CN101543417B - 带有改进的击发扳机布置的外科缝合装置 - Google Patents
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Abstract
本发明涉及一种外科缝合装置,更具体地涉及带有改进的击发扳机布置的外科缝合装置。所述外科缝合装置包括致动钮,所述致动钮能够从缝合装置的一侧移动到另一侧以便重新放置致动钮而无需在手术位置重新放置缝合装置。缝合装置可包括推杆、具有第一侧和第二侧的壳体,以及可旋转地装配在推杆上的致动钮,其中致动钮可构造为在致动钮可沿壳体的第一侧移动的第一位置和致动钮可沿壳体的第二侧移动的第二位置之间旋转。可替代地,外科缝合装置可包括一个或多个致动钮,其可操作地与推杆接合及脱离以便选择性地使用致动钮。
Description
技术领域
本发明涉及一种外科缝合装置,并且在各种实施方式中涉及一种用于产生一排或多排缝钉的胃肠吻合缝合装置。
背景技术
近年来,外科医生逐渐倾向于使用缝合装置来缝合身体组织,例如肺、食道、胃、十二指肠和/或其它肠道内的器官。在许多情况下使用合适的缝合装置可以在较短的时间内完成更好的工作,并简化诸如胃肠吻合之类的原先复杂的外科手术。以前的两排和四排线性切割缝合器包括无钉仓装置,缝钉被单独地手动装载到这些无钉仓装置内。其它的在先设备具有预先灭菌的一次性缝钉装载单元和切割部件,该切割部件可用于同时分离组织和使缝钉排成形。这种外科缝合器的例子公开于美国专利No.3,499,591中,其全部内容在此通过引用并入本文中。
线性吻合缝合装置可包括一对协同操作的细长钳口部件,其中每个钳口部件能够插入到将被吻合的内部管状身体器官中。在各种实施方式中,一个钳口部件可支撑一钉仓,该钉仓具有至少两个横向隔开的缝钉排,另一个钳口部件可支撑一砧座,该砧座具有与钉仓内的缝钉排对齐的钉成形凹窝。通常,缝合装置可进一步包括推杆和刀片组件,所述推杆和刀片组件能够相对于钳口部件滑动从而通过推杆上的凸轮表面从钉仓连续地发射缝钉。在至少一种实施方式中,凸轮表面可配置为致动多个缝钉驱动器,所述缝钉驱动器由钉仓支撑并与各个缝钉相关联以向砧座推动缝钉并在钳口部件之间夹住的组织内形成横向隔开的变形缝钉排。在至少一种实施方式中,刀片可以跟随推杆并沿缝钉排之间的线切割组织。这种吻合缝合装置的例子公开于美国专利No.4,429,695中,其全部内容在此通过引用并入本文中。
在不同的情况下,线性吻合缝合装置可包括从推杆伸出的致动钮,该致动钮可配置为由外科医生抓握并被向远侧推进以在钉仓内推进推杆和刀片组件。不过,在至少一种情况下,由于致动钮可从外科装置向外延伸,其有可能无意间接触手术位置周围的组织,因此,组织可能阻碍致动钮的推进。在这种情况下,外科医生可能不得不强制推动致动钮通过组织和/或重新放置缝合装置,这样就会增加完成手术所需的时间。需要对上述情况加以改进。
发明内容
在本发明的至少一种形式中,外科缝合装置可以包括致动钮,所述致动钮能够从缝合装置的一侧移动到另一侧以便重新放置致动钮而无需在外科手术位置内重新放置缝合装置。在各种实施方式中,缝合装置可包括在其中储存至少两个缝钉排的钉仓、推杆、可操作地与推杆接合的缝钉驱动器,其中,缝钉驱动器可配置为从钉仓发射缝钉,并且砧座可配置为当缝钉从钉仓施放出后使它们发生形变。在至少一种实施方式中,缝合装置可进一步包括具有第一侧和第二侧的壳体,以及另外还包括可旋转地装配在推杆上的致动钮,其中,致动钮可配置为在致动钮可以沿着壳体的第一侧移动的第一位置和致动钮可以沿着壳体的第二侧移动的第二位置之间旋转。
在本发明的至少一种形式中,外科缝合装置可包括一个或多个致动钮,所述致动钮能可操作地与推杆接合及从推杆上脱离以便选择性地使用致动钮。在各种实施方式中,缝合装置可包括一个或多个可旋转的致动钮,所述致动钮可在可操作地从推杆脱离的缩回的第一位置和可操作地与推杆接合的伸出的第二位置之间旋转。在至少一个实施方式中,外科医生可以选择性地伸出致动钮来推进推杆,使得被选择的致动钮不会侵害,或至少基本上不会侵害周围组织。其它的一个或多个致动钮可以保持在缩回的脱离位置上,从而它们不必与推杆一起被推进和/或基本上不从外科缝合装置的外周边伸出。
更具体而言,本发明涉及如下内容:
(1).一种外科缝合装置,包括:
具有第一侧和第二侧的壳体;
构造为可操作地支撑钉仓的第一钳口部件,所述钉仓中储存有至少两排缝钉,其中所述第一钳口部件和钉仓中的至少一个构造为可滑动地支撑缝钉驱动器,所述缝钉驱动器构造为从所述钉仓施放缝钉;
构造为可操作地支撑砧座的第二钳口部件,所述砧座构造为当缝钉从所述钉仓中被施放时使缝钉变形;
构造为使所述缝钉驱动器相对于所述第一钳口部件和所述第二钳口部件移动的推杆;和
构造为接受施加在其上的力的致动钮,其中,所述致动钮可旋转地装配于所述推杆上,所述致动钮构造为在第一位置和第二位置之间旋转,所述致动钮构造为当所述致动钮处于所述第一位置时沿所述第一侧移动,并且所述致动钮构造为当所述致动钮处于所述第二位置时沿所述第二侧移动。
(2).根据第(1)项所述的外科缝合装置,其中,所述壳体进一步包括:
限定在所述第一侧内的第一槽,其中,所述致动钮构造为当所述致动钮处于所述第一位置时所述致动钮在所述第一槽内滑动;和
限定在所述第二侧内的第二槽,其中,所述致动钮构造为当所述致动钮处于所述第二位置时所述致动钮在所述第二槽内滑动。
(3).根据第(2)项所述的外科缝合装置,其中,所述壳体进一步包括连接所述第一槽和所述第二槽的第三槽,并且所述致动钮构造为在所述第三槽内滑动以选择性地使所述致动钮在所述第一位置和所述第二位置之间移动。
(4).根据第(3)项所述的外科缝合装置,其中,所述第三槽基本上与所述第一槽和所述第二槽共面。
(5).根据第(3)项所述的外科缝合装置,其中,所述第三槽垂直于并横穿所述第一槽和所述第二槽。
(6).根据第(2)项所述的外科缝合装置,其中,所述第一槽基本平行于所述第二槽。
(7).根据第(1)项所述的外科缝合装置,其中,所述推杆限定延长的轴线,并且所述致动钮可绕所述轴线旋转。
(8).根据第(1)项所述的外科缝合装置,其中,所述第一侧基本平行于所述第二侧。
(9).根据第(1)项所述的外科缝合装置,进一步包括:
所述砧座;
所述钉仓;
所述缝钉驱动器;和
可操作地与所述缝钉驱动器接合的切割部件。
(10).一种处理外科装置的方法,包括:
获得根据第(1)项所述的外科缝合装置;
对所述外科缝合装置进行消毒;和
将所述外科缝合装置储存在灭菌容器中。
(11).一种外科缝合装置,包括:
具有第一槽和第二槽的壳体;
构造为可操作地支撑钉仓的第一钳口部件,所述钉仓中储存有至少两排缝钉,其中,所述第一钳口部件和钉仓中的至少一个构造为可滑动地支撑缝钉驱动器,所述缝钉驱动器构造为从所述钉仓施放缝钉,并且所述第一钳口部件包括远端;
构造为可操作地支撑砧座的第二钳口部件,所述砧座构造为当缝钉从所述钉仓中被施放时使缝钉变形,其中,所述第二钳口部件包括远端;
构造为使所述缝钉驱动器相对于所述第一钳口部件和所述第二钳口部件移动的推杆;和
从所述推杆延伸出的致动钮,其中,所述致动钮构造为被选择性地放置在所述第一槽和所述第二槽之一内并被朝所述第一和第二钳口部件的远端移动。
(12).根据第(11)项所述的外科缝合装置,其中,所述壳体进一步包括连接所述第一槽和所述第二槽的第三槽,并且所述致动钮构造为在所述第三槽内滑动以选择性地被放置在所述第一槽和所述第二槽内。
(13).根据第(12)项所述的外科缝合装置,其中,所述第三槽基本与所述第一槽和所述第二槽共面。
(14).根据第(12)项所述的外科缝合装置,其中,所述第三槽垂直于并横穿所述第一槽和所述第二槽。
(15).根据第(11)项所述的外科缝合装置,其中,所述第一槽基本平行于所述第二槽。
(16).一种处理外科装置的方法,包括:
获得根据第(11)项所述的外科缝合装置;
对所述外科缝合装置进行消毒;和
将所述外科缝合装置储存在灭菌容器中。
(17).一种外科缝合装置,包括:
壳体;
构造为可操作地支撑钉仓的第一钳口部件,所述钉仓中储存有至少两排缝钉,其中,所述第一钳口部件和钉仓中的至少一个构造为可滑动地支撑缝钉驱动器,所述缝钉驱动器构造为从所述钉仓施放缝钉;
构造为可操作地支撑砧座的第二钳口部件,所述砧座构造为当缝钉从所述钉仓中被施放时使缝钉变形;
构造为使所述缝钉驱动器相对于所述第一钳口部件和所述第二钳口部件移动的推杆;和
能够选择性地与所述推杆接合的致动钮,其中,所述致动钮能够在第一位置和第二位置之间旋转,所述致动钮在其处于所述第一位置时可操作地脱离所述推杆,并且所述致动钮在其处于所述第二位置时可操作地与所述推杆接合。
(18).根据第(17)项所述的外科缝合装置,其中,所述致动钮是第一致动钮,并且所述外科缝合装置进一步包括能够选择性地与所述推杆接合的第二致动钮,其中,所述第二致动钮能够在所述第一位置和第二位置之间旋转,所述第二致动钮在其处于所述第一位置时可操作地脱离所述推杆,并且所述第二致动钮在其处于所述第二位置时可操作地与所述推杆接合。
(19).根据第(18)项所述的外科缝合装置,其中,所述第一致动钮能够独立于所述第二致动钮而与所述推杆接合。
(20).根据第(18)项所述的外科缝合装置,其中,所述壳体进一步包括:
限定在所述壳体内的第一槽,其中,所述第一致动钮构造为在所述第一槽内滑动,从而使所述推杆朝着所述第一和第二钳口部件移动;和
限定在所述壳体内的第二槽,其中,所述致动钮构造为在所述第二槽内滑动,从而使所述推杆朝着所述第一和第二钳口部件移动。
(21).根据第(17)项所述的外科缝合装置,其中,所述推杆包括第一离合特征件,并且所述致动钮包括第二离合特征件,该第二离合特征件构造为与所述第一离合特征件接合,从而当所述致动钮处于所述第二位置时可操作地使所述致动钮与所述推杆接合。
(22).根据第(21)项所述的外科缝合装置,其中,所述第一离合特征件包括凹槽,并且所述第二离合特征件包括构造为容纳在所述凹槽内的凸起。
(23).一种处理外科装置的方法,包括:
获得根据第(17)项所述的外科缝合装置;
对所述外科缝合装置进行消毒;和
将所述外科缝合装置储存在灭菌容器中。
附图说明
通过结合附图参考以下对本发明实施方式的说明,本发明的上述和其它特征和优点以及获得它们的方式将变得更清楚,而发明本身也将更好理解,其中:
图1是线性吻合缝合装置的透视图;
图2是示出了图1中的部分分解的吻合缝合装置的侧视图,其中,其上部砧座支撑钳口部件与其下部钉仓支撑钳口部件相分离;
图3是示出了图1中处于组装构型的吻合缝合装置的侧视图;
图4是图1中的吻合缝合装置的剖视图,其中示出了用于促使上、下钳口部件的后部分开的凸轮机构;
图5是图1中的吻合缝合装置的砧座支撑钳口部件的仰视图;
图6是图1中的吻合缝合装置的钉仓支撑钳口部件的俯视图;
图7是图1中的吻合缝合装置的仰视图;
图8是图1中的吻合缝合装置的前端视图;
图9是图1中的吻合缝合装置的后端视图;
图10是图1中的吻合缝合装置的推杆和刀片组件的透视图;
图11是推块和致动钮的透视图,其中推块和致动钮是图10中的推杆和刀片组件的组成部分;
图12是图1中的吻合缝合装置后部的局部剖视图,其中示出了处于不可操作位置的凸轮机构;
图13是图1中的吻合缝合装置后部的局部剖视图,其中示出了处于可操作位置的凸轮机构;
图14是图1中的吻合缝合装置的钉仓的侧视图;
图15是图1中的吻合缝合装置的钉仓的俯视图;
图16是图1中的吻合缝合装置的钉仓的仰视图;
图17是图5和6中的砧座和钉仓支撑钳口部件的局部剖视图,其中示出了图10中的推杆和刀片组件的操作。
图18是沿图4中的线18-18切开的图1中的吻合缝合装置的剖视图;
图19是沿图4中的线19-19切开的图1中的吻合缝合装置的剖视图;
图20是图18中示出的砧座和钉仓的一部分的详细视图;
图21是根据本发明一种非限制性实施方式的缝合装置的透视图;
图22是图21中的缝合装置的透视图,其中示出了处于伸出位置的第一致动钮;
图23是图21中的缝合装置的透视图,其中示出了已经向远侧推进后的图22中的伸出的致动钮;
图24是用于可操作地将一个或多个致动钮与图21中的缝合装置的推杆接合的离合机构的分解图;
图25是图24中的离合机构的导引部件的透视图;
图26是图21中的缝合装置的致动钮的透视图;
图27是图24中的离合机构的另一个透视图;
图28是图21中的缝合装置的透视图,其中示出了处于缩回位置的第一致动钮和处于伸出位置的第二致动钮;
图29是根据本发明一种非限制性实施方式的缝合装置的局部分解图;
图30是图29中的缝合装置的局部透视图,其中示出了在其已经被沿着缝合装置的第一侧向远侧推进后的致动钮;
图31是图29中的缝合装置的局部透视图,其中示出了正在第一位置和第二位置之间旋转的图30中的致动钮;
图32是图29中的缝合装置的局部透视图,其中示出了在其已经被沿着缝合装置的第二侧向远侧推进后的图30中的致动钮;
图33是图29中的缝合装置的推杆组件的分解图,该推杆组件配置为允许图30中的致动钮在其第一和第二位置之间旋转。
在全部视图中,相应的附图标记表示相应的部分。在此展示的范例以一种形式解释发明的优选实施方式,这样的范例不应解释为以任何方式限制本发明范围。
具体实施方式
现在将描述特定示例性实施方式,以提供对在此公开的装置和方法的结构原理、功能、制造和使用的全面理解。这些实施方式的一个或多个例子在附图中示出。本领域技术人员将理解在此特别描述并在附图中示出的装置和方法是非限制性的示例性实施方式,并且本发明各种实施方式的范围仅由权利要求限定。结合一种示例性实施方式示出或描述的特征可与其它实施方法的特征相结合。此类更改和变形也将包括在本发明的范围内。
参考图1和2,一种线性吻合缝合装置20,可包括细长的砧座支撑上部钳口部件22和细长的钉仓支撑下部钳口部件24。上部砧座支撑钳口部件22可由手柄26支撑,该钳口部件的前面部分从手柄26向前伸出。钉仓支撑下部钳口部件24可由手柄28支撑,该钳口部件的前面部分从手柄28向前伸出。如图3所示,上部手柄26和下部手柄28可适于形成把手以便于由外科医生抓握和操作缝合装置。为此目的,可以在每个手柄上提供增大的前凸起27和小的后凸起29。在各种实施方式中,手柄26和28可例如由塑料或其它轻质材料制成,而钳口部件22和24可例如由不锈钢或其它类似材料制成。
如附图5所示,上部钳口部件22可包括一体式的细长槽形框架,所述框架包括一对相对的细长侧壁30,两侧壁由顶壁31连接。上部手柄26可包括一对悬垂耳32,所述悬垂耳位于上部手柄内部且邻近其前端。上部钳口部件22可包括在沿其顶壁31的中间位置上形成的槽34(图4),悬垂耳32可通过该槽向下伸出。锁销36可以延伸穿过形成在上部钳口部件22的侧壁30中的圆形孔并穿过形成在悬垂耳32中的圆形孔,以枢转地将上部钳口部件连接到上部手柄26。
参考图5,可以在上部钳口部件22的前部提供一对细长的向内延伸的凸缘38,所述凸缘可以限定缝合装置的砧座40。凸缘38可以被沿砧座40的整个长度延伸的中心纵向槽42间隔开。在中心槽42的近端处,可以在凸缘38上提供向内倾斜的引导表面41。也可以在每个凸缘38上提供两个纵向排的均匀间隔开的钉成形凹窝44。参考图4和5,逐渐变细的砧座末端46可以装配在砧座支撑钳口部件22的前面,以便于将钳口部件插入例如中空的管状的身体器官内。砧座末端46可包括细长主体48(图4),其可以通过在砧座40上方由上部钳口部件的侧壁30和凸缘38限定的纵向通道插入。该细长主体48可在锁销36上方且在悬垂耳32之间延伸并且可包括位于悬垂耳32后面的增大的后部50,从而将砧座末端46保持就位在上部钳口部件22上。
参考图2和6,钉仓支撑下部钳口部件24可包括一体式细长槽形框架,所述框架包括一对相对的细长侧壁52,两侧壁由底壁53连接。沿着下部钳口部件24的后面部分,一对隔开的细长的直立侧凸缘54(图2)可从下部钳口部件的相对侧壁52向上延伸。如图5和6所示,下部钳口部件24在其侧凸缘54之间的宽度可大于上部钳口部件22在其侧壁30之间的宽度,以允许在为了操作而组装缝合装置时上部钳口部件的后部被容纳在下部钳口部件的侧凸缘54之间。如图2所示,下部钳口部件24的每个侧凸缘54可以包括与上部钳口部件22上的锁销36对齐的竖直槽口56。当组装上部钳口部件22和下部钳口部件24时,锁销36相对的两端可容纳在槽口56内。
如图2和6所示,下部钳口部件24可支撑适于容纳多个外科缝钉61(图17)的钉仓60,其中缝钉设置成至少两个横向隔开的纵向排。钉仓60可装配在下部钳口部件24的前部上且位于两个侧壁52之间。钉仓60可以被从钉仓近端向其远端延伸的中心细长槽62(图6)沿纵向分开。在各种实施方式中,多个形成在钉仓60内的钉孔64可设置为两对横向隔开的排,每对排被布置在中心纵向槽62的相对两侧上。多个外科缝钉61(图17)可装配在钉仓60的钉孔64内。如图6所示,相邻排中的钉孔64可以错开以便在操作装置时提供更有效的组织缝合。参考图15和16,钉仓60可包括一对纵向槽66,它们位于在细长中心槽62的相对两侧上,并在中心槽的每一侧上布置于钉孔64的错列排之间。每个纵向槽66可从钉仓60的近端向其远端延伸。
如图17所示,多个缝钉驱动器65可以可滑动地安装在钉孔64内,用以致动装载在钉仓60内的缝钉61。参考图6,每一缝钉驱动器65可设计为同时致动两个位于钉仓60内相邻排中的缝钉61。因此,在各种实施方式中,可提供第一组缝钉驱动器65以致动位于中心纵向槽62的一侧上的错列排内的缝钉61,并可提供第二组缝钉驱动器65以致动位于中心纵向槽62的另一侧上的一对相邻排内的缝钉61。
如图2和3所示,与前面类似,钉仓60的前端或远端可包括逐渐变细的末端68,以便于将下部钳口部件24插入到例如中空的管状的身体器官中。紧邻其末端68的后面,可在钉仓60上提供一对向后延伸的凸起70(一个在图14中示出),该对凸起可容纳在下部钳口部件24的侧壁52中提供的相应槽口中。在钉仓60的后部,一对悬垂臂72可从钉仓向下延伸。每个臂72可被开槽以提供侧孔74。当钉仓60被组装到下部钳口部件24上时,其凸起70可容纳到在侧壁52的前端提供的相应槽口中,并且其悬垂臂72向下延伸穿过形成在钳口部件24的底壁53中的孔76(图4)。下部钳口部件24可包括在孔76的相对两侧上从其侧壁52向下延伸的一对悬垂耳78(图18)。枢轴销80可延伸穿过形成在下部钳口部件24的悬垂耳78中的孔并穿过钉仓60上的悬垂臂72的侧孔74,以将钉仓固定到下部钳口部件上。
参考图2,缝合装置20可包括闭锁机构90,用于将上部钳口部件22和下部钳口部件24在沿钳口部件的中间位置闭锁在一起。在各种实施方式中,钳口部件22和24可在邻近砧座40和钉仓60的近端的位置上闭锁到一起。在至少一种实施方式中,闭锁机构90可包括通过枢轴销80(图4)枢转地连接到下部钳口部件24的闭锁臂92(图2)。闭锁臂92可配置为槽形并可包括一对相对的细长侧壁94(图6),这两个侧壁被隔开足够的距离以横跨下部钳口部件24的侧壁52。闭锁臂92的每个侧壁94可包括向上且向前延伸的钩形部件96,该钩形部件设有用于容纳锁销36的朝向前面的槽98。护罩100可安装在闭锁臂92的下表面上。当闭锁臂92被关闭时,如图3所示,护罩100可与下部手柄28的底部对齐以便于由外科医生抓握并操作缝合装置20。在各种实施方式中,护罩100可以例如由塑料或其它轻质材料制成,而闭锁臂92可以例如由不锈钢制成。如图7所示,护罩100可包括从其相对的两侧向外延伸的细长凸缘102和104,所述凸缘可用作指握部,以使得闭锁臂92能够向下枢转而从其闭锁位置到达其解锁位置。当闭锁臂92移动到其关闭或闭锁位置时,钩形部件96的槽98的表面可与锁销36协作,该锁销可以作为将闭锁臂92保持在其闭锁位置的偏心锁。
参考图6和10,缝合装置20的优选实施方式可包括改进的推杆和刀片组件110,所述推杆和刀片组件110可滑动地装配,以分别相对于上部钳口部件22和下部钳口部件24纵向移动,从而将缝钉61从钉仓60推入被夹紧在钳口部件之间的组织,抵靠砧座40使缝钉61成形,以及沿着形成在组织中的缝钉排之间的线切割组织。推杆和刀片组件110可包括推块112(图6),其可滑动地容纳在槽形的下部钳口部件24内且位于其直立的侧凸缘54之间。如图11所示,推块112可通过凸缘116连接到致动钮114上,所述凸缘116包括横向突出指118,该突出指在其顶表面上具有纵向延伸的槽口119。突出指118可以卡扣配合的方式卡入形成在推块122内的横向槽120,以将槽口119设置在纵向锁定杆121之下,从而将推块112和致动钮114固定在一起。致动钮114的凸缘116可延伸穿过形成在下部钳口部件24的一个侧凸缘54上的细长槽122(图2)并沿着该细长槽移动。
推杆和刀片组件110可包括一对从推块112向前突出的缝钉推杆124(图10),该缝钉推杆可滑动地容纳在钉仓60的细长槽66(图16)内。推块112可以具有一对竖直槽126(图11),推杆124固定在该对竖直槽内。如图10所示,每个缝钉推杆124的前端可以具有一楔形末端128,其限定了倾斜的凸轮表面130以便当推杆124被推进钉仓60时与缝钉驱动器65接合。如图20所示,每个缝钉驱动器65可具有斜面132,该斜面的倾斜角度与每一缝钉推杆124的凸轮表面130的倾斜角度相同以便在表面之间提供平的滑动接触。
参考图6和10,推杆和刀片组件110可包括刀块134,其可滑动地安装以便可沿着下部钳口部件124在其直立侧凸缘54之间纵向移动。刀块134可包括刀支撑杆136,其向前延伸进入钉仓60的中心纵向槽62中。具有斜切割刃140的倾斜刀片138可设置在刀支撑杆136的前端。刀片138的斜切割刃可相对于细长钳口部件22和24成一角度定向并可滑动地被容纳在钉仓60的中心纵向槽62内。
在各种实施方式中,刀块134可包括一对从其中延伸穿过的纵向槽135(图19),该对纵向槽可滑动地容纳缝钉推杆123以允许推块112相对于刀块滑动。相应地,当推块112被致动钮114朝向钉仓60推进时,缝钉推杆124可以滑动通过刀块134,而刀块134保持不动直到推块移动到与刀块接合。在刀块134被推块112接合后,刀块和推块可以同时朝钉仓60推进。如图17所示,刀片138可以与缝钉推杆124一起被推进通过钉仓60,使缝钉61在被夹紧在钳口部件之间的组织中成形并在缝钉排之间切割组织。之后,当缩回致动钮114时,推块112可开始使缝钉推杆124通过刀块134向后滑动,其中刀块134可保持不动。每个缝钉推杆124可包括偏置部分142,其可在缝钉推杆124被收回预定距离之后移动至与刀块134接合。由于缝钉推杆124的偏置部分142与刀块134接合,推块112和刀块134可同时被致动钮114缩回以使得推杆124和刀片138返回其初始位置。
根据本发明的各种实施方式,缝合装置20可以具有钳口夹紧部件,其用于对钳口部件施加夹紧力以便在缝钉61成形期间促使钉仓60和砧座40合在一起。钳口夹紧部件可包括用于促使钳口部件在一远离闭锁机构的位置分开,以便当缝钉61成形时抵抗施加在钉仓60和砧座40上的力。在至少一种实施方式中,可在其中一个钳口部件上安装凸轮部件,该凸轮部件可与另一个钳口部件接合,从而使所述钳口部件在远处位置分开以促使钉仓60和砧座40合在一起。在各种实施方式中,凸轮部件可枢转地安装在其中一个钳口部件上且位于远离闭锁机构的位置上。凸轮部件可从第一不可操作位置枢转到第二可操作位置,以便使钳口部件的远端分开。凸轮部件可以由推杆和刀片组件110的推块112操作,以在推块被推进时移动到其可操作位置并在推块被缩回时回到其不可操作位置。
在各种实施方式中,凸轮机构150,可设置成邻近下部钳口部件24的后端,如附图4所示。凸轮机构150可包括一个凸轮部件152,其枢转地安装在横向枢轴销154上,所述枢轴销154在下部钳口部件24的直立侧凸缘54之间延伸。凸轮部件152可包括:较低的第一凸轮表面156,其用于在凸轮152处于其第一不可操作位置(图12)时与上部钳口部件22的顶壁31接合;和较高的第二凸轮表面158,其用于在凸轮152处于其第二可操作位置(图13)与上部钳口部件22的顶壁31接合。第一凸轮表面156可布置为保持上部和下部钳口部件在凸轮152处于不可操作位置时基本平行。第二凸轮表面158可设置为当凸轮152从其不可操作位置枢转到其可操作位置时,把上部钳口部件22的后端抬高例如大约0.125英寸(3.2毫米)。另外,上部钳口部件22可具有足够挠性以便当凸轮部件152从其不可操作位置移动到其可操作位置时允许上部钳口部件22的后部向上弯曲离开下部钳口部件24。
如图4所示,凸轮部件152可包括径向延伸的槽口160,其将凸轮部件分成大前指162和小后指164。凸轮前指162可包括平的、朝后的表面165,而凸轮后指164可包括倾斜的、朝前的表面166。当凸轮152处于其不可操作位置时,凸轮前指162和凸轮后指164可向下延伸穿过形成在下部钳口部件24底壁53中的细长槽168。
在各种实施方式中,当推进推块时,凸轮部件152可由推块112操作而从其不可位置移动到其可操作位置。如图11所示,推块112可包括一对朝后延伸的臂170,所述臂170被隔开以在它们之间限定开口172。臂170的后端可由延伸横穿开口172的凸轮致动销174连接。参考图4和11,当凸轮部件152处于其不可操作位置时,凸轮前指162可延伸穿过推块112的臂170之间的开口172,同时凸轮致动销174可被容纳在凸轮部件的前指162和后指164之间的槽口160内。
如图12所示,当凸轮部件152处于其第一不可操作位置时,上部钳口部件22的顶壁31可抵靠在凸轮部件的第一凸轮表面156上。当凸轮部件152处于其不可操作位置时,上部钳口部件22的顶壁31可基本平行于下部钳口部件24的底壁53。另外,推块112可设置在其从刀块134向后隔开的初始位置上。当推进推块112时,如箭头182所指示(图13),凸轮致动销174可与凸轮前指162的后表面165接合以使凸轮部件152沿逆时针方向旋转,如箭头184所示,从而使凸轮部件枢转至其第二可操作位置并使其第二凸轮表面158与上部钳口部件22的顶壁31接合。随着凸轮部件152枢转至其可操作位置,上部钳口部件22的顶壁31可向上弯曲,如箭头186所示,离开下部钳口部件24的底壁53。凸轮部件可对上部钳口部件22和下部钳口部件24施加力,该力将钳口部件的后部弯曲而分开。将上部钳口部件22和下部钳口部件24的后部弯曲而分开所产生的结果是,可在上部钳口部件22和下部钳口部件24的前部施加附加的夹紧力以使砧座40和钉仓60夹紧在被夹在钳口部件之间的组织上。因此,砧座40和钉仓60可被合到一起以抵抗当推进推杆和刀片组件110以使缝钉61成形并切割组织时施加在砧座和钉仓上的力。
参考图13,当推块112在缝钉61成形后被缩回时,凸轮致动销174可与凸轮后指164的斜面166接合以使凸轮部件152沿顺时针方向枢转。当凸轮致动销174沿斜面166移动进入槽口160时,凸轮部件152可沿顺时针方向枢转并返回到其在第一凸轮表面与上部钳口部件22的顶壁31接合时的第一不可操作位置(图12)。因此,由凸轮152施加在上部钳口部件22和下部钳口部件24的后部的力可以解除,并且上部钳口部件22的顶壁31可返回到与下部钳口部件24的底壁53基本平行的关系。同样,施加到钳口部件22和24的前部的夹紧力可解除以松开砧座40和钉仓60。
在各种实施方式中,缝合装置20可包括间隔部件,其装配在其中一个钳口部件上用于保持缝合装置的钉仓60和砧座40之间的预定间隔。参考图4和6,该间隔部件可具体实施为邻近钉仓60的远端装配的间隔销190。间隔销190可从下部钳口部件24的底壁53竖直向上延伸通过钉仓60并从钉仓的顶部向上突出预定距离。如图5所示,砧座40的一个凸缘38可包括邻近其远端的凸缘部分192,该凸缘部分用于与间隔销190接合。当缝合装置被组装用于操作时(图4),间隔销190可与凸缘部分192接合以保持砧座40和钉仓60之间的预定间隔。
在操作缝合装置20的过程中,待缝合和切割的组织初始可被放置在钳口部件22和24之间,并被钳口部件夹住。因此,可以通过闭锁臂92向下枢转运动至其解锁位置(图2)而将手柄26和28解锁。因此,锁销36相对的两端可以从形成在闭锁臂92的钩形部件96内的槽98中脱离。此后,上部和下部钳口部件22和24可以通过将锁销36从形成在下部钳口部件的侧凸缘54中的槽56中脱离而分开。
接着,待缝合和切割的组织可被放置在钳口部件22和24上。例如,如图17所示,可将一段管状的肠组织滑动到每个钳口部件的前部上。组织被放置到钳口部件上之后,可重新组装缝合装置。可通过把锁销36与形成在下部钳口部件24的直立侧凸缘54中的竖直槽56对齐来完成重新组装。此后,下部钳口部件24的侧凸缘54可被放置到上部手柄26内部,横跨上部钳口部件22的侧壁30,而锁销36相对的两端可插入到竖直槽56中。最后,闭锁臂92可向上枢转至其在盖子100与下部手柄28齐平时的闭锁位置(图3)。因此,钩形部件96可以枢转越过锁销36,槽98可以容纳锁销相对的两端。因此,上部钳口部件22和下部钳口部件24可以在沿着它们本身邻近砧座40和钉仓60的中间位置闭锁到一起。另外,间隔销190可穿过身体组织与砧座40的凸缘部分192接合,以保持砧座40和钉仓60之间的预定间隔。
当组织被夹在钳口部件之间后,可以通过推进致动钮114来致动推杆和刀片组件110,从而击发缝合装置20。开始时,在凸轮机构150的致动中,可以推进推块112和推杆124(图4),而同时刀块134可保持不动。由于仅推进推块112及其推杆124来致动凸轮部件152,操作缝合装置20所需的初始的力可被最小化。
参考图12,在推杆112的初始推进过程中,推杆124可以滑动通过刀块134,并且推杆的楔形末端128可以开始推进通过钉仓60的槽66。随着推块112朝刀块134向前推进,其凸轮致动销174可以与凸轮前指162的后表面165接合以使凸轮部件152沿着逆时针方向枢转,如图13中的箭头184所示,从而使凸轮部件的第二凸轮表面158与上部钳口部件22的顶壁31接合。凸轮部件152可对上部钳口部件22和下部钳口部件24施加力,所述力使钳口部件的后部弯曲而分开。因此,上部钳口部件22的顶壁31的后端可相对于下部钳口部件24的底壁53的后端向上弯曲例如大约0.125英寸(3.2毫米)。钳口部件22和24的后端弯曲而分开可导致在钳口部件的前部产生附加的夹紧力以使砧座40和钉仓60夹紧在被夹在钳口部件之间的组织上。在切割组织并且抵靠砧座40使缝钉61成形时,该附加的夹紧力易于抵抗施加在砧座40和钉仓60上的力,从而保持砧座40和钉仓60之间期望的间隔以产生高度基本一致的成形缝钉61。
参考图13,致动凸轮机构150后,推块112可随后与刀块134接合以便使刀块134开始朝钉仓60纵向移动。在各种实施方式中,推块112和刀块134之间的初始间隔可布置为在凸轮部件152到达其可操作位置稍微之前使推块112与刀块134接合。可替代地,推块112和刀块134之间的初始间隔可布置为在凸轮部件152移动到其可操作位置之后推块112开始与刀块134接合。当推块112与刀块134接合时,可以开始沿砧座40和钉仓60各自的中心纵向槽42和62推进刀片138。此后,可同时推进缝钉推杆124和刀片138以缝合和切割被夹在砧座40和钉仓60之间的组织。
当推进推块112时,缝钉推杆124可沿设置在钉仓60中的槽66纵向移动。缝钉推杆124的两个楔形凸轮表面130可移动穿过槽66与缝钉驱动器65的倾斜表面接合,从而从钉仓60中连续地驱动缝钉61并抵靠砧座凸缘38使缝钉61成形为B形结构。凸轮表面130可设置在距离推块112相同的距离处以同时致动位于中心纵向槽62相对两侧的缝钉驱动器65。同时,可推进刀块134从而使刀片138移动通过砧座40的中心纵向槽42并通过钉仓60的中心纵向槽62,以切割被夹在钳口部件之间的组织。通过凸轮机构150施加到上部钳口部件22和下部钳口部件24的前部上的附加夹紧力能易于抵抗当钉61成形时施加在砧座40和钉仓60上的力。
当推块112完全被推进以使钉仓60中的所有缝钉成形后,通过缩回致动钮114,可朝其初始位置缩回推块。开始时,由于缝钉推杆124滑动通过保持静止的刀块134,仅有推块112可从钉仓60向后移动。当缝钉推杆124的偏置部分142与刀块134的前部接合时,可使刀块同推块112一起从钉仓60向后移动。结果,缝钉推杆124和刀片138可同时从钉仓60和砧座40缩回。
当推块112朝其初始位置返回时,凸轮致动销174可与凸轮后指164的倾斜表面166接合以使凸轮部件152沿顺时针方向朝其不可操作位置枢转。凸轮致动销174可沿倾斜表面166移动进入凸轮指162和164之间的槽160,而将凸轮部件152返回至其不可操作位置。结果,凸轮部件152的第二凸轮表面158可脱离上部钳口部件22的顶壁,而上部钳口部件22的顶壁31的后端可以向下移动与第一凸轮表面156接合。同时,凸轮前指162可向下枢转进入推块112上的指170之间的开口172,并且凸轮指162和164都可以向下枢转进入形成在下部钳口部件24的底壁53中的槽168内。此后,在凸轮部件152处于其不可操作位置时,可以如图2所示向下枢转闭锁臂92,从而允许上部钳口部件22和下部钳口部件24拆开。到这种时刻,被切割和缝合的组织可以从钳口部件上被移除。
如上面所述,外科缝合装置可包括致动钮,例如诸如致动钮114(图1)之类,其可以被构造为在外科缝合装置的钉仓内推进诸如推杆组件110(图10)之类的推杆组件。在各种实施方式中,致动钮114可构造为由外科医生抓握,这样外科医生可以向其施加力。在各种情况下,当向远侧推进致动钮114时,致动钮可以接触或邻接外科手术位置周围的组织。在至少一种情况下,外科医生也许因此不得不重新放置缝合装置,从而使致动钮114能从组织旁边经过。在其他情况下,外科医生可能不得不使致动钮114强行从组织旁边经过。无论这样或那样,这样的情况也许是不适当的,因此需要一种具有致动钮的缝合装置,该致动钮可被操纵以减小致动钮碰撞周围组织的可能性。
在本发明的各种实施方式中,参考图21,缝合装置220可包括从上部手柄226延伸出的砧座支撑钳口部件222、从下部手柄228延伸出的钉仓支撑钳口部件224,以及能够可操作地与推杆组件接合的致动钮214a和214b,所述推杆组件例如为诸如图24所示的推杆组件210之类。在各种实施方式中,钉仓可例如被可拆卸地连接到钉仓支撑钳口部件224上,从而当钉仓已经被用尽后,其可以被其它钉仓所取代。在至少一种实施方式中,推杆组件210可包括与其整体形成的或可操作地装配在其上的缝钉驱动器,该缝钉驱动器可以如上所述地移动通过钉仓。在至少一种其它的实施方式中,钉仓可包括包含在其中的缝钉驱动器,该驱动器可与推杆组件接合并被该推杆组件向远侧推动。在任何情况下,第一致动钮214a例如可以在可操作地从推杆组件210脱离的第一位置(图21)和可操作地与推杆组件210接合的第二位置(图22)之间旋转。类似地,第二致动钮214b可构造为在分别可操作地与推杆组件210脱离和接合的第一和第二位置之间旋转。
在各种实施方式中,作为上述的结果,缝合装置的致动钮可选择性地与推杆组件接合,从而如果当推进致动钮时致动钮可能接触或邻接外科手术位置周围的组织,则致动钮可保持在其缩回位置,而另一个致动钮可被伸出以向远侧推进推杆组件。在至少一种这样的实施方式中,参考图22,第一致动钮214a可旋转到其第二位置,从而它可以可操作地与推杆组件210接合,同时第二致动钮214b仍然保持在其缩回位置。此后,参考图23,为了推动推杆组件210,可以沿着外科缝合装置220的第一侧201相对于上部手柄226和下部手柄228向远侧推进第一致动钮214a。在至少一种实施方式中,第一致动钮214a可在上部手柄26和下部手柄228之间或其中所限定的第一槽227内滑动。在各种其它情况下,参考图28,第一致动钮214a可保持在其缩回位置,而第二致动钮214b可旋转到其伸出位置。与上述类似,可以沿缝合装置220的第二侧203向远侧推进第二致动钮214b,从而例如在第二槽229内推进推杆组件210。在至少一种实施方式中,两个致动钮214都可被伸出以向远侧推进推杆组件210。在各种替代的实施方式中,虽然没有示出,缝合装置可包括两个以上的致动钮,所述致动钮可选择性地用于推动推杆和/或刀片组件。实际上,作为上述的结果,外科缝合装置的致动钮可相互独立地与推杆组件接合。
在各种实施方式中,进一步地,缝合装置的致动钮可位于第一位置,在该第一位置上它们可被保持就位并保持与推杆组件脱离操作性接合。在至少一种实施方式中,参考图24,缝合装置220可进一步包括引导部件209,其可构造为当使它们在它们的第一位置和第二位置之间旋转时引导致动钮214。在各种实施方式中,参考图24-26,引导部件209可包括导轨211,其能够可滑动地容纳在致动钮214的凹槽213内,这样,当旋转致动钮214时,引导部件209可决定致动钮214移动的路径。此外,导轨211和凹槽213可包括互锁特征,所述特征可协作地防止致动钮214被无意中向例如近侧和/或远侧移动。在至少一种这样的实施方式中,当推杆组件210如上所述被向远侧推进时,引导部件209可以防止一个或更多致动钮214与推杆组件210一起移动。在各种实施方式中,可以在导轨211和凹槽213之间存在轻微的摩擦或干涉配合,从而可以降低致动钮214可能被无意中旋转到其伸出位置的可能性。虽然没有示出,致动钮可包括从其延伸出的导轨,该导轨可以可滑动地容纳在例如引导部件的凹槽中。在任何情况下,参考图25,引导部件209可以包括一个或更多保持部件215,这些保持部件可构造为保持引导部件209在上部手柄226和下部手柄228之间的中间位置上。此外,参考图24和25,引导部件209可包括孔217,其可构造为容纳延伸穿过其中的保持销219,其中保持销219可构造为与上部手柄226和/或下部手柄228接合,以将引导部件209保持就位。
在各种实施方式中,当致动钮214如上所述在第一和第二位置之间旋转时,凹槽213可旋转至脱离导轨211,并且致动钮214可以可操作地与推杆组件210接合。在至少一种实施方式中,主要参考图24,推杆组件210可包括第一离合特征件,例如为诸如槽或凹槽205之类,而致动钮214的每一个可以包括第二离合特征件,例如为诸如凸起207之类,其中第一和第二离合特征件能够可操作地彼此接合以便使一个或多个致动钮214与推杆组件210接合。在至少一种这样的实施方式中,凸起207可紧密地容纳在槽205内,这样,当对一个或多个致动钮214施加力时,力可以通过凸起207和槽205的侧壁被传递给推杆组件210。在至少一种实施方式中,与上述类似,在凸起207和槽205之间可以存在轻微的摩擦或干涉配合,以将致动钮214保持在它们的伸出位置上。在任何情况下,尽管没有示出,第一离合特征件可包括从推杆组件上延伸出的凸起,这些凸起可构造为容纳在致动钮内的凹槽或槽里。作为上述的附加或替代,参见图24,推杆组件210可进一步包括第二导轨221,其可构造为可滑动地容纳在致动钮214内的槽或凹槽223内,其中导轨221和凹槽223可构造为引导致动钮214进入它们的第二位置和/或一旦它们处于第二位置时将力从致动钮214传递给推杆组件210。类似于导轨211,导轨221可构造为与凹槽223形成轻微摩擦或干涉配合,以便将致动钮214保持就位。更进一步地,在不同实施方式中,推杆组件210可包括柱225,致动钮214能绕该柱转动。在至少一种实施方式中,致动钮214可包括凹槽227,该凹槽的轮廓使得凹槽227的侧壁可以紧密地容纳柱225并绕该柱滑动,因此,柱225例如可在其第一位置和第二位置之间旋转时引导致动钮214。
在本发明的各种实施方式中,缝合装置可包括致动钮,该致动钮可构造为选择性地沿着缝合装置的第一侧和缝合装置的第二侧推进。在至少一种实施方式中,参考29和30,缝合装置320可包括上部手柄326、下部手柄328和致动钮314,其中与上面类似,致动钮314可构造为推进钉仓内的推杆组件。在至少一种实施方式中,上部手柄326和下部手柄328可在其之间限定第一槽327和第二槽329,其中槽327和329都可构造为允许致动钮314滑动通过它们。更具体地,在各种实施方式中,致动钮314可构造使其能够选择性地沿第一侧301滑动通过第一槽327,或者,可替代的,沿第二侧303滑动通过第二槽329。在各种实施方式中,参考图31,缝合装置320可进一步包含第三槽331,其可构造为允许致动钮314从缝合装置的一侧移动到另一侧。在至少一种这样的实施方式中,外科医生因此可以选择性地放置致动钮314,这样,如果当致动钮314在缝合装置的一侧上向远侧推进的时候看上去致动钮314可能碰撞组织,那么致动钮314可在被推进之前被旋转翻到缝合装置的另一侧。虽然缝合装置的第一和第二侧位于外科设备320相对的两侧上,但可以想到其它实施方式,其中,比如,第一和第二槽位于相邻的两侧上和/或不是正对的两侧上。此外,可以想到其它实施方式中,其中,缝合装置的各侧不容易辨别,比如具有圆形和/或弯曲部分的装置。
在各种实施方式中,主要参考图29,第一槽327可构造为使其限定致动钮314的路径,该路径平行于或至少基本平行于由第二槽329所限定的路径。在至少一种实施方式中,第三槽331可构造为连接第一槽327和第二槽329,从而该第三槽可限定与由槽327和329所限定的路径垂直或至少基本垂直的致动钮的路径。在这样的实施方式中,致动钮314可被旋转翻过外科装置的顶部,从而将致动钮314从第一侧301移动到第二侧303。如果外科医生决定将致动钮重新放置在第一侧301上,外科医生可向后移动致动钮314通过槽311直到它被再次放置在第一槽327内。在各种替代的实施方式中,虽然没有示出,第三槽可限定与由槽327和329限定的路径平行或至少基本平行,和/或共面或基本共面的致动钮的路径。在其它的各种实施方式中,第三槽可限定相对于槽327和329所限定的路径倾斜的路径。在任何情况下,第三槽可构造为连接第一和第二槽,从而致动钮可以在该第三槽内滑动。
如上所述,缝合装置320可包括推杆组件,其能够可操作地与例如致动钮314接合,从而致动钮314可构造为向远侧推进推杆组件。在各种实施方式中,参考图33,缝合装置320可包括推杆组件310,该推杆组件310可包括例如可操作地与刀片组件接合的第一部分333,此外还包括能够可旋转地装配在第一部分333上的第二部分335。在至少一种实施方式中,第一部分333可限定轴线337,第二部分335可绕该轴线旋转。在至少一种这种实施方式中,第二部分335可包括限定在其中的孔339,所述孔可构造为紧密地容纳第一部分333。在至少一种实施方式中,虽然没有示出,推杆组件310可进一步包括一个或更多的保持部件,例如为诸如紧定螺钉之类,这些保持部件构造为延伸进入例如位于第一部分333中的凹槽中,以便将第二部分335保持在第一部分333上。在各种实施方式中,第二部分335可包括从其中延伸出的固定件341,该固定件可构造为将致动钮314保持在第二部分335上。为了如上面所述使致动钮从缝合装置320的第一侧移动到另一侧,致动钮314和第二部分335可相对于第一部分333旋转,从而致动钮314可选择性地放置在第一槽327和第二槽329内。在至少一种实施方式中,虽然没有示出,缝合装置可具有两个以上的槽,这些槽用于当致动钮在钉仓内推进时容纳致动钮。在任何情况下,在各种替代的实施方式中,第一部分333和第二部分335可固定地装配在一起,从而它们可以一起绕轴线337旋转。在至少一种这样的实施方式中,第一部分333可构造为相对于推杆组件310的基本不可旋转的部分旋转。
在此披露的装置可被设计为一次性使用,或者它们可被设计为多次使用。但是,无论在哪一种情况下,可以修复装置以便在经过至少一次使用后再次使用。修复可包括拆卸装置、清洗或更换特定部件以及随后重新组装的步骤的任何组合。特别地,装置可重新组装,并且任意数量的特定零部件可以任何组合方式选择性地被替换或被移除。经过清洗和/或更换特定部件,装置可以在修复设备中,或者在临近手术之前由手术团队重新组装用于后续的使用。本领域技术人员将认识到装置的修复可使用各种技术来进行拆卸、清洗/更换和重新组装。这样的技术的使用,和产生的修复装置全部落入本申请的范围内。
优选地,在此描述的本发明可在手术之前进行处理。首先,获得新的或用过的装置,如有必要进行清洗。装置接着要进行消毒。在一种消毒技术中,装置被放置在关闭的且密封的容器中,例如塑料或高密度聚乙烯合成纸包。接着把容器和装置放在能够穿透容器的辐射场,例如伽马射线、X射线或高能电子。辐射杀死了装置上和容器内的细菌。随后消毒过的装置可储存在无菌容器中。密封容器保持装置无菌直到它在医学设备中打开。
虽然本发明已描述为具有示例性的设计,本发明可以在公开的精神和范围内进行进一步修改。本申请因此旨在覆盖任何利用本发明的总原理对本发明进行的变形、使用或修改。此外,本申请旨在覆盖背离本发明公开内容的这样的偏离,其落入本发明所述的技术领域中公知的或惯用的手段范围内。
Claims (8)
1.一种外科缝合装置,包括:
具有第一侧和第二侧的壳体;
构造为可操作地支撑钉仓的第一钳口部件,所述钉仓中储存有至少两排缝钉,其中所述第一钳口部件和钉仓中的至少一个构造为可滑动地支撑缝钉驱动器,所述缝钉驱动器构造为从所述钉仓施放缝钉;
构造为可操作地支撑砧座的第二钳口部件,所述砧座构造为当缝钉从所述钉仓中被施放时使缝钉变形;
构造为使所述缝钉驱动器相对于所述第一钳口部件和所述第二钳口部件移动的推杆;和
构造为接受施加在其上的力的致动钮,其中,所述致动钮可旋转地装配于所述推杆上,所述致动钮构造为在第一位置和第二位置之间旋转,所述致动钮构造为当所述致动钮处于所述第一位置时沿所述第一侧移动,并且所述致动钮构造为当所述致动钮处于所述第二位置时沿所述第二侧移动;
其中,所述壳体进一步包括:
限定在所述第一侧内的第一槽,其中,所述致动钮构造为当所述致动钮处于所述第一位置时所述致动钮在所述第一槽内滑动;和
限定在所述第二侧内的第二槽,其中,所述致动钮构造为当所述致动钮处于所述第二位置时所述致动钮在所述第二槽内滑动;
其中,所述壳体进一步包括连接所述第一槽和所述第二槽的第三槽,并且所述致动钮构造为在所述第三槽内滑动以选择性地使所述致动钮在所述第一位置和所述第二位置之间移动。
2.根据权利要求1所述的外科缝合装置,其中,所述第三槽基本上与所述第一槽和所述第二槽共面。
3.根据权利要求1所述的外科缝合装置,其中,所述第三槽垂直于并横穿所述第一槽和所述第二槽。
4.根据权利要求1所述的外科缝合装置,其中,所述第一槽基本平行于所述第二槽。
5.根据权利要求1所述的外科缝合装置,其中,所述推杆限定延长的轴线,并且所述致动钮可绕所述轴线旋转。
6.根据权利要求1所述的外科缝合装置,其中,所述第一侧基本平行于所述第二侧。
7.根据权利要求1所述的外科缝合装置,进一步包括:
所述砧座;
所述钉仓;
所述缝钉驱动器;和
可操作地与所述缝钉驱动器接合的切割部件。
8.一种处理外科装置的方法,包括:
获得权利要求1所述的外科缝合装置;
对所述外科缝合装置进行消毒;和
将所述外科缝合装置储存在灭菌容器中。
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CN101543417A (zh) | 2009-09-30 |
RU2009104917A (ru) | 2010-08-20 |
EP2090234A2 (en) | 2009-08-19 |
BRPI0900471A2 (pt) | 2009-09-29 |
BRPI0900471B1 (pt) | 2019-06-18 |
US20090200355A1 (en) | 2009-08-13 |
RU2497465C2 (ru) | 2013-11-10 |
BRPI0900471B8 (pt) | 2021-06-22 |
EP2090234A3 (en) | 2009-09-16 |
US20110011914A1 (en) | 2011-01-20 |
HK1135882A1 (en) | 2010-06-18 |
JP5490420B2 (ja) | 2014-05-14 |
US8540129B2 (en) | 2013-09-24 |
US7766209B2 (en) | 2010-08-03 |
JP2009189816A (ja) | 2009-08-27 |
EP2090234B1 (en) | 2013-09-11 |
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