CN102665574A - 具有电致动器定向控制组件的电机驱动的外科切割器械 - Google Patents
具有电致动器定向控制组件的电机驱动的外科切割器械 Download PDFInfo
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- A61B17/32—Surgical cutting instruments
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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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- H01H3/00—Mechanisms for operating contacts
- H01H3/02—Operating parts, i.e. for operating driving mechanism by a mechanical force external to the switch
- H01H3/16—Operating parts, i.e. for operating driving mechanism by a mechanical force external to the switch adapted for actuation at a limit or other predetermined position in the path of a body, the relative movement of switch and body being primarily for a purpose other than the actuation of the switch, e.g. for a door switch, a limit switch, a floor-levelling switch of a lift
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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Abstract
本发明提供了一种电机驱动的外科器械，所述电机驱动的外科器械具有控制组件以用于控制所述器械的开关。所述外科器械可以包括电机控制电路、传动构件和滑动件。所述传动构件包括位于第一位置处的第一肩部和位于第二位置处的第二肩部。所述滑动件的第一部分与所述传动构件相接口，使得当所述传动构件的第一肩部或所述第二肩部接合所述滑动件的第一部分时，所述滑动件可在所述传动构件的运动方向上运动。当所述传动构件使所述滑动件运动至相对于所述第一开关的第一位置时，所述滑动件的第二部分致动所述电机控制电路的开关。在各种实施例中，所述控制电路的所述开关并不作为IC的一部分来实施。
Description
背景技术
手术缝合器用于同时在组织中制造纵向切口和将成排的缝合钉施加到切口的相对侧。这种器械常常包括具有一对协同工作的钳口构件的端部执行器，如果意图将所述器械用于内窥镜式或腹腔镜式应用，则所述钳口构件能够穿过套管通道。钳口构件之一容纳有钉仓，钉仓具有横向间隔的至少两行缝合钉，每一行位于刀槽的一侧。另一钳口构件限定砧，所述砧具有与钉仓中的成行的缝合钉对齐的缝合钉成形凹陷部。器械具有多个往复式楔形件，当朝远侧驱动时，所述多个往复式楔形件穿过钉仓中的开口并且接合支承缝合钉的驱动器，以使缝合钉朝着砧击发。同时，切割器械(或刀)沿着钳口构件朝远侧拉动，使得被夹持的组织同时被切割和紧固(例如，被缝合)。
适用于内窥镜式应用的手术缝合器的一个实例描述于公开的美国专利申请公开No.2004/0232196A1标题为“Surgical stapling instrument havingseparate distinct closing and firing systems”(具有独立不同的关闭和击发系统的外科缝合器械)，该专利的公开内容全文以引用方式并入本文。在使用中，临床医生能够在组织上关闭缝合器的钳口构件，以在击发之前将组织定位。一旦临床医生确定钳口构件正确地抓住组织时，临床医生可随后击发手术缝合器，从而切断和缝合组织。同时切断和缝合组织的行为避免了当利用分别仅切断或缝合的不同的外科手术工具按次序执行这些行为时可能产生的并发症。
电机驱动的内腔切割器(endocutter)是本领域已知的。在这种装置中，电机为器械的切割和紧固行为提供动力。使用位于器械的手柄中的机载电池为电机提供动力也是已知的。同样，全文以引用方式并入本文的、标题为“Motor-driven surgical cutting and fastening instrument with loading forcefeedback”(具有加载力反馈的电机驱动的外科切割和紧固器械)的公开的美国专利申请公开No.2007/0175952A1描述了一种这样的电机驱动的外科器械。
在电机驱动的外科器械中，用于控制电机的操作的控制电路并不包括由半导体材料制成的任何集成电路(IC)有时是优选的，因为对包括IC的外科器械进行消毒通常是困难、复杂并且昂贵的。
发明内容
在一个大体方面中，本发明涉及电机驱动的外科器械，该电机驱动的外科器械具有用于控制器械的开关的控制组件。该开关可以是对电机进行控制的电路的一部分或者器械中的一些其它电路的一部分。在各种实施例中，该外科器械包括：(i)手柄；(ii)连接至手柄的端部执行器；(iii)位于手柄中的电机，该电机用于为端部执行器提供动力；(iv)电机控制电路，该电机控制电路连接至电机以用于控制电机；(v)由电机驱动的传动构件；以及(vi)滑动件。电机控制电路包括多个开关，所述多个开关包括具有可动(例如，可压低的)致动器(例如，柱塞)的第一开关。当由电机驱动时，传动构件致使端部执行器的可动部件运动，并且传动构件包括位于第一位置处的第一肩部和位于第二位置处的第二肩部。滑动件包括第一部分和第二部分。第一部分与传动构件相接口，使得当传动构件的第一肩部或第二肩部接合滑动件的第一部分时，滑动件可沿传动构件的运动方向运动。当传动构件使滑动件运动至相对于第一开关的第一位置时，滑动件的第二部分致动第一开关的可动致动器。在各种实施例中，控制电路的开关并不作为IC的一部分来实施。因此，在各种实施例中，电机控制电路并不包括集成电路。在各种实施例中，第一开关对电机的旋转方向进行控制。
在各种实施例中，传动构件可以在由电机致动时纵向地或旋转地运动。例如，在一个实施例中，传动构件包括可纵向运动的齿条，该齿条在一侧上具有齿轮连接至小齿轮的齿状物，该小齿轮通过电机旋转，并且齿条在该齿条的另一侧上限定了具有第一肩部和第二肩部的槽。与传动构件相接口的滑动件的第一部分可以包括延伸到槽中的一个或多个凸块。对开关进行致动的滑动件的第二部分可以包括悬臂。
附图说明
本文通过实例并结合以下附图描述本发明的各种实施例，其中：
图1是根据本发明的各种实施例的外科器械10的透视图，显示了手柄、轴和端部执行器；
图2是根据本发明的各种实施例的外科器械10的侧视图，显示了手柄、轴和端部执行器；
图3是用于控制根据各种实施例的外科器械的电机的电机控制电路的示意图；
图4是根据各种实施例的外科器械的方向控制组件的下视、正面透视图，除了别的以外，显示了方向控制开关、滑动件、齿条和小齿轮；
图5是根据各种实施例的图4的方向控制组件的上视、背面透视图；
图6是根据各种实施例的图4的方向控制组件的上视、正面透视图；
图7是根据各种实施例的图4的方向控制组件的顶面图；
图8是根据各种实施例的图4的方向控制组件的底面图；
图9是根据各种实施例的图4的方向控制组件的正面图；
图10是根据各种实施例的图4的方向控制组件的近侧侧视图；
图11是根据各种实施例的图4的方向控制组件的远侧侧视图；
图12是根据各种实施例的方向控制组件的方向控制开关、滑动件和齿条的下视、正面、透视图；
图13是根据各种实施例的方向控制组件的方向控制开关、滑动件和齿条的俯视图；
图14是根据各种实施例的方向控制组件的方向控制开关、滑动件和齿条的上视、正面、透视图；
图15是根据各种实施例的方向控制组件的方向控制开关、滑动件和齿条的远侧侧视图；
图16是根据各种实施例的方向控制组件的滑动件的下视、正面、透视图；
图17是根据各种实施例的方向控制组件的滑动件的背面、透视图；
图18是根据各种实施例的方向控制组件的滑动件的正面图；
图19是根据各种实施例的方向控制组件的滑动件的远侧侧视图；
图20-21是根据各种实施例的方向控制开关、滑动件和齿条的正面图；
图22是根据各种实施例的机架的正面图；
图23是根据各种实施例的机架的正面、透视图；
图24是根据各种实施例的机架和滑动件的正面、透视图；
图25是根据各种实施例的机架和滑动件的正面图，其中滑动件处于其近侧位置；
图26是根据各种实施例的机架和滑动件的正面图，其中滑动件处于其远侧位置；
图27是根据各种实施例的方向控制组件的正面图，除了别的以外，显示了电路板、方向控制开关、滑动件、齿条和机架；
图28是根据各种实施例的图27的方向控制组件的背面图；
图29是根据各种实施例的图27的方向控制组件的上视、正面、透视图；
图30是根据各种实施例的图27的方向控制组件的背面透视图；
图31是根据各种实施例的图27的方向控制组件的底面图；
图32是显示了根据各种实施例的电路板、齿条、小齿轮和齿轮组件的背面、透视图；
图33-34是根据各种实施例的手柄的正面透视、剖视图；
图35是根据各种实施例的手柄的正面图；
图36-37是显示了根据各种实施例的连接至驱动轴的齿条的图示；以及
图38-40显示了根据本发明的其它各种实施例的传动构件。
具体实施方式
现在将描述本发明的某些实施例，从而得到对本文公开的装置和方法的结构、功能、制造和使用的原理的综合理解。这些实施例的一个或多个实例在附图中示出。本领域普通技术人员将会理解，本文具体描述并在附图中示出的装置和方法是非限制性的实施例，并且这些实施例的范围完全由权利要求书来限定。结合一个实施例进行图解说明或描述的部件可以与其他实施例的部件进行组合。这样的修改形式和变型形式旨在纳入所附权利要求书的范围内。
总体而言，本发明的实施例涉及电机驱动的外科器械，该电机驱动的外科器械包括机械致动的滑动件，以用于致动对电机的操作进行控制的电机控制电路的电开关。例如，开关的致动可以使供给电机的电压的极性反向，由此使电机的旋转反向。图1和图2示出了根据本发明的各种实施例的电机驱动的外科切割和紧固器械10，该电机驱动的外科切割和紧固器械10可以包括机械致动的滑动件。图示实施例是内窥镜式器械，并且总体而言，本文所述的器械10的实施例是内窥镜式外科切割和紧固器械。然而，应该指出的是，本发明并不因此受到限制并且根据本发明的其它实施例，该器械可为非内窥镜式外科切割和紧固器械，例如是腹腔镜式器械。
图1和图2示出的外科器械10包括手柄6、轴8和连接至轴8的端部执行器12。在各种实施例中，端部执行器12能够绕关节枢轴14进行关节运动。关节控制部16可被设置成与手柄6相邻，以使端部执行器12绕关节枢轴14旋转。尽管在其它实施例中，可以使用不同类型的端部执行器，例如用于其它类型的外科装置(例如抓取器、切割器、缝合器、施夹器、进入装置、药物/基因治疗装置、超声、RF或激光装置等)的端部执行器，但是在所示实施例中，端部执行器12被构造成用作用于夹持、切断和缝合组织的内腔切割器。关于RF装置的更多细节可见全文以引用方式并入本文的美国专利5,403,312和2008年2月14日提交的标题为“Surgical cutting andfastening instrument having RF electrodes”(具有RF电极的外科切割和紧固器械)美国专利申请序列No.12/031,573。
器械10的手柄6可包括用来使端部执行器12致动的闭合触发器18和击发触发器20。应当理解，具有涉及不同手术任务的端部执行器的器械可具有用于操纵端部执行器12的不同数量或类型的触发器或者其它合适的控制器。端部执行器12被显示为通过细长轴8与手柄6分离。在一个实施例中，器械10的临床医生或操作者可通过利用关节控制部16使端部执行器12相对于轴8进行关节活动，如更详细地描述于公开的美国专利申请公开No.2007/0158385A1(标题为“Surgical Instrument Having An ArticulatingEnd Effector”(具有铰接端部执行器的外科器械)，Geoffrey C.Hueil等人)，该专利的全文以引用方式并入本文中。
在该实例中，除了别的以外，端部执行器12包括缝合钉槽22和可枢转地运动的夹持构件，例如砧24，其保持在当砧24处于其夹持位置时确保有效地缝合和切断被夹持在端部执行器12中的组织的距离处。手柄6包括向下延伸的手枪式握把26，由临床医生将闭合触发器18可枢转地拉向手枪式握把26，以致使砧24朝着端部执行器12的缝合钉槽22夹持或关闭，从而夹持置于砧24和槽22之间的组织。击发触发器20在闭合触发器18的更外侧。一旦闭合触发器18被锁定在关闭位置，击发触发器20就可朝着手枪式握把26稍微旋转以使得其可由操作者用一只手接触到。然后，操作者可将击发触发器20朝着手枪式握把12可枢转地拉动以缝合和切断端部执行器12中夹持的组织。在其它实施例中，能够使用除了砧24之外的不同类型的夹持构件。手柄6还可以包括上部28，当使用者用他/她的手握住手枪式握把部26时，上部28可以位于使用者的手之上。
应当理解，本文使用的术语“近侧”和“远侧”是相对于握住器械10的手柄6的外科医生而言的。因此，端部执行器12相对于更近侧的手柄6为远侧。还应当理解，为便利和清楚起见，本文可以结合附图使用诸如“垂直”和“水平”之类的空间术语。然而，外科器械在多个取向和位置中使用，并且这些术语并非意图进行限制，也并非绝对。
在操作性使用中，闭合触发器18可被首先致动。一旦临床医生对于端部执行器12的定位感到满意，则临床医生可将闭合触发器18拉回至其邻近手枪式握把26的完全闭合的、锁定的位置。然后，致动击发触发器20。当临床医生去除压力时，击发触发器20返回至打开位置(图1和图2所示)。当压下手柄6上的释放按钮时，可释放被锁定的闭合触发器18。释放按钮可以通过各种形式实现，例如，如公开于公开的美国专利申请公开No.2007/0175955、标题为“Surgical cutting and fastening instrument withclosure trigger locking mechanism”(具有闭合触发器锁定机构的外科切割和紧固器械)，该专利的全文以引用方式并入本文中。
端部执行器12可以包括切割器械(例如刀)，以用于在击发触发器20被使用者收缩时切割被夹持在端部执行器12中的组织。端部执行器12还可以包括用于紧固被切割器械切断的组织的装置(例如缝合钉、RF电极、粘合剂等)。关于端部执行器12的可能构造的更多细节可见以下专利和公开的专利申请，这些专利的全文以引用方式并入本文中：专利No.5,709,680、专利No.5,688,270、专利No.7,000,818、公开No.2005/0173490A1、公开No.2006/0025809A1、公开No.2007/0102453A1、No.2007/0102452A1、公开No.2009/0206134A1以及公开No.2009/0206124A1。
器械10还可以包括闭合系统以用于随着闭合触发器18的关闭(或者收缩)而关闭(或者夹持)端部执行器。下列美国专利参考文献提供了关于用于通过收缩闭合触发器18来闭合系统(或者夹持)端部执行器12的砧24的示例性闭合系统的实施例的更多细节，这些专利的全文以引用方式并入本文中：公开No.2004/0232196A1、公开No.2007/0125956A1、公开No.2007/0158385A1、公开No.2007/0175962A1、专利No.7,464,849以及上文的段落中引用的参考文献。
位于器械10的轴8内的可纵向运动的驱动轴可以驱动/致动端部执行器12中的切割器械和紧固装置。可以使用位于器械10的手柄6的手枪式握把部26中的电机来对驱动轴进行间接驱动，如本文进一步描述的。在各种实施例中，电机可以是具有大约25,000RPM的最大转速的DC有刷驱动电机。在其它实施例中，电机可以包括无刷电机、无线电机、同步电机、步进电机或者任何其它合适的电机。可以在与电机相邻的手柄6的手枪式握把部26中设置电池(或者“电源”或“动力组”)，例如锂离子电池。电池通过电机控制电路向电机供给电力。根据各种实施例，可以使用串联连接的多个电池单元作为电源来为电机提供动力。此外，电源可以是可更换的和/或可充电的。
图3是用于通过来自电池组44的电力为电机42提供动力的控制电路40的示意图。在所示实施例中，当运行电机(或者击发)开关46闭合(在图3中显示为处于打开状态)和当安全开关48闭合(在图3中显示为打开)、从而表示装置安全被设定时，并且当通常闭合的闭锁开关50打开、从而表示器械10未处于闭锁状态时，电流经由闭锁指示器52(可以如图3所显示的为LED，该闭锁指示器52位于手柄6的外侧上，使得对器械10的操作者可见)通过安全开关48流向电机42。可以在器械10的操作者收缩击发触发器20时致动(或者闭合)运行电机(或者击发)开关46。
当到达切割行程的端部时，即，例如当端部执行器中的切割器械到达其切割行程的端部时，行程端部或方向开关54被转换至闭合位置，从而使施加至电机42的电压的极性反向，由此使电机42的旋转方向反向(击发开关46也已被操作者释放或打开)。在该状态下，电流还流过反向指示器56(例如位于手柄6的外部上的LED)，以向操作者提供电机42方向已经反向的视觉指示。
如图3所示，电路还可以包括手动返回开关58。如果端部执行器12中的切割器械仅被部分击发，则操作者可以手动触发该开关58。转换手动返回开关58可以致使电机42反向旋转，从而致使切割器械返回其初始或起始位置。根据各种实施例，电机控制电路40的开关并非作为基于半导体的集成电路(IC)的一部分来实施。例如，在各种实施例中，开关中的每一个都可以是单独的微动开关或者其它合适的非IC开关。
电机控制电路40的其它实施例可见于美国专利申请序列No.12/235,782，该专利的全文以引用方式并入本文中。
图4-15是根据本发明的各种实施例的用于致动电机控制电路40的开关(例如方向开关54)的定向控制组件70的视图。方向开关54可以包括例如可板安装的微动开关，该微动开关可以通过销36安装在电路板30的下表面上。电路板30可以位于手柄6的上部28(见图1-2)中。用于电机控制电路40的其它电路部件可以通过电路板30上的导电线路安装至电路板30，电路板30上的导电线路对部件进行连接。例如，电机控制电路40的其它开关也可以包括可板安装的微动开关，所述微动开关安装至电路板30(包括电路板30的上表面和下表面)。其它的电子开关在图4-15中显示为元件34。
如图5-6以及图8-9中更清楚地显示的，方向开关54可以包括可动(例如，可压低的)开关致动器(例如，柱塞)72。在各种实施例中，当可压低的开关致动器72被压下时，开关54闭合，由此使电机反向(击发开关46也已被操作者释放或打开)。相反地，当可压低的致动器72未被压下时，如图5-6以及图8-9所示，方向开关54打开。尽管应当指出，控制组件70能够用于致动另一种类型的装置或器械中的具有另一种用途的开关，但是本文在定向控制组件70用于致动电机驱动的外科器械中的电机控制电路的方向开关的情况下对本发明的实施例进行大体描述，并且本发明并不限于控制组件用于致动电机方向开关的情况下的实施例。
可压低的开关致动器72可以通过滑动件74被压下或者致动，滑动件74可以例如由单件注射成型塑料制成。在其它实施例中，滑动件74可以包括多个单独部件的组合；部件中的一些可以由除塑料之外的材料制成。图16-19提供了根据各种实施例的滑动件74的视图。图16是前透视图；图17是后透视图；图18是前视图；并且图19是远侧侧视图。如所示实施例中显示，滑动件74可以包括悬臂76。如图4-15所示，当滑动件74在由齿条82的前侧限定的槽80的近侧处被近侧槽肩部78朝远侧推进或推动时，滑动件74的悬臂76接合开关54的可压低的开关致动器72。齿条82的背面可以包括与小齿轮86的凹槽相啮合的一系列齿状物84。小齿轮86齿轮连接至电机42的输出齿轮并且通过电机42的输出齿轮旋转。通过这种方式，齿条82可以通过小齿轮86的向前或相反的旋转朝远侧或朝近侧纵向运动。
如图5-6、9、11、13-15中可见的，齿条82的远侧端部可以限定开口38以用于接收对端部执行器12进行驱动的驱动轴的近侧端部。图36-37显示了位于齿条82的开口38中的驱动轴150的近侧端部148。在这种构造中，齿条82的纵向运动(由小齿轮86的旋转造成，小齿轮86的旋转由电机42的旋转造成)致使驱动轴150纵向运动，由此致动(或者退动)端部执行器12的部件(例如切割器械154)。
当齿条82向朝近侧运动时，槽80的远侧槽肩部88可以朝近侧推进或推动滑动件74，由此使滑动件运动，使得其悬臂76与致动器72解除接合，以使得致动器72未被压下，进而使得方向开关54处于打开位置。
例如，如图所示，在图16-19中，悬臂76可以包括从滑动件74的基部92延伸的第一、向上倾斜部90，以及从第一部分90延伸的第二、向下倾斜部94。当滑动件74朝远侧被推进或推动时，悬臂76的第二部分94可以接合开关54上的可压低的致动器72并且将开关54上的可压低的致动器72压下。在各种实施例中，滑动件74可以朝远侧被推动，使得第二部分94朝远侧被推动超过致动器72，从而使得致动器72通过悬臂76的第一部分90保持在压下位置。
同样如图16-19所示，滑动件74可以包括从滑动件74刚性延伸的一体化凸块96。凸块96可以包括从滑动件74的后部122延伸的第一部分98和从第一部分98延伸的第二部分100。凸块96的第二部分100可以可动地位于齿条82的槽80中，如图6、10-11以及14-15所示。当齿条82朝远侧或朝近侧纵向运动时，凸块96可以分别被槽80的近侧槽肩部78或远侧槽肩部88推动，由此使滑动件74和凸块96一起朝远侧或朝近侧运动。
滑动件74还可以包括在基部92与后部122之间延伸的支撑部128。支撑部128可以为滑动件74提供结构稳定性，从而减少后部122与基部92之间的相对运动。如图所示，在各种实施例中，支撑部128可以与后部122和基部92二者正交。
图4、6、9、12和14显示了位于齿条82的槽80的远侧端部处的滑动件74。在该位置中，当齿条82朝近侧运动时，远侧槽肩部88接合滑动件74的凸块96，从而推动凸块96，并且由此推动滑动件74至其最近侧的位置，在该最近侧位置中，开关上的可压低的致动器72未被致动(例如，未被压下)。图20和图21显示了位于齿条82的槽80的近侧端部处的滑动件74。在该位置中，当齿条82朝远侧运动时，近侧槽肩部78接合滑动件74的76，从而推动凸块96，并且由此推动滑动件74至其最远侧位置，在该位置中，开关54上的可压低的致动器72被致动(例如，被压下)。
通过该方式，在滑动件74朝远侧运动以致动开关54之后，即使在齿条82改变方向且朝近侧运动时，滑动件74仍然位于其最远侧位置并且开关54仍然保持被滑动件74致动，直到远侧肩部88接合凸块96并且使滑动件74朝近侧运动，以使得滑动件74不再致动开关54。类似地，在滑动件74朝近侧运动使得其不再致动开关54之后，即使在齿条82改变方向并且朝近侧运动时，滑动件74仍然保持与开关54脱离使得开关54保持未被致动，直到近侧肩部78接合凸块96并且使滑动件74移回到其最远侧、开关致动的位置。
同样如图16-19所示，滑动件74可以包括限定了U形槽106的上臂102和下臂104。U形槽106可以接合机架上的止动件，该机架在滑动件74被推动至其最远侧位置时对电路板30进行支承，如下文进一步描述的。止动件可以紧密地贴合到U形槽106中，使得即使在齿条82朝近侧运动时，贴合的紧密度仍然将滑动件74保持在最远侧位置。在各种实施例中，来自远侧槽肩部88的相对于凸块96的力足以使U形槽106与机架上的止动件脱离，由此允许远侧槽肩部88将滑动件74从其远侧位置(图4、6、9、12和14中所示)推动至其近侧位置(图20-21所示)。通过该方式，滑动件74并不与齿条82一起运动，而是仅在齿条82的槽肩部78、88中的任何一个接合布置在齿条槽80中的凸块96从而推动滑动件74时运动。
如上所述，由滑动件74限定的U形槽106接合止动件，该止动件位于器械10的手柄6内部的机架上。图22和图23显示了具有止动件112的机架110的一部分。如这些附图所示，止动件112可以从机架110的侧面面向滑动件74的延伸。止动件112可以成形为在滑动件74处于其最远侧位置时紧密地贴合到由滑动件106限定的U形槽106中。图22是机架110的侧视图并且图23是机架110的透视图。机架110可以例如由塑料构成。器械10可以包括连接至机架110的第二机架件(未显示)。
图24-26示出了机架110和滑动件74两者。为了方便起见，方向控制组件70的其它部件未显示在图24-26中。图24是机架110的前透视图，其中滑动件74处于其近侧位置，使得U形槽106并未由机架110的止动件112接合。图25是正面图，其中滑动件74处于近侧位置。当滑动件74处于其近侧位置时，滑动件74的悬臂76通常不会将开关54的可压低的致动器72压下。相反地，图26是显示了处于其最远侧位置的滑动件74的正面图。当滑动件74处于最远侧位置时，悬臂76通常将开关54的可压低的致动器72压下。
如图16-19所示，滑动件74还可以包括从滑动件74的后部122延伸的机架凸块120。机架凸块120可以包括颈部124和头部126。颈部124可以布置在机架110面向滑动件74的侧面中的狭槽130中(例如见图22-27)。随着齿条82如上文所述地使滑动件74运动，狭槽130可以限定滑动件74相对于机架110的运动。
图27-31显示了具有电路板30、滑动件74、齿条82和小齿轮86的机架100。电路板30可以例如通过螺钉或者一些其它的安装技术连接至机架110的上表面。这些附图还显示了齿轮连接至小齿轮86的齿轮组件120的部分。齿轮组件120可以将电机42的输出驱动轴联接至小齿轮86。图27是正面图；图28是背面图；图29是正面、远侧透视图；图30是背面、近侧透视图；并且图31是底面图。
图32是显示了齿轮连接至小齿轮86的齿轮组件120的背面透视图(未显示机架110)。如图32所示，齿轮组件120可以包括(i)齿轮连接至小齿轮86的上部齿轮122，以及(ii)使上部齿轮122旋转的被下部齿轮组件覆盖件124覆盖的下部齿轮组件。下部齿轮组件可以联接至电机42，如图33-35所示。这些附图显示了联接至齿轮组件120、具有输出轴130的电机42。如这些附图中可见的，电机42可以位于手柄6的手枪式握把部26中。这些附图还显示了机架110如何根据各种实施例贴合到手柄6的上部28中。电池组44(未在图33-36中显示)可以位于电机42下方的手柄6的手枪式握把部26中。
此外，尽管在上文所述的实施例中，小齿轮用于使齿条纵向往复运动，但是在其它实施例中可以使用用于使齿条纵向往复运动的其它装置。例如，螺杆驱动器或者其它装置可以用于使齿条纵向往复运动。此外，在其它实施例中，齿条82的槽80可以包括一个或多个楔形件(或者凸轮)，当滑动件74的凸块96接合楔形件(或者凸轮)时，所述一个或多个楔形件(或者凸轮)致使滑动件74与齿条82的运动方向大体垂直地运动。在这种实施例中，根据开关相对于滑动件的位置，滑动件74的垂直运动(相对于齿条82的运动方向)可以致动或退动开关54。此外，在其它实施例中，齿条82可以包括凸轮并且滑动件74可以包括凸轮从动件。在这种实施例中，根据开关相对于滑动件的位置，齿条的纵向运动可以引发滑动件74中的偏心运动，从而可以致动或退动开关54。
在其它实施例中，与槽80相接合或相接口的滑动件74的部分(例如，凸块96)可以是动态的，由此允许具有固定槽长的齿条82用于端部执行器12的切割行程根据不同手术而不同的器械中。例如，滑动件可以具有根据情况选择性地使用的多个接口部分(例如，凸块)。例如，在端部执行器12允许钉仓具有不同长度从而需要由端部执行器12中的切割器械进行不同长度的切割时，这是期望的。在其它实施例中，轴/端部执行器组合可以是可更换的，从而适应需要通过端部执行器12中的切割器械进行不同长度的切割的用途。对于短切割行程而言，相比较长的切割行程，反向开关54需要在切割行程中更快地被致动。图40是根据各种实施例的这种滑动件74的图示。图40是滑动件74的一部分的俯视图，显示了向外延伸到由传动构件82限定的槽80中的凸块96。能够绕滑动件74的本体上的一个或多个枢转点402枢转的可动的第二凸块400与96相邻。滑动件本体可以通过枢转臂404连接至可动的第二凸块400。枢转臂404可以允许第二凸块400朝向槽80可枢转地旋转，使得第二凸块400延伸到槽80中。当第二凸块400的枢转使得其延伸到槽80中时，近侧槽肩部78首先接触第二凸块400，从而如上所述地将滑动件本体74推向开关致动位置，其时间和行进距离的长度小于如果第二凸块400未延伸到槽80中的情况下肩部78接触凸块96需要的时间和行进距离的长度。通过该方式，当第二凸块400延伸到槽中时，相比当第二凸块400未延伸到槽中的情况，开关54能够在切割行程中更快地被致动。这样一来，能够在使用缩短的切割行程从而需要反向电机开关54更快致动的手术中使用传动构件82。
在各种实施例中，第二凸块400能够通过来自推杆408的力枢转到槽80中，推杆408接合第二凸块400的部分410。例如，参照图40的视图，部分410可以从第二凸块400向下延伸到界面中，并且推杆408可以位于滑动件主体74的下方(进入界面)。当需要短切割行程时，可以朝近侧推进推杆408，由此致使推杆408接合第二凸块400的延伸部410，从而致使第二凸块400延伸到槽400中。推杆408还可以包括楔形部412，楔形部412楔于滑动件本体74与第二凸块400之间，以使得即使在肩部78接合凸块400时，第二凸块400仍然保持旋转/延伸。然而，推杆408可以与滑动件74一起运动，以使得滑动件74能够在槽80的近侧肩部78接合第二凸块400时运动至其开关致动位置。在另一个实施例中，推杆408可以朝向传动构件82(而不是朝近侧)运动，由此使第二凸块400朝向槽80运动。
推杆408可以机械地(例如通过操作者致动杠杆或者致使推杆408被致动的不同轴)、磁力地(例如通过螺线管)、电气地(例如通过由电流产生的热来改变形状的形状记忆材料)或者通过任何其它合适的装置被致动。
此外，在各种实施例中，滑动件74的操作和运动可以由器械的使用者接替，从而例如允许齿条82的早回(朝近侧运动)。例如，器械10可以包括可外部进入的手动接替控制器(例如杠杆或开关)，当被使用者致动时，该可外部进入的手动接替控制器致使电机停止或反向，而无论滑动件74的状态如何。例如，在一个实施例中，可外部进入的手动接替控制器的致动可以使小齿轮86与齿条82脱离，以使得齿条82并不由小齿轮86驱动。这种实施例中的电机控制电路可以包括电路部件，即使滑动件74并未处于其开关致动位置，该电路部件仍然使电机反向。
此外，在其它实施例中，该器械可以包括相对于开关54对滑动件74进行驱动的旋转传动构件，而不是使用纵向运动的传动构件(例如，齿条82)。例如，图38是螺旋旋转(即，绕辊轴线旋转)的传动构件300的图示。如图38所示，传动构件300限定了螺旋形槽302，该螺旋形槽302具有位于槽302的近侧处的第一肩部304和位于槽302的远侧处的第二肩部306。当传动构件300绕其辊轴线向前旋转时，近侧肩部304可以接合滑动件74，以将滑动件74推进至其开关致动位置。类似地，当传动构件300绕其辊轴线反向旋转时，远侧肩部306可以接合滑动件74，以将滑动件74推进至其非开关致动位置。传动构件300可以使用合适的传动结构通过电机42旋转。
如图39所示，在另一个实施例中，传动构件320可以是圆形或椭圆形的(例如盘形的)，并且绕其偏移轴线(yaw axis)旋转。在这种实施例中，盘形传动构件320可以限定部分地围绕传动构件320的周边延伸的周边槽322。槽322包括位于槽322的第一侧面处的第一肩部324和位于槽322的第二侧面处的第二肩部326。当传动构件320绕其偏移轴线逆时针旋转时，第一肩部324可以接合滑动件74，以将滑动件74推进至其开关致动位置。类似地，当传动构件320绕其偏移轴线顺时针旋转时，第二侧面肩部326可以接合滑动件74，以将滑动件74推进至其非开关致动位置。传动构件320可以使用合适的传动结构通过电机42旋转。在图39中，槽322是90度的弧；在其它实施例中，槽可以使用不同尺寸的弧。
本文所公开的外科器械可设计为单次使用后丢弃，或可设计为多次使用。然而无论是哪种情况，该装置都可在至少使用一次后经过修复重新使用。修复可包括如下步骤的任何组合：拆卸该外科器械，然后清洗或更换某些部件以及后续的重新组装。具体而言，可拆卸该外科器械，并且可按照任何组合选择性地更换或拆下装置的任何数量的特定零件或部件。清洗和/或更换特定部件后，可在修理厂或在紧临外科手术前由外科小组人员将外科器械重新组装，以供后续使用。本领域的技术人员将会理解，修复外科器械时可利用多种技术进行拆卸、清洗/更换和重新组装。此类技术的使用以及修复后所得的外科器械都落在本专利申请的范围内。
优选地，在外科手术前处理本文所述的外科器械。首先，获取新的或用过的器械，并根据需要进行清洗。然后可对器械进行消毒。在一种消毒技术中，将器械置于闭合并密封的容器(诸如塑料或TYVEK口袋)中。然后将容器和器械置于可穿透该容器(诸如γ辐射、X射线或高能电子)的辐射场中。辐射将杀死器械上和容器中的细菌。然后可将消毒后的器械保存在消毒容器中。该密封容器将器械保持无菌，直到在医疗设备中打开该容器。
因此，在各种实施例中，本发明涉及一种外科器械，该外科器械包括：(i)手柄；(ii)连接至手柄的端部执行器；(iii)位于手柄中的电机，该电机用于为端部执行器提供动力；(iv)电机控制电路，该电机控制电路连接至电机以用于控制电机；(v)由电机进行驱动的传动构件；以及(vi)滑动件。电机控制电路包括多个开关，其中包括具有可动(例如，可压低的)致动器(例如，柱塞)的第一开关。当由电机驱动时，传动构件致使端部执行器中的可动部件运动，并且传动构件包括位于第一位置处的第一肩部和位于第二位置处的第二肩部。滑动件包括第一部分和第二部分。第一部分延伸并且与传动构件相接口，使得当齿条的第一肩部或第二肩部接合第一部分时，滑动件可以沿传动构件的运动方向运动。当传动构件使滑动件运动至相对于第一开关的第一位置时，滑动件的第二部分对第一开关的可动致动器进行致动。在各种实施例中，电机控制电路并不包括集成电路。
在各种实施例中，传动构件通过电机旋转(例如绕传动构件的辊轴线或偏移轴线)。在其它实施例中，传动构件由电机纵向驱动。例如，在这种实施例中，传动构件可以包括齿条，该齿条齿轮连接至通过电机旋转的小齿轮，使得电机的旋转致使齿条纵向运动。当齿条通过小齿轮在第一方向上纵向运动使得第一肩部接合滑动件的凸块时，齿条使滑动件运动至相对于第一开关的第一位置，当齿条通过小齿轮在与第一方向相反的第二方向上纵向运动直到齿条的第二肩部接合滑动件的凸块时，滑动件保持在相对于第一开关的第一位置，并且当齿条的第二肩部使滑动件从相对于第一开关的第一位置运动至相对于第一开关的第二位置时，滑动件运动脱离与可动致动器的接合。
外科器械可以进一步包括位于手柄内部的机架，该机架包括止动件。滑动件可以包括共同地限定U形槽的上臂和下臂。当滑动件运动至相对于第一开关的第一位置时，U形槽可以接合止动件。
在又一个总体实施例中，本发明涉及一种装置，该装置致动具有可动致动器的开关，其中该装置包括：(i)可以纵向运动的齿条；以及(ii)滑动件，该滑动件接合齿条，使得齿条的纵向运动致使滑动件相对于开关运动，从而使得当齿条使滑动件运动至相对于开关的第一位置时，滑动件致动开关的可动致动器。在各种实施例中，齿条的纵向运动可以致使滑动件纵向、垂直或者偏心运动。
尽管已经将本发明作为示例性设计进行了描述，但还可以在本公开的精神和范围内对本发明进行修改。因此本发明旨在涵盖采用本发明一般原理的任何变型型式、用途或适应型式。此外，本发明旨在涵盖本发明之外但在本发明所属领域的已知或惯有实践范围内的偏差型式。
Claims (20)
1.一种外科器械，其包括：
手柄；
连接至所述手柄的端部执行器，所述端部执行器包括可动部件；
位于所述手柄中的电机，所述电机用于为所述端部执行器提供动力；
电机控制电路，所述电机控制电路连接至所述电机以用于控制所述电机，其中所述电机控制电路包括多个开关，其中所述多个开关包括具有可动致动器的第一开关；
传动构件，所述传动构件由所述电机驱动，其中所述传动构件在由所述电机驱动时致使所述端部执行器中的所述可动部件运动，所述传动构件具有位于第一位置处的第一肩部和位于第二位置处的第二肩部，并且其中所述传动构件随着所述电机的旋转而运动；以及
滑动件，其包括：
第一部分，所述第一部分与所述传动构件相接口，使得当所述传动构件的第一肩部或第二肩部接合所述滑动件的第一部分时，所述滑动件能够通过所述传动构件运动；以及
连接至所述第一部分的第二部分，当所述传动构件的第一肩部接合所述滑动件以使所述滑动件从相对于所述第一开关的第一滑动件位置运动至第二滑动件位置时，所述第二部分致动所述第一开关的可动致动器，
其中所述滑动件保持在相对于所述第一开关的第二滑动件位置，直到所述传动构件的第二肩部接合所述滑动件的第一部分，以使所述滑动件从所述第二滑动件位置运动至所述第一滑动件位置。
2.根据权利要求1所述的外科器械，其中所述第一滑动件位置包括非开关致动位置并且所述第二滑动件位置包括开关致动位置。
3.根据权利要求1所述的外科器械，其中所述传动构件在由所述电机驱动时纵向运动。
4.根据权利要求1所述的外科器械，其中所述传动构件在由所述电机驱动时旋转。
5.根据权利要求4所述的外科器械，其中所述传动构件在由所述电机驱动时绕滚动轴线旋转。
6.根据权利要求4所述的外科器械，其中所述传动构件在由所述电机驱动时绕偏航轴线旋转。
7.根据权利要求3所述的外科器械，其中所述传动构件包括齿条，所述齿条由可旋转的小齿轮纵向驱动，其中所述小齿轮通过所述电机旋转，并且其中所述滑动件在与所述齿条相同的方向上运动。
8.根据权利要求7所述的外科器械，其中所述齿条包括齿轮连接至所述小齿轮的齿状物，其中所述齿条具有第一侧面，所述第一侧面限定了槽，所述槽具有位于第一端部处的第一肩部和位于第二端部处的第二肩部。
9.根据权利要求1所述的外科器械，其中所述滑动件的第二部分包括悬臂，所述悬臂致动所述第一开关的可动致动器。
10.根据权利要求1所述的外科器械，其中所述滑动件的第一部分包括凸块，所述凸块延伸到由所述齿条限定的槽中，使得当所述齿条的第一肩部或第二肩部接合所述凸块时，所述滑动件能够沿所述齿条的运动方向运动。
11.根据权利要求10所述的外科器械，其中：
当所述齿条通过所述小齿轮在第一方向上纵向运动使得所述第一肩部接合所述滑动件的凸块时，所述齿条使所述滑动件运动至相对于所述第一开关的第二滑动件位置；
当所述齿条通过所述小齿轮在与所述第一方向相反的第二方向上纵向运动直到所述齿条的第二肩部接合所述滑动件的凸块时，所
述滑动件保持在相对于所述第一开关的第二滑动件位置；并且
当所述齿条的第二肩部使所述滑动件从相对于所述第一开关的第二滑动件位置运动至相对于所述第一开关的第一滑动件位置时，所述滑动件运动脱离与所述可动致动器的接合。
12.根据权利要求11所述的外科器械，其中所述滑动件的第二部分包括悬臂，并且其中所述悬臂接合所述第一开关的可动致动器，以在所述齿条使所述滑动件运动至相对于所述第一开关的第二滑动件位置时致动所述可动致动器。
13.根据权利要求12所述的外科器械，其中所述悬臂从所述滑动件的基部延伸，并且其中所述悬臂包括向下倾斜部和向上倾斜部，其中所述向上倾斜部连接至所述基部，并且其中所述向下倾斜部从所述向上倾斜部延伸。
14.根据权利要求13所述的外科器械，其中：
所述外科器械还包括位于所述手柄内部的机架，其中所述机架包括止动件；
所述滑动件包括共同限定U形槽的上臂和下臂；并且
当所述滑动件运动至相对于所述第一开关的第二滑动件位置时，所述U形槽接合所述止动件。
15.根据权利要求14所述的外科器械，其中：
所述第一开关安装至电路板；并且
所述电路板连接至所述机架。
16.根据权利要求1所述的外科器械，其中所述滑动件的第一部分包括：
固定的第一接口，所述第一接口延伸到由所述齿条限定的槽中，使得当所述齿条的第一肩部或第二肩部接合所述第一接口时，所述滑动件能够沿所述齿条的运动方向运动；以及
可动的第二接口，所述第二接口选择性地延伸到所述槽中。
17.一种用于致动具有可动致动器的开关的装置，所述装置包括：
能够纵向运动的齿条；以及
滑动件，所述滑动件接合所述齿条，使得所述齿条的纵向运动致使所述滑动件相对于所述开关运动，从而使得当所述齿条使所述滑动件运动至相对于所述开关的第一位置时，所述滑动件致动所述开关的可动致动器。
18.根据权利要求17所述的装置，其中所述齿条的纵向运动致使所述滑动件在与所述齿条相同的纵向方向上运动。
19.根据权利要求17所述的装置，其中所述齿条的纵向运动致使所述滑动件垂直于所述齿条的纵向运动的方向运动。
20.根据权利要求17所述的装置，其中所述齿条的纵向运动致使所述滑动件在所述齿条纵向地运动时偏心地运动。
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| PCT/US2010/059141 WO2011078960A1 (en) | 2009-12-24 | 2010-12-06 | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
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| CN201080059401.4A Active CN102665574B (zh) | 2009-12-24 | 2010-12-06 | 具有电致动器定向控制组件的电机驱动的外科切割器械 |
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| US (5) | US8220688B2 (zh) |
| EP (1) | EP2515768B1 (zh) |
| JP (1) | JP5697689B2 (zh) |
| CN (1) | CN102665574B (zh) |
| AU (1) | AU2010333869B2 (zh) |
| BR (1) | BR112012015586B1 (zh) |
| CA (1) | CA2784309C (zh) |
| PL (1) | PL2515768T3 (zh) |
| RU (1) | RU2555112C2 (zh) |
| WO (1) | WO2011078960A1 (zh) |
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| CN106821437A (zh) * | 2017-03-10 | 2017-06-13 | 北京派尔特医疗科技股份有限公司 | 一种吻合器控制电路及电动吻合器 |
| CN108042165A (zh) * | 2017-12-25 | 2018-05-18 | 苏州英途康医疗科技有限公司 | 用于腔镜吻合器的适配器和腔镜吻合器 |
| CN111374725A (zh) * | 2018-12-29 | 2020-07-07 | 江苏风和医疗器材股份有限公司 | 用于外科器械的端部执行器驱动装置及外科器械 |
| CN111870320A (zh) * | 2019-05-01 | 2020-11-03 | 江苏风和医疗器材股份有限公司 | 外科器械 |
| CN111870320B (zh) * | 2019-05-01 | 2024-01-16 | 江苏风和医疗器材股份有限公司 | 外科器械 |
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Also Published As
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|---|---|
| WO2011078960A1 (en) | 2011-06-30 |
| US20200054355A1 (en) | 2020-02-20 |
| AU2010333869B2 (en) | 2013-10-10 |
| AU2010333869A1 (en) | 2012-05-31 |
| US20120239012A1 (en) | 2012-09-20 |
| JP2013515566A (ja) | 2013-05-09 |
| US20110155785A1 (en) | 2011-06-30 |
| US20130261648A1 (en) | 2013-10-03 |
| BR112012015586B1 (pt) | 2020-03-24 |
| US8220688B2 (en) | 2012-07-17 |
| EP2515768B1 (en) | 2018-02-14 |
| BR112012015586A2 (pt) | 2018-05-29 |
| PL2515768T3 (pl) | 2018-07-31 |
| US10751076B2 (en) | 2020-08-25 |
| CN102665574B (zh) | 2015-02-04 |
| EP2515768A1 (en) | 2012-10-31 |
| US9675372B2 (en) | 2017-06-13 |
| US20170333070A1 (en) | 2017-11-23 |
| JP5697689B2 (ja) | 2015-04-08 |
| CA2784309A1 (en) | 2011-06-30 |
| US8453914B2 (en) | 2013-06-04 |
| CA2784309C (en) | 2018-07-17 |
| RU2012131549A (ru) | 2014-01-27 |
| RU2555112C2 (ru) | 2015-07-10 |
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