CN101268954A - 具有电活化聚合物致动的单锁定机构的外科缝合器械 - Google Patents

具有电活化聚合物致动的单锁定机构的外科缝合器械 Download PDF

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CN101268954A
CN101268954A CNA2007101630643A CN200710163064A CN101268954A CN 101268954 A CN101268954 A CN 101268954A CN A2007101630643 A CNA2007101630643 A CN A2007101630643A CN 200710163064 A CN200710163064 A CN 200710163064A CN 101268954 A CN101268954 A CN 101268954A
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K·多尔
M·E·塞特瑟
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Ethicon Endo Surgery Inc
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    • 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
    • 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
    • A61B17/07207—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 the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • 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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0801—Prevention of accidental cutting or pricking
    • A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0814—Preventing re-use

Abstract

本发明涉及具有电活化聚合物致动的单锁定机构的外科缝合器械，其包括E形梁击发杆，在远端击发运动过程中击发杆接合通道并选择性接合钉砧，其中组织被切割和缝合，缝钉从钉仓向上驱动以抵靠钉砧成形。特别是，与钉仓成一体的楔形件由击发杆的中间销向远端驱动以进行缝合。缝钉通道的单锁定装置响应于处于未击发位置中的楔形滑块，以允许击发杆击发。否则，当钉仓缺失或者用尽时单锁定装置防止击发。此外，一些方案包括电活化聚合物(EAP)致动器，其形成相对于缝钉通道中的倾斜凹槽的抵接表面或者作为活板门，以阻塞击发杆，作为一种或多种状况下防止击发的主动方式。

Description

具有电活化聚合物致动的单锁定机构的外科缝合器械
相关申请的交叉引用
本申请是Frederick E.Shelton IV，Michael Earl Setser和William Bruce Weisenburgh II于2003年5月20日提交的申请号为10/441424、题为“SURGICAL STAPLINGI NSTRUMENT HAVING ASINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利申请的部分继续申请，该美国专利申请的内容通过全文引用而包含于本申请中。
本申请要求Shelton IV于2004年7月28日提交的申请号为60/591694、题为“SURGICAL INSTRUMENT INCORPORATING ANELECTRICALLY ACTUATED ARTICULATION MECHANISM”的美国临时申请的优先权。
技术领域
本发明总体上涉及能够将缝钉线应用到组织上、同时切割缝钉线之间的组织的外科缝合器械，更具体地涉及缝合器械的改进和用于形成所述缝合器械的各种元件的工艺的改进。
背景技术
在现有技术中外科缝合器已经被用于在组织中形成纵向切口同时将缝钉线应用到切口的相对两侧上。这种器械一般包括一对协同动作的钳口构件，如果所述器械将用于内窥镜或者腹腔镜应用，该对钳口构件能够穿过套管通道。其中一个钳口构件容纳钉仓，所述钉仓具有至少两排横向间隔开的缝钉。另一个钳口构件限定了钉砧，该钉砧具有与钉仓中的成排缝钉对准的缝钉成形凹窝。该器械包括多个往复运动的楔形件，当向远端驱动时，这些楔形件穿过钉仓中的开口并与支承缝钉的驱动器接合，以使缝钉向着钉砧击发。
适于内窥镜应用的外科缝合器的一个例子在美国专利US5465895中有描述，其有利地提供了不同的关闭和击发动作。因此，医生能够将钳口构件闭合在组织上以便在击发之前定位组织。一旦医生确定钳口构件正确地夹持了组织，可随后击发外科缝合器，从而切断并缝合组织。同时切断和缝合避免了当使用仅仅分别进行切割或缝合的不同外科工具顺序进行所述动作时可能引起的并发症。
通常有利地是建立用于外科缝合器的可重复使用的端部执行器。例如，一名患者可能需要一系列切割和缝合操作。每次操作替换整个端部执行器经济效率很低。特别对于端部执行器就重复操作而言构建得坚固而且可靠的情况尤其如此。为此，在外科缝合器的每次操作之前将钉仓装配在端部执行器中。这样在每次使用之后有更少量的外科缝钉被弃置。
虽然钉仓提供了许多优点，但是当未击发的钉仓不存在时需要防止外科缝合器无意中击发。否则，可能进行了组织切割而没有缝钉来减少出血。尤其需要以不受到任何中间故障的可靠方式防止所述无意中击发的实现。此外，为了使制造和组装简便，还需要使用最少数量的组成元件来实现锁定特征。
在Geiste的美国专利US6202914中，公开了锁定机构，其包括击发杆(“致动通道”)并包括一对用于致动钉仓的一体式凸轮楔。倒T形构件跨设在凸轮楔之下并位于其间，以防止钩子钩住击发杆的边缘。一旦向远端行进，当击发杆被回缩时倒T形构件保持不动，由此在第二次行进时可被锁定。
虽然这种锁定机构提供了一些优点，但是需要将该锁定机构结合在外科切割和缝合机构中，该锁定机构在自身具有一定优点的E形梁击发杆中运行。特别是，在击发过程中E形梁与下钳口(缝钉通道)和上钳口(钉砧)接合，帮助钳口保持一致的间隔。还需要具有可遥控的锁定机构，从而包含其他的锁定状态。
因此，非常需要如下的改进的外科缝合和切割器械：当没有安装钉仓或者钉仓已经被前面的击发用尽时，该器械能够防止无意地击发(即切割和缝合)。
发明内容
本发明通过提供能够在没有安装钉仓或者钉仓被用尽时防止击发外科缝合和切割器械的单锁定机构，克服了现有技术的上述和其他缺点。特别是，单锁定机构防止了在不同时进行缝合的情况下击发杆向远端运动并且由此防止了组织切割。
在本发明的一个方面，外科器械包括手柄部分，该手柄部分可操作地产生致动执行部分的击发运动。锁定构件被定位在执行部分中以阻止该击发运动。电活化聚合物(EAP)致动器可选择性地从手柄部分或者其它远程位置接受能量，使锁定构件脱离阻塞位置，从而允许进行击发。由此，锁定机构可响应于一定范围内的条件来防止无意地击发。
在本发明的另一个方面，包括用于通过接收击发杆来夹钳、切割和缝合组织的上和下钳口的外科器械有利地包括定位在执行部分中的锁定装置，用于在击发所需条件不存在时阻止该击发动作。由此，在有效缝合没有得到保证时防止无意地切割。
(1)、一种外科器械，包括：
能够产生击发运动的手柄部分；
与所述手柄部分连接的细长轴；
容纳在所述细长轴中、用于在其中进行往复纵向运动以传递击发运动的击发杆；
在远侧与所述细长轴连接、形成执行部分的端部执行器，该端部执行器响应于击发杆来执行外科手术操作；
能够产生击发信号的控制电路；和
定位在所述执行部分中的电锁定机构，其响应于击发信号在击发杆阻挡位置和不阻挡位置之间改变状态。
(2)、根据第(1)项所述的外科器械，其中所述电锁定机构还包括电活化聚合物致动器。
(3)、根据第(2)项所述的外科器械，其中所述击发杆包括倾斜的侧表面，当在阻挡位置中回缩电锁定机构时该侧表面能够被越过。
(4)、根据第(2)项所述的外科器械，其中所述电活化聚合物致动器包括堆叠致动器，所述堆叠致动器被定位成沿与所述击发杆的运动轴线横交的方向致动。
(5)、根据第(2)项所述的外科器械，其中所述电活化聚合物致动器包括朝向近端的锁定指，所述锁定指能够在升高和下降位置之间致动和松弛。
(6)、根据第(5)项所述的外科器械，其中所述执行部分包括朝向内的凹槽，该凹槽定位成容纳处于所述下降位置中的朝向近端的锁定指，从而允许所述击发杆在锁定指上向远端平移，并且朝向近端的锁定指的近端被对准，以便当处于升高位置中时抵接所述击发杆。
(7)、根据第(5)项所述的外科器械，还包括与所述击发杆连接的横向接触表面，所述端部执行器包括被对准以便在击发冲程的初始部分容纳横向接触表面的凹槽，所述细长轴还能够对所述击发杆施加反向偏压，从而将所述接触表面促动到端部执行器凹槽中，所述朝向近端的锁定指被定位成相对所述接触表面封闭所述凹槽，以及将所述接触表面引导到所述凹槽中。
(8)、根据第(7)项所述的外科器械，还包括层压到电活化聚合物致动器上的刚性基板。
(9)、一种外科器械，包括：
能够产生击发运动的手柄部分；
与所述手柄部分连接的缝钉通道；
与所述缝钉通道可枢转连接的钉砧；
由所述缝钉通道接合的缝钉装置，包括多个缝钉驱动器，能够使缝钉驱动器向着钉砧作凸轮运动；
靠近缝钉驱动器并与缝钉驱动器纵向对准的楔形构件；
响应于击发运动向远端驱动楔形构件的击发装置；
定位在缝钉通道中的锁定装置，其能够响应于电信号致动，以防止击发装置向远端运动。
(10)、根据第(9)项所述的外科器械，其中缝钉装置包括击发驱动槽，至少一部分击发装置向远端横过该击发驱动槽以驱动楔形构件，锁定装置选择性地从缝钉通道侵入击发驱动槽。
(11)、根据第(9)项所述的外科器械，其中锁定装置包括电活化聚合物致动器。
(12)、根据第(10)项所述的外科器械，其中电活化聚合物致动器包括堆叠致动器，其能够响应于电信号向内膨胀。
(13)、根据第(10)项所述的外科器械，其中缝钉通道包括靠近电活化聚合物致动器的倾斜凹槽，电活化聚合物致动器还包括朝向近端的梁，所述梁能够通过向着倾斜凹槽弯曲而致动。
(14)、根据第(13)项所述的外科器械，其中朝向近端的梁被定位成在激励时形成相对于击发元件的抵接表面。
(15)、根据第(13)项所述的外科器械，其中朝向近端的梁被定位成在激励时将击发元件的一部分引导到倾斜凹槽中，倾斜凹槽包括远端抵接表面。
(16)、根据第(9)项所述的外科器械，其中击发装置包括横向突出的中间销和下支脚，它们对置地接合在缝钉通道的两侧，锁定装置横向偏置以选择性抵接中间销。
(17)、根据第(9)项所述的外科器械，其中细长轴还包括闭合套筒，其在近端连接到手柄部分以接收关闭运动，并且其远端连接到钉砧上的枢转元件以进行关闭。
(18)、一种外科器械，包括：
能够产生击发运动的手柄部分；
与手柄部分连接的细长轴；
容纳在细长轴中、在其中进行纵向往复运动以便传递击发运动的击发杆；
从远侧连接到细长轴、形成执行部分的端部执行器，该端部执行器响应于击发杆执行外科手术操作；
用于电致动执行部分中的击发杆锁定装置的部件，击发杆锁定装置定位成阻挡击发杆。
通过附图及其描述，本发明的这些和其它目的以及优点将容易理解。
附图说明
包含在说明书中并构成其一部分的附图示出了本发明的实施方式，并与上面给出的本发明的总体说明和下面给出的实施方式的详细说明一起，用于解释本发明的原理。
图1示出了处于打开位置的外科缝合和切割器械的局部切除的侧视图。
图2示出了沿着图1的外科缝合和切割器械的端部执行器的线2-2截取的详细侧剖视图。
图3示出了图2的外科缝合和切割器械的击发杆的放大侧视图。
图4示出了图2的外科缝合和切割器械的击发杆的放大主视图。
图5示出了用于图1的外科缝合和切割器械的备选端部执行器的详细侧剖视图，其中包含有击发杆，该击发杆缺少用于防止端部执行器夹紧的中间销。
图6示出了图1的外科缝合和切割器械的近端的手柄部分的侧视图，其中左侧被除去以暴露处于未夹钳、未击发(“开始”)位置的内部部件。
图7示出了图1的外科缝合和切割器械的近端的手柄部分的分解透视图。
图8示出了图1的外科缝合和切割器械的近端的手柄部分的侧视图，其中左侧被除去以暴露处于关闭(“已夹钳”)位置中的内部部件。
图9示出了图1的外科缝合和切割器械的近端的手柄部分的侧视图，其中左侧被除去以暴露处于缝合和切割(“已击发”)位置中的内部部件。
图10示出了图1的外科缝合和切割器械的远端处的端部执行器的等轴测图，其中钉砧处于向上或打开位置中，暴露出钉仓和击发杆的切割边缘。
图11示出了图1的外科缝合和切割器械的执行部分的等轴测分解图。
图12示出了图1的外科缝合和切割器械的远端处的端部执行器的等轴测图，其中钉砧处于向上或打开位置中，并且钉仓大部分被除去，暴露出作为例子的单缝钉驱动器和双缝钉驱动器以及抵靠击发杆的中间销处于其开始位置的楔形滑块。
图13示出了图1的外科缝合和切割器械的远端的等轴测图，其中钉砧处于向上或打开位置中并且钉仓被完全除去，而且一部分缝钉通道被除去，以暴露出击发杆的最下部销。
图14示出了沿一个剖面的侧剖视图，显示出图1的外科缝合和切割器械的关闭位置中的钉砧、缝钉通道和钉仓之间的机械关系，所述剖面大致沿着图10中的线14-14截取，以暴露出楔形滑块、缝钉驱动器和缝钉，还示出了沿着纵向中心线的击发杆。
图15示出了沿着图10的线15-15截取的外科缝合和切割器械的端部执行器的剖视图，其中钉仓和击发杆处于开始位置中。
图16示出了沿着图15的线16-16截取的剖视图，显示出击发杆、缝钉通道、楔形滑块、缝钉驱动器、缝钉和钉仓之间的截面关系。
图17示出沿着端部执行器的纵向中心线的图1的外科缝合和切割器械的侧剖视图，其中端部执行器抓持着组织、处于部分关闭但未夹钳的位置中。
图18示出了处于关闭或夹钳位置中的图1的外科缝合和切割器械的局部切除的侧视图。
图19示出了处于关闭或夹钳位置中的图1的外科缝合和切割器械的远端的中心线剖面中的侧剖视图，其中组织被正确压缩。
图20示出了处于部分击发位置中的图1的外科缝合和切割器械的局部切除侧视图。
图21示出了处于部分击发位置中的图1的外科缝合和切割器械的远端的中心线剖面的视图。
图22示出了处于完全击发位置中的图1的外科缝合和切割器械的局部切除的侧视图。
图23示出了处于完全击发位置中的图1的外科缝合和切割器械的远端的中心线剖面的视图。
图24示出了从远侧观看图1的缝钉通道处的透视图，其中部分地切除缝钉通道以暴露出钉仓主体和与击发杆的中间销接合的单锁定机构。
图25至28示出了图24的单锁定机构、钉仓和击发杆的详细侧剖视图，按顺序示出的是：在图25中显示出钉仓处于已加载且未击发的状态，图26显示出钉仓处于正在被击发状态，图27显示出钉仓用尽且击发杆正在被回缩的状态，图28显示出钉仓用尽且击发杆回缩的状态。
图29示出了还包括锁定槽的图24的单锁定机构。
图30示出了图1的缝钉通道的仰视透视图，局部切除以显示出当钉仓故障时接合击发杆的中间销的另一个单锁定机构。
图31至34示出了图30的单锁定机构的详细侧剖视图，示出的顺序为：在图31中显示出钉仓已加载和未击发的状态，图32显示出钉仓正在击发的状态，图33显示出钉仓用尽且击发杆正在被回缩的状态，图34显示出钉仓用尽且击发杆回缩的状态。
图35是用于外科切割和缝合器械的替代执行部分的局部切除的主透视图，其中钉仓被移除，所述钉仓包含有电活化聚合物(EAP)致动的锁定机构。
图36是沿着穿过EAP致动锁定机构的图35中的线36-36截取的所述替代执行部分的左侧剖视图，包括未击发的钉仓，该锁定机构处于去激励状态并示出处于未使用的钉仓近侧的回缩状态的E形梁/击发杆。
图37是所述替代执行部分的左剖视图，包括用尽的钉仓，沿着图35中的线36-36截取的剖面示出EAP致动锁定机构，示出当已尝试进行击发时EAP致动锁定机构与E形梁/击发杆之间的锁定。
图38是图37的EAP致动锁定机构和E形梁/击发杆的详细的左剖视图。
图39是用于外科切割和缝合器械的第二种替代执行部分的局部切除的主透视图，其中钉仓被移除，所述钉仓包含有EAP致动锁定机构。
图40是第二种替代执行部分的左剖视图，包括用尽的钉仓，沿着图39中的线40-40截取的剖面示出EAP致动锁定机构，示出当已尝试进行击发时EAP致动锁定机构与E形梁/击发杆之间的锁定。
图41是用于外科切割和缝合器械的第三种替代执行部分的局部切除的主透视图，其中钉仓被移除，所述钉仓包含有EAP致动锁定机构。
图42是第二种替代执行部分的左剖视图，包括用尽的钉仓，沿着图41中的线42-42截取的剖面示出EAP致动的锁定机构，示出当已经尝试击发时EAP致动锁定机构与E形梁/击发杆之间的锁定。
具体实施方式
参照附图，其中相同的附图标记在所有附图中表示相同的元件，图1和2示出了能够实践本发明的独特优点的外科缝合和切割器械10。外科缝合和切割器械10包括端部执行器12，该端部执行器12具有有利地控制端部执行器12的间隔的E形梁击发机构(“击发杆”)14。特别是，缝钉通道16和可枢转平移的钉砧18被保持间隔开，确保有效缝合及切割。此外，如果器械不能够使用单锁定机构缝合则防止发生击发(即切割和缝合)，这将在下面更详细地描述。
外科缝合和切割器械10包括与执行部分22连接的手柄部分20，执行部分22还包括远端终止于端部执行器12中的轴23。手柄部分20包括手枪式握把24，医生向着该握把24枢转拉动闭合扳机26引起钉砧18向着端部执行器12的缝钉通道16夹钳或关闭。击发扳机28在闭合扳机26更远的外侧并可由医生枢转拉动以引起端部执行器12中夹钳的组织的缝合和切割。
应当理解的是，术语“近端”和“远端”在本文中以握持器械手柄的医生为参照来使用。因此，端部执行器12相对于更近侧的手柄部分20位于远端。还应当理解的是，出于方便和清楚起见，空间术语诸如“垂直”和“水平”在本文中以附图为参考来使用。但是，外科器械可以许多朝向和位置来使用，这些术语并不是想限制和绝对化。
闭合扳机26首先被致动。一旦医生对端部执行器12的定位感到满意，医生可向后将闭合扳机26拉到靠近手枪式握把24的完全被关闭的锁定位置。击发扳机28然后被致动。当医生除去压力时击发扳机28弹性地复位。当手柄部分20的近端上的释放按钮30被压下时，释放按钮30释放任何锁定的闭合扳机26。
闭合套筒32包围框架34，框架34又包围由击发扳机28定位的击发驱动构件36。框架34将手柄部分20与端部执行器12连接。随着闭合套筒32由闭合扳机26向着近端回缩(如图所示)，钉砧18弹性地打开，枢转离开缝钉通道16并随着闭合套筒32向近端平移。
缝钉通道16容纳缝钉装置，图示为钉仓37，其响应于击发杆14驱动缝钉，使缝钉与钉砧18成形接触。应当理解，尽管在本文中有利地描述了易于更换的钉仓37，与本发明的各方面一致的钉仓37也可被永久地固定到缝钉通道16上或与缝钉通道16成为一体，例如每次击发后更换端部执行器12的较大部分。
应当理解，与本发明的应用一致的缝钉装置可与缝钉通道16成为一体，而不是可有利地从其上拆卸。
E形梁击发机构
特别参考图2至4，击发杆14包括三个沿垂直方向间隔开的销，用于在击发期间控制端部执行器12的间距。特别是，上部销38分级进入钉砧18和缝钉通道16之间的枢轴附近的钉砧槽口40。当被击发钉砧18关闭时，上部销38在经过钉砧18向远端延伸的纵向钉砧槽42中向远端行进。钉砧18中任何微小的向上偏转由上部销38施加的向下的力克服。
击发杆14还包括最下部销或者击发杆盖44，其向上与缝钉通道16中的通道槽45接合，从而与上部销38协同动作，以便在过量组织被夹钳于其间的情况下拉动钉砧18和缝钉通道16略微更靠近在一起。
击发杆14有利地包括中间销46，其穿过在钉仓37的下表面和缝钉通道16的上表面中形成的击发驱动槽47，从而驱动其中的缝钉(见下面的描述)。通过抵靠缝钉通道16滑动，中间销46有利地阻止端部执行器12在远端被挤压关闭的任何倾向。为了说明中间销46的优点，图5示出了在击发杆14’上缺少中间销的替代端部执行器12’。在该视图中，端部执行器12’的远端被允许挤压关闭，这可能损害期望的缝钉成形。
仍参照图2至4，在击发杆14上的上部销38和中间销46之间朝向远端形成的切割边缘48跨过钉仓37中朝向近端形成的垂直槽49以切割夹钳的组织。击发杆14相对于缝钉通道16和钉砧18的确定定位确保进行有效切割。
带有选定钉仓间隙的弧形钉砧
由E形梁击发杆14提供的确定垂直间隔适于对内窥镜装置来说可利用的受限尺寸。此外，E形梁击发杆14使得能够制造具有赋予远端垂直偏转的弧形部分的钉砧16，类似于图5中所示的位置。这种弧形钉砧16有利地帮助实现端部执行器12中所需的间隙，甚至在钉砧16具有减小的厚度的情况下，这样更适于内窥镜的限制尺寸。
E形梁击发杆14还能够进行增加的应用，尤其是与一系列构造的钉仓结合应用。例如，医生可选择产生0.02mm组织间隙的灰色钉仓，产生0.04mm组织间隙的白色钉仓，产生0.06mm组织间隙的蓝色钉仓，或者产生0.10mm组织间隙的绿色钉仓。各个钉仓的垂直高度与缝钉和一体楔形滑块的长度(将在下面更详细描述)一起预先确定了期望的组织厚度，并且通过E形梁击发杆14正确地垂直隔开钉砧。
两轴手柄
参见图6至9，手柄部分20包括第一和第二基部50和52，它们由聚合材料诸如玻璃填充聚碳酸酯模制而成。第一基部50设置有多个圆柱形的销54。第二基部52包括多个延伸构件56，每个延伸构件56具有六边形的开口58。圆柱形的销54被容纳在六边形开口58中并被摩擦保持于其中，用于保持第一和第二基部50和52的组装。
旋钮60具有贯穿其延伸的腔62，以便接合执行部分22并使执行部分22围绕其纵向轴线旋转。旋钮60包括沿着腔62的至少一部分延伸的向内突出的凸台64。突出的凸台64被容纳在形成于闭合套筒32的近侧部分处的纵向槽66中，这样旋钮60的旋转使闭合套筒32旋转。应当理解，凸台64还延伸经过框架34并与击发驱动构件36的一部分接触，从而也使它们旋转。因此，端部执行器12(在图6至9中未显示)随着旋扭60一起旋转。
框架34的近端68向近端穿过旋钮60并设置有周向槽口70，其由分别从基部50和52延伸的相对的通道连接构件72接合。图中仅显示了第二基部52的通道连接构件72。从基部50和52延伸的通道连接构件72用于将框架34连接到手柄部分20，使框架34不相对于手柄部分20纵向运动。
闭合扳机26具有手柄部分74、扇形齿轮部分76和中间部分78。腔80延伸穿过中间部分78。从第二基部52延伸的圆柱形支撑构件82穿过腔80，以便将闭合扳机26可枢转地安装在手柄部分20上。从第二基部52延伸的第二圆柱形支撑构件83穿过击发扳机28的腔81，以便可枢转地安装在手柄部分20上。六边形开口84设置在圆柱形支撑元件83中，用于容纳从第一基部50延伸的连接销(未显示)。
闭合轭86被容纳在手柄部分20中，用于在其中往复运动并用于从闭合扳机26向闭合套筒32传递运动。从第二基部52延伸的支撑构件88和穿过轭86中的凹槽89延伸的连接构件72将轭86支撑在手柄部分20中。
闭合套筒32的近端90设置有凸缘92，该凸缘92扣合在轭86的远端96中形成的容纳凹槽94中。轭86的近端98具有齿条100，该齿条100由闭合扳机26的扇形齿轮部分76接合。当闭合扳机26向着手柄部分20的手枪式握把24运动时，轭86和闭合套筒32向远端运动，压缩使轭86向近端偏置的弹簧102。闭合套筒32的远端运动使钉砧18向远端朝着端部执行器12的缝钉通道16进行枢转平移运动，闭合套筒32的近端运动导致关闭，这将在下面描述。
闭合扳机26由与击发扳机28的接合表面128相互作用的前表面130向前偏置到打开位置。在手柄部分20中围绕销106从顶部枢转到后部的夹钳用第一钩104限制了击发扳机28向着手枪式握把24的运动，直到闭合扳机26被夹钳到其关闭位置。钩104通过接合击发扳机28中的锁定销107来限制击发扳机28的运动。钩104还与闭合扳机26接触。特别是，钩104的向前的突起108与闭合扳机26的中间部分78上的构件110接合，该构件110在腔80之外并朝着手柄部分74。钩104向着与闭合扳机26的构件110接触的方向偏置并通过释放弹簧112与击发扳机28中的锁定销107接合。当闭合扳机26被压下时，钩104从顶部运动到后部，压缩被捕获在钩104上的向后突起114和释放按钮30上的向前突起116之间的释放弹簧112。
当轭86响应于闭合扳机26的近端运动向远端运动时，释放按钮30的上部栓锁臂118沿着轭86上的上表面120运动，直到落入轭86的近端下部中向上的凹槽122中。释放弹簧112向外促动释放按钮30，这将使上部栓锁臂118向下枢转成与向上的凹槽122接合，由此将闭合扳机26锁定在组织夹钳位置中，诸如图8中所示。
栓锁臂118可运动脱离凹槽122以通过向内推动释放按钮30释放钉砧18。特别地，上部栓锁臂118围绕第二基部52的销123向枢转。轭86然后被允许响应于闭合扳机26的复位运动向近端运动。
击发扳机复位弹簧124定位在手柄部分20中并且该复位弹簧的一个末端与第二基部52的销106连接，另一个末端与击发扳机28上的销126连接。击发扳机复位弹簧124将回复力施加到销126上，以便沿着远离手柄部分20的手枪式握把24的方向偏置击发扳机28。闭合扳机26也通过击发扳机28的接合表面128被偏置远离手枪式握把24，从而偏置闭合扳机26的前表面130。
当闭合扳机26向着手枪式握把24运动时，其前表面130接合击发扳机28上的接合表面128，引起击发扳机28运动到其“击发”位置。当处于其击发位置中时，击发扳机28以与手枪式握把24成大约45°的角被定位。在缝钉击发之后，弹簧124使击发扳机28回复到其初始位置。在击发扳机28的复位运动期间，其接合表面128推压闭合扳机26的前表面130，引起闭合扳机26回复到其初始位置。止动构件132从第二基部52延伸，防止闭合扳机26旋转超过其初始位置。
外科缝合和切割器械10还包括往复运动部分134、倍增器(multiplier)136和驱动构件138。往复运动部分134包括执行部分22中的楔形滑块(在图6至9中未显示)和金属的驱动杆140。
驱动构件138包括第一和第二齿条141和142。第一槽口144设置在驱动构件138上介于第一和第二齿条141、142中间。在击发扳机28的复位运动期间，击发扳机28上的齿146与第一槽口144接合，以便在缝钉击发之后使驱动构件138回复到其初始位置。第二槽口148被定位在金属驱动杆140的近端，以便在其未击发位置中将金属驱动杆140锁定到释放按钮30的上部栓锁臂118上。
倍增器136包括一体的第一和第二小齿轮150和152。一体的第一小齿轮150与设置在金属驱动杆140上的第一齿条154接合。一体的第二小齿轮152与驱动构件138上的第一齿条141接合。一体的第一小齿轮150具有第一直径，一体的第二小齿轮152具有比第一直径小的第二直径。
图6、8和9分别示出了处于开始位置(打开且未击发)、夹钳位置(关闭且未击发)和击发位置中的手柄部分20。击发扳机28设置有扇形齿轮部分156。扇形齿轮部分156与驱动构件138上的第二齿条142接合，使击发扳机28的动作引起驱动构件138在图8中所示的第一驱动位置和图9中所示的第二驱动位置之间前后运动。为了防止在发生组织夹钳之前击发缝钉，释放按钮30上的上部栓锁臂118与驱动构件138上的第二槽口148接合，使金属驱动杆140被锁定在其最近端位置中，如图6中所示。当上部栓锁臂118落入凹槽122中时，上部栓锁臂118与第二槽口148脱离接合，允许金属驱动杆140向远端运动，如图9中所示。
由于驱动构件138上的第一齿条141和金属驱动杆140上的齿条154与倍增器136接合，击发扳机28的运动引起金属驱动杆140在图8中所示的第一往复运动位置和图9中所示的第二往复运动位置之间往复运动。由于第一小齿轮150的直径大于第二小齿轮152的直径，倍增器136使往复运动部分134运动的距离比由击发扳机28使驱动构件138运动的距离大。第一和第二小齿轮150和152的直径可被改变，以允许击发扳机28的冲程长度和使其运动所需的力变化。
应当理解，手柄部分20是示意性的并且其它致动机构也可被采用。例如，关闭和击发动作可由自动化部件产生。
独立和不同地关闭和击发的端部执行器
外科缝合和切割器械10的端部执行器12进一步在图10至16中详细显示出。如上所述，手柄部分20产生致动端部执行器12的独立和不同的关闭和击发动作。端部执行器12有利地保持这种独立和不同的关闭和击发(即缝合和切割)的临床灵活性。另外，端部执行器12引入前述能力，在医生定位并夹钳组织之后，在击发过程中确定地保持关闭间隔。通过在夹钳不足量组织的情况下保证充足的间隔，以及在夹钳过量组织的情况下增强夹钳，这两种特征在程序上和结构上都增强了外科缝合和切割器械10的能力。
图10示出了端部执行器12，其通过闭合套筒32的回缩处于打开位置，其中钉仓37安装在缝钉通道16中。在钉砧18的下表面200上，将多个缝钉成形凹窝202排列成对应于钉仓37的上表面206中的多个钉孔204。击发杆14位于其近侧位置，并且上部销38以非干扰方式与钉砧凹口40对准。钉砧凹口40被显示为与钉砧18中的纵向钉砧槽42连通。击发杆14的朝向远端的切割边缘48与钉仓37中的垂直槽49对准并从其近端被移除，从而允许用尽的钉仓37被移除并且扣合在缝钉通道16中的未击发钉仓37被插入。特别是，钉仓37的延伸元件208、210接合缝钉通道16的凹槽212、214(在图12中显示)。
图11以组装形式显示了外科缝合和切割器械10的执行部分22。钉仓37被显示为包括钉仓主体216、楔形滑块218、单和双驱动器220、缝钉222和钉仓盘224。当组装时，钉仓盘224将楔形滑块218、单和双驱动器220以及缝钉222保持在钉仓主体216内部。
与在击发杆本身的表面上包含凸轮表面相比，具有与钉仓37一体的楔形滑块218使得能够执行一些灵活的设计选项。例如，一些不同的钉仓可被选择用于器械10中，其中每个钉仓分别具有不同的缝钉排构造，并由此具有被构造成与击发杆14的中间销46接触同时驱动缝钉222的独特楔形滑块。作为另一个例子，一体的楔形滑块218为一些锁定特征提供了有利条件(在第一和第三前述待审专利申请中更详细描述)。
缝钉通道16具有设置在近端的连接腔226，其容纳框架34的远端上的通道锚固构件228，以便将端部执行器12与手柄部分20连接。缝钉通道16还具有可枢转容纳钉砧18的钉砧枢轴232的钉砧凸轮槽230。包围框架34的闭合套筒32包括朝向远端的翼片234，翼片234接合靠近钉砧18上的钉砧枢轴232并且位于钉砧枢轴232远侧的钉砧元件236，从而影响钉砧18的打开和关闭。击发驱动构件36被显示为从通过销240与击发连接器238连接的击发杆14组装，击发连接器238又可旋转地在近侧连接到金属驱动杆140。击发杆14由插入其中的带槽引导件239在框架的远端受到引导。
特别参考图12，一部分钉仓37被除去以暴露部分缝钉通道16，诸如凹槽212、214，并暴露处于未击发位置中的钉仓37的一些元件。特别是，钉仓主体216(在图11中显示)已经被除去。所显示的楔形滑块218在其近端未击发位置，其中推顶块242与击发杆14的中间销46(在图12中未显示)接触。楔形滑块218在钉仓盘224上纵向滑动接触并包括楔形件228，当楔形滑块218向远端运动时楔形件228向上促动单和双驱动器220。搁置在驱动器220上的缝钉222(在图12中未显示)因而也被向上推动，与钉砧18上的缝钉成形凹窝202接触，以形成闭合的缝钉。还示出的是缝钉通道16中的通道槽45，其与钉仓37中的垂直槽49对准。
图13示出了图12的端部执行器12，其中整个钉仓37被除去以显示击发杆14的中间销46，并且除去了通道槽45附近的一部分缝钉通道16以暴露击发杆盖44。另外，部分轴23被除去以暴露击发杆14的近端部分。在枢轴附近从钉砧18向下突出的一对相对的组织止动器244防止在夹钳过程中组织被定位得进入端部执行器12中过远。
图14示出了被关闭、处于组织夹钳位置中的端部执行器12，其中击发杆14未被击发。上部销38位于钉砧凹口40中，与钉砧槽42垂直对准以便在击发过程中击发杆14向远端进行纵向运动。中间销46被定位成向远端推动楔形滑块218，使楔形件228顺序地接触并升高双驱动器220和各个缝钉222，与钉砧18的下表面200中的缝钉成形凹窝202成形接触。
图15示出了钉仓37的上表面206，其中击发杆14处于其未击发的近端位置。缝钉孔204被排列在钉仓37中的垂直槽49的两侧上。
图16示出了枢轴附近的端部执行器12，显示出缝钉通道16具有对置的倾斜部分246，从而与钉砧18的组织止动器244(在图16中未显示)协同动作，以防止组织阻塞端部执行器12。还更详细示出了双驱动器220以及它们与缝钉222的关系。
操作
在使用时，外科缝合和切割器械10被如图1、2和17至23所示地使用。在图1至2中，器械10处于其开始位置，具有扣合在缝钉通道16的远端中的未击发、完全加载的钉仓37。两个扳机26、28向前并且端部执行器12被打开，例如通常在经过套管针或者其它开口将端部执行器12插入到体腔中之后。器械10然后由医生操作使待夹钳和切割的组织248被定位在钉仓37和钉砧18之间，如图17所示。
参照图18至19，接着，医生向近端运动闭合扳机26直到直接定位在手枪式握把24附近，将手柄部分20锁定在关闭和夹钳位置中。回缩在端部执行器12中的击发杆14不会阻止端部执行器12的选择性打开和关闭，而只是保留在钉砧凹口40中。随着钉砧18的关闭和夹钳，E形梁击发杆14对准，以便穿过端部执行器12击发。特别是，上部销38与钉砧槽42对准并且缝钉通道16由中间销46和击发杆44确保围绕通道槽45接合。
参照图20至21，在组织夹钳发生之后，医生向近端运动击发扳机28，引起击发杆14向远端运动到端部执行器12中。特别是，中间销46经过击发驱动槽47进入钉仓37，以便经由楔形滑块218向着钉砧18击发缝钉222(在图20至21中未显示)。最下部销或者击发杆盖44与中间销46协同动作来滑动定位击发杆14的切割边缘48以切割组织。两个销44、46还将击发杆14的上部销38定位在钉砧18的纵向钉砧槽42中，确保在整个向远端击发运动期间保持钉砧18和缝钉通道16之间的间距。
参照图22至23，医生继续使击发扳机28运动，直到靠近闭合扳机26和手枪式握把24。由此，因为与钉砧18接合，所有缝钉222的端部被弯曲。击发杆盖44被捕获在向着通道槽45的远端突出的击发杆止动器250上。切割边缘48完全横穿组织。该过程通过释放击发扳机28然后压缩释放按钮30并同时挤压闭合扳机26以打开端部执行器12来完成。
用于缺少钉仓/用尽的钉仓的单锁定装置
如上所述，E形梁击发杆14提供了确保隔开端部执行器12同时切割组织并使缝钉在切口的两侧成形的独特能力。参照图24，防止击发杆14的远端运动，由此防止了无意地组织切割。通过阻止击发杆(仅仅击发杆的中间销在图24中显示)的中间销46，单锁定机构270有利地响应于缺少钉仓37或者用尽钉仓37的情况，后一情况在图24中示出。
特别是，单锁定机构270作为定位在缝钉通道16中的一对弯曲的弹簧指272被示出，用于响应于两种情况：缺少钉仓和钉仓用尽。特别是，当楔形滑块218(在图24中未显示)不存在诸如当钉仓37被除去或者当钉仓37已被击发时，弯曲弹簧指272升起以阻止击发杆14的中间销46。
图25至28顺序示出了当外科缝合和切割器械10被击发时的单锁定机构270、尤其是弯曲弹簧指272。在图25中，未击发的钉仓37已经被插入到缝钉通道16中并且楔形滑块218压下弯曲弹簧指272，使在钉仓37和缝钉通道16之间形成的击发驱动槽47不受到阻碍。
在图26中，钉仓37的击发已经开始，并且击发杆14的楔形滑块218和中间销46已经向远端横向穿过弯曲弹簧指272，然后弹簧指弹进击发驱动槽47中。
在图27中，钉仓37现在是用尽的，其中楔形滑块218完全被驱动到远端并不再示出。击发杆14被向近端回缩。由于弯曲弹簧指272从更远的点枢转，在回缩过程中击发杆14能够骑设在弯曲弹簧指272上，使弯曲弹簧指272被压下而脱离击发驱动槽47。
在图28中，击发杆14完全被回缩并且现在面对一对没有被压下的弯曲弹簧指272以防止向远端的运动。在用尽的钉仓37被除去的时间段内单锁定机构270由此保持被致动，直到未击发的钉仓37被安装。
图29示出了锁定沟槽274，其可有利地被包括在单锁定机构270中以便提供增加的机械强度。在一些应用中，可能需要阻止强的击发动作而不能损伤弯曲弹簧指272。当弯曲弹簧指272没有被压下时锁定沟槽274与击发驱动槽47连通。此外，锁定沟槽274沿着远端方向向下倾斜，使击发杆14的中间销46向着位于锁定沟槽274远端处的抵接表面276定向，从而将击发杆14的远端运动作用在缝钉通道16’中。特别是，处于其初始位置中的击发杆14运动到远侧下部位置，图示为14’，其中中间销46运动到图示为46’的位置。应当理解，当上部销38和下部击发杆盖44分别运动到远侧下部位置38’和44’时，上部销38和下部击发杆盖44使中间销46抵靠缝钉通道16定位，从而使中间销46进入锁定沟槽274。
还应理解，击发杆14’可以很容易地从锁定沟槽274回缩。此外，只要上部销38’可在该位置中接合钉砧18(在图29中未示出)，医生就必须回缩击发杆14’，使钉砧18可被打开，以便插入未击发的钉仓37，由此击发杆14可完全被回缩并可不妨碍弯曲弹簧指272压到它们的不致动位置。
图30示出了另一种单锁定机构270，图示为一对锁定钩280，锁定钩280具有相对于通过缝钉通道16中的孔286插入的连接装置284而言设置在远端的倾斜端部282。倾斜端部282位于在缝钉通道16中限定的钩凹槽288之上。因此，当每个倾斜端部282由未击发钉仓37(在图30中未显示)的楔形滑块218接触时，倾斜端部282被压入钩凹槽288中，从而清理了击发杆14的中间销46(在图30中仅仅显示了中间销)向远端运动击发钉仓37的路径。将连接装置284分别与每个锁定钩280的倾斜端部282连接的细轴290弹性地响应于楔形滑块218的缺失(如图所示)，其中倾斜端部282回复原位以阻碍击发驱动槽47，从而阻止击发杆中间销46回缩。
图31至34示出了锁定钩280的操作顺序。在图31中，钉仓37未击发，使定位在远端的楔形滑块218将倾斜端部282压入钩凹槽288中，从而允许击发杆14的中间销46在击发过程中向远端运动，如图32所示。随着楔形滑块218和中间销46相对于锁定机构270向远端移去，倾斜端部282弹性升高脱离钩凹槽282以占据击发驱动槽47。
在图33中，击发杆14被回缩到与锁定钩280的倾斜端部282接触的点。由于倾斜端部282的远端比倾斜端部282的近端部分低，击发杆14的中间销46骑设在倾斜端部282之上，迫使它们向下进入钩凹槽288中，直到中间销46经过倾斜端部282，如图34中所示，其中倾斜端部282弹性回弹以阻碍中间销46。因此，防止了击发杆14向远端的运动，同时用未击发的钉仓37替代用尽的钉仓37。
电活化聚合物
电活化聚合物(EAPs)是一组导电的掺杂聚合物，其在施加电压时改变形状。实质上，导电的聚合物与某些形式的离子流体或凝胶和电极配合。离子从流体/凝胶中流入导电的聚合物或者从导电的聚合物中流出的流动通过施加的电位引起，并且这种流动引起聚合物的形状变化。依据所使用的聚合物和离子流体，电位在1V到4KV的范围内。一些EAPs在施加电压时收缩，而一些则膨胀。EAPs可以与机械装置配合，比如与弹性或柔性盘配合，来改变施加电压时所产生的效果。
有两种基本类型的EAPs并且每种有多种构造。该两种基本类型是纤维束和层压形式。纤维束由大约在30-50微米的纤维构成。这些纤维可以被织成非常类似于织物的一束并且因此常被称为EAP纱。这种类型的EAP在施加电压时收缩。电极通常由中央线芯和导电的外套组成，该外套还用来包含围绕纤维束的离子流体。一种可以在市场上买到的纤维EAP材料的例子由Santa Fe Science andTechnology生产并且以商标PANIONTM纤维出售，而且在美国专利No.6,667,825中有描述，该专利的内容在此全部引入以供参考。
另一种类型是层压结构，其由一层EAP聚合物、一层离子凝胶和两个连接到所述层压件的每一侧上的柔性板构成。当施加电压时，方形的层压板沿一个方向膨胀，并且沿垂直方向收缩。一种可以在市场上买到的层压(板形)EAP材料的例子来自于Artificial MuscleInc，其为SRI实验室的一个部门。板形EAP材料还可以从日本的EAMEX得到，其被称为薄膜EAP。
应当注意的是，EAPs在被加电时体积不变；它们仅仅是沿一个方向膨胀或收缩，而在横向上则与之相反地变化。可以通过将一侧包含到刚性结构上并将另一侧更像活塞一样的使用而以其基本形式使用层压形式。层压形式还可以被粘接到柔性板的任意一侧上。当给柔性板EAP的一侧加电时，其沿相反方向扩张弯曲柔性板。依据加电侧的不同，这允许该板在任一方向上弯曲。
EAP致动器通常由许多层或者成束的纤维一起组成，以便配合工作。EAP的机械构造确定EAP致动器和其运动的能力。可以将EAP形成长绳并且缠绕在单个中心电极上。柔性的外部外套管将为致动器形成另一个电极并且装有该装置的功能所必需的离子流体。在这种结构中，当将电场施加到电极上时，EAP绳缩短。EAP致动器的这种构造被称为纤维EAP致动器。同样，可以在柔性板的每一侧上以多层放置层压结构或者仅仅在其自身上放置多层以增加其性能。典型的纤维结构具有2-4％的有效应力，典型的层压形式利用更高的电压可获得20-30％。然而，应当理解的是，这些性能范围不是限定的。
例如，层压EAP材料可以由连接到EAP层上的正板电极层形成，该EAP层又连接到离子细胞层上，而离子细胞层又连接到负板电极层上。多个层压EAP复合材料可以通过它们之间的粘合剂层以堆叠的方式固定，以形成EAP板状致动器。可以理解的是，相对的EAP致动器可以被形成为沿任一方向有选择性地弯曲。
收缩式EAP纤维致动器可以包括纵向的铂阴极电线，该阴极电线穿过绝缘的聚合物近端帽，然后经过一细长的圆柱形腔体，该圆柱形腔体形成于经导电涂层以作为阳极使用的塑料圆柱形壁内。铂阴极电线的远端被嵌入绝缘的聚合物远端帽内。许多收缩聚合物纤维与阴极电线平行地布置并且围绕该阴极电线，它们的端部被嵌入到相应的端帽中。塑料圆柱形壁沿圆周围绕相应的端帽连接，以包围圆柱形腔体来将填充位于收缩聚合纤维和阴极电线之间的空间的离子流体或凝胶密封。当经过圆柱形壁(阳极)和阴极电线施加电压时，离子流体进入收缩的聚合物纤维内，使它们的外径膨胀，同时长度相应地收缩，由此将各端帽拉向彼此。
具有垂直膨胀的EAP锁定机构的两件式刀
在图1中，外科缝合和切割器械510显示为被打开，并且E形梁512完全回缩到缝钉应用组件514中。在装配过程中，E形梁512的下支脚516经过缝钉应用组件514的缝钉通道520中的加宽的孔518落下。E形梁512然后被行进，使E形梁512沿着在缝钉通道520中形成的下部轨道522向远端滑动。特别是，下部轨道522包括窄槽524，该窄槽524打开成为缝钉通道520的下表面上的加宽槽526，从而形成与加宽的孔518连通的为倒转T形的横截面。一旦组装完成，和与E形梁512连接的击发杆528连接的组成元件不允许下支脚516再次向近端行进到加宽的孔518而进行拆卸。
参照图35至36，E形梁512的中间销530沿着钉仓520的顶面滑动到下部轨道522的两侧上，与下支脚516协同动作以纵向滑动接合缝钉通道520。当向近端回缩时，E形梁512的上部销532保留在钉砧凹口534中(图36)，从而允许缝钉应用组件514的上钳口或钉砧536响应于闭合套筒组件538的闭合运动重复打开和关闭，所述闭合套筒组件538在马蹄形孔540处接合到钉砧536的闭合元件542上。钉砧536围绕近端钉砧枢轴销544枢转，该近端钉砧枢轴销544在缝钉通道520(在图36中以虚线示出)中的相应的钉砧枢轴槽546中滑动。
在图36中，E形梁512的近端击发杆528包括向下的突起548，该突起548抵靠缝钉通道520滑动，当回缩时有利地升高远端E形梁512，有利地准备例如经过套管针插入缝钉应用组件514并分级运动中间销530以便进入EAP致动的锁定机构550。
在图37至38中，当击发开始时E形梁512已经向远端运动。上部销532进入在钉砧536中形成的加宽钉砧轨道552中，该钉砧轨道552与钉砧凹口534连通。与钉砧轨道552垂直连通的变窄的钉砧槽554允许E形梁512的切割表面556通过，该切割表面556切割夹钳在钉砧536与接合到缝钉通道520的钉仓512之间的组织。E形梁512的位于切割表面556和中间销530之间的接合表面530抵接楔形滑块562(图36)，该楔形滑块562与钉仓558形成一体并且初始时刻近端定位在钉仓558中。应当理解，楔形滑块562使缝钉驱动器564和在钉孔568中位于缝钉驱动器564上的缝钉向上作凸轮运动，从而抵靠钉砧536成形缝钉。
击发杆528更远的加高部分572接收夹箍弹簧574的向下的促动，所述夹箍弹簧574接合到外科缝合和切割器械510的执行部分580的细长轴578的框架576上。在击发冲程的第一部分中，响应于向下突起548落入加宽的孔518中和中间销530到达EAP致动锁定机构550，夹箍弹簧574与加高部分572之间的接触彼此对准。因此，在这部分击发冲程期间夹箍弹簧574帮助将中间销530向下驱动到缝钉通道520中形成的倾斜凹槽591中。在图35至38中，EAP致动锁定机构590包括EAP垂直膨胀致动器592，其从手柄部分(未显示)接收电激励信号，使EAP致动锁定机构590去激励而垂直收缩，以便清理出用于中间销530和下支脚516中的一个或两个的路径。具有向下偏转、抵接的EAP板状致动器的EAP致动锁定机构
在图39至40中，除EAP致动锁定机构650采用向近端突出的、向下致动的EAP板状致动器592以外，外科缝合和切割器械610与上述在图35至38中描述的相同，该EAP板状致动器592通常准直以阻塞在缝钉通道620中形成的倾斜凹槽691，并可被致动以向下弯曲成与倾斜凹槽691对准(在图40中作为692’以虚线显示出)。因此，EAP板状致动器692的近端形成抵接表面693，以吸收来自中间销530并由此吸收来自E形梁512的击发力。
带有向下偏转的活板门EAP板状致动器的EAP致动锁定机构
在图40至41中，除EAP致动锁定机构750利用向近端突出的、向下致动的EAP板状致动器692以外，外科缝合和切割器械710与上述在图35至38中描述的相同，该EAP板状致动器692通常被对准，作为活板门来打开在缝钉通道720中形成的倾斜凹槽791，并且该EAP板状致动器692可被激励以向下弯曲，从而关闭倾斜凹槽791(在图40中作为792’以虚线显示出)，以允许击发。这样，位于倾斜凹槽远端处的抵接表面793从E形梁512的中间销530吸收击发力，从而防止击发。
EAP致动器控制电路
应当理解，当被认为可取时，手柄部分中的控制电路可有利地响应于用户的击发命令或在用户的击发命令之前对EAP锁定装置去激励。例如，对于端部执行器来说被感测的缺少钉仓、用尽的钉仓或者尺寸错误的钉仓可阻止去激励信号到达EAP锁定装置，或者被手柄部分中的控制逻辑电路感测并被解释。作为另一个例子，不正确夹钳的组织也可被感测(例如，沿着钳口间隔开的压力传感器可沿着端部执行器的一些部分感测太多的组织或者太少的组织)。另外，对于包含用于薄或厚的组织的支持材料的端部执行器而言，在对立条件成立时支持材料存在与否可防止解除锁定。
虽然已经通过描述一些实施方式对本发明进行了解释，并且已经相当详细地描述了示例性实施方式，但是申请人并不是想以任何方式将所附的权利要求的范围限制或限定得如此详细。其它优点和修改对本领域技术人员来说是可以想到的。
例如，机械式单锁定机构可包括包含在缝钉通道16中的弹簧加载的撞针，当不与楔形滑块218接触时该撞针向上运动到击发驱动槽47中，并且所述撞针具有钩状或者不具有钩状。
作为另一个例子，虽然EAP致动器控制电路被描述为当不供电时其默认为锁定状态，应当理解，这种设置是示例性的。与本发明的各方面一致的应用可默认为解锁状态，使用一个或多个EAP致动器的能量使它们运动到锁定状态。
作为进一步的例子，虽然在示例性方案中描述了可拆卸钉仓，与本发明一致的应用可包括可互换的执行部分，其中EAP锁定机构至少部分地被包含在可互换部分的远端中。作为替代，靠近端部执行器的一部分击发杆或者击发棒可包括接触表面，该接触表面由靠近端部执行器的EAP锁定机构选择性地锁定。

Claims (8)

1、一种外科器械，包括：
能够产生击发运动的手柄部分；
与所述手柄部分连接的细长轴；
容纳在所述细长轴中、用于在其中进行往复纵向运动以传递击发运动的击发杆；
在远侧与所述细长轴连接、形成执行部分的端部执行器，该端部执行器响应于击发杆来执行外科手术操作；
能够产生击发信号的控制电路；和
定位在所述执行部分中的电锁定机构，其响应于击发信号在击发杆阻挡位置和不阻挡位置之间改变状态。
2、根据权利要求1所述的外科器械，其中所述电锁定机构还包括电活化聚合物致动器。
3、根据权利要求2所述的外科器械，其中所述击发杆包括倾斜的侧表面，当在阻挡位置中回缩电锁定机构时该侧表面能够被越过。
4、根据权利要求2所述的外科器械，其中所述电活化聚合物致动器包括堆叠致动器，所述堆叠致动器被定位成沿与所述击发杆的运动轴线横交的方向致动。
5、根据权利要求2所述的外科器械，其中所述电活化聚合物致动器包括朝向近端的锁定指，所述锁定指能够在升高和下降位置之间致动和松弛。
6、根据权利要求5所述的外科器械，其中所述执行部分包括朝向内的凹槽，该凹槽定位成容纳处于所述下降位置中的朝向近端的锁定指，从而允许所述击发杆在锁定指上向远端平移，并且朝向近端的锁定指的近端被对准，以便当处于升高位置中时抵接所述击发杆。
7、根据权利要求5所述的外科器械，还包括与所述击发杆连接的横向接触表面，所述端部执行器包括被对准以便在击发冲程的初始部分容纳横向接触表面的凹槽，所述细长轴还能够对所述击发杆施加反向偏压，从而将所述接触表面促动到端部执行器凹槽中，所述朝向近端的锁定指被定位成相对所述接触表面封闭所述凹槽，以及将所述接触表面引导到所述凹槽中。
8、根据权利要求7所述的外科器械，还包括层压到电活化聚合物致动器上的刚性基板。
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CN110087564A (zh) * 2016-12-21 2019-08-02 爱惜康有限责任公司 包括缺失的仓和/或耗尽的仓闭锁件的钉击发构件
CN110099645A (zh) * 2016-12-21 2019-08-06 爱惜康有限责任公司 用于具有单独且不同的闭合和击发系统的外科器械的具有凸轮表面布置的闭合构件
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CN109480939B (zh) * 2018-11-23 2020-04-21 苏州英途康医疗科技有限公司 钉仓组件及吻合器
CN109480939A (zh) * 2018-11-23 2019-03-19 苏州英途康医疗科技有限公司 钉仓组件及吻合器
CN114072074A (zh) * 2019-06-28 2022-02-18 西拉格国际有限公司 包括闭锁键的外科器械
CN115363660A (zh) * 2021-05-19 2022-11-22 欣格誉科技(无锡)有限公司 一种吻合器
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CN113288279A (zh) * 2021-06-15 2021-08-24 常州安康医疗器械有限公司 一种钉砧可上下移动和转动的腔镜切割吻合器
CN113288279B (zh) * 2021-06-15 2022-04-15 常州安康医疗器械有限公司 一种钉砧可上下移动和转动的腔镜切割吻合器

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