CN117257379A - Surgical instrument - Google Patents
Surgical instrument Download PDFInfo
- Publication number
- CN117257379A CN117257379A CN202310988709.6A CN202310988709A CN117257379A CN 117257379 A CN117257379 A CN 117257379A CN 202310988709 A CN202310988709 A CN 202310988709A CN 117257379 A CN117257379 A CN 117257379A
- Authority
- CN
- China
- Prior art keywords
- assembly
- state
- rack
- cutter
- gear
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 230000007246 mechanism Effects 0.000 claims abstract description 187
- 238000010009 beating Methods 0.000 claims abstract description 43
- 238000005452 bending Methods 0.000 claims abstract description 26
- 230000004044 response Effects 0.000 claims abstract description 18
- 230000033001 locomotion Effects 0.000 claims description 57
- 238000003825 pressing Methods 0.000 claims description 33
- 238000001514 detection method Methods 0.000 claims description 19
- 238000000926 separation method Methods 0.000 claims description 19
- 230000000994 depressogenic effect Effects 0.000 claims 1
- 238000000034 method Methods 0.000 description 37
- 230000008569 process Effects 0.000 description 36
- 230000005540 biological transmission Effects 0.000 description 22
- 230000001960 triggered effect Effects 0.000 description 9
- 238000006073 displacement reaction Methods 0.000 description 6
- 230000013011 mating Effects 0.000 description 5
- 230000002596 correlated effect Effects 0.000 description 4
- 230000008859 change Effects 0.000 description 3
- 230000001276 controlling effect Effects 0.000 description 3
- 230000000875 corresponding effect Effects 0.000 description 3
- 230000009471 action Effects 0.000 description 2
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000002324 minimally invasive surgery Methods 0.000 description 2
- 208000002847 Surgical Wound Diseases 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 230000003872 anastomosis Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000008878 coupling Effects 0.000 description 1
- 238000010168 coupling process Methods 0.000 description 1
- 238000005859 coupling reaction Methods 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 238000010304 firing Methods 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 230000009191 jumping Effects 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
Classifications
-
- 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
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3209—Incision instruments
-
- 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
- A61B2017/07214—Stapler heads
- A61B2017/07221—Stapler heads curved
-
- 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
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses a surgical instrument, comprising: the cutting tool comprises a jaw assembly, a sleeve assembly, a cutting tool assembly, a power source and a clutch mechanism, wherein the jaw assembly is rotatably connected to the sleeve assembly, and when the jaw assembly is in a direct-beating state, the length direction of the jaw assembly is collinear with the axis of the sleeve assembly; when the jaw assembly is in a bending state, the length direction of the jaw assembly and the axial direction of the sleeve assembly form a certain angle; when the jaw assembly rotates from the straight beating state to the bending beating state, the proximal end of the cutting knife assembly moves proximally; the clutch mechanism is in a first state, the power source is coupled with the cutter assembly, and the cutter assembly moves proximally in response to the driving of the power source; in the second state, the power source is decoupled from the cutter assembly and the proximal end of the cutter assembly is distally reset in response to rotation of the jaw assembly from the bent-over state to the straight-over state. After the tool withdrawal is completed, the jaw assembly can smoothly rotate from a bending state to a straight state, and surgical instruments can be smoothly taken out from a human body.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a surgical instrument.
Background
Surgical cutting staplers are a commonly used surgical instrument in medicine to replace manual suturing, and the main working principle is to use a cutting knife to sever tissues and use titanium nails to staple the tissues, similar to a stapler. A variety of staplers are classified according to the suitability for different body parts, and for surgical incision staplers, the working principle is to enter the patient's body through the cannula of the puncture outfit positioned precisely at the surgical site, then make a longitudinal incision in the tissue and apply staples on opposite sides of the incision, thereby performing dissection and anastomosis of the tissue.
The surgical instrument comprises a jaw assembly, a sleeve assembly, a cutting blade assembly and an operating assembly, wherein the jaw assembly and the sleeve assembly are rotatably connected, and an angle connecting piece is arranged at the rotating connection part. When in operation, medical staff can operate the operation assembly, so that the jaw assembly rotates from a straight beating state to a bending beating state, a cutter bar of the cutting knife assembly is bent along with the jaw assembly, and the proximal end of the cutter bar moves proximally. The motor component drives the cutter component to feed and retract, and after the cutter retracting is completed, the medical staff controls the jaw component to rotate back to the direct-beating state. During the process of rotating the jaw assembly to the direct-beating state, the proximal end of the cutter bar needs to be reset distally, but the proximal end of the cutter bar cannot be reset distally due to the fact that the motor assembly locks the cutter bar assembly at the position after the cutter is retracted, and the jaw assembly cannot be rotated to the direct-beating state. The surgical instrument is suitable for minimally invasive surgery in this application, and the puncture hole of accessible puncture ware gets into in the human body when keeping silent the subassembly in the state of directly beating, and when keeping silent the subassembly in the state of bending beating, if can't get back to the state of directly beating, then the lateral distance of keeping silent the subassembly is great, can't take out the subassembly of keeping silent from the human body through the puncture hole.
The prior art relies on the position of the cutting blade drive to determine whether the cutting blade assembly is fully retracted, however, this approach is not suitable for determining whether a rotatable surgical instrument of the jaw assembly is fully retracted.
Disclosure of Invention
Aiming at the defects of the prior art, the invention aims to provide a surgical instrument, after the tool withdrawal is completed, the jaw assembly can smoothly rotate from a bending state to a direct state, and the surgical instrument can be smoothly taken out from a human body; and whether the cutter assembly is cut to the bottom can be accurately judged.
The invention is realized by the following technical scheme: a surgical instrument, a jaw assembly, a sleeve assembly, a cutting blade assembly, a power source and a clutch mechanism, wherein the jaw assembly is rotatably connected to the sleeve assembly, and the length direction of the jaw assembly is collinear with the axis of the sleeve assembly when the jaw assembly is in a direct-beating state; when the jaw assembly is in a bending state, the length direction of the jaw assembly and the axial direction of the sleeve assembly form a certain angle; the proximal end of the cutter assembly moves proximally when the jaw assembly rotates from the straight-strike condition to the curved-strike condition;
The power source is coupled with or uncoupled from the cutter assembly through the clutch mechanism; the clutch mechanism has a first state in which the power source is coupled to the cutter assembly and a second state in which the cutter assembly moves proximally in response to actuation of the power source; in the second state, the power source is decoupled from the cutter assembly, and the proximal end of the cutter assembly is distally reset in response to rotation of the jaw assembly from the bent-over state to the straight-over state.
Further, the power source comprises a motor assembly and a driving gear structure connected with the motor assembly, the driving gear structure comprises a first gear connected with the motor assembly and a second gear connected with the cutting knife assembly, and the first gear is connected with the second gear through the clutch mechanism;
when the clutch mechanism is in the first state, the first gear is connected with the second gear in a first connection mode so that the power source is coupled with the cutter assembly, and when the motor assembly drives the first gear to rotate along a first direction, the second gear and the first gear synchronously rotate so as to drive the cutter assembly to move proximally;
When the clutch mechanism is in the second state, the first gear is connected to the second gear in a second connection mode so that the power source is decoupled from the cutter assembly, the proximal end of the cutter assembly is reset distally in response to rotation of the jaw assembly from the bending state to the straight state, and the second gear is driven to move relative to the first gear along a second direction opposite to the first direction.
Further, the first gear and the second gear are coaxially arranged, the clutch mechanism comprises a convex rib and a groove, one of the first gear and the second gear is provided with the convex rib, the other one of the first gear and the second gear is provided with the groove, the convex rib is rotatably positioned in the groove, the groove is provided with a first side wall and a second side wall, the first side wall and the second side wall are arranged along the circumferential direction of the first gear or the second gear, and when the convex rib abuts against the first side wall, the first gear is connected with the second gear in the first connection mode; when the convex rib abuts against the second side wall, the first gear is connected with the second gear in the second connection mode.
Further, the surgical instrument further comprises a main control module, wherein the main control module is electrically connected with the motor assembly;
the clutch mechanism is in the first state, and after the main control module controls the motor assembly to drive the cutting knife assembly to move proximally to the limit position, the main control module controls the motor assembly to drive the first gear to rotate along the second direction, so that the clutch mechanism is switched from the first state to the second state.
Further, the power source comprises a motor assembly and a driving gear structure connected with the motor assembly, and the driving gear structure is detachably connected with the cutter assembly;
the clutch mechanism comprises a pushing piece, when the clutch mechanism is in the first state, the pushing piece is located at a separation position, and the driving gear structure is connected with the cutting knife assembly so that the power source is coupled with the cutting knife assembly; when the clutch mechanism is switched from the first state to the second state, the pushing piece moves from the separation position to the pressing position to push the driving gear structure to move, so that the driving gear structure is separated from the cutting knife assembly, and the power source is decoupled from the cutting knife assembly.
Further, the clutch mechanism further comprises a driving piece and a pressing part, the driving piece is arranged on the frame and connected with the pushing piece, the pressing part is abutted against the driving gear structure, the pushing piece is provided with a low part and a high part, when the clutch mechanism is in the first state, the pushing piece is in the separation position, the pressing part is abutted against by the low part, and the driving gear structure is connected with the cutter assembly; in response to the driving of the driving piece, the pushing piece rotates to the pressing position, the pressing portion is pressed by the high portion, so that the pressing portion and the driving gear structure are driven to move, the driving gear structure is separated from the cutting knife assembly, and the clutch mechanism is switched from the first state to the second state.
Further, the driving gear structure further comprises a reset spring, one end of the reset spring is connected with the frame, the other end of the reset spring is connected with the driving gear structure, and when the pushing piece is switched from the separation position to the pressing position, the driving gear structure is driven to move to be separated from the cutting knife assembly, and the reset spring is compressed; when the pushing piece is switched from the pressing position to the separating position, the reset spring is released to drive the driving gear structure to move so that the driving gear structure is connected with the cutting knife assembly.
Further, the surgical instrument further comprises a rack, the rack is connected with the cutting blade assembly, the power source is connected with the cutting blade assembly through the rack, and the power source is coupled with the cutting blade assembly when the clutch mechanism is in the first state; when the clutch mechanism is in the second state, the power source is decoupled from the cutter assembly.
Further, the rack and the cutter assembly are movably connected, the cutter assembly having an abutment position against the rack and a separation position against the rack;
the power source drives the rack to move proximally to enable the cutting knife assembly to be in the separation position when the cutting knife assembly is retracted, and the power source drives the rack to move distally to enable the cutting knife assembly to be in the abutting position when the cutting knife assembly is fed.
Further, one of the rack and the cutter assembly is provided with a first accommodating groove, the other one of the rack and the cutter assembly is provided with a first moving member, the first moving member is movably arranged in the first accommodating groove, the first accommodating groove comprises a first opening side and a first groove bottom side which are arranged along the length direction of the first accommodating groove, when the first moving member is attached to the first opening side, the cutter assembly is in the separation position, and when the moving member is attached to the first groove bottom side, the cutter assembly is in the abutting position.
Further, the rack comprises a first rack and a second rack which are separable, the first rack is connected with the power source, the second rack is connected with the cutter assembly, the clutch mechanism comprises a second accommodating groove and a second moving piece, one of the first rack and the second rack is provided with the second accommodating groove, the other of the first rack and the second rack is provided with the second moving piece, and the second accommodating groove comprises a second opening side and a second groove bottom side which are arranged along the length direction of the second accommodating groove;
when the second moving piece is attached to the second opening side, the first rack and the second rack are separated relatively, the power source is coupled with the cutting knife assembly, and the clutch mechanism is in the first state; when the second moving piece is attached to the bottom side of the second groove, the first rack abuts against the second rack, the power source is decoupled from the cutter assembly, and the clutch mechanism is in the second state.
The invention also discloses a surgical instrument which comprises a jaw assembly, a sleeve assembly, a cutter driving piece, a motor assembly, a main control module, a travel recording module and a state detection module, wherein the main control module is electrically connected with the motor assembly, is electrically connected with the travel recording module and the state detection module, the motor assembly is connected with the cutter driving piece, the cutter driving piece is connected with the cutter assembly, and the main control module controls the motor assembly to drive the cutter driving piece to move so as to drive the cutter assembly to move;
The jaw assembly is rotatably connected with the sleeve assembly, and when the jaw assembly is in a direct-beating state, the length direction of the jaw assembly is collinear with the axis of the sleeve assembly; when the jaw assembly is in a maximum angle state, the length direction of the jaw assembly and the axial direction of the sleeve assembly form a certain angle, and when the jaw assembly rotates from the direct-beating state to the maximum angle state, the proximal end of the cutter assembly moves proximally;
when the motor assembly drives the cutter assembly to move towards the far end, the travel recording module obtains an output value representing the azimuth state of the cutter driving piece and sends the output value to the main control module; the main control module judges that the output value is larger than or equal to the second value and smaller than or equal to the first value, and meets a first preset condition;
the first value is indicative of an azimuthal state of the cutting blade drive when the cutting blade assembly is moved distally to a bottom-cut position when the jaw assembly is in a direct-beat state; the second value is indicative of an azimuthal state of the cutting blade drive when the cutting blade assembly is moved distally to the bottom-cut position when the jaw assembly is in the maximum rotational state;
The state detection module acquires a state signal used for representing the state of the motor assembly and sends the state signal to the main control module, and the main control module judges whether the motor assembly is locked or not according to the state signal; when the first preset condition is met and the main control module judges that the motor assembly is locked, the main control module controls the motor assembly to stop or controls the motor assembly to drive the cutter assembly to move towards the proximal end.
Further, the output value indicating the azimuth state of the cutter driving member is a feed stroke of the cutter driving member or a position of the cutter driving member.
Further, the surgical instrument further comprises a zero switch, the cutter driving piece moves distally for a preset distance and then reaches a feeding position, the zero switch sends a zero signal to the main control module at the feeding position, and the main control module clears the output value after receiving the zero switch.
Compared with the prior art, the invention has the beneficial effects that: when the clutch mechanism is in the second state after the retracting of the cutter is completed, the power source is decoupled from the cutter assembly, the cutter assembly can move proximally relative to the power source in response to the rotation of the jaw assembly from the bending state to the direct state, so that the proximal end of the cutter assembly is smoothly reset distally, and the jaw assembly can rotate from the bending state to the direct state so as to be smoothly taken out of a human body. And no matter the jaw assembly is in a direct beating state or a bending beating state, the main control module can accurately judge whether the cutting knife assembly is cut to the bottom or not, so that erroneous judgment is avoided.
Drawings
FIG. 1 is a schematic view of a surgical instrument according to a first embodiment of the present invention;
FIG. 2 is a schematic view of the rotatable connection of the jaw assembly and the sleeve assembly of the first embodiment of the present invention;
FIG. 3 is a schematic view of the jaw assembly of the first embodiment of the present invention in a maximum rotational position;
FIG. 4 is a schematic view of the structure of a cutter assembly according to a first embodiment of the present invention;
FIG. 5 is a schematic view of the first and second angle connectors according to the first embodiment of the present invention;
FIG. 6 is a schematic view of the jaw assembly of the first embodiment of the present invention in a maximum rotational position with the knife bar deformed;
FIG. 7 is a schematic view showing the structure of a cutter head and a pusher section according to a first embodiment of the present invention;
FIG. 8 is a schematic structural view of an empty cartridge lockout structure of a first embodiment of the present invention;
FIG. 9 is a schematic view showing a structure in which a first protrusion of a first embodiment of the present invention is engaged in a first recess;
fig. 10 is a schematic view of the structure of the jaw motor assembly of the first embodiment of the present invention;
fig. 11 is an exploded view of a motor assembly according to a first embodiment of the present invention;
fig. 12 is a schematic structural view of a clutch mechanism according to a first embodiment of the present invention;
Fig. 13 is a cross-sectional view of a first gear and a second gear of a first embodiment of the present invention;
fig. 14 is a schematic view showing a structure of the clutch mechanism according to the first embodiment of the present invention in a first state;
fig. 15 is a schematic view showing a structure of the clutch mechanism according to the first embodiment of the present invention in a second state;
FIG. 16 is a schematic view of a rib of a first embodiment of the present invention between a first side wall and a second side wall;
fig. 17 is a schematic view showing the structure of the moving member in the separated position according to the first embodiment of the present invention;
fig. 18 is a schematic view of the structure of the moving member in the abutting position according to the first embodiment of the present invention;
fig. 19 is a schematic structural view of a steering drive assembly according to a first embodiment of the present invention;
FIG. 20 is a schematic view of the connecting rod assembly of the first embodiment of the present invention in a first position;
FIG. 21 is a schematic view of the connecting rod assembly of the first embodiment of the present invention in a second position;
FIGS. 22-26 are schematic views of an open configuration of a jaw assembly according to a first embodiment of the present invention;
FIG. 27 is a schematic view of a jaw opening assembly of a first embodiment of the invention;
FIG. 28 is a schematic view of the jaw opening assembly of the first embodiment of the invention as operated;
Fig. 29 is a schematic view of the structure of the outer jaw assembly of the first embodiment of the invention;
FIG. 30 is a cross-sectional view of a jaw assembly of a first embodiment of the invention;
FIG. 31 is a schematic view of the construction of a fuse assembly according to a first embodiment of the present invention;
FIG. 32 is a schematic view of the safety assembly of the first embodiment of the present invention in a locked state;
fig. 33 is a schematic view showing the structure of the rack driving safety member according to the first embodiment of the present invention;
fig. 34 is a schematic view showing a structure in which a safety element according to the first embodiment of the present invention abuts against a holding portion;
fig. 35 to 36 are schematic structural views of a clutch mechanism according to a second embodiment of the present invention;
fig. 37 to 43 are schematic structural views of a clutch mechanism according to a third embodiment of the present invention
Fig. 44 to 46 are schematic structural views of a fuse assembly according to a fourth embodiment of the present invention.
Wherein:
100. a jaw assembly; 110. a staple cartridge holder; 111. an oblique waist-shaped groove; 112. a lower chute; 113. a first groove; 114. a spring plate; 1141. a storage groove; 120. a nail supporting seat; 121. a first driven part; 122. a second driven part; 123. a pin; 124. an upper chute; 140. A first angle connector; 150. a second angle connector; 141. a first storage groove; 151. a second storage groove; 160. a nail pushing plate; 161. lifting the surface;
210. An angle turning member; 218. a left side supporting part; 219. a right side supporting part;
300. a cutter assembly; 310. a cutter head; 311. a blade body; 312. a girder is arranged; 313. a lower beam; 314. a first protrusion; 315. a convex plate; 320. a cutter bar; 321. a push-type knife part; 322. a pressure receiving portion; 323. a boss; 330. a mandrel; 340. a moving member; 350. a cutter driving member; 351. a rack; 3511. a first rack; 3512. a second rack; 3513. a second moving member; 3514. a second accommodating groove; 3515. a second opening side; 3516. a second groove bottom side; 352. a first accommodating groove; 3522. a first opening side; 3521. a first groove bottom side; 353. a driving section; 3531. a driving surface; 354. a holding section; 3541. a holding surface;
400. a sleeve assembly; 410. an inner sleeve; 411. a needle holder; 412. a sliding groove; 413. a tool holder; 414. a straight portion accommodating groove; 420. an outer sleeve; 421. a first driving section; 422. a second driving section; 423. a first moving groove; 425. a body; 426. a driving tube; 4261. a first driving member; 4262. a second driving member; 427. a through groove; 428. a restriction section; 430. a spring; 440. a pushing block; 450. a sliding member; 451. a third storage groove;
500. a safety component; 510. a safety member; 511. a lever body; 512. an extension; 513. a trigger part;
600. A frame; 610. a connecting rod assembly; 611. a first link; 612. a second link;
700. a steering drive structure; 710. an operation handle; 740. a gear assembly; 741. a left gear portion; 742. a right gear portion; 750. a push rod assembly; 751. a left push rod; 752. a right push rod; 760. a first transmission member;
800. an operating assembly; 810. a handle; 820. a motor assembly; 821. an output shaft; 822. an output gear; 830. a drive gear structure; 831. a first gear; 8311. convex ribs; 832. a second gear; 8321. a groove; 8322. a first sidewall; 8323. a second sidewall; 833. a fixed shaft; 834. a return spring; 840. an operation unit; 850. a pushing member; 851. a cambered surface; 852. a locking surface; 860. a pressing part; 861. an upper surface; 870. a motor;
900. a jaw opening assembly; 910. releasing the button; 911. a driving rod; 912. a flange; 920. unlocking the rod; 930. zero position switch.
Detailed Description
The present invention will be described in further detail with reference to the drawings and examples, in order to make the objects, technical solutions and advantages of the present invention more apparent. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the scope of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It is to be understood that the terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle of a surgical instrument. The term "proximal" refers to the portion proximal to the clinician, and the term "distal" refers to the portion distal to the clinician. I.e., the handles are proximal and the jaw assembly is distal, e.g., the proximal end of a component represents an end relatively close to the handles and the distal end represents an end relatively close to the jaw assembly. The terms "upper" and "lower" refer to the relative positions of the staple abutment and the cartridge abutment of the jaw assembly, specifically, the staple abutment is "upper" and the cartridge abutment is "lower". However, surgical instruments are used in many orientations and positions, and these terms of relative positioning are not intended to be limiting and absolute.
In the present invention, unless explicitly specified and limited otherwise, the terms "connected," "connected," and the like are to be construed broadly, and may be fixedly connected, detachably connected, movably connected, or integrated, for example; can be directly connected or indirectly connected through an intermediate medium, and can be communication between the two elements or interaction relationship between the two elements such as abutting. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances. It should be noted that, when the terms "connected" and "connected" are used in the meanings defined by the corresponding terms, only the cases where the terms are clearly required are excluded, and other possible cases are not excluded, such as "detachably connected" means detachably connected, not including being integrated, but movable connection and the like are not excluded.
Example 1
The application discloses a surgical instrument, in particular to an anastomat, as shown in fig. 1 and 2, wherein the surgical instrument comprises a jaw assembly 100, a sleeve assembly 400, an angle steering member 210, a cutting knife assembly 300, a power source and an operation assembly 800, wherein the sleeve assembly 400 is connected between the operation assembly 800 and the jaw assembly 100, the jaw assembly 100 is rotatably connected with the sleeve assembly 400 through the angle steering member 210, so that the jaw assembly 100 can rotate relative to the sleeve assembly 400, when the jaw assembly 100 is in an open state during operation, a medical staff controls the jaw assembly 100 to rotate a certain angle through the operation assembly 800, the jaw assembly 100 is closed through the operation of the operation assembly 800 after rotating to a proper position, human tissue is clamped and squeezed, and after the squeezing is completed, the power source drives the cutting knife assembly 300 to move distally to feed, so that the tissue clamped by the jaw assembly 100 is cut; after cutting is completed, the power source drives the cutter assembly 300 to move proximally to retract the cutter, and the cutter assembly 300 is retracted to the original position; after the retracting is completed, the medical staff operates the operation assembly 800 to open the jaw assembly 100, and rotate and reset the jaw assembly 100 to take out from the human body.
As shown in fig. 4, the cutting blade assembly 300 includes a blade 310 and a blade bar 320, the blade 310 being provided in the jaw assembly 100 for cutting tissue, the blade bar 320 being connected to the blade 310 for driving the blade 310 forward or backward. The cutter bar 320 extends along the axial direction of the sleeve assembly 400, the power source is connected with the cutter bar 320, and the cutter bar 320 is driven by the power source to move relative to the sleeve assembly 400 so as to drive the cutter head 310 to move. The distal end of the cutter bar 320 is connected with the cutter head 310, the proximal end is connected with a power source, the power source drives the cutter head 310 to move distally through the cutter bar 320 to realize feeding, and the power source drives the cutter head 310 to move proximally through the cutter bar 320 to realize retracting.
As shown in fig. 1, 3, 5 and 6, the operating assembly 800 includes a steering drive structure 700 that a healthcare worker can operate to rotate the jaw assembly 100 relative to the cannula assembly 400. When the jaw assembly 100 is rotated, the knife bar 320 is swung with respect to the sleeve assembly 400, and the knife bar 320 is deformed as the jaw assembly 100 is swung, and when the jaw assembly 100 is rotated at a large angle, the portion of the knife bar 320 between the sleeve assembly 400 and the jaw assembly 100 is bent into an arc shape.
As shown in fig. 5, when the jaw assembly 100 is in the direct-drive state, the longitudinal direction of the jaw assembly 100 is collinear with the axial direction of the sleeve assembly 400, and the knife bar 320 extends along the axial direction of the sleeve assembly 400. When the jaw assembly 100 is in the bending state, the longitudinal direction of the jaw assembly 100 and the axial direction of the sleeve assembly 400 are at an angle to each other. With the jaw assembly 100 in the maximum rotational state, the jaw assembly 100 is rotated to a limit angle with respect to the sleeve assembly 400. A first angle connector 140 and a second angle connector 150 are arranged between the jaw assembly 100 and the sleeve assembly 400, the first angle connector 140 is provided with a first storage groove 141, the second angle connector 150 is provided with a second storage groove 151, the cutter bar 320 sequentially penetrates through the second storage groove 151 and the first storage groove 141, and when the jaw assembly 100 is in a direct-opening state, the part of the cutter bar 320 between the first storage groove 141 and the second storage groove 151 extends along the axis of the sleeve assembly 400.
When the jaw assembly 100 is rotated from the straight-driving state to the bent-driving state, the jaw assembly 100 is rotated around the rotation axis of the angle steering member 210, and as shown in fig. 6, the first angle link 140 and the second angle link 150 are swung with the jaw assembly. The distal opening of the first receiving slot 141 is a first point, the proximal opening of the second receiving slot 151 is a second point, the portion of the cutter bar 320 between the first point and the second point is deformed, the whole cutter bar 320 of the portion is arc-shaped, the arc-shaped cutter bar 320 is bent everywhere, and the arc-shaped cutter bar 320 deviates from the rotation axis of the angle steering member 210. The dashed line portion of the knife bar 320 in fig. 6 shows a path of deflection of the knife bar 320 at the turning axis of the angular steering member 210 for the inflection point, where the length of the portion between the first point and the second point is equal to that in the straight-driving state; the solid line portion of the knife bar 320 in fig. 6 is a path along which the knife bar 320 actually bends, and it is apparent that the length of the portion of the knife bar 320 between the first point and the second point in the actual bending path is smaller than the length of the portion of the broken line portion between the first point and the second point, so that the length of the portion of the knife bar 320 between the first point and the second point becomes shorter when the knife bar 320 is bent and deformed, and the knife bar 320 extends to both sides in the length direction, specifically including distal movement of the knife bar 320 and proximal movement of the knife bar 320. In this embodiment, the jaw assembly 100 further includes an empty cartridge safety structure, and the empty cartridge safety structure cooperates with the cutter head 310 to prevent distal movement of the cutter bar 320, so that only proximal movement of the cutter bar 320 occurs during rotation of the jaw assembly 100 from the straight-driving state to the bent-driving state.
The empty cartridge safety structure is matched with the cutter head 310, so that the distal end of the cutter bar 320 cannot move distally, and the empty cartridge safety structure is realized by the following structure:
as shown in fig. 7 to 9, the cutter bar 320 includes a push cutter portion 321, and the push cutter portion 321 is located at a distal end of the cutter bar 320 and is cooperatively connected with the cutter head 310, so that the cutter bar 320 can drive the cutter head 310 to move when moving. The push blade portion 321 includes a pressure receiving portion 322, and the pressure receiving portion 322 is disposed on the lower side of the push blade portion 321 and extends proximally. The empty nail bin safety structure comprises a first groove 113 formed in the nail bin seat 110, first protrusions 314 formed in two sides of the cutter head 310, a protruding plate 315 formed in the cutter head 310, and a spring plate 114 formed in the nail bin seat 110, a nail bin assembly is arranged in the nail bin seat 110, a nail pushing plate 160 is arranged on the near side of the nail bin assembly, when the cutter bar 320 drives the cutter head 310 to move distally, the cutter head 310 moves distally to cut tissues, the cutter head 310 pushes the nail pushing plate 160 to move distally, and the pushing plate pushes the staples in the nail bin assembly to discharge the cut tissues, so that bleeding of the cut tissues is avoided. The ejector plate 160 is provided with a lifting structure located proximal to the ejector plate 160.
One end of the elastic sheet 114 is fixed on the nail bin seat 110, the other end extends distally and is a free end, the elastic sheet 114 is provided with a containing groove 1141, the cutter assembly 300 is in an initial position when not in cutting, the pressed part 322 of the cutter head 310 is positioned at the lower side of the elastic sheet 114, the pressed part 322 is bent to form a protruding part 323, the protruding part 323 extends upwards and enters the containing groove 1141, and the elastic sheet 114 applies downward acting force to the pressed part 322, namely acting force towards the bottom direction of the nail bin seat 110. When the cutter assembly 300 is in the initial position, the protrusion 323 is located distally within the receiving slot 1141, and the first protrusion 314 of the cutter head 310 is located above the first recess 113. When the feeding starts, the power source applies a distally acting force to the cutter bar 320 to enable the cutter bar 320 to move distally, the protruding part 323 is abutted against the groove wall on the far side of the accommodating groove 1141, the power source applies a sufficiently large acting force to the cutter bar 320, so that the elastic sheet 114 can be lifted when the protruding part 323 moves distally, the protruding part 323 is separated from the accommodating groove 1141, and the lower side of the elastic sheet 114 is abutted against the top, so that the cutter bar 320 can move distally beyond the accommodating groove 1141 and is abutted against the elastic sheet 114. When the tool bit 310 moves distally, the tool bit 310 is pushed by the elastic sheet 114, so that the whole tool bit 310 is displaced downwards, the first protrusion 314 enters the first groove 113, and along with the distal movement of the tool bit 310, the first protrusion 314 moves distally in the first groove 113, and is blocked by the distal groove wall of the first groove 113, so that the tool bit cannot move further distally. If the cartridge assembly is installed in the cartridge holder 110, and the ejector pin plate 160 of the cartridge assembly is located at the proximal side of the cartridge assembly, the protruding plate 315 of the tool bit 310 may abut against the lifting structure of the ejector pin plate 160, the lifting structure has an inclined lifting surface 161, when the protruding plate 315 contacts with the lifting surface 161 and the tool bit 310 moves distally, the protruding plate 315 drives the entire tool bit 310 to move upwards and maintain the state after moving upwards in the subsequent distal movement process under the guidance of the lifting surface 161, so that the first protrusion 314 moves upwards and is separated from the first groove 113, the tool bit 310 and the tool bar 320 can move smoothly distally, and the tool bit 310 pushes the ejector pin plate 160 to move distally, the pressed portion 322 is separated from the elastic sheet 114, and the cutter assembly 300 can feed normally.
If no cartridge assembly is mounted in the cartridge holder 110, or the staple pushing plate 160 of the cartridge assembly is not located at the proximal side of the cartridge assembly, the cutter head 310 cannot be lifted by the lifting structure, as shown in fig. 9, when the first protrusion 314 moves distally in the first groove 113 to abut against the distal groove wall of the first groove 113, the cutter head 310 cannot continue to advance distally, so that the condition that the tissue incision bleeds due to the incapability of firing in the feeding process is avoided. The safety structure of the empty nail bin is only initially introduced in the application, and a specific structure can participate in the prior application CN202011453501.7. It should be noted that, other forms of safety structures of the empty staple cartridge may be selected, and the safety structures of the empty staple cartridge may be matched with the cutter head 310 or the cutter bar 320, so that the distal end of the cutter bar 320 cannot move distally, which is not described herein.
When the cutter assembly 300 is in the initial position, the protruding portion 323 of the cutter bar 320 is located in the receiving slot 1141 of the spring plate 114, and the protruding portion 323 is blocked by the inner wall of the distal side of the receiving slot 1141. As jaw assembly 100 rotates relative to sleeve assembly 400, knife bar 320 extends to both sides in the longitudinal direction, including specifically distal movement of knife bar 320 and proximal movement of knife bar 320, the force of distal movement of knife bar 320 is generated by the spring force of knife bar 320, which is insufficient to cause protrusions 323 to lift spring tab 114, so that when jaw assembly 100 rotates relative to sleeve assembly 400, the distal end of knife bar 320 is blocked from distal movement by spring tab 114, and only the proximal end of knife bar 320 moves proximally. The power source includes a motor assembly 820, and the motor assembly 820 drives the cutter assembly 300 to feed or retract. When retracting, the power source pulls the cutter bar 320 to move proximally to the limit position, after the retracting is completed, the output shaft 821 of the motor assembly 820 is locked due to the large resistance of the motor assembly 820, and the output shaft 821 is connected with the cutter assembly 300, so that the cutter assembly 300 is locked at the retracted position.
After the retracting is completed, the medical staff needs to rotate the jaw assembly 100 in the bending state to the direct-beating state by controlling the steering driving structure 700, when the jaw assembly 100 rotates to the direct-beating state, the proximal end of the cutter bar 320 needs to be reset distally, so that the jaw assembly 100 can smoothly rotate to the direct-beating position, and the proximal end of the cutter bar 320 cannot be reset distally due to the fact that the motor assembly 820 locks the cutter assembly 300 at the position after retracting, so that the jaw assembly 100 cannot rotate to the direct-beating state. The surgical instrument is applicable to minimally invasive surgery in this application, and the puncture hole that accessible puncture ware got into in the human body when the jaw subassembly 100 was in the state of directly beating, and when the jaw subassembly 100 was in biggest rotation angle, if can't get back to the state of directly beating, then jaw subassembly 100 and sleeve pipe subassembly 400 each other become certain angle for the lateral distance of whole surgical instrument is great, can't take out jaw subassembly 100 from the human body through the puncture hole. Transverse refers to a direction perpendicular to the axis of the cannula assembly 400.
To address the above, the surgical instrument further includes a clutch mechanism having a first state in which a power source is coupled to the cutter assembly 300 and in which the cutter assembly 300 is moved proximally in response to actuation of the power source, i.e., in the first state, the power source may drive the cutter assembly 300 to retract, the clutch mechanism being in the first state during retraction and prior to a change in state after retraction is complete. Wherein coupled means that a power source is connected to the cutter assembly 300 and the power source is capable of driving the cutter assembly 300 to move proximally. With the clutch mechanism in the second state, the power source is decoupled from the cutter assembly 300 and the proximal end of the cutter assembly 300 is reset distally in response to rotation of the jaw assembly 100 from the bent-over condition to the straight-over condition. With the clutch mechanism in the second state, the cutter assembly 300 can be moved proximally relative to the power source such that the jaw assembly 100 can be rotated from the bent-over state to the straight-over state. Therefore, after the retracting is completed, the jaw assembly 100 can be smoothly rotated to the direct-driving state by switching the clutch mechanism to the second state, and is taken out from the human body.
As shown in fig. 10 and 11, the power source further includes a driving gear structure 830 connected to the motor assembly 820, the driving gear structure 830 includes a first gear 831 connected to the motor assembly 820, a second gear 832 connected to the cutter assembly 300, and the first gear 831 and the second gear 832 are coaxially disposed. When the clutch mechanism is in the first state, the first gear 831 is connected to the second gear 832 through a first connection manner, so that the power source is coupled to the cutter assembly 300, and when the motor assembly 820 drives the first gear 831 to rotate along the first direction, the first gear 831 drives the second gear 832 coaxially arranged with the first gear 831 to synchronously rotate so as to drive the cutter assembly 300 to move proximally. When the clutch mechanism is in the second state, the first gear 831 is connected to the second gear 832 through a second connection mode, and when the jaw assembly 100 rotates from the bending state to the direct state, the proximal end of the cutter assembly 300 resets distally, so as to drive the second gear 832 to rotate relative to the first gear 831 along a second direction, and the second direction is opposite to the first direction. The clutch mechanism is disposed between the first gear 831 and the second gear 832, and when the clutch mechanism is switched from the first state to the second state, the first gear 831 and the second gear 832 are switched from the first connection mode to the second connection mode, so that the proximal end of the cutter assembly 300 can be reset distally, and the jaw assembly 100 can be rotated to the direct-beating state and taken out from the human body.
Further, as shown in fig. 12 to 15, the clutch mechanism includes a rib 8311 and a groove 8321, one of the first gear 831 and the second gear 832 is provided with the rib 8311, and the other is provided with the groove 8321, and in this embodiment, the first gear 831 is provided with the rib 8311, and the second gear 832 is provided with the groove 8321, which is not limited specifically. The protruding rib 8311 is movably located in the groove 8321, the groove 8321 has a first side wall 8322 and a second side wall 8323, the first side wall 8322 and the second side wall 8323 are arranged along the circumferential direction of the second gear 832, as shown in fig. 14, when the protruding rib 8311 abuts against the first side wall 8322, the clutch mechanism is in a first state, and at this time, the first gear 831 is connected with the second gear 832 in a first connection mode; as shown in fig. 15, when the rib 8311 abuts against the second side wall 8323, the clutch mechanism is in the second state, and the first gear 831 is connected to the second gear 832 in the second connection manner. The direction extending from the second side wall 8323 to the first side wall 8322 is clockwise, and in this embodiment, the first direction is clockwise, and the second direction is counterclockwise. When retracting the cutter, the clutch mechanism is in a first state, the convex rib 8311 abuts against the first side wall 8322, the first gear 831 rotates in a first direction, namely, when rotating clockwise, the convex rib 8311 is driven to rotate clockwise, the convex rib 8311 abuts against the first side wall 8322, so that the first gear 831 pushes the second gear 832 to rotate clockwise, and the cutter assembly 300 is driven to move proximally to retract the cutter. After the tool retracting is completed, the clutch mechanism is still in the first state, the motor assembly 820 is stopped, and the first gear 831 connected with the motor assembly 820 is locked, so that the first gear 831 cannot rotate. When the jaw assembly 100 rotates to the direct-beating state and the cutter assembly 300 resets distally, the second gear 832 needs to be driven to rotate anticlockwise, so that the first side wall 8322 and the second side wall 8323 rotate anticlockwise, and the clutch mechanism is in the first state, the ribs 8311 are located on the rotating path of the anticlockwise rotation of the first side wall 8322, so that the reverse rotation of the first side wall 8322 is blocked, the anticlockwise rotation of the second gear 832 is blocked, and the cutter assembly 300 is prevented from resetting distally.
Therefore, after the retracting operation is completed, as shown in fig. 15, the clutch mechanism is switched to the second state, so that the rib 8311 is abutted against the second side wall 8323 and separated from the first side wall 8322, thereby providing a rotation space for the counterclockwise rotation of the first side wall 8322, and the jaw assembly 100 rotates to the straight-driving state, and the second gear 832 is driven to rotate counterclockwise when the cutter assembly 300 is reset distally. When the jaw assembly 100 rotates from the maximum rotation state of the bending state to the direct state, the cutter assembly 300 is reset distally, the second gear 832 is driven to rotate anticlockwise, the first side wall 8322 and the second side wall 8323 rotate anticlockwise, the second side wall 8323 rotates anticlockwise to be far away from the convex rib 8311, the first side wall 8322 rotates anticlockwise to be close to the convex rib 8311, the cutter assembly 300 is reset smoothly, and the jaw assembly 100 rotates smoothly to the direct state. At this time, the distance of the distal reset of the cutter assembly 300 is the greatest, the second gear 832 is pulled to rotate counterclockwise until the first side wall 8322 abuts against the rib 8311, and the clutch mechanism is switched to the first state. When the jaw assembly 100 rotates from the middle state of the bending state (the angle of rotation of the jaw assembly 100 relative to the sleeve assembly 400 is smaller than the maximum angle) to the direct state, the second gear 832 is driven to rotate anticlockwise, the first side wall 8322 moves towards the rib 8311, and as shown in fig. 16, the rib 8311 is located between the first side wall and the second side wall after the jaw assembly 100 is located in the direct state. When the clutch mechanism is switched from the second state to the first state, the rotating stroke of the second gear 832 relative to the first gear 831 corresponds to the maximum distance of the reset of the cutter assembly 300, so as to ensure that the cutter assembly 300 can be smoothly reset and the cutter assembly 100 can be smoothly rotated to the direct-driving state when the jaw assembly 100 rotates at any angle relative to the sleeve assembly 400.
After the tool withdrawal is completed, the clutch mechanism is switched from the first state to the second state by the following modes:
the operation assembly 800 includes a main control module electrically connected to the motor assembly 820, and the main control module controls the motor assembly 820 to rotate so as to feed or retract the cutter assembly 300. When retracting the cutter, the clutch mechanism is in the first state, and the main control module controls the motor assembly 820 to rotate clockwise, so that the first gear 831 and the second gear 832 rotate clockwise synchronously, and the cutter assembly 300 is driven to move proximally to retract the cutter. The operation assembly 800 further includes a state detection module electrically connected to the motor assembly 820 and the main control module, respectively, where the state detection module is configured to obtain a motor state signal representing a motor state, and send the motor state signal to the main control module, where the motor state signal includes at least one of a voltage value, a current value, and a rotation speed value of the motor. In the tool retracting process, the main control module receives the motor state signal in real time, judges whether the motor has state change according to the received motor state signal, and controls the motor assembly 820 to stop after judging that the motor state changes. When the cutter assembly 300 is retracted to the limit position, the motor is blocked by the jaw assembly 100, the voltage value and the current value of the motor are increased, the rotating speed value is 0 or is close to 0, and when the state signal is the current value or the voltage value, the main control module judges that the state of the motor is changed when the state signal of the motor is larger than the preset value; when the state signal is a rotation speed value, the main control module judges the state change of the motor when judging that the state signal of the motor is smaller than a preset value, and after judging that the state of the motor is changed, the main control module controls the motor assembly 820 to stop working so as to finish tool withdrawal. And then the motor assembly 820 is driven to rotate reversely (anticlockwise), so that the first gear 831 rotates anticlockwise, the rib 8311 moves anticlockwise in the groove 8321, is separated from the first side wall 8322 and abuts against the second side wall 8323, and the clutch mechanism is switched from the first state to the second state, and the second gear 832 does not rotate in the process.
As shown in fig. 10 and 11, the surgical instrument further includes a cutting blade drive 350, the cutting blade drive 350 being coupled to the cutting blade assembly 300 and to a power source. Specifically, the cutter driving member 350 is a rack 351, the rack 351 is connected to the cutter assembly 300, and the rack 351 is engaged with the second gear 832 to connect the cutter assembly 300 to a power source.
Wherein the rack 351 is movably coupled to the cutter assembly 300, the cutter assembly 300 having an abutment position and a separation position relative to the rack 351, in the abutment position, the cutter assembly 300 being longitudinally adjacent to and abutting the rack 351, the power source driving the rack 351 to move distally such that when the cutter assembly 300 is advanced, the cutter assembly 300 is in the abutment position, being urged distally by the rack 351 for advancement; in the separated position, the cutter assembly 300 is separated from the rack 351 relatively in the length direction, wherein the cutter assembly 300 is connected with the rack 351 and separated from each other to a maximum distance, and when the power source drives the rack 351 to move proximally to retract the cutter assembly 300, the cutter assembly 300 is in the separated position and pulled proximally by the rack 351 to retract. When the jaw assembly 100 is rotated from the straight-beat state to the bent-beat state, the proximal end of the cutter assembly 300 moves proximally relative to the rack 351, and the rack 351 is always engaged with the second gear 832 during rotation of the jaw assembly 100 from the straight-beat state to the bent-beat state. Before feeding, the jaw assembly 100 is in the straight-on condition, the cutter assembly 300 is in the separated position, and when the jaw assembly 100 is rotated from the straight-on condition to the maximum rotation condition, the proximal end of the cutter assembly 300 is moved proximally to switch to the abutment position.
As shown in fig. 17 and 18, one of the rack 351 and the cutter assembly 300 is provided with a first receiving groove 352, the other one of the rack 351 and the cutter assembly 300 is provided with a first moving member 340, the first moving member 340 is movably disposed in the first receiving groove 352, the first receiving groove 352 includes a first opening side 3522 and a first groove bottom side 3521 arranged along a length direction of the first receiving groove 352, the first receiving groove 352 is provided on one of the rack 351 and the cutter assembly 300, and the first opening side 3522 is adjacent to the other one of the first moving member 340. When the first mover 340 is engaged with the first open side 3522, the cutter assembly 300 is in the disengaged position; when the first moving member 340 is engaged with the first groove bottom side 3521, the cutter assembly 300 is in the abutment position. When the proximal end of the cutter assembly 300 moves proximally, the cutter assembly 300 moves in a direction toward the rack 351, i.e., from the disengaged position to the abutted position.
In a preferred embodiment, the first accommodating groove 352 is formed on the distal side of the rack 351 and is disposed along the length direction of the rack 351, the first moving member 340 is movable in the first accommodating groove 352 along the length direction of the rack 351, and the first opening side 3522 is located on the distal side of the first groove bottom side 3521.
In this embodiment, the cutter assembly 300 further includes a mandrel 330 connected to the cutter bar 320, and the distal end of the mandrel 330 is connected to the cutter bar 320. In this embodiment, a first moving member 340 is disposed at the proximal end of the mandrel 330, and a first accommodating groove 352 is disposed in the rack 351. Specifically, when the cutter assembly 300 is in the abutting position, the first moving member 340 is attached to the first groove bottom side 3521, and when the rack 351 moves distally, the first groove bottom side 3521 pushes the first moving member 340 distally, and the rack 351 can directly push the mandrel 330 and the cutter bar 320 to move distally for feeding, which means that when the rack 351 moves distally, the cutter bar 320 moves distally synchronously; when the cutter assembly 300 is in the separation position, the first moving member 340 is attached to the first opening side 3522, and when the rack 351 moves proximally, the mandrel 330 and the cutter bar 320 can be directly pulled to move proximally to retract the cutter, which means that when the rack 351 moves proximally, the cutter bar 320 moves proximally synchronously.
The overall flow of surgical instrument operation when the jaw assembly 100 is rotated to a maximum angle to one side is described as follows:
after the surgical instrument has been advanced into the body, the jaw assembly 100 is in the direct-fire condition and the cutting blade assembly 300 is in the separated position. The medical staff first drives the jaw assembly 100 to rotate through the steering driving structure 700, the operating assembly 800 comprises a frame 600, the steering driving structure 700 is arranged on the frame 600, and the medical staff rotates the jaw assembly 100 through operating the steering driving structure 700. The specific structure and operation of the steering drive structure 700 is described below.
When the jaw assembly 100 is rotated from the direct-drive state to the maximum-rotation state, the proximal end of the knife bar 320 moves proximally, moving the cutting knife assembly 300 proximally from the disengaged position to the abutment position (from the position of fig. 17 to the position of fig. 18), the distance the cutting knife assembly 300 moves from the disengaged position to the abutment position is R, i.e., the distance the first mover 340 moves from the position of abutment with the first opening side 3522 to the position of abutment with the first groove bottom side 3521 is R. Wherein the distance of proximal movement of the first displacement member 340 is positively correlated with the angle of rotation of the jaw assembly 100, the first displacement member 340 is positioned between the first opening side 3522 and the first slot bottom side 3521 when the angle of rotation of the jaw assembly 100 to one side is less than the maximum angle.
When the jaw assembly 100 rotates to a maximum angle to one side and then is in a maximum rotation state, the jaw assembly 100 corresponds to the tissue to be clamped, and at the moment, the medical staff controls the jaw assembly 100 to be closed so as to clamp and squeeze the tissue to be clamped. The cannula assembly 400 includes an inner cannula 410 and an outer cannula 420 movably sleeved outside the inner cannula 410, and the operating assembly 800 further includes a handle 810, wherein upon completion of steering, a healthcare worker actuates the handle 810 to move the outer cannula 420 from a distal position to a proximal position, closing the jaw assembly 100. Actuation of the handles 810 moves the outer sleeve 420 from the distal position to the proximal position and drives the jaw assembly 100 closed, the specific structure of which is described below.
The medical staff actuates the handle 810 to enable the jaw assembly 100 to be closed to clamp and squeeze tissues for a period of time, after squeezing is completed, the medical staff actuates the handle 810 again, and when the main control module detects that the rotating angle of the handle 810 meets the preset condition, the motor assembly 820 is controlled to drive the cutting knife assembly 300 to feed.
Before feeding, the clutch mechanism is in the first state or the second state, or the rib 8311 is located between the first side wall 8322 and the second side wall 8323, since the cutter assembly 300 is already in the abutting position (the position in fig. 18), the rack 351 can directly push the mandrel 330 and the cutter bar 320 to move proximally to feed, and the distance of movement of the cutter assembly 300 from the initial position to the cutting bottom position is L, and the distance of movement of the rack 351 to the distal is L. When the feeding starts, the main control module controls the motor assembly 820 to rotate, and the motor assembly 820 drives the first gear 831 to rotate, specifically to rotate anticlockwise. If the clutch mechanism is in the second state, as shown in fig. 15, the motor assembly 820 may directly drive the rack 351 and the cutter assembly 300 distally for feeding. If the clutch mechanism is in the first state, as shown in fig. 14, or the rib 8311 is located between the first side wall 8322 and the second side wall 8323, as shown in fig. 16, the first gear 831 rotates counterclockwise relative to the second gear 832, so that the clutch mechanism is switched to the second state, as shown in fig. 15, in the second state, the first gear 831 rotates counterclockwise to drive the second gear 832 to rotate, and thus drive the rack 351 and the cutter assembly 300 to move distally to perform feeding. The reason why the clutch mechanism is in the first state or the second state, or the rib 8311 is located between the first side wall 8322 and the second side wall 8323 is described below.
After the main control module judges that the feeding of the cutter assembly 300 is completed, the power source is controlled to drive the cutter driving piece 350 to move proximally so as to drive the cutter assembly 300 to retract.
When the feeding is completed, the cutter assembly 300 is in the feeding bottom position, the cutter assembly 300 is in the abutting position, and the clutch mechanism is in the second state. When the medical staff releases the handle 810 and the main control module detects that the handle 810 is completely released, the motor assembly 820 is controlled to rotate reversely, the first gear 831 is driven to rotate clockwise by the motor assembly 820, the clutch mechanism is switched to the first state (the state is switched from the state in fig. 15 to the state in fig. 14), the motor assembly 820 can drive the rack 351 to move proximally, the rack 351 can drive the cutter assembly 300 to move proximally due to the abutting position (the position in fig. 18) of the cutter assembly 300, when the rack 351 moves proximally, the first opening side 3522 and the first groove bottom side 3521 move proximally along with the rack 351, the first groove bottom side 3521 is separated from the first moving member 340, the first opening side 3522 moves towards the first moving member 340, and when the rack 351 moves proximally by the distance R, the first opening side 3522 is abutted with the first moving member 340, the cutter assembly 300 is in the separated position (the position in fig. 17), the rack assembly 300 can be driven to move proximally, and the assembly 300 which does not drive the cutter assembly 300 to move proximally during the movement of the rack 351 is still in the bottom cutter position. When the rack 351 continues to move proximally to drive the cutter assembly 300 to move a distance L, the cutter assembly 300 returns to the initial position and the retracting is completed. Thus, during retraction, the rack 351 moves proximally a distance r+l.
When the retracting is completed, the cutter assembly 300 is at the initial position, the cutter assembly 300 is at the separating position, and the clutch mechanism is at the first state. After the main control module determines that the tool withdrawal is completed, the motor assembly 820 is controlled to rotate reversely, so that the clutch mechanism is switched to the second state.
The surgical instrument further includes a jaw opening assembly 900 that allows a medical practitioner to operate the jaw opening assembly 900 to open the jaw assembly 100 and release tissue after retraction is complete. The specific structure of the jaw opening assembly 900 is described below.
After the jaw assembly 100 is opened, the cutter assembly 300 is at the separation position, the clutch mechanism is at the second state, the medical staff operates the steering driving device to rotate the jaw assembly 100 to the straight state, in the process that the jaw assembly 100 rotates from the maximum rotation state of the bent state to the straight state, the movement of the proximal end of the cutter assembly 300 is opposite to the process that the jaw assembly 100 rotates from the straight state to the maximum rotation state, the distance of the distal movement of the proximal end (the first moving member 340) of the cutter assembly 300 is R, and when the cutter assembly 300 is at the separation position (the position in fig. 17), the first moving member 340 is moved distally by the pushing and pulling rack 351 abutted against the first opening side 3522, the movement distance is R. In this process, the rack 351 moves distally to reset, driving the second gear 832 to rotate counterclockwise relative to the first gear 831, and the clutch mechanism is switched to the first state after the cutter assembly 300 is reset. The distance that the rack 351 moves distally during feeding is L, the distance that the rack 351 moves proximally during retracting is l+r, and the distance that the rack 351 resets distally during return of the jaw assembly 100 to the direct-drive state is R, as can be appreciated, the rack 351 has returned to the original position. The jaw assembly 100 is in a direct-lit condition and a medical professional can remove surgical instruments from the body. When the stapler is used again to cut the tissue, the clutch mechanism is in the first state before feeding. If the jaw assembly 100 is always in the direct-open state when the stapler is used this time, after the retracting is completed, the clutch mechanism is switched to the second state, and then the jaw assembly 100 is opened, and when the stapler is used again to cut tissue, the clutch mechanism is in the second state. If the jaw assembly 100 is in the middle state of the bending state (the included angle between the jaw assembly 100 and the sleeve assembly 400 is smaller than the maximum angle) to clamp the tissue when the stapler is used this time, after the retracting is completed, the clutch mechanism is switched to the second state, the jaw assembly 100 rotates to the direct-beating position, the first moving member 340 drives the rack 351 to reset distally by a distance smaller than R, the rib 8311 of the clutch mechanism is located between the first side wall 8322 and the second side wall 8323, and when the stapler is used again to cut the tissue, the rib 8311 of the clutch mechanism is located between the first side wall 8322 and the second side wall 8323.
The specific structure and operation of the steering drive structure 700 are described below:
as shown in fig. 19, the steering drive structure 700 includes an operating handle 710 and a transmission assembly including a first transmission member 760, a second transmission member, and a push rod assembly 750, the first transmission member 760 being connected to the second transmission member, the second transmission member being connected to the angle steering member 210 through the push rod assembly 750, the operating handle 710 being slidably connected to the first transmission member 760, the operating handle 710 being moved to slide with respect to the first transmission member 760 to switch from a locked state to an unlocked state. In response to rotation of the operating handle 710, the first transmission 760 is driven to rotate by the operating handle 710, and the push rod assembly 750 is driven to move by the second transmission. The operating handle 710 is slidable relative to the first transmission member 760 and is configured to drive the first transmission member 760 to rotate, and the second transmission member converts the torque applied by the healthcare worker to the operating handle 710 into a force that drives the push rod assembly 750 to move linearly.
Specifically, the second transmission member includes a gear assembly 740, the first transmission member 760 is meshed with the gear assembly 740, the gear assembly 740 is meshed with the push rod assembly 750, and in response to rotation of the operating handle 710, the first transmission member 760 drives the gear assembly 740 to rotate, and the gear assembly 740 drives the push rod assembly 750 to move, thereby driving the angle steering member 210 to rotate. In this embodiment, the push rod assembly 750 includes a left push rod 751 and a right push rod 752, the left push rod 751 and the right push rod 752 are connected to two sides of the angle steering member 210, the gear assembly 740 includes a left gear portion 741 and a right gear portion 742, the left gear portion 741 and the right gear portion 742 are connected to the frame 600, and are respectively disposed on two sides of the first transmission member 760. The left gear part 741 and the right gear part 742 each include upper and lower gears coaxially provided, the left push rod 751 is engaged with the lower gear of the left gear part 741, the right push rod 752 is engaged with the lower gear of the right gear part 742, and the first transmission 760 is engaged with the upper gear of the left gear part 741 and the upper gear of the right gear part 742 at the same time. When the medical staff rotates the operation handle 710, the first transmission member 760 drives the left gear 741 and the right gear 742 to rotate, and the rotation directions of the left gear 741 and the right gear 742 are opposite, so that the movement directions of the left push rod 751 and the right push rod 752 are opposite. The left push rod 751 and the right push rod 752 both extend along the length direction of the sleeve assembly 400, the distal ends of the left push rod 751 and the right push rod 752 are connected with the angle steering member 210, specifically, as shown in fig. 2, the angle steering member 210 includes a left abutting portion 218 and a right abutting portion 219, the left push rod 751 abuts against the left abutting portion 218, the right push rod 752 abuts against the right abutting portion 219, when the operating handle 710 rotates to drive the left push rod 751 and the right push rod 752 to displace, for example, when the operating handle 710 rotates clockwise, the left push rod 751 moves distally, the right push rod 752 moves proximally, the left push rod 751 pushes the left abutting portion 218 of the angle steering member 210 to move distally, so that the angle steering member 210 rotates rightward, and the right abutting portion 219 is driven to move proximally and always abuts against the right push rod 752. Rotating the steering knob counter-clockwise causes the left push rod 751 to move proximally and likewise causes the right push rod 752 to move distally, and rotation of the angle steering member 210 to the left causes the push rod assembly 750 to drive the angle steering member 210 and, in turn, the jaw assembly 100.
Actuation of the handle 810 to switch the outer sleeve 420 from the proximal position to the distal position is accomplished by:
as shown in fig. 20 and 21, the frame 600 is provided with a link assembly 610, the link assembly 610 including a first link 611 and a second link 612, the distal outer sleeve 420 of the first link 611 being connected at a proximal end thereof, the distal end of the outer sleeve 420 being connected to the jaw assembly 100, the proximal end of the second link 612 being rotatably connected to the frame 600, the distal end being rotatably connected to the proximal end of the first link 611. The handle 810 is capable of engaging the linkage assembly 610 and driving the movement of the linkage assembly 610 upon actuation. The link assembly 610 has a first position and a second position, wherein when the link assembly 610 is in the first position, the first link 611 and the second link 612 are at an angle to each other, and the outer sleeve 420 is in the proximal position; when the link assembly 610 is in the second position, the first link 611 is collinear or substantially collinear with the second link 612, such that the link assembly 610 is self-locking in the second position, the outer sleeve 420 is in the distal position, and the outer sleeve 420 remains in the distal position under the influence of the self-locking of the link assembly 610.
Collinear refers to: the first link 611 and the second link 612 are positioned on the same straight line, and an included angle between the first link 611 and the second link 612 is 180 degrees. Substantially co-linear refers to: the first link 611 and the second link 612 go beyond the dead center position, and the included angle between the first link 611 and the second link 612 is greater than 0 ° and less than 5 °, when the link assembly 610 is at the dead center (corresponding to collinear) or substantially at the dead center (corresponding to substantially collinear), the pressure angle between the first link 611 and the second link 612 is substantially equal to 90 °, and when the first link 611 or the second link 612 receives an external force from the sleeve assembly 400, the moment to the other link is zero, so that the link assembly 610 cannot move, and the link assembly 610 is self-locked in the second position. Thereby locking the jaw assembly 100 in the closed position.
During the switching of the link assembly 610 from the first position to the second position, the hinge point gradually moves upward (away from the side of the grip of the handle 810), and since the proximal end of the second link 612 is connected to the frame 600, the hinge point at the distal end of the second link 612 moves distally, while the rotation of the first link 611 causes the distal end of the first link 611 to move distally, as can be seen from the above, the distal end of the first link 611 is connected to the proximal end of the outer sleeve 420, and the distal end of the outer sleeve 420 is connected to the jaw assembly 100, and thus the link assembly 610 can drive the outer sleeve 420 to move distally, causing the outer sleeve 420 to be located in the distal position.
Wherein the handle 810 is provided with a bearing portion 811, the bearing portion 811 being located at the lower side of the link assembly 610, and the handle 810 bearing the first link 611 or the second link 612 by the bearing portion 811 to be operatively engaged with the link assembly 610 during the switching of the link assembly 610 from the first position to the second position. When the link assembly 610 is locked in the second position after being in the second position, the bearing portion 811 is separated from the link assembly 610 during the return spring of the handle 810, and when the handle 810 is subsequently actuated, the handle 810 is switched from the initial position to the pressing position, the bearing portion 811 moves along with the movement of the handle 810, and the bearing portion 811 contacts the link assembly 610 in the second position only when the handle 810 reaches the pressing position (the end point of the movement track of the bearing portion 811), that is, the bearing portion 811 is not in contact with the link assembly 610 during the movement, so that the handle 810 cannot drive the link assembly 610 during the subsequent actuation. The support portion 811 is a rod body, and the handle 810 is operatively engaged with the link assembly 610 by the support portion 811, and the support portion 811 can always support the second link 612 during rotation of the second link 612.
The switching of the outer sleeve 420 from the proximal position to the distal position, and the switching of the jaw assembly 100 from the open state to the closed state, is accomplished by:
as shown in fig. 22 to 26, the jaw assembly 100 includes a cartridge holder 110 and a nail pushing holder 120 rotatably connected to the cartridge holder 110, and a motion conversion mechanism is disposed between the outer sleeve 420 and the nail pushing holder 120 of the jaw assembly 100, and converts the linear motion of the outer sleeve 420 into the pivoting motion of the nail pushing holder 120, so as to pivot the nail pushing holder 120 relative to the cartridge holder 110 to close or open the jaw assembly 100. Specifically, as the outer sleeve 420 moves proximally, the motion-altering mechanism drives the staple holder 120 to pivot upward to open the jaw assembly 100, and as the outer sleeve 420 moves distally, the motion-altering mechanism drives the staple holder 120 to pivot downward to close the jaw assembly 100.
Specifically, the outer sleeve 420 includes a body 425 and a drive tube 426 that are coupled, the drive tube 426 driving the anvil 120 to pivot upward or downward to open or close the jaw assembly 100. The body 425 and the drive tube 426 are connected by a hinge.
The motion changing mechanism includes a first driving member 4261 and a second driving member 4262 disposed on the driving tube 426, and a first driven portion 121 and a second driven portion 122 disposed on the nail holder 120.
The first driving member 4261 drives the nail holder 120 to open, and the first driving member 4261 is a protrusion provided on the driving tube 426 and extending obliquely along the lower right direction. The second driver 4262 drives the staple holder 120 closed, and the second driver 4262 is a driving surface 3531 at the distal end of the drive tube 426.
Correspondingly, the first driven portion 121 may be coupled to the first driving member 4261, where the first driven portion 121 is a protrusion disposed on the nail base 120, and the protrusion extends upward. The second driven portion 122 may be coupled to the second driving member 4262, where the second driven portion 122 is an abutment surface against the proximal end of the nail seat 120.
A guide mechanism is further provided between the nail pushing seat 120 and the nail cartridge seat 110, the guide mechanism comprises a pin 123 arranged on the nail pushing seat 120, an inclined waist-shaped groove 111 arranged on the nail cartridge seat 110, and the inclined waist-shaped groove 111 extends obliquely upwards along the direction of the proximal end towards the distal end.
Referring to fig. 26 to 25, when the jaw assembly 100 needs to be closed, the body 425 of the outer sleeve 420 pushes the driving tube 426 to move distally, the second driving member 4262 of the driving tube 426 abuts against the second driven portion 122 of the abutment 120, the pin 123 moves from the proximal lower end to the distal upper end of the inclined slot 111, the abutment 120 pivots downward, and the jaw assembly 100 closes.
Referring to fig. 25-26, when the jaw assembly 100 needs to be opened, the body 425 of the outer sleeve 420 pulls the driving tube 426 to move proximally, the first driving member 4261 of the driving tube 426 abuts against the first driven portion 121 of the abutment 120, the pin 123 moves from the distal upper end to the proximal lower end of the inclined slot 111, the abutment 120 pivots upward, and the jaw assembly 100 is opened.
The medical personnel can switch the jaw assembly to the open state through the jaw opening assembly 900 by the following structure:
as shown in fig. 27 and 28, the jaw opening assembly 900 includes a release button 910 provided outside the housing of the operating assembly 800, and an unlocking lever 920 provided in the housing of the operating assembly 800 to abut against the link assembly 610 in the second position, the unlocking lever 920 being linked with the release button 910, the release button 910 having a driving lever 911, and when the release button 910 is operated by a medical person, particularly when the release button 910 is pushed, the release button 910 and the driving lever 911 are rotated synchronously, the rotating driving lever 911 acts on the release lever to rotate the unlocking lever 920, and the unlocking lever 920 abuts against one end of the link assembly 610 to move downward to push the link assembly 610, so that the link assembly 610 is retracted to the first position, and the jaw assembly 100 is opened to release human tissue. When the release button 910 is not operated, the unlocking lever 920 is located above the link assembly 610, and the link assembly 610 is self-locked at the second position; when the medical staff operates the release button 910, the unlocking lever 920 is rotated, and one end of the unlocking lever 920 moves downward to push the link assembly 610, so that the link assembly 610 is no longer in the second position, and the self-locking state of the link assembly 610 is released. The outer sleeve 420 is sleeved with a spring 430, one end of the spring 430 is connected with the frame 600, the other end of the spring 430 is connected with the pushing block 440, the pushing block 440 is connected with the first connecting rod 611, when the connecting rod assembly 610 is in the second position, the spring 430 is in a compressed state, and the outer sleeve 420 is in a distal end position; when the linkage assembly 610 is in the first position, the spring 430 is in a released state. When the healthcare worker operates the release button 910 to release the link assembly 610 from the second position, the spring 430 is released to push the push block 440 proximally, and the link assembly 610 moves to the first position to open the jaw assembly 100 and simultaneously moves the outer sleeve 420 to the proximal position to move the locking element to the unlocked state. After the retracting is completed, the medical personnel operate the release button 910 to open the jaw assembly 100.
The overall flow of surgical instrument operation with the jaw assembly 100 always in the direct-fire state is described as follows:
after the surgical instrument is advanced into the body, the jaw assembly 100 is in the direct-drive state, with the clutch mechanism in either the first or second state, or the ribs 8311 positioned between the first and second side walls 8322, 8323, and the cutting blade assembly 300 in the disengaged position.
The healthcare worker controls the jaw assembly 100 to close, clamping and squeezing the assembly to be clamped. After the compression is completed, the healthcare worker again actuates the handle 810 to feed.
Prior to feeding, with the cutter assembly 300 in the disengaged position (position in fig. 17), the distal movement of the rack 351 cannot directly push the spindle 330 and knife bar 320 distally for feeding. When the feeding starts, the main control module controls the motor to rotate, the motor drives the first gear 831 to rotate, specifically to rotate anticlockwise, if the clutch mechanism is in the first state, the first gear 831 rotates anticlockwise relative to the second gear 832, so that the clutch mechanism is switched to the second state, and in the second state, as shown in fig. 12, the first gear 831 rotates anticlockwise to drive the second gear 832 to rotate, and further drive the rack 351 to move distally. If the clutch mechanism is in the second state, the motor assembly 820 may directly drive the rack 351 to move distally. When the distance of distal movement of the rack 351 is R, the first moving member 340 is located at the abutment position (the position in fig. 18), and at this time, the rack 351 is moved distally to drive the cutter assembly 300 to feed, the distance that the cutter assembly 300 advances from the initial position to the end of travel is L, and during feeding, the travel of the rack 351 is l+r.
When the feeding is completed, the cutter assembly 300 is in the feeding bottom position, the cutter assembly 300 is in the abutting position, and the clutch mechanism is in the second state. The main control module controls the motor assembly 820 to rotate reversely, the motor assembly 820 rotates reversely to drive the first gear 831 clockwise, the clutch mechanism is switched to the first state, the motor assembly 820 can drive the rack 351 to move proximally, because the cutter assembly 300 is in the abutting position, the rack 351 can pull the cutter assembly 300 to move proximally when the rack 351 moves proximally, the first opening side 3522 and the first groove bottom side 3521 move proximally, the first groove bottom side 3521 is separated from the first moving member 340, the first opening side 3522 moves towards the first moving member 340, and when the rack 351 moves proximally by the distance R, the first opening side 3522 is in contact with the first moving member 340, the cutter assembly 300 is in the separating position (the position is switched from the position in fig. 18 to the position in fig. 17), the cutter assembly 300 can be pulled to move proximally, in the above process, the movement of the rack 351 does not drive the cutter assembly 300 to move, and the cutter assembly 300 is still in the feeding position. When the distance that the rack 351 moves to the proximal side continuously drives the cutter assembly 300 to move is L, the cutter assembly 300 returns to the initial position, the cutter withdrawal is completed, the distance that the rack 351 moves to the proximal side in the cutter withdrawal process is R+L, and the rack 351 returns to the initial position. And after the main control module determines that the tool retracting is completed, the motor assembly 820 is controlled to rotate reversely, and the first gear 831 is driven to rotate anticlockwise relative to the second gear 832, so that the clutch mechanism is switched to the second state.
After the retracting is completed, the healthcare worker operates the jaw opening assembly 900 to open the jaw assembly 100 and release the tissue. The jaw assembly 100 is in a direct-lit condition and a medical professional can remove surgical instruments from the body.
It should be noted that, as shown in fig. 29 and 30, the cutter head 310 of the cutter assembly 300 is in an "h" shape, the cutter head 310 includes a cutter body 311, an upper beam 312 and a lower beam 313, a cartridge assembly is disposed in the cartridge seat 110, the lower chute 112 is disposed in the cartridge seat 110, the upper chute 124 is disposed in the upper chute 120, the lower beam 313 of the cutter head 310 is disposed in the lower chute 112, the cutter body 311 is disposed in the cartridge assembly, and the upper chute 124 is substantially parallel to the lower chute 112 when the jaw assembly 100 is in the closed state. When the jaw assembly 100 is switched to the closed condition, the knife head 310 is positioned at the proximal end of the staple cartridge, the lower beam 313 of the knife head 310 of the cutting knife is positioned within the lower chute 112, and the upper beam 312 does not enter the upper chute 124. In response to the driving of the power source, the cutter assembly 300 moves distally, the upper beam 312 of the cutter head 310 enters the upper chute 124 and cooperates with the upper chute 124 and the lower chute 112, and the cutter head 310 of the cutter is limited by the upper chute 124 and the lower chute 112, so that the position of the cutter head 310 is stable and no offset occurs during feeding. When the tool bit 310 is moved to the distal end of the cartridge assembly, the upper beam 312 of the tool bit 310 remains positioned in the upper chute 124. During retraction, the knife head 310 moves proximally from the distal end of the cartridge assembly, with the knife head 310 simultaneously engaging and moving proximally with the upper and lower runners 124, 112 until the upper beam 312 of the knife head 310 disengages from the upper runner 124, and the knife head 310 continues to move proximally until the proximal end of the cartridge assembly completes retraction.
During feeding or retracting, when the cutter head 310 cooperates with the upper chute 124 and the lower chute 112, if the medical staff operates the jaw opening assembly 900 to switch the jaw assembly 100 to the open state, the link assembly 610 is not self-locked at the second position, and moves to the first position under the action of the spring 430, so that the sleeve assembly 400 has a force of moving proximally, and further the staple holder 120 has a force of rotating to the open state of the jaw assembly 100, and since the staple holder 120 cooperates with the cutter head 310 through the upper chute 124 and the upper beam 312, the cutter head 100 cannot be rotated to completely open the jaw assembly, but the staple holder 120 is subject to the tension of the spring 430, there is a tendency to rotate upwards, so that the cutter head 310 is pulled upwards, the friction force of the cutter head 310 in the feeding or retracting direction (horizontal direction) is increased, so that the resistance of the movement of the cutter head 310 in the jaw assembly 100 is increased, and the situation that feeding or retracting cannot be performed normally is easy to occur. In addition, the abutment 120 may rotate at a small angle relative to the cartridge seat 110, so that the jaw assembly 100 opens at a small angle, the tissue cannot be clamped, and the cutter head 310 may push the tissue to move during the feeding process, resulting in poor cutting effect. Thus, when the cutter head 310 is engaged with both the upper and lower runners 124, 112 during the feeding and retracting processes, the jaw opening assembly 900 may be operated such that the feeding or retracting resistance is increased and the cutting effect is deteriorated during feeding.
As shown in fig. 31, the surgical instrument further includes a safety assembly 500, the safety assembly 500 being disposed on the frame 600. The safety assembly 500 includes a safety member 510 movably disposed with the frame, the safety assembly 500 having a locked state and an unlocked state in which the safety assembly 500 is separated from the jaw opening assembly 900, the jaw assembly 100 being switched from the closed state to the open state in response to the jaw opening assembly 900 being operated. In the locked state, the fuse 510 is in a locked state against the jaw opening assembly 900, such that the jaw opening assembly 900 is locked and the healthcare worker cannot operate the jaw opening assembly 900, i.e., the jaw assembly 100 is locked from opening. During feeding and retracting, the safety assembly 500 is in a locked state and the jaw opening assembly 900 cannot be operated by a healthcare worker to open the jaws.
In the prior art, the safety member 510 is rotatably disposed on the frame 600, the safety member 510 is provided with a first protrusion, the rack 351 is provided with a first mating member, when the safety assembly 500 is in the unlocking state, the first protrusion is separated from the first mating member, the rack 351 moves proximally when the tool is retracted, and the first protrusion abuts against the first mating member and drives the safety member 510 to rotate through the cooperation of the first protrusion and the first mating member. When the rack 351 is moved to the initial position, the safety assembly 500 is in the unlocked state, the safety member 510 rotates to be separated from the jaw opening assembly 900, and the first protrusion is engaged with the first mating member. In the surgical instrument of the present application, when the jaw assembly 100 is rotated to one side by the maximum angle relative to the sleeve assembly 400, the rack 351 moves distally from the initial position by a distance L, moves proximally by a distance l+r when retracting, the rack 351 retracts more than it advances when retracting, the rack 351 has an initial position and a limit retraction position, the initial position being the position of the rack 351 before feeding, the limit retraction position being: when the jaw assembly 100 is in the maximum rotation state, the rack 351 moves proximally by the distance l+r when retracting, and the limit retracting position is located proximal to the initial position. The jaw assembly 100 is in a maximum rotation state, the rack 351 still moves proximally towards the limit retracting position after the rack 351 is located at the initial position in the retracting process, in the scheme of the prior art, the rack 351 continues to move proximally from the initial position to further rotate the safety member 510, as shown in fig. 31, the safety member 510 is generally in a frame shape, the rack 351 passes through the middle space of the safety member 510, and further rotation of the safety member 510 can enable the upper end of the safety member 510 to press against the rack 351 to interfere with the rack 351, so that the rack 351 cannot move proximally, and the retracting cannot be completed.
In the present application, when retracting the knife, the safety assembly 500 is driven to switch to the unlocking state in the process of moving the rack 351 to the initial position in the proximal direction; during the movement of the rack 351 from the initial position to the withdrawal limit position, the rack 351 acts on the safety assembly 500 and maintains the safety assembly 500 in the unlocked state. The unlocked state means that the safety assembly 500 is separated from the jaw opening assembly and the safety assembly 500 does not interfere with the proximally moving rack 351. When the jaw assembly 100 is in the maximum rotation state and the knife is retracted, the safety assembly 500 is in the unlocking state when the rack 351 moves from the distal side to the initial position, the safety assembly 500 is separated from the jaw opening assembly, the safety assembly 500 does not interfere with the rack 351 moving proximally, so that the rack 351 can continue to move distally, in the process, the rack 351 acts on the safety assembly 500 to keep the safety assembly 500 in the unlocking state, the safety assembly 500 does not interfere with the rack 351 moving proximally all the time, and the rack 351 can move smoothly to the knife retraction limit position.
Specifically, the safety assembly 500 includes the safety assembly 500 including a safety member 510 and an elastic member (not shown) connected between the frame 600 and the safety member 510, and when the safety assembly 500 is in the unlocked state, the safety member 510 is restricted by the rack 351 to be separated from the unlocking assembly, and the elastic member is compressed. When the rack 351 moves distally from the initial position, the fuse 510 is released, and the elastic member drives the fuse 510 to move to abut against the unlocking assembly, so that the fuse assembly 500 is switched to the locking state.
Preferably, as shown in fig. 32 and 33, the release button 910 of the jaw opening assembly has a flange 912, the protection member 510 in this embodiment is rotatably disposed on the frame 600, the elastic member is a torsion spring, and when the safety member 500 is in the locked state, the protection member 510 is located under the flange 912 and abuts against the flange 912, so that the release button 910 cannot rotate, and the jaw assembly 100 cannot be switched to the open state. When the safety assembly 500 is switched from the locked state to the unlocked state, the safety 510 is rotated to disengage from the flange 912, compressing the torsion spring, the safety 510 no longer abuts the flange 912, and the release button 910 can be rotated to open the jaw assembly 100 when operated.
The rack 351 has a driving portion 353 and a holding portion 354, and during the distal movement of the rack 351 to the limit retraction position, the movement of the safety member 510 is driven by the driving portion 353 to switch the safety assembly 500 from the locked state to the unlocked state, and the holding portion 354 acts on the safety assembly 500 in the unlocked state, specifically on the safety member 510 to hold the safety assembly 500 in the unlocked state. When the holding portion 354 acts on the safety member 510, the safety member 510 does not rotate or rotates by a small extent until the rack 351 moves to the withdrawal limit position, and the safety member 510 does not interfere with the rack 351 due to an excessive rotation angle, thereby preventing the rack 351 from withdrawing the knife.
As shown in fig. 33 and 34, the driving portion 353 and the holding portion 354 are both protrusions provided on the rack 351, the driving portion 353 includes a driving surface 3531, the holding portion 354 includes a holding surface 3541, the driving surface 3531 is connected to the holding surface 3541, when the rack 351 moves from the distal direction to the initial position, the driving portion 353 abuts against the safety member 510 via the driving surface 3531 and drives the safety member 510 to rotate, and guides the safety member 510 to move along the driving surface 3531 until abutting against the holding surface 3541, and when the safety member 510 abuts against the holding surface 3541, the safety member 500 is restricted by the holding surface 3541, thereby maintaining the unlocking state of the safety member 500.
Wherein the driving surface 3531 is a slope with a high proximal side and a low distal side, and the holding surface 3541 is connected to the distal side of the driving surface 3531, as shown in fig. 33, when the safety component 500 is switched from the locked state to the unlocked state, the safety member 510 rotates clockwise, the abutment point between the safety member 510 and the driving portion 353 moves proximally in the horizontal direction, and moves downward in the vertical direction, that is, as the rotation angle of the safety member 510 with respect to the locked state increases, the height of the abutment point between the safety member 510 and the driving portion 353 decreases. The driving surface 3531 is high at the proximal side and low at the distal side, so that when the driving surface 3531 moves along with the rack 351 at the proximal side, the height of the abutting position with the safety member 510 is gradually reduced, and the end of the protruding portion 512 always abuts against the driving surface 3531 when rotating. When the driving surface 3531 abuts against the safety member 510, the driving force for moving the rack 351 proximally acts on the safety member 510 through the driving surface 3531, so that the safety member 510 rotates. The rack 351 continues to move proximally, the driving surface 3531 guides the safety element 510 to abut against the holding surface 3541, the holding surface 3541 is substantially planar, the safety element 510 abuts against the holding surface 3541 in a longitudinal direction (perpendicular to a moving direction of the rack 351), and the abutting direction of the safety element 510 and the holding surface 3541 is perpendicular to the moving direction of the rack 351, so that when the rack 351 moves proximally, the holding surface 3541 cannot apply a driving force for moving the rack 351 proximally to the safety element 510, so that the safety element 510 does not continue to rotate in a direction away from the release button 910, and meanwhile, the holding surface 3541 also blocks the safety element 510 from rotating in a direction of the release button 910, so that when the rack 351 moves proximally, the safety element 510 always abuts against the holding surface 3541, does not rotate, does not interfere with the rack 351 moving proximally, and is kept in an unlocked state.
In one embodiment, the holding surface 3541 is flat, the safety member 510 abuts against the holding surface 3541, and the holding surface 3541 cannot drive the safety member 510 to rotate when the rack 351 moves proximally. In another embodiment, the holding surface 3541 is an inclined surface with a smaller inclination angle, the holding surface 3541 is high at the proximal side and low at the distal side, the safety member 510 abuts against the holding surface 3541, and when the rack 351 moves proximally, the safety member 510 rotates in a small amplitude in a direction away from the jaw opening assembly; or the holding surface 3541 is high distally and low proximally, the guard 510 abuts the holding surface 3541, and as the rack 351 moves proximally, the guard 510 rotates a small amount in a direction toward the jaw opening assembly. Regardless of how the retaining surface 3541 is provided, the bumper 510 remains in the unlocked state when it abuts against the retaining surface 3541, separated from the jaw opening assembly, and does not interfere with the proximally moving rack 351.
Further, the rack 351 has a feeding position, the feeding position is located at the far side of the initial position, when the rack 351 moves distally from the initial position during feeding, the safety member 510 is released, the elastic member drives the safety member 510 to move, when the rack 351 moves to the feeding position, the safety member 510 is switched to a locking state to be abutted against the jaw opening assembly, and when the rack 351 moves to the far side of the feeding position, the safety member 510 does not rotate any more and is kept in the locking state. When the rack 351 moves to the feeding position during retracting, the driving surface 3531 contacts with the safety member 510, and during the process of moving the rack 351 from the feeding position to the retracting limit position, the safety member 510 sequentially abuts against the driving surface 3531 and the retaining surface 3541, and the safety member 510 rotates to switch the safety assembly 500 from the locking state to the unlocking state and is maintained in the unlocking state. Further, the safety member 510 includes a lever body 511 and an extension portion 512 connected to the lever body 511, the safety member 510 abuts against the flange 912 of the unlocking component through the lever body 511, and the safety member 510 abuts against the driving portion 353 or the holding portion 354 through the extension portion 512. When the rack 351 moves proximally from the feed position, the end of the extension 512 abuts against the driving surface 3531, and the driving surface 3531 moves proximally with the rack 351, so that the extension 512 is pushed, and the lever body 511 is rotated.
In an embodiment, when the rack 351 is located at the initial position, the safety member 510 abuts against the holding surface 3541, and when the rack 351 moves from the initial position to the tool withdrawal limit position, the safety member 510 always abuts against the holding surface 3541 and does not rotate, and is kept in the unlocked state and does not interfere with the rack 351 moving proximally, so that the rack 351 can move smoothly to the tool withdrawal limit position.
In another embodiment, when the rack 351 is at the initial position, the safety member 510 abuts against the middle portion of the driving surface 3531, and when the rack 351 moves from the initial position to the retracting limit position, the safety member 510 is driven by the driving surface 3531 to rotate, and is guided to the holding surface 3541 by the driving surface 3531, and after abutting against the holding surface 3541, the safety member 510 does not rotate and is kept in the unlocking state. That is, in the process of moving the rack 351 from the initial position to the retracting limit position, the safety member 510 is rotated to be in contact with the holding surface 3541, and then is held in the position in contact with the holding surface 3541, so that the rack 351 does not interfere with the rack 351 moving proximally, and the rack 351 can smoothly move to the retracting limit position.
When the jaw assembly 100 is in the direct-beating state and the retracting is completed, the rack 351 moves proximally by a distance L and is positioned at the initial position, so that the safety assembly 500 is in the unlocking state, and the medical staff can operate the jaw opening assembly 900 to switch the jaw assembly 100 to the opening state. When the jaw assembly 100 is in the maximum rotation state of the bending state and the retracting is completed, the rack 351 moves proximally by a distance l+r and is located at the limit retracting position, the safety assembly 500 is in the unlocking state, and it should be noted that when the rack 351 moves by a distance L and is located at the initial position, the safety assembly 500 is in the unlocking state, and the medical staff can operate the jaw opening assembly 900 to switch the jaw assembly 100 to the opening state during the process of moving the rack 351 from the initial position to the limit retracting position. When the rack 351 is in the initial position, the cutter assembly 300 is not retracted to the bottom, and the distance from the bottom is R, as shown in fig. 30, and the cutter head 310 is disengaged from the upper chute 124 of the nail seat 120, so that the jaw assembly 100 is opened when the rack 351 is between the initial position and the limit retracted position, the movement of the cutter assembly 300 is not affected, and the rack 351 and the cutter assembly 300 can still continue to move proximally until the retraction is completed.
It is noted that, the surgical instrument of this embodiment further includes a travel recording module and a status detection module, both of which are electrically connected with the main control module, the travel recording module obtains an output value for indicating the azimuth status of the rack 351 and sends the output value to the main control module, the status detection module is electrically connected with the motor assembly 820, the status detection module obtains a status signal for indicating the status of the motor assembly 820, and the main control module determines whether the cutter assembly 300 is cut to the bottom according to the output value and the status signal, and specifically includes the following steps:
s100, controlling the motor assembly 820 to drive the cutter driving piece 350 to move distally, and further drive the cutter assembly to move distally;
s200, receiving an output value sent by a travel record module, judging whether the output value meets a first preset condition, and if the output value is larger than or equal to a second value and smaller than or equal to the first value, meeting the first preset condition;
s300, receiving a state signal of the motor assembly 820, and judging whether the state signal meets a second preset condition, namely judging whether the motor assembly is locked;
if the judging results of the step S200 and the step S300 are yes, the step S400 is executed to control the motor assembly 820 to stop or control the motor assembly 820 to reverse to drive the cutter assembly to retract;
If one or both of the judgment results of S200 and S300 are negative, returning to the step: and S100, controlling the motor assembly 820 to drive the cutter driving piece 350 to move distally.
In step S100, after the jaw assembly 100 is closed, the medical staff actuates the handle 810, and the main control module determines that the actuating angle of the handle 810 meets the preset condition, controls the motor assembly 820 to start, and drives the rack 351 to move distally so as to push the cutter assembly 300 to feed. Specifically, the handle 810 has an initial position and a pressing position, between which a first area and a second area are formed, and the surgical instrument further includes a second detection device for detecting the position of the handle 810, where the second detection device is configured to send a second detection signal to the main control module, where the second detection signal is used to indicate the position of the handle 810, and when the main control module determines that the handle 810 is in the second area, the main control module meets a preset condition, and controls the motor assembly 820 to start. The specific manner in which the main control module controls the actuation of the motor assembly 820 can be seen in applicant's prior application CN202310399540.0.
In step S200, the first value is used to indicate the orientation of the rack 351 when the cutter assembly is fed to the bottom when the jaw assembly 100 is in the direct-drive state, and the second value is used to indicate the orientation of the rack 351 when the cutter assembly 300 is fed to the bottom when the jaw assembly 100 is in the maximum-rotation state. Specifically, in the present embodiment, the azimuth state is specifically the feed stroke of the rack 351. The feed stroke means: the rack 351 moves distally from the feed position to a distance that the cutter assembly 300 moves when cutting to the bottom. The feed position is a position where the rack 351 moves distally from the initial position by the distance R. When the angle of rotation of the jaw assembly 100 relative to the sleeve assembly 400 is less than the maximum angle of rotation, the feed stroke of the rack 351 at the bottom of the feed is between a first value, the maximum stroke of the feed stroke of the rack 351, and a second value, the minimum stroke of the feed stroke of the rack 351. Whether the jaw assembly 100 is in the straight-run state or the bent-run state, the feeding stroke of the rack 351 when feeding to the bottom is between a first value and a second value (including the first value and the second value), and the main control module judges that the output value is greater than or equal to the second value and is less than or equal to the first value, and the first preset condition is satisfied, that is, the stroke judging section for judging that the cutting knife assembly 300 cuts to the bottom includes all values between the first value and the second value (including the first value and the second value), so as to cover all possible feeding strokes of the rack 351. With this arrangement, the cutting blade assembly 300 can be accurately judged to be cut to the bottom.
In step S300, the state detection module detects the state of the motor assembly 820 in real time, and sends the state information to the main control module, and the main control module determines whether the state signal meets a second preset condition according to the state information, and when the second preset condition is met, the motor is blocked, and the motor assembly 820 cannot drive the cutter assembly 300 to move distally.
When the first preset condition is satisfied, the distance representing the movement of the rack 351 is within the stroke judgment interval, and the cutter assembly 300 moves to the bottom position or the vicinity; when the second preset condition is met, it represents a locked-rotor of the motor assembly 820. The first preset condition and the second preset condition are simultaneously satisfied, which means that the cutter assembly 300 has moved to or near the bottom position, and the cutter assembly 300 is blocked by the cartridge assembly at or near the bottom position so that the motor assembly 820 is blocked, so that the bottom of the cutter assembly 300 can be accurately determined.
After the cutter assembly 300 is judged to be cut to the bottom, the motor assembly 820 is controlled to stop, so that the motor assembly 820 is prevented from being damaged due to the fact that the motor assembly 820 continues to drive the motor assembly 820 to rotate. Alternatively, upon determining that the cutter assembly 300 has been cut to the end, the motor assembly 820 is rotated in a reverse direction and the rack 351 is moved proximally, causing the cutter assembly 300 to switch to the disengaged position and the cutter assembly 300 to be moved distally to retract the knife.
In the prior art, the position of the cutter driving member 350 is used as a basis to determine whether to cut to the bottom. However, when the jaw assembly 100 is in the straight-beating state and the curved-beating state, the stroke of the cutter driving member 350 is different, and it is not possible to accurately determine whether the cutter assembly 300 is cut to the bottom only according to a certain fixed value, and it is necessary to determine according to the numerical intervals formed by the strokes of the cutter driving member 350 in the straight-beating state and the curved-beating state. In order to prevent the occurrence of the excessive cutting or the insufficient cutting according to the numerical value interval judgment, judgment as to whether the motor assembly 820 is locked up is added. When the above two determination results satisfy the requirements at the same time, it can be determined that the cutter assembly 300 is cut to the bottom.
Further, after step S100, before step S200, the method further includes the following steps:
s110, judging whether a zero signal is received or not;
if yes, executing the step S120, resetting the output value, and jumping to the step S200 to receive the output value sent by the travel record module, and judging whether the output value meets a first preset condition;
if not, returning to the step S110, and judging whether a zero signal is received.
In step S110, the surgical instrument has a zero switch 930, and in a preferred embodiment, when the rack 351 is moved to the feed position, the zero switch 930 is triggered, and the zero switch 930 sends a zero signal to the master control module. In other embodiments, the rack 351 may also be located at other positions (non-feed positions) to trigger the zero switch 930, which is not specifically limited in this application. Further, as shown in fig. 29 to 31, the bumper of the safety component 500 is provided with a trigger portion 513, the trigger portion 513 is located at the top of the safety component 510, the rack 600 is provided with a circuit board, the circuit board is provided with a zero switch 930, the zero switch 930 is electrically connected with the main control module, the zero switch 930 is a push switch, when the safety component 500 is in an unlocked state, the trigger portion 513 is separated from the zero switch 930, and the zero switch 930 is in an un-triggered state; when the rack 351 moves to the feeding position, the safety component 500 is switched to a locking state, the safety piece 510 rotates to abut against the flange 912 of the release button 910, the jaw opening structure is locked, the zero switch 930 is triggered by pressing the trigger part 513, and a zero signal is sent to the main control module after the zero switch 930 is triggered. Note that, the manner in which the rack 351 activates the zero position switch 930 is not limited to the above manner.
In step S120, after receiving the zero signal, the main control module clears the output value, uses the position (feed position) of the rack 351 when the zero switch 930 is triggered as the start point of the feed stroke of the rack 351, and determines the feed stroke of the rack 351 according to the output value.
When the master control module does not receive the zero signal, the start point of the feeding stroke indicating that the rack 351 does not move to the feeding position is indicated, and the feeding stroke is not started, the step S110 is returned to again determine whether the zero signal is received or not until the rack 351 moves to the feeding position, and the master control module receives the zero signal.
The stroke recording module specifically includes an encoder connected to the motor assembly 820, the output value includes motor revolution information, the motor assembly 820 is connected to the rack 351 through the driving gear structure 830, and in the feeding position, the clutch mechanism is in the second state, and the motor assembly 820 can drive the rack 351 to move distally through the driving gear structure 830. During the distal movement of the rack 351 by the motor assembly 820 through the driving gear structure 830, the number of revolutions of the motor assembly 820 is positively correlated with the distal movement distance of the rack 351, and the motor revolution information may represent the distal movement distance of the rack 351. The encoder is used for detecting pulse signals generated by rotation of the motor output shaft 821 and sending the pulse signals to the main control module, the main control module obtains the number of turns of the rotation of the output shaft 821 according to the number of the pulse signals, the output value output by the travel recording module is specifically a plurality of pulse signals, and the main control module judges whether the output value is between a first value and a second value according to the number of the pulse signals in the output value. When the zero position switch 930 is triggered, the main control module clears the number of pulse signals stored in the main control module, and records the number of pulse signals sent by the encoder when the rack 351 moves distally from the feeding position from zero. The output value output by the travel recording module is specifically a plurality of pulse signals, and the main control module judges whether the output value meets the first preset condition according to the number of the pulse signals in the output value. The first value is specifically the number of turns of the rack 351 that the output shaft 821 of the motor assembly 820 rotates when the jaw assembly 100 is in the direct-drive state, and the second value is specifically the number of turns of the rack 351 that the output shaft 821 of the motor assembly 820 rotates when the jaw assembly 100 is in the maximum-rotation state.
The encoder may be a hall encoder (not shown in the drawings), and specifically includes a hall sensor and a plurality of magnets surrounding an output shaft 821 provided to the motor. When the magnet rotates along with the rotating shaft of the motor, the Hall sensor senses the magnet and outputs pulse signals, the pulse signals serve as detection signals, and the main control module determines the number of turns of the motor based on the number of the pulse signals and the motor rotation direction determined by the Hall sensor. Specifically, when the rotating shaft of the motor rotates, the hall sensor outputs a pulse signal every time when passing through one magnet.
The encoder can also be a photoelectric encoder, and comprises a photoelectric sensor and a plurality of gratings, wherein the photoelectric sensor can emit detection light in an infrared mode, and the gratings are distributed around the rotating shaft of the motor; when the rotating shaft rotates, the grating is driven to rotate, and the photoelectric sensor senses the grating and outputs a pulse signal. The principle of determining the rotation number of the motor by the main control module based on the pulse signal is the same as that of the Hall sensor, and the description is omitted here. Of course, the detecting element may be other ways of determining the number of turns of the motor.
It is further noted that prior to distal movement of the rack 351 by the motor assembly 820, the rack 351 is in the initial position, the safety assembly 500 is in the unlocked state, and the jaw assembly 100 can be opened by a medical professional by operating the release button 910. When the rack 351 moves distally from the initial position by the distance R, the feeding position is reached, and the rack 351 is at the start point of the feeding stroke, the zero position switch 930 is triggered, and feeding is started. At this time, the safety component 500 is in a locked state, and locks the jaw opening structure, so that the jaw component 100 cannot be opened, i.e. when feeding begins, the jaw component 100 is locked and cannot be opened, thereby ensuring that the situation that the cutter component 300 cannot feed normally due to the tendency of rotating the nail supporting seat 120 caused by misoperation of medical staff cannot occur in the feeding process. Wherein during the movement of the rack 351 from the initial position to the feeding position, the safety assembly 500 is switched to the locking state, but not abutted against the flange 912 of the release button 910, the jaw opening structure is not locked, and can be operated to switch the jaw assembly 100 to the unlocking state, when the rack 351 is located in the feeding position, as shown in fig. 27, the upper beam 312 of the cutter head 310 does not enter the upper chute 124 of the abutment 120, and opening the jaw before the rack 351 is located in the feeding position does not cause the problem that the cutter assembly 300 cannot move.
When the rack 351 moves from the initial position to the feeding position, the rack 351 moves distally by the distance R. When the jaw assembly 100 is in the direct-drive condition and the rack 351 is in the initial position, the cutter assembly 300 is in the disengaged position, the rack 351 reaches the feeding position after moving distally a distance R from the initial position, the cutter assembly 300 is in the abutment position, at which time the rack 351 can drive the cutter assembly 300 to move distally and the knife head 310 is at the proximal end of the cartridge assembly. The feeding stroke starts, and the rack 351 moves distally by a distance L to complete feeding, so that in the straight-driving state, the first distance of the feeding stroke of the rack 351 is specifically L. With the jaw assembly 100 in the maximum rotation state and the rack 351 in the initial position, the cutter assembly 300 is in the abutment position. The rack 351 is moved distally a distance R to a feed position where the rack 351 pushes the cutter assembly 300 distally R, and the knife head 310 has disengaged from the proximal end of the cartridge assembly. The feeding stroke starts and the rack 351 moves distally by L-R to complete feeding, so that in the maximum rotation state, the feeding stroke of the rack 351 is a second distance, specifically L-R.
In addition, during the feeding process, when the rack 351 is located at the feeding position or at the distal end of the feeding position, the safety assembly 500 is in a locked state, the zero switch 930 is always in a triggered state, and the zero switch 930 sends a zero signal to the main control module only once when being pressed to trigger. So as to avoid inaccurate judgment of the feed stroke caused by zero clearing of the pulse signal representing the rotation turns of the output shaft 821 in the feed process. And in the feeding process, the pulse signals sent by the encoder to the main control module are stored in a memory inside the main control module.
In the retracting process, when the rack 351 moves to the initial position proximally, the safety component 500 is switched to the unlocking state, the safety piece 510 no longer presses the zero switch 930 to release the zero switch 930, and no signal is sent to the main control module when the zero switch 930 is released. Until the anastomat is used again, the main control module controls the motor assembly 820 to drive the rack 351 to move distally to the feeding position to trigger the zero-position switch 930, the main control module receives the knife zero-position signal, clears the pulse signals stored in the internal memory, and re-receives and calculates the number of the pulse signals.
In another embodiment, the azimuthal state is specifically a position of the rack 351, and the first value is indicative of a position of the rack 351 when the cutter assembly 300 is moved distally to the bottom position when the jaw assembly 100 is in the direct-drive state, the position being the first position; the second value represents the position of the rack 351 when the cutter assembly 300 is moved distally to the bottom position when the jaw assembly 100 is in the maximum rotation state, which is the second position. The rack 351 is provided with a sensed part, the rack 600 is provided with a sensing area, the sensing area is arranged along the length direction of the rack 351, the sensing area is provided with a plurality of sensed parts, particularly sensors, the sensors are electrically connected with the main control module, and when the sensed parts move along with the rack 351 to correspond to the sensing area in a distal direction, the sensors of the sensing area detect the sensed parts and send output values to the main control module. When the jaw assembly 100 is in the direct-beating state and the cutter assembly 300 is cut to the bottom, the rack 351 is in the first position and corresponds to a sensor positioned at the distal edge of the sensing area, the sensed piece is detected by the sensor positioned at the distal edge of the sensing area, and the output value received by the main control module is the first value; when the jaw assembly 100 is in the maximum rotation state, the rack 351 is in the second position when the cutter assembly 300 is cut to the bottom, and corresponds to a sensor located in the proximal edge of the sensing area, and when the sensor located in the proximal edge of the sensing area detects the sensed piece, the output value received by the main control module is the second value. The angle of rotation of the jaw assembly 100 relative to the cannula assembly 400 is less than the maximum angle of rotation, and the position of the rack 351 at the time of feeding to the bottom is between a first value, which is the most distal position of the rack 351, and a second value, which is the most proximal position of the rack 351, when the cutter assembly is cutting to the bottom. Whether the jaw assembly 100 is in the straight-beating state or the bent-beating state, the position of the rack 351 when the cutter is fed to the bottom is between a first value and a second value (including the first value and the second value), and the main control module judges that the output value is greater than or equal to the second value and smaller than or equal to the first value, and meets a first preset condition, namely judges that the position of the rack 351 when the cutter assembly 300 is cut to the bottom is between the first value and the second value (including the first value and the second value), and covers all possible positions of the rack 351 when the cutter is fed to the bottom.
Specifically, in the embodiment, the sensing area is provided with a plurality of photoelectric sensors, the frame 600 is provided with a light source, the light source is opposite to the photoelectric sensors, and when the sensed piece is not opposite to the sensing area, all the photoelectric sensors can receive the light emitted by the light source. When the rack 351 is at the second position, the sensed member corresponds to a sensor located at the proximal edge of the sensing area, the sensed member blocks the light emitted by the light source, the sensor located at the proximal edge of the sensing area cannot receive the light emitted by the light source, and the sensor sends an output value to the main control module as a second value. When the rack 351 is at the first position, the sensed member corresponds to a sensor located at the distal edge of the sensing area, the sensed member blocks light emitted from the light source, and the sensor located at the distal edge of the sensing area cannot receive the light emitted from the light source, and then sends an output value to the main control module as a first value. In other embodiments, the sensor of the sensing area may be other types of sensors, such as a hall sensor, an infrared sensor, etc., which are not described herein.
Example 2
The surgical instrument of the second embodiment of the present application is generally identical to the first embodiment, and differs in the configuration of the clutch mechanism, in this embodiment, the rack 351 includes a first rack 3511 and a second rack 3512, the power source is connected to the first rack 3511, the second rack 3512 is connected to the cutter assembly 300, and in particular, the second rack 3512 is movably connected to the cutter assembly 300 through the first receiving slot 352 and the first mover 340.
The clutch mechanism includes a second accommodating groove 3514 and a second moving member 3513, one of the first rack 3511 and the second rack 3512 is provided with the second accommodating groove 3514, the other one is provided with the second moving member 3513, the second accommodating groove 3514 includes a second opening side 3515 and a second groove bottom side 3516 arranged along a length direction of the second accommodating groove 3514, the second accommodating groove 3514 is provided with one of the first rack 3511 and the second rack 3512, and the second opening side 3515 is close to the part provided with the second moving member 3513. Preferably, in this embodiment, the second accommodating groove 3514 is disposed on the first rack 3511, and the second moving member 3513 is disposed on the second rack 3512.
When the second moving member 3513 abuts against the second groove bottom side 3516, the first rack 3511 abuts against the second rack 3512, the power source is decoupled from the rack 351, and the clutch mechanism is in the second state, wherein the abutting means that the first rack 3511 and the second rack 3512 are connected to each other and mutually abut against each other through the second moving member 3513 and the second groove bottom side 3516. When the clutch mechanism is in the second state, the first rack 3511 can push the second rack 3512 to move distally when moving distally. When the second moving member 3513 is attached to the second opening side 3515, the first rack 3511 is relatively separated from the second rack 3512, the power source is coupled to the rack 351, and the clutch mechanism is in the first state, and when the first rack 3511 moves proximally, the second rack 3512 can be pulled to move proximally. The relative separation means that the first rack 3511 and the second rack 3512 are connected to each other and are separated from each other by a maximum distance, the cutter assembly 300 is in a separated position during the retracting process, the clutch mechanism is in a first state, the power source drives the first rack 3511 to move proximally, and the first rack 3511 pulls the second rack 3512 and the cutter assembly 300 to move proximally to retract. When the clutch mechanism is switched from the first state to the second state, that is, when the second moving member 3513 moves from a position where it contacts the second opening side 3515 to a position where it contacts the second groove bottom side 3516, the moving distance of the second moving member 3513 is R.
Specifically, the power source in this embodiment includes a motor assembly 820 and a driving gear structure 830 connected to the motor assembly 820, where the driving gear structure 830 includes only a first gear 831, and the first gear 831 is connected to the motor assembly 820 and meshed with a second rack 3512. When the retracting is completed, the cutter assembly 300 is at the separating position, the clutch mechanism is in the first state, the second moving member 3513 is attached to the second opening side 3515, the main control module controls the motor assembly 820 to drive the first rack 3511 to move distally by a distance R when the retracting is completed, so that the second opening side 3515 and the second groove bottom side 3516 move distally, the second moving member 3513 does not move, the second opening side 3515 is separated from the second moving member 3513, the second groove bottom side 3516 is attached to the second moving member 3513, the clutch mechanism is switched to the second state, and the cutter assembly 300 is still at the separating position. With the clutch mechanism in the second state, the second rack 3512 can be moved distally relative to the first rack 3511.
After the retracting is completed, the clutch mechanism is switched to the second state, the medical staff operates the jaw assembly 100 to open, and after the jaw assembly 100 is opened, the steering driving structure 700 is controlled to rotate the jaw assembly 100 from the bending position to the direct position. During rotation of the jaw assembly 100 from the bend-to-click position to the straight-to-click position, the proximal end of the knife bar 320 moves distally, and because the cutting knife assembly 300 is in the disengaged position, the proximal end of the knife bar 320 moves distally pulling the rack 351, and because the clutch mechanism is in the second state, the proximal end of the knife bar 320 can only pull the first rack 3511 to move distally, and the second rack 3512 does not move, yet remains coupled to the power source. The clutch mechanism is provided to enable the jaw assembly 100 to smoothly rotate to the direct-driving state.
The overall flow of surgical instrument operation when the jaw assembly 100 is rotated to a maximum angle to one side is described as follows:
after the surgical instrument has been advanced into the body, the jaw assembly 100 is in the direct-fire condition and the cutting blade assembly 300 is in the separated position. The healthcare worker first drives the jaw assembly 100 to rotate via the steering drive mechanism 700.
When the jaw assembly 100 is rotated from the direct-drive state to the maximum-rotation state, the proximal end of the knife bar 320 moves proximally, moving the cutting knife assembly 300 proximally from the disengaged position to the abutment position (from the position of fig. 17 to the position of fig. 18), the distance the cutting knife assembly 300 moves from the disengaged position to the abutment position is R, i.e., the distance the first mover 340 moves from the position of abutment with the first opening side 3522 to the position of abutment with the first groove bottom side 3521 is R. Wherein the distance of proximal movement of the first displacement member 340 is positively correlated with the angle of rotation of the jaw assembly 100, the first displacement member 340 is positioned between the first opening side 3522 and the first slot bottom side 3521 when the angle of rotation of the jaw assembly 100 to one side is less than the maximum angle.
When the jaw assembly 100 rotates to a maximum angle to one side and then is in a maximum rotation state, the jaw assembly 100 corresponds to the tissue to be clamped, and at the moment, the medical staff controls the jaw assembly 100 to be closed so as to clamp and squeeze the tissue to be clamped. The cannula assembly 400 includes an inner cannula 410 and an outer cannula 420 movably sleeved outside the inner cannula 410, and the operating assembly 800 further includes a handle 810, wherein upon completion of steering, a healthcare worker actuates the handle 810 to move the outer cannula 420 from a distal position to a proximal position, closing the jaw assembly 100.
The medical staff actuates the handle 810 to enable the jaw assembly 100 to be closed to clamp and squeeze tissues for a period of time, after squeezing is completed, the medical staff actuates the handle 810 again, and when the main control module detects that the rotating angle of the handle 810 meets the preset condition, the motor assembly 820 is controlled to drive the cutting knife assembly 300 to feed.
Before feeding, the clutch mechanism is in the first state or the second state, or the second moving member 3513 is located between the second opening side 3515 and the second slot bottom side 3516, since the cutter assembly 300 is already located in the abutment position (the position in fig. 18), the rack 351 can directly push the mandrel 330 and the cutter bar 320 to move proximally to perform feeding, and the distance of movement of the cutter assembly 300 from the initial position to the cutting bottom position is L, and the distance of movement of the first rack 3511 is L. When the feeding starts, the main control module controls the motor assembly 820 to rotate, and the motor assembly 820 drives the first gear 831 to rotate, specifically to rotate anticlockwise. If the clutch mechanism is in the second state, as shown in fig. 37, the motor assembly 820 may directly drive the second rack 3512, the first rack 3511, and the cutter assembly 300 distally for feeding. If the clutch mechanism is in the first state, as shown in fig. 36, or the second moving member 3513 is located between the second opening side 3515 and the second slot bottom side 3516, the motor assembly 820 drives the second rack 3512 to move distally, so that the clutch mechanism is switched to the second state, as shown in fig. 37, in which the second rack 3512 abuts against the first rack 3511, and when the motor assembly 820 drives the second rack 3512 to move distally, the first rack 3511 and the cutter assembly 300 can be driven to move distally for feeding. The reason why the clutch mechanism is in the first state or the second state, or the second mover 3513 is located between the second opening side 3515 and the second groove bottom side 3516 is explained below. After the main control module judges that the feeding of the cutter assembly 300 is completed, the power source is controlled to drive the cutter driving piece 350 to move proximally so as to drive the cutter assembly 300 to retract.
When the feeding is completed, the cutter assembly 300 is at the feeding bottom position, the cutter assembly 300 is at the abutting position, the clutch mechanism is in the second state, and the second moving piece 3513 is attached to the second groove bottom side 3516. When the medical staff releases the handle 810 and the main control module detects that the handle 810 is completely released, the motor assembly 820 is controlled to rotate reversely, the second rack 3512 is driven to move proximally by the motor assembly 820, when the distance of the second rack 3512 moving proximally is R, the clutch mechanism is switched to the first state (the state is switched from the state in fig. 36 to the state in fig. 37), the motor assembly 820 can drive the first rack 3511 to move proximally, because the cutter assembly 300 is in the abutting position (the position in fig. 18), the first rack 3521 attached to the first bottom side 3521 of the first accommodating groove 352, when the first rack 3511 moves proximally, the first opening side 3522 and the first bottom side 3521 move proximally along with the rack 351, the first rack 3521 is separated from the first moving member 340, when the distance of the first rack 3511 moving proximally is R, the first opening side 3522 is attached to the first moving member 340, the cutter assembly 300 is in the separating position (fig. 17), the cutter assembly 351 can be driven proximally, and the first rack 3512 and the cutter assembly 300 are still not driven to move proximally, and the cutter assembly 300 is still in the cutting position. When the rack 351 continues to move proximally to drive the cutter assembly 300 to move a distance L, the cutter assembly 300 returns to the initial position and the retracting is completed. Thus, during retraction, the first rack 3511 moves proximally a distance r+l and the second rack 3512 moves proximally a distance 2r+l.
When the retracting is completed, the cutter assembly 300 is at the initial position, the cutter assembly 300 is at the separating position, and the clutch mechanism is at the first state. After the main control module determines that the tool retracting is completed, the motor assembly 820 is controlled to rotate reversely, and the second rack 3512 is driven to move distally to abut against the first rack 3511, so that the clutch mechanism is switched to the second state.
After the retracting is completed, the healthcare worker operates the jaw opening assembly 900 to open the jaw assembly 100 and release the tissue.
After the jaw assembly 100 is opened, the cutter assembly 300 is in the separated position, the clutch mechanism is in the second state, the medical staff operates the steering driving assembly 700 to rotate the jaw assembly 100 to the straight state, during the process that the jaw assembly 100 rotates from the maximum rotating state of the bent state to the straight state, the movement of the proximal end of the cutter assembly 300 is opposite to the process that the jaw assembly 100 rotates from the straight state to the maximum rotating state, the distance of distal movement of the proximal end (the first moving member 340) of the cutter assembly 300 is R, and when the cutter assembly 300 is in the separated position (the position in fig. 17), the first moving member 340 is moved distally by pulling the second rack 3512 through abutting against the first opening side 3522, the movement distance is R. In this process, the first rack 3511 is kept in place, the second rack 3512 moves until the second moving member 3513 engages the second opening side 3515, and the clutch mechanism is switched to the first state. The jaw assembly 100 is in a direct-lit condition and a medical professional can remove surgical instruments from the body. When the stapler is used again to cut the tissue, the clutch mechanism is in the first state before feeding. If the jaw assembly 100 is always in the direct-open state when the stapler is used this time, after the retracting is completed, the clutch mechanism is switched to the second state, and then the jaw assembly 100 is opened, and when the stapler is used again to cut tissue, the clutch mechanism is in the second state. If the jaw assembly 100 is in the middle state of the bending state (the included angle between the jaw assembly 100 and the sleeve assembly 400 is smaller than the maximum angle) to clamp the tissue when the stapler is used this time, after the retracting is completed, the clutch mechanism is switched to the second state, the jaw assembly 100 rotates to the direct-opening position, the first moving member 340 drives the second rack 3512 to move distally by a distance smaller than R, the second moving member 3513 in the clutch mechanism is located between the second opening side 3515 and the second groove bottom side 3516, and when the stapler is used again to cut the tissue, the second moving member 3513 in the clutch mechanism is located between the second opening side 3515 and the second groove bottom side 3516.
The overall flow of surgical instrument operation when the jaw assembly 100 is rotated to a maximum angle to one side is described as follows:
after the surgical instrument has been advanced into the body, the jaw assembly 100 is in the direct-fire condition and the cutting blade assembly 300 is in the separated position. The healthcare worker first drives the jaw assembly 100 to rotate via the steering drive mechanism 700.
When the jaw assembly 100 is rotated from the direct-drive state to the maximum-rotation state, the proximal end of the knife bar 320 moves proximally, moving the cutting knife assembly 300 proximally from the disengaged position to the abutment position (from the position of fig. 17 to the position of fig. 18), the distance the cutting knife assembly 300 moves from the disengaged position to the abutment position is R, i.e., the distance the first mover 340 moves from the position of abutment with the first opening side 3522 to the position of abutment with the first groove bottom side 3521 is R. Wherein the distance of proximal movement of the first displacement member 340 is positively correlated with the angle of rotation of the jaw assembly 100, the first displacement member 340 is positioned between the first opening side 3522 and the first slot bottom side 3521 when the angle of rotation of the jaw assembly 100 to one side is less than the maximum angle.
When the jaw assembly 100 rotates to a maximum angle to one side and then is in a maximum rotation state, the jaw assembly 100 corresponds to the tissue to be clamped, and at the moment, the medical staff controls the jaw assembly 100 to be closed so as to clamp and squeeze the tissue to be clamped. The cannula assembly 400 includes an inner cannula 410 and an outer cannula 420 movably sleeved outside the inner cannula 410, and the operating assembly 800 further includes a handle 810, wherein upon completion of steering, a healthcare worker actuates the handle 810 to move the outer cannula 420 from a distal position to a proximal position, closing the jaw assembly 100.
The medical staff actuates the handle 810 to enable the jaw assembly 100 to be closed to clamp and squeeze tissues for a period of time, after squeezing is completed, the medical staff actuates the handle 810 again, and when the main control module detects that the rotating angle of the handle 810 meets the preset condition, the motor assembly 820 is controlled to drive the cutting knife assembly 300 to feed.
Before feeding, the clutch mechanism is in the first state or the second state, or the second moving member 3513 is located between the second opening side 3515 and the second slot bottom side 3516, and since the cutter assembly 300 is already located in the abutment position (the position in fig. 18), the second rack 3512 can be directly pushed to move the mandrel 330 and the cutter bar 320 proximally to perform feeding, and the distance of movement of the cutter assembly 300 from the initial position to the cutting bottom position is L, and the distance of movement of the second rack 3512 distally is L. At the beginning of the feeding, the main control module controls the motor assembly 820 to rotate, and the motor assembly 820 drives the first rack 3511 to move distally. If the clutch mechanism is in the second state, as shown in fig. 37, the motor assembly 820 may directly drive the first rack 3511, the second rack 3512, and the cutter assembly 300 distally for feeding. If the clutch mechanism is in the first state, as shown in fig. 36, or the second moving member 3513 is located between the second opening side 3515 and the second slot bottom side 3516, as shown in fig. 36 and 37, the motor assembly 820 drives the first rack 3511 to move distally, so that the clutch mechanism is switched to the second state, as shown in fig. 37, in which the second rack 3512 abuts against the first rack 3511, and when the motor assembly drives the first rack 3511 to move distally, the second rack 3512 and the cutter assembly 300 can be driven to move distally to perform feeding. The reason why the clutch mechanism is in the first state or the second state, or the second mover 3513 is located between the second opening side 3515 and the second groove bottom side 3516 is explained below.
After the main control module judges that the feeding of the cutter assembly 300 is completed, the power source is controlled to drive the cutter driving piece 350 to move proximally so as to drive the cutter assembly 300 to retract.
When the feeding is completed, the cutter assembly 300 is at the feeding bottom position, the cutter assembly 300 is at the abutting position, the clutch mechanism is in the second state, and the second moving piece 3513 is attached to the second groove bottom side 3516. When the medical staff releases the handle 810 and the main control module detects that the handle 810 is completely released, the motor assembly 820 is controlled to rotate reversely, the second rack 3512 is driven to move proximally, when the distance of the second rack 3512 moving proximally is R, the clutch mechanism is switched to the first state (the state is switched from the state in fig. 37 to the state in fig. 36), the motor assembly 820 can drive the first rack 3511 to move proximally, because the cutter assembly 300 is in the abutting position (the position in fig. 18), the first rack 3521 attached to the first slot bottom side 3521 of the first accommodating slot 352, when the first rack 3511 moves proximally, the first opening side 3522 and the first slot bottom side 3521 move proximally along with the rack 351, the first slot bottom side 3521 is separated from the first moving member 340, when the distance of the first rack moving proximally is R, the first opening side 3522 is attached to the first moving member 340, the cutter assembly 300 is in the separating position (the position in fig. 17), the cutter assembly 351 can be driven proximally, and the first rack 3522 and the first rack 3512 and the cutter assembly 300 are still not driven to move proximally, and the cutter assembly 300 is still in the cutting position. When the rack 351 continues to move proximally to drive the cutter assembly 300 to move a distance L, the cutter assembly 300 returns to the initial position and the retracting is completed. Thus, during retraction, the first rack 3511 moves proximally a distance r+l and the second rack 3512 moves proximally a distance 2r+l.
When the retracting is completed, the cutter assembly 300 is at the initial position, the cutter assembly 300 is at the separating position, and the clutch mechanism is at the first state. After the main control module determines that the tool retracting is completed, the motor assembly 820 is controlled to rotate reversely, and the second rack 3512 is driven to move distally to abut against the first rack 3511, so that the clutch mechanism is switched to the second state.
After the retracting is completed, the healthcare worker operates the jaw opening assembly 900 to open the jaw assembly 100 and release the tissue.
After the jaw assembly 100 is opened, the cutter assembly 300 is at the separation position, the clutch mechanism is at the second state, the medical staff operates the steering driving device to rotate the jaw assembly 100 to the straight state, in the process that the jaw assembly 100 rotates from the maximum rotation state of the bent state to the straight state, the movement of the proximal end of the cutter assembly 300 is opposite to the process that the jaw assembly 100 rotates from the straight state to the maximum rotation state, the distance of the distal movement of the proximal end (the first moving member 340) of the cutter assembly 300 is R, and when the cutter assembly 300 is at the separation position (the position in fig. 17), the first moving member 340 moves distally by pulling the first rack 3511 through the abutting with the first opening side 3522, the movement distance is R. In this process, the second rack 3512 is kept in place, the first rack 3511 moves until the second moving member 3513 engages the second opening side 3515, and the clutch mechanism is switched to the first state. The jaw assembly 100 is in a direct-lit condition and a medical professional can remove surgical instruments from the body. When the stapler is used again to cut the tissue, the clutch mechanism is in the first state before feeding. If the jaw assembly 100 is always in the direct-open state when the stapler is used this time, after the retracting is completed, the clutch mechanism is switched to the second state, and then the jaw assembly 100 is opened, and when the stapler is used again to cut tissue, the clutch mechanism is in the second state. If the jaw assembly 100 is in the middle state of the bending state (the included angle between the jaw assembly 100 and the sleeve assembly 400 is smaller than the maximum angle) to clamp the tissue when the stapler is used this time, after the retracting is completed, the clutch mechanism is switched to the second state, the jaw assembly 100 rotates to the direct-opening position, the first moving member 340 drives the first rack 351 to move distally for a distance smaller than R, the second moving member 3513 in the clutch mechanism is located between the second opening side 3515 and the second groove bottom side 3516, and when the stapler is used again to cut the tissue, the second moving member 3513 in the clutch mechanism is located between the second opening side 3515 and the second groove bottom side 3516.
The overall flow of surgical instrument operation with the jaw assembly 100 always in the direct-fire state is described as follows:
after the surgical instrument is advanced into the body, the jaw assembly 100 is in the direct-fire state, with the clutch mechanism in the first or second state, or with the second mover 3513 positioned between the second open side 3515 and the second slot bottom side 3516, and the cutter assembly 300 in the disengaged position.
The healthcare worker controls the jaw assembly 100 to close, clamping and squeezing the assembly to be clamped. After the compression is completed, the healthcare worker again actuates the handle 810 to feed.
Prior to feeding, with the cutter assembly 300 in the disengaged position (position in fig. 17), the distal movement of the rack 351 cannot directly push the spindle 330 and knife bar 320 distally for feeding. When the feeding starts, the main control module controls the motor assembly 820 to rotate, the motor assembly 820 drives the second gear to move distally, if the clutch mechanism is in the first state, the second rack 3512 moves distally to switch the clutch mechanism to the second state, and in the second state, as shown in fig. 37, the motor assembly 820 can drive the first rack 3511 to move distally, and further drive the second rack 3512 to move distally. If the clutch mechanism is in the second state, the first rack 3511 abuts the second rack 3512, and the motor assembly 820 can directly drive the second rack 3512 to move distally. When the first rack 3511 is moved distally a distance R, the cutter assembly 300 is in the rest position (the position in fig. 18), and the rack 351 is moved distally to drive the cutter assembly 300 to advance, the distance the cutter assembly 300 advances from the initial position to the end of travel is L, and during advance, the second rack 3512 is moved distally a distance l+r.
When the feeding is completed, the cutter assembly 300 is at the feeding bottom position, the cutter assembly 300 is at the abutting position, the clutch mechanism is in the second state, and the second moving piece 3513 is attached to the second groove bottom side 3516. When the medical staff releases the handle 810 and the main control module detects that the handle 810 is completely released, the motor assembly 820 is controlled to rotate reversely, the second rack 3512 is driven to move proximally by the motor assembly 820, when the distance of the second rack 3512 moving proximally is R, the clutch mechanism is switched to the first state (the state is switched from the state in fig. 37 to the state in fig. 36), the motor assembly 820 can drive the second rack 3512 to move proximally, because the cutter assembly 300 is in the abutting position (the position in fig. 18), the first rack 3521 attached to the first accommodating groove 352 is attached to the second rack 3512, when the second rack 3512 moves proximally, the first opening side 3522 and the first rack 3521 move proximally along with the rack 351, the first rack 3521 is separated from the first moving member 340, when the distance of the second rack 3512 moving proximally is R, the first opening side 3522 is attached to the first moving member 340, the cutter assembly 300 is in the separating position (fig. 17), the cutter assembly 351 can be driven proximally, and the first rack 3512 and the cutter assembly 300 are still not driven to move proximally, and the cutter assembly 300 is still in the cutting position when the first rack 3512 is not driven to move. When the rack 351 continues to move proximally to drive the cutter assembly 300 to move a distance L, the cutter assembly 300 returns to the initial position and the retracting is completed. Thus, during retraction, the first rack 3511 moves proximally a distance 2r+l and the second rack 3512 moves proximally a distance r+l. After the main control module determines that the tool retracting is completed, the motor assembly 820 is controlled to rotate reversely, and the first rack 3511 is driven to move distally until abutting against the second rack 3512, so that the clutch mechanism is switched to the second state.
After the retracting is completed, the healthcare worker operates the jaw opening assembly 900 to open the jaw assembly 100 and release the tissue. The jaw assembly 100 is in a direct-lit condition and a medical professional can remove surgical instruments from the body.
Example 3
The surgical instrument according to the third embodiment of the present application is substantially the same as the first embodiment, and the main difference is that the clutch mechanism has a different structure, in this embodiment, as shown in fig. 38 to 41, the clutch mechanism includes a pushing member 850, and in the driving gear structure 830, a first gear 831 is fixedly connected to a second gear 832, and the first gear 831 is driven to rotate by the motor assembly 820 to drive the second gear 832 to rotate synchronously.
When the clutch mechanism is in the first state, the pushing member 850 is in the separated position, the driving gear structure 830 is connected with the cutter assembly 300, specifically, the second gear 832 is connected with the rack 351, so as to realize the coupling between the power source and the cutter assembly 300, and the power source can drive the rack 351 and the cutter assembly 300 to move proximally. When the clutch mechanism is switched from the first state to the second state, the pushing member 850 moves from the disengaged position to the pressing position, specifically toward the driving gear structure 830, the pushing member 850 pushes the driving gear structure 830 to move, uncouples the driving gear structure 830 from the cutter assembly 300, specifically uncouples the second gear 832 from the rack 351, the power source cannot drive the rack 351 and the cutter assembly 300 to move, and the rack 351 can move relative to the power source, in response to the jaw assembly 100 rotating from the bent state to the straight state, the proximal end of the cutter assembly 300 and the rack 351 are reset distally. During the feeding and retracting process, the clutch mechanism is in a first state, so that the power source is connected with the rack 351 and the cutter assembly 300, and the power source can drive the cutter assembly 300 to feed or retract. After the tool withdrawal is completed, if the motor assembly 820 is connected to the rack 351 through the driving gear structure 830, the motor assembly 820 is stopped and locks the driving gear structure 830 and the rack 351 by its own resistance, so that the driving gear structure 830 cannot rotate and the rack 351 cannot move. Thus, after the retracting is completed, the clutch mechanism is switched to the second state, the driving gear structure 830 is disengaged from the rack 351, and the locking of the rack 351 and the cutter assembly 300 by the motor assembly 820 is released. During the process of switching the jaw assembly 100 from the bent beating state to the straight beating state, the proximal end of the cutter assembly 300 can be smoothly reset distally, pulling the rack 351 to reset distally, since the motor assembly 820 is disconnected from the rack 351. The driving gear structure 830 includes a fixed shaft 833 and a return spring 834, the fixed shaft 833 is fixedly disposed on the frame 600, the first gear 831 and the second gear 832 can both rotate around the axis of the fixed shaft 833 and can move along the axis direction of the fixed shaft 833, and preferably, the first gear 831 and the second gear 832 are both engaged with the fixed shaft 833 through keys.
The clutch mechanism further comprises a driving member and a pressing portion 860, the pressing portion 860 is located on the upper side of the second gear 832, the pushing member 850 is connected to the pressing portion 860, and when the clutch mechanism is in the first state, the second gear 832 is meshed with the rack 351. The driving member drives the pushing member 850 to move and push the pressing portion 860 to move downward, so as to push the second gear 832 to move downward to disengage from the rack 351, so that the clutch mechanism is switched to the second state, in which the second gear 832 is disengaged from the rack 351 and is no longer locked by the motor assembly 820, and when the jaw assembly rotates from the bending state to the direct-beating state, the proximal end of the knife bar 320 can pull the rack 351 to move distally, so that the jaw assembly 100 can be switched to the direct-beating state smoothly.
In a preferred embodiment, the driving member includes an electric motor 870, an output shaft of the electric motor 870 is connected to the pushing member 850, and the electric motor 870 is electrically connected to the main control module and controlled by the main control module to start or stop. The motor is fixedly arranged on the frame 600, and when the main control module controls the motor 870 to rotate, the motor drives the pushing piece 850 to rotate so as to switch the clutch mechanism to the second state.
The pusher 850 is a cam having a lower portion, an upper portion, and an arcuate surface 851 connected between the lower portion and the upper portion, the upper portion being spaced from the cam rotation axis a greater distance than the lower portion. When the clutch mechanism is in the first state, the lower portion of the pushing member 850 abuts against the pressing portion 860, and when the clutch mechanism is switched from the first state to the second state, the pushing member 850 rotates to abut against the pressing portion 860 through the upper portion, so that the pressing portion 860 moves downward, and the second gear 832 is pushed to move downward to be disengaged from the rack 351.
When retracting the cutter, the motor 870 is in a stop state, the clutch structure is in a first state, the main control module controls the motor assembly 820 to drive the rack 351 to move proximally, the state of the motor assembly 820 is detected through the state detection module, after the main control module judges that the motor is locked, the rack 351 retracts proximally to a limit position, at the moment, the main control module controls the motor assembly 820 to stop and controls the motor 870 to rotate, the motor 870 drives the pushing piece 850 to rotate until the clutch assembly is in a second state, the main control module controls the motor 870 to stop, and the pushing piece 850 is locked after the motor 870 stops, so that the clutch mechanism is kept in the second state.
After the jaw assembly 110 is opened, the clutch structure is in the second state, the cutter assembly 300 is in the separation position, the medical staff operates the steering driving assembly 700 to rotate the jaw assembly 100 from the bending state to the direct-beating state, the proximal end of the cutter bar 320 moves distally, and the rack 351 is pulled to move distally, so that the jaw assembly 100 rotates smoothly and is switched to the direct-beating state.
Further, the driving gear structure 830 further includes a return spring 834, where the return spring 834 is sleeved on the fixed shaft 833. One end of the clutch mechanism is connected to the rack 600, the other end of the clutch mechanism is connected to the first gear 831, when the clutch mechanism is in the second state, the first gear 831 and the second gear 832 are positioned below the rack 351, and the return spring 834 is compressed; when the clutch mechanism is switched from the second state to the first state, the return spring 834 is released, the first gear 831 and the second gear 832 move upwards under the action of elastic force, so that the second gear 832 is meshed with the rack 351, and when the clutch mechanism is in the first state, the pressing part 860 presses the second gear 832, so that the second gear 832 is in a position matched with the rack 351.
It should be noted that, when the jaw assembly 100 is in the open state, the clutch mechanism is in the second state, and after the jaw assembly 100 is in the closed state, the main control module controls the motor to rotate, so that the clutch mechanism is switched to the first state, the rack 351 is meshed with the second gear 832, the motor assembly 820 is in driving connection with the rack 351, and the rack 351 can be driven to move for feeding. Specifically, the stand 600 is provided with a limiting member and a switching member, the switching member is electrically connected with the main control module, when the jaw assembly 100 is switched from the open state to the closed state, the link assembly 610 is switched from the first position to the second position, the link assembly 610 drives the limiting member to move so that the limiting member is switched from the locking position to the unlocking position, when the jaw assembly 100 is in the closed state, the limiting member is in the unlocking state, the switching member is triggered, the switching member sends an electrical signal to the main control module, the main control module receives the electrical signal sent by the switching member and then controls the motor to start, and the pushing member 850 is driven to rotate so that the clutch mechanism is switched to the first state. In another embodiment, as shown in fig. 42 and 43, the driving member includes an operation portion 840, where the operation portion 840 is a rod, and is rotatably disposed on the stand 600 and extends out of the housing of the operation assembly, and the medical staff rotates the operation portion 840 to switch the clutch mechanism from the first state to the second state. The operation part 840 is connected with the pushing member 850 through a transmission shaft, the pushing member 850 is driven to rotate through the transmission shaft when the operation part 840 is operated, the pushing member is a cam, the cam is provided with a low part, a high part and an arc surface 851 connected between the low part and the high part, and the distance between the high part and the rotation axis of the cam is larger than that between the low part and the rotation axis of the cam. When the clutch mechanism is in the first state, the lower portion of the pushing member 850 abuts against the pressing portion 860, and when the clutch mechanism is switched from the first state to the second state, the pushing member 850 rotates to abut against the pressing portion 860 through the upper portion, so that the pressing portion 860 moves downward, and the second gear 832 is pushed to move downward to be disengaged from the rack 351.
Further, as shown in fig. 40, the pushing member 850 forms a locking surface 852 at the upper portion, the locking surface 852 is a plane, the pressing portion 860 has an upper surface 861, the upper surface 861 is also a plane, when the clutch mechanism is in the second state, the pushing member 850 is engaged with the upper surface 861 through the locking surface 852, the pushing member 850 is rotationally locked, at this time, the medical staff releases the operating portion 840, the locking surface 852 is engaged with the upper surface 861, so that the pushing member 850 cannot continue to rotate, the clutch mechanism is kept in the second state, and the medical staff can operate the steering driving assembly 700 to rotate the jaw assembly 100 from the bent state to the straight state. After the steering is completed, the medical staff can rotate the operation part 840, the direction of the rotation operation part 840 is anticlockwise, and the direction of the process of switching the clutch mechanism from the first state to the second state is opposite, so that the pushing piece 850 rotates relative to the pressing part 860, and further the clutch mechanism is switched from the second state to the first state, and the second gear 832 is meshed with the rack 351, so that the anastomat can be reused.
It should be noted that the motor assembly 820 includes an output shaft 821 and an output gear 822, when the clutch mechanism is in a first state, the output gear 822 is meshed with the first gear 831, and when the clutch mechanism is switched to a second state, the first gear 831 and the second gear 832 move downward, so as to avoid interference of the output gear 822 on the second gear 832 moving downward, in an embodiment, the outer diameter of the second gear 832 is smaller than that of the first gear 831, and a certain space is still provided between the second gear 832 and the output gear 822 in a radial direction after the second gear 832 moves downward, so that the output gear 822 will not interfere with the second gear 832 moving downward. In another embodiment, the second gear 832 can be meshed with the output gear 822 during the downward movement, so that the output gear 822 will not interfere with the downward movement of the second gear 832, the number of teeth, the modulus and the gear size of the second gear 832 and the first gear 831 are the same, the teeth of the first gear 831 are aligned with the teeth of the second gear 832 one by one in the axial direction, and the output gear 822 matched with the first gear 831 can be smoothly meshed with the second gear 832, so that the output gear 822 will not interfere with the downward movement of the second gear 832.
After the tool retracting is completed, the main control module controls the motor assembly 820 to stop, and the medical staff can switch the clutch mechanism to the second state by rotating the operation part 840, so that the locking of the motor assembly 820 to the rack 351 is released. When the jaw assembly 100 is subsequently turned from the bent state to the straight state, the cutter assembly 300 can drive the rack 351 to reset smoothly distally.
Example 4
The surgical instrument according to the fourth embodiment of the present application is substantially the same as the first embodiment, and the main difference is that the safety assembly 500 has a different structure, in this embodiment, as shown in fig. 44 to 46, the safety member 510 of the safety assembly 500 may be slidably disposed on the frame 600, the sliding direction of the safety member 510 is the axial direction (horizontal direction) of the sleeve assembly 400, the direction of the rack 351 is the same as the direction of retracting the rack 351 proximally, and the elastic member is horizontally disposed and connected between the safety member 510 and the frame 600.
The rack 351 has a driving portion 353, and when the rack 351 is in the feed position, the safety member 510 abuts against the flange 912 of the release button 910, and the driving portion 353 abuts against the distal end of the safety member 510. During retracting, when the rack 351 moves from the feeding position to the initial position, the driving part 353 pushes the safety member 510 to move proximally, the elastic member is compressed, the safety member 510 is separated from the flange 912, the safety member 510 does not interfere with the rack 351 moving proximally, and the safety assembly 500 is switched to the unlocking state. When the rack 351 moves from the initial position to the limit tool withdrawal position, the driving part 353 pushes the safety member 510 to move proximally to further compress the elastic member, and the safety assembly 500 is always in an unlocking state in the process, and the safety member 510 is separated from the flange 912 and does not interfere with the rack 351 which moves proximally; when the jaw assembly 100 rotates from the maximum rotation state to the direct-beating state, the cutter assembly 300 moves distally to drive the rack 351 to move from the limit retracting position to the initial position, the elastic element is released, the safety element 510 is pushed to slide distally and prop against the driving part 353, and the safety element 510 is always in the unlocking state in the process. During the feeding process, when the rack 351 moves from the initial position to the feeding position, the elastic member is released, and the safety member 510 is pushed to slide distally, so that the safety member 510 abuts against the flange 912, and the safety assembly 500 is switched to the locking state; the safety assembly 500 remains in the locked state as the rack 351 moves distally from the initial position.
It should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is for clarity only, and that the skilled artisan should recognize that the embodiments may be combined as appropriate to form other embodiments that will be understood by those skilled in the art.
The above list of detailed descriptions is only specific to practical embodiments of the present invention, and they are not intended to limit the scope of the present invention, and all equivalent embodiments or modifications that do not depart from the spirit of the present invention should be included in the scope of the present invention.
Claims (14)
1. A surgical instrument, comprising: the cutting tool comprises a jaw assembly, a sleeve assembly, a cutting tool assembly, a power source and a clutch mechanism, wherein the jaw assembly is rotatably connected to the sleeve assembly, and when the jaw assembly is in a direct-beating state, the length direction of the jaw assembly is collinear with the axis of the sleeve assembly; when the jaw assembly is in a bending state, the length direction of the jaw assembly and the axial direction of the sleeve assembly form a certain angle; the proximal end of the cutter assembly moves proximally when the jaw assembly rotates from the straight-strike condition to the curved-strike condition;
The power source is coupled with or uncoupled from the cutter assembly through the clutch mechanism; the clutch mechanism has a first state in which the power source is coupled to the cutter assembly and a second state in which the cutter assembly moves proximally in response to actuation of the power source; in the second state, the power source is decoupled from the cutter assembly, and the proximal end of the cutter assembly is distally reset in response to rotation of the jaw assembly from the bent-over state to the straight-over state.
2. The surgical instrument of claim 1, wherein the power source comprises a motor assembly and a drive gear structure coupled to the motor assembly, the drive gear structure comprising a first gear coupled to the motor assembly, a second gear coupled to the cutter assembly, the first gear coupled to the second gear via the clutch mechanism;
when the clutch mechanism is in the first state, the first gear is connected with the second gear in a first connection mode so that the power source is coupled with the cutter assembly, and when the motor assembly drives the first gear to rotate along a first direction, the second gear and the first gear synchronously rotate so as to drive the cutter assembly to move proximally;
When the clutch mechanism is in the second state, the first gear is connected to the second gear in a second connection mode so that the power source is decoupled from the cutter assembly, the proximal end of the cutter assembly is reset distally in response to rotation of the jaw assembly from the bending state to the straight state, and the second gear is driven to move relative to the first gear along a second direction opposite to the first direction.
3. The surgical instrument of claim 2, wherein the first gear and the second gear are coaxially disposed, the clutch mechanism comprising a rib and a groove, one of the first gear and the second gear being provided with the rib, the other of the first gear and the second gear being provided with the groove, the rib being rotatably disposed within the groove, the groove having a first side wall and a second side wall disposed in a circumferential array of the first gear or the second gear, the first gear being connected to the second gear in the first connection when the rib is in abutment with the first side wall; when the convex rib abuts against the second side wall, the first gear is connected with the second gear in the second connection mode.
4. The surgical instrument of claim 2, further comprising a master control module electrically connected to the motor assembly;
the clutch mechanism is in the first state, and after the main control module controls the motor assembly to drive the cutting knife assembly to move proximally to the limit position, the main control module controls the motor assembly to drive the first gear to rotate along the second direction, so that the clutch mechanism is switched from the first state to the second state.
5. The surgical instrument of claim 1, wherein the power source comprises a motor assembly and a drive gear structure coupled to the motor assembly, the drive gear structure being detachably coupled to the cutting blade assembly;
the clutch mechanism comprises a pushing piece, when the clutch mechanism is in the first state, the pushing piece is located at a separation position, and the driving gear structure is connected with the cutting knife assembly so that the power source is coupled with the cutting knife assembly; when the clutch mechanism is switched from the first state to the second state, the pushing piece moves from the separation position to the pressing position to push the driving gear structure to move, so that the driving gear structure is separated from the cutting knife assembly, and the power source is decoupled from the cutting knife assembly.
6. The surgical instrument of claim 5, wherein the clutch mechanism further comprises a drive member disposed on the frame and coupled to the pusher member, and an abutment portion abutting the drive gear structure, the pusher member having a lower portion and an upper portion, the clutch mechanism in the first state, the pusher member being in the disengaged position, the lower portion abutting the abutment portion, the drive gear structure being coupled to the cutter assembly; in response to the driving of the driving piece, the pushing piece rotates to the pressing position, the pressing portion is pressed by the high portion, so that the pressing portion and the driving gear structure are driven to move, the driving gear structure is separated from the cutting knife assembly, and the clutch mechanism is switched from the first state to the second state.
7. The surgical instrument of claim 6, wherein the drive gear structure further comprises a return spring having one end connected to the frame and the other end connected to the drive gear structure, the return spring being compressed when the pusher member is switched from the disengaged position to the depressed position to drive the drive gear structure into movement away from the cutter assembly; when the pushing piece is switched from the pressing position to the separating position, the reset spring is released to drive the driving gear structure to move so that the driving gear structure is connected with the cutting knife assembly.
8. The surgical instrument of claim 1, further comprising a rack coupled to the cutting blade assembly, the power source coupled to the cutting blade assembly via the rack, the clutch mechanism being in a first state, the power source coupled to the cutting blade assembly; when the clutch mechanism is in the second state, the power source is decoupled from the cutter assembly.
9. The surgical instrument of claim 8, wherein the rack and the cutter assembly are movably coupled, the cutter assembly having an abutment position with respect to the rack in which the cutter assembly abuts the rack and a separation position in which the cutter assembly is relatively separated from the rack;
the power source drives the rack to move proximally to enable the cutting knife assembly to be in the separation position when the cutting knife assembly is retracted, and the power source drives the rack to move distally to enable the cutting knife assembly to be in the abutting position when the cutting knife assembly is fed.
10. The surgical instrument of claim 9, wherein one of the rack and the cutter assembly defines a first pocket, and the other defines a first movable member movably disposed within the first pocket, the first pocket including a first open side and a first slot bottom side aligned along a length of the first pocket, the cutter assembly being in the disengaged position when the first movable member is engaged with the first open side and the cutter assembly being in the abutted position when the movable member is engaged with the first slot bottom side.
11. The surgical instrument of claim 8, wherein the rack comprises separable first and second racks, the first rack being coupled to the power source and the second rack being coupled to the cutting blade assembly, the clutch mechanism comprising a second pocket and a second moveable member, one of the first and second racks defining a second pocket, the other of the first and second racks defining a second moveable member, the second pocket comprising a second open side and a second pocket bottom side aligned along a length of the second pocket;
when the second moving piece is attached to the second opening side, the first rack and the second rack are separated relatively, the power source is coupled with the cutting knife assembly, and the clutch mechanism is in the first state; when the second moving piece is attached to the bottom side of the second groove, the first rack abuts against the second rack, the power source is decoupled from the cutter assembly, and the clutch mechanism is in the second state.
12. The surgical instrument is characterized by comprising a jaw assembly, a sleeve assembly, a cutter driving piece, a motor assembly, a main control module, a travel recording module and a state detection module, wherein the main control module is electrically connected with the motor assembly, is electrically connected with the travel recording module and the state detection module, the motor assembly is connected with the cutter driving piece, the cutter driving piece is connected with the cutter assembly, and the main control module controls the motor assembly to drive the cutter driving piece to move so as to drive the cutter assembly to move;
The jaw assembly is rotatably connected with the sleeve assembly, and when the jaw assembly is in a direct-beating state, the length direction of the jaw assembly is collinear with the axis of the sleeve assembly; when the jaw assembly is in a maximum angle state, the length direction of the jaw assembly and the axial direction of the sleeve assembly form a certain angle, and when the jaw assembly rotates from the direct-beating state to the maximum angle state, the proximal end of the cutter assembly moves proximally;
when the motor assembly drives the cutter assembly to move towards the far end, the travel recording module obtains an output value representing the azimuth state of the cutter driving piece and sends the output value to the main control module; the main control module judges that the output value is larger than or equal to the second value and smaller than or equal to the first value, and meets a first preset condition;
the first value is indicative of an azimuthal state of the cutting blade drive when the cutting blade assembly is moved distally to a bottom-cut position when the jaw assembly is in a direct-beat state; the second value is indicative of an azimuthal state of the cutting blade drive when the cutting blade assembly is moved distally to the bottom-cut position when the jaw assembly is in the maximum rotational state;
The state detection module acquires a state signal used for representing the state of the motor assembly and sends the state signal to the main control module, and the main control module judges whether the motor assembly is locked or not according to the state signal; when the first preset condition is met and the main control module judges that the motor assembly is locked, the main control module controls the motor assembly to stop or controls the motor assembly to drive the cutter assembly to move towards the proximal end.
13. The surgical instrument of claim 12, wherein the output value indicative of the azimuthal state of the cutting blade drive is a feed stroke of the cutting blade drive or a position of the cutting blade drive.
14. The surgical instrument of claim 12, further comprising a zero switch, wherein the cutting blade drive is moved distally a preset distance to a feed position in which the zero switch sends a zero signal to the master control module, and wherein the master control module clears the output value upon receiving the zero switch.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202310988709.6A CN117257379A (en) | 2023-08-07 | 2023-08-07 | Surgical instrument |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202310988709.6A CN117257379A (en) | 2023-08-07 | 2023-08-07 | Surgical instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
CN117257379A true CN117257379A (en) | 2023-12-22 |
Family
ID=89203438
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN202310988709.6A Pending CN117257379A (en) | 2023-08-07 | 2023-08-07 | Surgical instrument |
Country Status (1)
Country | Link |
---|---|
CN (1) | CN117257379A (en) |
-
2023
- 2023-08-07 CN CN202310988709.6A patent/CN117257379A/en active Pending
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US11890029B2 (en) | Motor-driven surgical cutting and fastening instrument | |
US11000275B2 (en) | Surgical instrument | |
CN110099619B (en) | Lockout device for surgical end effector and replaceable tool assembly | |
JP6862352B2 (en) | Surgical instrument with gradual rotary drive system | |
JP6640092B2 (en) | Surgical cutting and stapling methods | |
US7143923B2 (en) | Surgical stapling instrument having a firing lockout for an unclosed anvil | |
KR20210132146A (en) | Surgical Stapling Instrument with 2-Position Lockout Mechanism | |
JP5154060B2 (en) | Surgical instrument having a lockout mechanism and a lockout mechanism | |
US7044352B2 (en) | Surgical stapling instrument having a single lockout mechanism for prevention of firing | |
US20070010838A1 (en) | Surgical stapling instrument having a firing lockout for an unclosed anvil | |
CN110099618B (en) | Articulatable surgical stapling instrument | |
CN112617939A (en) | Cutting knife guard plate assembly, anastomat and steering control method | |
JP6957500B2 (en) | Circular staple fastening system including load control | |
CN117257379A (en) | Surgical instrument | |
CN217488731U (en) | Manual anastomat | |
CN108209999B (en) | End effector and surgical instrument | |
CN115153703A (en) | Shifting type secondary-firing prevention safety mechanism of endoscope linear cutting anastomat | |
CN110099613B (en) | Surgical stapling instrument and replaceable tool assembly therefor | |
CN117100342B (en) | Surgical instrument | |
CN117100344A (en) | Surgical instrument | |
CN111345862A (en) | Firing mechanism and anastomat | |
CN218009830U (en) | Surgical instrument | |
CN117100343A (en) | Surgical instrument | |
CN117100345A (en) | Surgical instrument | |
CN117481724A (en) | Surgical instrument |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination |