CN103732158B - 手术紧固件施加装置 - Google Patents

手术紧固件施加装置 Download PDF

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CN103732158B
CN103732158B CN201280038907.6A CN201280038907A CN103732158B CN 103732158 B CN103732158 B CN 103732158B CN 201280038907 A CN201280038907 A CN 201280038907A CN 103732158 B CN103732158 B CN 103732158B
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阿尔温德·库马尔·古普塔
尼基·R·卡特雷
基兰·加里基帕蒂
塞卡尔·佩鲁马尔
拉杰什·T·谢尔克
奇尼西·P·瓦尔格斯
理查德·罗兰·布埃诺
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    • A61B17/064—Surgical staples, i.e. penetrating the tissue
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    • 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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Abstract

手术紧固件施加装置包括砧座半段和包括细长通道构件的钉仓接收半段，钉仓接收半段具有由细长通道构件的侧壁限定的一对对置开口。夹紧杆固定至所述钉仓接收半段。一次性组件包括单次使用加载单元，单次使用发射单元构造为可释放地支撑在所述钉仓接收半段内。所述一次性组件包括用于支撑所述发射单元的固定壳体。所述固定壳体包括用于支撑所述单次使用加载单元的远侧延伸部。所述固定壳体包括一对喇叭状翼件，它们构造为可释放地接收在所述钉仓接收半段的所述开口内以将所述一次性组件可释放地接合在所述钉仓接收半段内。所述夹紧杆能够从非夹紧位置移动到夹紧位置以将所述砧座半段的所述砧座部可释放地固定成与单次使用加载单元紧密接近。

Description

手术紧固件施加装置
该申请要求提交于2011年8月8日的序号为61/521,070的临时申请的优先权，其整个内容通过引用合并于此。
技术领域
本公开涉及手术紧固件施加装置，尤其涉及具有可重复使用部件及一次性部件的手术紧固件施加装置。
背景技术
手术紧固件施加装置抓取或者夹紧对置钳夹结构之间的组织，并且依靠手术紧固件来结合组织。在一些这种装置中，设置刀具以切割已经用紧固件结合的组织。紧固件典型地呈手术吻合钉的形式，但是还可以利用其他手术紧固件，诸如，例如，夹子或者两部件式手术紧固件。
手术紧固件施加装置典型地包括两个细长梁构件，使用它们来在其间捕获或者夹紧组织。典型地，一个梁构件承载一次性的钉仓组件，钉仓组件收纳布置成至少两横排的多个吻合钉，而另一梁构件包括砧座，砧座限定一表面，该表面用于当吻合钉从钉仓组件驱动出来时使吻合钉钉腿成形。当使用两部件式紧固件时，包括砧座的梁构件承载两部件式紧固件的匹配部，例如接收器。通常，吻合钉成形处理受到一个或多个纵向移动的凸轮构件与一系列独立的吻合钉推进器之间相互作用的影响。随着凸轮构件纵向行进通过钉仓承载梁构件，各个吻合钉推进器向上偏置到支撑于钉仓组件中的吻合钉的钉冠，以从钉仓顺序地射出吻合钉。刀具可以设置成在吻合钉排之间随凸轮构件一起行进以切割成形的吻合钉排之间的组织。这种仪器的例子公开于美国专利7,631,794，其整体通过参考并入此处。
虽然已经开发了可重复使用的紧固件施加装置，但是这种装置会是过于复杂的，而且经证实也很难消毒。因为与对手术紧固件施加装置适当消毒以重复使用关联的困难，所以紧固件施加装置通常构造为一次性装置。在这种一次性装置中，钉仓组件可以被替换以对单个患者执行多次紧固件施加操作，但是紧固件施加装置典型地在手术程序已经完成之后是丢弃的。这种用后即丢弃的要求会增加与手术程序关联的成本。
因此，本领域中需要一种紧固件施加装置，其包括可重复使用的部件，不过于复杂并且构造为利于在手术程序中使用之后进行适当消毒。
发明内容
根据本公开的一个方案，提供了手术紧固件施加装置。所述装置包括：砧座半段，其包括远侧砧座部和近侧手柄部；以及钉仓接收半段，其包括细长通道构件。通过所述钉仓接收半段的所述细长通道构件的侧壁限定了一对对置开口。夹紧杆固定至所述钉仓接收半段并且包括近侧端部、远侧端部和手柄部。一次性组件包括单次使用加载单元，发射单元构造为可释放地支撑在所述钉仓接收半段内。所述一次性组件包括用于支撑所述发射单元的固定壳体。所述固定壳体包括从其延伸出的远侧延伸部用于支撑所述单次使用加载单元。所述固定壳体还包括从其向外延伸的一对喇叭状翼件。所述喇叭状翼件构造为可释放地接收在所述钉仓接收半段的所述对置开口内以将所述一次性组件可释放地接合在所述钉仓接收半段内。所述夹紧杆与所述砧座半段和所述钉仓接收半段可操作地关联，并且能够相对于其从非夹紧位置移动到夹紧位置以将所述砧座半段的所述砧座部可释放地固定成与所述单次使用加载单元紧密接近。
在一个实施例中，所述固定壳体还限定朝向其近侧端部定位的一对对置狭槽。所述钉仓接收半部能够包括布置在其近侧端部处且从其侧壁向内延伸的一对突起，所述突起构造为当所述一次性组件定位在所述钉仓接收半段内时接收在所述狭槽内。
所述一次性组件还可以包括枢转锁定构件，所述枢转锁定构件联接至所述固定壳体并且构造为接合定位在所述夹紧杆上的接合构件以将所述夹紧构件锁定在所述夹紧位置。
在一个实施例中，所述发射单元包括发射杆和牢固地固定至所述发射杆的凸轮杆，所述发射杆能够相对于所述固定壳体选择性地平移以使所述凸轮杆类似地平移通过所述单次使用加载单元以从其中射出紧固件。
所述发射单元还可以包括可枢转地支撑在所述固定壳体内的引导块，所述引导块构造为引导所述凸轮杆平移通过所述单次使用加载单元。所述引导块能够在抑制所述凸轮杆平移的锁定位置以及允许所述凸轮杆平移的解锁位置之间枢转。所述发射组件还可以包括刀具致动杆，其中在锁定位置，所述引导块与所述刀具致动杆接合。所述砧座半段可以包括从其延伸出的一个或多个延伸部，所述延伸部构造为当所述夹紧杆移动至所述夹紧位置时推动所述引导块至所述解锁位置。
在一个实施例中，所述固定壳体包括一对向外延伸的锯齿状抓握表面以利于相对于所述钉仓接收半段插入和移除所述一次性组件。所述钉仓接收半段可以包括构造为当所述一次性组件插入所述钉仓接收半段时接收所述锯齿状表面的一对切口部。
在一个实施例中，所述喇叭状翼件偏置成与所述对置开口接合。在一个实施例中，所述固定壳体的侧壁能够朝向彼此手动移动以从两个对置开口收缩所述喇叭状翼件，从而允许所述固定壳体从所述钉仓接收半段退回。
根据本公开的另一方案，提供了手术紧固件施加装置，其包括：砧座半段，其包括远侧砧座部和近侧手柄部；以及钉仓接收半段，其包括细长通道构件。夹紧杆固定至所述钉仓接收半段，并且具有近侧端部和远侧端部并且包括手柄部。一次性组件包括单次使用加载单元，还提供了单次使用发射单元。所述一次性组件构造为可释放地支撑在所述钉仓接收半段内，并且包括用于支撑所述发射单元的固定壳体，所述固定壳体具有从其延伸出的远侧延伸部用于支撑所述单次使用加载单元。所述单次使用加载单元在其远侧端部和近侧端部处经由独立的接合件接合至所述远侧延伸部。所述夹紧杆与所述砧座半段和所述钉仓接收半段可操作地关联，并且能够从非夹紧位置移动到夹紧位置以将所述砧座半段的所述砧座部可释放地固定成与所述单次使用加载单元紧密接近。
在一个实施例中，所述单次使用加载单元在所述单次使用加载单元的所述远侧端部处经由通过搭扣接合件固定的公母连接件接合至所述远侧延伸部。在所述单次使用加载单元的所述远侧端部处的所述公母连接件可以包括从所述单次使用加载单元延伸出的杆，所述杆构造为接收在限定于所述远侧延伸部内的管腔内。在所述单次使用加载单元的所述远侧端部处的所述搭扣接合件可以包括一对悬臂，所述悬臂从所述远侧延伸部延伸出并且构造为接合限定在所述单次使用加载单元内的一对切口。
在一个实施例中，所述单次使用加载单元在所述单次使用加载单元的所述近侧端部处经由通过搭扣接合件固定的公母连接件接合至所述远侧延伸部。在所述单次使用加载单元的所述近侧端部处的所述公母连接件可以包括限定在所述单次使用加载单元内的一个或多个狭槽，所述狭槽构造为接收从所述远侧延伸部延伸出的一个或多个突起。在所述单次使用加载单元的所述近侧端部处的所述搭扣接合件可以包括一对向内延伸的翼件，所述翼件布置在所述固定壳体上并且构造为搭扣在所述单次使用加载单元的所述近侧端部上。
根据本公开的另一方案还提供一种手术紧固件施加装置，其包括：砧座半段，其包括远侧砧座部和近侧手柄部；以及钉仓接收半段，其包括细长通道构件。夹紧杆固定至所述钉仓接收半段，并且具有近侧端部和远侧端部并且包括手柄部。一次性组件包括单次使用加载单元，还提供单次使用发射单元。所述一次性组件构造为可释放地支撑在所述钉仓接收半段内，并且包括用于支撑所述发射单元的固定壳体。所述固定壳体包括从其延伸出的远侧延伸部用于支撑所述单次使用加载单元。所述单次使用加载单元和所述固定壳体中的每个都包括从其延伸出的一对对置的锯齿状抓握表面。每对锯齿状抓握表面都被构造为利于从所述钉仓接收半段插入和移除所述一次性组件。所述夹紧杆与所述砧座半段和所述钉仓接收半段可操作地关联，并且能够从非夹紧位置移动到夹紧位置以将所述砧座半段的所述砧座部可释放地固定成与所述单次使用加载单元紧密接近。
在一个实施例中，所述钉仓接收半段包括一对切口部，所述切口部构造为当所述一次性组件插入所述钉仓接收半段时接收所述固定壳体的所述锯齿状抓握表面。
在一个实施例中，枢转锁定构件联接至所述一次性组件，锁定构件构造为接合定位在所述夹紧杆上的接合构件以将所述夹紧构件锁定在所述夹紧位置。
附图说明
将参考附图描述本公开手术紧固件施加装置的各种实施例，其中：
图1是从处于夹紧位置的本公开手术紧固件施加装置的一个实施例的远侧端部看的侧视立体图；
图2是从处于夹紧位置的图1所示的手术紧固件施加装置的近侧端部看的侧视立体图；
图2A是图1所示的手术紧固件施加装置处于打开位置的侧视立体图；
图2B是图2A所示的标示细节区域的放大图；
图2C是图1所示的手术紧固件施加装置的一次性组件的侧视立体图；
图2D是图2C所示的一次性组件的框架的俯视立体图；
图2E是图2C所示的一次性组件的远侧部的俯视立体图，SULU与一次性组件的框架分离；
图2F是图1所示的手术紧固件施加装置的钉仓接收半段的侧视立体图，手柄处于打开位置；
图3是图1所示的手术紧固件施加装置的部件分离的侧视立体图；
图3A是图1所示的紧固件施加装置的夹紧杆的侧视剖视图；
图4是图1所示的手术紧固件施加装置的钉仓接收半段的侧视立体图，一次性组件支撑在钉仓接收半段内；
图5是图4所示的标示细节区域的放大图；
图6是从手术紧固件施加装置的钉仓接收半段上方看的立体图，一次性组件支撑在其中；
图7是图6所示的标示细节区域的放大图；
图8是从图3所示的手术紧固件施加装置的一次性组件的上方看的前端立体图，移除了SULU；
图9是图8所示的标示细节区域的放大图；
图9A是通道构件的俯视立体图，一次性组件的发射单元安装在其中；
图9B是图9A所示的标示细节区域的放大图；
图9C是通道构件的中央部的俯视立体图；
图10是从图8所示的一次性组件的上方看的后端立体图，没有SULU；
图11是图10所示的标示细节区域的放大图；
图12是图10所示的一次性组件的部件分离的侧视立体图，没有SULU；
图12a是图12所示的一次性组件的发射单元的凸轮杆的仰视立体图；
图12b是图12所示的一次性组件的发射单元的发射杆的仰视立体图；
图13是图1所示的手术紧固件施加装置的SULU的侧视立体图；
图14是图13所示的标示细节区域的放大图；
图15是图13所示的SULU的前视立体图；
图16是图15所示的标示细节区域的放大图；
图17是图2C所示的一次性组件的部件分离的侧视立体图（没有发射单元）；
图18是图1所示的手术紧固件施加装置处于打开位置的侧视剖视图；
图19是图18所示的标示细节区域的放大图；
图20是图18所示的标示细节区域的放大图；
图21是图18所示的处于打开位置的手术紧固件施加装置的近侧端部的立体图；
图22是图18所示的标示细节区域的放大图；
图23是从图1所示的手术紧固件施加装置的夹紧杆的近侧端部下方看的立体图；
图24是图1所示的手术紧固件施加装置处于夹紧位置的侧视立体图；
图25是图24所示的处于夹紧位置的手术紧固件施加装置的侧视剖视图；
图26是图25所示的标示细节区域的放大图；
图27是图25所示的标示细节区域的放大图；
图28是沿着图26的剖线28-28截取的剖视图；
图29是随着发射单元移动通过致动行程以从紧固件施加装置的SULU射出紧固件，图1所示的手术紧固件施加装置的俯视图；
图30是图29所示的手术紧固件施加装置的侧视剖视图，发射单元处于致动位置；
图31是图30所示的标示细节区域的放大图；
图32是图30所示的标示细节区域的放大图；
图33是图1所示的手术紧固件施加装置在该装置已经发射并且移至打开位置之后的侧视剖视图；以及
图34是图33所示的标示细节区域的放大图。
具体实施方式
现在将参考图1-34详细描述根据本公开的手术紧固件施加装置的实施例，其中，相同的附图标记指代类似或者相同的结构元件。如此处使用的，如传统的，术语“近侧”指的是装置更靠近用户的一端，术语远侧指的是装置更远离用户的一端。
转至图1-3，示出了本公开手术紧固件施加装置的一个实施例，一般表示为手术吻合器10。手术吻合器10包括砧座半段100、钉仓接收半段200、夹紧杆300和一次性组件600，一次性组件600包括单次使用加载单元400（下文“SULU”）和发射单元500。将在下文更详细地描述这些部件或者组件中的每一个。
砧座半段100、钉仓接收半段200和夹紧杆300可以构造为可重复使用的部件，这样，由适于消毒和重复使用的生物相容材料制成，例如不锈钢。另一方面，SULU400和发射单元500彼此成一体以形成一次性组件600。将SULU400和发射单元500集成为单体式一次性组件600利于手术吻合器10的一次性部件与作为单个单元的手术吻合器10的可重复使用部件的脱离和分离，因而利于处置一次性部件和准备可重复使用部件以用于消毒。这种构造还利于新的一次性组件600与消毒后的可重复使用部件接合以准备用于后续使用。SULU400和发射单元500成一体还利于在单个手术程序中移除使用过的一次性组件以及替换成新的一次性组件用于后续发射。一次性组件600（例如，SULU400和发射单元500）可以由任何合适的生物相容材料构建，例如塑料、金属或者及它们的组合。此外，手术吻合器10可以构造为接收或者容纳各种不同构造的一次性组件，例如，包括SULU和发射组件的一次性组件，发射组件用于发射不同吻合钉线长度（例如，60mm、80mm和100mm）的吻合钉。
如以下更详细描述的，砧座半段100和钉仓接收半段200能够可释放地、可枢转地彼此接合，而夹紧杆300围绕钉仓接收半段200的中央部202可枢转地联接至钉仓接收半段200。夹紧杆300能够相对于钉仓接收半段200在隔开位置（图2A）以及接近位置（图1-2）之间枢转，用于将钉仓接收半段200以及砧座半段100相对于彼此在打开或非夹紧（图2A，图33）和关闭或夹紧位置（图1-2）之间移动以夹紧其间的组织。当手术吻合器10处于夹紧位置时，发射单元500可以操作，以顺序发射并且在夹紧于砧座半段100和钉仓接收半段200之间的组织周围成形多个手术吻合钉402（图17），并且推进刀具440（图17）以分割其吻合部分之间的组织。
继续参考图1-3，砧座半段100包括近侧手柄部102和远侧砧座部104。砧座部104包括吻合钉变形部106，吻合钉变形部106在其中包括多个吻合钉变形凹槽（未示出）。当一次性组件600接合在钉仓接收半段200的通道构件206内时，吻合钉变形部106布置与SULU400成相对关系。此外，吻合钉变形部106包括中央纵向狭槽（未示出）用于当刀具440前进通过SULU400以分割吻合组织时接收SULU400的刀具440（图17）。吻合钉变形部106能够与砧座半段100一体形成，或者可替换地，可以通过任何合适的紧固处理（例如，焊接）固定至砧座半段100。
一对定位指状部108（图2A）布置在砧座半段100的中央部，并且定位成邻近砧座部104的吻合钉变形部106的近侧端部，从砧座半段100朝向一次性组件600的SULU400延伸。当砧座半段100和钉仓接收半段200接近时，随着手术吻合器10移至夹紧位置，定位指状部108至少部分地接收在限定于SULU400内的凹槽404（图2E）内以使SULU400适当对准吻合钉变形部106。砧座半段100还包括定位在指状部108近侧的一对横向隔开的延伸部110（图2A），指状部108朝向一次性组件600向下延伸。延伸部110均限定成角度的远侧表面，并且构造为当手术吻合器10移动至夹紧位置时接合在一次性组件600的固定壳体502的凹口514（图2E）内，使得延伸部110的成角度的远侧表面与凹口514彼此匹配。延伸部110的成角度的表面各自还构造为随着延伸部110朝向凹口514平移，即随着手术吻合器10移向夹紧位置，而接触引导块548的上表面（图2E），使得如下文详细描述的，引导块548从第一、锁定位置（图19）枢转至第二、解锁位置（图26）。
参考图2A和图3，砧座半段100的中央部包括一对柱形横向支撑构件112。在砧座半段100和钉仓接收半段200的组装期间，横向支撑构件112支撑在限定于钉仓接收半段200的中央部202（图3）中的U形凹槽214中。中央部202的远侧壁204限定组织止挡部（图3）。横向支撑构件112还定位成当夹紧杆300移至夹紧位置（图2）时接收在形成于夹紧杆300的间隔凸缘部304上的切口302中。近侧手柄部102是以符合人体工学地方式形成的，并且包括拇指接合抵接部114以及抓握部116。手柄部102的近侧端部包括向下延伸的指状部118，向下延伸的指状部118包括一对对置的泪滴形状突起120（图3），将在下文进一步详细讨论。可替换地，突起120可以呈现各种构造。
参考图3-7，钉仓接收半段200包括细长通道构件206，细长通道构件206具有限定在其中的大致U形通道208，U形通道208构造为可释放地接收一次性组件600。更具体来说，U形通道208包括：远侧部210，其定尺寸为可释放地接收一次性组件600的固定壳体502的远侧延伸部504，远侧延伸部504支撑SULU400；以及近侧部212，其定尺寸为可释放地接收一次性组件600的固定壳体502的近侧部，近侧部支撑发射单元500。一次性组件600及其部件，即SULU400和发射单元500，将在下文更详细地描述。
如以上提到的，钉仓接收半段200包括居中间隔布置的U形凹槽214，U形凹槽214定位成支撑砧座半段100的横向支撑构件112。钉仓接收半段200的近侧端部包括一对垂直支撑构件216。每个垂直支撑构件216包括具有导圆底表面的细长垂直狭槽218。垂直狭槽218定尺寸为当组装期间砧座半段100支撑在钉仓接收半段200上时接收形成在砧座半段100的指状部118（图21）上的突起120。通过将突起120定位在垂直狭槽218内，砧座半段100能够相对于钉仓接收半段200以剪刀状方式在打开位置和关闭位置之间枢转。在一个实施例中，突起120具有泪滴轮廓。可替换地，可以想到其他突起构造。
钉仓接收半段200还包括布置在其近侧端部处并且向内延伸入U形通道208中的一对大致柱形的突起220。突起220构造为接收在限定于一次性组件600的固定壳体502中的弓形狭槽516内，以利于将一次性组件600接合在钉仓接收半段200内。钉仓接收半段200还包括构造为接收固定壳体502的向外延伸锯齿状表面518的一对对置的切口段222。锯齿状表面518提供可抓握表面以利于从钉仓接收半段200的通道构件206移除和/或替换一次性组件600。由通道构件206的侧壁限定的一对对置的开口224构造为接合固定壳体502的喇叭状翼件520以将一次性组件600可释放地固定在钉仓接收半段200内。
如图3和图3A中最佳所示，夹紧杆300包括具有握持部308和拇指接合抵接部310的手柄部306。如以上讨论的，一对间隔的凸缘部304支撑在夹紧杆300的远侧端部上。每个凸缘部304限定切口302，切口302定尺寸为当吻合器10移向夹紧位置时（图2B）接收砧座半段100的相应横向支撑构件112。夹紧杆300的远侧端部还限定一对开口312，开口312定尺寸为接收枢轴构件314（例如，销）。枢轴构件314定尺寸为延伸通过钉仓接收半段200中的开口226和夹紧杆300中的开口312，以可枢转地固定夹紧杆300至钉仓接收半段200。弹簧构件316包括折叠的T形近侧端部318，T形近侧端部318接合在限定于夹紧杆300的对置侧壁内的对置狭槽320内，并且可以以任何合适方式固定，例如，机械接合、焊接、粘接等。弹簧构件200的远侧端部322构造为抵接钉仓接收半段200的底表面以将夹紧杆300偏置离开钉仓接收半段200，即将夹紧杆300朝向隔开或者非夹紧位置偏置。夹紧杆300还包括接合构件，例如半柱形杆324，以下将更详细描述，其构造为当夹紧杆300移至夹紧位置时（图27）接合发射单元500的锁定构件700的卡掣部706。虽然图示了半柱形杆324，但是还可想到其他接合构件构造。
现在转到图2C-3和图8-12、一次性组件600包括SULU400和发射单元500，SULU400和发射单元500彼此一体形成以形成单个部件，即一次性组件600。更具体来说，一次性组件600包括：固定壳体502，其构造为容纳发射单元500的下述作业部件；以及远侧延伸部504，其构造为接合和保持SULU400于其上，因而形成整体式的一次性组件600。一次性组件600的远侧延伸部504从固定壳体502向远侧延伸。
固定壳体502包括近侧端部，近侧端部包括对置开口506（图2D），对置开口506接收枢轴构件508（图12）。枢轴构件508延伸通过限定于固定壳体502的每个侧壁内的开口506以及通过横向限定于锁定构件700中的镗孔702。锁定构件700可枢转地联接在固定壳体502的侧壁之间，邻近一次性组件600的发射单元500的近侧端部。枢轴构件508可以包括限定了一对有弹力的锁定翼件510（图12）的分叉式插入端，使得当枢轴构件508通过第一开口506、镗孔702插入并且离开第二开口506时，有弹力的锁定翼件510向外偏置以将枢轴构件508锁定成可枢转接合通过其中。
还参考图12，锁定构件700包括：推钮704，其布置在枢轴构件508的一侧；以及卡掣部706，其包括钩构件708，钩构件708布置在枢轴构件508的相对侧。偏置构件512定位成绕枢轴构件508以朝向一次性组件600的固定壳体502向内推动卡掣部706，因而从其向外推动推钮704。卡掣部706向下延伸超出固定壳体502的近侧端部而到达在通道构件206的底表面下方（图20）的位置，使得卡掣部706的钩构件708暴露。锁定构件700的暴露的钩构件708（偏置构件512的偏置促进暴露）构造为当夹紧杆300移至夹紧位置时接合夹紧杆300的半柱形杆324（图3），从而锁定夹紧杆300于夹紧位置。克服弹簧512的偏置，推钮704可被选择性地压下以使钩构件708从杆324脱离以解锁夹紧杆300，这允许夹紧杆300在弹簧316的偏置下返回打开或者非夹紧位置。
参考图2D和图8-12，描述发射单元500的部件和特征。发射单元500支撑在一次性组件600的固定壳体502内，并且包括刀具致动杆544、凸轮杆546、引导块548、发射杆550、滑动块552、踏板554和枢转锁定构件700（图12）。如图2D所示，固定壳体502包括U形框架522，U形框架522包括一对侧壁524和底壁526，底壁526向远侧延伸超出侧壁524以形成远侧延伸部504。侧壁524均包括沿其自由端布置的多个隔开的向内延伸翼件528，底壁526包括邻近每个侧壁524限定为贯通其中的多个隔开的狭槽530，每个狭槽530定位成与一个翼件530相对。固定壳体502的框架522的这种开槽和带翼件式的构造对固定壳体502提供了增加的柔性和弹性，因而利于从钉仓接收半段200插入和移除一次性组件600以及将一次性组件600接合在钉仓接收半段200内（图9A），例如，利于夹紧或者挤压固定壳体502的锯齿状表面518以从钉仓接收半段200插入和/或移除固定壳体502。固定壳体502的最远侧翼件528还可以构造为接合SULU400的近侧端部以利于将SULU400接合在远侧延伸部504上。如以上提到的，固定壳体502构造为经由将固定壳体502的喇叭状翼件520接合在钉仓接收半段200的对置开口224内（图4）以及将钉仓接收半段200的突起220接合在固定壳体502的弓形狭槽516内（图3），而可释放地接合在钉仓接收半段200的U形通道208内。更具体来说，喇叭状翼件520构造为当将固定壳体502插入钉仓接收半段200时偏置成接合在对置开口224内。侧壁524可以被向内挤压以利于将固定壳体502插入在钉仓接收半段200内。为了从钉仓接收半段200移除固定壳体502，固定壳体502的侧壁524可以被挤压或者朝向彼此夹捏（例如，经由朝向彼此抓取和挤压锯齿状表面518）以利于从开口224收缩喇叭状翼件520，因而允许从钉仓接收半段200退回固定壳体502。为此，固定壳体502可以由塑料或者其他能够弹性弯曲的合适材料形成，以利于固定壳体502在钉仓接收半段200内的接合和脱离，固定壳体502的侧壁524之一（或两个）包括通过其限定的瓶颈开口532，瓶颈开口532构造为接收钉仓接收半段200的有弹力的指状部230（图9B-9C）以确保一次性组件600和钉仓接收半段200之间的接合。
参考图1-3和图8-12，侧壁524的远侧端部均限定具有成角度的远侧表面的凹口514。凹口514构造为接收砧座半段100的延伸部110，如以上提到的，以便当手术吻合器10移至夹紧位置时确保SULU400和吻合钉变形部106之间适当的对准。每个侧壁524还包括向外延伸的锯齿状表面518，向外延伸的锯齿状表面518能够定位在钉仓接收半段200的对置切口段222内以利于抓握和挤压一次性组件600，从而允许从钉仓接收半段200的通道构件206移除和/或替换一次性组件600以及确保一次性组件600在钉仓接收半段200内的大致齐平装配，即，使得锯齿状表面518与钉仓接收半段200的通道构件206的自由端部大致齐平。
引导块548包括限定了三个纵向狭槽570a-c的主体和一对向外延伸的突起572。在一个实施例中，每个突起572是大致柱形并且包括锥形部（图9）。可替换地，可以想到其他突起构造。突起572定尺寸为接收在形成于固定壳体502的侧壁524中的开口574（图12）中，以将引导块548轴向固定在固定壳体502的远侧端部内。突起572允许引导块548在U形框架522内一定程度的枢转移动。如下文将进一步详细讨论的，响应于吻合器10移动至夹紧位置，引导块548从第一位置（图19）枢转至第二位置（图26），在第一位置，其锁定与刀具致动杆544的凹口549和551的接合，在第二位置，其与刀具致动杆544的凹口549和551脱离。更具体来说，随着砧座半段100接近钉仓接收半段200以实现夹紧位置，砧座半段100的延伸部110推动引导块548从第一位置（图19）枢转至第二位置（图26）以脱离闭锁机构。扭转弹簧556围绕突起572中的一个或两个布置以推动引导块548而凹口549和551锁定接合，即，将引导块548偏置入第一、锁定位置（图19）。每个狭槽570a和570c定尺寸为可滑动地接收凸轮杆546的相应侧壁547。类似地，狭槽570b定尺寸为可滑动地接收刀具致动杆544。
参考图8-17，滑动块552包括毂580，毂580包括有弹力的指状部580a，指状部580a构造为搭扣配合到形成在发射杆550中的枢轴孔582中。当滑动块552处于收缩位置时发射杆550绕毂580枢转以利于从吻合器10的任一侧致动发射单元500。踏板554可往复运动地接收在形成于滑动块552中的孔584内。踏板554包括分体式主体部554a，分体式主体部554a构造为跨过刀具致动杆544的近侧端部558。在一个实施例中，分体式主体部554a包括成角度的远侧表面586。销588从踏板554向上延伸通过滑动块552中的孔584。偏置构件590定位在分体式主体部554a和滑动块552之间，围绕销588以向下推动踏板554离开滑动块552到达延伸位置。在滑动块552的收缩位置上，踏板554被接收在形成于通道构件206的底壁中的切口555中（图20）。
如图2C、图3和图20-24最佳示出的，发射杆550包括第一和第二指状部接合构件550a和550b，它们中的任一个能够被选择性地接合以使发射杆550从吻合器10的任一侧移动通过发射行程。弓形凹槽594（图12B）形成在可滑动地接收踏板554的销588的发射杆550的底表面中，以限定发射杆550能够绕滑动块552的毂580枢转的旋转范围。如此处使用的，发射行程定义为发射杆550从完全收缩位置（图25）至完全前进位置（图30）的移动。停止凹槽594a形成在弓形凹槽594的每个端部处。停止凹槽594a构造且定尺寸为接收踏板554的销588的端部，以防止在手术吻合器10的发射行程期间发射杆550绕毂580枢转移动。更具体来说，当发射单元500被致动以使滑动块552在固定壳体502内向远侧前进时，踏板554的成角度的远侧表面586接合通道构件206并且做凸轮运动离开切口555（图27）以向上推动销588而进入停止凹槽594a，从而在发射杆550通过发射行程的移动期间防止发射杆550的枢转移动。很明显，销588必须定位在停止凹槽594a之下以允许踏板554从切口555向上提升，从而允许发射杆550移动通过发射行程。因而，在发射杆550能够移动通过发射行程之前，发射杆550必须枢转到发射单元500的一侧或另一侧。
刀具致动杆544包括近侧端部，近侧端部具有阶状部596，阶状部596包括具有第一高度的近侧第一台阶597a和具有第二高度的第二台阶597b，第二高度大于第一高度（图12）。致动杆544的远侧端部包括上弯钩部598以及上、下凹口549和551。指状部599在第一和第二台阶597a和597b之间从刀具致动杆544向上伸出。如图27所示，指状部599可滑动地接收在形成于滑动块552下侧的凹槽553内。当滑动块552在固定壳体502内向远侧前进时，指状部599在凹槽553内移动，使得滑动块552相对于刀具致动杆544移动，直到指状部599接合壁553a，壁553a限定了凹槽553的近侧端部。当指状部599接合壁553a时，滑动块552的进一步向远侧移动将还将引起刀具致动杆544的向远侧移动。如以下将明显的，这种布置允许吻合钉在切割组织之前从SULU400射出。
参考图12和图12A，凸轮杆546包括一对侧壁547和基壁559。每个侧壁547的近侧端部547a包括隆起壁部547b。每个隆起壁部547b构造为固定地接收在形成于滑动块552下侧的狭槽（未示出）内，以牢固地固定凸轮杆546的近侧端部至滑动块552。可替换地，滑动块552可以模制在凸轮杆546的近侧端部。每个侧壁547的远侧端部547c包括成角度的凸轮表面547d。基壁559限定了：向远侧延伸的细长狭槽559a（图12A），细长狭槽559a从凸轮杆546的远侧端部沿着凸轮杆546的大体长度延伸；以及向近侧延伸的纵向狭槽559b。狭槽559b定位成当滑动块552处于收缩位置时利于踏板554通过通道构件206的切口555（见图27）。
凸轮杆546的侧壁547可滑动地定位在引导块548的狭槽570a和570c，并且刀具致动杆544可滑动地定位在引导块548的纵向狭槽570b中。当发射单元500支撑在通道构件206中并且发射杆550枢转至固定壳体502的一侧并且被向远侧推动时，滑动块552在固定壳体502内向远侧移动。随着滑动块552开始向远侧移动，踏板554的锥形表面586接合通道构件206的限定了切口555的近侧边缘，以推动踏板554向上移出切口555、通过凸轮杆546的狭槽559b，并到达一次性组件600的固定壳体502的内表面上（图27）。当这发生时，踏板554的销588移动入停止凹槽594a以防止发射杆550进一步的枢转移动。如果发射杆550不枢转至使销588定位在停止凹槽594a之下的位置，则将阻止踏板554向上移出切口555并且将阻止发射杆550移动通过发射行程。随着发射杆550向远侧移动，指状部599在凹部553内移动，使得随着凸轮杆546向远侧前进，刀具致动杆544保持静止。当指状部599接合限定了凹槽553的近侧壁553a时，刀具致动杆544与滑动块552和凸轮杆546向远侧移动。如以下将讨论的，当凸轮杆546和刀具致动杆544在一次性组件600的固定壳体502及通道构件206内向远侧移动时，凸轮杆546的成角度的凸轮表面547d移动通过SULU400以从SULU400射出吻合钉402。同时，虽然具有等于凹槽553（图32）长度的预设延迟，但是刀具致动杆544驱动刀具刀片540通过SULU400以分割组织。
如以上提到的，固定壳体502的远侧延伸部504构造为接合和保持SULU400于其上以形成整体式的一次性组件600。如图2C-2E最佳示出的，远侧延伸部504接合SULU400以包围SULU400的钉仓主体420的底侧，例如，远侧延伸部504形成SULU400的钉仓主体420的底盖。更具体来说，从远侧延伸部504的对置侧延伸出的一对悬臂432接合形成在SULU400的钉仓主体420的远侧端部处的切口434；朝向远侧延伸部504的远侧端部限定的中央管腔505接收从钉仓主体420的远侧末端部延伸出的杆436；从远侧延伸部504的近侧端部延伸出的近侧突起507被接收在限定于SULU400的近侧部内的对应狭槽438内；并且固定壳体502的侧壁524的最远侧翼件528接合在SULU400的近侧端部周围以使SULU400和发射单元500的远侧延伸部504彼此接合。因而，经由在SULU400的远侧端部以及在SULU400的近侧端部处的搭扣接合件和公母连接件，SULU400牢固地固定至远侧延伸部504。也即，在SULU400的远侧端部，悬臂432在切口434内的接合（例如，搭扣接合）将杆436保持于中央管腔505内，而在SULU400的近侧端部，侧壁524的最远侧翼件528在SULU400的近侧端部周围的接合（例如，搭扣接合）将近侧突起507保持于狭槽438内。此外，这些接合还可以通过摩擦配合实现，例如，杆436可以以摩擦方式保持于官腔505内，和/或近侧突起507可以以摩擦方式保持于狭槽438内，和/或通过任何其他合适方式，例如，胶粘或粘合、超声或者其他合适的焊接处理、热融等。发射单元500的远侧延伸部504还包括形成在其上表面上的纵向脊509，纵向脊509接收在SULU400的钉仓主体420内，下文将描述其重要性。
参考图13-17，描述SULU400。SULU400包括钉仓主体420、多个吻合钉推进器422（仅示出一个）、具有成角度的尖导缘或刀片540a的刀具440、多个吻合钉402（仅示出一个）、以及可枢转地安装的安全闭锁件428。主体420具有：多排吻合钉保持狭槽430，例如，四个、六个等；以及居中地布置在主体420中的线性狭槽刀具轨道452。刀具440包括下弯钩部440b，下弯钩部440b定位成接合发射单元500的刀具致动杆544的上弯钩部598（图12）。在图示的实施例，主体420包括形成在线性狭槽刀具轨道452任一侧的两个错排的狭槽430。错排的狭槽430延伸超出刀具轨道452的远侧端部，以利于超出刀具刀片440a的行程的远侧端部的吻合钉成形，但是可想到其他构造。
吻合钉推进器422可以构造为延伸入一个或多个狭槽430。在一个实施例中，单个推进器与每个狭槽430关联。可替换地，如图17图示的，每个推进器422能够构造为延伸入两个相邻狭槽430，并且定位在保持在狭槽430中的相应吻合钉402下方。此外，每个推进器422包括下凸轮表面422a，下凸轮表面422a定位成接合凸轮杆546的远侧端部上的凸轮表面547d（图12、12A）之一，使得凸轮杆546通过SULU400的移动将顺序地提升相应的一个或多个狭槽430内的每个相应推进器422以从狭槽430射出吻合钉。
如以上提到的，远侧延伸部504的纵向脊509（图2E）接收在SULU400的钉仓主体420内。纵向脊509提供了用于刀具支撑构件496的支承表面（图17），刀具支撑构件496固定至刀具440的底部边缘。刀具440可以经由销、焊接或者其他公知紧固技术固定至支撑构件496。在发射行程期间，如下所述，随着发射杆550前进通过通道构件206，刀具440沿着刀具轨道452被引导。一对狭槽511（图2D）限定在脊509的侧面与钉仓主体420的外壁之间。纵向脊509定位在主体420内，并且定尺寸为可滑动地接收在凸轮杆446的狭槽559a（图12A）内，使得凸轮杆446能够绕纵向脊509可滑动地移动通过钉仓主体420，从而从SULU400射出吻合钉402。
SULU400的近侧端部包括对置的、向外延伸的锯齿状表面480（图7）以利于抓握SULU400的近侧端部，以允许从钉仓接收半段200的通道构件206移除和/或替换一次性组件600。因而，移除和/或替换一次性组件600可以通过抓取SULU400的锯齿状表面480和固定壳体502的锯齿状表面518中一者或两者来实现。
参考图13-17，安全闭锁件428可枢转地布置在主体420的上近侧端部上，并且绕枢轴构件450从锁定方位（图26）枢转到解锁方位（图34）。枢轴构件450接收在主体420中的开口454中。偏置构件（例如，弹簧451）定位在刀具支撑构件496和安全闭锁件428之间以朝向解锁方位推动安全闭锁件428。安全闭锁件428包括近侧钩456，近侧钩456定位成当刀具440处于收缩位置时（图19）时接收形成在刀具440上的接合构件458以将安全闭锁件428保持于锁定方位。当在发射行程期间刀具440移向前进位置时，接合构件458移开近侧钩456以允许安全闭锁件428响应于弹簧451的推动而朝向解锁位置枢转。应该注意的是，当砧座半段100和钉仓接收半段200处于夹紧位置时，防止安全闭锁件428枢转至解锁位置，因为安全闭锁件428的顶表面428a接合砧座半段100的内表面以防止安全闭锁件428的枢转。安全闭锁件428限定了定尺寸为可滑动地接收刀具440的狭槽460。在刀具440的收缩位置上，刀具440的导缘440a被约束在安全闭锁件428的狭槽460内，以防止刀具440的导缘440a意外碰到和伤害医疗人员。
现在参考图1-34描述手术吻合器10的组装和操作。首先，将一次性组件600接合在钉仓接收半段200内。为了将一次性组件600接合在钉仓接收半段200内，将包括SULU400和发射单元500的一次性组件600大致对准在钉仓接收半段200上方并且插入通道构件206的U形通道208。更具体来说，将一次性组件600对准钉仓接收半段200，使得在一次性组件600平移到通道构件206的U形通道208时，突起220接合在弓形狭槽516内，喇叭状翼件520接合在对置的开口224内，并且有弹力的指状部230接合在瓶颈开口532内，因而将一次性组件600可释放地接合在钉仓接收半段200内。如以上讨论的，通过抓取固定壳体502的锯齿状表面518（尤其通过抓取和向内挤压锯齿状表面518）和/或通过抓取SULU400的锯齿状表面480，可有利于安装一次性组件600。
一旦一次性组件600加载入通道构件206，砧座半段100能够组装至钉仓接收半段200，如图2A所示。为了将砧座半段100附接至钉仓接收半段200，指状部118的突起120定位在钉仓接收半段200的垂直支撑构件216的垂直狭槽218中。此后，砧座半段100朝向钉仓接收半段200旋转以将横向支撑构件112定位在U形凹槽214内。在该位置上，手术吻合器10准备待用。
在使用中，在手术吻合器10处于打开或者非夹紧位置的情况下，将手术吻合器10操纵至使待吻合和分割的组织布置在砧座半段100和钉仓接收半段200之间的位置。此后，手术吻合器10可以移至夹紧位置以将组织夹紧SULU400和砧座半段100的吻合钉变形部106之间。为了将手术吻合器10定位在夹紧位置，在砧座半段和钉仓接收半段200附接之后，夹紧杆300从图2A示出的位置沿逆时针方向旋转。随着夹紧杆300旋转，克服弹簧构件316的偏置（图3），横向支撑构件112被接收在夹紧杆300的凸缘部304的切口302中（图2）并且朝向钉仓接收半段200做凸轮运动。在如图1示出的夹紧位置上，吻合钉变形部106定位成紧密接近SULU400的顶表面。
如图27所示，随着夹紧杆300移向夹紧位置，卡掣部706的成角度面707（图20）接合杆324。该接合引起锁定构件700绕枢轴构件508枢转，使得卡掣部706的钩构件708绕杆324的另一表面滑动，最终卡入而与杆324接合。为了从杆324释放卡掣部706，即从夹紧位置释放夹紧杆300，锁定构件700的推钮704被压下以使卡掣部706枢转而脱离杆324。当这发生时，弹簧构件316推动夹紧杆300返回非夹紧位置。
参考图3、图12、图19和图26，如以上讨论的，引导块548可枢转地支撑在发射单元500的固定壳体502中。随着手术吻合器10移至夹紧位置，砧座半段100的延伸部110相对于一次性组件600接近，使得延伸部110最终接触引导块548的上表面并且推动引导块548以沿大致逆时针方向枢转（从图19示出的位置至图26示出的位置）。随着引导块548从锁定位置枢转至解锁位置，锁定表面545（当吻合器10处于非夹紧位置时起初接收在刀具致动杆544的凹口549和551中）旋转而摆脱凹口549、551以解锁刀具致动杆544（图26）。该构造可防止在夹紧之前刀具致动杆544相对于引导块548的移动，以确保在使用之前刀具致动杆544和刀具440适当地保持于用于操作接合的适当位置。
参考图24-28，当吻合器10处于夹紧、非发射位置时，发射单元500的滑动块552在通道构件206的近侧端部和固定壳体502处于收缩位置（参见图27）。在该位置上，踏板554定位在通道构件206的切口555中，踏板554的销588定位在发射杆550的弓形凹槽594中，位于停止凹槽594a下方。这样，发射杆550能够枢转以利于从吻合器10的任一侧致动吻合器10。另外，在滑动块552的该位置上，刀具致动杆544的指状部599定位成邻近滑动块552的凹槽553的远侧壁553b。锁定构件700的卡掣部706还与杆324接合以将夹紧杆300保持于夹紧位置。
参考图26，当滑动块552处于收缩位置时，刀具440和凸轮杆546的凸轮表面547d定位在SULU400的近侧端部，安全闭锁件428的近侧钩456定位成与刀具440的接合构件458接合以将安全闭锁件428保持于锁定方位。此外，刀具440的下弯钩部440b与刀具致动杆544的上弯钩部598接合以将发射单元500连接至SULU400的刀具440。
参考图29-32，当发射杆550沿图29的箭头“A”所示方向向远侧前进时，滑动块552在发射单元500的固定壳体502内向远侧移动以引起凸轮杆546的对应移动和刀具致动杆544的延迟移动。如以上讨论的，刀具致动杆544的延迟移动等于滑动块552的凹槽553的长度，并且源自刀具致动杆544的指状部599在滑动块552的凹槽553内的移动。当指状部599抵接凹槽553的近侧壁553a时，刀具致动杆544连同滑动块552的移动开始。随着凸轮杆546向远侧移动通过发射单元500的固定壳体502，凸轮杆546的侧壁547上的凸轮表面547d前进通过SULU400以顺序地接合推进器422从而从主体420的狭槽430射出吻合钉402。同时，因为刀具致动杆544的远侧端部接合刀具440，所以刀具440在预设延迟之后前进通过SULU400以切割吻合钉线之间的组织。
如图32的虚线所示，当滑动块552在固定壳体502内向远侧移动时，踏板554架在通道构件206上并且沿着一次性组件600的固定壳体502的内表面移动。当这发生时，踏板554的销588移入停止凹槽594a以防止发射杆550的进一步枢转移动。
参考图31和图32，当刀具440在SULU400内向远侧移动时，刀具440的接合构件458从安全闭锁件428的近侧钩456脱离。
参考图33和图34，当发射杆550返回其最近侧位置以收缩凸轮杆546和刀具540、并且锁定构件700被压下以使卡掣部706从杆324脱离时，弹簧316推动夹紧杆300到其非夹紧位置以允许吻合器10移动至打开位置。在打开位置上，砧座半段100与钉仓接收半段200隔开，并且弹簧451（图17）使安全闭锁件428在图34的箭头“B”指示的方向上绕枢轴构件250枢转到其解锁位置，使得安全闭锁件428从SULU400向上伸出。在解锁位置上，安全闭锁件428防止吻合器10移回夹紧位置。为了再次使用吻合器10，通过用新的一次性组件600替换使用过的一次性组件600，已使用的SULU400必须被新的SULU400替换。
在手术程序期间，一次性组件600（包括SULU400和发射组件500）能够多次替换以利于对单个患者多次使用吻合器10。每个一次性组件600设置有新的刀具。此外，每个一次性组件600还设置有新的发射单元500，例如，新的凸轮杆546、滑动块552等，因而抑制了其任何部件的疲劳或者磨损并且简化要重消毒的部件的数量和形式。在手术程序之后，例如，经由抓取和挤压固定壳体502的锯齿状表面518和/或通过抓取SULU400的锯齿状表面480，一次性组件600能够从通道构件206移除，并且以适当方式处置。
另一方面，砧座半段100、钉仓接收半段200和夹紧杆300能够被消毒（诸如通过高压灭菌法），并且以以上讨论的方式与新的一次性组件600一起使用。因为锁定构件700、发射单元500和SULU400都是一次性的，所以可重复使用的部件上会捕获组织和流体的区域较少。这样，能够更易于对该装置的可重复使用的部件进行消毒。
应理解的是，可以对此处公开的手术紧固件施加装置的实施例做出各种修改。因此，上述说明书不应该视为限制，而仅是作为实施例的范例。本领域的技术人员将想到在本公开的范围和精神内的其他修改。

Claims (10)

1.一种手术紧固件施加装置，包括：
砧座半段，其包括远侧砧座部和近侧手柄部；
钉仓接收半段，其包括细长通道构件，所述细长通道构件具有由侧壁、闭合下部和开口上部限定的U形构造，所述钉仓接收半段包括由所述细长通道构件的所述侧壁限定的一对对置开口；
夹紧杆，其固定至所述钉仓接收半段，所述夹紧杆具有近侧端部和远侧端部，并且包括手柄部；以及
一次性组件，其包括单次使用加载单元和单次使用发射单元，所述一次性组件构造为可释放地支撑在所述钉仓接收半段内，并且包括用于支撑所述发射单元的固定壳体，所述固定壳体包括从其延伸出的远侧延伸部用于支撑所述单次使用加载单元，所述远侧延伸部构造为接合并保持所述单次使用加载单元于其上而形成整体式的一次性组件，所述固定壳体包括一对侧壁，每个侧壁均包括喇叭状翼件，其中所述喇叭状翼件相对于所述固定壳体的侧壁成一角度向外延伸，所述喇叭状翼件构造为在所述固定壳体通过所述细长通道构件的开口上部而插入所述细长通道构件时，接触所述细长通道构件的侧壁且朝向关于所述固定壳体的侧壁对准的方位向内弯曲，所述喇叭状翼件构造为在所述喇叭状翼件与所述细长通道构件的对置开口对准时偏置而使得所述喇叭状翼件可释放地接收在所述钉仓接收半段的所述细长通道构件的所述对置开口内以将所述一次性组件可释放地接合在所述钉仓接收半段内；
所述夹紧杆与所述砧座半段和所述钉仓接收半段可操作地关联，并且能够从非夹紧位置移动到夹紧位置以将所述砧座半段的所述砧座部可释放地固定成与所述单次使用加载单元紧密接近。
2.根据权利要求1所述的手术紧固件施加装置，其中，所述固定壳体还限定朝向其近侧端部定位的一对对置狭槽，并且其中，所述钉仓接收半部包括布置在其近侧端部且从其侧壁向内延伸的一对突起，所述突起构造为当所述一次性组件定位在所述钉仓接收半段内时被接收在所述狭槽内。
3.根据前述任一项权利要求所述的手术紧固件施加装置，其中，所述一次性组件还包括联接至所述固定壳体的枢转锁定构件，所述枢转锁定构件构造为接合定位在所述夹紧杆上的接合构件以将所述夹紧杆锁定在所述夹紧位置。
4.根据权利要求1或2所述的手术紧固件施加装置，其中，所述发射单元包括发射杆和牢固地固定至所述发射杆的凸轮杆，所述发射杆能够相对于所述固定壳体选择性地平移，以使所述凸轮杆平移通过所述单次使用加载单元以从其中射出紧固件。
5.根据权利要求4所述的手术紧固件施加装置，其中，所述发射单元还包括可枢转地支撑在所述固定壳体内的引导块，所述引导块构造为引导所述凸轮杆平移通过所述单次使用加载单元，所述引导块能够在抑制所述凸轮杆平移的锁定位置和允许所述凸轮杆平移的解锁位置之间枢转。
6.根据权利要求5所述的手术紧固件施加装置，其中，所述砧座半段包括从其延伸出的至少一个延伸部，所述延伸部构造为当所述夹紧杆移动至所述夹紧位置时将所述引导块推动至所述解锁位置。
7.根据权利要求1或2所述的手术紧固件施加装置，其中，所述喇叭状翼件偏置成与所述对置开口接合。
8.根据权利要求7所述的手术紧固件施加装置，其中，所述固定壳体的所述侧壁能够朝向彼此手动移动以从所述对置开口收缩所述喇叭状翼件，从而允许从所述钉仓接收半段退回所述固定壳体。
9.根据权利要求1或2所述的手术紧固件施加装置，其中，所述固定壳体包括一对向外延伸的锯齿状抓握表面以利于相对于所述钉仓接收半段插入和移除所述一次性组件。
10.根据权利要求9所述的手术紧固件施加装置，其中，所述钉仓接收半段包括切口部，所述切口部限定在所述细长通道构件的侧壁的自由端处，所述切口部构造为当所述一次性组件插入所述钉仓接收半段时接收锯齿状的抓握表面。
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WO2013022703A1 (en) 2013-02-14
EP2741686B1 (en) 2019-02-20
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US20170325811A1 (en) 2017-11-16
CA2843617A1 (en) 2013-02-14
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US10517588B2 (en) 2019-12-31
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