CN108378889B - 变内窥镜手术施夹钳 - Google Patents
变内窥镜手术施夹钳 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00407—Ratchet means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
- A61B2017/00424—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping ergonomic, e.g. fitting in fist
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
Abstract
一种内窥镜手术施夹钳包括具有扳柄的柄部组件、内窥镜组件、一对夹爪构件、设置在所述柄部组件的外壳内的驱动杆以及设置在所述柄部组件的所述外壳内的棘轮组件。所述驱动杆可操作地连接到所述扳柄和所述一对夹爪构件。所述棘轮组件包括设置在所述驱动杆上的齿条和可滑动地安装在所述柄部组件的所述外壳内的棘爪外壳,所述齿条限定多个齿条齿,所述棘爪外壳具有可选择性地与所述齿条的所述多个齿条齿接合的棘爪,其中在所述棘爪外壳的第一位置中,阻止所述扳柄的移动方向逆转,并且其中在所述棘爪外壳的第二位置中,准许所述扳柄的所述移动方向逆转。
Description
相关申请的引用
本申请要求2017年2月2日提交的美国临时专利申请第62/453,551号的权益和优先权,所述专利申请的全部公开内容以引用的方式并入本文中。
技术领域
本公开大体上涉及手术施夹钳。更具体地说,本公开涉及具有用于其棘轮组件的释放开关的内窥镜手术施夹钳。
背景技术
内窥镜手术吻合器和手术施夹钳在本领域中是已知的,并且用于多种不同和可用的手术程序。微创程序通常被通称为内窥镜程序。通常管子或插管装置通过用于提供进入孔口的入口切口延伸到患者的身体中。孔口允许外科医生使用套管针通过所述孔口插入多种不同的手术器械,并且允许远离切口执行手术程序。
经构造以施用各种不同手术夹具的具有各种尺寸的内窥镜手术施夹钳在本领域中是已知的并且能够在进入体腔期间施用单个或多个手术夹具。这类手术夹具通常由生物相容性材料制成,并且通常在血管上压紧。一旦施用到血管,压紧的手术夹具终止通过其的流体的流动。
能够在内窥镜或腹腔镜程序中在单次进入体腔期间施用多个夹具的内窥镜手术施夹钳描述于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,所述美国专利均以全文引用的方式并入。另一种复合内窥镜手术施夹钳公开于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。这些装置通常(但不一定)在单次手术程序期间使用。
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施夹钳,所述专利的公开内容在此以引用的方式并入本文。内窥镜手术施夹钳在单次插入到体腔中期间推进并且形成多种夹具。此可再消毒内窥镜手术施夹钳构造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种夹具。
在内窥镜程序期间,例如为了在胆管造影或其它医疗程序期间将导管固定在组织周围的需要,可期望和/或必需部分地形成夹具。
因此,存在对包括用于棘轮组件的释放开关的内窥镜手术施夹钳的需要。因此,在夹具形成程序期间,临床医生可致动释放开关以使棘轮组件复位,并且因此仅部分地形成手术夹具。
发明内容
本公开涉及内窥镜手术施夹钳。
根据本发明的方面,提供内窥镜手术施夹钳。手术施夹钳包括柄部组件、内窥镜组件、驱动杆和棘轮组件。柄部组件包括外壳、从外壳延伸的固定柄部和枢转地连接到固定柄部的扳柄。内窥镜组件可选择性地连接到柄部组件的外壳,并且包括轴组件和可操作地连接到轴组件并且从轴组件延伸的一对夹爪构件。驱动杆设置在柄部组件的外壳内并且可操作地连接到扳柄和一对夹爪构件,以在致动扳柄时使一对夹爪构件在间隔开构型和接近构型之间移动。棘轮组件设置在柄部组件的外壳内并且包括设置在驱动杆上的齿条和可滑动地安装在柄部组件的外壳内的棘爪外壳,所述齿条限定多个齿条齿并且具有近侧端部和远侧端部,所述棘爪外壳具有可选择性地与齿条的多个齿条齿接合的棘爪,其中在棘爪外壳的第一位置中,棘爪与齿条的多个齿条齿对齐以阻止扳柄的移动方向逆转,直到棘爪经设置超出齿条的近侧端部或远侧端部为止,并且其中在棘爪外壳的第二位置中,棘爪不与齿条的多个齿条齿对齐以准许在棘爪与齿条的初始接合之后扳柄的移动方向逆转。
在一个实施例中,棘轮组件包括至少部分地支撑在柄部组件的外壳内并且以可操作方式与棘爪外壳连结的释放开关。可选择性地致动释放开关以将棘爪外壳从其第一位置移动到其第二位置,其中在棘爪外壳的第二位置中,棘爪外壳相对于齿条侧向地移动以使棘爪与齿条的多个齿条齿断开接合。
在一个方面中,棘爪外壳限定在其中的槽道,其中棘爪定位在棘爪外壳的槽道内。
在实施例中,棘轮组件包括开关销,其中棘爪外壳限定在其中的构造成定位开关销的中心狭槽,所述开关销可滑动地延伸通过棘爪外壳的槽道和棘爪以在棘爪外壳的槽道内支撑棘爪。
在一些实施例中,释放开关包括第一端帽和第二端帽,其中外壳的第一侧面包括经构造以可滑动地接收释放开关的第一端帽的第一开关狭槽,并且外壳的第二侧面包括经构造以可滑动地接收释放开关的第二端帽的第二开关狭槽。
在一个实施例中,释放开关的第一端帽在棘爪外壳的第一侧面上支撑在开关销的第一端部上,并且释放开关的第二端帽在棘爪外壳的第二相对侧面上支撑在开关销的第二端部上,使得可经由第一端帽和第二端帽分别从棘爪外壳的第一侧面和第二侧面触及释放开关以致动释放开关。
在一个方面中,释放开关包括支撑在第一端帽上并且在第一开关狭槽的内壁和棘爪外壳的第一侧面之间延伸的第一偏置构件,和支撑在第二端帽上并且在第二开关狭槽的内壁和棘爪外壳的第二侧面之间延伸的第二偏置构件。
在实施例中,第一偏置构件包括第一偏置力并且第二偏置构件包括第二偏置力,第一偏置力和第二偏置力经构造以进行协作从而将棘爪外壳维持在第一位置,使得棘爪外壳相对于齿条居中定位并且棘爪与多个齿条齿对齐。
在一些实施例中,当通过致动释放开关的第一端帽来致动释放开关时,第一端帽朝向棘爪外壳的第一侧面移动,使得第一端帽接合棘爪外壳以使棘爪外壳朝向第二偏置构件和相对于齿条侧向地移动到棘爪外壳的第二位置,以使棘爪移动成不与多个齿条齿对齐。
在一些实施例中,当通过致动释放开关的第二端帽来致动释放开关时,第二端帽朝向棘爪外壳的第二侧面移动,使得第二端帽接合棘爪外壳以使棘爪外壳朝向第一偏置构件和相对于齿条侧向地移动到棘爪外壳的第二位置,以使棘爪移动成不与多个齿条齿对齐。
在一个方面中,齿条包括经构造以接收处于初始和/或复位位置中的棘爪的远侧间隙和近侧间隙。
在实施例中,棘轮组件包括经构造以使棘爪偏置成在第一位置中与齿条对齐的棘爪弹簧,其中在第二位置中,棘爪弹簧以及第一偏置构件和第二偏置构件中的至少一个经构造以抵靠齿条的一侧推动棘爪,直到棘爪定位在齿条的远侧间隙或近侧间隙内为止。
在一些实施例中,当棘爪定位在齿条的远侧间隙或近侧间隙内时,第一偏置构件和第二偏置构件中的至少一个经构造以将棘爪侧向地推动到其第一位置,其中棘爪相对于齿条居中定位使得棘爪与多个齿条齿对齐。
在一个实施例中,棘轮组件包括远侧支撑销和近侧支撑销,其中棘爪外壳的外表面进一步限定经构造以用于定位远侧支撑销的远侧支撑狭槽和经构造以用于定位近侧支撑销的近侧支撑狭槽,远侧支撑销和近侧支撑销各自连接到柄部组件的外壳以将棘爪外壳可滑动地安装在柄部组件的外壳内。
在一个方面中,内窥镜组件进一步包含可滑动地设置在轴组件内并且可选择性地在一对夹爪构件之间形成的多个手术夹具,其中当棘爪外壳处于第一位置时,棘爪与设置在驱动杆上的齿条对齐,使得在致动扳柄时防止扳柄逆转其移动方向,直到扳柄被完全致动并且多个手术夹具中的最远侧手术夹具在一对夹爪构件之间完全形成为止。
在实施例中,当棘爪外壳处于第二位置时,棘爪不与设置在驱动杆上的齿条对齐,使得在部分致动扳柄时扳柄能够逆转其移动方向,使得多个手术夹具中的最远侧手术夹具在一对夹爪构件之间部分地形成。
在一些实施例中,棘轮组件包括设置在齿条上的盖板,盖板具有沿着齿条的至少一部分延伸的一对翼部,以在扳柄的行程长度的特定部分期间防止棘爪外壳的侧向移动和棘爪与多个齿条齿断开接合。
根据本公开的另一方面,提供内窥镜手术施夹钳。手术施夹钳包括柄部组件、从柄部组件延伸的轴组件、可操作地连接到轴组件并且从轴组件延伸的一对夹爪构件、驱动杆以及棘轮组件。柄部组件包括固定柄部和枢转地连接到固定柄部的扳柄。驱动杆设置在柄部组件内并且可操作地连接到扳柄和一对夹爪构件,以在致动扳柄时使一对夹爪构件在间隔开构型和接近构型之间移动。棘轮组件设置在柄部组件内并且包括齿条和棘爪外壳。齿条限定在驱动杆的顶部部分上,所述齿条包括多个齿条齿并且具有近侧端部和远侧端部。棘爪外壳可移动地安装在柄部组件内,棘爪外壳具有棘爪,所述棘爪可选择性地与齿条的多个齿条齿接合以在致动扳柄时阻止扳柄的移动方向逆转,直到在棘爪与齿条的初始接合之后棘爪经设置超出齿条的近侧端部或远侧端部为止。
附图说明
本文参考附图公开内窥镜手术施夹钳的特定实施例,其中:
图1是根据本公开的包括内窥镜组件和柄部组件的内窥镜手术施夹钳的透视图;
图2A是在零件分离的情况下图1的柄部组件的透视图;
图2B是图2A的细部指示区域的放大透视图,示出图1的柄部组件的棘爪外壳和棘爪;
图3是图1的柄部组件的透视图,其中从柄部组件移除至少外壳半区部;
图4A是图1的柄部组件的透视图,示出柄部组件的棘轮组件,其中从柄部组件移除或切除至少顶部外壳部分;
图4B是图4A的细部指示区域的放大透视图,示出棘轮组件;
图5是示出棘爪外壳的放大透视图,所述棘爪外壳包括图1的柄部组件的棘轮组件的棘爪;
图6是如通过图1的6-6截取的横截面平面视图,示出处于第一位置的棘轮组件;
图7是示出处于图6的第一位置的棘轮组件的横截面透视图;
图8是示出处于第二位置的棘轮组件的横截面透视图;
图9是如通过图1的6-6截取的横截面平面视图,示出处于第二位置的棘轮组件;
图10是图1的柄部组件的横截面透视图,示出处于第二位置的棘轮组件和不与棘轮组件的齿条对齐的棘爪,其中从柄部组件移除至少外壳半区部;
图11是图1的柄部组件的横截面透视图,示出复位到第一位置的棘轮组件和相对于棘轮组件的齿条居中定位的棘爪,其中从柄部组件移除至少外壳半区部;
图12是根据本公开的替代实施例的棘轮组件的齿条的透视图;
图13是根据本公开的另一替代实施例的棘轮组件的齿条的透视图;以及
图14是在零件分离的情况下内窥镜组件的透视图。
具体实施方式
根据本公开,内窥镜手术施夹钳包括具有齿条、棘爪和释放开关的棘轮组件。在一个实施例中,在致动扳柄时,棘爪经构造以接合齿条的多个齿条齿以阻止释放扳柄和扳柄的移动方向逆转,直到棘爪经设置超出齿条的近侧端部或远侧端部为止。在一个方面中,可选择性地致动释放开关以使棘爪移动成不与齿条的多个齿条齿对齐,使得扳柄的移动方向可逆转。预期例如为了在胆管造影或其它医疗程序期间将导管固定在组织周围的需要,释放开关可适用于部分地形成夹具。
现将参考附图详细描述根据本公开的内窥镜手术施夹钳的实施例,在附图中,相同参考标号标识同样或同一结构元件。如附图中所示并且如贯穿以下描述中所描述,如惯用的那样,当指是在手术器械上的相对位置时,术语“近侧”指是设备的较接近用户的端部,并且术语“远侧”指是设备的较远离用户的端部。
现在参考图1到图14,一般将根据本公开的实施例的和呈特定构型的组件的内窥镜手术施夹钳标示为10。手术施夹钳10大体上包括柄部组件100和从柄部组件100向远侧延伸的内窥镜组件200。一般来说,内窥镜组件200包括衬套组件210、从衬套组件210延伸的轴组件220,和枢转地连接到轴组件220的远侧端部的一对夹爪250。任选地,至少一个一次性手术夹具筒组件(未示出)可选择性地装载到内窥镜组件200的轴组件220中。
现在参考图1-2B,示出手术施夹钳10的柄部组件100,并且将对其进行描述。柄部组件100包括具有第一或右侧半区部102a和第二或左侧半区部102b的外壳102。柄部组件100的外壳102进一步包括或限定用于支撑内窥镜组件200的衬套组件210的凸出部102c和固定柄部102d。
柄部组件100的外壳102可由合适的塑料或热塑性材料形成。进一步预期柄部组件100的外壳102可由不锈钢等制成。
柄部组件100包括可枢转地支撑在外壳102的右侧半区部102a和左侧半区部102b之间的扳柄104。扳柄104可在第一方向上可枢转地移动,使得扳柄104和固定柄部102d接近,并且扳柄104可在第二相反方向上可枢转地移动使得扳柄104和固定柄部102d间隔开。
驱动杆106支撑在柄部组件100的外壳102内。驱动杆106可操作地连接到扳柄104和一对夹爪250,以在致动扳柄104时使一对夹爪在间隔开构型和接近构型之间移动。具体来说,柄部组件100包括经构造以连接扳柄104和驱动杆106的叉形杆连接件108。叉形杆连接件108包括具有尾部108a的第一端部和第二端部,所述第二端部具有间隔开以在其间限定空间108d的第一臂108b和第二臂108c。叉形杆连接件108的尾部108a通过扳柄狭槽104a可枢转地连接到扳柄104。具体来说,叉形杆连接件108的尾部108a包括经构造以用于可枢转地定位限定在扳柄狭槽104a内的销104b的开口108f。第一臂108b和第二臂108c之间的空间108d经构造以接收驱动杆106。叉形杆连接件108的第一臂108b和第二臂108c以及驱动杆106包括分别经构造以定位用于可枢转地连接叉形杆连接件108和驱动杆106的驱动杆销110的对应孔口108e、孔口106c。如下文将详述的,叉形杆连接件108经构造以将扳柄104的枢转移动转变为驱动杆106的纵向移动。
在一个实施例中,驱动杆106是具有远侧端部部分106a和近侧端部106b的基本上平坦的构件。一般来说,驱动杆106的远侧端部部分106a包括设置成与内窥镜组件200的特征配合的钩构件114。因此,驱动杆106经构造以使一个或多个驱动结构移动以进行装载并且致动一对夹爪250以形成完全形成或部分形成的夹具,并且然后复位到初始位置以用于下一次夹具施用。偏置构件(例如回位弹簧112)设置成围绕邻近远侧端部部分106a的驱动杆106。在致动扳柄104并且叉形杆连接件108以纵向或向远侧的方式推进驱动杆106之后,回位弹簧112设置成使驱动杆106和扳柄104返回到其原始位置以用于下一次夹具施用。
另外参考图3到图5,手术施夹钳10包括设置在柄部组件100的外壳102内的棘轮组件300。棘轮组件300包括齿条310、其中设置棘爪330的棘爪外壳320,和至少部分地支撑在柄部组件100的外壳102内的释放开关340。
如图3所示,齿条310由驱动杆106的顶部表面106d支撑或设置在其上并且包括远侧部分310a和近侧部分310b。齿条310在远侧部分310a和近侧部分310b之间限定连续的多个齿条齿312。齿条310还包括邻近远侧端部310a定位的远侧间隙或凹槽314a和邻近齿条310的近侧端部310b定位的近侧间隙或凹槽314b。如将进一步详述的,远侧凹槽314a和近侧凹槽314b经构造以接收处于初始和/或复位位置的棘爪330。
如图4B所示,棘爪外壳320可滑动地安装在外壳102的右侧半区部102a和左侧半区部102b之间的柄部组件100内。具体来说,棘轮组件300包括远侧支撑销302a和近侧支撑销302b,并且棘爪外壳320包括经构造以分别定位远侧支撑销302a和近侧支撑销302b的远侧支撑狭槽322a和近侧支撑狭槽322b。远侧支撑销302a和近侧支撑销302b安装到外壳102内的多个对应狭槽103a上,以将棘爪外壳320可滑动地安装在柄部组件100的外壳102内。在实施例中,如图5中最佳示出的,棘爪外壳320进一步包括经构造以用于分别定位从外壳102的右侧半区部102a或左侧半区部102b中的至少一个延伸的第一导引特征103b和第二导引特征103c的第一导引槽道323a和第二导引槽道323b。预期第一导引特征103b和第二导引特征103c设置成使棘爪外壳320的远侧支撑狭槽322a和近侧支撑狭槽322b与外壳102的多个对应狭槽103a对准,以便分别定位远侧支撑梢302a和近侧支撑梢302b。
如图2B和图5所示,棘爪外壳320进一步限定经构造以将棘爪330定位在其中的槽道或凹陷部324。棘爪330通过开关销332在其中棘爪330与齿条310基本上操作性接合的部位处可枢转地连接到棘爪外壳320。开关销332延伸通过在棘爪外壳320中限定的中心狭槽326和在棘爪330中限定的对应狭槽334。棘轮组件300进一步包括设置在棘爪外壳320内并且经构造以使棘爪330竖直地偏置成与齿条310操作性接合的棘爪弹簧336。具体来说,棘爪弹簧336包括经构造以闩锁到远侧支撑销302a上的远侧钩336a和经构造以闩锁到近侧支撑销302b上的近侧钩336b。预期以经构造以将棘爪330的棘爪齿338维持成与多个齿条齿312接合,以及将棘爪330维持在旋转或倾斜位置的方式定位棘爪弹簧336。
现参考图6,在第一位置中,棘爪330可与齿条310接合以限制齿条310的纵向移动,并且继而限制扳柄104的纵向移动。在使用时,当(从完全未致动位置)致动扳柄104时,也使齿条310移动成与棘爪330接合。齿条310具有一定的长度,在随着扳柄104到达完全致动或完全未致动位置,齿条310在向近侧或向远侧移动之间改变(在棘爪齿338进入远侧间隙314a之后)时,所述长度允许棘爪330在齿条310上逆转并且返回推进。棘轮组件300的齿条310、扳柄104和驱动杆106的相对长度和尺寸限定扳柄104、驱动杆106或柄部组件100的行程长度。
棘轮组件300进一步包括至少部分地支撑在柄部组件100的外壳102内的释放开关340。释放开关340以可操作方式与棘爪外壳320连结,并且可操作以选择性地使棘爪外壳320移动,并且继而使棘爪330移动成与齿条310的多个齿条齿312对齐或不与其对齐。
以此方式,当棘爪330移动到第二位置,不与齿条310的多个齿条齿312对齐时(参见图9),由于棘爪330对棘轮组件300的齿条310不具有阻挡作用,扳柄104可按需要自由张开和闭合。因此,扳柄104可部分地致动(不必完全致动)并且可返回到完全未致动位置。这类特征准许用户部分地挤压或致动扳柄104以便执行胆道造影程序等。
参考图6,释放开关340包括可滑动地支撑在开关销332的第一端部部分332a上的第一端帽342a和可滑动地支撑在开关销332的第二端部部分332b上的第二端帽342b。
第一端帽342a具有第一延伸部343a并且限定基本上“T”形的轮廓。第一端帽342a限定通过其的第一槽道或孔隙345a,所述第一槽道或孔隙345a经尺寸设定并且经构造以可滑动地接收开关销332的第一端部部分332a。类似地,第二端帽342b具有第二延伸部343b并且限定基本上“T”形的轮廓。第二端帽342b限定通过其的第二槽道或孔隙345b,所述第二槽道或孔隙345b经尺寸设定并且经构造以可滑动地接收开关销332的第二端部部分332b。
在一个实施例中,第一端帽342a和第二端帽342b是圆柱形的,各自包括第一直径“D1”。类似地,在一个实施例中,第一延伸部343a和第二延伸部343b是圆柱形的,各自包括小于第一直径“D1”的第二直径“D2”。替代地,第一端帽342a和第二端帽342b以及第一延伸部343a和第二延伸部343b可根据需要分别包括各种形状和尺寸以用于其预期目的。
外壳102的右侧半区部102a包括经尺寸设定并且经构造以可滑动地接收第一端帽342a的第一开关狭槽或孔隙105,并且外壳102的左侧半区部102b包括经尺寸设定并且经构造以可滑动地接收第二端帽342b的第二开关狭槽或孔隙107。一旦第一端帽342a和第二端帽342b分别接收在第一开关狭槽105和第二开关狭槽107内,则第一延伸部343a和第二延伸部343b经设置分别与棘爪外壳320的第一侧面328a和第二侧面328b接触。
在一个实施例中,第一开关狭槽105和第二开关狭槽107各自分别包括第一部分105a、107a,所述第一部分105a、107a限定稍微大于第一端帽342a和第二端帽342b的第一直径“D1”的第三直径“D3”,使得能够在第一部分105a、107a之间不具有明显空隙或间隙的情况下将第一端帽342a和第二端帽342b可滑动地插入到第一部分105a、107a中。第一开关狭槽105和第二开关狭槽107各自进一步包括内壁105b、107b。内壁105b、107b设置成分别防止第一端帽342a和第二端帽342b可滑动地插入超出第一部分105a、107a。内壁105b、107b分别各自限定开口105c、107c,所述开口105c、107c限定小于第一部分105a、107a的第三直径“D3”的第四直径“D4”。每个开口105c、107c的第四直径“D4”稍微大于第一延伸部343a和第二延伸部343b的第二直径“D2”,使得能够在开口105c、107c之间不具有明显空隙或间隙的情况下将第一延伸部343a和第二延伸部343b可滑动地插入到开口105c、107c中。
第一端帽342a和第二端帽342b分别从第一开关狭槽105和第二开关狭槽107伸出,并且可由用户的手指致动以致动释放开关340。预期第一开关狭槽105和第二开关狭槽107的第一部分105a、107a分别提供的足够滑道以使得第一端帽342a和第二端帽342b能够分别通过滑道移动以致动释放开关340。
在一个实施例中,柄部组件100的外壳102可设置有围绕第一端帽342a和第二端帽342b的防护壁(未具体地示出),以便阻止无意地致动释放开关340。在一些实施例中,第一端帽342a和第二端帽342b可与柄部组件100的外壳102的外表面齐平,以便另外阻止无意地致动释放开关340。
在致动第一端帽342a或第二端帽342b时,释放开关340可在第一位置(上文提及;参见图3、图6和图7)和第二位置(上文提及;参见图8到图10)之间移动,在所述第一位置中,棘轮组件300“启用”或“启动”,使得棘爪330与多个齿条齿312操作性接合/对齐或移动成与多个齿条齿312操作性接合/对齐,从而实现或再次实现棘轮组件300的操作性,在所述第二位置中,棘轮组件300“停用”或“禁用”,使得棘爪330不与多个齿条齿312操作性接合/对齐或移动成不与多个齿条齿312操作性接合/对齐。
预期释放开关340以及继而棘轮组件300预设到其中棘爪330与多个齿条齿312接合/对齐的第一位置。为此,释放开关340包括在棘爪外壳320的第一侧面328a和第一开关狭槽105的内壁105b之间延伸的支撑在第一端帽343a的第一延伸部343a上的第一偏置构件344,并且包括在棘爪外壳320的第二侧面328b和第二开关狭槽107的内壁107b之间延伸的支撑在第二端帽342b的第二延伸部343b上的第二偏置构件346。第一偏置构件344包括第一偏置力“BF1”并且经设置使第二端帽342b远离第二开关狭槽107的内壁107b偏置或推动第二端帽342b远离第二开关槽口107的内壁107b。类似地,第二偏置构件346包括第二偏置力“BF2”并且经设置使第一端帽342a远离第一开关槽口狭槽105的内壁105b偏置或推动第一端帽342a远离第一开关狭槽105的内壁105b。第一偏置构件344和第二偏置构件346一起协作以将棘爪外壳320维持在第一位置,使得棘爪外壳320相对于齿条310居中定位(参见图6),并且棘爪330可与齿条310接合以限制齿条310的纵向移动。
如上文所提及,在致动第一端帽342a或第二端帽342b时,可从第一位置朝向第二位置致动释放开关340。因此,出于说明性目的,将参考第一端帽342a的致动详述释放开关340的使用。
现在参考图6到图11,在使用时,当通过朝向棘爪外壳320的第一侧面328a侧向地移动或按压第一端帽342a来朝向第二位置致动释放开关340时,第一端帽343a的第一延伸部343a接合棘爪外壳320的第一侧面328a以使棘爪外壳320朝向第二偏置构件346移动,并且使棘爪330移动成不与齿条310的多个齿条齿312操作性接合/对齐。棘爪外壳320朝向第二偏置构件346的移动在棘爪外壳320的第二侧面328b和第二开关狭槽107的内壁107b之间压缩第二偏置构件346。
如上文所提及,棘爪外壳320包括设置在其中并且经构造以使棘爪330竖直地偏置的棘爪弹簧336。在第一位置中,棘爪弹簧336使棘爪330竖直地偏置成与齿条310操作性接合。在第二位置中,当棘爪330移动成不与多个齿条齿312操作性接合/对齐并且邻接齿条310的一侧时,棘爪弹簧336和第二偏置构件346的组合偏置作用于棘爪330,使得抵靠齿条310的一侧楔住或保持棘爪330(参见图9)并且使其与多个齿条齿312断开接合,直到齿条310向近侧移动(参见图10)使得棘爪330定位在远侧凹槽314a内(参见图11)为止,或直到齿条310向远侧移动使得棘爪330定位在近侧凹槽314b内为止。当棘爪330定位在远侧凹槽314a或近侧凹槽314b内时,准许第二偏置构件346扩张(未受齿条310的一侧阻碍)使得第二偏置力“BF2”作用于棘爪外壳320,以使棘爪外壳320朝向第一位置侧向地移动返回,在所述第一位置中棘爪330相对于齿条310居中定位,使得在齿条310进一步纵向移动时,棘爪330可与齿条310的多个齿条齿312接合,从而实现或再次实现棘轮组件300的操作性。
简要地参考图12和图13,在实施例中,齿条310可包括用于在扳柄104的行程长度的特定部分期间防止释放开关340朝向第二位置致动的特征。这些特征可有利于防止在夹具已经完全形成或部分地形成但尚未从手术施夹钳10放出时扳柄104无意的返回。这些特征还可有利于防止无意地两次加载夹具到一对夹爪250中。
在一个实施例中,如图12所示,齿条310可包括设置在其上的盖板350。盖板350包括槽道352,当盖板350设置在齿条310上时可通过所述槽道352触及齿条310的多个齿条齿312。盖板350包括从槽道352的相对侧并且朝向棘爪外壳320延伸的一对翼部或壁354a、354b。一对翼部354a、354b沿着齿条310长度的至少一部分延伸,以防止棘爪外壳320的侧向移动,并且防止在扳柄104的行程长度的特定部分期间棘爪330与多个齿条齿312断开接合。
在一个实施例中,如图13所示,齿条310可代替地包括附连到齿条310的相对侧的一对板360a、360b。一对板360a、360b从齿条310的相对侧并且朝向棘爪外壳320延伸以限定在多个齿条齿312的相对侧的一对肩部或壁362a、362b。一对肩部362a、362b沿着齿条310长度的至少一部分延伸,以防止棘爪外壳320的侧向移动,并且防止在扳柄104的行程长度的特定部分期间棘爪330与多个齿条齿312断开接合。
如上文所提及并且如图14所示,手术施夹钳10包括具有衬套组件210、轴组件220和一对夹爪250的内窥镜组件200。衬套组件210可旋转地安装在柄部组件100的外壳102的凸出部102c(参见图2A)上并且连接到轴组件220的近侧端部部分,以在其上相对于轴组件220的纵向中心轴线提供轴组件220和一对夹爪250的三百六十度旋转。衬套组件210具有合适的构型以便仅使用临床医生的手指使之旋转。
内窥镜组件200包括心轴连接件260,所述心轴连接件260用于将驱动杆106可操作地连接到驱动机构400,以在致动扳柄104时使一对夹爪250在间隔开构型和接近构型之间移动。具体来说,驱动杆106的钩构件114(参见图3)连接到心轴连接件260的第一端部260a,并且驱动机构400的心轴270连接到心轴连接件260的第二端部260b。以此方式,驱动杆106在远侧和近侧方向上的平移可因此分别推进和拉回心轴270。
驱动机构400进一步包括细长夹具槽道构件280,所述细长夹具槽道构件280用于将以对准方式示出的多个手术夹具290保持在夹具槽道构件280之上。提供夹具随动件282和夹具随动件弹簧284以向远侧推动手术夹具290通过细长夹具槽道构件280。提供槽道盖286以覆盖细长夹具槽道构件280并且在细长夹具槽道构件280中保持夹具随动件282和夹具随动件弹簧284且向远侧导引手术夹具290。
驱动机构400还具有用于在一对夹爪250之间馈送手术夹具290的馈送杆410。驱动机构400还包括填充部件420和楔板430。
对于内窥镜组件200的构造和操作的更详细描述,可参考美国专利第7,637,917号,所述专利的全部内容以引用的方式并入本文中。
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、方法和技术也在本公开的范围内。
Claims (19)
1.一种内窥镜手术施夹钳,包含:
柄部组件,包括:
外壳;
从所述外壳延伸的固定柄部;以及
枢转地连接所述固定柄部的扳柄;
可选择性地连接到所述柄部组件的所述外壳的内窥镜组件,所述内窥镜组件包括:
轴组件;以及
可操作地连接到所述轴组件并且从所述轴组件延伸的一对夹爪构件;
驱动杆,所述驱动杆设置在所述柄部组件的所述外壳内并且可操作地连接到所述扳柄和所述一对夹爪构件,以在致动所述扳柄时使所述一对夹爪构件在间隔开构型和接近构型之间移动;
设置在所述柄部组件的所述外壳内的棘轮组件,所述棘轮组件包括:
设置在所述驱动杆上的齿条,所述齿条限定多个齿条齿并且具有近侧端部和远侧端部;以及
可滑动地安装在所述柄部组件的所述外壳内的棘爪外壳,所述棘爪外壳具有可选择性地与所述齿条的所述多个齿条齿接合的棘爪,其中在所述棘爪外壳的第一位置中,所述棘爪与所述齿条的所述多个齿条齿对齐以阻止所述扳柄的移动方向逆转,直到所述棘爪经设置超出所述齿条的所述近侧端部或所述远侧端部为止,并且其中在所述棘爪外壳的第二位置中,所述棘爪不与所述齿条的所述多个齿条齿对齐以在所述棘爪与所述齿条的初始接合之后准许所述扳柄的所述移动方向逆转,
其中所述棘轮组件包括至少部分地支撑在所述柄部组件的所述外壳内并且以可操作方式与所述棘爪外壳连结的释放开关,所述释放开关经可选择性地致动以使所述棘爪外壳从其所述第一位置移动到其所述第二位置,其中在所述棘爪外壳的所述第二位置中,所述棘爪外壳相对于所述齿条侧向地移动以使所述棘爪与所述齿条的所述多个齿条齿断开接合。
2.根据权利要求1所述的内窥镜手术施夹钳,其中所述棘爪外壳限定在其中的槽道,并且其中所述棘爪定位在所述棘爪外壳的所述槽道内。
3.根据权利要求2所述的内窥镜手术施夹钳,其中所述棘轮组件包括开关销,其中所述棘爪外壳限定在其中的经构造以定位所述开关销的中心狭槽,所述开关销可滑动地延伸通过所述棘爪外壳的所述槽道和所述棘爪以在所述棘爪外壳的所述槽道内支撑所述棘爪。
4.根据权利要求3所述的内窥镜手术施夹钳,其中所述释放开关包括第一端帽和第二端帽,其中所述外壳的第一侧面包括经构造以可滑动地接收所述释放开关的所述第一端帽的第一开关狭槽,并且所述外壳的第二侧面包括经构造以可滑动地接收所述释放开关的所述第二端帽的第二开关狭槽。
5.根据权利要求4所述的内窥镜手术施夹钳,其中所述释放开关的所述第一端帽在所述棘爪外壳的第一侧面上支撑在所述开关销的第一端部上,并且所述释放开关的所述第二端帽在所述棘爪外壳的第二相对侧面上支撑在所述开关销的第二端部上,使得可分别经由所述第一端帽和所述第二端帽从棘爪外壳的所述第一侧面和所述第二侧面触及所述释放开关以致动所述释放开关。
6.根据权利要求4所述的内窥镜手术施夹钳,其中所述释放开关包括:
第一偏置构件,所述第一偏置构件支撑在所述第一端帽上并且在所述第一开关狭槽的内壁和所述棘爪外壳的所述第一侧面之间延伸;以及
第二偏置构件,所述第二偏置构件支撑在所述第二端帽上并且在所述第二开关狭槽的内壁和所述棘爪外壳的所述第二侧面之间延伸。
7.根据权利要求6所述的内窥镜手术施夹钳,其中所述第一偏置构件包括第一偏置力并且所述第二偏置构件包括第二偏置力,所述第一偏置力和所述第二偏置力经构造以进行协作从而使所述棘爪外壳维持在所述第一位置,使得所述棘爪外壳相对于所述齿条居中定位并且所述棘爪与所述多个齿条齿对齐。
8.根据权利要求7所述的内窥镜手术施夹钳,其中当通过致动所述释放开关的所述第一端帽来致动所述释放开关时,所述第一端帽朝向所述棘爪外壳的所述第一侧面移动,使得所述第一端帽接合所述棘爪外壳以使所述棘爪外壳朝向所述第二偏置构件以及相对于所述齿条侧向地移动到所述棘爪外壳的所述第二位置,以使所述棘爪移动成不与所述多个齿条齿对齐。
9.根据权利要求7所述的内窥镜手术施夹钳,其中当通过致动所述释放开关的所述第二端帽来致动所述释放开关时,所述第二端帽朝向所述棘爪外壳的所述第二侧面移动,使得所述第二端帽接合所述棘爪外壳以使所述棘爪外壳朝向所述第一偏置构件以及相对于所述齿条侧向地移动到所述棘爪外壳的所述第二位置,以使所述棘爪移动成不与所述多个齿条齿对齐。
10.根据权利要求6所述的内窥镜手术施夹钳,其中所述齿条包括经构造以接收处于初始和/或复位位置的所述棘爪的远侧间隙和近侧间隙。
11.根据权利要求10所述的内窥镜手术施夹钳,其中所述棘轮组件包括经构造以使所述棘爪偏置成在所述第一位置中与所述齿条对齐的棘爪弹簧,其中在所述第二位置中,所述棘爪弹簧以及所述第一偏置构件和所述第二偏置构件中的至少一个经构造以抵靠所述齿条的一侧推动所述棘爪,直到所述棘爪定位在所述齿条的所述远侧间隙或所述近侧间隙内为止。
12.根据权利要求11所述的内窥镜手术施夹钳,其中当所述棘爪定位在所述齿条的所述远侧间隙或所述近侧间隙内时,所述第一偏置构件和所述第二偏置构件中的至少一个经构造以将所述棘爪侧向地推动到其所述第一位置,其中所述棘爪相对于所述齿条居中定位使得所述棘爪与所述多个齿条齿对齐。
13.根据权利要求1所述的内窥镜手术施夹钳,其中所述棘轮组件包括远侧支撑销和近侧支撑销,其中所述棘爪外壳的外表面进一步限定经构造以用于定位所述远侧支撑销的远侧支撑狭槽和经构造以用于定位所述近侧支撑销的近侧支撑狭槽,所述远侧支撑销和所述近侧支撑销各自连接到所述柄部组件的所述外壳以将所述棘爪外壳可滑动地安装在所述柄部组件的所述外壳内。
14.根据权利要求1所述的内窥镜手术施夹钳,其中所述内窥镜组件进一步包含可滑动地设置在所述轴组件内并且可选择性地在所述一对夹爪构件之间形成的多个手术夹具,其中当所述棘爪外壳处于所述第一位置时,所述棘爪与设置在所述驱动杆上的所述齿条对齐,使得在致动所述扳柄时防止所述扳柄逆转其移动方向,直到所述扳柄被完全致动并且所述多个手术夹具中的最远侧手术夹具在所述一对夹爪构件之间完全形成。
15.根据权利要求14所述的内窥镜手术施夹钳,其中当所述棘爪外壳处于所述第二位置时,所述棘爪不与设置在所述驱动杆上的所述齿条对齐,使得在部分致动所述扳柄时所述扳柄能够逆转其所述移动方向,使得所述多个手术夹具中的所述最远侧手术夹具在所述一对夹爪构件之间部分地形成。
16.根据权利要求1所述的内窥镜手术施夹钳,其中所述棘轮组件包括设置在所述齿条上的盖板,所述盖板具有一对翼部,所述一对翼部沿着所述齿条的至少一部分延伸以在所述扳柄的行程长度的特定部分期间防止所述棘爪外壳的侧向移动并且防止所述棘爪与所述多个齿条齿断开接合。
17.一种内窥镜手术施夹钳,包含:
柄部组件,包括:
固定柄部;以及
枢转地连接到所述固定柄部的扳柄;
从所述柄部组件延伸的轴组件;
可操作地连接到所述轴组件并且从所述轴组件延伸的一对夹爪构件;
驱动杆,所述驱动杆设置在所述柄部组件内并且可操作地连接到所述扳柄和所述一对夹爪构件,以在致动所述扳柄时使所述一对夹爪构件在间隔开构型和接近构型之间移动;
设置在所述柄部组件内的棘轮组件,所述棘轮组件包括:
限定在所述驱动杆的顶部部分上的齿条,所述齿条包括多个齿条齿并且具有近侧端部和远侧端部;以及
可移动地安装在所述柄部组件内的棘爪外壳,所述棘爪外壳具有棘爪,所述棘爪可选择性地与所述齿条的所述多个齿条齿接合以在致动所述扳柄时阻止所述扳柄的移动方向逆转,直到在所述棘爪与所述齿条的初始接合之后所述棘爪设置超出所述齿条的所述近侧端部或所述远侧端部为止,
其中所述棘轮组件包括释放开关,所述释放开关以可操作方式与所述棘爪外壳连结并且经可选择性地致动以相对于所述齿条侧向地移动所述棘爪外壳,以使所述棘爪移动成不与所述齿条的所述多个齿条齿对齐,使得在致动所述扳柄时,在所述棘爪经设置超出所述齿条的所述近侧端部或所述远侧端部之前所述扳柄的所述移动方向不可逆转,从而使得能够部分地致动所述扳柄。
18.根据权利要求17所述的内窥镜手术施夹钳,进一步包含可滑动地设置在所述轴组件内并且可选择性地在所述一对夹爪之间形成的手术夹具,其中当所述棘爪与设置在所述驱动杆上的所述齿条对齐并且致动所述扳柄时,防止所述扳柄逆转其所述移动方向,直到完全致动所述扳柄以使得所述手术夹具在所述一对夹爪构件之间完全形成为止。
19.根据权利要求18所述的内窥镜手术施夹钳,其中当致动所述释放开关以使得所述棘爪不与设置在所述驱动杆上的所述齿条对齐时,所述扳柄可经部分地致动使得所述手术夹具在所述一对夹爪构件之间部分地形成。
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2018
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- 2018-01-29 CN CN201810083646.9A patent/CN108378889B/zh active Active
- 2018-02-01 EP EP18154617.7A patent/EP3357435A1/en not_active Withdrawn
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US10709455B2 (en) | 2020-07-14 |
CN108378889A (zh) | 2018-08-10 |
EP3357435A1 (en) | 2018-08-08 |
US20180214156A1 (en) | 2018-08-02 |
JP2018122086A (ja) | 2018-08-09 |
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