CN107635481A - 小直径外科手术缝合装置 - Google Patents

小直径外科手术缝合装置 Download PDF

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CN107635481A
CN107635481A CN201580080735.2A CN201580080735A CN107635481A CN 107635481 A CN107635481 A CN 107635481A CN 201580080735 A CN201580080735 A CN 201580080735A CN 107635481 A CN107635481 A CN 107635481A
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nail bin
anvil body
surgical operation
suturing device
anvil
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CN107635481B (zh
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王兆凯
张江峰
张细良
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Nellcor Puritan Bennett LLC
Covidien LP
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    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2944—Translation of jaw members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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Abstract

外科手术缝合装置(10)包括具有近侧主体部分(70)和远侧通道部分(74)的外管(14)。近侧主体部分(70)的远端(80)限定一对切口(82)。砧座组件(22)包括砧座主体(26)，所述砧座主体限定组织接触表面(30)以及支撑在切口(82)内的一对枢转构件(40)。钉仓(44)被支撑在外管(14)的远侧通道部分(74)中并且限定组织接触表面(44a)。切口(82)的尺寸被设定为允许枢转构件(40)在切口(82)内移动，以允许砧座主体(26)的组织接触表面(30)相对于钉仓(44)的组织接触表面(44a)从“停放位置”移动到“夹紧位置”，在所述“停放位置”中，组织接触表面(30、44a)并列接合，在所述“夹紧位置”中，组织接触表面(30、44a)限定组织间隙(G)。提供由金属片形成的驱动构件(62)，并包括上延伸构件(90)和下延伸构件(92)，所述上延伸构件和下延伸构件定位成接合砧座主体(26)和远侧通道部分(74)，以在砧座主体(26)和钉仓(44)的组织接触表面(30、44a)之间限定最大组织间隙(G)。

Description

小直径外科手术缝合装置
技术领域
本发明涉及外科手术缝合装置，并且更具体地涉及用于腹腔镜或内窥镜用途的外科手术缝合装置。
背景技术
用于缝合组织的外科手术缝合装置通常包括具有钉仓、砧座和刀的工具组件，该刀可以被致动以实现组织的同时解剖和缝合。当与传统的用线手工缝合组织的方法相比时，使用外科手术缝合装置缝合和解剖组织已经提高了缝合手术的速度，从而最大限度地降低患者创伤。
在内窥镜外科手术中，通过皮肤中的小切口或通过套管插入外科手术缝合器以进入手术部位。由于已知外科手术缝合装置的复杂性，故对小直径外科手术缝合装置存在持续需求，该小直径外科手术缝合装置适合于插入穿过小直径套管(例如5mm套管)，并且可以有效地缝合和解剖组织。
发明内容
本发明涉及可以插入穿过小直径套管的小直径外科手术缝合装置。缝合装置包括钉仓组件以及经由浮动枢转构件相对于钉仓组件可枢转地支撑的砧座。这种布置允许砧座定位于“停放位置”，其中砧座与钉仓组件并列接合。在停放位置中，缝合装置的尺寸被最小化，使其可以插入穿过小直径套管。
更具体地，本发明在一个方面提供了一种外科手术缝合装置，其包括外管、工具组件和驱动构件。外管具有近侧主体部分和远侧通道部分。近侧主体部分的远端限定切口，并且通道部分具有外表面。工具组件具有砧座组件，该砧座组件包括砧座主体，该砧座主体限定纵向轴线并具有外表面、组织接触表面和位于组织接触表面近侧的一对枢转构件。枢转构件可枢转地容纳在外管的近侧主体部分的切口内。钉仓组件包括钉仓和多个钉。钉仓限定纵向轴线、组织接触表面和多个钉保持凹腔。每个钉保持凹腔支撑多个钉中的一个。钉仓被支撑在外管的远侧通道部分内。砧座主体相对于钉仓可枢转地支撑在外管上，使得工具组件能够在闭合位置与打开位置之间移动，在闭合位置中，砧座主体和钉仓的纵向轴线是平行的，在打开位置中，砧座主体和钉仓的纵向轴线限定锐角。驱动构件被支撑在钉仓内并且能够平移穿过钉仓以从钉仓弹出多个钉。切口的尺寸被设定为允许枢转构件在切口内移动，使得当工具组件处于闭合位置时，砧座主体可相对于钉仓定位于“停放位置”到“夹紧位置”，在停放位置中，砧座主体和钉仓的接触表面并列接合，在夹紧位置中，砧座主体和钉仓的接触表面间隔开以限定组织间隙。
在一些实施例中，外管支撑联接构件，该联接构件适于将外科手术缝合装置可释放地固定到用于实现驱动构件的移动的致动器。
在某些实施例中，驱动构件包括具有上径向延伸构件和下径向延伸构件的远侧工作部分。上径向延伸构件定位成接合砧座主体的外表面，并且下径向延伸构件定位成接合外管的远侧通道部分的外表面。
在实施例中，砧座主体、钉仓和远侧通道部分各自限定纵向狭槽，并且驱动构件的工作部分具有包括垂直支柱的工字梁构造，该垂直支柱延伸穿过砧座主体、钉仓和远侧通道部分的狭槽。
在一些实施例中，上径向延伸构件和下径向延伸构件包括一对上径向延伸构件和一对下径向延伸构件。
在某些实施例中，该对上径向延伸构件中的一个在第一方向上从垂直支柱横向地延伸，并且该对上径向延伸构件中的另一个在与第一方向相反的第二方向上从垂直支柱延伸。此外，该对下径向延伸构件中的一个在第一方向上从垂直支柱横向地延伸，并且该对下径向延伸构件中的另一个在与第一方向相反的第二方向上从垂直支柱延伸。
在实施例中，驱动构件由金属片形成。
在一些实施例中，驱动构件支撑适于将驱动构件可释放地联接到致动器的连接器。
在某些实施例中，该对上径向延伸构件中的一个定位于该对径向延伸构件中的另一个的远侧，并且该对下径向延伸构件中的一个定位于该对下径向延伸构件中的另一个的远侧。
在实施例中，钉仓组件进一步包括多个推进器和滑动件。多个钉中的每一个与相应的推进器相关联，并且滑动件能够响应于驱动构件的远侧运动平移穿过钉仓而与推进器按顺序接合，以从钉仓弹出多个钉。
在一些实施例中，提供用于将工具组件推向打开位置的偏置构件。
本发明在另一方面提供了一种外科手术缝合装置，其包括外管、工具组件和驱动构件。外管具有近侧主体部分和具有外表面的远侧通道部分。工具组件包括砧座组件和钉仓组件。砧座组件包括限定纵向轴线的砧座主体。砧座主体具有外表面、组织接触表面和位于组织接触表面近侧的一对枢转构件。钉仓组件包括钉仓和多个钉。钉仓限定纵向轴线、组织接触表面和多个钉保持凹腔。每个钉保持凹腔支撑多个钉中的一个。钉仓被支撑在外管的远侧通道部分内，并且砧座主体相对于钉仓可枢转地支撑在外管上，使得工具组件能够在闭合位置与打开位置之间移动，在闭合位置中，砧座主体和钉仓的纵向轴线是平行的，在打开位置中，砧座主体和钉仓的纵向轴线限定锐角。驱动构件被支撑在钉仓内并且能够平移穿过钉仓以从钉仓弹出多个钉。驱动构件包括由金属片形成的主体，该主体具有包括一对上径向延伸构件和一对下径向延伸构件的远侧工作部分。该对上径向延伸构件和该对下径向延伸构件通过弯曲金属片的上边缘和下边缘而形成。
在实施例中，近侧主体部分的远端限定切口，并且枢转构件可枢转地容纳在切口内。
在一些实施例中，该对上径向延伸构件被定位成接合砧座主体的外表面，并且该对下径向延伸构件被定位成接合外管的通道部分的外表面以在砧座处于闭合位置时限定砧座主体和钉仓的组织接触表面之间的最大组织间隙。
在某些实施例中，砧座主体、钉仓和远侧通道部分均限定纵向狭槽，并且驱动构件的工作部分具有包括垂直支柱的工字梁构造，该垂直支柱延伸穿过砧座、钉仓和远侧通道部分的狭槽。
在一些实施例中，该对上径向延伸构件中的一个在第一方向上从垂直支柱横向地延伸，并且该对上径向延伸构件中的另一个在与第一方向相反的第二方向上从垂直支柱延伸，并且其中该对下径向延伸构件中的一个在第一方向上从垂直支柱横向地延伸，并且该对下径向延伸构件中的另一个在与第一方向相反的第二方向上从垂直支柱延伸。
在某些实施例中，该对上径向延伸构件中的一个定位于该对径向延伸构件中的另一个的远侧，并且该对下径向延伸构件中的一个定位于该对下径向延伸构件中的另一个的远侧。
在实施例中，切口的尺寸被设定为允许枢转构件在切口内移动，使得当工具组件处于闭合位置时，砧座主体可相对于钉仓从“停放位置”移动到夹紧位置，在停放位置中，砧座主体和钉仓的组织接触表面并列接合，在夹紧位置中，砧座主体和钉仓的组织接触表面间隔开以限定组织间隙。
在实施例中，提供用于将工具组件推向打开位置的偏置构件。
附图说明
本文参考附图描述目前公开的外科手术缝合装置的各种实施例，其中：
图1是呈再装件形式的目前公开的外科手术缝合装置的一个实施例的侧视透视图，其中工具组件处于打开位置；
图2是图1中所示的指定细节区域的放大图；
图3是固定到动力手柄组件的图1中所示的再装件的侧视透视图；
图4是图1中所示的再装件的侧视透视分解图；
图5是图1中所示的再装件的砧座的近端和外管的中心部分的侧视透视剖视图，其中部件分离；
图6是图1中所示的再装件的中心部分的侧视透视图；
图7是图6中所示的再装件的中心部分的侧视透视图，其中外管以虚线示出；
图8是包括工字梁和滑动件的刀杆的远端的侧视透视图，其中部件分离；
图9是图1中所示的再装件的侧视图，其中工具组件处于停放位置；
图10是图9中所示的再装件的侧视图，再装件插入5mm套管针中；
图10A是图9中所示的再装件的俯视图；
图11是图10中所示的指定细节区域的放大图；
图12是沿着图10A的剖面线12-12截取的横截面图；
图13是图1中所示的再装件的远端的侧视图，其中工具组件处于打开位置；
图14是图13中所示的指定细节的放大图；
图15是图1中所示的再装件的远端的侧视图，其中工具组件处于夹紧位置；
图16是图15所示的指定细节区域的放大图；
图17是示出了处于夹紧位置的工字梁的再装件中心部分的侧视剖视图。
图18是图1中所示的再装件的远端的侧视透视图，其中工具组件处于夹紧位置；
图19是图18中所示的指定细节区域的放大图；
图20是图1中所示的再装件的远端的仰视透视图，其中工具组件处于夹紧位置；
图21是图1中所示的再装件的远端的仰视透视图，其中工具组件处于夹紧位置并且外管移除；
图22是沿着图21的剖面线22-22截取的侧视剖视图；以及
图23是在再装件的做功冲程期间的图1中所示的再装件的工具组件的侧视横截面图。
具体实施方式
现在将参考附图详细描述目前公开的外科手术缝合装置的实施例，其中在若干视图中的每一个视图中，相同的附图标记表示相同或相应的元件。在本说明书中，术语“临床医生”通常用于指医务人员，包括医生、护士和支援人员。另外，术语“内窥镜”手术通常用于指通过小切口或插入患者体内的套管执行的内窥镜手术、腹腔镜手术、关节镜手术和任何其它外科手术。最后，术语“近侧”通常用于指靠近临床医生的设备部分，而术语“远侧”通常用于指远离临床医师的设备部分。
本发明涉及一种小直径外科手术缝合装置，其可插入穿过小直径套管(例如5mm套管)。缝合装置包括钉仓组件和经由浮动枢转构件相对于钉仓组件可枢转地支撑的砧座。浮动枢转构件允许砧座定位于“停放位置”，其中砧座与钉仓组件并列接合，如将在下文详细讨论。外科手术缝合装置还包括由金属片形成的小尺寸的驱动构件。
图1至图3示出了目前公开的外科手术缝合装置的一个实施例，其通常以10示出。外科手术缝合装置10呈再装件的形式示出，其适于可释放地联接到致动装置12(图3)。可选地，再装件10可以固定地固定到致动装置12的远端。在实施例中，致动装置12可以是如图3所示的动力致动装置。可选地，致动装置12可以是手动致动的致动装置、机器人控制的致动装置或被配置成操作缝合装置10的任何其它合适的手动或电动装置。
再装件10包括外管14、联接构件16和工具组件18。联接构件16限定纵向孔16a(图4)，该纵向孔固定地容纳外管14的近端并且包括一对直径上相对的凸块20。凸块20被构造成接合致动装置12的远端(图3)以将再装件10固定到致动装置12，诸如美国专利第8,070,033号(“‘033专利”)中所公开，其全部内容以引用方式并入本文。可选地，联接构件16可以与外管14一体地形成。
参考图4，工具组件18包括砧座组件22和钉仓组件24。砧座组件22包括砧座主体26和盖28。砧座主体26包括限定多个钉变形凹部32(图22)的内组织接触表面30、外凸轮表面26a和限定纵向凹槽36的外表面34，下文将详细描述。细长的狭槽38从邻近砧座主体26的远端的位置延伸穿过砧座主体26到砧座主体26的近端。砧座主体26的近端包括一对枢转构件40，下文将详细描述。
钉仓组件24包括钉仓44、多个钉46以及多个钉推进器48。钉仓44限定多个钉保持狭槽50。每个钉保持狭槽50支撑多个钉仓中的一个并且与多个推进器48中的一个相关联，使得推进器48相对于保持狭槽50移动而从保持狭槽50弹出钉46。为了更详细地描述推进器48与钉46之间的相互作用，参见‘033专利。钉仓44还限定纵向狭槽60，其容纳驱动构件62的远端，如下文详细描述。
还参考图4和图6，外管14包括近侧主体部分70和远侧主体部分72。在实施例中，外管14基本上是刚性的并且可以由金属诸如不锈钢形成。可选地，外管14可以由适合于医疗用途的其它基本上刚性的材料形成。
在实施例中，近侧主体部分70基本上是圆柱形的，并且尺寸被设定为可滑动地容纳驱动构件62。近侧主体部分70的远端80限定了下文详细描述的上狭槽和下狭槽73。远侧主体部分72基本上是U形的，并且限定容纳钉仓组件24的通道部分74。远侧主体部分72包括定位成支撑钉仓44的外壁的侧壁72a。钉仓44可以有摩擦地保持在通道部分74内。可选地，钉仓44可以使用互锁和/或搭扣配合连接保持在通道部分74内。远侧主体部分72的底壁76限定纵向狭槽78，该纵向狭槽与砧座主体26中的狭槽38以及与钉仓44中的狭槽60对准，使得驱动构件62延伸穿过狭槽38、60和78中的每一个，如下文所述。
近侧主体部分70具有限定一对间隔开的切口82的远端80，该对间隔开的切口的尺寸被设定为容纳砧座主体26的枢转构件40。枢转构件40容纳在相应的切口82内以便于砧座组件22相对于钉仓组件24的枢转运动并且允许工具组件从“打开位置”移动到“闭合位置”，在打开位置中，砧座组件22和钉仓组件24的纵向轴线限定锐角，在闭合位置中，砧座组件22和钉仓组件24的纵向轴线基本上是平行的。在实施例中，切口82相对于枢转构件40过大，使得枢转构件40能够在切口82内垂直移动。枢转构件40在外管14的切口82内的垂直运动允许在工具组件18处于“闭合位置”时，砧座主体26的近端相对于钉仓组件24移动，以允许砧座主体26在“停放位置”与“夹紧位置”之间移动，在停放位置中，砧座主体26与钉仓组件24并列接合，在夹紧位置中，砧座主体26和钉仓组件24限定组织间隙。
参考图4、图7和图8，驱动构件62是细长的并且具有小厚度，以便于分别移动通过砧座主体26、钉仓44和远侧主体部分72的纵向槽38、60和78。驱动构件62的远端62a支撑刀片86。在实施例中，刀片86被机械加工到驱动构件62的远端中。可选地，刀片86可以与驱动构件62分开地形成，并且例如通过焊接等固定到驱动构件62。驱动构件62包括工作远端部分62a，该工作远端部分具有包括垂直支柱89以及一对上延伸构件90和下延伸构件92的工字梁构造。上延伸构件90定位成沿着砧座主体26的外表面在槽36内滑动。上延伸构件90与形成于砧座主体26的近端上的凸轮表面26a的接合导致工具组件18从“打开位置”(图1)移动到“夹紧位置”(图16)。砧座组件22的盖28将凹槽34内的上延伸构件90封围。下延伸构件92被定位成沿着外管14的远端主体部分72的外表面滑动。在实施例中，驱动构件62由金属片形成并且变形以形成上延伸构件90和下延伸构件92，并且被机械加工以限定刀片86。更具体地，形成驱动构件62的远端62a的金属片的上端和下端可以向外弯曲以限定上延伸构件90和下延伸构件92。
驱动构件62的近端62b(图4)支撑连接器94。连接器94限定纵向狭槽96，该纵向狭槽容纳驱动构件62以将驱动构件62固定到连接器94。连接器94被构造成可释放地接合致动装置12(图3)的驱动轴(未示出)。有关合适的连接器94的更详细的讨论，参见‘033专利。
滑动件100在驱动构件62的远端62a远侧的位置处被支撑在钉仓44内。滑动件100包括凸轮构件102，该凸轮构件构造成平移穿过限定在钉仓44内的通道(未示出)而与推进器48接合以从钉仓44弹出钉46。
参考图9至图12，当驱动构件62处于完全缩回位置时，驱动构件62(图8)的垂直支柱89延伸穿过限定在外管的近侧主体部分70的远端80中的狭槽73，使得上延伸构件90和下延伸构件92沿着外管14的外表面定位于砧座主体26的凸轮表面26a的最近间隔开的位置处。在该位置中，砧座组件22可以被手动地移动来抵抗偏置构件106向“停放位置”的推动，其中砧座主体26的组织接触表面30与钉仓44的组织接触表面44a并列接合，以最小化工具组件18的外径。应注意的是，砧座主体26和钉仓44的表面对表面接触是可能的，因为砧座主体26的枢转构件40浮动在形成于外管14的近侧主体部分的远侧面80中的切口82内以便于砧座主体26的近端移动到支撑在切口82的下部中的位置(图11)。随着工具组件18的直径最小化，工具组件18可以插入穿过小直径套管107。
如上所述，参考图13和图14，工具组件18包括偏置构件106，该偏置构件包括一个或多个弹簧108。每个弹簧108定位于砧座主体26的近端26b与外管14的内表面之间以将砧座主体26推向“打开位置”。砧座主体26的近端26b定位于枢转构件40的近侧，使得砧座主体26的近端26b如图14中的箭头A所示的向下运动导致砧座主体26的组织接触表面30在背向钉仓44的组织接触表面44a的方向上移动，如图14中的箭头“B”所示。
参考图15至图21，当致动装置12(图3)被致动以在钉仓组件24内推进驱动构件62时，上延伸构件90沿着砧座主体26的外表面向远侧运动并越过凸轮表面26A。同时，下延伸构件92沿着外管14的通道部分74的外表面平移，以防止外管14的向外偏转。上延伸构件90与砧座主体26的凸轮表面26a的接合导致砧座组件22枢转到“夹紧位置”。更具体地，当驱动构件62的上延伸构件90(图19)接合砧座主体26的凸轮表面26a时，枢转构件40在切口82内枢转，并且砧座组件22在由图15中的箭头“C”所示的方向上移动到组织“T”周围的“夹紧位置”。最佳如图16中所见，当砧座主体26的组织接触表面30接触组织“T”时，砧座主体26的近端远离钉仓44移动，并且枢转构件40在外管14的切口82内向上移动以允许砧座组件22从钉仓44抬起并移动到限定组织间隙“G”的“夹紧位置”。组织间隙“G”分别适应砧座主体26的组织接触表面30与钉仓44的组织接触表面44a之间的组织放置。最大的组织间隙“G”由分别定位成沿着砧座组件22的外表面和外管14的通道部分74移动的上径向延伸构件90与下径向延伸构件92之间的距离确定。
如图17中所示，驱动构件62的远端62a定位成接合滑动件100的近端，使得驱动构件62的远侧移动导致滑动件100相应远侧移动穿过钉仓44。当工具组件18处于“夹紧位置”时，滑动件100位于推进器48的近侧(图4)。
如图19中所示，该对上延伸构件90包括第一上延伸构件90a和第二上延伸构件90b，该第一上延伸构件沿着砧座主体26的外表面在第一方向上从驱动构件62的垂直支柱89横向地延伸，该第二上延伸构件在与第一方向相反的第二方向上从垂直支柱89横向地延伸。第一上延伸构件92a定位于第二上延伸部分90b的远侧。类似地，如图20和图21中所示，该对下延伸构件92包括第一下延伸构件90a和第二下延伸构件92b，该第一下延伸构件沿着外管14的通道部分74的通道部分74的外表面在第一方向上从垂直支柱89和通道部分74的纵向狭槽78横向地延伸，该第二下延伸构件92b在与第一方向相反的第二方向上从垂直支柱89和纵向狭槽78横向地延伸。第一下延伸部分92a定位于第二下延伸构件92b的远侧。该对上延伸构件90和下延伸构件92被构造成提供与砧座组件22和外管14的牢固接合以限定最大组织间隙“G”(图15)。
在实施例中，形成驱动构件62的金属片的上边缘和下边缘可被切割并在相反方向上弯曲以形成该对上延伸构件90和下延伸构件92。
参考图22和图23，当驱动构件62在图23中的箭头“D”所示的方向上由致动器12(图3)推进时，驱动构件62的远侧工作部分62a在由箭头“E”所示的方向上将滑动件100推进穿过钉仓44而与推进器48按顺序接合，以从钉仓44的钉保持狭槽50中弹出钉46。为了更详细地描述滑动件100和推进器48的操作，参见‘033专利。当驱动构件62的工作端部62a平移穿过钉仓44时，驱动构件62的工作端62a的远端上的刀片86(图4)解剖定位于砧座组件22与钉仓44之间的组织“T”。
在使用中，外科手术缝合装置10的工具组件18被手动移动到“停放位置”并插入到小直径套管107(图10)中。当外科手术缝合装置10的工具组件18离开邻近手术部位(例如腹部)的套管107时，工具组件18将通过偏置构件106(例如，弹簧108(图13))移动到“打开位置”)。在“打开位置”中，工具组件18被定位成捕获待治疗的组织“T”。一旦工具组件18被适当地定位于组织“T”周围，致动装置12(图3)可被致动以推进驱动构件62以将工具组件18移动到“夹紧位置”(图15)。临床医生可以检查工具组件18，以确保工具组件18被适当地夹紧在组织“T”周围。此后，致动装置12可被致动以缝合和解剖组织“T”(图23)。
熟悉本领域的技术人员将会理解，本文中具体描述的以及在附图中示出的装置和方法是非限制性的示例性实施例。可以设想的是，在不脱离本发明的范围的情况下，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实施例的元件和特征组合。同样，熟悉本领域的技术人员将会理解基于上述实施例的本发明的另外特征和优点。因此，除非如所附权利要求所指出，本发明不受限于已经具体示出和描述的内容。

Claims (19)

1.一种外科手术缝合装置，其包括：
具有近侧主体部分和远侧通道部分的外管，所述近侧主体部分的远端限定切口，所述通道部分具有外表面；
工具组件，其包括：
砧座组件，其包括砧座主体，所述砧座主体限定纵向轴线并具有外表面、组织接触表面和位于所述组织接触表面近侧的一对枢转构件，所述枢转构件可枢转地容纳在所述外管的所述近侧主体部分的所述切口内；以及
钉仓组件，其包括钉仓和多个钉，所述钉仓限定纵向轴线、组织接触表面和多个钉保持凹腔，所述钉保持凹腔中的每一个支撑所述多个钉中的一个，所述钉仓被支撑在所述外管的所述远侧通道部分内，所述砧座主体相对于所述钉仓可枢转地支撑在所述外管上，使得所述工具组件能够在闭合位置与打开位置之间移动，在所述闭合位置中，所述砧座主体和所述钉仓的纵向轴线是平行的，在所述打开位置中，所述砧座主体和所述钉仓的所述纵向轴线限定锐角；以及
驱动构件，其被支撑在所述钉仓内，所述驱动构件能够平移穿过所述钉仓以从所述钉仓弹出所述多个钉；
其中所述切口的尺寸被设定为允许所述枢转构件在所述切口内移动，使得当所述工具组件处于所述闭合位置时，所述砧座主体能够相对于所述钉仓定位于停放位置到夹紧位置，在所述停放位置中，所述砧座主体和所述钉仓的所述接触表面并列接合，在所述夹紧位置中，所述砧座主体和所述钉仓的所述接触表面间隔开以限定组织间隙。
2.根据权利要求1所述的外科手术缝合装置，其中所述外管支撑联接构件，所述联接构件适于将所述外科手术缝合装置可释放地固定到用于实现所述驱动构件的移动的致动器。
3.根据权利要求1所述的外科手术缝合装置，其中所述驱动构件包括具有上延伸构件和下延伸构件的远侧工作部分，其中所述上延伸构件定位成接合所述砧座主体的所述外表面，并且所述下延伸构件定位成接合所述外管的所述远侧通道部分的所述外表面。
4.根据权利要求1所述的外科手术缝合装置，其中所述砧座主体、所述钉仓和所述远侧通道部分各自限定纵向狭槽，并且所述驱动构件的所述工作部分具有包括垂直支柱的工字梁构造，所述垂直支柱延伸穿过所述砧座主体、所述钉仓和所述远侧通道部分的所述狭槽。
5.根据权利要求4所述的外科手术缝合装置，其中所述上延伸构件和下延伸构件包括一对上径向延伸构件和一对下延伸构件。
6.根据权利要求5所述的外科手术缝合装置，其中所述对上延伸构件中的一个在第一方向上从所述垂直支柱横向地延伸，并且所述对上延伸构件中的另一个在与所述第一方向相反的第二方向上从所述垂直支柱延伸，并且其中所述对下延伸构件中的一个在所述第一方向上从所述垂直支柱横向地延伸，并且所述对下延伸构件中的另一个在与所述第一方向相反的所述第二方向上从所述垂直支柱延伸。
7.根据权利要求6所述的外科手术缝合装置，其中所述驱动构件由金属片形成。
8.根据权利要求1所述的外科手术缝合装置，其中所述驱动构件支撑适于将所述驱动构件可释放地联接到致动器的连接器。
9.根据权利要求6所述的外科手术缝合装置，其中所述对上延伸构件中的一个定位于所述对延伸构件中的另一个的远侧，并且所述对下延伸构件中的一个定位于所述对下延伸构件中的另一个的远侧。
10.根据权利要求1所述的外科手术缝合装置，其中所述钉仓组件进一步包括多个推进器和滑动件，所述多个钉中的每一个与相应的推进器相关联，所述滑动件能够响应于所述驱动构件的远侧运动平移穿过所述钉仓而与所述推进器按顺序接合，以从所述钉仓弹出所述多个钉。
11.根据权利要求1所述的外科手术缝合装置，其进一步包括用于将所述工具组件推向所述打开位置的偏置构件。
12.一种外科手术缝合装置，其包括：
具有近侧主体部分和远侧通道部分的外管，所述通道部分具有外表面；
工具组件，其包括：
砧座组件，其包括限定纵向轴线的砧座主体，所述砧座主体具有外表面、组织接触表面和位于所述组织接触表面近侧的一对枢转构件；以及
钉仓组件，其包括钉仓和多个钉，所述钉仓限定纵向轴线、组织接触表面和多个钉保持凹腔，所述钉保持凹腔中的每一个支撑所述多个钉中的一个，所述钉仓被支撑在所述外管的所述远侧通道部分内，所述砧座主体相对于所述钉仓可枢转地支撑在所述外管上，使得所述工具组件能够在闭合位置与打开位置之间移动，在所述闭合位置中，所述砧座主体和所述钉仓的纵向轴线是平行的，在所述打开位置中，所述砧座主体和所述钉仓的所述纵向轴线限定锐角；以及
驱动构件，其被支撑在所述钉仓内，所述驱动构件能够平移穿过所述钉仓以从所述钉仓弹出所述多个钉，所述驱动构件包括由金属片形成的主体，所述主体具有远侧工作部分，所述远侧工作部分包括一对上延伸构件和一对下延伸构件，所述对上延伸构件和所述对下延伸构件通过弯曲所述金属片的上边缘和下边缘而形成。
13.根据权利要求12所述的外科手术缝合装置，其中所述近侧主体部分的远端限定切口，所述枢转构件可枢转地容纳在所述外管的所述近侧主体部分的所述切口内。
14.根据权利要求12所述的外科手术缝合装置，其中所述对上延伸构件被定位成接合所述砧座主体的所述外表面，并且所述对下延伸构件被定位成接合所述外管的所述通道部分的所述外表面以在所述砧座处于闭合位置时限定所述砧座主体和所述钉仓的所述组织接触表面之间的最大组织间隙。
15.根据权利要求14所述的外科手术缝合装置，其中所述砧座主体、所述钉仓和所述远侧通道部分各自限定纵向狭槽，并且所述驱动构件的所述工作部分具有包括垂直支柱的工字梁构造，所述垂直支柱延伸穿过所述砧座主体、所述钉仓和所述远侧通道部分的所述狭槽。
16.根据权利要求15所述的外科手术缝合装置，其中所述对上延伸构件中的一个在第一方向上从所述垂直支柱横向地延伸，并且所述对上延伸构件中的另一个在与所述第一方向相反的第二方向上从所述垂直支柱延伸，并且其中所述对下延伸构件中的一个在所述第一方向上从所述垂直支柱横向地延伸，并且所述对下延伸构件中的另一个在与所述第一方向相反的所述第二方向上从所述垂直支柱延伸。
17.根据权利要求15所述的外科手术缝合装置，其中所述对上延伸构件中的一个定位于所述对径向延伸构件中的另一个的远侧，并且所述对下延伸构件中的一个定位于所述对下延伸构件中的另一个的远侧。
18.根据权利要求13所述的外科手术缝合装置，其中所述切口的尺寸被设定为允许所述枢转构件在所述切口内移动，使得当所述工具组件处于所述闭合位置时，所述砧座主体能够相对于所述钉仓从停放位置移动到夹紧位置，在所述停放位置中，所述砧座主体和所述钉仓的所述组织接触表面并列接合，在所述夹紧位置中，所述砧座主体和所述钉仓的所述组织接触表面间隔开以限定组织间隙。
19.根据权利要求12所述的外科手术缝合装置，其进一步包括用于将所述工具组件推向所述打开位置的偏置构件。
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