CN110652327B - 用于砧座组件输送系统的系紧方法 - Google Patents

用于砧座组件输送系统的系紧方法 Download PDF

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CN110652327B
CN110652327B CN201910550754.7A CN201910550754A CN110652327B CN 110652327 B CN110652327 B CN 110652327B CN 201910550754 A CN201910550754 A CN 201910550754A CN 110652327 B CN110652327 B CN 110652327B
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查理·科拉
黑莉·施特拉斯纳
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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
    • 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
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • 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

Abstract

本发明公开了一种用于砧座组件输送系统的系紧方法。一种将砧座组件的头部组件固定在用于经口输送的输送位置的方法包含系结缝合线，使得在适配器组件和所述头部组件之间延伸的缝合线的长度彼此接触和/或平行。

Description

用于砧座组件输送系统的系紧方法
相关申请的交叉引用
本申请要求2018年6月28日提交的第62/690,995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
本公开涉及用于将砧座组件经口输送到患者体腔中的输送系统。更具体地，本公开涉及一种用于将砧座组件固定到输送系统的系紧方法，其中头部组件处于用于经口输送到体腔中的位置。
背景技术
用于将砧座组件输送到手术部位(例如，胃)的经口输送系统通常包含用于将砧座组件的头部组件保持在便于无创伤的经口插入的位置的保持缝合线。通常，保持缝合线在砧座组件的头部组件和输送系统之间延伸，以将砧座组件固定到输送系统，其中头部组件处于倾斜位置。一旦砧座组件已经定位在患者体内，则切割或以其它方式释放保持缝合线以允许头部组件枢转到操作位置。
用于系紧砧座组件的头部组件的改进方法是期望的。
发明内容
提供了一种砧座输送系统。所述砧座输送系统包含输送组件，所述输送组件包含适配器构件、砧座组件和缝合线。所述适配器构件限定通孔。所述砧座组件包含可选择性地固定到适配器构件的中心杆组件，以及可枢转地固定到中心杆组件的头部组件。所述头部组件可在第一倾斜位置和操作位置之间枢转，所述头部组件包含具有第一开口的壳体。缝合线将头部组件保持在第一倾斜位置。缝合线具有第一端部和第二端部。缝合线延伸穿过适配器构件中的通孔，且包含将缝合线固定在适配器构件周围的第一结。缝合线的第一端部和第二端部通过壳体中的开口接收。
在实施例中，壳体还限定一对具有第一开口和第二开口的开口。缝合线的第一端部可以通过所述对开口的第一开口接收，并且缝合线的第二端部可以通过所述对开口的第二开口接收。缝合线的第一端部和第二端部可以在第一开口和第二开口外部形成第二结。缝合线的第一长度和第二长度可以在适配器构件和壳体之间延伸，彼此接触和/或彼此平行。
所述输送系统还可包含柔性管。所述适配器组件可以固定到柔性管。所述头部组件可以移动到与第一倾斜位置相对的第二倾斜位置。
还提供了一种将砧座组件固定在第一倾斜位置的方法。所述方法包含通过砧座输送系统的适配器构件的通孔接收缝合线，通过在缝合线中系结第一结来将缝合线固定到适配器构件，使缝合线的第一端和第二端穿过砧座组件的头部组件的壳体中的开口，使缝合线的第一端穿过壳体中的第一开口且使缝合线的第二端穿过壳体中的第二开口，以及通过在缝合线的第一端和第二端附近缝合第二结将缝合线的第一端和第二端固定在一起以将头部组件固定在第一倾斜位置。
在实施例中，所述方法进一步包含在系结第二结之前将头部组件相对于砧座组件的中心杆组件移动到第一倾斜位置。所述方法可以包含将适配器构件固定到砧座组件的中心杆组件。所述方法可以包含将适配器构件固定到砧座输送系统的柔性管。
附图说明
在此参考附图公开了本文公开的砧座组件和砧座组件输送系统的各种实施例，其中：
图1是根据本公开的实施例的砧座组件的透视图，所述砧座组件可释放地固定到现有技术的外科缝合器械上；
图2是图1的砧座组件从远端的侧视透视图；
图3是图1和2中所示的砧座组件从近端的侧视透视图；
图4是用于输送图1到3中所示的砧座组件的砧座输送系统的分解侧视透视图，其中各部分分开；
图5是图1-3中所示的砧座组件的俯视图，其固定到图4所示的砧座输送系统；
图6是根据本公开的方法的图1-3的砧座组件的侧视透视图，其中砧座组件的头部组件在第一倾斜位置系紧；
图7是图1-3中所示的砧座组件和图4所示的砧座输送系统的适配器构件的第一侧视图，其中在适配器构件固定到砧座组件之前，通过适配器构件接收保持缝合线；
图8是图7中所示的砧座输送系统的砧座组件和适配器构件的第一侧视图，其中保持缝合线围绕适配器构件并且在适配器构件固定到砧座组件之前；
图9是图7和8中所示的砧座组件、适配器构件和保持缝合线的第一侧视图，其中保持缝合线围绕适配器构件并且适配器构件固定到砧座组件；
图10是图7-9中所示的砧座组件、适配器构件和保持缝合线的第一侧视图，其中保持缝合线通过并固定在砧座组件的头部组件上并且头部组件系在第一倾斜位置；和
图11是如图10所示的砧座组件、适配器构件和保持缝合线的第二侧视图，其中头部组件系在第一倾斜位置。
具体实施方式
现在参考附图详细描述本发明公开的砧座组件和用于固定砧座组件的头部组件的方法的实施例，其中相同附图标记在若干视图中的每个视图中表示相同或对应元件。在整个说明书中，术语“近端”是指最靠近操作者的器械部分，且术语“远端”是指离操作者最远的器械部分。另外，术语临床医生通常用于指医务人员，包含医生、护士和支持人员。
图1示出了根据本公开的实施例的砧座组件，其总体上示为砧座组件110。砧座组件110可释放地固定到现有技术的外科缝合器械10，如本领域中已知的。尽管将参考外科缝合器械10和砧座输送系统150(图4)描述砧座组件110和将砧座组件110固定到砧座输送系统150的方法，但是可以设想砧座组件110并且可以修改固定砧座组件110的方法以与替代的外科缝合器械(例如动力手术器械)和其它已知的砧座输送系统一起使用。
外科缝合器械10包含近侧手柄组件12、细长中央主体部分14和远侧头部16。或者，在一些外科手术中，例如痔疮的治疗，希望具有基本笔直的、缩短的中央主体部分。主体部分14和远端头部16的长度、形状和/或直径也可以变化以适应特定的外科手术。
外科缝合器械10的手柄组件12包含固定手柄18、击发触发器20和可旋转的近似旋钮22。枢转安装的扳机锁26固定到手柄组件12，并且手动定位以防止缝合器械10的无意击发。头部16包含壳组件28和砧座组件110。砧座组件110可释放地固定到套管针组件30，套管针组件延伸穿过壳体组件28并且可相对于壳体组件28移动，以使砧座组件110相对于壳体组件28在隔开和接近位置之间移动。对于示例性手术缝合器械的详细描述，请参考共同拥有颁予Milliman的美国专利第7,364,060号，所述专利的内容通过引用以其全文并入本文中。
现在参考图2和3，外科缝合器械10的砧座组件110包含头部组件112和中心杆组件114。头部组件112可枢转地固定到中心杆组件114，并且可在第一倾斜位置(图6)和操作位置(图1)之间移动。在一些实施例中，头部组件112也可在操作位置(图1)和第二倾斜位置(未示出)之间移动。仅在完全公开本公开的方面所必需的程度上描述砧座组件110的结构和操作。对于示例性连接器组件的详细描述，请参考共同拥有的美国专利第9,554,802号，所述专利的内容通过引用以其全文并入本文中。
砧座组件110的头部组件112包含壳体116。头部组件112的壳体116限定第一对开口117(包含第一开口和第二开口117a、117b)、第二对开口119(包含第一开口和第二开口119a、119b)，以及单个开口121。如下面进一步详细描述的，根据本公开的系紧方法的实施例，第一对开口117和单个开口121定位在头部组件112的壳体116上以接收保持缝合线“S1”(图6)。回收缝合线“S2”(图5)可以通过第二对开口119接收，和/或可以与保持缝合线“S1”一起通过第一对开口117接收。
砧座组件110的中心杆组件114包含具有远端部分和近端部分的中心杆130。头部组件112可枢转地固定到中心杆130的远端部分。中心杆130的近端部分包含限定孔131的多个柔性臂132。槽133形成在多个柔性臂132中的每一个之间。如下面将进一步详细描述的，由多个柔性臂132限定的孔131(图3)接收砧座输送系统150(图4)的适配器构件162(图4)，且槽133接收适配器构件162的纵向引导特征166，以便于适配器构件162与砧座组件110的头部组件112对准。
现在参考图4和5，砧座输送系统150被配置成用于将砧座组件110经口插入患者(未示出)中。仅在完全公开本公开的方面所必需的程度上描述砧座输送系统150。对于示例性砧座输送系统的详细描述，请参考共同拥有的美国专利第9,861,367号(“'367专利”)和美国专利申请公开案第2017/0000475号(“'475公开案”)，其内容通过引用整体并入本文。
砧座输送系统150包含柔性管或引导构件152和适配器构件162。柔性管152包含用于接收和支撑适配器构件162的第一或开放端152a以及被配置成用于在患者体内进行口腔接收的第二或封闭端152b。砧座输送系统150的柔性管152的开放端152a可包含横向通孔153，用于接收锁定销154以将适配器构件162固定到柔性管152。
适配器构件162包含第一端162a和第二端162b，所述第一端被配置成容纳在柔性管152的开放端152a内，所述第二端被配置成容纳在形成于砧座组件110的中心杆130的第二端中的孔131中(图3)。适配器构件162的第二端162b包含纵向引导特征166，所述纵向引导特征被配置成容纳在形成于砧座组件110的中心杆130的多个柔性臂132之间的槽133中的一个中。适配器构件162的中心毂部分162c还限定横向通孔170。如下面将详细描述的，通孔170接收保持缝合线“S1”以便于系紧砧座组件110的头部组件112。
转到图6，砧座组件110被示出为固定到砧座输送系统150的适配器构件162。根据本公开的方法，砧座组件110的头部组件112保持在第一倾斜位置，其中保持缝合线“S1”系在砧座组件110上。将参照7-11描述将砧座组件110的头部组件112与保持缝合线“S1”系在一起的方法。
首先参考图7，用于将砧座组件110的头部组件112固定在倾斜位置的保持缝合线“S1”通过砧座输送系统150的适配器构件162的中心毂部分162c中的通孔170接收。尽管示出了砧座输送系统150的适配器构件162与砧座组件110分离，但是可以设想，在通过适配器构件162中的通孔170接收保持缝合线“S1”之前，适配器构件162可以固定到砧座组件110。
转到图8，第一结“K1”围绕砧座输送系统150的适配器构件162的中心毂部分162c系在保持缝合线“S1”中。保持缝合线“S1”中的第一结“K1”与砧座输送系统150的适配器构件162的纵向引导特征166对准地系结。
现在参考图9，在缝合线“S1”系结到适配器构件162之后，适配器构件162的第二端162b定位在由中心杆组件114的中心杆130的多个柔性臂132限定的孔131内，使得适配器构件162的纵向引导特征166容纳在形成于中心杆130的柔性臂132之间的槽133内，所述槽与头部组件112的壳体116中的单个开口121对准。在槽133内与单个开口121对准的纵向引导特征166的接收将保持缝合线“S1”中的第一结“K1”与砧座组件110的头部组件112的壳体116中的单个开口121对准。
现在转向图10和11，保持缝合线“S1”的第一端“S1a”和第二端“S1b”两者然后都通过砧座组件110的头部组件112的壳体116中的单个开口121接收。接下来，通过第一对开口117中的第一开口117a接收保持缝合线“S1”的第一端“S1a”，并且通过第一对开口117中的第二开口117b接收保持缝合线“S1”的第二端“S1b”。头部组件112克服位于中心杆130的远端部分中的弹簧(未示出)的偏置而移动到第一倾斜位置。然后将保持缝合线“S1”的第一端“S1a”和第二端“S1b”系在一起，以在保持缝合线“S1”中形成第二结“K2”。第二结“K2”被系结，使得保持缝合线“S1”将砧座组件110的头部组件112保持在第一倾斜位置。
如图10所示，在砧座输送系统150的适配器构件162和砧座组件110的头部组件112之间延伸的保持缝合线“S1”的长度彼此平行地延伸并且彼此紧密靠近，例如彼此接触。通过将保持缝合线“S1”的两个长度彼此紧密地保持，保持缝合线“S1”的两个长度可以由临床医生同时用切割装置一次剪断，以释放砧座组件110的头部组件112。砧座组件110的头部组件112的释放允许头部组件114枢转到操作位置。将缝合线的长度彼此紧密地定位简化了从倾斜位置释放头部组件的过程，以最小化完成切割所需的时间并减少产生可留在体腔内的松散缝合线残余物的可能性。
一旦砧座组件110的头部组件112固定在第一倾斜位置，砧座输送系统150的适配器组件162就固定到砧座输送系统150的柔性管152，并且如在'367专利和/或'475公开案中所述完成外科缝合过程。
本领域技术人员将理解，本文具体描述并在附图中示出的器械和方法是非限制性示例性实施例。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示出或描述的元件和特征可以与另一个的元件和特征组合。此外，本领域的技术人员将理解本公开的基于上文所描述的实施例的另外特征和优点。因此，本公开不应受特定示出并描述的内容限制，而是由所附权利要求书指示。

Claims (11)

1.一种砧座输送系统，其包括：
输送组件，其包含适配器构件，所述适配器构件限定通孔；
砧座组件，其包含：
中心杆组件，其能选择性地固定到所述适配器构件；和
头部组件，其能枢转地固定到所述中心杆组件，所述头部组件能在第一倾斜位置与操作位置之间枢转，所述头部组件包含具有单个开口的壳体；和
缝合线，其用于将所述头部组件保持在所述第一倾斜位置，所述缝合线具有第一端部和第二端部，其中所述缝合线延伸穿过所述适配器构件中的所述通孔并且包含将所述缝合线固定在所述适配器构件周围的第一结，其中所述缝合线的所述第一端部和所述第二端部通过所述壳体中的所述单个开口接收；
其中，所述第一结与所述单个开口对准，并且所述第一结围绕所述适配器构件的中心毂部分，使得所述缝合线的从所述适配器构件到所述头部组件的第一长度和第二长度相邻。
2.根据权利要求1所述的砧座输送系统，其中所述壳体还限定一对开口，所述一对开口具有第一开口和第二开口，所述缝合线的所述第一端部通过所述一对开口中的所述第一开口接收，并且所述缝合线的所述第二端部通过所述一对开口中的所述第二开口接收。
3.根据权利要求2所述的砧座输送系统，其中所述缝合线的所述第一端部和所述第二端部在所述第一开口和所述第二开口外部形成第二结。
4.根据权利要求1所述的砧座输送系统，其中在所述适配器构件和所述壳体之间延伸的所述缝合线的第一长度和第二长度彼此接触。
5.根据权利要求1所述的砧座输送系统，其中在所述适配器构件和所述壳体之间延伸的所述缝合线的第一长度和第二长度彼此平行。
6.根据权利要求3所述的砧座输送系统，其中所述砧座输送系统进一步包含柔性管，所述适配器构件固定到所述柔性管。
7.根据权利要求1所述的砧座输送系统，其中所述头部组件能移动到与所述第一倾斜位置相对的第二倾斜位置。
8.一种将砧座组件固定在第一倾斜位置的方法，所述方法包括：
通过砧座输送系统的适配器构件的通孔接收缝合线；
通过在所述缝合线中系上第一结将所述缝合线固定到所述适配器构件；
使所述缝合线的第一端部和第二端部穿过所述砧座组件的头部组件的壳体中的单个开口，其中，所述第一结与所述单个开口对准，并且所述第一结围绕所述适配器构件的中心毂部分，使得所述缝合线的从所述适配器构件到所述头部组件的第一长度和第二长度相邻；
使所述缝合线的所述第一端部穿过所述壳体中的第一开口，且使所述缝合线的所述第二端部穿过所述壳体中的第二开口；和
通过在所述缝合线的所述第一端部和所述第二端部附近系结所述缝合线的第二结来将所述缝合线的所述第一端部和所述第二端部固定在一起，以将所述头部组件固定在第一倾斜位置。
9.根据权利要求8所述的方法，其进一步包含在系结所述第二结之前将所述头部组件相对于所述砧座组件的中心杆组件移动到所述第一倾斜位置。
10.根据权利要求8所述的方法，其进一步包含将所述适配器构件固定到所述砧座组件的中心杆组件。
11.根据权利要求10所述的方法，其进一步包含将所述适配器构件固定到所述砧座输送系统的柔性管。
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