CN110384530A - 具有切割环偏置部件的吻合器 - Google Patents
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Abstract
一种圆形吻合器包含壳体组合件和砧座组合件。所述壳体组合件包含外壳、支撑在所述外壳上的钉仓、支撑在所述外壳内的环形刀,以及支撑在所述外壳内的偏置部件。所述砧座组合件包含中心杆和砧座头,所述砧座头支撑与所述环形刀轴向对准的切割环。所述偏置部件定位在所述外壳内,并且当所述环形刀处于所述缩回位置时延伸到所述环形刀的远侧位置以遮蔽所述环形刀。所述砧座组合件相对于所述壳体组合件以可移动方式支撑在未接近位置和接近位置之间,其中在所述接近位置,所述偏置部件与所述切割环接合并在远侧方向上推动所述切割环。
Description
相关申请的交叉引用
本申请要求2018年4月23日提交的第62/661,224号美国临时专利申请的权益和优先权,所述申请的全部公开内容以引用的方式并入本文中。
技术领域
本公开涉及圆形吻合器,且更具体地说,涉及具有在射出之后便于分离刀和切割环的结构的圆形装置的壳体组合件。
背景技术
用于执行端对端或端对侧的吻合手术的圆形吻合器是众所周知的。通常,圆形吻合器包含支撑多个钉的钉仓、可相对于钉仓移动以从钉仓中弹出钉的推动器、可移动到吻合口内的芯组织的环形刀,以及定位成使钉变形的砧座组合件。在实施例中,砧座包含为环形刀提供后档的切割环。
在已知的吻合器中,砧座组合件包含砧座头,所述砧座头从操作位置枢转到倾斜位置以缩小砧座组合件的轮廓,以便随后从患者身上去除砧座组合件。在此类吻合器中,切割环可响应于环形刀从第一位置接合到第二位置而移动,所述第一位置阻止砧座头从操作位置移动到倾斜位置,所述第二位置实现砧座头从操作位置枢转移动到倾斜位置。当环形刀在吻合器射出期间前进到砧座组合件的切割环中时,环形刀将切割环从第一位置推动到第二位置以便使砧座头倾斜。
通常,切割环部分地由比环形刀软的材料形成,使得环形刀在吻合器射出期间穿过切割环。在一些情况下,环形刀粘到切割环上,当环形刀在射出之后缩回到射出前位置时,切割环移回到它的第一位置。当这一情形发生时,阻止砧座头在射出之后移动到倾斜位置。
在本领域中需要不断改进圆形吻合器的壳体组合件,其包含一种简单的确保在吻合器射出之后分离环形刀和切割环以便在从患者身上去除吻合器时砧座头移动到倾斜位置的装置或机构。
发明内容
本公开的一个方面涉及具有细长主体、壳体组合件和砧座组合件的圆形吻合器。细长主体具有近侧部分和远侧部分。壳体组合件包含外壳、支撑在外壳上的钉仓、支撑在外壳内的环形刀,以及支撑在外壳内的偏置部件。偏置部件具有近侧部分和远侧部分。环形刀可在外壳内从缩回位置移动到前进位置,并在前进位置从外壳的远侧部分延伸。当环形刀处于缩回位置时,偏置部件延伸到环形刀的远侧位置。砧座组合件包含中心杆和砧座头,所述砧座头支撑与环形刀轴向对准的切割环。砧座组合件相对于壳体组合件以可移动方式支撑在未接近位置和接近位置之间,其中在接近位置,偏置部件与切割环接合并在远侧方向上推动切割环。
本公开的另一方面涉及包含外壳、钉仓、环形刀和偏置部件的壳体组合件。外壳具有近侧部分和远侧部分,并限定环形通道。钉仓支撑在外壳上。壳体组合件限定支撑钉的多个钉收容凹部。环形刀支撑在外壳内,并且可在外壳内从缩回位置移动到前进位置。当环形刀处于前进位置时,环形刀从外壳的远侧部分延伸。偏置部件支撑在外壳的环形通道内,并且在环形刀处于缩回位置时延伸到环形刀的远侧位置。
在实施例中,偏置部件是螺旋弹簧。
在一些实施例中,壳体组合件包含推动器组合件,所述推动器组合件包含具有多个指状件的推动器,其中所述推动器可从缩回位置移动到前进位置以从钉仓弹出钉。
在某些实施例中,壳体组合件包含支撑环形刀并且可在外壳内从缩回位置移动到前进位置的刀架,其中当砧座组合件和壳体组合件处于接近位置且环形刀处于前进位置时,环形刀与切割环接合。
在实施例中,环形刀包含当环形刀处于前进位置时定位在偏置部件远侧的切割刃。
在一些实施例中,偏置部件固定到刀架上。
在某些实施例中,刀架限定固持凹槽,所述固持凹槽收容一卷螺旋弹簧以将偏置部件固定到刀架上。
在实施例中,吻合器包含柄部组合件及从把手组装件向远侧延伸的细长主体。
在一些实施例中,壳体组合件包含支撑环形刀的刀架,并且刀架可独立于推动器而在外壳内从缩回位置移动到前进位置。
在某些实施例中,外壳限定环形通道,并且推动器和刀架以可移动方式支撑在环形通道内。
在实施例中,偏置部件定位在环形刀内。
附图说明
在下文中参考附图描述了本发明所公开的圆形吻合器的各种实施例,其中:
图1是处于未接近位置的本发明所公开的圆形吻合器的示例性实施例的侧透视图;
图2是图1中所示的所指示区域的细节放大视图;
图2A是沿图2的剖面线2A-2A截得的横截面图;
图3是图1所示的圆形吻合器的壳体组合件的远端的侧透视图;
图4是已去除环形刀的图1所示的圆形吻合器的刀架组合件的侧透视图;
图5是图1所示的圆形吻合器的刀架组合件的侧视横截面图;
图6是图5中所示的刀架组合件的分解图;以及
图7是工具组合件处于接近、已射出状态的图1所示的圆形吻合器的壳体组合件的侧视横截面图。
具体实施方式
现将参考附图详细描述本发明所公开的圆形吻合器,在附图中,类似参考标号表示若干视图中的每个视图中的相同或对应元件。然而,应理解,所公开的实施例仅仅是本公开的示例,并且可以用各种形式来体现。未详细描述众所周知的功能或构造以免用不必要的细节混淆本公开。因此,本文公开的具体结构和功能细节不应被解释为限制,而仅仅作为权利要求的基础,并且作为教导本领域技术人员以实际上任何适当详细的结构使用本公开的代表性基础。
在此描述中,术语“近侧”大体上用于指代装置的更接近临床医生的部分,而术语“远侧”大体上用于指代装置的距临床医生更远的部分。此外,使用的术语“内窥镜”大体上用于指代内窥镜、腹腔镜、关节镜和/或通过小直径切口或套管进行的任何其它程序。另外,术语“临床医生”大体上用于指代医务人员,包括医生、护士和辅助人员。
图1到2A说明大体上示出为吻合器10的本发明所公开的圆形吻合器的示例性实施例。吻合器10包含柄部组合件12、细长主体或适配器组合件14,以及砧座组合件16。适配器组合件14包含细长主体18和壳体组合件20。壳体组合件20具有支撑在细长主体18的远侧部分上的近侧部分和支撑钉仓22的远侧部分。钉仓22限定多个环形行的钉收容凹部24。每一个钉收容凹部24收容一个钉26(图2A),使得钉仓20支撑钉26的环形行。砧座组合件16包含头28和中心杆30。砧座头28通过枢轴部件32(图2A)支撑在砧座中心杆30的远端上,并且支撑切割环33(图2A)。切割环33可在限定于砧座头28内的凹部35(图2A)内从缩回位置(图2A)移动到前进位置(图7)。如所属领域中已知,在缩回位置,切割环33阻止砧座头28相对于中心杆30倾斜,在前进位置,切割环33允许砧座头28相对于中心杆30倾斜。具有可倾斜砧座组合件的砧座组合件的示例性实施例的详细描述见例如第7,303,106号美国专利(“'106专利”)。'106专利以全文引用的方式并入本文中。
柄部组合件12被说明为动力组合件,且包含固定把手34(图1)和致动按钮32,所述致动按钮32用于控制吻合器功能的运行,包含砧座组合件16和壳体组合件20各自的接近、钉26(图2A)从壳体组合件20的钉仓22的射出。适配器组合件14联接到柄部组合件12,以将来自柄部组合件12的动力转移到砧座组合件16和壳体组合件20。尽管本公开分别说明了动力柄部组合件12和适配器组合件14,但是设想如在下文详细描述的本公开的优点还适用于具有手动操作柄部和适配器组合件的圆形吻合器。'106专利公开了包含手动致动的柄部组合件的手术吻合器的实例,且以全文引用的方式并入本文中。第9,023,014号美国专利(“'014专利”)和第9,055,943号美国专利(“'943专利”)公开了包含示例性动力柄部和适配器组合件的外科吻合器的实例。这些专利各自以全文引用的方式并入本文中。
参考图2到3,壳体组合件20包含外壳40,所述外壳40具有内壳部分42(图2A)和外壳部分44。内壳部分42限定中心贯穿孔46。如本领域中已知,当吻合器10接近时,中心贯穿孔46收容适配器组合件14的砧座固持器(未示出)和砧座中心杆30。外壳部分44的内壳部分42和外壳部分44限定环形通道48。
壳体组合件20还包含推动器组合件50和刀组合件52。推动器组合件50和刀组合件52支撑在壳体外壳40的环形通道48内,以便在缩回位置(图2A)和前进位置(图7)之间移动。推动器组合件50包含回推器54和推动器56。回推器54包含联接到适配器组合件14的近端和邻接推动器56的远端。推动器56包含指状件58,所述指状件58收容在钉仓22的钉收容凹部24内并与钉26接合。当适配器组合件14被驱动成在壳体外壳40的环形通道48内使推动器组合件50前进时,推动器56的指状件58前进通过钉仓22的钉收容凹部24,以从钉仓22中射出钉26。
还参考图4到6,刀组合件52包含刀架60和环形刀片62。刀架60包含联接到适配器组合件14的近端和支撑环形刀片62的远端。在实施例中,环形刀62包含切割刃62a。环形刀62与砧座组合件16的砧座头28的切割环33轴向对准。当适配器组合件14被驱动成在壳体外壳40的环形通道48内使刀架60前进时,环形刀片62前进到砧座组合件16的切割环33中。为了更详细地描述圆形吻合器的适配器组合件14及推动器组合件50和刀组合件52的互连,参见第15/467,153号美国专利申请,其以全文引用的方式并入本文中。
刀组合件52还包含偏置部件64,所述偏置部件64定位在刀架60的远侧部分上,并沿着刀片62的内表面62a(图2A)延伸。在偏置部件64的未偏置状态中,偏置部件64的远端定位在环形刀片62的远端的远侧(图5),以免刀片62的端碰触到临床医生。当吻合器10处于未接近状态(图2A)时,偏置部件64处于未偏置状态。
在实施例中,偏置部件64是螺旋弹簧,且刀架60包含环形固持器凹槽66(图5)。环形固持器凹槽66配置成在偏置部件64的近端处收容线圈70,以将偏置部件64固定到刀架60上。如上文所描述,环形刀片62围绕偏置部件64定位在防止线圈70与固持凹槽66分离的位置。
参考图7,当砧座组合件16和壳体组合件20接近时,偏置部件64的远端与切割环33接触。当吻合器10进行射出时,偏置部件64和环形刀62前进到切割环33中以压缩偏置部件64,使得环形刀62的远端向远侧移动超出偏置部件64的远端并穿过砧座组合件16的切割环33。当刀组合件52在壳体组合件20的外壳40内处于前进位置时,偏置部件64在砧座组合件16的切割环33和刀架60之间压缩,以将刀组合件52推动到缩回位置,并将切割环33推动到前进位置。当刀组合件52在吻合器10进行射出之后缩回时,偏置部件64最大限度地降低了切割环33粘到环形刀62上并返回到它的缩回位置(图2A)的可能性。如上文所论述,如果切割环33返回到它的第一位置,那么可以阻止砧座头28在射出之后移动到轮廓缩小的倾斜位置。
本领域的技术人员将理解,在本文中具体地描述且在附图中说明的装置和方法是非限制性的示例性实施例。设想,在不脱离本公开的范围的情况下,结合一个示例性实施例说明或描述的元件和特征可以与另一示例性实施例的元件和特征组合。此外,本领域技术人员将理解本公开的基于上文所描述的实施例的其它特征和优点。因此,除了由所附权利要求指示之外,本公开不受已经特别示出和描述的内容的限制。
Claims (19)
1.一种圆形吻合器,其包括:
细长主体,其具有近侧部分和远侧部分;
壳体组合件,其包含外壳、支撑在所述外壳上的钉仓、支撑在所述外壳内的环形刀以及支撑在所述外壳内的偏置部件,所述偏置部件具有近侧部分和远侧部分,所述环形刀能在所述外壳内从缩回位置移动到前进位置,并在所述前进位置从所述外壳的所述远侧部分延伸,当所述环形刀处于所述缩回位置时,所述偏置部件延伸到所述环形刀的远侧位置;以及
砧座组合件,其包含中心杆和砧座头,所述砧座头支撑与所述环形刀轴向对准的切割环,所述砧座组合件相对于所述壳体组合件以可移动方式支撑在未接近位置和接近位置之间;
其中在所述接近位置,所述偏置部件与所述切割环接合并在远侧方向上推动所述切割环。
2.根据权利要求1所述的圆形吻合器,其中所述偏置部件是螺旋弹簧。
3.根据权利要求2所述的圆形吻合器,其中所述壳体组合件包含推动器组合件,所述推动器组合件包含具有多个指状件的推动器,所述推动器能从缩回位置移动到前进位置以从所述钉仓弹出钉。
4.根据权利要求2所述的圆形吻合器,其中所述壳体组合件包含支撑所述环形刀的刀架,所述刀架能在所述外壳内从缩回位置移动到前进位置,当所述砧座组合件和所述壳体组合件处于所述接近位置且所述环形刀处于所述前进位置时,所述环形刀与所述切割环接合。
5.根据权利要求1所述的圆形吻合器,其中所述环形刀包含切割刃,当所述环形刀处于所述前进位置时,所述切割刃定位在所述偏置部件远侧。
6.根据权利要求4所述的圆形吻合器,其中所述偏置部件固定到所述刀架上。
7.根据权利要求6所述的圆形吻合器,其中所述刀架限定固持凹槽,所述固持凹槽收容一卷所述螺旋弹簧以将所述偏置部件固定到所述刀架上。
8.根据权利要求1所述的圆形吻合器,另外包含柄部组合件,所述细长主体从所述柄部组合件向远侧延伸。
9.根据权利要求3所述的圆形吻合器,其中所述壳体组合件包含支撑所述环形刀的刀架,所述刀架能独立于所述推动器而在所述外壳内从缩回位置移动到前进位置。
10.根据权利要求9所述的圆形吻合器,其中所述外壳限定环形通道,所述推动器和所述刀架以可移动方式支撑在所述环形通道内。
11.根据权利要求2所述的圆形吻合器,其中所述偏置部件定位在所述环形刀内。
12.一种壳体组合件,其包括:
外壳,其具有近侧部分和远侧部分且限定环形通道;
支撑在所述外壳上的钉仓,所述壳体组合件限定多个钉收容凹部,每一个所述钉收容凹部具有一个钉;
支撑在所述外壳内的环形刀,所述环形刀能在所述外壳内从缩回位置移动到前进位置,当所述环形刀处于所述前进位置时,所述环形刀从所述外壳的所述远侧部分延伸;以及
支撑在所述外壳的所述环形通道内的偏置部件,当所述环形刀处于所述缩回位置时,所述偏置部件延伸到所述环形刀的远侧位置。
13.根据权利要求12所述的壳体组合件,其中所述偏置部件是螺旋弹簧。
14.根据权利要求13所述的壳体组合件,其中所述螺旋弹簧定位在所述环形刀内。
15.根据权利要求14所述的壳体组合件,其中所述壳体组合件包含推动器组合件,所述推动器组合件包含具有多个指状件的推动器,所述推动器能从缩回位置移动到前进位置以从所述钉仓弹出钉。
16.根据权利要求15所述的壳体组合件,其中所述壳体组合件包含支撑所述环形刀的刀架,所述刀架能在所述外壳内从缩回位置移动到前进位置。
17.根据权利要求16所述的壳体组合件,其中当所述环形刀处于所述前进位置时,所述环形刀的所述切割刃定位在所述偏置部件远侧。
18.根据权利要求16所述的壳体组合件,其中所述偏置部件固定到所述刀架上。
19.根据权利要求18所述的壳体组合件,其中所述刀架限定固持凹槽,所述固持凹槽收容一卷所述螺旋弹簧以将所述偏置部件固定到所述刀架上。
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