CN108784774A - 可重复使用的多发射外科手术施夹器 - Google Patents

可重复使用的多发射外科手术施夹器 Download PDF

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CN108784774A
CN108784774A CN201810409917.5A CN201810409917A CN108784774A CN 108784774 A CN108784774 A CN 108784774A CN 201810409917 A CN201810409917 A CN 201810409917A CN 108784774 A CN108784774 A CN 108784774A
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fixture
surgical operation
shaft assembly
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CN108784774B (zh
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P·V·R·莫汉
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Covidien LP
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    • 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
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
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Abstract

一种可重复使用的外科手术施夹器包括手柄组件，与手柄组件可释放地接合的轴组件，以及可释放地接合在轴组件内的夹具仓组件。当组装可重复使用的外科手术施夹器时，手柄组件的近侧驱动器向近侧定位成邻近轴组件的内驱动器，使得手柄组件的手柄朝向接近位置的移动致动轴组件的钳夹组件。当组装可重复使用的外科手术施夹器时，手柄组件的近侧推动器向近侧定位成邻近夹具仓组件的远侧推动器，使得手柄朝向隔开位置的移动将夹具仓组件的最远侧外科手术夹具装载到钳夹组件中。

Description

可重复使用的多发射外科手术施夹器
相关申请的交叉引用
本申请要求于2017年5月4日提交的美国临时专利申请第62/501,125号的权益和优先权，其全部公开内容以引用方式并入本文中。
技术领域
本发明涉及外科手术施夹器，并且更具体地涉及一种可重复使用的多发射外科手术施夹器，其包括手柄组件、轴组件和夹具仓组件，所述组件被构造成用于选择性拆卸以利于任何一次性部件的用后丢弃以及任何可重复使用部件的再处理以供进一步使用。
背景技术
本领域已知各种缝合器和施夹器，并用于许多独特且有用的外科手术。例如，在Green等人的共同转让的美国专利第5,084,057号和第5,100,420号中描述了能够在单次进入体腔期间施加多个夹具的施夹器，两个专利的全部内容以引用方式并入本文中。在Pratt等人的共同转让的美国专利第5,607,436号中公开了另一种多夹具施夹器，其全部内容也以引用方式并入本文中。Pier等人的美国专利第5,695,502号公开了一种可重复消毒的外科手术施夹器，其全部内容以引用方式并入本文中，该可重复消毒的外科手术施夹器被构造成接收可互换夹具库并与之协作，以便在单次进入体腔期间推进并形成多个夹具。
发明内容
本发明涉及一种可重复使用的多发射外科手术施夹器，其包括手柄组件、轴组件和夹具仓组件，所述组件被构造成用于选择性拆卸以利于任何一次性部件的用后丢弃以及任何可重复使用部件的再处理以供进一步使用。
根据本发明的各方面提供的可重复使用的外科手术施夹器包括手柄组件，与手柄组件可释放地接合的轴组件以及可释放地接合在轴组件内的夹具仓组件。
手柄组件包括壳体，相对于壳体在隔开位置与接近位置之间可移动的一个或多个手柄，以及设置在壳体内的内致动组件。内致动组件包括近侧推动器和近侧驱动器并可操作地联接到手柄，使得手柄朝向接近位置的移动使近侧推动器向近侧移动并使近侧驱动器向远侧移动，并且使得手柄朝向隔开位置的移动使近侧推动器向远侧移动并使近侧驱动器向近侧移动。
轴组件包括外管，支撑在外管的远端部分处的钳夹组件，以及内驱动器，该内驱动器可滑动地设置在外管内并可操作地联接到钳夹组件，使得内驱动器穿过外管的远侧移动致动钳夹组件。
夹具仓组件在其中保持一叠外科手术夹具并且包括可操作地联接到该叠外科手术夹具的最远侧外科手术夹具的远侧推动器，使得当夹具仓组件可释放地接合在轴组件内时，远侧推动器的远侧移动将最远侧外科手术夹具装载到钳夹组件中。
当轴组件与手柄组件可释放地接合并且夹具仓组件可释放地接合在轴组件内时，近侧驱动器向近侧定位成邻近内驱动器，使得手柄朝向接近位置的移动致动钳夹组件，并且近侧推动器向近侧定位成邻近远侧推动器，使得手柄朝向隔开位置的移动将最远侧外科手术夹具装载到钳夹组件中。
在本发明的一个方面，夹具仓组件还包括被构造成向近侧偏置远侧推动器的偏置构件。
在本发明的另一方面，轴组件还包括被构造成向近侧偏置内驱动器的偏置构件。
在本发明的另一方面，轴组件的外管限定细长切口。在这些方面，然后夹具仓组件可移除地插入到细长切口中以将夹具仓组件可释放地接合在轴组件内。在这些方面，夹具仓组件可以包括可在解锁位置与锁定位置之间移动的滑动件，以将夹具仓组件可释放地锁定在细长切口内。此外，滑动件可以可释放地保持在锁定位置和解锁位置的每一个中。
在本发明的又一方面，手柄组件的壳体包括限定中心通路和向内延伸到中心通路内的保持环的远侧口部。在这些方面，轴组件包括围绕外管的近端部分设置的近侧套环。近侧套环限定环形凹部，该环形凹部被构造成在近侧套环插入到远侧口部中之后容纳保持环，以将轴组件与手柄组件可释放地接合。
在本发明的又一方面，近侧套环限定倒角近侧表面。在些方面，保持环被构造成在近侧套环插入到远侧口部中之后在倒角近侧表面上凸轮接合并进入环形凹部。
在本发明的另一方面，手柄组件包括可枢转地联接到壳体并从其相对侧延伸的一对手柄。
在本发明的又一方面，手柄组件的壳体包括可在打开位置与关闭位置之间移动的门，以选择性地提供通向壳体内部的入口。
在本发明的另一方面，夹具仓组件包括至少部分透明的盖，以使得能够透过至少部分透明的盖可视该叠外科手术夹具。
在本发明的又一方面，该叠外科手术夹具的最近侧夹具限定实心盘构型，使得当最近侧夹具被装载到钳夹组件中时，阻止钳夹组件的致动。
在本发明的又一方面，夹具仓组件还包括被构造成向远侧偏置该叠外科手术夹具的夹具从动件。在这些方面，在将该叠外科手术夹具中的最近侧外科手术夹具装载到钳夹组件中之后，夹具从动件可以被构造成接合远侧推动器。
在本发明的另一方面，手柄组件的内致动组件的近侧推动器包括杆，手柄组件的内致动组件的近侧驱动器包括限定管腔的销钉，并且杆可滑动地设置在销钉的管腔内。
在本发明的又一方面，钳夹组件的至少一部分可从外管移除。另外或替代地，内驱动器的至少一部分可从外管移除。
在本发明的另一方面，内驱动器包括近侧驱动柱塞和接合到近侧驱动柱塞的远侧驱动杆。当轴组件与手柄组件可释放地接合并且夹具仓组件可释放地接合在轴组件内时，手柄朝向接近位置的移动向远侧推动近侧驱动器使其与近侧驱动柱塞接触，从而使远侧驱动杆向远侧移动以致动钳夹组件。
在本发明的另一方面，当轴组件与手柄组件可释放地接合并且夹具仓组件可释放地接合在轴组件内时，手柄朝向隔开位置的移动向远侧推动近侧推动器使其与远侧推动器接触，从而将最远侧外科手术夹具装载到钳夹组件中。
附图说明
根据本发明参考附图提供了可重复使用的多发射外科手术施夹器的各方面和特征，其中：
图1是根据本发明提供的可重复使用的多发射外科手术施夹器的俯视透视图，其以组装状态示出，其中手柄组件的门关闭；
图2是图1的外科手术施夹器的俯视透视图，其以组装状态示出，其中手柄组件的门打开；
图3是图1的外科手术施夹器的俯视透视图，其以拆卸状态示出；
图4是图1的外科手术施夹器的夹具仓组件的俯视图；
图5是图4的夹具仓组件的仰视图；
图6是图4的夹具仓组件的侧面透视图，其中从夹具仓组件的其它部件移除盖壳体；
图7是以图6中的“7”表示的细节区域的放大侧面透视图；
图8是沿图4中的截面线“8-8”截取的横截面的正面透视图；
图9是图4的夹具仓组件的正面透视图，其中各部分分开；
图10是沿图4的截面线“10-10”截取的纵向横截面图；
图11是在图10中以“11”表示的细节区域的放大的纵向横截面图；
图12是以图10中的“12”表示的细节区域的放大的纵向横截面图；
图13是图1的外科手术施夹器的轴组件的俯视透视图；
图14是图13的轴组件的侧视图；
图15是图13的轴组件的俯视图；
图16是沿图15的截面线“16-16”截取的纵向横截面图；
图17是图13的轴组件的俯视透视图，其中各部分分开；
图18是图1的外科手术施夹器的手柄组件的俯视透视图，其中移除了壳体部分以示出其中的内部部件；
图19是沿图3的截面线“19-19”截取的纵向横截面图；
图20是沿图3的截面线“20-20”截取的纵向横截面图；
图21是图18的手柄组件的俯视透视图，其中各部分分开；
图22和图23是示出图13的轴组件与图18的手柄组件的接合的纵向截面图；
图24和图25是示出图4的夹具仓组件与图13的轴组件的接合的俯视透视图；
图26是图1的外科手术施夹器的纵向截面图，其以组装状态设置；
图27是以图26中的“27”表示的细节的放大的纵向横截面图；
图28是图1的外科手术施夹器的远侧部分的俯视图；以及
图29是图1的外科手术施夹器的远端部分的放大的正面透视图，其中以虚线示出部件以示出外科手术施夹器的内部特征。
具体实施方式
下面参考附图详细描述根据本发明的可重复使用的多发射外科手术施夹器，其中相同的附图标记标识相似或相同的结构元件。如附图中所示以及贯穿以下描述所描述的，当涉及外科手术器械上的相对定位时，传统意义上的术语“近侧”是指装置或其部件的靠近用户的端部，并且术语“远侧”是指装置或其部件的远离用户的端部。
首先参考图1到图3中，根据本发明提供的外科手术施夹器总体上被表示为10。外科手术施夹器10包括手柄组件100，从手柄组件100向远侧延伸的轴组件200，以及安装在轴组件200内的夹具仓组件300。轴组件200可移除地且可选择性地与手柄组件100接合，并且夹具仓组件300可移除地且可选择性地安装在轴组件200内。手柄组件100和轴组件200可以被构造成可消毒的可重复使用的部件，而夹具仓组件300可以被构造成单次手术使用的部件。如下面详细描述，一叠外科手术夹具“C”(图6)被装载到夹具仓组件300中，使得在操作中，手柄组件100的每次致动致动手柄组件100、轴组件200以及仓组件300的协作驱动部件以围绕血管或其它组织从该叠外科手术夹具“C”(图6)发射并形成单个外科手术夹具以结扎血管或其它组织。
参考图4到图12，夹具仓组件300包括仓盖310、夹具载体320、夹具从动件330、远端推动器340、滑动件350、第一偏置构件360、第二偏置构件370以及一叠外科手术夹具“C”。
参考图4到图6和图9，仓盖310限定了多个接合狭槽312、内部空腔314、窗口316和一对相对的销管腔318。仓盖310可以至少部分地由透明材料形成，例如，透明塑料，以能够可视其内部空腔314。仓盖310的接合狭槽312被构造成容纳夹具载体320的接合凸缘326，以围绕夹具载体320接合仓盖310，例如与其卡扣配合接合。内部空腔314被构造成容纳夹具从动件330、远端推动器340、滑动件350、第一偏置构件360以及其中的该叠外科手术夹具“C”的至少一部分。
仓盖310的窗口316被构造成可滑动地容纳滑动件350的帽部分354。仓盖310包括从其一侧横向延伸到近侧窗口316中的突出部317。滑动件350的帽部分354限定了限定在其一侧上的更向近侧定位的凹部355a和限定在其相同侧上的更向远侧定位的凹部355b。更向近侧定位的凹部355a被构造成容纳仓盖310的突出部317，以将滑动件350可释放地保持在相对于仓盖310的远侧位置。一旦滑动件350的帽部分354相对于仓盖310充分向近侧推动，仓盖310的突出部317从滑动件350的帽部分354的更向近侧定位的凹部355a移出，使得滑动件350能够穿过窗口316向近侧滑动。一旦滑动件350充分向近侧滑动，突出部317接合在滑动件350的帽部分354的更向远侧定位的凹部355b内，从而将滑动件350可释放地保持在相对于仓盖310的近侧位置中。在下文中详细描述滑动件350的近侧位置和远侧位置。
仓盖310的相对销管腔318被构造成支撑横向销319的相对端部。第二偏置构件370的近端部分372围绕横向销319接合，因此将第二偏置构件370的近端部分372相对于仓盖310以及因此相对于夹具载体320固定。
参考图6到图9，夹具仓组件300的夹具载体320包括底板322和沿着底板322的相对侧纵向延伸的一对侧壁324，使得夹具载体320限定大致U形构型。夹具载体320被构造成用于定位在仓盖310与推动器330之间并且包括多个接合凸缘326，如上所述，该多个接合凸缘被构造成容纳在仓盖310的接合狭槽312内以围绕夹具载体320接合仓盖310，例如与其卡扣配合接合。
另外参考图12，夹具载体320还包括从底板322朝向夹具载体320的远端部分向上延伸的弹性中心柄脚328。弹性中心柄脚328被构造成接合该叠外科手术夹具的最远侧外科手术夹具的后跨部“C”以将该叠外科手术夹具“C”保持在夹具载体320内。夹具载体320还包括从底板322的下侧朝向其近端部分悬垂的支脚329。
参考图6和图9，夹具仓组件300的夹具从动件330包括可滑动地设置在该叠外科手术夹具“C”近侧的夹具载体320内的远侧滑块322。夹具从动件330的远侧滑块322更具体地构造成向近侧定位成邻近该叠外科手术夹具“C”的最近侧夹具，呈与其邻接关系。如下详述，远侧滑块322还限定穿过其中的一对狭槽333。夹具从动件330还包括从远侧滑块322向近侧延伸的细长杆334。细长杆334限定接合到远侧滑块322的固定远端和可滑动地设置在限定在滑动件350的基座部分352内的管腔353内的自由近端。第一偏置构件360围绕夹具从动件330的细长杆334设置在滑动件350的远侧滑块322与基座部分352之间，以将远侧滑块322向远侧偏置到该叠外科手术夹具“C”的最近侧夹具中，从而向远侧偏置该叠外科手术夹具“C”。
参考图9到图11，夹具仓组件300的远侧推动器340可滑动地围绕夹具载体320的下侧(例如，与夹具从动件330相对)设置。远侧推动器340包括位于其远端部分处的一对推动器凸缘342，该推动器凸缘被构造成在夹具载体320的弹性中心柄脚328上向远侧推动该叠外科手术夹具“C”的最远侧外科手术夹具并且从夹具仓组件300向远侧推动到钳夹238(图3)中。远侧推动器340还包括朝向其近端部分限定在其中的近侧狭槽344，该近侧狭槽被构造成可滑动地容纳夹具载体320的支脚329以使远侧推动器340和夹具载体320彼此保持对准，同时允许远侧推动器340相对于夹具载体320纵向滑动。
远侧推动器340还包括在远侧推动器340的中间部分从其下侧悬垂的凸缘346。凸缘346被构造成容纳第二偏置构件370的远侧端部374，使得第二偏置构件370的远侧端部374相对于远侧推动器340固定。在第二偏置构件370的远端部分374相对于远侧推动器340固定，并且其近端部分372相对于仓盖310(经由横向销319，如上所述)固定的情况下，第二偏置构件370用于将远侧推动器340相对于仓盖310，以及因此相对于夹具载体320和该叠外科手术夹具“C”向近侧偏置。
远端推动器340另外包括设置在其近端部分处的面向近侧的推动器表面348。面向近侧的推动器表面348可以是近侧延伸部349的一部分，该近侧延伸部与远侧推动器340整体地形成并且在其近端部分下面和下方折叠以限定面向近侧的推动器表面348。
参考图4、图6和图9，夹具仓组件300的滑动件350包括基座部分352和设置在基座部分352上的帽部分354。如上详述，帽部分352被构造成可滑动地容纳在仓盖310的窗口316内并且可以在近侧位置或远侧位置中可释放地接合在其中。在远侧位置中，滑动件350的基座部分352不向近侧延伸超出仓盖310的近端部分。在近侧位置中，基座部分352向近侧延伸超出仓盖310的近端部分。如下详述，滑动件350在远侧位置与近侧位置之间的移动能够实现夹具仓组件300在轴组件200内的选择性锁定和解锁(图3)。
如上所述，滑动件350的底座部分352限定纵向延伸穿过其中的管腔353。管腔353被构造成可滑动地容纳夹具从动件330的细长杆334。滑动件350的帽部分352可限定带纹理的(例如带凹槽的)上表面356，以利于抓握滑动件350的帽部分352以使滑动件350在近侧位置与远侧位置之间滑动。
继续参考图6和图9，如上详述，该叠外科手术夹具“C”支撑在夹具载体320内，其夹具以从头到尾的方位进行布置。除了最近侧夹具“PC”之外，该叠外科手术夹具“C”的每个外科手术夹具包括由后跨部互连的一对支脚。最近侧夹具“PC”形成为实心盘并且可以被区别地标记和/或着色。以这种方式提供最近侧夹具“PC”使得用户能够通过透过仓盖310观察最近侧夹具“PC”的位置来视觉地确定或至少估计剩余外科手术夹具的数量。如下详述，如果最近侧夹具“PC”装载到钳夹238(图3)中，则其也用作锁定件。
参考图13到图17，轴组件200包括外管210、近侧套环220、内止挡环225、钳夹组件230和内驱动组件240。外管210包括开口远端部分212、开口近端部分214，分别在开口远端部分212与开口近端部分214之间延伸并与其连通的管腔216，以及限定穿过外管210的侧壁并与穿过其的管腔216连通的细长切口218。细长切口218与外管210的开口远端部分212间隔开，使得外管210限定设置在细长切口218远侧的管状远侧部段219a。细长切口218也与外管210的开口近端部分214间隔开，使得外管限定设置在细长切口218近侧的管状近侧部段219b。
近端套环220围绕外管210的管状近侧部段219b固定地接合。近侧套环220限定环形凹部222和邻近环形凹部222的倒角近侧环形边缘224。内止挡环225设置在外管210的管状近侧部段219b内并且以任何合适的方式(例如焊接)固定地接合在其中。
钳夹组件230包括固定基座232和钳夹部件236。固定基座232例如经由焊接固定在外管210内的内部表面上。固定基座232包括近侧指状部233、中心块234和远侧指状部235。钳夹部件236包括近侧毂237a、分叉颈部237b和一对钳夹238，其中一个钳夹附接到分叉颈部237b的每个分叉部分的自由远端。钳夹部件236的近侧毂237a限定了狭槽237c，该狭槽被构造成容纳固定基座232的中心块234，而近侧指状部233被构造成接合近侧毂237a的近端部分，而远侧指状部235被构造成接合分叉颈部237b的分叉部分之间的近端毂237a的远端部分，以围绕外管210内的固定基座232接合钳夹组件236。在钳夹组件236以这种方式围绕固定基座232接合的情况下，钳夹238从外管210的开口远端214向远侧延伸。
钳夹组件230的钳夹238经由分叉颈部237b彼此偏置开。钳夹238限定了面向外的凸轮表面239a和面向内的通道239b。如下详述，内驱动组件240的远侧驱动杆242被构造成接合钳夹238的凸轮表面239a并且朝向彼此推动钳夹238。如下文还将详述，钳夹238的面向内的通道239b被构造成在其中容纳该叠外科手术夹具“C”中的一个外科手术夹具的支脚，以在其形成期间将该外科手术夹具保持在钳夹238内。
继续参考图13到图17，轴组件200的内驱动组件240包括具有远侧驱动杆242和近侧驱动柱塞244的内驱动器，以及驱动偏置构件246。远侧驱动杆242包括基座243a和沿着基座243a的相对侧纵向延伸的一对侧壁243b，以限定沿着远侧驱动杆242纵向延伸的内通道243c。
内驱动组件240的远侧驱动杆242还包括盒状远端部分243d和狭槽243e，该狭槽朝向其盒状远端部分243d限定穿过基座243a。远侧驱动杆242可滑动地设置在外管210的管腔216内。狭槽243e被构造成可滑动地容纳穿过其中的钳夹组件230的固定基座232，以使远侧驱动杆242能够在外管210内并且围绕固定基座232滑动。远侧驱动杆242的盒状远端部分243d被构造成用于围绕钳夹组件230的分叉颈部237b定位。在远侧驱动杆242的远侧推进之后，如下详述，远侧驱动杆242的盒状远端部分243d围绕钳夹部件236向远侧推进以围绕钳夹238的凸轮表面239a凸轮接合，从而将钳夹238朝向彼此推动。
近侧驱动柱塞244包括近侧毂245a和相对于近侧毂245a固定并向远侧延伸的远侧轴245b。远侧轴245b的远端部分接合在远侧驱动杆242的内通道243c的近端部分内。内驱动组件240的驱动偏置构件246围绕近侧驱动柱塞244的远侧轴245b设置在近侧毂245a与内环止挡件225之间以便向近侧偏置近侧驱动柱塞244并因此偏置远侧驱动杆242。近侧驱动柱塞244的近端毂245a还限定穿过其中的孔245c。
钳夹部件236和内驱动组件240可从外管210移除，以利于对其各种部件进行再处理以重新使用。为了将钳夹部件236和内驱动组件240插入以与外管210并彼此可操作地接合，由其近侧毂237a引导的钳夹部件236穿过外管210的开口远端212向近侧插入，直到钳夹部件236的狭槽237c在固定基座232的中心块234上方对齐。由远侧驱动杆242的盒状远端部分243d引导的内驱动组件240穿过外管210的开口近端214向远侧插入，并且围绕钳夹部件236向远侧滑动直到远侧驱动杆242的盒状远端部分243d围绕钳夹部件236的分叉颈部237b设置，使得钳夹部件236的近侧毂237a设置在远侧驱动杆242的基座243a的狭槽243e上方，并且使得驱动偏置构件246的远端部分被推动抵靠外管210内的内环止挡件225。
一旦内驱动组件240和钳夹部件236如上详述已被定位，钳夹部件236的近侧毂237a可通过远侧驱动杆242的基座243a的狭槽243e与固定基座232接合。更具体地说，钳夹部件236的近侧毂237a被推向固定基座232的中心块234，使得中心块234容纳在钳夹部件236的狭槽237c内，并且固定基座232的近侧指状部233和远侧指状部235分别围绕钳夹部件236的近侧毂237a的近端部分和远端部分接合。在钳夹部件236以这种方式与固定基座232接合的情况下，固定基座232至少部分地延伸穿过远侧驱动杆242的基座243a的狭槽243e并且远侧驱动杆242的盒式远端部分243d围绕钳夹部件236的分叉颈部237b设置。因此，外管210、钳夹部件236和内驱动组件240彼此可操作地接合。以与如上详述的插入和接合相反的方式实现钳夹部件236和内驱动组件240与外管210的脱离和移除。
参考图1到图3和图18到图21，手柄组件100包括壳体110、一对手柄130和内致动组件140。壳体110包括通过多个螺柱116彼此固定的上壳体部分112和下壳体部分114，但是也可以设想其它合适的接合。每个壳体部分112、114还限定了枢轴凹部117。壳体110的一个壳体部分(例如上壳体部分112)限定了通过门120选择性进入的进入开口118。门120经由铰链122联接到壳体部分以使门120能够在覆盖进入开口118的关闭位置(图1)与暴露进入开口118的打开位置(图3)之间枢转。门120还包括闩锁124，该闩锁使得能够将门120可释放地闩锁在关闭位置。在门120的打开位置(图3)中，提供通向壳体110内部的入口以利于手柄组件100的再处理以重新使用。
壳体110还包括开口远侧口部126，该开口的远侧口部被构造成容纳穿过其中的轴组件200的近端部分，以将轴组件200与手柄组件100可释放地接合，如下详述。开口远侧口部126由上壳体部分112和下壳体部分114的协作口部形成并且限定中心通路127。保持环128捕获在开口远侧口部126内并径向向内突出到中心通路127中。保持环128被构造成可释放地接合轴组件200的近侧套环220以将轴组件200与手柄组件100可释放地接合，如下详述。
手柄组件100的手柄130可枢转地联接到壳体110并从其相对侧向外延伸。每个手柄130更具体地包括在其远端部分处的枢轴柱132和在其近端部分处的指环134。枢轴柱132可枢转地联接到壳体110，以使得手柄130能够相对于壳体110在隔开位置与接近位置之间枢转。指环134利于操纵手柄130以在隔开位置与接近位置之间枢转手柄130。
手柄组件100的每个手柄130还包括连杆136，该连杆在其第一端部处经由枢转凸台138可枢转地联接到对应手柄130的中间部分。连杆136分别在其第二端部处可枢转地联接到内致动组件140，如下详述。
内致动组件140包括包括近侧驱动杆142和驱动销钉154的近侧驱动器，包括棘轮齿条144和一对棘轮棘爪146的棘轮组件，包括连杆臂150和连杆凸台152的连杆组件，包括近侧推杆156和近侧推动板158的近侧推动器，以及偏置构件160。
近侧驱动杆142可滑动地设置在壳体110内。近侧驱动杆142包括一对手柄枢转支撑件143a，手柄130的连杆136的第二端部围绕该枢轴支撑件枢转地接合。如下详述，近侧驱动杆142还包括突片143b，连杆凸台152围绕该突片143b可操作地联接。驱动销钉154固定地支撑在近侧驱动杆142的远端部分上，从近侧驱动杆142向远侧延伸，并限定纵向延伸穿过其中的管腔155。
棘轮齿条144固定地支撑在近侧驱动杆142的近端部分上并且限定沿着其相对侧延伸的第一组齿145和第二组齿145。第一组齿145和第二组齿145被构造成分别接合第一棘轮棘爪146和第二棘轮棘爪146。如下详述，棘轮棘爪146在棘轮齿条144的任一侧可枢转地支撑在壳体110内，并且相对于棘轮齿条144的该组齿145可操作地定位，以向内致动组件140提供棘轮功能。偏置构件147将棘轮棘爪146朝向中立位置偏置。
继续参考图18到图21，连杆臂150在其远端部分处可枢转地联接到近端推动板158并在其近端部分处联接到连杆凸台152。连杆凸台152经由其枢轴柱153a可枢转地支撑在壳体110内，该枢轴柱分别容纳上壳体部分112和下壳体部分114的对应枢轴凹部117内。连杆凸台152还限定了构造成可滑动地容纳近侧驱动杆142的突片143b的弓形狭槽153b。弓形狭槽153b是开口的，以实现与近侧驱动杆142的突片143b的选择性联接(和断开联接)，如下详述。
近侧推杆156的近端部分固定地接合在近侧推动板158上，该近侧推动板继而滑动地支撑在驱动销钉154近侧的近侧驱动杆142上。近侧推杆156从近侧推动板158向远侧延伸穿过相对于其可滑动地关联的驱动销钉154的管腔155，并且从驱动销钉154向远侧延伸。
偏置构件160围绕近侧驱动杆142设置。偏置构件160的远端部分邻接壳体110内的内部特征，而偏置构件160的近端部分邻接连杆136的第二端部。在此方式，偏置构件160用于将手柄130相对于壳体110朝向隔开位置偏置。
在操作中，在手柄130相对于壳体110设置在隔开位置(在偏置构件160的偏置下)的情况下，近侧驱动杆142以及因此驱动销钉154设置在最近侧位置，而近侧推杆156和近侧推动板158设置在最远侧位置。当手柄130朝向壳体110朝向接近位置枢转时，连杆136向远侧推动近侧驱动杆142。当驱动杆142向远侧被推动时，近侧驱动杆142的突片143b进入连杆凸台152的弓形狭槽153b并作用于其上，以使连杆凸台152围绕枢轴柱153a旋转，使得连杆臂150的近端部分横向向外移动，从而向近侧拉动连杆臂150的远端部分。如此，连杆臂150、近侧推动板158和近侧推杆156向近侧被拉动。在手柄130相对于壳体110设置在接近位置的情况下，近侧驱动杆142以及因此驱动销钉154设置在最远侧位置，而近侧推杆156和近侧推动板158设置在最近侧位置。
在上述手柄130朝向接近位置枢转期间，棘轮棘爪144与棘轮齿条146相互作用以提供可听见的咔哒声和/或触觉振动，指示手柄130正在移动穿过致动冲程。此外，在手柄130到达接近位置之后，棘轮棘爪146清除棘轮齿条144，翻转方位以使手柄130能够返回，并且提供冲程结束时可听见的咔哒声和/或触觉振动。
在手柄130被释放或相对于壳体110朝向隔开位置返回之后，手柄130向近侧拉动连杆136，从而向近侧拉动近侧驱动杆142。当驱动杆142向近侧被拉动时，近侧驱动杆142的突片143b沿着连杆凸台152的弓形狭槽153b移动并且最终离开，使得连杆凸台152围绕枢轴柱153a旋转以向内拉动连杆臂150的近端部分，从而向远侧推动连杆臂150的远端部分。如此，连杆臂150、近侧推动板158和近侧推杆156向远侧被推动。
在上述手柄130朝向隔开位置返回期间，棘轮棘爪144与棘轮齿条146相互作用以提供可听见的咔哒声和/或触觉振动，指示手柄130正在移动穿过返回冲程。此外，在手柄130到达隔开位置之后，棘轮棘爪144清除棘轮齿条146，翻转方位以允许手柄130的随后致动，并且提供返回结束时可听见的咔哒声和/或触觉振动。
现在转到图22到图27，为了组装外科手术施夹器10以供使用，如上详述，如果手柄组件100、轴组件200和夹具仓组件300未预组装，则单独组装。之后，如下详述，轴组件200与手柄组件100接合。
参考图22到图23，为了将轴组件200与手柄组件100接合，将轴组件200的近端部分向近侧插入到壳体110的开口远侧口部126中。更具体地，轴组件200相对于手柄组件100向近侧移动使得轴组件200的近侧套环220向近侧插入中心通路127中并且滑动穿过其中，直到保持环128在近侧套环220的倒角的近侧环形边缘224上凸轮接合并且接合到近侧套环220的环形凹部222内，从而将轴组件200与手柄组件100可释放地接合。在上述将轴组件200的近端部分插入到壳体110的开口远端口部126期间，近侧推杆156容纳在轴组件200的内驱动组件240的近侧驱动柱塞244的近侧毂245a的孔245c内并延伸穿过其中。此外，当如上详述轴组件200与手柄组件100接合时，驱动销钉154向近侧定位成邻近近侧驱动柱塞244。一旦轴组件200与手柄组件100接合，如下详述，夹具仓组件300可接合在轴组件200内。
参考图24到图27，为了将夹具仓组件300接合在轴组件200内，如果夹具仓组件300的滑动件150尚未处于远侧位置中，则将其移动到远侧位置，其中滑动件350的基座部分352不向近侧延伸超出仓盖310的近端部分，并且其中滑动件350的帽部分354的更向近侧定位的凹部355a接合在仓盖310的突出部317内以将滑动件350保持在远侧位置。
参考图24，在滑动件处于远侧位置的情况下，夹具仓组件300穿过轴组件200的外管210的细长切口218并且相对于外管210向远侧插入，使得仓盖310的远端部分潜在外管210的管状远侧部段219a下方并且延伸穿过由外管210的管状远侧部段219a限定的管腔216的部分。在以这种方式定位仓盖310的远端部分之后，将夹具仓组件300的其余部分穿过细长切口218插入以位于外管210的管腔216内。
参考图25，一旦夹具仓组件300完全位于外管210的管腔210内且仓盖310的远端部分延伸穿过外管210的管状远侧部段219a，滑动件350向近侧被推动，使得仓盖310的突出部317从滑动件350的帽部分354的更向近侧定位的凹部355a中移出，滑动件350穿过窗口316向近侧滑动，并且突出部317接合在滑动件350的帽部分354的更向远侧定位的凹部355b内以将滑动件350保持在近侧位置。
另外参考图26和图27，在滑动件350的近侧位置，滑动件350的基座部分352向近侧延伸超出仓盖310的近端部分并进入外管210的管状近侧部段219b。因此，在滑动件350的基座部分352延伸进入外管210的管状近侧部段219b并且仓盖310的远端部分延伸穿过外管210的管状远侧部段219a的情况下，夹具仓组件300被锁定成接合在轴组件200内。以与如上详述的插入和接合相反的方式实现夹具组件300的脱离和移除。
仍然参考图26和图27，并且另外参考图18和图19，在上述将夹具仓组件300插入到轴组件200期间，使手柄组件100的手柄130移动并保持在接近位置，但在滑动件350移动以将夹具仓组件300锁定在轴组件200内期间，手柄130不必保持在接近位置。
通过在将夹具仓组件300插入到轴组件200期间使手柄组件100的手柄130保持在接近位置，近侧推杆156和近侧推动板158设置在最近侧位置，并且因此近侧推杆156不妨碍夹具仓组件300插入到轴组件200中。更确切而言，近侧推杆156在其最近侧位置处保持在夹具仓组件300的远侧推动器340的面向近侧推动器表面348的近侧。
还参考图6和图7，一旦夹具仓组件300设置在轴组件200内，手柄130可被释放或朝向隔开位置返回，使得近侧推动板158和近侧推杆156朝向其最远侧位置向远侧移动。当近侧推杆156向远侧移动时，近侧推杆156的远端部分被推动到远侧推杆340的面向近侧的推杆表面348中，从而向远侧推动远侧推杆340。当远侧推动器340向远侧移动时，其推动器凸缘342接合该叠外科手术夹具“C”的最远侧外科手术夹具的后跨部并在夹具载体320的弹性中心柄脚328上方向远侧推动最远侧外科手术夹具以及使其从夹具仓组件300向远侧进入钳夹238的面向内的通道239b中。因此，外科手术施夹器10在钳夹238内装载有外科手术夹具并准备好供以使用。当该叠外科手术夹具“C”的最远侧夹具被装载到钳夹238中时，夹具从动件330的滑块332在第一偏置构件360的偏置下向远侧推动该叠外科手术夹具“C”中的剩余夹具，使得每个夹具占据先前由其远侧相邻夹具占据的位置。
在使用中，总体参考图1、图6、图7、图18、图23和图26到图28，操纵外科手术施夹器10，使得待结扎的血管(或其它组织)设置在钳夹238之间。一旦已经达到该位置，手柄130从隔开位置朝向接近位置移动。如上详述，当手柄130朝向接近位置移动时，近侧驱动杆142向远侧被推动。当驱动杆142向远侧被推动时，驱动销钉154同样向远侧被推动，使得驱动销钉154与轴组件200的内驱动组件240的近侧驱动柱塞244的近侧毂245a接触。近侧驱动柱塞244继而克服驱动偏置构件246的偏置向远侧移动从而向远侧推动远侧驱动杆242。当远侧驱动杆242向远侧推进时，远侧驱动杆242的盒状远端部分243d向远侧推进，以围绕钳夹238的凸轮表面239a凸轮接合，从而将钳夹238朝向彼此推动以围绕血管(或其它组织)形成装载在其中的外科手术夹具。
一旦围绕血管(或其它组织)形成外科手术夹具，如由棘轮144和棘爪146所提供的冲程结束指示所示，手柄130可被释放或朝向隔开位置返回，例如该叠外科手术夹具“C”中的下一个外科手术夹具被装载到钳夹238中用于随后的发射。可以重复外科手术施夹器10的以上详述使用，以从该叠外科手术夹具“C”中发射多个外科手术夹具，直到仅剩下最近侧夹具“PC”。
参考图1和图29，一旦已经发射第二最近侧外科手术夹具(向远侧设置成邻近最近侧夹具“PC”的外科手术夹具)并且手柄130被释放或朝向隔开位置返回，远侧推动器340向远侧移动，使得其推动器凸缘342接合最近侧夹具“PC”的面向近侧的边缘并且将最近侧夹具“PC”从夹具仓组件300向远侧推动到钳夹238的面向内的通道239b中。由于最近侧夹具“PC”形成为实心盘，所以当最近侧夹具“PC”设置在其间时，阻止钳夹238朝向彼此移动。因此，阻止手柄130的致动。此外，在夹具仓组件300中没有剩余夹具的情况下，夹具从动件330的滑块332在第一偏置构件360的偏置下移动到夹具载体320的远端部分。由于这种构型，当推动器凸缘342响应于手柄130的释放或朝向隔开位置返回而向近侧移动时，推动器凸缘342接合在夹具从动件330的滑块332的狭槽333内以进一步阻止手柄130的随后致动。因此，阻止外科手术施夹器10的无夹具发射。
本发明设想了外科手术施夹器10能够在轴组件200内装载不同的外科手术夹具仓组件300。具体地，外科手术施夹器10可以装载有夹具仓组件300，该夹具仓组件具有一叠具有特定尺寸和/或构型的外科手术夹具“C”。例如，取决于具体目的，具有第一尺寸的一叠外科手术夹具“C”的第一夹具仓组件300或具有第二尺寸的一叠外科手术夹具“C”的第二夹具仓组件300可以被装载到轴组件200中，第二尺寸不同于第一尺寸。另外，在外科手术期间，如果需要使用不同尺寸和/或构型的外科手术夹具，则用户可以移除正在使用的夹具仓组件300而用不同的夹具仓组件300取代。
本发明还设想了一种外科手术套件，其包括一个手柄组件100、一个轴组件200以及一个或多个夹具仓组件300(彼此相似或不同)。该套件还可以包括用于组装外科手术施夹器10、使用外科手术施夹器10和/或在使用后对外科手术施夹器10的可重新使用部件进行再处理的说明。还可以提供包装件、容器或盒子。
应该理解，前面的描述仅仅是对本发明的说明。在不脱离本发明的情况下，本领域技术人员可以设计各种替代和修改。因此，本发明旨在涵盖所有这些替代、修改和变更。提出参考附图描述的实施例仅用于说明本发明的某些示例。与上述和/或所附权利要求书中描述的无实质不同的其它元件、步骤、方法和技术也旨在处于本发明的范围内。

Claims (20)

1.一种可重复使用的外科手术施夹器，包括：
手柄组件，包括：
壳体；
至少一个手柄，其相对于所述壳体在隔开位置与接近位置之间可移动；以及
内致动组件，其设置在所述壳体内并且包括近侧推动器和近侧驱动器，所述内致动组件可操作地联接到所述至少一个手柄，使得所述至少一个手柄朝向所述接近位置的移动使所述近侧推动器向近侧移动并使所述近侧驱动器向远侧移动，并且使得所述至少一个手柄朝向所述隔开位置的移动使所述近侧推动器向远侧移动并使所述近侧驱动器向近侧移动；
轴组件，其与所述手柄组件可释放地接合，所述轴组件包括：
外管；
钳夹组件，其支撑在所述外管的远端部分处；以及
内驱动器，其可滑动地设置在所述外管内并可操作地联接到所述钳夹组件，使得所述内驱动器穿过所述外管的远侧移动致动所述钳夹组件；以及
夹具仓组件，其可释放地接合在所述轴组件内，所述夹具仓组件在其中保持一叠外科手术夹具并且包括可操作地联接到所述叠外科手术夹具的最远侧外科手术夹具的远侧推动器，使得当所述夹具仓组件可释放地接合在所述轴组件内时，所述远侧推动器的所述远侧移动将所述最远侧外科手术夹具装载到所述钳夹组件中；
其中，当所述轴组件与所述手柄组件可释放地接合并且所述夹具仓组件可释放地接合在所述轴组件内时：
所述近侧驱动器向近侧定位成邻近所述内驱动器，使得所述至少一个手柄朝向所述接近位置的移动致动所述钳夹组件，并且
所述近侧推动器向近侧定位成邻近所述远侧推动器，使得所述至少一个手柄朝向所述隔开位置的移动将所述最远侧外科手术夹具装载到所述钳夹组件中。
2.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述夹具仓组件还包括被构造成向近侧偏置所述远侧推动器的偏置构件。
3.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述轴组件还包括被构造成向近侧偏置所述内驱动器的偏置构件。
4.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述轴组件的所述外管限定细长切口，并且其中所述夹具仓组件可移除地插入到所述细长切口中以将所述夹具仓组件可释放地接合在所述轴组件内。
5.根据权利要求4所述的可重复使用的外科手术施夹器，其中所述夹具仓组件包括可在解锁位置与锁定位置之间移动的滑动件，以将所述夹具仓组件可释放地锁定在所述细长切口内。
6.根据权利要求5所述的可重复使用的外科手术施夹器，其中所述滑动件可释放地保持在所述锁定位置和所述解锁位置的每一个中。
7.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述手柄组件的所述壳体包括限定中心通路和向内延伸到所述中心通路中的保持环的远侧口部，并且其中所述轴组件包括围绕所述外管的近端部分设置的近侧套环，所述近侧套环限定环形凹部，所述环形凹部被构造成在所述近侧套环插入到所述远侧口部中之后容纳所述保持环，以将所述轴组件与所述手柄组件可释放地接合。
8.根据权利要求7所述的可重复使用的外科手术施夹器，其中所述近侧套环限定倒角近侧表面，并且其中所述保持环被构造成在所述近侧套环插入到所述远侧口部中之后在所述倒角近侧表面上凸轮接合并进入所述环形凹部。
9.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述手柄组件包括可枢转地联接到所述壳体并从其相对侧延伸的一对手柄。
10.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述手柄组件的壳体包括可在打开位置与关闭位置之间移动的门，以选择性地提供通向所述壳体内部的入口。
11.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述夹具仓组件包括至少部分透明的盖，以使得能够透过所述至少部分透明的盖可视所述叠外科手术夹具。
12.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述叠外科手术夹具中的最近侧夹具限定实心盘构型，使得当所述最近侧夹具被装载到所述钳夹组件中时，阻止所述钳夹组件的致动。
13.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述夹具仓组件还包括被构造成向远侧偏置所述叠外科手术夹具的夹具从动件。
14.根据权利要求13所述的可重复使用的外科手术施夹器，其中，在将所述叠外科手术夹具中的最近侧外科手术夹具装载到所述钳夹组件中之后，所述夹具从动件被构造成接合所述远侧推动器。
15.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述手柄组件的所述内致动组件的所述近端推动器包括杆，其中所述手柄组件的所述内致动组件的所述近侧驱动器包括限定管腔的销钉，并且其中所述杆可滑动地设置在所述销钉的所述管腔内。
16.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述钳夹组件的至少一部分可从所述外管移除。
17.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述内驱动器的至少一部分可从所述外管移除。
18.根据权利要求1所述的可重复使用的外科手术施夹器，其中所述内驱动器包括近侧驱动柱塞和接合到所述近侧驱动柱塞的远侧驱动杆。
19.根据权利要求18所述的可重复使用的外科手术施夹器，其中，当所述轴组件与所述手柄组件可释放地接合并且所述夹具仓组件可释放地接合在所述轴组件内时，所述至少一个手柄朝向所述接近位置的移动向远侧推动所述近侧驱动器使其与所述近侧驱动柱塞接触，从而使所述远侧驱动杆向远侧移动以致动所述钳夹组件。
20.根据权利要求1所述的可重复使用的外科手术施夹器，其中，当所述轴组件与所述手柄组件可释放地接合并且所述夹具仓组件可释放地接合在所述轴组件内时，所述至少一个手柄朝向所述隔开位置的移动向远侧推动所述近侧推动器使其与所述远侧推动器接触，从而将所述最远侧外科手术夹具装载到所述钳夹组件中。
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AU2018202841A1 (en) 2018-11-22
US20200229825A1 (en) 2020-07-23
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