CN102579094A - 动力外科器械 - Google Patents

动力外科器械 Download PDF

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CN102579094A
CN102579094A CN2012100276065A CN201210027606A CN102579094A CN 102579094 A CN102579094 A CN 102579094A CN 2012100276065 A CN2012100276065 A CN 2012100276065A CN 201210027606 A CN201210027606 A CN 201210027606A CN 102579094 A CN102579094 A CN 102579094A
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end effector
housing
surgical instruments
longitudinal axis
endoscopic portion
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CN102579094B (zh
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迈克尔·热姆洛克
戴维·C·瑞森耐特
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00026Conductivity or impedance, e.g. of tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00084Temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00115Electrical control of surgical instruments with audible or visual output
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00199Electrical control of surgical instruments with a console, e.g. a control panel with a display
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681Aspects not otherwise provided for
    • A61B2017/00734Aspects not otherwise provided for battery operated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2905Details of shaft flexible
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/90Identification means for patients or instruments, e.g. tags
    • A61B90/98Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders

Abstract

本公开涉及一种外科器械,包括壳体、内窥镜部、传动齿轮、驱动电动机、换档电动机和末端执行器。所述内窥镜部从所述壳体向远侧延伸并且限定了纵轴。所述传动齿轮至少部分地设置在所述壳体内并且可围绕从其延伸出的传动齿轮轴可旋转。所述传动齿轮沿所述传动齿轮轴可选择性地移动。所述驱动电动机被设置为与所述传动齿轮机械协作并且被配置为旋转所述传动齿轮。所述换档电动机被设置为与所述传动齿轮机械协作并且被配置为沿所述传动齿轮轴来移动所述传动齿轮。所述末端执行器邻近所述内窥镜部的远侧部设置。

Description

动力外科器械
本申请是申请日为2008年4月14日、申请号为200810090458.5、发明名称为“动力外科器械”的专利申请的分案申请。
技术领域
本公开涉及用于紧固身体组织的外科器械,更具体地,涉及具有传动齿轮的动力外科器械,所述传动齿轮配置为可移动的以实现所述器械的旋转、铰接和致动。
背景技术
在本领域中已公知一种外科装置,其中组织首先被抓紧或夹紧在对置的钳结构之间然后通过外科紧固件被连接。在某些器械中,设置有刀片以切割已经被所述紧固件连接的组织。所述紧固件典型地包括外科缝合钉和由两部分组成的聚合体紧固件。
用于这种目的的器械可以包括分别用于抓紧或夹紧组织的两个细长构件。典型地,所述构件之一具有容纳有成排排列的缝合钉的钉仓,而另一个构件具有砧座,所述砧座限定了随着缝合钉从所述钉仓中被驱动时用于使缝合钉钉腿成形的表面。若干器械包括夹具、手柄和/或旋钮以实现末端执行器的随着旋转和铰接的致动。这些外科器械可能需要用户在操作手柄、旋钮等时施加很大的力,并且需要多于一只手来操作所述器械。
现在期望一种具有需要较小的力来操作的致动器的外科器械。另外,还期望能用单手操作来执行多重功能的外科器械。
发明内容
本公开涉及一种外科器械,其包括壳体、内窥镜部、传动齿轮、驱动电动机、换档电动机和末端执行器。所述内窥镜部从壳体向远侧延伸并且限定纵轴。所述传动齿轮至少部分地被设置在所述壳体内并且可围绕从其延伸出的传动齿轮轴旋转。所述驱动电动机可选择性的沿所述传动齿轮轴移动。所述驱动电动机设置为与传动齿轮机械协作并且配置为旋转所述传动齿轮。所述换档电动机设置为与所述传动齿轮机械协作并且配置为沿所述传动齿轮轴来移动所述传动齿轮。所述末端执行器邻近所述内窥镜部的远侧部布置。
在特定实施例中,所述外科器械进一步包括至少部分地设置在所述壳体内的齿圈,所述传动齿轮沿所述传动齿轮轴可移动至一个位置以啮合所述齿圈。所述齿圈的旋转使所述末端执行器绕所述纵轴旋转。所述器械可以包括至少部分地设置在所述壳体内的致动器齿轮,所述传动齿轮沿所述传动齿轮轴可移动至一个位置以啮合所述致动器齿轮。所述致动器齿轮的旋转引起所述末端执行器的至少部分启动。
所述末端执行器限定了第二纵轴并且所述末端执行器可以从第一位置期望地移动至至少第二位置,在所述第一位置处所述第二纵轴与所述第一纵轴大体成一条直线,在所述第二位置处所述第二纵轴布置为相对于所述第一纵轴有一角度。所述外科器械可以包括至少部分地设置在所述壳体内的铰接齿轮,所述传动齿轮可沿所述传动齿轮轴移动至一个位置以啮合所述铰接齿轮。所述铰接齿轮的旋转引起末端执行器从其第一位置向其第二位置移动。在特定实施例中,所述传动齿轮在三个不同的位置之间沿所述传动齿轮轴选择性地移动。
在特定实施例中,外科器械进一步包括用户界面,所述用户界面包括显示可读信息的屏幕。所述用户界面可以包括至少一个控制传动齿轮沿传动齿轮轴的位置的开关。所述用户界面可以包括至少一个控制所述传动齿轮的旋转速度的开关。
所述壳体可以进一步包括远侧壳体部和近侧壳体部,所述远侧壳体部是可绕纵轴相对于所述近侧壳体部旋转的。所述远侧壳体部和近侧壳体部可以限定一个或多个制动器。在一个实施例中,所述远侧壳体部上具有多个制动器并且所述近侧壳体部上包括在其上的接头(tab)。所述接头是远侧受偏压的并且与布置在远侧壳体部上的制动器机械协作。
所述壳体理想地包括沿手柄轴布置的手柄部。在特定实施例中,所述手柄轴与所述传动齿轮轴大体平行。
本公开也涉及将外科紧固件应用在组织上的方法。该实施例的方法包括提供包括壳体、内窥镜部、传动齿轮和末端执行器的动力外科器械。所述内窥镜部从壳体向远侧延伸并且限定了纵轴。所述传动齿轮至少部分地设置在所述壳体内并且可绕从其延伸出的传动齿轮轴旋转。所述传动齿轮可沿所述传动齿轮轴选择性地移动。所述末端执行器邻近所述内窥镜部的远侧部设置。所述方法进一步包括沿所述传动齿轮轴移动所述传动齿轮并且绕所述传动齿轮轴旋转所述传动齿轮。
在特定实施例中,所述末端执行器绕所述纵轴被旋转。所述末端执行器可以限定第二纵轴并且所述末端执行器可以从第一位置移动到至少第二位置,在所述第一位置处所述第二纵轴与所述第一纵轴大体成一条直线,在所述第二位置处所述第二纵轴布置为相对于所述第一纵轴有一角度。在特定实施例中,所述末端执行器从其第一位置被移动至其第二位置。
在特定实施例中,所述传动齿轮可在三个不同的位置之间沿所述传动齿轮轴选择性地移动。三个位置中的两个理想地对应于旋转所述末端执行器和致动所述动力外科器械。
在另一方面,一种外科缝合器械,包括:壳体;从所述壳体向远侧延伸并限定了纵轴的内窥镜部;邻近内窥镜部的远端的末端执行器,其被可枢转地安装用于相对于所述内窥镜部铰接;用于将外科缝合钉从所述末端执行器部署到组织中的传动组件;具有传动构件的驱动电动机,所述传动构件可从第一位置移动至至少第二位置;被布置为与在第一位置的所述传动构件接合的铰接构件,所述铰接构件被连接到末端执行器,以便由所述传动构件引起的所述铰接构件的运动使所述末端执行器相对于所述内窥镜部铰接;以及被布置为与在第二位置的所述传动构件接合的致动构件,所述致动构件被连接到传动组件,以便由所述传动构件引起的所述致动构件的运动来部署外科缝合钉。
外科缝合器械可以包括连接到所述内窥镜部的旋转构件,其被布置被所述传动构件接合,以便所述传动构件的运动使所述内窥镜部围绕纵轴旋转。在特定优选实施例中,所述末端执行器具有钉仓组件、设置在所述钉仓组件中的外科缝合钉和邻近所述钉仓组件设置的砧座组件。所述钉仓组件和砧座组件可从相对彼此的打开位置可移动至接近位置,以将组织接合在钉仓组件和砧座组件之间。所述启动构件的运动可以使所述钉仓组件和砧座组件在部署所述外科缝合钉前相对彼此靠近。
在另一方面,一种外科缝合器械,包括:壳体;从所述壳体向远侧延伸并限定了纵轴的内窥镜部;邻近内窥镜部的远端设置的末端执行器;用于将外科缝合钉从所述末端执行器部署到组织中的传动组件;具有传动构件的驱动电动机,所述传动构件可从第一位置移动至至少第二位置;被布置为与在第一位置的所述传动构件接合的旋转构件,所述旋转构件被连接到内窥镜部,以便由所述传动构件引起的所述旋转构件的运动使内窥镜部旋转;以及被布置为与在第二位置的所述传动构件接合的致动构件,所述致动构件被连接到传动组件,以便由所述传动构件引起的所述致动构件的运动来部署所述外科缝合钉。
外科缝合器械可以包括被布置以与所述传动构件接合的铰接构件,所述铰接构件连接到末端执行器上以便铰接构件的运动通过传动构件将所述末端执行器相对于所述内窥镜部铰接。在特定实施例中,所述末端执行器具有钉仓组件、被布置在所述钉仓组件中的外科缝合钉和邻近所述钉仓组件布置的砧座组件。所述钉仓组件和砧座组件可以从相对彼此的打开位置移动至接近位置以将组织接合在钉仓组件和砧座组件之间。所述启动构件的运动可以在部署所述外科缝合钉之前使所述钉仓组件和砧座组件相对彼此靠近。
在另外的方面,一种外科缝合器械,包括:壳体;从所述壳体向远侧延伸的内窥镜部;至少部分地被布置在所述壳体内并具有传动构件的驱动电动机;邻近所述内窥镜部的远侧被连接,用于相对于所述内窥镜部铰接的末端执行器,所述末端执行器被连接到由驱动电动机驱动的铰接构件上,所述末端执行器具有将被部署在组织内的外科缝合钉;以及至少部分地被设置在所述壳体内并且被布置以向所述驱动电动机提供电力的电源。
在特定优选实施例中,所述末端执行器形成装载单元的远端,所述装载单元具有配置为连接到所述内窥镜部上的近侧主体部。举例来说,所述内窥镜部具有配置为和第一种装载单元和具有第二外科功能的至少第二种装载单元相连接的远侧,所述第一种为连接外科缝合装载单元而所述第二种为非连接外科缝合装载单元。
在另一方面,一种外科器械包括:壳体;从所述壳体向远侧延伸并限定纵轴的内窥镜部;在所述内窥镜部的远端并被布置用于相对于所述内窥镜部铰接的末端执行器;被布置以沿所述纵轴平移和用于接合所述末端执行器的传动轴;被布置以选择性地驱动所述末端执行器的一个或多个功能的电动机组件;以及用于显示所述末端执行器的状态的显示部件。
所述显示部件可以是手术室监视器。末端执行器的功能可以选自包括以下各项的集合:内窥镜部围绕所述纵轴的旋转、传动轴沿所述纵轴的移动以及末端执行器的铰接。
外科器械理想地包括壳体中的数字控制模块。所述数字控制模块将与所述末端执行器的运转有关的信息传输给所述显示部件。所述显示部件可以至少部分地布置在所述壳体内。
在另一方面,一种外科器械包括:壳体;从所述壳体向远侧延伸并且限定了纵轴的内窥镜部;可绕从其延伸的传动管轴旋转的传动管;至少部分地设置在所述壳体内的驱动电动机,所述驱动电动机可移动地接合至所述传动管;被布置为与所述传动管机械协作的杆,至少所述杆的一部分可相对于所述传动管平移;以及邻近所述内窥镜部的远侧部设置的末端执行器,所述末端执行器被布置为由所述杆驱动以便所述发射杆驱动所述末端执行器的外科功能。
在特定实施例中,离合器设置在所述驱动电动机和所述传动管之间,所述离合器包括离合器片和弹簧。所述离合器片可以被布置为与所述传动管的近端的接口相配合。
在特定的优选实施例中,所述末端执行器限定第二纵轴,所述末端执行器可以从第一位置移动到至少第二位置,在所述第一位置处所述第二纵轴与所述第一纵轴大体成一条直线,在所述第二位置处所述第二纵轴相对于所述第一纵轴设置为有一角度。所述末端执行器理想地可绕所述第一纵轴相对于所述壳体旋转。
在特定优选实施例中,包括具有至少一个控制所述发射杆的平移的开关的用户界面。至少所述杆的一部分理想地至少部分地被布置在所述传动管内。在特定实施例中,所述传动管包括其内表面上的螺纹部。所述发射杆包括在其上的螺纹部,所述发射杆的螺纹部可以和所述传动管的螺纹部相接合。至少所述发射杆的一部分可以被布置为贯穿一个板的开口,所述开口包括用于防止所述发射杆相对于所述板旋转的非圆形截面。
在特定实施例中,电源至少部分地设置在所述壳体内并且被布置为所述驱动电动机提供电力。所述末端执行器可以是一次性装载单元的一部分。
附图说明
在此将参考附图公开目前公开的动力外科器械的实施例,其中:
图1为依照本公开的实施例的动力外科器械的立体图;
图2为图1中的动力外科器械的局部放大立体图;
图3为图1和图2中的动力外科器械的局部放大立体图;
图4为依照本公开的实施例的图1至图3中的动力外科器械的内部部件的局部立体剖视图;
图5和图6为显示被布置在第一位置上的图1至图4中的动力外科器械的内部部件局部立体剖视图;
图7为布置在第二位置上的图1至图5中的动力外科器械的内部部件的横截面图;
图8A为包括依照本公开的实施例的图1至图7中的动力外科器械的内窥镜部的局部立体图;
图8B为图8A中图示的动力外科器械的一部分的放大立体图;
图9至图11为被布置在第三位置上的图1至图8中的动力外科器械的内部部件的局部立体剖视图;
图12和图13为依照本公开的实施例的图1至图11中的动力外科器械的一部分的放大立体图;
图14为依照本公开的实施例的包括手柄部的动力外科器械的一部分的横截面图;及
图15A至15B为依照本公开的实施例的图1中的动力外科器械的远侧部的铰接轴的立体图。
具体实施方式
现在将参考附图详细地描述目前公开的动力外科器械的实施例,其中相同的附图标记指代多幅视图中的每一幅的相同或相应构件。如本文所使用的术语“远侧”指的是动力外科器械或其部件远离用户的部分,而术语“近侧”指的是动力外科器械或其部件靠近用户的部分。
依照本公开的诸如外科缝合器的动力外科器械在图中用附图标记100指代。先参考图1,动力外科器械100包括壳体110、限定了穿过其延伸的纵轴A-A的内窥镜部140,以及限定了穿过其延伸的纵轴B-B(图示为与图1中轴线A-A基本成一条直线)的末端执行器160。内窥镜部140从壳体110向远侧延伸而且末端执行器160邻近内窥镜部140的远侧部142布置。
参考图2和图3,图示了依照本公开的实施例的壳体110的放大视图。在图示实施例中,壳体110包括手柄部142,其上具有至少一个按钮114(显示了两个按钮114a和114b)。限定了手柄轴H-H的手柄部142被显示具有和用户的手指一致的凹陷116。显示出每个按钮114a和114b被布置在凹陷116上以方便用户的手指按压。
继续参考图2和图3,壳体110的近侧区域118包括用户界面120。在图示实施例中,用户界面120包括屏幕122和至少一个开关124(显示了七个开关124a至124g)。屏幕122在其上显示可读信息,包括实施例中的动力外科器械100的状态信息。正如下面详细描述的,开关124a至124g控制动力外科器械100的各种动作。
图4至图7、图9至图11和图14示出了动力外科器械100的各种内部部件,包括传动齿轮200或传动构件、驱动电动机210和换档电动机220。可以预想到能够利用诸如三位线圈(three-position solenoid)来替代换档电动机220。传动齿轮200可以绕穿过其延伸的传动齿轮轴C-C旋转(图4),并且可选择性沿传动齿轮轴C-C移动。驱动电动机210被布置为与传动齿轮200机械协作并且配置为使传动齿轮200绕传动齿轮轴C-C旋转。换档电动机220被布置为与传动齿轮200机械协作(依照公开的实施例,驱动电动机210图示在传动齿轮200和换档电动机220之间)并且配置为使传动齿轮200沿传动齿轮轴C-C轴向平移。在公开的实施例中,驱动电动机210和/或换档电动机220可以是电动机或齿轮电动机,所述齿轮电动机可以包括结合在其壳体内的齿轮装置(gearing)。
换档电动机220被配置为可以使得传动齿轮200在多个位置间选择性地移动;在图示实施例中显示了三个位置。图5和图6中图示的第一位置能够使得末端执行器160旋转;图7中图示的第二位置能够使得末端执行器160铰接;以及图9至图11和图14中图示的第三位置能够使得动力外科器械100启动。
图4至图7、图9至图10和图14中图示了环绕驱动电动机210的驱动电动机外壳212的剖视图。驱动电动机外壳212中包括多个狭槽214(图示了三个狭槽214a、214b和214c)。各个狭槽214可以和位置锁216相配合以保持传动齿轮200在期望的位置。例如,在图5中示出位置锁216和狭槽214a相配合——对应于传动齿轮200位于其第一位置。在图7中,位置锁216被示出与狭槽214b相配合——对应于传动齿轮200位于其第二位置。图9、图10和图14示出位置锁216与狭槽214c相配合——对应于传动齿轮200位于其第三位置。在图示实施例中,位置锁216朝向驱动电动机外壳212被弹簧承载,其帮助将驱动电动机210放置和保持在期望的位置。
在图示实施例中,换档电动机220位于驱动电动机210的近侧并且配置为使得驱动电动机210沿传动齿轮轴C-C在其第一位置、第二位置和第三位置之间平移。参考图10,依照公开实施例,图示了换档电动机220与换档螺杆222协同来驱动内螺纹螺杆壳体223(见图10)。进一步公开了邻近位置锁216设置的换档传感器224(见图4)(例如,由位置锁216激活的微型开关或光学/铁磁学近程传感器),其和至少一个开关124电通信以启动或停止换档电动机220和/或提供与驱动电动机210的位置有关的反馈,例如动力外科器械100的操作状态被期望地显示在屏幕122上。例如,驱动电动机210的位置可以被显示在用户界面120的屏幕122上。
参考图5和图6,图示了传动齿轮200的第一位置。这里,齿圈230或旋转构件被布置在壳体110内,并且齿圈230的旋转引起动力外科器械100的内窥镜部140、末端执行器160和远侧壳体部110a的旋转。可以预想到齿圈230的内表面包括螺纹和/或齿以接合传动齿轮200,并且被连接到布置在近侧壳体部110b的远侧的远侧壳体部110a上。此外,经由设置在远侧壳体部110a内的外围布置的沟槽232和对应的设置在近侧壳体部110b内的外围布置的凸缘234,远侧壳体部110a可以相对于近侧壳体部110b旋转。
在实施例中,齿圈230被刚性地紧固在远侧壳体部110a内并且和传动齿轮200紧密配合。因此,传动齿轮200的旋转引起齿圈230和该远侧壳体部110a旋转。在图2中示出了使得用户的手与可旋转的远侧壳体部110a隔离的凸缘(lip)235。可以预想到在远侧壳体部110a和近侧壳体部110b之间布置多个垫圈或球轴承(可以由在特氟纶
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继续参考图6中所示实施例,环绕远侧壳体部110a的表面233设置有多个制动器231。接头237图示为设置在近侧壳体部110b上并可以包括棘爪或弹簧加载构件。在公开的实施例中,接头237向远端偏置并且与多个制动器231中的至少一个机械协作。制动器231和接头237的接合帮助将远侧壳体部110a相对于近侧壳体部110b固定在一旋转位置。此外,制动器231和接头237可以设置为当内窥镜部140旋转时给予用户听觉和/或触觉的反馈。在公开的实施例中,一旦选定了期望的旋转位置,可以利用三位线圈来锁紧末端执行器160的旋转位置。
在图7中,当位置锁216与狭槽214b对准时,图示传动齿轮200在其第二位置。这时,传动齿轮200和铰接齿轮240紧密配合,所述铰接齿轮240至少部分地布置在壳体110内。铰接齿轮240的旋转引起末端执行器160从纵轴B-B与纵轴A-A基本在一条直线上的第一位置朝纵轴B-B布置的与纵轴A-A成一角度的位置移动。优选地,可以达到多个铰接位置。
在图示实施例中并具体参考图7和图8,末端执行器160的铰接受铰接齿轮240、铰接螺杆242、铰接联动装置244和至少一个铰接杆260的影响。更具体地,铰接齿轮240被刚性地安装到铰接螺杆242上,以便使随着铰接齿轮240被在第二位置的传动齿轮200的旋转而旋转,铰接螺杆242也旋转。图示了在铰接螺杆242上的不同位置上的多个轴承262以帮助铰接螺杆242的固定和校准以及减少诸如铰接螺杆242和壳体110之间的摩擦。
继续参考图7,铰接螺杆242包括贯穿铰接联动装置244的内螺纹部248的螺纹部246。铰接螺杆242和铰接联动装置244之间的这种关系使得铰接联动装置244依照铰接螺杆242的旋转沿铰接螺杆242的螺纹部246向远侧和/或近侧(在箭头D和E的方向上)移动。例如,随着铰接螺杆242在第一方向(例如顺时针方向)上旋转,铰接联动装置244向近侧移动,而随着铰接螺杆242以第二方向(例如逆时针方向)上旋转,铰接联动装置244向远侧移动。
至少一个铰接臂250被示出从铰接联动装置244延伸出来。在实施例中,铰接臂250被刚性地连接到铰接杆260上,并且可以预想到多于一个的铰接臂250可以被连接到多于一个的铰接杆260上。随着铰接联动装置244响应铰接齿轮240的旋转向远侧和/或近侧平移,铰接杆260也随其向远侧和/或近侧(在箭头F和箭头G所示方向,沿纵轴A-A)平移。可以利用限位开关、近程传感器(例如光学的和/或铁磁学的)、线性可变位移传感器和转轴编码器(例如,设置在壳体110中)的任何组合来控制和/或记录铰接联动装置244的位置和/或末端执行器160的铰接角度和/或发射杆306的位置(如下面参考图9和图11讨论的)。
参考图gA和图8B,图示了铰接杆260贯穿至少内窥镜部140的一部分并与联动杆264机械协作。因此,联动杆264同样随铰接齿轮240的旋转沿纵轴A-A移动。联动杆264的远侧部266与末端执行器160机械协作,以便联动杆264的远近移动引起末端执行器160围绕枢转点P从其第一位置朝其第二位置移动。例如,联动杆264在横向偏离枢转点P的位置处被连接到末端执行器160上。更具体地,而且为了图示目的,随着联动杆264向远侧移动,末端执行器160在箭头H的方向被铰接,并且随着联动杆264向近侧平移,末端执行器160在箭头I方向被铰接。同样可以预想到铰接杆260的一部分与末端执行器160机械协作以影响其铰接。提供末端执行器160的铰接的更多细节在米利曼(Milliman)等人共有的专利号为6,953,139的美国专利中有详细描述,所述专利的全部内容合并于此以做参考。
依照本公开的实施例,末端执行器160包括钉仓组件(例如钳构件164)和砧座组件(例如钳构件162),所述砧座组件包括用于将外科紧固件部署在身体组织内并且使所述外科紧固件成形的砧座部。末端执行器160围绕与内窥镜部140的纵轴基本垂直的轴可枢转地安装。钉仓组件164容纳多个缝合钉。砧座组件162在与钉仓组件164间隔的开启位置和与钉仓组件164并列成一直线的接近位置或夹紧位置之间相对于钉仓组件164是可移动的。优选地,缝合钉被放置在钉仓组件164内以将排成列的钉应用到身体组织上。末端执行器160被连接到安装部,所述安装部可枢转地连接到主体部。所述主体部可以与动力外科器械100的内窥镜部140形成为一体,或者可以可拆卸地连接到其上以提供可替换的或一次性装载单元。所述装载单元通过销钉连接可连接到内窥镜部140上。可以预想到,所述装载单元具有连接到所述装载单元的安装部的铰链链接(articulation link),并且所述铰链链接被连接到联动杆,以使末端执行器160随着联动杆沿纵轴在远近方向上平移而被铰接。可以应用其他装置来将末端执行器160连接到内窥镜部140以实现铰接。例如,可以使用柔性管或多个可枢转构件。
装载单元可以和各种末端执行器结合(或被配置为一体的),例如脉管密封装置、线性缝合装置、圆形缝合装置、刀具等等。这些末端执行器可以被接合到动力外科器械100的内窥镜部140。中间柔性轴500可以被包括在手柄部112和装载单元之间。例如,如图15A至15B所示,内窥镜部140和远侧部142作为柔性轴500被示出。柔性轴500包括多个相互连接的成角的外管501和502。图15A示出了非铰接形态的柔性轴而图15B示出了铰接形态的柔性轴500。当柔性轴500是直的时,如图15A所示,管501的窄部和管502的宽部交替。当柔性轴500完全被铰接时,如图15B所示,管501和管502的短侧和宽侧对准(aligned)。这些柔性轴500有助于进入身体的特定区域。可以使用包括多于一个的中间轴的系统,每个所述中间轴被布置为与一个或多个末端执行器或装载单元连接。这些中间轴可以包括柔性的、弯曲的、刚性的、伸缩的、内窥镜的或其他的轴。
此外,在能够使用各种装载单元的地方,数字控制模块(DCM)130(图4)可以控制施加于发射杆306的力以便发射杆306能够驱动位于当时在使用中的装载单元上的特定末端执行器。为了清楚,图中没有示出将DCM 130连接到动力外科器械100的各种部件的线,但是这些线在本公开的考虑之中。装载单元也可以包括机械或电子传感器,所述传感器向DCM 130表明哪个末端执行器位于装载单元上。在实施例中,DCM 130也能够存储与施加到发射杆306上的力相关的信息。另外,可以测量来自驱动电动机210的电压和电流以提供与动力外科器械100的状态相关的信息和/或反馈。例如,如果用户试图在太厚的组织上施压,则所述电压和/或电流会增加。可以将该信息提供给用户和/或可以切断或停止电源。可以预想到这种特性帮助防止损坏器械中的机构。
参考图9至图11和图14,传动齿轮200被图示在位置锁216与狭槽214c对准的第三位置。这里,传动齿轮200与至少部分地设置在壳体110内的致动器齿轮300啮合。更具体地,设置在传动齿轮200的表面204(图4)上的一组齿202和致动器齿轮300上的齿啮合,以提供末端执行器160的抓紧组织、夹紧组织和发射(例如缝合和切割)以及将元件回退至其初始位置中的至少一个。
继续参考图9和图11,还包括传动管302、塞柱304和发射杆306。传动管302包括沿其至少一部分长度的内螺纹(未明确示出),传动管302刚性连接到致动器齿轮300。塞柱304螺纹接合到传动管302的内螺纹并且相对于致动器齿轮300在传动管302内是可平移的。图9显示塞柱304在其最近侧位置附近而图11图示了塞柱304在其最远侧位置附近。发射杆306被刚性连接到塞柱304上并且从那里向远侧延伸。在本公开的实施例中,发射杆306至少延伸到内窥镜部140的远侧部142。
致动器齿轮300和传动管302响应传动齿轮200的旋转也旋转。随着传动管302旋转,塞柱304和发射杆306在传动管302的界限内向近侧和/或远侧平移。发射杆306的远侧平移(例如,与传动齿轮200的顺时针旋转相对应)可以使末端执行器160的钳构件162、164(见图1)抓紧或夹紧保持在它们之间的组织。另外发射杆306的远侧平移可以使外科紧固件从末端执行器160中发射出来(例如经由凸轮杆和/或驱动滑轨(两者都没有在实施例中明确示出))以固定组织,并且也可以使刀片(在该实施例中未明确示出)切断组织。发射杆306的近侧平移(例如,与传动齿轮200的逆时针旋转相对应)可以使钳构件162、164和/或刀片返回其预发射位置。末端执行器160的发射和启动的更多细节在由米利曼等人共有的专利号为6,953,139的美国专利中有详细描述,其全部内容合并于此以作参考。
在本公开的实施例中,末端执行器160的砧座部包括用于与末端执行器160的传动组件接合的凸轮表面。所述传动组件包括理想地具有用于切割组织的刀片的传动梁。传动梁具有被定位以接合凸轮表面的凸轮滚子,以及被定位以接合钉仓组件从而当传动梁向远侧行进时来影响砧座组件162和钉仓组件164相对于彼此的接近的凸缘。另外,如第139号米利曼专利中所公开的,当传动梁在向远侧方向上进一步行进时,传动梁与用于部署来自钉仓组件的外科紧固件的启动构件相接合。
传感器的任何组合都可以被定位于动力外科器械100中以判断各部件的位置和/或动力外科器械100的运转阶段,例如,末端执行器160的铰接、旋转、夹紧和发射。例如,如上所述,限位开关、近程传感器(例如,线性的和/铁磁的)、电位计、线性可变位移传感器(LVDT)、转轴编码器等可以被用来帮助控制和/或记录铰接联动装置244、发射杆306和/或齿圈230的位置。
现在参考图9、图11和图12,内窥镜部140包括从邻近壳体110的区域向末端执行器160延伸的管壳体144。随着传动管302旋转,末端执行器160不会作为其直接结果而旋转。参考图13,管壳体144其上包括与发射杆306的平面部310相对应的平面部148。所述一对平面部148和310通过帮助限制发射杆306轴向运动来帮助防止发射杆306的旋转。
参考图9,驱动电动机轴218被示出从驱动电动机210延伸出来并被连接到传动齿轮200上。可以使用紧固件(在该实施例中未明确示出)来将传动齿轮200固定在驱动电动机轴218上。驱动电动机轴218被驱动电动机210旋转,因此导致传动齿轮200的旋转。驱动电动机轴218被示出具有平面部219(可以包括一个以上平面部219),所述平面部219允许传动齿轮200和驱动电动机轴218之间的“游隙(play)”或“可旋转的浮动(rotational float)”,以利于所述齿轮的齿对准并且帮助使得传动齿轮200能够在这些位置之间转换。图9还图示了设置在壳体110内并至少部分地环绕传动管302的轴承308。轴承308促进传动管302的旋转并且通过内窥镜部140帮助对准传动管302,并且支承传动齿轮200和致动器齿轮300之间的所有推力负载。
在图10中,变换器420被示出邻近驱动电动机210和换档电动机220。变换器420(例如力或压力变换器)可以测量和/或控制用于在致动器齿轮300上的期望的压力所需的力。变换器420可以与能为用户提供反馈的用户界面的部分通信。另外,弹簧连接器430被示出在驱动电动机210和换档电动机220之间。具体地,在公开实施例中,弹簧连接器430包括安装在伸缩罩434内的弹簧432。换档螺杆222被图示贯穿弹簧432并且被配置为施加压缩负载于弹簧432上。可以预想到,随着弹簧432被压缩,伸缩罩434是可收缩的。施加给驱动电动机210的力可以利用弹簧432和/或伸缩罩434调整。
在本公开的实施例中,传动齿轮200和致动器齿轮300形成咬合面。齿轮的齿被布置为滑动的,除非临界力通过换档电动机220和设置在其间的弹簧连接器430(如下面结合图10所讨论的)施加到驱动电动机210上。此外,当换档电动机220和弹簧连接器430将所需临界力施加于传动齿轮200和致动器齿轮300以实现无滑动接合时,发射杆306将被向远侧驱动。伸缩罩434可以包括结合在那里的止块,以便伸缩罩434将缩回发射杆306,而不是解除弹簧连接器430的压力。
参考图3,用户界面120被示出为包括屏幕122和七个开关124a至124g。在图示实施例中,用户界面显示可以通过换档传感器224(图4)传达至用户界面120的“模式”(例如,旋转、铰接或启动)、“状态”(例如,铰接角度、旋转速度或者致动类型)和诸如缝合钉是否已经被发射的“反馈”。开关124a被显示为具有“M”,代表模式,其可以被用于通过换档电动机220来定位传动齿轮200,以在旋转、铰接、抓紧、夹紧和发射间进行选择。也可以预想到开关124a能够被用于让用户输入不同组织类型以及钉仓的各种大小和长度。
用户界面120上的开关124b至124e被示出为上面具有箭头,并且可以被用于选择传动齿轮200被驱动电动机210旋转的方向、速度和/或转矩。也可以预想到至少一个开关124能被用于选择诸如各设定值被超越的紧急模式。此外,图示中开关124f和124g上面具有“N”和“Y”。可以预想到开关124f和124g可以被用于帮助用户导航和选择动力外科器械100的各种设置。开关124a至124g上的标记和它们各自的功能不局限于附图中所示出的,因为与它有偏差的情况也在本公开考虑之中并且在本公开的范围内。另外,参考图1和图2,按钮114a和114b可以被用于启动和/或停止驱动电动机210和/或换档电动机220的运动。按钮114a和114b的其它功能是可以预期的,并且具有更多或者更少的开关114也是可以预期的。在特别实施例中,例如,开关124a至124g可以包括一个或多个微电子薄膜开关。这种微电子薄膜开关包括相对较低的致动力、小封装尺寸、人体工程学的尺寸和外形、薄型、包括开关上的模制字母的能力、符号、描绘和/或指示以及低材料消耗。此外,开关124a至124g(诸如微电子薄膜开关)可以被密封以便于动力外科器械100的消毒,并且有助于防止颗粒和/或流体污染。
作为替代物,或者除了开关124或按钮114之外,其它输入装置可以包括声音输入技术,该输入装置可以包括结合在数字控制模块(DCM)130(图4)中的硬件和/或软件,或者连接到DCM 130上的单独的数字模块。声音输入技术可以包括声音识别、声音激活、声音校正和/或植入语音。用户可以通过声音命令来整个地或部分地控制器械的运转,这样解放出用户的一只或两只手以操作其它器械。声音或其它听得见的输出也可以被用来向用户提供反馈。
在实施例中,弹簧连接器430被用于动力外科器械100的反馈和控制中。如上所述,DCM 130可以被连接至一个或多个按钮114或开关124和一个或多个显示屏122,以向用户提供反馈并且用来帮助控制动力外科器械100的运转。DCM 130可以是结合到动力外科器械100的壳体110中的数字电路板。弹簧连接器430可以包括能够与DCM 130互相作用以控制施加于发射杆306的力的压力变换器。
同样可以预想到用户界面120包括屏幕122和/或开关124a至124g上的不同颜色和/或亮度的文字以进一步区别显示项目。也可以包括诸如灯的脉冲模式、听觉反馈(例如,蜂鸣器、铃或者可以以选定的时间间隔响起的嘟嘟声)、口头反馈和/或触觉振动反馈(诸如异步电机或者螺线管)的形式的用户反馈。视觉、听觉或者触觉反馈的强度能够增加或者降低。例如,反馈的强度可以用来表示器械上的力正变得过大。另外,可以将开关124a至124g定位在相互不同的高度并且/或者可以包括凸起的标记或者其它结构特征(例如,凹陷或者凸起)以使得用户不需要看用户界面120就能够按压适当的开关124。此外,近侧壳体部110b也可以被用作操纵杆式(joy stick-type)控制系统。
另外,用户界面120可以包括单独的显示屏或屏幕122和输入装置(诸如开关124或按钮114),或者所述输入装置可以完全或部分地结合在屏幕122中。例如,可以使用触摸屏液晶显示器(LCD)使得用户在观察运转反馈的同时提供输入。触摸屏LCD可以包括电阻的、电容的或者表面声波的控制。这种方法能够有利于密封屏幕122部件以便于动力外科器械100消毒,而且防止微粒和/或流体污染。在特定的实施例中,屏幕122被可枢转地或者可旋转地安装于动力外科器械100上以用于在使用或准备过程中机动地观察屏幕122。例如,屏幕122可以铰接于或者球窝式安装于动力外科器械100上。
在公开的实施例中,至少某些由动力外科器械100中各种传感器监测到的信息可以提供给手术室中的视频屏幕或者监测系统。例如,可以经由包括蓝牙、ANT3、KNX、Z波、X10、无线USB、WiFi、IrDa、Nanonet、Tiny OS、ZigBee、射频、UHF和VHF的技术将数据从结合在或者关联于动力外科器械100中的通信发射器发送至用于手术室监测系统的接收器。这种特征可以方便动力外科器械100的或其它手术室的用户或医护人员或远程人员进行监测。
参考图4,电池组400、燃料电池和/或高能电容器的任何组合都可以被用来向动力外科器械100提供电力。例如,电容器可以被用来与电池组400连接。这里,当所要求/所需的能量比电流不可能很快地从其流出的慢流(slow-drain)电池依靠其自身所能提供的要快时(例如,在夹紧厚组织、快速发射和夹紧等时),可以利用电容器来产生电力冲击(power burst)。可以预想到,能够将电池组连接至电容器以使电容器充电。
还可以预想到,电池组400包括至少一个一次性电池。该一次性电池或电池组可以介于大约9伏和大约30伏之间并且可以用于一次性外科器械,所述一次性外科器械将被使用而不需要医院职员连接器械到发电机或给电池充电。因为高压电池组在正常使用中消耗电流较少,它们是高效的并且能够处理电力中的尖峰,因此高压电池组是所期望的。包括电力的其它供电器件也在考虑之中。在选择性的实施例中,设置有电线将器械100连接至发电机。
在公开的实施例中,DCM被连接至换档电动机220和驱动电动机210,并且被配置和布置以监测电池组400的电阻、电压、温度和/或电流并且控制动力外科器械100的运转。如果一个负载或多个负载显示出达到或者接近破坏极限时,确定动力外科器械100的电池组400、电动机220、210和驱动部件上的一个负载或多个负载、输电来控制电机速度。例如,可以确定电池组400中的剩余电量、剩余发射次数、是否必须将电池组400替换或充电和/或接近动力外科器械100的潜在负载极限。
DCM能够被配置和布置来控制或者帮助控制换档电动机220和/或驱动电动机210的运转以响应监测到的信息。可以包括电子离合器的脉冲调制可以被用于控制输出。例如,DCM能够调节电压或者脉冲调制电压以调整功率和/或扭矩输出来防止系统损坏或者优化能量使用。电子制动电路可以用于控制驱动电动机210和/或换档电动机220,该电子制动电路使用旋转驱动电动机210的现有反电动势(EMF)以抵制和大致降低传动齿轮200的动量。电子制动电路可以改善驱动电动机210和/或换档电动机220的控制,用于控制动力外科器械100的停止精度和/或变位。用于监测动力外科器械100的部件并且帮助防止动力外科器械100过载的传感器可以包括诸如热传感器、电热调节器、热电堆、热电偶和/或热红外成像的热型传感器并且向DCM提供反馈。在达到或者接近极限的情况下,DCM可以控制动力外科器械100的部件并且这种控制可以包括切断来自电池组400的电力,临时性地中断电力或者进入暂停模式,进行脉冲调制以限制使用的能量,并且DCM能够监测部件的温度以确定何时能够重新开始运转。DCM的上述用途可以单独使用或者作为电流、电压、温度和/或阻抗测量的要素来使用。
在图5所示实施例中,示出换档电动机220包括两部分壳体226。两部分壳体226的每个部分226a和226b互相可滑动地接合。可以预想部分226a被刚性地紧固在驱动电动机外壳212上,而部分226b固定在换档电动机220上并且在壳体110内是可平移的。另外,例如,可以包括布线槽228以使得电线(在实施例中未明确示出)朝着用户界面120从变换器420穿过(同样见图10)。
参考图14,动力外科器械100被示出具有手枪握把式手柄部112。这里,手柄部112与纵轴A-A成一定角度(例如大致90℃)地设置。在此实施例中,可以预想到上面设置有至少一个按钮114。另外,用户界面120可以大约被定位于图14所示的位置处。此外,可移动手柄(在该实施例中未明确示出)可以被利用以控制动力外科器械100的各种功能。
可以预想到末端执行器160是可以重复利用的,能够容纳钉仓并且/或者作为一次性装载单元的部分。一次性装载单元的其它细节在由博拉诺斯(Bolanos)等人共有的专利号为5,752,644的美国专利中有详细描述,其全部内容合并于此以作参考。如先前合并于此作为参考的专利号为6,953,139的米利曼等人的美国专利所公开的,一次性和/或可替换装载单元可以包括没有铰接的末端执行器。可以邻近手柄部112设置开关以电子地使换档电动机220的第二位置失效。也可以使用诸如机械方法的其它方法。
在本公开的特定实施例中,结合有手术末端执行器160的一次性或可替换装载单元包括位于装载单元中的传感器,以判断末端执行器160的各种部件的位置和/或运转,诸如末端执行器160的铰接、旋转、夹紧和发射的末端执行器160。例如,电触头、近程传感器、光学传感器、光电二极管和/或机械或金属传感器被用于控制和/或记录与末端执行器160相关的信息。同样可以判断砧座组件162和钉仓组件164相对于彼此的位置,末端执行器160的铰接或非铰接位置,末端执行器160的旋转,和/或装载单元、钉仓和/或钉仓的部件的正确装载。
同样可以包括识别系统来判断并且向DCM传递包括用于操作特定的末端执行器160的速度、功率、扭矩、夹紧、移动长度和强度极限的各种信息。DCM也可以判断运转模式并且调整用于部件移动的电压、离合器弹簧载荷和停止点。更具体地,识别系统可以包括末端执行器160中的与DCM或者该处的接收器通信(例如,无线地、经由红外信号等)的部件(例如,微晶片、发射器或者传送器)。同样可以预想到,可以经由发射杆306发送信号,从而发射杆306用作用于DCM和末端执行器160之间的通信的导管(conduit)。识别系统与DCM传达外科器械相关的信息,例如,诸如连接到外科器械的末端执行器的类型和/或所述末端执行器的状态。
在依照本公开的特定实施例中,装载单元包括轴向传动组件,其与发射杆306协作以接近末端执行器160的砧座组件162和钉仓组件164并且从钉仓发射缝合钉。该轴向传动组件可以包括通过钉仓向远侧移动并且在缝合钉发射后可以回退的梁,正如专利号为6,953,139的米利曼等人的美国专利的特定实施例所公开的,该公开合并于此以作参考。通过实例,如果缝合钉已经被从钉仓发射,则上面讨论的传感器可以用于判断所述缝合钉是否已经被完全发射,所述梁是否已经通过钉仓向近侧回退及回退的程度以及与装载单元的运转有关的其它信息。在本公开的特定实施例中,装载单元结合了用于识别装载于器械100上的装载单元和/或钉仓的类型并且包括红外的、蜂窝的或者射频识别芯片(诸如感官的或类似技术的)的零件。装载单元和/或钉仓的类型可以由DCM中相关的接收器或者由手术室中的外部装置接收,用于提供反馈、控制和/或进行存量分析。电源或者电池组400能够与用于识别装在动力外科器械100上的电池组400的类型或者用于发送与电池组400相关的反馈的部件相结合。
在本公开的特定实施例中,动力外科器械100包括结合了手术末端执行器160的一次性或可替换的装载单元,以及包括壳体110和可拆卸地连接至装载单元的内窥镜部140的可重复利用部分。可重复利用部分可以被配置为用于消毒然后在随后的手术操作中再次使用。在实施例中,壳体110的部件被密封以防御微粒和/或流体污染的渗透并且帮助防止部件被消毒处理损坏。在依照本公开的特定实施例中,电池组400包括可再充电电池。例如,所述再充电电池能够被连接至在器械100的壳体110上,可以接近的触点,或者所述再充电电池可以通过密封于壳体110中的感应充电界面被再次充电。感应充电界面可以消除触点短路并且可以提供可以是密闭地或抗液密封的内部电池。
本公开也涉及一种将手术紧固件应用于组织的方法。如上所述,该方法包括动力外科器械100的使用。
应该理解,可以对本文公开的实施例做各种修改。例如,在开放性手术期间,可以设置包含或多或少螺旋紧固件的较短细长管状部,以更易于掌握。可以沿所述细长管状部的长度设置各种铰接以便于在身体内定位螺旋紧固件施加器。另外,可以设置各种构造的驱动杆和侠槽或紧固件夹持结构,以容纳各种类型的旋转的紧固件。沿驱动电动机210和/或传动齿轮200的纵轴的位置可以与所示的不同。可以使用用于驱动、旋转、铰接和/或启动的不同类型的齿轮。因此,上面的描述不应被解释为限制,而仅仅是作为各种实施例的范例。本领域技术人员能够预想到在此处所附权利要求的范围和精神之内的其它修改。

Claims (21)

1.一种外科缝合器械,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸;
驱动电动机,其至少部分地被布置在所述壳体内并具有传动构件;
末端执行器,其邻近所述内窥镜部的远端被连接,用于相对于所述内窥镜部铰接,所述末端执行器被连接到由驱动电动机驱动的铰接构件上,所述末端执行器具有将被部署在组织内的外科缝合钉;以及
电源,其至少部分地被设置在所述壳体内并且被布置以向所述驱动电动机提供电力。
2.根据权利要求1所述的外科缝合器械,其中所述末端执行器形成装载单元的远端,所述装载单元具有配置为连接到所述内窥镜部上的近侧主体部。
3.根据权利要求1或2所述的外科缝合器械,其中所述内窥镜部具有配置为和第一种装载单元和具有第二外科功能的至少第二种装载单元相连接的远端,所述第一种为铰接外科缝合装载单元而所述第二种为非铰接外科缝合装载单元。
4.一种外科器械,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了纵轴;
末端执行器,其在所述内窥镜部的远端并被布置用于相对于所述内窥镜部铰接;
传动轴,其被布置以沿所述纵轴平移和用于接合所述末端执行器;
电动机组件,其被布置以选择性地驱动所述末端执行器的一个或多个功能;以及
显示部件,其用于显示所述末端执行器的状态。
5.根据权利要4所述的外科器械,其中所述显示部件为手术室监视器。
6.根据权利要求4所述的外科器械,其中末端执行器的功能选自包括以下各项的集合:
内窥镜部围绕所述纵轴的旋转,
传动轴沿所述纵轴的移动,以及
末端执行器的铰接。
7.根据权利要求4所述的外科器械,进一步包括在所述壳体中的数字控制模块。
8.根据权利要求7所述的外科器械,其中所述数字控制模块将与所述末端执行器的运转相关的信息传送至所述显示部件。
9.根据权利要求4所述的外科器械,其中所述显示部件至少部分地设置在所述壳体内。
10.一种外科器械,包括:
壳体;
内窥镜部,其从所述壳体向远侧延伸并且限定了第一纵轴;
传动管,其可绕从其延伸的传动管轴旋转;
驱动电动机,其至少部分地设置在所述壳体内,所述驱动电动机可移动地接合至所述传动管;
杆,其被布置为与所述传动管机械协作,至少所述杆的一部分可相对于所述传动管平移;以及
末端执行器,其邻近所述内窥镜部的远侧部设置,所述末端执行器被布置为由所述杆驱动以便所述发射杆驱动所述末端执行器的外科功能。
11.根据权利要求10所述的外科器械,进一步包括设置在所述驱动电动机和所述传动管之间的离合器,所述离合器包括离合器片和弹簧。
12.根据权利要求11所述的外科器械,其中所述离合器片被布置为与所述传动管的近端的接口相配合。
13.根据权利要求10所述的外科器械,其中所述末端执行器限定第二纵轴,所述末端执行器可以从第一位置移动至至少第二位置,在所述第一位置处所述第二纵轴与所述第一纵轴大体成一条直线,在所述第二位置处所述第二纵轴设置为相对于所述第一纵轴有一角度。
14.根据权利要求10所述的外科器械,其中所述末端执行器可围绕所述第一纵轴相对于所述壳体旋转。
15.根据权利要求10所述的外科器械,进一步包括用户界面,所述用户界面包括至少一个控制所述杆的平移的开关。
16.根据权利要求10所述的外科器械,其中至少所述杆的一部分至少部分地设置在所述传动管内。
17.根据权利要求10所述的外科器械,其中所述传动管包括在其内表面上的螺纹部。
18.根据权利要求17所述的外科器械,其中所述杆包括其上的螺纹部,所述发射杆的螺纹部与所述传动管的螺纹部相接合。
19.根据权利要求10所述的外科器械,其中至少所述杆的一部分贯穿一个板的开口,所述开口包括用于防止所述发射杆相对于所述板旋转的非圆形截面。
20.根据权利要求10所述的外科器械,进一步包括至少部分地设置在所述壳体内并且被布置为向所述驱动电动机提供电力的电源。
21.根据权利要求10所述的外科器械,其中所述末端执行器为一次性装载单元的一部分。
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