CN102440814A - 用于手术器械的组织止挡件 - Google Patents
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Abstract
本发明公开了一种用于手术连接组织的手术器械，尤其是用于手术器械的组织止挡件。手术器械包括：手柄组件；细长部，其从手柄组件向远侧延伸出；一对相对的钳夹构件以及组织止挡件。组织止挡件与第一钳夹构件机械地接合并且构造为保持一对相对的钳夹构件之间的组织。组织止挡件能够在第一位置和第二位置之间运动，在第一位置处，组织止挡件的止挡部设置在第一钳夹构件的组织接触表面和第二钳夹构件的组织接触表面之间，在第二位置处，所述止挡部处于第一钳夹构件的组织接触表面和第一钳夹构件的下表面之间。组织止挡件的一部分由模压金属段制成并且组织止挡件的一部分由包覆成型塑料段制成。
Description
相关申请的引用
本申请要求于2010年10月1日提交的序列号为61/388,650的美国临时申请的权益和优先权，其全部内容通过引用合并于此。
技术领域
本公开通常涉及手术器械，并且尤其涉及用于手术连接组织的手术器械。
背景技术
本领域公知的手术吻合器械用于施加并排吻合钉穿过被压紧的活组织。这些手术器械通常用于在处理或切除之前闭合组织或器官、用于在胸部及腹部手术中封闭器官，及用于在吻合术中固定组织。
一般地，这样的手术吻合器械包括：砧座组件；用于支撑一批手术吻合钉的钉仓组件；用于使砧座及钉仓和砧座组件相接近的接近机构；以及用于使手术吻合钉从钉仓组件中射出的发射机构。
使用中，外科医生通常先使砧座构件及钉仓构件相接近。然后，外科医生能够启动器械以将吻合钉钉入组织。另外，外科医生可以使用同一器械或单独的器械来切割邻近吻合钉排或者在吻合钉排之间的组织。在特定的手术吻合器械中，在砧座及钉仓接近时，器械从吻合钉钉仓顺序地射出吻合钉。吻合钉被驱动穿过组织并且对着砧座成形。
发明内容
本公开涉及一种用于手术连接组织的手术器械。所述手术器械包括手柄组件、细长部、一对相对的钳夹构件和组织止挡件。手柄组件包括活动手柄。细长部从所述手柄组件向远侧延伸出并且限定纵轴线。一对相对的钳夹构件可操作地联接至所述细长部并且从其向远侧延伸出。所述一对相对的钳夹构件包括第一钳夹构件和第二钳夹构件。组织止挡件与所述第一钳夹构件机械地接合并且构造为保持所述一对相对的钳夹构件之间的组织。所述组织止挡件能够在第一位置和第二位置之间运动，在所述第一位置处，所述组织止挡件的止挡部设置在所述第一钳夹构件的组织接触表面和所述第二钳夹构件的组织接触表面之间，在所述第二位置处，所述止挡部处于所述第一钳夹构件的组织接触表面和所述第一钳夹构件的下表面之间。所述组织止挡件的一部分由模压金属段制成并且所述组织止挡件的一部分由包覆成型(overmolded)塑料段制成。
在公开的实施例中，所述组织止挡件的止挡部包括缺口部。在公开的实施例中，所述组织止挡件的缺口部包括多个间隔开的半圆形凹口。
在公开的实施例中，所述组织止挡件包括一对侧向壁。在公开的实施例中，所述止挡部设置在每个侧向壁的近侧边缘上。
本公开还涉及一种构造为与手术器械可拆卸地接合的装载单元，所述装载单元包括主体部、一对钳夹构件和组织止挡件。主体部限定了纵轴线并且包括构造为与所述手术器械的细长部可拆卸地接合的近侧部。所述一对钳夹构件从所述主体部向远侧延伸出。钳夹构件中的至少一个能够相对于另一个在打开位置和与其间的身体组织相接合的接近位置之间运动。所述一对钳夹构件包括第一钳夹构件和第二钳夹构件。所述组织止挡件与所述第一钳夹构件机械地接合并且构造为保持所述一对相对的钳夹构件之间的组织。所述组织止挡件能够在第一位置和第二位置之间运动，在所述第一位置处，所述组织止挡件的止挡部设置在所述第一钳夹构件的组织接触表面和所述第二钳夹构件的组织接触表面之间，在所述第二位置处，所述止挡部处于所述第一钳夹构件的组织接触表面和所述第一钳夹构件的下表面之间。所述组织止挡件的一部分由模压金属段制成并且所述组织止挡件的一部分由包覆成型塑料段制成。
在公开的实施例中，所述组织止挡件的止挡部包括缺口部。在公开的实施例中，所述组织止挡件的缺口部包括多个间隔开的半圆形凹口。
在公开的实施例中，所述装载单元的组织止挡件包括一对侧向壁。在公开的实施例中，所述止挡部设置在每个所述侧向壁的近侧边缘上。
本公开还涉及一种用于与手术器械一起使用的组织止挡件。所述组织止挡件包括模压金属部和包覆成型塑料部。所述组织止挡件与所述手术器械的钳夹构件机械地接合，并且构造为保持所述手术器械的相对的钳夹构件之间的组织。
在公开的实施例中，所述组织止挡件包括一对侧向壁。在公开的实施例中，所述止挡部设置在每个侧向壁的近侧边缘上。在公开的实施例中，所述止挡部包括缺口部。在公开的实施例中，所述组织止挡件的缺口部包括多个间隔开的半圆形凹口。
附图说明
此处参照附图公开本公开的手术器械的不同实施例，其中：
图1是根据本公开的手术器械的立体图；
图2是图1的手术器械的装载单元的立体图；
图3是图2的细节区域的立体图，图示出组织止挡件；
图4是包括图3的组织止挡件的手术器械的钳夹构件的远侧部的立体分解图；
图5是与手术器械的钳夹构件机械地接合的组织止挡件的纵向剖视图；
图6是钳夹构件和组织止挡件的一部分在插入组织之前的侧视图；
图7至图9是根据本公开的另一个实施例的钳夹构件和组织止挡件的一部分在各个操作阶段与组织相互作用的纵向剖视图；
图10是根据本公开的另一个实施例的装载单元的立体组装图；
图11和图12是根据本公开的实施例的包括用于与图1的手术器械一起使用的模压金属部和包覆成型塑料部的组织止挡件的立体图；
图13是图11和图12的组织止挡件的模压金属部的立体图；
图14至图17是图11和图12的组织止挡件的模压金属部的各种视图。
具体实施方式
参照附图详细描述本公开的手术器械的实施例，其中相似的附图标记表示附图中的每一幅附图中相似或者相同的元件。在附图以及下面的描述中，术语“近侧”指的是手术器械最靠近操作者的一端，而术语“远侧”指的是手术器械离操作者最远的一端。
本领域技术人员可以理解的是，虽然所描述的手术器械射出吻合钉，但是其也可以适于射出诸如夹子和两部分式(two-part)紧固件等其他任意适合的紧固件。另外，所公开的止挡构件可以与电手术镊一起使用。在于2003年2月20日提交的、名称为“脉管密封件和驱动器及其制造方法(VESSELSEALER AND DIVIDER AND METHOD OF MANUFACTURING)”、申请号为10/369,894的共有专利申请中描述了电手术镊的进一步的细节，其全部内容通过引用合并于此。
参照图1，附图标记100表示本公开的手术器械的一个实施例。为了简洁，本公开的重点是手术器械100的末端执行器和组织挡构件。于2007年11月28日提交的公开号为2008/0105730的美国专利申请；2008年1月8日提交的公开号为2008/0110960的美国专利申请；2008年1月24日提交的公开号为2008/0142565的美国专利申请；2007年10月15日提交的公开号为2008/0041916的美国专利申请；以及2007年4月10日提交的申请号为11/786,198的美国专利申请详细描述了其他手术紧固组件的结构和操作，这些在先申请的全部内容通过引用合并于此。
在图示的实施例中公开的手术器械100被构造为夹紧、固定和/或切割组织。一般地，如图1所示，手术器械100包括手柄组件110、从手柄组件110向远侧延伸并限定纵轴线“A-A”的细长部120，及装载单元180(共同指单次使用装载单元(“SULU”)和一次性装载单元(“DLU”))。参照图2，装载单元180包括近侧主体部156和工具组件150。近侧主体部156被构造为使用多种连接结构可拆卸地连接至手术器械100的细长部120，连接结构例如为卡口式联接、掣子、制动器(detent)或者搭扣配合(snap-fit)。在其他的实施例中，器械具有持久地连接至细长部的钳夹，并且诸如吻合钉钉仓的可替换钉仓能够在钳夹的一个中被装载、移除和重新装载。
工具组件150包括末端执行器154和组织止挡件170。邻近于主体部156的远侧部124设置的末端执行器154包括第一钳夹构件130和第二钳夹构件140。如图1和图2所示，第一钳夹构件130和第二钳夹构件140中的每一个相对于纵轴线“A-A”纵向地弯曲。与笔直的钳夹构件相比，弯曲的钳夹构件例如在低位前切除(“LAR”)期间，可以有助于进出下骨盆区。此外，带弯曲的钳夹构件可允许增加手术部位的可见性，并且还可使得外科医生有更多的空间用他或者她的手操作目标组织或者这些钳夹构件本身。虽然图示出的实施例将钳夹构件描述为弯曲的，但是可以设想并且在本公开的范围内的是：组织止挡件170可以与线性钳夹构件一起使用。
钳夹构件130、140中的至少一个适于相对于另一个钳夹构件(130或者140)在分开和接近位置之间运动。在图示出的实施例中，第一钳夹构件130包括钉仓组件132，并且第二钳夹构件140包括砧座组件142。例如，当致动活动手柄112时，砧座组件142相对于钉仓组件132在分开位置与接近位置之间运动。虽然钉仓组件132示出为能够相对于砧座组件142可枢转地活动，但是砧座组件142可以相对于钉仓组件132可枢转地安装。
手柄组件110包括静止手柄114及活动手柄112。活动手柄112适于朝向或者远离静止手柄114可枢转地运动。而且，活动手柄112通过一机构可操作地连接至砧座组件142，该机构适于将活动手柄112的至少一部分致动转化为钉仓组件132及砧座组件142中至少一个在分开位置与接近位置之间的枢转运动。如本领域技术人员所认识到的，任何常规的致动机构都可以用于将活动手柄112可操作地接合至工具组件150。
参照图2，钉仓组件132具有组织接触面134及多个紧固件保持槽(fastener retaining slot)136。组织接触面134大致面对砧座组件142，并且在操作过程中，当砧座组件142与钉仓组件132接近时，组织接触面134接合组织。紧固件保持槽136沿着组织接触面134成排地排列，并且每个紧固件保持槽136适于可拆卸地保持紧固件(未示出)。例如，当活动手柄112朝向固定手柄114枢转时，紧固件从紧固件保持槽136中被射出并朝向砧座组件142运动。
钉仓组件132还具有适于可滑动地容纳刀具(未示出)或者其他任何适合的切割工具的刀槽138(图3)。刀槽138限定在吻合钉钉仓中，设置在紧固件保持槽136的排间，并沿着组织接触面134延伸。在操作中，当活动手柄112朝固定手柄114枢转时，刀具滑动通过刀槽138。可选地，能够使用其他机构来驱动刀具通过刀槽138。
在公开的实施例中，手柄组件110包含致动机构，该致动机构用于从保持槽136中展开紧固件并沿着刀槽138推进刀具。该致动机构包括可操作地连接至活动手柄112的发射杆(未示出)。在操作中，活动手柄112朝向固定手柄114的枢转导致发射杆向远侧前进。发射杆接下来可操作地连接到至少部分位于工具组件150中的轴向传动组件。轴向传动组件被配置为响应发射杆向远侧的平移而向远侧运动。轴向传动组件包括传动梁，传动梁包含刀具、上构件和下构件。因为传动梁的上构件与砧座组件相接合，并且传动梁的下构件与钉仓组件相接合，所以轴向传动组件向远侧的平移导致砧座组件142朝向钉仓组件132枢转。另外，轴向传动组件向远侧方向推动设置在钉仓组件132中的致动滑块(actuation sled)，而致动滑块向远侧平移通过末端执行器154。随着致动滑块向远侧前进通过钉仓组件132，该致动滑块促使紧固件脱离紧固件保持槽136。在特定的实施例中，轴向传动组件包括安装在其远侧部上的刀具或者刀片。在操作中，当轴向传动组件向远侧运动通过末端执行器154时，包括刀具的传动梁运动通过刀槽138。在共同属于Milliman等人的第6，953，139号美国专利中详细描述了内窥镜手术吻合器械的进一步细节，其全文通过引用合并于此。然而，还可以设想的是，其他使钳口构件相互接近的方法也是可用的，包括使夹紧杆(clamp bar)(未示出)滑动。可考虑到射出紧固件的其他方法，例如考虑到凸轮杆。
参照图3和图4，组织止挡件170至少部分地可活动地设置在凹槽164内，所述凹槽164限定在钳夹构件130的远侧部中。术语“远侧”典型地指器械的远离用户的部分或者构件。如此处所使用的，术语“远侧”和“近侧”将考虑本公开的手术器械的弯曲部分的曲率。例如，“远侧”将指弯曲部分沿着由弯曲部分限定的轨线最远离用户的部分。也即是说，虽然在使用期间弯曲部分的中间部可能更远离用户，但是弯曲部分沿着其纵轴线最远的部分被认为是“远侧”。
钳夹构件130的远侧部限定凹槽164并且包括近侧壁165、一对侧壁166、168和下表面169。组织止挡件170包括主体172，主体172具有构造为和适于接合组织(例如从钳夹构件之间向远侧指向的组织)的上组织接触表面174、一对侧向壁176、178和止挡部182。
还公开了包括近侧凸轮销184和远侧凸轮销186的一对凸轮销。每个凸轮销184、186均构造为横向地贯穿主体172的两个侧向壁176、178。近侧凸轮销184构造为贯穿主体172的第一对孔177(在侧向壁176上仅示出了一个孔177；穿过侧向壁178设置的孔在图4中不可见)，并且构造为接合一对近侧凸轮槽196，所述近侧凸轮槽196至少部分地贯穿凹槽164的每个侧壁166、168。远侧凸轮销186构造为贯穿主体172的第二对孔179(在侧向壁176上仅示出了一个孔179；穿过侧向壁178设置的孔在图4中不可见)，并且构造为接合一对远侧凸轮槽198，所述远侧凸轮槽198至少部分地贯穿凹槽164的每个侧壁166、168。如能够理解的，凸轮销184、186、钳夹构件130和组织止挡件170之间的接合将组织止挡件170可活动地紧固至钳夹构件130。
在图示出的实施例中，远侧凸轮槽198大致上平行于钳夹构件130的组织接触表面134，并且近侧凸轮槽196相对于钳夹构件130的组织接触表面134成一定角度。可以设想的是：近侧凸轮槽196包括至少一个弯曲部、至少一个线性部，或者至少一个弯曲部和至少一个线性部的组合。凸轮槽196、198的图示出的构造使得组织止挡部182能够移进和移出邻近于近侧壁165的凹槽164，其中在其间具有减小的隙距“G”(见于图5)。还设想为：在当组织止挡件170从第一位置运动到第二位置时的每个时刻，可以使隙距“G”减小。能够使用其他凸轮布置将组织止挡件连接至钳夹。凸轮的形状为能够在组织止挡件从钳夹(第一位置)延伸时使得组织止挡件的高度最大，和/或当组织止挡件位于收缩的第二位置中时使得由组织止挡件占据的钳夹内的空间最小。
如图5所示，组织止挡件170还包括偏置构件173。偏置构件173构造为机械地接合凸轮销186，以及机械地接合贯穿钳夹构件130的每个侧壁166、168上的开口190(见图4)的支撑销158。然而，还可以考虑到的是，诸如柱等任何其他的保持构件可以代替支撑销158来保持偏置构件173的一端。偏置构件173将远侧凸轮销186推向其在凸轮槽198内最近侧的位置。响应于远侧凸轮销186被向近侧推动，近侧凸轮销184也由于凸轮销184、186、偏置构件173和组织止挡件170之间的机械关系而被向近侧推动。当凸轮销184、186分别处于其在凸轮槽196、198内的最近侧的位置处时，组织止挡件170位于第一位置，在第一位置处，止挡部182露出并且至少部分地延伸出凹槽164，即，设置在钉仓和砧座组件132、142相应的组织接触表面134、135之间(例如参见图5)。
组织止挡件170能够在如图5所示的第一位置和如图8所示的第二位置之间运动。在对应于当钳夹构件130、140处于打开位置处时的第一位置处，止挡部182的至少一部分(诸如大部分或者整个部分)露出凹槽164。钳夹构件130、140的接近使得组织止挡件170朝向其第二位置运动。也即是说，因为一个钳夹构件(诸如钳夹构件140)朝向另一个钳夹构件(诸如钳夹构件130)运动，组织接触表面135接触组织止挡件170的组织接触表面174，并且克服偏置构件173的偏置物理地将组织止挡件170推向其第二位置。在对应于当钳夹构件130、140处于接近的位置时的第二位置处，止挡部182的大部分(诸如全部)设置在凹槽164内。在这个实施例中，当组织止挡件170设置在第一位置处时，止挡部182相对于组织接触部134正交地设置(诸如大致垂直)。能够理解的是，这种方位可以有助于阻止组织向远侧脱离工具组件150。在其他实施例中，器械能够包括连接至组织止挡件的致动器以使得用户能够通过操作按钮或者杠杆使得组织止挡件在第一位置和第二位置之间运动。这种致动器还可以包括用于锁止组织止挡件的位置的锁和/或闩。
在使用中，如图6所示，外科医生最初使得手术吻合器械100邻近于目标组织定位。这里，组织止挡件170位于第一位置处，在第一位置处，钳夹构件130、140处于打开位置处并且止挡部182的至少一部分露出凹槽164。然后组织“T”被引入到工具组件150中，在钳夹构件130、140之间。如图6所示，由组织止挡件170的上组织接触表面174限定的角度利于在箭头“B”的大致方向上将组织“T”引入工具组件150中。如图7所示，由于组织“T”被向近侧插入到工具组件150中，所以组织“T”与组织止挡件170相接触并且可以迫使止挡部182的至少一部分在箭头“C”的大致方向上进入凹槽164中。在特定实施例中，组织止挡件具有面对钳夹的开口端的倾斜表面以促进组织移动组织止挡件。可选地，组织“T”通过在钳夹构件140的组织接触表面135和组织止挡件170的组织接触表面174之间的空间中移动，可以向近侧插入到钳夹构件130、140之间而不需要接触止挡构件170。
当组织止挡部182被朝向其第二位置移动时，组织止挡部182在箭头“C”的大致方向上移动(图7)。由于组织止挡部182在箭头“C”的大致方向上平移，所以远侧凸轮销186在箭头“E”的大致方向上沿着远侧凸轮槽198向远侧平移(图7)，而近侧凸轮销184在箭头“D”的大致方向上沿着近侧凸轮槽184向远侧滑动(图7)。
在外科医生已经将组织“T”的至少一部分置于钳夹构件130、140之间之后，外科医生能够诸如通过使得活动手柄112朝向静止手柄114枢转而致动接近机构，以使得砧座组件142朝向钉仓组件132接近，从而抓住组织接触表面134、135之间的组织“T”，如图8所示。这里，组织止挡件170的组织接触表面174的近侧部大致上与钉仓组件132的组织接触表面134相平齐，并且砧座组件142朝向凹槽164对止挡构件170施加力(穿过组织“T”)。响应于由砧座组件142施加到组织止挡件170上的力，凸轮销186在箭头“E”的大致方向上沿着凸轮槽198向远侧更进一步地平移，直至凸轮销186处于凸轮槽198的最远侧部处。此外，凸轮销184在箭头“H”(图8)的大致方向上沿着凸轮槽196向远侧更进一步地滑动，直至凸轮销184克服偏置构件173的偏置到达凸轮槽196的最远侧部。组织“T”现在被插入在钳夹130、140之间，并且可以由外科医生在箭头“F”的大致方向上更进一步地向近侧推进(图7至图9)。由于组织“T”的远端在大致“F”的方向上向组织止挡件170的近侧推动，所以由偏置构件173施加的偏置力在箭头“I”的大致方向上朝向(并且可能是对着)砧座组件142的组织接触表面135推动组织止挡件170。这里，凸轮销184、186分别沿着凸轮槽196、198与组织“T”的厚度成比例地向近侧运动。
在图9示出的实施例中，组织止挡件170与组织接触表面135相接触并且位于组织“T”的远侧，从而阻止或者防止组织“T”的任何远侧脱离。此时，外科医生可以在组织“T”上实施手术操作，诸如吻合、密封和/或切割组织“T”。在实施手术操作之后，使钳夹构件140运动离开钳夹构件130，并且组织止挡件170响应于偏置力回到其第一位置。
参照图10，图示出了根据本公开另一个实施例的装载单元500。装载单元500包括近侧主体部556和工具组件550。近侧主体部556可拆卸地连接至细长部120的远端。工具组件550包括一对钳夹构件，钳夹构件包括砧座组件542和钉仓组件532。特别地是，钉仓组件532相对于砧座组件是可枢转的，并且能够在打开(或者未夹紧)位置以及闭合(或者接近)位置之间运动。
砧座组件542包括纵向弯曲的砧座盖543和纵向弯曲的砧座板544，其限定了多个吻合钉成形凹陷(staple forming depression)。当工具组件550处于接近位置处时，吻合钉成形凹陷定位成与钉仓组件532并列地对齐。钉仓组件532包括纵向弯曲的托架537，所述弯曲的托架537经由诸如搭扣配合连接来容纳纵向弯曲的钉仓件518。钉仓件518包括放置在托架537的侧壁539上的一对支撑支架519，以使得钉仓件518稳定在托架537上。托架537的外表面包括成角度的凸轮表面516a。
钉仓件518限定多个侧向间隔的吻合钉保持槽536。每个槽536均构造为将吻合钉630容纳在其中。钉仓件518包括中央纵向弯曲槽538。随着致动滑块541运动穿过钉仓件518，致动滑块541的凸轮楔541a顺序地接合推动器632以使得推动器632在吻合钉保持槽536内竖直地移动并且将吻合钉630发射到砧座板544的吻合钉成形凹陷中。在从保持槽536发射吻合钉630之后，随着切割边缘606a行进穿过钉仓件518的弯曲槽538，动态夹紧构件606的切割边缘606a切断吻合的组织。
继续参照图10，近侧主体部556包括由模制的半部503a和503b形成的内部主体503和传动组件560。近侧主体部556通过安装组件570联接至工具组件550。安装组件570具有延伸进托架537的近侧端中的一对延伸部576。每个延伸部576具有与托架539的孔516A对准的横向孔578，以使得安装组件570通过托架539可枢转地紧固至钉仓件518。安装组件570通过一对竖直凸起584固定地紧固至半部503a。竖直凸起584从安装组件570向上延伸并且摩擦地配合到半部503a中的相应的凹槽中。
砧座盖543包括向近侧延伸的指状物588，指状物588具有形成在其中的一对切口589。切口589定位在指状物588的每个横向侧面上以协助将砧座盖紧固至半部503a。半部503a包括具有一对凸起505a的沟槽505。砧座盖的指状物588机械地接合半部503a的沟槽505，以使得切口589与凸起505a对准。外套筒602覆盖指状物588和沟槽505。指状物588和沟槽505的构造有利于砧座盖543和半部503a之间的紧固连接。此外，该连接导致了砧座组件542相对于近侧主体部556不可活动(诸如不可枢转)。
传动组件560包括柔性传动梁604和近侧接合部608，柔性传动梁604由三块堆叠的金属板604a至604c构造而成。传动梁604的至少一部分具有足够的柔性以被推动穿过工具组件550的弯曲部分。传动梁604具有紧固至动态夹紧构件606的远端。动态夹紧构件606包括在竖直支架606d的远侧面处的刀具或者切割边缘606a。
装载单元500包括至少部分地可活动地设置在凹槽764内的组织止挡件770，所述凹槽764限定在钉仓件518的远侧部中。凹槽764由近侧壁765、一对侧壁766、768和下表面限定。组织止挡件770包括主体772，主体772具有上组织接触表面、一对侧向壁和构造为和适于接合组织的止挡部782。近侧凸轮销758和远侧凸轮销786均构造为横向地贯穿主体772的两个侧向壁766、768。近侧凸轮销758构造为贯穿主体772的第一通孔777，并且构造为接合一对近侧凸轮槽796，所述一对近侧凸轮槽796至少部分地贯穿每个侧壁766、768。远侧凸轮销786构造为贯穿主体772的第二通孔779，并且构造为接合一对远侧凸轮槽798，所述一对远侧凸轮槽798至少部分地贯穿每个侧壁766、768。还可考虑至少一个796、798仅限定在侧壁766、768中的一个中。
组织止挡件770还包括偏置构件773。偏置构件773构造为机械地接合凸轮销786以及机械地接合支撑销784，支撑销784贯穿在钉仓组件532的每个侧壁766、768上的开口790(见图4)。偏置构件773将远侧凸轮销786推向其在凸轮槽798内最近侧的位置。响应于远侧凸轮销786在近侧方向上的推动，近侧凸轮销758由于凸轮销758、786、偏置构件773和组织止挡件770之间的机械关系也被向近侧推动。当凸轮销758、786分别处于其在凸轮槽796、798内最近侧的位置中时，止挡部782露出并且至少部分地延伸出凹槽764。装载单元500的操作大致上与上文的描述相类似，并且出于简洁而将被省略。
参照图11至17，图示出了根据本公开的另一个实施例的组织止挡件1000。组织止挡件1000由两部分制成：模压金属段1100和包覆成型塑料段1200。图13至图17图示出了模压金属段1100，并且在图11至图12中图示出了至少部分地覆盖模压金属段1100的包覆成型塑料段1200。组织止挡件1000的多块设计提供了金属的强度，同时允许适于塑料注射成型的复杂几何形状。虽然组织止挡件1000的特定部分是示出为由模压金属制成的，但是可以设想并且在本公开的范围内的是：模压金属部1100能够包括整个组织止挡件1000的更多或者更少的部分。类似地，包覆成型塑料段1200还可以包括比图示出的整个组织止挡件1000更多或者更少的部分。
组织止挡件1000包括主体1010，所述主体1010具有上组织接触表面1020、一对侧向壁1030、1040和构造为并且适于接合组织(诸如从钳夹构件之间向远侧指向的组织)的止挡部1050。组织止挡件1000的止挡部1050包括缺口部1060，所述缺口部包括多个间隔开的半圆形凹口。更具体地，缺口部1060设置在每个侧向壁1030、1040的近侧边缘上。如能够理解的，缺口部1060构造为协助防止组织相对于组织止挡件1000滑动。
如上文参照组织止挡件170所描述的，组织止挡件1000能够与凸轮销184、186一起使用，并且如图11和图12所示，组织止挡件1000还包括从主体1010横向地延伸的枢转凸起1400。枢转凸起1400构造为可枢转地接合钉仓组件的一部分以允许它们之间的枢转活动。
此外，在公开的实施例中，结合图1至图10描述的手术器械100和装载单元180包括模压/模制的组织止挡件1000。
可以理解的是，可以对本公开的手术器械进行各种修改。因此上述描述不能解释为限定性的，而仅是作为实施例的示例。本领域技术人员可以在本公开的范围和构思内设想其他的变化。
Claims (17)
1.一种用于手术连接组织的手术器械，所述手术器械包括：
手柄组件，其包括活动手柄；
细长部，其从所述手柄组件向远侧延伸出并且限定纵轴线；
一对相对的钳夹构件，其可操作地联接至所述细长部并且从其向远侧延伸出，所述一对相对的钳夹构件包括第一钳夹构件和第二钳夹构件；以及
组织止挡件，其与所述第一钳夹构件机械地接合并且构造为保持所述一对相对的钳夹构件之间的组织，所述组织止挡件能够在第一位置和第二位置之间运动，在所述第一位置处，所述组织止挡件的止挡部设置在所述第一钳夹构件的组织接触表面和所述第二钳夹构件的组织接触表面之间，在所述第二位置处，所述止挡部处于所述第一钳夹构件的组织接触表面和所述第一钳夹构件的下表面之间，其中，所述组织止挡件的一部分由模压金属段制成并且所述组织止挡件的一部分由包覆成型塑料段制成。
2.根据权利要求1所述的手术器械，其中，所述组织止挡件的止挡部包括缺口部。
3.根据权利要求2所述的手术器械，其中，所述组织止挡件的缺口部包括多个间隔开的半圆形凹口。
4.根据权利要求1所述的手术器械，其中，所述组织止挡件包括一对侧向壁。
5.根据权利要求4所述的手术器械，其中，所述止挡部设置在每个侧向壁的近侧边缘上。
6.根据权利要求5所述的手术器械，其中，所述止挡部包括缺口部。
7.一种构造为与手术器械可拆卸地接合的装载单元，所述装载单元包括：
主体部，其限定纵轴线，所述主体部包括构造为与所述手术器械的细长部可拆卸地接合的近侧部；
一对钳夹构件，其从所述主体部向远侧延伸出，钳夹构件中的至少一个能够相对于另一个在打开位置和与其间的身体组织相接合的接近位置之间运动，所述一对钳夹构件包括第一钳夹构件和第二钳夹构件；以及
组织止挡件，其与所述第一钳夹构件机械地接合并且构造为保持所述一对相对的钳夹构件之间的组织，所述组织止挡件能够在第一位置和第二位置之间运动，在所述第一位置处，所述组织止挡件的止挡部设置在所述第一钳夹构件的组织接触表面和所述第二钳夹构件的组织接触表面之间，在所述第二位置处，所述止挡部处于所述第一钳夹构件的组织接触表面和所述第一钳夹构件的下表面之间，其中，所述组织止挡件的一部分由模压金属段制成并且所述组织止挡件的一部分由包覆成型塑料段制成。
8.根据权利要求7所述的装载单元，其中，所述组织止挡件的止挡部包括缺口部。
9.根据权利要求8所述的装载单元，其中，所述组织止挡件的缺口部包括多个间隔开的半圆形凹口。
10.根据权利要求7所述的装载单元，其中，所述组织止挡件包括一对侧向壁。
11.根据权利要求10所述的装载单元，其中，所述止挡部设置在每个侧向壁的近侧边缘上。
12.根据权利要求11所述的装载单元，其中，所述止挡部包括缺口部。
13.一种用于与手术器械一起使用的组织止挡件，所述组织止挡件包括：
模压金属部；以及
包覆成型塑料部；
其中，所述组织止挡件与所述手术器械的钳夹构件机械地接合，并且构造为保持所述手术器械的相对的钳夹构件之间的组织。
14.根据权利要求13所述的组织止挡件，其中，所述组织止挡件包括一对侧向壁。
15.根据权利要求14所述的组织止挡件，其中，所述止挡部设置在每个侧向壁的近侧边缘上。
16.根据权利要求15所述的组织止挡件，其中，所述止挡部包括缺口部。
17.根据权利要求16所述的组织止挡件，其中，所述组织止挡件的缺口部包括多个间隔开的半圆形凹口。
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| US61/388,650 | 2010-10-01 | ||
| US13/208,447 US8899461B2 (en) | 2010-10-01 | 2011-08-12 | Tissue stop for surgical instrument |
| US13/208,447 | 2011-08-12 |
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| CN102440814A true CN102440814A (zh) | 2012-05-09 |
| CN102440814B CN102440814B (zh) | 2015-09-30 |
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| CN201110274276.5A Expired - Fee Related CN102440814B (zh) | 2010-10-01 | 2011-09-09 | 用于手术器械的组织止挡件 |
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| US (4) | US8899461B2 (zh) |
| EP (1) | EP2436319B1 (zh) |
| JP (2) | JP5944638B2 (zh) |
| CN (1) | CN102440814B (zh) |
| AU (1) | AU2011218637B2 (zh) |
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- 2011-08-29 AU AU2011218637A patent/AU2011218637B2/en not_active Ceased
- 2011-09-05 JP JP2011192771A patent/JP5944638B2/ja active Active
- 2011-09-09 ES ES11250785T patent/ES2778923T3/es active Active
- 2011-09-09 CN CN201110274276.5A patent/CN102440814B/zh not_active Expired - Fee Related
- 2011-09-09 EP EP11250785.0A patent/EP2436319B1/en active Active
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2014
- 2014-09-23 US US14/493,483 patent/US9901339B2/en active Active
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2015
- 2015-08-05 JP JP2015154714A patent/JP2015231557A/ja not_active Withdrawn
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2018
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2019
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| US10912556B2 (en) | 2011-10-26 | 2021-02-09 | Intuitive Surgical Operations, Inc. | Surgical instrument with integral knife blade |
| US11564681B2 (en) | 2011-10-26 | 2023-01-31 | Intuitive Surgical Operations, Inc. | Surgical instrument with integral knife blade |
| US10610223B2 (en) | 2011-11-15 | 2020-04-07 | Intuitive Surgical Operations, Inc. | Surgical instrument with stowing knife blade |
| US11350933B2 (en) | 2011-11-15 | 2022-06-07 | Intuitive Surigical Operations, Inc. | Surgical instrument with stowing knife blade |
| CN107518926A (zh) * | 2012-12-31 | 2017-12-29 | 直观外科手术操作公司 | 具有增大的刀间隙的外科手术钉仓 |
| CN107518926B (zh) * | 2012-12-31 | 2020-04-17 | 直观外科手术操作公司 | 具有增大的刀间隙的外科手术钉仓 |
| US10918387B2 (en) | 2012-12-31 | 2021-02-16 | Intuitive Surgical Operations, Inc. | Surgical staple cartridge with enhanced knife clearance |
| CN103860231A (zh) * | 2014-03-26 | 2014-06-18 | 中国人民解放军第三军医大学第二附属医院 | 腔镜下切割闭合器的执行头以及应用该执行头的直线切割闭合器 |
| CN103860231B (zh) * | 2014-03-26 | 2016-03-30 | 中国人民解放军第三军医大学第二附属医院 | 腔镜下切割闭合器的执行头以及应用该执行头的直线切割闭合器 |
| CN111479520A (zh) * | 2017-12-15 | 2020-07-31 | 爱惜康有限责任公司 | 用于与机电外科器械的适配器一起使用的具有正钳口打开特征部的端部执行器 |
Also Published As
| Publication number | Publication date |
|---|---|
| US10499910B2 (en) | 2019-12-10 |
| JP2012075868A (ja) | 2012-04-19 |
| EP2436319B1 (en) | 2020-02-12 |
| US20120080474A1 (en) | 2012-04-05 |
| US9901339B2 (en) | 2018-02-27 |
| US8899461B2 (en) | 2014-12-02 |
| US20180140298A1 (en) | 2018-05-24 |
| EP2436319A3 (en) | 2013-09-04 |
| AU2011218637B2 (en) | 2015-03-19 |
| US20200100784A1 (en) | 2020-04-02 |
| US20150008247A1 (en) | 2015-01-08 |
| JP5944638B2 (ja) | 2016-07-05 |
| CA2749735C (en) | 2019-04-02 |
| ES2778923T3 (es) | 2020-08-12 |
| JP2015231557A (ja) | 2015-12-24 |
| US11375998B2 (en) | 2022-07-05 |
| EP2436319A2 (en) | 2012-04-04 |
| AU2011218637A1 (en) | 2012-04-19 |
| CN102440814B (zh) | 2015-09-30 |
| CA2749735A1 (en) | 2012-04-01 |
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