CN101626731A - 手术缝合装置 - Google Patents
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A61B17/072—Surgical 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
- A61B17/07207—Surgical 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical 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
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- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical 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
- A61B2017/07214—Stapler heads
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical 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
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
Abstract
提供了一种手术缝合装置,该手术缝合装置包括:限定了组织接触表面的钉仓组件;限定了组织接触表面的砧座组件;和手术支撑件,其通过至少一个锚定件可松开地固定在钉仓组件的组织接触表面和砧座组件的组织接触表面中的至少一个上。提供了一种装载单元,该装载单元包括:手术支撑件,其通过至少一个锚定件可松开地固定在砧座组件和/或固定在砧座组件上的缝合钉钉仓上;和驱动组件,其包括刀片,其中,该驱动组件从近侧位置向远侧位置的运动导致刀片切割至少一个锚定件并从所述砧座组件和/或钉仓组件中释放各个手术支撑件。
Description
相关申请的引用
[0001]本申请为国际(PCT)申请,其要求于2007年3月6日提交的序列号为60/905,566的美国临时申请的权益和优先权,该临时申请的全部内容在此引入作为参考。
技术领域
[0002]本公开涉及一种手术装置,例如,一种手术缝合装置。更具体而言,本公开涉及一种手术缝合装置,所述手术缝合装置包括可拆卸的手术支撑件和/或内窥镜手术缝合装置,所述内窥镜手术缝合装置包括用于装载单元(例如,单次使用的装载单元)的可拆卸的手术支撑件。为了简便起见,在下文中,SULU或DLU将称为“DLU”,但是其应当理解为包括DLU和SULU两者之一或者两者均包括。
背景技术
[0003]在本领域中公知这样的手术装置:在所述手术装置中,组织首先被抓紧或夹紧在相对的钳口结构之间,然后通过手术紧固件连接。在一些器械中,设置刀来切割已通过手术紧固件连接的组织。该紧固件通常呈手术缝合钉的形式,但也可采用可分式聚合紧固件。
[0004]为此,器械可以包括两个细长的钳口构件,所述两个钳口构件分别用于俘获或夹紧组织。通常情况下,其中一个钳口构件携带缝合钉钉仓,该缝合钉钉仓容纳排列成至少两横排的多个缝合钉,而另一个钳口构件具有砧座,当缝合钉被排出缝合钉钉仓时,该砧座限定了用于形成缝合钉腿的表面。一般情况下,随着凸轮构件作用于缝合钉推动器以从缝合钉钉仓顺次弹射出缝合钉,通过沿缝合钉钉仓纵向行进的凸轮构件来实现缝合操作。刀可以在缝合钉排之间行进来纵向地切割和/或打开缝合钉排之间的缝合组织。例如,这样的器械公开在第3,079,606号美国专利和第3,490,675号美国专利中。
[0005]在第3,499,591号美国专利中公开的一种新近的缝合器同样也在切口的每一侧上都施加两排缝合钉。该专利公开了一种手术缝合器,该手术缝合器具有一次性装载单元,在该装载单元中,凸轮构件运动通过两组交错的缝合钉运送槽之间的细长导轨。缝合钉驱动构件位于所述运送槽中,并且以便于通过纵向运动的凸轮构件接触的方式设置以实现从一次性装载单元的缝合钉钉仓中弹射出缝合钉。这种缝合器的其它实例公开在第4,429,695和5,065,929号美国专利中。
[0006]上述每一种器械都设计用在其中外科医生直接用手进入手术部位的常规手术程序中。但是,在内窥镜或者腹腔镜程序中,手术通过皮肤上的小切口或者通过插入到皮肤上的小进入伤口中的狭窄套管来进行。为了满足内窥镜和/或腹腔镜手术程序的特殊需求,已经开发了内窥镜手术缝合装置,并公开在,例如,以下专利中:第5,040,715号美国专利(格林(Green)等人)、第5,307,976号美国专利(奥尔森(Olson)等人)、第5,312,023号美国专利(格林等人)、第5,318,221号美国专利(格林等人)、第5,326,013号美国专利(格林等人)、第5,332,142号美国专利(罗宾逊(Robinson)等人)和第6,241,139号美国专利(米利曼(Milliman)等人),上述各个专利的全部内容均在此引入作为参考。
[0007]Tyco医疗健康集团(Tyco Healthcare Group,LP),本申请的受让人,已经制造并销售内窥镜缝合器械(例如,Multifire ENDO GIATM.30和Multifire ENDO GIATM.60器械)许多年了。这些器械包括手术缝合装置和DLU。通常情况下,在进行手术之前立即将所述DLU连接到手术缝合装置上。在使用后,将DLU从手术缝合装置中去除,然后可以将新的DLU紧固在该手术缝合装置上以进行另外的缝合和/或切割操作。这些器械已经提供了重大的临床益处。但是,仍然可以对这些器械进行改进。
[0008]希望提供一种手术支撑件,该手术支撑件选择性地连接至所述手术缝合装置的钉仓半部和砧座半部的组织接触表面中的至少一个。
[0009]还希望提供一种用于在所述手术缝合装置的发射过程中从钉仓半部的组织接触表面和/或砧座半部的组织接触表面上去除手术支撑件的系统。
[0010]因此,本公开的目的是满足上述要求。
发明内容
[0011]根据本公开,提供了一种手术缝合装置,该手术缝合装置包括:壳体、由所述壳体支撑的手柄、从所述壳体向远侧延伸并具有适于可松开地接合装载单元的远端和可支撑在所述壳体的远端上的装载单元。所述装载单元包括:工具组件,其具有钉仓组件和砧座组件:所述钉仓组件被配置为且适应于将具有多个手术紧固件的缝合钉钉仓可松开地支撑在其中;所述砧座组件相对于所述钉仓组件可动地固定,其中,所述砧座组件被配置为且适于支撑砧板,并且其中,砧板和缝合钉钉仓中的每一个均限定了细长的纵向狭槽。所述装载单元进一步包括手术支撑件,该手术支撑件可松开地固定在砧板和缝合钉钉仓中的至少一个的组织接触表面上,其中,各个手术支撑件通过至少一个锚定件固定在砧座组件和钉仓组件中的至少一个上。所述装载单元还进一步包括可滑动地支撑在工具组件中的驱动组件,该驱动组件包括可滑动地布置在各个细长的纵向狭槽中的刀片,其中,该驱动组件从近侧位置向远侧位置的运动导致其刀片切割至少一个锚定件并从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件。
[0012]所述砧座组件可以包括将手术支撑件固定到砧座组件上的近侧缝合线和/或将手术支撑件固定到砧座组件上的远侧锚定件。所述钉仓组件可以包括将手术支撑件固定到钉仓组件上的近侧缝合线和/或将手术支撑件固定到钉仓组件上的远侧锚定件。所述砧座组件和钉仓组件的各个锚定件可以横跨砧板和缝合钉钉仓的相应的纵向狭槽延伸。
[0013]所述砧座组件可以包括可滑动或者可旋转地支撑在其中并且限定了刀口的刀片。在砧座组件的刀片致动时,该刀片可以切割砧座组件的近侧锚定件和远侧锚定件中的至少一个。所述砧座组件的刀片可以具有第一位置和第二位置:在第一位置处,所述刀片大体上位于砧座组件的远侧锚定件的近侧;在第二位置处,所述刀片大体上位于砧座组件的远侧锚定件的远侧,由此切割砧座组件的远侧锚定件。当驱动组件向远侧致动时,驱动组件可以使砧座组件的刀片从第一位置运动至第二位置。
[0014]钉仓组件可以包括可滑动或者可旋转地支撑在其中并且限定了刀口的刀片,其中,在钉仓组件的刀片致动时,该刀片切割钉仓组件的近侧锚定件和远额锚定件中的至少一个。所述钉仓组件的刀片可以具有第一位置和第二位置:在第一位置处,所述刀片大体上位于钉仓组件的远侧锚定件的近侧;在第二位置处,所述刀片大体上位于钉仓组件的远侧锚定件的远侧,由此切割钉仓组件的远侧锚定件。当驱动组件向远侧致动时,驱动组件可以使钉仓组件的刀片从第一位置运动至第二位置。
[0015]根据本公开的另一方案,提供了一种用于手术缝合装置的装载单元。所述装载单元包括:工具组件,其具有钉仓组件和砧座组件:所述钉仓组件被配置为且适于将具有多个手术紧固件的缝合钉钉仓可松开地支撑在其中;所述砧座组件相对于所述钉仓组件可动地固定,其中,所述砧座组件被配置为且适于支撑砧板,并且其中,砧板和缝合钉钉仓中的每一个均限定了细长的纵向狭槽。所述装载单元还包括手术支撑件,该手术支撑件可松开地固定在砧板和缝合钉钉仓中的至少一个的组织接触表面上,其中,各个手术支撑件通过至少一个锚定件固定在砧座组件和钉仓组件中的至少一个上。所述装载单元进一步包括可滑动地支撑在工具组件中的驱动组件,该驱动组件包括可滑动地布置在各个细长的纵向狭槽中的刀片,其中,该驱动组件从近侧位置向远侧位置的运动导致其刀片切割至少一个锚定件并从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件。
[0016]根据本公开的又一个方案,提供了一种选择性地用于手术缝合装置的装载单元。所述装载单元包括:工具组件,其具有钉仓组件和砧座组件:所述钉仓组件被配置为且适于将具有多个手术紧固件的缝合钉钉仓可松开地支撑在其中;所述砧座组件相对于所述钉仓组件可动地固定,其中,所述砧座组件被配置为且适于支撑砧板,并且其中,砧板和缝合钉钉仓中的每一个均限定了细长的纵向狭槽。所述装载单元进一步包括:手术支撑件,其可松开地固定在砧板和缝合钉钉仓中的每一个的组织接触表面上;和锚定件,其将手术支撑件固定在砧板和缝合钉钉仓中的每一个上,其中,锚定件位于砧板组件和钉仓组件中的每一个的近端和远端的附近。所述装载单元还包括操作地布置在砧座组件中的刀片,其中,所述砧座组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片位于砧座组件的远侧锚定件的近侧;在第二位置处,所述刀片位于砧座组件的远侧锚定件的远侧,由此切割砧座组件的远侧锚定件。所述装载单元还进一步包括操作地布置在钉仓组件中的刀片,其中,所述钉仓组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片位于钉仓组件的远侧锚定件的近侧;在第二位置处,所述刀片位于钉仓组件的远侧锚定件的远侧,由此切割钉仓组件的远侧锚定件。所述装载单元还包括可滑动地支撑在工具组件中的驱动组件,该驱动组件包括可滑动地布置在各个细长的纵向狭槽中的刀片,其中,该驱动组件从近侧位置向远侧位置的运动导致其刀片切割砧座组件和钉仓组件中的每一个的近侧锚定件并从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件的近端,并且其中,该驱动组件从近侧位置向远侧位置的运动使砧座组件的刀片和钉仓组件的刀片从它们相应的第一位置运动至它们相应的第二位置,由此切割砧座组件和钉仓组件的相应的远侧锚定件并从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件的远端。
[0017]根据本公开的另一个方案,提供了一种手术缝合装置。该手术缝合装置包括:限定了组织接触表面的钉仓组件;限定了组织接触表面的砧座组件;和手术支撑件,其通过至少一个锚定件可松开地固定在砧座组件的组织接触表面和钉仓组件的组织接触表面中的至少一个上。
[0018]锚定件可以位于各个手术支撑件的近端和远端中的至少一个的附近。各个锚定件可以横向于钉仓组件和砧座组件中的相应一个的纵轴延伸。
[0019]所述锚定件可以选自缝合线(suture)、线(thread)、系绳(tether)、带(strap)、条(band)、绳(line)、金属丝(wire)、缆索(cable)、大头钉(tack)、绞钉(anchor)和紧固件中。
[0020]至少一个近侧锚定件可以横跨在钉仓组件和砧座组件中的每一个中形成的相应的纵向刀槽延伸和/或至少一个远侧锚定件可以横跨在钉仓组件和砧座组件中的每一个中形成的相应的纵向刀槽延伸。
[0021]在所述手术缝合装置发射时,锚定件可以释放相应的手术支撑件。在所述手术缝合装置发射时,各个锚定件可以被切断以释放手术支撑件。
[0022]所述手术缝合装置可以包括刀片,该刀片被配置并定尺寸为可滑动地往复运动通过在钉仓组件和砧座组件中的每一个中形成的相应的纵向刀槽,其中当刀片向远侧推进时,刀片切断锚定件。
[0023]所述手术缝合装置可以进一步包括驱动组件,该驱动组件被可滑动地支撑以沿钉仓组件和砧座组件轴向运动,其中,驱动组件从近侧位置向远侧位置的运动导致手术支撑件从钉仓组件和砧座组件中的相应一个中分离。
[0024]锚定件可以位于在各个手术支撑件的近端和远端中的至少一个的附近。所述驱动组件可以直接切割各个锚定件或者可以使各个锚定件被切割以从相应的钉仓组件和砧座组件中释放手术支撑件。
[0025]通过结合附图的下列描述,另外的优点将变得明显。
附图说明
[0026]将参考附图进一步描述本发明,其中,在多个视图中类似的附图标记表示类似的部件,并且其中:
[0027]图1是根据本公开的一个实施方式的手术缝合装置的立体图;
[0028]图2是图1的手术缝合装置的DLU的远端的顶部分解立体图;
[0029]图3是在组装情况下显示的图2的DLU的顶部立体图;
[0030]图4是图2的DLU的远端的顶部立体图;
[0031]图5是图2和4的DLU的远端的另一个顶部立体图,具有从其中去除的顶部前盖;
[0032]图6是图2~5的DLU的近端的顶部立体图;
[0033]图7是图2~6的DLU的远端的侧面正视图;
[0034]图8是图2~7的DLU的远端的顶部平面图;
[0035]图9是图2~8的DLU的砧座半部的远端的底部立体图,图示了与其相关的刀组件;
[0036]图10是图9的砧座半部的近端的底部立体图,图示了与其相关的刀组件;
[0037]图11是图2的DLU的钉仓半部的远端的顶部立体图;
[0038]图12是图2和11的DLU的钉仓半部的远端的侧面正视图;
[0039]图13是图2、11和12的DLU的钉仓半部的远端的底部立体图;
[0040]图14是图2和11~13的DLU的钉仓半部的远端的另一个底部立体图;
[0041]图15是图13的细节表示区域的放大立体图;
[0042]图16是图2和11~15的DLU的钉仓半部的远端的底部放大立体图;
[0043]图17是图2和11~16的DLU的钉仓半部的远端的底部平面图;
[0044]图18是图2和11~17的DLU的钉仓半部的远端的纵向截面图;
[0045]图19是图2和11~18的DLU的钉仓半部的远端的底部立体图;
[0046]图20是根据本公开的另一个实施方式的图1的手术缝合装置的DLU的远端的分解立体图;
[0047]图21是图20的DLU的远端的立体图;
[0048]图22是图20和21的DLU的砧座半部的远端的顶部立体图;
[0049]图23是图22的砧座半部的远端的底部立体图,具有从其中去除的砧板;
[0050]图24是图20和21的DLU的砧座半部的近端的顶部立体图;
[0051]图25是图24的砧座半部的近端的底部立体图;
[0052]图26是图20和21的DLU的钉仓半部的顶部立体图;
[0053]图27是图26的钉仓半部的远端的顶部立体图;
[0054]图28是图27的钉仓半部的远端的顶部立体图,具有从其中去除的刀片停止嵌件;
[0055]图29是图28的钉仓半部的远端的侧面正视图;
[0056]图30是图26和27的钉仓半部的刀片停止嵌件的顶部立体图;
[0057]图31是图26和27的钉仓半部的刀片停止嵌件的底部立体图;
[0058]图32是图26和27的钉仓半部的远端的立体图,具有从其中去除的远侧前盖(nose cap);
[0059]图33是根据本公开的另一个实施方式的手术缝合装置的DLU的钉仓组件的远端的立体图;
[0060]图34是根据本公开的另一个实施方式的手术缝合装置的DLU的砧座组件的远端的立体图;
[0061]图35是图34的砧座组件的远端的顶部平面图,图示了其处于第一位置的刀片;
[0062]图36是图34和35的砧座组件的远端的顶部平面图,图示了其处于第二位置的刀片;
[0063]图37是根据本公开的另一个实施方式的手术缝合装置的DLU的钉仓组件的远端的立体图;
[0064]图38是图37的钉仓组件的远端的顶部平面图,图示了其处于第一位置的刀片;
[0065]图39是图37和38的钉仓组件的远端的顶部平面图,图示了其处于第二位置的刀片;
[0066]图40是根据本公开的又一个实施方式的手术缝合装置的DLU的砧座组件的远端的立体图;
[0067]图41是图40的砧座组件的远端的顶部平面图,图示了其处于第一位置的刀片;
[0068]图42是图40和41的砧座组件的远端的顶部平面图,图示了其处于第二位置的刀片;
[0069]图43是根据本公开的又一个实施方式的手术缝合装置的DLU的钉仓组件的远端的立体图;
[0070]图44是图43的钉仓组件的远端的顶部平面图,图示了其处于第一位置的刀片;
[0071]图45是图43和44的钉仓组件的远端的顶部平面图,图示了其处于第二位置的刀片;
[0072]图46是根据本公开的再一个实施方式的手术缝合装置的DLU的砧座组件的远端的示意性立体图;
[0073]图47是根据本公开的另一个实施方式的图1的手术缝合装置的DLU的分解立体图;
[0074]图48是图47的DLU的侧面正视图;
[0075]图49是图47和48的DLU的分解立体图;
[0076]图50是图47~49的DLU的致动滑块(actuation sled)的放大立体图;
[0077]图51是在闭合情况下显示的图47~49的DLU的放大立体图;
[0078]图52是图47的细节表示区域的放大立体图;
[0079]图53是沿图47的53-53截取的DLU的纵向截面正视图;
[0080]图54是图53的细节表示区域的放大立体图;
[0081]图55是图53的细节表示区域的放大立体图;
[0082]图56是图47~49的DLU的钉仓组件的立体图;
[0083]图57是图56的钉仓组件的远端的放大立体图;
[0084]图58是图56的细节表示区域的放大立体图;
[0085]图59是图58的细节表示区域的放大立体图;
[0086]图60是图56的钉仓组件的远端的部件分离的立体图;
[0087]图61是图56的钉仓组件的刀片组件的底部立体图;
[0088]图62是图56的钉仓组件的刀片组件的顶部立体图;
[0089]图63是图47~49的DLU的砧座半部的近端的底部立体图;
[0090]图64是图63的砧座组件的部件分离的立体图;
[0091]图65是图63和64的砧座组件的底部立体图;
[0092]图66是图65的砧座组件的底部立体图,带有从其中去除的支撑件;
[0093]图67是图65的砧座组件的底部立体图,带有从其中去除的支撑件和砧板;
[0094]图68是沿图47的53-53截取的DLU的纵向截面正视图,图示了其驱动组件的最初致动;
[0095]图69是图68的细节表示区域的放大图;
[0096]图70是沿图47的53-53截取的DLU的纵向截面正视图,图示了其驱动组件的最终致动;
[0097]图71是图70的细节表示区域的放大图;
[0098]图72是图70和71的DLU在致动后的放大远侧立体图;
[0099]图73是接合刀片组件的致动滑块的示意性立体图;
[00100]图74是接合刀片组件的致动滑块的顶部平面图;和
[00101]图75是在驱动组件的致动完成后的钉仓组件的远端的放大立体图。
具体实施方式
[00102]现在将参考附图详细描述本公开的手术缝合装置和DLU的实施方式,其中,在多个视图中的每一个视图中,相似的附图标记表示相同或相应的元件。
[00103]在附图中和在下面的描述中,依照惯例,术语“近侧”指的是缝合装置的最靠近用户的一端,而术语“远侧”指的是装置的距离用户最远的一端。
[00104]图1显示了一个手术装置,例如手术缝合装置,一般称作10。为简便起见,本公开将主要集中在用于将一次性装载单元(“DLU”)16装载、接合或结合至手术缝合装置10的系统、方法和结构。对于手术缝合装置10的剩余部件和使用方法的详细讨论公开在第6,241,139号美国专利中。
[00105]手术缝合装置10是一种内窥镜装置并且包括手柄组件12和从手柄组件12延伸的细长体14。将DLU 16可松开地固定在细长体14的远端。虽然本公开涉及DLU和手术缝合装置10的一起使用,但是应当理解,在本公开的范围内,单独使用的装载单元(SULU)或其它末端执行器和/或工具组件可以同样和手术缝合装置10协同使用。
[00106]DLU 16包括:工具组件17,其具有容纳多个手术紧固件或缝合钉84(见图2)的钉仓组件18;和砧座组件20,其相对于钉仓组件18可动地固定。如本文所述,DLU 16被配置为施加六直排缝合钉,DLU的长度为约30mm至约60mm。也可以想象到用于施加任何排数的缝合钉的具有以多种图案布置的缝合钉袋的DLU和/或具有任何其它长度(例如45mm)的DLU和末端执行器。手柄组件12包括固定手柄构件22、可运动手柄构件24和筒形部26。
[00107]可旋转构件28安装在筒形部26的前端上以便于细长体14的旋转并相对于手柄组件12连接DLU 16。在筒形部26的前端上还邻近可旋转构件28安装了铰接杠杆30以便于工具组件17的铰接。优选地,沿筒形部26可动地设置一对把手32。将把手32向远侧推进以接近或闭合钉仓组件18和/或砧座组件20,而向近侧收回把手32以远离或打开钉仓组件18和/或砧座组件20。
[00108]DLU 16理想地为可选择性去除地结合至细长体14。DLU 16包括壳体部36,壳体部36具有适于可松开地接合细长体14的远端的近端。安装组件38在“P”处枢转地固定在壳体部36的远端上,并被配置为容纳工具组件17的近端,以使得工具组件17围绕“P”处的轴的枢转运动(垂直于框架部分36的纵轴)实现工具组件17的铰接。
[00109]一般性地参考图2~8,DLU 16包括安装组件40。安装组件40包括上安装部40a和下安装部40b。中心定位的枢轴构件42从上安装部40a和下安装部40b中的每一个中伸出。
[00110]轴驱动组件50与钉仓组件18和/或砧座组件20操作地相关并可滑动地布置在钉仓组件18和砧座组件20之间。参考图2,轴驱动组件50包括具有远端54和近端56的细长驱动梁52。驱动梁52可以由单片或者优选地多片层叠材料构成。
[00111]驱动组件50的驱动梁52的近端56包括一对弹性接合指部(engagement finger),该对接合指部被定尺寸并配置为在DLU 16的近端与手术缝合装置10的细长体14接合时安装地接合驱动构件,例如驱动杆或控制杆(未显示)。控制杆用于从手柄组件12向驱动组件50传递轴向运动。
[00112]驱动组件50的驱动梁52的远端54被配置为且适于支撑I形梁60。I形梁60包括中心壁部62以及上轨部64a和下轨部64b。中心壁部62的远边限定了刀片等66。
[00113]如图2~10所示,砧座组件20包括具有多个缝合钉变形袋/腔70a(见图9和10)的砧板70和固定在砧板70的顶表面上的盖板72,其中,在砧板70和盖板72之间限定了一个腔(未显示)。在砧板70和盖板72之间限定的腔被定尺寸为将I形梁60的上轨部64a可滑动地容纳在其中。纵向狭槽70b贯穿砧板70以便于I形梁60的中心壁部62的通过。
[00114]在操作中,砧板70的上表面限定了凸轮表面70c,随着驱动组件50推进I形梁60通过纵向狭槽70b,I形梁60的上轨部64a接合凸轮表面70c以紧靠组织用凸轮带动、推动并夹紧砧座组件20。
[00115]继续参照图2~10,砧板70限定了一对近侧凹槽70d,该对近侧凹槽70d靠近砧板70的近端形成并且其每一个凹槽分别布置在纵向狭槽70b的两侧上。砧板70限定了一对远侧凹槽70e,该对远侧凹槽70e靠近砧板70的远端形成并且其每一个凹槽分别布置在纵向狭槽70b的两侧上。在一个实施方式中,一对近侧凹槽70d和一对远侧凹槽70e中的每一对的至少一个凹槽为非圆形的,优选为收缩的,以便摩擦地接合和/或夹紧锚定件“S”。
[00116]本文所使用的术语锚定件应理解为包括并且不限于缝合线、线、系绳、带、条、绳、金属丝、缆索、紧固件、大头钉、锚定件或适于本文所公开的预期目的的任何其它材料。
[00117]砧座组件20还包括刀片74,刀片74限定了远侧定位的刀口74a并且操作地插入在砧板70和盖板72之间所限定的腔中。刀片74具有初始或第一状态和最终或第二状态:在初始或第一状态下,刀片74位于一对远侧凹槽70e的近侧;在最终或第二状态下,刀片74位于一对远侧凹槽70e的远侧。刀片74包括形成在其表面中的接合元件74b,例如凹槽,接合元件74b用于选择性地接合从砧座组件20的盖板72或者远侧盖76的表面突出的附加接合元件,例如凸节(nub)(未显示)。所述接合元件彼此接合以使刀片74保持固定并处于初始或第一状态。
[00118]在一个实施方式中,远侧盖76包括形成在其相对侧边缘中的一对相对的凹槽76a,当盖板72与砧板70组装在一起时,凹槽76a与形成在砧板70中的一对远侧凹槽70e对齐。另外,盖板72限定了形成在其中的一对相对的凹槽72a,当盖板72与砧板70组装在一起时,凹槽72a与形成在砧板70中的一对近侧凹槽70d对齐。
[00119]砧板组件20还包括手术支撑件“B”、小拭子等,手术支撑件“B”、小拭子等通过锚定件“S”操作地固定在砧板70的下表面上,以覆盖至少部分砧座袋70a和/或纵向狭槽70b的长度的至少一部分。特别地,一个锚定件“S”穿过砧座支撑件“B”的远侧部以及一对远侧凹槽70e中的每一个凹槽,而一个锚定件“S”穿过砧座支撑件“B”的近侧部以及一对近侧凹槽70d中的每一个凹槽。
[00120]在一个特殊的实施方式中,锚定件“S”的第一端包括尺寸不能通过一对近侧凹槽70d中的一个凹槽的结、止挡等(未显示),而锚定件“S”的第二端穿过并且横穿砧座支撑件“B”至少一次,并且返回来穿过一对近侧凹槽70d的另一个凹槽。例如,可以将锚定件“S”的第二端夹紧(pinch)或束紧(cinch)在一对近侧凹槽70d中的另一个凹槽中,以便锚定锚定件“S”的第二端并紧靠砧板70的下表面固定砧座支撑件“B”。类似地,锚定件“S”用于横跨砧座支撑件“B”延伸并与一对远侧凹槽70e接合。
[00121]在操作中,如将在下面更详细地讨论的,当紧靠砧板70的下表面固定砧座支撑件“B”时,在手术缝合装置10的发射过程中,随着驱动组件50推进(也即是说,从最近侧位置向最远侧位置运动),刀片66切穿近侧锚定件“S”的中心部,由此从砧座组件20中释放砧座支撑件“B”的近端。随着驱动组件50接近砧板70的远端,I形梁60的上轨64a紧靠刀片74并向远侧推动刀片74。随着刀片74向远侧运动,从初始或第一状态移到最终或第二状态:在初始或第一状态下,刀片74位于一对远侧凹槽70e的近侧;在最终或第二状态下,刀片74位于一对远侧凹槽70e的远侧,刀片74的刀口74a切穿或割穿远侧锚定件“S”,由此从砧座组件20中释放砧座支撑件“B”的远端。刀片74切穿贯穿一对远侧凹槽70e的两个凹槽的远侧锚定件“S ”。
[00122]如图2~8和11~19所示,钉仓组件18包括限定了细长支撑通道80a的支架(carrier)80。支架80的细长支撑通道80a被定尺寸并配置为选择性地将缝合钉钉仓82容纳在其中。沿缝合钉钉仓82和支架80形成的相应凸起(tab)和狭槽用于将缝合钉钉仓82保持在支架80中。形成在缝合钉钉仓82上并从其伸出的一对支杆设置为倚靠在支架80的侧壁上以进一步将缝合钉钉仓82固定在支架80的支撑通道80a中。缝合钉钉仓82包括形成在其中用于容纳多个紧固件84和推动器86的保持狭槽82a。多个间隔开的纵向狭槽82b贯穿缝合钉钉仓82以容纳致动滑块90的直立凸轮楔90a。致动滑块90包括中心直立楔或壁90b。中心壁90b限定了形成在其中的远侧槽口(notch)或肩部(shoulder)90c。
[00123]中心纵向狭槽82c在缝合钉钉仓82中形成并沿缝合钉钉仓82的长度延伸以便于I形梁60的中心壁部62的通过。在手术缝合器10的操作中,致动滑块90平移通过缝合钉钉仓82的纵向狭槽82b以推进凸轮楔90a与推动器92顺次接触,以使推动器92在保持狭槽82a中垂直平移并推动紧固件84(例如,缝合钉)从狭槽82a进入砧座组件20的砧板70的缝合钉形成腔70a中。
[00124]继续参照图2和11~19,缝合钉钉仓82限定了一对近侧凹槽82e,该对近侧凹槽82e靠近缝合钉钉仓82的近端形成并且其每一个凹槽分别布置在纵向狭槽82c的两侧上。缝合钉钉仓82进一步限定了一对远侧凹槽82f,该对远侧凹槽82f靠近缝合钉钉仓的远端形成并且其每一个凹槽分别布置在纵向狭槽82c的两侧上。在一个实施方式中,一对近侧凹槽82e和一对远侧凹槽82f中的每一对的至少一个凹槽为非圆形的,优选为收缩的,以便摩擦地接合和/或夹紧锚定件“S”。
[00125]钉仓组件18还包括刀片94,刀片94限定了远侧定位的刀口94a(见图12~17和19)并操作地布置在限定在缝合钉钉仓82的远端附近的腔82d(见图16、17和19)。刀片94可以包括右侧和左侧刀口94a。刀片94具有初始或第一状态和最终或第二状态:在初始或第一状态下,刀片94位于在缝合钉钉仓82中形成的一对远侧凹槽82e的近侧;在最终或第二状态下,刀片94位于一对远侧凹槽82e的远侧。
[00126]刀片94可以包括形成在其表面中的接合元件(未显示),所述接合元件用于选择性地接合从钉仓组件18的缝合钉钉仓82的表面突出的附加接合元件(未显示)。所述接合元件彼此接合以使刀片94保持固定并处于初始或第一状态。
[00127]钉仓组件18还包括手术支撑件“B”、小拭子等,手术支撑件“B”、小拭子等通过锚定件“S”操作地固定在缝合钉钉仓82的上表面上,以覆盖至少部分缝合钉袋82a和/或纵向狭槽82c的长度的至少一部分。特别地,一个锚定件“S”穿过钉仓支撑件“B”的远侧部以及一对远侧凹槽82f中的每一个凹槽,而一个锚定件“S”穿过钉仓支撑件“B”的近侧部以及一对近侧凹槽82e中的每一个凹槽。
[00128]在一个特殊的实施方式中,锚定件“S”的第一端包括尺寸不能通过一对近侧凹槽82e中的一个凹槽的结、挡块等(未显示),而各个锚定件“S”的第二端穿过并且横穿钉仓支撑件“B”至少一次,并且返回来穿过一对近侧凹槽82e中的另一个凹槽。例如,可以将各个锚定件“S”的第二端夹紧(pinch)或束紧(cinch)在一对近侧凹槽82e中的另一个凹槽中,以便锚定锚定件“S”的第二端并紧靠缝合钉钉仓82的组织接触表面固定钉仓支撑件“B”。类似地,锚定件“S”用于横跨钉仓支撑件“B”延伸并与一对远侧凹槽82f接合。
[00129]在操作中,如将在下面更详细地讨论的,当紧靠缝合钉钉仓82的组织接触表面固定钉仓支撑件“B”时,在手术缝合装置10的发射过程中,随着驱动组件50推进(也即是说,从最近侧位置向最远侧位置运动),刀片66切穿近侧锚定件“S”的中心部,由此从钉仓组件18中释放钉仓支撑件“B”的近端。如图18所示,随着驱动组件50接近缝合钉钉仓82的远端,致动滑块90的中心直立楔或壁90b的肩部90c紧靠刀片94并向远侧推动刀片94。随着刀片94向远侧运动,从初始或第一状态移到最终或第二状态:在初始或第一状态下,刀片94位于一对远侧凹槽82f的近侧;在最终或第二状态下,刀片94位于一对远侧凹槽82f的远侧,刀片94的刀口94a切穿或割穿远侧锚定件“S”,由此从钉仓组件18中释放钉仓支撑件“B”的远端。刀片94切穿贯穿一对远侧凹槽82f的两个凹槽的远侧锚定件“S”。
[00130]随着驱动组件50从最近侧位置向最远侧位置推进,其刀片66纵向切穿或割穿砧座支撑件“B”和钉仓支撑件“B”,由此将支撑件“B”基本上对半分开。另外,随着驱动组件50从最近侧位置向最远侧位置推进,致动滑块90的直立凸轮楔90a致动推动器92,以使推动器92在保持狭槽82a中垂直平移并从狭槽82a中推动紧固件84。随着从缝合钉钉仓82的狭槽82a中推动紧固件84(例如缝合钉),紧固件84的支腿穿过并通过砧座支撑件“B”和钉仓支撑件“B”,通过插入砧座支撑件“B”和钉仓支撑件“B”之间的任何组织(未显示),并且紧靠砧座组件20的砧板70的缝合钉形成腔70a或者在砧座组件20的砧板70的缝合钉形成腔70a中形成。
[00131]根据本公开,砧座支撑件“B”和/或钉仓支撑件被分别预装(也即,由制造商装载)在DLU 17的砧座组件20或钉仓组件18上。根据需要或期望,砧座组件20和/或钉仓组件18的另外的或替换的支撑件“B”可以被固定在砧座组件20或钉仓组件18上。
[00132]在操作中,当将DLU 17结合至手术缝合装置10的细长体14的远端并将砧座支撑件“B”和钉仓支撑件“B”分别预装在砧座组件20和钉仓组件18上时,根据本领域技术人员公知的方法使用手术缝合装置10。一旦将砧座组件20和钉仓组件18夹紧在组织上,就发射手术缝合装置10。在发射手术缝合装置10的过程中,将驱动组件50从最近侧位置向最远侧位置推进。在这种情况下,驱动组件50的刀片66基本上同时切穿或割穿砧座组件20和钉仓组件18的近侧锚定件“S”的中心部,由此分别从砧座组件20和钉仓组件18释放砧座支撑件“B”和钉仓支撑件“B ”的近端。
[00133]随着驱动组件50接近最远侧位置,I形梁60的上轨64a紧靠刀片74并向远侧推动刀片74,而基本上同时或与之相伴随地,致动滑块90的中心直立楔或壁90b的肩部90c紧靠刀片94并向远侧推动刀片94。随着刀片74向远侧运动,从初始位置移至最终位置,其刀口74a切穿或割穿砧座组件20的远侧锚定件“S”,由此从砧座组件20中释放砧座支撑件“B”的远端。随着刀片94向远侧运动,从初始位置移至最终位置,其刀口94a切穿或割穿钉仓组件18的远侧锚定件“S”,由此从钉仓组件18中释放钉仓支撑件“B”的远端。
[00134]同样,驱动组件50的刀片66基本上同时纵向切穿或割穿砧座支撑件“B”和钉仓支撑件“B”,由此将支撑件“B”基本上对半分开。
[00135]现在转至图20~32,根据本公开的另一个实施方式的用于手术缝合装置10的DLU一般由116指代。DLU 116与DLU 16基本上相类似,并且在此将仅详细讨论在构造和操作上需要区分的差异。
[00136]如图20~25所示,DLU 116的砧座组件20限定了一对近侧凹槽70d和一对远侧凹槽70e,一对近侧凹槽70d靠近砧板70的近端形成并且其每一个凹槽分别布置在纵向狭槽70b的两侧上;一对远侧凹槽70e靠近砧板70的远端形成并且其每一个凹槽分别布置在纵向狭槽70b的两侧上。从图22、24和25中可以更清楚地看出,一对近侧凹槽70d和一对远侧凹槽70e中的每一对的至少一个凹槽呈收缩配置的槽口形式以将缝合线、线等摩擦地夹紧、容纳和固定在其中。
[00137]如图23所示,刀片74包括定位构件74c,定位构件74c呈翼片或凸起的形式,从刀片74的下面伸出并被配置为且适于在砧板70的纵向狭槽70b中可滑动的接合。定位构件74c用于帮助保持刀片74的适当的或者期望的位置。例如,刀片74的定位构件74c可以帮助将刀口74a保持在相对于纵向狭槽70b基本上正交的位置上。
[00138]如图20、21和26~32所示,DLU 116的钉仓组件18的缝合钉钉仓82限定了一对近侧凹槽82e和一对远侧凹槽82f,一对近侧凹槽82e靠近缝合钉钉仓82的近端形成并且分别布置在纵向狭槽82c的两侧上;一对远侧凹槽82f靠近缝合钉钉仓82的远端形成并且分别布置在纵向狭槽82c的两侧上。
[00139]在一个实施方式中,如图20和26所示,可以预想到的是,缝合钉钉仓82可以包括从其上表面伸出的至少一个柱并且覆盖缝合钉钉仓82的手术支撑件“B”可以包括形成在其中的相应的附加孔。这样,当将手术支撑件“B”放在缝合钉钉仓82上时,手术支撑件“B”的一个或多个孔和缝合钉钉仓82的一个或多个柱相互合作以将手术支撑件“B”基本上定位在缝合钉钉仓82上并使手术支撑件“B”与缝合钉钉仓基本上对齐。
[00140]缝合钉钉仓82限定了形成在其中的远侧凹槽82g,远侧凹槽82g用于将刀片嵌件83选择性地容纳在其中。如图20、21和26~32所示,缝合钉钉仓82的远侧凹槽82g限定了与其组织接触表面基本上平行的平面并且包括与纵向狭槽82c基本上对齐的伸长部。
[00141]如图31所示,刀片嵌件83包括呈凸节等形式的突出部83a,突出部83a用于与形成在钉仓组件18(见图2)的刀片74中的附加容纳结构74a(见图20)的搭锁式接合(snap-fit engaging)。虽然显示了具有突出部83a的刀片嵌件83,但是可以想象到的是,刀片嵌件83可以包括形成在其中的凹槽或凹陷,该凹槽或凹陷被配置为且适于与从刀片74伸出的附加突出部的搭锁式接合。
[00142]如图32所示,刀片嵌件83用于将刀片74保持在第一状态(也即是说,位于缝合钉钉仓82的一对远侧凹槽82f的近侧),直至由驱动组件50致动为止。
[00143]现在转至图33,依照本公开的另一个实施方式的钉仓组件18的远端一般由118指代。钉仓组件118与钉仓组件18基本上相类似,并且在此将仅详细讨论在构造和操作中需要区分的差异。
[00144]从图22、24和25中可以更清楚地看出,一对近侧凹槽70d和一对远侧凹槽70e中的每一对的至少一个凹槽呈收缩配置的槽口形式以将缝合线、线等摩擦地夹紧、容纳和固定在其中。如图33所示,钉仓组件18包括刀片194,刀片194操作地固定在支架80或缝合钉钉仓82的远端中。如果将刀片194支撑在缝合钉钉仓82中,则在更换缝合钉钉仓82时更换刀片194。
[00145]刀片194包括臂194a,臂194a具有靠近支架80或缝合钉钉仓82的远端固定的远端,和大体上朝向手术缝合装置10的手柄组件12延伸的近端。刀片194包括刀口194b,刀口194b在基本上平行于缝合钉钉仓82的纵向狭槽82c的方向上从臂194a的近端延伸。刀片194的刀口194b基本上对齐在缝合钉钉仓82的一对远侧凹槽82f之间,以使得刀口194b与在缝合钉钉仓82的一对远侧凹槽82f之间延伸的锚定件“S”并列对齐。刀片194的臂194a具有初始状态,其中,刀口194b与在缝合钉钉仓82的一对远侧凹槽82f之间延伸的锚定件“S”间隔开。
[00146]在操作中,随着驱动组件50向远侧推进,致动滑块90(例如,中心直立楔90b)与刀片194的臂194a的近端接合,由此朝向在缝合钉钉仓82的一对远侧凹槽82f之间延伸的锚定件“S”偏置且用凸轮带动刀片194的臂194a的近端,使得刀片194的刀口194b切穿或割穿锚定件“S”以从缝合钉钉仓82中释放手术支撑件“B”。
[00147]由于由臂194a产生的回到未偏置或初始状态的弹力,刀口194b缩回缝合钉钉仓82中。可选择地,如图33所示,可以将呈压缩弹簧等形式的偏置构件195插入到支架80和致动滑块90之间或者与支架80和致动滑块90操作地相关。这样,当完成发射行程时,致动滑块90压缩偏置构件195,而在去除完成发射行程所需的力时,偏置构件195在近侧方向上延伸并由此推动致动滑块90,从而使得刀口194b缩回缝合钉钉仓82中。
[00148]用于本文公开的手术缝合装置的示例性手术支撑件“B”显示并描述在共同转让的第5,542,594、5,908,427、5,964,774和6,045,560号美国专利以及于2006年4月20日提交的序列号为2006/0085034和于2006年6月22日提交的序列号为2006/0135992的共同转让的美国申请中,这些文件中的每一个的全部内容都在此引入作为参考。
[00149]通过这些附图特别是图2、9~11、13、14、20和26可以看出,每一个手术支撑件“B”可以设置有形成在其中的一对近侧和/或一对远侧的间隔开的孔,其中,手术支撑件“B”的近侧和/或远侧孔与砧板和/或缝合钉钉仓的相应近侧和/或远侧凹槽对齐和/或与砧板和/或缝合钉钉仓的相应近侧和/或远侧凹槽成并列关系。手术支撑件“B”的孔使得手术支撑件“B”更有效和更容易地通过锚定件“S ”连接到砧板和/或缝合钉钉仓上。
[00150]现在转至图34~36,根据本公开的另一个实施方式的用于手术缝合装置的DLU的砧座组件一般由220指代。砧座组件220与砧座组件20基本上相类似,并且在此将仅详细讨论在构造和操作上需要区分的差异。
[00151]如图34~36所示,砧座组件220包括枢转地固定到砧座组件220上特别是靠近砧座组件220的远端枢转地固定的刀片274。刀片274设置为便于围绕支点转动以随着驱动组件50(见图2)推进到砧座组件220的最远侧位置而切断锚定件“S”。
[00152]特别地,继续参考图34~36,砧座组件220包括形成在远侧盖276中、盖板272中和/或砧板270中的支点276b,支点276b用于枢转地接合或支撑刀片274。刀片274包括凸角(lobe)274a,凸角274a限定了枢轴窗口(pivot window)274b,枢轴窗口274b被配置并定尺寸成枢转地接合支点276b。支点276b和枢轴窗口274b限定了枢轴“Y”,枢轴“Y”与砧板270的纵向狭槽270b的纵轴“X”间隔一定距离。
[00153]刀片274限定了横跨砧板270的纵向狭槽270b延伸的凸轮缘274c,以及横向于凸轮缘274c延伸的刀口274d。刀片274被配置并定尺寸成使得凸轮缘274c的一部分和/或刀口274d的一部分横跨锚定件“S”延伸。
[00154]如图34和35所示,刀片274具有第一位置,在第一位置处,刀口274d没有横跨凹槽270e延伸并且没有与锚定件“S”接合。特别是,当处于第一位置时,刀片274的刀口274d包括向凹槽270e的近侧延伸的部分和向凹槽270e的远侧延伸的部分。另外,当处于第一位置处,刀片274的刀口274d布置在凹槽270e之间。同样,当处于第一位置时,刀片274的凸轮缘274c包括向凹槽270e的近侧延伸的至少一部分。
[00155]如图36所示,刀片274具有第二位置,在第二位置处,刀口274d横跨凹槽270e延伸并且与锚定件“S”接合。特别是,当处于第二位置时,刀片274的刀口274d包括超过凹槽270e延伸或布置的部分。
[00156]在操作中,在手术缝合装置10的发射过程中,随着驱动组件50(见图2)推进(也即,从最近侧位置向最远侧位置运动),驱动组件50使刀片274切穿锚定件“S”,由此释放砧座支撑件(见图2)的远端。特别是,如图35所示,当刀片274处于第一位置时,随着驱动组件50向远侧推进,如箭头“A”所示,驱动组件50接触或接合刀片274的凸轮缘274c。随着驱动组件50进一步向远侧推进,如箭头“B”所示,驱动组件50产生围绕支点276b的力矩,使得刀片274围绕支点276b旋转。在这种情况下,如图36所示,刀片274的刀口274d推进或者旋转通过锚定件“S”,由此切断锚定件“S”并释放砧座支撑件(见图2)的远端。
[00157]现在转至图37~39,根据本公开的另一个实施方式的用于手术缝合装置的DLU的钉仓组件一般由218指代。钉仓组件218与钉仓组件18基本上相类似,并且因此在此将仅详细讨论在其构造和操作上需要区分的差异。
[00158]如图37~39所示,钉仓组件218包括枢转地固定到钉仓组件218上特别是靠近钉仓组件218的远端枢转地固定的刀片294。刀片294设置为便于随着驱动组件50(见图2)推进至钉仓组件218中的最远侧位置而围绕支点旋转以切断锚定件“S”。
[00159]特别地,继续参考图37~39,钉仓组件218包括形成在刀片嵌件283和/或缝合钉钉仓282中的支点283a,支点283a用于枢转地接合或支撑刀片294。刀片294包括凸角294a,凸角294a限定了枢轴窗口294b,枢轴窗口294b被配置并定尺寸成枢转地接合支点283a。支点283a和枢轴窗口294b限定了枢轴“Y”,枢轴“Y”与缝合钉钉仓282的纵向狭槽282c的纵轴“X”间隔一定距离。
[00160]刀片294限定了横跨缝合钉钉仓282的纵向狭槽282c延伸的后缘或凸轮缘294c,以及平行于凸轮缘294c延伸的刀口294d。刀片294被配置并定尺寸为使得凸轮缘294c和刀口294d位于锚定件“S”的近侧。
[00161]如图37和38所示,刀片294具有第一位置,在第一位置处,刀口274d没有横跨凹槽282f延伸并且没有与锚定件“S”接合。特别是,当处于第一位置时,刀片294的刀口294d位于凹槽282f的近侧。
[00162]如图39所示,刀片294具有第二位置,在第二位置处,刀口274d横跨凹槽282f延伸并且与锚定件“S”接合。特别是,当处于第二位置时,刀片294的刀口274d包括超过凹槽282f延伸或布置的部分。
[00163]在操作中,在手术缝合装置10的发射过程中,随着驱动组件50(见图2)推进(也即,从最近侧位置向最远侧位置运动),驱动组件50使刀片294切穿锚定件“S”,由此释放钉仓支撑件“B”的远端。特别是,如图38所示,当刀片294处于第一位置时,随着驱动组件50向远侧推进,如箭头“A”所示,驱动组件50接触或接合刀片294的凸轮缘294c。随着驱动组件50进一步向远侧推进,如箭头“B”所示,驱动组件50产生围绕支点283a的力矩,使得刀片294围绕支点283a旋转。在这种情况下,如图39所示,刀片294的刀口294d推进或者旋转通过锚定件“S”,由此切断锚定件“S”并释放钉仓支撑件“B”的远端。
[00164]现在转至图40~42,根据本公开的又一个实施方式的用于手术缝合装置的DLU的砧座组件一般由320指代。砧座组件320与砧座组件220基本上相类似,并且因此在此将仅详细讨论在其构造和操作上需要区分的差异。
[00165]如图40~42所示,砧座组件320包括枢转地固定到砧座组件320上特别是靠近砧座组件320的远端枢转地固定的刀片374。刀片374设置为便于随着驱动组件50(见图2)推进至砧座组件320中的最远侧位置而围绕支点旋转以切断锚定件“S”。
[00166]特别地,继续参考图40~42,砧座组件320包括形成在远侧盖376中、盖板370(未显示)中和/或砧板370中的支点376b,支点376b用于枢转地接合或支撑刀片374。刀片374包括凸角374a,凸角374a限定了枢轴窗口374b,枢轴窗口374b被配置并定尺寸成枢转地接合支点376b。支点376b和枢轴窗口374b限定了枢轴“Y”,枢轴“Y”与砧板370的纵向狭槽370b的纵轴“X”间隔一定距离。
[00167]刀片374限定了横跨砧板370的纵向狭槽370b延伸的凸轮缘374c,以及横向于凸轮缘374c延伸的刀口374d。刀片374被配置并定尺寸为使得凸轮缘374c布置在锚定件“S”的近侧并且刀口374d的一部分横跨锚定件“S”延伸。
[00168]如图40和41所示,刀片374具有第一位置,在第一位置处,刀口374d没有横跨凹槽370e延伸并且没有与锚定件“S”接合。特别是,当处于第一位置时,刀片374的刀口374d包括向凹槽370e的近侧延伸的部分。同样,当处于第一位置时,刀片374的凸轮缘374c被布置在或者位于凹槽370e的近侧。
[00169]如图42所示,刀片374具有第二位置,在第二位置处,刀口374d横跨凹槽370e延伸并且与锚定件“S”接合。特别是,当处于第二位置时,刀片374的刀口374d包括超过凹槽370e延伸或布置的部分。
[00170]在操作中,在手术缝合装置10的发射过程中,随着驱动组件50(见图2)推进(也即,从最近侧位置向最远侧位置运动),驱动组件50使刀片374切穿锚定件“S”,由此释放砧座支撑件(见图2)的远端。特别是,如图41所示,当刀片374处于第一位置时,随着驱动组件50向远侧推进,如箭头“A”所示,驱动组件50接触或接合刀片374的凸轮缘374c。随着驱动组件50进一步向远侧推进,如箭头“B”所示,驱动组件50产生围绕支点376b的力矩,使得刀片374围绕支点376b旋转。在这种情况下,如图42所示,刀片374的刀口374d推进或者旋转通过锚定件“S”,由此切断锚定件“S”并释放砧座支撑件(见图2)的远端。
[00171]现在转至图43~45,根据本公开的另一个实施方式的用于手术缝合装置的DLU的钉仓组件一般由318指代。钉仓组件318与钉仓组件218基本上相类似,并且因此在此将仅详细讨论在其构造和操作上需要区分的差异。
[00172]如图43~45所示,钉仓组件318包括枢转地固定到钉仓组件318上特别是靠近钉仓组件318的远端枢转地固定的刀片394。刀片394设置为便于随着驱动组件50(见图2)推进至钉仓组件318中的最远侧位置而围绕支点旋转以切断锚定件“S”。
[00173]特别地,继续参考图43~45,钉仓组件318包括形成在刀片嵌件383和/或缝合钉钉仓382中的支点383a,支点383a用于枢转地接合或支撑刀片394。刀片394包括凸角394a,凸角394a限定了枢轴窗口394b,枢轴窗口394b被配置且定尺寸成枢转地接合支点383a。支点383a和枢轴窗口394b限定了枢轴“Y”,枢轴“Y”与缝合钉钉仓382的纵向狭槽382c的纵轴“X”间隔一定距离。
[00174]刀片394限定了横跨缝合钉钉仓382的纵向狭槽382c延伸的后缘或凸轮缘394c,以及平行于凸轮缘394c延伸的刀口394d。刀片394被配置并定尺寸为使得凸轮缘394c和刀口394d位于锚定件“S”的近侧。
[00175]如图43和44所示,刀片394具有第一位置,在第一位置处,刀口394d没有横跨凹槽382f延伸并且没有与锚定件“S”接合。特别是,当处于第一位置时,刀片394的刀口394d位于凹槽382f的近侧。
[00176]如图45所示,刀片394具有第二位置,在第二位置处,刀口374d横跨凹槽382f延伸并且与锚定件“S”接合。特别是,当处于第二位置时,刀片394的刀口394d包括超过凹槽382f延伸或布置的部分。
[00177]在操作中,在手术缝合装置10的发射过程中,随着驱动组件50(见图2)推进(也即,从最近侧位置向最远侧位置运动),驱动组件50将致动滑块90推入刀片394中,使刀片394切穿锚定件“S”,由此释放钉仓支撑件“B”的远端。特别是,如图44所示,当刀片394处于第一位置时,随着驱动组件50向远侧推进,如箭头“A”所示,驱动组件50运动致动滑块90,使其接触或接合刀片394的凸轮缘394c。随着驱动组件50进一步向远侧推进,如箭头“B”所示,致动滑块90产生围绕支点383a的力矩,使得刀片394围绕支点383a旋转。在这种情况下,如图45所示,刀片394的刀口394d推进或者旋转通过锚定件“S”,由此切断锚定件“S”并释放钉仓支撑件“B”的远端。
[00178]现在转至图46,根据本公开的又一个实施方式的用于手术缝合装置的DLU的砧座组件一般由420指代。砧座组件420与砧座组件220和320基本上相类似,并且因此在此将仅详细讨论在其构造和操作上需要区分的差异。
[00179]如图46所示,砧座组件420包括枢转地固定到砧座组件420上特别是靠近砧座组件420的远端枢转地固定的刀片474。刀片474设置为便于随着驱动组件50(见图2)推进至砧座组件420中的最远侧位置而围绕支点旋转以切断锚定件“S”。
[00180]特别地,继续参考图46,砧座组件420包括形成在远侧盖476中、盖板(未显示)中和/或砧板470中的支点476b,支点476b用于枢转地接合或支撑刀片474。刀片474包括凸角474a,凸角474a限定了枢轴窗口474b,枢轴窗口474b被配置并定尺寸成枢转地接合支点476b。支点476b和枢轴窗口474b限定了枢轴“Y”,枢轴“Y”与砧板470的纵向狭槽470b的纵轴“X”间隔一定距离。
[00181]刀片474限定了横跨砧板470的纵向狭槽470b延伸的凸轮缘474c,以及横向于凸轮缘474c延伸的刀口474d。刀片474被配置并定尺寸为使得凸轮缘474c布置在锚定件(未显示)的远侧并且刀口474d的一部分横跨锚定件延伸。
[00182]如图46所示,刀片474具有第一位置,在第一位置处,刀口474d没有横跨凹槽470e延伸并且没有与锚定件接合。特别是,当处于第一位置时,刀片474的刀口474d包括向凹槽470e的近侧延伸的部分和向凹槽470e的远侧延伸的部分。同样,当处于第一位置时,刀片474的凸轮缘474c布置在或者位于凹槽470e的近侧。
[00183]现在转至图47~75,被配置为用于内窥镜手术缝合装置的手柄或者与手柄连接在一起的末端执行器一般由1000指代。末端执行器1000包括容纳多个手术紧固件或缝合钉1228(见图48)的钉仓组件1200和相对于钉仓组件1200可动地固定的砧座组件1300。末端执行器1000的长度为约30mm至约60mm。末端执行器1000可以被配置为施加六直排缝合钉。
[00184]如图47~49所示,末端执行器1000被配置为一次性装载单元,该一次性装载单元被配置为与手柄组件(未显示)选择性地连接。
[00185]如图49所示,末端执行器1000包括轴驱动组件1150,轴驱动组件1150与钉仓组件1200和砧座组件1300操作性地相关并可滑动地布置在钉仓组件1200和砧座组件1300之间。轴驱动组件1150包括细长驱动梁1152,细长驱动梁1152具有远端1152a和近端1152b。驱动梁1152由多个层叠梁构成。
[00186]驱动梁1152的近端1152b形成为一对弹性接合指部,该弹性接合指部被定尺寸并配置为在末端执行器1000连接至手柄组件时安装地接合驱动杆或控制杆(未显示)。
[00187]驱动梁1152的远端1152a被配置为从其横向延伸的I形梁,I形梁包括上轨部1154a和下轨部1154b。驱动梁1152的中心梁的远边限定了刀片1156。
[00188]如图49~62所示,钉仓组件1200包括限定了细长支撑通道1212的支架1210。支架1210的细长支撑通道1212被定尺寸并配置为将缝合钉钉仓1220选择性地容纳在其中。沿缝合钉钉仓1220和支架1210形成的相应凸起和狭槽用于将缝合钉钉仓1220保持在支架1210中。缝合钉钉仓1220包括形成在其中的保持狭槽1222,保持狭槽1222用于容纳多个手术缝合钉1224和推动器1226。
[00189]如图49、50、53和55所示,钉仓组件1200进一步包括致动滑块1228,致动滑块1228布置在缝合钉钉仓1220和支架1210之间。致动滑块1228包括中心直立楔或壁1228a,其两侧为一对外凸轮楔或壁1228b。中心壁1228a限定了形成在其中的远侧槽口或肩部1228c。
[00190]如图49和60所示,中心纵向狭槽1234在缝合钉钉仓1220中形成并沿缝合钉钉仓1220的长度延伸以使得驱动梁1152能够通过。在手术缝合器的操作中,致动滑块1228沿缝合钉钉仓1220和支架1210平移以推进外凸轮楔1228b与推动器1226顺次接触,以使推动器1226在保持狭槽1222中垂直平移并推动缝合钉1224从狭槽1222进入砧座组件1300(见图66)的砧板1310的缝合钉形成腔1312中。
[00191]继续参照图56~59,缝合钉钉仓1220限定了一对近侧凹槽1236,该对近侧凹槽1236靠近缝合钉钉仓1220的近端形成并且其每一个凹槽分别布置在纵向狭槽1234的两侧上。缝合钉钉仓1220进一步限定了一对远侧凹槽1238,该对远侧凹槽1238靠近缝合钉钉仓1220的近端形成并且其每一个凹槽分别布置在纵向狭槽1234的两侧上。如图57~59所示,一对近侧凹槽1236和一对远侧凹槽1238中的每一对的至少一个凹槽呈收缩轮廓的狭槽或槽口形式,以便摩擦地接合和/或夹紧缝合线“S”。
[00192]如图49、53、54、57和60~62所示,钉仓组件1200还包括刀片1240,刀片1240限定了远侧定位的刀口1242并被枢转地支撑在缝合钉钉仓1220中。刀片1240具有初始或第一状态和最终或第二状态:在初始或第一状态下,刀口1242位于一对远侧凹槽1238中的一个凹槽的近侧;在最终或第二状态下,刀口1242位于一对远侧凹槽1238中的所述一个凹槽的远侧。
[00193]钉仓组件1200包括刀片壳体1246,刀片壳体1246被支撑在缝合钉钉仓1220中与一对远侧凹槽1238相关的位置上。如图61所示,刀片壳体1246包括轮毂(hub)1246a,在轮毂1246a上可旋转地连接了刀片1240。
[00194]如图49、51、52和54~59所示,钉仓组件1200还包括手术钉仓支撑件“B1”,手术钉仓支撑件“B1”通过缝合线“S”操作地固定到缝合钉钉仓1220的上表面上,以覆盖至少部分保持狭槽1222和/或纵向狭槽1234的长度的至少一部分。手术钉仓支撑件“B1”包括:呈凸榫形式的近端部“B1a”,其具有比手术钉仓支撑件“B1”的横向宽度尺寸小的横向宽度尺寸;和呈凸榫形式的远端部“B1b”,其具有比手术钉仓支撑件“B1”的横向宽度尺寸小的横向宽度尺寸。手术钉仓支撑件“B1”的近端部“B1a”限定了在其中形成的一对孔“B1c”,孔“B1c”用于将缝合钉钉仓1220的柱1252容纳在其中。第一缝合线“S1”穿过一对远侧凹槽1238中的每一个凹槽并绕过/越过钉仓支撑件“B1”的远侧凸榫“B1b”,而第二缝合线“S2”穿过一对近侧凹槽1236中的每一个凹槽并绕过/越过钉仓支撑件“B1”的近侧凸榫“B1a”。
[00195]缝合线“S1、S2”中的每一个的第一端被锚定或固定在一对近侧凹槽1236和一对远侧凹槽1238中的相应一对凹槽上,而缝合线“S1、S2”中的每一个的第二端横向穿过钉仓支撑件“B1”的相应远侧凸榫“B1b”和近侧凸榫“B1a”并被锚定或固定在一对近侧凹槽1236和一对远侧凹槽1238中的相应的另一对凹槽上。
[00196]如图49、56和58所示,缝合钉钉仓1220包括一对间隔开的柱1252,柱1252布置在纵向狭槽1234的两侧上。柱1252位于近侧缝合线“S2”的远侧并邻近近侧缝合线“S2”。柱1252容纳在钉仓支撑件“B1”中形成的开口中。柱1252用于随着驱动组件1150向远侧运动保持钉仓支撑件“B1”相对于缝合钉钉仓1220的位置。柱1252还用于随着驱动组件1150向远侧运动拉紧近侧缝合线“S2”。
[00197]如图49、51~55和63~67所示,砧座组件1300包括:砧板1310,其具有多个缝合钉变形袋/腔1312(见图66);和盖板1320,其固定在砧板1310的顶表面上,其中,在砧板1310和盖板1320之间限定了腔1313。在砧板1310和盖板1320之间限定的腔被定尺寸为将驱动梁1152的上轨部1154a可滑动地容纳在其中。纵向狭槽1314贯穿砧板1310以便于驱动梁1152的通过。
[00198]在操作中,砧板1310的上表面限定了凸轮表面1310a,随着驱动组件1150推进驱动梁1152通过纵向狭槽1314,驱动梁1152的上轨部1154a接合凸轮表面1310a以紧靠组织用凸轮带动、推动并夹紧砧座组件1300。
[00199]继续参照图49、51、52和63~67,砧板1310限定了一对近侧凹槽1316,该对近侧凹槽1316靠近砧板1310的近端形成并且其每一个凹槽分别布置在纵向狭槽1314的两侧上。砧板1310限定了一对远侧凹槽1318,该对远侧凹槽1318靠近砧板1310的远端形成并且其每一个凹槽分别布置在纵向狭槽1314的两侧上。一对近侧凹槽1316和一对远侧凹槽1318中的每一对的至少一个凹槽呈具有收缩轮廓的狭槽或槽口形式,以便摩擦地接合和/或夹紧缝合线“S”。
[00200]如图49、51~54和64~67所示,砧座组件1300还包括刀片1330,刀片1330限定了远侧定位的刀口1332并被枢转地置于限定在砧板1310和盖板1320之间的腔中。刀片1330具有初始或第一状态和最终或第二状态:在初始或第一状态下,刀口1332位于一对远侧凹槽1318中的一个凹槽的近侧;在最终或第二状态下,刀口1332位于一对远侧凹槽1318中的所述一个凹槽的远侧。
[00201]如图49、51~54和64~67所示,砧板组件1300包括刀片壳体1336,刀片壳体1336被支撑在砧板1310和盖板1320之间与一对远侧凹槽1318相关的位置上。如图64和67所示,刀片壳体1336包括轮毂1336a,在轮毂1336a上可旋转地连接了刀片1330。
[00202]砧板组件1300还包括手术砧座支撑件“B2”,手术砧座支撑件“B2”通过缝合线“S”操作地固定在砧板1310的下表面上,以覆盖至少部分砧座袋1312a和/或纵向狭槽1314的长度的至少一部分。手术砧座支撑件“B2”包括:呈凸榫形式的近端部“B2a”,其具有比手术砧座支撑件“B2”的横向宽度尺寸小的横向宽度尺寸;和呈凸榫形式的远端部“B2b”,其具有比手术砧座支撑件“B2”的横向宽度尺寸小的横向宽度尺寸。第一缝合线“S3”穿过一对远侧凹槽1318中的每一个凹槽,而第二缝合线“S4”穿过一对近侧凹槽1316中的每一个凹槽。
[00203]缝合线“S3”的第一端被锚定或固定在一对远侧凹槽1318中的一个凹槽中,而缝合线“S3”的第二端横跨砧座支撑件“B2”绕过/越过砧座支撑件“B2”的远侧凸榫“B2b”,以便被锚定或固定在一对远侧凹槽1318的另一个凹槽中。
[00204]缝合线“S4”的第一端被锚定或固定在一对近侧凹槽1316中的一个凹槽中,而缝合线“S4”的第二端绕过/越过砧座支撑件“B2”的近侧凸榫“B2a”并被锚定或固定在一对近侧凹槽1316中的另一个凹槽中。
[00205]如图47~49、51、63和65~67所示,砧座组件1300的盖板1320包括在砧板1310的方向上延伸的一对壁1322。壁1322靠近盖板1320的近端形成并从其相对侧边缘延伸。壁1322被配置为:当钉仓组件1200和砧座组件1300处于闭合或夹紧状态时,壁1322横跨在它们之间限定的组织间隙延伸。壁1322用作组织止挡(tissue stop),在末端执行器1000的夹紧或闭合过程中,抑制组织在近侧方向上流动。
[00206]在操作中,如图68~72所示,当紧靠砧板1310的下表面固定砧座支撑件“B2”时,在手术缝合装置10的发射过程中,随着驱动组件1150推进(例如,从最近侧位置向最远侧位置运动),刀片1156切穿缝合线“S4”的中心部,由此从砧座组件1300中释放砧座支撑件“B2”的近端。随着驱动组件1150接近砧座组件1300的远端,驱动梁1152的上轨部1154a紧靠刀片1330并推动刀片1330向远侧旋转。随着刀片1330向远侧旋转,刀口1332从初始或第一状态向最终或第二状态旋转:在初始或第一状态下,刀口1332位于一对远侧凹槽1318中的一个凹槽的近侧;在最终或第二状态下,刀口1332位于一对远侧凹槽1318中的所述一个凹槽的远侧。在这种情况下,刀口1332切穿或割穿缝合线“S3”,由此从砧座组件1300中释放砧座支撑件“B2”的远端。
[00207]与此同时,在操作中,如图68~75所示,当紧靠缝合钉钉仓1220的组织接触表面固定钉仓支撑件“B1”时,在手术缝合装置的发射过程中,随着驱动组件1150推进(例如,从最近侧位置向最远侧位置运动),刀片1156切穿近侧缝合线“S2”的中心部,由此从钉仓组件1200中释放钉仓支撑件“B1”的近端。
[00208]随着驱动组件1150接近缝合钉钉仓1220的远端,致动滑块1228的中心直立楔或壁1228a的肩部1228c紧靠刀片1240并推动刀片1240向远侧旋转。随着刀片1240向远侧旋转,刀口1242从初始或第一状态旋转到最终或第二状态:在初始或第一状态下,刀口1242位于一对远侧凹槽1238中的一个凹槽的近侧;在最终或第二状态下,刀口1242位于一对远侧凹槽1238中的所述一个凹槽的远侧。在这种情况下,刀口1242切穿或割穿缝合线“S1”,由此从钉仓组件1200中释放钉仓支撑件“B1”的远端。
[00209]随着驱动组件1150从最近侧位置向最远侧位置推进,其刀片1156纵向切穿或割穿钉仓支撑件“B1”和砧座支撑件“B”,由此将支撑件“B1,B2”基本上对半分开。另外,随着驱动组件1150从最近侧位置向最远侧位置推进,致动滑块1228的直立凸轮楔1228b致动推动器1226,以使推动器1226在保持狭槽1222中垂直平移并从狭槽1222中推动缝合钉1224。随着从缝合钉钉仓1220的狭槽1222中推动缝合钉1224,缝合钉1224的支腿穿过并通过钉仓支撑件“B1”和砧座支撑件“B2”,通过插入钉仓支撑件“B1”和砧座支撑件“B2”之间的任何组织(未显示),并且紧靠砧座组件1300的砧板1310的缝合钉变形袋1312形成或者在砧座组件1300的砧板1310的缝合钉变形袋1312中形成。
[00210]手术支撑件“B1、B2”均是由适合的生物相容性和生物可吸收性材料制成的。手术支撑件“B1、B2”均是由不存留液体的无吸收性材料制成的。手术支撑件“B1、B2”均是由GLYCOMER 631(一种嵌段共聚物)(一种由乙交酯、二噁烷酮(dioxanone)和亚丙基二碳酸酯(trimethylene carbonate)组成的合成聚酯)制备的“BIOSYN”制成的。
[00211]所得到的共聚物的一个嵌段包含衍生自对二噁烷酮(1,4-二噁烷-2-酮)和亚丙基二碳酸酯(1,3-二噁烷-2-酮)的无规组合单元。所述共聚物的第二嵌段包含衍生自乙交酯和对二噁烷酮的无规组合单元。所得聚酯是一种ABA型三嵌段三元共聚物,其带有约60%的乙交酯、约14%的二噁烷酮和约26%的亚丙基二碳酸酯。
[00212]末端执行器1000显示在图47和48中,能够围绕支点铰接。钉仓组件1200和砧座组件1300可以形成非铰接型SULU的一部分。
[00213]虽然在上述实施方式中已经相对于内窥镜手术缝合器示出并描述了包括切断手术支撑件并从砧座组件和钉仓组件的组织接触表面中释放手术支撑件的可运动刀片的手术缝合器,但是,可以想象到的是并且在本公开的范围内,任何一个上述实施方式都可以并入任意类型的手术缝合器中,所述手术缝合器包括但并不限于开放式手术缝合器,例如线性手术缝合器、弧形或圆形手术缝合器和横向手术缝合器。
[00214]应当理解的是,可以对本文公开的实施方式进行多种改进。例如,如在本领域中公知的,缝合装置不需要施加缝合钉而是可以施加可分式紧固件。另外,对直排缝合钉或紧固件的长度可以进行改进以满足特殊手术程序的需要。从而,可以相应地改变致动轴的单次行程的长度和/或在一次性装载单元中的直排缝合钉和/或紧固件的长度。因此,上述描述不应当被解释为对本公开的限制,而仅仅作为优选实施方式的范例。本领域技术人员将会想象到在所附的权利要求书的范围和精神内的其它改进。
Claims (46)
1.一种手术缝合装置,包括:
壳体;
由所述壳体支撑的手柄;
细长体,其从所述壳体向远侧延伸并具有适于可松开地接合装载单元的远端;和
能够支撑在所述壳体的远端上的装载单元,所述装载单元包括:
工具组件,其具有钉仓组件和砧座组件:所述钉仓组件被配置为且适于将具有多个手术紧固件的缝合钉钉仓可松开地支撑在其中;所述砧座组件相对于所述钉仓组件可动地固定,其中,所述砧座组件被配置为且适于支撑砧板,并且其中,砧板和缝合钉钉仓中的每一个均限定了细长的纵向狭槽;
手术支撑件,其可松开地固定在砧板和缝合钉钉仓中的至少一个的组织接触表面上,其中,各个手术支撑件通过至少一个锚定件固定在砧座组件和钉仓组件中的至少一个上;和
可滑动地支撑在工具组件中的驱动组件,其包括可滑动地布置在各个细长的纵向狭槽内的刀片,其中,所述驱动组件从近侧位置向远侧位置的运动导致其刀片切割至少一个锚定件并从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件。
2.根据权利要求1所述的手术缝合装置,其中,所述砧座组件包括将手术支撑件固定到砧座组件上的近侧缝合线。
3.根据权利要求1所述的手术缝合装置,其中,所述砧座组件包括将手术支撑件固定到砧座组件上的远侧锚定件。
4.根据权利要求1所述的手术缝合装置,其中,所述钉仓组件包括将手术支撑件固定到钉仓组件上的近侧锚定件。
5.根据权利要求1所述的手术缝合装置,其中,所述钉仓组件包括将手术支撑件固定到钉仓组件上的远侧锚定件。
6.根据权利要求1所述的手术缝合装置,其中,所述砧座组件包括将手术支撑件的近端固定到砧座组件上的近侧锚定件和将手术支撑件的远端固定到砧座组件上的远侧锚定件,并且其中,所述钉仓组件包括将手术支撑件的近端固定到钉仓组件上的近侧锚定件和将手术支撑件的远端固定到钉仓组件上的远侧锚定件。
7.根据权利要求6所述的手术缝合装置,其中,所述砧座组件和钉仓组件的各个锚定件横跨砧板和缝合钉钉仓的相应的纵向狭槽延伸。
8.根据权利要求6所述的手术缝合装置,其中,所述砧座组件包括通过操作支撑在其中并且限定了刀口的刀片,其中,在所述砧座组件的刀片致动时,所述刀片切割砧座组件的近侧锚定件和远侧锚定件中的至少一个。
9.根据权利要求8所述的手术缝合装置,其中,所述砧座组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片大体上位于砧座组件的远侧锚定件的近侧;在第二位置处,所述刀片大体上位于砧座组件的远侧锚定件的远侧,由此切割砧座组件的远侧锚定件。
10.根据权利要求9所述的手术缝合装置,其中,当驱动组件向远侧致动时,驱动组件使砧座组件的刀片从第一位置运动至第二位置。
11.根据权利要求10所述的手术缝合装置,其中,所述刀片为可滑动或可旋转地支撑在砧座组件中的刀片。
12.根据权利要求6所述的手术缝合装置,其中,所述钉仓组件包括通过操作支撑在其中并且限定了刀口的刀片,其中,在钉仓组件的刀片致动时,所述刀片切割钉仓组件的近侧锚定件和远侧锚定件中的至少一个。
13.根据权利要求12所述的手术缝合装置,其中,所述钉仓组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片大体上位于钉仓组件的远侧锚定件的近侧;在第二位置处,所述刀片大体上位于钉仓组件的远侧锚定件的远侧,由此切割钉仓组件的远侧锚定件。
14.根据权利要求13所述的手术缝合装置,其中,当驱动组件向远侧致动时,驱动组件使钉仓组件的刀片从第一位置运动至第二位置。
15.根据权利要求14所述的手术缝合装置,其中,所述刀片为可滑动或可旋转地支撑在钉仓组件中的刀片。
16.根据权利要求6所述的手术缝合装置,其中,所述钉仓组件和砧座组件中的每一个均包括通过操作支撑在其中并且限定了刀口的刀片,其中,在刀片致动时,各个刀片切割钉仓组件和砧座组件的近侧锚定件和远侧锚定件中的至少一个。
17.一种用于手术缝合装置的装载单元,所述装载单元包括:
工具组件,其具有钉仓组件和砧座组件:所述钉仓组件被配置为且适于将具有多个手术紧固件的缝合钉钉仓可松开地支撑在其中;所述砧座组件相对于所述钉仓组件可动地固定,其中,所述砧座组件被配置为且适于支撑砧板,并且其中,砧板和缝合钉钉仓中的每一个均限定了细长的纵向狭槽;
手术支撑件,其可松开地固定在砧板和缝合钉钉仓中的至少一个的组织接触表面上,其中,各个手术支撑件通过至少一个锚定件固定在砧座组件和钉仓组件中的至少一个上;和
可滑动地支撑在工具组件中的驱动组件,其包括可滑动地布置在各个细长的纵向狭槽内的刀片,其中,所述驱动组件从近侧位置向远侧位置的运动导致其刀片切割至少一个锚定件并从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件。
18.根据权利要求17所述的装载单元,其中,所述砧座组件包括将手术支撑件固定到砧座组件上的近侧锚定件。
19.根据权利要求17所述的装载单元,其中,所述砧座组件包括将手术支撑件固定到砧座组件上的远侧锚定件。
20.根据权利要求17所述的装载单元,其中,所述钉仓组件包括将手术支撑件固定到钉仓组件上的近侧锚定件。
21.根据权利要求17所述的装载单元,其中,所述钉仓组件包括将手术支撑件固定到钉仓组件上的远侧锚定件。
22.根据权利要求17所述的装载单元,其中,所述砧座组件包括将手术支撑件的近端固定到砧座组件上的近侧锚定件和将手术支撑件的远端固定到砧座组件上的远侧锚定件,并且其中,所述钉仓组件包括将手术支撑件的近端固定到钉仓组件上的近侧锚定件和将手术支撑件的远端固定到钉仓组件上的远侧锚定件。
23.根据权利要求22所述的装载单元,其中,所述砧座组件和钉仓组件的各个锚定件横跨砧板和缝合钉钉仓的相应的纵向狭槽延伸。
24.根据权利要求22所述的装载单元,其中,所述砧座组件包括通过操作支撑在其中并且限定了刀口的刀片,其中,在所述砧座组件的刀片致动时,所述刀片切割砧座组件的近侧和远侧锚定件中的至少一个。
25.根据权利要求24所述的装载单元,其中,所述砧座组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片大体上位于砧座组件的远侧锚定件的近侧;在第二位置处,所述刀片大体上位于砧座组件的远侧锚定件的远侧,由此切割砧座组件的远侧锚定件。
26.根据权利要求25所述的装载单元,其中,当驱动组件向远侧致动时,驱动组件使砧座组件的刀片从第一位置运动至第二位置。
27.根据权利要求26所述的装载单元,其中,所述刀片为可滑动或可旋转地支撑在砧座组件中的刀片。
28.根据权利要求22所述的装载单元,其中,所述钉仓组件包括通过操作支撑在其中并且限定了刀口的刀片,其中,在钉仓组件的刀片致动时,所述刀片切割钉仓组件的近侧锚定件和远侧锚定件中的至少一个。
29.根据权利要求28所述的装载单元,其中,所述钉仓组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片大体上位于钉仓组件的远侧锚定件的近侧;在第二位置处,所述刀片大体上位于钉仓组件的远侧锚定件的远侧,由此切割钉仓组件的远侧锚定件。
30.根据权利要求29所述的装载单元,其中,当驱动组件向远侧致动时,驱动组件使钉仓组件的刀片从第一位置运动至第二位置。
31.根据权利要求30所述的装载单元,其中,所述刀片为可滑动或可旋转地支撑在钉仓组件中的刀片。
32.根据权利要求22所述的装载单元,其中,所述钉仓组件和砧座组件中的每一个均包括通过操作支撑在其中并且限定了刀口的刀片,其中,在刀片致动时,各个刀片切割钉仓组件和砧座组件的近侧锚定件和远侧锚定件中的至少一个。
33.一种用于选择性地与手术缝合装置一同使用的装载单元,所述装载单元包括:
工具组件,其具有钉仓组件和砧座组件:所述钉仓组件被配置为且适于将具有多个手术紧固件的缝合钉钉仓可松开地支撑在其中;所述砧座组件相对于所述钉仓组件可动地固定,其中,所述砧座组件被配置为且适于支撑砧板,并且其中,砧板和缝合钉钉仓中的每一个均限定了细长的纵向狭槽;
手术支撑件,其可松开地固定在砧板和缝合钉钉仓中的每一个的组织接触表面上;
锚定件,其将手术支撑件固定在砧板和缝合钉钉仓中的每一个上,其中,锚定件位于砧座组件和钉仓组件中的每一个的近端和远端的附近;
刀片,其通过操作布置在砧座组件中,其中,所述砧座组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片位于砧座组件的远侧锚定件的近侧;在第二位置处,所述刀片位于砧座组件的远侧锚定件的远侧,由此切割砧座组件的远侧锚定件;
刀片,其通过操作布置在钉仓组件中,其中,所述钉仓组件的刀片具有第一位置和第二位置:在第一位置处,所述刀片位于钉仓组件的远侧锚定件的近侧;在第二位置处,所述刀片位于钉仓组件的远侧锚定件的远侧,由此切割钉仓组件的远侧锚定件;和
可滑动地支撑在工具组件中的驱动组件,其包括可滑动地布置在各个细长的纵向狭槽内的刀片,
其中,所述驱动组件从近侧位置向远侧位置的运动导致其刀片切割砧座组件和钉仓组件中的每一个的近侧锚定件并且从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件的近端,和
其中,所述驱动组件从近侧位置向远侧位置的运动使砧座组件的刀片和钉仓组件的刀片从它们相应的第一位置运动至它们相应的第二位置,由此切割砧座组件和钉仓组件的相应的远侧锚定件并且从相应的至少一个砧座组件和钉仓组件中释放各个手术支撑件的远端。
34.一种手术缝合装置,包括:
限定了组织接触表面的钉仓组件;
限定了组织接触表面的砧座组件;和
手术支撑件,其通过至少一个锚定件可松开地固定在所述钉仓组件的组织接触表面和所述砧座组件的组织接触表面中的至少一个上。
35.根据权利要求34所述的手术缝合装置,其中,锚定件位于各个手术支撑件的近端和远端中的至少一个的附近。
36.根据权利要求34所述的手术缝合装置,其中,各个锚定件横向于钉仓组件和砧座组件中的相应一个的纵轴延伸。
37.根据权利要求36所述的手术缝合装置,其中,所述锚定件选自缝合线、线、系绳、带、条、绳、金属丝、缆索、大头钉、绞钉和紧固件中。
38.根据权利要求34所述的手术缝合装置,其中,至少一个近侧锚定件横跨在钉仓组件和砧座组件中的每一个中形成的相应的纵向刀槽延伸。
39.根据权利要求34所述的手术缝合装置,其中,至少一个远侧锚定件横跨在钉仓组件和砧座组件中的每一个中形成的相应的纵向刀槽延伸。
40.根据权利要求34所述的手术缝合装置,其中,在手术缝合装置发射时,所述锚定件释放相应的手术支撑件。
41.根据权利要求38所述的手术缝合装置,其中,在手术缝合装置发射时,各个锚定件被切断以释放手术支撑件。
42.根据权利要求39所述的手术缝合装置,其中,在手术缝合装置发射时,各个锚定件被切断以释放手术支撑件。
43.根据权利要求34所述的手术缝合装置,进一步包括刀片,所述刀片被配置并尺寸设计为可滑动地往复运动通过在钉仓组件和砧座组件中的每一个中形成的相应的纵向刀槽,其中,当刀片向远侧推进时,刀片切断锚定件。
44.根据权利要求34所述的手术缝合装置,进一步包括驱动组件,所述驱动组件被可滑动地支撑以沿钉仓组件和砧座组件轴向运动,其中,驱动组件从近侧位置向远侧位置的运动导致手术支撑件与钉仓组件和砧座组件中的相应一个分离。
45.根据权利要求44所述的手术缝合装置,其中,锚固件位于在各个手术支撑件的近端和远端中的至少一个的附近。
46.根据权利要求45所述的手术缝合装置,其中,所述驱动组件采用直接切割各个锚定件和使各个锚定件被切割的方法中的至少一种以从相应的钉仓组件和砧座组件中释放手术支撑件。
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