CN111372526B - 与外科缝合器械一起使用的砧座组件 - Google Patents

与外科缝合器械一起使用的砧座组件 Download PDF

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CN111372526B
CN111372526B CN201880071323.6A CN201880071323A CN111372526B CN 111372526 B CN111372526 B CN 111372526B CN 201880071323 A CN201880071323 A CN 201880071323A CN 111372526 B CN111372526 B CN 111372526B
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K.S.韦阿多克
R.A.卢梭
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Aixikang Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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 the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation
    • A61B17/1155Circular staplers comprising a plurality of staples
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07228Arrangement of the staples
    • AHUMAN NECESSITIES
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07235Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07242Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07257Stapler heads characterised by its anvil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07257Stapler heads characterised by its anvil
    • A61B2017/07264Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material

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Abstract

本发明公开了一种外科缝合器,该外科缝合器具有砧座,该砧座包括用于使钉成形的多个钉成形凹坑。该钉成形凹坑包括第一钉成形杯和第二钉成形杯,该第一钉成形杯和该第二钉成形杯被构造成分别接收钉的第一腿和第二腿。每个钉成形凹坑内的第一钉成形杯与该钉成形凹坑内的第二钉成形杯具有不同的深度。

Description

与外科缝合器械一起使用的砧座组件
技术领域
本发明所属的技术领域为用于将组织缝合在一起的医疗装置和方法,其涉及用于防止具有变化厚度的组织中的沿钉线的渗漏的缝合器。更具体地讲,本发明涉及具有砧座的外科缝合器,该砧座具有用于使钉成形的钉成形凹坑和钉成形杯。
背景技术
外科缝合器械对于许多救生外科规程而言已变得至关重要。通常利用外科缝合器械(诸如称为吻合装置的外科缝合器械,包括胃肠吻合装置和横向吻合装置)来将外科钉机械地插入到组织中。钉通常由不锈钢或钛制成。未变形的钉为大体U形的,并且包括背跨部和从背跨部基本上垂直地延伸的两条腿。每条腿具有锋利的凿形端点,以用于刺穿身体器官或组织。在此类装置中,钉以一个或多个细长排装载到仓中。用于推动或驱动缝合器的机构被致动以朝砧座驱动钉穿过组织的两个或更多个节段。砧座包括形成于砧座的表面中的多个钉凹坑,其中每个钉凹坑包括第一钉成形杯和第二钉成形杯。凹坑和钉成形杯使钉变形为大体B形构型,其中B形钉为钉成形的金标准,因为据信该构型提供从钉线渗漏的较低机率。胃肠吻合型装置以快速顺序连续地驱动和弯曲成排排列的钉,而横向吻合型装置同时地驱动和弯曲全部钉。圆形吻合型装置将环形钉排同时地施加到组织。
图1示出了外科医生在执行套管胃切除术时感兴趣的人胃的区域。建议缝合的线为虚线。在男性和女性两者中,胃在幽门窦附近最厚,而在胃底附近最薄。对于女性而言,窦的典型厚度测量值为大约2.0mm-4.5mm,胃体为1.5mm-4.0mm,并且胃底为1.0mm-3.7mm。对于男性而言,窦的典型厚度测量值为大约2.5mm-5.7mm,胃体为1.5mm-3.5mm,并且胃底为1.5mm-2.5mm。为了适应各种组织厚度,外科医生可选择可能适用的钉长度。适当钉长度的选择对于确保因缝合过程而产生的合理并置至关重要。遗憾的是,外科医生必须估计组织厚度并且尝试选择他们认为将提供组织的充分并置的适当长度钉。用于给定组织的钉的选择还可取决于疾病状态。例如,在已变薄的气肿性肺组织中,需要短钉。对于肺纤维化而言,需要较高的钉。因此,使用过小或过大的钉可损害钉线完整性。过小的钉可成形得过紧并且潜在地压缩组织从而导致局部缺血,或者可太小而不能形成必要的闭合形式并且从而产生潜在的渗漏。过大的钉可完全成形,而实际上未实现必要的组织压缩以密封伤口,从而形成渗漏点。打开钉高度可在2.0mm至4.4mm之间变化,并且闭合钉高度可在0.75mm至2.3mm之间变化。下表1示出了通常被缝合的组织厚度以及打开位置和闭合位置中的钉高度的变化。仓通常被颜色编码,以使外科医生能够选择所需的钉高度。
表1
在临床实践中,外科医生可利用仅一种类型的钉仓来产生整个套管。然而,如果胃的厚度在仓的指示范围之外,则该方法具有出血或渗漏的风险。在另选的方法中,外科医生从最厚加载(黑色仓)开始,并且随后基于组织的感觉来选择后续的钉加载。这种触觉反馈方法不足之处在于其主观性。在没有客观测量结果的情况下,不正确的钉高度可被选择并且导致不完全的钉成形、渗漏、或出血。
在美国专利申请2014-0103092中,三钉构型被公开并且尝试通过提供施加平行钉排的缝合器来解决从缝合组织泄漏的问题,该缝合器对于每个钉仓具有共计三个不同的钉高度以及具有组织接触表面的变化高度。缝合器被构造成递送多个钉排,其中每个排平行于装置的纵向轴线并且每个排被构造成仅具有一个钉长度。相邻排被构造成具有不同长度的钉。组织接触表面被制备成与钉排平行延伸的一系列表面,并且每个表面处于与相邻平行表面不同的高度。缝合器的这种构型提供了以不同高度成形的多个完整的平行钉排。尽管每个钉排可具有不同的高度,但任何完整的钉排仅成形为一个高度。钳口的砧座侧面与驱动器侧面之间的间隙的局限性在于可能将最厚组织压缩在与形成于组织接触表面之间的最窄间隙联接的钳口内。任何给定排中的每个钉腿的潜在压缩距离对于每个单独钉而言是相同的。该缝合器设计将不足以解决沿待缝合的组织的轴线的组织厚度的任何可能的快速变化,即,平行于器械的钳口的中心线的偏移位置,因为利用最窄组织接触表面夹持被夹持组织的厚状况将保持钳口间隔开太远而不能实现完全钉成形。在US 2007-0194082中,设计采用具有两个钉凹坑群的砧座,其中邻接一个群中的钉凹坑深度的完整线大于另一个群中的钉凹坑的邻接完整线的深度。调整组织厚度的其他策略已在US 6978922和US4767044中有所公开。这些设计中的任一者均不能使外科医生安全地缝合具有快速变化的组织厚度变化的组织。需要一种使每个钉能够解决组织厚度变化的缝合装置,该缝合装置利用被变形的一种尺寸钉提供比传统均一变形钉更广泛的厚度覆盖范围。这种缝合器将使得外科医生能够降低沿钉线渗漏的发生率。
发明内容
本申请公开了一种与外科缝合器一起使用的砧座组件,所述外科缝合器包括被构造成接收钉的第一钉腿和第二钉腿的钉成形凹坑。钉成形凹坑中的每个包括具有第一深度的第一钉成形杯和具有第二深度的第二钉成形杯,其中第一深度不同于第二深度。所述多个钉成形凹坑可被排列成第一排和间隔开的至少第二排。它们可被排列成线性排或环形排。
在一个实施方案中,第一排上的钉成形凹坑中的钉成形杯的深度不同于第二排上的最近钉成形杯的深度。在另一个实施方案中,对于第一排和第二排中的每个而言,所述排中的全部钉成形杯的第一深度为相等的,并且所述排中的全部钉成形杯的第二深度为可变的。第一钉成形杯和第二钉成形杯还可相对于排的轴线排列成一角度。
还提供了一种外科缝合器,所述外科缝合器具有钉仓和砧座组件,所述钉仓具有容纳在其中的多个定向排列的钉和用于推进钉的推动器。砧座组件包括组织接触表面,所述组织接触表面具有形成于其中的多个钉成形凹坑。所述多个钉成形凹坑中的每个包括第一钉成形杯和第二钉成形杯,其中钉成形杯中的每个具有深度,并且其中对于每个钉成形凹坑而言,第一钉杯具有大于第二钉成形杯的深度。
钉成形凹坑可被排列成第一排和至少第二排。在一个实施方案中,第一排上的钉成形凹坑中的钉成形杯的深度不同于第二排上的最近钉成形杯的深度。
第一排和第二排可被排列成线性排或环形排。在一个实施方案中,第一排上的全部钉成形杯的第一深度彼此相等,并且第一排中的全部钉成形杯的第二深度为可变深度。在另一个实施方案中,第一钉成形杯和第二钉成形杯相对于钉成形杯排的轴线排列成一角度。
从以下描述和附图,本发明的这些方面和其它方面以及优点将变得更加显而易见。
附图说明
图1示出了人胃解剖结构;
图2示出了可结合本公开的教导内容的示例性外科缝合器;
图3A示出了根据本公开的钉仓的一个实施方案的放大剖视图;
图3B示出了利用本文所述的外科缝合器成形的示例性钉;
图4A示出了具有钉成形凹坑的线性缝合器的砧座组件的一个实施方案,该钉成形凹坑具有不同深度的钉成形杯;
图4B为图4A的砧座组件的圆圈部分的放大视图;
图5示出了具有钉成形凹坑的线性缝合器的砧座组件的另选实施方案的透视图,该钉成形凹坑具有固定深度的第一钉成形杯和从砧座的远侧端部到近侧端部递减的第二钉成形杯深度;
图6示出了具有线性钉成形凹坑排的线性缝合器的砧座组件的另选实施方案的透视图,该钉成形凹坑具有固定深度的第一钉成形杯和从砧座的远侧端部到近侧端部递增的第二钉成形杯深度;
图7示出了可结合本公开的教导内容的示例性圆形缝合器;
图8A示出了具有环形钉成形凹坑排的圆形缝合器的砧座组件的一个实施方案,该钉成形凹坑具有固定深度的第一钉成形杯和从内排到外排递减的第二钉成形杯深度;
图8B为图8A的砧座组件的圆圈部分的放大视图;
图9A示出了圆形缝合器的砧座组件的另选实施方案,该砧座组件具有成排的不同深度的钉成形凹坑和钉成形杯;
图9B为图9A的砧座组件的圆圈部分的放大视图;
图10A为具有钉成形杯的线性砧座的另选实施方案,该钉成形杯相对于钉成形凹坑排的轴线成一角度;
图10B为图10A的砧座组件的一部分的放大视图;
图10C示出了图10A和图10B的代表性钉成形杯;并且
图10D示出了利用图10A-10CB的装置成形的钉。
具体实施方式
在一个方面,本公开描述了一种与外科缝合器一起使用的砧座组件,该外科缝合器包括但不限于内镜切割器、圆形缝合器、弯曲切割缝合器、线性切割器和缝合器、以及痔缝合器。砧座组件具有组织接触表面,该组织接触表面包括至少一个钉凹坑并且通常包括多个钉凹坑,该钉凹坑具有第一钉成形杯和第二钉成形杯。第一钉成形杯和第二钉成形杯被构造成接收钉的第一腿和第二腿,并且各自具有不同的深度。变化的钉成形杯深度使得缝合器能够考虑组织厚度的变化,该变化可平行于所建议的钉线中的至少一者并且在其内发生。这是至关重要的,因为其降低了横跨钉线渗漏的可能性。
图2示出了可包括本文所述的砧座组件的示例性线性外科缝合器200。本领域的技术人员将易于理解,本发明不限于图2所示的缝合器,相反,本文所述的原理可结合到任何合适的外科缝合器中。缝合器200包括具有可枢转触发器230的柄部201、从柄部在近侧端部202与远侧端部235之间延伸的细长中空轴240。钉仓组件205和相对的砧座组件210定位在轴的远侧端部处。钉仓组件205能够围绕枢转点255枢转,并且细长轴也可包括枢转点245以改善器械的运动和定位来实现最佳缝合。钉仓组件205和相对的砧座组件210分别具有组织接触表面206和211,并且钉仓组件205中的孔与砧座组件210中的钉成形凹坑对准,如将在下文更详细所述。可枢转触发器230可致动完成一个或多个致动行程,以使砧座组件210相对于仓组件205在打开位置与夹持位置之间运动并且从仓组件205射出钉。另选地,致动行程可使仓组件205朝砧座组件210枢转,使得钉可抵靠钉成形凹坑成形。
图3A示出了根据本公开的可结合到诸如图2所示的外科缝合器中的钉仓305和砧座组件310的一个实施方案的放大视图。图3A示出了恰在击发钉穿过两层组织320和330之前的钉仓305内的两个钉340。对于每个钉340,砧座310上存在对应的钉凹坑390。每个钉凹坑390具有两个钉成形杯300、305,这两个钉成形杯在缝合过程中各自接收相应的单个钉腿341、342。钉成形杯300的深度d1小于钉成形杯305的深度d2,使得相比较而言,钉成形杯305较深并且钉成形杯300在深度上较浅。因此,在缝合之后,每个钉将存在两个不同的闭合钉高度,如图3BA所示。两个腿341、342在缝合之前初始具有相同的长度,但进入具有较浅深度d1的钉成形杯310中的第一钉腿341将具有大约h1的较小高度,并且其末端341a将更接近钉的拱形部311的中部。被推压到具有较深深度d2的钉成形杯305中的钉腿342将具有大约h2的较大高度,但末端342a将不会接近钉的拱形部311的中部。
图4A-4B示出了示例性砧座组件或砧座400的组织接触表面425。为清楚起见,术语砧座组件和砧座将可互换使用。组织接触表面425包括与钉仓(未示出)的组织接触表面中的钉孔对准的一系列钉成形凹坑410,如上所述。钉仓容纳由钉仓(未示出)的钉孔内的推动器支撑的钉。当仓被致动时,推动器将用于以任何熟知的方式驱动钉抵靠砧座组件400的钉成形凹坑410。钉仓的组织接触表面还包括狭槽430以供刀(未示出)在缝合过程完成之后切穿组织。砧座400的一个端部420的放大视图示出了每个钉成形凹坑410具有第一钉成形杯440和第二钉成形杯441的方式。在例示的实施方案中,钉成形凹坑的两个排450、451和460、461位于狭槽430的每侧,其中狭槽的每个相应侧的两个排相对于彼此为交错的。因此,最靠近狭槽430的钉成形杯排上的钉成形凹坑可具有较深(D)钉成形杯440,而最远离狭槽430的钉成形杯排中的相邻钉成形杯440具有紧邻其的较浅(S)杯。这种构型允许缝合器补偿组织厚度变化,因为较深的单个钉成形杯441将捕获较厚组织,而较浅的钉成形杯440将捕获较薄组织。由于在线性(L)和水平(H)方向上存在较深钉成形杯(D)和较浅钉成形杯(S)的交替,因此砧座可降低组织厚度的突然变化将导致不充分缝合和沿钉线的可能渗漏的可能性。为了解决单个闭合钉长度可太短而不能闭合比闭合钉高度更厚的组织节段的问题,钉成形凹坑排450、451和460、462可相对于彼此为交错的。然而,在一个实施方案中,这些排相对于彼此并非为交错的。在任一种情况下,如果给定的闭合钉高度对于组织厚度而言太短,则相邻钉排上的相邻钉将具有较高的闭合钉高度。可利用钉成形杯深度的各种组合来实现具有可变厚度的组织的最佳缝合。
在图5所示的一个实施方案中,砧座500上的钉成形凹坑排由一系列钉成形凹坑构成,每个钉成形凹坑具有第一深度d1的第一钉成形杯和第二深度d2的第二钉成形杯,第二钉杯深度d2不同于第一钉成形杯d1深度。如图所示,第二钉杯深度d2小于第一钉成形杯d1,其中钉成形杯d2的深度从钉成形凹坑排的远侧端部505到近侧端部510逐渐减小,即,d2a>d2b>d2c。钉成形杯深度的梯度存在于仅d2,而d1沿着砧座的长度保持恒定。在图6所示的另一个实施方案中,d1对于砧座600上的沿着钉成形凹坑排的全部钉成形杯而言为固定的,而d2的深度从砧座600的远侧端部605到砧座的近侧端部610逐渐增加。在另一个实施方案中,d1对于沿着钉成形凹坑排的全部钉成形凹坑而言为固定的,而d2从砧座的近侧端部到砧座的中心逐渐增加并且随后到砧座的远侧端部递减。在另一个实施方案中,d1对于沿着钉成形凹坑排的全部钉成形凹坑而言为固定的,而d2从砧座的近侧端部到砧座的中心逐渐减小并且随后到砧座的远侧端部递增。
根据本公开的砧座也可结合到图7所示的圆形缝合器700中。圆形缝合器最常用于在肠的两个节段之间形成吻合。缝合器具有轴730,该轴联接到具有组织面向表面720的可移除砧座710。图8A-8B更详细地示出了砧座组件的组织面向表面以及以圆圈810示出的放大视图。示例性砧座具有钉成形凹坑的三个环形排811、812和813,其中每个钉成形凹坑具有深度为d1和d2的两个钉成形杯,其中d1以类似于结合示例性线性缝合器所述的方式具有不同于d2的深度。砧座880的中心连接到轴。在一个实施方案中,钉成形凹坑的内排813分别具有钉成形杯深度d1和d2,其中d1大于d2。钉成形凹坑的中间排812还具有深度为d1和d3的钉成形杯,其中d3小于内排上的d2。钉成形凹坑的外排811具有深度分别为d1和d4的钉成形杯,其中d4小于中间排上的d3。在钉成形凹坑的全部环形排中,每个钉成形凹坑具有深度为d1的第一钉成形杯,但其他排具有用于第二钉成形杯的不同深度。
在图9A-9B所示的另一个实施方案中,砧座组件类似地具有钉成形凹坑的三个环形排911、912和913。在一个实施方案中,钉成形凹坑的内排913包括分别具有较深(D)深度和较浅(S)深度的钉成形杯921和922。外排911具有钉成形凹坑940,该钉成形凹坑包括具有第一深度的第一钉成形杯和第二深度的第二钉成形杯,其中第一深度不同于第二深度。两个其他钉成形凹坑920和930与钉成形凹坑940相邻。在该实施方案中,凹坑被布置成使得一个凹坑(即,940)的较浅钉成形杯与另一个钉成形凹坑(即,920和930)的较深钉成形杯相邻。该构型允许缝合器补偿组织厚度变化,因为具有较深钉成形杯的钉成形凹坑将被排列成与具有较浅钉成形杯的钉成形凹坑相邻。
在本文所述的砧座的全部实施方案中,钉杯深度可在0.5mm-3.0mm的范围内。在一个实施方案中,特定钉成形凹坑上的较浅钉杯深度为1.25mm,并且较深钉成形杯为2.1mm。单个钉成形凹坑内的钉杯深度的差值可在0.25mm至2.0mm之间变化。在一个实施方案中,钉成形凹坑具有深度为d1的第一钉成形杯和深度为d2的第二钉成形杯,并且d1和d2之间的深度差值为0.5mm。在一个实施方案中,钉成形凹坑具有深度为d1的第一钉成形杯和深度为d2的第二钉成形杯,并且d1和d2之间的深度差值为2.0mm。在图10A-10C所示的一个实施方案中,砧座1000上的任何钉成形凹坑1010内的钉成形杯d1和d2可彼此平行,但相对于该钉成形凹坑排的轴线1040成一角度。可供刀(未示出)切割组织的狭槽1030被示于砧座1000的组织接触表面上,第一和第二平行但间隔开的钉成形凹坑排位于狭槽1001、1002和1003、1004的相对侧。图10C示出了第二排1002上的第一钉成形凹坑1070中的第一钉成形杯1072将使钉腿远离轴线1071弯曲到深度d2以及朝在位于第一排1002上的排列于轴线1061上的具有深度d1的钉成形杯1063中成形的钉的钉腿进行弯曲的方式。钉成形杯1062和1063均远离钉成形凹坑的轴线1061成一角度。按照对应的方式,钉成形杯1072和1073均远离钉成形凹坑的轴线1071成一角度。角度Θ可位于3-45度的范围内。在一个实施方案中,角度θ为5度。在一个实施方案中,角度θ为30度。在该砧座构型中,可形成如图10D所示的三维钉,其中钉的一个腿沿着另一个钉腿的相反方向进行弯曲并且其中一个钉腿弯曲到与同一钉上的另一个钉腿不同的闭合钉高度。因此,在短钉杯深度d1中弯曲的第一钉1090的钉腿靠近在来自相邻钉成形凹坑排的具有深度d2的深钉成形杯中弯曲的第二钉1080的钉腿。用于形成砧座的材料可选自由金属、陶瓷、塑料、聚合物和玻璃构成的组。在一个实施方案中,砧座由400系列不锈钢制成。
尽管上文已详细描述了本公开的具体实施方案,但应当理解,该具体实施方式仅仅是为了举例说明。在不脱离以下权利要求书所限定的本公开的精神的情况下,除了上文所述的那些之外,本领域的技术人员还可制备对应于优选实施方案的公开方面的各种修改形式和等同结构,该权利要求书的范围应被赋予最广义的解释,以便涵盖此类修改形式和等同结构。

Claims (10)

1.一种与外科缝合器一起使用的砧座组件,所述砧座组件包括多个钉成形凹坑,其中所述钉成形凹坑中的每个被构造成接收钉的第一钉腿和第二钉腿,并且所述钉成形凹坑中的每个包括具有第一深度的第一钉成形杯和具有第二深度的第二钉成形杯,其中所述第一深度不同于所述第二深度;
其中,所述多个钉成形凹坑被排列成第一排和间隔开的至少第二排;以及
其中对于所述第一排和所述第二排中的每个而言,所述排的全部钉成形杯的所述第一深度为相等的,并且所述排中的全部钉成形杯的所述第二深度是可变的。
2.根据权利要求1所述的砧座组件,其中第一排上的钉成形凹坑中的钉成形杯的所述深度不同于所述第二排上的最近的所述钉成形杯的深度。
3.根据权利要求1所述的砧座组件,其中所述第一排和所述第二排被排列成线性且平行的排。
4.根据权利要求1所述的砧座组件,其中所述第一排和所述第二排被排列成环形排。
5.根据权利要求3所述的砧座组件,其中所述第一钉成形杯和所述第二钉成形杯相对于所述排的轴线排列成一角度。
6.一种外科缝合器,所述外科缝合器包括:钉仓,所述钉仓具有容纳在其中的多个定向排列的钉和用于推进所述钉的推动器;以及砧座组件,所述砧座组件包括:组织接触表面;多个钉成形凹坑,所述多个钉成形凹坑形成于所述组织接触表面中,其中所述多个钉成形凹坑中的每个包括具有第一深度的第一钉成形杯和具有第二深度的第二钉成形杯,并且其中对于每个钉成形凹坑而言,所述第一深度大于所述第二深度;
其中,所述多个钉成形凹坑被排列成钉成形凹坑的第一排和钉成形凹坑的至少第二排;以及
其中,第一排上的全部钉成形杯的所述第一深度彼此相等,并且所述第一排中的全部钉成形杯的所述第二深度为可变深度。
7.根据权利要求6所述的外科缝合器,其中所述第一排上的钉成形凹坑中的钉成形杯的所述深度不同于所述第二排上的最近的所述钉成形杯的深度。
8.根据权利要求6所述的外科缝合器,其中所述第一排和所述第二排被排列成线性排。
9.根据权利要求6所述的外科缝合器,其中钉成形凹坑的所述第一排和所述第二排被排列成环形排。
10.根据权利要求8所述的外科缝合器,其中所述第一钉成形杯和所述第二钉成形杯相对于钉成形杯的所述排的轴线排列成一角度。
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