ES2589586T3 - Realimentación de posición y velocidad de unidad de carga - Google Patents

Realimentación de posición y velocidad de unidad de carga Download PDF

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ES2589586T3
ES2589586T3 ES13189026.1T ES13189026T ES2589586T3 ES 2589586 T3 ES2589586 T3 ES 2589586T3 ES 13189026 T ES13189026 T ES 13189026T ES 2589586 T3 ES2589586 T3 ES 2589586T3
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unit
pattern
cartridge
drive
anvil
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Michael Ingmanson
Michael Zemlok
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Covidien LP
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • 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
    • A61B17/105Wound clamp magazines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation
    • A61B17/1155Circular staplers comprising a plurality of staples
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90Identification means for patients or instruments, e.g. tags
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00115Electrical control of surgical instruments with audible or visual output
    • A61B2017/00119Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00464Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473Distal part, e.g. tip or head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681Aspects not otherwise provided for
    • A61B2017/00734Aspects not otherwise provided for battery operated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07271Stapler heads characterised by its cartridge
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07285Stapler heads characterised by its cutter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0807Indication means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0807Indication means
    • A61B2090/0811Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

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  • Life Sciences & Earth Sciences (AREA)
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  • Pathology (AREA)
  • Surgical Instruments (AREA)

Abstract

Un dispositivo de grapado quirúrgico que comprende una porción alargada, una porción de mango y una unidad (20) de carga, comprendiendo la unidad (20) de carga: una unidad (508) de cartucho y una unidad (506) de yunque, incluyendo la unidad de cartucho un canal (516) y un cartucho (518) que tiene una pluralidad de grapas (530) quirúrgicas en su interior; y una unidad (560) de accionamiento axial con un miembro (606) de agarre, teniendo el miembro de agarre un reborde (606b) superior para el acoplamiento de la unidad de yunque, y un reborde (606c) inferior para el acoplamiento del canal, siendo la unidad (560) de accionamiento axial móvil a través del cartucho (518) de grapas para impulsar las grapas (530) hacia fuera del cartucho de grapas y contra la unidad (506) de yunque; teniendo la porción de mango una unidad (5) de motor; y un controlador; caracterizado por que se definen características (1020) mecánicas en el canal (516) para indicar un final de carrera (1040) para la unidad de accionamiento axial, teniendo las características mecánicas un primer patrón (1020a) y un segundo patrón (1020b), siendo cada patrón diferente de tal modo que el reborde (606c) inferior se acopla al primer patrón (1020a) y luego al segundo patrón (1020b) cambiando el cambio en el patrón de las características mecánicas la fuerza o par en la unidad de motor, siendo dicho cambio detectable por el controlador para indicar que el miembro (606) de agarre está alcanzando el final de carrera (1040).

Description

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DESCRIPCION
Realimentacion de posicion y velocidad de unidad de carga Referenda a solicitudes relacionadas
Esta solicitud reivindica el beneficio de la prioridad de la solicitud de patente provisional estadounidense N° 61/715,485 presentada el 18 de octubre de 2012.
Campo de la tecnica
La presente descripcion esta dirigida a dispositivos quirurgicos, tales como instrumentos de grapado quirurgico, que tienen una porcion de mango y una unidad de carga o actuador de extremo extralble e intercambiable. En particular, la presente descripcion se refiere a dispositivos quirurgicos y unidades de carga que tienen sensores para identificar el tipo de actuador de extremo, y proporcionar realimentacion relativa al uso de la unidad de carga.
Antecedentes
Los dispositivos quirurgicos que tienen una porcion de mango y una unidad intercambiable son conocidos. Un dispositivo quirurgico que se puede usar para disparar diferentes tipos y tamanos de unidades de carga se describe en la patente estadounidense US 7,044,353 a nombre de Mastri et al (“Mastri”). En Mastri, las unidades de carga pueden tener grapas quirurgicas de diferentes tamanos y, ademas, diferentes longitudes de llnea de grapado. La patente estadounidense US 7,565,993 de Milliman et al describe unidades de carga articuladas y no articuladas que se pueden usar con una porcion de mango.
En la publicacion estadounidense US 2011-0174099 se describen dispositivos quirurgicos que describen una unidad de adaptador y una pluralidad de actuadores de extremo que pueden fijarse al mismo. El adaptador se utiliza para permitir la conexion de un elemento de accionamiento electrico de mano a una variedad de actuadores de extremo, tal como un actuador de extremo para realizar una anastomosis de extremo a extremo, un actuador de extremo para realizar una anastomosis gastrointestinal endoscopica, tal como una grapadora endoscopica lineal, o un actuador de extremo para realizar una anastomosis transversal. Se han propuesto dispositivos quirurgicos electricos con una consola de alimentacion remota en la patente estadounidense US 6,846,307 de Whitman et al (“Whitman”). Whitman describe un controlador en la consola para controlar el dispositivo quirurgico. El controlador puede tener una unidad de memoria, incluyendo una RAM y una ROM, y lee datos del actuador de extremo particular fijado al controlador. El controlador puede leer datos de identificacion de una unidad de memoria en el actuador de extremo fijado al controlador y entonces, gracias a la conexion del controlador a los motores del dispositivo quirurgico, controlar el funcionamiento del dispositivo quirurgico.
En la patente estadounidense US 7,887,530 de Zemlok et al. se describe un instrumento quirurgico electrico que utiliza un motor de desplazamiento para accionar multiples funciones del instrumento. Se describe una variedad de sensores. El documento EP2165664 (Ethicon Endo Surgery Inc) describe una grapadora quirurgica que incluye un motor con un circuito de control de corriente para variar el par de salida del motor.
En el contexto de los dispositivos quirurgicos disenados para su uso con una variedad de unidades de carga o actuadores de extremo extralbles e intercambiables, es deseable identificar el tipo de actuador de extremo o unidad de carga que se fija. Esta information se puede utilizar para determinar como manejar el dispositivo quirurgico.
Compendio
Un dispositivo de grapado quirurgico que comprende una porcion alargada, una porcion de mango, y una unidad de carga, la unidad de carga comprende una unidad de cartucho y una unidad de yunque, la unidad de cartucho incluye un canal y un cartucho de grapas que tiene una pluralidad de grapas quirurgicas en su interior. La unidad de carga tiene una unidad de accionamiento axial con un miembro de agarre, teniendo el miembro de agarre un reborde superior para acoplarse a la unidad de yunque, y un reborde inferior para acoplarse al canal, siendo la unidad de accionamiento axial movil a traves del cartucho de grapas para impulsar las grapas hacia fuera del cartucho de grapas y contra la unidad de yunque. La porcion de mango tiene una unidad de motor y un controlador y se definen elementos mecanicos en el canal para indicar un final de carrera de la unidad de accionamiento axial, teniendo los elementos mecanicos un primer patron y un segundo patron, siendo cada patron diferente de modo que el reborde inferior se acople al primer patron y luego al segundo patron, modificando el cambio de patron de los elementos mecanicos la fuerza o par en la unidad de motor, siendo dicho cambio detectable por el controlador par indicar que el miembro de agarre esta alcanzando el final de carrera.
El cartucho de grapas de la unidad de carga puede tener una pluralidad de cavidades de retention de grapa y las grapas quirurgicas estan dispuestas en las cavidades de retencion de grapas. En ciertas realizaciones, las cavidades de retencion de grapas estan dispuestas segun filas lineales. La unidad de accionamiento axial puede incluir una barra de accionamiento.
En ciertas realizaciones, se incluye un sensor para determinar un hueco entre la unidad de yunque y la unidad de
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cartucho.
Un dispositivo de grapado quirurgico, que comprende una porcion alargada y una unidad de carga. La unidad de carga comprende una unidad de cartucho y una unidad de yunque, incluyendo la unidad de cartucho un canal y un cartucho de grapas que tiene una pluralidad de grapas quirurgicas en su interior. La unidad de carga tiene una unidad de accionamiento axial con un miembro de agarre, teniendo el miembro de agarre un reborde superior para el acoplamiento de la unidad de yunque, y un reborde inferior para el acoplamiento del canal, siendo la unidad de accionamiento axial movil a traves del cartucho de grapas para impulsar las grapas hacia fuera del cartucho de grapas y contra la unidad de yunque. Se definen en el canal unos elementos mecanicos para indicar un final de carrera para la unidad de accionamiento axial, teniendo los elementos mecanicos un primer patron y un segundo patron.
El controlador de dispositivo de grapado quirurgico puede configurarse para determinar el final de carrera. El dispositivo de grapado quirurgico puede tener el primer patron de elementos mecanicos con elemento mecanicos de un tamano diferente del tamano de los elementos mecanicos del segundo patron.
El cartucho de grapas de la unidad de carga puede definir un eje longitudinal y unas cavidades de retencion dispuestas en filas lineales a lo largo del eje longitudinal. El canal de la unidad de cartucho puede definir una ranura. Un extremo distal de la ranura puede formar el final de carrera.
El segundo patron de elementos mecanicos puede estar mas cercano al extremo distal de la ranura que el primer patron de elementos mecanicos. En ciertas realizaciones, un sensor de luz detecta los elementos mecanicos.
Breve descripcion de los dibujos
En el presente documento se describen realizaciones del dispositivo quirurgico descrito haciendo referencia a las siguientes figuras:
La FIG. 1 es una vista en perspectiva de la porcion de mango de acuerdo con ciertas realizaciones de la descripcion.
La FIG. 1A es una vista en perspectiva de una porcion de mango y unidades de carga de acuerdo con ciertas realizaciones de la descripcion.
La FIG. 2 es una vista en perspectiva de un adaptador fijado a una porcion de mango, con algunas partes eliminadas de acuerdo con ciertas realizaciones de la descripcion.
La FIG. 3 es una vista de despiece en perspectiva de un adaptador de acuerdo con ciertas realizaciones de la descri pcion.
La FIG. 4 es una vista de una seccion transversal de una parte de un adaptador de acuerdo con ciertas realizaciones de la descripcion.
La FIG. 5 es una vista en perspectiva de una unidad de carga de acuerdo con ciertas realizaciones de la presente descri pcion.
La FIG. 6 es una unidad de accionamiento axial para una unidad de carga de acuerdo con ciertas realizaciones de la presente descripcion.
La FIG. 7 es una vista detallada del miembro de agarre de la unidad de accionamiento axial de acuerdo con ciertas realizaciones de la presente descripcion.
La FIG. 8 es una vista de despiece de la unidad de carga de acuerdo con ciertas realizaciones de la presente descri pcion.
La FIG. 9 es una vista superior en planta de la unidad de carga de acuerdo con ciertas realizaciones de la presente descri pcion.
La FIG. 10A es una vista lateral en elevacion de una unidad de accionamiento de acuerdo con realizaciones de la presente descripcion.
La Fig. 10B es una vista lateral en elevacion de una unidad de accionamiento de acuerdo con realizaciones de la presente descripcion.
Descripcion detallada
Los expertos en la materia comprenderan la presente invencion a partir de una lectura de la siguiente descripcion en conjunto con las figuras adjuntas. Los slmbolos de referencia denotan elementos iguales o similares en todos los dibujos. Como es habitual, el termino “distal se refiere a una ubicacion mas alejada del usuario del instrumento y el termino “proximal” se refiere a una ubicacion que es mas cercana al usuario del instrumento.
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En las FIGS. 1 a 9 se muestra un dispositivo quirurgico que tiene una porcion 10 de mango, y una pluralidad de unidades de carga extraibles e intercambiables. El dispositivo quirurgico incluye una porcion alargada. Por ejemplo, la porcion 10 alargada puede tener un arbol endoscopico que forma parte de la porcion 10 de mango o la porcion 10 de mango puede estar conectada a una unidad 100 de adaptador que incluye un tubo 106 exterior y un boton 104 de liberacion que tiene un cierre para conectar de manera extraible la unidad de adaptador a la porcion 10 de mango. Alternativamente, la conexion puede ser una conexion roscada, una conexion de bayoneta, o cualquier otra conexion. En cualquiera de las realizaciones descritas en este documento, se puede proporcionar una pluralidad de diferentes adaptadores para que funcionen en conjunto con una pluralidad de diferentes porciones de mango y/o una pluralidad de diferentes actuadores de extremo para proporcionar un sistema quirurgico versatil. Por ejemplo, se pueden proporcionar unidades de adaptador con diferentes longitudes de arbol, o arboles con diferentes formas tales como curvada o recta. Se pueden proporcionar unidades de adaptador para su conexion a diferentes actuadores de extremo quirurgicos, tales como instrumentos electroquirurgicos, grapadoras circulares, grapadoras endoscopicas lineales, etc.
El extremo distal del arbol endoscopico, o el extremo distal de la unidad 100 de adaptador, tiene una porcion 12 de conexion para formar una conexion a una unidad de carga. Se muestran las unidades 20, 30 y 40 de carga. Aunque se describe con detalle una unidad 20 de carga de grapado endoscopico lineal, tambien puede conectarse al dispositivo quirurgico una unidad de carga de grapado 30 circular o de grapado 40 transversal. Se pueden proporcionar unidades de carga que incorporen energia electrica, energia de ultrasonidos, u otro tipo de energia. Se proporcionan unidades de adaptador adecuados para acomodar las diferentes unidades de carga. Por ejemplo, puede ser deseable proporcionar tres arboles de accionamiento para operar la unidad 30 de carga de grapado circular. Se podria usar una unidad de adaptador dotada de tres arboles en la misma para accionar separadamente la apertura y cierre del yunque para agarrar tejido, la impulsion de las grapas a traves del tejido y contra el yunque, y el corte del tejido.
La unidad 100 de adaptador que se utiliza con la unidad 20 de carga tiene un cuerpo 130 y dos accionadores; un cable 136 de accionamiento de articulacion y un cable 134 de accionamiento de grapado. Como se aprecia mejor en la FIG. 3, la unidad 100 de adaptador tiene una unidad de convertidor de accionamiento para cada uno de los arboles de accionamiento, para convertir el movimiento rotacional de la salida de la unidad 5 del motor en traslacion lineal de los miembros de accionamiento de la unidad de adaptador. Por ejemplo, la primera unidad 150 de convertidor de accionamiento tiene un primer arbol 152 que se conecta a una primera salida de la unidad 5 de motor a traves del cable 136 de accionamiento. El primer arbol 152 incluye un extremo 152b distal roscado. La barra 154 de articulacion tiene un collar 154a roscado interiormente que se acopla al extremo distal roscado del primer eje 152. El extremo 154b distal roscado es suficientemente largo como para trasladar la barra 154 de accionamiento de articulacion una distancia deseada.
La segunda unidad 140 de convertidor de accionamiento tiene un segundo eje 148 que se conecta a una segunda salida de la unidad 5 de motor a traves del cable 134 de accionamiento de grapado. El segundo eje 148 incluye un extremo 148a proximal roscado. Un collar 146 roscado internamente se acopla al extremo 148a proximal roscado del segundo arbol. El collar 146 se conecta a un manguito 144 tubular. Un acoplamiento 142 proximal conecta el cable 134 de accionamiento al manguito 144 tubular. A medida que el cable 134 de accionamiento rota, el manguito 144 tubular y el collar 146 rotan y el segundo eje 148 avanza en una direccion distal. El extremo 148a proximal roscado es lo suficientemente largo como para trasladar el arbol 148 de accionamiento de grapado o segundo arbol una distancia deseada para agarrar el tejido y disparar las grapas. En cualquiera de las realizaciones descritas en este documento, la unidad de convertidor de accionamiento puede tener arboles que estan roscados internamente y el arbol de accionamiento de articulacion y/o arbol de accionamiento de grapado puede tener un extremo que forma una varilla roscada para el acoplamiento y la interaccion con el miembro roscado internamente.
La unidad 5 de motor puede estar separada del dispositivo quirurgico, aunque deseablemente es parte de la porcion 10 de mango. Se usan uno o mas motores. Por ejemplo, se pueden montar dos motores de doble direccion en la porcion 10 de mango y conectarlos a una fuente de alimentacion que pue ser una bateria interna o externa con relacion a la porcion 10 de mango. Se contempla que la fuente de alimentacion pueda ser una fuente de alimentacion cableada tal como un generador o una conexion de salida electrica, y el mango puede no tener bateria o incluir una bateria ademas de la otra fuente de alimentacion. Cada motor puede conectarse a un interruptor en la porcion de mango y se puede proporcionar tambien en el mango un interruptor adicional para invertir la direccion de giro de los motores. La fuente de alimentacion es deseablemente una bateria de corriente continua extraible y recargable, aunque se pueden usar fuentes alternativas, tales como una salida de acceso remoto para el suministro de corriente alterna. Se puede usar un transformador o conjunto de engranajes para adaptar la fuente de alimentacion para los motores.
El extremo distal de la unidad 100 de adaptador tiene una porcion 12 de conexion para la conexion de manera extraible a la unidad 20 de carga. La porcion 12 de conexion puede formar esencialmente una conexion en bayoneta, tal como la descrita en la patente estadounidense US 7,044,353 de Mastri et al. (“Mastri”). Un miembro 164 de bloqueo para fijar la unidad 20 de carga sobre la unidad 100 de adaptador esta conectado a un boton 162. El boton 162 es impulsado por un resorte hacia una posicion bloqueada para evitar la extraccion de la unidad de carga hasta que el boton se ha desplazado hasta una posicion desbloqueada.
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La unidad de carga de grapado lineal endoscopico puede ser como la descrita en Mastri o en la patente estadounidense 7,565,993 de Millman et al. La unidad de carga tambien puede ser como la descrita en “Surgical Device Identification”, numero de etiqueta H-US-03725 de Joseph Taylor, presentada el mismo dla que el presente documento. La unidad 20 de carga tiene una porcion 502 de cuerpo alargada con un extremo 650 proximal que define dos orejetas 652 para formar una conexion con un arbol en una unidad 100 de adaptador o una porcion de mango. Se pueden usar otros medios para conectar la unidad de carga. Las unidades de carga pueden disenarse para su fijacion a un accionador quirurgico con alimentacion electrica o a un mango accionado a mano. Un extremo 164a del miembro 164 de bloqueo de la porcion de conexion de la unidad 100 de adaptador (ver la FIG. 3) se acopla a las orejetas 652 de la unidad de carga para fijarla en posicion. Se dispone un tubo 602 alrededor del cuerpo 502.
La unidad 20 de carga tiene un enlace 566 de articulacion con un extremo 666 proximal de gancho para el acoplamiento de un extremo 154c distal de gancho de la barra 154 de accionamiento de articulacion. Una unidad 560 de accionamiento axial tiene un empujador 614 proximal para el acoplamiento del arbol 148 de accionamiento de grapado. Tanto el arbol 148 de accionamiento de grapado como la barra 154 de accionamiento de articulacion son accionados por sus respectivas salidas de la unidad de motor y, gracias a las unidades de convertidor de accionamiento, se trasladan axialmente en una direccion distal.
La unidad 560 de accionamiento axial tiene un miembro de accionamiento de grapado o barra 604 de accionamiento y miembro 606 de agarre en un extremo distal de la barra 604 de accionamiento (ver la FIG. 8). La barra 604 de accionamiento puede ser una lamina alargada de material o una serie de laminas de material apiladas. El miembro 606 de agarre es un miembro que tiene un reborde 606b superior y un reborde 606c inferior (ver la FIG. 7) fijado a una porcion 606a vertical que tiene una hoja de cuchilla. El miembro 606 de agarre esta fijado a la barra de accionamiento o miembro 604 de accionamiento mediante soldadura, adhesivos, o cualquier otro metodo. La porcion proximal de la barra 604 de accionamiento tiene una abertura para trasportar el empujador 614 de modo que el eje 148 de accionamiento de grapado accionara el movimiento de la unidad de accionamiento axial distalmente. El miembro 606 de agarre puede tener piezas de plastico moldeado, u otro recubrimiento plastico, para reducir la friccion que se producira durante el agarre y grapado. Vease el documento EP 1,908,414 y la publicacion de patente estadounidense US 2008/0083812.
Un par de mordazas 506, 508 estan fijadas al cuerpo 502 alargado a traves de una porcion 572 de montaje. Una unidad 506 de yunque de grapadora incluye un yunque 512 y una cubierta 510. El yunque 512 define una ranura para permitir el paso de la unidad de accionamiento axial. La unidad 508 de cartucho incluye un cartucho 518 de grapas, un canal 516 y una unidad de disparo para interaccionar con la barra 604 de accionamiento y el miembro 606 de agarre. El canal tiene una superficie 516a inclinada o en rampa. El canal 516 define tambien una ranura (no mostrada) que permite que la porcion 606a vertical se extienda a traves de la ranura y situe el reborde 606c inferior bajo el canal 516. El cartucho 518 de grapas define una pluralidad de ranuras 528 de grapa y una ranura 526 que corresponde a las ranuras en el canal 516 y yunque 512.
La unidad de yunque, unidad de cartucho, o ambas, son pivotantes. Por ejemplo, el canal 516 tiene un extremo proximal con dos orificios 580 para recibir pernos 582. Los pernos se extienden a traves de la unidad 572 de montaje de modo que la unidad de cartucho puede pivotar con respecto de la unidad de yunque. De este modo, puede agarrarse el tejido entre la unidad 207 de yunque y la unidad 230 de cartucho.
Haciendo referencia a la FIG. 8, una unidad 572 de montaje esta fijada de manera pivotante al extremo distal del cuerpo 502, y esta configurada para ser fijada a los extremos proximales de las mordazas de la unidad 20 de carga de modo que el movimiento de pivote de la unidad 572 de montaje alrededor de un eje perpendicular al eje longitudinal de la porcion 502 de carcasa efectua la articulacion del par de mordazas.
Haciendo referencia a la FIG. 8, la unidad 572 de montaje incluye unas porciones 584 y 574 de montaje superior e inferior. Cada porcion de montaje incluye un orificio en cada lado de la misma que esta dimensionado para recibir pernos 582 para fijar el extremo proximal del canal 516 a la misma. Un par de miembros 594 de acoplamiento se acoplan al extremo distal de la porcion 502 de carcasa y se acoplan a las porciones de montaje. Los miembros 594 de acoplamiento incluyen cada uno de ellos una porcion proximal de interconexion configurada para ser recibida en las ranuras 598 formadas en la porcion 502 de carcasa para retener la unidad 572 de montaje y cuerpo 502 en una posicion longitudinalmente fija con relacion al mismo.
Un par de placas 710 de limitacion estan situadas junto al extremo distal del cuerpo 200 adyacente al extremo distal de la unidad de accionamiento axial para evitar que la unidad de accionamiento sobresalga hacia fuera durante la articulacion del par de mordazas. Cada placa 710 de limitacion incluye una superficie plana que es sustancialmente paralela al eje de pivote del par de mordazas y esta posicionada en un lado de la unidad de accionamiento para evitar que el miembro 604 de accionamiento sobresalga hacia fuera. Cada placa de limitacion incluye un primer extremo distal que esta situado en una primera ranura respectiva formada en la unidad 574 de montaje y un segundo extremo proximal que esta posicionado en una respectiva segunda ranura formada en un extremo distal de la carcasa 503b.
Se disponen unas grapas 530 en las ranuras 528 de grapa que son impulsadas hacia fuera de dichas ranuras de grapa por unos empujadores 533. La porcion 606a vertical tambien se extiende a traves de la ranura en el miembro
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512 de yunque para situar el reborde 606b superior sobre una superficie superior del yunque 512. Se dispone un deslizador 536 en el cartucho de grapas inicialmente en una posicion proximal, y tiene cunas 534 que se acoplan a los empujadores 533. Los empujadores tienen superficies de leva (no mostradas) de modo que a medida que el deslizador 536 es hecho avanzar por la barra 604 de accionamiento y el miembro 606 de agarre, el deslizador levantara los empujadores, impulsando las grapas hacia fuera de las ranuras 528, a traves del tejido, y contra las cavidades de formacion de grapa del yunque 512. A medida que la barra 604 de accionamiento y el miembro 606 de agarre avanzan inicialmente, el reborde superior recorre la superficie 516a inclinada para aproximarse a la unidad 506 de yunque con la unidad 508 de cartucho. A medida que se disparan las grapas, la barra 604 de accionamiento y el miembro 606 de agarre continuan fijados a la unidad de yunque y la unidad de cartucho para mantener la posicion de la unidad de yunque y la unidad de cartucho durante el disparo de las grapas.
La unidad 20 de carga puede incluir un primer conector de datos para la conexion con un segundo conector de datos en la unidad 100 de adaptador, para retroalimentar datos a un controlador 9 en la porcion 10 de mango. El primer conector de datos puede comprender un contacto o contactos en el cuerpo 200 de la unidad de carga, mientras que el segundo conector de datos puede ser uno o mas contactos dispuestos en la unidad 100 de adaptador para la conexion con los contactos del primer conector de datos. Se dispone una unidad de memoria en la unidad de carga y se conecta al primer conector de datos. La unidad de memoria puede comprender una EEPROM, EPROM, o similar, contenida en el cuerpo 200 y puede almacenar information tal como el tipo de unidad de carga, el tamano de las grapas en la unidad de carga, la longitud de la llnea de grapas formada por la unidad de carga cuando se disparan las grapas, e informacion acerca de si la unidad de carga ha sido ya disparada. El segundo conector de datos esta conectado al controlador 9 en la unidad de mango mediante hilos, o cables, que se extienden a traves de la unidad de adaptador, o a traves de una conexion inalambrica. Alternativamente, la unidad de memoria de la unidad de carga puede comunicarse de forma inalambrica con el controlador en la porcion de mango.
La unidad de memoria puede almacenar el final de carrera de la unidad de agarre axial, o la longitud de la carrera, para la unidad de carga. Esta informacion puede ser utilizada por el controlador 9 para evitar un accionamiento excesivo de la unidad de accionamiento axial, que podrla danar la unidad de carga. De este modo, el controlador puede recibir informacion sobre el final de carrera o la longitud de la carrera, y detener el accionamiento del cable 134 de accionamiento de grapa cuando se alcanza el final de carrera. Alternativamente, el controlador 9 puede estar configurado para detectar cuando la unidad de accionamiento axial ha alcanzado el final de carrera y ha disparado todas las grapas en la llnea de grapado. El controlador detecta esto usando sensores en la unidad de carga, o monitorizando la corriente en la unidad de motor. Por ejemplo, cuando la corriente en la unidad de motor aumenta drasticamente, o se producen picos, se detiene el funcionamiento de la unidad de motor.
El controlador 9 puede ser un circuito integrado, circuiterla logica o analogica, y/o un microprocesador, o un conjunto de tales componentes. El controlador recibe informacion de la unidad de carga, unidad de memoria, otros sensores en la unidad de adaptador y/o la unidad de carga, y puede controlar el funcionamiento del dispositivo quirurgico. Por ejemplo, pueden usarse sensores para detectar las fuerzas de agarre en la unidad de cartucho y la unidad de yunque. El controlador puede iniciar una alarma visual o audible en caso de que se superen las fuerzas recomendadas, o el controlador puede detener el funcionamiento del dispositivo quirurgico parando el motor de la unidad de mango. Tambien puede incluirse un chip o tarjeta de memoria extralble.
Cuando existen unidades 20 de carga con diferentes longitudes de llnea de grapado disponibles para su uso con el dispositivo quirurgico, puede ser util identificar la longitud de la llnea de grapado y utilizar esa informacion para controlar el funcionamiento del dispositivo quirurgico. Por ejemplo, el controlador 9 recibe la longitud de llnea de grapado de la unidad de memoria y a traves del primer conector de datos en la unidad de carga. Esa informacion se compara con datos de la unidad 11 de memoria en la porcion 10 de mango para determinar hasta que longitud accionar el arbol 148 de accionamiento de grapa y evitar accionar el arbol 148 demasiado lejos, y potencialmente danar la unidad de carga. El tipo de unidad de carga, y la longitud de la llnea de grapado, el tamano de grapa, etc. puede por tanto utilizarse para controlar el funcionamiento del dispositivo quirurgico. El controlador 9 puede programarse para invertir la direction segun la cual se acciona el cable 134 de accionamiento de grapado despues de que se alcanza la longitud de llnea de grapado, invirtiendo as! la direccion del arbol 148 de accionamiento de grapado y permitiendo que las mordazas de la unidad de carga se abran. Alternativamente o adicionalmente, se pueden disponer sensores en la unidad de carga para determinar la posicion del deslizador 536, miembro 606 de agarre, y/o barra 604 de accionamiento, y para invertir la direccion del motor cuando se ha alcanzado el extremo de la llnea de grapado.
La porcion 10 de mango suministra potencia a la unidad 5 de motor a traves de una baterla, generador, o enchufe electrico para alimentar la rotation de los cables 134, 136. La magnitud del par necesaria para que las mordazas de la unidad de carga agarren el tejido puede medirse mediante la monitorizacion de la corriente del motor. Durante el agarre del tejido, durante el movimiento inicial del miembro 606 de agarre sobre la superficie 516a inclinada del canal 516, el miembro 606 de agarre ejerce fuerzas sobre el canal 516, y sobre el tejido que se esta agarrando entre la unidad de cartucho y la unidad de yunque. Estas fuerzas pueden ser detectadas por el controlador 9, y caracterizadas. Por ejemplo, la fuerza de la unidad de cartucho cuando agarra el tejido contra el yunque 512 puede ser detectada y comparada en la unidad 11 de memoria del controlador para proporcionar informacion al cirujano. Tambien, esta informacion puede ser almacenada y reportada para su uso posterior. La porcion 10 de mango
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deseablemente tiene una unidad de visualizacion y/o indicador para mostrar informacion o alertar al usuario del dispositivo quirurgico. Adicionalmente o alternativamente, el dispositivo puede incluir un componente de audio para emitir una alarma audible o mensaje grabado. La unidad de visualizacion puede ser un diodo emisor de luz, pantalla de cristal llquido, u otros.
Puede utilizarse un encoder o encoders como uno o mas de los sensores del dispositivo quirurgico. El encoder incluye dispositivos de efecto Hall montados junto a los arboles de accionamiento de los motores para detectar un iman o imanes montados en los arboles. De este modo, puede determinarse la posicion angular de los arboles de accionamiento y su direction, as! como la posicion de los arboles de accionamiento, cables 134, 136 de accionamiento, barra 154 de accionamiento de articulation, y/o arbol 148 de accionamiento de grapado. Se contempla que, en cualquiera de las realizaciones descritas en este documento, se dispongan encoders u otros sensores para los cables 134, 136 de accionamiento, la barra 154 de accionamiento de articulacion, y/o el eje 148 de accionamiento de grapado. En cualquiera de las realizaciones descritas en este documento, se detectan las caracterlsticas de consumo de corriente de la baterla o baterlas y del uno o mas motores de la unidad 5 de motor. Tambien se contempla la disposition de otros sensores de deformation, fuerza y/o posicion en el actuador de extremo, la unidad de adaptador, y/o la portion de mango.
Tambien pueden disponerse sensores 211 en la unidad 20 de carga para determinar el hueco entre el cartucho 508 de grapado y el yunque 512. El controlador 9 puede incluir tablas de informacion que indican el hueco deseado para una unidad de carga particular (basada en el tamano de grapa, longitud de la llnea de grapado, etc) y se pueden utilizar para evitar el disparo de grapas en caso de que no se pueda conseguir el hueco deseado. Por ejemplo, la patente estadounidense publicada US 2012/0211542 describe modos de gestion de tejido para controlar un dispositivo quirurgico y utiliza unas tablas de correlacion almacenadas. En cualquiera de las realizaciones descritas en este documento, el dispositivo quirurgico puede incluir un controlador y sensores en la unidad 100 de adaptador, unidad 20 de carga, y/o porcion 10 de mango que determinan la fuerza de agarre, el hueco entre el cartucho 508 y el yunque 512, si la unidad de carga ha sido utilizada, el tipo de unidad de carga, y/o la longitud o tamano de la llnea de grapado. La informacion se utiliza para controlar el funcionamiento del dispositivo quirurgico, proporcionar indicaciones al usuario, y/o simplemente se almacena para su uso posterior.
En cualquiera de las realizaciones descritas en este documento, la unidad de carga tiene una caracterlstica mecanica para determinar el tipo de cartucho 220, la longitud de la llnea de grapado, el tamano de las grapas, etc.
La caracterlstica mecanica es un saliente, depresion, o serie de salientes o depresiones que tienen una forma especial, y que son unicos para ese tipo de unidad de carga. La caracterlstica mecanica puede tener diferentes formas y/o texturas, puede determinar el tamano de grapa, longitud de llnea de grapado, o ambas. Puede tambien utilizarse para determinar otros aspectos de la unidad de carga, tal como si es articulada o no articulada, o si se esta utilizando un material de refuerzo. La caracterlstica mecanica puede ser un recubrimiento en la unidad de carga, que proporciona textura, una resistencia a la friction diferente, o algun otro aspecto que pueda diferenciar el tipo de unidad de carga.
La caracterlstica 1020 mecanica esta situada en la unidad de carga en una ubicacion donde el miembro 606 de agarre se acopla a la unidad 508 de cartucho, unidad 506 de yunque, o ambas. Como se muestra en la FIG. 9, una unidad 1001 de carga tiene una unidad de yunque y una unidad 1230 de cartucho. En el avance inicial del miembro 606 de agarre, que puede ser el miembro de agarre que se muestra en las FIGS. 6, 7 y 8, el reborde 606c inferior del miembro de agarre atraviesa la superficie 516a inclinada. Entonces, el miembro de agarre pasa a desplazarse bajando la superficie del canal 1516, accionado por el miembro 148 de impulso de grapa. La caracterlstica o caracterlsticas 1020 mecanicas dispuestas en el canal 1516 modifican la fuerza o par en el motor. El cambio en la fuerza o par es detectado por el controlador 9 de la porcion de mango y se compara con datos en la unidad 11 de memoria del controlador. Se determina el final de carrera 1040 para la unidad 1001 de carga particular. Utilizando esta informacion, el controlador 9 determina que la unidad 1001 de carga tiene, por ejemplo, una longitud de llnea de grapado de 60 millmetros, y acciona el cable 134 de accionamiento de grapado un numero predeterminado de rotaciones para accionar el arbol 148 de accionamiento de grapado la distancia necesaria para impulsar todas las grapas, pero sin superar la longitud de la unidad de cartucho.
Por ejemplo, puede determinarse la fuerza lineal utilizando la corriente del motor, los llmites de corriente del motor, y/o las revoluciones por minuto. Alternativamente, pueden utilizarse galgas extensiometricas. Estas medidas pueden tomarse con sensores en el actuador de extremo, unidad de adaptador y/o porcion de mango.
Ademas, puede determinarse que la unidad de carga es una unidad de carga articulada, permitiendo el accionamiento del cable 136 de articulacion. Si se determina que la unidad de carga no es una unidad de carga articulada, se evita el accionamiento del cable 136 de accionamiento de articulacion evitando el giro en el motor correspondiente de la unidad 5 de motor. Por ejemplo, puede disponerse una caracterlstica o caracterlsticas 1020 mecanicas en el yunque 512 que identifican el tipo de unidad de carga, longitud de llnea de grapado, tamano de grapa, o que identifican la unidad de carga como articulada. Similarmente, se puede proporcionar una caracterlstica o caracterlsticas 1020 mecanicas en el canal 1218 y/o superficie de yunque que identifican que la unidad de carga tiene un refuerzo precargado sobre la unidad de carga, o que identifican que la unidad de carga tiene una punta de diseccion.
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En cualquiera de las realizaciones descritas en este documento, la caracterlstica mecanica 1020 puede estar dispuesta en la unidad de yunque, la unidad 1230 de cartucho, o ambas, en un patron de cavidades, salientes, protuberancias, huecos, o una combinacion de los anteriores. Las propiedades flsicas del patron de las caracterlsticas 1020 mecanicas modifican la fuerza o par en la unidad de motor y son detectadas en el controlador. En ciertas realizaciones, las caracterlsticas 1020 mecanicas tienen un primer patron 1020a y un segundo patron 1020b. Se pueden usar dos o mas patrones diferentes para expandir el numero de unidades 1001 de carga diferentes que se pueden indicar. Ademas, puede usarse el patron o un cambio en el patron de caracterlsticas 1020 mecanicas para indicar que el miembro 606 de agarre esta llegando al final 1040 de carrera. El controlador puede configurarse (programarse o estructurarse o similar) para monitorizar el cambio en la fuerza o par, y determinar cuando se debe detener el funcionamiento de la unidad 5 de motor. De este modo, se detiene el accionamiento de la unidad de accionamiento axial antes de que la unidad de accionamiento axial llegue al final 1040 de carrera. Por ejemplo, como se muestra en la FIG. 9, las caracterlsticas 1020 mecanicas tienen un primer patron 1020a y un segundo patron 1020b que son diferentes entre si por que tienen diferentes cavidades o salientes. Por ejemplo, el primer patron 1020a tiene cavidades o salientes cuya longitud es mayor que las cavidades o salientes del segundo patron 1020b. El controlador esta configurado para determinar el final de carrera 1040 para la unidad 1001 de carga particular basandose en el cambio en la fuerza o par detectado por el controlador. La velocidad del movimiento del miembro de agarre, as! como su posicion, pueden ser determinados basandose en la indicacion proporcionada por la caracterlstica mecanica.
Por ejemplo, la unidad 1001 de carga tiene una unidad 1230 de cartucho con un cartucho de grapas que define un eje X longitudinal segun se muestra en la FIG. 9. La unidad de accionamiento axial es accionada a traves del cartucho de grapas para disparar las grapas quirurgicas segun se ha descrito anteriormente, en la direccion longitudinal a lo largo del eje X. A medida que se acciona la unidad de accionamiento axial, el reborde 606c inferior del miembro 606 de agarre se acopla al canal 1516 y cualquier caracterlstica 1020 mecanica dispuesta en el canal 1516. De este modo, el reborde 606c inferior se acopla en primer lugar al primer patron 1020a de caracterlsticas mecanicas, y a continuacion se acopla al segundo patron 1020b de caracterlsticas mecanicas. El segundo patron 1020b de caracterlsticas mecanicas esta dispuesto mas cerca de un extremo distal del canal 1516, y mas cerca del final 1040 de carrera.
El canal 1516 define una ranura 1517 para permitir que la porcion 606a vertical del miembro de agarre pase a traves de la ranura 1517 de modo que el reborde 606c inferior pueda acoplarse al canal 1516. En el canal se define un extremo distal de la ranura 1517, y forma el final 1040 de carrera. Intentar accionar la unidad de accionamiento axial mas alla del extremo distal de la ranura 1517, pasado el final 1040 de carrera, puede provocar danos en la unidad 1001 de carga, la unidad de adaptador, componentes de la unidad de mango, etc.
En cualquiera de las realizaciones descritas en este documento, se pueden usar sensores electronicos, sensores opticos, sensores magneticos, y/o cualquier otro tipo de sensores, ademas de la caracterlstica 1020 mecanica, para proporcionar informacion acerca de la unidad de carga particular y su uso. En cualquiera de las realizaciones descritas en este documento, se dispone un sensor electronico, sensor magnetico, sensor optico, u otro sensor, en el reborde 606b superior, yunque 512, canal 516, o cualquier combinacion de los mismos, para indicar el tipo de unidad de carga, tamano de grapa, longitud de llnea de grapado, otros aspectos de la unidad de carga, y/o sin la unidad de carga ha sido disparada o utilizada previamente.
En cualquiera de las realizaciones descritas en este documento, la unidad de adaptador puede incluir un chip de identificacion o sensor para cualquiera de las funciones descritas en este documento, incluyendo para identificar el tipo de unidad de adaptador o sus caracterlsticas. Se pueden usar sensores electronicos, sensores opticos, sensores magneticos, y/o cualquier otro tipo de sensor. Deseablemente, el sensor o chip se comunica con el controlador, que puede estar situado en la porcion de mango, a traves de hilos o cables, o a traves de comunicacion inalambrica.
Los sensores dispuestos pueden incluir, en cualquiera de las realizaciones descritas en este documento, sensores de temperatura para medir la temperatura interna en o alrededor del dispositivo quirurgico.
El controlador comprende uno o mas chips o microprocesadores, como se ha descrito anteriormente. El controlador puede comprender mas de uno de tales chips o procesadores, y puede ser un conjunto de tales elementos. Se pueden almacenar datos para determinar el tipo y caracterlsticas de los actuadores de extremo, unidades de adaptador y/o porciones de mango en unidades de memoria en la forma de graficas, tablas matrices, o similar. Estos pueden utilizarse en conjunto con otros sistemas disenados para el dispositivo quirurgico.
Ademas, la unidad 30 de carga de grapado circular y la unidad 40 de carga de grapado transversal tienen miembros de accionamiento tales como el miembro 606 de agarre y la barra 604 de accionamiento descritos anteriormente que pueden utilizarse con las caracterlsticas 1020 mecanicas para determinar el tipo de unidad de carga, tamano de grapas, longitud o diametro de la llnea de grapado, etc. Las caracterlsticas mecanicas de los elementos accionados de estos componentes de grapado pueden usarse para identificar la informacion descrita en este documento.
Se puede utilizar informacion comunicada a traves de un bucle de realimentacion del controlador para determinar modos funcionales para cada actuador de extremo unico, unidad de adaptador, y/o porcion de mango. Basandose
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en un ID de unidad de carga o actuador de extremo y en las condiciones de disparo actuales, puede ajustarse dinamicamente el funcionamiento del sistema para conseguir mejores resultados. Estos ajustes pueden estar pre- determinados o ser adaptados de manera inteligente por el controlador durante el funcionamiento.
Un ejemplo de implementacion de lo anterior serla el ajuste del par de salida cuando se detecta el uso de un material de refuerzo desconocido.
Las caracterlsticas mecanicas pueden estar situadas en una variedad de posiciones. Ejemplos incluyen, sin limitacion, lo siguiente.
En un dispositivo de grapado circular, tal como una grapadora EEA, las caracterlsticas mecanicas se disponen a lo largo de cualquier componente o componentes que se mueven durante el funcionamiento. Las caracterlsticas mecanicas puede formarse en el arbol de agarre y/o el arbol de grapado. El arbol de grapado tiene la carrera mas larga y puede utilizarse para recoger tanto informacion posicional como informacion acerca de fuerzas. Por ejemplo, el controlador podrla monitorizar como se deforma un componente bajo la carga aplicada y medir esta deformacion usando los sensores de bucle de realimentacion y el controlador.
En un dispositivo endoscopico lineal, tal como una grapadora Endo GIA, la ubicacion de las caracterlsticas mecanicas en el actuador de extremo o unidad de carga puede incluir, sin limitacion, caracterlsticas mecanicas en los lados de la barra de accionamiento, que serlan leldas por un sensor a medida que pasan. Este patron puede aplicarse de manera simetrica en ambos lados, o de manera asimetrica para aumentar el ancho de banda de la senal.
Las caracterlsticas mecanicas en la parte superior o inferior de la barra de cuchilla (ver la FIG. 10) pueden ser tales que un sensor pueda detectar las caracterlsticas a lo largo de la superficie. La barra de accionamiento puede tener una pluralidad de aberturas o ventanas que se pueden usar en lugar o ademas de las caracterlsticas mecanicas. Podrla utilizarse un sensor flsico convencional, o una fotocelula, para determinar si han pasado esas ventanas, o cuantas han pasado, o a que velocidad han pasado. En cualquiera de las realizaciones descritas en este documento, se podrla usar un sensor flsico convencional, o una fotocelula, para determinar si han pasado las caracterlsticas mecanicas, y/o cuantas han pasado, y/o a que velocidad han pasado.
Ademas, la porcion inferior del miembro de grapado, el reborde 606c, o un miembro separado que constituye la porcion inferior, pueden incluir caracterlsticas mecanicas. Dichas caracterlsticas mecanicas pueden estar sobre la superficie que se acopla al canal, o en los lados del reborde. El propio canal podrla incluir caracterlsticas mecanicas, o los lados de la barra de accionamiento pueden incluir tales caracterlsticas. Veanse las Figs. 10A y 10B. La unidad de carga puede incluir un miembro 2001 de detection fijado a la carcasa de la unidad de carga en un extremo, y teniendo un extremo 2003 libre opuesto. El miembro 2001 es flexible e incluye un saliente 2005 en el extremo 2003 libre. A medida que la barra de accionamiento o miembro 2560 avanza a traves del cartucho de grapas y yunque, el saliente interactua con las caracterlsticas 2020 mecanicas de la barra de accionamiento. Como se muestra en la FIG. 10B, las caracterlsticas 2020 mecanicas pueden ser cavidades en la barra de accionamiento. En otras realizaciones, una fotocelula u otro sensor detecta, cuenta, almacena, o de cualquier modo reconoce las caracterlsticas mecanicas como un medio para identificar la unidad de carga, sus caracterlsticas, el final de carrera, y/o la velocidad de la barra de accionamiento. El resto de componentes de la unidad de carga que tienen la barra 2560 de accionamiento pueden ser segun se ha descrito anteriormente con relation a la unidad 20 de carga.
Aunque la presente invention se ha descrito e ilustrado con relacion a ciertas realizaciones, no es la intention del solicitante restringir o de cualquier otro modo limitar el alcance de las reivindicaciones a esos detalles. Para los expertos en la materia seran evidentes ventajas y modificaciones adicionales.

Claims (9)

  1. 5
    10
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    40
    REIVINDICACIONES
    1. Un dispositivo de grapado quirurgico que comprende una porcion alargada, una porcion de mango y una unidad (20) de carga, comprendiendo la unidad (20) de carga:
    una unidad (508) de cartucho y una unidad (506) de yunque, incluyendo la unidad de cartucho un canal (516) y un cartucho (518) que tiene una pluralidad de grapas (530) quirurgicas en su interior; y
    una unidad (560) de accionamiento axial con un miembro (606) de agarre, teniendo el miembro de agarre un reborde (606b) superior para el acoplamiento de la unidad de yunque, y un reborde (606c) inferior para el acoplamiento del canal, siendo la unidad (560) de accionamiento axial movil a traves del cartucho (518) de grapas para impulsar las grapas (530) hacia fuera del cartucho de grapas y contra la unidad (506) de yunque;
    teniendo la porcion de mango una unidad (5) de motor; y un controlador; caracterizado por que
    se definen caracterlsticas (1020) mecanicas en el canal (516) para indicar un final de carrera (1040) para la unidad de accionamiento axial, teniendo las caracterlsticas mecanicas un primer patron (1020a) y un segundo patron (1020b), siendo cada patron diferente de tal modo que el reborde (606c) inferior se acopla al primer patron (1020a) y luego al segundo patron (1020b) cambiando el cambio en el patron de las caracterlsticas mecanicas la fuerza o par en la unidad de motor, siendo dicho cambio detectable por el controlador para indicar que el miembro (606) de agarre esta alcanzando el final de carrera (1040).
  2. 2. El dispositivo de grapado quirurgico de acuerdo con la reivindicacion 1, donde el cartucho (518) de grapas tiene una pluralidad de cavidades (528) de retencion de grapas y las grapas (530) quirurgicas estan dispuestas en las cavidades de retencion de grapas, preferiblemente, donde las cavidades de retencion de grapas estan dispuestas segun filas lineales.
  3. 3. El dispositivo de grapado quirurgico de acuerdo con la reivindicacion 1 o reivindicacion 2, donde la unidad (560) de accionamiento axial incluye una barra (604) de accionamiento.
  4. 4. El dispositivo de grapado quirurgico de acuerdo con cualquiera de las reivindicaciones 1 a 3, que ademas comprende un sensor para determinar un hueco entre la unidad (506) de yunque y la unidad (508) de cartucho.
  5. 5. El dispositivo de grapado quirurgico de acuerdo con cualquiera de las reivindicaciones 1 a 4, donde el cartucho (518) de grapas define un eje longitudinal y unas cavidades (528) de retencion de grapas dispuestas segun filas lineales a lo largo del eje longitudinal.
  6. 6. El dispositivo de grapado quirurgico de acuerdo con cualquiera de las reivindicaciones 1 a 5, donde el canal (516) de la unidad de cartucho define una ranura (1517).
  7. 7. El dispositivo de grapado quirurgico de acuerdo con la reivindicacion 6, donde un extremo distal de la ranura (1517) forma el final de carrera.
  8. 8. El dispositivo de grapado quirurgico de acuerdo con cualquiera de las reivindicaciones 1 a 7, donde el segundo patron de caracterlsticas mecanicas es mas cercano al extremo distal de la ranura que el primer patron de caracterlsticas mecanicas.
  9. 9. El dispositivo de grapado quirurgico de acuerdo con cualquiera de las reivindicaciones precedentes, donde el primer patron (1020a) de caracterlsticas mecanicas tiene caracterlsticas mecanicas de un tamano diferente que un tamano de las caracterlsticas mecanicas del segundo patron (1020b).
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EP2722010A1 (en) 2014-04-23
CN103767748B (zh) 2017-12-22
AU2013216677B2 (en) 2018-03-08
JP2014083436A (ja) 2014-05-12
US20140110455A1 (en) 2014-04-24
CA2824590C (en) 2020-09-08
AU2013216677A1 (en) 2014-05-08
EP2901945B1 (en) 2018-08-15
US10201347B2 (en) 2019-02-12
CA2824590A1 (en) 2014-04-18
CN103767748A (zh) 2014-05-07
JP6368464B2 (ja) 2018-08-01
US11141152B2 (en) 2021-10-12
US20190159776A1 (en) 2019-05-30
EP2722010B1 (en) 2016-08-03
US20160338700A1 (en) 2016-11-24
EP2901945A1 (en) 2015-08-05
US9421014B2 (en) 2016-08-23

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