ES2863993T3 - Grapadora quirúrgica con mecanismo de accionamiento con árbol rotatorio - Google Patents

Grapadora quirúrgica con mecanismo de accionamiento con árbol rotatorio Download PDF

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ES2863993T3
ES2863993T3 ES19150575T ES19150575T ES2863993T3 ES 2863993 T3 ES2863993 T3 ES 2863993T3 ES 19150575 T ES19150575 T ES 19150575T ES 19150575 T ES19150575 T ES 19150575T ES 2863993 T3 ES2863993 T3 ES 2863993T3
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drive shaft
handle assembly
orientation
handle
drive
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Atal Patel
Johnathan Covach
Christina N Reed
Matthew M Becerra
Gary M Johnson
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Applied Medical Resources Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B17/07207—Surgical 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil

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  • General Health & Medical Sciences (AREA)
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  • Veterinary Medicine (AREA)
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Abstract

Un conjunto (40) de mango para una grapadora quirúrgica (10) comprendiendo el conjunto (40) de mango una carcasa que define un mango estacionario (42); un mango móvil (44) acoplado de manera pivotante a la carcasa y móvil desde una posición abierta a una posición cerrada; y un mecanismo (50) de accionamiento que comprende: un árbol (60) de accionamiento que tiene un eje longitudinal, comprendiendo el árbol (60) de accionamiento un eje longitudinal una superficie (62) de avance formada sobre el mismo, una superficie (64) de retroceso formada sobre el mismo angularmente desplazada desde la superficie de avance, y una superficie (66) de apertura formada sobre el mismo, siendo el árbol (60) de accionamiento longitudinalmente deslizable con relación a la carcasa y selectivamente rotatorio alrededor del eje longitudinal entre una primera orientación y una segunda orientación; un impulsor (52) de avance acoplado de manera operativa al mango (44) móvil, siendo el impulsor (52) de avance que se puede engranar con el árbol (60) de accionamiento en la primera orientación y desengranar del árbol (60) de accionamiento en la segunda orientación; un impulsor (54) de retroceso acoplado de forma operable a un mango (44) móvil; y un impulsor (58) de apertura acoplado de forma operable al mango (44) móvil.

Description

DESCRIPCIÓN
Grapadora quirúrgica con mecanismo de accionamiento con árbol rotatorio
Antecedentes de la invención
Campo de la invención
La presente solicitud se refiere en general a instrumentos de oclusión quirúrgica y, más particularmente, a grapadoras quirúrgicas.
Descripción de la técnica relacionada
Las grapadoras quirúrgicas se utilizan para aproximar o sujetar el tejido y para grapar el tejido sujeto. Como tales, las grapadoras quirúrgicas tienen mecanismos para asegurar que el tejido se posicione y se capture adecuadamente y para accionar las grapas a través del tejido. Como resultado, esto ha producido, por ejemplo, múltiples disparadores y mangos en conjunto con mecanismos complejos para proporcionar un grapado adecuado del tejido sujeto. Con estos complejos mecanismos, las grapadoras quirúrgicas pueden tener mayores cargas de fabricación, así como también fuentes potenciales de fallos del dispositivo y confusión para el usuario. Por lo tanto, se desea un grapado fiable de tejido sujeto sin mecanismos complejos.
Compendio de la invención
Según la presente invención se proporciona un conjunto de mango como se expone en la reivindicación 1
Breve descripción de los dibujos
La Figura 1 es una vista en perspectiva de una realización del dispositivo de grapado quirúrgico con las mordazas en una configuración abierta;
La Figura 2 es una vista en perspectiva de una realización de un cartucho para el dispositivo de grapado quirúrgico de la Figura 1 con las mordazas en una configuración cerrada;
La Figura 3 es una vista en perspectiva de una realización del conjunto de mango para un dispositivo de grapado quirúrgico;
La Figura 4 es una vista en perspectiva del conjunto de mango de la Figura 3 con un mango móvil en una configuración cerrada;
La Figura 5 es una vista superior del conjunto de mango de la Figura 3 con un selector en una primera configuración; La Figura 6 es una vista superior del conjunto de mango de la Figura 3 con un selector en una segunda configuración; La Figura 7 es una vista lateral del conjunto de mango de la Figura 3;
La Figura 8A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 en una configuración inicial;
La Figura 8B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 8A;
La Figura 9A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 accionado a una configuración cerrada;
La Figura 9B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 9A;
La Figura 10A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 en una configuración de accionamiento hacia delante;
La Figura 10B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 10A;
La Figura 11A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 en la configuración de accionamiento hacia delante;
La Figura 11B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 11A;
La Figura 12A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 en una configuración accionada totalmente hacia delante;
La Figura 12B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 12A;
La Figura 13A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 en una configuración de accionamiento hacia atrás;
La Figura 13B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 13A;
La Figura 14A es una vista lateral en sección transversal del conjunto de mango de la Figura 3 en una configuración accionada totalmente hacia atrás;
La Figura 14B es una vista en perspectiva en sección transversal del conjunto de mango de la Figura 14A;
La Figura 15 es una vista lateral de otra realización del conjunto de mango para un dispositivo de grapado quirúrgico; La Figura 16 es una vista en perspectiva del conjunto de mango de la Figura 15;
La Figura 17 es una vista lateral en corte del conjunto de mango de la Figura 15;
La Figura 18 es una vista superior de un mecanismo de rotación para un mecanismo de accionamiento del conjunto de mango de la Figura 15;
La Figura 19 es una vista superior de un collarín de cubo y un árbol de accionamiento del mecanismo de rotación de la Figura 18 con el collarín de cubo en una primera posición;
La Figura 20 es una vista superior del collarín de cubo y el árbol de accionamiento del mecanismo de rotación de la Figura 18 con un collarín de cubo en una segunda posición;
La Figura 21 es una vista superior del collarín de cubo y el árbol de accionamiento del mecanismo de rotación de la Figura 18 con un collarín de cubo en una tercera posición;
La Figura 22 es una vista superior del collarín de cubo y el árbol de accionamiento del mecanismo de rotación de la Figura 18 con un collarín de cubo en una cuarta posición;
La Figura 23 es una vista superior del collarín de cubo y el árbol de accionamiento del mecanismo de rotación de la Figura 18 con un collarín de cubo en una quinta posición;
La Figura 24 es una vista superior del collarín de cubo y del árbol de accionamiento del mecanismo de rotación de la Figura 18 con un collarín de cubo en una sexta posición; y
La Figura 25 es una vista superior del collarín de cubo y el árbol de accionamiento del mecanismo de rotación de la Figura 18 con un collarín de cubo en una séptima posición.
Descripción detallada de la invención
Con referencia a las Figuras 1-2, se ilustra una realización de un dispositivo de grapado quirúrgico. La realización ilustrada de la grapadora quirúrgica 10 comprende un árbol alargado 20, un conjunto 30 de mordaza y un conjunto 40 de mango. La Figura 1 ilustra la grapadora quirúrgica 10 con el conjunto 30 de mordaza en una configuración abierta. La Figura 2 ilustra un cartucho extraíble comprendiendo el árbol alargado 20 y el conjunto 30 de mordaza de la grapadora quirúrgica 10 con el conjunto 30 de mordaza en una configuración cerrada.
Con referencia continuada a las Figuras 1 y 2, la realización ilustrada de la grapadora quirúrgica 10 puede dimensionarse y configurarse para su uso en procedimientos quirúrgicos laparoscópicos. Por ejemplo, el árbol alargado 20 y el conjunto 30 de mordaza pueden dimensionarse y configurarse para ser introducidos en un campo quirúrgico a través de un puerto de acceso o cánula de trocar. En algunas realizaciones, el árbol alargado 20 y el conjunto 30 de mordaza pueden dimensionarse y configurarse para ser insertados a través de una cánula de trocar que tiene un diámetro de canal de trabajo relativamente pequeño, tal como, por ejemplo, menor de 8 mm. En otras realizaciones, el árbol alargado 20 y el conjunto 30 de mordaza pueden dimensionarse y configurarse para ser insertados a través de una cánula de trocar que tiene un diámetro de canal de trabajo mayor, tal como, por ejemplo, 10 mm, 11 mm, 12 mm o 15 mm. En otras realizaciones, se contempla que ciertos aspectos de las grapadoras quirúrgicas descritas en la presente memoria pueden incorporarse en un dispositivo de grapado quirúrgico para su uso en procedimientos quirúrgicos abiertos.
Con referencia continuada a las Figuras 1 y 2, como se ilustra, el árbol alargado 20 comprende un miembro generalmente tubular. El árbol alargado 20 se extiende desde un extremo proximal 22 hasta un extremo distal 24. El árbol alargado 20 define un eje longitudinal central, L. de la grapadora quirúrgica 10 que se extiende entre el extremo proximal 22 y el extremo distal 24.
Con referencia continuada a las Figuras 1 y 2, en la realización ilustrada, el conjunto 30 de mordaza está acoplado al árbol alargado 20 en el extremo distal 24 del árbol alargado 20. El conjunto 30 de mordaza comprende una primera mordaza 32 y una segunda mordaza 34 acoplada de manera pivotante a la primera mordaza 32. En la realización ilustrada, la primera mordaza 32 se fija al extremo distal 24 del árbol alargado 20 de manera que se extiende distalmente a lo largo del eje longitudinal central, L y permanece estacionaria con respecto al árbol alargado 20. En otras realizaciones, se contempla que tanto la primera como la segunda mordazas 32, 34 sean pivotantes con respecto al árbol alargado. En otras realizaciones, se contempla que el conjunto 30 de mordaza sea articulable con respecto al árbol alargado 20. En una configuración inicial, la primera mordaza 32 incluye una pluralidad 36 de grapas dispuestas en su interior. En algunas realizaciones, las grapas pueden posicionarse inicialmente en la segunda mordaza 34.
Con referencia continuada a las Figuras 1 y 2, en la realización ilustrada, el conjunto 30 de mordaza puede ser accionado desde una configuración abierta (Figura 1) a una configuración cerrada (Figura 2) a una configuración de grapado por un miembro o barra de accionamiento que puede deslizar longitudinalmente dentro del árbol alargado. En una posición inicial, la barra puede estar posicionada en el extremo distal 24 del árbol alargado 20. Con la barra en la posición inicial, la segunda mordaza 34 se hace pivotar lejos de la primera mordaza 32 de manera que el conjunto 30 de mordaza está en la configuración abierta. La barra de accionamiento se aplica a la segunda mordaza 34 después de la traslación del miembro o barra de accionamiento distalmente a lo largo del eje longitudinal L. La traslación de la barra de accionamiento distalmente desde la posición inicial en una primera distancia puede accionar el conjunto de mordaza desde la configuración abierta a la configuración cerrada. Con el conjunto 30 de mordaza en la configuración cerrada, la barra de accionamiento puede ser hecha retroceder de manera proximal en la primera distancia para devolver el conjunto 30 de mordaza a la configuración abierta. Un extremo distal de la barra de accionamiento puede hacer avanzar una corredera de grapas configurada para desplegar grapas desde la primera mordaza 32, de modo que una traslación adicional de la barra de accionamiento más allá de la primera distancia despliega la pluralidad 36 de grapas desde la primera mordaza 32.
Con referencia continuada a las Figuras 1 y 2, en la realización ilustrada, el conjunto de mango está acoplado al árbol alargado 20 en el extremo proximal 22 del árbol alargado 20. Como se ilustra, el conjunto 40 de mango tiene una configuración de empuñadura de pistola con una carcasa que define un mango estacionario 42 y un activador tal como un mango móvil 44 o un disparador acoplado de manera pivotante al mango estacionario 42. Se contempla que, en otras realizaciones, los dispositivos denominados grapadoras quirúrgicas que incluyen aspectos descritos en la presente memoria pueden tener conjuntos de mangos con otras configuraciones tales como, por ejemplo, configuraciones de asas de tijeras o configuraciones en línea. Como se describe con más detalle a continuación, el conjunto 40 de mango aloja un mecanismo de accionamiento configurado para hacer avanzar selectivamente un árbol de accionamiento en respuesta al movimiento del mango móvil 44. En algunas realizaciones, el mecanismo de accionamiento puede comprender un mecanismo de accionamiento propulsado tal como un motor eléctrico que puede ser accionado para hacer avanzar selectivamente un árbol de accionamiento. El accionamiento del motor eléctrico puede iniciarse mediante el movimiento del mango móvil 44 o el accionamiento de un disparador, botón, interruptor u otro activador acoplado eléctricamente de manera operativa al motor eléctrico del mecanismo de accionamiento propulsado.
En algunas realizaciones, la grapadora quirúrgica 10 puede incluir la pluralidad de grapas 36 colocadas en un cartucho desechable, mientras que el conjunto 40 de mango está configurado para reutilizarse con múltiples cartuchos de grapas. En la realización ilustrada, el árbol 20 alargado y el conjunto 30 de mordaza definen un cartucho desechable que se puede acoplar de manera extraíble al conjunto 40 de mango. Por consiguiente, en la realización ilustrada, el conjunto 40 de mango incluye un acoplador 46 en su extremo distal. El acoplador 46 está engranado para aplicarse al árbol alargado 20 de la grapadora quirúrgica 10. El acoplador 46 puede tener una conexión de bayoneta que tiene un conector externo que puede acoplar de manera extraíble el conjunto 40 de mango al árbol alargado 20, y un conector interno que puede acoplar de manera extraíble el árbol de accionamiento del conjunto de mango 42 al miembro de accionamiento del árbol alargado 20. Por consiguiente, la grapadora quirúrgica 10 puede configurarse de manera tal que el conjunto 40 de mango pueda reutilizarse con múltiples cartuchos desechables durante un procedimiento quirúrgico. Se contempla que, en otras realizaciones, el conjunto de mango y alguna parte del árbol alargado pueden ser reutilizables, mientras que el resto del árbol alargado y el conjunto de mordaza definen un cartucho desechable. En ciertas otras realizaciones, el conjunto de mango y el árbol alargado pueden ser reutilizables mientras que el conjunto de mordaza define un cartucho desechable. En aún otras realizaciones, un inserto de mordaza que aloja una pluralidad de grapas puede definir un cartucho desechable mientras que el resto de la grapadora quirúrgica es razonable.
Las Figuras 3-7 ilustran varias vistas de una realización del conjunto 40 de mango para una grapadora quirúrgica 10. En la Figura 3, una vista en perspectiva del conjunto 40 de mango como se ilustra con el mango móvil 44 en una posición abierta separada del mango estacionario 42. El conjunto 40 de mango ilustrado comprende además un selector 72 acoplado operativamente al mecanismo de accionamiento alojado dentro del conjunto 40 de mango como se ha tratado adicionalmente en la presente memoria. Como se ilustra en la Figura 3, el selector 72 está en una primera posición.
Con referencia a la Figura 4, se ilustra otra vista en perspectiva del conjunto 40 de mango de la Figura 3. Como se ilustra, el mango móvil 44 está en una posición cerrada posicionada adyacente al mango estacionario 42, y el selector 72 está en una segunda posición. Las Figuras 5 y 6 ilustran una vista superior del conjunto de mango de la Figura 3 con el selector 72, tal como una corredera 74, en la primera posición (Figura 5) y en la segunda posición (Figura 6). La Figura 7 ilustra una vista lateral del conjunto 40 de mango de la Figura 3.
Las Figuras 8A y 8B ilustran vistas en sección transversal del conjunto 40 de mango en una configuración inicial, revelando el funcionamiento del mecanismo 50 de accionamiento. En la realización ilustrada, el mecanismo 50 de accionamiento está configurado para trasladar selectivamente el árbol 60 de accionamiento desde una primera posición correspondiente al conjunto 30 de mordaza en la configuración abierta hasta una segunda posición correspondiente al conjunto 30 de mordaza en la configuración cerrada y desde la segunda posición hasta una tercera posición para colocar el conjunto 30 de mordaza en una configuración de grapado y desplegar la pluralidad de grapas 36. En la configuración inicial ilustrada en las Figuras 8A y 8B, el mecanismo 50 de accionamiento puede trasladar repetidamente el árbol 60 de accionamiento entre la primera posición y la segunda posición en respuesta al movimiento del mango móvil 44 o disparador sin desplegar las grapas para proporcionar una funcionalidad de apertura y cierre. Esta funcionalidad de apertura y cierre permite a un usuario colocar, sujetar el tejido y reposicionar la grapadora 10 para encontrar un lugar de colocación de grapas deseable antes de desplegar las grapas.
Con referencia a las Figuras 8-14, en la realización ilustrada, el mecanismo de accionamiento comprende un impulsor 52 de avance o hacia delante, un impulsor 54 de retroceso, un impulsor 58 de apertura, una superficie 62 de avance, una superficie 64 de retroceso y una superficie 66 de apertura. El impulsor 52 hacia delante puede aplicarse operativamente al mango móvil 44 de modo que el movimiento del mango móvil 44 desde la posición abierta a la posición cerrada hace avanzar el impulsor 52 hacia delante en una primera dirección tal como, por ejemplo, distalmente dentro del conjunto 40 de mango. El impulsor 52 hacia delante puede comprender un trinquete o diente configurado para aplicarse en un rebaje o ranura.
El impulsor 54 de retroceso puede estar acoplado operativamente al mango móvil 44 de manera que el movimiento del mango móvil 44 desde la posición abierta a la posición cerrada hace avanzar el impulsor 54 de retroceso en una segunda dirección opuesta a la primera dirección tal como, por ejemplo, de manera proximal dentro del conjunto 40 de mango. En algunas formas de realización, el mango móvil 44 puede estar acoplado operativamente con el impulsor 54 de retroceso con una conexión engranada que incluye un piñón loco 56. El impulsor 54 de retroceso puede comprender un trinquete o diente configurado para aplicarse en un rebaje o ranura.
El impulsor 58 de apertura puede estar acoplado operativamente al mango móvil 44 de manera que el movimiento del mango móvil 44 desde la posición abierta a la posición cerrada hace avanzar al impulsor 58 de apertura en una primera dirección tal como, por ejemplo, distalmente dentro del conjunto 40 de mango. En la realización ilustrada, el impulsor 58 de apertura está acoplado al piñón loco 56 con una conexión de pasador y ranura para acoplar operativamente el impulsor 58 de apertura al mango móvil 44. El impulsor 58 de apertura puede comprender un trinquete o diente configurado para aplicarse en un rebaje o ranura.
El árbol 60 de accionamiento incluye una superficie 62 de avance, una superficie 64 de retroceso y una superficie 66 de apertura formadas en él. En la realización ilustrada, la superficie 62 de avance comprende una cremallera, o una pluralidad de rebajes o dientes separados formados longitudinalmente a lo largo del árbol 60 de accionamiento. Como se ilustra, la superficie 64 de retroceso comprende una cremallera o una pluralidad de rebajes o dientes separados formados longitudinalmente a lo largo del árbol 60 de accionamiento y desplazados angularmente de la superficie 62 de avance. En la realización ilustrada, la superficie 66 de apertura comprende un rebaje formado en el árbol 60 de accionamiento.
En ciertas realizaciones, el árbol 60 de accionamiento puede rotar dentro del conjunto 40 de mango alrededor del eje longitudinal de la grapadora 10. El árbol 60 de accionamiento puede comprender una porción proximal 65 y una porción distal 61 que pueden rotar independientemente una con respecto a otra. Por ejemplo, la porción proximal 65 se puede acoplar a la porción distal 61 en un acoplamiento rotativo que permite la rotación libre entre ellas mientras se aplica la porción proximal a la porción distal con respecto a la traslación longitudinal. El conjunto 40 de mango puede comprender un mecanismo 70 de rotación para proporcionar una rotación selectiva de la parte proximal 65 del árbol 60 de accionamiento dentro del conjunto 40 de mango. El árbol 60 de accionamiento puede ser rotativo entre una primera orientación en la que el impulsor 52 hacia delante se puede aplicar con la superficie 62 de avance y una segunda orientación en la que el impulsor 54 de retroceso se puede aplicar con la superficie 64 de retroceso. Con el desplazamiento angular de la superficie 52 de avance desde la superficie 54 de retroceso con respecto al árbol 60 de accionamiento, con el árbol de accionamiento en la primera orientación, el impulsor 54 de retroceso se libera de la superficie 64 de retroceso, y con el árbol de accionamiento en la segunda orientación, el impulsor 52 hacia delante se libera de la superficie 62 de avance.
Con referencia continuada a las Figuras 8-14, en ciertas realizaciones, el mecanismo 70 de rotación comprende un selector 72, tal como una corredera. La corredera puede extenderse transversalmente a través de la carcasa del conjunto 40 de mango. La corredera se puede acoplar operativamente al árbol 60 de accionamiento de tal manera que al colocar la corredera en la primera posición extendiéndose desde un lado del conjunto 40 de mango posiciona el árbol 60 de accionamiento en la primera orientación, y al posicionar la corredera en la segunda posición extendiéndose desde un lado opuesto del conjunto 40 de mango rota el árbol 60 de accionamiento a la segunda orientación. En la realización ilustrada, la corredera está acoplada a una cremallera 76 en aplicación de engrane con un engranaje 78 que está fijo de forma rotativa al árbol 60 de accionamiento y puede deslizar longitudinalmente a lo largo del árbol 60 de accionamiento (tal como, por ejemplo, con una conexión con llave). De manera deseable, el mecanismo 70 de rotación ilustrado que incluye una corredera coloca discretamente el árbol 60 de accionamiento en una orientación deseada, reduciendo la incidencia de engranajes mal engranados dentro del mecanismo 50 de accionamiento. En algunas realizaciones, la corredera puede incluir indicadores visuales, tales como flechas, para indicar la orientación del árbol 60 de accionamiento y, por lo tanto, el modo de accionamiento de la grapadora a un usuario.
En la realización ilustrada, la superficie 62 de avance y la superficie 64 de retroceso están desplazadas angularmente en aproximadamente 90 grados alrededor del árbol de accionamiento. Por lo tanto, el mecanismo 70 de rotación está configurado para rotar el árbol de accionamiento aproximadamente 90 grados entre la primera orientación y la segunda orientación. En otras realizaciones, la superficie 62 de accionamiento y la superficie 64 de retroceso pueden tener un desplazamiento angular diferente, tal como, por ejemplo, 120 grados o 70 grados, y el mecanismo 70 de rotación puede configurarse para rotar el árbol 60 de accionamiento de manera correspondiente. Además, como se describe con más detalle en la presente memoria con respecto a una operación en modo de apertura/cierre del conjunto 40 de mango, en la realización ilustrada, el impulsor 58 de apertura se aplica con el árbol de accionamiento en la segunda orientación, en otras realizaciones, el árbol de accionamiento puede ser rotativo a una tercera orientación en la que el impulsor 58 de apertura se aplica con el árbol de accionamiento.
Con referencia a las Figuras 8-14, se ilustra una secuencia de operación típica del mecanismo 50 de accionamiento del conjunto 40 de mango. Las Figuras 8A-8B y 9A-9B ilustran el funcionamiento del conjunto 40 de mango en una configuración inicial que proporciona una funcionalidad de apertura/cierre al conjunto 30 de mordaza. En la Figura 8A, el disparador móvil 44 está en una posición abierta, y el árbol 60 de accionamiento está en una primera posición, correspondiente a la primera posición de la barra de accionamiento en el extremo distal del árbol alargado 20. En la posición inicial, el árbol 60 de accionamiento está posicionado en la segunda orientación de manera que el impulsor 54 de retroceso está alineado angularmente con la superficie 64 de retroceso. Con el árbol 60 de accionamiento en la segunda orientación, el impulsor 58 de apertura se coloca dentro de la superficie 66 de apertura o rebaje. El movimiento del mango móvil 44 desde la posición abierta (Figura 8A-8B) hasta la posición cerrada (Figura 9A-9B), hace avanzar el impulsor 52 hacia delante de manera distal a lo largo del árbol 60 de accionamiento para aplicar un rebaje 63 de avance formado en el árbol 60 de accionamiento y acciona el árbol 60 de accionamiento de manera distal en el conjunto 40 de mango a una segunda posición. La segunda posición del árbol 60 de accionamiento dentro del conjunto 40 de mango corresponde a la segunda posición de la barra de accionamiento, que coloca el conjunto 30 de mordaza en una configuración cerrada.
El mango móvil 44 se puede desplazar a la posición abierta mediante un elemento de desplazamiento, tal como un resorte helicoidal 68 (Figura 11A). Por lo tanto, liberar el mango móvil 44 de la posición cerrada ilustrada en las Figuras 9A-9B lo devolvería a la posición abierta de las Figuras 8A-8B. El acoplamiento operativo del mango móvil 44 al impulsor 58 de apertura también trasladaría el impulsor 58 de apertura de manera proximal dentro del conjunto 40 de mango cuando el mango móvil 44 vuelve a la posición abierta. En la segunda orientación del árbol 60 de accionamiento, el impulsor 58 de apertura se aplica a la superficie 66 de apertura de manera que el movimiento proximal del impulsor 58 de apertura devuelve el árbol 60 de accionamiento desde la segunda posición hasta la primera posición, devolviendo el conjunto 30 de mordaza a la configuración abierta.
Un usuario puede buscar una posición de grapado deseada dentro de un campo quirúrgico abriendo y cerrando repetidamente las mordazas para sujetar el tejido en varias ubicaciones. Una vez que se ha seleccionado la posición de grapado deseada, el mecanismo 50 de accionamiento puede configurarse en un modo de grapado o disparo rotando el árbol 60 de accionamiento hacia la primera orientación. Con el conjunto de mordaza en una configuración cerrada en una posición de grapado deseada (como se ilustra en las Figuras 9A-9B), un usuario puede reposicionar el selector 72 deslizando la corredera a la primera posición, correspondiente a la primera orientación del árbol 60 de accionamiento (como se ilustra en las Figuras 10A-10B). En la primera orientación del árbol 60 de accionamiento, el impulsor 52 hacia delante se puede aplicar con la superficie 62 de avance, el impulsor 54 de retroceso está desalineado angularmente con la superficie 64 de retroceso, y el impulsor 58 de apertura está desalineado angularmente con la superficie 66 de apertura. Con el árbol 60 de accionamiento en la primera orientación, el mango móvil 44 se puede liberar en la posición abierta (Figuras 11A-11B), aplicando el impulsor 52 hacia delante con la superficie 62 de avance
Con referencia a las Figuras 11A-11B y 12A-12B, con el árbol 60 de accionamiento en la primera orientación, y el impulsor 52 hacia delante aplicándose a la superficie 62 de avance, el mecanismo 50 de accionamiento está en un modo de grapado o disparo. Varios ciclos de movimiento del mango móvil 44 desde la posición abierta a la posición cerrada y de nuevo a la posición abierta hacen avanzar el árbol 60 de accionamiento desde la segunda posición (Figuras 11A-11B), a una tercera posición en la que el árbol 60 de accionamiento se mueve hacia su límite más distal con respecto al conjunto 40 de mango (Figuras 12A-12B). En algunas realizaciones, el mecanismo de accionamiento puede incluir un tope para interferir con el recorrido distal del árbol 60 de accionamiento en la tercera posición. La segunda posición del árbol de accionamiento corresponde a la segunda posición de la barra de accionamiento en el conjunto 30 de mordaza. La tercera posición del árbol de accionamiento corresponde a la tercera posición de la barra de accionamiento en el conjunto 30 de mordaza en la que la pluralidad de grapas se ha desplegado desde la primera mordaza. Con el movimiento del mango móvil 44 o el disparador en el modo de disparo para hacer avanzar el árbol de accionamiento desde la segunda posición hasta la tercera posición, el impulsor 52 hacia delante es hecho avanzar secuencialmente sobre los dientes o ranuras adyacentes de la superficie 62 de accionamiento en un avance similar a un trinquete.
Con referencia a las Figuras 13A-13B, una vez que el árbol 60 de accionamiento ha sido hecho avanzar a la tercera posición y las grapas han sido disparadas desde el conjunto de mordaza, el mecanismo 50 de accionamiento se puede configurar en un modo inverso. En consecuencia, el mecanismo 70 de rotación puede rotar el árbol 60 de accionamiento a la segunda orientación para colocar la superficie 64 de retroceso en alineación angular con el impulsor 54 de retroceso. La corredera se puede hacer deslizar a la segunda posición para rotar el árbol de accionamiento desde la primera orientación (Figuras 12A-12B) a la segunda orientación (Figuras 13A-13B). Con el árbol 60 de accionamiento en la segunda orientación, los ciclos repetidos del mango móvil 44 desde la posición abierta a la posición cerrada y de nuevo a la posición abierta aplican el impulsor 54 de retroceso con la superficie 64 de retroceso en un avance similar a un trinquete mientras retraen el árbol 60 de accionamiento de manera proximal en el conjunto 40 de mango. Una vez que el impulsor 54 de retroceso ha accionado el árbol 60 de accionamiento en dirección proximal a la segunda posición (ilustrada en las Figuras 14A-14B), el impulsor 58 de apertura se aplica a la superficie 66 de apertura. El impulsor 58 de apertura devuelve el árbol 60 de accionamiento a la primera posición cuando el mango móvil 44 se libera a la posición abierta. (Devolviendo el conjunto de mango a la configuración ilustrada en las Figuras 8A-8B). Con el árbol 60 de accionamiento en la primera posición, el cartucho, vaciado de grapas, se puede desacoplar del conjunto 40 de mango y se puede acoplar un nuevo cartucho al conjunto del mango para comenzar otra operación de grapado.
Con referencia a las Figuras 15-25, se ilustra otra realización del conjunto 40’ de mango para su uso con una grapadora quirúrgica 10’. La Figura 15 ilustra una vista lateral del conjunto 40’ de mango, y la Figura 16 ilustra una vista en perspectiva del conjunto 40’ de mango. En el conjunto 40’ de mango, el accionamiento del mecanismo 70’ de rotación se realiza con un interruptor deslizante 80 que puede deslizar longitudinalmente con respecto a la carcasa del conjunto 40’ de mango. Ventajosamente, tal disposición de interruptor deslizante puede permitir que un usuario rote fácilmente el árbol 60 de accionamiento en una operación con una sola mano.
Con referencia a la Figura 17, se ilustra una vista en sección transversal del conjunto 40’ de mango que revela el mecanismo 50’ de accionamiento y el mecanismo 70’ de rotación. El mecanismo de accionamiento funciona sustancialmente como se describió anteriormente con respecto a la realización de las Figuras 8A, 8B-14A, 14B para hacer avanzar el árbol 60’ de accionamiento desde una primera posición a una segunda posición en un modo de apertura/cierre, desde la segunda posición a una tercera posición en un modo de grapado, y desde la tercera posición hasta la primera posición en un modo de retroceso. El mecanismo 50’ de accionamiento incluye los correspondientes impulsores hacia delante, de retroceso y de apertura 52, 54, 58 acoplados operativamente a un mango móvil 44 y superficies de avance 62, de retroceso y de apertura en el árbol 60’ de accionamiento sustancialmente como se describe con respecto a la realización de las Figuras 8A, 8B-14A-14B. Sin embargo, en la realización ilustrada en las Figuras 15-25, el árbol 60’ de accionamiento es rotativo por el mecanismo 70’ de rotación discretamente entre una primera orientación correspondiente al modo de apertura/cierre del conjunto de mango en el que el impulsor 58 de apertura se aplica a la superficie 66 de apertura, una segunda orientación correspondiente a la posición de grapado, en la que el impulsor 52 hacia delante se aplica con la superficie 62 de avance, y una tercera orientación correspondiente a la posición de retroceso en la que el impulsor 54 de retroceso se aplica con la superficie de retroceso.
Con referencia a las Figuras 17-18, se ilustran ciertos aspectos del mecanismo 70’ de rotación. El mecanismo 70’ de rotación comprende el interruptor deslizable 80 longitudinalmente deslizable con respecto a la carcasa del conjunto 40’ de mango, un collarín 82 de cubo longitudinalmente deslizable por el interruptor 80 y un elemento de desplazamiento o resorte 98. En la realización ilustrada, el interruptor deslizable 80 está conectado al collarín 82 de cubo con una barra delgada, tal como un miembro de cuña. El collarín 82 de cubo se fija de forma rotativa y puede deslizar longitudinalmente con respecto a la carcasa del conjunto 40’ de mango. En algunas realizaciones, el collarín 82 de cubo puede comprender un primer y segundo brazos que pueden deslizar en las correspondientes primeras y segundas ranuras en la carcasa del conjunto de mango para permitir un movimiento longitudinal relativo y restringir el movimiento de rotación relativo entre ellos.
El collarín 82 de cubo puede ser un miembro generalmente tubular dispuesto alrededor del árbol 60’ de accionamiento. El collarín 82 de cubo puede extenderse entre un primer borde 84 que tiene una pluralidad de rampas 86 formadas en él y un segundo borde 88 que tiene una pluralidad de rebajes 90 formados en él. En la realización ilustrada, el collarín 82 de cubo comprende tres rampas 86 formadas en el primer borde 84 estando cada rampa separada aproximadamente 120 grados de las rampas 86 adyacentes. Como se ilustra, el collarín 82 de cubo comprende tres rebajes 90 formados en el segundo borde 88 estando cada rebaje 90 separado aproximadamente a 120 grados de los rebajes adyacentes 86. En otras realizaciones, el número y la separación relativa de las rampas 86 y los rebajes 90 pueden variar para hacer rotar el eje 50 de accionamiento entre diferentes orientaciones de las de la realización ilustrada.
En algunas realizaciones, el mecanismo 70’ de rotación puede incluir un resorte 98 para desplazar el interruptor deslizante 80 y el collarín 82 de cubo a una posición proximal con respecto a la carcasa del conjunto 40’ de mango.
Con referencia continuada a las Figuras 17-18, el árbol 60’ de accionamiento puede tener una primera pluralidad de salientes 92 que sobresalen radialmente hacia fuera adyacentes al primer borde 84 del collarín 82 de cubo. En la realización ilustrada, el árbol de accionamiento tiene tres salientes 92 cada uno separado aproximadamente en 120 grados a partir de los salientes adyacentes. El árbol 60’ de accionamiento puede comprender además una segunda pluralidad de salientes 94 que se extienden radialmente hacia fuera desde el árbol 60’ de accionamiento en una posición adyacente al segundo borde 88 del collarín 82 de cubo. En la realización ilustrada, el árbol 60’ de accionamiento tiene tres salientes 94 cada uno separado aproximadamente en 120 grados de los salientes adyacentes. En otras realizaciones, los números y separación de los salientes 92, 94 se pueden variar para lograr un mecanismo de rotación con diferentes características de rotación. En algunas realizaciones, los salientes 92, 94 pueden formarse en el árbol 60’ de accionamiento, mientras que, en otras realizaciones, los salientes 92, 94 pueden formarse por separado, tal como sobre un manguito que está adherido a, que tiene una aplicación enchavetada, o que, está fijado de otro modo de forma rotativa al árbol 60’ de accionamiento.
Con referencia a las Figuras 19-25, se ilustra una secuencia de operación del mecanismo 70’ de rotación para rotar el árbol 60’ de accionamiento desde una primera orientación a una segunda orientación. La Figura 19 ilustra una vista esquemática del collarín 82 de cubo y del árbol 50’ de accionamiento en una primera orientación. En la primera orientación, un primer saliente 94a de la segunda pluralidad de salientes 94 descansa en un primer rebaje 90a de la pluralidad de rebajes 90, y un primer saliente 92a de la primera pluralidad de salientes está colocado adyacente a una primera rampa 86a de la pluralidad de rampas 86.
Con referencia a las Figuras 19-22, se ilustra una secuencia de operación del mecanismo 70’ de rotación a medida que el interruptor deslizable 80 es avanzado distalmente. A medida que el interruptor deslizable 80 es avanzado distalmente con respecto a la carcasa del conjunto de mango, el collarín 82 de cubo se traslada de manera distal, llevando la primera pluralidad de salientes 92 a acoplamiento deslizante con la pluralidad de rampas 86 del collarín 82 de cubo (ilustrado en la Figura 20). El avance distal adicional del interruptor deslizable 80 y del collarín 82 de cubo con respecto a la carcasa del conjunto de mango hace avanzar la primera pluralidad de salientes 92 sobre la pluralidad de rampas 86 (ilustradas en las Figuras 21 y 22). Un perfil angular de las rampas 86 actúa como una superficie de leva tal que el desplazamiento de la primera pluralidad de salientes 92 a lo largo de la pluralidad de rampas 86 hace rotar el árbol 60’ de accionamiento. Una vez que el interruptor deslizable alcanza el extremo más distal de su recorrido, el resorte 98 desplaza el collarín 82 de cubo y el interruptor deslizante 80 de manera proximal con respecto a la carcasa del conjunto 40 de mango. Cuando el collarín 82 de cubo vuelve a una posición proximal, la segunda pluralidad de salientes 94 se aplica a la pluralidad de rebajes 90 (ilustrados en las Figuras 23-25). Como se ilustra en la Figura 25, después de un ciclo de accionamiento del interruptor deslizable 80, el primer saliente 94a de la segunda pluralidad de salientes 94 se ha colocado en el segundo rebaje 90b de la pluralidad de rebajes, de manera que el árbol 60’ de accionamiento se ha colocado en una segunda orientación rotada 120 grados desde la primera orientación. Los ciclos de accionamiento subsiguientes del interruptor deslizable 80 hacen rotar el árbol de accionamiento en incrementos discretos de 120 grados.
En otras realizaciones, el mecanismo de rotación puede comprender un mango conectado directamente al árbol de accionamiento. Por ejemplo, un extremo proximal del árbol de accionamiento se puede conectar a un mango 70” (Figura 1) que se extiende de manera proximal desde la carcasa. La rotación del mango con respecto al eje longitudinal rota el árbol de accionamiento para configurar el conjunto del mango en uno de los modos de apertura/cierre, un modo hacia adelante o un modo hacia atrás.
Aunque esta solicitud describe ciertas realizaciones y ejemplos preferidos, los expertos en la técnica entenderán que las presentes invenciones se extienden más allá de las realizaciones descritas específicamente a otras realizaciones y/o usos alternativos de la invención y sus modificaciones obvias y equivalentes. Además, las diversas características de estas invenciones se pueden usar solas, o en combinación con otras características de estas invenciones distintas a las expresamente descritas anteriormente. Por lo tanto, se pretende que el alcance de las presentes invenciones aquí expuestas no sea limitado por las realizaciones particulares descritas anteriormente, sino que debería ser determinado solo mediante una lectura imparcial de las reivindicaciones que siguen.

Claims (12)

REIVINDICACIONES
1. Un conjunto (40) de mango para una grapadora quirúrgica (10) comprendiendo el conjunto (40) de mango una carcasa que define un mango estacionario (42);
un mango móvil (44) acoplado de manera pivotante a la carcasa y móvil desde una posición abierta a una posición cerrada; y
un mecanismo (50) de accionamiento que comprende:
un árbol (60) de accionamiento que tiene un eje longitudinal, comprendiendo el árbol (60) de accionamiento un eje longitudinal una superficie (62) de avance formada sobre el mismo, una superficie (64) de retroceso formada sobre el mismo angularmente desplazada desde la superficie de avance, y una superficie (66) de apertura formada sobre el mismo, siendo el árbol (60) de accionamiento longitudinalmente deslizable con relación a la carcasa y selectivamente rotatorio alrededor del eje longitudinal entre una primera orientación y una segunda orientación;
un impulsor (52) de avance acoplado de manera operativa al mango (44) móvil, siendo el impulsor (52) de avance que se puede engranar con el árbol (60) de accionamiento en la primera orientación y desengranar del árbol (60) de accionamiento en la segunda orientación;
un impulsor (54) de retroceso acoplado de forma operable a un mango (44) móvil; y
un impulsor (58) de apertura acoplado de forma operable al mango (44) móvil.
2. El conjunto de mango de la reivindicación 1, en donde el impulsor (54) de retroceso se puede engranar con el árbol (60) de accionamiento en la segunda orientación y desengranado del árbol (60) de accionamiento en la primera orientación.
3. El conjunto de mango de la reivindicación 2, en donde el impulsor (52) de avance se puede engranar con lasuperficie de avance del árbol (60) de accionamiento y el impulsor (54) de retroceso se puede engranar con la superficie de retroceso del árbol (60) de accionamiento.
4. El conjunto de mango de la reivindicación 2, en donde el impulsor (58) de apertura se puede engranar con el árbol (60) de accionamiento en la segunda orientación.
5. El conjunto de mango de la reivindicación 1, que además comprende un mecanismo (70, 70') de rotación engranado con el mecanismo (50) de accionamiento para hacer rotar de forma selectiva el árbol (60) de accionamiento entre la primera orientación y la segunda orientación.
6. El conjunto de mango de la reivindicación 5, en donde el mecanismo (70) de rotación comprende una corredera (74) que se extiende transversalmente a través de la carcasa.
7. El conjunto de mango de la reivindicación 6, en donde la corredera (74) está acoplada a una cremallera (76) y en donde el mecanismo de rotación comprende además un engranaje (78) engranado con la cremallera (76), estando el engranaje (78) fijado de forma rotatoria al árbol (60) de accionamiento y deslizable longitudinalmente a lo largo del árbol de accionamiento.
8. El conjunto de mango de la reivindicación 5, en donde el mecanismo (70') de rotación comprende un interruptor (80) deslizante, longitudinalmente deslizable con respecto a la carcasa.
9. El conjunto de mango de una cualquiera de las reivindicaciones 2-3, en donde el mecanismo (50) de accionamiento además comprende un piñón loco (56) acoplando operativamente el mango (44) móvil al impulsor (54) de retroceso.
10. El conjunto de mango de la reivindicación 4, en donde el mecanismo (50) de accionamiento además comprende un piñón loco (56) acoplando operativamente el mango móvil (44) al impulsor (54) de retroceso y acoplando operativamente el mango (44) móvil al impulsor (58) de apertura.
11. El conjunto de mango de la reivindicación 10, en donde el piñón loco (56) comprende una ranura formada en él y el impulsor (58) de apertura comprende una conexión de pasador dispuesta en la ranura del piñón loco.
12. El conjunto de mango de la reivindicación 11, en donde la superficie (66) de apertura comprende un receso de apertura formado en el árbol (60) de accionamiento, el receso de apertura pudiendo engranar con el impulsor (58) de apertura con el árbol (60) de accionamiento en la segunda orientación.
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