CN111714188B - 包含旋转锁定特征的组织切除器械 - Google Patents
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Abstract
组织切除器械包括末端执行器组件,其具有近侧毂壳体、从其向近侧延伸的保持器盖、从近侧毂壳体向远侧延伸的细长外轴、可旋转地设置在细长外轴内的内切割轴以及包括近侧驱动器和远侧驱动器的内芯驱动组件。远侧驱动器联接到内切割轴,使得远侧驱动器的旋转使内切割轴相对于细长外轴旋转。近侧驱动器可相对于远侧驱动器在较近侧位置和较远侧位置之间滑动,在较近侧位置中,近侧驱动器与保持器盖接合,以旋转地固定近侧驱动器,从而旋转地锁定内切割轴,在较远侧位置中,近侧驱动器与保持器盖脱开,允许其旋转,从而允许内切割轴旋转。
Description
背景技术
1.技术领域
本公开一般涉及组织切除的领域。特别地,本公开涉及一种包括旋转锁定特征的组织切除器械。
2.背景技术
组织切除可以以内窥镜在器官诸如子宫内进行,其是通过插入内窥镜(或宫腔镜)到子宫并使组织切除器械通过内窥镜(或宫腔镜)并进入子宫。关于这种内窥镜组织切除手术,通常希望用流体例如盐水、山梨糖醇或甘氨酸使子宫扩张。手术期间流体的流入和流出将子宫保持在扩张状态,并从子宫内冲洗组织和其他碎片以保持可见的工作空间。
发明内容
如本文中所使用,术语“远侧”是指所描述的更远离使用者的部分,而术语“近侧”是指所描述的更接近使用者的部分。进一步地,在一致性程度上,本文描述的任何或所有方面都可以与本文描述的任何或所有其它方面结合使用。
根据本公开的方面提供一种组织切除器械的末端执行器组件。末端执行器组件包括近侧毂壳体、相对于近侧毂壳体固定并从近侧毂壳体向近侧延伸的保持器盖、相对于近侧毂壳体固定并从近侧毂壳体向远侧延伸的细长外轴、在细长外轴内延伸并相对于细长外轴可旋转的内切割轴、和至少部分地延伸穿过保持器盖和近侧毂壳体的内芯驱动组件。内芯驱动组件包括配置成接收旋转输入的近侧驱动器和旋转地固定并且可相对于近侧驱动器滑动的远侧驱动器。远侧驱动器联接到内切割轴,使得远侧驱动器的旋转使内切割轴相对于细长外轴旋转。近侧驱动器可相对于远侧驱动器在较近侧位置和较远侧位置之间滑动,在较近侧位置中,近侧驱动器与保持器盖接合,以相对于保持器盖旋转地固定近侧驱动器,从而相对于细长外轴旋转地锁定内切割轴,在较远侧位置中,近侧驱动器与保持器盖脱开,以允许近侧驱动器相对于保持器盖旋转,从而允许内切割轴相对于细长外轴旋转。
在本公开的一方面,内芯驱动组件还包括偏置构件,其配置成将近侧驱动器朝着较近侧位置偏置。
在本公开的另一个方面,近侧驱动器包括配置成接收和旋转接合配置成提供旋转输入的驱动转子的面向近侧的空腔。
在仍本发明的另一方面,近侧驱动器和远侧驱动器协作以限定设置成与内切割轴的内部流体连通的流出路径。此外,近侧毂壳体可限定与流出路径流体连通的流出开口。
在又本发明的另一个方面,在较近侧位置,近侧驱动器的凸舌接合在保持器盖的凹口内,以相对于保持器盖可旋转地固定近侧驱动器。
在又本发明的另一个方面,细长外轴在其远侧端部限定窗口。在这样的方面中,在近侧驱动器的较近侧位置中,内切割轴可以相对于细长外轴锁定在闭合位置,其中内切割轴阻挡细长外轴的窗口。
根据本公开的方面还提供一种组织切除器械,其包括手柄组件和末端执行器组件。手柄组件包括手柄壳体、设置在手柄壳体内的电动机以及可操作地联接至电动机并从电动机延伸的驱动转子。末端执行器组件被配置为可释放地接合手柄组件,并且包括近侧毂壳体、相对于近侧毂壳体固定并从近侧毂壳体向近侧延伸的保持器盖、相对于近侧毂壳体固定并从近侧毂壳体向远侧延伸的细长外轴、在细长外轴内延伸并相对于细长外轴可旋转的内切割轴、和至少部分地延伸穿过保持器盖和近侧毂壳体的内芯驱动组件。内芯驱动组件包括近侧驱动器和相对于近侧驱动器旋转固定和可滑动的远侧驱动器,远侧驱动器联接到内切割轴,使得远侧驱动器的旋转使内切割轴相对于细长外轴旋转。最初,近侧驱动器相对于远侧驱动器处于较近侧位置,其中近侧驱动器与保持器盖接合,以相对于保持器盖旋转地固定近侧驱动器,从而相对于细长外轴旋转地锁定内切割轴。在末端执行器组件与手柄组件接合期间,驱动转子与近侧驱动器可操作地接合,并且将近侧驱动器相对于远侧驱动器推动到较远侧位置,其中近侧驱动器与保持器盖脱开,以允许近侧驱动器相对于保持器盖旋转,从而允许内切割轴相对于细长外轴旋转。
在本公开的一方面,内芯驱动组件还包括偏置构件,其配置成将近侧驱动器朝着较近侧位置偏置。在末端执行器组件与手柄组件接合期间,驱动转子抵抗偏置构件的偏置将近侧驱动器推动到较远侧位置。
在本公开的另一个方面中,末端执行器组件包括从近侧毂壳体延伸的接合杆。接合杆配置成机械地接合手柄组件的手柄壳体以使末端执行器组件与手柄组件接合。
在本公开的另一个方面,近侧驱动器包括配置成接收和旋转地接合其中的驱动转子的面向近侧的空腔。在这样的方面中,驱动转子可被配置成在末端执行器组件与手柄组件接合期间与面向近侧的空腔触底,然后将近侧驱动器推动到较远侧位置。
在仍本发明的另一方面,近侧驱动器和远侧驱动器协作以限定设置成与内切割轴的内部流体连通的流出路径。在这样的方面中,近侧毂壳体可以限定流出开口,而手柄壳体可以限定流出端口,其中出流开口和流出端口设置成与流出路径流体连通。
在又本发明的另一个方面,近侧驱动器的凸舌接合在保持器盖的凹口内,以相对于保持器盖可旋转地固定近侧驱动器。
在又本发明的另一个方面,细长外轴在其远侧端部限定窗口。在这样的方面中,在近侧驱动器的较远侧位置中,内切割轴相对于细长外轴锁定在闭合位置,其中内切割轴阻挡细长外轴的窗口。
在本公开的另一个方面中,随着末端执行器组件与手柄组件接合和电动机开启,电动机被配置为驱动所述驱动转子的旋转,从而驱动近侧驱动器和远侧驱动器并因此内切割轴旋转。在这样的方面中,在随后的停用时,电动机被配置为进一步驱动所述驱动转子的旋转,从而驱动近侧驱动器和远侧驱动器和内切割轴旋转回至其起始位置。
附图说明
下文中参考图式描述本公开的各种方面和特征,其中相似的编号在若干视图中的每一个中指定相同或对应元件。
图1A是根据本公开的方面提供的组织切除器械的侧视图,其包括手柄组件和末端执行器组件,其中末端执行器组件的远端部分被放大以更好地示出其特征,并且末端执行器组件的内切割轴被设置在第一位置;
图1B是图1A的末端执行器组件的远端部分的放大侧视图,其中内切割轴设置在第二位置;
图2A是图1A的末端执行器组件的近侧部分的侧视图;
图2B是图2A的末端执行器组件的近侧部分的纵向截面图;
图3是图1A的末端执行器组件的保持器盖的透视图;
图4是图3的保持器盖的侧视图;
图5是沿着图4的截面线“5-5”截取的纵向横截面图;
图6是图1A的末端执行器组件的近侧驱动器的透视图;
图7为沿着图6的截面线“7-7”截取的纵向横截面图;
图8是在末端执行器组件与手柄组件接合之前图1的组织切除器械的一部分的纵向截面图;和
图9是图8的组织切除器械的一部分的纵向截面图,其中末端执行器组件与手柄组件接合。
具体实施方式
一般地参见图1A,根据本公开提供的并且配置用于切除组织的组织切除器械10包括末端执行器组件100和手柄组件200。组织切除器械10适于经由缆线300连接至控制单元(未示出),以向组织切除器械10提供电力和控制功能,尽管组织切除器械10可以替代地或附加地包括与手柄组件200相关联的控件和/或放置在手柄组件200中的电源例如电池。组织切除器械10还适于经由流出管400连接至流体管理系统(未示出),以通过组织切除器械10施加吸力以从手术部位去除流体、组织和碎屑,如下详述。控制单元和流体管理系统可以彼此集成、彼此联接或彼此分离。
组织切除器械10可配置为一次性使用的设备,其在使用后将其丢弃或发送给制造商进行再处理;可重复使用的设备,其能够被清洁和/或消毒以供最终用户重复使用;或部分一次性使用、部分可重复使用的设备。关于部分一次性使用、部分可重复使用的配置,手柄组件200可被配置为可清洁/可消毒的可重复使用的部件,而末端执行器组件100被配置为一次性使用的、一次性/可再处理的部件。在以上任何配置中,末端执行器组件100被配置为可释放地接合手柄组件200,以促进任何一次性部件的处置/再处理以及任何可重复使用部件的清洁和/或灭菌。此外,使末端执行器组件100与手柄组件200可释放地接合允许将不同的末端执行器组件(例如,不同长度、构造等的末端执行器组件)与手柄组件200互换使用。
继续参考图1A,手柄组件200通常包括手柄壳体210,穿过手柄壳体210限定的流出端口220(参见图8和9),设置在手柄壳体210内的电动机250以及驱动转子260,驱动转子260布置在手柄壳体210内并且可操作地联接至电动机250。手柄组件200还可包括一个或多个设置在手柄壳体210上或可操作地与手柄壳体210相关联的控件(未示出),以促进组织切除器械10的激活。此外,流出管400配置成连接至流出端口220,从而将流出端口220连接至流体管理系统(未示出)。流体管理系统包括真空源,以通过组织切除器械10和流出管400建立抽吸,以促进从手术部位清除流体、组织和碎屑,并且还可以包括用于收集清除的流体、组织和碎屑的收集储器,例如收集罐。替代于或附加于通过组织切除器械10和流出管400建立抽吸的真空源,还可以经由手术部位与流出路径之间的压力差在其中产生真空。
手柄壳体210限定了铅笔握持构造,但是也可以设想其他构造,例如,手枪握持构造,并且包括与内部孔214(图8和9)连通的敞开的远端部分212和围绕其敞开的远端部分212设置的远侧毂216。远侧毂216限定环形凹部218,该环形凹部被配置为促进末端执行器组件100与手柄组件200可释放地接合,如下文详述。手柄壳体210的敞开的远端部分212提供通向驱动转子260和手柄壳体210内的内部孔214(图8和9)的通道,从而在末端执行器组件100与手柄组件200接合时,也如下面详述,末端执行器组件100的一部分延伸穿过敞开的远端部分212并进入内部孔214(图8和9),以与驱动转子260可操作地联接并且将末端执行器组件100与内部孔214(图8和9)并因此与流出端口220流动地联接。
缆线300从手柄壳体210向近侧延伸,并且被配置为连接到所述控制单元(未示出),以向组织切除器械10提供电源和控制功能。更具体地,缆线300容纳一根或多根电线310,其延伸到手柄壳体210中并连接到其控件和/或电动机250以为电动机250供电并根据与手柄组件200相关的控件来控制组织切除器械10、控制单元和/或其他远程控制设备例如脚踏开关(未显示)的操作。
驱动转子260可操作地联接电动机250并从其向远侧延伸,使得在电动机250的激活后,电动机250驱动驱动转子260的旋转。驱动转子260限定基部262和从基部262向远侧延伸的转子主体264。转子主体264的至少一部分限定非圆形横截面构造,例如正方形或其他多边形构造,并且配置成在末端执行器组件100与手柄组件200接合之后以相对于其固定的旋转取向至少部分地接收在末端执行器组件100(参见图9)的近侧驱动器152内。这样,电动机250的激活驱动了驱动转子260的旋转,从而继而驱动末端执行器组件100的近侧驱动器152(参见图9)的旋转。
参考图1A-2B,末端执行器组件100包括近侧毂壳体110,与近侧毂壳体110整体形成、固定地接合或以其他方式与其连接并从其远端延伸的细长外轴120,设置在细长外轴120内的内切割轴130,在近侧毂壳体110的近端部分周围接合的保持器盖140,以及内芯驱动组件150。
末端执行器组件100的近侧毂壳体110包括远侧主体部分112和可被彼此整体地形成、接合或以其它方式连接的近侧延伸部分114。在末端执行器组件100与手柄组件200接合的情况下,近侧毂壳体110的近侧延伸部分114延伸到手柄组件200的手柄壳体210的内部孔214(图8和9)中,而远侧主体部分112基本邻接并从手柄组件200的手柄壳体210向远侧延伸。近侧毂壳体110的近侧延伸部分114限定穿过其侧壁的流出开口115,该流出开口115配置成当末端执行器组件100与其接合时与手柄组件200的手柄壳体210的内部孔214流体连通。
接合杆116从近侧毂壳体110延伸。接合杆116包括指状凸舌117a和接合齿117b,接合齿117b设置在活动铰链枢轴117c的相对侧上,使得朝近侧毂壳体110推动指状凸舌117a将接合齿117b推离近侧毂壳体110,反之亦然。
在将末端执行器组件100的近侧毂壳体110的近侧延伸部分114插入到手柄组件200的手柄壳体210的内部孔214(图8和9)中后,接合齿117b配置成凸轮越过手柄组件200的远侧毂216并接合在远侧毂216的环形凹槽218中以使末端执行器组件100和手柄组件200彼此接合。末端执行器组件100与手柄组件200的脱离是通过朝近侧毂壳体110压下指状凸舌117a从而将接合齿117b从环形凹槽218中抽出来实现的。在接合齿117b从环形凹槽218脱离的情况下,末端执行器组件100可以相对于手柄组件200向远侧移动,以从手柄壳体210的内部孔214(图8和9)缩回近侧延伸部分114,从而使末端执行器组件100与手柄组件200脱离。
参考图1A和1B,末端执行器组件100的细长外轴120包括与近侧毂壳体110的远端主体部分112固定地接合的近端部分122(参见例如图2B)。细长外轴120还包括限定闭合的远端126的远端部分124和与闭合的远端126向近侧间隔开的窗口128。窗口128提供进入细长外轴120的内部的通道,并且可以被围绕窗口128的外周的切割边缘129围绕,以便于切割穿过窗口128并进入细长外轴120的组织。
末端执行器组件100的内切割轴130穿过细长外轴120。内切割轴130限定了近端部分132(见图2B)和远端部分134。内切割轴130的近端部分132与内芯驱动组件150可操作地联接,如下文详述(见图2B)。内切割轴130的远端部分134限定闭合的远端136和从闭合的远端136向近侧间隔开的窗口138。窗口138提供进入内切割轴130的内部的通道,并且可以被围绕窗口138的外周的切割边缘139围绕,以便于切割穿过窗口138并进入内切割轴130的组织。
内切割轴130在细长外轴120内并且相对于细长外轴120旋转,从而相对于窗口128转动窗口138。更具体地,内切割轴130被配置为旋转,使得在内切割轴130的旋转运动的至少一部分期间,切割边缘139和窗口138在细长外轴120的窗口128内暴露,从而能够切割与其一起的组织。如下详述,提供抽吸以促进将组织吸入细长外轴120的窗口128和内切割轴130的窗口138中,并因此促进当内切割轴130相对于细长外轴120旋转时延伸进入内切割轴130的组织的切割。所施加的抽吸力还有助于通过内切割轴130去除组织、流体和碎屑,如下文详述。还考虑了协作以促进组织切割的细长外轴120和/或内切割轴130的其他合适的构造,例如内切割轴130相对于细长外轴120的往复运动和旋转。
另外参考图2A-5,保持器盖140连接至近侧毂壳体110的近侧延伸部分114并从其向近侧延伸。保持器盖140可以例如通过限定在近侧延伸部分114内的相应狭槽(未示出)内的保持器盖140的凸舌141(图3-5)的搭扣接合而与近侧延伸部分114接合,可以与近侧毂壳体110的近侧延伸部分114整体形成,或者可以以任何其他合适的方式连接到其上。保持器盖140包括内表面142,该内表面限定了延伸穿过保持器盖140的纵向内腔144。内部套环146从内表面142径向向内突出到纵向内腔144中。内部套环146包括在其中限定的朝远侧的凹口148。
回到图2A和图2B,内部芯驱动组件150可操作地设置在近侧毂壳体110和保持器盖140的至少一部分内,并且配置成可操作地将手柄组件200的驱动转子260(参见图1和9)与内切割轴130联接,以使驱动转子260(图1和9)的旋转驱动内切割轴130在细长外轴120内并相对于细长外轴120旋转。内芯驱动组件150更具体地包括近侧驱动器152、远侧驱动器154和偏置构件156,例如压缩卷簧。在一些实施例中,内芯驱动组件150进一步包括螺纹联接器和凸轮从动件(未示出),其可操作以将驱动转子260(图1和9)的旋转转换成内切割轴130的往复运动,使得内切割轴130响应于驱动转子260的旋转而既旋转又往复运动(见图1和9)。附加地或可替代地,内芯驱动组件150可包括齿轮(未示出),该齿轮配置成相对于来自驱动转子260(图1和图9)的输入旋转放大或减弱内切割轴130的输出旋转。
也参考图6和图7,内芯驱动组件150的近侧驱动器152包括近侧主体部分162和远侧主体部分164,它们可以彼此整体形成、彼此接合或以其他方式彼此连接。近侧主体部分162包括围绕近侧主体部分162环形布置的外部套环166。外部套环166包括沿近侧主体部分162的外表面从其延伸的近侧定向的凸舌168。近侧主体部分162还包括面向近侧的空腔170,其至少一部分具有非圆形横截面构造,例如8点星形或其他多边形构造,其配置成以固定的旋转取向至少部分地接收手柄组件200的驱动转子260(见图9)。远侧主体部分164包括面向远侧的空腔172,其至少一部分具有非圆形的横截面构造,例如矩形或其他多边形构造。穿过远侧主体部分164的侧壁限定的纵向延伸槽173与面向远侧的空腔172连通。
参考图2B,内芯驱动组件150的远侧驱动器154包括近侧主体部分174、远侧主体部分176和分别沿纵向延伸通过近侧主体部分174和远侧主体部分176的内腔178。近侧主体部分174和远侧主体部分176分别可以整体地形成、接合或以其他方式彼此连接。远侧驱动器154进一步包括分别在近侧主体部分174和远侧主体部分176之间围绕其设置的套环180。远侧驱动器154可纵向固定在近侧毂壳体110内并且相对于近侧毂壳体110可旋转。在其他实施例中,例如,在远侧驱动器154向内切割轴130施加往复运动和旋转的情况下,远侧驱动器154可以相对于近侧毂壳体110既可旋转又可往复运动。
内芯驱动组件150的远侧驱动器154的近侧主体部174包括从其向近侧延伸的近侧脚182。近侧脚182限定了与内腔178连通并且沿着近侧脚182的长度敞开的通道183。近侧脚182的至少一部分限定非圆形的横截面构造,例如矩形或其他多边形构造,并且以固定的旋转取向可滑动地容纳在近侧驱动器152的远侧主体部分164的面向远侧的空腔172内,使得近侧和远侧驱动器152、154分别可旋转地彼此联接,但相对于彼此可滑动。更具体地,近侧驱动器152的远侧主体部分164围绕近侧脚182和远侧驱动器154的近侧主体部分174的至少一部分可滑动地设置。
内芯驱动组件150的远侧驱动器154的远侧主体部分176配置为在其中接收并固定接合内切割轴130的近端部分132,从而使内切割轴130的开口近端设置成与远侧驱动器154的内腔178流体连通,并使得远侧驱动器154的旋转实现内切割轴130的类似旋转。
内芯驱动组件150的偏置构件156设置成围绕远侧驱动器154的近侧主体部174。更具体地,偏置构件156绕着远侧驱动器154的近侧主体部分174设置在套环180和近侧驱动器152的远侧主体部分164的远端之间。以这种方式,偏置构件156向近侧偏置近侧驱动器152,使得近侧驱动器152的近侧主体部分162的外套环166的近侧定向的凸舌168被偏置成接合在保持器盖140的内套环146的远侧定向的凹口148内,从而相对于保持器盖140和近侧毂壳体110旋转地固定近侧和远侧驱动器152、154,结果,内部切割刀片130相对于细长外轴130旋转地固定。
转向图8和9,详细描述了末端执行器组件100与手柄组件200的接合,以准备使用组织切除器械10。首先,如上所述,在将末端执行器组件100与手柄组件200接合之前,在偏置构件156的偏置下,将近端定向的凸舌168接合在远端定向的凹口148中,以旋转地固定近侧和远侧驱动器152、154,并因此相对于保持器盖140和近侧毂壳体110固定内切割轴130以及因此固定细长外轴120。暂时参考图1B,末端执行器组件100可以被配置成使得在该偏置的旋转锁定的位置中,细长外轴120和内切割轴130的窗口128、138分别相对于彼此不重叠地设置,对应于内切割轴130的闭合位置。
为了接合末端执行器组件100与手柄组件200,末端执行器组件100通过保持器盖140引导经由手柄组件200的手柄壳体210的敞开的远端部分212向近侧插入并进入内部孔214,如图8所示。参考图9,随着末端执行器组件100进一步向近侧插入内部孔214中,转子主体264被接收在内芯驱动组件150的近侧驱动器152的近侧主体部分162的面向近侧的空腔170内,以将转子主体264旋转地固定在近侧驱动器152内,并且因此相对于远侧驱动器154和内切割轴130固定。
在将末端执行器组件100进一步插入内部孔214中之后,转子主体264进一步插入到面向近侧的空腔170中,直到转子主体264在面向近侧的空腔170内触底。然而,在末端执行器组件100的接合杠杆116的接合齿117b接合在手柄组件200的远侧毂216的环形凹口218内之前,并且因此在末端执行器组件100与手柄组件200接合之前,转子主体264在面向近侧的空腔170内触底。因此,要求末端执行器组件100进一步向近侧移动到内部孔214中,以使末端执行器组件100与手柄组件200接合。结果,在转子主体264在面向近侧的空腔170内触底时,末端执行器组件100的进一步向近侧运动使近侧驱动器152朝远侧穿过并相对于末端执行器组件100的保持器盖140和近侧毂壳体110推动。
在从转子主体264的该推动下近侧驱动器152的远侧运动是克服偏置构件156的偏置而实现的。更具体地,近侧驱动器152向远侧运动,使得近侧驱动器152的远侧主体部分164围绕并相对于远侧驱动器154的近侧脚182和近侧主体部分174滑动,以在近侧驱动器152的远侧主体部分164的远端和套环180之间压缩偏置构件156。
除了压缩偏置构件156之外,近侧驱动器152相对于保持器盖140的远侧运动使近侧驱动器152的近侧主体部分162的外套环166的朝近侧的凸舌168从保持器盖140的内部套环146的朝远侧的凹口148内脱离,从而相对于保持器盖140和近侧毂壳体110旋转地解锁近侧和远侧驱动器152、154,从而相对于细长外轴120从旋转固定的方向(例如闭合位置)解锁内切割轴130。
此外,在末端执行器组件100插入到手柄组件200中以旋转解锁内切割轴130所需的插入深度处或附近,接合杆116的接合齿117b凸轮越过手柄组件200的远侧毂216并在手柄组件200的远侧毂216的环形凹槽218内接合,以使末端执行器组件100和手柄组件200彼此接合。因此,在末端执行器组件100和手柄组件200彼此接合时,内切割轴130被旋转解锁。
继续参考图9,末端执行器组件100和手柄组件200彼此接合下,在内切割轴130的内部、远侧驱动器154的内腔178、远侧驱动器154的近侧脚182的通道183、近侧驱动器152的面向远侧的空腔172、远端主体部分164的纵向延伸槽173、近侧毂壳体110的近侧延伸部分114的内部、近侧毂壳体110的流出开口115、手柄壳体210的内部孔214、流出端口220和流出管400之间建立了流体连通。以这种方式,可以通过流体管理系统的真空源施加抽吸,流出管400连接到该真空管理系统,从而通过末端执行器组件100的内切割轴130建立抽吸以通过其中抽吸组织、流体和碎屑。
一般地参考图1A、1B和9,在如上所述的末端执行器组件100与手柄组件200接合的情况下,组织切除器械10准备好使用。在使用中,手柄组件200的电动机250被启动以驱动驱动转子260的旋转。在启动电动机250时,相对于启动电动机250具有先启或延迟,或者独立于此,通过流出管400并因此通过组织切除器械10,例如,通过激活流体管理系统的真空源,建立吸力。
电动机250的启动将驱动驱动转子260旋转,进而驱动近侧驱动器152旋转,进而驱动远侧驱动器154旋转,从而使内切割轴130相对于细长外轴120旋转。内切割轴130相对于细长外轴120的旋转,连同通过内切割轴130施加的吸力,使得组织能够通过切割窗口128和138被抽吸到内切割轴130中,并与流体和碎屑一起被切割和抽吸,通过组织切除器械10和流出管400向近端到达流体管理系统的收集容器。
当末端执行器组件100与手柄组件200接合时,内切割轴130相对于细长外轴120的旋转位置是已知的,例如,内切割轴130的闭合位置。这是因为在末端执行器组件100与手柄组件200接合之前提供了旋转锁定。因此,在接合时,与电动机250相关联的控制程序(未示出)可以将驱动转子260的旋转位置记录为原始位置,并且在激活之后,确保驱动转子260停止在与内切割轴130相对于细长外轴120的闭合位置相对应的旋转位置。
控制程序可以利用相关信息,例如将驱动转子260的旋转与内切割轴130的旋转相关联,以确保在每次激活后内切割轴130相对于细长外轴120返回到闭合位置。由于相关信息可以根据所使用的特定末端执行器组件100的不同而变化,因此控制程序可以与末端执行器组件100进行通信或从中读取信息,以便使驱动转子260的旋转与内切割轴130的旋转相关联,从而设置原始位置。
返回到对应于内切割轴130的闭合位置的原始位置,还使近侧驱动器152返回其初始旋转位置,由此近侧驱动器152的近侧主体部分162的外套环166的朝近侧定向的凸舌168与保持器盖140的内部套环146的朝远侧定向的凹口148旋转对准。这样,在末端执行器组件100从手柄组件200脱离和退出时,偏置构件156使近侧驱动器152向远侧返回,从而将朝近侧定向的凸舌168偏置成接合在朝远侧定向的凹口148内。当凸舌168接合在凹口148内时,旋转锁被重新接合,分别相对于保持器盖140和近侧毂壳体110旋转地固定近侧和远侧驱动器152、154,从而将内切割轴130旋转地锁定在相对于细长外轴120的闭合位置。
大体上参考图1A,作为配置成在使用期间手动抓握和操纵的手柄组件200的替代方案,组织切除器械10可以替代地配置成与机器人手术系统一起使用,其中手柄壳体210配置成接合机器人手术系统的机器人臂。机器人手术系统采用各种机器人元件来辅助外科医生并允许远程操作(或部分远程操作)。更具体地,出于此目的,可以采用各种机器人臂、齿轮、凸轮、滑轮、电动电动机和机械电动机等并且其可以设计有机器人外科手术系统以便在操作或处理的过程期间辅助外科医生。机器人手术系统可以包含远程可转向系统、自动柔性外科手术系统、远程柔性外科手术系统、远程铰接外科手术系统、无线外科手术系统、模块化或可选择性地配置的远程操作外科手术系统等。
机器人手术系统可以与手术室旁边的或位于远程位置的一个或多个控制台一起使用。在这种情况下,一个外科医生或护士团队可以为患者做好手术准备,并且为机器人手术系统配置本文公开的一个或多个手术仪器,而另一位外科医生(或一组外科医生)经由机器人手术系统远程控制手术仪器。如可了解,高度熟练的外科医生可在多个位置执行多个操作而不离开他/她的远程控制台,这在经济上有利,且对于患者或一系列患者也是有益的。
机器人手术系统的机器人臂典型地由控制器联接到一对主手柄。外科医生可以移动手柄以使任何类型的外科手术器械(例如,末端执行器、抓握器、刀、剪刀、相机、流体递送设备等)的工作端产生相应的移动,这可以补充本文所描述的组织切除设备的使用。主手柄的移动可以缩放,使得工作端的相应的移动不同于、小于或大于外科医生的操作的手所执行的移动。比例因子或齿轮传动比可以是可调整的,使得操作者可以控制一个或多个外科手术器械的工作端的分辨率。
虽然在附图中已经示出了本公开的几个实施例,但并不意味着本公开局限于此,因为意图是使本公开的范围与本领域所允许的一样宽,并且同样地阅读说明书。因此,以上描述不应解释为限制性的,而仅仅是作为具体实施例的实例。本领域的技术人员将构想出在所附权利要求的范围和精神内的其它修改。
尽管已经通过说明和实例的方式详细描述了前述公开内容,但是为了清楚或理解的目的,显而易见的是,可以在所附权利要求的范围内实践某些改变和修改。
Claims (15)
1.一种组织切除器械,包括:
末端执行器组件,所述末端执行器组件包括:
近侧毂壳体;
相对于所述近侧毂壳体固定并从所述近侧毂壳体向近侧延伸的保持器盖;
相对于所述近侧毂壳体固定并从所述近侧毂壳体向远侧延伸的细长外轴;
在所述细长外轴内延伸并相对于所述细长外轴可旋转的内切割轴;和
内芯驱动组件,所述内芯驱动组件至少部分地延伸穿过所述保持器盖和所述近侧毂壳体,所述内芯驱动组件包括:
配置成接收旋转输入的近侧驱动器;和
相对于所述近侧驱动器旋转固定和可滑动的远侧驱动器,所述远侧驱动器联接到所述内切割轴,使得所述远侧驱动器的旋转使所述内切割轴相对于所述细长外轴旋转,
其中所述近侧驱动器可相对于所述远侧驱动器在较近侧位置和较远侧位置之间滑动,在较近侧位置中,所述近侧驱动器与所述保持器盖接合,以相对于所述保持器盖旋转地固定所述近侧驱动器,从而相对于所述细长外轴旋转地锁定所述内切割轴,在较远侧位置中,所述近侧驱动器与所述保持器盖脱开,以允许所述近侧驱动器相对于所述保持器盖旋转,从而允许所述内切割轴相对于所述细长外轴旋转。
2.根据权利要求1所述的组织切除器械,其中所述内芯驱动组件还包括偏置构件,所述偏置构件配置成将所述近侧驱动器朝着所述较近侧位置偏置。
3.根据权利要求1或2所述的组织切除器械,其中所述近侧驱动器包括配置成接收和旋转接合配置成提供所述旋转输入的驱动转子的面向近侧的空腔。
4.根据权利要求1或2所述的组织切除器械,其中所述近侧驱动器和所述远侧驱动器协作以限定设置成与所述内切割轴的内部流体连通的流出路径。
5.根据权利要求4所述的组织切除器械,其中所述近侧毂壳体限定与所述流出路径流体连通的流出开口。
6.根据权利要求1或2所述的组织切除器械,其中,在所述较近侧位置,所述近侧驱动器的突片接合在所述保持器盖的凹口内,以相对于所述保持器盖旋转地固定所述近侧驱动器。
7.根据权利要求1或2所述的组织切除器械,其中所述细长外轴在其远侧端部限定窗口。
8.根据权利要求7所述的组织切除器械,其中,在所述近侧驱动器的较近侧位置中,所述内切割轴相对于所述细长外轴锁定在闭合位置,其中所述内切割轴阻挡所述细长外轴的所述窗口。
9.根据权利要求1或2所述的组织切除器械,还包括:
手柄组件,所述手柄组件包括手柄壳体、设置在所述手柄壳体内的电动机以及可操作地联接至所述电动机并从所述电动机延伸的驱动转子,
其中,在所述末端执行器组件与所述手柄组件接合期间,所述驱动转子与所述近侧驱动器可操作地接合,并且将所述近侧驱动器相对于所述远侧驱动器推动到较远侧位置,其中所述近侧驱动器与所述保持器盖脱开,以允许所述近侧驱动器相对于所述保持器盖旋转,从而允许所述内切割轴相对于所述细长外轴旋转。
10.根据权利要求9所述的组织切除器械,其中所述末端执行器组件包括从所述近侧毂壳体延伸的接合杆,所述接合杆配置成机械地接合所述手柄组件的手柄壳体以使所述末端执行器组件与所述手柄组件接合。
11.根据权利要求9所述的组织切除器械,其中所述近侧驱动器包括配置成在其中接收并旋转地接合所述驱动转子的面向近侧的空腔。
12.根据权利要求11所述的组织切除器械,其中所述驱动转子被配置成在所述末端执行器组件与所述手柄组件接合期间与所述面向近侧的空腔触底,然后将所述近侧驱动器推动到所述较远侧位置。
13.根据权利要求9所述的组织切除器械,其中所述近侧驱动器和所述远侧驱动器协作以限定设置成与所述内切割轴的内部流体连通的流出路径。
14.根据权利要求13所述的组织切除器械,其中所述近侧毂壳体限定流出开口,而所述手柄壳体限定流出端口,所述流出开口和所述流出端口设置成与所述流出路径流体连通。
15.根据权利要求9所述的组织切除器械,其中,在所述末端执行器组件与所述手柄组件接合和所述电动机开启的情况下,所述电动机被配置为驱动所述驱动转子的旋转,从而驱动所述近侧驱动器和所述远侧驱动器以及因此所述内切割轴旋转,并且其中,在随后的停用时,所述电动机被配置为进一步驱动所述驱动转子的旋转,从而驱动所述近侧驱动器和所述远侧驱动器以及所述内切割轴旋转回至其起始位置。
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