CN107440753B - 内窥镜缝合装置 - Google Patents

内窥镜缝合装置 Download PDF

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CN107440753B
CN107440753B CN201710391510.XA CN201710391510A CN107440753B CN 107440753 B CN107440753 B CN 107440753B CN 201710391510 A CN201710391510 A CN 201710391510A CN 107440753 B CN107440753 B CN 107440753B
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雅各布·巴里尔
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Covidien LP
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066Needles, e.g. needle tip configurations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062Needle manipulators
    • A61B17/0625Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/047Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004Means for attaching suture to needle
    • A61B2017/06047Means for attaching suture to needle located at the middle of the needle
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066Needles, e.g. needle tip configurations
    • A61B2017/0609Needles, e.g. needle tip configurations having sharp tips at both ends, e.g. shuttle needle alternately retained and released by first and second facing jaws of a suturing instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2913Handles transmission of forces to actuating rod or piston cams or guiding means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2913Handles transmission of forces to actuating rod or piston cams or guiding means
    • A61B2017/2915Handles transmission of forces to actuating rod or piston cams or guiding means arcuate shaped guiding means

Abstract

本公开提供一种内窥镜缝合装置,以及一种用于该缝合装置的细长轴组件,细长轴组件包括毂组件和末端执行器。所述毂组件包括插入部分和接合部分。所述插入部分包括:主杆;可旋转毂,其与所述主杆操作地联接,使得所述主杆的轴向移位使所述可旋转毂旋转;和第一和第二臂,所述第一和第二臂与所述可旋转毂操作地联接,使得所述可旋转毂的旋转引起所述第一和第二臂的往复轴向移位。所述接合部分可相对于所述插入部分在再装载位置与已装载位置之间移动,在所述再装载位置,所述可旋转毂处于最远侧位置并且可独立于所述主杆的轴向移位而旋转,在所述已装载位置,所述主杆的轴向移位使所述可旋转毂旋转。

Description

内窥镜缝合装置
相关申请的交叉引用
本申请要求于2016年5月31日提交的美国临时专利申请第62/343,379号的权益和优先权,其全部内容通过引用并入本文。
技术领域
本公开涉及用于缝补或缝合的装置,并且更特别地,涉及用于通过入口管或类似物进行内窥镜缝补和/或缝合的装置。
背景技术
近年来减少手术操作的侵入性的进展之一是内窥镜手术。一般来说,内窥镜手术涉及穿透体壁进行切口。通常,套管针用于创建执行内窥镜手术所穿过的切口。套管针管体或插管装置延伸到腹壁中并留在适当位置以提供用于内镜手术工具的入口。相机或内窥镜插入穿过大致位于脐切口处的较大直径的套管针管体,并且允许对体腔的目视检查和放大。然后,外科医生可以借助于诸如设计成适于穿过额外的插管的镊子、切割器、敷料器等专门的仪器来在手术部位执行诊断和治疗操作。
在许多手术操作中,包括在内窥镜手术中涉及的手术操作中,常常需要缝补身体器官或组织。因为必须穿过小开口完成对身体器官或组织的缝补,所以在内窥镜手术期间缝补可能是挑战性的。相应地,需要简单且有效的用于内窥镜缝补或缝合的装置。
发明内容
本公开描述了一种用于缝补和缝合的装置,其例示出了一种满足性能要求并克服与内窥镜缝补或缝合相关的可用性挑战的实用方法。根据本公开的实施例,提供了一种包括手柄组件和细长轴组件的内窥镜缝合装置。手柄组件包括扳机。细长轴组件包括毂组件和末端执行器。
所述毂组件包括:主杆,其与所述手柄组件的所述扳机操作地相关联;可旋转毂,其与所述主杆操作地联接,使得所述主杆的轴向移位使所述可旋转毂旋转;以及第一和第二臂,所述第一和第二臂与所述可旋转毂操作地联接,使得所述可旋转毂的旋转引起所述第一和第二臂的往复轴向移位。所述末端执行器包括第一和第二钳夹以及可滑动地设置在相应的第一和第二钳夹中的第一和第二针接收刀片。所述第一和第二钳夹与所述毂组件的所述主杆操作地联接,使得所述主杆的轴向移位使所述第一和第二钳夹在打开和闭合位置之间枢转。所述第一和第二针接收刀片与所述毂组件的相应的第一和第二臂操作地联接,使得所述第一和第二臂的往复轴向移位引起所述第一和第二针接收刀片的往复轴向移位。
在实施例中,所述可旋转毂可以限定外凸轮轨道,所述外凸轮轨道被构造为在其中可滑动地接合所述毂组件的所述第一和第二臂。所述外凸轮轨道可以限定螺旋槽。所述外凸轮轨道可以包括远侧和近侧部分,其中所述远侧或近侧部分中的至少一个可以横向于由所述可旋转毂限定的纵向轴线而延伸。
在又一实施例中,所述可旋转毂可以进一步在其内表面中限定内凸轮路径。所述内凸轮路径可以限定一对间隔开的螺旋槽和将所述螺旋槽相互连接的一对相对的轴向定向槽。
在又一实施例中,所述毂组件的所述第一和第二臂可以彼此直径上(diametrically)相对。
在再一实施例中,所述主杆可以包括横向地向外延伸的凸轮销。所述凸轮销可以被构造为滑动通过所述可旋转毂的所述内凸轮路径,以引起所述可旋转毂的旋转。
在另一实施例中,所述手柄组件可以进一步包括与所述毂组件的所述主杆操作地相关联的驱动柱塞,其中所述扳机的致动可以向远侧推进所述驱动柱塞。
在再一实施例中,所述主杆可以可在近侧位置与远侧位置之间移动,在所述近侧位置,所述凸轮销处于所述可旋转毂的近侧,在所述远侧位置,所述凸轮销接收在所述内凸轮路径内。所述主杆可以朝向所述近侧位置偏置。
根据本公开的另一实施例,提供了一种用于内窥镜缝合装置的细长轴组件。所述细长轴组件包括毂组件和末端执行器。所述毂组件包括插入部分和接合部分。所述插入部分被构造为接收在所述内窥镜缝合装置的手柄组件中。所述插入部分包括:主杆;可旋转毂,其与所述主杆操作地联接,使得所述主杆的轴向移位使所述可旋转毂旋转;和第一和第二臂,所述第一和第二臂与所述可旋转毂操作地联接,使得所述可旋转毂的旋转引起所述第一和第二臂的往复轴向移位。所述接合部分可相对于所述插入部分在再装载位置与已装载位置之间移动,在所述再装载位置,所述可旋转毂处于最远侧位置并且可独立于所述主杆的轴向移位而旋转,在所述已装载位置,所述主杆的轴向移位使所述可旋转毂旋转。
所述末端执行器包括:第一和第二钳夹,所述第一和第二钳夹与所述主杆操作地联接,使得所述主杆的轴向移位使所述第一和第二钳夹在打开和闭合位置之间枢转;和第一和第二针接收刀片,所述第一和第二针接收刀片可滑动地设置在相应的第一和第二钳夹中。所述第一和第二针接收刀片与所述毂组件的相应的第一和第二臂操作地联接,使得所述第一和第二臂的往复轴向移位引起所述第一和第二针接收刀片的往复轴向移位。
在实施例中,所述毂组件的所述接合部分可以朝向所述再装载位置偏置。
在另一实施例中,所述毂组件可以进一步包括用于选择性地将所述接合部分固定到所述再装载位置或已装载位置的闩锁。所述插入部分可以限定锁定槽以将所述闩锁固定在其中。所述可旋转毂可以限定锁定凹部以将所述闩锁固定在其中。
附图说明
从结合附图来对以下描述的阅读中,本公开的上述目的、特征和优点将变得更加明显,其中:
图1是根据本公开的实施例的缝合装置的立体图;
图2是图1的缝合装置的手柄组件的横截面图;
图3是图1的缝合装置的立体图,示出了手柄组件和细长轴组件的可拆卸性;
图4是图3的细长轴组件的毂组件的立体图;
图5是图4的毂组件的可旋转毂的俯视图;
图6是图4的可旋转毂的内表面的横截面图,示出了其内凸轮路径;
图7是图4的可旋转毂的内表面的示意图,示出了其内凸轮路径;
图8是图5的可旋转毂的俯视图,以虚线示出了内凸轮路径;
图9是图1的细长轴组件的末端执行器的部分横截面图;
图10是用于图9的末端执行器的钳夹构件的侧视图;以及
图11是根据本公开的实施例的用于图1的缝合装置的毂组件的俯视图。
具体实施方式
现在将参照附图详细描述本公开的实施例,其中在若干视图中的每个中,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”如常规的那样是指器械、设备、装置或其部件的较远离使用者的那部分,而术语“近侧”是指器械、设备、装置或其部件的较靠近使用者的那部分。在下面的描述中,不详细描述公知的功能或结构,以避免以不必要的细节混淆了本公开。
参照图1,本公开的实施例总体示出为缝合装置1000。缝合装置1000适于特别有用于内窥镜或腹腔镜操作,其中诸如末端执行器300的缝合装置1000的内窥镜部分可经由插管组件或类似物(未示出)插入到手术部位中。缝合装置1000包括手柄组件100和从手柄组件100向远侧延伸的细长轴组件200。如下文所述的那样,手柄组件100和细长轴组件200可以可拆卸地联接。这样的构造便于例如缝合装置1000的消毒以及末端执行器300的可互换性。
参照图1和图2,手柄组件100包括可枢转地支撑在壳体102上的扳机104和操作地联接到扳机104的驱动柱塞120。驱动柱塞120可滑动地支撑在壳体102内。驱动柱塞120限定在其近侧部分中形成的向近侧延伸的扳机狭槽120b以操作地接收扳机104的驱动臂104b。扳机狭槽120b限定远侧表面或壁120c,扳机104的驱动臂104b的远侧表面抵靠该远侧表面或壁120c,以便在扳机104的致动期间向远侧推进驱动柱塞120。
手柄组件100进一步包括经由枢轴销132而枢转地支撑在壳体102上并连接到壳体102的内窥镜组件释放杆130。释放杆130包括向枢轴销132的远侧延伸的远侧130b。释放杆130的远侧130b包括在朝向驱动柱塞120的方向上从其突出的钩或齿130d。钩130d可以位于驱动柱塞120的远侧。可以提供例如板簧(leaf spring)形式的偏置构件134以将钩130d朝向驱动柱塞120偏置。偏压构件134保持释放杆130的钩130d与内窥镜组件200的环形凹部212c(图3)接合。手柄组件100可以进一步包括旋钮160,旋钮160可旋转地支撑在壳体102上以实现末端执行器300的伴随旋转。可以参考题为“Endoscopic Surgical Clip Applier”(“内窥镜手术施夹器”)的美国专利第7,905,890号或于2015年11月10日提交的题为“Endoscopic Reposable Surgical Clip Applier”(“内窥镜可再用手术施夹器”)的美国临时专利申请第62/253,162号,它们的每一个的全部内容通过引用并入本文,用于详细讨论手柄组件的结构和操作。
参照图3和图4,细长轴组件200可从手柄组件100拆卸。细长轴组件200包括毂组件210、细长轴220以及与手柄组件100的扳机104操作地联接的末端执行器300。毂组件210用作用于选择性地连接到手柄组件100的旋钮160的接合器组件。毂组件210包括插入部分210a和从插入部分210a向远侧延伸的接合部分210b。插入部分210a被构造为接收在手柄组件100内。当插入部分210a与手柄组件100固定时,接合部分210b邻近旋钮160而设置。
插入部分210a可以限定环形凹部212c,环形凹部212c被构造为可拆卸地接收释放杆130的钩130d(图2)以将细长轴组件200与手柄组件100固定。此外,插入部分210a包括周向地布置的肋212d(图4)。互补槽160b(图3)被限定在手柄组件100的旋钮160中,使得肋212d在细长轴组件200和手柄组件100的连接期间可滑动地接收在手柄组件100的旋钮160的相应的槽160b中。细长轴组件200的毂组件210与手柄组件100的旋钮160的连接使得细长轴组件200能够绕其纵向轴线相对于手柄组件100旋转。
参照图4和图5,毂组件210的插入部分210a包括驱动转换组件400,驱动转换组件400被构造为将手柄组件100的驱动柱塞120的轴向移位转换成可旋转毂405的旋转,以便提供主杆156的轴向输出和在相反方向上往复的第一臂420和第二臂422的轴向输出。如下文所将论述的,主杆156操作地联接到末端执行器300的钳夹130、132,并且可旋转毂405(即,第一臂420和第二臂422)操作地联接到末端执行器300的一对针接合构件或刀片150、152(图9)。
毂组件210限定近侧开口212e,近侧开口212e被构造为当细长轴组件200联接到手柄组件100时可滑动地接收手柄组件100的驱动柱塞120。主杆156包括被构造为接合手柄组件100的驱动柱塞120的近侧端156a和连接到末端执行器300的钳夹130、132(图9)的远侧端(未示出)。主杆156包括横向向外延伸的凸轮销401。诸如压缩弹簧的偏置构件403介于主杆156的近侧端156a与可旋转毂405之间,使得主杆156朝向初始位置偏置。
现在继续参照图4和图5,可旋转毂405被构造为可旋转地设置在毂组件210内。可旋转毂405限定管腔407,管腔407被构造为可滑动地接收穿过其的主杆156。可旋转毂405在其外表面中限定具有例如螺旋槽或螺线槽的形式的外凸轮轨道409(图5),并且在其内表面上限定内凸轮路径411(图6)。
参照图5至图7,外凸轮轨道409的远侧端和近侧端可以横向于可旋转毂405的纵向轴线“X-X”(图5)延伸。内凸轮路径411限定在可旋转毂405(图5)的内表面中形成的一对间隔开的螺旋槽411a以及在可旋转毂405的内表面中形成的并且将螺旋槽411a相互连接的一对相对的轴向定向的槽411b。
参照图8,毂组件210进一步包括与末端执行器300的刀片150、152(图9)操作地联接的第一臂420和第二臂422。第一臂420和第二臂422彼此直径上相对。第一臂420和第二臂422包括可滑动地接收在可旋转毂405的外凸轮轨道409中的相应的凸台420a、422a。从主杆156横向延伸的凸轮销401的尺寸设计成可滑动地接合在可旋转毂405的内凸轮路径411中。在这种构造下,当主杆156向远侧推进时,钳夹130、132转变到闭合位置,并且凸轮销401可滑动地接合内凸轮路径411,进而使可旋转毂405旋转。随着可旋转毂405旋转,第一臂420和第二臂422的相应的凸台420a、422a骑行在可旋转毂405的外凸轮轨道409内,并在相反的方向上轴向地移位。第一臂420和第二臂422的在相反方向上的轴向移位引起末端执行器300的刀片150、152(图9)的往复运动。以这种方式,扳机104的单独致动引起主杆156的轴向移位和第一臂420和第二臂422的往复移位这两者,其分别实现钳夹130、132的打开和闭合以及刀片150、152的往复轴向移位。
参照图9,细长轴组件200包括末端执行器300。末端执行器300包括支撑构件122和借助钳夹枢转销134可枢转地安装在支撑构件122上的钳夹130、132。为了在打开位置和闭合位置之间移动钳夹130、132,主杆156具有安装在其远侧端156a处的凸轮销(未示出)。凸轮销138骑行在限定在相应的钳夹130、132中的成一定角度的凸轮狭槽130c(图10)中,使得主杆156的轴向或纵向移动引起钳夹130、132在打开位置和闭合位置之间做凸轮式运动。例如,当主杆156向远侧推进时,钳夹130、132转变到闭合位置。
末端执行器300进一步包括可滑动地支撑在支撑构件122内的一对针接合构件或刀片150、152。每个刀片150、152包括远侧端150a、152a,远侧端150a、152a可滑动地延伸到相应的钳夹130、132的刀片接收通道130d、132d中。通道130d,132d的尺寸被设计成至少部分地与针凹部130a、132a相交。从而,当针107的至少一部分被接收到相应的针凹部130a、132a内时,通过在相应的通道130d、132d内推进刀片150或152,推进的刀片150、152的远侧端150a、152a接合针107中形成的槽107a或“锁定”在槽107a中。缝线(未示出)可以固定到针107。缝线可以包括定向成阻碍在与行进方向相反的方向上移动的多个倒钩。
参照图3和图4,在使用中,毂组件210的插入部分210a接收在手柄组件100中,使得释放杆130的钩130d(图2)牢固地接合被限定在毂组件210的插入部分210a中的环形凹部212c。此时,驱动柱塞120的一部分穿过毂组件210的近侧开口212e而被接收。
参照图9,最初,形成在相应的刀片150、152中的凹口(未示出)与限定在相应的钳夹130、132中的相应的针凹部130a、132a对准或配准。在刀片150、152的凹口与相应的钳夹130、132的相应的针凹部130a、132a对准或配准的状态下,针107可以被定位或装载到钳夹130、132的被选定的一个针凹部130a、132a中。
一旦针107被装载到钳夹130、132的针凹部130a、132a中的一个中,扳机104即被致动以使可旋转毂405旋转,这进而引起第一臂420和第二臂422的往复轴向移位(图4),使得仅刀片150、152中的一个与针107接合,而刀片150、152中的另一个与针107脱离。在仅刀片150、152中的一个与针10接合的状态下,扳机104可以被释放,从而使主杆156向近侧移动以打开钳夹130、132。
在钳夹130、132处于打开位置并且针107装载并保持在一个钳夹130或132中的状态下,钳夹130、132可被定位在目标组织周围或上方,并且手柄110可被致动以使钳夹130、132接近。随着钳夹130、132接近,针107的暴露端穿透目标组织并且进入相对的钳夹130或132。在针107处于相对的钳夹130或132中的状态下,随着主杆156被进一步推进,刀片150、152调换。在这样做时,针107从一个刀片150或152交换到另一个刀片150或152,从而被装载或保持在另一个钳夹130或132中。
在针107从一个刀片150、152交换到另一个刀片150、152的状态下,扳机104可以被释放,从而使钳夹130、132打开,并且牵引针107穿过目标组织。在这样做时,缝线也被牵引穿过组织。重复该过程:将针107经过钳夹130、132之间,并且牵引缝线穿过目标组织,从而根据需要或期望来缝补目标组织。
现在参照图11,示出了根据本公开的另一实施例的毂组件510。毂组件510包括与关于毂组件210所描述的特征相同的特征。从而,毂组件510中的相同部分将不在这里进行描述,以避免以不必要的细节混淆本公开。
毂组件510包括插入部分510a和插入部分510a的远侧的接合部分510b。插入部分510a被构造为被接收在手柄组件100内。当与手柄组件100联接时,接合部分510b邻近旋钮160(图3)而设置。毂组件510进一步包括再装载机构550,再装载机构550被构造为将末端执行器300的刀片150、152(图9)转变到再装载模式。在再装载模式中,相应的钳夹130、132的每个刀片150、152处于最远侧位置。以这种方式,形成在相应的刀片150、152中的凹口(未示出)与限定在相应的钳夹130、132中的相应的针凹部130a、132a对准或配准。在刀片150、152的凹口与相应的钳夹130、132的相应的针凹部130a、132a对准或配准的状态下,针107(图2)可以被定位或装载到钳夹130、132的被选定的一个针凹部130a、132a中。
接合部分510b可相对于插入部分510a移动。再装载机构550包括闩锁552,闩锁552被构造为接收在可旋转毂505的锁定凹部560或限定在插入部分510a中的锁定槽554中,由此接合部550b可在再装载位置与已装载位置之间转变,在再装载位置,闩锁552被接收在限定在可旋转毂505中的锁定凹部560中,在已装载位置,接合部分510b被向近侧拉动,使得闩锁552被接收在插入部分510a的锁定槽554中。当闩锁552被接收在限定在可旋转毂505中的锁定凹部560中时,可以禁止接合部分510b与可旋转毂505之间的相对旋转。
在再装载位置,可旋转毂505处于最远侧位置。此时,主杆156上的凸轮销509设置在可旋转毂505或限定在可旋转毂505的内表面中的内凸轮路径(未示出)的近侧,使得可旋转毂505可独立于主杆156的轴向移位而旋转。位于最远侧位置的可旋转毂505使相应的钳夹130、132的刀片150、152(图2)能够处于最远侧位置,这进而使针107能够装载到钳夹130、132的被选定的一个针凹部130a、132a中。在已装载位置,凸轮销509设置在可旋转毂505的内凸轮路径中,由此主杆156的轴向移位引起钳夹130、132在打开和闭合位置之间的转变以及刀片150、152的在相反方向上的往复轴向移位。毂组件510可以进一步包括诸如压缩弹簧的偏置构件513,以朝向再装载位置偏置可旋转毂505。
毂组件510的插入部分510a包括驱动转换组件500,驱动转换组件500被构造为将手柄组件100的驱动柱塞120的轴向移位转换成主杆156的轴向移位和可旋转毂505的旋转。主杆156操作地联接到末端执行器300的钳夹130、132,并且可旋转毂505操作地联接到末端执行器300的刀片150、152(图9)。
在使用中,缝合装置1000首先通过释放闩锁552并且向远侧滑动接合部分510b而转变到再装载模式,使得两个刀片150、152(图9)处于最远侧位置。以这种方式,形成在相应的刀片150、152中的凹口(未示出)与限定在相应的钳夹130、132中的相应的针凹部130a、132a对准或配准。在刀片150、152的凹口与相应的钳夹130、132的相应的针凹部130a、132a对准或配准的状态下,针107(图9)可以被定位或装载到钳夹130、132的被选定的一个针凹部130a、132a中。
此时,毂组件510的插入部分510a接收在手柄组件100中,使得释放杆130的钩130d牢固地接合限定在毂组件510的插入部分510a的环形凹部512c。此时,驱动柱塞120的一部分被接收在毂组件510的近侧开口512e中。
此时,可以挤压扳机104(图1)以引起主杆156的轴向移位,这进而将钳夹130、132转变到闭合位置,并且使可旋转毂505旋转,使得仅刀片150、152中的一个与针107(图2)接合,而另一个刀片150、152与针107脱离。当扳机104被释放时,主杆156向近侧移位,这进而使钳夹130、132打开。
在钳夹130、132处于打开位置并且针107装载并保持在一个钳夹130或132中的状态下,钳夹130、132可以位于目标组织周围或上方,并且扳机104可被致动以使钳夹130、132接近。随着钳夹130、132接近,针107的暴露端穿透目标组织并且进入相对的钳夹130或132。在针107处于相对的钳夹130或132中的状态下,杆182再次被致动或旋转,使得刀片150、152调换。在这样做时,针107从一个刀片150或152交换到另一个刀片150或152,从而被装载或保持在另一个钳夹130或132中。
在针107从一个刀片150、152交换到另一个刀片150、152的状态下,手柄110可以被释放,从而使钳夹130、132打开并且牵引针107穿过目标组织。在这样做时,缝线也被牵引穿过组织。重复该过程:将针107经过钳夹130、132之间,并且牵引缝线穿过目标组织,从而根据需要或期望来缝补目标组织。
尽管已经参照附图描述了本公开的示例性实施例,但是上述的描述、公开和附图不应被解释为限制性的,而仅仅是特定实施例的示例。例如,细长轴组件200可以包括可关节式运动部分,以便于缝合装置穿过患者的解剖结构的可操作性。应当理解,本公开不限于这些精确的实施例,并且在不偏离本公开的范围或精神的情况下,本领域技术人员可以对其进行各种其它改变和变型。

Claims (22)

1.一种内窥镜缝合装置,包括:
手柄组件,其包括:扳机;和
细长轴组件,所述细长轴组件包括:
毂组件,其包括:
主杆,其包括横向地向外延伸的凸轮销并且与所述手柄组件的所述扳机操作地相关联;
可旋转毂,其与所述主杆操作地联接,使得所述主杆的轴向移位使所述可旋转毂旋转;以及
第一和第二臂,所述第一和第二臂与所述可旋转毂操作地联接,使得所述可旋转毂的旋转引起所述第一和第二臂的往复轴向移位;和
末端执行器,其包括:
第一和第二钳夹,所述第一和第二钳夹与所述毂组件的所述主杆操作地联接,使得所述主杆在第一状态和第二状态之间的轴向移位使所述第一和第二钳夹在打开和闭合位置之间枢转,在所述第一状态中,所述主杆的所述凸轮销设置在可旋转毂外并且所述可旋转毂能够独立于所述主杆的轴向移位而旋转,在所述第二状态中,所述凸轮销设置在所述可旋转毂内;和
第一和第二针接收刀片,所述第一和第二针接收刀片能够滑动地设置在相应的第一和第二钳夹中,所述第一和第二针接收刀片与所述毂组件的相应的第一和第二臂操作地联接,使得所述第一和第二臂的往复轴向移位引起所述第一和第二针接收刀片的往复轴向移位。
2.根据权利要求1所述的内窥镜缝合装置,其中所述可旋转毂限定外凸轮轨道,所述外凸轮轨道被构造为在其中能够滑动地接合所述毂组件的所述第一和第二臂。
3.根据权利要求1所述的内窥镜缝合装置,其中所述毂组件的所述第一和第二臂彼此直径上相对。
4.根据权利要求2所述的内窥镜缝合装置,其中所述外凸轮轨道限定螺旋槽。
5.根据权利要求4所述的内窥镜缝合装置,其中所述外凸轮轨道包括远侧和近侧部分,所述远侧或近侧部分中的至少一个横向于由所述可旋转毂限定的纵向轴线而延伸。
6.根据权利要求2所述的内窥镜缝合装置,其中所述可旋转毂进一步在其内表面中限定内凸轮路径。
7.根据权利要求6所述的内窥镜缝合装置,其中所述主杆的所述凸轮销被构造为滑动通过所述可旋转毂的所述内凸轮路径,以引起所述可旋转毂的旋转。
8.根据权利要求6所述的内窥镜缝合装置,其中所述内凸轮路径限定一对间隔开的螺旋槽和将所述螺旋槽相互连接的一对相对的轴向定向槽。
9.根据权利要求2所述的内窥镜缝合装置,其中所述手柄组件进一步包括与所述毂组件的所述主杆操作地相关联的驱动柱塞,其中所述扳机的致动向远侧推进所述驱动柱塞。
10.根据权利要求7所述的内窥镜缝合装置,其中所述主杆能够在近侧位置与远侧位置之间移动,在所述近侧位置,所述凸轮销处于所述可旋转毂的近侧,在所述远侧位置,所述凸轮销接收在所述内凸轮路径内。
11.根据权利要求10所述的内窥镜缝合装置,其中所述主杆朝向所述近侧位置偏置。
12.一种用于内窥镜缝合装置的细长轴组件,包括:
毂组件,其包括:
插入部分,其被构造为接收在所述内窥镜缝合装置的手柄组件中,所述插入部分包括:
主杆,其包括横向地向外延伸的凸轮销;
可旋转毂,其与所述主杆操作地联接,使得所述主杆的轴向移位使所述可旋转毂旋转;以及
第一和第二臂,所述第一和第二臂与所述可旋转毂操作地联接,使得所述可旋转毂的旋转引起所述第一和第二臂的往复轴向移位;和
接合部分,其能够相对于所述插入部分在再装载位置与已装载位置之间移动,在所述再装载位置,所述可旋转毂处于最远侧位置并且能够独立于所述主杆的轴向移位而旋转,在所述已装载位置,所述主杆的轴向移位使所述可旋转毂旋转;和
末端执行器,其包括:
第一和第二钳夹,所述第一和第二钳夹与所述主杆操作地联接,使得所述主杆在第一状态和第二状态之间的轴向移位使所述第一和第二钳夹在打开和闭合位置之间枢转,在所述第一状态中,所述主杆的所述凸轮销设置在可旋转毂外,在所述第二状态中,所述凸轮销设置在所述可旋转毂内;和
第一和第二针接收刀片,所述第一和第二针接收刀片能够滑动地设置在相应的第一和第二钳夹中,所述第一和第二针接收刀片与所述毂组件的相应的第一和第二臂操作地联接,使得所述第一和第二臂的往复轴向移位引起所述第一和第二针接收刀片的往复轴向移位。
13.根据权利要求12所述的细长轴组件,其中所述毂组件的所述接合部分朝向所述再装载位置偏置。
14.根据权利要求12所述的细长轴组件,其中所述毂组件进一步包括用于选择性地将所述接合部分固定到所述再装载位置或所述已装载位置的闩锁。
15.根据权利要求13所述的细长轴组件,其中所述可旋转毂限定外凸轮轨道,所述外凸轮轨道被构造为在其中能够滑动地接合所述毂组件的所述第一和第二臂。
16.根据权利要求15所述的细长轴组件,其中所述可旋转毂进一步在其内表面中限定内凸轮路径。
17.根据权利要求16所述的细长轴组件,其中所述主杆的所述凸轮销被构造为滑动通过所述可旋转毂的所述内凸轮路径以引起所述可旋转毂的旋转。
18.根据权利要求17所述的细长轴组件,其中所述主杆能够在近侧位置与远侧位置之间旋转,在所述近侧位置,所述凸轮销处于所述可旋转毂的近侧,在所述远侧位置,所述凸轮销接合在所述内凸轮路径内。
19.根据权利要求18所述的细长轴组件,其中所述主杆朝向所述近侧位置偏置。
20.根据权利要求14所述的细长轴组件,其中所述插入部分限定锁定槽以将所述闩锁固定在其中。
21.根据权利要求14所述的细长轴组件,其中所述可旋转毂限定锁定凹部以将所述闩锁固定在其中。
22.根据权利要求12所述的细长轴组件,其中所述末端执行器的所述第一和第二钳夹与所述主杆操作地联接,使得所述主杆的向远侧移位使所述第一和第二钳夹接近。
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