WO2023046033A1 - 钉仓组件和外科器械 - Google Patents

钉仓组件和外科器械 Download PDF

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Publication number
WO2023046033A1
WO2023046033A1 PCT/CN2022/120654 CN2022120654W WO2023046033A1 WO 2023046033 A1 WO2023046033 A1 WO 2023046033A1 CN 2022120654 W CN2022120654 W CN 2022120654W WO 2023046033 A1 WO2023046033 A1 WO 2023046033A1
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WO
WIPO (PCT)
Prior art keywords
cutting knife
nail
knife
guide
cartridge assembly
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Application number
PCT/CN2022/120654
Other languages
English (en)
French (fr)
Inventor
孙宝峰
施龙霞
Original Assignee
江苏风和医疗器材股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Application filed by 江苏风和医疗器材股份有限公司 filed Critical 江苏风和医疗器材股份有限公司
Priority to AU2022350731A priority Critical patent/AU2022350731A1/en
Publication of WO2023046033A1 publication Critical patent/WO2023046033A1/zh

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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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments

Definitions

  • the application belongs to the field of medical and surgical instruments, and in particular relates to a staple cartridge assembly and a surgical instrument.
  • Surgical instruments can complete anastomosis and cutting at the same time, reduce operation time, reduce patient bleeding, and play a key role in clinical operations.
  • the cutting knife is an indispensable and important part of surgical instruments.
  • the front end of the surgical instrument includes a replaceable staple cartridge assembly, which is a disposable consumable.
  • the cutting knife of the nail cartridge assembly in the prior art can slide along the inclined guide groove under the action of an external force to switch between the above-mentioned hidden state and the edge-out state.
  • the inclined guide groove results in a longer length of the pusher plate, which affects the pusher.
  • the strength of the nail plate also causes the length of the nail cartridge to be longer, which is not conducive to performing surgical operations in a limited space.
  • the purpose of this application is to propose a staple cartridge assembly and a surgical instrument to solve the above-mentioned technical problem in the prior art that the inclined guide groove of the cutting knife affects the length of the staple cartridge assembly.
  • the present application provides a staple cartridge assembly.
  • the staple cartridge assembly includes: a staple cartridge main body and a nail pushing plate assembly installed on the staple cartridge main body.
  • the nail pushing plate assembly includes:
  • the nail pushing plate is provided with a knife receiving groove, the knife receiving groove is provided with a first guide, and a cutting knife is at least partially accommodated in the knife receiving groove, and the cutting knife is provided with a second guide; the first guide One of the guide piece and the second guide piece extends along the direction perpendicular to the nail outlet surface of the main body of the staple cartridge, the first guide piece and the second guide piece are relatively movably matched, and the first guide piece and the second guide piece can guide cutting The knife moves in a direction perpendicular to the nail-out surface.
  • the cutting knife includes a first surface, and the first surface is pushed to make the cutting knife move upward relative to the nail pushing plate in a direction perpendicular to the nail-exiting surface under the guidance of the first guide member and the second guide member, so that the cutting knife The blade of the knife protrudes from the surface of the nail.
  • the first surface is contacted to keep the blade of the cutting knife protruding from the nail-exiting surface.
  • the first surface is a plane parallel to the nail-exiting surface.
  • the knife receiving groove is provided with an opening, and the opening exposes the first surface from the knife receiving groove so as to be accessible.
  • the cutting knife includes a second surface, at least a part of the second surface is a plane inclined relative to the nail-exiting surface or an arc surface inclined and protruding outward relative to the nail-exiting surface, and the second surface faces the back of the nail-pushing plate
  • the side and the lower side push the second surface to make the cutting knife move upwards in the direction perpendicular to the nail-exiting surface under the guidance of the first guide and the second guide, so that the blade of the cutting knife protrudes from the nail-exiting surface.
  • the first surface of the cutting knife is connected with the second surface, and the first surface is located at the front side of the second surface; the first surface is in contact to keep the cutting knife edge protruding from the nail surface.
  • the first surface is a plane parallel to the nail-exiting surface.
  • the cutting knife further includes a second surface, at least a part of the second surface is an inclined surface inclined relative to the nail-exiting surface or an arc surface inclined relative to the nail-exiting surface and protruding outward,
  • the second surface faces the rear side and the lower side of the nail pushing plate, and pushing the second surface can make the cutting knife move vertically under the guidance of the first guide and the second guide. Move upward in the direction of the nail-out surface, so that the blade of the cutting knife protrudes from the nail-out surface; the first surface is connected to the second surface, and the first surface is located on the second surface. The front side of the second surface.
  • the knife receiving groove is provided with at least one set of first guides
  • one set of first guides includes two first guides respectively located on opposite side walls of the knife receiving groove
  • the cutting knife is provided with at least one set of second guides.
  • Guide member, a group of second guide members includes two second guide members located on opposite sides of the cutting knife respectively, and two first guide members of a group of first guide members correspond to a group of second guide members one by one. The two second guides of the piece are mated.
  • the knife receiving groove is provided with two sets of first guides, and the two sets of first guides are separated on the extension direction of the nail outlet surface, and the cutting knife is provided with two sets of second guides, and the two sets of second guides Separated in the extension direction of the nail outlet surface, the first set of first guides in the front of the two sets of first guides are matched with the second set of second guides in the front of the two sets of second guides, and the set of rear ones The first guide is matched with a group of second guides at the rear.
  • the nail pushing plate assembly further includes an elastic body, one end of the elastic body is mounted on the nail pushing plate, and the other end of the elastic body abuts against the cutting knife, and the elastic body is used to drive the cutting knife downward along a direction perpendicular to the nail output surface. sports.
  • the pusher plate assembly further includes a supporting plate
  • the knife receiving groove includes an accommodation cavity for accommodating at least a part of the elastic body
  • the accommodation cavity includes an opening
  • the supporting plate is installed on the nail pushing plate to at least partially close the opening.
  • the present application further provides a surgical instrument, including an end effector and a pusher, the end effector includes a jaw assembly and the above-mentioned nail cartridge assembly, the nail cartridge assembly is detachably mounted on the jaw assembly,
  • the pusher is used to drive the nail pusher to move forward along the length direction, the pusher includes a forward protruding knife lifting portion, and the knife lifting portion includes a third surface;
  • the lifting part In the state where the staple cartridge assembly is installed on the jaw assembly, the lifting part is located below the cutting knife, and the third surface acts on the cutting knife from below the cutting knife, so that the blade of the cutting knife protrudes from the nail exit surface of the staple cartridge assembly .
  • the third surface is a plane parallel to the nail exit surface of the staple cartridge assembly installed on the jaw assembly.
  • the knife lifting portion further includes a fourth surface, the fourth surface is a plane inclined relative to the nail exit surface of the nail cartridge assembly installed on the jaw assembly or an arc surface inclined relative to the nail exit surface and concave inward, the fourth surface faces toward the front and upper side of the surgical instrument;
  • the fourth surface can contact and push the cutting knife so that it slides relatively on the fourth surface, so that the cutting knife moves upward along the direction perpendicular to the nail-exiting surface.
  • the third surface is connected to the fourth surface, and the fourth surface is located on the front side of the third surface.
  • the pusher is provided with an arm part, the arm part is spaced apart from the knife lifting part, and a recess capable of accommodating the cutting knife is formed between the arm part and the knife lifting part.
  • the front end of the arm is provided with a guide surface, when the cutting knife is accommodated in the recess, the guide surface protrudes forward from the tip of the cutting knife, the guide surface faces the recess, and the guide surface is a slope or an arc.
  • the arm is provided with a groove, the groove faces the recess, and when the cutting knife is accommodated in the recess, the upper edge of the cutting knife fits into the groove.
  • the third surface pushes the cutting knife from below the cutting knife, so that the cutting knife moves in a direction perpendicular to the nail-exiting surface, so that the edge of the cutting knife protrudes from the nail-exiting surface of the staple cartridge assembly; or the third surface pushes the cutting knife from the The bottom of the cutting knife contacts the cutting knife to keep the edge of the cutting knife protruding from the nail surface.
  • the cutting knife is vertically ejected under the guidance of the first guide member and the second guide member, and the movement of the cutting knife during the blade ejection process does not use the space in the length direction inside the staple cartridge, so that the staple cartridge assembly remains the same
  • the case of the anastomotic stroke is short, which is convenient for operation.
  • FIG. 1 shows a schematic structural view of a stapler according to an embodiment of the present application
  • Fig. 2 shows a schematic structural view of a jaw assembly of a stapler according to an embodiment of the present application
  • FIG. 3 shows a schematic structural view of a pusher plate assembly of a stapler according to an embodiment of the present application
  • Fig. 4 shows a structural schematic diagram of another angle of the pusher plate assembly of the stapler according to the embodiment of the present application
  • Fig. 5 shows the cross-sectional view of the push plate assembly of the stapler according to the embodiment of the present application
  • Fig. 6 shows an exploded view of the pusher plate assembly of the stapler according to an embodiment of the present application
  • Fig. 7 shows a schematic structural diagram of a pusher of a stapler according to an embodiment of the present application
  • Fig. 8A shows a partial enlarged cross-sectional view of the pusher of the stapler at the initial position according to an embodiment of the present application
  • Figure 8B shows a partially enlarged view of Figure 8A
  • Fig. 9A shows a partially enlarged cross-sectional view of the pusher of the stapler according to an embodiment of the present application when it is at a certain position in the middle;
  • Figure 9B shows a partially enlarged view of Figure 9A
  • Fig. 10A shows a partially enlarged cross-sectional view of the pusher of the stapler according to the embodiment of the present application when it is retreating;
  • Figure 10B shows a partially enlarged view of Figure 10A
  • Fig. 11A shows a partial enlarged cross-sectional view of the pusher of the stapler according to an embodiment of the present application when it is re-triggered after retreating;
  • Figure 11B shows a partially enlarged view of Figure 11A
  • Fig. 12A shows a partially enlarged cross-sectional view of a situation where the staple cartridge assembly is installed on the staple cartridge seat
  • Figure 12B shows a partially enlarged view of Figure 12A
  • Fig. 13A shows a partial enlarged cross-sectional view of another situation where the staple cartridge assembly is installed on the staple cartridge seat
  • Figure 13B shows a partially enlarged view of Figure 13A
  • Fig. 14 shows a partially enlarged view of a staple cartridge assembly possibly installed on a stapler.
  • Nail bin seat , knife receiving groove; 111, slot; 112, first guide; 113, accommodating cavity; 114, force receiving part; 12, cutting knife; 121, second guide; 122, second surface; Surface; 1201, cutter body; 1202, holding structure; 13, elastic body; 14, supporting plate; 2, propeller; 21, cutter bar; 22, cutter holder head; 2212, the third surface; 222, the arm; 2221, the guide surface; 2222, the groove; 223, the recess; 224, the pushing part; Slider; X, length direction; Y, width direction; Z, height direction.
  • the user of the stapler can be a clinician, and the doctor operates the stapler during the operation to perform the operation.
  • the terms "proximal”, “rear” and “distal”, “anterior” as used herein are relative to the clinician manipulating the stapler.
  • the terms “proximal” and “posterior” refer to the part relatively close to the clinician, and the terms “distal” and “anterior” refer to the part relatively far away from the clinician.
  • Left” and “right” refer to the position of the stapler shown in FIG. 1 , for example, the end effector 100 is on the "left", and the handle assembly 300 and the shaft assembly are on the "right”.
  • the terms “upper” and “lower” refer to the relative positions of the nail anvil 20 and the cartridge holder 10 of the end effector 100, specifically, the nail anvil 20 is “upper” and the nailer holder 10 is “lower”. .
  • the nail output surface 31 is “upper”, and the side opposite to the nail output surface 31 is “lower”.
  • the staple exit surface 31 of the staple cartridge assembly 101 faces the nail abutment seat 20, that is, the staple exit surface 31 of the staple cartridge assembly 101 faces "up”.
  • the length direction X represents the length direction of the staple cartridge assembly 101
  • the length direction of the staple cartridge assembly 101 is consistent with the front and back direction of the stapler
  • the width direction Y represents the width direction of the staple cartridge assembly 101
  • the width direction Y is consistent with the length direction Vertical
  • the height direction Z represents the height direction of the staple cartridge assembly 101
  • the height direction of the staple cartridge assembly 101 is consistent with the up and down direction of the stapler
  • the height direction Z is perpendicular to both the length direction X and the width direction Y, specifically, as shown in the figure shown in 2.
  • the height direction Z is consistent with the direction perpendicular to the nail-exiting surface 31 .
  • connection should be interpreted in a broad sense unless otherwise clearly specified and limited, for example, it can be a fixed connection, a detachable connection, or Kinematic connection, or integration; it can be a direct connection or an indirect connection through an intermediary, and it can be the internal communication of two elements or the interaction relationship between two elements.
  • connection can be a fixed connection, a detachable connection, or Kinematic connection, or integration; it can be a direct connection or an indirect connection through an intermediary, and it can be the internal communication of two elements or the interaction relationship between two elements.
  • each direction in this specification is only for the convenience of explaining the technical solution of the application, and does not limit the operation of the electric stapler in the embodiment of the application, including but not limited to manufacturing, testing, transportation, use, etc.
  • the present application proposes a surgical instrument, preferably a stapler, which includes an end effector 100 , a sleeve assembly 200 and a handle assembly 300 , and the handle assembly 300 is connected to the end actuator through the sleeve assembly 200 . device 100.
  • the handle assembly 300 includes a housing and a power source module.
  • the power source module is a user manually operated handle connected to the transmission described below.
  • the power source module includes a motor and a power module disposed in the casing, the power module is composed of a plurality of electrically connected batteries, and is used to provide the motor with electrical energy required for rotation, and the motor is connected to the transmission device described below.
  • the type of power source module does not limit the scope of protection of this application. In the following, the overall function of the stapler will be described by taking the power source module including the motor and the power supply module as an example.
  • the cannula assembly 200 is disposed on the casing, and the cannula assembly 200 includes the propeller 2 (refer to FIG. 7 to FIG. 9B for example) and a cannula sleeved on part of the propeller 2 .
  • the stapler also includes a transmission device connected to the output shaft of the motor, and the transmission device includes a first transmission mechanism and a second transmission mechanism.
  • the sleeve and the pusher 2 are respectively connected to the motor through the first transmission mechanism and the second transmission mechanism, so as to be driven to move along the length direction X, including forward or backward movement along the length direction X.
  • the end effector 100 includes a jaw assembly and a staple cartridge assembly 101 .
  • the staple cartridge assembly 101 is detachably mounted on the jaw assembly.
  • the jaw assembly includes a staple cartridge base 10 and an abutment base 20 pivotably connected to the staple cartridge base 10, and the staple cartridge base 10 is used to operably support the staple cartridge assembly 101 therein.
  • the nail anvil 20 can selectively move between the open position and the closed position, and switch between the open state and the closed state, so as to cooperate with the staple cartridge seat 10 and the staple cartridge assembly 101 to clamp or loosen the tissue.
  • One end (front end) of the sleeve is connected to the nail anvil 20, and the other end (rear end) is connected to the first transmission mechanism, which can drive the sleeve to move backward or forward.
  • the backward movement of the sleeve can cause the anvil 20 to pivot upward to open the jaw assembly, and the forward movement of the sleeve can cause the anvil 20 to pivot downward to close the jaw assembly.
  • the staple cartridge assembly 101 includes a staple cartridge main body 3 and a pusher plate assembly 1 , and the pusher plate assembly 1 is detachably connected to the pusher 2 to be driven by the pusher 2 to perform a firing action or a knife retracting action.
  • the nail pushing plate assembly 1 includes a nail pushing plate 11 and a cutting knife 12 movably mounted on the nail pushing plate 11 .
  • One end (rear end) of the pusher 2 is connected to the second transmission mechanism, and the other end (front end) is detachably connected with the nail pushing plate 11 and the cutting knife, and the part of the pusher 2 is located in the casing except the other end.
  • the cutting knife 12 is located in the space formed between the staple cartridge seat 10 and the nail abutment seat 20 of the jaw assembly.
  • the second transmission mechanism can drive the propeller 2 to move forward and backward.
  • the forward movement of the pusher 2 causes the push plate assembly 1 to move forward, the staple push plate 11 pushes the staples of the staple cartridge assembly 101 out to anastomose the tissue, and the cutting knife 12 moves forward to cut tissue.
  • the motor drives the jaw assembly to close through the first transmission mechanism to clamp the tissue, then the motor drives the pusher plate assembly 1 to advance through the second transmission mechanism to cut and anastomose the tissue, and finally the motor drives the jaw assembly to open and loosen through the first transmission mechanism. Open the tissue, so as to realize the functions of stapler cutting and stapling.
  • the housing of the handle assembly 300 includes a connected handle housing and a head housing, the head housing can accommodate the transmission device, and the handle housing can be held by the user.
  • the handle housing can also accommodate part of the transmission device at the same time.
  • the handle housing can accommodate the motor, and the head housing can accommodate the aforementioned power module.
  • the staple cartridge assembly 101 includes a staple cartridge body 3 and a pusher plate assembly 1 , and the staple cartridge assembly 101 can be replaced on the staple cartridge seat 10 as a consumable item.
  • the interior of the staple cartridge main body 3 is arranged with a plurality of titanium nails along its length direction X, and a slide groove extending in the length direction X is arranged inside, the pusher plate assembly 1 can move in the slide groove, and the pusher plate assembly 1 can move from The tail of the staple cartridge main body 3 is inserted into the staple cartridge main body 3.
  • the pusher 2 of the sleeve assembly 200 pushes the pusher plate assembly 1, and the pusher plate assembly 1 can move toward the staple cartridge body 3 along the length direction X of the staple cartridge body 3
  • the distal end of the slides thereby contacting and pushing out the titanium nails in the main body 3 of the nail cartridge.
  • the titanium nail is pushed out, that is, the stapler performs the stapling action.
  • the anastomotic action is that the front end of the nail pushing plate 11 contacts the titanium nail and pushes out the titanium nail.
  • the staple cartridge assembly 101 also includes a cutting knife 12, specifically, the nail pushing plate assembly 1 includes a cutting knife 12 movably mounted on the nail pushing plate 11, and the cutting knife 12 is selectively movable between a first position and a second position, So that the cutting knife 12 is switched between the hidden state and the blade-out state.
  • Hidden state that is, the cutting knife 12 is hidden under the nail exit surface 31 of the staple cartridge body 3, which can prevent the user from being accidentally injured by the blade.
  • the cutting knife 12 is in the hidden state; state, that is, the blade of the cutting knife 12 protrudes from the nail outlet surface 31 of the staple cartridge body 3, so that the blade can cut the tissue clamped by the jaw assembly.
  • the cutting knife 12 is in an edge-out state. When cutting the tissue clamped by the jaw assembly, the nail outlet surface 31 contacts the clamped tissue.
  • the cutting knife 12 When the stapler performs an anastomotic action, the cutting knife 12 is in the edge-out state. As the pusher plate 11 moves forward, the cutting knife 12 also slides toward the distal end of the staple cartridge main body 3 along the length direction X of the staple cartridge main body 3, thereby To cut tissue, the stapler performs the cutting action.
  • Fig. 3 and Fig. 10B have shown the state that cutting knife 12 is positioned at the first position, namely hidden state
  • Fig. 8A, Fig. 8B, Fig. 9A and Fig. 9B have shown the state that cutting knife 12 is positioned at second position, namely out edge state.
  • the nail pushing plate assembly 1 includes a nail pushing plate 11 , a cutting knife 12 , an elastic body 13 and a supporting plate 14 .
  • the pusher plate assembly 1 in the present application realizes the hiding and edge-out of the cutting knife 12 .
  • the nail pushing plate 11 is provided with a knife receiving groove 110 capable of accommodating at least part of the cutting knife 12
  • the knife receiving groove 110 is provided with a first guide 112
  • the cutting knife 12 is provided with a second guide 121 .
  • One of the first guide 112 and the second guide 121 extends along a direction perpendicular to the nail outlet surface 31 of the staple cartridge main body 3, the first guide 112 and the second guide 121 can be relatively movably matched, and the first The guide piece 112 and the second guide piece 121 can guide the cutting knife 12 to move along a direction perpendicular to the nail-exiting surface 31 .
  • the first guide member 112 may be a guide groove extending along the height direction Z of the staple cartridge assembly 101 .
  • the knife receiving groove 110 includes a slot 111 and the following accommodating cavity.
  • the nail pushing plate 11 is provided with two opposite side walls, and the two opposite side walls and the space between the two opposite side walls form a slot 111 , the slot 111 includes the above-mentioned two opposite side walls and a space between the two side walls.
  • the first guiding member 112 is disposed in the slot 111 of the knife receiving groove 110 . Specifically, the first guide 112 is disposed on a sidewall of the slot 111 .
  • the second guide 121 can be a protrusion protruding from the side of the cutting knife 12, and the cutting knife 12 can be at least partially accommodated in the knife receiving groove 110 by inserting the protrusion into the guide groove.
  • the height direction Z of the staple cartridge assembly 101 (the direction perpendicular to the staple exit surface 31 ) is movable between the first position and the second position.
  • the three side openings of the slot 111 are located on the upper side, the lower side and the back side of the nail pushing plate 11, the opening on the upper side is an upward opening, and the opening on the lower side is a downward opening, the cutting knife 12 can
  • the lower side and the rear side of the nail pushing plate 11 are loaded into the knife receiving groove 110, and the following first surface 123 of the cutting knife 12 is exposed from the downward opening of the slot 111, so that the pusher 2 can be opened from the opening of the slot 111.
  • the opening on the lower side contacts the cutting knife 12 and pushes the cutting knife 12 upwards.
  • the side wall thickness of the slot 111 is relatively thin and elastic.
  • the cutting knife 12 includes a knife body 1201 and a holding structure 1202.
  • the knife body includes a blade. As shown in FIG. Extend into the accommodation cavity 113 and be accommodated in the accommodation cavity 113 . In another embodiment, based on the content shown in FIG. 5 , the rear end of the cutter body is exposed outside the slot 111 .
  • the knife body 1201 of the cutting knife 12 is completely accommodated in the slot 111 , which does not affect the implementation of the present application.
  • the first guide 112 may be a protrusion, and the second guide 121 may be a guide groove.
  • the first guide 112 may be a slide block or a slide rail, and the second guide 121 may be a slide rail or a slide block.
  • Fig. 14 shows a possible inclined blade cartridge assembly 101, wherein the cutting knife 12 can be slidably mounted on the push plate 11 relative to the push plate 11, the push plate 11 is provided with a guide groove A, the guide groove A extends forward at a slant.
  • the cutting knife 12 is provided with a slider B, which can slide along the guide groove A.
  • the propeller 2 moves forward (left side in the figure)
  • the propeller 2 abuts and pushes the cutting knife from the rear end of the cutting knife 12.
  • the cutting knife 12 can move obliquely upward relative to the nail pushing plate 11 under the guidance of the guide groove A, so that the cutting knife 12 can be edged out.
  • the cutting knife 12 must move forward relative to the nail pushing plate 11.
  • the distance C the fixed distance C is equal to the length of the guide groove A along the front-back direction.
  • the nail pusher plate 11 can remain still, and when the blade is finished, the forward displacement E of the cutting knife 12 relative to the staple cartridge seat 10 is equal to the displacement E of the cutting knife 12 relative to the pusher.
  • the distance that nail plate 11 moves forward that is, the length C of guide groove A along the front-to-back direction; in another possible situation, during the cutting knife 12’s edge-out process, nail pusher plate 11 may also be pushed to move forward A certain distance D, when the edge is finished, the forward displacement E of the cutting knife 12 relative to the staple cartridge seat 10 is the length C of the guide groove A along the front-to-back direction plus the distance D that the pusher plate 11 moves forward.
  • the cutting knife 12 when the cutting knife 12 completes the cutting, the cutting knife 12 will move forward relative to the pusher plate 11 by the length C of the guide groove A along the front-back direction, and the length C of the pusher plate 11
  • the design of the length should consider this length C, the length of the staple cartridge assembly 101 should consider the push plate 11, and the length of the jaw assembly of the stapler should consider the staple cartridge assembly 101, so that the nail cartridge assembly 101 and the jaw assembly of the stapler are both It will be designed to be longer.
  • the pusher plate 11 moves forward, that is, the staples are pushed out and the staples begin to be ejected, and the cutting knife is driven by the pusher plate 11 to start cutting tissue, but the above-mentioned blade ejection process is not expected to occur. , if it occurs, the tissue will be cut incompletely. Therefore, in order to avoid the incomplete cutting of tissue in the process of the above-mentioned advance of the nail pushing plate 11 by the distance D, the length design of the staple cartridge assembly should also consider this distance D, resulting in the design of the nail cartridge assembly and the jaw assembly of the stapler. longer.
  • the guide groove A and the slider B of the staple cartridge assembly in Fig. 14 are equivalent to the functions of the first guide 112 and the second guide 121 of the present application, the difference is that the guide groove A and the slider B guide the cutting knife to tilt, The first guide 112 and the second guide 121 of the present application guide the cutting knife to move up and down.
  • the first guide 112 and the second guide 121 of the present application are perpendicular to the The direction of the surface (height direction Z) extends, and the cutting knife 12 does not move in the front-back direction relative to the staple cartridge seat 10.
  • This section of displacement in the front-back direction is omitted, so that the length of the pusher plate 11 can be designed to be shorter, so that The staple cartridge assembly can have a shorter length while maintaining the same stapling stroke, and the jaw assembly has a shorter length, so that the user can make the jaw assembly reach a narrow area during the operation to facilitate the operation of the stapler.
  • the guide assembly (the first guide 112 and the second guide 121 ) extending only in the height direction of the present application is the best mode.
  • the guide groove along the height direction Z can make the cutting knife 12 move the same distance along the height direction Z.
  • the guide groove is shorter than the guide groove arranged obliquely, and the pusher plate 11 has fewer hollow parts to make the pusher plate 11 The structural strength can be higher.
  • the cutting knife 12 is provided with a first surface 123.
  • the pusher 2 can contact the first surface 123, so that the cutting knife 12 Under the guidance of the first guide piece 112 and the second guide piece 121, relative to the nail pushing plate 11, it moves upwards in a direction (height direction Z) perpendicular to the nail outlet surface 31, so that the blade portion of the cutting knife 12 can protrude.
  • a direction herein.
  • the first surface 123 is a plane parallel to the nail ejecting surface 31 , and the first surface 123 is parallel to the moving direction of the nail pushing plate 11 .
  • the cutting knife 12 is easily kept stable by the pusher 2 when the cutting knife 12 is lifted by the pusher 2, and it is not easy to make the cutting knife 12 slip to the state where the blade is hidden.
  • the structure of the assembly 101 is simple. It can be understood that since the first surface 123 is parallel to the nail ejecting surface 31 , when the pusher 2 abuts against the first surface 123 , the nail pushing plate 11 will not be pushed to move forward. That is to say, during the process of installing the cartridge assembly 101 on the cartridge holder 10, the push plate 11 will not move.
  • the rear end (near the end of the sleeve assembly 200) of the cutting knife 12 is provided with a second surface 122, at least a part of the second surface 122 is a plane inclined with respect to the nail-exiting surface 31 or inclined with respect to the nail-exiting surface 31 and toward In the convex arc surface, the second surface 122 faces the rear side and the lower side of the nail pushing plate 11 , and the second surface 122 extends upwards as it goes to the rear.
  • the second surface 122 can make the lifting part 221 of the propeller 2 easily inserted into the below of the cutting knife 12, and the movement of the propeller 2 along the front-back direction can be converted into the movement of the cutting knife 12 along the up-down direction by the guidance of the second surface 122. sports.
  • Fig. 10A, Fig. 10B, Fig. 11A and Fig. 11B if the stapler stops firing and withdraws the knife during the firing process, the propeller 2 will stop advancing and move backward to disengage from the cutting knife 12, so that the cutting knife 12 is out of the blade state. Switch to hidden state. When the stapler fires again, the pusher 2 moves forward again to push the cutting knife 12 and switch the cutting knife 12 from the hidden state to the edge-out state.
  • the process is as follows: the pusher 2 first pushes against the second surface 122, so that the cutting knife 12 Overcome the elastic force of the elastic body 13 and move upward along the first guide member 112, so that the blade of the cutting knife 12 protrudes from the nail exit surface 31 (upper surface) of the staple cartridge main body 3, so that the blade can cut tissue.
  • the second surface 122 can be brought into contact with the fourth surface 2211 of the lifter portion 221 described later, and the staple cartridge can be slid proximally.
  • the assembly 101 , the second surface 122 and the fourth surface 2211 can guide the cutting knife 12 to move upwards along the guide groove and above the knife lifting portion 221 .
  • the second surface 122 is connected to the first surface 123 , the first surface 123 is located at the front side of the second surface 122 , and the second surface 122 and the first surface 123 constitute at least a part of the bottom surface of the cutting blade 12 .
  • the connection between the second surface 122 and the first surface 123 can make the two cooperate with each other.
  • the knife receiving groove 110 is provided with two sets of first guides 112, here, two first guides that are respectively located in the two side walls of the slot 111 and are opposite to each other in the width direction Y can be arranged.
  • the pieces 112 are referred to as a set of first guides 112 .
  • the two sets of first guides 112 can be spaced apart in the length direction X, so that the movement of the cutting knife 12 can be reliably guided, and the two sets of first guides 112 can prevent the cutting knife 12 from turning over in the knife receiving groove 110 .
  • Each set of first guides 112 has two first guides 112, and these two first guides 112 are respectively located on two opposite side walls of the slot 111, that is, one first guide 112 is located on the side of the slot 111. On one side wall, another first guide member 112 is located on the other side wall opposite to the aforementioned one side wall.
  • the cutting knife 12 is provided with two sets of second guides 121, the two sets of second guides are separated on the extension direction of the nail outlet surface 31, the two sets of first guides 112
  • a group of first guides 112 in the front is matched with a group of second guides 121 in the front of the two groups of second guides 121
  • a group of first guides 112 in the rear is matched with a group of second guides 121 in the rear. catch.
  • Each set of second guides 121 has two second guides 121, and these two second guides 121 are respectively located on two opposite sides of the cutting knife 12, that is, one second guide 121 is located on the side of the cutting knife 12.
  • the other second guide member 121 is located on the other side wall opposite to one side wall of the cutting knife 12 .
  • Each first guide piece 112 is matched with a second guide piece 121 respectively. That is, the two first guides 112 of a set of first guides are relatively movably matched with the two second guides 121 of a set of second guides 121 in one-to-one correspondence. Guiding the cutting knife 12 from both sides can prevent the cutting knife 12 from tilting left and right in the knife receiving groove 110 , and keep the cutting knife 12 stable during the movement along the height direction Z.
  • the second guide member 121 may be a bump with a square cross section, such a bump is difficult to rotate in the guide groove, and can prevent the cutting knife 12 from turning over in the knife receiving groove 110 .
  • the square includes a square, a square with rounded corners, a rectangle, and a rectangle with rounded corners.
  • only one set of first guides 112 can be provided, and the shape and configuration of the first guides 112 and/or the second guides 121 can prevent the cutting knife 12 from turning over in the knife receiving groove 110, for example, the above-mentioned
  • the shape of the bump as the second guide 121 is square, or the second guide 121 includes a locking structure for locking the positional relationship between the first guide 112 and the second guide 121 .
  • the knife receiving groove 110 includes an accommodating cavity 113 , and the accommodating cavity 113 accommodates at least part of the elastic body 13 .
  • the elastic body 13 enables the cutting knife 12 to move downward along a direction perpendicular to the nail-exiting surface 31 .
  • the accommodating cavity 113 includes an opening, for example, the opening faces the lower side, and the supporting plate 14 is installed on the nail pushing plate 11 to at least partially close the opening, so as to prevent the shredded human tissue from entering from the bottom of the accommodating cavity 113, so that the elastic body 13 Movement is not impeded.
  • the supporting plate 14 can be firmly connected with the nail pushing plate 11 by means of plastic hot melting, the supporting plate 14 is located under the elastic body 13 , and the supporting plate 14 can but not necessarily support the elastic body 13 .
  • the width of the accommodating cavity 113 is consistent with that of the elastic body 13 , so that the accommodating cavity 113 can limit the movable range of the elastic body 13 along the width direction Y.
  • the accommodating cavity 113 communicates with the slot 111 , the rest of the holding mechanism of the cutting knife 12 can extend into the accommodating cavity 113 , and the movable end of the elastic body 13 can extend into the slot 111 .
  • One end of the elastic body 13 is installed on the push nail plate 11, and the other end (movable end) of the elastic body 13 is pressed against the holding mechanism of the cutting knife 12, so that the cutting knife 12 has a tendency to be accommodated in the knife receiving groove 110, that is, the cutting knife 12 is in the first position.
  • the elastic body 13 can be a special-shaped spring.
  • the movable end of the elastic body 13 protrudes into the slot 111 and presses against the holding mechanism of the cutting knife 12 .
  • the position of the movable end of the elastic body 13 and the holding mechanism of the cutting knife 12 in the knife receiving groove 110 does not limit the scope of the present application, as long as both are located in the knife receiving groove 110 and the position of the elastic body 13 It is enough for the movable end to press against the holding mechanism of the cutting knife 12 , for example, the movable end of the elastic body 13 and the holding mechanism of the cutting knife 12 are both in the accommodation cavity 113 .
  • the elastic body 13 can be first loaded into the accommodation chamber 113 from the bottom opening of the accommodation chamber 113, then the cutting knife 12 is packed into the slot 111, and finally the supporting plate 14 is installed after the cutting knife 12 and the elastic body 13 are installed, and the supporting plate 14 Installed on the nail push plate 11.
  • the nail pushing plate 11 is provided with a force receiving portion 114 for being pushed against by the pusher 2 , and the pusher 2 can drive the nail pushing plate 11 to move forward by pushing against the force receiving portion 114 .
  • the casing assembly 200 includes a pusher 2, and the pusher 2 includes a knife bar 21 and a knife head 22, the knife head 22 is connected to the front end of the knife bar 21, and the rear end of the knife bar 21 is connected to the second transmission Mechanism, when the staple cartridge assembly 101 is installed on the staple cartridge seat 10 and the pusher 2 moves forward along the length direction X, the knife holder head 22 can push the nail pushing plate 11 to move forward, and the knife holder head 22 and the cutting knife 12 The contact fit causes the cutting knife 12 to be pushed up, and the blade portion of the cutting knife 12 protrudes from the nail exit surface 31 of the staple cartridge main body 3 .
  • the tool holder head 22 is provided with a pushing portion 224 , and when the pusher 2 moves forward, the pushing portion 224 contacts and pushes against the force receiving portion 114 , thereby driving the nail pushing plate 11 to move forward.
  • the knife holder head 22 is also provided with a knife lifting part 221 and an arm part 222 , and the knife lifting part 221 and the arm part 222 protrude forward.
  • the knife lifting part 221 and the arm part 222 are spaced apart, and a concave part 223 capable of accommodating the cutting knife 12 is formed between the knife lifting part 221 and the arm part 222 , and the cutting knife 12 can be sandwiched between the knife lifting part 221 and the arm part 222 .
  • the lifting portion 221 is located below the cutting knife 12
  • the arm portion 222 is located above the cutting knife 12
  • the cutting knife 12 may not contact the bottom surface of the recess 223 .
  • the knife lifting part 221 is provided with a third surface 2212, and the third surface 2212 is in contact with the first surface 123 (bottom surface) of the cutting knife 12 to keep the cutting knife 12 in a lifted state.
  • the third surface 2212 is parallel to the nail exit surface 31
  • the third surface 2212 is parallel to the first surface 123 of the cutting knife 12
  • the third surface 2212 is parallel to the first surface 123 of the cutting knife 12
  • the third The surface 2212 is parallel to the moving direction (front-rear direction) of the pusher plate 11 .
  • the knife lifting part 221 is in contact with the cutting knife 12, and the knife lifting part 221 will not apply an external force along the length direction X to the cutting knife 12, so that the cutting knife 12 can Stay still. In this way, the cutting knife 12 is easily kept stable when it is lifted by the pusher 2, and it is not easy to make the cutting knife 12 slide to the hidden state of the blade. Simple.
  • the front end of the knife lifting part 221 is provided with a fourth surface 2211, the fourth surface 2211 is a plane inclined relative to the nail exit surface 31 of the nail cartridge assembly 101 installed in the jaw assembly or inclined and concave inward relative to the nail exit surface 31
  • the fourth surface 2211 faces the front side and the upper side of the stapler, and the fourth surface 2211 extends upwards as it goes to the rear.
  • the fourth surface 2211 and the second surface 122 can be parallel, so that when the second surface 122 and the fourth surface 2211 cooperate, the contact area can be larger and wear can be reduced .
  • the fourth surface 2211 contacts the second surface 122 .
  • the second surface 122 and the fourth surface 2211 are gradually staggered, so that the cutting knife 12 overcomes the elastic force of the elastic body 13 and moves upward along the first guide 112, and the cutting knife 12 is accommodated in the concave portion 223, so that The blade portion of the cutting knife 12 protrudes from the staple exit surface 31 of the staple cartridge main body 3 .
  • only the cutting knife 12 may be provided with an inclined second surface 122 or only the front end of the knife lifting part 221 is provided with an inclined fourth surface 2211, when the knife lifting part 221 moves forward, the second The surface 122 or the fourth surface 2211 can make the lifting portion 221 push the cutting knife 12 to move upward.
  • the front end of the knife lifting portion 221 or the other of the cutting knife 12 is provided with rounded corners matching the inclined surface.
  • a guiding surface 2221 is formed at the front end of the arm portion 222, and the guiding surface 2221 faces the concave portion 223, and the guiding surface 2221 may be an inclined surface or an arc surface.
  • the tip of the cutting knife 12 can be the tip of the blade of the cutting knife 12, or the tip of the cutting knife 12 is the front end of the exposed part of the cutting knife 12. In some possible embodiments, the tip of the cutting knife 12 can be the tip of the blade Also need not be the tip of the blade.
  • the arm 222 is provided with a groove 2222, the groove 2222 faces the recess 223, the groove 2222 extends roughly along the length direction X, the groove 2222 can be opened in the middle of the arm 222, and the groove 2222 is defined.
  • the surface of the sidewall facing the recess 223 is the guiding surface 2221 .
  • the upper edge of the cutting knife 12 can be embedded in the groove 2222, so that no gap will be formed in the height direction between the cutting knife 12 and the arm portion 222 as a whole, preventing tissue from entering the cutting knife 12
  • the gap between the arm portion 222 and the arm portion 222 cannot be cut, which ensures that all tissues can be cut by the cutting knife 12, and the cutting effect is better.
  • the stapler needs to switch the cutting knife 12 from the hidden state to the blade-out state before the first cut and cut to the tissue.
  • the doctor can realize the complete blade-out of the cutting knife 12 only through the installation action. There is no need for the doctor to activate the stapler to start firing.
  • the staple cartridge assembly 101 of the present application is obliquely installed on the jaw assembly, the following two situations will occur:
  • the staple cartridge assembly 101 continues to slide toward the proximal end of the jaw assembly, the third surface 2212 and the first surface 123 of the cutting knife 12 slide relative to each other until the cutting knife 12 is embedded in the recess 223 . Finally, the distal end of the cartridge assembly 101 is pressed down. When pressed to the bottom, the third surface 2212 stably keeps the cutting knife 12 at the second position, that is, the cartridge assembly 101 is installed on the cartridge holder 10 .
  • the second surface 122 of the cutting knife 12 at the proximal end of the staple cartridge assembly 101 and the fourth surface 2211 of the knife lifting part 221 are in contact, and then the contact surface becomes smaller. And gradually stagger, and finally break away.
  • the cutting knife 12 can be lifted by the knife lifting part 221 to carry out edge removal, and finally the cutting knife 12 is lifted to the second position.
  • the cutting knife 12 enters the concave portion 223 of the lifting knife portion, as shown in Figure 12A and Figure 12B, the third surface 2212 of the lifting knife portion is against the first surface 123 of the cutting knife 12 and keeps the cutting knife 12 at the first position. Second position.
  • the staple cartridge assembly 101 continues to slide into the proximal end of the jaw assembly, the third surface 2212 and the first surface 123 of the cutting knife 12 slide relative to each other until the cutting knife 12 is embedded in the recess 223, and finally the staple cartridge assembly is pressed down
  • the third surface 2212 stably keeps the cutting knife 12 at the second position, that is, the cartridge assembly 101 is installed on the cartridge holder 10 .
  • the staple cartridge assembly 101 is installed to a predetermined position, and it is not easy to install and dislocate.
  • the cutting knife 12 is lifted up by the lifting knife portion 221 so that the blade of the cutting knife 12 protrudes from the nail outlet surface 31 of the main body 3 of the staple cartridge, and the completion is completed. Out of the blade.
  • the above two installation methods can avoid the installation position deviation of the staple cartridge assembly 101, thereby avoiding damage to the pusher plate 11 when the jaws are closed, and reducing surgical risks.
  • the knife lifting part 221 is located below the cutting knife 12, and the third surface 2212 acts on the cutting knife 12 from below the cutting knife 12 to make the cutting The blade portion of the knife 12 protrudes from the staple exit surface 31 of the staple cartridge assembly 101 .
  • “Acting on” here includes pushing; the third surface 2212 pushes the cutting knife 12 from below the cutting knife 12, so that the cutting knife 12 moves along a direction perpendicular to the nail-exiting surface 31, so that the edge of the cutting knife 12 protrudes above the The staple exit surface 31 of the staple cartridge assembly 101 .
  • “Acting on” also includes contact; the third surface 2212 contacts the cutting knife 12 from below the cutting knife 12 to keep the edge of the cutting knife 12 protruding from the nail-exiting surface 31 .
  • the staple cartridge assembly 101 is installed on the staple cartridge seat 10 , the pusher plate assembly 1 is at the rear end of the staple cartridge assembly 101 at the starting position, and the cutting knife 12 is lifted by the knife lifting part 221 to come out of the blade. .
  • the tool post head 22 moves forward from the starting position to a certain position in the middle of the staple cartridge body 3 .
  • Pushing nail plate 11 and cutting knife 12 move forward, nail pushing plate 11 pushes the staples out of the anastomotic tissue, and the blade of cutting knife 12 can cut tissue.
  • the tool holder head 22 retreats from a certain position in the middle for a certain distance, so that the tool holder head 22 is separated from the pusher plate assembly 1, because the cutting knife 12 is first
  • the guide piece 112 is limited, and the knife lifting portion 221 is also separated from the cutting knife 12 .
  • the lifting portion 221 below the cutting knife 12 is retracted, the cutting knife 12 moves downward under the elastic force of the elastic body 13, and the blade of the cutting knife 12 is lower than the nail outlet surface 31 of the staple cartridge main body 3 and is in a hidden state.
  • the position of the cutting knife 12 along the length direction X remains unchanged, so as to avoid the problem that the cutting knife 12 may cause the cutting knife 12 to jam when the tool post head 22 retreats together.
  • the fourth surface 2211 of the knife lifting portion 221 first touches the second surface 122 of the cutting knife 12 .
  • the contact surface between the second surface 122 and the fourth surface 2211 becomes smaller and gradually staggers, so that the cutting knife 12 overcomes the elastic force of the elastic body 13 and moves upward along the first guide member 112 .
  • the third surface 2212 of the lifting portion 221 is in contact with the first surface 123 of the cutting knife 12, so that the cutting knife 12 remains lifted, and the third surface 2212 and the cutting knife 12
  • the first surface 123 slides relative to each other until the cutting knife 12 fits into the recess 223 , so that the blade of the cutting knife 12 protrudes from the staple exit surface 31 of the staple cartridge body 3 , so that the cutting knife 12 can cut tissue.
  • the surgical instrument in the present application can complete stapling and cutting at the same time, and the surgical instrument includes but is not limited to a stapler, a suturing device, and a surgical robot, wherein the stapler, the suturing device, and the surgical robot all have end effectors and pushers.
  • a stapler as an example to describe the surgical instrument in detail, the surgical instrument in the present application is not limited to the stapler.

Abstract

一种钉仓组件（101）和外科器械，钉仓组件（101）包括钉仓主体（3）和安装于钉仓主体（3）的推钉板组件（1），推钉板组件（1）包括：推钉板（11），推钉板（11）设置有收刀槽（110），收刀槽（110）设置有第一导向件（112），以及切割刀（12），切割刀（12）至少部分地收容于收刀槽（110），切割刀（12）设置有第二导向件（121），第一导向件（112）和第二导向件（121）中的一个沿垂直于钉仓主体（3）的出钉面（31）的方向延伸，第一导向件（112）和第二导向件（121）相对活动地配接，并能够引导切割刀（12）沿垂直于出钉面（31）的方向运动。

Description

钉仓组件和外科器械
相关申请
本申请要求于2021年9月23日提交至中国专利局、申请号为202111114909.6，申请名称为“钉仓组件和外科器械”，以及于2021年9月23日提交至中国专利局、申请号为202122299036.2，申请名称为“钉仓组件和外科器械”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本申请属于医疗手术器械领域，特别涉及一种钉仓组件和外科器械。
背景技术
外科器械能够同时完成吻合和切割工作，减少手术时间，降低患者出血量，在临床手术中扮演着关键的角色，切割刀是外科器械不可缺少的重要部件。外科器械的前端包括可以替换的钉仓组件，钉仓组件为一次性耗材。
为避免切割刀重复使用而造成磨损、切割效果差，出现了集成有切割刀的钉仓组件。这种钉仓组件，在未安装到外科器械上时，切割刀隐藏在钉仓主体内，避免锋利的刃口伤害使用者，在安装到外科器械上使用时，切割刀的刃口则伸出钉仓主体的表面，即出刃，以能够在手术过程中对组织进行切割。
现有技术的钉仓组件的切割刀可以在外力的作用下沿倾斜的导向槽滑动以在上述的隐藏状态和出刃状态之间切换，倾斜的导向槽导致推钉板的长度较长，影响推钉板的强度并且导致钉仓的长度较长，不利于在有限的空间内进行手术操作。
申请内容
本申请旨在提出一种钉仓组件和外科器械，解决上述现有技术的切割刀的倾斜导向槽影响钉仓组件长度的技术问题。
本申请提供一种钉仓组件，钉仓组件包括：钉仓主体和安装于钉仓主体的推钉板组件，推钉板组件包括：
推钉板，推钉板设置有收刀槽，收刀槽设置有第一导向件，以及切割刀，切割刀至少部分地收容于收刀槽，切割刀设置有第二导向件；第一导向件和第二导向件中的一个沿垂直于钉仓主体的出钉面的方向延伸，第一导向件和第二导向件相对活动地配接，第一导向件和第二导向件能够引导切割刀沿垂直于出钉面的方向运动。
优选地，切割刀包括第一表面，推动第一表面使切割刀在第一导向件和第二导向件的导向作用下，相对于推钉板沿垂直于出钉面的方向向上运动，使切割刀的刃部凸出于出钉面。
优选地，切割刀沿垂直于出钉面的方向向上运动使切割刀的刃部凸出于出钉面后，第一表面被接触以保持切割刀的刃部凸出于出钉面。
优选地，第一表面为与出钉面平行的平面。
优选地，收刀槽设置开口，开口使第一表面从收刀槽中裸露出来从而能够被接触到。
优选地，切割刀包括第二表面，第二表面的至少一部分为相对于出钉面倾斜的平面或相对于出钉面倾斜并向外凸起的弧面，第二表面朝向推钉板的后侧和下侧，推动第二表面使切割刀在第一导向件和第二导向件的导向作用下沿垂直于出钉面的方向向上运动，使切割刀的刃部凸出于出钉面。
优选地，切割刀的第一表面与第二表面连接，第一表面位于第二表面的前侧；第一表面被接触以保持切割刀的刃部凸出于出钉面。
优选地，第一表面为与出钉面平行的平面。
优选地，所述切割刀还包括第二表面，所述第二表面的至少一部分为相对于所述出钉面倾斜的斜面或相对于所述出钉面倾斜并向外凸起的弧面，所述第二表面朝向所述推钉板的后侧和下侧，推动所述第二表面能够使所述切割刀在所述第一导向件和所述第二导向件的导向作用下沿垂直于所述出钉面的方向向上运动，使所述切割刀的刃部凸出于所述出钉面；所述第一表面与所述第二表面连接，所述第一表面位于所述第二表面的前侧。
优选地，收刀槽设置有至少一组第一导向件，一组第一导向件包括两个分别位于收刀槽的相对的侧壁的第一导向件，切割刀设置有至少一组第二导向件，一组第二导向件包括两个分别位于切割刀相背的两侧的第二导向件，一组第一导向件的两个第一导向件一一对应地与一组第二导向件的两个第二导向件配接。
优选地，收刀槽设置有两组第一导向件，两组第一导向件在出钉面的延伸方向上分隔开，切割刀设置有两组第二导向件，两组第二导向件在出钉面的延伸方向上分隔开，两组第一导向件中前方的一组第一导向件与两组第二导向件中前方的一组第二导向件配接，后方的一组第一导向件与后方的一组第二导向件配接。
优选地，推钉板组件还包括弹性体，弹性体的一端安装于推钉板，弹性体的另一端抵接于切割刀，弹性体用于驱动切割刀沿垂直于出钉面的方向向下运动。
优选地，推钉板组件还包括托板，收刀槽包括收容至少一部分弹性体的容纳腔，容纳腔包括开口，托板安装于推钉板以至少部分地封闭开口。
本申请又提供一种外科器械，包括端部执行器和推进器，端部执行器包括钳口组件和上述的钉仓组件，钉仓组件可拆卸地安装于所述钳口组件，
推进器用于驱动推钉板沿着长度方向向前运动，推进器包括向前伸出的抬刀部，抬刀部包括第三表面；
在钉仓组件安装于钳口组件的状态下，抬刀部位于切割刀的下方，第三表面从切割刀的下方作用于切割刀，使切割刀的刃部突出于钉仓组件的出钉面。
优选地，第三表面为与安装于钳口组件的钉仓组件的出钉面平行的平面。
优选地，抬刀部还包括第四表面，第四表面为相对于安装于钳口组件的钉仓组件的出钉面倾斜的平面或相对于出钉面倾斜并向内凹入的弧面，第四表面朝向外科器械的前侧和上侧；
在抬刀部向前运动时，第四表面能够接触并推动切割刀使得其在第四表面上相对滑动，进而使得切割刀沿垂直于出钉面的方向向上运动。
优选地，第三表面和第四表面连接，第四表面位于第三表面的前侧。
优选地，推进器设置有臂部，臂部和抬刀部间隔开，在臂部和抬刀部之间形成能够收容切割刀的凹部。
优选地，臂部的前端设置有引导面，在切割刀收容于凹部的状态下，引导面向前突出于切割刀的尖端，引导面朝向凹部，引导面是斜面或弧面。
优选地，臂部设置有凹槽，凹槽朝向凹部，在切割刀收容于凹部时，切割刀的上边缘嵌入凹槽。
优选地，第三表面从切割刀的下方推动切割刀，使得切割刀沿垂直于出钉面的方向运动，以使切割刀的刃部突出于钉仓组件的出钉面；或者第三表面从切割刀的下方接触切割刀，以保持切割刀的刃部凸出于出钉面。
通过采用上述技术方案，切割刀在第一导向件和第二导向件的引导下垂直方向出刃，出刃过程中切割刀的运动不利用钉仓内部的长度方向的空间，使得钉仓组件在保持相同的吻合行程的情况较短，便于实施手术。
附图说明
图1示出了根据本申请的实施方式的吻合器的结构示意图；
图2示出了根据本申请的实施方式的吻合器的钳口组件的结构示意图；
图3示出了根据本申请的实施方式的吻合器的推钉板组件的结构示意图；
图4示出了根据本申请的实施方式的吻合器的推钉板组件的另一角度的结构示意图；
图5示出了根据本申请的实施方式的吻合器的推钉板组件的剖视图；
图6示出了根据本申请的实施方式的吻合器的推钉板组件的爆炸图；
图7示出了根据本申请的实施方式的吻合器的推进器的结构示意图；
图8A示出了根据本申请的实施方式的吻合器的推进器在起始位置时的局部放大剖视图；
图8B示出了图8A的局部放大图；
图9A示出了根据本申请的实施方式的吻合器的推进器在中间某个位置时的局部放大剖视图；
图9B示出了图9A的局部放大图；
图10A示出了根据本申请的实施方式的吻合器的推进器在回退时的局部放大剖视图；
图10B示出了图10A的局部放大图；
图11A示出了根据本申请的实施方式的吻合器的推进器在回退后重新击发时的局部放大剖视图；
图11B示出了图11A的局部放大图；
图12A示出了钉仓组件安装于钉仓座的一种情况的局部放大剖视图；
图12B示出了图12A的局部放大图；
图13A示出了钉仓组件安装于钉仓座的另一种情况的局部放大剖视图；
图13B示出了图13A的局部放大图；
图14示出了一种可能存在钉仓组件安装于吻合器的局部放大图。
附图标记说明
100、端部执行器；101、钉仓组件；200、套管组件；300、手柄组件；10、钉仓座；20、抵钉座；1、推钉板组件；11、推钉板；110、收刀槽；111、狭槽；112、第一导向件；113、容纳腔；114、受力部；12、切割刀；121、第二导向件；122、第二表面；123、第一表面；1201、刀体；1202、保持结构；13、弹性体；14、托板；2、推进器；21、刀杆；22、刀架头；221、抬刀部；2211、第四表面；2212、第三表面；222、臂部；2221、 引导面；2222、凹槽；223、凹部；224、推抵部；3、钉仓主体；31、出钉面；A、导向槽；B、滑块；X、长度方向；Y、宽度方向；Z、高度方向。
具体实施方式
为了更加清楚地阐述本申请的上述目的、特征和优点，在该部分结合附图详细说明本申请的具体实施方式。除了在本部分描述的各个实施方式以外，本申请还能够通过其他不同的方式来实施，在不违背本申请精神的情况下，本领域技术人员可以做相应的改进、变形和替换，因此本申请不受该部分公开的具体实施例的限制。本申请的保护范围应以权利要求为准。
吻合器的用户可以为临床医生，医生在手术中操作吻合器来进行手术。本文所用术语“近”、“后”和“远”、“前”是相对于操纵吻合器的临床医生而言的。术语“近”、“后”是指相对靠近临床医生的部分，术语“远”、“前”则是指相对远离临床医生的部分。“左”、“右”以图1所示的吻合器的位置为参考，例如，端部执行器100在“左”，手柄组件300和轴组件在“右”。术语“上”、“下”以端部执行器100的抵钉座20和钉仓座10的相对位置为参考，具体的，抵钉座20在“上”，钉仓座10在“下”。在钉仓组件101中，出钉面31为“上”，与出钉面31相反的一侧为“下”。钉仓组件101安装在钉仓座10时，钉仓组件101的出钉面31朝向抵钉座20，即钉仓组件101的出钉面31朝“上”。
如果没有单独说明，长度方向X表示钉仓组件101的长度方向，钉仓组件101的长度方向与吻合器的前后方向一致，宽度方向Y表示钉仓组件101的宽度方向，宽度方向Y与长度方向垂直，高度方向Z表示钉仓组件101的高度方向，钉仓组件101的高度方向与吻合器的上下方向一致，高度方向Z与长度方向X和宽度方向Y二者均垂直，具体的，如图2中所示。高度方向Z与垂直于出钉面31的方向一致。
需要理解的是，“远”“近”“前”“后”“左”“右”“上”“下”这些方位是为了方便描述而进行的定义。然而，吻合器可以在许多方向和位置使用。因此，这些表达相对位置关系的术语并不是限制性和绝对的。
在本申请中，除非另有明确的规定和限定，“连接”、“相连”、“设置”等术语应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，还可以是可运动连接，或成一体；可以是直接连接，也可以通过中间媒介间接连接，可以是两个元件内部的连通或两个元件的相互作用关系。对于本领域的普通技术人员而言，可以根据具体情况理 解上述术语在本申请中的具体含义。
也就是说，本说明书中的对各方向定义，只是为了说明本申请技术方案的方便，并不限定本申请实施例的电动吻合器在包括但不限定于制造、测试、运输、使用等其他可能导致电动吻合器方位发生颠倒或者位置发生变换的场景中的方向。
下面参考附图描述的实施例是示例性的，旨在用于解释本申请，而不能理解为对本申请的限制。
如图1所示，本申请提出一种外科器械，优选为吻合器，该吻合器包括端部执行器100、套管组件200和手柄组件300，手柄组件300通过套管组件200连接端部执行器100。
手柄组件300包括壳体和动力源模块。在一个实施方式中，动力源模块为用户手动操作的手柄，连接到下述传动装置。在另一个实施方式中，动力源模块包括设置在壳体内的电机和电源模块，电源模块由多个电连接的电池组成，用于为电机提供旋转所需电能，电机连接到下述传动装置。动力源模块的类型不限制本申请的保护范围。下面，以动力源模块包括电机和电源模块为例描述吻合器的整体功能。
套管组件200设置在壳体上，套管组件200包括推进器2(参照例如图7至图9B)及套设于部分推进器2的套管。吻合器还包括与电机的输出轴连接的传动装置，传动装置包括第一传动机构和第二传动机构。套管和推进器2分别通过第一传动机构和第二传动机构与电机传动连接，以被驱动沿长度方向X移动，包括沿长度方向X的向前或向后移动。
参照图1和图2，端部执行器100包括钳口组件和钉仓组件101。钉仓组件101可拆卸地安装于钳口组件。钳口组件包括钉仓座10和可枢转地相连于钉仓座10的抵钉座20，钉仓座10用于可操作地支撑位于其中的钉仓组件101。抵钉座20可在打开位置和闭合位置之间选择性地运动，实现在打开状态和闭合状态之间的切换，从而与钉仓座10和钉仓组件101配合而夹紧或松开组织。套管的一端(前端)连接于抵钉座20，另一端(后端)连接于第一传动机构，第一传动机构可驱动套管向后或向前移动。套管的向后移动可使得抵钉座20向上枢转以打开钳口组件，套管的向前移动可使得抵钉座20向下枢转以闭合钳口组件。
钉仓组件101包括钉仓主体3和推钉板组件1，推钉板组件1与推进器2可分离地连接以被推进器2驱动执行击发动作或退刀动作。参照图3至图7，具体的，推钉板组件1包括推钉板11和活动地安装于推钉板11的切割刀12。推进器2的一端(后端)连接于第二传动机构，另一端(前端)与推钉板11和切割刀可分离地连接，推进器2除了 另一端以外的部分位于套管内。在切割和吻合的过程中，切割刀12位于钳口组件的钉仓座10和抵钉座20之间形成的空间内。第二传动机构可驱动推进器2向前和向后运动。当安装了钉仓组件101时，推进器2的向前移动使得推钉板组件1向前移动，推钉板11推动钉仓组件101的吻合钉出钉来吻合组织，切割刀12向前移动来切割组织。
电机通过第一传动机构驱动钳口组件闭合而夹紧组织，然后电机通过第二传动机构驱动推钉板组件1前进而切割和吻合组织，最后电机通过第一传动机构驱动钳口组件打开而松开组织，从而实现吻合器切割及吻合的功能。
手柄组件300的壳体包括相连的手柄壳体和头部壳体，头部壳体可以收容传动装置，手柄壳体可供用户握持。当然，在一些实施例中，手柄壳体亦可同时收容部分传动装置。在一些实施例中，手柄壳体可以容纳电机，头部壳体可以容纳上述电源模块。
具体的，如图2所示，钉仓组件101包括钉仓主体3和推钉板组件1，钉仓组件101作为消耗品可以被替换地安装于钉仓座10。
钉仓主体3的内部沿着其长度方向X布置有多个钛钉，且内部设置有在长度方向X延伸的滑动槽，推钉板组件1可以在滑动槽内运动，推钉板组件1从钉仓主体3的尾部插入钉仓主体3中，在组装新的钉仓组件101时，将推钉板组件1从钉仓主体3的尾部插入钉仓主体3中且推钉板组件1的一部分置于滑动槽中。也即，未被使用的新的钉仓组件101，其推钉板组件1位于钉仓组件101的尾部。在将钉仓组件101安装于钉仓座10后，通过套管组件200的推进器2推动推钉板组件1，推钉板组件1可以沿钉仓主体3的长度方向X朝钉仓主体3的远端滑动，从而接触并推出钉仓主体3中的钛钉。钛钉被推出，即吻合器执行吻合动作。具体的，吻合动作为推钉板11的前端接触钛钉并推出钛钉。
钉仓组件101还包括切割刀12，具体地，推钉板组件1包括活动地安装于推钉板11的切割刀12，切割刀12可选择地在第一位置和第二位置之间活动，以使得切割刀12在隐藏状态和出刃状态之间切换。隐藏状态，即切割刀12隐藏在钉仓主体3的出钉面31之下，能避免用户被刃部误伤，钉仓组件101未被安装到钉仓座10时切割刀12处于隐藏状态；出刃状态，即切割刀12的刃部伸出于钉仓主体3的出钉面31，使得刃部能对钳口组件所夹持的组织进行切割，在钉仓组件101安装于钉仓座10且执行切割时，切割刀12处于出刃状态。对钳口组件夹持的组织进行切割时，出钉面31接触被夹持的组织。
吻合器在执行吻合动作时，切割刀12处于出刃状态，随着推钉板11的向前运动， 切割刀12同样沿钉仓主体3的长度方向X朝钉仓主体3的远端滑动，从而切割组织，即吻合器执行切割动作。
图3和图10B示出了切割刀12位于第一位置的状态，即隐藏状态，图8A、图8B、图9A和图9B示出了切割刀12位于第二位置的状态，即出刃状态。
如图3至图6所示，推钉板组件1包括推钉板11、切割刀12、弹性体13和托板14。本申请中的推钉板组件1实现切割刀12的隐藏和出刃。
推钉板11设置有能够收容至少部分的切割刀12的收刀槽110，收刀槽110设置有第一导向件112，切割刀12设置有第二导向件121。第一导向件112和第二导向件121中的一个沿垂直于钉仓主体3的出钉面31的方向延伸，第一导向件112和第二导向件121能够相对活动地配接，第一导向件112和第二导向件121能够引导切割刀12沿垂直于出钉面31的方向运动。
在一种具体的实施方式中，如图3至图6所示，第一导向件112可以是沿钉仓组件101的高度方向Z延伸的导向槽。收刀槽110包括狭槽111和下述容纳腔，推钉板11上设置有两个相对的侧壁，这两个相对的侧壁以及两个相对的侧壁之间的空间形成狭槽111，狭槽111包括上述两个相对的侧壁和两个侧壁之间的空间。第一导向件112设置于收刀槽110的狭槽111。具体地，第一导向件112设置于狭槽111的侧壁。第二导向件121可以为突出于切割刀12的侧面的凸块，通过凸块嵌入导向槽使切割刀12可以至少部分地收容于收刀槽110，通过导向槽的引导，切割刀12可以沿钉仓组件101的高度方向Z(垂直于出钉面31的方向)在第一位置和第二位置之间活动。在凸块位于导向槽的最下端时，切割刀12位于第一位置，在凸块位于导向槽的最上端时，切割刀12位于第二位置。
狭槽111的三侧开口，开口位于推钉板11的上侧面、下侧面和后侧面，位于上侧面的开口是朝上的开口，位于下侧面的开口是朝下的开口，切割刀12可以通过推钉板11的下侧面和后侧面装入收刀槽110，切割刀12的下述第一表面123从狭槽111的朝下的开口裸露出来，使推进器2可以从狭槽111的下侧的开口接触切割刀12并向上推动切割刀12，切割刀12向上运动时通过狭槽111的上侧面的开口出刃，并且，狭槽111的后侧面的开口不会阻碍切割刀12的向上运动。狭槽111的侧壁厚度较薄且具有弹性，在安装切割刀12时，狭槽111的侧壁可以弹性地张开使后述的切割刀12的第二导向件121和第一导向件112配合。切割刀12包括刀体1201和保持结构1202，刀体包括刃部，如图5所示，刀体部分地收容于狭槽111内，部分的保持结构收容于狭槽111内，其余的 保持结构伸入容纳腔113而收容于容纳腔113。在另外的实施例中，在图5所示内容的基础上，刀体的后端露在狭槽111的外部。
在其他实施例中，在隐藏状态下，切割刀12的刀体1201全部收容于狭槽111，不影响本申请的实施。
在其他可能的实施方式中，第一导向件112可以是凸块，第二导向件121可以是导向槽。或者第一导向件112可以是滑块或滑轨，第二导向件121可以是滑轨或滑块。本领域技术人员可以理解的是，能够实现导向功能的实施方式，都落在本申请的保护范围内。
图14示出了一种可能存在的倾斜出刃的钉仓组件101，其中切割刀12可以相对于推钉板11滑动地安装于推钉板11，推钉板11设置有导向槽A，导向槽A向前倾斜延伸。切割刀12设置有滑块B，滑块B可以沿导向槽A滑动，在推进器2向前(图中左侧)移动时，推进器2从切割刀12的后端抵接并推动切割刀12，切割刀12可以在导向槽A的引导作用下相对于推钉板11斜向上运动，使切割刀12出刃，当完成出刃时，切割刀12相对于推钉板11必然向前运动了固定距离C，固定距离C等于导向槽A沿前后方向的长度。
在一种可能的情况下，切割刀12的出刃过程中，推钉板11可以保持不动，完成出刃时，切割刀12相对于钉仓座10向前的位移量E等于切割刀相对于推钉板11向前运动的距离，也即导向槽A沿前后方向的长度C；在另一种可能的情况下，切割刀12的出刃过程中，推钉板11可能也被推着向前移动一段距离D，完成出刃时，切割刀12相对于钉仓座10向前的位移量E为导向槽A沿前后方向的长度C加上推钉板11向前移动的距离D。
总之，如图14的倾斜出刃的钉仓组件101，切割刀12在完成出刃时，切割刀12都会相对于推钉板11向前移动导向槽A沿前后方向的长度C，推钉板11的长度的设计要考虑这段长度C，钉仓组件101的长度考虑推钉板11，吻合器的钳口组件的长度要考虑钉仓组件101，从而钉仓组件101和吻合器的钳口组件均会设计得比较长。另外，正常情况下，推钉板11向前移动即，吻合钉被推出而开始出钉和切割刀被推钉板11带动下开始切割组织，而上述出刃过程，则不期望发生出钉和切割，如发生，则将不完整地切割组织。因此，为避免上述推钉板11前移距离D的过程发生不完整地切割组织，钉仓组件的长度设计要还要考虑这段距离D，造成钉仓组件和吻合器的钳口组件设计的更长。
图14的钉仓组件的导向槽A和滑块B，相当于本申请的第一导向件112和第二导向 件121的功能，差别在于，导向槽A和滑块B引导切割刀倾斜运动，本申请的第一导向件112和第二导向件121引导切割刀上下运动。本申请相比于图14所示的钉仓组件101，在切割刀12由隐藏状态切换到出刃状态的过程中，由于本申请的第一导向件112和第二导向件121沿垂直于出钉面的方向(高度方向Z)延伸，切割刀12相对于钉仓座10没有沿前后方向的移动，省略掉这段沿前后方向的位移，使得推钉板11的长度可以设计的更短，使得钉仓组件在保持相同的吻合行程的情况下，可以具有更短的长度，钳口组件具有更短的长度，从而在手术中用户可以使得钳口组件到达狭窄的区域，便于操作吻合器。本申请的仅沿高度方向延伸的导向组件(第一导向件112和第二导向件121)是最佳的方式。
沿高度方向Z的导向槽相比倾斜设置的导向槽可以使切割刀12沿高度方向Z移动相同距离的情况下导向槽更短，推钉板11有更少的镂空部分使推钉板11的结构强度可以较高。
如图4和图5所示，切割刀12设置有第一表面123，在钉仓组件101安装于吻合器的钉仓座10时，推进器2可以接触到第一表面123，使切割刀12在第一导向件112和第二导向件121的导向作用下，相对于推钉板11沿垂直于出钉面31的方向(高度方向Z)向上运动，使切割刀12的刃部能够凸出于出钉面31。
优选地，第一表面123为与出钉面31平行的平面，并且第一表面123与推钉板11的运动方向平行。从而使切割刀12在被推进器2抬起的状态下容易被推进器2保持稳定，不易使切割刀12滑落到刀刃隐藏的状态，无需单独设置阻止切割刀12滑落的锁定结构，使钉仓组件101的结构简单。可以理解，由于第一表面123与出钉面31平行，在推进器2抵接第一表面123时，不会导致推钉板11受到推动而向前运动。也就是说，在将钉仓组件101安装于钉仓座10的过程中，推钉板11不会运动。
切割刀12的后端(靠近套管组件200的那端)设置有第二表面122，第二表面122的至少一部分为相对于出钉面31倾斜的平面或相对于出钉面31倾斜并向外凸起的弧面，第二表面122朝向推钉板11的后侧和下侧，第二表面122越靠后就越向上延伸。第二表面122可以使推进器2的抬刀部221容易插入到切割刀12的下方，并且通过第二表面122的引导可以将推进器2沿前后方向的运动转化为切割刀12沿上下方向的运动。
如图10A、图10B、图11A和图11B所示，吻合器在击发过程中停止击发并且退刀，则推进器2将停止前进并后退而与切割刀12脱离，从而切割刀12从出刃状态切换到隐藏状态。当吻合器再次击发时，推进器2重新向前运动至推动切割刀12并使切割刀12 从隐藏状态切换到出刃状态，过程如下：推进器2首先推抵第二表面122，使切割刀12克服弹性体13的弹力沿第一导向件112向上运动，使切割刀12的刃部突出于钉仓主体3的出钉面31(上表面)，从而使刃部能够切割组织。
如图13A和图13B所示，在钉仓组件101安装于钉仓座10的过程中，可以将第二表面122与后述抬刀部221的第四表面2211接触，向近端滑动钉仓组件101，第二表面122和第四表面2211可以引导切割刀12沿导向槽向上运动到抬刀部221的上方。
第二表面122和第一表面123连接，第一表面123位于第二表面122的前侧，第二表面122和第一表面123构成了切割刀12的底面的至少一部分。第二表面122和第一表面123连接可以使二者相互协同作用，在上述吻合器退刀后再次击发时，第二表面122使切割刀12抬刀而出刃，第一表面123使切割刀12稳定保持出刃状态，两者配合使切割刀12出刃和保持出刃的状态连续。
对照图3和图6，收刀槽110设置有两组第一导向件112，这里，可以将分别位于狭槽111的两个侧壁中的在宽度方向Y上彼此相对的两个第一导向件112称为一组第一导向件112。两组第一导向件112可以在长度方向X上间隔开，这样可以可靠地引导切割刀12的运动，两组第一导向件112可以避免切割刀12在收刀槽110内翻转。
每组第一导向件112具有两个第一导向件112，这两个第一导向件112分别位于狭槽111的两个相对的侧壁，即，一个第一导向件112位于狭槽111的一个侧壁，另一个第一导向件112位于与前述一个侧壁相对的另一个侧壁。
对应的两组第一导向件112，切割刀12设置有两组第二导向件121，两组第二导向件在出钉面31的延伸方向上分隔开，两组第一导向件112中前方的一组第一导向件112与两组第二导向件121中前方的一组第二导向件121配接，后方的一组第一导向件112与后方的一组第二导向件121配接。每组第二导向件121具有两个第二导向件121，这两个第二导向件121分别位于切割刀12的两个相背的侧面，即，一个第二导向件121位于切割刀12的一个侧壁，另一个第二导向件121位于与切割刀12的一个侧壁相反的另一个侧壁。每个第一导向件112分别与一个第二导向件121配接。即，一组第一导向件的两个第一导向件112一一对应地与一组第二导向件121的两个第二导向件121相对活动地配接。从两侧对切割刀12进行导向可以防止切割刀12在收刀槽110内左右倾斜，使切割刀12沿高度方向Z运动的过程中保持稳定。
进一步地，第二导向件121可以是横截面为方形的凸块，这样的凸块难以在导向槽内转动，可以防止切割刀12在收刀槽110内翻转。其中方形包括正方形、圆角的正方形、 长方形和圆角的长方形等。
在其他实施方式中，可以仅设置一组第一导向件112，通过第一导向件112和/或第二导向件121的形状构造来避免切割刀12在收刀槽110内翻转，例如，上述作为第二导向件121的凸块的形状为方形，或者第二导向件121包括锁定结构，用于锁定第一导向件112和第二导向件121之间的位置关系。
参照图5，收刀槽110包括容纳腔113，容纳腔113收容至少部分弹性体13。弹性体13使切割刀12可以沿垂直于出钉面31的方向向下运动。容纳腔113包括开口，例如该开口朝向下侧，托板14安装于推钉板11以至少部分地封闭该开口，避免被切碎的人体组织从容纳腔113的底部进入，使弹性体13的运动不被阻碍。托板14可以通过塑料热熔的方式与推钉板11连接牢固，托板14位于弹性体13的下方，托板14可以、但不必须承托弹性体13。
容纳腔113的宽度和弹性体13的宽度一致，使容纳腔113可以限制弹性体13沿宽度方向Y的活动范围。容纳腔113和狭槽111连通，切割刀12的保持机构的其余部分可伸入容纳腔113，弹性体13的活动端可伸入狭槽111。弹性体13的一端安装于推钉板11，弹性体13的另一端(活动端)压抵于切割刀12的保持机构，使切割刀12具有收纳于收刀槽110中的趋势，即切割刀12位于第一位置。弹性体13可以为异形弹簧。如图5所示，弹性体13的活动端伸入狭槽111并压抵切割刀12的保持机构。需要说明的是，弹性体13的活动端和切割刀12的保持机构在收刀槽110内的位置，不限制本申请的范围，只要实现两者均位于收刀槽110内且弹性体13的活动端压抵切割刀12的保持机构即可，例如，弹性体13的活动端和切割刀12的保持机构均在容纳腔113内。
弹性体13可以先从容纳腔113的底部开口装入容纳腔113，然后将切割刀12装入狭槽111，最后托板14在安装完切割刀12和弹性体13之后安装，将托板14安装于推钉板11。
如图3和图6所示，推钉板11设置有用于被推进器2推抵的受力部114，推进器2可以通过推抵受力部114来驱动推钉板11向前运动。
如图7所示，套管组件200包括推进器2，推进器2包括刀杆21和刀架头22，刀架头22连接于刀杆21的前端，刀杆21的后端连接第二传动机构，在钉仓组件101安装于钉仓座10以及推进器2沿长度方向X向前运动时，刀架头22可以推动推钉板11向前运动，并且由刀架头22与切割刀12接触配合，使切割刀12被顶起，切割刀12的刃部突出于钉仓主体3的出钉面31。
刀架头22设置有推抵部224，在推进器2向前运动时，由推抵部224接触并推抵受力部114，从而驱动推钉板11向前运动。
刀架头22还设置有抬刀部221和臂部222，抬刀部221和臂部222向前侧延伸突出。抬刀部221和臂部222间隔开，抬刀部221和臂部222之间形成能够收容切割刀12的凹部223，切割刀12可以夹在抬刀部221和臂部222之间。在切割刀12收容于凹部223的状态下，抬刀部221位于切割刀12的下方，臂部222位于切割刀12的上方，切割刀12可以不接触凹部223的底面。
抬刀部221设置有第三表面2212，第三表面2212与切割刀12的第一表面123(底面)接触，使切割刀12保持在被抬起的状态。优选的一种方式，在钉仓组件101安装于钉仓座10的状态下，第三表面2212与出钉面31平行，第三表面2212与切割刀12的第一表面123平行，并且第三表面2212与推钉板11的运动方向(前后方向)平行。在切割刀12保持出刃状态并且推进器2静止不动时，抬刀部221与切割刀12接触，抬刀部221不会对切割刀12施加沿长度方向X的外力，从而使切割刀12可以保持静止不动。从而使切割刀12在被推进器2抬起的状态下容易保持稳定，不易使切割刀12滑落到刀刃隐藏的状态，无需单独设置阻止切割刀12滑落的锁定结构，使钉仓组件101的结构简单。
抬刀部221的前端设置有第四表面2211，第四表面2211为相对于安装于钳口组件的钉仓组件101的出钉面31倾斜的平面或相对于出钉面31倾斜并向内凹入的弧面，第四表面2211朝向吻合器的前侧和上侧，第四表面2211越靠后就越向上延伸。在钉仓组件101安装于钉仓座10的状态下，第四表面2211和第二表面122可以平行，从而在第二表面122和第四表面2211配合时能够使接触面积较大，减小磨损。
如图10A至图11B所示，在推进器2向前推动切割刀12使切割刀12出刃时，第四表面2211和第二表面122接触。随着抬刀部221向前运动，第二表面122和第四表面2211逐渐错开，使切割刀12克服弹性体13的弹力沿第一导向件112向上运动，切割刀12收容于凹部223，使切割刀12的刃部突出于钉仓主体3的出钉面31。
在其他可能的实施方式中，可以仅切割刀12设置有倾斜的第二表面122或者仅抬刀部221的前端设置有倾斜的第四表面2211，在抬刀部221向前运动时，第二表面122或第四表面2211可以使抬刀部221推动切割刀12向上运动。优选的，抬刀部221的前端或切割刀12中的另一个设置有与倾斜的表面相配合的圆角。
如图8B和图9B所示，在切割刀12收容于凹部223的状态下，臂部222的前端向 前突出于切割刀12的尖端。在臂部222的前端形成引导面2221，引导面2221朝向凹部223，引导面2221可以是斜面或弧面。在刀架头22推动切割刀12向前运动时，引导面2221比切割刀12先接触到组织，从而可以引导组织朝向切割刀12的刃口运动，使组织容易被切割刀12切割。切割刀12的尖端可以是切割刀12的刀刃的尖端，或者切割刀12的尖端是切割刀12的露出部分的前端，在一些可能的实施方式中，切割刀12的尖端既可以是刀刃的尖端也可以不是刀刃的尖端。
参照图7至图9B，臂部222设置有凹槽2222，凹槽2222朝向凹部223，凹槽2222大致沿长度方向X延伸，凹槽2222可以开设于臂部222的中间位置，限定凹槽2222的侧壁的朝向凹部223的表面为引导面2221。在切割刀12容纳于凹部223时，切割刀12的上边缘能够嵌入凹槽2222，这样，切割刀12和臂部222之间整体的在高度方向上不会形成缝隙，防止组织进入切割刀12和臂部222之间的该缝隙而不能被切割到，保证了所有组织能够被切割刀12切割，切割效果较好。
吻合器在首次切割和切割到组织前需要切割刀12从隐藏状态切换到出刃状态，在本申请中，通过上述抬刀部221的结构，医生仅仅通过安装动作即实现切割刀12的完全出刃，无须医生启动吻合器开始击发。具体的，本申请的钉仓组件101倾斜安装到钳口组件时，会发生如下两种情形一：
情形一：如图12A和图12B所示，在安装钉仓组件101时，钉仓组件101远端向上翘起，形成倾斜的角度，近端首先伸入钳口组件的近端，并且近端的切割刀12部分地收容于推进器2的凹部223，此时切割刀12的第一表面123抵触到抬刀部221的第三表面2212上，安装动作使得切割刀12的第一表面123受到了向上抬起的力，从而使切割刀12被抬刀部221顶起而进行出刃，最终切割刀12被抬高到第二位置。然后，随钉仓组件101继续向钳口组件的近端的滑动伸入，第三表面2212和切割刀12的第一表面123相对滑动，直到切割刀12嵌入凹部223。最后向下按压钉仓组件101的远端，按压到底时，第三表面2212稳定地保持切割刀12在第二位置上，即钉仓组件101安装于钉仓座10。
情形二：如图13A和图13B所述，在安装钉仓组件101时，钉仓组件101的远端向上翘起，形成倾斜的角度，近端首先伸入钳口组件的近端，但是切割刀12未直接嵌入推进器2的凹部223，而是位于抬刀部221的前侧或与抬刀部221的第四表面2211相抵。医生操作钉仓组件101继续向钳口组件的近端滑动，此时钉仓组件101近端的切割刀12的第二表面122和抬刀部221的第四表面2211相抵，然后接触面变小而逐渐错开，最终 脱离，这个过程中在这两个面的引导作用下切割刀12可以被抬刀部221顶起而进行出刃，最终切割刀12被抬高到第二位置。当上述脱离时，切割刀12进入抬刀部的凹部223，如图12A和图12B所示，抬刀部的第三表面2212抵住切割刀12的第一表面123而保持切割刀12在第二位置。随着钉仓组件101继续向钳口组件的近端的滑动伸入，第三表面2212和切割刀12的第一表面123相对滑动，直到切割刀12嵌入凹部223，最后向下按压钉仓组件101的远端，按压到底时，第三表面2212稳定地保持切割刀12在第二位置上，即钉仓组件101安装于钉仓座10。通过第二表面122和第四表面2211的引导，使钉仓组件101被安装到预定位置，不易安装错位。
上述两种安装方式，均在刀架头22位于起始位置的状态下，切割刀12被抬刀部221顶起使切割刀12的刃部突出于钉仓主体3的出钉面31，完成出刃。上述两种安装方式均可以避免出现钉仓组件101安装位置偏移，从而避免在钳口闭合时损坏推钉板11，降低手术风险。
上述安装方式中，可知，在钉仓组件101安装于钳口组件的状态下，抬刀部221位于切割刀12的下方，第三表面2212从切割刀12的下方作用于切割刀12，使切割刀12的刃部突出于钉仓组件101的出钉面31。此处的“作用于”包括推动；第三表面2212从切割刀12的下方推动切割刀12，使得切割刀12沿垂直于出钉面31的方向运动，以使切割刀12的刃部突出于钉仓组件101的出钉面31。“作用于”还包括接触；第三表面2212从切割刀12的下方接触切割刀12，以保持切割刀12的刃部凸出于出钉面31。
参考图8A至图11B来说明在钉仓组件101安装于钉仓座10的状态下，推进器2推动推钉板组件1的工作过程。
如图8A和图8B所示，钉仓组件101安装于钉仓座10，推钉板组件1在起始位置处于钉仓组件101的后端，切割刀12被抬刀部221抬起而出刃。
如图9A和图9B所示，刀架头22从起始位置向前运动到钉仓主体3的中间某个位置，这个过程中抬刀部221保持切割刀12抬起，刀架头22推动着推钉板11和切割刀12向前运动，推钉板11推动吻合钉出钉吻合组织，切割刀12的刃部可以切割组织。
如图10A和图10B所示，当停止击发并退刀时，刀架头22从中间某个位置后退一段距离，使刀架头22与推钉板组件1分离，由于切割刀12被第一导向件112限位，抬刀部221也与切割刀12分离。由于切割刀12下方的抬刀部221退回，切割刀12在弹性体13的弹力作用下向下运动，切割刀12的刃部低于钉仓主体3的出钉面31而处于隐藏状态。刀架头22回退过程中，切割刀12沿长度方向X的位置不变，避免切割刀12随刀 架头22一起回退可能导致的切割刀12卡阻的问题。
如图11A和图11B所示，当退刀后再次使刀架头22向前运动时，抬刀部221的第四表面2211首先接触到切割刀12的第二表面122。随着抬刀部221向前运动，第二表面122和第四表面2211的接触面变小而逐渐错开，使切割刀12克服弹性体13的弹力沿第一导向件112向上运动。当第二表面122和第四表面2211完全错开时，抬刀部221的第三表面2212抵触切割刀12的第一表面123，使切割刀12保持抬起，第三表面2212和切割刀12的第一表面123相对滑动，直到切割刀12嵌入凹部223，使切割刀12的刃部突出于钉仓主体3的出钉面31，使切割刀12可以切割组织。
本申请中的外科器械能够同时完成吻合和切割，外科器械包括但不限于吻合器、缝合设备、手术机器人，其中吻合器、缝合设备和手术机器人均具有端部执行器和推进器。虽然本申请以吻合器为例对外科器械进行具体说明，但本申请中的外科器械不限于吻合器。
虽然使用上述实施方式对本申请进行了详细说明，但对于本领域技术人员来说，本申请显然并不限定于在本说明书中说明的实施方式。本申请能够在不脱离由权利要求书所确定的本申请的主旨以及范围的前提下加以修改并作为变更实施方式加以实施。因此，本说明书中的记载以示例说明为目的，对于本申请并不具有任何限制性的含义。

Claims (21)

  1. 一种钉仓组件，其特征在于，所述钉仓组件(101)包括钉仓主体(3)和安装于所述钉仓主体(3)的推钉板组件(1)，所述推钉板组件(1)包括：
    推钉板(11)，所述推钉板(11)设置有收刀槽(110)，所述收刀槽(110)设置有第一导向件(112)，以及
    切割刀(12)，所述切割刀(12)至少部分地收容于所述收刀槽(110)，所述切割刀(12)设置有第二导向件(121)；
    所述第一导向件(112)和所述第二导向件(121)中的一个沿垂直于所述钉仓主体(3)的出钉面(31)的方向延伸，所述第一导向件(112)和所述第二导向件(121)相对活动地配接，所述第一导向件(112)和所述第二导向件(121)能够引导所述切割刀(12)沿垂直于所述出钉面(31)的方向运动。
  2. 根据权利要求1所述的钉仓组件，其特征在于，所述切割刀(12)包括第一表面(123)，推动所述第一表面(123)使所述切割刀(12)在所述第一导向件(112)和所述第二导向件(121)的导向作用下，相对于所述推钉板(11)沿垂直于所述出钉面(31)的方向向上运动，使所述切割刀(12)的刃部凸出于所述出钉面(31)。
  3. 根据权利要求2所述的钉仓组件，其特征在于，所述切割刀(12)沿垂直于所述出钉面(31)的方向向上运动使所述切割刀(12)的刃部凸出于所述出钉面(31)后，所述第一表面(123)被接触以保持所述切割刀(12)的刃部凸出于所述出钉面(31)。
  4. 根据权利要求2至3中任一项所述的钉仓组件，其特征在于，所述第一表面(123)为与所述出钉面(31)平行的平面。
  5. 根据权利要求2所述的钉仓组件，其特征在于，所述收刀槽(110)设置开口，所述开口使所述第一表面(123)从所述收刀槽(110)中裸露出来从而能够被接触到。
  6. 根据权利要求1所述的钉仓组件，其特征在于，所述切割刀(12)包括第二表面(122)，所述第二表面(122)的至少一部分为相对于所述出钉面(31)倾斜的平面或相对于所述出钉面(31)倾斜并向外凸起的弧面，所述第二表面(122)朝向所述推钉板(11)的后侧和下侧，推动所述第二表面(122)使所述切割刀(12)在所述第一导向件(112)和所述第二导向件(121)的导向作用下沿垂直于所述出钉面(31)的方向向上运动，使所述切割刀(12)的刃部凸出于所述出钉面(31)。
  7. 根据权利要求6所述的钉仓组件，其特征在于，所述切割刀(12)的第一表面(123) 与所述第二表面(122)连接，所述第一表面(123)位于所述第二表面(122)的前侧；所述第一表面(123)被接触以保持所述切割刀(12)的刃部凸出于所述出钉面(31)。
  8. 根据权利要求7所述的钉仓组件，其特征在于，所述第一表面(123)为与所述出钉面(31)平行的平面。
  9. 根据权利要求2所述的钉仓组件，其特征在于，所述切割刀(12)还包括第二表面(122)，所述第二表面(122)的至少一部分为相对于所述出钉面(31)倾斜的斜面或相对于所述出钉面(31)倾斜并向外凸起的弧面，所述第二表面(122)朝向所述推钉板(11)的后侧和下侧，推动所述第二表面(122)能够使所述切割刀(12)在所述第一导向件(112)和所述第二导向件(121)的导向作用下沿垂直于所述出钉面(31)的方向向上运动，使所述切割刀(12)的刃部凸出于所述出钉面(31)；
    所述第一表面(123)与所述第二表面(122)连接，所述第一表面(123)位于所述第二表面(122)的前侧。
  10. 根据权利要求1所述的钉仓组件，其特征在于，所述收刀槽(110)设置有至少一组第一导向件(112)，一组所述第一导向件(112)包括两个分别位于所述收刀槽(110)的相对的侧壁的所述第一导向件(112)，所述切割刀(12)设置有至少一组第二导向件(121)，一组所述第二导向件(121)包括两个分别位于所述切割刀(12)相背的两侧的所述第二导向件(121)，一组所述第一导向件(112)的两个所述第一导向件(112)一一对应地与一组所述第二导向件(121)的两个所述第二导向件(121)配接。
  11. 根据权利要求9所述的钉仓组件，其特征在于，所述收刀槽(110)设置有两组所述第一导向件(112)，两组所述第一导向件(112)在所述出钉面(31)的延伸方向上分隔开，所述切割刀(12)设置有两组所述第二导向件(121)，两组所述第二导向件(121)在所述出钉面(31)的延伸方向上分隔开，两组所述第一导向件(112)中前方的一组所述第一导向件(112)与两组所述第二导向件(121)中前方的一组所述第二导向件(121)配接，后方的一组所述第一导向件(112)与后方的一组所述第二导向件(121)配接。
  12. 根据权利要求1所述的钉仓组件，其特征在于，所述推钉板组件(1)还包括弹性体(13)，所述弹性体(13)的一端安装于所述推钉板(11)，所述弹性体(13)的另一端抵接于所述切割刀(12)，所述弹性体(13)用于驱动所述切割刀(12)沿垂直于所述出钉面(31)的方向向下运动。
  13. 根据权利要求11所述的钉仓组件，其特征在于，所述推钉板组件(1)还包括 托板(14)，所述收刀槽(110)包括收容至少一部分所述弹性体(13)的容纳腔(113)，所述容纳腔(113)包括开口，所述托板(14)安装于所述推钉板(11)以至少部分地封闭所述开口。
  14. 一种外科器械，包括端部执行器(100)和推进器(2)，其特征在于，所述端部执行器(100)包括钳口组件和权利要求1至12中任一项所述的钉仓组件(101)，所述钉仓组件(101)可拆卸地安装于所述钳口组件，
    所述推进器(2)用于驱动所述推钉板(11)沿着长度方向(X)向前运动，所述推进器(2)包括向前伸出的抬刀部(221)，所述抬刀部(221)包括第三表面(2212)；
    在所述钉仓组件(101)安装于所述钳口组件的状态下，所述抬刀部(221)位于所述切割刀(12)的下方，所述第三表面(2212)从所述切割刀(12)的下方作用于所述切割刀(12)，使所述切割刀(12)的刃部突出于所述钉仓组件(101)的出钉面(31)。
  15. 根据权利要求14所述的外科器械，其特征在于，所述第三表面(2212)为与安装于所述钳口组件的所述钉仓组件(101)的所述出钉面(31)平行的平面。
  16. 根据权利要求14所述的外科器械，其特征在于，所述抬刀部(221)还包括第四表面(2211)，所述第四表面(2211)为相对于安装于所述钳口组件的所述钉仓组件(101)的所述出钉面(31)倾斜的平面或相对于所述出钉面(31)倾斜并向内凹入的弧面，所述第四表面(2211)朝向所述外科器械的前侧和上侧；
    在所述抬刀部(221)向前运动时，所述第四表面(2211)能够接触并推动所述切割刀(12)使得其在所述第四表面(2211)上相对滑动，进而使得所述切割刀(12)沿垂直于所述出钉面(31)的方向向上运动。
  17. 根据权利要求16所述的外科器械，其特征在于，所述第三表面(2212)和所述第四表面(2211)连接，所述第四表面(2211)位于所述第三表面(2212)的前侧。
  18. 根据权利要求14所述的外科器械，其特征在于，所述推进器(2)设置有臂部(222)，所述臂部(222)和所述抬刀部(221)间隔开，在所述臂部(222)和所述抬刀部(221)之间形成能够收容所述切割刀(12)的凹部(223)。
  19. 根据权利要求18所述的外科器械，其特征在于，所述臂部(222)的前端设置有引导面(2221)，在所述切割刀(12)收容于所述凹部(223)的状态下，所述引导面(2221)向前突出于所述切割刀(12)的尖端，所述引导面(2221)朝向所述凹部(223)，所述引导面(2221)是斜面或弧面。
  20. 根据权利要求18所述的外科器械，其特征在于，所述臂部(222)设置有凹槽 (2222)，所述凹槽(2222)朝向所述凹部(223)，在所述切割刀(12)收容于所述凹部(223)时，所述切割刀(12)的上边缘嵌入所述凹槽(2222)。
  21. 根据权利要求14所述的外科器械，其特征在于，所述第三表面(2212)从所述切割刀(12)的下方推动所述切割刀(12)，使得所述切割刀(12)沿垂直于所述出钉面(31)的方向运动，以使所述切割刀(12)的刃部突出于所述钉仓组件(101)的所述出钉面(31)；或者
    所述第三表面(2212)从所述切割刀(12)的下方接触所述切割刀(12)，以保持所述切割刀(12)的刃部凸出于所述出钉面(31)。
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