CN100571642C - 构造为防止夹具掉出的夹具施放器 - Google Patents
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Abstract
本发明提供用于在外科手术期间将外科夹具施放到导管、脉管、分流管等的外科夹具施放器和方法。在示范性实施例中，提供的外科夹具施放器具有触发器可动地与其相连的外壳以及从外壳伸出的细长轴，该细长轴带有形成于其远端的相对的钳口。所述触发器适于推进夹具以将夹具定位在钳口之间，并且适于将该钳口从张开位置运动到闭合位置，以压扁已在其间定位的夹具。该外科夹具施放器可包括多种部件以便于装置的使用，包括将夹具与钳口对准的部件，防止夹具无意地运动的部件以及防止夹具在形成期间掉出的部件。
Description
相关申请的交叉引用
本发明是2005年4月14日提交的题为“Surgical Clip ApplierMethods”的美国专利申请No.10/907,763、2005年4月14日提交的题为“Force Limiting Mechanism For Medical Instrument”的美国专利申请No.10/907,764、2005年4月14日提交的题为“Surgical ClipAdvancement Mechanism”的美国专利申请No.10/907,765、2005年4月14日提交的题为“Surgical Clip Applier Ratchet Mechanism”的美国专利申请No.10/907,766以及2005年4月14日提交的题为“SurgicalClip Advancement And Alginment Mechnism”的美国专利申请No.10/907,768的部分继续申请。这些文件在此通过引用将全文并入本申请。
技术领域
本发明广泛涉及外科装置，更具体的涉及用于将外科夹具施放到导管、脉管、分流管等上的方法和装置。
背景技术
近几年，外科通过腹腔镜和内窥镜外科手术的施行已有显著的进步，这些手术例如胆囊切除术、胃造口术、阑尾切除术以及疝的修复。完成这些手术要通过套管针组件，它是用于穿刺体腔的外科器械。套管针典型地包括尖锐的闭塞器尖端和套管针管或插管。通过使用闭塞器尖端穿透皮肤将套管针插管插入皮肤以接近体腔。在穿刺以后，移去闭塞器并将套管针插管留在体内。正是通过这个插管放入外科器械。
一种通常与套管针插管一起使用的外科器械是用于在外科手术过程中结扎血管、脉管、分流管或人体组织部分的外科夹具施放器。大多数夹具施放器通常具有带有细长轴的手柄，该轴在其端部形成有一对可动的相对钳口，用于在其间固定并形成结扎夹具。在脉管或导管周围定位钳口，并通过钳口的闭合将夹具压扁或在血管上成形。
在现有技术的许多夹具施放器中，输送和成形机构要求精确定时和所要操作的组成元件的协同运动。这种对精确定时和控制的要求导致需要复杂的机械设计，由此增大了夹具施放器的成本。许多现有技术的夹具施放器还使用弹簧加载夹具推进组件，以使一个或多个夹具前进穿过装置的轴。结果，钳口必须包括用于防止在夹具形成之前夹具意外的发射的机构。现有夹具施放器的其它缺点包括不能处理在多种情况下由触发器施加到钳口的过载。许多装置要求钳口的完全闭合，而当定位在钳口之间的脉管或导管过大而不能完全闭合时，或在钳口之间有外物时会导致在钳口上的过载。
因此，依然需要一种用于将外科夹具施放到脉管、导管、分流管等上的方法和装置。
发明内容
本发明提供了用于将外科夹具施放到脉管、导管、分流管等上的方法和装置。在示范性实施例中，提供的外科夹具施放器具有外壳，触发器可动地连接到该外壳，并且细长轴从该外壳伸出，在该细长轴的远端形成有相对的钳口。触发器适于推进夹具，以将夹具定位在钳口之间，并且触发器适于将钳口从张开位置运动到闭合位置，以卷曲定位在其间的夹具。
外科夹具施放器具有多种结构，并且它可包括便于外科夹具的推进和成形的多种部件。在一种实施方式中，外科夹具施放器可包括送料履带片，其可滑动地布置在细长轴内并适于驱动至少一个外科夹具通过细长轴。在示范性实施例中，该送料履带片适于只向远侧方向运动，从而基本上防止送料履带片向近侧运动。细长轴还包括夹具轨道，该夹具轨道布置在细长轴内并适于安置至少一个外科夹具。送料履带片可滑动地布置在夹具轨道内。
可使用多种技术来便于送料履带片向远侧方向运动并防止送料履带片向近侧运动。在一个示范性实施例中，送料履带片包括柄脚，该柄脚适于与夹具轨道接合以防止送料履带片在夹具轨道内向近侧运动，但是该柄脚允许送料履带片在夹具轨道内向远侧运动。夹具轨道包括形成在其内用于接收柄脚的数个开口，以防止送料履带片在夹具轨道内向近侧运动。在另一个示范性实施例中，送料履带片包括柄脚，并且进给杆包括数个形成于其中的定位槽，所述定位槽适于与柄脚接合以当向远侧运动进给杆时向远侧运动送料履带片。
在另一个实施例中，细长轴包括可滑动地布置在其内并与触发器连接的进给杆，从而触发器向闭合位置的运动适于推动进给杆向远侧运动，由此推进送料履带片向远侧运动。作为非限制实例，进给杆通过与触发器配合的触发器插入件以及在触发器插入件和进给杆近端之间延伸的连杆与触发器连接。进给杆近端包括联接器，其适于接收部分连杆。进给杆还包括具有推进器的远端，该推进器适于与最远侧夹具接合并驱动最远侧夹具进入钳口。在一些示范性实施例中，进给杆适于在开始推动送料履带片以前与最远侧夹具接合并开始推进最远侧夹具进入钳口。
在又一个实施例中，提供用于推进夹具通过外科夹具施放器的夹具推进组件。该夹具推进组件可以与多种外科夹具施放器一起使用，包括那些本领域已知的。在一个示范性实施例中，夹具推进组件可包括：夹具轨道，其适于安置至少一个夹具；和送料履带片，其适于与夹具轨道可滑动地配合并沿远侧方向运动，以沿远侧运动方向运动布置在夹具轨道内的至少一个夹具。在一个示范性实施例中，送料履带片包括柄脚，其适于与夹具轨道接合以防止在夹具轨道内的送料履带片向近侧运动，并适于允许在夹具轨道内的送料履带片向远侧运动。该夹具轨道包括形成在其内用于接收柄脚的多个开口，以防止送料履带片在夹具轨道内向近侧运动。
夹具推进组件还包括进给杆，其适于与形成在外科夹具施放器外壳上的可动触发器连接，并当闭合触发器时适于向远侧可滑动地运动，以推进送料履带片和布置在夹具轨道中的至少一个夹具。该进给杆可具有多种结构，而在一个示范性实施例中，进给杆的远端包括推进器，其适于与最远侧夹具接合并将最远侧夹具从夹具轨道驱动进入形成在外科夹具施放器远端的钳口中。在另一个示范性实施例中，送料履带片包括柄脚，进给杆包括多个形成于其中的定位槽，所述定位槽适于与柄脚接合以当向远侧运动进给杆时向远侧运动送料履带片。在使用中，进给杆近端包括联接器，其适于接收用于连接进给杆和外科夹具施放器的触发器的连杆。
还提供了用于推进外科夹具通过外科夹具施放器的细长轴的示范性方法。在一个实施例中，可在外科夹具施放器的细长轴内向远侧推进进给杆，以向远侧推进设置在细长轴内的送料履带片并由此向远端推进至少一个夹具。可通过例如致动触发器来向远侧推进进给杆，该触发器与外壳连接并与细长轴近端配合。在一个示范性实施例中，当向远侧推进进给杆时，在进给杆远端的推进器与最远侧夹具接合并将夹具推进到形成于细长轴远端的相对钳口之间。该方法还包括在细长轴内向近侧缩回进给杆，同时将送料履带片保持在基本上固定的位置。
在另一个示范性实施例中，提供用于施放外科夹具器的方法，并且该方法包括使连接到外壳的触发器向着闭合位置运动第一距离，以致动布置在外壳内的夹具推进组件，以此推进夹具进入形成在细长轴远端的钳口组件中，进一步使触发器向闭合位置运动第二距离，以致动布置在外壳内的夹具形成组件，以此形成布置在钳口组件中的夹具。触发器在夹具形成组件致动期间相对夹具推进组件优选是顺应性的。夹具形成组件在其致动期间相对钳口组件也是顺应性的。
在其它方面，提供一种与外科装置一起使用的过载机构。在一个示范性实施例中，过载机构包括力接收构件，其可枢转地并可滑动地布置在外壳中，并具有带有第一端和相对的第二端的表面，以及布置在外壳中的偏压组件，其适于阻止力接收构件的运动。在一个示范性实施例中，阻力从第一端到第二端增加。
力接收构件可具有多种结构，但在一个实施例中，形成于其上的力接收表面定位在外壳的开口内。该力接收表面包括第一部分，其适于接收用于外壳内可枢转地运动力接收构件的力，以及第二部分，其适于接收用于在外壳内可滑动地运动力接收构件的力。偏压组件也可具有多种结构，但在一个示例性实施例中，偏压组件包括围绕弹簧柱布置的弹簧，以及相对弹簧柱可滑动地布置的撞针，该撞针具有形成于其上的头部，当撞针向弹簧柱可滑动地运动时，该头部适于压缩弹簧。
在另一个实施例中，外壳可包括枢转组件，其连接在力接收构件和偏压组件之间，以使枢转组件适于将施加到力接收构件上的力传递到偏压组件上以克服阻力。在一个示范性实施例中，枢转组件包括：肘节连杆，其枢转地与力接收构件连接；以及枢转连杆，其枢转地与肘节连杆连接，并当其枢转运动时适于对偏压组件施加力。
在另一个实施例中，提供的外科夹具施放器具有用于防止施加到夹具施放器的闭合力过载的过载机构。在一个示范性实施例中，外科夹具施放器包括：触发器可动地与其相连的外壳；从外壳伸出的细长轴，该细长轴带有形成于其远端的相对的钳口，并且该钳口可在张开位置和闭合位置运动；以及布置在外壳和细长轴内并与触发器连接的凸轮组件。该凸轮组件适于在触发器致动时将闭合力施加到钳口，以将钳口从张开位置运动到闭合位置，并且当闭合力大于施加到过载组件的过载机构阻力时，该凸轮系统还适于传递闭合力到布置在外壳内的过载机构。在一个示范性实施例中，过载机构阻力与将钳口从张开位置运动到闭合位置所需要的力相关联。
虽然可使用多种技术将凸轮组件与过载机构连接，在一个示范性实施例中，凸轮组件相对过载机构的力接收表面运动，以便施加凸轮组件的闭合力越过过载机构的力接收表面，同样地致动触发器使凸轮组件将钳口从张开位置运动到闭合位置。过载机构的力接收表面可适于阻止向近侧方向的运动，并且当致动触发器使凸轮组件相对于力接收表面将钳口从张开位置运动到闭合位置时阻力将上升。
在另一个示范性实施例中，过载机构可包括外壳具有可滑动枢转地布置在其中的翼形连杆，和具有形成在其上并定位邻近形成在外壳内开口的力接收表面。力接收表面包括第一部分适于接收用于枢转地运动外壳内力接收构件的力，以及第二部分适于接收用于可滑动地运动外壳内力接收构件的力。过载机构还可包括偏压组件，其适于施加阻力到翼形连杆。在一个示范性实施例中，偏压组件通过枢转组件与翼形连杆连接，当翼形连杆枢转运动时枢转组件适于枢转，而当翼形连杆滑动运动时枢转组件适于滑动以对偏压组件施加力以克服阻力。
还提供了用于应用具有过载机构的外科夹具施放器的方法。在一个示范性实施例中，可向形成在外科夹具施放器上的一对钳口施加闭合力。该闭合力可有效地将相对的钳口从张开位置运动到闭合位置。当闭合力大于过载机构的阈值力时，将闭合力传递到布置在外科夹具施放器内的过载机构。在一个示范性实施例中，当钳口从张开位置运动到闭合位置时，过载机构的阈值力升高。
虽然过载机构可具有多种结构，在一个示范性实施例中，过载机构可包括适于接收闭合力的力接收构件，和适于阻止力接收构件响应闭合力的运动的偏压组件。该外科夹具施放器可包括凸轮组件，该凸轮组件适于施加闭合力到钳口，并包括滚柱构件，当对钳口施加闭合力时其滚动越过力接收构件。当滚柱构件滚动越过力接收构件时，过载机构的阈值力升高。具体地，当滚柱构件滚动越过力接收构件的第一部分时，如果闭合力大于阈值力，力接收构件可枢转，而当滚柱构件滚动越过力接收构件的第二部分时，如果闭合力大于阈值力，力接收构件可滑动。在一个示范性实施例中，枢转力接收构件所需的阈值力小于滑动力接收构件所需的阈值力。
在其它方面，提供外科夹具施放器，它包括：夹具推进组件，其与触发器连接并适于推进至少一个夹具通过从外壳伸出的细长轴；和夹具形成组件，其与触发器连接并适于致动形成于细长轴远端的钳口组件以形成外科夹具。触发器可与外壳连接并适于致动夹具推进组件和夹具形成组件。在一个示范性实施例中，触发器有致动的两个连续的阶段，在致动的第一阶段，触发器有效致动夹具推进组件，在致动的第二阶段，触发器有效致动夹具形成组件，同时触发器相对夹具推进组件是顺应性的。
在其它实施例中，外科夹具施放器具有例如在装置运输期间防止夹具的无意运动的部件。在一个示范性实施例中，外科夹具施放器具有带推动器机构的夹具推进组件，该机构布置在夹具轨道内并可向钳口运动以连续地推进多个夹具进入钳口。推动器机构适于与夹具轨道产生摩擦力，以防止在夹具轨道内的推动器机构无意地运动，但当夹具推进组件致动时，它适于运动以向远侧推动推动器机构。
虽然可使用多种技术在推动器机构与夹具轨道之间产生摩擦力，在一个实施例中，夹具轨道包括形成于其上的一个或多个并与推动器机构接触以与夹具轨道产生摩擦力的突起。在另一个示范性实施例中，推动器机构包括形成于其上的并偏压送料履带片以与夹具轨道产生摩擦力的可弯曲的柄脚。可弯曲的柄脚包括形成在其上并适于接合形成在送料履带片内的相应凸脊的凸缘。在另一个示范性实施例中，推动器机构具有悬臂式结构以与夹具轨道产生摩擦力。在一个实施例中，沿夹具轨道长度延伸的相对侧壁偏压推动器机构从基本上V形的横截面到基本上直的横截面，由此产生摩擦力。
在另一个示范性实施例中，所提供的外科夹具施放器具有带有可动地连接到其上的触发器的外壳，以及从外壳延伸的轴，该轴带有形成在其远端的相对的钳口。夹具轨道从该轴中延伸通过并适于保持多个夹具。该外科夹具施放器还包括送料履带片，其可滑动地布置在夹具轨道内并适于推进多个夹具通过夹具轨道。该送料履带片被构造成与夹具轨道产生摩擦力以阻止送料履带片无意地运动。例如，送料履带片和/或夹具轨道可包括至少一个突起、可弯曲的柄脚或其它表面部件，以适于与夹具轨道产生摩擦力。在其它实施例中，推动器包括可弯曲的柄脚，其带有形成在其上并适于接合形成在夹具轨道内的相应凸脊的凸缘。可选择性地，或另外，送料履带片具有悬臂式结构，以与夹具轨道产生摩擦力。夹具轨道包括带有沿其延伸的相对侧壁的支撑表面，并且送料履带片可滑动地布置在相对侧壁之间。相对侧壁偏压送料履带片从基本V形的截面到基本直的截面，以此产生摩擦力
在另一个示范性实施例中，所提供的外科夹具施放器具有外壳，从外壳延伸的轴，形成在该轴远端并适于在其间容纳组织的第一和第二钳口，夹具轨道从该轴中延伸通过并适于保持多个夹具，布置在夹具轨道内并适于推进多个夹具通过夹具轨道并进入第一和第二钳口的夹具推动器。该夹具推动器在夹具轨道内受偏压，从而防止夹具推动器的运动，直到施加到夹具推动器上的力大于在夹具推动器和夹具轨道之间产生的偏压力。
在一个示范性实施例中，夹具推动器包括形成在其上并适于在夹具轨道内偏压夹具推动器的偏压机构。偏压机构包括例如形成在夹具推动器上的突起或形成在夹具推动器上的可弯曲的柄脚。在其它实施例中，夹具推动器的宽度大于夹具轨道宽度，以便偏压在夹具轨道内的夹具推动器。在一个示范性实施例中，夹具推动器由夹具轨道弯曲，以使夹具推动器受压从基本V形外形到基本平面外形。
在另一个示范性实施例中，所提供的外科夹具施放器具有防止夹具在变形期间掉出的部件。在一个示范性实施例中，提供一种改进的内窥镜外科夹具施放器，该施放器具有：一起闭合靠近待夹住的组织的钳口，适于闭合钳口的顶杆，适于致动顶杆的触发器，和在至少部分闭合冲程期间适于防止触发器打开的棘齿机构。在顶杆和将顶杆连接到触发器的联接件之间形成预载接合件，在闭合冲程期间当触发器部分打开时，预载接合件可有效地保持钳口在基本固定的部分闭合位置，以保持在钳口之间的部分成形的夹具。预载接合件适于将顶杆保持在基本固定的位置，而允许联接件向近侧运动。
预载接合件具有多种结构，但在一个实施例中，预载接合件是偏压构件，在闭合冲程期间，其适于由顶杆压缩，而当触发器部分打开时，其适于将偏压力施加到顶杆。偏压构件可以是例如悬臂梁或弹簧。在一个示范性实施例中，顶杆的近端和偏压构件布置在形成于联接机构内的凹槽中，而悬臂梁或弹簧向远侧偏压顶杆的近端。凹槽还有选择地包括形成于其中的凸脊，并在闭合冲程期间当弹簧被压缩时，该凸脊适于将弹簧保持在基本稳定的载荷。凸脊还适于防止弹簧被完全压缩。
在另一个示范性实施例中，所提供的外科夹具施放器具有：带有从其延伸的轴的手柄，形成在该轴远端的钳口，从该杆延伸穿过并与钳口连接的钳口闭合机构，适于致动钳口闭合机构以闭合钳口的触发器。在钳口闭合机构和触发器之间形成预载接合件，在闭合冲程期间当触发器部分打开时，该预载接合件构造成防止夹具从钳口掉出。在一个实施例中，预载接合件可以是弹簧，在闭合冲程期间，该弹簧适于由部分钳口闭合机构压缩。弹簧由例如镍钛诺形成。在另一个实施例中，预载接合件可布置在形成于联接机构内的凹槽中。在闭合冲程期间，预载接合件适于由顶杆压缩。
在其它方面，所提供的外科夹具施放器具有：外壳，从外壳向远侧延伸的轴，形成在该轴远端的第一和第二钳口，与外壳可动地连接的触发器，适于在至少部分闭合冲程期间当触发器松开时接合触发器的防倒退机构。连接在触发器和钳口之间的组件适于在至少部分闭合冲程期间当触发器松开时将钳口保持在基本上固定的位置，以防止夹具掉出。
在一个示范性实施例中，所述组件包括形成于其中的预载接合件，用于将部分组件保持在固定位置并在至少部分闭合冲程期间当触发器松开时允许部分组件向近侧运动。在一些方面，预载接合件形成在顶杆和联接机构之间，所述顶杆适于推进凸轮越过钳口以闭合钳口，所述联接机构用于将顶杆连接到触发器。预载接合件将顶杆保持在固定位置并在至少部分闭合冲程期间当触发器松开时允许联接机构向近侧运动。在一些示范性实施例中，预载接合件是布置在顶杆和联接机构之间的弹簧。
本发明还提供示范性技术，用于将夹具与形成在外科夹具施放器远端的相对钳口对准，并且优选地用于在夹具形成期间保持夹具与相对钳口对准。在一个示范性实施例中，所提供的外科夹具施放器具有带有近端和远端的轴，形成在轴的远端上的相对钳口以及引导构件，所述引导构件与钳口连接并具有形成在其上的对准机构，该引导构件适于引导夹具进入相对的钳口，并当夹具相对的腿闭合时该引导构件保持夹具与相对的钳口对准。该对准机构还适于抵靠在形成于相对钳口之间的至少部分夹具的下表面上，以限制或防止夹具垂直运动，即，顶点和腿沿上下方向的枢转。
对准机构可形成在夹具施放器的各个部分，但在一个示范性实施例中，引导构件是组织止挡件，该组织止挡件具有远端，该远端带有形成于其内用于固定脉管的凹槽。对准机构可是从组织止挡件的上表面突出的斜面构件。在一个示范性实施例中，斜面构件在高度上从组织止挡件的近端到远端增加。
在另一个示范性实施例中，所提供的外科夹具施放器具有轴，形成在该轴远端并且适于一起闭合以便靠近待夹住的组织的相对的钳口，与轴可动地连接并适于推进夹具进入相对的钳口的夹具推进组件。推进器引导器刚好布置在相对的钳口的近侧并适于引导由夹具推进组件推进的夹具进入相对的钳口。推进器引导器适于将夹具与相对的钳口对准。推进器引导器还适于限制或防止形成在相对钳口之间的夹具垂直运动。
在一些示范性实施例中，推进器引导器形成在与相对钳口连接的组织止挡件上，该组织止挡件具有形成在其远侧末端中的凹槽，该凹槽适于在其中容纳组织。推进器引导器可是斜面构件的形式，突出于组织止挡件的上表面之上。
在其它方面，提供一种改进的内窥镜外科夹具施放器，具有：一起闭合以便靠近待夹住的组织的钳口；以及适于连续地推进多个夹具进入钳口的夹具推进组件。斜面引导构件刚好定位于相对的钳口的近侧，并适于对准并引导由夹具推进组件推进的夹具进入相对的钳口，并适于在相对钳口之间形成夹具时限制或防止夹具的垂直运动。在一个示范性实施例中，斜面引导构件形成在与相对钳口连接的组织止挡件上，组织止挡件包括远侧末端，适于在其中容纳组织，以对准待夹住的组织和钳口。在一些示范性实施例中，斜面引导构件在高度上从其近端到远端增加。该斜面引导构件适于抵靠在形成于相对钳口之间的至少部分夹具的下表面，以限制或防止夹具垂直运动，即，顶点和腿沿上下方向的枢转。在一个示范性实施例中，斜面引导构件具有约0.025”的最大高度，和/或斜面引导构件倾斜的角度在约5°到45°的范围内。
更具体地说，本发明涉及如下内容：
(1)一种改进的内窥镜外科夹具施放器，该施放器具有一起闭合以便靠近待夹住的组织的钳口，适于闭合钳口的推进杆，适于致动推进杆的触发器，以及适于在至少部分闭合冲程期间防止触发器打开的棘齿机构，其特征在于：
推进杆通过联接机构与连接到触发器的联接件相连接，预载接合件和所述推进杆的近端布置在形成于所述联接机构内的凹槽中，在闭合冲程期间当触发器部分打开时，所述预载接合件能够将钳口保持在固定的部分闭合位置中，以保持在钳口之间的部分成形的夹具。
(2)如第(1)项所述的外科夹具施放器，其中，所述预载接合件适于将推进杆保持在固定的位置，同时允许所述联接件向近侧运动。
(3)如第(1)项所述的外科夹具施放器，其中，所述预载接合件包括偏压构件，在闭合冲程期间，该偏压构件适于由推进杆压缩，当触发器部分打开时，该偏压构件适于将偏压力施加到推进杆的近端。
(4)如第(3)项所述的外科夹具施放器，其中，所述偏压构件包括悬臂梁。
(5)如第(3)项所述的外科夹具施放器，其中，所述偏压构件包括弹簧。
(6)如第(1)项所述的外科夹具施放器，其中，所述凹槽包括至少一个形成于其中的凸脊，在闭合冲程期间当偏压构件被压缩时，所述凸脊适于将偏压构件保持在恒定的载荷。
(7)如第(6)项所述的外科夹具施放器，其中，所述至少一个凸脊适于防止偏压构件被完全压缩。
(8)一种外科夹具施放器，包括：
带有从其延伸的轴的手柄；
形成在所述轴的远端上的钳口；
从所述轴延伸穿过并连接到钳口上的钳口闭合机构；
适于致动钳口闭合机构以闭合钳口的触发器；以及
在钳口闭合机构和触发器之间形成的预载接合件，该预载接合件构造成在闭合冲程期间当触发器部分打开时防止夹具从钳口掉出。
(9)如第(8)项所述的外科夹具施放器，其中，所述预载接合件包括弹簧，在闭合冲程期间，该弹簧适于由部分钳口闭合机构压缩。
(10)如第(9)项所述的外科夹具施放器，其中，所述弹簧由镍钛诺形成。
(11)如第(8)项所述的外科夹具施放器，其中，所述钳口闭合机构包括适于闭合钳口的凸轮，连接到所述凸轮的推进杆以及在推进杆和触发器之间延伸的联接机构。
(12)如第(11)项所述的外科夹具施放器，其中，所述预载接合件布置在形成于联接机构内的凹槽中，在闭合冲程期间，所述预载接合件适于由推进杆压缩。
(13)如第(12)项所述的外科夹具施放器，其中，所述凹槽包括至少一个形成于其中的凸脊，在闭合冲程期间当预载接合件被压缩时，所述凸脊适于将预载接合件保持在基本上恒定的载荷。
(14)如第(13)项所述的外科夹具施放器，其中，所述至少一个凸脊适于防止弹簧完全压缩。
(15)一种外科夹具施放器，包括：
外壳；
从所述外壳向远侧延伸的轴；
形成在所述轴的远端的第一和第二钳口；
可动地连接到所述外壳的触发器；
适于在至少部分闭合冲程期间当将触发器松开时接合触发器的防倒退机构；以及
连接在触发器和钳口之间的组件，在至少部分闭合冲程期间当触发器被松开时该组件适于将钳口保持在基本上固定的位置，以防止夹具掉出。
(16)如第(15)项所述的外科夹具施放器，其中，所述组件包括形成于其中的预载接合件，用于将部分组件保持在固定的位置并在至少部分闭合冲程期间当触发器被松开时允许部分组件向近侧运动。
(17)如第(16)项所述的外科夹具施放器，其中，所述预载接合件形成在推进杆和联接机构之间，所述推进杆适于推进凸轮越过钳口以闭合钳口，所述联接机构用于将推进杆连接到触发器，在至少部分闭合冲程期间当触发器被松开时，所述预载接合件将推进杆保持在固定的位置并允许联接机构向近侧运动。
(18)如第(17)项所述的外科夹具施放器，其中，所述预载接合件包括布置在推进杆和联接机构之间的弹簧。
附图说明
从下面结合附图的详细描述中将会对本发明有更全面的理解，其中：
图1A是外科夹具施放器的示范性实施例的侧视图；
图1B是图1A所示外科夹具施放器的分解图；
图2A是图1A所示外科夹具施放器的钳口保持器组件的俯视图；
图2B是图2A所示钳口保持器组件的仰视图；
图2C是图2B所示钳口保持器组件的侧视图；
图2D是沿着线D-D截取的图2C所示钳口保持器组件的横截面图；
图3A是与图2A-2D所示钳口保持器组件一起使用的送料履带片的俯视图；
图3B是图3A所示送料履带片的仰视图；
图4A是构建为推进图3A和3B所示送料履带片通过图2A-2D所示钳口保持器组件的进给杆的侧视透视图；
图4B是图4A所示进给杆近端以及图2A和2B所示钳口保持器轴的远端的侧视图，示出了在最近侧位置的进给杆；
图4C是图4B所示进给杆和钳口保持器轴的侧视图，示出了在最远侧位置的进给杆；
图4D是与图2A和2B所示钳口保持器轴的近端一起示出的进给杆近端的另一个实施例的侧视图，示出了在最近侧位置的进给杆；
图4E是图4D所示进给杆和钳口保持器轴的侧视图，示出了在最远侧位置的进给杆；
图4F是与图2A和2B所示钳口保持器轴的近端一起示出的进给杆近端的又一个实施例的侧视图，示出了在最近侧位置的进给杆；
图4G是图4F所示进给杆和钳口保持器轴的侧视图，示出了在中间位置的进给杆；
图4H是图4F所示进给杆和钳口保持器轴的侧视图，示出了在最远侧位置的进给杆；
图5A是构建为与图4A所示进给杆的远端连接的推进器的侧视透视图；
图5B是构建为与图4A所示进给杆的远端连接的推进器的另一个实施例的侧视透视图；
图6A是夹具推进组件的横截面图，其中包括图2A-2D所示钳口保持器组件，图3A和3B所示送料履带片，以及图4A所示处于相对于钳口保持器组件的夹具轨道为初始近侧位置的进给杆；
图6B是图6A所示夹具推进组件的横截面图，示出了向远侧方向运动的进给杆；
图6C是图6B所示夹具推进组件的横截面图，示出了进给杆进一步向远侧运动，由此向远侧方向运动送料履带片和布置在送料履带片远侧的夹具供应器；
图6D是图6C所示夹具推进组件的横截面图，示出回到图6A所示初始近侧位置的进给杆，同时送料履带片和夹具供应器依然在图6C所示的推进位置；
图6E是图5A所示推进器的仰视透视图，该推进器布置在图2A-2D所示钳口保持器组件的夹具轨道内，其中示出在最近侧位置的推进器；
图6F是6E所示推进器的仰视透视图，示出了将一个夹具推进到外科夹具施放器的钳口后处于最远侧位置的推进器；
图7是图1A所示外科夹具施放器的一对钳口的侧视透视图；
图8是与图7所示钳口一起使用的凸轮的侧视透视图；
图9是顶杆适于与图8所示凸轮连接以用于使凸轮相对于图7所示钳口运动的俯视透视图；
图10A是连接到图7所示钳口的图8所示凸轮的俯视图，示出了处于初始位置的凸轮和张开的钳口；
图10B是连接到图7所示钳口的图8所示凸轮的俯视图，示出了推进到钳口上方的凸轮和处于闭合位置的钳口；
图11A是组织止挡件的俯视透视图，该止挡件适于与图2A-2D所示钳口保持器组件的夹具轨道的远端连接；
图11B是组织止挡件的另一个实施例的俯视透视图，在该止挡件上形成有斜面，用于将夹具引导进入钳口并在夹具形成期间稳固夹具；
图11C是图11B所示的组织止挡件的侧视图；
图11D是图11B和图11C所示的组织止挡件的放大视图；
图12是图1A所示外科夹具施放器的远端的俯视透视图，示出了图11A所示的组织止挡件位于图7所示的钳口之间；
图13是图1A所示外科夹具施放器的手柄部分的部分侧剖视图；
图14是图1A所示外科夹具施放器的触发器插入件的侧视透视图；
图15A是图1A所示外科夹具施放器的进给杆联接器的一半的侧视透视图；
图15B是图15A所示的进给杆联接器的另一半的侧视透视图；
图16是形成部分图1A所示外科夹具施放器的夹具推进组件的柔性连杆的俯视透视图；
图17A是图1A所示外科夹具施放器的手柄部分的部分侧剖视图，示出了处于初始位置的夹具推进组件；
图17B是图17A所示外科夹具施放器手柄部分的部分侧剖视图，示出部分致动的夹具推进组件；
图17C是图17B所示外科夹具施放器手柄部分的部分侧剖视图，示出了完全致动的夹具推进组件；
图17D是图17A所示外科夹具施放器手柄部分的部分侧剖视图，示出了已致动的夹具推进组件；
图18是作为图1A所示外科夹具施放器的夹具形成组件的形成部分的闭合连杆滚柱的侧视图；
图19是与图18所示闭合连杆滚柱连接以形成图1A所示外科夹具施放器的部分夹具形成组件的闭合连杆的俯视透视图；
图20A是闭合连杆联接器的俯视透视图，其与图19所示闭合连杆连接并形成图1A所示外科夹具施放器的部分夹具形成组件；
图20B是与图9所示顶杆连接的图20A所示闭合连杆联接器的仰视图，示出了在其中布置有偏压部件的实施例；
图20C是与图9所示顶杆连接的图20A所示闭合连杆的仰视图，示出了在其中布置有偏压部件的另一实施例；
图20D是移动图20B所示的偏压部件所需力的大小的图表；
图20E是具有形成在其中的凸脊的闭合连杆联接器的另一实施例的侧视图；
图21A是图1A所示外科夹具施放器的防倒退机构(anti-backupmechanism)的放大俯视透视图；
图21B是图21A所示防倒退机构的棘爪机构的透视图；
图22A是图1A所示外科夹具施放器的部分手柄的部分侧剖视图，示出了在初始位置的防倒退机构；
图22B是图22A所示外科夹具施放器的部分手柄的部分侧剖视图，示出了部分致动的防倒退机构；
图22C是图22B所示外科夹具施放器的部分手柄的部分侧剖视图，示出完全致动的防倒退机构；
图22D是图22C所示外科夹具施放器的部分手柄的部分侧剖视图，示出了防倒退机构正返回初始位置；
图22E是图22D所示外科夹具施放器的部分手柄的部分侧剖视图，示出了防倒退机构已回到初始位置；
图23A是图1A所示外科夹具施放器的过载机构的剖视图；
图23B是图23A所示过载机构的部分剖视图，示出了闭合连杆滚柱首先与翼型连杆接触；
图23C是图23B所示过载机构的部分剖视图，示出了闭合连杆滚柱对翼型连杆施加力造成翼型连杆枢转。
图23D是与外科夹具施放器一起使用的过载机构的另一个实施例的透视图；
图24A是图1A所示的外科夹具施放器的夹具量指示轮的侧视透视图；
图24B是图24A所示的夹具量指示轮的侧视图；
图25是与图24所示的夹具量指示轮一起使用的夹具量致动器的俯视透视图；
图26A是图1A所示外科夹具施放器的部分手柄的部分侧剖视图，示出了图25的夹具量致动器和图24的夹具量指示轮的运动；
图26B是图26A所示外科夹具施放器的部分手柄的部分侧剖视图，示出了图25的夹具量致动器和图24的夹具量指示轮的进一步运动。
图27A是示出了送料履带片的另一个实施例的侧视图，该送料履带片具有形成在其中的预成型为A形并构成为在送料履带片和夹具轨道之间造成摩擦力的弯曲部；
图27B是示出了送料履带片的又一个实施例的侧视图，该送料履带片具有形成在其中的预成型为V形并构成为在送料履带片和夹具轨道之间造成摩擦力的弯曲部；
图28A是部分夹具轨道的俯视透视图，其具有形成在其中的并构成为与根据本发明另一个实施例的送料履带片之间造成摩擦力的表面突起；
图28B是送料履带片的另一个实施例的端部透视图，该送料履带片具有形成在其上的并适于接合形成在图28A的夹具轨道内的表面突起的柄脚；
图29A是送料履带片的另一个实施例的底部透视图，具有形成在柄脚上的止挡凸缘，该止挡凸缘适于接合形成在进给杆上的对应凹槽；
图29B是进给杆的另一个实施例的俯视透视图，该进给杆具有形成在其内的捕获凹槽，该捕获凹槽适于由形成在图29A所示的送料履带片的柄脚上的止挡凸缘接合；以及
图29C是布置在图29B的进给杆内并与之接合的图29A所示送料履带片的侧剖视图。
具体实施方式
本发明总的来说提供外科夹具施放器以及使用外科夹具施放器在外科手术过程中对血管、脉管、分流管等施放外科夹具的方法。示范性的外科夹具施放器包括多种便于施放外科夹具的部件，如此处所述和附图所示的。然而，本领域普通技术人员应该理解，外科夹具施放器可只包括这些部件中的一些和/或可包括多种本领域已知的其它部件。在此描述的外科夹具施放器仅仅用于表示某些示范性的实施例。
图1A示出示范性的外科夹具施放器10。如所示出的，夹具施放器10通常包括具有固定手柄14的外壳12和与外壳12枢轴连接的可动手柄或触发器16。细长轴18从外壳12伸出，且该细长轴18包括一对形成在其远端的相对钳口20，用于使外科夹具弯边。细长轴18可旋转地与外壳12连接，并且该细长轴18包括用于相对外壳12旋转轴18的旋钮22。图1B示出图1A所示外科夹具施放器10的分解图，多种部件将在下面更详细描述。
图2A-12示出外科夹具施放器10的轴18的多种部件的示范性实施例。总的来说，参照图1B，轴18包括容纳轴部件的外管24，所述轴部件可包括钳口保持器组件26，它具有带夹具轨道30和形成在其上的顶杆通道32的钳口保持器轴28。钳口20被构成为与夹具轨道30的远端配合。轴组件18还可包括夹具推进组件，在一个示范性实施例中该夹具推进组件包括：送料履带片34，其适于可滑动地布置在夹具轨道30内以推进位于其中的一连串夹具36；进给杆38，其适于驱动送料履带片34通过夹具轨道30。进给杆38可包括推进器组件40，其适于与进给杆38远端配合以将最远端的夹具推进钳口20。轴组件18还可包括夹具成形或凸轮组件，在一个示范性实施例中，该夹具成形或凸轮组件包括：凸轮42，其适于可滑动地与钳口20配合；顶杆44，其可与凸轮42连接以相对钳口20运动凸轮42。轴组件还可包括组织止挡件46，其可与夹具轨道30的远端配合，以便于相对外科手术位置定位钳口20。
一种示范性夹具推进组件的多种部件在图2A-5中更详细地示出。首先参照图2A-2D，所示的钳口保持组件26包括细长的、基本上平的钳口保持器轴28，它具有与外管24配合的近端28a，和适于与钳口20配合的远端28b。尽管可使用多种技术将钳口保持器轴28的近端28a与外管24配合，在所示出的实施方式中，近端28a包括：在其相对侧形成的齿牙31，其适于被容纳在形成于外管24内的相应孔或开口(未示出)中；形成在其内的切口29，允许近端28a的相对侧偏转或形成一弹簧。具体地，当钳口保持器轴28插入外管24时，切口29允许钳口保持器轴28的近端28a的相对侧向着彼此挤压。一旦齿牙31对准外管24中的相应开口，钳口保持器轴28的近端28a将返回其初始的未压缩结构，由此使齿牙31延伸进入相应开口以接合外管24。如参考图4A在下面将更详细地叙述的，所述装置还包括如下所述的部件，该部件用于防止在装置使用期间钳口保持器轴28的近端28a的相对侧挤压，从而防止齿牙31与外管24的意外脱离。
还可以使用多种技术使钳口保持器轴28的远端28b与钳口20配合，但是在示出的实施例中，钳口保持器轴28的远端28b包括数个形成于其中的切口或齿牙78，用以与形成在钳口20上的相应突起或齿牙94配合，在下面将参考图7更详细地叙述。齿牙78允许钳口20的近侧部分基本上与钳口保持器轴28共面。
钳口保持组件26还包括形成于其上的顶杆通道32，用于可滑动地接收用于推进凸轮42越过钳口20的顶杆44，如下面将更详细地叙述的。可使用多种技术形成顶杆通道32，而其所具有的形状和尺寸取决于顶杆44的形状和尺寸。如图2D所示，将顶杆通道32用例如焊接法固定地连接到保持器轴28的上表面，并且其具有基本上为矩形的形状且限定穿过其中延伸的通道32a。顶杆通道32还可沿着整个或者部分保持器轴28延伸。本领域熟练技术人员应该理解，钳口保持组件26不必包括顶杆通道32用以便于顶杆44在外科夹具施放器10的细长轴18内的运动。
进一步如图2A-2D所示，钳口保持组件26还包括与其配合或形成在其上的夹具轨道30。所示的夹具轨道30与保持器轴28的下表面配合，并其向远侧延伸超过钳口保持器轴28的远端28b，以允许夹具轨道30的远端30b与钳口20基本上对准。在使用中，夹具轨道30被构成为在其中安置至少一个、优选为一连串夹具。由此，夹具轨道30包括相对的导轨80a、80b，其适于在其中安置一个或多个夹具的相对的腿，以使夹具腿沿轴向彼此对准。在示范性实施例中，构成的夹具轨道30安置约20个在生产时预先布置在夹具轨道30中的夹具。本领域熟练技术人员应该理解，夹具轨道30的形状、尺寸和结构可根据夹具的形状、尺寸和结构或其它可适于被接收在其中的闭合装置(如钉)而改变。另外，可使用不同的其它技术代替夹具轨道30来夹持与细长轴18一起的夹具供给器。
夹具轨道30还包括形成于其内的几个开口30c，用于接收形成在适于布置在夹具轨道30内的送料履带片34上的柄脚82a，如下面将更详细地叙述的。在示范性实施例中，夹具轨道30包括一些开口30c，该开口30c的数目至少与适于预先布置在装置10中并在使用时施放的夹具数目一致。开口30c优选地彼此是等距的，以确保每次推进送料履带片34时送料履带片34上的柄脚82a与开口30c接合。虽然未示出，夹具轨道30可包括定位槽而不是开口30c，或它可包括其它部件以允许夹具轨道30与送料履带片34接合并防止送料履带片34的向远侧运动而允许其向近侧运动。夹具轨道30还包括形成于其上的止挡柄脚118，如图2B所示，该止挡柄脚118可有效地由在送料履带片34上形成的相应止挡柄脚接合以防止送料履带片34运动超出最远侧的位置，如下面将要更详细地描述的。止挡柄脚118可具有不同结构，但在示范性实施例中它是两个邻近的接片的形式，所述接片彼此相互延伸，以闭合部分夹具轨道，从而允许夹具通过。
在图3A和3B中更详细显示了示范性送料履带片34，并且它适于直接驱动夹具通过夹具轨道30。虽然送料履带片34可有不同的结构并可使用不同的其它技术驱动夹具通过夹具轨道30，在示范性实施例中，送料履带片34为具有近端34a和远端34b的细长形状。远端34b可适于将在夹具轨道30中最近侧的夹具支住以推动夹具通过夹具轨道30。在示出的示范性实施例中，远端34b基本上是V形，用于安置夹具的V形弯曲部分。远端34b还包括形成于其中的矩形槽口34c，用于允许推进器40接合最远侧夹具并将其推进钳口20中，如下面将要更详细地描述的。当然远端34b可根据夹具的结构或与装置10一起使用的其它闭合机构而改变。
在另一个示范性实施例中，送料履带片34还可以包括便于送料履带片34在夹具轨道30内的向远侧运动并基本上防止送料履带片34在夹具轨道30内的向近侧运动的部件。这样的结构确保夹具在夹具轨道30内的推进和适当定位，从而允许在触发器16每次致动时将最远侧的夹具推进到钳口20之间，如下面将要更详细地描述的。在示出的示范性实施例中，送料履带片34包括柄脚82a，该柄脚82a形成在其上表面34s上并向近侧成一角度，用于接合形成在夹具轨道30内的其中一个开口30c。在使用时，柄脚82a的角度允许送料履带片34在夹具轨道30内向远侧滑动。每次推进送料履带片34，柄脚82a向远侧从夹具轨道30内的一个开口30c运动到下一个开口30c。柄脚82a与夹具轨道30内的开口30c的接合防止送料履带片34向近侧运动而返回以前的位置，如下面将要更详细地描述的。
为了便于送料履带片34在夹具轨道30内向近侧的运动，送料履带片34包括形成在其下表面34i的柄脚82b，如图3B所示，用于允许在进给杆38向远侧运动时由进给杆38(图4A)接合送料履带片34。下柄脚82b与上柄脚82a在其可向近侧成一角度方面是类似的。在使用中，每次进给杆38向远侧运动，形成在进给杆38内的定位槽84与下柄脚82b接合并使送料履带片34在夹具轨道30内向远侧运动一预定距离。接着可向近侧运动进给杆38使其返回其初始位置，而下柄脚82b的角度允许柄脚82b滑动入形成在进给杆38内的下一个定位槽84。如先前解释的，可不使用柄脚82a、82b和开口30c或定位槽84而使用多种其它部件来控制送料履带片34在夹具轨道30内的运动。
如先前提到的，送料履带片34还可包括形成于其上的止挡件，当送料履带片34在最远侧位置且在装置10中没有夹具时，该止挡件适于挡住送料履带片34的运动。止挡件可具有多种结构，图3A和3B示出形成在送料履带片34上的第三柄脚82c，该第三柄脚82c沿向下方向延伸，用于接合形成在夹具轨道30上的止挡柄脚118(图2B)。这样定位第三柄脚82c，当送料履带片34在最远侧位置时，该柄脚接合在夹具轨道30上的止挡柄脚118，以此防止当夹具供给器用空时送料履带片34和进给杆38的运动。
图4A示出示范性进给杆38，用于驱动送料履带片34通过钳口保持组件26的夹具轨道30。如所示，进给杆38具有带有近端38a和远端38b的大致细长形状。进给杆38的近端38a可适于与进给杆联接器50配合(图1B)，这将在下面更详细地描述。进给杆联接器50与进给连杆52配合，当触发器16致动时，进给连杆52可有效地使进给杆38在细长轴18中沿着远侧方向可滑动地运动。进给杆38的近端38b可适于与推进器40、40’配合，如图5A和5B所示的示范性实施例所示，其有效地驱动布置在夹具轨道30内的最远侧夹具进入钳口20，这将在下面更详细地描述。
如先前提到的，进给杆38的近端38b可包括如下部件，该部件在装置使用过程中防止钳口保持器轴28的近端28a的相对侧的挤压(图2A和2B)，从而防止齿牙31与外管24的意外脱离。在示范性实施例中，图4A-4C所示，进给杆38的近端38a可包括形成于其上的突起39，其适于伸入形成在钳口保持器轴28的近端28a内的开口29。当进给杆38在最近侧位置(即，当触发器16在张开位置时)时，将突起39定位在开口29的近端，如图4B所示，允许钳口保持器轴28的近端28a进行挤压，以允许轴28滑入外管24。当进给杆38在最远侧位置(即，当触发器16在至少部分闭合的位置时)时，将突起39定位在邻近齿牙31的中间位置，如图4C所示，以防止钳口保持器轴28的近端28a的挤压。这在装置使用过程中特别有利，突起39防止在装置使用期间钳口保持器轴28与外管24的意外脱离。尽管图4A-4C示出的突起39具有带有圆边的矩形横截面形状，突起39可具有多种其它形状和尺寸。例如，如图4D和4E所示的，突起39’具有带有锥形端的类似三角形的截面形状，其可适于延伸到齿牙31之间以进一步确保在装置使用过程中钳口保持器轴28的近端28a不被挤压。还可使用多于一个的突起。例如，图4F-4H示出的另一个实施例，其中进给杆38的近端38a’可包括形成于其上并彼此相隔的两个突起39a、39b。如图4F所示当进给杆38在最近侧位置时，以及如图4H所示当进给杆38在最远侧位置时，两个突起39a、39b可以防止钳口保持器轴28的近端28a的挤压。钳口保持器轴28的近端28a的挤压只发生在如图4G所示当进给杆38在中间位置齿牙31定位在突起39a，39b之间时。
还如先前提到的，进给杆38可包括形成在其内的定位槽84，用于与形成在送料履带片34上的下柄脚82b接合。定位槽84的数量可变，但在示范性实施例中，进给杆38具有的定位槽84的数量对应于或大于适于由装置10施放的夹具的数量，并且更优选地，它比适于由装置10施放的夹具的数量多一个定位槽84。作为非限制性的例子，进给杆38可包括形成在其内的18个定位槽84，用于施放预先布置在夹具轨道30内的17个夹具。这样的结构允许进给杆38推进送料履带片34十七次，以此将17个夹具推进钳口20，以便使用。定位槽84还优选地彼此等距，以确保每次进给杆38推进时都可由进给杆38接合并推进送料履带片34。
进给杆38还可包括如下的部件，其用于控制进给杆38相对夹具轨道30的运动量。这样的结构确保触发器16每次致动时将送料履带片34推进一个预定距离，以此只推进单个夹具进入钳口20。尽管可使用多种技术控制进给杆38的向远侧运动，但是在示范性实施例中，进给杆38可包括形成于其上的突起86，其适于被可滑动地接收在形成在钳口保持器轴28内的相应的狭槽88(图2B)内。狭槽88的长度可有效限制其中的突起86的运动，这样就限制了进给杆38的运动。据此，在使用中，进给杆38可在固定的近侧位置和固定的远侧位置之间相对夹具轨道30滑动，以此随着进给杆38的每次推进允许进给杆38将送料履带片34推进一个预定距离。
图5A示出推进器40的一个示范性实施例，该推进器40适于与进给杆38的远端38b配合，并且它有效地驱动最远侧的夹具从夹具轨道30进入钳口20。尽管可使用多种技术将推进器40与进给杆38配合，但在示出的实施例中，推进器40的近端40a为内孔连接器的形式，其适于接收形成在进给杆38的远端38b的插入连接器。推进器40优选地与进给杆38固定地配合，然而它可选的与进给杆38一体地形成。进给杆38的远端40b优选地适于将夹具推进钳口20并且推进器40的远端40b可包括例如形成在其上的夹具推进部件90。夹具推进部件90可具有多种形状和尺寸，但在示出的实施例中，它具有细长的形状，带有形成在其远端的凹槽92，用于安置夹具的弯曲部分。凹槽92的形状根据夹具的具体结构各有不同。夹具推进部件90还可以相对推进器40的纵向轴线A沿向上方向以一定角度伸出。这种结构允许夹具推进部件90伸入夹具轨道30以接合夹具，同时推进器40的余部与夹具轨道30基本上平行地延伸。图5B示出推进器40’的夹具推进部件90’的另一个示范性实施例。在此实施例中，夹具推进部件90’稍微更窄点并且它具有形成在其最远端的小凹槽92’。在使用中，推进器40只接合夹具轨道30内最远侧的夹具并将其推进钳口20。这是由于进给杆38的定位，它如先前描述的，可在近侧和远侧位置之间滑动地运动。
图6A-6G示出在使用中的夹具推进组件，图6A-6D特别地示出在夹具轨道30内进给杆38的运动，以推进送料履带片34和夹具供给器36，而图6E-6F示出推进器40的运动，以将最远侧的夹具推进钳口20。用于致动夹具推进组件的在外壳12内的部件将在下面更详细地描述。
如图6A所示，在停靠位置(resting position)的进给杆38是在最近侧位置，以使突起86向近侧定位在钳口保持器轴28内的细长狭槽88中。送料履带片34布置在夹具轨道30内并且，假设还没有使用装置10，送料履带片34是在最近侧位置，以使在送料履带片34上的上柄脚82a与形成在夹具轨道30内的最近侧或第一开口30c1接合，以防止送料履带片34向近侧运动，而送料履带片34上的下柄脚82b定位在进给杆38中的第一定位槽841和第二定位槽842之间，以使由进给杆38沿向上方向偏压该下柄脚82b。进给杆中的定位槽84顺序标号为841，842等，在夹具轨道30内的开口30c顺序标号为30c1，30c2等。如图6A进一步所示，一连串夹具36顺序标号为361，362，...36x，其中36x为最远侧的夹具，这些夹具36定位在夹具轨道30内位于送料履带片34远侧。
在触发器16致动时，向远侧推进进给杆38，造成突起86在狭槽88中向远侧滑动。因为进给杆38向远侧运动，送料履带片34上的下柄脚82b将滑入在进给杆38中的第一定位槽841内。进给杆38进一步向远侧运动，将造成第一定位槽841与下柄脚82b的接合，如图6B所示，从而向远侧方向运动送料履带片34和夹具供给器361、362等。如图6C所示，当突起86抵接在钳口保持器轴28内的细长狭槽88的远端时，防止进给杆38向更远侧运动。在该位置，送料履带片34已推进一预定距离，以将夹具供给器361、362、...36x在夹具轨道30内推进预定距离。送料履带片34的上柄脚82a已经推进入在夹具轨道30内的第二开口30c2，以防止送料履带片34向近侧运动，而送料履带片34上的下柄脚82b将仍由进给杆38内的第一定位槽841接合。
进给杆38从在图6A所示的初始的最近侧位置运动到在图6C所示的最后的最远侧位置将最远侧的夹具36x推进到钳口20中。具体的，如图6E所示，进给杆38的远侧运动造成连接到进给杆38远端的推进器40的夹具推进部件90与布置在夹具轨道30内的最远侧的夹具36x接合并将夹具36x推进入钳口20中，如图6F所示。在示范性实施例中，推进器40将在接合并开始送料履带片34推进之前接合并开始最远侧的夹具36x的推进。结果是最远侧的夹具36x推进的距离大于送料履带片34行进的距离。这种结构只允许将最远侧的夹具36x推进入钳口20，而没有将另外的夹具意外推进入钳口20。
夹具36x一旦部分或完全形成，就释放触发器16以释放已形成的夹具36x。触发器16的释放还使进给杆38沿近侧方向缩回，直到突起86回到在狭槽88中的初始的最近侧位置，如图6D所示。在向近侧缩回进给杆38时，送料履带片34不向近侧运动，因为上柄脚82a与在夹具轨道30内的第二开口30c2接合。下柄脚82b不影响进给杆38的近侧运动，一旦如所示进给杆38在初始的最近侧位置，就将下柄脚82b定位在进给杆38内的第二定位槽842和第三定位槽843之间。
重复该步骤，以便将另一个夹具推进入钳口20。随着触发器16的每一次致动，由下一个定位槽，即，形成在进给杆38中的定位槽842接合下柄脚82b，送料履带片34的上柄脚82a向远侧运动进入下一个开口，即，在夹具轨道30上的开口30c3，最远侧的夹具被推进入钳口20中并释放。在装置10包括预定的夹具量(例如17个夹具)时，装置10可致动17次。一旦已经施放完最后的夹具，止挡件、例如送料履带片34上的第三柄脚82c可与夹具轨道30上的止挡柄脚118接合，以防止送料履带片34进一步向远侧运动。
送料履带片34、进给杆38和/或夹具轨道30还可包括用于防止送料履带片34例如在装置的运输期间意外的或无意的运动的部件。这特别有利，因为特别是在装置第一次使用前送料履带片34的运动会造成装置故障。例如，如果送料履带片34向远侧运动，送料履带片34将同时推进两个夹具进入钳口，以此导致两个错误变形的夹具的递送。因此，在示范性实施例中，送料履带片34、进给杆38和/或夹具轨道30可包括接合机构和/或被构造成在其间产生摩擦力，所述摩擦力足以阻止运动，但可由触发器16的致动克服以允许进给杆推进送料履带片34通过夹具轨道30。
虽然可以使用多种技术来防止送料履带片34在夹具轨道30内不希望的移动，图27A-29C示出用于在送料履带片34、进给杆38和/或夹具轨道30之间产生摩擦力或接合机构的技术的多种示范性实施例。首先参考图27A，所示出的示范性实施例的送料履带片34’具有在自由状态(即当送料履带片34’从夹具轨道30中移出时)时为预成形的悬臂或弓形的结构，这样当其布置在夹具轨道30内时送料履带片34’形成悬臂弹簧。具体地，送料履带片34’可包括形成在其中的弯曲部35’，以使送料履带片34’的相对端34a’、34b’相对彼此成角度。弯曲部35’可使送料履带片34’的高度hb大于夹具轨道30的高度。虽然高度hb可变，在示范性实施例中，构成的弯曲部35’增加了送料履带片34’的高度，增高量足以在送料履带片34’和夹具轨道30之间产生摩擦拖曳力，但当触发器16致动时依然允许送料履带片34’在夹具轨道30内滑动。在示范性实施例中，送料履带片34’的高度增加至少大约30％，或更优选地为大约40％。在使用中，夹具轨道30将迫使送料履带片34’成为基本上平的结构，以使当送料履带片34’布置在夹具轨道30中时偏压该夹具轨道30。送料履带片34’的弯曲部35’以及送料履带片34’的终端34a’、34b’将由此对夹具轨道30施加力，因此在送料履带片34’和夹具轨道30之间产生摩擦拖曳力。摩擦力防止送料履带片34’相对夹具轨道30移动，除非触发器16致动，在这种情况下由触发器16施加的力克服了摩擦力。
本领域普通技术人员应该理解，弯曲部35’可有多种结构，而且其可形成在沿送料履带片34’的长度的任意位置。在图27A中弯曲部35’形成在送料履带片34’的中部或接近送料履带片34’的中部。弯曲部35’还可在其它方向延伸。虽然图27A示出弯曲部35’在垂直于轴线的方向延伸，以使弯曲部35’和端部34a’、34b’对夹具轨道30施加力，但是弯曲部35’也可选择沿送料履带片34’的纵向轴线延伸，以使送料履带片34’对夹具轨道30的相对侧导轨80a、80b(图2D)施加力。弯曲部35’还可使相对端34a’、34b’沿向下方向成角度，如图27A所示，以使送料履带片34’基本上呈A形，或者，弯曲部35’还可使相对端34a’，34b’沿向上方向成角度，如图27B所示，以使送料履带片34’基本上呈V形。送料履带片34’还包括其内形成的任意数量的弯曲部。本领域普通技术人员应该理解，基于送料履带片34’和夹具轨道30的特性可修改弯曲部的具体结构，以获得在其之间所需大小的摩擦力。
图28A和图28B示出用于在送料履带片和夹具轨道之间产生摩擦力的技术的另一个实施例。在该实施例中，夹具轨道30’和/或送料履带片34x可包括一个或多个形成在其上的表面突起。如图28A所示，两个表面突起82d1、82d2形成在夹具轨道30’上。虽然表面突起82d1、82d2可形成在夹具轨道30’上的多种位置处，包括相对侧导轨或沿夹具轨道30’的整个长度，或在送料履带片34x的多种位置处，在所示的实施例中，两个表面突起82d1、82d2邻近夹具轨道30’的近端形成并将其定位成防止在使用前例如在运输期间送料履带片的初始运动。突起82d1、82d2的尺寸可根据防止送料履带片34x无意运动所需的摩擦力的大小而不同。
虽然突起82d1、82d2可被构造成提供防止送料履带片34x无意运动所需的足够大小的摩擦力，送料履带片34x和/或夹具轨道30’可选择性地包括适于接合对应的表面突起的部件。图28B示出形成在送料履带片34x远侧部分的柄脚82e1、82e2，用于接合夹具轨道30’上的突起82d1、82d2。柄脚82e1、82e2的形状和尺寸可不同，并且它们可包括构成为接合或“捕获”突起82d1、82d2的凸缘或其它突起。如图28B所示，柄脚82e1、82e2从送料履带片34x的相对侧壁向彼此延伸。
图29A-29C示出用于防止送料履带片无意运动的技术的另一个实施例。在该实施例中，在送料履带片和进给杆之间产生摩擦力。具体地，送料履带片34y包括带有形成在其上的凸缘82g的柄脚82f，如图29A所示，并且进给杆38y包括形成在其内的凹槽84y。在使用中，如图29C所示，凸缘82g构成为接合凹槽84y，以防止送料履带片34y无意运动。然而，凸缘82g和凹槽84y构成为当由触发器16致动施加到送料履带片34y上足够的力时允许送料履带片34y运动。
本领域普通技术人员应该理解，可使用多种其它技术以防止送料履带片或在夹具轨道内其它夹具推进机构无意的运动，而且可使用部件的任何组合并且将其定位在一个或两个部件的各个位置上。
图7-9示出夹具形成组件的多种示范性实施例。首先参照图7所示的钳口20的示范性实施例。如前面提到的，钳口20可包括近侧部分20a，其具有与形成在钳口保持器轴28上的相应齿牙78配合的齿牙94。然而可以使用其它技术使钳口20与钳口保持器轴28配合。可使用例如鸠尾连接、插件-内孔连接等。或者，钳口20可与保持器轴28形成一体。钳口20的远侧部分20b可适于在其间接收夹具，因此远侧部分20b可包括第一和第二相对钳口构件96a、96b，他们可相对彼此运动。在示范性实施例中，偏压钳口构件96a、96b到张开位置，需要用力来使钳口构件96a、96b向彼此运动。钳口构件96a、96b分别包括形成于其内位于相对内表面上的凹槽(只显示了一个凹槽97)，用于接收与钳口构件96a、96b对准的夹具腿。钳口构件96a、96b还可分别包括形成于其内的凸轮轨道98a、98b，用于允许凸轮42与钳口构件96a、96b接合，并使钳口构件96a、96b向彼此运动。在示范性实施例中，凸轮轨道98a、98b形成在钳口构件96a、96b的上表面上。
图8示出的示范性凸轮42用于与钳口构件96a、96b配合并接合。凸轮42可具有多种结构，但在示出的实施例中，它包括适于与顶杆44配合的近端42a(在下面更详细地描述)，它还包括适于与钳口构件96a、96b接合的远端42b。可使用多种技术将凸轮42与顶杆44配合，但在示出的实施例中，凸轮42包括形成在其内的孔型或带键槽的切口100和适于接收形成在顶杆44的远端44b上的插入或键构件102。插入构件102在图9中更详细的显示，图9中示出了顶杆44。如所示，插入构件102具有与切口100形状对应的形状以允许两个构件42、44配合。本领域普通技术人员应该理解，凸轮42和顶杆44可选地彼此形成在一起。顶杆44的近端44a可适于与闭合连杆组件配合(在下面更详细地描述)，用于相对钳口20运动顶杆44和凸轮42。
如图8进一步所示，凸轮42还可包括形成于其上的突起42c，其适于被形成在钳口20内的细长狭槽20c可滑动地接收。在使用中，突起42c和狭槽20c用来形成用于夹具形成组件的近侧止挡件。
再参照图8，凸轮42的远端42b可适于与钳口构件96a、96b接合。虽然可使用多种技术，在示出的示范性实施例中，远端42b包括形成在其中的凸轮通道或锥形凹槽104，用于可滑动地接收在钳口构件96a、96b上的凸轮轨道98a、98b。在使用中，如图10A和10B所示，可将凸轮42从近侧位置推进到远侧位置，在近侧位置中钳口构件96a、96b彼此相隔一段距离，在远侧位置中钳口构件96a、96b彼此邻近定位并处于闭合位置。在推进凸轮42越过钳口构件96a、96b时，锥形凹槽104将向彼此推动钳口构件96a、96b，以此压扁布置在其中的夹具。
如上面提到的，外科夹具施放器10还可包括组织止挡件46，它可用于易于将组织定位在钳口20内的手术位置。图11A显示具有近端46a和远端46b的组织止挡件46的示范性实施例。近端46a可适于与夹具轨道30的远端配合，用于邻近钳口20定位组织止挡件46。但是，组织止挡件46可与夹具轨道30形成为一体，或它可适于与轴18的多种其它部件配合或形成为一体。组织止挡件46的远端46b可具有适于在其间安置导管、脉管、分流管等的形状以相对目标位置定位和对准钳口20。如图11A所示，组织止挡件46的远端46b基本是V形。远端46b还具有弯曲结构以易于通过套管针或其它通过管放置所述装置。
装置的组织止挡件或其它部件还可有选择地包括在夹具形成期间支撑和固定夹具的部件。当夹具在钳口之间形成时，夹具可能会枢转并变得不对准。具体地，当钳口闭合时，夹具每个腿的终端向彼此运动。结果，钳口只接合在每个腿上的弯曲部分，这样允许腿的终端和夹具的顶点偏离开与钳口的对准，即，相对钳口垂直枢转。这样钳口的进一步闭合可导致畸形夹具。据此，装置可包括如下部件，其用于使夹具和钳口对准并引导夹具进入钳口，并用于防止在夹具形成期间夹具枢转或变得不对准。
虽然对准部件具有多种结构，而且它可在装置的多种部件上形成，图11A示出形成在组织止挡件46的远端46b的中间部分的中央柄脚47，用于使夹具与推进器组件40的末端对准。具体的，中央柄脚47可允许夹具的顶点沿其安放，以防止夹具相对推进器组件40变得不对准，该推进器组件40正向远侧方向推动夹具。本领域普通技术人员应该理解，组织止挡件46可有多种其它结构，并且它可包括多种其它部件以易于夹具沿其推进。
图11B-11D示出具有形成在其上的对准部件或引导构件的组织止挡件46’的另一个示范性实施例，所述对准部件或引导构件适于使夹具和钳口对准并且将夹具引导进入钳口，而更优选地适于在夹具形成期间保持夹具与钳口对准。在该实施例中，对准部件是斜面构件47’的形式，其沿组织止挡件46’的中央轴线纵向延伸，并突出到组织止挡件46’的上表面之上。斜面构件47’优选是刚性的，并在高度上从组织止挡件46’的近端46a’到远端46b’增加。在角度上根据钳口的特定角度而不同。斜面构件47’优选地刚好在形成在组织止挡件46’的远侧末端内的组织接收凹槽46c’的近侧终止。结果，斜面构件47’刚好近侧定位到钳口20，这样允许斜面构件47’引导夹具以及推进器组件40的末端(正推动夹具)以适当的角度进入钳口20。在使用中，斜面构件47’抵接布置在钳口20之间的夹具的顶点的下表面，以防止在钳口20闭合形成夹具期间夹具垂直枢转。具体地，当推进器组件40沿斜面构件47’运动到最远侧位置时，夹具的顶点抵接斜面构件47’的表面。由于在钳口20之间夹具受压并夹具腿彼此相对运动，钳口20将只接合每个腿上的弯曲部分。结果，夹具的腿和顶点将不会垂直枢转。然而，由于顶点搁在斜面构件47’的上表面47a’上，斜面构件47’就防止顶点沿向下或朝下的方向垂直运动，即，斜面构件47’将防止夹具在钳口20内摆动。斜面构件47’有效地防止或限制在钳口20闭合形成夹具期间产生有害的旋转力。这样保持夹具与钳口20对准。
本领域普通技术人员应该理解，斜面构件的形状、尺寸和结构可根据钳口和夹具施放器的其它部件的特定结构而不同。在一个示范性实施例中，斜面构件47’可具有约0.025”的最大高度hRmax(从延伸通过组织止挡件46’的中央平面测量的)。更优选地，高度hRmax在约0.008”到0.020”范围内，而高度hRmax最好在约0.010”到0.015”范围内。斜面构件47’的倾斜角αR也可以变化，但在示范性实施例中，斜面构件47’具有约5°到45°范围内的倾斜角αR，更优选地在5°到30°范围内，最好在10°到20°范围内。斜面构件47’的宽度Wr也可以变化，但在示范性实施例中，斜面构件47’优选地具有稍微小于在完全闭合位置的钳口20之间的间隙的宽度Wr。
图12示出在使用中的组织止挡件46。如所示，将组织止挡件46刚好定位在钳口20下面，而所在的位置允许导管、脉管、分流管等在钳口20之间被接收。如进一步所示，在钳口20之间定位外科夹具36，以使夹具36的弯曲部分36a与组织止挡件46对准。这将允许夹具36的腿36b围绕导管、脉管、分流管或其它目标位置完全定位。
图13-26B示出用于控制夹具推进和形成的外壳12的多种示范性内部部件。如上面描述的，外科夹具施放器10可包括这里公开的某些或全部部件，并且它可包括本领域已知的多种其它部件。在特定示范性实施例中，夹具施放器10的内部部件包括：夹具推进组件，其与轴18的夹具推进组件连接，用于推进至少一个夹具通过细长轴18，以将夹具定位在钳口20之间；和夹具形成组件，它可与轴18的夹具形成组件连接，用于闭合钳口20以形成部分或全部闭合的夹具。其它示范性部件包括用于控制触发器16运动的防倒退机构，用于防止由夹具形成组件施加到钳口20的力过载的过载机构，以及用于指示留在装置10中的夹具数量的夹具数量指示器。
图13-16D示出用于使进给杆38在轴18中运动的外壳12的夹具推进组件的示范性实施例。通常，夹具推进组件包括与触发器16连接的触发器插入件48，与进给杆38的近端38a配合的进给杆联接器50以及适于在触发器插入件48和进给杆联接器50之间延伸的进给连杆52，该进给连杆52用于将运动从触发器插入件48传递到进给杆联接器50。
图14更详细地示出触发器插入件48。触发器插入件48的形状可根据外壳12的其它部件而改变，但在示出的实施例中，触发器插入件48包括适于与外壳12枢转地配合的中央部分48a，以及适于伸入触发器16并与触发器16配合的细长部分48b。中央部分48a可包括贯穿其延伸的孔106，用于接收用于枢转地将触发器插入件48配合到外壳12的轴。中央部分48a还可包括形成于上侧边缘的第一凹槽108，用于接收部分进给连杆52。第一凹槽108优选地具有允许部分进给连杆52在其中延伸的尺寸和形状，以使当触发器插入件48由于触发器16的运动枢转时，迫使进给连杆52枢转。如图14所示，第一凹槽108基本上是细长的并包括形成在其中的基本上圆形的部分，用于安置形成在进给连杆52近端上的轴，如参照图16更详细描述的。触发器插入件48还包括形成于后侧边缘的第二凹槽110，用于接收与用于运动凸轮42以闭合钳口20的顶杆44连接的闭合连杆滚柱54；还包括形成于其底侧边缘上的棘齿112，用于与控制触发器16运动的棘爪60配合，如下面将更详细描述的。
图15A和15B更详细地示出示范性的进给杆联接器50，它适于将进给杆38的近端连接到进给连杆52的远端。虽然可使用多种技术将进给杆联接器50与进给杆38的近端38a连接，在示出的示范性实施例中，进给杆联接器50由两个分开的半部50a、50b形成，他们一起配合以保持在其之间的进给杆38的近端38a。当配合时，两个半部50a、50b一起限定中心轴50c，该中心轴50c具有形成在其相对端上的基本圆形的凸缘50d、50e，并在他们之间限定用于安置进给连杆52的远端的凹槽50f。中心轴50c形成贯穿其中的腔50g，其用于接收进给杆38的近端38a和用于将进给杆38相对进给杆联接器50锁定在基本上固定的位置。然而，进给杆联接器50可与进给杆38形成一体，而它可具有易于与进给连杆52配合的多种其它形状和尺寸。
图16示出示范性的进给连杆52，其可在触发器插入件48和进给杆联接器52之间延伸。通常，进给连杆52带有近端52a和远端52b并具有基本上平的细长形状。近端52a适于可旋转地位于触发器插入件48的第一凹槽108内，如前所述，并且它可包括在其中延伸的轴53(图1B)。轴53可适于在触发器插入件48的第一凹槽108内可枢转地旋转，以此允许触发器插入件48枢转进给连杆52。进给连杆52的远端52b可适于连接到进给杆联接器50，而在示范性实施例中，它包括形成于其上的相对的臂114a、114b，臂114a、114b在其间限定用于安置进给杆联接器50的中心轴50a的开口116。当进给连杆52绕枢轴X枢转时，臂114a、114b有效地与联接器50接合并使之运动。枢轴X由进给连杆52与外壳12连接的位置限定，并且他可定位在进给连杆52上的任何位置，但在示出的实施例中，它邻近进给连杆52的近端52a定位。
在示范性实施例中，进给连杆52可以是柔性的，从而不必校准夹具推进组件和夹具形成组件。尤其是，进给连杆52甚至在进给杆38和进给杆联接器50在最远侧位置后还允许触发器16继续向闭合位置运动，并且它给夹具形成组件和夹具推进组件提供一些自由度。换句话说，在触发器闭合期间，触发器16相对进给杆38是顺应性的。
进给连杆52的具体刚度和强度可根据夹具推进组件和夹具形成组件的结构而改变，但在一个示范性实施例中，进给连杆52的刚度在每英寸75到110lbs的范围内，更优选的是约每英寸93lbs(在连杆52和进给杆联接器50之间的界面处测量)，它的强度在每英寸25lbs到50lbs的范围内，更优选的是约35lbs。进给连杆52还可以由多种材料制成，包括各种聚合体、金属等。一种示范性的材料是强化玻璃聚醚酰亚胺，但可使用多种强化热塑性塑料，包括强化玻璃液晶聚合体、强化玻璃尼龙以及他们的强化碳素纤维变体和类似的热塑性塑料。还可使用强化纤维热固性聚合体，例如热固性聚酯。进给连杆52还可以由金属(例如弹簧钢)制造，以实现限定的弹性和可控制的强度的理想组合。
图17A和17D示出在使用中的示范性夹具推进组件。图17A显示初始位置，其中触发器16置于张开位置，进给杆联接器50和进给杆38在最近侧位置，进给连杆52在触发器插入件48和进给杆联接器50之间延伸。如前所述，在初始张开位置中，突起86在进给杆38上，在钳口保持器轴28内的细长狭槽88近侧定位。第一偏压构件(例如弹簧120)与触发器插入件48和外壳12连接，以将触发器插入件48和触发器16保持在张开位置，而第二偏压构件(例如弹簧122)在轴联接器124和进给杆联接器50之间延伸，以便将进给杆联接器50和进给杆38保持在最近侧位置，所述轴联接器124使轴18与外壳12旋转地配合。
当致动触发器16并使其朝着闭合位置(即朝着固定手柄14)运动时，克服由弹簧120、122施加的偏压力，触发器插入件48开始沿逆时针方向枢转，如图17B所示。结果迫使进给连杆52沿逆时针方向枢转，由此向远侧运动进给杆联接器50和进给杆38。在进给杆38上的突起86在钳口保持器轴28内的细长狭槽88内向远侧运动，以此推进布置在夹具轨道30内的送料履带片34和夹具36。弹簧120在外壳与触发器插入件48之间延伸，而弹簧122在进给杆联接器50和轴联接器124之间压缩。
随着进一步致动触发器16，触发器插入件48继续枢转，进给杆联接器50和进给杆38最终达到最远侧位置。在该位置，将进给杆38上的突起86定位在钳口保持器轴28内狭槽88的远端，并且定位夹具在钳口20之间，如前所述。弹簧122在轴联接器124和进给杆联接器50之间完全压缩，进给连杆52将挠曲，如图17C和17D所示。当进给连杆52挠曲、更优选的一旦进给连杆52完全挠曲就致动夹具形成组件闭合钳口20。在致动夹具形成组件期间，例如致动的第二阶段，进给连杆52将保持挠曲，以使触发器插入件48相对于夹具推进组件、特别是进给杆38是顺应性的。
图18-20更详细示出外壳的示范性夹具形成组件。通常，夹具形成组件布置在外壳12内并可有效地相对钳口20运动顶杆44和凸轮42，以运动钳口20到闭合位置，以此压扁已在其间定位的夹具。虽然夹具形成组件可有不同的结构，在示出的示范性实施例中，夹具形成组件包括闭合连杆滚柱54，其可滑动地连接到触发器插入件48，闭合连杆56适于连接到闭合连杆滚柱54，而闭合联接器58适于连接到闭合连杆56和顶杆44。
图18更详细示出闭合连杆滚柱54，如所示，闭合连杆滚柱54包括中心轴54a，其具有邻近其相对终端形成的基本为圆形的凸缘54b、54c。中心轴54a可适于位于触发器插入件48中的第二凹槽110内，以使凸缘54b、54c容纳于触发器插入件48的相对侧上。中心轴54a还适于与闭合连杆56的相对臂126a、126b配合，以将该臂定位在触发器插入件48的相对侧上。
图19更详细示出了闭合连杆56的示范性实施例，如所示，它具有彼此相隔一定距离的相对臂126a、126b。每个臂126a、126b包括近端128a、128b，他们适于与闭合连杆滚柱54的中心轴54a接合，而远端130a、130b适于与闭合联接器58配合，用于将闭合连杆滚柱54和闭合连杆56连接到顶杆44。在示范性实施例中，每个臂126a、126b的近端128a、128b适于与闭合连杆滚柱54枢转地配合，臂126a、126b可包括例如形成于其上的钩状构件132a、132b，用于与中心轴54a接合。钩状构件132a、132b沿相对方向延伸以易于在闭合连杆56和闭合连杆滚柱54之间接合。臂126a、126b的远端130a、130b彼此配合，而它们可包括延伸贯通的腔134，用于接收适于与闭合连杆56枢转地配合到闭合联接器58的轴。本领域普通技术人员应该理解，可使用其它多种技术将闭合连杆56配合到闭合连杆滚柱54和闭合联接器58。
图20A更详细示出的示范性闭合联接器58，如所示，它包括近侧部分58a，它具有两个臂136a、136b，该臂带有延伸贯通的腔138a、138b并适于与闭合连杆56的腔134对准，用于接收轴以与两部件配合。闭合联接器58还包括远侧部分58b，其适于与顶杆44的近端44a配合(图9)。在示范性实施例中，闭合联接器58包括形成于其中的切口59(图20B和20C)并具有适于安置顶杆44的近端44a的形状。还将闭合联接器58的远侧部分58b成形为当触发器16在张开位置时接收部分进给杆联接器50。本领域普通技术人员应该理解，可使用多种其它配合的技术将闭合联接器58配合到顶杆44上，闭合联接器58和顶杆44可任意地彼此形成为一体。
在其它的示范性实施例中，在顶杆44和闭合联接器58之间可形成预载接合件以防止夹具从钳口意外释放，特别是在闭合的早期阶段，如果使用者在触发器16上放松。具体的，虽然下面将要更详细地描述的，防倒退机构可适于防止触发器16打开直到触发器16到达预定位置，但是防倒退机构允许触发器16一些轻微运动。这样，在使用者在触发器16上放松并将触发器16轻微运动的事件发生时，预载接合件向远侧方向偏压顶杆44，以此保持顶杆44在基本固定位置，虽然允许闭合联接器58向近侧运动直到触发器16由防倒退机构接合。
虽然预载接合件可具有多种结构，并可沿夹具形成组件的各个位置定位，在一个实施例中，预载接合件是以偏压构件的形式布置在切口59内以向远端偏压顶杆44。虽然可使用多种偏压构件，在图20B示出的实施例中，偏压构件是悬臂梁61，其定位在顶杆44的近端44a和凹槽59的后壁以向远端偏压顶杆44。悬臂梁61可由形状记忆材料(例如镍钛诺)构成，当对其施加向近端的力时允许梁61弯曲或变平。悬臂梁61可由其它材料、例如弹簧钢或强化聚合体构成，并可使用多个梁。图20C示出由线圈或其它类型的弹簧63形成的偏压构件的另一个实施例。如所示，弹簧63布置在顶杆44的近端44a和凹槽59的后壁以向远端偏压顶杆44。当对其施加向近端的力时弹簧63适于压缩。本领域普通技术人员应该理解，可使用多种其它偏压构件，包括弹性材料的压缩构件。
预载接合件还可选择性地包括部件，以在夹具形成过程期间加强悬臂梁或弹簧的性能。在图20B示出的实施例中，由于悬臂梁在闭合期间压缩，悬臂梁61的载荷起初保持均匀，然而在闭合的最后阶段载荷明显增加。这在图20D中示出，图20D示出图20B所示的悬臂梁61的载荷/位移曲线的图表。曲线的左端表示悬臂梁61无载荷的高度，而曲线的右端表示悬臂梁61全部压缩或变平的点。上面的曲线表示在典型的闭合冲程期间导致悬臂梁61压缩的力，除了悬臂梁61布置在闭合联接器58内时被初始地部分压缩在悬臂梁61的自由状态所测的力外。如所示，载荷基本保持稳定(除了初始压缩状态)，在典型的闭合冲程期间由于悬臂梁61被压缩，载荷只是轻微增加。然而，当悬臂梁61完全变平时，载荷在闭合最终阶段显著增加。这是由于悬臂梁61的变形导致载荷从悬臂梁61的终端向内传递。由于悬臂梁61的变形和载荷的向内传递，悬臂梁61的有效长度减小，以此增加了载荷。为了对此进行防止，预载接合件可选择性地包括部件，以在夹具形成期间加强悬臂梁或弹簧的性能，并且特别是保持基本稳定的载荷。
图20E示出用于加强悬臂梁或弹簧的性能的技术的示范性实施例。如所示，在闭合联接器58’内的凹槽59’包括在后表面上的形成在其中的两个凸脊59a’、59b’，以使将凸脊59a’、59b’定位在悬臂梁(未示出)的下面或后面。凸脊59a’、59b’彼此隔开一定距离并且每个凸脊59a’、59b’具有至少约0.005”的高度，以防止悬臂梁完全变平靠到凹槽的后表面。作为结果，凸脊59a’、59b’防止悬臂梁变平，以此防止悬臂梁或弹簧的载荷向内传导到终端。本领域普通技术人员应该理解，凸脊59a’、59b’的具体位置、数量以及尺寸可根据预载接合件的结构以及在闭合期间防止夹具掉出所需的力而不同。
返回参照图17A-17D，在使用中，当触发器16从张开位置开始运动到闭合位置时，闭合连杆滚柱54在触发器插入件48内的凹槽110中滚动。一旦进给杆38和进给杆联接器50在最远侧位置，如图17C所示，触发器16的进一步致动将造成触发器插入件48内凹槽110与闭合连杆滚柱54接合，迫使其与触发器插入件48一起绕枢轴转动，如图17D所示。作为结果，闭合联接器58向远侧运动，以此造成顶杆44向远侧运动。当顶杆44向远侧推进，推进凸轮42越过钳口20以闭合钳口20并压扁已在其间定位的夹具。触发器16可任意地部分闭合以只部分闭合钳口20并部分压扁已在其间定位的夹具。用于易于选择完全和部分压扁已在其间定位的夹具的示范性技术将在下面要更详细地描述。一旦施放了夹具，可释放触发器16，以此允许弹簧120将触发器插入件48缩回到其初始位置，并允许弹簧122迫使进给杆联接器50和进给杆38回到近侧位置。当触发器插入件48返回到其初始位置时，闭合连杆滚柱54同样返回到其初始位置，以此将闭合连杆56、闭合联接器58和顶杆44向近侧拉。
外科夹具施放器10还可包括多种其它部件，以易于装置10的使用。在一个示范性实施例中，外科夹具施放器10包括用于控制触发器16运动的防倒退机构。具体的，防倒退机构可防止在部分闭合击发期间触发器16的开启。然而，一旦触发器达到预定位置，在该点已在钳口之间定位的夹具可部分压接，防倒退机构可释放触发器允许触发器开启并释放夹具或闭合以完全压扁夹具，如使用者所希望的。
图21A和21B示出由棘齿形成的防倒退机构的示范性实施例。如所示，棘齿包括形成于触发器插入件48上的一组齿牙112，和适于旋转地布置在外壳12内而邻近触发器插入件48定位的棘爪60，以使触发器16的闭合和触发器插入件48绕枢轴运动造成棘爪60与齿牙112接合。这样构成齿牙112，防止棘爪60旋转，直到棘爪60达到预定位置，在该位置点棘爪60是自由旋转，以此允许触发器16开启或闭合。预定位置优选地对应于在钳口20部分闭合的位置。在一个示范性实施例中，如所示，齿牙112包括第一组齿牙112a(例如10个齿牙)，他们具有防止棘爪60相对其旋转的尺寸，这样当棘爪60与第一组齿牙112a接合时防止触发器16开启。齿牙112还包括最后的或终端齿牙，称为托科齿牙112b，这样当棘爪60与托科齿牙112b接合时，它具有允许棘爪60相对其旋转的尺寸。具体的，托科齿牙112b优选地具有基本上大于第一组齿牙112a尺寸的尺寸，以使在第一组齿牙112a和托科齿牙112b之间形成相对大的槽口140。槽口140具有允许棘爪60在其中枢转的尺寸。这样允许棘爪60选择性地移出托科齿牙112b或返回到第一组齿牙112a。本领域普通技术人员应该理解，托科齿牙112b可与第一组齿牙112a具有相同尺寸或较小尺寸，同时还提供形成在其之间的槽口140以允许棘爪60在其中枢转。
图22A-22D示出使用中的棘齿机构。如图22A所示，当开始运动触发器16到闭合位置时，棘爪60与第一组齿牙112a接合以此防止触发器16开启。触发器16的进一步致动造成棘爪60推进通过第一组齿牙112a，直到棘爪60到达邻近托科齿牙112b的槽口140。一旦棘爪60到达托科齿牙112b，在该位置点由于凸轮42部分远侧运动越过钳口20，钳口20部分闭合，棘爪60自由旋转，以此允许触发器16开启或闭合，如使用者所希望的。图22C示出触发器16在完全闭合位置，而图22D和22E示出触发器16回到张开位置。
棘齿机构还可以设计成发出听得见的声音，以指示钳口20的位置。例如，当棘爪60与第一组齿牙112a接合时发出第一种声音，当棘爪60与托科齿牙112b接合时发出第二种不同的声音，例如，高声。结果，当触发器16达到棘爪60与达托科齿牙112b接合的预定位置时，声音指示使用者：钳口20在部分闭合位置。使用者可释放触发器16以释放部分闭合的夹具，或他们可闭合触发器16以完全闭合夹具。
在另一个示范性实施例中，外科夹具施放器10包括过载机构，以适于防止由触发器16施加到钳口20上的力过载。典型地，在外科夹具施加期间，需要特定的力闭合钳口20并压扁围绕定位在其间的组织的夹具。由于形成过程的进行和至少部分闭合夹具，继续闭合环绕夹具的钳口20所需的力明显上升。据此，在示范性实施例中，过载机构具有相对于闭合钳口20所需的力的阻力。换句话说，过载机构的阻力可随着闭合钳口20所需的力的升高而升高。然而，该阻力优选地稍微大于闭合钳口20所需的力，以防止过载机构的意外致动。结果，如果当触发器16开始致动时防止钳口20闭合，所需克服过载机构的阻力的力相对较低。当它们开启或只部分打开时这对更易变形的钳口20特别有利。过载机构在夹具成形早期致动更容易以防止钳口的变形。相反，当钳口20基本闭合时，阻力相对高，以使在应用施加到钳口20的大的力时只致动过载机构。
图23A示出过载机构的示范性实施例，示出了分解图。通常过载机构包括由两个半部64a、64b形成的过载外壳64，该过载外壳64容纳翼形连杆66、肘节连杆68、枢转连杆70以及偏压组件72。偏压组件72包括与外壳连接的弹簧柱150以及包括用于容纳撞针154的延伸贯通的孔。弹簧152围绕弹簧柱150布置，撞针154延伸贯通弹簧柱150并包括形成于其上的头部154a，该头部154a适于抵接弹簧152。枢转连杆70通常可是L形并可由延伸贯通的枢轴销156连接到外壳64。枢转连杆70的近端70a可与撞针154的头部154a接触，而枢转连杆70的远端70b可由枢轴销166连接到肘节连杆68。肘节连杆68又连接到翼形连杆66，该翼形连杆66可滑动地并枢转地定位于邻近形成在外壳内开口64d的外壳64内。实现外壳64内的翼形连杆66的枢转运动可通过例如枢轴销158，该枢轴销158延伸贯通翼形连杆66并布置在形成于外壳64的每个半部64a、64b内的第一狭槽160a内(只显示一个狭槽)，而实现外壳64内翼形连杆66的可滑动运动可通过例如形成在翼形连杆66上的相对突起168a、168b，该突起被形成于外壳64的每个半部64a、64b内的第二狭槽160b(只显示一个狭槽)所接收。
在使用中，翼形连杆66可适于接收从夹具形成组件来的力并用偏压组件72的阻力反抗该力。具体地，过载机构62使用弹簧152与肘节连杆68和枢转连杆70一道从绕枢轴销158旋转或相对外壳64滑动来偏压翼形连杆66。对于旋转方面，由压缩弹簧152作用的力传递通过肘节连杆68和枢转连杆70，以便施加旋转力矩到正对着外壳64的翼形连杆66。这样该组件造成翼形连杆66阻止相对外壳64的旋转。如果由从闭合连杆滚柱54到翼形连杆66的径向载荷产生的力矩超过枢转连杆70和肘节连杆68的力矩，翼形连杆66开始旋转，使肘节连杆68弯曲并使枢转连杆70进一步压缩弹簧152。对于滑动方面，枢转连杆70，肘节连杆68和翼形连杆66对准，以使滑动力(滑动的阻力)是弯曲肘节连杆68和枢转连杆70所需的力。如果从闭合连杆滚柱54到翼形连杆66的径向载荷超过连杆机构的弯曲力，则枢转连杆70进一步压缩弹簧152，同样翼形连杆66向近侧滑动。
这在图23B-23C中更详细地显示，如所示，在外壳64中的开口64d允许夹具形成组件的闭合连杆滚柱54靠着翼形连杆66滚动。结果，当致动触发器16并运动到闭合位置时，闭合连杆滚柱54对翼形连杆66施加力。过载弹簧152的阻力将把翼形连杆66保持在基本固定的位置，除非由闭合连杆滚柱54施加的力增加到该力大于阻力，例如，阈值力。这可由例如定位在钳口20之间的外部物质造成或当钳口20在其之间带有夹具和导管、脉管、分流管等时完全闭合造成。当钳口20不能进一步闭合时，由触发器16的闭合运动施加到闭合连杆滚柱54的力传递到翼形连杆66(其将在外壳64内枢转和滑动)，由此使枢转连杆70枢转，同时迫使撞针154压缩过载弹簧152。
如前所提到的，致动过载机构所需的力与闭合钳口20所需的力相关联，闭合钳口20所需的力随着触发器16运动到闭合位置而增加。这可由翼形连杆66的结构实现。具体的，当闭合连杆滚柱54首先与翼形连杆66接触时，它是在较低的位置，翼形连杆66可在外壳64内枢转，如图23B所示。当闭合连杆滚柱54沿翼形连杆66向上运动，因为翼形连杆66必须在外壳64内滑动，所以克服过载机构的阻力所需的力增加，如图23C所示。翼形连杆66枢转所需的力小于翼形连杆66滑动所需的力。据此，如果当触发器16开始致动时防止钳口20闭合，例如由于外部物质，所需较小的力就造成闭合连杆滚柱54传递该力到翼形连杆66的下部，造成翼形连杆66的枢转。当钳口20基本闭合且几乎完全致动触发器16时，所需很大的力造成闭合连杆滚柱54传递该力到翼形连杆66的上部，造成翼形连杆66在外壳64内的滑动以克服过载弹簧152的阻力。虽然致动过载机构所需力的大小大于闭合钳口20所需力的大小并相对有所升高，该力优选的只稍微大于闭合钳口20所需的力，以防止钳口20的变形或其它损坏。本领域普通技术人员应该理解，阻力可根据闭合钳口20所需的力而调整。
翼形连杆66、特别是翼形连杆66的面向远侧的表面66s还具有这样的形状，该形状易于使致动过载机构所需的力和闭合钳口20所需的力之间相关联。例如，闭合钳口20所需力以线性速率增加的地方，翼形连杆66的面向远侧的表面66s可是平面的，以防止翼形连杆66干扰闭合连杆滚柱54的运动，而允许对钳口20施加线性力以闭合钳口20。相反，在运动触发器16到闭合位置时闭合钳口20所需的力是非线性的地方，翼形连杆66具有非线性的形状，该形状对应于非线性的力。这种结构防止闭合凸轮42所需的力(图8)变得太高。
作为非限制性实例，闭合钳口20所需的力可以是非线性的，这是由于在凸轮42内凹槽104的形状适于向彼此推动钳口构件96a、96b。如图8所示，凹槽104可具有弯曲结构以使该力在凸轮42越过钳口构件96a、96b时改变。翼形连杆66可因此具有相应弯曲的面向远侧的表面，以使该力在闭合连杆滚柱54越过那里时改变。如图23A和23B所示，翼形连杆66是弯曲的，翼形连杆66的下部基本是凸状的，翼形连杆66的上部基本是凹状的。本领域普通技术人员应该理解，翼形连杆66可具有多种其它形状，而可使用多种其它技术优化闭合钳口20所需的力和致动过载机构所需的力。
本领域普通技术人员还应该理解，过载机构可具有多种其它结构。作为非限制性实例，图23D示出过载机构为悬臂梁170的形式，用于接收由闭合连杆滚柱54施加的力。梁170可具有带有连接到其一端的支架174的大致弯曲构件172。弯曲构件172具有弯矩，当加载的力大于弯矩时，弯曲以呈现低刚度状况。支架174可向构件172提供更高刚度，以使邻近支架174的弯矩升高。在使用中，可将梁170定位在外科施放器10的外壳12内，以使闭合连杆滚柱54与凹面接触，而以一定角度定位梁170，以使当触发器16开始致动时闭合连杆滚柱54远离梁，而当触发器16运动到闭合位置时，闭合连杆滚柱54与梁靠近。其结果是，当闭合连杆滚柱54运动而外科施放器的触发器16运动到闭合位置时，弯曲阻力增加。虽然没有示出，但可以叠层的方式任意使用多个梁并且将梁的终端或自由端的轮廓形成为沿梁长度的具体位置调整翘曲载荷。
在另一个示范性实施例中，外科夹具施放器10包括夹具数量指示器，用于指示留在装置10中的夹具数量。可使用多种技术指示剩下的夹具数量，图24A-25示出具有指示轮74和指示器致动器76的夹具数量指示器的示范性实施例。
图24A和24B详细示出指示轮74，如所示，它具有限定中心轴线Y的大致圆形或圆柱形的形状，轮74适于围绕该中心轴线Y旋转。轮74包括形成在其周围的齿牙142并适于通过指示器致动器76与指示器构件144接合。指示器构件144可具有多种结构，但在一个示范性实施例中，指示器构件144为具有例如桔黄、红等不同于指示轮74的剩余部分的颜色的对比色盘的形式。
图25示出更详细的指示器致动器76的示范性实施例。致动器76适于可滑动地布置在外壳12内并与进给杆联接器50连接，并且当进给杆联接器50和进给杆38运动时它也运动。相应地，指示器致动器76包括形成在其下表面上的突起146(只示出一部分)，它用于伸入到形成在进给杆联接器50上的圆形凸缘50d、50e之间的凹槽50f中。突起146允许指示器致动器76与给杆联接器50接合并一起运动。指示器致动器76还可包括形成在其上并适于接合形成在指示轮74上的齿牙142的接合机构148。如图25所示，指示器致动器76上的接合机构148是臂的形式，所述臂具有形成在其端部用于接合齿牙142的小片。
在使用中，如图26A-26B所示，指示轮74旋转地布置在外壳12内，并且指示器致动器76适于可滑动地布置在外壳12内，以便邻近指示轮74定位接合机构148，突起146伸入进给杆联接器50中。外壳12包括形成于其中的窗孔12a，用于提供可视读取指示轮144。当运动触发器16到闭合位置且进给杆联接器50向远侧运动时，指示器致动器76与进给杆38和进给杆联接器50向远侧运动。结果，在指示器致动器76上的接合机构148将接合在指示轮74上的齿牙142，以此在一个夹具推进入钳口20时使轮74旋转。每次致动触发器推动一个夹具进入钳口20，指示器致动器74旋转指示轮76。当夹具供应剩下两个或三个夹具时，在指示轮74上的对比色盘144开始出现在形成于外壳12内的窗孔12a，以此指示使用者只剩下几个夹具了。当夹具供应用尽时，对比色盘144出现在整个窗孔12a中。
在另一个示范性实施例中，指示轮74包括防倒退机构，其适于防止指示轮74在推进后向相反方向、例如逆时针方向旋转。虽然防倒退机构可具有多种结构，在图24B所示实施例中，指示轮74包括相对的臂73a、73b，他们与Y轴基本平行地延伸。每个臂73a、73b具有形成在其最远侧的棘爪75a、75b，他们适于接合形成在外壳12上对应的齿牙。虽然未示出，对应的齿牙可形成于圆形突起内，该突起形成在外壳12的邻近窗孔12a的内表面上。当指示轮74布置在外壳12内时，臂73a、73b伸入围绕其内周形成的圆形突起中。当施加夹具且指示轮74旋转时，臂73a、73b在外壳内偏转过齿牙运动到下一个位置。当指示轮74向近侧滑动以返回其初始位置时，臂73a、73b与在外壳内的齿牙接合，以防止指示轮74向相反方向旋转，即回到初始位置。本领域普通技术人员应该理解，可使用多种其它技术防止指示轮74的回转。
如前面提到的，可使用外科夹具施放器10施放部分或完全闭合夹具到例如导管、脉管、分流管等外科手术位置。在腹腔镜和内窥镜外科手术中，在患者身体制造一小的切口以提供到达的通道。典型地使用套管或通道口来限定从皮肤切口到手术位置的工作通道。在外科手术中经常需要止住通过导管或脉管的血流，而在一些手术中需要使用分流管。在此可使用外科夹具来压接导管或紧闭分流管到导管。据此，外科夹具施放器，例如夹具施放器10可通过插管或其它引入手术位置，将钳口20定位在脉管、分流管或其他导管的周围。组织止挡件46可便于钳口20围绕目标位置的定位。接着致动触发器16使夹具在钳口之间推进并围绕目标位置定位，以及使钳口20闭合压扁夹具。根据打算使用的夹具，触发器16可部分致动，并由棘爪60到达托科齿牙112b的可听见的声音指示，或触发器16可全部致动。接着释放触发器16，以释放部分或完全闭合的夹具，并且如果需要施加其他夹具，此过程可重复。
本领域普通技术人员将基于上述实施例进一步理解本发明的部件和优点。据此，本发明并不由具体的所示和所述限制，除非附加的权利要求书说明的。此处引用的所有公开物和参考文献全文在此通过引用明确结合于本申请中。
Claims (7)
1.一种改进的内窥镜外科夹具施放器，该施放器具有一起闭合以便靠近待夹住的组织的钳口，适于闭合钳口的推进杆，适于致动推进杆的触发器，以及适于在至少部分闭合冲程期间防止触发器打开的棘齿机构，其特征在于：
推进杆通过联接机构与连接到触发器的联接件相连接，预载接合件和所述推进杆的近端布置在形成于所述联接机构内的凹槽中，在闭合冲程期间当触发器部分打开时，所述预载接合件能够将钳口保持在固定的部分闭合位置中，以保持在钳口之间的部分成形的夹具。
2.如权利要求1所述的外科夹具施放器，其中，所述预载接合件适于将推进杆保持在固定的位置，同时允许所述联接件向近侧运动。
3.如权利要求1所述的外科夹具施放器，其中，所述预载接合件包括偏压构件，在闭合冲程期间，该偏压构件适于由推进杆压缩，当触发器部分打开时，该偏压构件适于将偏压力施加到推进杆的近端。
4.如权利要求3所述的外科夹具施放器，其中，所述偏压构件包括悬臂梁。
5.如权利要求3所述的外科夹具施放器，其中，所述偏压构件包括弹簧。
6.如权利要求3所述的外科夹具施放器，其中，所述凹槽包括至少一个形成于其中的凸脊，在闭合冲程期间当偏压构件被压缩时，所述凸脊适于将偏压构件保持在恒定的载荷。
7.如权利要求6所述的外科夹具施放器，其中，所述至少一个凸脊适于防止偏压构件被完全压缩。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US11/162,587 US8038686B2 (en) | 2005-04-14 | 2005-09-15 | Clip applier configured to prevent clip fallout |
| US11/162,587 | 2005-09-15 |
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| Publication Number | Publication Date |
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| CN1994233A CN1994233A (zh) | 2007-07-11 |
| CN100571642C true CN100571642C (zh) | 2009-12-23 |
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| CNB2006101444931A Active CN100571642C (zh) | 2005-09-15 | 2006-09-15 | 构造为防止夹具掉出的夹具施放器 |
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| US (2) | US8038686B2 (zh) |
| EP (1) | EP1764045B1 (zh) |
| JP (1) | JP5042571B2 (zh) |
| KR (1) | KR101283902B1 (zh) |
| CN (1) | CN100571642C (zh) |
| AT (1) | ATE422336T1 (zh) |
| AU (1) | AU2006213960B2 (zh) |
| BR (1) | BRPI0605646B1 (zh) |
| CA (1) | CA2559770C (zh) |
| DE (1) | DE602006005117D1 (zh) |
| ES (1) | ES2320033T3 (zh) |
| HK (1) | HK1100159A1 (zh) |
| MX (1) | MXPA06010633A (zh) |
| RU (1) | RU2435536C2 (zh) |
| SG (1) | SG131068A1 (zh) |
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-
2005
- 2005-09-15 US US11/162,587 patent/US8038686B2/en active Active
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2006
- 2006-09-13 AU AU2006213960A patent/AU2006213960B2/en not_active Ceased
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- 2006-09-14 RU RU2006133129/14A patent/RU2435536C2/ru not_active IP Right Cessation
- 2006-09-14 SG SG200606360-6A patent/SG131068A1/en unknown
- 2006-09-14 DE DE602006005117T patent/DE602006005117D1/de active Active
- 2006-09-14 JP JP2006249646A patent/JP5042571B2/ja active Active
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- 2006-09-15 BR BRPI0605646-6A patent/BRPI0605646B1/pt active IP Right Grant
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- 2006-09-15 KR KR1020060089735A patent/KR101283902B1/ko active IP Right Grant
- 2006-09-15 CN CNB2006101444931A patent/CN100571642C/zh active Active
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Also Published As
| Publication number | Publication date |
|---|---|
| RU2006133129A (ru) | 2008-03-20 |
| BRPI0605646B1 (pt) | 2021-04-27 |
| AU2006213960B2 (en) | 2013-03-07 |
| US8038686B2 (en) | 2011-10-18 |
| SG131068A1 (en) | 2007-04-26 |
| CA2559770C (en) | 2014-09-09 |
| US20060235443A1 (en) | 2006-10-19 |
| AU2006213960A1 (en) | 2007-03-29 |
| KR20070031821A (ko) | 2007-03-20 |
| BRPI0605646A (pt) | 2007-10-16 |
| CA2559770A1 (en) | 2007-03-15 |
| JP2007075621A (ja) | 2007-03-29 |
| HK1100159A1 (en) | 2007-09-07 |
| RU2435536C2 (ru) | 2011-12-10 |
| MXPA06010633A (es) | 2007-06-05 |
| EP1764045A1 (en) | 2007-03-21 |
| US8216257B2 (en) | 2012-07-10 |
| EP1764045B1 (en) | 2009-02-11 |
| ATE422336T1 (de) | 2009-02-15 |
| DE602006005117D1 (de) | 2009-03-26 |
| CN1994233A (zh) | 2007-07-11 |
| JP5042571B2 (ja) | 2012-10-03 |
| ES2320033T3 (es) | 2009-05-18 |
| US20110224696A1 (en) | 2011-09-15 |
| KR101283902B1 (ko) | 2013-07-16 |
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