CN114533227A - 整合了抽吸的组织移除手持件 - Google Patents

整合了抽吸的组织移除手持件 Download PDF

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CN114533227A
CN114533227A CN202111373069.5A CN202111373069A CN114533227A CN 114533227 A CN114533227 A CN 114533227A CN 202111373069 A CN202111373069 A CN 202111373069A CN 114533227 A CN114533227 A CN 114533227A
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N·D·贝格
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Abstract

一种用于移除组织的外科手持件包含在其中限定腔的壳体，所述壳体具有设置在其远端的近侧毂连接器。端部执行器组合件由所述近侧毂连接器可操作地支撑并且包含支撑切割轴的外轴，所述切割轴被配置成在其启动时通过平移或旋转移除组织。流体泵设置在所述壳体的所述腔内并且被配置成在其启动时从所述切割轴排出流体。马达设置在所述壳体的所述腔内并且包含功率耦合器，所述功率耦合器可操作地耦合到所述切割轴和所述流体泵以向其供应电力。

Description

整合了抽吸的组织移除手持件
技术领域
本公开总体上涉及外科系统，并且更具体地说，涉及用于宫腔镜外科手术的流出收集容器、系统及其部件。
背景技术
如宫腔镜外科手术等外科手术可以通过将内窥镜插入子宫并使组织切除装置穿过内窥镜并进入子宫而在如子宫等器官内通过内窥镜进行。对于这种宫腔镜组织切除手术，通常令人期望的是，用例如盐水、山梨糖醇或甘氨酸等流体来扩张子宫。手术过程中流体的流入和流出使子宫保持在扩张状态，并冲洗子宫内的组织和其它碎屑以保持可见的工作空间。流出流体由收集系统收集。
发明内容
如本文所使用的，术语“远侧”是指所描述的距用户更远的部分，而术语“近侧”是指所描述的距用户更近的部分。进一步地，在一致的程度上，本文中所描述的方面的任何或所有方面可以与本文中所描述的其它方面的任何或所有结合使用。
根据本公开的方面提供了一种用于移除组织的外科手持件，所述手持件包含在其中限定腔的壳体。所述壳体包含设置在其远端的近侧毂连接器。端部执行器组合件由所述近侧毂连接器可操作地支撑并且包含支撑切割轴的外轴，所述切割轴被配置成在其启动时通过其中的平移或旋转移除组织。流体泵设置在所述壳体的所述腔内并且被配置成在其启动时从所述切割轴排出流体。马达设置在所述壳体的所述腔内并且包含功率耦合器，所述功率耦合器可操作地耦合到所述切割轴和所述流体泵以向其供应电力。
在根据本公开的方面中，所述流体泵包含限定在其中的通路，所述通路被配置成可操作地连接到所述端部执行器组合件以从所述切割轴排出流体和组织。在根据本公开的其它方面中，所述流体泵是蠕动泵。
在根据本公开的方面中，所述端部执行器可移除地接合到所述近侧毂连接器。在根据本公开的其它方面中，所述流体泵可移除地接合到所述壳体。仍在根据本公开的其它方面中，所述端部执行器和所述流体泵可移除地接合到所述壳体。又在根据本公开的其它方面中，所述流体泵与所述壳体是一体的。
在根据本公开的方面中，所述切割轴可操作地耦合到输入耦合器，所述输入耦合器进而可操作地耦合到与所述马达电耦合的输出耦合器。
在根据本公开的方面中，所述外科手持件是组织切除器械。
根据本公开的方面提供了一种用于移除组织的外科手持件，所述手持件包含在其中限定腔的壳体。所述壳体包含设置在其远端的近侧毂连接器。端部执行器组合件由所述近侧毂连接器可操作地支撑并且包含支撑切割轴的外轴，所述切割轴被配置成在其启动时通过其中的平移或旋转移除组织。流体泵设置在所述壳体的所述腔内并且被配置成在其启动时从所述切割轴排出流体。第一马达设置在所述壳体的所述腔内并且包含输出耦合器，所述输出耦合器可操作地耦合到所述切割轴以向其供应电力。第二马达设置在所述壳体的所述腔内并且可操作地耦合到所述流体泵以向其供应电力。
在根据本公开的方面中，所述外科手持件是组织切除器械。
在根据本公开的方面中，所述第一马达和所述第二马达可独立被启动。在根据本公开的其它方面中，所述第一马达和所述第二马达被配置成与控制台协作以在使用期间调节功率。
在根据本公开的方面中，所述流体泵是蠕动泵。
在根据本公开的方面中，所述端部执行器可移除地接合到所述近侧毂连接器。在根据本公开的其它方面中，所述流体泵可移除地接合到所述壳体。仍在根据本公开的其它方面中，所述端部执行器和所述流体泵可移除地接合到所述壳体。又在根据本公开的其它方面中，所述流体泵与所述壳体是一体的。
附图说明
下面参照附图描述本公开的各个方面和特征，其中相同的编号在若干视图中的每一个视图中指定相同或对应元件。
图1是被配置用于宫腔镜外科手术的外科系统的透视图；
图2是与图1所示系统一起使用的外科手持件的侧视示意图；并且
图3是与图1所示系统一起使用的外科手持件的另一个实施例的侧视示意图。
具体实施方式
参考图1，根据本公开的方面提供的外科系统总体上由附图标记100标识示出。外科系统100包含外科器械110、控制台130和收集容器150。外科系统100进一步包含电缆170、流出管180和真空管190。外科系统100可以进一步包含内窥镜(未示出)，例如，宫腔镜，其限定用于穿过其中插入外科器械110的工作通道，并适于连接到流入管(未示出)以将流体供应到内部外科位点和/或连接到额外的流出管(未示出)以将流体返回到收集容器150。
外科器械110包含可被配置为可重复使用的部件的手持件112和可被配置为单次使用的一次性部件的端部执行器组合件114。手持件112包含壳体116以有利于用户抓握和操纵外科器械110。手持件112进一步包含被配置成可操作地接合端部执行器组合件114的输出耦合器118、设置在壳体116内并且可操作地耦合到输出耦合器118以驱动输出耦合器118并因此驱动端部执行器组合件114的马达120。电缆170将手持件112和控制台130彼此电耦合，更具体地说，将控制台130与马达120电耦合以向马达120供电并控制马达的操作，并且将控制台130与例如微芯片(未明确示出)等与手持件112和/或端部执行器组合件114相关联的存储装置电耦合，以实现例如识别、设置和控制信息之间的通信。在实施例中，电缆170固定地附接到手持件112并且可释放地与控制台130耦合，但是也可以设想其它配置。
继续参考图1，端部执行器组合件114包含近侧毂124，所述近侧毂被配置成可释放地接合手持件112的壳体116以将端部执行器组合件114与手持件112可释放地机械接合。端部执行器组合件114进一步包含从近侧毂124向远侧延伸的外轴126和延伸穿过外轴126的切割轴128。切割轴128的近端延伸到近侧毂124中，其中输入耦合器129与切割轴128接合。输入耦合器129被配置成当近侧毂124与壳体116接合时可操作地耦合到手持件112的输出耦合器118，使得当马达120被启动以驱动输出耦合器118时，输入耦合器129以相应的方式被驱动从而在外轴126内并相对于所述外轴移动切割轴128。
如上所述，外轴126从近侧毂124向远侧延伸，并且在实施例中，其相对于近侧毂124是固定的，但是也可以设想其它配置。外轴126可以限定穿过其侧壁朝向其远端的窗口(未示出)，以提供通向可旋转和/或可平移地设置在外轴126内的切割轴128的入口。切割轴128可以限定朝向其远端的开口(未示出)，从而提供通向其内部的入口，并且可以包含围绕开口的锯齿状切削刃(未示出)，但是也可以设想其它合适的切削刃配置。可替代地或另外地，外轴126可以包含围绕其窗口限定的切削刃。
如上所述，马达120被启动以移动切割轴128，并且更具体地说，驱动切割轴128相对于外轴126的旋转和/或平移。通过电缆170耦合到马达120的控制台130实现对马达120的选择性供电和控制，并且因此，实现切割轴128相对于外轴126的选择性旋转和/或平移以切除邻近端部执行器组合件114的远端的组织。控制台130在下文中详述。
流出管180包含被配置成可释放地耦合到手持件112的远端184和被配置成耦合到收集容器150的近端186。更具体地说，手持件112限定了内部通道(未示出)，所述内部通道将流出管180的远端184与与切割轴128的内部流体连通的切割轴128的内部耦合，使得流体、组织和碎屑被吸入切割轴128中和/或外轴126可以在真空下被抽吸，例如从控制台130的真空泵139，通过端部执行器组合件114、手持件112和流出管180到达收集容器150。
仍然参考图1，如上所述，收集容器150耦合到流出管180的近端186以接收通过端部执行器组合件114和流出管180抽吸的流体、组织和碎屑。真空管190耦合在收集容器150和真空源(例如，控制台130的真空泵139)之间，使得在真空泵139启动时，通过收集容器150、流出管180和端部执行器组合件114的切割轴128的内部建立负压以将流体、组织和碎屑吸入并通过切割轴128、手持件112、流出管180，并进入收集容器150。
控制台130通常包含外壳体132、可从外壳体132的外部访问的触摸屏显示器134、被配置成接收电缆170的电缆端口136、被配置成接收真空管190的真空管端口138、以及设置在外壳体132内并与真空端口138可操作地耦合的真空泵139。外壳体132进一步容纳控制台130的内部电子设备(未示出)。控制台130可以被配置成连接到主电源(未示出)，用于为控制台130供电。进一步地，控制台130可以被配置成通过触摸屏显示器134或耦合到控制台130的外围输入装置(未示出)接收用户输入，例如，使用信息、设置选择等。操作输入，例如，开/关信号、功率电平设置(高功率对比低功率)等，同样可以通过触摸屏显示器134或如例如脚踏开关(未示出)、设置在手持件112上的手动开关(未示出)等外围输入装置(未示出)输入。
在使用中，在向控制台130提供启动输入时，控制台130为手持件112的马达120供电并控制所述马达，以进而驱动端部执行器组合件114的切割轴128以切除邻近端部执行器组合件114的远端的组织，同时控制台130的真空泵139通过切割轴128、手持件112、流出管180抽吸流体、切除的组织和碎屑，并使其进入收集容器150。
收集容器150可以限定各种不同的配置和/或可以与各种不同的部件一起使用以限定收集系统。此类收集容器和系统是根据本公开提供的，并在下文中参考共有美国专利申请序列号16/593,432进行详述，所述美国专利申请的全部内容通过引用并入本文。作为与外科系统100一起使用的替代方案，本公开的收集容器和系统可用于任何其它合适的外科系统内。
参考图2，示出了外科手持件212的另一个实施例，并且所述实施例包含与上述元件相似的元件，因此，将仅详细描述对于描述手持件112和手持件212之间的差异所必需的元件。外科手持件212可以与端部执行器组合件214一起被配置为可重复使用的部件，所述端部执行器组合件可被配置为单次使用的或一次性的部件。手持件212包含壳体216以有利于用户抓握和操纵它。手持件212进一步包含被配置成可操作地接合端部执行器组合件214的输出耦合器218、设置在壳体216内并且可操作地耦合到输出耦合器218以驱动输出耦合器218并因此驱动端部执行器组合件214的马达220。
电缆270将耦合274处的手持件212和控制台(例如，控制台130)彼此电耦合，并且更具体地说，将控制台130与马达220电耦合以向马达220供电并控制马达的操作，并将控制台130与一个或多个存储装置电耦合，如上文关于图1所解释的。这实现了手持件212和/或端部执行器组合件214之间的通信，例如，识别、设置和控制信息。
继续参考图2，端部执行器组合件214包含近侧毂224，所述近侧毂被配置成可释放地接合手持件212的壳体216以将端部执行器组合件214与手持件212可释放地机械接合。端部执行器组合件214进一步包含从近侧毂224向远侧延伸的外轴226和延伸穿过外轴226的切割轴228。切割轴228的近端延伸到近侧毂224中，其中输入耦合器229与切割轴228接合。输入耦合器229被配置成当近侧毂224与壳体216接合时可操作地耦合到手持件212的输出耦合器218，使得当马达220被启动以驱动输出耦合器218时，输入耦合器229以相应的方式被驱动从而在外轴226内并相对于所述外轴移动切割轴228。
如上所述，马达220被启动以移动切割轴228，并且更具体地说，驱动切割轴228相对于外轴226的旋转和/或平移。通过电缆270耦合到马达220的控制台130(图1)实现对马达220的选择性供电和控制，并且因此，实现切割轴228相对于外轴226的选择性旋转和/或平移以切除邻近端部执行器组合件214的远端的组织。在此实施例中，马达220还被配置成为设置在壳体216内的流体泵300供电。
更具体地说，流出管280包含被配置成可释放地耦合到手持件212的远端284和被配置成耦合到收集容器150(图1)的近端(未示出但类似于近端186)。手持件212可以限定内部通道(未示出)，所述内部通道将流出管280的远端284与与切割轴228的内部流体连通的切割轴228的内部耦合，使得流体、组织和碎屑被吸入切割轴228中和/或外轴226可以在真空下被抽吸，例如从流体泵300，通过端部执行器组合件214、手持件212和流出管280到达收集容器150。流出管280可以包含设置在其中的多个管(未示出)，以根据特定目的，将流体提供给切割轴228并从切割轴228抽吸。另一方面，流体可以通过限定在壳体216内的内腔215供应并且通过限定在外轴226或切割轴228的近端处的通路330被吸出。
功率耦合器250与输入耦合器229和马达220电耦合，并向输入耦合器229和流体泵300两者供应电力。以这种方式，单个马达220可用于为输入耦合器229(切割轴228)和流体泵300供电。
流体泵300可以与壳体216一体式关联或者可以以筒或类似物的形式可移除地耦合到壳体上。在实施例中，切割组合件，例如切割轴228和外轴226两者都可以与流体泵300一起可移除地接合到近侧毂224，从而使得整个单元能够相对于手持件212的其余部分是一次性的。在其它实施例中，流体泵300、切割轴228和外轴可根据特定目的单独地与手持件212分离或彼此分离。
外轴226与上述外轴126类似，并且从近侧毂224向远侧延伸，并且在实施例中，其相对于近侧毂224是固定的，但是也可以设想其它配置。外轴226可以限定穿过其侧壁朝向其远端的窗口(未示出)，以提供通向可旋转和/或可平移地设置在外轴226内的切割轴228的入口。切割轴228可以限定朝向其远端的开口(未示出)，从而提供通向其内部的入口，并且可以包含围绕开口的锯齿状切削刃(未示出)，但是也可以设想其它合适的切削刃配置。可替代地或另外地，外轴226可以包含围绕其窗口限定的切削刃。
如上所述，马达220被启动以移动切割轴228，并且更具体地说，驱动切割轴228相对于外轴226的旋转和/或平移。耦合到马达220的控制台(例如，控制台130)实现对马达220的选择性供电和控制，并且因此，实现切割轴228相对于外轴226的选择性旋转和/或平移以切除邻近端部执行器组合件214的远端的组织。控制台130在上文中详述。
当泵300和切割轴228由马达220的启动驱动时，向切割轴228施加抽吸以帮助切除和组织排空，并且流体和组织被驱动进入通路330和流出管280以由样本容器150收集。
参考图3，示出了外科手持件312的另一个实施例，并且所述实施例包含与上述元件相似的元件，因此，将仅详细描述对于描述手持件112、212和手持件312之间的差异所必需的元件。与上述手持件类似，外科手持件312可以与端部执行器组合件314一起被配置为可重复使用的部件，所述端部执行器组合件可被配置为单次使用的或一次性的部件。手持件312包含壳体316以有利于用户抓握和操纵它。手持件312进一步包含被配置成可操作地接合端部执行器组合件314的输出耦合器318、设置在壳体316内并且可操作地耦合到输出耦合器318以驱动输出耦合器318并因此驱动端部执行器组合件314的马达320a以及可操作地耦合到流体泵300的马达320b。
电缆370a将手持件312和控制台(例如，控制台130)彼此电耦合，并且更具体地说，将控制台130与马达320a电耦合以向马达320a供电并控制马达的操作，并将控制台130与一个或多个存储装置电耦合，如上文关于图1所解释的。这实现了手持件312和/或端部执行器组合件314之间的通信，例如，识别、设置和控制信息。
继续参考图3，端部执行器组合件314包含近侧毂324，所述近侧毂被配置成可释放地接合手持件312的壳体316以将端部执行器组合件314与手持件312可释放地机械接合。端部执行器组合件314进一步包含从近侧毂324向远侧延伸的外轴326和延伸穿过外轴326的切割轴328。切割轴328的近端延伸到近侧毂324中，其中输入耦合器329与切割轴328接合。输入耦合器329被配置成当近侧毂324与壳体316接合时可操作地耦合到手持件312的输出耦合器318，使得当马达320a被启动以驱动输出耦合器318时，输入耦合器329以相应的方式被驱动从而在外轴326内并相对于所述外轴移动切割轴328。
如上所述，马达320a被启动以移动切割轴328，并且更具体地说，驱动切割轴328相对于外轴326的旋转和/或平移。通过电缆370a耦合到马达320a的控制台130(图1)实现对马达320a的选择性供电和控制，并且因此，实现切割轴328相对于外轴326的选择性旋转和/或平移以切除邻近端部执行器组合件314的远端的组织。外轴326类似于上文关于图1和2所述的外轴126、226。
流出管380包含被配置成可释放地耦合到手持件212的远端384和被配置成耦合到收集容器150(图1)的近端(未示出但类似于近端186)。手持件312可以限定内部通道(未示出)，所述内部通道将流出管380的远端384与与切割轴328的内部流体连通的切割轴328的内部耦合，使得流体、组织和碎屑被吸入切割轴328中和/或外轴326可以在真空下被抽吸，例如从流体泵300，通过端部执行器组合件314、手持件312和流出管380到达收集容器150。流出管380可以包含设置在其中的多个管(未示出)，以根据特定目的，将流体提供给切割轴328并从切割轴328抽吸。另一方面，流体可以通过壳体316的内部供应并且通过限定在外轴326或切割轴328的近端处的通路330被吸出。
流体泵300可以与壳体316一体式关联或者可以以筒或类似物的形式可移除地耦合到壳体上。在实施例中，切割组合件，例如切割轴328和外轴326两者都可以与流体泵300一起可移除地接合到近侧毂324，从而使得整个单元能够相对于手持件312的其余部分是一次性的。在其它实施例中，流体泵300、切割轴328和外轴326可根据特定目的单独地与手持件312分离或彼此分离。输出管380可以与流体泵300可移除地接合。
马达320b被包含在内并且被配置成向流体泵300供应电力。马达320b可以通过电缆370b连接到相同的控制台，例如，如上所述的控制台130，或者可以连接到单独的控制台(未示出)。马达320b可被启动以控制流体泵300并且可以电耦合到马达320a以用于同时或按顺序启动，或者可以是单独的和独立启动的。
当泵300由马达320b的启动驱动并且切割轴228由马达320a的启动驱动时，向切割轴328施加抽吸以帮助切除和组织排空，并且流体和组织被驱动进入通路330和流出管380以由样本容器150收集。在根据本公开的方面中，流体泵300是蠕动泵。
虽然已经在附图中示出了本公开的若干实施例，但是本公开并不旨在受其限制，因为本公开的范围旨在如领域将允许的一样广泛并且对说明书的理解也是如此。因此，以上描述不应被解释为限制性的，而仅仅是作为特定实施例的实例。本领域的技术人员将构想在本文所附权利要求书的范围和精神范围内的其它修改。
尽管为了清楚或理解起见，已通过图解和实例方式详细地对前述公开进行了描述，但显而易见的是，可以在所附权利要求的范围内进行某些改变和修改。

Claims (18)

1.一种用于移除组织的外科手持件，其包括：
在其中限定腔的壳体，所述壳体包含设置在其远端的近侧毂连接器；
由所述近侧毂连接器可操作地支撑的端部执行器组合件，所述端部执行器组合件包含支撑切割轴的外轴，所述切割轴被配置成在其启动时通过其中的平移或旋转中的至少一种移除组织；
设置在所述壳体的所述腔内的流体泵，所述流体泵被配置成在其启动时从所述切割轴排出流体；以及
设置在所述壳体的所述腔内的马达，所述马达包含功率耦合器，所述功率耦合器可操作地耦合到所述切割轴和所述流体泵以向其供应电力。
2.根据权利要求1所述的用于移除组织的外科手持件，其中所述流体泵包含限定在其中的通路，所述通路被配置成可操作地连接到所述端部执行器组合件以从所述切割轴排出流体和组织。
3.根据权利要求1所述的用于移除组织的外科手持件，其中所述流体泵是蠕动泵。
4.根据权利要求1所述的用于移除组织的外科手持件，其中所述端部执行器可移除地接合到所述近侧毂连接器。
5.根据权利要求1所述的用于移除组织的外科手持件，其中所述流体泵可移除地接合到所述壳体。
6.根据权利要求1所述的用于移除组织的外科手持件，其中所述端部执行器和所述流体泵可移除地接合到所述壳体。
7.根据权利要求1所述的用于移除组织的外科手持件，其中所述流体泵与所述壳体是一体的。
8.根据权利要求1所述的用于移除组织的外科手持件，其中所述切割轴可操作地耦合到输入耦合器，所述输入耦合器进而可操作地耦合到与所述马达电耦合的输出耦合器。
9.根据权利要求1所述的用于移除组织的外科手持件，其中所述外科手持件是组织切除器械。
10.一种用于移除组织的外科手持件，其包括：
在其中限定腔的壳体，所述壳体包含设置在其远端的近侧毂连接器；
由所述近侧毂连接器可操作地支撑的端部执行器组合件，所述端部执行器组合件包含支撑切割轴的外轴，所述切割轴被配置成在其启动时通过其中的平移或旋转中的至少一种移除组织；
设置在所述壳体的所述腔内的流体泵，所述流体泵被配置成在其启动时从所述切割轴排出流体；
设置在所述壳体的所述腔内的第一马达，所述第一马达包含输出耦合器，所述输出耦合器可操作地耦合到所述切割轴以向其供应电力；以及
设置在所述壳体的所述腔内的第二马达，所述第二马达可操作地耦合到所述流体泵以向其供应电力。
11.根据权利要求10所述的用于移除组织的外科手持件，其中所述外科手持件是组织切除器械。
12.根据权利要求11所述的用于移除组织的外科手持件，其中所述第一马达和所述第二马达可独立被启动。
13.根据权利要求10所述的用于移除组织的外科手持件，其中所述第一马达和所述第二马达被配置成与控制台协作以在使用期间调节功率。
14.根据权利要求10所述的用于移除组织的外科手持件，其中所述流体泵是蠕动泵。
15.根据权利要求10所述的用于移除组织的外科手持件，其中所述端部执行器可移除地接合到所述近侧毂连接器。
16.根据权利要求10所述的用于移除组织的外科手持件，其中所述流体泵可移除地接合到所述壳体。
17.根据权利要求10所述的用于移除组织的外科手持件，其中所述端部执行器和所述流体泵可移除地接合到所述壳体。
18.根据权利要求10所述的用于移除组织的外科手持件，其中所述流体泵与所述壳体是一体的。
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