CN111989051A - 带闭锁机构的外科手术器械 - Google Patents
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Abstract
用于外科手术夹持和切割器械的锁定组件包括锁定构件和开关。驱动构件可以被配置成可释放地接合外科手术器械的刀具和/或梭件，用于使刀具和/或梭件在远侧方向上平移通过击发行程。锁定构件从第一位置可移动到第二位置，第一位置允许驱动构件向远侧平移通过击发行程，并且第二位置阻止驱动构件向远侧平移通过击发行程。当开关在近侧定位时，开关可释放地接合锁定构件以将锁定构件保持在第一位置。当开关移动到远侧位置时，开关与锁定构件脱离。
Description
相关申请
本申请要求2018年2月12日提交的第62/629572号美国临时申请的权益，其全部内容通过引用并入本文。
技术领域
本公开涉及一种外科手术吻合器械，其具有锁定机构，用于当有用过的或先前击发的钉仓(cartridge)就位时防止刀具的致动。更具体地说，本公开涉及用于手术夹持和切割器械的锁定组件(locking assembly)，该锁定组件包括锁定构件和开关。
背景技术
手术夹持和切割器械(诸如外科手术吻合器械)例如可以包括末端执行器，末端执行器具有夹持组织的对置夹具和切割夹持组织的刀具。通常有利的是外科手术吻合器械的末端执行器可重复使用。为此，在每次使用外科手术吻合器械之前，可以将订合钉钉仓装配到末端执行器的一个夹具中。
期望的是，当用过的钉仓在夹具上保持就位时，防止外科手术吻合器械击发。因此，需要有效的机构用于在用过的订合钉钉仓在外科手术吻合器械的末端执行器中就位时防止外科手术吻合器械的击发。
发明内容
以下呈现所要求保护的主题的简化概述，以便提供对所要求保护的主题的某些方面的基本理解。该概述不是所要求保护的主题的详尽概述。它既不旨在标识所要求保护的主题的关键或重要元素，也不旨在描绘所要求保护的主题的范围。其唯一目的是以简化的形式呈现所要求保护的主题的一些概念，作为稍后呈现的更详细描述的序言。
本公开涉及一种外科手术吻合器械，其具有锁定机构，用于当有用过的或先前击发的钉仓就位时防止刀具的致动。
在一个方面中，用于与外科手术吻合器械一起使用的闭锁组件(lockoutassembly)包括锁定构件(locking member)和开关。驱动构件被配置为可释放地接合刀具或梭件中的至少一个，并且使刀具或梭件中的至少一个在远侧方向上平移通过订合钉击发行程。锁定组件的锁定构件从第一位置可移动到第二位置，第一位置允许驱动构件向远侧平移通过订合钉击发行程，第二位置阻止驱动构件向远侧平移通过订合钉击发行程。弹簧可以使锁定构件朝向第二位置偏压。锁定组件的开关可从近侧位置移动到远侧位置。当开关处于近侧位置时，开关将锁定构件可释放地保持在第一位置。当开关处于远侧位置时，开关与锁定构件脱离，从而允许锁定构件移动到第二位置。
在另一方面中，外科手术吻合器械包括砧夹具组件和订合钉夹具组件，订合钉夹具组件包括刀具和梭件。驱动构件被配置成可释放地接合刀具和梭件并且使刀具和梭件沿远侧方向平移通过订合钉击发行程。在订合钉击发行程之后，当驱动构件向远侧移动时，刀具和梭件从驱动构件脱离。外科手术吻合器械进一步包括锁定构件，该锁定构件从允许驱动构件向远侧平移的第一位置可枢转到防止驱动构件向远侧平移的第二位置。外科手术吻合器械进一步包括开关，当处于近侧位置时，开关将锁定构件可释放地保持在第一位置。当开关处于远侧位置时，开关与锁定构件脱离，从而允许锁定构件移动到第二位置。
在另一方面中，外科手术吻合器械包括砧夹具组件和包括梭件的订合钉夹具组件。外科手术吻合器械进一步包括具有在其边缘上整体形成的刀具的驱动构件。驱动构件被配置为可释放地接合梭件并且使梭件在远侧方向上平移通过订合钉击发行程。在订合钉击发行程之后，当驱动构件随后向远侧移动时，梭件与驱动构件脱离。外科手术吻合器械进一步包括锁定构件，锁定构件从允许驱动构件向远侧平移的第一位置可枢转到防止驱动构件向远侧平移的第二位置。外科手术吻合器械进一步包括开关，当开关处于近侧位置时，开关将锁定构件可释放地保持在第一位置。当开关处于远侧位置时，开关与锁定构件脱离，从而允许锁定构件移动到第二位置。
附图说明
当结合附图考虑以下详细描述时，具有锁定机构的本外科手术吻合器械的上述和其他方面、特征和优点将变得更加明显，其中：
图1A是说明性外科手术吻合器械的透视图；
图1B是外科手术吻合器械的说明性末端执行器的分解图；
图2描绘了根据本公开的实施例的包括闭锁组件(lockout assembly)的外科手术吻合器械的末端执行器的部分横截面侧视图，外科手术吻合器械安装有未击发的再装载器；
图3是图示了根据图2的实施例的包括闭锁组件的末端执行器的局部透视图，其示出了安装有未击发的再装载器的外科手术吻合器械的近侧定位开关；
图3a是图示了根据图2的实施例的包括闭锁组件的末端执行器的局部透视图，其示出了与未击发的再装载器的下切部分(undercuts)接合的开关的一对固定卡扣。
图4是根据图2的实施例的包括闭锁组件的末端执行器的局部横截面侧视图，其中驱动构件被推进以接触刀具；
图5是根据图2的实施例的包括闭锁组件的末端执行器的局部横截面侧视图，图示了开关被推进到远侧位置；
图6是根据图2的实施例的包括闭锁组件的末端执行器的局部横截面侧视图，其示出了切割开关的刀具；
图6a是根据图2的实施例的包括闭锁组件的末端执行器的局部透视图，其示出了阻止开关向远侧平移的远侧壁；
图7是根据图2的实施例的包括闭锁组件的末端执行器的局部透视图，其示出了通过刀具被推动到远侧位置的未切割开关；
图8是根据图2的实施例的包括闭锁组件的末端执行器的局部透视图，其具有通过一对止动件防止缩回的切割开关；
图9是根据图2的实施例的包括闭锁组件的末端执行器的局部截面侧视图，其示出了梭件；以及
图10是根据图2的实施例的包括闭锁组件的末端执行器的局部截面侧视图，其图示了驱动构件，该驱动构件在其边缘上具有整体形成的刀具。
具体实施方式
本文下面参考附图描述了本外科手术吻合器械的具体实施；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以各种形式实现。因此，本文公开的具体结构和功能细节不应被解释为限制性的，而仅作为权利要求的基础，并且作为教导本领域技术人员在实际上任何适当详细的结构中以各种方式使用本公开的代表性基础。没有详细描述众所周知的功能或构造以避免以不必要的细节模糊本公开。
本公开涉及包括锁定构件和开关的锁定组件。驱动构件被配置为接合外科手术吻合器械的刀具或梭件中的至少一个，并且使刀具和/或梭件在远侧方向上平移通过订合钉击发行程。驱动构件与刀具和/或梭件之间的接触是可释放的，因为一旦刀具和/或梭件被驱动构件在远侧方向上平移通过订合钉击发行程，刀具和/或梭件就从驱动构件脱离，保持在吻合器械的远侧部分处，并且不被驱动构件在近侧方向上平移。锁定构件可从第一位置和第二位置移动，第一位置允许驱动构件向远侧平移通过订合钉击发行程，第二位置阻止驱动构件向远侧平移通过订合钉击发行程。弹簧被配置为将锁定构件朝向第二位置偏压。锁定组件的开关可从近侧位置移动到远侧位置。当开关处于近侧位置时，开关将锁定构件可释放地保持在第一位置。当开关处于远侧位置时，开关与锁定构件脱离，从而允许锁定构件移动到第二位置。
虽然下面的公开内容是关于订合钉被顺序击发的线性手术吻合器来呈现的，但应该理解的是，无论手术夹持和切割器械是否应用紧固件，本锁定组件可以容易地适于在任何类型的手术夹持和切割器械中使用。手术夹持和切割器械可以是微创(例如腹腔镜)器械或用于开放手术的器械。
另外，本锁定组件可以容易地适于在通过使用本领域技术人员力所能及的任何技术而被激活的手术器械中使用，诸如，手术器械是例如手动激活的手术器械、动力手术器械(例如，机电动力器械)、机器人外科手术器械和诸如此类。
图1A是根据本公开的能够利用锁定组件的说明性外科手术吻合器械10的透视图。外科手术吻合器械10包括手柄组件12和末端执行器100，该末端执行器包括砧夹具(anviljaw)组件102和安装在外科手术吻合器械10的细长轴160上的订合钉夹具(staple jaw)组件104。
图1B示出了砧夹具组件102，其包括砧106和订合钉夹具组件104，该砧106具有支撑在其上的订合钉形成袋103(未示出)。订合钉夹具组件104和砧夹具组件102被配置为从打开位置移动到闭合位置。在打开位置中，新的订合钉仓可以被装载到夹具组件104中，用过的订合钉钉仓从夹具组件104移除，并且组织可以被定位在夹具组件102、104之间。在闭合位置中，夹具组件102、104协作以闭合并夹紧组织，使得钉仓122和砧106紧密协作对齐。在图1A和图1B所示的实施例中，订合钉夹具组件104是静止的并且砧夹具组件102枢转到打开位置。在其他实施例中，可以预期包含砧的夹具组件是静止的，并且包含订合钉钉仓的夹具组件枢转到打开位置。正如阅读本公开的本领域技术人员将理解的，在其他实施例中，砧夹具组件和订合钉夹具组件都可以枢转。
继续参考图1B，订合钉夹具组件104包括订合钉钉仓122，订合钉钉仓122被支撑在下部夹具123上的通道134中。钉仓122包括多个订合钉124，订合钉124被支撑在对应的订合钉驱动器126上，订合钉驱动器被提供在形成于钉仓122中的相应订合钉孔128内。钉仓122还包括具有倾斜的远侧部分131的梭件130，当向远侧移动时梭件130顺序地作用于订合钉驱动器126，使它们向上凸轮运动，从而将订合钉124移动成与砧106的变形接触。钉仓122还包括刀具150，其被配置为向远侧平移通过钉仓122中的通道127并切开夹紧的吻合组织。
图1B进一步示出驱动构件110，其被可移动地支撑在外科手术吻合器械上从而使得当外科手术吻合器械被击发(例如，致动)时，其可以向远侧穿过钉仓122和订合钉夹具组件104。图1B中还示出了锁定组件，其包括在订合钉夹具组件104上的锁定构件116和在钉仓122上的开关170。
对于说明性末端执行器的更详细描述，可以参考美国专利号6669073和8800841，其全部内容通过引用并入本文。当然，应该理解图1A和图1B中所示的末端执行器仅仅是说明性的，并且可以使用其他末端执行器，包括但不限于WO2014/106275中所示的末端执行器，其全部内容通过引用并入本文。
图2示出了安装有未击发的再装载器的示例性外科手术吻合器械，其包括驱动构件110、弹簧114、锁定构件116、刀具150、开关170和槽180。
在新的再装载器中，驱动构件110处于尚未接合刀具150的近侧位置。驱动构件110可以是能够以有效切开或吻合人体组织的必要力推动外科手术吻合器械的梭件或刀具中的至少一个的任何结构。驱动构件110可以是I形梁，E形梁或能够执行类似功能的任何其他类型的驱动构件。驱动构件110包括下部远侧部分111和上部远侧部分113。
当未击发的再装载器被安装时，如图2所示，开关170处于第一近侧位置。在新的、未击发的再装载器中，锁定构件116的远侧部分119位于开关170的支架171上，使锁定构件116的接合部分118保持在槽180上方并且与槽180脱离接合。当锁定构件116处于该禁用位置时，因为锁定构件116不阻碍驱动构件110的移动，因此驱动构件110的远侧平移被允许。
如图3所示，未击发的再装载器包含新钉仓，刀具150位于未切割的开关170的中心部分174的近侧。如图3a所示，在安装未击发的再装载器时，开关170的固定卡扣172被配置成接合形成在未击发的再装载器上的下切部分177。这种相互作用可以是卡扣配合的相互作用，并且在击发外科手术吻合器械之前将开关保持在近侧位置。
如图4所示，在订合钉击发行程开始时，驱动构件110向远侧移动以接触刀具150。在致动行程的这一点处，锁定构件116保持与狭缝180脱离接合，因为锁定构件的远侧部分119继续搁置在开关170的支架171上。在该位置中，当驱动行程继续时，驱动构件110的上部远侧部分113接触刀具150用于远侧平移。驱动构件110的下部远侧部分111类似地向远侧移动，以便接合和平移梭件130(参见图9)。
如图5所示，当驱动构件110继续向远侧移动时，刀具150开始前进。刀具150与开关170接触，并且因此将开关170从近侧位置推动和平移到远侧位置。如图5所示，一旦处于远侧位置，开关170与锁定构件116的远侧部分119分离并且不再支撑锁定构件116的远侧部分119，远侧部分119基本上从支架171上掉下来。因此，锁定构件116的接合部分118落入并接合槽180，从而实现闭锁。弹簧114被配置为沿着箭头“B”的方向偏压锁定构件116的接合部分118，促使接合部分118落入槽180中以启用锁定机构。
在图6中，开关170处于远侧位置。一旦开关170向远侧平移，如图6a中最佳示出的，由于开关170变得被远侧壁179阻碍，进一步向远侧平移被防止。由于这种阻碍，由于使刀具150向远侧平移的驱动构件110所提供的力，刀具150的持续的远侧平移切割通过开关170的中心部分174(见图7)。图7中示出了刚好在中心部分174的切割之前在第二远侧位置中的开关170的透视图。图7还图示了止动件176，每个止动件176包括近侧斜坡面175。当驱动构件110使刀具150向远侧平移并且刀具150向远侧推动开关170时，开关170骑跨在止动件176的斜坡面175上。止动件176的远侧面181阻止开关170移回其初始近侧位置。
在图8中，刀具150已经切割通过开关170的中心部分174，以便刀具150可以继续朝向最终的停留位置向远侧平移。如图所示，止动件176被定位在开关170的近侧上。在该位置中，开关170的缩回是不可能的，因为开关170的近侧部分178邻接止动件176的远侧面181。通过防止开关170缩回，确保锁定构件116不能脱离，同时还保持开关170的两个切割部分被包含在再装载器中。
一旦驱动构件110向远侧平移通过完成吻合和切开组织的整个击发行程，驱动构件110可以被缩回，使刀具150停在钉仓122的远侧部分中的位置处。在实施例中，诸如图9所示的实施例中，梭件130由于与钉仓122的摩擦而可能不能朝向原始位置向近侧移动。在实施例中，如图10所示，刀具150可以与驱动构件110整体形成。在实施例中，刀具150可以停留在位于远侧的库(garage)165中的预定位置中。库165包括面向刀具150的切割尖端的侧向表面。当驱动器构件110被缩回时，由于弹簧114将其保持在锁定位置，所以锁定构件116的接合部分118不能向上移出槽180。
驱动构件110的进一步缩回将锁定构件116定位在驱动构件的远侧。由于钉仓已用过，并且没有近侧定位的开关将锁定构件保持与槽180脱离接合，因此驱动构件110接合锁定构件116将防止重新击发外科手术吻合器械的任何尝试。
为了禁用外科手术吻合器械的闭锁，必须安装未击发的再装载器(即新钉仓)。每个新钉仓都包含新开关170、梭件130和刀具150。当新钉仓被安装时，开关170向近侧移动，使得锁定构件116的远侧部分119与开关170的近侧斜坡表面173接合并沿其向上行进，直到锁定构件116再次停留在支架171上，如图2所示。然后闭锁被禁用，从而允许用户再次击发外科手术吻合器械。
尽管在附图中已经示出了本公开的若干实施例，但并不旨在将本公开限于此，因为旨在使本公开的范围与本领域所允许的范围一样广泛，并且本说明书同样被阅读。因此，上述描述不应被解释为限制性的，而应仅被解释为目前公开的实施例的范例。因此，实施例的范围应由所附权利要求及其法定等效物确定，而不是由给出的示例确定。
本领域技术人员将理解，本文具体描述并在附图中图示的装置和方法是非限制性示例性实施例。关于一个示例性实施例说明或描述的特征可以与其他实施例的特征组合。本领域技术人员可以设计各种替代方案和修改，而不脱离本公开。因此，本公开旨在涵盖所有这些替代方案、修改和变体。同样，本领域技术人员将基于上述实施例理解本公开的其他特征和优点。因此，除了所附权利要求所指出的之外，本公开不受已经具体示出和描述的内容的限制。
Claims (17)
1.一种闭锁组件，其包括：
锁定构件，所述锁定构件从第一位置可移动到第二位置，所述第一位置允许驱动构件向远侧平移通过订合钉击发行程，所述第二位置阻止所述驱动构件向远侧平移通过所述订合钉击发行程；以及
开关，所述开关能够从近侧位置移动到远侧位置，其中当所述开关处于所述近侧位置时，所述开关将所述锁定构件可释放地保持在所述第一位置，并且其中当所述开关处于所述远侧位置时，所述开关与所述锁定构件脱离。
2.根据权利要求1所述的闭锁组件，进一步包括配置成将所述锁定构件朝所述第二位置偏压的弹簧。
3.根据权利要求1所述的闭锁组件，其中所述开关被容纳在订合钉钉仓中，并且所述锁定构件被安装到外科手术吻合器械的夹具，所述夹具包括被配置成接收所述订合钉钉仓的通道。
4.根据权利要求1所述的闭锁组件，其中所述锁定构件搁置在所述开关的支架上。
5.根据权利要求3所述的闭锁组件，其中所述夹具进一步包括一对止动件，所述一对止动件被配置成在所述开关已经移动到所述远侧位置之后防止所述开关移动到所述近侧位置。
6.根据权利要求1所述的闭锁组件，其中所述夹具进一步包括槽，并且所述锁定构件在所述第二位置中接合所述槽。
7.一种外科手术吻合器械，其包括：
砧夹具组件；
订合钉夹具组件，其包括刀具和梭件；
驱动构件，其被配置成可释放地接合所述刀具和所述梭件并且使所述刀具和所述梭件在远侧方向上平移通过订合钉击发行程；以及
锁定组件，其包括：
锁定构件，其可在允许驱动构件向远侧平移的第一位置和防止所述驱动构件向远侧平移的第二位置之间枢转；以及
开关，其从近侧位置可移动至远侧位置，其中当所述开关处于所述近侧位置时，所述开关将所述锁定构件可释放地保持在所述第一位置，并且其中当所述开关处于所述远侧位置时，所述开关与所述锁定构件脱离，从而允许所述锁定构件移动到所述第二位置。
8.根据权利要求7所述的外科手术吻合器械，其中所述订合钉夹具组件包括容纳所述刀具的可移除订合钉钉仓。
9.根据权利要求7所述的外科手术吻合器械，其中所述订合钉夹具组件包括容纳所述开关的可移除订合钉钉仓。
10.根据权利要求7所述的外科手术吻合器械，其中所述订合钉夹具组件包括容纳所述梭件的可移除订合钉钉仓。
11.根据权利要求7所述的外科手术吻合器械，其中当所述锁定构件处于所述第二位置时，所述锁定构件接合所述订合钉夹具组件中的槽。
12.根据权利要求7所述的外科手术吻合器械，其中所述刀具被配置成切割通过所述开关的中心部分。
13.一种外科手术吻合器械，其包括：
砧夹具组件；
订合钉夹具组件，其包括梭件；
驱动构件，其具有在其边缘上整体形成的刀具，所述驱动构件被配置成可释放地接合所述梭件并且使所述梭件在远侧方向上平移通过订合钉击发行程；
锁定组件，其包括：
锁定构件，其在允许所述驱动构件向远侧平移的第一位置和防止所述驱动构件向远侧平移的第二位置之间可枢转；以及
开关，其从近侧位置可移动至远侧位置，其中当所述开关处于所述近侧位置时，所述开关将所述锁定构件可释放地保持在所述第一位置，并且其中当所述开关处于所述远侧位置时，所述开关与所述锁定构件脱离，从而允许所述锁定构件移动到所述第二位置。
14.根据权利要求13所述的外科手术吻合器械，其中所述订合钉夹具组件包括容纳所述开关的可移除订合钉钉仓。
15.根据权利要求13所述的外科手术吻合器械，其中所述订合钉夹具组件包括容纳所述梭件的可移除订合钉钉仓。
16.根据权利要求13所述的外科手术吻合器械，其中当所述锁定构件处于所述第二位置时，所述锁定构件接合所述订合钉夹具组件中的槽。
17.根据权利要求13所述的外科手术吻合器械，其中所述刀具被配置成切割通过所述开关的中心部分。
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| Publication number | Publication date |
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| WO2019157500A2 (en) | 2019-08-15 |
| US20240108343A1 (en) | 2024-04-04 |
| US11864762B2 (en) | 2024-01-09 |
| US11517312B2 (en) | 2022-12-06 |
| EP3752074A2 (en) | 2020-12-23 |
| US20210022736A1 (en) | 2021-01-28 |
| WO2019157500A3 (en) | 2020-04-30 |
| EP3752074A4 (en) | 2022-03-23 |
| US20230052074A1 (en) | 2023-02-16 |
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