CN113303854A - 具有可拆卸的刀的缝合重新装载组件 - Google Patents
具有可拆卸的刀的缝合重新装载组件 Download PDFInfo
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Abstract
一种外科缝合装置包含砧座组件和重新装载组件,所述重新装载组件包含刀和刀架。所述刀以可拆卸方式联接到所述刀架,且当所述缝合装置被击发时,所述刀嵌入所述砧座组件的切割环中。在将预定力施加到所述刀上之后,所述刀可与所述刀架分离。在通过将所述砧座组件相对于所述重新装载组件从夹紧位置移动到打开位置而击发所述缝合装置之后,将所述预定力施加到所述刀上。
Description
相关申请的交叉引用
本申请要求2020年2月26日提交的第62/981,636号美国临时专利申请的权益和优先权,所述申请的整个公开内容以引用的方式并入本文中。
技术领域
本公开大体上涉及外科缝合装置,且更确切地说,涉及包含用于切割组织的刀的圆形外科缝合装置。
背景技术
圆形缝合装置通常包含具有钉仓、推钉器和环形刀的外壳或重新装载组件。钉仓支撑一个或多个环形钉排,并且推钉器可在钉仓内移动以从钉仓中弹出钉。环形刀定位在环形钉排的径向内侧,并且可从缩回位置移动到推进位置以切割或取心组织。环形刀可以与推钉器同步移动或可独立于推钉器移动以在例如吻合手术的外科手术期间切割组织。
在吻合手术期间,两个管状的组织切片彼此连接,并且用刀对管状切片内的组织进行取心,以在连接的管状切片之间限定中空通道。一般来说,在组织切片被切割之后,组织圆环保持在重新装载组件的环形刀内。当从患者身上取出重新装载组件时,临床医生从环形刀内取出组织圆环。
在吻合手术期间致动圆形缝合装置以切割组织之后,将刀从推进位置移动,在所述推进位置,环形刀的切割边缘暴露于缩回位置,在所述缩回位置,刀的切割边缘凹入在重新装载组件的钉仓内并进行遮蔽。在从环形刀内取出组织圆环期间,沿远侧方向拉动刀的切割边缘,这可能会无意中暴露刀的切割边缘。刀的切割边缘的暴露对操作缝合装置的临床医生构成了危险。
发明内容
本公开的技术大体上涉及具有用于切割组织的刀的圆形缝合装置。在本公开的各方面中,外壳缝合装置包含砧座组件和重新装载组件,所述重新装载组件包含刀和刀架。刀以可拆卸方式联接到刀架,且当缝合装置被击发时,所述刀嵌入砧座组件的切割环中。在将预定力施加到刀上之后,所述刀可与刀架分离。在通过将砧座组件相对于重新装载组件从夹紧位置移动到打开位置而击发缝合装置之后,将预定力施加到刀上。
本公开的一个方面涉及一种重新装载组件,其包含外壳壳体、钉仓、推钉构件、刀架和刀。外壳壳体限定空腔且具有近侧部分和远侧部分。钉仓支撑在外壳壳体的远侧部分上且支撑多个钉。推钉构件可在外壳壳体内在推进位置与缩回位置之间移动,以从钉仓弹出多个钉。推钉构件限定纵向孔。刀架支撑在推钉构件的纵向孔内,并且具有限定第一接合部分的远侧部分。刀架可在外壳壳体内在缩回位置与推进位置之间移动。刀具有近侧部分和远侧部分。近侧部分限定第二接合部分,所述第二接合部分联接到第一接合部分以将刀以可拆卸方式固定到刀架。在远侧方向上将预定力施加到刀之后,所述刀可以与刀架的第一接合部分断开联接。
在本公开的各方面中,刀是环形的。
在本公开的一些方面中,第一接合部分由形成在刀架的远侧部分上的多个弹性指状件限定。
在本公开的某些方面中,多个弹性指状件中的每一个限定凹表面,以限定围绕刀架的远侧部分的环形凹部。
在本公开的各方面中,第二接合部分形成在刀的近侧部分上且包含环形凸出部分,所述环形凸出部分收纳在由刀架的多个弹性指状件限定的环形凹部内,以将所述刀以可拆卸方式固定到所述刀架。
在本公开的各方面中,通过使刀的近侧部分倒转,在所述刀的所述近侧部分上形成第二接合部分。
本公开的另一方面涉及一种缝合装置,其包含适配器组件、重新装载组件和砧座组件。适配器组件具有远侧末端部分。重新装载组件被固定到适配器组件的远侧末端部分且包含外壳壳体、钉仓组件、推钉构件、刀架和刀。外壳壳体限定空腔且具有近侧部分和远侧部分。钉仓支撑在外壳壳体的远侧部分上且支撑多个钉。推钉构件可在外壳壳体内在推进位置与缩回位置之间移动,以从钉仓弹出多个钉。推钉构件限定纵向孔。刀架支撑在推钉构件的纵向孔内,并且具有限定第一接合部分的远侧部分。刀架在外壳壳体内在缩回位置与推进位置之间移动。刀具有近侧部分和远侧部分。远侧部分限定切割边缘。近侧部分限定第二接合部分,所述第二接合部分联接到第一接合部分以将刀以可拆卸方式固定到刀架。在远侧方向上将预定力施加到刀之后,所述刀可以与刀架的第一接合部分断开联接。砧座组件可相对于钉仓在打开位置与夹紧位置之间移动,并且包含由可被刀穿透的材料形成的切割环。当缝合装置被击发时,刀嵌入切割环中,且当砧座组件从夹紧位置移动到打开位置时,在缝合装置被击发之后,所述刀与刀架分离。
本公开的另一方面涉及一种刀组件,其包含刀架和刀。刀架具有限定第一接合部分的远侧部分。刀具有近侧部分和远侧部分。远侧部分限定切割边缘。近侧部分限定第二接合部分,所述第二接合部分联接到第一接合部分以将刀以可拆卸方式固定到刀架。在将预定力施加到刀之后,所述刀可以与刀架的第一接合部分断开联接。
在以下附图和描述中阐述本公开的一个或多个方面的细节。根据说明书和附图以及权利要求书,本公开中所描述的技术的其它特征、目的和优点将显而易见。
附图说明
参考图式描述本公开的各种方面和特征,其中相同的标号在若干视图中的每一个中指定相同或对应元件,并且:
图1是根据本公开的各方面的包含具有重新装载组件的工具组件的外科缝合装置的侧面透视图;
图2是图1所示的取出砧座组件的外科缝合装置的远侧部分的放大视图;
图3是图1的外科缝合装置的重新装载组件的侧面透视分解视图;
图4是图3所示的指定的细节区域的放大视图;
图5是图3所示的外科缝合装置的刀架和环形刀的侧面透视图;
图6是沿着图4的截面线6-6截得的环形刀与刀架分离的截面图;
图7是当环形刀移动到与刀架接合时穿过刀架和环形刀的远侧部分的横截面剖视图;
图8是在环形刀与刀架接合的情况下穿过刀架和环形刀的远侧部分的横截面剖视图;
图9是在环形刀与刀架接合的情况下穿过刀架和环形刀的远侧部分的横截面图;
图10是沿着图2的截面线10-10截得的横截面图,其中外科缝合装置处于夹紧位置;
图11是沿着图2的截面线11-11截得的横截面图,其中外科缝合装置处于已夹紧和已击发位置;
图12是沿着图2的截面线11-11截得的横截面图,其中当外科缝合装置朝向未夹紧位置移动时,所述外科手术缝合装置处于已击发位置;
图13是当外科缝合装置移动到非夹紧位置且环形刀与刀架分离时,沿着图2的截面线11-11截得的在外科缝合装置被击发之后的横截面图;
图14是图1所示的外科缝合装置的远侧部分的横截面图,其中外科缝合装置处于已击发、未夹紧位置,砧座组件处于倾斜位置,且环形刀与刀架分离;以及
图15是图14所示的外科缝合装置的远侧部分的侧面透视图,其中外科缝合装置处于未夹紧、已击发位置且环形刀与刀架分离。
具体实施方式
现在将参考附图详细地描述包含本公开的各种方面的包含重新装载组件的所公开的外科缝合装置,其中相同的参考标号在若干视图的每一个中表示相同或对应元件。然而,应理解,所公开的方面仅是本公开的实例,并且可以各种形式体现。未详细描述众所周知的功能或构造以避免用不必要的细节混淆本公开。因此,本文中所公开的具体结构和功能细节不应被解释为限制性的,而是仅作为权利要求书的基础,并且作为用于教示所属领域的技术人员以在实际上任何适当的详细结构中来不同地采用本公开的代表性基础。此外,例如前部、后部、上部、下部、顶部、底部、远侧、近侧的方向术语以及类似术语用于帮助理解描述,且并不旨在限制本公开。
在此描述中,术语“近侧”通常用于指代装置的较靠近临床医生的部分,而术语“远侧”通常用于指代装置的离临床医生较远的部分。另外,术语“临床医生”通常用于指代医务人员,包含医生、护士和辅助人员。
本公开涉及一种圆形外科缝合装置,其包含具有刀架的重新装载组件,所述刀架以可拆卸方式联接到具有切割边缘的刀,并且可以在将预定力施加到刀之后与刀架分离。刀被定位成在缝合装置被击发时与缝合装置的砧座组件上的切割环组件接合且穿透所述切割环组件。刀与切割环组件的接合足以在缝合装置已经被击发之后当刀架返回到缩回位置时使所述刀与所述刀架分离。当刀与刀架分离时,刀的切割边缘嵌入切割环组件中,以避免将刀的切割边缘暴露于临床医生。
图1说明包含根据本公开的各方面的通常展示为重新装载组件100的重新装载组件的圆形缝合装置10。圆形缝合装置10包含手柄或致动器组件12、细长主体或适配器组件14、重新装载组件100和砧座组件18,所述砧座组件被支撑以相对于重新装载组件100在未夹紧位置与夹紧位置(图10)之间移动。在本公开的各方面中,重新装载组件100包含以可拆卸方式联接到适配器组件14的远侧部分的近侧部分102,且适配器组件14包含以可拆卸方式联接到手柄组件12的近侧部分。替代地,可以设想,重新装载组件100可以牢固地固定到适配器组件14和/或适配器组件可以牢固地固定到手柄组件12。手柄组件12包含主体22,所述主体限定支撑用于控制圆形缝合装置10的各种功能的操作的致动按钮24的固定把手22a,所述操作包含接近重新装载组件100和砧座组件18、从重新装载组件100击发钉,以及切割组织或对组织进行取心,如下文进一步详细描述。
圆形缝合装置10被说明为包含电动手柄组件12的电动缝合装置,所述电动手柄组件可支撑一个或多个电池(未展示)。适配器组件14将来自手柄组件12的电力分别转移到重新装载组件100和砧座组件18,以便缝合和切割组织。电动缝合装置的示例可见于第9,055,943号和第9,023,014号美国专利以及第2018/0125495号和第2017/0340351号美国公开案。或者,设想本文中所公开的重新装载组件100的各方面还可并入到例如公开于第7,303,106号美国专利('106专利)中的手动缝合装置或公开于例如第9,962,159号美国专利中的配置成与机器人***一起使用且不包含手柄组件的缝合装置中。
图2和3说明重新装载组件100,其包含外壳壳体110、钉致动器112、推钉构件112a、刀架114、支撑在刀架114上的环形刀116、钉仓118和支撑在钉仓118内的多个钉120。外壳壳体110包含彼此间隔开的外壳体部分121和内壳体部分122,以限定环形空腔124。钉致动器112和推钉构件112a可在外壳壳体110的环形空腔124内从缩回位置移动到推进位置,以从钉仓118中弹出钉120。
钉仓118是环形的并限定钉凹座126的环形排。每个钉凹座126支撑钉120中的一个。钉致动器112和推钉构件112a限定收纳刀架114的纵向通孔128(图10)。钉致动器112具有远侧部分,所述远侧部分邻接推钉构件112a的近侧部分,使得钉致动器112在外壳壳体110内的远侧移动引起推钉构件112a在外壳壳体110内的远侧移动。重新装载组件100的推钉构件112a具有多个指状件130(图3)。多个指状件130中的每一个收纳在钉仓118的钉凹座126中的相应一个钉凹座内,并且可移动通过相应的钉凹座126,以在推钉构件112a在外壳壳体110内从缩回位置(图10)移动到推进位置(图11)时从钉凹座126弹出钉120。
刀架114收纳在钉致动器112的纵向通孔128内,并且包含远侧部分140和多个隔开的纵向延伸的近侧部分142(图3)。远侧部分140和近侧部分142限定收纳外壳壳体110的内壳体部分122(图3)的阶梯式中心孔,使得刀架114可在钉致动器112内在外壳壳体110的内壳体部分122周围在缩回位置(图10)与推进位置(图11)之间移动。刀架114的近侧部分142限定狭槽148,所述狭槽收纳外壳壳体110的导向部分110a,以将刀架114限于在外壳壳体110内纵向移动。
外壳壳体110包含支撑联接机构160(图3)的近侧部分158,所述联接机构以可拆卸方式将重新装载组件100联接到缝合装置10(图1)的适配器组件14,以有助于更换重新装载组件100和重复使用缝合装置10。联接机构160包含保持构件162和联接构件164。保持构件162将联接构件164固定在外壳壳体110的近侧部分158周围。联接构件164收纳在外壳壳体110的近侧部分158周围,且与适配器组件14的远侧部分14a(图1)接合以将适配器组件14联接到重新装载组件100。可以设想,可以使用其它联接机构将重新装载组件100固定到适配器14。
图4至6说明刀架114的远侧部分140和重新装载组件100的环形刀116。刀架114的远侧部分140是大致圆柱形的,并且包含直径减小的区域170。在本公开的各方面中,直径减小的区域170部分地由多个弹性指状件或棘爪172限定。多个弹性指状件172中的每一个包含接合部分174,所述接合部分以可拆卸方式接合环形刀116以将环形刀116固定到刀架114。在本公开的某些方面中,弹性指状件172中的每一个的接合部分174限定朝外的凹表面174a,使得在刀架114的远侧部分140上的直径减小的区域170限定环形凹部。
环形刀116包含主体180,所述主体在其远侧末端处具有环形切割边缘182且在其近侧末端部分上具有接合部分184。在本公开的各方面中,在环形刀116的近侧末端上的接合部分184包含环形或大致环形凸出部分186(图6),所述环形或大致环形凸出部分被收纳在由弹性指状件172的接合部分174限定的环形凹部内,以将环形刀116以可拆卸方式固定到刀架114的远侧部分140。在本公开的某些方面中,环形刀116的近侧末端部分上的接合部分184通过使环形刀116的近侧末端部分向内自身卷曲或自身倒转而形成。
图7至9说明当环形刀116联接到刀架114的远侧部分140时的环形刀116。为了将环形刀116联接到刀架114,环形刀116的近侧末端部分与刀架114的远侧部分140对准,并且环形刀116沿着图7中的箭头“A”指示的方向朝向刀架114移动。当环形刀116的近侧末端部分上的接合部分184与刀架114的远侧部分184上的弹性指状件172接合时,弹性指状件172沿着图7中的箭头“B”指示的方向向内变形,以允许环形刀116的近侧末端上的接合部分184越过弹性指状件172并进入由弹性指状件172的凹表面174a限定的环形凹部中。当环形刀116的接合部分184越过弹性指状件172并进入由弹性指状件172限定的环形凹部中时,弹性指状件172沿着图8中的箭头“C”的方向返回到其未变形的位置,以将环形刀116保持在刀架114的远侧部分上。环形刀116将保持在刀架114的远侧部分上,直到预定力施加到环形刀116,所述预定力足以使环形刀116的近侧末端上的接合部分184与由弹性指状件172的凹表面174a限定的环形凹部内分离。可以通过选择用于形成具有合适的弹性和/或厚度的刀架114的指状件172的材料来将预定力设置为期望水平。
可以设想,刀架114和环形刀116的接合部分可以具有此处未示出的多种不同的配置,所述配置用于将环形刀116以可拆卸方式与刀架114联接。还可以设想,环形刀116和刀架114的接合部分可以配置成联锁装置,经由摩擦和/或断裂操作。
图10说明处于已夹紧、未击发位置的缝合装置10的重新装载组件100和砧座组件18,其中钉致动器112、推钉构件112a、刀架114和环形刀116处于其缩回位置,且砧座组件18与钉仓118并列对准。在此位置中,环形切割边缘182凹入钉仓118内。
如所说明,砧座组件18包含可枢转地支撑于中心杆32上的砧座头30。砧座头30可在中心杆32上从操作位置(图10)枢转到倾斜或减小的轮廓位置(图14)。关于包含可倾斜的砧座头的砧座组件的示例性方面的操作的描述,请参见'106专利。砧座头30支撑切割环组件40,所述切割环组件包含与刀116的切割边缘182对准的切割环42。切割环42由当缝合装置10(图1)被击发时当刀116被推进到切割环42中时能够被刀116的切割边缘182穿透的材料形成。
图11说明处于已夹紧和已击发位置的缝合装置10的重新装载组件100和砧座组件18。在此位置中,钉致动器112和推钉构件112a已经沿着箭头“D”指示的方向移动到推进位置,以将钉120从钉仓118弹出到砧座头30中。另外,刀架114和联接到刀架114的远侧部分140的环形刀116已经沿着箭头“E”的方向移动到其推进位置,以使环形刀116的切割边缘182前进到砧座组件18的切割环42中。在此位置中,环形刀116的远侧部分嵌入砧座组件18的切割环42中。
图12和13说明当砧座组件18从砧座头30与钉仓118并列对准的夹紧位置移向砧座头30与钉仓118隔开的打开位置时,处于已击发位置的缝合装置10的重新装载组件100和砧座组件18。在此位置中,砧座组件18沿着箭头“F”的方向从刀架114移开。由于环形刀116嵌入砧座头30的切割环42中,因此砧座头30沿着箭头“F”的方向的移动将使刀架114沿着箭头“G”的方向移动,如图12所示。当限制刀架114在外壳壳体110内的任何进一步远侧移动时,砧座头30相对于刀架114沿着图13中的箭头“H”的方向的进一步远侧移动将使环形刀116的近侧部分上的接合部分184在刀架114的远侧末端上的弹性指状件172上施加力,以使环形刀116与刀架114分离。环形刀116的切割边缘182将保持嵌入砧座组件18的砧座头30中的切割环组件40的切割环42中,以安全地保护临床医生远离环形刀116的切割边缘182。
图14和15说明缝合装置10的重新装载组件100和砧座组件18,其中砧座组件18的砧座头30处于倾斜位置,并且环形刀116嵌入砧座组件18的切割环组件40的切割环42中。砧座头30由支撑在砧座组件18的中心杆32内的偏置机构50推动到倾斜位置。对于偏置机构50的示例性方面的详细描述,参见例如'106专利。
本领域的技术人员将理解,在本文具体描述并在附图中说明的装置和方法是非限制性的示例性实施例。据设想,在不脱离本公开的范围的情况下,结合一个示例性实施例说明或描述的元件和特征可以与另一个示例性实施例的元件和特征组合。同样,所属领域技术人员将基于上述实施例了解本公开的其它特征和优点。因此,除了由所附权利要求书所指示的以外,本公开不受已特别示出和描述的内容限制。
Claims (19)
1.一种重新装载组件,其包括:
外壳壳体,其限定空腔且具有近侧部分和远侧部分;
钉仓,其支撑在所述外壳壳体的所述远侧部分上,所述钉仓支撑多个钉;
推钉构件,其能在所述外壳壳体内在推进位置与缩回位置之间移动以从所述钉仓弹出所述多个钉,所述推钉构件限定纵向孔;
刀架,其支撑在所述推钉构件的所述纵向孔内,所述刀架具有限定第一接合部分的远侧部分,所述刀架能在所述外壳壳体内在缩回位置和推进位置之间移动;以及
具有近侧部分和远侧部分的刀,所述近侧部分限定第二接合部分,所述第二接合部分联接到所述第一接合部分,以将所述刀以可拆卸方式固定到所述刀架,其中在远侧方向上将预定力施加到所述刀之后,所述刀能够与所述刀架的所述第一接合部分断开联接。
2.根据权利要求1所述的重新装载组件,其中所述刀是环形的。
3.根据权利要求1所述的重新装载组件,其中所述第一接合部分由形成在所述刀架的所述远侧部分上的多个弹性指状件限定。
4.根据权利要求3所述的重新装载组件,其中多个弹性指状件中的每一个限定凹表面,以限定围绕所述刀架的所述远侧部分的环形凹部。
5.根据权利要求4所述的重新装载组件,其中形成在所述刀的所述近侧部分上的所述第二接合部分包含环形凸出部分,所述环形凸出部分收纳在由所述刀架的所述多个弹性指状件限定的所述环形凹部内,以将所述刀以可拆卸方式固定到所述刀架。
6.根据权利要求5所述的重新装载组件,其中通过使所述刀的所述近侧部分倒转,在所述刀的所述近侧部分上形成所述第二接合部分。
7.一种缝合装置,其包括:
适配器组件,其具有远侧末端部分;
重新装载组件,其被固定到所述适配器组件的所述远侧末端部分,所述重新装载组件包含:
外壳壳体,其限定空腔且具有近侧部分和远侧部分;
钉仓,其支撑在所述外壳壳体的所述远侧部分上,所述钉仓支撑多个钉;
推钉构件,其能在所述外壳壳体内在推进位置与缩回位置之间移动以从所述钉仓弹出所述多个钉,所述推钉构件限定纵向孔;
刀架,其支撑在所述推钉构件的所述纵向孔内,所述刀架具有限定第一接合部分的远侧部分,所述刀架能在所述外壳壳体内在缩回位置与推进位置之间移动;以及
具有近侧部分和远侧部分的刀,所述远侧部分限定切割边缘,所述近侧部分限定联接到所述第一接合部分的第二接合部分,以将所述刀以可拆卸方式固定到所述刀架,其中在远侧方向上将预定力施加到所述刀之后,所述刀与所述刀架的所述第一接合部分断开联接;以及
砧座组件,其能相对于所述钉仓在打开位置与夹紧位置之间移动,所述砧座组件包含由能被所述刀穿透的材料形成的切割环,其中当所述缝合装置被击发时,所述刀嵌入所述切割环中,且当所述砧座组件从所述夹紧位置移动到所述打开位置时,在所述缝合装置被击发之后,所述刀与所述刀架分离。
8.根据权利要求7所述的缝合装置,其中所述刀是环形的。
9.根据权利要求8所述的缝合装置,其中所述第一接合部分由形成在所述刀架的所述远侧部分上的多个弹性指状件限定。
10.根据权利要求9所述的缝合装置,其中所述多个弹性指状件中的每一个限定凹表面,以限定围绕所述刀架的所述远侧部分的环形凹部。
11.根据权利要求10所述的缝合装置,其中形成在所述刀的所述近侧部分上的所述第二接合部分包含环形凸出部分,所述环形凸出部分收纳在由所述刀架的所述多个弹性指状件限定的所述环形凹部内,以将所述刀以可拆卸方式固定到所述刀架。
12.根据权利要求11所述的缝合装置,其中通过使所述刀的所述近侧部分倒转,在所述刀的所述近侧部分上形成所述第二接合部分。
13.根据权利要求1所述的缝合装置,其中所述砧座组件包含砧座头和中心杆,所述砧座头可枢转地联接到所述中心杆并且能从操作位置移动到倾斜位置。
14.一种刀组件,其包括:
刀架,其具有限定第一接合部分的远侧部分;以及
具有近侧部分和远侧部分的刀,所述远侧部分限定切割边缘,所述近侧部分限定第二接合部分,所述第二接合部分联接到所述第一接合部分,以将所述刀以可拆卸方式固定到所述刀架,其中在将预定力施加到所述刀之后,所述刀可以与所述刀架的所述第一接合部分断开联接。
15.根据权利要求14所述的刀组件,其中所述刀是环形的。
16.根据权利要求15所述的刀组件,其中所述第一接合部分由形成在所述刀架的所述远侧部分上的多个弹性指状件限定。
17.根据权利要求16所述的刀组件,其中所述多个弹性指状件中的每一个限定凹表面,以限定围绕所述刀架的所述远侧部分的环形凹部。
18.根据权利要求17所述的刀组件,其中形成在所述刀的所述近侧部分上的所述第二接合部分包含环形凸出部分,所述环形凸出部分收纳在由所述刀架的所述多个弹性指状件限定的所述环形凹部内,以将所述刀以可拆卸方式固定到所述刀架。
19.根据权利要求18所述的刀组件,其中通过使所述刀的所述近侧部分倒转,在所述刀的所述近侧部分上形成所述第二接合部分。
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-
2021
- 2021-01-14 US US17/148,842 patent/US11779343B2/en active Active
- 2021-02-08 CN CN202110182992.4A patent/CN113303854A/zh active Pending
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EP3871616B1 (en) | 2024-04-03 |
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