CN107106167A - 用于加电医疗装置的多马达控制 - Google Patents

用于加电医疗装置的多马达控制 Download PDF

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Publication number
CN107106167A
CN107106167A CN201580060472.9A CN201580060472A CN107106167A CN 107106167 A CN107106167 A CN 107106167A CN 201580060472 A CN201580060472 A CN 201580060472A CN 107106167 A CN107106167 A CN 107106167A
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CN
China
Prior art keywords
sensor
motor
end effector
surgical instruments
drive component
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CN201580060472.9A
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CN107106167B (zh
Inventor
M·D·奥弗迈耶
J·S·斯韦兹
A·T·贝克曼
D·L·巴伯
D·C·亚特斯
A·K·纳拉加特拉
D·L·舒尔茨
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Angiotech Pharmaceuticals Inc
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Angiotech Pharmaceuticals Inc
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Publication of CN107106167A publication Critical patent/CN107106167A/zh
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    • A61B17/07207Surgical 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 the staples being applied sequentially
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Abstract

本发明公开了一种外科器械,该外科器械包括具有第一钳口和第二钳口的端部执行器。该器械还包括第一驱动组件、联接到所述第一驱动组件的第一马达、第二驱动组件、联接到所述第二驱动组件的第二马达、控制模块、和闭合触发器。该第一马达能够操作以促动所述第一驱动组件,并且所述第二马达能够操作以促动所述第二驱动组件。该控制模块能够操作地联接到所述第一马达和所述第二马达。该闭合触发器能够在闭合行程期间运动,从而使所述端部执行器转变成所述接近构型、和使所述控制模块从与所述第一马达可操作地接合转变成与所述第二马达可操作地接合同时发生。

Description

用于加电医疗装置的多马达控制
相关申请的交叉引用
本专利申请涉及下列专利申请案卷号:名称为“CIRCUITRY AND SENSORS FORPOWERED MEDICAL DEVICE”的END7420USNP/140125、名称为“ADJUNCT WITH INTEGRATEDSENSORS TO QUANTIFY TISSUE COMPRESSION”的END7421USNP/140126、名称为“MONITORINGDEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的END7422USNP/140127、名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR’S OUTPUT ORINTERPRETATION”的END7423USNP/140128、名称为“POLARITY OF HALL MAGNET TO DETECTMISLOADED CARTRIDGE”的END7424USNP/140129、名称为“SMART CARTRIDGE WAKE UPOPERATION AND DATA RETENTION”的7425USNP/140130、和名称为“LOCAL DISPLAY OFTISSUE PARAMETER STABILIZATION”的END7427USNP/140132,这些专利申请中的每一个与本文同时提交并且全文以引用方式并入本文。
背景技术
本发明的实施方案涉及外科器械,并且在各种情况下,涉及被设计成缝合和切割组织的外科缝合和切割器械及其钉仓。
发明内容
在一个实施方案中,提供了一种外科器械,所述外科器械包括端部执行器,所述端部执行器包括:第一钳口和第二钳口,其中第一钳口和第二钳口中的至少一者能够相对于第一钳口和第二钳口中的另一者在打开构型与接近构型之间运动;第一驱动组件;联接到第一驱动组件的第一马达,所述第一马达能够操作以促动第一驱动组件;第二驱动组件;联接到第二驱动组件的第二马达,所述第二马达能够操作以促动第二驱动组件;能够操作地联接到第一马达和第二马达的控制模块;以及闭合触发器,其中闭合触发器能够在闭合行程期间运动以使端部执行器转变成接近构型,并且其中闭合触发器能够在闭合行程期间运动以使控制模块从与第一马达可操作地接合转变成与第二马达可操作地接合。
在一个实施方案中,控制模块包括马达驱动器。在一个实施方案中,马达驱动器在端部执行器处于打开构型时电联接到第一马达,并且其中马达驱动器在端部执行器处于接近构型时电联接到第二马达。在一个实施方案中,控制模块包括开关,其中开关能够在第一位置与第二位置之间运动,其中开关在处于第一位置时使马达驱动器电联接到第一马达,并且其中开关在处于第二位置时使马达驱动器电联接到第二马达。在一个实施方案中,控制模块包括功率源。
在一个实施方案中,闭合触发器能够操作地联接到开关,使得闭合触发器的运动使开关在第一位置与第二位置之间转变。在一个实施方案中,闭合触发器能够在闭合行程期间运动,从而使端部执行器转变成接近构型、和使控制模块从与第一马达可操作地接合转变成与第二马达可操作地接合同时发生。
在一个实施方案中,第一驱动组件包括能够操作以使端部执行器进行关节运动的关节运动驱动组件。在一个实施方案中,第二驱动组件包括击发驱动组件。
在一个实施方案中,提供了一种外科器械。所述外科器械包括第一驱动组件;联接到第一驱动组件的第一马达,所述第一马达能够操作以促动第一驱动组件;第二驱动组件;联接到第二驱动组件的第二马达,所述第二马达能够操作以促动第二驱动组件;以及能够在与所述第一马达交接和与所述第二马达交接之间选择性地切换的控制模块。
在一个实施方案中,第一驱动组件包括能够操作以使端部执行器进行关节运动的关节运动驱动组件。在一个实施方案中,第二驱动组件包括击发驱动组件。
在一个实施方案中,控制模块包括功率源。在一个实施方案中,控制模块包括马达驱动器。在一个实施方案中,控制模块包括开关。在一个实施方案中,开关能够在第一位置与第二位置之间运动,其中开关在处于第一位置时使马达驱动器电联接到第一马达,并且其中开关在处于第二位置时使马达驱动器电联接到第二马达。
在一个实施方案中,提供了一种外科器械。所述外科器械包括端部执行器;第一驱动组件;联接到第一驱动组件的第一马达,所述第一马达能够操作以促动第一驱动组件;第二驱动组件;联接到第二驱动组件的第二马达,所述第二马达能够操作以促动第二驱动组件;能够操作地联接到第一马达和第二马达的控制模块;以及触发器,所述触发器能够运动,从而使端部执行器起作用、和使控制模块从与第一马达可操作地接合转变成与第二马达可操作地接合同时发生。在一个实施方案中,第一驱动组件包括能够操作以使端部执行器进行关节运动的关节运动驱动组件。在一个实施方案中,端部执行器包括钉仓,其中钉仓包括能够部署到被端部执行器捕获的组织中的多个钉,其中第二驱动组件包括能够操作以部署所述多个钉的击发驱动组件。在一个实施方案中,控制模块包括功率源。
附图说明
通过结合附图来参考本发明的实施方案的以下说明,本发明的各种实施方案的特征和优点以及其获取方法将会变得更加明显,并可更好地理解本发明的实施方案本身,其中:
图1为具有能够操作地联接到其的可互换轴组件的外科器械的透视图;
图2为图1的可互换轴组件和外科器械的分解组件视图;
图3为示出图1和图2的可互换轴组件和外科器械的多个部分的另一个分解组件视图;
图4为图1至图3的外科器械的一部分的分解组件视图;
图5为图4的外科器械的一部分的横截面侧视图,其中击发触发器处于完全致动位置;
图6为图5的外科器械的一部分的另一个横截面视图,其中击发触发器处于未致动位置;
图7为可互换轴组件的一种形式的分解组件视图;
图8为图7的可互换轴组件的多个部分的另一个分解组件视图;
图9为图7和图8的可互换轴组件的多个部分的另一个分解组件视图;
图10为图7至图9的可互换轴组件的一部分的横截面视图;
图11为图7至图10的轴组件的一部分的透视图,其中为清楚起见,已省去切换筒;
图12为其上安装有切换筒的图11所示可互换轴组件部分的另一个透视图;
图13为可操作地联接到图1的外科器械的一部分的图11所示可互换轴组件的一部分的透视图,图中示出外科器械的闭合触发器处于未致动位置;
图14为图13的可互换轴组件和外科器械的右侧正视图;
图15为图13和图14的可互换轴组件和外科器械的左侧正视图;
图16为可操作地联接到图1的外科器械的一部分的图11所示可互换轴组件的一部分的透视图,图中示出外科器械的闭合触发器处于致动位置,并且其击发触发器处于未致动位置;
图17为图16的可互换轴组件和外科器械的右侧正视图;
图18为图16和图17的可互换轴组件和外科器械的左侧正视图;
图18A为可操作地联接到图1的外科器械的一部分的图11所示可互换轴组件的右侧正视图,图中示出外科器械的闭合触发器处于致动位置,并且其击发触发器也处于致动位置;
图19为用于当轴组件未联接到外科器械柄部的电连接器时使电连接器掉电的系统的示意图;
图20为图1的外科器械的端部执行器的一个实施方案的分解图;
图21A-21B为横跨两张图纸的图1的外科器械的电路图;
图22示出了功率组件的一个实例,该功率组件包括被构造成能够生成电池组的使用循环计数的使用循环电路;
图23示出了用于顺序地为分段电路通电的过程的一个实施方案;
图24示出了功率段的一个实施方案,该功率段包括多个菊花链式功率转换器;
图25示出了分段电路的一个实施方案,该分段电路被构造成能够使可用于关键功能和/或功率密集功能的功率最大化;
图26示出了功率系统的一个实施方案,该功率系统包括被构造成能够被顺序通电的多个菊花链式功率转换器;
图27示出了包括单点控制节段的分段电路的一个实施方案;
图28示出了包括第一传感器和第二传感器的端部执行器的一个实施方案;
图29为逻辑图,其示出了用于基于得自图28中所示的端部执行器的第二传感器的输入来调整第一传感器的测量结果的方法的一个实施方案;
图30为逻辑图,其示出了用于基于得自第二传感器的输入来确定第一传感器的查找表的方法的一个实施方案;
图31为逻辑图,其示出了用于响应于得自第二传感器的输入来校正第一传感器的方法的一个实施方案;
图32A为逻辑图,其示出了用于确定并且显示被夹持在端部执行器的砧座和钉仓之间的组织节段的厚度的方法的一个实施方案;
图32B为逻辑图,其示出了用于确定并且显示被夹持在端部执行器的砧座和钉仓之间的组织节段的厚度的方法的一个实施方案;
图33为示出与未修改的霍尔效应厚度测量结果进行比较的调整的霍尔效应厚度测量结果的曲线图;
图34示出了包括第一传感器和第二传感器的端部执行器的一个实施方案;
图35示出了包括第一传感器和多个第二传感器的端部执行器的一个实施方案;
图36为逻辑图,其示出了用于响应于多个第二传感器来调整第一传感器的测量结果的方法的一个实施方案;
图37示出了电路的一个实施方案,该电路被构造成能够将得自第一传感器和多个第二传感器的信号转换成能够由处理器接收的数字信号;
图38示出了包括多个传感器的端部执行器的一个实施方案;
图39为逻辑图,其示出了用于基于多个传感器来确定一个或多个组织特性的方法的一个实施方案;
图40示出了包括联接到第二钳口构件的多个传感器的端部执行器的一个实施方案;
图41示出了钉仓的一个实施方案,该钉仓包括一体地形成于其中的多个传感器;
图42为逻辑图,其示出了用于确定夹持在端部执行器内的组织节段的一个或多个参数的方法的一个实施方案;
图43示出了包括多个冗余传感器的端部执行器的一个实施方案;
图44为逻辑图,其示出了用于选择得自多个冗余传感器的最可靠输出的方法的一个实施方案;
图45示出了包括传感器的端部执行器的一个实施方案,该传感器具有特定采样率以限制或消除假信号;
图46为逻辑图,其示出了用于产生定位在端部执行器的砧座和钉仓之间的组织节段的厚度测量结果的方法的一个实施方案;
图47示出了圆形缝合器的一个实施方案;
图48A-48D示出了图47中所示的圆形缝合器的夹持过程,其中图48A示出了处于初始位置的其中砧座和主体呈闭合构型的圆形缝合器,图48B示出一旦圆形缝合器3400被定位,砧座就朝远侧运动以与主体脱离并且产生被构造成能够在其中接收组织节段的间隙,图48C示出了在砧座和主体之间被压缩到预先确定的压缩量的组织节段;并且图48D示出了处于对应于钉部署的位置的圆形缝合器;
图49示出了圆形缝合器砧座和被构造成能够与其接合的电连接器的一个实施方案;
图50示出了包括传感器的外科器械的一个实施方案,该传感器联接到外科器械的驱动轴;
图51为流程图,其示出了用于确定端部执行器中的不均匀组织加载的方法的一个实施方案;
图52示出了端部执行器的一个实施方案,该端部执行器被构造成能够确定夹持操作期间的组织节段的一个或多个参数;
图53A和53B示出了端部执行器的一个实施方案,该端部执行器被构造成能够标准化霍尔效应电压,而不论钉仓的平台高度如何;
图54为逻辑图,其示出了用于确定端部执行器(例如,图53A-53B中所示的端部执行器)内的组织压缩何时已达到稳态的方法的一个实施方案;
图55为示出各种霍尔效应传感器读数的曲线图;
图56为逻辑图,其示出了用于确定端部执行器(例如,图53A-53B中所示的端部执行器)内的组织压缩何时已达到稳态的方法的一个实施方案;
图57为逻辑图,其示出了用于控制端部执行器以改善部署期间的适当钉成形的方法的一个实施方案;
图58为逻辑图,其示出了用于控制端部执行器以允许流体排空并且提供改善的钉成形的方法的一个实施方案;
图59A-59B示出了包括压力传感器的端部执行器的一个实施方案;
图60示出了端部执行器的一个实施方案,该端部执行器包括定位在钉仓和第二钳口构件之间的第二传感器;
图61为逻辑图,其示出了用于确定和显示夹持在根据图图59A-59B或图60的端部执行器中的组织节段的厚度的方法的一个实施方案;
图62示出了端部执行器的一个实施方案,该端部执行器包括定位在钉仓和细长通道之间的多个第二传感器;
图63A和63B进一步示出了组织的完全咬合相对于部分咬合的效果。
图64示出了端部执行器的一个实施方案,该端部执行器包括用于测量砧座和钉仓之间的间隙的线圈和振荡器电路;
图65示出了端部执行器的另选视图。如图所示,在一些实施方案中,外部接线可将功率供应给振荡器电路;
图66示出了用于检测目标中的涡流的线圈的操作的示例。
图67示出了随线圈与目标的间距而变化的线圈半径的测得品质因子、测得电感、和测得电阻的曲线图;
图68示出了端部执行器的一个实施方案,该端部执行器包括布置在钉仓与细长通道之间的发射器和传感器;
图69示出了操作中的发射器和传感器的实施方案;
图70示出了包括MEMS换能器的发射器和传感器的实施方案的表面;
图71示出了可由图69的发射器和传感器测得的反射信号的示例的曲线图;
图72示出了端部执行器的实施方案,该端部执行器被构造成能够确定切割构件或刀的位置;
图73示出了与红色LED和红外LED一起操作的编码条的示例;
图74示出了根据本文所述的各种实施方案的包括钉仓的外科器械的端部执行器的局部透视图;
图75示出了根据本文所述的各种实施方案的图74的端部执行器的一部分的正视图;
图76示出了根据本文所述的各种实施方案的图74的外科器械的模块的逻辑图;
图77示出了根据本文所述的各种实施方案的图74的外科器械的切割刃、光学传感器、和光源的局部视图;
图78示出了根据本文所述的各种实施方案的图74的外科器械的切割刃、光学传感器、和光源的局部视图;
图79示出了根据本文所述的各种实施方案的图74的外科器械的切割刃、光学传感器、和光源的局部视图;
图80示出了根据本文所述的各种实施方案的图74的外科器械的切割刃、光学传感器、和光源的局部视图;
图81示出了根据本文所述的各种实施方案的图74的外科器械的切割刃、光学传感器、和光源的局部视图;
图82示出了根据本文所述的各种实施方案的图74的外科器械的清洁刀片之间的切割刃的局部视图;
图83示出了根据本文所述的各种实施方案的图74的外科器械的清洁海绵之间的切割刃的局部视图;
图84示出了根据本文所述的各种实施方案的包括锐度测试构件的钉仓的透视图;
图85示出了根据本文所述的各种实施方案的外科器械的模块的逻辑图;
图86示出了根据本文所述的各种实施方案的外科器械的模块的逻辑图;
图87示出了逻辑图,其列出了根据本文所述的各种实施方案的用于评估外科器械的切割刃的锐度的方法;
图88示出了根据本文所述的各种实施方案的在各种锐度水平下由图84的锐度测试构件抵靠外科器械的切割刃施加的力的图;
图89示出了流程图,其列出了根据本文所述的各种实施方案的用于确定外科器械的切割刃是否足够锐利以横切由外科器械捕获的组织的方法;
图90示出了表格,其示出了根据本文所述的各种实施方案的预定义组织厚度和对应的预定义阈值力。
图91示出了包括柄部、轴组件、和端部执行器的外科器械的透视图;
图92示出了与图91的外科器械的多个马达一起使用的公共控制模块的逻辑图;
图93示出了图91的外科器械的柄部的局部正视图,其中外部壳体被移除;
图94示出了图91的外科器械的局部正视图,其中外部壳体被移除;
图95A示出了其中砧座处于闭合位置的端部执行器的侧面角视图,该图示出了位于仓平台的任一侧面上的一个LED;
图95B示出了其中砧座处于打开位置的端部执行器的四分之三角视图,以及位于仓平台的任一侧面上的一个LED;
图96A示出了其中砧座处于闭合位置的端部执行器的侧面角视图,以及位于仓平台的任一侧面上的多个LED;
图96B示出了其中砧座处于打开位置的端部执行器的四分之三角视图,以及位于仓平台的任一侧面上的多个LED;
图97A示出了其中砧座处于闭合位置的端部执行器的侧面角视图,以及位于仓平台的任一侧面上的从钉仓的近侧端部到远侧端部的多个LED;并且
图97B示出了其中砧座处于打开位置的端部执行器的四分之三角视图,该图示出了从钉仓的近侧端部到远侧端部的并且位于仓平台的任一侧面上的多个LED。
图98A示出了其中组织补偿件能够移除地附接到端部执行器的砧座部分的实施方案;
图98B示出了图98A中所示的组织补偿件的一部分的细部图;
图99示出了使用导电元件层和钉仓中的导电元件来检测砧座与钉仓的上表面之间的距离的各种示例实施方案;
图100A和100B示出了操作中的包括导电元件层的组织补偿件的实施方案;
图101A和101B示出了包括组织补偿件的端部执行器的实施方案,该组织补偿件还包括嵌入其中的导体;
图102A和102B示出了包括组织补偿件的端部执行器的实施方案,该组织补偿件还包括嵌入其中的导体;
图103示出了钉仓和组织补偿件的实施方案,其中钉仓将功率提供给构成组织补偿件的导电元件;
图104A和104B示出了钉仓和组织补偿件的实施方案,其中钉仓将功率提供给构成组织补偿件的导电元件;
图105A和105B示出了包括位置感测元件和组织补偿件的端部执行器的实施方案;
图106A和106B示出了包括位置感测元件和组织补偿件的端部执行器的实施方案;
图107A和107B示出了钉仓和组织补偿件的实施方案,该组织补偿件能够操作以指示切割构件或刀杆的位置;
图108示出了包括磁体和霍尔效应传感器的端部执行器的一个实施方案,其中检测的磁场可用于标识钉仓;
图109示出了包括磁体和霍尔效应传感器的端部执行器的一个实施方案,其中检测的磁场可用于标识钉仓;
图110示出了响应于例如如图108和图109所示的定位在砧座中的磁体与钉仓中的霍尔效应传感器之间的距离或间隙而由例如如图108和图109所示的定位在钉仓的远侧末端中的霍尔效应传感器检测到的电压的曲线图;
图111示出了包括显示器的外科器械的外壳的一个实施方案;
图112示出了包括磁体的钉保持器的一个实施方案;
图113A和113B示出了端部执行器的一个实施方案,该端部执行器包括用于识别不同类型的钉仓的传感器;
图114为根据一个实施方案的具有传感器功率导体的端部执行器的局部视图,该传感器功率导体用于在外科器械的连接部件之间传输功率和数据信号。
图115为图114中所示的端部执行器的局部视图,其示出了定位在端部执行器中的传感器和/或电子部件。
图116为根据一个实施方案的外科器械电子子系统的框图,该外科器械电子子系统包括用于传感器和/或电子部件的短路保护电路。
图117为根据一个实施方案的短路保护电路,该短路保护电路包括联接到主电源电路的补充电源电路7014。
图118为根据一个实施方案的外科器械电子子系统的框图,该外科器械电子子系统包括采样率监控器以在外科器械处于非感测状态时通过限制传感器部件的采样率和/或占空比来实现功率降低。
图119为根据一个实施方案的外科器械电子子系统的框图,该外科器械电子子系统包括用于外科器械的传感器和/或电子部件的过流/过压保护电路。
图120为根据一个实施方案的用于外科器械的传感器和电子部件的过流/过压保护电路。
图121为根据一个实施方案的外科器械电子子系统的框图,该外科器械电子子系统具有用于传感器和/或电子部件的反向极性保护电路。
图122为根据一个实施方案的用于外科器械的传感器和/或电子部件的反向极性保护电路。
图123为根据一个实施方案的外科器械电子子系统的框图,该外科器械电子子系统利用用于传感器和/或电子部件的睡眠模式监控器实现功率降低。
图124为外科器械电子子系统的框图,该外科器械电子子系统包括临时性功率丢失电路以提供保护以防模块化外科器械中的传感器和/或电子部件的间歇性功率丢失。
图125示出了实施为硬件电路的临时性功率丢失电路的一个实施方案。
图126A示出了端部执行器的一个实施方案的透视图,该端部执行器包括磁体和与处理器连通的霍尔效应传感器;
图126B示出了端部执行器的一个实施方案的侧面剖视图,该端部执行器包括磁体和与处理器连通的霍尔效应传感器;
图127示出了与霍尔效应传感器的操作相关的可操作尺寸的一个实施方案;
图128A示出了钉仓的实施方案的外部侧视图;
图128B示出了推出耳状物的下表面与霍尔效应传感器的顶部之间的各种可能尺寸;
图128C示出了钉仓的实施方案的外部侧视图;
图128D示出了推出耳状物的下表面与霍尔效应传感器上方的钉仓的上表面之间的各种可能尺寸;
图129A进一步示出了砧座10002和砧座的中心轴线点的前端剖视图;
图129B为图129A中所示的磁体的剖视图;
图130A-130E示出了包括磁体的端部执行器的一个实施方案,其中图130A示出了端部执行器的前端剖视图,图130B示出了处于原位的砧座和磁体的前端剖面图,图130C示出了砧座和磁体的透视剖面图,图130D示出了砧座和磁体的侧面剖面图,并且图130E示出了砧座和磁体的顶部剖面图;
图131A-131E示出了包括磁体的端部执行器的另一个实施方案,其中图131A示出了端部执行器的前端剖视图,图131B示出了处于原位的砧座和磁体的前端剖面图,图131C示出了砧座和磁体的透视剖面图,图131D示出了砧座和磁体的侧面剖面图,并且图131E示出了砧座和磁体的顶部剖面图;
图132示出了砧座与钉仓和/或细长通道之间的接触点;
图133A和133B示出了端部执行器的一个实施方案,该端部执行器能够操作以利用远侧接触点处的导电表面产生电连接;
图134A-134C示出了端部执行器的一个实施方案,该端部执行器能够操作以利用导电表面形成电连接,其中图134A示出了包括砧座、细长通道、和钉仓的端部执行器,图134B示出了还包括定位在钉成形凹痕远侧的第一导电表面的砧座的内表面,并且图134C示出了包括仓体和第一导电表面的钉仓,该仓体和第一导电表面被定位成使得它们与定位在钉仓上的第二导电表面接触;
图135A和135B示出了端部执行器的一个实施方案,该端部执行器能够操作以利用导电表面形成电连接,其中图135A示出了包括砧座、细长通道、和钉仓的端部执行器,并且图135B为示出第一导电表面的钉仓的近距离视图,该第一导电表面被定位成使其与第二导电表面接触;
图136A和136B示出了端部执行器的一个实施方案,该端部执行器能够操作以利用导电表面形成电连接,其中图136A示出了包括砧座、细长通道、和钉仓的端部执行器,并且图136B为示出还包括磁体和内表面的砧座的近距离视图,该内表面还包括多个钉成形凹痕;
图137A-137C示出了端部执行器的一个实施方案,该端部执行器能够操作以利用近侧接触点形成电连接,其中图137A示出了包括砧座、细长通道、和钉仓的端部执行器,图137B为用于此目的的置于限定在细长通道中的孔内的销的近距离视图,并且图137C示出了另选实施方案,其中孔的表面上的第二导电表面具有另选位置;
图138示出了具有远侧传感器插头的端部执行器的一个实施方案;
图139A示出了其中砧座处于打开位置的图138中所示的端部执行器;
图139B示出了其中砧座处于打开位置的图139A中所示的端部执行器的剖视图;
图139C示出了其中砧座处于闭合位置的图138中所示的端部执行器;
图139D示出了其中砧座处于闭合位置的图139C中所示的端部执行器的剖视图;
图140提供了端部执行器的远侧端部的截面的近距离视图;
图141示出了包括远侧传感器插头的钉仓的近距离顶视图;
图142A为包括远侧传感器插头的钉仓的下侧的透视图;
图142B示出了钉仓的远侧端部的剖视图;
图143A-143C示出了钉仓的一个实施方案,该钉仓包括连接到霍尔效应传感器和处理器的挠性缆线,其中图143A为钉仓的分解图,图143B更详细地示出了钉仓和挠性缆线的组装,并且图143C示出了根据本实施方案的钉仓的剖视图,以图示说明钉仓的远侧端部内的霍尔效应传感器、处理器、和传导联接件的布置方式;
图144A-144F示出了钉仓的一个实施方案,该钉仓包括连接到霍尔效应传感器和处理器的挠性缆线,其中图144A为钉仓的分解图,图144B示出了钉仓的组装,图144C示出了组装的钉仓的下侧并且还更详细地示出了挠性缆线,图144D示出了钉仓的剖视图,以示出霍尔效应传感器、处理器、和传导联接件的布置方式,图144E示出了不含仓托盘并且包括位于其最远侧位置中的楔形滑动件的钉仓的下侧,并且图144F示出了钉仓,该钉仓不含仓托盘以便图示说明缆线迹线的可能布置方式;
图145A和145B示出了包括挠性缆线、霍尔效应传感器、和处理器的钉仓的一个实施方案,其中图145A为钉仓的分解图并且图145B更详细地示出了钉仓和挠性缆线的组装;
图146A示出了联接到轴组件的端部执行器的透视图;
图146B示出了图146A中所示的端部执行器和轴组件的下侧的透视图;
图146C示出了含有挠性缆线并且不含轴组件的图146A和146B中所示的端部执行器;
图146D和146E示出了不含砧座或钉仓的图146A和146B中所示的端部执行器的细长通道部分,以便图示说明图146C中所示的挠性缆线可如何安置于细长通道内;
图146F单独示出了图146C-120E、图146C-146E中所示的挠性缆线;
图147示出了图146D和146E中所示的细长通道的近距离视图,该细长通道具有联接到其的钉仓;
图148A-148D进一步示出了与端部执行器的本实施方案一起操作的钉仓的一个实施方案,其中图148A示出了钉仓的近侧端部的近距离视图,图148B示出了具有用于远侧传感器插头的空间的钉仓的远侧端部的近距离视图,图148C进一步示出了远侧传感器插头,并且图148D示出了远侧传感器插头的近侧面向侧;
图149A和149B示出了远侧传感器插头的一个实施方案,其中图149A示出了远侧传感器插头的剖面图并且图149B进一步示出了霍尔效应传感器和处理器,该霍尔效应传感器和处理器能够操作地联接到挠性板使得它们能够通信;
图150示出了具有挠性缆线的端部执行器的实施方案,该挠性缆线能够操作以将功率提供给砧座部分的远侧末端中的传感器和电子器件;
图151A-151C示出了端部执行器的关节运动接头和挠性缆线的操作,其中图151A示出了端部执行器的顶视图,其中端部执行器相对于轴组件枢转-45度,图151B示出了端部执行器的顶视图,并且图151C示出了端部执行器的顶视图,其中端部执行器相对于轴组件枢转+45度;
图152示出了具有传感器和电子器件的砧座的实施方案的远侧末端的剖视图;并且
图153示出了砧座的远侧末端的剖面图。
具体实施方式
现在将描述某些示例实施方案,从而提供对本文所公开的装置和方法的结构、功能、制造和使用的原理的全面理解。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应当理解,本文具体描述并且示于附图中的装置和方法均为非限制性的示例实施方案。结合一个示例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实施方案的范围之内。
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,意指结合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”等并不一定均指相同的实施方案。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,在没有限制的情况下,结合一个实施方案示出或描述的具体特征结构、结构或特性可全部或部分地与一个或多个其它实施方案的特征结构、结构或特性组合。这些修改和变型旨在涵盖于本发明的实施方案的范围之内。
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,本文可结合附图使用例如“竖直”、“水平”、“上”和“下”之类的空间术语。然而,外科器械在许多取向和位置中使用,并且这些术语并非旨在为限制性的和/或绝对的。
提供各种示例装置和方法以用于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至图6示出了可再利用或不可再利用的马达驱动外科切割和紧固器械10。在示出的实施方案中,器械10包括外壳12,该外壳包括被构造成能够被临床医生抓握、操纵和致动的柄部14。外壳12被构造用于可操作地附接到可互换轴组件200,该可互换轴组件上可操作地联接有外科端部执行器300,该外科端部执行器被构造成能够执行一种或多种手术任务或外科手术。继续参阅本具体实施方式,应当理解,本文公开的各种形式的可互换轴组件的各种独特且新颖的构造也可以有效地与机器人控制的外科系统结合使用。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生成并施加可用于致动本文所公开的可互换轴组件及其相应的等同物的至少一种控制动作。术语“框架”可以是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,本文所公开的可互换轴组件可与名称为“SURGICALSTAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利申请公布US 2012/0298719)中公开的各种机器人系统、器械、部件和方法一起使用。名称为“SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利申请公布US 2012/0298719)全文以引用方式并入本文。
图1至图3中所示的外壳12结合包括端部执行器300的可互换轴组件200示出,所述端部执行器包括被构造成能够可操作地支撑其中的外科钉仓304的外科切割和紧固装置。外壳12可被构造用于结合可互换轴组件使用,这些可互换轴组件包括适于支撑不同尺寸和类型的钉仓的端部执行器,并具有不同的轴长度、尺寸和类型等。此外,外壳12也可有效地与多种其他可互换轴组件一起使用,所述其他可互换轴组件包括被构造成能够将其他运动和能量形式(诸如,射频(RF)能量、超声能量和/或运动)施加到适于结合各种外科应用和外科手术使用的端部执行器构造的那些组件。此外,端部执行器、轴组件、柄部、外科器械和/或外科器械系统可以利用任何合适的一个或多个紧固件以将组织紧固。例如,包括多个可移除地存储在其中的紧固件的紧固件仓能够可移除地插入和/或附接到轴组件的端部执行器。
图1示出了具有可操作地联接到其的可互换轴组件200的外科器械10。图2和图3示出可互换轴组件200附接到外壳12或柄部14。如图4所示,柄部14可以包括一对可互连柄部外壳段16和18,该对柄部外壳段可通过螺钉、按扣特征结构、粘合剂等互连。在所示构造中,柄部外壳段16,18配合以形成可被临床医生抓握和操纵的手枪式握把部19。如将在下文进一步详细地讨论,柄部14在其中可操作地支撑多个驱动系统,该多个驱动系统被构造成能够生成各种控制动作并将该控制动作施加到可操作地附接到其的可互换轴组件的对应部分。
现在参见图4,柄部14还可包括可操作地支撑多个驱动系统的框架20。例如,框架20能够可操作地支撑通常标示为30的“第一”或闭合驱动系统,该“第一”或闭合驱动系统可用于将闭合和打开动作施加到可操作地附接或联接到其的可互换轴组件200。在至少一种形式中,闭合驱动系统30可包括被框架20枢转地支撑的闭合触发器32形式的致动器。更具体地,如图4所示,闭合触发器32经由销33枢转地联接到外壳14。这种构造使闭合触发器32能够被临床医生操纵,使得当临床医生抓握柄部14的手枪式握把部19时,闭合触发器32可被其轻易地从起始或“未致动”位置枢转到“致动”位置,并且更具体地,枢转到完全压缩或完全致动位置。闭合触发器32可被弹簧或其他偏置结构(未示出)偏置到未致动位置。在各种形式中,闭合驱动系统30还包括可枢转地联接到闭合触发器32的闭合连杆组件34。如图4所示,闭合连杆组件34可包括由销35枢转地联接到闭合触发器32的第一闭合连杆36和第二闭合连杆38。第二闭合连杆38在本文中也可称为“附接构件”并且包括横向附接销37。
仍参见图4,可观察到,第一闭合连杆36可在其上具有锁定壁或锁定端39,该锁定壁或锁定端被构造成能够与枢转地联接到框架20的闭合释放组件60配合。在至少一种形式中,闭合释放组件60可包括具有在其上形成的朝远侧突起的锁定棘爪64的释放按钮组件62。释放按钮组件62可被释放弹簧(未示出)沿逆时针方向枢转。临床医生将闭合触发器32从其未致动位置朝向柄部14的手枪式握把部19按压时,第一闭合连杆36向上枢转至某个点,其中锁定爪64落入该点中以与第一闭合连杆36上的锁定壁39保持接合,从而阻止闭合触发器32返回未致动位置。参见图18。因此,闭合释放组件60用来将闭合触发器32锁定在完全致动位置。当临床医生期望将闭合触发器32解锁以允许其被偏置到未致动位置时,临床医生只需枢转闭合释放按钮组件62,使得锁定爪64运动成与第一闭合连杆36上的锁定壁39脱离接合。当锁定棘爪64已运动成与第一闭合连杆36脱离接合时,闭合触发器32可枢转回到未致动位置。也可采用其他闭合触发器锁定构造和释放构造。
除上述之外,图13至图15示出了处于未致动位置的闭合触发器32,该未致动位置与轴组件200的打开或未夹紧构型相关联,在该构型中,组织可定位在轴组件200的钳口之间。图16至图18示出了处于致动位置的闭合触发器32,该致动位置与轴组件200的闭合或夹持构型相关联,在该构型中,组织被夹持在轴组件200的钳口之间。读者在将图14与图17比较之后将会知道,当闭合触发器32从其未致动位置(图14)向其致动位置(图17)运动时,闭合释放按钮62在第一位置(图14)与第二位置(图17)之间枢转。闭合释放按钮62的旋转可称为向上旋转,然而,闭合释放按钮62的至少一部分朝向电路板100旋转。参见图4,闭合释放按钮62可包括从其延伸的臂61和安装到臂61的磁性元件63(诸如永磁体)。当闭合释放按钮62从其第一位置旋转到其第二位置时,磁性元件63可朝向电路板100运动。电路板100可包括被构造成能够检测磁性元件63的运动的至少一个传感器。在至少一个实施方案中,例如,霍尔效应传感器65可安装到电路板100的底部表面。霍尔效应传感器65可被构造成能够检测由磁性元件63的运动引起、环绕霍尔效应传感器65的磁场变化。霍尔效应传感器65可例如与微控制器1500(图19)进行信号通信,该微控制器可确定闭合释放按钮62是处于其第一位置、其第二位置,还是/或者第一位置与第二位置之间的任何位置,所述第一位置与闭合触发器32的未致动位置和端部执行器的打开构型相关联,所述第二位置与闭合触发器32的致动位置和端部执行器的闭合构型相关联。
在至少一种形式中,柄部14和框架20可以可操作地支撑在本文中被称为击发驱动系统80的另一个驱动系统,该驱动系统被构造成能够将击发动作施加到附接到其上的可互换轴组件的对应部分。击发驱动系统80在本文中也可称作“第二驱动系统”。击发驱动系统80可以采用位于柄部14的手枪式握把部19中的电动马达82。在各种形式中,马达82可以是直流有刷驱动马达,其具有大约例如25,000RPM的最大转速。在其他构造中,马达可包括无刷马达、无绳马达、同步马达、步进马达或任何其他合适的电动马达。马达82可由功率源90供电,在一种形式中,该功率源可包括可移除电源组92。如图4所示,例如,电源组92可包括近侧外壳部分94,该近侧外壳部分被构造用于附接到远侧外壳部分96。近侧外壳部分94和远侧外壳部分96被构造成能够在其中可操作地支撑多个电池98。电池98可各自包括例如锂离子(“LI”)电池或其他合适的电池。远侧外壳部分96被构造成用于以可移除方式可操作地附接到同样可操作地联接到马达82的控制电路板组件100。可使用可串联连接的多个电池98作为外科器械10的功率源。此外,功率源90可以是可更换的和/或可再充电的。
如上面相对于其他各种形式所概述,电动马达82可包括与齿轮减速器组件84可操作地交接的可旋转轴(未示出),该齿轮减速器组件被安装成与纵向可动驱动构件120上的一组或一齿条的驱动齿122啮合接合。在使用中,功率源90所提供的电压极性可沿顺时针方向操作电动马达82,其中由电池施加给电动马达的电压极性可被反转,以便沿逆时针方向操作电动马达82。当电动马达82沿一个方向旋转时,驱动构件120将沿远侧方向“DD”被轴向地驱动。当马达82被沿相反的旋转方向驱动时,驱动构件120将沿近侧方向“PD”被轴向地驱动。柄部14可包括开关,该开关被构造成能够使由电源90施加到电动马达82的极性反转。与本文所述的其他形式一样,柄部14还可包括传感器,该传感器被构造成能够检测驱动构件120的位置和/或驱动构件120运动的方向。
马达82的致动可通过被可枢转地支撑在柄部14上的击发触发器130来控制。击发触发器130可在未致动位置和致动位置之间枢转。击发触发器130可被弹簧132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130时,击发触发器可被弹簧132或偏置构造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130可以定位在闭合触发器32“外侧”,如上文所讨论。在至少一种形式中,击发触发器安全按钮134可由销35枢转地安装到闭合触发器32。安全按钮134可定位在击发触发器130和闭合触发器32之间,并且具有从其突起的枢转臂136。参见图4。当闭合触发器32处于未致动位置时,安全按钮134被容纳在柄部14中,此时临床医生可能无法轻易地触及所述按钮并使其在防止对击发触发器130致动的安全位置与其中击发触发器130可被击发的击发位置之间运动。临床医生按压闭合触发器32时,安全按钮134和击发触发器130向下枢转,随后可被临床医生操纵。
如上文所讨论,柄部14可包括闭合触发器32和击发触发器130。参见图14至图18A,击发触发器130能够可枢转地安装到闭合触发器32。闭合触发器32可包括从其延伸的臂31,击发触发器130可围绕枢轴销33可枢转地安装到臂31。如上文所概述,当闭合触发器32从其未致动位置(图14)向其致动位置(图17)运动时,击发触发器130可向下下降。在安全按钮134已运动到其击发位置之后,主要参见图18A,可按压击发触发器130,以操作外科器械击发系统的马达。在各种情况下,柄部14可包括跟踪系统(诸如系统800),该跟踪系统被构造成能够确定闭合触发器32的位置和/或击发触发器130的位置。主要参照图14、图17和图18A,跟踪系统800可包括磁性元件(诸如永磁体802),该磁性元件安装到从击发触发器130延伸的臂801。跟踪系统800可包括一个或多个传感器,诸如第一霍尔效应传感器803和第二霍尔效应传感器804,这些传感器可被构造成能够跟踪磁体802的位置。读者在将图14与图17比较之后将会知道,当闭合触发器32从其未致动位置向其致动位置运动时,磁体802可在邻近第一霍尔效应传感器803的第一位置与邻近第二霍尔效应传感器804的第二位置之间运动。读者在将图17与图18A比较之后将进一步知道,当击发触发器130从未击发位置(图17)向击发位置(图18A)运动时,磁体802可相对于第二霍尔效应传感器804运动。传感器803和804可跟踪磁体802的运动,并且可与电路板100上的微控制器进行信号通信。微控制器可利用来自第一传感器803和/或第二传感器804的数据,确定磁体802沿预定义的路径的位置,并且微控制器可基于该位置,确定闭合触发器32是处于其未致动位置、其致动位置、还是其未致动位置和其致动位置之间的位置。相似地,微控制器可利用来自第一传感器803和/或第二传感器804的数据,确定磁体802沿预定义的路径的位置,并且微控制器可基于该位置,确定击发触发器130是处于其未击发位置、其完全击发位置、还是其未击发位置和其完全击发位置之间的位置。
如上所述,在至少一种形式中,可纵向运动的驱动构件120具有在其上形成的一齿条的齿122,以用于与齿轮减速器组件84的相应驱动齿轮86啮合接合。至少一种形式还包括可手动致动的“应急”组件140,该组件被构造成能够允许临床医生在马达82万一变成被停用时手动地缩回可纵向运动的驱动构件120。应急组件140可包括杠杆或应急柄部组件142,该杠杆或应急柄部组件被构造成能够被手动地枢转为与同样设置在驱动构件120中的齿124棘轮接合。因此,临床医生可使用应急柄部组件142手动地缩回驱动构件120,以使驱动构件120沿近侧方向“PD”做棘轮运动。美国专利申请公布US 2010/0089970公开了应急构造,以及还可与本文公开的各种器械一起使用的其他部件、构造和系统。名称为“POWEREDSURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRINGSYSTEM”的美国专利申请序列号12/249,117(现为美国专利申请公布2010/0089970)据此全文以引用方式并入本文。
现在转到图1和图7,可互换轴组件200包括外科端部执行器300,该外科端部执行器包括被构造成能够可操作地支撑其中的钉仓304的细长通道302。端部执行器300还可包括砧座306,该砧座相对于细长通道302可枢转地支撑。可互换轴组件200还可包括关节运动接头270和关节运动锁350(图8),该关节运动锁可被构造成能够可释放地将端部执行器300相对于轴轴线SA-SA保持在期望的位置。有关端部执行器300、关节运动接头270和关节运动锁350的构造和操作的细节,在2013年3月14日提交的名称为“ARTICULATABLE SURGICALINSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086中示出。2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING ANARTICULATION LOCK”的美国专利申请序列号13/803,086的完整公开内容据此以引用方式并入本文。如图7和图8所示,可互换轴组件200还可包括由喷嘴部分202和203构成的近侧外壳或喷嘴201。可互换轴组件200还可包括闭合管260,该闭合管可用于闭合和/或打开端部执行器300的砧座306。现在主要参见图8和图9,轴组件200可包括脊210,该脊可被构造成能够可固定地支撑关节运动锁350的轴框架部分212。参见图8。脊210可被构造成能够:第一,可滑动地支撑其中的击发构件220;第二,可滑动地支撑围绕脊210延伸的闭合管260。脊210还被构造成能够可滑动地支撑近侧关节运动驱动器230。关节运动驱动器230具有远侧端部231,该远侧端部被构造成能够可操作地接合关节运动锁350。关节运动锁350与关节运动框架352交接,该关节运动框架能够可操作地接合端部执行器框架(未示出)上的驱动销(未示出)。如上所述,有关关节运动锁350和关节运动框架的操作的更多细节可见于美国专利申请序列号13/803,086。在各种情况下,脊210可包括可旋转地支撑在底座240中的近侧端部211。在一种构造中,例如,脊210的近侧端部211具有在其上形成的螺纹214,以便通过螺纹附接到被构造成能够被支撑在底座240内的脊轴承216。参见图7。这种构造有利于将脊210可旋转地附接到底座240,使得脊210可以相对于底座240选择性地围绕轴轴线SA-SA旋转。
主要参见图7,可互换轴组件200包括闭合梭动件250,该闭合梭动件以可相对于底座240轴向运动的方式可滑动地支撑在该底座内。如图3和图7所示,闭合梭动件250包括被构造成能够附接到附接销37的一对朝近侧突起的钩252,该附接销附接到第二闭合连杆38,如将在下文进一步详细地讨论。闭合管260的近侧端部261联接到闭合梭动件250以用于相对于其旋转。例如,将U形连接器263插入闭合管260的近侧端部261中的环形狭槽262中,使其保留在闭合梭动件250中的竖直狭槽253内。参见图7。这种构造用来将闭合管260附接到闭合梭动件250,以用于与闭合梭动件一起轴向行进,同时使闭合管260能够围绕轴轴线SA-SA相对于闭合梭动件250旋转。闭合弹簧268轴颈连接在闭合管260上,用来沿近侧方向“PD”偏置闭合管260,当轴组件可操作地联接到柄部14时,该闭合弹簧可用来将闭合触发器枢转到未致动位置。
在至少一种形式中,可互换轴组件200还可包括关节运动接头270。然而,其他可互换轴组件可能不能够进行关节运动。如图7所示,例如,关节运动接头270包括双枢轴闭合套管组件271。根据各种形式,双枢轴闭合套管组件271包括具有朝远侧突出的上柄脚273和下柄脚274的端部执行器闭合套管组件272。端部执行器闭合套管组件272包括马蹄形孔275和插片276,用于按2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086(该专利申请以引用方式并入本文)中所述的各种方式接合砧座306上的开口插片。如本文进一步详细地描述,当砧座306打开时,马蹄形孔275和插片276与砧座上的插片接合。上部双枢轴连杆277包括向上突出的远侧枢轴销和近侧枢轴销,这些枢轴销分别接合闭合管260上的朝近侧突出的上柄脚273中的上部远侧销孔以及朝远侧突出的上柄脚264中的上部近侧销孔。下部双枢轴连杆278包括向上突出的远侧枢轴销和近侧枢轴销,这些枢轴销分别接合朝近侧突出的下柄脚274中的下部远侧销孔以及朝远侧突出的下柄脚265中的下部近侧销孔。另外参见图8。
在使用中,闭合管260朝远侧(方向“DD”)平移,以(例如)响应于闭合触发器32的致动而闭合砧座306。通过朝远侧平移闭合管260,因而平移轴闭合套管组件272,致使轴闭合套管组件按前述参考文献美国专利申请序列号13/803,086中所述的方式冲击砧座360上的近侧表面,由此闭合砧座306。还如该参考文献所详述,通过朝近侧平移闭合管260和轴闭合套管组件272,致使插片276和马蹄形孔275接触并推压砧座插片以将砧座306抬起,由此打开砧座306。在砧座打开位置,轴闭合管260运动至其近侧位置。
如上所述,外科器械10还可包括其类型和构造在美国专利申请序列号13/803,086中进一步详细描述的关节运动锁350,该关节运动锁可被构造成能够操作以选择性地将端部执行器300锁定在适当的位置。当关节运动锁350处于其解锁状态时,这种构造使端部执行器300能够相对于轴闭合管260旋转或做关节运动。在这种解锁状态下,端部执行器300可抵靠例如围绕患者体内手术部位的软组织和/或骨定位和推压,以使端部执行器300相对于闭合管260做关节运动。端部执行器300也可在关节运动驱动器230作用下,相对于闭合管260做关节运动。
同样如上所述,可互换轴组件200还包括击发构件220,该击发构件被支撑以便在轴脊210内轴向行进。击发构件220包括被构造成能够附接到远侧切割部分或刀杆280的中间击发轴部分222。击发构件220在本文中也可称为“第二轴”和/或“第二轴组件”。如图8和图9所示,中间击发轴部分222可在其远侧端部中包括纵向狭槽223,该纵向狭槽可被构造成能够接收远侧刀杆280的近侧端部282上的插片284。纵向狭槽223和近侧端部282可被设定尺寸并被构造成能够允许两者间的相对运动,并且可包括滑动接头286。滑动接头286可允许击发驱动装置220的中间击发轴部分222运动,以在不运动或至少基本上不运动刀杆280的情况下,使端部执行器300做关节运动。一旦端部执行器300已被适当地取向,中间击发轴部分222就可朝远侧推进,直到纵向狭槽223的近侧侧壁接触到插片284,以便推进刀杆280并击发定位在通道302内的钉仓。如图8和图9中可进一步看到的那样,轴脊210在其中具有细长的开口或窗口213,以利于把中间击发轴部分222装配进轴框架210以及插入该轴框架中。一旦中间击发轴部分222已被插入轴框架中,顶部框架段215就可与轴框架212接合,以封闭其中的中间击发轴部分222与刀杆280。有关击发构件220的操作的进一步描述可见于美国专利申请序列号13/803,086。
除上述之外,轴组件200可包括离合器组件400,该离合器组件可被构造成能够选择性地和可释放地将关节运动驱动器230联接到击发构件220。在一种形式中,离合器组件400包括围绕击发构件220定位的锁定衬圈或锁定套管402,其中锁定套管402可在接合位置与脱离位置之间旋转,在所述接合位置,锁定套管402将关节运动驱动器360联接到击发构件220,在所述脱离位置,关节运动驱动器360没有可操作地联接到击发构件200。当锁定套管402处于其接合位置时,击发构件220的远侧运动可使关节运动驱动器360朝远侧运动,相应地,击发构件220的近侧运动可使关节运动驱动器230朝近侧运动。当锁定套管402处于其脱离位置时,击发构件220的运动不传递到关节运动驱动器230,因此,击发构件220可独立于关节运动驱动器230运动。在各种情况下,当击发构件220没有使关节运动驱动器230在近侧方向或远侧方向上运动时,关节运动驱动器230可被关节运动锁350保持就位。
主要参见图9,锁定套管402可包括圆柱形或至少基本上圆柱形的主体,该主体包括限定于其中、被构造成能够接收击发构件220的纵向孔403。锁定套管402可包括面向内的锁定突起404和面向外的锁定构件406,这两者沿直径相对。锁定突起404可被构造成能够与击发构件220选择性地接合。更具体地,锁定套管402处于其接合位置时,锁定突起404被定位在击发构件220中限定的驱动凹口224内,使得远侧推力和/或近侧拉力可从击发构件220传递到锁定套管402。当锁定套管402处于其接合位置时,第二锁定构件406被接收在关节运动驱动器230中限定的驱动凹口232内,使得施加到锁定套管402的远侧推力和/或近侧拉力可传递到关节运动驱动器230。实际上,当锁定套管402处于其接合位置时,击发构件220、锁定套管402和关节运动驱动器230将一起运动。另一方面,当锁定套管402处于其脱离位置时,锁定突起404可以不定位在击发构件220的驱动凹口224内,因此,远侧推力和/或近侧拉力可以不从击发构件220传递到锁定套管402。相应地,远侧推力和/或近侧拉力可以不传递到关节运动驱动器230。在这种情况下,击发构件220可相对于锁定套管402和近侧关节运动驱动器230朝近侧和/或朝远侧滑动。
如图8-12所示,轴组件200还包括可旋转地接收在闭合管260上的切换筒500。切换筒500包括中空轴段502,该中空轴段具有在其上形成的轴凸台504,以用于将向外突起的致动销410接收在其中。在各种情况下,致动销410延伸穿过狭槽267进入设置在锁定套管402中的纵向狭槽408,以在锁定套管402与关节运动驱动器230接合时,利于该锁定套管做轴向运动。旋转扭转弹簧420被构造成能够如图10所示接合切换筒500上的凸台504以及喷嘴外壳203的一部分,以将偏置力施加到切换筒500。参见图5和图6,切换筒500还可包括其中限定的至少部分周边的开口506,这些开口可被构造成能够接收从喷嘴半部202,203延伸的周边安装架204,205,并允许切换筒500与近侧喷嘴201之间相对旋转而不是相对平移。如这些图所示,安装架204和205还延伸穿过闭合管260中的开口266以安置在轴脊210中的凹陷部211中。然而,喷嘴201旋转到某个点(在该点处,安装架204,205到达它们各自的狭槽506在切换筒500中的末端)将导致切换筒500围绕轴轴线SA-SA旋转。切换筒500的旋转最终将引起致动销410旋转,并引起锁定套管402在其接合位置与脱离位置之间旋转。因此,喷嘴201本质上可用于按美国专利申请序列号13/803,086中进一步详细描述的各种方式,将关节运动驱动系统与击发驱动系统可操作地接合和脱离。
也如图8至图12所示,轴组件200可包括滑环组件600,例如,该滑环组件可被构造成能够将电力传导至端部执行器300和/或从该端部执行器传导电力,并且/或者将信号传送至端部执行器300和/或从该端部执行器接收信号。滑环组件600可包括近侧连接器凸缘604和远侧连接器凸缘601,该近侧连接器凸缘安装到从底座240延伸的底座凸缘242,该远侧连接器凸缘定位在轴外壳202,203中限定的狭槽内。近侧连接器凸缘604可包括第一面,并且远侧连接器凸缘601可包括第二面,其中第二面与第一面相邻定位,并能够相对于第一面运动。远侧连接器凸缘601可围绕轴轴线SA-SA相对于近侧连接器凸缘604旋转。近侧连接器凸缘604可包括限定在其第一面中的多个同心或至少基本上同心的导体602。连接器607可安装在连接器凸缘601的近侧侧面上,并可具有多个触点(未示出),其中每个触点对应于导体602中的一个并与其电接触。这种构造在保持近侧连接器凸缘604与远侧连接器凸缘601之间电接触的同时,允许这两个凸缘之间相对旋转。例如,近侧连接器凸缘604可包括电连接器606,该电连接器可使导体602与安装到轴底座240的轴电路板610进行信号通信。在至少一种情况下,包括多个导体的线束可在电连接器606与轴电路板610之间延伸。电连接器606可朝近侧延伸穿过限定在底盘安装凸缘242中的连接器开口243。参见图7。2013年3月13日提交的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067全文以引用方式并入本文。2013年3月13日提交的名称为“STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,025全文以引用方式并入本文。有关滑环组件600的更多细节可见于美国专利申请序列号13/803,086。
如上文所讨论,轴组件200可包括可固定地安装到柄部14的近侧部分和可围绕纵向轴线旋转的远侧部分。如上文所讨论,可旋转的远侧轴部分可围绕滑环组件600相对于近侧部分旋转。滑环组件600的远侧连接器凸缘601可定位在可旋转的远侧轴部分内。而且,除上述之外,切换筒500也可定位在可旋转的远侧轴部分内。当可旋转的远侧轴部分旋转时,远侧连接器凸缘601和切换筒500可彼此同步地旋转。另外,切换筒500可相对于远侧连接器凸缘601在第一位置与第二位置之间旋转。当切换筒500处于其第一位置时,关节运动驱动系统可与击发驱动系统可操作地脱离接合,因此,击发驱动系统的操作可不使轴组件200的端部执行器300进行关节运动。当切换筒500处于其第二位置时,关节运动驱动系统能够可操作地与击发驱动系统接合,因此,击发驱动系统的操作可以使轴组件200的端部执行器300做关节运动。当切换筒500在其第一位置和其第二位置之间运动时,切换筒500相对于远侧连接器凸缘601运动。在各种情况下,轴组件200可包括被构造成能够检测切换筒500的位置的至少一个传感器。现在转到图11和图12,远侧连接器凸缘601可包括例如霍尔效应传感器605,切换筒500可包括例如磁性元件,诸如永磁体505。霍尔效应传感器605可被构造成能够检测永磁体505的位置。当切换筒500在其第一位置和其第二位置之间旋转时,永磁体505可相对霍尔效应传感器605运动。在各种情况下,霍尔效应传感器605可检测当永磁体505运动时产生的磁场变化。霍尔效应传感器605可与例如轴电路板610和/或柄部电路板100进行信号通信。跟据来自霍尔效应传感器605的信号,轴电路板610和/或柄部电路板100上的微控制器可确定关节运动驱动系统是与击发驱动系统接合还是脱离。
再次参见图3和图7,底座240包括在其上形成的至少一个、优选地两个锥形附接部分244,该锥形附接部分适于被接收在对应的燕尾形狭槽702内,所述燕尾形狭槽在框架20的远侧附接凸缘部分700内形成。每个燕尾形狭槽702可以是锥形,或换句话讲,可以略成V形,从而以坐置方式将附接部分244接收在其中。如图3和图7中可进一步看到的那样,轴附接耳状物226在中间击发轴222的近侧端部上形成。如将在下文进一步详细地讨论,当可互换轴组件200联接到柄部14时,轴附接耳状物226被接收在纵向驱动构件120的远侧端部125中形成的击发轴附接支架126中。参见图3和图6。
各种轴组件实施方案采用闩锁系统710以可移除地将轴组件200联接到外壳12,并且更具体地,联接到框架20。如图7所示,例如,在至少一种形式中,闩锁系统710包括可动地联接到底盘240的锁定构件或锁定轭712。在例示的实施方案中,例如,锁定轭712为U形,具有两个隔开并向下延伸的支脚714。支脚714各自具有在其上形成的枢轴耳状物716,这些枢轴耳状物适于被接收在底座240中形成的对应孔245中。这种构造有利于将锁定轭712枢转附接到底座240。锁定轭712可包括两个朝近侧突起的锁定耳状物714,这两个锁定耳状物被构造成能够与框架20的远侧附接凸缘700中对应的锁定棘爪或凹槽704可释放地接合。参见图3。在各种形式中,锁定轭712被弹簧或偏置构件(未示出)沿近侧方向偏置。锁定轭712的致动可通过可滑动地安装在闩锁致动器组件720上的闩锁按钮722来实现,该闩锁致动器组件安装到底盘240。闩锁按钮722可相对于锁定轭712沿近侧方向偏置。如将在下文进一步详细地讨论,锁定轭712可通过沿远侧方向偏置闩锁按钮而运动到解锁位置,这也使锁定轭712枢转成不再与框架20的远侧附接凸缘700保持接合。当锁定轭712与框架20的远侧附接凸缘700“保持接合”时,锁定耳状物716保持坐置在远侧附接凸缘700中对应的锁定棘爪或凹槽704内。
当采用包括适于切割和紧固组织的本文所述类型的端部执行器以及其他类型的端部执行器的可互换轴组件时,可能有利的是防止可互换轴组件在端部执行器致动期间不经意地从外壳脱离。例如,在使用中,临床医生可致动闭合触发器32以抓持目标组织并将其操纵至期望的位置。一旦目标组织以期望取向定位在端部执行器300内,临床医生就可完全致动闭合触发器32,以关闭砧座306并将目标组织夹持在合适位置供切割与缝合。在这种情况下,第一驱动系统30已被完全致动。在目标组织已被夹持在端部执行器300中之后,可能有利的是防止轴组件200不经意地从外壳12脱离。闩锁系统710的一种形式被构造成能够防止这种不经意的脱离。
如可在图7中最具体所见,锁定轭712包括至少一个且优选地两个锁定钩718,所述锁定钩能够接触在闭合梭动件250上形成的对应的锁定耳状物部分256。参见图13至图15,当闭合梭动件250处于未致动位置(即,第一驱动系统30未致动并且砧座306打开)时,锁定轭712可沿远侧方向枢转,以将可互换轴组件200从外壳12解锁。当处于该位置时,锁定钩718不接触闭合梭动件250上的锁定耳状物部分256。然而,当闭合梭动件250运动到致动位置(即,第一驱动系统30被致动并且砧座306处于闭合位置)时,锁定轭712被阻止枢转到解锁位置。参见图16-18。换句话讲,如果临床医生试图将锁定轭712枢转到解锁位置,或者例如,锁定轭712不经意地以原本可能引起其朝远侧枢转的方式受到碰撞或发生接触,则锁定轭712上的锁定钩718将接触闭合梭动件250上的锁定耳状物256,并且防止锁定轭712运动到解锁位置。
现在将参照图3描述可互换轴组件200与柄部14附接的操作。要开始联接过程,临床医生可将可互换轴组件200的底座240定位在框架20的远侧附接凸缘700上方或附近,使得底座240上形成的锥形附接部分244与框架20中的燕尾形狭槽702对齐。然后临床医生可沿垂直于轴轴线SA-SA的安装轴线IA运动轴组件200,以使附接部分244坐置成与对应的燕尾形接收狭槽702“可操作地接合”。这样做时,中间击发轴222上的轴附接耳状物226也将坐置在可纵向运动的驱动构件120中的支架126中,并且第二闭合连杆38上的销37的部分将坐置在闭合轭250中的对应钩252中。如本文所用,在具有两个部件的上下文中的术语“可操作地接合”是指所述两个部件彼此充分地接合,使得一旦向其施加致动动作,所述部件就可以执行其预期活动、功能和/或工序。
如上文所讨论,可互换轴组件200的至少五个系统能够可操作地与柄部14的至少五个对应系统联接。第一系统可包括框架系统,该框架系统将轴组件200的框架或脊与柄部14的框架20联接并/或对齐。第二系统可包括闭合驱动系统30,该闭合驱动系统可将柄部14的闭合触发器32与轴组件200的闭合管260和砧座306可操作地连接。如上文所概述,轴组件200的闭合管附接轭250可与第二闭合连杆38上的销37接合。第三系统可包括击发驱动系统80,该击发驱动系统可将柄部14的击发触发器130与轴组件200的中间击发轴222可操作地连接。
如上文所概述,轴附接耳状物226可与纵向驱动构件120的支架126可操作地连接。第四系统可包括电气系统,该电气系统能够:发送轴组件(诸如轴组件200)已与柄部14可操作地接合的信号到柄部14中的控制器(诸如微控制器),并且/或者在轴组件200与柄部14之间传导功率和/或通信信号。例如,轴组件200可包括可操作地安装到轴电路板610的电连接器1410。电连接器1410被构造用于与柄部控制板100上的对应的电连接器1400配合接合。有关电路系统和控制系统的更多细节可见于美国专利申请序列号13/803,086,该专利申请的完整公开内容此前以引用方式并入本文。第五系统可由用于可释放地将轴组件200锁定到柄部14的闩锁系统组成。
再次参见图2和图3,柄部14可包括电连接器1400,该电连接器包括多个电触点。现在转到图19,电连接器1400可包括例如第一触点1401a、第二触点1401b、第三触点1401c、第四触点1401d、第五触点1401e和第六触点1401f。尽管所示的实施方案利用了六个触点,但设想了可利用多于六个触点或少于六个触点的其他实施方案。
如图19所示,第一触点1401a可与晶体管1408电连通,触点1401b-1401e可与微控制器1500电连通,并且第六触点1401f可与地电连通。在某些情况下,电触点1401b-1401e中的一个或多个可与微控制器1500的一个或多个输出通道电连通,并且在柄部1042处于加电状态时可通电,或具有施加到其的电压电位。在一些情况下,电触点1401b-1401e中的一个或多个可与微控制器1500的一个或多个输入通道电连通,并且当柄部14处于加电状态时,微控制器1500可被构造成能够检测电压电位何时被施加到此类电触点。当轴组件(诸如轴组件200)装配到柄部14时,电触点1401a-1401f可不彼此连通。然而,当轴组件未装配到柄部14时,电连接器1400的电触点1401a-1401f可暴露,并且在一些情况下,触点1401a-1401f中的一个或多个可意外地布置成彼此电连通。例如,当触点1401a-1401f中的一个或多个接触导电材料时,可出现此类情况。当发生这种情况时,例如,微控制器1500可接收错误的输入并且/或者轴组件200可接收错误的输出。为解决这个问题,在各种情况下,当轴组件(诸如轴组件200)未附接到柄部14时,柄部14可以不加电。
在其他情况下,柄部1042可在轴组件诸如轴组件200未附接到柄部1042时加电。在这种情况下,例如,微控制器1500可被构造成能够忽视施加到与微控制器1500电连通的触点(即,触点1401b-1401e)的输入或电压电位,直到轴组件附接到柄部14。虽然在这种情况下微控制器1500可被供电以操作柄部14的其他功能,但柄部14可处于掉电状态。在某种程度上,当施加到电触点1401b-1401e的电压电势可不影响柄部14的操作时,电连接器1400可处于掉电状态。读者将会知道,即使触点1401b-1401e可处于掉电状态,但未与微控制器1500电连通的电触点1401a和1401f可处于或可不处于掉电状态。例如,无论柄部14是处于加电还是掉电状态,第六触点4001f均可保持与地电连通。
此外,无论柄部14是处于加电还是掉电状态,晶体管1408和/或晶体管的任何其他合适结构(诸如晶体管1410)和/或开关可被构造成能够控制从柄部14内的电源1404(诸如电池90)例如到第一电触点1401a的功率供应。在各种情况下,例如,当轴组件200与柄部14接合时,轴组件200可被构造成能够改变晶体管1408的状态。在某些情况下,除下述之外,霍尔效应传感器1402可被构造成能够转换晶体管1410的状态,因此可转换晶体管1408的状态,最终将来自功率源1404的功率供应给第一触点1401a。这样,联接到连接器1400的功率电路和信号电路两者当轴组件未安装到柄部14时可被掉电,并且当轴组件安装到柄部14时可被加电。
在各种情况下,再次参见图19,柄部14可包括例如霍尔效应传感器1402,当轴组件联接到柄部14时,该霍尔效应传感器可被构造成能够检测位于该轴组件(诸如轴组件200)上的可检测元件,诸如磁性元件1407(图3)。霍尔效应传感器1402可由诸如电池之类的功率源1406供电,该功率源实际上可放大霍尔效应传感器1402的检测信号,并经由图19所示的电路与微控制器1500的输入通道通信。一旦微控制器1500接收到指示轴组件已至少部分地联接到柄部14、因而电触点1401a-1401f不再暴露的输入,微控制器1500就可进入其正常的或加电的操作状态。在此类工作状态中,微控制器1500将对从轴组件传输到一个或多个触点1401b-1401e的信号进行评估,和/或通过处于其正常使用状态的一个或多个触点1401b-1401e将信号传输到轴组件。在各种情况下,在霍尔效应传感器1402可检测到磁性元件1407之前,可能必须使轴组件200完全坐置。例如,虽然可利用霍尔效应传感器1402来检测轴组件200是否存在,但也可利用传感器和/或开关的任何合适的系统来检测轴组件是否已装配到柄部14。这样,除上述之外,联接到连接器1400的功率电路和信号电路两者当轴组件未安装到柄部14时可被掉电,并且当轴组件安装到柄部14时可被加电。
在各种实施方案中,例如,可采用任何数量的磁感测元件来检测轴组件是否已装配到柄部14。例如,用于磁场感测的技术包括探测线圈、磁通门、光泵、核旋、超导量子干涉仪(SQUID)、霍尔效应、各向异性磁电阻、巨磁电阻、磁性隧道结、巨磁阻抗、磁致伸缩/压电复合材料、磁敏二极管、磁敏晶体管、光纤、磁光,以及基于微机电系统的磁传感器等。
参见图19,微控制器1500通常可包括微处理器(“处理器”)和可操作地联接到该处理器的一个或多个存储器单元。处理器通过执行存储器中存储的指令码,可控制外科器械的各种部件,诸如马达、各种驱动系统和/或用户显示器。微控制器1500可使用集成的和/或分立的硬件元件、软件元件和/或硬件元件和软件元件两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、专用集成电路(ASIC)、可编程逻辑器件(PLD)、数字信号处理器(DSP)、现场可编程门阵列(FPGA)、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、片上系统(SoC)和/或封装系统(SIP)。分立硬件元件的示例可包括电路和/或电路元件,诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些情况下,例如,微控制器1500可包括混合电路,该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。
参见图19,微控制器1500可例如是可购自Texas Instruments的LM 4F230H5QR。在某些情况下,Texas Instruments LM4F230H5QR为ARM Cortex-M4F处理器芯,其包括:256KB的单循环闪存存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环串行随机访问存储器(SRAM)、装载有软件的内部只读存储器(ROM)、2KB电可擦编程只读存储器(EEPROM)、一个或多个脉宽调制(PWM)模块、一个或多个正交编码器输入(QEI)模拟、具有12个模拟输入通道的一个或多个12位模数转换器(ADC),以及易得的其他特征。可以很方便地换用其他微控制器,来与本公开联合使用。因此,本公开不应限于这一上下文。
如上文所讨论,当轴组件200未装配到或未完全装配到柄部14时,柄部14和/或轴组件200可包括下述系统和结构:这些系统和结构被构造成能够防止或至少降低柄部电连接器1400的触点和/或轴电连接器1410的触点发生短路的可能性。参见图3,柄部电连接器1400可至少部分地陷入柄部框架20中限定的腔体1409内。电连接器1400的六个触点1401a-1401f可完全陷入腔体1409内。这种构造可降低物体意外地接触触点1401a-1401f中的一个或多个的可能性。相似地,轴电连接器1410可定位在轴底座240中限定的凹陷部内,这可降低物体意外地接触轴电连接器1410的触点1411a-1411f中的一个或多个的可能性。参照图3所示的具体实施方案,轴触点1411a-1411f可包括凸形触点。在至少一个实施方案中,例如,每个轴触点1411a-1411f可包括从其延伸的柔性突出部,该柔性突出部可被构造成能够接合对应的柄部触点1401a-1401f。柄部触点1401a-1401f可包括凹形触点。在至少一个实施方案中,每个柄部触点1401a-1401f可包括例如平坦表面,轴凸形触点1401a-1401f可抵靠该平坦表面擦过或滑过,并且维持平坦表面和轴凸形触点1401a-1401f之间的导电接合。在各种情况下,将轴组件200装配到柄部14的方向可平行于、或至少基本上平行于柄部触点1401a-1401f,使得在将轴组件200装配到柄部14时,轴触点1411a-1411f抵靠柄部触点1401a-1401f滑动。在各种替代实施方案中,柄部触点1401a-1401f可包括凸形触点,并且轴触点1411a-1411f可包括凹形触点。在某些替代实施方案中,柄部触点1401a-1401f和轴触点1411a-1411f可具有任何合适的触点布置方式。
在各种情况下,柄部14可包括被构造成能够至少部分地覆盖柄部电连接器1400的连接器防护件和/或被构造成能够至少部分地覆盖轴电连接器1410的连接器防护件。当轴组件未装配到、或只部分地装配到柄部时,连接器防护件可防止、或至少降低物体意外地接触电连接器的触点的可能性。连接器防护件可以是可动的。例如,连接器防护件可在防护位置与非防护位置之间运动,在防护位置,该连接器防护件至少部分地保护连接器,在非防护位置,该连接器防护件不保护连接器,或至少为连接器提供较少保护。在至少一个实施方案中,将轴组件装配到柄部时,连接器防护件的位置可被移置。例如,如果柄部包括柄部连接器防护件,则在将轴组件装配到柄部时,轴组件可接触并移置柄部连接器防护件。相似地,如果轴组件包括轴连接器防护件,则在将轴组件装配到柄部时,柄部可接触并移置轴连接器防护件。在各种情况下,例如,连接器防护件可包括门。在至少一种情况下,该门可包括倾斜表面,在门与柄部或轴接触时,该倾斜表面可有利于门沿确定方向的位移。在各种情况下,例如,连接器防护件可被平移和/或旋转。在某些情况下,连接器防护件可包括覆盖电连接器触点的至少一层膜。当将轴组件装配到柄部时,这层膜可能破裂。在至少一种情况下,连接器的凸形触点可先刺透这层膜,再与定位在这层膜下方的对应触点接合。
如上所述,外科器械可包括能够选择性地对电连接器(诸如电连接器1400)的触点进行加电或激活的系统。在各种情况下,触点可在未激活状况与激活状况之间转换。在某些情况下,触点可在监控状况、去激活状况与激活状况之间转换。例如,当轴组件尚未装配到柄部14时,微控制器1500例如可监控触点1401a-1401f,以确定触点1401a-1401f中的一个或多个是否可能已经短路。微控制器1500可被构造成能够将低电压电位施加到触点1401a-1401f中的每个,并评估在该触点中的每个处是否仅存在最小电阻。这种操作状态可包括监控状况。如果在某个触点处检测到的电阻很高,或超过了阈值电阻,则微控制器1500可去激活该触点、多于一个触点,或者全部触点。这种操作状态可包括去激活状况。如上文所讨论,如果轴组件装配到柄部14,并被微控制器1500检测到,则微控制器1500可提高施加到触点1401a-1401f的电压电位。这种操作状态可包括激活状况。
本文所公开的各种轴组件可采用传感器和各种其他部件,所述传感器和各种其他部件需要与外壳中的控制器电连通。这些轴组件通常被构造成能够相对于外壳旋转,因此必须在两个或更多个可相对彼此旋转的部件之间设置有利于这种电连通的连接件。当采用本文所公开类型的端部执行器时,连接器构造在本质上必须相对稳固,同时还必须略微紧凑,以装配到轴组件的连接器部分中。
参见图20,示出了端部执行器300的非限制性形式。如上所述,端部执行器300可包括砧座306和钉仓304。在该非限制性实施方案中,砧座306联接到细长通道198。例如,孔199可限定在细长通道198中,该孔可接收从砧座306延伸的销152并允许砧座306相对于细长通道198和钉仓304从打开位置枢转到闭合位置。此外,图20示出了被构造成能够纵向平移到端部执行器300内的击发杆172。击发杆172可由一个实心部分构成,或在各种实施例中,可包括层压材料,该层压材料包括例如一叠钢板。击发杆172的远侧突出端可附接到E型横梁178,该E型横梁可(除了其他以外)在砧座306处于闭合位置时有助于将砧座306与定位在细长通道198中的钉仓304间隔开。E型横梁178还可包括锋利切割刃182,当通过击发杆172向远侧推进E型横梁178时,切割刃182可用于切断组织。在操作中,E型横梁178还可致动或击发钉仓304。钉仓304可包括模塑的仓体194,该仓体保持多个钉191,所述多个钉安置在钉驱动器192上,所述钉驱动器位于分别向上打开的钉腔195中。楔形滑动件190通过E形梁178朝远侧驱动,从而在仓托盘196上滑动,该仓托盘将可替换钉仓304的各种部件保持在一起。楔形滑动件190使钉驱动器192向上进行凸轮运动,以将钉191挤出成与砧座306变形接触,同时E形梁178的切割表面182切断夹紧的组织。
除上述之外,E型横梁178可包括在击发期间接合砧座306的上部销180。E型横梁178还可包括中间销184和底脚186,其可接合仓体194、仓托盘196和细长通道198的各个部分。当钉仓304定位在细长通道198内时,限定在仓体194中的狭槽193可与限定在仓托盘196中的狭槽197以及限定在细长通道198中的狭槽189对齐。在使用中,E型横梁178可滑动穿过对齐的狭槽193,197和189,如图20所示,其中E型横梁178的底脚186可沿着狭槽189的长度接合沿着通道198的底面延伸的沟槽,中间销184可沿着纵向狭槽197的长度接合仓托盘196的顶部表面,并且上部销180可接合砧座306。在这种情况下,当击发杆172向远侧运动以从钉仓304击发钉和/或切入砧座306和钉仓304之间捕集的组织时,E型横梁178可分开或限制砧座306和钉仓304之间的相对运动。然后,击发杆172和E型横梁178可向近侧回缩,从而允许砧座306打开,以释放两个缝合和切割的组织部分(未示出)。
现已概括地描述了外科器械10,下面将详细描述外科器械10的各种电力/电子部件。现在转到图21A-21B,其中示出了包括多个电路段2002a-2002g的分段电路2000的一个实施方案。包括多个电路段2002a-2002g的分段电路2000被构造成能够控制加电外科器械,诸如但不限于图1-18A中所示的外科器械10。多个电路段2002a-2002g被构造成能够控制加电外科器械10的一种或多种操作。安全处理器段2002a(第1段)包括安全处理器2004。主处理器段2002b(第2段)包括主处理器2006。安全处理器2004和/或主处理器2006被构造成能够与一个或多个另外的电路段2002c-2002g进行交互,以控制加电外科器械10的操作。主处理器2006包括联接到例如一个或多个电路段2002c-2002g、电池2008和/或多个开关2058a-2070的多个输入装置。分段电路2000可通过任何合适的电路(诸如加电外科器械10内的印刷电路板组件(PCBA))来实施。应当理解,本文使用的术语“处理器”包括任一种微处理器、微控制器,或者将计算机的中央处理单元(CPU)的功能结合到一个集成电路或最多几个集成电路上的其他基础计算装置。处理器是多用途的可编程装置,该装置接收数字数据作为输入,依据其存储器中存储的指令来处理输入,然后提供结果作为输出。处理器具有内部存储器,所以是顺序数字逻辑的示例。处理器的操作对象是以二进制数字系统表示的数字和符号。
在一个实施方案中,主处理器2006可以是任一种单核或多核处理器,诸如已知的由Texas Instruments生产的商品名为ARM Cortex的那些。在一个实施方案中,安全处理器2004可以是包括两个基于微控制器的系列(诸如TMS570和RM4x)的安全微控制器平台,已知同样由Texas Instruments生产的商品名为Hercules ARM Cortex R4。然而,可不受限制地采用微控制器和安全处理器的其他合适的替代物。在一个实施方案中,安全处理器2004可具体地针对IEC 61508和ISO 26262安全关键应用等等进行构造,以在输送可量化的性能、连通性和存储选项时提供高级集成安全特征。
在某些情况下,主处理器2006可以是例如可购自Texas Instruments的LM4F230H5QR。在至少一个示例中,Texas Instruments LM4F230H5QR为ARM Cortex-M4F处理器芯,其包括:256KB的单循环闪存存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC,以及对于产品数据表而言易得的其他特征。可以很方便地换用其他处理器,因此,本公开不应限于这一上下文。
在一个实施方案中,分段电路2000包括加速度段2002c(第3段)。加速度段2002c包括加速度传感器2022。加速度传感器2022可包括例如加速度计。加速度传感器2022被构造成能够检测加电外科器械10的运动或加速度。在一些实施方案中,来自加速度传感器2022的输入用于例如转变到休眠模式和从休眠模式转变到其他模式、识别加电外科器械的取向,并且/或者识别外科器械何时已被放下。在一些实施方案中,加速度段2002c联接到安全处理器2004和/或主处理器2006。
在一个实施方案中,分段电路2000包括显示器段2002d(第4段)。显示器段2002d包括联接到主处理器2006的显示器连接器2024。显示器连接器2024通过一个或多个显示器驱动器集成电路2026将主处理器2006联接到显示器2028。显示器驱动器集成电路2026可与显示器2028集成,和/或可与显示器2028分开定位。显示器2028可包括任一种合适的显示器,诸如有机发光二极管(OLED)显示器、液晶显示器(LCD)和/或其他任何合适的显示器。在一些实施方案中,显示器段2002d联接到安全处理器2004。
在一些实施方案中,分段电路2000包括轴段2002e(第5段)。轴段2002e包括用于联接到外科器械10的轴2004的一个或多个控件,和/或用于联接到轴2004的端部执行器2006的一个或多个控件。轴段2002e包括轴连接器2030,该轴连接器被构造成能够将主处理器2006联接到轴PCBA 2031。轴PCBA 2031包括第一关节运动开关2036、第二关节运动开关2032、和轴PCBA EEPROM 2034。在一些实施方案中,轴PCBA EEPROM 2034包括特定于轴2004和/或轴PCBA 2031的一个或多个参数、例程和/或程序。轴PCBA 2031可联接到轴2004和/或与外科器械10一体成型。在一些实施方案中,轴段2002e包括第二轴EEPROM 2038。第二轴EEPROM 2038包括对应于可与加电外科器械10交接的一个或多个轴2004和/或端部执行器2006的多个算法、例程、参数、和/或其他数据。
在一些实施方案中,分段电路2000包括位置编码器段2002f(第6段)。位置编码器段2002f包括一个或多个磁性旋转位置编码器2040a-2040b。一个或多个磁性旋转位置编码器2040a-2040b被构造成能够识别外科器械10的马达2048、轴2004和/或端部执行器2006的旋转位置。在一些实施方案中,磁性旋转位置编码器2040a-2040b可联接到安全处理器2004和/或主处理器2006。
在一些实施方案中,分段电路2000包括马达段2002g(第7段)。马达段2002g包括马达2048,该马达被构造成能够控制加电外科器械10的一种或多种运动。马达2048通过H桥驱动器2042和一个或多个H桥场效应晶体管(FET)2044联接到主处理器2006。H桥FET 2044联接到安全处理器2004。马达电流传感器2046与马达2048串联联接,用于测量马达2048的电流消耗。马达电流传感器2046与主处理器2006和/或安全处理器2004进行信号通信。在一些实施方案中,马达2048联接到马达电磁干扰(EMI)滤波器2050。
分段电路2000包括功率段2002h(第8段)。电池2008联接到安全处理器2004、主处理器2006,以及另外的电路段2002c-2002g中的一个或多个。电池2008通过电池连接器2010和电流传感器2012联接到分段电路2000。电流传感器2012被构造成能够测量分段电路2000的总电流消耗。在一些实施方案中,一个或多个电压转换器2014a,2014b,2016被构造成能够向一个或多个电路段2002a-2002g提供预先确定的电压值。例如,在一些实施方案中,分段电路2000可包括3.3V的电压转换器2014a-2014b和/或5V的电压转换器2016。升压转换器2018被构造成能够提供最高为预先确定的量(诸如,最高至13V)的升压电压。升压转换器2018被构造成能够在功率密集操作期间提供附加的电压和/或电流,并且能够防止电压降低状况或低功率状况。
在一些实施方案中,安全段2002a包括马达功率中断2020。马达功率中断2020联接在功率段2002h与马达段2002g之间。安全段2002a被构造成能够在安全处理器2004和/或主处理器2006检测到错误或故障状况时中断到马达段2002g的功率,如本文更详细地讨论。尽管电路段2002a-2002g被示为具有电路段2002a-2002h中物理位置接近的所有部件,但本领域的技术人员将认识到,电路段2002a-2002h可包括在物理上和/或在电学上与相同电路段2002a-2002g的部件分开的其他部件。在一些实施方案中,一个或多个部件可由两个或更多个电路段2002a-2002g共享。
在一些实施方案中,多个开关2056-2070联接到安全处理器2004和/或主处理器2006。多个开关2056-2070可被构造成能够控制外科器械10的一种或多种操作、能够控制分段电路2000的一种或多种操作,和/或能够指示外科器械10的状态。例如,应急门开关2056被构造成能够指示应急门的状态。多个关节运动开关(诸如左侧向左关节运动开关2058a、左侧向右关节运动开关2060a、左侧向中心关节运动开关2062a、右侧向左关节运动开关2058b、右侧向右关节运动开关2060b和右侧向中心关节运动开关2062b)被构造成能够控制轴2004和/或端部执行器2006的关节运动。左侧换向开关2064a和右侧换向开关2064b联接到主处理器2006。在一些实施方案中,左侧开关(包括左侧向左关节运动开关2058a、左侧向右关节运动开关2060a、左侧向中心关节运动开关2062a和左侧换向开关2064a)通过左挠性连接器2072a联接到主处理器2006。右侧开关(包括右侧向左关节运动开关2058b、右侧向右关节运动开关2060b、右侧向中心关节运动开关2062b和右侧换向开关2064b)通过右挠性连接器2072b联接到主处理器2006。在一些实施方案中,击发开关2066、夹持释放开关2068和轴接合开关2070联接到主处理器2006。
多个开关2056-2070可包括例如安装到外科器械10的柄部的多个柄部控件、多个指示器开关、和/或它们的任何组合。在各种实施方案中,多个开关2056-2070允许外科医生操纵外科器械,向分段电路2000提供有关外科器械的位置和/或操作的反馈,和/或指示外科器械10的不安全操作。在一些实施方案中,另外的或较少的开关可联接到分段电路2000,开关2056-2070中的一个或多个可组合成单个开关,和/或扩展成多个开关。例如,在一个实施方案中,左侧关节运动开关和/或右侧关节运动开关2058a-2064b中的一个或多个可组合成单个多位置开关。
在一个实施方案中,安全处理器2004被构造成能够除了其他的安全操作以外实现看门狗功能。分段电路2000的安全处理器2004和主处理器2006进行信号通信。微处理器活心跳信号在输出端2096处提供。加速度段2002c包括加速度计2022,该加速度计被构造成能够监控外科器械10的运动。在各种实施方案中,加速度计2022可以是单轴、双轴或三轴加速度计。加速度计2022可用于测量适当的加速度,该加速度不一定是坐标加速度(速度改变的速率)。作为替代,加速度计观察到在加速度计2022的参照系静止时,与测试质量经受的重量现象相关联的加速度。例如,在地球的表面上静止的加速度计2022由于其重量将测量竖直向上的(重力)加速度g=9.8m/s2。加速度计2022可测量的另一类加速度是重力加速度。在各种其他实施方案中,加速度计2022可包括单轴、双轴或三轴加速度计。此外,加速度段2002c可包括一个或多个惯性传感器,以检测和测量加速度、倾斜、冲击、振动、旋转和多自由度(DoF)。合适的惯性传感器可包括加速度计(单轴、双轴或三轴)、用于测量空间磁场(诸如地球磁场)的磁力计和/或用于测量角速度的陀螺仪。
在一个实施方案中,安全处理器2004被构造成能够针对一个或多个电路段2002c-2002h(诸如马达段2002g)实现看门狗功能。就这一点来说,安全处理器2004采用看门狗功能来检测主处理器2006的故障并从主处理器2006的故障中恢复。在正常操作期间,安全处理器2004监控主处理器2004的硬件故障或程序错误,并发起一种或多种纠正行动。纠正行动可包括将主处理器2006置于安全状态,并恢复正常的系统操作。在一个实施方案中,安全处理器2004至少联接到第一传感器。第一传感器测量外科器械10的第一性质。在一些实施方案中,安全处理器2004被构造成能够将外科器械10的所测量性质与预先确定的值进行比较。例如,在一个实施方案中,马达传感器2040a联接到安全处理器2004。马达传感器2040a向安全处理器2004提供马达的速度和位置信息。安全处理器2004监控马达传感器2040a并将值与最大速度和/或位置值进行比较,并且如果值高于预先确定的值,则阻止马达2048的操作。在一些实施方案中,预先确定的值基于马达2048的实时速度和/或位置计算、由与主处理器2006通信的第二马达传感器2040b提供的值计算,并且/或者从例如联接到安全处理器2004的存储器模块提供给安全处理器2004。
在一些实施方案中,第二传感器联接到主处理器2006。第二传感器被构造成能够测量第一物理性质。安全处理器2004和主处理器2006被构造成能够提供分别指示第一传感器的值和第二传感器的值的信号。当安全处理器2004或主处理器2006指示值超出可接受范围时,分段电路2000便阻止电路段2002c-2002h中至少一个(诸如马达段2002g)的操作。例如,在图21A-21B所示的实施方案中,安全处理器2004联接到第一马达位置传感器2040a,并且主处理器2006联接到第二马达位置传感器2040b。马达位置传感器2040a,2040b可包括任何合适的马达位置传感器,诸如,具有正弦和余弦输出的磁性角度旋转输入装置。马达位置传感器2040a,2040b向安全处理器2004和主处理器2006提供指示马达2048的位置的相应的信号。
当第一马达传感器2040a的值和第二马达传感器2040b的值处于预先确定的范围内时,安全处理器2004和主处理器2006生成激活信号。当主处理器2006或安全处理器2004检测到值超出预先确定的范围时,则终止激活信号,随即中断并/或阻止至少一个电路段2002c-2002h(诸如马达段2002g)的操作。例如,在一些实施方案中,来自主处理器2006的激活信号和来自安全处理器2004的激活信号耦合到与门。与门联接到马达功率开关2020。当来自安全处理器2004和主处理器2006这两者的激活信号都较高(指示马达传感器2040a,2040b的值在预先确定的范围内)时,与门便将马达功率开关2020保持在闭合或打开位置。当马达传感器2040a,2040b中任一者检测到值超出预先确定的范围时,则来自马达传感器2040a,2040b的激活信号被设定为低,并且与门的输出也被设定为低,从而断开马达功率开关2020。在一些实施方案中,第一传感器2040a的值与第二传感器2040b的值例如通过安全处理器2004和/或主处理器2006进行比较。当第一传感器的值与第二传感器的值不同时,安全处理器2004和/或主处理器2006便可阻止马达段2002g的操作。
在一些实施方案中,安全处理器2004接收指示第二传感器2040b的值的信号,并且将第二传感器的值与第一传感器的值进行比较。例如,在一个实施方案中,安全处理器2004直接联接到第一马达传感器2040a。第二马达传感器2040b联接到主处理器2006(该主处理器将第二马达传感器2040b的值提供给安全处理器2004)和/或直接联接到安全处理器2004。安全处理器2004将第一马达传感器2040的值与第二马达传感器2040b的值进行比较。当安全处理器2004检测到第一马达传感器2040a与第二马达传感器2040b之间存在失配时,安全处理器2004可例如通过切断到马达段2002g的功率来中断马达段2002g的操作。
在一些实施方案中,安全处理器2004和/或主处理器2006联接到被构造成能够测量外科器械的第一性质的第一传感器2040a和被构造成能够测量外科器械的第二性质的第二传感器2040b。第一性质和第二性质包括外科器械正常操作时的预先确定的关系。安全处理器2004监控第一性质和第二性质。当检测到第一性质的值和/或第二性质的值与预先确定的关系不一致时,则发生故障。发生故障时,安全处理器2004至少采取一种行动,诸如,阻止电路段中的至少一个的操作、执行预先确定的操作,和/或重置主处理器2006。例如,安全处理器2004在检测到故障时可断开马达功率开关2020,以切断到马达电路段2002g的功率。
在一个实施方案中,安全处理器2004被构造成能够执行独立的控制算法。在操作中,安全处理器2004监控分段电路2000并且被构造成能够独立地控制和/或覆写来自其他电路部件诸如主处理器2006的信号。安全处理器2004可执行预先编程的算法并且/或者在操作期间可基于外科器械10的一种或多种行动和/或位置进行联机更新或联机编程。例如,在一个实施方案中,每当新的轴和/或端部执行器联接到外科器械10时,便使用新的参数和/或安全算法对安全处理器2004进行重新编程。在一些实施方案中,安全处理器2004存储的一个或多个安全值由主处理器2006复制。执行双向错误检测,以确保处理器2004或2006存储的值和/或参数是正确的。
在一些实施方案中,安全处理器2004和主处理器2006实施冗余的安全检查。安全处理器2004和主处理器2006提供周期性信号,用于指示操作正常。例如,在操作期间,安全处理器2004可向主处理器2006指示安全处理器2004正在执行代码并且操作正常。主处理器2006同样可向安全处理器2004指示主处理器2006正在执行代码并且操作正常。在一些实施方案中,安全处理器2004和主处理器2006以预先确定的间隔通信。预先确定的间隔可以是常数,也可能可依据电路状态和/或外科器械10的操作而改变。
图22示出了功率组件2100的一个示例,该功率组件包括被构造成能够监控功率组件2100的使用循环计数的使用循环电路2102。功率组件2100可联接到外科器械2110。使用循环电路2102包括处理器2104和使用指示器2106。使用指示器2106被构造成能够向处理器2104提供信号,以指示电池组2100和/或联接到功率组件2100的外科器械2110的使用情况。“使用情况”可包括任何合适的动作、条件和/或参数,例如,改变外科器械2110的模块化部件、部署或击发联接到外科器械2110的一次性部件、从外科器械2110递送电外科能量、修复外科器械2110和/或功率组件2100、交换功率组件2100、为功率组件2100再充电,和/或超出外科器械2110和/或电池组2100的安全限制。
在一些情况下,使用循环或使用情况由一个或多个功率组件2100参数限定。例如,在一种情况下,当功率组件2100处于完全充电水平时,使用循环包括使用大于5%的可得自功率组件2100的总能量。在另一种情况下,使用循环包括超出预先确定的时间限值的从功率组件2100的连续能量消耗。例如,使用循环可对应于从功率组件2100连续和/或总能量消耗五分钟。在一些情况下,功率组件2100包括使用循环电路2102,该使用循环电路存在连续功率消耗,以将使用循环电路2102的一个或多个部件例如使用指示器2106和/或计数器2108保持在操作状态下。
处理器2104保持着使用循环计数。使用循环计数指示出由使用指示器2106检测到的功率组件2100和/或外科器械2110的使用次数。处理器2104可根据来自使用指示器2106的输入而增加和/或减少使用循环计数。使用循环计数用于控制功率组件2100和/或外科器械2110的一个或多个操作。例如,在一些情况下,当使用循环计数超出预先确定的使用限度时,停用功率组件2100。尽管本文所述情况是相对于增加使用循环计数使其超出预先确定的使用限度而论述的,但本领域中的那些技术人员将认识到,使用循环计数可开始于某个预先确定的量,并可由处理器2104减少。在这种情况下,当使用循环计数降至低于预先确定的使用限度时,处理器2104即启动和/或阻止功率组件2100的一个或多个操作。
使用循环计数由计数器2108保持。计数器2108包括任何合适的电路,例如,存储器模块、模拟计数器和/或被构造成能够保持使用循环计数的任何电路。在一些情况下,计数器2108与处理器2104一体地形成。在其他情况下,计数器2108包括单独的部件,例如固态存储器模块。在一些情况下,使用循环计数被提供给远程系统,例如中央数据库。使用循环计数由通信模块2112传输到远程系统。通信模块2112被构造成能够使用任何合适的通信媒介,例如,有线和/或无线通信。在一些情况下,通信模块2112被构造成能够在使用循环计数超出预先确定的使用限度时,接收来自远程系统的一个或多个指令,例如控制信号。
在一些情况下,使用指示器2106被构造成能够监控与联接到功率组件2100的外科器械2110一起使用的模块化部件的数目。模块化部件可包括例如模块化轴、模块化端部执行器、和/或任何其他模块化部件。在一些情况下,使用指示器2106监控一个或多个一次性部件的使用情况,例如,在联接到外科器械2110的端部执行器内插入和/或部署钉仓的情况。使用指示器2106包括一个或多个传感器,这些传感器用于检测外科器械2110的一个或多个模块化和/或一次性部件的交换。
在一些情况下,使用指示器2106被构造成能够监控在已安装功率组件2100时进行的单次患者外科手术。例如,当功率组件2100联接到外科器械2110时,使用指示器2106可被构造成能够监控外科器械2110的击发。击发可对应于钉仓的部署、电外科能量的施加和/或任何其他合适的外科事件。使用指示器2106可包括用于在已安装功率组件2100时测量击发次数的一个或多个电路。当进行单次患者手术时,使用指示器2106向处理器2104提供信号,然后处理器2104增加使用循环计数。
在一些情况下,使用指示器2106包括被构造成能够监控功率源2114的一个或多个参数(例如,自功率源2114消耗的电流)的电路。功率源2114的一个或多个参数对应于可由外科器械2110执行的一个或多个操作,例如,切割和缝合操作。使用指示器2106向处理器2104提供一个或多个参数,当这一个或多个参数指示出手术已进行时,该处理器增加使用循环计数。
在一些情况下,使用指示器2106包括被构造成能够在预先确定的时间段后增加使用循环计数的计时电路。预先确定的时间段对应于单次患者手术时间,即操作者执行手术(例如,切割和缝合手术)所需的时间。当功率组件2100联接到外科器械2110时,处理器2104轮询使用指示器2106,以确定单次患者手术时间是否已结束。若预先确定的时间段已经过去,处理器2104则增加使用循环计数。在增加使用循环计数之后,处理器2104重置用户指示器2106的计时电路。
在一些情况下,使用指示器2106包括与单次患者手术时间近似的时间常数。在一个实施方案中,使用循环电路2102包括电阻器-电容器(RC)计时电路2506。RC计时电路包括由电阻器-电容器对限定的时间常数。时间常数由电阻器和电容器的值限定。在一个实施方案中,使用循环电路2552包括可再充电电池和时钟。当功率组件2100安装在外科器械中时,可再充电电池由电源充电。可再充电电池包括足够的功率以使时钟运行至少单次患者手术时间。时钟可包括实时时钟、被构造成能够实现计时功能的处理器或任何其他合适的计时电路。
重新参见图2,在一些情况下,使用指示器2106包括传感器,该传感器被构造成能够监控功率组件2100所经受的一种或多种环境条件。例如,使用指示器2106可包括加速度计。加速度计被构造成能够监控功率组件2100的加速度。功率组件2100具有最大加速度耐受度。加速度超过预先确定的阈值表示例如功率组件2100已被放下。当使用指示器2106检测到加速度超过最大加速度耐受度时,处理器2104增加使用循环计数。在一些情况下,使用指示器2106包括水分传感器。水分传感器被构造成能够在功率组件2100已暴露于水分时进行指示。水分传感器可包括例如被构造成能够指示功率组件2100何时已完全浸入清洁流体中的浸没传感器、被构造成能够指示使用期间水分何时接触功率组件2100的水分传感器、和/或任何其他合适的水分传感器。
在一些情况下,使用指示器2106包括化学品接触传感器。化学品接触传感器被构造成能够在功率组件2100已经与有害和/或危险化学品接触时进行指示。例如,在消毒期间,可能使用了导致功率组件2100劣化的不适用的化学品。当使用指示器2106检测到不适用的化学品时,处理器2104增加使用循环计数。
在一些情况下,使用循环电路2102被构造成能够监控功率组件2100所历经的修复循环次数。修复循环可包括例如清洁循环、消毒循环、充电循环、常规和/或预防维修、和/或任何其他合适的修复循环。使用指示器2106被构造成能够检测修复循环。例如,使用指示器2106可包括水分传感器以检测清洁和/或消毒循环。在一些情况下,使用循环电路2102监控功率组件2100所历经的修复循环次数,并在修复循环次数超出预先确定的阈值之后,停用功率组件2100。
使用循环电路2102可被构造成能够监控功率组件2100交换的次数。每当交换功率组件2100时,使用循环电路2102便增加使用循环计数。当超出最大交换次数时,使用循环电路2102锁定功率组件2100和/或外科器械2110。在一些情况下,当功率组件2100联接到外科器械2110时,使用循环电路2102识别功率组件2100的序列号并锁定功率组件2100,使得功率组件2100只能与外科器械2110一起使用。在一些情况下,每当功率组件2100从外科器械2110移除和/或联接到该外科器械时,使用循环电路2102增加使用循环。
在一些情况下,使用循环计数对应于功率组件2100的消毒。使用指示器2106包括被构造成能够检测消毒循环的一个或多个参数(例如,温度参数、化学参数、水分参数和/或任何其他合适的参数)的传感器。当检测到消毒参数时,处理器2104增加使用循环计数。在预先确定的消毒次数之后,使用循环电路2102停用功率组件2100。在一些情况下,使用循环电路2102在消毒循环、电压传感器和/或任何合适的传感器检测再充电循环期间被重置。当检测到修复循环时,处理器2104增加使用循环计数。当检测到消毒循环时,停用使用循环电路2102。当功率组件2100联接到外科器械2110时,重新激活和/或重置使用循环电路2102。在一些情况下,使用指示器包括零功率指示器。零功率指示器在消毒循环期间改变状态,并当功率组件2100联接到外科器械2110时由处理器2104检查。当零功率指示器指示已经发生消毒循环时,处理器2104增加使用循环计数。
计数器2108保持着使用循环计数。在一些情况下,计数器2108包括非易失性存储器模块。每当检测到使用循环时,处理器2104便增加存储在非易失性存储器模块中的使用循环计数。存储器模块可由处理器2104和/或控制电路(例如,控制电路200)访问。当使用循环计数超出预先确定的阈值时,处理器2104停用功率组件2100。在一些情况下,使用循环计数由多个电路部件保持。例如,在一种情况下,计数器2108包括电阻器(或熔断器)组。在每次使用功率组件2100之后,电阻器(或熔断器)可被烧断成打开位置,从而改变电阻器组的电阻。功率组件2100和/或外科器械2110读取剩余的电阻值。当电阻器组的最后一个电阻器被烧坏时,电阻器组便具有预先确定的电阻(例如,对应于开式电路的无穷大电阻),这表明功率组件2100已经达到其使用限度。在一些情况下,电阻器组的电阻用于推导出剩余的使用次数。
在一些情况下,当使用循环计数超出预先确定的使用限度时,使用循环电路2102便阻止功率组件2100和/或外科器械2110的进一步使用。在一种情况下,例如,利用与外科器械2110一体形成的屏幕将与功率组件2100相关的使用循环计数提供给操作者。外科器械2110向操作者提供使用循环计数已经超出功率组件2100的预先确定的限值的指示,并阻止外科器械2110的进一步操作。
在一些情况下,使用循环电路2102被构造成能够当达到预先确定的使用限度时在物理上防止其操作。例如,功率组件2100可包括护罩,该护罩被构造成能够在使用循环计数超出预先确定的使用限度时部署在功率组件2100的触点上。该护罩通过覆盖功率组件2100的电连接件阻止功率组件2100的再充电及使用。
在一些情况下,使用循环电路2102至少部分地位于外科器械2110内,并被构造成能够保持外科器械2110的使用循环计数。图22以虚线示出了外科器械2110内的使用循环电路2102的一个或多个部件,并示出使用循环电路2102的替代定位。当超出外科器械2110的预先确定的使用限度时,使用循环电路2102停用和/或阻止外科器械2110的操作。当使用指示器2106检测到特定事件和/或需求(例如,外科器械2110的击发、对应于单次患者手术时间的预先确定的时间段)时,使用循环电路2102响应于表明达到了一个或多个预先确定的阈值和/或满足了任何其他合适需求的系统诊断,而根据外科器械2110的一个或多个马达参数递增使用循环计数。如上所论述,在一些情况下,使用指示器2106包括对应于单次患者手术时间的计时电路。在其他情况下,使用指示器2106包括一个或多个传感器,这些传感器被构造成能够检测外科器械2110的特定事件和/或条件。
在一些情况下,使用循环电路2102被构造成能够防止在达到预先确定的使用限度之后使用外科器械2110。在一些情况下,外科器械2110包括可视指示器,以便当已经达到和/或超过预先确定的使用限度时给出指示。例如,标记(诸如红色标记)可从外科器械2110(诸如从柄部)弹出,从而为操作者提供外科器械2110已超出预先确定的使用限度的视觉指示。又如,使用循环电路2102可联接到与外科器械2110一体地形成的显示器。使用循环电路2102显示出指示已经超出预先确定的使用限度的信息。外科器械2110可以向操作者提供已经超出预先确定的使用限度的听觉指示。例如,在一种情况下,当超出预先确定的使用限度时,外科器械2110发出可以听见的音调,然后将功率组件2100从外科器械2110移除。可以听见的音调指示出外科器械2110的最后一次使用,并指示应该丢弃或修复外科器械2110。
在一些情况下,使用循环电路2102被构造成能够将外科器械2110的使用循环计数传输到远程位置,例如,中央数据库。使用循环电路2102包括被构造成能够将使用循环计数传输到远程位置的通信模块2112。通信模块2112可利用任何合适的通信系统,例如有线和/或无线通信系统。远程位置可包括被构造成能够保持使用信息的中央数据库。在一些情况下,当功率组件2100联接到外科器械2110时,功率组件2100记录外科器械2110的序列号。例如,当功率组件2100联接到充电器时,该序列号被传输到中央数据库。在一些情况下,中央数据库保持着对应于外科器械2110的每一次使用的计数。例如,每次使用外科器械2110时,与外科器械2110相关联的条形码便可被扫描。当使用计数超过预先确定的使用限度时,中央数据库向外科器械2110提供指示应该丢弃外科器械2110的信号。
外科器械2110可被构造成能够当使用循环计数超出预先确定的使用限度时锁定和/或阻止操作外科器械2110。在一些情况下,外科器械2110包括一次性仪器,并且在使用循环计数超出预先确定的使用限度之后被丢弃。在其他情况下,外科器械2110包括可重复使用的外科器械,该外科器械可在使用循环计数超出预先确定的使用限度之后被修复。在达到预先确定的使用限度之后,外科器械2110引发可逆闭锁。技术人员例如利用被构造成能够重置使用循环电路2102的专业技术键来修复外科器械2110并释放闭锁。
在一些实施方案中,分段电路2000被构造成能够顺序地启动。先由每个电路段2002a-2002g执行错误检查,再对顺序的下一个电路段2002a-2002g通电。图23示出了用于对分段电路2270,例如分段电路2000顺序地通电的过程的一个实施方案。当电池2008联接到分段电路2000时,安全处理器2004通电2272。安全处理器2004执行错误自检2274。当检测到错误时2276a,安全处理器停止对分段电路2000供电并生成错误代码2278a。当未检测到错误时2276b,安全处理器2004开始对主处理器2006加电2278b。主处理器2006执行错误自检。当未检测到错误时,主处理器2006开始对剩余的电路段中的每个顺序地加电2278b。主处理器2006对每个电路段进行供电及错误检查。当未检测到错误时,对下一个电路段通电2278b。当检测到错误时,安全处理器2004和/或主处理器停止对电流段通电,并生成错误2278a。继续顺序地启动,直到电路段2002a-2002g已全部通电为止。在一些实施方案中,分段电路2000在相似的顺序加电过程11250之后从睡眠模式进行转变。
图24示出了功率段2302的一个实施方案,该功率段包括多个菊花链式功率转换器2314,2316,2318。功率段2302包括电池2308。电池2308被构造成能够提供源电压,诸如12V的电压。电流传感器2312联接到电池2308,以监控分段电路和/或一个或多个电路段的电流消耗。电流传感器2312联接到FET开关2313。电池2308联接到一个或多个电压转换器2309,2314,2316。始终接通的转换器2309向一个或多个电路部件例如运动传感器2322提供恒定的电压。始终接通的转换器2309包括例如3.3V转换器。始终接通的转换器2309可向附加电路部件例如安全处理器(未示出)提供恒定的电压。电池2308联接到升压转换器2318。升压转换器2318被构造成能够提供大于由电池2308所提供电压的升压电压。例如,在所示实施方案中,电池2308提供12V的电压。升压转换器2318被构造成能够将该电压升高至13V。升压转换器2318被构造成能够在外科器械(例如,图69至图71中示出的外科器械10)的操作期间维持最小的电压。马达的操作可引起提供给主处理器2306的功率降到低于最小阈值,并且在主处理器2306中产生电压降低或重置状况。升压转换器2318确保在外科器械10的操作期间有足够的功率可用于主处理器2306和/或其他电路部件,诸如马达控制器2343。在一些实施方案中,升压转换器2318直接联接到一个或多个电路部件,诸如OLED显示器2388。
升压转换器2318联接到一个或多个降压转换器,以提供低于升压电压水平的电压。第一电压转换器2316联接到升压转换器2318,并且向一个或多个电路部件提供降低的电压。在所示实施方案中,第一电压转换器2316提供5V的电压。第一电压转换器2316联接到旋转位置编码器2340。FET开关2317联接在第一电压转换器2316和旋转位置编码器2340之间。FET开关2317由处理器2306来控制。处理器2306例如在功率密集操作期间断开FET开关2317,以去激活位置编码器2340。第一电压转换器2316联接到第二电压转换器2314,该第二降压转换器被构造成能够提供第二降低的电压。第二降低的电压包括例如3.3V的电压。第二电压转换器2314联接到处理器2306。在一些实施方案中,升压转换器2318、第一电压转换器2316和第二电压转换器2314以菊花链式构型联接。菊花链式构型允许使用更小且更高效的转换器以用于产生低于该升压电压水平的电压水平。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
图25示出了分段电路2400的一个实施方案,该分段电路被构造成能够使可用于电路和/或功率密集功能的功率最大化。分段电路2400包括电池2408。电池2408被构造成能够提供源电压,例如12V的电压。源电压被提供给多个电压转换器2409,2418。始终接通的电压转换器2409向一个或多个电路部件例如运动传感器2422和安全处理器2404提供恒定的电压。始终接通的电压转换器2409直接联接到电池2408。始终接通的电压转换器2409提供例如3.3V的电压。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
分段电路2400包括升压转换器2418。升压转换器2418提供大于由电池2408所提供源电压(例如13V)的升压电压。升压转换器2418直接向一个或多个电路部件例如OLED显示器2488和马达控制器2443提供升压电压。通过将OLED显示器2488直接联接到升压转换器2418,分段电路2400消除了专门用于OLED显示器2488的功率转换器的需要。升压转换器2418在马达2448的一个或多个功率密集操作例如切割操作期间向马达控制器2443和马达2448提供升压电压。升压转换器2418联接到降压转换器2416。降压转换器2416被构造成能够将低于所述升压电压的电压(例如5V)提供给一个或多个电路部件。降压转换器2416联接到例如FET开关2451和位置编码器2440。FET开关2451联接到主处理器2406。当分段电路2400转变到休眠模式时,并且/或者在需要将额外的电压传送给马达2448的功率密集功能期间,主处理器2406断开FET开关2451。断开FET开关2451去激活位置编码器2440,并且消除了位置编码器2440的功率消耗。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
降压转换器2416联接到线性转换器2414。线性转换器2414被构造成能够提供例如3.3V的电压。线性转换器2414联接到主处理器2406。线性转换器2414向主处理器2406提供操作电压。线性转换器2414可联接到一个或多个额外的电路部件。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
分段电路2400包括应急开关2456。应急开关2456联接到外科器械10上的应急门。应急开关2456和安全处理器2404联接到与门2419。与门2419向FET开关2413提供输入。当应急开关2456检测到电压降低的状况时,应急开关2456向与门2419提供应急关闭信号。当安全处理器2404检测到例如由于传感器失配而引起的不安全状况时,安全处理器2404向与门2419提供关闭信号。在一些实施方案中,应急关闭信号和关闭信号两者在正常操作期间都较高,并且当检测到电压降低状况或不安全的状况时都较低。当与门2419的输出较低时,FET开关2413是断开的,并且马达2448的操作受到阻止。在一些实施方案中,安全处理器2404利用关闭信号将马达2448转变到休眠模式下的关闭状态。由联接到电池2408的电流传感器2412向FET开关2413提供第三输入。电流传感器2412监控由电路2400消耗的电流,并且当检测到电流大于预先确定的阈值时,断开FET开关2413从而关闭马达2448的电源。FET开关2413和马达控制器2443联接到被构造成能够控制马达2448的操作的一组FET开关2445。
马达电流传感器2446与马达2448串联联接,从而向电流监控器2447提供马达电流传感器读数。电流监控器2447联接到主处理器2406。电流监控器2447提供了指示马达2448电流消耗的信号。主处理器2406可利用来自马达电流监控器2447的信号来控制马达的操作,例如,以确保马达2448的电流消耗位于可接受范围内、将马达2448的电流消耗与电路2400(诸如位置编码器2440)的一个或多个其他参数进行比较、和/或确定治疗部位的一个或多个参数。在一些实施方案中,电流监控器2447可联接到安全处理器2404。
在一些实施方案中,一个或多个柄部控件例如击发触发器的致动引起主处理器2406在柄部控件被致动时降低供给一个或多个部件的功率。例如,在一个实施方案中,击发触发器控制切割构件的击发行程。切割构件由马达2448驱动。击发触发器的致动引起马达2448的向前操作和切割构件的推进。在击发期间,主处理器2406闭合FET开关2451,以从位置编码器2440移除功率。一个或多个电路部件的去激活允许更高的功率传送至马达2448。当击发触发器被释放时,例如,通过闭合FET开关2451并且再激活位置编码器2440,全功率恢复至停用的部件。
在一些实施方案中,安全处理器2404控制分段电路2400的操作。例如,安全处理器2404可启动分段电路2400的顺序加电、分段电路2400进入和退出睡眠模式的转变,和/或可覆写来自主处理器2406的一个或多个控制信号。例如,在所示实施方案中,安全处理器2404联接到降压转换器2416。安全处理器2404通过激活或去激活降压转换器2416来控制分段电路2400的操作,以向分段电路2400的其余部分提供功率。
图26示出了功率系统2500的一个实施方案,该功率系统包括被构造成能够被顺序通电的多个菊花链式功率转换器2514,2516,2518。所述多个菊花链式功率转换器2514,2516,2518可在初始加电和/或转变自休眠模式期间被例如安全处理器顺序地激活。安全处理器可由独立的功率转换器(未示出)供电。例如,在一个实施方案中,当电池电压VBATT联接到功率系统2500并且/或者加速度计检测到睡眠模式下的运动时,安全处理器引发菊花链式功率转换器2514,2516,2518的顺序启动。安全处理器激活13V升压段2518。升压段2518通电并执行自检。在一些实施方案中,升压段2518包括集成电路2520,该集成电路被构造成能够升高源电压并执行自检。二极管D阻止5V供电段2516加电,直到升压段2518已完成自检并已向二极管D提供了指示升压段2518未识别到任何错误的信号为止。在一些实施方案中,由安全处理器提供该信号。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
5V供电段2516被顺序地在升压段2518之后通电。5V供电段2516在加电期间执行自检,以识别5V供电段2516中的任何错误。5V供电段2516包括集成电路2515,该集成电路被构造成能够从升压电压提供降低电压,并能够执行错误检查。当未检测到错误时,5V供电段2516完成顺序加电,并向3.3V供电段2514提供激活信号。在一些实施方案中,安全处理器向3.3V供电段2514提供激活信号。3.3V供电段包括集成电路2513,该集成电路被构造成能够由5V供电段2516提供降低电压,并能够在加电期间执行错误自检。当在自检期间未检测到错误时,3.3V供电段2514向主处理器提供功率。主处理器被构造成能够顺序地对剩余的电路段中的每个供电。通过顺序地对功率系统2500和/或分段电路的剩余部分供电,功率系统2500降低了错误风险,在施加负荷之前实现电压水平的稳定性,并防止所有硬件以不可控的方式同时被接通而产生较大的电流消耗。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
在一个实施方案中,功率系统2500包括过压识别及消减电路。过压识别及消减电路被构造成能够检测外科器械中的单极返回电流,并且在检测到单极返回电流时中断来自功率段的功率。过压识别及消减电路被构造成能够识别功率系统的地电浮动。过压识别及消减电路包括金属氧化物变阻器。过压识别及消减电路至少包括一个瞬时电压抑制二极管。
图27示出了包括单点控制节段2602的分段电路2600的一个实施方案。单点控制节段2602使分段电路2600的控制硬件与分段电路2600的功率节段(未示出)隔离。控制节段2602包括例如主处理器2606、安全处理器(未示出),和/或附加的控制硬件(例如FET开关2617)。功率节段包括例如马达、马达驱动器和/或多个马达MOSFET。单点控制节段2602包括充电电路2603和联接到5V功率转换器2616的可再充电电池2608。充电电路2603和可再充电电池2608使主处理器2606与功率节段隔离。在一些实施方案中,可再充电电池2608联接到安全处理器和任一附加的支持硬件。使控制节段2602与功率节段隔离允许控制节段2602(例如主处理器2606)保持活动的(甚至当主电源被移除时)、穿过可再充电电池2608提供过滤器以保持噪声远离控制节段2602、使控制节段2602与电池电压中的剧烈变化隔离以确保适当的操作(甚至在较大的马达负载期间)、并且/或者允许实时操作系统(RTOS)被分段电路2600使用。在一些实施方案中,可再充电电池2608向主处理器提供降低电压,例如,3.3V的电压。然而,这些实施方案不限于本说明书的上下文中所述的特定电压范围。
其中一个传感器影响第二传感器的输出或判读的多个传感器的使用
图28示出了包括第一传感器3008a和第二传感器3008b的端部执行器3000的一个实施方案。端部执行器3000类似于上述端部执行器300。端部执行器3000包括能够枢转地联接到第二钳口构件3004的第一钳口构件或砧座3002。第二钳口构件3004被构造成能够在其中接收钉仓3006。钉仓3006包括多个钉(未示出)。多个钉能够在外科操作期间从钉仓3006部署。端部执行器3000包括第一传感器3008a。第一传感器3008a被构造成能够测量端部执行器3000的一个或多个参数。例如,在一个实施方案中,第一传感器3008a被构造成能够测量砧座3002与第二钳口构件3004之间的间隙3010。第一传感器3008a可包括例如霍尔效应传感器,该霍尔效应传感器被构造成能够检测由嵌入第二钳口构件3004和/或钉仓3006中的磁体3012产生的磁场。又如,在一个实施方案中,第一传感器3008a被构造成能够测量由第二钳口构件3004和/或夹持在砧座3002和第二钳口构件3004之间的组织施加到砧座3002上的一个或多个力。
端部执行器3000包括第二传感器3008b。第二传感器3008b被构造成能够测量端部执行器3000的一个或多个参数。例如,在各种实施方案中,第二传感器3008b可包括应变仪,该应变仪被构造成能够测量夹持状态期间的砧座3002中的应变量值。应变仪提供电信号,该电信号的幅值随着应变量值而变化。在各种实施方案中,第一传感器3008a和/或第二传感器3008b可包括例如磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或用于测量端部执行器3000的一个或多个参数的任何其他合适的传感器。第一传感器3008a和第二传感器3008b可被布置成串联构型和/或并联构型。在串联构型中,第二传感器3008b可被构造成能够直接影响第一传感器3008a的输出。在并联构型中,第二传感器3008b可被构造成能够间接影响第一传感器3008a的输出。
在一个实施方案中,由第一传感器3008a测得的一个或多个参数与由第二传感器3008b测得的一个或多个参数相关。例如,在一个实施方案中,第一传感器3008a被构造成能够测量砧座3002与第二钳口构件3004之间的间隙3010。间隙3010表示夹持在砧座3002和钉仓3006之间的组织节段的厚度和/或可压缩性。第一传感器3008a可包括例如霍尔效应传感器,该霍尔效应传感器被构造成能够检测由联接到第二钳口构件3004和/或钉仓3006的磁体3012产生的磁场。单个位置处的精确测量可描述经校正的组织的完全咬合的压缩组织厚度,但在组织的部分咬合设置在砧座3002与第二钳口构件3004之间时可提供不精确的结果。组织的部分咬合(近侧部分咬合或远侧部分咬合)改变砧座3002的夹持几何形状。
在一些实施方案中,第二传感器3008b被构造成能够检测指示组织咬合类型(例如,完全咬合、部分近侧咬合、和/或部分远侧咬合)的一个或多个参数。第二传感器3008b的测量结果可用于调整第一传感器3008a的测量结果以精确地表示近侧或远侧定位的部分咬合的真实压缩组织厚度。例如,在一个实施方案中,第二传感器3008b包括应变仪诸如微应变仪,该应变仪被构造成能够监控夹持状态期间的砧座中的应变幅值。砧座3002的应变幅值用于修改第一传感器3008a例如霍尔效应传感器的输出,以精确地表示近侧或远侧定位的部分咬合的真实压缩组织厚度。可在夹持操作期间实时地测量第一传感器3008a和第二传感器3008b。实时测量结果允许基于时间的信息例如由主处理器2006进行分析并且用于选择一个或多个算法和/或查找表,由此识别组织特性和夹持定位,以动态地调整组织厚度测量结果。
在一些实施方案中,可将第一传感器3008a的组织测量结果提供给联接到端部执行器3000的外科器械10的输出装置。例如,在一个实施方案中,端部执行器3000联接到包括显示器2028的外科器械10。将第一传感器3008a的测量结果提供给处理器,例如,主处理器2006。主处理器2006基于第二传感器3008b的测量结果调整第一传感器3008a的测量结果,以反映夹持在砧座3002与钉仓3006之间的组织节段的真实组织厚度。主处理器2006将调整的组织厚度测量结果和完全或部分咬合的指示输出到显示器2028。操作者可基于显示的值来确定是否部署钉仓3006中的钉。
在一些实施方案中,第一传感器3008a和第二传感器3008b可定位在不同的环境中,例如,第一传感器3008a钉为在患者体内的治疗部位处并且第二传感器3008b定位在患者的外部。第二传感器3008b可被构造成能够校正和/或修改第一传感器3008a的输出。第一传感器3008a和/或第二传感器3008b可包括例如环境传感器。环境传感器可包括例如温度传感器、湿度传感器、压力传感器、和/或任何其他合适的环境传感器。
图29为逻辑图,其示出了用于基于得自第二传感器3008b的输入来确定第一传感器3008a的测量结果的方法3020的一个实施方案。通过第一传感器3008a捕集第一信号3022a。可基于一个或多个预先确定的参数(例如,平滑函数、查找表、和/或任何其他合适的调理参数)调理第一信号3022a。通过第二传感器3008b捕集第二信号3022b。可基于一个或多个预先确定的调理参数调理第二信号3022b。将第一信号3022a和第二信号3022b提供给处理器,例如,主处理器2006。处理器2006基于得自第二传感器的第二信号3022b调整由第一信号3022a表示的第一传感器3022a的测量结果。例如,在一个实施方案中,第一传感器3022a包括霍尔效应传感器并且第二传感器3022b包括应变仪。通过由第二传感器3022b测得的应变幅值调整第一传感器3022a的测量结果,以确定端部执行器3000中的组织咬合的完全性。将调整的测量结果通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图30为逻辑图,其示出了用于基于得自第二传感器3008b的输入来确定第一传感器3008a的查找表的方法3030的一个实施方案。第一传感器3008a捕集指示端部执行器3000的一个或多个参数的信号3022a。可基于一个或多个预先确定的参数(例如,平滑函数、查找表、和/或任何其他合适的调理参数)调理第一信号3022a。通过第二传感器3008b捕集第二信号3022b。可基于一个或多个预先确定的调理参数调理第二信号3022b。将第一信号3022a和第二信号3022b提供给处理器,例如,主处理器2006。处理器2006基于第二信号的值从一个或多个可用查找表3034a,3034b选择查找表。所选择的查找表用于将第一信号转换成定位在砧座3002与钉仓3006之间的组织的厚度测量结果。将调整的测量结果通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图31为逻辑图,其示出了用于响应于得自第二传感器3008b的输入来校正第一传感器3008a的方法3040的一个实施方案。第一传感器3008a被构造成能够捕集指示端部执行器3000的一个或多个参数的信号3022a。可基于一个或多个预先确定的参数(例如,平滑函数、查找表、和/或任何其他合适的调理参数)调理第一信号3022a。通过第二传感器3008b捕集第二信号3022b。可基于一个或多个预先确定的调理参数调理第二信号3022b。将第一信号3022a和第二信号3022b提供给处理器,例如,主处理器2006。主处理器2006响应于第二信号3022b来校正3042第一信号3022a。校正3042第一信号3022a以反映端部执行器3000中的组织咬合的完全性。将校正的信号通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图32A为逻辑图,其示出了用于确定并且显示被夹持在端部执行器3000的砧座3002和钉仓3006之间的组织节段的厚度的方法3050的一个实施方案。方法3050包括通过例如定位在砧座3002的远侧末端处的霍尔效应传感器获得霍尔效应电压3052。将霍尔效应电压3052提供给模数转换器3054并且转换成数字信号。将数字信号提供给处理器,例如,主处理器2006。主处理器2006校正3056霍尔效应电压3052信号的曲线输入。应变仪3058(例如,微应变仪)被构造成能够测量端部执行器3000的一个或多个参数,例如,夹持操作期间施加到砧座3002上的应变的幅值。将测得的应变转换3060成数字信号并且提供给处理器,例如,主处理器2006。主处理器2006响应于由应变仪3058测得的应变来利用一个或多个算法和/或查找表调整霍尔效应电压3052,以反映由砧座3002和钉仓3006夹持的组织的真实厚度和咬合完全性。将调整的厚度通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
在一些实施方案中,外科器械还可包括负荷元件或负荷传感器3082。负荷传感器3082可定位在例如轴组件200中(如上所述)或者壳体12中(也如上所述)。图32B为逻辑图,其示出了用于确定并且显示被夹持在端部执行器3000的砧座3002和钉仓3006之间的组织节段的厚度的方法3070的一个实施方案。该方法包括通过例如定位在砧座3002的远侧末端处的霍尔效应传感器获得霍尔效应电压3072。将霍尔效应电压3072提供给模数转换器3074并且转换成数字信号。将数字信号提供给处理器,例如,主处理器2006。主处理器2006对霍尔效应电压3072信号的曲线输入施加校正3076。应变仪3078(例如,微应变仪)被构造成能够测量端部执行器3000的一个或多个参数,例如,夹持操作期间施加到砧座3002上的应变的幅值。将测得的应变转换3080成数字信号并且提供给处理器,例如,主处理器2006。负荷传感器3082测量砧座3002相对于钉仓3006的夹持力。将测得的夹持力转换3084成数字信号并且提供给处理器,例如,主处理器2006。主处理器2006响应于由应变仪3078测得的应变和由负荷传感器3082测得的夹持力来利用一个或多个算法和/或查找表调整霍尔效应电压3072,以反映由砧座3002和钉仓3006夹持的组织的真实厚度和咬合完全性。将调整的厚度通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图33为示出与未修改的霍尔效应厚度测量结果3092进行比较的调整的霍尔效应厚度测量结果3094的曲线图3090。如图33所示,未修改的霍尔效应厚度测量结果3092指示较厚的组织测量结果,因为单个补偿器不能补偿部分远侧/近侧咬合,所述部分远侧/近侧咬合导致不正确的厚度测量结果。通过例如图32A所示的方法3050产生调整的厚度测量结果3094。基于得自一个或多个另外传感器(例如,应变仪)的输入来校正霍尔效应厚度测量结果3092。调整的霍尔效应厚度3094反映定位在砧座3002与钉仓3006之间的组织的真实厚度。
图34示出了包括第一传感器3108a和第二传感器3108b的端部执行器3100的一个实施方案。端部执行器3100类似于图28中所示的端部执行器3000。端部执行器3100包括能够枢转地联接到第二钳口构件3104的第一钳口构件或砧座3102。第二钳口构件3104被构造成能够在其中接收钉仓3106。端部执行器3100包括联接到砧座3102的第一传感器3108a。第一传感器3108a被构造成能够测量端部执行器3100的一个或多个参数,例如,砧座3102与钉仓3106之间的间隙3110。间隙3110可对应于例如夹持在砧座3102和钉仓3106之间的组织的厚度。第一传感器3108a可包括任何合适的传感器,以用于测量端部执行器的一个或多个参数。例如,在各种实施方案中,第一传感器3108a可包括磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。
在一些实施方案中,端部执行器3100包括第二传感器3108b。第二传感器3108b联接到第二钳口构件3104和/或钉仓3106。第二传感器3108b被构造成能够检测端部执行器3100的一个或多个参数。例如,在一些实施方案中,第二传感器3108b被构造成能够检测一个或多个器械状态,例如,联接到第二钳口构件3104的钉仓3106的颜色、钉仓3106的长度、端部执行器3100的夹持状态、端部执行器3100和/或钉仓3106的使用次数/剩余使用次数、和/或任何其他合适的器械状态。第二传感器3108b可包括用于检测一个或多个器械状态的任何合适的传感器,例如,磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。
端部执行器3100可与图29-33所示的方法一起使用。例如,在一个实施方案中,得自第二传感器3108b的输入可用于校正第一传感器3108a的输入。第二传感器3108b可被构造成能够检测钉仓3106的一个或多个参数,例如,钉仓3106的颜色和/或长度。检测的参数(例如,钉仓3106的颜色和/或长度)可对应于仓的一个或多个特性,例如,仓平台的高度、用于钉仓的可用/最佳组织厚度、和/或钉仓3106中的钉图案。钉仓3106的已知参数可用于调整由第一传感器3108a提供的厚度测量结果。例如,如果钉仓3106具有较高的平台高度,则可减小由第一传感器3108a提供的厚度测量结果以补偿增加的平台高度。可将调整的厚度通过例如联接到外科器械10的显示器2026显示给操作者。
图35示出了包括第一传感器3158和多个第二传感器3160a,3160b的端部执行器3150的一个实施方案。端部执行器3150包括第一钳口构件或砧座3152和第二钳口构件3154。第二钳口构件3154被构造成能够接收钉仓3156。砧座3152能够相对于第二钳口构件3154枢转地运动以将组织夹持在砧座3152与钉仓3156之间。砧座包括第一传感器3158。第一传感器3158被构造成能够检测端部执行器3150的一个或多个参数,例如,砧座3152与钉仓3156之间的间隙3110。间隙3110可对应于例如夹持在砧座3152和钉仓3156之间的组织的厚度。第一传感器3158可包括任何合适的传感器,以用于检测端部执行器的一个或多个参数。例如,在各种实施方案中,第一传感器3158可包括磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。
在一些实施方案中,端部执行器3150包括多个第二传感器3160a,3160b。第二传感器3160a,3160b被构造成能够检测端部执行器3150的一个或多个参数。例如,在一些实施方案中,第二传感器3160a,3160b被构造成能够测量夹持期间施加到砧座3152上的应变的幅值。在各种实施方案中,第二传感器3160a,3160b可包括磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。第二传感器3160a,3160b可被构造成能够测量砧座3152的不同位置处的一个或多个相同参数、砧座3152上的相同位置处的不同参数、和/或砧座3152上的不同位置处的不同参数。
图36为逻辑图,其示出了用于响应于多个第二传感器3160a,3160来调整第一传感器3158的测量结果的方法3170的一个实施方案。在一个实施方案中,例如通过霍尔效应传感器获得3172霍尔效应电压。通过模数转换器转换3174霍尔效应电压。校正3176所转换的霍尔效应电压信号。校正曲线表示定位在砧座3152与钉仓3156之间的组织节段的厚度。通过多个第二传感器(例如,多个应变仪)获得3178a,3178b多个第二测量结果。将应变仪的输入例如通过多个电子μ应变转换电路转换3180a,3180b成一个或多个数字信号。将校正的霍尔效应电压和多个第二测量结果提供给处理器,例如,主处理器2006。主处理器利用第二测量结果并且例如通过应用算法和/或使用一个或多个查找表来调整3182霍尔效应电压。调整的霍尔效应电压表示由砧座3152和钉仓3156夹持的组织的咬合的完全性。将调整的厚度通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图37示出了电路3190的一个实施方案,该电路被构造成能够将得自第一传感器3158和多个第二传感器3160a,3160b的信号转换成能够由处理器(例如,主处理器2006)接收的数字信号。电路3190包括模数转换器3194。在一些实施方案中,模数转换器3194包括4通道、18位模数转换器。本领域中的技术人员将会认识到,模数转换器3194可包括任何合适的通道数和/或位数以将一个或多个输入从模拟信号转换成数字信号。电路3190包括一个或多个电平转换电阻器3196,该电平转换电阻器被构造成能够接收得自第一传感器3158(例如,霍尔效应传感器)的输入。电平转换电阻器3196调整得自第一传感器的输入,由此将该值转换成较高或较低电压,这取决于输入。电平转换电阻器3196将得自第一传感器3158的电平转换输入提供给模数转换器。
在一些实施方案中,多个第二传感器3160a,3160b联接到多个电路3190内的桥3192a,3192b。多个桥3192a,3192b可对得自多个第二传感器3160a,3160b的输入提供滤波。在输入信号滤波之后,多个桥3192a,3192b将得自多个第二传感器3160a,3160b的输入提供给模数转换器3194。在一些实施方案中,联接到一个或多个电平转换电阻器的开关3198可联接到模数转换器3194。开关3198被构造成能够校正输入信号中的一个或多个,例如,得自霍尔效应传感器的输入。开关3198可用于提供一个或多个电平转换信号,以调整传感器中的一个或多个的输入,例如由此来将校正霍尔效应传感器的输入。在一些实施方案中,调整并非必需的,并且开关3198保持在打开位置以断开电平转换电阻器。开关3198联接到模数转换器3194。模数转换器3194将输出提供给一个或多个处理器,例如,主处理器2006。主处理器2006基于得自模数转换器3194的输入来计算端部执行器3150的一个或多个参数。例如,在一个实施方案中,主处理器2006基于得自一个或多个传感器3158,3160a,3160b的输入来计算定位在砧座3152与钉仓3156之间的组织的厚度。
图38示出了包括多个传感器3208a-3208d的端部执行器3200的一个实施方案。端部执行器3200包括能够枢转地联接到第二钳口构件3204的砧座3202。第二钳口构件3204被构造成能够在其中接收钉仓3206。砧座3202包括其上的多个传感器3208a-3208d。多个传感器3208a-3208d被构造成能够检测端部执行器3200(诸如砧座3202)的一个或多个参数。多个传感器3208a-3208d可包括一个或多个相同传感器和/或不同传感器。多个传感器3208a-3208d可包括例如磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器或者它们的组合。例如,在一个实施方案中,多个传感器3208a-3208d可包括多个应变仪。
在一个实施方案中,多个传感器3208a-3208d允许实现强健性组织厚度感测方法。通过检测沿砧座3202的长度的各个参数,多个传感器3208a-3208d允许外科器械(例如,外科器械10)计算钳口中的组织厚度,而无论咬合如何,例如,部分咬合或完全咬合。在一些实施方案中,多个传感器3208a-3208d包括多个应变仪。多个应变仪被构造成能够测量砧座3202上的各个点处的应变。砧座3202上的各个点中的每个处的应变的幅值和/或斜率可用于确定砧座3202与钉仓3206之间的组织的厚度。多个应变仪可被构造成能够基于夹持动力学来优化最大幅值和/或斜率差,以确定厚度、组织布置方式、和/或组织的材料特性。夹持期间的多个传感器3208a-3208d的基于时间的检测允许处理器(例如,主处理器2006)利用算法和查找表来识别组织特性和夹持位置并且动态地调整端部执行器3200和/或夹持在砧座3202与钉仓3206之间的组织。
图39为逻辑图,其示出了用于基于多个传感器3208a-3208d来确定一个或多个组织特性的方法3220的一个实施方案。在一个实施方案中,多个传感器3208a-3208d产生3222a-3222d指示端部执行器3200的一个或多个参数的多个信号。将多个产生的信号转换3224a-3224d成数字信号并且提供给处理器。例如,在包括多个应变仪的一个实施方案中,多个电子μStrain(微应变)转换电路将应变仪信号转换3224a-3224d成数字信号。将数字信号提供给处理器,例如,主处理器2006。主处理器2006基于所述多个信号来确定3226一个或多个组织特性。处理器2006可通过应用算法和/或查找表来确定一个或多个组织特性。将一个或多个组织特性通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图40示出了包括联接到第二钳口构件3254的多个传感器3260a-3260d的端部执行器3250的一个实施方案。端部执行器3250包括能够枢转地联接到第二钳口构件3254的砧座3252。砧座3252能够相对于第二钳口构件3254运动以在两者间夹持一种或多种材料,例如,组织节段3264。第二钳口构件3254被构造成能够接收钉仓3256。第一传感器3258联接到砧座3252。第一传感器被构造成能够检测端部执行器3150的一个或多个参数,例如,砧座3252与钉仓3256之间的间隙3110。间隙3110可对应于例如夹持在砧座3252和钉仓3256之间的组织的厚度。第一传感器3258可包括任何合适的传感器,以用于检测端部执行器的一个或多个参数。例如,在各种实施方案中,第一传感器3258可包括磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。
多个第二传感器3260a-3260d联接到第二钳口构件3254。多个第二传感器3260a-3260d可与第二钳口构件3254和/或钉仓3256一体地形成。例如,在一个实施方案中,多个第二传感器3260a-3260d设置在钉仓3256的外侧排上(参见图41)。多个第二传感器3260a-3260d被构造成能够检测端部执行器3250和/或夹持在砧座3252与钉仓3256之间的组织节段3264的一个或多个参数。多个第二传感器3260a-3260d可包括用于检测端部执行器3250和/或组织节段3264的一个或多个参数的任何合适的传感器,例如,磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器或者它们的组合。多个第二传感器3260a-3260d可包括相同的传感器和/或不同的传感器。
在一些实施方案中,多个第二传感器3260a-3260d包括两用传感器和组织稳定元件。多个第二传感器3260a-3260d包括电极和/或感测几何结构,该电极和/或感测几何结构被构造成能够当多个第二传感器3260a-3260d例如在夹持操作期间与组织节段3264时产生稳定组织状态。在一些实施方案中,多个第二传感器3260a-3260d中的一个或多个可用非感测组织稳定元件替换。第二传感器3260a-3260d通过控制夹持、缝合、和/或其他处理过程期间的组织流动、钉变形、和/或其他组织状态来产生稳定组织状态。
图41示出了钉仓3270的一个实施方案,该钉仓包括一体地形成于其中的多个传感器3272a-3272h。钉仓3270包括多个排,所述多个排容纳多个孔以用于在其中存储钉。外侧排3278中的一个或多个孔用多个传感器3272a-3272h中的一个替换。剖面部分3274被示出以图解说明联接到传感器线3276b的传感器3272f。传感器线3276a,3276b可包括多个线以用于将多个传感器3272a-3272h联接到外科器械(例如,外科器械10)的一个或多个电路。在一些实施方案中,多个传感器3272a-3272h中的一个或多个包括两用传感器和组织稳定元件,该两用传感器和组织稳定元件具有被构造成能够提供组织稳定的电极和/或感测几何结构。在一些实施方案中,多个传感器3272a-3272h可用多个组织稳定元件替换和/或占据。可通过例如夹持和/或缝合期间的组织流动和/或钉成形来提供组织稳定。多个传感器3272a-3272h将信号提供给外科器械10的一个或多个电路,以增强缝合性能和/或组织厚度感测的反馈。
图42为逻辑图,其示出了用于确定夹持在端部执行器(例如,图40中所示的端部执行器3250)内的组织节段3264的一个或多个参数的方法3280的一个实施方案。在一个实施方案中,第一传感器3258被构造成能够检测端部执行器3250和/或定位在砧座3252与钉仓3256之间的组织节段3264的一个或多个参数。通过第一传感器3258产生3282第一信号。第一信号指示由第一传感器3258检测的一个或多个参数。一个或多个第二传感器3260被构造成能够检测端部执行器3250和/或组织节段3264的一个或多个参数。如同第一传感器3258,第二传感器3260可被构造成能够检测相同的参数、另外的参数、或不同的参数。通过第二传感器3260产生第二信号3284。第二信号3284指示由第二传感器3260检测的一个或多个参数。将第一信号和第二信号提供给处理器,例如,主处理器2006。处理器2006基于由第二传感器3260产生的输入来调整3286由第一传感器3258产生的第一信号。调整的信号可指示例如组织节段3264的真实厚度和咬合完全性。将调整的信号通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图43示出了包括多个冗余传感器3308a,3308b的端部执行器3300的一个实施方案。端部执行器3300包括能够枢转地联接到第二钳口构件3304的第一钳口构件或砧座3302。第二钳口构件3304被构造成能够在其中接收钉仓3306。砧座3302能够相对于钉仓3306运动以将材料(例如,组织节段)抓持在砧座3302与钉仓3306之间。多个传感器3308a,3308b联接到砧座。多个传感器3308a,3308b被构造成能够检测端部执行器3300和/或定位在砧座3302与钉仓3306之间的组织节段的一个或多个参数。在一些实施方案中,多个传感器3308a,3308b被构造成能够检测砧座3302与钉仓3306之间的间隙3310。间隙3310可对应于例如定位在砧座3302和钉仓3306之间的组织的厚度。多个传感器3308a,3308b可通过例如检测由联接到第二钳口构件3304的磁体3312产生的磁场来检测间隙3310。
在一些实施方案中,多个传感器3308a,3308b包括冗余传感器。冗余传感器被构造成能够检测端部执行器3300和/或定位在砧座3302与钉仓3306之间的组织节段的相同特性。冗余传感器可包括例如霍尔效应传感器,该霍尔效应传感器被构造成能够检测砧座3302与钉仓3306之间的间隙3310。冗余传感器提供代表一个或多个参数的信号,由此允许处理器(例如,主处理器2006)评估多个输入并且确定最可靠的输入。在一些实施方案中,冗余传感器用于降低噪声、假信号、和/或漂移。可在夹持期间实时地测量冗余传感器中的每个,由此允许分析基于时间的信息并且利用算法和/或查找表来动态地识别组织特性和夹持定位。可调整和/或选择冗余传感器中的一个或多个的输入以标识真实组织厚度和定位在砧座3302与钉仓3306之间的组织节段的咬合。
图44为逻辑图,其示出了用于选择得自多个冗余传感器(例如,图43中所示的多个传感器3308a,3308b)的最可靠输出的方法3320的一个实施方案。在一个实施方案中,通过第一传感器3308a产生第一信号。通过模数转换器转换3322a第一信号。通过一个或多个冗余传感器3308b产生一个或多个另外的信号。通过模数转换器转换3322b所述一个或多个另外的信号。将转换的信号提供给处理器,例如,主处理器2006。主处理器评估3324冗余输入以确定最可靠的输出。最可靠的输出可基于一个或多个参数来选择,例如,算法、查找表、得自另外传感器的输入、和/或器械状态。在选择最可靠的输出之后,处理器可基于一个或多个另外传感器来选择输出,以反映例如定位在砧座3302与钉仓3306之间的组织节段的真实厚度和咬合。将调整的最可靠输出通过例如嵌入外科器械10中的显示器2026显示3026给操作者。
图45示出了包括传感器3358的端部执行器3350的一个实施方案,该传感器具有特定采样率以限制或消除假信号。端部执行器3350包括能够枢转地联接到第二钳口构件3354的第一钳口构件或砧座3352。第二钳口构件3354被构造成能够在其中接收钉仓3356。钉仓3356包括多个钉,所述多个钉可被递送到定位在砧座3352与钉仓3356之间的组织节段。传感器3358联接到砧座3352。传感器3358被构造成能够检测端部执行器3350的一个或多个参数,例如,砧座3352与钉仓3356之间的间隙3364。间隙3364可对应于材料(例如,组织节段)的厚度和/或定位在砧座3352与钉仓3356之间的材料的咬合完全性。传感器3358可包括用于检测端部执行器3350的一个或多个参数的任何合适的传感器,例如,磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。
在一个实施方案中,传感器3358包括磁传感器,该磁传感器被构造成能够检测由联接到第二钳口构件3354和/或钉仓3356的电磁源3360产生的磁场。电磁源3360产生被传感器3358检测的磁场。检测到的磁场的强度可对应于例如定位在砧座3352和钉仓3356之间的组织的厚度和/或咬合完全性。在一些实施方案中,电磁源3360产生已知频率(例如,1MHz)的信号。在其他实施方案中,由电磁源3360产生的磁场可基于例如安装在第二钳口构件3354中的钉仓3356的类型、一个或多个另外传感器、算法、和/或一个或多个参数来进行调整。
在一个实施方案中,信号处理器3362联接到端部执行器3350,例如,砧座3352。信号处理器3362被构造成能够处理由传感器3358产生的信号,以消除假信号并且增强得自传感器3358的输入。在一些实施方案中,信号处理器3362可被定位成独立于端部执行器3350,例如,定位在外科器械10的柄部14中。在一些实施方案中,信号处理器3362与由通用处理器(例如,主处理器2006)执行的算法一体地形成并且/或者包括该算法。信号处理器3362被构造成能够处理得自传感器3358的特定频率的信号,所述频率基本上等于由电磁源3360产生的信号的频率。例如,在一个实施方案中,电磁源3360产生1MHz频率的信号。通过传感器3358检测信号。传感器3358产生信号,该信号指示提供给信号处理器3362的检测到的磁场。该信号由信号处理器3362在1MHz的频率下进行处理以消除假信号。将处理的信号提供给处理器,例如,主处理器2006。主处理器2006使接收到的信号与端部执行器3350的一个或多个参数(例如,砧座3352与钉仓3356的间隙3364)相关联。
图46为逻辑图,其示出了用于产生定位在端部执行器(例如,图45中所示的端部执行器3350)的砧座和钉仓之间的组织节段的厚度测量结果的方法3370的一个实施方案。在方法3370的一个实施方案中,通过调制的电磁源3360产生3372信号。产生的信号可包括例如1MHz信号。磁传感器3358被构造成能够检测3374由电磁源3360产生的信号。磁传感器3358产生指示检测到的磁场的信号并且将信号提供给信号处理器3362。信号处理器3362处理3376所述信号以去除噪声、假信号和/或增强所述信号。将处理的信号提供给模数转换器以用于转换3378成数字信号。可例如通过应用校正曲线输入算法和/或查找表来校正3380数字信号。信号处理3376、转换3378、和校正3380可由一个或多个电路来执行。将校正的信号通过例如与外科器械10一体地形成的显示器2026显示3026给用户。
尽管目前为止描述的各种实施方案包括具有能够枢转地联接的第一钳口和第二钳口,但所描述的实施方案并非受此限制。例如,在一个实施方案中,端部执行器可包括圆形缝合器端部执行器。图47示出了圆形缝合器3400的一个实施方案,该圆形缝合器被构造成能够实施图28-46中描述的方法中的一个或多个。圆形缝合器3400包括主体3402。主体3402可联接到轴,例如,外科器械10的轴组件200。主体3402被构造成能够在其中接收钉仓和/或一个或多个钉(未示出)。砧座3404能够运动地联接到主体3402。砧座3404可例如通过轴3406联接到主体3402。轴3406能够接收在主体内的腔体内(未示出)。在一些实施方案中,分离垫圈3408联接到砧座3404。分离垫圈3408可包括缝合期间的支撑物或增强材料。
在一些实施方案中,圆形缝合器3400包括多个传感器3410a,3410b。多个传感器3410a,3410b被构造成能够检测圆形缝合器3400和/或定位在主体3402与砧座3404之间的组织节段的一个或多个参数。多个传感器3410a,3410b可联接到砧座3404的任何合适部分,例如,定位在分离垫圈3408下面。多个传感器3410a,3410b可以任何合适的布置方式进行布置,例如,围绕砧座3404的周边等间距地间隔开。多个传感器3410a,3410b可包括任何合适的传感器以用于检测端部执行器3400和/或定位在主体3402与砧座3404之间的组织节段的一个或多个参数。例如,多个传感器3410a,3410b可包括磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、它们的任何组合、和/或任何其他合适的传感器。
在一个实施方案中,多个传感器3410a,3410b包括定位在分离垫圈3408下面的多个压力传感器。传感器3410a,3410b中的每个被构造成能够检测由存在于主体3402与砧座3404之间的压缩组织产生的压力。在一些实施方案中,多个传感器3410a,3410b被构造成能够检测定位在砧座3404与主体3402之间的组织节段的阻抗。检测到的阻抗可指示定位在砧座3404与主体3402之间的组织的厚度和/或完全性。多个传感器3410a,3410b产生指示检测到的压力的多个信号。将多个产生的信号提供给处理器,例如,主处理器2006。主处理器2006基于得自多个传感器3410a,3410b的输入来应用一个或多个算法和/或查找表以确定端部执行器3400和/或定位在主体3402与砧座3404之间的组织节段的一个或多个参数。例如,在包括多个压力传感器的一个实施方案中,处理器2006被构造成能够应用算法以将多个传感器3410a,3410b的输出相对于彼此并且相对于预先确定的阈值进行比较。在一个实施方案中,如果多个传感器3410a,3410b的输出之间的Δ或差值大于预先确定的阈值,则向操作者提供反馈,由此指示可能不均匀的加载状态。在一些实施方案中,端部执行器3400可联接到包括一个或多个另外传感器的轴,例如,下文结合图50描述的驱动轴3504。
图48A-48D示出了图47中所示的圆形缝合器3400的夹持过程。图48A示出了处于初始位置的其中砧座3404和主体3402呈闭合构型的圆形缝合器3400。圆形缝合器3400以闭合构型定位在治疗部位处。一旦圆形缝合器3400被定位,砧座3404就朝远侧运动以脱离主体3402并且产生被构造成能够在其中接收组织节段3412的间隙,如图48B所示。将组织节段3412在砧座3404与主体3402之间压缩到预先确定的压缩量3414,如图48C所示。在砧座3404与主体3402之间进一步地压缩组织节段3412。另外的压缩将一个或多个钉从主体3402部署到组织节段3412中。通过砧座3404使钉成形。图48D示出了处于对应于钉部署的位置的圆形缝合器3400。正确的钉部署取决于在主体3402与砧座3404之间获得正确的组织咬合。设置在砧座3404上的多个传感器3410a,3410b允许处理器在钉部署之前将正确的组织咬合设置在砧座3404与主体3402之间。
图49示出了圆形缝合器砧座3452和被构造成能够与其接合的电连接器3466的一个实施方案。砧座3452包括联接到砧座轴3456的砧座头3454。分离垫圈3458联接到砧座头3452。多个压力传感器3460a,3460b在砧座头3452与分离垫圈3458之间联接到砧座头3452。挠性电路3462形成于轴3456上。挠性电路3462联接到多个压力传感器3460a,3460b。一个或多个触点3464形成在轴3456上以将挠性电路3462联接到一个或多个电路,例如,外科器械10的控制电路2000。挠性电路3462可通过电连接器3466联接到一个或多个电路。电连接器3466联接到砧座3454。例如,在一个实施方案中,轴3456为中空的并且被构造成能够在其中接收电连接器3466。电连接器3466包括多个触点3468,所述多个触点被构造成能够与形成于砧座轴3456上的触点3464接合。电连接器3466上的多个触点3468联接到挠性电路3470,使得该挠性电路联接到一个或多个电路,例如,控制电路2000。
图50示出了包括传感器3506的外科器械3500的一个实施方案,该传感器联接到外科器械3500的驱动轴3504。外科器械3500可类似于上述外科器械10。外科器械3500包括柄部3502和联接到柄部的远侧端部的驱动轴3504。驱动轴3504被构造成能够在远侧端部处接收端部执行器(未示出)。传感器3506固定地安装在驱动轴3504中。传感器3506被构造成能够检测驱动轴3504的一个或多个参数。传感器3506可包括任何合适的传感器,例如,磁传感器(诸如霍尔效应传感器)、应变仪、压力传感器、电感传感器(诸如涡流传感器)、电阻传感器、电容传感器、光学传感器、和/或任何其他合适的传感器。
在一些实施方案中,传感器3506包括磁霍尔效应传感器。磁体3508定位在驱动轴3504内。传感器3506被构造成能够检测由磁体3508产生的磁场。磁体3508联接到弹簧支承型托架3510。弹簧支承型托架3510联接到端部执行器。弹簧支承型托架3510能够响应于端部执行器的动作(例如,砧座朝主体和/或第二钳口构件的压缩)而运动。弹簧支承型托架3510响应于端部执行器的运动而运动磁体3508。传感器3506检测由磁体3508产生的磁场的变化并且产生指示磁体3508的运动的信号。磁体3508的运动可对应于例如由端部执行器夹持的组织的厚度。可将组织的厚度通过例如嵌入外科器械3500的柄部3502中的显示器3512显示给操作者。在一些实施方案中,霍尔效应传感器3508可与一个或多个另外传感器(例如,图47中所示的压力传感器)结合。
图51为流程图,其示出了用于确定端部执行器(例如,联接到图50中所示的外科器械3500的图47中所示的端部执行器3400)中的不均匀组织加载的方法3550的一个实施方案。在一个实施方案中,方法3550包括利用一个或多个第一传感器3552(例如,多个压力传感器)以检测3554端部执行器内的组织的存在。在端部执行器3400的夹持操作期间,分析得自压力传感器的输入P以确定P的值。如果P小于3556预先确定的阈值,则端部执行器3400继续3558夹持操作。如果P大于或等于3560预先确定的阈值,则停止夹持。比较3562多个传感器3552之间的Δ(差值)。如果Δ大于预先确定的Δ,则外科器械3500向用户显示3564警示。警示可包括例如信息,该信息指示在端部执行器中存在不均匀的夹持。如果Δ小于或等于预先确定的Δ,则将一个或多个传感器3552的输入与得自另外传感器3566的输入进行比较。
在一些实施方案中,第二传感器3566被构造成能够检测外科器械3500的一个或多个参数。例如,在一些实施方案中,磁传感器(例如,霍尔效应传感器)定位在外科器械3500的轴3504中。第二传感器3566产生指示外科器械3500的一个或多个参数的信号。将预设校正曲线应用3568到得自第二传感器3566的输入。预设校正曲线可调整3568由第二传感器3566产生的信号(例如,由霍尔效应传感器产生的霍尔电压)。例如,在一个实施方案中,调整霍尔效应电压,使得当砧座3404与主体3402之间的间隙X1等于零时,所产生的霍尔效应电压被设定为预先确定的值。使用调整的传感器3566输入来计算3570当达到压力阈值P时砧座3404与主体3402之间的距离X3。继续3572夹持过程以将多个钉部署到夹持在端部执行器3400中的组织节段中。得自第二传感器3566的输入在夹持过程期间动态地变化并且用于实时地计算砧座3404与主体3402之间的距离X2。计算3574实时压缩百分比并且将其显示给操作者。在一个实施方案中,压缩百分比计算如下:[((X3-X2)/X3)*100]。
在一些实施方案中,图28-50中所示的传感器中的一个或多个用于指示:砧座是否附接到外科装置的主体;压缩组织间隙;和/或砧座是否处于正确位置以用于移除该装置,或者这些指示的任何组合。
在一些实施方案中,图28-50中所示的传感器中的一个或多个用于影响装置性能。可通过至少一个传感器输出来调整外科装置10的一个或多个控制参数。例如,在一些实施方案中,可通过一个或多个传感器(例如,霍尔效应传感器)的输出来调整击发操作的速度控制。在一些实施方案中,传感器中的一个或多个可基于负载和/或组织类型来调整闭合和/或夹持操作。在一些实施方案中,多级压缩传感器允许外科器械10在预先确定的负载和/或预先确定的位移下停止闭合。控制电路2000可应用一个或多个预先确定的算法,以将变化的压缩施加到组织节段,由此例如基于组织响应来确定组织类型。可基于闭合速率和/或预先确定的组织参数来改变算法。在一些实施方案中,一个或多个传感器被构造成能够检测组织特性并且一个或多个传感器被构造成能够检测装置特性和/或构型参数。例如,在一个实施方案中,电容块可与钉仓一体地形成以测量斜度。
用于加电医疗装置的电路和传感器
图52示出了端部执行器3600的一个实施方案,该端部执行器被构造成能够确定夹持操作期间的组织节段的一个或多个参数。端部执行器3600包括能够枢转地联接到第二钳口构件3604的第一钳口构件或砧座3602。第二钳口构件3604被构造成能够在其中接收钉仓3606。钉仓3606包含多个钉(未示出),所述多个钉被构造成能够在夹持和缝合操作期间部署到组织节段中。钉仓3606包括具有预先确定的高度的钉仓平台3622。钉仓3606还包括限定在钉仓的主体内的狭槽3624,该狭槽类似于上述狭槽193。霍尔效应传感器3608被构造成能够检测霍尔效应传感器3608与联接到第二钳口构件3604的磁体3610之间的距离3616。霍尔效应传感器3608与磁体3610之间的距离3616指示定位在砧座3602与钉仓平台3622之间的组织的厚度。
第二钳口构件3604被构造成能够接收多种钉仓3606类型。钉仓3606的类型可通过例如包括不同长度的钉、包括支撑物材料、和/或包含不同类型的钉而改变。在一些实施方案中,钉仓平台3622的高度3618可基于联接到第二钳口构件3604的钉仓3606的类型而改变。改变的仓高度3618可导致霍尔效应传感器3608产生不精确的厚度测量结果。例如,在一个实施方案中,第一仓包括第一仓平台高度X并且第二仓包括第二仓平台高度Y,其中Y>X。固定的霍尔效应传感器3608和固定的磁体将产生仅针对所述两个仓平台高度中的一个的精确厚度测量结果。在一些实施方案中,使用可调整的磁体补偿各种平台高度。
在一些实施方案中,第二钳口构件3604和钉仓3606包括磁体腔体3614。磁体腔体3614被构造成能够在其中接收磁体3610。磁体联接到弹簧臂3612。弹簧臂3612被构造成能够朝磁体腔体3614的上表面偏置磁体。磁体腔体3614的深度3620根据钉仓3606的平台高度3618而改变。例如,每个钉仓3606可限定腔体深度3620,使得腔体3614的上表面与平台3622的平面相距设定距离。磁体3610抵靠腔体3614的上表面进行偏置。通过霍尔效应传感器3608观察的磁体3610的磁参考值相对于全部仓平台是一致的,但相对于狭槽3624是可变的。例如,在一些实施方案中,向上偏置的磁体3610和腔体3614在霍尔效应传感器3608与磁体3610提供设定距离3616,而不论插入到第二钳口构件3604内的钉仓3606如何。设定距离3616允许霍尔效应传感器3608产生精确的厚度测量结果,而不论钉仓3606类型如何。在一些实施方案中,可调整腔体3614的深度3620,以针对一个或多个外科手术校正霍尔效应传感器3608。
图53A和53B示出了端部执行器3650的一个实施方案,该端部执行器被构造成能够标准化霍尔效应电压,而不论钉仓3656的平台高度如何。图53A示出了端部执行器3650的一个实施方案,该端部执行器包括插入其中的第一仓3656a。端部执行器3650包括能够枢转地联接到第二钳口构件3654的第一钳口构件或砧座3652以在两者间抓持组织。第二钳口构件3654被构造成能够接收钉仓3656a。钉仓3656a可包括多种钉长度、支撑物材料、和/或平台高度。磁传感器3658(例如,霍尔效应传感器)联接到砧座3652。磁传感器3658被构造成能够检测由磁体3660检测的磁场。检测到的磁场强度指示磁传感器3658与磁体3660之间的距离3664,该距离可指示例如抓持在砧座3652与钉仓3656之间的组织节段的厚度。如上所述,各种钉仓3656a可包括变化的平台高度,该变化的平台高度产生校正的压缩间隙3664的差值。
在一些实施方案中,磁衰减器3662联接到钉仓3656a。磁衰减器3662被构造成能够衰减由磁体3660产生的磁通量。基于钉仓3656a的高度校正磁衰减器3662以产生磁通量。通过基于钉仓3656类型来衰减磁体3660,磁衰减器3662将磁传感器3658信号标准化为用于各种平台高度的相同校正水平。磁衰减器3662可包括任何合适的磁体衰减器,例如,铁金属帽。磁衰减器3662模塑到钉仓3656a内,使得当钉仓3656插入第二钳口构件3654中时,磁衰减器3662定位在磁体3660上方。
在一些实施方案中,不需要磁体3660的衰减以用于钉仓的平台高度。图53B示出了端部执行器3650的一个实施方案,该端部执行器包括联接到第二钳口构件3654的第二钉仓3656b。第二钉仓3656b包括匹配磁体3660和霍尔效应传感器3658的校正的平台高度,并且因此不需要衰减。如图53B所示,第二钉仓3656b包括腔体3666以取代第一钉仓3656a的磁衰减器3662。在一些实施方案中,根据仓平台的高度提供较大的和/或较小的衰减构件。可优化衰减构件3662形状的设计以在由霍尔效应传感器3658生成的响应信号中产生特征,所述特征允许区分一个或多个另外的仓特性。
图54为逻辑图,其示出了用于确定端部执行器(例如,图53A-53B中所示的端部执行器3650)内的组织压缩何时已达到稳态的方法3670的一个实施方案。在一些实施方案中,临床医生启动3672夹持过程以将组织夹持在端部执行器内,例如,砧座3652与钉仓3656之间。端部执行器在夹持过程期间接合3674组织。一旦组织已被接合3674,端部执行器就开始3676实时间隙监控。实时间隙监控技术监控例如端部执行器3650的砧座3652和钉仓3656之间的间隙。可通过例如联接到端部执行器3650的传感器3658(例如霍尔效应传感器)监控间隙。传感器3658可联接到处理器,例如,主处理器2006。处理器确定3678何时已达到端部执行器3650和/或钉仓3656的组织夹持条件。一旦处理器确定组织已稳定,所述方法就向用户指示3680组织已稳定。该指示可通过例如嵌入外科器械10内的显示器来提供。
在一些实施方案中,通过霍尔效应传感器提供间隙测量结果。霍尔效应传感器可定位在例如砧座3652的远侧末端处。霍尔效应传感器被构造成能够测量远侧末端处的砧座3652与钉仓3656平台之间的间隙。测得的间隙可用于计算钳口闭合间隙和/或监控夹持在端部执行器3650中的组织节段的组织压缩变化。在一个实施方案中,霍尔效应传感器联接到处理器,例如,主处理器2006。处理器被构造成能够接收得自霍尔效应传感器的实时测量结果并且将接收到的信号与一组预先确定的标准进行比较。例如,在一个实施方案中,当间隙读数在预先确定的间期(例如,3.0秒)内保持不变化时,利用等时间间隔(例如一秒)下的逻辑方程向用户指示组织节段的稳定。也可在预先确定的时间段(例如,15.0秒)之后指示组织稳定。又如,当yn=yn+1=yn+2时可指示组织稳定,其中y等于霍尔效应传感器的间隙测量结果并且n为预先确定的测量间隔。外科器械10可在已形成稳定时向用户显示指示,例如,图形表示和/或数字表示。
图55为示出各种霍尔效应传感器读数3692a-3692d的曲线图3690。如曲线图3690所示,组织节段的厚度或压缩在预先确定的时间段之后稳定。处理器(例如,主处理器2006)可被构造成能够指示得自传感器(例如,霍尔效应传感器)的计算厚度何时在预先确定的时间段内保持相对一致或恒定。处理器2006可例如通过多个显示器向用户指示组织已稳定。
图56为逻辑图,其示出了用于确定端部执行器(例如,图53A-53B中所示的端部执行器3650)内的组织压缩何时已达到稳态的方法3700的一个实施方案。在一些实施方案中,临床医生启动3702夹持过程以将组织夹持在端部执行器内,例如,砧座3652与钉仓3656之间。端部执行器在夹持期间接合3704组织。一旦组织已被接合3704,端部执行器就开始3706实时间隙监控。实时间隙监控技术监控3706例如端部执行器3650的砧座3652和钉仓3656之间的间隙。可通过例如联接到3706端部执行器3650的传感器3658(诸如霍尔效应传感器)监控间隙。传感器3658可联接到处理器,例如,主处理器2006。处理器被构造成能够执行一个或多个算法以确定由端部执行器3650压缩的组织节段何时已稳定。
例如,在图56所示的实施方案中,方法3700被构造成能够利用斜率计算来确定组织的稳定。处理器计算3708得自传感器(诸如霍尔效应传感器)的输入的斜率S。可通过例如方程S=((V_1-V_2))/((T_1-T_2))计算3708斜率。处理器将所计算的斜率与预先确定的值(例如,0.005伏/秒)进行比较3710。如果所计算的斜率的值大于预先确定的值,则处理器将计数C重置3712为零。如果所计算的斜率小于或等于预先确定的值,则处理器递增3714计数C的值。将计数C与预先确定的阈值(例如,3)进行比较3716。如果计数C的值大于或等于预先确定的阈值,则处理器向用户指示3718组织节段已稳定。如果计数C的值小于预先确定的阈值,则处理器继续监控传感器3658。在各种实施方案中,可监控传感器输入的斜率、斜率变化、和/或输入信号的任何其他合适变化。
在一些实施方案中,端部执行器(图52、图53A、和图53B中所示的端部执行器3600,3650)可包括能够部署于其中的切割构件。切割构件可包括例如I形梁,该I形梁被构造成能够使切割定位在砧座3602与钉仓3608之间的组织节段、和从钉仓3608部署钉同时发生。在一些实施方案中,I形梁可包括仅切割构件和/或可仅部署一个或多个钉。击发期间的组织流动可影响钉的适当成形。例如,在I形梁部署期间,组织中的流体可导致组织的厚度临时地增加,由此导致钉的不适当部署。
图57为逻辑图,其示出了用于控制端部执行器以改善部署期间的适当钉成形的方法3730的一个实施方案。控制方法3730包括产生3732指示端部执行器3650内的组织节段的厚度的传感器测量结果,例如,由霍尔效应传感器产生的霍尔效应电压。通过模数转换器将传感器测量结果转换3734成数字信号。校正3736数字信号。可通过例如处理器和/或专用校正电流来执行校正3736。基于一个或多个校正曲线输入来校正3736数字信号。将校正的数字信号通过例如嵌入外科器械10中的显示器2026显示3738给操作者。可将校正的信号显示3738为抓持在砧座3652与钉仓3656之间的组织节段的厚度测量结果和/或无单位范围。
在一些实施方案中,使用所产生的3732霍尔效应电压来控制I形梁。例如,在例示的实施方案中,将霍尔效应电压提供给处理器(例如,主处理器2006),该处理器被构造成能够控制端部执行器内的I形梁的部署。处理器接收霍尔效应电压并且计算预先确定的时间段内的电压变化率。处理器将所计算的变化率与预先确定的值x1进行比较3740。如果所计算的变化率大于预先确定的值x1,则处理器减慢3742I形梁的速度。可通过例如将可变速度减小预先确定的单位来降低速度。如果所计算的电压变化率小于或等于预先确定的值x1,则处理器保持3744I形梁的当前速度。
在一些实施方案中,处理器可临时地降低I形梁的速度以补偿例如较厚的组织、不均匀的负载、和/或任何其他组织特征。例如,在一个实施方案中,处理器被构造成能够监控3740霍尔效应传感器的电压变化率。如果由处理器监控的变化率3740超过第一预先确定的值x1,则处理器减慢或停止I形梁的部署,直到变化率小于第二预先确定的值x2。当变化率小于第二预先确定的值x2时,处理器可使I形梁返回到正常速度。在一些实施方案中,可通过例如压力传感器、应变仪、霍尔效应传感器、和/或任何其他合适的传感器来产生传感器输入。在一些实施方案中,处理器可在I形梁的部署期间实施一个或多个暂停点。例如,在一些实施方案中,处理器可实现三个预先确定的暂停点,在该暂停点处处理器将I形梁的部署暂停预先确定的时间段。暂停点被构造成能够提供优化的组织流控制。
图58为逻辑图,其示出了用于控制端部执行器以允许流体排空并且提供改善的钉成形的方法3750的一个实施方案。方法3750包括产生3752传感器测量结果,例如,霍尔效应电压。传感器测量结果可指示例如抓持在端部执行器3650的砧座3652和钉仓3656之间的组织节段的厚度。将产生的信号提供给模数转换器以用于转换3754成数字信号。基于一个或多个输入(例如,第二传感器输入和/或预先确定的校正曲线)校正3756转换的信号。校正的信号表示端部执行器3650的一个或多个参数,例如,抓持在其中的组织节段的厚度。可将校正的厚度测量结果以厚度和/或无单位范围显示给用户。可通过例如嵌入外科器械10中的联接到端部执行器3650的显示器2026显示校正的厚度。
在一些实施方案中,使用校正的厚度测量结果来控制端部执行器3650内的I形梁和/或其他击发构件的部署。将校正的厚度测量结果提供给处理器。处理器将校正的测量结果的变化与预先确定的阈值百分比x进行比较3760。如果厚度测量结果的变化率大于x,则处理器减慢3762端部执行器内的I形梁的速度或部署速率。处理器可通过例如将可变速度减小预先确定的单位来减慢3762I形梁的速度。如果厚度测量结果的变化率小于或等于x,则处理器保持3764端部执行器3650内的I形梁的速度。组织厚度和/或压缩的实时反馈允许外科器械10改变击发速度,以允许流体排空并且/或者提供改善的钉成形。
在一些实施方案中,可通过一个或多个另外的传感器输入来调整由传感器产生3752的传感器读数(例如,霍尔效应电压)。例如,在一个实施方案中,可通过得自砧座3652上的微应变仪传感器的输入来调整所产生的3752霍尔效应电压。微应变仪可被构造成能够监控砧座3652的应变幅值。可通过监控的应变幅值来调整所产生的3752霍尔效应电压以指示例如部分近侧或远侧组织咬合。夹持期间的微应变和霍尔效应传感器输出的基于时间的检测允许一个或多个算法和/或查找表识别组织特性和夹持定位并且动态地调整组织厚度测量结果以控制例如I形梁的击发速度。在一些实施方案中,处理器可在I形梁的部署期间实现一个或多个暂停点。例如,在一些实施方案中,处理器可实现三个预先确定的暂停点,在该暂停点处处理器将I形梁的部署暂停预先确定的时间段。暂停点被构造成能够提供优化的组织流控制。
图59A-59B示出了包括压力传感器的端部执行器3800的一个实施方案。端部执行器3800包括能够枢转地联接到第二钳口构件3804的第一钳口构件或砧座3802。第二钳口构件3804被构造成能够在其中接收钉仓3806。钉仓3806包括多个钉。第一传感器3808在远侧末端处联接到砧座3802。第一传感器3808被构造成能够检测端部执行器的一个或多个参数,例如,砧座3802与钉仓3806之间的距离或间隙3814。第一传感器3808可包括任何合适的传感器,例如,磁传感器。磁体3810可联接到第二钳口构件3804和/或钉仓3806以将磁信号提供给磁传感器。
在一些实施方案中,端部执行器3800包括第二传感器3812。第二传感器3812被构造成能够检测端部执行器3800和/或定位在其间的组织节段的一个或多个参数。第二传感器3812可包括任何合适的传感器,例如,一个或多个压力传感器。第二传感器3812可联接到砧座3802、第二钳口构件3804、和/或钉仓3806。得自第二传感器3812的信号可用于调整第一传感器3808的测量结果,以调整第一传感器的读数,由此精确地表示近侧和/或远侧定位的部分咬合的真实压缩组织厚度。在一些实施方案中,第二传感器3812可相对于第一传感器3808为替代品。
在一些实施方案中,第二传感器3812可包括例如单个连续压力感测膜和/或一系列压力感测膜。第二传感器3812沿着中心轴线联接到钉仓3806的平台,从而覆盖如被构造成能够接收切割和/或钉部署构件的狭槽3816。第二传感器3812提供信号,该信号指示夹持操作期间由组织施加的压力的幅值。在切割和/或部署构件的击发期间,可例如通过切割第二传感器3812与一个或多个电路之间的电连接来切断得自第二传感器3812的信号。在一些实施方案中,第二传感器3812的切断电流可指示用尽的钉仓3806。在其他实施方案中,第二传感器3812可被定位成使得切割和/或部署构件的部署不切断与第二传感器3812的连接。
图60示出了端部执行器3850的一个实施方案,该端部执行器包括定位在钉仓3806和第二钳口构件3804之间的第二传感器3862。端部执行器3850包括能够枢转地联接到第二钳口构件3854的第一钳口构件或砧座3852。第二钳口构件3854被构造成能够在其中接收钉仓3856。第一传感器3858在远侧末端处联接到砧座3852。第一传感器3858被构造成能够检测端部执行器3850的一个或多个参数,例如,砧座3852与钉仓3856之间的距离或间隙3864。第一传感器3858可包括任何合适的传感器,例如,磁传感器。磁体3860可联接到第二钳口构件3854和/或钉仓3856以将磁信号提供给磁传感器。在一些实施方案中,端部执行器3850包括第二传感器3862,该第二传感器除了定位在钉仓3856与第二钳口构件3864之外在所有方面均类似于图59A-59B的第二传感器3812。
图61为逻辑图,其示出了用于确定和显示夹持在根据图59A-59B或图60的端部执行器3800或3850中的组织节段的厚度的方法3870的一个实施方案。该方法包括通过例如定位在砧座3802的远侧末端处的霍尔效应传感器获得霍尔效应电压3872。将霍尔效应电压3872提供给模数转换器3874并且转换成数字信号。将数字信号提供给处理器,例如,主处理器2006。主处理器2006校正3874霍尔效应电压3872信号的曲线输入。压力传感器(例如,第二传感器3812)被构造成能够测量3880例如端部执行器3800的一个或多个参数,例如,由砧座3802施加到夹持在端部执行器3800中的组织上的压力的量。在一些实施方案中,压力传感器可包括单个连续压力感测膜和/或一系列压力感测膜。压力传感器可因而能够操作以确定端部执行器3800的近侧端部和远侧端部之间的不同位置处的测量压力的变化。将所测量的压力提供给处理器,例如,主处理器2006。主处理器2006响应于由压力传感器3880测量的压力来利用一个或多个算法和/或查找表调整3882霍尔效应电压3872,以较精确地反映夹持在例如砧座3802与钉仓3806之间的组织的厚度。将调整的厚度通过例如嵌入外科器械10中的显示器2026显示3878给操作者。
图62示出了端部执行器3900的一个实施方案,该端部执行器包括定位在钉仓3906和细长通道3916之间的多个第二传感器3192a-3192b。端部执行器3900包括能够枢转地联接到第二钳口构件或细长通道3904的第一钳口构件或砧座3902。细长通道3904被构造成能够在其中接收钉仓3906。砧座3902还包括位于远侧末端中的第一传感器3908。第一传感器3908被构造成能够检测端部执行器3900的一个或多个参数,例如,砧座3902与钉仓3906之间的距离或间隙。第一传感器3908可包括任何合适的传感器,例如,磁传感器。磁体3910可联接到细长通道3904和/或钉仓3906以将磁信号提供给第一传感器3908。在一些实施方案中,端部执行器3900包括位于钉仓3906与细长通道3904之间的多个第二传感器3912a-3912c。第二传感器3912a-3912c可包括任何合适的传感器,例如,压阻型压力膜条。在一些实施方案中,第二传感器3912a-3912c可均匀地分布在端部执行器3900的远侧端部和近侧端部之间。
在一些实施方案中,可利用得自第二传感器3912a-3912c的信号调整第一传感器3908的测量结果。例如,可利用得自第二传感器3912a-3912c的信号调整第一传感器3908的读数以精确地表示砧座3908与钉仓3906之间的间隙,该间隙可在端部执行器3900的远侧端部和近侧端部之间有所变化,这取决于砧座3902与钉仓3906之间的组织3920的位置和/或密度。图11示出了组织3920的部分咬合的示例。如针对此示例的目的所示,组织仅定位在端部执行器3900的近侧区域中,由此产生位于端部执行器3900的近侧区域附近的高压力区域3918和位于端部执行器的远侧端部附近的相应低压力区域3916。
图63A和63B进一步示出了组织3920的完全咬合相对于部分咬合的效果。图63A示出了具有组织3920的完全咬合的端部执行器3900,其中组织3920具有均匀密度。在具有均匀密度的组织3920的完全咬合的情况下,端部执行器3900处的远侧末端处的测得第一间隙3914a可大体等于端部执行器3900的中部或近侧端部中的测得第二间隙3922a。例如,第一间隙3914a可测得为2.4mm,并且第二间隙可测得为2.3mm。图63B示出了具有组织3920的部分咬合或另选地具有不均匀密度的组织3920的完全咬合的端部执行器3900。在这种情况下,第一间隙3914b将测得为小于在组织3920的最厚或最致密部分处测得的第二间隙3922b。例如,第一间隙可测得为1.0mm,而第二间隙可测得为1.9mm。在图63A和图63B所示的情况下,得自第二传感器3912a-3912c的信号(例如,沿端部执行器3900的长度的不同点处的测得压力)可被器械用于确定组织3920的布置方式和/或组织3920的材料特性。器械还可操作以利用随时间变化的测得压力识别组织特性和组织位置并且动态地调整组织厚度测量结果。
图64示出了端部执行器3950的一个实施方案,该端部执行器包括用于测量砧座和钉仓3956之间的间隙的线圈3958和振荡器电路3962。端部执行器3950包括能够枢转地联接到第二钳口构件或细长通道3954的第一钳口构件或砧座3952。细长通道3954被构造成能够在其中接收钉仓3956。在一些实施方案中,钉仓3954还包括位于远侧端部处的线圈3958和振荡器电路3962。线圈3958和振荡器电路3962能够操作以作为涡流传感器和/或电感传感器。线圈3958和振荡器电路3962可在目标3960(例如,砧座3952的远侧末端)靠近线圈3958时检测涡流和/或电感。可使用由线圈3958和振荡器电路3962检测的涡流和/或电感来检测砧座3952与钉仓3956之间的距离或间隙。
图65示出了端部执行器3950的另选视图。如图所示,在一些实施方案中,外部接线3964可将功率提供给振荡器电路3962。外部接线3964可沿着细长通道3954的外侧进行布置。
图66示出了用于检测目标3960中的涡流3972的线圈3958的操作的示例。以选定频率流过线圈3958的交流电流在线圈3958周围产生磁场3970。当线圈3958处于距目标3960特定距离的位置3976a时,线圈3958将不感应涡流3972。当线圈3958处于靠近导电目标3960的位置3976b时,在目标3960中产生电流3972。当线圈3958处于靠近目标3960中的裂缝的位置3976c时,裂缝可中断涡流循环;在这种情况下,与线圈3958耦合的磁场发生变化并且可通过测量线圈阻抗变化来读取缺陷信号3974。
图67示出了随线圈3958相对目标3960的间距3978而变化的线圈半径3958的测得品质因子3984、测得电感3986、和测得电阻3988的曲线图3980。品质因子3984依赖于间距3978,而电感3986和电阻3988两者为位移的函数。较高的品质因子3984导致较完全无功的传感器。电感3986的具体值仅受以下需求的约束:可制造的线圈3958以及在适当的频率下消耗适当的能量值的实际电路设计。电阻3988为寄生效应。
曲线图3980示出了电感3986、电阻3988、和品质因子3984如何依赖于目标间距3978。当间距3978增加时,电感3986增加四倍,电阻3988轻微降低,并且因而品质因子3984增加。全部三个参数的变化为高度非线性的并且每个曲线趋于随着间距3978的增加而大致以指数形式下降。敏感度随距离的快速丢失将涡流传感器的范围严格地限制为大约1/2线圈直径。
图68示出了端部执行器4000的一个实施方案,该端部执行器包括布置在钉仓4006与细长通道4004之间的发射器和传感器4008。端部执行器4000包括能够枢转地联接到第二钳口构件或细长通道4004的第一钳口构件或砧座4002。细长通道3904被构造成能够在其中接收钉仓4006。在一些实施方案中,端部执行器4000还包括定位在钉仓4006与细长通道4004之间的发射器和传感器4008。发射器和传感器4008可为任何合适的装置,例如,MEMS超声换能器。在一些实施方案中,发射器和传感器可沿着端部执行器4000的长度进行布置。
图69示出了操作中的发射器和传感器4008的实施方案。发射器和传感器4008可操作以发射脉冲4014并且感测脉冲4014的反射信号4016。发射器和传感器4008还可操作以测量脉冲4014的发出与反射信号4016的接收之间的飞行时间4018。可使用测得的飞行时间4018确定沿着端部执行器4000的整个长度的压缩在端部执行器4000中的组织的厚度。在一些实施方案中,发射器和传感器4008可联接到处理器,例如主处理器2006。处理器2006可操作以利用飞行时间4018确定有关组织的另外信息,例如组织是否患病、凸起、或损伤。外科器械还能够操作以将此信息传送给器械的操作者。
图70示出了包括MEMS换能器的发射器和传感器4008的实施方案的表面。
图71示出了可由图69的发射器和传感器4008测得的反射信号4016的示例的曲线图4020。图71示出了随时间4024变化的反射信号4016的幅值4022。如图所示,发射脉冲4026的幅值大于反射脉冲4028a-4028c的幅值。发射脉冲4026的幅值可具有已知值或预期值。第一反射脉冲4028a可例如得自由端部执行器4000包封的组织。第二反射脉冲4028b可例如得自砧座4002的下表面。第三反射脉冲4028c可例如得自砧座4002的上表面。
图72示出了端部执行器4050的实施方案,该端部执行器被构造成能够确定切割构件或刀4058的位置。端部执行器4050包括能够枢转地联接到第二钳口构件或细长通道4054的第一钳口构件或砧座4052。细长通道4054被构造成能够在其中接收钉仓4056。钉仓4056还包括狭槽4058(未示出)和定位在其中的切割构件或刀4062。刀4062能够操作地联接到刀杆4064。刀杆4064能够操作以将刀4062从狭槽4058的近侧端部运动到远侧端部。端部执行器4050还可包括定位在狭槽4058的近侧端部附近的光学传感器4060。光学传感器可联接到处理器,例如,主处理器2006。光学传感器4060可操作以朝刀杆4064发射光信号。刀杆4064还可包括沿其长度的编码条4066。编码条4066可包括切口、凹口、反射件、或光学可读的任何其他构型。编码条4066被布置成使得来自光学传感器4060的光信号从编码条4066反射或者穿过编码条4066。当刀4062和刀杆4064沿着狭槽4058运动4068时,光学传感器4060将检测耦合到编码条4066的所发射的光信号的反射。光学传感器4060可操作以将所检测的信号发送给处理器2006。处理器2006可被构造成能够利用所检测的信号确定刀4062的位置。可通过设计编码条4066以使得所检测的光信号具有渐变增加和降低来更精确地感测刀4062的位置。
图73示出了与红色LED 4070和红外LED 4072一起操作的编码条4066的示例。仅为了此示例的目的,编码条4066包括切口。当编码条4066运动4068时,由红色LED 4070发射的光将随着切口在其前面通过而被中断。红外LED 4072将因此检测到编码条4066的运动4068,并且因此通过引申可检测到刀4062的运动。
基于部件评估监控装置劣化
图74示出了外科器械10的端部执行器300的局部视图。在图74所示的示例形式中,端部执行器300包括钉仓1100,该钉仓在许多方面类似于钉仓304(图20)。端部执行器300的若干部分被省略以允许更清楚地理解本公开。在某些情况下,端部执行器300可包括第一钳口(例如,砧座306(图20))和第二钳口(例如,通道198(图20))。在某些情况下,如上所述,通道198可容纳钉仓,例如,钉仓304或钉仓1100。通道198和砧座306中的至少一者可相对于通道198和砧座306中的另一者运动以将组织捕获在钉仓1100与砧座306之间。本文描述了各种致动组件以有利于通道198和/或砧座306例如在打开构型(图1)和闭合构型(图75)之间的运动。
在某些情况下,如上所述,可朝远侧推进E形梁178,以将钉191部署到所捕获的组织中和/或在多个位置之间推进切割刃182以接合和切割所捕获的组织。如图74所示,可例如沿着由狭槽193限定的路径朝远侧推进切割刃182。在某些情况下,可将切割刃182从钉仓1100的近侧部分1102推进到钉仓1100的远侧部分1104以切割所捕获的组织,如图74所示。在某些情况下,可例如通过朝近侧回缩E形梁178来使切割刃182从远侧部分1104朝近侧回缩到近侧部分1102。
在某些情况下,可采用切割刃182以在多个手术中切割由端部执行器300捕获的组织。读者将会知道,切割刃182的重复使用可影响切割刃182的锐度。读者还将会知道,当切割刃182的锐度降低时,利用切割刃182切割捕获的组织所需的力可增加。参见图74-76,在某些情况下,外科器械10可包括模块1106(图76)以用于例如在外科手术中在外科器械10的操作期间、之前、和/或之后监控切割刃182的锐度。在某些情况下,可在利用切割刃182切割所捕获的组织之前采用模块1106来测试切割刃182的锐度。在某些情况下,可在切割刃182已用于切割所捕获的组织之后采用模块1106来测试切割刃182的锐度。在某些情况下,可在切割刃182用于切割所捕获的组织之前和之后采用模块1106来测试切割刃182的锐度。在某些情况下,可在近侧部分1102处和/或远侧部分1104处采用模块1106来测试切割刃1106的锐度。
参见图74-76,模块1106可包括一个或多个传感器,例如,光学传感器1108;可采用模块1106的光学传感器1108来测试例如切割刃182的反射能力。在某些情况下,切割刃182反射光的能力可与切割刃182的锐度相关联。换句换讲,切割刃182的锐度降低可导致切割刃182反射光的能力降低。因此,在某些情况下,可例如通过检测从切割刃182反射的光的强度来评估切割刃182的钝度。在某些情况下,光学传感器1108可限定光感测区域。光学传感器1108可例如被取向成使得光感测区设置在切割刃182的路径中。当切割刃182例如位于光感测区中时,可采用光学传感器1108来感测从切割刃182反射的光。反射光的强度降低到阈值之下可指示切割刃182的锐度已降低到可接受水平之下。
再次参见图74-76,模块1106可包括一个或多个光源,例如,光源1110。在某些情况下,模块1106可包括微控制器1112(“控制器”),该微控制器可操作地联接到光学传感器1108,如图76所示。在某些情况下,控制器1112可包括微处理器1114(“处理器”)和一个或多个计算机可读介质或存储单元1116(“存储器”)。在某些情况下,存储器1116可存储各种程序指令,所述各种程序指令在执行时可使得处理器1114执行本文所述的多个功能和/或计算。在某些情况下,存储器1116可例如联接到处理器1114。电源1118可被构造成能够例如将功率提供给控制器1112、光学传感器1108、和/或光源1110。在某些情况下,电源1118可包括电池(或者“电池组”或“电源组”),例如,锂离子电池。在某些情况下,电池组可被构造成能够可释放地安装到柄部14以用于将功率供应给外科器械10。可将多个串联的电池单元用作电源4428。在某些情况下,电源1118可为例如可更换的和/或可再充电的。
控制器1112和/或本公开的其他控制器可使用集成的和/或分立的硬件元件、软件元件和/或该硬件元件和软件元件两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、SoC、和/或SIP。分立硬件元件的示例可包括电路和/或电路元件,诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些情况下,例如,控制器1112可包括混合电路,该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。
在某些情况下,控制器1112和/或本公开的其他控制器可为例如购自TexasInstruments的LM 4F230H5QR。在某些情况下,Texas Instruments LM4F230H5QR为ARMCortex-M4F处理器芯,其包括:256KB的单循环闪存存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC,以及易得的其他特征。可以很方便地换用其他微控制器,来与本公开联合使用。因此,本公开不应限于这一上下文。
在某些情况下,光源1110可用于发射光,所述光可例如被引导到光感测区中的切割刃182处。光学传感器1108可用于响应暴露于由光源1110发射的光来测量从处于光感测区中的切割刃182反射的光的强度。在某些情况下,处理器1114可接收反射光的测量强度的一个或多个值并且可将反射光的测量强度的一个或多个值存储在例如存储器1116上。存储值可在例如由外科器械10执行的外科手术之前、之后、和/或期间来检测和/或记录。
在某些情况下,处理器1114可将反射光的测量强度与例如可存储在存储器1116上的预定义阈值进行比较。在某些情况下,如果所测量的光强度超过预定义阈值例如1%、5%、10%、25%、50%、100%和/或多于100%,则控制器1112可断定切割刃182的锐度已下降到低于可接受水平。在某些情况下,处理器1114可用于检测从处于光感测区的切割刃182反射的光的测量强度的存储值的下降趋势。
在某些情况下,外科器械10可包括一个或多个反馈系统,例如,反馈系统1120。在某些情况下,如果从处于光感测区的切割刃182反射的光的测量光强度超过例如存储阈值,则处理器1114可采用反馈系统1120来警示用户。在某些情况下,反馈系统1120可包括例如一个或多个视觉反馈系统,例如,显示屏、背光源、和/或LED。在某些情况下,反馈系统1120可包括例如一个或多个听觉反馈系统,诸如,扬声器和/或蜂鸣器。在某些情况下,反馈系统1120可包括例如一个或多个触觉反馈系统。在某些情况下,反馈系统1120可包括例如视觉反馈系统、听觉反馈系统、和/或触觉反馈系统的组合。
在某些情况下,外科器械10可包括击发闭锁机构1122,该击发闭锁机构可用于阻止切割刃182的推进。各种合适的击发闭锁机构更详细地描述于2012年6月28日提交的名称为“FIRING SYSTEM LOCKOUT ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利公布2014/0001231中,该专利公布全文以引用方式并入本文。在某些情况下,如图76所示,处理器1114能够操作地联接到闭锁机构1122;如果确定从切割刃182反射的光的测量强度超过例如存储阈值,则处理器1114可采用闭锁机构1122来阻止切割刃182的推进。换句话讲,如果切割刃不足够锐利以切割由端部执行器300捕获的组织,则处理器1114可激活闭锁机构1122。
在某些情况下,光学传感器1108和光源1110可容纳在轴组件200的远侧部分处。在某些情况下,如上所述,可在切割刃182过渡到端部执行器300中之前,通过光学传感器1108评估切割刃182的锐度。当例如切割刃182处于轴组件182中时并且在进入端部执行器300之前,击发杆172(图20)可推进切割刃182穿过由光学传感器1108限定的光感测区。在某些情况下,可在切割刃182从端部执行器300朝近侧回缩之后通过光学传感器1108评估切割刃182的锐度。当例如切割刃182从端部执行器300回缩到轴组件200中之后,击发杆172(图20)可回缩切割刃182穿过由光学传感器1108限定的光感测区。
在某些情况下,光学传感器1108和光源1110可容纳在例如端部执行器300的近侧部分处,该近侧部分可位于钉仓1100的近侧。可例如在切割刃182过渡到端部执行器300中之后但在接合钉仓1100之前,通过光学传感器1108评估切割刃182的锐度。在某些情况下,当例如切割刃182处于端部执行器300时但在接合钉仓1100之前,击发杆172(图20)可推进切割刃182穿过由光学传感器1108限定的光感测区。
在各种情况下,可在切割刃182由击发杆172推进穿过狭槽193时通过光学传感器1108评估切割刃182的锐度。如图74所示,光学传感器1108和光源1110可容纳在例如钉仓1100的近侧部分1102处;并且可例如通过近侧部分1102处的光学传感器1108评估切割刃182的锐度。击发杆172(图20)可例如在切割刃182接合捕获在钉仓1100与砧座306之间的组织之前推进切割刃182穿过由近侧部分1102处的光学传感器1108限定的光感测区。在某些情况下,如图74所示,光学传感器1108和光源1110可容纳在例如钉仓1100的远侧部分1104处。可通过远侧部分1104处的光学传感器1108评估切割刃182的锐度。在某些情况下,击发杆172(图20)可例如在切割刃182已穿过捕获在钉仓1100与砧座306之间的组织之后推进切割刃182穿过由远侧部分1104处的光学传感器1108限定的光感测区。
再次参见图74,钉仓1100可包括例如多个光学传感器1108和多个对应光源1110。在某些情况下,一对光学传感器1108和光源1110可容纳在例如钉仓1100的近侧部分1102处;并且一对光学传感器1108和光源1110可容纳在例如钉仓1100的远侧部分1104处。在此类情况下,切割刃182的锐度可例如在接合组织之前在近侧部分1102处进行第一次评估,并且例如在穿过所捕获的组织之后在远侧部分1104处进行第二次评估。
读者将会知道,光学传感器1108可在外科手术期间多次地评估切割刃182的锐度。例如,切割刃的锐度可例如在击发行程中在切割刃182推进穿过狭槽193期间进行第一次评估,并且例如在返回行程中在切割刃182回缩穿过狭槽193期间进行第二次评估。换句话讲,从切割刃182反射的光可例如在切割刃推进穿过光感测区时由同一光学传感器1108测量一次并且在切割刃182回缩穿过光感测区时测量一次。
读者将会知道,处理器1114可从光学传感器1108中的一个或多个接收从切割刃182反射的光的强度的多个读数。在某些情况下,处理器1114可被构造成能够例如忽略异常值并且计算得自多个读数的平均读数。在某些情况下,可将平均读数与例如存储器1116中的阈值进行比较。在某些情况下,处理器1114可被构造成能够例如在确定所计算的平均读数超过存储在存储器1116中的阈值的情况下通过反馈系统1120警示用户和/或激活闭锁机构1122。
在某些情况下,如图75、图77、和图78所示,一对光学传感器1108和光源1110可定位在钉仓1100的相对侧。换句换讲,光学传感器1108可定位在例如狭槽193的第一侧1124,并且光源1110可定位在例如狭槽193的第二侧1126(与第一侧1124相对)。在某些情况下,所述对光学传感器1108和光源1110可基本上设置在横断钉仓1100的平面上,如图75所示。所述对光学传感器1108和光源1110可被取向成限定光感测区,该光感测区例如定位在或至少基本上定位在横断钉仓1100的平面上。另选地,所述对光学传感器1108和光源1110可被取向成限定光感测区,该光感测区例如定位在横断钉仓1100的平面的近侧,如图78所示。
在某些情况下,一对光学传感器1108和光源1110可定位在钉仓1100的同一侧。换句换讲,如图79所示,当切割刃182推进穿过狭槽193时,所述对光学传感器1108和光源1110可定位在切割刃182的第一侧,例如,侧面1128。在此类情况下,光源1110可被取向成将光引导到切割刃182的侧面1128处;并且通过光学传感器1108测得的从侧面1128反射的光的强度可表示侧面1128的锐度。
在某些情况下,如图80所示,第二对光学传感器1108和光源1110可定位在例如切割刃182的第二侧,例如,侧面1130。所述第二对可用于评估侧面1130的锐度。例如,所述第二对中的光源1110可被取向成将光引导到切割刃182的侧面1130处;并且通过所述第二对中的光学传感器1108测得的从侧面1130反射的光的强度可表示侧面1130的锐度。在某些情况下,处理器可被构造成能够例如基于从切割刃182的侧面1128和1130反射的光的测得强度来评价切割刃182的锐度。
在某些情况下,如图75所示,一对光学传感器1108和光源1110可容纳在钉仓1100的远侧部分1104处。如图81所示,光源1108可例如定位在或至少基本上定位在轴线LL上,该轴线LL沿着切割刃182穿过狭槽193的路径纵向地延伸。此外,光源1110可例如定位在切割刃182的远侧并且被取向成在切割刃朝光源1110推进时将光引导到切割刃182处。此外,光学传感器1108可定位在或至少基本上定位在与轴线LL相交的轴线AA上,如图81所示。在某些情况下,轴线AA可例如垂直于轴线LL。在任何情况下,光学传感器1108可被取向成将光感测区限定在例如轴线LL与轴线AA的交点处。
读者将会知道,本文所述的与外科器械10结合的光学传感器和对应光源的位置、取向、和/或数量为旨在用于举例说明目的的示例性实施方案。本公开可采用光学传感器和光源的各种其他布置方式来评估切割刃182的锐度。
读者将会知道,在外科器械10的每次击发期间,切割刃182推进穿过由端部执行器300捕获的组织可导致切割刃聚集组织碎屑和/或体液。此类碎屑可干扰模块1106精确地评估切割刃182的锐度的能力。在某些情况下,外科器械10可配备有一个或多个清洁机构,该清洁机构可用于例如在评估切割刃182的锐度之前清洁切割刃182。在某些情况下,如图82所示,清洁机构1131可包括例如一个或多个清洁构件1132。在某些情况下,清洁构件1132可设置在例如狭槽193的相对侧面上,以在切割刃182推进穿过狭槽193时接收两个侧面之间的切割刃182(参见图82)。在某些情况下,如图82所示,清洁构件1132可包括例如擦拭刀片。在某些情况下,如图830所示,清洁构件1132可包括例如海绵。读者将会知道,可例如采用各种其他清洁构件来清洁切割刃182。
参见图74,在某些情况下,钉仓1100可包括例如可容纳在钉仓1100的近侧部分1102中的第一对光学传感器1108和光源1110。此外,如图74所示,钉仓1100可包括可在近侧部分1102中容纳在狭槽193的相对侧面上的第一对清洁构件1132。第一对清洁构件1132可例如定位在第一对光学传感器1108和光源1110的远侧。如图74所示,钉仓1100可包括例如可容纳在钉仓1100的远侧部分1104中的第二对光学传感器1108和光源1110。如图74所示,钉仓1100可包括可在远侧部分1104中容纳在狭槽193的相对侧面上的第二对清洁构件1132。第二对清洁构件1132可定位在第二对光学传感器1108和光源1110的近侧。
除上述之外,如图74所示,切割刃182可在击发行程中朝远侧推进以切割由端部执行器300捕获的组织。当切割刃推进时,可例如在切割刃182与组织接合之前,通过第一对光学传感器1108和光源1110执行切割刃182的锐度的第一评估。可例如在切割刃182已横切所捕获的组织之后,通过第二对光学传感器1108和光源1110执行切割刃182的锐度的第二评估。切割刃182可在切割刃182的锐度的第二评估之前推进穿过第二对清洁构件1132,以移除由切割刃182在所捕获的组织的横切期间聚集的任何碎屑。
除上述之外,如图74所示,切割刃182可在返回行程中朝近侧回缩。当切割刃回缩时,可在返回行程期间通过第一对光学传感器1108和光源1110执行切割刃182的锐度的第三评估。切割刃182可例如在切割刃182的锐度的第三评估之前推进穿过第一对清洁构件1132,以移除由切割刃182在所捕获的组织的横切期间聚集的任何碎屑。
在某些情况下,光源1110中的一个或多个可包括一个或多个光纤缆线。在某些情况下,一个或多个挠性电路1134可用于将得自电源1118的能量传输到光学传感器1108和/或光源1110。在某些情况下,挠性电路1134可被构造成能够例如将光学传感器1108的读数中的一个或多个传输到控制器1112。
现在参见图84,示出了钉仓4300;钉仓4300在许多方面类似于钉仓304(图20)。例如,钉仓4300可与端部执行器300一起使用。在某些情况下,如图84所示,钉仓4300可包括锐度测试构件4302,该锐度测试构件可用于测试切割刃182的锐度。在某些情况下,锐度测试构件4302可例如附接到钉仓4300的仓体194和/或与其形成一体。在某些情况下,锐度测试构件4302可设置在例如钉仓4300的近侧部分1102中。在某些情况下,如图84所示,锐度测试构件4302可设置在例如钉仓4300的仓平台4304上。
在某些情况下,如图84所示,锐度测试构件4302可例如延伸横跨钉仓4300的狭槽193,以桥接或至少部分地桥接由狭槽193限定的间隙。在某些情况下,锐度测试构件4302可中断或至少部分地中断切割刃182的路径。当切割刃182例如在击发行程期间推进时,切割刃182可接合、切割、和/或穿过锐度测试构件4302。在某些情况下,切割刃182可被构造成能够例如在击发行程中在接合由端部执行器300捕获的组织之前接合、切割、和/或穿过锐度测试构件4302。在某些情况下,切割刃182可被构造成能够例如在锐度测试构件4302的近侧端部4306处接合锐度测试构件4302,并且在锐度测试构件4302的远侧端部4308处离开和/或脱离锐度测试构件4302。在某些情况下,当切割刃182在击发行程期间推进时,切割刃182可例如穿过锐度测试构件4302在近侧端部4306与远侧端部4308之间行进和/切割距离(D)。
主要参见图84和图85,外科器械10可包括例如用于测试切割刃182的锐度的锐度测试模块4310。在某些情况下,模块4310可通过测试切割刃182推进穿过锐度测试构件4302的能力来评估切割刃182的锐度。例如,模块4310可被构造成能够观测切割刃182完全横切和/或完全穿过锐度测试构件4302的至少预先确定的部分所需要的时间段。如果所观测的时间段超过预定义阈值,则模块4310可断定例如切割刃182的锐度已下降到低于可接受水平。
在某些情况下,模块4310可包括微控制器4312(“控制器”),该微控制器可包括微处理器4314(“处理器”)和一个或多个计算机可读介质或存储单元4316(“存储器”)。在某些情况下,存储器4316可存储各种程序指令,所述各种程序指令在执行时可使得处理器4314执行本文所述的多个功能和/或计算。在某些情况下,存储器4316可例如联接到处理器4314。电源4318可被构造成能够例如将功率供应给控制器4312。在某些情况下,电源4138可包括电池(或者“电池组”或“电源组”),例如,锂离子电池。在某些情况下,电池组可被构造成能够可释放地安装到柄部14。可将多个串联的电池单元用作电源4318。在某些情况下,电源4318可为例如可更换的和/或可再充电的。
在某些情况下,处理器4313可操作地联接到例如反馈系统1120和/或闭锁机构1122。
参见图84和图85,模块4310可包括一个或多个位置传感器。适合与本公开一起使用的示例位置传感器和定位系统在2013年3月14日提交的名称为“SENSOR ARRANGEMENTSFOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS”的美国专利申请序列13/803,210中有所描述,该专利申请的公开内容全文以引用方式并入本文。在某些情况下,模块4310可包括第一位置传感器4320和第二位置传感器4322。在某些情况下,第一位置传感器4320可用于检测例如锐度测试构件4302的近侧端部4306处的切割刃182的第一位置;并且第二位置传感器4322可用于检测例如锐度切割构件4302的远侧端部4308处的切割刃182的第二位置。
在某些情况下,位置传感器4320和4322可用于分别将第一位置信号和第二位置信号提供给微控制器4312。应当理解,位置信号可为模拟信号或数字值,这取决于微控制器4312与位置传感器4320和4322之间的接口。在一个实施方案中,微控制器4312与位置传感器4320和4322之间的接口可为标准串行外围设备接口(SPI),并且位置信号可为表示切割刃182的第一位置和第二位置的数字值,如上所述。
除上述之外,处理器4314可确定接收第一位置信号与接收第二位置信号之间的时间段。所确定的时间段可对应于切割刃182从例如锐度测试构件4302的近侧端部4306处的第一位置到例如锐度测试构件4302的远侧端部4308处的第二位置推进穿过锐度测试构件4302所需要的时间。在至少一个示例中,控制器4312可包括时间元件,该时间元件可在接收到第一位置信号时由处理器4314激活并且可在接收到第二位置信号时去激活。时间元件的去激活和停用之间的时间段可对应于例如切割刃182从第一位置推进到第二位置所需要的时间。时间元件可包括实时时钟、被构造成能够实现计时功能的处理器、或任何其他合适的计时电路。
在各种情况下,控制器4312可例如将切割刃182从第一位置推进到第二位置所需要的时间段与预定义阈值进行比较以评价切割刃182的锐度是否已下降到低于可接受水平。在某些情况下,如果所测量的时间段超过预定义阈值例如1%、5%、10%、25%、50%、100%和/或多于100%,则控制器4312可断定切割刃182的锐度已下降到低于可接受水平。
参见图86,在各种情况下,电动马达4330可驱动击发杆172(图20)以例如在击发行程期间推进切割刃182和/或在返回行程期间回缩切割刃182。马达驱动器4332可控制电动马达4330;并且微控制器(例如,微控制器4312)可与马达驱动器4332进行信号通信。当电动马达4330推进切割刃182时,微控制器4312可例如确定由电动马达4330消耗的电流。在此类情况下,推进切割刃182所需的力可对应于例如由电动马达4330消耗的电流。仍参见图86,外科器械10的微控制器4312可确定切割刃182的推进期间由电动马达4330消耗的电流是否增大,并且如果增大,则可计算电流的增量百分比。
在某些情况下,当切割刃182与锐度测试构件4302接触时,由电动马达4330消耗的电流可因锐度测试构件4302对切割刃182的阻力而显著增大。例如,当切割刃182接合、穿过、和/或切穿锐度测试构件4302时,由电动马达4330消耗的电流可显著增大。读者将会知道,锐度测试构件4302对切割刃182的阻力部分地取决于切割刃182的锐度;并且当切割刃182的锐度因重复使用而降低时,锐度测试构件4302对切割刃182的阻力将增加。因此,当切割刃与锐度测试构件4302接触时由电动马达4330消耗的电流的增量百分比的值可例如随着切割刃182的锐度因重复使用造成的降低而增大。
在某些情况下,所确定的由电动马达4330消耗的电流的增量百分比的值可为由电动马达4330消耗的电流的最大检测增量百分比。在各种情况下,微控制器4312可将所确定的由电动马达4330消耗的电流的增量百分比的值与由电动马达4330消耗的电流的增量百分比的预定义阈值进行比较。如果所确定的值超过预定义阈值,则微控制器4312可断定例如切割刃182的锐度已下降到低于可接受水平。
在某些情况下,如图86所示,处理器4314可例如与反馈系统1120和/或闭锁机构1122连通。在某些情况下,如果所确定的由电动马达4330消耗的电流的增量百分比的值超过预定义阈值,则处理器4314可例如采用反馈系统1120警示用户。在某些情况下,如果所确定的由电动马达4330消耗的电流的增量百分比的值超过预定义阈值,则处理器4314可例如采用闭锁机构1122来阻止切割刃182的推进。
在各种情况下,微控制器43312可利用算法确定由电动马达4330消耗的电流的变化。例如,电流传感器可检测击发行程期间由电动马达4330消耗的电流。电流传感器可连续检测由电动马达消耗的电流,和/或可间歇性地检测由电动马达消耗的电流。在各种情况下,算法可比较最新的电流读数与例如紧接进展的电流读数。除此之外或另选地,算法可比较时间段X内的样品读数X与此前的电流读数。例如,算法可比较样品读数与例如此前的时间段X(诸如紧接进展的时间段X)内的样品读数。在其他情况下,算法可计算由马达消耗的电流趋势平均值。算法可计算时间段X期间消耗的平均电流(包括例如最新电流读数),并且可比较消耗的平均电流与例如在紧接进展的时间段X期间消耗的平均电流。
参见图87,示出了用于评估外科器械10的切割刃182的锐度的方法;并且如果切割刃182的锐度下降到和/或低于例如警示阈值和/或高严重性阈值,则列出各种响应。在各种情况下,微控制器(例如,微控制器4312)可被构造成能够实施图87所示的方法。在某些情况下,外科器械10可包括负荷传感器4334(图86);如图86所示,微控制器4312可与负荷传感器4334连通。在某些情况下,负荷传感器4334可包括例如可操作地联接到击发杆172的力传感器,例如,应变仪。在某些情况下,微控制器4312可采用负荷传感器4334来监控当切割刃182在击发行程期间推进时施加到切割刃182的力(Fx)。
在某些情况下,如图88所示,负荷传感器4334可被构造成能够例如监控当切割刃182接合和/或接触锐度测试构件4302时施加到切割刃182的力(Fx)。读者将会知道,当切割刃182接合和/或接触锐度测试构件4302时由锐度测试构件4302施加到切割刃182的力(Fx)至少部分地取决于切割刃182的锐度。在某些情况下,切割刃182的锐度的降低可导致切割刃182切割或穿过锐度测试构件4302所需的力(FX)增加。例如,如图88所示,曲线4336,4338和4340表示当切割刃182穿过三个相同的或至少基本上相同的锐度测试构件4302行进预定义距离(D)时施加到切割刃182的力(Fx)。曲线4336对应于切割刃182的第一锐度;曲线4338对应于切割刃182的第二锐度;并且曲线4340对应于切割刃182的第三锐度。第一锐度大于第二锐度,并且第二锐度大于第三锐度。
在某些情况下,微控制器4312可将施加到切割刃182的监控力(Fx)的最大值与一个或多个预定义阈值进行比较。在某些情况下,如图88所示,预定义阈值可包括警示阈值(F1)和/或高严重性阈值(F2)。在某些情况下,如图88的曲线4336所示,监控力(Fx)可例如小于警示阈值(F1)。在此类情况下,如图87所示,切割刃182的锐度处于良好水平并且微控制器4312可不采取任何动作来向用户警示切割刃182的状态或者可通知用户切割刃182的锐度在可接受范围之内。
在某些情况下,如图88的曲线4338所示,监控力(Fx)可例如大于警示阈值(F1)但小于高严重性阈值(F2)。在此类情况下,如图87所示,切割刃182的锐度可钝化但仍在可接受水平之内。微控制器4312可不采取任何动作来向用户警示切割刃182的状态。另选地,微控制器4312可通知用户切割刃182的锐度在可接受范围之内。另选地或除此之外,微控制器4312可确定或估计切割刃182的生命周期中剩余的切割周期数并且可因此警示用户。
在某些情况下,存储器4316可包括数据库或表,该数据库或表使切割刃182的生命周期中剩余的切割周期数与监控力(Fx)的预先确定的值相关联。处理器4314可例如访问存储器4316以确定切割刃182的生命周期中剩余的切割周期数,其对应于监控力(Fx)的具体测量值并且可向用户警示切割刃182的生命周期中剩余的切割周期数。
在某些情况下,如图88的曲线4340所示,监控力(Fx)可例如大于高严重性阈值(F2)。在此类情况下,如图87所示,切割刃182的锐度可低于可接受水平。作为响应,微控制器4312可例如采用反馈系统1120来警告用户切割刃182太钝而不能安全使用。在某些情况下,微控制器4312可例如在检测到监控力(Fx)超过高严重性阈值(F2)时采用闭锁机构1122来阻止切割刃182的推进。在某些情况下,微控制器4312例如可采用反馈系统1122来向用户提供指令以用于重设闭锁机构1122。
参见图89,示出了一种方法,该方法用于例如确定切割刃(例如,切割刃182)是否足够锐利以用于横切由端部执行器300捕获的具有特定组织厚度的组织。在某些情况下,微控制器4312可用于例如执行执行图16所示的方法。如上所述,切割刃182的重复使用可钝化或降低切割刃182的锐度,由此可增加切割刃182横切所捕获组织所需的力。换句换讲,可例如通过切割刃182横切所捕获组织所需的力来限定切割刃182的锐度水平。读者将会知道,切割刃182横切所捕获组织所需的力还可依赖于所捕获组织的厚度。在某些情况下,例如,在相同的锐度水平下,所捕获组织的厚度越大,则切割刃182横切所捕获组织所需的力也越大。
在某些情况下,例如,切割刃182可足够锐利以横切具有第一厚度的所捕获组织,但可不足够锐利以横切具有大于第一厚度的第二厚度的所捕获组织。在某些情况下,例如,如果所捕获组织具有位于特定组织厚度范围内的组织厚度,则由切割刃182横切所捕获组织所需的力限定的切割刃182的锐度水平可足以横切所捕获组织。在某些情况下,如图90所示,存储器4316可存储由端部执行器300捕获的组织的一个或多个预定义组织厚度范围;以及与预定义组织厚度范围相关联的预定义阈值力。在某些情况下,每个预定义阈值力可表示适于横切具有组织厚度(Tx)的所捕获组织的切割刃182的最小锐度水平,该组织厚度(Tx)由与预定义阈值力相关联的组织厚度范围涵盖。在某些情况下,如果切割刃182横切具有组织厚度(Tx)的所捕获组织所需的力(Fx)超过例如与涵盖组织厚度(Tx)的预定义组织厚度范围相关联的预定义阈值力,则切割刃182可不足够锐利以横切所捕获组织。
在某些情况下,可将预定义阈值力及其对应的预定义组织厚度范围存储在存储器4316上的数据库和/或表(例如,表4342)中,如图90所示。在某些情况下,处理器4314可被构造成能够接收切割刃182横切所捕获组织所需的力(Fx)的测量值以及所捕获组织的组织厚度(Tx)的测量值。处理器4314可访问表4342以确定涵盖所测量的组织厚度(Tx)的预定义组织厚度范围。此外,处理器4314可将所测量的力(Fx)与预定义阈值力进行比较,该预定义阈值力与涵盖组织厚度(Tx)的预定义组织厚度范围相关联。在某些情况下,如果所测量的力(Fx)超过例如预定义阈值力,则处理器4314可断定切割刃182可不足够锐利以横切所捕获组织。
除上述之外,处理器4314可采用一个或多个组织厚度感测模块(例如,组织厚度感测模块4336)以确定所捕获组织的厚度。各种合适的组织厚度感测模块在本公开中有所描述。此外,适合与本公开一起使用的各种组织厚度感测装置和方法在2009年12月24日提交的名称为“SURGICAL CUTTING INSTRUMENT THAT ANALYZES TISSUE THICKNESS”的美国专利公布US 2011/0155781中有所公开,该专利公布的完整公开内容以引用方式并入本文。
在某些情况下,处理器4314可采用负荷传感器4334测量切割刃182横切包括组织厚度(Tx)的所捕获组织所需的力(Fx)。读者将会知道,当切割刃182接合和/或接触所捕获组织时由所捕获组织施加到切割刃182的力可随着切割刃182抵靠所捕获组织推进而增加,直至达到切割刃182可横切所捕获组织的力(Fx)。在某些情况下,当切割刃182抵靠所捕获组织推进时,处理器4314可采用负荷传感器4334连续地监控由所捕获组织抵靠切割刃182施加的力。处理器4314可连续地比较所监控的力与预定义阈值力,该预定义阈值力与涵盖所捕获组织的组织厚度(Tx)的预定义组织厚度范围相关联。在某些情况下,如果所监控的力超过例如预定义阈值力,则处理器4314可断定切割刃不足够锐利以安全地横切所捕获组织。
图89所述的方法列出了例如在确定切割刃182不足够锐利以安全地横切所捕获组织的情况下可由处理器4313采取的各种示例动作。在某些情况下,微控制器4312可例如通过反馈系统1120向用户警示例如切割刃182太钝而不能安全使用。在某些情况下,微控制器4312可例如在断定切割刃182不足够锐利以安全地横切所捕获组织时采用闭锁机构1122来阻止切割刃182的推进。在某些情况下,微控制器4312例如可采用反馈系统1122来向用户提供指令以用于重设闭锁机构1122。
用于加电医疗装置的多马达控制
图91-93示出了采用公共控制模块的设备、系统、和方法的各种实施方案,该公共控制模块与结合外科器械(例如,外科器械4400)的多个马达一起使用。外科器械4400在许多方面类似于本公开描述的其他外科器械,例如,上文更详细描述的图1的外科器械10。例如,如图91所示,外科器械4400包括外壳12、柄部14、闭合触发器32、轴组件200、和外科端部执行器300。因此,为本公开的简洁和清楚起见,与外科器械10相同的外科器械4400的某些特征结构的详细描述将不在此处进行重复。
主要参见图92,外科器械4400可包括多个马达,所述多个马达可被激活以结合外科器械4400的操作来执行各种功能。在某些情况下,第一马达可被激活以执行第一功能;第二马达可被激活以执行第二功能;并且第三马达可被激活以执行第三功能。在某些情况下,外科器械4400的多个马达可被单独地激活以导致端部执行器300中的关节运动动作、闭合动作、和/或击发动作。关节运动动作、闭合动作、和/或击发动作可例如通过轴组件200传输到端部执行器300。
在某些情况下,如图92所示,外科器械4400可包括击发马达4402。击发马达4402可操作地联接到击发驱动组件4404,该击发驱动组件可被构造成能够将由马达4402产生的击发动作传输到端部执行器300。在某些情况下,由马达4402产生的击发动作可导致例如钉191从钉仓304部署到由端部执行器300捕获的组织内和/或导致切割刃182被推进以切割所捕获组织。
在某些情况下,如图92所示,外科器械4400可包括例如关节运动马达4406。马达4406可操作地联接到关节运动驱动组件4408,该关节运动驱动组件可被构造成能够将由马达4406产生的关节运动动作传输到端部执行器300。在某些情况下,关节运动动作可导致例如端部执行器300相对于轴组件200进行关节运动。在某些情况下,外科器械4400可包括例如闭合马达。闭合马达可操作地联接到闭合驱动组件,该闭合驱动组件可被构造成能够将闭合动作传输到端部执行器300。在某些情况下,闭合动作可导致例如端部执行器300从打开构型转变成接近构型以捕获组织。读者将会知道,本文所述的马达及其对应驱动组件旨在作为可结合本公开使用的马达和/或驱动组件的类型的示例。外科器械4400可包括可用于结合外科器械4400的操作来执行各种其他功能的各种其他马达。
如上所述,外科器械4400可包括多个马达,所述多个马达可被构造成能够执行各种独立功能。在某些情况下,外科器械4400的多个马达可被单独地或独立地激活以执行一个或多个功能,而其他马达保持非活动的。例如,关节运动马达4406可被激活以导致端部执行器300进行关节运动,而击发马达4402保持非活动的。另选地,击发马达4402可被激活以击发多个钉191和/或推进切割刃182,而关节运动马达4406保持非活动的。
在某些情况下,外科器械4400可包括公共控制模块4410,该公共控制模块可与外科器械4400的多个马达一起使用。在某些情况下,公共控制模块4410每次可调节多个马达中的一个。例如,公共控制模块4410可分别单独地联接到外科器械4400的多个马达。在某些情况下,外科器械4400的多个马达可共用一个或多个公共控制模块,例如,模块4410。在某些情况下,外科器械4400的多个马达可独立地或选择性地接合公共控制模块4410。在某些情况下,模块4410可从接合外科器械4400的多个马达中的一个切换到接合外科器械4400的多个马达中的另一个。
在至少一个示例中,模块4410可在可操作地接合关节运动马达4406与可操作地接合击发马达4402之间选择性地切换。在至少一个示例中,如图92所示,开关4414可在多个位置和/或状态(例如,第一位置4416和第二位置4418)之间运动或转变。在第一位置4416中,开关4414可将模块4410电联接到关节运动马达4406;并且在第二位置4418中,开关4414可例如将模块4410电联接到击发马达4402。在某些情况下,当开关4414处于第一位置4416时,模块4410可电联接到关节运动马达4406,以控制4406的操作,由此使端部执行器300关节运动到所需位置。在某些情况下,当开关4414处于第二位置4418时,模块4410可例如电联接到击发马达4402,以控制马达4402的操作,由此击发多个钉191和/或推进切割刃182。在某些情况下,开关4414可为机械开关、机电开关、固态开关、或任何合适的开关机构。
现在参见图93,为本公开的清楚起见,外科器械4400的柄部14的外部壳体被移除并且外科器械4400的若干特征结构和元件也被移除。在某些情况下,如图93所示,外科器械4400可包括可在多个位置和/或状态之间选择性地转变的接头4412。在第一位置和/或状态中,接头4412可将模块4410联接到第一马达,例如,关节运动马达4406;并且在第二位置和/或状态中,接头4412可将模块4410联接到第二马达,例如,击发马达4402。本公开可设想到接头4412的另外的位置和/或状态。
在某些情况下,接头4412能够在第一位置和第二位置之间运动,其中模块4410在第一位置中联接到第一马达并且在第二位置中联接到第二马达。在某些情况下,当接头4412从第一位置运动时,模块4410与第一马达分离;并且当接头4412从第二位置运动时,模块4410与第二马达分离。在某些情况下,开关或触发器可被构造成能够使接头4412在多个位置和/或状态之间转变。在某些情况下,触发器能够运动,从而使端部执行器起作用、和使控制模块4410从可操作地接合外科器械4400的马达中的一个转变成与外科器械4400的马达中的另一个可操作地接合同时发生。
在至少一个示例中,如图93所示,闭合触发器32可操作地联接到接头4412并且可被构造成能够使接头4412在多个位置和/或状态之间转变。如图93所示,闭合触发器32能够例如在击发行程期间运动,以例如使接头4412从第一位置和/或状态转变到第二位置和/或状态同时使端部执行器300转变到接近构型以通过端部执行器捕获组织。
在某些情况下,在第一位置和/或状态中,模块4410可电联接到第一马达,例如,关节运动马达4406,并且在第二位置和/或状态中,模块4410可电联接到第二马达,例如,击发马达4402。在第一位置和/或状态中,模块4410可与关节运动马达4406接合以允许用户使端部执行器300关节运动到所需位置;并且模块4410可保持与关节运动马达4406接合,直到触发器32被致动。当用户致动闭合触发器32以通过所需位置下的端部执行器300捕获组织时,接头4412可进行转变或移位,以使模块4410从例如可操作地接合关节运动马达4406转变成例如可操作地接合击发马达4402。一旦实现与击发马达4402的可操作接合,模块4410就可控制击发马达4402;并且模块4410可响应于用户输入来激活马达4402,以例如击发多个钉191并且/或者推进切割刃182。
在某些情况下,如图93所示,模块4410可包括适于与接头4412联接的多个电触点和/或机械触点4411。共用模块4410的外科器械4400的多个马达可各自包括例如适于与接头4412联接的一个或多个对应的电触点和/或机械触点4413。
在各种情况下,外科器械4400的马达可为电动马达。在某些情况下,外科器械4400的马达中的一个或多个可为例如具有大约25,000RPM的最大转速的直流有刷驱动马达。在其他构造中,外科器械4400的马达可包括一个或多个下述马达,所述马达选自无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。
在各种情况下,如图92所示,公共控制模块4410可包括马达驱动器4426,该马达驱动器可包括一个或多个H桥场效应晶体管(FET)。马达驱动器4426可例如基于得自微控制器4420(“控制器”)的输入来调节从电源4428传输到联接至模块4410的马达的功率。在某些情况下,当马达联接到模块4410时,可例如采用控制器4420来确定由马达消耗的电流,如上所述。
在某些情况下,控制器4420可包括微处理器4422(“处理器”)和一个或多个计算机可读介质或存储单元4424(“存储器”)。在某些情况下,存储器4424可存储各种程序指令,所述各种程序指令在执行时可使得处理器4422执行本文所述的多个功能和/或计算。在某些情况下,存储单元4424中的一个或多个可例如联接到处理器4422。
在某些情况下,电源4428可例如用于将功率供应给控制器4420。在某些情况下,电源4428可包括电池(或者“电池组”或“电源组”),例如,锂离子电池。在某些情况下,电池组可被构造成能够可释放地安装到柄部14以用于将功率供应给外科器械4400。可将多个串联的电池单元用作电源4428。在某些情况下,电源4428可为例如可更换的和/或可再充电的。
在各种情况下,处理器4422可控制马达驱动器4426以控制联接到模块4410的马达的位置、旋转方向、和/或速度。在某些情况下,处理器4422可发信号通知马达驱动器4426,以停止和/或停用联接到模块4410的马达。应当理解,本文使用的术语“处理器”包括任何合适的微处理器、微控制器,或者将计算机的中央处理单元(CPU)的功能结合到一个集成电路或最多几个集成电路上的其他基础计算装置。处理器是多用途的可编程装置,该装置接收数字数据作为输入,依据其存储器中存储的指令来处理输入,然后提供结果作为输出。因为处理器具有内部存储器,所以是顺序数字逻辑的示例。处理器的操作对象是以二进制数字系统表示的数字和符号。
在一种情况下,处理器4422可以是任一种单核或多核处理器,诸如已知的由TexasInstruments生产的商品名为ARM Cortex的那些。在某些情况下,微控制器4420可以是例如可购自Texas Instruments的LM4F230H5QR。在至少一个示例中,Texas InstrumentsLM4F230H5QR为ARM Cortex-M4F处理器芯,其包括:256KB的单循环闪存存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC,以及对于产品数据表而言易得的其他特征。可容易地换用其他微控制器,以与模块4410一起使用。因此,本公开不应限于这一上下文。
在某些情况下,存储器4424可包括用于控制可联接到模块4410的外科器械4400的马达中的每个的程序指令。例如,存储器4424可包括用于控制关节运动马达4406的程序指令。当关节运动马达4406联接到模块4410时,此类程序指令可导致处理器4422根据用户输入来控制关节运动马达4406以使端部执行器300进行关节运动。又如,存储器4424可包括用于控制击发马达4402的程序指令。当击发马达4402联接到模块4410时,此类程序指令可导致处理器4422根据用户输入来控制击发马达4402以击发多个钉191和/或推进切割刃182。
在某些情况下,一个或多个机构和/或传感器(例如,传感器4430)可用于提示处理器4422使用应当用于特定设置中的程序指令。例如,当模块4410联接到关节运动马达4406时,传感器4430可提示处理器4422使用与端部执行器300的关节运动相关联的程序指令;并且当模块4410联接到击发马达4402时,传感器4430可提示处理器4422使用与击发外科器械4400相关联的程序指令。在某些情况下,传感器4430可包括例如可用于感测开关4414的位置的位置传感器。因此,当通过传感器4430检测到例如开关4414处于第一位置4416时,处理器4422可使用与端部执行器300的关节运动相关联的程序指令;并且当通过传感器4430检测到例如开关4414处于第二位置4418时,处理器4422可使用与击发外科器械4400相关联的程序指令。
现在参见图94,为本公开的清楚起见,外科器械4400的外部壳体被移除并且外科器械4400的若干特征结构和元件也被移除。如图94所示,外科器械4400可包括多个传感器,所述多个传感器可用于结合外科器械4400的操作来执行各种功能。例如,如图94所示,外科器械4400可包括传感器A、B、和/或C。在某些情况下,传感器A可用于例如执行第一功能;传感器B可用于例如执行第二功能;并且传感器C可用于例如执行第三功能。在某些情况下,例如,传感器A可用于感测闭合行程的第一段期间的由端部执行器300捕获的组织的厚度;传感器B可用于感测第一段之后的闭合行程的第二段期间的组织厚度;并且传感器C可用于感测第二段之后的闭合行程的第三段期间的组织厚度。在某些情况下,传感器A、B、和C可例如沿着端部执行器300进行设置。
在某些情况下,如图94所示,传感器A、B、和C可被布置成使得例如传感器A设置在传感器B的近侧并且传感器C设置在传感器B的近侧。在某些情况下,如图94所示,例如,传感器A可感测第一位置处的由端部执行器300捕获的组织的组织厚度;传感器B可感测第一位置远侧的第二位置处的由端部执行器300捕获的组织的组织厚度;并且传感器C可感测第二位置远侧的第三位置处的由端部执行器300捕获的组织的组织厚度。读者将会知道,本文所述的传感器旨在作为可结合本公开使用的传感器的类型的示例。本公开可采用其他合适的传感器和感测构造。
在某些情况下,外科器械4400可包括公共控制模块4450,该公共控制模块可在许多方面类似于模块4410。例如,类似于模块4410的模块4450可包括控制器4420、处理器4422、和/或存储器4424。在某些情况下,电源4428可例如将功率供应给模块4450。在某些情况下,外科器械4400可包括多个传感器,例如,传感器A、B、和C,所述多个传感器可被激活以结合外科器械4400的操作来执行各种功能。在某些情况下,传感器A、B、和C中的一个例如可被单独地或独立地激活以执行一个或多个功能,而其他传感器保持非活动的。在某些情况下,外科器械4400的多个传感器(例如,传感器A、B、和C)可共用模块4450。在某些情况下,每次传感器A、B、和C中的仅一个可联接到模块4450。在某些情况下,外科器械4400的多个传感器例如可单独地或独立地联接到模块4450。在至少一个示例中,模块4450可在与传感器A、传感器B、和/或传感器C的可操作接合之间选择性地切换。
在某些情况下,如图94所示,模块4450可例如设置在柄部14中,并且共用模块4450的传感器可例如设置在端部执行器300中。读者将会知道,模块4450和/或共用模块4450的传感器并不限于上文指明的位置。在某些情况下,模块4450和共用模块4450的传感器可例如设置在端部执行器300中。本公开可设想到用于模块4450和共用模块4450的传感器的位置的其他布置方式。
在某些情况下,如图94所示,接头4452可用于控制外科器械4400的传感器与模块4450的联接和/或分离。在某些情况下,接头4452可在多个位置和/或状态之间选择性地转变。在第一位置和/或状态中,接头4452可例如将模块4450联接到传感器A;在第二位置和/或状态中,接头4452可例如将模块4450联接到传感器B;并且在第三位置和/或状态中,接头4452可例如将模块4450联接到传感器C。本公开可设想到接头4452的另外的位置和/或状态。
在某些情况下,接头4452能够例如在第一位置、第二位置、和/或第三位置之间运动,其中模块4450在第一位置中联接到第一传感器,在第二位置中联接到第二传感器,并且在第三位置中联接到第三传感器。在某些情况下,当接头4452从第一位置运动时,模块4450与第一传感器分离;当接头4452从第二位置运动时,模块4450与第二传感器分离;并且当接头4452从第三位置运动时,模块4450与第三传感器分离。在某些情况下,开关或触发器可被构造成能够使接头4452在多个位置和/或状态之间转变。在某些情况下,触发器能够运动,从而例如使端部执行器起作用、和使控制模块4450从可操作地接合共用模块4450的传感器中的一个转变成可操作地接合共用模块4450的传感器中的另一个同时发生。
在至少一个示例中,如图94所示,闭合触发器32可操作地联接到接头4450并且可被构造成能够使接头4450在多个位置和/或状态之间转变。如图94所示,闭合触发器32能够例如在击发行程期间在多个位置之间运动,以使接头4450在例如其中模块4450电联接到传感器A的第一位置和/或状态、例如其中模块4450电联接到传感器B的第二位置和/或状态、和/或例如其中模块4450电联接到传感器C的第三位置和/或状态之间转变。
在某些情况下,用户可致动闭合触发器32以通过端部执行器300捕获组织。闭合触发器的致动可导致接头4452进行转变或移位,以使模块4450从例如可操作地接合传感器A转变成例如可操作地接合传感器B、和/或从例如可操作地接合传感器B转变成例如可操作地接合传感器C。
在某些情况下,当触发器32处于第一致动位置时,模块4450可联接到传感器A。当触发器32穿过第一致动位置朝第二致动位置致动时,模块4450可与传感器A分离。另选地,当触发器32处于未致动位置时,模块4450可联接到传感器A。当触发器32穿过未致动位置朝第二致动位置致动时,模块4450可与传感器A分离。在某些情况下,当触发器32处于第二致动位置时,模块4450可联接到传感器B。当触发器32穿过第二致动位置朝第三致动位置致动时,模块4450可与传感器B分离。在某些情况下,当触发器32处于第三致动位置时,模块4450可联接到传感器C。
在某些情况下,如图94所示,模块4450可包括适于与接头4452联接的多个电触点和/或机械触点4451。共用模块4450的外科器械4400的多个传感器可各自包括例如适于与接口4452联接接合的一个或多个对应的电触点和/或机械触点4453。
在某些情况下,当传感器联接到模块4452时,处理器4422可接收得自共用模块4450的多个传感器的输入。例如,当传感器A联接到模块4450时,处理器4422可接收得自传感器A的输入;当传感器B联接到模块4450时,处理器4422可接收得自传感器B的输入;并且当传感器C联接到模块4450时,处理器4422可接收得自传感器C的输入。在某些情况下,输入可为测量值,例如,由端部执行器300捕获的组织的组织厚度的测量值。在某些情况下,处理器4422可将得自传感器A、B、和C中的一个或多个的输入存储在存储器4426上。在某些情况下,处理器4422可基于例如由传感器A、B、和C提供的输入来执行各种计算。
组织参数稳定性的局部显示
图95A和图1B示出了包括钉仓5306的端部执行器5300的一个实施方案,该钉仓还包括两个发光二极管(LED)5310。端部执行器5300类似于上述端部执行器300。端部执行器包括能够枢转地联接到第二钳口构件或细长通道5304的第一钳口构件或砧座5302。细长通道5304被构造成能够在其中接收钉仓5306。钉仓5306包括多个钉(未示出)。多个钉能够在外科操作期间从钉仓5306部署。钉仓5306还包括安装在钉仓5306的上表面或仓平台5308上的两个LED 5310。LED 5310被安装成使得它们将在砧座5304处于闭合位置时可见。此外,LED 5310可足够明亮以穿过任何组织可见,该组织可遮蔽LED 5310的直视。另外,一个LED5310可安装在钉仓5306的任一侧面上,使得至少一个LED 5310从端部执行器5300的任一侧可见。LED 5310可安装在钉仓530的近侧端部附近,如图所示,或者可安装在钉仓5306的远侧端部处。
LED 5310可与处理器或微控制器连通,例如,图19的微控制器1500。微控制器1500可被构造成能够检测由砧座5304抵靠仓平台5308压缩的组织的特性。由端部执行器5300包封的组织可因组织内的流体从组织的各层渗出而改变高度。在组织已足够稳定之前缝合组织可影响缝合的有效性。组织稳定性通过以变化率表示,其中变化率指示由端部执行器包封的组织正如何快速地改变高度。
位于器械操作者的视野中的安装到钉仓5306的LED 5310可用于指示所包封组织正变稳定的速率和/或组织是否已达到稳态。LED 5310可例如被构造成能够以与组织稳定速率直接相关联的速率闪光,即,初始可快速地闪光、随着组织的稳定而较慢地闪光、并且在组织稳定时保持稳态。另选地,LED 5310可初始缓慢地闪光、随着组织的温度而较快速地闪光、并且在组织稳定时熄灭。
安装在钉仓5306上的LED 5310可另外地或任选地用于指示其他信息。其他信息的示例包括但不限于:端部执行器5300是否正包封足够量的组织、钉仓5306是否适用于所包封的组织、所包封的组织是多于适用于钉仓5306的组织、钉仓5306是否与外科器械不相容、将对器械的操作者有用的任何其他指示信息。LED 5310可通过以特定速率闪光、在特定情况下点亮或熄灭、针对不同信息以不同颜色发光来指示信息。另选地或除此之外,LED 5310可用于照亮操作区域。在一些实施方案中,可选择LED 5310以发射紫外光或红外光来照亮在正常光下不可见的信息,其中该信息被打印在钉仓5300上或组织补偿件(未示出)上。另选地或除此之外,钉可涂覆有荧光染料并且LED 5310的波长可被选定以使得LED 5310导致荧光染料发光。利用LED 5310照亮钉允许器械的操作者观察已被驱动之后的钉。
返回图95A和图95B,图95A示出了其中砧座5304处于闭合位置的端部执行器5300的侧面角视图。以举例的方式,例示的实施方案包括位于仓平台5308的任一侧面上的一个LED 5310。图95B示出了其中砧座5304处于打开位置的端部执行器5300的四分之三角视图,以及位于仓平台5308的任一侧面上的一个LED 5310。
图96A和图96B示出了包括钉仓5356的端部执行器5300的一个实施方案,该钉仓还包括多个LED 5360。钉仓5356包括安装到钉仓5356的仓平台5358上的多个LED 5360。LED5360被安装成使得它们将在砧座5304处于闭合位置时可见。此外,LED 5360可足够明亮以穿过任何组织可见,该组织可遮蔽LED 5360的直视。另外,相同数量的LED 5360可安装在钉仓5356的任一侧面上,使得相同数量的LED 5360从端部执行器5300的任一侧面可见。LED5360可安装在钉仓5356的近侧端部附近,如图所示,或者可安装在钉仓5356的远侧端部处。
LED 5360可与处理器或微控制器连通,例如,图15的微控制器1500。微控制器1500可被构造成能够检测由砧座5304抵靠仓平台5358压缩的组织的特性,例如,组织的稳定的速率,如上所述。LED 5360可用于指示所包封组织正变稳定的速率和/或组织是否已达到稳态。LED 5360可被构造成能够例如按照开始于钉仓5356的近侧端部处的顺序点亮,其中每个后续LED 5360以所包封组织正变稳定的速率点亮;当组织稳定时,全部LED 5360可被点亮。另选地,LED 5360可按照开始于钉仓5356的远侧端部处的顺序点亮。然而,LED 5360的另一种另选形式按照连续的、重复的顺序点亮,其中所述顺序开始于LED 5360的近侧端部或远侧端部处。LED 5360点亮的速率和/或重复速度可指示所包封组织正变稳定的速率。应当理解,这些仅为LED 5360可如何指示有关组织的信息的示例,并且也可以使用LED 5360点亮的顺序的其他组合、它们点亮的速率、和/或它们的点亮或熄灭状态。还应当理解,LED5360可用于将一些其他信息传送给外科器械的操作者或者照亮工作区域,如上所述。
返回图96A和图96B,图96A示出了其中砧座5304处于闭合位置的端部执行器5300的侧面角视图。以举例的方式,例示的实施方案包括位于仓平台5358的任一侧面上的多个LED 5360。图96B示出了其中砧座5304处于打开位置的端部执行器5300的四分之三角视图,其示出了位于仓平台5358的任一侧面上的多个LED 5360。
图97A和图97B示出了包括钉仓5406的端部执行器5300的一个实施方案,该钉仓还包括多个LED 5410。钉仓5406包括安装在钉仓5406的仓平台5408上的多个LED 5410,其中LED 5410从钉仓5406的近侧端部连续地布置到远侧端部。LED 5410被安装成使得它们将在砧座5302处于闭合位置时可见。相同数量的LED 5410可安装在钉仓5406的任一侧面上,使得相同数量的LED 5410从端部执行器5300的任一侧面可见。
LED 5410可与处理器或微控制器连通,例如,图15的微控制器1500。微控制器1500可被构造成能够检测由砧座5304抵靠仓平台5408压缩的组织的特性,例如,组织的稳定的速率,如上所述。LED 5410可被构造成能够按照所需的顺序或分组点亮或熄灭,以指示组织的稳定的速率和/或组织已稳定。LED 5410还可被构造成能够将一些其他信息传送给外科器械的操作者或者照亮工作区域,如上所述。除此之外或另选地,LED 5410可被构造成能够指示端部执行器5300的哪些区域包括稳定组织、和/或端部执行器5300的哪些区域正包封组织、和/或这些区域是否正包封足够的组织。LED 5410还可被构造成能够指示所包封组织的任何部分是否不适用于钉仓5406。
返回图97A和图97B,图97A示出了其中砧座5304处于闭合位置的端部执行器5300的侧面角视图。以举例的方式,例示的实施方案包括从钉仓5406的近侧端部到远侧端部的位于仓平台5408的任一侧面上的多个LED 5410。图97B示出了其中砧座5304处于打开位置的端部执行器5300的四分之三角视图,其示出了从钉仓5406的近侧端部到远侧端部的并且位于仓平台5408的任一侧面上的多个LED 5410。
具有用于量化组织压缩的一体化传感器的辅助物
图98A示出了包括组织补偿件5510的端部执行器5500的实施方案,该组织补偿件还包括导电元件5512层。端部执行器5500类似于上述端部执行器300。端部执行器5500包括能够枢转地联接到第二钳口构件5504(未示出)的第一钳口构件或砧座5502。第二钳口构件5504被构造成能够在其中接收钉仓5506(未示出)。钉仓5506包括多个钉(未示出)。多个钉191能够在外科操作期间从钉仓3006部署。在一些实施方案中,端部执行器5500还包括能够移除地定位在砧座5502或钉仓5506上的组织补偿件5510。图98B示出了图98A中所示的组织补偿件5510的一部分的细部图。
如上所述,多个钉191可在未击发位置与击发位置之间进行部署,使得钉腿5530运动穿过和穿透压缩在砧座5502与钉仓5506之间的组织5518,并且接触砧座5502的钉成形表面。在包括组织补偿件5510的实施方案中,钉腿5530还穿透和刺穿组织补偿件5510。当钉腿5530抵靠砧座的钉成形表面变形时,每个钉191可捕获组织5518和组织补偿件5510的一部分,并且将压缩力施加到组织5518。组织补偿件5510因而在外科器械10从患者体内抽出之后利用钉191保留在适当的位置。因为它们将被患者身体保持,所以组织补偿件5510由生物耐用性和/或生物降解性材料构成。组织补偿件5510更详细地描述于名称为“TISSUETHICKNESS COMPENSATOR FOR SURGICAL STAPLER”的美国专利8,657,176中,该专利全文以引用方式并入本文。
返回图98A,在一些实施方案中,组织补偿件5510包括导电元件5512层。导电元件5512可包括具有任何种类的构型的导电材料的任何组合,例如,线圈、线网或线栅、导电条、导电板、电路、微处理器、或它们的任何组合。包含导电元件5512的层可定位在组织补偿件5510的砧座面向表面5514上。另选地或除此之外,导电元件5512层可定位在组织补偿件5510的钉仓面向表面5516上。另选地或除此之外,导电元件5512层可嵌入组织补偿件5510内。另选地,导电元件5512层可构成组织补偿件5510的全部,例如,当导电材料均匀地或非均匀地分布在构成组织补偿件5510的材料中。
图98A示出了其中组织补偿件5510能够移除地附接到端部执行器5500的砧座部分5502的实施方案。组织补偿件5510将在端部执行器5500插入患者体内之前以此方式进行附接。除此之外或另选地,在钉仓5506施加到端部执行器6600之后或之前并且在该装置插入患者体内之前,组织补偿件5610可附接到钉仓5506(未示出)。
图99示出了使用导电元件5512层和钉仓5506中的导电元件5524,5526和5528来检测砧座5502与钉仓5506的上表面之间的距离的各种示例实施方案。砧座5502与钉仓5506之间的距离指示压缩在两者间的组织5518的量和/或密度。除此之外或另选地,此距离可指示端部执行器5500的哪些区域包含组织。可将组织5518厚度、密度、和/或位置传送给外科器械10的操作者。
在例示的示例实施方案中,导电元件5512层定位在组织补偿件5510的砧座面向表面5514上,并且包括与微处理器5520连通的一个或多个线圈5522。微处理器5500可定位在端部执行器5500或其任何部件中,或者可定位在器械的外壳12中,或者可包括此前描述的任何微处理器或微控制器。在例示的示例实施方案中,钉仓5506还包括导电元件,该导电元件可为下述元件中的任一者:一个或多个线圈5524、一个或多个导电板5526、线网5528、或任何其他方便构型、或者它们的任何组合。钉仓5506的导电元件可与器械中的同一微处理器5520或一些其他微处理器连通。
当砧座5502处于闭合位置并且因而正抵靠钉仓5506压缩组织5518时,组织补偿件5510的导电元件5512层可与钉仓5506中的导体电容耦合。导电元件5512层与钉仓5506的导电元件之间的电容场的强度可用于确定正被压缩的组织5518的量。另选地,钉仓5506可包括与微处理器5520连通的涡流传感器,其中涡流传感器可操作以利用涡流感测砧座5502与钉仓5506的上表面之间的距离。
应当理解,导电元件的其他构型也是可以的,并且图99的实施方案仅为示例而非作为限制。例如,在一些实施方案中,导电元件5512层可定位在组织补偿件5510的钉仓面向表面5516上。另外,在一些实施方案中,导电元件5524,5526、和/或5528可定位在砧座5502上或内部。因此,在一些实施方案中,导电元件5512层可与砧座5502中的导电元件电容耦合并且由此感测包封在端部执行器内的组织5518的特性。
还可认识到,组织补偿件5512可包括位于砧座面向表面5514和仓面向表面5516两者上的导电元件5512层。用于检测由砧座5502抵靠钉仓5506压缩的组织5518的量、密度、和/或位置的系统可包括位于砧座5502、钉仓5506、或这两者中的导体或传感器。包括位于砧座5502和钉仓5506两者中的导体或传感器的实施方案可任选地通过允许对可由此构型获得信息进行差分分析来获得改善的结果。
图100A和图100B示出了操作中的包括导电元件5512层的组织补偿件5510的实施方案。图100A示出了已部署之后的多个钉191中的一个。如图所示,钉191已穿透组织5518和组织补偿件5510两者。导电元件5512层可包括例如网丝。在穿透导电元件5512层时,钉腿5530可刺穿线网,由此改变导电元件5512层的导电性。导电性的这种变化可用于指示多个钉191中的每个的位置。钉191的位置可相对于钉的预期位置进行比较,并且这种比较可用于确定任何钉是否未击发或者任何钉是否不处于其被预期所在的位置。
图100A还示出了不能完全变形的钉腿5530。图100B示出了已适当并且完全变形的钉腿5530。如图100B所示,当钉腿5530抵靠砧座5502的钉成形表面变形并且折回组织5518时,导电元件5512层可被钉腿5530第二次刺穿。导电元件5512层中的第二中断可用于指示完全钉191成形(如图100B所示)或不完全钉191成形(如图100A所示)。
图101A和101B示出了包括组织补偿件5610的端部执行器5600的实施方案,该组织补偿件还包括嵌入其中的导体5620。端部执行器5600包括能够枢转地联接到第二钳口构件5604的第一钳口构件或砧座5602。第二钳口构件5604被构造成能够在其中接收钉仓5606。在一些实施方案中,端部执行器5600还包括能够移除地定位在砧座5602或钉仓5606上的组织补偿件5610。
首先转到图4B,图4B示出了能够移除地定位在钉仓5606上的组织补偿件5610的剖面图。该剖面图示出了嵌入构成组织补偿件5610的材料内的一系列导体5620。一系列导体5620可布置成相对构型,并且相对元件可由绝缘材料隔开。一系列导体5620各自联接到一根或多根传导线5622。传导线5622允许一系列导体5620与微处理器连通,例如,微处理器1500。一系列导体5620可横跨组织补偿件5610的宽度,使得它们将位于切割构件或刀杆280的路径中。当刀杆280推进时,其将切断、破坏、或以其他方式损坏导体5620,并且由此指示其在端部执行器5600内的位置。一系列导体5610可包括导电元件、电子电路、微处理器、或它们的任何组合。
现在转到图101A,图101A示出了其中砧座5602处于闭合位置的端部执行器5600的近距离剖面图。在闭合位置中,砧座5602可抵靠钉仓5606压缩组织5618和组织补偿件5610。在一些情况下,端部执行器5600的仅一部分可正包封组织5618。在包封组织5618的端部执行器5600区域中,组织补偿件5610可比不包封组织5618的区域被压缩更大的量5624,在不包封组织的区域中组织补偿件5618可保持未压缩5626或较少地压缩。在较大压缩的区域5624中,一系列导体5620也将被压缩,而在未压缩的区域5626中,一系列导体5620将较远地间隔开。因此,一系列导体5620之间的导电性、电阻、电容、和/或一些其他电特性可指示端部执行器5600的哪些区域包括组织。
图102A和102B示出了包括组织补偿件5660的端部执行器5650的实施方案,该组织补偿件还包括嵌入其中的导体5662。端部执行器5650包括能够枢转地联接到第二钳口构件5654的第一钳口构件或砧座5652。第二钳口构件5654被构造成能够在其中接收钉仓5656。在一些实施方案中,端部执行器5650还包括能够移除地定位在砧座5652或钉仓5656上的组织补偿件5660。
图102A示出了能够移除地定位在钉仓5656上的组织补偿件5660的剖面图。该剖面图示出了嵌入构成组织补偿件5660的材料内的导体5670。导体5672中的每个联接到传导线5672。传导线5672允许一系列导体5672与微处理器连通,例如,微处理器1500。导体5672可包括导电元件、电子电路、微处理器、或它们的任何组合。
图102A示出了其中砧座5652处于闭合位置的端部执行器5650的近距离侧视图。在闭合位置中,砧座5652可抵靠钉仓5656压缩组织5658和组织补偿件5660。嵌入组织补偿件5660内的导体5672可操作以将预先确定的频率的电流脉冲5674施加到组织5658。相同的或另外的导体5672可检测组织5658的响应并且将此响应传输到定位在器械中的微处理器或微控制器。组织5658对电脉冲5674的响应可用于确定组织5658的特性。例如,组织5658的流电响应指示组织5658的含水量。又如,组织5658中的电阻抗的测量结果可用于确定组织5648的导电性,该导电性为组织类型的指示因素。可确定的其他特性以举例的方式包括并且并不限于:氧含量、盐度、密度、和/或某些化学物的存在。通过组合得自若干传感器的数据,可确定其他特性,例如,血液流速、血液类型、抗体的存在等等。
图103示出了钉仓5706和组织补偿件5710的实施方案,其中钉仓5706将功率提供给构成组织补偿件5710的导电元件5720。如图所示,钉仓5706包括形式为贴片、辐条、凸耳、或一些其他凸起构型的电触点5724。组织补偿件5710包括可电联接到钉仓5706上的触点5724的线网或实体接触点5722。
图104A和图104B示出了钉仓5756和组织补偿件5760的实施方案,其中钉仓将功率提供给构成组织补偿件的5710导电元件5770。如图104A所示,组织补偿件5760包括被构造成能够接触钉仓5756的伸出部或插片5772。插片5772可接触并且附着到钉仓5756上的电触点(未示出)。插片5772还包括定位在构成组织补偿件5760的导电元件5770的线中的断裂点5774。当组织补偿件5760被压缩时,例如当砧座相对于钉仓5756处于闭合位置时,断裂点5774将断裂,由此允许组织补偿件5756与钉仓5756分离。图104B示出了采用定位在插片5772中的断裂点5774的另一个实施方案。
图105A和F8B示出了包括位置感测元件5824和组织补偿件5810的端部执行器5800的实施方案。端部执行器5800包括能够枢转地联接到第二钳口构件5804(未示出)的第一钳口构件或砧座5802。第二钳口构件5804被构造成能够在其中接收钉仓5806(未示出)。在一些实施方案中,端部执行器5800还包括能够移除地定位在砧座5802或钉仓5806上的组织补偿件5810。
图105A示出了端部执行器5800的砧座5804部分。在一些实施方案中,砧座5804包括位置感测元件5824。位置感测元件5824可包括例如电触点、磁体、RF传感器等。位置感测元件5824可定位在关键位置(例如,组织补偿件5810将进行附接的拐角点)中或者沿着砧座5802的组织面向表面进行定位。在一些实施方案中,组织补偿件5810可包括位置指示元件5820。位置指示元件5820可定位在对应于砧座5802上的位置感测元件5824的位置中、或近侧位置中、或重叠位置中。组织补偿件5810任选地还包括导电元件5812层。导电元件5812层和/或位置指示元件5820可电联接到传导线5822。传导线5822可提供与微处理器(例如,微处理器1500)的连通。
图F8B示出了操作中的位置感测元件5824和位置指示元件5820的实施方案。当组织补偿件5810被定位时,砧座5802可感测到5826组织补偿件5810被正确定位。当组织补偿件5810未对准或完全缺失时,砧座5802(或一些其他部件)可感测到5826组织补偿件5810未对准。如果未对准高于阈值量,则可将警告发信号通知给器械的操作者,并且/或者可禁用器械的功能以阻止钉被击发。
在图105A和图105B中,位置感测元件5824仅以举例的方式被示为砧座5804的一部分。应当理解,位置感测元件5824可替代地或另外地定位在钉仓5806上。还应当理解,位置感测元件5824和位置指示元件5820的位置可被颠倒,使得组织补偿件5810能够操作以指示其是否被正确对准。
图106A和F9B示出了包括位置感测元件5874和组织补偿件5860的端部执行器5850的实施方案。端部执行器5850包括能够枢转地联接到第二钳口构件5854(未示出)的第一钳口构件或砧座5852。第二钳口构件5854被构造成能够在其中接收钉仓5856(未示出)。在一些实施方案中,端部执行器5850还包括能够移除地定位在砧座5852或钉仓5856上的组织补偿件5860。
图106A示出了端部执行器5850的砧座5852部分。在一些实施方案中,砧座5854包括一系列导电元件5474。一系列导电元件5474可包括例如电触点、磁体、RF传感器等等。一系列导电元件5474沿着砧座5852的组织面向表面的长度进行排列。在一些实施方案中,组织补偿件5860可包括导电元件5862层,其中导电元件包括线栅或线网。导电元件5862层可联接到传导线5876。传导线5862可提供与微处理器(例如,微处理器1500)的连通。
图106A示出了其中砧座5852的导电元件5474与导电元件5862层可操作以指示组织补偿件5860是否未对准或缺失的实施方案。如图所示,一系列导电元件5874能够操作以与导电元件5862层电联接。当组织补偿件5860未对准或缺失时,电联接将为不完全的。如果未对准高于阈值量,则可将警告发信号通知给器械的操作者,并且/或者可禁用器械的功能以阻止钉被击发。
应当理解,除此之外或另选地,一系列导电元件5874可定位在钉仓5856上。还应当理解,砧座5852、钉仓5856、和/或组织补偿件5860中的任一个可操作以指示组织补偿件5860的未对准。
图107A和图107B示出了钉仓5906和组织补偿件5910的实施方案,该组织补偿件能够操作以指示切割构件或刀杆280的位置。图107A为钉仓5906的顶部朝下式视图,该钉仓具有设置在其上表面5916上的组织补偿件5920。钉仓5906还包括可操作以接收切割构件或刀杆280的仓通道5918。为清楚起见,图107A示出了组织补偿件5910的仅导电元件5922层。如图所示,导电元件5922层包括偏心定位的纵长段5930。纵长段5930联接到传导线5926。传导线5926允许导电元件5922层与微处理器连通,例如,微处理器1500。导电元件5922层还包括水平元件5932,该水平元件联接到纵长段5930并且横跨组织补偿件5910的宽度,因此横越刀杆280的路径。当刀杆280推进时,其将切断水平元件5932并且由此改变导电元件5922层的电特性。例如,刀杆280的推进可改变导电元件5922层的电阻、电容、导电性、或一些其他电特性。当每个导电元件5932被刀杆280切断时,导电元件5922层的电特性的变化将指示刀杆280的位置。
图107B示出了导电元件5922层的另选构型。如图所示,导电元件5922层包括位于仓通道5918的任一侧的纵长段5934。导电元件5922层还包括水平元件5936,该水平元件联接到两个纵长段5934,由此横跨刀杆280的路径。当刀杆280推进时,例如刀杆与水平元件5396之间的电阻可被测量并且用于确定刀杆280的位置。导电元件5922层的其他构型可用于实现相同的结果,例如,图98A至图102B所示的构造中的任一个。例如,导电元件5922层可包括线网或线栅,使得当刀杆280推进时,其可切断线网并且由此改变线网的导电性。导电性的这种变化可用于指示刀杆280的位置。
可设想到导电元件5922层的其他使用。例如,可在导电元件592层中产生特定电阻,或者可实现电阻器或导体的二进制梯,使得可将简单的数据存储在组织补偿件5910中。当砧座和/或钉仓中任一者与导电元件5922层电联接时,可通过砧座和/或钉仓中的导电元件从组织补偿件5910提取该数据。该数据可表示例如序列号、“有效使用”日期等等。
用于检测误加载仓的霍尔磁体的极性
图108示出了包括磁体6008和霍尔效应传感器6010的端部执行器6000的一个实施方案,其中检测的磁场6016可用于识别钉仓6006。端部执行器6000类似于上述端部执行器300。端部执行器6000包括能够枢转地联接到第二钳口构件或细长通道6004的第一钳口构件或砧座6002。细长通道6004被构造成能够在其中支撑钉仓6006。钉仓6006类似于上述钉仓304。砧座6002还包括磁体6008。钉仓6006还包括霍尔效应传感器6010和处理器6012。霍尔效应传感器6010能够操作以通过传导联接件6014与处理器6012连通。霍尔效应传感器6010被定位在钉仓6006内以在砧座6002处于闭合位置时与磁体6008可操作地耦合。霍尔效应传感器6010可操作以检测由磁体6008产生的磁场6016。磁场6016的极性可为北极或南极中的一个,这取决于砧座6002内的磁体6008的取向。在图108的例示实施方案中,磁体6008被取向成使其南极朝向钉仓6006。霍尔效应传感器6010可操作以检测由南极产生的磁场6016。如果霍尔效应传感器6010检测到南磁极,则钉仓6006可被识别为具有第一类型。
图109示出了包括磁体6058和霍尔效应传感器6060的端部执行器6050的一个实施方案,其中检测的磁场6066可用于识别钉仓6056。端部执行器6050包括能够枢转地联接到第二钳口构件或细长通道6054的第一钳口构件或砧座6052。细长通道6054被构造成能够在其中支撑钉仓6056。砧座6052还包括磁体6058。钉仓6056还包括经由传导联接件6064与处理器6062连通的霍尔效应传感器6060。霍尔效应传感器6060被定位成使其在砧座6052处于闭合位置时将与磁体6058可操作地耦合。霍尔效应传感器6060可操作以检测由磁体6058产生的磁场6066。在例示的实施方案中,磁体6058被取向成使其北磁极朝向钉仓6056。霍尔效应传感器6060可操作以检测由北极产生的磁场6066。如果霍尔效应传感器6060检测到北磁极,则钉仓6056可被识别为第二类型。
可认识到,图109的第二类型钉仓6056可替换图108的第一类型钉仓6006,反之亦然。在图108中,第二类型钉仓6056将能够操作以检测北磁极,但相反将检测到南磁极。在这种情况下,端部执行器6000将识别钉仓6056为具有第二类型。如果端部执行器6000不期望第二类型的钉仓6056,则器械的操作者可被警示并且/或者器械的功能将被禁用。除此之外或另选地,钉仓6056的类型可用于识别钉仓6056的某个参数,例如,仓的长度和/或钉的高度和长度。
类似地,如图109所示,第一类型钉仓6006可替换第二钉仓6056。第一类型钉仓6006将能够操作以检测南磁极,但相反将检测到北磁极。在这种情况下,端部执行器6050将识别钉仓6006为具有第一类型。
图110示出了响应于例如如图108和图109所示的定位在砧座中的磁体与钉仓中的霍尔效应传感器之间的距离或间隙6024而由例如如图108和图109所示的定位在钉仓的远侧末端中的霍尔效应传感器检测到的电压6022的曲线图6020。如图110所示,当砧座中的磁体被取向成使其北极朝向钉仓时,随着磁体接近霍尔效应传感器,电压将趋于靠近第一值;当磁体被取向成使其南极朝向钉仓时,电压将趋于靠近第二、不同值。所测量的电压可被器械用于识别钉仓。
图111示出了包括显示器6102的外科器械的外壳6100的一个实施方案。外壳6100类似于上述外壳12。显示器6102可操作以将下述信息传送给器械的操作者,例如,联接到端部执行器的钉仓不适用于本应用。除此之外或另选地,显示器6102可显示钉仓的参数,例如,仓的长度和/或钉的高度和长度。
图112示出了包括磁体6162的钉保持器6160的一个实施方案。钉保持器6160可操作地联接到钉仓6156并且用于阻止钉离开钉仓6156。当钉仓6156施加到端部执行器时,钉保持器6160可保留在适当的位置。在一些实施方案中,钉保持器6160包括定位在钉保持器6160的远侧区域中的磁体6162。端部执行器的砧座可包括霍尔效应传感器,该霍尔效应传感器可操作以与钉保持器6160的磁体6162耦合。霍尔效应传感器可操作以检测磁体6162的特性,例如,磁场强度和磁极性。可通过例如将磁体6162设置在钉保持器6160之上或之中的不同位置和/或深度处或通过选择具有不同组成的磁体6162来改变磁场强度。磁体6162的不同特性可用于识别不同类型的钉仓。
图113A和图113B示出了端部执行器6200的一个实施方案,该端部执行器包括用于识别不同类型的钉仓6206的传感器6208。端部执行器6200包括能够枢转地联接到第二钳口构件或细长通道6204的第一钳口构件或砧座6202。细长通道6204被构造成能够在其中支撑钉仓6206。端部执行器6200还包括定位在近侧区域中的传感器6208。传感器6208可为光学传感器、磁传感器、电传感器、或任何其他合适的传感器中的任一个。
传感器6208能够操作以检测钉仓6206的特性并且由此识别钉仓6206类型。图113B示出了其中传感器6208为光学发射器和检测器6210的示例。钉仓6206的主体可具有不同的颜色,使得颜色标识钉仓6206类型。光学发射器和检测器6210可操作以探询钉仓6206主体的颜色。在例示的实施方案中,光学发射器和检测器6210可通过接收到红色、绿色、和蓝色光谱中等强度的反射光来检测白色6212。光学发射器和检测器6210可通过接收到绿色和蓝色光谱中极少的反射光同时接收到红色光谱中较高强度的光来检测红色6214。
另选地或除此之外,光学发射器和检测器6210或另一个合适的传感器6208可探询和识别钉仓6206上的一些其他符号或标记。符号或标记可为条形码、形状或字符、颜色编码的标志、或任何其他合适的标记中的任一者。可将由传感器6208读取的信息传送给外科装置10中的微控制器,例如,微控制器1500。微控制器1500可被构造成能够将有关钉仓6206的信息传送给器械的操作者。例如,所识别的钉仓6206可不适用于给定应用;在这种情况下,器械的操作者可被告知并且/或者器械的功能不合适。在这种情况下,微控制器1500可任选地被构造成能够禁用外科器械的功能。另选地或除此之外,微控制器1500可被构造成能够向外科器械10的操作者通知所识别的钉仓6206类型的参数,例如,钉仓6206的长度、或有关钉的信息(例如,高度和长度)。
智能仓唤醒操作和数据保持
在一个实施方案中,本文所述的外科器械包括用于传感器和/或电子部件的短路保护技术。为了启用此类传感器和其他电子技术,在外科器械的模块化部件之间传输功率信号和数据信号。在模块化传感器部件的装配期间,被连接的用于在所连接部件之间传输功率信号和数据信号的电导体通常为暴露的。
图114为根据一个实施方案的具有电导体7002,7004的端部执行器7000的局部视图,该电导体用于在外科器械的连接部件之间传输功率和数据信号。这些电导体7002,7004可能变为短路并且因而损坏关键系统电子部件。图115为图114中所示的端部执行器7000的局部视图,其示出了定位在端部执行器中的传感器和/或电子部件7005。现在参考图114和图115,在本公开通篇公开的外科器械的各种实施方案中,本公开利用电子传感器提供有关组织的可压缩性和厚度的实施反馈。模块化架构将使得定制模块化轴的构型能够采用任务专用技术。为了启用外科器械中的传感器和其他电子电路部件,需要在包括模块化传感器和/或电子电路部件7005的第二电路之间传输功率和数据信号。在模块化传感器和/或电子部件7005的装配期间,电导体7002,7004被暴露,使得当被连接时,它们在所连接的传感器和/或电子部件7005之间传输功率和数据信号。因为这些电导体7002,7004在装配期间可能变为短路并且因而损坏其他系统电子电路,所以本文所述的外科器械的各种实施方案包括用于传感器和/或电子部件7005的短路保护技术。
在一个实施方案中,本公开提供了用于外科器械的第二电路的传感器和/或电子部件7005的短路保护电路7012。图116为根据一个实施方案的外科器械电子子系统7006的框图,该外科器械电子子系统包括用于传感器和/或电子部件7005的短路保护电路7012。主电源电路7010通过主电源端子7018,7020连接到包括微处理器和其他电子部件7008(在下文中,处理器7008)的主电路。主电源电路7010还连接到短路保护电路7012。短路保护电路7012联接到补充电源电路7014,该补充电源电路7014通过电导体7002,7004将功率供应给传感器和/或电子部件7005。
为了降低对连接到主电源端子7018,7020的处理器7008的损坏,在馈电给传感器和/或电子部件7005的电源端子的电导体7002,7004之间的短路期间,提供自隔离/恢复式短路保护电路7012。在一个实施方案中,可通过将补充电源电路7014联接到主电源电路7010来实现短路保护电路7012。在补充电源电路7014功率导体7002,7004短路的情况下,补充电源电路7014自身与主电源电路7010隔离以避免损坏外科器械的处理器7008。因此,当在补充电源电路7014的电导体7002,7004中发生短路时,实际上对联接到主电源端子7018,7020的处理器7008和其他电子电路部件没有影响。因此,如果在补充电源电路7014的电导体7002,7004之间发生短路,则主电源电路7010不受影响并且保持能够有效地将功率供应给受保护的处理器7008,使得处理器7008可监控短路状态。当补充电源电路7014的电导体7002,7004之间的短路被纠正时,补充电源电路7014重新接合主电源电路7010并且可再次用于将功率供应给传感器部件7005。还可监控短路保护电路7012以向外科器械的最终用户指示一个或多个短路状态。还可监控短路保护电路7012以在短路事件被指示时闭锁外科器械的击发。多个补充保护电路可网联在一起,以隔离、监控、或保护其他电路功能。
因此,在一个方面,本公开提供了用于端部执行器7000(图114和图115)中的电导体7002,7004或外科器械的其他元件的短路保护电路7012。在一个实施方案中,短路保护电路7012采用联接到主电源电路7010的补充的自隔离/恢复式电源电路7014。可监控短路保护电路7012以向外科器械的最终用户指示一个或多个短路状态。在短路情况下,短路保护电路7012可用于闭锁外科器械以防被击发或者闭锁其他装置操作。多个其他补充保护电路可网联在一起,以隔离、监控、或保护其他电路功能。
图117为根据一个实施方案的短路保护电路7012,该短路保护电路包括联接到主电源电路7010的补充电源电路7014。主电源电路7010包括变压器7023(X1),该变压器联接到利用二极管91-94实现的全波整流器7025。全波整流器7025联接到稳压器7027。稳压器7027的输出(OUT)联接到主电源电路7010的输出端子7018,7020(OP1)和补充电源电路7014。输入电容器C1对稳压器7027中的输入电压进行滤波并且一个或多个电容器C2对稳压器7027的输出进行滤波。
在图117所示的实施方案中,补充电源电路7014包括被构造成能够控制电导体7002,7004之间的电源输出OP2的一对晶体管T1、T2。在电导体7002,7004未发生短路的正常操作期间,输出OP2将功率供应给传感器部件7005。一旦晶体管T1和T2开启(激活)并且开始传导电流,来自稳压器7027的输出端的电流就被第一晶体管T1分流,使得没有电流流过R1并且iR1=0。稳压器的输出电压+V被施加到节点处,使得补充电源电路7014的输出电压OP2则为Vn~+V,并且第一晶体管T1驱动电流通过输出端子7002流到传感器部件7005,其中输出端子7004为电流返回路径。输出电流iR5的一部分转向穿过R5以驱动输出指示器LED2。流过LED2的电流为iR5。只要节点电压Vn高于开启(激活)第二晶体管T2所需的阈值,补充电源电路7014就用作馈电给传感器和/或电子部件7005的电源电路。
当第二电路的电导体7002,7004短路时,节点电压Vn下降到地电或零,并且第二晶体管T2关闭且停止导电,这关闭第一晶体管T1。当第一晶体管T1截断时,稳压器7027的输出电压+V导致电流iR1流过短路指示器LED1并且经由电导体7002,7004之间的短路流到地。因此,没有电流流过R5,并且iR5=0A且+VOP2=0V。补充电源电路7014自身与主电源电路7010隔离,直到短路被去除。在短路期间,仅短路指示器LED1被供电,而输出指示器LED2不被供电。当电导体7002,7004之间的短路被去除时,节点电压Vn上升,直到T2开启并且随后开启T1。当T1和T2开启(被偏置成导电状态,诸如,饱和)直到节点电压Vn达到+VOP2时,并且补充电源电路7014恢复其用于传感器部件7005的电源功能。一旦补充电源电路7014恢复其电源功能,短路指示器LED1就关闭并且输出指示器LED2就开启。如果在补充电源电路7014电导体7002,7004之间发生另一次短路,则重复该循环。
在一个实施方案中,提供了采样率监控器以在外科器械处于非感测状态时通过限制传感器的采用率和/或占空比来实现功率降低。图118为根据一个实施方案的外科器械电子子系统7022的框图,该外科器械电子子系统包括采样率监控器7024以在外科器械处于非感测状态时通过限制第二电路的传感器和/或电子部件7005的采样率和/或占空比来实现功率降低。如图118所示,外科器械电子子系统7022包括联接到主电源电路7010的处理器7008。主电源电路7010联接到采样率监控器电路7024。补充电源电路7014在通过电导体7002,7004对传感器和/或电子部件7005加电时联接到采样率监控器7024。包括处理器7008的主电路联接到装置状态监控器7026。在各种实施方案中,外科器械电子子系统7022利用传感器和/或电子部件7005提供有关组织的可压缩性和厚度的实时反馈,如本文此前所述。外科器械的模块化架构使得定制模块化轴的构型能够采用功能任务专用技术。为了启用此类附加功能,采用电子连接点和部件以在外科器械的模块化部件之间传输功率和信号。传感器和/或电子部件7005的数量的增加将提高外科器械系统7022的功率消耗并且由此需要用于降低外科器械系统7022的功率消耗的各种技术。
在一个实施方案中,为了降低功率消耗,被构造为具有传感器和/或电子部件7005(第二电路)的外科器械包括采样率监控器7024,该采样率监控器可实现为硬件电路或软件技术以降低传感器和/或电子部件7005的采样率和/或占空比。采样率监控器7024与装置状态监控器7026结合来操作。装置状态监控器7026感测外科器械的各种电子/机械子系统的状态。在图118所示的实施方案中,装置状态监控器7026感测端部执行器的状态处于未夹持(状态1)、正在夹持(状态2)、还是已夹持(状态3)操作状态。
采样率监控器7024基于由装置状态监控器7026确定的端部执行器的状态来设定传感器部件7005的采样率和/或占空比。在一个方面,采样率监控器7024可在端部执行器处于状态1时将占空比设定为约10%,在端部执行器处于状态2时将占空比设定为约50%,或者在端部执行器处于状态3时将占空比设定为约20%。在各种其他实施方案中,由采样率监控器7024设定的占空比和/或采样率可采用数值范围。例如,在另一方面,采样率监控器7024可在端部执行器处于状态1时将占空比设定为约5%至约15%,在端部执行器处于状态2时将占空比设定为约45%至约55%,或者在端部执行器处于状态3时将占空比设定为约15%至约25%。在各种其他实施方案中,由采样率监控器7024设定的占空比和/或采样率可采用另外的数值范围。例如,在另一方面,采样率监控器7024可在端部执行器处于状态1时将占空比设定为约1%至约20%,在端部执行器处于状态2时将占空比设定为约20%至约80%,或者在端部执行器处于状态3时将占空比设定为约1%至约50%。在各种其他实施方案中,由采样率监控器7024设定的占空比和/或采样率可采用另外的数值范围。
在一个方面,可通过产生联接到主电路/软件的补充电路/软件来实现采样率监控器7024。当补充电路/软件确定外科器械系统7022处于非感测状态时,采样率监控器7024使传感器和/或电子部件7005进入降低的采用或占空比模式,由此降低主电路上的功率负荷。主电源电路7010将仍能够有效地供应功率,使得主电路的受保护的处理器7008可监控状态。当外科器械系统7022进入需要较严格感测活动的状态时,采样率监控器7024提高补充电路采样率或占空比。电路可采用集成电路、固态部件、微处理器、或固件的混合物。还可监控降低采样率或占空比模式的电路以向外科器械系统7022的最终用户指示状态。还可监控电路/软件以在装置处于功率节省模式时闭锁装置的击发或功能。
在一个实施方案中,采样率监控器7024硬件电路或软件技术可降低用于传感器和/或电子部件7005的采样率和/或占空比以降低外科器械的功率消耗。可监控降低的采样率或占空比模式以向外科器械的最终用户指示一个或多个状态。如果在外科器械中出现降低的采样率和/或占空比状态,则保护电路/软件可被构造成能够闭锁外科器械以防被击发或以其他方式进行操作。
在一个实施方案中,本公开提供了用于外科器械中的传感器和/或电子部件的过流和/或过压保护电路。图119为根据一个实施方案的外科器械电子子系统7028的框图,该外科器械电子子系统包括用于外科器械的第二电路的传感器和/或电子部件7005的过流/过压保护电路7030。在各种实施方案中,外科器械电子子系统7028利用第二电路的传感器和/或电子部件7005提供有关组织的可压缩性和厚度的实时反馈,如本文此前所述。外科器械的模块化架构使得定制模块化轴的构型能够采用功能任务专用技术。为了启用传感器和/或电子部件7005,添加另外的电子连接点和部件以在模块化部件之间传输功率和信号。用于得自模块化部分的传感器和/或电子部件7005的这些另外导体可能短路和/或损坏,由此导致较大的电流消耗,这可损坏主电路的脆弱处理器7008电路和/或其他电子部件。在一个实施方案中,过流/过压保护电路7030利用联接到主电源电路7010的补充自隔离/恢复电路7014保护用于外科器械上的传感器和/或电子部件7005的导体。补充自隔离/恢复电路7014的一个实施方案的操作已结合图117进行描述,并且为本公开的简洁和清楚起见,将不在此处进行重复。
在一个实施方案中,为了减少感测外科器械中的大电流消耗期间的电子损坏,外科器械的电子子系统7028包括用于传感器和/或电子部件7005的导体的过流/过压保护电路7030。可通过产生联接到主电源电路7010的补充电路来实现过流/过压保护电路7030。就补充电路电导体7002,7004经受高于预期值的电流水平的情况而言,过流/过压保护电路7030隔离来自主电源电路7010的电流以避免损害。主电源电路7010将仍能够有效地供应功率,使得受保护的主处理器7008可监控状态。当补充电源电路7014的较大电流消耗被纠正时,补充电源电路7014重新接合主电源电路7010并且可用于将功率供应给传感器和/或电子部件7005(例如,第二电路)。过流/过压保护电路7030可采用集成电路、固态部件、微处理器、固件、断路器、熔断器、或PTC(正温度系数)型技术的混合物。
在各种实施方案中,还可监控过流/过压保护电路7030以向装置的最终用户指示过流/过压状态。还可监控过流/过压保护电路7030以在过流/过压状态事件被指示时闭锁外科器械的击发。还可监控过流/过压保护电路7030以向装置的最终用户指示一个或多个过流/过压组状态。如果在装置中出现过流/过压状态,则过流/过压保护电路7030可闭锁外科器械以防被击发或者闭锁外科器械的其他操作。
图120为根据一个实施方案的用于外科器械的第二电路的传感器和电子部件7005(图119)的过流/过压保护电路7030。在硬短路(SHORT)期间,过流/过压保护电路7030在过流/过压保护电路7030的输出端处提供电流路径,并且还通过由杂散电感LSTRAY驱动的旁路电容器CBYPASS提供用于后续电流的路径。
在一个实施方案中,过流/过压保护电路7030包括具有自动重置特性的电流限制开关7032。电流限制开关7032包括联接到放大器A的电流感测电阻器RCS。当放大器A感测到高于预先确定的阈值的浪涌电流时,放大器激活断路器CB以打开电流路径,由此中断浪涌电流。在一个实施方案中,可利用得自Maxim的MAX1558集成电路来实现具有自动重置特征的电流限制开关7032。电流限制开关7032具有自动重置特征。如果开关7032短路超过20ms,则自动重置特征闩锁该开关,从而节省系统功率。然后测试短路输出(SHORT)来确定短路何时被去除,以自动地重新启动该通道。低休眠供应电流(45μA)和待机电流(3μA)保持外科器械中的电池功率。具有自动重置安全特征结构的电流限制开关7032保持外科器械受到保护。内置热过载保护限制功率耗散和结点温度。精确的、可编程的电流限制电路保护输入源以防过载和短路状态。20ms的故障消隐使得电路能够忽略暂态故障,例如,热插拔电容负载时产生的故障,由此避免将假警报提供给主机系统。在一个实施方案中,具有自动重置特征的电流限制开关7032还提供反向电流保护电路,以在开关7032断开时阻止电流从输出端流到输入端。
在一个实施方案中,本公开提供了用于外科器械中的传感器和/或电子部件的反向极性保护。图121为根据一个实施方案的外科器械电子子系统7040的框图,该外科器械电子子系统具有用于第二电路的传感器和/或电子部件7005的反向极性保护电路7042。利用联接到主电源电路7010的本文称为补充电源电路7014的补充自隔离/恢复电路来提供反向极性保护以用于外科器械的暴露引线(电导体7002,7004)。可监控反向极性保护电路7042以向装置的最终用户指示一个或多个反向极性状态。如果反向极性被施加到装置,则保护电路7042可闭锁该装置以免被击发或闭锁其他装置关键操作。
在各种实施方案中,本文所述的外科器械利用传感器和/或电子部件7005提供有关组织的可压缩性和厚度的实时反馈。外科器械的模块化架构使得定制模块化轴的构型能够采用任务专用技术。为了传感器和/或电子部件7005,在模块化部件之间传输功率信号和数据信号。在模块化部件的装配期间,被连接的用于在所连接部件之间传输功率信号和数据信号的电导体通常为暴露的电导体。这些导体可能由反向极性进行加电。
因此,在一个实施方案中,外科器械电子子系统7040被构造成能够降低感测外科器械中的反向极性联接7044施加期间的电子损坏。外科器械电子子系统7040采用与暴露的电导体7002,7004内联的极性保护电路7042。在一个实施方案中,可通过产生联接到主电源电路7010的补充电源电路7014来实现极性保护电路7042。在补充电源电路7014电导体7002,7004由反向极性进行加电的情况下,其隔离来自主电源电路7010的功率以避免损坏。主电源电路7010将仍能够有效地供应功率,使得主电路的受保护的处理器7008可监控状态。当补充电源电路7014的反向极性被纠正时,补充电源电路7014重新接合主电源电路7010并且可用于将功率供应给第二电路。还可监控反向极性保护电路7042以向装置的最终用户指示反向极性状态。还可监控反向极性保护电路7042,以在反向极性事件被指示的情况下闭锁装置的击发。
图122为根据一个实施方案的用于外科器械的第二电路的传感器和/或电子部件7005的反向极性保护电路7042。在正常操作期间,继电器开关S1包括处于常闭(NC)位置的输出触点并且主电源电路7010(图121)的电池电压B1被施加到联接到第二电路的VOUT。二极管D1阻止电流流过继电器开关S1的线圈7046(电感器)。当电池B1的极性反向时,二极管D1导电并且电流流过继电器开关S1的线圈7046,由此对继电器开关S1供电,以将输出触点设置为常开(NO)位置并且从而使反向电压与联接到第二电路的VOUT断开连接。一旦开关S1处于NO位置,来自电池B1的正极端子的电流就流过LED D3和R1,以避免电池B1短接。二极管D2为夹持二极管,以防切换期间由线圈7046产生的尖峰。
在一个实施方案中,本文所述的外科器械利用用于模块化装置上的传感器的睡眠模式来提供功率降低技术。图123为根据一个实施方案的外科器械电子子系统7050的框图,该外科器械电子子系统利用用于传感器和/或电子部件7005的睡眠模式监控器7052实现功率降低。在一个实施方案中,用于第二电路的传感器和/或电子部件7005的睡眠模式监控器7052可实施为电路和/或软件程序以降低外科器械的功率消耗。可监控睡眠模式监控器7052保护电路以向装置的最终用户指示一个或多个睡眠模式状态。如果在装置中出现睡眠模式状态,则睡眠模式监控器7052保护电路/软件可被构造成能够锁定装置以防被击发或被用户操作。
在各种实施方案中,本文所述的外科器械利用电子传感器7005提供有关组织的可压缩性和厚度的实时反馈。外科器械的模块化架构使得外科器械被构造为具有采用任务专用技术的定制模块化轴。为了启用传感器和/或电子部件7005,可采用另外的电子连接点和部件以在模块化部件之间传输功率和数据信号。当传感器和/或电子部件7005的数量增加时,外科器械的功率消耗将增加,由此需要用于降低外科器械的功率消耗的技术。
在一个实施方案中,电子子系统7050包括用于传感器7005的睡眠模式监控器7052电路和/或软件,以降低感测外科器械的功率消耗。可通过产生联接到主电源电路7010的补充电源电路7014来实现睡眠模式监控器7052。装置监控器7054监控外科器械处于1=未夹持状态、2=正在夹持状态、还是3=已夹持状态。当睡眠模式监控器7052软件确定外科器械处于非感测状态(1=未夹持状态)时,睡眠模式监控器7052使第二电路的传感器和/或电子部件7005进入睡眠模式,以降低主电源电路7010上的功率负荷。主电源电路7010将仍能够有效地供应功率,使得主电路的受保护的处理器7008可监控状态。当外科器械进入需要传感器活动的状态时,补充电源电路7014被唤醒并且重新接合主电源电路7010。睡眠模式监控器7051电路可采用集成电路、固态部件、微处理器、和/或固件的混合物。还可监控睡眠模式监控器7051电路以向装置的最终用户指示状态。还可监控睡眠模式监控器7051电路以在装置处于功率节省模式时闭锁装置的击发或功能。
在一个实施方案中,本公开提供了保护以防模块化外科器械中的传感器和/或电子部件的功率丢失。图124为外科器械电子子系统7060的框图,该外科器械电子子系统包括临时性功率丢失电路7062以提供保护以防模块化外科器械中的传感器和/或电子部件7005的间歇性功率丢失。
在各种实施方案中,本文所述的外科器械利用传感器和/或电子部件7005提供有关组织的可压缩性和厚度的实时反馈。外科器械的模块化架构使得外科器械被构造为具有采用任务专用技术的定制模块化轴。为了启用传感器和/或电子部件7005,可采用另外的电子连接点和部件以在模块化部件之间传输电力和信号。当电连接点的数量增加时,传感器和/或电子部件7005经受短期间歇性功率丢失的可能性会增加。
根据一个实施方案,临时性功率丢失电路7062被构造成能够降低源自感测外科器械中的短期间歇性功率丢失的装置操作误差。临时性功率丢失电路7062能够在来自主电源电路7010的电力中断的情况下在短时间段内递送连续电力。临时性功率丢失电路7062可包括电容元件、电池、和/或能够均衡、检测或存储电力的其他电子元件。
如图124所示,可通过产生联接到主电路/软件的补充电路/软件来实现临时性电力丢失电路7062。在补充电路/软件经受得自主电源的突然功率丢失的情况下,由补充电源电路7014加电的传感器和/或电子部件7005将在短时间段内不受影响。在功率丢失期间,可通过电容元件、电池、和/或能够均衡或存储电力的其他电子元件来对补充电源电路7014加电。还可监控以硬件或软件实施的临时性功率丢失电路7062以在装置处于功率节省模式时闭锁外科器械的击发或功能。如果在外科器械中出现间歇性功率丢失状态,则以硬件或软件实施的临时性功率丢失电路7062可闭锁外科器械以防被击发或操作。
图125示出了实现为硬件电路的临时性电力丢失电路7062的一个实施方案。临时性功率丢失电路7062硬件电路被构造成能够降低得自短期间歇性功率丢失的外科器械操作误差。临时性功率丢失电路7062能够在来自主电源电路7010(图124)的电力中断的情况下在短时间段内递送连续电力。临时性功率丢失电路7062采用电容元件、电池、和/或能够均衡、检测或存储电力的其他电子元件。可监控临时性功率丢失电路7062以向外科器械的最终用户指示一个或多个状态。如果在外科器械中出现间歇性功率丢失状态,则临时性功率丢失电路7062保护电路/软件可闭锁装置以防被击发或操作。
在例示的实施方案中,临时性功率丢失电路7062包括模拟开关集成电路U1。在一个实施方案中,模拟开关集成电路U1为单刀单掷(SPST)、低电压、单源、CMOS模拟开关,例如,由Maxim提供的MAX4501。在一个实施方案中,模拟开关集成电路U1为常开(NO)的。在其他实施方案中,模拟开关集成电路U1可为常闭(NC)的。输入端IN通过待机“反向电容器”激活NO模拟开关7064以将升压DC-DC转换器U3的输出端连接到线性稳压器U2的输入端。线性稳压器U2的输出端联接到DC-DC转换器U3的输入端。线性稳压器U2通过组合超低源电流和低压差电压来最大化电池寿命。在一个实施方案中,线性稳压器U2为由Maxim提供的MAX882集成电路。
电池还联接到升压DC-DC转换器U3的输入端。升压DC-DC转换器U3可为紧凑、高效、升压DC-DC转换器,其具有内置同步整流器以提高效率并且通过无需外部Schottky二极管来降低尺寸和成本。在一个实施方案中,升压DC-DC转换器U3为得自Maxim的MAX1674集成电路。
智能仓技术
图126A和图126B示出了端部执行器10000的一个实施方案的透视图,该端部执行器包括磁体10008和与处理器10012连通的霍尔效应传感器10010。端部执行器10000类似于上述端部执行器300。端部执行器包括能够枢转地联接到第二钳口构件或细长通道10004的第一钳口构件或砧座10002。细长通道10004被构造成能够在其中支撑钉仓10006。钉仓10006类似于上述钉仓304。砧座10008包括磁体10008。钉仓包括霍尔效应传感器10010和处理器10012。霍尔效应传感器10010能够操作以通过传导联接件10014与处理器10012连通。霍尔效应传感器10010被定位在钉仓10006内以在砧座10002处于闭合位置时与磁体10008可操作地耦合。霍尔效应传感器10010可被构造成能够检测由磁体10008的运动或位置引起的环绕霍尔效应传感器10010的磁场变化。
图127示出了与霍尔效应传感器10010的操作相关的可操作尺寸的一个实施方案。第一尺寸10020位于磁体10008中心的底部与钉仓10006的顶部之间。第一尺寸10020可随着钉仓10006的尺寸和形状而变化,例如,0.0466英寸、0.0325英寸、0.0154英寸、或0.0154英寸、或任何适当的值。第二尺寸10022位于磁体10008中心的底部与霍尔效应传感器10010的顶部之间。第二尺寸也可随着钉仓10006的尺寸和形状而变化,例如,0.0666英寸、0.0525英寸、0.0354英寸、0.0347英寸、或任何适当的值。第三尺寸10024位于处理器10012的顶部与钉仓10006的前沿表面10028之间。第三尺寸也可随着钉仓的尺寸和形状而变化,例如,0.0444英寸、0.0440英寸、0.0398英寸、0.0356英寸、或任何适当的值。角度10026为砧座10002与钉仓10006的顶部之间的角度。角度10026也可随着钉仓10006的尺寸和形状而变化,例如,0.91度、0.68度、0.62度、0.15度、或任何适当的值。
图128A至图128D进一步示出了可随着钉仓10006的尺寸和形状而变化并且影响霍尔效应传感器10010的操作的尺寸。图128A示出了钉仓10006的实施方案的外部侧视图。钉仓10006包括推出耳状物10036。当钉仓10006与端部执行器10000可操作地联接时,如图126A所示,推出耳状物10036置于细长通道10004的侧面上。
图128B示出了推出耳状物10036的下表面10038与霍尔效应传感器10010(未示出)的顶部之间的各种可能尺寸。第一尺寸10030a可以用于黑色、蓝色、绿色或金色钉仓10006,其中钉仓10006的主体的颜色可用于标识钉仓10006的各个方面。第一尺寸10030a可为例如在推出耳状物10036的下表面10038之下0.005英寸。第二尺寸10030b可以用于灰色钉仓10006,并且可为在推出耳状物10036的下表面10038之上0.060英寸。第三尺寸10030c可以用于白色钉仓10006,并且可为在推出耳状物10036的下表面10038之上0.030英寸。
图128C示出了钉仓10006的实施方案的外部侧视图。钉仓10006包括具有下表面10038的推出耳状物10036。钉仓10006还包括位于霍尔效应传感器10010(未示出)正上方的上表面10046。图128D示出了推出耳状物10038的下表面10038与霍尔效应传感器10010上方的钉仓10006的上表面10046之间的各种可能尺寸。第一尺寸10040可以用于于黑色、蓝色、绿色或金色钉仓10006,并且可例如为在推出耳状物10036的下表面10038之上0.015英寸。第二尺寸10042可以用于灰色钉仓10006,并且可为例如0.080英寸。第三尺寸10044可以用于白色钉仓10006,并且可为例如0.050英寸。
应当理解,所提及的钉仓10006的主体的颜色仅用于方便和示例目的。应当理解,其他钉仓10006主体颜色也是可以的。还应当理解,提供用于图128A至图128D的尺寸也为示例的和非限制性的。
图129A示出了根据每个磁体10058a-10058d可如何适配在砧座(例如,图126A-126B所示的砧座10002)的远侧端部中的具有各种尺寸的磁体10058a-10058d的各种实施方案。磁体10058a-10058d可在距砧座销或枢转点10052的给定距离10050处定位在砧座10002的远侧末端中。应当理解,此距离10050可随着端部执行器和钉仓的构造和/或磁体的所需位置而变化。图129B进一步示出了砧座10002和砧座10002的中心轴线点的前端剖视图10054。图129A还示出了磁体10058a-10058d的各种实施方案可如何装配在同一砧座10002内的示例10056。
图130A-130E示出了端部执行器10100的一个实施方案,该端部执行器以举例的方式包括如图129A-129B所示的磁体10058a。图130A示出了端部执行器10100的前端剖视图。端部执行器10100类似于上述端部执行器300。端部执行器10100包括第一钳口构件或砧座10102、第二钳口构件或细长通道10104、以及可操作地联接到细长通道10104的钉仓10106。砧座10102还包括磁体10058a。钉仓10106还包括霍尔效应传感器10110。砧座10102在此处被示为处于闭合位置。图130B示出了处于原位的砧座10102和磁体10058a的前端剖面图。图130C示出了处于任选位置的砧座10102和磁体10058a的透视剖面图。图130D示出了处于任选位置的砧座10102和磁体10058a的侧面剖面图。图130E示出了处于任选位置的砧座10102和磁体10058a的顶部剖面图。
图131A-131E示出了端部执行器10150的一个实施方案,该端部执行器以举例的方式包括如图129A-129B所示的磁体10058d。图131A示出了端部执行器10150的前端剖视图。端部执行器10150包括砧座10152、细长通道10154、和钉仓10156。砧座10152还包括磁体10058d。钉仓10156还包括霍尔效应传感器10160。图131B示出了处于原位的砧座10150和磁体10058d的前端剖面图。图131C示出了处于任选位置的砧座10152和磁体10058d的透视剖面图。图131D示出了处于任选位置的砧座10152和磁体10058d的侧面剖面图。图131E示出了处于任选位置的砧座10152和磁体10058d的顶部剖面图。
图132示出了如上所述的端部执行器300,并且示出了砧座306与钉仓304和/或细长通道302的接触点。砧座306与钉仓304和/或细长通道302之间的接触点可用于确定砧座306的位置并且/或者提供用于砧座306与钉仓304之间、和/或砧座306与细长通道302之间的电接触的点。远侧接触点10170可提供砧座306与钉仓304之间的接触点。近侧接触点10172可提供砧座306与细长通道302之间的接触点。
图133A和图133B示出了端部执行器10200的一个实施方案,该端部执行器能够操作以利用远侧接触点处的导电表面产生电连接。端部执行器10200类似于上述端部执行器300。端部执行器包括砧座10202、细长通道10204和钉仓10206。砧座10202还包括磁体10208和内表面10210,该内表面还包括多个钉成形凹痕10212。在一些实施方案中,砧座10202的内表面10210还包括围绕钉成形凹痕10212的第一导电表面10214。第一导电表面10214可与钉仓10206上的第二导电表面10222接触,如图107B所示。图107B示出了钉仓10206的仓体10216的近距离视图。仓体10216包括被设计用于保持钉(未示出)的钉腔10218。在一些实施方案中,钉腔10218还包括在仓体10216的表面上方突出的钉腔延伸部10220。钉腔延伸部10220可涂覆有第二导电表面10222。因为钉腔延伸部10222在仓体10216的表面上方突出,所以当砧座10202处于闭合位置时,第二导电表面10222将与第一导电表面10214接触。这样,砧座10202可与钉仓10206形成电接触。
图134A-134C示出了示出了端部执行器10250的一个实施方案,该端部执行器能够操作以利用导电表面形成电连接。图134A示出了包括砧座10252、细长通道10254和钉仓10256的端部执行器10250。砧座还包括磁体10258和内表面10260,该内表面还包括钉成形凹痕10262。在一些实施方案中,砧座10250的内表面10260还可包括第一导电表面10264,该第一导电表面以举例的方式定位在钉成形凹痕10262的远侧,如图134B所示。第一导电表面10264被定位成使得它们与定位在钉仓10256上的第二导电表面10272接触,如图134C所示。图134C示出了包括仓体10266的钉仓10256。仓体10266还包括上表面10270,该上表面在一些实施方案中可涂覆有第二导电表面10272。第一导电表面10264定位在砧座10252的内表面10260上,使得它们在砧座10252处于闭合位置时与第二导电表面10272接触。这样,砧座10250可与钉仓10256形成电接触。
图135A和图135B示出了端部执行器10300的一个实施方案,该端部执行器能够操作以利用导电表面形成电连接。端部执行器10300包括砧座10302、细长通道10304和钉仓10306。砧座10302还包括磁体10308和内表面10310,该内表面还包括多个钉成形凹痕10312。在一些实施方案中,内表面10310还包括围绕钉成形凹痕10312的第一导电表面10314。第一导电表面被定位成使其与第二导电表面10322接触,如图109B所示。图109B示出了钉仓10306的近距离视图。钉仓10306包括仓体10316,该仓体还包括上表面10320。在一些实施方案中,上表面10320的前沿可涂覆有第二导电表面10322。第一导电表面10312被定位成使其在砧座10302处于闭合位置时将与第二导电表面10322接触。这样,砧座10302可与钉仓10306形成电连接。
图136A和图136B示出了端部执行器10350的一个实施方案,该端部执行器能够操作以利用导电表面形成电连接。图136A示出了包括砧座10352、细长通道10354、和钉仓10356的端部执行器10350。砧座10352还包括磁体10358和内表面10360,该内表面还包括多个钉成形凹痕10362。在一些实施方案中,内表面10360还包括围绕钉成形凹痕10362的第一导电表面10364。第一导电表面被定位成使其与第二导电表面10372接触,如图136B所示。图136B示出了钉仓10356的近距离视图。钉仓10356包括仓体10366,该仓体还包括上表面10370。在一些实施方案中,上表面10327的前沿可涂覆有第二导电表面10372。第一导电表面10362被定位成使其在砧座10352处于闭合位置时将与第二导电表面10372接触。这样,砧座10352可与钉仓10356形成电连接。
图137A-137C示出了端部执行器10400的一个实施方案,该端部执行器能够操作以利用近侧触点10408形成电连接。图137A示出了包括砧座10402、细长通道10404、和钉仓10406的端部执行器10400。砧座10402还包括销10410,该销从砧座10402延伸并且允许砧座相对于细长通道10404和钉仓10406在打开位置和闭合位置之间枢转。图137B为用于此目的的置于限定在细长通道10404中的孔10418内的销10410的近距离视图。在一些实施方案中,销10410还包括定位在销10410的外部的第一导电表面10412。在一些实施方案中,孔10418还包括位于其外表面上的第二导电表面10141。当砧座10402在闭合位置和打开位置之间运动时,销10410上的第一导电表面10412旋转并且接触孔10418的表面上的第二导电表面10414,由此形成电接触。图137C示出了另选实施方案,其中孔10418的表面上的第二导电表面10416具有另选位置。
图138示出了具有远侧传感器插头10466的端部执行器10450的一个实施方案。端部执行器10450包括第一钳口构件或砧座10452、第二钳口构件或细长通道10454、和钉仓10466。钉仓10466还包括定位在钉仓10466的远侧端部处的远侧传感器插头10466。
图139A示出了其中砧座10452处于打开位置的端部执行器10450。图139B示出了其中砧座10452处于打开位置的端部执行器10450的剖视图。如图所示,砧座10452还可包括磁体10458,并且钉仓10456还可包括远侧传感器插头10466和楔形滑动件10468,该楔形滑动件类似于上述楔形滑动件190。图139C示出了其中砧座10452处于闭合位置的端部执行器10450。图139D示出了其中砧座10452处于闭合位置的端部执行器10450的剖视图。如图所示,砧座10452还可包括磁体10458,并且钉仓10456还可包括远侧传感器插头10466和楔形滑动件10468。如图所示,当砧座10452相对于钉仓10456处于闭合位置时,磁体10458接近远侧传感器插头10466。
图140提供了端部执行器10450的远侧端部的截面的近距离视图。如图所示,远侧传感器插头10466还可包括与处理器10462连通的霍尔效应传感器10460。霍尔效应传感器10460可操作地连接到挠性板10464。处理器10462也可操作地连接到挠性板10464,使得挠性板10464提供霍尔效应传感器10460与处理器10462之间的连通路径。砧座10452被示为处于闭合位置,并且如图所示,当砧座10452处于闭合位置时,磁体10458接近霍尔效应传感器10460。
图141示出了包括远侧传感器插头10466的钉仓10456的近距离顶视图。钉仓10456还包括仓体10470。仓体10470还包括电迹线10472。电迹线10472将电力提供给远侧传感器插头10466,并且连接到钉仓10456的近侧端部处的电源,如下文更详细所述。电迹线10472可通过各种方法布置在仓体10470中,例如,激光蚀刻。
图142A和142B示出了具有远侧传感器插头10516的钉仓10506的一个实施方案。图142A为钉仓10506的下侧的透视图。钉仓10506包括仓体10520和仓托盘10522。钉仓10506还包括远侧传感器覆盖件10524,该远侧传感器覆盖件包封钉仓10506的远侧端部的下部区域。仓托盘10522还包括电触点10526。图142B示出了钉仓10506的远侧端部的剖视图。如图所示,钉仓10506还可包括定位在仓体10520内的远侧传感器插头10516。远侧传感器插头10516还包括霍尔效应传感器10510和处理器10512,这两者均可操作地连接到挠性板10514。远侧传感器插头10516可连接到电触点10526,并且因而可利用仓托盘10522中的导电性作为电源。图142B还示出了远侧传感器覆盖件10524,该远侧传感器覆盖件包封仓体10520内的远侧传感器插头10516。
图143A-143C示出了包括连接到霍尔效应传感器10610和处理器10612的挠性缆线10630的钉仓10606的一个实施方案。钉仓10606类似于上述钉仓306。图143A为钉仓10606的分解图。钉仓10606包括仓体10620、楔形滑动件10618、仓托盘10622、和挠性缆线10630。挠性缆线10630还包括位于钉仓10606的近侧端部处的电触点10632,该电触点被布置成在钉仓10606与端部执行器(例如,下述端部执行器10800)可操作地联接时形成电连接。电触点10632与缆线迹线10634形成一体,该缆线迹线沿着钉仓10606的长度的一部分延伸。缆线迹线10634在钉仓10606的远侧端部附近连接10636,并且此连接10636与传导联接件10614接合。霍尔效应传感器10610和处理器10612可操作地联接到传导联接件10614,使得霍尔效应传感器10610和处理器10612能够连通。
图143B更详细地示出了钉仓10606和挠性缆线10630的装配。如图所示,仓托盘10622包封仓体10620的下侧,由此包封楔形滑动件10618。挠性缆线10630可定位在仓托盘10622的外部上,其中传导联接件10614定位在仓体10620的远侧端部内并且电触点10632定位在近侧端部附近的外部上。挠性缆线10630可通过任何适当的方式(例如,粘结或激光蚀刻)布置在仓托盘10622的外部上。
图143C示出了根据本实施方案的钉仓10606的剖视图,以图示说明钉仓的远侧端部内的霍尔效应传感器10610、处理器10612、和传导联接件10614的布置方式。
图144A-144F示出了包括连接到霍尔效应传感器10660和处理器10662的挠性缆线10680的钉仓10656的一个实施方案。图144A为钉仓10656的分解图。钉仓包括仓体10670、楔形滑动件10668、仓托盘10672、和挠性缆线10680。挠性缆线10680还包括缆线迹线10684,该缆线迹线沿着钉仓10656的长度的一部分延伸。缆线迹线10684中的每个在其远侧端部处具有角度10686,并且从其连接到传导联接件10664。霍尔效应传感器10660和处理器10662可操作地联接到传导联接件10664,使得霍尔效应传感器10660和处理器10662能够连通。
图144B示出了钉仓10656的装配。仓托盘10672包封仓体10670的下侧,由此包封楔形滑动件10668。挠性缆线10680定位在仓体10670与仓托盘10672之间。由此,在该图示中,仅角度10686和传导联接件10664可见。
图144C示出了装配的钉仓10656的下侧,并且还更详细地示出了挠性缆线10680。在装配的钉仓10656中,传导联接件10664定位在钉仓10656的远侧端部中。因为挠性缆线10680可定位在仓体10670与仓托盘10672之间,所以仅缆线迹线10684的角度10686端部以及传导联接件10664将从钉仓10656的下侧可见。
图144D示出了钉仓10656的剖视图,以图示说明霍尔效应传感器10660、处理器10662、和传导联接件10664的布置方式。还示出了缆线迹线10684的角度10686,以图示说明角度10686可被布置的位置。未示出缆线迹线10684。
图144E示出了不含仓托盘10672并且包括位于其最远侧位置中的楔形滑动件10668的钉仓10656的下侧。钉仓10656被示为不含仓托盘10672,以便图示说明缆线迹线10684的布置方式,该缆线迹线原本可被仓托盘10672遮蔽。如图所示,缆线迹线10684可被放置在仓体10670内部。角度10686任选地允许缆线迹线10684在仓体10670的远侧端部中占据较狭窄空间。
图144F还示出了钉仓10656,该钉仓不含仓托盘10672以便图示说明缆线迹线10684的可能布置方式。如图所示,缆线迹线10684可沿着仓体10670的外部的长度进行布置。此外,缆线迹线10684可形成角度10686以进入仓体10670的远侧端部的内部。
图145A和145B示出了包括挠性缆线10730、霍尔效应传感器10710、和处理器10712的钉仓10706的一个实施方案。图145A为钉仓10706的分解图。钉仓10706包括仓体10720、楔形滑动件10718、仓托盘10722、和挠性缆线10730。挠性缆线10730还包括电触点10732,该电触点被布置成在钉仓10706与端部执行器可操作地联接时形成电连接。电触点10732与缆线迹线10734形成一体。缆线迹线在钉仓10706的远侧端部附近连接10736,并且此连接10736与传导联接件10714接合。霍尔效应传感器10710和处理器10712可操作地联接到传导联接件10714,使得它们能够连通。
图145B更详细地示出了钉仓10706和挠性缆线10730的装配。如图所示,仓托盘10722包封仓体10720的下侧,由此包封楔形滑动件10718。挠性缆线10730可定位在仓托盘10722的外部上,其中传导联接件10714定位在仓体10720的远侧端部内。挠性缆线10730可通过任何适当的方式(例如,粘结或激光蚀刻)放置在仓托盘10722的外部上。
图146A-146F示出了具有挠性缆线10840的端部执行器10800的一个实施方案,该挠性缆线可操作以将电力提供给包括远侧传感器插头10816的钉仓10806。端部执行器10800类似于上述端部执行器300。端部执行器10800包括第一钳口构件或砧座10802、第二钳口构件或细长通道10804、以及可操作地联接到细长通道10804的钉仓10806。端部执行器10800可操作地联接到轴组件10900。轴组件10900类似于上述轴组件200。轴组件10900还包括包封轴组件10900的外部的闭合管10902。在一些实施方案中,轴组件10900还包括关节运动接头10904,该关节运动接头包括双枢轴闭合套管组件10906。双枢轴闭合套管组件10906包括能够操作以与端部执行器10800联接的端部执行器闭合套管组件10908。
图146A示出了联接到轴组件10900的端部执行器10800的透视图。在各种实施方案中,轴组件10900还包括挠性缆线10830,该挠性缆线被构造成能够不干扰关节运动接头10904的功能,如下文更详细所述。图146B示出了端部执行器10800和轴组件10900的下侧的透视图。在一些实施方案中,轴组件10900的闭合管10902还包括挠性缆线10908可延伸穿过的第一孔10908。闭合套管组件10908还包括挠性缆线10908也可延伸穿过的第二孔10910。
图146C示出了具有挠性缆线10830并且不具有轴组件10900的端部执行器10800。如图所示,在一些实施方案中,挠性缆线10830可包括单个线圈10832,该单个线圈可操作以缠绕关节运动接头10904并且由此可操作以随着关节运动接头10904的运动而挠曲。
图146D和图146E示出了不含砧座10802或钉仓10806的端部执行器10800的细长通道10804部分,以便图示说明挠性缆线10830可如何置于细长通道10804内。在一些实施方案中,细长通道10804还包括用于接收挠性缆线10830的第三孔10824。在细长通道10804的主体内,挠性缆线分裂10834以形成位于细长通道10804的任一侧的延伸部10836。图146E还示出连接器10838可操作地联接到挠性缆线延伸部10836。
图146F示出了仅挠性缆线10830。如图所示,挠性缆线10830包括可操作以缠绕关节运动接头10904的单个线圈10832和附接到延伸部10836的分裂部10834。延伸部可联接到连接器10838,该连接器具有位于其远侧面向表面上的插针10840以用于联接到钉仓10806,如下所述。
图147示出了细长通道10804的近距离视图,该细长通道具有联接到其的钉仓10806。钉仓10804包括仓体10822和仓托盘10820。在一些实施方案中,钉仓10806还包括电迹线10828,该电迹线在钉仓10806的近侧端部处联接到近侧触点10856。近侧触点10856可被定位成与连接器10838的插针10840形成导电连接,该连接器联接到挠性缆线延伸部10836。因此,当钉仓10806与细长通道10804可操作地联接时,挠性缆线10830可通过连接器10838和连接器插针10840将电力提供给钉仓10806。
图148A-148D进一步示出了可与端部执行器10800的本实施方案一起操作的钉仓10806的一个实施方案。图148A示出了钉仓10806的近侧端部的近距离视图。如上所述,钉仓10806包括电迹线10828,该电迹线在钉仓10806的近侧端部处形成近侧触点10856,该近侧触点可操作以与如上所述的挠性缆线10830联接。图148B示出了钉仓10806的远侧端部的近距离视图,该远侧端部具有用于远侧传感器插头10816的空间,如下所述。如图所示,电迹线10828可沿着钉仓体10822的长度延伸并且在远侧端部处形成远侧触点10856。图148C进一步示出了远侧传感器插头10816,该远侧传感器插头在一些实施方案中被成形为由针对其在钉仓10806的远侧端部中形成的空间接收。图148D示出了远侧传感器插头10816的近侧面向侧。如图所示,远侧传感器插头10816具有传感器插头触点10854,该传感器插头触点被定位成与钉仓10806的远侧触点10858联接。因此,在一些实施方案中,电迹线10828可操作以将电力提供给远侧传感器插头10816。
图149A和图149B示出了远侧传感器插头10816的一个实施方案。图149A示出了远侧传感器插头10816的剖面图。如图所示,远侧传感器插头10816包括霍尔效应传感器10810和处理器10812。远侧传感器插头10816还包括挠性板10814。如图149B进一步所示,霍尔效应传感器10810和处理器10812可操作地联接到挠性板10814,使得它们能够连通。
图150示出了具有挠性缆线10980的端部执行器10960的实施方案,该挠性缆线可操作以将电力提供给砧座19052部分的远侧末端中的传感器和电子器件10972。端部执行器10950包括第一钳口构件或砧座10962、第二钳口构件或细长通道10964、以及可操作地联接到细长通道10952的钉仓10956。端部执行器10960可操作地联接到轴组件10960。轴组件10960还包括包封轴组件10960的闭合管10962。在一些实施方案中,轴组件10960还包括关节运动接头10964,该关节运动接头包括双枢轴闭合套管组件10966。
在各种实施方案中,端部执行器10950还包括挠性缆线19080,该挠性缆线被构造成能够不干扰关节运动接头10964的功能。在一些实施方案中,闭合管10962包括挠性缆线10980可延伸穿过的第一孔10968。在一些实施方案中,挠性缆线10980还包括套环或线圈10982,该套环或线圈缠绕关节运动接头10964以使得挠性缆线10980不干扰关节运动接头10964的操作,如下文进一步所述。在一些实施方案中,挠性缆线10980沿着砧座10951的长度延伸到砧座10951的远侧末端中的第二孔10970。
图151A-151C示出了端部执行器10950的关节运动接头10964和挠性缆线19080的操作。图151A示出了端部执行器10952的顶视图,其中端部执行器109650相对于轴组件10960枢转-45度。如图所示,挠性缆线10980的线圈10982与关节运动接头10964一起挠曲,使得挠性缆线10980不干扰关节运动接头10964的操作。图151B示出了端部执行器10950的顶视图。如图所示,线圈10982缠绕关节运动接头10964一次。图151C示出了端部执行器10950的顶视图,其中端部执行器10950相对于轴组件10960枢转+45度。如图所示,挠性缆线10980的线圈10982与关节运动接头10964一起挠曲,使得挠性缆线10980不干扰关节运动接头10964的操作。
图152示出了具有传感器和电子器件10972的砧座10952的实施方案的远侧末端的剖视图。砧座10952包括挠性缆线10980,如相对于图150和图151A-151C所述。如图152所示,砧座10952还包括第二孔10970,挠性缆线10980可穿过该第二孔以使得挠性缆线10980砧座10952内的外壳10974。在外壳10974内,挠性缆线10980可操作地联接到定位在10974内的传感器和电子器件10972并且由此将电力提供给传感器和电子器件10972。
图153示出了砧座10952的远侧末端的剖面图。图153示出了可包括如图152所示的传感器和电子器件10972的外壳10974的实施方案。
根据各种实施方案,本文所述的外科器械可包括联接到各种传感器的一个或多个处理器(例如,微处理器、微控制器)。此外,存储(具有操作逻辑)和通信接口与一个或多个处理器彼此联接。
如前所述,传感器可被构造成能够检测和采集与外科装置相关联的数据。处理器处理从传感器接收的传感器数据。
处理器可被构造成能够执行操作逻辑。处理器可为本领域中已知的多个单核或多核处理器中的任一个。存储装置可包括被构造成能够存储操作逻辑的永久和临时(工作)拷贝的易失性和非易失性存储介质。
在各种实施方案中,操作逻辑可被构造成能够执行初始处理,并且将数据传送到托管应用程序的计算机以确定和生成指令。对于这些实施例,操作逻辑可以被进一步构造成能够从托管计算机接收信息并且向其提供反馈。在另选实施例中,操作逻辑可以被构造成能够在接收信息和确定反馈中扮演更重要的角色。在任一种情况下,无论是其独立确定还是响应于来自托管计算机的指令,操作逻辑可以被进一步构造成能够控制反馈并向使用者提供反馈。
在各种实施例中,操作逻辑可以由处理器的指令集架构(ISA)所支持的指令来实施,或者以更高级语言来实施,并且编译成受支持的ISA。操作逻辑可包括一个或多个逻辑单元或模块。操作逻辑可以面向对象的方式来实现。操作逻辑可被构造成能够以多任务方式和/或多线程方式来执行。在其他实施例中,操作逻辑可在硬件(诸如门阵列)中实现。
在各种实施例中,通信接口可以被构造成能够有利于外围设备与计算系统之间的通信。该通信可包括将所收集的与位置、姿势相关联的生物计量数据和/或使用者身体部分的运动数据传送到托管计算机,以及将与触觉反馈相关联的数据从主计算机传送到外围设备。在各种实施例中,通信接口可为有线或无线通信接口。有线通信接口的例子可包括但不限于通用串行总线(USB)接口。无线通信接口的例子可包括但不限于蓝牙接口。
对于各种实施例,处理器可与操作逻辑封装在一起。在各种实施方案中,处理器可与操作逻辑封装在一起以形成SiP。在各种实施方案中,处理器可与操作逻辑一起集成在同一块裸片上。在各种实施例中,处理器可与操作逻辑封装在一起以形成片上系统(SoC)。
各种实施例可在本文中于计算机可执行指令的一般背景中进行描述,所述计算机可执行指令诸如软件、程序模块、和/或正由处理器执行的引擎。一般来讲,软件、程序模块、和/或引擎包括被布置成执行特定操作或实现特定抽象数据类型的任何软件元件。软件、程序模块、和/或引擎可包括执行特定任务或实现特定抽象数据类型的例程、程序、对象、部件、数据结构等。软件、程序模块、和/或引擎部件和技术的具体实施可存储在某种形式的计算机可读介质上并且/或者通过某种形式的计算机可读介质传输。就此而言,计算机可读介质可以是可用于存储信息且可由计算设备访问的任何可用介质。一些实施方案还可在分布式计算环境中实践,在所述分布式计算环境中,操作由通过通信网络链接的一个或多个远程处理设备执行。在分布式计算环境中,软件、程序模块和/或引擎可位于包括存储器存储装置在内的本地和远程计算机存储介质两者中。可采用存储器(诸如随机存取存储器(RAM)或其他动态存储装置)来存储信息以及待由处理器执行的指令。存储器还可用于在执行待由处理器执行的指令期间存储临时变量或其他中间信息。
虽然可将一些实施方案例示和描述为包括功能部件、软件、引擎、和/或执行各种操作的模块,但应当理解,此类部件或模块可由一个或多个硬件部件、软件部件、和/或它们的组合实现。功能部件、软件、引擎、和/或模块可由例如待被逻辑设备(例如,处理器)执行的逻辑(例如,指令、数据、和/或代码)实现。这种逻辑可存储在位于一种或多种类型的计算机可读存储介质上的逻辑设备内部或外部。在其他实施方案中,功能部件诸如软件、引擎、和/或模块可由硬件元件实现,所述硬件元件可包括处理器、微处理器、电路、电路元件(例如,晶体管、电阻器、电容器、电感器等)、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体设备、芯片、微芯片、芯片组,等等。
软件、引擎和/或模块的示例可包括软件部件、程序、应用、计算机程序、应用程序、系统程序、机器程序、操作系统软件、中间件、固件、软件模块、例程、子例程、函数、方法、过程、软件接口、应用程序接口(API)、指令集、计算代码、计算机代码、代码片段、计算机代码片段、字、值、符号、或它们的任何组合。确定实施方案是否使用硬件元件和/或软件元件来实现可以根据任何数量的因素改变,这些因素诸如期望的计算速率、功率电平、热容差、处理循环预算、输入数据速率、输出数据速率、存储器资源、数据总线速度以及其他设计或性能约束。
本文所述的模块中的一个或多个可包括实施为固件、软件、硬件或它们的任意组合的一个或多个嵌入式应用程序。本文所述的模块中的一个或多个可包括各种可执行模块,诸如软件、程序、数据、驱动器、应用程序API等等。固件可存储在控制器和/或控制器的可包括非易失性存储器(NVM)的存储器诸如位屏蔽只读存储器(ROM)或闪存存储器中。在各种具体实施中,将固件存储在ROM中可保护闪存存储器。NVM可包括其他类型的存储器,包括例如可编程ROM(PROM)、可擦除可编程ROM(EPROM)、EEPROM或电池支持的RAM(诸如动态RAM(DRAM)、双数据率DRAM(DDRAM)和/或同步DRAM(SDRAM))。
在一些情况下,各种实施方案可实现为制造制品。所述制造制品可以包括被布置为存储用于执行一个或多个实施例的各种操作的逻辑、指令和/或数据的计算机可读存储介质。在各种实施例中,例如,所述制品可包括磁盘、光盘、闪存存储器或固件,这些制品均含有适于由通用处理器或专用处理器执行的计算机程序指令。然而,实施例并不仅限于此。
结合本文所公开的实施例描述的各种功能性元件、逻辑块、模块、和电路元件的功能可在计算机可执行指令的一般环境中实施,诸如由处理单元执行的软件、控制模块、逻辑、和/或逻辑模块。一般而言,软件、控制模块、逻辑、和/或逻辑模块包括布置成执行特定操作的任何软件元件。软件、控制模块、逻辑、和/或逻辑模块可包括执行特定任务或实施特定抽象数据类型的例程、程序、对象、部件、数据结构等。软件、控制模块、逻辑、和/或逻辑模块和技术的具体实施可存储在某种形式的计算机可读介质上并且/或者通过某种形式的计算机可读介质传输。就此而言,计算机可读介质可以是可用于存储信息且可由计算设备访问的任何可用介质。一些实施方案还可在分布式计算环境中实践,在所述分布式计算环境中,操作由通过通信网络链接的一个或多个远程处理设备执行。在分布式计算环境中,软件、控制模块、逻辑和/或逻辑模块可位于包括存储器存储设备在内的本地和远程计算机存储介质两者中。
此外,应当理解,本文所述的实施方案阐明了示例性具体实施,并且功能性元件、逻辑块、模块和电路元件可以与所述实施方案一致的各种其他方式来实施。此外,由此类功能性元件、逻辑块、模块和电路元件执行的操作可组合和/或分离以用于给定的具体实施,并且可由更多数量或更少数量的部件或模块来执行。如本领域技术人员在阅读本公开之后所显而易见的,本文所述和所示的单独实施例中的每个具有分立部件和特征,在不背离本公开的范围的前提下,所述部件和特征可容易地与其他若干方面中任意方面的特征分离或组合。可按所述事件的顺序或按任何其他在逻辑上可能的顺序来执行任何所述方法。
值得注意的是,任何对“一个实施方案”或“实施方案”的提及均意指结合实施方案所述的特定特征、结构或特性包括在至少一个实施方案中。在说明书中各处出现的短语“在一个实施例中”或“在一个方面”并不一定全部是指相同的实施例。
除非另外特别说明,否则应当理解,术语诸如“处理”、“运算”、“计算”、“确定”等是指计算机或计算系统、或类似电子计算装置的动作和/或过程,所述电子计算装置诸如通用处理器、DSP、ASIC、FPGA或其他可编程逻辑装置、分立门或晶体管逻辑、分立硬件部件,或它们的任何组合,其被设计以执行本文所述的功能,其操纵表示为寄存器和/或存储器内的物理量(例如,电子)的数据并且/或者将其转换成相似地表示为存储器、寄存器或其他此类信息存储装置、传送装置或显示装置内的物理量的其他数据。
值得注意的是,一些实施方案可使用表达“联接”和“连接”以及它们的衍生词来描述。并不希望这些术语彼此同义。例如,一些实施方案可使用术语“连接”和/或“联接”来描述,以表示两个或更多个元件彼此直接物理接触或电接触。然而,术语“耦合”还可以指两个或更多个元件彼此不是直接接触,而是彼此配合或相互作用。就软件元件而言,例如,术语“联接”可指接口、消息接口、API、交换消息等。
应当理解,据称以引用方式并入本文中的任何专利、出版物或其他公开材料,无论是全文或部分,仅在所并入的材料与本公开中给出的定义、陈述或者其他公开材料不冲突的范围内并入本文。同样地并且在必要的程度下,本文明确阐述的公开内容取代以引用方式并入本文的任何冲突材料。任何据称以引用方式并入本文但与本文所述的现有定义、陈述或其它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。
本发明所公开的实施方案应用于常规的内窥镜检查和开放式外科器械以及应用于机器人辅助的手术。
本文所公开的装置的实施例可设计为使用单次后丢弃,也可设计为供多次使用。在上述任一或两种情况下,都可对这些实施例进行修复,以便在使用至少一次后再使用。修复可包括以下步骤的任意组合:拆卸装置、然后清洗或更换特定零件和随后进行重新装配。具体地讲,可拆卸装置的实施方案,并且可选择性地以任何组合形式来更换或移除装置的任意数量的特定零件或部件。在清洁和/或更换特定部件时,所述装置的实施例可在修复设施中重新装配或在即将进行外科手术前由外科手术团队重新装配以供随后使用。本领域的技术人员将会了解,装置修复可以利用多种技术进行拆卸、清洗/更换以及重新装配。这些技术的使用和所得重新修复的装置均在本申请的范围内。
仅以举例的方式,可在外科手术之前对本文所述的实施方案进行处理。首先,可以获得新的或用过的器械,并且根据需要进行清洁。然后,可对器械进行消毒。在一种消毒技术中,将该器械放置在闭合且密封的容器中,例如塑料袋或TYVEK袋中。然后可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。辐射可以杀死器械上和容器中的细菌。消毒后的器械随后可被存放在无菌容器中。密封容器可将器械保持处于无菌状态,直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置消毒,包括但不限于β辐射或γ辐射、环氧乙烷或蒸汽。
本领域技术人员将会认识到,本文所述的组成部分(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,阐述的具体例子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,并且具体组成部分(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。
本文所述的主题有时阐述了包含在其他不同部件中的不同部件或与其他不同部件连接的不同部件。应当理解,这样描述的架构仅是例子,并且事实上可以实施实现获得相同功能性的许多其他架构。在概念意义上,获得相同功能性的部件的任何布置方式都是有效“相关联的”,从而获得所需的功能性。因此,本文中为获得特定功能性而结合在一起的任何两个组件都可视为彼此“相关联”,从而获得所需的功能性,而不论结构或中间组件如何。同样,如此相关联的任何两个组件也可被视为彼此“操作地连接”或“操作地联接”,以获得所需的功能性,并且能够如此相关联的任何两个组件都可被视为彼此“可操作地联接”,以获得所需的功能性。可操作地联接的具体示例包括但不限于可物理配合的和/或物理交互组件,和/或无线交互式,和/或无线交互式组件,和/或逻辑交互式,和/或逻辑交互式组件。
一些方面可以使用表达“联接”和“连接”以及它们的衍生词来描述。应当理解,并不希望这些术语是彼此同义的。例如,某些方面可以利用术语“连接”来描述,以表示两个或更多个元件彼此直接物理接触或电接触。在另一个例子中,一些方面可使用术语“联接”来描述,以表示两个或更多个元件直接物理接触或电接触。然而,术语“耦合”还可以指两个或更多个元件彼此不是直接接触,而是彼此配合或相互作用。
在一些情况下,一个或多个部件在本文中可被称为“被构造成能够”、“可被构造成能够”、“可操作/可操作地”、“适合/适于”、“能够”、“适应/适合”等。本领域的技术人员将会认识到,除非上下文另有所指,否则“被构造成能够”通常可涵盖活动状态的部件和/或未活动状态的部件和/或待机状态的部件。
虽然已经示出并描述了本文所述的本发明主题的特定方面,但是对本领域的技术人员将显而易见的是,基于本文的教导,可在不脱离本文所述的主题的情况下作出改变和变型,并且如在本文所述的主题的真实范围内,其更广泛的方面并因此所附权利要求将所有此类改变和变型包括在其范围内。本领域的技术人员应当理解,一般而言,本文、以及特别是所附权利要求(例如,所附权利要求的正文)中所使用的术语通常旨在为“开放”术语(例如,术语“包括”应解释为“包括但不限于”,术语“具有”应解释为“至少具有”,术语“包含”应解释为“包含但不限于”等)。本领域的技术人员还应当理解,当所引入权利要求表述的具体数目为预期数目时,则这样的意图将在权利要求中明确表述,并且在不存在这样的表述的情况下,不存在这样的意图。例如,为有助于理解,下述所附权利要求可含有对介绍性短语“至少一个”和“一个或多个”的使用以引入权利要求。然而,对此类短语的使用不应视为暗示通过不定冠词“一个”或“一种”引入权利要求表述将含有此类引入权利要求表述的任何特定权利要求限制在含有仅一个这样的表述的权利要求中,甚至当同一权利要求包括介绍性短语“一个或多个”或“至少一个”和诸如“一个”或“一种”(例如,“一个”和/或“一种”通常应解释为意指“至少一个”或“一个或多个”)的不定冠词时;这也适用于对用于引入权利要求表述的定冠词的使用。
另外,即使在明确叙述引入权利要求叙述的特定数目时,本领域的技术人员应当认识到,这种叙述通常应解释为意指至少所叙述的数目(例如,在没有其他修饰语的情况下,对“两个叙述”的裸叙述通常意指至少两个叙述、或两个或更多个叙述)。此外,在其中使用类似于“A、B和C中的至少一者等”的惯例的那些情况下,一般而言,这种结构意在具有本领域的技术人员将理解所述惯例的意义(例如,“具有A、B和C中的至少一者的系统”将包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。在其中使用类似于“A、B或C中的至少一者等”的惯例的那些情况下,一般而言,这种结构意在具有本领域的技术人员将理解所述惯例的意义(例如,“具有A、B或C中的至少一者的系统”将包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。本领域的技术人员还应当理解,通常,除非上下文另有指示,否则无论在具体实施方式、权利要求或附图中呈现两个或更多个替代术语的转折性词语和/或短语应理解为涵盖包括所述术语中的一者、所述术语中的任一个或这两个术语的可能性。例如,短语“A或B”通常将被理解为包括“A”或“B”或“A和B”的可能性。
对于所附的权利要求,本领域的技术人员将会理解,其中表述的操作通常可以任何顺序进行。另外,尽管以一定顺序列出了多个操作流程,但应当理解,可以不同于所示顺序的其他顺序进行所述多个操作,或者可以同时进行所述多个操作。除非上下文另有规定,否则此类替代排序的例子可包括重叠、交错、中断、重新排序、增量、预备、补充、同时、反向,或其他改变的排序。此外,除非上下文另有规定,否则像“响应于”、“相关”这样的术语或其他过去式的形容词通常不旨在排除此类变体。
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说明。所述说明并非意图为详尽的或限定到本发明所公开的精确形式。可以按照上述教导内容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 (20)

1.一种外科器械,包括:
端部执行器,所述端部执行器包括:
第一钳口;和
第二钳口,其中所述第一钳口和所述第二钳口中的至少一者能够相对于所述第一钳口和所述第二钳口中的另一者在打开构型与接近构型之间运动;
第一驱动组件;
联接到所述第一驱动组件的第一马达,所述第一马达能够操作以促动所述第一驱动组件;
第二驱动组件;
联接到所述第二驱动组件的第二马达,所述第二马达能够操作以促动所述第二驱动组件;
能够操作地联接到所述第一马达和所述第二马达的控制模块;以及
闭合触发器,其中所述闭合触发器能够在闭合行程期间运动以使所述端部执行器转变成所述接近构型,并且其中所述闭合触发器能够在所述闭合行程期间运动以使所述控制模块从与所述第一马达可操作地接合转变成与所述第二马达可操作地接合。
2.根据权利要求1所述的外科器械,其中,所述控制模块包括马达驱动器。
3.根据权利要求2所述的外科器械,其中,所述马达驱动器在所述端部执行器处于所述打开构型时电联接到所述第一马达,并且其中所述马达驱动器在所述端部执行器处于所述接近构型时电联接到所述第二马达。
4.根据权利要求2所述的外科器械,其中,所述控制模块包括开关,其中所述开关能够在第一位置与第二位置之间运动,其中所述开关在处于所述第一位置时使所述马达驱动器电联接到所述第一马达,并且其中所述开关在处于所述第二位置时使所述马达驱动器电联接到所述第二马达。
5.根据权利要求4所述的外科器械,其中,所述闭合触发器能够操作地联接到所述开关,使得所述闭合触发器的运动使所述开关在所述第一位置与所述第二位置之间转变。
6.根据权利要求1所述的外科器械,其中,所述闭合触发器能够在所述闭合行程期间运动,从而使所述端部执行器转变成所述接近构型、和使所述控制模块从与所述第一马达可操作地接合转变成与所述第二马达可操作地接合同时发生。
7.根据权利要求1所述的外科器械,其中,所述第一驱动组件包括能够操作以使所述端部执行器进行关节运动的关节运动驱动组件。
8.根据权利要求1所述的外科器械,其中,所述第二驱动组件包括击发驱动组件。
9.根据权利要求1所述的外科器械,其中,所述控制模块包括功率源。
10.一种外科器械,包括:
第一驱动组件;
联接到所述第一驱动组件的第一马达,所述第一马达能够操作以促动所述第一驱动组件;
第二驱动组件;
联接到所述第二驱动组件的第二马达,所述第二马达能够操作以促动所述第二驱动组件;以及
能够在与所述第一马达交接和与所述第二马达交接之间选择性地切换的控制模块。
11.根据权利要求10所述的外科器械,其中,所述第一驱动组件包括能够操作以使所述端部执行器进行关节运动的关节运动驱动组件。
12.根据权利要求10所述的外科器械,其中,所述第二驱动组件包括击发驱动组件。
13.根据权利要求10所述的外科器械,其中,所述控制模块包括功率源。
14.根据权利要求10所述的外科器械,其中,所述控制模块包括马达驱动器。
15.根据权利要求14所述的外科器械,其中,所述控制模块包括开关。
16.根据权利要求15所述的外科器械,其中,所述开关能够在第一位置与第二位置之间运动,其中所述开关在处于所述第一位置时使所述马达驱动器电联接到所述第一马达,并且其中所述开关在处于所述第二位置时使所述马达驱动器电联接到所述第二马达。
17.一种外科器械,包括:
端部执行器;
第一驱动组件;
联接到所述第一驱动组件的第一马达,所述第一马达能够操作以促动所述第一驱动组件;
第二驱动组件;
联接到所述第二驱动组件的第二马达,所述第二马达能够操作以促动所述第二驱动组件;
能够操作地联接到所述第一马达和所述第二马达的控制模块;以及
触发器,所述触发器能够运动,从而使所述端部执行器起作用、和使所述控制模块从与所述第一马达可操作地接合转变成与所述第二马达可操作地接合同时发生。
18.根据权利要求17所述的外科器械,其中,所述第一驱动组件包括能够操作以使所述端部执行器进行关节运动的关节运动驱动组件。
19.根据权利要求17所述的外科器械,其中,所述端部执行器包括钉仓,其中所述钉仓包括能够部署到被所述端部执行器捕获的组织中的多个钉,其中所述第二驱动组件包括能够操作以部署所述多个钉的击发驱动组件。
20.根据权利要求17所述的外科器械,其中,所述控制模块包括功率源。
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