CN109171828B - 包含集成的滑动抓紧器的标本取出装置 - Google Patents

包含集成的滑动抓紧器的标本取出装置 Download PDF

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CN109171828B
CN109171828B CN201810916298.9A CN201810916298A CN109171828B CN 109171828 B CN109171828 B CN 109171828B CN 201810916298 A CN201810916298 A CN 201810916298A CN 109171828 B CN109171828 B CN 109171828B
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狄米其·梅恩
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    • AHUMAN NECESSITIES
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    • AHUMAN NECESSITIES
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Abstract

本发明公开了一种包含集成的滑动抓紧器的标本取出装置。提供一种标本取出装置。该标本取出装置包含:内轴,其具有近侧部、远侧部以及外表面;小袋,其支撑在所述内轴的所述远侧部上,所述小袋具有开口近侧端和闭合远侧端;以及组织接合装置,其支撑在所述内轴上,所述组织接合装置能够沿着所述内轴的所述外表面从所述小袋的外部的位置穿过所述小袋的所述开口近侧端而移动至位于所述小袋内的位置,其中所述组织接合装置构造为接合组织并且使所述组织移动穿过所述小袋的所述开口近侧端。

Description

包含集成的滑动抓紧器的标本取出装置
本申请是申请号为201410267816.0、申请日为2014年6月16日、发明名称为“包含集成的滑动抓紧器的标本取出装置”的专利申请的分案申请。
相关申请的交叉引用
本申请要求于2013年6月14日提交的申请号为61/834,948的美国临时专利申请的权益和优先权,该专利的全部内容通过引用合并于此。
技术领域
本公开涉及一种标本取出装置。更具体地,本公开涉及一种包含集成的滑动抓紧器的标本取出装置。
背景技术
腹腔镜和内窥镜外科手术操作是微创操作,在该微创操作中,依靠通过身体中的小入口或进入口(例如,由身体的固有出入口、通过组织刺穿器械(如套针等)生成的开口所限定)插入的细长器械在身体内实施手术。
微创操作经常用来从身体内部局部地或完全地移除身体组织或器官,例如,肾切除术、胆囊切除术、十二指肠切除术、回肠切除术、空肠切除术以及其它的这种操作。在这种操作期间,通常是染病的组织或器官必须通过皮肤中的进入口或通过套管来移除。已知本领域中的各种捕集装置来促进这个操作。传统的捕集装置典型地包含细长的操作器,该操作器包含在近侧端的手柄,其能被操作以从操作器的远侧端打开小袋或其它合适装置。小袋典型地由不能渗透的薄板材料(如尼龙)所形成,以阻止不期望的组织细胞转移。
在微创操作期间可能出现的困难之一是发生在大的切离的组织标本定位在小袋内时(如长的标本进入该小袋)。例如,使用单独的器具(如抓紧器)将相对长的切离的标本放入无支撑的小袋内对于外科医生来说有时是困难的,因为该小袋无法维持其打开的状态。进一步地,当定位在小袋内时,长的切离的标本有时倾向于“聚成一团”,这会使得通过平常小的腹腔镜切口来取出小袋成为困难。可以理解,在这种条件下的组织标本取出可导致小袋破裂,这接下来可导致切离的标本(或部分标本)转移出小袋。
发明内容
可以理解,包含设在标本取出装置小袋内的集成的滑动抓紧器的标本取出装置可在外科手术界中证明是有用的。
本公开的一个方案提供一种标本取出装置。所述标本取出装置包含壳体,所述壳体包含从其向远侧延伸的外轴。内轴布置在所述外轴内。所述内轴包含配置为接合组织的一个或多个组织接合装置和一个或多个弹簧。小袋,其联接至所述内轴和所述至少一个弹簧。所述小袋包含开口近侧端和闭合远侧端,且能从用于从所述外轴展开的第一结构移动至用于在其中接纳组织的第二结构。所述组织接合装置能在所述小袋内重新定位且能沿所述内轴移动,用于接合组织以及将组织拉入所述小袋内。
所述组织接合装置可沿所述内轴的轨道移动。所述轨道可包含配置为允许组织接合装置沿所述轨道移动的沟槽。
所述组织接合装置可以是一对钳夹构件、针、带刺缝合线以及抽吸装置。所述标本取出装置可包含致动装置,所述致动装置配置为使所述一对钳夹构件从用于抓紧组织的开口结构移动至用于在所述小袋内拉动组织的闭合结构。而且,所述致动装置也可配置为使所述一对钳夹构件沿所述内轴纵向地移动。
所述弹簧可配置为使所述小袋从所述第一结构移动至所述第二结构。所述标本取出装置可包含肚带手柄,所述肚带手柄包含联接至所述小袋的开口近侧端的肚带,用于捆紧所述小袋至捆紧的结构。当所述小袋处于所述第二结构中时,所述小袋可向其闭合远侧端逐渐变细。
本公开的一个方案提供一种标本取出装置。所述标本取出装置包含壳体,所述壳体包含从其向远侧延伸的外轴。内轴布置在所述外轴内且能从其展开。所述内轴包含一个或多个沟槽和一个或多个弹簧。所述沟槽使得一个或多个组织接合装置定位在其中以沿其进行纵向移动。小袋联接至所述内轴的远侧端和所述弹簧,以便于邻接所述内轴的沟槽的一部分。所述小袋包含开口近侧端和闭合远侧端,且能通过所述至少一个弹簧从用于从所述外轴的展开的第一结构移动至用于在其中接纳组织的第二结构。所述组织接合装置能在所述小袋内沿所述沟槽移动,以便接合组织以及将组织拉入所述小袋内。
所述内轴的沟槽可设在所述内轴的轨道上。所述组织接合装置可以是针或一对钳夹构件。所述标本取出装置可包含致动装置,所述致动装置配置为使所述一对钳夹构件从用于抓紧组织的开口结构移动至用于将组织拉入所述小袋内的闭合结构。而且,所述标本取出装置也可配置为使所述一对钳夹构件沿所述内轴纵向地移动。
所述标本取出装置可包含肚带手柄,所述肚带手柄包含联接至所述小袋的开口近侧端的肚带,用于捆紧所述小袋至捆紧的结构。当所述小袋处于所述第二结构中时,所述小袋可向其闭合远侧端逐渐变细。
本公开的一个方案提供一种用于从患者身体移除组织的方法。最初,标本取出装置的外轴插入患者的体腔内。其后,所述标本取出装置的内轴从所述外轴展开以使所述标本取出装置的小袋从第一结构移动至第二结构。接着,设在所述内轴上的至少一个组织接合装置向所述小袋的近侧端定位,用于接合组织。然后,目标组织被接合。接下来,所述组织接合装置向所述小袋的远侧端定位,用于将组织拉入所述小袋内。其后,所述小袋从所述患者的体腔移出。
在移除所述小袋之前,所述小袋的开口端可被捆紧。在插入所述标本取出装置的外轴之前,进入口可定位在所述患者的组织上。
所述标本取出装置的内轴可设有至少一个沟槽,所述至少一个沟槽配置为在其中接纳所述至少一个组织接合装置。而且,所述标本取出装置的内轴可设有至少一个弹簧,所述至少一个弹簧配置为联接至所述小袋。一对钳夹构件、针、带刺缝合线或抽吸装置可被用于至少一个组织接合装置。
附图说明
在下文中将参考附图来描述本公开的标本取出装置的实施例,其中:
图1是依照本公开的一个实施例的标本取出装置的侧面立体图;
图2是图1中示出的标本取出装置的内轴的远侧端的局部侧视图,图示出远侧端的部件;
图3是通过进入口定位在体腔内的图1中示出的标本取出装置的内轴和小袋的立体图,其中该小袋处于用于接纳组织的开口结构中;
图4是图3中示出的内轴和小袋的立体图,其中组织定位于小袋内;
图5是图3至图4中示出的内轴和小袋的立体图,其中组织定位于小袋内且小袋处于捆紧结构;以及
图6A至图6C是图示出可与图1中示出的标本取出装置一起使用的各种组织接合装置。
具体实施方式
现在,将参考附图更详细地描述本公开的实施例,其中同样的附图标记表示几幅视图的每一幅视图中相同或对应的元件。如在此使用的,术语远侧指的是离用户远的器械部分,而术语近侧指的是离用户近的器械部分。在以下描述中,公知的用途或构造没有详细地描述,以避免在不必要的细节上使本公开不清楚。
如参考本公开在此使用的,术语腹腔镜和内窥镜是可互换的且涉及具有用于插入套管或皮肤中的小切口的相对狭窄的手术部分的器械。它们也涉及微创手术操作。可相信的是本公开可在进入限于相对小切口的身体内部的任何操作中发现有用,无论在微创操作时借助或不借助套管。
参考图1至图5,并且最初参考图1,图示出依照本公开的一个实施例的标本取出装置10。简要地,标本取出装置10包含壳体12,该壳体12包含固定地结合在一起的手柄部14和16(图1)。细长的管或外轴18从壳体12延伸且被定尺寸为适于通过内窥镜或腹腔镜操作的套针管或进入口19(图3)插入。在某些实施例中,外轴18可配置为进行关节式运动。纵轴线“A-A”限定穿过外轴18且以相对于纵轴线“B-B”基本上平行的方向来定向,该纵轴线“B-B”限定为在小袋22处于展开的状态中(图3至图5)时穿过小袋22。
在外轴18的内部且沿外轴18的长度延伸的内轴24可操作地联接至抓紧构件26(图1)。抓紧构件26配置为被用户的手指所接合且配置为在外轴18内平移或移动内轴24。
拉环28通过任何合适的联接方法(例如,打结、粘合剂等)可操作地联接至肚带30的近侧端(例如缝合线“S”、丝线、金属丝、线缆或类似物),并且拉环28配置为便于通过内轴24向近侧拉肚带30。在图示的实施例中,通过一个或多个合适的联接方法(例如压入配合或摩擦配合),拉环28能释放地联接至抓紧构件26。肚带30的远侧端可操作地联接至小袋22的一部分(例如,开口近侧部32(图3至图4))。
可变形弹簧34(图3中虚线示出)通过一个或多个合适的联接方法(例如,弹簧34可与内轴16二次成型)可操作地联接至内轴24,且包含两个大体柔性的或弹性的条板35a、35b(图3中虚线示出),在小袋22从外轴18展开时,所述条板35a、35b从受力的或未扩张的状态(图5)移动至未受力的或自由扩张的状态(图3至图4)。在受力的或未扩张的状态中,环绕内轴24的弹性条板来缠绕或卷绕小袋22。环绕弹性条板来卷绕小袋22有助于小袋22从外轴18内的相对小的区域展开。在未受力的或自由扩张的状态中,两个弹性条板整体地形成大体环形或三角形的结构,以支撑小袋22的开口近侧部32的外围(例如,见图3至图4)。
对于标本取出装置10和与其有关的可操作的部件的更详细的描述,参考托维(Tovey)等人在1994年9月16日提交的共同拥有的美国专利号5,647,372,该专利的全部通过引用合并于此。
再次参考图1,并参考图2,内轴24包含致动装置36,其配置为控制组织接合装置(例如,一对钳夹构件38、40)工作(图2)。为此,致动装置36包含可配置为由用户抓紧的底座部41和挠性的杆42(或其它合适的装置,例如金属丝)。底座部41通过一个或多个合适的联接方法(例如,压入配合或摩擦配合)能释放地联接至抓紧构件26。杆42包含与底座41的远侧端联接且从底座41向远侧延伸的近侧端。杆42的远侧端定位为穿过设在抓紧构件26的近侧端的孔(未明确示出)。杆42的远侧端从抓紧构件26延伸至布置在内轴24上的轨道46,且通过合适的联接方法联接至钳夹构件38、40(图2)。
继续参考图2,根据本公开,致动装置36的近侧移动和远侧移动使钳夹构件38、40在小袋22内沿内轴24向近侧和向远侧移动。致动装置36被配置,以便在致动装置36的底座部41向近侧移动时,钳夹构件38、40向开口近侧部32移动且自动地移动至开口结构(图2至图3)。同样地,在致动装置36的底座部41向远侧移动时,钳夹构件38、40向小袋22的闭合远侧部44移动且自动地移动至闭合结构(见图2和图4至图5)。弹簧或其它合适的装置(未示出)可联接至钳夹构件38、40,以使钳夹构件偏置到开口或闭合结构。
可选地,在一个实施例中,凸轮构件(未示出)可定位于钳夹构件38、40上,且使钳夹构件38、40在开口和闭合结构之间移动。在这个具体实施例中,致动装置36的底座41以第一方向的旋转可致动凸轮构件,以用凸轮带动钳夹构件38、40至闭合结构,而底座41以第二方向的旋转可致动凸轮构件,以用凸轮带动钳夹构件38、40至开口结构。本领域的技术人员将意识到可被用来使钳夹构件38、40在开口和闭合结构之间移动其它的方法和/或装置。
在图示的实施例中,沟槽48设在轨道46的远侧端,且至少部分地沿轨道46的长度延伸(图2)。在一个实施例中,如图示的实施例中,沟槽48沿内轴延伸且被定位以邻接小袋22。具体地,沟槽48沿轨道46延伸,且邻接小袋22的开口近侧部32和闭合远侧部44。可以理解,通过不允许沟槽48向近侧延伸经过开口上部32来有助于确保钳夹构件38、40(和在其之间抓紧的切离的组织)不延伸超过小袋22的界限,这接下来有助于确保切离的组织不从小袋22转移。
小袋22可由能够形成不渗透的柔性薄膜的任何合适的生物相容材料(例如,尼龙)所制成。小袋22包含由能开的和能闭的近侧部32和闭合的远侧部44所限定的大体管状或细长的结构。合适结构的沟槽沿小袋22延伸且在其中包含肚带30的一部分,该肚带30的一部分被用来在组织定位在小袋22内之后来捆紧小袋22。而且,近侧部32包含配置为接纳弹簧34的弹性构件的套筒(未明确示出)。套筒可通过使近侧部32折入小袋22的内部且随后将近侧部32粘合至其上来在小袋22上形成。可选地,在实施例中,可不使用弹簧34且小袋22的近侧部32可由允许小袋22的近侧部32在压缩的状态至未压缩的状态之间移动的能压缩的材料所形成。在未压缩的状态中,近侧部32限定有开口,所述开口配置为允许临床医生将目标组织定位在小袋22内。而且,当小袋22在未压缩的状态中时,小袋22可向其闭合的远侧端44逐渐变细。可选地,当小袋22在未压缩的状态中时,小袋22可向其闭合远侧端44不逐渐变细。
小袋22的一对侧壁52、54通过合适的联接方法联接至邻近轨道的沟槽48的轨道46(图2)。侧壁52、54各自邻接沟槽48的对应侧,以允许在小袋22内的钳夹构件38、40的无阻的移动。
参考图3至图5,现在描述标本取出装置10的操作。在使用中,进入口19可定位于患者身上,以允许标本取出装置10进入患者的体腔(图3)。此后,内轴24可从外轴18展开,并且外轴18可从患者的体腔移除而内轴24保持在体腔内。可以理解,在内轴24的展开之后,外轴18也可保持在体腔内。一旦内轴24从外轴18展开之后,通过弹簧30的弹性构件的偏置力,迫使小袋22的能开的近侧端32至开口结构(图3)。
在开口结构中,钳夹构件38、40可向小袋22的开口近侧端32移动。在这个定位中,钳夹构件38、40处于开口结构中且开始抓紧切离的组织。在实施例中,如图示的实施例中,外科医生可用单独的器具(如,抓紧器)来抓紧切离的组织,且将切离的组织定位在钳夹构件38、40之间。选择地,外科医生可移动包含邻近切离组织的钳夹构件38、40的小袋22,且用钳夹构件38、40抓紧切离的组织。
一旦组织定位在钳夹构件38、40之间,那么致动装置的底座部41可向远侧移动,这接下来使钳夹构件38、40沿轨道46的沟槽48向小袋22的闭合的远侧部44移动,且移动至闭合结构(图4)。
外科医生于是可向近侧拉拉环28,这捆紧小袋22(图5)。此后,包含捆紧的小袋22的内轴24可从患者体腔通过进入口19来移出。
本公开的标本取出装置10允许用户将切离的组织(例如,相对大的样本的切离组织)插入小袋22内而维持小袋22的密实度(例如,打开的结构)。而且,由于切离的组织被拉入小袋22内,因此切离的组织在定位于小袋内时聚成一团的可能性减小,这接下来可使通过平常小的腹腔镜切口或进入口19来取出小袋22变得更容易。
由前述的且参考各种附图,本领域的技术人员将意识到也可对本公开作出某些修改而不脱离相同的范围。例如,尽管钳夹构件38、40已经按照用作组织接合装置来描述,但是其它的组织接合装置也可使用。例如,任何类型的针56(图6A)、带刺缝合线58(图6B)、抽吸装置60(图6C)或其它合适的装置可用来代替钳夹构件38、40。可以理解,对标本取出装置10可需要做出某些修改,以适应实施的不同的组织接合装置。
在实施例中,一个或多个支撑构件50(例如见图3)可沿小袋22的表面设置且可配置为促进小袋22移动至开口结构。例如,弹性的条、金属丝或类似物可沿设在与小袋22的侧壁52、54相反的小袋22的表面延伸。在这个具体实施例中,条和/或线可被编结或以其它方式附接至小袋22的内部或外部。
尽管本公开的几个实施例已经在图中示出,但并不意图将本公开限制于此,而意图将允许本公开在范围方面与本领域一样是广泛的,且同样地理解说明书。因此,上述的描述不应该理解为限制,而仅仅是作为具体实施例的例证。本领域的技术人员将预想到所附权利要求书的范围和构思内的其它修改。

Claims (18)

1.一种标本取出装置,包含:
内轴,其具有近侧部、远侧部以及外表面;
小袋,其支撑在所述内轴的所述远侧部上,所述小袋具有开口近侧端和闭合远侧端;以及
组织接合装置,其支撑在所述内轴上,所述组织接合装置能够沿着所述内轴的所述外表面从所述小袋的外部的位置穿过所述小袋的所述开口近侧端而移动至位于所述小袋内的位置,其中所述组织接合装置构造为接合组织并且使所述组织移动穿过所述小袋的所述开口近侧端。
2.根据权利要求1所述的标本取出装置,还包含布置在所述内轴上的轨道,所述组织接合装置能够沿着所述轨道和所述内轴移动。
3.根据权利要求1所述的标本取出装置,其中所述小袋的所述闭合远侧端邻近所述内轴的所述远侧部的远侧端而被支撑。
4.根据权利要求1所述的标本取出装置,其中所述小袋为管状。
5.根据权利要求1所述的标本取出装置,其中所述组织接合装置包含一对钳夹构件。
6.根据权利要求1所述的标本取出装置,其中所述小袋与弹簧配合,所述弹簧构造为打开所述小袋的所述开口近侧端。
7.根据权利要求1所述的标本取出装置,其中所述标本取出装置包含肚带,所述肚带用于捆紧所述小袋至捆紧的结构。
8.根据权利要求1所述的标本取出装置,其中所述小袋从所述开口近侧端向所述闭合远侧端逐渐变细。
9.根据权利要求1所述的标本取出装置,其中所述标本取出装置还包含手柄部和从所述手柄部延伸的外轴。
10.根据权利要求9所述的标本取出装置,其中所述内轴在所述外轴内延伸。
11.一种标本取出装置,包含:
外轴;
内轴,其具有近侧部、远侧部以及外表面,所述内轴在所述外轴内延伸;
小袋,其支撑在所述内轴的所述远侧部上,所述小袋具有开口近侧端和闭合远侧端;
组织接合装置,其支撑在所述内轴上,所述组织接合装置能够沿着所述内轴的所述外表面从所述小袋的外部的位置穿过所述小袋的所述开口近侧端而移动至位于所述小袋内的位置;以及
轨道,其布置在所述内轴上,所述组织接合装置能够沿着所述轨道和所述内轴移动,所述轨道限定在所述小袋的所述开口近侧端与所述小袋的所述闭合远侧端之间延伸的通道,所述组织接合装置能够沿着所述轨道的所述通道移动,其中所述组织接合装置构造为接合组织并且使所述组织移动穿过所述小袋的所述开口近侧端。
12.根据权利要求11所述的标本取出装置,其中所述小袋的所述开口近侧端被支撑在所述小袋的所述闭合远侧端的近侧位置。
13.根据权利要求11所述的标本取出装置,其中所述小袋的所述闭合远侧端邻近所述内轴的所述远侧部的远侧端而被支撑。
14.根据权利要求11所述的标本取出装置,其中所述小袋为管状。
15.根据权利要求11所述的标本取出装置,其中所述组织接合装置包含一对钳夹构件。
16.根据权利要求11所述的标本取出装置,还包含与所述小袋配合的至少一个弹簧,所述弹簧构造为打开所述小袋的所述开口近侧端。
17.根据权利要求11所述的标本取出装置,其中所述标本取出装置包含肚带,所述肚带用于捆紧所述小袋至捆紧的结构。
18.根据权利要求12所述的标本取出装置,其中所述小袋从所述开口近侧端向所述闭合远侧端逐渐变细。
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