CN110664452A - 具有砧支撑件的外科钉合设备 - Google Patents

具有砧支撑件的外科钉合设备 Download PDF

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CN110664452A
CN110664452A CN201910578217.3A CN201910578217A CN110664452A CN 110664452 A CN110664452 A CN 110664452A CN 201910578217 A CN201910578217 A CN 201910578217A CN 110664452 A CN110664452 A CN 110664452A
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anvil
support
stapling apparatus
anvil head
head
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贾斯汀·威廉斯
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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
    • 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
    • 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
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • 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
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • 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
    • A61B2017/07285—Stapler heads characterised by its cutter

Abstract

一种圆形钉合设备包含支撑件和砧头组合件。所述砧头组合件包含砧头和紧固到所述砧头的砧帽。所述砧帽被定位成将所述支撑件选择性地紧固到所述砧头。所述砧帽是柔性的且包含外环，所述外环相对于所述砧头可选择性地移动以从所述砧头释放所述支撑件。

Description

具有砧支撑件的外科钉合设备
相关申请的交叉引用
本申请要求2018年7月2日提交的美国临时专利申请第62/693,167号的权益和优先权，所述专利申请的全部公开内容以引用的方式并入本文中。
技术领域
本公开涉及外科钉合设备，并且，更确切地说，涉及用于将支撑件材料可移除地附接到圆形外科钉合设备以用于在吻合手术中使用的结构和方法。
背景技术
已传统地使用扣件来在结合各种身体结构(例如，肠或支气管)时替换缝接。用以应用这些扣件的外科钉合设备通常被设计成同时切割和密封组织以减少吻合手术涉及的时间和风险。
外科医生使用圆形外科钉合设备来将一个或多个外科扣件(例如，钉或两部分扣件)应用到身体组织，以用于将身体组织的段结合在一起的目的和/或用于创造吻合术。圆形外科钉合设备通常包括：环形扣件仓组合件，其支撑多个环形行扣件；操作性地与所述扣件仓组合件相关联的环形砧组合件，其提供一旦起动圆形钉合设备就形成扣件所抵靠的表面；和用于切割组织的环形刀片。
对于多数手术，使用裸露的扣件通常是可接受的，其中所述扣件与患者的组织直接接触。所述组织的完整性将通常用以在已发生愈合前防止扣件扯下组织和损坏密封。然而，在一些外科手术中，外科医生使用支撑件材料结合圆形钉合设备桥接、修复和/或加固患者内的组织缺陷。明确地说，支撑件材料减少患者受到外伤，减少泄漏的情况，减少出血的情况，和创造邻近身体组织之间的相对强结合。
因此，需要将支撑件材料可靠且可移除附接到圆形钉合设备，使得支撑件材料不干扰设备的操作，保留在设备上直到在起动扣件后，和方便且容易地安装与使用。
发明内容
根据一个方面，本公开涉及一种钉合设备。所述钉合设备包含砧头、支撑件和砧帽。所述砧头包含顶表面和底表面。所述底表面界定钉形成凹穴。所述支撑件支撑于所述砧头的所述底表面上且被定位成覆盖所述钉形成凹穴。所述砧帽紧固到所述砧头的所述顶表面且被定位成选择性地将所述支撑件紧固到所述砧头。所述砧帽包含内环组合件和外环。所述外环与所述支撑件可选择性地接合，且相对于所述内环组合件可移动以将所述砧帽与所述支撑件分开并从所述砧头释放所述支撑件。
在一些实施例中，所述内环组合件可为柔性的以有助于所述外环相对于所述支撑件的移动。所述内环组合件可包含柔性杯和将所述柔性杯连接到所述外环的环形凸缘。所述钉合设备可进一步包含扣件，其将所述砧帽紧固到所述砧头且安放在所述柔性杯内。所述钉合设备可进一步包含销，其定位于所述砧头中且相对于所述砧头可移动以当所述扣件维持所述柔性杯紧固到所述砧头时将所述外环移动远离所述支撑件。所述销可与所述砧帽成整体。所述砧头可支撑相对于所述砧头可移动的垫板。所述垫板可与所述销可选择性地接合以相对于所述砧头移动所述销。所述钉合设备可进一步包含圆柱形刀，其与所述垫板可选择性地接合以相对于所述砧头移动所述垫板。
在某些实施例中，所述支撑件可包含从所述支撑件延伸的指状物。所述指状物可沿着所述砧头的所述顶表面定位且安置于所述外环之下以抵靠所述砧头的所述底表面支撑所述支撑件。所述外环可包含环形唇缘，其被定位成接触所述指状物以将所述支撑件紧固到所述砧头。
根据本公开的另一方面，提供一种圆形钉合设备。所述圆形钉合设备包含支撑件和砧头组合件。所述砧头组合件包含砧头和紧固到所述砧头的砧帽。所述砧帽被定位成将所述支撑件选择性地紧固到所述砧头。所述砧帽是柔性的且包含外环，所述外环相对于所述砧头可选择性地移动以从所述砧头释放所述支撑件。
在某些实施例中，所述砧帽可包含紧固到所述砧头的内环组合件。所述内环组合件可被配置成响应于所述外环相对于所述支撑件的移动而挠曲。所述内环组合件可包含紧固到所述砧头的柔性杯，和将所述柔性杯连接到所述外环的环形凸缘。所述圆形钉合设备可进一步包含收纳在由所述柔性杯界定的凹穴中的扣件。所述扣件可以可螺接方式联接到所述砧头以将所述柔性杯紧固到所述砧头。所述砧头组合件可包含收纳在所述砧头内的一个或多个销。所述一个或多个销可为相对于所述砧头可移动以分开所述外环与所述支撑件。所述一个或多个销可独立于所述砧帽。所述一个或多个销可包含围绕所述砧帽定位的多个间隔开的销。所述圆形钉合设备可进一步包含圆柱形刀，其可选择性地移动成与所述砧头中支撑的垫板接合以相对于所述砧头移动所述垫板。所述垫板可被定位成接合所述一个或多个销。
在一些实施例中，所述支撑件可包含将所述支撑件支撑于所述砧头上的指状物。所述外环可包含抵靠所述砧头选择性地捕捉所述指状物的环形唇缘。
其它方面、特征和优点将从接下来的描述、图式和权利要求书显而易见。
附图说明
并入在本说明书中且构成本说明书的部分的附图说明本公开的实施例，并与上文给出的本公开的一般描述和下文给出的详细描述一起用以解释本公开的原理，其中：
图1是根据本公开的外科钉合设备的透视图，所述外科钉合设备包含在未接近位置中展示的末端执行器的一个实施例；
图2是图1中展示的指示的细节区域的放大透视图；
图3是图1的末端执行器的透视图，其中末端执行器的砧组合件展示与末端执行器的仓组合件分开；
图4是图3的砧组合件的砧头组合件的透视图，其中零件分开；
图5是图4的砧头组合件的砧帽的透视图；
图6是图3的砧组合件的透视图，其中零件分开；
图7是图1的末端执行器的侧横截面图，其中末端执行器图示处于接近位置中；
图8-10是说明实行吻合手术的图1的外科钉合设备的渐进图；
图11是砧组合件的另一实施例的透视图；且
图12是图11的砧组合件的砧头组合件的透视图，其中零件分开。
具体实施方式
参考附图详细描述当前公开的外科钉合设备的实施例，其中相似参考数字表示在若干视图中的每个中的相同或对应元件。如通常已知，术语“临床医生”是指医生、护士或任何其它医护人员且可包含支持人员。另外，术语“近侧”指结构的更靠近临床医生的部分，且术语“远侧”指结构的距临床医生较远的部分。此外，例如前、后、上部、下部、顶部、底部等的方向术语仅为描述的方便起见而使用，且并不希望限制随附于此的公开内容。
在以下描述中，没有详细描述公知的功能或构造，以避免以不必要的细节使本公开模糊。
现在转到图1，提供外科钉合设备，其大体被称作10。在实施例中，外科钉合设备10适于重新使用，并且在某些实施例中，外科钉合设备10或其部分可适于单次使用和/或为一次性。外科钉合设备10界定中心线“CL”，且包含呈动力型手持式机电仪器的形式的外科装置100。外科钉合设备10进一步包含可选择性地附接到外科装置100的适配器组合件200。适配器组合件200从外科装置100在远侧延伸并且具有延伸到远端的细长主体202。细长主体202的远端支撑末端执行器300。末端执行器300包含可定位于松开或未接近位置(见图1)与夹紧或接近位置(见图7)之间以选择性地夹紧组织“T”(图10)用于切割和/或钉合组织“T”的壳或仓组合件310和砧组合件320。外科装置100被配置成用于与适配器组合件200选择性的连接，并且，适配器组合件200又被配置成用于与末端执行器300的选择性连接。外科装置100和适配器组合件200一起合作以操作末端执行器300。
外科钉合设备10的外科装置100包含把手外壳102，其被配置成用于可再充电电池103的选择性的可移除式收纳。电池103被配置成将电力供应到外科装置100的电组件。把手外壳102界定空腔“C”，其将被配置成控制外科装置100的各种操作的控制器或电路板105支撑于其中。
外科钉合设备10进一步包含驱动机构106，其被配置成在把手外壳102内驱动可旋转轴和/或齿轮组件(未展示)以便执行外科钉合设备10的各种操作。举例来说，驱动机构106可以是可操作的以围绕和/或相对于外科钉合设备10的中心线“CL”选择性地旋转末端执行器300；相对于仓组合件310选择性地移动砧组合件320以选择性地夹紧组织；和/或起动外科钉合设备10用于扣紧和/或切割夹紧的组织。电池103、控制器105和/或驱动机构106可以可操作地联接到一个或多个致动器107a、107b，例如，手指致动式控制按钮、摇臂装置等，以实现外科钉合设备10的例如以上描述的功能的各种功能。
机电外科钉合设备10的驱动机构106包含在远侧延伸通过细长主体202的接近机构108。接近机构108被配置成选择性或可移除地联接到砧组合件320，如在Milliman等人的美国专利第7,303,106号中所描述，所述专利的全部内容以引用的方式并入本文中。接近机构108还被配置成沿着外科钉合设备10的中心线“CL”在远侧位置与近侧位置之间移动，以相对于仓组合件310在接近的位置与未接近的位置之间移动砧组合件320以选择性地夹紧和/或松开组织。
可对Ross等人的美国专利第8,806,973号进行参考，所述专利的全部内容以引用的方式并入本文中，以取得实例机电外科钉合设备的构造和操作的详细描述，其组件可与本文中描述的外科钉合设备10的一个或多个组件组合和/或互换。
虽然外科钉合设备10被描述为机电动力式外科钉合设备，但是目前公开的外科钉合设备可提供为手动动力式钉合设备。为了示范性手动动力式钉合设备的构造和操作的更详细描述，其一个或多个组件可与本文中描述的机电动力式钉合设备组合和/或互换，可对Viola等人的美国专利第5,915,616号、Milliman等人的美国专利第8,109,426号、Holsten等人的美国专利第8,272,552号、Milliman的美国专利第9,504,470号和Penna的美国专利第9,414,839号进行参考，所述专利的全部内容以引用的方式并入本文中。
现在转到图2-10，末端执行器300的砧组合件320包含中心杆组合件322，和从中心杆组合件322在远侧延伸且可在不倾斜位置(图2)与倾斜位置(图9)之间枢转地联接到其的砧头组合件324。简要地，中心杆组合件322包含中心杆322a，其支撑合作以使砧组合件324能够在起动末端执行器300且未从仓组合件310接近砧组合件320后从不倾斜位置移动到倾斜位置的柱塞组合件322b和凸轮闩锁322c。为了中心杆组合件322和/或其组件的结构和操作的更详细描述，可对Milliman等人的美国专利第8,109,426号进行参考，所述专利以引用的方式并入上文中。
砧组合件320的砧头组合件324包含砧头326、由砧帽330选择性紧固到砧头326的支撑件328和将砧帽330紧固到砧头326的扣件340。
砧头326包含底表面326a，其在其中界定钉形成凹穴326b和垫板凹口326x。砧头326亦包含顶表面326c，其在其中界定可为螺纹式的销孔326d和扣件孔326e。此外，砧头326在垫板凹口326x中支撑垫板组合件327。垫板组合件327可从近侧位置(图7)轴向移动通过砧头326的垫板凹口326x到远侧位置(图8)。为了垫板组合件327和/或其组件的结构和操作的更详细描述，可对Milliman等人的美国专利第8,109,426号进行参考，所述专利以引用的方式并入上文中。
砧头组合件324的支撑件328包含环形主体328a和从环形体328a延伸的多个圆周间隔开的指状物328b。环形体328a被配置成在砧头326的底表面326a之上延伸以便覆盖在底表面326a中界定的钉凹穴326b。环形主体328a界定穿过其的中心开口328c。指状物328b被定位成在砧头326的顶表面326c之上且在砧帽330之下延伸以选择性维持安装到砧头326的底表面326a的支撑件328的环形主体328a。
砧头组合件324的砧帽330包含外环332、内环组合件334和从砧帽330的底表面在近侧延伸的间隔开的销336。销336可整体或单块地与砧帽330一起形成。外环332包含环形唇缘332a，其被定位成当砧帽330与砧头326接合(图7)时抵靠砧头326捕捉支撑件328的指状物328b，和当砧帽330从砧头326脱离(图8)时释放支撑件328的指状物328b。内环组合件334包含柔性杯334a和将柔性杯334a联接到外环332的柔性环形凸缘334b。柔性杯334a界定将扣件340支撑于其中的凹穴334c和孔隙334d。柔性杯334a和柔性环形凸缘334b可以由足够柔性以使砧帽330能够相对于砧头326从第一或接合位置(图7)移动到第二或脱离位置(图8)以从砧头326选择性地释放支撑件328的任何合适材料形成。在接合位置中，砧帽330的外环332被配置成将支撑件328a的指状物328b紧固到砧头326的顶表面，且在脱离位置中，砧帽330的外环332与砧头326的顶表面间隔开以使支撑件328a的指状物328b能够与砧头326分开且从砧头326释放支撑件328。
砧头组合件324的扣件340包含头部分342，其安放于砧帽330的柔性杯334a的凹穴334c中以保持柔性杯334a抵靠砧头326的顶表面。扣件340进一步包含螺纹轴部分344，其从头部分342在近侧延伸以用于与砧头326的扣件孔326e螺纹接合以将砧帽330紧固到砧头326。头部分342界定在其顶表面中的驱动凹口342a，其被配置成收纳例如螺丝刀的驱动仪器(未展示)以将扣件340紧固到砧帽330和砧头326。驱动凹口342a可具有任何合适配置，例如，星形、十字形、六叶形等。
末端执行器300的仓组合件310包含壳312、用于将扣件317(例如，钉)起动到砧组合件320内的推动器313、用于切割组织的圆柱形刀314和用于在仓组合件310中支撑扣件317的钉仓315。仓组合件310进一步包含外驱动套筒318，其被配置成相对于钉仓315在远侧推进推动器313，如由箭头“A”指示；和支撑于外驱动套筒318上的内驱动套筒319。内驱动套筒319被配置成当外驱动套筒318相对于钉仓315在远侧推进推动器313以用于抵靠砧组合件320的砧头326形成扣件317时，相对于钉仓315在远侧推进圆柱形刀314，如由箭头“B”指示。
仓组合件310的壳312紧固到适配器组合件202(图1)的细长主体202的远侧端部分。壳312包含：外部外壳312a，其被配置成支持钉仓315；和内部外壳312b，其被配置成在其中收纳砧组合件320的中心杆组合件322；和联接部分312x，其被配置成将仓组合件310联接到适配器组合件200的细长主体202。
仓组合件310的推动器313围绕壳312的内部外壳312b可滑动地定位。推动器313包含被配置成支撑一阵列扣件317的在远侧延伸的指状物313a的环形阵列。指状物313a中的一个或多个和/或扣件317中的一个或多个可具有不同高度。在一些实施例中，指状物313a中的一个或多个和/或扣件317中的一个或多个可具有相同高度。
仓组合件310的圆柱形刀314摩擦保持于推动器313内以关于推动器313固定地紧固刀314。刀314的远端包含被配置成切断组织的圆形刃口314a。
仓组合件310的钉仓315包含组织接触表面315a，其中槽315b的环形阵列被形成且与砧头326的钉形成凹穴326b对齐地定位。钉仓315的槽315b的环形阵列被配置成在其中支撑并且可滑动地收纳扣件317的环形阵列。
现在参看图7-10，在操作中，一旦外科钉合设备10的末端执行器300被定位成邻近外科手术部位，就可使末端执行器300的砧组合件320朝向末端执行器300的仓组合件310接近以握紧仓组合件310与砧组合件320之间的组织。然后可起动钉合设备10，使得外驱动套管317和内驱动套管319在远侧推进推动器313和圆柱形刀314以用于将扣件317起动到组织“T”内且切割组织“T”。随着圆柱形刀314轴向推进通过支撑件328并与砧组合件320的垫板327接合，圆柱形刀314相对于砧头326移动砧组合件320的垫板327，如由箭头“C”指示。垫板327相对于砧头326从其第一位置(图7)到其第二位置(图8)的移动使垫板327在远侧相对于砧头326驱动砧帽330的销336，如由箭头“E”指示。随着销336相对于砧头326在远侧移动，砧帽330的外环332与支撑件328和砧头326分开。明确地说，在砧组合件320的扣件340保持砧帽330的内环组合件334的柔性杯334a紧固到砧组合件320的砧头326的情况下，内环组合件334，即，其柔性杯334a和柔性环形凸缘334b，在远侧且径向向内移动，如由箭头“F”指示，从第一状态(例如，其中内环组合件334处于未挠曲状态中，见图7)移动到第二状态(例如，其中内环组合件334处于挠曲状态中，见图8)，以有助于砧帽330的外环332远离支撑件328移动。随着外环332移动远离砧头326和支撑件328的指状物328b，支撑件328从砧头326释放，使得当末端执行器300被起动和松开时，支撑件328可与砧组合件320分开且提供扣件317抵靠组织“T”的钉线加固。有利地，此支撑件分开会减少或消除钉线压力。
一旦末端执行器300被起动，就可然后不接近或从末端执行器300的仓组合件310分离(例如，松开)末端执行器300的砧组合件320，使得砧组合件320从不倾斜位置(图8)移动到倾斜位置(图9)以释放被钉合的组织和从外科手术部位移除末端执行器300。砧组合件320和/或仓组合件310然后可从外科钉合设备10移除和/或按需要替换。为了扣件317的起动、切割和/或扣紧和/或砧组合件320和/或仓组合件310的替换的更详细描述，可对并入本文中的美国专利第7,303,106号进行参考。
参看图11和12，砧组合件420的另一实施例包含大体上类似砧组合件324的砧头组合件424，但包含单独的或独立于砧帽430的销436。
如可了解，可使用例如焊接、压接、胶合、扣紧等的已知紧固技术来实现紧固本发明所公开的设备的组件中的任一个。
本文中公开的各种实施例也可被配置成对机器人外科手术系统起作用，且其通常被称作“遥控外科手术”。此类系统使用各种机器人元件来辅助临床医生和允许外科仪表的远程操作(或部分远程操作)。可出于此目的使用各种机器人臂、齿轮、凸轮、滑轮、电动机和机械电动机等，且可将其设计成具有机器人外科手术系统以在操作或治疗过程期间辅助临床医生。此类机器人系统可以包含远程可导向系统、自动灵活外科手术系统、远程灵活外科手术系统、远程铰接式外科手术系统、无线外科手术系统、模块化或选择性可配置远程操作外科手术系统等。
机器人外科手术系统可供紧接于手术室或位于远程位置中的一个或多个控制台使用。在此例子中，一个临床医生团队可使患者做好外科手术准备，并用本文中所公开的仪器中的一个或多个配置机器人外科手术系统，而另一临床医生(或一组临床医生)经由机器人外科手术系统远程地控制所述仪器。如可了解，高度熟练的临床医师可在多个位置执行多个操作而不离开他/她的远程控制台，这在经济上有利，且对于病人或一系列病人也是有益的。为了示范性医疗工作站和/或其组件的详细描述，可对美国专利申请公开案第2012/0116416号和PCT申请公开案第WO2016/025132号进行参考，所述公开案中之每一者之全部内容以引用的方式并入本文中。
所属领域的技术人员应理解，本文中具体描述且附图中所图示的结构和方法是非限制性示范性实施例，且应将描述、公开和图仅仅解释为举例说明特定实施例。因此，应理解，本公开不限于所描述的精确实施例，且所属领域的技术人员可在不脱离本公开的范围或精神的情况下实现各种其它改变和修改。另外，预见到结合一个示范性实施例说明或描述的元件和特征可与不脱离本公开的范围的另一示范性实施例的元件和特征组合，并且此类修改和变化还意图包含在本公开的范围内。实际上，目前公开的元件和特征中的任何者的任何组合在本公开的范围内。因此，本公开的主题并不受到已特定展示和描述的内容限制。

Claims (20)

1.一种钉合设备，包括：
砧头，其包含顶表面和底表面，所述底表面界定钉形成凹穴；
支撑件，其支撑于所述砧头的所述底表面上且被定位成覆盖所述钉形成凹穴；以及
砧帽，其紧固到所述砧头的所述顶表面且被定位成将所述支撑件选择性地紧固到所述砧头，所述砧帽包含内环组合件和外环，所述外环与所述支撑件可选择性地接合且相对于所述内环组合件可移动以将所述砧帽与所述支撑件分开和从所述砧头释放所述支撑件。
2.根据权利要求1所述的钉合设备，其中所述内环组合件为柔性的以有助于所述外环相对于所述支撑件的移动。
3.根据权利要求2所述的钉合设备，其中所述内环组合件包含柔性杯和将所述柔性杯连接到所述外环的环形凸缘。
4.根据权利要求3所述的钉合设备，其进一步包括将所述砧帽紧固到所述砧头且安放在所述柔性杯内的扣件。
5.根据权利要求4所述的钉合设备，其进一步包含销，所述销定位于所述砧头中且相对于所述砧头可移动以当所述扣件维持所述柔性杯紧固到所述砧头时将所述外环移动远离所述支撑件。
6.根据权利要求5所述的钉合设备，其中所述销与所述砧帽成整体。
7.根据权利要求5所述的钉合设备，其中所述砧头支撑相对于所述砧头可移动的垫板，所述垫板与所述销可选择性地接合以相对于所述砧头移动所述销。
8.根据权利要求7所述的钉合设备，其进一步包含圆柱形刀，所述圆柱形刀与所述垫板可选择性地接合以相对于所述砧头移动所述垫板。
9.根据权利要求1所述的钉合设备，其中所述支撑件包含从所述支撑件延伸的指状物，所述指状物沿着所述砧头的所述顶表面定位且安置在所述外环之下以抵靠所述砧头的所述底表面支撑所述支撑件。
10.根据权利要求9所述的钉合设备，其中外环包含环形唇缘，其被定位成接触所述指状物以将所述支撑件紧固到所述砧头。
11.一种圆形钉合设备，包括：
支撑件；以及
砧头组合件，其包含砧头和紧固到所述砧头的砧帽，所述砧帽被定位成选择性地将所述支撑件紧固到所述砧头，所述砧帽是柔性的且包含外环，所述外环相对于所述砧头可选择性地移动以从所述砧头释放所述支撑件。
12.根据权利要求11所述的圆形钉合设备，其中所述砧帽包含紧固到所述砧头的内环组合件，所述内环组合件被配置成响应于所述外环相对于所述支撑件的移动而挠曲。
13.根据权利要求12所述的圆形钉合设备，其中所述内环组合件包含紧固到所述砧头的柔性杯，和将所述柔性杯连接到所述外环的环形凸缘。
14.根据权利要求13所述的圆形钉合设备，其进一步包括收纳在由所述柔性杯界定的凹穴中的扣件，所述扣件以可螺接方式联接到所述砧头以将所述柔性杯紧固到所述砧头。
15.根据权利要求14所述的圆形钉合设备，其中所述砧头组合件包含收纳在所述砧头内的至少一个销，所述至少一个销相对于所述砧头可移动以分开所述外环与所述支撑件。
16.根据权利要求15所述的圆形钉合设备，其中所述至少一个销独立于所述砧帽。
17.根据权利要求15所述的圆形钉合设备，其中所述至少一个销包含围绕所述砧帽定位的多个间隔开的销。
18.根据权利要求15所述的圆形钉合设备，其进一步包括圆柱形刀，所述圆柱形刀可选择性地移动成与支撑于所述砧头中的垫板接合以相对于所述砧头移动所述垫板，所述垫板被定位成接合所述至少一个销。
19.根据权利要求11所述的圆形钉合设备，其中所述支撑件包含在所述砧头上支撑所述支撑件的指状物。
20.根据权利要求19所述的圆形钉合设备，其中所述外环包含抵靠所述砧头选择性地捕捉所述指状物的环形唇缘。
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