套筒和管形延伸件的第一区段时的立体图；
图48是图45的连接器组件在去除了套筒时的立体图；
图49是沿着图45的线49-49截取的剖面侧视图；
图50是根据本公开的实施例的图1的接合器组件的远侧端在部件分离时的立体图；
图51是图50的接合器组件的远侧端的一部分的横向剖视图；
图52是沿着图50的线52-52截取的接合器组件的远侧端的纵向剖视图；
图53和图54是图50的接合器组件的远侧部在去除了一些部件时的立体图；
图55是图50的接合器组件的传感器组件的立体图；
图56和图57是与支撑板接合的驱动轴组件的一部分的替代实施例的立体图；
图58是图56和图57的驱动轴组件和支撑板的所述一部分的立体装配图；
图59是图56至图58的驱动轴组件的远侧齿轮的立体图；
图60是沿着图57中的线60-60截取的驱动轴组件和支撑板的剖视图；并且
图61是沿着图60中的线61-61截取的驱动轴组件和支撑板的局部剖视图。
具体实施方式
参照附图详细描述当前公开的用于手术装置的接合器组件和延伸组件和/或手柄组件的实施例，在若干图中的每个中类似附图标记指代相同或者对应元件。正如在此所使用的，术语“远侧”表示接合器组件或手术装置或其部件的更远离用户的部分，而术语“近侧”表示接合器组件或手术装置或其部件的更靠近用户的部分。
参照图1，总体上示出为接合器组件100的根据本公开的实施例的接合器组件和总体上示出为延伸组件200的根据本公开的实施例的延伸组件，被构造成用于选择性地连接到总体上示出为手术装置10的动力手持式机电器械。如图1中所图示的，手术装置10构造成用于与接合器组件100选择性地连接，而接合器组件100构造成用于与延伸组件200选择性地连接。延伸组件200构造成用于与工具组件或末端执行器选择性地连接，例如，包括装载单元的工具组件30(图34)和例如砧座组件50(图34)的砧座组件，该装载单元例如装载单元40(图40)，该砧座组件用于将圆形阵列的吻合钉(未示出)施加到组织(未示出)。
如图1和图2中所图示的，手术装置10包括手柄壳体12，所述手柄壳体12具有下壳体部14、从下壳体部14延伸和/或支撑在下壳体部14上的中间壳体部16以及从中间壳体部16延伸和/或支撑在中间壳体部16上的上壳体部18。上壳体部18的远侧半部限定鼻状部或连接部18a，所述鼻状部或连接部18a构造成接收接合器组件100的相应的驱动联接组件110(图10)。对于示例性机电器械的结构和功能的详细描述，请参考共同拥有的公开号为2012/0253329的美国专利申请(“'329申请”)，其内容通过引用整体上并入本文。
现在将参照图3至图20描述接合器组件100。首先参考图3，接合器组件100包括近侧端102和远侧端104，所述近侧端102构造成用于可操作地连接到手术装置10(图1)的连接部18a(图1)，所述远侧端104构造成用于可操作地连接到延伸组件200(图1)。根据本公开，接合器组件100可以沿着整个长度基本上或完全是刚性的。
转向图3至图5，从接合器组件100的近侧端102到远侧端104，接合器组件100包括驱动联接组件110、可操作地连接到驱动联接组件110的驱动传递组件130、可操作地连接到驱动传递组件130的第一推进器组件160和可操作地连接到第一推进器组件160的第二推进器组件180。驱动传递组件130、第一推进器组件160和第二推进器组件180中的每一个可操作地保持在外套筒106(图3)内。如下面将进一步详细描述的，轴108(图3)纵向延伸穿过接合器组件100，并且可操作地连接到驱动传递组件130。
参照图5至图9，驱动联接组件110具有圆柱形轮廓并且构造成将接合器组件100选择性地稳固到手术装置10(图1)。驱动联接组件110包括连接器壳体112和通过安装板113固定地连接到连接器壳体112的连接器延伸件114。连接器壳体112和连接器延伸件114操作以可旋转地支撑第一可旋转近侧驱动轴116、第二可旋转近侧驱动轴118和第三可旋转近侧驱动轴120。驱动联接组件110的连接器壳体112和连接器延伸件114还分别可旋转地支撑第一连接器套筒122、第二连接器套筒124和第三连接器套筒126。连接器套筒122、124、126中的每个构造成与手术装置10(图1)的相应的第一驱动连接器、第二驱动连接器和第三驱动连接器(未示出)配合。每个连接器套筒122、124、126还被构造成与相应的第一近侧驱动轴116、第二近侧驱动轴118和第三近侧驱动轴120的近侧端116a、118a、120a配合。
驱动联接组件110还包括设置在相应的第一连接器套筒122、第二连接器套筒124和第三连接器套筒126的远侧的第一偏置构件122a、第二偏置构件124a和第三偏置构件126a。偏置构件122a、124a和126a中的每个关于相应的第一可旋转近侧驱动轴122、第二可旋转近侧驱动轴124和第三可旋转近侧驱动轴126布置，以在接合器组件100(未示出)连接至手术装置10时帮助维持连接器套筒122、124和126与手术装置10的相应的驱动可旋转驱动连接器的远侧端的接合。特别地，第一偏置构件122a、第二偏置构件124a和第三偏置构件126a用于将相应的连接器套筒122、124和126在近侧方向上偏置。
对于示例性驱动联接组件的详细描述，请参考'329申请，其内容先前通过引用并入本文。
参照图9至图13，接合器组件100的驱动传递组件130(图10和13)具有圆柱形轮廓并且将第一可旋转近侧驱动轴116、第二可旋转近侧驱动轴118和第三可旋转近侧驱动轴120的远侧端分别可操作地连接到轴108、第一推进器组件160和第二推进器组件180。驱动传递组件130包括稳固到连接器壳体112的近侧端的支撑板132(图11和12)和邻近支撑板132定位的驱动传递壳体134。支撑板132和壳体134操作以可旋转地支撑第一可旋转远侧驱动轴136、第二可旋转远侧驱动轴138和驱动构件140。
第一可旋转远侧驱动轴136和第二可旋转远侧驱动轴138各自通过一对齿轮可操作地连接到驱动联接组件110的相应的第一可旋转近侧驱动轴116和第二可旋转近侧驱动轴118。特别地，第一可旋转近侧驱动轴116和第二可旋转近侧驱动轴118中的每个的远侧端分别包括齿轮传动部142a和齿轮传动部144a，其接合在相应的第一远侧驱动轴136和第二远侧驱动轴138的近侧端上的齿轮组件或近侧驱动齿轮142b和144b。如所示的，相应的成对的齿轮传动部和近侧驱动齿轮142a、142b和144a、144b中的每对的尺寸相同，以在相应的可旋转近侧和远侧驱动轴之间提供1:1的传动比。以这种方式，相应的可旋转近侧驱动轴和远侧驱动轴以相同的速度旋转。然而，可以想到的是，成对的齿轮传动部和近侧驱动齿轮中的一者或两者可以具有不同的尺寸，以改变可旋转近侧驱动轴和可旋转远侧驱动轴之间的传动比。
驱动联接组件110的第三近侧驱动轴120的远侧端包括齿轮传动组件或齿轮部146a，所述齿轮传动组件或齿轮部146a接合形成在驱动传递组件130的驱动构件140的近侧端上的齿轮传动组件或齿轮部146b。第三近侧驱动轴120上的齿轮传动部146a和驱动构件140上的齿轮传动部146b的尺寸在大小上相同，以在第三近侧驱动轴120和驱动构件140之间提供1:1的传动比。以这种方式，第三近侧驱动轴120和驱动构件140以相同的速度旋转。然而，可以想到的是，齿轮传动部146a、146b中的一者或两者可以具有不同的尺寸以改变第三近侧驱动轴120和驱动构件140之间的传动比。驱动构件140的远侧端限定接收轴108的近侧端108a的插座145。或者，插座145可被构造成可操作地接合延伸组件200(图17)的驱动轴(图17)的近侧端208a。
驱动传递组件130还包括将第一可旋转远侧驱动轴136可操作地连接到第一推进器组件160的驱动连接器148(图11)和将第二可旋转远侧驱动轴138可操作地连接到第二推进器组件180的管状连接器150。特别地，第一可旋转远侧驱动轴136的远侧端包括接合驱动连接器148的齿轮传动部152b的齿轮传动部152a。第二可旋转远侧驱动轴138的远侧端包括齿轮传动部154a，所述齿轮传动部154a接合稳固到管状连接器150的远侧端的驱动齿轮154b。
如图10中所示，第一可旋转远侧驱动轴136的齿轮传动部152a小于驱动连接器148的齿轮传动部152b，以在第一可旋转远侧驱动轴136和驱动连接器148之间提供大于1:1的传动比。以这种方式，驱动连接器148以比第一可旋转远侧驱动轴136更慢的速度旋转。类似地，第二可旋转远侧驱动轴138的齿轮传动部154a小于管状连接器150上的驱动齿轮154b，以在第二可旋转远侧驱动轴136和驱动连接器148之间的大于1:1的传动比。以这种方式，管状连接器150以比第二可旋转远侧驱动轴138更慢的速度旋转。然而，可以想到的是，成对的齿轮传动部152a和齿轮传动部152b以及齿轮传动部154a和驱动齿轮154b中的每对可以具有相同的尺寸，以在相应的第一可旋转远侧驱动轴136和驱动连接器148之间以及在第二可旋转远侧驱动轴138和管状连接器150之间提供1:1的传动比。
另外参考图56至图61，示出了驱动轴组件590，其包括近侧驱动轴600、支撑板640和齿轮组件或远侧齿轮680的替代实施例。近侧驱动轴600包括导向轴610和齿轮组件或齿轮传动部620。支撑板640包括延伸穿过其中的多个孔642。特别地，支撑板640包括第一孔642a、第二孔642b和第三孔642c(见图58)。远侧齿轮680包括近侧部682、齿轮传动部684、远侧部686和内腔688。
远侧齿轮680的近侧部682至少部分地延伸穿过支撑板640的第一孔642a的壁643a(图58)并由其支撑。此外，近侧部682的外径“od”(图59)略小于第一孔642a的直径“dfo”(图58)，使得近侧部682可旋转地支撑在第一孔642a(图60和61)内。
近侧驱动轴600的导向轴610的远侧部612(图58)至少部分地延伸穿过远侧齿轮680的内腔688。导向轴610的远侧部612和内腔688的直径被构造成允许引导轴610相对于内腔688旋转。此外，近侧驱动轴600因此能够相对于远侧齿轮680旋转。此外，近侧驱动轴600也由支撑板640支撑。另外，近侧驱动轴600和远侧齿轮680都可绕公共轴线(即，纵向轴线“Z”(图61))旋转。
尽管在图56至图61中未明确示出，支撑板640以与上面讨论的支撑板132(例如，图11和12)相似的方式支撑在连接器壳体112的近侧端内和/或稳固到连接器壳体112的近侧端。
特别参考图60，近侧驱动轴600的齿轮传动部620接合第一远侧驱动轴136的近侧端上的近侧驱动齿轮142b。因此，近侧驱动轴600的旋转引起第一远侧驱动轴136的旋转。此外，如本文进一步详细讨论的，第一远侧驱动轴136的旋转驱动末端执行器30的功能(例如，夹紧组织)。
此外，第三近侧驱动轴120的齿轮传动部146a接合远侧齿轮680的齿轮传动部684。因此，第三近侧驱动轴120的旋转引起远侧齿轮680的旋转。进一步地并且具体参照图60，远侧齿轮680的远侧部686形成U形插孔或插座，所述U形插孔或插座被构造成接收或接合轴108的近侧端108a。如本文进一步详细讨论的，轴108的旋转驱动末端执行器30的功能(例如，轴向移动套管针构件274)。
可以想到的是，近侧驱动轴600的齿轮传动部620包括在大约10个齿和大约15个齿之间数量的齿。在特定实施例中，近侧驱动轴600的齿轮传动部620包括13个齿。可以想到的是，远侧齿轮680的齿轮传动部684包括在大约25个齿和大约35个齿之间数量的齿。在特定实施例中，远侧齿轮680的齿轮传动部684包括30个齿。还公开了齿轮传动部620和684可以包括比所讨论的特定数量更多或更少的齿。
还公开了近侧驱动轴600和远侧齿轮680可以同时在彼此不同的方向上旋转。也就是说，可以想到的是，在近侧驱动轴600顺时针旋转的同时，远侧齿轮680逆时针旋转。还可以想到的是，近侧驱动轴600和远侧齿轮680同时沿彼此相同的方向旋转。这种旋转至少因为近侧驱动轴600和远侧齿轮680围绕相同的轴线旋转并且它们可以相对于彼此旋转(如上所讨论的)而能够实现。
特别参考图58和图60，示出了支撑板640。支撑板640包括延伸穿过其中的多个孔642和凹口644。如图60和图61中所示，导向轴610的远侧部612和远侧齿轮680的近侧部682延伸穿过第一孔642a、由第一孔642a支撑并且可相对于第一孔642a旋转。此外，导向轴610、远侧齿轮680和第一孔642a是同轴的。另外，可以想到的是，第三近侧驱动轴120的一部分延伸穿过第二孔642b、由第二孔642b支撑并且可相对于第二孔642b旋转(图60)。在这些实施例中，第三近侧驱动轴120、第三近侧驱动轴120的齿轮传动部146a以及第二孔642b是同轴的。还可以想到的是，第一远侧驱动轴136的一部分延伸穿过第三孔642c、由第三孔642c支撑并且可相对于第三孔642c旋转(图60)。这里，第一远侧驱动轴136、近侧驱动齿轮142b和第三孔642c是同轴的。另外，孔642和凹口644的数量、尺寸、形状和定位可以被制造成适合特定的目的。
现在参考图9至图13，第一推进器组件160包括近侧壳体部162和远侧壳体部164(图11)、可操作地安装在近侧壳体部162内的行星齿轮组件166、可操作地连接至行星齿轮组件166并可旋转地支撑在远侧壳体部164内的螺杆构件168(图11)，以及可操作地连接到螺杆构件168并可滑动地布置在远侧壳体部164内的推进器构件170(图11)。行星齿轮组件166包括第一行星齿轮系统166a和第二行星齿轮系统166b(图10)。第一行星齿轮系统166a包括安装在驱动传递组件130的驱动连接器148的远侧端上的中心驱动齿轮172a和可旋转地安装到可旋转支撑环176的多个行星齿轮174a。
第一行星齿轮系统166a的每个行星齿轮174a接合中心驱动齿轮172a和近侧壳体部162的带齿内表面165。当中心驱动齿轮172a沿第一方向(即，顺时针)旋转时，每个行星齿轮174a沿第二方向(即，逆时针)旋转。当每个行星齿轮174a沿第二方向旋转时，行星齿轮174a与远侧壳体部162的带齿内表面165的接合引起可旋转支撑环176沿第一方向旋转。相反，中心驱动齿轮172a在第二方向上的旋转引起每个行星齿轮174a沿第一方向的旋转，从而引起可旋转支撑环176沿第二方向的旋转。第一行星齿轮系统166a的构造提供了传动比的减小。以这种方式，可旋转支撑环174的旋转速度小于中心驱动齿轮172a的旋转速度。
第二行星齿轮系统166b包括稳固地附接到可旋转支撑环176的中心驱动齿轮172b和可旋转地安装到螺杆构件168的近侧端表面168a的多个行星齿轮174b。第二行星齿轮系统166b的每个行星齿轮174b接合中心驱动齿轮172b和近侧壳体部162的带齿内表面165。当第一行星齿轮系统166a的可旋转支撑环176沿第一方向旋转，从而使中心驱动齿轮172b也沿第一方向旋转时，每个行星齿轮174b沿第二方向旋转。当每个行星齿轮174b沿第二方向旋转时，行星齿轮174b与近侧壳体部162的带齿内表面165的接合引起螺杆构件168沿第一方向旋转。相反，中心驱动齿轮172b在第二方向上的旋转引起每个行星齿轮174b在第一方向上的旋转，从而引起螺杆构件168沿第二方向旋转。第二行星齿轮系统166b的构造提供了传动比的减小。以这种方式，螺杆构件168的旋转速度小于中心驱动齿轮172b的旋转速度。第一行星齿轮系统166a和第二行星齿轮系统166b协同地操作以提供第一可旋转近侧驱动轴116和螺杆构件168之间的传动比的减小。以这种方式，螺杆构件168相对于驱动连接器148的旋转速度的减小是由第一行星齿轮系统166a和第二行星齿轮系统166b提供的减速的产物。
螺杆构件168可旋转地支撑在近侧壳体部162内，并且包括螺纹远侧端168b，所述螺纹远侧端168b可操作地接合推进器构件170的螺纹内表面170a。当螺杆构件168沿第一方向旋转时，螺杆构件168的螺纹远侧端168b与推进器构件170的螺纹内表面170a(其被键合以允许其轴向平移而防止其旋转)的接合，引起推进器构件170的纵向推进，如由图12中的箭头“A”所标示的。相反，螺杆构件168在第二方向上的旋转引起推进器构件170的缩回。
接合器组件100的第一推进器组件160的推进器构件170包括形成在其远侧端上的一对凸起178，所述一对凸起178用于接合延伸组件200(图17)的外柔性带组件230(图19)的连接器延伸件240、242(图19)。尽管示出为凸起178，但是可以想象，推进器构件170可以包括适于选择性地接合延伸组件200的外柔性带230的连接器延伸件240、242的任何结构。
现在具体参考图14至图16，第二推进器组件180基本上类似于第一推进器组件160，并且包括近侧壳体部182和远侧壳体部184、可操作地安装在近侧壳体部182内的行星齿轮组件186、可操作地连接到行星齿轮组件186并可旋转地支撑在远侧壳体部184内的螺杆组件188以及可操作地连接到螺杆构件188并可滑动地布置在远侧壳体部184内的推进器构件190。行星齿轮组件186包括第一行星齿轮系统186a和第二行星齿轮系统186b(图16)。第一行星齿轮系统186a包括安装在驱动传递组件130的管状连接器150的远侧端上的中心驱动齿轮192a和可旋转地安装到可旋转支撑环196的多个行星齿轮194a。
第一行星齿轮系统186a的每个行星齿轮194a接合中心驱动齿轮192a和近侧壳体部182的带齿内表面185。当中心驱动齿轮192a沿第一方向(即，顺时针)旋转时，每个行星齿轮194a沿着第二方向(即，逆时针)旋转。当每个行星齿轮194a在第二方向上旋转，行星齿轮194a与近侧壳体部182的带齿内表面185的接合引起可旋转支撑环196沿第一方向旋转。相反，中心驱动齿轮192a在第二方向上的旋转引起每个行星齿轮194a沿第一方向的旋转，从而引起可旋转支撑环196沿第二方向的旋转。第一行星齿轮系统186a的构造提供了传动比的减小。以这种方式，可旋转支撑环194的旋转速度小于中心驱动齿轮190a的旋转速度。
第二行星齿轮系统186b包括稳固地附接到可旋转支撑环196的中心驱动齿轮192b和可旋转地安装到螺杆构件188的近侧端表面188a的多个行星齿轮194b。第二行星齿轮系统186b的每个行星齿轮194b接合中心驱动齿轮192b和近侧壳体部182的带齿内表面185。当第一行星齿轮系统186a的可旋转支撑环196沿第一方向旋转，从而引起中心驱动齿轮192b也沿第一方向旋转时，每个行星齿轮194b沿第二方向旋转。当每个行星齿轮194b沿第二方向旋转，行星齿轮194b与近侧壳体部182的带齿内表面185的接合引起螺杆构件188沿第一方向旋转。相反，中心驱动齿轮192b在第二方向上的旋转引起每个行星齿轮194b在第一方向上的旋转，从而引起螺杆构件198沿第二方向旋转。第二行星齿轮系统186b的构造提供了传动比的减小。以这种方式，螺杆构件188的旋转速度小于中心驱动齿轮192b的旋转速度。第一行星齿轮系统186a和第二行星齿轮系统186b协同地操作以提供第二可旋转近侧驱动轴118和螺杆构件188之间的传动比的减小。以这种方式，螺杆构件188相对于管状连接器150的旋转速度的降低是由第一行星齿轮系统186a和第二行星齿轮系统186b提供的减速的产物。
螺杆构件188可旋转地支撑在近侧壳体部182内，并且包括螺纹远侧端188b，所述螺纹远侧端188b可操作地接合推进器构件190的螺纹内表面190a。当螺杆构件188沿第一方向旋转时，螺杆构件188的螺纹远侧端188b与推进器构件190的螺纹内表面190a(其被键合以允许轴向平移而防止其旋转)的接合引起推进器构件190的纵向推进。相反，螺杆构件188沿第二方向的旋转引起推进器构件190的缩回。
接合器组件100的第二推进器组件180的推进器构件190包括形成在其远侧端上的一对凸起198，所述一对凸起198用于接合延伸组件200(图17)的内柔性带组件210(图18)的连接器延伸件220、222(图18)。尽管示出为凸起198，但是可以想到的是，推进器构件190可以包括适于选择性地接合延伸组件200的外柔性带230的连接器延伸件240、242的任何结构。
现在转向图17到图34，将描述延伸组件200，其用于将接合器组件100(图3)可操作地连接于圆形装载单元(例如，装载单元40(图34))和砧座组件(例如，砧座组件50(图34))。特别地，延伸组件200的近侧端202可操作地连接于接合器组件100(图3)的远侧端104(图3)，并且延伸组件200的远侧端204可操作地连接于装载单元40和砧座组件50。如所示的，延伸组件200在近侧端202和远侧端204之间提供了轻微的弯曲。在替代实施例中，延伸组件200可以是直的或者可以包括更大的弯曲。根据本公开，延伸组件200可以沿着其整个长度基本上或完全地是刚性的。
尽管延伸组件200将被示出和描述为用于将装载单元40和砧座组件50连接到接合器组件100(图3)，但是可以想到的是，本公开的各方面可以修改为用于与各种装载单元、砧座组件和接合器组件一起使用。示例性的装载单元和砧座组件在共同拥有的专利号为8,590,763的美国专利和序列号为14/056,301和14/149,355的美国专利申请中进行了描述，其内容通过引用整体上并入本文。
延伸组件200包括内柔性带组件210(图18)、关于内柔性带组件210可滑动地设置的外柔性带组件230(图19)、用于支撑内柔性带组件210和外柔性带组件230的框架组件250(图20)、被可操作地接收通过内柔性带组件210和外柔性带组件230的套管针组件270(图28)，以及用于将装载单元40(图34)稳固到延伸组件200的连接器组件290。外套筒206(图17)围绕框架组件250和套管针组件270接收，并且内柔性带组件210和外柔性带组件230被滑动地接收穿过外套筒206。如将在下面进一步详细描述的，延伸组件200可包括驱动轴208，所述驱动轴208可操作地连接到套管针组件270并延伸穿过延伸组件200的近侧端202。
参照图18，内柔性带组件210包括第一内柔性带212和第二内柔性带214、支撑环216、支撑基部218以及第一连接延伸件220和第二连接延伸件222。相应的第一内柔性带212和第二内柔性带214的近侧端212a、214a横向间隔开并且被稳固地附接到支撑环216。第一内柔性带212和第二内柔性带214的远侧端212b、214b横向间隔开并且被稳固地附接到支撑基部218的近侧端218a。第一内柔性带212和第二内柔性带214中的每个可以以任何合适的方式附接到支撑环216和/或支撑基部218，包括例如通过压配合、焊接、粘合剂和/或机械紧固件。如将在下面进一步详细描述的，内柔性带组件210构造成关于套管针组件270(图28)被可滑动地接收并且接收在外柔性带组件230(图19)和外套筒206(图17)内。
内柔性带组件210的第一连接延伸件220和第二连接延伸件222从支撑环216向近侧延伸并且将内柔性带组件210与接合器组件100(图3)的第二推进器组件180(图15)的推进器构件190(图15)可操作地连接。特别地，第一连接延伸件220和第二连接延伸件222中的每个限定相应的开口221、223，所述开口221、223构造成接收第二推进器组件180的推进器构件190(图15)的凸起198(图15)。推进器构件190的凸起198在相应的第一延伸件220和第二延伸件222的开口221、223内的接收将延伸组件200的内柔性带组件210与接合器组件100的第二推进器组件180稳固。第一连接延伸件220和第二连接延伸件222可以与支撑件环216一体地形成，或者以任何合适的方式附接到其上。
支撑基部218从内柔性带212、214向远侧延伸并且构造成将延伸组件200与装载单元40(图34)选择性地连接。具体地，支撑基部218的远侧端218a包括凸缘224，所述凸缘224用于与装载单元40(图34)的可轴向移动的组件(未示出)可操作地接合。在一个实施例中，凸缘224构造成用于与装载单元40(图34)的刀组件(未示出)连接。
现在参照图19，外柔性带组件230基本上类似于内柔性带组件210，并且包括第一柔性带232和第二柔性带234，所述第一柔性带232和第二柔性带234横向间隔开并且在近侧端232a、234a上连接到支撑环236且在远侧端232b、234b上连接到支撑基部238的近侧端238a。第一外柔性带232和第二外柔性带234中的每个可以以任何合适的方式附接到支撑环236和支撑基部238，所述任何合适的方式包括例如通过压配合、焊接、粘合剂和/或机械紧固件。如将在下面进一步详细描述的，外柔性带组件230构造成接收穿过其中的套管针组件270(图28)。
外柔性带组件230的第一连接延伸件240和第二连接延伸件242从支撑环236向近侧延伸并且将外柔性带组件230与接合器组件100(图1)的第一推进器组件160(图12)的推进器构件170(图12)可操作地连接。特别地，第一连接延伸件240和第二连接延伸件242中的每个限定相应的开口2241、243，所述开口241、243构造成接收第一推进器组件180的推进器构件170的凸起178(图12)。推进器构件170的凸起178在相应的第一延伸件240和第二延伸件242的开口241、243内的接收将延伸组件200的外柔性带组件230稳固于接合器组件100的第一推进器组件180。第一连接延伸件240和第二连接延伸件242可以与支撑环236一体地形成，或者以任何合适的方式附接至此。
支撑基部238从外柔性带232、234向远侧延伸并且构造成将延伸组件200与装载单元40(图34)选择性地连接。具体地，支撑基部238的远侧端238b包括凸缘244，其用于与装载单元(未示出)的可轴向移动的组件(未示出)可操作地接合。在一个实施例中，凸缘244构造成用于与装载单元40(图34)的吻合钉推进器组件(未示出)连接。
现在参照图20至图26，框架组件250包括第一近侧间隔构件252和第二近侧间隔构件254以及第一远侧间隔构件256和第二远侧间隔构件258。当稳固在一起时，第一近侧间隔构件252和第二近侧间隔构件254限定一对内纵向狭槽253a和一对外纵向狭槽253b，所述一对内纵向狭槽253a用于可滑动地接收内柔性带组件210(图18)的第一柔性带212和第二柔性带214(图18)，所述一对外纵向狭槽253b用于可滑动地接收外柔性带组件230(图19)的第一柔性带232和第二柔性带234(图19)。第一近侧间隔构件252和第二近侧间隔构件254进一步限定用于接收套管针组件270的纵向通道255。
在一个实施例中，并且如所示的，第一近侧间隔构件252和第二近侧间隔构件254由塑料形成并且通过卡扣布置稳固在一起。或者，第一近侧间隔构件252和第二近侧间隔构件254可以由金属或其它合适的材料形成，并且可以以任何合适的方式固定在一起，所述任何合适的方式包括通过焊接、粘合剂和/或使用机械紧固件。
第一远侧间隔构件256和第二远侧间隔构件258限定一对内狭槽257a和一对外狭槽257b，所述一对内狭槽257a用于可滑动地接收内柔性带组件210(图18)的第一柔性带212和第二柔性带214(图18)，所述一对外狭槽257b用于可滑动地接收外柔性带组件230(图19)的第一柔性带232和第二柔性带234(图19)。第一远侧间隔构件256和第二远侧间隔构件258还限定用于容纳套管针组件270的纵向通道259。
在一个实施例中，并且如所示的，第一远侧间隔构件256和第二远侧间隔构件258中的每个关于内柔性带组件210和外柔性带组件230稳固并通过一对螺钉260a、260b(图26)稳固到外套筒206(图17)。或者，第一远侧间隔构件256和第二远侧间隔构件258可以以任何合适的方式稳固在一起，所述任何合适的方式包括通过焊接、粘合剂和/或使用机械紧固件。第一远侧间隔构件256和第二远侧间隔构件258可以由金属或任何其它合适的材料形成。
现在参考图27和图28，框架组件250还包括近侧密封构件262以及第一远侧密封构件264和第二远侧密封构件266。近侧密封构件262以及第一远侧密封构件264和第二远侧密封构件266中的每个分别包括密封半部262a、262b、264a、264b、266a、266b。近侧密封构件262被接收在第一近侧间隔构件252和第二近侧间隔构件254与第一远侧间隔构件256和第二远侧间隔构件258之间。第一远侧密封构件264的第一半部264a稳固到第二远侧密封构件266的第一半部266a，并且第一远侧密封构件264的第二半部264b稳固到第二远侧密封构件266的第二半部。近侧密封构件262以及第一远侧密封构件264和第二远侧密封构件266以密封的方式接合外套筒206(图17)、相应的内柔性带组件210和外柔性带组件230的内柔性带212、214和外柔性带232、234以及套管针组件270(图28)。以这种方式，近侧密封构件262以及第一远侧密封构件264和第二远侧密封构件266操作以在延伸组件200的远侧端204和近侧端202之间提供流体紧密密封。
参照图29至图32，延伸组件200的套管针组件270包括外壳体272、可滑动地布置在管状外壳体272内的套管针构件274以及可操作地接收在套管针构件274内用于使套管针构件274相对于管状壳体272轴向移动的驱动螺杆276。特别地，套管针构件274包括具有内螺纹部275的近侧端274a，所述内螺纹部274a接合驱动螺杆276的螺纹远侧部276b。当驱动螺杆276在套管针构件274内旋转时，套管针构件274的内螺纹部275与驱动螺杆276的螺纹远侧部276b的接合引起套管针构件274在套管针组件270的外壳体272内的纵向移动。驱动螺杆276沿第一方向的旋转引起套管针构件274的纵向推进并且驱动螺杆276沿第二方向的旋转引起套管针构件274的纵向缩回。套管构件274的远侧端274b构造成选择性地接合砧座组件50(图34)。
轴承组件278安装到套管针组件270的外壳体272的近侧端272a，用于相对于外壳体272和套管针构件274可旋转地支撑驱动螺杆276的近侧端276a。轴承组件278包括壳体280、近侧间隔件282a和远侧间隔件282b、近侧保持夹284a和远侧保持夹284b、近侧轴承286a和远侧轴承286b以及垫圈288。如所示的，驱动螺杆276的近侧端276a包括用于连接于连杆组件277的凸缘276c。连杆组件277的远侧部277b枢转地接收在第一近侧间隔构件252和第二近侧间隔构件254之间，并且可操作地接合驱动螺杆276上的凸缘276c。连杆组件277的近侧端277a构造成用于与驱动轴208的远侧端208b可操作的接合。
现在参考图32和图33，延伸组件200的连接器组件290包括附接到外套筒206的远侧端206b并且围绕内柔性组件210和外柔性组件230(图26)的远侧端以及套管针组件270的管状连接器292。特别地，管状连接器292的近侧端292a接收在外套筒206的远侧端206b内并且通过保持夹294稳固地附接到外套筒206的远侧端206b。O形环296在连接器组件290的管状连接器292和外套筒206之间形成流体紧密密封。管状连接器292的远侧端292b构造成选择性地接合装载单元40(图34)的近侧端。管状连接器292的远侧端292b借助卡扣配合布置、卡口联接件或以另一合适的方式接合圆形装载单元。
现在参考图34和图35，延伸组件200通过将延伸组件200的近侧端202(图17)接收在接合器组件100的远侧端104内而连接到接合器组件100。特别地，相应的内柔性带组件210和外柔性带组件230的第一和第二连接延伸件220、240、222、242接收在接合器组件100的套筒106内，使得接合器组件100的第一推进器组件160的推进器构件170的凸起178被接收在外柔性带组件230的相应的第一和第二连接延伸件240、242的开口241、243内，以将外柔性带组件230稳固于第一推进器组件160，并且接合器组件100的第二推进器组件180的推进器构件190的凸起198被接收在内柔性带组件210的第一和第二连接延伸件221、223的开口221、223内，以将内柔性带组件210稳固于第二推进器组件180。
正如上面所指出的，接合器组件100可以包括从接合器组件100的远侧端104延伸的驱动轴108(图3)。或者，延伸组件200可以包括从延伸组件200的近侧部202延伸的驱动轴208。在接合器组件100包括驱动轴108并且延伸组件200也包括驱动轴208的情况下，在延伸组件200的近侧部202接收在接合器组件100的远侧端104内之前，驱动轴108、208中的一个必须从相应的接合器组件100和延伸组件200移除。在延伸组件200的近侧部202接合在接合器组件100的远侧端102内期间，驱动轴108(图35)的远侧端108b(图35)接合连杆组件277的近侧部277b(图35)，或者驱动轴208(图17)的近侧端208a(图17)被接收在接合器组件100(图12)的驱动传递组件130的驱动构件140的插座145内。
在延伸组件200与接合器组件100可操作地接合并且接合器组件100与手术装置10(图1)可操作地接合之后，末端执行器30(图34)的装载单元40(图34)可以附接到延伸组件200的连接器组件290，并且砧座组件50(图34)可以以常规方式附接到延伸组件200的套管针274的远侧端274b。在装载单元40和砧座组件50的致动期间，如上所述，并且如图35中的箭头“C”所标示的，接合器组件100的第二推进器组件180的推进器构件190的纵向推进，引起延伸组件200的外柔性带组件230的纵向推进，并且如上所述且如图35中箭头“D”所标示的，第一推进器组件160的推进器构件170的纵向推进，引起内柔性带组件210的纵向推进。如上所述并且如由箭头“E”所标示的，驱动轴108在第一方向上的旋转，引起延伸组件200的套管针274的推进。相反，推进器构件190的纵向缩回引起外柔性带组件230的纵向缩回，推进器构件170的纵向缩回引起内柔性带组件210的纵向缩回，并且驱动轴108在第二方向上的旋转引起延伸组件200的套管针274的缩回。
在一个实施例中，内柔性带组件210可操作地连接到附接到延伸组件200的连接组件290的末端执行器30(图34)的装载单元40(图34)的刀组件(未示出)，外柔性带组件230可操作地连接到装载单元40的吻合钉驱动器组件(未示出)，并且套管针274可操作地连接到末端执行器30(图34)的砧座组件50(图34)。以这种方式，内柔性带组件210的纵向移动引起刀组件的纵向移动，外柔性带组件230的纵向移动引起吻合钉驱动器组件的纵向移动，并且套管针274的纵向移动引起砧座组件50相对于装载单元40的纵向移动。
参照图36至图41，根据本公开的另一个实施例的接合器组件被示出为接合器组件300。接合器组件300基本上类似于上文描述的接合器组件100，并且将仅仅描述它们之间的差异。
正如从下面的描述将变得显而易见的，接合器组件300的构造允许接合器组件300的远侧部304相对于接合器组件300的近侧部302围绕纵向轴线“X”(图37)旋转。以这种方式，末端执行器，例如，稳固到接合器组件300的远侧部304的末端执行器30(图34)或稳固到延伸组件(例如，稳固到接合器组件300的远侧部304的延伸组件200(图17))的末端执行器是可独立于附接了接合器组件300的手术装置(未示出)的运动而围绕纵向轴线“X”旋转的。
接合器组件300包括基部306和相对于基部306沿着接合器组件300的纵向轴线“X”可旋转的支撑结构308。旋转手柄310可旋转地稳固到基部306并固定地稳固到支撑结构308的近侧端。旋转手柄310允许接合器组件300的远侧部304相对于接合器组件300的近侧端302纵向旋转。正如下面将进一步详细描述的，锁闩312安装到旋转手柄310并且将旋转手柄310选择性地稳固在固定纵向位置。
接合器组件300的近侧部302包括驱动联接组件320和可操作地连接到驱动联接组件320的驱动传递组件330。接合器组件300的远侧部304包括可操作地连接到驱动传递组件330的第一推进器组件340以及可操作地连接到驱动传递组件330的第二推进器组件350。驱动联接组件320和驱动传递组件330安装在基部306内，并且因此相对于附接了接合器组件300的手术装置(未示出)保持可旋转固定。第一推进器组件340和第二推进器组件350安装在支撑结构308内，并因此可相对于附接了接合器组件300的手术装置(未示出)旋转。
驱动联接组件320构造成将接合器组件300选择性地稳固到手术装置(未示出)。对于示例性手术装置和驱动联接组件的详细描述，请参考2013年12月9日提交的共同拥有的序列号61/913,572的美国临时专利申请，其内容通过引用整体上并入本文。
旋钮310可旋转地稳固到基部306。锁闩312包括被配置为相对于基部306锁定旋钮310的销312a(图40)。特别地，锁闩312的销312a被接收在形成于基部306中的狭槽307内并且被弹簧314向远侧偏置到形成于基部306中并与狭槽307连通的凹口307a(图40)中，以将旋钮310相对于基部306锁定。如由图36中的箭头“F”所标示的，闩锁312的近侧移动使销312a从凹口307a缩回以允许旋钮310相对于基部306旋转。尽管未示出，但可以想象的是，基部306可以限定围绕基部306径向间隔开并且与狭槽307连通的多个凹口，所述多个凹口允许旋钮310相对于基部306锁定在多个纵向定向上。
接合器组件300的驱动传递组件330、第一驱动推进器组件340和第二驱动推进器组件350与上文描述的接合器组件100的相应的驱动传递组件130、第一驱动推进器组件160和第二驱动推进器组件180基本相同，并因此，将仅关于它们之间的差异来描述。
支撑结构308围绕第一推进器组件340和第二推进器组件350固定地接收并且相对于基部306可旋转。正如上面所指出的，旋钮310固定地稳固到支撑结构308的近侧端，以便于支撑结构308相对于基部306的旋转。支撑结构308与接合器组件300的外套筒305保持在一起，并且构造成维持第一推进器组件340和第二推进器组件350的轴向对准。与接合器组件100的成本相比，支撑结构308还可以降低接合器组件300的成本。
支撑结构308分别包括第一板360a、第二板360b、第三板360c、第四板360d、第五板360e、第六板360f和第七板360g，第一多个管状支撑件362a和第二多个管状支撑件362b，第一支撑环364a和第二支撑环364b，第一多个肋366a和第二多个肋366b以及多个铆钉368。从近侧到远侧，第一板360a和第二板360b通过第一多个管状支撑件362a而维持彼此间隔开的关系，第二板360b和第三板360c通过第一支撑环364a而维持彼此间隔开的关系，第三板360c和第四板360d通过第一多个支撑肋366a而维持彼此间隔开的关系，第四板360d和第五板360e通过第二多个管状支撑件362b而维持彼此间隔开的关系，第五板360e和第六板360f通过第二支撑环364b而维持彼此间隔开的关系，并且第六板360f和第七板360g通过第二多个支撑肋366b而维持彼此间隔开的关系。第一板、第二板、第三板、第四板、第五板、第六板和第七板360a-g通过稳固到第一板360a和第七板360g并延伸穿过第二板、第三板、第四板、第五板和第六板360b-360f、第一支撑环364a和第二支撑环364b以及相应的第一多个管状支撑件362a和第二多个管状支撑件362b的多个铆钉368而保持在一起。
接合器组件300以与上文描述的接合器组件100基本相似的方式操作。另外，如上面详细描述的，接合器组件300被构造成允许末端执行器，例如，附接到接合器组件300或附接到(附接至接合器组件300的)延伸组件的末端执行器30(图34)，的旋转，以在使用期间围绕纵向轴线“X”(图37)选择性地旋转。
现在参考图42至图44，根据本公开的另一实施例的接合器组件总体上示出为接合器组件400。接合器组件400基本上类似于上文描述的接合器组件100和300，因此将仅描述为与其之间的差异。
接合器组件400包括近侧部402和相对于近侧部402沿着纵向轴线“X”可旋转的远侧部404。远侧部404包括稳固到外套筒405并且围绕第一推进器组件440和第二推进器组件450形成的支撑结构408。支撑结构408包括基本上在外套筒405的长度上延伸的多个加强构件462。加强构件462各个包括延伸穿过外套筒405以将加强构件462稳固在外套筒405内的近侧凸起462a和远侧凸起462b。加强构件462的近侧凸起462a进一步构造成接合接合器组件400的旋钮410。接合器组件400可包括位于加强构件462径向内侧的环形板(未示出)，其维持加强构件462的近侧凸起462a和远侧凸起462b与外套筒405接合。环形板还可以为接合器组件400的远侧部404提供结构支撑。
参照图45至图49，根据本公开的实施例的连接组件总体上被示出为连接组件500。如所示并将被描述的，连接组件500被构造成附接到第一管状体和第二管状体(未示出)用于将第一管状体，即接合器组件100(图3)、300(图36)、400(图42)连接到第二管状体，即延伸组件200(图17)。然而，可以想到的是，本公开的各方面可以直接结合到第一管状体和第二管状体中，以允许第一管状主体直接连接到第二管状主体。
连接组件500包括管状基部510以及由第一区部520a和第二区部520b和外套筒522形成的管状延伸件520。如所示的，管状基部510限定一对开口511，用于将管状基部510稳固到第一管状体(未示出)。或者，管状基部510可以仅包括单个开口、一个或更多凸起(未示出)和/或一个或更多狭槽(未示出)，用于将管状基部510稳固到第一管状体(未示出)。凸缘512从管状基部510的第一端延伸并且包括在其周围延伸的环形边缘514。
管状延伸件520的第一区部520a和第二区部520b基本上彼此类似，并且每个限定沿着其内部第一表面形成的环形沟槽521。管状延伸件520的第一区部520a和第二区部520b中的每个被构造成关于管状基部510的凸缘512接收，使得管状基部510的边缘514接收在管状延伸件520的第一区部520a和第二区部520b的沟槽521内。一旦管状延伸件520的第一区部520a和第二区部520b关于管状基部510的凸缘512被接收，则管状延伸件520的外套筒522关于管状延伸件520的第一区部520a和第二区部520b而被接收，以将管状延伸件520稳固至管状基部510。
如所示的，管状延伸件520的第一区部520a和第二区部520b中的每个限定开口523，所述开口523构造成与外套筒522中的一对开口525对准，以将外套筒522稳固到第一区部520a和第二区部520b。第一区部520a和第二区部520b中的一者或两者以及外套筒522可以包括一个或更多凸起，和/或一个或更多狭槽，用于将外套筒522稳固在第一延伸件和第二延伸件周围。或者，外套筒522可以以任何合适的方式稳固到第一区部520a和第二区部520b。
外套筒522可以被选择性地稳固在第一延伸件和第二延伸件周围，用于将外套筒522从第一区部520a和第二区部520b周围选择性地移除，以允许管状延伸件520与管状基部510分离。或者，外套筒522可以被永久地稳固在第一区部520a和第二区部520b周围，以防止管状延伸件520与管状基部510分离。正如上面所指出的，尽管管状基部510和管状延伸件520被示出并描述为形成独立的连接组件500，但可以想到的是，管状基部510可以形成在第一管状构件上，即接合器组件100(图3)，并且管状延伸件520可以形成在第二管状构件上，即延伸组件200(图17)，使得第一管状构件可以直接连接到第二管状构件。
参考图50至图52，套管针组件1270的替代实施例结合延伸组件1200的替代实施例示出。套管针组件1270类似于上述的套管针组件270，并且不是所有相似之处都将在此进行讨论。然而，尽管套管针组件270构造成用于稳固地接合至延伸组件200的连杆组件277，套针组件1270构造成用于可释放地接合于延伸组件1200。
特别参考图50，套管针组件1270包括围绕其周边的一对平坦部1280，并且延伸组件1200包括穿过其外壁或套管1206的一对开口1210a、1210b(开口1210a在图50中是不可见的)。当套管针组件1270与延伸组件1200接合时，套管针组件1270的平坦部1280与延伸组件1200的开口1210a、1210b轴向对准。在该位置，一对保持构件1300a、1300b可插入穿过相应的开口1210a、1210b并且与平坦部1280相邻(例如，接触)。
更具体地，每个保持构件1300a、1300b分别包括延伸部1310a、1310b和插孔1320a、1320b。每个延伸部1310a、1310b被构造成可释放地接合相对的保持构件1300a、1300b的插孔1320a、1320b。也就是说，保持构件1300a的延伸部1310a被构造成可释放地接合保持构件1300b的插孔1320b；保持构件1300b的延伸部1310b被构造成可释放地接合保持构件1300a的插孔1320a。可以想到的是，延伸部1310a、1310b分别经由卡扣配合连接来接合插孔1320b、1320a。进一步想到的是，保持构件1300a与保持构件1300b相同，这可有助于最小化制造成本并便于组装。
在使用中，为了使套管针组件1270与延伸组件1200接合，套管针组件1270被插入穿过延伸组件1200的远侧开口1202，直到套管针组件1200的驱动螺杆1276的近侧端1276a接合延伸组件1200的连杆组件(例如，参见图32中的套管针组件270的连杆组件277)。接下来，每个保持构件1300a、1300b的延伸部1310a、1310b分别插入穿过外套筒1206的相应开口1210a、1210b，横跨套管针组件1270的平坦部1280，并分别进入到另一个保持构件1300b、1300a的插孔1320b、1320a中。也就是说，保持构件1300a的延伸部1310a被插入穿过外套管1206的开口1210a(或1210b)、横跨平坦部1280并进入保持构件1300b的插孔1320b，并且保持构件1300b的延伸部1310b被插入穿过外套筒1206的开口1210b(或1210a)、横跨平坦部1280并进入保持构件1300a的插孔1320a。延伸部1310a、平坦部1280和插孔1320b之间的接合以及延伸部1310b、平坦部1280和插孔1320a之间的接合被配置为防止套管针组件1270的套管针构件1274相对于套管针组件1200的外套管1206的纵向平移(例如，由于延伸部1310a、1310b与平坦部1280的壁1282之间的接合)。另外，延伸部1310a、平坦部1280和插孔1320b之间的接合以及延伸部1310b、平坦部1280和插孔1320a之间的接合被配置为防止套管针组件1270的套管针构件1274与套管针组件1200的外套管1206之间的相对旋转。
另外，并且特别参考图50，每个保持构件1300a、1300b包括凸块1302(仅示出与保持构件1300a相关联的凸块1302)，其被构造成机械地接合套管针组件1270的棘爪1284。可以想到的是，凸块1302和棘爪1284之间的结合有助于维持保持构件1300a、1300b和套管针组件1270之间的适当对准和/或取向。
为了使保持构件1300a、1300b彼此脱离，可以想到的是，用户可以使用工具(例如，螺丝刀型工具)将延伸部1310a、1310b分别推出插孔1320b、1320a。还可以想到的是，保持构件1300a、1300b被构造成为彼此以及从套管针组件1270无工具地脱离。保持构件1300a、1300b的脱离允许套管针组件1270从套管针组件1200的外套筒1206移除(例如，用于替换或清洁)。可以想到的是，例如，清洁可以通过将清洁装置至少部分地插入延伸组件1200的外套筒1206的至少一个开口1210a、1210b内，并且向近侧和/或向远侧引导清洁流体(例如，盐水)以帮助冲掉可能存在于外套管1206内的任何污染物而发生。
另外，尽管延伸组件1200和套管针组件1270被示出为与接合器组件100结合使用，但是本公开还预见延伸组件1200和/或套管针组件1270与手术装置(例如，圆形吻合器械)一起使用而不使用接合器组件。
参考图53至图55，本公开还包括应变仪1500、位置传感器1520和存储器传感器1540(例如，E-PROM(可擦除可编程只读存储器)传感器)。特别参考图55，可以想到的是，例如，柔性电缆1600在应变仪1500、位置传感器1520、存储器传感器1540和印刷电路板(未示出)之间延伸，并且从印刷电路板延伸到布置在接合器组件300的近侧部302处的电连接器。
可以想到的是，应变仪1500用于检测在夹紧组织期间施加在组织上的轴向载荷。这里，可以想到的是，如果该负载太大或超过预定值，则用户(或吻合装置10本身)可以中止吻合操作，或者例如可以选择使用不同的吻合装置10或接合器组件100。
可以想到的是，位置传感器1520用于在吻合处理期间(例如，当紧固件被从接合器组件100发射时)检测紧固件的轴向位置。进一步可以想到的是，存储器传感器1540被配置为识别接合于与吻合装置10接合的接合器组件100的吻合钉钉仓的尺寸和/或类型，并将该信息回复到吻合装置10的手柄壳体12。
考虑到强度、耐用性、耐磨性、重量、耐腐蚀性、易于制造性、制造成本等等，本文所述的任意部件可由金属、塑料、树脂、复合材料等进行制造。
本领域技术人员将理解的是，本文具体描述并在附图中图示出的装置和方法是非限制性的示例性实施例。可以想到的是，结合一个示例性实施例图示出或描述的元件和特征可以与另一个的元件和特征组合，而不偏离本公开的范围。同样，本领域技术人员将基于上述实施例理解本公开的其它特征和优点。因此，除非由所附权利要求指示，否则本公开不限于已经具体示出和描述的内容。
Claims (20)
1.一种接合器组件，其用于将末端执行器可操作地连接至手术器械，所述接合器组件包括：
第一近侧轴，其包括第一齿轮组件；
第二近侧轴，其限定纵向轴线并且包括第二齿轮组件；
第一远侧轴，其沿着所述纵向轴线布置并且包括第三齿轮组件，所述第一齿轮组件被机械地接合于所述第三齿轮组件，使得所述第一齿轮组件的旋转引起所述第三齿轮组件的旋转；以及
第二远侧轴，其包括第四齿轮组件，所述第二齿轮组件被机械地接合于所述第四齿轮组件，使得所述第二齿轮组件的旋转引起所述第四齿轮组件的旋转，所述第二近侧轴的远侧部至少部分地布置在所述第三齿轮组件的内腔中。
2.根据权利要求1所述的接合器组件，其中，所述第二近侧轴相对于所述第三齿轮组件能够关于所述纵向轴线旋转。
3.根据权利要求1所述的接合器组件，其中，所述第一齿轮组件、所述第二齿轮组件、所述第三齿轮组件和所述第四齿轮组件中的每个布置在壳体内。
4.根据权利要求3所述的接合器组件，进一步包括布置在所述壳体内的支撑板，所述支撑板相对于所述壳体被可旋转地固定。
5.根据权利要求4所述的接合器组件，其中，所述支撑板包括延伸穿过其中的至少一个孔。
6.根据权利要求5所述的接合器组件，其中，所述支撑板的所述至少一个孔中的第一孔关于所述纵向轴线布置并且与所述第一远侧轴的一部分轴向对准。
7.根据权利要求6所述的接合器组件，其中，所述第一孔与所述第三齿轮组件的一部分轴向对准。
8.根据权利要求4所述的接合器组件，其中，所述第二齿轮组件包括在所述支撑板的近侧布置的多个齿轮齿。
9.根据权利要求8所述的接合器组件，其中，所述第三齿轮组件包括在所述支撑板的远侧布置的多个齿轮齿。
10.根据权利要求9所述的接合器组件，其中，所述第一近侧轴的一部分延伸穿过所述支撑板的所述至少一个孔中的第二孔。
11.根据权利要求10所述的接合器组件，其中，所述第二远侧轴的一部分延伸穿过所述支撑板的所述至少一个孔中的第三孔。
12.根据权利要求6所述的接合器组件，其中，所述第一远侧轴的与所述支撑板的所述第一孔轴向对准的所述一部分包括比所述第一孔的直径略小的直径，使得所述第一远侧轴相对于所述支撑板能够旋转并且使得所述支撑板支撑所述第一远侧轴。
13.根据权利要求1所述的接合器组件，进一步包括可操作地连接至所述第一远侧轴的第一组件，用于将来自所述第一远侧轴的旋转运动转变成纵向移动来执行第一功能。
14.根据权利要求13所述的接合器组件，进一步包括可操作地连接至所述第二远侧轴的第二组件，用于将来自所述第二远侧轴的旋转运动转变成纵向移动来执行第二功能。
15.根据权利要求13所述的接合器组件，其中，所述第一功能包括使套管针构件相对于所述第一远侧轴轴向移动。
16.根据权利要求14所述的接合器组件，其中，所述第二功能包括使砧座相对于所述第二远侧轴轴向移动。
17.一种手术器械，包括：
第一近侧轴，其布置成与第一齿轮组件机械协作；
第二近侧轴，其限定纵向轴线并且被布置成与第二齿轮组件机械协作，所述第二齿轮组件相对于所述第一近侧轴能够关于所述纵向轴线旋转；
第一远侧轴，其沿着所述纵向轴线布置并且被布置成与第三齿轮组件机械协作，所述第三齿轮组件相对于所述第一近侧轴能够关于所述纵向轴线旋转，所述第一齿轮组件被机械地接合于所述第三齿轮组件，使得所述第一齿轮组件的旋转引起所述第三齿轮组件的旋转；以及
第二远侧轴，其包括第四齿轮组件，所述第二齿轮组件被布置成与所述第四齿轮组件机械协作，使得所述第二齿轮组件的旋转引起所述第四齿轮组件的旋转，所述第二近侧轴的远侧部被至少部分地布置在所述第三齿轮组件的内腔中。
18.根据权利要求17所述的手术器械，其中，所述第二近侧轴能够相对于所述第三齿轮组件旋转。
19.根据权利要求17所述的手术器械，进一步包括可操作地连接至所述第一远侧轴的第一组件，用于转变来自所述第一远侧轴的旋转运动以使套管针构件相对于所述第一远侧轴轴向移动。
20.根据权利要求19所述的手术器械，进一步包括可操作地连接至所述第二远侧轴的第二组件，用于转变来自所述第二远侧轴的旋转运动以使砧座相对于所述第二远侧轴轴向移动。
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2017
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| JP2017164487A (ja) | 2017-09-21 |
| JP2021100609A (ja) | 2021-07-08 |
| EP3205290A2 (en) | 2017-08-16 |
| JP6962691B2 (ja) | 2021-11-05 |
| US20170224345A1 (en) | 2017-08-10 |
| CA2956829A1 (en) | 2017-08-10 |
| EP3205290B1 (en) | 2021-12-08 |
| EP3205290A3 (en) | 2017-10-25 |
| AU2017200793A1 (en) | 2017-08-24 |
| AU2017200793B2 (en) | 2021-04-01 |
| CN107049400A (zh) | 2017-08-18 |
| US10398439B2 (en) | 2019-09-03 |
| ES2906134T3 (es) | 2022-04-13 |
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