CN111479519A - 具有用于定位与其联接的适配器的部件的改善的马达控制布置的手持式机电外科器械 - Google Patents
具有用于定位与其联接的适配器的部件的改善的马达控制布置的手持式机电外科器械 Download PDFInfo
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Abstract
本发明公开了一种手持式机电外科装置,所述手持式机电外科装置被构造成能够操作地联接到外科附件。所述装置包括柄部组件,所述柄部组件操作地支撑由所述柄部组件内的处理器控制的多个电动马达。所述柄部组件包封在外壳体外壳中。阻隔板组件插置在所述柄部组件和所述外壳体外壳之间,并且支撑用于将所述电动马达的轴联接到位于所述外壳体外部的所述外科附件的对应部分的轴联接布置。感测布置支撑在所述柄部组件内以用于监测马达驱动轴中的每个马达驱动轴的旋转并且与所述处理器通信以将适当的控制信号施加到所述马达。
Description
背景技术
本发明涉及外科器械,并且在各种布置中,涉及被设计成缝合和切割组织的外科缝合和切割器械以及与其一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解:
图1为机电外科系统的透视图;
图2为图1的外科系统的机电外科器械部分的远侧端部的透视图;
图3为外壳体特征部和图2的机电外科器械的分解装配视图;
图4为图2的机电外科器械的一部分的后透视图;
图5为适配器的一部分和图1的外科系统的机电外科器械的局部分解装配视图;
图6为图5的适配器的一部分的分解装配视图;
图7为适配器的关节运动组件的一部分的剖面透视图;
图8为图7的关节运动组件的透视图;
图9为图8的关节运动组件的另一个透视图;
图10为图1的机电外科系统中采用的加载单元的分解装配视图;
图11为另选的适配器实施方案的透视图;
图12为图11的适配器的一部分的侧正视图,其中其钳口处于打开位置;
图13为图11的加载单元的一部分的另一个侧正视图,其中其部分以横截面示出并且其钳口处于闭合位置;
图14为图13的加载单元的一部分的底视图,其中其部分以横截面示出;
图15为图14的加载单元的一部分的透视图,其中外管的一部分以虚线示出;
图16为其中采用各种密封布置的另一个适配器的近侧部分的剖视图;
图17为图16的适配器的一部分的端部剖视图;
图18为另一个适配器的侧正视图;
图19为图18的适配器的一部分的剖视图;
图20为另一个适配器的部分的后透视图;
图21为另一个适配器的剖视图;
图22为用于控制其马达的机电外科装置的马达控制系统的分解组件透视图;
图23为用于控制其马达的机电外科装置的另一个马达控制系统的透视图;
图24为图23的马达控制系统的分解侧视图;并且
图25为与机电外科器械的马达中的一个马达相联的马达控制系统的一部分的局部端视图。
在所述若干视图中,对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案,且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有于2017年12月15日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SEALED ADAPTERS FOR USE WITH ELECTROMECHANICAL SURGICALINSTRUMENTS”的美国专利申请序列号15/843,485;
-名称为“END EFFECTORS WITH POSITIVE JAW OPENING FEATURES FOR USE WITHADAPTERS FOR ELECTROMECHANICAL SURGICAL INSTRUMENTS”的美国专利申请序列号15/843,518;
-名称为“SURGICAL END EFFECTORS WITH CLAMPING ASSEMBLIES CONFIGURED TOINCREASE JAW APERTURE RANGES”的美国专利申请序列号15/843,535;
-名称为“SURGICAL END EFFECTORS WITH PIVOTAL JAWS CONFIGURED TO TOUCHAT THEIR RESPECTIVE DISTAL ENDS WHEN FULLY CLOSED”的美国专利申请序列号15/843,558;
-名称为“SURGICAL END EFFECTORS WITH JAW STIFFENER ARRANGEMENTSCONFIGURED TO PERMIT MONITORING OF FIRING MEMBER”的美国专利申请序列号15/843,528;
-名称为“ADAPTERS WITH END EFFECTOR POSITION SENSING AND CONTROLARRANGEMENTS FOR USE IN CONNECTION WITH ELECTROMECHANICAL SURGICALINSTRUMENTS”的美国专利申请序列号15/843,567;
-名称为“DYNAMIC CLAMPING ASSEMBLIES WITH IMPROVED WEARCHARACTERISTICS FOR USE IN CONNECTION WITH ELECTROMECHANICAL SURGICALINSTRUMENTS”的美国专利申请序列号15/843,556;
-名称为“ADAPTERS WITH FIRING STROKE SENSING ARRANGEMENTS FOR USE INCONNECTION WITH ELECTROMECHANICAL SURGICAL INSTRUMENTS”的美国专利申请序列号15/843,514;
-名称为“ADAPTERS WITH CONTROL SYSTEMS FOR CONTROLLING MULTIPLE MOTORSOF AN ELECTROMECHANICAL SURGICAL INSTRUMENT”的美国专利申请序列号15/843,501;
-名称为“SYSTEMS AND METHODS OF CONTROLLING A CLAMPING MEMBER FIRINGRATE OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/843,682;代理人案卷号END8280USNP/170226;
-名称为“SYSTEMS AND METHODS OF CONTROLLING A CLAMPING MEMBER”的美国专利申请序列号15/843,689;以及
-名称为“METHODS OF OPERATING SURGICAL END EFFECTORS”的美国专利申请序列号15/843,704;
本文列出了许多具体细节,以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件,以免使说明书中描述的实施方案模糊不清。读者将会理解,本文所述和所示的实施方案为非限制性示例,从而可认识到,本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下,可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式,诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式,诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式,诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式,诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此,“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件,但不限于仅具有这些一个或多个元件。同样,“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部,但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分,术语“远侧”是指远离临床医生定位的部分。还应当理解,为简洁和清楚起见,本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而,外科器械在许多方向和位置中使用,并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术。然而,读者将容易理解,本文所公开的各种方法和装置可用于多种外科手术和应用中,包括例如与开放式外科手术结合。继续参阅本具体实施方式,读者将进一步理解,本文所公开的各种器械能够以任何方式插入体内,诸如通过自然腔道、通过成形于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入,外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除;然而,设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其它实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转;然而,可设想到其中第一钳口能够相对于第二钳口枢转的其它实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其它实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中,钉仓被定位在待缝合的组织的第一侧上,并且砧座被定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并夹持抵靠平台。然后,可移除地储存在仓体中的钉可被部署到组织中。仓体包括限定于其中的钉腔,其中钉可移除地储存在钉腔中。钉腔被布置成六纵向排。三排钉腔被定位在纵向狭槽的第一侧上且三排钉腔被定位在纵向狭槽的第二侧上。钉腔和钉的其它布置也是可能的。
钉由仓体中的钉驱动装置支撑。驱动装置能够在第一或非击发位置和第二或击发位置之间运动,以从钉仓射出钉。驱动装置通过保持器保留在仓体中,所述保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动装置能够通过滑动件在其非击发位置与其击发位置之间移动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面,该斜坡表面被构造成能够朝向砧座在驱动装置下方滑动以及提升驱动装置,并且钉在驱动装置上受到支撑。
除上述以外,滑动件还可通过击发构件朝远侧移动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时,第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕集的组织的刀。希望刀定位成至少部分接近斜坡表面,使得钉先于刀被射出。
图1示出了可用于执行多种不同外科手术的马达驱动(机电)外科系统1。如在该图中可见,外科系统1的一个示例包括动力手持式机电外科器械100,该动力手持式机电外科器械被构造用于将多个不同的外科工具器具(本文称为“适配器”)选择性地附接到其上,这些外科工具器具各自被构造成能够由动力手持式机电外科器械致动并操纵。如图1中所示,手持式外科器械100被构造用于与适配器200选择性地连接,并且继而适配器200被构造用于与包括单次使用的加载单元(“SULU”)或一次性加载单元(“DLU”)或多次使用的加载单元(“MULU”)的端部执行器选择性地连接。在另一个外科系统实施方案中,适配器200的各种形式也可以有效地与机器人控制的外科系统或自动外科系统的工具驱动组件一起使用。例如,本文所公开的外科工具组件可与各种机器人系统、器械、部件和方法诸如但不限于名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利9,072,535中公开的那些一起使用,该专利申请据此全文以引用方式并入本文。
如图1和图2中所示,外科器械100包括电源组101和被构造成能够选择性地接收并且基本上包封电源组101的外壳体外壳10。电源组101在本文中也可称为柄部组件101。一种形式的外科器械100例如公开于名称为“HANDHELD ELECTROMECHANICAL SURGICAL SYSTEM”的国际公布号WO 2016/057225A1、国际申请号PCT/US2015/051837中,其全部公开内容据此以引用方式并入本文。本文所公开的外科器械100的各种特征部将不超出理解本文所公开的本发明的各种特征部所必需的内容,并且应当理解,可通过参考WO 2016/057225A1和以引用方式并入本文的其它参考文献获得更多细节。
如图3中所示,外壳体外壳10包括远侧半节段10a和近侧半节段10b,近侧半节段通过沿远侧半节段10a和近侧半节段10b的上边缘定位的铰链16可枢转地连接到远侧半节段10a。当接合时,远侧半节段10a和近侧半节段10b在其中限定壳体腔体10c,电源组101选择性地位于该壳体腔体中。远侧半节段10a和近侧半节段10b中的每一者包括相应的上壳体部分12a、12b和相应的下壳体部分14a、14b。下壳体部分14a、14b限定按扣闭合特征部18,该按扣闭合特征部用于选择性地将下壳体部分14a、14b彼此固定并且用于将壳体外壳10保持在闭合状态。壳体外壳10的远侧半节段10a限定连接部分20,该连接部分被构造成能够接收适配器200的对应驱动联接组件210(参见图5)。具体地,壳体外壳10的远侧半节段10a具有凹陷部,当适配器200配合到外科器械100时,该凹陷部接收适配器200的驱动联接组件210的一部分。
远侧半节段10a的连接部分20限定从其内侧表面径向向内突出的一对轴向延伸的导轨21a、21b,如图5所示。当适配器200配合到外科器械100时,导轨21a、21b有助于相对于外科器械100旋转地取向适配器200。远侧半节段10a的连接部分20限定三个孔22a、22b、22c,这些孔形成于其面向远侧的表面上并且被布置在彼此共用的平面或线上。远侧半节段10a的连接部分20还限定也形成于其面向远侧的表面上的细长狭槽24。远侧半节段10a的连接部分20还限定形成于其表面上的凹形连接特征部26(参见图2)。凹形连接特征部26与适配器200的凸形连接特征部选择性地接合。
壳体外壳10的远侧半节段10a支撑面向远侧的切换控制按钮30。在向其施加对应的力或向其施加按压力时,能够沿左、右、上和下方向致动切换控制按钮30。壳体外壳10的远侧半节段10a支撑右侧的一对控制按钮32a、32b(参见图3);以及左侧的一对控制按钮34a、34b(参见图2)。在向其施加对应的力或向其施加按压力时,能够致动右侧控制按钮32a、32b和左侧控制按钮34a、34b。壳体外壳10的近侧半节段10b支撑右侧控制按钮36a(参见图3)和左侧控制按钮36b(参见图2)。在向其施加对应的力或向其施加按压力时,能够致动右侧控制按钮36a和左侧控制按钮36b。
壳体外壳10包括选择性地支撑在远侧半节段10a上的无菌阻隔板组件60。具体地,无菌阻隔板组件60设置在远侧半节段10a的连接部分20后面和壳体外壳10的壳体腔体10c内。板组件60包括可旋转地支撑三个联接轴64a、64b、64c的板62(参见图3和图5)。每个联接轴64a、64b、64c从板62的相对两侧延伸并且具有三叶形横向横截面轮廓。当无菌阻隔板组件60设置在壳体外壳10的壳体腔体10c内时,每个联接轴64a、64b、64c延伸穿过远侧半节段10a的连接部分20的相应孔22a、22b、22c。板组件60还包括支撑在板62上的电直通连接器66。直通连接器66从板62的相对两侧延伸。直通连接器66限定多个接触路径,每个接触路径包括用于在板62上延伸电连接的电缆。当板组件60设置在壳体外壳10的壳体腔体10c内时,联接轴64a、64b、64c的远侧端部和直通连接器66的远侧端部设置在或位于壳体外壳10的远侧半节段10a的连接部分20内,并且被构造成能够电接合和/或机械接合适配器200的相应对应特征部。
参见图3和图4,电源组或柄部组件101包括内柄部外壳110,该内柄部外壳具有下外壳部分104和从下外壳部分104延伸和/或支撑在其上的上外壳部分108。下外壳部分104和上外壳部分108被分成远侧半节段110a和可通过多个紧固件连接到远侧半节段110a的近侧半节段110b。当接合时,远侧半节段110a和近侧半节段110b在其中限定具有内外壳腔体110c的内柄部外壳110,电源组芯组件106位于内外壳腔体中。电源组芯组件106被构造成能够控制外科器械100的各种操作。
内柄部外壳110的远侧半节段110a支撑远侧切换控制接口130,该远侧切换控制接口与壳体外壳10的远侧切换控制按钮30操作性地配准。在使用中,当电源组101设置在壳体外壳10内时,切换控制按钮30的致动对触发控制接口130施加力。内柄部外壳110的远侧半节段110a还支撑右侧的一对控制接口(未示出)和左侧的一对控制接口132a、132b。在使用中,当电源组101设置在壳体外壳10内时,壳体外壳10的远侧半节段10a的右侧控制按钮对或左侧控制按钮对中的一者的致动将对内柄部外壳110的远侧半节段110a的右侧控制接口对132a、132b或左侧控制接口对132a、132b中的相应一者施加力。
参考图1至图5,内柄部外壳110提供外壳,电源组芯组件106位于其中。电源组芯组件106包括电池电路140、控制器电路板142和可再充电电池144,该可再充电电池被构造成能够向外科器械100的电子部件中的任一者供电。控制器电路板142包括马达控制器电路板142a、主控制器电路板142b、以及将马达控制器电路板142a和主控制器电路板142b互连的第一带缆142c。电源组芯组件106还包括支撑在主控制器电路板142b上的显示屏146。透过设置在内柄部外壳110的近侧半节段110b上的透光或透明窗口110d(参见图3)可以看见显示屏146。设想内柄部外壳110的至少一部分可由透明刚性塑料等制成。还设想壳体外壳10可包括形成于其上的窗口(与显示屏146和内柄部外壳110的近侧半节段110b的窗口110d视觉配准),并且/或者壳体外壳10可由透明刚性塑料等制成。
电源组芯组件106还包括第一马达152、第二马达154和第三马达156,这些马达由马达托架148支撑并且各自电连接到控制器电路板142和电池144。马达152、154、156设置在马达控制器电路板142a和主控制器电路板142b之间。每个马达152、154、156包括从其延伸的相应马达轴152a、154a、156a。每个马达轴152a、154a、156a具有用于传递旋转力或扭矩的三叶形横向横截面轮廓。每个马达152、154、156由相应的马达控制器控制。马达轴152a、154a、156a通过相应马达152、154、156的旋转用于驱动适配器200的轴和/或齿轮部件,以便执行外科器械100的各种操作。具体地,电源组芯组件106的马达152、154、156被构造成能够驱动适配器200的轴和/或齿轮部件。
如图1和图5中所示,外科器械100被构造用于与适配器200选择性地连接,并且继而适配器200被构造用于与端部执行器500选择性地连接。适配器200包括外旋钮外壳202和从旋钮外壳202的远侧端部延伸的外管206。旋钮外壳202和外管206被构造成并且尺寸被设计成能够适于容纳适配器组件200的部件。外管206的尺寸被设计用于内窥镜插入,具体地,外管可穿过典型的套管针端口、插管等。旋钮外壳202的尺寸被设计不用于进入套管针端口、插管等。旋钮外壳202被构造成能够并且适于连接到外科器械100的壳体外壳10的连接部分20。
适配器200被构造成能够将外科器械100的第一联接轴64a或第二联接轴64b中的任一者的旋转转换成可用于操作端部执行器500的驱动组件540和关节运动连接件560的轴向平移,如图10中所示并且如将在下文更详细地描述。如图6中所示,适配器200包括近侧内外壳组件204,其中可旋转地支撑着第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214和第三可旋转近侧驱动轴216。每个近侧驱动轴212、214、216用作旋转接收构件以接收来自外科器械100的相应联接轴64a、64b和64c的旋转力。此外,适配器200的驱动联接组件210还被构造成能够可旋转地支撑第一连接器套筒218、第二连接器套筒220和第三连接器套筒222,这些连接器套筒分别布置在彼此共用的平面或线上。每个连接器套筒218、220、222被构造成能够与外科器械100的相应的第一联接轴64a、第二联接轴64b和第三联接轴64c配合,如上所述。每个连接器套筒218、222、220还被构造成能够与适配器200的相应的第一近侧驱动轴212、第二近侧驱动轴214和第三近侧驱动轴216的近侧端部配合。
适配器200的驱动联接组件210还包括设置在相应的第一连接器套筒218、第二连接器套筒220和第三连接器套筒222的远侧的第一偏压构件224、第二偏压构件226和第三偏压构件228。每个偏压构件224、226和228围绕相应的第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214和第三可旋转近侧驱动轴216设置。偏压构件224、226和228作用在相应的连接器套筒218、222和220上,以在适配器200连接到外科器械100时帮助保持连接器套筒218、222和220与外科器械100的相应联接轴64a、64b和64c的远侧端部接合。
同样在例示的布置中,适配器200分别包括第一驱动转换组件240、第二驱动转换组件250和第三驱动转换组件260,这些驱动转换组件各自设置在内外壳组件204和外管206内。每个驱动转换组件240、250、260被构造成能够并且适于将外科器械100的第一联接轴64a、第二联接轴64b和第三联接轴64c的旋转传递或转换成:适配器200的关节运动驱动器或杆258的轴向平移,以实现端部执行器500的关节运动;适配器200的环形齿轮266的旋转,以实现适配器200的旋转;或适配器200的远侧驱动构件248的轴向平移,以实现端部执行器500的闭合、打开和击发。
仍然参见图6,第一力/旋转传递/转换组件240包括第一可旋转近侧驱动轴212,如上所述,该近侧驱动轴可旋转地支撑在内外壳组件204内。第一可旋转近侧驱动轴212包括被构造用于与第一连接器套筒218连接的非圆形或成型的近端部分,第一连接器套筒连接到外科器械100的相应第一联接轴64a。第一可旋转近侧驱动轴212包括螺纹远端部分212b。第一力/旋转传递/转换组件240还包括驱动联接螺母244,该驱动联接螺母通过螺纹接合第一可旋转近侧驱动轴212的螺纹远端部分212b并且可滑动地设置在外管206内。驱动联接螺母244可滑动地键合在外管206的近侧芯管部分内,以在第一可旋转近侧驱动轴212旋转时阻止旋转。这样,当第一可旋转近侧驱动轴212旋转时,驱动联接螺母244沿着第一可旋转近侧驱动轴212的螺纹远端部分212b平移,并且继而通过和/或沿着外管206平移。
第一力/旋转传递/转换组件240还包括远侧驱动构件248,该远侧驱动构件与驱动联接螺母244以机械方式接合,使得驱动联接螺母244的轴向移动导致远侧驱动构件248的对应量的轴向移动。远侧驱动构件248的远端部分支撑连接构件247,该连接构件被构造成并且尺寸被设计成能够用于与端部执行器500的驱动组件540的接合构件546选择性地接合(图10)。驱动联接螺母244和/或远侧驱动构件248用作端部执行器500的部件的传力构件。在操作中,随着第一可旋转近侧驱动轴212由于外科器械100的第一联接轴64a的旋转而旋转,驱动联接螺母244沿第一可旋转近侧驱动轴212轴向平移。随着驱动联接螺母244沿第一可旋转近侧驱动轴212轴向平移,远侧驱动构件248相对于外管206轴向平移。随着远侧驱动构件248轴向平移,其中连接构件247连接到其上并且接合中空远侧驱动构件548,该中空远侧驱动构件附接到端部执行器500的驱动组件540(图10),该远侧驱动构件248导致端部执行器500的驱动组件540的同时轴向平移,以实现端部执行器500的工具组件部分600的闭合和工具组件内各种部件的击发。
仍然参见图6,适配器200的第二驱动转换组件250包括可旋转地支撑在内外壳组件204内的第二近侧驱动轴214。第二可旋转近侧驱动轴214包括被构造用于与外科器械100的第二联接轴64c连接的非圆形或成型的近端部分。第二可旋转近侧驱动轴214还包括螺纹远端部分214a,该螺纹远端部分被构造成能够通过螺纹接合关节运动轴承组件252的关节运动轴承外壳253。参考图6至图9,关节运动轴承外壳253支撑关节运动轴承255,该关节运动轴承具有可相对于外座圈259独立地旋转的内座圈257。关节运动轴承外壳253具有非圆形外轮廓,例如泪滴形状,其可滑动地且不可旋转地设置在内外壳毂部204a的互补孔(未示出)内。适配器200的第二驱动转换组件250还包括关节运动杆258,该关节运动杆具有固定到关节运动轴承255的内座圈257的近侧部分。关节运动杆258的远侧部分在其中包括狭槽258a,该狭槽被构造成能够接收端部执行器500的关节运动连接件560的钩562(图10)。关节运动杆258用作端部执行器500的部件的传力构件。在例示的布置中并且如WO 2016/057225A1中进一步讨论,关节运动轴承组件252是可旋转的和可纵向平移的,并且被构造成能够在端部执行器500的第一钳口构件610和第二钳口构件700处于接近位置时和/或当钳口构件610、700进行关节运动时允许端部执行器自由、无阻碍的旋转移动。
在操作中,随着第二近侧驱动轴214旋转,关节运动轴承组件252沿第二近侧驱动轴214的螺纹远端部分214a轴向平移,这继而导致关节运动杆258相对于外管206轴向平移。随着关节运动杆258轴向平移,联接到端部执行器500的关节运动连接件560的关节运动杆258导致端部执行器500的关节运动连接件560的同时轴向平移,以实现工具组件600的关节运动。关节运动杆258固定到关节运动轴承253的内座圈257,因此相对于关节运动轴承253的外座圈259围绕纵向轴线自由旋转。
如图6中所示,适配器200包括支撑在内外壳组件204中的第三驱动转换组件260。第三驱动转换组件260包括固定地支撑在外旋钮外壳202中并且连接到其上的旋转环形齿轮266。环形齿轮266限定齿轮齿266a的内部阵列,并且包括一对沿直径相对的径向延伸的突起266b。突起266b被构造成能够设置在限定于外旋钮外壳202中的凹陷部内,使得环形齿轮266的旋转导致外旋钮外壳202的旋转,反之亦然。第三驱动转换组件260还包括第三可旋转近侧驱动轴216,如上所述,该第三可旋转近侧驱动轴可旋转地支撑在内外壳组件204内。第三可旋转近侧驱动轴216包括被构造用于与第三连接器220连接的非圆形或成型的近端部分。第三可旋转近侧驱动轴216包括键合到其远侧端部的正齿轮216。反向正齿轮264将第三可旋转近侧驱动轴216的正齿轮216a相互接合到环形齿轮266的齿轮齿266a。在操作中,随着第三可旋转近侧驱动轴216由于外科器械100的第三联接轴64b的旋转而旋转,第三可旋转近侧驱动轴216的正齿轮216a接合反向齿轮264,从而导致反向齿轮264旋转。随着反向齿轮264旋转,环形齿轮266也旋转,从而导致外旋钮外壳202旋转。外旋钮外壳202的旋转导致外管206围绕适配器200的纵向轴线旋转。随着外管206旋转,连接到适配器200的远端部分的端部执行器500也围绕适配器200的纵向轴线旋转。
适配器200还包括支撑在杆273(图6)上的附接/脱离按钮272(图5),该杆从适配器200的驱动联接组件210突出。附接/脱离按钮272被设置在杆273内或周围的偏压构件(未示出)偏压到未致动状态。按钮272包括唇缘或凸缘,该唇缘或凸缘被构造成能够卡扣在外科器械100的连接部分20的对应唇缘或凸缘后面。同样如WO 2016/057225A1中所讨论,适配器200还可包括用于固定远侧驱动构件248的轴向位置的锁定机构280。如在图21中可见,例如,锁定机构280包括可滑动地支撑在外旋钮外壳202上的按钮282。锁定按钮282连接到纵向延伸穿过外管206的致动杆(未示出)。致动杆在锁定按钮282移动时移动。在操作中,为了锁定远侧驱动构件248的位置和/或取向,使用者将锁定按钮282从远侧位置移动到近侧位置,从而导致锁定件(未示出)朝近侧移动,使得锁定件的远侧面移动脱离与凸轮构件288的接触,这导致凸轮构件288凸轮进入远侧驱动构件248的凹陷部249中。这样,即阻止远侧驱动构件248朝远侧和/或朝近侧移动。当锁定按钮282从近侧位置移动到远侧位置时,致动杆的远侧端部抵抗偏压构件(未示出)的偏压而朝远侧移动到锁定件(未示出)中,以迫使凸轮构件288离开凹陷部249,从而允许远侧驱动构件248的无阻碍的轴向平移和径向移动。
再次返回图6,适配器200包括支撑在外旋钮外壳202和内外壳组件204之上和之中的电气组件290。电气组件290包括支撑在电路板294上的多个电接触刀292,用于电连接到外科器械100的壳体外壳10的板组件的直通连接器。电气组件290用于允许校准和通信信息(即寿命周期信息、系统信息、力信息)经由外科器械100的电源组芯组件106的电插座部分传递到外科器械100的电路板。电气组件290还包括电连接到电路板294的应变仪296。应变仪296安装在内外壳组件204内,以限制应变仪296相对于其的旋转。第一可旋转近侧驱动轴212延伸穿过应变仪296,以使应变仪296能够为第一可旋转近侧驱动轴212表现出的击发/夹持负载提供闭环反馈。电气组件290还包括沿外管206的驱动联接螺母244不可旋转地且可滑动地设置的滑环298。滑环298与电路板294电连接,并且用于允许第一可旋转近侧驱动轴212的旋转和驱动联接螺母244的轴向平移,同时仍然保持滑环298与适配器200内的至少另一个电子部件的电接触,并且同时允许其它电子部件围绕第一可旋转近侧驱动轴212和驱动联接螺母244旋转。
仍然参见图6,内外壳组件204包括毂部205,该毂部具有限定基本上圆形外轮廓的朝远侧取向的环形壁207。毂部205包括基本上泪滴形的内凹陷部或镗孔,其形状和尺寸被设计用于将关节运动轴承组件252可滑动地接收在其内。内外壳组件204还包括固定到毂部204a的朝远侧取向的环形壁207的远侧面的环板254。环板254限定通过其的孔254a,该孔的尺寸适于在其中并且形成于其中,以便与第二近侧驱动轴214对齐并且可旋转地接收其远侧末端。这样,随着第二近侧驱动轴214旋转以轴向平移关节运动轴承组件252,第二近侧驱动轴214的远侧末端受到支撑并且阻止径向移动远离第二近侧驱动轴214的纵向旋转轴线。
接下来转到图10,在一个示例中,端部执行器500可被构造用于单次使用(“一次性加载单元-DLU”)并且类似于以下专利申请中公开的那些DLU:名称为“LOADING UNITHAVING DRIVE ASSEMBLY LOCKING MECHANISM”的美国专利申请公布号2010/0301097,现为美国专利号9,795,384;名称为“LOCKING MECHANISM FOR USE WITH LOADING UNITS”的美国专利申请公布号2012/0217284,现为美国专利号8,292,158;以及名称为“ADAPTERASSEMBLIES FOR INTERCONNECTING SURGICAL LOADING UNITS AND HANDLE ASSEMBLIES”的美国专利申请公布号2015/0374371,每个此类参考文献的全部公开内容据此以引用方式并入本文。还可以设想,端部执行器500可被构造用于多次使用(MULU),诸如在名称为“MULTI-USE LOADING UNIT”的美国专利申请公布号2017/0095250中公开的那些端部执行器,该专利申请的全部公开内容据此以引用方式并入本文。
所描绘的外科器械100击发钉,但其可适于击发任何其它合适的紧固件,诸如夹具和两部分紧固件。在例示的布置中,端部执行器500包括加载单元510。加载单元510包括近侧主体部分520和工具组件600。工具组件600包括一对钳口构件,该对钳口构件包括具有砧座组件612的第一钳口构件610和具有仓组件701的第二钳口构件700。一个钳口构件相对于另一个枢转,以使组织能够夹持在钳口构件之间。仓组件701能够相对于砧座组件612移动,并且能够在打开或未夹持位置和闭合或接近位置之间移动。然而,砧座组件612或仓组件701和砧座组件612两者可以为可移动的。
仓组件701具有仓体702,并且在一些情况下具有通过卡扣配合连接、棘爪、闩锁或通过另一种类型的连接附接到通道720的支撑板710。仓组件701包括可移动地支撑在多个侧向间隔的钉保持狭槽706中的紧固件或钉704,保持狭槽被构造为组织接触表面708中的开口。每个狭槽706被构造成能够在其中接收紧固件或钉。仓体702还限定多个凸轮楔形狭槽,这些凸轮楔形狭槽容纳钉推动器709并且在底部开放(即远离组织接触表面)以允许致动滑动件712纵向地通过其。在钉已从仓体702击发之后,仓组件701可从通道720移除。另一个可移除仓组件能够被装载到通道720上,使得外科器械100可被再次致动以击发另外的紧固件或钉。关于仓组件的另外细节可见于例如美国专利申请公布号2017/0095250以及已以引用方式并入本文的各个其它参考文献中。
仓组件701可相对于砧座组件612枢转,并且能够在打开或未夹持位置和闭合或夹持位置之间移动,以通过套管针的插管插入。近侧主体部分520包括至少驱动组件540和关节运动连接件560。在一种布置中,驱动组件540包括具有远侧端部544和近侧接合节段546的柔性驱动梁542。接合节段546的近侧端部包括沿直径相对的向内延伸的指状物547,该指状物接合中空的驱动构件548以将驱动构件548牢固地固定到梁542的近侧端部。驱动构件548限定近侧孔口,当端部执行器500附接到适配器200的远侧端部时,该近侧孔口接收适配器200的第一驱动转换组件240的驱动管246的连接构件247。
端部执行器500还包括外壳组件530,该外壳组件包括外外壳532和设置在外外壳532内的内外壳534。第一耳状物和第二耳状物536各自设置在外外壳532的近侧端部533的外表面上,并且被构造成能够操作地接合适配器200的远侧端部,如WO 2016/057225 A1中进一步详细讨论。
参考图10,例如,砧座组件612包括砧座盖630和砧座板620,该砧座板包括多个钉成形凹入部。砧座板620固定到砧座盖630的下侧。当工具组件600处于接近位置时,钉成形凹入部被定位成与仓组件701的钉接收狭槽并置对齐。
工具组件600包括安装组件800,该安装组件包括上安装部分810和下安装部分812。安装尾部632从砧座盖630的近侧端部631向近侧突出。居中定位的枢转构件814从每个上安装部分810和下安装部分812延伸穿过形成于联接构件820上的开口822。在至少一种布置中,上安装部分810的枢转构件814也延伸穿过安装尾部632上的开口634。联接构件820各自包括被构造成能够接收在形成于外外壳532和内外壳534的远侧端部上的对应沟槽中的互锁近侧部分824。端部执行器500的近侧主体部分520包括具有钩状近侧端部562的关节运动连接件560。关节运动连接件560的尺寸被设计成可滑动地定位在内外壳中的狭槽中。一对H块组件830被定位成与外外壳532的远侧端部相邻并且与轴向驱动组件540的远侧端部544相邻,以阻止柔性驱动梁542在外科缝合装置10的关节运动和击发期间向外屈曲和隆起。每个H块组件830包括柔性主体832,该柔性主体包括牢固地固定到外外壳532的远侧端部的近侧端部和牢固地固定到安装组件800的远侧端部。在一种布置中,关节运动连接件的远侧端部564枢转地销接到右侧H块组件830。关节运动连接件560的轴向移动将导致工具组件相对于主体部分520进行关节运动。
图11至图15示出了适配器200’,除下述不同之外,该适配器基本上与上述适配器200相同。如在图11中可见,适配器200'包括外管206,该外管具有近端部分910,该近端部分具有第一直径“FD”并且安装在外旋钮外壳202内。近端部分910可例如以WO 2016/057225A1中进一步详细讨论的方式联接到内外壳组件204或以其它方式支撑在其中。近端部分910从具有第二直径“SD”的中心管部分912向近侧延伸。在例示的实施方案中,端部执行器500联接到轴组件203的远侧端部914或外管206。外管206限定在近端部分910和远侧端部914之间延伸的纵向轴线LA,如在图11中可见。如在图10和图11中可见,端部执行器500的近侧主体部分520的外套筒570具有远端部分572和近端部分574。近端部分574具有约等于中心管部分912的第二直径SD的直径SD'。远端部分572具有第三直径“TD”。在一种布置中,FD和TD大约相等并且大于SD。设想了其它布置,其中FD和TD不相等,但各自大于SD。然而,优选的是,对于大多数情况,FD和TD的尺寸被设计用于通过典型的套管针端口、插管等进行内窥镜式插入。在至少一种布置(图11)中,外套筒570形成有平坦或扇形的侧面576,以有利于改善在患者体内的进入,同时有效地容纳适配器200'的各种驱动和关节运动部件。此外,通过提供具有减小直径的中心管部分912,可为适配器200'提供改善的肋骨间胸部进入。
在至少一种布置中,可由金属片加工或制成的通道720包括一对近侧孔722(图10),该对近侧孔被构造成能够与砧座盖630中的一对对应孔636对齐以接收对应的销或凸台638(图12),从而有利于砧座组件612和仓组件701之间的枢转关系。在例示的示例中,动态夹持组件550附接到或形成于柔性驱动梁542的远侧端部544。动态夹持组件550包括竖直主体部分552,该竖直主体部分具有形成于其上或附接到其上的组织切割表面554。例如,参见图10。砧座接合特征部556形成于主体部分552的一个端部上,并且包括从主体部分552的每个侧面突起的砧座接合突片557。类似地,通道接合特征部558形成于主体部分552的另一个端部上,并且包括从主体部分552的每个侧面突出的通道接合突片559。参见图15。
如上所述,砧座组件612包括砧座板620。砧座板620包括细长狭槽622,该细长狭槽被构造成能够在击发过程中随着动态夹持组件550轴向推进而容纳动态夹持组件550的主体部分552。细长狭槽622被限定在沿细长狭槽622的每个侧面延伸的两个砧座板凸缘624之间。参见图10。随着动态夹持组件550朝远侧推进,砧座接合突片557可滑动地接合砧座板凸缘624,以将砧座组件612保持夹持在目标组织上。类似地,在击发操作期间,动态夹持组件550的主体部分552延伸穿过通道720上的中心狭槽,并且通道接合突片559可滑动地接合沿中心通道狭槽的每一侧延伸的通道凸缘725,以将仓组件701保持夹持在目标组织上。
转到图13和图15,槽720限定通常标示为730的对接区域,该对接区域被构造成能够在动态夹持组件550处于其最近侧位置(本文中称为未击发或起始位置)时容纳该动态夹持组件。具体地,对接区域730由平坦对接表面732部分地限定,该平坦对接表面在动态夹持组件550上的通道接合突片559之间提供间隙,以使仓组件701能够枢转到完全打开位置。倾斜或凸轮表面726从对接表面732中的每一个的远侧端部延伸。倾斜表面726由动态夹持组件550接合,以使砧座组件612和仓组件701相对于彼此移动。在其它实施方案中,类似的凸轮表面可设置在砧座组件612上。设想倾斜表面726还可有利于通道720和支撑板620和/或仓体702之间的对准和/或接合。随着驱动组件540朝远侧推进(击发),动态夹持组件550上的通道接合突片559接合对应的倾斜表面726以将闭合运动施加到仓组件701,从而闭合仓组件701和砧座组件612。动态夹持组件550的进一步远侧平移致使致动滑动件712朝远侧移动通过仓体702,这致使致动滑动件712的凸轮楔形件713依次接合钉推动器709,以使钉推动器709在钉保持狭槽706内竖直地移动,并且将钉704射入砧座板620的钉成形凹入部。在钉704从保持狭槽706射出(并进入组织)之后,随着动态夹持组件550的竖直主体部分552上的组织切割刃554朝远侧行进通过仓体702的中心狭槽703,动态夹持组件550的切割刃554切断被缝合的组织。在钉704已从仓体702射出并且使用者希望使用同一器械10来击发另外的钉704(或另一类型的紧固件或刀)之后,使用者可从适配器200'移除加载单元510并且将其替换为另一个新的或未用过的加载单元。在另选的布置中,使用者可直接移除用过的仓体702,并且将其替换为新的未用过的或未击发的仓体702。
在常规适配器的使用期间,碎屑和体液可迁移到适配器的外管中并且不利地妨碍适配器关节运动和击发驱动系统的操作。在恶劣情况下,此类碎屑和流体渗透到适配器的内外壳组件中,这可能导致其中支撑的电子部件短路并且发生故障。此外,由于对适配器外管内部的进入受限,此类碎屑和流体难以从其中去除,这可能阻碍或降低再利用适配器的能力。
转到图16和图17,在一种布置中,至少一个第一密封件230设置在近侧内外壳组件204和第一可旋转近侧驱动轴212之间,以阻止流体/碎屑渗入近侧内外壳组件204内和近侧。此外,在关节运动杆258和外管206之间提供至少一个第二密封件232,以阻止流体/碎屑穿过其间而进入近侧内外壳组件204。至少一个第三壳体密封件233可设置在近侧内外壳204的毂部205周围,以在毂部205和外旋钮外壳202之间建立密封。第一密封件230、第二密封件232和第三密封件233可包括例如由橡胶或其它合适材料制成的柔性O形环。
在其它布置中,希望第一密封件230和第二密封件232位于适配器200中,处于容纳在外旋钮外壳202内的电子部件的远侧。例如,为了阻止流体/碎屑污染/短路滑环组件298,希望在适配器200的各种移动部件之间建立密封,这些移动部件操作地支撑在外管206内的例如各自在滑环组件298的远侧的一个或多个位置处。密封件230、232可支撑在外管的壁上和/或安装构件234上或其它单独的安装构件/衬套/外壳上,这些单独的安装构件/衬套/外壳支撑在外管206内并且被构造成能够有利于远侧驱动构件248以及关节运动杆258的轴向移动,同时在衬套和/或外管与远侧驱动构件248和关节运动杆258之间建立不透流体的密封。参见图18和图20。例如,在图19中例示的实施方案中,第一密封件230可另外具有擦拭特征部231,该擦拭特征部也可滑动地接合远侧驱动构件248以阻止流体/碎屑D沿近侧方向PD渗透到近侧内外壳组件204中。在至少一种布置中,为了使碎屑和流体能够收集在第一密封件230和第二密封件232的远侧的外管206中,在外管206内提供至少两个冲洗端口236、238。参见例如图18和图20。轴向间隔的冲洗端口236、238位于第一密封件230和第二密封件232的远侧。冲洗溶液(例如,清洁流体、盐水流体、空气等)可进入一个或多个端口以迫使偏离正路的碎屑和流体离开一个或多个其它端口。
如上所讨论的,机电外科器械100包括电源组或柄部组件101以及被构造成能够选择性地接收并且基本上包封柄部组件101的外壳体外壳10。无菌阻隔板60插置在柄部组件101和外壳体外壳之间,以有利于马达的可旋转马达驱动轴通过无菌阻隔板操作地联接到与其联接的适配器的对应驱动轴。然后,马达驱动轴的旋转用于驱动适配器200的轴和/或齿轮部件,以便执行外科器械100的各种操作。在操作期间,可能期望控制马达以基于与其联接的适配器200的各种部件的位置来调节轴旋转速率和/或轴旋转方向。例如,可能期望根据动态夹持组件550在端部执行器内的位置来控制马达152和可旋转驱动轴152a的旋转速率(和方向)。例如,当动态夹持组件550接近其击发行程的端部时,减慢其远侧推进以避免在击发行程结束时将动态夹持组件和/或相关部件猛击到仓体中可能是有用的。此外,在击发行程期间有时可能有用的是减慢动态夹持组件550的推进或加速其推进。也可发生与马达154和156的操作相关的类似条件。
图22示出了可用于控制马达152、154、156的操作并且完全位于无菌阻隔板或外壳体外壳10内的电源组芯组件9106和马达控制系统9180的一部分。除了下文讨论的差异之外,电源组芯组件9106与上述电源组芯组件106基本上相同。如在图22中可见,每个马达152、154、156支撑在与上述马达托架148类似的马达托架9148上。马达托架9148可旋转地支撑键合到马达152、154、156的相应马达轴152a、154a、156a的三个可旋转驱动连接器套筒152b、154b、156b。驱动连接器套筒152b、154b、156b不可旋转地接收板组件9160的相应可旋转联接轴组件9152a、9154a、9156a的近侧端部。
除了下文讨论的差异之外,板组件9160与板组件60相同。例如,可旋转联接轴组件9152a包括可旋转地支撑在板组件9160的板9162中的联接器衬套9152b。联接器轴9152c不可旋转地联接到所述联接器衬套9152b。联接器轴9152c的近侧端部从板9162朝近侧延伸以与驱动连接器套筒152b驱动地接合。当无菌阻隔板组件9160设置在壳体外壳10的壳体腔体10c内时,联接器轴9152c的远侧端部被构造成能够延伸穿过远侧半节段10a的连接部分20中的对应孔22b(图3)。可旋转联接轴组件9154a包括可旋转地支撑在板9162中的联接器衬套9154b。联接器轴9154c不可旋转地联接到所述联接器衬套9154b。联接器轴9154c的近侧端部从板9162朝近侧延伸以与驱动连接器套筒154b驱动地接合。当无菌阻隔板组件9160设置在壳体外壳10的壳体腔体10c内时,联接器轴9154c的远侧端部被构造成能够延伸穿过远侧半节段10a的连接部分20中的对应孔22c(参见图5)。可旋转联接轴组件9156a包括可旋转地支撑在板9162中的联接器衬套9156b。联接器轴9156c不可旋转地联接到所述联接器衬套9156b。联接器轴9156c的近侧端部从板9162朝近侧延伸以与驱动连接器套筒156b驱动地接合。当无菌阻隔板组件9160设置在壳体外壳10的壳体腔体10c内时,联接器轴9156c的远侧端部被构造成延伸穿过远侧半节段10a的连接部分20中的对应孔22a(图3)。
仍然参见图22,驱动连接器套筒152b、154b、156b各自由对应弹簧9158和垫圈9159弹簧偏压远离相应的马达152、154、156。驱动连接器套筒152b用于将可旋转马达驱动轴152a驱动地联接到联接器轴9152c。驱动连接器套筒154b用于将可旋转马达驱动轴154a驱动地联接到联接器轴9154c。驱动连接器套筒156b用于将可旋转马达驱动轴156a驱动地联接到联接器轴9156c。
马达控制系统9180包括联接到每个马达152、154、156的控制器电路板142a和电池144(图4)。每个马达152、154、156由相应的马达控制器控制。马达控制器设置在马达控制器电路板142a上。在一个示例中,马达控制器包括得自Allegro Microsystems公司的A3930/31K马达驱动器。A3930/31K马达驱动器被设计成控制具有N沟道外部功率MOSFET(诸如马达152、154、156)的三相无刷直流(BLDC)马达。马达控制器中的每个马达控制器联接到设置在主控制器电路板142b上的主控制器。主控制器还联接到存储器,该存储器也设置在主控制器电路板142b上。在一个示例中,主控制器包括得自Freescale Semiconductor公司的ARMCortex M4处理器,该处理器包括1024千字节的内部闪存存储器。主控制器通过FPGA与马达控制器通信,FPGA提供控制逻辑信号。然后马达控制器的控制逻辑使用固定频率脉宽调制(PWM)将对应激励信号输出到其相应的马达152、154、156。
在例示的布置中,马达控制系统9180还包括固定式传感器9182、9184、9186,这些固定式传感器有线连接到主控制器电路板142b和/或马达控制器或以其它方式与其通信。例如,固定式传感器9182与马达152相联并且有线连接到主控制器电路板142b和/或马达152的马达控制器或以其它方式与其通信。固定式传感器9184与马达154相联并且有线连接到主控制器电路板142b和/或马达154的马达控制器或以其它方式与它们通信。固定式传感器9186与马达156相联并且有线连接到主控制器电路板142b和/或马达156的马达控制器或以其它方式与它们通信。在一个示例中,传感器9182、9184、9186包括被布置成检测与联接器轴9152c、9154c、9156c相联的传感器致动器的霍尔效应传感器。例如,联接器衬套9152b可被磁化或支撑其中的磁体9152d。联接器衬套9154b可被磁化或支撑其中的磁体9154d。联接器衬套9156b可被磁化或支撑其中的磁体9156d。
马达152的致动将导致驱动联接器轴9152c和附带的磁体9152d的旋转。传感器9182被构造成能够检测磁体9152d的旋转行进并且将指示此类位置的信号传送到马达控制器或处理器控制马达152。这些信号可由控制器/处理器用于根据信号保持、增加或减小可旋转马达驱动轴152a的旋转速率。处理器还可改变可旋转驱动轴152a的旋转方向。马达154的致动将导致驱动联接器轴9154c和附带的磁体9154d的旋转。传感器9184被构造成能够检测磁体9154d的旋转行进并且将指示此类位置的信号传送到马达控制器或处理器控制马达154。这些信号可由控制器/处理器用于根据信号保持、增加或减小可旋转马达驱动轴154a的旋转速率。处理器还可改变可旋转驱动轴154a的旋转方向。马达156的致动将导致驱动联接器轴9156c和附带的磁体9156d的旋转。传感器9186被构造成能够检测磁体9156d的旋转行进并且将指示此类位置的信号传送到马达控制器或处理器控制马达156。这些信号可由控制器/处理器用于根据信号保持、增加或减小可旋转马达驱动轴156a的旋转速率。处理器还可改变可旋转驱动轴156a的旋转方向。
图23至图25示出了用于控制马达152、154、156的操作的另选的马达控制系统9200。在该示例中,至少一个开关9210与可旋转马达驱动轴152a、154a、156a中的每个可旋转马达驱动轴相联并且安装在支撑马达152、154、156的马达托架9248中。在例示的示例中,四个开关9210围绕可旋转驱动轴152a、154a、156a中的每个可旋转驱动轴周向间隔。图25示出了用于可旋转马达驱动轴152a的此类开关布置。每个开关9210有线连接到主控制器电路板142b和/或对应马达152、154、156的马达控制器或以其它方式与其通信。在一种布置中,每个驱动连接器套筒在其上具有至少一个开关致动器。图23至图25示出了驱动连接器套筒9220,该驱动连接器套筒具有形成于其上的四个周向间隔开的开关致动器凸块9222,以用于与对应开关9210操作地相互作用。驱动连接器套筒9220用于将可旋转马达驱动轴152a、154a、156a操作地联接到其对应联接器轴9152c、9154c、9156c。当可旋转马达驱动轴152a、154a、156a旋转时,与其不可旋转地连接的驱动连接器套筒9220也旋转,从而导致对应开关致动器9222旋转成与对应开关9210进行可致动的接触和脱离可致动的接触,以将指示对应驱动轴152a、154a、156a的旋转位置的信号传送到控制该特定马达的马达控制器或处理器。这些信号可由控制器/处理器用于根据信号保持、增加或减小可旋转马达驱动轴的旋转速率。处理器还可改变可旋转驱动轴的旋转方向。
实施例
实施例1—一种手持式机电外科装置,所述手持式机电外科装置被构造成能够操作地联接到外科附件。在至少一个示例中,所述机电外科装置包括柄部组件,所述柄部组件包括支撑在所述柄部组件内的多个电动马达。所述电动马达中的每个电动马达包括可旋转马达驱动轴。处理器联接到每个电动马达并且被配置成能够控制每个电动马达。所述机电外科装置还包括外壳体外壳,所述外壳体外壳被构造成能够选择性地将所述柄部组件包封在其中。阻隔板组件插置在所述柄部组件和所述外壳体外壳之间。所述阻隔板组件包括可旋转联接轴组件,所述可旋转联接轴组件对应于每个可旋转马达驱动轴以用于与其驱动接合。每个可旋转联接轴组件穿过所述外壳体外壳突出以用于与操作地联接到所述柄部组件的所述外科附件的对应附件驱动轴选择性地驱动接合。该外科装置还包括支撑在所述柄部组件内并且与所述阻隔板组件中的所述可旋转联接轴组件配合以用于监测每个可旋转马达驱动轴的旋转并且与所述处理器通信以将控制信号施加到每个电动马达的装置。
实施例2—根据实施例1所述的手持式机电外科装置,其中,所述电动马达各自由支撑在所述柄部组件中的马达托架支撑,使得每个电动马达的所述可旋转马达驱动轴从所述马达托架突出以用于与所述对应可旋转联接轴组件驱动接合。
实施例3—根据实施例2所述的手持式机电外科装置,其中,用于监测每个可旋转马达驱动轴的旋转的装置包括位于所述马达托架上的传感器,所述传感器对应于每个可旋转马达驱动轴并且与所述处理器通信。传感器致动器对应于每个可旋转联接轴组件并且被构造成能够由对应于所述可旋转联接轴组件所附接的所述可旋转马达驱动轴的所述传感器感测。
实施例4—根据实施例3所述的手持式机电外科装置,其中,每个传感器包括与所述处理器通信的霍尔效应传感器,并且其中每个传感器致动器包括对应于每个可旋转联接轴组件的磁体。
实施例5—根据实施例1、2、3或4所述的手持式机电外科装置,其中,每个可旋转联接轴组件包括:联接器衬套,所述联接器衬套可旋转地支撑在所述阻隔板组件中;以及联接器轴,所述联接器轴与所述联接器衬套相联以与其一起旋转行进。所述联接器轴延伸穿过所述阻隔板组件,使得所述联接器轴的远侧端部被构造成能够延伸穿过外壳体以用于与操作地联接到所述柄部组件的所述外科附件的对应附件驱动轴选择性地驱动接合。所述联接器轴的近侧端部被构造成能够由联接器套筒联接到所述对应可旋转马达驱动轴。
实施例6—根据实施例5所述的手持式机电外科装置,其中,每个磁体由对应联接器衬套支撑。
实施例7—根据实施例5所述的手持式机电外科装置,其中,每个磁体由对应联接器套筒支撑。
实施例8—根据实施例2、3、4、5、6或7所述的手持式机电外科装置,其中,用于监测每个可旋转马达驱动轴的旋转的装置包括位于马达托架上的至少一个开关,所述至少一个开关对应于每个可旋转马达驱动轴并且与所述处理器通信。联接器套筒对应于每个可旋转马达驱动轴和对应可旋转联接轴组件,并且被构造用于附接到二者上以将所述可旋转马达驱动轴和所述对应可旋转联接轴组件驱动地接合在一起以作为单元旋转。每个联接器套筒包括至少一个致动器,所述至少一个致动器被构造成能够在所述可旋转马达驱动轴旋转时致动至少一个开关,所述至少一个开关对应于所述轴联接器所附接的所述可旋转马达驱动轴。
实施例9—根据实施例8所述的手持式机电外科装置,其中,所述至少一个开关包括多个开关,其中每个开关对应于一个可旋转马达驱动轴。这些开关被布置成围绕所述可旋转马达驱动轴在所述马达托架上的周向间隔的布置并与所述处理器通信。所述至少一个致动器包括多个周向间隔的致动器,所述多个周向间隔的致动器位于每个联接器套筒上并且被构造成能够致动与所述联接器套筒所附接的所述可旋转马达驱动轴对应的多个开关。
实施例10—根据实施例9所述的手持式机电外科装置,其中,位于每个联接器套筒上的多个周向间隔的致动器中的每一个周向间隔的致动器被构造成能够机械地致动对应于所述联接器套筒所附接的所述可旋转马达驱动轴的所述多个开关。
实施例11—根据实施例8所述的手持式机电外科装置,其中,每个可旋转联接轴组件包括联接器轴,所述联接器轴可旋转地支撑在所述阻隔板组件中并且对应于每个可旋转马达驱动轴,并且其中所述联接器套筒被构造成能够不可旋转地接合所述对应联接器轴和所述可旋转马达驱动轴。
实施例12—一种手持式机电外科装置,所述手持式机电外科装置被构造成能够操作地联接到外科附件。在至少一个示例中,所述机电外科装置包括柄部外壳,所述柄部外壳具有支撑在其中的多个电动马达。每个电动马达包括可旋转马达驱动轴。所述外科装置还包括外壳体外壳,所述外壳体外壳被构造成能够选择性地包封所述柄部外壳。阻隔板组件插置在所述柄部外壳和所述外壳体外壳之间。阻隔板组件包括可旋转联接轴,所述可旋转联接轴对应于每个可旋转马达驱动轴以用于与其驱动接合。每个可旋转联接轴穿过所述外壳体外壳突出以用于与操作地联接到所述外科装置的所述外科附件的对应附件驱动轴选择性地驱动接合。所述装置还包括马达控制系统,所述马达控制系统包括被构造成能够控制每个电动马达的处理器。马达控制器布置支撑在所述柄部外壳中并且对应于每个可旋转马达驱动轴。每个马达控制器布置被构造成能够将与所述对应可旋转马达驱动轴的旋转位置相关的信号传输到所述处理器。
实施例13—根据实施例12所述的手持式机电外科装置,其中,所述马达控制器布置包括固定式传感器,所述固定式传感器支撑在所述柄部外壳内并对应于每个可旋转马达驱动轴并与所述处理器通信。传感器致动器对应于每个可旋转联接轴并且被构造成能够由对应于所述可旋转联接轴所附接的所述可旋转马达驱动轴的所述固定式传感器感测。
实施例14—根据实施例13所述的手持式机电外科装置,其中,每个传感器包括与所述处理器通信的霍尔效应传感器,并且其中每个传感器致动器包括对应于每个可旋转联接轴的磁体。
实施例15—根据实施例14所述的手持式机电外科装置,其中,每个可旋转联接轴包括:联接器衬套,所述联接器衬套可旋转地支撑在阻隔板组件中;以及联接器轴,所述联接器轴与所述联接器衬套相联以与其一起旋转行进。所述联接器轴延伸穿过所述阻隔板组件,使得所述联接器轴的远侧端部被构造成能够延伸穿过所述外壳体外壳以用于与操作地联接到所述柄部外壳的所述外科附件的对应附件驱动轴选择性地驱动接合,并且所述联接器轴的近侧端部被构造成能够由联接器套筒联接到所述对应可旋转马达驱动轴。
实施例16—根据实施例15所述的手持式机电外科装置,其中,每个磁体由对应联接器衬套支撑。
实施例17—根据实施例15所述的手持式机电外科装置,其中,每个磁体由对应联接器套筒支撑。
实施例18—根据实施例12所述的手持式机电外科装置,其中,所述马达控制器布置包括至少一个固定式开关,所述至少一个固定式开关对应于每个可旋转马达驱动轴并与所述处理器通信。联接器套筒对应于每个可旋转马达驱动轴和对应可旋转联接轴并且被构造用于附接到二者上以将所述可旋转马达驱动轴和所述对应可旋转联接轴驱动地接合在一起以作为单元旋转,并且其中每个联接器套筒包括至少一个致动器,所述至少一个致动器被构造成能够在所述对应可旋转马达驱动轴旋转时致动对应于所述轴联接器所附接的所述可旋转马达驱动轴的至少一个固定式开关。
实施例19—根据实施例18所述的手持式机电外科装置,其中,所述至少一个固定式开关包括多个固定式开关,所述多个固定式开关对应于每个可旋转马达驱动轴并且被布置成围绕所述可旋转马达驱动轴在所述马达托架上的周向间隔的布置并与所述处理器通信,并且其中所述至少一个致动器包括多个周向间隔的致动器,所述多个周向间隔的致动器位于每个联接器套筒上,所述多个周向间隔的致动器被构造成能够致动对应于所述联接器套筒所附接的所述可旋转马达驱动轴的多个固定式开关。
实施例20—根据实施例12、13、14、15、16、17、18或19所述的手持式机电外科装置,其中,所述处理器被配置成能够响应于由每个马达控制器布置传输到所述处理器的信号来调节每个可旋转马达驱动轴的旋转速率和旋转方向。
已结合钉的部署和变形描述了本文所述的外科器械系统;然而,本文所述的实施方案不限于此。例如,设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外,还设想了利用用于密封组织的任何合适装置的各种实施方案。例如,根据各种实施方案的端部执行器可包括被配置成能够加热和密封组织的电极。另外,例如,根据某些实施方案的端部执行器可施加振动能量来密封组织。
虽然本文已结合某些实施方案描述了各种装置,但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中,具体特征、结构或特性可以任何合适的方式进行组合。因此,在无限制的情况下,结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其它实施方案的特征、结构或特性组合。另外,在公开了用于某些部件的材料的情况下,也可使用其它材料。此外,根据多种实施方案,单个部件可被替换为多个部件,并且多个部件也可被替换为单个部件,以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用之后废弃,或者其可被设计成多次使用。然而无论是哪种情况,该装置都可在至少使用一次后经过修整再行使用。修整可包括以下步骤的任意组合,这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地,修整设施和/或外科团队可拆卸装置,并且在清洁和/或更换装置的特定部件之后,可重新组装装置以供后续使用。本领域的技术人员将会理解,修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修整装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先,可获得新的或用过的器械,并且根据需要进行清洁。然后,可对器械进行消毒。在一种消毒技术中,将所述器械放置在密闭且密封的容器(诸如,塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场,诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的,直至在医疗设施中将该容器打开。还可使用本领域已知的任何其它技术对装置进行消毒,所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计,但可在本公开的实质和范围内进一步修改本发明。因此,本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
Claims (20)
1.一种手持式机电外科装置,所述手持式机电外科装置被构造成能够操作地联接到外科附件,所述机电外科装置包括:
柄部组件,所述柄部组件包括:
多个电动马达,所述多个电动马达支撑在所述柄部组件内,每个所述电动马达包括可旋转马达驱动轴;和
处理器,所述处理器联接到每个所述电动马达并且被配置成能够控制每个所述电动马达,并且其中所述机电外科装置还包括:
外壳体外壳,所述外壳体外壳被构造成能够选择性地将所述柄部组件包封在其中;
阻隔板组件,所述阻隔板组件插置在所述柄部组件和所述外壳体外壳之间,所述阻隔板组件包括对应于每个所述可旋转马达驱动轴以用于与其驱动接合的可旋转联接轴组件,每个所述可旋转联接轴组件穿过所述外壳体外壳突出以用于与操作地联接到所述柄部组件的所述外科附件的对应附件驱动轴选择性地驱动接合;和
支撑在所述柄部组件内并且与所述阻隔板组件中的所述可旋转联接轴组件配合以用于监测所述可旋转马达驱动轴中的每个可旋转马达驱动轴的旋转并且与所述处理器通信以将控制信号施加到所述电动马达中的每个电动马达的装置。
2.根据权利要求1所述的手持式机电外科装置,其中,所述电动马达各自由支撑在所述柄部组件中的马达托架支撑,使得每个所述电动马达的所述可旋转马达驱动轴从所述马达托架突出以用于与所述对应可旋转联接轴组件驱动接合。
3.根据权利要求2所述的手持式机电外科装置,其中,用于监测每个所述可旋转马达驱动轴的旋转的装置包括:
位于所述马达托架上的传感器,所述传感器对应于每个所述可旋转马达驱动轴并且与所述处理器通信;和
传感器致动器,所述传感器致动器对应于每个所述可旋转联接轴组件并且被构造成能够由对应于所述可旋转联接轴组件所附接的所述可旋转马达驱动轴的所述传感器感测。
4.根据权利要求3所述的手持式机电外科装置,其中,每个所述传感器包括与所述处理器通信的霍尔效应传感器,并且其中每个所述传感器致动器包括对应于每个所述可旋转联接轴组件的磁体。
5.根据权利要求4所述的手持式机电外科装置,其中,每个所述可旋转联接轴组件包括:
联接器衬套,所述联接器衬套可旋转地支撑在所述阻隔板组件中;和
联接器轴,所述联接器轴与所述联接器衬套相联以用于与所述联接器衬套一起旋转行进并且延伸通过所述联接器衬套,使得所述联接器轴的远侧端部被构造成能够延伸穿过所述外壳体以用于与操作地联接到所述柄部组件的所述外科附件的对应附件驱动轴选择性地驱动接合,并且所述联接器轴的近侧端部被构造成能够由联接器套筒联接到所述对应可旋转马达驱动轴。
6.根据权利要求5所述的手持式机电外科装置,其中,每个所述磁体由对应的所述联接器衬套支撑。
7.根据权利要求5所述的手持式机电外科装置,其中,每个所述磁体由对应的所述联接器套筒支撑。
8.根据权利要求2所述的手持式机电外科装置,其中,用于监测每个所述可旋转马达驱动轴的旋转的装置包括:
位于所述马达托架上的至少一个开关,所述至少一个开关对应于每个所述可旋转马达驱动轴并且与所述处理器通信;和
联接器套筒,所述联接器套筒对应于每个所述可旋转马达驱动轴和所述对应可旋转联接轴组件并且被构造用于附接到二者上以将所述可旋转马达驱动轴和所述对应可旋转联接轴组件驱动地接合在一起以作为单元旋转,并且其中每个所述联接器套筒包括至少一个致动器,所述至少一个致动器被构造成能够在所述可旋转马达驱动轴旋转时致动对应于所述轴联接器所附接的所述可旋转马达驱动轴的所述至少一个开关。
9.根据权利要求8所述的手持式机电外科装置,其中,所述至少一个开关包括多个开关,所述多个开关对应于每个所述可旋转马达驱动轴并且被布置成围绕所述可旋转马达驱动轴在所述马达托架上的周向间隔的布置并与所述处理器通信,并且其中所述至少一个致动器包括多个周向间隔的致动器,所述多个周向间隔的致动器位于每个所述联接器套筒上并且被构造成能够致动对应于所述联接器套筒所附接的所述可旋转马达驱动轴的所述多个开关。
10.根据权利要求9所述的手持式机电外科装置,其中,位于每个所述联接器套筒上的每个所述多个周向间隔的致动器被构造成能够机械地致动对应于所述联接器套筒所附接的所述可旋转马达驱动轴的所述多个开关。
11.根据权利要求8所述的手持式机电外科装置,其中,每个所述可旋转联接轴组件包括联接器轴,所述联接器轴可旋转地支撑在所述阻隔板组件中并且对应于每个所述可旋转马达驱动轴,并且其中所述联接器套筒被构造成能够不可旋转地接合所述对应联接器轴和所述可旋转马达驱动轴。
12.一种手持式机电外科装置,所述手持式机电外科装置被构造成能够操作地联接到外科附件,所述机电外科装置包括:
柄部外壳;
多个电动马达,所述多个电动马达支撑在所述柄部外壳内,每个所述电动马达包括可旋转马达驱动轴;
外壳体外壳,所述外壳体外壳被构造成能够选择性地包封所述柄部外壳;
阻隔板组件,所述阻隔板组件插置在所述柄部外壳和所述外壳体外壳之间,所述阻隔板组件包括对应于每个所述可旋转马达驱动轴以用于与其驱动接合的可旋转联接轴,每个所述可旋转联接轴穿过所述外壳体外壳突出以用于与操作地联接到所述外科装置的所述外科附件的对应附件驱动轴选择性地驱动接合;和
马达控制系统,所述马达控制系统包括:
处理器,所述处理器被配置成能够控制每个所述电动马达;和
马达控制器布置,所述马达控制器布置支撑在所述柄部外壳中并且对应于每个所述可旋转马达驱动轴,每个所述马达控制器布置被构造成能够将与所述对应可旋转马达驱动轴的旋转位置相关的信号传输到所述处理器。
13.根据权利要求12所述的手持式机电外科装置,其中,所述马达控制器布置包括:
固定式传感器,所述固定式传感器支撑在所述柄部外壳内并且对应于每个所述可旋转马达驱动轴并与所述处理器通信;和
传感器致动器,所述传感器致动器对应于每个所述可旋转联接轴并且被构造成能够由对应于所述可旋转联接轴所附接的所述可旋转马达驱动轴的所述固定式传感器感测。
14.根据权利要求13所述的手持式机电外科装置,其中,每个所述传感器包括与所述处理器通信的霍尔效应传感器,并且其中每个所述传感器致动器包括对应于每个所述可旋转联接轴的磁体。
15.根据权利要求14所述的手持式机电外科装置,其中,每个所述可旋转联接轴包括:
联接器衬套,所述联接器衬套可旋转地支撑在所述阻隔板组件中;和
联接器轴,所述联接器轴与所述联接器衬套相联以用于与所述联接器衬套一起旋转行进并且延伸通过所述联接器衬套,使得所述联接器轴的远侧端部被构造成能够延伸穿过所述外壳体外壳以用于与操作地联接到所述柄部外壳的所述外科附件的对应附件驱动轴选择性地驱动接合,并且所述联接器轴的近侧端部被构造成能够由联接器套筒联接到所述对应可旋转马达驱动轴。
16.根据权利要求15所述的手持式机电外科装置,其中,每个所述磁体由对应的所述联接器衬套支撑。
17.根据权利要求15所述的手持式机电外科装置,其中,每个所述磁体由对应联接器套筒支撑。
18.根据权利要求12所述的手持式机电外科装置,其中,所述马达控制器布置包括:
至少一个固定式开关,所述至少一个固定式开关对应于每个所述可旋转马达驱动轴并且与所述处理器通信;和
联接器套筒,所述联接器套筒对应于每个所述可旋转马达驱动轴和所述对应可旋转联接轴并且被构造用于附接到二者上以将所述可旋转马达驱动轴和所述对应可旋转联接轴驱动地接合在一起以作为单元旋转,并且其中每个所述联接器套筒包括至少一个致动器,所述至少一个致动器被构造成能够在所述对应可旋转马达驱动轴旋转时致动对应于所述轴联接器所附接的所述可旋转马达驱动轴的所述至少一个固定式开关。
19.根据权利要求18所述的手持式机电外科装置,其中,所述至少一个固定式开关包括多个固定式开关,所述多个固定式开关对应于每个所述可旋转马达驱动轴并且被布置成围绕所述可旋转马达驱动轴在所述马达托架上的周向间隔的布置并与所述处理器通信,并且其中所述至少一个致动器包括多个周向间隔的致动器,所述多个周向间隔的致动器位于每个所述联接器套筒上并且被构造成能够致动对应于所述联接器套筒所附接的所述可旋转马达驱动轴的所述多个固定式开关。
20.根据权利要求12所述的手持式机电外科装置,其中,所述处理器被配置成能够响应于由每个所述马达控制器布置传输到所述处理器的所述信号来调节所述电动马达的每个所述可旋转马达驱动轴的旋转速率和旋转方向。
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PCT/IB2018/060053 WO2019116316A1 (en) | 2017-12-15 | 2018-12-13 | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
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