CN110811748A - 用于手术施夹器的细长组合件和并有细长组合件的手术施夹器 - Google Patents

用于手术施夹器的细长组合件和并有细长组合件的手术施夹器 Download PDF

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CN110811748A
CN110811748A CN201910722036.3A CN201910722036A CN110811748A CN 110811748 A CN110811748 A CN 110811748A CN 201910722036 A CN201910722036 A CN 201910722036A CN 110811748 A CN110811748 A CN 110811748A
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assembly
spaced apart
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surgical clip
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雅各布·C·巴里尔
罗伊·J·皮列特雷
贾斯廷·托马斯
马修·A·迪尼诺
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122Clamps or clips, e.g. for the umbilical cord
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    • AHUMAN NECESSITIES
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    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
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    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2932Transmission of forces to jaw members
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2932Transmission of forces to jaw members
    • A61B2017/2933Transmission of forces to jaw members camming or guiding means
    • A61B2017/2937Transmission of forces to jaw members camming or guiding means with flexible part
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/036Abutting means, stops, e.g. abutting on tissue or skin abutting on tissue or skin

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Abstract

本发明涉及用于手术施夹器的细长组合件和并有细长组合件的手术施夹器。本发明的细长组合件包含:外轴;末端执行器组合件,其从所述外轴向远侧延伸且包含第一间隔开的臂和第二间隔开的臂,在所述第一间隔开的臂和所述第二间隔开的臂的相应自由端处安置有第一钳口和第二钳口;以及内驱动套管,其包含围绕所述末端执行器组合件可滑动地安置的轴承组合件。所述轴承组合件包含邻近于所述间隔开的臂而定位的第一轴承滚柱和第二轴承滚柱。所述轴承组合件从近侧位置到远侧位置的滑动使所述轴承滚柱沿着所述间隔开的臂滚动,以朝向彼此推动所述间隔开的臂,由此将所述钳口从间隔开的位置移动到接近位置,以围绕安置于所述钳口之间的组织施放手术夹具。

Description

用于手术施夹器的细长组合件和并有细长组合件的手术施 夹器
相关申请的交叉引用
本申请要求2018年8月13日提交的第62/717,952号美国临时专利申请的权益和优先权,所述美国临时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
本公开涉及一种手术器械。更具体地,本公开涉及用于手术施夹器的细长组合件和包含细长组合件的手术施夹器。
背景技术
手术施夹器为本领域中已知的并且用于多种不同和有用的手术。在进行腹腔镜手术的情况下,通过插入皮肤中的小入口切口的窄管或插管来实现进入腹部内部。在主体中的其它地方执行微创手术通常被称作内窥镜手术。
具有各种尺寸(例如,直径)的内窥镜手术施夹器在本领域中也是已知的,所述手术施夹器配置成施放各种不同的手术夹具,并且能够在进入体腔期间施放单个或多个手术夹具。这类手术夹具通常由生物相容性材料制成,并且通常压缩在组织上。一旦施放到组织,压缩的手术夹具终止从中穿过的流体的流动。
发明内容
如本文中详述且在附图中示出,传统上当涉及手术器械上的相对定位时,术语“近侧”是指设备或其组件更接近使用者的部分,且术语“远侧”是指设备或其组件更远离使用者的部分。另外,在某种程度上一致,本文详述的方面和特征中的任一者或全部可以与本文详述的另一方面和特征中的任一者或全部结合使用。
根据本公开的方面,提供一种手术施夹器的细长组合件,其包含外轴、末端执行器组合件和内驱动套管。所述末端执行器组合件部分安置于所述外轴内且从所述外轴向远侧延伸。所述末端执行器组合件包含第一间隔开的臂和第二间隔开的臂以及分别安置于所述第一间隔开的臂和所述第二间隔开的臂的自由端处的第一钳口和第二钳口。
所述内驱动套管安置于所述外轴内且包含围绕所述末端执行器组合件可滑动地安置的轴承组合件。所述轴承组合件包含邻近于所述第一间隔开的臂而定位的第一轴承滚柱和邻近于所述第二间隔开的臂而定位的第二轴承滚柱。所述轴承组合件从近侧位置到远侧位置的滑动使所述第一轴承滚柱和所述第二轴承滚柱分别沿着所述第一间隔开的臂和所述第二间隔开的臂滚动,以朝向彼此推动所述第一间隔开的臂和所述第二间隔开的臂,由此将所述第一钳口和所述第二钳口从间隔开的位置移动到接近位置,以围绕安置于所述第一钳口与所述第二钳口之间的组织施放手术夹具。
在本公开的方面中,所述第一轴承滚柱和所述第二轴承滚柱可旋转地安装在第一柱和第二柱上,所述第一柱和所述第二柱安置于所述内驱动套管的相对侧上。在各方面中,所述第一柱和所述第二柱安置于所述内驱动套管的所述远侧端处。另外或替代地,在各方面中,所述内驱动套管可限定矩形截面配置,其包含相对的窄侧和相对的宽侧,其中所述第一柱和所述第二柱沿着所述窄侧安装。
在本公开的另一方面中,所述第一轴承滚柱和所述第二轴承滚柱与安置于其间的所述第一间隔开的臂和所述第二间隔开的臂以相对于彼此平行、间隔开的关系安置。
在本公开的又一方面中,所述第一间隔开的臂和所述第二间隔开的臂限定面向内的表面和面向外的表面,其中所述第一轴承滚柱和所述第二轴承滚柱配置成分别沿着所述第一间隔开的臂和所述第二间隔开的臂的所述面向外的表面滚动。在此些方面中,所述第一间隔开的臂和所述第二间隔开的臂的所述面向外的表面限定大体上光滑、平坦的配置。
在本公开的又一方面中,所述第一间隔开的臂和所述第二间隔开的臂响应于所述轴承组合件从所述近侧位置移动到所述远侧位置而从静止位置弹性地弯曲到弯折位置,由此将所述第一钳口和所述第二钳口从所述间隔开的位置移动到所述接近位置。
在本公开的又另一方面中,所述第一间隔开的臂和所述第二间隔开的臂经由相对于所述外轴固定的近侧基部接合到彼此。
在本公开的另一方面中,所述细长组合件进一步包含近侧毂,所述近侧毂安置于所述外轴的近侧端处且配置成将所述细长组合件与手柄组合件可释放地接合。
根据本公开的方面还提供一种手术施夹器,其包含:手柄组合件,所述手柄组合件包含壳体和可操作地联接到所述壳体的触发器;以及细长组合件,其从所述手柄组合件向远侧延伸。所述细长组合件可包含上文或本文中详述的方面和特征中的任一个。
附图说明
参考附图详细描述本公开的方面和特征,其中类似的附图标号表示相似或相同的结构元件,并且:
图1是包含具有与其接合的细长组合件的手柄组合件的根据本公开提供的手术施夹器的前透视图;
图2是从手柄组合件移除细长组合件的手术施夹器的前透视图;
图3A是用以说明其中的内部组件和特征的已移除部分的手术施夹器的手柄组合件的放大侧视图,其中触发器安置在未致动位置中;
图3B是用以说明其中的内部组件和特征的已移除部分的手术施夹器的手柄组合件的放大侧视图,其中触发器安置在致动位置中;
图4是已移除部分的手术施夹器的侧视图;
图5是图1的细长组合件的远侧部分的侧透视图,其中部分示出为透明的;
图6是图1的细长组合件的远侧部分的侧面部分纵向截面透视图;
图7A是图1的细长组合件的远侧部分的纵向截面视图;
图7B是在图7A中指示为“7B”的细节区域的放大纵向截面视图;
图8是类似于图1的细长组合件的且配置成与图1的手柄组合件一起使用的另一细长组合件的远侧部分的部分切开透视图;且
图9是图8的细长组合件的远侧部分的纵向俯视截面视图。
具体实施方式
转向图1到4,示出大体上以附图标号10标识的体现本公开的方面和特征的手术施夹器。手术施夹器10通常包含手柄组合件100和能够可选择地连接到手柄组合件100的细长组合件200。手柄组合件100配置成在连接到其上时操作细长组合件200,并且可配置为可灭菌的可重复使用的组件,使得手柄组合件100可在一个或多个手术的过程期间与不同的和/或附加的细长组合件200一起重复地使用。根据特定目的,细长组合件200可配置为单次使用的一次性组件、有限使用的一次性组件或可重复使用组件。
手柄组合件100通常包含壳体110、可操作地与壳体110相关联的致动机构120、可操作地与壳体110相关联的闩锁组合件160,和可操作地联接到壳体110的远侧部分的旋转接纳器组合件180。手柄组合件100的壳体110支撑和/或包封手柄组合件100的操作组件,并且限定主体部分111和从主体部分111悬垂的固定手柄部分112。壳体110的主体部分111包含在主体部分111内横向延伸的内部枢轴柱114和远侧开口118,当细长组合件200与手柄组合件100接合时,细长组合件200的近侧端部分延伸通过远侧开口118。
致动机构120通过壳体110可操作地支撑,并且包含触发器122、驱动杆130,和连杆组合件140。触发器122包含抓握部分123、中间枢轴部分124和近侧延伸部125。触发器122的抓握部分123以相对于壳体110的固定手柄部分112相对的关系从壳体110的主体部分111向下延伸。抓握部分123配置成便于触发器122的抓握和操纵。触发器122的中间枢轴部分124至少部分安置于壳体110内并且限定配置成接纳壳体110的枢轴柱114的枢轴孔口126,以便使得触发器122能够围绕枢轴柱114并且相对于壳体110枢转,例如在未致动位置与致动位置之间枢转,在未致动位置中,触发器122的抓握部分123相对于固定手柄部分112间隔开,在致动位置中,触发器122的抓握部分123相对于固定手柄部分112接近。
与触发器122的抓握部分123相比,触发器122的近侧延伸部125安置于中间枢轴部分124的相对侧上并且因此安置于枢轴柱114上。因此,枢转抓握部分123以在一个方向上旋转,例如朝向固定手柄部分112向近侧旋转,会使近侧延伸部125枢转,以在相反的方向上例如向远侧旋转。
连杆组合件140包含第一连杆142、第二连杆144,和第三连杆146。第一连杆142朝向第一连杆142的第一端143a可枢转地联接到触发器122的近侧延伸部125。第二连杆144和第三连杆146各自分别在第二连杆144和第三连杆146的相应第一端145a、147a处可枢转地联接到第一连杆142的第二端143b。第二连杆144的第二端145b可枢转地联接到驱动杆130,而第三连杆146的第二端147b可枢转地联接到壳体110的主体部分111。因此,在第一连杆142与触发器122的近侧延伸部125之间的枢转点、在第一连杆142与第二连杆144和第三连杆146之间的枢转点以及在第二连杆144与驱动杆130之间的枢转点分别是可移动枢转点(例如,相对于壳体110可移动),而在第三连杆146与壳体110之间的枢转点是固定枢转点(例如,相对于壳体110固定)。
在触发器122的致动时,例如,触发器122的抓握部分123的近侧枢转时,近侧延伸部125在逆时针方向上(从图3A中示出的定向)移动,由此将第一连杆142朝向驱动杆130推动。第一连杆142朝向驱动杆130的这种移动继而分别朝向驱动杆130推动第二连杆144和第三连杆146的第一端145a、147a,继而向远侧推动第二连杆144的第二端145b,使得驱动杆130通过壳体110的主体部分111向远侧平移。可提供偏置弹簧(未示出)以朝向未致动位置偏置触发器122,由此向近侧偏置驱动杆130。
当细长组合件200与手柄组合件100接合时,驱动杆130与细长组合件200的内驱动套管280的近侧部分282纵向对齐,可滑动地安置在壳体110的主体部分111内(见图4),使得驱动杆130通过壳体的主体部分111的远侧滑动推动驱动杆130与内驱动套管280的近侧部分282接触,由此向远侧平移内驱动套管280,例如,以施放、形成或闭合支撑在细长组合件200的末端执行器组合件260处的手术夹具,如下详述。
闩锁组合件160配置成便于细长组合件200与手柄组合件100的可释放锁定接合。更具体来说,闩锁组合件160包含可操作地安置在壳体110的主体部分111上并且延伸到其中的枢转杠杆臂162。杠杆臂162包含朝向其一端安置的接合指164和朝向其另一端安置的可操纵部分166,其中枢轴部分168安置在其间。因此,当可操纵部分166从锁定位置到解锁位置按压到壳体110中时,接合指164向上抽出,并且在释放可操纵部分166并使其返回到锁定位置时,接合指164向下返回。可提供围绕枢轴部分168安置的扭转弹簧(未示出),或在任何合适位置中的其它合适的偏置弹簧,以朝向锁定位置偏置杠杆臂162,但是也预期其它配置。
旋转接纳器组合件180配置成接纳细长组合件200的近侧端部分并且使其能够相对于壳体110选择性旋转。旋转接纳器组合件180包含可旋转地联接到壳体110的主体部分111并且从其向远侧延伸的旋转旋钮182。旋转旋钮182限定通过其延伸与壳体110的主体部分111的远侧开口118连通的管腔184,以使得细长组合件200的近侧部分能够通过其插入并且在壳体110内可操作接合。旋转旋钮184限定安置在其内表面上并且围绕管腔184环形布置的通道186,以使得细长组合件200能够与其可旋转联接,如下详述。
参看图4到7B,细长组合件200通常包含近侧毂220(图4)、从近侧毂220向远侧延伸的细长轴240、朝向细长轴240的远侧端部分安置的末端执行器组合件260,和内驱动套管280,所述内驱动套管可滑动地安置通过近侧毂220和细长轴240,且配置成用于当细长组合件200与手柄组合件100接合时在手柄组合件100和末端执行器组合件260之间可操作联接,使得能够围绕组织起动手术夹具(未示出)。细长组合件200进一步包含轴承组合件290(图6到7B),所述轴承组合件配置成便于内驱动套管280围绕末端执行器组合件260移动,由此便于围绕组织起动手术夹具(未示出),如下详述。
近侧毂220配置成用于插入通过旋转旋钮182的管腔184并且进入壳体110的主体部分111。近侧毂220限定朝向其近侧端的环形凹槽222和倒角的近侧边缘224。因此,在近侧毂220插入通过旋转旋钮182的管腔184并且进入壳体110的主体部分111时,倒角的近侧边缘224使闩锁组合件160的接合指164在近侧毂220的外表面上凸出,直到接合指164与环形凹槽222对齐安置,其中接合指164在环形凹槽222内接合,以接合近侧毂220,并且因此使细长组合件200与手柄组合件100接合。如可理解的,为了从手柄组合件100脱离和移除细长组合件200,闩锁组合件160的可操纵部分166被按压到壳体110中,以从环形凹槽222中抽出接合指164,并且使得细长组合件200能够被向远侧牵拉,并且从手柄组合件100移除。近侧毂220可进一步包含锁定突片226,所述锁定突片沿其长度的一部分延伸,并且配置成用于接纳在旋转旋钮182内限定的通道186中的一个内,以在插入其中时相对于旋转旋钮182旋转地固定细长组合件200。
细长轴240从近侧毂220向远侧延伸并且限定通过其延伸的纵向管腔242。细长轴240进一步包含主体244和包含从主体244向远侧延伸的一对径向相对的凸缘248的分叉的远侧部分246。相对的凸缘248限定配置成阻止组织穿入其间限定的空间的组织止动件249。
继续参看图4到7B,细长组合件200的末端执行器组合件260例如经由冲压或其它合适的制造过程形成为单件材料的整体式组件(见图7A)(但还预期多部件配置和/或其它制造技术),且包含具有近侧基部264的钳口组件262、从近侧基部264向远侧延伸的一对间隔开的臂266a、266b,以及分别安置于每个臂266a、266b的自由远侧端处的钳口268a、268b。
钳口组件262的近侧基部264限定通过其横向延伸并且彼此纵向对齐的一对孔口265,但是也预期更多或更少的孔口或以其它方式布置的孔口。孔口265配置成用于接纳横向延伸通过细长轴240并且分别至少部分到通过细长轴240横向限定的相对的一对孔口254、256中的销250、252。延伸到孔口254、256中或通过其的销250、252的部分可焊接到细长轴240,或以其它方式接合到其上,以固定销250、252,并且因此相对于细长轴240固定钳口组件262的近侧基部264。
钳口组件262的间隔开的臂266a、266b分别从近侧基部264向远侧延伸到钳口268a、268b,并且可从静止位置弹性地弯曲(或可以其它方式移动)到弯折位置,在静止位置中,间隔开的臂266a、266b彼此成角度地分开,以在近侧-远侧方向上限定其间的增大距离,在弯折位置中,间隔开的臂266a、266b彼此更靠近并且以更平行的定向安置或朝向彼此成角度。间隔开的臂266a、266b从细长轴240的凸缘248偏移90度定向,使得安置在凸缘248之间的间隔开的臂266a、266b的部分能够在其静止位置中朝外延伸超出细长轴240的外部尺寸,而不受凸缘248的干扰。此配置还将组织止动件249定位在间隔开的臂266a、266的侧边上,以阻止组织进入在间隔开的臂266a、266b之间限定的空间。在实施例中,臂266a、266b可沿着其纵向长度的至少部分在其相对的外表面上限定纵向延伸的沟槽267。如下详述,每个沟槽267配置成接纳一个或多个滚珠轴承294且当内驱动套管280和其轴承组合件290围绕钳口组件262移动时充当滚珠轴承294沿着臂266a、266b的导轨。
如上文所提及,钳口268a、268b分别安置于间隔开的臂266a、266b的自由远侧端处。钳口268a、268b可限定横向凹口270、纵向狭槽272,和/或其它合适的特征,以便于将手术夹具(未示出)的支腿保持在其中。在间隔开的臂266a、266b从静止位置移动到弯折位置时,钳口268a、268b从间隔开的位置移动到接近位置,由此围绕安置在钳口268a、268b之间的组织形成在钳口268a、268b之间保持的手术夹具。在实施例中,末端执行器组合件260可配置成形成类似于在第4,834,096号美国专利中示出和描述的那些手术夹具的手术夹具,所述美国专利的全部内容由此以引用的方式并入本文中。
内驱动套管280限定近侧部分282(图4)和远侧部分284。内驱动套管280的近侧部分282配置成用于当细长组合件200与手柄组合件100接合时邻近手柄组合件100的驱动杆130的远侧端定位(见图4),使得,如上文所提及,驱动杆130通过壳体110的远侧平移(例如响应于致动触发器122)会推动驱动杆130与内驱动套管280的近侧部分2828接触,以向远侧平移内驱动套管280通过细长组合件200的细长轴240。在实施例中,内驱动套管280的近侧部分282配置成可释放地接合驱动杆130的远侧端。
仍参看图4到7B,内驱动套管280的远侧部分284包含在其中朝向其远侧端安置的轴承组合件290,围绕末端执行器组合件260的钳口组件262的至少近侧部分可滑动地安置,且限定具有一对窄侧285a和一对宽侧285b的矩形横向截面配置。相对的纵向延伸狭槽286彼此对齐,通过内驱动套管280的远侧部分284的宽侧285b限定。狭槽286使得销250、252能够通过其穿过,同时仍然使得内驱动套管280的远侧部分284能够通过细长轴240并且围绕末端执行器组合件260滑动。内驱动套管280的远侧部分284定向成使得钳口组件262的间隔开的臂266a、266b邻近远侧部分284的相对的窄侧285a安置,其中在实施例中,相对的窄侧285a的宽度大体上接近间隔开的臂266a、266b的宽度,以阻止在间隔开的臂266a、266b之间的相对侧向运动,由此阻止钳口268a、268b之间张开。
内驱动套管280的远侧部分284的宽侧285b限定大于间隔开的臂266a、266b之间的最小距离但小于间隔开的臂266a、266b之间的最大距离的高度,使得例如响应于触发器122的致动(图1到4),内驱动套管280围绕钳口组件262的远侧部分284的远侧滑动会使轴承组合件290围绕间隔开的臂266a、266b的外表面移动,以使间隔开的臂266a、266b从静止位置朝向弯折位置朝向彼此推动,由此使钳口268a、268b从间隔开的位置朝向接近位置移动,以围绕安置于钳口268a、268b之间的组织形成或闭合定位在其间的手术夹具。在释放或返回触发器122(图1)时,内驱动套管280向近侧返回,允许间隔开的臂266a、266b弹性地朝向静止位置返回,由此使钳口268a、268b朝向间隔开的位置返回,以使得能够装载随后手术夹具,用于围绕组织的形成或闭合。可提供与细长组合件200相关联的偏置弹簧(未示出),以向近侧偏置内驱动套管280,使得在释放触发器122(图1到4)时,内驱动套管280向近侧返回。还预期其它合适的偏置配置。
如上文所提及,轴承组合件290安置于内驱动套管280的远侧部分284内且配置成围绕间隔开的臂266a、266b的外表面移动,以将间隔开的臂266a、266b从静止位置朝向弯折位置推动。轴承组合件290包含套圈292和多个滚珠轴承294。套圈292与内驱动套管280的远侧部分284接合,形成为所述远侧部分的部分,或以其它方式在所述远侧部分内朝向其远侧端安置。套圈292限定从中延伸穿过的纵向管腔296,其接纳钳口组件262的间隔开的臂266a、266b,且类似地,与内驱动套管280的远侧部分284一样,限定具有相似定向的矩形截面配置。
滚珠轴承294由套圈292捕获但保持相对于套圈292且因此内驱动套管280的自由旋转。每个滚珠轴承294的部分朝内伸出通过在套圈292的内表面上限定的相应开口298(围绕纵向管腔296)并进入纵向管腔296。替代地,滚珠轴承294可由套圈292以任何其它合适的方式捕获,使得滚珠轴承294保持可相对于套圈292旋转且每个滚珠轴承294的部分延伸到纵向管腔296中在其它实施例中,在套圈292与钳口组件262之间协作地捕获滚珠轴承。
滚珠轴承294可以任何合适方式布置,例如以两个组的方式,其中滚珠轴承294的第一组299a(包含一个或多个滚珠轴承294)沿着轴承组合件290的第一侧纵向对齐且滚珠轴承294的第二组299b(包含一个或多个其它滚珠轴承294)沿着轴承组合件290的第二相对侧纵向对齐,使得滚珠轴承294从其相对侧伸出到纵向管腔296中。更具体地说,滚珠轴承294的第一组299a可沿着内驱动套管280的窄侧285a中的一个布置,而滚珠轴承294的第二组299b沿着与内驱动套管280的窄侧285a相对的一侧布置。在实施例中,第一组299a和第二组299b各自包含纵向对齐或以其它方式布置的多个滚珠轴承294。在其中钳口组件262的间隔开的臂266a、266b限定纵向延伸的沟槽267的实施例中,滚珠轴承294的第一组299a可接纳在间隔开的臂266a中的一个的沟槽267内,而滚珠轴承294的第二组299b接纳在另一间隔开的臂266b的沟槽267内。
如上文所提及,在使用中,例如响应于触发器122(图1)的致动,内驱动套管280的远侧部分284围绕钳口组件262的远侧滑动会使轴承组合件290围绕间隔开的臂266a、266b的外表面移动,以使间隔开的臂266a、266b朝向彼此从静止位置朝向弯折位置推动,以围绕组织形成或闭合位于钳口268a、268b之间的手术夹具。更具体地说,当内驱动套管280的远侧部分284围绕间隔开的臂266a、266b向远侧移动时,滚珠轴承294沿着间隔开的臂266a、266b的外表面且相对于套圈292(并且因此内驱动套管280)滚动,以使间隔开的臂266a、266b朝向彼此推动。滚珠轴承294通过沿着间隔开的臂266a、266b且相对于套圈292滚动有助于减少在致动期间的摩擦,由此实现更平滑的致动,减少致动力,在致动期间在触发器122(图1)处实现更大的触觉反馈,并且延长使用寿命。此外,分别将滚珠轴承294的第一组299a和第二组299b接纳在间隔开的臂266a、266b的沟槽267内建立了导轨,有助于在致动期间维持臂266a、266b且因此钳口268a、268b的对齐。
转向图8和9,示出大体上以附图标号300标识的根据本公开提供且配置成与手柄组合件100(图1到3B)一起用作手术施夹器10(图1)的部分的细长组合件的另一实施例。细长组合件300可类似于或包含细长组合件200的特征中的任一个(图1到7B),除下文特别矛盾之外。
细长组合件300通常包含近侧毂(未示出,类似于细长组合件200(图4到5)的近侧毂220)、从近侧毂向远侧延伸的细长轴340、朝向细长轴340的远侧端部分安置且从其向远侧延伸的末端执行器组合件360,和内驱动套管380,所述内驱动套管可滑动地安置通过近侧毂和细长轴340,且配置成用于当细长组合件300与手柄组合件100(图1)接合时在手柄组合件100(图1)和末端执行器组合件360之间可操作联接,使得能够围绕组织起动手术夹具(未示出)。细长组合件300进一步包含轴承组合件390,所述轴承组合件配置成便于内驱动套管380围绕末端执行器组合件360移动,由此便于围绕组织起动手术夹具(未示出),如下详述。
细长轴340从近侧毂向远侧延伸并且限定通过其延伸的纵向管腔342。细长轴340进一步包含分叉远侧部分346,其包含与上文关于细长组合件200(图4到5)所详述类似的一对组织止动件349。
细长组合件300的末端执行器组合件360类似于细长组合件200(图4到7B)的末端执行器组合件260且通常包含钳口组件362,所述钳口组件具有近侧基部(未示出)、从近侧基部向远侧延伸的一对间隔开的臂366a、366b以及分别安置于每个臂366a、366b的自由远侧端处的钳口368a、368b。间隔开的臂366a、366b限定大体上光滑且平坦(在制造、材料和使用公差内)的相对外表面367a、367b。
内驱动套管380限定近侧部分(未示出,类似于内驱动套管280(图4)的近侧部分282)和远侧部分384,且类似于内驱动套管280(图4),除其相应轴承组合件290(图7A到7B)、390的配置以外,如下详述。内驱动套管380的远侧部分384包含朝向其远侧端安置和在实施例中安置于其远侧端处的轴承组合件390。内驱动套管380的远侧部分384围绕末端执行器组合件360的钳口组件362的至少近侧部分可滑动地安置,并且限定具有一对窄侧385a和一对宽侧385b的矩形横向截面配置。内驱动套管380的远侧部分384定向成使得钳口组件362的间隔开的臂366a、366b邻近远侧部分384的相对窄侧385a安置。
如上文所提及,轴承组合件390朝向内驱动套管380的远侧部分384的远侧端安置且在实施例中安置于内驱动套管380的远侧部分384的远侧端处,且包含一对轴承滚柱394a、394b和一对间隔开的柱392a、392b,其中每个轴承滚柱394a、394b分别围绕柱392a、392b中的一个安置且可分别相对于柱392a、392b中的一个旋转。柱392a、392b邻近内驱动套管380的远侧部分384的窄侧385a安装且沿着所述窄侧延伸,且在内驱动套管380的远侧部分384的宽侧385b之间以相对于彼此大体上平行且间隔开的关系延伸。轴承滚柱394a、394b围绕柱392a、392b可旋转地安置,并且类似地沿着内驱动套管380的远侧部分384的窄侧385a延伸且在内驱动套管380的远侧部分384的宽侧385b之间以相对于彼此大体上平行且间隔开的关系延伸。钳口组件362在轴承滚柱394a、394b之间延伸。
由于以上详述的轴承滚柱394a、394b的位置和定向,末端执行器组合件360的钳口组件362的间隔开的臂366a、366b在轴承滚柱394a、394b之间延伸,其中间隔开的臂366a、366b的相对外表面367a、367b邻接或在一些位置中分别非常接近于轴承滚柱394a、394b。在使用中,例如响应于触发器122(图1)的致动,内驱动套管380的远侧部分384围绕钳口组件362的远侧滑动会使轴承组合件390围绕间隔开的臂366a、366b的外表面367a、367b移动,以使间隔开的臂366a、366b从静止位置朝向弯折位置朝向彼此推动,由此使钳口368a、368b从间隔开的位置朝向接近位置移动,以围绕安置于钳口368a、368b之间的组织形成或闭合定位在其间的手术夹具。更具体地说,当内驱动套管380的远侧部分384向远侧滑动时,轴承滚柱394a、394b沿着间隔开的臂366a、366b的相对外表面367a、367b接触和滚动(同时相对于内驱动套管380围绕柱392a、392b旋转),以朝向彼此推动间隔开的臂366a、366b。滚珠轴承394a、394b通过沿着间隔开的臂366a、366b有助于减少在致动期间的摩擦,由此实现更平滑的致动,减少致动力,在致动期间在触发器122(图1)处实现更大的触觉反馈,并且延长使用寿命。
应理解,前面的描述仅是对本公开的说明。本领域的技术人员可在不脱离本公开的情况下设计各种替代方案和修改。因此,本公开旨在涵盖所有此类替代、修改和变化。呈现参看附图所描述的实施例仅为了表明本公开的某些实例。与上文描述和/或所附权利要求中非实质地不同的其它元件、步骤、方法和技术也旨在本公开的范围内。

Claims (20)

1.一种手术施夹器的细长组合件,其包括:
外轴;
末端执行器组合件,其部分安置于所述外轴内且从所述外轴向远侧延伸,所述末端执行器组合件包含第一间隔开的臂和第二间隔开的臂以及分别安置于所述第一间隔开的臂和所述第二间隔开的臂的自由端处的第一钳口和第二钳口;以及
内驱动套管,其安置于所述外轴内且包含围绕所述末端执行器组合件可滑动地安置的轴承组合件,所述轴承组合件包含邻近于所述第一间隔开的臂而定位的第一轴承滚柱和邻近于所述第二间隔开的臂而定位的第二轴承滚柱,其中所述轴承组合件从近侧位置到远侧位置的滑动使所述第一轴承滚柱和所述第二轴承滚柱分别沿着所述第一间隔开的臂和所述第二间隔开的臂滚动,以朝向彼此推动所述第一间隔开的臂和所述第二间隔开的臂,由此将所述第一钳口和所述第二钳口从间隔开的位置移动到接近位置,以围绕安置于所述第一钳口与所述第二钳口之间的组织施放手术夹具。
2.根据权利要求1所述的细长组合件,其中所述第一轴承滚柱和所述第二轴承滚柱可旋转地安装在第一柱和第二柱上,所述第一柱和所述第二柱安置于所述内驱动套管的相对侧上。
3.根据权利要求2所述的细长组合件,其中所述第一柱和所述第二柱安置于所述内驱动套管的所述远侧端处。
4.根据权利要求2所述的细长组合件,其中所述内驱动套管限定矩形截面配置,其包含相对的窄侧和相对的宽侧,且其中所述第一柱和所述第二柱沿着所述窄侧安装。
5.根据权利要求1所述的细长组合件,其中所述第一轴承滚柱和所述第二轴承滚柱与安置于其间的所述第一间隔开的臂和所述第二间隔开的臂以相对于彼此平行、间隔开的关系安置。
6.根据权利要求1所述的细长组合件,其中所述第一间隔开的臂和所述第二间隔开的臂限定面向内的表面和面向外的表面,所述第一轴承滚柱和所述第二轴承滚柱配置成分别沿着所述第一间隔开的臂和所述第二间隔开的臂的所述面向外的表面滚动。
7.根据权利要求6所述的细长组合件,其中所述第一间隔开的臂和所述第二间隔开的臂的所述面向外的表面限定大体上光滑、平坦的配置。
8.根据权利要求1所述的细长组合件,其中所述第一间隔开的臂和所述第二间隔开的臂响应于所述轴承组合件从所述近侧位置移动到所述远侧位置而从静止位置弹性地弯曲到弯折位置,由此将所述第一钳口和所述第二钳口从所述间隔开的位置移动到所述接近位置。
9.根据权利要求1所述的细长组合件,其中所述第一间隔开的臂和所述第二间隔开的臂经由近侧基部接合到彼此,所述近侧基部相对于所述外轴固定。
10.根据权利要求1所述的细长组合件,其进一步包括安置于所述外轴的近侧端处的近侧毂,所述近侧毂配置成将所述细长组合件与手柄组合件可释放地接合。
11.一种手术施夹器,其包括:
手柄组合件,其包含壳体和可操作地联接到所述壳体的触发器;
细长组合件,其从所述手柄组合件向远侧延伸,所述细长组合件包含:
外轴;
末端执行器组合件,其部分安置于所述外轴内且从所述外轴向远侧延伸,所述末端执行器组合件包含第一间隔开的臂和第二间隔开的臂以及分别安置于所述第一间隔开的臂和所述第二间隔开的臂的自由端处的第一钳口和第二钳口;以及
内驱动套管,其安置于所述外轴内,包含围绕所述末端执行器组合件可滑动地安置的轴承组合件,所述轴承组合件包含邻近于所述第一间隔开的臂而定位的第一轴承滚柱和邻近于所述第二间隔开的臂而定位的第二轴承滚柱,其中所述触发器的致动使所述轴承组合件从近侧位置滑动到远侧位置,由此所述第一轴承滚柱和所述第二轴承滚柱分别沿着所述第一间隔开的臂和所述第二间隔开的臂滚动,以朝向彼此推动所述第一间隔开的臂和所述第二间隔开的臂,由此将所述第一钳口和所述第二钳口从间隔开的位置移动到接近位置,以围绕安置于所述第一钳口与所述第二钳口之间的组织施放手术夹具。
12.根据权利要求11所述的手术施夹器,其中所述第一轴承滚柱和所述第二轴承滚柱可旋转地安装在第一柱和第二柱上,所述第一柱和所述第二柱安置于所述内驱动套管的相对侧上。
13.根据权利要求12所述的手术施夹器,其中所述第一柱和所述第二柱安置于所述内驱动套管的所述远侧端处。
14.根据权利要求12所述的手术施夹器,其中所述内驱动套管限定矩形截面配置,其包含相对的窄侧和相对的宽侧,且其中所述第一柱和所述第二柱沿着所述窄侧安装。
15.根据权利要求11所述的手术施夹器,其中所述第一轴承滚柱和所述第二轴承滚柱与安置于其间的所述第一间隔开的臂和所述第二间隔开的臂以相对于彼此平行、间隔开的关系安置。
16.根据权利要求11所述的手术施夹器,其中所述第一间隔开的臂和所述第二间隔开的臂限定面向内的表面和面向外的表面,所述第一轴承滚柱和所述第二轴承滚柱配置成分别沿着所述第一间隔开的臂和所述第二间隔开的臂的所述面向外的表面滚动。
17.根据权利要求16所述的手术施夹器,其中所述第一间隔开的臂和所述第二间隔开的臂的所述面向外的表面限定大体上光滑、平坦的配置。
18.根据权利要求11所述的手术施夹器,其中所述第一间隔开的臂和所述第二间隔开的臂响应于所述轴承组合件从所述近侧位置移动到所述远侧位置而从静止位置弹性地弯曲到弯折位置,由此将所述第一钳口和所述第二钳口从所述间隔开的位置移动到所述接近位置。
19.根据权利要求11所述的手术施夹器,其中所述第一间隔开的臂和所述第二间隔开的臂经由近侧基部接合到彼此,所述近侧基部相对于所述外轴固定。
20.根据权利要求11所述的手术施夹器,其中所述细长组合件进一步包含安置于所述外轴的近侧端处的近侧毂,所述近侧毂配置成将所述细长组合件与手柄组合件可释放地接合。
CN201910722036.3A 2018-08-13 2019-08-06 用于手术施夹器的细长组合件和并有细长组合件的手术施夹器 Pending CN110811748A (zh)

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