JP5524066B2 - 手動解放付電気自己駆動式手術器具 - Google Patents
手動解放付電気自己駆動式手術器具 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2931—Details of heads or jaws with releasable head
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- A—HUMAN NECESSITIES
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- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A90/00—Technologies having an indirect contribution to adaptation to climate change
- Y02A90/10—Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
Description
・電源オン
・ホームポジションを確認し、必要/所望の場合にホームポジションへ移動
・伸長/収縮ボタンをエネイブル(点灯)にし、ステープル射出ボタンをディセーブル(消灯)にする
・ステープル射出ボタンを完全に伸ばした(アンビルが取り去られた)後にのみエネイブルにし、伸長/収縮ボタンをエネイブルにしたままその後収縮させる。
・ステープル射出ボタンの作動時、フォーススイッチが作動するまでアンビルを引き戻す。
・ボタンLEDの点滅により秒読みを開始し、射出サイクルが切迫するごとに点滅速度を速くする。継続的にフォーススイッチを監視し、アンビルを引き戻してフォーススイッチが作動したままとする。
・ステープル射出サイクルの間は、どのボタン押下もステープル射出ルーチンを打ち切る。
・ステープル射出モータの作動前に打ち切りが生じたら、射出サイクルは停止し、アンビルがホームポジションに伸ばされ、ステープル射出ボタンはアクティブのままで再発射可能となる。
・あるいは、射出モータの作動時に打ち切りが生じたら、射出サイクルは停止し、射出モータは引き戻され、アンビルがホームポジションに戻り、射出ボタンは非アクティブとなる。したがって、ステープラ(またはステープルカートリッジ)は使用不可となる。
・射出の秒読みが終了したら、ステープル範囲制限スイッチの位置が確認される。ステープル範囲制限スイッチが作動したら、それはアンビルが良好なステープル射出範囲にあることを意味し、ステープル射出モータが作動して射出サイクルが進められる。ステープル範囲制限スイッチが作動しない場合、射出サイクルは打ち切られ、アンビルはホームポジションに戻り、ステープル射出ボタンはアクティブのままで再発射可能となる。
・ステープル射出が完了したら、アンビルは閉じ位置に維持され、伸長ボタンのみがアクティブのままとなる。アンビルが少なくともホームポジションまで伸びたら、伸長ボタンと収縮ボタンの双方をアクティブにする。ステープル射出ボタンは、ステープル射出が完了したら非アクティブに維持される。
'8-3-06
'Modified program to abort with only fire button, added pbcount variable
'Added PWM ramping
'7-28-06
'final tweaks - stan is now an integer etc.
'7-17-06 This version written for the 3c board.
'7-14 DEBUGGING VERSION
'Program written for 3c board using the Cubloc 280 chipset
'Note: this program is a modified version of the ones noted below. All changes not related to the addition of the E/R limit switches
'apply. The programs below were written to deal with the "gray logic" of the 1 cm switch. This version uses
'a limit switch at either end of the extend/retract stage.
'V6.20 Final Version of Gray Logic program as used in prototype 0, serial number 100
'V6.05
'modified the extend to cm 1 and retract to cm 1 routines to make sure that when they are called that they move the motor until the cm
'switch is closed; ie: When the anvil is all the way out and the retract button is pressed, retract the anvil until the cm limit switch
'is closed regardless of whether the retract button is released before the cm switch is closed. Same change for when the anvil is
'extended from the 1 cm position.
'made changes to comments in the extend/retract routines
'V6.02
'added loop requiring the release of both buttons to exit jog routine, and a 1 second delay at the end of jog subroutine before
'going back to main routine
'reformatted datadump labels
'added variables for high and low speed pwm values
'added extend only capability at end of completed fire to prevent crushing stapled tissue
'NOT WORKING- REMOVED added checks To ensure 1 cm switch Is made when extending Or retracting from the 1 cm And fully extended positions respectively
'V6.01
'All prior versions were made for testing the program on the Cubloc development board. All outputs were pulled LOW. The actual device
'requires all the outputs to be pulled high (+5V). This version is set-up to run on the actual device.
'limited the values of the EEPROM data to 255 max
'added delays before changes in motor direction, made program run smoother
'removed pwmoff commands. They were not allowing the motors to stay on when changing subroutines (for some reason)
'V5.27
'added the recording of jog routine button presses
'added the recording of datadump requests
'V5.26
'added the recording of Extend/Retract button presses
'added serial number field in eeprom
'the datadump routine now keeps running total of data as it is read from eeprom
'V5.25 (circular-staρler-5-25.cul)
'added code to allow storage of data each power on cycle in eeprom
'V5.24 works well, no known bugs (circular-stapler-5-24.cul)
'KMS Medical LLC (c) 2006
'MAP
'P10 Extend Button
'P11 Retract Button
'P12 Fire Button
'P13 Extend Limit
'P14 Retract Limit
'P15 Fire Forward Limit
'Pl6 Fire Back Limit
'P17 1 cm Limit Switch
'P18 Staple Range Limit Switch
'P19 Force Switch
'P20 Extend Button LED
'P21 Retract Button LED
'P22 Fire Button LED
'P23 Force LED (blue)
'P24 Not USED
'P25 Not USED
'P26 Not USED
'P27 Not USED
'P28 Not USED
'P29 Staple Range LED (green)
Const Device=cb280 'Comfile Tech. Cubloc CB280 chipset
Dim ver As String*7
ver="3C-8.03" 'set software version here
Dim extendbutton As Byte
Dim retractbutton As Byte
Dim firebutton As Byte
Dim firstout As Byte
Dim firstback As Byte
Dim cmstatus As Byte
'lcm limit switch status
Dim srstatus As Byte 'staplerange limit switch status
Dim x As Integer
Dim powerons As Byte 'store in eeprom address 2
Dim cycnumfires As Byte 'store in eeprom (powerons* 5)
Dim cycabortfires As Byte 'store in eeprom (powerons*5)+l
Dim cycers As Byte 'store in eeprom, number of cycle extend/retract presses
Dim cycjogs As Byte
Dim arm As Byte
Dim completefire As Byte
Dim staplerangestatus As Byte
Dim bail As Byte
Dim ds As Integer 'eeprom data start location for individual cycle data writing
Dim fast As Integer
Dim slow As Integer
Dim extendonly As Byte
Dim extlimit As Byte
Dim retlimit As Byte
Dim speed As Integer
Dim dracula As Byte
'initalize outputs
Out 20,0 'extend button LED
Out 21,0 'retract button led
Out 22,0 'fire button led
Out 23,0 'force led
Out 29,0 'staple range led
'initialize variables
firstout=0
firstback=0
completefire=0
arm=0
bail=0
cycnumfires=0
cycabortfires=0
cycers=0
cycjogs=0
extendonly=0
'CHANGE PWM VALUES HERE
fast=60000 'highspeed pwm value
slow=60000 'lowspeed pwm value
speed=0
Output 5 'turns on pwm output for PINCH
Output 6 'turns on pwm output for FIRE
'read totals from eeprom
powerons=Eeread(2, 1 )
Incr powerons 'increment total power on number
If powerons>=255 Then powerons=255 limit number of recorded powerons to an integer of one byte max
Eewrite 2,powerons,l 'write total power on number to eeprom
ds=powerons*5
'JOG and DATADUMP Check
'push any button within 2 (or so) seconds to go to jog routine
'hold all three buttons on at startup to dump the data
For x=l To 50
If Keyin(10,20)=0 And Keyin(11,20)=0 And Keyin(12,20)=0 Then
datadump 'write all stored data to the debug screen
Exit For
Elseif Keyin(10,20)=0 Or Keyin(11,20)=O Or Keyin(12,20)=0 Then 'either e/r button or the fire button pressed
jog
Exit For
End If
Delay 20
Next
'ホーミングシーケンス
cmstatus=Keyin(17,20) 'read the status of the lcm limit switch
If cmstatus=0 Then
homeretract
Elseif cmstatus=l Then
homeextend
End If
'Return fire motor to back position
homefire 'this returns the fire motor to the full retracted condition (P6 limit switch)
**********
'メインループ
**********
Do
'Debug "Main Loop",Cr
'Delay 1000
cmstatus=Keyin(17,20) 'read the 1 cm switch
'staplerangestatus=Keyin(5,20) 'read the staplerange limit switch
extendbutton=Keyin(10,20)
retractbutton=Keyin(11,20)
firebutton=Keyin(12,20)
If cmstatus=0 And Keyin(13,20)<>0 Then
Out 20,1 'turn extend led on
Out 21,1 'turn retract led on
Elseif cmstatus=0 And Keyin(13,20)=O Then
Out 20,0 'turn off extend led because extend limit met
Out 21,1 'turn on retract limit
Elseif cmstatus=l Then
Out 20,1
Out 21,0
End If
'check firebutton led status
If firstout=l And firstback=l And arm=l And completefire<>l And cmstatus<>0 Then
Out 22,1 'turn on fire button led
Else
Out 22,0 'turn off fire led
End If
'check for extend retract button press
If extendbutton=0 And cmstatus=0 Then
extend
Elseif cmstatus=l And extendbutton=0 Then
extend
End If
If retractbutton=0 And cmstatus=0 Then 'And extendonly=0
retract
End If
'check for firebutton press
If firebutton=0 And firstout=l And firstback=l And arm=l And completefire<>l And cmstatus<>0 Then initialfire
Loop 'keep looping til powerdown
End 'End of program
************
サブルーチン
************
'ホーム:cmスイッチまで引き戻す=押下なし
Sub homeretract() 'retract until 1 cm switch is open
'Debug "Homeretract",Cr
'Delay 1000
Pwm 0,slow,60000
Do Until Keyin(17,20)=l 'retract until 1 cm switch is open
Out 31,1 'ER motor reverse
Loop
Out 31,0 'er motor off
Out 21 ,0 'turn retract led Off
Out 20,1 'turn extend led On
Pwmoff 0 'turn pwm off
End Sub
'
'ホーム:cmスイッチまで伸長=押下あり
Sub homeextend() 'extend until 1 cm switch is closed
'Debug 'Ηomextend",Cr
'Delay 1000
Pwm 0,slow,60000
If Keyin(17,20)=l Then
Do Until Keyin(17,20)=0 'now the 1 cm switch is pressed
Out 30, l 'ER motor forward DDD
Loop
End If
Out 30,0 'DDD
Pwmoff O
Delay 300
homeretract 'once the switch is made, call homeretract
End Sub
'射出モータホーミングルーチン
Sub homefire()
'Debug "Homefire",Cr
'Delay 1000
Pwm l,slow,60000
Do Until Keyin(16,20)=0 'retract firing stage until back switch is closed
Out 33,1
Loop
Out 33,0
Pwmoff 1
End Sub
'JOG ルーチン
Sub jog()
Out 20,1
Out 21,1
Do
Delay 25
If Keyin(10,20)=0 And Keyin(11,20)=O Then Exit Do 'if both buttons pressed, exit jog routine and start homing routine after 1 second delay
If Keyin(10,20)=0 And Keyin(11,20)<>0 And Keyin(12,20)<>0 Then
Pwm 0,slow,60000
Out 30,1 'extend motor forward
Do Until Keyin(10,20)<>0 Or Keyin(13,20)=0
Out 30,1 'extend motor on forward DDD
Loop
Out 30,0 'extend motor off forward DDD
Pwmoff 0
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
If Keyin(11,20)=O And Keyin(10,20)<>0 And Keyin(12,20)<>0 Then
Pwm 0,slow,60000
Do Until Keyin(11,20)<>0 Or Keyin(14,20)=0
Out 31,1 'extend motor reverse
Loop
Out 31,0 'extend motor off reverse
Pwmoff0
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
If Keyin(12,20)=0 And Keyin(10,20)=0 Then 'jog the fire motor forward
Pwm l,slow,60000
Do Until Keyin(10,20)<>0 Or Keyin(12,20)<>0 Or Keyin(15,20)=0
Out 32,1 'fire motor forward
Loop
Out 32,0 'fire motor off forward
Pwmoff 1
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
If Keyin(12,20)=0 And Keyin(11,20)=O Then 'jog the fire motor reverse
Pwm l,slow,60000
Do Until Keyin(11,20)<>0 Or Keyin(12,20)<>0 Or Keyin(16,20)=0
Out 33,1 'fire motor reverse
Loop
Out 33,0 'fire motor off reverse
Pwmoff 1
Incr cycjogs
If cycjogs>=255 Then cycjogs=255
Eewrite ds+3,cycjogs,l
End If
Loop
Do Until Keyin(10,20)=I And Keyin(11,20)=I 'let off both buttons before exiting jog routine
Delay 10
Loop
Out 20,0 'turn on e/r button leds
Out 21,0
Delay 1000
End Sub
'伸長制限を満たすまで伸長する
Sub extend()
Out 22,0 'turn off fire button led while extending
Out 21,0 'turn off retract button led while extending
Pwm 0,fast,60000
Do Until Keyin(l0,20)=1 Or Keyin(l3,20)=0 'extend until either the extend limit is closed or the extend button is released
Out 30,1 'ER motor forward DDD
Loop
Out 30,0 'DDD
If firstout=0 Then 'this will keep the extend motor going on the first extension until the anvil is all the way out
Do Until Keyin(l3,20)=0
Out 30,l 'DDD
Loop
End If
Out 30,0 'DDD
Pwmoff 0
Incr cycers
If cycers>=255 Then cycers=255
Eewrite ds+2, cycers, 1
If Keyin(l3,20)=0 Then
firstout=l 'set the firstout flag to enable fire button
Out 20,0 'turn off extend led
End If
End Sub
'cmスイッチが開になるまで収縮
Sub retract()
Out 22,0 'turn off fire button led while retracting
Out 20,0 'turn off extend button led while retracting
Pwm 0,fast,60000
Do Until Keyin(11,20)=1 Or Keyin(17,20)=l 'retract until either the lcm switch goes open or the extend button is released
Out 31,1 'ER motor reverse
Loop
Out 31,0
Pwmoff 0
Incr cycers
If cycers>=255 Then cycers=255
Eewrite ds+2, cycers, 1
If Keyin(17,20)=l Then
firstback=l
Out 21,0 'turn retract led off
End If
If firstout=l And firstback=l Then arm=l 'set the arm flag to arm the fire button
End Sub
'DATADUMP ルーチン
Sub datadump()
Dim chef As Byte
Dim tf As Byte 'total fires
Dim ta As Byte 'total aborts
Dim ers As Integer
Dim tj As Byte
Dim tdd As Byte
Dim stan As Integer
Dim kyle As Byte
Dim token As Byte
Dim ike As Byte
Dim kenny As Byte
Dim sn As Byte
tf=0
ta=0
ers=0
tj=0
tdd=0
Eewrite ds+4,1,1 'write 1 to the ds+4 eeprom register denoting that datadump was accessed
Delay 1000
sn=Eeread(0,l)
Debug "Circular Stapler Stored Data",Cr
Debug "Version ",ver,Cr
Debug "KMS Medical LLC",Cr
Debug "-----------------------",Cr
Debug Cr
Debug "Serial Number: ",Dec sn,Cr
powerons=Eeread(2,1)
If powerons>=255 Then powerons=255
Debug "Total Cycles: ",Dec powerons,Cr
Debug Cr
Debug "----------------------------",Cr
Debug Cr
For stan=5 To (powerons*5) Step 5
Debug "Cycle ",Dec (stan/5),Cr
Debug "-----------------------------",Cr
chef=Eeread(stan, 1)
tf=chef+tf
Debug "Completed Fires: ",Dec chef,Cr
kyle=Eeread(stan+ 1,1)
ta=kyle+ta
Debug "Aborted Fires: ",Dec kyle,Cr
token=Eeread(stan+2 , 1)
ers=token+ers
Debug "E/Rs: ",Dec token,Cr
ike=Eeread(stan+3 , 1)
tj=ike+tj
Debug "Jogs: ",Dec ike,Cr
kenny=Eeread(stan+4, 1)
tdd=kenny+tdd
Debug "Datadumps: ",Dec kenny,Cr
Debug Cr
Next 'stan
Debug "--------------------------------------",Cr
Debug "Cycle Totals",Cr
Debug Cr
Debug "Completed Fires: ",Dec tf,Cr
Debug "Aborted Fires: ",Dec ta,Cr
Debug "E/R Presses: ",Dec ers,Cr
Debug "Jog Presses: ",Dec tj,Cr
Debug "Datadumps: ",Dec tdd,Cr
Debug Cr
Delay 1000
For x=l To tf'blink the number of completed firing cycles
Out 22,1
Delay 500
Out 22,0
Delay 500
Next 'x
Do Until Adin(0)>800 And Keyin(3,20)=l 'wait until datadump buttons are released
Loop
End Sub
'最初の射出
Sub initialfire()
Dim f As Integer
Dim p As Integer
Dim t As Integer
Dim y As Integer
Dim z As Integer
Dim q As Integer
Dim timmy As Integer
Dim butter As Integer
Dim numblinks As Integer
Dim fbcount As Integer
Debug clr,Cr
'turn off extend and retract buttons to show that they are not active for abort?
Out 20,0 'extend button
Out 21,0 'retract button
bail=0
t=15 'total blink time
p=3 'number of blink periods
Pwm 0,fast,60000
'start blink and adjust pinch motor to force
f=(t*1000)/p
fbcount=0
If Keyin(12,20)=l Then fbcount=l
For y=l To p
numblinks= (t*y)/p
For z=l To numblinks
timmy=f/numblinks
butter=timmy/50 'calibrate this to seconds
If timmy=0 Then timmy=l
If Keyin(12,20)=0 And fbcount=l Then
bail=l 'set abortfire flag
Exit For
End If
If Keyin(12,20)=l Then fbcount=l
Do Until Keyin(19,20)=0 Or Keyin(14,20)=0 'retract until force switch met or retract limit met
Out 31,1
If Keyin(12,20)=0 And fbcount= 1 Then
bail=l 'set abortfire flag
Exit Do
End If
If Keyin(12,20)=l Then fbcount=l
Loop
If bail=1 Then Exit For
Out 31,0
Out 23,1 'force led
Out 22,1 'fire button led
For q=0 To butter
Delay 10
If Keyin(12,20)=0 And fbcount=l Then
bail=l 'set abortfire flag
Exit For
End If
If Keyin(12,20)=l Then fbcount=l
If Keyin(19,20)=l Then Out 23,0
Next 'q
If bail=l Then Exit For
Do Until Keyin(19,20)=0 Or Keyin(14,20)=0 'retract until force switch met or retract limit met
Out 31,1
If Keyin(12,20)=0 And fbcount=l Then
bail=l 'set abortfire flag
Exit Do
End If
IfKeyin(12,20)=l Then fbcount=l
Loop
Out 31,0
Out 23,1
If Keyin(12,20)=0 And fbcount=l Then
bail=l 'set abortfire flag
Exit For
End If
If Keyin(12,20)= 1 Then fbcount= 1
Out 22,0
For q=0 To butter
Delay 10
If Keyin(12,20)=0 And fbcount=l Then
bail=l 'set abortfire flag
Exit For
End If
If Keyin(12,20)=l Then fbcount=l
If Keyin(l9,20)=1 Then Out 23,0
Next 'q
If bail=l Then Exit For
Next 'z
'Debug Dec? fbcount,Cr
If bail=l Then Exit For
Next 'y
Pwmoff 0
If bail=l Then
abortfire
Else
'staplerangecheck
finalfire
End If
End Sub
'ステープル範囲確認ルーチン
Sub staplerangecheck()
srstatus=Keyin(29,20) 'read the staplerange limit switch
If srstatus=0 Then
finalfire
Else
abortfire
End If
End Sub
'最終射出ルーチン
Sub finalfire()
Out 23,0 'turn force led off
Out 20,0 'turn extend led off
Out 21,0 'turn retract led off
Out 22,1 'Turn on fire led to signify final fire abort ready
Pwmoff 1
'Pwm l,fast,60000
'Out 32,1 'fire motor forward DDD
completefire=l
Do Until Keyin(15,20)=0 'fire forward until forward limit is met
If speed>=60000 Then speed=60000
If speed<60000 Then
speed=speed+10000
End If
Pwm l,speed,60000
Out 32,1
Delay 50
If Keyin(12,20)=0 Then 'Or Keyin(10,20)=0 Or Keyin(11,20)=0
bail=l
Exit Do
End If
Loop
Out 32,0 'fire motor fwd off DDD
speed=0
Delay 250
Do Until Keyin(16,20)=0 'retract fire motor
If speed>=60000 Then speed=60000
If speed<60000 Then
speed=speed+10000
End If
Pwm l,speed,60000
Out 33,1
Delay 50
Loop
speed=0
Out 33,0
Pwmoff l
Out 22,0 'turn fire led off
Out 21,0 'turn off retract led
extendonly=l
Incr cycnumfires
If cycnumfires>=255 Then cycnumfires=255
Eewrite ds,cycnumfires,l 'write the current cycle number of fires to the eeprom
Delay 200
End Sub 'return to the main routine
'射出打ち切り
Sub abortfire()
'Debug "Fire aborted before firing! !",Cr
Out 31 ,0 'turn retract motor off
Out 32,0 'turn fire forward off DDD
Out 23,0 'turn force led off
Pwm l,fast,60000
Delay 250
Do Until Keyin(16,20)=O 'retract fire motor
Out 33,1
Loop
Out 33,0
Pwmoff 1
Out 22,0 'turn fire led off
Incr cycabortfires
If cycabortfires>=255 Then cycabortfires=255
Eewrite ds+1, cycabortfires, 1 'write the current cycle abortfires to the eeprom
Delay 200
homeextend 'extend to lcm
End Sub
1)約3秒以内で約60mm(〜2.4”)のストロークに約54.5kg(120ポンド)をかける、
2)約8秒以内で約60mm(〜2.4”)のストロークに約82kg(180ポンド)をかけるものである。
本発明の電気駆動式ハンドヘルド型手術用線形ステープル装置は、後述するように新規な方法で最適化され、これらの要求を満たすことができる。
・セル内の電解質の種類
・電解質の濃度および化学組成
・陽極と陰極がどうやって作られているか(化学的あるいは機械的構造の両方)
・PTC(抵抗の正温度係数)装置の種類と構造
これらの特性の1またはそれ以上を試験すると、ステープル装置への使用に最も望ましい電池を選択するのに価値ある情報を与えてくれる。最後の特性、すなわちPTC装置の動作の試験により、望む作業を行う電池種類の最適化が実現する。
・4x1電池パックでは、約2.5アンペア、約8ボルトで、負荷を約0.6IPSで駆動した。
・6x1電池パックでは、約2.5アンペア、約13ボルトで、負荷を約0.9IPSで駆動した。
・3x2電池パックでは、約2.5アンペア、約6ボルトで、負荷を約0.4IPSで駆動した。
180#負荷について、
・4x1電池パックでは、約4アンペア、約7.5ボルトで、負荷を約0.65IPSで駆動した。
・6x1電池パックでは、約4アンペア、約12ボルトで、負荷を約0.9IPSで駆動した。
・3x2電池パックでは、約4アンペア、約7ボルトで、負荷を約0.4IPSで駆動した。
明確に、ピーク電流は制限され、この限界は負荷に依存する。この実験は、所定の負荷では電源に拘わらず電流は同じとなるが、電池構成によって電圧は変化することを示している。各負荷について、予想通り、6x1構成で出力が大きく、3x2構成で少なかった。ここから、電池パックの合計出力は電流ではなく電圧により変化し、このため、並列構成(3x2)はこの電源を最適化する方法ではない。
(60rpm→1回転/秒(rps);1rps@0.8IPR→0.8インチ/秒)
このような理想化されたケースでは、速度に対してIPRをプロットすると、真っ直ぐな線が出来上がる。固定の距離に対する速度は、さらに射出時間まで低減することができる。したがって、IPRに対する射出時間のプロットもこの理想的なケースでは真っ直ぐな線となる。しかしながら、モータの出力(rpm)と、それ故ギアボックスの出力は、負荷によって変化するため一定ではない。負荷の程度により、モータが出力しうる出力量が決定される。負荷が増えると、rpmが減り効率が変化する。負荷を変化させた効率試験によると、効率のピークは丁度60%以上と判明している。しかしながら、このピーク効率における対応する電圧とアンペアは、出力のピーク時点と同じではない。負荷が増大するのに伴い、電力の増加速度より効率の定価が早くなるまで電力は増え続ける。IPRが増大すると、速度が増加することが見込まれるが、IPRの増加に対応して機械的利益は低くなり、したがって負荷が増大する。この負荷が増大すると、段々増える高い負荷に応じて効率が落ちることは、IPRが大きくなってもラックからの出力速度が大きくならなくなる点が存在することを意味する。この性質は、IPRに対する射出時間(秒)のプロットにおける予測される真っ直ぐな線からの偏向として反映される。本発明のシステムの実験は、不要な機械的利益と不十分な機械的利益が約0.4IPRで生じることを示している。
Claims (17)
- 電気駆動式の手術器具であって:
作動時、外科処置を行うために操作可能な作動アセンブリを有する手術用エンドエフェクタを具え、前記作動アセンブリの一部は、開始位置と十分に作動した位置との間を動くよう動作可能であり;
前記作動アセンブリを作動させるために前記エンドエフェクタに接続されるハンドルを具え、前記ハンドルが:
前記ハンドル内に全体が配置される自立型の電源と;
前記ハンドル内に全体が配置された駆動アセンブリであって:
電気的に駆動されるモータと;
前記電源と前記モータとに電気的に接続され、前記モータを選択的に作動させるコントローラとを有する駆動アセンブリと;
前記モータを前記可動部分に機械的に接続し、前記モータが動作すると、前記可動部分を前記開始位置と十分に伸長した位置の間のどこかに、選択的に配置するよう操作可能な変速機と;
前記変速機に機械的に接続され、前記変速機を選択的に中断させ、この中断中に、前記モータの動作から独立して、前記可動部分を前記開始位置の方へ配置する手動解放と、を有することを特徴とする手術器具。 - 請求項1に記載の器具において:
前記手術用エンドエフェクタは、手術用線形ステープルエンドカッタであって;
前記可動部分は、少なくともステープル作動および組織切開スライドを含むことを特徴とする器具。 - 請求項2に記載の器具において、前記駆動アセンブリと前記変速機は、前記エンドカッタのステープル切開機能を作動させるよう操作可能であることを特徴とする器具。
- 請求項1に記載の器具において、前記電源は、少なくとも1のバッテリを含む取り外し可能なバッテリパックであることを特徴とする器具。
- 請求項4に記載の器具において、前記電源は4乃至6のCR123またはCR2のパワーセルの直列接続であることを特徴とする器具。
- 請求項1に記載の器具において、前記コントローラは、前記スイッチが第1の状態にあるとき、前記モータを順方向に回転させ、前記スイッチが第2の状態にあるとき、前記モータを逆方向に回転させるよう操作可能なマルチステートスイッチを含むことを特徴とする器具。
- 請求項1に記載の器具において、前記変速機は、モータドライブ側と作動ドライブ側とを有し、前記手動解放はその間に連結されることを特徴とする器具。
- 請求項1に記載の器具において、前記手動解放は、前記変速機内に機械的に配置されることを特徴とする器具。
- 請求項7に記載の器具において:
前記モータドライブ側は、最終ギアを含む一連の回転減少ギアを有し;
前記作動ドライブ側は:
少なくとも1のギアと;
前記少なくとも1のギアに連結され、前記可動部分の少なくとも一部に直接連結されるラックアンドピニオンアセンブリとを有し;
前記手動解放は、前記少なくとも1のギアと前記最終ギアとの間に機械的に連結されることを特徴とする器具。 - 請求項9に記載の器具において:
前記モータは出力ギアを有し;
前記一連のギアは、前記出力ギアに連結される第1段を有することを特徴とする器具。 - 請求項10に記載の器具において:
前記一連のギアは、第1、第2および第3段と、前記モータドライブ側から前記作動ドライブ側にわたるシャフトを有するクロスオーバギアとを具え;
前記クロスオーバギアは、前記第3段に連結されることを特徴とする器具。 - 請求項9に記載の器具において:
前記一連のギアは、前記モータドライブ側から前記作動ドライブ側にわたるクロスオーバシャフトを有するクロスオーバギアを有し;
前記クロスオーバギアは、前記一連のギアに連結され;
キャッスルギアが、前記クロスオーバシャフトの周りに回転可能に連結固定され、その上を長手方向に移動可能であり、前記キャッスルギアは、前記作動ドライブ側の方へ伸長する胸壁を有し;
前記作動ドライブ側の少なくとも1のギアは、前記胸壁と合致するよう形成される胸壁スロットを有する第1のピニオンを含み;
バイアス装置が、前記クロスオーバギアと前記キャッスルギアとの間に配置され、前記作動ドライブ側の方へ前記キャッスルギアにバイアスを付与し、前記キャッスルギアの前記第1のピニオンへの選択的な係合を可能にし、これにより、係合時、前記シャフトの回転で前記第1のピニオンを回転させ;
前記手動解放は、前記バイアスを越える反力を前記キャッスルギアに提供し、前記手動解放が少なくとも部分的に作動すると、前記第1のピニオンから前記キャッスルギアを解放するよう形成され、配置された解放部分を有することを特徴とする器具。 - 請求項12に記載の器具において、前記作動駆動側の少なくとも1のギアは、第2のピニオン段を具え、この第2のピニオン段が:
第2のピニオンシャフトと;
前記第1のピニオンに連結され、前記第2のピニオンシャフトに回転可能に取り付けられる第2のピニオンギアと;
前記第2のピニオンシャフトに回転可能に取り付けられる第3のピニオンとを有し、前記第3のピニオンは、前記ラックアンドピニオンアセンブリのピニオンであって、回転時、そのラックを長手方向に動かすことを特徴とする器具。 - 請求項12に記載の器具において、前記手動解放は:
前記解放部分が、前記バイアスより小さい反力を前記キャッスルギアに提供している休止状態と;
前記解放部分が、前記バイアスより大きい反力を前記キャッスルギアに提供し、前記胸壁を前記胸壁スロットの外へ動かす第1の部分作動状態と;
前記手動解放が、前記ピニオンを回転させ、前記ラックを退避方向へ長手方向に動かす第2の部分作動状態とを有することを特徴とする器具。 - 請求項12に記載の器具において:
前記作動ドライブ側の少なくとも1のギアは、少なくとも1の解放ギアを具え;
前記第1のピニオンは、前記少なくとも1の解放ギアに直接接続され、回転時、前記少なくとも1の解放ギアを回転させることを特徴とする器具。 - 請求項12に記載の器具において:
前記作動ドライブ側の少なくとも1のギアは、第1段および第2段の解放ギアを具え;
前記第1のピニオンは、前記第1段の解放ギアに直接接続され、回転時、前記第1および第2の解放ギアを回転させることを特徴とする器具。 - 請求項15に記載の器具において:
前記手動解放は、手動解放レバーを具え、この手動解放レバーが:
前記ハンドルに回転可能に接続され;
一方向ラチェットアセンブリを有し;
前記少なくとも1の解放ギアが、前記ラチェットアセンブリに直接接続されるシャフトを有し、前記レバーが少なくとも部分的に作動されると、前記レバーに対応して回転し、前記レバーが作動されないと、前記レバーとは独立して回転することを特徴とする器具。
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