CN101495046A - 例如用于机电手术设备的轴 - Google Patents

例如用于机电手术设备的轴 Download PDF

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CN101495046A
CN101495046A CNA2006800315081A CN200680031508A CN101495046A CN 101495046 A CN101495046 A CN 101495046A CN A2006800315081 A CNA2006800315081 A CN A2006800315081A CN 200680031508 A CN200680031508 A CN 200680031508A CN 101495046 A CN101495046 A CN 101495046A
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axle
axle according
connection part
flexible shaft
shaft
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CN101495046B (zh
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迈克尔·P·惠特曼
唐纳德·马里努斯卡斯
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Covidien LP
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Power Medical Interventions LLC
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Abstract

一种例如柔性的轴,其包括:长形的外护套;至少一个驱动轴,其设置在外护套内;环,其以不能旋转的方式安装到至少一个可旋转驱动轴上;以及至少一个光源,其安装到轴内,从而,当至少一个可旋转驱动轴旋转时,所述环交替地阻挡来自光源的光和允许来自光源的光被检测到。轴还可包括湿度传感器,湿度传感器设置在轴的外护套内,并且构造成检测外护套内的湿气。轴可包括耦联件,耦联件将外护套的远端连接到手术附件并且将外护套的近端连接到远程动力控制台。

Description

例如用于机电手术设备的轴
相关申请的交叉引入
本申请要求于2005年7月27日提交、名称为“Flexible Shaft,e.g.,foran Electro-Mechanical Surgical Device(例如用于机电手术设备的柔性轴)”的美国临时专利申请序列号No.60/703,227的优先权,其全部内容以参引方式结合入本文。
发明领域
本发明涉及一种轴,更具体地,涉及一种用于与机电手术设备一起使用的轴。
背景技术
已知多种手术系统。例如,手术系统可包括以可拆卸方式耦联到手术附件的机电驱动设备。这样的机电驱动设备描述于例如2000年11月28日提交的名称为“Electro-Mechanical Surgical Device(机电手术外科设备)”的美国专利申请序列号No.09/723,715且现在被授予美国专利号No.6,793,652、2001年4月17日提交的名称为“Electro-MechanicalSurgical Device(机电手术设备)”的美国专利申请序列号No.09/836,781、以及2001年6月22日提交的名称为“Electro-Mechanical Surgical Device(机电手术设备)”的美国专利申请序列号No.09/887,789中,它们中每一个的全部内容都以参引方式结合入本文中。所述的特定手术器械和系统具有很多缺点,这些将在下面做另外的具体描述。通常,传统的手术系统可包括轴,这些轴可提供有限的扭矩、但不能为使用者提供相关器械和系统的操作元件的精确确定的位置、不能提供湿度检测功能并且通常组装复杂且价格昂贵。
发明内容
在本发明的示例实施方式中,提供一种用于耦联手术附件与机电驱动设备的柔性轴,所述柔性轴包括:柔性的、长形的外护套,该护套由耐高压加热的材料制成;以及至少一个设置在所述外护套中的驱动轴。在本发明的示例实施方式中,柔性轴包括设置在外护套内的湿度传感器,所述湿度传感器构造成用于检测柔性外护套内的湿气。柔性轴还可包括一个或多个可旋转的驱动轴,所述可旋转驱动轴连接到机电驱动设备的马达系统的驱动轴,从而旋转并因此操作手术附件。柔性轴的每个可旋转驱动轴可包括带有凸耳的正交环,所述正交环交替地阻挡和允许来自于光源的光线通过光缆传送到控制器,控制器构造成检测和解译通过光缆接收到的光信号,并响应于该信号来确定例如诸如手术吻合器的手术附件的诸如钉砧或切割刀片的部件的位置和/或方向。柔性轴还可包括另外的通道,所述另外的通道用于通过柔性轴对手术部位提供冲洗和/或抽吸。
在本发明的示例实施方式中,一种轴包括:长形的外护套;至少一个可旋转的驱动轴,所述可旋转的驱动轴设置在外护套内;构件,其从至少一个可旋转的驱动轴径向地延伸并构造成随所述至少一个可旋转的驱动轴旋转;以及至少一个光源,其安装到外护套内,其中,当至少一个可旋转的驱动轴旋转时,所述构件交替地阻挡来自光源的光和允许来自光源的光被检测到。所述构件可以是例如从安装在至少一个可旋转的驱动轴上的正交环延伸的一个凸耳或两个凸耳。此外,可设置安装在轴的远端的两个光源,例如,所述光源安装成相对于至少一个可旋转驱动轴的轴线彼此大约成90度。
附图说明
图1是根据本发明的示例实施方式的机电手术设备的立体图。
图2是根据本发明的示例实施方式的柔性轴的立体图。
图3(A)是图2所示的柔性轴的侧视图。
图3(B)是仰视图,其图示出沿图3(A)所示的线3B-3B所截取的柔性轴的局部剖视图。
图3(C)是俯视图,其图示出沿图3(A)所示的线3C-3C所截取柔性轴的局部剖视图。
图4(A)是根据本发明的示例实施方式的第二耦联件在组装好时的放大截面图。
图4(B)是根据本发明的示例实施方式的第二耦联件的前视立体图,其分解图示出第二耦联件的一些部件。
图4(C)是图4(B)所示的第二耦联件在部分组装好时的后视立体图,示出了第二耦联件的一些另外的特征。
图4(D)和4(E)分别是根据本发明的示例实施方式的远侧接触组件在组装好时的前视立体图和后视立体图。
图4(F)是远侧接触组件的后视立体图,其分解图示出远侧接触组件的一些部件。
图4(G)是根据本发明的示例实施方式的远侧传感器组件在组装好时的前视图。
图4(H)是耦联到数据传输线缆的湿度传感器的示意图。
图5(A)是根据本发明的示例实施方式的第一耦联件在组装好时的放大截面图。
图5(B)是根据本发明的示例实施方式的第一耦联件的前视立体图,其分解图示出第一耦联件的一些部件。
图6是图1中图示的机电手术设备的柔性轴的局部剖视的侧视图。
图7是沿图6中所示的线7-7所截取的柔性轴的横截面图。
图8是图2中图示的柔性轴的第一耦联件的后端视图。
图9是图2中图示的柔性轴的第二耦联件的前端视图。
图10是图1中图示的机电手术设备的马达设备的示意图。
图11是图1中图示的机电手术设备的示意图。
图12是图4(B)图示的柔性轴的正交环设备的示意图。
图13是手术附件和/或柔性轴的存储设备的示意图。
图14是图1中图示的机电手术设备的无线遥控单元的示意图。
图15是图1中图示的机电手术设备的有线遥控单元的示意图。
具体实施方式
参照图1,可以看到根据本发明的示例实施方式的机电手术设备10的立体图。机电手术设备10可包括例如远程动力控制台12,其包括具有前面板15的壳体14。安装在前面板15上的是显示设备16以及指示器18a、18b,这将在下文中进行全面描述。轴20可从壳体14延伸并且可通过第一耦联件22以可拆卸方式固定到所述壳体14。轴20可以是柔性的、刚性的、活节的、铰接的等等。尽管轴20在下面称为柔性轴20,应当理解,柔性轴20仅是轴20的一个示例实施方式并且轴20决不限制于柔性设置。柔性轴20的远端24可包括第二耦联件26,第二耦联件26适于以可拆卸方式将手术器械或附件固定到柔性轴20的远端24。手术器械或附件可以是例如手术吻合器、手术切割器、手术吻合-切割器、线形手术吻合器、线形手术吻合-切割器、圆形手术吻合器、圆形手术吻合-切割器、手术施夹钳、手术夹钳结扎器、手术夹具、血管扩张设备、内腔扩张设备、手术刀、流体输送设备或者任何其它类型的手术器械。这些手术器械例如描述于名称为“A Stapling Device forUse with an Electromechanical Driver Device for Use withAnastomosing,Stapling,and Resecting Instruments(与用于接合、吻合及切除器械的机电驱动设备一起使用的吻合设备)”的美国专利申请序列号No.09/324,451且现授权号为美国专利号No.6,315,184、名称为“Electromechanical Driver Device for Use with Anastomosing,Stapling,and Resecting Instruments(用于接合、吻合及切除器械的机电驱动设备)”美国专利申请序列号No.09/324,452号且现授权号为美国专利号No.6,443,973、名称为“Automated Surgical Stapling System(自动手术吻合系统)”的美国专利申请序列号No.09/351,534且现授权号为美国专利号No.6,264,087、名称为“A vessel and Lumen ExpanderAttachment for Use with an Electromechanical Driver Device(与机电驱动设备一起使用的血管以及内腔扩张附件)”的美国专利申请序列号No.09/510,926且现授权号为美国专利号No.6,378,061、名称为“Electromechanical Driver and Remote Surgical InstrumentsAttachment Having Computer Assisted Control Capability(具有计算机辅助控制能力的远程手术器械附件及机电驱动器)”的美国专利申请序列号No.09/510,927且现授权号为美国专利号No.6,716,233、名称为“ATissue Stapling Attachment tor Use with an Electromechanical DriverDevice(用于机电驱动设备的组织吻合附件)”的美国专利申请序列号No.09/510,931且现授权号为美国专利号No.6,533,157、名称为“A FluidDelivery Mechanism for Use with Anastomosing,Stapling,andResecting Instruments(用于接合、吻合和切除器械的流体输送机构)”的美国专利申请序列号No.09/510,932且现授权号为美国专利号No.6,491,201、以及名称为“A Fluid Delivery Device for Use withAnastomosing,Stapling,and Resecting Instruments(用于接合、吻合和切除器械的流体输送设备)”的美国专利申请序列号No.09/510,933且现授权号为美国专利号No.6,488,197中,它们中每一个的全部内容都以参引方式结合入本文。
图2是柔性轴20的立体图。应当理解,虽然此处图示和描述的柔性轴20是以可拆卸方式耦联到远程动力控制台12,但是在其它的示例实施方式中,柔性轴20可以永久地耦联到远程动力控制台12或者与远程动力控制台12结合成一体。下面将结合附图3(A)-15描述柔性轴20的其它方面和特征。
图3(A)是图示出柔性轴20的侧视图。根据示例实施方式,柔性轴20包括管状护套28,管状护套28可包括涂层或者其它的密封设置以在其内部通道40与环境之间提供不漏水的密封。护套28可由与组织相容的消毒弹性体材料形成。护套28还可由耐高压加热的材料形成。护套28可以由具有高润滑性或相对较高润滑性的材料形成。例如,护套28可包括特氟纶TM(即含氟聚合物,例如聚四氟乙烯——“PTFE”)、硅酮、特氟纶TM/硅酮组合物——例如诸如SIL-KORETM(由W.L.Gore&Associates制造)。
图3(B)是仰视图,其图示出沿图3(A)中所示的线3B-3B所截取的柔性轴20的局部剖视图。图3(B)以截面方式图示出柔性轴20的近端以及第一耦联件22。下面将结合附图5(A)、5(B)和8描述柔性轴20的第一耦联件22的其它方面和特征。
图3(C)是俯视图,其图示出沿图3(A)所示的线3C-3C所截取的柔性轴20的局部剖视图。图3(C)以截面方式图示出柔性轴20的远端以及第二耦联件26。下面将结合附图4(A)-4(H)和9描述柔性轴20的第二耦联件26的其它方面和特征。
图4(A)是根据本发明的示例实施方式的第二耦联件26在组装好时的放大截面图。图4(B)是根据本发明的示例实施方式的第二耦联件26的前视立体图,其分解图示出第二耦联件的一些部件。图4(B)示出远侧组件2231。两个远侧线缆端部组件2078的第一端部设置在远侧组件2231内。每个远侧线缆端部组件2078的第二端部设置在远侧连接组件2066的各孔内。对于每个远侧线缆端部组件2078配置有远侧线缆端部2082。远侧线缆端部2082的第一端部具有沿纵向设置的分别用作连接装置66和68的孔,这将在下面更加具体地描述。远侧组件2231的最远侧表面通过开口通向连接装置66、68,还设置有连接装置70以及分别通向冲洗及抽吸通道101和102的开口101b和102b,如下面所进一步讨论的。枢轴承330安装在远侧线缆端部2082的外表面的大致中点处。远侧线缆端部2082的第二端部与远侧正交环2080接合。各驱动线缆30、32(下面会结合附图6进行更具体地描述)连接到每个远侧正交环2080,驱动线缆30、32由套管377包围,套管377由例如特氟纶TM制成。每个驱动线缆30、32在柔性轴20内部沿着柔性轴20的长度方向延伸。
图4(C)是图4(B)所示的第二耦联件26在部分组装好时的后视立体图,示出了第二耦联件的一些另外的特征。如图4(C)所示,远侧线缆端部组件2078与远侧光学模块2085的各孔接合。远侧光学模块2085连接到远侧压力模座2069,在远侧压力模座2069中设置有枢轴承330。在枢轴承330的远侧安装有各密封件764。远侧压力模座2069的远端连接到远侧外罩2237。远侧接触组件2073安装在远侧压力模座2069内,远侧接触组件2073从图4(C)中无法看到但是在图4(D)至图4(F)中图示出。远侧传感器组件2233也安装在远侧压力模座2069内,远侧传感器组件2233从图4(C)中无法看到但是在图4(G)中图示出。
图4(D)和4(E)分别是根据本发明的示例实施方式的远侧接触组件2073在组装好时的前视立体图和后视立体图。图4(F)是远侧接触组件2073的后视立体图,其分解图示出远侧接触组件的一些部件。参照图4(F),远侧接触组件2073包括远侧PCB 2232,远侧PCB 2232具有多个通孔。两个发光二极管379安装在远侧PCB 2232的近端侧。绝缘体2084安装在远侧PCB 2232的远端侧,绝缘体2084具有大致与远侧PCB 2232中的孔对应的孔。设置在接触护套2238内的五个套筒214延伸穿过绝缘体2084以及远侧PCB 2232的孔。接触护套2238的远端由接触绝缘体块2189盖住。
图4(G)是根据本发明的示例实施方式的远侧传感器组件2233在组装好时的前视图。远侧传感器组件2233包括其中带有一对孔的远侧传感器PCB 2234。此外,远侧传感器组件2233具有安装于其上的四个例如光电晶体管的传感器217。
回到图4(A),其以截面形式示出了组装好的第二耦联件26的所有各个部件。图4(A)还图示出安装在第二耦联件26内的湿度传感器990。湿度传感器990的另外细节在图4(H)中示出。参照图4(H),湿度传感器990耦联到数据传输线缆38以将存在有湿气的信号传递到(例如,将检测到的湿气数据传递到)远程动力控制台12。存在于柔性轴20内的湿气会导致柔性轴20部件——例如诸如可旋转驱动轴30、32及设置在柔性轴20中的电子或电气部件等——的腐蚀。根据和/或基于检测到的湿气数据,远程动力控制台12可以例如通过声频信号或视频信号告知使用者湿气的存在。湿度传感器990可包括第一印刷引线995以及第二印刷引线996,每个印刷引线印刷在板元件997上并与数据传输线缆38连接。湿气的存在会改变印刷引线995、996之间的导电率,例如,印刷引线995、996之间的电阻会根据湿气存在的量而变化。应当理解,湿度传感器990可以另外地或者可替代地设置在柔性轴20的长形护套内并且耦联到例如数据传输线缆38。
图5(A)是根据本发明的示例实施方式的第一耦联件22在组装好时的放大截面图。图5(B)是根据本发明的示例实施方式的第一耦联件22的前视立体图,其分解图示出第一耦联件的一些部件。如图5(B)所示,第一耦联件22包括近侧组件2095。近侧组件2095包括数据连接器60。近侧PCB组件2030设置在近侧组件2095内并且安装于近侧组件2095的近端处的内表面。近侧驱动轴2102穿过近侧PCB组件2030的切口区域并且与近侧组件2095的近端中的孔连通。近侧驱动轴2102在它们的近端具有非圆形的——例如六边形的——驱动连接装置44、48以与远程动力控制台12内的马达设备的对应驱动轴接合,将在下面进行更加具体地描述。近侧驱动轴2102的远端与近侧压接端子2071接合,近侧压接端子2071以例如不能够旋转的方式将近侧驱动轴2102的远端连接到在柔性轴20内延伸的驱动线缆30、32的近端。驱动线缆30、32在它们的相对端处以例如不能够旋转的方式连接到位于第一耦联件22内的远侧线缆端部组件2078,如前所述。
图6是根据本发明的示例实施方式的柔性轴20的局部剖视的侧视图。第一可旋转驱动轴30以及第二可旋转驱动轴32可设置在柔性轴20内并且沿着柔性轴的整个长度延伸。此外,根据本发明的不同的示例实施方式,在柔性轴20内可设置操纵线缆34、35、36和37、数据传输线缆38、光缆组39、冲洗通道101以及抽吸通道102。应当指出,例如101、102的通道可以用于除了冲洗和/或抽吸手术部位之外的其它目的,例如可以用于使手术器械从中穿过。此外,应当指出,虽然光缆组39示出为单束光缆,但是在其它的示例实施方式中,光缆可以分开地设置。可以采用任何数目的光缆,如下面所述。图7是沿着图6中所示的线7-7所截取的柔性轴20的横截面图,并且还图示出若干线缆30、32、34-39以及通道101、102。若干线缆30、32、34-39中的每一个可以容纳在各自的护套内。
第一可旋转驱动轴30和第二可旋转驱动轴32可构造成例如高度柔性驱动轴,比如麻花状或螺旋状驱动线缆。应当理解,这种高度柔性驱动轴的扭矩传递特性和能力可能是有限的。还应当理解,例如手术吻合器附件或类似物的手术器械或者其它以可拆卸方式附连到柔性轴20的附件所需要的扭矩输入可能高于通过驱动轴30、32传递的扭矩。从而,驱动轴30、32可构造成用以传递低的扭矩但是高的速度,高的速度/低的扭矩通过齿轮设备转化成低的速度/高的扭矩,齿轮设备例如于柔性轴20的远端和/或近端处设置在手术器械或附件和/或远程动力控制台12中。应当理解,这种齿轮设备可沿动力传动系设置在任何适当的位置,所述传动系设置在壳体14中的马达与附连的手术器械或其它以可拆卸方式附连到柔性轴20的其它附件之间。这种齿轮设备可设置在手术器械或者其它以可拆卸方式附连到柔性轴20的附件中。这种齿轮设备可包括例如正齿轮设备、行星齿轮设备、谐波齿轮设备、摆线传动设备、周转齿轮设备等。
现在参照图8,可以看到第一耦联件22的后端示意图。第一耦联件22包括第一连接装置44和第二连接装置48,每个连接装置相对于第一耦联件22以能够旋转的方式设置。每个连接装置44、48包括各自的延伸穿过第一耦联件22的最近端表面的突出部46、50。如图8所示,每个突出部46、50可呈六边形形状。然而,应当理解,突出部46、50可以具有任何形状和构造以将连接装置44、48以不能够旋转的方式耦联并刚性地附连到容纳在壳体12内的马达设备的各驱动轴,下面会更全面地描述。应当理解,可在马达设备的各驱动轴上设置互补的凹部,因此如下面所述地驱动柔性轴20的驱动元件。还应当理解,可在驱动轴上设置突出部而在连接装置44、48上设置互补的凹部。可配置构造成以不能旋转但能够松开的方式将连接装置44、48耦联到马达设备的驱动轴的任何其它的耦联设备。
连接装置44、48中的一个以不能够旋转的方式固定到第一驱动轴30,而连接装置44、48中的另一个以不能够旋转的方式固定到第二驱动轴32。连接装置44、48、52、56中的剩余两个与传递元件接合,传递元件构造成将张力施加到操纵线缆34、35、36、37上,因此用以操纵柔性轴20的远端24。第一耦联件22可包括分别连接到冲洗通道101和抽吸通道102的开口101a、102a,用于将流体引入到手术部位和/或从手术部位排走。
数据传输线缆38与数据连接器60电气地并逻辑地连接。数据连接器60包括例如电触点62,电触点的数目对应于并且等于容纳在数据线缆38中的各电线的数目。第一耦联件22包括键结构42,用以使第一耦联件22适当地朝向设置于壳体12上的匹配互补的耦联设备。这种键结构42可设置在第一耦联件22以及设置于壳体12上的互补匹配的耦联设备中的一个或两个上。第一耦联件22可包括快速连接类型的连接装置,所述连接装置可通过例如简单的推入动作将第一耦联件22接合到壳体12。可与若干连接装置44、48、60中的任何一个结合地设置密封件,以在第一耦联件22的内部与环境之间提供不漏水的密封。
现在参照图9,可以看到柔性轴20的第二耦联件26的前端示意图。第二耦联件26包括第一连接装置66和第二连接装置68,每个连接装置以相对于第二耦联件26能够旋转的方式设置并且每个都以不能够旋转的方式固定到相应的第一和第二驱动轴30、32的远端。可在第二耦联件26上设置快速连接类型的配合件64,用于将手术器械或附件以可拆卸方式固定到第二耦联件上。快速连接类型的配合件64可以是例如旋转式快速连接类型的配合件、卡口类型的配合件等。可在第二耦联件26上设置键结构74,用于将手术器械或附件与第二耦联件26适当地对齐。用于将手术器械或附件与柔性轴20适当地对齐的键结构74或其它设备可以设置在第二耦联件26以及手术器械或附件中的一个或两个上。此外,快速连接类型的配合件可设置在手术器械或附件上。具有电触点72的数据连接器70也设置在第二耦联件26中。与第一耦联件22的数据连接器60相似,第二耦联件26的数据连接器70包括触点72,触点72电气地并逻辑地连接到数据传输线缆38的各电线以及数据连接器60的触点62。连接装置66、68、70可结合设置有密封件,以在第二耦联件26的内部与环境之间提供不漏水的密封。第二耦联件26可包括分别连接到冲洗通道101和抽吸通道102的开口101b、102b,用于将流体引入到手术部位和/或从手术部位排走。
构造成用以驱动上述驱动轴30、32、从而操作机电手术设备10以及附连到第二耦联件26的手术器械或附件的机电驱动元件设置在远程动力控制台12的壳体14内。在图10中示意性图示的示例实施方式中,每个通过电源来操作的五个电动马达76、80、84、90、96可设置在远程动力控制台12中。然而,应当理解,可以设置任何适当数目的马达,并且马达可通过电池电源、线路电流、直流电源、电气控制的直流电源等来操作。还应当理解,马达可以连接到直流电源,直流电源由连接到线路电流并且由线路电流为马达供应操作电流。
图10示意性地图示出马达的一种可能设置。当第一耦联件22——并因此柔性轴20——与壳体14接合从而驱动第一驱动轴30以及第二耦联件26的第一连接装置66时,第一马达76的输出轴78与第一耦联件22的第一连接装置44接合。相似地,当第一耦联件22——并因此柔性轴20——与壳体14接合从而驱动第二驱动轴32以及第二耦联件26的第二连接装置68时,第二马达80的输出轴82与第一耦联件22的第二连接装置48接合。
如上所述,柔性轴20可包括操纵线缆,例如可用于操纵柔性轴20的操纵线缆34、35、36和37。图10还图示出一种可采用的马达设置,其中可利用那些包括有操纵线缆的柔性轴20的示例实施方式中的操纵线缆。例如,图10图示出当第一耦联件22——并因此柔性轴20——与壳体14接合从而通过第一滑轮设备88驱动第一和第二操纵线缆34、35时,第三马达84的输出轴86与第一耦联件22的第三连接装置52接合。当第一耦联件22——并因此柔性轴20——与壳体14接合从而通过第二滑轮设备94驱动第三和第四操纵线缆36、37时,第四马达90的输出轴92与第一耦联件22的第四连接装置56接合。第三和第四马达84、90可固定到托架100上,托架100可通过第五马达96的输出轴98在第一位置和第二位置之间选择地移动以使第三和第四马达84、90与各滑轮设备88、94选择地接合以及脱开,因此允许柔性轴20如需地变得绷紧并可操纵或者变松。应当理解,可以利用其它的机械、电气或机电机构来选择性地接合和脱开操纵结构。马达的设置和构造可如例如名称为“A Carriage Assembly for Controlling a Steering Wire MechanismWithin a Flexible Shaft(用于控制柔性轴内的操纵线机构的托架组件)”的美国专利申请序列号No.09/510,923且授权号为美国专利号No.6,715,565中所述,其全部内容以参引方式结合入本文。
应当理解,马达76、80、84、90、96中的任何一个或多个可以是高速/低扭矩马达或低速/高扭矩马达。如上面指出,第一可旋转驱动轴30和第二可旋转驱动轴32可构造成用以传递高的速度和低的扭矩。因此,第一马达76和第二马达80可构造成高速/低扭矩马达。可替代地,第一马达76和第二马达80可构造成低速/高扭矩马达、同时带有设置在第一马达76和第二马达80与对应的第一可旋转驱动轴30和第二可旋转驱动轴32之间的减小扭矩/增加速度的齿轮设备。这种减小扭矩/增加速度的齿轮设备可包括例如正齿轮设备、行星齿轮设备、谐波齿轮设备、摆线传动设置、周转齿轮设备等。应当理解,任何这种齿轮设备可设置在远程动力控制台12内或设置在柔性轴20的近端中,例如设置在诸如第一耦联件22中。应当理解,齿轮设备设置在第一可旋转驱动轴30和/或第二可旋转驱动轴32的远端和/或近端处,用以防止其缠绕和破损。
现在参照图11,可以看到机电手术设备10的示意图。控制器122设置在远程动力控制台12的壳体14中并且构造成用以控制机电手术设备10以及附连到柔性轴20的任何手术器械或附件的所有功能和操作。设置存储单元130并且其可包括例如ROM部件132和/或RAM部件134的存储设备。ROM部件132通过线路136与控制器122电气地并逻辑地连通,并且RAM部件134通过线路138与控制器122电气地并逻辑地连通。RAM部件134可包括任何类型的随机存取存储器,例如诸如磁存储设备、光学存储设备、磁-光存储设备、电子存储设备等。相似地,ROM部件132可包括任何类型的只读存储器,例如是诸如PC卡或PCMCIA类型的设备的可移动存储设备。应当理解,ROM部件132和RAM部件134可设置成单个单元或设置成分开的单元,并且ROM部件132和/或RAM部件134可设置成PC卡或PCMCIA类型的设备的形式。控制器122还连接到壳体14的前面板15,更具体地,通过线路154连接到显示器设备16并且通过各线路156、158连接到指示器18a、18b。线路116、118、124、126、128电气地并逻辑地将控制器122分别连接到第一马达76、第二马达80、第三马达84、第四马达90和第五马达96。有线遥控单元(“RCU”)150通过线路152电气地并逻辑地连接到控制器122。还设置有无线RCU 148并且其通过无线链路160与接收/发送单元146连通,接收/发送单元146通过线路144连接到收发器140。收发器140通过线路142电气地并逻辑地连接到控制器122。无线链路160可以是例如诸如红外链路的光链路、无线电链路或者其他任何形式的无线通信链路。
可以是例如一排DIP开关的开关设备186可通过线路188连接到控制器122。开关设备186可以例如在用于在显示器设备16上显示信息和提示的多种语言中选择一种语言。信息和提示可与例如机电手术设备10和/或附连于其上的任何手术器械或附件的操作和/或状态相关。
根据本发明的示例实施方式,每个正交环2080设置在第二耦联件26内并且构造成响应对应的第一和第二驱动轴30、32的旋转并根据对应的第一和第二驱动轴30、32的旋转输出信号。由每个正交环2080输出的信号可表示各驱动轴30、32的旋转位置及其旋转方向。尽管描述正交环2080设置在第二耦联件26内,但是应当理解,正交环2080可设置在马达系统与手术器械或附件之间的任何位置。应当理解,将正交环2080设置在第二耦联件26内或设置在柔性轴20的远端提供了驱动轴旋转的精确确定。如果正交环2080设置在柔性轴20的近端,则第一可旋转驱动轴30和第二可旋转驱动轴32的缠绕会导致测量误差。
图12是正交环2080设置的示意图。具有第一凸耳20801和第二凸耳20802的正交环2080以不能够旋转的方式安装在驱动轴30、32之一上。正交环2080设备还包括例如发光二极管、光电晶体管等的第一光源和第二光源217,第一光源和第二光源217设置成关于驱动轴30、32的纵向轴线或旋转轴线隔开大约90°。此外,正交环2080设备可包括光缆组39,例如用于在光源217与远程动力控制台12之间沿柔性轴20的长度方向传递光线。正交环2080的第一凸耳20801和第二凸耳20802构造成交替地阻挡从光源217发出的光和允许从光源217发出的光通过光缆到达远程动力控制台217。应当理解,虽然此处正交环2080被描述和显示成安装到各可旋转驱动轴30、32上的独立结构,但是可以采用任何随可旋转驱动轴30、32旋转并且执行各正交环2080的功能的构件,例如可旋转驱动轴30、32自身可具有例如凸耳的一体结构。基于由远程动力控制台12接收到的从各光源217发射的光,可以在四分之一转内确定驱动轴30、32的角位置并且可以确定驱动轴30、32的旋转方向。每个正交环2080的输出被传递到控制器122。通过基于来自正交环2080的输出信号来跟踪驱动轴30、32的角位置和旋转方向,控制器122从而能够确定连接到机电手术设备10的手术器械或附件的部件的位置和/或状态。即,通过计数驱动轴30、32的转数,控制器122能够确定连接到机电手术设备10的手术器械或附件的部件的位置和/或状态。应当理解,取决于期望的角运动分辨率,可以设置任何数目的凸耳。
例如,柔性轴20的第二耦联件26可以可拆卸方式附连到手术吻合器附件,手术吻合器附件包括钉砧杆,钉砧杆伸出以及缩进以将一部分组织夹紧于钉砧上,手术吻合器附件还包括缝钉驱动器/切割器,其切割该部分组织并且驱动一组缝钉抵住砧钉座以吻合该部分组织。钉砧的伸出和缩进可由第一马达76的操作实现,而缝钉驱动器/切割器的伸出和缩进可由第二马达80的操作来实现。用于驱动钉砧的驱动轴的节距以及用于驱动缝钉驱动器/切割器的驱动轴的节距可以是预先确定并已知数量的,使得钉砧以及缝钉驱动器/切割器的前进距离可以是各驱动轴30、32的转动的函数并且能够基于各驱动轴30、32的转动来确定。通过确定处于某一时间点的钉砧和缝钉驱动器/切割器的绝对位置,基于来自各正交环2080的输出信号以及钉砧驱动轴和缝钉驱动器/切割器驱动轴的已知节距,之后都可以利用钉砧和缝钉驱动器/切割器的相对位移来确定钉砧和缝钉驱动器/切割器的绝对位置。可以在圆形手术吻合器附件最初耦联到柔性轴20时固定并确定钉砧和缝钉驱动器/切割器的绝对位置。可替代地,钉砧和缝钉驱动器/切割器相对于例如手术吻合器附件的单独部件的位置可以基于来自正交环2080的输出信号而确定。
再次参照图11,手术吻合器附件和柔性轴20可包括存储单元174、850,存储单元174、850通过柔性轴20内的数据线缆分别电气地并逻辑地连接到控制器122。存储单元174、850可以是例如EEPROM、EPROM等的形式。图13示意地图示出根据本发明示例实施方式的存储单元174。存储单元850可具有图13所示的相似的设置。从图13中可以看到,数据连接器272包括触点276,每个触点通过对应的线路278电气地并逻辑地连接到存储单元174。存储单元174构造成用以存储例如序列号数据180、附件类型识别(ID)数据182以及使用数据184。存储单元174可另外地存储其它数据。序列号数据180和ID数据182都可以构造成只读数据。在示例实施方式中,序列号数据180是唯一识别特定的手术器械或附件的数据,而ID数据182是识别例如诸如圆形手术吻合器附件、线形手术吻合器附件等的附件类型的数据。使用数据184表示特定附件的使用,例如通过柔性轴20连接的手术吻合器附件的钉砧前进的次数或者圆形手术吻合器附件的缝钉驱动器/切割器前进或开动的次数。
应当理解,附连到柔性轴20远端24的每种类型的手术器械或附件可设计并构造成仅可以使用一次或者可多次使用。手术器械或附件还可以设计并构造成使用预定的次数。相应地,使用数据184可用来确定手术器械或附件是否已经被使用过以及使用次数是否已经超过允许使用的最多次数。如下面更加全面的描述,在达到允许使用的最多次数后尝试使用手术器械或附件会产生错误(ERROR)状态。
应当理解,上文关于例如圆形手术吻合器附件的任何特定手术附件的讨论仅作为可与柔性轴20结合使用的手术附件的示例。还应当理解,例如那些在上文中列举的任何其它类型的手术器械或附件也可以与柔性轴20结合使用。不管手术器械或附件的特定类型,在本发明的示例实施方式中,手术器械或附件可包括对于手术器械或附件的适当操作可能是必须的耦联元件以及包括存储单元174。尽管驱动轴和马达在此处描述为实现圆形手术吻合器附件的特定功能,应当理解,驱动轴和马达可以实现其它类型的手术器械或附件的相同或其它功能。
再次参照图11,根据本发明的示例实施方式,控制器122构造成当手术器械或附件最初连接到柔性轴20时从手术器械或附件的存储单元174读取ID数据182,并且控制器122构造成从柔性轴20的存储单元850读取ID数据880。存储单元174、850可通过数据传输线缆38的线路120电气地并逻辑地并联到控制器122,或者可替代地,存储单元174、850可以通过各自的专用线路连接到控制器122。
控制器122可基于所读取的柔性轴20的使用数据870防止手术设备10驱动柔性轴20。如上所述,特定的柔性轴20可设计并构造成使用一次、使用多次或者使用预定的次数。因此,可由控制器122读取使用数据870以确定柔性轴20是否已经被使用过以及使用的次数是否已经超过允许使用的最多次数。如果已经超过使用的最多次数,则控制器122可以阻止接下来使用柔性轴20的企图。
此外,控制器122可将使用数据870写入柔性轴20的存储单元850。写入的使用数据870可包括下列的信息,例如可旋转驱动轴30、32之一或两者的转动次数、可旋转驱动轴30、32之一或两者的使用次数,可旋转驱动轴30、32之一或两者的开动次数,和/或柔性轴20已经被使用的次数等。应当理解,写入的使用数据870可包括任何形式的适于指出柔性轴20的任何与使用有关的状态改变的信息。
基于读取的ID数据182,控制器122构造成从存储单元130读取或选择与连接到柔性轴20的手术器械或附件的类型相对应的操作程序或算法。存储单元130构造成存储用于每种可能类型的手术器械或附件的操作程序或算法,控制器122根据从所附连的手术器械或附件的存储单元174读取的ID数据182从存储单元130选择和/或读取操作程序或算法。如上面指出,存储单元130可包括可移动ROM部件132和/或RAM部件134。因此,当必要时可以对存储在存储单元130中的操作程序或算法进行更新、增加、删除、改善或其它修改。可基于例如使用者的特殊需要对存储于存储单元130中的操作程序或算法进行用户化。例如诸如键盘、鼠标、点击设备、触摸屏等的数据输入设备可通过例如数据连接端口连接到存储单元130,以便于操作程序或算法的用户化。可替代地或另外地,可将操作程序或算法用户化并预先编程到远离机电手术设备10的存储单元130中。应当理解,序列号数据180和/或使用数据184也可以用来确定从存储单元130中读取或选择多个操作程序或算法中的哪一个。应当理解,操作程序或算法可以可替代地存储在手术器械或附件的存储单元174中并且通过数据传输线缆38传输到控制器122。一旦通过控制器122读取或选择了适当的操作程序或算法或将适当的操作程序或算法传递到控制器122,控制器122就根据使用者通过有线RCU150和/或无线RCU 148所执行的操作来运行操作程序或算法。如上文中指出,控制器122通过各线路116、118、124、126、128电气地并逻辑地与第一马达76、第二马达80、第三马达84、第四马达90、第五马达96连接,并且通过各线路116、118、124、126、128根据所读取、选择或传递的操作程序或算法控制这些马达76、80、84、90、96。
现在参照图14,可以看到无线RCU 148的示意图。无线RCU 148包括操纵控制器300,操纵控制器300具有设置于四向摇杆310下方的多个开关302、304、306、308。通过摇杆310对开关302、304的操作、经由第三马达84来控制第一和第二操纵线缆34、35的操作。相似地,通过摇杆310对开关306、308的操作经由第四马达92来控制第三和第四操纵线缆36、37的操作。应当理解,设置摇杆310和开关302、304、306、308,使得开关302、304的操作在南北方向上操纵柔性轴20,并且使得开关306、308的操作在东西方向上操纵柔性轴20。此处参照相应的坐标系统来描述东、西、南、北。可替代地,可以设置数字操纵杆、模拟操纵杆等来替代摇杆310和开关302、304、306、308。还可以使用电位计或任何其它类型的致动器来替代开关302、304、306、308。
无线RCU 148还包括操纵接合/脱离开关312,该开关的操作控制第五马达96的操作,以选择性地接合和脱开操纵机构。无线RCU 148还包括二向摇杆314,二向摇杆314具有由其操作的第一和第二开关316、318。根据对应于附连的手术器械或附件——如果存在的话——的操作程序或算法,这些开关316、318的操作控制机电手术设备10以及任何附连到柔性轴20的手术器械或附件的某些功能。例如,当手术器械是圆形手术吻合器附件时,二向摇杆314的操作可以控制钉砧的前进和缩进。无线RCU 148设置有另一开关320,根据对应于附连的手术器械或附件——如果存在的话——的操作程序或算法,开关320的操作可进一步控制机电手术设备10以及任何附连到柔性轴20的手术器械或附件的操作。例如,当圆形手术吻合器附件附连到柔性轴20时,开关320的操作导致缝钉驱动器/切割器的前进或开动程序。
无线RCU 148包括控制器322,控制器322通过线路324与开关302、304、306、308电气地并逻辑地连接,通过线路326与开关316、318电气地并逻辑地连接,通过线路328与开关312电气并逻辑地连接,并通过线路330与开关320电气地并逻辑地连接。无线RCU 148可包括对应于前面板15的指示器18a、18b的指示器18a’、18b’和对应于前面板的显示器设备16的显示器设备16’。如果设置了指示器18a’、18b’和显示器设备16’,则指示器18a’、18b’通过相应线路332、334电气地并逻辑地连接到控制器322,且显示器设备16’通过线路336电气地并逻辑地连接到控制器322。控制器322通过线路340电气地并逻辑地连接到收发器338,并且收发器338通过线路334电气地并逻辑地连接到接收器/发送器342。图中未示出的例如电池的电源可设置在无线RCU148中以为之提供动力。因此,通过无线链路160,无线RCU 148可用于控制机电手术设备10以及附连到柔性轴20的任何手术器械或附件的操作。
无线RCU 148可包括通过线路348连接到控制器322的开关346。操作开关346,将数据信号通过无线链路160传递到发送器/接收器146。数据信号包括唯一识别无线RCU 148的识别数据。控制器122利用此识别数据来防止机电手术设备10的未授权操作并防止另一无线RCU影响机电手术设备10的操作。在无线RCU 148与机电手术设备10之间的每个随后的传送都可包括识别数据。因此,控制器122能够在无线RCU之间进行区别并且因此仅允许单一的、可识别的RCU 148来控制机电手术设备10以及任何附连到柔性轴20的手术器械或附件的操作。
基于根据来自正交环2080的输出信号确定的附连到柔性轴20的手术器械或附件的部件的位置,控制器122可选择性地允许或禁止由与附连的手术器械或附件对应的操作程序或算法限定的机电手术设备10的功能。例如,当手术器械或附件是圆形手术吻合器附件时,由开关320的操作控制的开动功能会被禁止,除非确定在钉砧与身体部分之间的空间或间隙落在可接受的范围内。在钉砧与身体部分之间的空间或间隙基于来自正交环2080的输出信号来确定,如上文中更加全面的描述。应当理解,开关320本身仍然是可操作的,但是控制器122不执行对应的功能,除非确定上述的空间或间隙落在可接受的范围内。此外,如果湿度传感器990在柔性轴20内检测到了湿气,则由开关320的操作控制的开动功能会被禁止。
现在参照图15,可以看到有线RCU 150的示意图。在示例实施方式中,有线RCU 150包括与无线RCU 148大致相同的控制元件,将省略对这些元件的进一步的描述。相似的元件在图15中标记有伴随的撇号。应当理解,机电手术设备10以及任何附连到柔性轴20的手术器械或附件的功能可由有线RCU 150和/或无线RCU 148控制。例如在无线RCU 148的电池失效的情况下,可使用有线RCU 150来控制机电手术设备10以及任何附连到柔性轴20的手术器械或附件的功能。
如上文所述,壳体14的前面板15包括显示器设备16以及指示器18a、18b。显示器设备16可包括例如LCD显示器设备的字母数字式显示器设备。显示器设备16还可包括例如扬声器、蜂鸣器等的声频输出设备。控制器122根据与附连到柔性轴20的手术器械或附件——如果存在的话——相对应的操作程序或算法来操作并控制显示器设备16。如果没有附连手术器械或附件,则控制器122会读取或选择默认的操作程序或算法或者将所述操作程序或算法传递到控制器122,因此控制显示器设备16的操作以及机电手术设置10的其它方面和功能。如果圆形手术吻合器附件附连到柔性轴20,则显示器设备16可显示例如根据正交环2080的输出信号来确定的、表示位于钉砧与身体部分之间的间隙的数据,如在本文中更加全面地描述的。
相似地,控制器122根据与附连到柔性轴20的手术器械或附件——如果存在的话——相对应的操作程序或算法来操作并控制指示器18a、18b。指示器18a和/或指示器18b可包括例如扬声器、蜂鸣器等的声频输出设备和/或例如LED、灯、光线等的视觉指示器设备。如果圆形手术吻合器附件附连到柔性轴20,则指示器18a可指示例如机电手术设备10处于接通状态,且指示器18b可例如指示位于钉砧与身体部分之间的间隙是否确定是落在可接受的范围内,如本文中更加全面地描述的。应当理解,尽管仅描述了两个指示器18a、18b,但是如果必要的话可以设置任何数目的另外的指示器。此外,应当理解,尽管描述了单一的显示器设备16,但是如果必要的话可以设置任何数目的另外的显示器设备。
相应的控制器322、322’根据与附连到柔性轴20的手术器械或附件——如果存在的话——的操作程序或算法来类似地操作和控制无线RCU 150的显示器设备16’和指示器18a’、18b’以及有线RCU 148的显示器设备16”和指示器18a”、18b”。

Claims (22)

1.一种轴,包括:
长形的外护套;
至少一个可旋转驱动轴,其设置在所述外护套内;
构件,其从所述至少一个可旋转驱动轴径向地延伸并构造成随所述至少一个可旋转驱动轴旋转;以及
至少一个光源,其安装到所述外护套内,
其中,当所述至少一个可旋转驱动轴旋转时,所述构件交替地阻挡来自所述光源的光和允许来自所述光源的光被检测到。
2.根据权利要求1所述的轴,其中,所述构件是凸耳。
3.根据权利要求2所述的轴,其中,所述构件包括两个从安装在所述至少一个可旋转驱动轴上的正交环延伸的凸耳。
4.根据权利要求1所述的轴,其中,所述至少一个光源包括两个安装到所述轴的远端的光源。
5.根据权利要求4所述的轴,其中,所述两个光源安装成相对于所述至少一个可旋转驱动轴的轴线彼此大约成90度。
6.根据权利要求1所述的轴,其中,所述轴是柔性的。
7.根据权利要求1所述的轴,其中,所述轴是刚性的。
8.根据权利要求1所述的轴,其中,所述轴是活节的。
9.根据权利要求1所述的轴,其中,所述轴是铰接的。
10.根据权利要求1所述的轴,其中,所述至少一个光源是发光二极管。
11.根据权利要求10所述的轴,其中,所述外护套是耐高压加热的。
12.根据权利要求10所述的轴,其中,所述外护套包括含氟聚合物/硅酮材料。
13.根据权利要求1所述的轴,进一步包括用于传递来自所述光源的光的至少一条光缆。
14.根据权利要求13所述的轴,其中,所述构件和所述至少一个光源构造成使得从所述至少一个光源传递的光能够由控制器解译以确定所述至少一个可旋转驱动轴的转动。
15.根据权利要求14所述的轴,其中,所述控制器设置在远程动力控制台内。
16.根据权利要求15所述的轴,进一步包括:
处于所述轴的近端的第一耦联件,所述第一耦联件构造成以可拆卸方式将所述轴耦联到所述远程动力控制台。
17.根据权利要求16所述的轴,进一步包括:
连接到所述外护套的远端的第二耦联件,所述第二耦联件构造成以可拆卸方式耦联到手术附件。
18.根据权利要求17所述的轴,其中,所述控制器构造成基于对所传递的光的解译来确定所述手术附件的部件的位置。
19.根据权利要求1所述的轴,进一步包括:
设置在所述外护套内的湿度传感器,所述湿度传感器构造成检测所述外护套内的湿气。
20.根据权利要求1所述的轴,进一步包括:
设置在所述轴中的存储单元。
21.根据权利要求20所述的轴,其中,所述存储单元存储的数据包括序列号数据、识别数据以及使用数据中的至少一种。
22.根据权利要求21所述的轴,进一步包括:
设置在所述轴内的数据传输线缆,其中,所述存储单元逻辑地并电气地连接到所述数据传输电缆。
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US20200205921A1 (en) 2020-07-02
EP1912570A2 (en) 2008-04-23
US20070055219A1 (en) 2007-03-08
EP2799014A3 (en) 2015-03-11
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US9504455B2 (en) 2016-11-29
WO2007014355A2 (en) 2007-02-01
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WO2007014355A3 (en) 2009-04-16
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US20150133224A1 (en) 2015-05-14
EP1912570B1 (en) 2014-10-08
CN102988087A (zh) 2013-03-27
CN102988087B (zh) 2015-09-09
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US20170056119A1 (en) 2017-03-02
EP2799014B1 (en) 2018-09-05
EP2799014A2 (en) 2014-11-05
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US10582978B2 (en) 2020-03-10

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Patentee before: TYCO Healthcare