CN101396294A - 用于外科器械的铰接机构 - Google Patents
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- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2946—Locking means
Abstract
一种铰接伸长外科器械，包括手柄组件、伸长的管体部和枢转地支撑在伸长的管体部的远端上的工具组件。所述伸长外科器械也包括实现工具组件运动的铰接机构，该铰接机构包括可操作地结合到工具组件的枢轴构件。所述伸长的管体包括至少一个在其上具有至少一个止动表面的铰接驱动构件；与铰接驱动邻近的发射杆，在该发射杆上设有铰接锁定致动表面；和铰接锁定器件，该铰接锁定器件设置为选择性地与致动表面接合和脱离以及选择性地与铰接驱动构件的止动表面接合和脱离。
Description
技术领域
本申请涉及一种使外科器械的至少一部分实现运动的机构，更具体地，涉及一种与伸长外科器械一起使用的铰接机构。
背景技术
首先将组织抓紧或夹紧在对置的钳夹(jaw)结构之间，然后用外科紧固件对其进行接合的外科装置在本领域中是公知的。在有些器械中，装备刀具以切割已被紧固件接合的组织。典型地，所述紧固件的形式为外科缝合钉，但是也可以利用两部分的聚合紧固件。
在专利号为3,499,591的美国专利中公开的缝合器在切口的每侧上应用双排缝合钉。这通过提供一种一次性装载单元来实现，其中，凸轮构件通过在两套错列的缝合钉运送沟槽之间的伸长导向槽(guidepath)而移动。缝合钉驱动构件位于沟槽中并且以被纵向移动的凸轮构件接触的方式安置，以便实现缝合钉从一次性装载单元的钉仓中射出。专利号为4,429,695和5,065,929的美国专利中公开了这种缝合器的其它实例。
上述各个器械被设计为用于常规的外科操作中，其中，外科医生直接手动接近手术位置。然而，在内窥镜或腹腔镜的操作中，手术是通过小的切口或通过插入皮肤中的小伤口的狭窄套管来进行的。为了满足内窥镜和/或腹腔镜外科操作的特殊需求，内窥镜外科缝合设备已经被开发并在例如专利号为5,040,715的美国专利(格林(Green)等人)、专利号为5,307,976的美国专利(奥尔森(Olson)等人)、专利号为5,312,023的美国专利(格林等人)、专利号为5,318,221的美国专利(格林等人)、专利号为5,326,013的美国专利(格林等人)和专利号为5,332,142的美国专利(罗宾逊(Robinson)等人)中被公开。
某些现有的腹腔镜线性缝合器被设置成在铰接离轴结构下进行操作。铰接内窥镜外科缝合器的实例在授权给米利曼(Milliman)等人的专利号为6,953,139的美国专利中被公开。
发明内容
本公开涉及一种铰接的伸长外科器械，包括手柄组件和从手柄组件向远处延伸并限定第一纵轴的伸长的管体部(body portion)。所述伸长的外科器械还包括工具组件，该工具组件围绕着基本正交于第一纵轴的枢轴可枢转地支撑在伸长的管体部的远端。所述伸长的外科器械也包括实现工具组件的运动的铰接机构。
所述器械具有至少一个带有至少一个止动表面(retaining surface)的铰接驱动构件；设置为邻近所述至少一个铰接驱动构件的杆，在该杆上有致动表面(actuating surface)；以及铰接锁定组件，该铰接锁定组件被设置为选择性地与致动表面接合和脱离以及选择性地与至少一个铰接驱动构件的所述至少一个止动表面接合和脱离。
所述至少一个铰接驱动构件可包括两个铰接驱动构件，这两个铰接驱动构件中的每一个具有至少一个由铰接锁定组件接合和脱离的止动表面。所述铰接锁定组件可具有至少两个止动表面，至少一个止动表面与两个铰接驱动构件中的一个接合，而且至少另一个止动表面与两个铰接驱动构件中的另一个接合。
所述止动表面或铰接锁定组件的表面可设置成一个或多个突起。该突起可以选择性地与铰接驱动构件的相应的至少一个止动表面接合和脱离。所述铰接驱动构件的至少一个止动表面可设置为容纳各自的铰接锁定组件的突起的沟槽。
所述铰接锁定组件的至少一个止动表面可各自包括一个摩擦表面。一个或多个所述铰接驱动构件的至少一个止动表面可包括一个摩擦表面。
在一个实施方式中，所述铰接锁定组件可包括一个可横向扩张的挠性构件。所述铰接锁定组件可进一步包括朝向挠性构件可动的运动构件。可将置于杆上的致动表面设置为在杆的表面上的制动沟槽(detentchannel)。该制动沟槽可包括至少一个斜表面，当杆运动时，该斜表面促使运动构件运动。
在一个实施方式中，所述挠性构件可具有一个内部空间，其中，当杆运动时，所述运动构件进入挠性构件的内部空间并使挠性构件横向扩张。所述运动构件可具有一个用于接合挠性构件的斜面。
所述挠性构件可设置为具有足够的弹性以促使运动构件远离挠性构件，并因此释放驱动构件以使驱动构件运动。所述挠性构件可包括至少一对横跨内部空间的斜面，并且所述运动构件可设置如下：其接合挠性构件的斜面的运动使挠性构件的止动表面与相应的铰接驱动构件的止动表面接合或脱离。所述挠性构件可进一步包括孔，而所述运动构件可进一步包括突起，该突起被设置为与挠性构件的孔锁定结合并被其接收。在运动构件接合挠性构件的斜面的运动中，所述运动构件的突起可与挠性构件的孔锁定接合并被其接收，从而使铰接锁定器件的止动表面选择性地与相应的铰接驱动构件的止动表面接合和脱离。
在一个实施方式中，所述伸长的管体部包括至少两个驱动构件、操作杆和底板，每个驱动构件具有至少两个止动表面。所述底板具有第一对远侧接合部和第二对近侧接合部，该底板可以可操作地与操作杆结合。当操作杆运动时，第一对远侧接合部可被设置为交替地与远侧接合孔接合，而当操作杆运动时，第二对近侧接合部可被设置为交替地与近侧接合孔接合。
所述底板可进一步包括多个凹口(notch)，其中，每个凹口与影响枢轴构件铰接的具体位置的底板的具体位置相对应，所述外科器械进一步包括锁定致动器(actuator)，该锁定致动器与底板上的任一个凹口锁定接合，从而锁定枢轴构件铰接的具体位置。
所述器械的杆可包括实现将外科缝合钉从工具组件中发射的发射杆(firing rod)。
在本公开的另一方案中，一种防止外科器械中铰接的方法包括使其上具有致动表面的杆运动，从而致动表面与铰接锁定组件接合。所述铰接锁定组件具有挠性构件，该挠性构件用凸轮横向带动以接合至少一个铰接驱动构件。所述方法可包括使运动构件与杆相接合，致动表面促使运动构件的运动。所述运动构件可朝向挠性构件运动。在有些实施方式中，所述运动构件进入挠性构件的内部空间，使挠性构件横向扩张。所述方法可包括使运动构件进入杆的沟槽内并远离挠性构件。挠性构件上的止动表面可被移动以与至少一个铰接驱动构件上的止动表面接合。
在有些实施方式中，所述挠性构件用凸轮横向在两个方向带动，以便接合两个铰接驱动构件。所述运动构件能沿至少一个斜面滑动。在一个优选的实施方式中，所述将外科缝合钉从外科器械中射出，包括向远侧方向移动杆。
附图说明
此处参照附图描述了不同的实施方式。
图1为目前公开的外科缝合装置的一个实施方式的立体图；
图2为在图1中所示的外科器械的铰接机构的立体图；
图3为图2的显示根据本公开的枢轴构件和铰接驱动构件的细部图；
图4为图2的显示根据本公开的驱动构件和其它部件的细部图；和
图5为图示驱动构件的根据本公开的铰接机构的近端的平面图。
图6为用于伸长外科器械的铰接操作机构和伸长的管体部的立体图，根据本公开，两者围住铰接锁定机构；
图7为图6的伸长外科器械的伸长的管体部的内部部件的零件处于分离状态的立体图；
图8A为显示图6的伸长外科器械的伸长的管体部的枢轴构件和铰接驱动构件的一个实施方式的立体图；
图8B为图8A的伸长的管体部的枢轴构件和一个铰接驱动构件的侧视图；
图8C为图8A的伸长的管体部的枢轴构件和另一个铰接驱动构件的侧视图；
图9A为显示用于图6的伸长的外科器械的伸长的管体部的枢轴构件和铰接驱动构件的另一个实施方式的立体图；
图9B为图9A的伸长的管体部的枢轴构件和铰接驱动构件的侧视图；
图10为图8的伸长外科器械的伸长的管体部的内部部件的零件处于分离状态的立体图，其图示了根据本公开的铰接锁定机构的一个实施方式；
图11为图10的铰接锁定机构的立体图；
图12为图6、7和10的伸长的管体部的内部部件的剖视立体图；
图13为沿图12的线13-13截取的伸长的管体部的内部部件的另一个截面图，其显示了处于脱离状态的铰接锁定机构；
图14为图10、11和13的伸长的管体部的内部部件的横截面图，其显示铰接锁定机构处于脱离状态；
图15为图10、11、13和14的伸长的管体部的内部部件的截面图，其显示了处于接合状态的铰接锁定机构；
图16为图10、11、13、14和15的伸长的管体部的内部部件的横截面图，其显示了处于接合状态的铰接锁定机构；
图17为图10、11、13、14、15和16的伸长的管体部的内部部件的平面图，其显示了处于接合状态的铰接锁定机构；
图18为伸长的管体部的内部部件的立体图，其显示了铰接驱动构件止动表面的供替换的构造；
图19为伸长的管体部的内部部件的立体图，其显示了铰接驱动构件止动表面的供替换的构造；
图20为图19的伸长的管体部的内部部件的横截面图，其显示了处于接合状态的铰接驱动构件止动表面；及
图21为图19和20的伸长的管体部的内部部件的平面图，其显示了处于接合状态的铰接驱动构件止动表面的供替换的构造。
具体实施方式
现在参照附图将详细描述本公开的实施方式，在附图中，相同的附图标记表示相同或相应的元件。
在附图和以下的描述中，如常规情况，术语“近侧”指的是离操作者最近的外科器械的端部或部分，而术语远侧指的是离操作者最远的外科器械的端部或部分。
参照图1至图5，根据本公开的伸长外科器械，例如使用外科缝合钉的外科缝合装置通常如外科器械10所示。外科器械10通常包括具有带有把手部18的外罩16的手柄组件12和可动的扳机部20。外科器械10包括可操作地与外罩16结合的伸长的管体14。铰接杆130也安装在手柄组件12的前端从而便于工具组件17铰接。在一个实施方式中，工具组件17可松开地固定在伸长的管体14的远端19上。如图1至图2所示，工具组件17有一对包括砧组件23a和钉仓组件23b的钳夹23a和23b。砧组件23a可动地与伸长的管体14连接。砧组件23a设置在钉仓组件23b的对面，并且钉仓组件23b被构造为应用线性的缝合钉排。可替换的装载单元可与伸长的管体140的远端19连接，所述装载单元具有使用几排大约30mm至60mm长度的缝合钉的工具组件。具有例如45mm的其它长度的缝合钉的线性排的可替换装载单元也是可以想到的。在公开号为2004/0232201 A1的美国专利申请中公开了外科缝合钉的配置及其致动机构，其全部公开内容通过引用合并于此。
外科器械10，具体为内窥镜外科缝合装置的总体设置、构造和操作在许多方面与以下现有技术的外科缝合装置类似，例如，但不局限于由Milliman等人共同转让的于2005年10月11日公开的专利号为6,953,139 B2的美国专利中详细描述的外科缝合装置，其全部内容通过引用合并于此。外科器械10也可具体为抓取器械、牵引器或需要外科工具构件的铰接的另外的器械。实施方式不局限于内窥镜外科缝合器。
在根据本公开的一个实施方式中，外科器械10进一步包括铰接机构100(见图2)，以实现工具组件17的运动。铰接机构100包括枢轴构件102，该枢轴构件可操作地在铰接机构的近端21处与工具组件17结合(见图1)。伸长的管体部14从手柄组件12向远侧延伸并限定了第一纵轴。工具组件17由枢轴构件102围绕枢轴可枢转地支撑在伸长的管体部14的远端上，所述枢轴由与第一纵轴大体正交的枢轴构件102限定。工具组件17限定了第二纵轴，并且其在第二纵轴与第一纵轴成一直线的第一位置和第二纵轴与第一纵轴成一定角度的第二位置之间是可动的。
铰接机构100进一步被设置为分别具有至少第一和第二铰接驱动构件110a和110b，它们可操作地与枢轴构件102结合，从而第一铰接驱动构件110a相对于第二铰接驱动构件110b的相对运动使枢轴构件102运动以实现工具组件17的运动。
铰接机构100可进一步包括致动组件104。致动组件104分别包括至少第一和第二铰接驱动板112a和112b。第一铰接驱动板112a可以可操作地至少与第一铰接驱动构件110a结合，而至少第二铰接驱动板112b可以可操作地至少与第二铰接驱动构件110b结合，从而第一和第二铰接驱动板112a或112b中的一个分别相对于第一和第二铰接驱动板112b或112a的另一个的相对运动使枢轴构件102运动，以实现工具组件17的运动。在一个实施方式中，所述驱动构件110a和110b可为平的或圆形的条板或杆。在一个实施方式中，所述第一和第二铰接驱动构件110a和110b分别设置在伸长的管体部14内。
所述驱动板112a和112b可垂直地与相应的驱动构件110a和110b结合。所述驱动板112a和112b可设置为各自具有在其上分别形成的远侧接合孔114a、114b或近侧接合孔116a、116b的矩形板。各个孔114a、114b和116a、116b分别具有内表面118a、118b和120a、120b。
所述铰接机构100可进一步包括与驱动板112a和112b接触的铰接驱动杆130，从而当与驱动板112a和112b接触时，铰接驱动杆130的运动使驱动板112a和112b运动，以实现工具组件17的运动。
在一个实施方式中，所述铰接驱动杆130被设置为分别与第一和第二驱动板112a和112b之一的至少远侧或近侧接合孔114a、114b或116a、116b接合，从而当至少与远侧或近侧接合孔114a、114b和116a、116b接合时，所述铰接驱动杆130的运动实现了工具组件17的运动。
所述铰接驱动杆130可设置成分别与驱动板112a、112b之一的至少远侧或近侧接合孔114a、114b或116a、116b的内表面118a、118b、120a、120b接触，从而当与内表面118a、118b、120a、120b接触时，所述铰接驱动杆130的运动实现了工具组件17的运动。
所述铰接驱动杆130可包括操作杆140和可操作地与操作杆140结合的底板150。在一个实施方式中，如图2、4和5所示，所述底板150具有围绕其外围周围的分别如第一对远侧接合部152a和152b以及第二对近侧接合部154a和154b的四个突起的蝴蝶结构造。当操作杆140运动时，所述远侧接合部152a和152b分别与远侧接合孔114a和114b接合，而当操作杆140运动时，所述近侧接合部154a和154b分别交替地与近侧接合孔116a和116b接合。
参照图5，所述底板150可进一步包括设置在底板150外围的近侧部分的多个凹口156。当底板150围绕垂直的中心线轴Y-Y旋转时，多个凹口156中的每一个都与底板150的特定位置相对应，以实现枢轴构件102的特定位置的铰接。轴Y-Y在图4中示出，锁定致动器，例如锁定销160与在底板150上的多个凹口156中的一个接合，以限定工具组件17的预定铰接位置。
外科器械10可进一步包括张紧装置，例如螺旋弹簧170a和170b，该张紧装置例如分别在第一和第二铰接驱动板112a和112b的近端122a和122b处与所述外科器械10可操作地连接，从而所述张紧装置为铰接驱动构件110a和110b的相对运动提供张力。
所述铰接驱动构件110a、110b，铰接驱动板112a、112b和铰接机构100的铰接驱动杆130及关联的部件可由如塑料、金属或金属合金或者其它适合的材料制成。
在操作过程中，使用者操作操作杆140，将其向左或向右转动。从使用者的角度观察，当使用者将操作杆140向右转动时，如图1和5所示，所述近侧接合部154b使第二铰接驱动板112b朝远侧方向运动。所述底板150也可以按如下方式设置，即所述远侧接合部152a朝近侧方向牵引第一铰接驱动板112a，就如使驱动板112b运动一样。枢轴构件102枢转，从而所述工具组件17向左铰接，如图1所示。
从上述描述中能够得出，本公开提供了包括伸长的管体部14的铰接内窥镜外科器械10。该伸长的管体部14限定了第一纵轴A-A(见图1)。内窥镜外科器械10还包括具有一对钳夹23a和23b(以闭合状态在图1中示出)的铰接工具组件17。铰接工具组件17限定了第二纵轴B-B(见图1)。所述铰接工具组件17设置在管体部14的远端19，并且至少从第二纵轴B-B与第一纵轴A-A大体成一直线的第一位置到第二纵轴B-B与第一纵轴A-A成角度θ的第二位置可动。铰接内窥镜器械10还包括铰接机构100和工具组件17，该工具组件17可操作地与枢轴构件102连接以实现工具组件17的铰接。
枢轴构件102可枢转地在枢轴Y-Y处与伸长的管体部14连接(见图4)。第一铰接驱动构件110a和第二铰接驱动构件110b与枢轴构件102连接，从而铰接驱动构件110a、110b的相对运动使工具组件17铰接。第一铰接驱动构件110a在枢轴X-X的第一侧与枢轴构件102连接，而第二铰接驱动构件110b在枢轴X-X的第二侧与枢轴构件102连接。
包括转动地安装的底板150的铰接组件104可操作地分别与第一和第二铰接驱动构件110a和110b连接，从而当操作杆140转动时，第一铰接驱动构件110a向近侧方向运动，而第二铰接驱动构件110b向远侧方向运动。
现在参照公开了用于铰接伸长外科器械的铰接锁定机构的一个实施方式的图6至图21。在图6至图21中，仅图示出铰接外科器械的那些必要的部分以描述铰接锁定机构的构造和操作。更具体地，参照图6，用于伸长外科器械的铰接操作组件230包括一对上部和下部部分232和234，该上部和下部部分罩住可操作地与伸长外科器械(未示出)的外罩(未示出)相连接的伸长的管体部214。
图7为伸长的管体部214的内部部件的零件处于分离状态的立体图。所述伸长的管体部214包括至少一个在其中具有至少一个止动表面的铰接驱动构件，例如分别具有第一和第二铰接驱动构件210a和210b，每个驱动构件在其上分别具有止动表面205a和205b。发射杆216可与一个或多个铰接驱动构件相邻，例如发射杆216可与第一铰接驱动构件210a相邻和与第二铰接驱动构件210b相邻。在所述发射杆216上可设置致动表面250。
伸长的支架214还包括铰接锁定器件或铰接锁定组件260，其被设置为选择性地与致动表面250接合和脱离，以及选择性地与至少一个铰接驱动构件的至少一个止动表面接合和脱离，例如，止动表面205a和205b分别选择性地与铰接驱动构件210a和210b接合和脱离。
铰接锁定器件260可设置为选择性地与致动表面250接合和脱离，以及与铰接驱动构件的至少一个止动表面，例如分别与铰接驱动构件210a和210b的止动表面205a和205b接合和脱离。所述铰接锁定器件260包括两个止动表面265a和265b，其选择性地与相应的铰接驱动构件210a和210b的止动表面205a和205b接合和脱离。
铰接锁定器件260的止动表面，如止动表面265a和265b可设置为突起，其中突起265a和265b中的每一个选择性地分别与相应的铰接驱动构件210a和210b的止动表面205a和205b接合和脱离。
在一个实施方式中，铰接驱动构件210a和210b的止动表面205a和205b分别包括至少两个止动表面，例如分别包括止动表面215a1、215a2、215a3、215a4、215a5和215b1、215b2、215b3、215b4、215b5。每个止动表面，例如止动表面215a1、215a2、215a3、215a4、215a5和215b1、215b2、215b3、215b4、215b5可分别地设置为接收相应的铰接锁定器件260的突起265a和265b的沟槽。所述止动表面215a1、215a2、215a3、215a4、215a5可设置在铰接驱动构件210a的上部边缘210a’和下部边缘210a”的至少之一上，而所述止动表面215b1、215b2、215b3、215b4、215b5可设置在铰接驱动构件210b的上部边缘210b’和下部边缘210b”的至少之一上。所述铰接驱动构件沟槽215a1、215a2、215a3、215a4、215a5和215b1、215b2、215b3、215b4、215b5可设置为至少一种开口沟槽，如图7所示，以及可设置为闭合的沟槽215a1’、215a2’、215a3’、215a4’、215a5’和215b1’、215b2’、215b3’、215b4’、215b5’，如图18所示，或者可具有其它形状。在有些实施方式中，仅在铰接驱动构件的上部或下部边缘之一上设置止动表面。在其它的实施方式中，为了制造的目的或为了由第二锁定器件接合，止动表面对称地设置在两个边缘上。
图7还图示了，所述驱动构件210a和210b各自分别包括近端212a和212b以及远端212a’和212b’。在远端212a’和212b’，分别设有枢轴接头(pivot engaging joint)218a和218b，图7、8A和8B示例的为U形环接头。
在远端212a’，所述伸长的管体构件214包括枢轴构件202，该枢轴构件可操作地与如砧组件23a(见图1)和筒组件23b(见图1至图3和图8A)的砧组件连接。所述砧组件23a可动地固定于伸长的管体214。
枢轴接头218a和218b设置在枢轴构件202中以便将驱动构件210a和210b与枢轴构件202连接。将枢轴接头218a’设置成倒转的U形环以便通过衬套(sleeve)220与枢轴接头218a的垂直U形环相接合，而将所述枢轴接头218b’设置成垂直的U形环以便通过另一个衬套220与枢轴接头218b的倒转U形环相接合(见图8B和8C)。
图9A和9B图示了枢轴构件202及驱动构件210a和210b的远端212a’和212b’的替代构造。更具体地，驱动构件210a和210b的远端212a”和212b”以及枢轴构件202’各自分别设有具有T形臂228’的T形构造的枢轴接头228a和228b。所述枢轴构件202’设有设置在枢轴构件202’中的衬套222，以便分别接收T形远端212a”和212b”的臂228’。
参照图19至图21，在一个实施方式中，铰接锁定器件的止动表面，例如铰接锁定器件260的止动表面265a和265b可各自包括摩擦表面。摩擦表面265a’和265b’各自选择性地分别与铰接驱动构件210a和210b的止动表面205a和205b接合和脱离。所述摩擦表面265a’和265b’选择性地与相应的摩擦表面225a和225b接合和脱离。所述摩擦表面265a’、265b’和225a、225b由提高驱动构件和锁定器件260之间的摩擦力的材料构成或者具有这种构造，从而阻碍驱动构件210a和210b的运动。
如图10至图17中看得最清楚，铰接锁定器件260设置为选择性地与致动表面250接合和脱离以及选择性地分别与铰接驱动构件210a和210b的止动表面205a和205b接合和脱离。
铰接锁定器件260可包括如活塞(plunger)264的运动构件，其设置为选择性地与挠性构件262接合和脱离或者与挠性构件262相互作用，以实现止动表面265a和265b分别与驱动构件210a和210b的止动表面205a和205b的接合和脱离。
致动表面250和运动构件264可设置为如下构造，即部件在细长管体214内的运动引起运动构件264的运动。发射杆216的致动表面250可设置为在发射杆216的表面216’上的制动沟槽252。该制动沟槽252包括至少一个斜表面252a，当发射杆216运动时，所述斜表面促使运动构件264运动。
挠性构件262可设置为具有内部空间266的环形装置。当发射杆216运动时，所述运动构件264进入内部空间266并被迫使向挠性构件262运动且与挠性构件262相互作用，从而使突起265a和265b向驱动构件210a和210b运动。
挠性构件262包括跨越内部空间266的斜面266a和266b。所述发射杆216向前运动以使运动构件264从沟槽252缩上去。当运动构件264停在表面216’之上时(见图10)，挠性构件262与驱动构件210a和210b接合。运动构件264设置或构造成使挠性构件262的侧面横向扩张的结构。所述运动构件264具有与挠性构件262的斜面266a和266b相接合的斜面269a、269b，从而当所述运动构件264被迫使向挠性构件262运动时，所述挠性构件262的侧面(带有突起265a和265b)由凸轮横向朝驱动构件210a和210b带动。所述突起265a和265b与止动表面205a和205b接合。运动构件264上的导肋(guidance rib)270通过与挠性构件262上的狭槽267接合而防止运动构件264的纵向运动。
优选地，挠性构件262具有足够的弹性以促使运动构件264远离挠性构件262，从而释放驱动构件210a和210b并允许其运动。当牵引发射杆216时，运动构件264与沟槽252成一直线，这使得运动构件264离开挠性构件262。所述挠性构件262的弹性特性使得挠性构件262的侧面向内运动，这使得止动表面265a、265b离开止动表面205a、205b。所述发射杆216可以是用于促使缝合钉发射的杆或者是用于锁定工具组件17的位置的杆。在有些替代的实施方式中，所述发射杆216具有在发射杆216上成为突起形式的致动部件250。当发射杆216运动时，所述运动构件264在突起的斜表面上缩上去而与挠性构件262接合。
应该认识到的是，上述在伸长的支架214上的铰接机构100和铰接锁定器件260以及关联部件的实施方式可用于除缝合设备以外的外科器械。其例子包括抓握器械或牵引器。
在其它的实施方式中，设置有一个铰接驱动构件210并且铰接锁定器件在一面上具有止动表面，设置该止动表面以接合在铰接驱动构件上的止动表面。
在有些实施方式中，所述工具组件17为与伸长管体部14连接的可动的且可替代的组件。所述工具组件17和与伸长管体部14连接的外罩部分形成了装载单元，该装载单元包括一个或多个与铰接组件的一个或多个驱动构件连接的连接物。
尽管结合示例性的实施方式描述了本公开主题，但是在不偏离如所附权利要求限定的本公开主题的实质或范围的情况下，对本领域的普通技术人员来说对其进行改变和修正是很显而易见的。
Claims (16)
1、一种铰接伸长外科器械，包括：
手柄组件；
从所述手柄组件向远处延伸并限定第一纵轴的伸长的管体部；
围绕着基本正交于所述第一纵轴的枢轴可枢转地支撑在所述伸长的管体部的远端上的工具组件；
实现所述工具组件的运动的铰接机构；
至少一个具有至少一个止动表面的铰接驱动构件，所述至少一个铰接驱动构件由所述铰接机构而致动；
设置为邻近所述至少一个铰接驱动构件的杆，在所述杆上设有致动表面；及
铰接锁定组件，其被设置为选择性地与所述致动表面接合和脱离以及选择性地与所述至少一个铰接驱动构件的至少一个止动表面接合和脱离。
2、根据权利要求1所述的铰接伸长外科器械，其中所述至少一个铰接驱动构件包括两个铰接驱动构件，所述两个铰接驱动构件中的每一个都具有至少一个由所述铰接锁定组件接合和脱离的止动表面。
3、根据权利要求2所述的铰接伸长外科器械，其中所述铰接锁定组件具有至少两个止动表面，至少一个止动表面与所述两个铰接驱动构件中的一个接合，而至少一个其它止动表面与所述两个铰接驱动构件中的另一个接合。
4、根据权利要求1所述的铰接伸长外科器械，其中所述铰接锁定组件具有至少一个突起，所述突起用于选择性地与所述至少一个铰接驱动构件的至少一个止动表面接合和脱离。
5、根据权利要求4所述的铰接伸长外科器械，其中所述至少一个铰接驱动构件的至少一个止动表面包括用于容纳所述至少一个突起的沟槽。
6、根据权利要求1所述的铰接伸长外科器械，其中所述至少一个铰接驱动构件的至少一个止动表面包括摩擦表面。
7、根据权利要求6所述的铰接伸长外科器械，其中所述铰接锁定组件具有至少一个摩擦表面，所述摩擦表面选择性地与所述至少一个铰接驱动构件的摩擦表面接合和脱离。
8、根据权利要求1所述的铰接伸长外科器械，其中所述铰接锁定组件包括横向上能够扩张的挠性构件。
9、根据权利要求8所述的铰接伸长外科器械，其中所述铰接锁定组件包括朝向所述挠性构件可动的运动构件。
10、根据权利要求9所述的铰接伸长外科器械，其中所述杆是可动的，以便使所述致动表面与所述运动构件相接触。
11、根据权利要求9所述的铰接伸长外科器械，其中置于所述杆上的所述致动表面被设置为位于杆表面内的制动沟槽。
12、根据权利要求11所述的铰接伸长外科器械，其中所述制动沟槽包括至少一个斜表面，所述斜表面被设置为当杆运动时促使所述运动构件运动。
13、根据权利要求8所述的铰接伸长外科器械，其中所述挠性构件具有内部空间并且其中，当所述杆运动时，所述运动构件进入所述挠性构件的内部空间并使所述挠性构件横向扩张。
14、根据权利要求9所述的铰接伸长外科器械，其中所述运动构件具有用于接合所述挠性构件的斜面。
15、根据权利要求1所述的铰接伸长外科器械，其中所述伸长的管体部包括：
至少两个驱动构件，每个所述驱动构件具有至少两个止动表面；
操作杆；和
底板，所述底板可操作地与操作杆结合，所述底板具有第一对远侧接合部及第二对近侧接合部，当操作杆运动时，所述第一对远侧接合部被设置为交替地与远侧接合孔接合，当操作杆运动时，第二对近侧接合部被设置为交替地与近侧接合孔接合。
16、根据权利要求1所述的铰接伸长外科器械，其中所述杆是实现从所述工具组件中发射外科缝合钉的发射杆。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US11/863,653 | 2007-09-28 | ||
| US11/863,653 US7703653B2 (en) | 2007-09-28 | 2007-09-28 | Articulation mechanism for surgical instrument |
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| CN101396294A true CN101396294A (zh) | 2009-04-01 |
| CN101396294B CN101396294B (zh) | 2012-04-18 |
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| CN2008101674218A Expired - Fee Related CN101396294B (zh) | 2007-09-28 | 2008-09-26 | 用于外科器械的铰接机构 |
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| US (2) | US7703653B2 (zh) |
| EP (1) | EP2042107B1 (zh) |
| JP (3) | JP5371342B2 (zh) |
| CN (1) | CN101396294B (zh) |
| AU (1) | AU2008207366B2 (zh) |
| CA (2) | CA2875037A1 (zh) |
| ES (1) | ES2366493T3 (zh) |
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-
2007
- 2007-09-28 US US11/863,653 patent/US7703653B2/en active Active
-
2008
- 2008-08-18 AU AU2008207366A patent/AU2008207366B2/en not_active Ceased
- 2008-09-09 CA CA2875037A patent/CA2875037A1/en not_active Abandoned
- 2008-09-09 CA CA002639439A patent/CA2639439A1/en not_active Abandoned
- 2008-09-17 JP JP2008238600A patent/JP5371342B2/ja not_active Expired - Fee Related
- 2008-09-24 EP EP08253122A patent/EP2042107B1/en not_active Expired - Fee Related
- 2008-09-24 ES ES08253122T patent/ES2366493T3/es active Active
- 2008-09-26 CN CN2008101674218A patent/CN101396294B/zh not_active Expired - Fee Related
-
2010
- 2010-03-10 US US12/721,160 patent/US8205619B2/en active Active
-
2013
- 2013-05-07 JP JP2013097309A patent/JP5647710B2/ja not_active Expired - Fee Related
- 2013-05-07 JP JP2013097310A patent/JP2013146605A/ja active Pending
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103458809A (zh) * | 2011-03-15 | 2013-12-18 | 伊西康内外科公司 | 具有可锁定的关节运动式端部执行器的外科器械 |
| CN103458809B (zh) * | 2011-03-15 | 2016-03-30 | 伊西康内外科公司 | 具有可锁定的关节运动式端部执行器的外科器械 |
| CN104042281A (zh) * | 2013-03-14 | 2014-09-17 | 伊西康内外科公司 | 包括击发驱动器的可关节运动的外科器械 |
| CN106232026A (zh) * | 2013-12-23 | 2016-12-14 | 伊西康内外科有限责任公司 | 具有能够关节运动的轴构造的外科器械 |
| CN106232026B (zh) * | 2013-12-23 | 2019-05-10 | 伊西康内外科有限责任公司 | 具有能够关节运动的轴构造的外科器械 |
| CN107427312A (zh) * | 2015-01-09 | 2017-12-01 | 美国奥林匹斯外科技术吉鲁斯阿克米公司 | 组合式医疗器械 |
| WO2022241744A1 (en) * | 2021-05-21 | 2022-11-24 | Covidien Lp | Articulation assembly for a surgical device |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2009082704A (ja) | 2009-04-23 |
| EP2042107B1 (en) | 2011-06-01 |
| AU2008207366B2 (en) | 2013-11-07 |
| ES2366493T3 (es) | 2011-10-20 |
| AU2008207366A1 (en) | 2009-04-23 |
| CA2875037A1 (en) | 2009-03-28 |
| CN101396294B (zh) | 2012-04-18 |
| US20090084826A1 (en) | 2009-04-02 |
| US20100163597A1 (en) | 2010-07-01 |
| JP5371342B2 (ja) | 2013-12-18 |
| JP2013146604A (ja) | 2013-08-01 |
| US7703653B2 (en) | 2010-04-27 |
| EP2042107A1 (en) | 2009-04-01 |
| JP5647710B2 (ja) | 2015-01-07 |
| CA2639439A1 (en) | 2009-03-28 |
| US8205619B2 (en) | 2012-06-26 |
| JP2013146605A (ja) | 2013-08-01 |
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