CN102090911B - 外科施夹器 - Google Patents
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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
- A61B17/10—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
- 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
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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
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/083—Clips, e.g. resilient
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
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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
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00407—Ratchet means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0803—Counting the number of times an instrument is used
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
Abstract
本发明提供了一种外科施夹器，所述外科施夹器包括：外壳；至少一个手柄，其可枢转地连接到所述外壳上；通道组件，其从所述外壳向远侧延伸出；装载于夹子承载器中的多个夹子；驱动通道，其可平移地支撑在所述外壳和所述通道组件中，所述驱动通道基于所述至少一个手柄的致动而平移；以及计数器机构，其支撑在所述外壳中，所述计数器机构包括通过所述外壳可视的标记，其中所述标记与装载于所述施夹器中的夹子的数量相对应，其中当所述施夹器每次弹射导致多个夹子中剩余夹子的数量减少时，所述标记递减。
Description
相关申请的交叉引用
本申请要求于2009年12月9日提交的、序列号为61/285,006的美国临时申请的利益和优先权，将所述申请的全部内容通过引用合并于此。
技术领域
本申请涉及外科器械，更特别地，涉及具有多个夹子的外科施夹器，所述外科施夹器用于在外科手术过程中将夹子施加到体组织和血管。
背景技术
外科施夹器是现有技术已知的，并由于向体组织和血管的传统缝合提供了另一种选择而越来越受外科医生的欢迎。专利号为5,030,226的格林(Green)等人的美国专利和专利号为5,431,668的伯班克三世(Burbank III)等人的美国专利公开了典型的器械。这些器械通常提供多个夹子，所述多个夹子存储在器械中并基于器械近端处手柄的开合而被相继送入器械远端处的钳夹机构。当手柄闭合时，钳夹闭合以使位于钳夹构件之间的夹子变形，而当钳夹张开以释放变形的夹子时，将一个新的夹子从其序列送入钳夹之间的位置。这个过程重复执行直到将夹子序列中的所有夹子都已用过。
施夹器的用户想知道有多少个夹子保留在施夹器中和/或想知道什么时候多个夹子中的最后一个夹子已经被弹射出的需求是存在的。
发明内容
本申请涉及具有多个夹子的外科施夹器及其使用方法，所述外科施夹器用于在外科手术期间将所述夹子施加到体组织和血管中。
根据本公开的一个方案，提供一种外科施夹器，其包括：外壳；可枢转地连接到外壳上的至少一个手柄；从外壳向远侧延伸出的通道组件；装载在夹子承载器中的多个夹子；可平移地支撑在外壳和通道组件中的驱动通道，所述驱动通道基于所述至少一个手柄的致动而平移；以及支撑在外壳中的计数器机构，所述计数器机构包括通过外壳可视的标记，其中所述标记与装载于施夹器中的夹子的数量相对应，其中当施夹器每次弹射导致多个夹子中剩余夹子的数量减少时，所述标记递减。
计数器机构可以可旋转地支撑在外壳中，并且可以包括允许计数器机构在单一方向上旋转的单向离合器构件。计数器机构可以包括可旋转地支撑在外壳中的计数器刻度盘，其中所述计数器刻度盘包括在其中的标记，并且计数器离合器可操作地连接到计数器刻度盘上，以使计数器离合器在第一方向上的旋转导致计数器刻度盘在第一方向上的旋转，并且使计数器离合器在第二方向上的旋转不会导致计数器刻度盘的旋转。
计数器机构可以包括与计数器刻度盘可操作地接合的闩构件。使用时，所述闩构件允许计数器刻度盘在第一方向上旋转，并且禁止计数器机构在与所述第一方向相反的方向上旋转。
计数器刻度盘可以包括形成在其周边的多个凹槽，并且闩构件可以包括与计数器刻度盘的多个凹槽偏压接合的弹性指状部。
计数器离合器可以同心地、可旋转地嵌套于限定在计数器刻度盘中的镗孔内。计数器离合器可以包括从其延伸出的至少一个弹性指状部，用于与形成在计数器刻度盘的镗孔周边表面中的单向齿接合。
驱动通道可以在其中限定倾斜狭槽，并且计数器离合器可以包括从其表面延伸出并且可以可滑动地配置在驱动通道的倾斜狭槽中的离合器销。使用时，驱动通道相对于计数器机构在第一方向的平移会致使离合器销通过所述驱动通道的倾斜狭槽而做凸轮运动，从而使计数器离合器在第一方向上旋转，并且驱动通道相对于计数器机构在第二方向上的平移会致使离合器销通过所述驱动通道的倾斜狭槽而做凸轮运动，从而使计数器离合器在第二方向上旋转。
计数器机构可以包括与计数器刻度盘可操作地接合的闩构件。使用时，闩构件允许计数器刻度盘在第一方向上旋转，并且禁止计数器机构在与所述第一方向相反的方向上旋转。
计数器机构可以包括限定形成在其外周边缘中的锁定凹槽(lock outgroove)的计数器刻度盘；以及支撑在外壳中的锁定件。锁定件可以被偏压以使其第一掣子(catch)紧密接合计数器刻度盘的外周边缘。使用时，当计数器刻度盘旋转且计数器刻度盘的锁定凹槽与锁定件的第一掣子达到配准时，促使锁定件的第一掣子进入到锁定凹槽中，从而防止计数器刻度盘在相反的方向上旋转。
锁定件可以包括第二掣子。使用时，当锁定件的第一掣子移动到计数器刻度盘的锁定凹槽中时，锁定件的第二掣子移动到施夹器的平移构件的路径(path)中，从而禁止施夹器的平移构件平移。
当多个夹子中的最后一个夹子已经被弹射出时，计数器刻度盘的锁定凹槽可以移动成与锁定件的第一掣子配准。计数器刻度盘的锁定凹槽可以与计数器机构上指示最后一个夹子已经被弹射出的标记关联。计数器机构上指示多个夹子中的最后一个夹子已经被弹射出的标记可以由数字“0”来表示。
施夹器可进一步包括棘轮机构，所述棘轮机构具有枢转地支撑在外壳中的棘爪和设置在平移构件上的齿条构件。齿条构件可与棘爪可操作的配准。使用时，当平移构件平移时，齿条构件平移通过棘爪。当齿条构件还未完成次个完整平移时，可防止棘轮机构复位。
附图说明
由于从下述结合下列附图考虑时的详细描述中本发明的施夹器变得更好理解，因此将能够更完全地认识本施夹器。在附图中：
图1是依照本公开的实施例的外科施夹器的立体图；
图2是图1的外科施夹器的俯视图；
图3是图2所指示细节区域的放大图；
图4是图1和图2的外科施夹器的机械计数器组件的立体图；
图5是图1至图4的外科施夹器的分解立体图；
图6是从其中移除了外壳半部分的手柄组件的立体图，并且图示了与驱动通道接合的机械计数器组件的计数器；
图7是从其中移除了外壳半部分和驱动通道的手柄组件的立体图，并且图示了与棘轮接合的机械计数器组件的计数器；
图8是图7所指示细节区域的放大图；
图9是从其中移除了外壳半部分、驱动通道和棘轮的手柄组件的立体图；
图10是机械计数器组件的计数器和离合器的部件分离的正视立体图；
图11是图10的机械计数器组件的计数器和离合器的部件分离的后视立体图；
图12是图10和图11的机械计数器组件的计数器和离合器的后视立体图；
图13是图1至图4的施夹器的锁定件的立体图；
图14是示意性示出了当施夹器处于初始未致动位置时机械计数器组件可操作地连接到驱动通道上的俯视图；
图14A是沿图14的14A-14A观看时的机械计数器组件的侧视图；
图14B是图14所指示细节区域的放大图；
图14C是沿图14A的14C-14C剖切的机械计数器组件的剖视图；
图15是示意性示出了当施加器开始致动时机械计数器组件可操作地连接到驱动通道上的俯视图；
图15A是图15所指示细节区域的放大图；
图15B是在施夹器的致动期间沿图14A的14C-14C剖切的机械计数器组件的剖视图；
图16是示意性示出了当施夹器完全致动时机械计数器组件可操作地连接到驱动通道上的俯视图；
图16A是图16所指示细节区域的放大图；
图16B是在施夹器完全致动后沿图14A的14C-14C剖切的机械计数器组件的剖视图；
图17是示意性示出了当施夹器在完全致动后被释放时机械计数器组件可操作地连接到驱动通道上的俯视图；
图17A是图17所指示细节区域的放大图；
图17B是在完全致动后释放施夹器期间沿14A的14C-14C剖切的机械计数器组件的剖视图；
图18是沿14A的14C-14C剖切的机械计数器组件的剖视图，图示机械计数器组件完全复位；
图19是机械计数器组件的俯视图，图示计数器处于“0”位置且被锁定；
图19A是沿14A的14C-14C剖切的机械计数器组件的剖视图，图示计数器处于“0”位置且被锁定；以及
图19B是图19A所指示细节区域的放大图。
具体实施方式
现在将参照附图对依照本公开的外科施夹器的实施例进行详细描述，其中相同的附图标记代表类似或相同的结构元件。如附图所示以及如下贯穿全文所描述的，当涉及外科器械的相对位置时，跟传统的一样，术语“近侧”表示装置靠近用户的一端，而术语“远侧”表示装置远离用户的一端。
现在参照图1至图5，依照本公开的实施例的外科施夹器通常用100表示。外科施夹器100通常包括手柄组件102，该手柄组件102包括具有上半外壳104a和下半外壳104b的外壳104。手柄组件102进一步包括一对手柄106，所述一对手柄106可枢转地固定在外壳104上并从外壳104向外延伸。通道组件108稳固地固定在外壳104上并从外壳104向外延伸，终止于钳夹组件110。
如在图1至图5中可见，施夹器100的半外壳104a和半外壳104b通过彼此卡扣配合(snap fit)接合而装在一起。如在下文将进行更详细讨论的，外壳104限定了形成于下半外壳104b内的用于支撑并显示计数器机构的窗口104c。
如在图4中可见，手柄106通过手柄枢轴支柱104d固定在外壳104上，支柱104d从下半外壳104b延伸出并进入到形成于手柄106上的相应的孔106a内。手柄组件102包括连杆构件122，该连杆构件122在形成于相应手柄106上的枢轴点106b处可枢转地连接至每个手柄106。每个连杆构件122的远端通过驱动销124可枢转地连接到形成于驱动通道140内的枢轴点。驱动销124的每端可滑动地容纳在形成于相应的上半外壳104a和下半外壳104b内的细长通道中。使用时，如下文将更详细描述的，当扳动手柄106时，连杆构件122通过驱动销124向远侧推动驱动通道140。
通道组件108包括通道或仓盖130和外部或下部通道132，各自均具有保持在外壳组件102内并位于上半外壳104a和下半外壳104b之间的近端。
如在图5中可见，施夹器100包括：夹子推杆(push bar)160，其可滑动地配置在仓盖130下方；稳定器162，其被构造为覆于推杆160之上并与其接合；运动倍增系统155，其支撑在外壳104内；夹子承载器170，其配置在通道组件108内且位于推杆160下方；一叠外科夹子“C”，其装载和/或保持在夹子承载器170内，以便在夹子承载器170内滑动和/或沿夹子承载器170滑动；夹子输出器(clip follower)174，其可滑动地配置在夹子承载器170内并位于一叠外科夹子“C”的后方；楔形板180，其可滑动地配置在手柄组件102和通道组件108内；楔形板枢转臂179，其可枢转地支撑在外壳104的下半外壳104b上，用于将驱动通道140的平移传递成楔形板180的平移；驱动通道140，其往复地支撑在手柄组件102的外壳104和通道组件108内并在二者之间延伸；听觉/触觉指示器148，其通过驱动销124连接到驱动通道140上；以及钳夹组件110，其安装在通道组件108的远端上或远端处，并且能够通过手柄组件102的手柄106来致动。
可以参考下述申请：于2008年8月25日提交的、申请号为61/091,467、名称为“Surgical Clip Applier(外科施夹器)”的美国临时申请和于2008年8月25日提交的、申请号为61/091,485、名称为“Surgical Clip Applier and Methodof Assembly(外科施夹器及其装配方法)”的美国临时申请，将所述每个申请的全部内容通过引用都并入于此，用于详细讨论外科施夹器100的各种零件的结构、操作和装配方法。也可以参考于2009年12月15日提交的、申请号为61/286,569、名称为“Surgical Clip Applier(外科施夹器)”(Attorney DocketNo.H-US-02062(203-6802))的美国临时申请，将所述申请的全部内容通过引用并入于此，用于另外详细讨论外科施夹器100的各种零件的结构、操作和装配方法。
如在图1至图12中可见，施夹器100进一步包括支撑在手柄组件102的外壳104中的机械计数器机构190。计数器机构190包括：计数器刻度盘192，其可旋转地配置在外壳104内以便覆于形成在下半外壳104b内的窗口104c之上；计数器离合器194，其可操作地连接到计数器刻度盘192上并被构造为允许计数器刻度盘192的单向旋转；以及闩构件(latch member)196，其被构造为接合计数器刻度盘192。
如在图4至图11中可见，计数器刻度盘192包括邻近形成于下半外壳104b上的窗口104c配置的第一面192a。第一面192a包括多个标记192b，这些标记呈配置在第一面中且基本围绕第一面的径向周边配置的连续数字的形式。标记192b可以与装载于施夹器100内的夹子的数目相对应。仅仅作为示例，标记192b可为从“0至22”的数字。标记192b位于第一面192a上，以便与形成在下半外壳104b中的窗口104c配准。计数器刻度盘192包括与第一面192a相反且在其中限定了镗孔192d的第二面192c。镗孔192d包括形成于其中的径向排列的单向齿192e。计数器刻度盘192进一步包括第一缘或外缘和第二缘或内缘，所述第一缘或外缘限定了围绕其外周边形成的多个凹槽192f，所述第二缘或内缘限定了形成在其外周边上的单一凹槽192g。
继续参照图4至图11，计数器离合器194同心且可旋转地嵌套在计数器刻度盘192的镗孔192d内。机械计数器机构190的计数器离合器194包括主体部194a，所述主体部194a被构造且定尺寸为可旋转地配置在计数器刻度盘192的镗孔192d内。计数器离合器194包括一对对置的弹性指状部194b、194c，其从主体部194a基本切向地延伸出。弹性指状部194b、194c从主体部194a延伸出足够的量以与刻度盘192的单向齿192e弹性地接合。计数器离合器194包括离合器销194d，所述离合器销194d从主体部194a延伸出并从计数器刻度盘192的镗孔192d向外突出。
如在图4至图9中可见，机械计数器机构190的闩构件196固定在下半外壳104b上。闩构件196包括弹性指状部196a，其被构造为接触围绕计数器刻度盘192的外周边形成的凹槽192f并与之可选择地接合。
如在图5和图6中可见，驱动通道140限定形成在其中一位置处的倾斜狭槽140a，以便可滑动地容纳从计数器离合器194的主体部194a延伸出的离合器销194d。驱动通道140的倾斜狭槽140a在远离施夹器100的纵轴的方向上从近侧方向向远侧方向延伸。
如在图4、5、7和8中可见，施夹器100包括可滑动地配置在下半外壳104b内的齿条构件141。齿条构件141被钉(pin)在驱动销124上，以使驱动销124相对于外壳104的平移引起齿条构件141的伴随平移。齿条构件141配置在外壳104内，以使计数器离合器194的离合器销194d搭跨在齿条构件141的侧边缘141b上或接触侧边缘141b。齿条构件141包括沿着其边缘形成的棘齿141a，并且棘齿141a被构造且适于与支撑在外壳104内的棘爪142接合。齿条构件141和棘爪142限定了棘轮机构144。
使用时，当驱动通道140通过驱动销124轴向移动时，齿条构件141也移动。当齿条构件141随着驱动通道140到达最近侧位置或最远侧位置而在近侧运动和远侧运动之间变化时，齿条构件141的棘齿141a具有允许棘爪142反向并在齿条构件141上返回的长度。
在棘爪142与齿条构件141基本可操作的接合的位置处，棘爪142通过爪销枢转地连接到下半外壳104b上。棘爪142能够与齿条构件141接合以限制齿条构件141的纵向移动，这又限制驱动通道140的纵向移动。棘轮机构144进一步包括爪簧145，其被构造且定位为将棘爪142偏压到与齿条构件141可操作的关联。爪簧145起着保持棘爪142的齿与齿条构件141的齿141a接合、以及保持棘爪142在旋转位置或倾斜位置(canted position)的作用。
如在图4、5、7至9和13中可见，施夹器100进一步包括枢转地连接到外壳104上或支撑在外壳104中的锁定件146。锁定件146包括：主体部146a；第一掣子146b，其形成在主体部146a的一端处；以及第二掣子146c，其从主体部146a的侧边缘延伸出。第一掣子146b被构造且定尺寸为接合形成在计数器刻度盘192的内缘的外周边中的凹槽192g。第二掣子146c被构造且定尺寸为接合形成在齿条构件141的侧边缘内的凹口141c。设置偏压构件147以保持锁定件146的第一掣子146b与计数器刻度盘192的内缘的外周边接触。
现在参照图14至图19B，提供了对施夹器100的操作。在任何初始扳动施夹器100的手柄106之前且在施夹器100完全装满夹子“C”的情况下，如在图14至14C中可见，驱动通道140位于最近侧位置处，与施夹器100完全装满(在本例中足足装载22个夹子)有关的机械计数器机构190的计数器刻度盘192的标记192b通过形成在半外壳104b上的窗口104c可见。因此，如在图14B中可见，通过窗口104c可见数字“22”。此外，如在图14B中可见，闩构件196的弹性指状部196a与围绕计数器刻度盘192的外周边形成的凹槽192f接合。
如在图14C中可见，在任何一次扳动手柄106之前，计数器离合器194的离合器销194d配置在驱动通道140的倾斜狭槽140a的远端处。此外，锁定件146的第一掣子146b与计数器刻度盘192的内缘的外周边相接触，以使锁定件146的第二掣子146c脱离齿条构件141。而且，在任何一次扳动手柄106之前，并且在施夹器100完全装满夹子时，形成在计数器刻度盘192的内缘的外周边上的凹槽192g定位在锁定件146的第一掣子146b的远侧。
如在图15至15B中可见，在如由箭头“A1”所示开始扳动手柄106时，如由箭头“B1”所示，驱动销124使驱动通道140和齿条构件141在远侧方向上平移。随着驱动通道140在远侧方向上平移，驱动通道140的倾斜狭槽140a相对于计数器离合器194的离合器销194d在远侧方向上移动，离合器销194d通过驱动通道140的倾斜狭槽140a做凸轮运动，致使计数器离合器194在箭头“C1”的方向上旋转。如在图15B中可见，当计数器离合器194在箭头“C1”的方向上旋转时，其弹性指状部194b、194c接合刻度盘192的单向齿192e，从而使得刻度盘192也在箭头“C1”的方向上旋转。而且，当刻度盘192在箭头“C1”的方向上旋转时，形成在计数器刻度盘192的内缘的外周边上的凹槽192g远离锁定件146的第一掣子146b旋转，同时第一掣子146b继续搭跨在计数器刻度盘192的内缘的外周边上。
如在图15A中可见，当刻度盘192在箭头“C1”的方向上旋转时，数字“22”的标记192b相对于形成在半外壳104b中的窗口104c移动，从而开始递减。因此，当刻度盘192在箭头“C1”的方向上旋转时，闩构件196的弹性指状部196a开始脱离围绕在计数器刻度盘192的外周边形成的凹槽192f。
如在图16至16B中可见，在如由箭头“A1”所示最后一次(final)或者完全(complete)扳动手柄106期间，如由箭头“B1”所示，驱动销124使驱动通道140和齿条构件141进一步在远侧方向上平移。当驱动通道140在远侧方向上进一步平移时，驱动通道140的倾斜狭槽140a相对于计数器离合器194的离合器销194d进一步在远侧方向上移动，离合器销194d通过驱动通道140的倾斜狭槽140a进一步做凸轮运动，致使计数器离合器194进一步在箭头“C1”的方向上旋转。如在图16B中可见，随着计数器离合器194进一步在箭头“C1”的方向上旋转，弹性指状部194b、194c继续使刻度盘192在箭头“C1”的方向上旋转。而且，随着刻度盘192进一步在箭头“C1”的方向上旋转，形成在计数器刻度盘192的内缘的外周边上的凹槽192g进一步远离锁定件146的第一掣子146b旋转，同时第一掣子146b进一步继续搭跨在计数器刻度盘192的内缘的外周边上。
如在图16A中可见，随着刻度盘192进一步在箭头“C1”的方向上旋转，数字“22”的标记192b完全移出形成在半外壳104b中的窗口104c的视野，而新的数字“21”移入窗口104c的视野，从而彻底递减。这种数字的改变或者递减与夹子从施夹器100的成型(formation)和/或弹射/弹出/释放相符合。如此，显示给用户的是在施夹器100中剩余的且可用于弹射的夹子的数目。相应地，随着刻度盘192进一步在箭头“C1”的方向上旋转，闩构件196的弹性指状部196a移动以接合到围绕计数器刻度盘192的外周边形成的凹槽192f附近的凹槽192f中。
现在参照图17至图18，在如由箭头“A2”所示打开手柄106期间，驱动销124使驱动通道140和齿条构件141在近侧方向上平移。随着驱动通道140在近侧方向上平移，驱动通道140的倾斜狭槽140a相对于计数器离合器194的离合器销194d在近侧方向上移动，离合器销194d通过驱动通道140的倾斜狭槽140a做凸轮运动，致使计数器离合器194在与“C1”相反的箭头“C2”的方向上旋转。如在图17B中可见，随着计数器离合器194在箭头“C2”的方向上旋转，使得弹性指状部194b、194c偏转并且滑过(snap over)刻度盘192的单向齿192e。如在图17A中可见，通过使闩构件196的弹性指状部196a接合在围绕计数器刻度盘192的外周边形成的凹槽192f中，趋于使刻度盘192也在箭头“C2”的方向上旋转的任何摩擦力被抵消，由此保持住刻度盘192的旋转方位。
当将刻度盘192控制或者保持在所述旋转方位时，数字“21”的标记192b保留在窗口104c的视野中。
如在图18中可见，当驱动通道140已经移回到完全地近侧位置时，计数器离合器194的弹性指状部194b、194c复位至与邻接的刻度盘192的单向齿192e的接合。
此外，随着刻度盘192进一步在箭头“C1”的方向上旋转，闩构件196的弹性指状部196a移动成与围绕计数器刻度盘192的外周边形成的凹槽192f相邻的凹槽192f的接合。
现在参照图19至19B，在扳动手柄106期间，在弹射装载于施夹器100内的最后一个夹子时，以数字“0”的形式表示的刻度盘的标记192b完全移入到形成于半外壳104b中的窗口104c的视野中，从而向用户指示施夹器100中不再有夹子了。如在图19A和19B中可见，当刻度盘192已经旋转至所述位置时，形成在计数器刻度盘192的内缘的外周边上的凹槽192g旋转至与锁定件146的第一掣子146b配准。在所述位置，作用于锁定件146上的偏压构件147促使锁定件146的第一掣子146b进入到刻度盘192的凹槽192g中。
此外，在当前位置，锁定件146的第二掣子146c移入到形成在齿条构件141的侧边缘中的凹口141c内，并因此进入到齿条构件141的近侧平移的路径中。因此，当释放手柄106且驱动销124使齿条构件141在近侧方向上开始移动时，齿条构件141的凹口141c接合锁定件146的第二掣子146c，从而禁止齿条构件141返回到最近侧位置或原位置。在禁止或阻止齿条构件141返回到最近侧位置的情况下，防止棘轮机构144的棘爪142(见图5)使其本身复位。由于防止棘爪142使其本身复位，因此手柄106不能被再次致动或再次扳动，因为它们仅仅部分打开。再次，可以参考下述申请：于2008年8月25日提交的、申请号为61/091,467、名称为“Surgical Clip Applier(外科施夹器)”的美国临时申请；于2008年8月25日提交的、申请号为61/091,485、名称为“Surgical Clip Applier and Method of Assembly(外科施夹器及其装配方法)”的美国临时申请；以及于2009年12月15日提交的、申请号为61/286,569、名称为“Surgical Clip Applier(外科施夹器)”(Attorney Docket No.H-US-02062(203-6802))的美国临时申请，这些申请用于详细讨论外科施夹器100的各种零件的结构、操作和装配方法。
应该理解的是，之前的描述仅仅是本公开示意性的描述。在不脱离本公开的情况下，所属领域技术人员可设计多种变形和修改。因此，本公开旨在包含所有这些变形、修改和变化。参考随附的附图描述的实施例仅仅展示了本公开的特定实例。其它非实质性不同于以上描述和/或附加的权利要求的元件、步骤、方法和技术也希望包括在本公开的范围内。
Claims (13)
1.一种外科施夹器，其包括：
外壳；
至少一个手柄，其可枢转地连接到所述外壳上；
通道组件，其从所述外壳向远侧延伸出；
多个夹子，它们装载于夹子承载器中；
驱动通道，其可平移地支撑在所述外壳和所述通道组件中，所述驱动通道基于所述至少一个手柄的致动而平移；以及
计数器机构，其支撑在所述外壳中，所述计数器机构包括通过所述外壳可视的标记，其中所述标记与装载于所述施夹器中的夹子的数量相对应，其中当所述施夹器每次弹射导致所述多个夹子中剩余夹子的数量减少时，所述标记递减，
其中，所述计数器机构可旋转地支撑在所述外壳中，并且包括：
计数器刻度盘，其可旋转地支撑在所述外壳中，其中所述计数器刻度盘包括所述标记；以及
计数器离合器，其可操作地连接到所述计数器刻度盘上，允许所述计数器刻度盘在单一方向上旋转，以使所述计数器离合器在第一方向上的旋转导致所述计数器刻度盘在所述第一方向上的旋转，并且使所述计数器离合器在第二方向上的旋转不会导致所述计数器刻度盘的旋转，
其中，所述计数器离合器同心地、可旋转地嵌套于限定在所述计数器刻度盘中的镗孔内，并且其中所述计数器离合器包括从其延伸出的至少一个弹性指状部，用于与形成在所述计数器刻度盘的镗孔的周边表面中的单向齿接合。
2.根据权利要求1所述的施夹器，其中，所述计数器机构包括与所述计数器刻度盘可操作地接合的闩构件，其中，所述闩构件允许所述计数器刻度盘在所述第一方向上旋转，并且禁止所述计数器机构在与所述第一方向相反的方向上旋转。
3.根据权利要求2所述的施夹器，其中，所述计数器刻度盘包括形成在其外周边的多个凹槽，并且所述闩构件包括与所述计数器刻度盘的多个凹槽偏压接合的弹性指状部。
4.根据权利要求1所述的施夹器，其中，所述驱动通道在其中限定了倾斜狭槽，并且其中所述计数器离合器包括从其表面延伸出并且可滑动地配置在所述驱动通道的倾斜狭槽中的离合器销，其中所述驱动通道相对于所述计数器机构在第一方向的平移致使所述离合器销通过所述驱动通道的倾斜狭槽而做凸轮运动，从而使所述计数器离合器在第一方向上旋转，并且所述驱动通道相对于所述计数器机构在第二方向上的平移致使所述离合器销通过所述驱动通道的倾斜狭槽而做凸轮运动，从而使所述计数器离合器在第二方向上旋转。
5.根据权利要求4所述的施夹器，其中所述计数器机构包括与所述计数器刻度盘可操作地接合的闩构件，其中所述闩构件允许所述计数器刻度盘在第一方向上旋转，并且禁止所述计数器机构在与所述第一方向相反的方向上旋转。
6.根据权利要求5所述的施夹器，其中所述计数器刻度盘包括形成在其外周边上的多个凹槽，并且所述闩构件包括与所述计数器刻度盘的多个凹槽偏压接合的弹性指状部。
7.根据权利要求1所述的施夹器，其中，所述计数器机构包括：
计数器刻度盘，其限定了形成在其外周边缘上的锁定凹槽；以及
锁定件，其支撑在所述外壳中，所述锁定件被偏压以使其第一掣子紧密接合所述计数器刻度盘的外周边缘，
其中，当所述计数器刻度盘旋转且所述计数器刻度盘的所述锁定凹槽与所述锁定件的第一掣子达到配准时，促使所述锁定件的第一掣子进入到所述锁定凹槽中，从而防止所述计数器刻度盘在相反的方向上旋转。
8.根据权利要求7所述的施夹器，其中，所述锁定件包括第二掣子，并且其中当所述锁定件的第一掣子移动到所述计数器刻度盘的锁定凹槽中时，所述第二掣子移动到施夹器的平移构件的路径中，从而禁止所述施夹器的所述平移构件的平移。
9.根据权利要求8所述的施夹器，其中，当所述多个夹子中的最后一个夹子已经被弹射出时，所述计数器刻度盘的锁定凹槽移动成与所述锁定件的第一掣子配准。
10.根据权利要求9所述的施夹器，其中，所述计数器刻度盘的锁定凹槽与所述计数器机构上指示最后一个夹子已经被弹射出的标记关联。
11.根据权利要求10所述的施夹器，其中，所述计数器机构上指示所述多个夹子中的最后一个夹子已经被弹射出的标记由数字“0”来表示。
12.根据权利要求8所述的施夹器，进一步包括棘轮机构，其包括：
棘爪，其可枢转地支撑在外壳中；以及
齿条构件，其设置在所述平移构件上，其中所述齿条构件与所述棘爪可操作的配准，并且其中随着所述平移构件平移，所述齿条构件平移通过所述棘爪。
13.根据权利要求12所述的施夹器，其中当所述齿条构件还未完成一次完整平移时，防止所述棘轮机构复位。
Applications Claiming Priority (4)
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| US61/285,006 | 2009-12-09 | ||
| US12/939,296 US9186136B2 (en) | 2009-12-09 | 2010-11-04 | Surgical clip applier |
| US12/939,296 | 2010-11-04 |
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| CN102090911A CN102090911A (zh) | 2011-06-15 |
| CN102090911B true CN102090911B (zh) | 2014-12-03 |
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| CN201010589177.1A Active CN102090911B (zh) | 2009-12-09 | 2010-12-09 | 外科施夹器 |
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| US (3) | US9186136B2 (zh) |
| EP (2) | EP2332471B1 (zh) |
| JP (2) | JP5721414B2 (zh) |
| CN (1) | CN102090911B (zh) |
| AU (1) | AU2010241454A1 (zh) |
| CA (1) | CA2720558A1 (zh) |
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2010
- 2010-11-04 US US12/939,296 patent/US9186136B2/en active Active
- 2010-11-12 CA CA2720558A patent/CA2720558A1/en not_active Abandoned
- 2010-11-16 AU AU2010241454A patent/AU2010241454A1/en not_active Abandoned
- 2010-12-07 JP JP2010273070A patent/JP5721414B2/ja not_active Expired - Fee Related
- 2010-12-08 EP EP10252079.8A patent/EP2332471B1/en active Active
- 2010-12-08 EP EP12161291.5A patent/EP2471470B1/en active Active
- 2010-12-09 CN CN201010589177.1A patent/CN102090911B/zh active Active
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2014
- 2014-09-19 JP JP2014190735A patent/JP2015016354A/ja active Pending
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2015
- 2015-10-14 US US14/882,535 patent/US10004502B2/en active Active
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2018
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| US10758234B2 (en) | 2020-09-01 |
| CA2720558A1 (en) | 2011-06-09 |
| US9186136B2 (en) | 2015-11-17 |
| JP2011120908A (ja) | 2011-06-23 |
| EP2332471A1 (en) | 2011-06-15 |
| US20110137323A1 (en) | 2011-06-09 |
| EP2471470B1 (en) | 2013-07-31 |
| US20160030045A1 (en) | 2016-02-04 |
| CN102090911A (zh) | 2011-06-15 |
| JP2015016354A (ja) | 2015-01-29 |
| EP2471470A1 (en) | 2012-07-04 |
| US20180263624A1 (en) | 2018-09-20 |
| EP2332471B1 (en) | 2013-05-01 |
| US10004502B2 (en) | 2018-06-26 |
| JP5721414B2 (ja) | 2015-05-20 |
| AU2010241454A1 (en) | 2011-06-23 |
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