CN113840578B - 用于管理患者体液的宫腔镜检查***和方法 - Google Patents
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Abstract
一种薄型外科手术***包括可移动的推车组件、内窥镜,以及外科手术器械。可移动的推车组件包括彼此流体连通的流体源和接收器组件。内窥镜可操作地耦接到推车组件并与流体源流体连通。外科手术器械可操作地耦接到推车组件。外科手术器械和内窥镜被配置为将流出流体分配到接收器组件中。
Description
相关申请的交叉引用
本申请要求2019年5月29日提交的序列号为62/854,205的美国临时申请的权益,所述临时申请的全部内容以引用的方式并入本文中。
技术领域
本发明涉及用于管理患者体液的外科手术***和方法,更具体地,用于在宫腔镜检查手术期间管理患者体液。
背景技术
通过将内窥镜***子宫,并使组织切除装置穿过内窥镜并进入子宫,可以通过内窥镜在子宫等器官内进行外科手术(诸如,组织切除手术)。对于此类内窥镜组织切除手术,通常希望用从流体袋或其他流体源提供的流体来使子宫扩张。这种流体可包括,例如,生理盐水、山梨糖醇,或甘氨酸。手术期间流体的流入和流出使子宫保持在扩张状态,并冲洗子宫内组织和其它碎屑,以保持可见的工作空间。
发明内容
本发明总体涉及外科手术推车***,其有助于在此类手术过程中进行子宫内组织切除和体液管理。有利地,外科手术推车***具有薄型布置,其可以定位在患者床下,以完成手术并且在不使用时滚动到(例如,角落)中。外科手术推车***还有利地提供了缩短的管廓型,其可以在手术过程中保持在临床医生的面前,而无需繁琐的设置或过度占用手术室内的空间。
在本发明的方面,一种外科手术推车***包括推车组件、内窥镜、流体源,以及接收器(receptacle)组件。推车组件包括被配置为便于运输的一个或多个轮子。内窥镜可操作地耦接到推车组件。流体源可操作地支撑在推车组件上并与内窥镜流体连通。流体源被配置为将流入流体输送到位于患者床上的患者。接收器组件可操作地支撑在推车组件上,并被配置为接收流出流体。外科手术推车***包括廓型,所述廓型被配置为当利用内窥镜对患者实施外科手术时使推车和接收器组件能够定位在患者床下。
在实施例中,所述推车组件可包括流入量表和流出量表。流入量表和流出量表可被配置为监测外科手术推车***中的流体不足。
在各种实施例中,外科手术推车***还可包括压力泵,所述压力泵可操作地支撑在推车组件上并且定位成对流体源加压。
在实施例中,外科手术推车***还可包括可操作地支撑在推车组件上的显示器组件。显示器组件可以电耦接到控制器组件,并且可以被配置为控制显示器组件上显示的信息。显示器组件可以可旋转地耦接到推车组件,以使得显示器组件能够相对于推车组件旋转。显示器组件可以是触摸屏显示器,其被配置为接收输入并将输入电传送到控制器组件。
在各种实施例中,外科手术推车***还可包括可操作地支撑在推车组件上并与接收器组件流体连通的外科手术器械。外科手术器械可以是组织切除器械。
在实施例中,接收器组件可包括接收器袋和可操作地支撑在推车组件上的容器。接收器袋可以与容器流体连通。接收器袋可以支撑捕集器(trap),所述捕集器被配置为捕集接收器袋中接收的碎屑或组织,同时使流体能够通过捕集器,从而使流体可以收集在接收器袋的底部。
根据一个方面,本发明涉及一种薄型外科手术***。薄型外科手术***包括可移动的推车组件、内窥镜,以及外科手术器械。可移动的推车组件包括彼此流体连通的流体源和接收器组件。内窥镜可操作地耦接到推车组件,并与流体源流体连通。外科手术器械可操作地耦接到推车组件。外科手术器械和内窥镜被配置为将流出流体分配到接收器组件中。
在实施例中,推车组件可包括流入量表和流出量表,流入量表和流出量表被配置为监测薄型外科手术***中的流体不足。
在一些实施例中,推车组件可包括被配置为对流体源加压的压力泵。
推车组件可包括电耦接在一起以在显示器组件上显示信息的显示器组件和控制器组件。显示器组件可以相对于推车组件旋转。显示器组件可以是触摸屏显示器。
接收器组件可包括接收器袋和可操作地支撑在推车组件上的容器。接收器袋可以通过管与容器流体连通。接收器袋可以支撑捕集器,所述捕集器被配置为捕集接收在接收器袋中的碎屑或组织,同时使流体能够通过捕集器,使得流体收集在接收器袋的底部并通过管进料到容器中。
根据又一方面,本发明涉及一种用于在外科手术期间管理流体的方法。所述方法包括将来自流体源的流入流体分配到一个或多个外科手术器械中。所述流体源支撑在可移动的推车组件上。所述方法还包括在支撑在可移动的推车组件上的接收器组件中接收来自一个或多个外科手术器械的流出流体,同时接收器组件和可移动的推车组件定位在患者床下。
附图和下文的描述中阐述了本发明的一个或多个方面的详细内容。根据以下的描述、附图以及权利要求书,其它方面、特征以及优点将是显而易见的。
附图说明
并入本说明书中且构成本说明书的一部分的附图示出本发明的实施例,且与上文所给出的本发明的一般描述及下文所给出的实施例的详细描述一起用以阐释本发明的原理,其中:
图1是根据本发明的原理的定位在患者床下的外科手术推车***的立体图;
图2是图1的外科手术推车***的推车组件的示意图。
具体实施方式
参考附图详细地描述了本发明的实施例,其中相同的附图标记指代若干视图中的每一个中的相同或对应元素。众所周知,术语“临床医生”是指医生(例如,外科医生)、护士或任何其他护理提供者,并且可包括支持人员。另外,术语“近端”是指结构中更接近临床医生的部分,而术语“远端”是指结构中更远离临床医生的部分。在以下描述中,未详细描述公知的功能或构造,以避免在不必要的细节上模糊本发明。
参照图1,例示本发明的方面和特征的外科手术推车***总体上由附图标记10标识。外科手术推车***10,其可以是宫腔镜检查推车***,总体包括内窥镜100、外科手术器械200,以及推车组件300,推车组件300具有适于定位在患者床“B”下(例如,低于其床高)的薄廓型构型。推车组件300支撑通过流入流体管500耦接到内窥镜100的一个或多个流体源400、选择性地耦接到推车组件300的接收器组件410,以及可以可旋转地安装到推车组件300的显示器组件320,如箭头“A”所示,以便于一名或多名临床医生在手术室中查看。尽管本文针对外科手术推车***10进行了详细说明,但本发明的方面和特征同样适用于与其他外科手术***一起使用。
出于本文的目的,外科手术***10的部件被大体描述。
外科手术推车***10的内窥镜100在本文中被详细描述为宫腔镜,所述宫腔镜被配置为用于女性患者子宫内的妇科手术。然而,也设想了其他合适的内窥镜和流体输送装置。内窥镜100包括细长管状构件102和近端主体140。近端主体140包括流入阀146、流出阀148,以及臂152,臂152被配置为连接到成像装置(例如,摄像头)以捕获经由延伸穿过细长管状构件102的可视化机件(例如,光学器件(未示出))接收的图像。
内窥镜100的细长管状构件102限定用于流体流入的第一通道103a、在流体流出和器械入路(例如,用于器械200)之间共享的第二通道103b,以及容置光学器件(未示出)的第三通道103c。第一通道103a耦接到流入阀146,以能够通过内窥镜100的第一通道103a将流体引入患者体内,例如,引入患者的子宫内。流体源400的流体流入流体管500耦接到流入阀146,用于能够将流体从流体源400输送到内窥镜100,并因此从流体源400输送到患者体内。第二通道103b经由流出流体管600耦接到流出阀148以使得能够通过内窥镜100和流出流体管600从患者体内抽取流体,例如,用于沉积到接收器组件410中并且经由真空管252最终沉积到接收器组件410的一个或多个收集容器325中。
继续参照图1,外科手术器械200在本文中详细描述为组织切除器械;然而,也可以设想其他合适的外科手术器械。外科手术器械200总体包括外壳210、轴220、切割构件230、驱动机件240、流出组织和流体管250以及线缆260。外壳210在其中支撑驱动机件240并且用作使使用者能够抓握和操纵外科手术器械200的手柄。外壳210可以包括设置在其上的致动器212,用于选择性地致动外科手术器械200。
轴220从外壳210向远端延伸,并且在实施例中,相对于外壳210是固定的,但是也可以设想其他构型。轴220限定了穿过其侧壁朝向其远端的窗口222,以提供接近切割构件230的入路,切割构件230可旋转地和/或可平移地设置在轴220内并且可操作地耦接到驱动机件240,如下详述。切割构件230限定了提供进入其内部的入路的开口232,并且可以包括围绕开口232的锯齿状切割刃234,但是也可以设想其他合适的切割刃构型。可替代地或附加地,轴220可以包括围绕窗口222限定的切割刃。
驱动机件240包括电机242并且可操作地耦接到切割构件230以驱动切割构件230相对于轴220的旋转和/或平移。驱动机件240适于经由线缆260连接到推车组件300,以驱动和控制电机242。致动器212可以耦接到驱动机件240和/或推车组件300,以能够选择性地致动外科手术器械200,例如,选择性地旋转和/或平移切割构件230。
当外科手术器械200被致动时,流出组织和流体管250接收切除的组织以及通过切割构件230抽吸的流体和碎屑。流出组织和流体管250与推车组件300的真空泵组件360(图2)可操作地耦接,以使得能够通过切割构件230将切除的组织、流体以及碎屑抽吸到流出组织和流体管250中,用于沉积在与组织和流体管250耦接的一个或多个收集容器325内。
继续参照图1,如上所述,推车组件300被配置为驱动和控制外科手术器械200的驱动机件240的电机242,并经由真空泵组件360(但是也可以设想其他合适的抽吸源)提供抽吸,以通过外科手术器械200和流出组织和流体管250抽吸切除的组织、流体以及碎屑,以沉积在一个或多个收集容器325中。推车组件300可以附加地或替代地包括通信、识别以及参数监测部件,如下详述。
推车组件300总体包括外壳310、可从外壳310的外部接近的显示器组件320(例如,触摸屏)以及控制器组件330和相关联的电路(例如,印刷电路板、导体、电子部件等),它们可以设置在外壳310内和/或与显示器组件320一体形成。控制器组件330被配置为控制信息在显示器320上的显示,并且可以被配置为感测(例如,触摸屏)向其输入的信息。推车组件300还支撑设置在外壳310内并配置为控制外科手术器械200的驱动机件240的电机控制组件340、设置在外壳310内并配置为将来自主电源(未示出)的电力转换成用于为外科手术器械200的驱动机件240提供动力的合适形式的电源350,以及被配置为通过外科手术器械200经由流出组织和流体管250抽吸和控制切除的组织、流体以及碎屑的抽吸的真空泵组件360。真空泵组件360还可以被配置为经由耦接到接收器组件410的真空管252抽吸和控制收集在接收器组件410中的组织、流体以及碎屑的抽吸。在一些实施例中,管252可以通过重力供给将流体从接收器组件410输送到容器325。
真空泵组件360可包括任何合适的真空泵,其具有排气管以从其中排出废气,废气可经由通风口364从外壳310排出和/或导向、上方/下方、周围、之间、穿过等一些或所有部件(例如,泵312、组件320-380等),以便利用废气来帮助这些部件。废气的这种再利用消除了对一个或多个冷却风扇的需要,减少了冷却风扇的数量,和/或减少了所需的冷却风扇输出。在一些实施例中,推车组件300支撑一个或多个冷却风扇或散热器314。此外,和/或替代地,可提供可操作地耦接到真空泵组件360的排气流出物的排气增强器316,以吸入外部空气,例如,通过通风口364,以补充废气,从而进一步促进推车组件300的各种不同部件的冷却。
推车组件300还可以包括识别(ID)组件370,识别(ID)组件370被配置为识别,例如,经由RFID耦接到其的外科手术器械,例如,外科手术器械200。推车组件300可以附加地或替代地包括流体监测组件380,其被配置为,例如,监测流体流速、流体压力、总流体体积、流体阻抗、流体不足等,并且提供关于它们的反馈,例如,合适的警报和/或禁用一个或多个其他组件。
综上所述,推车组件300的各种不同的部件包括合适的硬件部件,并且还可以包括一个或多个处理器和相关联的内存,内存存储将由处理器执行以控制硬件部件的软件(但是可替代地提供一个或多个中央处理器和/或内存)。这些部件,即其电路***,产生可以消散的废热(例如,通过使用冷却风扇/散热器314、通风口364等),以便将这些部件的电路***保持在安全操作温度。
推车组件300还包括输出端390,输出端390能够将外科手术器械200的线缆260耦接到推车组件300。还可以提供附加的或替代的组件和/或与推车组件300相关联的其他部件。例如,推车组件300可以包括脚踏开关342,其可以凹进推车组件300的外壳310内并且可操作地连接到推车组件300的外科手术器械200、控制器350和/或电机控制组件340。推车组件300可包括任意数量的轮子394(例如,脚轮),其可锁定以防止推车组件300滚动,或可解锁以使得推车组件300能够滚动到,例如,患者床“B”下方或从患者床“B”下滚动出来,以接近、移除、修理和/或更换外科手术推车***10的一个或多个部件。推车组件300还可以包括支撑接收器组件410的接收器支撑杆396和支撑流体源400的流体源支撑杆398,并且包括被配置为测量流体源400内的流体特性(例如,其体积、重量)的流入量表398a。推车组件300还可以包括流出量表325a,流出量表325a被配置为测量流出流体特性(例如,从患者体内提取并由接收器组件410和/或一个或多个容器325接收的流体的体积或重量,并且其可以包括来自内窥镜100的流出流体、来自外科手术器械200的流出流体,和/或来自臀部下盖布“D”的流出流体。特别地,流出流体由流出量表325a共同加权,以确定流体不足。
流体源400可以是,例如,其中包含流体,例如,生理盐水、山梨糖醇或甘氨酸的流体袋401。流体袋401连接到流体流入管500的输入端,如上所述,流体流入管500的输入端在其输出端处耦接到内窥镜的流入阀146,以便能够将流体从流体源400输送到内窥镜100。由推车组件300支撑的压力泵312或其他合适的泵(未示出)经由压力管线402与流体源400连通,以对供应到内窥镜100的流体加压。在一些实施例中,压力泵312和真空泵组件360可以是相同的泵或相同组件的一部分。在其他实施例中,流体源400可以在重力压力下将流体输送到内窥镜100。
接收器组件410包括支撑在安装环414上的接收器袋412,安装环414将接收器袋412固定就位。安装环414支撑在支撑杆396上。接收器袋412具有在其中接收流出流体的开口端412a,流出流体包括碎屑、组织以及流体(例如,血液、生理盐水等)。接收器组件410还包括安置在接收器袋412中以捕集接收器袋412中接收的碎屑和/或组织的捕集器416。捕集器416可包括任意数量的孔416a,孔被配置为使流体能够通过捕集器416,但防止碎屑和/或组织通过捕集器416。捕集器416被配置为在从接收器袋412的底部偏移的位置处安置在接收器袋412中,以使得流体能够在通过真空管252被吸出并进入到接收器组件410的一个或多个容器325中之前收集在捕集器416下方。接收器袋412可以由任何合适的材料形成,诸如,聚合材料(例如,尼龙)并且可以是半透明和/或透明的,以促进通过接收器袋12的可视化。在实施例中,接收器袋412可包括锥形构型,其可有助于在与接收器袋412的底部间隔开的位置处支撑捕集器416。
所公开的装置的任何部件的固定可以使用,例如,焊接、压接、胶合、热缩、紧固等已知的固定技术来实现。
本文中公开的各种实施例也可被配置为与机器人外科手术***和通常被称作“遥控外科手术”的***协作。此类***使用各种机器人元件来辅助临床医生并允许外科手术器械的远程操作(或部分远程操作)。可出于此目的使用各种机器人臂、齿轮、凸轮、滑轮、电机和机械电机等,且可将其设计成具有机器人外科手术***,以在操作或治疗过程中辅助临床医生。此类机器人***可以包括可远程操纵的***、自动柔性外科手术***、远程柔性外科手术***、远程铰接外科手术***、无线外科手术***、模块化或可选择性配置的远程操作的外科手术***等。
机器人外科手术***可以与靠近手术室或位于远程位置的一个或多个控制台一起使用。在此情况下,一个临床医生团队可以使患者做好手术准备并用本文中所公开的器械中的一个或多个器械来配置机器人外科手术***,而另一名临床医生(或另一组临床医生)经由机器人外科手术***远程地控制所述器械。可以理解,高度熟练的临床医生可在不离开他/她的远程控制台的情况下在多个位置上执行多个操作,这在经济方面是有利的,并且对于患者或一系列患者而言是有益的。对于示例性的医疗工作站和/或其部件的详细描述,可参考第8,828,023号美国专利和第WO2016/025132号PCT申请公开案,其中每一篇文献的全部内容通过引用的方式并入本文中。
所属领域的技术人员应理解,本文中具体描述且附图中所示的结构和方法是非限制性的示例性实施例,且应将描述、公开内容及附图仅理解为示例性特定实施例。因此,应理解,本发明不限于所描述的精确实施例,并且本领域技术人员可以在不脱离本发明的范围或精神的情况下实现各种其它变化和修改。另外,在不脱离本发明的范围的情况下,结合某些实施例示出的或描述的元件和特征可以与某些其他实施例的元件和特征相结合,并且此类修改和改变也包含在本发明的范围内。因此,本发明的主题不受已经具体所示和描述的内容的限制。
Claims (19)
1.一种外科手术推车***,包括:
推车组件,包括外壳和被配置为便于运输的至少一个轮子;
内窥镜,可操作地耦接到所述推车组件;
流体源,可操作地支撑在推车组件上并与所述内窥镜流体连通,所述流体源被配置为将流入流体输送到位于患者床上的患者;以及
接收器组件,可操作地支撑在所述推车组件上并被配置为接收流出流体,所述接收器组件包括接收器袋和与所述接收器袋流体连通的容器,所述接收器袋悬在所述推车组件的外壳上方,所述容器被支撑在所述外壳内,其中所述接收器袋被支撑在安装环上,所述安装环由从所述推车组件的外壳延伸的至少一个柱支撑在所述推车组件的外壳上面;
其中,所述外科手术推车***包括廓型,所述廓型被配置为当利用所述内窥镜对患者实施外科手术时使所述推车组件和接收器组件能够定位在患者床下。
2.根据权利要求1所述的外科手术推车***,其中,所述推车组件包括流入量表和流出量表,所述流入量表和流出量表被配置为监测所述外科手术推车***中的流体不足。
3.根据权利要求1所述的外科手术推车***,还包括压力泵,所述压力泵可操作地支撑在所述推车组件上并且定位成对所述流体源加压。
4.根据权利要求1所述的外科手术推车***,还包括可操作地支撑在所述推车组件上的显示器组件,所述显示器组件电耦接到控制器组件并被配置为控制在所述显示器组件上显示的信息。
5.根据权利要求4所述的外科手术推车***,其中,所述显示器组件可旋转地耦接到所述推车组件,以使得所述显示器组件能够相对于所述推车组件旋转。
6.根据权利要求4所述的外科手术推车***,其中,所述显示器组件是触摸屏显示器,其被配置为接收输入并且将所述输入电传送到所述控制器组件。
7.根据权利要求1所述的外科手术推车***,还包括外科手术器械,所述外科手术器械可操作地支撑在所述推车组件上并且与所述接收器组件流体连通。
8.根据权利要求7所述的外科手术推车***,其中,所述外科手术器械是组织切除器械。
9.根据权利要求1所述的外科手术推车***,其中,所述接收器袋具有锥形构型。
10.根据权利要求9所述的外科手术推车***,其中,所述接收器袋支撑捕集器,所述捕集器被配置为捕集接收在所述接收器袋中的碎屑或组织,同时使流体能够通过所述捕集器,使得所述流体能够收集在所述接收器袋的底部。
11.一种外科手术***,包括:
可移动的推车组件,包括彼此流体连通的流体源和接收器组件,所述接收器组件包括接收器袋和与所述接收器袋流体连通的容器,所述接收器袋悬在所述可移动的推车组件上方,所述容器被支撑在所述可移动的推车组件内,其中所述接收器袋被支撑在安装环上,所述安装环由从所述可移动的推车组件延伸的至少一个柱支撑;
内窥镜,可操作地耦接到所述可移动的推车组件并与所述流体源流体连通;以及
外科手术器械,可操作地耦接到所述可移动的推车组件,
其中,所述外科手术器械和内窥镜被配置为将流出流体分配到所述接收器组件中。
12.根据权利要求11所述的外科手术***,其中,所述可移动的推车组件包括流入量表和流出量表,所述流入量表和流出量表被配置为监测所述外科手术***中的流体不足。
13.根据权利要求11所述的外科手术***,其中,所述可移动的推车组件包括被配置为对所述流体源加压的压力泵。
14.根据权利要求11所述的外科手术***,其中,所述可移动的推车组件包括显示器组件和控制器组件,所述显示器组件和控制器组件电耦接在一起以在所述显示器组件上显示信息。
15.根据权利要求14所述的外科手术***,其中,所述显示器组件相对于所述可移动的推车组件旋转。
16.根据权利要求14所述的外科手术***,其中,所述显示器组件是触摸屏显示器。
17.根据权利要求11所述的外科手术***,其中,所述外科手术器械是组织切除器械。
18.根据权利要求17所述的外科手术***,其中,所述接收器袋具有锥形构型。
19.根据权利要求11所述的外科手术***,其中,所述接收器袋支撑捕集器,所述捕集器被配置为捕集接收在所述接收器袋中的碎屑或组织同时使流体能够通过所述捕集器以使得所述流体收集在所述接收器袋的底部并通过管进料到所述容器中。
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EP3975913A1 (en) | 2022-04-06 |
CN113840578A (zh) | 2021-12-24 |
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US11553977B2 (en) | 2023-01-17 |
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