CN100515349C - 采用电致动的关节机构的外科器械 - Google Patents
采用电致动的关节机构的外科器械 Download PDFInfo
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Abstract
一种尤其适用于内窥镜使用的外科器械通过在伸长轴中包括铰接结构铰接端部执行器,该细长轴包括电力致动的聚合物(EAP)致动器,以遥控地使该端部执行器进行关节运动。特别地,细长颈部的框架的柔性颈部可以由EAP致动器横向推向左侧或者右侧并有利地锁定到铰接状态。
Description
相关申请的交叉参考
本申请要求Shelton IV于2004年7月28日递交的系列号为Ser.No.60/591,694、名称为“采用电致动的关节机构的外科器械”的美国临时申请的优先权。
技术领域
本发明大体上涉及适合于以可内窥的方式将端部执行器(例如,内切割器,抓钳,切割器,缝合器,夹具施放器,接触装置,药物/基因治疗输送装置以及使用超声波、RF、激光等的能量装置等)插入到手术位置的外科器械,更具体地说,涉及具有关节连接轴的这种外科器械。
背景技术
内窥镜外科器械通常相对于传统的开放式外科装置来说是优选的,因为较小的切口易于减少术后的恢复时间和并发症。因此,在适于通过套管针的套管在所需的手术部位上精确地放置远端端部执行器的内窥镜外科器械领域内已取得了显著的发展。该远端端部执行器以多种方式与组织接合,以实现诊断或者治疗效果(例如,内切割器,抓钳,切割器,缝合器,夹具施放器,接触装置,药物/基因治疗输送装置以及使用超声波、RF、激光等的能量装置等)。
端部执行器的定位受到套管针的限制。通常,这些内窥镜外科器械包括在端部执行器和临床医生操作的手柄部分之间的长轴。该长轴能够插入到需要的深度并能围绕该轴的纵向轴线转动,从而将该端部执行器定位到一定程度。在合理布置套管针和使用抓钳的情况下,例如,通过另一个套管针,通常该定位量是充分的。外科缝合和切割器械,如美国专利No.5,465,895中描述的,是通过插入和旋转成功地定位端部执行器的内窥镜外科器械的一个例子。
更近地,在Shelton等人于2003年5月20日递交系列号为10/443,617、名称为“采用E-梁发射机构的外科缝合器械”的美国专利中描述了一种改进的用于切割组织和致动缝钉的“E形梁”发射杆,该其在此全部引入作为参考。一些附加优点包括即使为了最佳缝合形成被夹住的组织略微过多或者过少,也能肯定地隔开该端部执行器的钳口,或者更具体地说,是缝钉施加组件。另外,该E形梁发射杆以能采用一些有利的闭锁方式与端部执行器和缝钉匣接合。
根据手术的性质,可能需要进一步调整内窥镜外科器械的端部执行器的定位。特别是,经常需要在横切该器械的轴的纵向轴线的轴线上对端部执行器定向。端部执行器相对于器械轴的横向运动通常被称作“关节运动”。这通常通过在伸长轴中接近缝钉施加组件处放置枢轴(或者关节)接头来实现。这使得外科医生能向任一侧远程地致动缝钉施加组件,以更好地放置缝合线并更容易的操纵和定向组织。这种关节连接定位使临床医生在某些情况下能更容易接合组织,例如在器官的后面。另外,关节连接定位有利地允许内窥镜定位在端部执行器后方,而不会被器械轴挡住。
通过使控制闭合端部执行器以夹住组织及向内窥镜器械的小直径约束内发射端部执行器(例如,缝合和切割)与关节连接的控制结合,而使得外科缝合和切割器械的关节连接方法趋向复杂。通常,三个控制动作都通过该轴转换纵向平移。例如,美国专利No.5,673,840公开一种风琴状关节机构(“柔性颈部”),该机构通过选择性地将两个连接杆中的一个由执行轴向回拉而进行关节运动,每个轴都分别在杆中心线的相对侧上偏移。该连接杆通过一系列离散的位置渐进运动。
关节机构的纵向控制的另一个实施例是美国专利No.5,865,361,其包括从凸轮枢轴偏置的关节连接连件,从而推动或者拉动关节连接连杆的纵向平移实现向各侧的关节运动。同样地,美国专利No.5,797,537披露了一种通过该轴的类似杆以实现关节运动。
在Frederick E、Shelton IV等人的未审结和共同所有的系列号为10/615,973的美国专利申请“采用具有绕纵向轴线旋转的关节机构的外科器械”中,使用了旋转运动作为可选择的方式将关节运动转换为纵向运动,该申请的全部公开内容在此被引入作为参考。
虽然这些机械连接的关节运动成功地使内窥镜外科缝合和切割器械进行关节运动,发展趋势为进入市场提出大量的挑战和阻碍。相冲突的设计目标包括轴的直径尽可能的小以减小手术开口的尺寸,还要有足够的强度以进行多种运动(例如,闭合,发射,关节运动,旋转,等)。
另外,即使希望进一步减小横截面的大小,另一个相冲突的需要是在端部执行器包括附加功能。例如,一种这类附加功能是在缝合位置展开支撑物。支撑物是一对薄泡沫塑料或者织物带,其被放置在砧板上和缝钉匣上,并被缝合在横切的组织的各侧上。这样增加了极薄或极厚的组织的缝合线的结构完整性。将要额外地进行加强以用于防止在端部执行器被不正确闭合,空缝缝钉匣,缺少盒以及通过发送能量或者流体到端部执行器来执行治疗或者诊断的处理等的情况下发射。为了方便这种附加功能而在器械的轴中产生足够的空间形成刺激以改进端部执行器如何被链接。
因此,存在对于包括要求通过该器械的轴的机械机构较少的铰接机构的铰接外科器械的明显需求。
发明内容
本发明通过提供在手柄和端部执行器之间具有的铰接轴的外科器械来克服上面提到的缺陷以及现有技术中的其它缺陷。布置在轴的关节接头中的电活化聚合物(EAP)致动器响应于通过该轴的电信号以实现关节运动。从而可实现有利的小直径的轴,还具有遥控致动的功能。
在本发明的一个方面中,外科器械包括连接到端部执行器和伸长轴远端之间的关节接头。电致动器被放置成响应于在近侧连接到细长轴的手柄中远程产生的电信号来致动关节接头。
在本发明的另一个方面中,外科器械具有细长轴,该细长轴具有框架组件和包围的并被纵向滑动地接收的闭合套管组件。缝钉施加组件包括细长槽、接合在细长槽中的缝钉匣、枢转地连接在细长槽并为缝钉匣提供缝钉形成表面的砧板。关节接头形成在框架组件中。特别地,远侧框架部分被连接在细长槽上,而近侧框架部分被枢转地连接在远侧框架部分上。连接在细长轴的近侧端部的手柄选择性地将电信号传递到细长轴,以便与关节接头相连的响应于此的电活化聚合物致动器执行缝钉施加组件的关节运动。由此提供了一种可以从所需的角度靠近组织的外科缝合和切割器械。
(1)根据本发明的一种外科器械,包括:端部执行器;细长轴;关节接头,其包括:上部条带和下部条带,每个由柔性的且沿纵向不可压缩的材料制成;多个左侧垂直肋和多个右侧垂直肋,每个肋都连接在所述上部条带和下部条带之间的各横向侧上;至少一个右侧电活化聚合物致动器连接到多个右侧垂直肋,并且至少一个左侧电活化聚合物致动器连接到多个左侧垂直肋,每个电活化聚合物致动器都响应于电信号而致动;手柄部分,其与该细长轴的近端连接并包括具有可操作的构造以产生电信号的控制电路。
(2)根据项目(1)所述的外科器械,其中,所述多个左侧垂直肋包括容纳该左侧电活化聚合物致动器的左侧纵向致动器凹槽,所述多个右侧垂直肋包括容纳右侧电活化聚合物致动器的右侧纵向致动器凹槽。
(3)根据项目(2)所述的外科器械,其中,该左侧和右侧电活化聚合物致动器每个都包括具有可操作的构造以在通电时至少沿一个横向弯曲的板状致动器。
(4)根据项目(2)所述的外科器械,其中,所述左侧和右侧电活化聚合物致动器每个都包括至少一个具有可操作的构造以在激活时沿纵向收缩的电活化聚合物纤维致动器,该左侧和右侧电活化聚合物纤维致动器的各远端和近端被连接在该关节接头的各远端和近端上。
(5)根据项目(1)所述的外科器械,进一步包括:多个左侧电活化聚合物叠层致动器,每个都位于在多个左侧垂直肋的相邻肋之间;并包括多个右侧电活化聚合物叠层致动器,每个都位于在多个右侧垂直肋的相邻肋之间。
(6)根据项目(5)所述的外科器械,其中,所述多个左侧和右侧电活化聚合物叠层致动器具有可操作的构造以在激活时沿纵向扩张,以将所述相邻的肋推压分开并在减活时弹性地收缩。
(7)根据项目(5)所述的外科器械,其中,所述多个左侧和右侧电活化聚合物叠层致动器具有可操作的构造以在激活时沿纵向收缩,以将所述相邻的肋推到一起并在减活时弹性地扩张。
(8)根据项目(1)所述的外科器械,其中,多个左侧和右侧垂直肋中的每个都包括锁定凹槽,该关节接头进一步包括每个分别位于相应的左侧和右侧锁定凹槽中的左侧锁定条带和右侧锁定条带,每个锁定条带都包括具有可操作的构造以改变该锁定条带的纵向长度的电活化聚合物锁定致动器,并包括多个沿纵向对齐的锁定凸起,以在相邻的肋和锁定条带都处于纵向扩张状态时插入到相邻肋之间,由此在扩张的间隔中保持肋。
(9)根据项目(1)所述的外科器械,其中,该端部执行器包括下部钳口和枢转连接的上部钳口。
(10)根据项目(9)所述的外科器械,其中,该端部执行器进一步包括:由发射杆致动的缝合和切割组件;手柄部分,其在近侧处连接在发射杆并具有可操作的构造以给予发射杆纵向发射运动;细长轴和关节接头进一步包括通过该关节接头支撑该发射杆的发射杆引导件。
(11)根据项目(10)所述的外科器械,其中,该下部钳口包括容纳缝钉匣的细长槽,并且枢转连接的上部钳口包括提供缝钉形成表面的砧板。
(12)根据项目(11)所述的外科器械,其中,该细长轴进一步包括:框架组件,其包括连接在手柄部分与该关节接头之间的近侧框架部分和连接在关节接头与细长槽之间的远侧框架部分;闭合套管组件,其包围该框架组件和关节接头,并包括与该砧板接合的远侧闭合管部分、与手柄部分连接的近侧闭合管部分和在其间包围关节接头的横向柔性闭合套管;该手柄部分具有可操作的构造以沿纵向平移闭合套管组件,从而实现砧板的闭合。
(13)根据项目(12)所述的外科器械,其中,柔性闭合套管包括由弹性材料形成的圆柱形套管,并包括左侧和右侧成排的垂直槽。
(14)根据本发明的一种外科器械,包括:包含框架组件的细长轴;缝钉施加组件,包括细长槽、与细长槽接合的缝钉匣以及枢转地连接在细长槽上的为缝钉匣提供缝钉形成表面的砧板;形成在框架组件上的关节接头,框架组件包括连接在细长槽的远侧框架部分和枢转地连接在远侧框架部分上的近侧框架部分;连接在细长轴的近端的手柄部分,其具有可操作的构造以选择性地将电信号传递给细长轴;电活化聚合致动器,其被连接在关节接头上并响应于该电信号以使缝钉施加组件进行关节运动。
(15)根据项目(14)所述的外科器械,其中,细长轴进一步包括:纵向滑动的闭合套管组件,其包围关节接头并在远侧处与上部钳口接合以实现上部钳口的枢转;手柄部分,其具有可操作的构造以平移闭合套管组件从而实现上部钳口的开启和闭合。
(16)根据本发明的一种外科器械,包括:端部执行器;细长轴;连接在该端部执行器和该细长轴远端之间的关节接头;用于电力致动关节接头的部件。
(17)根据项目(16)所述的外科器械,其中,关节接头包括在伸长轴的纵向轴线的弧形中支撑该端部执行器的部件。
(18)根据项目(16)所述的外科器械,其中,端部执行器进一步包括由发射杆致动的缝合和切割组件,手柄部分在近侧处连接在发射杆上并具有可操作的构造以给予发射杆纵向发射运动,细长轴和关节接头进一步包括通过进行关节运动的关节接头支撑发射杆的发射杆引导件。
(19)根据项目(18)所述的外科器械,其中,下部钳口包括容纳缝钉匣的细长槽,被枢转连接的上部钳口包括提供缝钉形成表面的砧板。
(20)根据项目(16)所述的外科器械,其中,细长轴包括:框架组件;闭合套管组件;关节接头,将枢转地将端部执行器的下部钳口连接到该框架组件的远端上,该手柄部分具有可操作的构造以沿着纵向将闭合运动结合到该闭合套管组件,并且该闭合套管组件的多枢转轴头包围该关节接头并在远侧接合该上部钳口以实现该上部钳口的枢转。
从附图及其描绘从更加清楚地了解本发明的这些以及其它的目的和优点。
附图说明
引入并构成本说明书的一部份的附图,示出了本发明的实施方式,并且和上面给出的总体描述,以及下面给出的详细说明一起,用于解释本发明的原理。
图1是外科器械的右侧剖视图,该外科器械具有切去了闭合套管组件以露出使柔性关节连接框架区关节运动的EAP致动的铰接机构。
图1A是图1中向左侧进行关节运动的外科器械的俯视图。
图2是层压电活化聚合物(EAP)复合材料的透视图
图3是EAP板式致动器的透视图,该EAP板致动器由图2中粘结固定在一起的多层层压EAP复合材料形成的叠层构成。
图4是沿收缩EAP纤维致动器的纵向轴线切开的透视图。
图5是沿图4中收缩EAP纤维致动器的线5-5截得的横截面的主剖视图。
图6是用于图1中外科器械的EAP致动关节接头的右前侧透视图,其具有横向柔性闭合套管组件和柔性颈部框架组件以及闭合的缝钉施加组件。
图7是图6中EAP致动关节接头和闭合的缝钉施加组件的右前侧透视图,其中拆掉了柔性闭合套管组件并部分分解了柔性颈部框架组件。
图8是图6中的EAP致动关节接头和缝钉施加组件的右前侧分解透视图。
图9是图1中包含EAP板致动器和锁定条的关节连接框架区的右前侧透视图。
图10是图1A中关节连接框架区在左侧关节运动状态下的俯视图,其中以双点划线示出在解锁致动状态和锁定松弛(relaxed)状态下的左侧EAP锁定条。
图11是图1A中关节连接框架区处于左侧关节运动状态下的俯视图,其为沿着EAP板致动器和EAP锁定条截得的横截面。
图12是图10中关节连接框架区的主剖视图,其为沿通过横向引导销的线12-12截得的横截面。
图13是用于图1中外科器械的可替换关节连接框架区的俯视图,其为沿着通过多个EAP肋分隔致动器截得的横截面图。
图14是用于图1中外科器械的另一个具有多个EAP纤维致动器的可选关节连接框架区的局部分解的右视图。
图15是沿线15-15截得的图14中另一个可选关节连接框架区的横截面的主剖视图。
图16是沿通过外科器械的关节接头的发射杆的纵向横截面截得的俯视图,其中发射杆有利地由被具有一个滑动端部的向内致动的EAP板致动器的支撑板横向引导。
图17是沿通过图16中外科器械的关节接头的发射杆的纵向横截面截得的俯视图。
图18是沿通过外科器械的关节接头的发射杆的纵向横截面图,其中发射杆有利地被具有一个滑动端部的向外致动EAP板致动器的支撑板横向引导。
图19是沿通过外科器械的关节接头的发射杆的纵向横截面截得的俯视图,其中发射杆有利地被向外致动的EAP支撑板横向引导,该EAP支撑板具有被限制但纵向浮动的钩形端部。
图20是沿通过外科器械的关节接头的发射杆的纵向横截面截得的俯视图,该发射杆有利地被外致动的EAP支撑板横向引导,该EAP支撑板每个具有一个固定的钩形端部和一个纵向受到弹性限制的端部。
图21是沿通过外科器械的关节接头的发射杆的纵向横截面截得的俯视图,其中发射杆有利地被外致动的EAP支撑板横向引导,该EAP支撑板每个都具有纵向受到弹性限制的两端。
图22是包括有图43-46中的EAP支撑板的柔性关节接头的俯视图。
图23是沿图22中线23-23截得的柔性关节接头的主视图。
图24是图22中铰接在左侧的柔性关节接头俯视图。
图25是包括图16-19中EAP支撑板的柔性关节接头的右前侧透视图,并且该柔性关节接头还包括左侧和右侧EAP板铰接致动器。
具体实施方式
具有EAP致动的柔性颈(flexneck)关节接头的外科器械。
在图1中,外科器械1200有利地包括与细长轴1206的关节连接框架组件1204成一体的EAP致动的关节接头1202,该细长轴1206将分开的闭合和发射运动从手柄1208传递到端部执行器1210,端部执行器1210被描述为具有可闭合的砧板1214的缝钉施加组件1212,砧板1214被枢转地连接在细长槽1216上,细长槽1216保持有可更换的缝钉匣1218。手柄1208包括被向近侧朝着手枪握柄1222靠近的方向挤压以实现砧板1214的闭合的闭合扳柄1220。应该理解的是,闭合套管组件1223或者其它没有示出的闭合部件(例如,EAP致动的砧板,内部纵向平移构件等)作用在砧板闭合件1224上以实现砧板1214的打开和闭合。一旦处于闭合和夹紧状态,更远侧的发射扳机1226被朝着手枪握柄1222的方向挤压以实现发射构件1228纵向沿着伸长轴1206的发射,以进行组织的切割并且缝合该被切割端部。一旦松开发射扳机1226,随着轻轻地压下闭合扳机1220一起按压闭合释放按钮1230,然后在松开闭合扳机1220之后松开夹紧元件,从而打开砧板1214并允许松开被缝合和切割的组织。旋钮1232允许沿伸长轴1206的纵向轴线选择性旋转。
关节连接框架组件1204包括在近侧可旋转地连接在手柄1208上的近侧框架区1240,并且在远侧连接到关节连接框架区1242,该关节连接框架区1242又与支撑端部执行器1210的远侧框架区1244连接。在手柄1208上的关节控制器1246有利地允许通过激励到其上的适当的电信号对关节连接框架区1242的关节运动进行选择,例如图1A所描述的,在通过关节控制器1246已选择向左侧关节运动时。应该理解,关节控制器1246可以有利地包括用于关节连接框架区1242的铰接锁定的手动和/或自动的脱离接合。
手柄
在图1中,缝钉施加组件12通过在轴框架上在纵向沿轴1206(在图1中没有示出,但是在下面参照图7描述)传递的两种不同的运动完成夹紧组织驱动缝钉和切割组织的功能。该杆框架组件在近侧连接到手柄14上,并与旋钮30旋转地连接。用于图1中的外科缝合和切割器械10的示例性多冲程手柄14在以下这些未审定和共同拥有的美国专利申请中被更详细地描述,即,Swayze和Shelton的名称为“具有多冲程发射位置指示器和收回机构的外科缝合器械”,其系列号为10/674,026,Kevin Doll,Jeffrey S.Swayze,Frederick E.Shelton IV,Douglas Hoffman和Michael Setser在2005年2月7日提交的名称为“包括具有发射行程收回自动结束的多冲程发射机构的外科缝合器械”,其系列号为11/052,632。其公开内容在此全部被引入作为参考,并在此描述附加特征和变化。
当多冲程手柄14有利地支持在长距离上具有高发射力的应用时,与本发明一致的应用可以包括单发射冲程,例如在Frederick E.Shelton IV,Michael E.Setser和Brian J.Hemmelgarn的审定和共同拥有的美国专利申请“具有分开的不同的闭合和发射系统的外科缝合器械”,其系列号为10/441,632中所描述的,其公开内容在此全部被引入作为参考。
电活化聚合物
电活化聚合物(EAPs)为一组在施加电压时改变形状的导电的掺杂处理的聚合物。本质上,导电聚合物与离子流体或者凝胶体和电极中的一些形式配对。由施加的电压电势使离子流通过液体/凝胶体流入或者流出导电聚合物,并且该流动导致该聚合物形状发生改变。从1V到4kV的电压电势范围取决于使用的聚合物和离子流体。当施加电压时,一些EAPs收缩而一些EAPs扩张。该EAPs可以与机械部件例如弹簧或者柔性板配对,以在施加电压时改变其所导致的效果。
有两种基本类型的电活化聚合物并且每个类型具有多种结构。这两种基本类型是纤维束和层状形式。纤维束由大约30-50微米的纤维组成。这些纤维可被织成非常像纺织品的束,并由此通常被称为EAP纱线。这类EAP在施加电压时收缩。该电极通常是中央导线芯和导电外壳,该外套还用来容纳围绕该纤维束的离子流体。市场上可得到的纤维EAP材料的一个示例由Santa Fe Science and Technology生产被以PANIONTM纤维销售,并且在美国专利No.6,667,825中被描述,在此其全部内容被引入作为参考。
另一类为层状结构。其由一层EAP聚合物、一层离子凝胶体和连接在层板的两侧上的两个弹性板组成。当施加电压时,方形的层状板在一个方向上扩张并且在垂直的方向上收缩。市场上可得到的薄片(板)EAP材料的一个示例由为SRI Laboratories分公司的ArtificialMuscle Inc生产。板EAP材料也可以从日本EAMEX得到并被称为薄膜EAP。
应该注意,EAPs在通电时不改变体积,它们只是在一个方向上扩张或者收缩而在横向上正好相反。可以通过包括将一侧紧贴在刚性结构上以及像活塞那样使用另一侧的方式来使用该薄片形式的基本形状。其也可以附着在柔性板的两侧。当对柔性板EAP的一侧施加电压,其将扩张,使该板沿相反方向弯曲。根据对电压施加在哪侧,使该板沿两个方向中任一个弯曲。
EAP致动器通常由被束在一起以协同工作大量层或者纤维构成。EAP的机械构造决定了EAP致动器以及其运动性能。该EAP可被制成长股并且缠绕在单个中央电极的周围。柔性外部外侧套管将形成致动器的另一个电极,并且容纳设备的功能所必需的离子流体。在该构造中,当在电极上施加电场时,EAP的股(strands)将变短。EAP致动器称为纤维EAP致动器。同样地,薄片构造可被设置在柔性板的两侧上的许多层中或者仅在其自身上的层中以增加其性能。典型的纤维结构2-4%的具有效应变,而使用更高电压的典型薄片形式可以达到20-30%。
在图2中,薄片EAP复合材料100被描述成这样形成,即,阳极板电极层1302连接在EAP层104上,而EAP层104与离子单元(cell)层106连接,而离子单元(cell)层106与阴极板电极层108连接。在图3中,多个五层薄片EAP复合材料100通过其间的粘合剂层110被层叠地固定在一起以形成EAP板致动器120。应该可以理解,可将相对的EAP致动器120形成为可选择地向任一方向弯曲。
在图4-5中,收缩的EAP纤维致动器140包括纵向铂阴极线142,该铂阴极线142穿过绝缘聚合物近端端盖144,并穿过形成在涂有传导性的涂层以作为阳性的阳极的塑料圆柱体壁148内的细长圆柱形腔室146。铂阴极线142的远端被嵌入绝缘聚合物远端盖150中。许多收缩聚合物纤维152被平行于阴极导线142地布置并围绕在其周围,并且将它们的端部嵌入各端盖144、150。在塑料圆柱体壁148的周边周围固定有各端盖144、150以封闭圆柱形腔室146,从而密封充满在收缩聚合物纤维152与阴极线142之间的空间的离子流体或者凝胶体154。当通过塑料圆柱形壁(阳极)148和阴极导线142施加电压时,离子流体进入收缩聚合物纤维152,导致它们的外直径相应于长度的收缩而增大,从而朝着彼此拉动端盖144、150。
EAP致动关节接头
在图6-7中,外科切割和缝合器械200包括EAP致动关节接头202,该关节接头202被形成在该外科器械的细长轴204中并靠近端部执行器,该端部执行器由外科缝合和切割组件12图示出,该组件12有利地响应于由细长轴204沿纵向传递的分开的闭合和发射运动。EAP致动关节接头202有利地增加了使缝钉施加组件12进行关节运动所需的临床灵活性。
在图6-8的示例中,更为具体地,EAP致动关节接头202为一种柔性闭合和枢转框架关节接头210,如图6所示,其包括柔性闭合套管组件212,该套管组件具有通过柔性闭合管218相连的近侧闭合管214和远侧闭合环216。形成在柔性闭合管218中的左侧和右侧垂直槽220、222的纵向列允许向右侧或者向左侧弯曲以进行关节运动,而连续的顶部纵向条带224和底部纵向条带(未示出)与这种弯曲量无关地传递纵向闭合运动。特别是,远侧闭合环216的顶部部分包括与砧板22的砧板闭合件228接合马蹄形孔226。在图7-8中,砧板22包括在其近端处的横向突出的枢销230,该枢销与形成在细长槽18的近端附近的枢轴孔232枢转地接合。由此稍远端的砧板闭合部件228在柔性闭合套管组件212向远端运动时发生闭合运动,在其向近端运动时发生打开运动。该柔性闭合管218可以沿左侧和右侧垂直槽220、222的纵排的长度弯曲,由此当进行关节运动时容纳柔性闭合和枢转框架关节接头210的横向被包围的柔性框架组件234。
在图6-8中,横向柔性框架组件234包括具有在远侧开口的圆柱形端部237的近侧框架区236,该圆柱形端部237具有与在柔性框架构件240的近端上的顶部键形片239接合的顶部槽238。而柔性框架构件240的远端具有向远端伸出的顶部键形片241,该顶部键形片241被容纳在远侧框架区250的近侧开口的圆柱形端部243中的顶部槽242中。柔性框架构件240中的左侧和右侧垂直槽244、245允许被插入这些槽244、245中的EAP致动器245以维持柔性框架组件234的关节运动。
在图8中,外科器械200的由细长轴16和缝钉施加组件12形成的执行部分260进一步包括发射杆270,该发射杆270纵向平移穿过近侧框架区236、柔性闭合和枢转框架关节接头210以及远侧框架区250中的发射槽272进入缝钉施加组件12。形成在远侧框架区250的顶部上的远端和近端方形孔274、276在其间形成夹杆278,其接收夹合弹簧282的顶部臂280,在该夹合弹簧280的下方、且向远侧延伸的臂284在凸起部分286上沿对应于发射过程的空的/缺少缝钉匣锁定部分的发射杆270的上部部分保持向下的压力。
特别参照图8,发射杆270的远侧凸起端部与E形梁288连接在一起,该E形梁288有助于砧板22与缝钉匣20分开、切断组织并致动缝钉匣20。缝钉匣20包括容纳有大量放置在位于各向上开口的缝钉孔294内的缝钉致动器292上的缝钉的模制匣体290。楔形板296由E形梁288向远端驱动,并在缝钉匣托架298上滑动,该缝钉匣托架298将可更换的缝钉匣20的各组件保持到一起。当E形梁288的切割表面300切割夹紧的组织时,楔形板296使缝钉致动器292向上凸起,以将缝钉挤出而与砧板22变形接触。应该可以理解,在发射过程中,E形梁288的上部销302与砧板22接合,同时中部销304和底部支座306通过相应的缝钉匣托架298中的纵向开口310和匣体290中向后开口的垂直槽312与形成在细长槽18中的纵向槽308的各顶面和底面接合。之后,将发射杆270向近侧拉回,同样地拉回E形梁288,允许打开砧板22以松开这两个缝合和切割的组织部分(没有示出)。
缝钉施加组件12在Frederick E.Shelton IV等人于2004年9月30日递交的未审定和共同拥有的名称为“包括两件套E形梁发射机构的关节连接外科缝合器械”、系列号为10/955,042的美国专利申请中被详细地描述,其公开内容在此全部被引入作为参考。
作为柔性框架组件234的可替换方案,在图9-12中,关节连接框架区1242包括使用左侧和右侧EAP板致动器1302、1304的EAP致动系统1300,该致动器1302、1304穿过在基本上为圆柱形的弹性框架体1310的每个横向侧中的各左侧和右侧矩形致动器凹槽1306、1308(图11-12)。矩形刀槽1312位于在左侧和右侧矩形致动器凹槽1306,1308之间地形成在弹性框架体1310中,以引导发射机构1228远侧部分的发射杆1314。
当关节连接框架区1242为平直的或者进行关节运动时,弹性框架体1310的连续的顶部和底部纵向段1320(图9-10)对发射杆1314保持一纵向行程量。为了有利地从均质材料形成沿其纵向轴线没有明显压缩的弹性框架体1310,多个左侧和右侧纵向排列的垂直凹槽1322、1324分别与左侧和右侧EAP致动器凹槽1306、1308贯穿(interseet)。每个竖直凹槽1322、1324包括矩形通孔1326,该矩形通孔从顶部到底部穿过弹性框架体1310并平行于且从矩形刀槽1312和左侧或右侧矩形致动器凹槽1306、1308中适当的一个横向偏移。每个矩形通孔1326与窄的横向间隙1328横向连通。在相邻的竖直凹槽1322、1324之间形成肋1330,该肋1330具有狭窄的内壁1332和较厚的弯曲外板1334,其允许连续的顶部和底部纵向段1320横向弯曲,该弯曲外板1334支撑对应的一个EAP板形致动器1302、1304并限制在该方向上可能达到的关节运动量,该铰接量为当一个或者两个EAP板致动器1302、1304都激活以沿选择方向弯曲时在窄的横向间隙1328完全塌缩之前限制在该方向上可能得到的铰接量。在图10中,例如,左侧EAP板致动器1302被激活以向左侧致动,而右侧EAP板致动器1304也相应地拉伸。应该可以理解,当被电力地激活以分别在左侧和右侧矩形致动器凹槽1306、1308中产生拉动或者推动时,该左侧和右侧EAP板致动器1302、1304可交替地收缩或者扩张。
在图11-12中,关节连接框架区1242有利地包括EAP铰接锁定机构1350,该铰接锁定机构1350选择性地将弹性框架体1310保持在左侧关节运动或者右侧关节运动的状态。为此,左侧锁定通道1352被形成为通过邻近其最左侧的外部的多个左侧矩形通孔1326,并允许左侧脊形EAP锁定条1354从其中穿过。同样地,右侧锁定通道1356被形成为通过邻近其最右侧的外部的多个右侧矩形通孔1326,并允许右侧脊形EAP锁定条1358从其中穿过。沿左侧和右侧脊形EAP锁定条1354、1358的各最外侧表面1360,多个沿纵向间隔开的竖直阻挡脊1362被沿纵向间隔开并多个肋1330的几何形状一同确定其大小以在需要的铰接量进行锁定。特别地,当柔性框架区1242向着脊形EAP锁定带1354、1358的各相对侧进行关节运动,在该侧上的肋1330成弧形彼此分开,如图11中示出向左侧进行关节运动。一旦肋1330达到用于锁定的足够间隔(即,比竖直阻挡脊1362的纵向宽度要宽),右侧脊形EAP锁定条1358被向外偏压以使其脊1362卡入相邻肋1330的相邻的增加的弯曲外板1334之间。激活右侧脊形EAP锁定条1358引起释放右侧脊形EAP锁定条1358的收缩。在图12中,横向上部引导销1370和下部引导销1372通过矩形刀槽1312的上部和下部以保护横向排列。
在图13中,关节连接框架区1242包括EAP致动系统1400,其使用多个位于弹性框架体1408的一对相对的远侧和近侧开口的矩形凹槽之间的左侧和右侧EAP肋分隔板致动器1402。每对的相对的远侧和近侧开口的矩形致动器凹槽对1404、1406分别形成在横向形成的肋1410的相邻对(近端/远端)中。每个肋1410都包括垂直槽1412,该垂直槽1412沿其高度横向向外开口且在更靠内的位置具有较宽的矩形通孔1414,该通孔1414收缩到外垂直槽1416之内。因而,每个肋1410包括与上部和下部纵向连续段1420相连的薄内壁1418。矩形刀槽1422沿纵向中心线横向地形成。如上所述的左侧和右侧脊形EAP锁定条1354、1358有利地放松成在关节连接框架区1242的扩张侧上的扩张弯曲形状以锁定,并由横向引导销1370保持纵向排列。
在图14-15中,关节连接框架区1242将另一个可替换的EAP驱动系统1500结合在弹性框架体1502中,该弹性框架体1502包括布置成左侧和右侧竖直叠层1506、1508的纵向排列的EAP纤维致动器1504,该竖直叠层1506、1508分别通过在左侧和右侧的多个横向肋1510,该横向肋1510每个都具有薄的内竖直壁1512,该竖直壁1512与连续纵向顶部和底部段1514相连以由此便于横向弯曲。每个肋1510沿横向变宽到厚的外部1516,该外部1516的尺寸限制向该侧的铰接。每个厚的外部1516包括允许EAP纤维致动器1504通过的竖直排列的纵向通孔1518。远端和近端横向盖1520、1522纵向位于肋1510的侧面以覆盖各EAP纤维致动器1504的末端。横向中央刀槽1524在弹性框架体1502中形成以用于发射杆1314。收缩选定的EAP纤维致动器1504的竖直叠层1506、1508引起向该侧的关节运动,而非致动的竖直叠层1506、1508由此被动地伸长。
用于发射杆的EAP支撑板
在图16中,用于外科器械2002的关节接头2000包括一对EAP支撑板2004、2006,该支撑板2004、2006其横向地支撑发射杆2008以在关节运动时使束缚和变形(buckling)最小化。每个支撑板2004、2006都包括结构件2010(例如,刚性聚合物,金属),该结构构件2010包括横向加宽的端部2012和直端部2018,该加宽的端部2012由在第一框架区2016中相应大小的凹槽2014捕获,该直端部2018被滑动地接收在第二框架区2020内。纵向膨胀的EAP薄片2022覆盖每个支撑板2004、2006的内表面。
在图17中,关节接头2000向一个横向侧进行关节运动,由此导致发射杆2008越过关节纵向轴线2024并与支撑板2006接触。横向支撑由此防止发射杆2008从关节接头2000中爆裂和/或允许安装更柔性的发射杆2008以减小的力进行关节运动。另外,在每个支撑板2004、2006上的EAP压压板2022根据需要被激活,以控制两者的曲率大小以在其间为发射杆2008保留所需的空间。直端部2018在第二框架区部分2020上滑动以提供给内支撑板2004与外支撑板2006相比所需要的减小的行程。EAP薄片2022可以进一步提供有助于横向引导发射杆2008的减震和低表面摩擦特性。
在图18中,用于外科器械2102的可替换关节接头2100包括一对EAP支撑板2104、2106,该支撑板2104、2106横向支撑发射杆2108以在铰接时最小化束缚和变形(buckling)。每个支撑板2104、2106包括包括横向加宽的端部2112和直端部2118的结构构件2110(例如,刚性聚合物、金属),该加宽的端部2112被捕获在第一框架区2116中相应大小的凹槽2114中,直的端部2118滑动地接收在第二框架区2120内。纵向膨胀的EAP薄片2122覆盖每个支撑板2104、2106的外表面。关节接头2100向一个横向侧进行关节运动,由此引起发射杆2108超过铰接纵向轴线2124并与支撑板2106相接触。(横向支撑由此防止发射杆2108从关节接头2100爆裂出和/或允许允许安装更柔性的发射杆2108以减低关节运动力)。另外,在每个支撑板2104、2106上的EAP薄片2122根据需要被激活,以控制两者的曲率大小以在其间为发射杆2108保留所需的空间。直端部2118在第二框架区部分2120中滑动,以提供给内支撑板2104与外支撑板2106相比所需要的减小行程。将EAP薄片2122放置得远离与发射杆2108接触可以具有例如减少EAP薄片2122磨损的优点。
在图19中,用于外科器械2202的另一个可替换关节接头2200包括一对EAP支撑板2204、2206,该支撑板2204、2206横向支撑发射杆2208以在关节运动时最小化束缚和变形(buckling)。每个支撑板2204、2206包括结构件2210(例如,金属),该结构构件2210包括第一向外凸出的端部2212和第二向外凸出的端部2218,该第一向外凸出的端部2212受到约束并在第一框架区2216中的第一向内开口凹槽2214中纵向自由浮动,第二向外凸出的端部2218受到约束并在第二框架区2222的第二向内开口凹槽2220中纵向自由浮动。纵向扩张的EAP薄片2224覆盖每个支撑板2204、2206的内表面。
在图20中,用于外科器械2302的另一个可替换关节接头2300包括一对EAP支撑板2304、2306,该支撑板2304、2306横向支撑发射杆2308以在铰接时最小化束缚(binding)和变形(buckling)。每个支撑板2304、2306包括结构构件2310(例如,金属),该结构构件2310包括第一向外凸出的端部2312和第二向外凸出的端部2318,该第一向外凸出的端部2312被固定在第一框架区2316中的向内开口凹槽2314,第二向外凸出的端部2318被限制并在第二框架区2322的向内开口凹槽2320中纵向自由浮动。纵向扩张的EAP薄片2324覆盖每个支撑板2304、2306的内表面。一对压缩弹簧2326、2328被纵向排列在向内开口凹槽2320中,以偏压每个支撑板2304、2306的第二向外凸出的端部2318到中间位置。
在图21中,用于外科器械2402的另一个可替换关节接头2400包括一对EAP支撑板2404、2406,该支撑板2404、2406横向支撑发射杆2408以在铰接时最小化束缚(binding)和弯曲(buckling)。每个支撑板2404、2406包括结构构件2410(例如,金属),结构构件2410包括第一向外凸出的端部2412和第二向外凸出的端部2418,该第一向外凸出的端部2412被限制但在第一框架区2416的第一向内开口凹槽2414中纵向自由浮动,第二向外凸出的端部2418被限制并在第二框架区2422的第二向内开口凹槽2420中纵向自由浮动。纵向扩张的EAP薄片2424覆盖每个支撑板2404、2406的内表面。一对压缩弹簧2426、2428被纵向排列在第一向内开口凹槽2414中,以偏压每个支撑板2404、2406的第一向外凸出的端部2412到其中的中间位置。另一对压缩弹簧2430、2432被纵向排列在第二向内开口凹槽2420中,以偏压每个支撑板2404、2406的第二向外凸出的端部2418到在其中的中间位置。
在图22-25中,用于外科器械2502的另一个可替换关节接头2500包括安放在发射杆2508两侧的EAP支撑板2504,2506,该发射杆2508在关节连接框架2514的弹性框架体2512的刀槽2510中,并且在近侧处连接在近侧框架区2516上和在远侧处连接在远侧框架区2518上。左侧EAP板致动器2520通过左侧多个在弹性框架体2512中形成的横向肋2522。右侧EAP板致动器2524通过多个右侧横向肋2526。每个EAP板致动器2520、2524向近侧延伸到近侧框架区2516中,并且包括连接在内侧板2530上的外部EAP薄片层2528,并被设置成在被电力激活时致动以向另一侧弯曲远侧框架环2518。该弹性框架体2512包括夹紧每个支撑板2504、2506的近端且向外弯曲的端部2534的内开口凹槽2532。允许每个支撑板2504、2506的远端的直端部2536从刀槽2510中滑出,以对铰接的行程变化进行调整,如图24所示。
尽管通过多个实施方式的描述来说明本发明并且已经对说明性实施方式进行了详细的描述,但意图不在于限制本发明申请或者以任何方式将从属权利要求的范围限制在这些细节中。对于本领域的普通技术人员来说其它优点和修改是显而易见的。
Claims (10)
1.一种外科器械,包括:
端部执行器;
细长轴;
关节接头,其包括:上部条带和下部条带,每个由柔性的且沿纵向不可压缩的材料制成;多个左侧垂直肋和多个右侧垂直肋,每个垂直肋都连接在所述上部条带和下部条带之间的各横向侧上;
至少一个右侧电活化聚合物致动器连接到多个右侧垂直肋,并且至少一个左侧电活化聚合物致动器连接到多个左侧垂直肋,每个电活化聚合物致动器都响应于电信号而致动;以及
手柄部分,其与该细长轴的近端连接并包括具有可操作的构造以产生电信号的控制电路。
2.如权利要求1所述的外科器械,其特征在于,所述多个左侧垂直肋包括容纳该左侧电活化聚合物致动器的左侧纵向致动器凹槽,所述多个右侧垂直肋包括容纳右侧电活化聚合物致动器的右侧纵向致动器凹槽。
3.如权利要求2所述的外科器械,其特征在于,该左侧和右侧电活化聚合物致动器每个都包括具有可操作的构造以在通电时至少沿一个横向弯曲的板状致动器。
4.如权利要求2所述的外科器械,其特征在于,所述左侧和右侧电活化聚合物致动器每个都包括至少一个具有可操作的构造以在激活时沿纵向收缩的电活化聚合物纤维致动器,该左侧和右侧电活化聚合物纤维致动器的各远端和近端被连接在该关节接头的各远端和近端上。
5.如权利要求1所述的外科器械,进一步包括:多个左侧电活化聚合物叠层致动器,每个都位于在多个左侧垂直肋的相邻垂直肋之间;并包括多个右侧电活化聚合物叠层致动器,每个都位于在多个右侧垂直肋的相邻垂直肋之间。
6.如权利要求5所述的外科器械,其特征在于,所述多个左侧和右侧电活化聚合物叠层致动器具有可操作的构造以在激活时沿纵向扩张,以将所述相邻的垂直肋推压分开并在减活时弹性地收缩。
7.如权利要求5所述的外科器械,其特征在于,所述多个左侧和右侧电活化聚合物叠层致动器具有可操作的构造以在激活时沿纵向收缩,以将所述相邻的垂直肋推到一起并在减活时弹性地扩张。
8.如权利要求1所述的外科器械,其特征在于,多个左侧和右侧垂直肋中的每个都包括锁定凹槽,该关节接头进一步包括每个分别位于相应的左侧和右侧锁定凹槽中的左侧锁定条带和右侧锁定条带,每个锁定条带都包括具有可操作的构造以改变该锁定条带的纵向长度的电活化聚合物锁定致动器,并包括多个沿纵向对齐的锁定凸起,以在相邻的垂直肋和锁定条带都处于纵向扩张状态时插入到相邻垂直肋之间,由此在扩张的间隔中保持垂直肋。
9.如权利要求1所述的外科器械,其特征在于,该端部执行器包括下部钳口和枢转连接的上部钳口。
10、如权利要求9所述的外科器械,其特征在于,该端部执行器进一步包括:由发射杆致动的缝合和切割组件;手柄部分,其在近侧处连接在发射杆并具有可操作的构造以给予发射杆纵向发射运动;细长轴和关节接头进一步包括通过该关节接头支撑该发射杆的发射杆引导件。
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CNB2005100895309A Active CN100569189C (zh) | 2004-07-28 | 2005-07-28 | 带有电活化聚合物致动的拱托脱离机构的外科缝合器械 |
CN2005100895296A Active CN1745720B (zh) | 2004-07-28 | 2005-07-28 | 具有电活化聚合物防倒退机构的多击发手术器械 |
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CNB2005100873329A Active CN100479769C (zh) | 2004-07-28 | 2005-07-28 | 包含eap阻挡锁定机构的外科器械 |
CNB2005100895192A Active CN100500104C (zh) | 2004-07-28 | 2005-07-28 | 具有电活化聚合物致动的医疗物质投放器的外科缝合器械 |
CN200510089521XA Active CN1732859B (zh) | 2004-07-28 | 2005-07-28 | 具有两件式e形梁发射机构的铰接手术缝合器 |
CN200510087341A Active CN100579470C (zh) | 2004-07-28 | 2005-07-28 | 包含通过关节接头的电活化聚合物致动发射杆轨道的外科缝合器械 |
CNB2005100873333A Active CN100569188C (zh) | 2004-07-28 | 2005-07-28 | 包含eap完整击发系统锁定机构的外科器械 |
CN200510087334A Active CN100579467C (zh) | 2004-07-28 | 2005-07-28 | 采用电致动的枢转关节机构的外科器械 |
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CN2005100895296A Active CN1745720B (zh) | 2004-07-28 | 2005-07-28 | 具有电活化聚合物防倒退机构的多击发手术器械 |
CN200510087335A Active CN100579468C (zh) | 2004-07-28 | 2005-07-28 | 采用电致动关节机构的外科器械 |
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JP (1) | JP4902973B2 (zh) |
CN (11) | CN100566667C (zh) |
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CA (1) | CA2512977C (zh) |
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- 2005-07-28 CN CNB2005100895205A patent/CN100515349C/zh active Active
- 2005-07-28 CN CNB2005100895309A patent/CN100569189C/zh active Active
- 2005-07-28 CN CN2005100895296A patent/CN1745720B/zh active Active
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CN1726878A (zh) | 2006-02-01 |
CN100579470C (zh) | 2010-01-13 |
CN1726877A (zh) | 2006-02-01 |
CN1726876A (zh) | 2006-02-01 |
CN1732857A (zh) | 2006-02-15 |
RU2005123979A (ru) | 2007-02-10 |
CN100569189C (zh) | 2009-12-16 |
MXPA05008046A (es) | 2006-02-10 |
BRPI0503041A (pt) | 2006-03-14 |
CN100479769C (zh) | 2009-04-22 |
CN1745719A (zh) | 2006-03-15 |
JP4902973B2 (ja) | 2012-03-21 |
CN100566667C (zh) | 2009-12-09 |
JP2006034980A (ja) | 2006-02-09 |
CN1732855A (zh) | 2006-02-15 |
CN1745720A (zh) | 2006-03-15 |
RU2005123961A (ru) | 2007-02-10 |
US20060022015A1 (en) | 2006-02-02 |
CN100500104C (zh) | 2009-06-17 |
CA2512977C (en) | 2014-12-09 |
CN1732859B (zh) | 2010-07-07 |
CN1726874A (zh) | 2006-02-01 |
CN100579467C (zh) | 2010-01-13 |
CA2512977A1 (en) | 2006-01-28 |
CN100569188C (zh) | 2009-12-16 |
CN1745720B (zh) | 2010-12-15 |
BRPI0503039A (pt) | 2006-03-14 |
CN100579468C (zh) | 2010-01-13 |
CN1732859A (zh) | 2006-02-15 |
US7143925B2 (en) | 2006-12-05 |
CN1726875A (zh) | 2006-02-01 |
CN1732856A (zh) | 2006-02-15 |
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