CN111616762B - 具有可独立移动钳口的外科缝合装置 - Google Patents
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Abstract
本发明涉及具有可独立移动钳口的外科缝合装置，并具体提供一种外科缝合装置，其包含细长主体和工具组件。所述细长主体具有远侧部分和近侧部分。所述工具组件支撑在所述细长主体的所述远侧部分上，并且包含固定钳口、位于所述固定钳口的一侧上的顶部钳口和位于所述固定钳口的相对侧上的底部钳口。所述顶部钳口可相对于所述固定钳口独立于所述底部钳口在打开位置与夹紧位置之间移动，以将组织夹紧在所述顶部钳口与所述固定钳口之间，并且所述底部钳口可相对于所述固定钳口独立于所述顶部钳口在打开位置与夹紧位置之间移动，以将组织夹紧在所述底部钳口与所述固定钳口之间。
Description
相关申请的交叉引用
本申请要求2019年2月28日提交的美国临时专利申请第62/811,925号的权益和优先权，其全部公开内容通过引用并入本文。
技术领域
本公开涉及缝合装置，且更具体地，涉及包含用于将两个组织段连接在一起的两个可独立移动钳口的缝合装置。
背景技术
用于接合组织段的外科缝合装置在本领域中是已知的，并且通常包含第一钳口和第二钳口，所述第一钳口和第二钳口可相对于彼此移动以夹紧并缝合组织。在某些外科手术中，例如在阴道断端闭合手术中，必须将两个组织段彼此移近，然后再夹紧并缝合组织段。在已知的具有移动到夹紧位置的两个钳口的缝合器中，在夹紧并缝合组织段之前，必须使用抓紧器或类似装置来重新定位组织段。在腹腔镜下进行外科手术的情况下，需要额外的进入端口为抓紧器提供进入手术部位的通道。
在本领域中，对外科缝合装置存在持续需求，外科缝合装置能够在接合组织段之前独立地抓握和重新放置两个组织段。
发明内容
本公开的一个方面涉及一种外科缝合装置，其包含细长主体和工具组件。所述细长主体具有远侧部分和近侧部分。所述工具组件支撑在所述细长主体的所述远侧部分上，并且包含固定钳口、位于所述固定钳口的一侧上的顶部钳口和位于所述固定钳口的相对侧上的底部钳口。所述顶部钳口可相对于所述固定钳口独立于所述底部钳口在打开位置与夹紧位置之间移动，以将组织夹紧在所述顶部钳口与所述固定钳口之间，并且所述底部钳口可相对于所述固定钳口独立于所述顶部钳口在打开位置与夹紧位置之间移动，以将组织夹紧在所述底部钳口与所述固定钳口之间。
在实施例中，所述顶部钳口支撑多个缝钉。
在一些实施例中，缝钉推动器在所述顶部钳口内延伸并且可移动以将所述多个缝钉中的最远侧缝钉从所述顶部钳口弹向所述底部钳口。
在某些实施例中，所述底部钳口支撑多个缝钉保持器，其中所述多个缝钉保持器中的每一个可与所述多个缝钉中的相应一个接合，以将所述多个缝钉中的每一个固定到组织。
在实施例中，所述外科缝合装置包含致动器，所述致动器可操作地与所述顶部钳口相关联并且可从前进位置移向缩回位置以使所述顶部钳口从所述打开位置移动到所述夹紧位置。
在一些实施例中，所述致动器可操作地与所述底部钳口相关联并且可移动以使所述底部钳口从所述打开位置移动到所述夹紧位置。
在某些实施例中，所述外科缝合装置包含具有连接到所述致动器的远侧部分的夹紧杆，其中所述夹紧杆可从前进位置移动到缩回位置以使所述致动器从所述前进位置移动到所述缩回位置。
在实施例中，所述顶部钳口包含第一凸轮槽，所述底部钳口包含第二凸轮槽，并且所述致动器包含凸轮构件，其中所述凸轮构件可在所述第一凸轮槽和所述第二凸轮槽内移动以使所述顶部钳口和所述底部钳口从所述打开位置移动到所述夹紧位置。
在一些实施例中，所述第一凸轮槽和所述第二凸轮槽被构造成使得所述致动器从所述前进位置到中间位置的移动能使所述顶部钳口从所述打开位置移动到所述夹紧位置，并且所述致动器从所述中间位置到所述缩回位置的移动能使所述底部钳口从所述打开位置移动到所述夹紧位置。
在某些实施例中，所述外科缝合装置包含具有夹紧触发器的手柄组件，所述夹紧触发器通过夹紧杆连接到所述致动器，其中所述夹紧触发器可以从非致动位置枢转到部分致动位置以使所述顶部钳口从所述打开位置移动到所述夹紧位置，并且可以从所述部分致动位置枢转到完全致动位置以使所述底部钳口从所述打开位置移动到所述夹紧位置。
在实施例中，缝钉推动器在所述顶部钳口内延伸并且可从缩回位置移动到前进位置，以将所述多个缝钉中的一个从所述顶部钳口弹向所述底部钳口。
在一些实施例中，所述手柄组件包含击发触发器，所述击发触发器通过击发杆连接到所述缝钉推动器，其中所述击发触发器可从非致动位置移动到致动位置，以使所述缝钉推动器从所述缩回位置移动到所述前进位置。
在某些实施例中，所述夹紧触发器包含锁定构件，所述锁定构件被定位成防止所述击发杆前进，直到所述夹紧触发器移动到所述完全致动位置为止。
本公开的另一方面涉及一种执行外科手术的方法，所述方法包含：将外科装置的工具组件定位在第一组织段附近，使得所述第一组织段位于所述工具组件的顶部钳口与所述工具组件的固定钳口之间；移动所述外科装置的致动器以使所述顶部钳口移向所述固定钳口，从而将所述第一组织段夹紧在所述顶部钳口与所述固定钳口之间；将所述工具组件移向第二组织段从而使所述第一组织段移向所述第二组织段；将所述外科装置的所述工具组件定位在所述第二组织段附近，使得所述第二组织段位于所述工具组件的底部钳口与所述工具组件的所述固定钳口之间；移动所述外科装置的所述致动器以使所述底部钳口移向所述固定钳口，从而将所述第二组织段夹紧在所述底部钳口与所述固定钳口之间；以及移动击发杆以将缝钉从第一钳口穿过所述第一组织段和所述第二组织段弹向第二钳口，从而将所述第一组织段接合到所述第二组织段。
在实施例中，移动所述外科装置的所述致动器以使所述顶部钳口移向所述固定钳口包含使所述致动器从前进位置移动到中间位置。
在一些实施例中，移动所述外科装置的所述致动器以使所述底部钳口移向所述固定钳口包含使所述致动器从所述中间位置移动到缩回位置。
在某些实施例中，使所述外科装置的所述致动器从所述前进位置移动到所述中间位置包含：抓握手柄组件的夹紧触发器的第一抓握环并将所述第一抓握环拉向所述手柄组件的固定手柄。
在实施例中，使所述外科装置的所述致动器从所述中间位置移动到所述缩回位置包含：抓握所述手柄组件的所述夹紧触发器的第二抓握环并将所述第二抓握环拉向所述手柄组件的所述固定手柄。
在一些实施例中，移动所述击发杆以将所述缝钉从所述第一钳口穿过所述第一组织段和所述第二组织段弹向所述第二钳口从而将所述第一组织段与所述第二组织段接合包含：使手柄组件的击发触发器移向所述手柄组件的固定手柄以使所述击发杆前进从而使支撑在所述顶部钳口内的缝钉推动器前进。
附图说明
本文以下参考附图描述当前公开的缝合装置的各种实施例，其中：
图1是当前公开的外科缝合装置的示例性实施例，其中顶部钳口和底部钳口处于打开位置；
图2是图1所示细节的指定区域的放大视图；
图3是图1所示的缝合装置的分解透视图；
图3A是图3所示细节的指定区域的放大视图；
图4是图3所示细节的指定区域的放大视图；
图5是图1所示的缝合装置的侧视图，其中所述缝合装置的顶部钳口和底部钳口处于打开位置；
图6是沿图1的截面线6-6截取的横截面视图；
图7是图1所示的缝合装置的手柄组件的侧透视图，其中夹紧触发器和击发触发器处于非致动位置；
图8是图7所示的手柄组件的夹紧触发器、夹紧杆和击发杆的侧透视图，其中击发杆锁定；
图9是图6所示细节的指定区域的放大视图；
图10是沿图6的截面线10-10截取的横截面视图；
图11是图1所示的缝合装置的侧视横截面图，其中顶部钳口处于打开位置，底部钳口处于夹紧位置，且夹紧触发器处于部分致动位置；
图12是图11所示细节的指定区域的放大视图；
图13是图11所示的缝合装置的侧视横截面图，其中顶部和底部钳口处于夹紧位置，且夹紧触发器处于完全致动位置；
图14是图13所示细节的指定区域的放大视图；
图15是图13所示的缝合装置的手柄组件的侧透视图，其中夹紧触发器处于完全致动位置，且击发触发器处于非致动位置；
图16是图15所示的手柄组件的夹紧触发器、夹紧杆和击发杆的侧透视图，其中击发杆锁定；
图17是图13所示的缝合装置的手柄组件的侧视图，其中夹紧触发器处于完全致动位置，且击发触发器处于致动位置；以及
图18是图13所示的缝合装置的放大视图，其中顶部钳口和底部钳口夹紧，且缝钉推动器处于前进位置。
具体实施方式
现在将参考附图详细描述当前公开的缝合装置，在附图中，相同的附图标记指代若干视图中的每一者中完全相同或对应的元件。然而，应理解，所公开的实施例仅仅是本发明的示例，并且可以以各种形式实施。为了避免以不必要的细节模糊本发明，没有对公知的功能或构造进行详细描述。因此，本文公开的具体结构和功能细节不应被解释为具有限制性，而仅仅是作为权利要求的基础并作为用于教导本领域技术人员以实际上任何适当的详细结构不同地使用本发明的代表性基础。
在本说明书中，术语“近侧”通常用于指代装置的更靠近临床医生的部分，而术语“远侧”通常用于指代装置的更远离临床医生的部分。此外，术语“内窥镜”通常用于指内窥镜、腹腔镜、关节镜和/或通过小直径切口或套管进行的任何其它手术。此外，术语“临床医生”通常用于指代医务人员，包含医生、护士和辅助人员。还应理解，所有空间参考(例如，水平的、垂直的、顶部、上部、下部、底部、左和右)仅用于说明性目的，并且可在本公开的范围内变化。例如，参考“上部”和“下部”是相对的并且仅在另一者的语境中使用，并且不一定是“上级”和“下级”。
参考图1，当前公开的具有可独立移动钳口的缝合装置总体上示为缝合装置10，并且包含手柄组件12、细长主体14和工具组件16。手柄组件12包含固定手柄18、夹紧触发器20和击发触发器22。细长主体14从手柄组件12向远侧延伸，并且包含限定安装构件25(图2)的远侧部分24以及近侧部分26。近侧部分26固定到手柄组件12，而远侧部分24支撑工具组件16。尽管将手柄组件12示为手动致动装置，但是可以设想，缝合装置10可以例如利用电动机来电致动或联接到机器人系统。在实施例中，固定手柄18和细长主体14由一体的半部28a和28b(图3)形成。半部28a和28b可以使用螺钉29固定在一起。替代地，可以使用其它固定技术将半部28a和28b固定在一起。
参考图2到4，工具组件16包含固定钳口30、底部钳口32和顶部钳口34。固定钳口30包含壳体36和从壳体36向远侧延伸并牢固地固定到壳体36的组织板38。壳体36具有由后壁40和间隔开的侧壁42限定的盒状构造。每个间隔开的侧壁限定了沿着壳体36的长度延伸的线性槽44。壳体36包含限定开口36a的远侧部分，所述开口接收枢转构件46，所述枢转构件设置成将顶部钳口和底部钳口32和34联接到固定钳口30，如下文进一步详细描述的。在实施例中，组织板38包含远侧指状件48，所述远侧指状件彼此间隔开以限定狭槽50，所述狭槽的尺寸设计成便于缝钉52通过。
固定钳口30的壳体36的后壁40牢固地接收在形成于细长主体14的安装构件25中的第一切口56内。在实施例中，固定钳口30的后壁40使用螺钉58牢固地固定在安装构件25的第一切口56内。替代地，可以使用其它紧固技术将固定钳口30固定到细长主体14的远侧部分24上的安装构件25。
顶部钳口34包含主体62和盖64。主体62限定缝钉接收器66和从主体62向近侧延伸的间隔开的凸缘68。缝钉接收器66的尺寸设计成接收多个缝钉52。盖64使用枢转构件70可枢转地支撑在主体62上，使得盖64可以枢转以打开或关闭接收器66。每个间隔开的凸缘68限定弯曲的或非线性的凸轮槽74，这将在下文进一步详细描述。主体62限定孔72，所述孔接收枢转构件46以将顶部钳口34可枢转地固定到固定钳口30。
在实施例中，接收器66的下部由板76(图4)覆盖，所述板固定到顶部钳口34的主体62。板76与顶部钳口34的远端间隔开以限定狭槽80。狭槽80与接收器66连通，并且与多个缝钉52中的最远侧缝钉52a(图4)以及与固定钳口30的组织板38中的狭槽50对准，以允许缝钉52从接收器66中弹出并通过狭槽50弹向底部钳口32。
在一些实施例中，顶部钳口34的主体62限定通孔84，所述通孔接收偏置构件86，所述偏置构件被定位成将多个缝钉52朝接收器66的远侧部分推动，使得最远侧缝钉52a(图4)与顶部钳口34中的狭槽80对准。主体62还限定了通道88，所述通道从主体的近侧部分向远侧延伸，并在最远侧缝钉52a上方的位置处与接收器66连通(图9)。通道88在狭槽80上方的位置朝固定钳口30向下弯曲。
工具组件16包含缝钉推动器92，所述缝钉推动器包含位于顶部钳口34的通道88内的远侧部分和联接到击发杆94的近侧部分。缝钉推动器92大体上是平坦的，并且由柔性材料形成，以促进缝钉推动器92移动通过顶部钳口34的通道88。缝钉推动器92可从缩回位置(图14)移动到前进位置，以将最远侧缝钉52a(图4)从顶部钳口34弹出。当缝钉推动器92处于缩回位置时，缝钉推动器92的远端位于最远侧缝钉52a的反向间隔53附近(图14)。当缝钉推动器92处于前进位置时，缝钉推动器92的远端位于顶部钳口34中的狭槽80附近，以将最远侧缝钉52a从顶部钳口34的接收器66通过狭槽80(图14)弹出。
工具组件16还包含铰链引导件100，所述铰链引导件包含主体102，所述主体具有包含枢轴销104的远侧部分以及包含近侧延伸部106的近侧部分。主体102限定接收缝钉推动器92的贯穿通道108(图4)。枢轴销104被接收在形成于顶部钳口34的间隔开的凸缘68中的U形凹口110内，并且近侧延伸部106位于形成于细长主体14的安装构件25中的第二切口112(图3A)内。第二切口112与形成于安装构件25中的通道112a连通，所述通道接收缝钉推动器的近侧部分。第二切口112的尺寸设计成便于铰链引导件100的枢转移动。更具体地，当顶部钳口34在夹紧位置(图14)与打开位置(图9)之间移动时，第二切口112的尺寸设计成当顶部钳口34在打开位置与夹紧位置之间移动时允许铰链引导件100的近侧延伸部106随顶部钳口34枢转。
底部钳口32包含主体116，所述主体具有组织板118，所述组织板限定与顶部钳口34中的狭槽80对准的远侧狭槽120。在实施例中，主体116限定接收多个缝钉保持器126的腔124(图9)。缝钉保持器126被构造成接合缝钉52的支腿以将缝钉52固定到组织“T”(图9)。最远侧缝钉保持器126a与底部钳口32中的狭槽120对准，使得当顶部钳口34和底部钳口32处于夹紧位置并且缝合装置10被击发时，如下面详细描述的，最远侧缝钉52a接合最远侧缝钉保持器126a以将缝钉52a和缝钉保持器126a固定到组织。还可以设想，顶部钳口34可以支撑传统的缝钉，并且底部钳口可以限定砧板，所述砧板被定位且构造成接收缝钉并使其变形为预定构造，例如B形。
底部钳口32的主体116具有底部，所述底部限定开口130，所述开口位于与组织板118相对的位置，并提供通向由底部钳口32限定的腔124的通道。开口130由板132覆盖，以将缝钉保持器126保持在腔124内。偏置构件134在近侧定位在腔124内，以将缝钉保持器126推向腔124的远端，从而将最远侧缝钉保持器定位成与底部钳口32的组织板118中的狭槽120对准。
底部钳口32包含具有间隔开的直立凸缘138的近侧部分。每个直立凸缘138限定弯曲的或非线性的凸轮槽140，这将在下文详细描述。底部钳口32的每个凸缘138限定孔142，所述孔接收枢转构件46以将底部钳口32固定至固定钳口30和顶部钳口34，使得顶部钳口34和底部钳口32可以相对于固定钳口30在打开位置与夹紧位置之间独立地枢转。
缝合装置10包含致动器150，所述致动器可在工具组件16内的前进位置与缩回位置之间移动，以使顶部钳口34和底部钳口32在打开位置与夹紧位置之间移动。在实施例中，致动器包含凸轮构件152，所述凸轮构件支撑在固定钳口30的壳体36的线性槽44之间，以在前进位置与缩回位置之间移动。凸轮构件152包含指状件154，所述指状件延伸到顶部钳口34的凸轮槽74和底部钳口32的凸轮槽140中。固定钳口30中的线性槽44将致动器150的移动限制为线性移动。因此，当指状件154移动通过凸轮槽74和140时，顶部钳口34和底部钳口32在打开位置与夹紧位置之间枢转。凸轮槽74和140被构造成使得致动器150在固定钳口30的线性槽44内从前进位置到中间位置的移动能使底部钳口32从打开位置移动到夹紧位置，而顶部钳口34相对于固定钳口30保持固定，并且致动器150从中间位置到缩回位置的移动能使顶部钳口34从打开位置移动到夹紧位置，而底部钳口32保持在夹紧位置。
致动器150联接到夹紧杆160，所述夹紧杆通过细长主体14从手柄组件12延伸到工具组件16。在实施例中，夹紧杆160具有固定到致动器150的近端的远侧部分。夹紧杆160如下文进一步详细描述的那样联接到手柄组件12，并且可在前进位置与缩回位置之间移动以使致动器在其前进位置与缩回位置之间移动。
参考图5到8，夹紧触发器20包含主体162，所述主体围绕枢转构件164可枢转地支撑在半部28a与28b之间。主体162限定通道166，所述通道接收夹紧杆160的接合部分168。当夹紧触发器20在非致动位置与致动位置之间移动时，通道166被构造成使得夹紧杆160在其前进位置与缩回位置之间移动，以使致动器150在其前进位置与缩回位置之间移动。主体162包含第一抓握环170和第二抓握环172。当临床医生抓握第一抓握环170并将夹紧触发器20拉向固定手柄18时，夹紧杆160和致动器150从其前进位置缩回到其中间位置，以使底部钳口34从打开位置(图6)移动到夹紧位置(图12)。当临床医生抓握第二抓握环172并将夹紧触发器20进一步拉向固定手柄18时，夹紧杆160和致动器150从其中间位置缩回到其缩回位置，以使所述顶部钳口34从打开位置移动到关闭位置。
击发触发器22包含主体180，所述主体围绕枢转构件182(图10)可枢转地支撑在半部28a与28b之间。主体180限定通道184，所述通道接收击发杆94的接合部分186。当击发触发器22在非致动位置与致动位置之间移向固定手柄18时，通道184被构造成使得击发杆94在缩回位置与前进位置之间移动，以使缝钉推动器92在其缩回位置与前进位置之间移动。如上所述，当缝钉推动器92从其缩回位置移动到其前进位置时，缝钉推动器92的远端与顶部钳口34中的最远侧缝钉52a接合，以驱动最远侧缝钉52a从接收器66穿过顶部钳口34中的狭槽80、穿过固定钳口30中的狭槽50以及穿过底部钳口32中的狭槽120与最远侧缝钉保持器126a接合，从而将缝钉52a固定到组织“T”(图9)。
参考图8，夹紧触发器20包含锁定构件190(图8)。当夹紧触发器20处于与固定手柄18间隔开的非致动位置时，锁定构件190被定位成阻止击发杆94的接合部分186前进，以防止当顶部钳口34和底部钳口32处于打开位置时缝合装置10击发。当夹紧触发器20被致动时，即朝向固定手柄18枢转时，锁定构件190移动到击发杆94的接合部分186可以穿过锁定构件190的位置。在实施例中，锁定构件190包含平面192，当夹紧触发器20被完全致动时，所述平面旋转成与击发杆94的接合部分186对准以促进击发杆94的前进从而击发最远侧缝钉52。因此，直到使夹紧触发器20移动到完全致动位置并且顶部钳口34和底部钳口32处于夹紧位置才能击发缝合装置10(图14)。
参考图9和10，当夹紧触发器20处于图8所示的非致动位置时，顶部钳口34和底部钳口32处于与固定钳口30间隔开的其打开位置。另外，凸轮构件152的指状件154分别位于顶部钳口34和底部钳口32的凸轮槽74和140的远端。如上所述，夹紧触发器20上的锁定构件190防止击发触发器22的致动，直到顶部钳口34和底部钳口32移动到其夹紧位置为止。因此，当夹紧触发器20处于其未致动位置时，缝钉推动器92锁定在其缩回位置。
参考图11和12，当临床医生“C”抓握夹紧触发器20的第一抓握环170并使夹紧触发器20在图11中的箭头“A”所示的方向上朝固定手柄18从非致动位置(图6)枢转到中间或部分致动位置时，夹紧杆160在箭头“B”所示的方向上从其前进位置(图9)缩回到其中间位置，以使致动器150从其前进位置缩回到其中间位置。当致动器150朝其中间位置向近侧移动时，致动器150的指状件154移动通过顶部钳口34和底部钳口32的凸轮槽74和140以使底部钳口32在箭头“C”所示的方向上从打开位置枢转到夹紧位置。如图所示，致动器150从其前进位置到其中间位置的移动不会引起顶部钳口34相对于固定钳口30的任何实质性移动。在中间位置，指状件154位于凸轮槽74和140的中央部分。
参考图13和14，当临床医生“C”抓握夹紧触发器20的第二环172并将夹紧触发器20在图13中的箭头“D”所示的方向上朝固定手柄18枢转时，夹紧杆160在箭头“E”所示的方向上从其中间位置(图12)缩回到其缩回位置，以使致动器150从其中间位置缩回到其缩回位置。当致动器150向近侧移向其缩回位置时，致动器150的指状件154进一步移动通过顶部钳口34和底部钳口32的凸轮槽74和140，以使顶部钳口32在箭头“F”所示的方向上从打开位置枢转到夹紧位置。如上所述，随着顶部钳口34移动到夹紧位置，底部钳口保持在夹紧位置。
参考图12和14，提供可相对于固定钳口30在打开与夹紧位置之间独立地移动的两个钳口32和34能使临床医生使用抓紧器将第一组织切片“T1”相对于第二组织切片“T2”移动以促进所述组织切片的结合。更具体地，当待结合的两个组织切片“T1”和“T2”彼此间隔开时，第一组织切片“T1”可夹在底部钳口32与固定钳口30之间，并被拉向或移向第二组织切片“T2”。当第一组织切片“T1”重新定位在第二组织切片“T2”附近时，第二组织切片“T2”可以夹在顶部钳口34与固定钳口30之间。如图14所示，当组织切片“T1”和“T2”都被夹在底部钳口32和顶部钳口34与固定钳口30之间时，可以致动击发触发器22以缝合组织切片“T1”和“T2”，如下所述。
参考图15和16，当如上所述通过使夹紧触发器20在箭头“A”(图11)的方向上移动而完全致动夹紧触发器20时，锁定构件190(图16)移动而脱离击发杆94的接合部分186。这样，可以致动击发触发器22以使击发杆94从缩回位置前进到前进位置。
参考图17和18，当击发触发器22在图17中的箭头“G”所示的方向上从非致动位置朝致动位置枢转时，击发杆94的接合部分186被向远侧驱动，以使击发杆94在图17中的箭头“H”所示的方向上从缩回位置移向前进位置。当击发杆94移向其前进位置时，缝钉推动器92在箭头“I”所示的方向上移向其前进位置，并移动通过通道88。通道88的远端朝最远侧缝钉52a向下延伸。缝钉推动器92接合缝钉52a并驱动缝钉52a从顶部钳口34的接收器66穿过顶部钳口34中的狭槽80、穿过组织切片“T1”和“T2”以及穿过底部钳口32中的狭槽120与最远侧缝钉保持器126接合，以将缝钉52a固定到组织切片“T1”和“T2”，并将组织切片“T1”和“T2”固定在一起。
在缝合装置10被击发之后，触发器20和22可以返回到未致动位置，并且缝合装置10可以用于执行新的外科手术或完成所执行的外科手术。如本领域中已知的，这可以手动地或使用弹簧来完成。应注意，在将最远侧缝钉52a和最远侧缝钉保持器126a固定到组织切片“T1”和“T2”之后，偏置构件86和134向远侧推动多个缝钉52和多个缝钉保持器126，以重新定位多个缝钉52和多个缝钉保持器126分别与顶部钳口34和底部钳口32的狭槽80和120对准，以便于重新击发缝合装置10。
本领域技术人员将理解，本文中具体描述并且在附图中说明的装置和方法为非限制性示例性实施例。可以设想，在不脱离本公开的范围的情况下，结合一个示例性实施例说明或描述的元件和特征可与另一个实施例的元件和特征组合。同样，本领域技术人员将基于上述实施例理解本发明的其它特征和优点。因此，除了由所附权利要求指示之外，本公开不受已特别示出和描述的内容限制。
Claims (11)
1.一种外科缝合装置，其包括：
细长主体，所述细长主体具有远侧部分和近侧部分；
工具组件，所述工具组件支撑在所述细长主体的所述远侧部分上，所述工具组件包含固定钳口、位于所述固定钳口的一侧上的顶部钳口和位于所述固定钳口的相对侧上的底部钳口，所述顶部钳口能相对于所述固定钳口独立于所述底部钳口在打开位置与夹紧位置之间移动，并且所述底部钳口能相对于所述固定钳口独立于所述顶部钳口在打开位置与夹紧位置之间移动；
能操作地与所述顶部钳口相关联的致动器，所述致动器能从前进位置移向缩回位置以使所述顶部钳口从所述打开位置移动到所述夹紧位置；以及
具有连接到所述致动器的远侧部分的夹紧杆，所述夹紧杆能从前进位置移动到缩回位置以使所述致动器从所述前进位置移动到所述缩回位置。
2.根据权利要求1所述的外科缝合装置，其中所述顶部钳口支撑多个缝钉。
3.根据权利要求2所述的外科缝合装置，其进一步包含在所述顶部钳口内延伸的缝钉推动器，所述缝钉推动器能移动以将所述多个缝钉中的最远侧缝钉从所述顶部钳口弹向所述底部钳口。
4.根据权利要求3所述的外科缝合装置，其中所述底部钳口支撑多个缝钉保持器，所述多个缝钉保持器中的每一个能与所述多个缝钉中的相应一个接合，以将所述多个缝钉中的每一个固定到组织。
5.根据权利要求1所述的外科缝合装置，其中所述致动器能操作地与所述底部钳口相关联，并且所述致动器能移动以使所述底部钳口从所述打开位置移动到所述夹紧位置。
6.根据权利要求5所述的外科缝合装置，其中所述顶部钳口包含第一凸轮槽，所述底部钳口包含第二凸轮槽，并且所述致动器包含凸轮构件，所述凸轮构件能在所述第一凸轮槽和所述第二凸轮槽内移动以使所述顶部钳口和所述底部钳口从所述打开位置移动到所述夹紧位置。
7.根据权利要求6所述的外科缝合装置，其中所述第一凸轮槽和所述第二凸轮槽被构造成使得所述致动器从所述前进位置到中间位置的移动能使所述顶部钳口从所述打开位置移动到所述夹紧位置，并且所述致动器从所述中间位置到所述缩回位置的移动能使所述底部钳口从所述打开位置移动到所述夹紧位置。
8.根据权利要求7所述的外科缝合装置，其进一步包含具有夹紧触发器的手柄组件，所述夹紧触发器通过夹紧杆连接到所述致动器，所述夹紧触发器能从非致动位置枢转到部分致动位置以使所述顶部钳口从所述打开位置移动到所述夹紧位置，并且能从所述部分致动位置枢转到完全致动位置以使所述底部钳口从所述打开位置移动到所述夹紧位置。
9.根据权利要求8所述的外科缝合装置，其进一步包含在所述顶部钳口内延伸的缝钉推动器，所述缝钉推动器能从缩回位置移动到前进位置，以将所述多个缝钉中的一个从所述顶部钳口弹向所述底部钳口。
10.根据权利要求9所述的外科缝合装置，其中所述手柄组件包含击发触发器，所述击发触发器通过击发杆连接到所述缝钉推动器，其中所述击发触发器能从非致动位置移动到致动位置，以使所述缝钉推动器从所述缩回位置移动到所述前进位置。
11.根据权利要求10所述的外科缝合装置，其中所述夹紧触发器包含锁定构件，所述锁定构件被定位成防止所述击发杆前进，直到所述夹紧触发器移动到所述完全致动位置为止。
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| US62/811,925 | 2019-02-28 | ||
| US16/777,980 US11344297B2 (en) | 2019-02-28 | 2020-01-31 | Surgical stapling device with independently movable jaws |
| US16/777,980 | 2020-01-31 |
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| DE102021201311A1 (de) | 2021-02-11 | 2022-08-11 | Aesculap Ag | Chirurgisches Instrument, Werkzeugeinrichtung für ein solches chirurgisches Instrument und Verfahren zur Herstellung einer solchen Werkzeugeinrichtung |
| CN117083024A (zh) * | 2022-08-31 | 2023-11-17 | 宁波新跃医疗科技股份有限公司 | 插入式组织夹闭装置及其运动控制组件 |
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| EP3701883A1 (en) | 2020-09-02 |
| CN111616762A (zh) | 2020-09-04 |
| US20200275923A1 (en) | 2020-09-03 |
| US11344297B2 (en) | 2022-05-31 |
| EP3701883B1 (en) | 2023-10-04 |
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