CN108289684B - 砧座组件和输送系统 - Google Patents
砧座组件和输送系统 Download PDFInfo
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Abstract
一种砧座输送组件包括砧座组件(100)和固定到砧座组件(100)的管状引导组件(202)。砧座组件(100)适用于经口输送并且包括构造成倾斜的头部组件(102)。管状引导组件(202)包括具有扁平横截面的柔性管(204)。
Description
技术领域
本发明涉及一种与外科手术缝合器械一起使用的砧座组件。更具体地，本发明涉及一种砧座组件以及一种用于经口输送砧座组件的系统。
背景技术
吻合是使分开的中空器官部分接合以允许该部分彼此相互连通的外科手术接合。典型地，吻合手术在外科手术之后进行，其中中空组织的患病或有缺陷的部分被移除并且剩余的末端部分将被接合。取决于期望的吻合手术，可以使用圆形、端对端、端对侧或侧对侧器官重建方法来接合中空器官的末端部分。
在圆形吻合手术中，器官部分的两端通过外科手术缝合器械接合，所述外科手术缝合器械驱使圆形缝钉阵列穿过器官末端部分和芯体，并移除任何重叠组织以释放管状通道。在圆形吻合手术的一些应用中，在将器械插入要吻合的组织之前，将具有附接的砧座头部的砧座杆安装到外科手术缝合器械轴的远端。然而，在其它应用中，在将外科手术缝合器械和砧座组件定位在相应的器官部分内之后，可将可拆卸的砧座杆安装到该器械。在这种情况下，外科手术缝合器械和砧座组件被分开输送到手术部位。然后，例如通过荷包式缝合将每个器官末端部分固定到相应的砧座或钉保持部件。通过将砧座杆的安装部分插入外科手术缝合器械的远端内而将砧座组件安装到外科手术缝合器械，使得外科手术缝合器械内的安装机构牢固地接合砧座杆。可以使用微创外科手术技术，即在腹腔镜引导下进行要接合的器官部分的准备工作和将砧座杆安装到外科手术缝合器械。
在共同拥有的美国专利第8,109,426号中公开了一种用于将砧座组件经口输送到外科手术部位(例如胃部)的砧座组件输送系统，该专利的内容以引用方式并入本文中。如所描述的，砧座组件包括固定到主体组件的倾斜头部组件，以利于将砧座组件经口输送到外科手术部位。
为了进一步利于将砧座组件经口输送到外科手术部位，具有尺寸较小的头部组件的砧座组件将是有益的。能够较大程度地倾斜的砧座组件也是有益的。
发明内容
根据本发明，提供了一种用于与外科手术缝合器械一起使用以执行组织的端对端吻合的砧座组件。砧座组件包括限定通孔的砧座中心杆和定位在砧座中心杆的通孔内的柱塞构件。柱塞构件可在近侧位置与远侧位置之间移动，并且弹簧容纳在柱塞构件周围。弹簧定位成朝向近侧位置偏置柱塞构件。头部组件围绕枢转轴线枢转地固定到砧座中心杆。头部组件可在倾斜位置与操作位置之间移动。柱塞构件可操作地连接到头部组件，以在当柱塞构件从近侧位置移动到远侧位置时引起头部组件从倾斜位置移动到操作位置。
在实施例中，柱塞构件通过驱动连杆连接到头部组件。柱塞构件可以包括用于支撑弹簧的细长主体和用于将弹簧维持在细长主体周围的细长主体的近端上的凸缘。柱塞构件可以具有J形。砧座组件还可以包括夹具，该夹具支撑在砧座中心杆内并且围绕柱塞的细长主体，以进一步将弹簧维持在细长主体周围。
还提供了一种砧座输送系统，其包括砧座组件和用于经口插入砧座组件的管状引导组件。管状引导组件可以包括柔性管和构造成将柔性管可操作地连接到砧座中心杆的适配器。管状引导组件还可以包括用于将砧座组件的头部组件维持在倾斜位置的保持缝线。柔性管可以包括扁平横截面。
还提供了一种砧座输送系统，其包括砧座组件和用于经口插入砧座组件的管状引导组件。砧座组件包括限定通孔的砧座中心杆和定位在砧座中心杆的通孔内的柱塞构件。柱塞构件可在近侧位置与远侧位置之间移动，并且弹簧定位成朝向近侧位置偏置柱塞构件。头部组件围绕枢转轴线枢转地固定到砧座中心杆。头部组件可在倾斜位置与操作位置之间移动。柱塞构件可操作地连接到头部组件，以在当柱塞构件从近侧位置移动到远侧位置时引起头部组件从倾斜位置移动到操作位置。管状引导组件包括具有扁平横截面的柔性管。
在实施例中，弹簧容纳在柱塞构件周围。柱塞构件可以通过驱动连杆连接到头部组件。柱塞构件可以包括J形。柱塞构件可以包括用于支撑弹簧的细长主体和用于将弹簧维持在细长主体周围的细长主体的近端上的凸缘。管状引导组件可以包括用于将砧座组件的头部组件维持在倾斜位置的保持缝线。管状引导组件可以包括构造成将柔性管可操作地连接到砧座中心杆的适配器。砧座组件还可以包括夹具，该夹具支撑在砧座中心杆内并且围绕柱塞的细长主体，以进一步将弹簧维持在细长主体周围。
附图说明
下面参考附图描述目前公开的外科手术缝合器械、砧座组件和砧座输送系统的实施例，其中：
图1是目前公开的外科手术缝合器械的近端处于非接近位置的俯视透视图；
图2是固定到砧座输送系统的图1中所示的外科手术缝合器械的砧座组件的俯视透视图；
图3是沿着图2中所示的截面线3-3截取的横截面端视图；
图4是图2中所示的砧座组件的侧面横截面图，其中头部组件处于第一或倾斜位置；
图5是固定到套管针组件的图4中所示的砧座组件的侧面横截面图，其中头部组件处于第二或操作位置；
图6是图4和图5中所示的砧座组件的柱塞构件的放大侧面透视图；以及
图7是图4和5中所示的头部组件的放大侧面透视图，其包括以虚线示出的传统头部组件的轮廓。
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器械、砧座组件和砧座输送系统的实施例，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。如本领域中所常见，术语“近侧”是指更靠近使用者或操作者即外科医生或临床医生的部分或部件，而术语“远侧”是指更远离使用者的部分或部件。
参考图1，根据本发明的包括砧座组件的外科手术缝合器械通常被示出为缝合装置10。简言之，缝合装置10包括近侧手柄组件12，包括弯曲细长外管14a的细长中心主体部分14，以及远侧头部16。手柄组件12包括固定手柄18、发射触发器20、可旋转接近旋钮22和指示器24。可枢转地安装的触发器锁定件26紧固到手柄组件12并手动定位以防止缝合装置10的意外发射。指示器24定位在固定手柄18上并且包括标记，例如颜色编码、字母数字标记等，以使外科医生识别装置是否接近并准备好发射。头部16包括砧座组件100和外壳组件30。砧座组件100可释放地固定到延伸穿过外壳组件30的套管针构件32。将仅在所需程度上描述缝合装置10的结构和功能以充分公开本发明的各方面。对于示例性缝合装置的详细描述，请参考共同拥有的美国专利第7,364,060号(“'060专利”)，其内容整体以引用方式并入本文中。
现在参考图2，砧座组件100被示出为可操作地连接到用于将砧座组件100输送到患者体内的系统，如一般示出为砧座输送系统200。简言之，砧座输送系统200包括可释放地固定到砧座组件100以利于将砧座组件100经口定位在患者体内的管状引导组件202。更具体地，管状引导组件202包括柔性管204，该柔性管通过适配器206可释放地固定到砧座组件100。砧座输送系统200可以可选地包括缝线引导组件(未示出)，该缝线引导组件可释放地固定到砧座组件100用于在将砧座组件100经口输送到患者体内期间操纵砧座组件100。
继续参考图2，管状引导组件202被构造成在将砧座组件100附接到缝合装置10(图1)之前手动地从砧座组件100上拆卸。将仅在所需程度上描述砧座输送系统200以充分公开本发明的各方面。对于包括柔性管和适配器的示例性管状引导组件的详细描述，请参考共同拥有的美国专利第8,109,426号(“'426专利”)，其内容整体以引用方式并入本文中。
传统的输送系统(未示出)通常包括具有圆形横截面的柔性管(未示出)。转到图3，管状引导组件200的柔性管202的实施例包括扁平横截面。柔性管202的扁平横截面使临床医生能够简单地通过在将砧座组件100输送到外科手术部位期间观察柔性管202来确定砧座组件100的头部组件102的方位。扁平横截面也利于在砧座组件100的输送期间操纵砧座组件100。
现在参考图4到图6，如上所述，砧座组件100被构造成用于可释放地附接到缝合装置10(图1)。砧座组件100包括枢转地固定到中心杆组件104的头部组件102。头部组件102响应于将砧座组件100附接到套管针构件32而在第一或倾斜位置(图4)与第二或操作位置(图5)之间移动，如下面详细描述。将仅在所需程度上描述砧座组件100以公开本发明的各方面。对于示例性砧座组件的详细描述，请参考'060和'426专利，其先前整体以引用方式并入本文中。
在实施例中，头部组件102包括砧座头部110，从砧座头部110向近侧延伸的砧座柱112，用于容纳外科手术缝合器10(图1)的圆形刀(未示出)的切割环/支撑构件114，容纳在切割环/支撑构件114上的盖116，以及固定到砧座头部110并限定钉形成凹腔118a的砧座板118。砧座柱112可以与砧座头部110整体(例如整体式)形成，或者通过摩擦配合、卷曲、焊接或以任何合适的方式固定到砧座头部110。枢转构件112a从砧座柱112向外延伸，用于容纳中心杆组件104的连杆构件124的远端124b。
砧座组件100的中心杆组件104包括砧座中心杆120，可滑动地支撑在砧座中心杆120内的柱塞构件122，用于将柱塞构件122连接到砧座组件100的头部组件102的驱动连杆124，容纳在柱塞构件122周围用于在近侧方向上偏置柱塞构件122的弹簧或偏置构件，例如螺旋弹簧126，以及容纳在柱塞构件122周围用于将弹簧126维持在柱塞构件122周围的夹具构件，即U形夹具128。头部组件102通过枢轴销106枢转地固定到中心杆组件104。
砧座中心杆120包括多个柔性臂130，该柔性臂限定砧座中心杆120的通孔121的近端121a。通孔121的近端121a被构造成可释放地容纳外科手术缝合装置10(图1)的套管针构件32(图5)。砧座中心杆120的通孔121的远端121b容纳柱塞构件122和容纳在柱塞构件122周围的弹簧构件126。砧座中心杆120还限定与通孔121的远端121b连通的纵向开口123，当头部组件110在倾斜位置和操作位置之间移动时其容纳并利于驱动连杆124的移动，如下面详细描述。
具体参考图6，中心杆组件104的柱塞构件122包括细长主体142，该细长主体具有在细长主体142的近端142a上的环形凸缘144和从细长主体142的远端142b径向向外延伸的延伸部146，柱塞构件122具有大致J形的外观。柱塞构件122的细长主体142支撑弹簧构件126，使得弹簧构件126与环形凸缘144接合并且定位在细长主体142周围。当柱塞构件122容纳在通孔121的远端121b内时，柱塞构件122的径向延伸部146穿过纵向开口123容纳在砧座中心杆120中。延伸部146包括枢转构件146a，该枢转构件用于将柱塞构件122的径向延伸部146枢转地连接到驱动连杆124的近端124a。如上所述，径向延伸部146和驱动连杆124可移动地容纳在砧座中心杆120的纵向开口123内。
如将在下面进一步详细描述，砧座中心杆120和柱塞构件122的环形凸缘144可以在使用期间向临床医生提供可听见和/或可触知的反馈，以指示砧座组件100的头部组件110已经返回到倾斜位置(图4)。当柱塞构件122的环形凸缘144a接合砧座中心杆120的内表面120a(图5和图6)时，可以听见并且产生反馈。
再次参考图4和图5，中心杆组件104的柱塞构件122和弹簧构件126容纳在砧座中心杆120的通孔121的远端121b内。当柱塞122容纳在通孔121内时，柱塞构件122的延伸部146从通孔121的远端121b向外延伸穿过砧座中心杆120的纵向开口123。U形夹具128容纳在柱塞构件122周围并且支撑在砧座中心杆120的环形凹部123a内以将柱塞构件122维持在通孔121内并且将弹簧构件126维持在柱塞构件122的细长主体140周围。U形夹具128中的开口(未示出)允许柱塞构件122的细长主体140纵向移动穿过其中并且在通孔121的远端121b内。当砧座组件100的头部组件102移动到操作位置(图5)时，弹簧构件126被压缩在柱塞构件122的环形凸缘144与U形夹具128之间以将柱塞构件122偏置到近侧位置。
中心杆组件104的驱动连杆124的近端124a被固定到柱塞构件122的延伸部146的枢转构件146a，并且驱动连杆124的远端128b被固定到头部组件102的砧座柱112的枢转构件112a。如上所述，驱动连杆124被构造成实现头部组件102相对于中心杆组件104在倾斜位置(图4)与第二或操作位置(图5)之间的枢转。砧座组件100的构型使得头部组件102能够比传统砧座组件(未示出)更大程度地倾斜。更具体地，当头部组件102处于倾斜位置时，砧座中心杆120的纵向开口123延伸穿过砧座中心杆120的远端以容纳驱动连杆124和头部组件102的一部分。
现在将参考附图描述砧座组件100的操作。首先参考图4，砧座组件100的头部组件102被示出处于第一或倾斜位置。当头部组件102处于倾斜位置时，中心杆组件104的柱塞构件122处于砧座中心杆120的通孔121的远端121a内的最近侧位置。弹簧构件126容纳在处于环形凸缘144与U形夹具128之间的柱塞构件122的细长主体142的周围，并且处于扩张状态以将驱动连杆124向近侧拉入纵向开口123内以使头部组件102枢转到倾斜位置。
砧座组件100通过穿过砧座组件100的头部组件102容纳的缝线“S”(图2)固定到砧座输送系统200(图2)，并固定在适配器206与砧座输送系统200的管状引导组件202的柔性管204之间。
现在参考图5，砧座组件100被示出为可释放地容纳在外科手术装置10(图1)的套管针构件32上。具体地，套管针构件32的远端容纳在砧座中心杆120的通孔121内。当套管针构件32容纳在砧座中心杆120的通孔121内时，套管针构件32的远端32b接合柱塞构件122的细长主体142的近端。套管针构件32克服弹簧构件126的偏置以使柱塞构件122从最近侧位置(图4)向远侧移动到最远侧位置(图5)，如由图5中的箭头“A”所示。当柱塞构件122在砧座中心杆120的通孔121的远侧部分121b内向远侧移动时，中心杆组件104的驱动连杆124与头部组件102之间的接合引起头部组件102从倾斜位置(图4)枢转到第二或操作位置(图5)，如由图5中的箭头“B”所示。柱塞构件122的远侧移动也引起弹簧构件126的压缩。
一旦处于操作位置，砧座组件100就类似于传统的砧座组件(未示出)进行操作。在使用外科手术装置10和砧座组件100进行外科缝合手术之后，砧座组件100与外科手术装置10的套管针构件32分离。当套管针构件32从中心杆组件104的砧座中心杆120的通孔121内缩回时，已经在柱塞构件122向远侧移动期间被压缩的弹簧构件126引起柱塞构件122向近侧移动到最近侧位置(图4)，由此使头部组件102返回到第一或倾斜位置。
如上所述，柱塞构件122的砧座中心杆120和凸缘144可以被构造成向临床医生提供可听见的和/或可触知的指示柱塞构件122处于其最近侧位置，并且因此，砧座组件100的头部组件102处于倾斜位置(图4)。以这种方式，临床医生能够确定头部组件102相对于中心杆组件104的位置而不需要查看砧座组件100的头部组件102。砧座组件100然后可以从外科手术部位并且外科手术过程可以以传统方式完成。
现在参考图7，为了减小砧座组件100的头部组件102的投影面积大小并进一步利于砧座组件100的经口输送，头部组件102的砧座头部110可以包括经修改的轮廓。用虚线示出传统砧座组件(未示出)的传统砧座头部110'的轮廓。如图7中所示，砧座头部110包括更浅且更光滑的轮廓。可以设想的是，可以对砧座组件100的砧座头部110进行其它修改以进一步减小头部组件102的投影面积大小并且进一步利于砧座组件100的经口输送。
本领域的技术人员将会理解，在本文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的元件和特征组合。同样，本领域技术人员将会基于上述实施例理解本发明的另外特征和优点。因此，除了如所附权利要求所指示的之外，本发明不限于已经具体示出和描述的内容。
Claims (12)
1.一种砧座组件，包括：
限定通孔的砧座中心杆；
定位在所述砧座中心杆的所述通孔内并且能够在近侧位置与远侧位置之间移动的柱塞构件；
容纳在所述柱塞构件周围的弹簧，所述弹簧定位成朝向所述近侧位置偏置所述柱塞构件；以及
围绕枢转轴线枢转地固定到所述砧座中心杆的头部组件，所述头部组件能够在倾斜位置与操作位置之间移动，其中所述柱塞构件可操作地连接到所述头部组件，以便当所述柱塞构件从所述近侧位置移动到所述远侧位置时引起所述头部组件从所述倾斜位置移动到所述操作位置；
其中，所述柱塞构件包括：构造成支撑所述弹簧并且完全延伸穿过所述弹簧的细长主体、和从所述细长主体的远端径向向外延伸的延伸部，所述延伸部经由驱动连杆连接到所述头部组件；以及
其中，所述砧座组件还包括夹具，所述夹具被支撑在所述砧座中心杆内并且围绕所述柱塞构件的所述细长主体，所述夹具构造成将所述弹簧维持在所述细长主体周围。
2.根据权利要求1所述的砧座组件，其中所述柱塞构件包括构造成将所述弹簧维持在所述细长主体周围的、所述细长主体的近端上的凸缘。
3.根据权利要求1所述的砧座组件，其中所述柱塞构件包括J形。
4.一种砧座输送系统，包括：
根据权利要求1所述的砧座组件；以及
用于经口插入所述砧座组件的管状引导组件。
5.根据权利要求4所述的砧座输送系统，其中所述管状引导组件包括柔性管和构造成将所述柔性管可操作地连接到所述砧座中心杆的适配器。
6.根据权利要求5所述的砧座输送系统，其中所述管状引导组件还包括保持缝线，所述保持缝线定位成将所述砧座组件的所述头部组件维持在所述倾斜位置。
7.根据权利要求5所述的砧座输送系统，其中所述柔性管包括扁平横截面。
8.一种砧座输送系统，包括：
砧座组件，其包括：
限定通孔的砧座中心杆；
定位在所述砧座中心杆的所述通孔内并且能够在近侧位置与远侧位置之间移动的柱塞构件；
容纳在所述柱塞构件周围的弹簧，所述弹簧定位成朝向所述近侧位置偏置所述柱塞构件；以及
围绕枢转轴线枢转地固定到所述砧座中心杆的头部组件，所述头部组件能够在倾斜位置与操作位置之间移动，其中所述柱塞构件可操作地连接到所述头部组件，以便当所述柱塞构件从所述近侧位置移动到所述远侧位置时引起所述头部组件从所述倾斜位置移动到所述操作位置；以及
用于经口插入所述砧座组件的管状引导组件，所述管状引导组件包括具有扁平横截面的柔性管；
其中，所述柱塞构件包括：构造成支撑所述弹簧并且完全延伸穿过所述弹簧的细长主体、和从所述细长主体的远端径向向外延伸的延伸部，所述延伸部经由驱动连杆连接到所述头部组件；以及
其中，所述砧座组件还包括夹具，所述夹具被支撑在所述砧座中心杆内并且围绕所述柱塞构件的所述细长主体，所述夹具构造成将所述弹簧维持在所述细长主体周围。
9.根据权利要求8所述的砧座输送系统，其中所述管状引导组件还包括保持缝线，所述保持缝线定位成将所述砧座组件的所述头部组件维持在所述倾斜位置。
10.根据权利要求8所述的砧座输送系统，其中所述管状引导组件包括构造成将所述柔性管可操作地连接到所述砧座中心杆的适配器。
11.根据权利要求8所述的砧座输送系统，其中所述柱塞构件包括构造成将所述弹簧维持在所述细长主体周围的、所述细长主体的近端上的凸缘。
12.根据权利要求8所述的砧座输送系统，其中所述柱塞构件包括J形。
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Also Published As
| Publication number | Publication date |
|---|---|
| US20190083096A1 (en) | 2019-03-21 |
| EP3386401B1 (en) | 2020-08-26 |
| ES2821891T3 (es) | 2021-04-28 |
| WO2017096502A1 (en) | 2017-06-15 |
| EP3386401A1 (en) | 2018-10-17 |
| US11020119B2 (en) | 2021-06-01 |
| EP3386401A4 (en) | 2019-09-18 |
| CN108289684A (zh) | 2018-07-17 |
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