CN1161078C - 外科手术机头 - Google Patents

外科手术机头 Download PDF

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Publication number
CN1161078C
CN1161078C CNB971981566A CN97198156A CN1161078C CN 1161078 C CN1161078 C CN 1161078C CN B971981566 A CNB971981566 A CN B971981566A CN 97198156 A CN97198156 A CN 97198156A CN 1161078 C CN1161078 C CN 1161078C
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joint
electromagnetic coil
linear electromagnetic
head
housing
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Expired - Fee Related
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CN1231589A (zh
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约翰・约瑟夫・魏登班那
约翰·约瑟夫·魏登班那
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Bausch and Lomb Surgical Inc
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Bausch and Lomb Surgical Inc
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Abstract

本发明涉及眼科微外科手术装置,特别是涉及一外科手术机头。本发明的目的是克服现有技术中各机加工部件的尺寸偏差问题,并提高工作可靠性和耐用性。为此,本发明提出一种驱动手术器械作直线运动的机头,该手术器械与该机头连接,该机头包括一壳体,该壳体包括第一端和第二端和一从壳体第一端伸展到壳体第二端的连续侧壁;其中,该机头还包括:一装在该壳体中的线性电磁线圈;一装在壳体第一端上、与一手术器械连接的接头,该接头在线性电磁线圈的纵向轴线的一预定校正位置上固定在线性电磁线圈上;以及该壳体的第二端封闭成液密。本发明的外科手术机头主要用于眼科手术器械以及其他类型的电动外科手术器械中。

Description

外科手术机头
                      技术领域
本发明一般涉及眼科微外科手术装置,特别涉及把各种外科手术器械使用于″垂直″型眼科手术剪刀的一机头的控制装置,该机头可用一脚踏控制线性电磁线圈电动机驱动;本发明还特别涉及该机头的制造方法。
                      背景技术
现有眼科微外科手术装置包括一个或多个与一控制台连接的外科手术器械。这些器械常常用电或气驱动,而该控制台提供操纵这些器械的电控制信号或液压控制信号。该控制台通常包括若干种生成提供给外科手术器械的控制信号的可由人操纵的控制器。外科大夫常常使用一脚踏控制器遥控外科手术器械。
眼内外科手术剪刀的使用是众所周知的。尽管全世界还在广泛使用手动剪刀,但它们的缺点是,人手动作的速度和精度都很低。人们还广泛使用用电动机驱动的外科手术剪刀,电动机驱动剪刀按照驱动类型主要有两种,一种是电磁线圈驱动,另一种是直流电动机驱动或″均衡″控制。
大多数眼科手术剪刀的设计都相同,其中,从一管形″针″的端部伸出一对刀刃,一个刀刃固定,另一刀刃端部在相对于固定刀刃的一打开位置与一合上位置之间来回运动。这一来回运动用上述驱动装置之一、例如手动或电动机驱动实现。
旋转电磁线圈型或线性电磁线圈型的电动机驱动器把电动机能量受控地传给可动刀刃,从而使剪刀合上。剪刀可以是″垂直″型(轧刀,或平行刀刃型)、角形或″水平″型或其他型式,驱动器也可用来驱动剪刀以外的器械。
线性电磁线圈型驱动器生成来回运动,其中,电磁线圈通电时使得可动刀刃移动到与固定刀刃合上的位置,然后,通常使用剪刀柄中的一弹簧使可动刀刃回到打开位置。这种类型的机头的一个例子可见授予Lo等人的美国专利No.5,275,607。
电磁线圈驱动剪刀机头的特点是,由于电磁线圈活塞的快速起动,其切割动作为一快速剪断动作。因此,电磁线圈驱动型机头适用于现有轧刀型外科手术剪刀,例如由STORZ@眼科器械公司提供的手术剪刀,其商标为ERGOTEC,产品号为E8700。
与此对照,当需要更精确控制器械动作时,例如小心切割或夹断时,最好使用均衡型电动机而获得增量运动。因此,在器械为镊子或现有″水平″型眼科剪刀或其他器械(例如ERGOTEC剪刀E8500或E8600)时,可使用比方说由步进电动机提供的均衡型电动机控制。因此,本申请所述用于电磁线圈电动机的新机头可使用现有外科手术剪刀而无需改动器械。
现有均衡控制/机头的一个例子可见授予Wang等人的美国专利No.4,757,814,它用于气动切割装置。但是,该装置尽管公开为均衡型,却包括一由一可变电信号起动的线性电磁阀,该信号由一电源生成、由一电位计控制,而该电位计又受一脚踏板操纵。
制造用于外科手术器械的线性电磁线圈驱动机头时的一个难点是,在制造各部件时必然会发生尺寸偏差。这一偏差特别发生在电磁线圈活塞长度与眼科手术中所使用的外科手术器械中的驱动销长度上。各部件之间的尺寸偏差甚至会造成新器械无法工作或遭磨损或工作不正常以及过早断裂,因为驱动销与驱动活塞之间的距离不是过长就是过短。
                       发明概述
因此,本发明的目的在于提出所述电磁线圈驱动机头、包括机头的独特的接头以及新机头的装配方法,以直接解决各机加工部件的尺寸偏差问题而提供一种用于眼科手术器械的改进电磁线圈驱动机头,该机头的工作可靠性和耐用性提高。
当然,尽管特别用于眼科器械,但新机头结构也可用于其他类型的电动外科手术器械。因此,尽管结合一垂直眼科剪刀说明本发明,但新机头及其接头的使用并不受此限制。
此外,尽管本申请所述接头使用于新机头,但不难看出,结构不变或作合理、合适改动的接头也可用于其他类型的机头,甚至手动型机头。换言之,只要接头可以预定位置与一线性电磁线圈连接并与一手术器械连接,就可看成在本发明范围内。
本发明的优点之一是新机头的结构比现有机头简单,从而制造较简单和经济。此外,新机头由一与一模件式新电子控制装置连接的脚踏板控制,这在下文说明。
因此,为了实现新机头和制造方法的上述目的和优点,本发明提出一种驱动手术器械作直线运动的机头,该手术器械与该机头连接,该机头包括一壳体,该壳体包括第一端和第二端和一从壳体第一端伸展到壳体第二端的连续侧壁;其中,该机头还包括:一装在该壳体中的线性电磁线圈;一装在壳体第一端上、与一手术器械连接的接头,该接头在线性电磁线圈的纵向轴线的一预定校正位置上固定在线性电磁线圈上;以及该壳体的第二端封闭成液密。
本发明还涉及一把手术器械连接到一线性电磁线圈上的接头,该接头位于该线性电磁线圈纵向轴线的预定位置上,其中,该接头装在该线性电磁线圈上,并包括把该接头可脱开地连接到一手术器械上的结构、把接头可调节地装到线性电磁线圈上的结构以及以预定位置把接头固定在线性电磁线圈上的装置。
本发明还涉及一种制造由一线性电磁线圈驱动的手术器械的机头的方法。该方法包括为该机头制作一接头组件,为此,a)把一滑动配合密封和一压入配合垫圈装入一接头中,b)把一线性电磁线圈的前端可调节地插入该接头,c)把该线性电磁线圈的活塞插入该接头的后端,d)把线性电磁线圈的活塞固定在接头中该插入位置,e)校正线性电磁线圈与接头的纵向相对位置,该纵向位置必须能使线性电磁线圈的活塞正确推动一与该接头连接的手术器械的驱动销,以及f)把线性电磁线圈固定在该纵向校正位置上。
本发明的上述和其他目的的一部分一眼就可看出,一部分在下文说明。
                    附图的简要说明
图1为用于眼科微外科手术器械的微外科手术控制装置的立体图,包括多个使用本发明种种机头的控制模件;
图2为即将完成装配的本发明剪刀机头的侧视图;
图3为图2机头的一接头的侧视图;
图4为图3接头的俯视图;
图5为图3接头的仰视图;
图5A为图2机头的接头为看得清楚起见放大的侧视图;以虚线示出内部轮廓;
图6为图2机头的分解侧视图,为简明起见未示出剪刀;
图7为图6中7-7线方向上的视图,示出机头的内部情况和电力线的互连,为简明起见引线甩向一边;
图8为图2机头的一尾件的放大立体图;
图9为图2机头的接头和电磁线圈组件的放大侧视图,用虚线示出未受驱动的电磁线圈活塞的位置。
                    具体实施方式
参见各附图,其中相同部件用同一标号表示,图1示出本发明一优选实施例的微外科手术控制装置1。如图所示,装置1包括一具有一显示平板5的计算机3、一内装多个模件13的基座7和周边设备例如一脚控组件15和一机动静脉(IV)杆组件17(各机动静脉杆组件各用其标号表示)。装在基座7中的每一模件13控制至少一个眼科微外科手术器械19,眼科大夫在进行不同眼科手术操作时使用这些器械。
如所公知,眼科手术中使用若干具有不同作用的器械19。这些器械19包括玻璃体摘除刀、晶状体摘除机头、电动微剪刀、光纤照明器具、促凝机头和其他公知微手术器械。为使这些器械在手术中性能最佳,其工作参数比方说视所进行的特别操作、该操作的不同步骤、外科大夫的个人爱好的不同而不同,不管该操作是在病人眼睛的前部还是后部进行。
如图1所示,装置1支撑在一器械车21上。最好是,该器械车21包括一手术盘25、自动静脉杆组件17、一收藏控制组件15的储藏室27、一次性填塞物和其他物品、一内装一扩展基座(图1中未示出)的开口33以及自位轮35。基座7和计算机3最好如图1所示置于器械车21的顶面上,手术盘25装在一最好装在器械车21顶面上的铰接臂(未示出)上而位于基座7的正下方。器械车21上还有一用来遥控装置1的遥控发射机39。
基座7中的模件13中装有各微外科手术器械19的控制电路,从而该装置的用户可把装置1配置成最适合于外科大夫使用。模件13有供一个或多个微外科手术器械19连接其上的插口,其中有控制连接其上的器械19所需的控制电路。因此,用户把所需模件13插入基座17中后根据外科大夫的要求配置装置1,以便控制进行手术操作所需的各器械19或使装置1最适合于外科大夫使用。
下面参见图2-9,首先参见图2和6,1810示出本发明一机头。该机头1810最好使用于一模件13,特别是剪刀模件3,该剪刀模件的详情见本申请的共同悬而未决申请(该申请的内容引用在此,作为本发明的一部分)。机头1810基本上由一中部壳体1812构成,一接头1814连接在壳体1812的前端上,一尾件1816连接在壳体1812的后端上。在本说明书中″前端″指接头1810与一手术器械连接的一端,″后端″指机头经一电缆1820与一控制装置连接的一端。
壳体1812最好如图所示呈细长圆柱形,但也可呈其他形状,只要便于用手(或用作手的机器人握持装置)握持,其中装有线性电磁线圈电动机,该壳体与下文说明的尾件1816和接头1814连接(最好是压入配合)。
尾件1816最好是用不锈钢制成的整件。但也可使用其他材料和结构。尾件的横截面通常呈圆形,以便与壳体1812的后端密封配合。但如壳体的横截面形状改变,尾件也应相应改变,以确保这两个部件之间可靠液密。
图8放大图所示优选尾件1816有一管形伸长部1822,其上连接一电缆应变消除件1818(见图2和6),该电缆应变消除件向后伸展,保护套在其中的一普通电缆1820(与上述控制模件13连接)不受由机头1810正常使用过程中扭曲、拉动和弯曲造成的应变和应力的影响。电缆应变消除件1818最好用硅酮或其他塑性材料制成,它结实但稍有柔性,最好模制在伸长部1822上或制成套管套在伸长部1822上,以便于清洗。
尾件1816的伸长部1822与中间部1824相接,其前端有一抵靠壳体1812的环形开口后端的凸缘1826。从凸缘1826向前伸出一圆柱形插入部1828,其大小足以压入壳体1812的后端1832中。
尾件1816的插入部1828上有一供一普通O形环(未示出)紧套其中的环形凹槽1830,从而进一步确保与壳体1812后端内壁的液密密封。只要能封闭壳体1812的后端(电力线端),同时能消除电缆1820所受应变,尾件1818当然也可使用其他结构。
所示壳体1812后端1832相对壳体主体沿轴向向里稍呈锥形。尽管最好如此,但机头1810的这一部位也可采取其他形式而不会影响到机头的作用。
此外,壳体1812最好用不锈钢制成,但也可使用其他结实、耐用、使用后可反复消毒的材料。需要时,壳体1812表面上可比方说模制一层弹性体,以提高使用者的手感。
尽管如上所述,机头1820用一普通电缆1820与一电源连接,但机头1820也可使用电池作为电源或同时使用电池和外接电源。例如,一大小和容量合适的电池可装在壳体1812的后端中,一控制开关可装在机头1810中或与之连接,从而外科大夫可在远处操纵机头1810而无需把上述整个控制模件当作本发明优选实施例。
图2、6和7示出壳体1810前端1834纵向上有一现有线性电磁线圈1836,该线性电磁线圈用引线1838与电缆1820连接。该电磁线圈举例说可使用Lucas Company销售的STA系列推式电磁线圈。特别可使用部件号为195203-331的电磁线圈,它长约1英寸,宽约半英寸,其活塞长约1(7/8)英寸。
当然也可使用其他推式电磁线圈,只要它们的规格可实现上述功能。例如,如使用一较小的机头,电磁线圈必须相应小才能套入壳体中。
一活塞1840沿纵向可滑动地套在电磁线圈1836中,从而当电磁线圈收到由上述脚踏控制器15发出的信号时活塞前推。电磁线圈1836前端外表面上有用来可调节地与接头1814连接的阳螺纹1842,这在下文说明。在优选实施例中,如使用STA型电磁线圈,前端1842上的螺纹为3/8-24,尽管这一规格可随机头壳体和电磁线圈的大小而变。
如图6和9所示,电磁线圈活塞1840上同轴地装有一压入配合垫圈1844和垫圈1844前方的一滑动配合密封1846,垫圈1844把密封1846夹持在接头1814中。最好是(尽管并非非此不可),滑动配合密封1846为用特氟龙或其他类似材料制成的公知公用密封,它的内部有一盘簧随着接头1814中套在垫圈1844和密封1846中的电磁线圈活塞1840的向前、向后运动而沿径向向外、向里偏置密封1846。
接头1814如图2、3、5A和6所示呈截头圆锥形,其顶端1848上有阳螺纹。顶端1848上的阳螺纹可旋入上述只在图2示出的轧刀型眼科剪刀1870的柄1870′的阴螺纹中。因此,顶端1848上的阳螺纹最好为#10-32。
各制造商所生产的相似剪刀可有与上述ERGOTECTM装置不同的螺纹或其他连接结构。此时,接头顶端1848可相应改变而与手术器械柄连接。
接头1814有一具有一朝顶端1848向前倾斜的光滑外表面的把手端1849,整个接头1814比方说用抛光不锈钢制成。向前呈锥形的把手部1849也可至少局部有一硅酮或弹性体涂层,从而该表面仍为光滑表面,或作为举例模制成图3和5所示凸脊,以便用手舒适地抓住并减小手术器械从手中滑脱的危险。
图4和5示出接头1848中的一纵向中心孔1852,活塞1840在图9实线所示受驱动位置时电磁线圈活塞1840的顶端1841沿纵向推动剪刀1870在该中心孔中的驱动销(未示出)。图9中虚线表示电磁线圈不通电时活塞1840的退后位置,即活塞在驱动手术器械后的位置。手术器械柄1870中的公知弹簧机构通常是造成活塞向该位置(图9中用标号1843表示)后退的至少一部分原因。
接头1814的后端有一如图4所示正对电磁线圈1836的前端的环形平面1854。接头1814在端面1854内部有一正圆柱形壁,其上的阴螺纹与电磁线圈1836顶端1842上的阳螺纹配合。端面1854沿径向向外伸展,直到与正圆形外侧壁1856相交。与接头的其他边缘相同,端面1854与侧壁1856的交线需要时可如图所示倒角,以便于使用。
外侧壁1856上最好有至少三个(等距分布的)、但必须至少有一个横向阴螺纹孔1858,以便把定位螺丝(例如#2-56螺丝)旋入其中,从而把电磁线圈1836的螺纹端1842固定在接头1814中预定纵向位置上,这在下文详述。
外侧壁1856上最好有环形凹槽1860供普通O形环1862紧套其中,从而使接头1814与壳体1812的圆柱形内侧壁紧配合。环形凹槽1860从图9可看得最清楚,图中未示出O形环。图2、3和6示出了O形环。
接头1814中在图4所示后端的有阴螺纹的内壁的前方设有一对肩,这一对肩在图5A和9中可看得最清楚,分别用标号1864和1866表示。肩1864与1866之间有一正圆形侧壁1868在电磁线圈活塞1840沿纵向来回运动时紧紧套住滑动配合密封1846。壁1868向前终止于环形肩1866而套住滑动配合密封1846。密封1846后方的压入配合垫圈1844抵靠肩1846并与接头的内壁压入配合。因此,滑动配合密封在接头中被夹持在预定位置上,电动机轴可与滑动配合密封及其后方的压入配合垫圈同轴地在纵向上运动。
机头1810用耐用、反复清洗和消毒也不容易破裂的材料制成。此外,如上所述,机头1810可稍有改动而不会影响其功能。但电磁线圈活塞必须在轴向上与剪刀驱动销的顶端对齐。当然,最好使用上述优选接头组件或功能与其相当的接头。
图5A用箭头a-g示出在本发明范围内制作的接头的一例的各部分尺寸。应该看到,这些尺寸并非限制性的,只是例示出一优选接头1814。精确到一英寸的千分之一,接头1814的优选尺寸如下:a-0.450,b-0.240,c-1.031,d-0.906,e-0.406,f-0.146,g-0.094/0.104。
在制造时,机头1810的接头组件(即接头、电磁线圈和电磁线圈活塞以及滑动配合密封和压入配合垫圈)的装配步骤如下:1)把滑动配合密封1846和压入配合垫圈1844装入接头1814中,2)把电磁线圈1836的螺纹端1842旋到接头1814上,3)把电磁线圈活塞1840朝着接头1814向前插入电磁线圈1846中,4)在把电磁线圈活塞1840固定在电磁线圈中上述抵靠位置上的同时旋转接头1814直到预定的校正位置(或用刻度盘校正);即活塞1840顶端1841与接头1841的相对纵向位置可使剪刀1870正确工作,以及5)把定位螺丝旋入接头1814中紧紧顶住电磁线圈1836的螺纹端1842,确保接头1814与电磁线圈1836固定在预定的相对位置上。
在完成上述步骤后把装配好的接头组件压入壳体1812前端1834,然后把尾件1816压入壳体1812后端1832。
如此装配好的机头1810无需外科大夫再作调节或装配。而且,用户不得拆开机头,因为那样做会搞乱小心校正好的电磁线圈活塞与接头顶端的相对位置,即电磁线圈活塞与可拆开地与接头连接的手术器械的受驱动针尖的相对位置。
因此,不难看出,新机头1810的总体结构和装配方法比现有机头大大简化,因此新机头制造成本降低,便于使用,外科大夫无需另外进行专门学习就会使用新机头。
因此本发明的若干目的和其他优点得以实现。
尽管以上说明了实施本发明的最佳方式,但可作出种种修正。
由于可在本发明范围内对所示、所述结制作出种种修正,因此以上附图所示、所述所有内容应看成例示性的而非限制性的。

Claims (19)

1、一种驱动手术器械作直线运动的机头,该手术器械与该机头连接,该机头包括一壳体,该壳体包括第一端和第二端和一从壳体第一端伸展到壳体第二端的连续侧壁;其特征在于,该机头还包括:
一装在该壳体中的线性电磁线圈;
一装在壳体第一端上、与一手术器械连接的接头,该接头在线性电磁线圈的纵向轴线的一预定校正位置上固定在线性电磁线圈上;以及
该壳体的第二端封闭成液密。
2、按权利要求1所述的机头,其特征在于,进一步包括一装在壳体第二端上、把壳体第二端封闭成液密的尾件。
3、按权利要求2所述的机头,其特征在于,一电缆穿过尾件而使壳体中的线性电磁线圈与一电源连接。
4、按权利要求3所述的机头,其特征在于,该电磁线圈为推式。
5、按权利要求1所述的机头,其特征在于,该线性电磁线圈有一纵向向前活塞,该接头有一纵向中心孔,从而线性电磁线圈的活塞的前端穿过该中心孔在纵向上推动与接头连接的一手术器械的驱动销的后端。
6、按权利要求1所述的机头,其特征在于,该线性电磁线圈与一电源和一控制机构连接。
7、按权利要求1所述的机头,其特征在于,该机头的至少一部分用不锈钢制成。
8、按权利要求1所述的机头,其特征在于,该接头的至少一部分有一光滑涂层。
9、按权利要求1所述的机头,其特征在于,该接头有一弹性体涂层用作软把手。
10、一种把一手术器械连接到一线性电磁线圈上的接头,该接头位于该线性电磁线圈纵向轴线的预定位置上,其特征在于,该接头装在该线性电磁线圈上,包括把该接头可脱开地连接到一手术器械上的结构、把接头可调节地装到线性电磁线圈上的结构以及以预定位置把接头固定在线性电磁线圈上的装置。
11、按权利要求10所述的接头,其特征在于,把接头可调节地装到线性电磁线圈上的结构为沿纵向把接头可调节地装到线性电磁线圈上的结构。
12、按权利要求10所述的接头,其特征在于,该接头有一后端,该线性电磁线圈为一具有一阳螺纹前端的电磁线圈;可调节地装配接头的结构为该接头后端上的阴螺纹,该阴螺纹与电磁线圈的螺纹端的阳螺纹配合,从而该接头可调节地装到该电磁线圈上。
13、按权利要求10所述的接头,其特征在于,该接头有一纵向中心孔,该接头沿纵向套住该线性电磁线圈;把该接头固定在该线性电磁线圈上的装置为该接头的一侧壁和至少一个定位螺丝,该接头的侧壁上有至少一个供至少一个定位螺丝旋入的横向螺纹孔,从而把线性电磁线圈紧固在一预定位置上。
14、一种制造一机头的方法,该机头用于受一线性电磁线圈驱动的手术器械,其特征在于,该方法包括用下述步骤制作该机头的一接头组件;
a)把一滑动配合密封和一压入配合垫圈装入一接头中;
b)把一线性电磁线圈的前端可调节地引入该接头中;
c)把该线性电磁线圈的一活塞插入该接头的后端;
d)把线性电磁线圈的该活塞固定在接头中该插入位置上;
e)校正线性电磁线圈与接头的相对纵向位置,该纵向相对位置必须使线性电磁线圈的活塞能推动与该接头连接的一手术器械的驱动销;以及
f)把线性电磁线圈固定在该校正的纵向位置上。
15、按权利要求14所述的方法,其特征在于,进一步包括下述步骤:把接头组件的接头的后端压入机头壳体的前端,从而固定在接头上的线性电磁线圈套在该壳体中。
16、按权利要求15所述的方法,其特征在于,进一步包括下述步骤:把机头的一尾件压入该壳体的后端,从而使该壳体的后端液密封。
17、按权利要求16所述的方法,其特征在于,进一步包括下述步骤:在把尾件压入壳体后端之前,将套在尾件中的电缆和与线性电磁线圈连接的引线连接,从而使机头可用电驱动,该电缆与一电源连接。
18、按权利要求14所述的方法,其特征在于,为固定该纵向位置,把至少一个定位螺丝旋入接头后端一外侧壁中的一横向螺纹孔,从而用该至少一个定位螺丝紧紧顶住线性电磁线圈的前端。
19、按权利要求14所述的方法,其特征在于,该方法包括下述步骤:用一推式线性驱动电磁线圈作为该线性电磁线圈。
CNB971981566A 1996-08-29 1997-08-28 外科手术机头 Expired - Fee Related CN1161078C (zh)

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