CN111631773A - 用于圆形缝合装置的重新装载组件 - Google Patents
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Abstract
一种重新装载组件包含外壳壳体、刀架和单向套环。刀架围绕外壳壳体的内壳体部分可移动地定位在缩回位置和前进位置之间，并且支撑卡环。响应于刀架从其缩回位置向其前进位置的移动，单向套环围绕外壳壳体的内壳体部分从缩回位置运动至前进位置。当单向套环处于其前进位置时，卡环可与刀架一起移动至单向套环的近端的位置，以阻止刀架移回其前进位置。
Description
技术领域
本公开涉及圆形缝合装置，并且更具体地说，涉及用于圆形缝合装置的重新装载组件，其具有用以在击发缝合装置之后将刀架保持在缩回位置中的结构。
背景技术
常规的圆形缝合装置包含细长主体和支撑在细长主体的远端部分上的外壳或重新装载组件。所述重新装载组件包含外壳壳体、支撑在所述外壳壳体上的具有多个缝钉的钉仓、推进器组件、限定圆柱形空腔的刀和支撑所述刀的刀架。所述推进器组件包含环形推进器和缝钉推进构件，所述缝钉推进构件与环形推进器接合且可移动以移动缝钉推进构件以从所述钉仓弹出缝钉。所述刀架可移动以使刀通过钉仓前进到核心组织。
在缝合装置已经用于缝合且切割组织之后，刀架和刀缩回以将刀撤回到外壳壳体中。这有两个目的。第一个目的在于将刀移动到一位置以允许从由刀限定的空腔内移出组织圆环。第二个目的在于将刀定位在凹陷在外壳壳体内的位置中以避免临床医生在操纵和安置重新装载组件期间受伤。
在一些情况下，将组织圆环在由刀限定的空腔内压缩到一定程度使得难以从由刀限定的空腔内移出组织圆环。本领域中始终需要包含经过改进的用于将刀/刀架保持在缩回位置中的结构的重新装载组件。
发明内容
本公开的一个方面涉及一种重新装载组件，其包含外壳壳体、钉仓、推进器、刀架、和单向套环。外壳壳体包含内壳体部分和外壳体部分。内壳体部分具有限定环形凹槽的外表面。钉仓支撑在壳体的远端部分上。钉仓具有多个钉凹座，每个钉凹座接收钉。推动器支撑在环形空腔内，并可在缩回位置与前进位置之间移动，以从钉仓中弹出钉。所述刀架包含限定纵向轴线和支撑刀的主体。刀架的主体限定中心孔。外壳壳体的内壳体部分定位在刀架的中心孔内，使得刀架可围绕外壳壳体的内壳体部分在前进位置与缩回位置之间移动。弹性卡环轴向固定在刀架的中心孔内。单向套环可响应于刀架从其前进位置向其缩回位置的运动而在外壳壳体的内壳体部分的环形凹槽内从缩回位置运动至前进位置。当单向套环处于其前进位置时，卡环可移动至单向套环的近端位置，以阻止刀架向其前进位置运动。
本公开的另一方面涉及一种圆形缝合装置，其包含细长主体和重新装载组件。细长主体具有近端部分和远端部分。所述重新装载组件支撑在细长主体的远端部分上并且包含外壳壳体、钉仓、推进器、刀架、和单向套环。外壳壳体包含内壳体部分和外壳体部分。内壳体部分具有限定环形凹槽的外表面。钉仓支撑在壳体的远端部分上。钉仓具有多个钉凹座，每个钉凹座接收钉。推动器支撑在环形空腔内，并可在缩回位置与前进位置之间移动，以从钉仓中弹出钉。所述刀架包含限定纵向轴线和支撑刀的主体。刀架的主体限定中心孔。外壳壳体的内壳体部分定位在刀架的中心孔内，使得刀架可围绕外壳壳体的内壳体部分在前进位置与缩回位置之间移动。弹性卡环轴向固定在刀架的中心孔内。单向套环可响应于刀架从其前进位置向其缩回位置的运动而在外壳壳体的内壳体部分的环形凹槽内从缩回位置运动至前进位置。当单向套环处于其前进位置时，卡环可移动至单向套环的近端位置，以阻止刀架向其前进位置运动。
在实施例中，单向套环具有限定保持槽的外表面，并且当刀架和单向套环处于其缩回位置时，弹性卡环被容纳在保持槽内。
在一些实施例中，当刀架从其前进位置移动到其缩回位置时，卡环和单向套环之间的接合导致单向套环从其缩回位置运动到其前进位置。
在某些实施例中，保持槽具有半圆形构造。
在实施例中，单向套环包括具有至少一个定向柄脚的主体，该定向柄脚被构造成防止单向套环绕外壳壳体的内壳体部分向近侧运动。
在一些实施例中，至少一个定向柄脚中的每个都包括悬臂，该悬臂的远端固定到单向套环的主体。
在某些实施例中，单向套环限定通孔，并且至少一个定向柄脚中的每一个的悬臂包括近侧边缘，该近侧边缘朝单向套环的通孔偏置以与外壳壳体的内壳体部分接合。
在实施例中，至少一个定向柄脚包括多个定向柄脚。
在一些实施例中，环形凹槽具有近端和远端，并且外壳壳体的内壳体部分在环形凹槽的远端处限定了止动表面，其中止动构件被定位成与单向套环接合，以防止单向套环向止动表面的远端移动。
在某些实施例中，单向套环包括限定止动表面的近端，该止动表面被定位成当单向套环处于前进位置并且刀架处于其缩回位置时与卡环接合以防止刀架再次前进。
在一些实施例中，圆形缝合装置包含手柄组件。
在一些在实施例中，细长主体适于联接到机器人式控制的手术系统。
附图说明
本文结合附图对本发明公开的重新装载组件的各种实施例进行了描述，附图中：
图1是根据本公开的包含本发明公开的重新装载组件的示范性实施例的圆形缝合装置的侧透视图；
图2是图1的重新装载组件的侧透视图；
图3是图2的重新装载组件的分解侧视图；
图4为图3所示的细节指示区域的放大视图；
图5是图3所示的重新装载组件的外壳壳体的侧视截面图，其中刀架的卡环与刀架分开；
图6是图3所示的重新装载组件的刀架的侧视截面图；
图7是沿图2的截面线7-7截取的横截面视图；
图8是图7中所示细节的指定区域的放大视图，其中重新装载组件处于击发前位置；
图9是当刀架在重新装载组件的击发行程中开始从其缩回位置向前进位置移动时图7所示的细节的指定区域的放大视图；
图10是当刀架在重新装载组件的击发行程中进一步向其前进位置移动时图7所示的细节的指定区域的放大视图；
图11是在重新装载组件的击发行程中刀架和刀处于其前进位置的重新装载组件的侧视横截面图；
图12是刀架在重新装载组件的击发行程中处于其前进位置时图11所示的细节的指定区域的放大视图；
图13是当刀架在重新装载组件的击发行程中开始从其前进位置移动回其缩回位置时图11所示的细节的指定区域的放大视图；
图14是当刀架在重新装载组件的击发行程中进一步移动回其缩回位置时图11所示的细节的指定区域的放大视图；
图15是在重新装载组件的击发行程之后刀架和刀处于其缩回位置的重新装载组件的侧视横截面图；和
图16是图16所示细节的指定区域的放大视图，其中重新装载组件处于其击发后位置。
具体实施方式
本文结合附图对本发明所公开的重新装载组件加以详细描述，其中在几个视图中的每一个中，相同的附图标记表示相同或相应的元件。然而，应当理解的是，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。
图1和2示出圆形缝合装置10，其包含大体上示出为重新装载组件100的本发明所公开的重新装载组件的示范性实施例。缝合装置10包含柄部组件12、细长主体或适配器组件14、重新装载组件100和砧座组件18，所述砧座组件18经过支撑以用于相对于重新装载组件100在间隔开的位置与合拢位置之间移动，如本领域中已知。重新装载组件100包含近侧部分102(图1)，所述近侧部分102以可拆卸方式连接到细长主体14的远侧部分14a。柄部组件12包含固定把手22，其支撑用于控制缝合装置10的各种功能的操作的致动按钮24，所述操作包含重新装载组件100和砧座组件18的接近，或者从重新装载组件100击发钉和切割组织或取出组织的核心。
缝合装置10被示出为电力驱动缝合装置，包含可支持一个或多个电池(未示出)的电力驱动柄部组件12。细长主体14呈适配器组件的形式，其将功率从手柄组件12分别转移到重新装载组件100和砧座组件18。电动缝合装置的实例可以在美国专利第9,055,943号(‘943专利)、第9,023,014号(‘014专利)以及美国公开案第2018/0125495号和第2017/0340351号中找到，其全部内容通过引用并入本文。可选地，可以设想，本发明还可以并入到例如在美国专利第7,303,106号(‘106专利)中公开的手动缝合装置中，或者并入到配置为与例如在美国专利第9,962,159号(‘159专利)中公开的不包括手柄组件的机器人系统一起使用的缝合装置中。‘106和‘159专利也全文通过引用并入本文。
参照图3，重新装载组件100包括外壳壳体110、单向套环112、刀架114、支撑在刀架114上的环形刀具116、钉仓118、支撑在钉仓118内的多个钉120、环形推动器128和钉推动构件130。钉仓118为环形的，并限定钉凹座124的环形行。每个钉凹座124支撑多个钉120中的一个。环形推动器128和钉推动构件130限定纵向通孔132。推动器128具有邻接缝合钉推动构件130的近端部分的远端部分，使得推动器128在外壳壳体110内的远端运动导致缝合钉推动构件130的远端运动。重新装载装置100的钉推动构件130具有多个指形件134。多个指形件134中的每一个接收在钉仓118的相应钉凹座124并移动通过其中，以便在钉推动构件130从缩回位置移动到外壳壳体110内的前进位置时从钉凹座124中弹出钉120。
外壳壳体110包含外壳体部分140和内壳体部分142，其彼此间隔开以在内壳体部分142与外壳体部分140之间限定环形空腔144。环形推动器128、推动构件130、刀架114和环形刀具116可在壳体110的环形空腔144内在缩回位置与前进位置之间移动。环形推动器128和推动构件130可独立于刀架114和环形刀116移动，以从钉仓118弹出钉120。环形刀116支撑在刀架114的外表面周围，且限定圆柱形空腔117和远侧切割边缘117a。在实施例中，刀116包含突出部116a(图3)，其收纳在刀架114中的开口117c中以将刀116紧固在刀架114周围。或者，可以使用其它紧固技术将刀116固定到刀架114上。在环形推动器128和推动构件130从其缩回位置移动到其前进位置之后，刀架114可从其缩回位置移动到其前进位置，以使刀116前进以切割定位在钉仓118径向内侧的组织。
外壳壳体110的内壳体部分142限定通孔150(图3)，其收纳砧座组件18的砧座轴(未示出)。对于示范性砧座组件18的更详细描述，参见例如‘106专利。通孔150具有收纳衬套152的近端部分，所述衬套限定通孔150a，所述通孔150a是同轴的并形成内壳体部分142的通孔150的延伸。在实施例中，衬套152由金属等高强度材料构成，以向外壳壳体110的内壳体部分142提供增大的强度。外壳壳体110的内壳体部分142包括限定环形凹槽159的外表面，该环形凹槽具有由止动表面159a限定的远端，这将在下面进一步详细讨论。
外壳壳体110包含支撑联接机构160(图2)的近端部分158(图3)，所述联接机构可用于以可拆卸方式将重新装载组件100联接到缝合装置10(图1)的适配器组件14以促进替换重新装载组件100和重新使用缝合装置10。连接机构160包含保持构件162和连接构件164。联接构件164收纳在外壳壳体110的近端部分158周围，且配置成接合适配器组件14的远端部分114a(图1)以将适配器组件14联接到重新装载组件100。可以设想，可以使用其它连接机构将重新装载组件100固定到适配器14上。
重新装载组件100可包含支撑在外壳壳体110上的可擦除可编程只读存储器支撑器170(图3)，以支撑可擦除可编程只读存储器(未示出)。如本领域中已知，可擦除可编程只读存储器与适配器组件14通信以向适配器组件14和手柄组件12提供与重新装载组件10的特性有关的信息。
参照图4和5，单向套环112包括主体180(图4)，其限定了纵向轴线“Z”(图4)和通孔182，并且被容纳在壳体组件110的内壳体部分142周围的环形凹槽159中。主体180包括至少一个定向柄脚184，该定向柄脚被配置为允许单向套环112在环形凹槽159内向远侧运动，而在环形凹槽159内不向近侧运动。在实施例中，每个定向柄脚184包括悬臂186，悬臂186包括固定至单向套环112的主体180的远端和位于通孔182内的近端。每个定向柄脚184限定轴线，该轴线与单向套环112的主体180的纵向轴线“Z”限定锐角。每个定向柄脚184的近端包括与内壳体部分142接合的边缘188，以防止单向套环112围绕外壳壳体110的内壳体部分142向近侧运动。
单向套环112的主体180的近端还限定了环形保持槽190和基本垂直于纵向轴线“Z”的近侧止动表面192。在实施例中，环形保持槽190由弯曲的或渐缩的近端壁和远端壁(图8)限定，并且在下面进一步详细描述。在实施例中，限定环形保持槽190的一个或多个壁的横截面可以是扇形的或半圆形的。
参考图6和7，刀架114限定阶梯式中心孔172并且在其缩回和前进位置之间可移动地位于环形推动器128和推动构件130限定的通孔132内。阶梯式中心孔172包含小直径近侧部分172a和接纳刀116的较大直径远侧部分172b。刀架114的中心孔172的近端部分172a由纵向狭缝178a分开的纵向延伸主体部分173限定，并收纳外壳壳体110的内壳体部分142(图5)，使得刀架114围绕内壳体部分142滑动。
还参考图6和图8，刀架114的内表面194限定了容纳卡环198的环形通道196。卡环198由柔性材料形成并且具有半圆形构造，其第一和第二末端200彼此间隔开以限定空间202(图6)。卡环198的末端之间的空间202有利于卡环198从无偏压状态(图7)变形到偏压状态(图11)，以允许卡环198的外径变化，如下进一步详述。
参考图7和8，当刀架114处于击发前的缩回位置时，卡环198位于单向套环112的环形保持槽190内，而单向套环112位于外壳壳体110的内壳体部分142的环形凹槽159的近侧部分内。在此位置，单向套环的定向柄脚184向内偏置，并通过外壳壳体110的内壳部分142的外表面保持在偏置状态。如图7所示，单向套环112的长度小于环形凹槽159的长度，使得单向套环112可在环形凹槽159内沿着外壳壳体110的内壳体部分142在缩回和前进位置之间移动。卡环198和单向套环112之间的接合将单向套环112保持在缩回位置。
参考图9，在通过致动器组件14的致动使环形推动器128和钉推动构件130前进之后，刀架114沿箭头“A”所示的方向从其缩回位置朝其前进位置前进，以使刀116前进。当刀架114前进时，支撑在刀架114上的卡环198和单向套环112之间的接合最初使单向套环112在由外壳壳体110的内壳体部分142限定的环形凹槽159内向远侧运动，沿箭头“B”指示的方向从其缩回位置到其前进位置。当单向套环112到达其前进位置时，单向套环112的远端与由内壳体部分142限定的止动表面159a接合，以防止单向套环112相对于内部壳体部分142进一步前进。
参考图10-12，当单向套环112的远端接合止动表面159a(图10)时，刀架112独立于单向套环112沿箭头“C”指示的方向继续朝其前进位置移动，以沿图11中箭头“D”所示的方向使刀116前进。当刀架114相对于单向套环112向远侧运动时，卡环198在图10中的箭头“E”所示的方向上向外压缩，因为它从环形保持槽190中移出到偏置状态，其中卡环198沿单向套环112的外表面滑动。
参考图13-16，当刀架114从其前进位置(图12)沿图13中的箭头“F”所示的方向朝向其缩回位置(图15)移回时，卡环198沿着单向套环112的外表面滑动并且穿过单向套环112的环形凹槽159(图13)。卡环198和单向套环112之间的接合不会引起单向套环112朝其缩回位置的近侧运动，因为悬臂186的边缘188被向内偏压成与外壳壳体110的内壳体部分142的外表面接合，以防止单向套环向近侧运动。如图15所示，当刀架114移动到其缩回位置时，卡环198移动到单向套环112的近侧的位置。当发生这种情况时，卡环198返回到其无偏压状态，并向内移动到单向套环112的近侧位置，以阻止刀架114向其前进位置移回。在实施例中，单向套环112的近端限定了基本上垂直于单向套环112的纵向轴线“Z”的止动表面204，并且卡环198包括平坦的远侧面206，其定位成与单向套环112的止动表面204接合以阻止刀架114的前进。
上述结构阻碍了刀架114和刀116的前进，以将刀116安全地保持在重新装载组件100的壳体110内。这最小化了在操作和处置重新装载组件200期间对临床医生造成伤害的风险。
尽管在动力手持器械的背景下描述了当前公开的重新装载，但是应当理解，当前公开的重新装载可以适于与机器人控制的系统以及手动器械一起使用。例如，该重新装载可以与适配器14一起使用，该适配器被配置为联接至机器人控制的手术系统。
本领域的技术人员将理解，在本文中具体地描述且在附图中所说明的装置和方法是非限制性的示例性实施例。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 (20)
1.一种重新装载组件，包括：
外壳壳体，其包括内壳体部分和外部壳体部分，所述内壳体部分具有限定环形凹槽的外表面；
钉仓，其支撑在所述外壳壳体的远侧部分上，所述钉仓具有多个钉凹座，所述钉凹座中的每一个接收钉；
推动器，其支撑在所述环形空腔内，所述推动器能在缩回位置与前进位置之间移动，以从所述钉仓中弹出所述钉；
刀架，其包含限定纵向轴线且支撑刀的主体，所述刀架的所述主体限定中心孔，所述外壳壳体的所述内壳体部分定位在所述刀架的所述中心孔内，使得所述刀架能围绕所述外壳壳体的所述内壳体部分在前进位置与缩回位置之间移动；
弹性卡环，其轴向固定在所述刀架的所述中心孔内；和
单向套环，其可响应于所述刀架从其前进位置向其缩回位置的运动而在所述外壳壳体的所述内壳体部分的所述环形凹槽内从缩回位置运动至前进位置，其中所述卡环当所述单向套环处于其前进位置时可移动到所述单向套环的近端的位置，以阻止所述刀架向其前进位置移回。
2.根据权利要求1所述的重新装载组件，其中所述单向套环具有限定保持槽的外表面，并且当所述刀架和所述单向套环处于其缩回位置时，所述弹性卡环被容纳在所述保持槽内。
3.根据权利要求2所述的重新装载组件，其中当所述刀架从其前进位置移动到其缩回位置时，所述卡环和所述单向套环之间的接合导致所述单向套环从其缩回位置运动到其前进位置。
4.根据权利要求3所述的重新装载组件，其中所述保持槽具有半圆形构造。
5.根据权利要求1所述的重新装载组件，其中所述单向套环包括具有至少一个定向柄脚的主体，所述定向柄脚被构造成防止所述单向套环绕所述外壳壳体的所述内壳体部分向近侧运动。
6.根据权利要求5所述的重新装载组件，其中所述至少一个定向柄脚中的每个都包括悬臂，所述悬臂的远端固定到所述单向套环的主体。
7.根据权利要求6所述的重新装载组件，其中所述单向套环限定通孔，并且所述至少一个定向柄脚中的每一个的所述悬臂包括近侧边缘，所述近侧边缘朝所述单向套环的所述通孔偏置以与所述外壳壳体的所述内壳体部分接合。
8.根据权利要求7所述的重新装载组件，其中所述至少一个定向柄脚包括多个定向柄脚。
9.根据权利要求2所述的重新装载组件，其中所述环形凹槽具有近端和远端，并且所述外壳壳体的所述内壳体部分在所述环形凹槽的远端处限定了止动表面，所述止动构件被定位成与所述单向套环接合，以防止所述单向套环向所述止动表面的远端移动。
10.根据权利要求1所述的重新装载组件，其中所述单向套环包括限定止动表面的近端，所述止动表面被定位成当所述单向套环处于前进位置并且所述刀架处于其缩回位置时与所述卡环接合以防止所述刀架再次前进。
11.一种圆形缝合装置，包括；
细长主体，其具有近端部分和远端部分；和
重新装载组件，其支撑在所述细长主体的所述远端部分上，所述重新装载组件包括：
外壳壳体，其包括内壳体部分和外部壳体部分，所述内壳体部分具有限定环形凹槽的外表面；
钉仓，其支撑在所述外壳壳体的远侧部分上，所述钉仓具有多个钉凹座，所述钉凹座中的每一个接收钉；
推动器，其支撑在所述环形空腔内，所述推动器能在缩回位置与前进位置之间移动，以从所述钉仓中弹出所述钉；
刀架，其包含限定纵向轴线且支撑刀的主体，所述刀架的所述主体限定中心孔，所述外壳壳体的所述内壳体部分定位在所述刀架的所述中心孔内，使得所述刀架能围绕所述外壳壳体的所述内壳体部分在前进位置与缩回位置之间移动；
弹性卡环，其轴向固定在所述刀架的所述中心孔内；和
单向套环，其可响应于所述刀架从其前进位置向其缩回位置的运动而在所述外壳壳体的所述内壳体部分的所述环形凹槽内从缩回位置运动至前进位置，其中所述卡环当所述单向套环处于其前进位置时可移动到所述单向套环的近端的位置，以阻止所述刀架向其前进位置移回。
12.根据权利要求11所述的圆形缝合装置，其中所述单向套环具有限定保持槽的外表面，并且当所述刀架和所述单向套环处于其缩回位置时，所述弹性卡环被容纳在所述保持槽内。
13.根据权利要求12所述的圆形缝合装置，其中当所述刀架从其前进位置移动到其缩回位置时，所述卡环和所述单向套环之间的接合导致所述单向套环从其缩回位置运动到其前进位置。
14.根据权利要求13所述的圆形缝合装置，其中所述保持槽具有半圆形构造。
15.根据权利要求11所述的圆形缝合装置，其中所述单向套环包括具有至少一个定向柄脚的主体，所述定向柄脚被构造成防止所述单向套环绕所述外壳壳体的所述内壳体部分向近侧运动。
16.根据权利要求15所述的圆形缝合装置，其中所述至少一个定向柄脚中的每个都包括悬臂，所述悬臂的远端固定到所述单向套环的主体。
17.根据权利要求16所述的圆形缝合装置，其中所述单向套环限定通孔，并且所述至少一个定向柄脚中的每一个的所述悬臂包括近侧边缘，所述近侧边缘朝所述单向套环的所述通孔偏置以与所述外壳壳体的所述内壳体部分接合。
18.根据权利要求17所述的圆形缝合装置，其中所述至少一个定向柄脚包括多个定向柄脚。
19.根据权利要求18所述的圆形缝合装置，其中所述环形凹槽具有近端和远端，并且所述外壳壳体的所述内壳体部分在所述环形凹槽的远端处限定了止动表面，所述止动构件被定位成与所述单向套环接合，以防止所述单向套环向所述止动表面的远端的远侧移动。
20.根据权利要求11所述的圆形缝合装置，其中所述单向套环包括限定止动表面的近端，所述止动表面被定位成当所述单向套环处于前进位置并且所述刀架处于其缩回位置时与所述卡环接合以防止所述刀架再次前进。
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Also Published As
| Publication number | Publication date |
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| US11331782B2 (en) | 2022-05-17 |
| CN111631773B (zh) | 2024-06-25 |
| US20200276693A1 (en) | 2020-09-03 |
| EP3701886B1 (en) | 2024-04-17 |
| EP3701886A1 (en) | 2020-09-02 |
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| CN114246625A (zh) | 具有椭圆形工具组合件的手术缝合器 |
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