CN107249479A - 包括具有整体构造的击发指示器的外科吻合装置 - Google Patents
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- 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
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Abstract
一种指示器(26)，其包括指示器主体部分(50)、枢转支撑构件(52)、弹性杆(54)以及锚定件(66)。所述枢转支撑构件(52)具有紧固到所述指示器主体部分(50)的第一端部(52a)和紧固到所述弹性杆(54)的第一端部(54a)的第二端部(52b)。所述弹性杆(54)具有紧固到所述锚定件(66)的第二端部(54b)。所述枢转支撑构件(52)适于可枢转地安装到外科装置的主体部分(18)，并且所述锚定件(66)适于紧固到所述外科装置，以使得所述指示器主体部分(50)从第一位置到第二位置的枢转移动实现所述弹性杆(54)从松弛构型到受压构型的移动。在所述受压构型中，所述弹性杆(54)朝所述第一位置推动所述指示器主体部分(50)。所述指示器主体部分(50)可由塑料材料一体模塑而成以限定具有整体构造的单个零件。
Description
背景
1.技术领域
本公开涉及具有击发指示器的外科吻合装置。更具体地说，本公开涉及包括具有整体构造的击发指示器的外科吻合装置。
2.相关领域背景
具有被构造来夹紧并缝合组织的末端执行器的外科装置在医学领域中是众所周知的。通常，这些装置包括支撑砧座的第一夹爪和支撑容纳有多个卡钉的盒的第二夹爪。第一夹爪和第二夹爪可在间隔位置与接近位置之间相对于彼此移动，以在将卡钉击发到组织中之前将组织夹紧在所述夹爪之间。为了防止在夹爪已接近“击发区”内部之前(即，在夹爪已足够接近以实现适当的卡钉结构之前)击发卡钉，已知的是在外科装置上提供封锁件和/或指示器。通常，封锁件防止击发触发器的致动，直到夹爪接近击发区内部，而指示器提供夹爪接近击发区内部的可见指示。
外科吻合装置上的已知指示器可包括多个部件并且过于复杂，所述指示器提供夹爪接近击发区内部的可见指示。在医学领域中需要用于识别吻合装置的夹爪何时接近击发区内部的简单且便宜的装置。
概述
本公开的一个方面涉及外科吻合装置，所述外科吻合装置包括手柄组件，所述手柄组件具有限定握把的主体部分、旋钮以及指示器。细长主体部分从所述手柄组件向远端延伸。末端执行器支撑在所述细长主体部分的远端上并且包括盒组件和砧座组件。所述外科吻合装置包括接近组件，所述接近组件具有可移动地支撑在所述手柄组件内的驱动螺杆和可操作地连接到所述驱动螺杆的砧座保持器。所述砧座保持器被构造来支撑所述砧座组件，并且所述驱动螺杆可操作地与所述旋钮接合，以使得所述旋钮的致动实现所述砧座组件相对于所述盒组件在间隔位置与接近位置之间的移动。螺杆止动件紧固到所述驱动螺杆。所述指示器具有整体构造并且包括指示器构件、枢转支撑构件、弹性杆以及锚定件。所述枢转支撑构件具有紧固到所述指示器构件的第一端部和紧固到所述弹性杆的第一端部的第二端部。所述弹性杆具有紧固到所述锚定件的第二端部。所述枢转支撑构件可枢转地紧固到所述手柄组件的所述主体部分，并且所述锚定件固定在所述手柄组件的所述主体部分内，以使得所述指示器构件从第一位置到第二位置的枢转移动实现所述弹性杆从松弛构型到受压构型的移动，其中在所述受压构型中，所述弹性杆朝第一位置推动所述指示器构件。
在实施方案中，所述螺杆止动件包括块，所述块被定位成在所述砧座组件从间隔位置移动到接近位置时接合所述指示器，以使所述指示器构件从第一位置枢转到第二位置。所述块可形成在所述螺杆止动件的上表面上。
在一些实施方案中，所述弹性杆被定位成在所述砧座组件从接近位置移动到间隔位置时使所述指示器构件从第二位置移动到第一位置。
在实施方案中，所述枢转支撑构件定位在所述指示器构件与所述弹性杆之间并且限定接收枢转构件的孔。所述枢转构件可支撑在所述手柄组件的所述主体部分的内壁上。
在某些实施方案中，所述锚定件支撑在所述弹性杆的与所述枢转支撑构件相对的端部上并且限定接收支撑销的孔，所述支撑销从所述手柄组件的所述主体部分的内壁延伸。
在一些实施方案中，所述弹性杆包括折叠的可伸展主体。
在某些实施方案中，所述指示器构件包括标记，所述标记向临床医生提供所述外科吻合装置的状态的指示。
在实施方案中，所述手柄组件的所述主体部分限定窗口，并且所述指示器构件定位在所述窗口下方，以利于所述标记的至少一部分的可视化。
在一些实施方案中，所述标记包括定位在绿色表面上的红色条纹。当所述指示器构件处于第一位置时，所述红色条纹通过所述窗口可见，并且当所述指示器构件处于第二位置时，所述绿色表面通过所述窗口可见。
在实施方案中，所述指示器组件由塑料材料一体模塑而成。
本公开的另一个方面包括具有整体构造的指示器。所述指示器包括指示器构件、枢转支撑构件、弹性杆以及锚定件。所述枢转支撑构件具有紧固到所述指示器构件的第一端部和紧固到所述弹性杆的第一端部的第二端部。所述弹性杆具有紧固到所述锚定件的第二端部。所述枢转支撑构件适于可枢转地安装到外科装置的主体，并且所述锚定件适于紧固到所述外科装置，以使得所述指示器构件从第一位置到第二位置的枢转移动实现所述弹性杆从松弛构型到受压构型的移动，其中在所述受压构型中，所述弹性杆朝第一位置推动所述指示器构件。
在实施方案中，所述枢转支撑构件定位在所述指示器构件与所述弹性杆之间并且限定被构造来接收枢转构件的孔。
在实施方案中，所述锚定件支撑在所述弹性杆的与所述枢转支撑构件相对的端部上并且限定被构造来接收支撑销的孔。
在一些实施方案中，所述弹性杆包括折叠的可伸展主体。
在某些实施方案中，所述指示器构件包括标记，以向临床医生提供外科吻合装置的状态的指示。
在一些实施方案中，所述标记包括定位在绿色表面上的红色条纹。
在一些实施方案中，所述指示器组件由塑料材料一体模塑而成。
附图简述
目前公开的外科吻合装置和击发指示器的各种实施方案在本文中参考附图进行描述，其中：
图1是本公开的吻合装置的一个实施方案的侧面透视图，其示出执行器的夹爪呈间隔构型的吻合装置；
图2是图1所示的吻合装置的手柄组件的一部分的侧面透视图，其中外壳的半部被去除，并且示出处于第一位置的支撑在外壳内的指示器，所述指示器邻近吻合装置的螺杆止动件；
图3是图2所示的指示器的侧视图；
图4是处于第一位置的图2所示的指示器和螺杆止动件的侧面剖视图；
图5是在螺杆止动件移动成与指示器接合并且指示器移动到第二位置之后，图4所示的指示器和螺杆止动件的侧面剖视图。
实施方案详述
本领域的技术人员将理解，在本文中具体描述并且在附图中示出的装置和方法是非限制性的示例性实施方案。可设想的是，在不背离本公开的范围的情况下，结合一个示例性实施方案所示出或描述的元件和特征可与另一个实施方案的元件和特征组合。同样地，本领域的技术人员将基于上述实施方案来理解本公开的其他特征和优点。因此，除了如所附权利要求书所指出的内容之外，本公开不受已具体示出并描述的内容的限制。
如本文所用，术语远端是指装置的离临床医师最远的那部分，而术语近端是指仪器的最靠近临床医师的那部分。此外，如本文所用，术语临床医师是指包括医生、护士和辅助人员的医务人员。
图1示出外科吻合装置10，所述外科吻合装置10具有手柄组件12、细长主体部分14以及末端执行器16。手柄组件12包括限定握把20的主体部分18、旋钮22、击发触发器24以及指示器26。指示器26定位在形成在主体部分18中的开口或窗口25下方，所述开口或窗口25允许临床医生看见指示器26。透镜26a可支撑在指示器26上方，以改进指示器26的可视性。如本领域中已知的，击发封锁件27邻近击发触发器24可枢转地支撑在手柄组件的主体部分18上，以防止击发触发器24的致动，直到末端执行器16移动到接近位置，如下文将更详细讨论。
细长主体部分14是管状的并且从手柄组件12的主体部分18向远端延伸。末端执行器16支撑在细长主体部分14的远端上，并且包括盒或壳组件28和砧座组件30。砧座组件30支撑在砧座保持器32上，所述砧座保持器32限定吻合装置10的接近组件(未示出)的远端。砧座保持器32可操作地连接到旋钮22，以使得致动旋钮22的旋转使砧座保持器32在细长主体部分14内往复运动，以使砧座组件30相对于盒组件28在间隔位置与接近位置之间移动。Milliman等人的美国专利号7,303,106(“’106专利”)公开了在许多方面类似于外科吻合装置10的外科吻合装置。‘106专利描述了适合于与吻合装置10一起使用的击发机构和接近机构，并且以引用的方式整体并入本文。
参考图2，外科吻合装置10的接近机构包括驱动螺杆40，所述驱动螺杆40支撑螺杆止动件42。驱动螺杆40具有可操作地连接到旋钮22(图1)的近端和可操作地连接到砧座保持器32(图1)的远端。驱动螺杆40可响应于旋钮22的旋转而在手柄组件12内线性地移动，以实现砧座保持器32在盒28内的线性移动。螺杆止动件42固定地紧固到驱动螺杆40，以使得驱动螺杆40的移动实现螺杆止动件42的对应移动。已以引用的方式整体并入本文的‘106专利公开了如上文所讨论的包括螺杆和螺杆止动件的接近机构。
指示器26具有整体构造并且包括弓形指示器主体部分50、枢转支撑构件52以及弹性杆54。可设想的是，指示器主体部分50可呈不同于弓形的各种构型，例如平坦状、凹形、凸形、球形等。枢转支撑构件52具有由指示器主体部分50的底部形成并从所述底部延伸的一个端部52a、连接到弹性杆54的一个端部54a的第二端部52b，以及限定接收枢转构件60的孔58的中心部分56。枢转构件60可一体地形成在手柄组件12的主体部分18的内壁62上，并且将指示器26在透镜盖26a下方可枢转地支撑在主体部分18内。可选地，枢转构件60可与手柄组件12的主体部分18分开形成。
如上文所讨论，弹性杆54与枢转支撑构件52一体地形成。弹性杆54的定位成与枢转支撑构件52相对的第二端部54b端部限定锚定件66，所述锚定件66限定接收支撑销70的孔68。支撑销70可形成在手柄组件12的主体部分18的内壁62上，并且将弹性杆54的端部54b固定地紧固到手柄组件12的主体部分18。
弹性杆54包括在锚定件66与枢转支撑构件52之间延伸的折叠的可伸展主体74。可伸展主体74可从图2和图3所示的松弛构型移动到图5所示的压缩或受压构型，如下文将详细讨论。如上文所讨论，枢转支撑构件52和弹性杆54的端部54b相对于手柄组件12的主体部分18被紧固并轴向固定。这样，当指示器主体部分50如图3所示在逆时针方向上枢转时，枢转支撑构件的端部52b朝锚定件66枢转，以将弹性杆54的可伸展主体74压缩成受压构型(图5)。
参考图1、图4和图5，螺杆止动件42固定地支撑在吻合装置10的驱动螺杆40上，并且包括接合构件，例如块80，所述块80被定位来接合指示器26的枢转支撑构件52的第二端部52b。在实施方案中，枢转支撑构件52的第二端部52b可包括被定位来接合螺杆止动件42的块80的肋状物或类似物。
参考图4，当砧座组件30与盒组件28间隔开(图1)时，螺杆止动件42被定位成使得块80定位在枢转支撑构件52的第二端部52b的远端。如上文所讨论，如医学领域中已知的，螺杆止动件42轴向固定到驱动螺杆40，并且驱动螺杆40可操作地联接到砧座组件30并且联接到旋钮22。
参考图5，当旋钮22(图1)由临床医生致动(即旋转)时，驱动螺杆40在手柄组件12的主体部分18内缩回，以使砧座保持器32缩回到盒组件28中并且使砧座组件30朝盒组件28移动到接近位置。当驱动螺杆40在吻合装置10的手柄组件12内缩回以使砧座组件30朝接近位置移动时，螺杆止动件42的块80接合枢转支撑构件52的第二端部52b。在驱动螺杆40和螺杆止动件42继续缩回时，螺杆止动件42的块80使枢转支撑构件52绕枢转构件60枢转，以将指示器构件50从窗口25下方的第一位置枢转到窗口25下方的第二位置。
还是参考图3，指示器主体部分50包括标记，所述标记向临床医生提供吻合装置10的状态的指示。更具体地说，标记可以呈红色条纹90的形式，所述红色条纹90定位在指示器主体部分50的绿色上表面92上。当指示器主体部分50处于第一位置(图4)并且红色条纹90与窗口25对准时，红色条纹90向临床医生指示末端执行器16或末端执行器16的砧座30处于间隔位置或未接近位置，并且因此，吻合装置10不处于准备击发的位置。当指示器主体部分50响应于驱动螺杆40和螺杆止动件42在手柄组件12的主体部分18内缩回而枢转到第二位置(图5)时，指示器主体部分50的绿色上表面92变得通过吻合装置10的窗口25可见并且向临床医生指示吻合装置10处于准备击发的位置。
可设想的是，标记可选自各种不同的颜色、字符等。
应注意，当枢转支撑构件52朝弹性杆54的可伸展主体74枢转时，弹性杆54移动到受压或压缩构型。这样，当通过旋钮22的致动使砧座组件30从接近位置朝间隔位置移动时，可伸展主体74返回到其松弛构型以使指示器构件50枢转回到第一位置。
指示器构件26可由诸如尼龙或聚氯乙烯(PVC)的塑料材料模塑成单个、一体的整体零件。通过提供具有整体构造的指示器，可使手柄组件的部件数量和复杂性最小化以降低成本。
本领域的技术人员将理解，在本文中具体描述并在附图中示出的装置和方法是非限制性的示例性实施方案。可设想的是，在不背离本公开的范围的情况下，结合一个示例性实施方案所示出或描述的元件和特征可与另一个实施方案的元件和特征组合。同样地，本领域的技术人员将基于上述实施方案来理解本公开的其他特征和优点。因此，除了如所附权利要求书所指出的内容之外，本公开不受已具体示出并描述的内容的限制。
Claims (18)
1.一种外科吻合装置，其包括：
手柄组件，所述手柄组件包括限定握把的主体部分、旋钮以及指示器；
细长主体部分，所述细长主体部分从所述手柄组件向远端延伸；
末端执行器，所述末端执行器支撑在所述细长主体部分的远端上，所述末端执行器包括盒组件和砧座组件；
接近组件，所述接近组件包括可移动地支撑在所述手柄组件内的驱动螺杆和可操作地连接到所述驱动螺杆的砧座保持器，所述砧座保持器被构造来支撑所述砧座组件，并且所述驱动螺杆可操作地与所述旋钮接合，以使得所述旋钮的致动实现所述砧座组件相对于所述盒组件在间隔位置与接近位置之间的移动；以及
螺杆止动件，所述螺杆止动件紧固到所述驱动螺杆；
其中所述指示器具有整体构造并且包括指示器主体部分、枢转支撑构件、弹性杆以及锚定件，所述枢转支撑构件具有紧固到所述指示器主体部分的第一端部和紧固到所述弹性杆的第一端部的第二端部，所述弹性杆具有紧固到所述锚定件的第二端部，所述枢转支撑构件可枢转地紧固到所述手柄组件的所述主体部分，并且所述锚定件固定在所述手柄组件的所述主体部分内，以使得所述指示器构件从第一位置到第二位置的枢转移动实现所述弹性杆从松弛构型到受压构型的移动，其中在所述受压构型中，所述弹性杆将朝所述第一位置推动所述指示器主体部分。
2.根据权利要求1所述的外科吻合装置，其中所述螺杆止动件包括块，所述块被定位来接合所述指示器，以在所述砧座组件从所述间隔位置移动到所述接近位置时使所述指示器主体部分从所述第一位置枢转到所述第二位置。
3.根据权利要求2所述的外科吻合装置，其中所述弹性杆被定位成在所述砧座组件从所述接近位置移动到所述间隔位置时使所述指示器主体部分从所述第二位置移动到所述第一位置。
4.根据权利要求2所述的外科吻合装置，其中所述块形成在所述螺杆止动件的上表面上。
5.根据权利要求1所述的外科吻合装置，其中所述枢转支撑构件定位在所述指示器主体部分与所述弹性杆之间并且限定接收枢转构件的孔，所述枢转构件支撑在所述手柄组件的所述主体部分的内壁上。所述锚定件支撑在所述弹性杆的与所述枢转支撑构件相对的端部上
6.根据权利要求6所述的外科吻合装置，其中所述锚定件限定接收支撑销的孔，所述支撑销从所述手柄组件的所述主体部分的所述内壁延伸。
7.根据权利要求1所述的外科吻合装置，其中所述弹性杆包括折叠的可伸展主体。
8.根据权利要求1所述的外科吻合装置，其中所述指示器主体部分包括标记，所述标记向临床医生提供所述外科吻合装置的状态的指示。
9.根据权利要求8所述的外科吻合装置，其中所述手柄组件的所述主体部分限定窗口，所述指示器主体部分定位在所述窗口下方，以利于所述标记的至少一部分的可视化。
10.根据权利要求9所述的外科吻合装置，其中所述标记包括定位在绿色表面上的红色条纹，当所述指示器主体部分处于所述第一位置时，所述红色条纹通过所述窗口可见，并且当所述指示器主体部分处于所述第二位置时，所述绿色表面通过所述窗口可见。
11.根据权利要求1所述的外科吻合装置，其中所述指示器组件由塑料材料一体模塑而成。
12.一种具有整体构造的指示器，其包括：
指示器主体部分、枢转支撑构件、弹性杆以及锚定件，所述枢转支撑构件具有紧固到所述指示器主体部分的第一端部和紧固到所述弹性杆的第一端部的第二端部，所述弹性杆具有紧固到所述锚定件的第二端部，所述枢转支撑构件适于可枢转地安装到外科装置，并且所述锚定件适于紧固到所述外科装置，以使得所述指示器构件从第一位置到第二位置的枢转移动实现所述弹性杆从松弛构型到受压构型的移动，其中在所述受压构型中，所述弹性杆朝所述第一位置推动所述指示器主体部分。
13.根据权利要求12所述的外科吻合装置，其中所述枢转支撑构件定位在所述指示器主体部分与所述弹性杆之间并且限定被构造来接收枢转构件的孔。
14.根据权利要求12所述的外科吻合装置，其中所述锚定件限定被构造来接收支撑销的孔。
15.根据权利要求12所述的外科吻合装置，其中所述弹性杆包括折叠的可伸展主体。
16.根据权利要求12所述的外科吻合装置，其中所述指示器主体部分包括标记，以向临床医生提供外科吻合装置的状态的指示。
17.根据权利要求16所述的外科吻合装置，其中所述标记包括定位在绿色表面上的红色条纹。
18.根据权利要求12所述的外科吻合装置，其中所述指示器组件由塑料材料一体模塑而成。
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| PCT/CN2015/073114 WO2016127433A1 (en) | 2015-02-15 | 2015-02-15 | Surgical stapling device with firing indicator of unitary construction |
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|---|---|
| EP3256057A4 (en) | 2018-12-26 |
| CN107249479B (zh) | 2020-05-08 |
| ES2886023T3 (es) | 2021-12-16 |
| EP3256057B1 (en) | 2021-07-28 |
| US20180028188A1 (en) | 2018-02-01 |
| WO2016127433A1 (en) | 2016-08-18 |
| EP3256057A1 (en) | 2017-12-20 |
| US10517601B2 (en) | 2019-12-31 |
| JP2018504987A (ja) | 2018-02-22 |
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