CN103989496A - 用于内窥镜操作的器械 - Google Patents

用于内窥镜操作的器械 Download PDF

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CN103989496A
CN103989496A CN201410055582.3A CN201410055582A CN103989496A CN 103989496 A CN103989496 A CN 103989496A CN 201410055582 A CN201410055582 A CN 201410055582A CN 103989496 A CN103989496 A CN 103989496A
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CN103989496B (zh
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保罗·西里卡
贾斯汀·威廉斯
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Covidien LP
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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
    • 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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16H—GEARING
    • F16H25/00—Gearings comprising primarily only cams, cam-followers and screw-and-nut mechanisms
    • F16H25/18—Gearings comprising primarily only cams, cam-followers and screw-and-nut mechanisms for conveying or interconverting oscillating or reciprocating motions
    • F16H25/20—Screw mechanisms
    • 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
    • A61B2017/00398—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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00734—Aspects not otherwise provided for battery operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2902—Details of shaft characterized by features of the actuating rod
    • A61B2017/2903—Details of shaft characterized by features of the actuating rod transferring rotary motion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2943—Toothed members, e.g. rack and pinion

Abstract

本公开提供一种用于内窥镜操作的器械和机电手术系统。本公开还提供一种轴组件，其用于将手持式机电手术装置的至少一个可旋转驱动轴与能够由轴向驱动力致动的末端执行器相互连接。所述轴组件包括可旋转地支撑在外管内的挠性驱动线缆，挠性驱动线缆包括与手持式手术装置的对应的可旋转驱动轴操作性连接的近侧端。所述挠性驱动线缆自外管的中心纵向轴线偏离一径向距离。所述轴组件包括至少部分地可滑动地支撑在外管内的关节式运动杆和关节式运动连杆，关节式运动连杆具有近侧端和远侧端，所述近侧端与关节式运动杆的远侧端可枢转地连接，所述远侧端与远侧颈部壳体可枢转地连接。所述关节式运动杆自外管的中心纵向轴线偏离一径向距离。

Description

用于内窥镜操作的器械
技术领域
本公开涉及用于执行内窥镜手术操作的手术器械、装置和/或系统以及它们的使用方法。更具体地，本公开涉及机电手持式手术器械、装置和/或系统，其构造成与用于夹紧、切割和/或吻合组织的能够拆卸的可置换装载单元和/或单次使用的装载单元一起使用。
背景技术
许多手术装置制造商已经开发了具有用于操作和/或操纵机电手术装置的专用驱动系统的产品线。在很多情况下，机电手术装置包括可再用的手柄组件以及在使用前与手柄组件选择性连接、然后在使用后从手柄组件脱离以便被处理或在某些情况下为了再次使用而被消毒的可置换装载单元和/或单次使用的装载单元等。
许多这种机电手术装置的制造、购买和/或运行是相对昂贵的。制造商和终端用户一直需要开发出制造、购买和/或运行相对廉价但是仍能提供良好的操作性的机电手术装置。
因此，需要从开发和制造阶段到销售/购买阶段、到储存/运输阶段、到使用/操作阶段以及替换和/或再次使用阶段都相对经济但是仍能为终端用户提供良好的操作性的机电手术器械、装置和/或系统。
发明内容
本公开涉及机电手持式手术器械、装置和/或系统，其构造成与用于夹紧、切割和/或吻合组织的能够拆卸的可置换装载单元和/或单次使用的装载单元一起使用。
根据本公开的一个方案，提供一种机电手术装置，所述机电手术装置包括末端执行器和轴组件，所述末端执行器构造成执行至少一种功能。所述轴组件包括：近侧颈部壳体，其支撑在所述外管的远侧端；远侧颈部壳体，其与所述近侧颈部壳体枢转地连接，其中，所述远侧颈部壳体的远侧端构造成并适用于与所述末端执行器操作性连接；挠性驱动线缆，其延伸通过所述轴组件、所述近侧颈部壳体和所述远侧颈部壳体；以及关节式运动杆，其至少部分地可滑动地支撑在所述远侧颈部壳体内。所述关节式运动杆包括：远侧端；和近侧端，所述近侧端与可旋转驱动轴操作性连接；其中，所述关节式运动杆自所述轴组件的所述中心纵向轴线偏离一径向距离。所述轴组件还包括关节式运动连杆，其具有枢转地连接至所述关节式运动杆的所述远侧端的近侧端和枢转地连接至所述远侧颈部壳体的远侧端。
在使用中，所述手持式手术仪器的与所述关节式运动杆连接的所述可旋转驱动轴的致动引起所述关节式运动杆轴向平移；并且所述关节式运动杆的轴向平移引起所述远侧颈部壳体相对于所述近侧颈部壳体枢转偏离轴线。
所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线可与所述中心纵向轴线交叉。所述远侧颈部壳体相对于所述近侧颈部壳体可在单一方向上枢转。
所述远侧颈部壳体可限定近侧斜切表面，并且所述近侧颈部壳体可限定远侧斜切表面，这样所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
所述挠性驱动线缆可以包括：远侧端和近侧端，所述近侧端与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆自所述外管的所述中心纵向轴线偏离一径向距离。
所述轴组件可包括：毂（hub），其可旋转地支撑在所述远侧颈部壳体的远侧端；以及旋转毂，其可旋转地支撑在所述毂内，其中，所述旋转毂与所述挠性驱动线缆的所述远侧端连接，并且其中，所述旋转毂构造成与所述末端执行器的可旋转驱动轴杆选择性连接。
所述挠性驱动线缆可包覆在盘簧内。
所述挠性驱动线缆的所述远侧端可绕所述中心纵向轴线旋转，同时所述旋转毂相对于所述中心纵向轴线旋转。
所述旋转毂可以旋转大约+/-90°。
所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线可与所述中心纵向轴线交叉。
所述远侧颈部壳体相对于所述近侧颈部壳体可在单一方向上枢转。
所述远侧颈部壳体可限定近侧斜切表面，并且其中，所述近侧颈部壳体可限定远侧斜切表面，这样，所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
所述轴组件可包括可旋转地支撑在外管内的挠性驱动线缆。所述挠性驱动线缆可包括：远侧端和近侧端，所述近侧端与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆偏离所述外管的所述中心纵向轴线一径向距离。
根据本公开的另一方案，提供一种机电手术系统，其包括手持式手术装置、末端执行器和轴组件，所述手持式手术装置包括装置壳体和至少一个可旋转驱动轴，所述装置壳体限定用于与接合器组件选择性连接的连接部；所述末端执行器构造成执行至少一种功能；以及所述轴组件用于将所述末端执行器和所述手术装置选择性相互连接。所述轴组件包括：近侧颈部壳体，其支撑在所述外管的远侧端；远侧颈部壳体，其能够与所述近侧颈部壳体枢转地连接，其中，所述远侧颈部壳体的远侧端构造成并适用于与所述末端执行器操作性连接；以及挠性驱动线缆，其可旋转地支撑在所述外管内。所述挠性驱动线缆包括：远侧端和近侧端，所述近侧端与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆自所述外管的所述中心纵向轴线偏离一径向距离。
所述轴组件进一步包括：毂，其可旋转地支撑在所述远侧颈部壳体的远侧端；和旋转毂，其可旋转地支撑在所述毂内，其中，所述旋转毂与所述挠性驱动线缆的所述远侧端连接。所述旋转毂构造成与所述末端执行器的可旋转驱动轴杆选择性连接。
所述挠性驱动线缆可包覆在盘簧内。
所述挠性驱动线缆的所述远侧端可绕所述中心纵向轴线旋转，同时所述旋转毂相对于所述中心纵向轴线旋转。
所述旋转毂可以旋转大约+/-90°。
所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线可与所述中心纵向轴线交叉。所述远侧颈部壳体相对于所述近侧颈部壳体可在单一方向上枢转。
所述远侧颈部壳体可限定近侧斜切表面，并且其中，所述近侧颈部壳体可限定远侧斜切表面，这样所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
所述轴组件可进一步包括关节式运动杆，所述关节式运动杆至少部分地可滑动地支撑在所述远侧颈部壳体内。所述关节式运动杆可包括远侧端和近侧端，所述近侧端与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述关节式运动杆自所述外管的所述中心纵向轴线偏离一径向距离。所述轴组件可包括关节式运动连杆，所述关节式运动连杆具有枢转地连接至所述关节式运动杆的所述远侧端的近侧端和枢转地连接至所述远侧颈部壳体的远侧端。
在使用中，所述手持式手术仪器的与所述关节式运动杆连接的所述可旋转驱动轴的致动引起所述关节式运动杆的轴向平移。在使用中，所述关节式运动杆的轴向平移可引起所述远侧颈部壳体相对于所述近侧颈部壳体枢转偏离轴线。
根据本公开的又一方案，提供一种轴组件，其用于将手持式机电手术装置的至少一个可旋转驱动轴与末端执行器相互连接，所述末端执行器能够由轴向驱动力致动。所述轴组件包括：轴联接组件，其构造成并适用于与所述手术装置的连接部选择性连接并且构造成与所述手术装置的所述至少一个可旋转驱动轴中的每一个可操作连通；外管，其具有由所述轴联接组件支撑的近侧端，所述外管限定中心纵向轴线；近侧颈部壳体，其支撑在所述外管的远侧端；远侧颈部壳体，其与所述近侧颈部壳体枢转地连接，其中，所述远侧颈部壳体的远侧端构造成并适用于与所述末端执行器操作性连接；挠性驱动线缆，其可旋转地支撑在所述外管内；关节式运动杆，其至少部分地可滑动地支撑在所述远侧颈部壳体内；以及关节式运动连杆，其具有与所述关节式运动杆的所述远侧端枢转地连接的近侧端和与所述远侧颈部壳体枢转地连接的远侧端。所述手持式手术仪器的与所述关节式运动杆连接的所述可旋转驱动轴的致动引起所述关节式运动杆的轴向平移。所述关节式运动杆的轴向平移引起所述远侧颈部壳体相对于所述近侧颈部壳体枢转偏离轴线。
所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线可与所述中心纵向轴线交叉。所述远侧颈部壳体相对于所述近侧颈部壳体可在单一方向上枢转。
所述远侧颈部壳体可限定近侧斜切表面，并且其中，所述近侧颈部壳体可限定远侧斜切表面，这样所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
所述轴组件可包括可旋转地支撑在所述外管内的挠性驱动线缆。所述挠性驱动线缆可包括：远侧端和近侧端，所述近侧端与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆偏离所述外管的所述中心纵向轴线一径向距离。
所述轴组件可进一步包括：毂，其可旋转地支撑在所述远侧颈部壳体的远侧端；旋转毂，其可旋转地支撑在所述毂内，其中，所述旋转毂与所述挠性驱动线缆的所述远侧端连接。所述旋转毂可构造成与所述末端执行器的可旋转驱动轴杆选择性连接。
所述挠性驱动线缆可包覆在盘簧内。
所述挠性驱动线缆的所述远侧端可绕所述中心纵向轴线旋转，同时所述旋转毂相对于所述中心纵向轴线旋转。
所述旋转毂可以旋转大约+/-90°。
所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线可与所述中心纵向轴线交叉。所述远侧颈部壳体相对于所述近侧颈部壳体可在单一方向上枢转。
所述远侧颈部壳体可限定近侧斜切表面，并且其中，所述近侧颈部壳体可限定远侧斜切表面，这样，所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
所述轴组件可进一步包括可旋转地支撑在所述外管内的挠性驱动线缆。所述挠性驱动线缆可包括远侧端和近侧端，所述近侧端与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆自所述外管的所述中心纵向轴线偏离一径向距离。
在下文中将参照附图更详细地描述本发明的示例性实施例的其他细节和方案。
附图说明
在此参照附图描述本公开的实施例，其中，
图1为根据本公开的实施例的机电手术系统的立体图；
图2为图1的机电手术系统的零件分离的立体图；
图2A为本公开的机电手术系统的动力手术仪器的零件分离的立体图；
图3为图1和图2的机电手术系统的轴组件和动力手术仪器的后视立体图，其图示了它们之间的连接；
图4为图1至图3的轴组件的零件分离的立体图；
图5为图1至图3的轴组件的纵向剖视图；
图5A为图5的标示区域的细节放大图；
图6为图示末端执行器的立体图，所述末端执行器与图1至图5的轴组件的远侧端连接，定方位为直线、非关节式运动的状态；
图7为图6的标示区域的细节放大图；
图8为沿图6的8-8截取的剖视图；
图9为图示所述末端执行器与所述轴组件的所述远侧端的连接的零件分离的、放大、立体图；
图10为图示与所述末端执行器连接的所述轴组件的所述远侧端的连接毂的零件分离的、放大、立体图；
图11为所述轴组件的所述远侧端和所述末端执行器的俯视平面图，它们显示为部分呈关节式运动的状态；
图12为图11的部分呈关节式运动的末端执行器的剖视图；
图13为所述轴组件的所述远侧端和所述末端执行器的俯视平面图，它们显示为完全呈关节式运动的状态；以及
图14为图13的完全呈关节式运动的末端执行器的剖视图。
具体实施方式
参照附图详细描述本公开的机电手术系统、器械和/或装置的实施例，在附图中，在一系列图的每一幅中类似的附图标记表示相同或相应的零件。如在此使用的术语“远侧”是指机电手术系统、器械和/或装置或者其部件更远离用户的部分，而术语“近侧”是指机电手术系统、器械和/或装置或者其部件更靠近用户的部分。
首先，参照图1至图4，显示根据本公开的实施例的机电手持式动力手术系统并将其概括地标示为10。机电手术系统10包括以机电手持式动力手术仪器100形式存在的手术器械或装置，手术器械或装置构造成经由轴组件200与多个不同的末端执行器400选择性附接，各个末端执行器400构造成通过机电手持式动力手术装置100致动和操纵。特别地，手术仪器100构造成与轴组件200选择性连接，并且，接下来，轴组件200构造成与多个不同的末端执行器400中的任一个选择性连接。
对于示例性机电手持式动力手术装置100的结构和操作的详细描述，可以参考于2008年9月22日提交的国际申请No.PCT/US2008/077249(国际公开号：WO2009/039506)和于2009年11月20日提交的序列号为12/622,827的美国专利申请，在此通过引用方式并入上述两件申请的全部内容。
通常，如图1至图4中所图示的，手术仪器100包括手柄壳体102，手柄壳体102具有下壳体部104、从下壳体部104延伸和/或支撑在下壳体部104上的中间壳体部106以及从中间壳体部106延伸和/或支撑在中间壳体部106上的上壳体部108。手柄壳体102限定电路板或控制器150和驱动机构160位于其中的腔体。驱动机构160可包括用于选择手术仪器100的能够旋转的驱动构件的第一电机164和用于驱动手术仪器100的各个能够旋转的驱动构件的第二电机166。
电路板150构造成控制手术仪器100的各种操作。根据本公开，手柄壳体102提供可充电电池156可拆卸地位于其中的壳体。电池156构造成向手术仪器100的任一个电气元件供应电力。尽管显示并预期为电池156，但可以使用任何已知的电源，例如电源线等。
手柄壳体102的上壳体部108限定前端部或连接部108a，鼻部或连接部108a构造成接受轴组件200的变速箱壳体（transmission housing）208的对应的轴联接组件208a。如图3中所示，手术仪器100的上壳体部108的连接部108a具有圆柱形凹部108b，当轴组件200与手术仪器100配接时，凹部108b接收轴组件200的变速箱壳体208的轴联接组件214。连接部108a容纳三个能够旋转的驱动连接器118、120、122，驱动连接器中的每一个通过手柄壳体102中容纳的驱动机构(未示出)能够独立地致动并旋转。
手柄壳体102的上壳体部108提供驱动机构(未示出)位于其中的壳体。驱动机构构造成驱动轴和/或齿轮部件以执行手术仪器100的各种操作。特别地，驱动机构构造成：驱动轴和/或齿轮部件以相对于轴组件200选择性地移动末端执行器400；相对于手柄壳体102、绕纵向轴线“X”(参见图1和图2)旋转轴组件200和/或末端执行器400；相对于末端执行器400的下钳夹或钉仓组件432移动末端执行器400的上钳夹或砧座组件442，和/或发射末端执行器400的钉仓组件432中的吻合和切割钉仓。
在使用中，当轴组件200与手术仪器100配接时，手术仪器100的可旋转的驱动连接器118、120中的每一个与轴组件200的对应的近侧驱动轴212、214的相应的近侧端部212a、214a(参见图3)联接。就此而言，相应的第一驱动连接器118和第一近侧驱动轴212的近侧端部212a之间的交接以及相应的第二驱动连接器120和第二近侧驱动轴214的近侧端部214a之间的交接是键连接的，这样手术仪器100的驱动连接器118、120中的每一个的旋转引起轴组件200的相应的驱动轴212、214的相应旋转。
手术仪器100的驱动连接器118、120与轴组件200的相应的驱动轴212、214的配接允许独立地传递旋转力。手术仪器100的驱动连接器118、120构造成被驱动机构独立地旋转。就此而言，驱动机构的功能选择模块(未示出)选择手术仪器100的哪个或哪几个驱动连接器118、120被驱动机构的输入驱动部件(未示出)驱动。
由于手术仪器100的驱动连接器118、120中的每一个与轴组件200的各自相应的驱动轴212、214具有键连接和/或基本上不能旋转的交接，因此当轴组件200与手术仪器100联接时，旋转力被从手术仪器100的驱动机构选择性地传递至轴组件200，并传递至末端执行器400，这将在下文中更详细地讨论。
手术仪器100的驱动连接器118和/或120的选择性旋转允许手术仪器100选择性地致动末端执行器400的不同功能。如下面将更详细地讨论的，手术仪器100的第一驱动连接器118的选择性的且独立的旋转对应于末端执行器400的选择性的且独立的打开和闭合以及末端执行器400的吻合/切割部件的驱动。同样地，手术仪器100的第二驱动连接器120的选择性的且独立的旋转对应于末端执行器400的与纵向轴线“X”(参照图1和图2)交叉的选择性的且独立的关节式运动。
根据本公开，驱动机构可包括：换挡器齿轮箱组件(未示出)；功能选择模块(未示出)，其位于换挡器齿轮箱组件的近侧，起到选择性地移动换挡器齿轮箱组件内的齿轮零件以与第二电机(未示出)相啮合的作用。驱动机构可构造成在给定的时间选择性地驱动手术仪器100的驱动连接器118、120中的一个。
如图1和图2中所图示的，手柄壳体102支撑一对手指致动的控制按钮124、126和/或摇杆装置130(仅显示一个摇杆装置)。控制按钮124、126和摇杆装置130中的每一个包括对应的磁体(未示出)，磁体通过操作者的致动来移动。此外，容纳在手柄壳体102内的电路板(未示出)包括与控制按钮124、126和摇杆装置130中每一个对应的霍尔效应开关(未示出)，霍尔效应开关由控制按钮124、126和摇杆装置130内的磁体的移动来致动。具体地，一旦操作者致动控制按钮124，位于控制按钮124最近侧的对应的霍尔效应开关(未示出)就会在控制按钮124内的磁体移动时被致动。与控制按钮124对应的霍尔效应开关(未示出)的致动引起电路板向功能选择模块和驱动机构的输入驱动部件提供合适的信号以闭合末端执行器400和/或发射在末端执行器400内的吻合/切割钉仓。
同样地，一旦操作者致动控制按钮126，位于控制按钮126最近侧的对应的霍尔效应开关(未示出)就会在控制按钮126内的磁体(未示出)移动时被致动。与控制按钮126对应的霍尔效应开关的致动引起电路板向功能选择模块和驱动机构的输入驱动部件提供合适的信号以打开/闭合末端执行器400。
此外，一旦操作者致动摇杆装置130，位于摇杆装置130最近侧的对应的霍尔效应开关(未示出)就会在摇杆装置130内的磁体(未示出)移动时被致动。与摇杆装置130对应的霍尔效应开关的致动引起电路板向功能选择模块和驱动机构的输入驱动部件提供合适的信号以相对于轴组件200旋转末端执行器400或相对于手术仪器100的手柄壳体102旋转末端执行器400和轴组件200。具体地，摇杆装置130在第一方向上的移动引起末端执行器400和/或轴组件200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，例如第二方向上的移动引起末端执行器400和/或轴组件200相对于手柄壳体102在相反方向，例如第二方向上旋转。
现转向图1至图14，将更详细地显示并描述轴组件200。轴组件200构造成将手术仪器100的第一和第二可旋转的驱动连接器118、120的旋转力传递至末端执行器400。如上所述，轴组件200构造成用于与手术仪器100选择性连接。
如图1至图10中所示，轴组件200包括：细长的、基本为刚性的管状体210，其具有近侧端210a和远侧端210b；变速箱壳体208，其与管状体210的近侧端210a连接并且构造成用于与手术仪器100选择性连接；以及关节运动式颈部组件230，其与细长体部210的远侧端210b连接。
变速箱壳体208和管状体210构造成并且定尺寸为容纳轴组件200的部件。管状体210定尺寸为用于内窥镜的插入，特别地，外管能够穿过通用的套管针端口、套管等。变速箱壳体208定尺寸为不能进入套管针端口、套管等。
轴组件200的变速箱壳体208构造成并适于与手术仪器100的上壳体部108的连接部108a连接。如图2至图5A中所示，轴组件200的变速箱壳体208包括支撑在其近侧端的轴联接组件208a。轴连接组件208a构造成并适于与手术装置100的远侧半体110a的上壳体部108的连接部108a连接。
变速箱壳体208，特别是轴联接组件208a可旋转地支撑其内的至少第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214和可选择的第三可旋转近侧驱动轴。
轴组件200包括多个力/旋转传递/转换组件，每一个均布置在变速箱壳体208和管状体210中。每一个力/旋转传递/转换组件构造成并适于在将手术仪器100的第一和第二驱动连接器118、120和可选择的第三可旋转的驱动连接器122的旋转的旋转速度/力传递到末端执行器400之前传递/转换(例如，提高或降低)该旋转速度/力。
具体地，轴组件200包括分别布置在变速箱壳体208和管状体210中的第一和第二力/旋转传递/转换组件260、270。力/旋转传递/转换组件260、270中的每一个构造成并适于将手术装置100的第一和第二驱动连接器118、120的旋转传递或转换成轴组件200的驱动或关节式运动杆278的轴向平移，以实现末端执行器400的关节式运动；或者传递或转换成轴组件200的驱动轴212的旋转，以实现末端执行器400的闭合、打开和发射。
如图3至图5A中所示，第一力/旋转传递/转换组件260包括第一可旋转近侧驱动轴212，如上所述，第一可旋转近侧驱动轴212可旋转地支撑在变速箱壳体208内。第一可旋转近侧驱动轴212包括近侧端部212a和远侧端部212b，近侧端部212a构造成支撑用于与手术装置100的第一驱动连接器118选择性连接的连接套筒(未示出)，远侧端部212b与挠性驱动线缆242的近侧端连接，这将在下面更详细地讨论。
在操作中，作为手术装置100的第一驱动连接器118的旋转的结果，当第一可旋转近侧驱动轴212由于第一连接器套筒218的旋转而旋转时，所述旋转被直接传递至轴组件200的挠性驱动线缆242以实现末端执行器400的闭合和发射，这将在下面更详细地讨论。
继续参照图3至图5A，第二力/旋转传递/转换组件270包括第二可旋转近侧驱动轴214，如上所述，第二可旋转近侧驱动轴214可旋转地支撑在变速箱壳体208内。第二可旋转近侧驱动轴214包括近侧端部214a和螺纹远侧端部214b，近侧端部214a构造成支撑用于与手术装置100的第二驱动连接器120选择性连接的连接套筒(未示出)。
第二力/旋转传递/转换组件270进一步包括与第二可旋转近侧驱动轴214的螺纹远侧端部214a可旋转地联接的驱动联接螺母274，并且驱动联接螺母274可滑动地布置在变速箱壳体208中。驱动联接螺母274可滑动地锁止在变速箱壳体208中，这样在第二可旋转近侧驱动轴214旋转时能够防止驱动联接螺母274旋转。以这种方式，当第二远侧可旋转近侧驱动轴214旋转时，驱动联接螺母274穿过变速箱壳体208和/或沿变速箱壳体208平移。
第二力/旋转传递/转换组件270进一步包括关节式运动杆278，关节式运动杆278具有固接或连接至驱动联接螺母274的近侧端278a。关节式运动杆278的远侧端278b穿过管状体210延伸。关节式运动杆278至少部分地可滑动地支撑在关节式运动颈部组件230内。关节式运动杆278限定偏离轴组件200的纵向轴线“X”的纵向轴线“A”。
在操作中，作为手术装置100的第二对应的驱动连接器120的旋转的结果，当第二可旋转近侧驱动轴214由于第二连接器套筒(未示出)的旋转而旋转时，第二可旋转近侧驱动轴214的螺纹远侧端部214a旋转。因此，当第二可旋转近侧驱动轴214旋转时，引起驱动联接螺母274沿第二可旋转近侧驱动轴214的螺纹远侧部214a轴向平移。
当引起驱动联接螺母274沿第二可旋转近侧驱动轴214轴向平移时，引起关节式运动杆278相对于管状体210轴向平移。如将在下面更详细地描述的，当关节式运动杆278轴向平移时，关节式运动杆278引起轴组件200的关节式运动颈部组件230呈关节式运动，并且接下来，当末端执行器400与轴组件200连接时，引起末端执行器400进行关节式运动。
现转向图4至图14，显示并描述关节式运动颈部组件230。关节式运动颈部组件230包括近侧颈部壳体232和远侧颈部壳体236，远侧颈部壳体236通过枢转销234与近侧颈部壳体232枢转地连接并且从近侧颈部壳体232向远侧延伸。枢转销234限定枢转轴线“P”(参见图6)，枢转轴线“P”定方位成与纵向轴线“X”正交并且延伸穿过纵向轴线“X”。
关节式运动颈部组件230包括具有近侧端240a和远侧端240b的关节式运动连杆240。关节式运动连杆240的近侧端240a枢转地连接至关节式运动杆278的远侧端278b。关节式运动连杆240的远侧端240b在偏离纵向轴线“X”横向距离的位置处枢转地连接至远侧颈部壳体236。
近侧颈部壳体232限定远侧斜切表面232a，并且远侧颈部壳体236限定近侧斜切表面236a。在实施例中，斜切表面232a、236a彼此呈毗邻关系。在使用中，当致动末端执行器400至偏离轴线的方位时，这将在下面更详细地讨论，近侧颈部壳体232和远侧颈部壳体236的斜切表面232a、236a朝向彼此靠近。期望的是，斜切表面232a、236a中的每一个相对于纵向轴线“X”成大约45°的角度。具体地，近侧颈部壳体232的斜切表面232a相对于纵向轴线“X”成大约(-)45°的角度，而远侧颈部壳体236的斜切表面236a相对于纵向轴线“X”成大约(+)45°的角度。以这种方式，当致动末端执行器400至最大程度地偏离轴线的方位时，如图13和图14中所示，末端执行器400定方位为相对于纵向轴线“X”成大约90°。在使用中，如图11和图12中所示，根据需要或期望，末端执行器400可定方位为相对于纵向轴线“X”成从大约0°至大约90°的任意角取向，例如，大约45°。
根据本公开，远侧颈部壳体236相对于近侧颈部壳体232能够在单一方向上枢转。
关节式运动颈部组件230进一步包括可旋转地支撑和/或联接在远侧颈部壳体236的远侧端内的远侧旋转毂250。旋转毂250可旋转地支撑在远侧颈部壳体236内，这样旋转毂250限定与纵向轴线“X”共轴的旋转轴线。旋转毂250可旋转地支撑旋转螺母252。如将在下面更详细地讨论的，旋转螺母252限定向远侧延伸的镗孔252a，镗孔252a构造并定尺寸为选择性地接收末端执行器400的驱动轴杆426的近侧头部426a。
轴组件200的第一力/旋转传递/转换组件240包括可旋转地支撑在近侧颈部壳体232和远侧颈部壳体236内的挠性驱动线缆242。挠性驱动线缆242是由如不锈钢的扭转无声(torsionally still)和挠性的材料制造。挠性驱动线缆242限定偏离纵向轴线“X”的纵向轴线“B”。挠性驱动线缆242包括与第一可旋转近侧驱动轴212的远侧端212b联接的近侧端242a。挠性驱动线缆242包括与旋转螺母252联接的远侧端242b，其中，挠性驱动线缆242的旋转导致旋转螺母252的相应的旋转。期望的是，挠性驱动线缆242的远侧端242b与旋转螺母252联接，这种联接是阻止它们之间相对旋转的方式，并且是相对于彼此能够轴向滑动的，例如，彼此键连接。
轴组件200包括围绕挠性驱动线缆242的加强盘簧244。根据本公开，加强盘簧244在其近侧端和远侧端被约束，并且在挤压下被安装。加强盘簧244起到在末端执行器400的关节式运动过程中帮助保持挠性驱动线缆242不弯折的作用。加强盘簧244还起到帮助保持挠性驱动线缆242以免在其旋转过程中因开卷和/或“成猪尾样”而损坏。
由于挠性驱动线缆242的远侧端242b(如上所述)与旋转螺母252联接，并且旋转螺母252可旋转地支撑在旋转毂250内，因此如图9和图10中所图示的，当旋转毂250绕纵向轴线“X”旋转时，挠性驱动线缆242的远侧端242b绕纵向轴线“X”自由旋转。
如图8至图10中所示，远侧颈部壳体236限定形成在其外表面内的螺纹236b。远侧颈部壳体236的螺纹236b构造成接收并啮合末端执行器400的近侧锁紧螺母422的互补螺纹422a。在使用中，末端执行器400的锁紧螺母422被手动地联接至远侧颈部壳体236以闭锁和/或固定末端执行器400相对于轴组件200的角取向。具体地，在使用过程中，终端用户将末端执行器400成角度地定方位成相对于轴组件200期望的或需要的角取向，然后向轴组件200的远侧颈部壳体236拧紧末端执行器400的锁紧螺母422以锁紧和/或固定末端执行器400相对于轴组件200的角取向。
尽管显示并描述了锁紧螺母422，但能想到的是，末端执行器400和轴组件200可以通过卡口型连接等相互连接。
如图8、图9、图12和图14中所示，远侧颈部壳体236限定在其远侧表面内形成的至少一个对准镗孔236c。此外，末端执行器400包括从其向近侧突出的至少一个相应的对准柱424a，对准柱424a被接收在形成在远侧颈部壳体236的远侧表面内的对准镗孔236c内。对准柱424a和对准镗孔236c用于将末端执行器400与轴组件200的远侧颈部壳体236对准并联接。
在操作中，当挠性驱动线缆242旋转时，由于第一可旋转近侧驱动轴212(如上所述)的旋转，所述旋转通过挠性驱动线缆242被传递至挠性驱动线缆242的远侧端242b并且传递至可旋转地支撑在旋转毂250内的旋转螺母252。由于末端执行器400与轴组件200的远侧颈部壳体236联接，并且具体地，由于末端执行器400的驱动轴杆426与旋转螺母252联接，因此当旋转螺母252旋转时，所述旋转导致末端执行器400的驱动轴杆426的旋转和末端执行器400的致动。
同样在操作中，一旦第二可旋转近侧驱动轴214(如上所述)旋转，所述旋转被传递至驱动联接螺母274以轴向平移驱动联接螺母274。当驱动联接螺母274轴向平移时，所述轴向平移被传递至关节式运动杆278以轴向平移关节式运动杆278。当关节式运动杆278轴向平移时，例如在近侧方向上，关节式运动杆278作用于关节式运动连杆240上以引起关节式运动连杆240在近侧方向上平移。当关节式运动连杆240在近侧方向上轴向平移时，关节式运动连杆240作用于远侧颈部壳体236以引起远侧颈部壳体236绕枢转销234的枢转轴线“P”枢转。当远侧颈部壳体236枢转时，远侧颈部壳体236作用于末端执行器400以使末端执行器400相对于纵向轴线“X”呈关节式运动。
如上所述，末端执行器400可以被手动地绕纵向轴线“X”旋转。由于驱动线缆242是挠性的，因此当末端执行器400绕纵向轴线“X”旋转时，引起远侧颈部壳体236同样绕纵向轴线“X”旋转，挠性驱动线缆242的远侧端242b同样绕纵向轴线“X”旋转。根据本公开，远侧颈部壳体236，并且接下来挠性驱动线缆242的远侧端242b能够绕纵向轴线“X”旋转大约+/-90°。
对于末端执行器400的结构和操作的详细讨论可以参考于2011年10月25日提交的、名称为“Apparatus for Endoscopic Procedures(用于内窥镜操作的器械)”的、序列号为13/280,898的美国专利申请。末端执行器400可以构造成并适于施用紧固件的多个线性排，所述紧固件在实施例中可为各种大小，并且所述紧固件在某些实施例中可具有各种长度或排，例如，大约长度为30mm、45mm和60mm。
会理解的是，可以对在此公开的实施例进行各种改进。例如，手术仪器100和/或钉仓组件410不需要施用吻合钉而是可施用本领域公知的两部紧固件。此外，可以改进吻合钉或紧固件的线性排的长度以符合特定手术操作的需要。所以，在吻合钉钉仓组件内的吻合钉和/或紧固件的线性排的长度可以相应地改变。因此，不应将上述描述解释为限制性的，其仅为优选实施例的示例。本领域技术人员在随附权利要求书的范围和构思内会想到其他的改进。

Claims (23)

1.一种轴组件，其用于将手持式机电手术装置的至少一个可旋转驱动轴与能够由轴向驱动力致动的末端执行器相互连接，所述轴组件包括：
轴联接组件，其构造成并适用于与所述手术装置的连接部选择性连接并且构造成与所述手术装置的所述至少一个可旋转驱动轴中的每一个可操作连通；
外管，其具有由所述轴联接组件支撑的近侧端，所述外管限定中心纵向轴线；
近侧颈部壳体，其支撑在所述外管的远侧端处；
远侧颈部壳体，其与所述近侧颈部壳体可枢转地连接，其中，所述远侧颈部壳体的远侧端构造成并适用于与所述末端执行器可操作连接；
挠性驱动线缆，其可旋转地支撑在所述外管内；
关节式运动杆，其至少部分地可滑动地支撑在所述远侧颈部壳体内；以及
关节式运动连杆，其具有可枢转地连接至所述关节式运动杆的所述远侧端的近侧端和可枢转地连接至所述远侧颈部壳体的远侧端；
其中，所述手持式手术仪器的与所述关节式运动杆连接的所述可旋转驱动轴的致动引起所述关节式运动杆轴向平移；并且
其中，所述关节式运动杆的轴向平移引起所述远侧颈部壳体相对于所述近侧颈部壳体枢转偏离轴线。
2.根据权利要求1所述的轴组件，其中，所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线与所述中心纵向轴线交叉。
3.根据权利要求1所述的轴组件，其中，所述远侧颈部壳体相对于所述近侧颈部壳体在单一方向上枢转。
4.根据权利要求1所述的轴组件，其中，所述远侧颈部壳体限定近侧斜切表面，并且其中，所述近侧颈部壳体限定远侧斜切表面，这样所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
5.根据权利要求1所述的轴组件，其中，所述轴组件包括可旋转地支撑在所述外管内的挠性驱动线缆，所述挠性驱动线缆包括：
远侧端；以及
近侧端，其与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆自所述外管的所述中心纵向轴线偏离一径向距离。
6.根据权利要求5所述的轴组件，其进一步包括：
毂，其可旋转地支撑在所述远侧颈部壳体的远侧端；
旋转毂，其可旋转地支撑在所述毂内，其中，所述旋转毂与所述挠性驱动线缆的所述远侧端连接，并且其中，所述旋转毂构造成与所述末端执行器的可旋转驱动轴杆选择性连接。
7.根据权利要求6所述的轴组件，其中，所述挠性驱动线缆包覆在盘簧内。
8.根据权利要求7所述的轴组件，其中，所述挠性驱动线缆的所述远侧端绕所述中心纵向轴线旋转，同时所述旋转毂相对于所述中心纵向轴线旋转。
9.根据权利要求8所述的轴组件，其中，所述旋转毂能够旋转大约+/-90°。
10.根据权利要求8所述的轴组件，其中，所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线与所述中心纵向轴线交叉。
11.根据权利要求8所述的轴组件，其中，所述远侧颈部壳体相对于所述近侧颈部壳体在单一方向上枢转。
12.根据权利要求8所述的轴组件，其中，所述远侧颈部壳体限定近侧斜切表面，并且其中，所述近侧颈部壳体限定远侧斜切表面，这样，所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
13.根据权利要求8所述的轴组件，其进一步包括可旋转地支撑在所述外管内的挠性驱动线缆，所述挠性驱动线缆包括：
远侧端；和
近侧端，其与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆自所述外管的所述中心纵向轴线偏离一径向距离。
14.一种机电手术装置，其包括构造成执行至少一种功能的末端执行器和根据权利要求1所述的轴组件。
15.一种机电手术系统，其包括：
手持式手术装置，其包括装置壳体和至少一个可旋转驱动轴，所述装置壳体限定用于与接合器组件选择性连接的连接部；
末端执行器，其构造成执行至少一种功能；以及
轴组件，其用于将所述末端执行器和所述手术装置选择性相互连接，所述轴组件包括：
近侧颈部壳体，其支撑在所述外管的远侧端；
远侧颈部壳体，其与所述近侧颈部壳体可枢转地连接，其中，所述远侧颈部壳体的远侧端构造成并适用于与所述末端执行器操作性连接；
挠性驱动线缆，其可旋转地支撑在所述外管内，所述挠性驱动线缆包括：
远侧端；和
近侧端，其与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述挠性驱动线缆自所述外管的中心纵向轴线偏离一径向距离；
毂，其可旋转地支撑在所述远侧颈部壳体的远侧端；和
旋转毂，其可旋转地支撑在所述毂内，其中，所述旋转毂与所述挠性驱动线缆的所述远侧端连接，并且其中，所述旋转毂构造成与所述末端执行器的可旋转驱动轴杆选择性连接。
16.根据权利要求15所述的机电手术系统，其中，所述挠性驱动线缆包覆在盘簧内。
17.根据权利要求16所述的机电手术系统，其中，所述挠性驱动线缆的所述远侧端绕所述中心纵向轴线旋转，同时所述旋转毂相对于所述中心纵向轴线旋转。
18.根据权利要求15所述的机电手术系统，其中，所述旋转毂能够旋转大约+/-90°。
19.根据权利要求15所述的机电手术系统，其中，所述近侧颈部壳体和所述远侧颈部壳体之间的枢转轴线与所述中心纵向轴线交叉。
20.根据权利要求15所述的机电手术系统，其中，所述远侧颈部壳体相对于所述近侧颈部壳体在单一方向上枢转。
21.根据权利要求15所述的机电手术系统，其中，所述远侧颈部壳体限定近侧斜切表面，并且其中，所述近侧颈部壳体限定远侧斜切表面，这样所述远侧颈部壳体相对于所述中心纵向轴线能够枢转大约90°。
22.根据权利要求15所述的机电手术系统，其中，所述轴组件进一步包括：
关节式运动杆，其至少部分地可滑动地支撑在所述远侧颈部壳体内，所述关节式运动杆包括：
远侧端；和
近侧端，其与所述手持式手术装置的对应的可旋转驱动轴操作性连接；其中，所述关节式运动杆自所述外管的所述中心纵向轴线偏离一径向距离；以及
关节式运动连杆，其具有可枢转地连接至所述关节式运动杆的所述远侧端的近侧端和可枢转地连接至所述远侧颈部壳体的远侧端。
23.根据权利要求22所述的机电手术系统，其中，所述手持式手术仪器的与所述关节式运动杆连接的所述可旋转驱动轴的致动引起所述关节式运动杆的轴向平移；并且
其中，所述关节式运动杆的轴向平移引起所述远侧颈部壳体相对于所述近侧颈部壳体枢转偏离轴线。
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