CN108472044B - 内窥镜可搁置手术施夹器 - Google Patents
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- 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
- A61B2017/00473—Distal part, e.g. tip or head
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- A—HUMAN NECESSITIES
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/35—Surgical robots for telesurgery
Abstract
一种可搁置手术施夹器(100)包含具有外壳的手柄组合件(110)、触发器(114)和驱动组合件(120)，所述驱动组合件(120)包含驱动杆(122)。所述可搁置手术施夹器(100)进一步包含安置在所述外壳的远端上并从其向远端延伸的外部导管组合件(200)，和选择性地可连接到所述外部导管组合件(200)的远端的夹筒组合件(300)。所述夹筒组合件(300)包含：外部导管(314)和固定地支撑在其远端中的一对夹钳(320a)、与所述驱动杆(122)的远端(122b)选择性地啮合的第一夹钳推动器(130)，与近端上的所述第一夹钳推动器(130)和第二端上的所述一对夹钳(320a)选择性地啮合的第二夹钳推动器(132)，以及被安置在所述外部导管(314)内的多个手术夹具(C)。还提供一种组装可搁置手术施夹器(100)的方法。
Description
技术领域
本公开涉及手术施夹器。更确切地说，本公开涉及具有可再用的手柄组合件、可再用的轴组合件和可弃式夹筒组合件的内窥镜可搁置手术施夹器。
背景技术
内窥镜缝合器和施夹器在所属领域中是已知的并用于数个不同且适用的手术程序。在腹腔镜外科手术程序的状况下，通过狭窄导管或通过皮肤中的较小进入切口插入的插管实现到腹部内的接入。在身体中的其它地方执行微创手术常常大体上被称作内窥镜手术。通常导管或插管装置通过用于提供接入端口的进入切口延伸到患者的身体中。端口允许外科医生使用套管针通过其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。
在大多数这些手术期间，外科医生必须常常终止血液的流动或者通过一个或多个脉管的另一流体。外科医生将常常在手术期间将手术夹具施用到血脉管或另一管道以防止体液流动通过。内窥镜施夹器在所属领域中已知用于在进入体腔期间施用单个夹具。此类夹具通常由生物兼容性材料制造，并且通常压缩在脉管上。一旦施用到脉管，压缩的夹具就终止从中通过的流体的流动。
能够在内窥镜或腹腔镜手术中在单次进入体腔期间施用多种夹具的内窥镜施夹器描述于共同转让给Green等人的美国专利第5,084,057号和第5,100,420号中，所述美国专利以全文引用的方式并入本文。另一多种内窥镜施夹器公开于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号公开了可再消毒的内窥镜外科手术施夹器，所述专利的公开内容在此以引用的方式并入本文。施夹器在单次插入到体腔中期间推进并形成多种夹具。这个可再消毒的施夹器被配置成收纳可互换弹夹并与可互换弹夹配合以便在单次进入体腔期间推进并形成多种夹具。
在内窥镜或腹腔镜手术期间，取决于待结扎的基础组织或脉管，可能需要和/或必需使用不同大小的手术夹具。为了减少手术施夹器的总成本，单个手术施夹器需要视需要可装载不同大小的手术夹具且能够发动不同大小的手术夹具。
因此，需要包含可再用的手柄组合件、可再用的轴组合件和可弃式夹筒组合件的内窥镜手术施夹器，其中每一夹筒组合件装载有经特别大小设定的夹具(例如，相对较小、相对中等或相对较大)。
发明内容
本公开涉及可搁置内窥镜手术施夹器。
根据本公开的一个方面，提供一种可搁置手术施夹器，且所述可搁置手术施夹器包含手柄组合件、外部导管组合件和夹筒组合件。所述手柄组合件包含固定手柄、触发器和可移除地支撑在所述外壳内且可由所述触发器操作性地致动的驱动组合件。所述驱动组合件包含具有近端和远端的驱动杆。
所述外部导管组合件安置在所述外壳的远端上且从其向远侧延伸。
所述夹筒组合件选择性地可连接到所述外部导管组合件的远端，且包含：外部导管；一对夹钳，其固定地支撑在所述外部导管的远端中；第一夹钳推动器，其与所述驱动杆的所述远端选择性地啮合；第二夹钳推动器；和多个手术夹具，其安置在所述外部导管内。所述第二夹钳推动器的近端与所述第一夹钳推动器选择性地啮合且所述第二夹钳推动器的远端与所述一对夹钳选择性地啮合。
所述驱动杆的所述远端可以限定从其延伸的突片。
所述第一夹钳推动器的所述近端可以包含限定在其中的凹穴，所述凹穴被配置成选择性地啮合所述驱动杆的所述突片。
所述夹筒组合件的所述外部导管可以进一步包含一对限定在其中的窗口，所述一对窗口被配置成收纳从所述第一夹钳推动器的每一侧延伸的对应的一对突片。所述第一夹钳推动器的所述一对突片可以收纳于所述外部导管的对应的所述一对窗口内。可以准许所述第一夹钳推动器的所述凹穴收纳所述驱动杆的所述突片。
所述触发器的致动可以造成所述驱动杆和所述第一夹钳推动器的远侧移动。所述触发器的持续致动可以使得所述第一夹钳推动器的远端邻接所述第二夹钳推动器的近侧表面，借此在远侧方向上推动所述第二夹钳推动器。
所述第二夹钳推动器可以包含限定在其近端上的倒钩。
所述第一夹钳推动器可以包含限定在其远端上的倒钩。所述第一夹钳推动器的所述倒钩可以被配置成当所述第一夹钳推动器在近侧方向上前进时，啮合所述第二夹钳推动器的所述倒钩。
所述手柄组合件的所述外壳可以是具有从其延伸的所述固定手柄的中空圆筒外壳。所述圆筒外壳可以限定从中通过的镗孔、开口近端和开口远端。所述触发器可以可枢转地支撑在所述圆筒外壳上并从所述圆筒外壳延伸。所述触发器可以包含延伸到所述圆筒外壳的所述镗孔中的致动端。
所述可搁置手术施夹器可以进一步包含端盖，所述端盖包含限定在其中的镗孔。所述端盖可以被配置成收纳于所述外壳的所述镗孔的所述开口近端内。
所述驱动杆可以包含从其近端延伸并在近侧方向上从其延伸的细长延伸部。所述细长延伸部可以被配置成可滑动地收纳于带螺纹盖的所述镗孔内。
所述手柄组合件的所述触发器可以包含安置在所述驱动杆近侧并与所述驱动杆操作性地接触的致动端。
所述手柄组合件的所述触发器可以可枢转到其中所述触发器的所述致动端不在所述圆筒外壳的所述镗孔内的位置。
在使用中，当所述触发器的所述致动端不在所述圆筒外壳的所述镗孔内时，所述驱动组合件的所述远端可以可插入到所述圆筒外壳的所述近端中且能够推进通过所述圆筒外壳并通过所述外部导管组合件。
所述外部导管组合件可以包含支撑其所述外部导管的旋钮。所述手柄组合件的所述圆筒外壳和所述外部导管组合件的所述旋钮可以经由卡口型连接彼此可选择性地连接。
所述夹筒组合件的近端可以经由搭扣配合连接选择性地可连接到所述外部导管组合件。
根据本公开的另一方面，提供一种组装可搁置手术施夹器的方法，且所述方法包含在包含外壳、固定手柄和触发器的手柄组合件内推进驱动组合件。所述方法进一步包含在筒组合件的外部导管内推进安置在所述手柄组合件的远端上的外部导管的远端。所述方法还包含在限定在第一夹钳推动器的近端内的凹穴内推进安置在所述驱动组合件的驱动杆的远端上的突片，所述近端安置在所述筒组合件的所述外部导管内。所述方法进一步包含在安置在所述驱动杆的近端上的细长延伸部上方推进端盖，和在限定在所述手柄组合件的所述外壳的近端内的镗孔内推进所述端盖。在使用中，在所述镗孔内推进所述端盖会在远侧方向上推动所述驱动杆，使得所述驱动杆的远侧移动又在所述远侧方向上推动所述第一夹钳推动器，借此将所述驱动杆的所述突片捕获在所述第一夹钳推动器的所述凹穴内，使得所述驱动杆和夹钳部件可以一致地推进或后退。
在使用中，在所述筒组合件的外部导管内推进手柄组合件的外部导管的所述远端可以包含在所述筒组合件的所述外部导管内推进所述手柄组合件的所述外部导管的所述远端，直到所述筒组合件摩擦地保留在所述手柄组合件的所述外部导管内为止。
在使用中，继续推进所述手柄组合件的所述外部导管的所述远端可以包含在所述筒组合件的所述外部导管内推进所述手柄组合件的所述外部导管，直到所述筒组合件借助于搭扣配合连接保留在所述手柄组合件的所述外部导管内为止。
在使用中，在限定在所述手柄组合件的所述外壳的近端内的镗孔内推进所述端盖可以使得安置在所述第一夹钳推动器的每一侧上的一对突片从安置在所述筒组合件的所述外部导管中的对应的一对窗口移开，借此使得第一夹钳部件的所述凹穴使所述驱动杆的所述突片保留在其中。
所述方法可以进一步包含使所述触发器旋转，使得在外壳组合件的所述镗孔中推进所述驱动组合件之前，所述触发器的致动端不在所述外壳组合件的所述镗孔内。
附图说明
本文参考图式公开了手术施夹器的特定实施例，在图式中：
图1是根据本公开的可搁置内窥镜手术施夹器的俯视正面透视图；
图2是图1的可搁置内窥镜手术施夹器的部件分离的后部透视图；
图3是图1和2的可搁置内窥镜手术施夹器的手柄组合件的部件分离的透视图；
图4是图1和2的可搁置内窥镜手术施夹器的外部导管组合件的部件分离的透视图；
图5是图1和2的手柄组合件的主轴组合件的透视图；
图6是图5的主轴组合件的部件分离的透视图；
图7是根据本公开的实施例的可弃式夹筒组合件的后部透视图；
图8是图7的可弃式夹筒组合件的部件分离的的透视图；
图9是图7和8的可弃式夹筒组合件的透视图，其中可弃式夹筒组合件的外部导管被移除；
图10是图9的所指示细节区域的放大视图；
图11是图9的所指示细节区域的透视图；
图12是图7到11的可弃式夹筒组合件的仰视透视图，其中可弃式夹筒组合件的外部导管和筒夹盘被移除；
图13是图12的所指示细节区域的放大视图；
图14是图7到13的可弃式夹筒组合件的如沿着图7的截面线14-14截取的横截面视图；
图15是图14的所指示细节区域的放大视图；
图16是图7到15的可弃式夹筒组合件的如沿着图14的截面线16-16截取的横截面视图，其中可弃式夹筒组合件的夹具推杆被移除；
图17是图16的所指示细节区域的放大视图；
图18是手柄组合件的说明主轴组合件插入到手柄组合件中的横截面视图；
图19是可搁置内窥镜手术施夹器的说明图7到16的可弃式夹筒组合件连接到手柄组合件的主轴组合件的透视图；
图20是图19的所指示细节区域的放大视图；
图20A是图20的可弃式夹筒组合件的如沿着图20的截面线20A-20A截取的横截面视图；
图20B是图20的可弃式夹筒组合件的推杆的俯视图；
图21是图1的可搁置内窥镜手术施夹器的在未致动条件下展示的纵向横截面视图，且其中可弃式夹筒组合件从可搁置内窥镜手术施夹器移除；
图22是图21的所指示细节区域的放大视图；
图23是如沿着图22的截面线23-23截取的横截面视图；
图24是如沿着图23的截面线24-24截取的横截面视图；
图25是图21的所指示细节区域的放大视图；
图26是图25的所指示细节区域的放大视图；
图27是经展示连接到可搁置内窥镜手术施夹器的外部导管组合件的可弃式夹筒组合件的纵向横截面视图；
图28是图27的所指示细节区域的放大视图；
图28A是可弃式夹筒组合件的远端的仰视透视图；
图29是图1的所指示细节区域的说明可弃式夹筒组合件连接到可搁置内窥镜手术施夹器的外部导管组合件的放大透视图；
图30是图1的可搁置内窥镜手术施夹器的手柄组合件的说明其触发器的致动或挤压的纵向横截面视图；
图31到33是可搁置内窥镜手术施夹器的可弃式夹筒组合件和外部导管组合件的说明在触发器的挤压期间主轴的致动的侧横截面正视图；
图34和35是可弃式夹筒组合件的说明筒夹推杆的致动的侧横截面正视图；
图36是可搁置内窥镜手术施夹器的过载保护的横截面正视图；
图37到39是可搁置内窥镜手术施夹器的可弃式夹筒组合件和外部导管组合件的说明主驱动杆和推杆的选择性附接的俯视横截面视图；
图40到42是可搁置内窥镜手术施夹器的可弃式夹筒组合件和外部导管组合件的说明主驱动杆和推杆的选择性移除的俯视横截面视图；且
图43是被配置成供根据本公开使用的机器人手术系统的示意性说明。
具体实施方式
现在将参考附图详细地描述根据本公开的可搁置手术施夹器的实施例，在附图中，相同参考标号标识相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位置时，术语“近侧”指代设备的更接近用户的端部，且术语“远侧”指代设备的更远离用户的端部。
最初参看图1到3，一般将根据本公开的实施例的手术施夹器指定为100。手术施夹器100包含手柄组合件110、从手柄组合件110突出或从手柄组合件110延伸的细长外部导管组合件200，以及可以可移除地且选择性地安装在外部导管组合件200的远端上的夹筒组合件300。如下文将更详细地描述，多个手术夹具“C”(图8)装载到夹筒组合件300中。并且，如下文将更详细地描述，在如致动手柄组合件110的操作中，单个手术夹具“C”在待结扎的脉管周围发动并形成。
如图1到3中所展示，手柄组合件110包含固定手柄112和在枢转轴116处可枢转地附接到固定手柄112的可挤压触发器114。可挤压触发器114包含近侧致动端114a，所述近侧致动端114a向近侧延伸超出枢转轴116并延伸到支撑在固定手柄112上的圆筒118的镗孔118a中。
圆筒118被支撑在固定手柄112上且被配置成收纳外部导管组合件200的近端。圆筒118限定从中通过的管腔或镗孔118a。带螺纹端盖119封闭圆筒118的近端。圆筒118的前端118b包含一对直径相对的从其径向地突出的凸起118c，且所述凸起118c被配置和大小经过设置成以卡口式连接的方式可滑动地啮合外部导管组合件200的外部套环或旋钮204的相应对的反向安置的J形凹口204a，以将外部导管组合件200紧固到手柄组合件110。
参看图2、5和6，手柄组合件110支撑和/或包含可移除地支撑在圆筒118的镗孔118b内或可移除地连接到圆筒118的主驱动组合件或推进机构120。主驱动组合件120包含具有近端122a和远端122b的主驱动杆122。主驱动杆122的近端122a支撑其上的凸缘122c，且偏压部件124(例如，复位压缩弹簧)安置在主驱动杆122上并在凸缘122c远侧以将主驱动杆122推动到最近侧位置。细长延伸部122d在近侧方向上从凸缘122c延伸并被配置成收纳在带螺纹端盖119内限定的镗孔119a内(图18)。主驱动杆122的远端122b包含安置在其上并从其向远侧延伸的球形突片122f。
主驱动杆122经由枢轴销127可枢转地支撑其上的摇臂126。摇臂126包含近端126a和远端126b。远端126b具有放大头部或活塞配置。偏压部件128(例如，钢板弹簧)支撑在驱动杆122上并被配置成作用于摇臂126的近端126a。凸轮斜面126c(图26)设置在摇臂126的表面上或摇臂126的表面中，且摇臂126的表面邻近于外部导管组合件200的外部导管202。
参看图1、2、4和19，外部导管组合件200包含具有近端202a和远端202b的中空外部导管202，以及外部套环或旋钮204。
外部套环或旋钮204的近端包含形成于其中且被配置和大小经过设置成选择性地收纳手柄组合件110的圆筒118的相应凸起118c的两个反向安置的J形凹口204a，以用于选择性地将外部导管组合件200紧固到手柄组合件110。
外部导管组合件200进一步包含被配置和大小经过设置成用于安置在外部套环204内的内部套环206。内部套环206使用任何合适方式(例如焊接、粘着剂、摩擦配合等等)机械地紧固到外部导管202的近端202a。
外部导管组合件200还包含插入在外部套环204与内部套环206之间的偏压部件208。
内部套环206进一步包含形成在其一侧中的纵向延伸的狭槽或窗口206a。提供锁块210以用于选择性地插入到内部套环206的纵向狭槽或窗口206a中。在使用中，当将锁块210插入内部套环206的狭槽或窗口206a时，锁块210抵靠主驱动杆122的平坦表面122e安放或接触主驱动杆122的平坦表面122e(参见图6、23和24)，借此使得能够在第一方向上旋转，且当将主驱动杆122安置在外部导管组合件200的外部导管202内时，抑制或防止主驱动杆122在第二相反的方向上旋转。
手柄组合件110以及外部导管组合件200可由例如高级别外科手术不锈钢的生物兼容性材料、钛或高强度耐高压加热聚合物、热塑性材料等等制成。
参看图18，描述手柄组合件110、主驱动组合件120和外部导管组合件200的组合件。通过以下操作，外部导管组合件200的外部套环或旋钮204连接到手柄组合件110的圆筒118的前端118b：将外部套环或旋钮204的J形凹口204a的开口端与手柄组合件110的圆筒118的凸起118c对准，接近外部导管组合件200和手柄组合件110直到凸起118c充分地收纳于J形凹口204a中为止，且接着相对于手柄组合件110旋转外部导管组合件200以围绕J形凹口204a径向地推进凸起118c，例如，以卡口型连接的方式。
在外部导管组合件200连接到手柄组合件110且端盖119从圆筒118移除的情况下，触发器114围绕枢转轴116移动或枢转直到触发器114的致动端114a不阻塞圆筒118的镗孔118a为止。在触发器114如此定位的情况下，主驱动杆122的远端122b(图2)经由圆筒118的开口近端插入到圆筒118的镗孔118a中。主驱动组合件120推进通过圆筒118的镗孔118a并通过外部导管组合件200直到主驱动组合件120的凸缘122c定位在圆筒118的镗孔118a内为止。在主驱动组合件120的凸缘122c定位在圆筒118的镗孔118a内的情况下，触发器114围绕枢转轴116移动或枢转直到触发器114的致动端114a再一次安置在圆筒118的镗孔118a中且安置为邻近于主驱动组合件120的凸缘122c并与主驱动组合件120的凸缘122c接触为止。端盖119接着可以在细长延伸部122d上方推进，使得细长延伸部122d嵌套在镗孔119a内。在细长延伸部122d嵌套在镗孔119a内的情况下，端盖119进一步在其上方推进并再连接到圆筒118以将主驱动组合件120和触发器114的致动端114a紧固到手柄组合件110的圆筒118。如将在下文进一步详细论述，端盖119可以推进到圆筒118的镗孔118a中并推出圆筒118的镗孔118a以有助于夹筒组合件300的附接和移除。以此方式，在端盖119在圆筒118的镗孔118a内推进或退出时，细长延伸部122d保持与镗孔119a可滑动地啮合并维持主驱动组合件120与外部导管组合件200对准。
现在转而参看图1、2和7到17，展示手术施夹器100的夹筒组合件300。夹筒组合件300被配置成选择性地可装载或可连接到外部导管组合件200的远端，且在手柄组合件110的触发器114的致动后就被致动以将装载在其中的手术夹具“C”发动并形成到基础组织和/或脉管上。每一夹筒组合件300可以装载有一组经特别大小设定的手术夹具(例如，相对较小的手术夹具、相对中等的手术夹具或相对较大的手术夹具)。
夹筒组合件300包含夹具盘302，夹具盘302包含底壁302a和一对支撑在底壁302a上间隔开的下侧壁或轨条302b1。底壁302a和下部轨条302b1限定夹具通道302c1(图11)。夹具通道302c1被配置和大小经过设置成可滑动地支撑其中的多个手术夹具“C”。夹具盘302进一步包含至少一对支撑在下侧壁302b1上间隔开的上侧壁或轨条302b2。下部轨条302b1和上部轨条302b2限定推杆通道302c2(图11)。推杆通道302c2被配置和大小经过设置成可滑动地支撑其中的筒夹推杆304。
夹具盘302包含线性阵列的向远侧延伸的弹性、可偏转指形件302d(图13、15和17)，指形件302d从底壁302a向上突出并进入侧轨条302b之间的部位处的下部夹具通道302c1中。最远侧的可偏转指形件302d1形成单个矩形指形件，单个矩形指形件被配置成啮合最远侧夹具“C1”的后跨部或冠部且嵌套在筒夹推杆304的间隔开的叉状件304d1、304d2(图13)之间，如下文所论述。一对通道302f(图17)安置或形成在最远侧指形件302d1的任一侧上且被配置成当所有手术夹具“C”已经形成时，选择性地收纳、啮合夹具推杆304的间隔开的叉状件304d1、304d2中的每一个，如将在下文进一步详细论述。剩余的近侧可偏转指形件302d中的每一个限定适用于啮合手术夹具“C”的堆叠中的每一剩余夹具的后跨部的相对的近侧的V形配置，如图12、13、16和17中所说明。
如图11和17中所展示，夹具盘302进一步包含一对间隔开、向远侧延伸的弹性可偏转叉状件302e，叉状件302e从底壁302a的近端向上突出并进入侧轨条3021之间的部位处的下部夹具通道302c1中。叉状件302e中的每一个间隔开，使得其与最远侧夹具“C1”的相应支脚的表面可滑动地啮合。叉状件302e的尺寸被设置成啮合最远侧夹具“C1”的支脚并抵靠每一侧轨条302b1摩擦地按压最远侧夹具“C1”，使得当最远侧夹具“C1”被装载到一对夹钳320中时，叉状件302e帮助防止最远侧夹具“C1”(靠近最远侧夹具“C1”)向远侧推进超过叉状件302e。当最远侧夹具“C1”通过筒夹推杆304向远侧推动时，克服由叉状件302e提供的偏压力，且一旦最远侧夹具“C1”已被装载到所述一对夹钳320中，叉状件302e中的每一个就返回到其初始位置以防止下一夹具“C”进一步推进。
如图8到15中所展示，夹筒组合件300包含筒夹推杆304，所述筒夹推杆304可滑动地安置在夹具盘302的一对间隔开的上侧壁或轨条302b2(图11)之间并安置在所述上侧壁或轨条302b2内。筒夹推杆304包含可与筒推杆或轴306的远端啮合或通过筒推杆或轴306的远端可啮合的近端304a，如下文将更详细地描述。筒夹推杆304进一步包含限定推动器304d的远端部分304b，推动器304d被配置成啮合手术夹具“C”的堆叠的最远侧夹具“C1”，以用于将最远侧夹具“C1”装载到夹筒组合件300的一对夹钳320中。推动器304d包含如上文所描述的一对间隔开的叉状件304d1、304d2，叉状件304d1、304d2被配置成啮合最远侧夹具“C1”的后跨部，如图11和15中所说明。
如图8、14和15中所说明，筒夹推杆304进一步包含线性阵列的向远侧延伸的弹性可偏转指形件304e，其中每一指形件304e限定矩形剖面，矩形剖面包含形成在其远端处的远侧凸肩。在使用中，当筒夹推杆304叠对或安置在夹具盘302的一对间隔开的上部轨条302b2之间时，夹具盘302的可偏转指形件302d中的每一个轴向地安置在筒夹推杆304的每一可偏转指形件304e之间，使得当夹具推杆304相对于夹具盘302位于近侧位置中时，可偏转指形件302d、304e中的每一个以串列配置形式布置。另外，当筒夹推杆304叠对或安置在夹具盘302的一对间隔开的上部轨条302b2之间时，筒夹推杆304的每一可偏转指形件304e跨越夹具盘302的夹具通道302c1延伸，使得可偏转指形件304e的远侧凸肩与手术夹具“C”的堆叠配准。
在使用中，夹具盘302的近侧可偏转指形件302d的V形配置准许筒夹推杆304的每一近侧可偏转指形件304e嵌套在近侧可偏转指形件302d的V形内，使得当筒夹推杆304向远侧驱动时，可偏转指形件304e的远侧凸肩啮合手术夹具“C”的堆叠中的剩余手术夹具中的每一个的后跨部。
如图8和12到17中所展示，夹筒组合件300进一步包含插入在夹具盘302与筒夹推杆304之间的手术夹具“C”的堆叠。手术夹具“C”的堆叠支撑在夹具盘302上或装载到夹具盘302中，使得每一手术夹具“C”的冠部或后跨部安置在夹具盘302的相应可偏转指形件302d远侧。此外，当筒夹推杆304相对于夹具盘302位于近侧位置中时，筒夹推杆304的每一可偏转指形件304e还安置在手术夹具“C”的堆叠的相应夹具的冠部或后跨部近侧，如上文所论述。
夹筒组合件300可以装载有10个手术夹具“C”，或在实施例中，夹筒组合件300可以装载有任何数目个手术夹具C”。手术夹具“C”可由所属领域的技术人员已知的材料制造，包含但不限于不锈钢、钛或其它金属合金。在一实施例中，预期手术夹具“C”的堆叠中的至少最末手术夹具可以染成特定颜色以向用户指示何时将夹筒组合件300的最末手术夹具装载到一对夹钳320中。
一旦所有手术夹具“C”装载到夹具盘302中且筒夹推杆304邻近于其放置，被配置和被调适用于在夹具盘302上连接和支撑的通道盖罩307(图8)就可以搭扣成与夹具盘302的下部轨条302b1啮合。
参看图8到10、14和16，夹筒组合件300包含可滑动地支撑在夹具盘302内的筒推杆或轴306。筒推杆306包含连接到筒夹推杆304的近端304a的远端和固定地连接到驱动滑板308的近端，驱动滑板308可滑动地支撑在夹具盘302内。
夹筒组合件300包含围绕筒推杆306安置并插入在远侧止动块312a与驱动滑板308之间的偏压部件310。在夹具盘302的近端附近提供近侧止动块312b以限制驱动滑板308的移动。筒推杆306的远端向远侧延伸超过远侧止动块312a以用于与筒夹推杆304的近端啮合。
在操作中，如下文将更详细地描述，当手柄组合件110的触发器114致动时，触发器114实现主驱动组合件120的主驱动杆122和摇臂126的致动以在轴向远侧方向上移动摇臂126。当主驱动组合件120在远侧方向上移动时，摇臂126的远端126b啮合、邻接于或作用于驱动滑板308以在远侧方向上移动驱动滑板308。当驱动滑板308在远侧方向上移动时，驱动滑板308作用于筒夹推杆304以向远侧推进筒夹推杆304，并将偏压部件310的压缩实现为偏压状况。
继续参看图8到10、14和16，夹筒组合件300包含邻近于夹具盘302固定地支撑在夹筒组合件300的外部导管314的管腔314a内的夹钳刀片320。夹钳刀片320包含从外部导管314突出或从外部导管314内向远侧延伸的一对夹钳320a，和近侧地延伸到外部导管314的管腔314a中的近侧杆柄320b。夹钳刀片320是由例如不锈钢的弹性材料制造，且经形成使得其一对夹钳320a彼此间隔开或彼此偏压开。
每一夹钳320a包含从其突出的凸轮齿或楔形件320c，且凸轮齿或楔形件320c被配置成当主驱动组合件120的主驱动杆122向远侧推进时，通过提供在第二夹钳推动器132的远端132b处的V形凸轮槽132e啮合(图28A和34)。在操作中，当主驱动杆122向远侧推进时，主驱动杆122将第一夹钳推动器130向远侧推动直到第一夹钳推动器130的远端130b接触第二夹钳推动器132的近侧表面132d为止。以此方式，第一夹钳推动器130和第二夹钳推动器132首先安置成彼此隔开，使得第一夹钳推动器130与第二夹钳推动器132之间存在间隙。此后，第一夹钳推动器130和第二夹钳推动器132向远侧推进，使得第二夹钳推动器132的V形凸轮槽132e啮合一对夹钳320a的凸轮齿320c，借此引起一对夹钳320a的封闭或接近。以此方式，第一夹钳推动器130可以向远侧推进而不致使一对夹钳320a接近。
当夹钳刀片320在非接近状况中时，夹钳刀片320限定一对夹钳320a之间的通道以用于在其中收纳手术夹具“C”。
如上文简要地提及且如图7和8中所展示，夹筒组合件300包含限定从中通过的管腔314a的外部导管314。外部导管314被配置和大小经过设置成操作性地容纳夹具盘302、夹筒推动器304、盖罩307、夹具推杆306、驱动滑板308、偏压部件310、夹钳刀片320和在其内的手术夹具“C”的堆叠。外部导管314的近端314b限定形成于其中的向远侧延伸的槽或通道314c。
一般来说，在操作中，当手柄组合件110的主驱动杆122向远侧推进时，由于触发器114的致动，主驱动杆122使摇臂126推进以作用于筒组合件300的驱动滑板308，从而在远侧方向上移动驱动滑板308。当驱动滑板308在远侧方向上移动时，驱动滑板308作用于筒推杆306，且继而，筒夹推杆304使筒夹推杆304向远侧推进一定的量或距离“X”(例如，约12mm)，并将偏压部件310的压缩实现为偏压状况。
当夹筒组合件300的筒夹推杆304在远侧方向上移动时，筒夹推杆304的推动器304d的间隔开的叉状件304d1、304d2啮合最远侧夹具“C1”的后跨部并将最远侧夹具“C1”向远侧推动所述量或距离“X”，从而推出夹筒组合件300并进入一对夹钳320a。
如上文所提及，最远侧夹具“C1”的远侧移动压缩夹具盘302的间隔开的叉状件302e中的每一个，借此准许将最远侧夹具“C1”装载在一对夹钳320a内，如上文所描述。一旦将最远侧夹具“C1”装载到一对夹钳320a中，叉状件302e就返回到其初始位置并防止靠近最远侧夹具“C1”的夹具“C”进一步向远侧推进。
另外且与最远侧夹具“C1”的远侧移动同时进行，当夹筒组合件300的筒夹推杆304在远侧方向上移动时，筒夹推杆304的每一指形件304e的远侧凸肩邻靠着剩余手术夹具“C”中的相应手术夹具的相应后跨部，从而也使剩余手术夹具“C”在远侧方向上推动所述量或距离“X”。在如此操作时，夹具盘302的指形件302d偏转，从而准许剩余手术夹具“C”中的每一个向远侧推进以替换手术夹具“C”的堆叠中的每一相应的手术夹具。一旦完成筒夹推杆304的远侧推进，就也完成手术夹具“C”的堆叠的远侧推进。一旦手术夹具“C”的剩余堆叠中的夹具已向远侧推进超出夹具盘302的相应指形件302d，夹具盘302的指形件302d就回弹或返回到其原始位置，借此防止每一手术夹具“C”此后在近侧方向上发生任何移动。
筒夹推杆304使剩余的手术夹具“C”向远侧推进，直到每一剩余的手术夹具“C”向远侧推进所述量或距离“X”，超过夹具盘302的下一个邻近弹性、可偏转指形件302d为止。
在筒夹推杆304移动所述量或距离“X”之后，为了将最远侧夹具“C1”装载到一对夹钳320a中，释放或反转特征220(例如，提供在外部导管组合件200的外部导管202中的凸起或销)通过摇臂126的凸轮斜面126c(图26)啮合或接触，因此使摇臂126的活塞126b与驱动滑板308脱啮，从而实现夹筒推杆304从远侧方向到近侧方向的行进方向的反转。摇臂126通过外部导管202的反转特征220的致动产生作用于待移除的筒夹推杆304的向远侧引导的力，且因此，偏压部件310任意再扩展。当偏压部件310任意再扩展时，偏压部件310近侧地推动或移动驱动滑板308，以借此近侧地退出筒夹推杆304。
当筒夹推杆304在近侧方向上移动时，其指形件304e的近侧表面邻靠着剩余的手术夹具“C”的后跨部的远侧表面，从而也在近侧方向上推动剩余的手术夹具“C”。筒夹推杆304的指形件304e使剩余的手术夹具“C”近侧地回缩，直到每一剩余的手术夹具“C”回缩小于“X”的量或距离(例如，“X-Y”)以与夹具盘302的相应的弹性、可偏转指形件302d的相应远端接触为止，此阻挡或阻止剩余的手术夹具“C”的进一步近侧回缩，而筒夹推杆304继续近侧地移动到其最近侧位置，例如量或距离“X”。
当筒夹推杆304继续近侧地牵引时，同时，筒夹推杆304的推动器304d和指形件304e的间隔开的叉状件304d1、304d2向上且在剩余的手术夹具“C”中的每一个上方偏转，直到筒夹推杆304返回到最近侧位置为止。
当夹筒组合件300装载有至少一个夹具“C”时，且当筒夹推杆304位于最近侧位置中时，安置在筒夹推杆304的最远侧端部上的前端304g(图28)朝向最远侧手术夹具“C1”的后跨部的上部表面偏压并由所述上部表面支撑，从而防止推动器304d的间隔开的叉状件304d1、304d2中的每一个啮合或进入夹具盘302的一对通道302f。
现在转而参看图19、20和37到39，在外部导管组合件200连接到手柄组合件110且主驱动组合件120装载到手柄组合件和外部导管组合件200中的情况下，如上文所描述，夹筒组合件300可以选择性地连接到主驱动组合件120的远端和外部导管组合件200的远端。
一般来说，参看图37到39，在夹筒组合件300充分组装的情况下，主驱动组合件120的远端插入到夹筒组合件300的外部导管314的近端314b中，且夹筒组合件300朝向手柄组合件110接近，直到提供在外部导管组合件200的外部导管202的近端202a上的对准肋条202c与夹筒组合件300的外部导管314的通道314c(参见图29)对准并进入所述通道314c为止。此时，第一夹钳推动器130位于最近侧位置中，使得从第一夹钳推动器130的近端130a的外部侧横向地延伸的一对突片134延伸到限定在夹筒组合件300的外部导管314内的相应窗口316(参见图39)316中以此方式，第一夹钳推动器130的近端130a可以扩展到能够在限定在第一夹钳推动器130内的凹穴136内接受主驱动杆122的球形突片122f的间隔开的状况。此后，夹筒组合件300可以摩擦地保留在外部导管组合件200上或通过搭扣配合连接件或所属领域的技术人员已知的某一其它连接配置(例如通过卡掣、边缘或翼形件)紧固到外部导管组合件200。在一个示范性实施例中，突片202d从外部导管组合件200的外部导管202的外部侧突出并延伸到形成在夹筒组合件300的外部导管314中的相应窗口314d中，使得夹筒组合件300可拆卸地紧固到外部导管组合件200和手柄组合件110。
此时，带螺纹端盖119在圆筒118的镗孔118a内推进，使得主驱动杆122的细长延伸部122d邻接于镗孔119a的内部表面，使得主驱动杆122向远侧推动(图38)。以此方式，当主驱动杆122向远侧推动时，第一夹钳推动器130同样向远侧推动，使得一对突片134从外部导管314的窗口316移开(图39)。由于一对突片134从窗口316移开，所以一对相应突片中的每一个在外部导管314的内部表面(未展示)中接触，借此使得第一夹钳推动器130的近端130a压缩到接近位置并将球形突片122f捕获在其中。以此方式，主驱动杆122和第一夹钳推动器130都一致地起作用，使得当主驱动杆推进或回缩时，第一夹钳推动器130同样推进或回缩。为了将夹筒组合件300从外部导管组合件200移除，可以按相反方式进行上文所提到的程序，如图40到42中所说明。
继续参看图1到20B和37到42，且额外特别参看图21到36，展示并描述施夹器100的示范性操作模式。如图27到29中所展示，说明施夹器100具有连接到外部导管组合件200的远端和主驱动组合件120的远端的夹筒组合件300(如上文所描述)。
参看图30，当触发器114被挤压或围绕枢转轴116沿顺时针方向枢转时，触发器114的致动端114a啮合手柄组合件110的主驱动杆122的近端，借此向远侧推动主驱动杆122抵抗复位压缩弹簧124的偏压力。当触发器114被挤压时，触发器114的致动端114a还压缩复位压缩弹簧124。当手柄组合件110的主驱动杆122向远侧推进时，由于触发器114的致动，主驱动杆122使摇臂126推进以作用于筒组合件300的驱动滑板308，以在远侧方向上移动驱动滑板308并在远侧方向上移动筒夹推杆304，如上文所描述。
当筒夹推杆304在远侧方向上移动时，其推动器304d啮合最远侧夹具“C1”的后跨部且将最远侧夹具“C1”向远侧推出夹筒组合件300并进入一对夹钳320a。
另外且与最远侧夹具“C1”的远侧移动同时进行，当夹筒组合件300的筒夹推杆304在远侧方向上移动时，剩余的手术夹具“C”、主驱动杆122和第一夹钳推动器130也在远侧方向上移动。在将最远侧夹具“C1”装载到一对夹钳320a中之后，如图32和33中所展示，摇臂126的凸轮斜面126c邻接于或啮合外部导管组合件200的释放或反转特征220，以使摇臂126围绕枢轴销127枢转，借此使摇臂126的活塞126b与驱动滑板308脱啮，从而实现夹筒推杆304从远侧方向到近侧方向的行进方向的反转。
当筒夹推杆304在近侧方向上移动时，筒夹推杆304作用于剩余的手术夹具“C”的后跨部，从而也在近侧方向上推动剩余的手术夹具“C”。确切地说，筒夹推杆304的指形件304e使剩余的手术夹具“C”近侧地回缩直到每一剩余的手术夹具“C”回缩以与夹具盘302的相应的弹性、可偏转指形件302d的相应远端接触为止，此阻挡或阻止剩余的手术夹具“C”的进一步近侧回缩，而筒夹推杆304继续近侧地移动到其最近侧位置。
在筒夹推杆304返回到其最近侧位置的情况下，触发器114的持续挤压继续使主驱动杆122以及第一夹钳推动器130在远侧方向上推进。当触发器114进一步挤压时，第一夹钳推动器130邻接于第二夹钳推动器132并在远侧方向上推动第二夹钳推动器132。触发器114进一步挤压使得主驱动杆122、第一夹钳推动器130和第二夹钳推动器到达其最远侧位置(例如，总远侧推进为约17mm)，直到第二夹钳推动器132的V形凸轮槽132e啮合一对夹钳320a的凸轮齿320c以封闭所述一对夹钳320a并形成装载有其的最远侧夹具“C1”为止。
在形成最远侧夹具“C1”之后，触发器114可以释放，由此准许复位压缩弹簧124再扩展以作用于凸缘122c并在近侧方向上移动主驱动杆122以及第一夹钳推动器130和第二夹钳推动器132，直到主驱动杆122、第一夹钳推动器130和第二夹钳推动器132中的每一个返回到其最近侧位置为止。以此方式，参看图34和35，当第一夹钳推动器130返回到近侧位置时，安置在第二推杆132的远端130b上的倒钩130c啮合安置在第二推杆132的近端132a上的对应倒钩132c。倒钩132c以一种方式安置在第二夹钳推动器132上使得倒钩132c与近侧表面132d之间存在间隙，借此允许第一夹钳推动器130在近侧和远侧方向上行进而不影响第二夹钳推动器132的移动。
当主驱动杆122返回到其最近侧位置时，摇臂126的凸轮斜面126c使外部导管组合件200的释放或反转特征220近侧地移动，由此作用于摇臂126的近端126a的偏压部件钢板弹簧128使摇臂126枢转，使得摇臂的活塞126b返回到与夹筒组合件300的驱动滑板308轴向配准。
另外，当主驱动杆122，且因此第一夹钳推动器130和第二夹钳推动器132返回到其最近侧位置时，第二夹钳推动器132的V形凸轮槽132e从一对夹钳320a的凸轮齿320c退出并啮合所述凸轮齿320c，借此允许一对夹钳320a由于其自身的弹性偏压而打开。
可以根据需要重复上述操作，直到所有手术夹具“C”已经形成为止。
手术施夹器100可具有锁定机构，其中一旦所有手术夹具“C”已经发动，手术施夹器100就无法致动。仅作为实例，此类锁定机构可以包含推动器304d的间隔开的叉状件304d1、304d2，一旦夹具“C”的堆叠中的最末夹具形成且筒夹推杆304回缩到最近侧位置，叉状件304d1、304d2就进入到夹具盘302的一对通道302f(图28A)中并啮合所述通道302f。一旦推动器304d的间隔开的叉状件304d1、304d2与夹具盘302的一对通道302f啮合或安置在所述通道302f内，例如，在触发器114的致动后，如上文所描述，就禁止筒夹推杆304的任何远侧移动。
在使用中，如上文所提及，手术施夹器100能够将不同的手术夹筒组合件300装载在外部导管组合件200上。确切地说，施夹器100可以装载有手术夹筒组合件300，手术夹筒组合件300装载有具有第一尺寸的手术夹具“C”的堆叠，或手术夹筒组合件300装载有具有不同于第一尺寸的第二尺寸的手术夹具“C”的堆叠。
以此方式，取决于待执行的特定手术程序，用户或外科医生可以负荷装载有特定大小的手术夹具的手术夹筒组合件300。另外，在手术程序期间，如果需要使用经不同大小设定的手术夹具，那么用户或外科医生可以弹出或卸荷装载到外部导管组合件200上的手术夹筒组合件300，且接着将新手术夹筒组合件300(与卸载的手术夹筒组合件300相比较，具有装载在其中的经不同大小设定的手术夹具的堆叠)装载到外部导管组合件200上。
另外，根据本公开，可以在恰当清洁、消毒、高压处理等等之后再使用手柄组合件110和外部导管组合件200，且在其完整和/或部分使用之后安置夹筒组合件300。
同样根据本公开，进一步预期可以提供包含一手术施夹器100和多个夹筒组合件300的手术成套工具，多个夹筒组合件300包含装载有具有第一尺寸的手术夹具的堆叠的至少第一组夹筒组合件和装载有具有不同于第一尺寸的第二尺寸的手术夹具的堆叠的第二组夹筒组合件。成套工具可以包含针对以下的指令：组合件或手术施夹器100、对手术施夹器100的使用和在使用之后处理手术施夹器组合件100，手术施夹器100包含单个手柄组合件110、单个外部导管组合件200、单个夹筒组合件300和被配置成保留其的封装体、容器或盒子。
例如本文中所描述的施夹器的手术器械还可以被配置成对机器人手术系统起作用，且机器人手术系统通常被称为“遥控手术”。此类系统使用各种机器人元件来辅助外科医生，且允许手术器械的远程操作(或部分远程操作)。出于此目的可使用各种机器人臂、齿轮、凸轮、滑轮、电马达以及机械马达等等，并且可将其设计成具有机器人手术系统以在手术或治疗的过程期间辅助外科医生。此类机器人系统可包含远程可导向系统、自动柔性手术系统、远程柔性手术系统、远程铰接手术系统、无线手术系统、模块化或可选择性配置远程操作手术系统等等。
机器人手术系统可与紧接于手术室或位于远程位置中的一个或多个控制台一起使用。在此情况下，一个团体的外科医生或护士可使患者对手术作好准备，并用一个或多个本文公开的器械配置机器人手术系统，而另一外科医生(或一组外科医生)经由机器人手术系统远程控制器械。如可理解，高度熟练的外科医生可在多个位置执行多个操作而不离开他/她的远程控制台，这在经济上可有利且对于患者或一系列患者也是有益的。
手术系统的机器人臂通常通过控制器耦接到一对主控手柄。手柄可通过外科医生移动以产生任何类型手术器械(例如，末端执行器、抓钳、小刀、剪刀等等)的工作端的对应移动，这可对本文中所描述的一或多个实施例的使用进行补充。可按比例缩放主控手柄的移动，使得工作端的对应移动不同于(小于或大于)通过外科医生的操作手执行的移动。可调整比例因子或齿轮比率(gearingratio)，从而使得操作员可控制手术器械的工作端的分辨率。
主控手柄可以包含各种传感器，传感器用以将与各种组织参数或状况(例如，归因于操纵的组织抗性、切割或以其它方式治疗、通过器械压在组织上、组织温度、组织阻抗等等)相关的反馈提供给外科医生。如可理解，此类传感器向外科医生提供模拟实际操作状况的增强的触觉反馈。主控手柄还可包含多种不同致动器，其用于精细组织操纵或治疗，从而进一步增强外科医生模仿实际操作状况的能力。
参看图43，医疗工作站通常展示为工作站1000，且其通常可包含多个机器人臂1002、1003；控制装置1004；以及与控制装置1004耦接的操作控制台1005。操作控制台1005可包含可被特定设定成显示三维图像的显示装置1006；和手动输入装置1007、1008，例如外科医生的人员(未展示)借助于所述手动输入装置可能够以第一操作模式远距离操控机器人臂1002、1003。
根据本文中所公开的若干实施例中的任一个，机器人臂1002、1003中的每一个可以包含通过接合件连接的多个部件和例如支撑末端执行器1100的手术工具“ST”可以附接到的附接装置1009、1011，如下文将更详细地描述。
机器人臂1002、1003可由连接到控制装置1004的电动驱动器(未展示)驱动。控制装置1004(例如，计算机)可以设定成特别借助于计算机程序激活驱动器，以此方式使得机器人臂1002、1003，其附接装置1009、1011和因此手术工具(包含末端执行器1100)根据借助于手动输入装置1007、1008限定的移动执行所要移动。还可以使其调节机器人臂1002、1003的移动和/或驱动器的移动的方式来设定控制装置1004。
医疗工作站1000可被配置成用于在位于患者检查台1012上的患者1013上使用，所述患者待借助于末端执行器1100以微创方式治疗。医疗工作站1000也可包含多于两个机械臂1002、1003，额外的机器人臂类似地连接到控制装置1004且可借助于操作控制台1005远距离操控。医疗器械或手术工具(包括末端执行器1100)也可附接到额外机器人臂上。医疗工作站1000可包含数据库1014，具体地说所述数据库连接为与控制装置1004结合，在所述控制装置中存储例如来自患者/活体1013和/或身体结构数据集的手术前数据。
在本文中参考2011年11月3日提交的名为“医疗工作站(Medical Workstation)”的美国专利公开案第2012/0116416号，所述美国专利公开案的全部内容以引用的方式并入本文中，以用于更详细地论述示范性机器人手术系统的建构和操作。
预期在本公开的范围内，包含具有独特且多样关闭冲程长度的一对夹钳的其它内窥镜组合件可具有与本文中所描述的驱动组合件中的任一个相似的驱动组合件，以用于将其一对夹钳的关闭冲程长度调整和调适成恒定的触发器冲程长度。
因此，可以提供根据本公开的原理的建构各种内窥镜组合件并且其也能够在用于多个不同制造商的多个平台上发动或形成或关闭具有各种尺寸、材料及配置的手术夹具。
应理解，前述描述仅说明本公开。所属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此类替代、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 (12)
1.一种可搁置手术施夹器，包括：
手柄组合件，包含外壳、固定手柄、触发器和可移除地支撑在所述外壳内且可由所述触发器操作性地致动的驱动组合件，所述驱动组合件包含具有近端和远端的驱动杆；
外部导管组合件，安置在所述外壳的远端上且从其向远侧延伸；和
夹筒组合件，选择性地可连接到所述外部导管组合件的远端，所述夹筒组合件包含：
外部导管；
一对夹钳，固定地支撑在所述外部导管的远端中；
第一夹钳推动器，与所述驱动杆的所述远端选择性地啮合；
第二夹钳推动器，其中所述第二夹钳推动器的近端与所述第一夹钳推动器选择性地啮合且所述第二夹钳推动器的远端与所述一对夹钳选择性地啮合；和
多个手术夹具，其安置在所述外部导管内，
其中所述驱动杆的所述远端限定从其延伸的突片，
其中所述第一夹钳推动器的近端包含限定在其中的凹穴，所述凹穴被配置成选择性地啮合所述驱动杆的所述突片，
其中所述夹筒组合件的所述外部导管进一步包含一对限定在其中的窗口，所述一对窗口被配置成收纳从所述第一夹钳推动器的每一侧延伸的对应的一对突片，其中当所述第一夹钳推动器的所述一对突片收纳于所述外部导管的对应的所述一对窗口内时，准许所述第一夹钳推动器的所述凹穴收纳所述驱动杆的所述突片。
2.根据权利要求1所述的可搁置手术施夹器，其中所述触发器的致动造成所述驱动杆和所述第一夹钳推动器的远侧移动，其中所述触发器的持续致动使得所述第一夹钳推动器的远端邻接所述第二夹钳推动器的近侧表面，借此在远侧方向上推动所述第二夹钳推动器。
3.根据权利要求1所述的可搁置手术施夹器，其中所述第二夹钳推动器包含限定在其所述近端上的倒钩。
4.根据权利要求3所述的可搁置手术施夹器，其中所述第一夹钳推动器包含限定在其远端上的倒钩，所述第一夹钳推动器的所述倒钩被配置成当所述第一夹钳推动器在近侧方向上前进时啮合所述第二夹钳推动器的所述倒钩。
5.根据权利要求1所述的可搁置手术施夹器，其中所述手柄组合件的所述外壳包含圆筒外壳，所述固定手柄从所述圆筒外壳延伸，所述圆筒外壳限定从中通过的镗孔、开口近端和开口远端；且
其中所述触发器可枢转地支撑在所述圆筒外壳上并从所述圆筒外壳延伸，所述触发器包含延伸到所述圆筒外壳的所述镗孔中的致动端。
6.根据权利要求5所述的可搁置手术施夹器，进一步包含端盖，所述端盖包含限定在其中的镗孔，所述端盖被配置成收纳于所述圆筒外壳的所述开口近端内。
7.根据权利要求6所述的可搁置手术施夹器，其中所述驱动杆包含从所述驱动杆的所述近端延伸并在近侧方向上从其延伸的细长延伸部，所述细长延伸部被配置成可滑动地收纳于所述端盖的所述镗孔内。
8.根据权利要求5所述的可搁置手术施夹器，其中所述手柄组合件的所述触发器包含致动端，其中所述触发器的所述致动端安置在所述驱动杆近侧并与所述驱动杆操作性地接触。
9.根据权利要求8所述的可搁置手术施夹器，其中所述手柄组合件的所述触发器可枢转到其中所述触发器的所述致动端不在所述圆筒外壳的所述镗孔内的位置。
10.根据权利要求9所述的可搁置手术施夹器，其中当所述触发器的所述致动端不在所述圆筒外壳的所述镗孔内时，所述驱动组合件的远端可插入到所述圆筒外壳的所述开口近端中且能够推进通过所述圆筒外壳并至少部分地通过所述外部导管组合件。
11.根据权利要求5所述的可搁置手术施夹器，其中所述外部导管组合件包含支撑所述夹筒组合件的所述外部导管的旋钮，其中所述手柄组合件的所述圆筒外壳和所述外部导管组合件的所述旋钮经由卡口型连接彼此可选择性地连接。
12.根据权利要求1所述的可搁置手术施夹器，其中所述夹筒组合件的近端经由搭扣配合连接选择性地可连接到所述外部导管组合件。
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2016
- 2016-01-11 JP JP2018534822A patent/JP6642955B2/ja active Active
- 2016-01-11 WO PCT/CN2016/070571 patent/WO2017120734A1/en active Application Filing
- 2016-01-11 US US16/063,711 patent/US10932793B2/en active Active
- 2016-01-11 AU AU2016386597A patent/AU2016386597A1/en not_active Abandoned
- 2016-01-11 EP EP16884297.9A patent/EP3402417A4/en active Pending
- 2016-01-11 CA CA3009420A patent/CA3009420A1/en not_active Abandoned
- 2016-01-11 CN CN201680078525.4A patent/CN108472044B/zh active Active
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Also Published As
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|---|---|
| EP3402417A4 (en) | 2019-12-04 |
| AU2016386597A1 (en) | 2018-07-05 |
| CA3009420A1 (en) | 2017-07-20 |
| EP3402417A1 (en) | 2018-11-21 |
| US10932793B2 (en) | 2021-03-02 |
| JP2019503223A (ja) | 2019-02-07 |
| JP6642955B2 (ja) | 2020-02-12 |
| US20200261095A1 (en) | 2020-08-20 |
| CN108472044A (zh) | 2018-08-31 |
| WO2017120734A1 (en) | 2017-07-20 |
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