CN111789651A - 外科缝合装置 - Google Patents

外科缝合装置 Download PDF

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CN111789651A
CN111789651A CN202010258786.2A CN202010258786A CN111789651A CN 111789651 A CN111789651 A CN 111789651A CN 202010258786 A CN202010258786 A CN 202010258786A CN 111789651 A CN111789651 A CN 111789651A
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约瑟夫·格雷拉
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Abstract

本发明涉及外科缝合装置。一种缝合装置，该缝合装置包括壳组件、砧座保持器组件、砧座组件、和应变计。该壳组件包括外壳，该外壳包括外壳内部，该外壳内部限定通孔并且支承至少一个检测构件或腿部。该砧座组件包括砧头和具有凸台的砧座中心杆。该至少一个检测腿部定位成与中心杆的凸台相接合，以阻碍砧座组件相对于壳组件在打开位置与夹紧位置之间的移动。该应变计定位成在至少一个检测腿部与凸台相接合时确定缝合装置中的应变增大。这使得临床医师能够在击发该缝合装置之前确认砧座组件正确附接到该缝合装置。

Description

外科缝合装置
相关申请的交叉引用
本申请要求2019年4月5日提交的美国临时专利申请序列号62/829，709的权益和优先权，其全部公开内容通过引用的方式结合到本文中。
技术领域
本公开涉及外科缝合装置，并且更具体地，涉及包括指示机构的环形缝合装置，该指示机构用于为临床医师确认砧座组件正确附接到缝合装置。
背景技术
环形缝合装置是外科领域已知的并且通常用于进行联结组织段的多种外科手术。这些手术包括可通过内窥镜进行的多种端对端或者端对侧面的吻合术。通常，环形缝合装置包括工具组件，该工具组件具有砧座组件和逼近机构，该砧座组件具有砧头和砧座中心杆，该逼近机构包括砧座保持器，砧座中心杆可释放地联接到砧座保持器。在许多使用环形缝合装置联结组织段的外科手术中，工具组件独立于缝合装置的其余部分定位于体腔内并且砧座组件在体腔内附接于砧座保持器。在这些外科手术中，重要的是，临床医师能够在击发缝合装置之前，无需看到缝合装置就确认砧座组件正确附接至砧座保持器，以避免对患者的潜在伤害。
本领域始终需要一种环形缝合装置，该环形缝合装置具有用于向临床医师确认砧座组件正确附接于缝合装置的砧座保持器而无需看到缝合装置的机构。
发明内容
本公开的一个方面涉及一种缝合装置，该缝合装置包括壳组件、砧座保持器组件、砧座组件、和应变计。壳组件包括外壳和缝钉筒。外壳具有支承缝钉筒的远侧部分、近侧部分、外壳外部和外壳内部。外壳外部和外壳内部限定环形腔。外壳内部限定通孔并且支承至少一个检测构件。砧座保持器组件能够在壳体的通孔内在缩回位置和前进位置之间移动。砧座组件包括砧头和具有凸台的砧座中心杆。砧座中心杆具有近侧部分和支承砧头的远侧部分。砧座中心杆的近侧部分适于与砧座保持器组件可释放地联接。砧座组件能够在打开位置与夹紧位置之间相对于壳组件移动。至少一个检测构件定位成与砧座中心杆的凸台相接合，以阻碍砧座组件在打开位置与夹紧位置之间移动，并且应变计定位成在至少一个检测构件与凸台相接合时确认缝合装置中的应变增大。
本公开的另一个方面涉及一种壳组件，该壳组件包括外壳和缝钉筒。该外壳包括远侧部分、近侧部分、外壳外部和外壳内部。外壳外部和外壳内部限定了环形腔并且外壳内部限定了通孔。外壳的外壳内部支承至少一个检测构件。该至少一个检测构件具有径向部分，该径向部分朝向通孔延伸并且定位成与位于通孔内的砧座组件的中心杆相接合。
在实施例中，至少一个检测构件包括围绕壳组件的外壳的外壳内部的外周间隔开的多个检测构件。
在一些实施例中，多个检测构件中的每一个包括从外壳内部向内延伸的径向部分。
在某些实施例中，缝合装置包括支承壳组件的适配器组件。
在实施例中，应变计被支承在适配器组件上。
在一些实施例中，缝合装置包括柄部组件并且适配器组件被支承在柄部组件上。
在某些实施例中，缝钉筒包括环形主体。
在实施例中，壳组件包括推动器和环形刀。
在一些实施例中，砧座保持器组件包括保持器构件，该保持器构件具有远侧套管针部分，该远侧套管针部分被构造成刺穿组织。
在某些实施例中，砧座保持器组件包括驱动螺杆并且该保持器构件包括近侧部分，该近侧部分限定了螺纹孔，驱动螺杆定位在螺纹孔内。
在一些实施例中，凸台呈环形。
在某些实施例中，至少一个检测构件包括多个检测腿部。
附图说明
下文参照附图描述了本文所公开的缝合装置的多个实施例，其中：
图1是本文所公开的外科缝合装置的示例性实施例的侧透视图，该外科缝合装置具有工具组件，该组件处于打开位置；
图2是图1中所示的细节指示区域的放大图；
图3是图1中所示的缝合装置的远端的侧透视图，其缝合装置的工具组件的砧座组件与缝合装置的工具组件的砧座保持器分开；
图3A是砧座保持器组件的放大图；
图4是图1中所示的缝合装置的工具组件的壳组件的外壳的远端的透视图；
图5是图4中所示的细节显示区域的放大图；
图6是沿图2的剖面线6-6截取的横截面图；
图7是图6中所示的细节指示区域的放大图；
图8是砧座组件从打开位置朝向夹紧位置移动时，沿图2的剖面线6-6截取的横截面图。
图9是图8中所示的细节指示区域的放大图。
图10是在砧座组件移动远离夹紧位置时，沿图2中的剖面线6-6截取的横截面图。
图11是图10中所示的细节指示区域的放大图。
具体实施方式
现在参照附图详细描述本文中所公开的装置，在附图中，相似的附图标记表示若干视图的各个视图中相同或相对应的元件。然而，应当理解，所公开的实施例仅仅是本公开的示例并且可以多种方式实施。未对众所周知的功能或构造进行描述，以免由于不必要的细节模糊本公开。因此，本文中所公开的特定的结构和功能不应当理解为构成限制，而仅仅是权利要求的基础并且作为代表性的基础，以教导本领域技术人员以不同方式将本公开实际应用于任何适当的具体结构。
在本说明书中，术语“近侧”大体用于表示装置的更靠近临床医师的部分，而术语“远侧”大体用于表示装置的更远离临床医师的部分。此外，术语“内窥镜”大体用于表示内窥镜、腹腔镜、关节镜、和/或通过小直径切口或插管进行的任何其它的手术。此外，术语“临床医师”大体用于表示包括医生、护士和保障人员在内的医务人员。
图1至3图示了外科缝合装置10，该外科缝合装置10包括柄部组件12，从柄部组件12延伸的适配器组件14、被支承在适配器组件14的远侧部分上的壳组件16、砧座保持器组件18、和可释放地支承在砧座保持器组件18上的砧座组件20(图3A)。柄部组件12图示为电动组件并且包括固定抓握部24、和致动按钮26，该致动按钮用于控制缝合装置10的功能操作，包括壳组件16和砧座组件20的逼近、和从壳组件16击发缝钉(未示出)。细长主体14联接到柄部组件12，以使动力从柄部组件12平移到壳组件16和砧座组件20。美国专利No.9,023,014(“014专利”)和No.9,055,943(“943专利”)公开了包括示例性动力柄部组件的外科缝合装置的示例。这些专利中的每一个都通过全文引用的方式结合到本文中。
尽管本公开图示了动力组件，能够构想，下文详细描述的本公开的优点也能够应用于具有手动操作柄部和主体组件的外科缝合装置或者自动致动外科装置。美国专利No.7,303,106(“106专利”)公开了一种外科缝合装置的示例，该外科缝合装置包括手动致动的柄部组件并且通过全文引用的方式结合到本文中。还能够构想，本文公开的缝合装置能够被支承在自动系统上并且不必包括柄部组件。
参照图2和图3，砧座组件20包括砧头28和砧座中心杆30。砧头28包括缝钉变形表面34，该缝钉变形表面34包括缝钉变形凹入部36。在图示实施例中，砧座中心杆30包括近侧部分和远侧部分，近侧部分具有多个柔性指38(图3)，远侧部分包括环形凸出部40。多个柔性指38限定了纵向孔44(图3)，该纵向孔44的尺寸能够接收和可释放地接合砧座保持器组件18的远侧部分，如下文进一步详细描述的。在实施例中，砧头28枢转地联接到砧座中心杆30并且能够在用于形成缝钉的操作位置(图1)与倾斜、轮廓减小位置(未示出)之间移动。对包括具有柔性指38和枢转砧头28的砧座中心杆30的砧座组件的更详细的描述请参见“106专利”。
还参照图4和图5，壳组件16(图2)被支承在细长主体14的远侧端部上并且包括壳外壳46、和环形缝钉筒48，该环形缝钉筒48限定了环形的缝钉接收凹入部50(图6)。缝钉接收凹入部50中的每一个支承缝钉54(图6)，该缝钉54能够通过致动柄部组件12(图1)从缝钉筒48被击发并且在砧头28的缝钉变形表面34的缝钉变形凹入部36(图8)内变形。壳组件16的壳外壳46包括外壳外部56和外壳内部58，该外壳外部56和外壳内部58共同限定环形腔60。环形腔60尤其支承缝钉推动器64和环形刀66，使得缝钉推动器64(图6)和环形刀66(图6)能够相对于缝钉筒48移动，以从缝钉筒48喷射缝钉54并且解剖或切割定位在被缝钉筒48限定的环68(图6)内的组织。外壳内部58基本呈圆柱形并且限定了中心通孔70(图5)，该中心通孔70接收砧座保持器组件18。壳外壳46的外壳内部58包括砧座检测构件74，该砧座检测构件74可以呈从外壳内部58向远侧延伸的腿部或指部的形式。砧座检测构件或腿部74中的每一个都包括径向部分75，该径向部分75向内延伸到通孔70上方的位置处，如下文进一步详细描述的。
还参照图3A，外科缝合装置10的砧座保持器组件18(图1)包括保持器构件76，该保持器构件76限定了螺纹开孔78(图3A)、和被接收在保持器构件76的螺纹开孔78内的驱动螺杆80。驱动螺杆80包括外部螺纹82，该外部螺纹82与沿螺纹开孔78形成的内部螺纹84相配合。当驱动螺杆80响应于外科缝合装置10的柄部组件12(图1)的致动旋转时，驱动螺杆80与保持器构件76之间的接合造成保持器构件76轴向移动穿过壳外壳46的外壳内部58的通孔70。
还参照图6，在实施例中，保持器构件76包括套管针部分86和环形保持凹入部88，该环形保持凹入部88限定肩部90。砧座中心杆30(图3)的柔性指38中的每一个限定向内延伸的突出部94。当套管针部分86被接收在砧座中心杆30的纵向开孔44(图3)中时，突出部94(图6)被接收在保持构件76的环形保持凹入部88中，使得突出部94与肩部90相接合，以将砧座组件可释放地固定到砧座保持器组件18的保持器构件76。这样一来，当保持器构件76缩回至通孔70中时，砧座组件20从打开位置(图1)朝向夹紧位置(未示出)移动，在该夹紧位置中，砧座组件20的缝钉变形表面34(图2)定位成与缝钉筒48并列对准。
参照图6和图7，当砧座组件20联接到砧座保持器组件18并且保持器构件76通过操作柄部组件12(图1)缩回至壳外壳46的通孔70中时，砧座组件20的中心杆30也被收回通孔70中，如众所周知。当砧座中心杆30沿图6中箭头“A”所示的方向被收回通孔70中时，砧座中心杆30上的环形凸台40朝向壳外壳46(图7)的外壳内部58的检测构件或腿部74的径向部分75(图7)移动。
参照图8和图9，当砧座组件20沿由箭头“B”指示的方向缩回壳外壳46的通孔70中直到检测腿部74的径向部分75与砧座中心杆30的凸台40相接合的程度时，检测腿部74沿图9中箭头“C”指示的方向向外变形。壳外壳46的检测腿部74与砧座中心杆30的凸台40之间的接合阻碍砧座组件20朝向夹紧位置移动。该阻碍使得关闭或夹紧砧座组件20与缝钉筒48所需的力增加。检测腿部74的厚度和/或数量能够被选择成在夹紧期间控制砧座中心杆30上阻碍的程度或数量。
参照图10和图11，当砧座中心杆30上的凸台40沿由箭头“D”指示的方向朝近侧移动通过检测腿部74的径向部分75时，检测腿部74沿由箭头“E”指示的方向回到其非变形状态，以去除或减小砧座中心杆30上的阻碍力。
外科缝合装置10包括应变计100(示意性示出)，该应变计在逼近和击发缝合装置10的过程中测量适配器组件14(图1)中的应变。在实施例中，应变计100能够被支承在适配器组件14中。在本申请中，应变计100能够用于在砧座组件20相对于缝钉筒48移动期间测量适配器组件14中的应变，以确定砧座组件20是否正确联接到砧座保持器组件18。当砧座组件20正确附接到砧座保持器组件18的保持器构件76并且砧座组件20从打开位置朝向夹紧位置移动时，检测腿部74的径向部分75与砧座中心杆30上的凸台40之间的接合使适配器组件14中的应变增加预先选定量。适配器组件14中该应变的增大能够由应变计100测量，以向临床医师提供砧座组件20联接到砧座保持器组件18的保持器构件76的指示。相反地，如果适配器组件14中的应变未增加预先选择量，会向临床医师提供砧座中心杆30上的凸台40尚未与壳外壳40的检测腿部74相接合并且砧座组件20未联接或者未正确联接至砧座保持器组件18的指示。应变计100能够向听觉或视觉指示器(未示出)提供信号，以警示临床医师存在或不存在砧座组件20。
对应变计结构和功能更详细的讨论参见例如(203-12085)美国临时申请No.62/801,979，该申请于2019年2月6日提交并且通过全文引用的方式结合到本文中。
本领域技术人员应当理解，本文中具体描述和附图中示出的装置以及方法是非限制性的示例性实施例。能够构想，结合一个示例性实施例图示或描述的元件及特征可以与另一个实施例的元件和特征结合，而不偏离本公开的范围。同样，本领域技术人员应当领会基于上述实施例的公开内容的进一步的特征和优点。因此，本公开不受到图示和描述内容的限制，所附权利要求指出的除外。

Claims (19)

1.一种缝合装置，其包括：
壳组件，所述壳组件包括外壳和缝钉筒，所述外壳具有远侧部分、近侧部分、外壳外部和外壳内部，所述外壳外部和所述外壳内部限定环形腔，所述外壳内部限定通孔并且支承至少一个检测构件，所述缝钉筒被支承在所述外壳的远侧部分上；
砧座保持器组件，所述砧座保持器组件能够在所述通孔内在缩回位置和前进位置之间移动；
砧座组件，所述砧座组件包括砧头和砧座中心杆，所述砧座中心杆具有近侧部分、远侧部分、和凸台，所述砧头被支承在所述砧座中心杆的远侧部分上，所述砧座中心杆的近侧部分适于与所述砧座保持器组件可释放地联接，所述砧座组件能够在打开位置与夹紧位置之间相对于所述壳组件移动；和
应变计；
其中所述至少一个检测构件定位成与所述砧座中心杆的环形凸台相接合，以阻碍所述砧座组件在打开位置与夹紧位置之间的移动，所述应变计定位成在所述至少一个检测构件与所述凸台相接合时确认所述缝合装置中的应变增大。
2.根据权利要求1所述的缝合装置，其中所述至少一个检测构件包括围绕所述壳组件的外壳的外壳内部的外周间隔开的多个检测构件。
3.根据权利要求2所述的缝合装置，其中所述至少一个检测构件中的每一个包括从所述外壳内部向内延伸的径向部分。
4.根据权利要求1所述的缝合装置，所述缝合装置还包括支承所述壳组件的适配器组件。
5.根据权利要求4所述的缝合装置，其中所述应变计被支承在所述适配器组件上。
6.根据权利要求5所述的缝合装置，其还包括柄部组件，所述适配器组件被支承在所述柄部组件上。
7.根据权利要求1所述的缝合装置，其中所述缝钉筒包括环形主体。
8.根据权利要求7所述的缝合装置，其中所述壳组件包括推动器和环形刀。
9.根据权利要求1所述的缝合装置，其中所述砧座保持器组件包括保持器构件，所述保持器构件具有被构造成刺穿组织的远侧套管针部分。
10.根据权利要求1所述的缝合装置，其中所述砧座保持器组件包括驱动螺杆并且所述保持器构件包括限定螺纹孔的近侧部分，所述驱动螺杆定位在所述螺纹孔内。
11.根据权利要求1所述的缝合装置，其中所述凸台呈环形。
12.根据权利要求1所述的外科装置，其中所述至少一个检测构件包括检测腿部，所述检测腿部包括从所述外壳内部向内延伸的径向部分。
13.一种壳组件，其包括：
外壳，所述外壳包括远侧部分、近侧部分、外壳外部和外壳内部，所述外壳外部和所述外壳内部限定了环形腔，所述外壳内部限定了通孔，所述外壳的外壳内部支承至少一个检测构件，所述至少一个检测构件具有径向部分，所述径向部分朝向所述通孔延伸并且定位成与位于所述通孔内的砧座组件的中心杆的一部分相接合。
14.根据权利要求13所述的壳组件，其中所述至少一个检测构件包括围绕所述外壳内部的外周定位的多个检测构件。
15.根据权利要求13所述的壳组件，其中所述至少一个检测构件中的每一个由弹性材料形成，使得所述至少一个检测构件能够弯曲，以使所述至少一个检测构件的径向部分相对于所述通孔向外移动。
16.根据权利要求13所述的壳组件，其中所述壳组件包括推动器和环形刀。
17.根据权利要求13所述的壳组件，其中所述缝钉筒包括环形主体。
18.根据权利要求13所述的壳组件，其中所述至少一个检测构件包括至少一个检测腿部。
19.根据权利要求18所述的壳组件，其中所述至少一个检测腿部包括多个检测腿部。
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