CN108135603A - 具有轴释放、动力击发和动力关节运动的外科缝合器械 - Google Patents
具有轴释放、动力击发和动力关节运动的外科缝合器械 Download PDFInfo
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Abstract
本发明提供了一种外科器械,所述外科器械包括轴组件、柄部组件和闩锁系统,所述闩锁系统被构造成能够操作地联接所述轴组件和所述柄部组件。所述闩锁系统包括分别连接到所述轴组件和所述柄部组件以抑制所述轴组件和柄部组件的可操作脱开的轴锁定构件和柄部锁定构件。所述闩锁构件具有凸轮表面和闩锁构件。所述闩锁构件被构造成能够从锁定位置选择性地移动到释放位置,使得所述闩锁构件的移动使得所述轴锁定构件和柄部锁定构件将所述轴组件和柄部组件脱离和脱开。所述闩锁构件进一步被构造成能够从所述释放位置选择性地移动到移除位置,使得所述闩锁构件的进一步移动使得所述闩锁构件的所述凸轮表面接合所述凸轮基座并沿移除方向推动所述轴组件。
Description
背景技术
在一些环境下,内窥镜式外科器械相对于传统的开放式外科装置来说是优选的,因为较小的切口可减少术后恢复时间和并发症。因此,一些内窥镜式外科器械可适于通过套管针的插管来将远侧端部执行器放置在期望的外科手术部位。这些远侧端部执行器(例如,内镜切割器、抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因治疗递送装置、以及使用超声波振动、RF、激光等的能量递送装置)可以多种方式接合组织,以实现诊断效果或治疗效果。内窥镜式外科器械可包括位于端部执行器和由临床医生操纵的柄部部分之间的轴。此类轴可使得能够插入到期望的深度并围绕轴的纵向轴线旋转,由此有利于将端部执行器定位在患者体内。还可通过包括一个或多个关节运动接头或特征结构而进一步有利于定位该端部执行器,从而使得端部执行器能够选择性地进行关节运动或者以其他方式相对于轴的纵向轴线偏转。
内窥镜式外科器械的示例包括外科缝合器。一些此类缝合器能够操作以夹紧组织层,切穿夹持的组织层,并且将钉驱动穿过组织层,以在组织层的切断端部附近将切断的组织层基本上密封在一起。仅示例性外科缝合器被公开于以下专利中:1989年2月21日公布的标题为“Pocket Configuration for Internal Organ Staplers”的美国专利No.4,805,823;1995年5月16日公布的标题为“Surgical Stapler and Staple Cartridge”的美国专利No.5,415,334;1995年11月14日公布的标题为“Surgical Stapler Instrument”的美国专利No.5,465,895;1997年1月28日公布的标题为“Surgical Stapler Instrument”的美国专利No.5,597,107;1997年5月27日公布的标题为“Surgical Instrument”的美国专利No.5,632,432;1997年10月7日公布的标题为“Surgical Instrument”的美国专利No.5,673,840;1998年1月6日公布的标题为“Articulation Assembly for SurgicalInstruments”的美国专利No.5,704,534;1998年9月29日公布的标题为“SurgicalClamping Mechanism”的美国专利No.5,814,055;2005年12月27日公布的标题为“SurgicalStapling Instrument Incorporating an E-Beam Firing Mechanism”的美国专利No.6,978,921;2006年2月21日公布的标题为“Surgical Stapling Instrument HavingSeparate Distinct Closing and Firing Systems”的美国专利No.7,000,818;2006年12月5日公布的标题为“Surgical Stapling Instrument Having a Firing Lockout for anUnclosed Anvil”的美国专利No.7,143,923;2007年12月4日公布的标题为“SurgicalStapling Instrument Incorporating a Multi-Stroke Firing Mechanism with aFlexible Rack”的美国专利No.7,303,108;2008年5月6日公布的标题为“SurgicalStapling Instrument Incorporating a Multistroke Firing Mechanism Having aRotary Transmission”的美国专利No.7,367,485;2008年6月3日公布的标题为“SurgicalStapling Instrument Having a Single Lockout Mechanism for Prevention ofFiring”的美国专利No.7,380,695;2008年6月3日公布的标题为“Articulating SurgicalStapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism”的美国专利No.7,380,696;2008年7月29日公布的标题为“Surgical Stapling and CuttingDevice”的美国专利No.7,404,508;2008年10月14日公布的标题为“Surgical StaplingInstrument Having Multistroke Firing with Opening Lockout”的美国专利No.7,434,715;2010年5月25日公布的标题为“Disposable Cartridge with Adhesive for Use witha Stapling Device”的美国专利No.7,721,930;2013年4月2日公布的标题为“SurgicalStapling Instrument with An Articulatable End Effector”的美国专利No.8,408,439;以及2013年6月4日公布的标题为“Motor-Driven Surgical Cutting Instrumentwith Electric Actuator Directional Control Assembly”的美国专利No.8,453,914。以上引用的美国专利中的每个的公开内容以引用方式并入本文。
尽管上文所涉及的外科缝合器被描述为用于内窥镜式规程中,但应当理解,此类外科缝合器也可用于开腹规程和/或其他非内窥镜式规程中。仅以举例的方式,在胸廓外科规程中,外科缝合器可通过胸廓切开术被插入并由此位于患者肋骨之间以到达一个或多个器官,所述胸廓外科规程不使用套管针作为缝合器的导管。此类规程可包括使用缝合器来切断和闭合通向肺部的血管。例如,在从胸腔中取出器官之前,可通过缝合器来切断并闭合通向器官的血管。当然,外科缝合器可用于各种其他情况和规程中。
可特别适合或通过胸廓切开术使用的外科缝合器的示例被公开在2014年8月28日公布的标题为“Surgical Instrument End Effector Articulation Drive with Pinionand Opposing Racks”的美国专利申请公布No.2014/0243801;2014年8月28日公布的标题为“Lockout Feature for Movable Cutting Member of Surgical Instrument”的美国专利申请公布No.2014/0239041;2014年8月28日公布的标题为“Integrated TissuePositioning and Jaw Alignment Features for Surgical Stapler”的美国专利申请公布No.2014/0239042;2014年8月28日公布的标题为“Jaw Closure Feature for EndEffector of Surgical Instrument”的美国专利申请公布No.2014/0239036;2014年8月24日公布的标题为“Surgical Instrument with Articulation Lock having a DetentingBinary Spring”的美国专利申请公布No.2014/0239040;2014年8月28日公布的标题为“Distal Tip Features for End Effector of Surgical Instrument”的美国专利申请公布No.2014/0239043;2014年8月28日提交的标题为“Staple Forming Features forSurgical Stapling Instrument”的美国专利申请公布No.20140239037;2014年8月28日公布的标题为“Surgical Instrument with Multi-Diameter Shaft”的美国专利申请公布No.2014/0239038;以及2014年8月28日公布的标题为“Installation Features forSurgical Instrument End Effector Cartridge”的美国专利申请公布No.2014/0239044中。上述美国专利申请中的每个的公开内容均以引用方式并入本文。
尽管已经制造和使用了若干外科器械和系统,但据信在本发明人之前无人制造或使用所附权利要求中描述的本发明。
附图说明
尽管本说明书得出了具体地指出和明确地声明这种技术的权利要求,但是据信从下述的结合附图描述的某些示例将更好地理解这种技术,其中相似的参考标号指示相同的元件,并且其中:
图1示出了包括可互换轴组件和柄部组件的示例性外科器械的透视图;
图2示出了图1的器械的透视图,其示出从器械的柄部组件拆卸的轴组件;
图3示出了图1的器械的部分透视图,其示出从器械的柄部组件拆卸的轴组件;
图4A示出了沿图1的线4-4截取的图1的器械的横截面侧视图,其中轴组件操作地联接到柄部组件;
图4B示出了沿图1的线4-4截取的图1的器械的横截面侧视图,其中轴组件处于与柄部组件操作地脱开的初始阶段;
图5A示出了图1的器械的透视图,其中外壳的部分被去除以显示轴组件操作地联接到柄部组件;
图5B示出了图1的器械的透视图,其中外壳的部分被去除以显示轴组件处于与柄部组件操作地脱开的初始阶段;
图6示出了另一示例性外科缝合器械的透视图;
图7A示出了大体沿轴组件的中心线截取的图6的器械的放大横截面侧视图,其中轴组件操作地联接到柄部组件;
图7B示出了大体沿轴组件的中心线截取的图6的器械的放大横截面侧视图,其中轴组件处于与柄部组件脱开的第一阶段;
图7C示出了大体沿轴组件的中心线截取的图6的器械的放大横截面侧视图,其中轴组件处于与柄部组件脱开的第二阶段;
图8A示出了另一示例性外科缝合器械的放大后部透视图,其中轴组件操作地联接到柄部组件;
图8B示出了图8A的器械的放大后部透视图,其中轴组件处于与柄部组件脱开的第一阶段;
图8C示出了图8A的器械的放大后部透视图,其中轴组件处于与柄部组件脱开的第二阶段;
图9示出了图8A的器械的闩锁系统的一部分的分解透视图;
图10A示出了大体沿轴组件的中心线截取的图8A的器械的放大横截面侧视图,其中轴组件操作地联接到柄部组件;
图10B示出了大体沿轴组件的中心线截取的图8A的器械的放大横截面侧视图,其中轴组件处于与柄部组件脱开的第一阶段;
图10C示出了大体沿轴组件的中心线截取的图8A的器械的放大横截面侧视图,其中轴组件处于与柄部组件脱开的第二阶段;
图11A示出了另一示例性外科缝合器械的放大后部透视图,其中轴组件操作地联接到柄部组件;
图11B示出了图11A的器械的放大后部透视图,其中轴组件处于与柄部组件脱开的初始阶段;
图12A示出了大体沿轴组件的中心线截取的图11A的器械的放大横截面侧视图,其中轴组件操作地联接到柄部;
图12B示出了大体沿轴组件的中心线截取的图11A的器械的放大横截面侧视图,其中轴组件处于与柄部组件脱开的初始阶段;
图13示出了具有场可编程门阵列的示例性外科缝合器械的示意图,该场可编程门阵列被构造成能够当将轴组件操作地联接到柄部组件时接收来自闪存存储器的核心逻辑;
图14示出了图13的器械的柄部组件的顶部透视图;
图15示出了具有轴组件的另一示例性外科缝合器械的部分分解透视图,该轴组件包括移动机构;
图16示出了图15的轴组件的分解透视图;
图17示出了在组件的第一阶段的图16的轴组件的放大分解透视图;
图18示出了在组件的第二阶段的图17的轴组件的放大的、部分分解透视图;
图19示出了在组件的第三阶段的图17的轴组件的放大的、部分分解透视图;
图20A示出了图16的轴组件的放大透视图,其中移动机构处于第一接合位置;以及
图20B示出了图16的轴组件的放大透视图,其中移动机构处于第二接合位置。
附图并非旨在以任何方式进行限制,并且可以设想本技术的各种实施方案可以多种其他方式来执行,包括那些未必在附图中示出的方式。并入本说明书中并构成其一部分的附图示出了本技术的若干方面,并与说明书一起用于解释本技术的原理;然而,应当理解,本技术不限于所示出的精确布置方式。
具体实施方式
下面对本技术的某些示例的描述不应用于限制本技术的范围。从下面的描述而言,本技术的其他示例、特征、方面、实施方案和优点对本领域的技术人员而言将变得显而易见,下面的描述以举例的方式进行,这是为实现本技术所设想的最好的方式中的一种方式。正如将意识到的,本文所述的技术能够具有其他不同的和明显的方面,所有这些方面均不脱离本技术。因此,附图和说明应被视为实质上是例示性的而非限制性的。
另外应当理解,本文所述的教导内容、表达方式、实施方案、示例等中的任何一者或多者可与本文所述的其他教导内容、表达方式、实施方案、示例等中的任何一者或多者相结合。因此,下述教导内容、表达方式、实施方案、示例等不应视为彼此孤立。参考本文的教导内容,本文的教导内容可进行组合的各种合适方式对于本领域的普通技术人员而言将显而易见。此类修改和变型旨在包括在权利要求书的范围内。
为公开的清楚起见,术语“近侧”和“远侧”在本文中为相对于抓握具有远侧外科端部执行器的外科器械的操作者或其他操作者定义的。术语“近侧”是指元件的更靠近操作者或其他操作者的位置,并且术语“远侧”是指元件的更靠近外科器械的外科端部执行器并且更远离操作者或其他操作者的位置。尽管本文所述的外科器械包括用于切割和缝合的电动工具,但应当理解,本文所述的电池构型可结合任何合适类型的电外科器械来使用,所述电外科器械为例如诸如切割器、抱握器、缝合器、RF切割器/凝固器、超声切割器/凝固器和激光切割器/凝固器等。
I.示例性外科器械的概述
图1示出了可再利用或不可再利用的马达驱动外科切割和紧固器械(10)。在所示实施方案中,外科器械(10)包括具有外壳(12)的柄部组件(11)。外壳(12)的至少一部分形成被构造成能够由临床医生抓握、操纵和致动的柄部(14)。外壳(12)被构造用于操作地附接到可互换轴组件(16),该可互换轴组件具有操作地联接到其的被构造成能够执行一个或多个外科任务或规程的外科端部执行器(18)。应当理解,本文公开的各种形式的可互换轴组件的各种独特且新颖的布置也可有效地与机器人控制的外科系统结合使用。因此,术语“外壳”也可涵盖机器人系统的容纳或以其它方式操作地支撑至少一个驱动系统的外壳或类似部分,其中所述至少一个驱动系统被构造成能够生成和施加可用于致动本文所公开的可互换轴组件及其相应的等同物的至少一个控制运动。术语“框架”可指手持式外科器械的一部分。术语“框架”还可表示机器人控制的外科器械的一部分和/或机器人系统的可用以操作地控制外科器械的一部分。例如,本文公开的可互换轴组件可与美国专利No.9,072,535中公开的各种机器人系统、器械、部件和方法一起使用。该专利为2015年7月7日公布的标题为“Surgical Stapling Instruments with Rotatable Staple DeploymentArrangements”,其公开内容以引用的方式并入本文。
柄部组件(11)结合包括端部执行器(18)的可互换轴组件(16)示出,所述端部执行器包括操作地支撑其中的外科钉仓(20)的外科切割和紧固装置(10)。外壳(12)可被构造用于与可互换轴组件结合使用,该可互换轴组件包括端部执行器,该端部执行器能够支撑不同尺寸和类型的钉仓,具有不同的轴长度、尺寸和类型等。除此之外,柄部组件(11)还可有效地用于多种其他可互换轴组件,其包括被构造成能够将其他运动和形式的能量(诸如例如射频(RF)能量、超声能量和/或运动)施加到适合与各种外科应用和规程结合使用的端部执行器布置的那些组件。此外,端部执行器、轴组件、柄部、外科器械和/或外科器械系统可利用任何合适的一种或多种紧固件来紧固组织。例如,包括可移除地被存储在其中的多个紧固件的紧固件仓能够可移除地插入轴组件的端部执行器中和/或附接到轴组件的端部执行器。此类仓的各种示例被公开在本文引用的各种参考文献中。
图1示出了具有操作地联接到柄部组件(11)的可互换轴组件(16)的外科器械(10)。图2-图3示出了可互换轴组件(16)到柄部(14)的外壳(12)的附接。柄部(14)包括一对可互换的柄部外壳段(22,24),这对柄部外壳段可通过螺钉、按扣特征结构、粘合剂等互连。在所示布置中,柄部外壳段(22,24)配合以形成可由临床医生抓握和操纵的手枪式握把部(26)。如将在下文进一步详细地讨论,柄部(14)操作地支撑其中的多个驱动系统,这些驱动系统被构造成能够生成各种控制动作并且将这些控制动作施加到操作地附接到其上的可互换轴组件(16)的对应部分。
柄部(14)还包括操作地支撑多个驱动系统的框架(28)。例如,框架(28)能够操作地支撑通常被标记为(30)的“第一”或闭合驱动系统,该“第一”或闭合驱动系统可用于将闭合和打开动作施加到操作地附接或联接到其的可互换轴组件(16)。在一个示例中,闭合驱动系统(30)包括呈由框架(28)可枢转地支撑的闭合触发器(32)的形式的致动器。更具体地,闭合触发器(32)通过销(34)可枢转地联接到外壳(14)(参见图4A)。此类布置使得闭合触发器(32)能够由临床医生操纵,使得当临床医生抓握柄部(14)的手枪式握把部(26)时,闭合触发器(32)可被轻易地从起始或“未致动”位置朝手枪式握把部(26)枢转到“致动”位置,并且更具体地,枢转到完全压缩或完全致动位置。闭合触发器(32)可由弹簧或其他偏压布置(未示出)偏压到未致动位置中。在各种示例中,闭合驱动系统(30)还包括可枢转地联接到闭合触发器(32)的闭合连杆组件(36)。闭合连杆组(36)可包括通过销(未示出)枢转地联接到闭合触发器(32)的第一闭合连杆(未示出)和第二闭合连杆(38)。第二闭合连杆(38)在本文中也可被称为“附接构件”并且包括横向附接销(37)。
继续参见图1-图3,第一闭合连杆(未示出)被构造成能够与枢转地联接到框架(28)的闭合释放组件(44)配合。在至少一个示例中,闭合释放组件(44)具有在其上形成的远侧突起的锁定爪(未示出)的释放按钮组件(46)。释放按钮组件(46)可通过释放弹簧(未示出)在逆时针方向上枢转。当临床医生将闭合触发器(32)从其未致动位置朝柄部(14)的手枪式握把部(26)按压时,第一闭合连杆(未示出)向上枢转到其中锁定爪(未示出)下降成与第一闭合连杆(未示出)保持接合,由此防止闭合触发器(32)返回到未致动位置的点。因此,闭合释放组件(44)用于将闭合触发器(32)锁定在完全致动位置中。当临床医生期望将闭合触发器(32)从致动位置解锁以返回到未致动位置时,临床医生简单地枢转闭合释放按钮组件(46),使得锁定爪(未示出)被移动成与第一闭合连杆(未示出)不再接合。当锁定爪(未示出)已被移动成与第一闭合连杆(未示出)不再接合时,闭合触发器(32)可枢转回到未致动位置。也可采用其它闭合触发器锁定布置和释放布置。
可互换轴组件(16)包括外科端部执行器(18),该外科端部执行器包含被构造成能够操作地支撑其中的钉仓(20)的细长通道(48)。本示例的端部执行器(18)还包括相对于细长通道(48)可枢转支撑的砧座(50)。可互换轴组件(16)还包括关节运动接头(52)和关节运动锁(未示出),该关节运动接头和关节运动锁可被构造成能够将端部执行器(18)可释放地保持在相对于轴组件(16)的纵向轴线的期望位置中。仅以举例的方式,端部执行器(18)、关节运动接头(52)和关节运动锁(未示出)可根据以下专利的教导内容中的至少一些教导内容进行构造和操作:2014年9月18日公布的标题为“Articulatable Surgical InstrumentComprising an Articulation Lock”的美国专利No.2014/0263541。另外地,端部执行器(18)、关节运动接头(52)和关节运动锁(未示出)可根据本文引用的任何其他参考文献的教导内容中的至少一些教导内容进行构造和操作;或者可以任何其他适宜方式进行构造和操作。
可互换轴组件(16)还包括由喷嘴部分(56,58)构成的近侧外壳或喷嘴(54)。可互换轴组件(16)还包括闭合管(60),该闭合管可用于闭合和/或打开端部执行器(18)的砧座(50)。轴组件(16)也包括闭合梭动件(62),该闭合梭动件在底盘(64)内能够滑动地支撑使得它可相对于其轴向地移动。闭合梭动件(62)包括被构造用于附接到附接销(42)的一对朝近侧突起的钩(66),该附接销附接到第二闭合连杆(38)。闭合管(60)的近侧端部(68)(参见图5A)联接到闭合梭动件(62),以相对于其旋转。闭合弹簧(未示出)轴颈连接在闭合管(60)上并用来沿近侧方向(PD)偏压闭合管(60),当轴组件(16)操作地联接到柄部(14)时,该闭合弹簧可用来将闭合触发器(32)枢转进未致动位置中。下文将更详细地提供关于替换轴组件的一个或多个特征的额外细节。
在本示例中,关节运动接头(52)包括双枢轴闭合套管组件(70)。双枢轴闭合套管组件(70)包括端部执行器闭合套管组件(72),其用于以在美国专利公布No.2014/0263541中描述的各种方式将开口突片接合在砧座(50)上,该专利的公开内容以引用方式并入本文。尽管本示例的轴组件(16)包括关节运动接头(52),但其他可互换轴组件可能缺乏关节运动能力。
参见图3-图4B,底盘(64)包括在其上形成的一对锥形附接部分(74),所述锥形附接部分能够容纳于在框架(28)的远侧附接凸缘部分(78)内形成的相应燕尾形狭槽(76)内。每个燕尾形狭槽(76)可以是锥形,或大致V形,以坐置方式将附接部分(74)接收在其中。轴附接凸耳(80)形成于中间击发轴(82)的近侧端部上。因此,当可互换轴组件(16)联接到柄部(14)时,轴附接凸耳(80)被接收在形成于纵向驱动构件(86)的远侧端部中的击发轴附接支架(84)中。
轴组件(16)的一个示例包括用于将轴组件(16)可拆卸地联接到柄部组件(11),并且更具体地联接到框架(28)的闩锁系统(88)。如可在图4A-图5B中所见,例如,闩锁系统(88)包括可移动地联接到底盘(64)的锁构件或锁定轭(90)。在所示示例中,锁定轭(90)为U形,其具有两个隔开并向下延伸的支脚(92)。支脚(92)各自具有在其上形成的枢轴凸耳(94),这些枢轴凸耳能够被接收在形成于底盘(64)中的对应孔(未示出)中。此类布置有利于将锁定轭(90)枢转附接到底盘(64)。锁定轭(90)包括两个向近侧突起的锁定凸耳(96),这两个锁定凸耳被构造用于与框架(28)的远侧附接凸缘部分(78)中对应的锁定棘爪或凹槽(98)可释放地接合(参见图3)。在各种形式中,锁定轭(90)通过弹簧(91)或其他偏压构件(例如,如在图7A-图7C、图10A-图10C和图12A-图12B中可见,其在下文更详细地描述)沿近侧方向偏压。锁定轭(90)的致动可通过能够滑动地安装在闩锁致动器组件(102)上的闩锁按钮(100)来实现,该闩锁致动器组件安装到底盘(64)。闩锁按钮(100)可相对于锁定轭(90)沿近侧方向偏压。如将在下文进一步详细地讨论,锁定轭(90)可通过沿远侧方向推动闩锁按钮(100)而移动到解锁位置,这也使锁定轭(90)枢转成不再与框架(28)的远侧附接凸缘部分(78)保持接合。当锁定轭(90)与框架(28)的远侧附接凸缘部分(78)“保持接合”时,锁定凸耳(96)保持坐置在远侧附接凸缘部分(78)中对应的锁定棘爪或凹槽(98)内。
当采用包括能够切割和紧固组织的本文所述类型的端部执行器以及其他类型的端部执行器的可互换轴组件时,可能需要防止可互换轴组件(16)在端部执行器(18)致动的过程中不经意地从柄部组件(11)脱离。例如,在使用中,临床医生可致动闭合触发器(32)以抓持目标组织并将其操纵至期望的位置。一旦目标组织以期望取向定位在端部执行器(18)内,临床医生就可完全地致动闭合触发器(32),以关闭砧座(50)并将目标组织夹持在合适位置供切割与缝合。在那种情况下,闭合驱动系统(30)已被完全致动。在目标组织已被夹紧在端部执行器(18)中之后,可能需要防止轴组件(16)与柄部组件(11)的意外脱离。
为此,图5A-图5B示出包括能够接触对应锁定凸耳(96)的一对锁定钩(104)的锁定轭(90),该锁定凸耳形成于闭合梭动件(62)上。参见图3和图5A-图5B,当闭合梭动件(62)处于未致动位置(即,未致动第一驱动系统(30)并且打开砧座(50))时,锁定轭(90)可沿远侧方向枢转,以将可互换轴组件(16)从柄部组件(11)解锁。当处于该位置时,锁定钩(104)不接触闭合梭动件(62)上的锁定凸耳(96)。然而,当闭合梭动件(62)移动到致动位置(即,第一驱动系统(30)被致动并且砧座(50)处于闭合位置)时,锁定轭(90)被阻止枢转到解锁位置。换句话讲,如果临床医生试图将锁定轭(90)枢转到解锁位置,或者例如,锁定轭(90)不经意地以原本可能引起其朝远侧枢转的方式受到碰撞或发生接触,则锁定轭(90)上的锁定钩(104)将接触闭合梭动件(62)上的锁定凸耳(96),并且防止锁定轭(90)运动到解锁位置。
现在将参照图3-图5B描述可互换轴组件(16)到柄部(14)的附接。为了开始联接过程,临床医生可将可互换轴组件(16)的底盘(64)定位在框架(28)的远侧附接凸缘部分(78)上方或附近,使得在底盘(64)上形成的锥形附接部分(74)与框架(28)中的燕尾形狭槽(76)对齐。然后临床医生可沿垂直于轴组件(16)的纵向轴线的安装轴线(IA)移动轴组件(16),以使附接部分(74)坐置成与对应的燕尾形接收狭槽(76)“操作地接合”。这样做时,中间击发轴(82)上的轴附接凸耳(80)也将坐置在可纵向移动的驱动构件(86)中的支架(84)中,并且第二闭合连杆(38)上的销(42)的部分将坐置在闭合梭动件(62)中的对应钩(66)中。如本文所用,术语“操作地接合”在两个部件的情况下指所述两个部件彼此充分地接合,使得一旦向其施加致动运动,所述部件便可以执行其预期动作、功能和/或规程。
如上文所讨论,可互换轴组件(16)的至少五个系统操作地与柄部(14)的至少五个对应系统联接。第一系统包括框架系统,该框架系统将轴组件(16)的框架或脊与柄部(14)的框架(28)联接和/或对齐。第二系统为将柄部(14)的闭合触发器(32)与轴组件(16)的闭合管(60)和砧座(50)操作地连接的闭合驱动系统(30)。如上文所概述,轴组件(16)的闭合梭动件(62)与第二闭合连杆(38)上的销(42)接合。第三系统为将柄部(14)的击发触发器与轴组件(16)的中间击发轴(82)操作地连接的击发驱动系统。如上文所概述,轴附接凸耳(80)与纵向驱动构件(86)的支架(84)操作地连接。第四系统为电气系统,该电气系统能够发送轴组件(16)已与柄部(14)操作地接合的信号到柄部(14)中的控制器,诸如微控制器,以在轴组件(16)和柄部(14)之间传导功率和/或通信信号。例如,轴组件(16)包括操作地安装到轴电路板(未示出)的电连接器(106)。电连接器(106)被构造用于与柄部控制板(未示出)上的对应电连接器(108)配合接合。关于电路和控制系统的另外细节可在美国专利公布No.2014/0263541中查找到,该专利的公开内容以引用方式并入本文。第五系统为用于将轴组件(16)可释放地锁定到柄部(14)的闩锁系统(88)。
本文所公开的各种轴组件(16)可采用传感器和各种其他部件,所述传感器和各种其他部件需要与外壳(12)中的控制器电连通。这些轴组件(16)通常被构造成能够相对于外壳旋转,从而必须在两个或更多个可相对彼此旋转的部件之间设置有利于此类电连通的连接件。当采用本文所公开类型的端部执行器时,连接器布置在本质上必须相对稳固,同时还必须略微紧凑,以装配到轴组件的连接器部分中。除了上述之外,器械(10)可根据以下专利的教导内容中的至少一些教导内容进行构造和操作:2014年3月26日提交的标题为“Surgical Instrument Comprising a Sensor System”的美国专利申请No.14/226,142,其公开内容以引用方式并入本文。除此之外或可选地,器械(10)可根据本文引用的各种其他参考文献的任何其他参考文献的教导内容中的至少一些教导内容来构造和操作。
II.具有弹出闩锁系统的外科器械
尽管上述外科器械(10)提供可互换轴组件(16),但是应当理解,轴组件(16)通过沿安装轴线(IA)运动来联接和脱开。因此,操作者可能无法记得从柄部组件(11)移除轴组件(16)的方向并且无意中试图沿另一不正确的方向(例如,通过沿轴组件(16)的纵向轴线牵拉轴组件(16))移除轴组件(16)。最好的情况,此试图移除可导致手术过程中的时间浪费和受抑,尤其在复杂且时间敏感的外科规程中。最坏的情况,操作者可能在不正确移除过程中或不正确移除时不经意地损坏外科器械(10)。因此可能需要提供具有弹出闩锁系统(288)的外科器械(210),该弹出闩锁系统被构造成能够从柄部组件(11)至少部分地移除轴组件(16)以便更容易地向操作者指示移除轴组件(16)的方向。应当理解,下文所述的特征结构可易于与上述外科器械(10)结合。为此,相似标号指示上文更详细描述的相似特征。
图6-图7C示出了示例性外科器械(210),其包括柄部组件(11)、轴组件(16)和被构造成能够指示沿安装轴线(IA)移除的方向的弹出闩锁系统(288)(参见图2)。闩锁系统(288)包括具有闩锁构件的闩锁致动器组件(302),该闩锁构件呈闩锁按钮(300)和闩锁安装主体(310)的形式。闩锁安装主体(310)被构造成能够能够滑动地支撑闩锁按钮(300),在操作者在如图7A-图7C中分别示出的锁定位置、释放位置和移除位置之间操纵闩锁按钮(300)时。由此,操作者将闩锁按钮(300)从锁定位置向远侧地滑动到释放位置,以便将轴组件(16)与柄部组件(11)操作地脱开。然后操作者进一步将闩锁按钮(300)从释放位置向远侧地滑动到移除位置,以朝相对于轴组件(16)的移除方向推动轴组件(16)。尽管下文将锁定位置、释放位置和移除位置详细地描述为离散的位置,但是应当理解,操作者可将闩锁按钮(300)从锁定位置平滑地递送到释放位置并且使用单个、普通的运动移除轴组件(16);或者通过操作者所需的离散操纵。
如图7A中示出,闩锁系统(288)还包括呈远侧附接凸缘部分(78)形式的柄部锁定构件和呈锁定轭(90)形式的轴锁定构件。如上文所述,锁定轭(90)枢转地连接到轴组件(16)的近侧端部部分(312)处的底盘(64)并且朝远侧附接凸缘部分(78)近侧地偏压。当将轴组件(16)操作地联接到柄部组件(11)时,枢轴凸耳(94)抵靠远侧附接凸缘部分(78)滑动并且将锁定轭(90)围绕远侧附接凸缘部分(78)枢转直到凹槽(98)捕获枢轴凸耳(94)。远侧附接凸缘部分(78)和锁定轭(90)由此抑制轴组件(16)的移除直到操作者操纵闩锁按钮(300)。
为此,闩锁按钮(300)包括用以枢转锁定轭(90)并将枢轴凸耳(94)从凹槽(98)释放的上抓握表面(314)和远侧鼻状物(316)。上抓握表面(314)被纹理化以便提供操作者通过其可有效地抓住闩锁按钮(300)的表面。远侧鼻状物(316)从上抓握表面(314)向远侧地突出并延伸到锁定轭(90)。闩锁按钮(300)还包括被构造成能够接合凸轮基座(320)并沿其滑动的下斜坡凸轮表面(318),该凸轮基座刚性地附接到柄部组件(11)。
闩锁安装主体(310)能够使得闩锁按钮(300)能够纵向滑动并抵靠凸轮基座(320)。在本示例中,闩锁安装主体(310)具有能够滑动地接收闩锁按钮(300)的相对端部的一对相对地纵向闩锁狭槽(322)。闩锁安装主体(310)也包括定位的孔(324)使得下斜坡凸轮表面(318)接触其间的凸轮基座(320)。因此,下斜坡凸轮表面(318)和凸轮基座(320)之间的接合引导闩锁按钮(300)的横向移动,而闩锁按钮(300)被构造成能够在闩锁安装主体(310)中的每个纵向闩锁狭槽(322)内纵向滑动。
在使用中,图7A示出了在锁定位置与柄部组件(11)和闩锁按钮(300)操作地联接的轴组件(16)。11为了将轴组件和柄部组件(16,11)脱开,操作者使用手的拇指或手指抓住上抓握表面(314)并将闩锁按钮(300)向远侧地朝释放位置滑动。继而,远侧鼻状物(316)接合锁定轭(90)并向远侧地枢转锁定轭(90)以释放枢转凸耳(94)。图7B示出了在释放位置与闩锁按钮(300)操作地脱开的轴组件和柄部组件(16,11)。
在本示例中,轴组件(16)可从释放位置沿安装轴线(IA)(参见图2)移除,因为轴组件和柄部组件(16,11)在此阶段机械地脱开。然而,为了指示沿安装轴线(IA)移除的方向,操作者进一步将闩锁按钮(300)向远侧地朝图7C中示出的释放位置滑动。更具体地,当闩锁按钮(300)向远侧滑动时,下斜坡凸轮表面(318)沿凸轮基座(320)横向向上滑动。因为闩锁按钮(300)容纳在闩锁安装主体(310)的闩锁狭槽(322)内,闩锁按钮(300)的向上移动类似地在沿安装轴线(IA)的移除方向上向上地推动整个轴组件(16)。换句话说,闩锁系统(288)响应于按钮(300)的进一步远侧滑动在沿安装轴线(IA)的移除方向上向上地部分弹出轴组件(16)。通过触觉反馈感受到此弹射的操作者,随后可继续在沿安装轴线(IA)的移除方向上移除轴组件(16),以完成可互换轴组件(16)从柄部组件(11)的移除。
III.具有替换闩锁系统的外科器械
在一些情况下,可能需要提供具有替换形式的闩锁系统(88,288)的外科器械(10,210)。特别地,可能需要提供具有另一弹出闩锁系统(488)的外科器械(10,210),该另一弹出闩锁系统包括被构造成能够将轴组件和柄部组件(16,11)操作地脱开并指示沿安装轴线(IA)(参见图2)移除的方向的可枢转闩锁开关(500)。另外,也可能需要提供具有非弹出闩锁系统(688)的外科器械(10,210),该非弹出闩锁系统包括不推动轴组件(16)或以另外方式将轴组件(16)从柄部组件(11)弹出的可枢转闩锁开关(700)。下文更详细地描述替换闩锁系统(488,688)的各种示例。而参考本文的教导内容,其他示例对于本领域的普通技术人员而言是显而易见的。应当理解,下文所述的各种闩锁系统可容易地纳入外科器械(10,210)中以替换各自闩锁系统(88,288)。因此,下文类似的标号继续表示上述类似的特征。
A.具有闩锁开关的示例性替换弹出闩锁系统
图8A-图10C示出了另一示例性外科器械(410),其包括柄部组件(11)、轴组件(16)和被构造成能够指示沿安装轴线(IA)(参见图2)移除的方向的弹出闩锁系统(488)。闩锁系统(488)包括具有闩锁构件的闩锁致动器组件(502),该闩锁构件呈闩锁开关(500)和闩锁安装主体(510)的形式。闩锁安装主体(510)被构造成能够枢转地支撑闩锁开关(500),在操作者在如图8A-图8C和图10A-图10C中分别示出的锁定位置、释放位置和移除位置之间操纵闩锁开关(500)时。由此,操作者将闩锁开关(500)从锁定位置向远侧地枢转到释放位置,以便将轴组件(16)从柄部组件(11)操作地脱开。然后操作者进一步将闩锁开关(500)从释放位置向远侧地枢转到移除位置,以朝相对于轴组件(16)的移除方向推动轴组件(16)。尽管下文将锁定位置、释放位置和移除位置详细地描述为分离散的位置,但是应当理解,操作者可将闩锁按钮(500)从锁定位置平滑地递送到释放位置并且使用单个、普通的运动移除轴组件(16);或者通过操作者所需的离散的操纵。
如图8A和图10A中示出,闩锁系统(488)还包括呈远侧附接凸缘部分(78)形式的柄部锁定构件和呈锁定轭(90)形式的轴锁定构件。闩锁按钮(500)包括用以枢转锁定轭(90)并将枢轴凸耳(94)从凹槽(98)释放的上抓握表面(514)和远侧鼻状物(516)。远侧鼻状物(516)从近侧抓握表面(314)向远侧地突出并延伸到锁定轭(90)。在本示例中,远侧鼻状物(516)还包括被构造成能够接合锁定轭(90)并抵靠锁定轭(90)枢转以向远侧引导锁定轭(90)的弧形凸轮表面(530)。闩锁开关(500)还包括一对凸轮叶(532),每个凸轮叶具有被构造成能够接合凸轮基座(520)并沿该凸轮基座枢转的凸轮凸角表面(518),该凸轮基座刚性地附接到柄部组件(11)。
闩锁安装主体(510)能够使得闩锁开关(500)能够纵向枢转并抵靠凸轮基座(520)。在图9和图10A中示出的示例中,闩锁安装主体(510)具有枢转地接收闩锁开关(500)的相对端部的一对相对横向闩锁狭槽(522)。更具体地,闩锁开关(500)包括枢转地容纳在各自闩锁狭槽(522)内的同轴并相对的横向轴(534)。横向轴(534)的每个也分别包括从其朝凸轮基座(520)延伸的凸轮叶(532)。闩锁安装主体(510)也包括定位的孔(524)使得每个凸轮凸角表面(518)接触其间的凸轮基座(520)。因此,在每个凸轮凸角表面(518)和凸轮基座(520)之间的接合引导闩锁开关(500)的横向移动,而闩锁开关(500)被构造成能够在闩锁安装主体(510)中的横向闩锁狭槽(522)内枢转。
在使用中,图8A和图10A示出了在锁定位置中与柄部组件(11)和闩锁开关(500)操作地联接的轴组件(16)。为了将轴组件和柄部组件(16,11)脱开,操作者使用手的拇指或手指抓住近侧抓握表面(514)并将闩锁开关(500)向远侧地朝释放位置枢转。继而,远侧鼻状物(516)的弧形凸轮表面(530)接合锁定轭(90)并向远侧地枢转锁定轭(90)以释放枢转凸耳(94)。图8B和图10B示出了在释放位置中与闩锁开关(500)操作地脱开的轴组件和柄部组件(16,11)。
在本示例中,轴组件(16)可从释放位置沿安装轴线(IA)(参见图2)移除,因为轴组件和柄部组件(16,11)在此阶段机械地脱开。然而,为了指示沿安装轴线(IA)移除的方向,操作者进一步将闩锁开关(500)向远侧地朝图8C和图10C中示出的释放位置枢转。更具体地,当闩锁开关(500)向远侧枢转时,每个凸轮凸角表面(518)围绕凸轮基座(520)枢转并向上引导闩锁开关(500)的横向轴(534)。因为闩锁开关(500)容纳在闩锁安装主体(510)的闩锁狭槽(522)内,所述闩锁开关(500)的向上移动类似地在沿安装轴线(IA)的移除方向上向上推动整个轴组件(16)。换句话说,闩锁系统(488)响应于闩锁开关(500)的进一步枢转在沿安装轴线(IA)的移除方向上向上地部分弹出轴组件(16)。通过触觉反馈感受到此弹射的操作者,随后可继续在沿安装轴线(IA)的移除方向上移除轴组件(16),以完成可互换轴组件(16)从柄部组件(11)的移除。
B.具有闩锁开关的示例性替换非弹出闩锁系统
图11A-图12B示出了另一示例性外科器械(610),其包括具有闩锁开关(700)的非弹出闩锁系统(688),该闩锁开关被构造成能够将柄部组件和轴组件(16,11)脱开而不指示沿安装轴线(IA)(参见图2)移除的方向。闩锁系统(688)包括具有闩锁构件的闩锁致动器组件(702),所述闩锁构件呈闩锁开关(700)和闩锁安装主体(510)的形式。闩锁安装主体(510)被构造成能够枢转地支撑闩锁开关(700),在操作者操纵闩锁开关(700)从锁定位置到释放位置时,如图11A-图11B和图12A-图12B中分别地示出。由此,操作者将闩锁开关(700)从锁定位置向远侧地枢转到释放位置,以便将轴组件(16)从柄部组件(11)操作地脱开。
一般地,闩锁开关(700)操作类似闩锁开关(500)(参见图10A-图10B)从锁定位置到释放位置。然而,闩锁开关(700)不包括用于在沿安装轴线(IA)的移除方向上推动轴组件(16)的凸轮叶(532)和配合凸轮基座(520)。相反地,闩锁系统(688)依靠闩锁开关(700)的直观感觉以向操作者指示沿安装轴线(IA)的移除方向。
在使用中,图11A和图12A示出了在锁定位置中与柄部组件(11)和闩锁开关(700)操作地联接的轴组件(16)。为了将轴组件与柄部组件(16,11)脱开,操作者使用手的拇指或手指抓住近侧抓握表面(514)并将闩锁开关(500)朝释放位置枢转。继而,远侧鼻状物(516)的弧形凸轮表面(530)接合锁定轭(90)并向远侧地枢转锁定轭(90)以释放枢转凸耳(94)。图11B和图12B示出了在释放位置中与闩锁开关(500)操作地脱开的轴组件和柄部组件(16,11)。从释放位置来看,操作者在沿安装轴线(IA)移除的方向上简单地引导轴组件(16)以完成可互换轴组件(16)从柄部组件(11)的移除。
IV.具有与柄部组件数据通信的轴组件的外科器械
在一些情况下,可能需要提供具有硬件和软件的外科器械(10,210,410,610),该硬件和软件被构造成能够从轴组件(16)到柄部组件(11)传送数据。具体地,可能需要设置具有对特定种类的可互换轴组件(16)独特的预定临床功能的柄部组件(11),该可互换轴组件刚好与柄部组件(11)联接。因此,柄部组件(11)可在分别对于各种轴组件(未示出)独特的各种预定临床功能中使用。下文更详细地描述此类外科器械(810)的示例;而参考本文的教导内容,其他示例对于本领域的普通技术人员而言是显而易见的。应当理解,以下描述的硬件和任意关联软件可易于并入外科器械(10,210,410,610)中。因此,下文类似的标号表示上述类似的特征。
图13-图14示出了被构造成能够从轴组件(816)到柄部组件(811)传送数据(诸如软件和/或操作参数)的外科器械(810)的一个示例。轴组件(816)包括存储器,诸如被构造成能够存储诸如尤其与特定种类的轴组件(816)关联的软件和/或操作参数的数据的闪存构件(910)。柄部组件(811)包括显示器(912)、微控制器(914)和场可编程门阵列(916)。当轴组件(816)与柄部组件(811)操作地联接时,场可编程门阵列(916)和微控制器(914)在显示器(912)和闪存构件(910)之间并联电连接。
微控制器(914)包括用于柄部组件(811)的一般操作的基础功能代码,而场可编程门阵列(916)一般为空白并且易于编程。在此示例中,微控制器(914)不包括诸如与特别种类轴组件(816)特别关联的软件和/或操作参数的数据。或者,微控制器(914)包括诸如与各种轴组件(816)一般关联的软件和/或操作参数的数据。在使用中,微控制器(914)引导用户操作柄部组件(811),诸如通过显示器(912)向操作者提供说明。为了准备操作轴组件(816),操作者将轴组件(816)操作地联接到柄部组件(811),如图13-图14中示出。在操作性联接时,微控制器(914)有利于将数据从闪存存储器(910)传送和递送到场可编程门阵列(916)中,使得柄部组件(811)随后被构造成能够执行与特种轴组件(816)具体关联的预定临床功能。
换句话说,柄部组件(811)不包含诸如与特种轴组件(816)特别关联的软件和/或操作参数的数据,直到轴组件(816)与柄部组件(811)完全联接。轴组件(816)为永久存储诸如与特种轴组件(816)特别关联的软件和/或操作参数的数据的部件。此数据(即,与特种轴组件(816)特别关联的软件和/或操作参数)自动地传送到场可编程门阵列(916),当轴组件(816)与柄部组件(811)完全联接时。当此后使用器械(810)(在相同轴组件(816)与柄部组件(811)完全联接)时,与特种轴组件(816)特别关联的软件和/或操作参数由场可编程门阵列(916)执行。因此,应当理解,场可编程门阵列(916)为与柄部组件(811)联接的每个轴组件(816)提供空白状态,使得柄部组件(811)不需要永久地存储与某种轴组件(816)特别关联的软件和/或操作参数。柄部组件(811)仅需要存储诸如在各种轴组件(816)中常见的软件和/或操作参数的数据。这可使柄部组件(811)更易于适于新且不同种类的轴组件(816)。
应当进一步理解,从闪存存储器(910)传送到场可编程门阵列(916)的诸如软件和/或操纵参数的数据可包括轴组件(816)的全部逻辑操作参数,而不仅仅为简单地硬件定义。换句话说,柄部组件(811)的全部临床功能可通过轴组件(816)的闪存存储器(910)更新或更改。
V.具有替换轴组件的外科器械
也可能需要提供具有替换轴组件(1016)的外科器械(10,210,410,610,810),该替换轴组件被构造成能够提供改良的组件。下文更详细地描述具有轴组件(1016)的此类外科器械(1016)的示例;而参考本文的教导内容,其他示例对于本领域的普通技术人员而言是显而易见的。应当理解,下文所述的轴组件(1016)可易于并入外科器械(10,210,410,610)中。因此,下文类似的标号表示上述类似的特征。
如在图15-图19中可见,外科器械(1010)包括可互换轴组件(1016)和柄部组件(11)。轴组件(1016)包括被构造成能够固定地支撑关节运动锁(未示出)的轴框架部分(未示出)的脊(1020)。脊(1020)也被构造成能够能够滑动地支撑其中的击发构件(1022)。另外,脊(1020)被构造成能够能够滑动地支撑围绕脊(1020)延伸的闭合管(60)。脊(1020)也被构造成能够能够滑动地支撑近侧关节运动驱动器(1024)。关节运动驱动器(1024)具有被构造成能够操作地接合关节运动锁(未示出)的远侧端部(1026)。如上文指出,关节运动锁(未示出)和关节运动框架(未示出)可根据美国专利公布No.2014/0263541的教导内容中的至少一些教导内容进行构造和操作,该专利的公开内容以引用方式并入本文。
在本示例中,脊(1020)具有在底盘(64)中可转动支撑的近侧端部(1028)(参见图5A)。具体地,脊(1020)的近侧端部(1028)具有在其上形成的用于螺纹附接到脊轴承(未示出)的螺纹(1030),该脊轴承被构造成能够在底盘(64)内被支撑(参见图5A)。此类布置有利于脊(1020)的可旋转附接,使得脊(1020)可相对于底盘(64)围绕轴组件(16)的纵向轴线选择性地旋转。
击发构件(1022)被支撑以在脊(1020)内轴向行进。击发构件(1022)包括被构造用于附接到刀杆(未示出)的远侧切割部分的中间击发轴部分(1032)。击发轴部分(1032)包括在其远侧端部中的纵向狭槽(1034),该纵向狭槽被构造成能够接收远侧刀杆(未示出)。脊(1020)也具有其中的细长开口或窗口(1036)以有利于将中间击发轴部分(1032)组装和插进轴框架(未示出)中。击发构件(1022)可根据美国专利公布No.2014/0263541的教导内容中的至少一些教导内容来构造和操作,该专利的公开内容以引用方式并入本文。
除上述以外,轴组件(1016)包括可操作以将关节运动驱动器(1024)选择性地和可释放地联接到击发构件(1022)的离合器组件(1038)。在本示例中,离合器组件(1038)包括围绕击发构件(1022)定位的锁圈或锁套管(1040)。锁套管(1040)可在其中锁套管(1040)将关节运动驱动器(1024)联接到击发构件(1022)的接合位置和其中关节运动驱动器(1024)不操作地联接到击发构件(1022)的脱离位置之间旋转。当锁套管(1040)处于其接合位置时,击发构件(1022)的远侧移动可向远侧地移动关节运动驱动器(1024),并且相应地,击发构件(1022)的近侧移动可向近侧地移动关节运动驱动器(1024)。当锁套管(1040)处于其脱离位置时,击发构件(1022)的移动未被传输到关节运动驱动器(1024),并且因此,击发构件(1022)可独立于关节运动驱动器(1024)移动。因此,应当理解,锁套管(1040)可旋转以在关节运动驱动模式和击发驱动模式之间过渡。在各种情况下,当关节运动驱动器(1024)未通过击发构件(1022)沿近侧方向或远侧方向移动时,关节运动驱动器(1024)可通过关节运动锁(未示出)保持在适当的位置。
锁套管(1040)包括圆柱形的或至少基本上圆柱形的主体,该主体限定在其中限定的被构造成能够接收击发构件(1022)的纵向孔(1042)。锁套管(1040)也包括沿直径相对的、面朝内的锁定突起(1044)和面朝外的锁定构件(1046)。锁定突起(1044)被构造成能够与击发构件(1022)选择性地接合。更具体地,当锁套管(1040)处于其接合位置时,锁定突起(1044)定位在限定于击发构件(1022)中的驱动槽口(1048)内,使得远侧推力和/或近侧拉力可从击发构件(1022)传输到锁套管(1040)。当锁套管(1040)处于其接合位置时,锁定构件(1046)容纳在限定于关节运动驱动器(1024)中的驱动槽口(1050)内,使得施加到锁套管(1040)的远侧推力和/或近侧拉力可传输到关节运动驱动器(1024)。实际上,当锁套管(1040)处于其接合位置时,击发构件(1022)、锁套管(1040)和关节运动驱动器(1024)将一起移动。
另一方面,当锁套管(1040)处于其脱离位置时,锁定突起(1044)可不定位在击发构件(1022)的驱动槽口(1048)内,并且因此,远侧推力和/或近侧拉力不从击发构件(1022)传输到锁套管(1040)。相应地,远侧推力和/或近侧拉力不传输到关节运动驱动器(1024)。在此类情况下,击发构件(1022)可相对于锁套管(1040)和近侧关节运动驱动器(1024)朝近侧和/或朝远侧滑动。
轴组件(1016)还包括可旋转地容纳在闭合管(60)上的切换筒,如图19-图20更详细地示出。切换筒(1052)包括具有L型狭槽(1056)的空心轴段(1054),该L型狭槽延伸到进入L型狭槽(1056)的远侧开口(1058)。远侧开口(1058)接收移动板(1062)的横向销(1060)。在一个示例中,移动板(1062)容纳在设置在锁套管(1040)中的纵向狭槽(1064)内,以当锁套管(1040)与关节运动驱动器(1024)接合时有利于该锁套管的轴向移动。另外,闭合管(60)包括外部L形狭槽(1066),移动板(1062)在安装期间通过该L形狭槽插入穿过以进入纵向狭槽(1064)。可包括旋转扭力弹簧(未示出)以接合切换筒(1052)以相对于锁套管(1040)旋转地偏压切换筒(1052)。切换筒(1052)还包括限定于其中的至少部分周向开口(1068),该至少部分周向开口可被构造成能够接收从喷嘴半块(56,58)延伸的周向安装件(未示出)并且允许在切换筒(1052)和近侧喷嘴(54)之间的相对旋转而不是平移。切换筒(1052)的旋转最终将导致移动板(1062)和锁套管(1040)在其接合位置和脱离位置之间旋转。因此,实质上,喷嘴(54)可用以将关节运动驱动系统与击发驱动系统操作地脱离和接合,如图20A和图20B分别示出。
VI.示例性组合
下述实施例涉及本文的教导内容可被组合或应用的各种非穷尽性方式。应当理解,下述实施例并非旨在限制可在本申请或本申请的后续提交文件中的任何时间提供的任何权利要求的覆盖范围。不旨在进行免责声明。提供以下实施例仅仅是出于例示性目的。设想到,本文的各种教导内容可按多种其他方式进行布置和应用。还设想到,一些变型可省略在以下实施例中所提及的某些特征。因此,下文提及的方面或特征中的任一者均不应被视为决定性的,除非另外例如由发明人或关注发明人的继承者在稍后日期明确指明如此。如果本申请或与本申请相关的后续提交文件中提出的任何权利要求包括下文提及的那些特征之外的附加特征,则这些附加特征不应被假定为因与专利性相关的任何原因而被添加。
实施例1
一种外科器械,包括:(a)轴组件,所述轴组件具有远侧端部部分和近侧端部部分,所述近侧端部部分包括从其向远侧地突出的端部执行器;(b)柄部组件,所述柄部组件被构造成能够接收所述轴组件的所述近侧端部部分;以及(c)闩锁系统,所述闩锁系统被构造成能够将所述轴组件操作地联接到所述柄部组件,所述闩锁系统包括:(i)轴锁定构件,所述轴锁定构件连接到所述轴组件,(ii)柄部锁定构件,所述柄部锁定构件连接到所述柄部组件,其中所述柄部锁定构件被构造成能够接合所述轴锁定构件并抑制所述轴组件与所述柄部组件操作地脱开,(iii)凸轮基座,以及(iv)闩锁构件,所述闩锁构件具有被构造成能够接合所述凸轮基座的凸轮表面,其中所述闩锁构件被构造成能够从锁定位置选择性地移动到释放位置,使得所述闩锁构件朝解锁位置的移动能够使得所述轴锁定构件与所述柄部锁定构件脱离,并由此将所述轴组件与所述柄部组件在所述释放位置中操作地脱开,其中所述闩锁构件进一步被构造成能够从所述释放位置选择性地移动到移除位置,使得所述闩锁构件朝所述移除位置的移动能够使得所述闩锁构件的所述凸轮表面接合所述凸轮基座,并由此相对于所述柄部组件沿移除方向推动所述轴组件以向使用者指示所述移除方向。
实施例2
根据实施例1所述的外科器械,其中所述闩锁构件被构造成能够接合所述轴锁定构件和柄部锁定构件中的至少一个,并由此使得当所述闩锁构件从所述解锁位置朝所述释放位置移动时所述轴锁定构件与所述柄部锁定构件脱离。
实施例3
根据实施例2所述的外科器械,其中所述柄部组件包括所述凸轮基座并且所述轴组件包括所述闩锁构件。
实施例4
根据实施例3所述的外科器械,其中所述轴组件的所述闩锁构件被构造成能够接合所述轴锁定构件,并由此使得当所述闩锁构件从所述解锁位置朝所述释放位置移动时所述轴锁定构件与所述柄部锁定构件脱离。
实施例5
根据实施例4所述的外科器械,其中所述柄部锁定构件刚性地连接到所述柄部组件,并且所述轴锁定构件呈轴锁定轭形式枢转地连接到所述轴组件,使得所述轴锁定轭被偏压以接合所述柄部锁定构件。
实施例6
根据实施例1至5中任一项或多项所述的外科器械,其中所述柄部组件包括所述凸轮基座并且所述轴组件包括所述闩锁构件,并且所述闩锁构件包括闩锁按钮,其中所述闩锁按钮能够滑动地安装到所述轴组件的所述近侧端部部分,使得所述闩锁按钮被构造成能够从所述锁定位置朝所述移除位置滑动。
实施例7
根据实施例6所述的外科器械,其中所述闩锁按钮包括被构造成能够接合所述轴锁定构件以与所述柄部锁定构件脱离的远侧鼻状物。
实施例8
根据实施例6至7中任一项或多项所述的外科器械,其中所述闩锁按钮的所述凸轮表面呈下斜坡凸轮表面的形式,所述下斜坡凸轮表面被构造成能够沿所述凸轮基座横向地滑动以由此相对于所述柄部组件沿所述移除方向推动所述轴组件。
实施例9
根据实施例6至8中任一项或多项所述的外科器械,其中所述闩锁系统还包括刚性地连接到其所述近侧端部部分的闩锁安装主体,所述闩锁安装主体被构造成能够当所述闩锁按钮被构造成能够相对于所述闩锁安装主体从所述锁定位置朝所述移除位置滑动时横向捕获所述闩锁按钮。
实施例10
根据实施例9所述的外科器械,其中所述闩锁安装主体包括穿过其延伸的孔,并且所述孔被构造成能够经由其在所述凸轮基座与所述闩锁按钮的所述凸轮表面之间提供直接接触。
实施例11
根据实施例1至10中任一项或多项所述的外科器械,其中所述柄部组件包括所述凸轮基座并且所述轴组件包括所述闩锁构件,并且所述闩锁构件包括闩锁开关,其中所述闩锁开关可枢转地安装到所述轴组件的所述近侧端部部分,使得所述闩锁开关被构造成能够从所述锁定位置朝所述移除位置枢转。
实施例12
根据实施例11所述的外科器械,其中所述闩锁开关包括被构造成能够接合所述轴锁定构件以与所述柄部锁定构件脱离的远侧鼻状物。
实施例13
根据实施例11至12中任一项或多项所述的外科器械,其中所述闩锁开关的所述凸轮表面呈凸轮凸角表面的形式,所述凸轮凸角表面被构造成能够沿所述凸轮基座旋转地滑动以由此相对于所述柄部组件沿所述移除方向推动所述轴组件。
实施例14
根据实施例11至13中任一项或多项所述的外科器械,其中所述闩锁系统还包括刚性地连接到其所述近侧端部部分的闩锁安装主体,所述闩锁安装主体被构造成能够捕获所述闩锁开关,使得所述闩锁开关被构造成能够相对于所述闩锁安装主体从所述锁定位置朝所述移除位置枢转。
实施例15
根据实施例14所述的外科器械,其中所述闩锁安装主体包括穿过其延伸的孔,并且所述孔被构造成能够经由其在所述凸轮基座与所述闩锁开关的所述凸轮表面之间提供直接接触。
实施例16
一种外科器械,包括:(a)轴组件,所述轴组件具有远侧端部部分和近侧端部部分,所述近侧端部部分包括从其向远侧地突出的端部执行器;(b)柄部组件,所述柄部组件被构造成能够接收所述轴组件的所述近侧端部部分;以及(c)闩锁系统,所述闩锁系统被构造成能够将所述轴组件操作地联接到所述柄部组件,所述闩锁系统包括:(i)轴锁定构件,所述轴锁定构件连接到所述轴组件,(ii)柄部锁定构件,所述柄部锁定构件连接到所述柄部组件,其中所述柄部锁定构件被构造成能够接合所述轴锁定构件并抑制所述轴组件与所述柄部组件操作地脱离,以及(iii)闩锁开关,所述闩锁开关被构造成能够从锁定位置选择性地枢转到释放位置,使得所述闩锁开关朝解锁位置的移动被构造成能够使得所述轴锁定构件与所述柄部锁定构件脱离,并由此将所述轴组件与所述柄部组件在所述释放位置中操作地脱开。
实施例17
根据实施例16所述的外科器械,其中所述闩锁系统还包括凸轮基座并且所述闩锁开关包括凸轮凸角表面,其中所述凸轮凸角表面被构造成能够沿所述凸轮基座旋转地滑动,以由此相对于所述柄部组件沿移除方向将所述轴组件从所述释放位置朝移除位置推动,以向使用者指示所述移除方向。
实施例18
一种将外科器械的轴组件从柄部组件移除的方法,所述外科器械具有闩锁系统,所述闩锁系统具有轴锁定构件、柄部锁定构件、凸轮基座和闩锁构件,所述轴锁定构件连接到所述轴组件,所述柄部锁定构件连接到所述柄部组件,其中所述柄部锁定构件被构造成能够接合所述轴锁定构件并抑制所述轴组件与所述柄部组件操作地脱开,所述闩锁构件具有被构造成能够接合所述凸轮基座的凸轮表面,方法包括以下步骤:(a)将所述闩锁构件从锁定位置朝释放位置移动,以便将所述轴锁定构件与所述柄部锁定构件在所述释放位置中脱离;(b)将所述轴组件与所述柄部组件操作地脱开;(c)将所述闩锁构件从所述释放位置朝移除位置移动;以及(d)抵靠所述凸轮基座接合所述轴组件的所述凸轮表面,以便相对于所述柄部组件沿移除方向推动所述轴组件,以将所述轴组件从所述柄部组件移除。
实施例19
根据实施例18所述的方法,其中所述闩锁构件包括闩锁按钮并且移动所述闩锁按钮还包括滑动所述闩锁按钮。
实施例20
根据实施例18至19中任一项或多项所述的方法,其中所述闩锁构件包括闩锁开关并且移动所述闩锁按钮还包括枢转所述闩锁开关。
VII.杂项
应当理解,本文所述的任何型式的器械还可包括除上述那些之外或作为上述那些的替代的各种其他特征。仅以举例的方式,本文所述的器械中的任一个还可包括公开于以引用方式并入本文的各参考文献中的任一个中的各种特征结构中的一者或多者。还应当理解,本文的教导内容可易于应用于本文所引述的任何其他参考文献中所述的任何器械,使得本文的教导内容可易于以多种方式与本文所引述的任何参考文献中的教导内容结合。可并入本文的教导内容的其他类型的器械对于本领域普通技术人员而言将是显而易见的。
还应当理解,本文中所参照的任何值的范围应当被理解为包括此类范围的上限和下限。例如,除了包括在这些上限和下限之间的值之外,表示为“在约1.0英寸和约1.5英寸之间”的范围应被理解为包括约1.0英寸和约1.5英寸。
应当理解,据称以引用的方式并入本文的任何专利、专利公布或其他公开材料,无论是全文或部分,仅在所并入的材料与本公开中所述的现有定义、陈述或者其他公开材料不冲突的范围内并入本文。因此,并且在必要的程度下,本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分,将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。
上述装置的型式可应用于由医疗专业人员进行的传统医学治疗和规程、以及机器人辅助的医学治疗和规程的应用中。仅以举例的方式,本文的各种教导内容可易于并入机器人外科系统,诸如Intuitive Surgical,Inc.(Sunnyvale,California)的DAVINCITM系统。相似地,本领域的普通技术人员将认识到,本文的各种教导内容可易于与以下专利中的各种教导内容结合:2004年8月31日公布的标题为“Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument”的美国专利No.6,783,524,其公开内容以引用方式并入本文。
上文所述型式可被设计成在单次使用后废弃,或者其可被设计成使用多次。在任一种情况下或两种情况下,可对这些型式进行修复以在至少一次使用之后重复使用。修复可包括以下步骤的任意组合:拆卸装置,然后清洁或替换特定零件以及随后进行重新组装。具体地,可拆卸一些型式的装置,并且可以任何组合来选择性地替换或移除装置的任意数量的特定零件或部分。在清洁和/或替换特定部分时,一些型式的装置可在修复设施处重新组装或者在即将进行规程之前由操作者重新组装用于随后使用。本领域的技术人员将会理解,装置的修复可利用多种技术进行拆卸、清洁/更换、以及重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
仅以举例的方式,本文描述的型式可在规程之前和/或之后消毒。在一种消毒技术中,将该装置放置在闭合且密封的容器诸如塑料袋或TYVEK袋中。然后可将容器和装置放置在可穿透容器的辐射场中,诸如γ辐射、X射线、或高能电子。辐射可杀死装置上和容器中的细菌。经消毒的装置随后可储存在无菌容器中,以供以后使用。还可使用本领域已知的任何其他技术对装置进行消毒,所述技术包括但不限于β辐射或γ辐射、环氧乙烷或蒸汽。
已经示出和阐述了本发明的各种实施方案,可在不脱离本发明的范围的情况下由本领域的普通技术人员进行适当修改来实现本文所述的方法和系统的进一步改进。已经提及了若干此类可能修改,并且其他修改对于本领域的技术人员而言将显而易见。例如,上文所讨论的实施例、实施方案、几何形状、材料、尺寸、比率、步骤等均是示例性的而非必需的。因此,本发明的范围应根据以下权利要求书来考虑,并且应理解为不限于说明书和附图中示出和描述的结构和操作的细节。
Claims (20)
1.一种外科器械,包括:
(a)轴组件,所述轴组件具有远侧端部部分和近侧端部部分,所述近侧端部部分包括从其向远侧地突出的端部执行器;
(b)柄部组件,所述柄部组件被构造成能够接收所述轴组件的所述近侧端部部分;以及
(c)闩锁系统,所述闩锁系统被构造成能够将所述轴组件操作地联接到所述柄部组件,所述闩锁系统包括:
(i)轴锁定构件,所述轴锁定构件连接到所述轴组件,
(ii)柄部锁定构件,所述柄部锁定构件连接到所述柄部组件,
其中所述柄部锁定构件被构造成能够接合所述轴锁定构件并且抑制所述轴组件与所述柄部组件操作地脱开,
(iii)凸轮基座,以及
(iv)闩锁构件,所述闩锁构件具有被构造成能够接合所述凸轮基座的凸轮表面,
其中所述闩锁构件被构造成能够从锁定位置选择性地移动到释放位置,使得所述闩锁构件朝解锁位置的移动能够使得所述轴锁定构件与所述柄部锁定构件脱离,并由此将所述轴组件与所述柄部组件在所述释放位置操作地脱开,
其中所述闩锁构件进一步被构造成能够从所述释放位置选择性地移动至移除位置,使得所述闩锁构件朝所述移除位置的移动能够使得所述闩锁构件的所述凸轮表面接合所述凸轮基座,并由此沿移除方向相对于所述柄部组件推动所述轴组件以向使用者指示所述移除方向。
2.根据权利要求1所述的外科器械,其中所述闩锁构件被构造成能够接合所述轴锁定构件和柄部锁定构件中的至少一个,并由此使得当所述闩锁构件从所述解锁位置朝所述释放位置移动时所述轴锁定构件与所述柄部锁定构件脱离。
3.根据权利要求2所述的外科器械,其中所述柄部组件包括所述凸轮基座并且所述轴组件包括所述闩锁构件。
4.根据权利要求3所述的外科器械,其中所述轴组件的所述闩锁构件被构造成能够接合所述轴锁定构件,并由此使得当所述闩锁构件从所述解锁位置朝所述释放位置移动时所述轴锁定构件与所述柄部锁定构件脱离。
5.根据权利要求4所述的外科器械,其中所述柄部锁定构件刚性地连接到所述柄部组件,并且所述轴锁定构件呈轴锁定轭形式枢转地连接到所述轴组件,使得所述轴锁定轭被偏压以接合所述柄部锁定构件。
6.根据权利要求1所述的外科器械,其中所述柄部组件包括所述凸轮基座并且所述轴组件包括所述闩锁构件,并且所述闩锁构件包括闩锁按钮,其中所述闩锁按钮能够滑动地安装到所述轴组件的所述近侧端部部分,使得所述闩锁按钮被构造成能够从所述锁定位置朝所述移除位置滑动。
7.根据权利要求6所述的外科器械,其中所述闩锁按钮包括被构造成能够接合所述轴锁定构件以与所述柄部锁定构件脱离的远侧鼻状物。
8.根据权利要求6所述的外科器械,其中所述闩锁按钮的所述凸轮表面呈下斜坡凸轮表面的形式,所述下斜坡凸轮表面被构造成能够沿所述凸轮基座横向地滑动以由此相对于所述柄部组件沿所述移除方向推动所述轴组件。
9.根据权利要求6所述的外科器械,其中所述闩锁系统还包括刚性地连接到其所述近侧端部部分的闩锁安装主体,所述闩锁安装主体被构造成能够当所述闩锁按钮被构造成能够相对于所述闩锁安装主体从所述锁定位置朝所述移除位置滑动时横向捕获所述闩锁按钮。
10.根据权利要求9所述的外科器械,其中所述闩锁安装主体包括穿过其延伸的孔,并且所述孔被构造成能够经由其在所述凸轮基座与所述闩锁按钮的所述凸轮表面之间提供直接接触。
11.根据权利要求1所述的外科器械,其中所述柄部组件包括所述凸轮基座并且所述轴组件包括所述闩锁构件,并且所述闩锁构件包括闩锁开关,其中所述闩锁开关枢转地安装到所述轴组件的所述近侧端部部分,使得所述闩锁开关被构造成能够从所述锁定位置朝所述移除位置枢转。
12.根据权利要求11所述的外科器械,其中所述闩锁开关包括被构造成能够接合所述轴锁定构件以与所述柄部锁定构件脱离的远侧鼻状物。
13.根据权利要求11所述的外科器械,其中所述闩锁开关的所述凸轮表面呈凸轮凸角表面的形式,所述凸轮凸角表面被构造成能够沿所述凸轮基座旋转地滑动以由此相对于所述柄部组件沿所述移除方向推动所述轴组件。
14.根据权利要求11所述的外科器械,其中所述闩锁系统还包括刚性地连接到其所述近侧端部部分的闩锁安装主体,所述闩锁安装主体被构造成能够捕获所述闩锁开关,使得所述闩锁开关被构造成能够相对于所述闩锁安装主体从所述锁定位置朝所述移除位置枢转。
15.根据权利要求14所述的外科器械,其中所述闩锁安装主体包括穿过其延伸的孔,并且所述孔被构造成能够经由其在所述凸轮基座与所述闩锁开关的所述凸轮表面之间提供直接接触。
16.一种外科器械,包括:
(a)轴组件,所述轴组件具有远侧端部部分和近侧端部部分,所述近侧端部部分包括从其向远侧地突出的端部执行器;
(b)柄部组件,所述柄部组件被构造成能够接收所述轴组件的所述近侧端部部分;以及
(c)闩锁系统,所述闩锁系统被构造成能够将所述轴组件操作地联接到所述柄部组件,所述闩锁系统包括:
(i)轴锁定构件,所述轴锁定构件连接到所述轴组件,
(ii)柄部锁定构件,所述柄部锁定构件连接到所述柄部组件,
其中所述柄部锁定构件被构造成能够接合所述轴锁定构件并抑制所述轴组件与所述柄部组件操作地脱开,以及
(iii)闩锁开关,所述闩锁开关被构造成能够从锁定位置选择性地枢转到释放位置,使得所述闩锁开关朝解锁位置的移动被构造成能够使得所述轴锁定构件与所述柄部锁定构件脱离,并由此将所述轴组件与所述柄部组件在所述释放位置操作地脱开。
17.根据权利要求16所述的外科器械,其中所述闩锁系统还包括凸轮基座并且所述闩锁开关包括凸轮凸角表面,其中所述凸轮凸角表面被构造成能够沿所述凸轮基座旋转地滑动,以由此相对于所述柄部组件沿移除方向将所述轴组件从所述释放位置朝移除位置推动,以向使用者指示所述移除方向。
18.一种将外科器械的轴组件从柄部组件移除的方法,所述外科器械具有闩锁系统,所述闩锁系统具有轴锁定构件、柄部锁定构件、凸轮基座和闩锁构件,所述轴锁定构件连接到所述轴组件,所述柄部锁定构件连接到所述柄部组件,其中所述柄部锁定构件被构造成能够接合所述轴锁定构件并抑制所述轴组件与所述柄部组件操作地脱开,所述闩锁构件具有被构造成能够接合所述凸轮基座的凸轮表面,方法包括以下步骤:
(a)将所述闩锁构件从锁定位置朝释放位置移动,以便将所述轴锁定构件与所述柄部锁定构件在所述释放位置中脱离;
(b)将所述轴部件与所述柄部组件操作地脱开;
(c)将所述闩锁构件从所述释放位置朝移除位置移动;以及
(d)抵靠所述凸轮基座接合所述轴组件的所述凸轮表面,以便相对于所述柄部组件沿移除方向推动所述轴组件,以将所述轴组件从所述柄部组件移除。
19.根据权利要求18所述的方法,其中所述闩锁构件包括闩锁按钮并且移动所述闩锁按钮还包括滑动所述闩锁按钮。
20.根据权利要求18所述的方法,其中所述闩锁构件包括闩锁开关并且移动所述闩锁按钮还包括枢转所述闩锁开关。
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EP3150132A3 (en) | 2017-05-10 |
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RU2728508C1 (ru) | 2020-07-29 |
CN108135603B (zh) | 2021-01-29 |
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US20170086823A1 (en) | 2017-03-30 |
WO2017058592A1 (en) | 2017-04-06 |
MX2018003965A (es) | 2018-11-09 |
EP3150132A2 (en) | 2017-04-05 |
JP2018529497A (ja) | 2018-10-11 |
EP3679869A1 (en) | 2020-07-15 |
EP3150132B1 (en) | 2020-08-19 |
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