CN107811666A - 用于内窥镜操作的装置 - Google Patents
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Abstract
本发明提供用于内窥镜操作的装置。公开了一种用于将手术器械和末端执行器相互连接的接合器组件,包括:细长主体,其近侧端和远侧端;致动杆,其布置在所述细长主体内,所述致动杆被构造为接合末端执行器且响应于所述细长主体与末端执行器联接是能运动的;释放按钮,其布置在所述细长主体上且联接至所述致动杆,使得所述释放按钮通过所述致动杆是能运动的;以及传感器,其通过通过所述致动杆运动的所述释放按钮是能致动的,所述传感器被配置为传送表示末端执行器固定至所述细长主体的信号。
Description
本申请是申请号为201310369318.2、申请日为2013年7月9日、发明名称为“用于内窥镜操作的装置”的专利申请的分案申请。
相关申请的交叉引用
本申请要求于2012年7月9日提交的第61/669,253号美国临时申请的权益和优先权,其全部内容通过引用合并于此。
技术领域
本公开涉及用于执行内窥镜手术操作的手术装置、设备和/或系统及其使用方法。更加具体而言,本公开涉及机电的、手持式手术装置、设备和/或系统,其配置为与可移除的一次性装载单元和/或单次使用装载单元一起使用以夹持、切割和/或吻合组织。
背景技术
一些手术设备制造厂商已经开发了具有用于操作和/或操纵机电手术设备的专门驱动系统的产品线。在许多情况下,机电手术设备包括可重复使用的手柄组件,以及一次性的或单次使用的装载单元。所述装载单元在使用前选择性地连接至手柄组件,并随后在使用后从手柄组件分离而被处理或在一些情况下消毒以再次使用。
许多这样的机电手术设备包括复杂的驱动部件,其利用各种用户接口接受用户输入(例如控制),以控制设备以及为用户提供反馈。存在对于具有改进的用户接口的机电手术装置、设备和/或系统的需求。
发明内容
下面参照附图更为详细地描述本公开示例性实施方式的更多细节和方案。
根据本公开的一个实施方式,提供了一种手术设备。该手术设备包括:钳夹组件,其限定了第一纵轴线并且包括第一钳夹和能够相对于第一钳夹运动的第二钳夹;细长主体,其限定了第二纵轴线并且联接至钳夹组件的近侧端,其中钳夹组件被配置为相对于细长主体绕横向于第二纵轴线的关节式运动轴线做关节式运动;以及手柄组件,其联接至细长主体的近侧端并且包括控制组件以及机械地联接至钳夹组件的至少一个电动机,所述控制组件包括第一控制按钮及第二控制按钮,其中第一控制按钮的致动使第二钳夹运动而相对于第一钳夹接近,而致动第二控制按钮使第二钳夹运动而远离第一钳夹,并且致动第一控制按钮和第二控制按钮使钳夹组件运动至中央位置,在该中央位置上第一纵轴线和第二纵轴线基本上对准。
控制组件还包括第一摇杆开关,其中第一摇杆开关的致动被配置为使得钳夹组件绕关节式运动轴线做关节式运动。
钳夹组件还配置为相对于细长主体绕第二纵轴线枢转。
控制组件还包括第二摇杆开关,其中第二摇杆开关的致动被配置为使钳夹组件相对于细长主体绕第二纵轴线旋转。
手柄组件还包括照明构件,照明构件配置为输出指示手术器械的状态的光模式(light pattern)。
光模式包括多个灯的渐进激活并且该状态是钳夹组件的发射进程。
照明构件具有大体上圆形的形状并且包括绕照明构件的周边布置的多个发光器件。
照明构件包括绕水平面布置的上部和下部,上部包括第一多个发光器件,以及下部包括第二多个发光器件。
第一多个发光器件对于具有位于水平面之上的第一视线的第一用户是可视的,而多个第二发光器件对于具有位于水平面之下的第二视线的第二用户是可视的。
照明构件还包括至少一个侧面发光器件,其布置在水平面上并位于照明构件的每一侧上,该至少一个侧面发光器件对于第一用户和第二用户是可视的。
根据本公开的实施方式,提供了一种手术设备。该手术设备包括:钳夹组件,其限定了第一纵轴线并且包括第一钳夹和能够相对于第一钳夹运动的第二钳夹;细长主体,其限定了第二纵轴线并且可移除地联接至钳夹组件的近侧端,其中钳夹组件被配置为相对于细长主体绕横向于第二纵轴线的关节式运动轴线做关节式运动;以及手柄组件,其可移除地联接至细长主体的近侧端,并且包括照明构件以及机械地联接至钳夹组件的至少一个电动机,所述照明构件配置为输出指示手术器械的状态的光模式。
照明构件具有大体上圆形的形状并且包括绕照明构件的周边布置的多个发光器件。
照明构件包括绕水平面布置的上部和下部,上部包括第一多个发光器件,并且下部包括第二多个发光器件。
第一多个发光器件对于具有位于水平面之上的第一视线的第一用户是可视的,而多个第二发光器件对于具有位于水平面之下的第二视线的第二用户是可视的。
照明构件还包括至少一个侧面发光器件,其布置在水平面上并位于照明构件的每一侧上,该至少一个侧面发光器件对于第一用户和第二用户是可视的。
第一多个发光器件被配置为输出指示钳夹组件的发射进程的光模式。
第二多个发光器件被配置为输出指示钳夹组件、细长主体和手柄组件中的每个的状态的光模式。
第一多个发光器件被配置为输出指示细长主体或手柄组件中的至少一个的剩余使用次数的光模式。
照明构件还包括至少一个侧面发光器件,其布置在水平面上并位于照明构件的每一侧上,该至少一个侧面发光器件对于第一用户和第二用户是可视的。
发光器件被配置为输出指示钳夹组件、细长主体或手柄组件中的至少一个的错误状态的光模式。
附图说明
这里参照附图描述本公开的实施方式,其中:
图1是根据本公开的机电手术系统的拆卸立体图,其包括手术器械、细长构件、和末端执行器;
图2是根据本公开的图1的手术器械的立体图;
图3是根据本公开的图1的手术器械的分解立体图;
图4是根据本公开的图1的手术器械的电池的立体图;
图5是根据本公开的图1的手术器械的部分拆卸俯视图;
图6是根据本公开的图1的手术器械的前视立体图,其中细长构件与其分离;
图7是根据本公开的沿图1的7-7取的图1的手术器械的侧视剖面图;
图8是根据本公开的沿图1的8-8取的图1的手术器械的俯视剖面图;
图9是根据本公开的图1的手术器械的控制组件的分解立体图;
图10是根据本公开的图1的细长构件的立体图;
图11是根据本公开的图1的细长构件的分解立体图;
图12是根据本公开的图1的细长构件的联接组件的分解立体图;
图13是根据本公开的图1的细长构件的驱动传递组件的分解立体图;
图14是根据本公开的图1的细长构件的侧视剖面图;
图15是根据本公开的图1的细长构件的俯视剖面图;
图16是根据本公开的图1的细长构件的近侧细节区域的放大侧视剖面图;
图17是根据本公开的图1的细长构件的近侧细节区域的放大俯视剖面图;
图18是根据本公开的图1的细长构件的远侧细节区域的放大侧视剖面图;
图19是根据本公开的图1的细长构件的远侧细节区域的放大俯视剖面图;
图20是根据本公开的图1的细长构件的驱动传递组件的分解立体图;
图21是根据本公开的图1的细长构件的致动杆的立体图;
图22是根据本公开的图1的细长构件的部分拆卸立体图;
图23是根据本公开的处于未装载配置下的图1的细长构件的近侧部的部分拆卸放大立体图;
图24是根据本公开的处于未装载配置下的图1的细长构件的远侧部的部分拆卸放大立体图;
图25是根据本公开的处于装载配置下的图1的细长构件的远侧部的部分拆卸放大立体图;
图26是根据本公开的处于装载配置下的图1的细长构件的近侧部的部分拆卸放大立体图;
图27是根据本公开的处于锁定配置下的图1的细长构件的远侧部的部分拆卸放大立体图;
图28是根据本公开的处于锁定配置下的图1的细长构件的近侧部的部分拆卸放大立体图;
图29是根据本公开的图1的末端执行器的分解立体图;
图30是根据本公开的图1的机电手术系统的硬件图解视图;
图31是根据本公开的末端执行器检测电路的图解视图;
图32是根据本公开的图1的手术器械的照明构件的正视图解视图;
图33A-T是根据本公开的示出各种状态模式的图32的照明构件的正视图解视图;
图34A-D是根据本公开的图1的手术器械100和示出各种状态模式的图32的照明构件的俯视图。
具体实施方式
参照附图更为详细地描述本公开的机电手术系统、装置和/或设备的实施方式,其中在多个视图的每幅中,同样的附图标记表示相同或相应的构件。如这里所使用的,术语“远侧”指的是机电手术系统、装置和/或设备或其部件的更远离用户的部分,而术语“近侧”指的是机电手术系统、装置和/或设备或其部件的更靠近用户的部分。术语“左”和“右”指的是在手术系统、装置和/或设备以非旋转配置定向时,用户从近侧端向机电手术系统、装置和/或设备的远侧端的视角来看,机电手术系统、设备和/或装置或其部件的分别位于左(例如左向)侧和右(例如右向)侧上的部分。
首先参照图1至图8,根据本公开的一个实施方式,示出了一种机电、手持式、动力手术系统并通常以附图标记10表示。机电手术系统10包括以机电、手持式、动力手术器械100形式的手术装置或设备,其配置用于通过接合器组件200(例如细长主体)选择性地附接多个不同的末端执行器300。末端执行器300和接合器组件200配置为由机电、手持式、动力手术器械100进行致动和操控。特别地,手术器械100、接合器组件200、和末端执行器300彼此分离,从而使手术器械100配置为选择性地与接合器组件200连接,并且接合器组件200转而配置为选择性地与多个不同的末端执行器300中的任意一个连接。
为了获得对于示例性的机电、手持式、动力手术器械100的结构和操作的更为详细的描述,可以参照于2008年9月22日提交的申请号为PCT/US2008/077249(国际公开号WO2009/039506)的国际申请和于2009年11月20日提交的序列号为12/622,827的美国专利申请,其全部内容通过引用合并于此。
如图1至图3中所示意的,手术器械100包括手柄外壳102,手柄外壳102具有外壳下部104、外壳中部106和外壳上部108,外壳中部106从外壳下部104延伸出和/或支撑在外壳下部104上,外壳上部108从外壳中部106延伸出和/或支撑在外壳中部106上。外壳中部106和外壳上部108分成远侧半体110a和近侧半体110b,远侧半体110a与下部104整体形成并从下部104延伸出,近侧半体110b能够通过多个紧固件连接至远侧半体110a。在结合时,远侧和近侧半体110a、110b限定了手柄外壳102,手柄外壳102具有空腔102a,电路板150和驱动机构160位于空腔102a中。
参照图2和图3,远侧和近侧半体110a、110b沿横向于外壳上部108的纵轴线“X-X”的垂直面分开。手柄外壳102包括垫圈112,其绕远侧半体和/或近侧半体110a、110b的边缘完全地延伸,并且插入在远侧半体110a和近侧半体110b之间。垫圈112密封远侧半体110a和近侧半体110b的周边。垫圈112的作用在于在远侧半体110a和近侧半体110b之间建立气密密封,从而使得电路板150和驱动机构160免受杀菌和/或清洁操作的损害。
以这样的方式,沿远侧半体110a和近侧半体110b的周边密封手柄外壳102的空腔102a,而手柄外壳102的空腔102a配置为使得在手柄外壳102中更容易、更高效地装配电路板150和驱动机构160。
手柄外壳102的外壳中部106提供了放置电路板150的外壳。电路板150配置为控制手术器械100的各种操作,这将在下面更为详细地陈述。
手术器械100的外壳下部104限定了形成在其上表面的孔(未示出),并且所述孔位于外壳中部106的下方或内部。如图3和图4所示,外壳下部104的孔提供了一个通道,导线152穿过该通道以使位于外壳下部104中的电气部件(诸如电池156和电路板154)与位于外壳中部106和/或外壳上部108中的电气部件(诸如电路板150、驱动机构160等)电气互连。
手柄外壳102包括垫圈107,其布置在外壳下部104的孔(未示出)内,从而堵塞或密封外壳下部104的孔,同时允许导线152从中穿过。垫圈107的作用在于在外壳下部106和外壳中部108之间建立气密密封,从而使得电路板150和驱动机构160免受杀菌和/或清洁操作的损害。
继续参照图3和图4,手柄外壳102的外壳下部104提供了一个外壳,电池156可移除地布置于外壳中。电池156可以是可再充电的电池(例如,铅基、镍基、锂离子基等)。还能预见的是,电池156可以是一次性使用的、非可再充电的电池。电池156配置为对手术器械100的任意电气部件提供电力。外壳下部104限定了空腔(未示出),电池156插入空腔中。外壳下部104包括枢转连接于其的门105,用于关闭外壳下部104的空腔并将电池156保持在其中。
继续参照图3和图5,外壳上部108的远侧半体110a限定了鼻部或连接部108a。鼻锥部114支撑在外壳上部108的鼻部108a上。鼻锥部114由透明的、可透射光的材料制成。照明构件116布置在鼻锥部114内,从而使得照明构件116通过它而可视。鼻锥部114可以是带色彩的,从而当它被激活时照明构件116是可视的。
参照图5,照明构件116可包括多个任意合适的发光器件,例如发光二极管(LED),其布置在印刷电路板(LED PCB)116a上,其中印刷电路板116a布置在横向于纵轴线“X-X”的垂直面内。照明构件116配置为以多种颜色来照明,其中特定色彩模式与唯一离散事件相关联。在各实施方式中,LED可以是单色LED或多色LED。
手柄外壳102的外壳上部108提供了放置驱动机构160的外壳。如图5所图示的,驱动机构160配置为驱动轴和/或齿轮部件,从而执行手术器械100的各种操作。特别地,驱动机构160配置为驱动轴和/或齿轮部件,从而使末端执行器300的工具组件304相对于末端执行器300的近侧主体部302选择性地运动,使末端执行器300相对于手柄外壳102绕纵轴线“X-X”(图3)旋转,使砧座组件306相对于末端执行器300的钉仓组件308运动,和/或发射末端执行器300的钉仓组件308中的吻合和切割钉仓。
驱动机构160包括换挡器齿轮箱组件162,其定位成相对于接合器组件200紧密接近。换挡器齿轮箱组件162的近侧是功能选择模块163,功能选择模块163具有第一(例如,换挡器)电动机164,第一电动机164的作用在于使齿轮元件在换挡器齿轮箱组件162中选择性地运动而与具有第二(例如,驱动)电动机166的输入驱动部件165啮合。
如图1至图4中所示意的,外壳上部108的远侧半体110a限定了连接部108a,连接部108a被配置为接受接合器组件200的相应的驱动联接组件210。
如图6至图8中所示意的,手术器械100的连接部108a具有筒状凹部108b,其在接合器组件200与手术器械100匹配时接收接合器组件200的驱动联接组件210。连接部108a容纳三个可旋转的驱动连接器118、120、122。
参照图6,在接合器组件200与手术器械100匹配时,手术器械100的每个可旋转的驱动连接器118、120、122与接合器组件200的相应的可旋转连接器套筒218、220、222联接。关于这点,相应的第一驱动连接器118和第一连接器套筒218之间的接口、相应的第二驱动连接器120和第二连接器套筒220之间的接口、以及相应的第三驱动连接器122和第三连接器套筒222之间的接口都是键联接的,从而使得手术器械100的每个驱动连接器118、120、122的旋转会引起接合器组件200的相应的连接器套筒218、220、222的相应旋转。
手术器械100的驱动连接器118、120、122与接合器组件200的连接器套筒218、220、222的匹配允许旋转力通过三个对应连接器接口中的每一个独立地传输。手术器械100的驱动连接器118、120、122被配置为通过驱动机构160独立地旋转。关于这点,驱动机构160的功能选择模块163选择手术器械100的驱动连接器或连接器118、120、122中的哪一个将由驱动机构160的输入驱动部件165进行驱动。
由于手术器械100的每个驱动连接器118、120、122与相应的接合器组件200的连接器套筒218、220、222都具有键联接的和/或基本上非可旋转的接口,所以当接合器组件200联接至手术器械100时,旋转力选择性地从手术器械100的驱动机构160传递至接合器组件200。
手术器械100的驱动连接器118、120和/或122的选择性的旋转允许手术器械100选择性地致动末端执行器300的不同功能。如下面更为详细的讨论,手术器械100的第一驱动连接器118的选择性且独立的旋转对应于末端执行器300的工具组件304的选择性且独立的打开和关闭,以及末端执行器300的工具组件304的吻合/切割部件的驱动。同样,手术器械100的第二驱动连接器120的选择性且独立的旋转对应于末端执行器300的工具组件304绕横向于纵轴线“X-X”(图2)的关节式运动轴线的选择性且独立的关节式运动。特别地,末端执行器300限定第二纵轴线且能够从第一位置移动到至少第二位置,在所述第一位置,第二纵轴线与第一纵轴线“X-X”基本对准,在所述第二位置,第二纵轴线布置在关于第一纵轴线“X-X”的非零角度处。另外,手术器械100的第三驱动连接器122的选择性且独立的旋转对应于末端执行器300相对于手术器械100的手柄外壳102绕纵轴线“X-X”(图2)的选择性且独立的旋转。
如图1至图3和图9中所示意的,手柄外壳102将控制组件103支撑在外壳中部108的远侧表面或侧面上。控制组件103与外壳中部108相配合地支撑一对手指致动的控制按钮124、126和摇杆设备128、130。特别地,控制组件103限定了用于可滑动地接收第一控制按钮124的上部孔124a,以及用于可滑动地接收第二控制按钮126的下部孔126a。
控制按钮124、126和摇杆设备128、130中的每一个都包括各自的通过操作者的致动而移动的磁体(未示出)。另外,针对控制按钮124、126和摇杆设备128、130中的每一个,电路板150包括各自的霍尔效应开关150a-150d(图7),由控制按钮124、126和摇杆设备128、130中的磁体的运动来致动霍尔效应开关150a-150d。特别地,第一霍尔效应开关150a(图3和图7)位于控制按钮124的紧邻近侧,其在操作者致动控制按钮124时在控制按钮124中磁体的运动时被致动。对应于控制按钮124的第一霍尔效应开关150a的致动,使电路板150为驱动机构160的功能选择模块163和输入驱动部件165提供合适的信号,从而关闭末端执行器300的工具组件304和/或发射末端执行器300的工具组件304内的吻合/切割钉仓。
而且,第二霍尔效应开关150b(图3和图7)位于摇杆设备128的紧邻近侧,其在操作者致动摇杆设备128时在摇杆设备128中磁体(未示出)运动时被致动。对应于摇杆设备128的第二霍尔效应开关150b的致动,使电路板150为驱动机构160的功能选择模块163和输入驱动部件165提供合适的信号,从而使工具组件304相对于末端执行器300的主体部302进行关节式运动。有益的是,摇杆设备128在第一方向上的运动使得工具组件304相对于主体部302在第一方向上进行关节式运动,而摇杆设备128在相反、例如第二方向上的运动使得工具组件304相对于主体部302在相反、例如第二方向上进行关节式运动。
此外,第三霍尔效应开关150c(图3和图7)位于控制按钮126的紧邻近侧,其在操作者致动控制按钮126时在控制按钮126中磁体(未示出)运动时被致动。对应于控制按钮126的第三霍尔效应开关150c的致动,使电路板150为驱动机构160的功能选择模块163和输入驱动部件165提供合适的信号,从而打开末端执行器300的工具组件304。
另外,第四霍尔效应开关150d(图3和图7)位于摇杆设备130的紧邻近侧,其在操作者致动摇杆设备130时在摇杆设备130中磁体(未示出)运动时被致动。对应于摇杆设备130的第四霍尔效应开关150d的致动,使电路板150为驱动机构160的功能选择模块163和输入驱动部件165提供合适的信号,从而使末端执行器300相对于手术器械100的手柄外壳102旋转。具体而言,摇杆设备130在第一方向的运动使得末端执行器300相对于手柄外壳102在第一方向上旋转,而摇杆设备130在相反、例如第二方向上的运动使得末端执行器300相对于手柄外壳102在相反、例如第二方向上旋转。
如图1至图3中所示,手术器械100包括发射按钮或安全开关132,其支撑在外壳中部108和外壳上部之间,并位于控制组件103上方。在使用中,根据需要和/或期望在打开和闭合状态之间致动末端执行器300的工具组件304。为了发射末端执行器300,以当末端执行器300的工具组件304处于闭合状态时使紧固件从中排出,将安全开关132压下从而对手术器械100指示末端执行器300已准备从中排出紧固件。
如图1和图10至图20中所示意的,手术器械100配置为选择性地与接合器组件200连接,并且接合器组件200转而配置为选择性地与末端执行器300连接。
接合器组件200配置为将手术器械100的驱动连接器120和122中任一个的旋转转换成用于操作末端执行器300的驱动组件360和关节式运动连杆366的轴向平移,如图29中所示意并且在下面会更为详细的描述。
接合器组件200包括第一驱动传递组件,其用于使手术器械100的第三可旋转驱动连接器122和末端执行器300的第一可轴向平移驱动构件相互连接,其中,第一驱动传递组件将手术器械100的第三可旋转驱动连接器122的旋转转换并传递成末端执行器300的第一可轴向平移驱动组件360的轴向平移以用于发射。
接合器组件200包括第二驱动传递组件,其用于使手术器械100的第二可旋转驱动连接器120与末端执行器300的第二可轴向平移驱动构件相互连接,其中,第二驱动传递组件将手术器械100的第二可旋转驱动连接器120的旋转转换并传递成末端执行器300的关节式运动连杆366的轴向平移以用于进行关节式运动。
参照图10和图11,接合器组件200包括旋钮外壳202和从旋钮外壳202的远侧端延伸出的外管206。旋钮外壳202和外管206配置并定尺寸以容纳接合器组件200的部件。外管206被定尺寸以使得外管206能够穿过常规的套管针端口、套管等。旋钮外壳202被定尺寸为不能进入套管针端口、套管等。
旋钮外壳202被配置并适合于连接至手术器械100的远侧半体110a的外壳上部108的连接部108a。参照图10至图12,接合器组件200在其近侧端包括手术设备驱动联接组件210,在其远侧端包括末端执行器联接组件230。驱动联接组件210包括至少部分地可旋转地支撑在旋钮外壳202中的远侧驱动联接外壳210a和近侧驱动联接外壳210b。驱动联接组件210可旋转地支撑其中的第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214、和第三可旋转近侧驱动轴216。
近侧驱动联接外壳210b被配置为分别可旋转地支撑第一连接器套筒218、第二连接器套筒220和第三连接器套筒222。每个连接器套筒218、220、222配置为分别与手术器械100的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122配合,如上所述。每个连接器套筒218、220、222进一步配置为分别与第一近侧驱动轴212、第二近侧驱动轴214和第三近侧驱动轴216的近侧端配合。
近侧驱动联接组件210包括第一偏置构件224、第二偏置构件226和第三偏置构件228,它们分别布置在第一连接器套筒218、第二连接器套筒220和第三连接器套筒222的远侧。每个偏置构件224、226和228分别绕第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214和第三可旋转近侧驱动轴216布置。偏置构件224、226和228分别作用于连接器套筒218、220、222上,以在接合器组件200连接至手术器械100时帮助保持连接器套筒218、220、222与手术器械100的对应的驱动可旋转驱动连接器118、120、122的远侧端啮合。
特别地,第一偏置构件224、第二偏置构件226和第三偏置构件228使对应的连接器套筒218、220和222沿近侧方向偏置。以这种方式,在接合器组件200装配至手术器械100的过程中,如果第一连接器套筒218、第二连接器套筒220和/或第三连接器套筒222与手术器械100的驱动连接器118、120、122没有对准,则可压缩第一偏置构件224、第二偏置构件226和/或第三偏置构件228。因而,当接合手术器械100的驱动机构160时,手术器械100的驱动连接器118、120、122将会旋转,并且第一偏置构件224、第二偏置构件226和/或第三偏置构件228将分别使得第一连接器套筒218、第二连接器套筒220和/或第三连接器套筒222向近侧滑回,这使得手术器械100的驱动连接器118、120、122有效地联接至近侧驱动联接组件210的第一近侧驱动轴212、第二近侧驱动轴214和/或第三近侧驱动轴216。
在校准手术器械100时,旋转手术器械100的每个驱动连接器118、120、122,并且当达到恰当的对准时,连接器套筒218、220和222的偏置使手术器械100的连接器套筒218、220和222在各个驱动连接器118、120、122上恰当地就位。
接合器组件200包括第一驱动传递组件240、第二驱动传递组件250和第三驱动传递组件260,它们分别布置在手柄外壳202和外管206内。每个驱动传递组件240、250、260被配置并且适于将手术器械100的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122的旋转传递或转换成接合器组件200的驱动管246和驱动杆258的轴向平移,从而实现末端执行器300的闭合、打开、关节式运动和发射;或者将手术器械100的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122的旋转传递或转换成接合器组件200的环形齿轮266的旋转,以实现接合器组件200的旋转。
如图13至图19所示,第一驱动传递组件240包括第一远侧驱动轴242,第一远侧驱动轴242可旋转地支撑在外壳202和外管206内。第一远侧驱动轴242的近侧端部242a被键联接至正齿轮242c,正齿轮242c被配置用于通过复合齿轮243连接至正齿轮212a,正齿轮212a键联接至第一可旋转近侧驱动轴212。第一远侧驱动轴242还包括远侧端部242b,远侧端部242b具有螺纹外侧面或表面。
第一驱动传递组件240还包括驱动联接螺母244,驱动联接螺母244可旋转地联接至第一远侧驱动轴242的螺纹远侧端部242b,并且其可滑动地布置在外管206内。驱动联接螺母244被键联接至外管206的内侧外壳管206a,从而防止其随着第一远侧驱动轴242旋转而转动。以这种方式,在第一远侧驱动轴242旋转时,驱动联接螺母244通过和/或沿着外管206的内侧外壳管206a平移。
第一驱动传递组件240还包括驱动管246,驱动管246围绕第一远侧驱动轴242并且具有连接至驱动联接螺母244的近侧端部和延伸超过第一远侧驱动轴242的远侧端的远侧端部。驱动管246的远侧端部支撑连接构件247(图13),连接构件247被配置并且被定尺寸为与末端执行器300的驱动组件360的驱动构件374选择性啮合。
在操作中,由于手术器械100的第一对应驱动连接器118的旋转引起第一连接器套筒218的旋转从而使第一可旋转近侧驱动轴212旋转,第一可旋转近侧驱动轴212的正齿轮212a啮合复合齿轮243的第一齿轮243a,这使得复合齿轮243旋转。随着复合齿轮243旋转,复合齿轮243的第二齿轮243b旋转并因此使得键联接至第一远侧驱动轴242并与其啮合的正齿轮242c也旋转,从而使得第一远侧驱动轴242旋转。随着第一远侧驱动轴242旋转,使得驱动联接螺母244沿第一远侧驱动轴242轴向平移。
随着引起驱动联接螺母244沿第一远侧驱动轴242轴向平移,使得驱动管246相对于外管206的内外壳管206a轴向平移。随着驱动管246轴向平移,通过连接构件247连接至驱动管246并且连接至末端执行器300的驱动组件360的驱动构件374,驱动管246使得末端执行器300的驱动构件374随之轴向平移,从而实现末端执行器300的工具组件304的闭合和工具组件304的发射。
参照图13至图19,接合器组件200的第二驱动传递组件250包括第二可旋转近侧驱动轴214,第二可旋转近侧驱动轴214可旋转地支撑在驱动联接组件210内。第二可旋转近侧驱动轴214包括非圆形或异形的近侧端部214a,其配置为与第二连接器220连接,所述第二连接器220连接至手术器械100的相应的第二连接器120。第二可旋转近侧驱动轴214还包括具有螺纹外侧面或表面的远侧端部214b。
如图20所示意,第二驱动传递组件250还包括联接封套254,联接封套254可旋转地且可平移地支撑在形成于旋钮外壳202中的环形轨道或凹部内。联接封套254限定了穿过其中的腔254a,以及形成在腔254a的表面中的环形轨道或凹部。第二驱动传递组件250还包括联接滑块256,联接滑块256延伸越过联接封套254的腔254a并且可滑动地布置在联接封套254的轨道内。联接滑块256螺纹连接至第二可旋转近侧驱动轴214的螺纹远侧端部214b。正是这样的配置,联接封套254能够绕第二可旋转近侧驱动轴214旋转,从而保持第二可旋转近侧驱动轴214相对于第一可旋转近侧驱动轴242的径向位置。
第二可旋转近侧驱动轴214限定了旋转轴线,并且联接封套254限定的旋转轴线与第二可旋转近侧驱动轴214的旋转轴线间隔开径向距离。联接滑块256限定了与联接封套254的旋转轴线重合的旋转轴线。
第二驱动传递组件250还包括驱动杆258,驱动杆258可平移地被支撑以轴向平移通过外管206。驱动杆258包括联接至联接封套254的近侧端部258a,以及限定了联接钩258c的远侧端部258b,联接钩258c被配置并且定尺寸为与末端执行器300的关节式运动连杆366的钩状近侧端366a选择性啮合(图29)。
在操作中,如图10至图19所示意,由于手术器械100的第二驱动连接器120的旋转引起第二连接器套筒220的旋转从而使驱动轴214旋转,使得联接滑块256沿第二可旋转近侧驱动轴214的螺纹远侧部214b轴向平移,这转而使得联接封套254相对于旋钮外壳202轴向平移。随着联接封套254轴向平移,使得驱动杆258轴向平移。因此,随着驱动杆258轴向平移,由于驱动杆258的钩258c连接至末端执行器300的关节式运动连杆366的钩状近侧端366a(图29),驱动杆258使得末端执行器300的关节式运动连杆366随之轴向平移,从而实现工具组件304的关节式运动。
如图10至图19所示,接合器组件200包括支撑在旋钮外壳202中的第三驱动传递组件260。第三驱动传递组件260包括各自可旋转地支撑在旋钮外壳202中的第一旋转外壳半体262和第二旋转外壳半体264,以及支撑和插入在第一旋转外壳半体262和第二旋转外壳半体264之间的内部旋转环形齿轮266。第一旋转外壳半体262和第二旋转外壳半体264中的每一个都包括臂262a、264a,它们从此处开始向远侧延伸并且彼此平行且彼此间隔开一横向距离。每个臂262a、264a包括在其远侧端附近径向向内延伸的凸起262b、264b。
第三驱动传递组件260还包括一对旋转传递杆268、270,每个杆在其近侧端处连接至臂262a、264a的凸起262b、264b,并且在其远侧端处连接至支撑在外管206的远侧端处的远侧联接组件230。
第三驱动传递组件260包括环形齿轮266,环形齿轮266限定了齿轮齿266a的内部阵列。环形齿轮266包括一对完全相对的、径向延伸的突起266b,这些突起266b从环形齿轮266的外缘突出。突起266b布置在第一旋转外壳半体262和第二旋转外壳半体264的内表面中所限定的凹部262c、264c内,从而使得环形齿轮266的旋转引起第一旋转外壳半体262和第二旋转外壳半体264的旋转。
第三驱动传递组件260还包括第三可旋转近侧驱动轴216,第三可旋转近侧驱动轴216可旋转地支撑在外壳202和外管206内。第三可旋转近侧驱动轴216的近侧端部被键联接至接合器组件200的第三连接器222。第三可旋转近侧驱动轴216包括键联接至其远侧端的正齿轮216a。齿轮组274使第三可旋转近侧驱动轴216的正齿轮216a与环形齿轮266的齿轮齿266a相互啮合。齿轮组274包括与第三可旋转近侧驱动轴216的正齿轮216a啮合的第一齿轮274a,以及与环形齿轮266的齿轮齿266a啮合的第二齿轮274b。
在操作中,如图10至图19所示意,由于手术器械100的第三驱动连接器122的旋转引起第三连接器套筒222的旋转从而使第三可旋转近侧驱动轴216旋转,第三可旋转近侧驱动轴216的正齿轮216a啮合齿轮组274的第一齿轮272a,使得齿轮组274旋转。随着齿轮组274旋转,齿轮组274的第二齿轮274b旋转,并且因而使得环形齿轮266也旋转,从而使得第一旋转外壳半体262和第二旋转外壳半体264旋转。随着第一旋转外壳半体262和第二旋转外壳半体264旋转,使得旋转传递杆268、270(以及其所连接的远侧联接组件230)绕接合器组件200的纵轴线“X-X”旋转(图10)。随着远侧联接组件230旋转,也使得连接至远侧联接组件230的末端执行器300绕接合器组件200的纵轴线旋转。
参照图10、图11、图13和图18,接合器组件200还包括锁定机构280(用于固定驱动管246的轴向位置和径向定向)以用于末端执行器与其连接和分离。锁定机构280包括释放按钮282,释放按钮282可滑动地支撑在旋钮外壳202上。释放按钮282连接至致动杆284,致动杆284纵向延伸穿过外管206。致动杆284插入在外管206和内外壳管206a与远侧末端外壳289之间。致动杆284响应于末端执行器300的插入和/或锁定释放按钮282的运动而运动。末端外壳289配置并且被定尺寸为用于将末端执行器300插入其中。
末端外壳289包括卡口连接座291,用于可释放地连接至末端执行器300。参照图29,末端执行器300包括一对凸耳301a和301b,它们布置在末端执行器300的近侧部。凸耳301a和301b被配置且定尺寸为插入具有与一对对应卡口通道的卡口连接座291。
参照图13和图21和图22,致动杆284包括限定了窗口284b的远侧部284a,以及从远侧部284a向远侧延伸的指状件。致动杆284的指状件包括近侧凸轮表面284c和远侧大翼件284d以及远侧小翼件284e。致动杆284还包括具有开口284g的近侧部284f,开口284g被配置且定尺寸为接合释放按钮282的翼件282a。
参照图13和图23,锁定机构280还包括片簧传感器287,片簧传感器287布置在联接封套254的远侧端处并位于释放按钮282下方,从而使得当释放按钮282沿其近侧或远侧方向行进时,释放按钮282在近侧方向的纵向行进接合传感器287。
如图13和图18中所示意的,锁定机构280还包括闭锁件286,闭锁件286支撑在远侧联接组件230上与致动杆284的远侧部284a的窗口284b配准的位置处。闭锁件286包括朝着驱动管246的连接构件247延伸的翼件286a。闭锁件286的翼件286a配置且定尺寸为选择性地接合形成在驱动管246的连接构件247中的切口247a。锁定机构280还包括偏置构件288,偏置构件288倾向于保持闭锁件286及其翼件286a与驱动管246的连接构件247中所形成的切口247a间隔开。
参照图23和图24,锁定机构280示意为处于其“原初”(例如,未装载)配置,其中末端执行器300未连接至接合器组件200。在该配置中,致动杆284向远侧延伸并且远侧大翼件284d与卡口连接座291相接触。锁定机构280包括布置在致动杆284的窗口284b内的弹簧293,弹簧293抵靠末端外壳289的支托或止挡件289a偏置致动杆284。由于致动杆284向远侧延伸,释放按钮282也布置在传感器287的远侧(图23),对手术器械100提供末端执行器300未连接至接合器组件200的信号,如下面更为详细地描述。
参照图25和图26,示意了末端执行器300插入接合器组件200中。随着末端接合器300插入到末端外壳289的卡口连接座291中,凸耳301a与致动杆284的远侧大翼件284d接合,将它向近侧推动,如下文图25中所示。这转而沿近侧方向推动释放按钮282经过传感器287,从而触发传感器287。这对手术器械100提供末端执行器300已插入但未固定的信号,如下面更为详细地描述。
致动杆284的向近侧移动也锁定了驱动管246的位置和/或方位。特别地,随着致动杆284向近侧移动,致动杆284的凸轮表面284c接合锁定臂286并克服偏置构件288的偏置而朝向驱动管246推进闭锁件286,从而使得闭锁件286的翼件286a被接收在形成于驱动管246的连接构件247中的切口247a中。以这样的方式,阻止了驱动管246向远侧和/或近侧的移动。
参照图27和图28,示意了将末端执行器300固定在接合器组件200的连接座291中。在末端执行器300的远侧插入之后,它通过绕纵轴线“X-X”旋转而固定至接合器组件200。随着末端执行器300在末端外壳289的卡口连接座291中旋转,凸耳301a脱离远侧大翼件284d并接合致动杆284的远侧小翼件284e。这允许致动杆284在弹簧293的偏压下向远侧移动(参见图24),如下面图27中所示。弹簧293在远侧方向上保持致动杆284,其中凸耳301a布置在连接座291和远侧大翼件284d之间,从而固定末端执行器300。致动杆284的远侧移动也允许远侧小翼件284e抵靠在凸耳301a上,这转而使释放按钮282抵靠在传感器287上,从而持续地接合传感器287并对手术器械100提供末端执行器300已经插入并固定至接合器组件200的信号,如下面更为详细描述。
致动杆284的远侧移动还允许驱动管246与末端执行器300的分离。特别地,随着致动杆284向远侧移动,凸轮表面284c从闭锁件286分离,从而允许偏置构件288将闭锁件286及其翼件286a从形成在驱动管246的连接构件247中的切口247a中推出。
末端执行器300的分离可通过向近侧方向移动释放按钮282来实现。这也向近侧方向移动了致动杆284并同时使释放按钮282与传感器287分离,从而对手术器械100提供末端执行器300已经分离的信号。致动杆284的近侧移动使得远侧大翼件284d和远侧小翼件284e脱离与末端执行器300的凸耳301a的接合。在释放按钮282在近侧方向上持续接合的同时,旋转末端执行器300并随后从接合器组件200中拉出末端执行器300。随着释放按钮282分离,致动杆284与释放按钮282一起,通过弹簧293而向远侧方向移动,这再次触发传感器287以对手术器械100提供末端执行器已经移除的信号。
从图6、图12和图31中可看出,接合器组件200包括一对电触针290a、290b,用于电连接至布置在手术器械100的连接部108a中的相应电气插头190a、190b。接合器组件200还包括电路板292,电路板292支撑在旋钮外壳202中并且与电触针290a、290b电通信。电路板292为手术器械100的电路板150提供高压灭菌和使用计数以及来自传感器287的信号。
参照图29,末端执行器300包括近侧主体部302和工具组件304。近侧主体部302可释放地附接至接合器组件200的远侧联接组件230,而工具组件304可枢转地附接至近侧主体部302的远侧端。工具组件304包括砧座组件306和钉仓组件308。钉仓组件308相对于砧座组件306可枢转并且在打开或未夹紧位置和闭合或夹紧位置之间可移动,用于通过套管针的套管插入。近侧主体部302至少包括驱动组件360和关节式运动连杆366。
参照图29,驱动组件360包括挠性驱动梁364,其具有固定至动力夹紧构件365的远侧端,以及近侧接合部368。接合部368包括限定了台肩370的台阶部。接合部368的近侧端包括完全相对、向内延伸的指状件372。指状件372与中空驱动构件374接合以将驱动构件374牢固地紧固至梁364的近侧端。驱动构件374限定了近侧孔口376,当末端执行器300附接至接合器组件200的远侧联接组件230时,近侧孔口376接收接合器组件200的第一驱动传递组件240的驱动管246的连接构件247。
当驱动组件360在工具组件304中向远侧行进时,夹紧构件365的上梁在砧座板312和砧座盖310之间限定的通道内移动,而下梁在承载器316的外表面上移动以闭合工具组件304并从中发射吻合钉。
末端执行器300的近侧主体部302包括关节式运动连杆366,关节式运动连杆366具有钩状近侧端366a,钩状近侧端366a从末端执行器300的近侧端延伸出。当末端执行器300固定至接合器组件200的远侧外壳232时,关节式运动连杆366的钩状近侧端366a与接合器组件200的驱动杆258的联接钩258c接合。当接合器组件200的驱动杆258如上所述地前进或缩回时,末端执行器300的关节式运动连杆366在末端执行器300内前进或缩回,以使工具组件304相对于近侧主体部302的远侧端枢转。
如图29中所示意的,工具组件304的钉仓组件308包括能够支撑在承载器316中的可移除吻合钉钉仓305。吻合钉钉仓305限定了中央纵向槽305a,以及定位在纵向槽305a每一侧的三线性排的吻合钉保持槽305b。每个吻合钉保持槽305b接收单个吻合钉307和吻合钉推进器309的一部分。在手术器械100操作期间,驱动组件360抵接致动滑板并推动致动滑板通过钉仓305。随着致动滑板移动通过钉仓305,致动滑板的凸轮楔顺序地接合吻合钉推进器309,从而使吻合钉推进器309在吻合钉保持槽305b中垂直移动并从中顺序地弹射单个吻合钉307来抵靠砧座板312成形。
末端执行器300的构造和操作更为详细地描述在2009年8月31日提交的、名称为“用于手术吻合设备的工具组件”(TOOL ASSEMBLY FOR A SURGICAL STAPLING DEVICE)的共有美国专利公开No.2009/0314821中,其全部内容通过引入合并于此。
系统10的高级硬件结构图示于图30中,并示意了各种硬件与软件接口的相互连接。硬件接口400包括布置在电路板154上操纵所有通信的主微控制器402、以及作为从属的编码器微控制器412,用于手指致动的控制按钮124、126和摇杆设备128、130的霍尔效应扫描、通过通信接口41与ID芯片406、408、410的通信、LED闪烁频率和更新、第一电动机(例如,选择电动机)164和第二电动机(例如,驱动电动机)166的电动机控制、以及所有其他高级功能。
主微控制器402包括内部闪存402a、内部存储器402b,以及内部随机存取存储器(RAM)402c。闪存402a可以是任意合适的可擦除、可重写的存储器,其适于对能够电擦除和编程的计算机数据和软件进行非易失性存储。闪存402a包含用于操作手术器械100、轴组件200和/或末端执行器300的设备软件。存储在闪存402a中的软件可经由布置在外壳下部104中的串口连接器利用启动程序进行更新。启动程序是同样存在于闪存402a中并且控制软件更新过程的独立程序。
存储器402b用于存储(例如,读取和写入)关于手术器械100的操作的各种数据,例如使用计数、校准预设、事件记录等。存储器402b也可以是任意合适的可擦除、可重写的存储器,其适于计算机数据的非易失性存储。RAM 402c在通过主微控制器402执行程序指令期间使用,也就是将指令从闪存402a装载到RAM 402c中。
主微控制器402还联接至控制组件103(也就是手指致动的控制按钮124、126和摇杆设备128、130)并且被配置为接收来自它们的输入。主微控制器402随后控制手术器械100,也就是响应输入和操作软件而操作第一电动机(例如选择电动机)164和第二电动机(例如驱动电动机)166,这将在下文更为详细地所述。主微控制器402还联接至用于与电池156通信的系统管理总线(SMB)405。特别地,电池状态(诸如温度和容量)通过SMB 405进行传送。
主微控制器402还分别通过通信接口413与布置在手术器械100、轴组件200及电池156中的器械ID芯片406、接合器ID芯片408、及电池ID芯片410通信。接口413提供与主微控制器402的单触点通信接口,并提供可再用部件的电子标识符,也就是轴组件200、电池156、和末端执行器300的电子标识符,以防止这些部件超过它们的规定极限而使用。
器械ID芯片406标识手术器械100并记录使用信息,从而在启动时确认手术器械100还未达到其高压灭菌周期极限和/或操作发射极限。接合器ID芯片408标识轴组件200的类型并且包括用于检测末端执行器300的存在的末端执行器检测电路411。接合器ID芯片408还记录使用信息以确保轴组件200还未达到其高压灭菌周期极限和/或发射极限。电池ID芯片410标识电池156并记录使用信息,例如充电循环计数,并用于防止手术器械100在不支持的电池、电池不能够成功发射末端执行器300和/或电池超过充电循环计数极限的情况下操作。
硬件接口400还包括编码器微控制器402,编码器微控制器402同样布置在电路板154上并联接至主微控制器402。编码器微控制器402包括内部闪存412a和内部随机存取存储器(RAM)412b。闪存412a用于软件存储,所述软件控制编码器微控制器402和板外部件(诸如电动机164、166和照明构件116)的操作。在编码器微控制器402执行程序指令期间使用RAM 412b,也就是将指令从闪存412a装载到RAM 412c中。
编码器微控制器402用于接收来自选择电动机编码器414和驱动电动机编码器416的反馈。选择电动机编码器414和驱动电动机编码器416配置为接收来自霍尔效应传感器的反馈,霍尔效应传感器通过它们各自的编码器脉冲计数器来监测第一电动机(例如选择电动机)164和第二电动机(例如驱动电动机)166的旋转。特别地,编码器微控制器402对来自选择电动机164和驱动电动机166的电动机编码记号脉冲进行计数,以获得其位置和速率。在被请求时,编码器微控制器402向主微控制器402报告该信息。编码器微控制器402还联接至照明构件116,其在图32中示出。照明构件116包括绕照明构件116的周边布置的多个LED。
当手术器械100加电时,主微控制器402执行驻存在闪存402a中的软件。在启动时,手术器械100被初始化,其包括布置在电路板上的硬件系统的激活,诸如I/O端口、模数转换器、实时时钟、电动机PW、数据监测、脉冲计数器通信、通信电路以及监视器都被激活。此外,初始化包括微控制器402和412的测试操作,以及存储在闪存402a、存储器402b、和闪存412a中的编码和数据的完整性校验。
如果初始化成功,则主微控制器402开始换挡器和驱动电动机164和166的校准测试。这些测试校验电动机164和166的驱动电子电路并将换挡器电动机164校准至其原初位置。
通信接口413同样被测试以校验与手术器械100、轴组件200和电池156的ID芯片406、408、410建立了通信。
电池156也被初始化,其包括基于其ID号来检验电池156被支持。另外,执行下面的测试:1)在启动时测试电池容量,并连续测试以保证它在发射前大于预定阈值;2)连续测试电池温度以保证它处于合适的工作范围;以及3)还针对寿命终止条件测试电池的完全充电容量。
主要微控制器402还检验手术器械100和轴组件200的剩余使用次数,例如是否已达到高压灭菌周期和操作发射极限。
如果上述测试和/或校准中的任意一个失败,则在照明构件116上告知相应的错误,如下面关于图32至图34D中更为详细地所述。如果所有上述测试都已成功完成,那么准备就绪状态信号就会显示在照明构件116上。
在手术器械100初始化之后,轴组件200也被识别并校准。在启动期间,手术器械100判定轴组件200和/或末端执行器300是否连接。当连接时,末端执行器300自动缩回至完全打开位置,并且直到末端执行器300移除才校准轴组件200。
在启动后,手术器械100监测通信接口413(例如,以1赫兹的频率)是否存在附接的轴组件200。特别地,主微控制器402询问轴组件200的ID芯片408以判定它是否是所支持的轴组件200。如果附接的接合器不支持和/或未知,就不能进行校准并且相应的错误就显示在照明构件116上。
在不附接末端执行器300的情况下,校准轴组件200。校准轴组件200的关节式运动范围以通过向左驱动驱动轴214直到它在其机械极限处停止而获得基准位置。一旦检测到左端挡板,则向右驱动驱动轴214至中央位置。通过向近侧驱动驱动轴212直到它在其机械极限处停止而获得基准位置来校准夹紧驱动轴212。一旦检测到终点挡板,向远侧驱动驱动轴212至原初位置。如果关节式运动或旋转校准失败,就不能进行进一步的操作直到轴组件200被移除。
在启动后,手术器械100监测通信接口413(例如,以1赫兹的频率)是否存在附接的末端执行器300,从而使得当自最后校准起末端执行器300被移除并且电动机运动已经发生时,手术器械100将需要轴组件200的再次校准。
在实施方式中,末端执行器300和/或吻合钉钉仓305可被更换。特别地,通信接口413(例如,以1赫兹的频率)监测末端执行器300的移除和重新附接。如果检测到末端执行器300和/或吻合钉钉仓305已被更换,则通过末端执行器300的砧座组件306和钉仓组件308的完全打开并随后闭合而对手术器械100进行再次校准。
在确定所有部件都已检验和校准之后,手术器械100就准备进行使用。参照图9,致动控制按钮124以实现末端执行器300的夹紧和/或发射。控制按钮126用于实现末端执行器300的砧座组件306和钉仓组件308的打开。摇杆开关128用于使得工具组件304相对于末端执行器300的主体部302进行关节式运动。摇杆开关130用于使末端执行器300和轴组件200相对于手术器械100绕纵轴线“X-X”旋转。安全开关132用于对手术器械100提供末端执行器300准备从中发射紧固件且在致动控制按钮124以开始发射之前必须被按下的信号。用户可以在发射紧固件之前在任一点旋转、关节式运动、和/或打开末端执行器300,每一种模式将在下面更为详细地描述。
从手术器械100的后部观察,通过从右向左按压摇杆开关130,使末端执行器300和轴组件200顺时针旋转,而通过从左向右按压摇杆开关130,使末端执行器300和轴组件200逆时针旋转。旋转可在末端执行器300附接之前发生。然而,当手术器械100处于发射模式和/或末端执行器300被夹紧时,则禁止旋转。当每分钟转数(RPM)达到0时,驱动电动机166停止并且保持停止直到摇杆开关130释放为止。
关节式运动仅能在轴组件200校准后并且当手术器械100未处于发射模式时被激活。关节式运动还能在末端执行器300分离或末端执行器300被夹紧时发生,但处于较低速率。从手术器械100的后部观察同时末端执行器300的钉仓组件308朝向上方的视角,通过分别向左方或右方按压摇杆开关128,末端执行器300向左方和右方做关节式运动。
当控制按钮124和126都被按下并且手术器械100未处于发射模式时,末端执行器300可位于中央,即关节式运动至中央位置。一旦处于中央位置,直到摇杆开关128已被释放并再次致动才停止关节式运动。当按压不同的按钮、达到预定的电流极限值、和/或末端执行器300已达到其关节式运动极限时,驱动电动机166也被停止。
通过按压控制按钮126来打开末端执行器300的砧座组件306和钉仓组件308。该打开持续直到控制按钮126被释放、按下不同的按钮、达到预定的电流极限值、和/或末端执行器300已达到其打开极限为止。
末端执行器300的砧座组件306和钉仓组件308闭合以在启动发射模式之前接触其间的组织。在闭合之前,手术器械100检验联接至它的轴组件200是否如上所述已校验。
只有在轴组件200校准之后并且当手术器械100未处于发射模式时才能够闭合。当末端执行器300分离时,可以进行闭合操作,但处于较低速率。通过按压控制按钮124,末端执行器300的砧座组件306和钉仓组件308闭合。该闭合持续直到控制按钮124被释放、按下不同的按钮、达到预定的电流极限值、和/或末端执行器300已达到其闭合极限为止。
一旦砧座组件306和钉仓组件308闭合,可以启动发射序列。在开始发射之前,接合安全开关132,这启动安全校验算法。安全算法检验是否为:1)轴组件200安装并校准;2)轴组件200和手术器械100的使用计数低于其极限值;3)末端执行器300已安装;4)末端执行器300之前尚未发射;5)电池156的充电水平足以发射;以及6)末端执行器300处于夹紧位置。如果所有上述条件都满足,那么手术器械100进入发射模式并且相应的状态模式通告在照明构件116上,如上所述。
当末端执行器300被夹紧并且如上所述地接合发射模式时,通过按压控制按钮124来启动发射。持续按压控制按钮124推进夹紧构件365,这同时射出紧固件并切割组织。发射持续直到控制按钮124被释放和/或终点挡板被检测到为止。发射进程,例如夹紧构件365行进的距离,由照明构件116来指示,如下所述。
在发射期间,主微控制器402通过调整对联接至驱动电动机166的电动机控制器电路的极限值控制来设定针对驱动电动机166的标准速度电流极限值。当驱动电动机166被设定为标准速度电流极限值时,主微控制器402还监测驱动电动机166的旋转速度,并且一旦达到与标准速度电流极限值相关联的速度阈值,则降低发射速度。速度阈值表示针对与电流极限值相关联的旋转速度范围的最低极限值。一旦速度被降低到较低速度,主微控制器402还设定低速电流极限值。在驱动电动机166以低速电流极限值操作时,主微控制器402还监测驱动电动机166的旋转速度,并且一旦达到与低速电流极限值相关联的速度阈值,则停止发射过程。
在发射序列期间的任意时刻按压控制按钮126继续存在发射模式,以及相应指示会在照明构件116上通告,如上所述。在控制按钮124被释放时持续按压控制按钮126使夹紧构件365缩回,以及一旦达到夹紧位置,则末端执行器300被打开,如上所述。
在发射后,在照明构件116上通告完成指示,如下所述。在发射后,存储在手术器械100和轴组件200的ID芯片406和408中的发射计数也分别增加。如果它不是自加电起检测到的最后(例如,五(5)个)接合器之一,则用于手术器械100的高压灭菌计数器在关断时增加,并且轴组件200的高压灭菌计数器在初始连接至手术器械100之后增加。
参照图32,布置在鼻锥部114中的照明构件116(参见图1至图3)被水平面“H”和垂直面“V”分开,水平面“H”限定了位于水平面“H”上方的上部116b和位于水平面“H”下方的下部116c。照明构件116包括白色LED 117a、117b、117c、117d、117e,它们布置在照明构件116的上部116b上。LED 117a、117b、117c、117d、117e用于指示发射进程,例如夹紧构件365行进的距离,以及手术器械100的剩余使用寿命,如下面更为详细地所述。
照明构件116还包括绿色LED 119a、119b、119c、119d、119e,它们布置在照明构件116的下部116c上。照明构件116还包括蓝色LED 121a和121b,它们布置在照明构件116的上部116b中并且在其相对侧(即,在垂直面“V”的相对侧)。LED 119a-119e和121a-121b用于提供各种状态指示器。如下面详细所述,蓝色LED 121a和121b用于指示错误状态。鼻锥部114可包括有关LED 119b、119c、119d的标记,这些标记将它们分别与手术器械100、轴组件200、和末端执行器300相关联。照明构件116还包括红色LED 123a、123b、123c,它们也布置在照明构件116的上部116b上,散布在白色LED 117b、117c、117d之间。
编码器微控制器412为照明构件116提供信号以输出多个信号模式,用于指示手术器械100的特定操作状态,例如自检失败、设备100使用寿命结束指示、轴组件200使用剩余、校准失败、准备就绪状态、发射进程、器械100使用剩余等等,如图33A至图33T所示。
LED绕鼻锥部114周边的定位允许白色LED 117a、117b、117c、117d、117e对具有位于水平面“H”上方视线的用户是可视的。布置在照明构件116下部116c上的绿色LED 119b、119c、119d对于外科医生(例如,手术师)之外的视线位于水平面“H”下方的用户是可视的。由于蓝色LED 121a和121b及绿色LED 119a和119g布置在水平面“H”上或水平面“H”上方,它们对于外科医生以及其它用户都是可视的。这允许照明构件116为外科医生提供一组状态指示器,为其它用户提供另一组指示器,并为整个手术团队提供同一组指示器。
图33A示出了一种状态模式,其指示在电池156插入后在加电期间,正在进行加电自检和/或激活控制组件103。该模式由闪烁的绿色LED 119b显示。
图33B示出了一种状态模式,其指示加电时自检失败。该状态模式通过纯蓝色LED121a和121b来显示以指示错误状态,以及闪烁的绿色LED 119b指示该错误归属于手术器械100。示于图33B中的模式指示在上述加电自检期间所测试的任意部件(例如,通信接口413、电动机164和166、存储器402b、使用计数器、编码器414和416等)的故障。
图33C示出了一种状态模式,其指示电池156有缺陷。该状态指示器通过纯蓝色LED121a和121b响应于如上所述的电池初始化测试而显示。该故障指示电池156存在任意的下列问题,包括但不限于:初始化失败、使用寿命结束、温度超出可接受范围、容量低、通信失败及其组合。
图33D示出了一种状态模式,其指示手术器械100的自检成功并提供了手术器械100的剩余使用情况。该状态指示器由与手术器械100相关联的原色LED 119b及变化数量的原色LED 117a-117e来显示,如图34A至图34C中所示。参照图34A,所有的LED 117a-117e被激活,其指示仍然剩余很大数目、或超过上限(例如,大于15)的使用次数。参照图34B,LED117a、117b、117d、117e被激活,而LED 117c被关断,其指示剩余中间数目的使用次数,也就是处于下限和上限之间(例如,5和15之间)。参照图34C,LED 117a和117e被激活,而LED117b、117c、117d被关断,这指示剩余较少数目的使用次数,也就是低数值或以下。
图33E示出了一种状态模式,其指示当使用次数低于下限时,手术器械100的剩余使用次数。在关于图33D和图34A-D如上所描述的剩余使用次数指示器示出之后,该状态指示器可通过同时按压控制按钮124和126而被触发。在激活控制按钮124和126时,LED 119b原色照明且LED 117a-117e闪烁对应于剩余使用次数的次数。
图33F和34D示出了一种状态模式,其指示手术器械100的使用寿命结束。该状态指示器通过所有LED 117a-117e的闪烁、LED 121a和121b的原色照明、以及LED 119b的闪烁来显示。
图33G示出了一种状态模式,其指示轴组件200可联接至手术器械100。该状态指示器通过与手术器械100相关联的LED 119b的原色照明以及与轴组件200相关联的闪烁的LED119c来显示。
图33H示出了一种状态模式,其指示轴组件200的校准失败。该状态指示器通过指示错误状态的蓝色LED 121a和121b的原色照明、与手术器械100相关联的LED 119b的原色照明、以及与轴组件200相关联的闪烁的LED 119c来显示。该故障指示轴组件200存在任意的下列问题,包括但不限于:在关节式运动终点挡板检测期间的超时、在发射杆终点挡板检测期间的超时、轴组件200的使用计数超过极限值,及其组合。
图33I示出了一种状态模式,其指示轴组件200成功校准并提供了轴组件200的剩余使用次数。该状态指示器通过与手术器械100相关联的LED 119b的原色照明、与轴组件200相关联的LED 119c的原色照明、以及不同数量LED 117a-117e的原色照明来显示,如图34A-C所示。参照图34A,所有的LED 117a-117e被激活,其指示仍然剩余很大数目、或超过上限(例如,大于15)的使用次数。参照图34B,LED 117a、117b、117d、117e被激活,而LED117c被关断,其指示剩余中间数目的使用次数,也就是处于下限和上限之间(例如,5和15之间)。参照图34C,LED 117a和117e被激活,而LED 117b、117c、117d被关断,这指示剩余较少数目的使用次数,也就是低数值或以下。
图33J示出了一种状态模式,其指示当剩余使用次数低于下限时,轴组件200的剩余使用次数。在关于图33I和34A-D如上所描述的剩余使用次数指示器示出之后,该状态指示器可通过同时按压控制按钮124和126而被触发。在激活控制按钮124和126之后,LED119b和119c原色照明且LED 117a-117e闪烁对应于剩余使用次数的次数。
图33K和图34D示出了一种状态模式,其指示轴组件200的使用寿命结束。该状态指示器通过所有LED 117a-117e的闪烁、LED 121a和121b的原色照明、LED 119b的原色照明、以及LED 119c的闪烁来显示。
图33L示出了一种状态模式,其指示末端执行器300可联接至轴组件200。该状态指示器通过与手术器械100相关联的LED 119b的原色照明、与轴组件200相关联的LED 119c的原色照明、以及与末端执行器300相关联的闪烁的LED 119d来显示。
图33M示出了一种状态模式,其指示末端执行器300的故障。该状态指示器通过LED119b、119c、121a、121b、117a-117c的原色照明、以及LED 119d的闪烁来显示。该故障指示末端执行器300存在任意的下列问题,包括但不限于发射后缩回而超过了完全夹紧。
图33N示出了一种状态模式,其通过LED 119b、119c、119d的原色照明来指示末端执行器300的夹紧测试成功。
图33O示出了一种状态模式,其指示末端执行器300完全夹紧(例如,准备接合发射模式)。该状态指示器通过LED 119a-119e的原色照明来显示。
图33P示出了一种状态模式,其指示系统100处于发射模式。该状态指示器通过LED119b、119c、119d的原色照明和闪烁的LED 119a和119e来显示。
图33Q-T示出了多个状态模式,其指示末端执行器300的发射进程。类似于图33P的发射模式指示,LED 119b、119c、119d原色照明并且LED119a和119e闪烁,同时LED 117a-117e从外侧(例如,LED 117a和117e)顺序地激活,直到所有LED都原色照明,指示发射进程的完成。鼻锥部114可用距离标记来标识(例如,30mm针对LED 119a和119e,45mm针对LED119b和119d,以及60mm针对LED 119c),如图34A-D所示。
图33Q示出了在发射过程开始时,随着夹紧构件365开始行进(例如30mm),外侧LED119a和119e被激活。图33R示出了随着夹紧构件365处于例如45mm,LED 119a、119b、119c、119d照明。图33S示出了随着夹紧构件365完全伸展(例如60mm),所有的LED 119a-119e照明。
图33T示出了一种状态模式,其指示夹紧构件365在发射过程完成后的缩回序列。该状态指示器通过LED 117a-117e的原色照明、LED 119a、119b、119c、119e的原色、以及与末端执行器300相关联的LED 119d的闪烁来显示。
应当理解的是,可对本文披露的实施方式进行各种修改。例如,器械100不必施加吻合钉而是可以使用本领域内公知的两件式紧固件。此外,可以修改吻合钉或紧固件的线性排的长度以满足特定手术操作的需要。因而,致动轴的单行程的长度和/或一次性装载单元中吻合钉和/或紧固件的线性排的长度也可以相应地改变。因此,上述说明不应当被解释为限制性的,而仅仅是优选实施方式的例证。本领域技术人员能够在所附权利要求书的范围和精神内预见到其它修改。
Claims (8)
1.一种用于将手术器械和末端执行器相互连接的接合器组件,包括:
细长主体,其近侧端和远侧端;
致动杆,其布置在所述细长主体内,所述致动杆被构造为接合末端执行器且响应于所述细长主体与末端执行器联接是能运动的;
释放按钮,其布置在所述细长主体上且联接至所述致动杆,使得所述释放按钮通过所述致动杆是能运动的;以及
传感器,其通过通过所述致动杆运动的所述释放按钮是能致动的,所述传感器被配置为传送表示末端执行器固定至所述细长主体的信号。
2.根据权利要求1所述的接合器组件,其中所述致动杆被构造为在与末端执行器接合时从第一位置纵向地运动到第二位置。
3.根据权利要求2所述的接合器组件,还包括锁定机构,所述锁定机构被构造为在所述致动杆与末端执行器接合时将所述致动杆紧固在所述第二位置。
4.根据权利要求3所述的接合器组件,其中所述锁定机构包括被构造为使所述致动杆沿远侧方向偏置的弹簧。
5.根据权利要求3所述的接合器组件,其中所述释放按钮沿近侧方向是能运动的,以使所述致动杆从所述第二位置运动至所述第一位置。
6.根据权利要求5所述的接合器组件,其中所述释放按钮在沿所述近侧方向运动时使所述传感器停止工作。
7.根据权利要求6所述的接合器组件,其中所述传感器在通过所述释放按钮停止工作时终止所述信号的传送。
8.根据权利要求1所述的接合器组件,其中所述传感器是扳钮开关。
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2013
- 2013-07-01 US US13/932,313 patent/US10492814B2/en active Active
- 2013-07-05 AU AU2013206723A patent/AU2013206723B2/en not_active Ceased
- 2013-07-08 CA CA2820156A patent/CA2820156A1/en not_active Abandoned
- 2013-07-08 EP EP13175477.2A patent/EP2684529B1/en active Active
- 2013-07-08 ES ES13175477.2T patent/ES2545762T3/es active Active
- 2013-07-09 CN CN201310369318.2A patent/CN103565490B/zh active Active
- 2013-07-09 CN CN201711259557.7A patent/CN107811666B/zh active Active
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2017
- 2017-05-22 AU AU2017203410A patent/AU2017203410B2/en not_active Ceased
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2019
- 2019-07-10 AU AU2019204962A patent/AU2019204962A1/en not_active Abandoned
- 2019-12-02 US US16/700,115 patent/US11490918B2/en active Active
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2022
- 2022-11-07 US US17/981,540 patent/US20230056274A1/en active Pending
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US11490918B2 (en) | 2022-11-08 |
AU2019204962A1 (en) | 2019-07-25 |
AU2013206723B2 (en) | 2017-03-02 |
CN103565490A (zh) | 2014-02-12 |
EP2684529B1 (en) | 2015-07-22 |
EP2684529A2 (en) | 2014-01-15 |
AU2013206723A1 (en) | 2014-01-23 |
CA2820156A1 (en) | 2014-01-09 |
US20200100805A1 (en) | 2020-04-02 |
AU2017203410A1 (en) | 2017-06-08 |
ES2545762T3 (es) | 2015-09-15 |
CN107811666B (zh) | 2020-08-25 |
AU2017203410B2 (en) | 2019-04-18 |
EP2684529A3 (en) | 2014-03-12 |
CN103565490B (zh) | 2018-02-02 |
US10492814B2 (en) | 2019-12-03 |
US20230056274A1 (en) | 2023-02-23 |
US20140012289A1 (en) | 2014-01-09 |
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