CN107205747B - 可重复使用的内窥镜外科夹具施加器 - Google Patents

可重复使用的内窥镜外科夹具施加器 Download PDF

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CN107205747B
CN107205747B CN201580072284.8A CN201580072284A CN107205747B CN 107205747 B CN107205747 B CN 107205747B CN 201580072284 A CN201580072284 A CN 201580072284A CN 107205747 B CN107205747 B CN 107205747B
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assembly
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CN107205747A (zh
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M·巴特纳加尔
易鹏
陈琳
龚大毛
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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Abstract

提供了一种可重复使用的外科夹具施加器(10)，其包括：手柄组件(100)和内窥镜组件(200)，所述内窥镜组件能够选择性地连接到手柄组件(100)的壳体(102)；和盒组件(300)，所述盒组件选择性装载在内窥镜组件(200)中并且能够连接到内窥镜组件。

Description

可重复使用的内窥镜外科夹具施加器
技术领域
技术领域涉及外科夹具施加器。更具体地，本公开涉及可重复使用的(reposable)内窥镜外科夹具施加器，所述可重复使用的内窥镜外科夹具施加器具有可再用手柄组件、可再用轴组件和一次性夹具盒组件。
背景技术
在本领域中已知内窥镜吻合器和夹具施加器，它们用于多种独特有用的外科手术。在腹腔镜外科手术的情况中，通过窄管或者套管进入到腹部内部，所述窄管或者套管插入通过皮肤中的小进入切口。在身体中的其它地方实施的微创手术通常称作内窥镜手术。通常，管或者套管装置通过进入切口延伸到患者身体中，以便提供进入口。进入口允许外科医生使用套管针将多种不同手术器械插入通过其中并且用于在远离切口位置处实施外科手术。
在大多数这些手术期间，外科医生通常必须终止经由一根或者多根血管的血流或者另一种流体的流动。外科医生通常将外科夹具施加到血管或者另一管道，以便防止在手术期间体液流动通过其中。本领域已知内窥镜夹具施加器，其用于在进入体腔期间施加单个夹具。这种夹具一般由生物相容材料制造而成而且通常压缩在血管上。一旦施加到血管，则压缩夹具终止流体流动通过其中。
在Green等人的共同转让的美国专利No.5,084,057和No.5,100,420中(其全部内容以援引方式并入本申请)描述了内窥镜夹具施加器，所述内窥镜夹具施加器能够在单次进入体腔期间在内窥镜或者腹腔镜手术中施加多个夹具。在Pratt等人的共同转让的美国专利No.5,607,436中描述了另一种多内窥镜夹具施加器，其全部内容在此以援引的方式并入本申请。在单个外科手术期间通常使用这些装置，不过这不是必要的。Pier等人的美国专利No.5,695,502公开了一种可重复消毒的外科夹具施加器，其全部内容在此以援引方式并入本申请。夹具施加器在单次插入体腔期间前进并且形成多个夹具。这些可重复消毒的夹具施加器构造成接收可更换夹具盒并且与可更换夹具盒配合，以便在单次进入体腔期间前进并且形成多个夹具。
在内窥镜或者腹腔镜手术中，理想和/或需要的是根据待结扎的下层组织或者血管使用不同尺寸的外科夹具。为了减小外科夹具施加器的总体成本，理想的是单个外科夹具施加器能够根据需要装载和发射(fire)不同尺寸的外科夹具。
因此，需要一种内窥镜外科夹具施加器，所述内窥镜外科夹具施加器包括可再用手柄组件、可再用轴组件和一次性夹具盒组件，其中，每个夹具盒组件均装载有特定尺寸(例如，相对小、相对中等或者相对大)的夹具。
发明内容
本公开涉及一种可重复使用的内窥镜外科夹具施加器。
根据本公开的一方面，提供了一种可重复使用的外科夹具施加器并且其包括：手柄组件；能够选择性连接到手柄组件的壳体的内窥镜组件；和夹具盒组件，所述夹具盒组件能够选择性装载在内窥镜组件中并且能够连接到内窥镜组件。
可重复使用的外科夹具施加器的手柄组件包括：壳体；触发器，所述触发器枢转支撑在壳体上并且从壳体延伸；和驱动组件，所述驱动组件被支撑在壳体内并且可由触发器操作致动。
可重复使用的外科夹具施加器的内窥镜组件包括：旋钮组件，所述旋钮组件构造成适于选择连接到手柄组件的壳体；外管，所述外管连接到旋钮组件并且从旋钮组件延伸，所述外管在其远端处限定了窗口；一对钳口，所述一对钳口被支撑在外管的窗口中并且从外管的远端延伸；钳口闭合杆，所述钳口闭合杆能够滑动地支撑在外管内，在将内窥镜组件连接到手柄组件时所述钳口闭合杆操作连接到手柄组件的触发器；和夹具推进杆，所述夹具推进杆能够滑动地支撑在外管中，在将内窥镜组件连接到手柄组件时所述夹具推进杆操作连接到手柄组件的驱动组件。
可重复使用的外科夹具施加器的夹具盒组件包括：夹具托盘，所述夹具托盘包括多个向远侧定向的可偏转的弹性指状件，所述指状件从夹具托盘的底壁延伸；盒夹具推进杆，所述盒夹具推进杆布置成毗邻夹具托盘并且能够相对于夹具托盘滑动，所述盒夹具推进杆包括多个向远侧定向的斜坡，每个斜坡均终结于远侧肩部，所述盒夹具推进杆的近端构造成用于与内窥镜组件的夹具推进杆选择性相连；和多个外科夹具，所述多个外科夹具插在夹具托盘和盒夹具推进杆之间，其中，外科夹具布置在夹具托盘的每个指状件的远侧。
在使用中，在向远侧致动盒夹具推进杆时，盒夹具推进杆的每个肩部均可以接触相应外科夹具的后跨部(backspan)，以使得所有外科夹具同时向远侧前进。
在向远侧致动盒夹具推进杆之后，在向近侧致动盒夹具推进杆时，盒夹具推进杆的每个肩部可以接触外科夹具中的相应剩余一个的后跨部，以使得所有剩余外科夹具向近侧移动，直到剩余外科夹具的后跨部接触夹具托盘的相应指状件而阻止剩余外科夹具向近侧移动。
夹具盒组件可以包括盖，所述盖布置在盒夹具推进杆附近，其中，盖包括至少一个偏压构件，所述至少一个偏压构件从盖伸出并且抵靠盒夹具推进杆，以便朝向夹具托盘推压盒夹具推进杆。
夹具盒组件的盒夹具推进杆可以在其近端处包括联接凸台，并且其中，内窥镜组件的夹具推进杆可以包括远侧联接件，用于当夹具盒组件装载在内窥镜组件中时与盒夹具推进杆的联接凸台机械相联。
夹具盒组件的盒夹具推进杆可以包括释放按钮，能够通过形成在夹具盒组件的盖中的窗口接近所述释放按钮。通过致动释放按钮可以致动夹具盒组件的盒夹具推进杆的联接凸台，以使得联接凸台与内窥镜组件的夹具推进杆的远侧联接件分离。
内窥镜组件的夹具推进杆的远侧联接件可以是凹陷部，所述凹陷部构造并且成适当尺寸，以选择性接收夹具盒组件的盒夹具推进杆的联接凸台。
所述一对钳口可以可移除地支撑在外管的窗口中。
内窥镜组件可以包括齿，所述齿伸出到内窥镜组件的外管的窗口中，并且其中，一对钳口可以包括形成在其柄部分中的窗口。当一对钳口安装在外管的窗口中时外管的齿可以布置在一对钳口的柄部分的窗口内。
内窥镜组件可以包括偏压构件，所述偏压构件推压一对钳口与外管的齿接合。
手柄组件的驱动组件可以包括：引导块体，所述引导块体操作连接到触发器并且可滑动地支撑在手柄组件的壳体内；近侧解锁构件，所述近侧解锁构件枢转连接到引导块体的远端，所述近侧解锁构件包括一对间隔开的向远侧延伸的臂，每个臂均包括凸轮销，所述凸轮销朝向彼此从臂延伸；和远侧解锁构件，所述远侧解锁构件被支撑在手柄组件的壳体中，所述远侧解锁构件可滑动地布置在近侧解锁构件的一对间隔开的臂之间，远侧解锁构件包括一对相对的向外伸出的凸轮斜坡，所述凸轮斜坡与近侧解锁构件的凸轮销操作配准。
近侧解锁构件和远侧解锁构件可以被偏压到未致动位置。
手柄组件可以包括：夹具推进杆，所述夹具推进杆可滑动地被支撑在手柄组件的壳体中；和偏压构件，所述偏压构件作用在手柄组件的夹具推进杆上，以沿着远侧方向推压手柄组件的夹具推进杆。
手柄组件的夹具推进杆可以在其中限定槽，其中，驱动组件的远侧解锁构件可以包括从其伸出的锁止突片，并且其中，远侧解锁构件的锁止突片可以在手柄组件的夹具推进杆处于近侧位置中时被推到手柄组件的夹具推进杆的槽中。
在使用中，致动触发器可以沿着近侧方向驱动引导块体和近侧解锁构件，其中，近侧解锁构件的凸轮销可以作用在远侧解锁构件的凸轮斜坡上，以使得远侧解锁构件移动离开手柄组件的夹具推进杆，从而从手柄组件的夹具推进杆的槽内移除远侧解锁构件的锁止突片。
在使用中，在从手柄组件的夹具推进杆的槽内移除远侧解锁构件的锁止突片时，偏压构件可以使得手柄组件的夹具推进杆沿着远侧方向移动。
手柄组件的夹具推进杆可以向远侧移动，直到被固定支撑在手柄组件的夹具推进杆的近端上的凸缘接触引导块体为止。
在使用中，持续致动触发器可以持续使得引导块体沿着近侧方向移动，这可以沿着近侧方向推压手柄组件的夹具推进杆，直到远侧解锁构件的锁止突片与手柄组件的夹具推进杆的槽对准并且可以被推到手柄组件的夹具推进杆的槽中。
手柄组件可以包括钳口推进管，所述钳口推进管被可滑动支撑在手柄组件的壳体中。钳口推进管可以限定通过其中的管腔，其中，夹具推进杆可滑动地布置在钳口推进管的管腔内。
钳口推进管可以操作地连接到触发器，其中，通过致动触发器可以导致钳口推进管向远侧前进。
内窥镜组件可以包括夹具推进杆，所述夹具推进杆具有近端，所述近端构造成在内窥镜组件连接到手柄组件时与手柄组件的夹具推进杆的远端选择性相连。
内窥镜组件的夹具推进杆的远端可以构造成在盒组件装载到内窥镜组件的外管的窗口中时与盒组件的盒夹具推进杆相联。
致动触发器可以释放手柄组件的夹具推进杆，以使得手柄组件的夹具推进杆、内窥镜组件的夹具推进杆和盒组件的盒夹具推进杆向远侧前进。
在使用中，在向远侧致动盒夹具推进杆时，盒夹具推进杆的每个肩部均可以接触相应外科夹具的后跨部，以便使得所有外科夹具同时向远侧前进。
在使用中，在向远侧致动盒夹具推进杆之后，在因驱动组件的引导块体作用在手柄组件的夹具推进杆的凸缘上而向近侧致动盒夹具推进杆时，盒夹具推进杆的每个肩部均可以接触外科夹具中的相应剩余一个的后跨部，以使得所有剩余外科夹具向近侧移动，直到剩余外科夹具的后跨部接触夹具托盘的相应指状件而阻止剩余外科夹具向近侧移动。
附图说明
参照附图在此公开了外科夹具施加器的特定实施例，在所述附图中：
图1是根据本公开的可重复使用的内窥镜外科夹具施加器的透视图；
图2是图1的细节的指示区域的放大视图；
图3是图1的夹具施加器的透视图，其中部件分离；
图4是图1和图3的夹具施加器的手柄组件的透视图，其中部件分离；
图5是图4的手柄组件的侧视图，其中从其移除了壳体的半段；
图6是图5的细节的指示区域的放大视图；
图7是图5至图6的手柄组件的驱动组件的放大透视图；
图8是图7的驱动组件的透视图，其中部件分离；
图9是图1和图3的夹具施加器的轴组件的透视图；
图10是图9的轴组件的透视图，其中部件分离；
图11是图9的轴组件的钳口推进器组件的透视图；
图12是图11的钳口推进器组件的透视图，其中部件分离；
图13是图9的轴组件的夹具推进器组件的透视图；
图14是图13的夹具推进器组件的透视图，其中部件分离；
图15是外科夹具盒组件的透视图；
图16是图15的夹具盒组件的透视图，其中部件分离；
图17是图14至15的夹具盒组件的透视图，其中从其移除了盖；
图18是图14至图15的夹具盒组件的透视图，其中从其移除了盖和夹具推进器；
图19是图14至图15的夹具盒组件的夹具推进器的透视图；
图20是图解了将夹具盒组件装载到轴组件或者与轴组件装载在一起的透视图；
图21是图解了将夹具盒组件装载到轴组件或者与轴组件装载在一起的透视图，其中从轴组件移除了外管；
图22是图解了夹具盒组件的夹具推进器与轴组件的夹具推进器组件的联接的透视图；
图23是图1的外科夹具施加器的通过图1的23-23获得的纵向截面图，其示出了处于未致动状态的夹具施加器；
图24是图23的细节的指示区域的放大视图；
图25是图24的指示区域的放大视图，其示出了轴组件与手柄组件的联接；
图26是图23的细节的指示区域的放大视图，其示出了夹具推进杆的锁定；
图27是图7和图8的驱动组件的通过图26的27-27获得的截面图；
图28是图24中示出的轴组件的细节的指示区域的放大视图；
图29是图28的细节的指示区域的放大视图；
图30是图5中示出的手柄组件的视图，其示出了触发器的初始致动；
图31是图30的指示区域的放大视图，其示出了夹具推进杆的解锁；
图32和33是作用于夹具施加器的一对钳口的夹具推进杆的夹具逻辑特征的透视图；
图34和35是图解了将最远侧的外科夹具装载到夹具施加器的一对钳口中的纵向截面图；
图36和37是作用在夹具施加器的一对钳口上以便闭合钳口并且形成装载在其中的夹具的钳口闭合杆的透视图；并且
图38是形成在血管上的外科夹具的透视图。
具体实施方式
现在将参照附图详细描述根据本公开的可重复使用的内窥镜外科夹具施加器的实施例，其中，相同的附图标记表示类似或者相同的结构元件。如附图所示并且如在以下描述中描述的那样，作为惯例当参照外科器械的相关定位时，术语“近侧”指的是设备的更靠近用户的端部，而术语“远侧”指的是设备的更远离用户的端部。
现在参照图1至图37，根据本公开的实施例的内窥镜外科夹具施加器整体用附图标记10表示。外科夹具施加器10整体包括：手柄组件100；内窥镜组件200，所述内窥镜组件200包括轴组件210，所述轴组件210能够选择性连接到手柄组件100并且从手柄组件100向远侧延伸；和至少一个外科夹具盒组件300，所述至少一个外科夹具盒组件300选择性地装载到内窥镜组件200的轴组件210中。
简言之，内窥镜组件200的轴组件210可以根据预期用途具有各种外径，例如大约5mm或者大约10mm。此外，轴组件210可以根据预期用途(诸如应用在肥胖症手术中)而具有各种相对伸长或者缩短的长度。在一个实施例中，在肥胖症手术中，轴组件210可以具有介于大约30cm和大约40cm之间的长度。然而，本领域技术人员应当理解，轴组件210可以具有超过大约30cm的任何长度，并且本公开并不局限于上述长度中的任意一个。
根据本公开，如将在下文更加详细讨论的那样，每个外科夹具盒组件300均可以装载具有特定尺寸的外科夹具组(例如，相对小外科夹具、相对中等外科夹具、相对大外科夹具)。每个夹具盒组件300均构造成选择性装载到内窥镜组件200的轴组件210中并且由手柄组件100致动，以便将装载在其中的外科夹具发射和形成到下层组织和/或血管上。
现在参照图1至图8，示出了外科夹具施加器10的手柄组件100。手柄组件100包括壳体102，所述壳体102具有第一或者右侧半段102a和第二或者左侧半段102b。手柄组件100包括触发器104，所述触发器104可枢转地支撑在壳体102的右侧半段102a和左侧半段102b之间。触发器104由偏压构件104a(例如弹簧)偏压到未致动状态。
手柄组件100的壳体102可以由适当的塑料或者热塑材料形成。手柄组件100包括可移除盖106等，所述可移除盖106等提供了接近夹具施加器10的驱动组件120的途径。手柄组件100的壳体102还包括如图3至图5所示的突出部102c，所述突出部102c限定了环形凸缘102d。
手柄组件100包括驱动组件120，所述驱动组件120操作连接到触发器104。具体地，驱动组件120包括：近侧连杆(或者一对连杆)122；和远侧连杆124。近侧连杆122包括枢转连接到触发器104的远侧联接部分122a和枢转连接到引导块体126的近侧联接部分122b。远侧连杆124包括：远侧联接部分124a，所述远侧联接部分124a枢转连接到钳口推进管或者筒体156；和近侧联接部分124b，所述近侧联接部分124b枢转连接到触发器104。销126将近侧连杆122和远侧连杆124枢转连接到触发器104。销126还可滑动地布置在相对的弧形通道102c内，所述相对的弧形通道102c形成在相对的手柄半段102a、102b中。以这种方式，在致动触发器104时，销126沿着槽102e(图4)移动，并且致使相对的近侧连杆122的近侧联接部分122b和远侧连杆124的远侧联接部分124a相互分离。
如图4至图8所示，驱动组件120还包括引导块体132，所述引导块体132限定了通过其中的纵向延伸通道132a。近侧连杆122的近侧联接部分122b枢转连接到引导块体132。
驱动组件120还包括近侧解锁构件134，所述近侧解锁构件134枢转连接到引导块体132的远侧部分。近侧解锁构件134包括一对向远侧定向的间隔开的臂134a，每条臂134a均包括凸轮销134b，所述凸轮销134b从臂134a朝向彼此延伸。设置了偏压构件136(例如，片簧)并且偏压构件136包括固定到引导块体132的第一端部和作用在近侧解锁构件134上的自由端部，以便将力施加在近侧解锁构件134上并且将近侧解锁构件134保持在锁止位置，如将在下文更加详细描述的那样。
驱动组件120还包括远侧解锁构件138，所述远侧解锁构件138被诸如支撑块体139等枢转地支撑在手柄组件100的壳体102中。替代地，远侧解锁构件138可以直接枢转连接到手柄组件100的壳体102。远侧解锁构件138包括突出部分138a(图8)，所述突出部分138a构造并且成适当尺寸，以布置在近侧解锁构件134的间隔开的臂134a之间。远侧解锁构件138包括一对凸轮斜坡138b，所述一对凸轮斜坡138b从远侧解锁构件138的突出部分138a的相对两侧延伸。远侧锁止构件138的凸轮斜坡138b与近侧解锁构件134的凸轮销134b操作关联，如将在下文更加详细描述的那样。远侧解锁构件138还包括锁止突片138c，所述解锁突片138c从远侧解锁构件138伸出并且朝向夹具推进杆150(见图6、26和31)延伸，以选择性地与夹具推进杆150接合，如将在下文更加详细描述的那样。提供了偏压构件140(例如，盘簧等)并且偏压构件140包括：第一端部，所述第一端部固定到支撑块体139；和自由端部，所述自由端部作用在远侧解锁构件138上，以便将力施加在远侧解锁构件138上并且保持远侧解锁构件138处于锁止位置，如将在下文更加详细描述的那样。
继续参照图4至图8，驱动组件120包括夹具推进杆150，所述夹具推进杆150被可滑动地支撑在手柄组件100的壳体102内并且穿过所述壳体102。夹具推进杆150包括：凸缘152a，所述凸缘152a被支撑在其近端150a处；和联接末端152b，所述联接末端152b形成在其远端150b处。夹具推进杆150成适当的尺寸，以使得其联接末端152b从手柄组件100的壳体102的突出部102c突出。夹具推进杆150限定了位于其中的窗口或者槽150c，以选择性地接收远侧解锁构件138的锁止突片138c(图6和图26)，如将在下文更加详细描述的那样。偏压构件154(例如，压缩弹簧)插在手柄组件100的壳体102和夹具推进杆150的凸缘152a之间。偏压构件154作用在夹具推进杆150上，以便沿着远侧方向偏压或者推压夹具推进杆150。
当夹具推进杆150处于近侧位置时，远侧解锁构件138的锁止突片138c布置在夹具推进杆150的窗口或者槽150c中，并且偏压构件154被压缩在手柄组件100的壳体102和夹具推进杆150的凸缘152a之间。
驱动组件120还包括钳口推进管156，所述钳口推进管156被可滑动地支撑在手柄组件100的壳体102内。钳口推进管156限定了通过其中的管腔，用于将夹具推进杆150接收在其中并且使其在管腔中可滑动地通过。钳口推进管156包括：近端156a，所述近端156a枢转连接到远侧连杆124的远侧联接部分124a；和联接末端156c，所述联接末端156c形成在钳口推进管156的远端156b处。钳口推进管156成适当的尺寸，以使得其联接末端156c从手柄组件100的壳体102的突出部102c伸出。
现在，参照图1至图3和9至10，示出外科夹具施加器10的内窥镜组件200。内窥镜组件200包括旋钮组件202，所述旋钮组件202构造成选择性地连接到手柄组件100的壳体102的突出部102c的环形凸缘102d。旋钮组件202包括外旋钮套圈202a、构造成接收在外旋钮套圈202a中的内旋钮套圈202b和构造成接收在内旋钮套圈202b中的锁止套圈202c。
在使用中，当外旋钮套圈202a处于相对于内旋钮套圈202b的第一位置时，旋钮组件202可以联接到手柄组件100的壳体102的突出部102c上或者可以接收所述突出部102c。当外旋钮套圈202a处于相对于内旋钮套圈202b的第二位置，壳体102的突出部102c布置在旋钮组件202的锁止套圈202c内时，外旋钮套圈202a作用在锁止套圈202c的突片202d上，以将突片202d推到壳体102的突出部102c的环形凸缘102d中，以便将内窥镜组件200锁止到手柄组件100上。
旋钮组件202可以旋转地安装在壳体102的突出部102c上，以便将围绕其纵向轴线的360°旋转传递和/或提供到轴组件210和一对钳口214。
如图1至图3和9至14所示，内窥镜组件200包括轴组件210，所述轴组件210从旋钮组件202延伸。轴组件210包括外管212，所述外管212具有：近端部分212a，所述近端部分212a固定到旋钮组件202的内旋钮套圈202b；和远端部分212b，所述远端部分212b从旋钮组件202的内旋钮套圈202b延伸。外管212的远端部分212b限定了形成在其侧部中的通道或者窗口212c。
轴组件210包括一对钳口214，所述一对钳口214安装在外管212的通道212c中并且能够通过致动手柄组件100的触发器104而致动。一对钳口214由适当的生物相容材料(例如不锈钢或者钛)形成。一对钳口214可移除地安装在外管212的通道212c中。参照图10、20和29，一对钳口214可以布置在安装齿215a上，所述安装齿215a从管填充件215伸出，所述管填充件215被固定安装或者支撑在内窥镜组件200的外管212的通道或者窗口212c中。特别地，一对钳口214可以限定有形成在其柄部分214b中的窗口214c，其中，当一对钳口214安装在外管212的通道212c中时，一对钳口214的窗口214c将安装齿215a接收在其中。提供了偏压构件215b，以保持一对钳口214与安装齿215a接合。
即刻参照图32、33、36和37，一对钳口214限定了位于其间的通道214a，以将外科夹具“C”接收在其中。一对钳口214包括一对从其伸出的凸轮楔形表面214b。如将在下文详细描述的那样，由钳口闭合杆216作用在一对凸轮楔形表面214b上，以便将一对钳口214致动到闭合位置。
参照图3和图9至13，轴组件210包括钳口闭合杆216，所述钳口闭合杆216能够滑动地支撑在外管212内。钳口闭合杆216包括：近端部分216a，所述近端部分216a固定支撑联接衬套217；和远端部分216b，所述远端部分216b构造成接合以及作用在一对钳口214上。具体地，钳口闭合杆216的远端部分216b限定了向远侧的端部开口的通道216c，其构造并且成适当尺寸，以便在钳口闭合杆216相对于一对钳口214沿着远侧方向移动时接合一对钳口214的一对凸轮楔形表面214b的外表面以使得一对钳口214靠近。
钳口闭合杆216的联接衬套217构造成选择性连接到手柄组件100的驱动组件120的钳口推进管156的联接末端156c。在使用中，在钳口闭合杆216的联接衬套217连接到钳口推进管156的联接末端156c的情况中，钳口推进管156的轴向平移导致钳口推进管156轴向平移。考虑的是，钳口闭合杆216的联接衬套217和钳口推进管156的联接末端156c可以具有燕尾型的构造等。
继续参照图3和9至13，轴组件210包括夹具推进杆218，所述夹具推进杆218被可滑动地支撑在外管212内，位于钳口闭合杆216附近。夹具推进杆218包括：近端部分218a，所述近端部分218a限定了近侧联接件218c；和远端部分218b，所述远端部分218b限定了远侧联接件218d，所述远侧联接件218d构造成接合并且作用在夹具盒组件300的盒夹具推进杆304上，如将在下文更加详细描述的那样。夹具推进杆218的近侧联接件218c构造成选择性连接到手柄组件100的驱动组件120的夹具推进杆150的联接末端152b。在使用中，在夹具推进杆218的近侧联接件218c连接到夹具推进杆150的联接末端152b的情况中，手柄组件100的夹具推进杆150的轴向平移导致内窥镜组件200的夹具推进杆218轴向平移。考虑的是，夹具推进杆218的近侧联接件218c和夹具推进杆150的联接末端152b可以具有燕尾型构造等。
轴组件210还包括夹具逻辑推进器或楔形板220，所述夹具逻辑推进器或楔形板220被可滑动地支撑在外管212内并且插在钳口闭合杆216和夹具推进杆218之间。楔形板220包括：近端部分220a，所述近端部分220a可滑动地连接到夹具推进杆218；和远端部分220b，所述远端部分220b构造成接合并且作用在一对钳口214上，如将在下文更加详细描述的那样。可以提供偏压构件，以便将楔形板220推动到远侧位置而使得一对钳口214展开。
现在参照图1至图3和15至22，示出了外科夹具施加器10的夹具盒组件300。如上所述，夹具盒组件300构造并且成适当的尺寸，以有效装载到形成在内窥镜组件200的外管212的远端部分212b中的通道212c中，并且构造而且成适当的尺寸，以便选择性连接或者联接到夹具推进杆218的远侧联接件218d，如将在下文更加详细描述的那样。
夹具盒组件300包括夹具托盘302，所述夹具托盘302包括：底壁302a；和被支撑在底壁302b上的一对间隔开的侧壁或者轨道302b，其中底壁302a和侧壁302b限定了夹具通道302c。夹具托盘302在侧壁302b之间的位置处包括向远侧延伸的弹性可偏转指状件302d的直线阵列，所述直线阵列从底壁302a向上伸出到夹具通道302c中，位于侧壁302b之间的位置。
夹具盒组件300包括盒夹具推进杆304，所述盒夹具推进杆304可滑动地布置成毗邻夹具托盘302。盒夹具推进杆304包括：近端304a，所述近端304a限定了联接杆、头部或者凸台304c，所述联接杆、头部或者凸台304c构造成与内窥镜组件200的夹具推进杆218的远侧联接件218d选择性相连；远端部分304b，所述远端部分304b限定了推进器304d，所述推进器304d构造成接合一堆夹具“C”的最远侧夹具“C1”，以将最远侧夹具“C1”装载到内窥镜组件200的一对钳口214中。
盒夹具推进杆304包括远侧定向的斜坡304e的直线阵列，每条斜坡304e均限定了远侧肩部304f。在一实施例中，斜坡304e的阵列包括一对侧向间隔开的斜坡阵列，所述一对侧向间隔开的斜坡阵列限定了在其间纵向的通道。在使用中，当盒夹具推进杆304重叠或者毗邻夹具托盘302时，夹具托盘302的可偏转指状件302d布置在一对侧向间隔开的斜坡304e阵列之间。
夹具盒组件300包括插在夹具托盘302和盒夹具推进杆304之间的一堆外科夹具“C”。这堆外科夹具“C”被支撑在夹具托盘302上或者装载在所述夹具托盘302中，以使得每个外科夹具“C”的顶端布置在夹具托盘302的相应可偏转指状件302d的远侧。此外，当盒夹具推进杆304处于相对于夹具托盘302的近侧位置时，盒夹具推进杆304的一对侧向间隔开的斜坡304e阵列布置在这堆外科夹具的相应外科夹具“C”的冠部或者腿部的近侧。
只要夹具盒组件300和内窥镜组件200适当构造并且成适当尺寸，夹具盒组件300可以装载有10个外科夹具“C”或者在实施例中夹具盒组件300可以装载有任何数量的外科夹具“C”。外科夹具“C”可以由本领域技术人员已知的材料制成，所述材料包括但不局限于不锈钢、钛或者其它金属合金。在一实施例中，考虑的是这堆外科夹具“C”的至少最后外科夹具可以染成特定颜色，以在夹具盒组件300的最后外科夹具被装载到一对钳口214中时指示用户。
夹具盒组件300包括盖306，所述盖306构造成连接到夹具托盘302并且被支撑在夹具托盘302上。盖306包括一系列弹性的可偏转指状件306a，所述一系列弹性的可偏转指状件306a从盖306伸出并且向盒推进杆304伸出。盖306的指状件306a用于将盒夹具推进杆304偏压向夹具托盘302并且保持这堆外科夹具“C”与夹具托盘302的底壁302b滑动接触。
盖306限定了形成在其近侧区域中的窗口306b，以接近盒夹具推进杆304的释放按钮304g。在使用中，在盒夹具推进杆304的联接凸台304c联接到内窥镜组件200的夹具推进杆218的远侧联接件218d的情况下，用户可以按压释放按钮304g，以便使得联接凸台304c与夹具推进杆218的互补远侧联接件218d脱离(例如，从远侧联接件218d内按压联接凸台304c)，并且因此使得夹具盒组件300与内窥镜组件200分离。
参照图20至22，将夹具盒组件300装载到内窥镜组件200。为了将夹具盒组件300装载到内窥镜组件200的外管212的通道或者窗口212c，用户按压盒夹具推进杆304的释放按钮304g(沿着图20中的箭头“A”的方向)。在按压盒夹具推进杆304的释放按钮304g的情况中，盒夹具推进杆304的联接凸台304c插入到内窥镜组件200的外管212中，直到盒夹具推进杆304的联接凸台304c与内窥镜组件200的夹具推进杆218的远侧联接件218d配准。在盒夹具推进杆304的联接凸台304c与内窥镜组件200的夹具推进杆218的远侧联接件218d配准的情况中，可以释放盒夹具推进杆304的释放按钮304g，以使得盒夹具推进杆304的联接凸台304c进入内窥镜组件200的夹具推进杆218的互补远侧联接件218d中并且与所述互补远侧联接件218d配合。这样，夹具盒组件300被装载到内窥镜组件200的外管212的通道或者窗口212c中，并且夹具盒组件300的盒夹具推进杆304联接到内窥镜组件200的夹具推进杆218。
如图2和图10所示，内窥镜组件200的外管212的通道或者窗口212c可以设置有唇沿或者翼状件212d，所述唇沿或者翼状件212d沿着其侧边缘延伸并且朝向彼此延伸，以便卡合在或者以其它方式接合在夹具盒组件300的横向侧部上，而且进一步辅助保持装载在内窥镜组件200中的夹具盒组件300。
继续参照图1至图22，并且另外特别地参照图23至38，示出并且描述了夹具施加器10的示例性操作模式。如图23至29所示，示出夹具施加器10，其中内窥镜组件200连接到手柄组件100(如上所述)，并且夹具盒组件300装载在内窥镜组件200中(如上所述)。
具体地，在手柄组件的触发器104处于未致动状态的条件下，手柄组件100的夹具推进杆150、内窥镜组件200的夹具推进杆218和夹具盒组件300的盒夹具推进杆304处于未致动或者最近侧位置。在这样定位时，驱动组件120的远侧解锁构件138的锁止突片138c布置在夹具推进杆150的窗口内或者槽150c内，从而将夹具推进杆150保持在未致动或者最近侧位置，并且将偏压构件154保持压缩在手柄组件100的壳体102和夹具推进杆150的凸缘152a之间。
另外，在手柄组件的触发器104处于未致动状态的情况中，夹具盒组件300的盒夹具推进杆304的向远侧定向的斜坡304e的远侧肩部304f布置在这堆外科夹具“C”的相应外科夹具的近侧。
此外，在手柄组件的触发器104处于未致动状态的情况中，内窥镜组件200的楔形板220保持在未致动或者最近侧位置。
继续参照图1至图28并且特别地参照图30至38，示出并且在下文描述了外科夹具施加器10的发射冲程。在夹具盒组件300装载在内窥镜组件200中的情况下，在将手柄组件100的触发器104致动至完全被致动位置时，这堆外科夹具“C”的最远侧夹具“C1”被装载到内窥镜组件200的一对钳口214中并且由一对钳口214形成。
更加具体地，在致动触发器104时，沿着图30的箭头“B”的方向，触发器104作用在近侧连杆122上，以便使得近侧连杆122的近侧联接部分122b沿着近侧方向移动(由图30中的箭头“C”表示)并且作用在远侧连杆124上，以便使得远侧连杆124的远侧联接部分124a沿着远侧方向移动(由图30中的箭头“D”表示)。
在近侧连杆122的近侧联接部分122b沿着近侧方向移动时，近侧连杆122作用在驱动组件120的引导块体132上，以便使得引导块体132(并且继而近侧解锁构件134)沿着近侧方向移动。在近侧解锁构件134沿着近侧方向移动时，近侧解锁构件134的凸轮销134b移动成与远侧解锁构件138的凸轮斜坡138b接合，以便沿着图30和31中的箭头“E”的方向推动远侧解锁构件138离开手柄组件100的夹具推进杆150。在推动远侧解锁构件138离开夹具推进杆150时，一旦远侧解锁构件138的锁止突片138c清空夹具推进杆150的窗口或者槽150c，就允许偏压构件154扩张并且向远侧驱动夹具推进杆150直到夹具推进杆150的凸缘152a抵接引导块体132。一旦近侧解锁构件134的凸轮销134b向远侧移动越过远侧解锁构件138的凸轮斜坡138b，偏压构件140就将远侧解锁构件138朝向夹具推进杆150推回，以使得远侧解锁构件138的锁止突片138a接触夹具推进杆150的表面，而与此同时仍然允许夹具推进杆150沿着远侧方向移动。
在手柄组件100的夹具推进杆150沿着远侧方向移动时，夹具推进杆150使得内窥镜组件200的夹具推进器组件218沿着远侧方向移动，这继而作用在夹具盒组件300的盒夹具推进杆304上，以便使得盒夹具推进杆304沿着远侧方向移动，从而将外科夹具“C”装载到一对钳口214中。
另外，如图32和33所示，在内窥镜组件200的夹具推进器组件218(图13和29)沿着远侧方向移动时，夹具推进器组件218作用在楔形板220上，以便使得楔形板220向远侧移动，直到楔形板220的远端部分220b接触一对钳口214的凸轮楔形表面214b，以便将一对钳口214保持在间隔开的状态或者将一对钳口214推动至间隔开状态。具体地，楔形板220的远端部分220b限定了一对V状凹口220c、一对钳口214的每个凸轮楔形表面214b对应一个V状凹口220c，以便在楔形板220向远侧前进时引导一对钳口214。
在楔形板220推动一对钳口214分开的情况中，在夹具推进杆150沿着远侧方向移动时，夹具推进杆150使得内窥镜组件200的夹具推进器组件218沿着远侧方向移动，这继而如图34和35所示使得夹具盒组件300的盒夹具推进杆304沿着远侧方向移动，以将这堆夹具“C”中的最远侧夹具“C1”沿远侧方向装载到一对钳口214中。具体地，盒夹具推进杆304的推进器304d接合最远侧夹具“C1”的后跨部并且将最远侧夹具“C1”推出夹具盒组件300而且推入到一对钳口214的通道214a中。另外并且与最远侧夹具“C1”的远侧移动同时，在夹具盒组件300的盒夹具推进杆304沿着远侧方向移动时，盒夹具推进杆304的斜坡304e的远侧肩部304f抵接剩余外科夹具“C”的相应外科夹具的相应后跨部，以便沿着远侧方向推动剩余外科夹具“C”。盒夹具推进杆304使得剩余外科夹具“C”向远侧前进直到每个剩余外科夹具“C”均向远侧前进经过夹具盒组件300的下一个毗邻的弹性的可偏转指状件302d。
在夹具推进杆150的凸缘152a抵接引导块体132之后，在进一步致动触发器104时，近侧连杆122继续使得引导块体132沿着近侧方向移动并且引导块体132作用在夹具推进杆150的凸缘152a上，以便沿着近侧方向推动夹具推进杆150。在夹具推进杆150沿着近侧方向移动时，夹具推进杆150沿着近侧方向拉动或移动内窥镜组件200的夹具推进器组件218，这继而沿着近侧方向拉动或移动夹具盒组件300的盒夹具推进杆304。在沿着近侧方向使得盒夹具推进杆304移动时，盒夹具推进杆304的斜坡304e抵接剩余外科夹具“C”的后跨部的远侧表面，从而也沿着近侧方向推动剩余外科夹具“C”。盒夹具推进杆304向近侧缩回剩余外科夹具“C”，直到每个剩余外科夹具“C”均缩回成与夹具盒组件300的相应弹性可偏转凸缘302d的相应远侧末端接触，这阻止或者停止剩余外科夹具“C”向近侧进一步缩回。
在引导块体132继续沿着近侧方向推动手柄组件100的夹具推进杆150时，当夹具推进杆150的窗口或者槽150c与远侧解锁构件138的锁止突片138c配准时，偏压构件140推动远侧解锁构件138的锁止突片138c返回到夹具推进杆150的窗口或者槽150c中。
如上所述，在沿着图30的箭头“B”的方向致动触发器104时，触发器104还作用在远侧连杆124上，以便使得远侧连杆124的远侧联接部分124a沿着远侧方向移动(图30中的箭头“D”表示)。在远侧连杆124的远侧联接部分124a沿着远侧方向移动时，远侧联接部分124a沿着远侧方向推动钳口推进管156。在钳口推进管156连接到内窥镜组件200的钳口闭合杆216(如上所述)的情况中，在钳口推进管156沿着远侧方向移动时，钳口闭合杆216也沿着远侧方向移动。参照图36和37，在钳口闭合杆216沿着远侧方向移动时，钳口闭合杆216的通道216c(见图11和12)接收或者以其它方式接合一对钳口214的一对凸轮楔形表面214b，以便使得一对钳口移动到闭合或者接近位置。
在最远侧外科夹具“C1”装载在一对钳口214中的情况中，在钳口闭合杆216将一对钳口移动到闭合或者靠近位置时，在血管“V”等上在一对钳口之间形成了最外侧外科夹具“C1”，如图38所示。
致动夹具施加器10的时机使得在钳口闭合杆216接合一对钳口214的一对凸轮楔形表面214b之前从内窥镜组件200的一对钳口214之间收回夹具盒组件300的盒夹具推进杆304的推进器304d。
在形成外科夹具“C”的情况下，触发器104可以释放并且通过触发器回位弹簧104a或者借助于所述触发器回位弹簧104a的辅助返回到未致动位置(见图4和图5)。在触发器104返回到未致动位置时，触发器104作用在近侧连杆122上以便使得引导块体132沿着远侧方向移动，并且作用在远侧连杆124上以便使得钳口推进管156沿着近侧方向移动，从而针对另一个发射重新设置夹具施加器10。
可以考虑的是，手柄组件100可以包括如图4、5和30所示的计数机构110，所述计数机构110构造并且适于随着每次发射外科夹具施加器10减少其上的标示。以这种方式，用户可以保持追踪剩余在夹具盒组件300中的外科夹具的数量。
在使用中，如上所述，外科夹具施加器10能够将不同外科夹具盒组件300装载在内窥镜组件200中。具体地，内窥镜组件200可以装载有外科夹具盒组件300，所述外科夹具盒组件300装载有具有第一尺寸的一堆外科夹具“C”，或者内窥镜组件200可以装载有外科夹具盒组件300，所述外科夹具盒组件300装载有具有与第一尺寸不同的第二尺寸的一堆外科夹具“C”。
以这种方式，用户或者外科医生可以装载外科夹具盒组件300，所述外科夹具盒组件300根据待实施的特定外科手术而装载有特定尺寸的外科夹具。另外，在外科手术期间，如果需要使用不同尺寸的外科夹具，用户或者外科医生可以排出或者卸载装载在内窥镜组件200中的外科夹具盒组件300，然后将新的外科夹具盒组件300(在其中装载有尺寸与卸载外科夹具盒组件300不同的一堆外科夹具)装载到内窥镜组件200中。
根据本公开，可以考虑的是，外科夹具施加器10包括：可再用和可消毒的手柄组件100，所述可再用和可消毒的手柄组件100可以用于多个外科手术；可再用和可消毒的内窥镜组件200，其也可以用于多个外科手术；和可重复使用的的一次性夹具盒组件300(例如，其中，在从内窥镜组件200卸载时抛弃夹具盒组件300)。可以考虑的是，内窥镜组件200可以在特定外科手术之后抛弃而不能重复使用或者消毒。
而且，根据本公开，还能够考虑的是可以提供外科套件，其包括单个手柄组件100、单个内窥镜组件200和多个夹具盒组件300，所述多个夹具盒组件300包括：至少第一组夹具盒组件，所述至少第一组夹具盒组件装载有具有第一尺寸的一堆外科夹具；和第二组夹具盒组件，所述第二组夹具盒组件装载有具有第二尺寸的一堆外科夹具，所述第二尺寸与第一尺寸不同。套件可包括用于外科夹具施加器10的组装、外科夹具施加器10的使用以及外科夹具施加器组件10在使用之后的处理的指南。
应当理解的是，前述描述仅仅为本公开的阐释。在不背离本公开的前提下本领域技术人员能够设想各种替代方案和修改方案，因此，本公开旨在包含所有这些替代方案、修改方案和变型方案。参照附图描述的实施例仅仅为论证本公开的特定实施例。与上文描述无实质不同和/或在附属权利要求中的其它元件、步骤、方法和技术也旨在处于本公开的范围内。

Claims (25)

1.一种可重复使用的外科夹具施加器，其包括：
手柄组件，所述手柄组件包括：
壳体；
触发器，所述触发器枢转支撑在所述壳体上并且从所述壳体延伸；和
驱动组件，所述驱动组件被支撑在所述壳体内并且能够由所述触发器操作致动；
能够选择性连接到所述手柄组件的所述壳体的内窥镜组件，所述内窥镜组件包括：
旋钮组件，所述旋钮组件构造成适于选择性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且从所述旋钮组件延伸，所述外管在其远端处限定了窗口；
一对钳口，所述一对钳口被支撑在所述外管的所述窗口中，并且从所述外管的所述远端延伸；
钳口闭合杆，所述钳口闭合杆被能够滑动地支撑在所述外管内，在所述内窥镜组件连接到所述手柄组件时所述钳口闭合杆能够操作地连接到所述手柄组件的所述触发器；和
夹具推进杆，所述夹具推进杆被能够滑动地支撑在所述外管内，在将所述内窥镜组件连接到所述手柄组件时所述夹具推进杆能够操作地连接到所述手柄组件的所述驱动组件；和
夹具盒组件，所述夹具盒组件能够选择性装载在所述内窥镜组件的所述窗口中并且能够连接到所述窗口，所述夹具盒组件包括：
夹具托盘，所述夹具托盘包括多个向远侧定向的可偏转弹性指状件，所述指状件从所述夹具托盘的底壁延伸；
盒夹具推进杆，所述盒夹具推进杆布置在所述夹具托盘附近并且能够相对于所述夹具托盘滑动，所述盒夹具推进杆包括多个向远侧定向的斜坡，每个斜坡均终结于远侧肩部，所述盒夹具推进杆的近端构造成用于与所述内窥镜组件的所述夹具推进杆选择性相连；和
多个外科夹具，所述外科夹具插在所述夹具托盘和所述盒夹具推进杆之间，其中，外科夹具布置在所述夹具托盘的每个指状件的远侧，
其中，所述手柄组件的所述驱动组件包括：
引导块体，所述引导块体操作连接到所述触发器并且被能够滑动地支撑在所述手柄组件的所述壳体内；
近侧解锁构件，所述近侧解锁构件枢转连接到所述引导块体的远端，所述近侧解锁构件包括向远侧延伸的一对间隔开的臂，每个臂均包括凸轮销，所述凸轮销朝向彼此从所述臂延伸；和
远侧解锁构件，所述远侧解锁构件被支撑在所述手柄组件的所述壳体中，所述远侧解锁构件能够滑动地布置在所述近侧解锁构件的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伸出的凸轮斜坡，所述凸轮斜坡与所述近侧解锁构件的所述凸轮销操作配准。
2.根据权利要求1所述的可重复使用的外科夹具施加器，其中，在向远侧致动所述盒夹具推进杆时，所述盒夹具推进杆的每个肩部均接触相应外科夹具的后跨部，以使得所有所述外科夹具同时向远侧前进。
3.根据权利要求2所述的可重复使用的外科夹具施加器，其中，在向远侧致动所述盒夹具推进杆之后，在向近侧致动所述盒夹具推进杆时，所述盒夹具推进杆的每个肩部均接触所述外科夹具中的相应的剩余一个外科夹具的后跨部，以便使得所有剩余外科夹具向近侧移动，直到剩余外科夹具的后跨部接触夹具托盘的相应指状件而阻止剩余外科夹具向近侧移动。
4.根据权利要求1所述的可重复使用的外科夹具施加器，其中，所述夹具盒组件包括盖，所述盖布置在所述盒夹具推进杆附近，其中，所述盖包括至少一个偏压构件，所述至少一个偏压构件从所述盖伸出并且抵靠所述盒夹具推进杆，以便朝向所述夹具托盘推压所述盒夹具推进杆。
5.根据权利要求1所述的可重复使用的外科夹具施加器，其中，所述夹具盒组件的所述盒夹具推进杆在其近端处包括联接凸台，并且其中，所述内窥镜组件的所述夹具推进杆包括远侧联接件，用于当所述夹具盒组件装载在所述内窥镜组件中时与所述盒夹具推进杆的联接凸台机械联接。
6.根据权利要求4所述的可重复使用的外科夹具施加器，其中，所述夹具盒组件的所述盒夹具推进杆包括释放按钮，能够通过形成在所述夹具盒组件的所述盖中的窗口接近所述释放按钮，其中，所述释放按钮的致动致动所述夹具盒组件的所述盒夹具推进杆的联接凸台，以便使得所述联接凸台与所述内窥镜组件的所述夹具推进杆的远侧联接件分离。
7.根据权利要求1所述的可重复使用的外科夹具施加器，其中，所述夹具盒组件的所述盒夹具推进杆在其近端处包括联接凸台，并且其中，所述内窥镜组件的所述夹具推进杆包括远侧联接件，用于当所述夹具盒组件装载到所述内窥镜组件中时与所述盒夹具推进杆的联接凸台机械联接；
其中，所述夹具盒组件包括盖，所述盖布置成毗邻所述盒夹具推进杆，所述盖在其中限定窗口；并且
其中，所述夹具盒组件的所述盒夹具推进杆包括释放按钮，能够通过所述盖的所述窗口接近所述释放按钮，其中，所述释放按钮的致动致动所述联接凸台，以便使得所述联接凸台与所述内窥镜组件的所述夹具推进杆的所述远侧联接件脱离。
8.根据权利要求7所述的可重复使用的外科夹具施加器，其中，所述内窥镜组件的所述夹具推进杆的所述远侧联接件是凹陷部，所述凹陷部构造和定尺寸为选择性接收所述夹具盒组件的所述盒夹具推进杆的所述联接凸台。
9.根据权利要求1所述的可重复使用的外科夹具施加器，其中，所述一对钳口被能够移除地支撑在所述外管的所述窗口中。
10.根据权利要求9所述的可重复使用的外科夹具施加器，其中，所述内窥镜组件包括齿，所述齿伸出到所述内窥镜组件的外管的所述窗口中，并且其中，所述一对钳口包括形成在其柄部分中的窗口，其中，当所述一对钳口安装在所述外管的所述窗口中时所述外管的所述齿布置在所述一对钳口的所述柄部分的所述窗口内。
11.根据权利要求10所述的可重复使用的外科夹具施加器，其中，所述内窥镜组件包括偏压构件，所述偏压构件推压所述一对钳口而使其与所述外管的所述齿接合。
12.根据权利要求1所述的可重复使用的外科夹具施加器，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。
13.根据权利要求12所述的可重复使用的外科夹具施加器，其中，所述手柄组件包括：
夹具推进杆，所述手柄组件的所述夹具推进杆被能够滑动地支撑在所述手柄组件的壳体中；和
偏压构件，所述偏压构件作用在所述手柄组件的所述夹具推进杆上而沿着远侧方向推压所述手柄组件的所述夹具推进杆。
14.根据权利要求13所述的可重复使用的外科夹具施加器，其中，所述手柄组件的所述夹具推进杆在其中限定槽，其中，所述驱动组件的所述远侧解锁构件包括从其伸出的锁止突片，并且其中，在所述手柄组件的所述夹具推进杆处于近侧位置中时所述远侧解锁构件的所述锁止突片被推到所述手柄组件的所述夹具推进杆的所述槽中。
15.根据权利要求14所述的可重复使用的外科夹具施加器，其中，所述触发器的致动沿着近侧方向驱动所述引导块体和所述近侧解锁构件，其中所述近侧解锁构件的所述凸轮销作用在所述远侧解锁构件的所述凸轮斜坡上，而使得所述远侧解锁构件移动离开所述手柄组件的所述夹具推进杆，从而从所述手柄组件的所述夹具推进杆的所述槽内移除所述远侧解锁构件的所述锁止突片。
16.根据权利要求15所述的可重复使用的外科夹具施加器，其中，在从所述手柄组件的所述夹具推进杆的所述槽内移除所述远侧解锁构件的所述锁止突片时，所述偏压构件使得所述手柄组件的所述夹具推进杆沿着远侧方向移动。
17.根据权利要求16所述的可重复使用的外科夹具施加器，其中，所述手柄组件的所述夹具推进杆向远侧移动，直到被固定支撑在所述手柄组件的所述夹具推进杆的近端上的凸缘接触所述引导块体为止。
18.根据权利要求16所述的可重复使用的外科夹具施加器，其中，所述触发器的持续致动使得所述引导块体持续沿着近侧方向移动，这沿着近侧方向推压所述手柄组件的所述夹具推进杆，直到所述远侧解锁构件的所述锁止突片与所述手柄组件的所述夹具推进杆的所述槽对准并且被推到所述手柄组件的所述夹具推进杆的所述槽中。
19.根据权利要求13所述的可重复使用的外科夹具施加器，其中，所述手柄组件包括钳口推进管，所述钳口推进管被能够滑动地支撑在所述手柄组件的所述壳体中，所述钳口推进管限定有通过其中的管腔，其中，所述手柄组件的所述夹具推进杆能够滑动地布置在所述钳口推进管的所述管腔内。
20.根据权利要求19所述的可重复使用的外科夹具施加器，其中，所述钳口推进管操作地连接到所述触发器，其中，所述触发器的致动导致所述钳口推进管向远侧前进。
21.根据权利要求16所述的可重复使用的外科夹具施加器，其中，所述内窥镜组件包括夹具推进杆，所述内窥镜组件的所述夹具推进杆的近端构造成在所述内窥镜组件连接到所述手柄组件时与所述手柄组件的所述夹具推进杆的远端选择性相连。
22.根据权利要求21所述的可重复使用的外科夹具施加器，其中，所述内窥镜组件的所述夹具推进杆的远端构造成在所述盒组件装载到所述内窥镜组件的所述外管的所述窗口中时与所述盒组件的所述盒夹具推进杆联接。
23.根据权利要求22所述的可重复使用的外科夹具施加器，其中，所述触发器的致动释放所述手柄组件的所述夹具推进杆，以使得所述手柄组件的所述夹具推进杆、所述内窥镜组件的所述夹具推进杆和所述盒组件的所述盒夹具推进杆向远侧前进。
24.根据权利要求23所述的可重复使用的外科夹具施加器，其中，在向远侧致动所述盒夹具推进杆时，所述盒夹具推进杆的每个肩部均接触相应外科夹具的后跨部，以使得所有外科夹具同时向远侧前进。
25.根据权利要求24所述的可重复使用的外科夹具施加器，其中，在向远侧致动所述盒夹具推进杆之后，在因所述驱动组件的所述引导块体作用在所述手柄组件的所述夹具推进杆的凸缘上而向近侧致动所述盒夹具推进杆时，所述盒夹具推进杆的每个肩部均接触所述外科夹具中的相应剩余一个外科夹具的后跨部，以使得所有剩余外科夹具向近侧移动，直到剩余外科夹具的后跨部接触夹具托盘的相应指状件而阻止剩余外科夹具向近侧移动。
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WO2016112509A1 (en) 2016-07-21
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US11058432B2 (en) 2021-07-13
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