CN103445816B - 手持式手术用手柄组件、手术用手柄组件与手术用装载单元之间使用的手术用接合器及使用方法 - Google Patents

手持式手术用手柄组件、手术用手柄组件与手术用装载单元之间使用的手术用接合器及使用方法 Download PDF

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CN103445816B
CN103445816B CN201310217445.0A CN201310217445A CN103445816B CN 103445816 B CN103445816 B CN 103445816B CN 201310217445 A CN201310217445 A CN 201310217445A CN 103445816 B CN103445816 B CN 103445816B
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longitudinal axis
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戴维·尼古拉斯
约翰·比尔兹利
拉塞尔·普里巴尼奇
迈克尔·热姆洛克
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Covidien LP
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    • B25F—COMBINATION OR MULTI-PURPOSE TOOLS NOT OTHERWISE PROVIDED FOR; DETAILS OR COMPONENTS OF PORTABLE POWER-DRIVEN TOOLS NOT PARTICULARLY RELATED TO THE OPERATIONS PERFORMED AND NOT OTHERWISE PROVIDED FOR
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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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    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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    • A61B90/08—Accessories or related features not otherwise provided for
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Abstract

本发明公开了手持式手术用手柄组件、手术用手柄组件与手术用装载单元之间使用的手术用接合器及使用方法。公开了包括接合器组件的手术装置。接合器组件选择性地将装载单元与装置壳体相互连接，并且包括至少一个驱动转换器组件以用于将可旋转驱动轴和所述装载单元的可轴向平移驱动构件相互连接。至少一个驱动转换器组件将可旋转驱动轴的旋转转换并传递成所述装载单元的所述可轴向平移驱动构件的轴向平移。至少一个驱动转换器组件包括驱动元件、驱动螺母以及远侧驱动构件。所述驱动元件限定纵轴线。所述驱动螺母围绕所述纵轴线布置，并且所述远侧驱动构件沿着所述纵轴线布置。

Description

手持式手术用手柄组件、手术用手柄组件与手术用装载单元 之间使用的手术用接合器及使用方法
相关申请的交叉引用
本申请要求递交于2012年6月1日、序列号为61/654，206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
本公开涉及手术装置和/系统、手术用接合器及其使用方法。更具体地，本公开涉及手持式动力手术装置、手术用接合器和/或接合器组件，所述手术用接合器和/或接合器组件在动力、旋转和/或关节式运动手术装置或手柄组件与用于夹紧、切割和/或吻合组织的装载单元之间使用并用于将其相互连接。
背景技术
一种类型的手术装置为一种线性夹紧、切割和吻合装置。这样的装置可以用在手术操作中来切除胃肠道中癌变的或异常的组织。常规的线性夹紧、切割和吻合器械包括具有细长轴和远侧部的手枪握柄样式的结构。所述远侧部包括一对剪刀样式的夹持元件，其夹紧闭合结肠的开口端。在该装置中，两个剪刀样式的夹持元件中的一个元件，例如砧座部，相对于整个结构移动或枢转，而另一个夹持元件相对于整个结构保持固定。该剪取装置的致动（砧座部的枢转）受保留在所述手柄内的握柄扳机控制。
除了剪取装置外，所述远侧部还包括吻合机构。剪取机构的固定的夹持元件包括吻合钉钉仓接收区域和用于驱动吻合钉向上穿过紧靠砧座部的组织的被夹紧端从而密封先前的开口端的机构。剪取元件可以与所述细长轴整体形成或者可以是可分离的，使得可以互换各种剪取元件和吻合元件。
若干手术装置的生产商已经开发出具有适用于操作和/或操纵所述手术装置的专用驱动系统的产品线。在许多情况下，所述手术装置包括可重复使用的手柄组件和一次性装载单元等，所述装载单元在使用前选择性地连接至所述手柄组件上，然后在使用后与所述装载单元分离从而被丢弃或者在某些情况下被消毒用于再使用。
与许多现有的手术装置和/或手柄组件一起使用的许多现有的装载单元由线性力驱动。例如，用于执行胃肠内吻合术操作、端对端吻合术操作和横向吻合术操作的装载单元通常均需要线性驱动力以便于被操作。因此，这些装载单元与利用旋转运动来传递动力等的手术装置和/或手柄组件无法配合使用。
为了使所述线性驱动的装载单元与利用旋转运动来传递动力的手术装置和/或手柄组件互相配合使用，对于在所述线性驱动的装载单元与所述旋转驱动的手术装置和/或手柄组件之间进行交接并且将其相互连接的接合器和/或接合器组件存在需求。
发明内容
本公开涉及一种手术装置，其包括装置壳体、至少一个驱动电动机、电池、电路板、装载单元以及接合器组件。所述装置壳体限定了选择性地与所述接合器组件相连接的连接部。所述至少一个驱动电动机被支撑在所述装置壳体内并被配置以旋转至少一个驱动轴。所述电池被布置以与所述至少一个驱动电动机的电连通。所述电路板被布置在所述壳体内以用于控制从所述电池传送至所述至少一个驱动电动机的电力。所述装载单元被配置以执行至少一种功能，并且包括至少一个可轴向平移驱动构件。所述接合器组件用于选择性地将所述装载单元和所述装置壳体相互连接并且包括旋钮壳体以及至少一个驱动转换器组件。所述旋钮壳体被配置并适于选择性地连接至所述装置壳体并与所述至少一个可旋转驱动轴中的每一个可操作地连通。至少一个驱动转换器组件用于将所述至少一个可旋转驱动轴中的相应一个和所述装载单元的所述至少一个可轴向平移驱动构件中的一个相互连接。所述至少一个驱动转换器组件将所述可旋转驱动轴的旋转转换并传递成所述装载单元的所述至少一个可轴向平移驱动构件的轴向平移。所述至少一个驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括驱动元件、驱动螺母以及远侧驱动构件。所述驱动元件被旋转地支撑在所述旋钮壳体中。所述驱动元件的近端能够与所述可旋转驱动轴啮合。所述驱动元件限定了纵轴线。所述驱动螺母与所述驱动元件的远侧部通过螺纹啮合。所述远侧驱动构件的近侧部被布置以与所述驱动螺母机械配合。所述远侧驱动构件的远侧部被配置以与所述装载单元的所述至少一个可轴向平移驱动构件选择性地啮合。所述可旋转驱动轴的旋转引起所述驱动元件的旋转。所述驱动元件的旋转引起所述驱动螺母、所述远侧驱动构件以及所述装载单元的所述至少一个可轴向平移驱动构件的轴向平移。所述驱动螺母围绕所述纵轴线布置，并且所述远侧驱动构件沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件的所述螺纹部沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件、所述驱动螺母以及所述远侧驱动构件中的每个的径向中心均沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件的所述螺纹部的径向中心沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件和所述远侧驱动构件中的每个的整体长度均沿着所述纵轴线布置，并且其中所述驱动螺母的整体长度围绕所述纵轴线布置。
在所公开的实施例中，所述驱动元件相对于所述旋钮壳体径向地偏心。这里公开的是所述驱动轴相对于所述连接部径向地偏心。
在所公开的实施例中，所述驱动件能够相对于所述驱动螺母旋转。这里公开的是所述远侧驱动构件相对于所述驱动螺母被固定而不能旋转。
本公开还涉及一种接合器组件，其用于选择性地将手术用装载单元与具有至少一个可旋转驱动轴的手柄组件相互连接。所述接合器组件包括旋钮壳体和至少一个驱动转换器组件。所述旋钮壳体被配置且适合于选择性地连接至手柄组件，而且包括驱动联接壳体。所述至少一个驱动转换器组件用于将所述至少一个可旋转驱动轴中的相应一个和手术用装载单元的一部分相互连接。所述至少一个驱动转换器组件将所述可旋转驱动轴的旋转转换并传递成所述装载单元的所述至少一个可轴向平移驱动构件的轴向平移。所述至少一个驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括驱动元件、驱动螺母以及远侧驱动构件。所述驱动元件被旋转地支撑在所述旋钮壳体中。所述驱动元件的近侧端能够与所述可旋转驱动轴啮合。所述驱动元件限定了纵轴线。所述驱动螺母与所述驱动元件的远侧部通过螺纹啮合。所述远侧驱动构件的近侧部被布置以与所述驱动螺母机械配合。所述远侧驱动构件的远侧部被配置以与所述装载单元的所述至少一个可轴向平移驱动构件选择性地啮合。所述可旋转驱动轴的旋转引起所述驱动元件的旋转，并且所述驱动元件的旋转引起所述驱动螺母、所述远侧驱动构件以及所述装载单元的所述至少一个可轴向平移驱动构件的轴向平移。所述驱动螺母围绕所述纵轴线布置，并且所述远侧驱动构件沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件的所述螺纹部沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件、所述驱动螺母以及所述远侧驱动构件中的每个的径向中心均沿着所述纵轴线布置。这里公开的是所述驱动元件的所述螺纹部的径向中心沿着所述纵轴线布置。
在所公开的实施例中，所述驱动元件和所述远侧驱动构件中的每个的整体长度均沿着所述纵轴线布置，并且其中所述驱动螺母的整体长度围绕所述纵轴线布置。
在所公开的实施例中，所述驱动元件相对于所述旋钮壳体径向地偏心。
在所公开的实施例中，所述驱动件能够相对于所述驱动螺母旋转。这里公开的是所述远侧驱动构件相对于所述驱动螺母被固定而不能旋转。
附图说明
在此参照附图描述本公开的实施例，其中：
图1是根据本公开的实施例的零件分离的手术装置和接合器的立体图，示出了手术装置和接合器与装载单元的连接；
图2是图1中的手术装置的立体图；
图3是图1和图2中的手术装置的零件分离的立体图；
图4是用于图1至图3中的手术装置内的电池的立体图；
图5是壳体已拆除的图1至图3中的手术装置的立体图；
图6是手术装置和接合器各自的连接端的立体图，示出了它们之间的连接；
图7是沿图2的7-7截取的图1至图3的手术装置的剖视图；
图8是沿图2的8-8截取的图1至图3的手术装置的剖视图；
图9是图1至图3的手术装置的扳机壳体的零件分离的立体图；
图10是图1中的接合器的立体图；
图11是沿图10的11-11截取的图1和图10的接合器的端部视图；
图12是沿图10的12-12截取的图1和图10的接合器的剖视图；
图13是图12中所指示细节区域的放大视图；
图14是图12中所指示细节区域的放大视图；
图15是沿图12的15-15截取的图1和图10中的接合器的剖视图；
图16是图15中所指示细节区域的放大视图；
图17是图15中所指示细节区域的放大视图；
图18是沿图17的18-18截取的图1和图10中的接合器的剖视图；
图19是图15中所指示细节区域的放大视图；
图20是本公开的击发系统的立体图；
图21是图20中的击发系统的纵向剖视图；
图22是图21中所指示细节区域的放大视图；
图23是图20中所指示细节区域的放大视图；
图24是邻近装载单元的近侧部的图1和图10中的接合器的远侧部的立体图；
图25是与本公开的所述手术装置和接合器一起使用的示例性装载单元的零件分离的立体图；以及
图26是向LED的输出、电动机的选择（选择夹紧/切割、旋转或关节式运动）和为了执行所选择的功能而选择驱动电动机的示意图。
具体实施方式
参照附图详细描述本公开的手术装置和用于手术装置和/或手柄组件的接合器组件的实施例，其中在几幅附图的每幅附图中相同附图标记指代相同的或对应的元件。在本文中使用时，术语“远侧”指的是接合器组件或手术装置或其部件的距用户较远的部分，而术语“近侧”指的是接合器组件或手术装置或其部件的距用户较近的部分。
根据本公开的实施例，手术装置总体被指定为100，且为一种动力手持式机电器械的形式，其被配置用来选择性地将多个不同的装载单元附接于此，每一个装载单元均被配置为通过所述动力手持式机电手术器械来实现致动和操纵。
如图1所图示，手术装置100被配置为用来选择性地连接接合器200，然后，依次地，接合器200被配置为选择性地连接装载单元或单次使用装载单元300。
如图1至图3所图示，手术装置100包括手柄壳体102，手柄壳体102包括下壳体部104、中间壳体部106以及上壳体部108，其中，中间壳体部106从下壳体部104延伸出和/或被支撑在下壳体部104上，上壳体部108从中间壳体部106延伸出和/或被支撑在中间壳体部106上。中间壳体部106和上壳体部108被分离成远侧半部110a和近侧半部110b，其中，远侧半部110a从下壳体部104延伸出且与下壳体部104整体形成，近侧半部110b通过采用多个紧固件可与远侧半部110a相连接。当接合时，远侧半部110a与近侧半部110b限定了手柄壳体102，手柄壳体102内有空腔102a，电路板150和驱动机构160被设置在空腔102a中。
如图3所示，沿横切上壳体部108的纵向轴线“X”的平面分隔远侧半部110a和近侧半部110b。
手柄壳体102包括垫圈112，垫圈112完全地在远侧半部110a和/或近侧半部110b的缘边的周围延伸且被插入在远侧半部110a和近侧半部110b之间。垫圈112密封远侧半部110a和近侧半部110b的周边。垫圈112的功能是在远侧半部110a和近侧半部110b之间形成气密密封以便于在消毒和/或清洗操作时保护电路板150和驱动机构160。
以这种方式，手柄壳体102的空腔102a沿着远侧半部110a的周边密封，并且近侧半部110b还被配置为使得能够更轻松、更高效地将电路板150和驱动机构160装配在手柄壳体102中。
手柄壳体102的中间壳体部106提供了电路板150被设置在其中的壳体。将在下面额外详细阐明，配置电路板150来控制手术装置100的各种操作。
手术装置100的下壳体部104限定了在其上表面中形成的孔隙（未显示）并且孔隙位于中间壳体部106的下方或内部。下壳体部104的孔隙提供了可供导线152穿过的通道以将位于下壳体部104中的电气部件（如图4中所图示的电池156、如图3中所图示的电路板154等）与位于中间壳体部106和/或上壳体部108中的电气部件（电路板150、驱动机构160等）相互电连接。
手柄壳体102包括被布置在下壳体部104（未显示）的孔隙内的垫圈103，因而在允许导线152穿过下壳体部104的孔隙的同时还堵塞或密封下壳体部104的孔隙。垫圈103的功能是在下壳体部106和中间壳体部108之间形成气密密封以便于在消毒和/或清洗操作时保护电路板150和驱动机构160。
正如图所示，手柄壳体102的下壳体部104提供了可拆卸地位于其中的可再充电电池156。电池156被配置为给手术装置100的电气部件中的任何一个部件提供电力。下壳体部104限定了电池156被插入其中的空腔（未显示）。下壳体部104包括枢转地连接于其上的门105，门105用来封闭下壳体部104的空腔并将电池156保持在空腔中。
参照图3和图5，上壳体部108的远侧半部110a限定了鼻部或连接部108a。鼻锥114被支撑在上壳体部108的鼻部108a上。鼻锥114是由透明材料制造。照明构件116被布置在鼻锥114内使得透过鼻锥114可见照明构件116。照明构件116采用发光二极管印刷电路板（LEDPCB）的形式。照明构件116被配置为使用与独特离散事件关联的特定颜色图案来照亮多种颜色。
手柄壳体102的上壳体部108提供了驱动机构160位于其中的壳体。如图5所示，配置驱动机构160来驱动轴和/或齿轮部件以便于执行手术装置100的各种操作。特别地，配置驱动机构160来驱动轴和/或齿轮部件，以便于相对于装载单元300的近侧主体部302，选择性地移动装载单元300的工具组件304（参照图1和图20），从而使得装载单元300相对于手柄壳体102绕纵轴线“X”（参照图3）旋转，以使得砧座组件306相对于装载单元300的钉仓组件308移动，和/或击发在装载单元300的钉仓组件308内的吻合切割钉仓。
驱动机构160包括相对紧邻接合器200定位的选择变速箱组件（selector gearboxassembly）162。邻近选择变速箱组件162的是具有第一电动机164的功能选择模块163，第一电动机164的功能为选择性地移动选择变速箱组件162内的齿轮元件以与具有第二电动机166的输入驱动部件165相啮合。
如图1至图4所示，且如上所述，上壳体部108的远侧半部110a限定了连接部108a，连接部108a配置为接受接合器200的对应的驱动联接组件210。
如图6至图8所示，当接合器200与手术装置100匹配时，手术装置100的连接部108a具有用来接纳接合器200的驱动联接组件210的柱形凹槽108b。连接部108a容纳三个可旋转驱动连接器118、120、122。
当接合器200与手术装置100匹配时，手术装置100的可旋转驱动连接器118、120、122中的每一个均与接合器200的对应的可旋转连接器套管218、220、222相联接。（参照图6）。在这点上，对应的第一驱动连接器118和第一连接器套管218之间的交接、对应的第二驱动连接器120和第二连接器套管220之间的交接，以及对应的第三驱动连接器122和第三连接器套管222之间的交接都是键联接，以便于手术装置100的驱动连接器118、120、122中的每一个的旋转都会引起接合器200的对应的连接器套管218、220、222的对应的旋转。
手术装置100的驱动连接器118、120、122与接合器200的连接器套管218、220、222的匹配允许经由三个对应的连接器交接中的每一个独立地传输旋转力。手术装置100的驱动连接器118、120、122被配置为通过驱动机构160独立地旋转。在这点上，驱动机构160的功能选择模块163会选择由驱动机构160的输入驱动部件165来驱动手术装置100的驱动连接器118、120、122中的哪一个或多个驱动连接器。
因为手术装置100的驱动连接器118、120、122中的每一个驱动连接器都是与接合器200的相应的连接器套管218、220、222进行键联接和/或基本上非可旋转地相接，当接合器200被联接到手术装置100时，会选择性地将旋转力从手术装置100的驱动机构160传递到接合器200。
手术装置100的驱动连接器118、120和/或122的选择性的旋转允许手术装置100选择性地致动装载单元300的不同功能。如下面更详细地讨论，手术装置100的第一驱动连接器118的选择性的且独立的旋转对应于装载单元300的工具组件304的选择性的且独立的打开和闭合，以及对应于装载单元300的工具组件304的吻合/切割部件的驱动。同样，手术装置100的第二驱动连接器120的选择性的且独立的旋转对应于横切于纵轴线“X”（参照图3）的装载单元300的工具组件304的选择性的且独立的关节式运动。另外，手术装置100的第三驱动连接器122的选择性的且独立的旋转对应于装载单元300相对于手术装置100的手柄壳体102的绕纵轴线“X”（参照图3）的选择性的且独立的旋转。
如上所述且如图5和图8所图示，驱动机构160包括选择变速箱组件162；邻近选择变速箱组件162定位的功能选择模块163，功能选择模块163的功能为选择性地移动选择变速箱组件162内的齿轮元件以与第二电动机166相啮合。这样，驱动机构160就在给定时间选择性地驱动手术装置100的驱动连接器118、120、122中的一个驱动连接器。
如图1至图3和图9所示，手柄壳体102在中间壳体部108的远侧表面或远侧上支撑扳机壳体107。与中间壳体部108配合的扳机壳体107支撑一对手指致动的控制按钮124、126和摇杆装置128、130。特别地，扳机壳体107限定了上孔隙124a以用于可滑动地接纳第一控制按钮124，以及下孔隙126b以用于可滑动地接纳第二控制按钮126。
控制按钮124、126和摇杆装置128、130中的每一个均包括由操作者的致动来移动的相应的磁体（未显示）。此外，对于控制按钮124、126和摇杆装置128、130中的每一个，电路板150都包括靠控制按钮124、126和摇杆装置128、130中磁体的移动来致动的相应的霍尔效应开关150a-150d。特别地，位置紧邻控制按钮124的是第一霍尔效应开关150a(参照图3和图7)，在操作者致动控制按钮124时，控制按钮124中的磁体就会移动，从而致动第一霍尔效应开关150a。对应于控制按钮124的第一霍尔效应开关150a的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来闭合装载单元300的工具组件304和/或击发装载单元300的工具组件304内的吻合/切割钉仓。
同样，位置紧邻摇杆装置128的是第二霍尔效应开关150b（参照图3和图7），在操作者致动摇杆装置128时，摇杆装置128中的磁体（未显示）就会移动，从而致动第二霍尔效应开关150b。对应于摇杆装置128的第二霍尔效应开关150b的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来使得工具组件304相对于装载单元300的主体部302进行关节式运动。有利的是，摇杆装置128在第一方向上的移动会引起工具组件304相对于主体部302在第一方向上进行关节式运动，而摇杆装置128在相反方向（如第二方向）上的移动会引起工具组件304相对于主体部302在相反方向（如第二方向）上进行关节式运动。
此外，位置紧邻控制按钮126的是第三霍尔效应开关150c（参照图3和图7），在操作者致动控制按钮126时，控制按钮126中的磁体（未显示）就会移动，从而致动第三霍尔效应开关150c。对应于控制按钮126的第三霍尔效应开关150c的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来打开装载单元300的工具组件304。
另外，位置紧邻摇杆装置130的是第四霍尔效应开关150d（参照图3和图7），在操作者致动摇杆装置130时，摇杆装置130中的磁体（未显示）就会移动，从而致动第四霍尔效应开关150d。对应于摇杆装置130的第四霍尔效应开关150d的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来使装载单元300相对于手术装置100的手柄壳体102旋转。特别地，摇杆装置130在第一方向上的移动会引起装载单元300相对于手柄壳体102在第一方向上旋转，而摇杆装置130在相反方向（如第二方向）上的移动会引起装载单元300相对于手柄壳体102在相反方向（如第二方向）上旋转。
如图1至图3所示，手术装置100包括被支撑在中间壳体部108和上壳体部之间且被定位于扳机壳体107上方的击发按钮或安全开关132。在使用中，根据需要和/或要求，装载单元300的工具组件304在打开状态和闭合状态之间被致动。为了击发装载单元300，为了当装载单元300的工具组件304处于闭合状态时从其中射出紧固件，按下安全开关132，从而指示手术装置100：装载单元300准备从其中射出紧固件。
如图1和图10至图24所示，手术装置100被配置为用来选择性地与接合器200相连接，然后，依次地，接合器200被配置为用来选择性地与装载单元300相连接。
如图25所示并如下文中将更详细讨论的，接合器200被配置以将手术装置100的驱动连接器120和122中任何一个驱动连接器的旋转转换成用于操作装载单元300的驱动组件360和关节式运动连杆366的轴向平移。
接合器200包括用于将手术装置100的第三可旋转驱动连接器122与装载单元300的第一可轴向平移驱动构件360相互连接的第一驱动传递/转换组件，其中，第一驱动传递/转换组件将手术装置100的第三可旋转驱动连接器122的旋转转换并传递成装载单元300的第一可轴向平移驱动组件360的轴向平移以便进行击发。
接合器200包括用于将手术装置100的第二可旋转驱动连接器120和装载单元300的第二可轴向平移驱动构件366相互连接的第二驱动传递/转换组件，其中，第二驱动传递/转换组件将手术装置100的第二可旋转驱动连接器120的旋转转换并传递成装载单元300的关节式运动连杆366的轴向平移以便进行关节式运动。
现在转向图10，接合器200包括旋钮壳体202和从旋钮壳体202的远侧端延伸出的外管206。旋钮壳体202和外管206被配置和定尺寸为容纳接合器200的部件。外管206被定尺寸为用于内窥镜插入，特别地，外管可通过典型的套管针口、插管或同类物。旋钮壳体202的尺寸无法进入套管针口、插管或同类物。旋钮壳体202被配置且适于连接到手术装置100的远侧半部110a的上壳体部108的连接部108a。
如图10、图12和图15所示，接合器200包括在其近侧端处的手术装置驱动联接组件210和在其远侧端处的装载单元联接组件230。驱动联接组件210包括至少部分被可旋转地支撑在旋钮壳体202内的驱动联接壳体210a。在图示实施例中，驱动联接组件210可旋转地支撑第一可旋转近侧驱动轴或元件212。
如图6和图11所示，驱动联接壳体210a被配置为分别可旋转地支撑第一连接器套管218、第二连接器套管220和第三连接器套管222。如上所述，连接器套管218、220和222中的每一个均被配置分别与手术装置100的相应第一、第二和第三驱动连接器118、120、122配合。连接器套管220还被配置与第一近侧驱动轴212的近侧端配合。可以进一步想到的是，连接器套管218和222被配置分别与第二近侧驱动轴的近端和第三近侧驱动轴的近端配合。
特别参照图13和图16，近侧驱动联接组件210包括被布置在相应的连接器套管220的远侧的偏置构件224。偏置构件224围绕驱动轴212布置。当接合器200被连接至手术装置100时，偏置构件224作用于连接器套管220以帮助保持连接器套管220与手术装置100的可旋转驱动连接器118的远侧端相啮合。
特别地，偏置构件224起到在近侧方向上偏置连接器套管220的作用。以这种方式，在将接合器200组装在手术装置100上的过程中，如果连接器套管220未与手术装置100的驱动连接器120对准，则偏置构件224被挤压。因此，当手术装置100的驱动机构160被啮合时，手术装置100的驱动连接器120会旋转并且偏置构件224会引起连接器套管220向后滑向近侧，有效地将手术装置100的驱动连接器120联接至近侧驱动联接组件210的近侧驱动轴212。可以进一步想到的是，驱动联接组件210包括相应的偏置构件以用于向近侧偏置每个连接器套管218、222而与相应的可驱动连接器118、122的远侧端啮合。
如图12、15、20和21所示，接合器200包括被布置在手柄壳体202和外管206内的驱动传递/转换组件240。驱动传递/转换组件240被配置且适用于将手术装置100的驱动连接器120的旋转转换并传递成接合器200的远侧驱动构件248的轴向平移，以实现装载单元300的闭合、打开、和发射操作。
如图12至图24所示，并且特别地如图20-23所示，第一驱动传递/转换组件240包括驱动轴212、导螺杆250、驱动螺母260以及远侧驱动构件248。导螺杆250是被向远侧布置在驱动轴212上的螺纹部252。驱动螺母260是细长构件并且包括沿着其长度的至少一部分（例如，近侧部262a）的内周边的内螺纹部262。驱动螺母260的螺纹部262被配置以与导螺杆250的螺纹部252机械啮合。远侧驱动构件248的近侧部248a被布置以经由连杆组件270与驱动螺母260的远侧部260b机械配合。
特别地，关于图15、图17和图18，连杆组件270包括被布置垂直于由驱动轴212限定的纵轴线B-B的第一销272a和第二销272b。每个销272延伸通过槽264(图17)以及一对对应的凹槽249(图18)，槽264至少部分地延伸通过驱动螺母260，并且一对对应的凹槽249至少部分地延伸通过远侧驱动构件248。另外，远侧驱动构件248的近侧部248a被布置在插槽266内，插槽266形成在驱动螺母260的远侧部260b内。此外，例如，远侧驱动构件248包括被布置邻近其近侧部248a的止挡构件247，止挡构件247被配置有助于限制驱动螺母260相对于远侧驱动构件248的远侧平移。因此，包括销272的连杆组件270有效地将驱动螺母260与远侧驱动构件248联接，使得驱动螺母260的纵向平移引起远侧驱动构件248的伴随的纵向平移。
此外，特别参照图18，驱动螺母260的周边的至少一部分包括防旋转段261。显示防旋转段261包括平坦表面，该平坦表面被布置在驱动螺母260的两个侧面上并且邻近接合器200的内部的形状相似的表面201。因此，在驱动轴212的旋转引起导螺杆250的旋转的同时，并且在导螺杆250的旋转通常会引起驱动螺母260的旋转和纵向平移的同时，驱动螺母260的防旋转段261消除了其运动的旋转分量。因此，驱动轴212的旋转引起驱动螺母260的非旋转的纵向平移，从而引起远侧驱动构件248的非旋转的纵向平移。
参照图20-23，第一驱动传递/转换组件240还包括一对止推轴承280。在图示实施例中，止推轴承280被布置为周向地围绕在导螺杆250的近侧的驱动轴212的一部分。另外，显示驱动轴212包括被布置在第一止推轴承280a与第二止推轴承280b之间的扩径环或凸缘215。可以想到的是止推轴承280有助于驱动轴212相对于驱动联接壳体210a的旋转，同时当驱动轴212受到轴向力时(例如，当末端执行器300的钳夹构件夹紧组织时等)保持旋转的能力。
如图21所示，纵轴线B-B延伸通过驱动轴212的径向中心、导螺杆250的径向中心、驱动螺母260的径向中心（即，驱动螺母260围绕纵轴线B-B布置）以及远侧驱动构件248的径向中心。此外，纵轴线B-B沿着驱动轴212、导螺杆250、驱动螺母260以及远侧驱动构件248各自的整个长度延伸通过它们的径向中心。这种所谓的“在中心上的驱动系统”的定向允许直接由电动机(例如，第一电动机164)驱动远侧驱动构件248而不需要任何的齿轮，因此降低了通常与齿轮组件相关联的复杂性和成本。另外，因为驱动轴212和导螺杆250处于相同的转矩负载下，能够有利于准确监控来自手柄壳体102的转矩。
在使用中，驱动轴212的旋转引起导螺杆250的旋转，这样引起驱动螺母260沿着由驱动轴212限定的纵轴线B-B纵向平移，这引起远侧驱动构件248的纵向平移。当末端执行器300与接合器200啮合时，远侧驱动构件248的纵向平移引起装载单元300的驱动构件374的伴随的轴向平移，从而实现工具组件304的闭合以及装载单元300的工具组件304的击发。
如图6所示，接合器200包括一对电触销290a、290b，一对电触销290a、290b与被布置在手术装置100的连接部108a中的对应的电插头190a、190b电连接。电触销290a、290b用来允许经由被电连接到电路板150上的电气插头190a、190b校准和传递生命周期信息给手术装置100的电路板150。接合器200还包括被支撑在旋钮壳体202中且与电触销290a、290b电连通的电路板。
当用户激活手术装置的按钮时，软件会核对预定义的条件。如果符合条件，则软件会控制电动机并且将机械驱动传递给附接的手术吻合器，然后根据按下的按钮的功能，手术吻合器随后能够进行打开、闭合、旋转、关节式运动或发射。软件还通过按照定义的方式打开或熄灭彩色灯给用户提供反馈，从而指示出手术装置100、接合器200和/或装载单元300的状态。
所述系统的高级电气结构图显示在图26中并示出了与各种硬件和软件接口的连接。来自按钮124、126的按压和来自驱动轴的电动机编码器的输入显示在图26的左侧。微型控制器包含操作手术装置100、接合器200和/或装载单元300的装置软件。微型控制器接收微型局域网（MicroLAN）、超级ID（Ultra ID）芯片、电池ID（Battery ID）芯片以及接合器ID（Adaptor ID）芯片的输入以及发送输出给它们。微型局域网、超级ID芯片、电池ID芯片以及接合器ID芯片如下控制手术装置100、接合器200和/或装载单元300：
微型局域网 ---串行1导线总线通信以读/写系统部件ID信息。
超级ID芯片 ---识别手术装置100并且记录使用信息。
电池ID芯片 ---识别电池156并且记录使用信息
接合器ID芯片 ---识别接合器200的类型，记录末端执行器300的存在并且记录使用信息
在图26中呈现的示意图的右侧指示了：至LED的输出；电动机的选择（选择夹紧/切割、旋转或关节式运动）；以及执行所选择功能的驱动电动机的选择。
如图1和图25所示，装载单元被指示为300。装载单元300被配置和定尺寸为内窥镜插入通过插管、套管针或同类物。特别地，在图1和图25所图示的实施例中，当装载单元300处于闭合状态下时，装载单元300可以通过插管或套管针。
装载单元300包括近侧主体部302和工具组件304。近侧主体部302被可释放地附接到接合器200的远侧联接组件230，而工具组件304可枢转地附接到近侧主体部302的远侧端。工具组件304包括砧座组件306和钉仓组件308。钉仓组件308相对于砧座组件306枢转并且能够在打开或未夹紧位置与闭合或夹紧位置之间移动以便于插入通过套管针的插管。
近侧主体部302至少包括驱动组件360和关节式运动连杆366。
参照图25，驱动组件360包括挠性驱动梁364以及近侧啮合部368，挠性驱动梁364具有被固定到动力夹紧构件365的远侧端。啮合部368包括限定台肩370的阶状部。啮合部368的近侧端包括沿直径对置的向内延伸的指状件372。指状件372与中空的驱动构件374啮合从而将驱动构件374牢固地固定到梁364的近侧端上。驱动构件374限定近侧孔口376，近侧孔口376用来当装载单元300被附接到接合器200的远侧联接组件230时接纳接合器200的第一驱动转换器组件240的驱动管246的连接构件247。
当驱动组件360在工具组件304内被向远侧推进时，夹紧构件365的上梁在砧座板312和砧座盖310之间限定的通道内移动，而且下梁移动到托架316外表面的上方来闭合工具组件304并从其中发射吻合钉。
装载单元300的近侧主体部302包括关节式运动连杆366，关节式运动连杆366具有从装载单元300的近侧端延伸出的带钩近侧端366a。当装载单元300被固定到接合器200的远侧壳体232时，关节式运动连杆366的带钩近侧端366a与接合器200的驱动杆258的联接钩258c相啮合。当接合器200的驱动杆258如上被推进或缩回时，装载单元300的关节式运动连杆366会在装载单元300内被推进或缩回以使得工具组件304相对于近侧主体部302的远侧端枢转。
如图25中所示，工具组件304的钉仓组件308包括可支撑在托架316中的吻合钉钉仓305。吻合钉钉仓305限定中央纵向狭槽305a，以及被安置在纵向狭槽305a每一侧上的三个线性排吻合钉保持狭槽305b。每一个吻合钉保持狭槽305b接纳单个吻合钉307和吻合钉推动器309的一部分。在操作手术装置100期间，驱动组件360抵靠致动滑块并推动致动滑块通过钉仓305。随着致动滑块移动通过钉仓305，致动滑块的凸轮楔顺序地与吻合钉推动器309相啮合，从而在吻合钉保持狭槽305b内垂直地移动吻合钉推动器309并从其中顺序地发射单个吻合钉307以紧靠着砧座板312成形。
可以参考递交于2009年8月31日、名称为“手术吻合装置的工具组件（TOOLASSEMBLY FOR A SURGICAL STAPLING DEVICE）”、公开号为2009/0314821的美国专利中对于装载单元300的结构和操作的详细讨论。
将要理解的是可以对这里公开的接合器组件的实施例进行各种修改。例如，电池156可以被更换成交替的电源，例如线路电压（AC或者DC）或者燃料电池。因此，上述说明不应该视为限制，而仅仅是一些特定实施例的示范。本领域技术人员将在本公开的范围和精神内构想出其他的修改。

Claims (17)

1.一种手术装置，包括：
装置壳体，其限定用于选择性地与接合器组件连接的连接部；
驱动电动机，其被支撑在所述装置壳体内并被配置以旋转驱动轴；
电池，其被布置以与所述驱动电动机电连通；
电路板，其被布置在所述装置壳体内以用于控制从所述电池输送到所述驱动电动机的电力；
装载单元，其被配置以执行功能，所述装载单元包含可轴向平移驱动构件；以及
所述接合器组件，其选择性地将所述装载单元和所述装置壳体相互连接，所述接合器组件限定纵轴线，所述接合器组件包括：
旋钮壳体，其被配置且适于选择性地连接至所述装置壳体并与所述驱动轴可操作地连通，其中所述旋钮壳体的径向中心与通过其的纵轴线对准；
驱动联接壳体，其从所述旋钮壳体向近侧延伸，其中所述驱动联接壳体的径向中心与所述旋钮壳体的径向中心偏移；
驱动转换器组件，其用于将所述驱动轴和所述装载单元的所述可轴向平移驱动构件相互连接，其中，所述驱动转换器组件将所述驱动轴的旋转转换并传递成所述装载单元的所述可轴向平移驱动构件的轴向平移，其中，所述驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括：
驱动元件，其可旋转地支撑在所述驱动联接壳体中，所述驱动元件具有能够与所述驱动轴啮合的近侧部，其中所述驱动元件被沿着所述纵轴线布置；
驱动螺母，其与所述驱动元件的远侧部螺纹啮合；以及
远侧驱动构件，所述远侧驱动构件的近侧部被布置以与所述驱动螺母机械配合，所述远侧驱动构件的远侧部被配置以与所述装载单元的所述可轴向平移驱动构件选择性地啮合，
其中所述驱动轴的旋转引起所述驱动元件的旋转，并且其中所述驱动元件的旋转引起所述驱动螺母、所述远侧驱动构件以及所述装载单元的所述可轴向平移驱动构件的轴向平移；并且
其中所述驱动螺母围绕所述纵轴线布置，并且所述远侧驱动构件沿着所述纵轴线布置。
2.根据权利要求1所述的手术装置，其中，所述驱动元件包括沿着所述纵轴线布置的螺纹远侧部。
3.根据权利要求1所述的手术装置，其中，所述驱动元件、所述驱动螺母以及所述远侧驱动构件中的每个的径向中心均沿着所述纵轴线布置。
4.根据权利要求2所述的手术装置，其中，所述驱动元件的所述螺纹远侧部的径向中心沿着所述纵轴线布置。
5.根据权利要求1所述的手术装置，其中，所述驱动元件和所述远侧驱动构件中的每个的整体长度均沿着所述纵轴线布置，并且其中所述驱动螺母的整体长度围绕所述纵轴线布置。
6.根据权利要求1所述的手术装置，其中，所述驱动元件相对于所述旋钮壳体径向地偏心。
7.根据权利要求6所述的手术装置，其中，所述驱动轴相对于所述连接部径向地偏心。
8.根据权利要求1所述的手术装置，其中，所述驱动元件能够相对于所述驱动螺母旋转。
9.根据权利要求8所述的手术装置，其中，所述远侧驱动构件相对于所述驱动螺母被固定而不能旋转。
10.一种接合器组件，其用于选择性地将手术用装载单元与具有可旋转驱动轴的手柄组件相互连接，所述接合器组件包括：
旋钮壳体，其被配置且适于选择性地连接至手柄组件，其中所述旋钮壳体的径向中心与被所述接合器组件限定的纵轴线对准；
驱动联接壳体，其从所述旋钮壳体向近侧延伸，其中所述驱动联接壳体的径向中心与所述旋钮壳体的径向中心偏移；以及
驱动转换器组件，其用于将所述可旋转驱动轴和手术用装载单元的一部分相互连接，其中，所述驱动转换器组件将可旋转驱动轴的旋转转换并传递成所述装载单元的可轴向平移驱动构件的轴向平移，其中，所述驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括：
驱动元件，其可旋转地支撑在所述驱动联接壳体中，所述驱动元件具有能够与所述可旋转驱动轴啮合的近侧部，其中所述驱动元件被沿着所述纵轴线布置；
驱动螺母，其与所述驱动元件的远侧部螺纹啮合；以及
远侧驱动构件，所述远侧驱动构件的近侧部被布置以与所述驱动螺母机械配合，所述远侧驱动构件的远侧部被配置以与所述装载单元的所述可轴向平移驱动构件选择性地啮合，
其中所述可旋转驱动轴的旋转引起所述驱动元件的旋转，并且其中所述驱动元件的旋转引起所述驱动螺母、所述远侧驱动构件以及所述装载单元的所述可轴向平移驱动构件的轴向平移，并且其中所述驱动螺母围绕所述纵轴线布置，并且所述远侧驱动构件沿着所述纵轴线布置。
11.根据权利要求10所述的接合器组件，其中，所述驱动元件包括沿着所述纵轴线布置的螺纹远侧部。
12.根据权利要求10所述的接合器组件，其中，所述驱动元件、所述驱动螺母以及所述远侧驱动构件中的每个的径向中心均沿着所述纵轴线布置。
13.根据权利要求11所述的接合器组件，其中，所述驱动元件的所述螺纹远侧部的径向中心沿着所述纵轴线布置。
14.根据权利要求10所述的接合器组件，其中，所述驱动元件和所述远侧驱动构件中的每个的整体长度均沿着所述纵轴线布置，并且其中所述驱动螺母的整体长度围绕所述纵轴线布置。
15.根据权利要求10所述的接合器组件，其中，所述驱动元件相对于所述旋钮壳体径向地偏心。
16.根据权利要求10所述的接合器组件，其中，所述驱动元件能够相对于所述驱动螺母旋转。
17.根据权利要求16所述的接合器组件，其中，所述远侧驱动构件相对于所述驱动螺母被固定而不能旋转。
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AU2013205872B2 (en) 2017-09-28
US9868198B2 (en) 2018-01-16
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CN103445816A (zh) 2013-12-18
US11633844B2 (en) 2023-04-25
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US10661422B2 (en) 2020-05-26
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US20200262046A1 (en) 2020-08-20
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EP3508143A1 (en) 2019-07-10
CA2816233A1 (en) 2013-12-01
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US20130319706A1 (en) 2013-12-05
US20180133883A1 (en) 2018-05-17

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