CN108451568B - 用于具有低剖面推动器的手术器械的装载单元 - Google Patents
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Abstract
一种用于与手术器械接合且包含双推动器和双保持腔的装载单元。至少一个双推动器包含：第一本体部分，具有配置成接合第一紧固件的一部分的第一上部表面；第二本体部分，具有配置成接合第二紧固件的一部分的第二上部表面；以及桥接器，使所述第一本体部分和所述第二本体部分互连。所述第一上部表面和所述第二上部表面中的每一个定义相对于纵向轴线的锐角。至少一个双保持腔包含配置成接合保持在其中的所述双推动器的所述第一本体部分的近侧推动器导引表面的第一保持导引表面，以及配置成接合保持在其中的所述双推动器的所述第一本体部分的远侧推动器导引表面的第二保持导引表面。
Description
技术领域
本公开大体上涉及用于以手术方式连接组织的器械，且更具体地说，涉及用于具有低剖面推动器的手术器械的装载单元。
背景技术
本领域中已知各种类型的用于以手术方式连接组织的手术器械，且所述手术器械通常用于例如在横切术、切除术、吻合术中闭合组织或器官，用于在胸部及腹部手术中缝合器官，以及用于以电外科学方式融合或密封组织。
此类手术器械的一个实例是手术钉合器械，所述手术钉合器械可以包含：砧座组件；卡盘组件，用于支撑一系列的手术紧固件；逼近机构，用于使卡盘与砧座组件接近；以及发射机构，用于将手术紧固件从卡盘组件中弹出。
使用手术钉合器械时，外科医生通常使砧座和卡盘构件接近。接下来，外科医生可以启动手术钉合器械以将手术紧固件安放于组织中。另外，外科医生可以使用同一器械或单独的器械来剪切与手术紧固件的行相邻的或其之间的组织。
另外，装载单元(例如，单次使用的装载单元或一次性装载单元)可以附接到手术钉合器械的细长或内窥镜部分上。此类装载单元允许手术钉合器械具有较大的通用性。装载单元可以配置成单次使用，和/或可以配置成多次使用。
另外，末端执行器和/或装载单元的大小通常受其中所含有的各种组件限制。即，可能需要直径小于那些通常可使用的末端执行器和/或装载单元，但末端执行器和/或装载单元的直径通常受到例如其中所含有的推动器、I形梁、致动滑板和紧固件的大小、几何形状和/或定向的限制。
发明内容
本公开涉及一种配置成用于与手术器械接合的装载单元。所述装载单元包含近侧本体部分、末端执行器、致动滑板、双推动器和双保持腔。近侧本体部分定义纵向轴线。末端执行器设置成与近侧本体部分机械配合，且包含卡盘组件(cartridge assembly)和砧座组件。卡盘组件和砧座组件中的一个可在打开位置与接近位置之间相对于卡盘组件和砧座组件中的另一个移动。卡盘组件配置成容纳其中的紧固件。致动滑板可在卡盘组件内纵向平移。双推动器设置在卡盘组件内。至少一个双推动器包含：第一本体部分，具有配置成接合第一紧固件的一部分的第一上部表面；第二本体部分，具有配置成接合第二紧固件的一部分的第二上部表面；以及桥接器，使所述第一本体部分和所述第二本体部分互连。第一本体部分包含近侧推动器导引表面和远侧推动器导引表面。第一上部表面和第二上部表面中的每一个定义相对于纵向轴线的锐角。双保持腔设置在卡盘组件内，且各双保持腔配置成保持一个双推动器在其中。至少一个双保持腔包含配置成接合保持在其中的双推动器的第一本体部分的近侧推动器导引表面的第一保持导引表面，以及配置成接合保持在其中的双推动器的第一本体部分的远侧推动器导引表面的第二保持导引表面。
在所公开的实施例中，至少一个双推动器可以包含设置在第一本体部分的下部表面上的第一斜坡。第一斜坡可以配置成通过致动滑板的第一倾斜的楔状物来接合。还公开，至少一个双推动器可以包含设置在第二本体部分的下部表面上的第二斜坡。第二斜坡可以配置成通过致动滑板的第二倾斜的楔状物来接合。另外，公开第一斜坡可以相对于纵向轴线成平行角的方式设置，且第二斜坡可以相对于纵向轴线成平行角的方式设置。进一步公开，第一斜坡可以设置在第一本体部分的上部表面的一部分的正下方，且第二斜坡可以设置在第二本体部分的上部表面的一部分的正下方。
在实施例中，所述锐角可以在约30°与约60°之间。
还公开，至少一个双保持腔可以包含配置成接合保持在其中的双推动器的第二本体部分的近侧推动器导引表面的第三保持导引表面，以及配置成接合保持在其中的双推动器的第二本体部分的远侧推动器导引表面的第四保持导引表面。
在所公开的实施例中，所述桥接器可以使第一本体部分的近侧部分与第二本体部分的远侧部分互连。
进一步公开，末端执行器的最外直径可为约12mm，其中末端执行器处于接近位置中。另外，公开了装载单元可以包含至少部分保持在卡盘组件内的紧固件。至少一个紧固件可以具有约5mm的高度。
本公开还涉及配置成用于与手术器械一起使用的末端执行器。末端执行器包含卡盘组件、砧座组件、致动滑板、推动器和多个紧固件。卡盘组件和砧座组件中的一个可在打开位置与接近位置之间相对于卡盘组件和砧座组件中的另一个移动。致动滑板可在卡盘组件内沿纵向轴线平移。推动器至少部分设置在卡盘组件内且配置成通过致动滑板来选择性地接合。至少一个推动器具有配置成接合第一紧固件的第一上部表面和配置成由致动滑板的第一楔状物接合的第一斜坡。第一上部表面以相对于纵向轴线成锐角的方式设置。第一斜坡是以相对于纵向轴线成平行角的方式设置。多个紧固件至少部分保持在卡盘组件内。多个紧固件中的每个紧固件设置成与多个推动器中的一个推动器接触，且多个紧固件中的每个紧固件包含约5mm的高度。末端执行器的最外直径为约12mm。
在所公开的实施例中，至少一个推动器可以包含配置成接合第二紧固件的第二上部表面和配置成由致动滑板的第二楔状物接合的第二斜坡。还公开第一上部表面可以平行于第二上部表面。
在实施例中，第一斜坡可以设置在第一上部表面的一部分的正下方。进一步公开，第二斜坡可以设置在第二上部表面的一部分的正下方。
还公开了锐角可以在约30°与约60°之间。
在所公开的实施例中，第一上部表面可以包含在至少一个推动器的第一本体部分上，且第二上部表面可以包含在至少一个推动器的第二本体部分上，且推动器还可以包含使第一本体部分的近侧部分与第二本体部分的远侧部分互连的桥接器。
附图说明
在本文中参考随附图式说明本公开的各种实施例，其中：
图1是根据本公开的实施例的手术器械的透视图；
图2是根据本公开的具有末端执行器的装载单元的透视图，图示处于打开位置的末端执行器；
图3是图2的装载单元的侧视图，图示处于接近位置的末端执行器；
图4是图3的末端执行器的一部分的远端视图；
图5说明图2中指定的详细区域；
图5A说明图5中指定的详细区域；
图5B是图5A的末端执行器的卡盘组件的俯视图；
图5C是由图5的末端执行器的使用而产生的钉线的俯视图；
图6是图5B的包含与其接合的多个紧固件的末端执行器的卡盘组件的一部分的透视图；
图7是图2的末端执行器的卡盘组件的组件视图；
图8是图1到图7的末端执行器的两对双推动器的透视图；
图9是图8的一对双推动器的下侧的透视图；
图10是图8和图9的双推动器中的一个的横截面视图；
图11是图2的卡盘组件的致动滑板和图8的一对双推动器的透视图；
图12说明图6中指定的详细区域；
图13A是根据本公开的末端执行器的卡盘组件且其中不具有推动器的透视图；
图13B说明图13A中指定的详细区域；
图13C说明图13A中指定的详细区域，其中在卡盘组件内增加了推动器；
图14是沿图4的线14-14截取的末端执行器的部分的剖视图；
图15是沿图4的线15-15截取的末端执行器的部分的剖视图；
图16是根据本公开的实施例的双推动器的透视图；以及
图17是根据本公开的实施例的单个推动器的透视图。
具体实施方式
参考图式详细描述本发明所公开的手术器械、与其一起使用的装载单元、以及与其一起使用的卡盘组件的实施例，其中相同的参考标号表示几个视图中的每一个中的对应元件。如本领域中常见的，术语“近侧”是指较接近用户或操作员(例如外科医生或医生)的那一构件或组件，而术语“远侧”是指较远离用户的那一构件或组件。
本公开的手术器械在图1中指定为参考标号100。通常，手术器械100包含：手柄组件110；细长部分120，从手柄组件110向远侧延伸；和装载单元200，邻接细长部分120的远端而设置。尽管图1说明包含手柄组件的手术器械100，所述手柄组件包含可移动手柄112和静止手柄，但可以使用其它类型的手柄，例如电动型、电驱动型、液压型、棘轮型等。如本文中所使用，“手柄组件”涵盖所有类型的手柄组件。装载单元200可以可释放方式附接到手术器械100的细长部分120，例如以允许手术器械100更具多功能性。此布置允许临床医生选择用于指定手术的特定装载单元200。如本文中所使用，“装载单元”涵盖单次使用装载单元(“SULU”)和一次性装载单元(“DLU”)两种。另外或替代地，手术器械100可以具有卡盘，所述卡盘在手术器械100的可再用的夹钳中是可拆装且可替换的。
供与手术钉合器械一起使用的装载单元的实例公开于Bolanos等人共同拥有的美国专利第5,752,644号中，所述专利的全部内容由此以引用的方式并入本文中。内窥镜手术钉合器械的其它细节详细地描述于Milliman等人共同拥有的美国专利第6,953,139号中，所述专利的全部内容由此以引用的方式并入本文中。
在根据本公开的手术器械100中，发射杆(未图示)回应于手柄组件110的致动而向远侧移动以部署紧固件600(图6和图7)。参考图1中所说明的实施例，可移动手柄112的至少一部分致动纵向平移发射杆。发射杆的远侧平移引起夹持构件500(图7)的远侧平移以相对于另一个接近至少一个夹钳构件，如在下文进一步详细讨论。夹持构件500的远侧平移还引起致动滑板520的相应平移，所述致动滑板以依序方式接合推动器800(图7)，且其引起推动器800在卡盘组件400的保持腔1000(图5A)内移动，以使得紧固件600从此处弹出，如在下文进一步详细讨论(图7)。
参考图2，展示根据本公开的装载单元200。装载单元200包含定义纵向轴线“A-A”的近侧本体部分210，和包含第一夹钳构件或砧座组件300的工具组件或末端执行器220以及第二夹钳构件或卡盘组件400。卡盘组件400包含设置在卡盘通道409内的卡盘408(图7)。近侧本体部分210配置成以可拆卸方式附接到如将在下文中详细论述的手术器械100的细长部分120(图1)上。另外，末端执行器220可相对于近侧本体部分210(和纵向轴线“A-A”)枢转。
与具有约15mm直径的更常规器械相比，本文中所公开的装载单元200的各种特征允许装载单元200具有相对较小的直径“d”(例如约12mm)。如图3和图4中所展示，装载单元200，且确切地说末端执行器220的直径“d”是在砧座组件300的径向最外侧壁与卡盘组件400的径向最外侧壁之间测量的。此类低剖面允许将装载单元200插入到具有相似内径的套管针或其它进入装置中。预计可以将本发明所公开的末端执行器220插入到身体组织中具有类似直径的开口(例如，切口或天然存在的孔口)中。如可以理解，举例来说，此类低剖面装载单元200适用于儿科手术和/或其它组织部位。
另外，在所说明的实施例中，对装载单元200的近侧本体部分210的近侧部分212设定大小且将其配置成接合手术器械100的细长部分120(图1)。设想手术器械100的细长部分120包含与装载单元200的直径“d”相同或相似的直径(例如，约12mm)，由此实现更大的通用性。
更确切地说，参考图2和图3，可以线性方式将装载单元200的插入尖端202插入到手术器械100的细长部分120的远端(图1)中。插入尖端202的凸块204以线性方式移动穿过邻近细长部分120的远端而形成的槽口(未图示)。随后，使装载单元200围绕纵向轴线“A-A”相对于细长部分120旋转，使得凸块204相对于纵向轴线“A-A”横向移动穿过细长部分120内的槽口。另外，在装载单元200和细长部分120的接合期间，手柄组件110的发射杆接合装载单元200的驱动杆510(图7)的一部分。如图7中所展示，驱动杆510的远端耦合到夹持构件500。
参考图7，夹持构件500包含I形横截面，其包含：顶部部分502，所述顶部配置成接合砧座组件300(图2)；底部部分504，所述底部配置成接合卡盘组件400；和竖直部分503，所述竖直部分连接顶部部分502和底部部分504，且其可以包含在其远侧或前表面上的切割边缘506。另外，通过末端执行器220使夹持构件500向远侧前进引起底部部分504接触卡盘组件400的凸轮表面402(图3)。夹持构件500的继续向远侧前进由此引起卡盘组件400相对于砧座组件300从其打开位置(图2)朝其接近位置(图3)枢转。进一步设想，砧座组件300可以相对于固定的卡盘组件400枢转。因此，发射杆(且由此驱动杆510)的预定量的远侧移动引起夹钳构件的接近。另外，如果夹持构件500的切割边缘506包含于夹持构件500上，那么当切割边缘506通过卡盘组件400的介刀通道401(图5到图6)时，切断设置在夹钳构件(在已经紧固组织之后)之间的组织。在末端执行器220是曲形的实施例中，介刀通道401可以定义纵向轴线。
进一步考虑致动滑板520，致动滑板520向远侧平移依序接合推动器800，且引起推动器800在箭头“B”的大体方向(图7)上移动且朝砧座组件300(图3)弹出紧固件600。如上文所提及，在弹出紧固件600之后，夹持构件500的切割边缘506可以切断钉合的组织。
特别参考图7、图14和图15，将公开致动滑板520的其它细节。致动滑板520包含四个倾斜的楔状物524a、524b、524c、524d，其中的每一个配置成接触推动器800的凸轮表面、倾斜表面或斜坡840、850，如下文所论述。致动滑板520的楔状物524a、524b、524c、524d与推动器800的凸轮表面840、850之间的接合引起推动器800在箭头“B”的大体方向(图7)上移动，这使得紧固件600从卡盘组件400的保持腔1000中弹出，且朝向砧座组件300的对应的钉成形凹座(未图示)(例如，通过保持在夹钳构件之间的组织)。
现在参考图8到图11，公开推动器800的其它细节。通常，推动器800包含多个双推动器，其中各双推动器保持在卡盘组件400的保持腔1000(图14和图15)内。
特别参考图7和图8，推动器800包含第一双推动器800a和第二双推动器800b。第一双推动器800a设置在卡盘组件400的介刀通道401的第一侧上，且第二双推动器800b设置在卡盘组件400的介刀通道401的第二侧上。各双推动器800a配置成接合两个紧固件600：介刀通道401的第一侧上内排中的一个紧固件600和外排中的一个紧固件600。各双推动器800b配置成接合两个紧固件600：介刀通道401的第二侧上内排中的一个紧固件600和外排中的一个紧固件600。第一双推动器800a是第二双推动器800b的镜像。因此，仅在本文中论述一个双推动器800a的细节，且其通常被称为推动器或双推动器800。
参考图8和图9，双推动器800包含第一本体部分810，第二本体部分820，桥接器830，第一凸轮构件、倾斜表面或斜坡840以及第二凸轮构件、倾斜表面或斜坡850。将双推动器800放置在卡盘组件400内，以使得第一本体部分810和第二本体部分820以相对于纵向轴线“A-A”成角度α(参看图5C)的方式设置。尽管角度α可在约30°与约60°之间，但也涵盖例如较大角和较小角。
另外，第一本体部分810包含拱形近侧边缘813和拱形远侧边缘814，且第二本体部分820包含拱形近侧边缘823和拱形远侧边缘824(图9)。各近侧边缘813、823和远侧边缘814、824配置成接合保持腔1000的相应部分(图5)以有助于导引和/或对准双推动器800相对于卡盘组件400的移动。桥接器830在第一本体部分810与第二本体部分820之间垂直延伸且使两者互连。更确切地说，桥接器830使第一本体部分810的近侧部分和第二本体部分820的远侧部分互连。
参考图8，配置双推动器800的第一本体部分810的上部表面或通道815和第二本体部分820的上部表面或通道825且将其大小设置为接合一个紧固件600的后跨部602(图11)。举例来说，上部通道815和上部通道825包含拱形横截面，这有助于使与后跨部602的圆柱形部分的接合最佳。
现在参考图10和图11，楔状物524a到524d配置成接合双推动器800的第一凸轮构件840和第二凸轮构件850。更确切地说，楔状物524b配置成接合第一双推动器800a的第一凸轮构件840，楔状物524c配置成接合第二双推动器800b的第一凸轮构件840，楔状物524a配置成接合第一双推动器800a的第二凸轮构件850，以及楔状物524d配置成接合第二双推动器800b的第二凸轮构件850。
在使用时，致动滑板520通过卡盘组件400向远侧移动引起致动滑板520的楔状物524b和楔状物524c接触双推动器800a、800b的第一凸轮构件840，且引起楔状物524a和楔状物524d接触双推动器800a、800b的第二凸轮构件850，这因此引起双推动器800a、800b在箭头“B”的大体方向(图7)上移动。各双推动器800a、800b的这种移动引起两个相应的紧固件600从卡盘组件400的保持腔1000中弹出。
参考图10，第一本体部分810的上部通道815相对于双推动器800的下部表面802的高度“h1”大于第二本体部分820的上部通道825相对于双推动器800的下部表面802的高度“h2”。据公开，高度“h1”在约1.42mm与约1.62mm之间(例如，等于约1.52mm)，且高度“h2”在约1.04mm与约1.24mm之间(例如，等于约1.14mm)。
另外，参考图8和图9，第一凸轮构件840以相对于第一本体部分810的上部通道815成锐角(例如，在约30°与约60°之间，举例来说)的方式设置，且第二凸轮构件850以相对于第二本体部分820的上部通道825成锐角(例如，在约30°与约60°之间，举例来说)的方式设置。第一凸轮构件840和第二凸轮构件850各自平行于介刀通道401和纵向轴线“A-A”。另外，第一凸轮构件840的一部分放置在第一本体部分810的上部通道815的正下方，且第二凸轮构件850的一部分放置在第二本体部分820的上部通道825的正下方。由于在桥接器830下方不存在凸轮表面，因此将凸轮构件840、850分别放置在上部通道815、825下方使得桥接器830高度能够降低(相对于双推动器800的下部表面802(图10))。另外，桥接器830的高度降低使得推动器800能够具有相对于先前类型的推动器降低的高度。由于推动器800的高度相对较小，因此推动器800可以移动的距离量(即，“推动器行程”)相对较大。此较大“推动器行程”允许将较大紧固件600(例如，具有约5mm的高度)用于连接卡盘组件400。另外，推动器800配置成以鲱骨状图案的方式弹出紧固件600，如图5C中所展示。所得钉合线包含以相对于纵向轴线“A-A”成锐角α(例如，在约30°与约60°之间，举例来说)的方式设置的紧固件600。
参考图8，推动器800的第一本体部分810包含第一导向区块870，且推动器800的第二本体部分820包含第二导向区块880。导向区块870、880配置成接合保持腔1000的相应的导引表面，如下文所论述。将导向区块870、880与保持腔1000的相应导引表面之间的接合配置成导引至少部分保持在保持腔1000内的推动器800的移动。在所说明的实施例中，导向区块870的上部表面872与第一本体部分810的上部表面817齐平，且导向区块880的上部表面882与第二本体部分820的上部表面827齐平。
导向区块870包含平行于纵向轴线“A-A”设置的宽度“w1”，且导向区块880包含平行于纵向轴线“A-A”设置的宽度“w2”。在导向区块870的近侧表面870a与远侧表面870b之间测量宽度“w1”，且在导向区块880的近侧表面880a与远侧表面880b之间测量宽度“w2”(图8)。宽度“w1”和宽度“w2”都可以在约0.92mm与约1.12mm之间(例如，等于约1.02mm)。导向区块870、880的高度可分别与第一本体部分810和第二本体部分820的高度相同。即，导向区块870的高度“h1”可在约1.42mm与约1.62mm之间(例如，等于约1.52mm)，且导向区块880的高度“h2”可在约1.04mm与约1.24mm之间(例如，等于约1.14mm)(参看图10)。
因此，导向区块870的高宽比为约1.5:1，且导向区块880的高宽比为约1.1:1。此较大比率(相对于更多传统的推动器)有助于使得能够使用相对较短的推动器800，这有助于实现在相对较小直径“d”的末端执行器200(例如，12mm)中使用相对较大的紧固件600(例如，5mm)。
另外，在双推动器800(即，第一双推动器800a和第二双推动器800b)的任一定向中，第一本体部分810的上部通道815的高度“h1”比第二本体部分820的上部通道825更接近介刀通道401。此处，第一本体部分810的上部通道815可以接合较小紧固件(例如，4mm的缝钉)，而第二本体部分820的上部通道825可以接合较大紧固件(例如，5mm的缝钉)。
参考图12，推动器800配置成接合和/或通过多个特定位置中的保持腔1000来导引。确切地说，推动器800包含设置在导向区块870的近侧表面上的第一推动器导引表面或第一导引表面873、设置在导向区块870的远侧表面上的第二推动器导引表面或第二导引表面874、设置在导向区块880的近侧表面上的第三推动器导引表面或第三导引表面883以及设置在导向区块880的远侧表面上的第四推动器导引表面或第四导引表面884。
如图5和图5A(或图5到图5B)中所展示，例如，保持腔1000沿卡盘组件400的组织接触表面410以倾斜或鲱骨状图案配置。保持腔1000包含相应导引表面，所述相应导引表面配置成接合和/或导引至少部分保持在其中的推动器800的移动。确切地说，且特别参考图12，保持腔1000在某种程度上是通过以下定义的：配置成接合或导引推动器800的第一导引表面873的第一保持导引表面或第一导引表面1002；配置成接合或导引推动器800的第二导引表面874的第二保持导引表面或第二导引表面1004；配置成接合或导引推动器800的第三导引表面883的第三保持导引表面或第三导引表面1006；以及配置成接合或导引推动器800的第四导引表面884的第四保持导引表面或第四导引表面1008。
推动器800的各部分的定向使得装载单元200的直径“d”(图2和图3)能够小于更多常规的器械。例如，本公开的装载单元200的直径“d”可以为约12mm，而更多常规装载单元的直径可以为约15mm。在其它类型的装载单元中，推动器的本体部分(即，直接在其上支撑紧固件的部分)包含导引表面，其接合保持槽口内的相应导引表面。在本公开中，且如上文所论述，推动器的导引表面包含在推动器800的导向区块870和导向区块880上。由于导引表面不包含(或不单独包含)在推动器800的本体部分上，推动器800的总高度相对于先前类型的推动器可能减小。由于推动器800的高度相对较小，推动器800可以移动的距离量(即，“推动器行程”)相对较大。此较大“推动器行程”允许将较大紧固件600(例如，具有约5mm的高度)用于连接卡盘组件400。
本公开还包含使用具有彼此相同高度的紧固件600，和/或具有与其它紧固件600不同高度的紧固件600。举例来说，位于最远离卡盘组件400的介刀通道401的外排中的紧固件600可以具有比位于最接近于介刀通道401内排的紧固件600(例如，4mm)更大的高度(例如，5mm)。卡盘组件400的组织接触表面410的步进式配置可以促进具有不同高度的紧固件600的使用。具有不同高度的紧固件和步进式组织接触表面的其它细节公开于Czernik共同拥有的美国专利申请公开案第2016/0270788号中，所述专利的全部内容由此以引用的方式并入本文中。
还设想，将装载单元200配置成与替代推动器一起使用。参考图16和图17，推动器的替代性实施例经展示，且可与本公开的装载单元200一起使用。图16说明第一替代推动器900，且图17说明第二替代推动器950。第一替代推动器900类似于推动器800，因为推动器900包含第一本体部分910、第二本体部分920和桥接器930。推动器900还包含以相对于推动器900的各上部通道912、922成锐角的方式且设置在其下方的斜坡935。与推动器800相比，推动器900的导向区块940包含于桥接器930上。
如图17中所展示，推动器950包含单个本体部分960，以使得推动器950配置成接合单个紧固件600。推动器950的本体部分960包含上部通道962，且包含以相对于上部通道962成锐角的方式且设置在其下方的斜坡970。另外，推动器950包含从本体部分960的两个侧边延伸的导向区块980。
使用替代推动器900、950的装载单元200包含塑形为与推动器900、950的形状相对应的保持腔1000。
本公开还包含执行使用本文中所公开的手术器械100和/或装载单元200的手术程序的方法。举例来说，公开一种包含使用具有约12mm直径的装载单元200来弹出具有约5mm高度的紧固件的方法。此类方法还包含至少部分通过具有约12mm直径的套管针的插入装载单元200。
在本文中所公开的任何实施例中，紧固件或缝钉在钉仓中可以具有成角度的定向。此定向影响如何配置钉合推动器。结果是，钉合器械可以布置成钉合较大的组织厚度，或将器械的总尺寸减到最小。
尽管在图1中展示手动钉合器，但本文中所公开的实施例中的任一个可以包含马达，或附接到马达上，或成为机器人手术系统的一部分。
虽然以上描述包含许多特殊性，但这些特殊性不应理解为限制本公开的范围，而是仅仅对本公开的不同实施例的说明。因此，以上描述不应解释为限制性的，而仅仅是作为不同实施例的范例。所属领域的技术人员将设想在本文所附权利要求书的范围和精神内的其它修改。
Claims (16)
1.一种配置成用于与手术器械接合的装载单元，所述装载单元包括：
近侧本体部分，定义纵向轴线；
末端执行器，设置成与所述近侧本体部分机械配合，所述末端执行器包含卡盘组件，所述卡盘组件配置成容纳其中的紧固件；
致动滑板，可在所述卡盘组件内纵向平移；
双推动器，设置在所述卡盘组件内，至少一个双推动器包含：第一本体部分，具有配置成接合第一紧固件的一部分的第一上部表面；第二本体部分，具有配置成接合第二紧固件的一部分的第二上部表面；以及桥接器，使所述第一本体部分和所述第二本体部分互连，所述第一本体部分包含近侧推动器导引表面和远侧推动器导引表面，所述第二本体部分包含近侧推动器导引表面和远侧推动器导引表面，所述第一上部表面和所述第二上部表面中的每一个定义相对于所述纵向轴线的锐角；以及
双保持腔，设置在所述卡盘组件内，各双保持腔配置成将一个双推动器保持在其中，至少一个双保持腔包含配置成接合保持在其中的所述双推动器的所述第一本体部分的所述近侧推动器导引表面的第一保持导引表面，以及配置成接合保持在其中的所述双推动器的所述第一本体部分的所述远侧推动器导引表面的第二保持导引表面，
其中所述第一上部表面平行于所述第二上部表面。
2.根据权利要求1所述的装载单元，其中所述至少一个双推动器包含设置在所述第一本体部分的下部表面上的第一斜坡，所述第一斜坡配置成通过所述致动滑板的第一倾斜的楔状物来接合。
3.根据权利要求2所述的装载单元，其中所述至少一个双推动器包含设置在所述第二本体部分的下部表面上的第二斜坡，所述第二斜坡配置成通过所述致动滑板的第二倾斜的楔状物来接合。
4.根据权利要求3所述的装载单元，其中所述第一斜坡是以相对于所述纵向轴线成平行角的方式设置，且其中所述第二斜坡是以相对于所述纵向轴线成平行角的方式设置。
5.根据权利要求2所述的装载单元，其中所述第一斜坡设置在所述第一本体部分的所述上部表面的一部分的正下方。
6.根据权利要求3所述的装载单元，其中所述第二斜坡设置在所述第二本体部分的所述上部表面的一部分的正下方。
7.根据权利要求1所述的装载单元，其中所述锐角在30°与60°之间。
8.根据权利要求1所述的装载单元，其中所述至少一个双保持腔包含配置成接合保持在其中的所述双推动器的所述第二本体部分的所述近侧推动器导引表面的第三保持导引表面，以及配置成接合保持在其中的所述双推动器的所述第二本体部分的所述远侧推动器导引表面的第四保持导引表面。
9.根据权利要求1所述的装载单元，其中所述桥接器使所述第一本体部分的近侧部分与所述第二本体部分的远侧部分互连。
10.根据权利要求1所述的装载单元，其中所述末端执行器的最外直径为约12mm，其中所述末端执行器处于接近位置。
11.根据权利要求10所述的装载单元，进一步包含至少部分保持在所述卡盘组件内的紧固件，至少一个紧固件具有约5mm的高度。
12.一种配置成用于与手术器械一起使用的末端执行器，所述末端执行器包括：
卡盘组件；
致动滑板，可在所述卡盘组件内沿纵向轴线平移；
推动器，至少部分设置在所述卡盘组件内且配置成通过所述致动滑板来选择性地接合，至少一个推动器具有配置成接合第一紧固件的第一上部表面和配置成由所述致动滑板的第一楔状物接合的第一斜坡，所述第一上部表面以相对于所述纵向轴线成锐角的方式设置，所述第一斜坡以相对于所述纵向轴线成平行角的方式设置；以及
多个紧固件，至少部分保持在所述卡盘组件内，所述多个紧固件中的每个紧固件设置成与所述多个推动器中的一个推动器接触，且所述多个紧固件中的每个紧固件包含约5mm的高度；
其中所述末端执行器的最外直径为约12mm，
其中所述至少一个推动器包含配置成接合第二紧固件的第二上部表面和配置成由所述致动滑板的第二楔状物接合的第二斜坡，
其中所述第一上部表面平行于所述第二上部表面。
13.根据权利要求12所述的末端执行器，其中所述第一斜坡设置在所述第一上部表面的一部分的正下方。
14.根据权利要求12所述的末端执行器，其中所述第一斜坡设置在所述第一上部表面的一部分的正下方，且其中所述第二斜坡设置在所述第二上部表面的一部分的正下方。
15.根据权利要求12所述的末端执行器，其中所述锐角在30°与60°之间。
16.根据权利要求12所述的末端执行器，其中所述第一上部表面包含在所述至少一个推动器的第一本体部分上，且所述第二上部表面包含在所述至少一个推动器的第二本体部分上，且进一步包含使所述第一本体部分的近侧部分与所述第二本体部分的远侧部分互连的桥接器。
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| US15/439,312 US20180235618A1 (en) | 2017-02-22 | 2017-02-22 | Loading unit for surgical instruments with low profile pushers |
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| CN108451568A CN108451568A (zh) | 2018-08-28 |
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| US (2) | US20180235618A1 (zh) |
| EP (1) | EP3366228A3 (zh) |
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2018
- 2018-01-26 CA CA2993194A patent/CA2993194A1/en active Pending
- 2018-02-06 AU AU2018200849A patent/AU2018200849A1/en not_active Abandoned
- 2018-02-19 JP JP2018026892A patent/JP2018134408A/ja active Pending
- 2018-02-21 EP EP18157828.7A patent/EP3366228A3/en active Pending
- 2018-02-22 CN CN201810153883.8A patent/CN108451568B/zh active Active
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2022
- 2022-11-02 US US17/979,130 patent/US11944304B2/en active Active
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| US4978049A (en) * | 1989-05-26 | 1990-12-18 | United States Surgical Corporation | Three staple drive member |
| US5415334A (en) * | 1993-05-05 | 1995-05-16 | Ethicon Endo-Surgery | Surgical stapler and staple cartridge |
| US5630540A (en) * | 1995-05-24 | 1997-05-20 | United States Surgical Corporation | Surgical staple and staple drive member |
| US8496154B2 (en) * | 2009-10-08 | 2013-07-30 | Covidien Lp | Pair of double staple pusher in triple row stapler |
| CN104546040A (zh) * | 2013-10-17 | 2015-04-29 | 柯惠Lp公司 | 手术仪器、装载单元以及与其一起使用的紧固件 |
| CN106028970A (zh) * | 2013-12-23 | 2016-10-12 | 伊西康内外科有限责任公司 | 具有包括紧固件传递表面的击发构件的紧固件仓 |
| CN105078532A (zh) * | 2014-05-16 | 2015-11-25 | 柯惠Lp公司 | 原位装载吻合器 |
| EP3120783A1 (en) * | 2015-07-21 | 2017-01-25 | Covidien LP | Small diameter cartridge design for a surgical stapling instrument |
Also Published As
| Publication number | Publication date |
|---|---|
| US20230050107A1 (en) | 2023-02-16 |
| JP2018134408A (ja) | 2018-08-30 |
| CA2993194A1 (en) | 2018-08-22 |
| US20180235618A1 (en) | 2018-08-23 |
| CN108451568A (zh) | 2018-08-28 |
| EP3366228A2 (en) | 2018-08-29 |
| US11944304B2 (en) | 2024-04-02 |
| EP3366228A3 (en) | 2018-10-10 |
| AU2018200849A1 (en) | 2018-09-06 |
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