CN108348259B - 内窥镜手术夹具施加器 - Google Patents
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Abstract
一种可再利用的手术器械包括手柄组件(100)和可与所述手柄组件(100)可拆卸地啮合的内窥镜组件(200、300、400、500、600、700)。所述手柄组件(100)包括外壳(110)、支撑棘轮棘爪(142)的驱动杆(132)和联接到所述外壳(110)和所述驱动杆(132)的触发器(122)。所述内窥镜组件(200、300、400、500、600、700)包括有包括棘轮齿条(215、415、515、615)的近侧轮毂(210、310、410、510、610、710)、从所述近侧轮毂(210、310、410、510、610、710)延伸并且在其远侧末端(344)处支撑末端执行器组件(350)的细长轴(220、340、420)和可操作地联接到所述末端执行器组件(350)的驱动组件(230、320、430)。在使用中，所述触发器(122)从未致动位置朝向致动位置的移动将所述驱动杆(132)从近侧位置朝向远侧位置平移以将所述棘轮棘爪(142)与所述棘轮齿条(215、415、515、615)啮合，使得所述驱动杆(132)朝向所述远侧位置的进一步远侧平移逐渐地从未启动位置朝向启动位置推动所述驱动组件(230、320、430)。
Description
背景技术
技术领域
本公开涉及手术夹具施加器。更明确而言，本公开涉及具有被配置成用于与各种不同内窥镜组件一起使用的手柄组件的内窥镜手术夹具施加器。
现有技术的描述
内窥镜手术缝合器和手术夹具施加器在本领域中是已知的，并且用于多种不同和有用的手术过程。在腹腔镜手术过程的情况下，通过穿过皮肤中的小入口切口插入的窄管或插管来实现进入腹部内部。在身体其它部位进行的微创过程通常一般被称作内窥镜过程。典型地，管或插管装置通过入口切口延伸到患者体内以提供进入端口。端口允许外科医生使用套管针通过所述端口插入多个不同的手术器械，并且允许远离切口进行手术过程。
在大多数这些过程期间，外科医生必须经常终止通过一个或多个脉管的血液或另一流体的流动。外科医生将经常使用特定的内窥镜手术夹具施加器以将手术夹具施加到血管或另一管道以防止在过程期间通过其的体液的流动。
具有各种尺寸(例如直径)的被配置成施加各种不同手术夹具的内窥镜手术夹具施加器是本领域已知的，并且能够在进入体腔期间施加单个或多个手术夹具。这类手术夹具典型地由生物相容性材料制造，并且通常压缩在脉管上。一旦施加到脉管，压缩的手术夹具就终止通过其的流体的流动。
能够在单次进入体腔期间在内窥镜或腹腔镜过程中施加多个夹具的内窥镜手术夹具施加器描述于Green等人的共同转让的美国专利第5,084,057号和美国专利第5,100,420号中，所述两个专利以全文引用的方式并入。另一多内窥镜手术夹具施加器公开于Pratt等人的共同转让的美国专利第5,607,436号中，所述专利的内容也在此以全文引用的方式并入本文。这些装置典型地(但不是一定地)在单次手术过程期间使用。Pier等人的美国专利第5,695,502号公开可再消毒的内窥镜手术夹具施加器，所述专利的公开内容在此以引用的方式并入本文。内窥镜手术夹具施加器在单次插入到体腔中期间推进并且形成多个夹具。此可再消毒的内窥镜手术夹具施加器被配置成接收可互换的夹具储匣并且与其协作以便在单次进入体腔期间推进并且形成多个夹具。
在内窥镜或腹腔镜过程期间，根据待结扎的下层组织或脉管，可期望和/或必需使用不同尺寸的手术夹具或不同配置的手术夹具。为了降低内窥镜手术夹具施加器的总成本，期望单个内窥镜手术夹具施加器根据需要可加载有并且能够启动不同尺寸的手术夹具。
因此，存在对包括手柄组件的内窥镜手术夹具施加器的需要，所述手柄组件被配置成用于与具有其中加载的不同夹具的各种不同内窥镜组件一起使用和/或被配置成用于进行各种不同手术任务。
发明内容
如本文中详述和附图中所示的，如在涉及手术器械上的相关定位时传统的那样，术语“近侧”是指更接近用户的设备的末端或其部件并且术语“远侧”是指更远离用户的设备的末端或其部件。此外，在某种程度上一致，本文详述的方面和特征中的任一者或全部可与本文详述的其它方面和特征中的任一者或全部结合使用。
根据本公开的各方面提供包括手柄组件和第一内窥镜组件的可再利用的手术器械。手柄组件包括外壳、可滑动地支撑在外壳内的驱动杆、可枢转地连接到外壳并且可操作地联接到驱动杆的触发器使得触发器相对于外壳从未致动位置到致动位置的移动将驱动杆从近侧位置平移到远侧位置、可枢转地支撑在驱动杆上的棘轮棘爪和从外壳延伸并且被配置成在其中可拆卸地啮合内窥镜组件的接收器组件。第一内窥镜组件被配置成用于棘轮用途并且包括近侧轮毂、细长轴、末端执行器组件和驱动组件。近侧轮毂可插入到接收器组件中并且可拆卸地啮合在其内并且包括设置在其中的棘轮齿条。棘轮齿条限定多个棘轮齿。细长轴从近侧轮毂向远侧延伸。末端执行器组件支撑在细长轴的远侧末端处。驱动组件包括可滑动地设置在近侧轮毂和细长轴内并且限定近侧末端和远侧末端的内轴。内轴的远侧末端可操作地联接到末端执行器组件使得内轴从未启动位置到启动位置的移动执行末端执行器组件的操纵。在近侧轮毂可拆卸地啮合在接收器组件内的情况下，驱动杆从近侧位置朝向远侧位置的初始平移将棘轮棘爪移动成与棘轮齿条啮合并且将驱动杆移动成与驱动组件邻接，使得当沿着棘轮齿条逐渐地推进棘轮棘爪与所述棘轮齿条的棘轮齿连续啮合时，驱动杆朝向远侧位置的进一步远侧平移逐渐地从未启动位置朝向启动位置推动内轴。
在本公开的各方面中，在棘轮棘爪与棘轮齿条啮合之前，准许驱动杆向近侧返回，由此使内轴朝向未启动位置返回。另一方面，在棘轮棘爪与棘轮齿条啮合的情况下，阻止驱动杆向近侧返回，由此阻止内轴朝向未启动位置返回。
在本公开的各方面中，一旦内轴到达启动位置，棘轮棘爪就离开棘轮齿条并且与其脱离。此外，在棘轮棘爪离开棘轮齿条并且与其脱离的情况下，准许驱动杆向近侧返回，由此使内轴朝向未启动位置返回。
在本公开的各方面中，第一内窥镜组件的驱动组件进一步包括与内轴的近侧末端可操作地啮合的柱塞。驱动杆被配置成邻接柱塞并且向远侧推动柱塞以由此从未启动位置朝向启动位置推动内轴。柱塞可进一步被配置成连同内轴从未启动位置平移到启动位置，并且独立于内轴并且相对于其从启动位置向远侧平移到末端位置。
在本公开的各方面中，第一内窥镜组件的驱动组件包括第一弹簧和第二弹簧。第二弹簧限定弹簧常数，所述弹簧常数大于第一弹簧的弹簧常数，使得在柱塞连同内轴从未启动位置平移到启动位置后压缩第一弹簧，并且使得在柱塞独立于内轴并且相对于其从启动位置向远侧平移到末端位置后压缩第二弹簧。
在本公开的各方面中，驱动杆从近侧位置到远侧位置的平移限定手柄组件的致动冲程长度并且内轴从未启动位置到启动位置的平移限定小于手柄组件的致动冲程长度的第一内窥镜组件的启动冲程长度。同样，柱塞从启动位置到末端位置的平移在第一内窥镜组件的启动冲程完成之后实现手柄组件的致动冲程的完成。
在本公开的各方面中，第一内窥镜组件的末端执行器组件包括第一夹钳构件和第二夹钳构件。在此方面中，第一内窥镜组件的驱动组件的内轴从未启动位置到启动位置的移动将第一夹钳构件和第二夹钳构件从打开位置移动到闭合位置。此外，第一夹钳构件和第二夹钳构件可被配置成在其间接收手术夹具，使得将第一夹钳构件和第二夹钳构件从打开位置移动到闭合位置形成手术夹具。
在本公开的各方面中，可再利用的手术器械进一步包括第二内窥镜组件。第二内窥镜组件被配置成用于非棘轮用途并且包括可插入到接收器组件中并且可拆卸地啮合在其内的近侧轮毂、从近侧轮毂向远侧延伸的细长轴、支撑在细长轴的远侧末端处的末端执行器组件和驱动组件。驱动组件包括可滑动地设置在近侧轮毂和细长轴内并且限定近侧末端和远侧末端的内轴。内轴的远侧末端可操作地联接到末端执行器组件使得内轴从未启动位置到启动位置的移动执行末端执行器组件的操纵。在第二内窥镜组件的近侧轮毂可拆卸地啮合在接收器组件内的情况下，驱动杆从近侧位置到远侧位置的平移将驱动杆移动成与驱动组件邻接以由此从未启动位置朝向启动位置持续地推动内轴。
在本公开的各方面中，在第二内窥镜组件的近侧轮毂可拆卸地啮合在接收器组件内的情况下，棘轮棘爪在驱动杆在近侧位置和远侧位置之间的平移期间保持空闲。
在本公开的各方面中，在第二内窥镜组件的近侧轮毂可拆卸地啮合在接收器组件内的情况下，准许驱动杆向近侧返回，由此在驱动杆的远侧平移期间的任一点处使内轴朝向未启动位置返回。
在本公开的各方面中，第二内窥镜组件可进一步包括上面关于第一内窥镜组件详述的特征中的任一者或全部。
附图简要说明
参考附图详细地描述当前公开的内窥镜手术夹具施加器的方面和特征，其中相似参考标号标识类似或相同的结构元件，并且：
图1为根据本公开提供的包括具有与其啮合的内窥镜组件的手柄组件的内窥镜手术夹具施加器的近侧部分的透视图；
图2为其中内窥镜组件从手柄组件移除的图1的夹具施加器的透视图；
图3为在图2中指示为“3”的细节区域的放大透视图；
图4为沿图3中的剖面线4-4截取的横向截面视图；
图5为沿图3中的剖面线5-5截取的横向截面视图；
图6为图1的手柄组件的接收器组件的纵向截面视图；
图7为包括图1的内窥镜组件的图6的接收器组件的横向截面视图，其缺乏图1的内窥镜组件的可操作地啮合在接收器组件内的内部部件；
图8为沿图7中的剖面线8-8截取的纵向截面视图；
图9为包括可操作地啮合在其中的图1的内窥镜组件的图1的手柄组件的一部分的纵向截面视图；
图10A为在图9中指示为“10A”的细节区域的放大纵向截面视图，其说明设置在未致动位置中的图1的手柄组件；
图10B为在图9中指示为“10A”的细节区域的放大纵向截面视图，其说明从未致动位置平移到致动位置的图1的手柄组件；
图10C为在图9中指示为“10A”的细节区域的放大纵向截面视图，其说明设置在致动位置中的图1的手柄组件；
图10D为在图9中指示为“10A”的细节区域的放大纵向截面视图，其说明从致动位置平移回到未致动位置的图1的手柄组件；
图11A为被配置成用于与图1的手柄组件一起使用的另一内窥镜组件的透视图；
图11B为图11A的内窥镜组件的远侧部分的放大透视图；
图11C为图11A的内窥镜组件的纵向截面视图；
图11D为图11A的内窥镜组件的近侧部分的放大纵向截面视图；
图12A为被配置成用于与图1的手柄组件一起使用的另一内窥镜组件的透视图；
图12B为图12A的内窥镜组件的远侧部分的放大透视图；
图12C为图12A的内窥镜组件的纵向截面视图；
图12D为图12A的内窥镜组件的近侧部分的放大纵向截面视图；
图13为被配置成用于与图1的手柄组件一起使用的另一内窥镜组件的近侧末端的分解透视图；
图14为被配置成用于与图1的手柄组件一起使用的另一内窥镜组件的近侧末端的分解透视图；和
图15为被配置成用于与图1的手柄组件一起使用的另一内窥镜组件的近侧末端的透视图。
具体实施方式
转向图1和图2，根据本公开提供的内窥镜手术夹具施加器由参考标号10标识。夹具施加器10大体上包括手柄组件100和多个内窥镜组件，例如，选择性地可连接到手柄组件100并且从其向远侧可延伸的内窥镜组件200。手柄组件100有利地被配置成在连接到其后操作多个内窥镜组件中的每一个，并且可被配置为可消毒的、可重用部件，使得手柄组件100可在一个或多个手术过程的进程期间反复地与不同的和/或另外的内窥镜组件一起使用。内窥镜组件根据特定目的和/或特定内窥镜组件的配置可被配置为单次使用的一次性部件、有限使用的一次性部件或可重用部件。在任一配置中，避免对于多个手柄组件100的需要，并且相反，外科医生仅需要选择恰当的内窥镜组件并且将所述内窥镜组件连接到手柄组件100以准备使用。
手柄组件100最初被详述为用于与通用内窥镜组件200结合使用，所述通用内窥镜组件200包括可与手柄组件100一起使用的任何内窥镜组件共有的特征。此后在下面详述特定内窥镜组件的示范性实施例，所述内窥镜组件例如内窥镜组件300(图11A到图11D)和内窥镜组件400(图12A到图12D)。
继续参考图1和图2，如上所述，内窥镜组件200被配置成选择性连接到手柄组件100并且从其向远侧延伸。内窥镜组件200包括被配置成用于插入到手柄组件100中并且可释放啮合在其内的近侧轮毂210、从近侧轮毂210向远侧延伸的细长轴220、设置在细长轴220的远侧末端处的末端执行器组件(未示出)，和包括内驱动轴232(图9)的内部驱动组件230(图9)，所述内驱动轴232延伸通过近侧轮毂210和细长轴220并且可操作地联接到在内驱动轴232(图9)的远侧末端处的末端执行器组件(未示出)。如下详述，在内窥镜组件200与手柄组件100啮合之后，手柄组件100的致动执行通过近侧轮毂210和细长轴220的内窥镜组件200的内驱动轴232(图9)的远侧平移以操纵内窥镜组件200的末端执行器组件(未示出)，例如，以进行内窥镜组件200的一个或多个手术任务。
内窥镜组件200的近侧轮毂210限定大体上管状配置并且包括其中限定的纵向延伸槽212和其中限定的环状沟槽214。纵向延伸槽212限定开口近侧末端。环状沟槽214围绕近侧轮毂210周向延伸并且与纵向延伸槽212交叉，但也预期其它非交叉配置。在其中内窥镜组件200被配置成用于棘轮用途的实施例中，内窥镜组件200可进一步包括安装在近侧轮毂210的近侧末端内并且朝向其设置的棘轮齿条215(图9)。在其中内窥镜组件200被配置成用于非棘轮用途的实施例中，省略棘轮齿条215(图9)。
另外参考图3到图6，手柄组件100包括被配置成接收内窥镜组件200的近侧轮毂210并且实现内窥镜组件200与手柄组件100可释放啮合的接收器组件170。接收器组件170包括外环管172和内管状构件174。内管状构件174限定稍微大于内窥镜组件200的近侧轮毂210的外部直径的内部直径，以实现近侧轮毂210到内管状构件174中的可滑动插入而不需要在其间的显著游隙或间隙。内管状构件174进一步包括通过其限定并且围绕内管状构件174周向定位的多个孔口176。在孔口176中的每一个内捕获滚珠轴承178(图8)使得每一个滚珠轴承178(图8)的一部分向内突出到内管状构件174中。然而，孔口176被配置成阻止滚珠轴承178(图8)全部通过其并且进入内管状构件174中。另一方面，外环管172经定位以便遮挡孔口176的外向末端，由此保留滚珠轴承178在外环管172和内管状构件174之间的孔口176内(除滚珠轴承178(图8)延伸到内管状构件174中的部分之外)。
销180延伸通过限定在内管状构件174内的销孔口182并且至少部分通过在外环管172内限定的销槽184(图5和图6)。销180至少部分延伸到内管状构件174的内部中，并且如下详述，其被配置成在内窥镜组件200插入到手柄组件100中后促进内窥镜组件200的对准。销180进一步被配置成将外环管172和内管状构件174相对于彼此保留在固定旋转定向。外环管172以固定旋转定向与手柄组件100的旋转旋钮190啮合，使得在销180可旋转地联接外环管172和内管状构件174的情况下，可执行旋转旋钮190的旋转以类似地旋转接收器组件170。旋转旋钮190包括设置在其上与销180对准的对准指示器192以实现内窥镜组件200与接收器组件170对准而不需要直接观看销180的位置。
参考图1、图2、图7和图8，为了将内窥镜组件200与手柄组件100啮合，内窥镜组件200经定向使得其纵向延伸槽212与接收器组件170的销180对准。如上所述，而非必须直接对准销180，可经由对准纵向延伸槽212与手柄组件100的旋转旋钮190的对准指示器192实现纵向延伸槽212和销180的对准。一旦已实现对准，内窥镜组件200的近侧轮毂210就向近侧滑动到接收器组件170的内管状构件174中。纵向延伸槽212和销180的对准确保在近侧轮毂210近侧滑动到内管状构件174中后，销180通过纵向延伸槽212平移。
当近侧轮毂210向近侧滑动到内管状构件174中时，滚珠轴承178在近侧轮毂210的外部上施加径向向内的力，使得近侧轮毂210、外环管172、内管状构件174和/或滚珠轴承178移动或挠曲以接纳在滚珠轴承178之间的近侧轮毂210。当近侧轮毂210向近侧滑动到内管状构件174中时准许滚珠轴承178在孔口176内旋转，从而减小摩擦并且准许近侧轮毂210相对容易的滑动到内管状构件174中。在近侧轮毂210完全插入到内管状构件174中后，例如，在销180到达纵向延伸槽212的闭合的远侧末端后，滚珠轴承178被移动到围绕环状沟槽214的位置中。由于由滚珠轴承178和/或接收器组件170和内窥镜组件200的其它部件赋予径向向内的力，一旦已实现完全插入位置，就在偏压下推动滚珠轴承178到环状沟槽214中以由此将内窥镜组件200的近侧轮毂210可拆卸地锁定啮合在手柄组件100的接收器组件170内。
为了从手柄组件100移除内窥镜组件200，在充分推动下相对于手柄组件100向远侧拉动内窥镜组件200以便从环状沟槽214移走滚珠轴承178，由此准许内窥镜组件200的近侧轮毂210向远侧滑出手柄组件100的接收器组件170。
现转向图1、图2和图9，手柄组件100大体上包括外壳110、可枢转地联接到外壳110的触发器组件120、可操作地联接到触发器组件120的棘轮驱动组件130、从外壳110向远侧延伸的接收器组件170和可操作地围绕接收器组件170设置的旋转旋钮190。
外壳110被配置成容纳手柄组件100的内部工作部件并且限定主体部分111和从主体部分111向下延伸的固定手柄部分112。主体部分111限定在其内部上的环状槽115。外壳110的主体部分111进一步包括在主体部分111内横向延伸的内部枢转支柱116。
手柄组件100的接收器组件170包括围绕其内管状构件174的近侧末端设置的固定夹具186。在外壳110的环状槽115内捕获固定夹具186以将接收器组件170与外壳110可旋转地啮合。手柄组件100的旋转旋钮190以相对于其的固定旋转定向可操作地围绕接收器组件170啮合，使得旋转旋钮190相对于外壳110的旋转执行接收器组件170相对于外壳110的类似旋转。因此，在内窥镜组件200啮合在接收器组件170内的情况下，旋转旋钮190可相对于外壳110旋转以相对于外壳110类似地旋转内窥镜组件200。
外壳110的固定手柄部分112被配置成促进手柄组件100的握紧和其操纵并且与主体部分111单块形成，但也预期其它配置。
触发器组件120大体上包括触发器122、偏压构件127和连杆128。触发器122包括握紧部分123、中间枢转部分124和近侧延伸部分125。触发器122的握紧部分123相对于外壳110的固定手柄部分112以相对关系从外壳110的主体部分111向下延伸。握紧部分123被配置成促进触发器122的握紧和操纵。触发器122的中间枢转部分124至少部分设置在外壳110内并且被配置成接收外壳110的枢转支柱116以便实现触发器122围绕枢转支柱116并且相对于外壳110例如在其中触发器122的握紧部分123相对于固定手柄部分112间隔开的未致动位置和其中触发器122的握紧部分123相对于固定手柄部分112接近的致动位置之间的枢转。
相比于触发器122的握紧部分123，触发器组件120的触发器122的近侧延伸部分125设置在中间枢转部分124并且因此枢转支柱116的相对侧上。同样，握紧部分123向近侧例如朝向致动位置的枢转向远侧推动近侧延伸部分125。触发器122的近侧延伸部分125进一步被配置成接收用于将连杆128的近侧末端和触发器122的近侧延伸部分125彼此可枢转地联接的第一销129a。偏压构件127啮合在近侧延伸部分125和外壳110的固定手柄部分112之间并且以静置状态设置在触发器122的握紧部分123的未致动位置中。握紧部分123朝向致动位置的枢转延长在其中储存能量的偏压构件127使得在释放握紧部分123后，在偏压构件127的偏压下使握紧部分123朝向未致动位置返回。尽管说明为延伸螺旋弹簧，但偏压构件127可限定用于朝向未致动位置偏压触发器122的握紧部分123的任何合适的配置。
如上所述，经由第一销129a将连杆128在其近侧末端处联接到触发器122的近侧延伸部分125。另外，经由第二销129b将连杆128在其远侧末端处可枢转地联接到棘轮驱动组件130的驱动杆132的近侧块134。由于这种配置，握紧部分123朝向致动位置的枢转向远侧推动近侧延伸部分125，其继而向远侧推动连杆128以由此向远侧推动驱动杆132。
继续参考图1、图2和图9，手柄组件100的棘轮驱动组件130大体上包括驱动杆132和棘爪组件140。驱动杆132包括主体部分133、在其近侧末端处啮合到主体部分133的近侧块134和在其远侧末端处啮合到主体部分133的远侧块136。近侧块134包括在限定在外壳110的主体部分111内的轨道118内接收的向近侧延伸的指状物135以便引导驱动杆132通过外壳110的主体部分111的平移。如上所述，经由第二销129b将近侧块134与连杆128联接使得在触发器122的握紧部分123朝向致动位置枢转后，通过外壳110的主体部分111向远侧平移驱动杆132。在驱动杆132充分远侧平移后，推进远侧块136到接收器组件170的内管状构件174中并且与内窥镜组件200的内驱动组件230的内驱动轴232的近侧末端接触以由此向远侧推动内驱动轴232。如上所述，内驱动轴232通过并且相对于近侧轮毂210和细长轴220的远侧平移执行内窥镜组件200的末端执行器组件(未示出)的操纵，例如以进行内窥镜组件200的一个或多个手术任务。
棘轮驱动组件130的棘爪组件140安装在远侧块136内并且包括棘轮棘爪142、棘爪销144和棘爪偏压构件146。棘轮棘爪142通过棘爪销144可枢转地联接到远侧块136并且在其内以便实现棘轮棘爪142相对于远侧块136的枢转。棘爪组件140的棘爪偏压构件146在一个末端处联接到棘轮棘爪142并且在另一末端处联接到远侧块136以便朝向可操作的定向偏压棘轮棘爪142。
如下详述，在其中内窥镜组件200包括棘轮齿条215以实现棘轮用途的实施例中，棘轮棘爪142被配置成在手柄组件100的致动期间连续啮合棘轮齿条215的棘轮齿以便实现内驱动轴232的逐渐推进，以操纵内窥镜组件200的末端执行器组件(未示出)。在其中内窥镜组件200被配置成用于非棘轮用途并且因此不包括棘轮齿条215的实施例中，在致动手柄组件100后，通过内窥镜组件200的近侧轮毂210简单地推进棘轮棘爪142而不干扰内驱动轴232的推进，以操纵内窥镜组件200的末端执行器组件(未示出)。
参考图1、图9和图10A到图10D，现在详述手柄组件100与内窥镜组件200的结合使用，其中内窥镜组件200包括棘轮齿条215以实现棘轮用途(如所说明的)。初始地，内窥镜组件200与手柄组件100啮合，如上面所详述的。一旦啮合内窥镜组件200和手柄组件100，手柄组件100和内窥镜组件200就准备好一起使用。在使用中，触发器122在偏压构件127的偏压下初始地设置在未致动位置中。如图9和图10A中所示，在触发器122设置在未致动位置中的情况下，驱动杆132设置在其相应的与内窥镜组件200间隔开的最近侧位置中。因此，内窥镜组件200的内驱动组件230的内驱动轴232设置在最近侧位置中使得内窥镜组件200的末端执行器组件(未示出)设置在其初始位置中。
为了操纵内窥镜组件200的末端执行器组件(未示出)，例如以进行内窥镜组件200的一个或多个手术任务，从未致动位置到致动位置推动触发器122。更具体地说，朝向外壳110的固定手柄部分112枢转触发器122的握紧部分123以向远侧推动连杆128，其继而向远侧推动驱动杆132。当向远侧推动驱动杆132时，向远侧平移远侧块136并且因此向远侧平移棘轮棘爪142。在驱动杆132充分远侧平移后，远侧块136最终延伸到接收器组件170和内窥镜组件200的近侧轮毂210中，其中远侧块136邻接内窥镜组件200的驱动组件230的内驱动轴232的近侧末端。如图10B中所示，在远侧块136进一步远侧平移后，远侧块136通过内窥镜组件200的近侧轮毂210向远侧推动内驱动轴232以开始操纵其末端执行器组件(未示出)。同时或接近同时向远侧推动驱动轴232，将手柄组件100的棘轮棘爪142移动到位置中以可操作地啮合内窥镜组件200的棘轮齿条215。
如可理解的，在棘轮棘爪142与棘轮齿条215啮合之前，可释放触发器122以使驱动杆132向近侧返回，由此允许内窥镜组件200的内驱动组件230和末端执行器组件(未示出)返回到其相应的初始位置。然而，一旦棘轮棘爪142与棘轮齿条215啮合，就仅准许驱动杆132的进一步远侧推进直到在启动冲程结束时棘轮棘爪142已离开棘轮齿条215。因此，在手柄组件100的致动和内窥镜组件200的启动期间棘轮棘爪142定位成啮合棘轮齿条215的点是夹具施加器10的致动的许多事件的决定因素。因此，根据内窥镜组件200相对于手柄组件100的致动冲程的特定启动需求，可进一步向近侧或向更远侧定位棘轮齿条215以确保在致动和启动期间在期望的点处的啮合。
在棘轮棘爪142与棘轮齿条215啮合的情况下，驱动杆132和对应地内驱动组件230的逐渐推进以逐渐地启动内窥镜组件200可通过进一步朝向致动位置移动触发器122来实现。在这类逐渐推进期间，借助于啮合棘轮齿条215的连续齿的棘轮棘爪142的触感反馈可由外科医生感觉到。
在充分致动触发器122以完全启动内窥镜组件200后，充分地向远侧定位驱动杆132使得棘轮棘爪142已离开棘轮齿条215，由此从棘轮齿条215脱离棘轮棘爪142，如图10C中所示。如可理解的，棘轮齿条215的长度由此被配置以便仅在内窥镜组件200已完全启动之后实现棘轮棘爪142离开棘轮齿条215并且从棘轮齿条215脱离。因此，根据内窥镜组件200相对于手柄组件100的致动冲程的特定启动需求，棘轮齿条215可限定较长或较短的长度以确保在棘轮棘爪142从棘轮齿条215脱离之前完全启动。
一旦棘轮棘爪142离开棘轮齿条215并且与其脱离，就可将触发器122释放或返回到未致动位置使得如图10D中所示，准许驱动杆132向近侧返回，同时棘轮棘爪142在棘轮齿条215上向近侧滑动。驱动杆132的近侧返回允许内窥镜组件200的内驱动组件230和末端执行器组件(未示出)向近侧返回到其相应的初始位置。
转向图11A到图11D和图12A到图12D，分别示出根据本公开提供并且被配置成用于与手柄组件100(图1)一起使用的两个不同内窥镜组件300和400，尽管设想可提供各种其它不同内窥镜组件用于与手柄组件100(图1)一起使用。内窥镜组件300被配置成握紧和/或操纵组织，取回手术夹具并且围绕组织闭合、启动或形成手术夹具。预期内窥镜组件300被配置成闭合、启动或形成类似于在美国专利第4,834,096号中所示和所描述的那些的手术夹具，其全部内容以引用的方式并入本文。内窥镜组件400被配置成围绕组织闭合、启动或形成一个或多个手术夹具。更具体地说，预期内窥镜组件400可被配置成闭合、启动或形成类似于在美国专利第7,819,886号或第7,905,890号中所示和所描述的那些的手术夹具，其中的每一个的全部内容以引用的方式并入本文。
参考图11A到图11D，内窥镜组件300被配置成用于非棘轮用途并且大体上包括近侧轮毂310、设置在近侧轮毂310内并且延伸通过其的内驱动组件320、从近侧轮毂310向远侧延伸的细长轴340和包括设置在细长轴340的远侧末端处的一对夹钳构件360a、360b的末端执行器组件350。
参考图1到图3，除了图11A到图11D之外，内窥镜组件300的近侧轮毂310限定大体上管状配置和稍微小于手柄组件100的接收器组件170的内管状构件174的内部直径的外部直径，以实现近侧轮毂310到内管状构件174中的可滑动插入而不需要在其间的显著游隙或间隙。近侧轮毂310包括类似于上面关于内窥镜组件200(图2)详述的那些的特征以便以类似方式实现在手柄组件100的接收器组件170内的近侧轮毂310的啮合。更具体地说，近侧轮毂310包括被配置成接收接收器组件170的销180的纵向延伸槽311以确保内窥镜组件300相对于手柄组件100的正确对准，以及被配置成接收每一个滚珠轴承178的至少一部分的环状沟槽312以将内窥镜组件300的近侧轮毂310可拆卸地锁定啮合在手柄组件100的接收器组件170内。当内窥镜组件300被配置成用于非棘轮用途时，近侧轮毂310不包括设置在其中的棘轮齿条。内窥镜组件300的近侧轮毂310进一步限定具有开口近侧末端314以及相比于膛313的直径的减小直径的远侧开口的内部膛313以便在其间限定肩状物315。
再次参考图11A到11D，内窥镜组件300的内驱动组件320包括可滑动地设置在内窥镜组件300的近侧轮毂310和细长轴340两者内的内轴322。内轴322包括支撑设置在近侧轮毂310的膛313内的横向销324的近侧末端323和支撑朝向细长轴340的远侧末端344设置的凸轮销326的远侧末端325。如下详述，凸轮销326设置在末端执行器组件350的夹钳构件360a、夹钳构件360b的凸轮槽(未示出)内以响应于通过细长轴340的内轴322的平移实现在打开位置和闭合位置之间的夹钳构件360a、夹钳构件360b的枢转。
内驱动组件320进一步包括柱塞328以及分别地第一偏压构件330和第二偏压构件332。柱塞328可滑动地设置在近侧轮毂310的膛313内并且限定在其内可滑动地限制内轴322的近侧末端323的横向销324的内腔329。
内驱动组件320的第一偏压构件330设置在近侧轮毂310的内部膛313内并且插在近侧轮毂310的肩状物315和内轴322的横向销324之间。第一偏压构件330具有小于第二偏压构件332的第二弹簧常数“K2”的第一弹簧常数“K1”，其目的在下面详述。第二偏压构件332设置在柱塞328的腔329内并且内置在内轴322的横向销324和柱塞328的近侧末端之间。如下详述，分别地第一偏压构件330和第二偏压构件332促进通过近侧轮毂310和细长轴340的内轴322的恰当平移，以打开和闭合夹钳构件340a、夹钳构件340b，并且以实现触发器122(图1)的完全致动，如下详述。
内窥镜组件300的细长轴340限定大体上管状配置并且在近侧轮毂310和末端执行器组件350之间延伸和互连。更具体地说，细长轴340的近侧末端342固定到近侧轮毂310，同时细长轴340的远侧末端344支撑被配置成经由枢转销352可枢转地啮合在细长轴340的远侧末端344处的末端执行器组件350的夹钳构件360a、夹钳构件360b的U形夹346。
如上所述，末端执行器组件350包括第一夹钳构件360a和第二夹钳构件360b。夹钳构件360a、夹钳构件360b经由枢转销352可枢转地啮合到彼此和U形夹346以便准许夹钳构件360a、夹钳构件360b相对于彼此以及在打开位置和闭合位置之间的细长轴340的枢转。每个夹钳构件360a、360b的近侧末端限定被配置成接收内轴322的凸轮销326的凸轮槽(未示出)，使得内轴322的平移枢转在打开位置和闭合位置之间的夹钳构件360a、夹钳构件360b。夹钳构件360a、夹钳构件360b的远侧末端被配置成接收和闭合、启动或形成手术夹具，例如类似于在美国专利第4,834,096号中所示和所描述的那些的手术夹具，其先前以引用的方式并入本文。
参考图1、图9和图11A到图11D，现在详述手柄组件100与内窥镜组件300的结合使用。内窥镜组件300首先与手柄组件100啮合，类似地如上面关于内窥镜组件200(图7和图8)所详述的。在此时，触发器122在偏压构件127的偏压下设置在未致动位置中。在触发器122设置在未致动位置中的情况下，驱动杆132设置在最近侧位置中。此外，内窥镜组件300的内驱动组件320的内轴322在第一偏压构件330和第二偏压构件332的偏压下设置在最近侧位置中。因此，夹钳构件360a、夹钳构件360b初始地设置在打开位置中。在夹钳构件360a、夹钳构件360b设置在打开位置中的情况下，新的未成形或打开的手术夹具(未示出)可位于或加载在夹钳构件360a、夹钳构件360b内。末端执行器组件350的夹钳构件360a、夹钳构件360b可用于取回或拾取来自夹具固定器(未示出)的手术夹具，手术夹具可由用户人工地加载，末端执行器组件350可由制造商预加载，或者手术夹具可以任何其它合适的方式置放在夹钳构件360a、夹钳构件360b之间。
为了闭合、启动或形成加载在夹钳构件360a、夹钳构件360b之间的手术夹具，从未致动位置到致动位置推动触发器122以向远侧推动连杆128，其继而通过外壳110向远侧推动驱动杆132使得通过接收器组件170推动远侧块136并且进入内窥镜组件300的近侧轮毂310的膛313中。当触发器122进一步朝向致动位置枢转时，远侧块136最终接触内窥镜组件300的驱动组件320的柱塞328。由于第一偏压构件330的第一弹簧常数“K1”小于第二偏压构件332的第二弹簧常数“K2”，当初始地推动远侧块136到柱塞328中时，柱塞328和内轴322一起向远侧平移使得第一偏压构件330被压缩同时第二偏压构件332保持基本上未压缩。
当向远侧平移内轴322时，通过夹钳构件360a、夹钳构件360b的凸轮槽平移凸轮销326以朝向闭合位置枢转夹钳构件360a、夹钳构件360b以闭合和/或形成在末端执行器组件350内加载的手术夹具(未示出)。向远侧推进凸轮销326直到凸轮销326达到夹钳构件360a、夹钳构件360b的凸轮槽的末端和/或直到夹钳构件360a、夹钳构件360b彼此完全接近或在手术夹具上完全闭合。如可理解的，根据所使用的特定内窥镜组件、形成手术夹具的配置和/或其它因素，完全形成手术夹具的内轴322的所需行进距离可变化。由于触发器122在未致动位置和致动位置之间的行进距离不变化，因此内窥镜组件300解决此变化同时允许外科医生执行触发器122的完全致动冲程，如下详述。
一旦夹钳构件360a、夹钳构件360b已彼此完全接近或在手术夹具上完全闭合，和/或当凸轮销326已达到夹钳构件360a、夹钳构件360b的凸轮槽的末端时，就不再准许内轴322进一步向远侧行进。因此，如果出现其中需要远侧块136的进一步远侧推动的情形，例如，以完成触发器122的致动冲程，那么独立于内轴322向远侧推进柱塞328以压缩第二偏压构件332。因此，第二偏压构件332的压缩实现内轴322保持在适当位置上同时完成触发器122的完全致动冲程。
一旦已经完全形成手术夹具，就可释放触发器122并且允许其在偏压下返回到未致动位置，由此拉动驱动杆132和远侧块136回到其相应的最近侧位置并且允许夹钳构件360a、夹钳构件360b返回到打开位置。此后，可重复上面详述的使用以闭合、启动或形成另外的手术夹具。另外地或可替代地，末端执行器组件350的夹钳构件360a、夹钳构件360b可用于在形成一个或多个手术夹具之前或之后按需要握紧和/或操纵组织。当内窥镜组件300被配置成用于非棘轮用途时，在上面详述的操作期间棘轮组件140保持空闲，而不干扰内窥镜组件300的启动。此外，在这类非棘轮用途配置中，触发器122的致动并且因此内窥镜组件300的启动可在致动和/或启动过程期间的任一点处中止。
参看图12A到图12D，内窥镜组件400大体上包括近侧轮毂410、从近侧轮毂410向远侧延伸的细长轴420、设置在近侧轮毂410和细长轴420内的驱动组件430以及支撑在细长轴420的远侧末端处的一对夹钳构件460a、夹钳构件460b。内窥镜组件400被配置成围绕组织闭合、启动或形成一个或多个手术夹具，如在美国专利第7,819,886或7,905,890号中所示和所描述的那些，其先前以引用的方式并入本文。
另外参考图3到图6，近侧轮毂410进一步包括类似于上面关于内窥镜组件200(图2)详述的那些的特征以便以类似方式实现在手柄组件100的接收器组件170内的近侧轮毂410的啮合。更具体地说，近侧轮毂410包括被配置成接收接收器组件170的销180的纵向延伸槽411以确保内窥镜组件400相对于手柄组件100的正确对准，以及被配置成接收每个滚珠轴承178的至少一部分的环状沟槽412以将内窥镜组件400的近侧轮毂410可拆卸地锁定啮合在手柄组件100的接收器组件170内。
再次参考图12A到图12D，内窥镜组件400被配置成用于棘轮用途并且因此内窥镜组件400的近侧轮毂410进一步包括安装在其中并且朝向其近侧末端设置的棘轮齿条415。如下详述，在手柄组件100的致动和内窥镜组件400的启动期间，棘爪组件140(图9)被配置成可操作地啮合棘轮齿条415以实现内窥镜组件400的棘轮用途。
内窥镜组件400的驱动组件430包括可滑动地支撑在细长轴420和近侧轮毂410的内部内的内轴431。内轴431包括近侧末端433和远侧末端434。内轴431的近侧末端433延伸到近侧轮毂410的内部膛413中并且经由在柱塞435的纵向槽437内的内轴431的横向销436的接收可操作地联接到驱动组件430的柱塞435。内轴431的远侧末端434可操作地联接到设置在细长轴420的远侧末端内的启动部件，其继而联接到夹钳构件460a、夹钳构件460b使得夹钳构件460a、夹钳构件460b从打开位置移动到闭合位置，以响应于通过细长轴420的内轴431的远侧平移形成已经加载到第一夹钳构件460a和第二夹钳构件460b的手术夹具(未示出)。
驱动组件430进一步包括止动环438以及第一偏压构件439a和第二偏压构件439b，其中的每一个围绕内轴431设置。止动环438固定地围绕内轴431啮合并且设置在近侧轮毂410的内部膛413内。第一偏压构件439a定位在止动环438的远侧并且保留在止动环438和近侧轮毂410的远侧末端之间。第二偏压构件439b定位在止动环438的近侧并且保留在止动环438和柱塞435的远侧末端之间。第一偏压构件439a具有小于第二偏压构件439b的第二弹簧常数“KK2”的第一弹簧常数“KK1”，其目的在下面详述。
参考图1、图9和图12A到图12D，现在详述手柄组件100与内窥镜组件400的结合使用。内窥镜组件400首先与手柄组件100啮合，类似地如上面关于内窥镜组件200(图7和图8)所详述的。在此时，触发器122在偏压构件127的偏压下设置在未致动位置中。在触发器122设置在未致动位置中的情况下，驱动杆132设置在最近侧位置中并且因此驱动组件430的内轴431在分别地第一偏压构件439a和第二偏压构件439b的偏压下设置在最近侧位置中。因此，夹钳构件460a、夹钳构件460b初始地设置在打开位置中。在夹钳构件460a、夹钳构件460b设置在打开位置中的情况下，新的未成形或打开的手术夹具(未示出)可位于或加载在夹钳构件460a、夹钳构件460b内，或者可以其它方式可操作地定位(人工地或自动地)用于插入其间，从而用于在夹钳构件460a、夹钳构件460b闭合后围绕组织形成或闭合。举例来说，在一些实施例中，在启动期间，首先从在夹钳构件460a、夹钳构件460b之间的细长轴420推进手术夹具，并且此后，闭合夹钳构件460a、夹钳构件460b以形成手术夹具。在这类实施例中，可以类似方式在细长轴420内加载一系列手术夹具用于依序启动。然而，也预期用于其启动的其它合适的手术夹具和/或配置。
为了闭合、启动或形成加载在夹钳构件460a、夹钳构件460b之间的手术夹具，从未致动位置到致动位置推动触发器122。更具体地说，朝向外壳110的固定手柄部分112枢转触发器122的握紧部分123以向远侧推动连杆128，其继而向远侧推动驱动杆132。当向远侧推动驱动杆132时，同样地向远侧平移远侧块136和棘轮棘爪142。在充分致动触发器122后，棘轮棘爪142移动成与内窥镜组件400的棘轮齿条415啮合。类似地如上面关于内窥镜组件200(图9和图10A到图10D)所详述的，一旦棘轮棘爪142与棘轮齿条415啮合，触发器122就可不朝向未致动位置返回并且因此驱动杆132可不向近侧返回直到内窥镜组件400已完全启动。
当驱动杆132向远侧平移时，推进远侧块136通过外壳110、接收器组件170，并且进入内窥镜组件400的近侧轮毂410的膛413中。最终，手柄组件100的远侧块136接触内窥镜组件400的驱动组件430的柱塞435。由于第一偏压构件439a的第一弹簧常数“KK1”小于第二偏压构件439b的第二弹簧常数“KK2”，当初始地推动远侧块136到柱塞435中时，柱塞435和内轴431一起向远侧平移使得第一偏压构件439a被压缩同时第二偏压构件439b保持基本上未压缩。当向远侧平移内轴431时，首先在第一夹钳构件460a和第二夹钳构件460b之间加载手术夹具，并且此后，第一夹钳构件460a和第二夹钳构件460b从打开位置平移到闭合位置以围绕组织形成手术夹具，但也预期其它配置。在手柄组件100的致动和内窥镜组件400的启动期间，棘轮棘爪142逐渐地与内窥镜组件400的棘轮齿条415的连续棘轮齿啮合，类似地如上面关于内窥镜组件200(图9和图10A到图10D)所详述的。
如上面关于内窥镜组件300(图11A到图11D)所述，根据使用的特定内窥镜组件、形成的手术夹具的配置和/或其它因素，完全形成手术夹具的内窥镜组件的驱动组件的所需行进距离可变化。因此，为了确保触发器122可通过其完全致动冲程(例如从未致动位置到致动位置)而致动，内窥镜组件400允许驱动杆132进一步行进超出内窥镜组件400的完全启动位置，如下详述。
当进一步致动触发器122以完成其完全致动冲程时，继续向远侧驱动柱塞435。然而，因为内轴431不可超出其最远侧位置进一步向远侧行进，压缩第二偏压构件439b，由此允许柱塞435独立于内轴431向远侧平移。也就是说，第二偏压构件439b的压缩实现内轴431保持在适当位置上同时完成触发器122的完全致动冲程。
内窥镜组件400的棘轮齿条415被配置成使得在完全致动手柄组件100和/或完全启动内窥镜组件400后，棘轮棘爪142已离开棘轮齿条415并且与其脱离。更具体地说，棘轮齿条415限定长度，所述长度适用于实现从打开位置朝向闭合位置的棘轮的逐渐平移夹钳构件460a、夹钳构件460b，并且使得在达到夹钳构件460a、夹钳构件460b的完全闭合位置、手柄组件100的完全致动位置和/或柱塞435的最远侧位置后，棘轮棘爪142已离开棘轮齿条415。一旦棘轮棘爪142已离开棘轮齿条415并且与其脱离，就可将触发器122释放或返回到未致动位置以由此使驱动杆132和内轴431返回到其初始位置，因此使第一夹钳构件460a和第二夹钳构件460b返回到打开位置。此后，可重复上面详述的使用以闭合、启动或形成另外的手术夹具。
转向图13到图15，示出分别地各种其它内窥镜组件500、600、700的近侧末端被配置成用于与手柄组件100一起使用。内窥镜组件500、内窥镜组件600(分别地图13和图14)被配置成用于棘轮用途并且因此近侧轮毂510、近侧轮毂610包括被配置成安装在其中并且朝向其近侧末端设置的棘轮齿条515、棘轮齿条615。类似于内窥镜组件400的棘轮齿条415(图12A到图12D)，棘轮齿条515、棘轮齿条615限定长度，所述长度适用于实现其内驱动组件530、内驱动组件630的棘轮的推进，用于操纵其末端执行器组件(未示出)并且用于在完全致动和/或启动冲程之后实现内驱动组件530、内驱动组件630的完全返回。如可理解的，棘轮齿条415(图12)、棘轮齿条515和棘轮齿条615限定对应于相应的内窥镜组件500、600的不同启动冲程需求的不同长度。除了不同长度配置之外，根据用于提供棘轮齿条的特定内窥镜组件的启动冲程需求，也预期各种其它配置的棘轮齿条。举例来说，棘轮齿条不必设置在内窥镜组件的近侧轮毂的近侧末端处，但实际上可从其向远侧分隔以延迟棘轮啮合直到进一步进入启动冲程中。内窥镜组件700(图15)，类似于内窥镜组件300(图11A到图11D)被配置成用于非棘轮用途并且因此近侧轮毂710不包括棘轮齿条。
除了上面的示范性实施例之外，预期并且在本公开的范围内可提供包括具有其独特的并且不同的启动冲程长度的一对夹钳的其它内窥镜组件，用于与用于棘轮用途或非棘轮用途的手柄组件100(图1)一起使用。这类配置接纳具有不同配置和/或不同启动冲程长度同时提供恒定致动冲程长度的不同内窥镜组件。因此，可提供根据本公开的原理构造的各种内窥镜组件并且其也能够在用于多个不同制造商的多个平台上启动或形成或闭合各种尺寸、材料和配置的手术夹具。
应理解，前述描述仅说明本公开。本领域的技术人员可在不脱离本公开的情况下设计各种替代和修改。因此，本公开旨在涵盖所有这类替代、修改和变化。呈现参考附图所描述的实施例仅为了展现本公开的某些实例。与上文所描述和/或所附权利要求书中的元件、步骤、方法和技术无实质不同的其它元件、步骤、方法和技术也旨在在本公开的范围内。
Claims (20)
1.一种可再利用的手术器械，包含：
手柄组件，包括：
外壳；
驱动杆，所述驱动杆可滑动地支撑在所述外壳内；
触发器，所述触发器可枢转地连接到所述外壳并且可操作地联接到所述驱动杆使得所述触发器相对于所述外壳从未致动位置到致动位置的移动将所述驱动杆从近侧位置平移到远侧位置；
棘轮棘爪，所述棘轮棘爪可枢转地支撑在所述驱动杆上；和
接收器组件，所述接收器组件从所述外壳延伸并且被配置成在其中可拆卸地啮合内窥镜组件；和
第一内窥镜组件，所述第一内窥镜组件被配置成用于棘轮用途，所述第一内窥镜组件包括：
近侧轮毂，所述近侧轮毂能够插入到所述接收器组件中并且能够可拆卸地啮合在所述接收器组件内，所述近侧轮毂包括设置在其中的棘轮齿条，所述棘轮齿条限定多个棘轮齿；
细长轴，所述细长轴从所述近侧轮毂向远侧延伸；
末端执行器组件，所述末端执行器组件支撑在所述细长轴的远侧末端处；和
驱动组件，所述驱动组件包括可滑动地设置在所述近侧轮毂和所述细长轴内并且限定近侧末端和远侧末端的内轴，所述内轴的所述远侧末端可操作地联接到所述末端执行器组件，使得所述内轴从未启动位置到启动位置的移动实现所述末端执行器组件的操纵，
其中，在所述近侧轮毂可拆卸地啮合在所述接收器组件内的情况下，所述驱动杆从所述近侧位置朝向所述远侧位置的初始平移将所述棘轮棘爪移动成与所述棘轮齿条啮合并且将所述驱动杆移动成与所述驱动组件邻接，使得当沿着所述棘轮齿条逐渐地推进所述棘轮棘爪与所述棘轮齿条的所述棘轮齿连续啮合时，所述驱动杆朝向所述远侧位置的进一步远侧平移逐渐地从所述未启动位置朝向所述启动位置推动所述内轴。
2.根据权利要求1所述的可再利用的手术器械，其中，在所述棘轮棘爪与所述棘轮齿条啮合之前，准许所述驱动杆向近侧返回，由此使所述内轴朝向所述未启动位置返回。
3.根据权利要求1所述的可再利用的手术器械，其中，在所述棘轮棘爪与所述棘轮齿条啮合的情况下，阻止所述驱动杆向近侧返回，由此阻止所述内轴朝向所述未启动位置返回。
4.根据权利要求1所述的可再利用的手术器械，其中，一旦所述内轴到达所述启动位置，所述棘轮棘爪就离开所述棘轮齿条并且与其脱离。
5.根据权利要求4所述的可再利用的手术器械，其中，在所述棘轮棘爪离开所述棘轮齿条并且与其脱离的情况下，准许所述驱动杆向近侧返回，由此使所述内轴朝向所述未启动位置返回。
6.根据权利要求1所述的可再利用的手术器械，其中所述第一内窥镜组件的所述驱动组件进一步包括与所述内轴的所述近侧末端可操作地啮合的柱塞，其中所述驱动杆被配置成邻接所述柱塞并且向远侧推动所述柱塞以由此从所述未启动位置朝向所述启动位置推动所述内轴。
7.根据权利要求6所述的可再利用的手术器械，其中所述柱塞被配置成连同所述内轴从所述未启动位置平移到所述启动位置，并且其中所述柱塞进一步被配置成独立于所述内轴并且相对于所述内轴从所述启动位置向远侧平移到末端位置。
8.根据权利要求7所述的可再利用的手术器械，其中所述第一内窥镜组件的所述驱动组件包括第一弹簧和第二弹簧，所述第二弹簧限定弹簧常数，所述第二弹簧的弹簧常数大于所述第一弹簧的弹簧常数，使得在所述柱塞连同所述内轴从所述未启动位置平移到所述启动位置后压缩所述第一弹簧，并且使得在所述柱塞独立于所述内轴并且相对于所述内轴从所述启动位置向远侧平移到所述末端位置后压缩所述第二弹簧。
9.根据权利要求7所述的可再利用的手术器械，其中所述驱动杆从所述近侧位置到所述远侧位置的平移限定所述手柄组件的致动冲程长度，其中所述内轴从所述未启动位置到所述启动位置的平移限定所述第一内窥镜组件的启动冲程长度，所述第一内窥镜组件的所述启动冲程长度小于所述手柄组件的所述致动冲程长度，并且其中所述柱塞从所述启动位置到所述末端位置的平移在所述第一内窥镜组件的所述启动冲程完成之后实现所述手柄组件的所述致动冲程的完成。
10.根据权利要求1所述的可再利用的手术器械，其中所述第一内窥镜组件的所述末端执行器组件包括第一夹钳构件和第二夹钳构件，并且其中所述第一内窥镜组件的所述驱动组件的所述内轴从所述未启动位置到所述启动位置的移动将所述第一夹钳构件和第二夹钳构件从打开位置移动到闭合位置。
11.根据权利要求10所述的可再利用的手术器械，其中所述第一夹钳构件和第二夹钳构件被配置成在所述第一夹钳构件和第二夹钳构件之间接收手术夹具，并且其中将所述第一夹钳构件和第二夹钳构件从所述打开位置移动到所述闭合位置形成所述手术夹具。
12.根据权利要求1所述的可再利用的手术器械，进一步包含：
第二内窥镜组件，所述第二内窥镜组件被配置成用于非棘轮用途，所述第二内窥镜组件包括：
近侧轮毂，所述第二内窥镜组件的近侧轮毂能够插入到所述接收器组件中并且能够可拆卸地啮合在所述接收器组件内；
细长轴，所述第二内窥镜组件的细长轴从所述第二内窥镜组件的近侧轮毂向远侧延伸；
末端执行器组件，所述第二内窥镜组件的末端执行器组件支撑在所述第二内窥镜组件的细长轴的远侧末端处；和
驱动组件，所述第二内窥镜组件的驱动组件包括可滑动地设置在所述第二内窥镜组件的近侧轮毂和所述第二内窥镜组件的细长轴内并且限定近侧末端和远侧末端的内轴，所述第二内窥镜组件的内轴的所述远侧末端可操作地联接到所述第二内窥镜组件的末端执行器组件，使得所述第二内窥镜组件的内轴从未启动位置到启动位置的移动实现所述第二内窥镜组件的末端执行器组件的操纵，
其中，在所述第二内窥镜组件的所述近侧轮毂可拆卸地啮合在所述接收器组件内的情况下，所述驱动杆从所述近侧位置到所述远侧位置的平移将所述驱动杆移动成与所述第二内窥镜组件的驱动组件邻接以由此从所述未启动位置朝向所述启动位置持续地推动所述第二内窥镜组件的内轴。
13.根据权利要求12所述的可再利用的手术器械，其中，在所述第二内窥镜组件的所述近侧轮毂可拆卸地啮合在所述接收器组件内的情况下，所述棘轮棘爪在所述驱动杆在所述近侧位置和所述远侧位置之间的平移期间保持空闲。
14.根据权利要求12所述的可再利用的手术器械，其中，在所述第二内窥镜组件的所述近侧轮毂可拆卸地啮合在所述接收器组件内的情况下，准许所述驱动杆向近侧返回，由此在所述驱动杆的远侧平移期间的任一点处使所述第二内窥镜组件的内轴朝向所述未启动位置返回。
15.根据权利要求12所述的可再利用的手术器械，其中所述第二内窥镜组件的所述末端执行器组件包括第一夹钳构件和第二夹钳构件，并且其中所述第二内窥镜组件的所述驱动组件的所述内轴从所述未启动位置到所述启动位置的移动将所述第二内窥镜组件的第一夹钳构件和第二夹钳构件从打开位置移动到闭合位置。
16.根据权利要求15所述的可再利用的手术器械，其中所述第二内窥镜组件的所述第一夹钳构件和第二夹钳构件被配置成在其间接收手术夹具，并且其中将所述第二内窥镜组件的第一夹钳构件和第二夹钳构件从所述打开位置移动到所述闭合位置形成所述手术夹具。
17.根据权利要求12所述的可再利用的手术器械，其中所述第二内窥镜组件的所述驱动组件进一步包括与所述第二内窥镜组件的内轴的所述近侧末端可操作地啮合的柱塞，其中所述驱动杆被配置成邻接所述柱塞并且向远侧推动所述柱塞以由此从所述未启动位置朝向所述启动位置推动所述第二内窥镜组件的内轴。
18.根据权利要求17所述的可再利用的手术器械，其中所述柱塞被配置成连同所述第二内窥镜组件的内轴从所述未启动位置平移到所述启动位置，并且其中所述柱塞进一步被配置成独立于所述第二内窥镜组件的内轴并且相对于所述第二内窥镜组件的内轴从所述启动位置向远侧平移到末端位置。
19.根据权利要求18所述的可再利用的手术器械，其中所述第二内窥镜组件的所述驱动组件包括第一弹簧和第二弹簧，所述第二内窥镜组件的第二弹簧限定弹簧常数，所述第二内窥镜组件的第二弹簧的弹簧常数大于所述第二内窥镜组件的第一弹簧的弹簧常数，使得在所述柱塞连同所述第二内窥镜组件的内轴从所述未启动位置平移到所述启动位置后压缩所述第二内窥镜组件的第一弹簧，并且使得在所述柱塞独立于所述第二内窥镜组件的内轴并且相对于所述第二内窥镜组件的内轴从所述启动位置向远侧平移到所述末端位置后压缩所述第二内窥镜组件的第二弹簧。
20.根据权利要求18所述的可再利用的手术器械，其中所述驱动杆从所述近侧位置到所述远侧位置的平移限定所述手柄组件的致动冲程长度，其中所述第二内窥镜组件的内轴从所述未启动位置到所述启动位置的平移限定所述第二内窥镜组件的启动冲程长度，所述第二内窥镜组件的所述启动冲程长度小于所述手柄组件的所述致动冲程长度，并且其中所述柱塞从所述启动位置到所述末端位置的平移在所述第二内窥镜组件的所述启动冲程完成之后实现所述手柄组件的所述致动冲程的完成。
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| US10959737B2 (en) | 2017-12-13 | 2021-03-30 | Covidien Lp | Reposable multi-fire surgical clip applier |
| US10849630B2 (en) | 2017-12-13 | 2020-12-01 | Covidien Lp | Reposable multi-fire surgical clip applier |
| US10743887B2 (en) | 2017-12-13 | 2020-08-18 | Covidien Lp | Reposable multi-fire surgical clip applier |
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-
2015
- 2015-11-03 WO PCT/CN2015/093626 patent/WO2017075752A1/en active Application Filing
- 2015-11-03 JP JP2018521252A patent/JP6626197B2/ja active Active
- 2015-11-03 CA CA2998890A patent/CA2998890A1/en not_active Abandoned
- 2015-11-03 CN CN201580084311.3A patent/CN108348259B/zh active Active
- 2015-11-03 US US15/751,240 patent/US10702279B2/en active Active
- 2015-11-03 EP EP15907594.4A patent/EP3370625B1/en active Active
- 2015-11-03 AU AU2015413639A patent/AU2015413639A1/en not_active Abandoned
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2020
- 2020-06-19 US US16/905,974 patent/US20200315629A1/en not_active Abandoned
Also Published As
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|---|---|
| CN108348259A (zh) | 2018-07-31 |
| EP3370625B1 (en) | 2020-07-01 |
| JP2018534055A (ja) | 2018-11-22 |
| US20180235637A1 (en) | 2018-08-23 |
| US20200315629A1 (en) | 2020-10-08 |
| AU2015413639A1 (en) | 2018-04-05 |
| JP6626197B2 (ja) | 2019-12-25 |
| WO2017075752A1 (en) | 2017-05-11 |
| US10702279B2 (en) | 2020-07-07 |
| EP3370625A1 (en) | 2018-09-12 |
| CA2998890A1 (en) | 2017-05-11 |
| EP3370625A4 (en) | 2019-09-25 |
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