WO2023143313A1 - Instrument chirurgical - Google Patents

Instrument chirurgical Download PDF

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Publication number
WO2023143313A1
WO2023143313A1 PCT/CN2023/072932 CN2023072932W WO2023143313A1 WO 2023143313 A1 WO2023143313 A1 WO 2023143313A1 CN 2023072932 W CN2023072932 W CN 2023072932W WO 2023143313 A1 WO2023143313 A1 WO 2023143313A1
Authority
WO
WIPO (PCT)
Prior art keywords
clutch
assembly
drive
surgical instrument
drives
Prior art date
Application number
PCT/CN2023/072932
Other languages
English (en)
Chinese (zh)
Inventor
李正治
孙宝峰
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.)
Filing date
Publication date
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
Publication of WO2023143313A1 publication Critical patent/WO2023143313A1/fr

Links

Classifications

    • 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
    • A61B17/28—Surgical forceps
    • 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
    • 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter

Definitions

  • the present application relates to the technical field of medical instruments, in particular to a surgical instrument.
  • the electric stapler includes a battery and a motor, the battery provides power for the motor, the motor is connected and drives the transmission mechanism, the transmission mechanism drives the end effector to perform closing and opening actions, and drives the cutting knife assembly to perform firing (including cutting and stapling) and knife retraction action.
  • the cutting knife assembly When the tissue is clamped in the end effector of the electric stapler, if the cutting knife assembly is located at the end position or at an intermediate position between the end position and the initial position, the cutting knife assembly is first driven to move backward (i.e. retract) to The initial position, at which point the end effector can be opened and the tissue held by it can be removed.
  • the initial position refers to the position when the cutting knife assembly is not fired, and the end position refers to the position where the cutting knife assembly is fired to the bottom.
  • the cutter assembly has a mechanical structure that keeps the end effector closed so that the end effector cannot be opened when the cutter assembly is in the end or intermediate position.
  • the motor cannot drive the transmission mechanism, so the cutting knife assembly cannot return to the initial position from the stop position or the intermediate position, and the end effector cannot be opened to loosen and remove it. clamped tissue.
  • the electric stapler in the prior art has a forced reset device to realize the actions including the retraction of the cutting knife assembly and the opening of the jaws (that is, the opening of the end effector).
  • the reset device includes a power disengaging operating part, a manual retracting operating part and a manual opening jaw operating part, both of which are directly connected to the transmission mechanism without a motor, and the power disengaging operating part
  • the transmission between the motor and the transmission mechanism can be cut off, so that the manual power of the manual knife retracting operation part and the manual opening of the jaw operation part is transmitted to the transmission mechanism.
  • the user When a power failure occurs, first of all, the user operates the power to disengage the operating member, so that the motor is separated from the transmission mechanism, so that the electric motor The machine is no longer connected to the transmission mechanism; then, the user operates the manual retraction operation part to drive the transmission mechanism to perform the retraction action; finally, the user operates the manual opening jaw operation part to drive the transmission mechanism to perform the action of opening the jaws, and the clamped Tissue is removed from the jaws.
  • there are multiple operating elements for manual operation arranged in different positions of the stapler, and have a clear sequence of operations, which is inconvenient to use.
  • the present application aims to provide a surgical instrument.
  • the user can realize a forced reset through a simple operation, so that the jaw assembly is opened, and the clamped tissue is removed from the jaw.
  • this application includes the following technical solutions:
  • a surgical instrument comprising:
  • the transmission mechanism includes a clutch mechanism.
  • the electric module drives the movement of the jaw assembly and the cutting knife assembly through the clutch mechanism;
  • the surgical instrument has a first state and a second state. In the first state, the electric module is connected to the clutch mechanism , in the second state, the electric module is disengaged from the clutch mechanism;
  • a manual return mechanism including a manual operating member capable of moving in a first direction
  • the manual operation part moves along the first direction to switch the surgical instrument from the first state to the second state, and in the second state, the manual operation part moves along the first direction to drive the clutch mechanism to drive the cutting knife assembly to perform knife retraction
  • the action and drive jaw assembly performs the opening action.
  • the transmission mechanism also includes an input member, the input member has a first position and a second position, when the input member is in the first position, the electric module is connected with the clutch mechanism through the input member; the manual operation member moves along the first direction to drive the input The part moves from the first position to the second position; when the input part is in the second position, the input part is disengaged from the electric module or the clutch mechanism, so that the electric module is disengaged from the clutch mechanism.
  • the manual return mechanism also includes a return transmission assembly, and the manual operation part drives the clutch mechanism through the return transmission assembly;
  • the return drive assembly includes:
  • the ratchet is connected with the clutch mechanism
  • the pawl is rotatably connected with the manual operation part
  • the manual operating part moves in the first direction to drive the pawl, and the pawl drives the clutch through the ratchet structure.
  • the manual return mechanism also includes a disengagement transmission assembly, and the manual operation member drives the input member to move from the first position to the second position through the disengagement transmission assembly;
  • the movement of the manual operating member along the first direction is a rotation around the first rotating shaft along the first direction
  • the movement of the input member between the first position and the second position is a linear movement
  • the direction of the linear motion of the input member is parallel to the first rotating shaft.
  • the disengagement transmission assembly includes an actuator and a follower driven by the actuator;
  • the manual operation part rotates around the first rotating shaft along the first direction to drive the actuator to make the first movement
  • the actuator performs the first movement to drive the follower to perform the second movement
  • the driven member makes a second movement to drive the input member to move from the first position to the second position.
  • first movement of the actuator is rotation around the second shaft; the second movement of the follower is rotation around the pin shaft.
  • the actuator includes a motion conversion mechanism, which converts the first motion of the actuator into the second motion of the driven member.
  • the motion conversion mechanism is a helical surface arranged on the outer peripheral side of the actuator.
  • the follower includes a rod that rotates around the pin shaft, and the second movement is the rotation of the rod;
  • the helical surface drives the rod to rotate, and the rod drives the input to move from the first position to the second position when the rod rotates.
  • the actuator further includes a terminal abutment surface arranged on the outer peripheral side of the actuator, and the terminal abutment surface is adjacent to the distal end of the helical surface and arranged at an angle;
  • the first movement of the actuator is rotation around the second rotation axis; the abutment surface at the end point is perpendicular to the second rotation axis, and the abutment surface at the end point is used to lock the input member at the second position after the electric module is disengaged from the clutch mechanism.
  • the manual operation part is disengaged from the clutch mechanism, and in the second state, the manual operation part is operatively connected to the clutch mechanism.
  • the clutch mechanism includes a first gear, an intermediate piece and a second clutch; the intermediate piece is connected to the second clutch; the intermediate piece includes a first clutch structure, and the first gear includes a first gear that selectively cooperates with the first clutch structure.
  • the transmission mechanism also includes an input part; the manual return mechanism also includes a return transmission assembly;
  • the first gear is used to selectively drive one of the jaw assembly and the cutting knife assembly, and the first gear also includes a first effective travel structure and a first idle travel structure;
  • the second clutch is used to selectively drive the other assembly in the jaw assembly and the cutting knife assembly, and the second clutch includes a second effective rotation configuration and a second idle travel configuration; in response to the second clutch being driven and responding In the second effective transfer structure Cooperating with another component, the second active stroke structure drives the movement of the cutting knife assembly; in response to the second clutch being driven and in response to the second idle stroke structure being coupled with another component, the second idle stroke structure does not drive the cutting Knife assembly movement;
  • the jaw assembly and the cutter assembly are alternatively driven;
  • the electric module is connected to the input member to drive the input member; in response to the first effective rotation structure being matched with the input member, the first effective rotation
  • the structure drives a component to move; in response to the first idle travel structure being coupled to the input, the first idle travel structure does not drive a component to move;
  • the second clutch is driven by the input, and the second active travel structure is coupled to another component cooperating with, or coupling to, a second idler structure with another component;
  • the jaw assembly and the cutting knife assembly are driven alternatively; the manual operation part drives the second clutch through the return transmission assembly and the intermediate piece to drive the cutting knife assembly to retreat.
  • the first clutch structure and The second clutch structure is coupled so that the first gear is not driven, and thus the jaw assembly is not driven; the manual operation part drives the first gear through the return transmission assembly and the intermediate piece, the matched first clutch structure and the second clutch structure Open with drive jaw assembly.
  • the first clutch structure and the second clutch structure are used to realize the transition from phase coupling to cooperation between the first effective rotation structure and the input member.
  • the cutting knife assembly in the second state, if the cutting knife assembly is at the end position or the middle position, the manual operation part moves along the first direction to drive the second clutch part, and the second effective rotation structure cooperates with another component to drive the cutting
  • the knife assembly returns to the initial position, and then the middle piece drives the first gear through the matching first clutch structure and the second clutch structure to drive the jaw assembly to open; if the cutting knife assembly is in the initial position, the middle piece passes through the matching first The clutch structure and the second clutch structure drive the first gear to drive the jaw assembly to open.
  • first clutch structure is one of the arc groove and the protrusion
  • second clutch structure is the other of the arc groove and the protrusion
  • the arc groove includes an arc track and a head end
  • the coupling of the clutch structure includes that the protrusion is accommodated in the arc track, and the cooperation between the first clutch structure and the second clutch structure includes that the protrusion abuts against the head end.
  • the transmission mechanism also includes a first output member and a second output member; the first output member is connected with the jaw assembly, and the first output member is connected with the first gear, and the second output member is connected with the cutting knife assembly , and the second output part is matched or coupled with the second clutch part, or the second output part is connected with the jaw assembly, and the second output part is matched or coupled with the second clutch part, and the first output part is connected with the cutting knife assembly connected, and the first output member is connected to the first gear.
  • the surgical instrument also includes a jaw drive mechanism and a cutting drive mechanism; the first output member is connected to the jaw assembly through the jaw drive mechanism, and the second output member is connected to the cutting knife assembly through the cutting drive mechanism, or, the first The second output part is connected with the jaw assembly through the jaw driving mechanism, and the first output part is connected with the cutting knife assembly through the cutting driving mechanism.
  • first output member is a connecting rod
  • the connecting rod is rotatably connected to the first gear
  • second output member is a driving gear
  • the driving gear is matched or coupled with the second clutch member.
  • the return transmission assembly includes a ratchet, a ratchet gear, and a biasing member, and the ratchet gear meshes with the intermediate member; the manual operation
  • the working part is rotatably connected to one end of the pawl, and the biasing part abuts against the manual operation part and the pawl to bias the other end of the pawl away from one end in a direction away from the manual operation part; in response to manual operation
  • the movement of the member along the first direction the pawl combines with the ratchet gear and drives the ratchet gear to rotate.
  • a surgical instrument comprising:
  • the transmission mechanism includes a clutch mechanism.
  • the electric module drives the movement of the jaw assembly and the cutting knife assembly through the clutch mechanism;
  • the surgical instrument has a first state and a second state. In the first state, the electric module is connected to the clutch mechanism , in the second state, the electric module is disengaged from the clutch mechanism;
  • the power disengagement device includes a manual operation part and a disengagement transmission assembly driven by the manual operation part.
  • the disengagement transmission assembly In response to the driving of the manual operation part, the disengagement transmission assembly disengages between the electric module and the clutch mechanism, so that the surgical instrument can be disengaged from the first
  • the first state is switched to the second state; in the second state, in response to the driving of the manual operating part, the clutch mechanism alternatively drives the cutting knife assembly to perform the retracting action and drives the jaw assembly to perform the opening action.
  • the transmission mechanism also includes an input part, the input part has a first position and a second position, when the input part is in the first position, the electric module is connected with the clutch mechanism through the input part; the manual operation part moves along the first direction to drive the disengagement Open the transmission assembly and then drive the input part to move from the first position to the second position; when the input part is in the second position, the input part is disengaged from the electric module or the clutch mechanism, so that the electric module is disengaged from the clutch mechanism.
  • the movement of the manual operating part in the first direction is to rotate around the first rotating shaft in the first direction
  • the movement of the input part between the first position and the second position is a linear motion
  • the manual operating part is disengaged from the transmission assembly.
  • Rotation in the first direction is converted to linear motion of the input member from the first position to the second position.
  • the disengagement transmission assembly includes a second rotating shaft, an actuating member sleeved on the second rotating shaft, and a driven member driven by the actuating member.
  • the actuating member rotates around the second rotating shaft; the manual operation member rotates along the first direction
  • the rotation of the first rotating shaft can drive the actuator to make the first movement around the second rotating shaft, and the driving member makes the first movement to drive the driven member to make the second movement.
  • linear movement direction of the input member is parallel to the axis of the first rotating shaft; or the first rotating shaft is parallel to the second rotating shaft.
  • the manual operation part includes a driving surface extending substantially along the radial direction of the first rotating shaft, the actuating part includes a sliding end, and the sliding end abuts against the driving surface movably;
  • the manual operating part rotates in the first direction, and the driving surface pushes the sliding end to rotate in the first direction around the central axis of the second rotating shaft, and at the same time, the sliding end slides on the driving surface approximately along the radial direction of the first rotating shaft from the starting end to the ending end.
  • the actuator is a cylindrical cam
  • the cylindrical cam includes an axially protruding protruding post
  • the protruding post is a sliding end
  • the actuator includes a motion conversion mechanism, which converts the first motion of the actuator into the second motion of the driven member.
  • the motion conversion mechanism is a helical surface arranged on the outer peripheral side of the actuator.
  • the follower includes a rod that rotates around the pin shaft, and the second movement is the rotation of the rod;
  • the helical surface drives the rod to rotate, and the output end of the rod drives the input member to move from the first position to the second position when rotating, and the output end of the rod has Displacement in the direction of linear motion.
  • the first end of the rod abuts against the helical surface.
  • the disengagement transmission assembly also includes an intermediate transmission member.
  • the frame of the surgical instrument is provided with a guide groove for guiding the linear movement of the intermediate transmission member.
  • the rods abut against each other, and the actuating member is connected through the intermediate transmission member and drives the driven member to perform the second movement.
  • the actuator also includes a starting point abutting surface, which is adjacent to the proximal end of the helical surface and arranged at an angle, and the starting point abutting surface is perpendicular to the central axis of the second rotating shaft, and is used to drive the motor
  • the module and the clutch mechanism remain in a combined state.
  • the actuator also includes a terminal abutment surface, which is adjacent to the distal end of the helical surface and arranged at an angle, the terminal abutment surface is perpendicular to the central axis of the second rotating shaft, and the terminal abutment surface is used to drive the motor The module and the clutch mechanism remain in a disengaged state.
  • the manual return mechanism also includes a return transmission assembly, and the manual operation part drives the clutch mechanism through the return transmission assembly;
  • the return drive assembly includes:
  • the ratchet is connected with the clutch mechanism
  • the pawl is rotatably connected with the manual operation part
  • the manual operation part moves along the first direction to drive the ratchet, and the ratchet drives the clutch mechanism through the ratchet wheel.
  • a surgical instrument comprising:
  • the transmission mechanism includes an input part, a clutch mechanism and an output part.
  • the electric module drives the movement of the jaw assembly and the movement of the cutting knife assembly through the clutch mechanism;
  • the clutch mechanism includes a clutch and an intermediate piece, and the clutch includes an effective stroke structure and an idle stroke structure, and the input The component is connected to the output component through an effective travel structure to drive the output component, and the input component is coupled to the output component through an idle travel structure so as not to drive the output component;
  • the clutch includes a first clutch and a second clutch, the output includes a first output and a second output, the first output is used to drive one of the jaw assembly and the cutter assembly to move, and the second output It is used to drive the movement of another component in the jaw assembly and the cutting knife assembly, the input piece selectively drives the first output piece through the first clutch piece, and the input piece selectively drives the second output piece through the second clutch piece; the intermediate piece and the The first clutch part and the second clutch part are coaxially arranged, and the intermediate part is connected with the second clutch part and moves synchronously, the input part cooperates with the middle part, drives the second clutch part through the middle part, and then selectively drives the second output part .
  • the second clutch part and the intermediate part are formed on the same part.
  • the first clutch includes a first effective stroke structure and a first idle stroke structure.
  • first effective stroke structure cooperates with the input piece
  • the input piece drives the first output piece
  • first idle stroke structure cooperates with the input piece coupled
  • the input does not drive the first output
  • the second clutch includes a second effective stroke structure and a second idle stroke structure.
  • the input element drives the second output element;
  • the second idle stroke structure is matched with the second output coupled, the input does not drive the second output.
  • the second idle stroke structure is coupled with the second output member, so that the input member can drive the first output member through the clutch mechanism but cannot drive the second output member;
  • the second effective stroke structure cooperates with the second output member, so that the first input member can drive the second output member through the clutch mechanism but cannot drive the first output member.
  • the first clutch is a first gear, including a first toothed portion and a first toothless portion, the first toothed portion is a first effective stroke structure, and the first toothless portion is a first idle stroke structure, Both the first toothed portion and the first toothless portion are located on the outer peripheral surface of the first gear, and the first toothed portion and the first toothless portion are disposed adjacent to each other.
  • the second clutch is a second gear, including a second toothed portion and a second toothless portion, the second toothed portion is a second effective stroke structure, and the second toothless portion is a second idle stroke structure, Both the second toothed portion and the second toothless portion are located on the outer peripheral surface of the second clutch member, and the second toothed portion and the second toothless portion are adjacent to each other.
  • the intermediate part is a third gear
  • the third gear is engaged with the input part
  • teeth are distributed on the entire outer peripheral surface of the third gear
  • the third gear is adjacent to the upper part of the second clutch part.
  • the intermediate part includes a first clutch structure
  • the first clutch part includes a second clutch structure
  • the first clutch structure and the second clutch structure cooperate or couple to selectively drive the first output part.
  • one of the first clutch structure and the second clutch structure is an arc groove, and the other is a protrusion.
  • the center of the arc groove is located on the rotation axis of the component.
  • the arc groove includes an arc track and a head end, and the protrusion Stretch into the arc track and It is slidably connected with the arc track.
  • middle piece and the first clutch piece can be rotatably sleeved on the rotating shaft, the first end surface of the middle piece is adjacent to the second end surface of the first clutch piece, and one of the two end surfaces is provided with an arc groove, Another set has protrusions.
  • the beneficial effect of the present application is that the surgical instrument can sequentially realize the electric power disengagement, the cutting knife assembly retreat and the jaw assembly opening by operating a manual operation part, that is, one piece can realize three functions , and can sequentially realize the electric power disengagement and the opening of the jaw assembly, that is, two functions in one piece, and realize the forced reset of the electric surgical instrument that has a power failure.
  • a manual operation part that is, one piece can realize three functions
  • the electric power disengagement and the opening of the jaw assembly that is, two functions in one piece, and realize the forced reset of the electric surgical instrument that has a power failure.
  • the user only one operating part needs to be operated, and the operation is simple and the experience is good.
  • Fig. 1 is the three-dimensional schematic view of the first embodiment of the surgical instrument provided by the present application
  • Fig. 2 is a schematic diagram of a partial internal structure of the surgical instrument shown in Fig. 1;
  • Fig. 3 is an exploded view of a partial internal structure of the surgical instrument shown in Fig. 1;
  • Fig. 4 is a schematic perspective view of the first clutch shown in Fig. 3;
  • Fig. 5 is a three-dimensional schematic diagram of the middleware shown in Fig. 3;
  • 6-A to 6-D are schematic diagrams of state changes of the clutch mechanism of the surgical instrument
  • Fig. 7 is a structural schematic diagram of the manual return mechanism
  • Fig. 8 is a schematic perspective view of the actuator shown in Fig. 7;
  • Fig. 9 is a schematic diagram of the development of the partial peripheral surface of the actuator shown in Fig. 7;
  • 10-A to 12-B are schematic diagrams of state changes of the hand of the dynamic return mechanism
  • Fig. 13 is a schematic structural view of the manual return mechanism of the surgical instrument provided by the second embodiment of the present application.
  • Fig. 14 is an exploded view of the structure of the manual operating part and the pawl
  • Fig. 15 is a schematic structural view of the manual operation part
  • Fig. 16 is a structural schematic diagram of the intermediate transmission member
  • Figure 17 is a schematic diagram of a cutting drive mechanism and a cutting knife assembly
  • Fig. 18 is a schematic diagram of the connection between the first output member and the casing
  • 19 to 24 are schematic diagrams of the connection between the sleeve and the jaw assembly.
  • Surgical instrument 110. Main body; 116. Cover plate; 120. Shaft assembly; 126. Sleeve; 128. Jaw Components; 130, end effector; 133, nail bin seat; 134, abutting nail seat; 140, battery pack; 112, head shell; 114, handle shell; 150, motor; 152, output gear; 200, Pawl; 202, limited part; 204, second support shaft; 205, biasing member; 206, spiral part; 207, first torsion spring arm; 208, second torsion spring arm; 209, wing; 210, Pawl limiter; 230, ratchet gear; 232, ratchet; 234, return gear; 254, body; 256, driving tube; 258, first driving part; 260, second driving part; 262, first driven part ; 264, the second driven part; 266, the pin; 268, the waist groove; 300, the rack; 301, the mandrel; 302, the cutter bar; 303, the cutter head; ;
  • Main driving gear 4. Pin shaft; 5. Elastic member; 6. Upper gear; 7. Lower gear; 8. Recess; 10. First clutch member; 12. First effective rotation structure; 20. The second clutch; 22. The second effective travel structure; 24. The second idle travel structure; 25. Parts; 32. The third effective travel structure; 34.
  • the third idle travel structure; 40 middle piece; 41, rotating shaft; 52, connecting rod; 54, cutting drive gear; 55, slider; 62, arc groove; 64, protrusion; 66, head end; 67, arc track; 70, manual operation 71, the first rotating shaft; 74, the driving surface; 80, the actuator; 81, the second rotating shaft; 82, the starting point contact surface; 84, the spiral surface; , driven part; 92, output end; 94, intermediate transmission part.
  • proximal and distal are relative to the operator manipulating the manual operation part of the stapler.
  • proximal refers to the part near the operator and the term “distal” refers to the part away from the operator. That is, the wrench is the proximal side, and the jaw assembly is the far side.
  • the proximal end of a component means the end relatively close to the wrench, and the distal end means the end relatively close to the jaw assembly.
  • upper and “lower” refer to the relative positions of the nail abutment seat and the staple cartridge seat of the jaw assembly, specifically, the nail anvil seat is “upper” and the staple cartridge seat is “lower”.
  • staplers can be used in many orientations and positions, so these terms expressing relative positional relationships are not limiting and absolute.
  • the surgical instrument 100 includes a main body 110, a shaft assembly 120 and an end effector 130 connected in sequence, and the surgical instrument 100 also includes a transmission mechanism and a cutting knife assembly. A part of the transmission mechanism is located in the main body 110 , a part of the cutter assembly is located in the shaft assembly 120 , and a part is located in the end effector 130 .
  • the main body 110 includes a first casing and a battery pack 140 detachably mounted on the first casing.
  • the first housing includes a connected head housing 112 and a handle housing 114
  • the battery pack 140 is detachably mounted on the head housing 112
  • the head housing 112 accommodates a part of the transmission mechanism
  • the handle housing 114 can be
  • the handle housing 114 accommodates the electric module
  • the electric module includes a motor 150
  • the motor 150 includes an output gear 152 connected with an output shaft.
  • the battery pack 140 includes a second case (not shown), which is detachably mounted to the head case 112 , and a battery housed in the second case.
  • the battery provides electric energy to the motor 150, and the motor 150 outputs electric power when working.
  • the transmission mechanism is connected to the electric module, and works when the electric power output by the motor 150 is obtained.
  • the shaft assembly 120 includes a core shaft 301 and a sleeve 126 sleeved on the core shaft 301 . While the mandrel 301 is part of the cutting drive mechanism, the sleeve 126 is part of the jaw drive mechanism.
  • End effector 130 includes a jaw assembly and a cartridge assembly.
  • the jaw assembly includes a staple cartridge seat 133 and a staple abutment seat 134 pivotably connected to the staple cartridge seat 133 .
  • the staple cartridge base 133 is used to operatively support a staple cartridge assembly (not shown) located therein, and the nail abutment base 134 can selectively move between an open position and a closed position, so as to cooperate with the staple cartridge base 133 and the staple cartridge assembly Cooperate to loosen or clamp tissue.
  • the staple cartridge assembly is provided with a groove for the movement of the cutting knife assembly. The cutting knife assembly cuts the tissue while moving in the groove toward the far side, and pushes out the staples accommodated in the staple cartridge assembly to anastomose the tissue.
  • the motor 150 first drives the jaw assembly to close through the transmission mechanism to clamp the tissue, then the motor 150 drives the cutting knife assembly forward through the transmission mechanism to cut and anastomose the tissue (that is, feed or fire), and then the motor 150 drives the cutting knife assembly through the transmission mechanism Treat (that is, withdraw the knife), and finally the motor 150 drives the jaw assembly to open through the transmission mechanism to loosen the tissue, thereby realizing the functions of cutting and stapling of the stapler.
  • the transmission mechanism includes a switching mechanism and a driving mechanism.
  • the switching mechanism includes an input part, a clutch mechanism and an output part. The input part is driven by the motor 150, and the output part is drivably connected to the drive mechanism.
  • the clutch mechanism includes a clutch part, and the clutch part includes an effective turning structure and an idle turning structure.
  • the input part is connected with the output part through the effective rotation structure, so as to drive the output part through the effective rotation structure, so as to realize the drive mechanism driven by the motor 150 .
  • the input element is coupled with the output element through the idle motion structure, so that the output element is not driven through the idle motion structure, so that the motor 150 does not drive the driving mechanism. Therefore, the input element selectively drives the output element through the clutch mechanism, and the motor 150 selectively drives the driving mechanism through the switching mechanism.
  • Method 1 The clutch part is selectively matched with the input part, and the clutch part is connected with the output part.
  • the clutch part is driven, and the clutch part drives the output part;
  • the idling travel structure of the clutch part is coupled with the input part, the clutch part is not driven, and the clutch part does not drive the output part.
  • Method 2 the clutch part is connected to the input part, and the clutch part is selectively matched with the output part.
  • the clutch part is driven by the input part.
  • the clutch part drives the output part.
  • the clutch part does not drive the output part.
  • Selective mating includes mating and coupling.
  • Coupling refers to the termination of cooperation due to the lack of structure for cooperation between interacting parts due to changes in relative position or state.
  • the idling range means that the switching mechanism is driven when it has motion input, but the switching mechanism has no motion output, that is, it does not drive the cutter assembly or the jaw assembly.
  • the idle travel structure refers to the structure of the components of the switching mechanism that can realize the idle travel.
  • the effective rotation range means that when the switching mechanism has a motion input, it is driven, and the switching mechanism has a motion output, that is, it drives the cutting knife assembly or the jaw assembly.
  • the effective stroke structure refers to the structure of the components of the switching mechanism that can realize the effective stroke.
  • the switching mechanism may receive motion input from the motor 150 while the motor 150 is running.
  • the driving mechanism includes a jaw driving mechanism and a cutting driving mechanism.
  • the clutch includes a first clutch 10 and a second clutch 20 .
  • the output part includes a first output part and a second output part, the first output part is connected with the jaw drive mechanism, and the second output part is connected with the cutting drive mechanism.
  • the input part selectively drives the first output part through the first clutch part 10, so as to realize the selective driving of the jaw driving mechanism.
  • the input part selectively drives the second output part through the second clutch part 20, so as to realize the selective driving of the cutting drive mechanism.
  • the first clutch part 10 adopts the above-mentioned method 1 to realize the input part to selectively drive the first output part
  • the second clutch part 20 adopts the above-mentioned method 2 to realize the input part to selectively drive the second output part.
  • the first clutch part 10 is connected with the first output part, and the first clutch part 10 selectively cooperates with the input part, so that the input part selectively drives the first output part through the first clutch part 10, thereby realizing the selection of the jaw drive mechanism sex drive.
  • the first clutch member 10 includes a first effective stroke structure 12 and a first idle stroke structure 14. When the first effective stroke structure 12 cooperates with the input member, the first clutch member 10 is driven, and the first output member is driven, and then The jaw driving mechanism is driven, when the first idle travel structure 14 is coupled with the input member, the first clutch member 10 is not driven, the first output member is not driven, and the jaw driving mechanism is not driven, so that the first output member is selectively driven and thus the jaw driving mechanism is selectively driven.
  • the first effective stroke structure drives the jaw assembly to move, and the first idle stroke structure does not drive the jaw assembly to move.
  • the second clutch part 20 is connected with the input part, and the second clutch part 20 is selectively matched with the second output part, so that the input part selectively drives the second output part through the second clutch part 20, thereby realizing the selectivity of the cutting drive mechanism drive.
  • the second clutch member 20 includes a second effective stroke structure 22 and a second idle stroke structure 24.
  • the second effective stroke structure 22 cooperates with the second output member, the second output member is driven, and then the cutting drive mechanism is driven.
  • the second idle path structure 24 is coupled with the second output member, the second output member is not driven, and the cutting drive mechanism is not driven, thereby realizing the selective driving of the second output member and thus the selective driving of the cutting drive mechanism.
  • the second effective stroke structure drives the movement of the cutting knife assembly
  • the second idle stroke structure does not drive the movement of the cutting knife assembly.
  • the clutch mechanism further includes an intermediate piece 40 , which cooperates with the input piece, and the intermediate piece 40 is connected with the second clutch piece 20 and rotates synchronously, so that the middle piece 40 drives the second clutch piece 20 .
  • the intermediate piece 40 and the second clutch piece 20 are formed on the same part 25 .
  • the jaw driving mechanism includes a slider 55 and a sleeve 126 connected to the slider 55
  • the cutting driving mechanism includes a rack 300 and a mandrel 301 connected to the rack 300 .
  • the first clutch part 10 selectively drives the jaw assembly
  • the second clutch part 20 selectively drives the cutting knife assembly.
  • a motion conversion mechanism between the sleeve 126 and the nail anvil 134 of the jaw assembly 128, and the motion conversion mechanism converts the linear motion of the sleeve 126 into the motion of the nail anvil 134.
  • the pivotal movement realizes that the nail anvil seat 134 pivots relative to the staple cartridge seat 133 to close or open the jaw assembly 128 .
  • the movement changing mechanism drives the nail anvil 134 to pivot upwards to open the jaw assembly 128, and when the sleeve 126 moves toward the distal end, the motion changing mechanism drives the nail anvil 134 to pivot downward. In turn, the jaw assembly 128 is closed.
  • the sleeve 126 includes a connected body 254 and a driving tube 256 , and the driving tube 256 drives the anvil 134 to pivot upward or downward to open or close the jaw assembly 128 .
  • the main body 254 and the driving pipe 256 are connected by a hinge, and can also be integrally formed.
  • the motion changing mechanism includes a first driving part 258 and a second driving part 260 disposed on the driving tube 256 , and a first driven part 262 and a second driven part 264 disposed on the nail anvil 134 .
  • the first driving part 258 drives the nail anvil 134 to open, and the first driving part 258 is a protrusion disposed on the driving tube 256, and the protrusion extends obliquely along the lower right.
  • the second driving part 260 drives the nail anvil 134 to close, and the second driving part 260 is the driving surface at the distal end of the driving tube 256 .
  • the first driven part 262 can be matched with the first driving part 258 , the first driven part 262 is a convex part provided on the nail anvil 134 , and the convex part extends upward.
  • the second driven part 264 can be matched with the second driving part 260 , and the second driven part 264 is the abutting surface of the proximal end of the nail anvil 134 .
  • a guiding mechanism is also provided between the nail anvil seat 134 and the nail cartridge seat 133, and the guide mechanism includes a pin 266 arranged on the nail anvil seat 134, a waist-shaped groove 268 arranged on the nail cartridge seat 133, and the waist-shaped groove 268 along the The proximal end extends obliquely upward toward the distal end.
  • the cutting knife assembly is connected to the mandrel 301 to be driven by the mandrel 301 to perform a firing action or a knife retracting action.
  • the cutting knife assembly includes a knife bar 302 and a knife head 303 connected to the knife bar 302 .
  • the rack 300 is connected to the proximal end of the mandrel 301 , and the groove at the distal end of the mandrel 301 engages with the protrusion at the proximal end of the knife rod 302 .
  • the rack 300 can drive the spindle 301 to move forward and backward.
  • the forward movement of the mandrel 301 can cause the cutting knife assembly to move forward, cut the tissue and push the staples of the staple cartridge assembly out to staple the tissue.
  • the mandrel 301 moves backward, it drives the cutting knife assembly to move backward to return to the original position.
  • the cutter head 303 is located in the space formed between the staple cartridge seat 133 and the nail abutment seat 134 of the jaw assembly.
  • the nail anvil seat 134 has a nail anvil seat groove (not shown in the figure) therein
  • the staple cartridge seat 133 has a nail cartridge seat groove therein; the position of the nail cartridge seat groove corresponds to the nail anvil seat groove.
  • the staple cartridge seat groove, the nail abutment seat groove, and the knife feed groove of the staple cartridge assembly together provide accommodation space and path guidance for the cutting knife assembly. As shown in FIG.
  • the cutter head 303 includes a supporting portion 304 and a locking portion 305 , and the supporting portion 304 and the locking portion 305 form an I-shape.
  • the shape of the nail cartridge seat groove is adapted to the clamping part 305
  • the shape of the nail abutting seat groove is adapted to the shape of the support part 304.
  • the clamping part is placed in the nail cartridge seat groove, and the support part enters the nail abutment seat groove. This allows the cutter head 303 to move in the upper and lower sides of the anvil seat groove and the staple cartridge seat groove, and move from the proximal end to the distal end to cut and anastomose human tissues.
  • the supporting part 304 can reciprocate in the nail abutment seat groove and the engaging part 305 can respond to the applied force in the nail cartridge seat groove, that is, the cutting knife assembly can respond to being received.
  • the firing or retracting force reciprocates within the end effector 130.
  • the supporting part 304 of the knife head 303 is located in the nail abutment seat groove, and the snap-in part 305 is located in the nail cartridge seat groove and is limited by the knife head 303.
  • the jaw assembly Unable to open. If you want to open the jaw assembly, the cutting knife assembly should be in the initial position.
  • the supporting part 304 is disengaged from the nail abutment seat groove, and the clamping part 305 is disengaged from the nail cartridge seat groove.
  • the opening of the jaw assembly is no longer affected by the knife. Header 303 Restrictions.
  • the clutch mechanism alternatively drives the first output member and the second output member.
  • the first clutch When the first effective rotation structure 12 of the member 10 is matched with the first input member so that the first input member drives the first output member through the clutch mechanism, the second idle travel structure of the second clutch member 20 is coupled with the second output member, so that The second input part cannot drive the second output part through the clutch mechanism, that is, the clutch mechanism drives the first output part but does not drive the second output part;
  • the second effective rotation structure 22 of the second clutch part 20 cooperates with the second output part, so that the second input part drives the second output part through the clutch mechanism , that is, at this time the clutch mechanism drives the second output member but does not drive the first output member.
  • the first output member and the second output member are driven alternatively, so that the jaw drive mechanism and the cutting drive mechanism are alternatively driven, and then the jaw assembly and the cutting knife assembly are alternatively driven.
  • the first input member and the second input member are driven alternatively, so that the jaw drive mechanism and the cutting drive mechanism are alternatively driven, and
  • the jaw assembly when cutting and stapling tissues, the jaw assembly should be kept closed, so the actions of the cutting knife assembly and the jaw assembly cannot be performed simultaneously, and the actions of the cutting knife assembly and the jaw assembly should be Following the established order, it therefore makes sense to drive either of the above two components.
  • the motor 150 alternatively drives the cutting drive mechanism and the jaw drive mechanism.
  • the motor 150 either drives the jaw assembly or the cutting knife assembly to avoid error.
  • the action of the jaw assembly includes opening and closing, and the action of the cutting knife assembly includes moving forward (that is, feeding) and moving backward (that is, retracting).
  • the driving object of the first clutch part 10 can also be replaced by the jaw assembly with the cutting knife assembly, so as to realize that the input part selectively drives the first output part through the first clutch part 10, and then selectively drives the cutting drive mechanism Then selectively drive the cutting knife assembly;
  • the driving object of the second clutch 20 can also be replaced by the cutting knife assembly to the jaw assembly, so that the input can selectively drive the second output through the second clutch 20, and then selectively drive the The jaw drive mechanism in turn selectively drives the jaw assembly.
  • the cutting drive mechanism includes a mandrel, one end of the connecting rod 52 is rotatably connected to the first clutch member 10, and the other end of the connecting rod 52 is rotatably connected to one end of the mandrel, so that the connecting rod
  • the swing of the mandrel is converted into the linear motion of the mandrel, and the other end of the mandrel is connected with the cutter bar of the cutting knife assembly;
  • the jaw driving mechanism includes a rack 300 and a sleeve 126, and one end of the sleeve 126 can be driven with the anvil 134
  • the other end of the bushing 126 is connected to the rack 300, and the rack 300 is engaged with the second output member (driving gear 54).
  • the operation mode of the transmission mechanism is: the input part moves, the first toothed part of the first clutch part 10 cooperates with the input part, thereby driving the first clutch part 10 to move, and then driving the first output part, the jaw driving mechanism and The jaw assembly, the jaw assembly is driven to close or open; the first toothless part of the first clutch 10 is coupled with the input, the first clutch 10 is not driven, and then the first output, the jaw driving mechanism And the jaw assembly is not driven, the jaw assembly is not driven and maintains the current state; when the input piece moves, the intermediate piece 40 that is engaged with it is synchronously driven to move, and the intermediate piece 40 drives the second clutch 20 to move, and the second clutch 20
  • the second toothed part cooperates with the second output member, and the second output member is driven, so that the second output member moves to drive the cutting drive mechanism, and then drives the cutting knife assembly to advance or retreat;
  • the tooth portion is coupled with the second output member, and the second output member is not driven, so that the cutting drive mechanism and the cutting knife assembly are not driven,
  • the specific operation mode of the clutch mechanism is as follows: the first toothed part of the first clutch part 10 cooperates with the input part, so that the first clutch part 10 is driven to move, and then drives the jaw driving mechanism and the pliers sequentially through the first output part.
  • the mouth assembly, the jaw assembly is driven to close; in the process of closing and opening the jaw assembly, the second toothless part of the second clutch 20 is coupled with the second output member, and the second output member is not driven, and then
  • the cutting drive mechanism and the cutting knife assembly are not driven, and the cutting knife assembly is not driven but maintains its position; after the jaw assembly is closed and in place, in the process of the cutting knife assembly feeding and retreating, the first clutch of the first clutch 10 will The tooth part is coupled with the input part, the first clutch part 10 is not driven, and then the jaw driving mechanism and the jaw assembly are not driven, the jaw assembly is not driven and remains closed, and the second gear of the second clutch part 20
  • the part is engaged with the second output member, so as to drive the second output member to move,
  • the cutting knife assembly is driven to feed, and the feed is in place (that is, fired to the end) or the feed stops Finally, the motor 150 rotates in the reverse direction, driving the cutter assembly to retreat until it returns to the initial position; the motor 150 continues to rotate in the reverse direction, and the first toothed part of the first clutch part 10 meshes with the input part, so that the first clutch part 10 reverse rotation, and then sequentially drive the jaw driving mechanism and the jaw assembly through the first output member, and the jaw assembly is driven to open.
  • the clutch mechanism enables the jaw assembly and the cutting knife assembly to complete the following actions in sequence: closing the jaw assembly, advancing the knife, retracting the knife, and opening the jaw assembly, and the actions of the jaw assembly and the cutting knife assembly are not performed at the same time.
  • the input member is the main driving gear 2
  • the main driving gear 2 is connected with the output gear 152 of the motor 150 so as to be driven by the motor 150 .
  • the middle piece 40 is a third gear, which keeps meshing with the input piece, and the whole outer peripheral surface of the middle piece 40 has teeth distributed thereon.
  • the first clutch member 10 is a first gear, specifically a crank gear, which is roughly fan-shaped in shape and includes a first toothed part and a first toothless part.
  • the first toothed part is the first effective rotation structure 12, and the first toothless part is The tooth portion is the first idle stroke structure 14 .
  • Both the first toothed portion and the first toothless portion are located on the outer peripheral surface of the first gear, and the first toothed portion and the first toothless portion are arranged adjacent to each other.
  • the second clutch 20 is a second gear, including a second geared portion and a second gearless portion, the second geared portion is a second effective stroke structure 22 , and the second gearless portion is a second idle stroke structure 24 .
  • Both the second toothed portion and the second toothless portion are located on the outer peripheral surface of the second clutch member 20 , and the second toothed portion and the second toothless portion are disposed adjacent to each other.
  • the intermediate piece 40 and the second clutch piece 20 are integrally formed into one part 25
  • the third gear is adjacent to the upper part of the second gear.
  • the first output is the connecting rod 52 and the second output is the cutting drive gear 54 .
  • One end of the connecting rod 52 is rotatably arranged on the second end surface of the first clutch member 10, the first clutch member 10 drives the connecting rod 52 to move, and the movement of the connecting rod 52 drives the jaw driving mechanism to move and further drives the jaw assembly to open or close.
  • the position of the second clutch 20 corresponds to the position of the cutting drive gear 54 so that the second clutch 20 selectively cooperates with the cutting drive gear 54, and the cutting drive gear 54 meshes with the rack 300 to drive the rack 300 forward or backward.
  • the rack 300 drives the cutter assembly forward or backward through the mandrel 301 .
  • one end of the connecting rod 52 is rotatably connected to the first clutch member 10
  • the other end of the connecting rod 52 is rotatably connected to the slider 55
  • the slider 55 is fixedly connected to the sleeve 126 .
  • the first clutch member 10 drives the connecting rod 52 to move
  • the connecting rod 52 drives the slider 55 to move, and then drives the bushing 126 to move.
  • the middle piece 40 and the first clutch piece 10 can be rotatably sleeved on the rotating shaft 41, the first end surface of the middle piece 40 is adjacent to the second end surface of the first clutch piece 10, and an arc groove is provided on one of the two end surfaces 62, the other is provided with a protrusion 64 extending into the arc groove 62, and the center of the arc groove 62 is located on the rotation axis of the part where it is located.
  • the protrusion 64 can slide in the arc groove 62 .
  • the protrusion 64 cooperates with the arc groove 62 to make the intermediate piece 40 and the first clutch 10 overlap; Sliding in the arc groove 62, the first clutch part 10 does not rotate with the intermediate part 40.
  • the first idle travel structure 14 is coupled with the input part, so that when the driving device drives the cutting knife assembly to move, the first clutch part 10 will not drive
  • the end effector 130 is closed or opened.
  • the arc groove 62 is provided on the middle member 40 and the protrusion 64 is provided on the first clutch member 10 for detailed description.
  • the middle piece 40 rotates so that the head end 66 of the arc groove 62 drives the protrusion 64 abutted against it to rotate, thereby driving the first A clutch part 10 rotates, so that the first clutch part 10 and the input part are switched from a coupling state to a mating state, the coupling state is that the first toothless part is coupled with the input part, and the mating state is that the first toothed part is mated with the input part .
  • the cooperation between the protrusion 64 and the arc groove 62 can make the coupling between the input part and the first idle stroke structure 14 be converted into the cooperation between the input part and the first effective stroke structure 12, thereby realizing the first output of the first clutch part 10.
  • the component changes from the non-driving state to the driving state.
  • the protrusion 64 abuts against the head end 66 of the arc groove 62, so that the first toothed portion of the first clutch member 10
  • the teeth of the middle piece and the teeth of the middle piece 40 are aligned up and down, but the first toothed part has not yet meshed with the input piece.
  • the head end 66 drives the protrusion 64 to rotate synchronously when the middle piece 40 rotates, so that the first toothed portion
  • the first clutch part 10 and the intermediate part 40 can be engaged with the input part synchronously, so as to ensure the smooth opening of the subsequent end effector 130 to loosen the tissue.
  • the end effector 130 in an initial state, the end effector 130 is in an open state, and the cutting knife assembly is in an initial position.
  • the protrusion 64 is located at the head end 66 of the arc groove 62 , and the first toothed portion of the first clutch member 10 and the intermediate member 40 mesh with the main driving gear 2 at the same time.
  • the operator starts the motor 150, and the motor 150 rotates forward to drive the main drive gear 2 to rotate, and the main drive gear 2 rotates to simultaneously drive the first clutch 10 and the middle piece 40 rotate (both rotate counterclockwise in FIG. 6-A ), the middle piece 40 drives the second clutch piece 20 to rotate, and the second toothless portion is coupled with the cutting drive gear 54 at this moment.
  • the first clutch member 10 and the intermediate member 40 do not rotate relative to each other, therefore, the protrusion 64 remains at the head end 66 of the arc groove 62 .
  • the rotation of the first clutch part 10 drives the movement of the connecting rod 52, and the connecting rod 52 drives
  • the jaw driving mechanism further drives the jaw assembly (end effector 130 ) to close, and the clutch mechanism reaches the position shown in FIG. 6-B .
  • the cutting knife assembly In the position shown in Fig. 6-D, the cutting knife assembly is at the end position, and the tissue cutting and anastomosis are completed.
  • the operator can operate the motor 150 to rotate in reverse, and the motor 150 drives the cutting drive mechanism through the main drive gear 2, the second clutch member 20, and the second output member to drive the cutter assembly back, so that the cutter assembly moves from the end position Back to the initial position, during this process, the first gearless part is coupled with the main drive gear 2, the first clutch 10 does not rotate, the main drive gear 2 cannot drive the end effector 130 to move, that is, the jaw assembly remains closed state, but the middle piece 40 reversely rotates (starts to rotate clockwise in Fig.
  • the second toothed part meshes with the cutting drive gear 54, and the main drive gear 2 drives the cutting drive gear 54 reversely through the second toothed part Rotate, and make the protrusion 64 slide towards the head end 66 in the arc groove 62, when the protrusion 64 abuts against the head end 66 of the arc groove 62, the teeth of the first toothed part of the first clutch member 10 and the intermediate member The teeth of 40 are aligned up and down, reaching the position shown in Fig. 6-B. At this point, the tool retraction process is complete.
  • the motor 150 continues to rotate in the reverse direction.
  • the head end 66 drives the protrusion 64 to rotate synchronously to make the first clutch part rotate clockwise, so that the first clutch part of the first clutch part rotates clockwise.
  • the tooth part is no longer coupled with the main drive gear 2, and the first toothed part starts to mesh with the main drive gear 2, so that the first clutch part 10 and the intermediate part 40 mesh with the main drive gear 2 synchronously, realizing the end effector 130 The smooth opening and loosening of the tissue.
  • the second toothless portion is coupled with the cutting driving gear 54, so the cutting blade assembly is not driven to maintain the initial position.
  • the main drive gear 2 simultaneously drives the first clutch member 10 and the intermediate member 40 to rotate in reverse (both rotate clockwise in FIG. Engaging with the main drive gear 2 makes the first clutch part rotate, and the first clutch part drives the connecting rod 52 and then drives the jaw driving mechanism, thereby driving the end effector 130 to open, returning to the state shown in FIG. 6-A .
  • the surgical instrument 100 realizes a complete operation. During this operation, the surgical instrument 100 sequentially realizes the closing of the end effector 130 to clamp the tissue, the cutting knife assembly advances to cut and anastomose the tissue, and the cutting knife assembly retracts. , end execution The actuator 130 is opened to loosen the tissue.
  • the surgical instrument of the present application includes a manual return mechanism.
  • the operator manually operates the manual return mechanism to realize electric power disengagement, drive the jaw assembly to open, or drive the cutting knife assembly to retreat and the jaw assembly to open to realize Forced reset.
  • the manual return mechanism includes a manual operation part 70 operated by a user, a disengagement transmission assembly driven by the manual operation part 70 and a return transmission assembly driven by the manual operation part 70 . Disengage the transmission assembly to disengage between the electric module and the clutch mechanism, and return the transmission assembly to drive the clutch mechanism to realize the opening of the jaw assembly, or to realize the retraction of the cutting knife and the opening of the jaw assembly.
  • the jaw driving mechanism, the connecting rod 52, and the first clutch member 10 can all be driven to move by the anvil 134 of the jaw assembly, that is to say, when the When the nail anvil 134 exerts force, the nail anvil 134 will pivot relative to the nail cartridge seat 133 to close the jaw assembly. At this time, it will drive the jaw driving mechanism, the connecting rod 52, and the first clutch 10 to move without By the pinning of the motor 150.
  • the anvil 134 is urged, for example, when the surgical instrument is taken out of the body cavity through the trocar sleeve, the inner wall of the trocar sleeve exerts force on the anvil 134 to close the jaw assembly. The surgical instrument with the jaw assembly closed can be removed from the body cavity.
  • the disengagement drive assembly and the return drive assembly have a sequence of being driven: first the disengagement drive assembly is driven and then the return drive assembly is driven. Under the condition that the motor 150 is not disengaged from the clutch mechanism, the clutch mechanism, the jaw drive mechanism and jaw assembly selectively driven by the clutch mechanism, the cutting drive mechanism and the cutter assembly are all connected to the motor 150, and the resistance of manual operation It is relatively large, and it is impossible to drive the cutting knife assembly and the jaw assembly through the manual operation part 70. Therefore, the manual return mechanism first disengages the electric module from the clutch mechanism, that is, the disengagement transmission assembly is first driven, and then the return transmission assembly is driven to realize the jaw assembly. The assembly is opened, or the cutting knife is retracted and the jaw assembly is opened, that is, the return transmission assembly is then driven.
  • the clutch mechanism when the clutch mechanism is driven, the clutch mechanism will either drive the movement of the cutting knife assembly or the movement of the jaw assembly, and sequentially drive the cutting knife assembly to execute the retraction action, and then drive the jaw assembly to perform the jaw opening action. Therefore, the return transmission assembly can realize the withdrawal of the cutting knife assembly and the opening of the jaw assembly by driving the clutch mechanism.
  • the return transmission assembly When the cutting knife assembly is not in the initial position, the return transmission assembly first drives the cutting knife assembly to retreat through the clutch mechanism, and then drives the jaw assembly to open to loosen the tissue; when the cutting knife assembly is in the initial position, the return transmission assembly passes through the clutch mechanism The jaw assembly is driven open to loosen tissue. After the jaw assembly is opened to loosen and take out the tissue, further, after the jaw assembly is driven to close, the stapler can be taken out of the body.
  • the surgical instrument has a first state and a second state.
  • the transmission mechanism In the first state, the transmission mechanism is driven by the electric module in response to the power output of the electric module, and in the second state, the electric module is disengaged from the transmission mechanism, and the manual return mechanism is operatively connected with the transmission mechanism to The mechanism drives the transmission mechanism to realize the retraction of the cutting knife assembly and the opening of the jaw assembly, or to realize the opening of the jaw assembly.
  • the user uses the surgical instrument normally, and the electric module drives the transmission mechanism, and then drives the cutting knife assembly and the jaw assembly to perform jaw closing, feeding, retracting, and jaw opening.
  • the user When a power failure occurs in the first state, the user operates the manual operation member 70 to drive and disengage the transmission assembly, and the disengagement of the transmission assembly converts the surgical instrument from the first state to the second state, so that the electric module is disengaged from the transmission mechanism.
  • the user operates the manual operation part 70 to drive back the driving assembly, thereby driving the clutch mechanism to realize the retreat of the cutting knife assembly and the opening of the jaw assembly, or to drive the clutch mechanism to realize the opening of the jaw assembly.
  • the surgical instrument has a first state and a second state: in the first state, the clutch mechanism is driven by the electric module in response to the power output of the electric module, and in the second state, the electric module is disengaged from the clutch mechanism and returns manually
  • the mechanism is operably connected with the clutch mechanism, so as to respond to the driving of the clutch mechanism by the manual return mechanism to realize the retraction of the cutting knife assembly and the opening of the jaw assembly, or to realize the opening of the jaw assembly.
  • the disengagement of the electric module from the clutch mechanism includes the following situation: the motor 150 is disengaged from the input member of the switching mechanism.
  • the motor 150 of the electric module In the first state, the motor 150 of the electric module is connected to the input member, and in response to the power output of the motor 150, the input member is driven, and thus the clutch mechanism is driven.
  • the motor 150 In the second state, the motor 150 is separated from the input member, so that the motor 150 cannot be connected to the clutch mechanism through the input member, so that the movement of the clutch mechanism is no longer restricted by the motor 150, which is a kind of separation between the electric module and the clutch mechanism situation.
  • disengagement of the electric module from the clutch mechanism can be replaced by: the input member of the switching mechanism of the transmission mechanism is separated from the clutch mechanism, so that the movement of the clutch mechanism is no longer restricted by the electric module. I won't repeat them here.
  • there is one manual operating member 70 which can move along the first direction, and the manual operating member 70 moves along the first direction to switch the surgical instrument from the first state to the second state, and at the second In the second state, the manual operation part 70 moves in the first direction to drive the clutch mechanism to alternatively drive the cutting knife assembly to move to execute the retracting action or drive the jaw assembly to move to perform the opening action.
  • the manual operation part 70 moves in the first direction, and the jaw assembly can be driven to perform the opening action through the clutch mechanism, or the cutting knife assembly can be driven to perform the retracting action through the clutch mechanism, and then the jaw assembly can be driven to perform Open action.
  • first drive disengagement The transmission assembly disengages the electric power (that is, the electric module is separated from the clutch mechanism), and then drives the clutch mechanism.
  • the clutch mechanism When the clutch mechanism is driven, it first drives the cutting knife assembly to perform the knife retraction work, and then drives the jaw assembly to perform the opening action.
  • a manual The operating part 70 can not only sequentially realize the three functions of disengagement by electric power, withdrawal of the cutter assembly and opening of the jaw assembly, that is, three functions in one piece, but also sequentially realize disengagement by electric power and opening of the jaw assembly, that is, two functions in one piece. This function realizes the forced reset of surgical instruments that have a power failure under any circumstances that require manual return of the knife and opening of the jaws. The user only needs to operate one operating part, which is easy to operate and easy to use.
  • the following preferably takes a power failure during the cutting process as an example to describe the operation process of the manual return mechanism in detail.
  • the manual return mechanism is used.
  • the difference in the operation process of the clutch mechanism is that the cutting knife assembly is first driven to retract and then the jaw assembly is driven to open, or the jaw assembly is driven to open.
  • the one manual operating part 70 when the one manual operating part 70 moves along the first direction, it sequentially drives the disengagement transmission assembly and the return transmission assembly: first, the manual operation part 70 moves along the first direction to drive the disengagement transmission assembly, so that the surgical instrument moves from the first The state is switched to the second state and maintained in the second state; then, the manual operation member 70 continues to move in the first direction, thereby connecting and driving the return transmission assembly. That is to say, the disengagement transmission assembly and the return transmission assembly are successively driven by the same manual operation part 70, and the disengagement transmission assembly is driven first, and then the return transmission assembly is driven. After the manual operation part 70 moves to the end point along the first direction, it moves back to the starting point along the second direction opposite to the first direction.
  • the manual operation part 70 is operatively connected to the return transmission mechanism, including the connection between the manual operation part 70 and the return transmission mechanism, and the separation of the manual operation part 70 from the return transmission mechanism.
  • the manual operation part 70 is a wrench, and the wrench set is set on the support shaft 71 (first rotating shaft), which can rotate around the central axis of the support shaft 71 along the first direction and the second direction, and the first direction is opposite to the second direction. .
  • the input member in the transmission relationship, is located between the electric module and the clutch mechanism.
  • the input member is selectively movable between a first position and a second position.
  • the electric module When the input part is in the first position, the electric module is connected to the clutch mechanism through the input part. At this time, the surgical instrument is in the first state.
  • the input part In response to the power output of the electric module, the input part is driven by the electric module, and then the clutch mechanism is driven by the input part.
  • the input member is at the second position, the input member is disengaged from the electric module, so that the electric module is disengaged from the clutch mechanism, and the surgical instrument is in the second state at this moment.
  • the electric module does not constrain the actions of the clutch mechanism, the driving mechanism, and the driven object (including the cutting knife assembly and the jaw assembly).
  • the manual operation part 70 moves along the first direction, and can drive the input part to move from the first position to the second position, so that the surgical instrument 100 is converted from the first state to the second state.
  • the input member when the input member is in the second position, the input member may also be disengaged from the clutch mechanism, and the surgical instrument is in the second state at this time.
  • the input member is the main drive gear 2, and the electric module transmits electric power to the clutch mechanism through the input member.
  • the main drive gear 2 is axially slidably sleeved on the pin shaft 4, and the main drive gear 2 can move along the pin shaft 4 Sliding from the first position to the second position, and the bottom of the main drive gear 2 is provided with an elastic member 5 for maintaining it in the first position, so as to ensure the effectiveness of transmitting electric power to the clutch mechanism in the first state and stability.
  • Fig. 3 Fig. 7 and Fig.
  • the main drive gear 2 is a duplex gear, including an upper gear 6 and a lower gear 7 that rotate synchronously, and a recess is formed between the upper gear 6 and the lower gear 7 8.
  • the diameter of the concave portion 8 is smaller than the upper gear 6 and smaller than the lower gear 7.
  • the concave portion 8 transmits the driving force of the motor received by the lower gear 7 to the upper gear 6 so that the lower gear 7 and the upper gear 6 rotate synchronously, and the concave portion 8 provides accommodation.
  • the main drive gear 2 is in the first position, the upper gear 6 meshes with the intermediate piece 40 of the clutch mechanism and selectively cooperates with the first clutch member 10 of the clutch mechanism (including matching and coupling), and the lower gear 7 and the output gear of the motor 150 152 meshes.
  • the main drive gear 2 is in the second position, the elastic member 5 is compressed, the lower gear 7 disengages from the output gear 152 of the motor 150 and no longer meshes, so that the motor 150 disengages from the clutch mechanism.
  • the upper gear 6 is disengaged from the intermediate member 40 of the clutch mechanism and the first clutch member 10, so that the main drive gear 2 is disengaged from the clutch mechanism, that is, the input
  • the part is disengaged from the clutch mechanism, so that the motor 150 is disengaged from the clutch mechanism.
  • the elastic member 5 is preferably a spring, which is sheathed on the pin shaft 4, one end of the spring is connected with the bottom of the main driving gear 2, and the other end is connected with the frame of the surgical instrument.
  • the upper gear 6 is disengaged from the first clutch member 10 of the clutch mechanism, which means that the upper gear 6 cannot cooperate with the first clutch member 10 .
  • the manual operation part 70 drives the disengagement transmission assembly and then drives the input part to move from the first position to the second position, so as to realize the disengagement of the electric module from the clutch mechanism.
  • One end of the manual operation member 70 is connected to the disengagement transmission assembly and drives the disengagement transmission assembly to move, and the disengagement transmission assembly further drives the input member to move.
  • the movement of the manual operation member 70 in the first direction is specifically to rotate around the central axis of the support shaft 71 (the first rotating shaft) along the first direction, and the movement of the input member between the first position and the second position is a linear movement.
  • the transmission assembly converts the rotation of the manual operation part 70 along the first direction into the linear motion of the input part from the first position to the second position, and the direction of the linear motion of the input part is parallel to the central axis of the first rotating shaft.
  • the main drive gear 2 moves linearly up and down along the pin shaft 4 .
  • the disengagement transmission assembly includes a second rotating shaft 81 , an actuating member 80 sleeved on the second rotating shaft 81 , and a driven member 90 driven by the actuating member 80 .
  • the actuator 80 can rotate around the central axis of the second rotating shaft 81 .
  • Rotating the manual operation member 70 along the first direction around the central axis of the first rotating shaft can drive the actuator 80 to make a first movement around the central axis of the second rotating shaft 81 .
  • the driving member 80 makes the first movement to drive the driven member 90 to make the second movement.
  • the follower 90 includes an output end 92. When the follower 90 makes a second movement, the output end 92 has a displacement in the linear motion direction of the input member. The output end 92 abuts and drives the input member to move from the first position to second position.
  • the first rotation axis is parallel to the second rotation axis 81 .
  • the power disengagement operating part of the forced reset device includes a wrench and a cam that rotates coaxially with the wrench.
  • the cam surface of the cam abuts against the gear connected to the motor and drives the above-mentioned gear to move.
  • the axis is vertical, the movement direction of the wrench is roughly the same as that of the gear, and the wrench and the gear are arranged sequentially in a certain direction (such as the up and down direction), resulting in a large size of the stapler in this direction, which is not conducive to the miniaturization of the stapler design.
  • the cam and the gear are arranged in contact with each other in this direction, which further causes the size of the stapler to become larger in this direction, which is not conducive to the miniaturization design of the stapler.
  • the solution adopted in this embodiment is that the movement direction of the input member is parallel to the first rotating shaft 71 , and the movement direction of the manual operation member 70 is perpendicular to the movement direction of the input member.
  • the manual operation part 70 rotates in the horizontal direction, and the input part moves linearly in the up and down direction.
  • the movement direction of the manual operation part 70 is perpendicular to the movement direction of the input part, so as to minimize the superposition of the two dimensions and the movement space along the vertical direction, which is beneficial to the rational use of the overall space of the surgical instrument and the miniaturization design.
  • the manual operating part 70 is accommodated in the head housing 112, and can protrude from the head housing 112 for the operator to operate when manually retracting the knife and opening the jaws.
  • the head housing 112 is "upper”
  • the handle housing 114 is “lower”
  • the jaw assembly is "front”
  • the main body 110 is "rear”.
  • the first rotating shaft 71 and the second rotating shaft 81 are parallel but not coaxial.
  • the manual operation member 70 includes a driving surface 74 extending substantially along the radial direction of the first rotating shaft 71 and has a certain length.
  • the actuator 80 includes a sliding end 88 , and the sliding end 88 abuts against the driving surface 74 movably.
  • the manual operation part 70 rotates along the first direction, and the driving surface 74 rotates along the first direction accordingly, and the driving surface 74 pushes the sliding end 88 abutting against it to rotate along the central axis of the second rotating shaft 81 along the first direction, and at the same time, the sliding end 88 slides on the driving surface 74 substantially along the radial direction of the first rotating shaft 71, and slides from the starting end to the ending end.
  • the actuator 80 is provided with a motion conversion mechanism, which converts the first motion of the actuator 80 into the second motion of the driven member 90 .
  • the motion conversion mechanism includes a helical surface 84 provided on the outer peripheral side of the actuator 80 .
  • the spiral surface 84 refers to a surface that surrounds the outer peripheral side of the actuator 80 and spirals upward in the upward direction.
  • the follower 90 includes a rod that rotates around a pin, and the second movement of the follower 90 is the rotation of the rod.
  • the disengagement transmission assembly further includes an intermediate transmission member 94 through which the actuating member 80 is connected and drives the driven member 90 to perform a second movement.
  • the frame of the surgical instrument is provided with a guide groove for guiding the linear movement of the intermediate transmission member 94 , and the linear movement direction of the intermediate transmission member 94 is parallel to the first rotating shaft 71 and the second rotating shaft 81 , or may not be parallel.
  • the first end of the intermediate transmission member 94 abuts against the helical surface 84
  • the second end abuts against the first end of the rod
  • the second end 92 of the rod is located in the recess 8 of the main drive gear 2 and can abut against the top of the lower gear 7 . end face and push it to move downward, so as to realize the movement of the input member from the first position to the second position.
  • the driving process of disengaging the transmission assembly when the actuator 80 performs the first movement, such as rotating in the first direction, the helical surface 84 rotates accordingly, so that the first end of the intermediate transmission member 94 slides relatively on the helical surface 84, The helical surface 84 drives the first end of the intermediate transmission member 94 to lift, so that the intermediate transmission member 94 moves upwards in a straight line, and then the second end of the intermediate transmission member 94 pushes the first end of the rod to move upwards.
  • the upward movement of the first end causes the lever to perform a second movement, such as a rotation, and the output end 92 (second end) of the lever is depressed due to the second movement of the lever, thereby pushing the input member abutted by it from
  • the elastic member 5 is compressed.
  • the output end 92 of the rod has a displacement in the direction of the linear motion of the input member during rotation.
  • the actuator 80 is a cylindrical cam, and the cylindrical cam includes an axially protruding protruding post, and the protruding post is a sliding end 88 .
  • the driving surface 74 abuts the protruding post and pushes the protruding post to also rotate in the first direction, so that the cylindrical cam also rotates in the first direction, and during the rotation, The raised post slides relative to the drive surface 74 from the start end to the end end of the drive surface 74 .
  • the actuator 80 may also be a square column cam, and the shape of the actuator 80 does not limit the protection scope of the present application.
  • the actuator 80 also includes a start point abutment surface 82 and an end point abutment surface 86, the start point abutment surface 82 is adjacent to the proximal end of the helical surface 84 and is arranged at an angle, and the end point abutment surface 86 is adjacent to the distal end of the helical surface 84 and is arranged at an angle. Angled settings. In other words, the starting point abutting surface 82 is adjacent to the lower end of the helical surface 84 and arranged at an angle, and the end point abutting surface 86 is adjacent to the upper end of the helical surface 84 and is arranged at an angle.
  • the proximal end refers to the end where the first end of the helical surface 84 and the intermediate transmission member 94 abuts first
  • the distal end refers to the end where the helical surface 84 and the first end of the intermediate transmission member 94 end to abut.
  • the interval is the stroke during which the helical surface abuts against the first end of the intermediate transmission member 94 .
  • the angle between the starting point contact surface 82 and the spiral surface 84 (also referred to as included angle) refers to the angle between the starting point contact surface 82 and the part of the spiral surface 84 closest to the starting point contact surface 82 .
  • the definition of the included angle between the contact surface 86 at the end point and the helical surface 84 is similar and will not be repeated here.
  • the angle between the abutting surface 82 at the starting point and the helical surface 84 is an obtuse angle
  • the angle between the abutting surface 86 at the end point and the helical surface 84 is a reflex angle (greater than 180 degrees and less than 270 degrees).
  • Both the contact surface 86 at the end point and the spiral surface 84 and the contact surface 82 at the start point and the spiral surface 84 can be smoothly connected.
  • the starting point contact surface 82 is perpendicular to the central axis of the actuator 80
  • the end point contact surface 86 is perpendicular to the central axis of the actuator 80 .
  • the starting point abutting surface 82 is perpendicular to the central axis of the actuator 80 (also the central axis of the second rotating shaft 81 ), and the starting point abutting surface 82 is also perpendicular to the vertical linear motion direction of the intermediate transmission member 94 .
  • the starting point abutting surface 82 provides a stable initial starting position for the first end of the intermediate transmission member 94, keeps the electric module and the clutch mechanism in a combined state, and the surgical instrument is in the first state.
  • the terminal abutting surface 86 is perpendicular to the central axis of the actuator 80 (the central axis of the second rotating shaft 81 ), and the terminal abutting surface 86 is also perpendicular to the up-and-down linear motion direction of the intermediate transmission member 94 .
  • the terminal contact surface 86 is used to lock the input member in the second position after the electric module is disengaged from the clutch mechanism, that is, to keep the electric module and the clutch mechanism in the disengaged state, and the surgical instrument is in the second state.
  • FIGS. 10-B to 12B show the state changes of the disengagement transmission assembly when the input member moves from the first position to the second position.
  • the elastic member 5 is not compressed, the input member is at the first position, and the first end of the intermediate transmission member 94 abuts against the starting point abutting surface 82 .
  • the user operates the manual operation part 70 to rotate in the first direction, the actuating part 80 is driven to rotate, and the first end of the intermediate transmission part 94 slides from the abutting surface 82 of the starting point to the spiral surface.
  • the first end of the intermediate transmission member 94 is held by the helical surface 84 Drive to move upwards in a straight line, so that the intermediate transmission member 94 moves upwards, and the second end of the intermediate transmission member 94 also moves upwards in a straight line, driving the first end of the driven member 90 to move upwards, so that the driven member 90 winds around the pin
  • the output end 92 (second end) of the driven member 90 is pressed down, driving the input member abutting against the output end 92 to move downward, and the elastic member 5 is compressed, as shown in FIG. 11-B .
  • the intermediate transmission member 94 After the intermediate transmission member 94 reaches the end abutment surface 86, it is held on the end abutment surface 86, and the input member also reaches the second position and is held in the second position, and the elastic member 5 is further compressed, as shown in Fig. 12- Shown in B.
  • the user operates the manual operation part 70 to rotate in the second direction, the driving surface 74 disengages and moves away from the protruding column, the actuating part 80 does not rotate, and the first end of the intermediate transmission part 94 remains on the terminal abutting surface 86, The input member is thus locked in the second position, maintaining the position shown in Figure 12-B.
  • the wrench is operated to move in the first direction, the actuating member 80 remains stationary, and the abutting surface 86 at the end point continues to lock the input member at the second position, maintaining the position shown in FIG. 12-B .
  • the sliding of the first end of the intermediate transmission member 94 on the helical surface 84 is relative sliding.
  • the present application provides a power disengagement device for the surgical instrument 100 to realize the power disengagement of the electric module and the transmission mechanism.
  • the surgical instrument also includes an electric module, a transmission mechanism, a jaw assembly and a cutting knife assembly.
  • the transmission mechanism includes an input piece, a clutch mechanism, a jaw drive mechanism and a cutting drive mechanism.
  • the jaw drive mechanism and the jaw The components are connected, the cutting drive mechanism is connected with the cutter assembly, the electric module drives the jaw drive mechanism and the cutting drive mechanism alternatively through the input piece and the clutch mechanism, and the jaw drive mechanism is driven to realize the opening and closing of the jaw assembly.
  • the cutting drive mechanism is driven to realize the feeding and retracting of the cutting knife assembly.
  • the electric module is detachably connected with the clutch mechanism through the input piece.
  • the input member can selectively move between the first position and the second position, and the manual operation member 70 drives the input member to move from the first position to the second position by disengaging the transmission assembly, thereby converting the surgical instrument from the first state to the second position.
  • Two states When the input part is at the first position, the electric module is connected to the clutch mechanism through the input part; when the input part is at the second position, the input part is separated from the electric module, or the input part is separated from the clutch mechanism.
  • the power disengagement device includes a manual operation part 70 and a disengagement transmission assembly.
  • the manual operation part 70 can rotate along the first direction, and the movement of the input part between the first position and the second position is linear motion.
  • the transmission mechanism also includes an output member, and the electric module drives the output member alternatively through the input member and the clutch mechanism to drive the jaw drive mechanism and the cutting drive mechanism.
  • the output member includes a first output member and a second output member, and the electric module drives the first output member and the second output member alternatively through the input member and the clutch mechanism, and the first output member is connected with the jaw drive mechanism, The second output member is connected to the cutting drive mechanism.
  • the manual operation member 70 is connected to the clutch mechanism through the return transmission assembly so as to drive the clutch mechanism.
  • the return drive assembly includes pawl 200 and ratchet 232 .
  • the ratchet 200 is operably connected with the manual operating member 70, so that under the drive of the manual operating member 70, the ratchet 200 drives the ratchet wheel 232 to rotate in steps in a single direction, that is, the manual operating member 70 drives the ratchet 200 to move, and then The ratchet 232 is driven to rotate.
  • the ratchet 232 is connected with the clutch mechanism. Therefore, in the second state, the manual operation part 70 moves along the first direction to drive the pawl 200 to rotate, and the pawl 200 drives the ratchet wheel 232 rotates to drive the clutch mechanism.
  • the driving method of the pawl 200 and the ratchet wheel 232 is a conventional technical means in the mechanical field, and will not be repeated here.
  • the clutch mechanism includes an intermediate piece 40 , a second clutch piece 20 , and a first gear 10 .
  • the middle piece 40 is the third gear.
  • the intermediate piece 40 includes a first clutch structure
  • the first gear 10 includes a second clutch structure.
  • the first clutch structure cooperates or is coupled with the second clutch structure to selectively drive the first output member, thereby realizing selective driving of the jaw driving mechanism, and further realizing selective driving of the jaw assembly.
  • the first clutch structure and the second clutch structure are used to be driven by the manual operation member 70 so that the jaw assembly selectively performs an opening action, and the jaw assembly selectively performs an opening action refers to that the jaw performs an opening action or the jaw does not perform an opening action action (keep closed).
  • the intermediate piece 40 in the second state, is connected with the manual operation piece 70 through the return transmission assembly to obtain power input.
  • the intermediate piece 40 selectively cooperates with the first gear 10 , so that the intermediate piece 40 selectively drives the first output piece through the first gear 10 , thereby realizing the selective driving of the jaw driving mechanism.
  • the first clutch structure is an arc track and the head end
  • the second clutch structure is a protrusion
  • the arc groove includes the arc track and the head end
  • the first clutch structure is coupled with the second clutch structure when the protrusion is accommodated in the arc track , when the protrusion abuts against the head end, the first clutch structure cooperates with the second clutch structure.
  • the first clutch structure is a protrusion
  • the second clutch structure is an arc track and a head end.
  • the first clutch structure is coupled with the second clutch structure, the first output member is not driven, and the jaw driving mechanism is not driven, and the jaw assembly remains closed; when the first clutch structure cooperates with the second clutch structure, The first output member is driven, and then the jaw driving mechanism is driven, and the jaw assembly is opened, thereby realizing that under the driving of the manual operation member 70, the first output member is selectively driven, and then the jaw driving mechanism is selectively driven.
  • the clutch mechanism alternately drives the first output member and the second output member through the first clutch member 10 and the second clutch member 20, and the first clutch member 10 drives the jaw drive mechanism , the second clutch 20 does not drive the cutting drive mechanism, and when the second clutch 20 drives the cutting drive mechanism, the first clutch 10 does not drive the jaw drive mechanism, that is, the electric module alternatively drives the first effective stroke structure and The second effective transfer structure.
  • the clutch mechanism can alternatively drive the first output member and the second output member through the second clutch member 20, the first clutch structure and the second clutch structure, and the first clutch structure and the second clutch structure cooperate
  • the second clutch 20 does not drive the cutting drive assembly
  • the second clutch 20 drives the cutting drive assembly
  • the first clutch structure and the second clutch structure are coupled and do not drive the jaw assembly, that is, manual operation
  • One of the third effective rotation configuration and the second effective rotation configuration is driven when the member moves in the first direction.
  • the clutch mechanism alternatively drives the first output member and the second output member.
  • the first clutch structure and the second clutch structure cooperates to drive the first output member
  • the second idling structure 24 of the second clutch member 20 is coupled with the second output member, at this moment, the clutch mechanism drives the first output member but does not drive the second output member;
  • the first clutch structure and the second clutch structure are coupled so as not to drive the first output member
  • the second effective rotation structure 22 of the second clutch member 20 cooperates with the second output member, and now the clutch mechanism drives the second output member But the first output is not driven.
  • the first output member and the second output member are alternatively driven, so that the jaw drive mechanism and the cutting drive mechanism are alternatively driven, and then the jaw assembly and the cutting knife assembly are alternatively driven.
  • the middle piece 40 includes an arc groove 62 disposed on the first end surface of the middle piece 40 .
  • the arc groove 62 includes a head end 66 and an arc track 67 excluding the head end 66 , the head end 66 is the third effective stroke structure 32 , and the arc track 67 is the third idle stroke structure 34 .
  • the protrusion 64 of the first gear can slide in the arc groove 62, and the second end surface of the first gear is rotatably connected to the first output member. The first end of the protrusion 64 and the arc groove 62 is converted from non-abutting to abutting so that the first clutch structure and the second clutch structure are switched from a coupling state to a mating state.
  • the coupling state is that the protrusion 64 is located in the arc track 67
  • the mating state is that the protrusion 64 is located at the head end 66 and abuts against the head end 66 .
  • the arc groove 62 is disposed on the first gear 10
  • the protrusion is disposed on the middle piece 40 .
  • the first clutch structure and the second clutch structure can not only realize the above-mentioned functions in the second state, but also in the first state, the input member of the surgical instrument can Coupling with the first idling stroke structure 14 is converted into an input member cooperating with the first effective stroke structure 12 to realize the switching of the first clutch member 10 from non-driving to driving state for the first output member.
  • the gear 10 can also selectively drive the first output member, the principle is the same, the technical means and effects are the same, and will not be repeated here.
  • the return transmission assembly further includes a return gear 234 , the return gear 234 and the ratchet 232 integrally form the ratchet gear 230 , and the return gear 234 and the ratchet 232 rotate coaxially.
  • the return gear 234 is engaged with the intermediate piece 40 .
  • the ratchet 232 drives the first gear to rotate through the intermediate piece 40, thereby realizing the opening of the jaw assembly.
  • FIGS. 6-A to 6-D are schematic diagrams of states in which the electric module of the surgical instrument 100 alternatively drives the first output member and the second output member through the clutch mechanism in the first state.
  • the electric module and the clutch mechanism In the connected state the following content illustrates how the manual return mechanism implements the retraction of the cutting knife assembly and the opening of the jaw assembly in Figures 6-A to 6-D except for the connection between the main drive gear 2 and the clutch mechanism.
  • the electric module must first be disengaged from the clutch mechanism, that is, the electric power is disengaged.
  • the arc groove 62 is provided on the intermediate member 40, and the protrusion 64 is provided on the first gear 10.
  • the arc groove 62 is provided on the first gear 10.
  • the protrusion 64 is disposed on the middle piece 40 .
  • the cutting knife assembly is at the end position, and the tissue has been cut and anastomosed.
  • the protrusion 64 is located at the end of the arc track 67 and not at the head end 66, and the first clutch structure is coupled with the second clutch structure.
  • the operator operates the manual operation part 70, as shown in Figures 10-A to 11-B, so that the clutch mechanism is disengaged from the motor 150 and connected to the return transmission assembly to reach the state of Figure 12-A.
  • the ratchet 200 of the return transmission assembly is combined with the ratchet gear 230, and the movement of the ratchet makes the ratchet gear 230 rotate to drive the intermediate piece 40 to rotate reversely (clockwise in FIG.
  • Figure 6-D shows the intermediate piece 40 passes through the first
  • the two clutches 20 drive the cutting knife assembly to retreat, so that the cutting knife assembly returns from the end position to the initial position.
  • Figure 6-D shows the tool retraction from the end position, in fact, the process of retracting the tool from the middle position is similar.
  • the ratchet gear 230 cannot drive the movement of the jaw assembly through the head end 66 of the arc groove 62, but the ratchet gear 230 can drive the intermediate piece 40 and the second clutch 20 reverse rotation, and then drive the cutting drive gear 54 reverse rotation through the second effective rotation structure 22 of the second clutch 20, and the reverse rotation driving protrusion 64 of the intermediate member 40 is in the arc groove 62 toward the head end 66 Relatively moving, when the protrusion 64 abuts against the head end 66 of the arc groove 62, the intermediate piece 40 drives the first gear 10 through the matching first clutch structure and the second clutch structure to reach the position shown in Fig. 6-B .
  • the relative movement includes: the protrusion 64 does not move, and the intermediate piece 40 drives the arc groove 62 to rotate in reverse, so that the arc groove 62 and the protrusion accommodated in the arc groove 62 move relative to each other until the protrusion 64 abuts against the head end 66 .
  • the surgical instrument 100 implements an operation of forcibly withdrawing the knife and forcibly opening the jaws.
  • the surgical instrument 100 sequentially implements the retraction of the cutting knife assembly and the opening of the jaw assembly to loosen the clamped tissue.
  • the manual return mechanism can realize the electric power disengagement, the cutting knife assembly retracts and the jaw assembly opens. Specifically, the manual operation part is driven to disengage the transmission assembly to realize the disengagement of the electric module from the clutch mechanism. Then, the manual operation part is driven to return to the transmission assembly, and then the cutting knife assembly is driven back through the clutch mechanism. Then, the manual operation part is driven to return to the transmission assembly and then passed The clutch mechanism drives the jaw assembly to open.
  • the manual return mechanism can realize the electric power disengagement and the opening of the jaw assembly.
  • the manual operation part is driven to disengage the transmission assembly to realize the disengagement of the electric module from the clutch mechanism, and then the manual operation part is driven back to the transmission assembly to drive the jaw assembly to open through the clutch mechanism.
  • the ratchet 200 and the ratchet 232 are limited.
  • the rotation of the ratchet gear 230 is prevented to interfere with the normal operation of the clutch mechanism.
  • the movement of the clutch mechanism is restrained by the electric module because it is not completely disengaged, so that the clutch mechanism cannot be driven by the cooperation of the ratchet 200 and the ratchet wheel 232.
  • the motor 150 is disengaged from the clutch mechanism, it is matched
  • the ratchet 200 will not contact the ratchet 232 until the switch is switched from the first state to the second state.
  • the return transmission assembly further includes a pawl limiter 210 to prevent the pawl 200 from contacting and mating with the ratchet wheel 232 accidentally.
  • the pawl 200 is supported by the pawl limiter 210 to limit the position, so that the pawl 200 does not contact the ratchet wheel 232 .
  • the pawl 200 slides along the surface of the pawl limiter 210 , and when the motor 150 is disengaged from the clutch mechanism, the pawl 200 disengages from the pawl limiter 210 , and contact and cooperate with the ratchet 232, so that the ratchet 200 drives the ratchet 232 to move in one direction by reciprocating the manual operation part 70, so that the clutch mechanism drives the cutter assembly to retreat and the jaw assembly to open.
  • the pawl limiter 210 is disposed on the frame, and the pawl 200 includes a restricted portion 202 .
  • the restricted portion 202 abuts against the pawl limiting member 210 and slides, so that the ratchet 200 slides along the pawl limiting member 210 .
  • the pawl limiter 210 is a cylinder extending from the frame
  • the restricted portion 202 is a structure protruding from one side of the main body of the ratchet 200
  • the restricted portion 202 abuts against the pawl to limit the position.
  • 210 and slide along the pawl limiter 210 so that the pawl limiter 210 limits the contact and cooperation between the ratchet 200 and the ratchet 232 .
  • One end of the ratchet 200 is rotatably connected to the manual operation member 70 , and the other end is operatively engaged with the ratchet 232 .
  • a gap is formed between the end of the restricted portion 202 near the other end of the ratchet 200 and the main body of the ratchet 200 , and as the ratchet 200 slides, the ratchet limiter 210 slides out from the gap, and the ratchet 200 The restricted portion 202 is disengaged, so that the ratchet 200 is no longer constrained.
  • the manual operation member 70 drives the ratchet 200 to move in a small range, so that the ratchet limiting member 210 will not constrain the ratchet 200 again.
  • the pawl 200 is accommodated in the U-shaped groove formed by the main body of the manual operation part 70 , and the pawl 200 is substantially parallel to the manual operation part 70 . It can be seen that, by cooperating with the limited portion 202 of the ratchet 200, the pawl limiter 210 realizes the restriction in a stroke of the ratchet 200 from its initial position, preventing the ratchet 200 from moving in the above-mentioned stroke. Accidental engagement with ratchet 232 .
  • the pawl limiter 210 is a depression formed on the frame, the above-mentioned depression extends along the movement direction of the restricted part 202 to have a certain length, and is limited during a stroke of the pawl 200 from its initial position.
  • the portion 202 abuts against the bottom of the above-mentioned recess and slides along the bottom, which can also prevent the ratchet 200 from accidentally contacting the ratchet wheel 232 during the above-mentioned stroke.
  • the manual operation member 70 is rotatably disposed on the frame through a first support shaft 71 (first rotating shaft), and rotates around the first support shaft 71 in a first direction and a second direction under the action of an external force.
  • the pawl 200 is rotatably disposed on the manual operation member 70 via the second support shaft 204 .
  • the return transmission assembly also includes a biasing member 205, which is used to make the ratchet 200 move toward the ratchet 232 and contact the ratchet 232 after detaching from the ratchet limiter 210, and bias the ratchet 200 to the ratchet 232 when in contact so that the ratchet 200 Cooperate with the ratchet 232 to prevent the ratchet 200 from jumping teeth or disengaging from the ratchet 232 .
  • a biasing member 205 which is used to make the ratchet 200 move toward the ratchet 232 and contact the ratchet 232 after detaching from the ratchet limiter 210, and bias the ratchet 200 to the ratchet 232 when in contact so that the ratchet 200 Cooperate with the ratchet 232 to prevent the ratchet 200 from jumping teeth or disengaging from the ratchet 232 .
  • Operating the manual operation part 70 drives the ratchet 200 to drive the ratchet 232 to move.
  • the manual operation part 70 is operated to move along the first direction to drive the ratchet 200.
  • the ratchet 200 is driven by cooperating with one of the tooth grooves of the ratchet 232
  • the ratchet 232 moves, and continues to operate the manual operation part 70 to drive the ratchet 200 along the slope of the above-mentioned tooth groove to move out of the tooth groove (in this process, the ratchet 200 and the manual operation part 70 are close to each other) and enter into the tooth groove along the second direction.
  • the adjacent next tooth groove further drives the ratchet wheel 232 to continue to move, and so on until the cutting knife assembly returns to the initial position.
  • the driving method of the pawl 200 and the ratchet wheel 232 is a conventional technical means in the mechanical field, and will not be repeated here.
  • the biasing member is a torsion spring 205.
  • the torsion spring 205 includes a helical part 206 and a first torsion spring arm 207 and a second torsion spring arm 208 connected to both sides of the helical part 206.
  • the helical part 206 is sleeved on The second support shaft 204 , the first torsion spring arm 207 abuts against the inner wall of the manual operation member 70 , and the second torsion spring arm 208 abuts against the wing 209 extending from the side of the ratchet 200 .
  • the surgical instrument further includes a cover plate 116 .
  • the cover plate 116 is detachably connected to the head housing 112, for example, through a buckle connection.
  • the cover plate 116 In the first state, the cover plate 116 is connected to the head housing 112 , and the inner surface of the cover plate 116 abuts against the manual operation part 70 to keep the manual operation part 70 at its initial position.
  • the cover plate 116 hides the manual operation part 70 to avoid misoperation thereof.
  • the cover plate 116 is removed, and the manual operation part 70 is exposed from the position where the cover plate 116 is located, and can be operated.
  • the motor in the first state, the motor is connected to the clutch mechanism through the input piece, and the manual operation piece is disengaged from the clutch mechanism.
  • the input piece is in the first position, and the input piece is connected to the intermediate piece 40 of the clutch mechanism.
  • the member selectively cooperates with the first clutch member of the clutch mechanism, and the ratchet 200 of the return transmission assembly is disengaged from the ratchet wheel 232 .
  • the motor in the second state, the motor is disengaged from the clutch mechanism, and the manual operation part is connected to the clutch mechanism.
  • the input part is in the second position, and the pawl 232 is driven by the manual operation part 70 to intermittently connect the ratchet wheel 200 to drive the ratchet wheel 200
  • the manual operation member 70 is connected with the intermediate member 40 of the clutch mechanism through the pawl 200 , the ratchet wheel 232 , and the return gear 234 .
  • one of the motor 150 and the manual operation member 70 is connected to the clutch mechanism, and the other is disengaged from the clutch mechanism, so that the power of the motor 150 and the manual operation member 70 will not interfere with each other.
  • the electric stapler is in the first state. After the manual operation part 70 is operated, the manual operation part 70 drives the disengagement transmission assembly to move, and the input part leaves the first position until it reaches the second position. The instrument transitions from the first state to the second state.
  • the present application also provides a second embodiment.
  • the difference between the second embodiment and the first embodiment is that the disengagement transmission assembly does not include the intermediate transmission member 94 and the guide groove on the frame, and one end of the rod directly abuts against the helical surface 84 .
  • the disengagement transmission assembly of the second embodiment is simpler and can achieve the same function.
  • the driving process of disengaging the transmission assembly Referring to Figure 13, when the actuator 80 is driven by the manual operation member 70 to make the first movement, that is, to rotate in the first direction, the first end of the rod slides relatively on the helical surface 84, and the helical The surface 84 drives the first end of the rod to move upward, so that the rod does the second movement, that is, to rotate, and the output end 92 (the second end) of the rod is pressed down due to the rotation, and then abuts and pushes the input member from the first position to the second position, the elastic member 5 is compressed.
  • the one-piece three-function and one-piece two-function technical solutions in this application can be applied to other surgical instruments with jaw assembly, jaw drive mechanism, cutting knife assembly, cutting drive mechanism, clutch mechanism, and are not limited to Electric stapler.
  • one manual operation part can sequentially realize the power disengagement, the cutting knife assembly retracting and the opening of the jaw assembly, that is, one piece can realize three functions, It can also sequentially realize the power disengagement and the opening of the jaw assembly, that is, two functions in one piece, and realize the forced reset of the surgical instrument that has a power failure.
  • the operation is simple, the experience is good, and the product structure design is simple.

Abstract

L'invention concerne un instrument chirurgical comprenant : un module électrique ; un mécanisme d'embrayage entraîné par le module électrique, le mécanisme d'embrayage entraînant alternativement le mouvement d'un ensemble mâchoire et le mouvement d'un ensemble de coupe, et l'instrument chirurgical ayant un premier état et un second état ; dans le premier état, le module électrique est relié au mécanisme d'embrayage et, dans le second état, le module électrique est libéré du mécanisme d'embrayage ; et un mécanisme de retour manuel, comprenant un élément d'actionnement manuel (70) pouvant se déplacer dans une première direction ; le mouvement de l'élément d'actionnement manuel (70) dans la première direction amène l'instrument chirurgical à passer du premier état au second état et, dans le second état, le mouvement de l'élément d'actionnement manuel (70) dans la première direction entraîne le mécanisme d'embrayage à entraîner en alternance l'ensemble dispositif de coupe pour exécuter une action de rétraction et entraîner l'ensemble mâchoire à exécuter une action d'ouverture. Au moyen d'un élément d'actionnement manuel (70), le présent instrument chirurgical peut mettre en oeuvre une réinitialisation forcée dans tous les cas de défaillance d'alimentation, et le fonctionnement est simple.
PCT/CN2023/072932 2022-01-25 2023-01-18 Instrument chirurgical WO2023143313A1 (fr)

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CN202210086078.4 2022-01-25

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CN117694952B (zh) * 2024-02-01 2024-04-16 以诺康医疗科技（苏州）有限公司 紧急切换装置、电动吻合器及医疗设备

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JP2019515714A (ja) * 2016-04-01 2019-06-13 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 組織の選択的切断を提供するように構成されている外科用ステープル留めシステム
CN110868941A (zh) * 2017-06-28 2020-03-06 爱惜康有限责任公司 包括可选择性致动的可旋转联接器的外科器械
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CA2535142A1 (fr) * 2005-02-07 2006-08-07 Ethicon Endo-Surgery, Inc. Instrument d'agrafage chirurgical comprenant un mecanisme de declenchement multicoups muni d'un systeme de retraction a manivelle et a ressort de rappel
US20100089970A1 (en) * 2008-10-10 2010-04-15 Ethicon Endo-Surgery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
CN102176869A (zh) * 2008-10-10 2011-09-07 伊西康内外科公司 具有可手动回缩的击发系统的电动外科切割缝合装置
US20150005789A1 (en) * 2013-06-28 2015-01-01 Covidien Lp Articulating apparatus for endoscopic procedures
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CN107257663A (zh) * 2014-12-18 2017-10-17 伊西康有限责任公司 用于能够关节运动的外科器械的驱动布置结构
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US20180168677A1 (en) * 2016-12-20 2018-06-21 Ethicon Llc Robotic Endocutter Drivetrain with Bailout and Manual Opening
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