CN100579468C - 采用电致动关节机构的外科器械 - Google Patents

采用电致动关节机构的外科器械 Download PDF

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CN100579468C
CN100579468C CN200510087335A CN200510087335A CN100579468C CN 100579468 C CN100579468 C CN 100579468C CN 200510087335 A CN200510087335 A CN 200510087335A CN 200510087335 A CN200510087335 A CN 200510087335A CN 100579468 C CN100579468 C CN 100579468C
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eap
joint
surgical instruments
articulated joint
actuator
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弗雷德里克·E·谢尔顿四世
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Ethicon Endo Surgery Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • A61B2017/00871Material properties shape memory effect polymeric
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft

Abstract

一种特别适合内窥镜使用的外科器械,通过将关节接头包括在在细长轴中弯曲端部执行器,该细长轴结合用于遥控地弯曲端部执行器的电活化聚合物(EAP)致动器。

Description

采用电致动关节机构的外科器械
相关申请的交叉参考
本申请要求系列号为60/591,694的美国临时申请的优先权,该申请由Shelton IV于2004年7月28日提交,名称为“结合电致动关节机构的外科器械”。
技术领域
本发明大体上涉及适合于将端部执行器(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/基因治疗输送装置和使用超声波、RF、激光等的能量装置)以可内窥的方式插入到手术部位的外科器械,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比传统的开方式外科装置更受到偏爱,这是因为较小的切口易于减少术后恢复时间和并发症。因此,在内窥镜外科器械的领域中已经有了显著发展,该内窥镜外科器械适合于将远端执行器通过套管针的套管精确地放置在所需的手术部位。这些远端执行器以多种方式接合组织以实现诊断或治疗作用(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/基因治疗输送装置和使用超声波、RF、激光等的能量装置)。
通过套管针限制端部执行器的定位。通常,这些内窥镜外科器械包括在端部执行器和由医生操作的手柄部分之间的长轴。这个长轴能够插入到所需深度并围绕轴的纵向轴线转动,从而将端部执行器定位到一定程度。在正确定位套管针和例如通过另一套管针使用抓钳器的条件下,通常这个定位量是足够的。诸如在美国专利NO.5,465,895中描述的外科缝合和切割器械是通过插入和转动成功定位端部执行器的内窥镜外科器械的一个例子。
更近地,美国专利系列号10/443,617描述了一种改进的用于切割组织和致动缝合的“E形梁”发射杆,该申请由Shelton等人于2003年5月20日提交,名称为“采用E形梁发射机构的外科缝合器械”,该申请在此全部引入作为参考。一些另外的优点包括即使为了最优化缝钉的形成而夹住略微过多或过少的组织,也可肯定地分隔端部执行器的钳口,或更具体地说,缝钉施加组件的钳口。此外,E形梁发射杆以能够采用几个有利的闭锁的方式接合端部执行器和缝钉匣。
取决于操作的性质,可能希望进一步调整内窥镜外科器械的端部执行器的定位。特别是,通常希望在横切该器械的轴的纵向轴线的轴线上定向端部执行器。通常将端部执行器相对器械轴的横向运动称为“关节运动”(articulation)。这典型地通过被放置在靠近缝钉施加组件的伸长的轴中的枢轴(或关节)接合来实现。这允许外科医生远程致动缝钉施加组件到任一侧,以便更好的手术放置缝合线和更简单的组织操作和定向。这种关节连接定位允许医生在一些情况下(例如在器官后)更简单地接合组织。另外,关节连接定位有利地允许将内窥镜定位在端部执行器后方,而不会被器械轴挡住。
由于将关节连接控制结合到在内窥镜器械的小直径的限制下闭合端部执行器以夹住组织和发射端部执行器(即,缝合和切割)的控制一起,关节连接外科缝合和切割器械的方法很复杂。通常,将三个控制动作都通过轴转换为纵向平移。例如美国专利NO.5,673,840披露了手风琴状的关节机构(“柔性颈”)该关节机构由有选择地通过执行轴拉回两个连接杆中的一个而进行关节运动,每个轴分别在杆中心线的相对侧处偏移。连接杆通过一系列不连续位置渐进运动。
关节机构的纵向控制器的另一个例子是美国专利No.5,865,361,该关节机构包括与一凸轮枢轴偏置的关节连接件,从而推动或拉动关节连接件的纵向平移而实现向各侧面的关节运动。同样地,美国专利No.5,797,537披露了穿过轴的类似的杆来实现关节运动。
在Kenneth Wales等人的未审结和共同拥有的系列号为10/615,973、名称为“采用具有围绕纵向轴线旋转的关节结构的外科器械”的美国专利申请中公开了采用旋转运动作为可选方式将关节运动转换成纵向运动的情况,该申请的全部内容在此引入作为参考。
虽然机械方式连接的关节运动已经成功地使内窥镜外科吻合和切割器械进行关节运动,但发展趋势为进入市场提出多种挑战和阻碍。矛盾的设计目标包括设计一种具有尽可能小的直径以减小手术开口的尺寸,然而具有足够强度以进行几种运动(例如,闭合,发射,关节运动,转动等)的轴。
另外,尽管希望进一步减小横截面的尺寸,还有与之相冲突的要求,在端部执行器处还希望有附加功能。例如,一种这样的附加功能是在缝合部位采用拱托(buttress)。拱托为一对薄的泡沫塑料或纤维条,被放置在砧板或匣上并被缝合到被横切的组织的各侧面的位置上。其为用于极薄或极厚组织的缝合线增加了结构完整性。其它的期望特征是附加的增强以防止采用不正确地闭合的端部执行器、空的缝钉匣或缺少匣而发射,以及通过向端部执行器发送能量或流体等进行治疗或者诊断处理的能力。在该器械的轴中产生足够的空间以便于这些附加功能,这是改进端部执行器进行关节运动的一个激励。
因此,对于关节运动外科器械存在这样的需要,即:采用关节机构,该关节机构需要更少的穿过该器械的轴的机械机构。
发明内容
通过提供具有在手柄和端部执行器之间连接的关节连接轴的外科器械,本发明克服了现有技术的上述和其它的缺点。布置在轴的关节接头的电活化聚合物(EAP)致动器响应通过轴的电信号以实现关节运动。从而可以得到有利的较小直径的轴,而且还具有可遥控致动的功能。
在本发明的一个方面中,外科器械包括在端部执行器和细长轴的远端的枢转关节接头。定位电动致动器以致动关节接头,响应在近侧连接到细长轴上的手柄所远程产生的电信号。
在本发明的另一方面中,外科器械具有细长轴,该细长轴具有框架组件和包围并且沿纵向可滑动接收的闭合套管组件。缝钉施加组件包括细长槽、连接在细长槽内的缝钉匣和以可枢转方式连接到细长轴的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。特别是,远侧框架部分被连接到细长槽而近侧框架部分以可枢转方式被连接到远侧框架部分。连接到细长槽近端的手柄选择地将电信号传递到细长轴以使连接到关节接头的与之响应的电活化聚合物操作缝钉施加组件的关节。这样,提供了一种可以从需要的角度接近组织的外科缝合和切割器械。
在本发明的又一方面中,所述闭合套管组件进一步包括接合砧板的远侧闭合管部分和联接到手柄部分上的近侧闭合管部分,闭合套管组件的多枢轴接头包括上部和下部双枢轴连接件,每个双枢轴连接件在两端中的每一端分别以可枢转的方式连接到远侧和近侧闭合管部分上。
在本发明的再一方面中,所述闭合套管组件的多支枢点轴接头包括远侧圆柱形构件,连接到其上的柔性闭合接头以及连接到该柔性闭合接头上的近侧圆柱形构件。
在本发明的另一方面中,所述柔性闭合接头包括由弹性材料形成并包括左和右列垂直狭槽的圆柱形套管。
在本发明的又一方面中,外科器械包括细长轴,该细长轴包括框架组件和包围的并被沿纵向滑动接收的闭合套管组件;缝钉施加组件,其包括一细长槽,接合在该细长通道中的缝钉匣以及以可枢转的方式连接到细长槽上的砧板,所述砧板为缝钉匣提供缝钉形成表面;在框架组件中形成的关节接头,该框架组件包括连接到细长通道的远侧框架部分和以可枢转的方式连接到远侧框架部分上的近侧框架部分;手柄部分,其被连接到细长轴的近侧上并具有可操作的构造以有选择地将电信号传达到细长轴;以及电活化聚合物致动器,其被连接到关节接头上并响应电信号以执行缝钉施加组件的关节运动。
在本发明的再一方面中,所述细长轴还包括框架组件,包围的并被沿纵向滑动接收的闭合套管组件,闭合套管组件的多枢轴接头包围关节接头并且在远侧接合上部钳口以使上部钳口枢转,手柄部分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打开和关闭。
在本发明的又一方面中,外科器械包括:端部执行器;细长轴;连接在端部执行器和细长轴的远端之间的关节接头;以及用于电致动关节接头的装置。
在本发明的另一方面中,所述关节接头包括用于在围绕细长轴的纵向轴线的圆弧上支撑端部执行器的装置。
在本发明的再一方面中,所述端部执行器进一步包括由发射杆致动的缝合和切割组件,手柄部分在近侧连接到该发射杆上并具有可操作的构造以将纵向的发射运动传给该发射杆,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该发射杆的发射杆导向器。
在本发明的另一方面中,所述下部钳口包括包含缝钉匣的细长通道,以可枢转的方式连接的上部钳口包括提供缝钉形成表面的砧板。
在本发明的又一方面中,所述细长轴包括框架组件和闭合套管组件,关节接头将端部执行器的下部钳口以可枢转的方式连接到框架组件的远端上,手柄部分具有可操作的构造以使沿纵向闭合运动接合闭合套管组件,并且闭合套管组件的多枢轴接头包围关节接头并在远端侧接合到上部钳口,从而实现上部钳口的枢转。
通过下面的附图和对附图的说明,将清楚地了解本发明的这些和其它目的及优点。
附图说明
包括在该说明书中并构成该说明书的一部分的附图图示出本发明的实施例,并且与上述本发明的概述以及下述实施例的详细说明一起用来解释本发明的原理。
图1是处于打开、未进行关节运动状态的用于外科缝合和切割的内窥镜外科缝合器械的后侧透视图。
图2是层压的电活化聚合物(EAP)复合材料的透视图。
图3是由堆叠形成的EAP板状致动器的透视图,该堆叠由粘合固定的多个图2中的层压EAP复合材料形成。
图4是沿收缩的EAP纤维致动器的纵向轴线的剖面的透视图。
图5是沿图4中收缩的EAP纤维致动器的线5-5截取的横截面的主剖视图。
图6是图1中用于外科器械的EAP致动关节接头的前右侧透视图,带有柔性闭合套管组件、枢转框架组件和关闭的缝钉施加组件。
图7是图6中EAP致动关节接头和闭合的缝钉施加组件的前右侧透视图,去除了柔性闭合套管组件并部分分解了单枢轴框架组件。
图8是图6中EAP致动关节接头和缝钉施加组件的前右侧分解透视图。
图9是包括图7中的EAP纤维致动器的分解的单枢轴框架组件的详视图。
图10是沿图6的线10-10截取的横截面的右侧剖视图,其通过EAP致动关节接头的枢轴轴线并向右看时可见一对EAP纤维致动器。
图11是沿图6的线11-11截取的横截面的俯视图,其通过EAP致动关节接头的纵轴,向下看时可见下部力矩臂和下部EAP纤维致动器。
图12是沿着图10的线12-12沿横向EAP纤维致动器的横截面截取的主剖视图。
图13是图11的EAP致动关节接头的俯视图,其中右上部和下部EAP纤维致动器收缩以使缝钉施加组件向左进行关节运动。
图14是另一可替换的EAP致动关节接头的前右侧透视图,该关节接头包括在端部执行器的砧板的近侧位置开口处的双枢轴闭合套管组件。
图15是图14中另一可替换的EAP致动关节接头的前右侧分解图,该关节接头包括双枢轴闭合套管组件和单枢轴框架组件。
图16是沿图14的线16-16的横截面截取的可替换EAP致动关节接头的右侧剖视图,其中包括了发射元件。
图17是可替换EAP致动关节接头在未进行关节运动条件下沿图14的线17-17截取的横截面的俯视图。
图18是可替换EAP致动关节接头在向左进行关节运动条件下沿图14的线17-17截取的横截面的俯视图。
图19是处于轻微关节运动状态的又一可替换EAP致动关节接头,其中使收缩的EAP纤维致动器定位以伸直接头。
图20是部分分解的单枢轴关节接头的右前侧透视图,该关节接头有利地包括被偏置以正常锁定的EAP关节锁定机构。
图21是在单枢轴关节接头的近侧框架底(frame ground)的EAP关节锁定机构的近侧部分的详细示出的右前透视图。
图22是图20中的单枢轴关节接头的俯视图。
图23是图22的单枢轴关节接头沿线23-23的纵向中心线截取的横截面的右侧剖视图。
图24是图23的单枢轴关节接头沿线24-24的横截面截取的俯视图,以便示出在未处于关节运动状态的由EAP关节锁定机构锁定的位于上部枢轴柄脚上的扇形齿轮。
图25是向下看近侧框架底的下部枢轴凸起沿线24-25的中心线的横截面截取的图23的单枢轴关节接头的俯视图,其中该近侧框架底使端部执行器部分地向左进行关节运动,同时EAP关节锁定机构被致动到未锁定状态。
图26是沿线26-26的横截面截取的图24中单枢轴关节接头的远侧框架底的剖视图,示出了使接头进行关节运动的EAP纤维致动器的连接。
图27是沿线27-27的横截面截取以暴露出EAP堆叠致动器和EAP致动锁定机构的锁定销的图24中单枢轴关节接头的近侧框架底的主剖视图。
图28是沿单枢轴关节接头的远侧框架底的上部枢轴柄脚和近侧框架底的上部枢轴凸起之间的界面的横截面截取的俯视图,其中变长的EAP纤维致动器与EAP关节锁定机构相结合作用在反向(rounded)力矩臂上。
图29是大体沿通过近侧框架底和EAP关节锁定机构的横截面截取的主剖视图,但是示出了更远侧看到的力矩臂和连接到其上的变长的EAP纤维致动器。
图30是沿近侧框架底的上部枢轴凸起的顶表面的横截面的单枢轴关节接头的俯视图,显示了靠着力矩臂作用的膨胀的EAP堆叠致动器,该力矩臂在远侧连接到上部枢轴凸起上,以同为了准备进行关节运动而激励的沿垂直方向锁定的EAP关节锁定机构一起使用来实现关节运动。
图31是沿通过力矩臂的上部和下部末端销并通过EAP堆叠致动器的横截面截取的图30中单枢轴关节接头的主剖视图。
图32是在使远侧框架底向左进行关节运动后、但是在EAP关节锁定机构断电以实现关节锁定之前、沿近侧框架底的上部枢轴凸起的顶表面的横截面截取的图30中单枢轴关节接头的俯视图。
图33是沿通过力矩臂的上部和下部末端销并通过左侧膨胀和右侧压缩的EAP堆叠致动器的横截面截取的图31的单枢轴关节接头的主剖视图。
图34是将闭合套管组件切除以露出使柔性关节连接框架底进行关节运动的EAP致动关节机构的外科器械的右侧剖视图。
图35是向左进行关节运动的图34的外科器械的俯视图。
图36是采用EAP板状致动器和锁定条的图34的关节连接框架底的前右侧透视图。
图37是处于向左进行关节运动状态的图34的关节连接框架底的俯视图,其中以双点划线示出了处于未锁定致动状态和锁定释放状态的左侧EAP锁定条。
图38是沿通过EAP板状致动器和EAP锁定条的横截面截取的处于向左关节运动状态的图34中关节连接框架底的俯视图。
图39是沿通过横向导向销的线39-39的横截面截取的图37中关节连接框架底的主剖视图。
图40是沿通过多个EAP肋撑板致动器(rib spreader actuator)的横截面截取的可替换关节连接框架底的俯视图。
图41是具有多个EAP纤维致动器的又一可替换的关节连接框架底的部分分解的右侧透视图。
图42是沿线42-42的横截面截取的图41中另外的可替换的关节连接框架底的主剖视图。
图43是沿穿过外科器械的关节接头的发射杆的纵向横截面的俯视图,其中通过带有一个滑动端的向内致动EAP板状致动器的支撑板来有利地沿横向导向发射杆。
图44是穿过图43的外科器械的进行关节运动的关节接头的发射杆的纵向横截面截取的俯视图。
图45是沿穿过外科器械的进行关节运动的关节接头的发射杆的纵向横截面截取的俯视图,其中通过带有一个滑动端的向外致动的EAP板状致动器的支撑板来有利地沿横向导向发射杆。
图46是沿穿过外科器械的关节接头的发射杆的纵向横截面截取的俯视图,其中通过向外致动的EAP支撑板有利地沿横向导向发射杆,每个支撑板具有受约束但是可沿纵向浮动的钩状端。
图47是沿穿过外科器械的关节接头的发射杆的纵向横截面截取的俯视图,通过向外致动的EAP支撑板有利地沿横向导向发射杆,该支撑板分别具有一个固定的钩状端和一个被弹簧沿纵向约束的端部。
图48是沿穿过外科器械的关节接头的发射杆的纵向横截面截取的俯视图,其中通过向外致动的EAP支撑板有利地沿横向导向发射杆,该支撑板具有两个被弹簧沿纵向约束的端部。
图49是采用图45或46的EAP支撑板的柔性关节接头的俯视图。
图50是沿线49-49的图49的柔性关节接头的主剖视图。
图51是向左进行关节运动的图49的柔性关节接头的俯视图。
图52是采用图45或46的EAP支撑板并包括左和右侧EAP板状关节致动器的柔性关节接头的前右侧透视图。
具体实施方式
关节轴概述
图1中示出了作为外科切割和缝合器械10的一种外科器械,该器械10在其远端具有缝钉施加组件12的端部执行器,通过细长轴16使该缝钉施加组件远离手柄14。缝钉施加组件12包括用于接收可更换的缝钉匣20的缝钉槽18。砧板22以可枢转的方式连接到缝钉槽18上,该砧板22抵靠缝钉匣20夹紧组织,以便缝合和切割。当闭合缝钉施加组件12时,它的横截面区域和细长轴16适合于通过小手术开口(例如通过套管针的插管(未示出))插入。
通过控制手柄14便于正确的定位和定向缝钉施加组件12。特别是,旋钮30导致轴16围绕其纵向轴线旋转,并由此旋转缝钉施加组件12。在轴16中的关节接头32处能够实现附加的定位,能够使缝钉施加组件12在从轴16的纵向轴线开始的一段圆弧上枢转,从而允许放置在器官后方或允许将诸如内窥镜(未示出)的其它器械在缝合施加组件12的后方定向。通过位于手柄14上的关节控制开关34有利地控制该关节,该手柄将电信号传送到关节接头32,并传送到由EAP控制器和手柄14内的电源38供能的电活化聚合物(EAP)致动器36。
当将组织定位在缝钉施加组件12中,医生通过将闭合扳柄40向近侧拉向手枪式握柄42闭合砧板22。从而一旦夹住组织,医生可以握住位于更远侧的发射扳柄44,将该扳柄向后拉,以发射缝钉施加组件12,在一些应用中这由一个发射冲程实现,而在另一些应用中通过多个发射冲程实现。在切割其间组织的同时,发射同时实现至少两排缝钉的缝合。
可以在全部行程上自动开始发射元件的收回。可替换地,可以向后拉动回位杆46以实现收回。在收回发射元件的条件下,通过医生将闭合扳柄40朝手枪式握柄42向后轻轻地拉动并且压下闭合释放按钮48,然后释放闭合扳柄40,可以使缝钉施加组件12松开和张开,从而将被切割组织的两个被缝钉缝合端部从缝钉施加组件12中释放。
应当理解,此处的有关空间的术语,例如垂直,水平等参考附图给出,附图中假设外科器械10的纵向轴线水平,并且缝钉施加组件12的砧板22在手柄顶部垂直排列,而扳柄40、44在手柄14的底部垂直排列。然而,在实际使用中,可以将外科器械10以各种角度定向,同样地,这些有关空间的术语是相对外科器械10本身使用的。另外,近侧是指在手柄14后方将端部执行器12向远侧远离自己的医生的透视角。
手柄
在图1中,缝钉施加组件12通过在轴架(图1中未示出,但在下面参考图7描述)上沿轴16纵向向下传递的两个不同的动作实现夹住组织、驱动缝合和切割组织的功能。这种轴架组件向近侧连接到手柄14,并为了旋转与旋钮30连接。在如下的未审结和共同拥有的美国专利申请中更详细地描述了图1中用于外科缝合和切割器械10的示例性多冲程手柄14,该申请是Swayze和Shelton申请的系列号为10/674,026、名称为“采用多冲程发射位置指示器和收回机构的外科缝合器械”的申请和由Kevin R.Doll、Jeffrey S.Swayze、FrederickE.Shelton IV、Douglas B.Hoffman和Michael E.Setser于2005年2月7日申请的系列号为11/052,387、名称为“采用具有回位弹簧旋转手动缩回系统的多冲程发射机构的外科缝合器械”的申请,上述申请公开的内容在此全部引入作为参考,附加特征和变化在此进行描述。
虽然多冲程手柄14有利地支持在长距离上高发射力的应用,但是与本发明一致的应用可以采用单一发射冲程,例如在由FrederickE.Shelton IV、Michael E.Setser和Brian J.Hemmelgarn申请的系列号为10/441,632的名称为“具有分开的不同闭合和发射系统的外科缝合器械”未审结和共同拥有的美国专利申请中所描述的,该申请的公开内容在此全部引入作为参考。
电活化聚合物
电活化聚合物(EAPs)是一组当施加电压时改变形状的导电的掺杂质的聚合物。本质上,导电聚合物与一些形式的离子流体或凝胶和电极配对。通过施加电势导致离子从流体/凝胶流入或流出导电聚合物,并且这种流动导致聚合物形状的变化。根据使用的聚合物和离子流体,电势的范围为1V-4kV。当施加电压时,一些EAP收缩,而另一些则膨胀。可以将EAP与诸如弹簧或柔性板的机械装置配对,以改变在施加电压时产生的效果。
存在两种基本类型的电活化聚合物并且每种类型有多个结构。两种基本类型是纤维束和层压形式。纤维束由大约为30-50微米的纤维组成。这些纤维可以类似纺织品那样被编织成束,并由此通常被称为EAP纱。当施加电压时,这种EAP收缩。电极通常是中央线芯和同样用来包含围绕纤维束的离子流体的导电外壳。可从商业渠道获得的纤维EAP材料的一个例子是由Santa Fe Science andTechnology制造,其作为PANIONTM纤维出售,这在美国专利NO,6,667,825中有描述,该专利在此全部引入作为参考。
另一种类型是层压结构,该层压结构由一层EAP聚合物、一层离子凝胶和两个附着到层板各侧面的柔性板组成。当施加电压时,正方形层压板沿一个方向膨胀,并且在其垂直方向收缩。作为SRILaboratories的一个部门的Artificial Muscle Inc.制造了可以商业渠道获得的层压(板状)EAP材料的一个例子。板状EAP材料也可以从日本的EZMEX获得,并被称为薄膜EAP。
应当注意,当提供能量时EAP不会改变体积;它们仅在一个方向膨胀或收缩,而在其横向进行相反的变化。通过将一侧靠着刚性结构并类似活塞一样使用另一侧可以以其基本形式使用层压形式。也可以将它粘贴在柔性板的各侧。当向柔性板状EAP的一侧施加能量时,该EAP膨胀,从而将该板以相反方向弯曲。这允许根据施加能量的侧面使板向任一方向弯曲。
一个EAP致动器通常由许多层或捆扎在一起的纤维组成,以便协同工作。EAP的机械构造决定了EAP致动器和它的运动性能。可以将EAP形成长导线束并围绕一个中央电极缠绕。柔性外部外套管形成用于致动器的其它电极以及包含设备功能所必需的离子流体。在这种构造中,当对电极施加电场时,EAP的导线束变短。将这种构造的EAP致动器称为纤维EAP致动器。同样,可以将层压构造放置在柔性板的各侧上的许多层中,或者仅在它本身的层上以增加它的性能。典型的纤维结构具有2-4%的有效伸长率(effetive strain),而使用更高的电压,典型的层压形式可达到20-30%的有效伸长率。
在附图2中示出了层压EAP复合材料100,该层压EAP复合材料由连接到EAP层104的正的板状电极层102形成,该EAP层104又被连接到离子室(ionic cell)层106,该离子室层又被连接到负的板状电极层108。在图3中,许多五层层压EAP复合材料100通过其间的粘合剂层110被固定成堆,以形成EAP板致动器120。应当理解,可以形成相反的EAP致动器120,该EAP致动器120能够有选择地沿各方向弯曲。
在图4-5中,收缩的EAP纤维致动器140包括纵向铂阴极导线142,该导线穿过绝缘聚合物近端帽144,通过在塑料圆柱形壁148内形成的细长的圆柱形腔替146,该塑料圆柱壁导电地掺杂以用作阳极。将铂阴极导线142的远端埋放入绝缘聚合物远端帽150中。许多收缩聚合物纤维152被平行且围绕阴极导线142布置,它们的端部被埋放入各端部帽144、150中。塑料圆柱形壁148沿外周围绕各端部帽144、150连结以封闭圆柱形腔体146,从而密封入填充在收缩聚合物纤维152和阴极导线142之间的空间的离子流体或凝胶154。当跨过塑料圆柱壁(正极)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,导致它们的外径膨胀,并且长度相应地收缩,从而将端部帽144、150朝向彼此拉动。EAP致动关节接头
在图6-13中,外科切割和缝合器械200包括一EAP致动关节接头202,该EAP致动关节接头在该器械的细长轴204靠近侧部执行器处形成,通过外科缝合和切割组件12图示出该端部执行器,该外科缝合和切割组件有利地响应由细长轴204纵向传递的分开的闭合和发射运动。EAP致动关节接头202有利地增加了关节接头的缝钉施加组件12的理想的临床灵活性。
在图6-13的示例性形式中,EAP致动关节接头202更具体化为柔性闭合和枢转框架关节接头210,在图6中示出的绕枢轴转动框架关节接头包括具有近侧闭合管214和由柔性闭合管218连接的远侧闭合环216的柔性闭合套管组件212。在柔性闭合管218中形成的垂直狭缝220、222的左和右纵向列允许向右或向左弯曲以进行关节运动,但是连续的顶部纵向条带224与该弯曲量无关地传递纵向闭合运动。应当理解,相同的连续底部纵向条条带沿着柔性闭合管218的底部延伸(未示出),该底部纵向条条带与顶部纵向条条带224相对并与它共同作用传递这种运动。特别是,远侧闭合环216的顶部部分包括接合砧板22的砧板闭合件228的马蹄形孔226。在图7中,砧板22包括在其近端处的横向突出的枢轴销230,该枢轴销以可枢转的方式接合靠近细长槽18的近端形成的枢轴孔232(图7-8)。当柔性闭合套管组件212向远侧运动时,略微更远侧砧板闭合件228就这样传递闭合运动,当该柔性闭合套管组件向近侧运动时,该砧板闭合件传递打开运动。柔性闭合管218可以沿着垂直缝220、222的左和右纵向列的长度弯曲,从而在进行关节运动时容纳柔性闭合和枢转框架关节接头210的被包裹的单枢轴框架组件234。
特别参考图7-9,单枢轴框架组件234包括具有向远侧突出的顶部和底部枢轴凸起238、240的近侧框架底236,每个枢轴凸起分别具有顶部和底部枢轴销孔242、244。从远侧框架底250向近侧突出的相应的顶部和底部枢轴柄脚246、248以可枢转的方式接合近侧框架底236,各柄脚246、248分别具有顶部和底部枢轴销孔252、254。特别是,垂直对准的顶部枢轴销孔242、252和底部枢轴销孔244、254分别通过顶部和底部框架枢轴销256、258接合(图10)。
在图8中,由细长轴16和缝钉施加组件12形成的外科器械200的执行部分260还包括发射杆270,该发射杆沿纵向平移穿过近侧框架底218、通过柔性闭合和枢转框架关节接头210并通过在远侧框架底250中的发射狭槽272进入缝钉施加组件12。在远侧框架底250的顶部形成的远侧和近侧方形孔274、276限定了在其间的夹条278,该夹条接收夹弹簧282的顶部臂280,该夹弹簧的较低的、向远侧延伸的臂284在沿着发射杆270的上部、对于发射行程的空/缺少缝钉匣闭锁部分的升起部分286上维持向下的压力。
特别参考图8,将发射杆270的向远侧突起端连接到E形架288,该E形架辅助将砧板22与缝钉匣20分隔开、切割组织和致动缝钉匣20。缝钉匣20包括模制的缝钉匣本体290,该缝钉匣本体保持有许多位于各向上开口的缝钉孔294内的缝钉驱动器292上的缝钉。通过E形架288向远侧驱动楔形滑轨296,在缝钉匣托架298上滑动,该缝钉匣托架将可更换缝钉匣20的各个元件保持在一起。楔形橇296向上凸起(cam)缝钉驱动器292以迫使缝钉与砧板22变形接触同时E形架288的切割表面300切割被夹紧的组织。应当理解,在发射过程中E形架288的上部销302接合砧板22,而中间销304和底部支脚306使在细长槽18中形成的纵向狭缝槽308的各顶部和底部表面与对应的缝钉匣托架298中的纵向开口310和位于缝钉匣本体290中向后开口的垂直狭缝312接合。其后,向近侧收回发射杆270,以及收回E形架288,允许砧板22打开以释放两个被缝钉缝合和切割的组织部分(未示出)。
在未审结和共同拥有的系列号为10/955,042的美国专利申请中更详细描述了缝钉施加组件12,该申请由Frederick E.Shelton IV等人于2004年9月30日申请,名称为“采用两片E形架发射机构的关节连接外科缝合器械”,该申请公开的内容在此全部引入作为参考。
特别参考图9-13,EAP致动系统400响应从手柄14接收的电动关节运动信号(未示出)而有利地致动单枢轴框架组件234。在图7-13的示例性形式中,顶部左侧和顶部右侧的EAP纤维致动器402、404沿水平方向连接到顶部的向远侧突出的力矩臂406的各横向侧,该力矩臂406连接到顶部枢轴凸起238。将顶部左侧和顶部右侧的EAP纤维致动器402、404的外端连接到远侧框架底250的内径410的对应的上部左侧和右侧横向连接点406、408。同样地,底部左侧和底部右侧的EAP纤维致动器412、414沿水平方连接到底部的向远侧突出的力矩臂416的各横向侧边,该力矩臂416连接到底部枢轴凸起240。将底部左侧和底部右侧的EAP纤维致动器412、414的外端连接到远侧框架底250的内径410的对应的下部左侧和右侧横向连接点418、420。图12示出了连接点406、408、418、420穿过远侧框架底250,在图9中的远侧框架底250的外部能够看到左侧的连接点406、418。致动一对EAP致动器,例如在图13中所示,特别参照上部和下部右侧EAP纤维致动器404、414,使它们收缩,将上部和下部力矩臂406、416朝远侧框架底250的右侧拉动,从而伸展上部和下部EAP纤维致动器402、412,塌缩垂直狭槽220的左侧纵向列排,并扩张垂直狭槽222的右边纵向列。
在图14-18中,外科切割和缝合器械500包括可替换的EAP致动关节接头502,该接头包括双枢轴闭合套管组件504(图14-15)和单枢轴框架组件506(图15-18)。图14中示出了去掉可更换的缝钉匣20并且砧板22打开的缝钉施加组件12。从而,双枢轴闭合套管组件504在其近侧位置,使它的远侧枢转轴线对准框架组件506的枢转轴线。应当理解,随着闭合套管组件504向远侧运动以闭合砧板22,闭合套管组件504的近侧枢转轴线也进行枢转,以便在进行关节运动的框架组件506上平移。
特别参考图15,双枢轴闭合套管组件504包括近侧闭合管510,将近侧闭合管的远端采用键连接(keyed)固定到具有上部和下部远侧突出柄脚514、516的近侧闭合环512。将包括马蹄铁形孔520以将砧板闭合件228接合到砧板22上的远侧闭合管518在近侧通过销连接到具有上部和下部近侧突出柄脚524、526的远侧闭合环522。上部双枢轴连接件528包括向上突出的远侧和近侧枢轴销530、532,该枢轴销530、532分别接合到上部近侧突出柄脚524中的上部远侧销孔534和上部远侧突出柄脚514中的上部近侧销孔536。下部双枢轴连接件538包括向下突出的远侧和近侧枢轴销540、542,该枢轴销540、542分别接合下部近侧突出柄脚526中的下部远侧销孔544和下部远侧突出柄脚516中的下部近侧销孔546。
特别参考图15-18,单枢轴框架组件506包括近侧框架底550,该框架底550的远端包括居中心的并靠近在左和右力矩臂556、558之间限定的远侧开口的枢轴凹口554的枢轴销孔552。八字形(dogbone)连接件560包括:向上接合在近侧框架底550中的枢轴销孔552的近侧销562,和在左和右力矩臂556、558之间枢转的中央杆564。八字形连接件560的远侧销566刚性连接在远侧框架底570中的下部近侧孔568中,该远侧框架底具有接合细长槽18中的近侧导向件574的远侧侧面导向件572。
EAP致动系统580包括左侧和右侧EAP堆叠致动器582、584,该堆叠致动器有选择地膨胀以在八字形连接件560的中央杆564上维持关节力,该八字形连接件被动地压缩其它的EAP堆叠致动器。在图18中,右侧EAP堆叠致动器582已经膨胀,而使八字形连接件560枢转,并因此将缝钉施加组件12绕枢轴转动到左边侧,并且被动地压缩左侧EAP堆叠致动器584。
在图19中,另一可替换的用于外科器械602的EAP致动关节接头600包括单枢轴框架组件604,其中将近侧框架底606在枢轴销612处接合远侧框架底610的向近侧突出柄脚608。将向近侧突出柄脚608在右部横向侧凹进以限定在枢轴销612的右侧上的半个泪珠形滑轮614。连接到半个泪珠形滑轮614的远点的是收缩的EAP纤维致动器616的远端,该致动器符合其外形并穿入近侧框架底606。收缩的EAP纤维致动器616可以充分长,从而即便对于小比率的长度收缩,也可以实现明显的转动。应当理解,可以在示出的柄脚608的左侧上使用反向转动机构,该柄脚608位于EAP关节接头600的另一侧形成的相同但反向的机构上。用于枢转关节机构的关节锁定机构
在图20-27中,将EAP致动关节锁定器700结合到用于外科器械704的枢转关节接头702。为了清楚起见,将单枢轴框架组件706与具有向远侧延伸的上部和下部枢轴凸起710、712的近侧框架底708一起示出,枢轴凸起710、712可枢转地接合到远侧框架底718的向近侧指向的上部和下部柄脚714、716,该远侧框架底718被连接到端部执行器720上。将上部枢轴凸起710的上部内孔722在上部柄脚714的上部外孔724的下方对准,通过上部枢轴销726将上部内孔和上部外孔可枢转地通过销连接在一起。将下部枢轴凸起712的下部内孔728在下部柄脚716中的下部外孔730的下方对准。通过下部枢轴销732将孔728、712可枢转地通过销连接在一起。上部和下部力矩臂734、736分别从上部和下部枢轴凸起710、712向远侧延伸。可以通过基本上水平地上部左侧EAP纤维致动器740将上部力矩臂734朝形成在远侧框架底718中的上部左侧连接点738向左推动。通过基本上水平的上部右侧EAP纤维致动器744可以将上部力矩臂734朝形成在远侧框架底718中的上部右侧连接点742向右推动。通过基本上水平的下部左侧EAP纤维致动器748可以将下部力矩臂736朝形成在远侧框架底718中的下部左侧连接点746向左推动。通过基本上水平的下部右侧EAP纤维致动器752可以将下部力矩臂736朝形成在远侧框架底718中的下部右侧连接点750向右推动。
通过未示出的闭合机构(例如作用在砧板枢轴上的EAP致动器)的动作可以产生砧板22的闭合。或者,在实现缝合和切割的进一步的运动之前发射运动可以首先关闭砧板。作为另一替换,闭合套管组件或其它纵向联接机构(未示出)可以将闭合运动传递到砧板22。
上部EAP致动关节锁定机构800有利地解锁枢转关节接头702以允许进行关节运动。然后EAP致动关节锁定机构800放松到锁定状态,从而提供不允许能量在关节运动量变化之间消耗及由此的元件加热的稳定锁定位置。在矩形上部锁定凹口804中示出了上部锁定栓组件802,矩形上部锁定凹口形成在近侧框架底708中,该近侧框架底接近上部枢轴凸起710,并且垂直地比上部枢轴凸起更远离纵向中心线。锁定栓806将锁定尖端808延伸到在上部锁定凹口804中形成的远侧狭槽810之外、与形成围绕近侧表面形成的扇形齿轮814的最接近的齿根接合,该近侧表面围绕远侧框架底718的上部枢轴柄脚714。锁定栓806在近侧终止到横向板816,该横向板在近侧定位压缩弹簧818以及上部左和右侧EAP堆叠致动器820、822的推力之间在矩形上部锁定凹口804中沿纵向滑动,可以致动EAP堆叠致动器820、822,以便沿纵向膨胀,从而在向近侧运动锁定栓806时压缩该压缩弹簧818,由此使锁定尖端808与扇形齿轮814脱离接合,允许枢转关节接头702被重新定位。上部锁定盖824封闭上部锁定凹口804。
为了附加的锁定支撑,在图23中与上部锁定机构800相同的下部EAP致动关节锁定机构830作用在靠着下部枢轴柄脚716的相对位置上。还应当理解,可以将相同的锁定机构结合到细长轴的远侧部分中而不是结合到近端。另外,双枢轴连接件可以包括在各枢轴处的锁定装置。
在使用中,将未进行关节运动的端部执行器720和枢转关节接头702(图20-24)插入到手术部位。随着EAP锁定机构800、830通常地断电,连接到近侧框架底708的锁定尖端808接合远侧框架底718的扇形齿轮814,锁定单枢轴框架组件706。当需要时,给EAP堆叠致动器820、822提供能量以沿纵向加长,从而解锁EAP关节锁定机构800、830。当解锁时,可以使关节接头702进行关节运动,例如通过收缩上部和下部右侧EAP纤维致动器744、752,以将端部执行器720枢转到左侧(图25),将不同的齿根812提供给锁定尖端808,从而当断电时,EAP致动锁定机构800将锁定到外科器械704的关节运动状态。
在图28-29中,示出了用于单枢轴关节接头901的可替换EAP关节系统900,用于与前述的EAP关节锁定机构800一起使用。通过将上部和下部反向(rounded)力矩臂910、912在远侧分别结合在近侧框架底918的上部和下部枢轴凸起914、916上,使上、下成对的左、右侧EAP纤维致动器902、904、906、908变长。远侧框架底922中的上部左侧连接点920稍微高于上部右侧连接点924。下部左侧连接点926也稍微高于下部右侧连接点928,这对应于上部和下部左侧EAP纤维致动器902、906分别在对应的上部和下部反向力矩臂910、912的比上部和下部右侧EAP纤维致动器904、908高的部分缠绕(图29)。从而,可以根据所需的性能特征选择与力矩臂910、912的长度和外形轮廓结合的变长的EAP纤维致动器902-908。
在图30-33中,示出了用于单枢轴关节接头1001的另外的可替换的EAP关节系统1000,用于与前述的EAP致动锁定机构800一起使用。代替致动关节运动作用的EAP纤维致动器,上部和下部成对的左、右侧EAP堆叠致动器1002、1004、1006、1008分别相对,并沿横向运动上部和下部纵向轨道1010、1012。向远侧突出的上部力矩臂1014连接到近侧框架底1018的上部枢轴凸起1016。在上部力矩臂1014的远端处的上部向内指向末端销1020沿纵向滑动地接合上部纵向轨道1010,从而响应由远侧框架底1022沿横向限制的上部左和右侧EAP堆叠致动器1002、1004的不同的收缩和膨胀。向远侧突出的下部力矩臂1024连接到近侧框架底1018的上部枢轴凸起1026。在上部力矩臂1024的远端处的下部向内指向末端销1030沿纵向滑动地接合下部纵向轨道1012,从而响应由远侧框架底1022沿横向限制的下部左和右侧EAP堆叠致动器1006、1008的不同的收缩和膨胀。
在图30-31中,为了准备进行关节运动,将EAP关节锁定机构800致动以使锁定尖端808与扇形齿轮814脱离接合。在图32-33中,上部和下部左侧EAP堆叠致动器1002、1006已经被供能膨胀,沿横向向右运动上部和下部纵向轨道1010、1012,从而压缩上部和下部EAP堆叠致动器1004、1008,并且相应地运动远侧框架底1022抵抗来自上部和下部向内指向末端销1020、1030的反作用力,该末端销在示例性关节中向左。
带有EAP致动柔性颈(flexneck)关节接头的外科器械
在图34中,外科器械1200有利地采用EAP致动关节接头1202,该关节接头与细长轴1206的关节连接框架组件1204成为一体,该细长轴1206将单独地闭合和发射运动从手柄1208传递到端部执行器1210,该端部执行器被示出为具有可闭合砧板1214的缝钉施加组件1212,将可闭合砧板以可枢转的方式连接到保持有可更换缝钉匣1218的细长槽1216。手柄1208包括向近侧朝手枪式握柄1222握紧以关闭砧板1214的闭合扳柄1220。应当理解,闭合套管组件1223或未示出的其它闭合装置(例如,EAP致动砧板、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。一旦被闭合或夹紧,向手枪式握柄1222握紧更远侧的发射扳柄1226,以实现发射构件1228沿纵向向下发射细长轴1206以导致组织的切割和被切割端部的缝合。一旦将发射扳柄1226释放,随着轻轻压下闭合扳柄1220一起压下闭合释放钮1230,以在释放闭合扳柄1220后释放夹紧元件,从而打开砧板1214并允许被缝合和切割组织的释放。旋钮1232允许围绕细长轴1206的纵向轴线的有选择地转动。
关节连接框架组件1204包括在近侧可转动地连接到手柄1208,并且在远侧连接到关节连接框架底1242的近侧框架底1240,该关节连接框架底1242又被连接到支撑端部执行器1210的远侧框架底1244。手柄1208上的关节控制器1246有利地允许通过致动到该处适当的的电信号来选择关节连接框架底1242的关节运动,例如图35中示出了已通过关节控制器1246选择的向左的关节运动。应当理解,关节控制器1246可以有利地包括手动和/或自动地使用于关节连接框架1242的关节锁定器脱离接合。
在图36-39中,关节连接框架底1242结合使用左和右侧EAP板状致动器1302、1304的EAP致动系统1300,该EAP板状致动器1302、1304穿过在基本上为圆柱形的弹性框架体1310的各横向侧的对应的左边和右侧矩形致动器凹槽1306、1308(图38-39)。矩形刀槽1312形成在弹性框架体1310中,该弹性框架体在用于引导发射杆1314的左、右矩形致动器凹槽1306、1308之间对准,该发射杆是发射构件1228的远侧部分。
当关节连接框架底1242是直的或在进行关节运动的时候,弹性框架体1310的连续的顶部和底部纵向条带1320(图36-37)保持发射杆1314的纵向行程量。弹性框架体1310有利地由均质材料形成,该均质材料不会沿其纵向轴线显著地压缩。左、右多个纵向排列的垂直凹槽1322、1324分别贯穿(intersect)左、右EAP致动器凹槽1306、1308。各垂直凹槽1322、1324均包括矩形通孔1326,该通孔与矩形刀槽1312和左或右矩形致动器凹槽1306、1308中适当的一个平行地但沿横向偏离地从顶部到底部穿过弹性框架体1310。各矩形通孔1326沿横向与横向窄缝1328连通。在相邻垂直凹槽1322、1324之间限定了具有狭窄内壁1332的肋1330,该狭窄内壁允许连续顶部和底部纵向条带1320的沿横向弯曲,该肋还具有较厚的弯曲外板1334,该弯曲外板支撑对应的一个EAP板状致动器1302、1304,并且当致动一个或两个EAP板状致动器1302、1304以在所选择的方向弯曲时,在横向窄缝1328完全塌缩之前,限制可以在那个方向实现的关节活动量。例如在图37中,激励左侧EAP板状致动器1302以向左致动,同时右侧EAP板状致动器1304相应地扩展。应当理解,当电激励以分别在左和右侧矩形致动器凹槽1306、1308内产生拉力或推力时,左、右侧EAP板状致动器1302、1304可以交替地收缩或膨胀。
在图38-39中,关节连接框架底1242有利地包括EAP关节锁定机构1350,该锁定机构有选择地将弹性框架体1310保持在向左进行关节运动或向右进行关节运动的状态。为了该目的,限定左侧锁定通道1352临近多个矩形通孔最左侧的外部部分穿过左侧多个矩形通孔1326,从而允许左侧凸脊状EAP锁定条1354从该处穿过。同样,限定右侧锁定通道1356临近多个矩形通孔1326穿过它们的右侧的外部部分,从而允许右侧凸脊状EAP锁定条1358的放置。沿着左、右凸脊状EAP锁定条1354、1358的各自的最外侧表面1360,多个沿纵向间隔开的垂直堵塞凸脊1362被沿纵向间隔开和设定尺寸,以同肋1330的几何形状一起限定而锁定在期望的关节运动量。特别是,当柔性框架底1242朝一个对应的凸脊状EAP锁定条1354、1358的相对侧进行关节运动时,在该侧上的肋1330变成弓形彼此远离,如图38所示的正在向左进行关节运动。一旦肋1330达到足够用于锁定的间隔时(即,比竖直堵塞凸脊1362的纵向宽度更宽),右侧凸脊状EAP锁定条1358被向外偏压以将其凸脊1362卡接在相邻肋1330的相邻的被变厚的较厚弯曲外部片1334之间。致动右侧凸脊状EAP锁定条1358导致解锁右侧凸脊状EAP锁定条1358的收缩。在图39中,在矩形刀槽1312上方和下方穿过的横向的上部和下部导向销1370、1372保持横向对准。
在图40中,关节连接框架底1242结合使用多个左和右侧EAP肋撑板致动器(rib spreader plate actuator)1402的EAP致动系统1400,该撑板致动器每一个均位于弹性框架体1408相对的一对远侧和近侧开口矩形凹槽之间。各相对的一对远侧和近侧开口矩形致动器凹槽1404、1406分别形成于相邻一对(近侧的/远侧的)横向限定的肋1410中。各肋1410包括沿横向向外开口的垂直狭槽1412,沿该垂直狭槽的高度较宽矩形通孔1414更向内定位,缩入外部垂直狭槽1416之内。由此每个肋1410包括连接到上部和下部纵向连续条带1420的薄内壁1418。沿着纵向中心线在横向形成矩形刀槽1422。如上所述,左、右凸脊状EAP锁定条1354、1358有利地放松成在关节连接框架底1242的膨胀侧上的膨胀的、弯曲的形状以进行锁定,纵向对准由横向导向销1370保持。
在图41-42中,关节连接框架底1242将另一可替换的EAP致动系统1500结合到弹性框架体1502中,该弹性框架体包括布置在左、右垂直堆叠1506、1508中的纵向排列的EAP纤维致动器1504,该堆叠穿过相应的左、右多个横向肋1510,每个肋具有薄的垂直内壁1512,该内壁连接到连续的纵向顶部和底部条带1514,以便于在其横向弯曲。每个肋1510沿横向加宽成厚的外板1516,将该外板的尺寸设定成用于限定向该侧的关节运动。每个厚的外板1516包括允许EAP纤维致动器1504穿过的垂直排列的纵向通孔1518。远侧和近侧侧盖1520、1522沿纵向位于肋1510的侧面,以覆盖EAP纤维致动器1504的相应的终端。在弹性框架体1502中形成用于发射杆1314的沿横向位于中央的刀槽1524。收缩EAP纤维致动器1504的选择的垂直堆叠1506、1508导致向该侧的关节运动,并且没有致动的垂直堆叠1506、1508响应于该情况而被动地伸长。
用于发射杆的EAP支撑板
在图43中,用于外科器械2002的关节接头2000包括一对EAP支撑板2004、2006,该支撑板沿横向支撑发射杆2008,从而当进行关节运动时使束缚和变形最小化。每个支撑板2004、2006均包括结构件2010(例如,刚性聚合物、金属),该结构件包括沿横向加宽的端部2012,该加宽端部被捕获在第一框架底2016中的对应尺寸的凹槽2014内,该结构件还包括被滑动地接收在第二框架底2020内的平直端部2018。纵向膨胀的EAP层压板2022覆盖各支撑板2004、2006的内表面。
在图44中,使关节接头2000向一横向侧进行关节运动,导致发射杆2008越过进行关节运动的纵向轴线2024并接触支撑板2006。该处的横向支撑防止发射杆2008爆裂到关节接头2000之外,和/或允许装配具有如此减小的力得更柔软的发射杆2008以进行关节运动。另外,当必要时激励在各支撑板2004、2006上的EAP层压板2022以控制二者的曲率大小,从而维持期望的用于发射杆2008的其间的间距。当平直端部2018滑入第二框架底部分2020以容纳内部支撑板2004与外部支撑板2006相比所需减少的行程。EAP层压板2022还可以提供辅助沿横向导向的发射杆2008的缓冲和低表面摩擦性质。
在图45中,用于外科器械2102的可替换的关节接头2100包括一对EAP支撑板2104、2106,该支撑板沿横向支撑发射杆2108,以在进行关节运动时使束缚和变形最小化。各支撑板2104、2106分别包括结构件2110(例如,刚性聚合物、金属),该结构件包括沿横向加宽的端部2112,该加宽端部被捕获在第一框架底2116中的对应尺寸的凹槽2114内,该结构件还包括被滑动地接收在第二框架底2120内的平直端部2118。纵向膨胀的EAP层压板2122覆盖各支撑板2104、2106的内表面。使关节接头2100向一横向侧关节运动,导致发射杆2102越过进行关节运动的纵向轴线2124并接触支撑板2106。该处的横向支撑防止发射杆2008爆裂到关节接头2100之外,和/或允许装配具有如此减小的力得更柔软的发射杆2108以进行关节运动。另外,当必要时激励在各支撑板2104、2106上的EAP层压板2122以控制二者的曲率大小,从而维持期望的用于发射杆2108的其间的间距。当平直端部2118滑入第二框架底部分2120以容纳内部支撑板2104与外部支撑板2106相比所需减少的行程。将EAP层压板2122远离与发射杆2108接触的放置可以具有诸如减少磨损EAP层压板2122的优点。
在图46中,用于外科器械2202的可替换的另外的关节接头2200包括一对EAP支撑板2204、2206,该支撑板沿横向支撑发射杆2208,以在进行关节运动时使束缚和变形最小化。各支撑板2204、2206包括结构件2210(例如,金属),该结构件包括第一向外突起端2212,该第一向外突起端受到约束,并且可在第一框架底2216中的第一向内开口凹槽2214内沿纵向自由浮动,该结构件还包括第二向外突起端2218,该第二向外突起端受到约束,并且可在第二框架底2222的第二向内开口凹槽2220内沿纵向自由浮动。沿纵向膨胀的EAP层压板2224覆盖各支撑板2204、2206的内表面。
在图47中,再一个用于外科器械2302的可替换的关节接头2300包括一对EAP支撑板2304、2306,该支撑板沿横向支撑发射杆2308,以在进行关节运动时使束缚和变形最小化。各支撑板2304、2306包括结构件2310(例如,金属),该结构件包括第一向外突起端2312a,该第一向外突起端与第一框架底2316中的向内开口的狭槽2314a固定在一起,该结构件还包括第二向外突起端2318,该第二向外突起端受到约束,并且可在第二框架底2322的第二向内开口凹槽2320内沿纵向自由浮动。纵向膨胀的EAP层压板2324覆盖各支撑板2304、2306的内表面。在向内开口凹槽2320内沿纵向排列一对压缩弹簧2326、2328,将每个支撑板2304,2306的第二向外突起端2318偏压到其中的中间位置。
在图48中,用于外科器械2402的还有另一可替换的关节接头2400,其包括一对EAP支撑板2404、2406,该支撑板沿横向支撑发射杆2408,以在进行关节运动时使束缚和变形最小化。各支撑板2404、2406包括结构件2410(例如,金属),该结构件包括第一向外突起端2412,该第一向外突起端受到约束,但可在第一框架底2416中的第一向内开口凹槽2414内沿纵向自由浮动,该结构件还包括第二向外突起端2418,该第二向外突起端受到约束,并且可在第二框架底2422的第二向内开口凹槽2420内沿纵向自由浮动。沿纵向膨胀的EAP层压板2424覆盖各支撑板2404、2406的内表面。在第一向内开口凹槽2414内沿纵向排列对应的成对压缩弹簧2426-2428,将各支撑板2404、2406的第一向外突起端2412偏压到其中的中间位置。在第二向内开口凹槽2420内沿纵向排列另一对应成对压缩弹簧2430-2432,将各支撑板2404、2406的第二向外突起端2418偏压到其中的中间位置。
在图49-52中,用于外科器械2502的另一可替换的关节接头2500采用EAP支撑板2504、2506,该EAP支撑板位于关节连接框架底2514的弹性框架体2512的刀槽2510中的发射杆2508的各横向侧上,该关节连接框架底在近侧连接到近侧框架底2516上并在远侧连接到远侧框架底2518上。左侧EAP板状致动器2520穿过左侧的多个形成在弹性框架体2512中的横向肋2522。右侧EAP板状致动器2524穿过右侧的多个横向肋2526。向近侧延伸到近侧框架底2516中的各EAP板状致动器2520、2524包括连接到内部板2530的外部EAP层压层2528,并被构成为当供应电能时致动,以将远侧框架圆形件(round)2518朝另一侧弯曲。弹性框架体2512包括在近侧向内开口凹槽2532,该近侧向内开口凹槽分别抓紧各支撑板2504、2506的相应的近侧、向内弯曲端2534。允许各支撑板2504、2506的平直远侧2536滑动脱离刀槽2510,以调整用于关节运动行程的变化,如图51所示。
虽然已经通过几个实施例的说明示例性描述了本发明,并且虽然示例性的实施例已经被相当详细地描述,但是不意味着申请人限制或以任何方式限定后附权利要求的范围到该细节。另外的优点和变更对本领域普通技术人员来说是显而易见的。

Claims (10)

1.一种外科器械,其包括:
端部执行器;
细长轴;
连接在端部执行器和细长轴的远端之间的关节接头,该关节接头能够使端部执行器在从细长轴的纵向轴线开始的一段圆弧上枢转;
位于关节接头中、响应于电信号而使关节接头进行关节运动的电致动器;以及
连接到细长轴的近端上并包含具有可操作的构造的产生电信号的控制电路的手柄部分。
2.根据权利要求1所述的外科器械,其特征在于,所述电致动器包括电活化聚合物致动器。
3.根据权利要求2所述的外科器械,其特征在于,所述电活化聚合物致动器包括一对反向作用在关节接头上的电活化聚合物纤维致动器。
4.根据权利要求2所述的外科器械,其特征在于,所述电活化聚合物致动器包括一对反向作用在关节接头上的电活化聚合物板状致动器。
5.根据权利要求1所述的外科器械,其特征在于,所述细长轴包括框架组件,该框架组件包括连接到手柄部分上的近侧框架部分和以可枢转的方式连接到近侧框架部分上的远侧框架部分。
6.根据权利要求5所述的外科器械,其特征在于,所述关节接头进一步包括关节锁定机构,该关节锁定机构包括:
连接到端部执行器上的向近侧突出的接合表面;
为了纵向平移而连接到近侧框架部分上的锁定构件;
连接在近侧框架组件和锁定构件之间的弹性构件,该弹性构件偏压锁定构件,使之与接合表面接合;以及
连接到手柄部分上并被联接以收回锁定构件的由用户致动的构件。
7.根据权利要求1所述的外科器械,其特征在于,端部执行器包括一下部钳口和一以可枢转的方式连接的上部钳口。
8.根据权利要求7所述的外科器械,其特征在于,所述端部执行器进一步包括由发射杆致动的缝合和切割组件,手柄部分在近侧连接到该发射杆并具有可操作的构造以将纵向发射运动传递给该发射杆,所述细长轴和所述关节接头进一步包括通过进行关节运动的所述关节接头支撑该发射杆的发射杆导向件。
9.根据权利要求8所述的外科器械,其特征在于,所述下部钳口包括一包含缝钉匣的细长槽,以可枢转的方式连接的上部钳口包括提供缝钉形成表面的砧板。
10.根据权利要求7所述的外科器械,其特征在于,细长轴包括框架组件和闭合套管组件,关节接头将端部执行器的下部钳口以可枢转的方式连接到框架组件的远端上,手柄部分具有可操作的构造以沿纵向将闭合运动传递到闭合套管组件,并且闭合套管组件的一个多枢轴接头包围关节接头并在远侧接合上部钳口以实现上部钳口的枢转。
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CN1732859B (zh) 2010-07-07
CN1726877A (zh) 2006-02-01
CN1745720B (zh) 2010-12-15
CN100579470C (zh) 2010-01-13
JP4902973B2 (ja) 2012-03-21
CN100515349C (zh) 2009-07-22
CN1726876A (zh) 2006-02-01
BRPI0503041A (pt) 2006-03-14
US20060022015A1 (en) 2006-02-02
US7143925B2 (en) 2006-12-05
MXPA05008046A (es) 2006-02-10
CN1726874A (zh) 2006-02-01
CN1726875A (zh) 2006-02-01
CN100569189C (zh) 2009-12-16
CN100579467C (zh) 2010-01-13
RU2005123961A (ru) 2007-02-10
CN1732857A (zh) 2006-02-15
CN100566667C (zh) 2009-12-09
CN1745719A (zh) 2006-03-15
CN1732859A (zh) 2006-02-15
CN1732856A (zh) 2006-02-15
JP2006034980A (ja) 2006-02-09
CN1732855A (zh) 2006-02-15
CA2512977C (en) 2014-12-09
CN1726878A (zh) 2006-02-01
CA2512977A1 (en) 2006-01-28
RU2005123979A (ru) 2007-02-10
CN100569188C (zh) 2009-12-16
CN100500104C (zh) 2009-06-17
BRPI0503039A (pt) 2006-03-14
CN100479769C (zh) 2009-04-22
CN1745720A (zh) 2006-03-15

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