CN112165909A - 具有用于除非其中已安装兼容仓否则将其击发构件保持在锁定构型中的布置的外科缝合器 - Google Patents
具有用于除非其中已安装兼容仓否则将其击发构件保持在锁定构型中的布置的外科缝合器 Download PDFInfo
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- CN112165909A CN112165909A CN201980035437.XA CN201980035437A CN112165909A CN 112165909 A CN112165909 A CN 112165909A CN 201980035437 A CN201980035437 A CN 201980035437A CN 112165909 A CN112165909 A CN 112165909A
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Abstract
本发明公开了一种外科缝合器械,该外科缝合器械包括第一钳口和第二钳口,该第一钳口被构造成能够在该第一钳口中可移除地支撑外科钉仓,该第二钳口能够相对于该第一钳口在打开位置和闭合位置之间运动。击发构件被构造成能够在对该击发构件施加击发动作时在起始位置和结束位置之间轴向运动。击发构件闭锁件与外科钉仓中的凸轮作用组件交接以闭锁击发构件,除非凸轮作用组件处于未击发位置。仓验证构件被构造成能够使凸轮作用组件从未击发位置运动离开到达中间位置,除非仓验证构件检测到外科钉仓上的验证特征部。
Description
相关申请的交叉引用
本申请要求2019年2月19日提交的名称为“METHODS FOR CONTROLLING A POWEREDSURGICAL STAPLER THAT HAS SEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国临时专利申请序列号62/807,310、2019年2月19日提交的名称为“SURGICAL STAPLINGDEVICES WITH IMPROVED LOCKOUT SYSTEMS”的美国临时专利申请序列号62/807,319、以及2019年2月19日提交的名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARYDRIVEN CLOSURE SYSTEMS”的美国临时专利申请序列号62/807,309的权益,这些申请的公开内容全文以引用方式并入本文。本申请要求2018年3月30日提交的名称为“SURGICALSYSTEMS WITH OPTIMIZED SENSING CAPABILITIES”的美国临时专利申请序列号62/650,887的权益,该申请的公开内容全文以引用方式并入本文。本申请要求2018年3月28日提交的名称为“INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATIONCAPABILITIES”的美国临时专利申请序列号62/649,302、2018年3月28日提交的名称为“DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZEDRECORD”的美国临时专利申请序列号62/649,294、2018年3月28日提交的名称为“SURGICALHUB SITUATIONAL AWARENESS”的美国临时专利申请序列号62/649,300、2018年3月28日提交的名称为“SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATINGTHEATER”的美国临时专利申请序列号62/649,309、2018年3月28日提交的名称为“COMPUTERIMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”的美国临时专利申请序列号62/649,310、2018年3月28日提交的名称为“USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TODETERMINE PROPERTIES OF BACK SCATTERED LIGHT”的美国临时专利申请序列号62/649,291、2018年3月28日提交的名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICALDEVICES”的美国临时专利申请序列号62/649,296、2018年3月28日提交的名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER”的美国临时专利申请序列号62/649,333、2018年3月28日提交的名称为“CLOUD-BASED MEDICALANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES”的美国临时专利申请序列号62/649,327、2018年3月28日提交的名称为“DATA HANDLING ANDPRIORITIZATION IN A CLOUD ANALYTICS NETWORK”的美国临时专利申请序列号62/649,315、2018年3月28日提交的名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国临时专利申请序列号62/649,313、2018年3月28日提交的名称为“DRIVE ARRANGEMENTSFOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,320、2018年3月28日提交的名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国临时专利申请序列号62/649,307、以及2018年3月28日提交的名称为“SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,323的权益,这些申请的公开内容全文以引用方式并入本文。
背景技术
本发明涉及外科器械,并且在各种布置中,涉及被设计成缝合和切割组织的外科缝合和切割器械以及与其一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解:
图1为动力外科缝合系统的透视图;
图2为图1的动力外科缝合系统的可互换外科轴组件的透视图;
图3为图1的动力外科缝合系统的柄部组件的各部分的分解组装视图;
图4为图2的可互换外科轴组件的分解组装视图;
图5为图4的可互换外科轴组件的一部分的另一个局部分解组装视图;
图6为另一个动力外科缝合系统的透视图;
图7为图6的动力外科缝合系统的轴组件的部分的分解组装视图;
图8为图6的动力外科缝合系统的柄部组件的各部分的分解组装视图;
图9为可与旋转动力外科缝合系统一起使用的另一个外科端部执行器的侧正视图;
图10是图9的外科端部执行器的分解组装视图;
图11为可与图9和图10的外科端部执行器一起使用的旋转动力击发构件的分解组装视图;
图12为图9的外科端部执行器的局部剖视图,其示出了新的未击发外科钉仓在其中的初始插入;
图13为图12的外科端部执行器在已将外科钉仓可操作地安装在其中之后的另一个局部剖视图;
图14为示出图13的端部执行器的击发构件和凸轮作用组件的放大局部剖视图;
图15为在将新的外科钉仓插入其中之前并且其中其击发构件闭锁组件处于锁定位置的图9的外科端部执行器的另一个局部剖视图;
图16为示出图15的端部执行器的击发构件和闭锁凸耳的放大局部剖视图,其中为清楚起见省略了凸轮作用组件和端部执行器通道;
图17为另一个外科端部执行器的侧正视图,其中其砧座处于打开位置;
图18为图17的外科端部执行器的局部底部透视图;
图19为图17的外科端部执行器的通道安装特征部和砧座闭锁弹簧的透视图;
图20为其中未安装有外科钉仓并且其砧座处于锁定位置的图17的外科端部执行器的局部底部透视图;
图21为在兼容外科钉仓已安装在其中并且砧座闭锁弹簧已运动到解锁位置后的图20的外科端部执行器的另一个局部底部透视图;
图22为图21所示的外科钉仓的近侧端部部分的透视图;
图23为外科钉仓以及外科端部执行器的对应砧座和砧座闭锁系统的局部分解组装视图;
图24为外科钉仓以及另一个外科端部执行器的对应砧座和砧座闭锁系统的局部分解组装视图;
图25为其中装载有兼容外科钉仓的另一个端部执行器的通道的局部底视图,其中为清楚起见省略了兼容外科钉仓的各部分;
图26为图25的外科端部执行器的一部分的侧正视图,其中为了清楚起见省略了通道、砧座和仓的各部分;
图27为图25和图26的外科端部执行器的局部剖面端视图,其中砧座示出为在兼容外科钉仓上处于闭合位置;
图28为图25和图26的外科端部执行器的另一个局部剖面端视图,其中其砧座示出为处于锁定打开位置;
图29为图25和图26的外科端部执行器的砧座锁的侧正视图,该外科端部执行器被示出为处于锁定构型和解锁构型(以虚线显示);
图30为另一个外科端部执行器的一部分的侧正视图,其中为了清楚起见省略了通道、砧座和仓的部分;
图31为图30的外科端部执行器的砧座锁的前正视图;
图32为图31的砧座锁的顶视图;
图33为另一个外科端部执行器的剖面侧视图,其中其砧座处于打开位置并且其中安装有兼容外科钉仓;
图34为与图33的外科端部执行器的砧座锁定特征部的一部分相关的图33的兼容外科钉仓的近侧端部的局部透视图;
图35为图33的外科端部执行器的通道的一部分和插入其中的图33的兼容外科钉仓的轮廓的顶视图;
图36为图33的外科端部执行器的另一个剖面侧视图,其中其砧座在将不兼容外科钉仓初始安装在其中期间处于打开位置;
图37为另一个外科端部执行器的剖面侧视图,其中其砧座在将兼容外科钉仓安装在其中期间处于打开位置;
图38为另一个外科端部执行器的各部分的剖面侧视图,在其中安装兼容外科钉仓期间其砧座处于打开位置;
图39为另一个外科端部执行器的各部分的剖面侧视图,其中其砧座在将兼容外科钉仓安装在其中期间处于打开位置;
图40为图39的端部执行器在将不兼容仓安装在其中期间的剖面侧视图;
图41为砧座的近侧端部部分的局部透视图;
图42为另一个砧座的近侧端部部分的局部透视图;
图43为另一个外科端部执行器的各部分的局部剖面端视图;
图44为图43的外科端部执行器的砧座的近侧端部部分的局部透视图;
图45为图43的外科端部执行器的通道和砧座锁的一部分的局部剖面透视图,其中砧座锁处于锁定位置;
图46为图43的外科端部执行器的局部侧正视图,其中砧座处于打开位置并且其砧座锁以虚线示出为处于锁定位置;
图47为图43的外科端部执行器的通道和砧座锁的一部分的另一个局部剖面透视图,其中砧座锁处于解锁位置;
图48为图43的外科端部执行器的另一个局部侧正视图,其中砧座处于闭合位置并且其砧座锁以虚线示出为处于解锁位置;
图49为另一个外科端部执行器的各部分的局部剖面端视图;
图50为图49的外科端部执行器的砧座的近侧端部部分的局部透视图;
图51为图49的外科端部执行器的通道和砧座锁的一部分的局部剖面侧视图,其中砧座锁处于锁定位置;
图52为另一个外科端部执行器的局部侧正视图,其中其砧座处于打开位置并且其砧座锁以虚线示出为处于锁定位置;
图53为图52的外科端部执行器的砧座的一部分的侧正视图;
图54为图53的砧座的一部分的局部透视图;
图55为图52的外科端部执行器的通道和砧座锁的一部分的局部剖面透视图,其中砧座锁处于锁定位置;
图56为图52的外科端部执行器的通道和砧座锁的一部分的另一个局部剖面透视图,其中砧座锁处于解锁位置;
图57为图52的外科端部执行器的局部侧正视图,其中砧座处于闭合位置并且其砧座锁以虚线示出为处于解锁位置;
图58为另一个砧座的局部透视图;
图59为可结合图58的砧座使用的另一个通道的一部分的局部剖面透视图;
图60为另一个砧座的一部分的侧正视图;
图61为图60的砧座的一部分的透视图;
图62为另一个砧座的一部分的透视图;
图63为另一个外科端部执行器的侧正视图,其中其砧座在将外科钉仓安装在其中之前处于打开位置;
图64为图63的外科端部执行器在已将兼容外科钉仓安装在其中之后的另一个侧正视图;
图65为图63的外科端部执行器的外科端部执行器闭合管的端部正视图,并且其中其闭合锁处于锁定位置;
图66为图65的外科端部执行器闭合管和闭合锁的另一个端部正视图,其中闭合锁被示出为处于解锁位置;
图67为图63的外科端部执行器的兼容外科钉仓和闭合锁的一部分的局部透视图;
图68为图63的外科端部执行器的局部侧正视图,其中其砧座处于打开位置并且在将外科钉仓安装在其中之前;
图69为图68的外科端部执行器的另一个局部侧正视图,其中其砧座处于打开位置并且在将兼容外科钉仓安装在其中期间;
图70为图68的外科端部执行器的局部侧正视图,其中其砧座处于打开位置并且在将兼容外科钉仓初始安装在其中期间;
图71为图70的外科端部执行器的另一个局部侧正视图,其中其砧座处于打开位置并且在兼容外科钉仓已被可操作地安置在其中之后;
图72为图70和图71所示的兼容外科钉仓的一部分的局部剖面透视图;
图73为图70的外科端部执行器的另一个局部侧正视图,其中其砧座处于打开位置并且在其安装期间缺少兼容凸轮作用组件的外科钉仓处于起始位置;
图74为另一个外科端部执行器的局部侧正视图,其中其砧座处于打开位置并且在将兼容外科钉仓初始安装在其中期间;
图75为图74的外科端部执行器的另一个局部侧正视图,其中其砧座处于打开位置并且在兼容外科钉仓已被可操作地安置在其中之后;
图76为图74和图75的外科端部执行器的砧座锁和通道安装特征部的透视图;
图77为与图74和图75的外科端部执行器兼容的外科钉仓的一部分的透视图;
图78为图74的外科端部执行器的另一个局部侧正视图,其中其砧座处于打开位置并且在不兼容外科钉仓已被安置在其中之后;
图79为另一个外科端部执行器的侧正视图,其中装载有兼容外科钉仓并且其砧座处于打开位置;
图80为与图79的外科端部执行器兼容的外科钉仓的一部分的顶视图,其中为清楚起见省略了其各部分;
图81为沿图80中的线81-81截取的安装在图79的外科端部执行器中的图80的外科钉仓的一部分的局部剖面侧视图,其示出了处于锁定位置的仓鼻部组件;
图82为沿图80中的线82-82截取的安装在图79的外科端部执行器中的图80的外科钉仓的一部分的另一个局部剖面侧视图,其示出了处于解锁位置的仓鼻部组件;
图83为沿图80中的线83-83截取的安装在图79的外科端部执行器中的图80的外科钉仓的一部分的另一个局部剖面侧视图,其示出了处于锁定位置的仓鼻部组件;
图84为沿图80中的线84-84截取的安装在图79的外科端部执行器中的图80的外科钉仓的一部分的另一个局部剖面侧视图,其示出了处于解锁位置的仓鼻部组件;
图85为外科钉仓的击发构件和凸轮作用组件的一部分的局部剖视图,其中凸轮作用组件处于起始位置并且与击发构件上的击发构件锁解锁接合;
图86为图85的击发构件的一部分的另一个局部剖视图,其中击发构件锁处于锁定位置;
图87为另一个外科端部执行器的砧座的一部分的侧正视图,其中砧座相对于安装在对应通道内的兼容外科钉仓处于打开位置,为了清楚起见已省略该通道;
图88为图87的砧座和外科钉仓在砧座的初始闭合期间的另一个侧正视图;
图89为图87的砧座和外科钉仓在砧座已运动到闭合位置之后的另一个侧正视图;
图90为图87至图89所示的兼容外科钉仓的一部分的透视图;
图91为图87至图89的砧座的局部底视图;
图92为与图87至图89的砧座不兼容的外科钉仓的一部分的透视图;
图93为图87至图89的砧座的侧正视图,该砧座相对于安装在对应通道内的图92的不兼容外科钉仓处于打开位置,为了清楚起见已省略该通道;
图94为图93的砧座和外科钉仓在砧座的初始闭合期间的另一个侧正视图;
图95为图93的砧座和外科钉仓在砧座已运动到闭合位置之后的另一个侧正视图;
图96为另一个外科端部执行器的一部分的局部剖面侧视图,其中装载有兼容外科钉仓并且为了清楚起见已省略其砧座;
图97为图96的外科钉仓和外科端部执行器的一部分的顶视图;
图98为图97所示的兼容外科钉仓的近侧端部的一部分的透视图;
图99为图96的外科端部执行器的一部分的另一个局部剖面侧视图,示出了其中兼容外科钉仓的安装;
图100为图96的外科端部执行器的一部分的另一个局部剖面侧视图,示出了其中兼容外科钉仓的安装;
图101为图98的外科端部执行器和兼容外科钉仓的顶视图;
图102为图96的外科端部执行器的一部分的另一个局部剖面侧视图,示出了其中不兼容外科钉仓的安装;
图103为图96的外科端部执行器的一部分的另一个局部剖面侧视图,示出了其中不兼容外科钉仓的安装;
图104为图103的外科端部执行器和不兼容外科钉仓的顶视图;
图105为图96的外科端部执行器的一部分的另一个局部剖面侧视图,示出了其中不兼容外科钉仓的安装;
图106为图105的外科端部执行器和不兼容外科钉仓的顶视图;
图107为其中安装有不兼容外科钉仓的另一个外科端部执行器的各部分的局部剖面透视图;
图108为图107的外科端部执行器和不兼容外科钉仓的各部分的局部顶视图;
图109为图105的外科端部执行器的另一个局部顶视图,其中兼容外科钉仓已安装在其中;
图110为其中安装有兼容外科钉仓的另一个外科端部执行器的各部分的局部剖面透视图;
图111为图110的外科端部执行器的各部分的局部分解组装视图;
图112为图110的外科端部执行器和兼容外科钉仓的局部剖面端视图;
图113为其中安装有不兼容外科钉仓的图110的端部执行器的另一个局部剖面外科端视图;
图114为其中安装有不兼容外科钉仓的图110的外科端部执行器的各部分的另一个局部剖面透视图;
图115为图114的外科端部执行器和外科钉仓的顶视图;
图116为另一个外科钉仓的一部分的顶视图;
图117为图116的外科钉仓的一部分的局部剖面透视图,其中其凸轮作用组件处于锁定位置;
图118为与外科端部执行器的兼容致动器部分交接的图116的外科钉仓的另一个顶视图;
图119为图116的外科钉仓的一部分的另一个局部剖面透视图,其中其凸轮作用组件处于解锁位置;
图120为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部正视图,该缝合器械包括仓通道、定位在仓通道中的钉仓以及击发构件,其中该击发构件处于未击发位置;
图121为图120的缝合器械的局部正视图,示出了处于闭锁位置的击发构件;
图122为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部正视图,该缝合器械包括仓通道、定位在仓通道中的钉仓以及击发构件,其中该击发构件处于未击发位置;
图123为图122的缝合器械的局部正视图,示出了处于解锁位置的击发构件;
图124为图122的缝合器械的局部正视图,示出了处于闭锁位置的击发构件;
图125为图122的缝合器械的局部底视图,示出了处于未击发位置的击发构件;
图126为图122的钉仓的局部透视图;
图127为根据至少一个实施方案的钉仓的局部透视图;
图128为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部正视图,该缝合器械包括仓通道、定位在仓通道中的钉仓以及击发构件,其中该击发构件处于未击发位置;
图129为图128的缝合器械的局部正视图,示出了处于解锁位置的击发构件;
图130为被示为处于图128的未击发位置的图128的缝合器械的局部顶视图;
图131为被示为处于图129的解锁位置的图128的缝合器械的局部顶视图;
图132为处于未用尽构型的图128的钉仓的局部透视图;
图133为处于用尽构型的图128的钉仓的局部透视图;
图134为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部正视图,该缝合器械包括仓通道、定位在仓通道中的钉仓以及击发构件,其中该击发构件处于未击发位置;
图135为图134的缝合器械的局部正视图,示出了处于闭锁位置的击发构件;
图136为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部透视图,该缝合器械包括仓通道、定位在仓通道中的钉仓、击发构件、以及击发构件锁,其中该击发构件已被钉仓解锁;
图137为图136的缝合器械的局部正视图,示出了安置在仓通道中的不正确的钉仓;
图138为图136的缝合器械的局部剖视平面图,示出了安置在仓通道中的不正确的钉仓;
图139为图136的缝合器械的局部剖视平面图,示出了被钉仓解锁的击发构件锁;
图140为根据至少一个另选实施方案的已被钉仓解锁的缝合器械的局部剖视图;
图141为根据至少一个另选实施方案的已被钉仓解锁的缝合器械的局部剖视图;
图142为图140的钉仓的局部透视图;
图143为图141的钉仓的局部透视图;
图144为根据至少一个实施方案的钉仓盘的局部剖面透视图;
图145为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部透视图,该缝合器械包括仓通道、定位在仓通道中的钉仓、击发构件、以及击发构件锁,其中该击发构件被钉仓解锁;
图146为图145的缝合器械的局部透视图,示出了定位在仓通道中的不解锁击发构件的不同钉仓;
图147为图145的缝合器械的局部透视图,示出了处于锁定构型的击发构件;
图148为被构造成能够被图146的不同钉仓解锁的缝合器械的局部透视图;
图149为钉仓的透视图,该钉仓类似于图146的钉仓并且被构造成能够解锁图148的缝合器械;
图150为钉仓的透视图,该钉仓类似于图145的钉仓并且被构造成能够解锁图145的缝合器械;
图151为根据至少一个实施方案的被示出为已移除一些部件的缝合器械的局部分解图,该缝合器械包括仓通道、定位在仓通道中的钉仓、击发构件、砧座、以及两用击发构件/砧座锁,其中该缝合器械被示出为处于锁定状态;
图152为通过将钉仓插入仓通道中而被解锁的图151的缝合器械的局部透视图;
图153为图151的缝合器械的局部剖视图,示出了处于图151的锁定状态的缝合器械;
图154为图151的缝合器械的局部剖视图,示出了处于图152的解锁状态的缝合器械;
图155为图151的击发构件/砧座锁的透视图;
图155A为根据至少一个实施方案的钉仓的局部透视图;
图155B为根据至少一个实施方案的钉仓的局部透视图;
图155C为根据至少一个实施方案的钉仓的局部透视图;
图155D为根据至少一个实施方案的钉仓的局部透视图;
图155E为根据至少一个实施方案的钉仓的局部透视图;
图156为外科缝合组件的局部剖视图,该外科缝合组件包括砧座、钉仓、击发构件和击发闭锁件;
图157为被示为处于解锁构型的图156的击发构件和击发闭锁件的局部剖视图;
图158为被示为处于锁定构型的图156的击发构件和击发闭锁件的局部剖视图;
图159为图156的外科缝合组件的局部剖视图,其中外科缝合组件还包括外部进入孔,该外部进入孔被构造成能够允许使用者利用单独的闭锁键使击发闭锁件人工地运动到解锁构型;
图160为图156的击发闭锁件的闭锁构件的透视图;
图161为外科缝合组件的局部剖视图,该外科缝合组件包括闭锁件和外部进入孔口,该外部进入孔口被构造成能够允许使用者利用单独的闭锁键使击发闭锁件人工地运动到解锁构型;
图162为图161的外科缝合组件的底部平面图;
图163为外科缝合组件的局部剖视图,该外科缝合组件包括击发构件、仓通道、被构造成能够安装到仓通道中的钉仓、以及闭锁件,其中该闭锁件被示出为处于未接合构型;
图164为图163的外科缝合组件的局部剖视图,其中该闭锁件被示出为处于接合构型;
图165包括两个钉仓的正视图,每个钉仓包括不同的闭锁键;
图166为示出由图165的钉仓的每个闭锁键提供的刀提升定时的曲线图;
图167为示出由图165的钉仓的每个闭锁键提供的刀提升位移的曲线图;
图168为与外科缝合系统一起使用的第一钉仓的透视图,其中第一钉仓包括仓体、盘、滑动件和第一闭锁键;
图169为与外科缝合系统一起使用的第二钉仓的透视图,图168的第一钉仓与该外科缝合系统一起使用,其中第二钉仓包括仓体、盘、滑动件和第二闭锁键;
图170为外科缝合组件的正视图,该外科缝合组件包括击发构件、包括钉仓的第一钳口、包括能够相对于第一钳口运动的砧座的第二钳口、以及闭锁件;
图171为图170的外科缝合组件的局部透视图;
图172为图170的外科缝合组件的局部正视图,其中钉仓未安装在第一钳口内;
图173为图170的外科缝合组件的局部正视图,其中钉仓安装在第一钳口内;
图174为图170的外科缝合组件的局部剖视图,其中钉仓安装在第一钳口内并且击发构件处于未击发位置;
图175为图170的外科缝合组件的局部剖视图,其中钉仓安装在第一钳口内并且击发构件处于部分击发位置;
图176为图170的外科缝合组件的局部剖视图,其中钉仓未安装在第一钳口内并且击发构件处于未击发位置;
图177为图170的外科缝合组件的局部剖视图,其中钉仓未安装在第一钳口内并且击发构件处于锁定位置;
图178为图170的外科缝合组件的局部正视图,其中钉仓安装在第一钳口内并且击发构件处于部分击发位置,其中一些部件以隐藏线示出;
图179为图170的外科缝合组件的钉仓的透视图,该钉仓包括从其近侧端部延伸的闭锁键;
图180为图179的钉仓的局部平面图;并且
图181为被构造用于与包括图179的钉仓的系统一起使用的第二钉仓的局部平面图,其中第二钉仓包括闭锁键,该闭锁键包括与图179的钉仓的闭锁键不同的构型。
在所述若干视图中,对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案,且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HASSEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国专利申请,代理人案卷号END9020USNP1/180504-1M;
-名称为“STAPLE CARTRIDGE COMPRISING A LOCKOUT KEY CONFIGURED TO LIFTA FIRING MEMBER”的美国专利申请,代理人案卷号END9021USNP1/180505-1;
-名称为“SURGICAL INSTRUMENT COMPRISING CO-OPERATING LOCKOUT FEATURES”的美国专利申请,代理人案卷号END9021USNP3/180505-3;
-名称为“SURGICAL STAPLING ASSEMBLY COMPRISING A LOCKOUT AND ANEXTERIOR ACCESS ORIFICE TO PERMIT ARTIFICIAL UNLOCKING OF THE LOCKOUT”的美国专利申请,代理人案卷号END9021USNP4/180505-4;
-名称为“SURGICAL STAPLING DEVICES WITH FEATURES FOR BLOCKINGADVANCEMENT OF A CAMMING ASSEMBLY OF AN INCOMPATIBLE CARTRIDGE INSTALLEDTHEREIN”的美国专利申请,代理人案卷号END9021USNP5/180505-5;
-名称为“STAPLING INSTRUMENT COMPRISING A DEACTIVATABLE LOCKOUT”的美国专利申请,代理人案卷号END9021USNP6/18505-6;
-名称为“SURGICAL INSTRUMENT COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请,代理人案卷号END9021USNP7/180505-7;
-名称为“SURGICAL STAPLING DEVICES WITH CARTRIDGE COMPATIBLE CLOSUREAND FIRING LOCKOUT ARRANGEMENTS”的美国专利申请,代理人案卷号END9021USNP8/180505-8;
-名称为“SURGICAL STAPLE CARTRIDGE WITH FIRING MEMBER DRIVEN CAMMINGASSEMBLY THAT HAS AN ONBOARD TISSUE CUTTING FEATURE”的美国专利申请,代理人案卷号END9022USNP1/180508-1;
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURESYSTEMS”的美国专利申请,代理人案卷号END9022USNP2/180508-2;
-名称为“SURGICAL STAPLING DEVICES WITH ASYMMETRIC CLOSURE FEATURES”的美国专利申请,代理人案卷号END9022USNP3/180508-3;
-名称为“ROTARY DRIVEN FIRING MEMBERS WITH DIFFERENT ANVIL AND CHANNELENGAGEMENT FEATURES”的美国专利申请,代理人案卷号END9022USNP4/180508-4;以及
-名称为“SURGICAL STAPLING DEVICE WITH SEPARATE ROTARY DRIVEN CLOSUREAND FIRING SYSTEMS AND FIRING MEMBER THAT ENGAGES BOTH JAWS WHILE FIRING”的美国专利申请,代理人案卷号END9022USNP5/180508-5。
本申请的申请人拥有于2019年2月19日提交且各自全文以引用方式并入本文的以下美国临时专利申请:
-名称为“METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HASSEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国临时专利申请序列号62/807,310;
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED LOCKOUT SYSTEMS”的美国临时专利申请序列号62/807,319;以及
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURESYSTEMS”的美国临时专利申请序列号62/807,309。
本申请的申请人拥有于2018年3月28日提交的以下美国临时专利申请,这些临时专利申请中的每个临时专利申请以引用方式全文并入本文:
-名称为“INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATIONCAPABILITIES”的美国临时专利申请序列号62/649,302;
-名称为“DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD”的美国临时专利申请序列号62/649,294;
-名称为“SURGICAL HUB SITUATIONAL AWARENESS”的美国临时专利申请序列号62/649,300;
-名称为“SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER”的美国临时专利申请序列号62/649,309;
-名称为“COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”的美国临时专利申请序列号62/649,310;
-名称为“USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINEPROPERTIES OF BACK SCATTERED LIGHT”的美国临时专利申请序列号62/649,291;
-名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”的美国临时专利申请序列号62/649,296;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER”的美国临时专利申请序列号62/649,333;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATIONTRENDS AND REACTIVE MEASURES”的美国临时专利申请序列号62/649,327;
-名称为“DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICSNETWORK”的美国临时专利申请序列号62/649,315;
-名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国临时专利申请序列号62/649,313;
-名称为“DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,320;
-名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国临时专利申请序列号62/649,307;以及
-名称为“SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,323。
本申请的申请人拥有于2018年3月30日提交的以下美国临时专利申请,该临时专利申请以引用方式全文并入本文:
-名称为“SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES”的美国临时专利申请序列号62/650,887。
本申请的申请人拥有于2018年12月4日提交的以下美国专利申请,该专利申请以引用方式全文并入本文:
-名称为“METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE ANDSIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS”的美国专利申请序列号16/209,423。
本申请的申请人拥有于2018年8月20日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD FOR FABRICATING SURGICAL STAPLER ANVILS”的美国专利申请序列号16/105,101;
-名称为“REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL”的美国专利申请序列号16/105,183;
-名称为“SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS ANDTISSUE STABILITY FEATURES”的美国专利申请序列号16/105,150;
-名称为“FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS”的美国专利申请序列号16/105,098;
-名称为“SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGUREDTO AVOID TISSUE PINCH”的美国专利申请序列号16/105,140;
-名称为“METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICALINSTRUMENT”的美国专利申请序列号16/105,081;
-名称为“SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSUREARRANGEMENTS”的美国专利申请序列号16/105,094;
-名称为“POWERED SURGICAL INSTRUMENTS WITH CLUTCHING ARRANGEMENTS TOCONVERT LINEAR DRIVE MOTIONS TO ROTARY DRIVE MOTIONS”的美国专利申请序列号16/105,097;
-名称为“POWERED ARTICULATABLE SURGICAL INSTRUMENTS WITH CLUTCHING ANDLOCKING ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A FIRINGDRIVE SYSTEM”的美国专利申请序列号16/105,104;
-名称为“ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITHDEDICATED ARTICULATION MOTOR ARRANGEMENTS”的美国专利申请序列号16/105,119;
-名称为“SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号16/105,160;以及
-名称为“SURGICAL STAPLER ANVILS”的美国设计专利申请序列号29/660,252。
本申请的申请人拥有各自全文以引用方式并入本文的以下美国专利申请和美国专利:
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185,现为美国专利申请公布2018/0168642;
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230,现为美国专利申请公布2018/0168649;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221,现为美国专利申请公布2018/0168646;
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209,现为美国专利申请公布2018/0168645;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号15/386,198,现为美国专利申请公布2018/0168644;
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240,现为美国专利申请公布2018/0168651;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,939,现为美国专利申请公布2018/0168629;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941,现为美国专利申请公布2018/0168630;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943,现为美国专利申请公布2018/0168631;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950,现为美国专利申请公布2018/0168635;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,945,现为美国专利申请公布2018/0168632;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946,现为美国专利申请公布2018/0168633;
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号15/385,951,现为美国专利申请公布2018/0168636;
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号15/385,953,现为美国专利申请公布2018/0168637;
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号15/385,954,现为美国专利申请公布2018/0168638;
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955,现为美国专利申请公布2018/0168639;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948,现为美国专利申请公布2018/0168584;
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956,现为美国专利申请公布2018/0168640;
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号15/385,958,现为美国专利申请公布2018/0168641;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,947,现为美国专利申请公布2018/0168634;
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号15/385,896,现为美国专利申请公布2018/0168597;
-名称为“STAPLE-FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号15/385,898,现为美国专利申请公布2018/0168599;
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899,现为美国专利申请公布2018/0168600;
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号15/385,901,现为美国专利申请公布2018/0168602;
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902,现为美国专利申请公布2018/0168603;
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号15/385,904,现为美国专利申请公布2018/0168605;
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905,现为美国专利申请公布2018/0168606;
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号15/385,907,现为美国专利申请公布2018/0168608;
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908,现为美国专利申请公布2018/0168609;
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909,现为美国专利申请公布2018/0168610;
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/385,920,现为美国专利申请公布2018/0168620;
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号15/385,913,现为美国专利申请公布2018/0168614;
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/385,914,现为美国专利申请公布2018/0168615;
-名称为“BILATERALLY ASYMMETRIC STAPLE-FORMING POCKET PAIRS”的美国专利申请序列号15/385,893,现为美国专利申请公布2018/0168594;
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,929,现为美国专利申请公布2018/0168626;
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号15/385,911,现为美国专利申请公布2018/0168612;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927,现为美国专利申请公布2018/0168625;
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917,现为美国专利申请公布2018/0168617;
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号15/385,900,现为美国专利申请公布2018/0168601;
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号15/385,931,现为美国专利申请公布2018/0168627;
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915,现为美国专利申请公布2018/0168616;
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897,现为美国专利申请公布2018/0168598;
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922,现为美国专利申请公布2018/0168622;
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924,现为美国专利申请公布2018/0168624;
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910,现为美国专利申请公布2018/0168611;
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,903,现为美国专利申请公布2018/0168604;
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906,现为美国专利申请公布2018/0168607;
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号15/386,188,现为美国专利申请公布2018/0168585;
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号15/386,192,现为美国专利申请公布2018/0168643;
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15/386,206,现为美国专利申请公布2018/0168586;
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,226,现为美国专利申请公布2018/0168648;
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号15/386,222,现为美国专利申请公布2018/0168647;
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号15/386,236,现为美国专利申请公布2018/0168650;
-名称为“METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号15/385,887,现为美国专利申请公布2018/0168589;
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号15/385,889,现为美国专利申请公布2018/0168590;
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890,现为美国专利申请公布2018/0168591;
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号15/385,891,现为美国专利申请公布2018/0168592;
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号15/385,892,现为美国专利申请公布2018/0168593;
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894,现为美国专利申请公布2018/0168595;
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895,现为美国专利申请公布2018/0168596;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,916,现为美国专利申请公布2018/0168575;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918,现为美国专利申请公布2018/0168618;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,919,现为美国专利申请公布2018/0168619;
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921,现为美国专利申请公布2018/0168621;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923,现为美国专利申请公布2018/0168623;
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925,现为美国专利申请公布2018/0168576;
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,926,现为美国专利申请公布2018/0168577;
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/385,928,现为美国专利申请公布2018/0168578;
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号15/385,930,现为美国专利申请公布2018/0168579;
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932,现为美国专利申请公布2018/0168628;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号15/385,933,现为美国专利申请公布2018/0168580;
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号15/385,934,现为美国专利申请公布2018/0168581;
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号15/385,935,现为美国专利申请公布2018/0168582;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936,现为美国专利申请公布2018/0168583;
-名称为“FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENTCONFIGURATIONS”的美国专利申请序列号14/318,996,现为美国专利申请公布2015/0297228;
-名称为“FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDINGFASTENER CONTROL FEATURES”的美国专利申请序列号14/319,006,现为美国专利10,010,324;
-名称为“SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZINGARRANGEMENTS”的美国专利申请序列号14/318,991,现为美国专利9,833,241;
-名称为“SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORINGARRANGEMENTS”的美国专利申请序列号14/319,004,现为美国专利9,844,369;
-名称为“FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS”的美国专利申请序列号14/319,008,现为美国专利申请公布2015/0297232;
-名称为“FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGINGMEMBERS”的美国专利申请序列号14/318,997,现为美国专利申请公布2015/0297229;
-名称为“FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES”的美国专利申请序列号14/319,002,现为美国专利9,877,721;
-名称为“FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVERARRANGEMENTS”的美国专利申请序列号14/319,013,现为美国专利申请公布2015/0297233;以及
-名称为“FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO”的美国专利申请序列号14/319,016,现为美国专利申请公布2015/0297235。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775,现为美国专利申请公布2017/0367695;
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807,现为美国专利申请公布2017/0367696;
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834,现为美国专利申请公布2017/0367699;
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788,现为美国专利申请公布2017/0367698;以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818,现为美国专利申请公布2017/0367697。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218,现为美国设计专利D826,405;
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227,现为美国设计专利D822,206;
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259;以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325,现为美国专利申请公布2017/0281171;
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321,现为美国专利申请公布2017/0281163;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326,现为美国专利申请公布2017/0281172;
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263,现为美国专利申请公布2017/0281165;
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262,现为美国专利申请公布2017/0281161;
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277,现为美国专利申请公布2017/0281166;
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296,现为美国专利申请公布2017/0281168;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258,现为美国专利申请公布2017/0281178;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278,现为美国专利申请公布2017/0281162;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284,现为美国专利申请公布2017/0281186;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295,现为美国专利申请公布2017/0281187;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300,现为美国专利申请公布2017/0281179;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196,现为美国专利申请公布2017/0281183;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203,现为美国专利申请公布2017/0281184;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210,现为美国专利申请公布2017/0281185;
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324,现为美国专利申请公布2017/0281170;
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335,现为美国专利申请公布2017/0281155;
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339,现为美国专利申请公布2017/0281173;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253,现为美国专利申请公布2017/0281177;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304,现为美国专利申请公布2017/0281188;
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331,现为美国专利申请公布2017/0281180;
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336,现为美国专利申请公布2017/0281164;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312,现为美国专利申请公布2017/0281189;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309,现为美国专利申请公布2017/0281169;以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349,现为美国专利申请公布2017/0281174。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488,现为美国专利申请公布2017/0189018;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525,现为美国专利申请公布2017/0189019;以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552,现为美国专利申请公布2017/0189020。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220,现为美国专利申请公布2017/0224333;
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228,现为美国专利申请公布2017/0224342;
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196,现为美国专利申请公布2017/0224330;
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206,现为美国专利申请公布2017/0224331;
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215,现为美国专利申请公布2017/0224332;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227,现为美国专利申请公布2017/0224334;
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235,现为美国专利申请公布2017/0224336;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230,现为美国专利申请公布2017/0224335;以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245,现为美国专利申请公布2017/0224343。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254,现为美国专利申请公布2017/0231623;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259,现为美国专利申请公布2017/0231626;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275,现为美国专利申请公布2017/0231627;以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289,现为美国专利申请公布2017/0231628。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925,现为美国专利申请公布2016/0367256;
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941,现为美国专利10,052,102;
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914,现为美国专利申请公布2016/0367255;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900,现为美国专利申请公布2016/0367254;
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885,现为美国专利申请公布2016/0367246;以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876,现为美国专利10,178,992。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746,现为美国专利9,808,246;
-名称为“MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/640,795,现为美国专利申请公布2016/02561185;
-名称为“ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURERATES FOR MULTIPLE TISSUE TYPES”的美国专利申请序列号14/640,832,现为美国专利申请公布2016/0256154;
-名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TOMEASURE TISSUE COMPRESSION”的美国专利申请序列号14/640,935,现为美国专利申请公布2016/0256071;
-名称为“MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTORFOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,831,现为美国专利9,895,148;
-名称为“TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINESTABILITY,CREEP,AND VISCOELASTIC ELEMENTS OF MEASURES”的美国专利申请序列号14/640,859,现为美国专利10,052,044;
-名称为“INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,817,现为美国专利申请公布9,924,961;
-名称为“CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULARSHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE”的美国专利申请序列号14/640,844,现为美国专利10,045,776;
-名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利申请序列号14/640,837,现为美国专利9,993,248;
-名称为“SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGEINTO A SURGICAL STAPLER”的美国专利申请序列号14/640,765,现为美国专利申请公布2016/0256160;
-名称为“SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON AROTATABLE SHAFT”的美国专利申请序列号14/640,799,现为美国专利9,901,342;以及
-名称为“SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING”的美国专利申请序列号14/640,780,现为美国专利申请公布2016/0256161。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576,现为美国专利10,045,779;
-名称为“SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCEPARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND”的美国专利申请序列号14/633,546,现为美国专利10,180,463;
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,560,现为美国专利申请公布2016/0249910;
-名称为“CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FORCHARGING A BATTERY”的美国专利申请序列号14/633,566,现为美国专利申请公布2016/0249918;
-名称为“SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TOBE SERVICED”的美国专利申请序列号14/633,555,现为美国专利申请公布2016/0249916;
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542,现为美国专利9,931,118;
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548,现为美国专利申请公布2016/0249909;
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526,现为美国专利申请公布2016/0249945;
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541,现为美国专利申请9,993,258;以及
-名称为“SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFEPARAMETER”的美国专利申请序列号14/633,562,现为美国专利10,159,483。
本申请的申请人拥有于2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478,现为美国专利9,844,374;
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483,现为美国专利申请公布2016/0174969;
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139,现为美国专利9,844,375;
-名称为“LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITHARTICULATABLE SURGICAL END EFFECTORS”的美国专利申请序列号14/575,148,现为美国专利10,085,748;
-名称为“SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLEABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE的美国专利申请序列号14/575,130,现为美国专利申请公布2016/0174972;
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143,现为美国专利10,004,501;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDMOVABLE FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,117,现为美国专利9,943,309;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDIMPROVED FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,154,现为美国专利9,968,355;
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493,现为美国专利9,987,000;以及
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLEARTICULATION SYSTEM”的美国专利申请序列号14/574,500,现为美国专利10,117,649;
本申请的申请人拥有于2013年3月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“Articulatable SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYSFOR SIGNAL COMMUNICATION”的美国专利申请序列号13/782,295,现为美国专利申请公布2014/0246471;
-名称为“ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号13/782,323,现为美国专利申请公布2014/0246472;
-名称为“THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号13/782,338,现为美国专利申请公布2014/0249557;
-名称为“ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAYARRANGEMENT”的美国专利申请序列号13/782,499,现为美国专利申请公布9,358,003;
-名称为“MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/782,460,现为美国专利申请公布2014/0246478;
-名称为“JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS”的美国专利申请序列号13/782,358,现为美国专利申请公布9,326,767;
-名称为“SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL ThroughTROCAR”的美国专利申请序列号13/782,481,现为美国专利申请公布9,468,438;
-名称为“CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLEIMPLEMENT PORTIONS”的美国专利申请序列号13/782,518,现为美国专利申请公布2014/0246475;
-名称为“Rotary POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OFFREEDOM”的美国专利申请序列号13/782,375,现为美国专利申请公布9,398,911;以及
-名称为“SURGICAL INSTRUMENT SOFT STOP”的美国专利申请序列号13/782,536,现为美国专利申请公布9,307,986。
本申请的申请人还拥有于2013年3月14日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”的美国专利申请序列号13/803,097,现为美国专利9,687,230;
-名称为“CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICALINSTRUMENT”的美国专利申请序列号13/803,193,现为美国专利申请公布9,332,987;
-名称为“INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICALINSTRUMENT”的美国专利申请序列号13/803,053,现为美国专利9,883,860;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATIONLOCK”的美国专利申请序列号13/803,086,现为美国专利申请公布2014/0263541;
-名称为“SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FORSURGICAL INSTRUMENTS”的美国专利申请序列号13/803,210,现为美国专利9,808,244;
-名称为“MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,148,现为美国专利申请公布2014/0263554;
-名称为“DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,066,现为美国专利9,629,623;
-名称为“ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICALINSTRUMENTS”的美国专利申请序列号13/803,117,现为美国专利申请公布9,351,726;
-名称为“DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,130,现为美国专利申请公布9,351,727;以及
-名称为“METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,159,现为美国专利9,888,919;
本申请的申请人还拥有于2014年3月7日提交且全文以引用方式并入本文的以下专利申请:
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111,现为美国专利9,629,629。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106,现为美国专利申请公布2015/0272582;
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099,现为美国专利9,826,977;
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094,现为美国专利申请公布2015/0272580;
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117,现为美国专利10,013,049;
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075,现为美国专利9,743,929;
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093,现为美国专利10,028,761;
-名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116,现为美国专利申请公布2015/0272571;
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071,现为美国专利9,690,362;
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097,现为美国专利9,820,738;
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126,现为美国专利申请公布10,004,497;
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133,现为美国专利申请公布2015/0272557;
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081,现为美国专利9,804,618;
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076,现为美国专利9,733,663;
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111,现为美国专利9,750,499;以及
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125,现为美国专利申请公布2015/0280384。
本申请的申请人还拥有于2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103,现为美国专利10,111,679;
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119,现为美国专利9,724,094;
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908,现为美国专利9,737,301;
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895,现为美国专利9,757,128;
-名称为“POLARITY OF HALL MAGNET TO IDENTIFY CARTRIDGE TYPE”的美国专利申请序列号14/479,110,现为美国专利10,016,199;
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098,现为美国专利10,135,242;
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115,现为美国专利9,788,836;以及
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108,现为美国专利申请公布2016/0066913。
本申请的申请人还拥有于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590,现为美国专利9,826,976;
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581,现为美国专利9,649,110;
-名称为“SURGICAL SYSTEM COMPRISING FIRST AND SECOND DRIVE SYSTEMS”的美国专利申请序列号14/248,595,现为美国专利9,844,368;
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588,现为美国专利申请公布2014/0309666;
-名称为“SURGICAL INSTRUMENT COMPRISING A GAP SETTING SYSTEM”的美国专利申请序列号14/248,591,现为美国专利10,149,680;
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584,现为美国专利9,801,626;
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587,现为美国专利9,867,612;
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586,现为美国专利10,136,887;以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607,现为美国专利9,814,460。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365;
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376;
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382;
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385;以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本文列出了许多具体细节,以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件,以免使说明书中描述的实施方案模糊不清。读者将会理解,本文所述和所示的实施方案为非限制性示例,从而可认识到,本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下,可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式,诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式,诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式,诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式,诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此,“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件,但不限于仅具有这些一个或多个元件。同样,“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部,但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分,并且术语“远侧”是指远离临床医生定位的部分。还应当理解,为简洁和清楚起见,本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而,外科器械在许多方向和位置中使用,并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术。然而,读者将容易理解,本文所公开的各种方法和装置可用于多种外科手术和应用中,包括例如与开放式外科手术结合。继续参阅本具体实施方式,读者将进一步理解,本文所公开的各种器械能够以任何方式插入体内,诸如通过自然孔口、通过成形于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入,外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除;然而,设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转;然而,可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中,钉仓被定位在待缝合的组织的第一侧上,并且砧座被定位在组织的第二侧上。砧座朝向钉仓运动以将组织抵靠平台压缩并夹持。然后,可移除地储存在仓体中的钉可被部署到组织中。仓体包括限定于其中的钉腔,其中钉可移除地储存在钉腔中。钉腔被布置成六纵向排。三排钉腔被定位在纵向狭槽的第一侧上且三排钉腔被定位在纵向狭槽的第二侧上。钉腔和钉的其他布置也是可能的。
钉由仓体中的钉驱动器支撑。驱动器能够在第一或未击发位置和第二或击发位置之间运动,以从钉腔射出钉。驱动器通过保持器保留在仓体中,该保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动器能够通过滑动件在其未击发位置与其击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面,该斜坡表面被构造成能够朝向砧座在驱动器下方滑动以及提升驱动器,并且钉在驱动器上受到支撑。
除上述以外,滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时,第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕集的组织的刀。希望刀定位成至少部分地接近斜坡表面,使得钉先于刀被射出。
图1示出了包括可操作地联接到外壳1012的可互换轴组件1200的外科器械1010。图2示出了与外壳1012或柄部1014分离的可互换轴组件1200。如在图3中可见,柄部1014可包括一对可互连柄部外壳段1016和1018,这对柄部外壳段可借助螺钉、按扣特征部、粘合剂等互连。在例示的布置中,柄部外壳段1016和1018配合形成手枪式握把部1019。图1和图3示出了可再利用或不可再利用的马达驱动外科切割和紧固器械1010。在例示的实施方案中,器械1010包括先前的外壳1012,该外壳包括被构造成能够被临床医生抓持、操纵和致动的柄部1014。外壳1012被构造用于可操作地附接到可互换轴组件1200,该可互换轴组件具有可操作地联接到其的外科端部执行器1300,该外科端部执行器被构造成能够执行一种或多种外科任务或外科手术。继续参阅本具体实施方式,将会理解,本文所公开的各种形式的可互换轴组件也可有效地与机器人控制的外科系统结合使用。因此,术语“外壳”也可涵盖机器人系统的容纳或以其他方式可操作地支撑至少一个驱动系统的外壳或类似部分,所述至少一个驱动系统被构造成能够生成并施加可用于致动本文所公开的可互换轴组件及其相应的等同物的至少一种控制动作。此外,各种部件可被“容纳”或包含在外壳中,或者各种部件可与外壳“相关联”。在此类情况下,部件可不容纳在外壳内或由外壳直接支撑。术语“框架”可指手持式外科器械的一部分。术语“框架”还可表示机器人控制的外科器械的一部分和/或机器人系统的可用于可操作地控制外科器械的一部分。例如,本文所公开的可互换轴组件可与名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利9,072,535中公开的各种机器人系统、器械、部件和方法一起使用,该专利全文以引用方式并入本文。
图1所示的先前外壳1012结合可互换轴组件1200示出(图2、图4和图5),该可互换轴组件包括端部执行器1300,该端部执行器包括被构造成能够在其中可操作地支撑外科钉仓4000的外科切割和紧固装置。外壳1012可被构造用于与可互换轴组件结合使用,该可互换轴组件包括端部执行器,该端部执行器适于支撑不同尺寸和类型的钉仓,具有不同的轴长度、尺寸和类型等。此外,外壳1012还可有效地用于多种其他可互换轴组件,其包括被构造成能够将其他动作和形式的能量(诸如例如射频(RF)能量、超声能量和/或动作)施加到适合与各种外科应用和手术结合使用的端部执行器布置的那些组件。此外,端部执行器、轴组件、柄部、外科器械和/或外科器械系统可利用任意合适的可被临床医生抓握和操纵的紧固件。如将在下文进一步详细地讨论,柄部1014可操作地支撑其中的多个驱动系统,这些驱动系统被构造成能够生成各种控制动作并将这些控制动作施加到可操作地附接到其上的可互换轴组件的对应部分。
现在参见图3,柄部1014还可包括可操作地支撑多个驱动系统的框架1020。例如,框架1020可操作地支撑通常被标记为1030的“第一”或闭合驱动系统,该“第一”或闭合驱动系统可用于将闭合和打开动作施加到可操作地附接或联接到其的可互换轴组件1200。在至少一种形式中,闭合驱动系统1030可包括被框架1020枢转地支撑的闭合触发器1032形式的致动器。更具体地,如图3所示,闭合触发器1032经由销1033枢转地联接到柄部1014。这种构造使闭合触发器1032能够被临床医生操纵,使得当临床医生抓握柄部1014的手枪式握把部1019时,闭合触发器1032可被其轻易地从起始或“未致动”位置枢转到“致动”位置,并且更具体地,枢转到完全压缩或完全致动位置。闭合触发器1032可由弹簧或其他偏压布置(未示出)偏压到未致动位置。在各种形式中,闭合驱动系统1030还包括枢转地联接到闭合触发器1032的闭合连杆组件1034。如在图3中可见,闭合连接件组件1034可包括通过销1035枢转地联接到闭合触发器1032的第一闭合连接件1036和第二闭合连接件1038。第二闭合连接件1038在本文中也可称为“附接构件”,并且包括横向附接销1037。
仍参见图3,可观察到,第一闭合连接件1036可在其上具有锁定壁或锁定端部1039,该锁定壁或锁定端部被构造成能够与枢转地联接到框架1020的闭合释放组件1060配合。在至少一种形式中,闭合释放组件1060可包括具有在其上形成的朝远侧突起的锁定棘爪1064的释放按钮组件1062。释放按钮组件1062可被释放弹簧(未示出)沿逆时针方向枢转。临床医生将闭合触发器1032从其未致动位置朝向柄部1014的手枪式握把部1019按压时,第一闭合连接件1036向上枢转至某个点,其中锁定棘爪1064落入该点中以与第一闭合连接件1036上的锁定壁1039保持接合,从而阻止闭合触发器1032返回未致动位置。因此,闭合释放组件1060用来将闭合触发器1032锁定在完全致动位置。当临床医生期望将闭合触发器1032解锁以允许其被偏压到未致动位置时,临床医生只需枢转释放按钮组件1062,使得锁定棘爪1064运动成与第一闭合连接件1036上的锁定壁1039脱离接合。当锁定棘爪1064已运动成与第一闭合连接件1036脱离接合时,闭合触发器1032可枢转回到未致动位置。也可采用其他闭合触发器锁定布置和释放布置。
臂1061可从释放按钮组件1062延伸。磁性元件1063(诸如永磁体)例如可安装到臂1061。当释放按钮组件1062被从其第一位置旋转到其第二位置时,磁性元件1063可朝电路板1100运动。电路板1100可包括至少一个传感器,该至少一个传感器被构造成能够检测磁性元件1063的运动。在至少一个实施方案中,例如,“霍尔效应”传感器(未示出)可安装到电路板1100的底部表面。霍尔效应传感器可被构造成能够检测由磁性元件1063的运动引起、在霍尔效应传感器周围出现的磁场变化。霍尔效应传感器可与例如微控制器进行信号通信,该微控制器可确定释放按钮组件1062是否处于其与闭合触发器1032的未致动位置和端部执行器的打开构型相关联的第一位置、其与闭合触发器1032的致动位置和端部执行器的闭合构型相关联的第二位置、和/或第一位置与第二位置之间的任何位置。
在至少一种形式中,柄部1014和框架1020可以可操作地支撑在本文中被称为击发驱动系统1080的另一个驱动系统,该驱动系统被构造成能够向附接到其的可互换轴组件的对应部分施加击发动作。击发驱动系统1080也可在本文中被称为“第二驱动系统”。击发驱动系统1080可采用电动马达1082,该电动马达位于柄部1014的手枪式握把部1019中。在各种形式中,马达1082例如可为具有约25,000RPM的最大旋转的DC有刷驱动马达。在其他布置中,马达可包括无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。马达1082可由功率源1090供电,在一种形式中,该功率源可包括可移除电源组1092。如在图3中可见,例如,电源组1092可包括近侧外壳部分1094,该近侧外壳部分被构造用于附接到远侧外壳部分1096。近侧外壳部分1094和远侧外壳部分1096被构造成能够在其中可操作地支撑多个电池1098。电池1098可各自包括例如锂离子(“LI”)或其他合适的电池。远侧外壳部分1096被构造用于以可移除方式可操作地附接到同样可操作地联接到马达1082的电路板1100。可使用可串联连接的多个电池1098作为外科器械1010的功率源。此外,功率源1090可为可更换的和/或可充电的。
如上文相对于其他各种形式所概述,电动马达1082可包括与齿轮减速器组件1084可操作地交接的可旋转轴(未示出),该齿轮减速器组件与一组或一齿条的驱动齿1122啮合接合地安装在可纵向运动的驱动构件1120上。在使用中,功率源1090所提供的电压极性可沿顺时针方向操作电动马达1082,其中由电池施加给电动马达的电压极性可被反转,以便沿逆时针方向操作电动马达1082。当电动马达1082在一个方向上旋转时,驱动构件1120将在远侧方向“DD”上轴向地驱动。当马达82在相反的旋转方向上被驱动时,驱动构件1120将在近侧方向“PD”上轴向地驱动。柄部1014可包括开关,该开关被构造成能够使由功率源1090施加到电动马达1082的极性反转。与本文所述的其他形式一样,柄部1014还可包括传感器,该传感器被构造成能够检测驱动构件1120的位置和/或驱动构件1120正在运动的方向。
马达1082的致动可通过被枢转地支撑在柄部1014上的击发触发器1130来控制。击发触发器1130可在未致动位置和致动位置之间枢转。击发触发器1130可由弹簧1132或其他偏压构造偏压到未致动位置,使得当临床医生释放击发触发器1130时,击发触发器可由弹簧1132或偏压构造枢转或以其他方式返回到未致动位置。在至少一种形式中,击发触发器1130可定位在闭合触发器1032的“外侧”,如上文所讨论。在至少一种形式中,击发触发器安全按钮1134可由销1035枢转地安装到闭合触发器1032。安全按钮1134可定位在击发触发器1130和闭合触发器1032之间,并具有从其突起的枢转臂1136。参见图3。当闭合触发器1032处于未致动位置时,安全按钮1134被容纳在柄部1014中,此时临床医生可能无法轻易触及该按钮,也无法将该按钮在防止对击发触发器1130致动的安全位置与击发触发器1130可被击发的击发位置之间运动。临床医生按压闭合触发器1032时,安全按钮1134和击发触发器1130向下枢转,随后可被临床医生操纵。
如上所述,在至少一种形式中,能够纵向运动的驱动构件1120具有在其上形成的一齿条的齿1122,以用于与齿轮减速器组件1084的相应驱动齿轮1086啮合接合。至少一种形式还包括可手动致动的被构造成能够使得临床医生能够在马达1082变得失效情况下手动地回缩能够纵向运动的驱动构件1120的“应急”组件1140。应急组件1140可包括杠杆或应急柄部组件1142,该杠杆或应急柄部组件被构造成能够被手动地枢转为与同样设置在驱动构件1120中的齿1124棘轮接合。因此,临床医生可使用应急柄部组件1142手动地缩回驱动构件1120,以使驱动构件1120沿近侧方向“PD”进行棘轮运动。名称为“POWERED SURGICALCUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM”的美国专利8,608,045公开了也可与本文所公开的各种器械一起使用的应急布置和其他部件、布置和系统。美国专利8,608,045据此全文以引用方式并入本文。
现在转到图2和图5,可互换轴组件1200包括外科端部执行器1300,该外科端部执行器包括被构造成能够在其中可操作地支撑钉仓4000的细长通道1310。端部执行器1300还可包括相对于细长通道1310被枢转地支撑的砧座2000。可互换轴组件1200还可包括关节运动接头3020和关节运动锁2140,该关节运动锁可被构造成能够可释放地将端部执行器1300相对于轴轴线SA保持在期望的位置。端部执行器1300、关节运动接头3020和关节运动锁的至少一种形式的各种特征的示例可在2013年3月14日提交的名称为“ARTICULATABLESURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)中找到。2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)的完整公开内容据此以引用方式并入本文。如在图4中可见,可互换轴组件1200还可包括由喷嘴部分1202和1203组成的近侧外壳或喷嘴1201。
可互换轴组件1200还可包括闭合系统或闭合构件组件3000,该闭合系统或闭合构件组件可用于闭合和/或打开端部执行器1300的砧座2000。轴组件1200可包括脊1210,该脊被构造成能够:第一,在其中可滑动地支撑击发构件;第二,可滑动地支撑围绕脊1210延伸的闭合构件组件3000。如在图5中可见,脊1210的远侧端部1212终止于上凸耳安装特征部1270和下凸耳安装特征部1280。上凸耳安装特征部1270在其中形成有凸耳狭槽1272,该凸耳狭槽适于将上安装连接件1274安装支撑在其中。类似地,下凸耳安装特征部1280在其中形成有凸耳狭槽1282,该凸耳狭槽适于在其中安装地支撑下安装连接件1284。上安装连接件1274在其中包括枢轴承窝1276,该枢轴承窝适于将枢轴销1292可旋转地接收在其中,该枢轴销形成在附接到细长通道1310的近侧端部部分1312的通道顶盖或砧座保持器1290上。下安装连接件1284包括下枢轴销1286,该下枢轴销适于被接收在形成于细长通道1310的近侧端部部分1312中的枢轴孔1314内。参见图5。下枢轴销1286与枢轴承窝1276竖直对准以限定关节运动轴线AA,外科端部执行器1300可围绕该关节运动轴线AA相对于轴轴线SA进行关节运动。参见图2。
在例示的示例中,外科端部执行器1300能够由关节运动系统2100围绕关节运动轴线AA选择性地进行关节运动。在一种形式中,关节运动系统2100包括近侧关节运动驱动器2102,该近侧关节运动驱动器枢转地联接到关节运动连接件2120。如图5中可以最具体地看出,在近侧关节运动驱动器2102的远侧端部2110上形成偏移附接凸耳2114。枢轴孔2116形成在偏移附接凸耳2114中,并且被构造成能够将形成在关节运动连接件2120的近侧端部2122上的近侧连接件销2124枢转地接收在其中。关节运动连接件2120的远侧端部2126包括枢轴孔2128,该枢轴孔被构造成能够将形成在细长通道1310的近侧端部部分1312上的通道销1317枢转地接收在其中。因此,近侧关节运动驱动器2102的轴向运动将由此向细长通道1310施加关节运动动作,从而使外科端部执行器1300围绕关节运动轴线AA相对于脊1210进行关节运动。有关于关节运动系统2100的构造和操作的更多细节可见于以引用方式并入本文的各种参考文献中,包括2017年6月28日提交的名称为“SURGICAL INSTRUMENT WITHAXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631中,现为美国专利申请公布2019/0000464,其全部公开内容据此以引用方式并入本文。在各种情况下,当近侧关节运动驱动器2102没有在近侧或远侧方向上运动时,近侧关节运动驱动器2102可被关节运动锁2140保持就位。关于关节运动锁2140的示例的附加细节可见于美国专利申请序列号15/635,631,现为美国专利申请公布2019/0000464,以及以引用方式并入本文的其他参考文献中。
在各种情况下,脊1210可包括可旋转地支撑在底座1240中的近侧端部1211。在一种布置中,例如,脊1210的近侧端部1211具有在其上形成的螺纹1214,以便通过螺纹附接到被构造成能够被支撑在底座1240内的脊轴承1216。参见图4。这种布置有利于脊1210到底座1240的可旋转附接,使得脊1210可以选择性地相对于底座1240围绕轴轴线SA旋转。
主要参见图4,可互换轴组件1200包括闭合梭动件1250,该闭合梭动件被可滑动地支撑在底座1240内,使得闭合梭动件相对于底座轴向运动。闭合梭动件1250包括被构造用于附接到附接销1037的一对朝近侧突起的钩1252(图3),该附接销附接到第二闭合连接件1038,如将在下文进一步详细地讨论。在至少一个示例中,闭合构件组件3000包括具有近侧端部3012的近侧闭合构件段3010,该近侧端部联接到闭合梭动件1250以相对于其旋转。例如,将U形连接器1263插入近侧闭合构件段3010的近侧端部3012中的环形狭槽3014中,并使其保留在闭合梭动件1250中的竖直狭槽1253内。此类布置用于将近侧闭合构件段3010附接到闭合梭动件1250,以与闭合梭动件一起轴向地行进,同时使得近侧闭合构件段3010能够相对于闭合梭动件1250围绕轴轴线SA旋转。闭合弹簧1268轴颈连接在近侧闭合构件段3010上,用来沿近侧方向“PD”偏压近侧闭合构件段3010,当轴组件可操作地联接到柄部1014时,该闭合弹簧可用来将闭合触发器1032枢转到未致动位置。
在至少一种形式中,可互换轴组件1200还可包括关节运动接头3020。然而,其他可互换轴组件可能无法进行关节运动。如在图5中可见,例如,远侧闭合构件或远侧闭合管段3030联接到近侧闭合构件段3010的远侧端部。关节运动接头3020包括双枢轴闭合套管组件3022。根据各种形式,双枢轴闭合套管组件3022包括具有朝远侧突出的上柄脚3052和下柄脚3054的端部执行器闭合管3050。上部双枢轴连接件3056包括向上突出的远侧枢轴销和近侧枢轴销,这些枢轴销分别接合远侧闭合管段3030上的朝近侧突出的上柄脚3052中的上部远侧销孔以及朝远侧突出的上柄脚3032中的上部近侧销孔。下部双枢轴连接件3058包括向上突出的远侧枢轴销和近侧枢轴销,这些枢轴销分别接合朝近侧突出的下柄脚3054中的下部远侧销孔以及朝远侧突出的下柄脚3034中的下部近侧销孔。参见图4和图5。如将在下文进一步详细讨论的,闭合构件组件3000朝远侧(方向“DD”)平移,以例如响应于闭合触发器1032的致动而使砧座2000闭合。通过朝近侧平移闭合构件组件3000来打开砧座2000,这使端部执行器闭合管3050与砧座2000交接并使其枢转至打开位置。
同样如上所述,可互换轴组件1200还包括击发构件1900,该击发构件被支撑以便在脊1210内轴向行进。击发构件1900包括被构造用于附接到远侧切割部分或刀杆1910的中间击发轴部分1222。中间击发轴部分1222可在其远侧端部中包括纵向狭槽1223,该纵向狭槽可被构造成能够接收远侧刀杆1910的近侧端部上的接片1912。纵向狭槽1223和近侧端部接片1912的尺寸和构造可被设置成允许该纵向狭槽和该近侧端部接片之间的相对运动并且可包括滑动接头1914。滑动接头1914可以允许击发构件1900的中间击发轴部分1222运动,以在不使刀杆1910运动或至少基本上不使刀杆1910运动的情况下,使端部执行器1300进行关节运动。一旦端部执行器1300已合适地取向,中间击发轴部分1222便可朝远侧推进,直到纵向狭槽1223的近侧侧壁与接片1912发生接触,以便推进刀杆1910并击发定位在通道1310内的钉仓4000。刀杆1910包括刀部分1920,该刀部分包括刀片或组织切割刃1922并且包括上部砧座接合接片1924和下部通道接合接片1926。各种击发构件构型和操作公开于以引用方式并入本文的各种其他参考文献中。
如在图4中可见,轴组件1200还包括可旋转地接收在近侧闭合构件段3010上的切换筒1500。切换筒1500包括中空轴段1502,该中空轴段具有在其上形成的轴凸台,用于将向外突起的致动销接收在其中。在各种情况下,致动销延伸穿过设置在锁套管中的纵向狭槽,以便在锁套管与关节运动驱动器接合的情况下,利于锁套管进行轴向运动。旋转扭转弹簧1420被构造成能够接合切换筒1500上的凸台以及喷嘴外壳1203的一部分,以将偏压力施加到切换筒1500。切换筒1500还可包括限定于其中的至少部分周边开口1506,该开口可被构造成能够接收从喷嘴部分1202、1203延伸的周边安装架,并且允许切换筒1500和喷嘴1201之间的相对旋转而不是相对平移。安装架还延伸穿过待安置在脊1210中的凹槽1219中的近侧闭合构件段3010中的开口3011。切换筒1500围绕轴轴线SA的旋转最终将引起致动销的旋转,并引起锁套管在其接合位置与脱离位置之间旋转。在一种布置中,切换筒1500的旋转可与闭合管或闭合构件的轴向推进相关联。因此,实质上,闭合系统的致动可以各种方式可操作地使关节运动驱动系统与击发驱动系统接合和脱离接合,这些方式在名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)和名称为“SURGICALINSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利9,913,642中更详细地描述,这些专利各自的全部公开内容据此以引用方式并入本文。例如,当闭合构件段3010处于其对应于“钳口打开”位置的最近侧位置时,闭合构件段3010将已定位切换筒1500,以便将关节运动系统与击发驱动系统连接。当闭合管已运动到其对应于“钳口闭合”位置的远侧位置时,闭合管已将切换筒1500旋转到其中关节运动系统与击发驱动系统脱离连接的位置。
也如图4所示,轴组件1200可包括滑环组件1600,例如,该滑环组件可被构造成能够将电力传导至端部执行器1300和/或从该端部执行器传导电力,并且/或者将信号传送至端部执行器1300和/或从该端部执行器接收信号。滑环组件1600可包括近侧连接器法兰1604和远侧连接器法兰,该近侧连接器法兰安装到从底座1240延伸的底座法兰1242上,该远侧连接器法兰定位在限定于轴外壳中的狭槽内。近侧连接器法兰1604可包括第一面,并且远侧连接器法兰可包括第二面,其中第二面与第一面相邻定位,并能够相对于第一面运动。远侧连接器法兰可围绕轴轴线SA相对于近侧连接器法兰1604旋转。近侧连接器法兰1604可包括限定于其第一面中的多个同心或至少基本上同心的导体。连接器可安装在连接器法兰的近侧侧面上,并且可具有多个触点,其中每个触点对应于导体中的一个并且与其电接触。这种布置在保持近侧连接器法兰1604与远侧连接器法兰之间电接触的同时,允许这两个法兰之间进行相对旋转。例如,近侧连接器法兰1604可包括电连接器1606,该电连接器可使导体与安装到轴底座1240的轴电路板1610进行信号通信。在至少一种情况下,包括多个导体的线束可在电连接器1606与轴电路板1610之间延伸。电连接器1606可朝近侧延伸穿过限定于底座法兰1242中的连接器开口1243。参见图4。例如,关于滑环组件1600的进一步细节可见于名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING ANARTICULATION LOCK”的美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)、提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067(现为美国专利申请公布2014/0263552,以及名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481。美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)、美国专利申请序列号13/800,067(现为美国专利申请公布2014/0263552)和美国专利9,345,481据此各自全文以引用方式并入本文。
如上文所讨论,轴组件1200可包括可固定地安装到柄部1014的近侧部分,以及能够围绕纵向轴线旋转的远侧部分。可旋转远侧轴部分可如上所述围绕滑环组件1600相对于近侧部分旋转。滑环组件1600的远侧连接器法兰可定位在可旋转远侧轴部分内。而且,除上述之外,切换筒1500也可定位在可旋转远侧轴部分内。当可旋转远侧轴部分旋转时,远侧连接器法兰和切换筒1500可彼此同步地旋转。另外,切换筒1500可相对于远侧连接器法兰在第一位置和第二位置之间旋转。当切换筒1500处于其第一位置时,关节运动驱动系统可与击发驱动系统可操作地脱离接合,因此,击发驱动系统的操作可不使轴组件1200的端部执行器1300进行关节运动。当切换筒1500处于其第二位置时,关节运动驱动系统可以与击发驱动系统可操作地接合,因此,击发驱动系统的操作可以使轴组件1200的端部执行器1300进行关节运动。当切换筒1500在其第一位置和其第二位置之间运动时,切换筒1500相对于远侧连接器法兰运动。在各种情况下,轴组件1200可包括被构造成能够检测切换筒1500的位置的至少一个传感器。
再次参见图4,底座1240包括在其上形成的至少一个、优选两个渐缩的附接部分1244,这种附接部分适于被接收在对应的燕尾形狭槽1702内,该燕尾形狭槽在框架1020的远侧附接法兰部分1700内形成。参见图3。每个燕尾形狭槽1702可以是锥形,或换句话讲,可以略成V形,从而以安置方式将附接部分1244接收在其中。如可在图4中进一步所见,轴附接凸耳1226形成在中间击发轴部分1222的近侧端部上。如将在下文进一步详细地讨论,当可互换轴组件1200联接到柄部1014时,轴附接凸耳1226被接收在形成于纵向驱动构件1120的远侧端部1125中的击发轴附接支架1126中。参见图3。
各种轴组件实施方案采用闩锁系统1710用于将轴组件1200可移除地联接到外壳1012并且更具体地联接到框架1020。如图4中可见,例如,在至少一种形式中,闩锁系统1710包括可动地联接到底座1240的锁构件或锁定轭1712。在例示的实施方案中,例如,锁定轭1712为U形,有两个隔开并向下延伸的腿部1714。腿部1714各自具有在其上形成的枢轴凸耳1715,这些枢轴凸耳适于被接收在底座1240中形成的对应孔1245中。这种布置有利于将锁定轭1712枢转附接到底座1240。锁定轭1712可包括两个朝近侧突起的锁定凸耳1716,这两个锁定凸耳被构造成能够与框架1020的远侧附接法兰部分1700中对应的锁定棘爪或凹槽1704可释放地接合。参见图3。在各种形式中,锁定轭1712被弹簧或偏压构件(未示出)沿近侧方向偏压。锁定轭1712的致动可通过闩锁按钮1722实现,该闩锁按钮可滑动地安装在安装于底座1240的闩锁致动器组件1720上。闩锁按钮1722可相对于锁定轭1712沿近侧方向偏压。如将在下文进一步详细地讨论,锁定轭1712可通过沿远侧方向偏压闩锁按钮而运动到解锁位置,这也使锁定轭1712枢转成不再与框架1020的远侧附接法兰部分1700保持接合。当锁定轭1712与框架1020的远侧附接法兰部分1700“保持接合”时,锁定凸耳1716保持安置在远侧附接法兰部分1700中对应的锁定棘爪或凹槽1704内。
当采用包括适于切割和紧固组织的本文所述类型的端部执行器以及其他类型的端部执行器的可互换轴组件时,可能有利的是防止可互换轴组件在端部执行器致动期间不经意地从外壳脱离。例如,在使用中,临床医生可致动闭合触发器1032以抓持目标组织并将其操纵成期望的位置。一旦目标组织以期望取向定位在端部执行器1300内,临床医生就可完全致动闭合触发器1032,以闭合砧座2000并将目标组织夹持在合适位置供切割与缝合。在这种情况下,第一驱动系统1030已被完全致动。在目标组织已被夹持在端部执行器1300中之后,可能有利的是防止轴组件1200不经意地从外壳1012脱离。闩锁系统1710的一种形式被构造成能够防止这种不经意的脱离。
如图4中可最清楚地看到的那样,锁定轭1712包括至少一个、优选两个锁钩1718,这些锁钩适于接触闭合梭动件1250上形成的对应锁定凸耳部分1256。在闭合梭动件1250处于未致动位置(也就是第一驱动系统1030未致动并且砧座2000打开)的情况下,锁定轭1712可沿远侧方向枢转,以将可互换轴组件1200从外壳1012解锁。处于该位置时,锁钩1718不接触闭合梭动件1250上的锁耳部分1256。但是,在闭合梭动件1250运动到致动位置(即第一驱动系统1030被致动并且砧座2000处于闭合位置)的情况下,锁定轭1712受到阻碍,不能枢转到解锁位置。换句话讲,如果临床医生试图将锁定轭1712枢转到解锁位置,或者例如,锁定轭1712不经意地以原本可能致使其向远侧枢转的方式受到碰撞或发生接触,则锁定轭1712上的锁钩1718将接触闭合梭动件1250上的锁定凸耳部分1256,并且防止锁定轭1712运动到解锁位置。
现在将描述可互换轴组件1200与柄部1014的附接。要开始联接过程,临床医生可将可互换轴组件1200的底座1240定位在框架1020的远侧附接法兰部分1700上方或附近,使得底座1240上形成的渐缩附接部分1244与框架1020中的燕尾形狭槽1702对准。然后临床医生可使轴组件1200沿垂直于轴轴线SA的安装轴线运动,以安置附接部分1244,使其与对应的燕尾形接收狭槽1702“可操作地接合”。这样做时,中间击发轴部分1222上的轴附接凸耳1226也将安置在能够纵向运动的驱动构件1120中的支架1126中,并且第二闭合连接件1038上的销1037的部分将安置在闭合梭动件1250中的对应钩1252中。如本文所用,术语“可操作地接合”在两个部件的背景下是指这两个部件彼此充分地接合,使得一旦对这两个部件施加致动动作,这些部件便可执行其预期行动、功能和/或程序。
可互换轴组件1200的至少五个系统可以与柄部1014的至少五个对应系统可操作地联接。第一系统可包括框架系统,该框架系统将轴组件1200的框架或脊与柄部1014的框架1020联接并/或对准。另一个系统可包括闭合驱动系统1030,该闭合驱动系统可将柄部1014的闭合触发器1032与轴组件1200的闭合管1260和砧座2000可操作地连接。如上文所概述,轴组件1200的闭合梭动件1250可与第二闭合连接件1038上的销1037接合。另一个系统可包括击发驱动系统1080,该击发驱动系统可将柄部1014的击发触发器1130与轴组件1200的中间击发轴部分1222可操作地连接。如上文所概述,轴附接凸耳1226可与纵向驱动构件1120的支架1126可操作地连接。另一个系统可包括电气系统,该电气系统能够:发送轴组件(诸如轴组件1200)已与柄部1014可操作地接合的信号到柄部1014中的控制器(诸如微控制器),并且/或者在轴组件1200与柄部1014之间传导功率和/或通信信号。例如,轴组件1200可包括可操作地安装到轴电路板1610的电连接器1810。电连接器1810被构造用于与柄部控制板1100上的对应电连接器1800配合接合。关于电路系统和控制系统的更多细节可见于美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)和美国专利申请序列号14/226,142(现为美国专利9,913,642),这两者各自的完整公开内容此前以引用方式并入本文。第五系统可由用于可释放地将轴组件1200锁定到柄部1014的闩锁系统组成。
在例示的示例中,砧座2000包括终止于砧座安装部分2010中的砧座主体2002。砧座安装部分2010可动地或可枢转地支撑在细长通道1310上,以便于围绕横向于轴轴线SA的固定砧座枢转轴线PA相对于该细长通道选择性地枢转。在例示的布置中,枢轴构件或砧座耳轴2012侧向延伸出砧座安装部分2010的每个侧向侧,以接收在形成于细长通道1310的近侧端部部分1312的直立壁1315中的对应耳轴支架1316中。砧座耳轴2012由通道顶盖或砧座保持器1290枢转地保持在其对应的耳轴支架1316中。通道顶盖或砧座保持器1290包括一对附接凸耳,该对附接凸耳被构造成能够保持地接收在形成于细长通道1310的近侧端部部分1312的直立壁1315中的对应凸耳凹槽或凹口内。参见图5。
仍然参见图5,在至少一种布置中,远侧闭合构件或端部执行器闭合管3050采用两个轴向偏移的近侧正钳口打开特征部3060和远侧正钳口打开特征部3062。正钳口打开特征部3060、3062被构造成能够与在砧座安装部分2010上形成的对应的释放区域和阶梯部分交接,如在名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631,现为美国专利申请公布2019/0000464中进一步详细描述的,其全部公开内容以引用方式并入本文。可采用其他钳口打开布置。
图6至图8示出了先前的外科切割和紧固器械5010,其被构造成能够产生旋转驱动动作以用于操作外科端部执行器5012。内窥镜式外科器械5010包括柄部5006、轴5008和在关节运动枢轴5014处枢转地连接至轴5008的进行关节运动的外科端部执行器5012。关节运动控件5016可邻近柄部5006提供,以实现端部执行器5012围绕关节运动枢轴5014的旋转。应当理解,各种实施方案可包括非枢转的端部执行器,并且因此可不具有关节运动枢轴5014或关节运动控件5016。
器械5010的柄部5006可包括用于致动端部执行器5012的闭合触发器5018和击发触发器5020。应当理解,具有涉及不同外科手术任务的端部执行器的器械可具有用于操作端部执行器5012的不同数量或类型的触发器或其他合适的控件。在一个实施方案中,器械5010的临床医生或操作者可通过利用关节运动控件5016使端部执行器5012相对于轴5008进行关节运动,如在名称为“SURGICAL INSTRUMENT HAVING AN ARTICULATING ENDEFFECTOR”的未决美国专利7,670,334中更详细地描述,该专利的全部公开内容以引用方式并入本文。在该示例中,端部执行器5012包括(除了别的以外)钉通道5022和能够枢转地平移的夹持构件诸如砧座5024,该钉通道和能够枢转地平移的夹持构件保持在确保有效缝合和切断夹持在端部执行器5012中的组织的间距处。柄部5006包括手枪式握把5026,临床医生将闭合触发器5018枢转地拉向该手枪式握把,以使砧座5024朝端部执行器5012的钉通道5022夹持或闭合,从而夹持定位在砧座5024和通道5022之间的组织。
在图7所示的布置中,除了前述通道5022和砧座5024之外,端部执行器5012还包括切割器械5032、滑动件5033、可移除地安置在通道5022中的钉仓5034、以及螺旋状螺杆轴5036。切割器械5032可为例如刀。砧座5024包括枢轴销5025,该枢轴销被可动地支撑在通道5022中的对应狭槽中。在一种布置中,砧座5024包括位于其近侧端部处的接片5027,该接片插入机械闭合系统(下文进一步描述)的部件中以打开和闭合砧座5024。
仍然参见图7,轴5008包括由枢转连接件5044枢转地连接的近侧闭合管5040和远侧闭合管5042。远侧闭合管5042包括开口5045,砧座5024上的接片5027插入该开口中,以便打开和闭合砧座5024,如下文进一步所述。近侧脊管5046可设置在闭合管5040、5042内。主旋转(或近侧)驱动轴5048可设置在近侧脊管5046内,该主旋转(或近侧)驱动轴经由锥齿轮组件5052a-c与次(或远侧)驱动轴5050连通。次驱动轴5050连接至驱动齿轮5054,该驱动齿轮接合螺旋状螺杆轴5036的近侧驱动齿轮5056。竖直锥齿轮5052b可位于近侧脊管5046的远侧端部中的开口5057中并在其中枢转。远侧脊管5058可用于包封次驱动轴5050和驱动齿轮5054、5056。主驱动轴5048、次驱动轴5050和关节运动组件(例如,锥齿轮组件5052a-c)在本文中有时统称为“主驱动轴组件”。
定位在钉通道5022的远侧端部处的轴承5038接收螺旋状螺杆轴5036,从而允许螺旋状螺杆轴5036相对于通道5022自由地旋转。螺旋状螺杆轴5036可与刀5032的螺纹开口(未示出)交接,使得螺旋状螺杆轴5036的旋转致使刀5032朝远侧或朝近侧(取决于旋转方向)平移穿过钉通道5022。
接下来转到图8,柄部5006包括外部下侧件5059、5060和喷嘴件5061、5062,它们装配在一起以总体上形成柄部5006的外部。电池5064诸如锂离子电池可设置在柄部5006的手枪式握把5026中。电池5064为设置在柄部5006的手枪式握把部5026的上部部分中的马达5065供电。马达5065可驱动包括第一锥齿轮5068和第二锥齿轮5070的90°锥齿轮组件5066。锥齿轮组件5066可驱动行星齿轮组件5072。行星齿轮组件5072可包括连接到驱动轴5076的小齿轮5074。小齿轮5074可驱动配对的环形齿轮5078,该配对的环形齿轮经由驱动轴驱动螺旋齿轮鼓5080。环5084可螺纹接合在螺旋齿轮鼓5080上。因此,当马达5065旋转时,通过插置的锥齿轮组件5066、行星齿轮组件5072和环形齿轮5078使环5084沿着螺旋齿轮鼓5080行进。
柄部5006可包括与击发触发器5020的上部部分相邻的中间柄部件5104。柄部5006还可包括连接在中间柄部件5104上的柱与击发触发器5020上的柱之间的偏压弹簧5112。偏压弹簧5112可将击发触发器5020偏压到其完全打开位置。这样,当操作者释放击发触发器5020时,偏压弹簧5112将击发触发器5020牵拉至其打开位置。螺旋齿轮鼓5080的远侧端部包括驱动环形齿轮5122的远侧驱动轴5120,该环形齿轮与小齿轮5124配合。小齿轮5124连接到主驱动轴组件的主驱动轴5048。这样,马达5065的旋转导致主驱动轴组件旋转,这导致端部执行器5012的致动。螺纹接合在螺旋齿轮鼓5080上的环5084可包括设置在开槽臂5090的狭槽5088内的柱5086。开槽臂5090在其相对端部5094中具有开口5092,该开口接收连接在柄部外侧件5059、5060之间的枢轴销5096。枢轴销5096还设置成穿过击发触发器5020中的开口5100和中间柄部件5104中的开口5102。
中间柄部件5104包括接合开槽臂5090的后侧肩部5106。中间柄部件5104还具有与击发触发器5020接合的向前动作止挡件5107。开槽臂5090的运动由马达5065的旋转控制。当开槽臂5090随着环5084从螺旋齿轮鼓5080的近侧端部行进至远侧端部而逆时针旋转时,中间柄部件5104将自由地逆时针旋转。因此,当使用者拉近击发触发器5020时,击发触发器5020将接合中间柄部件5104的向前动作止挡件5107,从而使中间柄部件5104逆时针旋转。然而,由于后侧肩部5106接合开槽臂5090,因此中间柄部件5104将仅能够在开槽臂5090允许的范围内逆时针旋转。这样,如果马达5065出于某种原因应该停止旋转,则开槽臂5090将停止旋转,并且使用者将不能进一步拉近击发触发器5020,因为中间柄部件5104将由于开槽臂5090而不能自由地逆时针旋转。
图8中还示出了用于通过回缩闭合触发器5018来闭合(或夹持)端部执行器5012的砧座5024的示例性闭合系统的部件。在例示的实施方案中,闭合系统包括连接到闭合触发器5018的轭5250。枢轴销5252穿过闭合触发器5018和轭5250两者中的对准开口插入,使得它们两者围绕相同点旋转。轭5250的远侧端部经由销5254连接到第一闭合托架5256。第一闭合托架5256连接到第二闭合托架5258。闭合托架5256、5258共同限定开口,近侧闭合管5040(参见图7)的近侧端部安置并保持在该开口中,使得闭合托架5256、5258的纵向运动引起近侧闭合管5040的纵向动作。器械5010还包括设置在近侧闭合管5040内的闭合驱动轴5260。闭合驱动轴5260可包括窗口5261,位于柄部外部件之一(诸如例示的实施方案中的外部下侧件5059)上的柱5263设置在该窗口中,以将闭合驱动轴5260固定地连接至柄部5006。这样,近侧闭合管5040能够相对于闭合驱动轴5260纵向运动。闭合驱动轴5260还可包括远侧套环5267,该远侧套环装配到近侧脊管5046中的腔中并且通过顶盖保持在其中。
在操作中,当轭5250由于闭合触发器5018的回缩而旋转时,闭合托架5256、5258使得近侧闭合管5040朝远侧运动(即,远离器械5010的柄部端部),这使得远侧闭合管5042朝远侧运动,从而使得砧座5024围绕枢轴销5025旋转到夹持或闭合位置。当闭合触发器5018从锁定位置解锁时,致使近侧闭合管5040朝近侧滑动,这致使远侧闭合管5042朝近侧滑动,这借助于将接片5027插入远侧闭合管5042的开口5045中,致使砧座5024围绕枢轴销5025枢转到打开或松开位置中。这样,通过回缩并锁定闭合触发器5018,操作者可将组织夹持在砧座5024和通道5022之间,并且可在切割/缝合操作之后通过将闭合触发器5018从锁定位置解锁来松开组织。关于现有外科器械5010的构造和操作的更多细节可见于名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利7,845,537,该专利的全部公开内容据此以引用方式并入本文。被构造用于与各种形式的机器人系统一起使用的其他旋转驱动布置公开于名称为“STAPLING END EFFECTOR CONFIGURED TO COMPENSATEFOR AN UNEVEN GAP BETWEEN A FIRST JAW AND A SECOND JAW”的美国专利申请公布2016/0287251中,该专利申请公布的全部公开内容据此以引用方式并入本文。
图9至图16示出了可例如与上述动力外科器械5010结合使用的外科端部执行器20012。外科端部执行器20012也可有效地与公开于以引用方式并入本文的各种参考文献中的各种其他旋转动力或机器人动力的外科系统一起使用。图9至图16中所示的与动力外科器械5010的部件相同的那些部件已用类似的部件编号标记。在例示的示例中,外科端部执行器20012包括细长通道20020,该细长通道被构造成能够在该细长通道中可操作地支撑外科钉仓20040。除了所指出的差异之外,细长通道20020类似于上述通道5022。转向图10,细长通道20020包括一对间隔开的直立壁20022和底部20024。螺旋状螺杆轴5036由轴承5038支撑在通道20020中,该轴承使螺旋状螺杆轴5036能够相对于通道20020自由旋转。外科端部执行器20012还包括具有枢轴销或耳轴5025的砧座5024,该枢轴销或耳轴被接收在设置于直立通道壁20022中的对应狭槽20026中。
在例示的布置中,钉仓20040包括细长仓体20042,该细长仓体定尺寸成可移除地安置在细长通道20020中。仓体20042包括从仓体20042的近侧端部部分20046延伸到远侧端部部分20044的仓狭槽20050。仓体20042还包括仓平台表面20043,当仓20040安置在通道20020中并且砧座5024枢转到闭合位置时,该仓平台表面面对砧座5024的钉成形下表面5029。同样在例示的示例中,三排外科钉凹坑20052形成在仓狭槽20050的每一侧上并且穿过仓平台表面20043打开。每个钉凹坑20052可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。
仍然参见图10,钉仓20040还包括凸轮作用组件20060,该凸轮作用组件包括凸轮作用组件主体20062,该凸轮作用组件主体具有穿过其中的通路20064,该通路被构造成能够跨越螺旋状螺杆轴5036而不影响其旋转。在其他实施方案中,凸轮作用组件20060可具有一系列内螺纹(未示出),这些内螺纹被构造成能够以螺纹方式接合螺旋状螺杆轴5036以由其驱动。在此类布置中,例如,螺旋状螺杆轴5036可设置有对应于凸轮作用组件20060的起始位置的无螺纹部分。此类凸轮作用组件布置在已以引用方式并入本文的各种参考文献中进一步描述。在例示的示例中,凸轮作用组件20060由击发构件20120朝远侧驱动穿过仓体20042。
如在图10中进一步可见,凸轮作用组件主体20062包括一系列凸轮构件20066,这些凸轮构件与在钉仓主体20042内成排支撑的对应钉驱动器对准。在例示的示例中,凸轮作用组件20060包括机载组织切割构件或刀片20068。组织切割构件20068在平台表面20043上方延伸,使得当凸轮作用组件20060朝远侧驱动时,组织切割构件20068切割夹持在砧座5024和钉仓20040之间的组织。当钉仓为“新鲜”或新的(即,仓从未被击发并且其中包含准备好击发的钉或紧固件)时,凸轮作用组件20060处于仓20040内的起始位置。当凸轮作用组件20060处于起始位置时,组织切割构件20068位于形成在仓体20042的近侧端部部分20046上的停放部分20048内,以防止在处理新鲜的仓20040时受伤。在一个方面,凸轮构件20066朝远侧延伸超过组织切割构件20068,使得钉或紧固件在组织切割构件20068切穿组织之前被部署穿过组织。因此,当击发构件20120和凸轮作用组件20060朝远侧驱动时,夹持的组织被缝合并且随后被切割。一旦击发构件20120和凸轮作用组件20060已被驱动到其最远侧结束位置,击发构件20120便可通过在反向旋转方向上旋转螺旋状螺杆轴5036而回缩回到其起始位置,同时凸轮作用组件20060保持在其结束位置。在至少一种布置中,组织切割构件20068能够从部署的切割位置运动到储存位置,在储存位置,组织切割构件20068储存在仓平台表面20043下方以防止在处理已击发或用尽的仓20040时受伤。例如,回缩构件(未示出)可策略性地位于仓体20042的远侧端部20044中,以在使组织切割构件20068的一部分与回缩构件接触时接触组织切割构件20068并使其从部署位置运动到储存位置。
图11示出了击发构件20120的一种形式。如在图11中可见,击发构件20120包括主体部分20122,该主体部分包括两个向下延伸的中空安装部分20124,这些中空安装部分为无螺纹的并且彼此间隔开以在它们之间接收带螺纹的驱动螺母20130。带螺纹的驱动螺母20130被构造成能够以螺纹方式接合螺旋状螺杆轴5036。驱动螺母20130包括竖直接片部分20131,该竖直接片部分定尺寸成延伸穿过细长通道20020的底部20024中的轴向狭槽20025(图10)。两个侧向延伸的保持法兰20134形成在带螺纹的驱动螺母20130上并且被构造成能够接合细长通道20020的底部20024。此外,两个侧向延伸的砧座接合接片20126形成在击发构件主体20122的顶部上,并且被构造成能够在击发构件20120在外科端部执行器20012内轴向运动时接合形成在砧座5024中的对应凸缘20102。
如在图11中也可见,击发构件20120还可配备有机载击发构件闭锁组件20140,该机载击发构件闭锁组件包括枢转地联接到击发构件主体20122的闭锁构件20142。闭锁构件20142包括滑动件闩锁20148,该滑动件闩锁被构造成能够在凸轮作用组件20060处于未击发位置时由凸轮作用组件20060接合。如在图12和图13中可见,凸轮作用组件20060包括被构造成能够接合闭锁构件20142上的滑动件闩锁20148的击发构件凸缘20061。闭锁弹簧20150安装在细长通道20020中并且被构造成能够向下偏压闭锁构件20142,使得如果凸轮作用组件20060不处于其未击发起始位置,则闭锁构件20142接触在细长通道20020的每个直立侧壁20022的内表面的部分上形成的闭锁凸耳20028。参见图15。当处于该位置时,如果使用者无意中试图朝远侧推进击发构件20120,则闭锁构件20142接触通道20020上的闭锁凸耳20028以防止击发构件20120朝远侧推进。
图12示出了将新鲜的未击发外科钉仓20040初始插入通道20020中。如在图12中可见,凸轮作用组件20060处于起始位置,并且外科钉仓20040的近侧端部部分20046相对于通道20020以一角度插入,然后沿近侧方向PD上推动,直到凸轮作用组件20060上的击发构件凸缘20061解锁地接合闭锁构件20142的滑动件闩锁部分20148。图13和图14示出了处于正确安装位置的外科钉仓20040。如在图13中可见,击发构件闭锁组件20140处于解锁位置。螺旋状螺杆轴5036沿第一旋转方向的旋转致动将使击发构件20120沿远侧方向DD朝远侧运动。当击发构件20120朝远侧运动时,凸轮作用组件20060也由此朝远侧被驱动。凸轮构件20066将储存在仓20040中的驱动器在仓体20042中向上凸轮。当驱动器被向上凸轮时,支撑在其上的钉或紧固件被驱动穿过已被夹持在砧座5024与仓20040之间的组织并与砧座5024上的钉成形下表面5029成形接触。缝合的组织随后被组织切割构件20068切割。一旦击发构件20120已被驱动到其在仓20040中的最远侧位置,螺旋状螺杆轴5036就可沿相反的第二旋转方向旋转以使击发构件20120回缩回到其开始位置。凸轮作用组件20060保持在仓体20042的远侧端部部分20044中。然后可从通道20020移除用尽的仓20040。
图14示出了已从通道20020移除用尽的仓之后的端部执行器20012。如在图14中可见,弹簧20150将击发构件闭锁组件20140的闭锁构件20142偏压成与通道20020中的闭锁凸耳20028锁定接合。如果使用者试图击发外科端部执行器20012(朝远侧推进击发构件20120),闭锁构件20142将防止击发构件20120朝远侧运动。同样,如果使用者试图再利用用尽的仓,因为凸轮作用组件20060不处于起始位置,所以击发构件闭锁组件20140将阻止击发构件20120的远侧推进。
在例示的布置中,闭锁构件20142通过枢轴销20143枢转地联接到击发构件主体20122,该枢轴销被接收在延伸穿过击发构件主体20122的孔20123中。参见图14和图16。在至少一种布置中,枢轴销20143的尺寸相对于击发构件主体20122中的孔20123被设定成便于闭锁构件20142的自由枢转行进并且考虑部件的公差差异。如在图14中可见,击发构件20120包括面向近侧的击发表面20145,该击发表面被构造成能够在击发构件闭锁组件20140处于解锁位置时邻接击发构件主体20122上的面向远侧的承载表面20125。因此,当击发构件20120朝远侧推进时,凸轮作用组件20060在其远侧运动期间遇到的抗力被直接施加到击发构件主体20122上的面向远侧的承载表面20125。此类布置可防止这些抗力传递回到枢轴销20143,这可能导致枢轴销20143在此类负载下失效。相似地,如在图16中可见,当击发构件闭锁组件20140处于锁定位置时,击发构件20120的面向近侧的成角度承载表面20145被构造成能够邻接击发构件主体20122上的面向远侧的承载表面20125。此类布置可防止由闭锁构件20142与锁定凸耳20028的锁定接合引起的抵抗性锁定力传递回枢轴销20143,这可能导致枢轴销20143在此类负载下失效。销20143与击发构件主体20122中的孔20123之间的松配合便于闭锁构件20142在负载下的一些平移,以便于将负载传递到击发构件主体20122中而不传递到销20143本身。
在另一种布置中,或除了上述闭锁构件20142布置之外,监测由用于将旋转动作施加到螺旋状螺杆轴5036的马达消耗的电流量。一旦电流增加超过预先确定的阈值,用于外科器械或机器人系统等的控制电路便可停止马达以防止螺旋状螺杆轴5036的任何进一步旋转和击发构件20120的运动,从而防止对上述部件的损坏。
一些先前的击发构件闭锁布置需要使用者在允许砧座打开之前主动地将击发构件回缩回到最近侧开始位置,这些先前的击发构件闭锁布置被构造成能够防止端部执行器的击发构件的推进,除非新鲜的未击发钉仓已正确地安装在外科端部执行器中。如果使用者在击发构件运动回到其最近侧位置之前试图打开砧座,则他可能无法理解砧座为何无法打开。上述布置可防止此类混淆。
图17至图21示出了可例如与上述动力外科器械1010结合使用的外科端部执行器20300。外科端部执行器20300也可有效地与公开于以引用方式并入本文的各种参考文献中的各种其他机器人动力的外科系统一起使用。图17至图21中所示的与外科器械1010的部件相同的那些部件已用类似的部件编号标记。为了简洁起见,本文将不再重复理解外科端部执行器20300的操作所不必要的外科器械1010的那些部件的那些构造和功能。
现在参考图17至图21,外科端部执行器20300包括细长通道20310,该细长通道被构造成能够在该细长通道中可操作地支撑外科钉仓20600。在例示的示例中,细长通道20310包括通道底部20312和一对直立侧壁20314。通道20310通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其围绕关节运动接头3020(图5)进行关节运动。如在图19中可见,在一种布置中,例如,通道安装特征部20340包括由直立支撑件20344组成的主体部分20342,该直立支撑件具有延伸穿过其的狭槽20346以接收穿过其的击发构件梁1900(图5)。通道安装特征部20340可通过通道安装特征部或通道销20320可动地或枢转地安装到通道20310的近侧端部20316。具体地,通道安装特征部20320还包括横向销开口20348,该横向销开口被构造成能够与通道20310的侧壁20314中的孔20318同轴对准以接收穿过其的通道销20320。
如上所述,轴组件1200包括终止于上部凸耳安装特征部1270和下部凸耳安装特征部1280中的脊1210。参见图5。上凸耳安装特征部1270在其中形成有凸耳狭槽1272,该凸耳狭槽适于将上安装连接件1274安装支撑在其中。类似地,下凸耳安装特征部1280在其中形成有凸耳狭槽1282,该凸耳狭槽适于在其中安装地支撑下安装连接件1284。上安装连接件1274包括其中的枢轴承窝1276,该枢轴承窝适于将枢轴销1292可旋转地接收在其中,该枢轴销形成在附接到细长通道20310的近侧端部部分20316的通道顶盖或砧座保持器1290上。如在图19中可见,通道安装特征部20340还包括从其朝近侧延伸的轴安装法兰20350。在一种布置中,例如,轴安装法兰20350具有穿过其的居中设置的枢轴孔20352,该枢轴孔枢转地接收下部凸耳安装特征部1280的下安装连接件1284上的下枢轴销1286(图5)。下枢轴销1286与枢轴承窝1276竖直对准以限定关节运动轴线AA,外科端部执行器20300可相对于脊1210围绕该关节运动轴线AA进行关节运动。在一种布置中,近侧关节运动驱动器2102(图5)可直接联接到形成在轴安装法兰20350上的关节运动凸耳20354。在其他布置中,近侧关节运动驱动器2102可附接到一个或多个关节运动连接件,该一个或多个关节运动连接件附接到轴安装法兰20350。在任一种情况下,近侧关节运动驱动器2102以上述方式的轴向运动将导致通道安装特征部相对于脊1210围绕关节运动轴线枢转(图5),以使端部执行器20300围绕关节运动轴线AA进行关节运动。
除下文讨论的差异外,外科端部执行器20300还包括非常类似于上述砧座2000的砧座20400。砧座20400包括细长砧座主体部分20402和砧座安装部分20410,该细长砧座主体部分具有钉成形下表面20404,该砧座安装部分被构造成能够以上述方式与端部执行器闭合管3050(图5)交接。砧座20400通过一对侧向延伸的砧座销或耳轴20412枢转地安装在细长通道20310上,该对侧向延伸的砧座销或耳轴被接收在形成于直立通道壁20314中的对应细长耳轴狭槽20322中。端部执行器闭合管3050沿远侧方向的轴向运动将导致砧座20400围绕由砧座耳轴20412限定的枢转轴线枢转到闭合位置,并且端部执行器闭合管3050沿近侧方向的运动将导致砧座相对于细长通道20310枢转到打开位置。
图22示出了可与外科端部执行器20300结合使用的钉仓20600的一种形式。在至少一种布置中,外科钉仓20600包括细长仓体20602,该细长仓体定尺寸成可移除地安置在细长通道20310中。仓体20602包括从仓体20602的近侧端部部分20604延伸到远侧端部部分20606(图17)的仓狭槽20608。仓体20602还包括仓平台表面20610,当仓20600安置在通道20310中并且砧座20400枢转到闭合位置时,该仓平台表面面对砧座20400的钉成形下表面20404。同样在例示的示例中,三排外科钉凹坑20612形成在仓狭槽20608的每一侧上并且穿过仓平台表面20610打开。每个钉凹坑20612可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体20602由其中模制或机加工有钉凹坑20612的聚合物材料模制而成。在一种布置中,钉凹坑20612还通过仓体20602的底部打开,以便于将驱动器和紧固件安装到其相应凹坑20612中。一旦驱动器和紧固件被插入其相应钉凹坑20612中,则仓盘20620附接到仓体20602的底部。在一种形式中,仓盘20620由金属材料制成并且包括跨越仓体20602的底部的底部20622以及与仓体20602的每一侧对应的两个直立侧壁20624。仓盘20620可通过一系列钩20626能够移除地附连到仓体20602,该一系列钩形成在侧壁20624上并且被构造成能够以钩的形式接合仓体20602的对应部分。参见图22。当安装时,仓盘20620可(除了别的以外)防止驱动器和紧固件在仓20600处理和安装到细长通道20310中期间从仓体20602的底部掉出。
如上文结合仓20040所述,仓20600可操作地支撑其中的凸轮作用组件。该凸轮作用组件包括一系列间隔开的凸轮构件,这些凸轮构件被构造成能够在对应凸轮狭槽20609内轴向运动,这些对应凸轮狭槽形成在仓体20602中的仓狭槽20608的每一侧上。凸轮狭槽20609与仓体20602中的对应排驱动器对准,以在凸轮作用组件从仓体20602的近侧端部部分20604内的开始位置被驱动穿过钉仓20600到远侧端部部分20606内的结束位置时,有利于与对应凸轮构件凸轮作用接触。
图20和图21所示的示例还采用了击发构件20500,该击发构件附接到击发构件梁1900的远侧端部,并且被构造成能够与钉仓20600中的凸轮作用组件可操作地交接,以将凸轮作用组件从其在仓20600内的起始位置驱动到其结束位置。在至少一种布置中,击发构件20500被构造成能够与已正确安装在细长通道20310中的钉仓20600中的凸轮作用组件(未示出)交接。例如,击发构件20500包括击发构件主体20502,该击发构件主体具有形成在其上或附接到其上的组织切割表面或刀片20504。击发构件主体20502定尺寸成在砧座20400中的轴向砧座狭槽(未示出)以及仓体20602中的仓狭槽20608和细长通道20310中的通道狭槽(未示出)内轴向运动。包括一对侧向延伸的下法兰20508的下脚部组件20506从击发构件主体20502的底端延伸,以可滑动地接合形成在通道狭槽的每一侧上的对应通道凸缘(未示出)。包括两个侧向延伸的砧座接片的上脚部(未示出)可形成在击发构件主体20502的上端上,并且被构造成能够可滑动地接合形成在砧座狭槽的每一侧上的砧座凸缘(未示出)。在至少一种布置中,击发构件20500还包括从击发构件主体20502的每一侧侧向延伸的一对中央接片20510。
仍然参见图20和图21,在一种布置中,击发构件主体20502被构造成具有朝近侧延伸的弹簧尾部20512,该弹簧尾部被构造成能够与击发构件闭锁弹簧20520可操作地交接,该击发构件闭锁弹簧安装在细长通道20310中并且被构造成能够将击发构件20500在细长通道20310中向下(箭头DN)偏压到锁定位置。当处于锁定位置时,击发构件脚部20506和/或中央接片20510与通道20310中的对应通路不对准时,并且因此,如果使用者试图在处于闭锁状态时朝远侧推进击发构件20500,则击发构件20500将不会由于此类不对准而朝远侧运动。即,脚部20506和/或中央接片20510接触细长通道的各部分,从而防止击发构件20500的远侧推进。在一种布置中,滑动件闩锁20514形成在击发构件主体20502上,并且被构造成能够由形成在可操作地支撑在外科钉仓20600中的凸轮作用组件上的对应部分接合。当其凸轮作用组件处于其起始位置的新鲜的未击发钉仓20600已可操作地安装在细长通道20310中时,凸轮作用组件的一部分接合击发构件主体20502上的滑动件闩锁20514并使击发构件20500向上运动(图20中的箭头向上)进入解锁位置,在解锁位置,下脚部组件20506和/或中央接片20510与通道20310中其相应通路对准,以允许击发构件20500在其中轴向推进。当使用者将击发构件20500朝远侧推进到仓20600中时,击发构件20500还驱动其中的凸轮作用组件,该凸轮作用组件将驱动器向上凸轮以驱动支撑在其上的钉或紧固件与砧座的下侧形成接触。然后,击发构件20500上的组织切割构件20504切穿缝合的组织。一旦击发构件20500已被驱动到其对应于凸轮作用组件的结束位置的最远侧位置,击发构件20500就回缩到其最近侧位置,从而将凸轮作用组件留在仓20600的远侧端部20606中。当击发构件20500返回到其最近侧开始位置时,击发构件闭锁弹簧20520再次将击发构件20500偏压回其锁定位置。因此,如果使用者无意中尝试再利用用尽的仓20600,则凸轮作用组件不处于其解锁击发构件20500所需的起始位置。
外科端部执行器20300还可采用闭合闭锁系统20700,以防止砧座20400从打开位置运动到闭合(夹持)位置,除非对应的兼容外科钉仓20600已可操作地安装在细长通道20310中。在例示的示例中,闭合闭锁系统20700包括砧座锁20702,该砧座锁被构造成能够响应于钉仓20600在其中的安装而在砧座锁定位置和砧座解锁位置之间运动。图19示出了砧座锁20702的一种形式。砧座锁20702可由弹簧钢或其他合适的金属制成并且包括近侧偏压臂20704,该近侧偏压臂可被构造成能够安置在横向弹簧安装狭槽20343中,该横向弹簧安装狭槽设置在通道安装特征部20340的主体部分20342中。砧座锁20702还包括朝远侧延伸的主体部分20706,该主体部分具有从其突起的向下延伸的安装接片20708和向上延伸的砧座闭锁接片20710。如在图17、图18和图20中可见,安装接片20708延伸到形成在细长通道20310中的间隙窗口20319中。
图19示出了其中未安装外科钉仓的外科端部执行器20300。如在图19中可见,近侧偏压臂20704已将砧座锁20702偏压在远侧“砧座锁定”位置。当处于该位置时,砧座闭锁接片20710与形成在砧座20400的砧座安装部分20410上的砧座锁定凸耳20414的一部分对准。如果使用者试图闭合砧座20400,则砧座锁定凸耳20414将接触砧座闭锁接片20710,从而防止砧座20400沿闭合方向的任何进一步行进。
返回图21,在至少一种布置中,钉仓20600包括砧座解锁特征部或接片20630,该砧座解锁特征部或接片从仓体20602朝近侧突起并且对准以在仓20600可操作地安装在细长通道20310中时解锁地接合形成在砧座锁20702的远侧端部上的致动接片20712。图20示出了可操作地安装在细长通道20310中的外科钉仓20600。如在图21中可见,钉仓体20602上的砧座解锁接片20630已接触砧座闭锁件20702的致动接片20712并沿近侧方向PD将砧座闭锁件20702偏压到解锁位置,在解锁位置,砧座闭锁接片20710不再与砧座20400上的砧座锁定凸耳20414对准。当处于该位置时,使用者可将砧座20400枢转到闭合位置。如果使用者试图安装缺少砧座解锁接片20630或被设计成解锁接合砧座闭锁件20702的类似特征部的不适当的仓,则使用者将无法闭合砧座20400以完成外科缝合手术。
图23示出了另选的闭合闭锁系统20700’,用于防止外科端部执行器20300’的砧座20400’从打开位置运动到闭合(夹持)位置,除非对应的正确外科钉仓20600’已可操作地安装在对应的细长通道(未示出)中。除了下文讨论的差异之外,外科端部执行器20300’与上述外科端部执行器20300基本上相同。除了以下差异之外,闭合闭锁系统20700’包括与上述砧座闭锁件20702基本上相同的砧座闭锁件20702’。例如,砧座闭锁件20702可由弹簧钢或其他合适的金属制成,并且包括其中形成有弹簧部分20707’的朝远侧延伸的主体部分20706’。砧座闭锁件20702’的近侧端部具有形成于其上的锚定接片20703’,该锚定接片用于将砧座闭锁件20702’联接到通道安装特征部20340(图19)。另外,主体部分20706’包括向下延伸的安装接片20708’和从其突起的向上延伸的砧座闭锁接片20710’。致动接片20712’形成在主体部分20706’的远侧端部上。
外科钉仓20600’类似于上述外科钉仓20600,并且包括仓体20602’,该仓体定尺寸成可移除地安置在细长通道20310中。仓体20602’包括从仓体20602’的近侧端部部分20604’延伸到远侧端部部分的仓狭槽20608’。仓体20602’还包括仓平台表面20610’和位于仓狭槽20608’的每一侧上的三排外科钉凹坑20612’。如在图23中可见,钉凹坑20612’以及其中的钉或紧固件(未示出)在平行于仓狭槽20608’的凹坑轴线PA’上对准。因此,钉/紧固件以大致平行于仓狭槽20608’和组织切割线的排施加。与外科钉仓20600类似,外科钉仓20600’包括仓盘20624’和从仓体20602’朝近侧突起的砧座解锁特征部或接片20630’。
仍然参见图23,砧座20400’类似于砧座20400,不同之处在于下文讨论的差异。砧座20400’包括细长砧座主体部分20402’和砧座安装部分20410’,该砧座安装部分被构造成能够以上述方式与端部执行器闭合管3050(图5)交接。砧座主体部分20402’包括由砧座狭槽20405’平分的钉成形下表面20404’,该砧座狭槽被构造成能够适应击发构件20500穿过其中。如在图23中可见,钉成形下表面20404’包括布置在与砧座狭槽20405’平行的成形凹坑轴线FPA上的三排钉成形凹坑20407’。当砧座20400’运动到闭合位置时,砧座狭槽20405’与仓狭槽20608’竖直对准,以允许击发构件20500穿过其中。多排钉成形凹坑20407’与钉凹坑20612’对准,使得当钉从仓20600’驱动时,它们接触对应的一对待压接的钉成形凹坑20407’。因此,砧座20400’中的钉成形凹坑阵列必须对应于仓20600’中的钉凹坑20612’的阵列,以确保钉正确成形。如在图23中进一步可见,在该布置中,砧座20400’包括向下延伸的砧座锁定凸耳20414’,该向下延伸的砧座锁定凸耳形成在砧座安装部分20410’的远侧,但以其他方式被构造成能够在砧座闭锁件20702’处于锁定位置时接触砧座闭锁接片20710’(例如,未将仓插入通道20310中或已将不正确的仓安置在通道20310中)。当仓20600’已正确地安置在细长通道20310中时,其上的砧座解锁特征部20630’接触砧座闭锁件20702’上的致动接片20712’,以将闭锁件20702’朝近侧偏压到解锁位置,在解锁位置,砧座闭锁接片20710’不与砧座锁定凸耳20414’锁定对准,以允许砧座20400’枢转到闭合位置。
图24示出了另选的闭合闭锁系统20700”,用于防止另一个外科端部执行器20300”的砧座20400”从打开位置运动到闭合(夹持)位置,除非兼容外科钉仓20600”已可操作地安装在细长通道20310中。除了下文讨论的差异之外,外科端部执行器20300”与上述外科端部执行器20300基本上相同。除了以下差异之外,闭合闭锁系统20700”包括与上述砧座闭锁件20702基本上相同的砧座闭锁件20702”。例如,砧座闭锁件20702”可由弹簧钢或其他合适的金属制成,并且包括其中形成有弹簧部分20707”的朝远侧延伸的主体部分20706”。砧座闭锁件20702”的近侧端部具有形成于其上的锚定接片20703”,该锚定接片用于将砧座闭锁件20702”联接到通道安装特征部20340(图19)。另外,主体部分20706”包括向下延伸的安装接片20708”和从其突起的向上延伸的砧座闭锁接片20710”。致动接片20712”形成在主体部分20706”的远侧端部上。
外科钉仓20600”类似于上述外科钉仓20600,并且包括仓体20602”,该仓体定尺寸成可移除地安置在细长通道20310中。仓体20602”包括从仓体20602”的近侧端部部分20604”延伸到远侧端部部分的仓狭槽20608”。仓体20602”还包括仓平台表面20610”和位于仓狭槽20608”的每一侧上的两排外科钉凹坑20612”。如在图24中可见,钉凹坑20612”以及其中的钉或紧固件(未示出)在横向于仓狭槽20608”的凹坑轴线PA”上对准。因此,钉/紧固件以大致横向于仓狭槽20608”和组织切割线的排施加。紧固件的此类布置形成“柔性”或“可拉伸”钉线。有关用于开发柔性或可拉伸成排缝钉的钉仓的进一步细节可见于名称为“FASTENER CARTRIDGE FOR CREATING A FLEXIBLE STAPLE LINE”的美国专利申请序列号14/498,121中,现为美国专利9,801,627,其全部公开内容据此以引用方式并入本文。与外科钉仓20600类似,外科钉仓20600”包括仓盘20624”和从仓体20602’朝近侧突起的砧座解锁特征部或接片20630”。
仍然参见图24,砧座20400”类似于砧座20400,不同之处在于下文讨论的差异。砧座20400”包括细长砧座主体部分20402”和砧座安装部分20410”,该砧座安装部分被构造成能够以上述方式与端部执行器闭合管3050(图5)交接。砧座主体部分20402”包括由砧座狭槽20405”平分的钉成形下表面20404”,该砧座狭槽被构造成能够适应击发构件20500穿过其中。如在图24中可见,钉成形下表面20404”包括布置在横向于砧座狭槽20405”的成形凹坑轴线FPA上的多排钉成形凹坑20407”。当砧座20400”运动到闭合位置时,砧座狭槽20405”与仓狭槽20608”竖直对准,以允许击发构件20500穿过其中。这多排钉成形凹坑20407”与钉凹坑20612”对准,使得当钉从仓20600”驱动时,它们接触对应的一对待压接的钉成形凹坑20407”。因此,砧座20400”中的钉成形凹坑阵列20407”必须对应于仓20600”中的钉凹坑20612”的阵列,以确保钉正确成形。如在图24中进一步可见,在该布置中,砧座20400”包括向下延伸的砧座锁定凸耳20414”,该向下延伸的砧座锁定凸耳形成或附接到砧座安装部分20410”,兵器被构造成能够在砧座闭锁件20702”处于锁定位置时接触砧座闭锁接片20710”(例如,未将仓插入通道20310中或将不正确的仓插入通道20310中)。当仓20600”已正确地安置在细长通道20310中时,其上的砧座解锁特征部20630”接触砧座闭锁件20702”上的致动接片20712”,以将闭锁件20702”朝近侧偏压到解锁位置,在解锁位置,砧座闭锁接片20710”不与砧座锁定凸耳20414”锁定对准,以允许砧座20400”枢转为闭合。
如上所述,各种外科钉仓可在其中具有钉/紧固件的不同阵列和/或取向。根据具体的外科手术或应用,钉或紧固件的尺寸以及紧固件的数量可因仓类型而异。为了确保钉被正确地压接或成形,外科钉仓必须与其中具有适当阵列的钉成形凹坑的对应砧座结合使用。如果“不兼容”的仓被装载到具有与仓不匹配的砧座的端部执行器中,则钉可能在击发过程期间不能正确地成形,这可能导致灾难性结果。例如,图23所示的外科钉仓20600’与图23所示的砧座20400’匹配或“兼容”。图24所示的外科钉仓20600”与图24所示的砧座20400”匹配或兼容。然而,例如,图24的外科钉仓20600”与图23所示的砧座20400’不兼容。
在上述示例中采用的闭合闭锁系统可避免以其他方式装载到端部执行器中的不匹配仓的激活。例如,钉仓20600’上的砧座解锁特征部或接片20630’位于仓狭槽20608’的左侧上,并且被定位成当仓20600’正确地装载在端部执行器20300’的通道20310中时接触砧座闭锁弹簧20707’上的致动器接片20712’。相反地,仓20600”上的砧座解锁特征部或接片20630”位于仓狭槽20608”的右侧上,并且对准以在仓20600”正确装载在通道20310中时接触砧座闭锁件20702”上的致动器接片20712”。如果使用者将仓20600”装载到端部执行器20300’的通道20310中,则钉仓20600”上的砧座解锁特征部或接片20630”将不接触砧座闭锁件20702’上的致动器接片20712’以使其运动到解锁位置,并且使用者将无法将砧座20400’枢转为闭合。同样,如果使用者将仓20600’装载到端部执行器20300”的通道中,则钉仓20600’上的砧座解锁特征部或接片20630’将不接触砧座闭锁件20702”上的致动器接片20712”以使其运动到解锁位置,并且使用者将无法将砧座20400”枢转为闭合。如果使用者无意地装载缺少与端部执行器中的砧座闭锁件对应的正确砧座解锁特征部或接片的另一个仓,则使用者将无法闭合该砧座。外科钉仓上的砧座解锁特征部或接片的位置、形状、长度等可因仓类型而异,并且与位于对应外科端部执行器中的对应砧座闭锁件上的致动器构件(尺寸、位置、形状、数量等)相互关联。例如,砧座解锁特征部或接片可例如一体地形成在仓体上、被机加工或模制到仓体中、附接到仓体、附接到仓的凸轮作用组件或一体地形成在仓的凸轮作用组件上,或者包括仓盘的一部分。本文设想了所有此类变型,并且这些变型旨在由所附权利要求书涵盖。
图25至图29示出了外科端部执行器21300,除了下文讨论的差异之外,该外科端部执行器非常类似于上述外科端部执行器20300、20300’、20300”。在该实施方案中,例如,端部执行器21300包括细长通道21310,该细长通道被构造成能够在该细长通道中可操作地支撑外科钉仓21600。在例示的示例中,细长通道21310包括通道底部21312和一对直立侧壁21314。尽管未示出,但通道21310可通过通道安装特征部20340(如上所述)联接到细长轴组件1200(图5),该通道安装特征部可有利于其围绕关节运动接头3020(图5)进行关节运动。除下文讨论的差异外,外科端部执行器21300还包括可非常类似于上述砧座20400的砧座21400。砧座21400包括细长砧座主体部分21402和砧座安装部分21410,该细长砧座主体部分具有钉成形下表面,该砧座安装部分被构造成能够以上述方式与端部执行器闭合管3050(图5)交接。砧座21400通过一对侧向延伸的砧座销或耳轴21412枢转地安装在细长通道21310上,该对侧向延伸的砧座销或耳轴被接收在形成于直立通道壁21314中的对应细长耳轴狭槽21320中。端部执行器闭合管3050沿远侧方向的轴向运动将导致砧座21400朝远侧平移,直到耳轴21412接触其相应耳轴狭槽21320的远侧端部并枢转到闭合位置。相反地,端部执行器闭合管3050沿近侧方向的运动将使砧座21400相对于细长通道21310枢转到打开位置。
端部执行器21300被构造成能够可操作地支撑外科钉仓21600,该外科钉仓可与外科钉仓20600基本上相同,不同的是砧座解锁特征部或接片21630包括仓盘21620的一部分。砧座解锁特征部21630被构造成能够与由通道21310支撑的能够轴向运动的砧座锁21702可操作地交接。转到图27,砧座锁21702由附接到通道21310的一部分的引导块21720支撑以用于在远侧锁定位置和近侧锁定位置之间轴向运动。在一个示例中,砧座锁21702可由金属形成,并且引导块21720可由40%碳填充的尼龙6/6制成,并且通过适当的粘合剂或其他扣紧部件附接到通道21310的侧壁21314。引导块21720可限定导槽21722,该导槽被构造成能够支撑砧座锁21702的锁定接片部分21710。砧座锁21702还包括竖直主体部分21706,该竖直主体部分具有形成在其远侧端部上的致动接片21712。砧座锁21702通过附接到砧座锁21702和通道侧壁21314的拉伸弹簧21730偏压到远侧锁定位置。当不存在仓时,拉伸弹簧21730将砧座锁21702偏压到远侧锁定位置,在锁定位置,锁定接片部分21710接触砧座21400的一部分以防止砧座21400枢转到闭合位置。当将正确的或兼容的仓21600装载到细长通道21310中时,仓盘21620的解锁特征部或接片21630接触砧座锁21702上的致动接片21712以使砧座锁21702朝近侧运动到解锁位置,在解锁位置,砧座锁21702的锁定接片部分21710不再阻止砧座21400的枢转动作。如在图25中可见,外科钉仓21600的砧座解锁特征部21630在设计上是“不对称的”。即,砧座解锁特征部21630仅位于仓21600的近侧端部的一侧上。图25示出了在先前的通道布置中存在的旧释放区域21315以及设置在通道21310中以在其中容纳仓21600的新释放区域21317、21319。
图30示出了外科端部执行器21300’的与端部执行器21300相同的各部分,不同的是端部执行器21300’采用如图31和图32所示的砧座锁21702’。在一个示例中,砧座锁21702’可由40%碳填充的尼龙6/6制成,并且包括竖直主体部分21706’,该竖直主体部分具有形成在其上端上的锁定部分21710’。致动接片21712’形成在远侧端部上,并且角撑板21714’也用于为致动接片21712’提供附加支撑。如上所述,当将正确的或兼容的外科钉仓21600装载到细长通道21310中时,仓盘21620的解锁特征部或接片21630接触砧座锁21702’上的致动接片21712’以使砧座锁21702’朝近侧运动到解锁位置,在解锁位置,砧座锁21702’的锁定接片部分21710’不再阻止砧座21400的枢转动作。
图33示出了采用砧座闭锁系统22700的另一个外科端部执行器22300。除了所指出的差异之外,端部执行器22300类似于上述端部执行器20300。在该实施方案中,端部执行器22300包括细长通道22310,该细长通道被构造成能够在该细长通道中可操作地支撑外科钉仓22600。在例示的示例中,细长通道22310包括通道底部22312和一对直立侧壁22314。尽管未示出,但通道22310可通过通道安装特征部20340(如上所述)联接到细长轴组件1200(图5),该通道安装特征部可有利于其围绕关节运动接头3020(图5)进行关节运动。除下文讨论的差异外,外科端部执行器22300还包括非常类似于上述砧座20400的砧座22400。砧座22400包括细长砧座主体部分22402和砧座安装部分22410,该砧座安装部分被构造成能够以上述方式与端部执行器闭合管3050(图5)交接。砧座22400通过一对侧向延伸的砧座销或耳轴22412枢转地安装在细长通道22310上,该对侧向延伸的砧座销或耳轴被接收在形成于直立通道侧壁22314中的对应细长耳轴狭槽22320中。端部执行器闭合管3050沿远侧方向的轴向运动将导致砧座耳轴22412朝远侧向上平移耳轴狭槽22320,以将砧座22400枢转到闭合位置。相反地,端部执行器闭合管3050沿近侧方向的运动将使砧座22400相对于细长通道22310枢转到打开位置。
端部执行器22300被构造成能够可操作地支撑外科钉仓22600,该外科钉仓可与外科钉仓20600基本上相同,不同的是砧座解锁特征部或接片22630形成于仓体22602的近侧端部部分22604的右侧上并且具有波状近侧端部表面22632。在例示的示例中,波状近侧端部表面22632具有弓形形状。砧座解锁特征部22630被构造成能够与由通道22310支撑的砧座闭锁系统22700的能够轴向运动的砧座锁22702可操作地交接。在例示的示例中,砧座锁22702被支撑用于在细长通道22310的近侧端部部分22316内在远侧锁定位置和近侧解锁位置之间轴向运动。在例示的示例中,砧座锁22702包括细长主体部分22706,该细长主体部分具有砧座锁定接片22710,该砧座锁定接片形成在其近侧端部上并且被构造成能够与形成在砧座22400的砧座安装部分22410上的锁定凸耳22413锁定地交接。参见图33。致动接片22712形成在主体部分22706的远侧端部上。致动接片22712具有形成于其中的波状致动表面22714,该波状致动表面被构造成能够与砧座解锁特征部22630上的波状近侧端部表面22632基本上匹配或配合。参见图34。
在至少一种布置中,弹簧或偏压构件22730(片簧、卷簧等)可附接到通道22310或安装在该通道内,并且被构造成能够将砧座锁22702沿远侧方向DD偏压到锁定位置,在锁定位置,其上的砧座锁定接片22710与砧座安装部分22410上的锁定凸耳22413阻挡对准,以防止砧座22400闭合。当将正确的或兼容的外科钉仓22600可操作地装载到通道22310中时,使砧座解锁特征部或接片22630与砧座锁22702的致动接片22712上的波状表面22714接合。然后外科钉仓22600朝近侧运动以将仓22600安置在通道22310内。当外科钉仓22600朝近侧运动时,砧座解锁特征部22630接触砧座锁22702的致动接片22712并且将砧座锁22702朝近侧偏压到解锁位置,在解锁位置,其上的砧座锁定接片22710运动成不与砧座安装部分22410上的锁定凸耳22413阻挡对准,以允许砧座22400枢转为闭合。当外科钉仓22600从通道22310移除时,弹簧22730将砧座锁22702朝远侧偏压回到锁定位置。图35示出了形成在仓体22602的近侧端部部分22604的右侧上的砧座解锁特征部22630的波状近侧端部22632和砧座锁22702的致动接片22712上的匹配波状表面22714,使得仓22600即使在仓相对于端部执行器22300的中心轴线EA以安装角度IA安装时也能够促进解锁特征部22630和致动接片22712之间的解锁交接。参见图35。
图36示出了试图使用不兼容仓22600X,该仓缺少将砧座锁22702从锁定位置运动到解锁位置的解锁特征部。如在图36中可见,闭锁接片22710与砧座22400上的锁定凸耳22413阻挡对准,从而甚至在仓22600X已安置在通道22310中之后也防止砧座22400闭合。
图37示出了,除了所指出的差异之外,另一个外科端部执行器22300’与上述外科端部执行器22300基本上相同。端部执行器22300’被构造成能够可操作地支撑钉仓22600’,该钉仓与仓20600基本上相同并且包括具有波状近侧端部表面22632’的砧座解锁特征部或接片22630’。在例示的示例中,砧座锁22702’包括细长主体部分22706’,该细长主体部分具有砧座锁定接片22710’,该砧座锁定接片形成在其近侧端部22711’上并且被构造成能够与形成在砧座22400的砧座安装部分22410上的锁定凸耳22413’锁定地交接。砧座锁22702’的远侧端部22712’包括形成于其中的波状致动表面22714’,该波状致动表面被构造成能够以上述方式与砧座解锁特征部22630’上的波状近侧端部表面22632’基本上匹配或配合。弹簧或偏压构件22730’(片簧、卷簧等)可附接到通道22310’或安装在该通道内,并且被构造成能够将砧座锁22702’沿远侧方向DD偏压到锁定位置,在锁定位置,其上的砧座锁定接片22710’与砧座安装部分22410上的锁定凸耳22413’阻挡对准,以防止砧座22400闭合。
当将正确的或兼容的外科钉仓22600’可操作地装载到通道22310’中时,使砧座解锁特征部或接片22630’与砧座锁22702’的波状表面22714’接合。然后仓22600’沿近侧方向PD朝近侧运动,以将仓22600’安置在通道22310’内。当仓22600’朝近侧运动时,砧座解锁特征部22630’接触砧座锁22702’的远侧端部并且将砧座锁22702’朝近侧偏压到解锁位置,在解锁位置,其上的砧座锁定接片22710’运动成不与砧座安装部分22410上的锁定凸耳22413’阻挡对准,以允许砧座22400枢转为闭合。当仓22600’从通道22310’移除时,弹簧22730’将砧座锁22702’朝远侧偏压回到锁定位置。如在图37中可见,当与上述砧座锁22702相比时,砧座锁22702’具有更稳固的主体部分22706’。在至少一个示例中,间隙凹口22709’设置在主体部分22706’中,以在砧座22400枢转到闭合位置时为锁定凸耳22413’提供足够的间隙。此外,通道止挡件22313’形成在通道22310’的底部22312’上,并且被构造用于在砧座锁22702’处于解锁位置时与砧座锁22702’的近侧端部22711’接触,以防止砧座锁22702’进一步朝近侧运动,从而确保锁定凸耳22413’在砧座22400闭合期间保持与砧座锁22702’中的间隙凹口22709’对准。
图38示出了,除了所指出的差异之外,另一个外科端部执行器22300”与上述外科端部执行器22300基本上相同。端部执行器22300”包括细长通道22310”,该细长通道包括枢转地支撑在其上的砧座22400”。通道22310”被构造成能够可操作地支撑与砧座22400”的钉成形下表面兼容的外科钉仓22600,并且采用被构造成能够防止砧座22400”闭合的砧座锁定系统22700”,除非外科钉仓22600已可操作地安装在端部执行器22300”中。在例示的示例中,砧座锁定系统22700”包括砧座锁22702”,该砧座锁包括主体部分22706”,该主体部分具有高于主体22706”的近侧部分的远侧端部部分22712”。当砧座锁22702”处于其最远侧锁定位置时,砧座22400”的一部分接触较高的远侧端部部分22712”以防止砧座22400”闭合。砧座锁22702”的远侧端部部分22712”包括波状致动表面22714”,该波状致动表面被构造成能够以上述方式与形成在仓22600上的砧座解锁特征部22630上的波状近侧端部表面22632基本上匹配或配合。弹簧或偏压构件22730”(片簧、卷簧等)可附接到通道22310”或安装在该通道内,并且被构造成能够将砧座锁22702”沿远侧方向DD偏压到锁定位置,在锁定位置,远侧端部部分22712”与砧座22400”的对应部分阻挡对准,以防止砧座22400”闭合。
当将正确的或兼容的外科钉仓22600可操作地装载到通道22310”中时,使仓22600上的砧座解锁特征部22630与砧座锁22702”的远侧端部22712”上的波状表面22714”接合。然后仓22600朝近侧运动以将仓22600安置在通道22310”内。当仓22600朝近侧运动时,砧座解锁特征部22630接触砧座锁22702”的远侧端部22712”并且将砧座锁22702”朝近侧偏压到解锁位置,在解锁位置,远侧端部部分22712”运动成不与砧座22400”的对应部分阻挡对准,以允许砧座22400”枢转到闭合位置。当仓22600从通道22310”移除时,弹簧22730”将砧座锁22702”朝远侧偏压回到锁定位置。还如在图38中可见,通道止挡件22313”形成在通道22310”的底部22312”上并且被构造用于与砧座锁22702”的近侧端部22711”接触以防止仓22600朝近侧插入到端部执行器22300”中太远。
图39和图40示出了另一个外科端部执行器23300,除了下文指出的各种差异之外,该外科端部执行器类似于本文所述的其他外科端部执行器。端部执行器23300包括细长通道23310,该细长通道包括枢转地支撑在其上的砧座23400。通道23310被构造成能够可操作地支撑与砧座23400的钉成形下表面兼容的外科钉仓22600,并且采用被构造成能够防止砧座23400闭合的砧座锁定系统23700,除非仓22600已可操作地安装在端部执行器23300中。在例示的示例中,砧座锁定系统23700包括砧座锁23702,该砧座锁包括具有远侧端部部分23712的主体部分23706。砧座锁23702的远侧端部部分23712包括波状致动表面23714,该波状致动表面被构造成能够以上述方式与形成在仓22600上的砧座解锁特征部22630上的波状近侧端部表面22632基本上匹配或配合。弹簧或偏压构件23730安装在通道23310内并且被构造成能够将砧座锁23702沿远侧方向DD偏压到“锁定”位置。
在例示的示例中,砧座23400包括细长砧座主体23402和砧座安装部分23410,该砧座安装部分被构造成能够以上述方式与端部执行器闭合管3050(图5)交接。砧座23400通过一对侧向延伸的耳轴形成部23412枢转地安装在细长通道22310上,这些耳轴形成部被接收在形成于通道23310的直立侧壁中的对应耳轴狭槽23320中。至少一个耳轴形成部23412包括侧向突起的致动器凸角23414,该侧向突起的致动器凸角限定致动器凸缘23416。耳轴销23418从致动器凸角23414向外突起,并且定尺寸成在对应的耳轴狭槽23320内平移和枢转。
如在图39中可见,至少一个耳轴狭槽23320包括弓形致动部分23322和形成在耳轴狭槽23320的近侧端部23321处的锁定偏移部分23324。图39示出了将仓22600插入细长通道23310中。为了将仓22600安装到细长通道23310中,首先将砧座23400运动到打开位置。这可通过致动闭合系统以使端部执行器闭合管3050(图5)沿近侧方向PD运动来实现。当闭合管3050朝近侧运动时,其与形成在砧座安装部分23410上的打开接片23411交接。当闭合管3050与砧座安装部分23410交接时,砧座23400朝近侧平移并开始枢转打开,这导致耳轴形成部23412在砧座23400到达其完全打开位置时向下平移对应耳轴狭槽23320的弓形致动部分23322并进入耳轴狭槽23320的近侧端部23321。
在将正确的或兼容的外科钉仓22600安装到通道23310中期间,使砧座解锁特征部或接片22630与砧座锁23702的远侧端部23712上的波状表面23714接合。然后仓22600朝近侧运动以将仓22600安置在通道22310内。当仓22600朝近侧运动时,砧座解锁特征部22630接触砧座锁23702的远侧端部23712并且将砧座锁23702朝近侧偏压解锁距离UD,以使砧座锁主体23706的近侧端部23710与至少一个耳轴形成部23412上的致动器凸角23414接合,以将耳轴形成部23412运动到一位置,在该位置,当向砧座安装部分23410施加闭合动作时,耳轴形成部23412可沿对应耳轴狭槽23320的弓形致动部分23322向上平移。换句话讲,砧座锁23702的近侧端部23710防止耳轴形成部23412进入在耳轴狭槽23320的近侧端部23321处形成的锁定偏移部分23324,以使耳轴形成部23412能够前进到耳轴狭槽23320的弓形致动部分23322中。
图40示出了试图插入不兼容仓22600X,该仓缺少使砧座锁23702运动出远侧锁定位置的必要解锁特征部或接片22630。然而,如果使用者将不兼容仓22600X安置在通道23310中并且随后试图闭合砧座23400,则砧座锁定系统23700将防止砧座23400的闭合。例如,为了闭合砧座23400,闭合系统被启动以使闭合管(或其他闭合构件)朝远侧运动成与砧座23400的砧座安装部分23410可操作地接触,从而对其施加闭合动作。对砧座安装部分23410的闭合动作的初始施加导致砧座安装部分23410向下运动(图40中的箭头DL),这导致砧座耳轴形成部23412进入形成在耳轴狭槽23320中的锁定偏移部分23324。因此,在对砧座23400施加闭合动作期间,砧座耳轴形成部23412不能平移到对应耳轴狭槽23320的弓形致动部分23322中,然后防止砧座23400闭合。
图41示出了包括砧座安装部分23410’的另选砧座23400’的一部分,该砧座安装部分具有形成于其上的耳轴形成部23412’。每个耳轴形成部23412’包括侧向突起的致动器凸角23414’,该侧向突起的致动器凸角限定被构造成能够以上述方式与砧座锁定系统23700交接的致动器凸缘23416’。如在图41中可见,致动器凸缘23416’从砧座安装部分23410’的底部表面23415’竖直偏移(距离OD)。耳轴销23418’从致动器凸角23414’向外突起,并且定尺寸成在对应的耳轴狭槽23320内平移和枢转。在该示例中,耳轴销23418’具有约等于致动器凸角23414’的宽度LW的耳轴销直径TRD。
图42示出了包括砧座安装部分23410”的另选砧座23400”的一部分,该砧座安装部分具有形成于其上的耳轴形成部23412”。每个耳轴形成部23412”包括侧向突起的致动器凸角23414”,该侧向突起的致动器凸角限定被构造成能够以上述方式与砧座锁定系统23700交接的致动器凸缘23416”。如在图42中可见,致动器凸缘23416”与砧座安装部分23410”的底部边缘23415”共延(例如,不偏移)。耳轴销23418”从致动器凸角23414”向外突起,并且定尺寸成在对应的耳轴狭槽23320内平移和枢转。在该示例中,耳轴销23418”具有约等于致动器凸角23414’的宽度LW’的耳轴销直径TRD’。
图43为包括枢转地支撑在细长通道24310上的砧座24400的外科端部执行器24100的局部剖面端部正视图。砧座24400包括砧座安装部分24410,该砧座安装部分具有形成于其上的耳轴形成部24412。每个耳轴形成部24412包括侧向突起的致动器凸角24414,该侧向突起的致动器凸角限定被构造成能够以上述方式与砧座锁定系统24700交接的底部凸角表面24416。如在图44中可见,底部凸角表面24416从砧座安装部分24410的底部表面24415竖直偏移(距离OD1)。耳轴销24418从致动器凸角24414向外突起,并且定尺寸成在形成于细长通道24310中的对应耳轴狭槽24320内平移和枢转。在该示例中,耳轴销24418具有约等于致动器凸角24414的宽度LW1的耳轴销直径TRD1。
通道20310包括通道底部24312和一对直立侧壁24314。通道24310可通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其围绕关节运动接头3020(图5)进行关节运动。图45示出了通道24310的近侧端部24316的一部分。在一个示例中,每个通道壁24314具有形成于其中的耳轴狭槽24320。在例示的布置中,凸角凸缘24340形成在每个通道壁24314中,使得凸角凸缘24340的顶部表面24342与对应耳轴狭槽24320的底部表面24321共延。每个耳轴24418被接收在对应的耳轴狭槽24320内并且在其中自由旋转和平移。
仍然参见图45,示出了砧座锁定系统24700的砧座锁24702的一部分。砧座锁24702以与上述砧座锁20702相同的方式操作,并且包括闭锁主体24706,该闭锁主体具有形成在其远侧端部上的致动器接片(未示出),该致动器接片被构造成能够由从兼容仓朝近侧突起的解锁特征部接触。砧座锁24702可由弹簧钢或其他合适的金属制成并且包括近侧偏压臂24704,该近侧偏压臂可被构造成能够安置在横向弹簧安装狭槽(未示出)中,该横向弹簧安装狭槽设置在通道安装特征部(未示出)的主体部分中。砧座锁24702还包括从其突起的向上延伸的砧座闭锁接片24710,该砧座闭锁接片被构造成能够在对应的凸角凸缘24340上方延伸并且接触对应的凸角24414,如将在下文描述。
图45和图46示出了处于锁定位置的砧座锁24702,在锁定位置,砧座24400枢转到打开位置。这可在没有仓已插入到通道24310中或不兼容仓(例如,除了别的以外,缺少将砧座锁定弹簧朝近侧偏压所必需的正确砧座解锁特征部的仓)已插入到通道24310中时发生。当砧座锁24702处于图45和图46所示的远侧锁定位置时,如果使用者无意中试图闭合砧座24400,则对应的凸角24414将接触砧座闭锁接片24710并防止砧座24400枢转到闭合位置。图47和图48示出了处于近侧解锁位置的砧座锁24702的位置,在近侧解锁位置,砧座闭锁接片24710定位在凸角24414的近侧,以允许凸角24414枢转到闭合位置。
图49为包括枢转地支撑在细长通道24310’上的砧座24400’的外科端部执行器24100’的局部剖面端部正视图。砧座24400’包括砧座安装部分24410’,该砧座安装部分具有形成于其上的耳轴形成部24412’。每个耳轴形成部24412’包括侧向突起的致动器凸角24414’,该侧向突起的致动器凸角限定被构造成能够以上述方式与砧座锁定系统24700’交接的底部凸角表面24416’。如在图50中可见,底部凸角表面24416’从砧座安装部分24410’的底部表面24415’共延。耳轴销24418’从致动器凸角24414’向外突起,并且定尺寸成在形成于细长通道24310’中的对应耳轴狭槽24320’内平移和枢转。在该示例中,耳轴销24418’具有小于致动器凸角24414’的宽度LW2的耳轴销直径TRD2。
通道20310’包括通道底部24312’和一对直立侧壁24314’。通道24310’可通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其围绕关节运动接头3020(图5)进行关节运动。图51示出了通道24310’的近侧端部24316’的一部分。在一个示例中,每个通道壁24314’具有形成于其中的耳轴狭槽24320’。在例示的布置中,凸角凸缘24340’形成在每个通道壁24314’中,使得凸角凸缘24340’的顶部表面24342’从对应耳轴狭槽24320’的底部表面24321’竖直偏移偏移距离OSD。偏移距离OSD可约等于耳轴销24418’和底部凸角表面24416’之间的距离TSD。参见图50。每个耳轴销24418’被接收在对应的耳轴狭槽24320’内并且在其中自由旋转和平移。
仍然参见图51,示出了砧座锁定系统24700’的砧座锁24702’的一部分。砧座锁24702’以与上述砧座锁20702相同的方式操作,并且包括闭锁主体24706’,该闭锁主体具有形成在其远侧端部上的致动器接片(未示出),该致动器接片被构造成能够由从兼容仓朝近侧突起的解锁特征部接触。砧座锁24702’可由弹簧钢或其他合适的金属制成并且包括近侧偏压臂24704’,该近侧偏压臂可被构造成能够安置在横向弹簧安装狭槽(未示出)中,该横向弹簧安装狭槽设置在通道安装特征部(未示出)的主体部分中。砧座锁24702’还包括从其突起的向上延伸的砧座闭锁接片24710’,该砧座闭锁接片被构造成能够在对应的凸角凸缘24340’上方延伸并且接触对应的凸角24414’,如在上文描述。
图51示出了处于锁定位置的砧座锁24702’,其中砧座24400枢转到打开位置。这可在没有仓已插入到通道中或不兼容仓(例如,除了别的以外,缺少将砧座锁定弹簧朝近侧偏压所必需的正确砧座解锁特征部的仓)已插入到通道24310’中时发生。当砧座锁24702’处于图45所示的远侧锁定位置时,如果使用者无意中试图闭合砧座24400’,则对应的凸角24414’将接触砧座闭锁接片24710’并防止砧座24400’枢转到闭合位置。一旦兼容外科钉仓已装载到端部执行器24100’中,砧座锁24702’将被偏压到解锁位置(参见,例如图47),并且砧座24400’将自由枢转到闭合位置。
图52示出了包括枢转地支撑在细长通道24310”上的砧座24400”的外科端部执行器24100”的一部分。砧座24400”包括砧座安装部分24410”,该砧座安装部分具有形成于其上的耳轴形成部24412”。如在图53和图54中可见,每个耳轴形成部24412”包括侧向突起的致动器凸角24414”,该侧向突起的致动器凸角限定被构造成能够以上述方式与砧座锁定系统24700”交接的底部凸角表面24416”。如在图53中可见,致动器凸角24414”以及致动器凸角24414”的底部凸角表面24416”相对于端部执行器轴线EA以及砧座安装部分24410”的底部边缘24419”和/或通道24310”的底部24312”成角度定位。如在图53中进一步可见,底部凸角表面24416”平行于凸角轴线LBA,该凸角轴线相对于端部执行器轴线EA成凸角角度LA定位。耳轴销24418”从致动器凸角24414”向外突起,并且定尺寸成在形成于细长通道24310”中的对应耳轴狭槽24320”内平移和枢转。参见图55。在该示例中,耳轴销24418”具有等于致动器凸角24414”的宽度LW3的耳轴销直径TRD3。
参见图55,通道24310”包括通道底部24312”和一对直立侧壁24314”。通道24310”可通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其以本文所述的各种方式围绕关节运动接头3020(图5)进行关节运动。图55示出了通道24310”的近侧端部24316”的一部分。在一个示例中,每个通道壁24314”具有形成于其中的耳轴狭槽24320”。在例示的布置中,凸角凸缘24340”形成在每个通道壁24314”中,使得凸角凸缘24340”的顶部表面24342”的近侧表面部分24344”与对应耳轴狭槽24320”的底部表面24321”共延。在例示的布置中,耳轴狭槽24320”的底部表面24321”大致平行于端部执行器轴线EA和/或通道24310”的底部24312”。如在图56中可见,顶部表面24342”的倾斜部分24346”以角度TSA从近侧表面部分24344”朝远侧延伸并终止于水平远侧表面部分24348”。在一种布置中,例如,远侧表面部分24348”大致平行于端部执行器轴线EA和/或通道24310”的底部24312”并且角度TSA=角度LA。然而,在其他实施方案中,角度TSA可不同于角度LA。每个耳轴24418”被接收在对应的耳轴狭槽24320”内并且在其中自由旋转和平移。
参见图55和图56,示出了砧座锁定系统24700”的砧座锁24702”的一部分。砧座锁24702”以与上述砧座锁20702相同的方式操作,并且包括闭锁主体24706”,该闭锁主体具有形成在其远侧端部上的致动器接片(未示出),该致动器接片被构造成能够由从兼容外科钉仓朝近侧突起的解锁特征部接触。砧座锁24702”可由弹簧钢或其他合适的金属制成并且包括近侧偏压臂24704”,该近侧偏压臂可被构造成能够安置在横向弹簧安装狭槽(未示出)中,该横向弹簧安装狭槽设置在通道安装特征部(未示出)的主体部分中。砧座锁24702”还包括向上延伸的砧座闭锁接片24710”,该砧座闭锁接片从其突起并且被构造成能够在对应的凸角凸缘24340”的远侧表面部分24348”上方延伸,并且与凸角凸缘24340”的近侧表面部分24344”平齐或齐平。
图55示出了处于远侧锁定位置的砧座锁24702”’,其中砧座24400”枢转到打开位置。这可在没有外科钉仓已插入到通道24310”中或不兼容外科钉仓(例如,除了别的以外,缺少将砧座锁24702”朝近侧偏压所必需的正确砧座解锁特征部的外科钉仓)已插入到通道24310”中时发生。当砧座锁24702”处于该位置时,砧座耳轴24418”位于其相应耳轴狭槽24320”的近侧端部中,并且至少一个凸角24414”的底部凸角表面24416”搁置在对应凸角凸缘24340”的近侧表面部分24344”上以及砧座闭锁接片24710”上。当砧座锁24702”处于图52和图55所示的远侧锁定位置时,如果使用者无意中试图闭合砧座24400”,则砧座闭锁接片24710”将防止凸角24414”向下枢转到凸角凸缘24340”的斜坡表面部分24346”上,这防止砧座24400”枢转到闭合位置。参见图52。一旦兼容外科钉仓已装载到端部执行器24100”中,其上的砧座闭锁特征部将砧座锁24702”朝近侧偏压到解锁位置。参见图56和图57。当砧座锁24702”处于近侧解锁位置时,砧座闭锁接片24710”锁定在凸角凸缘24340”上的斜坡表面24346”的近侧,从而允许凸角24414”在其上向下枢转,这导致砧座24400”的闭合。
图58示出了被构造成能够枢转地支撑在细长通道24310”’中的另一个砧座24400”’的近侧部分,除了下文讨论的差异之外,该细长通道类似于通道24310”。砧座24400”’包括砧座安装部分24410”’,该砧座安装部分具有形成于其上的耳轴形成部24412”’。每个耳轴形成部24412”’包括侧向突起的致动器凸角24414”’,该侧向突起的致动器凸角限定被构造成能够以上述方式与砧座锁定系统24700”交接的底部凸角表面24416”’。致动器凸角24414”’以及致动器凸角24414”’的底部凸角表面24416”’以与上文相对于致动器凸角24414”所述的角度LA相同的角度定位。耳轴销24418”’从致动器凸角24414”’向外突起,并且定尺寸成在形成于细长通道24310”’中的对应耳轴狭槽24320”’内平移和枢转。参见图59。在该示例中,耳轴销24418”’具有等于致动器凸角24414”’的宽度LW4的耳轴销直径TRD4。
如在图59中可见,通道24310”’包括通道底部24312”’和一对直立侧壁24314”’。通道24310”’可通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其围绕关节运动接头3020(图5)进行关节运动。图59示出了通道24310”’的近侧端部24316”’的一部分。在一个示例中,每个通道壁24314”’具有形成于其中的耳轴狭槽24320”’。在例示的布置中,凸角凸缘24340”’形成在每个通道壁24314”’中,使得凸角凸缘24340”’的顶部表面24342”’从对应耳轴狭槽24320”’的底部表面24321”’竖直偏移偏移距离OSD1。偏移距离OSD1可约等于耳轴24418”’和底部凸角表面24416”’之间的距离。在例示的布置中,凸角凸缘24340”’的顶表面24342”’与凸角凸缘24340”的顶表面24342”相同,并且包括平行于耳轴狭槽24320”’的底部表面24321”’的近侧部分24344”’以及倾斜表面24346”’和远侧表面24348”’。
砧座锁定系统24700”以相同方式工作以防止砧座24400”’闭合。当通道24310”’中不存在仓或不兼容仓(例如,缺少将砧座锁定弹簧朝近侧偏压的正确砧座解锁特征部的仓)已插入到通道24310”’中时,砧座锁定接片24710”处于其最远侧锁定位置,防止对应的致动器凸角24414”’向下枢转到斜坡表面24346”’上,从而将砧座24400”’保持在打开位置。一旦兼容外科钉仓已装载到端部执行器24100”’中,其上的砧座闭锁特征部将砧座锁24702”朝近侧偏压到解锁位置。当砧座锁24702”处于近侧解锁位置时,砧座闭锁接片24710”锁定在凸角凸缘24340”’上的斜坡表面24346”’的近侧,从而允许凸角24414”’在其上向下枢转,这导致砧座24400”’的闭合。
图60和图61示出了另一个砧座24400A,其在构造和操作上与上述砧座24400相同,不同的是耳轴形成部24412A从砧座24400A的砧座安装部分24410A的底部边缘24415A竖直偏移。图62示出了另一个砧座24400B,其在构造和操作上与上述砧座24400’相同,不同的是耳轴形成部24412B从砧座24400B的砧座安装部分24410B的底部边缘24415B竖直偏移。
图41至图62中描述的示例采用耳轴形成部,该耳轴形成部包括各种形状和构型的凸角结构,这些凸角结构用于与砧座锁定特征部交接,使得砧座锁定特征部和对应的凸角结构之间的交接用于促进砧座耳轴在其相应的耳轴狭槽内的定位。当将兼容外科钉仓装载到端部执行器中时,凸角结构的这种定位允许砧座在对其施加闭合动作时闭合。在不兼容外科钉仓已被装载到端部执行器中的情况下,砧座锁定特征部将对应的耳轴形成部保持在即使在对砧座施加闭合动作砧座也无法闭合的位置。因此,耳轴形成部的初始位置防止闭合,但将正确的或兼容的外科钉仓装载到通道中改变耳轴形成部的位置以允许发生闭合。本文所述的各种凸角特征部通常也比先前的耳轴布置更稳固,这可导致改善的砧座可靠性。
图63至图69示出了可例如与上述动力外科器械1010结合使用的外科端部执行器25300。外科端部执行器25300包括砧座25400,该砧座枢转地支撑在细长通道25310上,该细长通道被构造成能够可操作地支撑外科钉仓25600。砧座25400能够通过以本文所公开的各种方式与能够轴向运动的闭合构件交接而在打开位置和闭合位置之间运动。在例示的示例中,砧座25400包括砧座主体25402和砧座安装部分25410。砧座安装部分25410包括一对侧向延伸的耳轴25412,这对耳轴以本文所公开的各种方式可操作地接收在设置在通道25310的直立侧壁25314中的对应耳轴狭槽内。如上文相对于端部执行器1300所讨论的,砧座25400可通过以本文所述的各种方式与端部执行器闭合管3050交接而在打开位置与闭合位置之间枢转。例如,端部执行器闭合管3050可通过致动外科器械1010的闭合触发器1032而轴向运动。在其他布置中,端部执行器25300及其所附接到的轴组件可与机器人系统可操作地交接,如已经以引用方式并入本文的许多参考文献中详细描述的。在此类应用中,端部执行器闭合管3050可通过机器人系统的闭合控制系统的致动而轴向推进和回缩。
在例示的布置中,端部执行器闭合管3050的远侧运动使端部执行器闭合管3050的远侧端部3051与形成于砧座安装部分25410上的凸轮作用表面25411可操作地交接,以将砧座25400顶向闭合位置。当端部执行器闭合管3050沿近侧方向轴向回缩时,端部执行器闭合管3050可被构造成能够与各种形成部、凸缘或接片交接以将打开动作施加到砧座25400。更多细节可见于已以引用方式并入本文的各种其他参考文献中。
细长通道25310可通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其以本文所述的各种方式围绕关节运动接头3020(图5)进行关节运动。所示的示例还包括击发构件20500(图20),该击发构件附接到击发构件梁1900(图5)的远侧端部并且被构造成能够与已装载到通道25310中的外科钉仓25600中的凸轮作用组件可操作地交接。为了确保兼容外科钉仓25600在砧座25400闭合之前已装载到端部执行器25300中,该端部执行器采用闭合闭锁系统25700。在例示的示例中,闭合闭锁系统25700被构造成能够防止端部执行器闭合管3050的远侧运动,除非兼容仓25600已正确地安置在通道25310内。在一个示例中,闭合闭锁系统25700包括闭合锁25702,该闭合锁被构造成能够响应于兼容外科钉仓25600在其中的安装而在锁定位置和解锁位置之间运动。图65至图69示出了闭合锁25702的一种形式,该闭合锁可由弹簧钢或其他合适的金属制成并且包括主体部分25706,该主体部分通过延伸穿过主体部分25706中的枢轴孔25707的枢轴销25709枢转地销接到通道安装特征部20340的主体部分20342。闭合锁25702还包括近侧偏压臂25704,该近侧偏压臂可被构造成能够安置在狭槽(未示出)中,该狭槽设置在通道安装特征部20340的主体部分20342中。此类布置用于将闭合锁25702在通道25310内向下偏压。
如在图65和图66中最具体地可见,在例示的示例中,闭合锁25702还包括从主体部分25706的底部突起并且侧向向外延伸的阻挡特征部25710。如图65所示,当闭合锁25702处于锁定位置时,阻挡特征部25710被定位成阻挡端部执行器闭合管3050的远侧推进。当闭合锁25702处于如图66所示的解锁位置时,阻挡特征部25710运动远离阻挡位置以允许端部执行器闭合管3050的远侧推进。
转到图67,闭合锁25702还包括致动器部分25712,该致动器部分朝近侧延伸以由形成在兼容外科钉仓25600的近侧端部25604上的闭合解锁特征部25630接合。在至少一种布置中,外科钉仓25600包括细长仓体25602,该细长仓体定尺寸成可移除地安置在细长通道25310中。仓体25602包括从仓体25602的近侧端部部分25604延伸到远侧端部部分25606(图64)的仓狭槽25608。仓体25602还包括仓平台表面25610,当仓25600安置在通道25310中并且砧座25400枢转到闭合位置时,该仓平台表面面对砧座25400的钉成形下表面25404。尽管图67中未示出,但外科钉仓25600可在仓狭槽25608的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面25610打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体25602由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体25602的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。一旦驱动器和紧固件被插入其相应钉凹坑中,则仓盘25620附接到仓体25602的底部。当安装时,仓盘25620可(除了别的以外)防止驱动器和紧固件在仓25600处理和安装到细长通道25310中期间从仓体25602的底部掉出。如上文结合仓20040所述,仓25600可操作地支撑其中的凸轮作用组件。该凸轮作用组件包括一系列间隔开的凸轮构件,这些凸轮构件被构造成能够在对应凸轮狭槽25609内轴向运动,这些对应凸轮狭槽形成在仓体25602中的仓狭槽25608的每一侧上。凸轮狭槽25609与仓体25602中的对应排驱动器对准,以在凸轮作用组件从仓体25602的近侧端部部分25604内的开始位置被驱动穿过钉仓25600到远侧端部部分25606内的结束位置时,有利于与对应凸轮构件凸轮作用接触。
图63和图68示出了其中未安装外科钉仓的外科端部执行器25300。如在图68中可见,近侧偏压臂25704已将闭合锁25702在通道25310中向下偏压,这导致阻挡特征部25710运动到与端部执行器闭合管3050的远侧端部3051阻挡对准(锁定位置)。如果使用者启动闭合系统以使端部执行器闭合管3050朝远侧运动,则阻挡特征部25710将阻挡端部执行器闭合管3050的远侧推进,从而防止向砧座25400施加闭合动作。返回图67,在至少一种布置中,钉仓25600包括砧座解锁特征部或接片25630,该砧座解锁特征部或接片从仓体25602朝近侧突起并且对准以在仓25600可操作地安装在细长通道25310中时解锁地接合形成在闭合锁25702的远侧端部上的致动接片25712。在一个示例中,解锁特征部25630具有略微倾斜的表面25632,该倾斜表面被构造成能够与致动接片25712上的成角度表面25713可操作地交接,使得当倾斜表面25632和成角度表面25713接合时,闭合锁25702沿向上方向枢转。当闭合锁25702向上枢转到解锁位置时,阻挡特征部25710不再与端部执行器闭合管3050阻挡对准。参见图66。
图64和图69示出了外科端部执行器25300,其中兼容外科钉仓25600可操作地安装在细长通道25310中。如在图69中可见,钉仓主体25602上的解锁特征部25630上的倾斜表面25632已接触闭合锁25702上的致动接片25712上的成角度表面25713(示于图68中),以将闭合锁25702偏压到解锁位置。当处于该位置时,使用者可朝远侧推进端部执行器闭合管3050以向砧座25400施加闭合动作。如果使用者试图将缺少解锁特征部25630或被设计成解锁接合闭合锁25702的类似特征部的不适当的仓安装在适当位置,则使用者将无法朝远侧推进端部执行器闭合管3050以闭合砧座25400。
图70和图71示出了包括砧座25400’的外科端部执行器25300’,该砧座枢转地支撑在通道25310’上并且与上述端部执行器25300基本上相同,不同之处在于闭合锁定系统25700’采用不同的闭合锁25702’,该闭合锁被构造成能够与设置在外科钉仓25600’内的凸轮作用组件25650’上的解锁特征部交接。如在图70和图71中可见,闭合锁25702’包括细长主体25706’,该细长主体在其远侧端部上具有渐缩致动器接片部分25712’。主体25706’枢转地附接到通道安装特征部20340,并且近侧偏压臂25704’将闭合锁25702’偏压在通道25310’内。
图72示出了外科钉仓25600’,该外科钉仓包括细长仓体25602’,该细长仓体定尺寸成可移除地安置在细长通道25310’中。仓体25602’包括从仓体25602’的近侧端部部分25604’延伸到远侧端部部分的仓狭槽25608’。仓体25602’还包括仓平台表面25610’,当仓25600’安置在通道25310’中并且砧座25400’枢转到闭合位置时,该仓平台表面面对砧座25400’的钉成形下表面25404’。尽管图72中未示出,但外科钉仓25600’可在仓狭槽25608’的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面25610’打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体25602’由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体25602’的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。一旦驱动器和紧固件被插入其相应钉凹坑中,则仓盘25620’附接到仓体25602’的底部。当安装时,仓盘25620’可(除了别的以外)防止驱动器和紧固件在仓25600’处理和安装到细长通道25310’中期间从仓体25602’的底部掉出。凸轮作用组件25650’可操作地支撑在仓体25602’中。在至少一种布置中,凸轮作用组件25650’包括一系列间隔开的凸轮构件25652’,这些凸轮构件被构造成能够在对应凸轮狭槽25609’内轴向运动,这些对应凸轮狭槽形成在仓体25602’中的仓狭槽25608’的每一侧上。凸轮狭槽25609’与仓体25602’中的对应行驱动器对准,以在凸轮作用组件25650’从仓体25602’的近侧端部部分25604’内的开始位置被驱动穿过钉仓25600’到远侧端部部分内的结束位置时,有利于与对应凸轮构件25652’凸轮作用接触。在至少一个示例中,凸轮作用组件25650’包括闭合解锁特征部或接片25660’,该闭合解锁特征部或接片从凸轮作用组件25650’朝近侧突起,并且对准以在仓25600’已可操作地安装在细长通道25310’中并且凸轮作用组件25650’在仓25600’内处于其未击发开始位置时解锁地接合形成在闭合锁25702’的远侧端部上的致动接片25712’。
返回图71,在一个示例中,解锁特征部25660’具有渐缩鼻部部分25662’,该渐缩鼻部部分被构造成能够与致动接片25712’可操作地交接,使得当渐缩鼻部部分25662’与致动接片25712’接合时,闭合锁25702’向上枢转。当闭合锁25702’向上枢转到解锁位置时,闭合锁25702’上的阻挡特征部25710’不再与端部执行器闭合管3050阻挡对准。
如在图72中可见,仓体25602’还可包括从仓体25602’的近侧端部朝近侧突起并与渐缩鼻部部分25662’相邻的锁定安全装置25670’。锁定安全装置25670’的上表面25672’成角度以匹配渐缩鼻部部分25662’,但是当凸轮作用组件25650’处于其最近侧开始位置时,渐缩鼻部部分25662’朝近侧突起超过锁定安全装置25670’的端部。
图70示出了将未击发的兼容外科钉仓25600’初始插入通道25310’中。如在图70中可见,渐缩鼻部部分25662’已与闭合锁25702’上的致动器接片部分25712’初始接触。闭合锁25702’保持向下偏压到锁定位置,在锁定位置,闭合锁25702’的阻挡特征部25710’与端部执行器闭合管3050的远侧端部3051阻挡对准。当仓25600’进一步朝近侧推进到通道25310’内的安置位置时,凸轮作用组件25650’上的渐缩鼻部部分25662’将致动接片25712’向上提升到锁定安全装置25670’的成角度上表面25672’上方,以使闭合锁25702’能够枢转到解锁位置,在解锁位置,阻挡特征部25710’不再与端部执行器闭合管3050的远侧端部3051阻挡对准。当处于该位置时,使用者可朝远侧推进端部执行器闭合管3050以向砧座25400’施加闭合动作。因此,在该实施方案中,闭合锁定系统25700’由凸轮作用组件25650’致动,但仅在凸轮作用组件25650’处于未击发开始位置时才如此。
图73示出了钉仓25600X的插入,其中该钉仓凸轮作用组件不处于最近侧未击发位置。这可例如在使用者尝试使用先前已使用的钉仓25600X时发生。因为凸轮作用组件不处于其未击发开始位置,所以不存在开始将闭合锁25702’偏压到闭合安全装置25670’上方的向上位置中的渐缩鼻部部分。当仓25600X完全安置在通道25310’中时,闭合锁25702’的动作接片25712’定位在下锁定表面25674’下方。闭合锁25702’保持在锁定位置,在锁定位置,该闭合锁的阻挡特征部25710’与端部执行器闭合管3050的远侧端部3051阻挡对准。如果使用者无意中试图朝远侧推进端部执行器闭合管3050以闭合砧座25400’,则远侧端部3051将接触阻挡特征部25710’,并且闭合安全装置25670’将进一步防止闭合锁25702’在闭合负载下向上枢转到解锁位置。
图74和图75示出了包括砧座25400”的外科端部执行器25300”,该砧座枢转地支撑在通道25310”上并且与上述端部执行器25300’基本上相同。端部执行器25300”采用包括闭合锁25702”的闭合锁定系统25700”。如在图76中可见,闭合锁25702”包括细长主体25706”,该细长主体在其远侧端部上具有致动器接片部分25712”。主体25706”包括安装在通道25310”内的下弹簧臂25720”。安装下弹簧臂25720”以便向闭合锁25702”施加向下偏压力,这将在下文讨论。还如下文将进一步详细讨论的,闭合锁25702”还包括竖直延伸的砧座锁定接片25710”,该砧座锁定接片被构造成能够与形成在砧座25400”的砧座安装部分25410”上的锁定凸耳25414”锁定地交接。此外,闭合锁25702”包括近侧偏压弹簧25704”,该近侧偏压弹簧用于沿远侧方向DD(图76)偏压闭合锁25702”。如在图74中可见,通道25310”可通过通道安装特征部20340联接到细长轴组件1200(图5),该通道安装特征部可有利于其以本文所述的各种方式围绕关节运动接头3020(图5)进行关节运动。如在图76中可见,近侧偏压弹簧25704”被构造成能够安置在通道安装特征部20340的主体部分20342中的横向狭槽20343内。
与上述砧座25400’的闭合类似,端部执行器闭合管的远侧运动导致端部执行器闭合管的远侧端部与形成在砧座25400”的砧座安装部分25410”上的凸轮作用表面25411”可操作地交接,以将砧座25400”凸轮到闭合位置。当端部执行器闭合管沿近侧方向轴向回缩时,端部执行器闭合管可被构造成能够与各种形成部、凸缘或接片交接以将打开动作施加到砧座25400”。更多细节可见于已以引用方式并入本文的各种其他参考文献中。
图77示出了外科钉仓25600”,该外科钉仓包括细长仓体25602”,该细长仓体定尺寸成可移除地安置在细长通道25310”中。仓体25602”包括从仓体25602”的近侧端部部分25604”延伸到远侧端部部分的仓狭槽25608”。仓体25602”还包括仓平台表面25610’,当仓25600”安置在通道25310”中并且砧座25400”枢转到闭合位置时,该仓平台表面面对砧座25400”的钉成形下表面25404”。尽管图77中未示出,但外科钉仓25600”可在仓狭槽25608”的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面25610”打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体25602’由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体25602”的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。凸轮作用组件25650”可操作地支撑在仓体25602”中。在至少一种布置中,凸轮作用组件25650”包括一系列间隔开的凸轮构件25652”,这些凸轮构件被构造成能够在对应凸轮狭槽25609”内轴向运动,这些对应凸轮狭槽形成在仓体25602”中的仓狭槽25608”的每一侧上。凸轮狭槽25609”与仓体25602”中的对应行驱动器对准,以在凸轮作用组件25650”从仓体25602”的近侧端部部分25604”内的开始位置被驱动穿过钉仓25600”到远侧端部部分内的结束位置时,有利于与对应凸轮构件25652”凸轮作用接触。在至少一个示例中,凸轮作用组件25650”包括闭合解锁特征部或接片25660”,该闭合解锁特征部或接片从凸轮作用组件25650”朝近侧突起,并且对准以在外科钉仓25600”已可操作地安装在细长通道25310”中并且凸轮作用组件25650”在仓25600”内处于其未击发开始位置时解锁地接合形成在闭合锁25702”的远侧端部上的致动接片25712”。
返回图77,在一个示例中,解锁特征部25660”具有渐缩鼻部部分25662”,该渐缩鼻部部分被构造成能够与致动接片25712”可操作地交接,使得当渐缩鼻部部分25662”与致动接片25712”接合时,闭合锁25702”抵抗由下弹簧25720”造成的向下偏压力而向上运动。当闭合锁25702”向上枢转到解锁位置时,闭合锁25702”上的砧座锁定接片25710”不再与砧座安装部分24410”上的锁定凸耳25414”阻挡对准。
图74示出了将未击发的兼容外科钉仓25600”初始插入通道25310”中。如在图74中可见,凸轮作用组件25650”的渐缩鼻部部分25662”尚未与闭合锁25702”上的致动器接片部分25712”交接。闭合锁25702”保持向下偏压到锁定位置,在锁定位置,闭合锁25702”的砧座锁定接片25710”与砧座25400”的砧座安装部分25410”上的锁定凸耳25414”阻挡对准。当外科钉仓25600”进一步朝近侧推进到通道25310”内的安置位置时,凸轮作用组件25650”上的渐缩鼻部部分25662”接触致动接片25712”并且将闭合锁25702”向上偏压到解锁位置,在解锁位置,砧座锁定接片25710”不再与砧座锁定凸耳25414”对准。当处于该位置时,使用者可通过朝远侧推进端部执行器闭合管以向砧座25400”施加闭合动作来闭合砧座25400”。因此,在该实施方案中,闭合锁定系统25700”由凸轮作用组件25650”致动,但仅在凸轮作用组件25650”处于未击发开始位置时才如此。一旦外科钉仓25600”已从通道25310”移除,闭合锁25702”上的下弹簧25720”将向下偏压闭合锁25702”使其回到其锁定位置,在锁定位置,砧座锁定接片25710”与砧座25400”上的锁定凸耳25414”阻挡对准。
图78示出了其中具有凸轮作用组件的钉仓25600X”的插入,该凸轮作用组件不处于最近侧未击发位置。因为凸轮作用组件不处于其未击发开始位置,所以不存在将闭合锁25702”向上偏压到解锁位置的渐缩鼻部部分。闭合锁25702’保持在锁定位置,在锁定位置,该闭合锁的砧座锁定接片25710”与砧座25400”上的砧座锁定凸耳25414”阻挡对准。如果使用者无意中试图闭合砧座25400”,则砧座锁定凸耳25414”将接触闭合锁25702”上的砧座锁定接片25710”并防止砧座25400”枢转到闭合位置。
图79至图83示出了另选的仓鼻部组件25800,该仓鼻部组件可与本文所公开的仓和通道布置中的任一者一起使用,以提供用于确保插入端部执行器通道中的外科钉仓与端部执行器兼容的另一机构,并为使用者提供仓已被击发的另一视觉指示器。例如,仓鼻部组件25800可与仓25600和端部执行器25300的通道25310(图64)一起使用。在例示的布置中,仓鼻部组件25800包括鼻部组件主体25802,该鼻部组件主体可动地联接到仓体25602的远侧端部25606。如在图81和图82中可见,仓体25602的远侧端部部分25606包括朝远侧延伸的渐缩部分25605,该渐缩部分适于接收在鼻部组件主体25802中的互补形状的鼻部凹口25804内。此外,鼻部组件主体25802被构造成具有轴向对准特征部(未示出),该轴向对准特征部可以可滑动地支撑在设置于仓体25602的远侧端部部分25606中的轴向凹槽25607中。
如在图83和图84中可见,鼻部保持器闩锁臂25810从鼻部组件主体25802的上部部分朝近侧延伸到形成在仓体25602中的闩锁腔体25680中。鼻部组件主体25802能够从图81和图83所示的锁定位置轴向运动到图82和图84所示的解锁位置。当鼻部组件主体25802处于解锁位置时,形成在保持器闩锁臂25810的近侧端部上的保持闩锁25812接合形成在仓体25602的远侧端部部分25606上的保持凸耳25682,以将仓鼻部组件25800保持在仓体25602的远侧端部25606上。
现在参见图81和图82,鼻部组件主体25802还包括朝近侧延伸的鼻部接片部分25820,该鼻部接片部分定尺寸成摩擦地接合形成在通道25310的远侧端部25315上的对应远侧延伸的通道凸缘25317,以将鼻部组件25800保持在朝近侧向前的“锁定位置”。如在图83和图84中可见,鼻部组件主体25802还可包括一体式弹簧臂25830,该一体式弹簧臂被构造成能够与形成在仓体25602的朝远侧延伸的渐缩部分25605上的弹簧凸耳25684交接。弹簧臂25830向仓鼻部组件25800施加远侧偏压力BF,以增加鼻部接片部分25820和通道凸缘25317之间的摩擦力,从而将仓鼻部组件25800保持在锁定位置。
在操作中,当仓25600处于其未击发状态并且准备好安装在通道25310中时,仓鼻部组件25800处于锁定位置。为了将未击发仓25600安装到端部执行器25300中,将仓体25602放置在通道25310中,然后在其中朝近侧推进,以使通道凸缘25317与鼻部接片部分25820接合,如图81和图82所示。如上所述,当仓25600未击发时,凸轮作用组件25650处于其最近侧开始位置。在击发过程期间,凸轮作用组件25650在仓体25602中被驱动到其在其中的最远侧位置。当凸轮作用组件25650到达其最远侧位置时,凸轮作用组件25650的中心主体部分25651以足量的力接触仓鼻部组件25800,以克服将仓鼻部组件25800保持在锁定位置的摩擦力FF,并且使仓鼻部组件25800轴向运动到解锁位置。在另选的替代方案中,使用者可通过将仓鼻部组件25800朝远侧牵拉到解锁位置来使该仓鼻部组件脱离接合。一旦仓鼻部组件25800运动到解锁位置,仓25600就可从细长通道25310被移除。此外,朝远侧延伸的仓鼻部组件25800可向使用者提供该仓已被击发(用尽)的视觉指示。
图85和图86示出了采用击发构件26120的外科端部执行器26300的一部分,该击发构件可被构造成能够由旋转动力击发系统或轴向动力(非旋转动力)击发系统朝远侧推进。具体地讲,击发构件26120可结合本文所公开的各种端部执行器布置和击发驱动系统构型中的任一者以及结合以引用方式并入本文的各种参考文献中所述的那些端部执行器和击发驱动系统构型使用。
如在图85和图86中可见,击发构件26120包括击发构件主体26122,该击发构件主体包括击发构件闭锁系统26140,该击发构件闭锁系统包括枢转地附接到击发构件主体26122的击发构件闭锁件26142。击发构件闭锁件26142包括闭锁件主体26144,该闭锁件主体包括跨越击发构件主体26122并枢转地附接到其上的一对腿部26146。闭锁件主体26144还包括滑动件闩锁26148,该滑动件闩锁被构造成能够与可操作地支撑在钉仓(未示出)中的凸轮作用滑动件或凸轮作用组件26650接触。图85示出了处于最近侧起始位置的击发构件26120。如在图85和图86中可见,通过端部执行器26300的细长通道26310的底部部分26312提供击发闭锁孔26315。闭锁弹簧26150安装在细长通道26310中并且被构造成能够向下偏压击发构件闭锁件26142,使得如果新鲜的未击发钉仓尚不正确地装载到细长通道26310中,则闭锁主体26144的远侧边缘26149接合击发闭锁孔26315的成角度远侧边缘26317。当处于该位置时,如果使用者无意中试图朝远侧推进击发构件26120,则击发构件闭锁件26142防止击发构件26120朝远侧推进,如图86所示。
新鲜的未击发外科钉仓包含位于起始或未击发位置的凸轮作用组件26650,该起始或未击发位置位于支撑于仓体中的多排钉驱动器的近侧。如本文所用,术语“新鲜的、未击发的”意指钉仓的所有预期钉或紧固件处于其相应的未击发位置,并且凸轮作用组件处于近侧未击发起始位置。当新鲜的未击发外科钉仓已正确地安置在细长通道26310内时,凸轮作用组件26650上朝近侧延伸的解锁部分26653接合击发构件闭锁件26142上的滑动件闩锁26148,以使击发构件闭锁件26142枢转到解锁位置,在解锁位置,击发构件闭锁件26142不延伸到细长通道26310中的击发闭锁孔26315中。图85示出了处于起始位置的凸轮作用组件26650,并且击发构件26120通过致动击发驱动系统而自由地朝远侧推进。
在击发过程完成时,凸轮作用组件26650可保持在钉仓的远侧端部处(即,处于“击发”位置),同时击发构件26120回缩到其起始位置,在其起始位置,砧座可被打开并且用尽的仓从通道26310被移除。因此,一旦外科钉仓已被用尽(例如,完全击发),凸轮作用组件26650就不返回到其起始位置。因此,如果要将用尽的仓无意中重新安装在端部执行器26300中,则凸轮作用组件26650不处于其中凸轮作用组件26650可解锁击发构件闭锁件26142的起始位置。因此,击发构件闭锁系统26140在本文中也可称为“用尽的仓闭锁系统”。
图87至图90示出了被构造成能够枢转地支撑在本文所公开的各种类型的通道26310或类似通道上的砧座26400。在图87和图89中,为清楚起见省略了通道。在例示的布置中,砧座26400包括仓验证系统26440,该仓验证系统可被构造成能够防止原本已安置在仓中的不兼容仓的击发。砧座26400和仓验证系统26440可与外科端部执行器26300结合使用,该外科端部执行器采用配备有机载击发构件闭锁系统26140的击发构件26120,该机载击发构件闭锁系统被构造成能够防止击发构件26120的远侧推进,除非击发构件闭锁件26142已通过与位于外科钉仓中的对应凸轮作用组件交接而运动到解锁位置。仓验证系统26440还可与外科端部执行器结合使用,该外科端部执行器采用轴向推进的(非旋转的)击发构件,该击发构件以其他方式配备有类似于击发构件闭锁系统26140的击发构件闭锁系统。
图90示出了与外科端部执行器26300兼容外科钉仓26600的部分。在至少一种布置中,外科钉仓26600包括细长仓体26602,该细长仓体定尺寸成可移除地安置在端部执行器26300的细长通道中。仓体26602包括从仓体26602的近侧端部部分26604延伸到远侧端部部分的仓狭槽26608。仓体26602还包括仓平台表面26610,当仓26600安置在通道中并且砧座26400枢转到闭合位置时,该仓平台表面面对砧座26400的钉成形下表面26404。尽管图90中未示出,但外科钉仓26600可在仓狭槽26608的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面26610打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体26602由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体26602的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。一旦驱动器和紧固件被插入其相应钉凹坑中,则仓盘26620附接到仓体26602的底部。当安装时,仓盘26620可(除了别的以外)防止驱动器和紧固件在仓26600处理和安装到细长通道26310中期间从仓体26602的底部掉出。
在例示的布置中,仓26600在其中可操作地支撑凸轮作用组件26650。凸轮作用组件26650包括中央主体部分26652和一系列间隔开的凸轮构件26654,这些凸轮构件被构造成能够在对应凸轮狭槽26609内轴向运动,这些对应凸轮狭槽形成在仓体26602中的仓狭槽26608的每一侧上。凸轮狭槽26609与仓体26602中的对应排驱动器对准,以在凸轮作用组件26650从仓体26602的近侧端部部分26604内的开始位置被驱动穿过钉仓26600到仓体26602的远侧端部部分内的结束位置时,有利于与对应凸轮构件26654凸轮作用接触。中央主体部分26652”包括朝近侧延伸的解锁部分26653”,该解锁部分被构造成能够在仓26600”已正确地装载到通道26310”中时接合击发构件锁26142上的滑动件闩锁26148。如在图90中可见,当凸轮作用组件26650处于其最近侧起始位置(其中解锁部分26653可使击发构件闭锁件26142运动到解锁位置)时,凸轮构件26654中的每个可朝近侧突起到其相应的凸轮狭槽26609之外。
现在参见图87和图91,在示出的布置中,仓验证系统26440包括仓验证构件或梭动构件26442,该仓验证构件或梭动构件附接到砧座26400的砧座安装部分26410的下侧。仓验证构件26442可以是一体式构造,并且包括一对向下延伸的梭动件腿部26444,该对向下延伸的梭动件腿部由击发构件狭槽26447(图91)分叉,以便于击发构件26120在其间的通路。在其他布置中,仓验证构件26442可以是两件式构造,其由两个单独的向下延伸的梭动件腿部26444组成,这些梭动件腿部通过间距26448彼此分开,该间距被构造成能够适应击发构件主体26122从中通过。在任一种情况下,梭动构件26442可由柔顺聚合物或橡胶材料制成并且可通过紧固件布置的适当粘合剂附接到砧座安装部分26410的下侧。
在例示的示例中,每个梭动件腿部26444包括朝远侧突起的滑动件致动器臂26446。返回图90,仓体26602包括两个朝近侧突起的验证特征部或仓键部分26630,这些验证特征部或仓键部分被构造成能够在仓26600可操作地安置在通道26310中时解锁地接合对应梭动件腿部26444上的滑动件致动器臂26446。如下文将进一步讨论,如果不存在接触对应滑动件致动器臂26446的验证特征部26630,则滑动件致动器臂26446将以其他方式接触突起凸轮构件26654,并将凸轮作用组件26650朝远侧推动或推送到其中凸轮作用组件26650上的解锁部分26653不再与击发构件锁26142上的滑动件闩锁26148解锁接合的位置。
可参考图87至图92理解仓验证系统26440与仓26600之间的交接。图87示出了将兼容外科钉仓26600初始安装到端部执行器26300中。尽管已从附图中省略通道,但砧座26400被示为处于完全打开位置。在例示的示例中,砧座26400能够运动地轴颈连接在通道上,使得在从本文所述的各种闭合系统中的许多闭合系统的闭合构件布置对其施加初始闭合动作时,砧座26400枢转到图88所示的部分闭合位置或中间位置。当处于该位置时,每个滑动件致动器臂26446与仓体26602上的对应验证特征部26630面对对准。对砧座26400进一步施加闭合动作还可使砧座26400朝远侧平移到闭合位置。当砧座26400朝远侧运动时,验证特征部26630阻挡对应的柔顺滑动件致动器臂26446的远侧运动,以防止滑动件致动器臂26446接触朝近侧突起的凸轮构件26654。因此,凸轮作用组件26650保持在其起始位置,在其起始位置,凸轮作用组件26650上的解锁部分26653保持与击发构件锁26142上的滑动件闩锁26148解锁接合。因此,在致动击发驱动系统时,击发构件26120自由地朝远侧运动穿过仓26600。
图92示出了可非常类似于仓26600但与外科端部执行器26300“不兼容”的仓26600X。例如,仓26600X缺少仓26600的验证特征部或键部分26630。除了缺少验证特征部或键26630之外,仓26600X还可在包含于其中的紧固件的数量、尺寸、位置等方面不同于仓26600,尽管事实上仓26600X可具有凸轮作用组件26650,该凸轮作用组件在构造和使用上与仓26600中采用的凸轮作用组件26650相同。
图93至图95示出了将不兼容仓26600X插入到外科端部执行器26300中。图93示出了将不兼容外科钉仓26600X初始安装到端部执行器26300中。尽管已从附图中省略通道,但砧座26400被示为处于完全打开位置。图94示出了在对其施加初始闭合动作时处于中间位置的砧座26400。当处于该位置时,每个滑动件致动器臂26446与朝近侧突起到其相应凸轮狭槽26609之外的对应凸轮构件26654面对对准。对砧座26400进一步施加闭合动作可使砧座26400朝远侧平移到最终闭合位置。当砧座26400朝远侧运动时,滑动件致动器臂26446接触朝近侧突起的凸轮构件26654,并使凸轮作用组件26650朝远侧运动到一点,其中在该点处上的解锁部分26653不再与击发构件锁26142上的滑动件闩锁26148接合。因此,击发构件闭锁件26142保持与端部执行器26300的细长通道26310锁定接合,以在致动击发驱动系统时防止击发构件26120的远侧推进。
图96至图98示出了可与端部执行器26300一起使用的另一个仓验证系统26440,该端部执行器采用由击发构件梁1900以本文所讨论的各种方式轴向推进的击发构件20500。如上所述,击发构件20500包括击发构件主体20502,该击发构件主体被构造成能够轴向穿过砧座(未示出)、钉仓26600’和细长通道26310’中的竖直对准的狭槽。包括一对侧向延伸的下法兰的下脚部组件20506从击发构件主体20502的底端延伸,以可滑动地接合形成在通道狭槽的每一侧上的对应通道凸缘。包括两个侧向延伸的砧座接片20507的上脚部可形成在击发构件主体20502的上端上,并且被构造成能够可滑动地接合形成在砧座狭槽的每一侧上的砧座凸缘(未示出)。在至少一种布置中,击发构件20500还包括从击发构件主体20502的每一侧侧向延伸的一对中央接片(未示出)。
击发构件主体20502还被构造成具有朝近侧延伸的弹簧尾部20512,该弹簧尾部被构造成能够与击发构件闭锁弹簧(未示出)可操作地交接,该击发构件闭锁弹簧安装在细长通道26310中并且被构造成能够将击发构件20500在细长通道26310中向下偏压到锁定位置。当处于锁定位置时,击发构件脚部20506和/或中央接片与通道20310’中的对应通路不对准时,并且因此,如果使用者试图在处于闭锁状态时朝远侧推进击发构件20500,则击发构件20500将不会由于此类不对准而朝远侧运动。即,脚部20506和/或中央接片接触细长通道20310’的各部分,从而防止击发构件20500的远侧推进。在一种布置中,滑动件闩锁20514形成在击发构件主体20502上,并且被构造成能够由凸轮作用组件26650’上的朝近侧延伸的解锁部分26653’接合,该凸轮作用组件可操作地支撑在兼容仓26600’内的最近侧起始位置,该兼容仓已可操作地安置在通道26310’中。当其凸轮作用组件26650’处于其未击发位置的新鲜的未击发钉仓26600’已可操作地安装在细长通道26310’中时,凸轮作用组件26650’上的解锁部分26653’接合击发构件主体20502上的滑动件闩锁20514并使击发构件20500向上运动进入解锁位置,在解锁位置,下脚部组件20506和/或中央接片与通道26310’中其相应通路对准,以允许击发构件20500在其中轴向推进。当使用者将击发构件20500朝远侧推进到仓26600’中时,击发构件20500还驱动其中的凸轮作用组件20650’,该凸轮作用组件将驱动器向上凸轮以驱动支撑在其上的钉或紧固件与砧座的下侧形成接触。然后,击发构件20500上的组织切割构件20504切穿缝合的组织。一旦击发构件20500已被驱动到其对应于凸轮作用组件26650’的结束位置的最远侧位置,击发构件20500就回缩到其最近侧位置,从而将凸轮作用组件26650’留在仓26600’的远侧端部中。当击发构件20500返回到其最近侧开始位置时,锁定弹簧再次将击发构件20500偏压回其锁定位置。因此,如果使用者无意中尝试再利用用尽的仓,则凸轮作用组件26650’不处于其解锁击发构件20500所需的起始位置。因此,该击发构件闭锁布置在本文中也可称为“用尽的仓闭锁布置”。
在图96和图97所示的布置中,仓验证系统26440’包括能够轴向运动的仓验证构件或安置梭动件26442’,该能够轴向运动的仓验证构件或安置梭动件被支撑在通道26310’内,以用于从通道26310’内的最远侧仓接合位置轴向运动到近侧验证位置。梭动件弹簧26449’安装在通道26310’内并且用于将仓验证构件或安置梭动件26442’偏压到最远侧仓接合位置。如在图96和图97中可见,仓验证构件或梭动件26442’还包括一对朝远侧突起的滑动件致动器臂26446’。滑动件致动器臂26446’被定位成接触非柔顺仓的凸轮作用组件上的对应凸轮构件,如下文将讨论的。
图98示出了与外科端部执行器26300’兼容外科钉仓26600’的近侧端部部分26604’。在至少一种布置中,外科钉仓26600’包括细长仓体26602’,该细长仓体定尺寸成可移除地安置在细长通道26310’中。仓体26602’包括从仓体26602’的近侧端部部分26604’延伸到远侧端部部分的仓狭槽26608’。仓体26602’还包括仓平台表面26610’,当仓26600’安置在通道26310’中并且砧座枢转到闭合位置时,该仓平台表面面对砧座的钉成形下表面。尽管图98中未示出,但外科钉仓26600’可在仓狭槽26608’的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面26610’打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体26602’由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体26602’的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。一旦驱动器和紧固件被插入其相应钉凹坑中,则仓盘26620’附接到仓体26602’的底部。当安装时,仓盘26620’可(除了别的以外)防止驱动器和紧固件在仓26600’处理和安装到细长通道26310’中期间从仓体26602’的底部掉出。
在例示的布置中,仓26600’在其中可操作地支撑凸轮作用组件26650’。凸轮作用组件26650’包括中央主体部分26652’和一系列间隔开的凸轮构件26654’,这些凸轮构件被构造成能够在对应凸轮狭槽26609’内轴向运动,这些对应凸轮狭槽形成在仓体26602’中的仓狭槽26608’的每一侧上。凸轮狭槽26609’与仓体26602’中的对应排驱动器对准,以在凸轮作用组件26650’从仓体26602’的近侧端部部分26604’内的开始位置被驱动穿过钉仓26600’到仓体26602’的远侧端部部分内的结束位置时,有利于与对应凸轮构件26654’凸轮作用接触。中央主体部分26652’包括朝近侧延伸的解锁部分26653’,该解锁部分被构造成能够在仓26600’已正确地装载到通道26310’中时接合击发构件20500上的滑动件闩锁20514。
兼容仓26600’还包括朝近侧突起的验证特征部或键形成部26630’,这些验证特征部或键形成部被构造成能够在仓26600’可操作地安置在通道26310’中时接合滑动件致动器臂26446’。在例示的布置中,仓体26602’另外具有两个侧面验证特征部或仓键形成部26632’,这两个侧面验证特征部或仓键形成部也被构造成能够接合仓验证构件或梭动件26442’。如下文将进一步讨论,如果不存在接触对应滑动件致动器臂26446’和仓验证构件或梭动件26442’的验证形成部26630’、26632’,则滑动件致动器臂26446’将以其他方式接触突起凸轮构件26654’,并将凸轮作用组件26650’朝远侧推动或推送到其中凸轮作用组件26650’上的解锁部分26653’不再与击发构件20500上的滑动件闩锁20514解锁接合的位置。
现在转到图99至图101,在例示的布置中,验证特征部或键形成部26630’、26632’各自在其上具有成角度的下对准表面26634’,该成角度的下对准表面有利于仓26600’以第一位置角FPA初始插入通道26310’中,其中成角度的下对准表面26634’避免与滑动件致动器臂26446’邻接接触。表面26634’在本文中可称为次表面。一旦使用者已将外科钉仓26600’定位在第一安装位置,则仓26600’向下枢转到通道26310’中,进入位置2,其中验证特征部或仓键形成部26630’、26632’上的竖直邻接表面26636’(次表面)邻接仓验证构件或梭动件26442’上的对应竖直邻接表面26641’和26647’(主表面)。然后,使用者可将仓26600’朝近侧推进到细长通道26310’内的位置3。
图102示出了将不兼容仓26600X’插入到外科端部执行器26300’中。在该示例中,不兼容仓26600X’缺少设置在兼容仓26600’上以接合仓验证构件或梭动件26442’的验证特征部或仓键形成部26630’、26632’。因此,当仓26600X’安置在通道26310’中时,滑动件致动器臂26446’接触突起凸轮构件26654’,并将凸轮作用组件26650’朝远侧推动或推送到其中凸轮作用组件26650’上的解锁部分26653’不与击发构件20500上的滑动件闩锁20514解锁接合的位置。因此,击发构件20500保持锁定在适当位置,并且使用者将不能将击发构件20500朝远侧推进到不兼容仓26600X’中。
图103和图104示出了不兼容仓26600X’插入到端部执行器26300’中,其中不兼容仓26600X’最初已朝近侧插入到通道26310’中过远,使得击发构件20500的远侧端部已接触并推动凸轮作用组件26650’或“滑动件”在仓26600X’内朝远侧过远,以致在仓26600X’已最终安置在通道26310’中的适当位置之后处于适当位置而解锁地接合击发构件20500的滑动件闩锁20514部分。同样,当不兼容仓26600X’如上所述初始插入对角位置1,然后运动到位置2和3时,击发构件20500可将凸轮作用组件26650’或滑动件朝远侧碰撞出击发构件解锁位置,使得一旦被正确安置,凸轮作用组件26650’将无法解锁击发构件20500。参见图105和图106。
图107至图109示出了可与端部执行器26300”一起使用的另一个仓验证系统26440”,该端部执行器采用由击发构件梁1900以本文所讨论的各种方式轴向推进的击发构件20500。如上所述,击发构件20500包括击发构件主体20502,该击发构件主体被构造成能够轴向穿过砧座(未示出)、钉仓和细长通道26310”中的竖直对准的狭槽。包括一对侧向延伸的下法兰的下脚部组件(未示出)从击发构件主体20502的底端延伸,以可滑动地接合形成在通道狭槽的每一侧上的对应通道凸缘。包括两个侧向延伸的砧座接片20509的上脚部20507可形成在击发构件主体20502的上端上,并且被构造成能够可滑动地接合形成在砧座狭槽的每一侧上的砧座凸缘(未示出)。在至少一种布置中,击发构件20500还包括从击发构件主体20502的每一侧侧向延伸的一对中央接片20510。
击发构件主体20502还被构造成具有朝近侧延伸的弹簧尾部(未示出),该弹簧尾部被构造成能够与击发构件闭锁弹簧(未示出)可操作地交接,该击发构件闭锁弹簧安装在细长通道26310”中并且被构造成能够将击发构件20500在细长通道26310’中向下偏压到锁定位置。当处于锁定位置时,击发构件脚部和/或中央接片20510与通道20310中的对应通路不对准时,并且因此,如果使用者试图在处于该闭锁状态时朝远侧推进击发构件20500,则击发构件20500将不会由于此类不对准而朝远侧运动。即,脚部和/或中央接片20510接触细长通道26310”的各部分,从而防止击发构件20500的远侧推进。在一种布置中,滑动件闩锁20514形成在击发构件主体20502上,并且被构造成能够由凸轮作用组件上的朝近侧延伸的解锁部分接合,该凸轮作用组件可操作地支撑在兼容仓内的最近侧起始位置,该兼容仓已可操作地安置在通道26310”中。
当其凸轮作用组件处于其起始(未击发)位置的新鲜的未击发兼容钉仓已可操作地安装在细长通道26310”中时,凸轮作用组件上的解锁部分接合击发构件主体20502上的滑动件闩锁20514并使击发构件20500向上运动进入解锁位置,在解锁位置,下脚部组件和/或中央接片20510与通道26310”中其相应通路对准,以允许击发构件20500在其中轴向推进。当使用者将击发构件20500朝远侧推进到仓中时,击发构件20500还驱动其中的凸轮作用组件,该凸轮作用组件将驱动器向上凸轮以驱动支撑在其上的钉或紧固件与砧座的下侧形成接触。然后,击发构件20500上的组织切割构件20504切穿缝合的组织。一旦击发构件20500已被驱动到其对应于凸轮作用组件的结束位置的最远侧位置,击发构件20500就回缩到其最近侧位置,从而将凸轮作用组件留在仓的远侧端部(击发位置)中。当击发构件20500返回到其最近侧开始位置时,锁定弹簧再次将击发构件20500偏压回其锁定位置。因此,如果使用者无意中尝试再利用用尽的仓,则凸轮作用组件不处于其解锁击发构件20500所需的起始位置。此类击发构件锁定系统在本文中也可称为“用尽的仓闭锁系统”。
在图107至图109所示的布置中,仓验证系统26440”包括能够轴向运动的仓验证梭动件26442”,该能够轴向运动的仓验证梭动件被支撑在通道26310”内,以用于从通道26310”内的最远侧仓接合位置轴向运动到近侧验证位置。梭动件弹簧26449”安装在通道26310”内并且用于将仓验证梭动件26442”偏压到最远侧仓接合位置。如在图107和图108中可见,仓验证梭动件26442”还包括朝远侧延伸的梭动件基座构件26644”和一对能够侧向运动的梭动件驱动臂26450”。每个梭动件驱动臂26450”在其上具有驱动闩锁特征部26452”,这些驱动闩锁特征部具有成角度的近侧驱动表面26454”和成角度的远侧驱动表面26456”,这些成角度的近侧驱动表面和成角度的远侧驱动表面会聚在一起以形成点26548”。梭动件驱动臂26450”被梭动件弹簧26449”侧向向内偏压到驱动位置。当梭动件驱动臂26450”处于驱动位置时,成角度的近侧驱动表面26454”与击发构件20500上的中央接片20510驱动接合,如图107和图108所示。当梭动件驱动臂26450”处于该位置时,击发构件20500的远侧推进将导致安置梭动件26442”随其朝远侧运动。
图109示出了与外科端部执行器26300”兼容并且安置在通道26310”内的外科钉仓26600”的近侧端部部分26604”。在至少一种布置中,外科钉仓26600”包括细长仓体26602”,该细长仓体定尺寸成可移除地安置在细长通道26310”中。仓体26602”包括从仓体26602”的近侧端部部分26604”延伸到远侧端部部分的仓狭槽26608”。仓26600”在其中可操作地支撑凸轮作用组件26650”。凸轮作用组件26650”包括中央主体部分26652”和一系列间隔开的凸轮构件26654”,这些凸轮构件被构造成能够在对应凸轮狭槽26609”内轴向运动,这些对应凸轮狭槽形成在仓体26602”中的仓狭槽26608”的每一侧上。凸轮狭槽26609”与仓体26602”中的对应排驱动器对准,以在凸轮作用组件26650”从仓体26602”的近侧端部部分26604”内的开始位置被驱动穿过钉仓26600”到仓体26602”的远侧端部部分内的结束位置时,有利于与对应凸轮构件26654”凸轮作用接触。中央主体部分26652”包括朝近侧延伸的解锁部分26653”,该解锁部分被构造成能够在仓26600”已正确地装载到通道26310”中时接合击发构件20500上的滑动件闩锁20514。
兼容仓26600”还包括朝近侧突起的解锁特征部或仓键形成部26630”,这些解锁特征部或仓键形成部被构造成能够在仓26600”可操作地安置在通道26310”中时接合梭动件驱动臂26450”。如在图109中可见,在击发构件20500的远侧推进期间,验证梭动件26442”朝远侧被驱动,直到每个梭动件驱动臂26450”接触对应的仓键形成部26630”,这导致梭动件驱动臂26450”侧向向外偏压。当击发构件20500继续朝远侧运动时,梭动件驱动臂26450”上的驱动闩锁特征部26452”与击发构件主体20502上的对应中央接片20510脱离接合,以允许击发构件20500朝远侧运动而不朝远侧驱动验证梭动件26442”。因此,在这种情况下,验证梭动件26442”尚未充分朝远侧运动,以致使凸轮作用组件26650”运动成不与击发构件20500上的滑动件闩锁20514解锁接合。因此,击发构件20500可朝远侧驱动穿过兼容仓26600”,以从其驱动紧固件并切割已夹持在端部执行器26300”中的组织。当击发构件20500回缩到其起始位置时,每个中央接片20510上的渐缩表面20511接触对应驱动闩锁特征部26452”上的成角度的远侧驱动表面26456”,以侧向偏压梭动件臂26450”,从而允许中央接片20510重新接合成角度的近侧驱动表面26454”,使得验证梭动件26442”可再次随击发构件20500朝远侧驱动。
图107和图108示出了装载到外科端部执行器26300”中的不兼容仓26600X”。如在那些图中可见,不兼容仓26600X”缺少设置在兼容仓26600”上的朝近侧突起的解锁特征部或仓键形成部26630”。因此,当击发构件20500朝远侧推进时,仓验证梭动件26442”也随击发构件20500朝远侧运动。当仓验证梭动件26442”朝远侧运动时,朝远侧延伸的梭动件基座构件26644”的远侧端部26645”接触凸轮作用组件26650”,并使凸轮作用组件26650”运动成不与击发构件20500上的滑动件闩锁20514解锁接合。当凸轮作用组件26650”的解锁部分26653”与滑动件闩锁20514脱离结合时,击发构件主体20502将落入与细长通道26310”的锁定接合,从而防止击发构件20500进一步朝远侧推进。
如在图108和图109中进一步可见,在例示的布置中,侧向加劲件构件26470”从每个梭动件臂26450”侧向向外突起。当击发构件20500和验证梭动件26442”位于其相应最近侧起始位置时,每个侧向加劲件构件26470”与设置在每个通道侧壁26314”中的对应通道凹口26472”侧向地对准,以为梭动件臂26450”提供间隙以在兼容仓26600”已正确地装载到端部执行器26300”中时侧向地运动。然而,当不兼容仓26600X”已装载到端部执行器26300”中并且使用者开始朝远侧推进击发构件20500以及验证梭动件26442”时,侧向加劲件构件26470”不再与通道侧壁26314”中的通道凹口26472”对准,如在图108中可见。在这种情况下,侧向加劲件构件26470”防止梭动件臂26450”侧向向外偏压成与从击发构件主体20502的每一侧侧向延伸的中央接片20510脱离接合。
本文所述的仓验证系统可解决当使用能够初始接收多个仓的端部执行器时可能不时遇到的各种问题,其中仓中的一些原本不与端部执行器特别兼容。例如,仓可操作地装配到端部执行器的通道中,但该仓可缺乏与端部执行器砧座上的成形凹坑兼容的正确紧固件构型。不兼容仓可不具有正确数量和形式的钉等。仓可不具有与端部执行器所采用的击发构件闭锁件布置兼容的凸轮作用组件。一些仓可具有适当的凸轮作用组件,但凸轮作用组件可在某点处已运动到边缘解锁位置,在边缘解锁位置,凸轮作用组件可解锁地或可不解锁地接合击发构件闭锁布置。仓验证系统中的至少一些可以解决该问题。本文所公开的仓验证系统还可提供区分旧的废弃仓和较新的更合适的仓的能力,该较新的更合适的仓具有例如与端部执行器部件更好配对的特征部。仓验证系统还可确保仓正确地安置在端部执行器通道中,并且最小化仓在通道中的任何未对准,其中仓的近侧端部相对于击发构件定位在不期望的位置,在该位置,击发构件上的中央接片可根据需要位于仓盘下方而不是其顶部上。此类未对准可导致仓盘的损坏和弯曲,这可导致击发构件的过早锁定。
图110至图115示出了可与端部执行器27300一起使用的另一个仓验证系统27440,该端部执行器采用由击发构件梁1900以本文所讨论的各种方式轴向推进的击发构件20500(如上所述)。在例示的布置中,仓验证系统27440包括能够轴向运动的仓验证构件或梭动件27442,该能够轴向运动的仓验证构件或梭动件被支撑在端部执行器27300的通道27310内,以用于从通道27310内的最远侧仓接合位置轴向运动到近侧验证位置。仓验证构件或梭动件27442可由弹簧钢制成并且包括细长主体27444,该细长主体具有形成在细长主体27444的远侧端部27445上的阻挡钩27446。参见图111。仓验证构件或梭动件27442还包括形成在细长主体27444的近侧端部27447上的致动器部分27448。
仍然参见图111,仓验证构件或梭动件27442被构造成能够在形成于通道27310的通道底部27312中的梭动件轨道27360内轴向运动。如在图111中可见,梭动件轨道27360包括相对于通道狭槽27313横向延伸的弯曲横向部分27362,该通道狭槽居中设置在通道底部27312中以适应击发构件20500轴向通过通道狭槽。梭动件轨道27360的横向弯曲部分27362终止于位于通道狭槽27313的另一侧上的倾斜轨道部分27364。如在图111中可见,倾斜轨道部分27364具有成角度的底部表面27366。梭动件轨道27360的近侧端部27370邻接轴向弹簧腔27380,该轴向弹簧腔被构造成能够支撑梭动件弹簧27382,该梭动件弹簧轴颈连接在弹簧保持器销27449上,该弹簧保持器销从仓验证构件或梭动件27442的致动器部分27448朝近侧突起。梭动件弹簧27382用于将验证梭动件27442偏压到最远侧锁定位置,在最远侧锁定位置,仓验证构件或梭动件27442阻挡凸轮作用组件27650和击发构件20500的远侧推进。
图110示出了与外科端部执行器27300兼容外科钉仓27600的近侧端部部分27604。在至少一种布置中,外科钉仓27600包括细长仓体27602,该细长仓体定尺寸成可移除地安置在细长通道27310中。仓体27602包括从仓体27602的近侧端部部分27604延伸到远侧端部部分的仓狭槽27608。仓体27602还包括仓平台表面27610,当仓27600安置在通道27310中并且砧座枢转到闭合位置时,该仓平台表面面对砧座的钉成形下表面。尽管图110中未示出,但外科钉仓27600可在仓狭槽27608的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面27610打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体27602由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体27602的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。一旦驱动器和紧固件被插入其相应钉凹坑中,则仓盘27620附接到仓体27602的底部。当安装时,仓盘27620可(除了别的以外)防止驱动器和紧固件在仓27600处理和安装到细长通道27310中期间从仓体27602的底部掉出。
在例示的布置中,仓27600在其中可操作地支撑凸轮作用组件27650。凸轮作用组件27650包括中央主体部分27652和一系列间隔开的凸轮构件27654,这些凸轮构件被构造成能够在对应凸轮狭槽27609内轴向运动,这些对应凸轮狭槽形成在仓体27602中的仓狭槽27608的每一侧上。凸轮狭槽27609与仓体27602中的对应排驱动器对准,以在凸轮作用组件27650从仓体27602的近侧端部部分27604内的开始位置被驱动穿过钉仓27600到仓体27602的远侧端部部分内的结束位置时,有利于与对应凸轮构件27654凸轮作用接触。中央主体部分27652包括朝近侧延伸的解锁部分27653,该解锁部分被构造成能够在仓27600已正确地装载到通道27310中时接合击发构件20500上的滑动件闩锁20514。
兼容仓27600还包括朝近侧突起的验证特征部或仓键形成部27630,该验证特征部或仓键形成部被构造成能够在仓27600可操作地安置在通道27310中时接合滑动件致动器27448。验证特征部27630将仓验证构件或梭动件27442偏压到最近侧解锁位置,在最近侧解锁位置,凸轮作用组件27650和击发构件20500可朝远侧移位穿过仓27600。当仓验证构件或梭动件27442处于解锁位置时,形成在仓验证构件或梭动件27442的细长主体27444的远侧端部27445上的阻挡钩27446回缩到梭动件轨道27360的弯曲横向部分27362中并且不延伸跨过通道底部27312中的通道狭槽27313。当阻挡钩27446未延伸跨过通道狭槽27313时,击发构件20500和凸轮作用组件27650可推进到仓27310”中。
图114和图115示出了其中安装有不兼容仓27600X的外科端部执行器27300。在该示例中,不兼容仓27600X缺少设置在兼容仓27600上以接合仓验证构件或梭动件27442的致动器部分27448的验证特征部或仓键形成部27630。因此,梭动件弹簧27382已将仓验证构件或梭动件27442朝远侧偏压到其锁定位置,在其锁定位置,形成在仓验证构件或梭动件27442的细长主体27444的远侧端部27445上的阻挡钩27446横向延伸跨过通道狭槽27313并进入倾斜轨道部分27364。当阻挡钩27446进入倾斜轨道部分27364时,成角度的底部表面27366致使阻挡钩27446向上运动到其中阻挡钩27446阻挡凸轮作用组件27650和击发构件20500的远侧推进的位置。因此,当处于该位置时,如果使用者无意中试图朝远侧推进击发构件20500,则阻挡钩27446将阻挡凸轮作用组件27650和击发构件20500的远侧推进。
在如图115所示的至少一种布置中,可利用附接到阻挡钩27446的横向跨越通道狭槽27313的部分上的附加增强阻挡部分27450来增强该部分。即,阻挡钩27446中被增强的各部分的横截面厚度大于仓验证构件或梭动件26442的剩余主体部分的横截面厚度。设想了与本文所公开的那些端部执行器一起使用的另选的布置,这些端部执行器采用能够轴向运动的闭合构件(例如端部执行器闭合管)来使砧座运动到闭合位置。在此类端部执行器布置中,例如,端部执行器闭合管可被构造成能够在闭合构件被致动以闭合砧座时将验证梭动件偏压到锁定阻挡位置。仓验证系统27440还可有效地与具有旋转动力击发构件布置的外科端部执行器一起使用,这些旋转动力击发构件布置具有本文所公开类型的击发构件闭锁系统。
图116至图119示出了可与本文所公开的各种端部执行器布置结合使用的另选的外科钉仓28600。在例示的布置中,外科钉仓28600包括细长仓体28602,该细长仓体定尺寸成可移除地安置在端部执行器的细长通道中。如在图117中可见,仓体28602包括从仓体28602的近侧端部部分28604延伸到仓体28602的远侧端部部分的仓狭槽28608。仓体28602还包括仓平台表面28610,当仓28600安置在通道中并且砧座枢转到闭合位置时,该仓平台表面面对砧座的钉成形下表面。尽管图117中未示出,但外科钉仓28600可在仓狭槽28608的每一侧上具有多排(通常三排)外科钉凹坑,该多排外科钉凹坑通过仓平台表面28610打开。每个钉凹坑可具有与其相关联的钉驱动器(未示出),该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中,仓体28602由其中模制或机加工有钉凹坑的聚合物材料模制而成。在一种布置中,钉凹坑还通过仓体28602的底部打开,以便于将驱动器和紧固件安装到其相应凹坑中。一旦驱动器和紧固件被插入其相应钉凹坑中,则仓盘28620附接到仓体28602的底部。当安装时,仓盘28620可(除了别的以外)防止驱动器和紧固件在仓28600处理和安装到细长通道中期间从仓体28602的底部掉出。
在例示的布置中,仓28600在其中可操作地支撑凸轮作用组件28650。凸轮作用组件28650包括中央主体部分28652和一系列间隔开的凸轮构件28654、28654’,这些凸轮构件被构造成能够在对应凸轮狭槽28609内轴向运动,这些对应凸轮狭槽形成在仓体28602中的仓狭槽28608的每一侧上。凸轮狭槽28609与仓体28602中的对应排驱动器对准,以在凸轮作用组件28650从仓体28602的近侧端部部分28604内的开始位置被驱动穿过钉仓28600到仓体28602的远侧端部部分内的结束位置时,有利于与对应凸轮构件28654、28654’凸轮作用接触。
仍然参见图117,仓28600配备有凸轮作用组件锁定系统28440,该凸轮作用组件锁定系统被构造成能够将凸轮作用组件28650保持在其起始位置,除非仓28600已被装载到兼容的端部执行器中。在例示的布置中,例如,凸轮作用组件锁定系统28440包括能够侧向移位的锁定特征部28442,该锁定特征部包括致动器部分28444和锁定接片28446。如在图117中可见,当凸轮作用组件28650处于锁定位置时,锁定接片28446被构造成能够被接收在设置于对应凸轮构件28654’中的锁定腔28655内。参见图116和图117。致动器部分28444被构造成能够在砧座运动到闭合位置时由端部执行器砧座的致动器凸耳或其他部分接触。例如,致动器凸耳28411可形成在本文所公开的各种砧座中的任一者的砧座安装部分上,并且被构造成能够在砧座运动到闭合位置时将致动器部分28444侧向偏压到解锁位置。当致动器部分28444处于解锁位置时,锁定接片28446侧向运动出凸轮构件28654’中的锁定腔28655,并且当击发驱动系统如本文所述被启动时,凸轮组件28650可随后朝远侧推进穿过仓28600。参见图118和图119。
在各种情况下,外科缝合器械包括被构造成能够接收能够替换的钉仓的仓钳口。缝合器械还包括钉击发系统和砧座,该钉击发系统被构造成能够从钉仓射出或击发钉,该砧座包括被构造成能够使钉变形的成形表面或凹坑。钉击发系统包括组织切割刀,该组织切割刀在钉击发行程期间从钉仓的近侧端部朝远侧端部运动。在钉击发行程期间,组织切割刀邻接并推动钉仓中的滑动件,该滑动件朝砧座并且抵靠砧座驱动钉。当钉抵靠砧座变形时,钉以纵向排植入组织中,并且组织切割刀切入纵向钉排中的两排之间的组织。在钉击发行程已完成之后,并且/或者在足够长度的钉击发行程已完成之后,组织切割刀朝近侧回缩。然而,仓滑动件不与组织切割刀一起朝近侧回缩。相反,仓滑动件留在其被组织切割刀推动到的最远侧位置处。在钉仓已被击发或至少部分地击发之后,如果需要,将钉仓从仓钳口移除,然后用另一个能够替换的钉仓替换。此时,缝合器械可重新用于继续缝合和切入患者组织。然而,在一些情况下,先前击发的钉仓可被意外地装载到仓钳口中。如果组织切割刀将在此类先前击发的钉仓内朝远侧推进,则缝合器械将切割患者组织而不缝合患者组织。如果组织切割刀朝远侧推进穿过钉击发行程而根本没有钉仓定位在仓钳口中,则缝合器械将类似地切割患者组织而不缝合患者组织。为此,缝合器械包括防止发生这种情况的一个或多个闭锁件,如下文更详细地讨论。
以下专利申请的公开内容全文以引用方式并入本文:提交于2003年5月20日的名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT”的美国专利申请公布2004/0232200;名称为“SURGICAL STAPLING INSTRUMENT HAVING A FIRINGLOCKOUT FOR AN UNCLOSED ANVIL”的美国专利申请公布2004/0232199;提交于2003年5月20日的名称为“SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRINGMECHANISM”的美国专利申请公布2004/0232197;提交于2003年5月20日的名称为“SURGICALSTAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利申请公布2004/0232196;提交于2003年5月20日的名称为“SURGICAL STAPLINGINSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利申请公布2004/0232195;以及提交于2017年8月17日的名称为“ARTICULATINGSURGICAL STAPLING INSTRUMENT INCORPORATING A TWO-PIECE E-BEAM FIRINGMECHANISM”的美国专利申请公布2018/0085123。
参见图120,外科缝合器械30000包括仓钳口或通道30010和安置在仓钳口30010中的钉仓30020。钉仓30020包括仓体30022、限定于仓体30022中的钉腔以及可移除地储存在钉腔中的钉。钉仓30020还包括滑动件30030和钉驱动器,当滑动件30030在钉击发行程期间朝远侧推进时,这些钉驱动器由滑动件30030驱动以从钉腔射出钉。缝合器械30000还包括击发构件30040,该击发构件被构造成能够接合滑动件30030并朝远侧推动滑动件30030,如下文更详细地讨论。
除上述之外,击发构件30040包括包含组织刀30044的切割部分30042。切割部分30042还包括远侧鼻部30043,当滑动件30030在钉仓30020中处于其未击发位置并且击发构件30040从图120所示的其未击发位置朝远侧运动时,该远侧鼻部被构造成能够安置于限定于滑动件30030上的肩部30033上。一旦远侧鼻部30043位于滑动件肩部30033上,则击发构件30040可朝远侧推进以执行钉击发行程。值得注意的是,切割部分30042还包括被构造成能够接合通道30010的凸轮表面的第一凸轮作用构件30046和被构造成能够接合缝合器械30000的砧座上的凸轮表面的第二凸轮构件30048,第一凸轮构件和第二凸轮作用构件协作以相对于彼此定位砧座和钉仓30020。即便如此,设想了不具有凸轮作用构件30046和30048中的一者或两者的实施方案。
参见图121,击发构件30040通过弹簧朝通道30010偏压,并且如果当击发构件30040朝远侧推进以开始钉击发行程时滑动件30030不处于其未击发位置,则切割部分30042的远侧鼻部30043将错过肩部30033或不落在该肩部上,并且切割部分30042相反将朝向通道30010向下潜入。切割部分30042包括从其侧向延伸的闭锁销30045,当远侧鼻部30043不落在滑动件30030的肩部30033上时,这些闭锁销进入限定于通道30010中的闭锁窗口或凹槽30012。在此类情况下,允许击发构件30040在闭锁窗口30012内朝远侧行进;然而,闭锁窗口30012的远侧端部包括闭锁件肩部30015,该闭锁件肩部由闭锁销30045接触以停止击发构件30040的远侧推进。在此类情况下,因此,击发构件30040被锁定并防止其执行其钉击发行程。然而,如果滑动件30030处于其未击发位置,则切割部分30042的远侧鼻部30043与滑动件30030的肩部30033之间的交接将已防止击发构件30040潜入锁定窗口30012中并且可能已执行钉击发行程。
除上述之外,如果击发构件30040朝远侧推进而钉仓未定位在仓通道30010中并且/或者钉仓未正确地安置在该仓通道中,则击发构件30040将潜入闭锁窗口30012中。鉴于上述内容,外科器械30000包括闭锁件,如果外科器械30000中的钉仓缺失、不正确地安置以及/或者已至少部分地用尽,则该闭锁件防止钉击发行程。即便如此,可出现各种情况,其中钉仓尚未被击发,即,其所有钉仍定位在这些钉的钉腔中,然而,由于例如各种制造公差,切割部分30042的远侧鼻部30043可错过滑动件30030的肩部30033。此类情况将导致击发构件30040不必要地闭锁并且需要临床医生用另一个钉仓替换该钉仓。此类情况可能不会经常发生,但如果发生,则会给临床医生带来不便。
外科器械30100示于图122中并且包括可降低切割部分30042的远侧鼻部30043错过滑动件30030的肩部30033的可能性的改进。外科器械30100在许多方面类似于外科器械30000,但包括钉仓30120而不是钉仓30020。钉仓30120包括仓体30122、限定于仓体30122中的钉腔以及可移除地储存在钉腔中的钉。参见图123,钉仓30120还包括滑动件30030,与上述类似,如果切割部分30042的远侧鼻部30043落在滑动件30030的肩部30033上,则该滑动件能够在钉击发行程期间从未击发位置朝远侧运动。如果没有,参见图124,当击发构件30040朝远侧推进时,切割部分30042被推入限定于仓通道30010中的闭锁窗口30012中。
参见图125和图126,仓体30122包括近侧斜坡30126,这些近侧斜坡被构造成能够在击发构件30040朝远侧推进时向上提升击发构件30040。更具体地,从击发构件30040侧向延伸的闭锁销30045接触限定于近侧斜坡30126上的斜坡表面30127,当击发构件30040朝远侧推进时,这些闭锁销引导切割部分30042远离闭锁窗口30012。除上述之外,这些闭锁销抵抗朝仓通道30010推动击发构件30040的弹簧偏压力而这样做。以这种方式提升击发构件30040增加了击发构件30040的鼻部30043将落在滑动件30030的肩部30033上的概率,即使滑动件30030已意外地从其未击发位置略微朝远侧被推动。因此,降低了未击发钉仓被意外闭锁的可能性。然而,如果钉仓30120已被至少部分地击发,则鼻部30043将错过肩部30033,并且闭锁销30045将穿过限定于近侧斜坡30126之间的窗口30125落入闭锁窗口30012中。因此,如上所述,如果至少部分用尽的钉仓30120安置在仓通道30010中,则外科器械30100将被闭锁。此外,如上所述,如果钉仓从仓通道30010缺失,则外科器械30100将被闭锁,并且当击发构件30040由于不存在近侧斜坡30126而将立即进入闭锁窗口30012时启动钉击发行程。
值得注意的是,除上述之外,斜坡30126相对于滑动件30030的肩部30033朝近侧定位。因此,当击发构件30040朝远侧运动以执行钉击发行程时,击发构件30040必须连续地经过由斜坡30126提供的缺失的仓/不正确的仓闭锁件以及由滑动件30030提供的用尽的仓闭锁件。此外,斜坡30126将击发构件30040提升到由滑动件30030支撑的正确高度。最终,仓体30122的斜坡30126和滑动件30030的肩部30033一起工作以使缝合器械30100的闭锁件失效。
图127中示出了根据至少一个另选的实施方案的钉仓30220。钉仓30220包括在许多方面类似于仓体30122的仓体30222。即便如此,仓体30222包括比近侧斜坡30126朝近侧延伸得更远的近侧斜坡30226。因此,当使用钉仓30220时,击发构件30040将在其钉击发行程中更早被提升。在各种情况下,钉仓30220可包括比下落窗口30125更大的下落窗口30225。此外,近侧斜坡30226包括比斜坡表面30127更短的斜坡表面30227。在此类情况下,与使用钉仓30120时相比,击发构件30040将不被提升得与使用钉仓30220时一样高。在任何情况下,此类参数可用于训练击发构件30040的适当提升动作。
如上所述,击发构件30040的闭锁销30045被构造成能够接触提升击发构件30040的斜坡30226,使得如果滑动件30030正确地定位在钉仓30220中,则击发构件30040可落在滑动件30030的肩部30033上。即便如此,设想了另选的实施方案,其中斜坡可将钉击发构件的任何合适部分提升到滑动件30030的肩部30033上。例如,击发构件30040可包括附接到切割部分30042的层压杆,这些层压杆接触斜坡30226并且导致在钉击发行程启动时向上提升击发构件30040。
再次参见图127,钉仓30220包括至少部分地在仓体30222下方延伸的盘30024。盘30024被构造成能够防止仓体30222内的钉驱动器和/或钉从仓体30222的底部掉出。盘30024包括与限定于仓体30222中的狭槽接合的闩锁30021。盘30024还包括限定于其中的窗口30029,这些窗口与从仓体30222延伸的突出部协作,使盘30024与仓体30222对准。除上述之外或代替上述,提升斜坡30226例如可从盘30024延伸。
图128中示出了外科缝合器械30300。缝合器械30300在许多方面类似于缝合器械30200。即便如此,缝合器械30300包括钉仓30320而不是钉仓30220。钉仓30320包括仓体30322、限定于仓体30322中的钉腔以及可移除地储存在钉腔中的钉。仓体30322还包括限定于其中的被构造成能够接收击发构件30040的纵向狭槽30023,以及另外在纵向狭槽30023前方延伸的近侧斜坡30327,如果滑动件30030处于或至少几乎处于其未击发位置,则这些近侧斜坡将击发构件30040提升到滑动件30030上,如图129所示。如果滑动件30030已至少部分地推进穿过其钉击发行程,则肩部30033将不会接住击发构件30040的鼻部30043,并且切割部分30042将穿过限定于斜坡支撑件30326之间的窗口并落入闭锁窗口30012中。[0401]参见图130和图132,斜坡30327还包括门,该门被构造成能够在足够的推力施加至击发构件30040时枢转离开击发构件30040。斜坡30327包括可旋转地安装到斜坡支撑件30326中的一个的第一端部和可释放地附接到另一个斜坡支撑件30326的第二端部。参见图131和图133,斜坡30327的第二端部被构造成能够在击发构件30040已经被向上提升之后从其斜坡支撑件30326释放,使得一旦斜坡30327变形,如果滑动件30030处于其未击发位置或至少接近其未击发位置,击发构件30040的鼻部30043就落在滑动件30030的肩部30033上。此时,斜坡30327不再阻止击发构件30040的远侧运动,并且击发构件30040可朝远侧推进穿过纵向狭槽30023。斜坡30327在整个钉击发行程期间以及在击发构件30040已回缩到其未击发位置之后保持移位到侧面。因此,如果击发构件30040将再次朝远侧推进,则移位的斜坡30327不能提升击发构件30040。在此类情况下,如果击发构件30040在用尽钉仓30320被替换之前朝远侧推进,则切割部分30042的闭锁销30045将被作用于击发构件30040的弹簧推入闭锁窗口30012中。因此,斜坡30327用作用尽的仓闭锁件。在至少一个另选的实施方案中,斜坡30327被构造成能够脱离仓体30322以释放击发构件30040。
此外,除上述之外,缝合器械30300的闭锁布置也用作不正确/不兼容仓闭锁件。如果将不具有斜坡30327或另一合适构造的斜坡的不正确或不兼容的钉仓安置在仓通道30010中,则击发构件30040将不会被提升到不正确的钉仓的滑动件上,并且相反,闭锁销30045将被迫进入闭锁窗口30012中,从而闭锁钉击发系统。在此类情况下,击发构件30040可回缩到其未击发位置,并且可用正确/兼容的钉仓替换不正确/不兼容的钉仓。在某些钉仓旨在仅与某些缝合器械一起使用的手术室中,除了其他情况以外,可能发生不正确的钉仓与正确的钉仓的意外交换。
如上所述,斜坡30327在滑动件30030后面延伸。因此,斜坡30327可保护滑动件30030免于意外地朝远侧被碰撞。在各种情况下,通过首先将钉仓30320的近侧端部插入仓通道30010中,然后将钉仓30320安置在仓通道30010中,从而将钉仓30320装载到缝合器械30300中。因此,存在这样的可能性:滑动件30030将接触例如仓通道30010并且在钉仓30320内从其近侧未击发位置朝远侧被推动。在此类情况下,滑动件30030可不再被定位成在钉击发行程启动时使缝合器械30300的钉击发闭锁件失效,因此,缝合击发闭锁件将把该钉仓30320视为用尽的,并且必须更换该钉仓以使用缝合器械30300。斜坡30327可在其在滑动件30030后面朝近侧延伸时防止这种情况,并且可在钉仓30320被安装时防止滑动件30030在钉仓30320内朝远侧被碰撞。
如上所述,滑动件30030在正确地定位在钉仓中时使缝合器械的钉击发闭锁件失效,使得可完成钉击发行程。在使用中,击发构件30040至少部分地朝远侧推进,以评估滑动件30030是否正确定位以及钉击发闭锁件是否已失效。更具体地,击发构件30040朝远侧推进,直到击发构件30040由滑动件30030支撑以执行钉击发行程(如果滑动件30030正确地定位在钉仓30320中)或者接触闭锁件肩部30015(如果滑动件30030未正确地定位在钉仓30320中或者钉仓30320从仓通道30010缺失)。如果击发构件30040接触闭锁件肩部30015,则可能需要回缩击发构件30040以能够将未用尽钉仓30320插入仓通道30010中和/或回缩以开始另一个钉击发行程。据此,图134和图135的外科器械30400被构造成能够限制击发构件的行进,使得如果钉仓从仓通道缺失,则击发构件可在其到达闭锁件肩部30015之前停止,如下文更详细地讨论。
除上述之外,外科器械30400的击发构件30440在许多方面类似于击发构件30040,但包括切割构件30442,该切割构件包括从其侧向延伸的次闭锁销30449。如果钉仓30320未定位在缝合器械30400的仓通道30410中,则当击发构件30440朝远侧推进时,切割构件30442将立即进入闭锁窗口30012,并且次闭锁销30449将快速接触闭锁窗口30012中的次闭锁件肩部30419。因此,如果钉仓30320未存在于仓通道30410中,则击发构件30440将不必朝远侧行进,直到其接触闭锁件肩部30015。在此类情况下,击发构件30440需要回缩的距离至少减小。在某些情况下,次闭锁件肩部30419被定位成使得切割构件30442根本不需要回缩。因此,在此类情况下,可将未用尽钉仓30320插入通道30410中,并且可在不必回缩击发构件30440的情况下完成钉击发行程。
除上述之外,闭锁销30449和闭锁件肩部30419之间的交接提供缺失的仓闭锁件。如果钉仓30320安置在仓通道30410中,则切割构件30442接合钉仓30320的斜坡30327,该斜坡将闭锁销30449提升越过闭锁件肩部30419。换句话讲,钉仓30320在仓通道30010中的存在使次钉击发闭锁件失效。即便如此,钉仓30320的滑动件30030必须正确地定位在钉仓30320中,以便在切割构件30442的鼻部30043仍必须落在滑动件30030的肩部30033上时完成钉击发行程,以便将闭锁销30045提升超过闭锁件肩部30015,如上所述。换句话讲,钉仓30320中处于其未击发位置的滑动件30030的存在使主击发闭锁件失效,并且仓通道30410中的钉仓30320的存在使次击发闭锁件失效。因此,缝合器械30400包括主缺失仓闭锁件和次缺失仓闭锁件,其中主缺失仓闭锁件也用作用尽的仓闭锁件。
图136中示出了外科缝合器械30500。缝合器械30500在许多方面类似于缝合器械30000。除了别的以外,缝合器械30500包括仓通道30510、能够可移除地定位在仓通道30510中的钉仓30520、击发构件30040和钉击发闭锁件30514。钉击发闭锁件30514包括例如安装在仓通道30510中的弹性金属弹簧。即便如此,钉击发闭锁件30514可由任何合适的材料构成。钉击发闭锁件30514包括安装在仓通道30510中的基部和从该基部延伸的柔性锁定臂30516。每个柔性锁定臂30516独立于彼此运动并且包括限定于其中的锁定窗口30515,该锁定窗口被构造成能够接收并可释放地捕获从击发构件30040延伸的闭锁销30045。柔性锁定臂30516被构造成能够使得这些臂朝向和/或抵靠击发构件30040的侧面向内延伸,并且因此被偏压以捕获闭锁销30045。当闭锁销30045中的一个或两个被捕获在锁定窗口30515中时,防止钉击发构件30040朝远侧推进穿过钉击发行程。
除上述以外,钉仓30520包括仓体30522、限定于仓体30522中的钉腔以及能够移除地储存在钉腔中的钉。钉仓30520还包括附接到仓体30522的盘30024和滑动件,该滑动件被构造成能够在钉仓30520内向远侧行进以在钉击发行程期间从钉腔射出钉。与上述类似,一旦击发构件30040已被解锁,击发构件30040就被构造成能够朝远侧推动滑动件以执行钉击发行程。为此,参见图136和图139,仓体30522包括从其朝近侧延伸的突出部或键30526,这些突出部或键被构造成能够在钉仓30520安置在仓通道30510中时接合锁定臂30516。值得注意的是,锁定臂30516的端部向外张开,使得当突出部30526接触锁定臂30516时,锁定臂30516不被捕获在突出部30526与击发构件30040之间。因此,突出部30526使锁定臂30516侧向向外弯曲,使得当钉仓30520安置在仓通道30510中时,从击发构件30040延伸的闭锁销30045不再定位在击发闭锁件30514的闭锁窗口30515中。因此,将钉仓30520安置在仓通道30510中的动作解锁缝合器械30500。
如果钉仓30520未如上所述安置在仓通道30510中,则击发构件30040保持被击发闭锁件30514锁定,并且缝合器械30500不能用于缝合患者组织。如果钉仓(诸如钉仓30020)安置在不具有突出部或键30526的仓通道30510中,则其将不会解锁击发闭锁件30514,如图137和图138所示,因此缝合器械30500不能用于缝合患者组织。如图137和图138所示,仓体30022的近侧端部不接合和/或充分移位锁定臂30516。因此,在这种情况下,钉仓30020将是不正确的钉仓,因为其不解锁缝合器械30500的钉击发驱动装置,并且相应地,钉仓30520将是正确的钉仓,因为其可以解锁缝合器械30500的钉击发驱动装置。因此,击发闭锁件30514既是缺失的仓闭锁件也是不正确的仓闭锁件。缝合器械30500还可包括用尽的仓闭锁件。在不正确的钉仓安置在缝合器械30500中并且缝合器械30500不能被击发的情况下,可移除不正确的钉仓并且可将正确的钉仓(即,钉仓30520)安置在缝合器械30500中以解锁钉击发驱动装置。
如上文结合缝合器械30000所述,再次参见图121,如果滑动件30030不处于其在钉仓30020中的正确位置,则击发构件30040的闭锁销30045接合锁定肩部30015。同样如上所述,缝合器械30000的击发构件30040在接合锁定肩部30015之前朝远侧推进,并且因此在接触锁定肩部30015之前有时间加速。因此,缝合器械30000的击发构件30040可以显著的速度和能量冲击锁定肩部30015。因此,锁定肩部30015被稳健地设计成吸收该冲击;然而,存在击发构件30040可犁过或吹过锁定肩部30015的可能性,从而意外使缝合器械30000的钉击发闭锁件失效。图136和图137的闭锁件30514可减少(如果不消除的话)这些潜在问题。例如,击发闭锁件30514的锁定窗口30515的尺寸和构造被设置成能够在锁定臂30516与闭锁销30045接合时防止钉击发构件30040的很少的(如果有的话)近侧平移和远侧平移,因此钉击发构件30040在被锁定窗口30515的远侧端部停止之前具有很少的(如果有的话)加速的时间。此外,一旦闭锁销30045接合锁定窗口30515的远侧端部,锁定臂30516就被置于张力下,并且因此如果它们完全失效,则能够在失效之前处理显著的负载。
如上所述,当钉仓30520安置在缝合器械30500中时,两个锁定臂30516通过仓体30522与击发构件30040脱离接合。即便如此,设想了另选的实施方案,其中当钉仓安置在缝合器械30500中时,钉仓的第一部件解锁第一锁定臂30516并且钉仓的第二部件解锁第二锁定臂30516。例如,钉仓的仓体可解锁第一锁定臂30516,并且钉仓的滑动件可解锁第二锁定臂30516。
图140示出了外科缝合器械30600,并且图141示出了外科缝合器械30700。缝合器械30600和30700在许多方面类似于缝合器械30500。参见图140,缝合器械30600包括仓通道30610、能够可移除地定位在仓通道30610中的钉仓30620以及安装到仓通道30610的钉击发闭锁件30614,该钉击发闭锁件防止击发构件30040推进穿过钉击发行程,除非钉仓30620安置在仓通道30610中。类似地,参见图141,缝合器械30700包括仓通道30710、能够可移除地定位在仓通道30710中的钉仓30720以及安装到仓通道30710的钉击发闭锁件30714,该钉击发闭锁件防止击发构件30040推进穿过钉击发行程,除非钉仓30720安置在仓通道30710中。然而,值得注意的是,将钉仓30720安置在缝合器械30600中不会解锁缝合器械30600的钉击发系统,并且同样,将钉仓30620安置在缝合器械30700中不会解锁缝合器械30700的钉击发系统。因此,尽管事实上钉仓30620和30720可能令人混淆地相似,但缝合器械30600和30700可同时在同一手术室中使用,而不可能与错误的钉仓一起使用。
参见图142,除上述之外,钉仓30620还包括包含近侧端部30626的仓体30622,该近侧端部成角度以使得仓体30622的中心(即,最靠近纵向狭槽30023的部分)比仓体30622的侧向侧朝近侧延伸得更远。钉仓30620还包括滑动件30630,该滑动件在许多方面类似于滑动件30030,其包括近侧端部30636,该近侧端部具有与仓体30622的近侧端部30626的轮廓匹配或至少基本上匹配的轮廓。再次参见图140,击发闭锁件30614类似于击发闭锁件30514。除了别的以外,击发闭锁件30614包括锁定臂30616,该锁定臂将击发构件30040释放地保持在其未击发位置,直到锁定臂30616通过仓体30622的近侧端部和/或滑动件30630的近侧端部侧向移位,以从限定于锁定臂30616中的锁定窗口释放闭锁销30045。如果钉仓30620从仓通道30610移除,则锁定臂30616弹性地返回到其锁定位置。
参见图143,除上述之外,钉仓30700还包括包含近侧端部30726的仓体30722,该近侧端部成角度以使得仓体30722的侧向侧(即,距纵向狭槽30023最远的部分)比仓体30722的中心朝近侧延伸得更远。钉仓30720还包括滑动件30730,该滑动件在许多方面类似于滑动件30030,其包括近侧端部30736,该近侧端部具有与仓体30722的近侧端部30726的轮廓匹配或至少基本上匹配的轮廓。再次参见图141,击发闭锁件30714类似于击发闭锁件30514。除了别的以外,击发闭锁件30714包括锁定臂30716,该锁定臂将击发构件30040释放地保持在其未击发位置,直到锁定臂30716通过仓体30722的近侧端部和/或滑动件30730的近侧端部侧向移位,以从限定于锁定臂30716中的锁定窗口释放闭锁销30045。如果钉仓30720从仓通道30710移除,则锁定臂30716弹性地返回到其锁定位置。
值得注意的是,除上述之外,如果钉仓30620将被安置在缝合器械30700中,则钉仓30620的近侧端部将不使击发闭锁件30714的锁定臂30716移位或至少充分地移位以使击发闭锁件30714与击发构件30040脱离接合。此外,如果钉仓30720将被安置在缝合器械30600中,则钉仓30720的近侧端部将不使击发闭锁件30614的锁定臂30616移位或至少充分地移位以使击发闭锁件30614与击发构件30040脱离接合。因此,钉仓30620和30720各自包括独特的键控特征部,这些独特的键控特征部解锁其相应的或正确的缝合器械。
在各种情况下,除上述之外,钉仓的仓体和/或滑动件或钉仓类型可包括一个或多个独特的键控特征部,该一个或多个独特的键控特征部仅能够解锁其相应的缝合器械。在某些情况下,在仓体下方延伸的盘可包括被构造成能够解锁其缝合器械的钉击发驱动装置的近侧特征部或键。参见图144,在许多方面类似于盘30024的仓盘30824包括被构造成能够解锁缝合器械的钉击发驱动装置的近侧突出部或键30826。突出部30826由折叠金属片构成以形成例如管状结构。该管状结构通过包括接片30827和狭槽30828的嵌套互连装置来强化。
图145和图147示出了外科缝合器械30900,并且图148示出了外科缝合器械31000。缝合器械30900和31000在许多方面类似于缝合器械30500。参见图145,缝合器械30900包括仓通道30910、能够可移除地定位在仓通道30910中的钉仓30920以及安装到仓通道30910的钉击发闭锁件30914,该钉击发闭锁件防止击发构件30040推进穿过钉击发行程,除非钉仓30920安置在仓通道30910中。类似地,参见图148,缝合器械31000包括仓通道、能够可移除地定位在仓通道中的钉仓31020以及安装到仓通道的钉击发闭锁件31014,该钉击发闭锁件防止击发构件30040推进穿过钉击发行程,除非钉仓31020安置在仓通道中。
值得注意的是,钉击发闭锁件30914包括仅一个锁定臂30916,该锁定臂沿着击发构件30040的右侧边延伸。即便如此,一个锁定臂30916包括限定于其中的锁定窗口,该锁定窗口被构造成能够捕获并合适地保持击发构件30040的闭锁销30045以将击发构件30040保持在其未击发位置,如图147所示,直到钉仓30920安置在仓通道30910中,如图145所示。更具体地,钉仓30920的仓体30922包括从仓体30922的右侧延伸的近侧突出部或键30926,当钉仓30920安置在仓通道30910中时,该近侧突出部或键接合锁定臂30916并且使锁定臂30916侧向向外弯曲。值得注意的是,仓体30922不包括从仓体30922的左侧延伸的突出部或键30926。
另外,值得注意的是,钉击发闭锁件31014包括仅一个锁定臂31016,该锁定臂沿着击发构件30040的右侧边延伸。即便如此,一个锁定臂31016包括限定于其中的锁定窗口,该锁定窗口被构造成能够捕获并合适地保持击发构件30040的闭锁销30045以将击发构件30040保持在其未击发位置,如图148所示,直到钉仓31020安置在缝合器械31000的仓通道中。更具体地,钉仓31020的仓体31022包括从仓体31022的左侧延伸的近侧突出部或键31026,当钉仓31020安置在缝合器械31000中时,该近侧突出部或键接合锁定臂31016并且使锁定臂31016侧向向外弯曲。值得注意的是,仓体31022不包括从仓体31022的右侧延伸的突出部或键31026。
由于仓体30922和31022的不对称性以及钉击发闭锁件30914和31014的对应不对称性,将钉仓31020安置在缝合器械30900中不会解锁缝合器械30900的钉击发系统,并且同样,将钉仓30920安置在缝合器械31000中不会解锁缝合器械31000的钉击发系统。因此,尽管事实上钉仓30920和31020可能令人混淆地相似,但缝合器械30900和31000可同时在同一手术室中使用,而不可能与错误的钉仓一起使用。在一些情况下,由钉仓30920产生的钉图案不同于由钉仓30120产生的钉图案,因此,缝合器械30900的砧座将具有不同于缝合器械31000的砧座的成形凹坑布置。在此类情况下,本文所公开的非对称键/击发闭锁布置可防止钉腔的布置与钉成形凹坑的布置之间的失配。
参见图149和图150,钉仓31120包括仓体31122,该仓体包括平行纵向排的钉腔,而钉仓31220包括仓体31222,该仓体包括在横向方向上取向的多排钉腔。与上述类似,参见图149,仓体31122的近侧端部包括键31126,该键从仓体31122的左侧延伸,但不从仓体31122的右侧或相对侧延伸,参见图150,仓体31222的近侧端部包括键31226,该键从仓体31222的右侧延伸,但不从仓体31222的左侧延伸。钉仓31120(图149)与第一缝合器械一起使用,该第一缝合器械具有平行纵向排的砧座钉成形凹坑和左侧钉击发闭锁件(诸如击发闭锁件31014(图148))。钉仓31220(图150)与第二缝合器械一起使用,该第二缝合器械具有纵向排的横向钉成形凹坑和右侧钉击发闭锁件(诸如击发闭锁件30914(图147))。钉仓31220不解锁第一缝合器械,并且相似地,钉仓31120不解锁第二缝合器械。这样,钉仓31120的键31126不能解锁具有在横向方向上延伸的钉成形凹坑的缝合器械,并且相应地,钉仓31220的键31226不能解锁具有沿平行纵向排延伸的钉成形凹坑的缝合器械。
值得注意的是,钉仓31120和钉仓31220具有基本上相同的长度并且具有基本上相同的形状。此外,钉仓31120和31220两者被构造成能够在患者组织中产生长度为大约60mm的钉线。然而,钉仓31120和31220两者被构造成能够产生例如长度为大约30mm或45mm的钉线。此外,仓体31122和仓体31222完全可能具有相同的颜色。在各种情况下,商业供应商可对他们销售的钉仓的仓体进行颜色编码以指示储存在其中的钉的尺寸。例如,包含具有大约4mm未成形高度的未成形钉的仓体为例如绿色的。包含具有大约2.5mm未成形高度的未成形钉的仓体可为例如白色的。因此,钉仓31120和31220完全可能具有相同的颜色。因此,当临床医生想要抓住一个钉仓时,其可能抓住另一个钉仓并将该钉仓安装在错误的缝合器械中。本文所公开的改进考虑到此类可能性并且在此类情况下闭锁缝合器械。
图151至图155中示出了外科器械30800。主要参见图153和图154,外科器械30800包括仓通道30810、能够移除地定位在仓通道30810中的钉仓30820、击发构件30040以及安装到仓通道30810的闭锁件30814。闭锁件30814包括片簧30816,该片簧包括锚定在限定于仓通道30810中的孔中的近侧端部和能够相对于固定的近侧端部运动的远侧端部。主要参见图153和图155,闭锁件30814还包括闭锁盒30815,该闭锁盒被构造成能够捕获从击发构件30040的切割部分30042延伸的闭锁销30045中的一个闭锁销,并且当钉仓30820未安置在仓通道30810中时将击发构件30040保持在未击发位置。闭锁盒30815包括被构造成能够防止击发构件30040朝远侧推进的远侧壁、被构造成能够防止击发构件30040朝近侧回缩的近侧壁以及连接闭锁盒30815的近侧壁和远侧壁的底壁。然而,闭锁盒30815的顶部是打开的,但可以是闭合的。
钉仓30820包括仓体30822、滑动件和盘30824,该盘附接到仓体30822并且在该仓体下方延伸。除上述之外,盘30824包括近侧突出部30826,该近侧突出部被构造成能够在钉仓30820安置在仓通道30810中时接合闭锁件30814的片簧30816,如图152和图154所示。当突出部30826接触片簧30816时,片簧30816侧向挠曲,使得闭锁销30045不再被捕获在闭锁件30814的闭锁盒30815中。此时,击发构件30040已被解锁,并且击发构件30040可朝远侧推进以执行钉击发行程。主要参见图154,片簧30816的远侧端部或自由端部延伸到限定于仓通道30810中的窗口30819中。当片簧30816被钉仓30820挠曲时,窗口30819为片簧30816提供间隙。另外,窗口30819的底部侧壁支撑片簧30816的远侧端部,使得该远侧端部被至少简单地支撑。在任何情况下,闭锁件30814为不具有用于解锁缝合器械30800的适当键的钉仓(诸如钉仓30020)提供缺失的仓闭锁件和不正确的仓闭锁件。
如上所述,当钉仓30820安置在缝合器械30800的仓通道30810中时,闭锁件30814从锁定位置(图152和图153)运动到解锁位置(图154)。该偏转在图155中可见,该图示出了闭锁件30814处于其锁定位置(实线示出)以及其解锁位置(虚线示出)。在不正确或不兼容的钉仓(即,不具有合适键的钉仓)安置在仓通道30810中的情况下,片簧30816将不会偏转或至少适当地偏转以解锁击发构件30040。值得注意的是,闭锁件30814还包括从片簧30816延伸的接片30817,使得当闭锁件30814偏转时,接片30817与片簧30816一起侧向运动。当闭锁件30814处于其锁定位置时,如图153所示,接片30817防止外科器械30800的砧座(即,砧座30050)运动到闭合或完全夹持位置,如下文更详细地描述。
砧座30050围绕安装在限定于仓通道30810中的孔中的枢轴销30051可旋转地联接到仓通道30810。当砧座30050通过外科器械30800的闭合系统朝向仓通道30810旋转并且钉仓30820未安置在仓通道30810中时,砧座30050的底部表面30057接触接片30817并且阻挡砧座30050运动到其闭合或完全夹持位置。然而,当钉仓30820安置在仓通道30810中时,接片30817侧向移位,使得当砧座30050闭合时,砧座30050不接触接片30817,并且砧座30050可运动到其闭合或完全夹持位置。因此,闭锁件30814还包括砧座闭合闭锁件,因为闭锁件30814防止砧座30050在钉仓30820未安置在仓通道30810中时闭合。在此类情况下,临床医生将快速意识到不正确的钉仓定位在仓通道30810中并且/或者意识到钉仓完全缺失,因为他们将不能闭合砧座30050。因为砧座30050不能在组织上闭合,所以在此类情况下也将防止缝合器械30800的钉击发行程。在其中钉仓钳口而不是砧座能够旋转的另选的实施方案中,如果不正确的钉仓定位在钉仓钳口中或者钉仓完全从仓钳口缺失,则这种闭锁件可用于防止钉仓钳口旋转到闭合或完全夹持位置。
如上所述,闭锁件30814被构造成能够抵抗砧座30050的闭合。为此,除上述之外,闭锁件30814的近侧端部固定地支撑在仓通道30810中,并且闭锁件30814的远侧端部简单地由窗口30819的侧壁支撑。当闭锁件30814处于其锁定(图153)构型和解锁(图154)构型两者时就是这种情况。因此,闭锁件30814可充当在两端支撑的梁并且非常适于承受由砧座30050施加的夹持负载。类似地,从闭锁件30814延伸的接片30817也由仓通道30810支撑。更具体地讲,当闭锁件30814处于其锁定(图153)构型和解锁(图154)构型两者时,接片30817可滑动地支撑在限定于仓通道30810中的狭槽30818中。因此,闭锁件30814可充当在两端和中间位置支撑的梁并且非常适于承受由砧座30050施加的夹持负载。即便如此,可以使用任何合适的支撑布置。
如上所述,闭锁件30814被构造成能够在钉仓30820未安置在仓通道30810中时防止缝合器械30800的砧座30050运动到闭合或完全夹持位置。即便如此,闭锁件30814被构造成能够在钉仓30820未安置在仓通道30810中时防止砧座30050基本上完全闭合。在此类情况下,砧座30050可略微朝仓通道30810运动;然而,当砧座30050接触闭锁件30814的接片30817时,砧座30050能够明显打开。在各种另选的实施方案中,防止砧座30050运动,直到钉仓30820安置在仓通道30810中。在任一种情况下,当砧座30050被闭锁时,缝合器械30800不能通过套管针插入患者体内。更具体地,套管针包括内部通路或插管,该内部通路或插管的尺寸和构造被设置成能够在其中紧密地接收外科器械,并且当砧座30050如上所述被闭锁时,砧座30050与仓通道30810之间的距离对于缝合器械30800而言过大而不能配合穿过该内部通路。因此,在此类情况下,使用缝合器械30800的临床医生在将缝合器械30800插入患者体内之前将意识到不正确的钉仓定位在缝合器械30800中。
图155A中示出了钉仓31520。钉仓31520包括仓体31522和附接到仓体31522的盘31524。盘31524包括与限定于仓体31522中的侧向通道接合的锁定臂31521,这些锁定臂将盘31524保持到仓体31522。盘31524由冲压金属(诸如不锈钢)构成。盘31524包括两个侧向侧,在纵向狭槽30023的每一侧上各有一个。盘31524的每个侧向侧沿着仓体31522的侧向侧并且在仓体31522的一部分下方延伸。盘31524的每个侧向侧还包括近侧端部31527,该近侧端部包在仓体31522的近侧端部上。近侧端部31527与盘31524的侧向侧正交地或至少基本上正交地延伸。每个近侧端部31527包括接片,该接片被折叠以形成朝近侧延伸的键31526。与上述类似,键31526被构造成能够在钉仓31520安置在缝合器械中时解锁缝合器械的钉击发系统。
除上述之外,每个键31526包括通过向外折叠接片而形成的圆化近侧端部,使得接片的端部重新与近侧端部31527接触。因此,键31526是坚固的,并且防止或至少基本上减少键31526的偏转。这样,当钉仓31520安置在缝合器械中时,键31526将可靠地使击发系统锁偏转以解锁击发系统。每个近侧端部31527还包括延伸到限定于近侧端部31527中的狭槽31528中的一个或多个保持齿31529。狭槽31528有利于近侧端部31527的折叠,并且还防止或至少限制键31526内的运动和/或偏转。齿31529咬合到近侧端部31527中并且将键31526保持在其折叠构型。
图155B中示出了钉仓31620。钉仓31620包括仓体31522和附接到仓体31522的盘31624。盘31624包括与限定于仓体31522中的侧向通道接合的锁定臂31621,这些锁定臂将盘31624保持到仓体31522。盘31624由冲压金属(诸如不锈钢)构成。盘31624包括两个侧向侧,在纵向狭槽30023的每一侧上各有一个。盘31624的每个侧向侧沿着仓体31522的侧向侧并且在仓体31522的一部分下方延伸。盘31624的每个侧向侧还包括近侧端部,该近侧端部向下包在仓体31522的近侧端部上。近侧端部与盘31624的侧向侧正交地或至少基本上正交地延伸。每个近侧端部包括接片,该接片被折叠以形成朝近侧延伸的键31626。与上述类似,键31626被构造成能够在钉仓31620安置在缝合器械中时解锁缝合器械的钉击发系统。
除上述之外,每个键31626包括面向侧向的U形通道。更具体地讲,每个键31626包括内部基座31627、从内部基座31627延伸的侧向延伸的顶侧31628以及从内部基座31627的相对侧延伸的侧向延伸的底侧31629。键31626的U形构型防止键31626在纵向负载下屈曲以及/或者在侧向方向的扭矩下偏转。值得注意的是,键31626由从盘31624延伸的接片以这样的方式折叠以便在键31626下方形成间隙31625。间隙31625的尺寸和构造被设置成能够允许击发构件的锁定销在击发构件的钉击发行程期间在键31626下方通过。
图155C中示出了钉仓31720。钉仓31720包括仓体31522和附接到仓体31522的盘31724。盘31724包括与限定于仓体31522中的侧向通道接合的锁定臂31721和31721’,这些锁定臂将盘31724保持到仓体31522。盘31724由冲压金属(诸如不锈钢)构成。盘31724包括两个侧向侧,在纵向狭槽30023的每一侧上各有一个。盘31724的每个侧向侧沿着仓体31522的侧向侧并且在仓体31522的一部分下方延伸。盘31724的一个侧向侧还包括近侧端部31727,该近侧端部向下包在仓体31522的近侧端部上。近侧端部31727与盘31724的侧向侧正交地或至少基本上正交地延伸。近侧端部31727包括接片,该接片被折叠以形成朝近侧延伸的键31726。与上述类似,键31726被构造成能够在钉仓31720安置在缝合器械中时解锁缝合器械的钉击发系统。
除上述之外,盘31724的侧向侧包括弓形或圆形切口,并且近侧端部31727包括弓形或圆形突出部31723,该突出部围绕仓体31522的侧弯曲成圆形切口。突出部31723被紧密地接收在切口中,使得盘31724的近侧端部31727通过这种布置而被极大地硬化或强化。键31726包括从盘31724朝近侧弯曲的L形接片。键31726包括肩部31728,该肩部从近侧端部31727向上弯曲以形成该L形构型。肩部31728包括至少一个凹口或应变消除件31729,该凹口或应变消除件被构造成能够有利于键31726的弯曲。键31726的L形构型防止键31726在纵向负载下屈曲以及/或者在侧向方向的扭矩下偏转。值得注意的是,键31726由从盘31724延伸的接片以这样的方式折叠以便在键31726下方形成间隙31725。间隙31725的尺寸和构造被设置成能够允许击发构件的锁定销在击发构件的钉击发行程期间在键31726下方通过。
图155E中示出了钉仓31920。钉仓31920包括仓体31522和附接到仓体31522的盘31924。盘31924包括与限定于仓体31522中的侧向通道接合的锁定臂31921,这些锁定臂将盘31924保持到仓体31522。盘31924由冲压金属(诸如不锈钢)构成。盘31924包括两个侧向侧,在纵向狭槽30023的每一侧上各有一个。盘31924的每个侧向侧沿着仓体31522的侧向侧并且在仓体31522的一部分下方延伸。盘31924的一个侧向侧还包括近侧端部31927,该近侧端部包在仓体31522的近侧端部上。近侧端部31927与盘31924的侧向侧正交地或至少基本上正交地延伸。近侧端部31927包括接片,该接片被折叠以形成朝近侧延伸的键31926。与上述类似,键31926被构造成能够在钉仓31920安置在缝合器械中时解锁缝合器械的钉击发系统。
除上述之外,键31926包括从盘31924朝近侧弯曲的L形接片。键31926包括肩部31928,该肩部从近侧端部31927向上弯曲以形成该L形构型。键31926的L形构型防止键31926在纵向负载下屈曲以及/或者在侧向方向的扭矩下偏转。此外,肩部31928的自由边缘焊接、焊合和/或钎焊到近侧端部31927,以便强化键31926。即便如此,可使用任何合适数量的焊接件31929来固定或强化键31926。值得注意的是,键31926由从盘31924延伸的接片以这样的方式折叠以便在键31926下方形成间隙31925。间隙31925的尺寸和构造被设置成能够允许击发构件的锁定销在击发构件的钉击发行程期间在键31926下方通过。
图155D中示出了钉仓31820。钉仓31820包括仓体31522和附接到仓体31522的盘31824。盘31824包括与限定于仓体31522中的侧向通道接合的锁定臂31821,这些锁定臂将盘31824保持到仓体31522。盘31824由冲压金属(诸如不锈钢)构成。盘31824包括两个侧向侧,在纵向狭槽30023的每一侧上各有一个。盘31824的每个侧向侧沿着仓体31522的侧向侧并且在仓体31522的一部分下方延伸。盘31824的一个侧向侧还包括近侧端部31827,该近侧端部包在仓体31522的近侧端部上。近侧端部31827与盘31824的侧向侧正交地或至少基本上正交地延伸。近侧端部31827包括接片,该接片被折叠以形成朝近侧延伸的键31826。与上述类似,键31826被构造成能够在钉仓31820安置在缝合器械中时解锁缝合器械的钉击发系统。
除上述之外,键31826包括通过向外折叠接片而形成的圆化近侧端部,使得接片的端部重新与近侧端部31827接触。因此,键31826是坚固的,并且防止或至少基本上减少键31826的偏转。这样,当钉仓31820安置在缝合器械中时,键31826将可靠地使击发系统锁偏转以解锁击发系统。近侧端部31827还包括延伸到限定于近侧端部31827中的狭槽31828中的一个或多个保持齿31829。狭槽31828有利于近侧端部31827的折叠,并且还防止或至少限制键31826内的运动和/或偏转。齿31829咬合到近侧端部31827中并且将键31826保持在其折叠构型。值得注意的是,键31826由从盘31824延伸的接片以这样的方式折叠以便在键31826下方形成间隙31825。间隙31825的尺寸和构造被设置成能够允许击发构件的锁定销在击发构件的钉击发行程期间在键31826下方通过。
当兼容的或正确的钉仓安置在缝合器械中时,本文所公开的许多闭锁件失效。当被安置时,钉仓被锁定在缝合器械内的适当位置。在此类情况下,在钉仓和缝合器械之间存在很少的(如果有的话)相对运动,直到钉仓从缝合器械卸载。
在各种情况下,外科缝合组件包括轴和从轴朝远侧延伸的端部执行器,该端部执行器包括第一钳口和能够相对于第一钳口旋转的第二钳口。外科缝合组件可包括闭锁构件,该闭锁构件被构造成能够防止外科缝合组件的意外击发和/或外科缝合组件的夹持,直到闭锁键解锁闭锁构件。闭锁键可以是例如被构造成能够安装在第一钳口和第二钳口中的一者中的钉仓的一部分。具体地讲,闭锁键可以是钉仓的滑动件的一部分,使得当滑动件处于其未击发位置时钉仓可解锁闭锁构件,从而指示当钉仓安装在外科缝合组件内时该钉仓未用尽。在至少一种情况下,可能需要进一步的动作来用闭锁键解锁闭锁件。例如,可能需要端部执行器以在闭锁键可解锁闭锁构件之前获得完全夹持构型。闭锁件的一个示例可见于名称为“SURGICAL APPARATUS WITH CONDUCTOR STRAIN RELIEF”的美国专利申请公布2016/0249921,现为美国专利10,085,749,其全部公开内容据此以引用方式并入本文。
在至少一种情况下,外科缝合组件(诸如上述的外科缝合组件)可与外科机器人一起使用。外科缝合组件可被构造成能够附接到机器人系统并且通过机器人系统的机器人臂来操作。这些机器人系统允许外科医生在患者所在的无菌区之外。在至少一种情况下,技术人员和/或另一个外科医生例如可位于无菌区的边界内以监测工具和患者之间的接口。该技术人员和/或外科医生可在外科手术期间使器械附接到机器人臂以及从机器人臂脱离。在一些情况下,能够主动绕过外科缝合组件的闭锁构件可能是有利的。提供这种能力可使外科医生或技术人员能够在闭锁装置由于任何原因不能自动失效时手动使钉仓的闭锁装置失效。提供这种能力还可使得外科医生能够测试闭锁构件的可操作性,以确保闭锁构件在使用外科缝合组件之前是功能性的。在外科医生想要手动操控闭锁构件以击发钉仓的情况下,外科医生或临床医生可知道安装的钉仓是正确的未击发钉仓并且可能想要击发该钉仓,而不管闭锁构件事实上未失效的事实。在至少一种情况下,临床医生可能想要从击发序列移除该闭锁构件并防止其成为击发行程的一部分。此外,提供对端部执行器自身内的闭锁构件的直接触及以用于手动解锁可提供具有或不具有自动使闭锁构件失效的系统的优点。直接进入端部执行器内的闭锁构件可消除原本可存在于系统中的附加部件,该系统利用位于闭锁构件更上游的解锁机构来解锁闭锁构件。例如,使用位于外科器械的轴内的闭锁构件更上游的解锁机构可引入在施加解锁致动期间可能堵塞或失效的附加部件。
图156至图160示出了被构造成能够夹持、缝合和切割患者组织的外科缝合组件41000。外科缝合组件41000被构造成能够附接到外科机器人和/或外科器械柄部、与外科机器人和/或外科器械柄部脱离并由外科机器人和/或外科器械柄部操作。外科缝合组件41000包括轴41100、能够枢转地支撑在轴41100内的第一钳口41200以及附接到轴41100的第二钳口41300。第一钳口41200能够在松开构型与夹持构型之间运动,以夹持和松开定位在第一钳口41200与第二钳口41300之间的组织。外科缝合组件41000还包括钉仓41230,该钉仓包括可移除地储存在其中的多个钉。钉仓41230被构造成能够安装到第一钳口41200中并用其他钉仓替换。外科缝合组件41000还包括延伸穿过轴41100的击发构件41400,该轴被构造成能够使第一钳口41200相对于第二钳口41300在松开构型和夹持构型之间运动,从钉仓41230部署钉,并且在击发行程期间用刀或刀片41422切割组织。击发构件41400被构造成能够由外科机器人和/或外科器械柄部的驱动系统致动。设想了其中击发构件41400用旋转驱动轴驱动的实施方案。还设想了其中被构造成能够接收钉仓的钳口固定到轴并且包含砧座的钳口能够在夹持构型和松开构型之间运动的实施方案。
外科缝合组件41000还包括闭锁件41500(图160),该闭锁件被构造成能够防止击发构件41400朝远侧运动超过特定位置,除非正确的未用尽钉仓安装在第一钳口41200内并且第一钳口41200处于完全夹持构型。在至少一种情况下,无论闭锁件41500的状况如何,都允许击发构件41400在原始位置和特定位置之间运动第一距离,以允许夹持和松开组织,如下文更详细地讨论。闭锁件41500朝锁定构型偏压,其中防止击发构件41400朝远侧运动超过特定位置。闭锁件41500能够运动到解锁构型,其中允许击发构件41400朝远侧运动超过特定位置以从钉仓41230部署钉。下文更详细地讨论,外科缝合组件41000还包括限定于其中的直接进入孔口,该直接进入孔被构造成能够允许临床医生手动地或人工地解锁闭锁件41500,即,使闭锁件41500运动到解锁构型。
第一钳口41200包括被构造成能够在其中接收钉仓41230的通道41210。钉仓41230被构造成能够安装在通道41210内并且易于用另一个钉仓替换。钉仓41230还包括滑动件41235,该滑动件能够在未击发位置和击发位置之间运动,以在滑动件41235被击发构件41400朝远侧推动穿过钉仓41230的仓体41232时从钉仓41230射出钉。第二钳口41300包括砧座41320,该砧座包括被构造成能够使从钉仓41230射出的钉成形的钉成形表面41310。
第一钳口41200能够通过击发构件41400相对于第二钳口41300在松开构型和夹持构型之间运动。设想了其中第二钳口41300能够相对于第一钳口41200运动的实施方案。为了夹持组织,击发构件41400从原始位置朝远侧运动第一距离,以将第一钳口41200凸轮到夹持构型。参见图159,击发构件41400包括被构造成能够接合限定于第二钳口41300内的砧座通道41330的斜坡41332的砧座凸轮作用部分41423以及被构造成能够接合第一钳口41200的底部表面41220的斜坡41222的通道凸轮作用部分41424。砧座凸轮作用部分41423和通道凸轮作用部分41424从击发构件41400的远侧部分41420侧向延伸,并且被构造成能够在击发构件的远侧部分41420运动通过其击发行程时控制第一钳口41200与第二钳口41300之间的距离。在上述第一距离期间,砧座凸轮作用部分41423和通道凸轮作用部分41424接合第一钳口41200和第二钳口41300,并将第一钳口41200凸轮到夹持构型。击发构件41400的远侧部分41420的进一步远侧运动在击发行程期间保持第一钳口41200和第二钳口41300相对于彼此并且朝远侧推动滑动件41235以射出储存在钉仓41230内的钉。
外科缝合组件41000还包括闭锁件41500,该闭锁件被构造成能够防止击发构件朝远侧推进超过第一距离,除非正确的未用尽钉仓安装在第一钳口41200内并且第一钳口41200完全夹持。闭锁件41500包括闭锁构件41510,该闭锁构件能够枢转地支撑在轴41100内并且能够在解锁构型(图157)和锁定构型(图158)之间运动,其中,解锁构型允许击发构件41400运动超过第一距离以完成击发行程,并且锁定构型防止击发构件41400运动超过第一距离。闭锁构件41510由弹簧41520偏压成锁定构型。当第一钳口41200运动到夹持构型时,安装在通道41210内的正确的未用尽钉仓可克服由弹簧41520提供的偏压。
为了解锁闭锁件41500,第一钳口41200必须运动到其夹持构型以呈现滑动件41235,从而接合和解锁闭锁构件41510。当第一钳口41200不处于其夹持构型时,滑动件41235不能使闭锁件41500失效。设想了其中仓钳口不能够枢转而是砧座钳口能够枢转的实施方案。在此类实施方案中,仅插入钉仓呈现滑动件41235以使闭锁件41500失效。在此类实施方案中,闭锁件41500可在对砧座钳口施加任何夹持动作之前失效。
为了解锁闭锁件41500,如上所述,必须将正确的未用尽钉仓安装在外科缝合组件41000的第一钳口41200中。钉仓41230包括滑动件41235,该滑动件包括从该滑动件朝近侧延伸的闭锁键41237。闭锁键41237被构造成能够在滑动件41235处于未击发位置并且第一钳口41200运动到夹持构型时使闭锁构件41510运动到解锁构型。为了解锁闭锁件,闭锁键41237通过使闭锁构件41510的闭锁凸缘或腿部41511运动远离限定于击发构件41400的击发轴或杆41410中的闭锁凹口41412,来使闭锁构件41510枢转到解锁构型,该闭锁凹口原本将防止击发构件41400在第一钳口41200运动到夹持构型时其远侧运动超过用于夹持的初始距离。闭锁构件41510包括从闭锁凸缘41511朝远侧延伸的一对臂41512,该对臂被构造成能够在击发构件41400运动通过其击发行程时跨越击发构件41400。
图157示出了与闭锁构件41510的远侧端部41515上的臂41512的远侧端部41516接合的闭锁键41237。如图157所示,闭锁构件41510已相对于轴41100围绕闭锁构件41510的凸块41513(图160)枢转到解锁构型。当闭锁构件41510处于解锁构型时,击发轴41410的闭锁凹口41412将与闭锁构件41510的闭锁凸缘41511错开,从而允许击发构件41400朝远侧运动穿过钉仓41230。参见图158,如果闭锁键41237在将第一钳口41200夹持到夹持构型时不存在,则闭锁构件41510通过弹簧41520(图159)抵靠闭锁构件41510的接片41514(图160)推动来保持被偏压到锁定构型,其中闭锁凸缘41511接合击发轴41410的凹口41412,以阻挡击发构件41400的远侧运动超过用于夹持的初始距离。
如上所述,外科缝合组件41000还包括限定于其中的直接进入孔口41425,该直接进入孔口被构造成能够允许临床医生使闭锁构件41510人工地运动到解锁构型。孔41425可定位在任何合适的部件中,使得工具41590可通过孔41425进入闭锁构件41510以使闭锁构件41510运动到解锁构型。孔41425限定于击发构件41400的远侧部分41420的通道凸轮作用部分41424中。孔41425可包括例如限定于通道凸轮作用部分41424中的进入狭缝。在至少一种情况下,孔41425限定于轴41100和/或其部件中。尽管如此,闭锁构件41510能够通过孔41425直接触及。工具41590包括被构造成能够穿过孔41425插入的钩部分41591以及限定于闭锁构件41510的臂41512之间的开口41517,以用于钩住或闩锁在凸缘41511的上侧上以牵拉凸缘41511,并且因此克服促使闭锁构件41510进入锁定构型的弹簧偏压,使闭锁构件41510枢转到解锁构型。孔41425可被构造成使得通常能够避免的工具诸如螺丝刀不装配在孔口或外部进入孔41425内。闭锁构件41510的部分在解锁构型中以虚线示出,其中工具41590已将闭锁构件41510定位到解锁构型。臂41512’和凸缘41511’是在解锁构型中示出的闭锁构件41510的臂41512和凸缘41511的虚线型式。
一旦闭锁构件41510手动地或人工地失效以使闭锁件41500运动到解锁构型,则允许击发构件41400朝远侧运动超过未击发位置并进入钉仓41230中。该未击发位置被限定为夹持之后但击发之前的位置。一旦击发构件41400朝远侧推进超过其未击发位置,工具41590就可与闭锁构件41510脱离接合并从孔41425移除以允许闭锁件41500恢复正常操作。例如,当击发构件41400在已至少部分地击发钉仓之后返回到未击发位置时,闭锁构件41510将枢转到锁定构型。在击发行程期间,闭锁构件41510能够通过限定于通道41210的近侧端部和轴41100的远侧端部之间的次进入孔41160用工具41590触及。即便如此,闭锁构件41510将在钉击发行程期间保持失效。在至少一种情况下,直接进入孔例如定位在轴41100内,并且可在击发构件41400的击发行程期间提供进入闭锁构件41510的通道。在至少一种情况下,次进入孔41160包括主闭锁件进入孔。
闭锁件41500可定位在任何合适的位置。在至少一种情况下,当击发构件41400处于其最近侧位置(诸如图159所示的位置)时,闭锁件41500可定位在击发构件41400的远侧部分41420的近侧。在这种情况下,进入孔可限定于外科缝合组件41000的轴外壳或框架中。在至少一种情况下,进入孔限定于通道41210中。
在至少一种情况下,工具41590可穿过直接进入孔41425插入以在钉仓41230插入通道41210中之前解锁闭锁件41500。在插入钉仓之前使闭锁件41500运动到其解锁构型可通过防止闭锁件41500在安装期间接合钉仓来帮助钉仓安装。一些闭锁件通过将钉仓的滑动件从其未击发的可击发位置碰撞到未击发的不可击发位置而禁用不正确的钉仓,这可导致钉仓立即用尽。此外,此类闭锁件可在正确的钉仓的安装期间碰撞正确的钉仓的滑动件。在安装钉仓之前解锁闭锁件41500可确保在安装期间不会意外停用正确的钉仓。
图161和图162示出了用于夹持、缝合和切割患者组织的外科缝合组件42000。外科缝合组件42000在许多方面类似于本文所述的其他缝合组件。外科缝合组件42000包括击发组件42100和仓通道42200,该仓通道被构造成能够在该细长通道中接收钉仓。击发组件42100被构造成能够推动安装在仓通道42200内的正确的未用尽钉仓的滑动件以部署钉仓的钉并切割缝合的组织。外科缝合组件42000还包括闭锁件42300,该闭锁件被构造成能够防止击发组件42100推进穿过不正确的钉仓。闭锁件42300包括弹簧42310,该弹簧使闭锁件42300朝锁定构型偏压。闭锁件42300被构造成能够由正确的未用尽钉仓朝近侧推动以解锁击发组件42100。值得注意的是,闭锁件42300被构造成使得闭锁件42300不会意外地将正确的钉仓的滑动件推动到将引起击发组件42100的闭锁条件的位置。闭锁件42300可采用任何合适的闭锁方法。击发组件42100类似于本文所述的其他击发组件。
外科缝合组件42000还包括在限定于仓通道42200中的纵向狭槽42230的近侧端部处限定于仓通道42200的底部中的直接进入切口或孔42210。击发组件42100能够在钉击发行程期间运动穿过仓通道42200的狭槽42230。直接进入切口42210允许工具插入外科缝合组件42000内以直接进入闭锁件42300。该工具可穿过直接进入切口42210插入以使闭锁件42300运动到解锁构型(图162)。以这种方式解锁闭锁件42300可被称为人工地解锁闭锁件42300,因为未用尽钉仓由于任何原因尚未自动解锁闭锁件42300。直接进入切口42210包括近侧端部42211和远侧端部42213,该远侧端部包括比近侧端部42211宽的切口部分。远侧端部42213的较宽切口部分可帮助将工具正确插入通道42200中。例如,该工具可包括装配在远侧端部42213中而非近侧端部42211中的锁接合部分,从而消除了将工具错误插入近侧端部42211中的可能性。此外,闭锁件42300及其相对于外科缝合组件42000的其他部件的位置也通过直接进入切口42210直接可见。尽管如此,工具可穿过切口42210插入以朝近侧牵拉和/或推动闭锁件42300,从而克服弹簧偏压并使闭锁件42300运动到解锁构型。该工具还可从闭锁件42300移除和脱离接合,使得闭锁件42300可恢复正常操作。此外,提供手动运动闭锁件42300的能力可允许临床医生在将钉仓安装到仓通道42200中之前使闭锁件42300运动远离其锁定位置,以防止闭锁件42300过早地运动被安装到仓通道42200中的钉仓的滑动件。
图163和图164示出了外科缝合组件43000,该外科缝合组件包括击发组件43100、在其中支撑击发组件43100的框架43400、能够枢转地附接到框架43400的仓通道43300以及被构造成能够使外科缝合组件43000的闭锁件失效的闭锁键机构43500。外科缝合组件43000可包括任何合适的闭锁件;然而,下文描述了在不存在定位在仓通道43300中的正确的未用尽钉仓的情况下击发组件43100落入锁定凹槽中的潜入刀(diving knife)闭锁件。
击发组件43100包括击发轴43110和附接到击发轴43110的远侧端部的击发构件43120。尽管示出了线性击发轴,但击发组件43100可被构造成能够具有旋转驱动轴。击发轴43110被构造成能够由例如外科器械柄部和/或外科机器人的击发驱动器致动。可使用任何合适的驱动机构。击发构件43120包括砧座凸轮作用销43122和从其侧向延伸的通道凸轮作用销43123。销43122、43123被构造成能够在击发行程期间控制捕获在外科缝合组件43000内的组织上的夹持压力。击发构件43120还包括被构造成能够切割所夹持的组织的切割刃43121。击发构件43120还包括凸缘或远侧鼻部43124,该凸缘或远侧鼻部被构造成能够接合和/或搁置在未击发的正确的钉仓的滑动件的顶部上,使得击发构件43120不落入闭锁件凹槽中。
击发组件43100还包括延伸部43111,该延伸部被构造成能够通过安装在框架43400内的弹簧构件朝通道43300向下偏压。下面更详细地讨论,延伸部43111的向下偏压促使击发组件43100朝向其闭锁状态。当有未用尽的正确的钉仓安装在仓通道43300内时克服了该向下偏压。
闭锁键机构43500包括弹簧43530、可滑动地支撑在框架43400内的楔形件43520以及包括安装到框架43400的近侧端部43511的提升器弹簧43510。楔形件43520包括斜坡43521,提升器弹簧43510的远侧端部43512搁置在该斜坡上。当钉仓插入仓通道43300中时,钉仓43200朝近侧推动楔形件43520。楔形件43520的近侧运动使得提升器弹簧43510提升击发构件43120以使闭锁件的第一阶段失效。提升器弹簧43510包括限定于远侧端部43512上的凹口43513,该凹口被构造成能够在提升器弹簧43510被钉仓43200的楔形件43520提升时接合从击发构件43120侧向延伸的提升器销43125。
一旦闭锁件的第一阶段已被克服,则击发组件43100朝远侧推进以评估闭锁件的第二阶段。当钉仓43200的滑动件处于其近侧未击发位置时,闭锁件的该第二阶段失效。与上述类似,当击发轴43110朝远侧推进时,击发轴43110可被钉仓43200提升到滑动件上。
为了使击发构件43120的鼻部43124落在钉仓43200的未击发滑动件上以使闭锁件的第二阶段失效并防止击发构件43120落入闭锁件凹槽中,仓体键43211设置在仓体43210的近侧端部43201上。现在参见图164,当钉仓43200安装在仓通道43300中时,仓体键43211朝近侧推动楔形件43520并克服由弹簧43530提供的弹簧偏压。当朝近侧推动楔形件43520时,楔形件43520提升提升器弹簧43510。此时,凹口43513可抓住提升器销43125并提升击发组件43100。以这种方式提升击发组件43100可被称为使闭锁件的第一阶段失效。值得注意的是,不具有正确仓闭锁键的钉仓可能能够安装在仓通道43300中,但将不能提升击发组件43100。一旦钉仓43200安装在仓通道43300中并且击发组件43100被提升,则击发组件43100可朝远侧推进,使得凹口43513可将击发组件43100保持在正确的高度处并保持正确的距离,使得鼻部43124可落在钉仓43200中的未击发滑动件上,从而避开闭锁件凹槽。使鼻部43124落在未击发滑动件上可被称为使闭锁件的第二阶段失效。如果钉仓43200中的滑动件不处于其未击发位置,则击发组件43100将落入闭锁件凹槽中并且不能朝远侧推进超过其锁定构型。在至少一种情况下,仓体键43211从钉仓43200的仓体盘43220朝近侧延伸。
图165示出了第一钉仓43610,第一钉仓包括近侧端部43611和从近侧端部43611延伸的闭锁键43613。闭锁键43613包括第一轮廓。图165示出了第二钉仓43620,第二钉仓包括近侧端部43621和从近侧端部43621延伸的闭锁键43623。闭锁键43623包括不同于闭锁键43613的第一轮廓的第二轮廓。第一钉仓43610被构造成能够仅解锁与其兼容的缝合器械,并且第二钉仓43620被构造成能够仅解锁与其兼容的缝合器械。
重新参见图163和图164中的闭锁键机构43500,使用不同键轮廓的仓可用于确保击发构件在适当的位置被提升并具有适当的高度。参见图165,在不同位置处提升击发构件导致击发构件的不同提升定时。这可用于确保不正确的钉仓无法解锁不兼容的器械。图166和图167包含示出由仓43610、43620提供的不同提升定时43610’、43620’和位移43610”、43620”的曲线图。钉仓43610被构造成能够比钉仓43620更早地提升击发构件。在兼容外科器械中,第一钉仓43610将导致楔形件诸如本文所述的楔形件在适当的时间和位置提升击发构件,使得击发构件将落在第一钉仓43610的未击发滑动件上,以便使闭锁件失效并且使击发构件能够朝远侧推进以执行钉击发行程。在不兼容外科器械中,第一钉仓43610将导致楔形件例如在不正确的时间和位置提升击发构件,从而导致击发构件在到达滑动件之前掉落或导致击发构件在被提升到滑动件上之前朝远侧碰撞该滑动件。涉及安装不兼容仓和器械的两种情况将导致击发构件在试图使击发构件运动通过击发行程时进入闭锁状态。第二钉仓43620以类似方式工作。即便如此,第二钉仓43620不能解锁与第一钉仓43610兼容的器械,反之亦然。
图168和图169示出了包括第一仓44100(图168)和第二仓44200(图169)的系统44000。第一钉仓44100包括仓体44110,该仓体包括近侧端部44111、远侧端部44112以及在近侧端部44111和远侧端部44112之间成排延伸布置的多个钉腔44114。第一钉仓44100还包括被构造成能够将钉保持在仓体44110中的仓盘44130,以及被构造成能够从仓体44110部署钉的滑动件44120。仓体44110还包括限定于其中的纵向狭槽44113,其被构造成能够接收外科缝合组件的击发构件。纵向狭槽44113限定分别标记为“A”和“B”的第一侧向侧和第二侧向侧。仓体44110还包括从仓体44110的第一侧向侧“A”的近侧面44115延伸的闭锁键44116。
第二钉仓44200包括仓体44210,该仓体包括近侧端部44211、远侧端部44212以及在近侧端部44211和远侧端部44212之间成排延伸布置的多个钉腔44214。第二钉仓44200还包括被构造成能够将钉保持在仓体44210中的仓盘44230,以及被构造成能够从仓体44210部署钉的滑动件44220。仓体44210还包括限定于其中的纵向狭槽44213,其被构造成能够接收外科缝合组件的击发构件。纵向狭槽44213限定分别标记为“A”和“B”的第一侧向侧和第二侧向侧。仓体44210还包括从仓体44210的第二侧向侧“B”的近侧面44215延伸的闭锁键44216。
钉腔44114在纵向狭槽44113的每一侧上包括三个排。每个排限定排轴线,该排中的每个钉腔与该排轴线对准。换句话讲,单个排中的每个腔的近侧端部和远侧端部与该排的排轴线对准。钉腔44214在纵向狭槽44213的每一侧上包括三个排。每个排限定排轴线,该排中的每个钉腔与该排轴线横向对准。钉仓44200的每一侧包括钉腔44214的外排、钉腔44214的内排以及定位在钉腔44214的外排与钉腔44214的内排之间的钉腔44214的中间排。中间排的钉腔44214限定腔轴线,该腔轴线横向于由内排中的钉腔44214和外排中的钉腔44214限定的腔轴线。
系统44000通过在钉仓的不同侧上提供每个仓的闭锁键来提供防止不正确的钉仓与外科缝合组件一起使用的方式。在钉仓的不同侧上提供闭锁键防止将包括用于第一钉仓44100的对应钉成形凹坑的缝合组件与第二钉仓44200一起使用,并且防止将包括用于第二钉仓44200的对应钉成形凹坑的缝合组件与第一钉仓44100一起使用。因此,第一钉仓44100将不能解锁用于第二钉仓44200的外科缝合组件的击发闭锁件,并且第二钉仓44200将不能够解锁用于第一钉仓44100的外科缝合组件的击发闭锁件。这防止了不正确的仓安装,该不正确的仓安装可导致针对具有非对应的钉成形凹坑的砧座部署钉。
图170至图179示出了被构造成能够夹持、缝合和切割患者组织的外科缝合组件45000。外科缝合组件45000可与外科机器人和/或外科器械柄部一起使用。外科缝合组件45000包括第一钳口45200、能够相对于第一钳口45200在松开构型和夹持构型之间运动的第二钳口45400以及击发组件45500。外科缝合组件45000还包括能够替换的钉仓45300,该能够替换的钉仓包括可移除地储存在其中的多个钉,该多个钉被构造成能够由击发组件45500部署。第一钳口45200包括被构造成能够接收能够替换的钉仓45300的通道45210。第二钳口45400包括砧座45410,该砧座包括被构造成能够使从钉仓45300部署的钉成形的钉成形表面45415。第一钳口45200还包括销孔45212(图171),其中第二钳口45400的枢轴销45413被接收以允许第二钳口45400相对于第一钳口45200枢转。设想了其中固定钳口包括砧座并且能够运动的钳口包括通道和钉仓的实施方案。
为了用外科缝合组件45000夹持组织,第二钳口45400包括形成在其近侧端部45411上的凸轮作用表面45412,该凸轮作用表面被构造成能够由闭合构件接合。闭合构件包括例如闭合管,但可包括任何其他合适的构型。闭合构件被构造成能够通过接合凸轮作用表面45412并沿着该凸轮作用表面滑动而将第二钳口45400从松开构型朝通道45210凸轮到夹持构型。为了松开外科缝合组件45000,闭合构件朝近侧回缩。当闭合构件与凸轮作用表面45412脱离接合时,可提供弹簧以将第二钳口45400偏压到松开构型。
为了用外科缝合组件45000缝合和切割组织,必须将正确的未用尽钉仓安装在外科缝合组件45000内。当正确的未用尽钉仓安装在通道45210内时,击发组件45500可被致动穿过钉仓45300以将钉仓45300的滑动件45340从未击发位置朝远侧推动到击发位置,从而在钉击发行程期间部署储存在钉仓45300内的钉。当击发组件45500运动完成钉击发行程时,击发组件的切割刃45523切割夹持在第一钳口45200与第二钳口45400之间的组织。在至少一种情况下,切割刃45523跟在钉部署后面以防止组织在被缝合之前被切割。
主要参见图172至图175,击发组件45500包括击发构件45520,该击发构件包括切割刃45523、砧座凸轮作用部分45521和通道凸轮作用部分45522,该通道凸轮作用部分被构造成能够在钉击发行程期间控制第一钳口45200与第二钳口45400之间的距离,以及定位在砧座凸轮作用部分45521与通道凸轮部分45522之间的侧向延伸部分45525,该侧向延伸部分被构造成能够落入闭锁件中,如下文更详细地讨论。击发构件45520还包括从其朝近侧延伸的尾部45526,该尾部被构造成能够与安装在轴中的弹簧45240交接,如下文更详细地讨论。
为了防止击发组件45500推进穿过不正确的和/或用尽的钉仓,外科缝合组件45000还包括闭锁系统。外科缝合组件45000包括潜入刀闭锁件,诸如本文所公开的那些,其中如果正确的未用尽钉仓未安装在外科缝合组件45000内,则击发组件45500落入闭锁件凹坑中。正确的未用尽钉仓(诸如钉仓45300)被构造成能够在钉仓45300未用尽时通过提升击发组件45500来防止击发组件45500落入闭锁件凹坑中。在此类情况下,击发组件的远侧端部将落在钉仓45300的未击发滑动件上。然后,击发组件45500可推进穿过钉仓45300。
钉仓45300包括闭锁键45330以将击发组件45500提升到正确的高度和正确的距离,从而使击发组件45500落在未击发滑动件上并使外科缝合组件45000的闭锁件失效。钉仓45300还包括仓体45310,该仓体包括具有近侧面45313的近侧端部45301和被构造成能够在钉击发行程期间接收击发组件45500的纵向狭槽45311。闭锁键45330从仓体45310的近侧面45313朝近侧延伸并且包括限定纵向狭槽45311的近侧纵向狭槽部分45333的一对突起。近侧纵向狭槽部分45333被构造成能够在钉仓45300安装在通道45210中时跨越击发构件45520。闭锁键45330的每个突起包括倾斜表面或部分45331和非倾斜部分或表面45332。钉仓45300还包括被构造成能够在仓体45310内保持钉的盘45320。盘45320被构造成能够夹到仓体45310的平台45312上。盘45320可通过一系列钩45321能够移除地附连到仓体45310,该一系列钩形成在仓盘45320的侧壁上并且被构造成能够以钩的形式接合仓体45310的对应部分。在至少一种情况下,盘可包括闭锁键。
击发组件45500包括被构造成能够将击发动作传递到击发构件45520的击发轴45510。击发构件45520附接到击发轴45510的远侧端部45513。击发构件45520由安装在轴中的弹簧45420向下偏压。更具体地讲,弹簧45420向下推动击发构件45520的尾部45526以偏压击发构件45520,除非击发构件45520被向上提升远离击发闭锁件。为了提升击发组件45500,外科缝合组件45000包括定位在击发组件45500的击发构件45520后面的浮动销45600。浮动销45600支撑在限定于钉仓通道45210的侧面中的狭槽或通道45213内。浮动销45600被构造成能够通过倾斜表面45331在狭槽45213内竖直地运动。更具体地讲,浮动销45600被闭锁键45330向上推动到钉仓通道45210中,该钉仓通道继而接触击发构件45520的底部边缘并向上推动击发构件45520。因此,当钉仓45300安置在钉仓通道45210中时,浮动销45600阻止击发构件45520潜入到击发闭锁件中。这样,闭锁键45330克服了由弹簧45240施加到击发构件45520的向下弹簧偏压。
一旦钉仓45300被完全安装并且击发组件45500被提升到图174所示的位置,则击发组件45500可随后朝钉仓45300的滑动件45340朝远侧推进。因此,利用正确的闭锁键,使闭锁件的第一阶段失效。如果滑动件45340处于其未击发位置,则击发构件45520的远侧鼻部或搁架45524将落在滑动件45340的对应平台45341上并避免上述闭锁件。当滑动件45340处于其未击发位置时,使击发构件45520的远侧鼻部45524落在滑动件45340的平台45341上使闭锁件的第二阶段失效。当击发组件45500朝远侧推进时,底部表面45511骑在浮动销45600上方,并且击发组件45500的高度由浮动销45600、击发轴45510的底部表面45511与闭锁键45600之间的接合控制。
因为击发组件45500的高度由浮动销45600、击发轴45510的底部表面45511与闭锁键45600之间的接合控制,所以击发轴45510被构造成能够使得当钉仓45300的滑动件45340不处于其未击发位置时,击发组件45500仍可落入闭锁件中。参见图176和图177,底部表面45511包括限定于击发轴45510的远侧端部45513的近侧的凹口45515。凹口45515被构造成能够使得如果滑动件45340不存在于其未击发位置,则击发轴45510将落入闭锁件中。图176示出了安装在通道45210内的钉仓45300;然而,滑动件45340不存在于其未击发位置。因此,转到图177,击发轴45510未被浮动销45600充分向上提升以将击发轴45510提升出闭锁件。相反,当击发组件45500由于浮动销45600装配在凹口45515中而朝远侧推进时,击发轴45510被弹簧45240向下牵拉。为了执行钉击发行程,必须移除不正确的仓并用正确的未击发钉仓替换。
如果钉仓安装在不具有正确闭锁键的外科缝合组件中,则浮动销45600将保持在图172所示的其最下部位置。如果试图朝远侧推进击发组件45500,则击发组件45500将不能克服闭锁件的第一阶段。
图180示出了上述钉仓45300。图181示出了包括仓体45910和盘45920的第二钉仓45900,该盘被构造成能够将多个钉保持在钉仓45900中。仓体45910还包括从仓体45910的近侧面45913朝近侧延伸的闭锁键45930。如从图180和图181中可见,钉仓45300和第二钉仓45900包括类似的特征部;然而,这些钉仓包括具有不同构型的闭锁键。钉仓45300的闭锁键45330包括第一长度45338和第一高度45339,而第二钉仓45900的闭锁键45930包括分别不同于第一长度45338和第一高度45339的第二长度45938和第二高度45939。钉仓45300、45900是系统的一部分,在该系统中钉仓45300仅能解锁第一器械而不是第二器械,而第二钉仓45900仅能解锁第二器械而不是第一器械。闭锁键45930包括倾斜表面45931和平坦表面45932,该倾斜表面和平坦表面的尺寸与闭锁键45330的表面45331、45332不同。出于比较目的,钉仓45300的闭锁键45330在图181中以虚线示出。
例如,类似外观的仓之间的不同闭锁键构型可防止临床医生在第二器械中插入和使用不兼容仓。在这种情况下,闭锁键45330、45930将导致器械的击发组件在击发组件的击发行程期间提升到不同高度以及在不同时间提升。重新参见浮动销45600,击发组件45500在第二钉仓45900安装在外科缝合组件45000中的情况下将被浮动销45600提升的高度小于击发组件45500在钉仓45300被安装的情况下将被浮动销45600提升的高度。这将导致击发组件45500不能落在第二钉仓的滑动件平台上,而是将被闭锁。这将防止在缝合器械内使用不正确的钉仓。
可与第二钉仓45900一起使用的器械可包括如上所述的类似浮动销系统;然而,该浮动销可相对于第二钉仓45900定位在不同的位置,使得闭锁键45930可将该器械的击发构件提升到适当的高度并且在适当的时间落到第二钉仓45900的滑动件上以绕过器械的闭锁。在至少一种情况下,本文所述的闭锁键包括例如仓体翼片。
本文所述主题的各个方面在以下实施例中阐述:
实施例1-一种外科缝合器械,所述外科缝合器械被构造用于与外科钉仓一起使用,所述外科钉仓包括多个外科钉,所述多个外科钉被构造成能够随着支撑在所述外科钉仓中的凸轮作用组件在所述外科钉仓中从未击发位置运动到击发位置通过所述凸轮作用组件从所述外科钉仓射出,所述外科缝合器械包括:所述外科缝合器械包括被构造成能够在所述外科缝合器械中可移除地支撑所述外科钉仓的第一钳口、能够相对于所述第一钳口在打开位置和闭合位置之间运动的第二钳口、击发构件、击发构件闭锁件和仓验证构件,所述击发构件被构造成能够在对所述击发构件施加击发动作时在起始位置和结束位置之间轴向运动。所述击发构件闭锁件被构造成能够与支撑在所述第一钳口中的所述外科钉仓的所述凸轮作用组件交接。所述击发构件闭锁件还被构造成能够在对所述击发构件施加所述击发动作时防止所述击发构件运动出所述起始位置,除非所述凸轮作用组件在所述外科钉仓内处于所述未击发位置。所述仓验证构件被构造成能够使所述凸轮作用组件从所述未击发位置运动离开到达中间位置,除非所述仓验证构件检测到所述外科钉仓上的验证特征部。
实施例2-根据实施例1所述的外科缝合器械,其中,所述仓验证构件联接到所述第二钳口。
实施例3-根据实施例1或2所述的外科缝合器械,其中,所述仓验证构件被构造成能够在所述第二钳口运动到所述闭合位置时检测所述验证特征部。
实施例4-根据实施例1、2或3所述的外科缝合器械,其中,所述验证特征部从所述外科钉仓的近侧端部突出。
实施例5-根据实施例1、2、3或4所述的外科缝合器械,其中,所述仓验证构件包括柔顺部分,所述柔顺部分被构造成能够与所述凸轮作用组件和所述验证特征部交接。
实施例6-根据实施例1、2、3、4或5所述的外科缝合器械,其中,所述外科钉仓包括仓体,并且其中所述验证特征部包括从所述仓体的近侧端部朝近侧延伸的仓体延伸部。
实施例7-根据实施例1、2、3、4、5或6所述的外科缝合器械,其中,所述仓验证构件被可动地支撑在所述第一钳口内并且被构造成能够在致动位置和仓验证位置之间运动,在所述致动位置,所述仓验证构件被构造成能够使所述凸轮作用组件从所述未击发位置运动到所述中间位置。
实施例8-根据实施例7所述的外科缝合器械,还包括验证偏压器,所述验证偏压器用于将所述仓验证构件偏压到所述致动位置,除非所述仓验证构件被所述仓的所述验证特征部接触以使所述外科钉仓验证构件运动到所述仓验证位置。
实施例9-根据实施例1、2、3、4、5、6、7或8所述的外科缝合器械,其中,所述凸轮作用组件包括多个凸轮构件,并且其中所述仓验证构件包括对应于所述凸轮构件中的至少两个凸轮构件的多个位移臂。
实施例10-根据实施例1、2、3、4、5、6、7、8或9所述的外科缝合器械,其中,所述外科钉仓包括四个验证构件。
实施例11-根据实施例1、2、3、4、5、6、7、8、9或10所述的外科缝合器械,其中,所述仓验证构件在所述仓验证构件上具有至少一个主验证表面,所述至少一个主验证表面被构造成能够与所述验证特征部上的对应次验证表面交接,以有利于所述钉仓可操作地安置在所述第一钳口中。
实施例12-一种外科缝合器械,所述外科缝合器械被构造用于与外科钉仓一起使用,所述外科钉仓包括多个外科钉,所述多个外科钉被构造成能够随着支撑在所述外科钉仓中的凸轮作用组件在所述外科钉仓中从未击发位置运动到击发位置通过所述凸轮作用组件从所述外科钉仓射出,所述外科缝合器械包括:所述外科缝合器械包括被构造成能够在所述外科缝合器械中可移除地支撑所述外科钉仓的通道、能够相对于所述通道在打开位置和闭合位置之间运动的砧座、击发构件、击发构件闭锁件和仓验证构件,所述击发构件被构造成能够在对所述击发构件施加击发动作时在起始位置和结束位置之间轴向运动。所述击发构件闭锁件能够在锁定位置和解锁位置之间运动,在所述锁定位置,在对所述击发构件闭锁件施加所述击发动作时,所述击发构件闭锁件防止所述击发构件从所述起始位置运动,在所述解锁位置,在对所述击发构件施加所述击发动作时,允许所述击发构件从所述起始位置运动到所述结束位置。所述击发构件闭锁件包括闩锁部分,所述闩锁部分被构造成能够在所述凸轮作用组件处于所述未击发位置时解锁地接合所述凸轮作用组件的解锁部分,以使所述击发构件闭锁件从所述锁定位置运动到所述解锁位置。所述仓验证构件被可动地支撑在所述通道中并且被构造成能够使所述凸轮作用组件运动出所述未击发位置并且运动成不与所述击发构件的所述闩锁部分解锁接合而到达中间位置,除非所述仓验证构件检测到所述外科钉仓上的验证特征部。
实施例13-根据实施例12所述的外科缝合器械,其中,所述外科钉仓包括仓体,并且其中所述验证特征部包括从所述仓体的近侧端部朝近侧延伸的仓体延伸部。
实施例14-根据实施例12或13所述的外科缝合器械,其中,所述仓验证构件能够在所述通道内在致动位置和仓验证位置之间运动,在所述致动位置,所述仓验证构件使所述凸轮作用组件从所述未击发位置运动到所述中间位置。
实施例15-根据实施例14所述的外科缝合器械,还包括验证偏压器,所述验证偏压器用于将所述仓验证构件偏压到所述致动位置,除非所述仓验证构件被所述外科钉仓的所述验证特征部接触以使所述仓验证构件运动到所述仓验证位置。
实施例16-一种外科钉仓,所述外科钉仓被构造成能够安装在外科缝合器械中。所述外科缝合器械包括击发构件、击发构件闭锁件和仓验证构件。所述外科钉仓包括仓体、可移除地储存在所述仓体内的多个钉、凸轮作用组件以及至少一个验证特征部。所述仓体被构造成能够可操作地支撑在所述外科缝合器械中,并且包括近侧端部、远侧端部和仓狭槽,所述仓狭槽从所述近侧端部延伸到所述远侧端部以适应所述击发构件轴向通过仓狭槽。所述凸轮作用组件被构造成能够随着所述凸轮作用组件从与所述仓体的近侧端部相邻的未击发位置运动到击发位置从所述仓体部署所述钉。所述凸轮作用组件还被构造成能够使所述击发构件闭锁件从锁定位置运动到解锁位置,在所述锁定位置,所述击发构件不能朝远侧运动穿过所述仓体,在所述解锁位置,所述击发构件可轴向运动穿过所述仓体。所述至少一个验证特征部被构造成能够与所述仓验证构件可操作地交接,使得当所述仓体被可操作地支撑在所述外科缝合器械中时,所述验证特征部防止所述仓验证构件使所述凸轮作用组件从所述未击发位置运动到中间位置,在所述中间位置,所述凸轮作用组件与所述击发构件闭锁件脱离接合,以允许所述击发构件闭锁件被偏压到所述锁定位置,以防止在对所述击发构件施加击发动作时所述击发构件朝远侧运动穿过所述仓体。
实施例17-根据实施例16所述的外科钉仓,其中,所述至少一个验证特征部包括至少一个仓体延伸部,所述至少一个仓体延伸部从所述仓体的所述近侧端部朝近侧延伸并且与所述仓验证构件的对应部分致动对准。
实施例18-根据实施例16所述的外科钉仓,其中,所述至少一个验证特征部包括从所述仓体的所述近侧端部朝近侧延伸的四个仓体延伸部,其中每个仓体延伸部与所述仓验证构件的对应部分致动对准。
实施例19-根据实施例16、17或18所述的外科钉仓,其中所述凸轮作用组件还包括凸轮作用组件主体和至少一个凸轮构件,所述凸轮作用组件主体被支撑在所述仓狭槽中以用于在所述仓狭槽中轴向行进,所述至少一个凸轮构件位于所述凸轮作用组件主体的每个侧向侧上并且被可动地支撑在所述仓狭槽的每一侧上的所述仓体中的对应凸轮构件轴向狭槽中,并且其中所述仓验证构件包括致动器臂,所述致动器臂对应于每个凸轮构件轴向狭槽并且被构造成能够在所述凸轮构件轴向狭槽中延伸。
实施例20-根据实施例16、17、18或19所述的外科钉仓,其中,所述至少一个验证特征部包括位于所述至少一个验证特征部上的至少一个次验证表面,所述至少一个次验证表面被构造成能够与所述仓验证构件上的对应主表面交接,以有利于所述外科钉仓可操作地安置在所述外科缝合器械中。
实施例21-一种外科缝合组件,所述外科缝合组件被构造成能够接收选自包括兼容钉仓和不兼容钉仓的钉仓组的任何钉仓。所述兼容钉仓包括具有纵向狭槽的仓体、储存在所述仓体内的多个钉、被构造成能够从所述仓体射出所述钉的凸轮作用组件、以及仓验证特征部。所述凸轮作用组件能够在未击发位置和击发位置之间运动。所述不兼容钉仓包括具有另一个纵向狭槽的另一个仓体、储存在另一个仓体内的另外的多个其他钉、以及被构造成能够从另一个仓体射出其他钉的另一个凸轮作用组件。所述另一个凸轮作用组件能够在另一个未击发位置和另一个击发位置之间运动。所述外科缝合组件包括:第一钳口,所述第一钳口被构造成能够在所述第一钳口中可操作地支撑所述钉仓组中的任一个钉仓;第二钳口,所述第二钳口能够相对于所述第一钳口运动;击发构件,所述击发构件被构造成能够在对所述击发构件施加击发动作时在起始位置与结束位置之间轴向运动;击发构件闭锁件;以及仓验证构件。所述击发构件闭锁件能够从第一锁定位置运动到解锁位置,在所述第一锁定位置,所述击发构件闭锁件防止所述击发构件运动出所述起始位置,在所述解锁位置,在对所述击发构件施加所述击发动作时,所述击发构件能够从所述起始位置朝远侧运动。在所述兼容仓安装到所述第一钳口中且所述兼容仓凸轮作用组件处于所述未击发位置时,所述凸轮作用组件接合所述击发构件闭锁件以使所述击发构件闭锁件运动到所述解锁位置。在所述不兼容钉仓安装在第一钳口中且所述不兼容钉仓的另一个凸轮作用组件处于另一个未击发位置时,所述另一个凸轮作用组件被构造成能够接合所述击发构件闭锁件以使所述击发构件闭锁件运动到所述解锁位置。当所述不兼容钉仓安装在所述第一钳口中时,所述仓验证构件使所述另一个凸轮作用组件运动成与所述击发构件闭锁件脱离接合,以允许所述击发构件闭锁件被所述击发构件弹簧偏压到所述锁定位置。当所述兼容仓安装在所述第一钳口中时,所述兼容仓上的仓验证特征部防止所述仓验证构件使所述兼容仓凸轮作用组件运动成与所述击发构件闭锁件脱离接合。
本文所述的许多外科器械系统由电动马达促动;但是本文所述的外科器械系统可以任何合适的方式促动。在各种情况下,例如,本文所述的外科器械系统可由手动操作的触发器促动。在某些情况下,本文公开的马达可包括机器人控制系统的一部分或多个部分。此外,本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。例如,名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)更详细地公开了机器人外科器械系统的若干示例。
已结合钉的部署和变形描述了本文所述的外科器械系统;然而,本文所述的实施方案不限于此。例如,设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外,还设想了利用用于密封组织的任何合适装置的各种实施方案。例如,根据各种实施方案的端部执行器可包括被配置成能够加热和密封组织的电极。另外,例如,根据某些实施方案的端部执行器可施加振动能量来密封组织。
下述专利的全部公开内容据此以引用方式并入本文:
-公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312;
-公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818;
-公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139;
-公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849;
-公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR”的美国专利7,670,334;
-公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245;
-公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514;
-名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803,现为美国专利7,845,537;
-提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573;
-提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443);
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782,现为美国专利8,210,411;
-名称为“MOTORIZED SURGICAL INSTRUMENT”的美国专利申请序列号12/235,972,现为美国专利9,050,083。
-名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117,现为美国专利8,608,045;
-提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100,现为美国专利8,220,688;
-提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461,现为美国专利8,733,613;
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647,现为美国专利8,561,870;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241,现为美国专利9,072,535;
-提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049,现为美国专利9,101,358;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025,现为美国专利9,345,481;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067,现为美国专利申请公布2014/0263552;
-提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955;以及
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194,现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置,但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中,具体特征、结构或特性可以任何合适的方式进行组合。因此,在无限制的情况下,结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。另外,在公开了用于某些部件的材料的情况下,也可使用其他材料。此外,根据多种实施方案,单个部件可被替换为多个部件,并且多个部件也可被替换为单个部件,以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用之后废弃,或者其可被设计成多次使用。然而无论是哪种情况,该装置都可在至少使用一次后经过修整再行使用。修整可包括以下步骤的任意组合,这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地,修整设施和/或外科团队可拆卸装置,并且在清洁和/或更换装置的特定部件之后,可重新组装装置以供后续使用。本领域的技术人员将会理解,修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修整装置均在本申请的范围内。
本文所公开的装置可在外科手术之前进行处理。首先,可获得新的或用过的器械,并且根据需要进行清洁。然后,可对器械进行消毒。在一种消毒技术中,将所述器械放置在密闭且密封的容器(诸如,塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场,诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的,直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒,所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计,但可在本公开的实质和范围内进一步修改本发明。因此,本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
Claims (21)
1.一种外科缝合器械,所述外科缝合器械被构造用于与外科钉仓一起使用,所述外科钉仓包括多个外科钉,所述多个外科钉被构造成能够随着支撑在所述外科钉仓中的凸轮作用组件在所述外科钉仓中从未击发位置运动到击发位置通过所述凸轮作用组件从所述外科钉仓射出,所述外科缝合器械包括:
第一钳口,所述第一钳口被构造成能够在所述第一钳口中可移除地支撑所述外科钉仓;
第二钳口,所述第二钳口能够相对于所述第一钳口在打开位置和闭合位置之间运动;
击发构件,所述击发构件被构造成能够在对所述击发构件施加击发动作时在起始位置和结束位置之间轴向运动;
击发构件闭锁件,所述击发构件闭锁件被构造成能够与支撑在所述第一钳口中的所述外科钉仓的所述凸轮作用组件交接,所述击发构件闭锁件被构造成能够在对所述击发构件施加所述击发动作时防止所述击发构件运动出所述起始位置,除非所述凸轮作用组件在所述外科钉仓内处于所述未击发位置;以及
仓验证构件,所述仓验证构件被构造成能够使所述凸轮作用组件从所述未击发位置运动离开到达中间位置,除非所述仓验证构件检测到所述外科钉仓上的验证特征部。
2.根据权利要求1所述的外科缝合器械,其中,所述仓验证构件联接到所述第二钳口。
3.根据权利要求2所述的外科缝合器械,其中,所述仓验证构件被构造成能够在所述第二钳口运动到所述闭合位置时检测所述验证特征部。
4.根据权利要求1所述的外科缝合器械,其中,所述验证特征部从所述外科钉仓的近侧端部突出。
5.根据权利要求3所述的外科缝合器械,其中,所述仓验证构件包括柔顺部分,所述柔顺部分被构造成能够与所述凸轮作用组件和所述验证特征部交接。
6.根据权利要求1所述的外科缝合器械,其中,所述外科钉仓包括仓体,并且其中所述验证特征部包括从所述仓体的近侧端部朝近侧延伸的仓体延伸部。
7.根据权利要求1所述的外科缝合器械,其中,所述仓验证构件被可动地支撑在所述第一钳口内并且被构造成能够在致动位置和仓验证位置之间运动,在所述致动位置,所述仓验证构件被构造成能够使所述凸轮作用组件从所述未击发位置运动到所述中间位置。
8.根据权利要求7所述的外科缝合器械,还包括验证偏压器,所述验证偏压器用于将所述仓验证构件偏压到所述致动位置,除非所述仓验证构件被所述仓的所述验证特征部接触以使所述外科钉仓验证构件运动到所述仓验证位置。
9.根据权利要求7所述的外科缝合器械,其中,所述凸轮作用组件包括多个凸轮构件,并且其中所述仓验证构件包括对应于所述凸轮构件中的至少两个凸轮构件的多个位移臂。
10.根据权利要求9所述的外科缝合器械,其中,所述外科钉仓包括四个验证构件。
11.根据权利要求7所述的外科缝合器械,其中,所述仓验证构件在所述仓验证构件上具有至少一个主验证表面,所述至少一个主验证表面被构造成能够与所述验证特征部上的对应次验证表面交接,以有利于所述钉仓可操作地安置在所述第一钳口中。
12.一种外科缝合器械,所述外科缝合器械被构造用于与外科钉仓一起使用,所述外科钉仓包括多个外科钉,所述多个外科钉被构造成能够随着支撑在所述外科钉仓中的凸轮作用组件在所述外科钉仓中从未击发位置运动到击发位置通过所述凸轮作用组件从所述外科钉仓射出,所述外科缝合器械包括:
通道,所述通道被构造成能够在所述通道中可操作地支撑所述外科钉仓;
砧座,所述砧座能够相对于所述通道在打开位置和闭合位置之间运动;
击发构件,所述击发构件被构造成能够在对所述击发构件施加击发动作时在起始位置和结束位置之间轴向运动;
击发构件闭锁件,所述击发构件闭锁件能够在锁定位置和解锁位置之间运动,在所述锁定位置,在对所述击发构件闭锁件施加所述击发动作时,所述击发构件闭锁件防止所述击发构件从所述起始位置运动,在所述解锁位置,在对所述击发构件施加所述击发动作时,允许所述击发构件从所述起始位置运动到所述结束位置,所述击发构件闭锁件包括闩锁部分,所述闩锁部分被构造成能够在所述凸轮作用组件处于所述未击发位置时解锁地接合所述凸轮作用组件的解锁部分,以使所述击发构件闭锁件从所述锁定位置运动到所述解锁位置;以及
仓验证构件,所述仓验证构件被可动地支撑在所述通道中并且被构造成能够使所述凸轮作用组件运动出所述未击发位置并且运动成不与所述击发构件的所述闩锁部分解锁接合而到达中间位置,除非所述仓验证构件检测到所述外科钉仓上的验证特征部。
13.根据权利要求12所述的外科缝合器械,其中,所述外科钉仓包括仓体,并且其中所述验证特征部包括从所述仓体的近侧端部朝近侧延伸的仓体延伸部。
14.根据权利要求12所述的外科缝合器械,其中,所述仓验证构件能够在所述通道内在致动位置和仓验证位置之间运动,在所述致动位置,所述仓验证构件使所述凸轮作用组件从所述未击发位置运动到所述中间位置。
15.根据权利要求14所述的外科缝合器械,还包括验证偏压器,所述验证偏压器用于将所述仓验证构件偏压到所述致动位置,除非所述仓验证构件被所述外科钉仓的所述验证特征部接触以使所述仓验证构件运动到所述仓验证位置。
16.一种外科钉仓,所述外科钉仓被构造成能够安装在外科缝合器械中,其中所述外科缝合器械包括击发构件、击发构件闭锁件和仓验证构件,其中所述外科钉仓包括:
仓体,所述仓体被构造成能够可操作地支撑在所述外科缝合器械中并且包括近侧端部、远侧端部和仓狭槽,所述仓狭槽从所述近侧端部延伸到所述远侧端部以适应所述击发构件轴向通过仓狭槽;
多个钉,所述多个钉可移除地储存在所述仓体内;
凸轮作用组件,所述凸轮作用组件被构造成能够随着所述凸轮作用组件从邻近所述仓体的所述近侧端部的未击发位置运动到击发位置从所述仓体部署所述钉,所述凸轮作用组件还被构造成能够使所述击发构件闭锁件从锁定位置运动到解锁位置,在所述锁定位置,所述击发构件不能朝远侧运动穿过所述仓体,在所述解锁位置,所述击发构件能够轴向运动穿过所述仓体;以及
至少一个验证特征部,所述至少一个验证特征部被构造成能够与所述仓验证构件可操作地交接,使得当所述仓体被可操作地支撑在所述外科缝合器械中时,所述验证特征部防止所述仓验证构件使所述凸轮作用组件从所述未击发位置运动到中间位置,在所述中间位置,所述凸轮作用组件与所述击发构件闭锁件脱离接合,以允许所述击发构件闭锁件被偏压到所述锁定位置,以防止在对所述击发构件施加击发动作时所述击发构件朝远侧运动穿过所述仓体。
17.根据权利要求16所述的外科钉仓,其中,所述至少一个验证特征部包括至少一个仓体延伸部,所述至少一个仓体延伸部从所述仓体的所述近侧端部朝近侧延伸并且与所述仓验证构件的对应部分致动对准。
18.根据权利要求16所述的外科钉仓,其中,所述至少一个验证特征部包括从所述仓体的所述近侧端部朝近侧延伸的四个仓体延伸部,其中每个所述仓体延伸部与所述仓验证构件的对应部分致动对准。
19.根据权利要求16所述的外科钉仓,其中,所述凸轮作用组件还包括:
凸轮作用组件主体,所述凸轮作用组件主体被支撑在所述仓狭槽中以用于在所述仓狭槽中中轴向行进;以及
至少一个凸轮构件,所述至少一个凸轮构件位于所述凸轮作用组件主体的每个侧向侧上,并且被可动地支撑在所述仓狭槽的每一侧上的所述仓体中的对应凸轮构件轴向狭槽中,并且其中所述仓验证构件包括致动器臂,所述致动器臂对应于每个所述凸轮构件轴向狭槽并且被构造成能够在所述凸轮构件轴向狭槽中延伸。
20.根据权利要求16所述的外科钉仓,其中,所述至少一个验证特征部包括位于所述至少一个验证特征部上的至少一个次验证表面,所述至少一个次验证表面被构造成能够与所述仓验证构件上的对应主表面交接,以有利于所述外科钉仓可操作地安置在所述外科缝合器械中。
21.一种外科缝合组件,所述外科缝合组件被构造成能够接收选自包括以下的钉仓组的任何钉仓:
兼容钉仓,所述兼容钉仓包括:
仓体,所述仓体包括纵向狭槽;
多个钉,所述多个钉储存在所述仓体内;
凸轮作用组件,所述凸轮作用组件被构造成能够从所述仓体射出所述钉,其中所述凸轮作用组件能够在未击发位置和击发位置之间运动;以及
仓验证特征部,所述钉仓组还包括:
不兼容钉仓,所述不兼容钉仓包括:
另一个仓体,所述另一个仓体包括另一个纵向狭槽;
另外的多个其他钉,所述另外的多个其他钉储存在所述另一仓体内;以及
另一个凸轮作用组件,所述另一个凸轮作用组件被构造成能够从所述另一个仓体射出所述其他钉,其中所述另一个凸轮作用组件能够在另一个未击发位置和另一个击发位置之间运动,所述外科缝合组件包括:
第一钳口,所述第一钳口被构造成能够在所述第一钳口中可操作地支撑所述钉仓组中的任一个钉仓;
第二钳口,所述第二钳口能够相对于所述第一钳口运动;
击发构件,所述击发构件被构造成能够在对所述击发构件施加击发动作时在起始位置和结束位置之间轴向运动;
击发构件闭锁件,所述击发构件闭锁件能够在对所述击发构件施加所述击发动作时从第一锁定位置运动到解锁位置,在所述第一锁定位置,所述击发构件闭锁件防止所述击发构件运动出所述起始位置,在所述解锁位置,所述击发构件能够从所述起始位置朝远侧运动,其中在所述兼容仓安装到所述第一钳口中且所述兼容仓的所述凸轮作用组件处于所述未击发位置时,所述凸轮作用组件接合所述击发构件闭锁件以使所述击发构件闭锁件运动到所述解锁位置,并且其中在所述不兼容钉仓安装在所述第一钳口中且所述不兼容钉仓的所述另一个凸轮作用组件处于所述另一个未击发位置时,所述另一个凸轮作用组件被构造成能够接合所述击发构件闭锁件以使所述击发构件闭锁件运动到所述解锁位置;以及
仓验证构件,其中当所述不兼容钉仓安装在所述第一钳口中时,所述仓验证构件使所述另一个凸轮作用组件运动成与所述击发构件闭锁件脱离接合,以允许所述击发构件闭锁件被击发构件弹簧偏压到所述锁定位置,并且其中,当所述兼容仓安装在所述第一钳口中时,所述兼容仓上的所述仓验证特征部防止所述仓验证构件使所述兼容仓的所述凸轮作用组件运动成与所述击发构件闭锁件脱离接合。
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