CN112971889A - 具有柔性轴的手术钉合装置 - Google Patents

具有柔性轴的手术钉合装置 Download PDF

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CN112971889A
CN112971889A CN202011415869.4A CN202011415869A CN112971889A CN 112971889 A CN112971889 A CN 112971889A CN 202011415869 A CN202011415869 A CN 202011415869A CN 112971889 A CN112971889 A CN 112971889A
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assembly
inner cable
end portion
intermediate tube
stapling device
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贾斯汀·威廉斯
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Covidien LP
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Abstract

本发明涉及具有柔性轴的手术钉合装置，并具体提供一种手术钉合装置包括壳体组件，所述壳体组件通过具有外管、中间管和内缆的柔性细长主体联接到工具组件。所述外管和所述内缆中的每一个具有固定地连接到所述壳体组件的近侧端部部分和固定地连接到所述工具组件的远侧端部部分。所述中间管围绕所述内缆定位在所述外管内，并且能够从缩回位置移动到前进位置以操作所述工具组件。

Description

具有柔性轴的手术钉合装置
技术领域
本技术大体上涉及手术钉合装置，并且更具体地说涉及具有柔性轴的内窥镜手术钉合装置。
背景技术
用于用内窥镜执行手术过程的手术钉合装置为已知的，并且通常用于各种手术过程中以使患者创伤降到最低并且减少患者恢复时间。这些装置包括具有砧座组件、仓组件和用于将钉从仓组件中弹出到砧座中的驱动组件的工具组件。工具组件可具有各种配置，包括线性、圆形和弯曲的。
在线性内窥镜钉合装置中，驱动组件通常包括柔性梁，所述柔性梁前进穿过工具组件以将钉从仓组件中弹出并且切割夹持在砧座组件和仓组件之间的组织。典型地，柔性梁仅可在单个平面中弯曲。
在许多内窥镜手术过程期间，有必要进入被限制的手术部位。在这类过程中，工具组件在手术部位处触及组织的可操纵性为至关重要的。在本领域中，存在对具有改进的可操纵性以更好地进入手术部位处的组织的内窥镜钉合装置的持续的需求。
发明内容
本公开涉及一种手术钉合装置，其包括壳体组件，所述壳体组件通过具有外管、中间管和内缆的柔性细长主体而联接到工具组件。外管和内缆中的每一个具有固定地连接到壳体组件的近侧端部部分和固定地连接到工具组件的远侧端部部分。中间管可在外管内围绕内缆从缩回位置移动到前进位置以操作工具组件。外管和中间管以及内缆中的每一个由柔性材料形成。内缆和外管在钉合装置致动期间稳定并且防止中间管屈曲。
本公开的各方面涉及一种手术钉合装置，其包括壳体组件、细长主体和工具组件。壳体组件包括限定腔的主体和定位在腔内的驱动机构。细长主体包括外管、延伸穿过外管的中间管和延伸穿过中间管的内缆。外管、中间管和内缆由柔性材料形成。工具组件包括砧座组件、仓组件和夹持构件。仓组件可相对于砧座组件在打开位置和夹持位置之间移动并且包括仓主体和多个钉。仓主体限定多个钉接收槽。钉接收槽中的每一个接收多个钉中的一个。夹持构件可在工具组件内从缩回位置移动到前进位置以从仓主体中弹出多个钉。内缆包括固定地联接到壳体组件的主体的近侧端部部分和固定地联接到工具组件的远侧端部部分。中间管包括联接到驱动机构的近侧端部部分和联接到夹持构件的远侧端部部分。外管具有联接到壳体组件的主体的近侧端部部分和联接到工具组件的远侧端部部分。驱动机构可致动以使中间管在外管内沿内缆前进，以使夹持构件在其缩回位置和前进位置之间前进。
本公开的其它方面涉及一种手术装置，其包括壳体组件、细长主体、工具组件和内缆张紧机构。壳体组件包括限定腔的主体和定位在腔内的驱动机构。细长主体包括外管、延伸穿过外管的中间管和延伸穿过中间管的内缆。工具组件支撑在细长主体上并且包括操作构件。内缆包括固定地联接到壳体组件的主体的近侧端部部分和固定地联接到工具组件的远侧端部部分。中间管包括联接到驱动机构的近侧端部部分和联接到操作构件的远侧端部部分。外管包括联接到壳体组件的主体的近侧端部部分和联接到工具组件的远侧端部部分。内缆张紧机构包括壳体组件的主体的腔内的轴和支撑在所述轴上的转向器。内缆围绕转向器缠绕。驱动机构可致动以使中间管在外管内沿内缆前进，以使操作构件在其缩回位置和前进位置之间前进。
本公开的其它方面涉及一种手术钉合装置，其包括壳体、细长主体和工具组件。壳体支撑驱动机构。细长主体包括外管、延伸穿过外管的中间管和延伸穿过中间管的内缆。外管、中间管和内缆由柔性材料形成。工具组件包括砧座组件、仓组件和夹持构件。仓组件可相对于砧座组件在打开位置和夹持位置之间移动并且包括仓主体和多个钉。仓主体限定多个钉接收槽。钉接收槽中的每一个接收多个钉中的一个。夹持构件可在工具组件内从缩回位置移动到前进位置以从仓主体中弹出多个钉。内缆包括固定地联接到壳体组件的主体的近侧端部部分和固定地联接到工具组件的远侧端部部分。中间管包括联接到驱动机构的近侧端部部分和联接到夹持构件的远侧端部部分。外管具有联接到壳体组件的主体的近侧端部部分和联接到工具组件的远侧端部部分。驱动机构可致动以使中间管在外管内沿内缆前进，以使夹持构件在其缩回位置和前进位置之间前进。
在本公开的各方面，驱动机构包括驱动螺母，所述驱动螺母可在壳体组件的主体的腔内在缩回位置和前进位置之间移动，并且中间管的近侧端部部分联接到驱动螺母。
在本公开的一些方面，驱动机构包括导螺杆，所述导螺杆可旋转地支撑在腔内并且与驱动螺母可操作地接合。
在本公开的某些方面，驱动螺母限定螺纹孔，并且导螺杆延伸穿过螺纹孔并且可旋转以使驱动螺母在其缩回位置和前进位置之间移动。
在本公开的各方面，手术钉合装置包括内缆张紧机构，所述内缆张紧机构具有壳体组件的主体的腔内的轴和支撑在所述轴上的转向器，并且内缆围绕转向器缠绕。
在本公开的一些方面，轴包括螺纹螺杆，并且壳体组件的主体限定螺纹孔，其中螺纹螺杆接收在壳体组件的主体的螺纹孔内并且可旋转以调节转向器在壳体组件内的位置以调节内缆的张力。
在本公开的某些方面，转向器包括限定弯曲表面的远侧端部部分，并且内缆沿转向器的弯曲表面延伸。
在本公开的各方面，中间管限定定位在壳体组件的主体的腔内的纵向槽，并且内缆围绕转向器延伸穿过纵向槽。
在本公开的一些方面，仓组件包括致动滑板，所述致动滑板在仓主体内可响应于夹持构件从其缩回位置到其前进位置的移动而从缩回位置移动到前进位置以从仓主体中弹出多个钉。
在本公开的某些方面，仓组件包括刀，所述刀可响应于夹持构件从其缩回位置到其前进位置的移动而从缩回位置移动到前进位置以切割夹持在砧座组件和仓组件之间的组织。
将从以下描述中了解本公开的其它特征。
附图说明
下文参考附图在本文中描述本公开的各个方面，其中：
图1为所公开的包括处于打开的非铰接位置的工具组件的手术钉合装置的示例性方面的透视图；
图2为图1所示的手术钉合装置的透视图，其中工具组件处于夹持的铰接位置；
图3为图2所示的钉合装置的壳体组件的侧透视图、分解视图；
图4为图1所示的钉合装置的横截面视图；
图5为图4所示的细节指示区域的放大视图，其中钉合装置处于打开位置；
图6为图2所示的钉合装置的工具组件的侧透视图、分解视图；
图7为图5所示的细节指示区域的放大视图，其中钉合装置处于打开位置；
图8为图6所示的壳体组件的横截面视图，其中钉合装置处于预击发夹持位置；
图9为图7所示的工具组件的横截面视图，其中钉合装置处于预击发夹持位置；
图10为图8所示的壳体组件的横截面视图，其中钉合装置处于夹持和击发位置；
图11为图9所示的工具组件的横截面视图，其中钉合装置处于击发和夹持位置；
图12为图10所示的壳体组件的横截面视图，其中当驱动组件从击发位置缩回时，钉合装置处于夹持和击发位置；和
图13为图11所示的工具组件的横截面视图，其中当驱动组件从击发位置缩回时，钉合装置处于击发和夹持位置。
具体实施方式
现在将参考附图详细描述所公开的手术钉合装置的示例性方面，其中相似的附图标记在若干视图中的每一个中表示相同或对应元件。然而，应理解，本公开的各方面仅仅是本公开的示例，并且可以各种形式实施。为了避免在不必要的细节上模糊本公开，未对众所周知的功能或构造进行详细描述。因此，本文公开的具体结构和功能细节不应被解释为限制性的，而是仅作为权利要求书的基础，并且作为用于教示本领域技术人员以在实际上任何适当的详细结构中不同地采用本公开的代表性基础。如前部、后部、上部、下部、顶部、底部、远侧、近侧的方向术语以及类似术语用于帮助理解描述并且并非旨在限制本公开。
在本说明书中，术语“近侧”通常用于指代装置的更接近临床医生的部分，而术语“远侧”通常用于指代装置的更远离临床医生的部分。另外，术语“内窥镜”通常用于指代内窥镜、腹腔镜、关节镜和/或穿过小直径切口或套管进行的任何其它过程。另外，术语“临床医生”通常用于指代医务人员，包括医生、护士和辅助人员。
图1和2说明大体上示出为钉合装置10的所公开的手术钉合装置的示例性方面。钉合装置10包括壳体组件12、细长主体14和工具组件16。壳体组件12具有限定腔18a(图5)的主体18，所述腔18a如下所述接收壳体组件12的其它部件。细长主体14为柔性的，并且包括外管22、中间管24和内缆26。细长主体14的外管22具有近侧端部部分28和远侧端部部分30。外管22的近侧端部部分28固定地固定到壳体组件12的主体18，并且外管22的远侧端部部分30固定地联接到工具组件16，以控制壳体组件12和工具组件16之间的间距。
中间管24延伸穿过外管22，并且包括近侧端部部分34(图4)和远侧端部部分36。中间管24的近侧端部部分36联接到位于壳体组件12的主体18内的驱动机构40，并且中间管24的远侧端部部分36联接到工具组件16的夹持构件42。中间管24的上表面限定细长的纵向槽38。可如下面另外详细描述的那样致动驱动机构40，以使中间管24在外管22内前进，以使夹持构件42在工具组件16内前进。
内缆26延伸穿过中间管24，并且包括近侧端部部分46(图3)和远侧端部部分48。内缆26的近侧端部部分46延伸穿过腔18a内的中间管24中的槽38，并且联接到壳体组件12的主体18。内缆26的远侧端部固定地联接到工具组件16。中间管24可在外管22内围绕并且沿内缆26移动，如下面另外详细描述的。
在本公开的各方面，外管22和中间管24以及内缆26中的每一个分别由柔性材料形成。在本公开的一些方面，外管22和中间管24以及内缆26中的一个或全部由例如由不锈钢形成的绞合线缆形成。还设想，外管22和中间管24以及内缆26中的一个或全部可由包括合成聚合物、尼龙、钨等的其它材料形成。在本公开的一些方面，内缆26由钨形成以增加强度。
图3-5说明壳体组件12，其包括主体18、驱动机构40和内缆张紧机构50。主体18包括主体部分52和近侧盖54。主体部分52限定腔18a(图5)，并且包括远侧壁56、上壁58、侧壁60和底壁62。远侧壁56限定第一孔64、第二孔66和第三孔68。在本公开的某些方面，第一孔64为阶梯状的并且接收外管22的近侧端部部分28。据设想，可使用包括焊接、粘合等的各种固定技术中的任一种将外管22固定在主体18的远侧壁56的第一孔64内。第二孔66为螺纹的并且接收张紧机构50，如下面详细描述的。
近侧盖54固定到主体18的近侧部分，并且包括第一孔70和第二孔72。近侧盖54的第一孔70接收钉合装置10的驱动机构40的导螺杆76，并且近侧盖54的第二孔72接收螺栓78。螺栓78延伸穿过第二孔72，并且拧入形成在壳体组件12的主体18的近侧部分中的螺纹孔80(图5)中，以将近侧盖54固定到壳体组件12的主体18的主体部分52。
驱动机构40包括导螺杆76、驱动螺母84和驱动器插入件86。驱动螺母84限定螺纹孔88和通孔90。螺纹孔90接收导螺杆76，使得导螺杆76的旋转引起驱动螺母84在壳体组件12的主体18的腔18a内在缩回位置和前进位置之间纵向移动。导螺杆76的近侧端部包括环形凸缘92，并且支撑在壳体组件12的主体部分52内的间隔开的轴承94上。间隔开的轴承94中的一个定位在环形凸缘92的每一侧上，以支撑导螺杆76在壳体组件12的主体18的腔18a内旋转。
中间管24的近侧端部部分34限定螺纹的盲孔96(图5)。驱动螺母84通过延伸穿过驱动螺母84的孔90并且进入中间管24的螺纹孔96中的螺纹螺栓98联接到中间管24的近侧端部部分34。驱动器插入件86为管状的，并且围绕中间管24的近侧端部部分34接收在驱动螺母84的孔90内。驱动器插入件86在中间管24和螺纹螺栓98之间的螺纹连接区域中为中间管24的近侧端部部分34提供刚性和支撑。通过将中间管24的近侧端部部分34联接到驱动螺母84，驱动螺母84在壳体组件12的主体18的腔18a内的纵向移动引起中间管24在腔18a内的对应纵向移动，以使中间管24在外管22内沿内缆26移动。
内缆张紧机构50包括轴100和支撑在轴100上用于纵向移动的转向器102。在本公开的各方面，轴100包括螺纹螺杆100，并且转向器102包括具有限定螺纹孔106的近侧端部部分和限定弯曲表面108的远侧端部部分的主体104。在本公开的某些方面，弯曲表面108在约180度的弧上延伸，尽管可设想其它曲率度。螺纹螺杆100包括接收在壳体组件12的主体18的第二孔66内的近侧部分和支撑转向器102的远侧部分。螺纹螺杆100可在壳体组件12的主体18的第二孔66内旋转，以调节转向器102在壳体组件12的主体18的腔18a内的纵向位置。
如上所述，内缆26包括固定地固定到壳体组件12的主体18的近侧端部部分46。在本公开的某些方面，内缆26的近侧端部部分46从工具组件16分别向近侧延伸穿过外管22和中间管24，并且穿过壳体组件12的主体18的远侧壁56中的第一孔64并且进入腔18a。在壳体组件12的主体18的腔18a内，内缆26向近侧延伸，并且穿过限定在中间管24中的纵向槽38离开中间管24。在内缆26离开槽38之后，内缆26缠绕在转向器102周围，使得内缆26的近侧端部部分46向远侧重定向，并且联接到主体18的远侧壁56。在本公开的各方面，内缆26的近侧端部部分46延伸穿过主体18的远侧壁56中的孔68，以将内缆26固定到主体18。主体18可包括细长的槽，例如槽103，以适应内缆26的重定向。据设想，内缆26可使用各种固定技术在各种不同的位置处固定到壳体组件12的主体18。
内缆张紧机构50用于在制造工艺期间设定内缆26中的期望张力。在这方面，螺杆100的远侧端部可适于接收工具，例如螺杆驱动器、内六角扳手等，以调节螺杆100和转向器102在壳体组件12的主体18的腔18a内的位置。由于近侧端部部分46和远侧端部部分48分别固定地固定到壳体组件12和工具组件16，因此调节转向器102在腔18a内的位置增加或减小内缆26中的张力。
图6和7说明包括砧座组件110、仓组件112和枢转壳体114的工具组件16。简而言之，砧座组件110包括砧座主体116和砧座板118，它们固定在一起以在砧座组件110内限定通道120。砧座板118限定中心刀槽122，其延伸穿过砧座板118的组织夹持表面124(图7)并且与通道120连通。
仓组件112包括通道124和接收在通道124内的钉仓126。钉仓组件126包括仓主体128、钉130、推动器132、致动滑板和刀组件134以及下盖136。仓主体136限定成排的钉接收凹座140(图6)和与形成在砧座板118中的刀槽122对准的中心刀槽142(图6)。钉130和推动器132被支撑在推动器132中的相应一个上的仓主体128的钉接收凹座140内。致动滑板和刀组件134包括致动滑板134a和可枢转的刀134b。致动滑板134a包括当致动滑板134a被驱动穿过仓主体128以从仓主体136驱动钉130时接合推动器132的凸轮表面。当致动滑板134a被驱动穿过仓主体136以切割夹持在砧座组件110和仓组件112之间的组织时，刀134b被支撑在致动滑板134a上，并且分别平移穿过仓主体128和通道124中的刀槽122、142。据设想，刀134b可为静止的并且支撑在夹持构件42上。对于致动滑板和刀组件134的操作的更详细描述，参见例如美国专利第8,973,805号(“'805专利”)。
砧座组件110和仓组件112通过枢转构件150(图6)联接到枢转壳体114。枢转构件150允许仓组件112相对于砧座组件110在打开位置(图7)和夹持位置(图9)之间枢转。在本公开的各方面，偏置构件154(图6)将工具组件16朝打开位置推动。据设想，工具组件16还可包括朝固定的仓组件112枢转的砧座组件110，或者朝彼此枢转的砧座组件和仓组件。
夹持构件42支撑在工具组件16上并且与致动滑板134a对准。夹持构件42包括定位成接合砧座组件110的上梁42a和定位成接合仓组件112的通道124的下梁42b。夹持构件42可响应于中间管24的前进而在工具组件16内从缩回位置移动到前进位置，如下面另外详细描述的。当夹持构件42移动穿过工具组件16时，工具组件16从打开位置移动到夹持位置，并且随后接合致动滑板134a并且使其前进穿过仓主体128以从钉仓主体128中弹出钉130。对于夹持构件42的操作的更详细描述，参见'805专利。
仓组件112的通道124包括限定开口162的远侧上翻凸缘160(图6)。内缆26的远侧端部部分48沿通道124延伸穿过钉仓主体128，并且固定地接收在开口162内，以将内缆26固定到通道124。可替代地，据设想，内缆26的远侧部分可使用各种不同的固定技术在各种不同的位置处固定到通道124。
外管22的远侧端部部分30例如通过焊接等固定地固定到枢转壳体114的近侧面168。中间管24延伸穿过外管22并且例如通过焊接等固定到夹持构件42的近侧表面170。在本公开的一些方面，夹持构件42的近侧面170限定圆形凹部172，其接收中间管24的远侧端部部分36以将中间管26更牢固地紧固到夹持构件42。
尽管本文没有描述，但是壳体组件12的近侧端部适于并且被配置成接合能够选择性地旋转壳体组件12的导螺杆76的致动器(未示出)。致动器(未示出)可呈手持式动力手持件的形式或呈机器人装置的形式。
图8和9说明当钉合装置10从打开位置移动到夹持位置时的钉合装置10。当通过在由图8中的箭头“A”指示的方向上旋转导螺杆76来致动钉合装置10时，导螺杆76上的螺纹和驱动螺母84的螺纹孔88内的螺纹之间的接合引起驱动螺母84在壳体组件12的主体18的腔18a内在箭头“B的方向上纵向移动。应注意，通过主体18的壁防止驱动螺母84在壳体组件12的主体18的腔18a内旋转。当驱动螺母84在壳体组件12的主体18内移动时，固定地联接到驱动螺母84的中间管24在外管22内围绕内管26前进。中间管围绕内缆22向远侧的移动在工具组件16上在远侧方向上施加力，这使内缆26处于张紧状态。如上所述，内缆26固定地联接到壳体组件12和工具组件16两者，以防止工具组件16相对于壳体组件12向远侧移动。当中间管24在外管22内向远侧移动时，固定地联接到中间管24的远侧端部部分36的夹持构件42在工具组件16内在由图9中的箭头“D”指示的方向上向远侧移动。中间管24围绕内缆26并且在外管22内的定位为中间管24提供稳定性，以防止中间管24屈曲。
当夹持构件42从其在工具组件16内的缩回位置朝其前进位置移动时，夹持构件42的上梁42a和下梁42b分别接合砧座组件110和仓组件112，以使仓组件112相对于砧座组件110在图9中的箭头“D”的方向上枢转，以将工具组件16从打开位置移动到夹持位置。
图10和11说明当钉合装置10被击发时的钉合装置10。为了击发钉合装置10，导螺杆76再次在图10中的箭头“A”的方向上旋转，以使驱动螺母84在壳体组件12的主体18内在图10中的箭头“C”的方向上另外向远侧前进。当驱动螺母84在壳体组件12的主体18内继续前进时，中间管24在外管22内沿内缆26在图10和11中的箭头“D”的方向上继续前进。当中间管24前进穿过工具组件16时，夹持构件42穿过工具组件16移动成与致动滑板134a接合以使致动滑板134a前进穿过工具组件16。当致动滑板134a移动穿过工具组件16时，致动滑板134接合推动器132(图6)，以将钉130从仓组件112的仓主体128驱动到砧座组件110中。如上所述，可枢转的刀134b联接到致动滑板134a。由此，可枢转的刀134b与致动滑板134a一起向远侧移动穿过工具组件16。如本领域中已知的，刀134b分别移动穿过砧座板118和仓主体128中的刀槽122、142以切割夹持在砧座组件110和仓组件112之间的组织。
图12和13说明在工具组件16已经被击发之后当夹持构件42从其前进位置朝其缩回位置向后移动时的钉合装置10。为了使夹持构件42缩回，导螺杆76在与由图10中的箭头“A”所示的方向相反的方向上，即，在由图12中的箭头“E”指示的方向上旋转。当导螺杆76在由箭头“E”指示的方向上旋转时，驱动螺母84在壳体组件12内在由图12和13中的箭头“F”指示的方向上向近侧移动。当驱动螺母84在壳体组件12内向近侧移动时，中间管24在外管22内围绕内缆26向近侧拉动，以在工具组件16内在由图13中的箭头“G”指示的方向上向近侧拉动夹持构件42。当中间管24在外管22内向近侧移动并且在工具组件16内向近侧拉动夹持构件42时，向近侧指向的力被施加到工具组件16，这使外管22处于压缩状态。
本领域技术人员将理解，在本文中特定地描述并且在附图中说明的钉合装置和方法为本公开的非限制性的示例性方面。据设想，在不脱离本公开的范围的情况下，结合本公开的某些方面说明或描述的元件和特征可与本公开的其它方面的元件和特征组合。此外，本领域技术人员将基于本公开的上述方面了解本公开的另外的特征和优点。因此，除了由所附权利要求指示之外，本公开不受已经特别示出和描述的内容的限制。

Claims (20)

1.一种手术钉合装置，其包含：
壳体组件，所述壳体组件包括限定腔的主体和定位在所述腔内的驱动机构；
细长主体，所述细长主体包括外管、延伸穿过所述外管的中间管和延伸穿过所述中间管的内缆，所述外管、中间管和内缆由柔性材料形成；和
工具组件，所述工具组件包括砧座组件、仓组件和夹持构件，所述仓组件能够相对于所述砧座组件在打开位置和夹持位置之间移动并且包括仓主体和多个钉，所述仓主体限定多个钉接收槽，所述钉接收槽中的每一个接收所述多个钉中的一个，所述夹持构件能够在所述工具组件内从缩回位置移动到前进位置以从所述仓主体中弹出所述多个钉；
所述内缆包括固定地联接到所述壳体组件的所述主体的近侧端部部分和固定地联接到所述工具组件的远侧端部部分，所述中间管包括联接到所述驱动机构的近侧端部部分和联接到所述夹持构件的远侧端部部分，并且所述外管具有联接到所述壳体组件的所述主体的近侧端部部分和联接到所述工具组件的远侧端部部分；
其中所述驱动机构能够致动以使所述中间管在所述外管内沿所述内缆前进，以使所述夹持构件在所述夹持构件的缩回位置和前进位置之间前进。
2.根据权利要求1所述的手术钉合装置，其中所述驱动机构包括驱动螺母，所述驱动螺母能够在所述壳体组件的所述主体的所述腔内在缩回位置和前进位置之间移动，所述中间管的所述近侧端部部分联接到所述驱动螺母。
3.根据权利要求2所述的手术钉合装置，其中所述驱动机构包括能够旋转地支撑在所述腔内的导螺杆，所述导螺杆与所述驱动螺母能够操作地接合。
4.根据权利要求3所述的手术钉合装置，其中所述驱动螺母限定螺纹孔，所述导螺杆延伸穿过所述螺纹孔并且能够旋转以使所述驱动螺母在所述驱动螺母的缩回位置和前进位置之间移动。
5.根据权利要求1所述的手术钉合装置，其另外包括内缆张紧机构，所述内缆张紧机构包括所述壳体组件的所述主体的所述腔内的轴和支撑在所述轴上的转向器，所述内缆围绕所述转向器缠绕。
6.根据权利要求5所述的手术钉合装置，其中所述轴包括螺纹螺杆，并且所述壳体组件的所述主体限定螺纹孔，所述螺纹螺杆接收在所述壳体组件的所述主体的所述螺纹孔内并且能够旋转以调节所述转向器在所述壳体内的位置以调节所述内缆的张力。
7.根据权利要求6所述的手术钉合装置，其中所述转向器包括限定弯曲表面的远侧端部部分，所述内缆沿所述转向器的所述弯曲表面延伸。
8.根据权利要求7所述的手术钉合装置，其中所述中间管限定定位在所述壳体组件的所述主体的所述腔内的纵向槽，所述内缆延伸穿过所述中间管的所述纵向槽并且围绕所述转向器。
9.根据权利要求1所述的手术钉合装置，其中所述仓组件包括致动滑板，所述致动滑板在所述仓主体内能够响应于所述夹持构件从所述夹持构件的缩回位置到所述夹持构件的前进位置的移动而从缩回位置移动到前进位置以从所述仓主体中弹出所述多个钉。
10.根据权利要求9所述的手术钉合装置，其中所述仓组件包括刀，所述刀能够响应于所述夹持构件从所述夹持构件的缩回位置到所述夹持构件的前进位置的移动而从缩回位置移动到前进位置以切割夹持在所述砧座组件和仓组件之间的组织。
11.一种手术钉合装置，其包含：
壳体组件，所述壳体组件包括限定腔的主体和定位在所述腔内的驱动机构；
细长主体，所述细长主体包括外管、延伸穿过所述外管的中间管和延伸穿过所述中间管的内缆，所述外管、中间管和内缆由柔性材料形成；和
工具组件，所述工具组件支撑在包括操作构件的所述细长主体上；
所述内缆包括固定地联接到所述壳体组件的所述主体的近侧端部部分和固定地联接到所述工具组件的远侧端部部分，所述中间管包括联接到所述驱动机构的近侧端部部分和联接到所述操作构件的远侧端部部分，并且所述外管具有联接到所述壳体组件的所述主体的近侧端部部分和联接到所述工具组件的远侧端部部分；和
内缆张紧机构，所述内缆张紧机构包括所述壳体组件的所述主体的所述腔内的轴和支撑在所述轴上的转向器，所述内缆围绕所述转向器缠绕；
其中所述驱动机构能够致动以使所述中间管在所述外管内沿所述内缆前进，以使所述操作构件在所述操作构件的缩回位置和前进位置之间前进。
12.根据权利要求11所述的手术钉合装置，其中所述工具组件另外包括砧座组件和仓组件，并且所述操作构件包括夹持构件，所述仓组件能够相对于所述砧座组件在打开位置和夹持位置之间移动并且包括仓主体和多个钉，所述仓主体限定多个钉接收槽，所述钉接收槽中的每一个接收所述多个钉中的一个，所述夹持构件能够在所述工具组件内从缩回位置移动到前进位置以从所述仓主体中弹出所述多个钉。
13.根据权利要求11所述的手术钉合装置，其中所述驱动机构包括驱动螺母，所述驱动螺母能够在所述壳体组件的所述主体的所述腔内在缩回位置和前进位置之间移动，所述中间管的所述近侧端部部分联接到所述驱动螺母。
14.根据权利要求13所述的手术钉合装置，其中所述驱动螺母限定螺纹孔，导螺杆延伸穿过所述螺纹孔并且能够旋转以使所述驱动螺母在所述驱动螺母的缩回位置和前进位置之间移动。
15.根据权利要求14所述的手术钉合装置，其中所述轴包括螺纹螺杆，并且所述壳体组件的所述主体限定螺纹孔，所述螺纹螺杆接收在所述壳体组件的所述主体的所述螺纹孔内并且能够旋转以调节所述转向器在所述壳体内的位置以调节所述内缆的张力。
16.根据权利要求15所述的手术钉合装置，其中所述转向器包括限定弯曲表面的远侧端部部分，所述内缆沿所述转向器的所述弯曲表面延伸。
17.根据权利要求16所述的手术钉合装置，其中所述中间管限定定位在所述壳体组件的所述主体的所述腔内的纵向槽，所述内缆延伸穿过所述中间管的所述纵向槽并且围绕所述转向器。
18.一种手术钉合装置，其包含：
壳体，所述壳体支撑驱动机构；
细长主体，所述细长主体包括外管、延伸穿过所述外管的中间管和延伸穿过所述中间管的内缆，所述外管、中间管和内缆由柔性材料形成；和
工具组件，所述工具组件包括砧座组件、仓组件和夹持构件，所述仓组件能够相对于所述砧座组件在打开位置和夹持位置之间移动并且包括仓主体和多个钉，所述仓主体限定多个钉接收槽，所述钉接收槽中的每一个接收所述多个钉中的一个，所述夹持构件能够在所述工具组件内从缩回位置移动到前进位置以从所述仓主体中弹出所述多个钉；
所述内缆包括固定地联接到所述壳体组件的所述主体的近侧端部部分和固定地联接到所述工具组件的远侧端部部分，所述中间管包括联接到所述驱动机构的近侧端部部分和联接到所述夹持构件的远侧端部部分，并且所述外管具有联接到所述壳体组件的所述主体的近侧端部部分和联接到所述工具组件的远侧端部部分；
其中所述驱动机构能够致动以使所述中间管在所述外管内沿所述内缆前进，以使所述夹持构件在所述夹持构件的缩回位置和前进位置之间前进。
19.根据权利要求18所述的手术钉合装置，其另外包括支撑在所述壳体上的内缆张紧机构，所述内缆张紧机构包括螺纹螺杆和支撑在所述螺纹螺杆上的转向器，所述内缆围绕所述转向器缠绕，所述壳体限定螺纹孔，所述螺纹螺杆接收在所述壳体组件的所述主体的所述螺纹孔内，并且能够旋转以调节所述转向器在所述壳体内的位置，以调节所述内缆的张力。
20.根据权利要求19所述的手术钉合装置，其中所述驱动机构包括驱动螺母，所述驱动螺母能够沿所述壳体组件在缩回位置和前进位置之间移动，所述中间管的所述近侧端部部分联接到所述驱动螺母。
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US11109862B2 (en) 2021-09-07
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