CN108784769B - 包括铰接末端执行器的外科手术装载单元 - Google Patents
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Abstract
一种外科手术装载单元包括细长主体,可枢转地联接到细长主体的末端执行器以及延伸穿过细长主体的远侧部分和末端执行器的近侧部分的挠性刀杆。末端执行器相对于细长主体在第一方向上的铰接使刀杆的第一部段在第一方向上移动并且使刀杆的第二部段在与第一方向相反的第二方向上移动。
Description
相关申请的交叉引用
本申请要求于2017年5月2日提交的美国临时专利申请第 62/500,259号的权益和优先权,其全部公开内容以引用方式并入本文 中。
技术领域
本发明通常涉及用于内窥镜使用的外科手术装载单元,并且更具 体地涉及具有铰接(articulation)组件的外科手术装载单元,该铰接组 件用于铰接(articulating)外科手术装载单元的末端执行器。
背景技术
用于内窥镜治疗组织的各种类型的外科手术器械是本领域已知 的,并且通常用于例如在横切术、切除术、吻合术中闭合组织或器官, 用于在胸部和腹部手术中堵塞器官,并用于电外科手术融合或密封组 织。
这种外科手术器械的一个示例是外科手术缝合器械。外科手术缝 合器械通常包括具有砧座组件和用于支撑外科手术缝合钉阵列的钉仓 组件的末端执行器,用于接近钉仓和砧座组件的接近机构,以及用于 从钉仓组件射出外科手术缝合钉的发射机构。
在腹腔镜或内窥镜外科手术过程中,通过小切口或通过***患者 的小入口伤口的狭窄插管来实现进入外科手术部位。由于可用于进入 外科手术部位的面积有限,所以许多内窥镜器械包括用于相对于器械 的主体部分铰接器械的末端执行器的机构以改善进入待治疗的组织。 另外,一些末端执行器具有刀片,该刀片穿过其平移到由末端执行器 的钳夹抓握的组织。在末端执行器的铰接期间,刀片经历弯曲力矩和/ 或剪切力,该弯曲力矩和/或剪切力可能会随着末端执行器继续铰接而 使刀片降级。
因此,提供一种改进型外科手术器械将是有益的,该外科手术器 械包括用于相对于主体部分以各种方位铰接末端执行器而不会损坏移 动穿过末端执行器的刀片的机构。
发明内容
在本发明的一个方面,提供了一种外科手术装载单元,其包括细 长主体,具有可枢转地联接到细长主体的远侧部分的近侧部分的末端 执行器,以及设置在细长主体内的刀组件。刀组件包括细长导向构件 和挠性刀杆。细长导向构件可枢转地支撑在细长主体的远侧部分中。 刀杆被构造成移动穿过限定为穿过细长导向构件的纵向延伸通道。末 端执行器相对于细长主体在第一方向上的铰接实现细长导向构件的远 侧部分在与第一方向相反的第二方向上的移动。
在一些实施例中,细长主体可以限定第一纵向轴线并且末端执行 器可以限定第二纵向轴线。末端执行器可以被构造成相对于细长主体 从第一位置移动到第二位置,在该第一位置中,第二纵向轴线与第一 纵向轴线对齐,在该第二位置中,第二纵向轴线与第一纵向轴线不对 齐。在末端执行器移动到第二位置之后,末端执行器的远侧部分可以 设置在由细长主体限定的中心纵向轴线的第一侧上,并且刀组件的细 长导向构件的远侧部分可以设置在由细长主体限定的中心纵向轴线的 第二侧上。
可以设想的是,刀杆可以比细长导向构件更具挠性,使得细长导 向构件被构造成在末端执行器的铰接期间当刀杆的位于细长导向构件 远侧的部段挠曲时保持线性形状。
可以预想的是,刀组件还可以包括沿着刀杆的相对侧延伸的一对 吹出板。该对吹出板可以具有联接到末端执行器的近侧部分的远侧部 分。第一吹出板可以具有设置在刀杆的第一横向侧与细长导向构件的 第一横向侧之间的近侧部分,并且第二吹出板可以具有设置在刀杆的 第二横向侧与细长导向构件的第二横向侧之间的近侧部分。响应于末 端执行器的铰接,第一吹出板的近侧部分可以被构造成相对于细长导 向构件在第一轴向方向上滑动,并且第二吹出板的近侧部分可以被构 造成相对于细长导向构件在第二轴向方向上滑动。
在一些实施例中,末端执行器的近侧部分可以包括第一和第二壁, 该第一和第二壁向近侧渐缩,使得第一和第二壁协作地限定近侧扩张 空腔,刀杆的远侧部分和该对吹出板均延伸穿过该近侧扩张空腔。第 一和第二壁中的每一个可以限定彼此横向间隔开的弓形侧表面。第一 壁的弓形侧表面可以被构造成当末端执行器在第一方向上铰接时接触 第一吹出板,并且第二壁的弓形侧表面可以被构造成当末端执行器在 第二方向上铰接接触第二吹出板。
可以设想的是,第一壁的近侧部分可以被构造成响应于末端执行 器在第一方向上的铰接而接触第一吹出板,以使细长导向构件的远侧 部分在第二方向上移动。第二壁的近侧部分可以被构造成响应于末端 执行器在第二方向上的铰接而接触第二吹出板,以使细长导向构件的 远侧部分在第一方向上移动。
可以预想的是,第一壁的近侧部分可以被构造成响应于末端执行 器在第一方向上的铰接而使细长导向构件的远侧部分在第二方向上移 动,并且第二壁的近侧部分可以被构造成响应于末端执行器在第二方 向上的铰接而使细长导向构件的远侧部分在第一方向上移动。
在一些实施例中,细长导向构件可以包括可枢转地联接到细长主 体的近侧部分。细长导向构件的近侧部分可以具有可枢转地联接到细 长主体的圆形突片,从而防止细长导向构件相对于细长主体纵向平移。
可以设想的是,刀组件还可以包括限定纵向延伸通道的轨道。挠 性刀杆可以包括第一刀杆轴和第二刀杆轴,该第二刀杆轴联接到第一 刀杆轴并与其平行延伸。第一刀杆轴可以延伸穿过细长导向构件的通 道。第二刀杆轴可以延伸穿过轨道的通道。
可以预想的是,轨道和细长导向构件可以比刀杆更不具挠性,使 得轨道和细长导向构件被构造成在末端执行器相对于细长主体的铰接 期间保持线性形状。
在一些实施例中,外科手术装载单元还可以包括设置在挠性刀杆 的第一刀杆轴与第二刀杆轴之间的支撑结构。支撑结构可以包括其上 支撑细长导向构件的顶面以及其上支撑轨道的底面。
在一些方面,细长主体可以包括其上支撑刀组件的支撑结构。支 撑结构可以具有可枢转地联接到末端执行器的近侧部分的远侧部分。 支撑结构可以具有在其中限定了远侧扩张空腔的平坦顶面。细长导向 构件可以设置在远侧扩张空腔内。
可以设想的是,细长主体可以包括用于实现末端执行器的铰接的 铰接组件。铰接组件可以包括延伸穿过支撑结构的近侧部分的细长驱 动螺母,延伸穿过支撑结构的远侧部分并具有螺纹地联接到驱动螺母 的近侧部分的细长驱动螺杆,以及铰接连杆,该铰接连杆具有可枢转 地联接到驱动螺杆的远侧部分的近侧部分以及可枢转地联接到末端执 行器的近侧部分的远侧部分。驱动螺母的旋转可以使驱动螺杆轴向地 移动以枢转铰接连杆,继而铰接末端执行器。
可以预想的是,铰接组件可以与由细长主体限定的中心纵向轴线 横向偏移。
在一些实施例中,刀杆可以具有可操作地联接到致动器使刀杆轴 向地移动穿过细长主体的近侧部分,以及支撑用于切割组织的刀片的 远侧部分。末端执行器可以包括钉仓和砧座。钉仓可以限定纵向延伸 通道,该纵向延伸通道的尺寸设定为可滑动地容纳刀片。
在本发明的另一方面中,提供了一种外科手术装载单元,其包括 细长主体,具有可枢转地联接到细长主体的远侧部分的近侧部分的末 端执行器,以及延伸穿过细长主体的远侧部分和末端执行器的近侧部 分的挠性刀杆。末端执行器相对于细长主体在第一方向上的铰接可以 使刀杆的第一部段在第一方向上弯曲并且可以在与第一方向相反的第二方向上枢转刀杆的第二部段,同时第二部段保持线性形状。第二部 段可以设置在第一部段的近侧。
附图说明
本文参考附图公开了包括目前公开的铰接机构的实施例的外科手 术装载单元,其中:
图1A是根据本发明的外科手术缝合器械的透视图;
图1B是根据本发明的另一外科手术缝合器械的透视图,示出为处 于非铰接或线性位置;
图2A是与图1A和图1B的外科手术缝合器械一起使用的外科手术 装载单元的远端部分的透视图;
图2B是图2A的装载单元的俯视图;
图2C是图2A的装载单元的第一侧视图;
图2D是图2A的装载单元的第二侧视图;
图3是图2A的装载单元的透视图,其中移除了壳体,示出了其铰接 机构和刀组件;
图4是图3的外科手术装载单元的放大图,其中移除了外壳体和内 壳体;
图5是沿着图4中的线5-5截取的装载单元的透视横截面图,示出了 铰接机构;
图6A是图5的横截面的俯视图,示出了处于非铰接位置的装载单 元,其中装载单元的末端执行器与装载单元的细长主体轴向地对齐;
图6B是图5的横截面的俯视图,示出了装载单元的末端执行器相对 于装载单元的细长主体处于第一铰接位置;
图6C是图5的横截面的俯视图,示出了装载单元的末端执行器相对 于装载单元的细长主体处于第二铰接位置;
图7是外科手术装载单元的透视图,其中移除了细长主体的外壳 体,示出了装载单元的刀组件;
图8是图7的外科手术装载单元的俯视透视图,其中移除了细长主 体的内壳体和外壳体,进一步示出了刀组件;
图9是图8的指示的细节区域的放大图;
图10是图9的刀组件的刀杆、吹出板和刀杆轨道的放大图;
图11是图9的外科手术装载单元的俯视透视图,其中移除了各部 分,示出了处于铰接位置的末端执行器;
图12是图11的外科手术装载单元的侧视图,示出了处于铰接位置 的末端执行器;
图13A是外科手术装载单元的侧视图,示出了处于打开位置的末端 执行器的钉仓和砧座;以及
图13B是沿着线13B-13B截取的图13A的末端执行器的横截面,示 出了处于接近构型的钉仓和砧座。
具体实施方式
本领域技术人员将理解,本文中具体描述的和附图中示出的装载 单元和方法是非限制性的示例性实施例。可以预想的是,在不脱离本 发明的范围的情况下,结合一个示例性实施例示出或描述的元件和特 征可以与另一个元件和特征组合。同样,本领域技术人员将基于所描 述的实施例理解本发明的另外特征和优点。因此,除了如所附权利要 求所指示的之外,本发明不限于已经特别示出和描述的内容。
如本文所使用,术语“远侧”是指外科手术器械或装载单元的离临 床医生最远的那部分,而术语“近侧”是指外科手术器械或装载单元的 离临床医生最近的那部分。另外,如本文所使用,术语临床医生是指 医务人员,包括医生、护士和支援人员。
本发明涉及用于铰接外科手术装载单元或外科手术器械的刀组 件。刀组件包括由刀杆导向装置支撑的挠性刀杆。刀组件被构造成使 得在装载单元的末端执行器相对于装载单元的细长主体铰接之后,刀 组件的刀杆在铰接方向上弯曲,同时也在背向铰接的方向上移位。在 与刀杆弯曲大致相反的方向上移位或枢转的刀杆使得刀杆在末端执行 器的铰接期间采取更大的曲率半径。沿着较大曲率半径弯曲可通过减 小刀杆所承受的剪切力和/或弯曲力矩来延长刀杆的寿命,同时还提供 了末端执行器的较大铰接角度。
本发明还提供了一种用于将装载单元的末端执行器相对于装载单 元的细长主体进行铰接的铰接组件。铰接组件包括细长驱动单元和细 长驱动螺杆,其可操作地彼此联接并且每一个都朝向细长主体的远端 设置,如在下面将进一步详细描述。
下面描述目前公开的刀组件、铰接组件以及包括目前公开的刀组 件和铰接组件的外科手术装载单元的其它优点。
图1A和图1B示出了与外科手术装载单元一起使用的外科手术缝 合器械,该外科手术装载单元并入了目前公开的铰接组件130和刀组件 160的实施例,一般称为外科手术缝合器械10a和10b。外科手术缝合器 械10a和10b中的每一个可以与同一个外科手术装载单元100一起使用。 虽然所描绘的外科手术缝合器械10a、10b发射缝合钉,但是可以设想的是,外科手术装载单元100可以适于发射任何其它合适的紧固件,诸 如夹具和两部分紧固件。另外,虽然附图描绘了线性外科手术缝合器 械,但可以预想的是,目前公开的铰接组件和刀组件适合与其它类型 的内窥镜外科手术器械一起使用,包括非线性外科手术缝合器装载单 元、内窥镜钳、抓握器、解剖器、其它类型的外科手术缝合器械、动 力血管器密封和/或切割装置等。
一般来说,参考图1A,外科手术器械10a包括包含可移动手柄14 的手柄组件12,从手柄组件12延伸的适配器组件16以及联接到适配器 组件16的外管18的远端部分的外科手术装载单元100。如本领域中已知 的那样,可移动手柄14可致动(例如,通过一个或多个冲程)以引起 驱动杆(未示出)的远侧推进,使得驱动杆接合驱动组件(未示出) 的一部分,其迫使驱动组件的至少一部分向远侧平移,从而从外科手 术装载单元100发射缝合钉。关于可移动手柄14的致动如何引起驱动杆 的远侧推进的另外细节在Milliman等人的美国专利第6,953,139号中进 行解释,其全部内容以引用方式并入本文中。
一般来说,参考图1B,外科手术器械10b是马达驱动的机电装置, 其包括包含控制件或按钮22的手柄组件20,联接到手柄组件20的适配 器组件24以及邻近适配器组件24的外管30的远侧部分32设置的外科手 术装载单元100。适配器组件24包括联接到手柄组件20的远端部分的外 旋钮壳体26,并且适配器组件24的外管30从旋钮壳体26的远端部分延伸。手柄组件20的按钮22与机动驱动轴(未示出)电连通,该机动驱 动轴可操作地联接到装载单元100的铰接组件130,使得致动按钮22的 致动引起铰接机构130铰接装载单元100的末端执行器110,如将在下面 进一步详细描述。
例如,可以在美国专利申请第14/550,071号(现在的美国专利申请 公布第2015/0157320号)中找到外科手术器械10b的手柄组件20和适配 器组件24的各个部件的详细描述,其全部内容以引用方式并入本文中。
装载单元100适于附接到外科手术缝合器械10b的适配器组件24的 外管30(或外科手术缝合器械10a的适配器组件16的外管18)。装载单 元100可以被构造成单次使用,或者可以被构造成不止一次地使用,并 且包括细长主体102和支撑在细长主体102的远侧部分102b上的末端执 行器110。在一些实施例中,包括钉仓112和砧座114的末端执行器110可以不形成装载单元100的一部分,而是可以直接可枢转地联接到适配 器组件24的外管30的远侧部分32。
装载单元100的细长主体102限定第一纵向轴线“X1”并具有近侧部 分102a,该近侧部分使用例如卡口式或鲁尔式联轴器而可移除地容纳 在外科手术缝合器械10b的适配器组件24的外管30的远侧部分32内。装 载单元100的细长主体102可以包括外壳体或管106(图2A)以及设置在 外壳体106内的内壳体或管108。在一些实施例中,装载单元100的细长主体102可以与外科手术缝合器械10b的适配器组件24的外管30整体连 接或整体形成。
参考图2A到图2D,装载单元100的末端执行器110限定第二纵向轴 线“X2”,当末端执行器110处于非铰接位置时(图2A到图2D和图6A), 第二纵向轴线“X2”与细长主体102的第一纵向轴线“X1”对齐,并且当末 端执行器110处于铰接位置时(图6B和图6C),第二纵向轴线“X2”与细 长主体102的第一纵向轴线“X1”不对齐。末端执行器110具有可枢转地 联接到细长主体102的远侧部分102b的近侧部分110a。
具体而言,参考图3到图6C,装载单元100的细长主体102的远侧部 分102b包括轴向地固定在细长主体102的内壳108内的支撑结构或平台 116(图3)。支撑结构116具有细长的平面构造,但是在一些实施例中, 可以采取任何合适的构型,诸如管状、圆柱形等。细长主体102的支撑 结构116具有向远侧延伸的渐缩延伸部118。末端执行器110的近侧部分110a包括从其向近侧延伸的一对凸缘113a、113b。支撑结构116的渐缩 延伸部118容纳在限定在末端执行器110的该对凸缘113a、113b之间的空 间中。枢转销120延伸穿过细长主体102的支撑结构116的渐缩延伸部 118和末端执行器110的该对凸缘113a、113b中的每一个以将末端执行 器110可枢转地连接到细长主体102。在一些实施例中,可以设想到末 端执行器110与细长主体102之间的其它可枢转连接,诸如例如,球窝 连接。
继续参考图3到图6C,装载单元100包括铰接组件130,其将末端执 行器110可操作地互连到细长主体102,以利于末端执行器110相对于细 长主体102的铰接。目前公开的铰接组件130最适合与图1B的动力外科 手术缝合器械10b一起使用。然而,可以设想的是,铰接组件130可以 被修改以与图1A的手动操作的外科手术缝合器械10a一起使用。
装载单元100的铰接组件130与由细长主体102限定的中心纵向轴 线“X1”横向偏移,并且包括细长驱动螺母132,可操作地联接到驱动螺 母132的细长驱动螺杆134,以及可操作地联接到驱动螺杆134的铰接连 杆136。驱动螺母132和驱动螺杆134彼此轴向对齐,并且每一个平行延 伸并与细长主体102的中心纵向轴线“X1”横向偏移。驱动螺母132延伸 穿过支撑结构116的纵向侧122的近侧部分116a,并且驱动螺杆134延伸 穿过支撑结构116的纵向侧122的远侧部分116b。驱动螺母132可旋转地 支撑并且轴向地固定在支撑结构116的纵向侧122中,并且驱动螺杆134 键接到支撑结构116的纵向侧122以防止驱动螺杆134的旋转,同时允许 驱动螺杆134相对于支撑结构116的线性平移。
通过将铰接组件130的驱动螺母132和驱动螺杆134定位成邻近装 载单元100的细长主体102的远端而不是近端,减小了通常在细长主体 102的近端发生的空隙量。
铰接组件130的驱动螺母132具有可操作地联接到手柄组件20的致 动按钮22(图1B)的近侧部分132a,以及远侧部分132b。铰接组件130 的驱动螺杆134具有设置在驱动螺母132的远侧部分132b内的近侧部分 134a,并且限定可操作地联接到限定在驱动单元132中的内螺纹的外螺 纹。这样,驱动螺母132响应于按钮22(图1B)的致动相对于支撑结构116并在其内的旋转实现驱动螺杆134在支撑结构116内并相对于其的 线性平移。
铰接组件130的铰接连杆136具有可枢转地联接到驱动螺杆134的 远侧部分134b的近侧部分136a,以及可枢转地联接到末端执行器110的 近侧部分110a(例如,凸缘113a或113b中一个或两个)的远侧部分136b。 铰接连杆136可以具有弓形构型,其中凸横向侧朝向装载单元100的枢 转轴线定向而凹侧面背向该枢转轴线定向。在一些实施例中,铰接连 杆136可以采取任何合适的形状,诸如例如线性。铰接连杆136将驱动 螺杆134的线性运动转换为枢转运动,以将末端执行器110相对于细长 主体102进行铰接。
现在参考图6A到图6C,在使用中,铰接组件130的驱动螺母132经 由按钮22(图1B)致动的旋转使铰接组件130的驱动螺杆134基于驱动 螺母132的旋转方向在近侧或远侧方向上线性平移。例如,如图6B中所 示,驱动螺母132的顺时针旋转可以导致驱动螺杆134相对于驱动螺母 132的远侧平移。由于末端执行器110相对于细长主体102轴向地固定, 所以当驱动螺杆134在图6B中的箭头“A”所示的远侧方向上平移时,铰 接组件130的铰接连杆136围绕其近侧部分136a并相对于驱动螺杆134 的远侧部分134b在图6B中的箭头“B”所示的第一方向上枢转。铰接连杆 136还围绕其远侧部分136b相对于末端执行器110的近侧部分110a枢转, 这实现了末端执行器110在“B”方向上的铰接。
类似地,如图6C中所示,驱动螺母132的逆时针旋转可导致驱动螺 杆134相对于驱动螺母132的近侧平移。当驱动螺杆134在图6C中的箭头 “C”所示的近侧方向上平移时,铰接连杆136围绕其近侧部分136a相对 于驱动螺杆134的远侧部分134b稍微枢转。由于铰接连杆136的远侧部 分136b在与中心纵向轴线“X2”偏离的位置处联接到末端执行器110,所以末端执行器110在图6C中的箭头“D”所示的方向上相对于细长主体 102铰接。
参考图2A到图2D、图3、图4和图7到图12中,示出了装载单元100 的刀组件160。如上面简要提及,刀组件160包括挠性刀杆162,该挠性 刀杆在其第一或远侧部段162a处支撑刀片164(图13B),并且在末端执 行器110相对于细长主体102的上述铰接期间弯曲。
具体参考图7到图12,刀组件160的刀杆162具有延伸穿过装载单元 100的细长主体102的第二或中间部段162b,以及第三或近侧部段162c, 该第三或近侧部段可操作地联接到刀杆推动器166以将刀杆162联接到 手柄组件20的按钮22(图1B)或联接到手柄组件20的另一致动按钮, 例如致动按钮23。刀片164(图13B)联接到刀杆162的远侧部段162a 或与其整体形成。这样,按钮23的致动使刀杆162和相关联的刀片164 向远侧平移穿过末端执行器110以切割由末端执行器110抓握的组织。 刀杆162沿其长度分叉以限定一对纵向延伸的刀杆轴168a、168b(图 12),其间设置有细长主体102的支撑结构116。
刀组件160还包括支撑刀杆162的中间部段或第二部段162b的细长 导向构件或轨道170。轨道170支撑在支撑结构116的顶侧117a上并且在 装载单元100的细长主体102的内壳体108中(图3)。刀组件160的轨道170具有线性的矩形形状,并且限定了纵向延伸通道172,其具有可滑 动地支撑在其中的刀杆162的中间部段162b。在实施例中,轨道170可 以采取各种合适的形状,诸如例如管状。
轨道170包括其上支撑刀杆162的中间部段162b的底壁172,以及从 底壁172垂直延伸的一对平行侧壁174、176。该对侧壁174、176沿着刀 杆162的中间部段162b的相应横向侧178a、178b延伸并且支撑其,使得 轨道170至少部分地围绕刀杆162的中间部段162b。轨道170由赋予轨道 170轴向刚度的材料制成,诸如聚酰胺酰亚胺或聚醚醚酮。轨道170比 挠性刀杆162具有更大刚度(例如,较小的挠性)。由于轨道170比刀杆 162具有更大轴向刚度,所以轨道170在末端执行器110的铰接期间抵制 沿着其长度的弯曲以保持刀杆162的中间部段162b的线性。
刀组件160的轨道170可移动地支撑在细长主体102的支撑结构116 的顶侧117a上。支撑结构116的顶侧117a在其中限定浅空腔180。轨道170 可枢转地支撑在支撑结构116的空腔180中。限定在支撑结构116中的空 腔180具有近侧部分180a和远侧扩张的远侧部分180b。如将在下面详细 描述,空腔180的远侧部分180b允许轨道170的远侧部分170b在末端执 行器110的铰接期间横穿其中。支撑结构116的空腔180和轨道170具有 基本类似的长度,从而防止轨道170在空腔180内并且相对于支撑结构 116纵向平移。在一些实施例中,轨道170可以具有从轨道170的平行侧 壁174、176延伸的圆形突片182,其可枢转地连接到细长主体102的内 壳体108(图3),以允许轨道170相对于支撑结构116旋转,而防止轨道 170相对于支撑结构116的纵向平移。
继续参考图7到图12,刀组件160还包括分别沿着刀杆162的横向侧 178a、178b延伸的吹出板或支撑件184、186。吹出板184、186比轨道 170更具挠性,以允许板184、186在末端执行器110的铰接期间弯曲, 但是比刀杆162更不具挠性,以防止刀杆162的远侧部段162a在末端执 行器110的铰接期间屈曲。
每个吹出板184、186分别具有近侧部分184a、186a和远侧部分 184b、186b。第一吹出板184的近侧部分184a设置在刀杆162的第一横 向侧178a与轨道170的第一侧壁174之间。第二吹出板186的近侧部分 186a设置在刀杆162的第二横向侧178b与轨道170的第二侧壁176之间。 每个吹出板184、186的近侧部分184a、186a可滑动地容纳在轨道170的 通道172内。
每个吹出板184、186的远侧部分184b、186b固定到末端执行器110 的近侧部分110a。以这种方式,当末端执行器110相对于细长主体102 进行铰接时,由于吹出板184、186之间的径向距离在末端执行器110的 铰接期间改变,吹出板184或186中的一个将在近侧方向上被拉动,而 吹出板184或186中的另一个将在远侧方向上被推动。在吹出板184、186 的远侧部分184b、186b的推动和/或拉动期间,其近侧部分184a、186a 在轨道170的通道172和刀杆162内并相对于其滑动。
如图12中所示,刀组件160具有支撑刀杆162的第二刀杆轴168b的 另一个轨道170'和另一对吹出板184'、186',每个吹出板都设置在支撑 结构116的底侧117b上。由于设置在支撑结构116的顶侧117a上的刀组件 160的部件与设置在支撑结构116的底侧117b上的刀组件160的部件的 基本相似性,将不描述在支撑结构116的底侧117b上的刀组件160的部 件。
继续参考图7到图12,装载单元100的末端执行器110的近侧部分 110a与刀组件160协作以利于刀组件160的刀杆162沿着其轴线的弯曲 以及刀杆162相对于细长主体102的支撑结构116的移位。末端执行器 110的近侧部分110a包括在近侧方向上渐缩的第一壁188和第二壁190。 末端执行器110的壁188、190支撑在末端执行器110的顶部凸缘113a上。如上所述,刀杆162被分成两个轴168a、168b,因此末端执行器110的 近侧部分110a可以具有支撑在末端执行器110的底部凸缘113b上的另一 对壁(未明确示出),用于与刀杆162的第二刀杆轴168b相互作用。第 一壁188和第二壁190协作地限定近侧扩张空腔192,刀杆162的远侧部 段162a和每个吹出板184、186的远端部分184b、186b均延伸穿过该近 侧扩张空腔。当刀杆162随着末端执行器110的铰接而在第一或第二方 向中的任一个方向上弯曲时,末端执行器110的近侧部分110a的空腔192 容纳刀杆162的远侧部分162a的移动。
末端执行器110的第一壁188和第二壁190中的每一个分别限定弓 形侧表面194、196。弓形侧表面194、196横跨末端执行器110的近侧部 分110a的空腔192彼此横向间隔开。在一些实施例中,第一壁188和第 二壁190的侧表面194、196可采取各种形状。第一壁188的弓形侧表面 194朝向刀杆162的第一横向侧178a定向,而第二壁190的弓形侧表面 196朝向刀杆162的第二横向侧178b定向。如将在下面详细描述,在末 端执行器110相对于细长主体102的铰接期间,末端执行器110的相应第 一壁188和第二壁190的弓形侧表面194、196接触相应的吹出板,以使 吹出板184、186和刀杆162的远侧部段162a弯曲。
在操作中,末端执行器110可以相对于细长主体102在如由图6B和 图11中的箭头“B”所示的第一方向上或如由图6C中的箭头“D”所示的第 二方向上经由如上所述的铰接组件130进行铰接。在装载单元100的末 端执行器110相对于细长主体102在第一方向“B”上的铰接期间,刀杆 162的远侧部段162a(例如,跨越细长主体102的远侧部分102b和末端 执行器110的近侧部分110a中每一个的刀杆162部段)在第一方向“B”上 弯曲。
在末端执行器110达到阈值铰接量之后,末端执行器110的第一壁 188的弓形侧表面194接触第一吹出板184以在与第一方向“B”基本相反 的方向(例如,由图11中的箭头“D”所示的方向)上推动刀杆162的远 侧部段162a和中间部段162b。末端执行器110在方向“B”上的进一步铰 接导致末端执行器110的第一壁188的近端193接触第一吹出板184以进 一步在与末端执行器110的铰接运动基本相反的方向上推动刀杆162的 远侧部段162a和中间部段162b。
由于刀杆162的第二或中间部段162b设置在刀组件160的轨道170 的通道172内,所以刀杆162在方向“D”上的移动或移位也引起轨道170 在方向“D”上移动或移动。由于轨道170的近侧部分170a相对于支撑结 构116轴向地固定,并且轨道170的远侧部分170b自由移动,因此轨道 170的远侧部分170b围绕其近侧部分170a枢转。
虽然刀杆162的远侧部段162a在末端执行器110的铰接期间弯曲, 但刀杆162的中间部段162b保持线性,因为刀杆162的中间部段162b在 轨道170内延伸。当刀组件160的轨道170在方向“D”上枢转时,轨道170 的远侧部分170b朝向由细长主体102限定的中心纵向轴线“X1”的第一 侧移动,并且末端致动器110的远侧部分110b(图2B)朝向由细长主体 102限定的中心纵向轴线“X1”的第二侧移动。
当刀组件160的轨道170围绕其近侧部分170a枢转时,假设刀杆162 在轨道170的近侧部分170a附近的点“P”处设置在轨道170外部,则刀组 件160的刀杆162在点“P”处弯曲。当刀杆162的远侧部段162a在末端执 行器110的铰接期间在方向“B”上弯曲时,刀杆162在点“P”处在方向“D” 上弯曲。以这种方式,刀杆162的远侧部段162a和中间部段162b在与刀 杆162的远侧部段162a弯曲或屈曲的方向相反的方向上移位或枢转。通 过使刀杆162的远侧部段162a和中间部段162b在与刀杆162的远侧部段 162a的弯曲方向相反的方向上移动,刀杆162的远侧部段162a的曲率半 径增加。增加刀杆162的远侧部段162a的曲率半径减小了在末端执行器 110在方向“B”上的铰接期间刀杆162上的应力。
装载单元100的末端执行器110在相反方向(例如,方向“D”)上的 铰接引起刀组件160的刀杆162中的相似现象,但是在相反的方向上。 具体而言,当末端执行器110在第二方向“D”上铰接时,刀杆162的远侧 部段162a在第二方向“D”上弯曲或屈曲。在末端执行器110达到阈值铰 接量之后,末端执行器110的第二壁190的弓形侧表面196接触刀组件 160的第二吹出板186,以在与第二方向“D”基本相反的方向(例如,方 向“B”)上推动刀杆162的远侧部段162a和中间部段162b。
由于刀杆162的中间部段162b设置在轨道170的通道172内,因此刀 杆162的中间部段162b在方向“B”上的移动或移位也引起轨道170在方 向“B”上移动或枢转。当轨道170围绕其近侧部分170a枢转时,刀杆162 在点“P”处弯曲。当刀杆162在点“P”处在方向“B”上弯曲时,刀杆162的 中间部段162b的线性轮廓由轨道170保持。以这种方式,刀杆162的远侧部段162a在与刀杆162的远侧部段162a和中间部段162b移位或移动 方向相反的方向上弯曲或屈曲。通过使刀杆162的远侧部段162a和中间 部段162b在与刀杆162的远侧部段162a的弯曲方向相反的方向上移动, 刀杆162的远侧部段162a的曲率半径增加。增加刀杆162的远侧部段 162a的曲率半径减小了在末端执行器110在方向“D”上的铰接期间刀杆162上的应力。
参考图13A和图13B,示出了末端执行器110的钉仓112和砧座114。 钉仓112和砧座114中的每一个分别限定纵向延伸通道115a、115b。刀片 164的顶部具有可滑动地捕获在砧座114的通道115b内的横向延伸突起164a,并且刀片164的底部具有可滑动地捕获在钉仓112的通道115a内的 横向延伸突起164b。通道115a、115b在其中支撑刀片164以在刀片164平移穿过末端执行器110期间使刀片164稳定。
本发明还涉及使用所描述的外科手术缝合器械10a、10b来执行外 科手术和/或使外科手术缝合装载单元的末端执行器铰接的方法。可以 使用Milliman等人的美国专利第6,953,139号中公开的类似机构从末端 执行器的钉仓中发射缝合钉,该专利以引用方式并入本文中。
本领域技术人员将理解,本文中具体描述的和附图中示出的装载 单元和方法是非限制性的示例性实施例。可以预想的是,在不脱离本 发明的范围的情况下,结合一个示例性实施例示出或描述的元件和特 征可以与另一个元件和特征组合。同样,本领域技术人员将基于上述 实施例理解本发明的另外特征和优点。因此,除了如所附权利要求所 指示的之外,本发明不限于已经特别示出和描述的内容。
Claims (24)
1.一种外科手术装载单元,包括:
细长主体;
末端执行器,其具有可枢转地联接到所述细长主体的远侧部分的近侧部分;以及
刀组件,其设置在所述细长主体内并且包括:
细长导向构件,其可枢转地支撑在所述细长主体的所述远侧部分中并限定纵向延伸通道;以及
挠性刀杆,其延伸穿过所述细长导向构件的所述通道,所述刀杆构造成移动穿过所述细长导向构件的所述通道,其中所述末端执行器相对于所述细长主体在第一方向上的铰接实现所述细长导向构件的所述远侧部分在与所述第一方向相反的第二方向上的移动。
2.根据权利要求1所述的外科手术装载单元,其中所述细长主体限定第一纵向轴线,并且所述末端执行器限定第二纵向轴线,所述末端执行器被构造成相对于所述细长主体从第一位置移动到第二位置,在所述第一位置中,所述第二纵向轴线与所述第一纵向轴线对齐,在所述第二位置中,所述第二纵向轴线与所述第一纵向轴线不对齐。
3.根据权利要求2所述的外科手术装载单元,其中在所述末端执行器移动到所述第二位置之后,所述末端执行器的远侧部分设置在由所述细长主体限定的中心纵向轴线的第一侧上,并且所述刀组件的所述细长导向构件的所述远侧部分设置在由所述细长主体限定的所述中心纵向轴线的第二侧上。
4.根据权利要求1所述的外科手术装载单元,其中所述刀杆比所述细长导向构件更具挠性,使得所述细长导向构件被构造成在所述末端执行器的铰接期间当所述刀杆的位于所述细长导向构件远侧的部段挠曲时保持线性形状。
5.根据权利要求1所述的外科手术装载单元,其中所述刀组件还包括沿着所述刀杆的相对侧延伸的一对吹出板,所述一对吹出板具有联接到所述末端执行器的所述近侧部分的远侧部分。
6.根据权利要求5所述的外科手术装载单元,其中所述一对吹出板中的第一吹出板具有设置在所述刀杆的第一横向侧与所述细长导向构件的第一横向侧之间的近侧部分,并且所述一对吹出板中的第二吹出板具有设置在所述刀杆的第二横向侧与所述细长导向构件的第二横向侧之间的近侧部分。
7.根据权利要求6所述的外科手术装载单元,其中响应于所述末端执行器铰接,所述第一吹出板的所述近侧部分被构造成相对于所述细长导向构件在第一轴向方向上滑动,并且所述第二吹出板的所述近侧部分被构造成相对于细长导向构件在第二轴向方向上滑动。
8.根据权利要求6所述的外科手术装载单元,其中所述末端执行器的所述近侧部分包括:
第一壁,其向近侧渐缩;以及
第二壁,其向近侧渐缩使得所述第一壁和所述第二壁协作地限定近侧扩张空腔,所述刀杆的所述远侧部分和所述一对吹出板均延伸穿过所述近侧扩张空腔。
9.根据权利要求8所述的外科手术装载单元,其中所述第一和第二壁中的每一个限定弓形侧表面,所述弓形侧表面彼此横向间隔开。
10.根据权利要求9所述的外科手术装载单元,其中所述第一壁的所述弓形侧表面被构造成当所述末端执行器在所述第一方向上铰接时接触所述第一吹出板,并且所述第二壁的所述弓形侧表面被构造成当所述末端执行器在所述第二方向上铰接时接触所述第二吹出板。
11.根据权利要求8所述的外科手术装载单元,其中所述第一壁的近侧部分被构造成响应于所述末端执行器在所述第一方向上的铰接而接触所述第一吹出板,以使所述细长导向构件的所述远侧部分在所述第二方向上移动,并且所述第二壁的所述近侧部分被构造成响应于所述末端执行器在所述第二方向上的铰接而接触所述第二吹出板,以使所述细长导向构件的所述远侧部分在所述第一方向上移动。
12.根据权利要求1所述的外科手术装载单元,其中所述末端执行器的所述近侧部分包括:
第一壁,其向近侧渐缩;以及
第二壁,其向近侧渐缩使得所述第一壁和所述第二壁协作地限定近侧扩张空腔,所述刀杆的远侧部分延伸穿过所述近侧扩张空腔。
13.根据权利要求12所述的外科手术装载单元,其中所述第一壁的近侧部分被构造成响应于所述末端执行器在所述第一方向上的铰接而使所述细长导向构件的所述远侧部分在所述第二方向上移动,并且所述第二壁的近侧部分被构造成响应于所述末端执行器在所述第二方向上的铰接而使所述细长导向构件的所述远侧部分在所述第一方向上移动。
14.根据权利要求1所述的外科手术装载单元,其中所述细长导向构件包括可枢转地联接到所述细长主体的近侧部分。
15.根据权利要求14所述的外科手术装载单元,其中所述细长导向构件的所述近侧部分具有可枢转地联接到所述细长主体的圆形突片,从而防止所述细长导向构件相对于所述细长主体纵向平移。
16.根据权利要求1所述的外科手术装载单元,其中所述刀组件还包括限定纵向延伸通道的轨道,所述挠性刀杆包括:
第一刀杆轴,其延伸穿过所述细长导向构件的所述通道;以及
第二刀杆轴,其联接到所述第一刀杆轴并与其平行延伸,所述第二刀杆轴延伸穿过所述轨道的所述通道。
17.根据权利要求16所述的外科手术装载单元,其中所述轨道和所述细长导向构件比所述刀杆更不具挠性,使得所述轨道和所述细长导向构件被构造成在所述末端执行器相对于所述细长主体的铰接期间保持线性形状。
18.根据权利要求17所述的外科手术装载单元,还包括设置在所述挠性刀杆的所述第一刀杆轴与所述第二刀杆轴之间的支撑结构,所述支撑结构包括:
顶面,其上支撑所述细长导向构件;以及
底面,其上支撑所述轨道。
19.根据权利要求1所述的外科手术装载单元,其中所述细长主体包括支撑结构,其上支撑所述刀组件,所述支撑结构具有可枢转地联接到所述末端执行器的所述近侧部分的远侧部分。
20.根据权利要求19所述的外科手术装载单元,其中所述支撑结构具有平坦顶面,在其中限定了远侧扩张空腔,所述细长导向构件设置在所述远侧扩张空腔内。
21.根据权利要求19所述的外科手术装载单元,其中所述细长主体包括用于实现所述末端执行器的铰接的铰接组件,所述铰接组件包括:
细长驱动螺母,其延伸穿过所述支撑结构的近侧部分;
细长驱动螺杆,其延伸穿过所述支撑结构的远侧部分并具有螺纹地联接到所述驱动螺母的近侧部分;以及
铰接连杆,其具有可枢转地联接到所述驱动螺杆的远侧部分的近侧部分,以及可枢转地联接到所述末端执行器的所述近侧部分的远侧部分,其中所述驱动螺母的旋转使所述驱动螺杆轴向地移动以枢转所述铰接连杆,继而铰接末端执行器。
22.根据权利要求21所述的外科手术装载单元,其中所述铰接组件与由所述细长主体限定的中心纵向轴线横向偏移。
23.根据权利要求1所述的外科手术装载单元,其中所述刀杆具有可操作地联接到致动器使所述刀杆轴向地移动穿过所述细长主体的近侧部分,以及支撑用于切割组织的刀片的远侧部分。
24.根据权利要求23所述的外科手术装载单元,其中所述末端执行器包括钉仓和砧座,所述钉仓限定纵向延伸通道,所述纵向延伸通道的尺寸设定为可滑动地容纳所述刀片。
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2018
- 2018-04-04 US US15/945,404 patent/US10603035B2/en active Active
- 2018-04-18 AU AU2018202679A patent/AU2018202679A1/en not_active Abandoned
- 2018-04-27 JP JP2018086074A patent/JP7149729B2/ja active Active
- 2018-04-28 CN CN201810402506.3A patent/CN108784769B/zh active Active
- 2018-05-01 EP EP18170242.4A patent/EP3398528B1/en active Active
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2022
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US20180317913A1 (en) | 2018-11-08 |
EP3398528B1 (en) | 2019-12-25 |
JP2018187375A (ja) | 2018-11-29 |
CN108784769A (zh) | 2018-11-13 |
EP3398528A1 (en) | 2018-11-07 |
AU2018202679A1 (en) | 2018-11-22 |
JP7149729B2 (ja) | 2022-10-07 |
JP2022093690A (ja) | 2022-06-23 |
US10603035B2 (en) | 2020-03-31 |
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