CN110461253B - 具有对准花键的圆形缝合装置 - Google Patents

具有对准花键的圆形缝合装置 Download PDF

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CN110461253B
CN110461253B CN201780088801.XA CN201780088801A CN110461253B CN 110461253 B CN110461253 B CN 110461253B CN 201780088801 A CN201780088801 A CN 201780088801A CN 110461253 B CN110461253 B CN 110461253B
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anvil
apex
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王兆凯
张细良
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Covidien LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0807—Indication means
    • A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
    • A61B2090/0812—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument indicating loosening or shifting of parts of an instrument, signaling maladjustment of parts

Abstract

公开了一种砧座组合件和一种工具组合件。砧座组合件(20)包括：限定纵向轴线并且支撑第一花键(38a)、第二花键(38b)和第三花键(38c)的砧座轴(36)。所述第一花键、所述第二花键和所述第三花键中的每个花键包含在所述相应花键的近端处相交以限定顶点(46)的一对锥形凸轮表面(42，44)。所述第一花键(38a)的所述顶点(46)在所述第二花键(38b)的所述顶点(46)的近侧的位置定位在所述砧座轴(36)上，并且所述第二花键(38b)的所述顶点(46)在所述第三花键(38c)的所述顶点(46)的近侧的位置定位在所述砧座轴(36)上。在实施例中，所述花键中的每个花键包含顶点(46)。所述第一花键(38a)的所述顶点(46)与所述第一花键(38a)的纵向轴线对准，并且所述第二花键和所述第三花键的所述顶点(46)分别与所述第二花键和所述第三花键的纵向轴线对准。

Description

具有对准花键的圆形缝合装置
技术领域
本公开涉及圆形缝合装置，并且更具体地，涉及包括用于将砧座组合件与圆形缝合装置的外壳组合件的缝合钉仓正确地对准的结构的圆形缝合装置。
背景技术
圆形缝合装置被临床医生用于将一个或多个外科手术紧固件例如缝合钉或两件式紧固件施加到身体组织，以用于将身体组织的区段连接在一起和/或以用于进行吻合。圆形缝合装置总体上包含：仓或外壳组合件，其支撑多排环形排列的缝合钉；砧座组合件，其与仓组合件操作性地相关联并且具有缝合钉收纳袋的环形阵列，所述缝合钉收纳袋的环形阵列用于提供所述多排环形排列的缝合钉可以抵靠其形成的表面；以及环形刀片，其用于切割组织。
在典型的组织紧固过程中，将缝合装置的砧座组合件定位在身体组织的一个区段内，并且将外壳组合件以及缝合装置的支撑外壳组合件的主体部分定位在身体组织的相邻区段中。然后将砧座组合件附接到缝合装置的主体部分，并且致动缝合装置，以使砧座组合件接近外壳组合件的缝合钉仓并且将身体组织区段夹紧在一起。
通常，砧座组合件包含包括花键的砧座轴，所述花键与外壳组合件的外壳壳体内形成的花键配合以使砧座组合件的缝合钉形成袋与外壳组合件的缝合钉仓的缝合钉收纳袋对准。砧座轴上和外壳组合件的外壳壳体上的花键包含限定顶点的左侧锥形端和右侧锥形端。当砧座组合件的花键的右侧锥形端接合外壳组合件的左侧锥形端(或反之亦然)时，将旋转砧座组合件以允许砧座组合件的花键在外壳组合件的花键之间穿过从而使砧座组合件与外壳组合件对准。然而，如果砧座组合件的一个花键的右侧锥形端接合外壳组合件的一个花键的右侧锥形端并且砧座组合件的另一个花键的左侧锥形端部接合外壳组合件的另一个花键的左侧锥形端部，或者，如果砧座组合件和外壳组合件的花键的顶点同时撞到头部，即碰撞，则砧座组合件和外壳组合件的花键可能损坏和/或砧座组合件和外壳组合件可以结合，从而使得防止砧座组合件和外壳组合件靠近或者在击发缝合装置期间可能发生缝合钉畸形。
仍然需要一种圆形缝合装置，其包含用于将砧座组合件的缝合钉形成袋与外壳组合件的缝合钉仓的缝合钉收纳袋对准的更可靠的对准结构。
发明内容
本公开的一方面涉及一种砧座组合件，所述砧座组合件包含限定纵向轴线的砧座轴和支撑在所述砧座轴的远端上的砧座头组合件，所述砧座头组合件包含限定多个缝合钉变形凹槽的砧座。所述砧座轴支撑多个花键，所述多个花键包含第一花键、第二花键和第三花键。所述第一花键、所述第二花键和所述第三花键中的每个花键包含在相应花键的近端处相交以限定顶点的一对锥形凸轮表面。所述第一花键的所述顶点在所述第二花键的所述顶点的近侧的位置定位在所述砧座轴上，并且所述第二花键的所述顶点在所述第三花键的所述顶点的近侧的位置定位在所述砧座轴上。
本公开的另一方面涉及一种工具组合件，所述工具组合件包含砧座组合件和外壳组合件。所述砧座组合件包含限定纵向轴线的砧座轴和支撑在所述砧座轴的远端上的砧座头组合件。所述砧座轴支撑多个花键，所述多个花键包含第一花键、第二花键和第三花键。所述第一花键、所述第二花键和所述第三花键中的每个花键包含在每个相应花键的近端处相交以限定顶点的一对锥形凸轮表面。所述第一花键的所述顶点在所述第二花键的所述顶点的近侧的位置定位在所述砧座轴上，并且所述第二花键的所述顶点在所述第三花键的所述顶点的近侧的位置定位在所述砧座轴上。所述砧座头组合件支撑限定多个缝合钉变形凹槽的砧座。所述外壳组合件具有支撑多个缝合钉的缝合钉仓和具有限定多个壳体花键的内壳体部分的外壳壳体。所述多个壳体花键中的相邻花键限定通道，所述通道的尺寸被设定为收纳所述砧座轴的所述第一花键、所述第二花键和所述第三个花键。
在实施例中，所述第一花键的所述顶点以距离B在所述第二花键的所述顶点的近侧定位在所述砧座轴上，并且所述第二花键的所述顶点以距离C在所述第三花键的所述顶点的近侧定位在所述砧座轴上，其中B为约0.15mm到约0.2mm，并且C为约0.15mm到约0.2mm。
在一些实施例中，B和C为约0.175mm。
在某些实施例中，所述第一花键、所述第二花键和所述第三花键中的每个花键限定纵向轴线，所述纵向轴线平行于所述砧座轴的所述纵向轴线，并且所述第一花键的所述顶点与所述第一花键的所述纵向轴线对准。
在实施例中，所述第二花键的所述顶点从所述第二花键的所述纵向轴线横向偏移距离D，并且所述第三花键的所述顶点从所述第三花键的所述纵向轴线横向偏移距离E。
在一些实施例中，所述距离E大于所述距离D。
在某些实施例中，D可以为约0.15mm到约0.2mm，并且E可以为约0.3mm到约0.4mm。
本公开的另一方面涉及一种砧座组合件，所述砧座组合件包含限定纵向轴线的砧座轴和支撑在所述砧座轴的远端上的砧座头组合件。所述砧座轴支撑多个花键，所述多个花键包含第一花键和第二花键。所述多个花键中的每个花键包含在相应花键的近端处相交以限定顶点的一对锥形凸轮表面。所述第一花键和所述第二花键中的每个花键限定纵向轴线，所述纵向轴线平行于所述砧座轴的所述纵向轴线。所述第一花键的所述顶点与所述第一花键的所述纵向轴线对准，并且所述第二花键的所述纵向轴线从所述第二花键的所述纵向轴线横向偏移。所述砧座头组合件支撑限定多个缝合钉变形凹槽的砧座。
在实施例中，所述多个花键包含第三花键，其中所述第二花键的所述顶点从所述第二花键的所述纵向轴线横向偏移距离D，并且所述第三花键的所述顶点从所述第二花键的所述纵向轴线横向偏移距离E。
在一些实施例中，E大于D。
在某些实施例中，所述第一花键的所述顶点定位在所述第二花键的所述顶点的近侧。
在实施例中，所述第一花键的所述顶定位在所述第二花键的近侧，并且所述第三花键的所述顶点定位在所述第二花键的所述顶点的近侧。
附图说明
下文中参考附图描述了本公开外科手术缝合装置的各个实施例，在附图中：
图1是处于夹紧位置的具有工具组合件的本公开外科手术缝合装置的示例性实施例的侧面透视图；
图2是图1所示的外科手术缝合装置的侧面透视图，其中工具组合件的外壳组合件和工具组合件的砧座组合件与缝合装置的其余部分分离；
图3是“现有技术”外科手术缝合装置的远端的透视图，其中外科手术缝合装置的工具组合件的砧座组合件与外科手术缝合装置的砧座保持器(以虚线示出)分离；
图4是图3所示的“现有技术”外科手术缝合装置的砧座组合件的花键配置的示意图；
图5是图1所示的外科手术缝合装置的砧座组合件的侧面透视图；
图5A是沿图5的截面线5A-5A截取的截面视图；
图6是沿图5的箭头6-6所指示的方向截取的侧视图；
图7A是在图6所示的砧座组合件上的多个花键中的第一花键接合外壳组合件的多个花键中的第一花键时，砧座组合件的花键配置的示意图；
图7B是在图6所示的砧座组合件上的所述多个花键中的第二花键接合外壳组合件的所述多个花键中的第二花键时，砧座组合件的花键配置的示意图；
图7C是在图6所示的砧座组合件上的所述多个花键中的第三花键接合外壳组合件的所述多个花键中的第三花键时，砧座组合件的花键配置的示意图；并且
图8是沿图1的截面线8-8截取的截面视图。
具体实施方式
现在将参考附图详细地描述本公开的外科手术缝合装置，在附图中，相同的附图标记在若干个视图中的每个视图中标示完全相同的或对应的元件。在本说明书中，术语“近侧”通常用于指代装置的距临床医生较近的那部分，而术语“远侧”通常用于指代装置的距临床医生较远的那部分。另外，术语“内窥镜术”通常用于指代内窥镜术、腹腔镜术、关节镜术和/或通过小直径切口或套管进行的任何其它手术，并且术语“临床医生”通常用于指代医务人员，包含医生、护士和支持人员。进一步地，如本文所使用的，术语“约”用于意指鉴定出的参数的正或负10％。
本公开的外科手术缝合装置包含具有砧座组合件和外壳组合件的工具组合件。砧座组合件包含限定纵向轴线的砧座轴和支撑在砧座轴的远端上的砧座头组合件。砧座轴支撑多个花键，所述多个花键包含第一花键、第二花键和第三花键。第一花键、第二花键和第三花键中的每个花键包含在相应花键的近端处相交以限定顶点的一对锥形凸轮表面。第一花键的顶点在第二花键的顶点的近侧的位置定位在砧座轴上，并且第二花键的顶点在第三花键的顶点的近侧的位置定位在砧座轴上。在实施例中，第一花键的顶点与第一花键的纵向轴线对准，并且第二花键和第三花键的顶点分别与第二花键和第三花键的纵向轴线横向间隔开。本公开的花键配置降低了砧座轴的花键将与缝合装置的外壳组合件的花键结合的可能性以及砧座轴的花键与外壳组合件的花键的碰撞将显著影响外科手术缝合装置的操作的可能性。
参考图1和图2，总体上示出为10的本公开外科手术缝合装置示包含手柄组合件12、从手柄组合件12向远侧延伸的细长主体部分14、以及支撑在细长主体部分14的远端部分上的工具组合件16。工具组合件16包含支撑缝合钉仓18a的仓或外壳组合件18以及支撑砧座20a的砧座组合件20。手柄组合件12包含：接近旋钮22，所述接近旋钮操作接近机构(未示出)以使砧座组合件20相对于外壳组合件18在未夹紧位置与夹紧位置之间移动；击发触发器24，所述击发触发器操作击发机构(未示出)以将缝合钉(未示出)从缝合钉仓18a击发到组织中；以及击发触发器闭锁26，所述击发触发器闭锁可枢转地支撑在手柄组合件12上并且定位成防止缝合装置10的无意击发。关于包含已知的接近机构、击发机构和闭锁机构的示例性圆形缝合装置的详细描述，参见美国专利第7,857,187号(“187专利”)，所述美国专利通过全文引用的方式并入本文中。
尽管本公开的缝合装置10被示出并描述为手动驱动装置，但是设想了缝合装置10可以是电力驱动装置，如美国专利公开第2015/0048140号中所描述的，所述美国专利通过全文引用的方式并入本文中。
外壳组合件18的缝合钉仓18a和砧座组合件20的砧座20a具有环形配置。砧座组合件20可相对于外壳组合件18从间隔位置移动到夹紧位置，以将砧座20a移动到与缝合钉仓18a并列对准。缝合钉仓18a限定缝合钉收纳槽28，当缝合钉仓18a和砧座20a正确地对准时，所述缝合钉收纳槽与砧座20a的缝合钉变形凹槽(未示出)对准，使得当击发缝合装置10时，从缝合钉收纳槽28中弹出的缝合钉在缝合钉收纳凹槽内变形。
砧座组合件20支撑在砧座保持器30(图2)上，所述砧座保持器形成缝合装置10的接近机构(未示出)的一部分。砧座保持器30被配置成可释放地接合砧座组合件20。砧座保持器30包含远端部分和近端部分。砧座保持器30的远端部分从缝合装置10的细长主体部分14的远端延伸并且穿过外壳组合件18延伸到接合砧座组合件20的位置。砧座保持器30的近端部分操作性地连接到接近旋钮22，使得接近旋钮22的旋转使砧座保持器30在外壳组合件18内移动，从而使砧座组合件20相对于缝合钉仓18a在间隔位置与夹紧位置之间移动。外壳组合件18包含环形刀(未示出)，在击发缝合装置10期间，所述环形刀可在外壳组合件18内从缩回位置移动到前进位置，以横切夹紧在缝合钉仓18a与砧座20a之间的组织。
参考图2，外壳组合件18可释放地耦接到缝合装置10的细长主体14的远端部分，以便于在每次击发缝合装置10之后更换外壳组合件18。美国专利公开第2016/0310141号、第2016/0192938号和第2016/0192934号中描述了用于将外壳组合件18可释放地耦接到缝合装置10的细长主体部分14的机构，所述美国专利通过全文引用的方式并入本文中。
参考图3，在“现有技术”圆形缝合装置100中，砧座组合件120包含砧座头122和砧座轴124，并且外壳组合件118包含缝合钉仓118a和外壳体壳126，所述外壳壳体具有限定通孔128a的内壳体部分128。砧座头122支撑限定缝合钉变形凹槽122b的环形阵列的砧座122a，并且缝合钉仓118a限定缝合钉收纳槽118b的环形阵列。砧座保持器130(以虚线示出)包含远端，所述远端被配置成可释放地接合砧座组合件120的砧座轴124。砧座保持器130收纳在通孔128a内并且可在缩回位置与前进位置之间移动。当砧座轴124耦接到砧座保持器130并且砧座保持器130缩回时(经由图1的接近旋钮22的致动)，砧座轴124被拉入到外壳壳体126的内壳体部分128的通孔128a中。
为了将砧座组合件120的砧座头122的缝合钉变形凹槽122b的阵列与外壳组合件118的缝合钉仓118a的缝合钉收纳槽118b对准，砧座轴124包含多个花键134，所述多个花键包含相邻的花键134a、134b(图4)，所述相邻的花键收纳在沿着外壳壳体126的内壳体部分128的内壁形成的花键136之间。砧座组合件120的花键134中的每个花键限定中心轴线“Z”以及定位在中心轴线“Z”的相对侧的左侧锥形凸轮表面138a和右侧锥形凸轮表面138b，如图4中看到的。锥形表面138a、138b在其近端在顶点140处相交。类似地，外壳组合件118的花键136中的每个花键限定中心轴线“X”以及定位在中心轴线“X”的相对侧的左侧锥形凸轮表面142a和右侧锥形凸轮表面142b。锥形表面142a、142b在其远端在顶点144处相交。
当砧座组合件120附接到砧座保持器130并且砧座保持器130和砧座组合件120缩回到外壳壳体126的内壳体部分128的通孔128a(图3)中时，砧座组合件120的花键134朝向外壳组合件118的花键136移动。如果花键134与限定在外壳组合件118的花键136之间的通道148未对准，则砧座花键134a、134b的顶点140将接合花键136的凸轮表面142a、142b中的一个凸轮表面。当所有花键134a、134b(仅示出两个)的所有顶点140接合花键136的左侧锥形凸轮表面142a时，所述接合推动或凸动(cam)砧座组合件120在箭头“S”所指示的方向上旋转以重新对准花键134a、134b，使得所述花键进入限定在外壳组合件118的花键136之间的通道148中。类似地，当所有花键134a、134b的所有顶点140接合花键136的右侧锥形凸轮表面142b时，所述接合推动或凸动砧座组合件120在箭头“T”所指示的方向上旋转以重新对准花键134a、134b，使得所述花键进入限定在外壳组合件118的花键136之间的通道148中。然而，如果花键134a、134b中的任何两个花键的顶点140同时接合外壳组合件118的这两个花键136的左侧锥形凸轮表面142a和右侧锥形凸轮表面142b，则所述接合在相反方向上同时推动或凸动砧座组合件120。当这种情况发生时，花键134a-b和136将结合，直到花键134和/或136中的一个或两个花键破裂。另外，如果花键134a-b的顶点140与花键136的顶点144对准，则顶点可能彼此碰撞，从而导致花键134a-b和/或136损坏。当花键134和136彼此碰撞或结合并且砧座组合件120的缝合钉收纳凹槽127与外壳组合件118的缝合钉收纳槽128之间的适当对准未实现时，可能导致缝合装置100的的缝合钉形成或锁定不正确。
参考图5和图6，在本公开的外科手术缝合装置10(图1)中，砧座组合件20包含支撑砧座20a的砧座头组合件34和限定纵向轴线“SH”(图5)的砧座轴36。砧座轴36支撑围绕砧座轴36定位的多个花键38，所述多个花键包含第一花键38a、第二花键38b和第三花键38c。在一些实施例中，所述多个花键38包含第一花键38a和第二花键38b。花键38a-c中的每个花键限定在基本上平行于砧座轴36的纵向轴线“SH”(图5)的方向上延伸的纵向轴线“Z”(图6)，并且分别包含左侧锥形凸轮表面42和右侧锥形凸轮表面44(如图6中看到的)，所述左侧锥形凸轮表面和所述右侧锥形凸轮表面相交以限定定位在相应花键38的近端处的顶点46。在实施例中，花键38a的顶点46以距离“B”(图6)定位在花键38b的顶点46的近侧，其中“B”可以为约0.15mm到约0.2mm，并且花键36b的顶点46以距离“C”定位在顶点38c的近侧，其中“C”可以为约0.15mm到约0.2mm。通过沿着砧座轴36的纵向轴线“SH”将花键36的顶点46间隔开，花键38的顶点46中的两个或更多个顶点将同时接合外壳组合件18的花键54(图7A)的顶点的可能性或者砧座组合件20的花键38的顶点46将同时接合外壳组合件18的相应花键54的相对侧以使花键碰撞或结合的可能性最小化。
参考图6，在实施例中，第一花键38a的顶点46与第一花键38a的纵向轴线“Z”对准并且包含具有基本上相等的尺寸的左侧锥形凸轮表面42和右侧锥形凸轮表面44。相比之下，第二花键38b的顶点46从纵向轴线“Z”偏移距离“D”，并且第三花键38c的顶点46从纵向轴线“Z”偏移距离“E”，其中距离“D”可以为约0.15mm到约0.2mm，并且距离“E”可以为约0.3mm到约0.4mm。如此，花键38b-c的左侧凸轮表面42的尺寸大于花键38b-c的右侧凸轮表面44的尺寸。
参考图7A-8，如上文关于图3和图4所示的“现有技术”缝合装置所讨论的那样，缝合装置10(图1)的外壳组合件18(图2)包含多个间隔开的花键54，每个花键限定中心纵向轴线“Y”(图7A-7C)。所述多个花键54中的相邻花键54限定各个花键54之间的通道56(图8)。每个花键54包含左侧锥形凸轮表面58a和右侧锥形凸轮表面58b(如图7A-7C中看到的)，所述左侧锥形凸轮表面和所述右侧锥形凸轮表面定位在花键54的中心纵向轴线“Y”的相对侧。锥形表面58a、58b在其远端在顶点60处相交。
当砧座组合件20朝向夹紧位置(图1)接近缝合装置10的外壳组合件18时，砧座组合件20的花键38a-c靠近外壳组合件18的花键54。最初，第一花键38a的顶点46接触所述多个花键54(图7A)中的一个花键。如上文所讨论的，花键38a的顶点46定位在花键38b-c的顶点46的近侧，使得仅花键38a的顶点46最初将接合外壳组合件18的花键54。在花键38a的轴线“Z”与花键54的轴线“Y”对准(如图7A所示)的情况下，可能发生花键38a和花键54的碰撞。由于仅第一花键38a的顶点46最初接触外壳组合件18的相应花键54(图7A)中的一个花键的顶点60，因此碰撞限于仅所述一个花键38a。
如果花键38a与花键54的接合未使砧座组合件20凸动或旋转成与外壳组合件18对准，则砧座组合件20相对于外壳组合件18的持续接近使砧座组合件20的第二花键38b的顶点46接合外壳组合件18的另一个花键54(图7B)。如上文所讨论的，第二花键38b的顶点46从花键38b的纵向轴线“Z”偏移。如此，当砧座组合件20的花键38b的顶点46接合外壳组合件18的花键54时，花键38b的顶点46定位成从花键54的顶点60偏移。因此，花键38b的顶点46将接合花键38c的左侧锥形凸轮表面58a或右侧锥形凸轮表面58b中的一个锥形凸轮表面(如图7B所示，右侧锥形凸轮表面58b)，使得砧座组合件20在图7B中的箭头“K”所指示的方向上凸动或旋转。在砧座组合件20在箭头“K”所指示的方向上旋转时，花键38a-c朝向与外壳组合件18的通道56(图8)对准的位置旋转。当这种情况发生时，砧座轴36的花键38a的顶点46将旋转脱离与外壳组合件18的花键54的顶点60的接合。
在砧座组合件20相对于外壳组合件18朝向夹紧位置继续前进时，砧座组合件20(图1)的第三花键38c接合外壳组合件18的另一个花键54。如上文所讨论的，花键38c的顶点46从花键38c的纵向轴线“Z”进一步偏移。在砧座组合件20相对于外壳组合件18继续前进时，砧座轴36的花键38c的顶点46接合外壳组合件18的花键54的左侧锥形凸轮表面58a和右侧锥形凸轮表面58b中的一个锥形凸轮表面(如图7C所示，右侧锥形凸轮表面58b)。砧座组合件20的花键38c与外壳组合件18的花键54的接合进一步有助于将砧座组合件20凸动到花键38a-c与外壳组合件18的通道56(图8)对准的位置。
在实施例中，本公开的砧座组合件20(图1)包含多个花键38a-c，所述多个花键定位在砧座轴36(图5)上并且具有从彼此纵向偏移的近端。通过沿着砧座组合件20的砧座轴36将花键38a-c的近端纵向间隔开，所述多个花键38a-c中的任何两个花键将同时接合外壳组合件18的相应花键54的相对侧的任何可能性大大减小。这大大降低了砧座组合件20的花键38a-c将与外壳组合件18的花键54结合的任何可能性。另外，使砧座组合件20的花键38b-c的顶点从花键38b-c的纵向轴线“Z”横向偏移允许砧座组合件20从花键38a-c的顶点与外壳组合件18的花键54的顶点60对准的位置旋转，其中最近侧的花键38a撞上外壳组合件18的相应花键54。
本领域技术人员将理解，在本文中具体地描述并且在附图中展示的装置和方法是非限制性示例性实施例。可以设想，在不脱离本公开的范围的情况下，结合一个示例性实施例展示或描述的元件和特征可以与另一个示例性实施例的元件和特征组合。而且，本领域技术人员将基于上述实施例来了解本公开的另外的特征和优点。因此，除了由所附权利要求书指示之外，本公开不应当受已经特别示出和描述的内容的限制。

Claims (11)

1.一种砧座组合件，其包括：
砧座轴，其限定纵向轴线，所述砧座轴支撑第一花键、第二花键和第三花键，所述第一花键、第二花键和第三花键中的每个花键包含在相应花键的近端处相交以限定顶点的一对锥形凸轮表面，其中所述第一花键、第二花键和第三花键中的每个花键限定平行于所述砧座轴的纵向轴线的纵向轴线，所述第一花键的顶点与所述第一花键的纵向轴线对准；以及
砧座头组合件，其支撑在所述砧座轴的远端部分上，所述砧座头组合件支撑限定多个缝合钉变形凹槽的砧座；
其中所述第一花键的顶点在所述第二花键的顶点的近侧的位置定位在所述砧座轴上，并且所述第二花键的顶点在所述第三花键的顶点的近侧的位置定位在所述砧座轴上；以及
其中所述第二花键的顶点从所述第二花键的纵向轴线横向偏移第一偏移距离，并且所述第三花键的顶点从所述第三花键的纵向轴线横向偏移第二偏移距离。
2.根据权利要求1所述的砧座组合件，其中所述第一花键的顶点以第一纵向距离在所述第二花键的顶点的近侧定位在所述砧座轴上，并且所述第二花键的顶点以第二纵向距离在所述第三花键的顶点的近侧定位在所述砧座轴上，其中第一纵向距离为0.15mm到0.2mm，并且第二纵向距离为0.15mm到0.2mm。
3.根据权利要求2所述的砧座组合件，其中第一纵向距离为约0.175mm。
4.根据权利要求1-3中任一项所述的砧座组合件，其中所述第二偏移距离大于所述第一偏移距离。
5.根据权利要求1-3中任一项所述的砧座组合件，其中所述第一偏移距离为0.15mm到0.2mm，并且所述第二偏移距离为0.3mm到0.4mm。
6.一种工具组合件，其包括：
根据权利要求1-5中任一项所述的砧座组合件；以及
外壳组合件，其具有支撑多个缝合钉的缝合钉仓和具有限定多个壳体花键的内壳体部分的外壳壳体，其中所述多个壳体花键中的相邻花键限定通道，所述通道的尺寸被设定为收纳所述砧座轴的所述第一花键、第二花键和第三花键。
7.一种砧座组合件，其包括：
砧座轴，其限定纵向轴线，所述砧座轴支撑多个花键，
所述多个花键包含第一花键和第二花键，所述多个花键中的每个花键包含在相应花键的近端处相交以限定顶点的一对锥形凸轮表面，其中所述第一花键和所述第二花键中的每个花键限定纵向轴线，所述纵向轴线平行于所述砧座轴的纵向轴线，所述第一花键的顶点与所述第一花键的纵向轴线对准，并且所述第二花键的顶点从所述第二花键的纵向轴线横向偏移；以及
砧座头组合件，其支撑在所述砧座轴的远端部分上，所述砧座头组合件支撑限定多个缝合钉变形凹槽的砧座。
8.根据权利要求7所述的砧座组合件，其中所述多个花键包含第三花键，
所述第二花键的顶点从所述第二花键的纵向轴线横向偏移第一偏移距离，并且所述第三花键的顶点从所述第三花键的纵向轴线横向偏移第二偏移距离。
9.根据权利要求8所述的砧座组合件，其中所述第二偏移距离大于所述第一偏移距离。
10.根据权利要求7-9中任一项所述的砧座组合件，其中所述第一花键的顶点定位在所述第二花键的顶点的近侧。
11.根据权利要求8或9所述的砧座组合件，其中所述第一花键的顶点定位在所述第二花键的近侧，并且所述第二花键的顶点定位在所述第三花键的顶点的近侧。
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