CN108392242A - 内窥镜手术施夹器 - Google Patents
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Abstract
一种内窥镜手术施夹器包含内窥镜组合件和手柄组合件。所述内窥镜组合件包含轴杆组合件和一对夹爪部件。所述手柄组合件包含外壳、固定手柄、触发器、驱动杆以及棘轮组合件。所述棘轮组合件包含：以操作方式联接到所述驱动杆的第一齿条，所述第一齿条界定多个第一齿条齿，其中所述第一齿条包含位于其远端与近端之间的第一长度；以及以操作方式联接到所述驱动杆且与所述第一齿条间隔开的第二齿条，所述第二齿条界定多个第二齿条齿，其中所述第二齿条包含位于其远端与近端之间的第二长度，所述第二齿条的所述第二长度小于所述第一齿条的所述第一长度。
Description
相关申请的交叉引用
本申请要求2017年2月6日提交的第62/455,090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整个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器。更具体地说，本公开涉及具有用于其棘轮组合件的释放开关的内窥镜手术施夹器。
背景技术
内窥镜手术钉合器和手术施夹器用于许多微创或内窥镜手术过程。通常在微创手术过程中，管或插管装置通过入口切口延伸进入患者的身体以提供接入端口。所述端口允许外科医生将若干不同手术器械通过其插入，用于执行远离切口的手术过程。
内窥镜手术施夹器能够在微创手术过程期间施加单个或多个手术夹片。施加手术夹片通常涉及在血管上方按压夹片。一旦施加到血管，按压的手术夹片就终止通过其的流体的流动。终止通过血管的流体的流动通常需要手术夹片的完全形成。
在某些内窥镜过程期间，可能需要和/或必须部分地形成夹片。举例来说，部分地形成的夹片可用以在胆管造影或其它医疗过程期间将导管紧固于组织周围。
因此，需要为临床医生提供部分地形成手术夹片的方便方式的内窥镜手术施夹器。
发明内容
本公开涉及内窥镜手术施夹器，其允许临床医生选择是部分地还是完全地形成手术夹片。
根据本公开的一方面，一种内窥镜手术施夹器包含内窥镜组合件和手柄组合件。所述内窥镜组合件包含轴杆组合件以及以操作方式联接到轴杆组合件且从轴杆组合件延伸的一对夹爪部件。所述手柄组合件包含可选择性连接到内窥镜组合件的外壳。固定手柄从外壳延伸，且触发器枢转地连接到所述固定手柄。驱动杆安置于所述手柄组合件的所述外壳内且以操作方式联接到所述触发器和所述对夹爪部件，以在所述触发器的致动后使所述对夹爪部件在间隔开的配置与接近配置之间移动。棘轮组合件也安置于所述手柄组合件的外壳内。所述棘轮组合件包含以操作方式联接到驱动杆的第一齿条。第一齿条界定多个第一齿条齿，具有远端和近端，且包含位于其远端与近端之间的第一长度。第二齿条以操作方式联接到驱动杆且与第一齿条间隔开。第二齿条界定多个第二齿条齿，具有远端和近端，且包含位于其远端与近端之间的第二长度。第二齿条的第二长度小于第一齿条的第一长度。
在实施例中，所述棘轮组合件进一步包含安装在所述手柄组合件的外壳内的第一棘爪，所述第一棘爪在其第一位置中能够与第一齿条的所述多个第一齿条齿选择性接合。
在实施例中，所述棘轮组合件进一步包含安装在所述手柄组合件的外壳内的第二棘爪，所述第二棘爪在其第一位置中能够与第二齿条的所述多个第二齿条齿选择性接合。
在实施例中，所述棘轮组合件进一步包含邻近于第一齿条的远端安置的远侧凹孔，其中在触发器的未致动位置中所述第一棘爪定位于所述远侧凹孔中。
在一些实施例中，所述棘轮组合件进一步包含安置于第一齿条的近端与第二齿条的远端之间的近侧凹孔，其中在触发器的未致动位置中所述第二棘爪定位于所述近侧凹孔中。
在实施例中，第一齿条安置于第二齿条的远侧的位置中。
在实施例中，所述棘轮组合件进一步包含释放开关，所述释放开关至少部分地支撑在手柄组合件的外壳内且与第一棘爪以操作方式相关联。所述释放开关能够选择性致动以将所述第一棘爪从第一位置移动到第二位置，在所述第一位置中第一棘爪与第一齿条的所述多个第一齿条齿对齐，在所述第二位置中第一棘爪脱离与第一齿条的所述多个第一齿条齿的对齐。
在实施例中，当释放开关被致动时，第二棘爪在其第一位置中维持与第二齿条的所述多个第二齿条齿的对齐，直到第二棘爪安置于所述近侧凹孔中或直到第二棘爪向近侧安置超出第二齿条的近端。
在一些实施例中，驱动杆在触发器的致动后能够纵向移动，其中当所述驱动杆在第一方向上纵向移动且所述释放开关未被致动时，所述第一棘爪和所述第二棘爪分别在所述第一齿条和所述第二齿条的所述多个第一齿条齿和所述多个第二齿条齿上方移动，以使得所述驱动杆在第二相反方向上的纵向移动被阻止，直到所述第一棘爪安置于所述远侧凹孔中且所述第二棘爪安置于所述近侧凹孔中或者直到所述第一棘爪安置于所述第一齿条的所述近端处且所述第二棘爪向近侧安置超出所述第二齿条的所述近端。
在实施例中，所述驱动杆在所述触发器的致动后能够纵向移动，其中当所述驱动杆在第一方向上纵向移动且所述释放开关被致动以使所述第一棘爪移动脱离与所述第一齿条的所述多个第一齿条齿的对齐时，所述驱动杆在第二相反方向上的纵向移动被阻止，直到所述第二棘爪安置于所述近侧凹孔中或者直到所述第二棘爪向近侧安置超出所述第二齿条的所述近端。
在实施例中，当所述驱动杆在所述第一方向上纵向移动且所述释放开关被致动以使所述第一棘爪移动脱离与所述第一齿条的所述多个第一齿条齿的对齐时，在所述触发器到达部分致动位置时所述第二棘爪被安置超出所述第二齿条的所述近端，其中在所述触发器从所述部分致动位置到达完全未致动位置时所述驱动杆能够在所述第二相反方向上纵向移动。
在实施例中，所述内窥镜组合件进一步包含可滑动地安置于所述轴杆组合件内且能够在所述对夹爪部件之间选择性形成的多个手术夹片，其中当所述第一棘爪在所述第一位置中时，所述第一棘爪与安置于所述驱动杆上的所述第一齿条对齐，使得在所述触发器的致动后防止所述触发器逆转其移动方向，直到所述触发器移动到完全致动位置且所述多个手术夹片中的最远侧手术夹片在所述对夹爪部件之间完全形成。
在一些实施例中，当所述第一棘爪外壳在所述第二位置中时，所述第一棘爪脱离与安置于所述驱动杆上的所述第一齿条的对齐，以使得当所述第二棘爪被安置超出所述第二齿条的所述近端且所述触发器移动到所述部分致动位置时，所述触发器能够逆转其所述移动方向以使得所述多个手术夹片中的所述最远侧手术夹片部分地形成于所述对夹爪部件之间。
在实施例中，所述棘轮组合件进一步包含支撑在所述手柄组合件的所述外壳内的第一棘爪弹簧和第二棘爪弹簧。所述第一棘爪弹簧被配置成将所述第一棘爪偏置为与所述第一齿条的所述多个第一齿条齿接合，且所述第二棘爪弹簧被配置成将所述第二棘爪偏置为与所述第二齿条的所述多个第二齿条齿接合。
在实施例中，第一棘爪包含从其延伸的锁定部件。所述锁定部件在所述触发器移动到所述完全未致动位置时选择性接合所述释放开关，以防止所述释放开关使所述第一棘爪移动脱离与所述第一齿条的所述多个第一齿条齿的对齐而到其第二位置。
在实施例中，所述棘轮组合件进一步包含支撑于所述手柄组合件中的释放弹簧。所述释放弹簧与所述释放开关以操作方式相关联且被偏置以使所述释放开关返回到起始位置以使得所述释放开关从所述第一棘爪脱开。
根据本公开的另一方面，一种内窥镜手术施夹器包含内窥镜组合件和手柄组合件。所述内窥镜组合件包含轴杆组合件以及以操作方式联接到轴杆组合件且从轴杆组合件延伸的一对夹爪部件。所述手柄组合件包含可选择性连接到内窥镜组合件的外壳、从外壳延伸的固定手柄，以及枢转地连接到固定手柄的触发器。驱动杆安置于所述手柄组合件的所述外壳内且以操作方式联接到所述触发器和所述对夹爪部件，以在所述触发器的致动后使所述对夹爪部件在间隔开的配置与接近配置之间移动。棘轮组合件也安置于所述手柄组合件的外壳内。棘轮组合件包含界定于驱动杆的顶部部分上的第一齿条。第一齿条包含多个第一齿条齿且具有远端和近端。第二齿条界定于驱动杆的顶部部分上。第二齿条包含多个第二齿条齿且具有远端和近端。第一棘爪可移动地安装在所述手柄组合件内且能够与所述第一齿条的所述多个第一齿条齿选择性接合。第二棘爪可移动地安装在手柄组合件内且能够与第二齿条的所述多个第二齿条齿选择性接合。在触发器的移动后所述触发器的移动方向的逆转被禁止，直到第二棘爪向远侧安置超出第二齿条的远端或向近侧安置超出第二齿条的近端。
附图说明
本文参看附图描述内窥镜手术施夹器的具体实施例，其中：
图1是根据本公开的包含内窥镜组合件和手柄组合件的内窥镜手术施夹器的透视图；
图2A是图1的手柄组合件的侧视图，其中从其移除了至少外壳二分之一区段；
图2B是图1的手柄组合件在部件分离的情况下的透视图；
图3A是图2A的手柄组合件的说明其棘轮组合件的侧视图，处于所述棘轮组合件的正常致动的初始/复位位置；
图3B是图2A的手柄组合件的说明图3A的棘轮组合件的侧视图，处于所述棘轮组合件的正常致动的第一配置中；
图3C是图2A的手柄组合件的说明图3A的棘轮组合件的侧视图，处于所述棘轮组合件的正常致动的第二配置中；
图3D是图2A的手柄组合件的说明图3A的棘轮组合件的侧视图，处于所述棘轮组合件的正常致动的第三配置中；
图4A是图2A的手柄组合件的说明其棘轮组合件的侧视图，处于所述棘轮组合件的部分致动的第一配置中；
图4B是图2A的手柄组合件的说明图4A的棘轮组合件的侧视图，处于所述棘轮组合件的部分致动的第二配置中；
图4C是图2A的手柄组合件的说明图4A的棘轮组合件的侧视图，处于所述棘轮组合件的部分致动的第三配置中；
图5A是图2A的手柄组合件的说明其棘轮组合件的侧视图，处于所述棘轮组合件的正常致动的返回冲程的第一配置中；
图5B是图2A的手柄组合件的说明图5A的棘轮组合件的侧视图，处于棘轮组合件的正常致动的返回冲程的第二配置中；
图5C是图2A的手柄组合件的说明图5A的棘轮组合件的侧视图，处于棘轮组合件的正常致动的返回冲程的第三配置中；以及
图6是图1的内窥镜组合件在部件分离的情况下的透视图。
具体实施方式
根据本公开，内窥镜手术施夹器包含棘轮组合件，其具有：与第一棘爪以操作方式相关联的第一齿条，其具有第一长度；与第二棘爪以操作方式相关联的第二齿条，其具有小于第一齿条的第一长度的第二长度；以及与第一棘爪以操作方式相关联的释放开关。在实施例中，在触发器的致动后，第一和第二棘爪被配置成分别接合第一和第二齿条的多个第一和第二齿条齿，以禁止触发器的移动方向的释放和逆转，直到第一和第二棘爪安置于第一和第二齿条内的相应空隙内为止。在实施例中，释放开关可选择性致动以使第一棘爪移动脱离与第一齿条的所述多个第一齿条齿的对齐或接合，以使得一旦第二棘爪已经穿越第二齿条的第二较小长度便可以较早地逆转触发器的移动方向。举例来说如果需要，则预期释放开关可以有用于部分地形成夹片以在胆管造影或其它医疗过程期间将导管紧固于组织周围。
现将参照附图详细地描述根据本公开的内窥镜手术施夹器的实施例，在附图中，相似参考标号标识类似或相同的结构元件。如附图中所展示且如整个以下描述中所描述，如惯用的那样，当提及在手术器械上的相对定位时，术语“近侧”指代设备的更接近用户的末端，且术语“远侧”指代设备的更远离用户的末端。
现在参考图1-6，根据本公开的实施例的内窥镜手术施夹器一般表示为10。手术施夹器10大体上包含手柄组合件100和从手柄组合件100向远侧延伸的内窥镜组合件200。一般来说，内窥镜组合件200包含毂组合件210、从毂组合件210延伸的轴杆组合件220，以及枢转地连接到轴杆组合件220的远端的一对夹爪250。任选地，至少一个一次性手术夹片料筒组合件(未图示)可以选择性地装载到内窥镜组合件200的轴杆组合件220中。
现在参考图1-2B，手柄组合件100包含外壳102，其具有第一或右侧二分之一区段102a以及第二或左侧二分之一区段102b。手柄组合件100的外壳102进一步包含或界定用于支撑内窥镜组合件200的毂组合件210的鼻部102c，以及固定手柄102d。
手柄组合件100的外壳102可由合适的聚合物、塑料或热塑性材料形成。进一步预期手柄组合件100的外壳102可以由不锈钢等制成。
手柄组合件100包含可枢转地支撑在外壳102的右侧二分之一区段102a与左侧二分之一区段102b之间的触发器104。触发器104可在第一方向上可枢转地移动以使得触发器104和固定手柄102d接近，并且可在第二相反方向上可枢转地移动以使得触发器104和固定手柄102d间隔开。
驱动杆106支撑在手柄组合件100的外壳102内。驱动杆106是具有远端部分106a和近端部分106b的基本上平坦的部件。驱动杆106的远端部分106a包含被设置成与内窥镜组合件200的特征配合的钩部件114。驱动杆106以操作方式联接到触发器104和内窥镜组合件200的所述对夹爪250，以在触发器104的致动后即刻使所述对夹爪250在间隔开的配置与接近配置之间移动。具体来说，手柄组合件100包含被配置成联接触发器104和驱动杆106的叉骨连杆108。叉骨连杆108包含具有尾部108a的第一端部以及具有第一臂108b和第二臂108c的第二端部，所述第一臂和第二臂间隔开以在其间界定空间108d。叉骨连杆108的尾部108a通过触发器狭槽104a可枢转地连接到触发器104。具体地说，叉骨连杆108的尾部108a包含开口108f，所述开口被配置成用于可枢转地定位界定于触发器插槽104a内的销(未具体图示)。第一臂108b与第二臂108c之间的空间108d被配置成接收驱动杆106。叉骨连杆108的第一臂108b和第二臂108c以及驱动杆106分别包含对应的孔口108e、106c，所述孔口被配置成定位驱动杆销110以可枢转地连接叉骨连杆108和驱动杆106。如下文将详述的，叉骨连杆108被配置成将触发器104的枢转移动转变为驱动杆106的纵向移动。
驱动杆106被配置成移动一个或多个驱动结构以进行装载，且致动所述对夹爪250以完全或部分地形成夹片290(参见图6)，并且接着复位到初始位置以用于下一夹片施加。为实现此目的，例如第一回位弹簧112等偏置部件被安置成包围驱动杆106邻近于远端部分106a，以使得在触发器104被致动且叉骨连杆108以纵向或远侧方式使驱动杆106前进之后，第一回位弹簧112用以使驱动杆106和触发器104返回到其原始位置以用于下一夹片施加。此外，在一个实施例中，第二回位弹簧113安置于手柄组合件100的外壳102中且被配置成以操作方式连接触发器104和固定手柄102d，以使得在触发器104被致动之后，第二回位弹簧113用以使触发器104返回到其原始位置。
继续参考图2A和2B，手术施夹器10包含安置于手柄组合件100的外壳102内的棘轮组合件300。棘轮组合件300大体上包含第一齿条310、第二齿条320、第一棘爪330、第二棘爪340，以及至少部分地支撑在手柄组合件100的外壳102内的释放开关350。
如2A和2B中所示，第一齿条310和第二齿条320由驱动杆106的顶部表面106d支撑或提供于所述顶部表面上。第一齿条310包含远端310a和近端310b。第一齿条310在其远端310a与近端310b之间界定连续的多个第一齿条齿312。类似地，第二齿条320包含远端320a和近端320b。第二齿条320在其远端320a与近端320b之间界定连续的多个第二齿条齿322。
驱动杆106的顶部表面106d还包含邻近于第一齿条310的远端310a定位的远侧空隙或凹孔314a以及定位于第一齿条310的近端310b与第二齿条320的远端320a之间的近侧空隙或凹孔314b。在初始和/或复位位置中，远侧凹孔314a被配置成接收第一棘爪330且近侧凹孔314b被配置成接收第二棘爪340，如将进一步详细描述。
如图2B所示，第一棘爪330和第二棘爪340可枢转地安装在手柄组合件100内处于外壳102的右侧二分之一区段102a与左侧二分之一区段102b之间。具体地说，第一棘爪330通过第一棘爪销332可枢转地安装在手柄组合件100内处于外壳102的右侧二分之一区段102a与左侧二分之一区段102b之间，所述第一棘爪销处于其中第一棘爪330与第一齿条310成基本操作性接合的位置。第一棘爪销332延伸穿过界定于第一棘爪330中的狭槽334。类似地，第二棘爪340通过第二棘爪销342可枢转地安装在手柄组合件100内处于外壳102的右侧二分之一区段102a与左侧二分之一区段102b之间，所述第二棘爪销处于其中第二棘爪340与第二齿条320成基本操作性接合的位置。第二棘爪销342延伸穿过界定于第二棘爪340中的狭槽344。
如图2A和2B中所示，棘轮组合件300进一步包含第一棘爪弹簧336和第二棘爪弹簧346，所述第一棘爪弹簧336被配置成将第一棘爪330垂直地偏置为与第一齿条310成操作性接合，所述第二棘爪弹簧346被配置成将第二棘爪340垂直地偏置为与第二齿条320成操作性接合。第一棘爪弹簧336包含远侧钩336a和近侧钩336b，所述钩被配置成分别闩锁到外壳102的第一组支撑销116a、116b上，且第二棘爪弹簧346包含远侧钩346a和近侧钩346b，所述钩被配置成分别闩锁到第二组支撑销118a、118b上。预期第一棘爪弹簧336和第二棘爪弹簧346以如下方式定位：被配置成维持第一棘爪330的第一棘爪齿338和第二棘爪340的第二棘爪齿348分别与所述多个第一齿条齿312和第二齿条齿322对齐或接合，以及将第一棘爪330和第二棘爪340维持于旋转或倾斜位置。
继续参考图2A和2B，棘轮组合件300进一步包含至少部分地支撑在手柄组合件100的外壳102内的释放开关350。在实施例中，释放开关350在其近端部分上包含狭槽350a，所述狭槽被配置成用于定位外壳102的安装销119以使得释放开关350可围绕其枢转。释放开关350与第一棘爪330以操作方式相关联且在其远端部分上包含接合部件350b，所述接合部件可操作以接合第一棘爪330以选择性移动第一棘爪330脱离与第一齿条310的所述多个第一齿条齿312的操作性对齐或接合，如将进一步详细描述。在其它实施例中，释放开关350可包含适合于其既定目的的各种配置，且可以是被配置成在操作期间对用户提供接入的任何人体工程学形状。
在实施例中，第一棘爪330包含从其延伸的锁定部件339，所述锁定部件被设置成选择性接合释放开关350的接合部件350b以防止释放开关350使第一棘爪300的第一棘爪齿338移动脱离与第一齿条310的所述多个第一齿条齿312的对齐或接合。
棘轮组合件300进一步包含释放弹簧352，所述释放弹簧支撑在手柄组合件100的外壳102中且与释放开关350以操作方式相关联以使释放开关350返回到其未致动的起始位置，在所述位置中释放开关350从第一棘爪330脱开。预期释放弹簧352可包含任何合适的偏置部件，例如压缩弹簧、片弹簧或从释放开关350延伸的变形部件。
简单参考图3A，在初始和/或复位位置中，第一棘爪330安置于远侧凹孔314a内且第二棘爪340安置于近侧凹孔314b内。
继续参考图3A且额外参考图3B-3D，公开了棘轮组合件300的正常致动。在使用中，在触发器104从完全未致动位置被致动时，第一齿条310和第二齿条320的所述多个第一齿条齿312和第二齿条齿322分别移动到第一位置，变为分别与第一棘爪330和第二棘爪340的第一棘爪齿338和第二棘爪齿348对齐或接合(参见图3B)。
第一齿条310具有第一长度“L1”(参见图3A)，其允许第一棘爪330随着触发器104到达完全致动位置当第一齿条310相对于所述对夹爪250(参见图1)在远侧方向上移动时在第一齿条310上方逆转(从远侧凹孔314a；参见图3A)，且随着触发器104到达完全未致动位置当第一齿条310相对于所述对夹爪250在近侧方向上移动时在第一齿条310上方往回前进(从第一齿条310的近端310b；参见图3D)。第一齿条310的第一长度“L1”界定触发器104、驱动杆106或手柄组合件100的全冲程长度(参见图1)，其中夹片290已完全形成且从手术施夹器10发动。
第二齿条320具有第二长度“L2”(参见图3A)，其小于第一齿条310的第一长度“L1”。第二长度“L2”允许第二棘爪340随着触发器104到达部分致动位置当第二齿条320相对于所述对夹爪250(参见图1)在远侧方向上移动时在第二齿条320上方逆转(从近侧凹孔314b；参见图3A)，且随着触发器104到达完全未致动位置当第二齿条320相对于所述对夹爪250在近侧方向上移动时在第二齿条320上方往回前进(从第二齿条320的近端320b的近侧的位置；参见图3D)。第二齿条320的第二长度“L2”界定触发器104、驱动杆106或手柄组合件100的部分冲程长度(参见图1)，其中夹片290已部分地形成或者被形成为足以从手术施夹器10发动，且新夹片290装载到所述对夹爪250中而不会有夹片290进入所述对夹爪250的无意中双重装载。预期在棘轮组合件300的正常致动中，第一棘爪330和第二棘爪340以及相应第一齿条310和第二齿条320协作以使得触发器104、驱动杆106或手柄组合件100的冲程长度由第一齿条310的较大第一长度“L1”决定，以实现完全形成的夹片290从手术施夹器10发动。
现在参考图4A-4C，公开了棘轮组合件300的部分致动。预期棘轮组合件300的部分致动可以使得用户能够当执行胆管造影过程等时从手术施夹器10发动部分地形成的夹片290。还预期棘轮组合件300的部分致动可以使得用户能够在夹片290无意中定位于错误位置或者夹片290定位于堵塞处上方的情况下中止夹片290从手术施夹器10的发动。
在使用中，参考图4A，在触发器104被致动以使得第一齿条310和第二齿条320的所述多个第一齿条齿312和第二齿条齿322分别移动到第一位置变为分别与第一棘爪330和第二棘爪340的第一棘爪齿338和第二棘爪齿348对齐或接合(参见图3B)之后，释放开关350被致动以使得释放开关350围绕外壳102的安装销119枢转，且接合部件350b接合第一棘爪330以使第一棘爪330围绕第一棘爪销332旋转。以此方式，第一棘爪330移动到第二位置而脱离与第一齿条310的所述多个第一齿条齿312的对齐或接合。如图4A所示，虽然释放开关350被致动以将第一棘爪330移动到第二位置，但第二棘爪340保持于第一位置直到第二棘爪340移动到第二齿条320的近端320b的近侧的位置而清除第二齿条320，如图4B所示。在第一棘爪330脱离与第一齿条310的对齐或接合的情况下，触发器104、驱动杆106或手柄组合件100的冲程长度由第二齿条320的较小第二长度“L2”(相对于第一齿条310的第一长度“L1”)决定。在较小第二长度“L2”的持续时间中第二棘爪340与第二齿条320之间的接合防止在冲程的特定部分期间触发器104的无意中返回，直到装载到所述对夹爪250中的夹片290部分地形成而足以从手术施夹器10发动，以使得新夹片290可以装载到所述对夹爪250中而不会有夹片290进入所述对夹爪250的无意中双重装载。
现参看图4C，在释放开关350仍被致动以接合第一棘爪330的情况下，一旦第二棘爪340在第二齿条320上方往回前进且安置于近侧凹孔314b内以完成棘轮组合件300的部分致动，触发器104就可以返回到完全未致动位置(从其部分地致动的位置)。随后可以释放释放开关350以使得在释放弹簧352的偏置下释放开关350返回到其原始位置且第一棘爪330安置于远侧凹孔314a内(参见图3A)。
在实施例中，预期如果在棘轮组合件300的部分致动的一部分期间释放释放开关350(例如，参见图4A)，使得释放开关350的接合部件350b从第一棘爪330脱开，那么第一棘爪弹簧336被设置为使第一棘爪330返回到第一位置，以使得第一齿条310的所述多个第一齿条齿312移动为与第一棘爪330的第一棘爪齿338对齐或接合。因此，手术施夹器10返回到棘轮组合件300的正常致动(参见图3A-3D)，其中触发器104、驱动杆106或手柄组合件100的冲程长度由第一齿条310的较大第一长度“L1”(相对于第二齿条320的第二长度“L2”)决定，以实现完全形成的夹片290从手术施夹器10发动。此特征在例如无意中致动释放开关350的例子中可以是有利的。
现在参考图5A-5C，公开了棘轮组合件300的正常致动的返回冲程。在触发器104处于完全致动位置以使得第一棘爪330安置于第一齿条310的近端310b且第二棘爪340安置于第二齿条320的近端320b的近侧的位置(参见图5A)的情况下，释放触发器104以使得第一齿条310和第二齿条320相对于所述对夹爪250在近侧方向上移动。同时，第一棘爪330和第二棘爪340分别在第一齿条310和第二齿条320上方前进，以使得第一齿条310和第二齿条320的所述多个第一齿条齿312和第二齿条齿322分别移动到第一位置，变为分别与第一棘爪330和第二棘爪340的第一棘爪齿338和第二棘爪齿348对齐或接合(参见图5B)。在返回冲程期间，如果释放开关350被致动，则第一棘爪330围绕第一棘爪销332旋转以使得第一棘爪330的锁定部件339被定位成接合释放开关350的接合部件350b。以此方式，第一棘爪330的第一棘爪齿338与第一齿条310的所述多个第一齿条齿312之间的对齐或接合与第一棘爪330的锁定部件339协作以防止释放开关350接合第一棘爪330而使第一棘爪300的第一棘爪齿338旋转或移动脱离与第一齿条310的所述多个第一齿条齿312的对齐或接合。预期此特征确保触发器104移动到完全未致动位置，新夹片290装载到所述对夹爪250中，且棘轮组合件300移动到初始和/或复位位置，其中第一棘爪330安置于远侧凹孔314a内且第二棘爪340安置于近侧凹孔314b内(参见图3A)。
虽然本公开的图说明第一齿条310和第二齿条320在驱动杆106上纵向对准的配置，但在释放开关350与第一棘爪330可选择性接合的情况下，预期第一齿条310和第二齿条320可包含其中第一齿条310和第二齿条320逆转、堆叠、并排或以上各项的组合的配置。此外，预期释放开关350可以与第二棘爪340选择性接合。另外，预期致动释放开关350可以向用户发出听觉和/或触觉反馈。
如上所述且在图6中说明，手术施夹器10包含内窥镜组合件200，其具有毂组合件210、轴杆组合件220和所述对夹爪250。毂组合件210可旋转地安装在手柄组合件100的外壳102的鼻部102c(参见图2A)上，且连接到轴杆组合件220的近端部分以提供其上的轴杆组合件220和所述对夹爪250相对于轴杆组合件220的纵向中心轴线的三百六十度旋转。毂组合件210具有合适的配置以便使用临床医生的手指简单地旋转。
内窥镜组合件200包含主轴连杆260，所述主轴连杆用于将驱动杆106以操作方式连接到驱动机构400，以在致动触发器104后使所述对夹爪250在间隔开的配置与接近的配置之间移动。具体地说，驱动杆106的钩部件114(参见图2B)联接到主轴连杆260的第一末端260a，且驱动机构400的主轴270联接到主轴连杆260的第二末端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使主轴270前进和缩回。
驱动机构400进一步包含用于保持若干手术夹片290的伸长的夹片通道部件280，所述若干手术夹片以在夹片通道部件280上方的对准方式示出。夹片跟随器282和夹片跟随器弹簧284被设置成向远侧推动手术夹片290通过伸长的夹片通道部件280。通道盖286被设置成覆盖伸长的夹片通道部件280，且在伸长的夹片通道部件280中向远侧保持且导引夹片跟随器282和夹片跟随器弹簧284以及手术夹片290。
驱动机构400还具有用于在所述对夹爪250之间馈送手术夹片290的馈送杆410。驱动机构400还包含填充物组件420和楔板430。
对于内窥镜组合件200的构造和操作的更详细描述，可以参考第7,637,917号美国专利，其整个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形式和修改形式。因此，本公开旨在涵盖所有这类替代、修改和变化。呈现参照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、方法和技术也希望在本公开的范围内。
Claims (20)
1.一种内窥镜手术施夹器，包括：
内窥镜组合件，包含：
轴杆组合件；以及
一对夹爪部件，所述对夹爪部件以操作方式联接到所述轴杆组合件且从所述轴杆组合件延伸；以及
手柄组合件，包含：
外壳，所述外壳能够选择性连接到所述内窥镜组合件；
固定手柄，所述固定手柄从所述外壳延伸；以及
触发器，所述触发器枢转地连接到所述固定手柄；
驱动杆，所述驱动杆安置于所述手柄组合件的所述外壳内且以操作方式联接到所述触发器和所述对夹爪部件，以在所述触发器的致动后使所述对夹爪部件在间隔开的配置与接近配置之间移动；
棘轮组合件，所述棘轮组合件安置于所述手柄组合件的所述外壳内，所述棘轮组件包含：
第一齿条，所述第一齿条以操作方式联接到所述驱动杆，所述第一齿条界定多个第一齿条齿且具有远端和近端，其中所述第一齿条包含位于其所述远端与所述近端之间的第一长度；以及
第二齿条，所述第二齿条以操作方式联接到所述驱动杆且与所述第一齿条间隔开，所述第二齿条界定多个第二齿条齿且具有远端和近端，其中所述第二齿条包含位于其所述远端与所述近端之间的第二长度，所述第二齿条的所述第二长度小于所述第一齿条的所述第一长度。
2.根据权利要求1所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含安装在所述手柄组合件的所述外壳内的第一棘爪，所述第一棘爪在其第一位置中能够与所述第一齿条的所述多个第一齿条齿选择性接合。
3.根据权利要求2所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含安装在所述手柄组合件的所述外壳内的第二棘爪，所述第二棘爪在其第一位置中能够与所述第二齿条的所述多个第二齿条齿选择性接合。
4.根据权利要求3所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含邻近于所述第一齿条的所述远端安置的远侧凹孔，其中在所述触发器的未致动位置中所述第一棘爪定位于所述远侧凹孔中。
5.根据权利要求4所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含安置于所述第一齿条的所述近端与所述第二齿条的所述远端之间的近侧凹孔，其中在所述触发器的所述未致动位置中所述第二棘爪定位于所述近侧凹孔中。
6.根据权利要求5所述的内窥镜手术施夹器，其中所述第一齿条安置于所述第二齿条的远侧的位置中。
7.根据权利要求2所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含至少部分地支撑在所述手柄组合件的所述外壳内且与所述第一棘爪以操作方式相关联的释放开关，所述释放开关能够选择性致动以将所述第一棘爪从所述第一位置移动到第二位置，在所述第一位置中所述第一棘爪与所述第一齿条的所述多个第一齿条齿对齐，在所述第二位置中所述第一棘爪脱离与所述第一齿条的所述多个第一齿条齿的对齐。
8.根据权利要求7所述的内窥镜手术施夹器，其中当所述释放开关被致动时，所述第二棘爪在其所述第一位置中维持与所述第二齿条的所述多个第二齿条齿的对齐，直到所述第二棘爪安置于所述近侧凹孔中或者直到所述第二棘爪向近侧安置超出所述第二齿条的所述近端。
9.根据权利要求8所述的内窥镜手术施夹器，其中所述驱动杆在所述触发器的致动后能够纵向移动，其中当所述驱动杆在第一方向上纵向移动且所述释放开关未被致动时，所述第一棘爪和所述第二棘爪分别在所述第一齿条和所述第二齿条的所述多个第一齿条齿和所述多个第二齿条齿上方移动，以使得所述驱动杆在第二相反方向上的纵向移动被阻止，直到所述第一棘爪安置于所述远侧凹孔中且所述第二棘爪安置于所述近侧凹孔中或者直到所述第一棘爪安置于所述第一齿条的所述近端处且所述第二棘爪向近侧安置超出所述第二齿条的所述近端。
10.根据权利要求8所述的内窥镜手术施夹器，其中所述驱动杆在所述触发器的致动后能够纵向移动，其中当所述驱动杆在第一方向上纵向移动且所述释放开关被致动以使所述第一棘爪移动脱离与所述第一齿条的所述多个第一齿条齿的对齐时，所述驱动杆在第二相反方向上的纵向移动被阻止，直到所述第二棘爪安置于所述近侧凹孔中或者直到所述第二棘爪向近侧安置超出所述第二齿条的所述近端。
11.根据权利要求10所述的内窥镜手术施夹器，其中当所述驱动杆在所述第一方向上纵向移动且所述释放开关被致动以使所述第一棘爪移动脱离与所述第一齿条的所述多个第一齿条齿的对齐时，在所述触发器到达部分致动位置时所述第二棘爪被安置超出所述第二齿条的所述近端，其中在所述触发器从所述部分致动位置到达完全未致动位置时所述驱动杆能够在所述第二相反方向上纵向移动。
12.根据权利要求11所述的内窥镜手术施夹器，其中所述内窥镜组合件进一步包括可滑动地安置于所述轴杆组合件内且能够在所述对夹爪部件之间选择性形成的多个手术夹片，其中当所述第一棘爪在所述第一位置中时，所述第一棘爪与安置于所述驱动杆上的所述第一齿条对齐，使得在所述触发器的致动后防止所述触发器逆转其所述移动方向，直到所述触发器移动到完全致动位置且所述多个手术夹片中的最远侧手术夹片在所述对夹爪部件之间完全形成。
13.根据权利要求12所述的内窥镜手术施夹器，其中当所述第一棘爪外壳在所述第二位置中时，所述第一棘爪脱离与安置于所述驱动杆上的所述第一齿条的对齐，以使得当所述第二棘爪被安置超出所述第二齿条的所述近端且所述触发器移动到所述部分致动位置时，所述触发器能够逆转其所述移动方向以使得所述多个手术夹片中的所述最远侧手术夹片部分地形成于所述对夹爪部件之间。
14.根据权利要求3所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含支撑在所述手柄组合件的所述外壳内的第一棘爪弹簧和第二棘爪弹簧，所述第一棘爪弹簧被配置成将所述第一棘爪偏置为与所述第一齿条的所述多个第一齿条齿接合，且所述第二棘爪弹簧被配置成将所述第二棘爪偏置为与所述第二齿条的所述多个第二齿条齿接合。
15.根据权利要求11所述的内窥镜手术施夹器，其中所述第一棘爪包含从其延伸的锁定部件，所述锁定部件被设置成在所述触发器移动到所述完全未致动位置时选择性接合所述释放开关，以防止所述释放开关使所述第一棘爪移动脱离与所述第一齿条的所述多个第一齿条齿的对齐而到其所述第二位置。
16.根据权利要求7所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含支撑于所述手柄组合件中的释放弹簧，所述释放弹簧与所述释放开关以操作方式相关联且被偏置以使所述释放开关返回到起始位置以使得所述释放开关从所述第一棘爪脱开。
17.一种内窥镜手术施夹器，包括：
内窥镜组合件，包含：
轴杆组合件；以及
一对夹爪部件，所述对夹爪部件以操作方式联接到所述轴杆组合件且从所述轴杆组合件延伸；以及
手柄组合件，包含：
外壳，所述外壳能够选择性连接到所述内窥镜组合件；
固定手柄，所述固定手柄从所述外壳延伸；以及
触发器，所述触发器枢转地连接到所述固定手柄；
驱动杆，所述驱动杆安置于所述手柄组合件的所述外壳内且以操作方式联接到所述触发器和所述对夹爪部件，以在所述触发器的致动后使所述对夹爪部件在间隔开的配置与接近配置之间移动；以及
棘轮组合件，所述棘轮组合件安置于所述手柄组合件的所述外壳内，所述棘轮组件包含：
第一齿条，所述第一齿条界定于所述驱动杆的顶部部分上，所述第一齿条包含多个第一齿条齿且具有远端和近端；
第二齿条，所述第二齿条界定于所述驱动杆的所述顶部部分上，所述第二齿条包含多个第二齿条齿且具有远端和近端；
第一棘爪，所述第一棘爪可移动地安装在所述手柄组合件内且能够与所述第一齿条的所述多个第一齿条齿选择性接合；以及
第二棘爪，所述第二棘爪可移动地安装在所述手柄组合件内且能够与所述第二齿条的所述多个第二齿条齿选择性接合，其中在所述触发器的移动后所述触发器的移动方向的逆转被禁止，直到所述第二棘爪向远侧安置超出所述第二齿条的所述远端或向近侧安置超出所述第二齿条的所述近端。
18.根据权利要求17所述的内窥镜手术施夹器，其中所述第一齿条包含位于其所述远端与所述近端之间的第一长度，且其中所述第二齿条包含位于其所述远端与所述近端之间的第二长度，所述第二齿条的所述第二长度小于所述第一齿条的所述第一长度。
19.根据权利要求17所述的内窥镜手术施夹器，其中所述棘轮组合件进一步包含至少部分地支撑在所述手柄组合件的所述外壳内且与所述第一棘爪以操作方式相关联的释放开关，所述释放开关能够选择性致动以将所述第一棘爪从第一位置移动到第二位置，在所述第一位置中所述第一棘爪与所述第一齿条的所述多个第一齿条齿对齐，在所述第二位置中所述第一棘爪脱离与所述第一齿条的所述多个第一齿条齿的对齐。
20.根据权利要求19所述的内窥镜手术施夹器，其中当所述释放开关从所述第一棘爪脱开以使得所述第一棘爪保持于所述第一位置时，在所述触发器的移动后所述触发器的所述移动方向的所述逆转被禁止，直到所述第一棘爪向远侧安置超出所述第一齿条的所述远端或安置于所述第一齿条的所述近端处。
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Also Published As
| Publication number | Publication date |
|---|---|
| JP7086619B2 (ja) | 2022-06-20 |
| US10758244B2 (en) | 2020-09-01 |
| JP2018126504A (ja) | 2018-08-16 |
| EP3357436B1 (en) | 2020-12-30 |
| US20180221028A1 (en) | 2018-08-09 |
| EP3357436A1 (en) | 2018-08-08 |
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