CN111789646B - 具有改进的联接组合件的装载单元 - Google Patents

具有改进的联接组合件的装载单元 Download PDF

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CN111789646B
CN111789646B CN202010213527.8A CN202010213527A CN111789646B CN 111789646 B CN111789646 B CN 111789646B CN 202010213527 A CN202010213527 A CN 202010213527A CN 111789646 B CN111789646 B CN 111789646B
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assembly
body portion
drive assembly
surgical stapling
stapling device
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CN111789646A (zh
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约翰.W.比尔兹利
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Covidien LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B17/07207—Surgical 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526—Methods of manufacturing
    • A61B2017/0053—Loading magazines or sutures into applying tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft

Abstract

一种外科缝合装置包含主体部分和工具组合件。所述主体部分包含底座构件，所述底座构件限定纵向槽和隔开的键槽。所述工具组合件包含安装构件，所述安装构件限定具有开口端的通道，所述开口端被尺寸设定成收纳所述主体部分的所述底座构件。所述安装构件包含锁定接片，所述锁定接片定位在所述通道内。所述锁定接片中的每个锁定接片被配置成被收纳在所述底座构件的所述隔开的键槽中的一个隔开的键槽内，以将所述工具组合件可释放地固定到所述主体部分。

Description

具有改进的联接组合件的装载单元
技术领域
本公开涉及一种用于外科缝合装置的装载单元和适配器组合件，并且更具体地说，涉及一种包含改进的联接组合件的用于外科缝合装置的装载单元和适配器组合件，所述改进的联接组合件用于将装载单元连接到适配器组合件。
背景技术
用于在外科手术期间缝合身体组织的缝合装置是众所周知的。缝合装置包含具有砧座和支撑多个外科手术缝合钉的缝合钉仓的工具组合件。可以将缝合钉从缝合钉仓驱动到砧座中，以钉住夹在缝合钉仓与砧座之间的组织。一些缝合装置包含刀具构件，所述刀具构件被适配成在组织正在被缝合时切割夹在砧座与缝合钉仓之间的身体组织。这些缝合装置已经通过减少在外科手术期间连接组织区段所需的时间而减少了执行外科手术所需的时间量。
为了使与执行外科手术相关联的成本最小化，已知的缝合装置包含可移除地附接到缝合装置的适配器组合件的装载单元或重新装载。在将缝合钉通过组织从缝合钉仓击发到砧座之后，可以更换装载单元以促进缝合装置的重复使用。
通常，装载单元包含近侧主体部分和可枢转地支撑在所述近侧主体部分的远端上的工具组合件。装载单元的近侧主体部分支撑驱动组合件和铰接连杆，并且包含近端，所述近端被适配成接合适配器或缝合装置的主体，从而使得装载单元的驱动组合件与缝合装置的驱动构件联接且装载单元的铰接连杆联接到缝合装置的铰接机构。
在一些情况下，如果装载单元的驱动组合件未正确地联接到外科缝合装置的驱动构件，则可以在缝合装置被击发后将工具组合件锁定在夹固位置。另外，装载单元的铰接连杆与缝合装置的铰接机构的联接通常需要多个具有间隙的部件，所述部件使工具组合件在驱动组合件的击发和缩回期间摇摆。
缝合领域中持续存在对包含装载单元的缝合装置的需求，所述装载单元可以选择性地联接到缝合装置的主体，以确保重新装载的部件与缝合装置的部件正确地接合，从而提供可靠且稳定的装置。
发明内容
本公开的一个方面涉及一种包含主体部分和工具组合件的外科缝合装置。所述主体部分包含外壳、定位在所述外壳上的底座构件以及支撑在所述外壳内的驱动组合件。所述底座构件限定纵向槽和隔开的键槽。所述驱动组合件包含具有连接器的近侧部分和包含工作端的远侧部分。所述驱动组合件能够在所述外壳内在缩回位置与前进位置之间移动，在所述缩回位置中，所述驱动组合件的所述工作端定位在所述底座构件的所述纵向槽内。所述工具组合件包含第一钳口、第二钳口和安装构件。所述第一钳口和所述第二钳口固定到所述安装构件，使得所述第一钳口能够相对于所述第二钳口在打开位置与松开位置之间移动。所述安装构件限定具有开口端的通道，所述开口端被尺寸设定成收纳所述主体部分的所述底座构件。所述安装构件包含锁定接片，所述锁定接片定位在所述通道内。所述锁定接片中的每个锁定接片被配置成被收纳在所述底座构件的所述隔开的键槽中的一个隔开的键槽内，以将所述工具组合件可释放地固定到所述主体部分。
在一些实施例中，所述隔开的键槽中的每个隔开的键槽包含轴向部分和径向部分，其中所述工具组合件相对于所述主体部分的轴向移动使所述锁定接片移动通过所述键槽的所述轴向部分，并且所述工具组合件相对于所述主体部分的可旋转移动使所述锁定接片移动通过所述隔开的键槽的所述径向部分，从而将所述工具组合件固定到所述主体部分。
在某些实施例中，所述驱动组合件的所述工作端被配置成能够在所述驱动组合件从所述缩回位置移动到所述前进位置时移动通过所述工具组合件，以使所述工具组合件从所述打开位置移动到所述夹固位置并且击发所述工具组合件。
在实施例中，所述主体部分包含导螺杆和内管，并且所述导螺杆是可旋转的以使所述内管在所述外壳内轴向地前进，其中所述内管接合所述驱动组合件的所述连接器以使所述驱动构件在所述外壳内从所述缩回位置轴向地前进到所述前进位置。
在一些实施例中，所述主体部分包含偏置构件，所述偏置构件定位在所述内管的远侧部分与所述连接器之间，以在所述外壳内相对于所述内轴向远侧推动所述驱动组合件。
在某些实施例中，所述第一钳口包含砧座并且所述第二钳口包含支撑缝合钉仓的通道构件。
在实施例中，所述驱动构件的所述工作端包含具有刀刃的竖直支柱，并且所述通道构件和缝合钉仓限定在所述工具组合件固定到所述主体部分时收纳所述竖直支柱的纵向槽。
在一些实施例中，当所述锁定接片位于所述隔开的键槽的轴向部分中时，所述驱动组合件的所述工作端的所述竖直支柱与所述通道构件中的所述纵向槽未对准，使得当所述工具组合件朝向所述底座构件移动以使所述锁定接片移动通过所述隔开的键槽的所述轴向部分时，所述驱动组合件的所述工作端邻接所述通道构件，从而阻止所述驱动组合件相对于所述工具组合件的轴向移动。
在某些实施例中，当所述驱动组合件的所述工作端与所述通道构件邻接时，所述底座构件在所述安装构件的所述通道内的轴向前进引起所述驱动组合件相对于所述内管轴向地移动，从而压缩所述偏置构件。
在实施例中，当所述工具组合件相对于主体部分旋转以使所述锁定接片移动通过所述隔开的键槽的所述径向部分时，所述驱动组合件的所述竖直支柱被移动成与所述通道构件和所述缝合钉仓的所述纵向槽对准。
在一些实施例中，当所述竖直支柱旋转成与所述通道构件和所述缝合钉仓的所述纵向槽对准时，所述偏置构件将所述驱动组合件的所述工作端推动到所述工具组合件的近侧部分中。
在某些实施例中，所述外壳包含远侧部分，并且所述底座构件可枢转地支撑在所述外壳的所述远侧部分上。
在实施例中，所述主体部分包含平台，所述平台支撑在所述外壳的所述远侧部分上。
在一些实施例中，所述底座构件限定横向槽，并且所述平台包含可枢转地收纳在所述底座构件的所述横向槽内的凸缘。
在某些实施例中，所述平台限定在远侧方向上向外发散的上凹部和下凹部。
在实施例中，所述驱动组合件包含具有上主体部分和下主体部分的细长柔性主体，并且所述平台定位在所述上主体部分与所述下主体部分之间。
在一些实施例中，所述缝合装置包含上U形引导件和下U形引导件，其中所述上引导件定位在所述平台的所述上凹部中并且收纳所述驱动组合件的所述柔性主体的所述上主体部分，而所述下引导件定位在所述平台的所述下凹部中并且收纳所述驱动组合件的所述柔性主体的所述下主体部分。
在某些实施例中，所述上U形引导件和所述下U形引导件中的每一个引导件具有包含枢转构件的近侧部分，其中所述枢转构件可枢转地支撑所述上凹部和所述下凹部内的所述上U形引导件和所述下U形引导件。
在实施例中，所述缝合装置包含：上吹出板组合件，所述上吹出板组合件定位在所述柔性主体的所述上主体部分的相反侧上的所述上引导件内；以及下吹出板组合件，所述下吹出板组合件定位在所述柔性主体的所述下主体部分的相反侧上的所述下引导件内。
在一些实施例中，所述缝合装置包含铰接组合件，所述铰接组合件具有铰接驱动构件、固定到所述铰接驱动构件的第一铰接连杆、可枢转地联接到所述第一铰接连杆和所述底座构件的第二铰接连杆。
附图说明
下文参考附图描述了当前公开的装载单元和适配器组合件的各个实施例，在附图中：
图1是包含当前公开的装载单元和适配器组合件的示例性实施例的外科缝合装置的侧面透视图；
图2是图1中所示的外科手术缝合装置的装载单元的分解透视图；
图2A是图2中所示的外科缝合装置的装载单元的端帽的从远端看的透视图；
图3是图1中所示的装载单元和适配器组合件的侧面透视图，其中装载单元与适配器组合件分离；
图4是装载单元的近端和适配器组合件的远端的透视图，其中装载单元与适配器组合件分离；
图5是图1中所示的外科手术缝合装置的适配器组合件的分解透视图；
图6是图3中所示的指示区域的细节的放大图；
图6A是图5中所示的适配器组合件的枢转底座的侧面透视图；
图6B是图6A中所示的适配器组合件的枢转底座的顶部透视图；
图7是图3中所示的适配器组合件的远端的侧面透视图，其中外管和外壳半部被移除；
图7A是图5中所示的适配器组合件的驱动组合件引导件的侧面透视图；
图8是图7中所示的适配器组合件的远端的侧面透视图，其中外管、外壳半部和驱动构件被移除；
图9是沿图3的截面线9-9截取的截面图；
图10是图9中所示的指示区域的细节的放大图；
图11是图1中所示的外科缝合装置的装载单元和适配器组合件的远端的截面图，其中装载单元与适配器组合件分离；
图12是图9中所示的指示区域的细节的放大图；
图13是图11中所示的外科缝合装置的装载单元和适配器组合件的远端的截面图，其中装载单元朝向适配器组合件轴向地移动以启动装载单元与适配器组合件的联接；
图14是图13中所示的外科缝合装置的装载单元和适配器组合件的远端的截面图，其中装载单元继续轴向地前进并且联接到适配器组合件；
图15是图5中所示的指示区域的细节的放大图；
图16是图14中所示的适配器组合件的近侧部分的截面图，其中适配器组合件的驱动构件偏置构件被完全压缩；
图17是沿图14的截面线17-17截取的截面图；
图18是沿图14的截面线18-18截取的截面图；
图19是图14中所示的外科缝合装置的装载单元和适配器组合件的远端的截面图，其中装载单元相对于适配器组合件旋转以将装载单元完全联接到适配器组合件；
图20是沿图19的截面线20-20截取的截面图；并且
图21是沿图19的截面线21-21截取的截面图。
具体实施方式
现在将参照附图对当前公开的包含装载单元和适配器组合件的缝合装置进行详细的描述，在附图中，相似的附图标记指代若干视图中的每个视图中的完全相同或对应的元件。然而，应理解的是，公开的实施例仅是本公开的示例，并且可以用多种形式来实施。没有详细地描述众所周知的功能或结构，以避免在不必要的细节上混淆本公开。因此，本文中公开的具体结构和功能上的细节不应被解释为限制性的，而仅仅是作为权利要求书的基础并且作为教导本领域技术人员以实际上任何适当的详细结构来不同地使用本公开的代表性基础。
在本说明书中，术语“近侧”通常用于指代装置的距临床医生较近的部分，而术语“远侧”通常用于指代装置的距临床医生较远的部分。另外，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。进一步地，术语“临床医生”通常用于指医疗人员，包含医生、护士和辅助人员。
图1和2展示了通常示出为缝合装置10的外科缝合装置，所述缝合装置包含手柄组合件100以及当前公开的工具组合件200(例如，末端执行器、多次或单次使用的工具组合件)和适配器组合件300的示例性实施例。适配器组合件300包含具有远侧部分的细长主体308，所述远侧部分支撑工具组合件200。手柄组合件100被配置用于与适配器组合件300可释放地连接，并且进而，适配器组合件300被配置用于与工具组合件200可释放地连接。手柄组合件100和适配器组合件300可以一起协作，从而致动工具组合件 200。缝合装置10可以是机电动力系统，并且手柄组合件100可以支撑电源，例如电池组。可替代地，可以是手动地致动缝合装置10，并且可以将适配器组合件300牢固地固定到手柄组合件100。
在实施例中，手柄组合件100包含固定手柄102和多个致动开关104。提供致动开关104来控制缝合装置10的各种功能，包含接近工具组合件200 以及切割并击发组织。
图2展示了缝合装置10(图1)的当前公开的工具组合件200的示例性实施例，所述工具组合件包含砧座组合件210和钉仓组合件211。钉仓组合件211包含钉仓通道构件212和缝合钉仓214。砧座组合件210包含砧座盖220和砧座板222。砧座盖220包含限定近侧切口226的安装部分224以及沿砧座板222的远侧部分延伸的盖部分228。安装部分224包含限定切口226 和孔225的隔开的近侧延伸部224a。工具组合件200还包含固定到砧座组合件210和钉仓组合件211的近侧部分的安装构件216。
砧座板222包含与缝合钉仓214相对并限定多个缝合钉变形凹部(未示出)的组织接合表面230。砧座板222具有与组织接合表面230相对的一侧，所述组织接合表面限定细长凹部232，所述细长凹部被配置成收纳如下文进一步详细描述的适配器组合件300的驱动组合件320(图14)的上横梁336 (图4)。砧座盖220例如通过焊接或压接固定到砧座板222，使得盖部分228 包围细长凹部232。砧座板222还限定延伸通过砧座板222的组织接合表面230到达细长凹部232中的细长刀槽236。
钉仓通道构件212包含限定通道244的底壁240和一对隔开的侧壁242。通道244被尺寸设定成收纳缝合钉仓214。通道构件212的侧壁242各自包含限定孔246a的近侧延伸部246。底壁240限定纵向槽243(图17)，所述纵向槽在其近端处开口，以收纳如下文详细描述的驱动组合件320的工作端 328(图5)。缝合钉仓214还限定与通道构件212的纵向槽243对准的纵向槽214a。
还参考图2A，安装构件216包含基本上呈圆柱形的近侧部分250和远侧部分252。安装构件216的远侧部分252限定I形槽255(图2A)，并且包含限定孔254a的平坦外侧壁254。侧壁254被收纳在切口226内的砧座盖220 的安装部分224的一对近侧延伸部224a之间，使得近侧延伸部224a的孔225 与安装构件216的孔254a对准。通道构件212的侧壁242的延伸部246还定位在安装构件216的平坦侧壁254与砧座盖220的近侧延伸部224a之间，使得孔246a与砧座盖的孔225对准并与安装构件216的孔254a对准。
枢轴销260通过砧座盖220的孔225、通道构件212的孔246a和安装构件216的孔254a中的每个孔定位在砧座组合件210的每一侧上，以将砧座组合件210牢固地固定到安装构件216，并将钉仓通道构件212相对于安装构件216和砧座组合件210可枢转地固定。通道构件212绕枢轴销260从打开位置(图1)枢转到夹固位置(图3)。
参考图2-4，适配器组合件300(图3)的远侧部分被尺寸设定成被收纳在安装构件216的近侧部分250(图2)中，以将工具组合件200可释放地联接到适配器组合件300。更具体地说，安装构件216的近侧部分250限定通道262，所述通道被配置成收纳如下文进一步详细描述的适配器组合件300 的枢转底座302(图4)。安装构件216包含锁定接片264(图4)，所述锁定接片从安装构件216的内表面向内突出到通道262中。在实施例中，安装构件216的外表面包含在垂直于彼此的方向上延伸的一对箭头270、272。一对箭头中的第一箭头270指向平行于工具组合件200的纵向轴线“X”的方向，而一对箭头中的第二箭头272指向垂直于工具组合件200的纵向轴线“X”的方向。箭头270、272帮助临床医生将工具组合件200联接到如下文详细描述的适配器组合件300。
参考图4-10，适配器组合件300包含外壳304(图9)，所述外壳包含上外壳部分304a和下外壳部分304b。使用任何各种已知的紧固技术(例如，焊接、互锁结构等)将上外壳部分304a和下外壳部分304b固定在一起，以限定收纳适配器组合件300的其它部件的空腔306(图9)。上外壳部分304a 和下外壳部分304b中的每一个的远侧部分限定凹部310和切口312(图5)。上外壳部分304a和下外壳部分304b的凹部310在远侧方向上向外发散。上外壳部分304a和下外壳部分304b支撑在外部圆柱形外壳313内，以阻止上外壳部分304a与下外壳部分304b分离。
上外壳部分304a和下外壳部分304b的切口312限定外壳304的远端中的槽，所述槽在上外壳部分304a和下外壳部分304b被组装时收纳平台314 (图5)。可以使用任何已知的紧固技术(包含螺钉、焊接等)将平台314固定在上外壳部分304a与下外壳部分304b之间。平台314限定上凹部和下凹部316(图5)，所述凹部的形状对应于上外壳部分304a和下外壳部分304b 中的凹部310的形状。当平台314固定在上外壳部分304a与下外壳部分304b 之间时，上外壳部分304a和下外壳部分304b的凹部310以及平台314的凹部316限定外壳304的远侧部分处的上空腔和下空腔318(图7)，所述空腔在远侧方向上向外发散。
适配器组合件300包含枢转底座302、驱动组合件320、导螺杆322、击发螺母324和内管326。枢转底座302限定纵向槽302a，并且导螺杆322包含螺纹外壁322a。驱动组合件320定位在外壳304内(图9)，并且包含远侧工作端328、近侧连接器330以及定位在工作端328与连接器330之间的细长柔性主体332。柔性主体332包含上主体部分332a和下主体部分332b。工作端328包含上横梁336、下横梁338和竖直支柱340。竖直支柱340包含刀刃342。当驱动组合件320位于缩回位置中时，竖直支柱340定位在枢转底座302的纵向槽302a内。上横梁336和下横梁338被定位成接合砧座组合件 210和钉仓通道构件212，以使砧座组合件210和钉仓通道构件212在打开位置与夹固位置之间移动，如本领域中已知的。对驱动组合件320的工作端328 的更详细的描述，参见美国专利第5,865,361号(“'361专利”)，所述专利通过引用整体并入本文。
简要地参考图15，连接器330从驱动组合件320的柔性主体332向近侧延伸，并且包含远侧部分346和近侧部分348。连接器330的远侧部分346 固定到柔性主体332的近端，所述近端介于所述柔性主体332的上主体部分 332a与下主体部分332b之间。连接器330的近侧部分348包含环形凹部350 (图10)，并且被配置成被收纳在击发螺母324的远端内。销352通过连接器330的环形凹部350延伸通过击发螺母324的远侧部分，以将击发螺母324 的远侧部分固定到连接器330。环形凹部350的长度大于销352的直径，使得连接器330能够在击发螺母324内独立于击发螺母324轴向地移动。更具体地说，连接器330能够相对于击发螺母324在前进位置(图10)与缩回位置(图16)之间轴向地移动，在所述前进位置中，销352接合限定环形凹部 350的近端的近侧壁350a，在所述缩回位置中，销352接合限定环形凹部350的远端的远侧壁350b。当销352与限定环形凹部350的壁350a和壁350b接合时，连接器330将击发螺母324的移动转换为驱动组合件320的移动。
再次参考图4-10，击发螺母324包含具有螺纹部分356(图9)的内壁以及限定平面358(图5)的外侧壁。螺纹部分356被定位成接合导螺杆322 的螺纹外壁322a，使得导螺杆322在击发螺母324内的旋转引起击发螺母324 在外壳304(图9)内的纵向移动。内管326包含具有限定轴向孔360(图5) 的平坦表面部分(未示出)的内壁。内管326的内壁的平坦表面部分被定位成接合击发螺母324的外侧壁上的平面358(图5)，以阻止击发螺母324在适配器组合件300的内管326内的旋转。内管326还具有限定平面362的外壁。内管326的平面362定位在外壳304内，以阻止内管326在外壳304内的旋转。
在使用中，当导螺杆322在击发螺母324内旋转时，导螺杆322的螺纹外壁322a与击发螺母324的内壁的螺纹部分356(图9)之间的接合引起击发螺母324在适配器组合件300的内管326内的轴向移动。如上文所讨论的，击发螺母324的平面358与内管326的内壁上的平坦表面部分(未示出)之间的接合阻止击发螺母324旋转，并且因此限制击发螺母324在适配器组合件300的内管326内轴向地移动。当击发螺母324在内管326内轴向地移动时，销352在连接器330的环形凹部350内移动，直到销352接合限定环形凹部350的壁的端350a、350b中的一个端。当发生这种情况时，击发螺母 324的轴向移动将引起连接器330的轴向移动和对应的驱动组合件320的轴向移动。驱动组合件320的轴向移动引起驱动组合件320的工作端328在工具组合件200内移动，从而致动工具组合件200，如本领域中已知的。
如上文所讨论的，平台314(图5)固定在上外壳部分304a的远侧部分与下外壳部分304b的远侧部分之间，并且限定上空腔和下空腔318(图7) (仅示出了上空腔)。平台318的远端包含从适配器300的外壳304向远侧延伸的凸缘364(图5)。凸缘364限定孔366。
参考图6A和6B，枢转底座302包含具有远侧部分372和近侧部分374 的主体370(图5)，所述远侧部分限定纵向槽302a。主体370的远侧部分372 被尺寸设定成被收纳在安装构件216的近侧部分250(图2)中所限定的通道 262(图4)中，并且所述远侧部分限定隔开的键槽376。键槽376中的每个键槽被尺寸设定成在工具组合件200固定到适配器组合件300时收纳安装构件216的锁定接片264(图4)中的一个锁定接片。键槽376基本上呈J形，并且具有轴向部分378和横向部分380。
枢转底座302的主体370的近侧部分374具有倒圆近端382，并且限定横向通槽384和竖直开口386(图6B)。槽384收纳平台314的凸缘364(图 5)。枢转构件388通过枢转底座302的近侧部分374中的开口386和平台314 的凸缘364中的竖直孔366被收纳，以将枢转底座302可枢转地固定到平台 314。在实施例中，枢转底座302的主体370的近侧部分374的顶表面和底表面限定环形引导通道390(图6B)。
参考图5和7-8，适配器300(图1)包含上驱动组合件引导件和下驱动组合件引导件392。引导件392(图7A)中的每个引导件基本上呈U形，并且包含限定通道392a的侧壁394、底壁396以及与底壁396相对反的开口端 398，所述通道具有发散的远侧部分393。引导件392的开口端398被尺寸设定成收纳驱动组合件320的柔性主体332的上主体部分332a和下主体部分 332b中的一个。底壁396限定隔开的细长槽400(图5)，并且包含近侧圆形枢转构件402。枢转构件402被收纳在形成于平台314的近端中的开口404 (图5)内，以将驱动组合件引导件392中的每个引导件可枢转地固定在外壳304的远端中的平台314(图6)的空腔318中的一个空腔内。
适配器300还包含上吹出板组合件和下吹出板组合件406。上吹出板组合件和下吹出板组合件406中的每个吹出板组合件包含一对吹出板408和支撑块410。一个吹出板408在驱动组合件引导件392的通道392a中的相应一个通道内定位在柔性主体332的上主体部分332a的每一侧上。另外，一个吹出板408在驱动组合件引导件392的通道392a中的相应一个通道内定位在柔性主体332的下主体部分332b的每一侧上。吹出板408中的每个吹出板包含具有横向部分412(图8)和中心竖直延伸部414(图5)的远端。横向部分 412(图8)被收纳在形成于枢转构件388的远侧的枢转底座302中的槽416 (图8)内，以将吹出板408的远端轴向地固定到枢转底座302。吹出板408 的竖直延伸部414各自被收纳在形成于引导件392中的隔开的细长槽400中的一个隔开的细长槽内，以将吹出板408绕驱动组合件320的柔性主体332 正确地定位。当工具组合件200相对于适配器组合件300被铰接时，出吹板 408的近端沿柔性主体332轴向地自由移动，以在工具组合件200被铰接时阻止柔性主体332的缠结。
吹出板组合件406定位在驱动组合件320的柔性主体332的相对侧上，并且从由枢转构件388(图5)限定的工具组合件200的枢转轴线的近侧位置延伸，以稳定驱动组合件320的柔性主体332并使驱动组合件320的柔性主体332在缝合装置10(图1)的接近和击发期间向外屈曲的可能性最小化。
参考图5-9，适配器组合件300包含铰接组合件420，所述铰接组合件包含铰接驱动构件422、第一铰接连杆424和第二铰接连杆426。铰接驱动构件 422支撑在外壳304上，并且能够在缩回位置与前进位置之间移动。铰接驱动构件422包含联接到第一铰接连杆424的近端的远端430。在实施例中，铰接驱动构件422的远端限定槽432，并且第一铰接连杆424的近端包含肋 434，所述肋被收纳在槽432中，以将铰接驱动构件422联接到第一铰接连杆 424。可替代地，可以使用其它联接机构将铰接驱动构件422固定到第一铰接连杆424。在实施例中，第一铰接连杆424的远端通过枢转销428(图7)联接到第二铰接连杆426的近端，并且第二铰接连杆426的远端通过枢转销430 (图7)可枢转地固定到枢转底座302。枢转销430从由枢转构件388限定的工具组合件200的枢转轴线横向地偏移。
在使用中，铰接驱动构件422在外壳304内的轴向移动分别引起第一铰接连杆424和第二铰接连杆426的对应移动。当第二铰接连杆426轴向地移动时，工具组合件200绕由枢转构件388限定的枢转轴线从工具组合件200 的纵向轴线与适配器组合件300的纵向轴线对准的位置铰接到装载单元的纵向轴线与适配器组合件300的纵向轴线成锐角的位置。通过提供两个可枢转联接的铰接连杆424、426，可以实现工具组合件200的较大的铰接范围。
参考图9和10，驱动组合件320的近侧连接器330限定由径向凸缘501 封闭的通道500，所述径向凸缘跨通道500的近端横向地延伸。通道500收纳驱动组合件320的柔性主体332的上主体部分332a和下主体部分332b。径向凸缘501被定位成接合偏置构件502，所述偏置构件支撑在击发螺母324 的远端与径向凸缘500的近侧表面之间。偏置构件502被定位成相对于击发螺母324将驱动组合件320朝向前进位置推动(图10)。在前进位置中，支撑在击发螺母324的远端上的销352接合连接器330中的环形凹部350的近侧壁350a。在实施例中，偏置构件502是螺旋弹簧，并且击发螺母324的远端限定环形凹部504，所述环形凹部收纳螺旋弹簧502以使螺旋弹簧502与连接器330的凸缘500对准。
图11-21展示了缝合装置10，其中工具组合件200可释放地联接到适配器组合件300的远侧部分。首先参考图11-13，为了将工具组合件200附接到适配器组合件300，工具组合件200的近端在由图11和13中的箭头“A”指示的方向上朝向适配器组合件300的远端移动，以将枢转底座302的主体 370的远侧部分372和定位在枢转底座302的纵向槽380中的驱动组合件320 的工作端328定位到工具组合件200的安装构件216的通道262(图4)中。当枢转底座302的远侧部分372被收纳在安装构件216的通道262内时，安装构件的锁定接片264收纳在键槽376的轴向部分378内。当锁定接片264 定位在键槽376的轴向部分378内时，驱动组合件320的工作端328的竖直支柱340与安装构件216的远端中的槽255(图2A)未对准，并且与通道构件212中的刀槽243(图17)未对准。这样，驱动组合件320的工作端328 压靠在通道构件212的近端上。因此，当枢转底座302前进到安装构件216 的通道262中时，驱动组合件320从其前进位置(图10)被推动到其缩回位置(图16)并且偏置构件502被压缩。
参考图14-18，当安装构件216的锁定接片264在由图14中的箭头“A”指示的方向上移动通过键槽376的轴向部分378时，驱动组合件320被通道构件212向后按压，以使包含连接器330的驱动组合件320在由图16中的箭头“B”指示的方向上相对于击发螺母324从其前进位置(图10)向近侧移动到其缩回位置(图16)。如图16中所示，在驱动组合件320的缩回位置中，击发螺母324的远端上的销352与限定近侧连接器330(图16)的环形凹部 350的远侧壁350b接合，并且锁定接片264定位在键槽376的轴向部分378 的远端中。
参考图19-21，为了将工具组合件200固定到适配器组合件300的枢转底座302，使工具组合件200在由箭头“C”指示的方向上相对于适配器组合件300旋转，以在由图19中的箭头“D”指示的方向上将锁定接片264移动到键槽376的横向部分380中并且通过所述键槽的所述横向部分。当工具组合件200相对于适配器组合件300旋转时，驱动组合件320的工作端328移动成与安装构件216的远端中的槽255(图2A)对准，并且与通道构件212 中的刀槽243对准。一旦驱动组合件320的工作端328与安装构件216的远端中的槽255(图2A)对准并且与通道构件212中的刀槽243对准，则偏置构件502在由图19中的箭头“E”指示的方向上将驱动组合件320推动回到前进位置，从而使驱动组合件320的工作端328移动到通道组合件212的刀槽243中。在这个位置中，工具组合件200固定到适配器组合件300，并且缝合装置10准备好供使用。对缝合装置的操作的详细描述，参见'361专利。
在当前描述的缝合装置10中，工具组合件200形成装载单元，所述装载单元不包含必须连接到适配器组合件中的不同机构才能操作的铰接组合件或驱动组合件。这样，使与已知的装载单元或重新装载相关联的缺点最小化，从而提供更加可靠的工具组合件。
本领域技术人员将理解，在本文中具体地描述并且在附图中展示的装置和方法是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展示或描述的元件和特征可以与另一个的元件和特征组合。而且，基于上述实施例，本领域技术人员将理解本公开的另外的特征和优点。因此，除了由所附权利要求指示之外，本公开不受已经具体示出和描述的内容的限制。

Claims (20)

1.一种外科缝合装置，其包括：
主体部分，所述主体部分包含外壳、由所述外壳支撑的底座构件以及支撑在所述外壳内的驱动组合件，所述底座构件限定纵向槽和隔开的键槽，所述驱动组合件包含具有连接器的近侧部分和包含工作端的远侧部分，所述驱动组合件能够在所述外壳内在缩回位置与前进位置之间移动，在所述缩回位置中，所述驱动组合件的所述工作端定位在所述底座构件的所述纵向槽内；以及
工具组合件，所述工具组合件包含第一钳口、第二钳口和安装构件，所述第一钳口和所述第二钳口固定到所述安装构件，使得所述第一钳口能够相对于所述第二钳口在打开位置与夹固位置之间移动，所述安装构件限定具有开口端的通道，所述开口端被尺寸设定成收纳所述主体部分的所述底座构件，所述安装构件包含锁定接片，所述锁定接片中的每个锁定接片被配置成被收纳在所述底座构件的所述隔开的键槽中的一个隔开的键槽内，以将所述工具组合件可释放地固定到所述主体部分。
2.根据权利要求1所述的外科缝合装置，其中所述隔开的键槽中的每个隔开的键槽包含轴向部分和径向部分，并且所述工具组合件相对于所述主体部分的轴向移动使所述锁定接片移动通过所述键槽的所述轴向部分，并且所述工具组合件相对于所述主体部分的可旋转移动使所述锁定接片移动通过所述隔开的键槽的所述径向部分，从而将所述工具组合件固定到所述主体部分。
3.根据权利要求2所述的外科缝合装置，其中所述驱动组合件的所述工作端被配置成能够在所述驱动组合件从所述缩回位置移动到所述前进位置时移动通过所述工具组合件，以使所述工具组合件从所述打开位置移动到所述夹固位置并且击发所述工具组合件。
4.根据权利要求3所述的外科缝合装置，其中所述主体部分包含导螺杆和内管，所述导螺杆是可旋转的以使所述内管在所述外壳内轴向地前进，所述内管接合所述驱动组合件的所述连接器以使所述驱动组合件在所述外壳内从所述缩回位置轴向地前进到所述前进位置。
5.根据权利要求4所述的外科缝合装置，其中所述主体部分包含偏置构件，所述偏置构件定位在所述内管的远侧部分与所述连接器之间，所述偏置构件被定位成在所述外壳内相对于所述内轴向远侧推动所述驱动组合件。
6.根据权利要求5所述的外科缝合装置，其中所述第一钳口包含砧座并且所述第二钳口包含支撑缝合钉仓的通道构件。
7.根据权利要求6所述的外科缝合装置，其中所述驱动组合件的所述工作端包含具有刀刃的竖直支柱，并且所述通道构件和缝合钉仓限定在所述工具组合件固定到所述主体部分时收纳所述竖直支柱的纵向槽。
8.根据权利要求7所述的外科缝合装置，其中当所述锁定接片位于所述隔开的键槽的轴向部分中时，所述驱动组合件的所述工作端的所述竖直支柱与所述通道构件中的所述纵向槽未对准，使得当所述工具组合件朝向所述底座构件移动以使所述锁定接片移动通过所述隔开的键槽的所述轴向部分时，所述驱动组合件的所述工作端邻接所述通道构件，从而阻止所述驱动组合件相对于所述工具组合件的轴向移动。
9.根据权利要求8所述的外科缝合装置，其中当所述驱动组合件的所述工作端与所述通道构件邻接时，所述底座构件在所述安装构件的所述通道内的轴向前进引起所述驱动组合件相对于所述内管轴向地移动，从而压缩所述偏置构件。
10.根据权利要求9所述的外科缝合装置，其中当所述工具组合件相对于主体部分旋转以使所述锁定接片移动通过所述隔开的键槽的所述径向部分时，所述驱动组合件的所述竖直支柱被移动成与所述通道构件和所述缝合钉仓的所述纵向槽对准。
11.根据权利要求10所述的外科缝合装置，其中当所述竖直支柱旋转成与所述通道构件和所述缝合钉仓的所述纵向槽对准时，所述偏置构件将所述驱动组合件的所述工作端推动到所述工具组合件的近侧部分中。
12.根据权利要求1所述的外科缝合装置，其中所述外壳包含远侧部分，所述底座构件可枢转地支撑在所述外壳的所述远侧部分上。
13.根据权利要求12所述的外科缝合装置，其中所述主体部分包含平台，所述平台支撑在所述外壳的所述远侧部分上。
14.根据权利要求13所述的外科缝合装置，其中所述底座构件限定横向槽，并且所述平台包含可枢转地收纳在所述底座构件的所述横向槽内的凸缘。
15.根据权利要求14所述的外科缝合装置，其中所述平台限定在远侧方向上向外发散的上凹部和下凹部。
16.根据权利要求15所述的外科缝合装置，其中所述驱动组合件包含具有上主体部分和下主体部分的细长柔性主体，所述平台定位在所述上主体部分与所述下主体部分之间。
17.根据权利要求16所述的外科缝合装置，其包含上U形引导件和下U形引导件，所述上U形引导件定位在所述平台的所述上凹部中并且收纳所述驱动组合件的所述柔性主体的所述上主体部分，而所述下U形引导件定位在所述平台的所述下凹部中并且收纳所述驱动组合件的所述柔性主体的所述下主体部分。
18.根据权利要求17所述的外科缝合装置，其中所述上U形引导件和所述下U形引导件中的每一个引导件具有包含枢转构件的近侧部分，所述枢转构件可枢转地支撑所述上凹部和所述下凹部内的所述上U形引导件和所述下U形引导件。
19.根据权利要求18所述的外科缝合装置，其包含上吹出板组合件，所述上吹出板组合件定位在所述柔性主体的所述上主体部分的相反侧上的所述上U形引导件内，以及下吹出板组合件，所述下吹出板组合件定位在所述柔性主体的所述下主体部分的相反侧上的所述下U形引导件内。
20.根据权利要求12所述的外科缝合装置，其包含铰接组合件，所述铰接组合件具有铰接驱动构件、固定到所述铰接驱动构件的第一铰接连杆、可枢转地联接到所述第一铰接连杆和所述底座构件的第二铰接连杆。
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