CN108348255A - 可重复使用的内窥镜外科手术施夹器 - Google Patents
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Abstract
提供了一种可重复使用的外科手术施夹器(10)，其包括手柄组件(100)，可选择性地连接到手柄组件(100)的壳体的内窥镜组件(200)，以及可选择性地装载在内窥镜组件(200)中并可连接到其的夹具仓组件(300)。
Description
技术领域
本发明涉及外科手术施夹器。更具体地，本发明涉及具有可重复使用的手柄组件、可重复使用的轴组件以及一次性夹具仓组件的可重复使用的内窥镜外科手术施夹器。
背景技术
内窥镜缝合器和外科手术施夹器在本领域中是已知的并且用于许多不同且有用的外科手术。在腹腔镜外科手术的情况下，通过穿过皮肤中的小入口切口插入的狭窄管或套管实现进入腹部内部。在身体其它地方进行的微创手术常常被称为内窥镜手术。通常通过入口切口将管或套管装置延伸到患者体内以提供进入端口。该端口允许外科医生使用套管针通过其插入许多不同的外科手术器械并用于执行远离切口的外科手术。
在大多数这些手术期间，外科医生必须经常终止血液或另一流体流动通过一个或多个血管。外科医生通常将外科手术夹具应用于血管或另一个管道以防止手术过程中体液从中流过。本领域中已知内窥镜施夹器用于在进入体腔期间施加单个夹具。这类夹具通常由生物相容性材料制成并且通常在血管上压缩。一旦施加到血管上，压缩的夹具终止流体从其中流过。
在Green等人的共同转让的美国专利第5,084,057号和第5,100,420号中描述了能够在单次进入体腔期间在内窥镜或腹腔镜手术中施加多个夹具的内窥镜施夹器，两个专利整体均以引用方式并入。在Pratt等人的共同转让的美国专利第5,607,436号中公开了另一种多内窥镜施夹器，该专利内容整体也以引用方式并入本文中。这些装置通常但不一定在单次外科手术期间使用。Pier等人的美国专利第5,695,502号公开了一种可重复消毒的外科手术施夹器，其公开内容以引用方式并入本文中。施夹器在单次插入体腔期间推进并形成多个夹具。该可重复消毒的施夹器被构造成接收可互换夹具库并与之协作，以便在单次进入体腔期间推进并形成多个夹具。
在内窥镜或腹腔镜手术期间，取决于待结扎的下层组织或血管，可能需要和/或必须使用不同尺寸的外科手术夹具。为了降低外科手术施夹器的总成本，期望单个外科手术施夹器可装载并且能够根据需要发射不同尺寸的外科手术夹具。
另外，为了降低外科手术施夹器的总成本，期望提供一种具有可多次重复使用(在适当的清洁、消毒和修复过程之后)的部件并且限制了其一次性部件的数量的外科手术施夹器。
因此，需要包括可重复使用的手柄组件、可重复使用的轴组件和一次性夹具仓组件的改进型内窥镜外科手术施夹器。
发明内容
本发明涉及可重复使用的内窥镜外科手术施夹器。
根据本发明的一个方面，提供了一种可重复使用的外科手术施夹器，其包括手柄组件、内窥镜组件和夹具仓组件。
手柄组件包括在其中限定孔的壳体；从壳体延伸的固定手柄；以及枢转地连接到固定手柄的触发器，该触发器包括设置在壳体的孔内的致动端。
内窥镜组件可选择性地连接到手柄组件的壳体。内窥镜组件包括限定穿过其中的管腔的外管，该外管包括近端和远端；从外管的远端固定地支撑并延伸的一对钳夹；以及可滑动地支撑在外管的管腔中的驱动组件。
驱动组件包括可滑动地支撑在外管的管腔中的轴推动器管，该轴推动器管包括近端、远端并且限定穿过其中的管腔，其中在推动器管的近端轴设置径向凸缘。
驱动组件还包括可滑动地设置在轴推动器管的管腔内的闭合驱动杆，该闭合驱动杆具有从外管的近端突出并且可与触发器的致动端接合的近端，以及可选择性与该对钳夹接合以接近该对钳夹的远端，其中在闭合驱动杆的近端处设置肩部。
驱动组件还包括置于闭合驱动杆的肩部与轴推动器管的径向凸缘之间的偏置构件。
夹具仓组件可选择性地连接到外管的远端，并且连接到轴推动器管的远端。夹具仓组件包括夹具托盘；可滑动地支撑在夹具托盘中的多个外科手术夹具；可滑动地设置在夹具托盘内并且设置在多个外科手术夹具的近侧的夹具从动件；倾向于在远侧方向上推动夹具从动件的偏置构件；以及可滑动地支撑在夹具托盘附近的夹具推杆，其中该夹具推杆包括被构造成与轴推动器管的远端接合的近端，以及被构造成接合多个外科手术夹具中的最远侧夹具的远端。
在操作中，在触发器的初始致动期间，触发器的致动端可以作用于内窥镜组件的闭合驱动杆的近端上以向远侧推进闭合驱动杆。闭合驱动杆可以作用于偏置构件上以抵靠轴推动器管的径向凸缘向远侧推进偏置构件以向远侧推进轴推动器管。轴推动器管可以作用于夹具推杆上以向远侧推进夹具仓组件的夹具推杆，并且将其最远侧外科手术夹具装载到该对钳夹中。
内窥镜组件可以包括支撑在其外管中的止挡构件。止挡构件可以设置在轴推动器管的径向凸缘的远侧。轴推动器管的远侧推进可以通过止挡构件而停止。
在操作中，在止挡构件停止轴推动器管的远侧推进之后，在触发器的进一步致动期间，触发器的致动端可以作用于内窥镜组件的闭合驱动杆的近端上以进一步向远侧推进闭合驱动杆。闭合驱动杆可以作用于偏置构件上以压缩轴推动器管的径向凸缘与闭合驱动杆的肩部之间的偏置构件。
在操作中，在触发器的进一步致动期间，闭合驱动杆的远端可以作用于该对钳夹上以接近该对钳夹并形成装载在其中的任何外科手术夹具。
在接近该对钳夹期间，夹具仓组件的夹具推杆可保持在远侧位置。
手柄组件可以包括可选择地固定到壳体的近端的端帽。
根据本发明的另一方面，内窥镜组件被构造成用于选择性地连接到手柄组件并且可由手柄组件的触发器致动。内窥镜组件包括限定穿过其中的管腔的外管，该外管包括近端和远端；从外管的远端固定地支撑并延伸的一对钳夹，该对钳夹能够在打开位置与闭合位置之间移动，其中该对钳夹被构造成在该对钳夹从打开位置被致动到关闭位置时形成装载在其内的外科手术夹具；以及可滑动地支撑在外管的管腔中的驱动组件。
驱动组件包括可滑动地支撑在外管的管腔中的轴推动器管，该轴推动器管包括近端、远端并且限定穿过其中的管腔，其中在轴推动器管的近端设置径向凸缘。
驱动组件还包括可滑动地设置在轴推动器管的管腔内的闭合驱动杆，该闭合驱动杆具有从外管的近端突出并且可与手柄组件的触发器接合的近端，以及构造成选择性地接合该对钳夹以将该对钳夹移动到闭合位置的远端，其中在闭合驱动杆的近端处设置肩部。
驱动组件还包括置于闭合驱动杆的肩部与轴推动器管的径向凸缘之间的偏置构件。
在操作中，在闭合驱动杆的初始远侧推进期间，闭合驱动杆的肩部可以作用于偏置构件上以抵靠轴推动器管的径向凸缘向远侧推进偏置构件以向远侧推进轴推动器管。轴推动器管可以作用于装载在外管中的夹具仓组件以将夹具仓组件的最远侧外科手术夹具推进到该对钳夹中。
内窥镜组件可包括支撑在其外管中的止挡构件，其中该止挡构件设置在轴推动器管的径向凸缘的远侧。轴推动器管的远侧推进可以通过止挡构件而停止。
在操作中，在止挡构件停止轴推动器管的远侧推进之后，在闭合驱动杆的进一步推进期间，闭合驱动杆可以作用于偏置构件上以压缩轴推动器管的径向凸缘与闭合驱动杆的肩部之间的偏置构件。
在操作中，在闭合驱动杆的进一步推进期间，闭合驱动杆的远端可以作用于该对钳夹上以接近该对钳夹并形成装载在其中的任何外科手术夹具。
根据本发明的另一方面，提供了一种可重复使用的外科手术施夹器，其包括手柄组件、内窥镜组件和夹具仓组件。
手柄组件包括壳体；以及枢转地连接到壳体的触发器，该触发器包括设置在壳体内的致动端。
内窥镜组件可选择性地连接到手柄组件的壳体。内窥镜组件包括限定穿过其中的管腔和在其远端中的窗口的外管；从外管的远端固定地支撑并延伸的一对钳夹；以及可滑动地支撑在外管的管腔中的驱动组件。
驱动组件包括可滑动地支撑在外管的管腔中的轴推动器管，该轴推动器管包括近端、远端并且限定穿过其中的管腔，其中在推动器管的近端轴设置径向凸缘。
驱动组件还包括可滑动地设置在轴推动器管的管腔内的闭合驱动杆，该闭合驱动杆具有从外管的近端突出并且可与触发器的致动端接合的近端，以及可选择性与该对钳夹接合以接近该对钳夹的远端，其中在闭合驱动杆的近端处设置肩部。
驱动组件还包括置于闭合驱动杆的肩部与轴推动器管的径向凸缘之间的偏置构件。
夹具仓组件可选择地设置在外管的窗口内，并且可选择性地连接到轴推杆管的远端。夹具仓组件包括夹具托盘；可滑动地支撑在夹具托盘中的多个外科手术夹具；可滑动地设置在夹具托盘内并且设置在多个外科手术夹具的近侧的夹具从动件；倾向于在远侧方向上推动夹具从动件的偏置构件；以及可滑动地支撑在夹具托盘附近的夹具推杆，其中该夹具推杆包括被构造成与轴推动器管的远端接合的近端，以及被构造成接合多个外科手术夹具中的最远侧夹具的远端。
在操作中，在触发器的初始致动期间，触发器的致动端可以作用于内窥镜组件的闭合驱动杆的近端上以向远侧推进闭合驱动杆。闭合驱动杆可以作用于偏置构件上以抵靠轴推动器管的径向凸缘向远侧推进偏置构件以向远侧推进轴推动器管。轴推动器管可以作用于夹具推杆上以向远侧推进夹具仓组件的夹具推杆，并且将其最远侧外科手术夹具装载到该对钳夹中。
内窥镜组件可以包括支撑在其外管中的止挡构件。止挡构件可以设置在轴推动器管的径向凸缘的远侧。轴推动器管的远侧推进可以通过止挡构件而停止。
在操作中，在止挡构件停止轴推动器管的远侧推进之后，在触发器的进一步致动期间，触发器的致动端可以作用于内窥镜组件的闭合驱动杆的近端上以进一步向远侧推进闭合驱动杆。闭合驱动杆可以作用于偏置构件上以压缩轴推动器管的径向凸缘与闭合驱动杆的肩部之间的偏置构件。
在操作中，在触发器的进一步致动期间，闭合驱动杆的远端可以作用于该对钳夹上以接近该对钳夹并形成装载在其中的任何外科手术夹具。
在接近该对钳夹期间，夹具仓组件的夹具推杆可保持在远侧位置。
附图说明
本文参考附图公开了外科手术施夹器的特定实施例，其中：
图1是根据本发明的可重复使用的内窥镜外科手术施夹器的俯视正面透视图；
图2是图1的可重复使用的内窥镜外科手术施夹器的透视图，各部分分开；
图3是图1到图2的可重复使用的内窥镜外科手术施夹器的手柄组件的远侧透视图；
图4是图1到图3的手柄组件的远侧透视图，从中移除了旋钮；
图5是图1到图4的手柄组件的远侧透视图，从中移除了旋钮和圆筒；
图6是图1到图5的手柄组件的远侧透视图，从中移除了旋钮、圆筒和远侧套环；
图7是图1到图6的手柄组件的远侧透视图，从中移除了旋钮、圆筒、远侧套环和固定手柄；
图8是图1到图7的手柄组件的远侧透视图，从中移除了旋钮、圆筒、远侧套环、固定手柄和套囊；
图9是本发明的可重复使用的内窥镜外科手术施夹器的根据本发明的内窥镜轴组件的远端的透视图，仓组件装载在其中；
图10是内窥镜轴组件的远端的透视图，从中移除了外管，并且从中移除了仓组件的盖；
图11是内窥镜轴组件的远端的透视图，从中移除了外管，并且从中移除了仓组件的盖、恒力弹簧和一叠外科手术夹具；
图12是内窥镜轴组件的远端的透视图，从中移除了外管，并且从中移除了仓组件的盖、恒力弹簧、该叠外科手术夹具和夹具托盘；
图13是内窥镜轴组件的主闭合驱动杆的远端的透视图；
图14是如图1的14-14截取的可重复使用的内窥镜外科手术施夹器的横截面图；
图15是图14的指示的细节区域的放大图；
图16是如图15的16-16截取的横截面图；
图17是图14的指示的细节区域的放大图；
图18A到图18C是示出图1到图17的内窥镜轴组件的驱动机构的操作的放大图；
图19是根据本发明的另一实施例的内窥镜轴组件的示意性透视图；
图20是图19的内窥镜轴组件的透视图，各部分分开；
图21是如图19的21-21截取的横截面图；以及
图22A到图22C是示出图19到图21的内窥镜轴组件的驱动机构的操作的放大图。
具体实施方式
现在将参考附图详细描述根据本发明的可重复使用的外科手术施夹器的实施例，其中相同的附图标记标识相似或相同的结构元件。如附图中所示以及贯穿以下描述所描述的，当涉及外科手术器械上的相对定位时，传统意义上的术语“近侧”是指设备的更靠近用户的末端，而术语“远侧”是指到设备的远离用户的末端。
首先参考图1到图2根据本发明的实施例的外科手术施夹器总体上被表示为10。外科手术施夹器10包括手柄组件100，从手柄组件100突出或从手柄组件100延伸的细长外管或内窥镜组件200，以及可以可拆卸地且选择性地安装在内窥镜组件200的远端上/中的夹具仓组件300。如下面将更详细地描述，多个外科手术夹具“C”(图2)被装载到夹具仓组件300中。另外，如将在下面更详细地描述，在操作中，当手柄组件100被致动时，单个外科手术夹具“C”围绕要结扎的血管被发射并形成。
如图1到图8中所示，手柄组件100包括固定手柄112和在枢轴116处可枢转地连接到固定手柄112的可挤压触发器114。可挤压触发器114包括近侧致动端114b，该近侧致动端向近侧延伸超出枢轴116并且延伸到支撑在固定手柄112上的圆筒118的孔118a中。
圆筒118被支撑在固定手柄112上并构造成容纳内窥镜组件200的近端。圆筒118限定穿过其中的管腔或孔118a。带螺纹的端帽119封闭圆筒118的近端。如图2中所示，圆筒118的鼻部118b包括从其径向向内突出的一对径向相对的凸块118c，并且其被构造且尺寸设定成可滑动地接合内窥镜组件200的远侧套环204的环形外通道或座圈204a。
参考图2到图18C，内窥镜组件200支撑和/或包括可拆卸地支撑在圆筒118的孔118b内或可拆卸地连接到圆筒118的主驱动组件或推进机构220。主驱动组件220包括主闭合驱动杆222，该主闭合驱动杆包括近端222a和远端222b。主闭合驱动杆222的近端222a在其上支撑凸缘、活塞或驱动头222c。主闭合驱动杆222的远端222b限定形成于其中的V形凸轮凹槽222d，该V形凸轮凹槽被构造且尺寸设定成选择性地接合内窥镜组件200的一对钳夹214的凸轮楔214d，从而实现闭合或接近该对钳夹214。
主闭合驱动杆222还沿着其长度限定面向远侧的肩部222e。主闭合驱动杆222的肩部222e被构造且尺寸设定成选择性地接合夹具仓组件300的驱动滑块308并将其向远侧推进，从而实现将外科手术夹具“C”装载到该对钳夹214中，如将在下面更详细地描述。
主驱动组件220还包括具有近端223a和远端223b的轴推动器管223。轴推动器管223的近端223a在其上支撑环形凸缘或套囊223c。轴推动器管223的远端223b可以包括形成在其中的联接特征或者限定驱动最远端223d。
参考图2和图9，内窥镜组件200包括具有近端202a和远端202b中空外管202，以及固定到外管202的近端202a的套环或旋钮206。外管202的远端202b限定形成在其一侧的通道或窗口202c。外管202包括在窗口202c的远侧位置处延伸穿过窗口202c的远侧护罩202d。
手柄组件100以及内窥镜组件200可以由生物相容性材料制成，诸如例如高级外科手术不锈钢、钛，或者由高强度耐高压加热聚合物、热塑性塑料或类似物制成。
如图2和图9到图12中所示，内窥镜组件200包括一对钳夹214，该对钳夹安装在外管202的窗口202c中并可由手柄组件100的触发器114的致动而致动。该对钳夹214由合适的生物相容性材料形成，诸如例如，不锈钢或钛。该对钳夹214可以可拆卸地或固定地安装在外管202的通道202c中。
暂时参考图9到图12，该对钳夹214在其间限定通道214c，用于在其中容纳外科手术夹具“C”。该对钳夹214包括从其突出的一对凸轮楔面214d。如将在下面详细描述，该对凸轮楔面214d由主闭合驱动杆222的远端222b的V形凸轮凹槽222d加载，以将该对钳夹214致动到闭合位置。
继续参考图2和图9到图12，示出了外科手术施夹器10的夹具仓组件300。如上所述，夹具仓组件300被构造且尺寸设定成用于选择性地装载到形成在内窥镜组件200的外管202的远端202b中的窗口202c中，并且被构造且尺寸设定成选择性地连接、联接或接合主闭合驱动杆222的面向远侧的肩部222e，这将在下面更详细地讨论。
夹具仓组件300包括夹具托盘302，该夹具托盘包括底壁和支撑在底壁上的一对间隔开的侧壁或轨道，其中底壁和侧壁在其中限定夹具通道。
夹具托盘302的底壁的远端可以包括弹性中心柄脚(未示出)，其被构造并且适于选择性地接合保持在夹具托盘302内的该叠外科手术夹具“C”的最远侧外科手术夹具“C1”的后跨部，从而将该叠外科手术夹具“C”保持在夹具仓组件300的夹具托盘302内。
夹具仓组件300包括仓夹具推杆304，其可滑动地设置在夹具托盘302附近。仓夹具推杆304包括近端304a，该近端具有从其突出的联接杆304c，并且连接到或者可接合夹具仓组件300的驱动滑块308。仓夹具推杆304还包括限定推动器304d的远端部分304b，该推动器构造成接合一叠夹具“C”的最远侧夹具“C1”以用于将最远侧夹具“C1”装载到内窥镜组件200的该对钳夹214中。夹具推杆304还可以在其中限定细长窗口(未示出)，用于在其中可操作地容纳恒力弹簧310的近端，如将在下面更详细地讨论。
夹具仓组件300包括设置在夹具托盘302的通道和相邻的夹具仓推杆304内的一叠外科手术夹具“C”。夹具仓组件300可以装载有八(8)个外科手术夹具“C”，如在示出的示例性实施例中所示，或者在实施例中，夹具仓组件300可以装载有任何数量的外科手术夹具“C”，假设夹具仓组件300和内窥镜组件200各自经过适当地构造和尺寸设定。外科手术夹具“C”可以由本领域技术人员已知的材料制造，包括但不限于不锈钢、钛或其它金属合金。在实施例中，可以设想的是，该叠外科手术夹具“C”中的至少一个最终外科手术夹具可以被染成特定颜色，以在当夹具仓盒组件300的最终外科手术夹具被装载到该对钳夹214时向使用者进行指示。
夹具仓组件300还包括夹具从动件306，该夹具从动件至少部分地可滑动地设置在夹具托盘302的夹具通道内。如将在下面更详细地描述，夹具从动件306定位在该叠外科手术夹具“C”的近侧并且被设置成帮助在外科手术施夹器10的致动期间向前推动该叠外科手术夹具“C”。此外，如还将在下面更详细地描述，在外科手术施夹器10发射期间，在通过夹具推杆304将最远侧外科手术夹具“C1”推进到该对钳夹214中之后，夹具从动件306由恒力弹簧310致动。
夹具从动件306包括具有远端部分的细长主体，该细长主体被构造且尺寸设定成用于通过夹具托盘302的夹具通道。夹具从动件306的远端部分被构造成抵靠该叠外科手术夹具“C”的最近侧夹具“Cp”的后跨部来定位。
夹具从动件306包括从其近端部分306c横向突出的近端鳍片306d。夹具从动件306的近侧鳍片306d限定具有凹形弓形轮廓的近侧表面，该近侧表面被构造成容纳恒力弹簧310的盘绕或卷绕部分310c并与其定位在一起。
夹具仓组件300包括可滑动地设置在夹具托盘302的夹具通道内的驱动滑块308。驱动滑块308被构造成选择性地接合或选择性地与内窥镜组件200的主闭合驱动杆222的面向远侧的肩部222e接合。驱动滑块308包括从其向远侧延伸的仓推杆308a。驱动滑块308的仓推杆308a的远端操作性地连接到仓夹具推杆304的联接杆304c。
夹具仓组件300包括构造成连接到夹具托盘302并且支撑在其上的仓盖312。仓盖312可以包括从其内表面突出的大致向远侧延伸的钩或尖头(未示出)。仓盖312的钩被构造成容纳并保持恒力弹簧310的远端310b。仓盖312可以由透明材料制成，允许使用者清楚地看到该叠外科手术夹具“C”。
具体参考图2和图10，如上所述，夹具仓组件300包括支撑在夹具托盘302的夹具通道中的恒力弹簧310。恒力弹簧310呈带状，包括具有远端310b的主体部分310a以及盘绕在其自身上以形成卷轴的近端310c。
恒力弹簧310的主体部分310a和远端310b设置在夹具托盘302的夹具通道302c内，使得恒力弹簧310的主体部分310a和远端310b置于仓盖312与夹具推杆304之间。如上所述，恒力弹簧310的远端310b固定到夹具仓盖312的尖头(未示出)。可以设想的是，恒力弹簧310的远端310b可以在其中限定开口，该开口滑过夹具仓盖312的向远侧延伸的尖头。以这种方式，夹具仓盖312的尖头防止恒力弹簧310的远端310b向近侧移动。
恒力弹簧310的近侧盘绕或卷绕端310c设置在夹具从动件306的近侧鳍片306d的近侧。由于恒力弹簧310的记忆，其近侧盘绕或卷绕端310c倾向于想要沿着主体部分310a卷到其自身上。
恒力弹簧310是预应力的弹簧材料的扁条，其形成为实质上恒定半径的线圈，如上所述，其中恒力弹簧310的远端310b被固定到夹具仓盖312的尖头，并且如上所述，其中恒力弹簧310的近侧盘绕或卷绕端310c设置在夹具从动件306的近侧鳍片306d的近侧。
恒力弹簧310用以在夹具从动件306上并且继而在该叠外科手术夹具“C”上保持恒定的压力或远侧力，使得该叠外科手术夹具“C”压靠夹具托盘302的弹性中心柄脚(未示出)。以这种方式，在操作中，如将在下面更详细地描述，当夹具推杆304向远侧推进最远侧外科手术夹具“C”达任何量并且特别是越过夹具托盘302的弹性中心柄脚时，该叠外科手术夹具“C1”根据需要向远侧推进。
继续参考图1到图18C，示出并描述了施夹器10的示例性操作模式。如图1和图14到图17中所示，示出了施夹器10，其中夹具仓组件300连接到内窥镜组件200的远端，使得夹具仓组件300的驱动滑块308与内窥镜组件200的主闭合驱动杆222的面向远侧的肩部222e操作接合(如上所述)。
参考图14、图15、图18A和图18B，当触发器114围绕枢轴116挤压或枢转时，触发器114的致动端114b接合内窥镜组件200的主闭合驱动杆222的近端，从而向远侧推动主闭合驱动杆222。
当内窥镜组件200的主闭合驱动杆222向远侧推进时，由于触发器114的致动，主闭合驱动杆222的扩大的近端222a作用于偏置构件225(例如压缩弹簧)上，继而作用于轴推动器管223的套囊223c上以使轴推动器管223向远侧推进。当轴推动器管223向远侧推进时，轴推动器管223的远端223d作用于仓夹具推动器杆304的联接杆304c上以向远侧推进仓夹具推杆304。轴推动器管223向远侧推进，直到轴推动器管223的套囊223c邻接内窥镜组件200的止挡件227(见图2、图15和图17)。在这点上，轴推动器管223停住并静止。
当手柄组件100的触发器114被挤压该初始量时，夹具推杆304将已经推进足够的量以向远侧推进最远侧外科手术夹具“C1”越过夹具托盘302的弹性中心柄脚并且将最远侧外科手术夹具“C1”装载到该对钳夹214中。具体地，仓夹具推杆304的推动器304d在远侧方向上移动，使得推动器304d接合最远侧夹具“C1”的后跨部并向远侧推动最远侧外科手术夹具“C1”，使其离开夹具托盘302并进入该对钳夹214中。
当夹具推杆304向远侧推进，并且最远侧外科手术夹具“C1”被推进并装载到该对钳夹214中时，恒力弹簧310被致动，使得恒力弹簧310的卷绕端310c按压在夹具从动件306的近侧鳍片306d上以向远侧推进该叠外科手术夹具“C”，直到下一个最远侧夹具接合夹具托盘302的弹性中心柄脚并由其止挡。
在触发器114的整个挤压期间，夹具推杆304将保持在向远侧推进的位置。在触发器114被挤压之后，当触发器114被释放或返回到完全非挤压位置时，夹具推杆304通过偏置构件等(未示出)返回到原位置或最近侧位置。当夹具推杆304返回到原位置时，夹具推杆304的推动器304d移动到新的最远侧外科手术夹具“C1”近侧的位置。
另外，参考图18B和图18C，当内窥镜组件200的主闭合驱动杆222向远侧推进时，由于触发器114进一步致动超过初始量，在轴推动器管223的套囊223c邻接止动器227之后，触发器114的致动端114b继续以向远侧推进主闭合驱动杆222并且压缩主闭合驱动杆222的扩大近端222a与轴推动器管223的套囊223c之间的偏置构件225。当主闭合驱动杆222继续向远侧推进时，主闭合驱动杆222的V形凸轮凹槽222d向远侧推进到与内窥镜组件200的该对钳夹214的凸轮楔214d接合，从而实现闭合或接近该对钳夹214以及形成装载在其中的最远侧夹具“C1”。
在形成最远侧夹具“C1”之后，触发器114可以被释放，由此主闭合驱动杆222在近侧方向上移动，直到主驱动杆122返回到其最近侧位置。当主驱动杆122返回到其最近侧位置时，主闭合驱动杆222的V形凸轮凹槽222d从内窥镜组件200的该对钳夹214的凸轮楔214d向近侧收回，以允许该对钳夹214由于它们自身的弹性偏置而打开。
另外，当主驱动杆122返回到其最近侧位置时，允许偏置构件225扩张并且允许轴推动器管223返回到其最近侧位置。如上所述，当轴推动器管223返回到其最近侧位置时，夹具推杆304也返回到其最近侧位置。
可以根据需要重复上述操作，直到所有外科手术夹具“C”已经被发射并形成为止。
现在转到图19到图22C，根据本发明的替代实施例的内窥镜组件总体上被表示为400。内窥镜组件400包括具有近端402a和远端402b的中空外管402，该远端限定形成在其侧面的通道或窗口402c。中空外管402包括径向延伸到窗口402c中的肩部402d。
主驱动组件420包括具有近端422a和远端422b的主闭合驱动杆422。主闭合驱动杆422在其中限定通道422c。主闭合驱动杆422的通道422c包括近侧孔或凹部422d和近侧面422f，该近侧孔或凹部具有在其近端附近的远侧表面或肩部422e。
主驱动组件420还包括可滑动地设置在主闭合驱动杆422的通道422c内的轴推杆423.。轴推杆423包括近端或杆423a和远端或杆423b，其中限定面向近侧的表面423c的肩部被限定在近侧杆423a与远侧杆423b之间。轴推杆423的近侧杆423a延伸到主闭合驱动杆422的通道422c的近侧孔422d中。轴推杆423的远侧杆423b在中空外管402的肩部402d向远侧延伸。
主驱动组件420还包括偏置构件425(例如，压缩弹簧)，该偏置构件支撑在轴推杆423的近侧杆423a上并且置于主闭合驱动杆422的远侧表面或肩部422e与轴推杆423的面向近侧的表面423c之间。
继续参考图19到图22C，示出并描述了包括内窥镜组件400的施夹器10的示例性操作模式。在操作中，当触发器114围绕枢轴116挤压或枢转时，触发器114的致动端114b接合内窥镜组件400的主闭合驱动杆422的近端，从而向远侧推动主闭合驱动杆422。
当内窥镜组件400的主闭合驱动杆422向远侧推进时，由于触发器114的致动，主闭合驱动杆422的肩部422e作用于偏置构件425上，继而作用于轴推杆423的面向近侧的表面423c以向远侧推进轴推杆423。当轴推杆423向远侧推进时，轴推杆423的远侧杆423b的远端作用于仓夹具推杆304的联接杆或特征(例如，联接杆304c)上以向远侧推进仓夹具推杆304。轴推杆423向远侧推进，直到其肩部423c邻接中空外管402的肩部402d并停住且静止。
当手柄组件100的触发器114被挤压该初始量时，夹具推杆304将已经推进足够的量以向远侧推进最远侧外科手术夹具“C1”越过夹具托盘302的弹性中心柄脚并且将最远侧外科手术夹具“C1”装载到该对钳夹214中。具体地，仓夹具推杆304的推动器304d在远侧方向上移动，使得推动器304d接合最远侧夹具“C1”的后跨部并向远侧推动最远侧外科手术夹具“C1”，使其离开夹具托盘302并进入该对钳夹214中。
当夹具推杆304向远侧推进，并且最远侧外科手术夹具“C1”被推进并装载到该对钳夹214中时，恒力弹簧310被致动，使得恒力弹簧310的卷绕端310c按压在夹具从动件306的近侧鳍片306d上以向远侧推进该叠外科手术夹具“C”，直到下一个最远侧夹具接合夹具托盘302的弹性中心柄脚并由其止挡。
在触发器114的整个挤压期间，夹具推杆304将保持在向远侧推进的位置。在触发器114被完全挤压之后，当触发器114被释放或返回到完全非挤压位置时，夹具推杆304通过偏置构件等(未示出)返回到原位置或最近侧位置。当夹具推杆304返回到原位置时，夹具推杆304的推动器304d移动到新的最远侧外科手术夹具“C1”近侧的位置。
另外，参考图22B和图22C，当内窥镜组件400的主闭合驱动杆422向远侧推进时，由于触发器114进一步致动超过初始挤压，在轴推杆423的肩部423c邻接中空外管402的肩部402d之后，触发器114的致动端114b继续向远侧推进主闭合驱动杆422并且压缩轴推杆423的肩部423c与主闭合驱动杆422的肩部422e之间的偏置构件425。当主闭合驱动杆422继续向远侧推进时，在停顿期之后，主闭合驱动杆422的远端向远侧推进，从而实现与内窥镜组件400的该对钳夹214的凸轮楔214d的接合，从而实现闭合或接近该对钳夹214以及形成装载在其中的最远侧夹具“C1”。
应该理解，前面的描述仅仅是对本发明的说明。在不脱离本发明的情况下，本领域技术人员可以设计各种替代和修改。因此，本发明旨在涵盖所有这些替代、修改和变更。提出参考附图描述的实施例仅用于说明本发明的某些示例。与上述和/或所附权利要求书中描述的无实质不同的其它元件、步骤、方法和技术也旨在处于本发明的范围内。
Claims (21)
1.一种可重复使用的外科手术施夹器，包括：
手柄组件，其包括：
在其中限定孔的壳体；
从所述壳体延伸的固定手柄；以及
触发器，其枢转地连接到所述固定手柄，所述触发器包括设置在所述壳体的所述孔内的致动端；
内窥镜组件，其可选择性地连接到所述手柄组件的所述壳体，所述内窥镜组件包括：
限定穿过其中的管腔的外管，所述外管包括近端和远端；
一对钳夹，其从所述外管的所述远端固定地支撑并延伸；以及
驱动组件，其可滑动地支撑在所述外管的所述管腔中，所述驱动组件包括：
轴推动器管，其可滑动地支撑在所述外管的所述管腔中，所述轴推动器管包括近端、远端并且限定穿过其中的管腔，其中在所述轴推动器管的所述近端处设置径向凸缘；
闭合驱动杆，其可滑动地设置在所述轴推动器管的所述管腔内，所述闭合驱动杆具有从所述外管的所述近端突出并可与所述触发器的所述致动端接合的近端，以及可选择性地与所述对钳夹接合以接近所述对钳夹的远端，其中在所述闭合驱动杆的所述近端处设置肩部；以及
偏置构件，其置于所述闭合驱动杆的所述肩部与所述轴推动器管的所述径向凸缘之间；以及
夹具仓组件，其可选择性地连接到所述外管的所述远端并且连接到所述轴推送器管的所述远端，所述夹具仓组件包括：
夹具托盘；
多个外科手术夹具，其可滑动地支撑在所述夹具托盘中；
夹具从动件，其可滑动地设置在所述夹具托盘内并且设置在所述多个外科手术夹具的近侧；
偏置构件，其倾向于在远侧方向上推动所述夹具从动件；以及
夹具推杆，其可滑动地支撑在所述夹具托盘附近，其中所述夹具推杆包括被构造成与所述轴推动器管的所述远端接合的近端，以及被构造成接合所述多个外科手术夹具中的最远侧夹具的远端。
2.根据权利要求1所述的可重复使用的外科手术施夹器，其中在所述触发器的初始致动期间，所述触发器的所述致动端作用于所述内窥镜组件的所述闭合驱动杆的所述近端上以向远侧推进所述闭合驱动杆，其中所述闭合驱动杆作用于所述偏置构件上以抵靠所述轴推动器管的所述径向凸缘向远侧推进所述偏置构件以向远侧推进所述轴推动器管，并且其中所述轴推动器管作用于所述夹具推杆上以向远侧推进所述夹具仓组件的所述夹具推杆并且将其最远侧外科手术夹具装载到所述对钳夹中。
3.根据权利要求2所述的可重复使用的外科手术施夹器，其中所述内窥镜组件包括支撑在其所述外管中的止挡构件，其中所述止挡构件设置在所述轴推动器管的所述径向凸缘的远侧。
4.根据权利要求3所述的可重复使用的外科手术施夹器，其中所述轴推动器管的所述远侧推进是通过所述止挡构件而停止。
5.根据权利要求4所述的可重复使用的外科手术施夹器，其中在所述止挡构件停止所述轴推动器管的所述远侧推进之后，在所述触发器的进一步致动期间，所述触发器的所述致动端作用于所述内窥镜组件的所述闭合驱动杆的所述近端以进一步向远侧推进所述闭合驱动杆，其中所述闭合驱动杆作用于所述偏置构件上以压缩所述轴推动器管的所述径向凸缘与所述闭合驱动杆的所述肩部之间的所述偏置构件。
6.根据权利要求5所述的可重复使用的外科手术施夹器，其中在所述触发器的所述进一步致动期间，所述闭合驱动杆的所述远端作用于所述对钳夹上以接近所述对钳夹并形成装载在其中的任何外科手术夹具。
7.根据权利要求6所述的可重复使用的外科手术施夹器，其中在接近所述对钳夹期间，所述夹具仓组件的所述夹具推杆保持在远侧位置。
8.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述手柄组件包括可选择性地固定到所述壳体的近端的端帽。
9.一种内窥镜组件，其被构造成用于选择性地连接到手柄组件并且可通过所述手柄组件的触发器致动，所述内窥镜组件包括：
限定穿过其中的管腔的外管，所述外管包括近端和远端；
一对钳夹，其从所述外管的所述远端固定地支撑并延伸，所述对钳夹能够在打开位置与闭合位置之间移动，其中所述对钳夹被构造成在所述对钳夹从所述打开位置被致动到所述关闭位置时形成装载在其内的外科手术夹具；以及
驱动组件，其可滑动地支撑在所述外管的所述管腔中，所述驱动组件包括：
轴推动器管，其可滑动地支撑在所述外管的所述管腔中，所述轴推动器管包括近端、远端并且限定穿过其中的管腔，其中在所述轴推动器管的所述近端处设置径向凸缘；以及
闭合驱动杆，其可滑动地设置在所述轴推动器管的所述管腔内，所述闭合驱动杆具有从所述外管的所述近端突出并可与所述手柄组件的所述触发器接合的近端，以及构造成可选择性地接合所述对钳夹以将所述对钳夹移动到所述闭合位置的远端，其中在所述闭合驱动杆的所述近端处设置肩部；以及
偏置构件，其置于所述闭合驱动杆的所述肩部与所述轴推动器管的所述径向凸缘之间。
10.根据权利要求9所述的内窥镜组件，其中在闭合驱动杆的初始远侧推进期间，所述闭合驱动杆的所述肩部作用于所述偏置构件上以抵靠所述轴推进器管的所述径向凸缘向远侧推进所述偏置构件以向远侧推进所述轴推动器管，并且其中所述轴推动器管作用于装载在所述外管中的夹具仓组件上以将所述夹具仓组件的最远侧外科手术夹具推进到所述对钳夹中。
11.根据权利要求10所述的内窥镜组件，其中所述内窥镜组件包括支撑在其所述外管中的止挡构件，其中所述止挡构件设置在所述轴推动器管的所述径向凸缘的远侧。
12.根据权利要求11所述的内窥镜组件，其中所述轴推动器管的所述远侧推进是通过所述止挡构件而停止。
13.根据权利要求12所述的内窥镜组件，其中在所述止挡构件停止所述轴推动器管的所述远侧推进之后，在所述闭合驱动杆的进一步推进期间，所述闭合驱动杆作用于所述偏置构件上以压缩所述轴推动器管的所述径向凸缘与所述闭合驱动杆的所述肩部之间的所述偏置构件。
14.根据权利要求13所述的内窥镜组件，其中在所述闭合驱动杆的所述进一步推进期间，所述闭合驱动杆的所述远端作用于所述对钳夹上以接近所述对钳夹并形成装载在其中的任何外科手术夹具。
15.一种可重复使用的外科手术施夹器，包括：
手柄组件，其包括：
壳体；以及
触发器，其枢转地连接到所述壳体，所述触发器包括设置在所述壳体内的致动端；
内窥镜组件，其可选择性地连接到所述手柄组件的所述壳体，所述内窥镜组件包括：
外管，其限定穿过其中的管腔和在其远端中的窗口；
一对钳夹，其从所述外管的所述远端固定地支撑并延伸；以及
驱动组件，其可滑动地支撑在所述外管的所述管腔中，所述驱动组件包括：
轴推动器管，其可滑动地支撑在所述外管的所述管腔中，所述轴推动器管包括近端、远端并且限定穿过其中的管腔，其中在所述轴推动器管的所述近端处设置径向凸缘；
闭合驱动杆，其可滑动地设置在所述轴推动器管的所述管腔内，所述闭合驱动杆具有从所述外管的所述近端突出并可与所述触发器的所述致动端接合的近端，以及可选择性地与所述对钳夹接合以接近所述对钳夹的远端，其中在所述闭合驱动杆的所述近端处设置肩部；以及
偏置构件，其置于所述闭合驱动杆的所述肩部与所述轴推动器管的所述径向凸缘之间；以及
夹具仓组件，其可选择性地设置在所述外管的所述窗口内，并且可选择性地连接到所述轴推动器管的所述远端，所述夹具仓组件包括：
夹具托盘；
多个外科手术夹具，其可滑动地支撑在所述夹具托盘中；
夹具从动件，其可滑动地设置在所述夹具托盘内并且设置在所述多个外科手术夹具的近侧；
偏置构件，其倾向于在远侧方向上推动所述夹具从动件；以及
夹具推杆，其可滑动地支撑在所述夹具托盘附近，其中所述夹具推杆包括被构造成与所述轴推动器管的所述远端接合的近端，以及被构造成接合所述多个外科手术夹具中的最远侧夹具的远端。
16.根据权利要求15所述的可重复使用的外科手术施夹器，其中在所述触发器的初始致动期间，所述触发器的所述致动端作用于所述内窥镜组件的所述闭合驱动杆的所述近端上以向远侧推进所述闭合驱动杆，其中所述闭合驱动杆作用于所述偏置构件上以抵靠所述轴推动器管的所述径向凸缘向远侧推进所述偏置构件以向远侧推进所述轴推动器管，并且其中所述轴推动器管作用于所述夹具推杆上以向远侧推进所述夹具仓组件的所述夹具推杆并且将其最远侧外科手术夹具装载到所述对钳夹中。
17.根据权利要求16所述的可重复使用的外科手术施夹器，其中所述内窥镜组件包括支撑在其所述外管中的止挡构件，其中所述止挡构件设置在所述轴推动器管的所述径向凸缘的远侧。
18.根据权利要求17所述的可重复使用的外科手术施夹器，其中所述轴推动器管的所述远侧推进是通过所述止挡构件而停止。
19.根据权利要求18所述的可重复使用的外科手术施夹器，其中在所述止挡构件停止所述轴推动器管的所述远侧推进之后，在所述触发器的进一步致动期间，所述触发器的所述致动端作用于所述内窥镜组件的所述闭合驱动杆的所述近端以进一步向远侧推进所述闭合驱动杆，其中所述闭合驱动杆作用于所述偏置构件上以压缩所述轴推动器管的所述径向凸缘与所述闭合驱动杆的所述肩部之间的所述偏置构件。
20.根据权利要求19所述的可重复使用的外科手术施夹器，其中在所述触发器的所述进一步致动期间，所述闭合驱动杆的所述远端作用于所述对钳夹上以接近所述对钳夹并形成装载在其中的任何外科手术夹具。
21.根据权利要求20所述的可重复使用的外科手术施夹器，其中在接近所述对钳夹期间，所述夹具仓组件的所述夹具推杆保持在远侧位置。
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- 2015-11-10 JP JP2018522796A patent/JP6678741B2/ja active Active
- 2015-11-10 US US15/768,854 patent/US10905425B2/en active Active
- 2015-11-10 CN CN201580084429.6A patent/CN108348255B/zh active Active
- 2015-11-10 CA CA2999906A patent/CA2999906A1/en not_active Abandoned
- 2015-11-10 EP EP15908020.9A patent/EP3373826A4/en not_active Withdrawn
- 2015-11-10 AU AU2015414615A patent/AU2015414615A1/en not_active Abandoned
- 2015-11-10 WO PCT/CN2015/094172 patent/WO2017079890A1/en active Application Filing
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| CN110811746A (zh) * | 2018-08-13 | 2020-02-21 | 柯惠Lp公司 | 旋转旋钮组件和包括该旋转旋钮组件的外科器械 |
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| CN112690858A (zh) * | 2019-10-23 | 2021-04-23 | 苏州英途康医疗科技有限公司 | 夹仓装置及外科手术器械 |
| WO2022143955A1 (zh) * | 2020-12-31 | 2022-07-07 | 江苏风和医疗器材股份有限公司 | 一种施夹钳 |
| WO2022143954A1 (zh) * | 2020-12-31 | 2022-07-07 | 江苏风和医疗器材股份有限公司 | 一种施夹钳 |
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Also Published As
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|---|---|
| JP2018535753A (ja) | 2018-12-06 |
| CA2999906A1 (en) | 2017-05-18 |
| WO2017079890A1 (en) | 2017-05-18 |
| US10905425B2 (en) | 2021-02-02 |
| AU2015414615A1 (en) | 2018-04-12 |
| JP6678741B2 (ja) | 2020-04-08 |
| EP3373826A1 (en) | 2018-09-19 |
| US20190053806A1 (en) | 2019-02-21 |
| CN108348255B (zh) | 2020-11-27 |
| EP3373826A4 (en) | 2019-11-06 |
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