CN107374687A - 用于柔性圆形吻合器的适配器组件 - Google Patents

用于柔性圆形吻合器的适配器组件 Download PDF

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CN107374687A
CN107374687A CN201710348734.2A CN201710348734A CN107374687A CN 107374687 A CN107374687 A CN 107374687A CN 201710348734 A CN201710348734 A CN 201710348734A CN 107374687 A CN107374687 A CN 107374687A
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安东尼·斯格罗伊
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Abstract

一种用于柔性圆形吻合器的适配器组件，包括推进器组件、套管针组件、第一驱动组件和第二驱动组件。推进器组件包括推进器构件、牵拉器构件以及第一滑轮构件和第二滑轮构件。套管针组件包括相对于推进器组件可操作地设置的套筒针构件。第一驱动组件包括用于相对于推进器组件推进和缩回套管针构件的第一线缆，并且第二驱动组件包括用于缩回牵拉器构件以引起所述第一滑轮构件和第二滑轮构件的旋转的第二线缆。第一滑轮构件和第二滑轮构件的旋转引起推进器构件的推进。

Description

用于柔性圆形吻合器的适配器组件
相关申请的交叉引用
本申请要求于2016年5月17日递交的第62/337,564号美国临时专利申请的利益和优先权，该美国临时专利申请的全部内容通过引用合并于此。
技术领域
本公开涉及吻合器装置。更具体地说，本公开涉及用于柔性圆形吻合器的适配器组件。
背景技术
圆形吻合器用于执行端对端吻合术。典型的圆形吻合器包括相对于设置在细长轴的远端上的钉仓组件可释放地固定的砧座组件。圆形吻合器的操作需要致动设置在细长轴的近端上的手柄组件，以首先使砧座组件相对于钉仓组件缩回以夹紧组织，然后推进或推动一个或多个致动组件以吻合和切割组织。由于推进器组件的致动所要求的驱动轴的刚性，圆形吻合器的细长轴的柔性受到限制。
因此，具有一种使用线缆实现一个或多个致动组件的操作的圆形吻合器将是有益的，从而增加了圆形吻合器的柔性。
发明内容
提供了一种用于柔性圆形吻合器的适配器组件。所述适配器组件包括推进器组件、套管针组件、第一驱动组件以及第二驱动组件。所述推进器组件包括推进器构件、用于缩回所述推进器构件的牵拉器构件(puller member)、以及可操作地布置在所述推进器构件和所述牵拉器构件之间的第一滑轮构件和第二滑轮构件。套管针组件包括相对于所述推进器组件可操作地设置的套筒针构件。第一驱动组件包括第一线缆，所述第一线缆用于使所述套管针构件相对于所述推进器组件推进和缩回。第二驱动组件包括用于缩回所述牵拉器构件以引起所述第一滑轮构件和第二滑轮构件的旋转的第二线缆。所述第一滑轮构件和第二滑轮构件的旋转引起推进器构件的推进。
在实施例中，第一滑轮构件和第二滑轮构件通过相应的第一连接器和第二连接器连接到牵拉器构件。第一连接器和第二连接器可以在推进器构件的推进之前围绕相应的第一滑轮构件和第二滑轮构件缠绕。第一滑轮构件和第二滑轮构件中的每一个可以包括用于接合推进器构件的至少第一齿轮。推进器构件可以构造为当其推进时吻合组织。套管针构件可以可释放地固定到砧座组件。第三驱动组件包括连接到推进器构件的第三线缆。
在一些实施例中，第三驱动组件被构造为在其操作时引起所述推进器构件的缩回。所述第一滑轮构件和第二滑轮构件中的每一个包括用于保持相应的第一连接器和第二连接器上的张力的涂层。所述第一滑轮构件和第二滑轮构件中的每一个包括用于保持相应的第一连接器和第二连接器上的张力的扭转弹簧。适配器组件可以包括细长主体和支撑在所述细长主体的近端上的联接组件。适配器组件可以包括支撑在细长主体的远端上的装载单元。装载单元可以包括支撑多个吻合钉的吻合钉钉仓。适配器组件的细长主体的至少一部分是柔性的。细长主体可以包括内部柔性线圈和外部护套。
还提供了用于吻合组织的圆形吻合器，该圆形吻合器包括致动组件和可操作地固定到所述致动组件的适配器组件。
附图说明
并入且构成本说明书的一部分的附图示出了本公开的各实施例，并且连同上文给出的公开内容的总体描述以及下面给出的实施例的详细描述用于解释本公开的原理，其中：
图1是根据本公开的实施例的包括适配器组件的圆形吻合设备的侧面立体图；
图2是图1所示的适配器组件和装载单元的部分剖开的俯视立体示意图；
图3是图1所示的适配器组件和装载单元的远端的侧面剖视图；
图4A是图1所示的适配器组件的滑轮构件的放大立体图；
图4B是图1所示的适配器组件的滑轮构件的替代实施例的放大立体图；
图5是图4B所示的滑轮构件的俯视平面图；
图6是可选择地包括扭转弹簧的图4A所示的滑轮构件侧视图；
图7是图1所示的适配器组件和装载单元的远端的侧面剖视示意图，套管针组件的套管针构件处于推进的位置并且推进器组件的推进器构件处于缩回位置；
图8是图1所示的适配器组件和装载单元的远端的侧面剖视示意图，砧座组件固定到套管针构件，套管针构件处于缩回位置、并且推进器构件处于推进的位置；以及
图9是图1所示的适配器组件和装载单元的远端的侧面剖视示意图，套管针构件处于推进的位置，推进器构件处于缩回位置。
具体实施方式
参考附图对本公开的实施例进行详细描述，其中在每个视图中相同的附图标记表示相同或相应的元件。如本文所使用的，术语“远侧”是指适配器组件或手术装置或其部件的离使用者较远的部分，而术语“近侧”是指适配器组件或手术装置或其部件的离使用者较近的部分。
参照图1和图2，根据本公开的实施例的适配器组件总体上被示出为适配器组件100，其被配置为选择性地连接到总体上示出为致动组件20所示的动力手持机电器械。如图1所示，致动组件20构造为与适配器组件100的选择性连接，并且适配器组件100被配置为与砧座组件30选择性连接。共同地，适配器组件100、致动组件20和砧座组件30形成手术吻合装置10。
关于示例性机电器械的结构和功能的详细描述，请参考共同拥有的第9,055,943号美国专利，其全部内容通过引用并入本文。
继续参照图1和图2，适配器组件100包括细长主体110和联接组件112，联接组件112支撑在细长主体110的近端110a上，用于将细长主体110固定到致动组件20。如图所示，细长主体110包括内部柔性线圈111a(图3)和保护的外部护套111b(图3)，然而，细长主体110可以由刚性记忆金属、半柔性材料、波纹管和/或任何合适的材料形成。细长主体110的构造允许适配器组件100沿其长度弯曲和/或屈曲，使得装载单元150可以相对于致动组件10(图1)选择性地移动，以便于在患者(未示出)内定位装载单元150。可以设想细长主体110可以由诸如等形成。
适配器组件100还包括延伸穿过细长主体110的第一驱动组件或动力螺钉120、第二驱动组件或动力螺钉130和第三驱动组件或动力螺钉140(图2)，以及固定到所述细长主体110的远端110b的装载单元150。尽管示出为与细长主体110一体地形成，但是可以设想，装载单元150可以至少部分地从细长主体110释放，以允许适配器组件100的重复使用。
适配器组件100的联接组件112被配置为将适配器组件100可释放地固定到致动组件20。如图所示，致动组件20(图1)包括动力手柄组件22。如从在下面的公开内容中明显可知的，致动组件20可以包括适于致动第一驱动组件120、第二驱动组件130和第三驱动组件140中的每一个的任何机构。第一驱动组件120、第二驱动组件130和第三驱动组件140中的每一个可以是由相同的驱动构件(未示出)致动，或者将在下面更详细地描述，第一驱动组件120、第二驱动组件130和第三驱动组件140中的每一个由相应的第一、第二和第三驱动构件(未示出)致动。
继续参照图2，第一驱动组件120被配置为实现适配器组件100的第一功能，例如推进和缩回适配器组件100的套管针组件160的套管针构件162。第二驱动组件130被配置为实现适配器组件100的第二功能，例如推进装载单元150的推进器组件170(图3)的推进器构件172(图3)。第三驱动组件140被配置为实现适配器组件100的第三功能，例如缩回装载单元150的推进器组件170的推进器构件172。第一驱动组件120、第二驱动组件130和第三驱动组件140中的每一个包括相应的第一驱动轴122、第二驱动轴132和第三驱动轴142，它们可操作地连接到致动组件20的相应的第一驱动构件、第二驱动构件或第三驱动构件(未示出)。
继续参照图2，第一驱动组件120包括诸如第一推/拉线缆124的线缆，其被固定到套管针组件160的套管针构件162，以在装载单元150的致动之前相对于装载单元150的吻合钉钉仓152靠近砧座组件30(图1)，并且随着吻合操作将砧座组件30从装载单元150的吻合钉钉仓154移开。第一线缆124包括内部电线或编织电线124a和支撑内部电线124a的外部护套124b。例如，内部电线124a可以是不锈钢编织线缆，并且外部护套124b可以是缠绕在编织线缆上的弹簧绕组。内部电线124a和外部护套124b都是柔性的，以适应适配器组件100的细长主体110的屈曲。
第一驱动组件120还包括可操作地连接到第一驱动轴122的第一螺钉构件126和围绕第一螺钉构件126纵向设置的第一滑架构件或螺母128。可以想到，第一驱动轴122与第一螺钉构件126可以一体地形成。第一线缆124的内部电线124a的近端固定到第一滑架构件128，使得第一滑架构件128的纵向移动引起第一线缆124的内部电线124a的纵向移动。
第二驱动组件130包括诸如第二线缆134的相应的线缆。第二线缆134可以包括柔性电线、线缆、带状物、绳或任何其它类似的材料。第二线缆134固定到推进器组件170(图3)的牵拉器构件174(图3)以在手术吻合装置10的操作期间向近侧移动牵拉器构件17。如下面将进一步详细描述的，牵拉器构件174的缩回引起推进器组件170的推进器构件172推进。随着推进器组件170被推进，吻合钉“S”从装载单元150的吻合钉钉仓152射出并抵靠砧座组件30(图1)成形。
第二驱动组件130还包括可操作地连接到第二驱动轴132的第二螺钉构件136和围绕第二螺钉构件136纵向设置的第二滑架构件或螺母140。可以想到，第二驱动轴132以及第二螺钉构件136可以一体地形成。第二线缆134的近端可操作地连接到第二滑架构件138，使得第二滑架构件138的纵向移动引起第二线缆134的纵向移动。
第三驱动组件140包括诸如第三线缆144的相应的线缆。第三线缆144可以包括柔性电线、线缆、带状物、绳或任何其它类似的材料。如将在下面进一步详细描述的，第三线缆144固定到推进器组件170(图3)的推进器构件172(图3)，以在推进器组件170的推进器构件172的推进之后缩回推进器构件172。
第三驱动组件140还包括可操作地连接到第三驱动轴142的第三螺钉构件146、以及围绕第三螺钉构件146纵向设置的第三滑架构件或螺母148。可以设想，第三驱动轴142以及第三螺钉构件146可以一体地形成。第三线缆144的近端可操作地连接到第一滑动构件128。第三滑架构件138的纵向移动引起第三缆索144的纵向移动。第三线缆144的远端固定到推进器构件172。
由于第二驱动组件130和第三驱动组件140中的每一个仅需要在单个方向上操作，即相应的牵拉器构件174和推进器构件172的缩回，因此，设想第二驱动组件130和第三驱动组件140中的任一个或两个可以包括吸收滑轮(uptake pulley)(未示出)，相应的第二线缆134或第三线缆144围绕吸收滑轮缠绕以引起相应的牵拉器构件174和推进器构件172的缩回。进一步设想，适配器组件100可以是被修改为使得第一驱动组件120仅在单个方向上操作和/或第二和第三驱动组件130、140在诸如推/拉方向的两个方向上操作。
具体参照图3，装载单元150被支撑在细长主体110的远端110b上。如上所述，装载单元150可以与细长主体110一体地形成或者可以可释放地固定到其上以允许适配器组件100的重复使用。装载单元150包括外壳构件152、支撑在外壳构件152上的吻合钉钉仓154以及可操作地支撑在外壳构件152内的推进器组件170。装载单元150的吻合钉钉仓154被配置为分配圆形排列的吻合钉“S”。吻合钉钉仓154可以从外壳构件152移除，以允许在吻合操作之后更换吻合钉钉仓154，使得适配器组件100和/或装载单元150可以被重复使用。
继续参照图3，套管针组件160包括支撑在第一线缆124的远端上的套筒针构件162并且延伸穿过装载单元150的外壳构件152和推进器组件170。套管针构件162被构造为可释放地接合砧座组件30(图1)。如上所述，第一驱动组件120被构造为缩回并推进套管针构件162。可以设想，套管针组件160可以包括用于促进套管针构件162的推进和缩回之一的弹簧，使得第一驱动组件120只需要在单一方向上操作。
推进器组件170包括推进器构件172、牵拉器构件174以及诸如第一滑轮构件和第二滑轮构件176、178的启动组件。推进器构件172包括环形基部172a，其限定沿其外表面设置的多个凹口或齿条传动齿171。多个凹口171可以完全围绕推进器构件172的环形基部172a延伸，或者可以替代地定位成与第一滑轮构件176和第二滑轮构件178相对应。对应于吻合钉钉仓154内的吻合钉“S”的多个指状件173从推进器构件172的环形基部172a向远侧延伸，用于从吻合钉钉仓154射出吻合钉“S”。推进器构件172还包括用于切割组织(未示出)的圆形刀具175。
继续参照图3，装载单元150的推进器组件170的牵拉器构件174包括大体上U形的主体，其具有近端174a和分叉的远端174b，第二线缆134固定到近端174a，第一连接器180和第二连接器182固定到分叉的远端174b。尽管示出了包括用于容纳第一连接器180和第二连接器182的分叉的远端174b，但是牵拉器构件174的远端174b可以构造为容纳任何数量的连接器。
装载单元150的推进器组件170的第一滑轮构件176和第二滑轮构件178被可旋转地支撑在装载单元150的外壳构件152内。第一滑轮构件176和第二滑轮构件178中的每一个包括与推进器构件172的多个凹口171能可操作地接合的第一齿轮176a、178a(图4A)。在替代实施例中，第一滑轮构件176'和第二滑轮构件178'(图4B)分别包括第一齿轮176a'、178a'和第二齿轮176b'、178b'。如下面将进一步详细描述的那样，第一滑轮构件176和第二滑轮构件178的旋转引起推进器构件172的相应的纵向移动。
第一连接器180和第二连接器182中的每一个的第一端围绕相应的第一滑轮构件176和第二滑轮构件178缠绕，并且第一连接器180和第二连接器182的第二端固定到推进器组件170的牵拉器构件174。第一连接器180和第二连接器182围绕相应的第一滑轮构件176和第二滑轮构件178缠绕的匝数使得在由第二驱动组件130产生的行程中，第一滑轮构件176和第二滑轮构件178被充分旋转以实现适配器组件100的第二功能，例如推进器构件172的推进以引起组织(未示出)的吻合和切割。
为了防止第一连接器和第二连接器从相应的第一滑轮构件176和第二滑轮构件178过早地解绕和/或维持第一滑轮构件176和第二滑轮构件178上的张力，第一连接器180和第二连接器182可以使用低硬度涂层(即橡胶)或脱开粘合剂(break-away adhesive)184(图5)固定到相应的第一滑轮构件176和第二滑轮构件178。可替代地，第一滑轮构件176和第二滑轮构件178可各自包括用于保持相应的第一连接器180和第二连接器182的张力的扭转弹簧177(图6)。扭转弹簧177使相应的第一滑轮构件176和第二滑轮构件178沿相反方向旋转以引起推进器组件170的推进器构件172的缩回以及相应的第一连接器180和第二连接器182的吸收。
现在将参照图7-9对适配器组件100的操作进行描述。首先参照图7，适配器组件100被示出为套管针组件160的套管针构件162处于推进的位置。适配器组件100可以在套管针构件162处于推进的位置的状态下被提供给临床医生。可替代地，套管针构件162在处于缩回位置时(图9)被提供给临床医生，并且通过第一驱动组件120(图2)的操作被移动到推进的位置，如箭头“A”所示的。更具体地，第一驱动组件120(图2)的第一螺钉构件126(图2)沿第一方向(例如顺时针方向)的旋转使得第一滑架构件128(图2)向远侧移动(例如，相对于第一螺钉构件126被推进)，以推动第一推/拉线缆124。套管针构件162固定到第一推/拉线缆124，使得套管针构件162随着第一推/拉线缆124而被推进。当处于推进的位置时，套管针组件160的套管针构件162被构造为穿过组织和/或便于将砧座组件30附接到适配器组件100。
接下来待吻合的组织(未示出)以传统的方式围绕砧座组件30(图8)以及围绕套管针组件162的套管针构件162定位。接着，将砧座组件30固定到套管针构件162上。砧座组件30(图8)可以以任何合适的方式固定到套管针构件162。在实施例中，套管针构件162的缩回将砧座组件30锁定到套管针构件162，以防止砧座组件30与套管针构件162分离。
现在具体参照图8，适配器组件100被示出为使砧座组件30固定到套管针组件160的套管针构件162，并且套管针构件160处于缩回位置。通过第一驱动组件120(图2)的操作，套管针构件160移动到缩回位置。具体地，第一驱动组件120(图2)的第一螺钉构件126(图2)沿第二方向(例如逆时针方向)的旋转使得第一滑架构件128(图2)沿近侧方向移动(例如相对于第一螺钉构件126缩回)，以拉动第一推/拉线缆124。第一推/拉线缆124的缩回导致套管针构件162沿近侧方向移动，例如，如箭头“B”所示，缩回到装载单元150内。如上所述，当处于缩回位置时，砧座组件30可以被锁定到套管针构件162，以防止在适配器组件100的操作期间砧座组件30与套管针组件162分离。
推进器组件170的推进器构件172通过第二驱动组件130的操作而移动到推进的位置。更具体地，第二驱动组件130(图2)的第二螺钉构件136(图2)沿第一方向(例如顺时针方向)的旋转使第二滑架构件138(图2)沿近侧方向移动，例如相对于第二螺钉构件136缩回以拉动第二缆索134。拉动第二线缆134引起推进器组件170的牵拉器构件174的缩回。
继续参照图8，如箭头“C”所示，牵拉器构件174沿近侧方向的缩回使得第一连接器180和第二连接器182从相应的第一滑轮构件176和第二滑轮构件178解绕。如箭头“D”和“E”所示，随着第一滑轮构件176和第二滑轮构件178分别响应于相应的第一连接器180和第二连接器182从其解绕而旋转，相应的第一滑轮构件176和第二滑轮构件178的第一齿轮176a、178a接合推进器构件172以使推进器构件172沿远侧方向移动到推进的位置，如箭头“F”所示，以将吻合钉“S”从吻合钉钉仓152射出并使吻合钉“S”抵靠砧座组件30成形以吻合组织(未示出)，并推进圆形刀具175以切割组织(未示出)。可以设想，推进器组件170的圆形刀具175可以与推进器构件172分离并独立。以这种方式，可以独立于适配器组件100的吻合功能来执行适配器组件100的切割功能。
现在转到图9，在组织(未示出)被吻合之后，套管针组件160的套管针构件162以上述方式被推进(图7)，以允许将砧座组件30(图8)从其分离。如箭头“G”所示，在砧座组件30与套管针构件162分离之前、同时或之后，推进器组件170的推进器构件172向远侧移动到缩回位置。
如图所示，推进器构件172通过第三驱动组件140的操作而移动到缩回位置。具体地，第三驱动组件140(图2)的第三螺钉构件146(图2)沿第一方向(例如顺时针方向)的旋转使得第三滑架构件148(图2)沿近侧方向移动，即相对于第三螺钉构件146缩回，以拉动第三线缆144。拉动第三线缆144引起推进器构件172的缩回。为了允许推进器构件172的缩回，第一滑轮构件176和第二滑轮构件178必须沿相反方向自由旋转，或者构造为在推进器构件172推进之后使推进器构件172脱离。
可替代地，推进器组件170可以包括弹簧构件(未示出)或用于使推进器构件172返回到初始的缩回位置的其他偏置构件。以这种方式，推进器构件172的推进压缩弹簧，使得第一连接器180和第二连接器182上的张力的释放允许推进器构件172缩回。如上所述，可以结合到第一滑轮构件176和第二滑轮构件178中的弹簧可以是扭转弹簧177(图6)，或以任何其它合适的方式。
在手术操作之后，适配器组件100可以与致动组件20分离，并以传统的方式进行处理。可替代地，适配器组件100可以被灭菌并重复使用。如上所述，钉仓组件152和/或装载单元150可以是可替换的，从而允许适配器组件100的重复使用。
本领域技术人员将理解，在此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例。可以想到，在不脱离本公开的范围的情况下，结合一个示例性实施例示出或描述的元件和特征可以与另一个示例性实施例的元件和特征组合。同样地，本领域技术人员将基于上述实施例来理解本公开的进一步的特征和优点。因此，除了所附权利要求书所指出的内容之外，本公开不受具体地示出和描述的内容的限制。

Claims (17)

1.一种适配器组件，包括：
推进器组件，其包括推进器构件，用于缩回所述推进器构件的牵拉器构件，以及可操作地布置在所述推进器构件和所述牵拉器构件之间的启动组件；
套管针组件，其包括相对于所述推进器组件可操作地布置的套管针构件；
第一驱动组件，其包括用于相对于所述推进器组件推进和缩回所述套管针构件的第一线缆；以及
第二驱动组件，其包括用于缩回所述牵拉器构件以引起所述启动组件的启动的第二线缆，其中所述启动组件的启动引起所述推进器构件的推进。
2.根据权利要求1所述的适配器组件，其中所述启动组件包括第一滑轮构件和第二滑轮构件。
3.根据权利要求2所述的适配器组件，其中所述第一滑轮构件和第二滑轮构件通过相应的第一连接器和第二连接器连接到所述牵拉器构件。
4.根据权利要求3所述的适配器组件，其中所述第一连接器和第二连接器在所述推进器构件推进之前绕着相应的第一滑轮构件和第二滑轮构件缠绕。
5.根据权利要求2所述的适配器组件，其中所述第一滑轮构件和第二滑轮构件中的每一个包括用于接合所述推进器构件的至少第一齿轮。
6.根据权利要求1所述的适配器组件，其中，所述推进器构件被构造为当其推进时吻合组织。
7.根据权利要求1所述的适配器组件，其中所述套管针构件可释放地固定到砧座组件。
8.根据权利要求1所述的适配器组件，进一步包括第三驱动组件，所述第三驱动组件包括连接到所述推进器构件的第三线缆。
9.根据权利要求8所述的适配器组件，其中所述第三驱动组件被构造为在所述推进器构件的操作时引起所述推进器构件的缩回。
10.根据权利要求4所述的适配器组件，其中所述第一滑轮构件和第二滑轮构件中的每一个包括用于保持相应的第一连接器和第二连接器上的张力的涂层。
11.根据权利要求4所述的适配器组件，其中所述第一滑轮构件和第二滑轮构件中的每一个包括用于保持相应的第一连接器和第二连接器上的张力的扭转弹簧。
12.根据权利要求1所述的适配器组件，还包括细长主体和支撑在所述细长主体的近端上的联接组件。
13.根据权利要求12所述的适配器组件，还包括支撑在所述细长主体的远端上的装载单元。
14.根据权利要求13所述的适配器组件，其中所述装载单元包括支撑多个吻合钉的吻合钉钉仓。
15.根据权利要求12所述的适配器组件，其中所述细长主体的至少一部分是柔性的。
16.根据权利要求12所述的适配器组件，其中所述细长主体包括内部柔性线圈和外部护套。
17.一种圆形吻合器，包括：
致动组件；以及
可操作地固定到所述致动组件的根据权利要求1所述的适配器组件。
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