CN108338814B - 具有可复位砧座组合件的外科钉合装置 - Google Patents

具有可复位砧座组合件的外科钉合装置 Download PDF

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CN108338814B
CN108338814B CN201810053126.3A CN201810053126A CN108338814B CN 108338814 B CN108338814 B CN 108338814B CN 201810053126 A CN201810053126 A CN 201810053126A CN 108338814 B CN108338814 B CN 108338814B
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约瑟夫·格雷拉
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Abstract

一种外科钉合器包含砧座组合件，所述砧座组合件包含枢转地紧固到砧座中心棒的砧座头组合件。所述砧座头组合件包含具有支柱的外壳以及绕所述支柱支撑并且可在回缩与推进位置之间移动的切口环组合件。切口环保持器绕所述支柱定位并且可在回缩位置和推进位置之间移动以准许所述切口环组合件移动到其推进位置，在所述回缩位置中，所述切口环保持器将所述切口环组合件保持于其回缩位置中。在其回缩位置中，所述切口环保持器可收纳于绕所述支柱形成的保持器狭槽中。所述切口环保持器可为环形和/或由弹性材料形成以促进所述切口环保持器移动进出所述保持器狭槽。

Description

具有可复位砧座组合件的外科钉合装置
相关申请的交叉引用
本申请主张2017年1月24日申请的第62/449,704号美国临时专利申请的权益和优先权，所述美国临时专利申请的公开内容以引用的方式并入本文中。
技术领域
本发明涉及具有可倾斜砧座组合件的外科钉合装置，且更明确地说，涉及被配置成重复使用的具有可倾斜砧座组合件的圆形钉合装置。
背景技术
用于执行例如吻合术、瘘切手术和粘膜切除术等外科手术过程的是众所周知的。这些装置包含砧座组合件，其具有中心棒和支撑于中心棒上的砧座头。通常，在用圆形钉合装置执行的外科手术过程期间，钉合装置的工具组合件插入到组织的管状区段中以结合所述组织区段或从所述组织区段内移除患病或受损组织。为了使对组织区段的创伤降到最低，砧座头可以枢转地支撑于中心棒上，以在插入和/或从组织区段移除工具组合件期间减小砧座头的外形。在一些钉合装置中，组件在击发钉合装置以促进砧座头倾斜期间断裂。
归因于与医疗手术过程相关联的成本升高，可重复使用的外科手术器械是合乎需要的。因此，包含可重复使用或可复位砧座组合件的圆形钉合装置是合乎需要的。
发明内容
在本公开的一个方面中，一种外科钉合装置包含手柄组合件、转接器组合件和工具组合件。所述转接器组合件具有连接到所述手柄组合件的近端部分、远端部分和砧座保持器。所述砧座保持器从转接器组合件的远端部分延伸并且可从回缩位置移动到推进位置。工具组合件支撑于转接器组合件的远端部分上并且包含壳体组合件和砧座组合件。所述壳体组合件包含具有多个钉的环形钉仓。所述砧座组合件包含中心棒组合件和砧座头组合件。所述中心棒组合件包含界定纵向轴线的具有近端部分和远端部分的砧座中心棒。所述近端部分被配置成以可释放方式接合转接器组合件的砧座保持器。
砧座头组合件枢转地紧固到砧座中心棒的远端部分并且包含外壳和切口环组合件。所述外壳界定凹部并且包含安置于所述凹部内中心处的支柱和绕所述凹部定位的环形组织接触表面。所述支柱界定纵向轴线，且所述组织接触表面界定多个钉变形凹穴。所述切口环组合件在回缩位置和推进位置之间绕支柱可移动地支撑。切口环保持器绕所述支柱定位并且可在回缩位置和推进位置之间移动以准许切口环组合件移动到其推进位置，在所述回缩位置中，所述切口环保持器将切口环组合件保持于其回缩位置中。砧座头组合件从操作位置枢转到倾斜位置，在所述操作位置中，砧座中心棒的纵向轴线与支柱的纵向轴线对准，在所述倾斜位置中，砧座中心棒的纵向轴线和支柱的纵向轴线界定锐角。在其回缩位置中，切口环组合件定位成接合中心棒以将砧座头组合件保持于操作位置中，且在其推进位置中，切口环组合件定位成准许砧座头组合件枢转移动到倾斜位置。
在本公开的另一方面中，一种枢转砧座组合件包含中心棒组合件和砧座头组合件。所述中心棒组合件包含界定纵向轴线、近端部分和远端部分的砧座中心棒。所述砧座头组合件枢转地紧固到砧座中心棒的远端部分并且包含外壳和切口环组合件。所述外壳界定凹部并且包含安置于所述凹部内中心处的支柱和绕所述凹部定位的环形组织接触表面。所述支柱界定纵向轴线。所述切口环组合件绕所述支柱支撑并且可在回缩位置和推进位置之间移动。切口环保持器绕支柱定位并且可在回缩位置和推进位置之间移动以准许切口环组合件移动到其推进位置，在所述回缩位置中，所述切口环保持器将切口环组合件保持于其回缩位置中。砧座头组合件从操作位置枢转到倾斜位置，在所述操作位置中，砧座中心棒的纵向轴线与支柱的纵向轴线对准，在所述倾斜位置中，砧座中心棒的纵向轴线和支柱的纵向轴线界定锐角。在其回缩位置中，切口环组合件定位成接合中心棒以将砧座头组合件保持于操作位置中。在其推进位置中，切口环组合件定位成准许砧座头组合件枢转移动到倾斜位置。
在实施例中，砧座头组合件的外壳包含界定至少一个复位孔的远端面。所述至少一个复位孔与凹部连通并且被配置成提供对所述凹部的接取，从而促进所述切口环保持器从其推进位置移动回到其回缩位置。
在一些实施例中，所述支柱界定具有环形配置的保持器狭槽，且当切口环保持器处于其回缩位置中时，所述保持器定位于所述保持器狭槽内。
在某些实施例中，所述保持器狭槽的远端包含向外渐缩表面，所述向外渐缩表面定位成当所述切口环保持器从其回缩位置朝向其推进位置移动时，使所述切口环保持器扩张。
在实施例中，所述切口环保持器是环形的并且由弹性材料形成。
在一些实施例中，切口环保持器具有螺旋配置。
在某些实施例中，所述中心棒组合件包含柱塞和柱塞弹簧，所述柱塞弹簧定位成朝向砧座头组合件推进所述柱塞，从而将所述砧座头组合件从操作位置朝向倾斜位置推进。
在实施例中，所述外科钉合装置进一步包含可绕所述砧座头组合件的支柱移动地支撑的支承部件，切口环组合件支撑于所述支承部件上。
在一些实施例中，所述支承部件界定尺寸设定为收纳所述支柱的中心开口并且包含绕所述中心开口定位的凸缘，且所述切口环组合件绕所述支承部件的所述凸缘支撑。
在一些实施例中，所述切口环组合件包含内套管和主体，其中所述内套管和所述主体各自界定中心开口。所述内套管可紧固于所述主体的所述中心开口内，且所述内套管的所述中心开口尺寸可设定为收纳所述支承部件的凸缘。
在某些实施例中，所述切口环组合件包含定位于所述主体的近端表面与所述支承部件的远端表面之间的底座部件。
在实施例中，支承部件由金属形成。
在一些实施例中，所述主体由具有第一硬度的第一材料形成，且所述底座部件由具有第二较低硬度的第二材料形成。
附图说明
本文中在下文参看图式描述本发明所公开的具有可复位可倾斜砧座组合件的外科钉合装置的各种实施例，在图式中：
图1是本发明所公开的包含可复位可倾斜砧座组合件的外科钉合装置的一个实施例的侧视透视图；
图2是从图1中示出的可复位砧座组合件的近端的侧视透视图，其中砧座组合件的砧座头处于操作位置；
图3是从图2中示出的可复位砧座组合件的远端的透视图；
图4是图2中示出的可复位砧座组合件的分解侧视透视图；
图5是图4中示出的所指示细节区域的放大视图；
图6是沿着图5的截面线6-6截取的横截面图；
图7是沿着图5的截面线7-7截取的截面图；
图8是从图4中示出的可复位砧座组合件的砧座头的近端的透视图；
图9是图2中示出的所指示细节区域的放大视图；
图10是在预击发状态下经过图1中所示出的可复位砧座组合件的远端的侧视横截面图；
图11是在钉合装置击发期间经过图1中所示出的可复位砧座组合件的远端的侧视横截面图，其中以虚线示出为砧座组合件的切口环组合件的壳体组合件正推进到砧座头中；
图12是图1中示出的可复位砧座组合件的侧视透视图，其中可复位砧座组合件的砧座头处于倾斜位置中；
图13是图12中示出的所指示细节区域的放大视图；
图14是沿着图12的截面线14-14截取的横截面图；
图15是图14中示出的所指示细节区域的放大视图；
图16是在保持器通过复位工具返回到其预击发位置时，图2中示出的可复位砧座组合件的砧座头和保持器部件的透视图；
图17是图4中示出的可复位砧座组合件的保持器的替代实施例的侧视透视图；以及
图18是图4中示出的可复位砧座组合件的保持器部件的另一替代实施例的侧视透视图。
具体实施方式
现将参看图式详细地描述本发明所公开的包含可复位可倾斜砧座组合件的外科钉合装置，其中在数个视图中的每一个中用相同参考编号指定相同或对应元件。在此描述中，术语“近端”大体用来指代装置的较靠近临床医生的部分，而术语“远端”大体用来指代装置的距临床医生较远的部分。另外，术语临床医生大体用来指代医务人员，包含医生、护士和支持人员。
本发明所公开的外科钉合装置包含手柄或致动器组合件、细长主体或转接器，以及连接到转接器的远端部分的工具组合件。工具组合件包含可倾斜砧座组合件和壳体组合件。砧座组合件包含以可释放方式连接到转接器的中心棒和枢转地连接到中心棒的砧座头。砧座头支撑可在预击发或回缩位置与第二或推进位置之间移动的切口环组合件，在所述预击发或回缩位置中，所述切口环组合件将砧座头保持于不倾斜或操作位置中，在所述第二或推进位置中，所述切口环组合件定位成允许砧座头移动到倾斜位置。砧座组合件还包含保持器，所述保持器可从砧座头内的预击发或回缩位置移动到砧座头内的推进位置以允许切口环组合件从第一位置移动到第二位置。在实施例中，砧座头界定至少一个复位孔，所述复位孔尺寸设定为提供对砧座头内的切口环保持器和切口环组合件的接取，从而允许切口环组合件和切口环保持器在钉合装置已经击发以使砧座头返回并保持于操作位置中之后返回到其预击发或回缩位置。
参看图1，本发明所公开的外科钉合装置大体示出为钉合装置10并且包含手柄或致动器组合件20、细长主体或转接器组合件30以及工具组合件40。如所说明的手柄组合件20是电力驱动组合件并且包含把手22和致动按钮24，可压下所述致动按钮以致动钉合装置10的各种功能，包含工具组合件的接近和钉的击发。在实施例中，把手22支撑为手柄组合件20供电的电池组(未示出)。
在实施例中，转接器组合件30以可释放方式连接到手柄组合件20的远端部分并且包含多个驱动机构(未示出)，所述驱动机构响应于致动按钮24的致动将电力从手柄组合件20转译到工具组合件40以进行工具组合件40的操作，即接近和击发。转接器组合件30还包含砧座保持器59，所述砧座保持器从转接器组合件30的远端部分延伸并且可在回缩和推进位置之间移动。第9,247,940、9,055,943和8,806,973号美国专利和第2015/0014392号美国公开案公开电动手柄组合件和转接器组合件的示范性实施例，并且以全文引用的方式并入本文中。或者，细长主体或转接器组合件30可以不可移除方式紧固到致动器组合件20。
还设想可手动地为致动器组合件20供电。手动供电的手柄组合件的实例描述于第8,789,737、8,424,535('535专利)和8,360,295号美国专利中，所述美国专利以全文引用的方式并入本文中。
工具组合件40包含壳体组合件50和砧座组合件60。壳体组合件50包含支撑钉仓54的外壳52，所述钉仓具有钉凹穴56的环形阵列。钉仓54具有面向远端的组织接触表面57。钉凹穴56中的每一个容纳钉(未示出)。壳体组合件50还包含促进钉从钉仓54击发的组件以及环形刀58(图11)，所述环形刀可从凹入于外壳52内的回缩位置移动到延伸到砧座组合件60中的推进位置。'535专利描述适合与目前公开的钉合装置10一起使用的壳体组合件的组件。
参看图2-8，可复位砧座组合件60包含砧座中心棒组合件62和枢转地支撑于砧座中心棒组合件62的远端部分上的砧座头组合件64。砧座头组合件64包含外壳70(包含支柱72和砧座组织接触表面74)、支承部件76、切口环组合件78、凸轮卡锁部件80和切口环保持器82。在实施例中，外壳70、支柱72和砧座组织接触表面74单体地形成。或者，外壳70、支柱72和砧座组织接触表面74中的任何一个或全部可单独地形成并且使用任何包含焊接、压接等任一已知扣接技术紧固到一起。砧座头组合件64的外壳70界定凹部86(图4)，所述凹部定位于支柱72与组织接触表面74之间，其中支柱72位于凹部86内中心处。外壳70的组织接触表面74面向钉仓54的组织接触表面57(图1)并且包含用于收纳从钉仓54弹出的钉并使钉变形的多个钉变形凹穴92。
砧座头组合件64的外壳70也界定延伸通过外壳70的远端面并且与凹部86连通的一个或更多个复位孔75(图3和4)。虽然在说明的实施例中示出三个复位孔75，但外壳70可界定不同数目个复位孔，例如2、3、4、5、6或更多个复位孔。复位孔75在邻近支柱72的外表面的位置处与凹部86连通(图5)。复位孔75从通风孔77径向向内定位。通风孔77允许压缩于钉仓54和砧座头组合件64之间哦流体和组织从砧座组合件60排出。
特别参看图4，支承部件76界定中心开口96，所述中心开口尺寸设定为收纳外壳70的支柱72。中心开口96尺寸设定为促进支承部件76绕支柱72从预击发回缩位置移动到外壳70的凹部86内的推进位置，如在下文进一步详细地论述。支承板76包含绕开口96定位的凸起凸缘98。虽然凸起凸缘98说明为具有圆形形状，但可设想其它配置，例如正方形、矩形、三角形等。支承部件76包含一对向内延伸的指状件100，所述指状件可移动到与砧座组合件60的中心棒组合件62的远端部分接合以及脱离接合，从而允许砧座头组合件64相对于中心棒组合件62枢转，如下文详细地论述。在实施例中，支承部件76由例如金属等硬质材料形成，但可设想其它材料构造。第8,540,132号美国专利公开包含绕砧座头的支柱可移动地定位的支承部件和切口环组合件的可倾斜砧座组合件，所述专利以全文引用的方式并入本文中。
在实施例中，切口环组合件78包含由第一材料形成的环形主体102、由第二材料形成的环形底座部件104以及环形内套管106。切口环组合件78的主体102、底座部件104和套管106分别界定被配置成收纳支承板76的凸缘98的开口108a-c。套管106紧固到主体102的内表面102a并且绕支承部件76的凸缘98定位以将切口环组合件78紧固到支承部件76。因此，支承部件76在回缩和推进位置之间的移动使切口环组合件78的对应移动。
在实施例中，套管106由包覆模制到切口环组合件78的主体102的内表面102a上的硬质塑料材料形成。或者，套管106可使用其它已知扣接技术紧固到主体122的内表面102a。举例来说，套管106的外壁可包含接合主体102的内表面102a以将套管106紧固到主体102的突起部120。在实施例中，套管106压入配合到支承部件76的凸缘98上，以将切口环组合件78的套管106和主体102紧固到支承部件76上。主体102用粘附剂等紧固到底座部件104，使得底座部件104夹在主体106和支承部件76之间。底座部件104也可使用粘附剂紧固到支承部件76。
在实施例中，切口环组合件78的主体102由例如聚丙烯等具有第一硬度的第一材料形成，且底座部件104由例如聚酯等具有第二较低硬度的第二材料形成。切口环组合件78的上述构造允许刀58(图11)首先刺穿主体102的软硬度材料，并且接着刺穿底座部件104的第二较低硬度材料，最后抵靠支承板76的较硬材料降到最低点，如下文详细地论述。
设想多种切口环组合件可包含在本发明所公开的砧座头组合件中。举例来说，切口环组合件无需包含套管和/或底座部件104。
参看图4-10，切口环组合件78的主体102包含具有一系列突出部112的外壁110(图4)。砧座组合件60的外壳70包含界定环形凹槽114的内壁70a(图7)。在实施例中，砧座头组合件64的主体102的突出部112可滑动地收纳于环形凹槽114(图10)内，以导引切口环组合件和支承部件76在外壳70的凹部86内其推进和回缩位置之间的移动。环形止动部件116在环形凹槽114的近端处形成于外壳70上。切口环组合件78的主体102的环形止动部件116和突出部112被配置成将切口环组合件78和支承板76保持于砧座头组合件60的外壳70的凹部86内。
砧座头组合件64的支柱72界定收纳切口环保持器82的环形保持器狭槽130。保持器狭槽130通过支柱72的圆筒形部分136与外壳70的凹部86的远端间隔开，并且包含向外渐缩表面132。向外渐缩表面132在保持器狭槽130的底座和支柱72的圆筒形部分136之间延伸，使得支柱72的圆筒形部分136与保持器狭槽130的底座相比具有较大直径。切口环保持器82定位于保持器狭槽130内并且具有比保持器狭槽130的深度大的宽度，使得切口环保持器82延伸到凹部86中以当支承部件76和切口环组合件78处于其预击发或回缩位置中时接合支承部件76的近端表面(图10)。切口环保持器82和支承部件76之间的接合将支承部件76和切口环组合件78以可释放方式保持于其回缩位置中。界定保持器狭槽130的向外渐缩表面132定位成当切口环保持器82在凹部86内推进到绕支柱72的圆筒形部分136的位置时，响应于工具组合件的击发而扩张切口环保持器82的直径，如下文进一步详细地论述。
在实施例中，切口环保持器82包含弹性环82a。在实施例中，弹性环82a具有螺旋配置(图6)并且可当在远端方向上施加足够力时扩张。更具体地说，当弹性环82a通过预定力向远端按压到界定保持器狭槽130的远端部分的向外渐缩表面132中时，例如当环形刀将切口环组合件78驱动到砧座组合件60的外壳70的凹部86中时，随着弹性环82a向远端越过向外渐缩表面132，弹性环82a的直径扩张。此时，弹性环82a在外壳70的凹部86内向远端移动，从保持器狭槽130向外传送到支柱72的圆筒形部分136上。当切口环保持器82推进到支柱72的圆筒形部分136上时，切口环保持器82定位成紧邻复位孔75和/或至少部分地跨越所述复位孔。
设想切口环保持器82可具有多种替代配置。举例来说，图17中示出的切口环保持器182可具有大体上圆柱形配置，具有增加的宽度的区域184，其尺寸设定成从保持器狭槽130内径向向外延伸到与支承部件76的近端表面的接合中。增加的宽度的区域184可在大小和形状上不同。另外，保持器182可界定裂口186，所述裂口允许保持器182的直径沿着界定保持器狭槽130的向外渐缩表面132扩张到支柱72的圆筒形部分136上。
如图18中所示，切口环保持器282可具有大小和形状均匀且厚度增加的串联区域284。另外，保持器282可界定裂口286，所述裂口允许保持器282的直径沿着界定保持器狭槽130的向外渐缩表面132扩张到支柱72的圆筒形部分136上。或者，设想保持器182和/或282无需裂口，而是可包含绕界定保持器狭槽130的向外渐缩表面132扩张以传送到支柱72的圆筒形部分136上的弹性主体。
再次参看图2-4，中心棒组合件62包含中心棒140、柱塞142和柱塞弹簧144。中心棒140的第一端包含界定腔148(图10)的一对间隔开的臂146，所述腔尺寸设定为收纳砧座头组合件64的支柱72。所述对臂146的每一臂146具有面向远端的平板149a和横向贯穿孔150。横向贯穿孔150界定与中心棒140的中心纵向轴线相交的轴线。或者，贯穿孔150轴线可从中心棒62的纵向轴线偏移。砧座头组合件64的支柱72尺寸设定为定位于腔148内并还包括横向贯穿孔152，所述腔界定于中心棒62的间隔开的臂146之间。枢轴部件154延伸穿过臂146的贯穿孔150和支柱72的贯穿孔152，以将支柱72枢转地紧固到中心棒140，使得砧座头组合件64在操作位置(图2)和倾斜位置(图12)之间枢转地安装到中心棒组合件62。形成于中心棒140的远端上的面向远端的平板149a尺寸设定成当支承部件76处于外壳70的凹部86内的回缩位置时支撑支承部件76的向内延伸指状件100，以将砧座头组合件64以可释放方式保持于操作位置中，如下文进一步详细论述。
凸轮卡锁部件80收纳于切口172(图8)中，所述切口界定于砧座头组合件的支柱72内。凸轮卡锁部件80界定收纳枢轴部件154的贯穿孔170(图4)，使得凸轮卡锁部件80绕枢轴部件154枢转地支撑于切口172内。通过柱塞弹簧144将柱塞142推进到与凸轮卡锁部件80以及砧座头组合件64的支柱72的近端的接合中，从而绕枢轴部件154朝向倾斜位置(图12)推进砧座头组合件64。凸轮卡锁部件80被配置成接合支承部件76的内表面，以防止支承部件76以及因此切口环组合件78在钉合装置10击发之后从推进位置移动回到回缩位置。
包含凸轮卡锁部件80、柱塞142和柱塞弹簧144的操作的砧座组合件60的更详细描述，请参考第8,540,132号美国专利(“'132专利”)，所述专利的内容以全文引用的方式并入本文中。
参看图9和10，在钉合装置10击发之前(图1)，支承部件76和切口环组合件78处于其回缩位置中，其中绕支承部件76的凸缘98支撑切口环组合件78。切口环保持器82定位于保持器狭槽130内并且向外延伸到凹部86中到达远离支承部件76的位置，从而将支承部件76保持于其回缩位置中。
当支承部件76处于其回缩位置中时，支承部件76的向内延伸指状件100支撑于中心棒140的面向远端的平板149a(图9)上，使得砧座头组合件64保持于操作位置中。如上文所论述，中心棒组合件62的柱塞142定位成将凸轮卡锁部件80和砧座头组合件62绕枢轴部件154朝向倾斜位置(图12)推进。
参看图11-16，当接近钉合装置10(图1)并且随后进行击发时，壳体组合件50的环形刀58(图11)从凹入于壳体组合件50的外壳52内的回缩位置推进到延伸到砧座头组合件64的切口环组合件78中的推进位置。当环形刀58接合切口环组合件78时，切口环组合件78和支承部件76从其回缩位置推进到其在砧座头组合件64的外壳70的凹部86内的推进位置。当支承部件76朝向其推进位置移动时，支承部件76接合切口环保持器82并且使切口环保持器82在图11中的箭头“A”指示的方向上从收纳于保持器狭槽130内的位置沿着界定保持器狭槽130的向外渐缩表面132推进到绕支柱72的圆筒形部分136定位的位置。如上文所论述，当保持器82在图11中的箭头“B”指示的方向上沿着向外渐缩表面132向远端移动时，切口环保持器82的直径扩张直到切口环保持器82绕支柱72的圆筒形部分136被收纳(图14)。切口环保持器82的弹性将切口环保持器82绕支柱72的圆筒形部分136保持于推进位置中。在此位置中，切口环保持器82定位成紧邻复位孔75和/或至少部分地跨越所述复位孔(图16)。
如上文所论述，当支承部件76移动到其推进位置时，向内延伸指状件100移动到与中心棒140的远端上的面向远端平板149a(图11)间隔开的位置。当指状件100与面向远端平板149a间隔开并且钉合装置10移动到相对于壳体组合件50间隔开或不接近的位置时，柱塞弹簧144(图4)将柱塞142推进到凸轮卡锁部件80和支柱72中，从而朝向倾斜位置推进砧座头组合件64。
参看图16，在钉合装置10(图1)已经击发，砧座头组合件64已移动到倾斜位置，且工具组合件40已经从病人的身体抽出之后，砧座头组合件64可手动地复位到操作位置(图2)。更具体地说，可通过以下手动地将砧座头组合件64复位到操作位置：手动地将砧座头组合件64抵着弹簧144的偏置力返回到操作位置并且通过砧座头组合件64的外壳70的复位开口75插入复位工具180，从而使保持器82和支承部件76返回到其回缩位置。当通过复位开口75中的一个或更多个插入复位工具180时，可操控复位工具180以将凹部86内近端的切口环保持器82从其绕支柱72的圆筒形部分136定位的推进位置往回朝向其回缩位置推送。当切口环保持器82朝向其定位于外壳70的凹部86内的回缩位置移动时，切口环保持器82接合支承部件76以将支承部件76和支撑于支承部件76上的切口环组合件78朝向其回缩位置推进。在切口环保持器82的回缩位置中，切口环保持器82收纳于保持器狭槽132内并且在其中指状件100与中心棒140的平板149a接合的位置中接合支承部件76，从而使砧座头组合件64保持于操作位置中。
所属领域的技术人员将理解，在本文中具体地描述且在附图中所说明的装置和方法并非限制性的示范性实施例。可设想在不脱离本发明的范围的情况下，结合一个示范性实施例说明或描述的元件和特征可与另一实施例的元件和特征组合。此外，所属领域的技术人员将理解本公开的基于上文所描述的实施例的另外特征和优点。因此，本公开不受特定地展示和描述的内容限制，而是由所附权利要求书定义。

Claims (24)

1.一种外科钉合装置，包括：
手柄组合件；
转接器组合件，所述转接器组合件具有连接到所述手柄组合件的近端部分、远端部分和砧座保持器，所述砧座保持器从所述转接器组合件的所述远端部分延伸并且能够从回缩位置移动到推进位置；以及
工具组合件，所述工具组合件支撑于所述转接器组合件的所述远端部分上，所述工具组合件包含壳体组合件和砧座组合件，所述壳体组合件包括具有多个钉的环形钉仓，所述砧座组合件包含：
中心棒组合件，所述中心棒组合件包含砧座中心棒，所述砧座中心棒界定纵向轴线并且具有被配置成以可释放方式接合所述转接器组合件的所述砧座保持器的近端部分和远端部分；以及
砧座头组合件，所述砧座头组合件枢转地紧固到所述砧座中心棒的所述远端部分，所述砧座头组合件包含外壳和切口环组合件，所述外壳界定凹部并且包含安置于所述凹部内中心处的支柱和绕所述凹部定位的环形组织接触表面，所述支柱界定纵向轴线，所述外壳的所述组织接触表面界定多个钉变形凹穴，所述切口环组合件绕所述支柱支撑并且能够在回缩与推进位置之间移动，且切口环保持器绕所述支柱定位并且能够在回缩位置和推进位置之间移动以准许所述切口环组合件移动到其推进位置，在所述回缩位置中，所述切口环保持器将所述切口环组合件保持于其回缩位置中，所述砧座头组合件从操作位置枢转到倾斜位置，在所述操作位置中，所述砧座中心棒的所述纵向轴线与所述支柱的所述纵向轴线对准，在所述倾斜位置中，所述砧座中心棒的所述纵向轴线和所述支柱的所述纵向轴线界定锐角，其中在其回缩位置中，所述切口环组合件定位成接合所述中心棒以将所述砧座头组合件保持于所述操作位置中，且在其推进位置中，所述切口环组合件定位成准许所述砧座头组合件枢转移动到所述倾斜位置，
其中所述支柱界定具有环形配置的保持器狭槽，当所述切口环保持器处于其回缩位置中时，所述切口环保持器定位于所述保持器狭槽内。
2.根据权利要求1所述的外科钉合装置，其中所述砧座头组合件的所述外壳包含界定至少一个复位孔的远端面，所述至少一个复位孔与所述凹部连通并且被配置成提供对所述凹部的接取，从而促进所述切口环保持器从其推进位置移动回到其回缩位置。
3.根据权利要求1所述的外科钉合装置，其中所述保持器狭槽的远端包含向外渐缩表面，所述向外渐缩表面定位成当所述切口环保持器从其回缩位置朝向其推进位置移动时，使所述切口环保持器扩张。
4.根据权利要求3所述的外科钉合装置，其中所述切口环保持器是环形的并且由弹性材料形成。
5.根据权利要求3所述的外科钉合装置，其中所述切口环保持器具有螺旋配置。
6.根据权利要求1所述的外科钉合装置，其中所述中心棒组合件包含柱塞和柱塞弹簧，所述柱塞弹簧定位成朝向所述砧座头组合件推进所述柱塞，从而将所述砧座头组合件从所述操作位置朝向所述倾斜位置推进。
7.根据权利要求1所述的外科钉合装置，进一步包含能够绕所述砧座头组合件的所述支柱移动地支撑的支承部件，所述切口环组合件支撑于所述支承部件上。
8.根据权利要求7所述的外科钉合装置，其中所述支承部件界定尺寸设定为收纳所述支柱的中心开口并且包含绕所述中心开口定位的凸缘，所述切口环组合件绕所述支承部件的所述凸缘支撑。
9.根据权利要求8所述的外科钉合装置，其中所述切口环组合件包含内套管和主体，所述内套管和所述主体各自界定中心开口，所述内套管紧固于所述主体的所述中心开口内，其中所述内套管的所述中心开口尺寸设定为收纳所述支承部件的所述凸缘。
10.根据权利要求9所述的外科钉合装置，其中所述切口环组合件包含定位于所述主体的近端表面与所述支承部件的远端表面之间的底座部件。
11.根据权利要求10所述的外科钉合装置，其中所述支承部件由金属形成。
12.根据权利要求10所述的外科钉合装置，其中所述主体由具有第一硬度的第一材料形成，且所述底座部件由具有第二较低硬度的第二材料形成。
13.一种枢转砧座组合件，包括：
中心棒组合件，所述中心棒组合件包含界定纵向轴线并且具有近端部分和远端部分的砧座中心棒；以及
砧座头组合件，所述砧座头组合件枢转地紧固到所述砧座中心棒的所述远端部分，所述砧座头组合件包含外壳和切口环组合件，所述外壳界定凹部并且包含安置于所述凹部内中心处的支柱和绕所述凹部定位的环形组织接触表面，所述支柱界定纵向轴线，所述切口环组合件绕所述支柱支撑并且能够在回缩和推进位置之间移动，且切口环保持器绕所述支柱定位并且能够在回缩位置和推进位置之间移动以准许所述切口环组合件移动到其推进位置，在所述回缩位置中，所述切口环保持器将所述切口环组合件保持于其回缩位置中，所述砧座头组合件从操作位置枢转到倾斜位置，在所述操作位置中，所述砧座中心棒的所述纵向轴线与所述支柱的所述纵向轴线对准，在所述倾斜位置中，所述砧座中心棒的所述纵向轴线和所述支柱的所述纵向轴线界定锐角，其中在其回缩位置中，所述切口环组合件定位成接合所述中心棒以将所述砧座头组合件保持于所述操作位置中，且在其推进位置中，所述切口环组合件定位成促进所述砧座头组合件枢转移动到所述倾斜位置，
其中所述支柱界定具有环形配置的保持器狭槽，当所述切口环保持器处于其回缩位置中时，所述切口环保持器定位于所述保持器狭槽内。
14.根据权利要求13所述的枢转砧座组合件，其中所述砧座头组合件的所述外壳包含界定至少一个复位孔的远端面，所述至少一个复位孔与所述凹部连通并且被配置成提供对所述凹部的接取，从而促进所述切口环保持器从其推进位置移动回到其回缩位置。
15.根据权利要求13所述的枢转砧座组合件，其中所述保持器狭槽的远端包含向外渐缩表面，所述向外渐缩表面定位成当所述切口环保持器从其回缩位置朝向其推进位置移动时，使所述切口环保持器扩张。
16.根据权利要求13所述的枢转砧座组合件，其中所述切口环保持器是环形的并且由弹性材料形成。
17.根据权利要求13所述的枢转砧座组合件，其中所述切口环保持器具有螺旋配置。
18.根据权利要求13所述的枢转砧座组合件，其中所述中心棒组合件包含柱塞和柱塞弹簧，所述柱塞弹簧定位成朝向所述砧座头组合件推进所述柱塞，从而将所述砧座头组合件从所述操作位置朝向所述倾斜位置推进。
19.根据权利要求13所述的枢转砧座组合件，进一步包含能够绕所述砧座头组合件的所述支柱移动地支撑的支承部件，所述切口环组合件支撑于所述支承部件上。
20.根据权利要求19所述的枢转砧座组合件，其中所述支承部件界定尺寸设定为收纳所述支柱的中心开口并且包含绕所述中心开口定位的凸缘，所述切口环组合件绕所述支承部件的所述凸缘支撑。
21.根据权利要求20所述的枢转砧座组合件，其中所述切口环组合件包含内套管和主体，所述内套管紧固于所述主体的中心开口内并且被配置成收纳所述支承部件的所述凸缘。
22.根据权利要求21所述的枢转砧座组合件，其中所述切口环组合件包含定位于所述主体的近端表面与所述支承部件的远端表面之间的底座部件。
23.根据权利要求22所述的枢转砧座组合件，其中所述支承部件由金属形成。
24.根据权利要求23所述的枢转砧座组合件，其中所述主体由具有第一硬度的第一材料形成，且所述底座部件由具有第二较低硬度的第二材料形成。
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