CN1424891A - 手术夹置放器 - Google Patents

手术夹置放器 Download PDF

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CN1424891A
CN1424891A CN01806060A CN01806060A CN1424891A CN 1424891 A CN1424891 A CN 1424891A CN 01806060 A CN01806060 A CN 01806060A CN 01806060 A CN01806060 A CN 01806060A CN 1424891 A CN1424891 A CN 1424891A
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jaw
clip
area supported
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jaw device
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CN1302754C (zh
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斯蒂芬·F·彼得斯
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Conmed Corp
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Imagyn Medical Technologies California Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery

Abstract

公开了一种将手术夹(12)置放在身体组织中的手术夹置放器(10)。手术夹置放器包括一种具有近端(20)和远端(22)的细长管体(18)。此管体还限定了一种手术夹用的输送表面。手术夹置放器还包括第一和第二钳口(30),该钳口从管体的远端延伸。钳口打开与闭合,以将手术夹置放在患者的身体组织中。驱动器(64)设置在管体内,以使手术夹从输送表面(28)行进到钳口。本发明的手术夹置放器设置有支承表面(70),此支承表面从管体的远端延伸,并沿钳口延伸。相应地,支承表面通过恒定地施加力而贴靠支承钳口,于是,管体总是以预加负载的方式贴靠钳口。这样,保证钳口正确地对准手术夹输送表面,而手术夹可以从输送表面行进至钳口,不致发生传送失效。

Description

手术夹置放器
                     发明背景
                  1)技术领域
本发明总体涉及将手术夹置放在身体组织中用的夹子置放装置。更特别地,本发明涉及一种夹子置放装置,此置放装置引入一种支承表面,该支承表面沿钳口装置的一部分延伸,以施预加负载于管体,使管体贴靠钳口装置,以保证在夹子置放装置内正确对准。
                  2)现有技术说明
置放手术夹用的夹子置放装置,在现有手术技术中是众所周知的。现有技术中的夹子置放装置包括一个具有近端和远端的细长管体。现有技术的夹子置放装置的管体还限定了一个夹子输送表面。这些夹子置放装置还包括:钳口装置,从管体的远端延伸;和夹子驱动装置,设置在管体内,用于使手术夹从夹子输送表面向钳口装置运动,手术夹就是在钳口装置被置放在身体组织的。
现有技术的夹子置放装置不完善之处在于,设置在管体远端的钳口装置是允许运动的,即钳口是自由浮动的。就是说,在现有技术中,在夹子置放装置中没有这样的元件,这种元件主动地支撑贴靠钳口装置,以施预加负载于钳口装置,并防止钳口装置运动,即防止钳口装置浮动。普遍了解的是,在手术夹向钳口装置输送的过程中,夹子输送表面和钳口装置必须对准。这种正确地对准保证了手术夹在身体组织的正确设置。由于现有技术的钳口装置是没有预加负载的,因此允许其运动,这些夹子置放装置中的夹子,在从夹子输送表面向钳口装置输送时常常传送失效。手术夹进入钳口装置的传送失效,或者导致手术夹堵塞在夹子置放装置内,或者导致手术夹在身体组织内的不正确置放。整个行业都了解,手术夹被错误置放时,在纠正堵塞所需要的时间方面,以及在患者的安全方面,这两种结果都是不理想的。
由于现有技术中的夹子置放装置存在上述有关不足之处,希望使用一种新颖的夹子置放装置,这种夹子置放装置包括一种支承表面,该支承表面从管体的远端沿钳口装置的一部分延伸,此支承表面贴靠支承并预加负载于钳口装置,以保证钳口装置与夹子输送表面对准,于是,使手术夹可以从夹子输送表面正确地输送至钳口装置。这样,由于钳口装置被预加负载,钳口装置总是与夹子输送表面对准,手术夹不致在向钳口装置传送时发生传送失效,手术的时间和患者的安全得以获得最佳结果。
                   发明概述和发明的优点
公开了一种夹子置放装置。本发明的夹子置放装置将一个手术夹或多个手术夹置放到患者的身体组织中。此夹子置放装置包括一个具有近端部和远端部的细长管体。此管体限定了一种夹子输送表面,该夹子输送表面邻近远端设备。夹子置放装置还包括一种钳口装置,该钳口装置从管体的远端延伸,并包括至少一个钳口尖部。推荐钳口装置包括第一和第二腿部。一种夹子驱动装置设置在管体内。夹子驱动装置使手术夹从夹子输送表面向钳口装置行进,随后,手术夹在钳口装置处被置放在身体组织中。
夹子置放装置还包括支承表面,此支承表面从管体的远端沿钳口装置的一部分延伸。在这个位置,支承表面贴靠支承钳口装置的这个部分并施预加负载,即施加一恒定的力于钳口装置,以便保证钳口装置正确对准夹子输送表面。换言之,管体总是以预加负载的状态贴靠钳口装置。这样,手术夹可以从夹子输送表面正确地行进至钳口装置而不致传送失效,手术夹可以正确地置放在身体组织中,且不致发生夹子置放装置的堵塞。
                     对附图的简要说明
本发明的其它优点,通过结合附图参看下列详细说明将得到更好的了解,并容易做出评价,在这些附图中:
图1是一种夹子置放装置的透视图;
图2是这种夹子置放装置的放大透视图,示出了其钳口装置和贴靠支承钳口装置的支承表面;
图3是这种夹子置放装置没有钳口装置时的放大透视图,很详细地示出了支承表面;和
图5是手术夹的透视图,该手术夹为本发明的夹子置放装置所使用。
                   推荐实施例的详细说明
参看附图,其中,在这几个附图中,相同的数字表示相同或相当的部分,夹子置放装置总体用标号10表示。夹子置放装置10在现有技术中也称为手术夹置放器(clip applier)10,在下述说明中将按手术夹置放器这一术语进行说明。手术夹置放器10将手术夹12(在图5中专门示出)置放到患者的身体组织中。自然,应当理解,尽管在多次说明中用的是置放单个手术夹12的词语,手术夹置放器10也可以把数个手术夹置放到患者的身体组织中。在推荐实施例中的手术夹12具有如图5所公开的形状,并包括夹子基体14和夹子腿16。
主要参看图1,手术夹置放器10包括一个细长的管体或轴18,该管体具有近端20和远端22。管体18最好用聚碳酸酯喷注模制而成。管体18还包括一个顶半部24和底半部26。虽然并未提出要求,但管体18的顶半部24和底半部26最好是卡配在一起。管体18在邻近其远端处限定了一个夹子输送表面28(在图3中可以看得最清楚)。如图所示,夹子输送表面28包括第一和第二输送表面分支,在图中没有对其进一步编号。可以理解,手术夹12就储存在管体18内,最好储存在靠近夹子输送表面28的一种夹子盒里。
现在参看图2,手术夹置放器10还包括一种钳口装置30,该钳口装置至少包括一个钳口尖部32和至少一个钳口肩部34。钳口装置30打开和关闭以将手术夹12置放在患者身体组织中。尽管钳口肩部34可以制成角度的,在推荐实施例中,钳口尖部34是曲线轮廓。对此将在下面说明。钳口装置30以特定的角度从管体18的远端22向外延伸。如图所示,钳口装置从管体18的远端22向外向上延伸。这样,钳口装置30可以认为包括了一个下侧面36。不过,由于手术夹置放器10是可以转动的,对此下面将予以说明,钳口装置30的所谓从管体18向上延伸,仅仅是为了便于叙述的目的而并不是关键所在。钳口装置30还包括至少一个夹子通道38或夹子槽。推荐本发明包括两个夹子通道38。夹子通道38从夹子输送表面28接受手术夹12。手术夹12在钳口装置30打开和闭合时被设置在夹子槽38内,以将手术夹12置放在身体组织中。
回来再参看图1,本发明的手术夹置放器10与手柄40和扳机(trigger)42组合使用。扳机42可以是不超出本发明范围的任何形式的扳机,此扳机设置在手柄40上,帮助使手术夹12从夹子输送表面28向钳口装置30前进。正如本领域的技术人员可以理解的那样,手柄40和扳机42,通过旋转装置44可以相对于手术夹置放器10的管体18转动。此外,支承轴46可以可选择地结合在手柄40和管体18之间,以安装在手术夹置放器10和手柄40之间。如果设置支承轴46,则管体18的近端20安装在支承轴46上,用以与手柄40连接,如图1所示。这样,本发明的手术夹置放器10,可以在用于置放了一定数量的手术夹12之后更换,而手柄40、扳机42和支承轴46可以再次使用。
最好钳口装置30包括第一和第二腿部,对此,将在下面专门讨论。不过,可以理解,本发明的钳口装置30可以包括任何数量的腿部,只要不超出本发明的范围。推荐实施例的钳口装置30更特别地包括第一近端腿部48和第一远端腿部50。第一钳口尖部52设置在钳口装置30的第一远端腿部50上,而第一钳口肩部54被限定在第一近端腿部48和第一远端腿部50之间。推荐实施例还包括一个第二近端腿部56和第二远端腿部58。作为第二钳口尖部60,设置在钳口装置30的第二远端腿部58,而第二钳口肩部62被限定在第二近端腿部56和第二远端腿部58之间。推荐第一和第二钳口肩部54和62各自都是曲线轮廓。
手术夹置放器10还包括一个夹子驱动器64,也就是现有技术中的夹子推动器,设置在管体18内,用于使手术夹12从夹子输送表面28向钳口装置30行进。管体18还限定了一个引导通路或通道66,此引导通道在管体内是对准中心的,且此引导通道是设置在手术夹输送表面28的第一和第二输送分支之间的。于是,引导通道66使手术夹驱动器64在推动手术夹12从手术夹输送表面28向钳口装置30行进时保持对准中心。本发明还设置了夹子引导指68,在手术夹12向钳口装置30行进的过程中,此夹子引导指用于在手术夹输送表面28的每一个输送分支保持对手术夹12施加压力。正如所理解的,扳机42被致动,即拉动扳机,以致动手术夹驱动器64,并使手术夹12前进至钳口装置30。
参看图3,本发明设有支承表面70,此支承表面从管体18的远端22沿钳口装置30的一部分即一段长度延伸。更特别地,此支承表面70从管体18的远端22在管体18的底半部延伸。借助于对钳口装置30施加一种恒定的力,支承表面70贴靠支承钳口装置30的一部分,特别是贴靠支承钳口装置30的下表面36。这样,支承表面70主动地和连续地对钳口装置30施预加负载,因此避免了钳口装置30运动即浮动,并保持钳口装置30对准手术夹输送表面28。在本发明的整个说明中,在使用对钳口装置30预加负载这一术语的地方,这些术语意欲表示支承表面70贴靠支承钳口装置30的一部分,这样,管体18总是预加负载地贴靠钳口装置30。支承表面70使在钳口装置30中的夹子通道38对准手术夹输送表面28。如上所述,当手术夹置放器10正确对准时,手术夹12可以正确地从手术夹输送表面行进至钳口装置30的夹子通道38。
参看图3,支承表面70还包括一种升高的贴靠表面72,也称为垫块。最好此升高的贴靠表面72是支承表面70的直接延伸,这样,升高的贴靠表面是支承表面整体中的一部分。升高的贴靠表面72,从支承表面70向钳口装置30突起,以便预加负载于钳口装置30。如图4所最清楚地示出的那样,升高的贴靠表面72使支承表面70建立起一种变化的厚度,以便有效地贴靠支承钳口装置30。更特别地,此变化的厚度可以表述为第一厚度74和第二厚度76,且如图4所示,距钳口尖部32最近的第二厚度76,大于距手术夹输送表面28最近的第一厚度74。升高的贴靠表面72包括一种顶部小平面78,该顶部小平面具有特定的斜度S。顶部小平面78的斜度S向钳口尖部32向外增大,这样,正是贴靠支承钳口装置30部分的升高的贴靠表面72的顶部小平面78,对钳口装置30施预加负载。尽管顶部小平面78的斜度S的数值显然不是关键,但顶部小平面78的斜度S要等于或超过钳口装置30从管体18延伸的角度却是关键的。
支承表面70还包括一轮廓部80,此轮廓部分别绕第一和第二钳口肩部54和62制成轮廓部,这样,支承表面70并不分别与钳口肩部54和62接触。在钳口肩部54和62分别更靠近第一和第二钳口尖部52和60后,轮廓部80使支承表面70能够贴靠支承钳口装置30部分。如果正如在推荐实施例中那样,钳口肩部54和62分别为曲线形状,于是轮廓部80分别以互补的形状在钳口肩部54和62的附近绕其制成曲线轮廓,这样,支承表面70与钳口肩部54和62并不分别彼此接触。不过,在钳口肩部54和62分别不是成型轮廓的情况下,只要支承表面70不分别与钳口肩部54和62接触,轮廓部80可以制成角度轮廓。
在钳口装置30的第一远端腿50和第二远端腿58方面,升高的贴靠表面72从支承表面70突起,以分别施预加负载于第一和第二远端腿部50和58。为实现这一点,升高的贴靠表面72包括第一支块82和第二支块84。升高的贴靠表面72的第一支块82施预加负载于钳口装置30的第一远端腿50。升高的贴靠表面72的第二支块84施预加负载于钳口装置30的第二远端腿58。
最后,支承表面70还限定了一个槽86。槽86设置在第一和第二支块82和84之间,在推荐实施例中,槽86是对准中心的。槽86适当地接受在置放手术夹12过程中的身体组织。
预加负载只要求这样的允许误差,该允许误差能使升高的贴靠表面72恒定地对钳口装置30施加某种压力。钳口装置30通常用金属材料制成,钳口装置从管体18的支承表面70接受预加负载,而对钳口装置30中的夹子通道38的方向没有不利影响。这样,升高的贴靠表面72的高度可以在某种“机会窗口”的范围变化而不影响夹子通道38与夹子输送表面28对准。由于使用了包括升高的贴靠表面72的支承表面70,升高的贴靠表面72的高度只需要在±.010的允许误差范围内。过去,对于总的允许误差是±.025的要求,夹子通道38的定位允许误差是±.010,夹子输送表面28的定位允许误差是±.015。结果,本发明将夹子输送表面28与钳口装置30上的夹子通道38对准的精度提高了大约160%。
本发明已经以图解的方式进行了说明,可以理解,已经使用的名词术语旨在文字的叙述,并不意味对本发明的限制。
显然根据上述技术,对本发明可以有许多修改和变型方案。因此,应当理解,在所附权利要求范围内,本发明可以以不同于本具体说明的方式实施,在对本发明的说明中,参考数字仅仅是为了说明的方便,并不意味着对本发明的任何限制。

Claims (22)

1.一种夹子置放装置,用于将手术夹置放在身体组织中,所述装置包括:
细长的管体,具有近端和远端,所述管体在邻近所述远端处限定了一夹子输送表面;
钳口装置,从所述管体的所述远端延伸,且包括至少一个钳口尖部;
夹子驱动装置,设置在所述管体内,用于使手术夹从所述夹子输送表面向所述钳口装置行进;
支承表面,从所述管体的所述远端,沿所述钳口装置的一部分延伸,并贴靠支承钳口的所述部分,以预加负载于所述钳口装置,从而使所述钳口装置保持对准所述夹子输送表面,这样,手术夹可以正确地从所述夹子输送表面行进至所述钳口装置。
2.如权利要求1所述的置放装置,其中,所述支承表面包括一升高的贴靠表面,该贴靠表面从所述支承表面向所述钳口装置突出,以预加负载于所述钳口装置。
3.如权利要求2所述的置放装置,其中,所述升高的贴靠表面在所述支承表面建立了一变化的厚度,这样,所述支承表面贴靠支承所述钳口的所述部分,以预加负载于所述钳口装置。
4.如权利要求3所述的置放装置,其中,所述支承表面的所述变化的厚度包括:第一厚度,位于最接近所述夹子输送表面处;第二厚度,位于最接近所述至少一个钳口尖部处,所述第二厚度大于所述第一厚度。
5.如权利要求2所述的置放装置,其中,所述钳口装置从所述管体的所述远端成一角度延伸,而所述升高的贴靠表面包括具有斜度的顶部小平面,所述顶部小平面的斜度朝向所述至少一个钳口尖部向外增大,这样,所述顶部小平面贴靠支承钳口的所述部分,以施预加负载于所述钳口装置。
6.如权利要求1所述的置放装置,其中,所述钳口装置还包括至少一个钳口肩部,而所述支承表面包括一种轮廓部,此轮廓部绕所述钳口肩部制成轮廓部,这样,使所述支承表面并不与所述钳口肩部接触,在所述钳口肩部更靠近所述至少一个钳口尖部后,支承表面贴靠支承所述钳口装置的所述部分。
7.如权利要求6所述的置放装置,其中,所述至少一个钳口肩部是曲线形状,而所述轮廓部是绕所述曲线形状的钳口肩部制成轮廓部。
8.如权利要求1所述的置放装置,其中,所述钳口装置还包括:第一近端腿部和第一远端腿部,其具有第一钳口尖部和第一钳口肩部,该钳口肩部被限定在所述第一近端腿部和第一远端腿部之间;第二近端腿部和第二远端腿部,其具有第二钳口尖部和第二钳口肩部,该钳口肩部被限定在所述第二近端腿部和第二远端腿部之间。
9.如权利要求8所述的置放装置,其中,所述支承表面包括一种升高的贴靠表面,该贴靠表面从所述支承表面向所述钳口装置的所述第一和第二远端腿部突起,以施预加负载于所述第一和第二远端腿部。
10.如权利要求9所述的置放装置,其中,所述升高的贴靠表面还包括第一和第二支块,所述升高的贴靠表面的第一支块,对所述第一远端腿部施预加负载,所述升高的贴靠表面的第二支块,对所述第二远端腿部施预加负载。
11.如权利要求10所述的置放装置,其中,所述支承表面还包括轮廓部,该轮廓部绕所述第一和第二钳口肩部制成轮廓部,这样,所述支承表面并不与所述第一钳口肩部接触,而在所述第一钳口肩部更靠近所述第一钳口尖部后,支承表面贴靠支承所述钳口装置的所述部分,同样,使所述支承表面并不与所述第二钳口肩部接触,而在所述第二钳口肩部更靠近所述第二钳口尖部后,支承表面贴靠支承所述钳口装置的所述部分。
12.如权利要求1所述的置放装置,其中,所述管体还包括一个顶半部和一个底半部,所述支承表面从所述管体的所述远端的底半部延伸,以预加负载于所述钳口装置。
13.如权利要求1所述的置放装置,其中,所述钳口装置还包括至少一个夹子通道,该夹子通道适于从所述夹子输送表面接受手术夹,所述支承表面沿所述部分延伸,并贴靠支承所述部分,以对所述钳口装置施预加负载,从而使所述钳口装置的所述夹子通道与所述夹子输送表面保持对准。
14.如权利要求1所述的置放装置,其中,所述管体还包括一种所述夹子驱动器用的引导通道,设置在所述夹子输送表面的第一和第二分支之间,以保证所述夹子驱动器对准中心。
15.如权利要求1所述的置放装置,其中,所述钳口装置从所述管体的所述远端向上延伸。
16.如权利要求15所述的置放装置,其中,所述支承表面从所述管体的所述远端,沿所述钳口装置的下侧面延伸,并贴靠支承所述钳口的下侧面,以施预加负载于所述钳口装置。
17.如权利要求1所述的置放装置,与手柄和设置在所述手柄上的扳机相结合,用于致动所述夹子驱动器,使手术夹从所述夹子输送表面向所述钳口装置行进。
18.如权利要求17所述的置放装置,其中,所述手柄和所述扳机,相对于所述管体可以转动。
19.如权利要求17所述的置放装置,还包括一种支承轴,该支承轴设置在所述手柄与所述管体之间。
20.如权利要求19所述的置放装置,其中,所述管体的近端安装在所述支承轴上,以与所述手柄连接。
21.如权利要求10所述的置放装置,其中,所述支承表面限定了一个槽,设置在所述第一和第二支块之间,用于接受在置放手术夹过程中的身体组织。
22.一种夹子置放装置,包括:
手术夹,用于身体组织中;
细长的管体,具有近端和远端,所述管体在邻近所述远端处限定了一夹子输送表面;
钳口装置,从所述管体的所述远端延伸,且包括至少一个钳口尖部;
夹子驱动装置,设置在所述管体内,用于使手术夹从所述夹子输送表面向所述钳口装置行进;
支承表面,从所述管体的远端沿所述钳口装置的一部分延伸,并贴靠支承钳口的所述部分,以预加负载于所述钳口装置,从而使所述钳口装置保持对准所述夹子输送表面,这样,手术夹可以正确地从所述夹子输送表面行进至所述钳口装置。
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CA2398820A1 (en) 2001-08-09
CN1302754C (zh) 2007-03-07
MXPA02007506A (es) 2004-08-23
EP1251784B1 (en) 2007-09-05
US6520972B2 (en) 2003-02-18
CA2398820C (en) 2009-04-07
WO2001056455A3 (en) 2002-05-10
JP2006218331A (ja) 2006-08-24
JP2004500190A (ja) 2004-01-08
DE60130317T2 (de) 2008-06-12
EP1251784A2 (en) 2002-10-30
DE60130317D1 (de) 2007-10-18
EP1251784A4 (en) 2005-11-30
WO2001056455A2 (en) 2001-08-09
AU3665101A (en) 2001-08-14
AU783228B2 (en) 2005-10-06
KR20020081295A (ko) 2002-10-26
US20010047178A1 (en) 2001-11-29

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