CN105555206A - 外科夹施放器 - Google Patents
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Abstract
本发明涉及了一种外科夹施放器,所述外科夹施放器包括通用手柄以及具有集成压接头的单独夹匣,所述单独夹匣能够可拆卸地紧固至所述通用手柄上。所述通用手柄以及紧固至所述通用手柄的所述单独夹匣相互作用,以便形成用于单独夹从所述夹匣的夹容纳段至所述压接头的夹运输的进给路径,所述进给路径被限定或可单独用于致动。根据本发明,所述单独夹匣可按需要选自用于不同夹类型的多个夹匣,其中所述夹匣具有将根据要施放的夹类型来设计的集成编码机构,所述编码机构至少限定适于与所述通用手柄相互作用的相应夹类型的所述进给路径。
Description
技术领域
本发明涉及外科夹施放器、用于所述夹施放器的夹匣、以及用于可拆卸地接收所述夹匣的手柄。
背景技术
夹施放器是将组织夹设置(施放)在患者的组织上例如用于闭合缝接处或脉管的外科器械。这避免了昂贵缝合工艺,这在难以从外部接取的手术部位的情况下是尤其有利的。
现有技术
一般夹施放器例如从DE202011000755U1中已知。这种夹施放器可以在开放和内窥镜手术中用于通过施放并随后闭合优选地U形或V形夹来快速且可靠地连接必须进行手术的患者的组织结构。这种夹施放器尤其可用来在短时间内并以可靠方式夹断患者血管。在此可以使用不同的夹类型,这些夹类型就形状而言可能彼此不同,而且还在大小和厚度上彼此不同。
文献DE202011000755U1中描述的夹施放器包括手柄部分,具有集成夹存储装置的夹匣可以可拆卸的方式来紧固至所述手柄部分,该文献的公开内容并入本申请的主题。在这种布置中,提供并相应地布置手柄部分,以便作为可再用的零件使用数次。相反,提供并相应地布置夹匣,以仅用作一次性的零件,直到存储在夹匣的夹存储装置中的夹用完为止。
虽然这种夹施放器可在相对低成本下获得并还允许夹施放和闭合的相对安全的方式,但将需要改进对夹施放器的操纵。这种需要源自以下事实:此夹施放器的手柄部分仅提供来与具有相同设计、相同的夹类型和相同夹大小的夹匣结合。换句话说,仅一个夹类型可应用于同一手柄部分,但替换了单独夹匣。这意味着,多个各种手柄部分以及多个不同夹匣可能必须可在手术室中获得,并且手柄部分与夹匣的任何组合可仅用于单个的夹类型。然而,就手术室中的空间状况和清晰度而言,这样是不利的。
在DE4429084C1中,描述另一现有技术。其中所描述的夹施放器同样允许夹匣的相对简单的替换,所述夹匣可穿过侧向切口可拆卸地***到夹施放器的管状轴中。在此,夹匣被设计为一次性的零件,而手柄部分以及可紧固至手柄部分的管状轴配置为可再用的零件。另外,这种夹施放器提供将不同的管状轴紧固至单一手柄部分的可能性,所述不同的管状轴例如在其轴长度上彼此不同。虽然这种夹施放器允许相对灵活操纵,但不同的夹类型的应用仍然需要要求改变管状轴和夹匣两者。因此,仍然需要改进最初所描述的类型的夹施放器的操纵。
另外,US6599298B1公开一种夹施放器,所述夹施放器包括手柄部分以及能够可紧固至所述手柄部分的夹匣,这两者设计为一次性的零件。在这种布置中,夹匣集成到夹施放器的轴中,并且不同的轴长度允许在必要时储备或存储不同数量的夹并施放这些夹。然而,这种夹施放器也不提供将不同的夹类型应用于相同夹施放器的可能性,因此仍然需要改进上述种类的夹施放器的操纵。
发明内容
从DE202011000755U1开始,本发明是基于提供外科夹施放器目的,所述外科夹施放器可在相对低成本下获得,并且其中通过使用尽可能简单的构造措施来改进操纵。在此,一个目标是就不同夹类型的可能使用方面改进夹施放器的灵活性。另外/另一目标是能够提供夹施放器的部件,所述部件以最小可能成本设计成一次性的零件。
这个目的通过包括根据权利要求1所述的特征的通用手柄、包括根据权利要求4所述的特征的单独夹匣、以及包括通用手柄和具有根据权利要求9所述的特征的单独夹匣的夹施放器实现。本发明的另外有利发展提供于从属权利要求中。
根据本发明的第一方面,提出外科夹施放器的通用手柄,单独夹匣可安装至所述通用手柄,所述单独夹匣包括压接头且可任意地选自大量不同夹匣,使得通用手柄以及紧固至通用手柄的单独夹匣以机械方式来相互作用,以便在压接头中压接单独夹,并且经由单独进给路径将单独夹从单独夹匣的夹接收部分向压接头传送。为此,通用手柄包括集成传力齿轮或连杆机构,所述集成传力齿轮或连杆机构包括至少一个可用手抓握的把手(把手杠杆、剪刀把手)作为致动/输入部分,并且包括耦接装置作为该单独夹匣的致动/递送部分。根据本发明,在致动/输入部分与致动/递送部分之间提供适配装置,以补偿和调节在当前安装的单独夹匣的单独进给路径与通用手柄上的致动/输入部分的最大致动行程之间的夹相关的差异。
这允许给通用手柄配备提供特定最大致动行程/量的机械致动***,所述通用手柄适于施放适于所述最大致动行程/量的那些夹。如果出现必须施放要求较小致动行程/量的夹的情况,适配装置实现最大致动行程/量相对于单独夹匣限定的致动行程/量的补偿或适配。这也允许将通用手柄用于不同的夹。
有利的是,适配装置包括用于中断齿轮中的力传输的过载保护装置,优选地呈滑动离合器或释放机构形式。具体来说,该滑动离合器可调整为具有高于经由单独进给路径将单独夹从夹接收贮存器向压接头传送所需的力且低于使传力齿轮过载的预定的致动力的滑动值。以此方式,无需对传力齿轮或连杆机构进行任何修改(传动比改变等),由此使得通用手柄操纵总体简化。
根据本发明的另一方面,提出外科夹施放器的单独夹匣,所述夹匣将安装至夹施放器的通用手柄,所述夹匣包括压接头、夹接收部分、以及用于根据通用手柄的手动操作来经由单独进给路径将单独夹从夹接收部分朝压接头传送的的夹推进装置。在此,规定单独夹匣包括集成编码机构,所述单独夹匣可按需要选自用于不同夹类型的多个夹匣,所述集成编码机构根据将施放的夹类型来形成,并且至少使用所述集成编码机构限定适于相应夹类型的进给路径。
换句话说,编码机构固定集成到不同夹匣中,使得具有不同大小/安装长度和/或包括不同夹类型的不同夹匣可与一个通用手柄一起使用。在此上下文中,术语"进给路径"将理解为将单独夹从夹匣的夹接收部分/夹存储装置朝压接头运输的路线。
鉴于用于限定适于相应的夹类型的进给路径的编码机构集成到夹匣中这一事实,就有可能将多个不同夹匣(可拆卸地)紧固至单个(通用)手柄,以按需要替换夹匣并且在每种情况下施放存储在所述夹匣中的夹。呈大致轴状设计的夹匣可以具有不同的轴长度。另外,可将不同的夹类型储备在不同夹匣中,所述夹类型例如在形状和/或大小和/或厚度方面彼此不同。这意味着,单个(通用)手柄可与多个不同夹匣(例如两个、三个、四个、五个或更多个)组合,以便能够在抓住相同手柄时,施放不同的夹类型。
因此,本发明有效地改进夹施放器操纵和手术室中的空间状况,因为单个手柄允许仅仅通过夹匣的适当选择和替换施放不同的夹类型,并且仅仅通过替换夹匣来实现夹施放器的不同的轴长度。因此,本发明还减少必须在手术室中存储或提供的不同夹施放器数量。以此方式,本发明有助于改进在手术室中的清晰度。
另外,被集成到相应夹匣中的编码机构具有以下有利效果:在手术后,存在更少数量必须要杀菌的可再用的手柄数量。
优选的是,编码机构包括夹推进装置,所述夹推进装置包括至少一个限制挡块,所述限制挡块在夹推进装置的纵向方向上作用,并且意图至少部分限定进给路径。换句话说,该夹推进装置是编码机构的第一基本部分,并且确保单独夹的进给路径。举例来说,该夹推进装置可设计为夹推进棒,所述夹推进棒布置或配置成使得用户对手柄的每个手动操作以及由此而产生的纵向移动导致始终正好从储备在夹匣中的多个夹接收一个夹,并将所述夹朝施放工具运输并运输至施放工具。具体来说,该夹推进装置上的至少一个限制挡块允许限制该夹推进装置在手柄的轴的纵向方向上的向后移动和/或向前移动,由此确保从夹匣抓取单个夹并朝压接头运输所述夹。在这种情况下,手柄侧的适配装置在撞上限制挡块后生效。这意味着,在滑动离合器或对应释放机构情况下,容许另外致动把手杠杆,但是所述致动不转移至单独夹匣。
本发明的另一可能独立或另外的方面规定该夹推进装置包括两个限制挡块,所述限制挡块在纵向方向或夹推进装置的移动方向上彼此隔开,所述限制挡块的位置和/或距离根据将施放的夹类型来适配,使得进给单元的向后移动和/或向前移动允许正好从夹匣抓起一个夹,并正好将所述夹运输至压接头。限制挡块位置尤其是取决于将施放的夹的大小和/或厚度和/或形状,并可能取决于将存储在夹匣中的夹的数量和/或夹匣的轴长度。
已经证明,有利的是,至少一个限制挡块作为切割和/或弯曲部分来集成到夹推进装置中,以便以此方式提供可以相对低的成本提供的夹匣。举例来说,进给单元可为能够以低成本方式从金属板等生产的一种夹推进棒。随后,至少一个限制挡块可在金属板上冲压出且在必要时向上弯曲。作为此情况的替代,还可想到将夹推进装置实现为包括集成限制挡块的塑料零件。
本发明的另一可能独立或另外的方面规定夹匣的编码机构还包括适于将施放的夹类型的压接头(钳口部分)。换句话说,在设计上适于相应的夹类型的压接头可为夹匣的编码机构的基本部分,以便在夹施放期间确保正确的夹闭合过程。这意味着,作为形成在夹推进装置上的限制挡块的替代或附加,编码机构还可包括与将施放的夹类型匹配的压接头。这允许了可靠且安全地施放和闭合不同大小、厚度或形状的夹和/或使用轴长度而不对(通用)手柄部分进行任何适配。在这种情况下,设在匣内且意图打开和闭合压接头的机械***也相应地适于经由手柄致动。在此,有利的是,与压接头相关联且提供于匣内的机械致动***需要用于所有不同匣的统一致动行程/量,使得通过所连接的通用手柄对它们的致动无需任何适配装置,就像具有单独进给装置的情况那样。
在本发明的尤其有利实施方式中,压接头包括了引导装置,所述引导装置控制闭合和打开过程且所述引导装置的位置和/或几何形状适于将施放的夹类型和/或夹匣的轴长度。举例来说,引导装置可布置在压接头上,或以几何方式形成,使得具有相对大的夹的压接头的闭合移动并不同于具有相对小的夹的压接头的闭合移动。接着,可标准化与压接头相关联且布置在匣上的机械致动***。
已经证明,有利的是,夹匣的压接头适于与夹推进装置的至少一个限制挡块接触,以便限制夹推进装置的向后移动和/或向前移动。换句话说,夹匣的压接头和夹匣的夹推进装置可配合来达到始终正好从夹匣取出一个夹并向施放工具运输所述夹的效果。
根据本发明的另一可能独立或另外的方面,手柄包括与夹匣的编码机构相配合的上述过载保护装置,所述过载保护装置防止手柄和/或紧固至手柄的夹匣因对手柄的手动操作产生的过高致动力而损坏。这意味着,通过(机械)过载保护装置固定集成到手柄中这一措施,另外改进对普遍可用手柄部分的灵活操作。
在本发明的尤其有成本效益的实施方式中,手柄可设计为可再用的零件。这意味着,可与不同夹匣一起普遍使用的手柄可在杀菌后重复用于若干手术。
出于卫生原因,所述多个夹匣中的每个可形成为一次性的零件。
根据本发明的另一可能独立或另外的方面,手柄和/或夹匣可以包括基于颜色和/或基于符号的编码,所述编码适于将施放的夹类型且意图使当前能够与通用手柄一起使用的夹匣可视化。举例来说,夹匣壳体可着有与特定夹类型相关联的颜色。出于明确地使夹匣与能够与所述夹匣一起使用的手柄相关联,手柄可以设有相应相关联的颜色编码装置。夹施放器的两个组合基本零件的这种颜色编码装置允许以尤其直观的方式使用夹施放器。
总之,本发明规定了外科夹施放器由手柄和夹匣组成。夹匣被制造/提供为与手柄分离且可按需要可拆卸地紧固/安装至手柄的部件,其中手柄与紧固至所述手柄的夹匣相配合,以便形成用于施放单独夹的工具并且限定用于将单独夹从夹存储装置向匣的压接头运输的固定进给路径,所述进给路径。根据本发明,可按需要选自用于分别不同的夹类型的多个不同夹匣的夹匣包括集成编码机构,所述集成编码机构根据将施放的夹类型来实现,所述编码机构至少限定适于相应夹类型的进给路径。
手柄可包括集成轴,夹匣至少部分***所述集成轴中,并且在需要时,所述夹匣还可卡在所述集成轴的适当位置。在来自多个夹匣的每个夹匣中,可布置或储备特定数量的夹。存储在夹存储装置中的单独夹数量可总计为约五至四十个夹,优选的是20至30个夹。来自多个夹匣的单独夹匣彼此不同之处在于:由于它们大小(安装长度)。单独夹匣的另外区别特征包括存储在所述单独夹匣中的单独夹的大小/宽度、设计(U形或V形)、以及厚度(caliper/thickness),所述单独夹可接收在相应夹匣中。举例来说,为了区别,可将这些不同的夹称为“小”、“中”、“中大”或“大”。来自多个夹匣的夹匣还可在将实现的夹匣的轴长度或整个施放器长度(例如可总计为240mm、290mm或340mm)上有所不同。
通用手柄可配置来例如与保存大小为“小”的20个夹的夹匣组合,并且在组合状态(即,组装状态)下,导使施放器长度为240mm。相同手柄还可配置用于与保存大小为“中”的20个夹的夹匣组合,并且在组合状态下,致使施放器长度为240mm。
根据所述组合方案,至少和/或例如可构想出例示用于夹施放器组装的通用手柄与相应夹匣的组合的以下列表:
附图说明
以下参考附图,基于优选示例性的实施方式更详细解释本发明,在附图中:
图1示出根据本发明的夹施放器的顶透视图,所述夹施放器由手柄或手柄部分以及可紧固至所述手柄或手柄部分的夹匣组成,
图2示出处于组装状态下的图1的根据本发明的夹施放器的顶透视图,其中在组装状态下,夹匣可拆卸地紧固至手柄部分,
图3示出出于例示目的而部分拆开的根据本发明的夹匣的底透视图,
图4示出出于例示目的而部分拆开的根据本发明的夹匣的一段的底透视图,以及
图5示出根据本发明的夹施放器的侧透视图,所述夹施放器是由手柄部分以及紧固至所述手柄部分的夹匣组成并且出于例示目的而被部分拆开。
相同或类似的部件一致设有相同参考符号。
具体实施方式
图1以顶透视图来基本示出根据本发明的夹施放器(夹施放器组)1,所述夹施放器由通用(可再用的)手柄2以及大量单独可选单独夹匣(用于一次性的使用)组成,此处示例性地例示大量单独可选单独夹匣中的一个单独夹匣4。这种夹施放器1可用于例如开放和/或内窥镜手术中,以便快速且可靠地将患者的组织结构彼此连接或在短时间内且以可靠方式夹断患者血管。
根据以下详细描述的手柄2以及根据以下详细描述的基本轴状夹匣4基本各自被布置成使得按需要选自多个夹匣的夹匣4可以可拆卸地紧固至手柄2,以便以此方式共同构成夹施放器1。出于例示目的,手柄2和夹匣4在在此示出为彼此分离的。
来自多个轴状夹匣的每个夹匣保存或存储限定数量的夹。夹匣通常容纳约五至四十个夹,优选地20至30个夹。然而,来自多个夹匣的单独夹匣的彼此不同之处在于:由于它们大小和总长度,因此它们可以存储不同数量的夹。单独夹匣的另外区别特征在于可接收在相应夹匣中的单独夹的大小/宽度、设计(U形或V形)、以及厚度(caliper/thickness)。多个夹匣中的不同夹匣还可在它们安装长度、尤其是它们的轴长度方面有所不同。
从多个夹匣对用于安装至手柄2的特定夹匣4的任选或基于需要的选择可例如由在具体情况下必须通过卡钉或夹闭合的组织结构来确定,或例如还可由必须夹断的患者血管的尺寸来确定。为向用户明确指示哪个夹匣4可/可能用于哪个手柄2,手柄2至少在面向用户的上侧上设有两个标记5a和5b,这两个标记将手柄2标识为针对特定夹匣4布置或配置的手柄件。在这个示例性的实施方式中,标记5a、5b被形成为圆形彩色标记,其直观地向用户/操作者指示手柄部分的具体实施方式。在这个示例性的实施方式中,通用手柄2是最初提到的用于将施放的夹大小“小”和/或“中”的“手柄模型1”,相应地由两个彩色标记5a、5b(例如用于“小”的黄色和用于“中”的蓝色)示出。因此,相配夹匣4的壳体(优选地由塑料制成)是彩色或设有颜色标记的,在这个示例性的实施方式中,其呈黄色以将存储或储备在夹匣4中的夹的类型标识为“小”。
手柄构造
根据图1和图5,手柄2包括用于接收致动齿轮/连杆机构54的中心壳体2a,所述中心壳体的远端部分侧向设有两个铰接把手杠杆/剪刀把手6和8,作为用于由操作((例如外科医生)来手动操作夹施放器1的操作元件,所述操作元件被铰接以使得中心壳体2a两侧把手杠杆6、8在近端方向上延伸。把手杠杆6、8具有近侧的自由端,所述端部各自在构造上适于/近似手术医生的抓握手的解剖学构造。
此外,手柄2的远端部分(从操作者的角度来看)设有轴10,所述轴具有U形横截面且与壳体2a形成为整体或整体地连接至所述壳体(材料粘合);集成到轴中的是呈纵向可移动的U形滑块形式的压接触发装置或闭合装置12以及呈螺栓形式的保持部分14,所述保持部分被固定(焊接)至轴10并且在纵向中间部分中从U形手柄轴10的底部垂直伸出。
以下将会详细解释闭合装置12和保持部分14的确切工作方式。然而,在图1中,可以看出形成为U形滑块的闭合装置12的纵向中间部分设有狭槽状凹槽(切口)15,螺栓14穿过所述凹槽伸出,从而允许闭合装置(U形滑块)12在手柄轴10的纵向方向上相对于螺栓14的相对移动。
此外,限定手柄2的轴10的长度和宽度,使得大致轴状夹匣4可以某种方式至少部分***到轴10中,所述方式使得手柄2以及适当选择出的夹匣4在组装状态下产生从240mm至340mm的夹施放器的总长度,在这个示例性的实施方式中,长度为240mm。
根据图1和图5,可从外部致动的锁18支撑在手柄2的壳体2a上,以便能够在纵向方向上移动,所述锁的远侧边缘部分优选地形成棘爪凸耳或凸缘。在此,锁18借助弹簧54(图1中未例示,但可见于图5)在远侧方向上预加载至锁定位置。
壳体2a的面向把手杠杆6、8的两侧设有纵向延伸狭槽,两个连杆(张力/压力杆)56、58***到所述狭槽中,所述连杆将两个把手杠杆6、8连接至手柄2的致动齿轮54并连接至闭合装置12。在当前情况下,致动齿轮54由优选呈锁形的卡爪单元(dogunit)组成,所述卡爪单元可相对于闭合装置12纵向位移,并且用于下述所***的夹匣4的夹推进装置。
所述卡爪单元54优选包括输入元件,所述输入元件受支撑以在纵向方向上可在内部偏移;被铰接至这个输入元件的是连杆56,所述连杆各自用于将两个把手杠杆6、8连接至致动齿轮54。经由内部滑动离合器52,输入元件与输出元件成可操作的连接,所述输出元件受支撑以在纵向方向上能够相对偏移,并且所述输出元件在其远端设有用于当前***的夹匣4的夹推进装置的闭锁/啮合部分。在此,将输入元件与把手杠杆6、8连接起来的连杆56在起始于把手杠杆6、8的近侧方向上的取向,实际使得因两个把手杠杆6、8的呈剪刀状收缩,输入元件连同输出元件一起(经由滑动离合器52)在壳体2a中在近侧方向上移动。
在这个过程中,应当注意,根据以上描述的整个卡爪单元54借助于弹簧保持在壳体上,使得所述卡爪单元从近侧位置(根据图2按压把手杠杆)朝远侧位置(根据图1张开把手杠杆)弹性移动。另外,参考以下事实:卡爪单元54构造也可具有不同设计,只要经由对应于示例性输入-输出元件滑动离合器单元的适配装置(过载保护装置50)施加至把手杠杆6、8的致动力被转移至闭锁/啮合部分,以便在超出预定的致动力后中断力的流动,并且以此方式使把手杠杆6、8以不可操作方式移动(无任何力)。
借助另外连杆58,两个把手杠杆6、8在每种情况下均连接至闭合装置12,所述闭合装置呈支撑在手柄轴10中的U形滑块形式。这两个另外的连杆58具有相对于先前所提到的连杆56的相反定向,使得U形滑块12在两个把手杠杆6、8的呈剪刀状收缩后,在远侧方向上移动。
夹匣构造
根据图1和图4的夹匣4中的每个具有轴部分,所述轴部分就其大小而言可***到手柄2的U形轴10中,并且同时形成匣4的夹接收部分(夹存储装置)。为了将其可拆卸地紧固/固定至手柄2,大致轴状夹匣4包括安装装置16,所述安装装置设在轴部分的近端,并与手柄2的锁(保持装置)18配合,以将夹匣4可拆卸地锁定/固定在手柄2上,所述夹匣(部分)***到手柄2的轴10中。
根据图3和图4,夹匣4的轴部分的远端部分设有包括压接头(钳口部分)20的压接工具22,当将所述夹匣与手柄2组装时,所述压接头在手柄2的轴10的远侧轴端从轴10伸出。压接头20(以下也被称为钳口部分)布置成与手柄2的形成为U形滑块的闭合装置12配合,以便在夹施放器1的远端上共同形成夹施放器1的压接工具/压接机构22。
为了与形成为U形滑块的闭合装置12配合,钳口部分20(如在其纵向方向上所见)的左外侧和右外侧各自设有一个(控制)引导装置24和26。引导装置24、26和闭合装置12各自被布置来共同限定钳口部分20的打开和闭合移动。在此,钳口部分20的引导装置24、26的位置和几何形状可针对或针对来自多个夹匣的不同夹匣来单独限定,这尤其取决于选定夹匣和/或将要施放的夹类型,因为压接头20上根据夹匣和/或夹类型来需要较大或较小的钳口开口。
如果形成为U形滑块的闭合装置12在其在手柄轴10中的纵向移动期间至少部分从外部封闭钳口部分20的引导装置24、26,使得U形闭合装置12的两个内表面(图2中未示出)与引导装置24、26接触,且因此还限定或控制钳口部分20的打开和闭合移动,那么就会引起压接头/钳口部分20的打开和闭合移动。为此,钳口部分20和闭合装置12各自布置或配置成使得如果手动操作(收缩)两个把手杠杆6与8,那么形成为U形滑块的闭合装置12至少部分封闭钳口部分20,所述钳口部分借助于轴10的纵向方向上的保持部分(螺栓)14来固定。这意味着,在由先前所指示的手柄2的连杆56、58操作把手杠杆6、8后,闭合装置12在夹施放器1的远侧方向上纵向移动或推动至远侧方向上的更前面的位置,直到闭合装置12包围钳口部分20的引导装置24、26,并且因此迫使钳口部分20进行闭合移动。由于闭合装置12由引导装置24、26的位置和/或形状限定或控制的这种移动,钳口部分20闭合,并且在操作把手杠杆6、8后或通过释放把手杠杆,钳口部分20将会再次打开。打开移动将由形成为U形滑块的闭合装置12的向后移动(从远侧看)引起。
图3示出夹匣4的底透视图,出于例示目的,部分拆开所述夹匣,或为更明确地描述,已从所述夹匣移除单独部件。
在图3中可以看出,压接工具22大致上形成为叉状,并且包括彼此平行的两个分支28和30。在压接工具22指向远侧方向的自由端处,所述压接工具包括两个整体形成的钳口部分元件32和34,在所述钳口部分元件处布置/形成上述引导装置24、26,并且所述钳口部分元件构成钳口部分(压接头)20。还可看出,压接工具22在其近端设有凹槽36,作为用于与手柄2的保持部分(螺栓)14互锁配合的紧固开口。在这个示例性的实施方式中,凹槽36实施为细长孔,所述细长孔在组装状态下由手柄2的保持部分14啮合,以便以可靠方式将压接工具22(其卡在轴10中的适当位置)固定在轴10上,使得所述压接工具在夹匣4的纵向方向和手柄部分2的轴10的纵向方向上不可移动。换句话说,压接工具22的纵向位置以及因此钳口部分20的纵向位置是由凹槽36与保持部分14的配合来限定,使得所述钳口部分既不可相对于手柄2的轴10移动,也不可相对于夹匣4的其他部件移动。
图3中例示的夹匣4还包括了夹推进装置38,所述夹推进装置呈夹推进棒形式,用于接收和供应(即,运输)分离的夹。夹推进装置38被布置成与钳口部分20配合,并且在夹匣4的纵向方向或手柄2的轴10的纵向方向上相对于所述钳口部分而受到可移动地支撑。这意味着,进给单元38的功能是从夹匣4接收单独夹,并在轴10的远侧纵向方向上向前运输所述单独夹。为此,夹推进装置38的远端设有能够接收和供应或运输单独夹的夹舌片40。
为从夹匣4接收单独夹,需要夹推进装置38的向后移动(从远侧看),因为单独夹定位于用于存储所述单独夹的钳口部分元件32、34后面(从远侧看)。出于这个原因,夹推进装置38必须向后移动,使得该夹推进装置正好定位于夹后面(从远侧看),这个夹接下来将被接收并在轴10的纵向方向上向前朝钳口部分20进给或运输。另一方面,为了供应或运输借助于夹推进装置38接收的夹(从近侧看),需要向前移动来朝钳口部分20(即,在压接工具22的钳口部分元件32、34之间沿压接工具22的分支28、30)移动所接收到的夹。
为以简单方式限制夹推进装置38的这两个纵向移动,即,(从近侧看)向前朝钳口部分20以及(从近侧看)向后朝夹接收部分(夹存储装置)的纵向移动,夹推进装置38包括在其纵向方向上彼此隔开的两个限制挡块42和44。限制挡块42、44被设定形状和尺寸,使得它们各自可与压接工具22接触,所述压接工具22相对于夹推进装置38的纵向位置借助于保持部分14来限定,所述保持部分啮合凹槽36。这意味着,根据情况而撞上压接工具22的限制挡块42、44限制夹推进装置38在两个纵向方向上的纵向移动。
在这个示例性的实施方式中,限制挡块42、44实施为与夹推进装置38成整体的冲压/弯曲部分。两个限制挡块42、44之间在纵向方向上的距离被设定大小或选择和限定以使得夹舌片40在夹推进装置38向后移动(从近侧看)的情况下(即,在夹进给装置38的夹接收移动过程中),正好从夹匣4获取一个夹,如以下将更详细地解释。图3示出处于以下情况或位置的夹推进装置38:如夹推进装置中可见的近侧(即,向后)限制挡块44与压接工具22处于静止接触。根据图3,因此示出处于以下情况或位置的夹推进装置38:单独夹46已借助于夹推进装置38的夹舌片40朝钳口部分20的远端运输,即,运输至压接工具22中或布置在压接工具22中。
显然,图3中例示的夹推进装置38的位置(仍然)不是用于压接所***的夹的钳口部分20的钳口32、34能够闭合的位置。为了闭合钳口部分元件32、34,预先需要夹推进装置38的向后移动,使得该夹推进装置不在所例示的位置中在钳口部分元件32、34之间充分停留。
在图4中,示出处于部分拆开状态的一段夹匣4的底透视图,例示夹推进装置38处于以下另一情况/位置:所述夹推进装置能够从夹匣4的夹存储部分48接收单独夹46,以便将单独夹朝钳口部分20(压接工具22)供应或推进。也将看出,夹存储部分48(从远侧看)被布置在钳口部分元件32、34后面,使得必须在向前方向上供应或运输单独夹46(从远侧看),以在钳口部分元件32、34之间传送该单独夹。
此外,从图4中可看出,处于所例示的夹接收位置的夹推进装置38搁置在具有远侧限制挡块42(即,夹推进装置中向前的一个)的压接工具22上,借此,该夹接收移动在这个移动方向上受到限制。根据夹匣4设定尺寸且相应限定的限制挡块42的位置确保始终从夹匣4的夹存储装置获取仅单个夹46,并且在夹推进方向上的后续夹进给移动中,将单个夹朝压接工具22的远端运输,即在钳口部分元件32、34之间运输并且运输至钳口部分20中。
在示出处于部分拆开状态的夹施放器1的侧透视图的图5中,可以看出,夹施放器1的手柄2包括集成过载保护装置50,所述集成过载保护装置包括滑动离合器52。如果向前限制挡块42撞上压接工具22,那么过载保护装置50(包括滑动离合器52)防止手柄2的机械部分和/或夹匣4的机械部分或壳体部分、或还防止限制挡块42本身或钳口部分20因操作者的过高的致动力而受到损坏。由于用于来自多个夹匣的不同夹匣的夹匣4的限制挡块42、44之间的距离被定位或限定成不同的,因此过载保护装置50可另外地确保通用手柄2可与来自多个夹匣的若干匣配合,而不因过高的手动致动力而损坏相应手柄2和/或相应夹匣4的机械部分或部件。
夹施放器1的操作和实际使用可如以下所描述的那样进行。
图2以侧透视图来示出处于组装(即,操作)状态的夹施放器1,其中夹匣4通过安装装置16与保持装置18的配合进行紧固。
在通过将夹匣4(已按需要选择)安装至通用手柄2来组装夹施放器1后,夹施放器1处于操作状态。这意味着,在这个状态下,夹匣4***到手柄轴10中,并借助于锁18加以固定。
手柄2的两个把手杠杆6和8的手动操作激活手柄2的内部机械致动***54,使得实现为U形滑块的闭合装置12在远侧方向上纵向位移。由于闭合装置12的这种纵向位移,闭合装置被推过钳口部分20的引导装置24、26,由此将所述钳口部分的钳口部分元件32、34朝向彼此(即,在向内方向上)按压,从而闭合压接工具22。
另一方面,手柄2的内部机械致动***54同时也被致动,使得夹推进装置38在与闭合装置12的纵向移动相反的纵向移动(在近侧方向上)中偏移,直到向前限制挡块42撞上固定压接工具22,并且触发过载保护装置50的滑动离合器52,这视情况而定。手柄2的内部机械致动***54将夹推进装置38保持在这个位置中,直到钳口部分元件32、34通过推回闭合装置12再次彼此隔开,并且因此压接工具22再次打开。借此,再次在钳口部分元件32、34之间产生间隙,夹推进装置38借助内部机械致动***54(自动)释放,并且下一个夹能够通过夹舌片40的由弹簧偏压支持的向前移动在钳口部分元件32、34之间运输。
总之,公开一种外科夹施放器,所述外科夹施放器包括通用手柄以及具有集成压接头的单独夹匣,所述单独夹匣可以可拆卸地紧固至通用手柄。通用手柄与紧固至通用手柄的单独夹匣相互作用,以便形成用于将单独夹从所述夹匣的夹接收部分向所述压接头运输的进给路径,所述进给路径被限定或可单独地用于致动。根据本发明,单独夹匣可按需要选自用于不同夹类型的多个夹匣,其中所述夹匣具有将根据要施放的夹类型来设计的集成编码机构,所述编码机构至少限定适于与通用手柄相互作用的相应夹类型的进给路径。
Claims (13)
1.一种外科夹施放器(1)的通用手柄,包括压接头/压接工具(20,22)且可任意选自多个不同夹匣的单独夹匣(4)可安装或紧固至所述通用手柄,使得所述通用手柄(2)与紧固至所述通用手柄的所述单独夹匣(4)以机械方式相互作用,以便在所述压接头/压接工具(20,22)中压接单独夹(46)并且经由单独进给路径将单独夹从夹接收部分(48)向所述压接头/压接工具(20,22)传送,为了这个目的,所述通用手柄(2)设有集成传力齿轮(54),所述集成传力齿轮包括至少一个可用手抓握的把手(6,8)作为致动/输入部分并且包括耦接装置作为至单独夹匣(4)的致动/递送部分,其特征为处于所述致动/输入部分与所述致动/递送部分之间的适配装置(50,52),所述适配装置用于补偿和调节在当前安装的单独夹匣(4)的所述单独进给路径与所述通用手柄(2)上的所述致动/输入部分的最大致动行程之间的夹相关的差异。
2.根据权利要求1所述的通用手柄,其特征在于,所述适配装置(50,52)设计用于以下目的:适于相应夹类型的所述进给路径通过编码机构(20,24,26,38,42,44)限定,所述编码机构被集成到所述当前安装的单独夹匣(4)中并且根据将施放的所述夹类型来形成。
3.根据权利要求1或2所述的通用手柄,其特征在于:所述适配装置(50,52)是用于优选地借助于滑动离合器(52)或释放机构来中断所述齿轮中的传力的过载保护装置。
4.根据权利要求3所述的通用手柄,其特征在于,所述滑动离合器(52)被调整成具有高于经由所述单独进给路径将单独夹从所述夹接收贮存器(48)向所述压接头/压接工具(20,22)传送所需的力并低于使所述传力齿轮(54)过载的预定的致动力的滑动值。
5.一种外科夹施放器(1)的单独夹匣,所述单独夹匣将安装至所述夹施放器(1)的通用手柄(2),所述单独夹匣包括压接头/压接工具(20,22)、夹接收部分(48)、以及用于根据对所述通用手柄(2)的手动操作经由单独进给路径将单独夹从所述夹接收部分(48)向所述压接头/压接工具(20,22)传送的夹推进装置(38),其特征在于,可按需要选自用于不同的夹类型的多个夹匣的所述单独夹匣(4)包括集成编码机构(20,24,26,38,42,44),所述集成编码机构根据将施放的所述夹类型来形成,并且适于所述相应夹类型的所述进给路径至少利用所述集成编码机构限定。
6.根据权利要求5所述的单独夹匣,其特征在于,所述编码机构包括至少一个限制挡块(42,44),所述限制挡块在所述夹推进装置的纵向方向上作用并且意图至少部分限定所述进给路径。
7.根据权利要求5所述的单独夹匣,其特征在于,所述编码机构包括两个限制挡块(42,44),所述限制挡块在所述夹推进装置的纵向方向或移动方向上彼此隔开,所述限制挡块的位置是根据将施放的所述夹类型来适配,使得所述进给单元(38)的向后和/或向前移动允许正好将一个夹从所述夹匣(4)向所述压接头/压接工具(20,22)运输。
8.根据权利要求6或7所述的单独夹匣,其特征在于,所述夹推进装置(38)是杆,所述杆受支撑以便能够在纵向方向上移动,并优选地以板形式实现,进一步优选地,所述至少一个限制挡块(42,44)作为切割和/或弯曲部分来集成到所述杆中。
9.根据权利要求6或7所述的单独夹匣,其特征在于,所述压接头/压接工具(20,22)适于与所述夹推进装置(38)的所述至少一个限制挡块(42,44)接触,以便限制所述夹推进装置(38)的向后和/或向前移动。
10.一种外科夹施放器,其特征为根据权利要求1至4中任一项所述的通用手柄(2)以及根据权利要求5至9中任一项所述的单独夹匣(4)。
11.根据权利要求10所述的外科夹施放器,其特征在于,所述通用手柄(2)被设计为可再用的零件。
12.根据权利要求10和11中任一项所述的外科夹施放器,其特征在于,所述单独夹匣(4)被设计为一次性的零件。
13.根据前述权利要求10至12中任一项所述的外科夹施放器,其特征在于,所述通用手柄(2)和所述单独夹匣(4)包括基于颜色和/或基于符号的编码(5a,5b),所述编码适于将施放的夹类型且意图使当前与所述通用手柄(2)一起使用的所述单独夹匣(4)可视化。
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DE102013106277A1 (de) | 2014-12-18 |
WO2014202449A3 (de) | 2015-06-11 |
US20160113652A1 (en) | 2016-04-28 |
JP6771058B2 (ja) | 2020-10-21 |
CN105555206B (zh) | 2020-02-21 |
EP3010425A2 (de) | 2016-04-27 |
EP3010425B1 (de) | 2021-12-08 |
JP2016523617A (ja) | 2016-08-12 |
ES2907256T3 (es) | 2022-04-22 |
JP2019130328A (ja) | 2019-08-08 |
WO2014202449A2 (de) | 2014-12-24 |
US10390830B2 (en) | 2019-08-27 |
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