CN110179526B - 具有扭矩辅助特征的超声外科器械 - Google Patents

具有扭矩辅助特征的超声外科器械 Download PDF

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CN110179526B
CN110179526B CN201910140415.1A CN201910140415A CN110179526B CN 110179526 B CN110179526 B CN 110179526B CN 201910140415 A CN201910140415 A CN 201910140415A CN 110179526 B CN110179526 B CN 110179526B
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K·E·内泽尔
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Abstract

本发明题为“具有扭矩辅助特征的超声外科器械”。本发明公开了一种超声外科器械，所述超声外科器械包括外壳、超声换能器组件和波导。所述超声换能器组件穿过近侧开口延伸到所述外壳中，并且包括设置在所述外壳内的喇叭，所述喇叭限定第一接合构件。所述超声换能器组件还包括内部外壳，所述内部外壳延伸穿过所述近侧开口；以及外部旋钮，所述外部旋钮设置在所述外壳外部并且相对于所述内部外壳以固定旋转取向围绕所述内部外壳可滑动地定位。所述外部旋钮可相对于所述内部外壳从近侧解锁位置和远侧锁定位置选择性地平移，以相对于所述外壳旋转地锁定所述超声换能器。所述波导限定远侧端部处的刀和近侧端部处的第二接合构件。所述第二接合构件被配置为可释放地接合所述第一接合构件，从而将所述波导与所述超声换能器组件接合。

Description

具有扭矩辅助特征的超声外科器械
背景技术
技术领域
本公开涉及外科器械，并且更具体地讲，涉及超声外科器械，该超声外科器械包括扭矩辅助特征以促进波导与超声换能器的连接。
相关领域背景
超声外科器械利用超声能量即超声振动来处理组织。更具体地讲，超声外科器械利用以超声频率传输的机械振动能量来凝固、烧灼、融合、密封、切割、干燥、电灼、或以其他方式处理组织。
通常，超声外科器械被配置为将由发生器和换能器组件产生的超声能量沿着波导传输到与发生器和换能器组件间隔开的端部执行器。相对于无绳超声器械，例如，便携式功率源(例如电池)以及发生器和换能器组件被安装在手持式器械本身上，而波导将发生器和换能器组件以及端部执行器互连。有线超声器械以类似的方式操作，不同之处在于不是将发生器和功率源安装在手持式器械本身上，手持式器械被配置为通过有线连接连接到独立电源和/或发生器。
无论所使用的超声外科器械的具体类型和/或配置如何，重要的是确保换能器和波导之间的适当接合，使得超声能量被适当地传输到端部执行器以用于以其处理组织。因此，一直需要在超声外科器械中促进波导与超声换能器的连接，以确保其间的适当接合。
发明内容
本公开提供了超声外科器械，该超声外科器械包括扭矩辅助特征以促进波导与超声换能器的连接，该波导与超声换能器彼此适当地接合。如本文所用，术语“远侧”是指所描述的离使用者较远的部分，而术语“近侧”是指所描述的离使用者较近的部分。此外，在一致的程度上，本文详述的任何或所有方面可与本文详述的任何或所有其他方面结合使用。
根据本公开的方面，提供了超声外科器械，该超声外科器械包括外壳，该外壳限定近侧开口；超声换能器组件，该超声换能器组件穿过近侧开口延伸到外壳中；以及波导。超声换能器组件包括设置在外壳内的喇叭，该喇叭具有设置在其自由远侧端部处的第一接合构件。超声换能器组件还包括内部外壳，该内部外壳延伸穿过近侧开口；以及外部旋钮，该外部旋钮设置在外壳外部并且相对于内部外壳以固定旋转取向围绕内部外壳可滑动地定位。外部旋钮可相对于内部外壳在近侧解锁位置和远侧锁定位置之间选择性地平移，在该近侧解锁位置中，外部旋钮与外壳朝近侧间隔开，在该远侧锁定位置中，外部旋钮与外壳接合，从而将超声换能器相对于外壳旋转地锁定。波导限定远侧端部处的刀和近侧端部处的第二接合构件。第二接合构件被配置为可释放地接合第一接合构件，从而将波导与超声换能器组件接合。
在本公开的一方面，外壳包括限定在其中并且围绕近侧开口布置的多个凹槽，并且外部旋钮包括从其朝远侧延伸的多个指状物。每个指状物被配置用于在远侧锁定位置接合在凹槽中的一个内，从而相对于外壳旋转地锁定超声换能器。
在本公开的另一方面，超声换能器组件还包括偏置构件，该偏置构件设置在内部外壳和外部旋钮之间，并且被配置为将外部旋钮朝向近侧解锁位置偏置。
在本公开的另一方面，超声换能器组件还包括压电堆。在此类方面，内部外壳可形成机壳的至少一部分，该机壳将压电堆包封在其中。
在本公开的再一方面，第一接合构件和第二接合构件被配置为在其间相对旋转时彼此螺纹接合。
在本公开的又一方面，扭矩扳手组件与波导可操作地结合以限制在第一接合构件和第二接合构件之间相对旋转时施加扭矩。
在本公开的另外一方面，发生器与超声换能器组件接合以限定换能器和发生器组件，该换能器和发生器组件被配置为可释放地联接到外壳。在此类方面，可提供被配置为可释放地联接到外壳的电池组件以为发生器供电以便驱动超声换能器组件。
在本公开的另一方面，至少一个套管围绕波导从外壳朝远侧延伸。在此类方面，波导的刀从至少一个套管朝远侧延伸。钳口构件可设置在至少一个套管的远侧端部处，并且被配置为相对于刀从打开位置枢转到夹紧位置。另外，触发器可与外壳可操作地结合，其中至少一个套管的驱动套管可操作地联接在触发器和钳口构件之间，使得触发器的致动将钳口构件相对于刀枢转。在此类方面，可提供两个套管：驱动套管和固定支撑套管。
在本公开的另一方面，远侧旋转旋钮邻近外壳朝远侧定位，并且可操作地联接到波导，使得远侧旋转旋钮的旋转使波导相对于外壳旋转。
附图说明
根据以下结合附图进行的详细描述，本公开的上述和其他方面和特征将变得显而易见，其中类似的附图标号标识相似或相同的元件，并且：
图1为根据本公开提供的超声外科器械的透视图；
图2为图1的超声外科器械的透视图，其中细长组件与柄部组件分离；
图3为图1的超声外科器械的近侧部分的纵向剖视图；
图4为图3中示出的超声外科器械的近侧部分的一部分的放大纵向剖视图；
图5A为图1的超声外科器械的近侧端部的侧视图，其中其近侧旋钮组件设置在解锁条件下，其中部分被移除；
图5B为图1的超声外科器械的近侧端部的侧视图，其中其近侧旋钮组件设置在锁定条件下，其中部分被移除；并且
图6为沿图5A中的剖面线“6-6”截取的横向剖视图。
具体实施方式
参见图1-图4，超声外科器械10包括柄部组件100以及从柄部组件100朝远侧延伸的细长组件200。柄部组件100包括限定主体部分112和固定柄部部分114的外壳110。柄部组件100还包括启动按钮120和夹紧触发器130。
外壳110的主体部分112被配置为支撑包括发生器310和超声换能器320的超声换能器和发生器组件(“TAG”)300。TAG 300可与外壳110的主体部分112永久地接合或可从其移除。发生器310包括被配置为容纳发生器310的内部电子器件的外壳312，以及被配置为可旋转地支撑超声换能器组件320的托架314。另选地，发生器310可通过外科电缆(未示出)远程地设置并且联接到超声外科器械10。
超声换能器组件320包括压电堆322、喇叭324、壳体326、以及将压电堆322固定在喇叭324和近侧螺母329之间的螺栓328。超声换能器组件320还包括以下详细描述的近侧旋钮组件370。近侧旋钮组件370的壳体326和内部外壳372彼此接合并且配合以形成机壳，以封装近侧螺母329、螺栓328、压电堆322以及喇叭324的一部分，喇叭324的其余部分从壳体326朝远侧延伸。
分别与发生器310和超声换能器组件320相关联的一组连接器330和对应旋转触点334能够将驱动信号从发生器310传送到超声换能器组件320的压电堆322以驱动超声换能器组件320，而不管超声换能器组件320的旋转取向如何。继而，喇叭324被配置为将由压电堆322产生的超声能量传输到细长组件200的波导230，以便沿着其传输到细长组件200的端部执行器280的刀282，如下所详述。
继续参见图1-图4，外壳110的固定柄部部分114限定被配置为接收电池组件400的隔室116和被配置为包封隔室116的门118。电连接组件140被设置在柄部组件100的外壳110内，并且当TAG 300被支撑在外壳110的主体部分112上或该主体部分中并且电池组件400被设置在外壳110的固定柄部部分114的隔室116内时用于将启动按钮120、TAG 300的发生器310和电池组件400彼此电联接，从而响应于启动按钮120的按下而能够启动超声外科器械10。在其中发生器310远离超声外科器械10的实施方案中，不需要提供电池组件400和用于接收电池组件400的固定柄部部分114的配置，因为发生器310可由标准壁装插座或其他功率源供电。
超声外科器械10的细长组件200包括外部驱动套管210、设置在外部驱动套管210内的内部支撑套管220、延伸穿过内部支撑套管220的波导230、驱动组件250、集成扭矩扳手组件260、围绕集成扭矩扳手组件260设置并且形成其一部分的远侧旋转旋钮270、以及包括刀282和钳口284的端部执行器280。外部驱动套管210的近侧部分能够通过驱动组件250操作地联接到柄部组件100的夹紧触发器130，而外部驱动套管210的远侧部分能够操作地联接到钳口284。如此，夹紧触发器130能够选择性地致动，以由此使外部驱动套管210围绕内部支撑套管220运动，以使钳口284相对于端部执行器280的刀282从间隔位置枢转到接近位置，以用于夹持钳口284和刀282之间的组织。驱动组件250提供限制力的特征，由此施加到组织上的夹持压力被限制于特定的夹持压力或特定的夹持压力范围。在使用期间，远侧旋转旋钮270可沿任一方向旋转以使细长组件200相对于柄部组件100沿任一方向旋转。远侧旋转旋钮270还通过集成扭矩扳手组件260可操作地联接到波导230以促进波导230与超声换能器组件320的喇叭324的附接，如下所详述。
如上所述，波导230延伸穿过内部支撑套管220。波导230限定主体232和从主体232的远侧端部延伸的刀282。刀282用作端部执行器280的刀。波导230还包括近侧螺纹凸连接器236，该近侧螺纹凸连接器被配置为用于螺纹接合在喇叭324的螺纹凹接收器349内，使得由超声换能器组件320产生的超声运动沿着波导230传输到刀282以用于处理夹持在刀282和钳口284之间或邻近刀282定位的组织。
重要的是确保波导230和超声换能器组件320彼此充分接合，并且阻止螺纹凸连接器236和螺纹凹接收器349之间的接合过度紧固也是重要的。集成扭矩扳手组件260有助于在阻止过度紧固的同时确保波导230和超声换能器组件320充分地接合，如下所详述。近侧旋钮组件370还促进螺纹凸连接器236和螺纹凹接收器349之间的接合，同样如下所详述。
参见图3-图5B，近侧旋钮组件370包括内部外壳372、外部旋转旋钮374和偏置构件376，例如压缩螺旋弹簧。如上所述，内部外壳372与超声换能器组件320的壳体326一起配合以形成机壳，从而封装螺栓328、近侧螺母329、压电堆322和超声换能器组件320的喇叭324的一部分，喇叭324的其余部分从壳体326朝远侧延伸。壳体326和内部外壳372相对于超声换能器组件320的另一个部件(例如，近侧螺母329、压电堆322和喇叭324)是基本上固定的(在制造公差内，并且不考虑压电堆322的激活或由此产生的超声运动)。具体参见图5A-图6，另一方面，外部旋转旋钮374例如通过可滑动的肋-通道接合或其他合适的可滑动互配接合相对于内部外壳372旋转地固定，围绕内部外壳372设置，并且可相对于内部外壳372从近侧解锁位置和远侧锁定位置选择性地平移，在该近侧解锁位置中外部旋转旋钮374从内部外壳372进一步朝近侧延伸，在该远侧锁定位置中外部旋转旋钮374更加朝远侧定位以进一步围绕内部外壳372。偏置构件376设置在外部旋转旋钮374内并且定位在外部旋转旋钮374的内部近侧表面375和内部外壳372的外部近侧表面373之间以便将外部旋转旋钮374相对于内部外壳372朝向近侧解锁位置朝近侧偏置。凹槽378a、378b可分别限定在外部旋转旋钮374的内部近侧表面375和内部外壳372的外部近侧表面373内，以便接收偏置构件376的端部以将偏置构件376保持就位。
继续参见图5A-图6，近侧旋钮组件370的外部旋转旋钮374限定多个沟槽379，该沟槽被配置为有利于抓握和旋转外部旋转旋钮374。外部旋转旋钮374还包括多个朝远侧延伸的指状物380，该指状物在等间隔和/或径向相对的位置处从外部旋转旋钮374的外环形周边延伸。指状物380限定径向向外张开的自由远侧端部382。
另外参见图1和图3，柄部组件100的外壳110的主体部分112限定围绕其近侧开口113的多个凹槽111，超声换能器组件320延伸穿过该近侧开口。多个凹槽111围绕近侧开口113的环形周边径向相对和/或等间隔。在外部旋转旋钮374(图5A)的近侧解锁位置中，指状物380的自由远侧端部382与凹槽111朝近侧间隔，从而允许外部旋转旋钮374(以及因此超声换能器组件320)相对于外壳110旋转。然而，在外部旋转旋钮374抵抗偏置构件376的偏置运动到远侧锁定位置(图5B)后，指状物380的自由远侧端部382滑动到接合在凹槽111内，从而相对于外壳110旋转地固定外部旋转旋钮374(以及因此超声换能器组件320)。
一般参见图1-图6，详细描述了准备使用的超声外科器械10的组件。最初，TAG 300与柄部组件100的外壳110的主体部分112接合。此后，或在TAG 300的接合之前，将电池组件400插入柄部组件100的外壳110的固定柄部部分114的隔室116中，并且关闭门118以将电池组件400保持在其中。在以这种方式安装TAG 300和电池组件400的情况下，TAG 300和电池组件400通过电连接组件140彼此电联接并且与激活按钮120电联接。
接下来，由波导230的近侧连接器236引导的细长组件200朝近侧插入柄部组件100中，直到螺纹近侧连接器236定位在超声换能器组件320的喇叭324的螺纹凹接收器349附近。一旦实现该位置，使用者将近侧旋钮组件370的外部旋转旋钮374从近侧解锁位置向远侧推动到远侧锁定位置，以相对于柄部组件100的外壳110旋转地固定超声换能器组件320。在将外部旋转旋钮374保持在远侧锁定位置(用手，抵靠刚性表面，或以任何其他合适的方式)的同时，使用者可用一只手(例如，将外部旋转旋钮374保持在远侧锁定位置的同一只手)抓握外壳110，并且用另一只手抓握细长组件200的远侧旋转旋钮270。细长组件200的远侧旋转旋钮270然后沿第一接合方向相对于外壳110旋转，以将螺纹近侧连接器236螺纹接合在螺纹凹接收器349内，从而将波导230和超声换能器组件320彼此接合。
远侧旋转旋钮270相对于外壳110旋转，以实现波导230和超声换能器组件320之间的充分接合。一旦实现充分接合，集成扭矩扳手组件260便滑动，从而阻止对波导230和超声换能器组件320之间的接合进一步施加扭矩。在集成扭矩扳手组件260的这种滑动后，产生听觉和/或触觉“咔哒声”，以向使用者指示已经实现了波导230和超声换能器组件320的充分接合。此后，可以释放外部旋转旋钮374，从而允许外部旋转旋钮374在偏置下返回到近侧解锁位置，使得超声换能器组件320被允许相对于柄部组件100的外壳110旋转。超声器械10现在准备好使用。
在使用中，将超声器械10插入外科部位并在外科部位内操纵，使得端部执行器280定位在待处理的组织附近。如果需要，通过旋转远侧旋转旋钮270(超声换能器组件320也随其旋转)，端部执行器280可相对于柄部组件100旋转。一旦根据需要定位，夹紧触发器130便可被致动以将钳口构件282从打开位置朝向夹紧位置枢转，以夹持钳口构件282和刀234之间的待处理组织。如上所详述，驱动组件250用于将施加到抓握组织的夹持压力限制到特定夹持压力或特定夹持压力范围内的夹持压力。
利用充分夹持在钳口构件282和刀234之间的组织，激活按钮120可在“低”功率模式或“高”功率模式下激活，以启动从电池组件400到TAG 300的供电以便驱动超声换能器组件320，继而在“低”功率模式或“高”功率模式下，沿着波导230将超声机械运动传输到刀234以用于以其处理组织。
一旦组织被充分处理，超声外科器械10便从外科部位缩回。此后，细长组件200以与以上详细描述的其接合类似的方式与柄部组件100脱离接合，不同之处在于远侧旋转旋钮270沿相对的第二脱离接合方向旋转以使螺纹近侧连接器236与螺纹凹接收器349脱离接合。一旦脱离接合，细长组件200从柄部组件100移除，并且其中一个或两个被丢弃或消毒以供后续使用。将TAG 300和电池组件400从柄部组件100移除，并进行消毒、清洁、充电和/或以其他方式调节以供后续使用。
尽管在附图中已经示出了本公开的若干实施方案，但是本公开不旨在限于此，因为本公开旨在与本领域所允许的范围那样宽泛，并且旨在同样宽泛地阅读说明书。因此，以上说明不应理解为限制性的，而是仅作为具体实施方案的例示。本领域的技术人员能够设想在本文所附权利要求书的范围和实质内的其他修改。

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1.一种超声外科器械，包括：
外壳，所述外壳限定近侧开口；
超声换能器组件，所述超声换能器组件穿过所述近侧开口延伸到所述外壳中，所述超声换能器组件包括设置在所述外壳内的喇叭，所述喇叭具有设置在其自由远侧端部处的第一接合构件，所述超声换能器组件还包括延伸穿过所述近侧开口的内部外壳、以及设置在所述外壳外部并且相对于所述内部外壳以固定旋转取向围绕所述内部外壳可滑动地定位的外部旋钮，所述外部旋钮能够相对于所述内部外壳在近侧解锁位置和远侧锁定位置之间选择性地平移，在所述近侧解锁位置中，所述外部旋钮与所述外壳朝近侧间隔开，在所述远侧锁定位置中，所述外部旋钮与所述外壳接合，从而将所述超声换能器相对于所述外壳旋转地锁定；以及
波导，所述波导限定远侧端部处的刀和近侧端部处的第二接合构件，所述第二接合构件被配置为可释放地接合所述第一接合构件，从而将所述波导与所述超声换能器组件接合。
2.根据权利要求1所述的超声外科器械，其中所述外壳包括限定在其中并且围绕所述近侧开口布置的多个凹槽，并且其中所述外部旋钮包括从其朝远侧延伸的多个指状物，每个指状物被配置用于在所述远侧锁定位置接合在所述凹槽中的一个内，从而相对于所述外壳旋转地锁定所述超声换能器。
3.根据权利要求1所述的超声外科器械，其中所述超声换能器组件还包括偏置构件，所述偏置构件设置在所述内部外壳和所述外部旋钮之间，所述偏置构件被配置为将所述外部旋钮朝向所述近侧解锁位置偏置。
4.根据权利要求1所述的超声外科器械，其中所述超声换能器组件还包括压电堆，并且其中所述内部外壳形成机壳的至少一部分，所述机壳将所述压电堆包封在其中。
5.根据权利要求1所述的超声外科器械，其中所述第一接合构件和所述第二接合构件被配置为在其间相对旋转时彼此螺纹接合。
6.根据权利要求5所述的超声外科器械，其还包括扭矩扳手组件，所述扭矩扳手组件与所述波导可操作地结合以限制在所述第一接合构件和所述第二接合构件之间相对旋转时施加扭矩。
7.根据权利要求1所述的超声外科器械，其还包括与所述超声换能器组件接合的发生器以限定换能器和发生器组件，所述换能器和发生器组件被配置为可释放地联接到所述外壳。
8.根据权利要求7所述的超声外科器械，其还包括电池组件，所述电池组件被配置为可释放地联接到所述外壳，所述电池组件被配置为向所述发生器供电以便驱动所述超声换能器组件。
9.根据权利要求1所述的超声外科器械，其还包括至少一个套管，所述至少一个套管从所述外壳朝远侧延伸并且围绕所述波导设置，其中所述波导的所述刀从所述至少一个套管朝远侧延伸。
10.根据权利要求9所述的超声外科器械，其还包括钳口构件，所述钳口构件设置在所述至少一个套管的远侧端部处，所述钳口构件被配置为相对于所述刀从打开位置枢转到夹紧位置。
11.根据权利要求10所述的超声外科器械，其还包括触发器，所述触发器与所述外壳可操作地结合，其中所述至少一个套管的驱动套管可操作地联接在所述触发器和所述钳口构件之间，使得所述触发器的致动将所述钳口构件相对于所述刀枢转。
12.根据权利要求11所述的超声外科器械，其中所述至少一个套管包括两个套管：固定支撑套管和所述驱动套管。
13.根据权利要求1所述的超声外科器械，其还包括远侧旋转旋钮，所述远侧旋转旋钮邻近所述外壳朝远侧定位，并且可操作地联接到所述波导，其中所述远侧旋转旋钮的旋转使所述波导相对于所述外壳旋转。
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