CN107106180A - 具有自动闭锁机构的吻合装置 - Google Patents

具有自动闭锁机构的吻合装置 Download PDF

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CN107106180A
CN107106180A CN201480083948.6A CN201480083948A CN107106180A CN 107106180 A CN107106180 A CN 107106180A CN 201480083948 A CN201480083948 A CN 201480083948A CN 107106180 A CN107106180 A CN 107106180A
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assembly
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surgical stapling
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G·姆鲁格山
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Covidien LP
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    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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Abstract

本公开提供一种外科吻合装置(10)，其包括把手组件(12)、可移动的触发器(26)和细长本体部分(14)。吻合钉容纳壳体组件(22)安装在细长本体部分(14)的远侧端部上，并且砧座组件(20)相对于吻合钉容纳壳体组件(22)可移动地安装。设置有自动锁定安全机构(40)以防止初始致动之后外科吻合装置的二次致动。自动锁定安全机构(40)包括：主锁定件或滑块组件(42)，其用于阻碍触发器(26)的移动；和次锁定件或止动件(44)，其用于在砧座组件(20)相对于吻合钉容纳壳体组件(22)的接近之前阻碍滑块组件(42)的移动。滑块(70)被偏置构件(72)推压到锁定位置或阻碍位置。

Description

具有自动闭锁机构的吻合装置
技术领域
本公开涉及一种外科吻合装置。更具体地，本公开涉及一种外科吻合装置，所述外科吻合装置具有自动内部闭锁机构以防止外科吻合装置的再次击发。
背景技术
外科吻合装置，并且具体地，圆形的外科吻合装置经常用于处理痔疮并且从患者的直肠内移除痔疮。通常，外科吻合装置的砧座组件超出(beyond)痔疮定位在直肠中，并且连接到位于痔疮前方的外科吻合装置的吻合钉容纳壳体。随后，使用荷包式缝合(purse-string sutures)将痔疮和/或粘膜组织打结到砧座组件的中心杆，并且砧座组件靠近到与吻合钉容纳壳体相邻近的位置以夹紧痔疮或粘膜组织。此后，通过压下外科吻合装置的击发触发器来致动外科吻合装置以从吻合钉容纳壳体发射吻合钉并且产生穿过临近痔疮的组织的圆形的吻合钉线。同时，圆形的刀从吻合钉线向内切除定位在吻合钉容纳壳体内的痔疮和/或粘膜组织。随后从患者移除外科吻合装置，所述外科吻合装置容纳痔疮和/或粘膜组织被捕捉在砧座组件和吻合钉容纳壳体之间的被切除的部分。
各种外部闭锁装置已经被设置在外科吻合装置上以防止在使用之前意外致动吻合装置的击发触发器。这些闭锁装置包括可移动的闩锁，所述可移动的闩锁定位在外科吻合装置的击发触发器和把手外壳之间，所述可移动的闩锁接合击发触发器，并且防止击发触发器的致动直到所述闩锁被手动地移动到解锁位置。虽然是有用的，但这些闩锁不仅需要手动操纵来解锁击发触发器，而且更重要地，在外科吻合装置已经击发之后需要手动操作来再次锁定击发触发器。
在使用中，在从患者移除外科吻合装置之前、或在从患者移除外科吻合装置期间、或在重置手动外部闩锁之前，操作者可能意外地再次致动外科吻合装置。这种动作可以使得损坏组织并且危害外科手术的成功。
因此，需要一种用于处理痔疮以及多种其它程序的外科吻合装置，所述外科吻合装置包括闭锁装置以防止外科吻合装置的过早致动。还需要一种外科吻合装置，所述外科吻合装置包括内部自动闭锁机构，所述内部自动闭锁机构自动地防止外科吻合装置在初次击发之后的二次致动。
发明内容
在本公开的一个方面中，本公开提供一种外科吻合装置，所述外科吻合装置包括把手组件，所述把手组件具有固定不动的把手外壳和安装到把手外壳的可移动的触发器。细长本体部分从把手外壳延伸。吻合钉容纳壳体组件安装在细长本体部分的远侧端部上，并且砧座组件相对于吻合钉容纳壳体组件可移动地安装。接近机构包括安装在固定不动的把手外壳上的可旋转的接近旋钮和从接近旋钮延伸到砧座组件的螺杆轴组件。接近机构构造成使得接近旋钮的旋转实现螺杆轴组件在把手组件内的平移，以使砧座组件从与吻合钉容纳壳体组件间隔开的第一位置移动到邻近吻合钉容纳壳体组件的第二接近位置。推动器从把手外壳延伸穿过细长本体部分而至吻合钉容纳壳体组件。可移动的触发器可以移动到与推动器接合，从而使得可移动的触发器朝向固定不动的把手外壳的移动向远侧驱动推动器以驱动吻合钉离开吻合钉容纳壳体组件并且进入砧座组件。滑块组件定位在把手外壳内并且包括滑块和偏置构件。滑块能够在阻碍可移动的触发器移动的第一位置和与可移动的触发器间隔开的第二位置之间移动。偏置构件定位成朝向第一位置推压滑块。
在实施例中，滑块能够在把手外壳内纵向地移动，并且包括至少一个触发器块，所述至少一个触发器块定位成接合可移动的触发器。
在某些实施例中，偏置构件包括螺旋弹簧。
在一些实施例中，滑块组件包括开关，所述开关固定地附接到滑块，并且延伸穿过形成为穿过把手外壳的窗口。
在实施例中，滑块包括支架，所述支架具有直立杆和向近侧延伸的臂，并且所述开关固定地附接到向近侧延伸的臂的近侧端部。螺旋弹簧围绕向近侧延伸的臂安装，并且在螺旋弹簧的第一端部处接合直立杆，并且在螺旋弹簧的第二端部处接合把手外壳。
在某些实施例中，开关包括至少一个柔性闩锁，所述至少一个柔性闩锁构造成当滑块组件处于第二位置时接收在凹口内以将滑块组件保持在第二位置中，所述凹口形成在把手外壳中的窗口的边缘中。
在实施例中，滑块包括纵向狭槽并且推动器包括能够在纵向狭槽内移动的突起，使得突起向远侧移动到接合纵向狭槽的一个端部，从而将开关的至少一个柔性闩锁从把手外壳中的凹口脱开。
在一些实施例中，开关限定凹口。当滑块处于第一位置时，开关覆盖把手外壳的指示器，并且当开关朝向第二位置移动时，开关露出把手外壳的指示器。
在本公开的另一方面中，外科吻合装置包括把手组件，所述把手组件具有固定不动的把手外壳和安装到把手外壳的可移动的触发器。细长本体部分从把手外壳延伸。吻合钉容纳壳体组件安装在细长本体部分的远侧端部上，并且砧座组件相对于吻合钉容纳壳体组件可移动地安装。可旋转的接近旋钮安装在固定不动的把手外壳上，并且螺杆轴组件从接近旋钮延伸到砧座组件，使得接近旋钮的旋转将螺杆轴组件从前侧位置移动到缩回位置，以将砧座组件从与吻合钉容纳壳体组件间隔开的第一位置移动到邻近吻合钉容纳壳体组件的第二接近位置。推动器从把手外壳延伸穿过细长本体部分而至吻合钉容纳壳体组件，并且能够与可移动的触发器接合，使得可移动的触发器朝向固定不动的把手外壳的移动向远侧驱动推动器以驱动吻合钉离开吻合钉容纳壳体组件并且进入砧座组件。滑块组件包括滑块，滑块在所述滑块的近侧端部处具有突出部。滑块定位在把手外壳内，并且能够在阻碍可移动的触发器移动的第一位置和与可移动的触发器间隔开的第二位置之间移动。柔性止动件定位在把手外壳内，并且能够可释放地接合滑块的突出部。块固定到螺杆轴组件，并且能够响应于接近旋钮的旋转而在把手外壳内纵向移动。当螺杆轴组件从前侧位置朝向缩回位置移动时，块能够与柔性止动件接合以使柔性止动件从滑块的突出部脱开，以促使滑块从第一位置移动到第二位置。
在实施例中，止动件包括第一纵向杆、横杆和第二纵向杆，所述第一纵向杆安装到把手外壳，所述横杆连接到第一纵向杆，所述第二纵向杆的远侧端部连接到横杆。第二纵向杆包括抓锁部，所述抓锁部构造为可释放地接合滑块的突出部。
在一些实施例中，块包括具有凸出部边缘的突起，所述凸出部边缘能够与抓锁部接合以使抓锁部从滑块的突出部脱开。
在某些实施例中，抓锁部包括形成在第二纵向杆的近侧端部上的向内侧指向的部分和位于第二纵向杆上的凸出部(cam)，所述凸出部位于向内侧指向的部分的远侧。凸出部和向内侧指向的部分限定了间隙，所述间隙构造为接收滑块的突出部。
在一些实施例中，凸出部包括成角度的凸出部面，所述成角度的凸出部面定位成接合块上的突起的凸出部边缘。
在实施例中，块上的突起定位成接合滑块上的突出部使得块向近侧的移动向近侧移动滑块。滑块组件包括开关，所述开关指示器之上定位在把手外壳的窗口内，其中，滑块向近侧的移动实现开关的移动以通过把手外壳中的窗口露出指示器。
附图说明
本文中参考附图公开了当前公开的外科吻合装置的实施例，其中：
图1是用于痔疮手术的外科吻合装置的透视图；
图2是外科吻合装置的本体部分的透视图，其中，把手外壳的一半被移除并且示出了闭锁组件；
图3是闭锁组件的透视图；
图3A是图3的闭锁组件的透视图，其中部件被分开；
图3B是安全按钮的透视图；
图4是次闭锁构件的透视图；
图5是定位在一半把手外壳中的通道内的次闭锁构件的透视图；
图6是一半把手外壳的透视图，其中，闭锁组件的滑块的突出部与次闭锁构件接合；
图7是类似于图6的透视图，其中，次闭锁构件从滑块脱开；
图8是在把手外壳内可移动的块的透视图，所述块与次闭锁构件接合；
图9是示出了安全按钮的把手外壳的一部分的顶视平面图；
图10是类似于图9的顶视平面图，其中，示出了安全按钮相对于外壳移动以示出安全按钮的指示器部分；
图11是外科吻合装置的本体部分的透视图，其中，把手外壳的一半被移除，并且本体部分的触发器被闭锁组件的滑块阻碍；
图12是类似于图11的透视图，其中，闭锁组件的滑块被移动以释放触发器以便致动；
图13是安全按钮的顶视平面图，所述安全按钮定位在本体部分的窗口内，并且在锁定位置处与本体部分接合；并且
图14是外科吻合装置的触发器的透视图，所述触发器接合并且驱动外科吻合装置的推动器以击发外科吻合装置。
具体实施方式
现在将参考附图详细描述当前公开的外科吻合装置的实施例，其中在数个视图的每一个中，相同的附图标记表示相同的或对应的元件。如本技术领域中所常见的，术语“近”指的是更靠近用户或操作者(即，外科医生或内科医生)的那个部分或部件，而术语“远”指的是更远离用户的那个部分或部件。
首先参考图1，图1公开了用于在痔疮手术中使用的外科吻合装置10。外科吻合装置10大体包括把手组件12和细长本体部分14，所述细长本体部分14具有细长的外部管16和远侧头部部分18。
远侧头部部分18包括砧座组件20和壳体组件22，所述砧座组件20和壳体组件22设置成接近并且吻合被捕捉在两者之间的组织。虽然没有明确地示出，砧座组件20包括砧座头部和砧座轴，所述砧座头部包含吻合钉钉牢钉槽(staple clinching pockets)，所述砧座轴用于可移除地连接到细长本体部分14。同样，虽然没有明确地示出，壳体组件22包括多个吻合钉和推动器，所述推动器被设计成以本技术领域中熟知的方式驱动吻合钉离开壳体组件22、穿过组织、并且进入砧座组件20的吻合钉钉牢钉槽。
把手组件12大体包括：固定不动的把手外壳24，所述把手外壳24从细长本体部分14向近侧延伸；可移动的触发器或击发触发器26，所述可移动的触发器或击发触发器26可枢转地安装到把手外壳24；和可旋转的接近旋钮28，所述接近旋钮28定位在把手外壳24的近侧端部30上。如本技术领域中已知的，可旋转的接近旋钮28的致动用于相对于壳体组件22移动砧座组件20以捕捉位于壳体组件22和砧座组件20之间的组织。参见例如Milliman等人的美国专利No.7303106(“106专利”)，其全部内容通过引用并入本文。在实施例中，外部的手动致动的触发器闩锁32可枢转地安装在把手外壳24上，并且能够与击发触发器26接合以阻碍击发触发器26的移动。把手外壳24形成为两个连结的一半把手外壳24a和24b。在本公开的吻合装置10中，触发器闩锁32是任选的并且可以被抛弃。
此外，外科吻合装置10包括指示器34，所述指示器34通过形成在把手外壳24中的窗口36而可视，并且提供砧座组件20相对于壳体组件22的接近程度的可视指示。如下文详述，安全按钮或开关38能够在窗口36内移动，并且与自动锁定安全机构40相联。
现在参考图2-图7，并且首先参考图2-图3A，自动锁定安全机构40包括：开关38；主锁定件或滑块组件42，所述主锁定件或滑块组件42可移动地安装在把手外壳24内；次锁定件或止动件44(图4)，所述次锁定件或止动件44安装在把手外壳24中；和类凸轮(cam)构件或块46，所述类凸轮构件或块46固定到螺杆轴组件48。螺杆轴组件48可操作地在其近侧端部与接近旋钮28接合(图1)并且在其远侧接合到砧座组件20，使得能够如下所述致动接近旋钮28以相对于壳体组件22移动砧座组件20。
具体参考图2，螺杆轴组件48延伸穿过延伸旋钮管50。延伸旋钮管50支撑套圈52并且连接到接近旋钮28，所述套圈52可旋转地安装在把手外壳24内。如本技术领域中已知的(参见106专利)，螺杆轴组件48的近侧端部包括螺旋凹槽，所述螺旋凹槽接收设置在套圈52中的销或突起(未示出)。接近旋钮28、并且因此延伸旋钮管50和套圈52的旋转使该销在螺杆轴组件48中的螺旋凹槽内移动，以使螺杆轴组件48在外壳24内相对于壳体组件22向近侧和向远侧移动。
击发触发器26包括杠杆54和直立臂56，所述直立臂56延伸到把手外壳24中。直立臂56可以形成为一对间隔开的直立臂56a和56b。枢轴销58延伸穿过直立臂56并且安装到把手外壳24以允许击发触发器26相对于把手外壳24枢转。细长的圆柱形推动器60从击发触发器26延伸穿过外部管16(图1)而至壳体组件22。击发触发器26朝向把手外壳24的移动使得每一个直立臂56a、56b的远侧边缘62与凸缘64接合、并且向远侧驱动凸缘64以向远侧驱动推动器60，所述凸缘64位于圆柱形推动器60的近侧端部66。当推动器60在外部管16内被向远侧驱动时，推动器60的远侧端部(未示出)驱动吻合钉离开壳体组件22并且进入砧座组件20的吻合钉钉牢钉槽以吻合捕捉在壳体组件22和砧座组件20之间的组织。螺旋弹簧68围绕圆柱形推动器60设置在外壳24的内壁和推动器60的表面之间以在把手外壳24和细长外部管16内向近侧偏置推动器60。向近侧偏置推动器60经由凸缘64与直立臂56a、56b的接合将击发触发器26朝向未击发位置远离把手外壳24推压。
现在参考图3和3A，自动锁定安全机构40的滑块组件42设置为初始阻碍击发触发器26的移动直到被手动释放，并且此后，在击发吻合装置10之后自动再次阻碍击发触发器26。与手动致动的闩锁32相比，这提供了更高程度的安全，所述手动致动的闩锁32在致动击发触发器26之后需要手动操作来再次接合安全闩锁32。除了开关38外，滑块组件42还包括滑块70和安装在滑块70上的弹簧72，如下面将更详细地讨论的，所述弹簧72在把手外壳24内向远侧偏置滑块70。滑块70可以由金属片材形成，并且包括：中心本体部分74；远侧本体部分76，所述远侧本体部分76从中心本体部分74向远侧延伸；和近侧本体部分78，所述近侧本体部分78从中心本体部分74向近侧延伸。向下悬垂的臂或突出部80从近侧本体部分78的近侧端部延伸，并且如下详述地被接收在次锁定件或止动件44(图2)内以防止滑块70在把手外壳24内的移动。
中心本体部分74在中心本体部分74的远侧端部86处包括一对侧向延伸的臂或触发器块82、84。如下面更详细地描述的，触发器块82、84定位成接合形成在击发触发器26的相应的直立臂56a和56b上的平坦表面172a以防止击发触发器26的移动(参照图14)。此外，中心本体部分74包括向远侧延伸的L形支架88，所述L形支架88用来固定地支撑开关38和螺旋弹簧72。开关38可以使用任何已知的紧固技术(包括胶合、焊接、二次成型等)被固定地紧固到滑块70。支架88沿中心本体部分74的中心线向近侧延伸并且包括直立杆90和臂92，所述臂92从直立杆90纵向地向近侧延伸。螺旋弹簧72可移动地安装在臂92上，并且开关38固定到臂92的近侧端部94。螺旋弹簧72抵接直立杆90的近侧98和把手外壳24的内表面(未示出)以在把手外壳24内向远侧偏置滑块70和开关38。
细长狭槽100从中心本体部分74的远侧端部86纵向地延伸穿过远侧本体部分76而至远侧本体部分76的远侧端部102。细长狭槽100接收形成在推动器60上的突起178使得当推动器60通过击发触发器26而向远侧移动时，以如下详述的方式向远侧拉动滑块70以使开关38从把手外壳24脱开。
开关38固定到滑块70的支架88并且包括本体部分104，所述本体部分104具有向上突出的远侧指状突出部106和一对向远侧延伸的闩锁108、110，所述闩锁108、110在指状突出部106下面从本体部分104延伸。凹口112形成在本体部分106中。开关38是可移动的以再次定位凹口112从而覆盖或露出指示器34(图1)。
具体参考图3-图3B，开关38的闩锁108包括柔性臂114，所述柔性臂114从本体部分104延伸并且终止于向外侧延伸的突出部116(图3和图3A)。类似地，闩锁110也包括柔性臂118，所述柔性臂118从本体部分104延伸并且终止于向外侧延伸的突出部120(图3B)。如下面将更详细地描述的，突出部116和118可释放地接合把手外壳24，并且将开关38、并且因此将滑块70暂时地保持在近侧位置处以释放击发触发器26以用于致动。
参考图4，设置止动件44以在砧座组件20与壳体组件22接近之前防止滑块70的移动。止动件44为大体U形并且包括：第一纵向杆122；第二纵向杆124；和横杆126，所述横杆126将第一纵向杆122柔性地连接到第二纵向杆124。具体地，第一纵向杆122的远侧端部128连接到横杆126的第一端部130，并且第二纵向杆124的远侧端部132连接到横杆126的第二端部134。在实施例中，例如，第一纵向杆122、第二纵向杆124和横杆126可以由柔性材料一体形成，所述柔性材料例如为弹簧钢、聚合物材料等。
如图所示，第一纵向杆122的近侧端部136具有向内侧指向的部分138。第二纵向杆124短于第一纵向杆122，并且在其近侧端部142处形成有抓锁部140。抓锁部140包括形成在近侧端部142处的向内侧指向的部分144和形成在第二纵向杆124上的凸出部146，所述凸出部146位于向内侧指向的部分144的远侧。凸出部146具有面向远侧的成角度的凸出部面148。抓锁部140在向内侧指向的部分144和凸出部146之间限定了间隙150以用于接收滑块70的突出部80。
如图5中最佳地所示，止动件44支撑在形成在把手外壳24内的近侧支撑部152和远侧支撑部154内。近侧支撑部152和远侧支撑部154从一半把手外壳24b的内表面156向内侧延伸。具体地，第一纵向杆122的向内侧指向的部分138位于近侧支撑部152内，并且摩擦地保持在近侧支撑部152内，而第一纵向杆122的远侧端部128和横杆126的第一端部130摩擦地保持在远侧支撑部154内。如下详述，这使得第二纵向杆124相对于第一纵向杆122自由地向下弯曲以促使抓锁部140移动入与滑块70的突出部80的接合以及移动脱开突出部80。
现在参考图6-图8，为了移动或偏置(cam)抓锁部140以使其与滑块70的突出部80脱开，块158固定到螺杆轴组件48，所述块158具有安装在其第一表面或上表面162上的突起160。特别地，螺杆轴组件48穿过形成为贯穿块158的孔164(图8)并且使用例如定位螺钉(未示出)被固定地紧固到块158。因此，当螺杆轴组件48通过接近旋钮的致动而在把手外壳24内平移时，块158与螺杆轴组件48一起在把手外壳24内平移。块158另外包括一对折片(wings)166和168，所述折片166和168在形成在一半把手外壳24a和24b内的相应的通道(未示出)中移动以引导块158在把手外壳24内的移动。如图8中最佳地所示，突起160大体为L形并且具有近侧凸出部边缘170，所述近侧凸出部边缘170定位成接合止动件44的凸出部146的成角度的凸出部面148以向外推压抓锁部140，从而使得滑块70上的突出部80从抓锁部140脱开。
现在参考图1和图6-图15，现在将描述包括滑块组件42和止动件44的自动锁定安全机构40的操作。参考图1，触发器26初始被触发器闩锁32保持在锁定位置中，所述触发器闩锁32必须被手动地枢转到解锁位置。如上所述，触发器闩锁32是外科吻合装置10的任选特征，并且在使用之前被枢转远离触发器26。
还参考图6，在砧座组件20相对于壳体组件22接近之前，滑块70的突出部80被接收在止动件44的抓锁部140内，并且块158处于远侧位置或前侧位置，其中，块158的突起160向远侧地与止动件44的抓锁部140的凸出部146间隔开。突出部80接合在抓锁部140内防止滑块70在把手外壳24内的纵向移动。螺旋弹簧72(图11)处于压缩状态，并且朝向远侧方向推压滑块70。
简要参考图11，在初始闭锁位置中，滑块70的触发器块82和84搁置在触发器26的直立臂56a和56b的上部平坦表面172a上以防止触发器26的枢转运动。这内部地“闭锁”触发器26以免外科吻合装置10的致动和击发。
再次参考图1，当通过旋转接近旋钮28使砧座组件20接近壳体组件22或朝向壳体组件22向近侧移动时，螺杆轴组件48在把手外壳24内向近侧移动。当螺杆轴组件48向近侧移动时，块158在把手外壳24内向近侧移动。
再参考图6-8，块158从其初始前侧位置移动到第二位置，所述初始前侧位置定位成位于抓锁部140的凸出部146的远侧，并且在所述初始前侧位置处，止动件44的抓锁部140与滑块70的突出部80接合，在所述第二位置处，块158上的突起160的近侧凸出部边缘170接合凸出部146的成角度的凸出部面148。当块158向近侧移动时，通过近侧凸出部边缘170使成角度的凸出部面148侧向地移动以偏置止动件44的抓锁部140从而使其与滑块70上的突出部80脱开(图7和图8)。滑块70的突出部80从止动件44的抓锁部140的释放释放了滑块组件42以有助于沿把手外壳24手动移动开关38，并且因此有助于沿把手外壳24手动移动滑块组件42。
暂时参考图7和图9-图11，当包括块158的螺杆轴组件48被向近侧牵引时，块158的突起160接合滑块70的突出部80，并且逆着弹簧72的偏置向近侧拉动滑块组件42较短距离。当滑块组件42向近侧移动时，击发触发器26仍然被滑块70的触发器块82和84闭锁以便不能移动，所述触发器块82和84仍然部分地接合触发器26的直立臂56a和56b的平坦表面172a。固定到滑块70的开关38也向近侧移动较短距离。开关38从初始位置移动到第二位置，在所述初始位置中，开关38覆盖指示器34(图9)，在所述第二位置中，指示器34经由开关38中的凹口112可见(图10)。这可视地指示临床医生砧座组件20和壳体组件22为接近的并且确认滑块组件42已经从止动件44释放。外科吻合装置10现在适当地围绕待吻合的组织定位。
现在参考图12-图13，为了释放触发器26以用于外科吻合装置10的致动和击发，操作者推动开关38的指状突出部106以在把手外壳24内向近侧移动开关38，并且因此在把手外壳24内向近侧移动滑块70(图13)。当滑块70被向近侧牵引时，螺旋弹簧72被压缩，并且触发器块82和84移动远离触发器26的直立臂56a和56b的上部平坦表面172a以解锁触发器26以用于枢转移动(图12)。
如图13中最佳地所示，当开关38移动到其最近侧位置时，开关38、并且因此滑块70被突出部116、120保持在这个位置中。更具体地，滑块组件42的开关38被开关38的柔性臂114、118上的向外延伸的突出部116、120锁定在最近侧位置中，所述突出部116、120分别卡扣入凹口174和176中，所述凹口174和176邻近窗口36形成在把手外壳24中(图13)。突出部116、120接收在凹口174、176中将开关38并且因此将滑块组件42保持在近侧位置中，以保持触发器块82、84分别与触发器26的臂56a、56b的平坦表面172a间隔开，以将触发器26保持在解锁位置中。
如图14中最佳地所示，在解锁位置中，击发触发器26可以朝向把手外壳24枢转以逆着螺旋弹簧68的偏置推进推动器60，从而从壳体组件22发射吻合钉穿过组织并且进入砧座组件20。
参考图14，在完全致动触发器26的情况下，主滑块锁定组件42被释放以自动地再次闭锁触发器26以免二次致动。更具体地，当推动器60被触发器26驱动到最远侧位置时，形成在推动器60上的突起178在滑块70中的细长狭槽100内移动。当推动器60到达最远位置并且吻合钉已经形成为抵接砧座组件20时，块178接合滑块70的限定了细长狭槽100的远侧端部180的部分，以由此在把手外壳24内向远侧拉动滑块70。当滑块70被向远侧拉动或迫拉时，开关38也被向远侧迫拉使得开关38的柔性臂114和118上的突出部116和120从锁定凹口174和176释放，所述锁定凹口174和176邻近把手外壳24的窗口36。这释放了滑块组件42以使其在螺旋弹簧72的偏置下向远侧移动。当滑块组件42的开关38的突出部116和120从凹口174和176释放时，滑块70向远侧卡合并且发出“咔嗒”声以可听见地指示临床医生触发器26的致动完成并且外科吻合装置10的自动锁定安全机构40已经被自动地再次激活。注意到，开关38向远侧的移动还可视地指示临床医生触发器26的致动完成。当释放触发器26时，滑块70返回到初始位置(图11)，在所述初始位置中，滑块70再次阻碍触发器26枢转移动以防止外科吻合装置10的二次致动。
应当注意，当旋转接近旋钮28以从壳体组件22分离砧座组件20并且释放当前吻合的组织时，块158向远侧移动以牵引突起160使其与止动件44的抓锁部140脱开。抓锁部140向回弯曲与滑块70上的突出部80接合，以由此再次再锁定滑块组件42以防止其进一步的移动(图6)。
因此，以这种方式，在击发外科吻合装置10之后，外科吻合装置10的自动锁定安全机构40精确地再次闭锁触发器26以免二次致动。
应当理解，可以对本文公开的实施例作出各种修改。例如，公开的螺旋弹簧可以被替换为例如其它类型的弹簧，例如片簧等等。此外，如上所述，外部触发器闩锁可以被省略。因此，上述描述不应当被解释为限制性的，而是仅仅作为具体实施例的示例。本领域技术人员将在所附权利要求的范围和精神内想到其它修改。

Claims (15)

1.一种外科吻合装置，所述外科吻合装置包括：
把手组件，所述把手组件包括固定不动的把手外壳和可移动的触发器，可移动的所述触发器安装到所述把手外壳；
细长本体部分，所述细长本体部分从所述把手外壳延伸；
吻合钉容纳壳体组件和砧座组件，所述吻合钉容纳壳体组件安装在所述细长本体部分的远侧端部上，所述砧座组件相对于所述吻合钉容纳壳体组件可移动地安装；
接近机构，所述接近机构能够操作以将所述砧座组件从与所述吻合钉容纳壳体组件间隔开的第一位置移动到邻近所述吻合钉容纳壳体组件的第二接近位置；
推动器，所述推动器从所述把手外壳延伸穿过所述细长本体部分而至所述吻合钉容纳壳体组件，可移动的所述触发器能够移动以向远侧驱动所述推动器，从而驱动吻合钉离开所述吻合钉容纳壳体组件并且进入所述砧座组件；和
滑块组件，所述滑块组件定位在所述把手外壳内，所述滑块组件包括滑块和偏置构件，所述滑块能够在阻碍可移动的所述触发器移动的第一位置和与可移动的所述触发器间隔开的第二位置之间移动，所述偏置构件定位成将所述滑块朝向所述第一位置推压。
2.如权利要求1中所述的外科吻合装置，其中，所述接近机构包括可旋转的接近旋钮和螺杆轴组件，可旋转的所述接近旋钮安装在固定不动的所述把手外壳上，所述螺杆轴组件从所述接近旋钮延伸到所述砧座组件，所述接近机构被构造成使得所述接近旋钮的旋转实现所述螺杆轴组件在所述把手组件内的平移。
3.如权利要求1中所述的外科吻合装置，其中，所述滑块能够在所述把手外壳内纵向地移动，并且包括至少一个触发器块，所述至少一个触发器块定位成接合可移动的所述触发器。
4.如权利要求3中所述的外科吻合装置，其中，所述偏置构件包括螺旋弹簧。
5.如权利要求4中所述的外科吻合装置，其中，所述滑块组件包括开关，所述开关固定地附接到所述滑块，所述开关延伸穿过窗口，所述窗口形成为穿过所述把手外壳。
6.如权利要求5中所述的外科吻合装置，其中，所述滑块包括支架，所述支架具有直立杆和向近侧延伸的臂，所述开关固定地附接到所述向近侧延伸的臂的近侧端部，并且所述螺旋弹簧围绕所述向近侧延伸的臂安装，所述螺旋弹簧在所述螺旋弹簧的第一端部处接合所述直立杆并且在所述螺旋弹簧的第二端部处接合所述把手外壳。
7.如权利要求5中所述的外科吻合装置，其中，所述开关包括至少一个柔性闩锁，所述至少一个柔性闩锁构造为用于当所述滑块组件处于所述第二位置时被接收在形成在所述把手外壳中的窗口的边缘中的凹口内以将所述滑块组件保持在所述第二位置中。
8.如权利要求7中所述的外科吻合装置，其中，所述滑块包括纵向狭槽并且所述推动器包括在所述纵向狭槽内可移动的突起，使得所述推动器向远侧的移动实现所述突起向远侧移动到与所述纵向狭槽的远侧端部接合，以实现所述滑块向远侧的移动，其中所述滑块向远侧的移动使所述开关的至少一个柔性闩锁从所述把手外壳中的凹口脱开。
9.如权利要求5中所述的外科吻合装置，其中，所述开关限定了凹口，所述滑块处于所述第一位置时，所述开关当覆盖所述把手外壳的指示器，并且当所述开关朝向所述第二位置移动时，所述开关露出所述把手外壳的指示器。
10.一种用于痔疮手术的外科吻合装置，所述外科吻合装置包括：
把手组件，所述把手组件包括固定不动的把手外壳和可移动的触发器，可移动的所述触发器安装到所述把手外壳；
细长本体部分，所述细长本体部分从所述把手外壳延伸；
吻合钉容纳壳体组件和砧座组件，所述吻合钉容纳壳体组件安装在所述细长本体部分的远侧端部上，所述砧座组件相对于所述吻合钉容纳壳体组件可移动地安装；
可旋转的接近旋钮和螺杆轴组件，可旋转的所述接近旋钮安装在固定不动的所述把手外壳上并且所述螺杆轴组件从所述接近旋钮延伸到所述砧座组件，使得所述接近旋钮的旋转将螺杆轴组件从前侧位置移动到缩回位置，以将所述砧座组件从与所述吻合钉容纳壳体组件间隔开的第一位置移动到邻近所述吻合钉容纳壳体组件的第二接近位置；
推动器，所述推动器从所述把手外壳延伸穿过所述细长本体部分而至所述吻合钉容纳壳体组件，所述推动器能够与可移动的所述触发器接合使得可移动的所述触发器朝向固定不动的所述把手外壳的移动向远侧驱动所述推动器，以驱动吻合钉离开所述吻合钉容纳壳体组件并且进入所述砧座组件；
滑块组件，所述滑块组件包括滑块，所述滑块在所述滑块的近侧端部处具有突出部，所述滑块定位在所述把手外壳内，并且能够在阻碍可移动的所述触发器移动的第一位置和与可移动的所述触发器间隔开的第二位置之间移动；
柔性止动件，所述柔性止动件定位在所述把手外壳内，并且能够可释放地接合所述滑块的突出部；和
块，所述块固定到所述螺杆轴组件，并且能够响应于所述接近旋钮的旋转而在所述把手外壳内纵向地移动，当所述螺杆轴组件从所述前侧位置朝向所述缩回位置移动时，所述块能够与所述柔性止动件接合以使所述柔性止动件从所述滑块的突出部脱开，从而促使所述滑块从所述第一位置移动到所述第二位置。
11.如权利要求10中所述的外科吻合装置，其中，所述止动件包括第一纵向杆、横杆和第二纵向杆，所述第一纵向杆安装到所述把手外壳，所述横杆连接到所述第一纵向杆，所述第二纵向杆的远侧端部连接到所述横杆，所述第二纵向杆包括抓锁部，所述抓锁部构造为可释放地接合所述滑块的突出部。
12.如权利要求11中所述的外科吻合装置，其中，所述块包括具有凸出部边缘的突起，所述凸出部边缘能够与所述抓锁部接合以将所述抓锁部与所述滑块的突出部移动脱开。
13.如权利要求12中所述的外科吻合装置，其中，所述抓锁部包括向内侧指向的部分和位于所述第二纵向杆上的凸出部，所述向内侧指向的部分形成在所述第二纵向杆的近侧端部上，所述凸出部位于所述向内侧指向的部分的远侧，所述凸出部和所述向内侧指向的部分限定了间隙，所述间隙构造为接收所述滑块的突出部。
14.如权利要求13中所述的外科吻合装置，其中，所述凸出部包括成角度的凸出部面，成角度的所述凸出部面定位成接合所述块上的突起的凸出部边缘。
15.如权利要求14中所述的外科吻合装置，其中，所述块上的突起定位成接合所述滑块上的突出部，使得所述块向近侧的移动向近侧移动所述滑块，所述滑块组件包括开关，所述开关在指示器之上定位在所述把手外壳的窗口内，其中所述滑块向近侧的移动实现了所述开关的移动以通过所述把手外壳中的窗口露出所述指示器。
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