CN107115131A - 内窥镜可再用手术施夹器 - Google Patents

内窥镜可再用手术施夹器 Download PDF

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CN107115131A
CN107115131A CN201710099722.0A CN201710099722A CN107115131A CN 107115131 A CN107115131 A CN 107115131A CN 201710099722 A CN201710099722 A CN 201710099722A CN 107115131 A CN107115131 A CN 107115131A
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阿里夫穆罕默德·穆贾瓦尔
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Covidien LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0023—Surgical instruments, devices or methods, e.g. tourniquets disposable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526—Methods of manufacturing
    • A61B2017/0053—Loading magazines or sutures into applying tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2913—Handles transmission of forces to actuating rod or piston cams or guiding means
    • A61B2017/2916—Handles transmission of forces to actuating rod or piston cams or guiding means pins in guiding slots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/2922—Handles transmission of forces to actuating rod or piston details of linkages or pivot points toggle linkages
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0803—Counting the number of times an instrument is used

Abstract

一种用于与可再用手术施夹器一起使用的夹子仓组件，包括夹子托盘、多个手术夹子和盖。所述夹子托盘包括从其基壁突出的多个朝远侧定向的、可偏斜的弹性指部。每个弹性指部终止于远侧肩部，并且所述夹子托盘的近端被构造成与所述可再用手术施夹器的内窥镜组件的夹子推杆选择性地连接。所述盖包括在通过其近端和远端所限定的通道内突出的多个朝远侧定向的、可偏斜的弹性指部。所述盖的每个弹性指部终止于远侧肩部，并且所述盖包括限定在所述通道的侧壁内的一对相对的狭槽，所述一对相对的狭槽被构造成在其中可滑动地保持有所述夹子托盘和所述多个手术夹子。还提供了一种内窥镜可再用手术施夹器。

Description

内窥镜可再用手术施夹器
技术领域
本技术领域涉及一种手术施夹器。更具体地，本公开涉及一种具有可重复使用的手柄组件、可重复使用的轴组件和一次性夹子仓组件的内窥镜可再用手术施夹器。
背景技术
内窥镜吻合器和施夹器在本领域中是已知的，并且用于一些独立的且有用的手术操作。在腹腔镜手术的情况下，通过窄管或插管插入穿过皮肤中的微小进入切口来进入腹部的内部。在身体其他部位执行的微创手术经常一般性地被称为内窥镜手术。通常，管装置或插管装置通过进入切口延伸到患者体内以提供进入端口。该端口允许手术医生使用套管针将一些不同的手术器械插入其中，用于执行远离切口的手术操作。
在大多数这些手术操作期间，手术医生必须经常终止血液或其他流体流经一个或多个脉管。手术医生会经常将手术夹子应用于血管或其他管道以在手术期间防止体液流过其中。在本领域中已知一种用于在进入体腔期间施加单个夹子的内窥镜施夹器。这种夹子通常由生物相容性材料制成并且常常压紧在脉管上。一旦被施加到脉管上，压紧的夹子终止了流经其中的流体。
在共同转让给Green等人的美国专利第5,084,057号和第5,100,420号中，描述了能够在内窥镜手术操作或腹腔镜手术操作中在单次进入体腔期间施加多个夹子的内窥镜施夹器，上述两专利其整体通过引用而并入本文。另一多内窥镜施夹器公开于由Pratt等人共同转让的美国专利第5,607,436号，其内容在此也通过整体引用而并入本文。这些装置通常(但不必须)在单个手术操作期间使用。Pier等人的美国专利第5,695,502号的公开内容通过引用并入本文，其公开了一种可重复消毒的手术施夹器。施夹器在单次插入体腔期间推进多个夹子并使多个夹子成形。该可重复消毒的施夹器构被造成接收可更换的夹子盒并与其配合，以便在单次进入体腔期间推进多个夹子并使多个夹子成形。
在内窥镜手术操作或腹腔镜手术操作期间，取决于待结扎的下层组织或脉管，可能期望和/或必需使用不同尺寸的手术夹子。为了减小手术施夹器的总成本，期望能够根据需要可装载有不同尺寸的手术夹子并能够发射不同尺寸的手术夹子的单个手术施夹器。
相应地，存在对包括可重复使用的手柄组件、可重复使用的轴组件和一次性夹子仓组件的内窥镜手术施夹器的需要，其中每个夹子仓组件装载有特定尺寸的夹子(例如，相对较小的、相对中等的或相对较大的)。
发明内容
本公开涉及一种可再用内窥镜手术施夹器和适于与其一起使用的夹子仓组件。
根据本公开的方案，提供了一种与可再用内窥镜手术施夹器一起使用的夹子仓组件，并且所述夹子仓组件包括夹子托盘、多个手术夹子和盖。
所述夹子托盘包括从其基壁突出的多个朝远侧定向的、可偏斜的弹性指部。所述夹子托盘的每个弹性指部终止于远侧肩部。所述夹子托盘的近端被构造成与所述可再用手术施夹器的内窥镜组件的夹子推杆选择性连接。
所述多个手术夹子设置在所述夹子托盘的所述基壁上。所述多个手术夹子中的每个设置在所述夹子托盘的每个相应的弹性指部的远侧。
所述盖包括在通过所述盖的近端和远端所限定的通道内突出的多个朝远侧定向的、可偏斜的弹性指部。所述盖的每个弹性指部终止于远侧肩部。所述盖包括限定在所述通道的侧壁内的一对相对的狭槽，所述一对相对的狭槽被构造成在其中可滑动地保持有所述夹子托盘和所述多个手术夹子。所述多个手术夹子中的每个设置在所述盖的每个相应的弹性指部的远侧。
在使用时，在所述夹子托盘朝远侧致动时，所述夹子托盘的每个弹性指部的肩部可以接触相应的手术夹子的后跨部，以同时地向远侧推进全部所述手术夹子。
在所述夹子托盘朝远侧致动之后，在所述夹子托盘朝近侧致动时，所述夹子托盘的每个弹性指部的远侧肩部可以接触所述手术夹子中的相应的剩余的一个，以朝近侧移动全部剩余手术夹子直到剩余手术夹子的后跨部接触所述盖的所述弹性指部的相应的远侧肩部，以阻挡所述剩余手术夹子朝近侧移动。
所述夹子仓组件的所述夹子托盘可以包括穿过其近端限定的至少一个通孔。所述内窥镜组件的所述夹子推杆可以包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接。
所述夹子仓组件的所述夹子托盘可以包括穿过其近端限定的至少一个通孔。所述内窥镜组件的所述夹子推杆可以包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接。所述内窥镜组件的所述夹子推杆的所述远侧联接件可以包括限定在其上的至少一个凸台，所述至少一个凸台被构造成可释放地接合所述夹子仓组件的所述夹子托盘的所述至少一个通孔，使得按压所述至少一个凸台使所述内窥镜组件的所述夹子推杆的所述远侧联接件从所述夹子仓组件的所述夹子托盘分离。
所述夹子仓组件的所述盖的外表面可以包括限定在其上的一对相对的脊，所述一对相对的脊被构造成可释放地接合限定在所述内窥镜组件上的对应的一对翼。
所述仓夹子组件的所述盖的每个弹性指部可以在向下方向上偏压所述夹子托盘。
根据本公开的另一方案，提供了一种可再用手术施夹器，并且所述可再用手术施夹器包括：手柄组件；内窥镜组件，所述内窥镜组件可选择性地连接到所述手柄组件；以及夹子仓组件，所述夹子仓组件可选择性地装载于并连接到限定在所述内窥镜组件内的窗口。
所述夹子仓组件包括夹子托盘、多个手术夹子和盖。
所述夹子托盘包括从其基壁突出的多个朝远侧定向的、可偏斜的弹性指部。所述夹子托盘的每个弹性指部终止于远侧肩部。所述夹子托盘的近端被构造成与所述可再用手术施夹器的内窥镜组件的夹子推杆选择性连接。
所述多个手术夹子设置在所述夹子托盘的所述基壁上。所述多个手术夹子中的每个设置在所述夹子托盘的每个相应的弹性指部的远侧。
所述盖包括在通过所述盖的近端和远端所限定的通道内突出的多个朝远侧定向的、可偏斜的弹性指部。所述盖的每个弹性指部终止于远侧肩部。所述盖包括在所述通道的侧壁内限定的一对相对的狭槽。所述一对相对的狭槽被构造成在其中可滑动地保持有所述夹子托盘和所述多个手术夹子。所述多个手术夹子中的每个设置在所述盖的每个相应的弹性指部的远侧。
所述手柄组件可以包括：壳体；扳机，所述扳机枢转地支撑在所述壳体上并从所述壳体延伸；以及驱动组件，所述驱动组件支撑在所述壳体内并且由所述扳机可操作地致动。
所述内窥镜组件可以包括旋钮组件，所述旋钮组件被构造成并且适于选择性地连接到所述手柄组件的所述壳体。
所述内窥镜组件可以包括外管，所述外管连接到所述旋钮组件并从所述旋钮组件延伸。所述内窥镜组件的所述窗口可以限定在所述外管的远端中。
所述内窥镜组件还可以包括一对钳夹，所述一对钳夹支撑在所述外管的所述窗口中并从所述外管的所述远端延伸。
所述内窥镜组件可以包括钳夹闭合杆，所述钳夹闭合杆可滑动地支撑在所述外管内。所述钳夹闭合杆可以在所述内窥镜组件连接到所述手柄组件时可操作地连接到所述手柄组件的所述扳机。
所述夹子推杆可以可滑动地支撑在所述外管内，并且在所述内窥镜组件连接到所述手柄组件时可操作地连接到所述手柄组件的所述驱动组件。
在使用时，在所述夹子托盘朝远侧致动时，所述夹子托盘的每个弹性指部的肩部可以接触相应的夹子的后跨部，以同时地向远侧推进全部所述手术夹子。
在所述夹子托盘朝远侧致动之后，在所述夹子托盘朝近侧致动时，所述夹子托盘的每个弹性指部的远侧肩部可以接触所述手术夹子中的相应的剩余的一个的后跨部，以朝近侧移动全部所述剩余手术夹子直到剩余手术夹子的后跨部接触所述盖的所述弹性指部的相应的远侧肩部，以阻挡所述剩余手术夹子朝近侧移动。
所述夹子仓组件的所述夹子托盘可以包括穿过其近端限定的至少一个通孔。所述内窥镜组件的所述夹子推杆可以包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接。
所述夹子仓组件的所述夹子托盘可以包括穿过其近端限定的至少一个通孔。所述内窥镜组件的所述夹子推杆可以包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接。
所述内窥镜组件的所述夹子推杆的所述远侧联接件可以包括限定在其上的至少一个凸台，所述至少一个凸台被构造成可释放地接合所述夹子仓组件的所述夹子托盘的所述至少一个通孔，使得按压所述至少一个凸台使所述内窥镜组件的所述夹子推杆的所述远侧联接件从所述夹子仓组件的所述夹子托盘分离。
所述夹子仓组件的所述盖的外表面可以包括限定在其上的一对相对的脊，所述一对相对的脊被构造成可释放地接合限定在所述内窥镜组件的所述窗口上的相应的一对翼。
所述仓夹子组件的所述盖的每个弹性指部可以在向下方向上偏压所述夹子托盘。
所述一对钳夹可以可移除地支撑在所述外管的所述窗口中。
所述手柄组件的所述驱动组件可以包括引导块、近侧解锁构件和远侧解锁构件。
所述引导块可以可操作地连接到所述扳机并且可滑动地支撑在所述手柄组件的所述壳体中。
所述近侧解锁构件可以枢转地连接到所述引导块的远端。所述近侧解锁构件可以包括一对间隔开的朝远侧延伸的臂。每个臂可以包括从其延伸并朝向彼此的凸轮销。
所述远侧解锁构件可以支撑在所述手柄组件的所述壳体中。所述远侧解锁构件可以可滑动地设置在所述近侧解锁构件的所述一对间隔开的臂之间。所述远侧解锁构件可以包括一对相对的向外突出的凸轮斜面，所述凸轮斜面与所述近侧解锁构件的所述凸轮销可操作地对齐。
所述近侧解锁构件和所述远侧解锁构件可以被偏压到未致动位置。
所述手柄组件还可以包括：夹子推杆，所述夹子推杆可滑动地支撑在其壳体中；以及偏压构件，所述偏压构件作用在所述手柄组件的所述夹子推杆上，以在远侧方向上推动所述手柄组件的所述夹子推杆。
附图说明
此处参照附图公开了手术施夹器的特定实施例，其中：
图1是根据本公开的可再用内窥镜手术施夹器的立体图；
图2是图1的所表示的细节区域的放大图；
图3是图1的施夹器处于部件分离的立体图；
图4是图1和图3的施夹器的手柄组件处于部件分离的立体图；
图5是图4的手柄组件处于壳体半部分从其移除的侧视立体图；
图6是图5的所表示的细节区域的放大图；
图7是图5至图6的手柄组件的驱动组件的放大立体图；
图8是图7的驱动组件处于部件分离的立体图；
图9是图1和图3的施夹器的轴组件的立体图；
图10是图9的轴组件处于部件分离的立体图；
图11是图9的轴组件的钳夹推动器组件的立体图；
图12是图11的钳夹推动器组件处于部件分离的立体图；
图13是图9的轴组件的夹子推动器组件的立体图；
图14是图13的夹子推动器组件处于部件分离的立体图；
图15是手术夹子仓组件的立体图；
图15A是图15的手术夹子仓组件的替代实施例的立体图；
图15B是沿图15A的线15B-15B截取的图15A的手术夹子仓组件的截面图；
图16是图15的夹子仓组件处于部件分离的立体图；
图16A是图15A的夹子仓组件处于部件分离的立体图；
图17是图14至图15的夹子仓组件处于盖从其移除的立体图；
图18是图14至图15的夹子仓组件处于盖和夹子推动器从其移除的立体图；
图19是图14至图15的夹子仓组件的夹子推动器的立体图；
图20是图示了夹子仓组件装载到轴组件或与轴组件一起装载的立体图；
图21是图示了夹子仓组件装载到轴组件或与轴组件一起装载的立体图，其中外管从轴组件移除；
图22是图示了夹子仓组件的夹子推动器与轴组件的夹子推动器组件联接的立体图；
图22A是图示了图15A的夹子仓组件的夹子推动器与轴组件的替代夹子推动器组件相关联的立体图；
图23是沿图1的23-23截取的图示了施夹器处于未致动状态的图1的手术施夹器的纵向截面图；
图24是图23的所表示的细节区域的放大图；
图25是图示了轴组件联接到手柄组件的图24的所表示的细节区域的放大图；
图26是图示了夹子推杆的锁定的图23的所表示的细节区域的放大图；
图27是沿图26的27-27截取的图7和图8的驱动组件的截面图；
图28是图24所示的轴组件的所表示的细节区域的放大图；
图29是图28的所表示的细节区域的放大图；
图30是图示了扳机的初始致动的图5所示的手柄组件的正视图；
图31是图示了夹子推杆的解锁的图30的所表示区域的放大图；
图32和图33是作用在施夹器的一对钳夹上的夹子推杆的夹子压力特征(cliplogic feature)的立体图；
图34和图35是图示了将最远侧手术夹子装载到施夹器的一对钳夹中的纵向截面图；
图36和图37是作用在施夹器的一对钳夹上以使钳夹闭合并在使其中装载的夹子成形的夹子闭合杆的立体图；以及
图38是在脉管上成形的手术夹子的立体图。
具体实施方式
现在将参照附图详细描述根据本公开的可再用内窥镜手术施夹器的实施例，其中相同的附图标记表示相似或相同的结构元件。如附图所示和下面的描述通篇所描述的，当指在手术器械上的相对定位时，如常规那样，术语“近侧”是指装置的更靠近使用者的那端，并且术语“远侧”指装置的更远离使用者的那端。
参照图1至图37，根据本公开的实施例的内窥镜手术施夹器一般性地表示为10。手术施夹器10通常包括：手柄组件100；内窥镜组件200，其包括可选择性地连接到手柄组件100并且可从手柄组件100向远侧延伸的轴组件210；以及至少一个手术夹子仓组件300，其可选择性地装载到内窥镜组件200的轴组件210中。
简而言之，内窥镜组件200的轴组件210可以取决于特定的用途而具有诸如约5mm或约10mm的各种外径。此外，取决于特定的用途，例如在减肥手术中，轴组件210可以具有各种相对伸长或缩短的长度。在一个实施例中，在减肥手术中，轴组件210可以具有在约30cm与约40cm之间的长度。但是，本领域技术人员应当理解，轴组件210可以具有超过约30cm的任何长度，并且本公开不限于任何上述长度。
根据本公开，如下文将更详细地讨论的，每个手术夹子仓组件300可以装载有特定尺寸的一组手术夹子(例如，相对较小的手术夹子、相对中等的手术夹子、或者相对较大的手术夹子)。每个夹子仓组件300被构造为选择性地装载到内窥镜组件200的轴组件210中，并且由手柄组件100致动以将装载到其中的手术夹子发射并且使手术夹子成形在下层组织和/或脉管上。
参照图1至图8，示出了手术施夹器10的手柄组件100。手柄组件100包括具有第一或右侧半部分102a以及第二或左侧半部分102b的壳体102。手柄组件100包括可枢转地支撑在壳体102的右侧半部分102a与左侧半部分102b之间的扳机104。扳机104被偏压构件104a(例如，弹簧)偏压到未致动状态。
手柄组件100的壳体102可以由合适的塑料或热塑性材料形成。手柄组件100包括提供了进入施夹器10的驱动组件120的可移除的盖106等。如图3至图5所示，手柄组件100的壳体102还包括限定环形凸缘102d的鼻部102c。
手柄组件100包括可操作地连接到扳机104的驱动组件120。具体地，驱动组件120包括近侧连杆(或一对连杆)122和远侧连杆124。近侧连杆122包括枢转地连接到扳机104的远侧联接部分122a以及枢转地连接到引导块126的近侧联接部分122b。远侧连杆124包括枢转地连接到钳夹推动器管或缸156的远侧联接部分124a以及枢转地连接到扳机104的近侧联接部分124b。销126将近侧连杆122和远侧连杆124枢转地连接到扳机104。销126还可滑动地设置在相对的弓形通道102c内，相对的弓形通道102c在相对的手柄半部分102a、102b中形成。以这种方式，随着扳机104被致动，销126沿着狭槽102e(图4)移动，并且使得近侧连杆122的相对的近侧联接部分122b和远侧连杆124的远侧联接部分124a彼此分离。
如图4至图8所示，驱动组件120还包括引导块132，引导块132限定穿过其中的纵向延伸通道132a。近侧连杆122的近侧联接部分122b枢转地连接到引导块132。
驱动组件120还包括枢转地连接到引导块132的远侧部分的近侧解锁构件134。近侧解锁构件134包括一对朝远侧定向的间隔开的臂134a，每个臂134a包括从其延伸并朝向彼此的凸轮销134b。提供了偏压构件136(例如，板簧)，并且偏压构件136包括固定到引导块132的第一端以及自由端，所述自由端作用在近侧解锁构件134上，以在近侧解锁构件134上施加力并且将近侧解锁构件134保持在锁定位置，如下文将更详细地讨论的。
例如，驱动组件120另外包括诸如通过支撑块139等枢转地支撑在手柄组件100的壳体102中的远侧解锁构件138。可替代地，远侧解锁构件138可以直接枢转地连接到手柄组件100的壳体102。远侧解锁构件138包括鼻部138a(图8)，鼻部138a被构造成并且尺寸设定成用于设置在近侧解锁构件134的间隔开的两个臂134a之间。远侧解锁构件138包括从远侧解锁构件138的鼻部138a的相对侧延伸的一对凸轮斜面138b。远侧锁定构件138的凸轮斜面138b与近侧解锁构件134的凸轮销134b可操作地关联，如下文将更详细地描述的。远侧解锁构件138还包括锁定凸片138c，锁定凸片138c从其突出并且朝向夹子推杆150(参见图6、图26和图31)延伸，用以与夹子推杆150选择性接合，如下文将更详细地描述的。提供了偏压构件140(例如，螺旋弹簧等)，并且偏压构件140包括固定到支撑块139的第一端和自由端，所述自由端作用在远侧解锁构件138上，以在远侧解锁构件138上施加力并且将远侧解锁构件138保持在锁定位置，如下面将更详细地描述的。
继续参照图4至图8，驱动组件120包括可滑动地支撑在手柄组件100的壳体102内并穿过壳体102可滑动地支撑的夹子推杆150。夹子推杆150包括支撑在其近端150a上的凸缘152a以及在其远端150b处形成的联接件尖端152b。夹子推杆150的尺寸设定成使得其联接件尖端152b从手柄组件100的壳体102的鼻部102c突出。夹子推杆150在其中限定了窗口或狭槽150c，用于选择性地接收远侧解锁构件138的锁定凸片138c(图6和图26)，如下文将更详细地描述的。偏压构件154(例如，压缩弹簧)介于手柄组件100的壳体102与夹子推杆150的凸缘152a之间。偏压构件154作用在夹子推杆150上，以在远侧方向上偏压或推动夹子推杆150。
当夹子推杆150处于近侧位置时，远侧解锁构件138的锁定凸片138c设置在夹子推杆150的窗口或狭槽150c内，并且偏压构件154挤压在手柄组件100的壳体102与夹子推杆150的凸缘152a之间。
驱动组件120还包括可滑动地支撑在手柄组件100的壳体102内的钳夹推动器管156。钳夹推动器管156限定穿过其中的内腔，所述内腔用于在其中接收夹子推杆150并使夹子推杆150可滑动地通过。钳夹推动器管156包括枢转地连接到远侧连杆124的远侧联接部分124a的近端156a以及形成在其远端156b处的联接件尖端156c。钳夹推动器管156的尺寸设定成使得其联接件尖端156c从手柄组件100的壳体102的鼻部102c突出。
现在转到图1至图3以及图9至图10，示出了手术施夹器10的内窥镜组件200。内窥镜组件200包括旋钮组件202，旋钮组件202构造成用于选择性地连接到手柄组件100的壳体102的鼻部102c的环形凸缘102d。旋钮组件202包括外旋钮环202a、构造成接收在外旋钮环202a中的内旋钮环202b、以及构造成用于接收在内旋钮环202b中的锁环202c。
在使用时，当外旋钮环202a相对于内旋钮环202b处于第一位置时，旋钮组件202可以联接到手柄组件100的壳体102的鼻部102c上或者可以接收鼻部102c。当外旋钮环202a相对于内旋钮环202b处于第二位置时，壳体102的鼻部102c设置在旋钮组件202的锁环202c内时，外旋钮环202a作用在锁环202c的突片202d上，以将突片202d推入到壳体102的鼻部102c的环形凸缘102d中，以将内窥镜组件200锁定在手柄组件100上。
旋钮组件202可以可旋转地安装在壳体102的鼻部102c上，以将轴组件210和一对钳夹214传递和/或提供绕其纵向轴线的360°旋转。
如图1至图3以及图9至图14所示，内窥镜组件200包括从旋钮组件202延伸的轴组件210。轴组件210包括具有近端部分212a和远端部分212b的外管212，近端部分212a牢固地固定到旋钮组件202的内旋钮环202b，远端部分212b从旋钮组件202的内旋钮环202b延伸。外管212的远端部分212b限定在其侧面中形成的通道或窗口212c。
轴组件210包括一对钳夹214，一对钳夹214安装在外管212的通道212c中并且可通过手柄组件100的扳机104的致动来致动。所述一对钳夹214由适当的生物相容性材料形成，例如，由不锈钢或钛形成。所述一对钳夹214可移除地安装在外管212的通道212c中。参照图10、图20和图29，所述一对钳夹214可以设置在从管填充件215突出的安装齿215a上，管填充件215固定地安装或支撑在内窥镜组件200的外管212的通道或窗口212c中。特别地，所述一对钳夹214可以限定形成在其柄部214b中的窗口214c，其中当所述一对钳夹214安装在外管212的通道212c中时，所述一对钳夹214的窗口214c在其中接纳安装齿215a。偏压构件215b被设置成保持所述一对钳夹214与安装齿215a接合。
现参照图32、图33、图36和图37，所述一对钳夹214在其之间限定了通道214a，通道214a用于在其中接收手术夹子“C”。所述一对钳夹214包括从其突出的一对凸轮楔形表面214b。如下文将详细描述的，一对凸轮楔形表面214b被钳夹闭合杆216作用，以将所述一对钳夹214致动到闭合位置。
参照图3以及图9至图13，轴组件210包括可滑动地支撑在外管212内的钳夹闭合杆216。钳夹闭合杆216包括固定地支撑联接件毂217的近端部分216a以及构造成接合并作用于所述一对钳夹214的远端部分216b。具体地，钳夹闭合杆216的远端部分216b限定了远侧的端部开口的通道216c，所述通道216c被构造成并且尺寸设定成：在钳夹闭合杆216相对于所述一对钳夹214在远侧方向上移动以接近所述一对钳夹214时，接合所述一对钳夹214的一对凸轮楔形表面214b的外表面。
钳夹闭合杆216的联接件毂217被构造成选择性地连接到手柄组件100的驱动组件120的钳夹推动器管156的联接件尖端156c。在使用时，在钳夹闭合杆216的联接件毂217连接到钳夹推动器管156的联接件尖端156c上的情况下，钳夹推动器管156的轴向平移引起了钳夹推动器管156的轴向平移。可以预期，钳夹闭合杆216的联接件毂217和钳夹推动器管156的联接件尖端156c可以具有燕尾型构造等。
继续参照图3以及图9至图13，轴组件210包括可滑动地支撑在外管212内且与钳夹闭合杆216邻近的夹子推杆218。夹子推杆218包括近端部分218a和远端部分218b，近端部分218a限定近侧联接件218c，远端部分218b限定了构造成接合并作用于夹子仓组件300的仓夹子推杆304的远侧联接件218d，如下文将更详细地描述的。夹子推杆218的近侧联接件218c被构造成选择性地连接到手柄组件100的驱动组件120的夹子推杆150的联接件尖端152b。在使用时，在夹子推杆218的近侧联接件218c连接到夹子推杆150的联接件尖端152b的情况下，手柄组件100的夹子推杆150的轴向平移引起了内窥镜组件200的夹子推杆218的轴向平移。可以预期，夹子推杆218的近侧联接件218c和夹子推杆150的联接件尖端152b可以具有燕尾型构造等。
轴组件210还包括可滑动地支撑在外管212内并介于钳夹闭合杆216与夹子推杆218之间的夹子压力推动器(clip logic pusher)或楔形板220。楔形板220包括近端部分220a和远端部分220b，近端部分220a可滑动地连接到夹子推杆218，远端部分220b被构造成接合并作用于一对钳夹214，如下文将更详细描述的。可以提供偏压构件以将楔形板220推动到远侧位置以展开一对钳夹214。
现在转到图1至图3以及图15至图22，示出了手术施夹器10的夹子仓组件300。如上所述，夹子仓组件300被构造成并且尺寸设定成用于选择性地装载到在内窥镜组件200的外管212的远端部分212b中形成的通道212c内，并且被构造成并且尺寸设定成选择性地连接或联接到夹子推杆218的远侧联接件218d，如下文将更详细地论述的。
夹子仓组件300包括夹子托盘302，夹子托盘302包括基壁302a和支撑在基壁302b上的一对间隔开的侧壁或侧轨302b，其中基壁302a和侧壁302b限定夹子通道302c。夹子托盘302包括朝远侧延伸的、弹性的、可偏斜的指部302d的线性阵列，所述指部302d的线性阵列在两个侧壁302b之间的位置处从基壁302a向上突出到夹子通道302c中。
夹子仓组件300包括可滑动地设置在夹子托盘302附近的仓夹子推杆304。仓夹子推杆304包括限定联接件根部、头部或凸台304c的近端304a以及限定推动器304d的远端部分304b，联接件根部、头部或凸台304c被构造成选择性地与内窥镜组件200的夹子推杆218的远侧联接件218d连接，推动器304d被构造成接合一叠夹子“C”中的最远侧的夹子“C1”，用于将最远侧夹子“C1”装载到内窥镜组件200的一对钳夹214内。
仓夹子推杆304包括朝远侧定向的斜面304e的线性阵列，其中每个斜面304e限定远侧肩部304f。在实施例中，斜面304e的阵列包括一对侧向间隔开的斜面的阵列，所述斜面的阵列纵向地在其之间限定了通道。在使用时，当仓夹子推杆304覆盖或邻近夹子托盘302时，夹子托盘302的可偏斜的指部302d设置在一对侧向间隔开的斜面304e的阵列之间。
夹子仓组件300包括介于夹子托盘302与仓夹子推杆304之间的一叠手术夹子“C”。所述一叠手术夹子“C”支撑在夹子托盘302上或装载到夹子托盘302中，使得每个手术夹子“C”的顶点设置在夹子托盘302的相应的可偏斜指部302d的远侧。此外，当仓夹子推杆304相对于夹子托盘302处于近侧位置时，仓夹子推杆304的一对侧向间隔开的斜面304e的阵列设置在所述一叠手术夹子的相应的手术夹子“C”的冠部或腿部的近侧。
假定夹子仓组件300和内窥镜组件200被恰当地构造并设定了尺寸，夹子仓组件300可以装载有10个手术夹子“C”，或者在实施例中，夹子仓组件300可以装载有任何数量的手术夹子“C”。手术夹子“C”可以由本领域技术人员已知的材料制成，包括但不限于不锈钢、钛或其他金属合金。在实施例中，可以预期，可以将一叠手术夹子“C”中的至少最后一个手术夹子染成特定颜色，以当夹子仓组件300的最后手术夹子被装载到一对钳夹214时向使用者指示。
夹子仓组件300包括构造成连接到夹子托盘302并支撑在夹子托盘302上的盖306。盖306包括从其突出并且朝仓推杆304突出的一系列弹性的可偏斜的指部306a。盖306的指部306a用于朝夹子托盘302偏压仓夹子推杆304，并且保持所述一叠手术夹子“C”与夹子托盘302的基壁302b滑动接触。
盖306限定形成在其近侧区域中的窗口306b，用于接近仓夹子推杆304的释放按钮304g。在使用时，在仓夹子推杆304的联接件凸台304c联接到内窥镜组件200的夹子推杆218的远侧联接件218d的情况下，使用者可以按压释放按钮304g以使联接件凸台304c从夹子推杆218的互补的远侧联接件218d分离(例如，从远侧联接件218d内按下联接件凸台304c)，从而将夹子仓组件300从内窥镜组件200断开。
参照图20至图22，提供了夹子仓组件300到内窥镜组件200的装载。为了将夹子仓组件300装载到内窥镜组件200的外管212的通道或窗口212c内，使用者按下仓夹子推杆304的释放按钮304g(沿图20的箭头“A”的方向)。随着仓夹子推杆304的释放按钮304g被按下，仓夹子推杆304的联接件凸台304c被插入到内窥镜组件200的外管212中，直到仓夹子推杆304的联接件凸台304c与内窥镜组件200的夹子推杆218的远侧联接件218d对齐。随着仓夹子推杆304的联接件凸台304c与内窥镜组件200的夹子推杆218的远侧联接件218d对齐，仓夹子推杆304的释放按钮304g可以被释放，使得仓夹子推杆304的联接件凸台304c进入内窥镜组件200的夹子推杆218的互补远侧联接件218d并与互补远侧联接件218d配合。在这样做时，夹子仓组件300被装载到内窥镜组件200的外管212的通道或窗口212c中，并且夹子仓组件300的仓夹子推杆304联接到内窥镜组件200的夹子推杆218。
如图2和图10所示，内窥镜组件200的外管212的通道或窗口212c可以设置有沿其侧边缘延伸并朝向彼此延伸的唇或翼212d，以卡扣或接合夹子仓组件300的侧面，并且进一步有助于保持夹子仓组件300装载到内窥镜组件200中。
参照图15A、图15B和图16A，图示了根据本公开提供的夹子仓组件的替代实施例，并且一般性地由附图标记300'标识。
类似于夹子仓组件300，夹子仓组件300'被构造成并且尺寸设定成选择性地装载到在内窥镜组件200的外管212的远端部分212b中形成的通道212c中，并且被构造成并且尺寸设定成选择性地连接或联接到夹子推杆218的远侧联接件218d的替代实施例，其一般性地被标识为远侧联接件218d'(图22A)，如下文将更详细地描述的。
夹子仓组件300'包括夹子托盘302'，夹子托盘302'包括基壁302a'，基壁302a'限定在相对的侧面302b'之间延伸的大致平坦的表面。夹子托盘302'包括朝远侧延伸的、弹性的、可偏斜的指部302d'的线性阵列，所述指部302d'的线性阵列在相对的侧面302b'之间的位置处从基壁302a'向上突出。每个弹性指部302d'限定远侧肩部302f'。在实施例中，远侧肩部302f'包括对应于一叠夹子中的每个夹子“C”的冠部的形状的弓形轮廓，以便提供与其更有利的接合。夹子托盘302'包括多个通孔302e'，多个通孔302e'由在其近端处穿过基壁302a'而限定。多个通孔302e'中的每个被构造成可释放地接合夹子推杆218的远侧联接件218d'(图22A)，如下文将更详细地描述的。
以这种方式，夹子仓组件300'的夹子托盘302'用于装载最远侧的夹子“C1”并且代替夹子仓组件300的仓夹子推杆304来推进一叠夹子中的每个夹子“C”。通过移除夹子仓推杆304，减少了夹子仓组件300'的部件数量和总体复杂性。
夹子仓组件300'包括构造成用于连接到内窥镜组件200的外管212并且支撑在外管212上的盖306'。夹子仓组件300'包括限定在其中并且从其近端延伸到远端的U形通道306c'。U形通道306c'包括限定在其侧壁306e'中的一对相对的狭槽306d'。相对的狭槽306d'被构造成并且尺寸设定成在其中可滑动地接收夹子托盘302'。以这种方式，盖306'由适当的弹性材料形成，所述弹性材料能够暂时变形以在其中接收夹子托盘302'，但是一旦任何外力不再施加到其上时就保持其原始形状。盖306'包括朝远侧定向的、弹性的可偏斜的指部306f'的线性阵列，其中每个弹性指部306f'限定远侧肩部306g'。在实施例中，弹性指部306f'的阵列包括一对侧向间隔开的弹性指部的阵列，所述弹性指部的阵列纵向地在其之间限定了通道。正如可以理解的，盖306'的弹性指部306f'可以用于在向下方向上偏压夹子托盘302'，以确保夹子托盘302'仅可在纵向方向上行进(即，禁止夹子托盘302'的竖向运动)。
一对相对的脊306h'设置在盖306'的外表面306i'上，并且被构造成并且尺寸设定成可释放地接合内窥镜组件200的外管212的唇或翼212d，类似于上文针对夹子仓组件300所描述的。
夹子仓组件300'包括介于夹子托盘302'与盖306'之间的一叠手术夹子，使得手术夹子“C”也与夹子托盘302'一起设置在一对相对的狭槽306d'内。一叠手术夹子支撑在夹子托盘302'上或装载到夹子托盘302'中，使得每个手术夹子“C”的顶点或冠部设置在夹子托盘302'的相应的可偏斜指部302d'远侧。此外，当盖306'可滑动地连接到夹子托盘302'时，朝远侧定向的、弹性的可偏斜指部306f'的线性阵列中的每个弹性指部306f'设置在一叠手术夹子的相应手术夹子“C”的冠部或腿近侧。以这种方式，盖306'将一叠手术夹子和夹子托盘302'可滑动地保持在一对相对的狭槽306d'内。
假定夹子仓组件300'和内窥镜组件200被恰当地构造并设定了尺寸，夹子仓组件300'可以装载有10个手术夹子“C”，或者在实施例中，夹子仓组件300'可以装载有任何数量的手术夹子“C”。手术夹子“C”与上文针对夹子仓组件300所描述的那些相同，因此，为了简洁起见，这里不再描述其详细的描述。
另外参照图22A，提供了夹子仓组件300'装载到内窥镜组件200。为了将夹子仓组件300'装载到内窥镜组件200的外管212的通道或窗口212c中，使用者将设置在内窥镜组件200的夹子推杆218的远侧联接件218d上的一对凸台218e'或释放按钮与夹子托盘302'的每个相应的通孔302e'接合。可以预期，一对凸台218e'可以由弹性材料构成，使得使用者可以按下一对凸台218e'的每个凸台218e'，以可释放地接合夹子托盘302'的每个相应的通孔302e'。在这一点上，夹子仓300'被按入内窥镜组件200的外管212的通道或窗口212c中，使得内窥镜组件200的唇或翼212d可释放地接合盖306'的一对相对的脊306h'。正如可以理解的，借助卡扣装配构造，唇或翼212d可以可释放地接合一对相对的脊306h'。
继续参照图1至图22，并且另外具体参照图23至图38，示出并描述了施夹器10的示例性操作模式。如图23至图29所示，示出了施夹器10，其中内窥镜组件200连接到手柄组件100(如上所述)，并且夹子仓组件300装载到内窥镜组件200中(如上所述)。
具体地，在手柄组件的扳机104处于未致动状态的情况下，手柄组件100的夹子推杆150、内窥镜组件200的夹子推杆218以及夹子仓组件300的仓夹子推杆304处于未致动位置或最近侧位置。经这样定位，驱动组件120的远侧解锁构件138的锁定凸片138c设置在夹子推杆150的窗口或狭槽150c内，从而将夹子推杆150保持在未致动位置或最近侧位置，并且将偏压构件154保持被压缩在手柄组件100的壳体102与夹子推杆150的凸缘152a之间。
另外，在手柄组件的扳机104处于未致动状态的情况下，夹子仓组件300的仓夹子推杆304的朝远侧定向的斜面304e的远侧肩部304f设置在一叠手术夹子“C”中的相应手术夹子的近侧。
此外，在手柄组件的扳机104处于未致动状态的情况下，内窥镜组件200的楔形板220保持在未致动位置或最近侧位置。
继续参照图1至图28，并且另外具体参照图30至图38，下文示出并描述了手术施夹器10的发射行程。在夹子仓组件300装载到内窥镜组件200中的情况下，随着手柄组件100的扳机104被致动到完全致动位置，一叠手术夹子“C”中的最远侧的夹子“C1”被装载到内窥镜组件200的一对钳夹214内并由一对钳夹214成形。
更具体地，随着扳机104在图30的箭头“B”的方向上被致动，扳机104作用在近侧连杆122上，以在近侧方向上(如图30的箭头“C”所示)移动近侧连杆122的近侧联接部分122b，并且作用在远侧连杆124上以在远侧方向上(如图30的箭头“D”所示)移动远侧连杆124的远侧联接部分124a。
随着近侧连杆122的近侧联接部分122b在近侧方向上移动，近侧连杆122作用在驱动组件120的引导块132上，以在近侧方向上移动引导块132，进而在近侧方向上移动近侧解锁构件134。随着近侧解锁构件134在近侧方向上移动，近侧解锁构件134的凸轮销134b被移动而与远侧解锁构件138的凸轮斜面138b接合，以在图30和图31的箭头“E”的方向上将远侧解锁构件138推离手柄组件100的夹子推杆150。随着远侧解锁构件138被推离夹子推杆150，远侧解锁构件138的锁定凸片138c随即脱离夹子推杆150的窗口或狭槽150c，从而允许偏压构件154伸展并向远侧驱动夹子推杆150直到夹子推杆150的凸缘152a抵接引导块132。一旦近侧解锁构件134的凸轮销134b朝远侧移动超过远侧解锁构件138的凸轮斜面138b，则偏压构件140朝夹子推杆150推回远侧解锁构件138，使得远侧解锁构件138的锁定凸片138c接触夹子推杆150的表面，同时仍允许夹子推杆150在远侧方向上移动。
随着手柄组件100的夹子推杆150在远侧方向上移动，夹子推杆150在远侧方向上移动内窥镜组件200的夹子推动器组件218，进而作用在夹子仓组件300的仓夹子推杆304上，以在远侧方向上移动仓夹子推杆304，从而将手术夹子“C”装载到一对钳夹214内。
另外，如图32和图33所示，随着内窥镜组件200的夹子推动器组件218(图13和图29)在远侧方向上移动，夹子推动器组件218作用在楔形板220上以朝远侧移动楔形板220，直到楔形板220的远端部分220b接触一对钳夹214的凸轮楔形表面214b，以将一对钳夹214保持在间隔开的状态或将一对钳夹214推动到间隔开的状态。具体地，楔形板220的远端部分220b限定了一对V形凹口220c，一对钳夹214的每个凸轮楔形表面214b中的每个，以在楔形板220朝远侧推进时引导一对钳夹214。
在楔形板220推动一对钳夹214分开的情况下，随着夹子推杆150在远侧方向上移动，夹子推杆150在远侧方向上移动内窥镜组件200的夹子推动器组件218，进而如图34和图35所示，在远侧方向上移动夹子仓组件300的仓夹子推杆304，以将一叠夹子“C”中在远侧方向上的最远侧夹子“C1”装载到一对钳夹214中。具体地，仓夹子推杆304的推动器304d接合最远侧夹子“C1”的后跨部，并且将最远侧夹子“C1”推出夹子仓组件300而推入到一对夹钳214的通道214a内。另外，在最远侧夹子“C1”的朝远侧移动的同时，随着夹子仓组件300的仓夹子推杆304在远侧方向上移动，仓夹子推杆304的斜面304e的远侧肩部304f与剩余手术夹子“C”的相应的手术夹子的相应的后跨部抵接，以便同样在远侧方向上推动剩余手术夹子“C”。仓夹子推杆304朝远侧推进剩余手术夹子“C”，直到每个剩余手术夹子“C”朝远侧推进经过夹子仓组件300的下一个邻近的、弹性的、可偏斜的指部302d。
然后，夹子推杆150的凸缘152a抵接引导块132，随着扳机104被进一步致动，近端连杆122继续在近侧方向上移动引导块132，并且引导块132作用在夹子推杆150的凸缘152a上以在近侧方向上推动夹子推杆150。随着夹子推杆150在近侧方向上移动，夹子推杆150在近侧方向上拉动或移动内窥镜组件200的夹子推动器组件218，进而在近侧方向上拉动或移动夹子仓组件300的仓夹子推杆304。随着仓夹子推杆304在近侧方向上移动，仓夹子推杆304的斜面304e抵接剩余手术夹子“C”的后跨部的远侧表面，以便同样在近侧方向上推动剩余手术夹子“C”。仓夹子推杆304向近侧缩回剩余手术夹子“C”，直到每个剩余手术夹子“C”缩回到与夹子仓组件300的相应的弹性的、可偏斜的指部302d的相应的远侧尖端接触，其阻挡或阻止了剩余手术夹子“C”进一步朝近端缩回。
在手柄组件100的夹子推杆150继续被引导块132在近侧方向上推动的情况下，随着夹子推杆150的窗口或狭槽150c与远侧解锁构件138的锁定凸片138c对齐，偏压构件140将远侧解锁构件138的锁定凸片138c推回到夹子推杆150的窗口或狭槽150c中。
如上所述，随着扳机104在图30的箭头“B”的方向上被致动时，扳机104还作用在远侧连杆124上，以在远侧方向上(如图30的箭头“D”所示)移动远侧连杆124的远侧联接部分124a。随着远侧连杆124的远侧联接部分124a在远侧方向上移动，远侧联接部分124a在远侧方向上推动钳夹推进器管156。在钳夹推进器管156连接到内窥镜组件200的钳夹闭合杆216(如上所述)的情况下，随着钳夹推进器管156在远侧方向上移动，钳夹闭合杆216也在远侧方向上移动。参照图36和图37，随着钳夹闭合杆216在远侧方向上移动，钳夹闭合杆216的通道216c(参见图11和图12)接收或接合一对钳夹214的一对凸轮楔形表面214b，以将一对钳夹移动到闭合位置或接近位置。
在最远侧的手术夹子“C1”装载到一对钳夹214中的情况下，随着钳夹闭合杆216将一对钳夹移动到闭合位置或接近位置，最远侧的手术夹子“C1”在其之间成形在例如脉管“V”上等，如图38所示。
致动施夹器10的时机为这样：使得在钳夹闭合杆216接合一对钳夹214的一对凸轮楔形表面214b之前，夹子仓组件300的仓夹子推杆304的推动器304d从内窥镜组件200的一对钳夹214之间撤出。
在手术夹子“C”成形的情况下，扳机104可以通过扳机回位弹簧104a(参见图4和图5)或者借助于扳机回位弹簧104a而被释放并返回到未致动位置。随着扳机104返回到未致动位置，扳机104作用在近侧连杆122上以在远侧方向上移动引导块132，并且作用在远侧连杆124上以在近侧方向上移动钳夹推进器管156，从而使施夹器10复位以进行另一发射。
可以预期，手柄组件100如图4、图5和图30所示可以包括计数器机构110，计数器机构110被构造成并适于随着手术施夹器10的每次发射而减小其上的标记。以这种方式，使用者可以记录在夹子仓组件300中剩余的手术夹子的数量。
在使用时，如上所述，手术施夹器10能够将不同的手术夹子仓组件300装载到内窥镜组件200中。具体地，内窥镜组件200可以装载有手术夹子仓组件300，该手术夹子仓组件300装载有具有第一尺寸的一叠手术夹子“C”，或者内窥镜组件200可以装载有手术夹子仓组件300，该手术夹子仓组件300装载有具有不同于第一尺寸的第二尺寸的一叠手术夹子“C”。
以这种方式，使用者或手术医生可以依据待执行的特定手术操作来装载已装载有特定尺寸的手术夹子的手术夹子仓组件300。另外，在手术操作期间，如果产生了使用不同尺寸的手术夹子的需要，则使用者或手术医生可以弹出或卸载已装载到内窥镜组件200中的手术夹子仓组件300，然后将新的手术夹子仓组件300(与未装载的手术夹子仓组件300相比在其中装载有不同尺寸的一叠手术夹子)装载到内窥镜组件200内。
根据本公开，可以预期，手术施夹器10包括：可用于多个手术操作的可重复使用且可消毒的手柄组件100；同样可用于多个手术操作的可重复使用且可消毒的内窥镜组件200；以及一次性的、单次使用的夹子仓组件300(例如，其中夹子仓组件300当从内窥镜组件200卸载时被处理)。可以预期，内窥镜组件200可以在特定的手术操作之后被处理，并且不重复使用或消毒。
同样根据本公开，进一步预期，可以提供一种手术装备，其包括单个手柄组件100、单个内窥镜组件200以及多个夹子仓组件300，所述夹子仓组件300至少包括装载有具有第一尺寸的一叠手术夹子的第一组夹子仓组件、以及装载有具有不同于第一尺寸的第二尺寸的一叠手术夹子的第二组夹子仓组件。所述装备可以包括对组件或手术施夹器10的指示、手术施夹器10的使用以及在使用之后对手术施夹器组件10的处理。
应当理解，前面的描述仅仅是对本公开的说明。本领域技术人员可以不偏离本公开设计出各种替代例和变型例。相应地，本公开旨在涵盖所有这样的替代例、变型例和改变例。参照附图所描述的实施例仅用于示出来示范本公开的某些示例。与上文和/或所附权利要求中所述的那些元件、步骤、方法和技术无实质上不同的其它元件、步骤、方法和技术也认为在本公开的范围内。

Claims (20)

1.一种用于与可再用手术施夹器一起使用的夹子仓组件，包括：
夹子托盘，所述夹子托盘包括从其基壁突出的多个朝远侧定向的、可偏斜的弹性指部，所述夹子托盘的每个弹性指部终止于远侧肩部，所述夹子托盘的近端被构造成与所述可再用手术施夹器的内窥镜组件的夹子推杆选择性连接；
多个手术夹子，所述多个手术夹子设置在所述夹子托盘的所述基壁上，其中所述多个手术夹子中的每个设置在所述夹子托盘的每个相应的弹性指部的远侧；以及
盖，所述盖包括在通过所述盖的近端和远端所限定的通道内突出的多个朝远侧定向的、可偏斜的弹性指部，所述盖的每个弹性指部终止于远侧肩部，其中所述盖包括限定在所述通道的侧壁内的一对相对的狭槽，所述一对相对的狭槽被构造成在其中可滑动地保持有所述夹子托盘和所述多个手术夹子，
其中所述多个手术夹子中的每个设置在所述盖的每个相应的弹性指部的远侧。
2.根据权利要求1所述的夹子仓组件，其中，在所述夹子托盘朝远侧致动时，所述夹子托盘的每个弹性指部的肩部接触相应的手术夹子的后跨部，以同时地向远侧推进全部所述手术夹子。
3.根据权利要求2所述的夹子仓组件，其中，在所述夹子托盘朝远侧致动之后，在所述夹子托盘朝近侧致动时，所述夹子托盘的每个弹性指部的远侧肩部接触所述手术夹子中的相应的剩余的一个，以朝近侧移动全部剩余手术夹子，直到所述剩余手术夹子的后跨部接触所述盖的所述弹性指部的相应的远侧肩部，以阻挡所述剩余手术夹子朝近侧移动。
4.根据权利要求1所述的夹子仓组件，其中，所述夹子仓组件的所述夹子托盘包括穿过其近端限定的至少一个通孔，并且其中所述内窥镜组件的所述夹子推杆包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接。
5.根据权利要求1所述的夹子仓组件，其中，所述夹子仓组件的所述夹子托盘包括穿过其近端限定的至少一个通孔，并且其中所述内窥镜组件的所述夹子推杆包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接；
其中所述内窥镜组件的所述夹子推杆的所述远侧联接件包括限定在其上的至少一个凸台，所述至少一个凸台被构造成可释放地接合所述夹子仓组件的所述夹子托盘的所述至少一个通孔，使得按压所述至少一个凸台使所述内窥镜组件的所述夹子推杆的所述远侧联接件从所述夹子仓组件的所述夹子托盘分离。
6.根据权利要求1所述的夹子仓组件，其中，所述夹子仓组件的所述盖的外表面包括限定在其上的一对相对的脊，所述一对相对的脊被构造成可释放地接合限定在所述内窥镜组件上的对应的一对翼。
7.根据权利要求1所述的夹子仓组件，其中，所述仓夹子组件的所述盖的每个弹性指部在向下方向上偏压所述夹子托盘。
8.一种可再用手术施夹器，包括：
手柄组件；
内窥镜组件，所述内窥镜组件可选择性地连接到所述手柄组件；以及
夹子仓组件，所述夹子仓组件可选择性地装载于并连接到限定在所述内窥镜组件内的窗口，所述夹子仓组件包括：
夹子托盘，所述夹子托盘包括从其基壁突出的多个朝远侧定向的、可偏斜的弹性指部，所述夹子托盘的每个弹性指部终止于远侧肩部，所述夹子托盘的近端被构造成与所述可再用手术施夹器的内窥镜组件的夹子推杆选择性连接；
多个手术夹子，所述多个手术夹子设置在所述夹子托盘的所述基壁上，其中所述多个手术夹子中的每个设置在所述夹子托盘的每个相应的弹性指部的远侧；以及
盖，所述盖包括在通过所述盖的近端和远端所限定的通道内突出的多个朝远侧定向的、可偏斜的弹性指部，所述盖的每个弹性指部终止于远侧肩部，其中所述盖包括在所述通道的侧壁内限定的一对相对的狭槽，所述一对相对的狭槽被构造成在其中可滑动地保持有所述夹子托盘和所述多个手术夹子，
其中所述多个手术夹子中的每个设置在所述盖的每个相应的弹性指部的远侧。
9.根据权利要求8所述的可再用手术施夹器，其中，所述手柄组件包括：
壳体；
扳机，所述扳机枢转地支撑在所述壳体上并从所述壳体延伸；以及
驱动组件，所述驱动组件支撑在所述壳体内并且由所述扳机可操作地致动。
10.根据权利要求9所述的可再用手术施夹器，其中，所述内窥镜组件包括：
旋钮组件，所述旋钮组件被构造成并且适于选择性地连接到所述手柄组件的所述壳体；
外管，所述外管连接到所述旋钮组件并从所述旋钮组件延伸，其中所述内窥镜组件的所述窗口限定在所述外管的远端中；
一对钳夹，所述一对钳夹支撑在所述外管的所述窗口中并从所述外管的所述远端延伸；以及
钳夹闭合杆，所述钳夹闭合杆可滑动地支撑在所述外管内，所述钳夹闭合杆在所述内窥镜组件连接到所述手柄组件时可操作地连接到所述手柄组件的所述扳机，
其中所述夹子推杆可滑动地支撑在所述外管内，所述夹子推杆在所述内窥镜组件连接到所述手柄组件时可操作地连接到所述手柄组件的所述驱动组件。
11.根据权利要求8所述的可再用手术施夹器，其中，在所述夹子托盘朝远侧致动时，所述夹子托盘的每个弹性指部的肩部接触相应的手术夹子的后跨部，以同时地向远侧推进全部所述手术夹子。
12.根据权利要求11所述的可再用手术施夹器，其中，在所述夹子托盘朝远侧致动之后，在所述夹子托盘朝近侧致动时，所述夹子托盘的每个弹性指部的远侧肩部接触所述手术夹子中的相应的剩余的一个的后跨部，以朝近侧移动全部剩余手术夹子，直到所述剩余手术夹子的后跨部接触所述盖的所述弹性指部的相应的远侧肩部，以阻挡所述剩余手术夹子朝近侧移动。
13.根据权利要求8所述的可再用手术施夹器，其中，所述夹子仓组件的所述夹子托盘包括穿过其近端限定的至少一个通孔，并且其中所述内窥镜组件的所述夹子推杆包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接。
14.根据权利要求8所述的可再用手术施夹器，其中，所述夹子仓组件的所述夹子托盘包括穿过其近端限定的至少一个通孔，并且其中所述内窥镜组件的所述夹子推杆包括远侧联接件，所述远侧联接件用于当所述夹子仓组件装载到所述内窥镜组件中时与所述夹子托盘的所述至少一个通孔机械地联接；
其中所述内窥镜组件的所述夹子推杆的所述远侧联接件包括限定在其上的至少一个凸台，所述至少一个凸台被构造成可释放地接合所述夹子仓组件的所述夹子托盘的所述至少一个通孔，使得按压所述至少一个凸台使所述内窥镜组件的所述夹子推杆的所述远侧联接件从所述夹子仓组件的所述夹子托盘分离。
15.根据权利要求8所述的可再用手术施夹器，其中，所述夹子仓组件的所述盖的外表面包括限定在其上的一对相对的脊，所述一对相对的脊被构造成可释放地接合限定在所述内窥镜组件的所述窗口上的相应的一对翼。
16.根据权利要求8所述的可再用手术施夹器，其中，所述仓夹子组件的所述盖的每个弹性指部在向下方向上偏压所述夹子托盘。
17.根据权利要求10所述的可再用手术施夹器，其中，所述一对钳夹可移除地支撑在所述外管的所述窗口中。
18.根据权利要求9所述的可再用手术施夹器，其中，所述手柄组件的所述驱动组件包括：
引导块，所述引导块可操作地连接到所述扳机并且可滑动地支撑在所述手柄组件的所述壳体中；
近侧解锁构件，所述近侧解锁构件枢转地连接到所述引导块的远端，所述近侧解锁构件包括一对间隔开的朝远侧延伸的臂，每个臂包括从其延伸并朝向彼此的凸轮销；以及
远侧解锁构件，所述远侧解锁构件支撑在所述手柄组件的所述壳体中，所述远侧解锁构件可滑动地设置在所述近侧解锁构件的所述一对间隔开的臂之间，所述远侧解锁构件包括一对相对的向外突出的凸轮斜面，所述凸轮斜面与所述近侧解锁构件的所述凸轮销可操作地对齐。
19.根据权利要求18所述的可再用手术施夹器，其中，所述近侧解锁构件和所述远侧解锁构件被偏压到未致动位置。
20.根据权利要求19所述的可再用手术施夹器，其中，所述手柄组件还包括：
夹子推杆，所述夹子推杆可滑动地支撑在其壳体中；以及
偏压构件，所述偏压构件作用在所述手柄组件的所述夹子推杆上，以在远侧方向上推动所述手柄组件的所述夹子推杆。
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