CN101448463B - Electrical surgical instrument - Google Patents

Electrical surgical instrument Download PDF

Info

Publication number
CN101448463B
CN101448463B CN2007800177940A CN200780017794A CN101448463B CN 101448463 B CN101448463 B CN 101448463B CN 2007800177940 A CN2007800177940 A CN 2007800177940A CN 200780017794 A CN200780017794 A CN 200780017794A CN 101448463 B CN101448463 B CN 101448463B
Authority
CN
China
Prior art keywords
motor
accumulator
operating theater
theater instruments
instruments according
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN2007800177940A
Other languages
Chinese (zh)
Other versions
CN101448463A (en
Inventor
凯文·史密斯
托马斯·贝尔斯
德里克·德维尔
卡洛斯·里韦拉
马修·帕尔默
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Endo Surgery Inc
Syntheon LLC
Original Assignee
KMS Medical LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US11/705,381 external-priority patent/US8038046B2/en
Application filed by KMS Medical LLC filed Critical KMS Medical LLC
Priority to CN201110150657.2A priority Critical patent/CN102309352B/en
Priority to CN201110152302.7A priority patent/CN102293673B/en
Priority claimed from PCT/US2007/070085 external-priority patent/WO2007137304A2/en
Publication of CN101448463A publication Critical patent/CN101448463A/en
Application granted granted Critical
Publication of CN101448463B publication Critical patent/CN101448463B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • 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
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/032—Automatic limiting or abutting means, e.g. for safety pressure limiting, e.g. hydrostatic
    • 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
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Switches Operated By Changes In Physical Conditions (AREA)

Abstract

A surgical instrument includes a surgical end effector having a receiving portion for removably receiving therein an interchangeable part. The receiving portion has a communication connection. A handle connected to the end effector actuates the end effector. The handle has a controller electrically connected to the communication connection for authenticating the interchangeable part when placed at the end effector. An interchangeable part is removably connected to the receiving portion and has an encryption device electrically removably connected to the communication connection when placed at the receiving portion. The encryption device authenticates the interchangeable part when queried by the electric controller.

Description

Electrical surgical instrument
Technical field
The invention belongs to field of surgical, especially but to be not limited to be stapling apparatus.The stapling apparatus that the application describes is the all-electric and controllable operation anastomat of hand-held.
Background technology
Medical stapling apparatus is well known in the art.Ethicon Endo-surgery (the Johnson ﹠amp of company; Johnson company is hereinafter referred to as " Ethicon ") this class stapling apparatus of produce and market.The circular anastomosis device that Ethicon makes uses PROXIMATE, PPH, CDH and ILS brand name, and the straight line stapling apparatus that Ethicon makes uses CONTOUR and PROXIMATE brand name.In these anastomats, tissue is compressed between nail bin and the nail supporting base, when the percussion suturing nail, downcuts compressed tissue simultaneously.According to the concrete tissue that the doctor performs an operation, tissue can be compressed very few (wherein still can find out the color of tissue), too much (wherein organizing crushed) or appropriateness (wherein Zu Zhi liquid is extruded, be called drying or bleach).
Suturing nail has certain length, needs to have acceptable suturing nail percussion distance between nail bin and the nail supporting base, so that suturing nail can be correct closed when percussion.For this reason, these anastomats have indicating device to show that relative distance between two planes and this distance are whether in the percussion scope of suturing nail length.This indicator is mechanical, and the form indication safety stiich dowel in the window back with sliding bar is pulled the trigger scope.All these anastomats all are manual, in other words, require user or doctor with manually placing nail supporting base and nail bin with respect to the tissue that is coincide and/or cut, nail supporting base and nail bin is close mutually, pull the trigger and fixing suturing nail (and/or cutting and organizing) to tissue.There was not electronic anastomat to carry out each of these operations in the past, because at nail bin about 250 pounds longitudinal force percussion suturing nail must be arranged.In addition, this class anastomat can make the power the best that is applied to the tissue that is coincide and tissue degeneratiaon not take place without any the effective compression indicator of type.
5,104, No. 025 patent of the U.S. that transfers the people such as Main of Ethicon company has for example been described the circular anastomosis device that coincide in a kind of manual tube chamber.Therefore this patent of people such as Main is incorporated among the application for reference in full.Can be clear that trocar shaft 22 has a far-end zigzag groove 21 in Fig. 7 exploded view of people's such as Main patent, some of the sawtooth 29 that is used for making trocar shaft 22 aim at nail supporting bases are recessed 28, thereby suturing nail is aimed at nail supporting base 34.Can thrust tissue after trocar tip 26 is stressed.Fig. 3 to Fig. 6 of people's such as Main patent shows how circular seams dowel 10 links together two tissues.Along with nail supporting base 30 moves near head 20, in the middle of the tissue in the middle of placing is compressed in, shown in Fig. 5 and Fig. 6 are concrete.If tissue is by excessive compression, the surgical stapling operation may get nowhere.Therefore, need be no more than and organize acceptable maximum compression.Tissue in the middle of placing in operation process can bear the compression stress of certain limit.This scope is known and is called the best and organizes compression stress or OTC that it depends on the types of organization of being coincide.In people's such as Main patent, anastomat has a rod indicator, be used for showing suturing nail percussion safe distance between nail supporting base and the nail bin to user, but it can not show the size that is applied to any compression stress of tissue before coincideing to user.Be desirable to provide this indication, in order to avoid the excess compression tissue.
Summary of the invention
The present invention is by providing a kind of electric operation stapling apparatus, overcome the above-mentioned of prior art above-mentioned and other defective, this device with electronic with respect to the tissue that is coincide and/or cut place nail supporting base and nail bin, make nail supporting base and nail bin mutually close, pull the trigger and fixing suturing nail (and/or cutting and organizing) to organizing.And this electric operation stapling apparatus can be to the predetermined size that puts on the compression stress of tissue of user indication before the percussion suturing nail.The method of operation Motorized surgical surgical stapling apparatus when the present invention also is provided at and has the best and organize compression stress.
The bias axis structure of nail supporting base sub-portfolio part (sub-assembly) and suturing nail percussion sub-portfolio part forms a device, and its size can cosily be held in the hands of user.Owing to cancelled nested (coaxial) hollow axle of original requirement, reduced manufacture difficulty simultaneously.Because the axis of nail supporting base sub-portfolio part with respect to the biasing of suturing nail percussion sub-portfolio part, stretches out and the threaded rod of the nail supporting base of withdrawing can reduce about two inches, thereby saves manufacturing cost and shorten longitudinal size.
Use electronic anastomat typical method to comprise a start feature, it allows for test objective and enters manual mode.In operation technique, anastomat is non-return device.But in test model, user can be as required backward and move forward the trocar.Test model can be disengaged, and anastomat is readjusted the use pattern pack and transport.In order to pack, best (be not must) makes between nail supporting base and the nail bin certain distance.Therefore, before powered-down was packed and transported, the playback order can be carried out by follow procedure, nail supporting base is placed the position of leaving nail bin 1 centimetre (for example).Before using, the trocar is stretched out, nail supporting base is taken off.If anastomat is used for excising colon (for example), the trocar is withdrawn in the handle, and the handle per anum inserts downstream one side of colectomy section, simultaneously nail supporting base is inserted upstream one side of excision section from laparoscopic incision.Nail supporting base is connected on the trocar, and two parts are withdrawn to handle, reaches the percussion state of preparing up to a suturing nail.Suturing nail percussion sequential firing (can interrupt), the excision section of coincideing is simultaneously at excision section heartcut tissue, cleaning opening in the middle of the suturing nail annulus.The suturing nail percussion comprises that in proper order the best organizes compression stress (OTC) to measure and cause that suturing nail is only in the feedback control strategies of desired optimal compression power scope (being called the OTC scope) percussion.Characteristic according to compressed tissue between nail supporting base and nail bin is known this scope or numerical value in advance.
Can use some typical operation of electronic anastomat to comprise colectomy and gastric bypass.Electronic anastomat has many other purposes in multiple different technologies field.
According to purpose of the present invention, a kind of operating theater instruments also is provided, comprising: a kind of operation end effector, this end effector have at least one to drive molectron, carry out operation technique when this drives molectron when operation; A motor that is connected to end effector is used for this at least one driving molectron of running; And the power supply that connects motor, this power supply is selectively to the motor power supply, and at least one drives molectron to turn round.Power supply has an accumulator with critical current rate at least.When connecting at least one driving molectron of motor power and running, described power supply moves at least one accumulator with supercritical current rate (current rate).
According to purpose of the present invention, a kind of operating theater instruments also is provided, comprise a kind of operation end effector, end effector has at least one to drive molectron, carries out operation technique when this drives molectron when operation; A motor that is connected to end effector, this motor are used for this at least one driving molectron of running; And the power supply that connects motor, this power supply drives molectron selectively to the motor power supply to drive at least one.Power supply has an accumulator with critical current rate at least.When connecting motor power and drive at least one driving molectron, this at least one accumulator is to be higher than the average current speed power supply of critical current speed.
According to purpose of the present invention, a kind of operating theater instruments also is provided, comprise a kind of operation end effector, end effector has at least one to drive molectron, carries out operation technique when this drives molectron when starting; A motor that is connected to end effector is used for this at least one driving molectron of operation; The power supply that connects motor, selectively to the motor power supply, in the clinical lifetime of at least one end effector, motor and power supply with start this at least one drive molectron action at least 1 time and be less than 16 times.Power supply has at least one accumulator, and at least one drives molectron to start this when energized, only works about 0.5 second to 15 seconds.
According to purpose of the present invention, a kind of operating theater instruments also is provided, comprise a kind of operation end effector, end effector has at least one to drive molectron, carries out operation technique when this drives molectron when operation; The motor with rated operational voltage that is connected to end effector is used for this at least one driving molectron of operation; The power supply that connects motor selectively to the motor power supply, drives molectron to start at least one.Power supply has an accumulator with critical current rate at least.When connecting motor power and drive at least one execution molectron, this power supply drove this at least one accumulator and moves this motor in the supercritical pulsed discharge phase to be higher than rated operational voltage with the supercritical current rate in any time of at least a portion supercritical pulsed discharge phase.
Think that the further feature of feature of the present invention sets forth in appended claims.
Though the example of figure of the present invention and description is to have the Motorized surgical operating theater instruments of optimizing power supply and driving device, but the invention is not restricted to given details, because do not breaking away from spirit of the present invention and in the identical content of claim and scope, may carry out various remodeling and structural change.
The description of the example below reading by reference to the accompanying drawings will be understood structure of the present invention and operational approach and other purpose and advantage better.
Description of drawings
The advantage of example of the present invention will show by the detailed description to the example of following preferential selection, and these descriptions should be considered in conjunction with following accompanying drawing:
Fig. 1 is the axonometric chart according to a side of an electronic anastomat example of the present invention;
Fig. 2 is the partial side view of the anastomat of Fig. 1, has right half of handle and lays down near-end spine plate;
Fig. 3 is the exploded perspective view of nail supporting base control combination part of the anastomat of Fig. 1;
Fig. 4 is the amplification partial exploded view of the nail supporting base control combination part of Fig. 3;
Fig. 5 is the partial perspective view of the suturing nail percussion control combination part seen from behind of the anastomat of Fig. 1;
Fig. 6 is the exploded perspective view that the suturing nail of the anastomat of Fig. 1 is pulled the trigger the control combination part;
Fig. 7 is the exploded axonometric chart that the suturing nail percussion control combination part of Fig. 6 amplifies;
Fig. 8 is the anastomat of Fig. 1 is seen nail supporting base control combination part from below from the handle body portion local horizontal sectional drawing;
Fig. 9 is that horizontal sectional view is amplified in the part that the nail supporting base control combination part of Fig. 8 is seen below proximal part;
Figure 10 is that horizontal sectional view is amplified in the part that the nail supporting base control combination part of Fig. 8 is seen below the part of centre;
Figure 11 is that horizontal sectional view is amplified in the part that the nail supporting base control combination part of Fig. 8 is seen below distal portions;
Figure 12 is the partial vertical sectional drawing that the handle body portion of the anastomat of Fig. 1 is seen from the right side;
Figure 13 is that vertical cross section figure is amplified in the part that the right side of handle body proximal part of the anastomat of Figure 12 is seen;
Figure 14 is that vertical cross section figure is amplified in the part that the handle body mid portion of the anastomat of Figure 12 is seen from the right side;
Figure 15 is the further amplification partial vertical sectional drawing that the handle body mid portion of the anastomat of Figure 14 is seen from the right side;
Figure 16 is that vertical cross section figure is amplified in the part that the far-end handle body portion of the anastomat of Figure 12 is seen from the right side;
Figure 17 is the axonometric chart of a part of nail supporting base of the anastomat of Fig. 1;
Figure 18 is the schematic partial sectional view of dismountable identical molectron of the anastomat of Fig. 1, comprises nail supporting base, nail bin, power switch (force switch) and dismountable nail bin connecting assembly;
Figure 19 is the local horizontal sectional drawing of the nail supporting base control combination part seen above the handle body portion of the anastomat of Fig. 1, and the nail supporting base bar is at complete extended position;
Figure 20 is the partial elevation view that the handle body portion of the anastomat of Fig. 1 is seen from the left side, and left handle body and circuit board unload, and the nail supporting base bar is at complete extended position;
Figure 21 is the partial side view of handle body portion of the anastomat of Figure 20, and the nail supporting base bar is in 1cm nail supporting base make position;
Figure 22 is the local horizontal sectional drawing of the nail supporting base control combination part seen above the handle body portion of the anastomat of Fig. 1, and the nail supporting base bar is in the safe firing position of suturing nail;
Figure 23 is the local horizontal sectional drawing of the nail supporting base control combination part seen above the handle body portion of the anastomat of Fig. 1, and the nail supporting base bar is in complete retracted position;
Figure 24 is the local horizontal sectional drawing of the percussion control combination part seen above the handle body portion of the anastomat of Fig. 1;
Figure 25 is the horizontal sectional view that amplify the part seen above proximal part of the percussion control combination part of Figure 24;
Figure 26 is the horizontal sectional view that amplify the part seen above the part of centre of the percussion control combination part of Figure 24;
Figure 27 is the horizontal sectional view that amplify the part seen above distal portions of the percussion control combination part of Figure 24;
Figure 28 and 29 is axonometric charts of the partially transparent that amplifies of the part of hatching of nail bin dismounting molectron of the anastomat of Fig. 1;
Figure 30 is the schematic circuit according to the encrypted circuit example of the exchangeable part of medical treatment device of the present invention;
Figure 31 is the expression pinion promotes the speed of tooth bar shown in Figure 32 when different load block diagram;
Figure 32 is the partial perspective view according to the simplification example part of typical gear train between gear-box of the present invention and the tooth bar;
Figure 33 is the vertical sectional drawing of partial vertical of far-end of hinge portion of a kind of typical example of end effector, has unloaded interior pipe, push rod-insert supporting, nail supporting base, closed hoop and the suturing nail slide rail of half nearly;
Figure 34 is the schematic circuit diagram according to the example switch molectron of power supply of the present invention;
Figure 35 is the schematic circuit diagram of the illustrative switch molectron that rotates and reverse of control motor according to the present invention;
Figure 36 is the schematic circuit diagram of the exemplary on and off switch molectron of another kind according to the present invention and the switch assembly that rotates and reverse of control motor.
The specific embodiment
In the following explanation that relates to specific embodiments of the present invention and relevant drawings, will illustrate various aspects of the present invention.Under the prerequisite that does not break away from spirit of the present invention or content, can design alternative example.In addition, well-known element will no longer describe in detail or omit in the representative instance of the present invention, is convenient to outstanding correlative detail of the present invention.
Before describing the present invention, should know that employed term only is for describing the purpose of example, unqualified intention.Must be noted that in the claim of technical specification and adnexa, if not explanation in addition, odd number indefinite article and definite article comprise plural number.
Although the claim that description is considered to novel feature of the present invention with restriction is believed the following explanation of reference in conjunction with the drawings as conclusion, can understand the present invention better.Figure does not draw in proportion.In addition, should illustrate that figure forms with computer-aided design system.When being transformed into line frame graph from echo or cromogram, this program is removed some structure lines and/or face sometimes.Therefore, should regard as figure approximate and be used for explanation characteristics of the present invention.
With the aid of pictures in detail now, at first see Fig. 1 and 2, wherein demonstrate the representative instance of electric operation circular anastomosis device 1.The application coincide head employing electric handle just for easy understanding to circular surgical.The invention is not restricted to the circular anastomosis device, can be applied to any surgical stapling head, for example linear stapling apparatus.
Electronic anastomat 1 has handle 10, and handle has three switches: nail supporting base is opened switch 20, nail supporting base Closing Switch 21 and suturing nail percussion switch 22.Each switch is connected to circuit board 500 (seeing Figure 12), and circuit board 500 has the identical functional programs circuit of carrying out anastomat 1.Circuit board 500 is connected to the power supply 600 that is included in the handle 10.A kind of 2 to 6 CR123 of power supply 600 usefulness or CR2 lithium storage battery of typical example.Can adopt other power supply, for example the commutator of chargeable storage or connection power supply bus (for a kind of device in back, anastomat is not self-powered or full equipment).Here, the self-powered of power supply 600 or full equipment can exchange, and the meaning is this as complete sum unit independently, can work with its own power source, need not external power source.For example, the power supply that is inserted into the power supply main line with the service cable plug in use is not self-powered or full equipment.
Insulated conductor on the circuit board 500 or lead wire of conductor connect all electronic components of anastomat 1, for example power on/off switch 12, tissue compression indicator 14, nail supporting base and percussion switch 20,21,22; Circuit board 500, power supply 600.But for understanding and clear easily, these leads and conductor do not draw on figure.
The far-end of handle body 10 is connected to the near-end of rigidity nail supporting base cervical region 30.At the opposite end of this junction point, at the far-end of nail supporting base cervical region 30, removably connecting nail bin 50 and nail supporting base 60 with coupling arrangement 40.Another kind method is that nail bin 50 is non-dismountable, and the structure of anastomat 1 has only a kind of purposes.These connections will be described in further detail below.
Fig. 2 shows handle body 10, and right half part 13 and the circuit board 500 of handle body 10 have unloaded.As discussed below, near-end spine plate 70 also unloads in Fig. 2, in order to can see the internal part of handle body 10 from the right side.What can see from Fig. 2 is that two internal part axis are arranged in handle body 10.Article one, axis is suturing nail control axis 80, and this axis is level relatively in Fig. 2.Suturing nail control axis 80 is centrages, and the parts of control suturing nail percussion are housed along this centrage.The second axis is nail supporting base control axis 90, and this axis and suturing nail control axis 80 are angled.Nail supporting base control axis 90 is centrages, and the parts of control nail supporting base starting are housed along this centrage.Axis 80 and 90 separate make the handle body 10 that electronic anastomat 1 can be enough enough little power just, make its suitable doctor's hands and do not take excessive space, avoid limiting the doctor and move in the direction that is necessary.
Handle body 10 inside show power connection/cut-off switch 12 (for example Grenada (grenade) pin), are used for control to the power supply (for example battery feed) of all electric components and tissue compression indicator 14.Whether tissue compression indicator 14 is compressed in organizing between nail supporting base 60 and the nail bin 50 Xiang doctor's indication and is compressed greater than predefined compression stress, and this will be described in further detail below.Indicator 14 is connected with power switch 400, the serial number that the power switch has been submitted on May 19th, 2006 be 60/801,989 and title be description (here with reference to its full content) in the unexamined U.S. Provisional Patent Application of " power switch ".
Parts along nail supporting base control axis 90 form nail supporting base control combination part 100.Nail supporting base control frame 110 is aimed at nail supporting bases control axis 90, holds and/or the fixing various parts of nail supporting base control combination part 100.Nail supporting base control frame 110 has near-end mount pad 112, middle mount pad 114 and far-end mount pad 116.Mount pad 112,114,116 can be connected to control frame 110 or make one with it.In typical example, for easy manufacturing, near-end mount pad 112 in two,, separate with control frame 110, middle mount pad 114 with control frame 110 and separate.
Near-end at nail supporting base control combination part 100 has nail supporting base motor 120.Nail supporting base motor 120 comprises CD-ROM drive motor and intrinsic motor rotary speed is transformed into the needed any gear-box of output shaft rotating speed of requirement.In present case, the intrinsic rotating speed of CD-ROM drive motor is near 10,000 rev/mins, and the rotating speed of the axle 122 that gear-box will stretch out from nail supporting base motor 120 far-ends is reduced near 50 to 70 rev/mins.Nail supporting base motor 120 is vertically and be rotatably mounted in the near-end mount pad 112.
Motor drive shaft shaft coupling 130 is installed in rotation on the axle 122, rotates accordingly in order to make the rotation of axle 122 change motor shaft coupling 130 into.
The far-end of shaft coupling 130 has rotating nut molectron 140.In this example, nut assembly 140 separated into two parts have near-end half-nut 141 and far-end half-nut 142, and half-nut 142 rotationally and be vertically fixed on the half-nut 141.Should illustrate that half-nut 141,142 can be made of one as required.Here do into two, so that make.The near-end of nut assembly 140 is installed in rotation on the far-end of shaft coupling 130.These two interconnected parts are strengthened by middle mount pad 114 and far-end mount pad 116 at rotating support longitudinally.
Near-end nut lining 150 (see figure 3)s are installed between middle mount pad 114 and near-end half-nut 141, installation far-end nut lining 160 makes these parts and does not effectively rub with rotating reliably in handle body 10 and in the nail supporting base control frame 110 between far-end mount pad 116 and far-end half-nut 142.Lining 150,160 can be used any bearing material, can be with the metal of a bronze class or the polymer of nylon one class.In order further to reduce the nut assembly 140 of rotation and the vertical friction between the shaft coupling 130, installed thrust pad 170 between near-end lining 150 and near-end half-nut 141.
The rotation of shaft coupling 130 and nut assembly 140 be used for to advance or withdrawal threaded rod 180, nail supporting base 60 is stretched out or withdraws by threaded rod mechanism.Threaded rod 180 is expressed in more detail in the exploded view of Fig. 3 and Fig. 4 and will be described in detail below.Threaded rod supporting 190 is contained in the far-end of nail supporting base control frame 110, is used for extending the area supported in the nut assembly 140, in order to keep threaded rod 180 to align along nail supporting base control axis 90.Threaded rod supporting 190 has smooth interior shape, and is corresponding with the external shape of pass through the part that supports of threaded rod 180.The coupling of this shape makes threaded rod 180 not have frictionally reliably mobile by supporting 190 to near-end and far-end.In order to improve threaded rod 180 by the no frictional movement of supporting 190, in this typical example, between supporting 190 and threaded rod 180, cylindrical shape threaded rod lining 192 is housed.In Fig. 2, can't see threaded rod lining 192, because it is in the inside of supporting 190.But in the exploded view of Fig. 3 and Fig. 4, can see threaded rod lining 192.Install after the threaded rod lining 192, the interior shape of supporting 190 is corresponding with the external shape of threaded rod lining 192; The interior shape of threaded rod lining 192 is corresponding with the external shape of the part of passing through supporting of threaded rod 180.Threaded rod lining 192 can be with the metal of a bronze class or the polymer manufacturing of nylon one class.
Parts along suturing nail control axis 80 form the control combination part 200 that coincide.The control combination part 200 that coincide is illustrated in Fig. 5, and Fig. 5 is the perspective view of seeing with the side above near-end.The near-end of identical control combination part 200 comprises the motor 210 that coincide.The motor 210 that coincide comprises CD-ROM drive motor and intrinsic motor rotary speed is changed into the needed any gear-box of rotating speed of requirement.In present case, the intrinsic rotating speed of CD-ROM drive motor is near 20,000 rev/mins, slows down through gear-box, changes about 200 rev/mins at the rotating speed of the output shaft 212 of gear-box far-end.Can't see axle 212 at Fig. 5, but in the exploded view of Fig. 6 and Fig. 7, can see.
Coincide motor 210 rotationally and be vertically fixed on the motor mount 220.In the middle of having, the far-end of motor mount 220 is connected and installed seat 230.The centre is connected and installed seat 230 distal plate 232, as shown in Figure 6.Distal plate 232 can unload from being connected and installed seat 230, thereby it is middle that rotary screw 250 can be remained on.The driving effect of rotary screw 250 is launched suturing nail from nail bin 50 just.The efficient that the rotation of axle 212 is transformed into the rotation of screw rod 250 is significantly to reduce the factor that anastomat 1 is exported the ability of 250 pounds of longitudinal forces of launching suturing nail necessity.Therefore, typical screw rod 250 has Acme (acme) screw thread.
There are two kinds of typical methods to be used for effectively screw rod 250 being passed in the rotation of axle 212.First method is that identical motor 210 can be installed in " loosely " in the cavity of being determined by handle body 10, thereby the motor that coincide can stably rotate, but the gap of moving about is radially being arranged, vertically can stablize, but the gap of moving about is also arranged.In this structure, the motor 210 that coincide makes the axis of axle 212 aim at the axis of screw rod 250 with " self-centering ", and in typical example, this also is suturing nail control axis 80.
Make axle 212 second kind of typical embodiments of aiming at screw rod 250 be illustrated in Fig. 1 to Fig. 5.In this embodiment, the near-end of flexible clutch 240 is fixed on (rotatable and vertical) on the axle 212.This connection is that the proximal orifice 241 by flexible clutch 240 that the far-end of axle 212 is packed into forms.See Figure 12.Then that axle 212 usefulness proximally-located screws 213 are fixing.Screw rod 250 has proximal extension section 251, and this extension is inserted into the remote stomidium 242 of flexible clutch 240, and fixing with far-end dog screw 252.It should be noted that the flexible clutch 240 shown in the figure has protuberance at the middle part.On typical flexible clutch 240, part is molded with aluminum or plastics, at the core circumference spiral type otch is arranged.In this structure, an end of flexible clutch 240 can radially move (360 degree) (as universal joint) with respect to the other end any, and desired flexibility so just is provided, and effectively axle 212 is aimed at the central axis of screw rod 250.
The diameter of the proximal extension section 251 of screw rod 250 is connected and installed the diameter in the hole 231 in the seat 230 less than the centre.The step that the far-end in hole 231 has two diameters to increase.The size of the step that first diameter increases cooperates with the near-end radius of screw rod lining 260, and the screw rod lining is formed by the material of the material softer that is connected and installed seat 230 than the centre.Near-end radius screw rod lining 260 only is to keep screw rod 250 to axially align, and does not absorb or transmits any longitudinal thrust.The size of the step of second diameter increase cooperates with the near-end thrust bearing 270 of screw rod 250.On a kind of typical thrust bearing 270, proximal plate and distal plate are clipped in the middle bearing ball holding plate and bearing ball.When the suturing nail in the longitudinal force emission nail bin 50 that applies up to 250 pounds, thrust bearing 270 absorbs the longitudinal thrust that all act on axle 212.The proximal extension section 251 of screw rod 250 has the diameter of different size corresponding to the inside of screw rod lining 260 and thrust bearing 270.Therefore, motor mount 220 and be connected and installed seat 230 and form two devices is fixed on flexible clutch 240 between these two devices.
Rotating screw bolt 250 usefulness far-end radius screw rod linings 280 remain in the distal plate 232, and screw rod lining 280 is similar to near-end radius screw rod lining 260.Therefore, screw rod 250 freely rotates in distal plate 232.Move for the rotation with screw rod 250 is transformed into the far-end straight line, screw rod 250 is processed with screw thread in travelling nut 290.The movement of nut 290 is limited in finishes the needed amount of movement of percussion suturing nail, in other words, the distance that nut 290 moves only need enough form closed suturing nail and stretch out the blade (if there is) in nail bin 50, the same distance of withdrawing then between nail bin 50 and nail supporting base 60.When nut 290 during in most proximal position (seeing Figure 12), suturing nail is static, at cocked position.When nut 290 during in distal-most position, suturing nail passes and surrounds the tissue between nail bin 50 and the nail supporting base 60, will organize and coincide, and the blade (if there is) is passed tissue, and tissue is cut down.The distal-most position of nut 290 is limited by the position of distal plate 232.Therefore, restriction nut 290 in the position of the longitudinal length of the screw thread of screw rod 250 and distal plate 232 is to the movement of far-end.
Total power (pound) that friction loss between screw rod 250 and the nut 290 causes being delivered to nail bin 50 by nail bin plunger 320 significantly reduces.Therefore, require to select screw rod 250 and the material of nut 290 and the thread pitch of screw rod 250 with optimization.Have been found that with low friction polymer manufacturing nut 290 frictional force will be reduced to is enough to transmit about 250 pounds of longitudinal forces to the far-end of nail bin plunger 320, this power is the needed numerical value of pulling the trigger suturing nail effectively.Two kinds of exemplary materials have desired characteristic, are called as DELRIN in the art
Figure G2007800177940D0012150818QIETU
(a kind of containing evenly diffuses throughout DELRIN to AF Blend Acetal TEFLON in the acetal resin The thermoplastic material of fiber) and RULON (a kind of politef of mixed form) or other similarly low friction polymer.
Nut connection support 300 is vertically fixed on the nut 290 and with nut 290 and moves.Nut connects support 300 and provides support for softer and smooth nut material.Shown in typical device in, support 300 has the shape inner chamber corresponding with the profile of nut 290.Therefore, nut 290 is fixed on closely and connects in the support 300, and the movement of nut 290 is converted into the corresponding movement that nut connects support 300.In typical device, the shape that connects support 300 is limited by the parts around it and the longitudinal force of being born.For example, at the far-end of nut 290 cavity 302 is arranged, its shape is used for holding distal plate 232.Nut connects support 300 also has far-end chamber 304 to be used for holding a bracing piece 310.Bracing piece 310 increases longitudinal supportings and forms coupling part (see figure 5) between nut 290 and the nail bin plunger 320, this be the interior element of handle 10 with nail bin 50 between last moves and is connected.Being installed in nut connects support 300 and is connected being connected between support 300 and the bracing piece 310 with percussion support 330 stiffnuts between the bracing piece 310.
The various parts of anastomat 1 are interconnection, form spine.This root spine is a shelf, multi-direction stability is provided and forms (order from the near-end to the far-end) by four major parts: nail supporting base control frame 110, near-end spine plate 70 (seeing Fig. 3,4,6,7), far-end spine plate 340 and nail supporting base cervical region 30.Each part in these four parts is fastened to each other and form skeleton by this order vertically and rotationally, and the remaining part of handle is attached in some way on this skeleton.The lateral support of parts is provided by the shape of handle body 10 inner surfacies, and handle body 10 forms two halves, left half handle body 11 and right half handle body 13 in typical device.Perhaps, supporting can be punching press or be attached to single framework on half handle body 11,13.
The function of nail supporting base control combination part 100 is described with reference to Figure 17 to 27.In order to carry out anastomosis procedure with anastomat 1, whole nail supporting base 60 unloads from anastomat 1, as shown in figure 17.Press nail supporting base and open switch 20, stretch out the far-end of trocar tip 410, described trocar tip is contained in the nail bin and vertically is being fixedly connected on the screw rod 250.The tissue that is coincide can be passed or thrust in the summit of trocar tip 410 now.At this moment user can stress nail supporting base 60 new clothes (see Figure 18) to trocar tip 410 from opposite one of tissue, thus locking nail supporting base 60.Operation nail supporting base Closing Switch 22 begins facing to nail bin 50 closed nail supporting bases 60, compresses the tissue in the space 62 between nail supporting base and the nail bin.
How to control the movement of nail supporting base 60 in order to describe trocar tip, referring to Fig. 8 to 10,14,15 and 18.Shown in the dotted line among Figure 15, rod guidance pin 143 is contained in the centre bore 144 of far-end half-nut 142.Because threaded rod 180 is screwed into rotating nut 140,141,142, pin 143 pins the near-end of screw thread 182, and pin 143 is surrounded.Like this, nut 140 will cause bar 180 to move to near-end or far-end according to the nut rotation direction together with the rotation of pin 143 in screw thread 182.Screw thread 182 has variable pitch, shown in Figure 14 and 15, in order to move nail supporting base 60 with different longitudinal velocities.When pin 143 during at the long threaded portion (bottom) of pitch 183, nail supporting base 60 vertically moves comparatively fast.When pin during at the short threaded portion (top) of pitch 184, nail supporting base 60 vertically moves slower.Should be noted that pin 143 is parts of unique contact screw thread 182 at the long threaded portion (bottom) 183 of pitch.Therefore, at this moment pin 143 is exposed to the whole longitudinal force that acts on bar 180.The intensity of pin 143 is enough to bear this power, but may be not enough to bear all longitudinal forces that produce when nail supporting base 60 faces toward the tissue closure of clamping.
As shown in figure 14, bar 180 has the threaded portion 184 of shorter pitch, and the female thread 145 corresponding with the near-end of the centre bore 144 of near-end half-nut 141 engages.When the threaded portion 184 of shorter pitch engaged with female thread 145, the whole lateral surfaces of threaded portion 184 contacted with female thread 145.This contact surface is surperficial more much bigger than contacting between any part of pin 143 and screw thread 182, therefore can bear nail supporting base 60 closed all longitudinal forces that produce, especially in the longitudinal force of suturing nail percussion state generation when nail supporting base 60 is closed.For example in typical device, pin 143 the highest longitudinal forces of bearing near 30 to 50 pounds.Compare with the screw thread that can bear up to 400 pounds of longitudinal forces, 10 to 1 gap is almost arranged.
A kind of alternate embodiment of nail supporting base control combination part 100 can fully phase out the screw thread of bar 180 complexity.In this device, bar 180 has single thread pitch, nail supporting base motor 120 according to the lengthwise position of single thread bar 180 with different speed drive (by the corresponding program on the circuit board 500).
Be used for CD-ROM drive motor 120, any embodiment of 210, control sequence can have many forms.In a kind of typical embodiments, the microcontroller on the battery-driven circuit board 500 can adopt impulse modulation (for example pulse width, pulse frequency) to control any one or two motors.And because anastomat 1 is a kind of underload circulating device, or a kind of expendable equipment, driven parts can surpass manufacturer's technical specification of allowing.For example, the moment of torsion of gear-box can surpass the rated value of regulation.In addition, for example the CD-ROM drive motor of 6 volts of voltages can supervoltage, for example uses 12 volts of voltages.
Nail supporting base 60 from extended position be closed into do not have compress tissue or only the position of mild compression tissue can carry out rapidly and not damage the tissue that is clipped in the middle.Therefore, the threaded portion 183 that pitch is long allows user to make nail supporting base 60 close to organizing under its pre-compressed state quickly organizing.Wish compress tissue more slowly subsequently, so that user can be controlled, avoid the excess compression tissue.For this reason, use the short threaded portion 184 of pitch in the mobile the latter half, make user that control greatly be arranged.In this compression process, can use shown in Figure 18 and sequence number is 60/801, the power switch of describing in 989 the U.S. Provisional Patent Application 400, to user indication the control circuit of circuit board 500 (and/or be input to), the power of compress tissue is greater than the preload of the spring 420 in the power switch 400 by tissue compression indicator 14.Should be noted that the power switch 400 that is in normal open position shown in Figure 180 is that sequence number is first embodiment of 60/801,989 U.S. Provisional Patent Application.Also can measure tissue compression with strain gauge.
The movement of the position (see Figure 21) of Figure 19 to 23 display pole 180 from nail supporting base extended position (seeing Figure 19,20) to 1 centimetre of closed distance, suturing nail cocked position (seeing Figure 22) and the last complete make position of nail supporting base (seeing Figure 23).The movement of bar 180 by the cam face pusher 185 on the bar 180 be contained in handle 10 in the catch bar of a series of microswitchs or button between contact and carry out electrical control (by circuit board 500).
When bar 180 (with nail supporting base 60) during at complete extended position, bar is stretched out entirely and is closed 610 and be in handle 10 far-ends (seeing Figure 19), pusher 185 is pushed down stretch out entirely to close 610 catch bar.1 centimetre of switch 612 is positioned the centre position (seeing Figure 20 and 21) in handle 10, prevents that in 1 cm range of bar 180 (with nail supporting base 60) in make position fully time the 1 centimetre of cam face 186 of bar 180 from pushing down the promotion button of 1 centimetre of switch 612.After the closed distance by 1 centimetre, as shown in figure 22, cam face pusher 185 is prepared percussion switch 614 with suturing nail and is engaged.See as Figure 22 and 23, there is an oblique angle both sides, front and back that the button of percussion switch button 614 is prepared at suturing nail in the lower end of pusher 185, promote distance (or only its flat) between two oblique angles of button corresponding to the identical formation scope (namely safety is pulled the trigger length) of the suturing nail in the nail bin 50 that coincide.Therefore, when the button of suturing nail preparation percussion switch 614 was depressed for the first time, the distance between nail supporting base 60 and the nail bin 50 was in the longest scope of successfully percussion and closure seam dowel.When button was depressed, the separating distance 62 of nail supporting base 60 was still in the identical scope (seeing Figure 18) of safety.But when no longer depressing the button of suturing nail preparation percussion switch 614 (because pusher 185 is near buttons), suturing nail will not pulled the trigger so, because distance is too near for therapeutic is coincide.Figure 23 display pole 180 is in proximal most position, this by the top of pusher 185 near withdraw the fully handle indication of switch 616 of bar.When pull switch 616, the program on the circuit board 500 prevents that motor 120 from rotating to the bar retracted orientation; In other words, switch 616 is that bar 180 is to the shutdown switch of proximal direction withdrawal.
Should be noted that Fig. 2 and 3, Figure 11 are not connected (so should contact with the near-end of power switch 400) with the far-end of 12 bars 180 that show with Figure 16 with the far-end of other device.For clear, the connecting band of the near-end of the far-end of bar 180 and power switch 400 does not illustrate in the drawings.In one embodiment, drawstring is flat and flexibility, by nail supporting base neck 30, is horizontally through the below of nail bin plunger 320 bendings, upward to the near-end of power switch 400.Certainly, if do not adorn power switch 400, connecting band should be connected to the near-end of trocar tip 410, and this trocar tip is detachably connected to the near-end of nail supporting base 60.
Function contrast Figure 12 to 16 and Figure 24 to 27 of identical control combination part 200 especially contrast Figure 24 and describe.The motor 210 that coincide remains between motor bearing 222 and the motor shaft-cup 224.The axle 212 of identical motor 210 is pivotally connected to the near-end of flexible clutch 240, the far-end of flexible clutch 240 is pivotally connected to the near-end of screw rod 250, and it is connected and installed bearing 260,270,280 rotations in seat 230 and the distal plate 232 in the middle of being arranged at.Be connected and installed in the middle of vertically transmission nut 290 is screwed on the screw rod 250 between seat 230 and the distal plate 232.Therefore the rotation of axle 212 changes screw rod 250 into and rotates accordingly.
Nut connects support 300 and is vertically fixed on nut 290, bracing piece 310 and the percussion support 330.Percussion support 330 is vertically fixed on the nail bin plunger 320, and nail bin plunger upwards (by the suturing nail driver of not drawing) extends to nail bin 50 (or suturing nail).Use this connection, the vertically moving of nut 290 is converted into nail bin plunger 320 and vertically moves accordingly.Therefore, when suturing nail percussion switch 22 was started, the motor 210 that causes coincideing rotated time enough, so that suturing nail is pulled the trigger out (if cutting blade is housed, blade stretches out, and cuts off the tissue between nail supporting base 60 and the nail bin 50 fully) from nail bin 50 fully.As described below, after the percussion, the program in the circuit then causes 320 withdrawals of nail bin plunger, withdraws from any part of suturing nail percussion part and/or the blade in the nail bin from the space 62 between nail supporting base and the nail bin.
This identical motion is also controlled by the microswitch that is electrically connected (for example lead) with circuit board 500 usefulness.First gauge tap (proximal anastomosis switch 618) is controlled the withdrawal of described identical control combination part 200 and is limited the most proximal position of described identical control combination part 200.In order to start this switch, start-up plate 306 is connected the side that nut connects support 300 in adjustable mode, sees Fig. 6 and 24.Like this, when nut 290 moves to near-end, when causing nut to connect plate 306 starting proximal anastomosis switches 618 on the support 300, cut off the electric current of the motor 210 that coincide, the control combination part 200 that stops to coincide continues to move to proximal direction.
Second switch that the identical control combination part 200 of control moves is positioned at an opposite side of bracing piece 310 far-end lateral surfaces, sees Figure 27.Vertical adjustable cam 312 is housed on this surface, and cam 312 contacts with the identical switch 620 of far-end.In one embodiment, cam 312 is screws, is screwed into the remote stomidium of bracing piece 310.Therefore, when nut 290 moves and when causing cam 312 starting far-ends on the bracing piece 310 to coincide switch 620, cuts off the electric current of the motor 210 that coincide to far-end, the control combination part 200 that stops to coincide continues to move to distal direction.
Figure 28 and 29 shows dismountable connecting assembly, in order to change different nail bins 60 at the far-end of nail supporting base 30.
Handle body 10 most proximal end chambers have been established the cavity that holds power supply 600.Power supply 600 is connected to motor 120,210 and other electric component of anastomat 1 by circuit board 500.
The electric component of anastomat 1 is being made general description aspect the control of circuit board 500.As described in the top embodiment, electronic anastomat 1 comprises two CD-ROM drive motors 120,210, and described motor is by storage battery power supply with by button 20,21 and 22 controls.Motor 120,210 moving range by limit switch 610,616,618 and 620 controls in the stroke end and along the centre position 612,614 of stroke.Motor 120,210 control logic circuit can be realized with several method.For example can be with relay or ladder logic definition motor 120,210 and switch 610,612,614,616,618 and 620 control algolithm.This program is simple but circumscribed method is arranged.More flexibly method be adopt based on the control system of microprocessor carry out aware switch input signal, locking switch, connection display lamp, record data, send the auditory feedback signal, drive visual display, inquire recognition device [for example rfid device (RFID) or apparatus for security code recognition], perception, communicate by letter, monitor the life of storage battery etc. with external device (ED).Microprocessor can be to connect and control has the ingredient of the integrated circuit that complex electromechanical systems makes for the interface.The Mega128 that is provided by Atmel and the PIC 16F684 that is provided by PIC are provided the example of this chip.
Sort processor need have software program that the control indication is provided.In case exploitation can write program processor and long term storage fully.This system makes the change of control algolithm fairly simple; Control and user interface can be adjusted to the change of the software that is installed to processor, the mechanical layout of write-in program or device need not be changed.
For disposable apparatus, energized only takes place once.In this case, leave behind tab or finish the joint power supply from the trip gear (release) that installs permanent removal.Make this removal make the accumulator contact, can be to the device power supply.
In any example, when the device energized, control sequence begins to carry out, and before operative installations, carries out routine, guarantees to know the physical location of stretching out/withdrawing and pulling the trigger the sub-portfolio part, is called reset routine.Reset routine can be carried out before user's shipping in manufacturer.In this case, execution reset routine, setting molectron position, device are being ready under the user mode to user's shipping.In case energized, device are differentiated its position and are prepared and use.
Provide feedback signal with visual detector (for example light emitting diode) to user.Using under button 20,21,22 the situation, display lamp bright (or illuminating from behind) when switch can move, display lamp extinguishes when switch can not move.Display lamp can glimmer, and transmits other information to user.If delayed response takes place behind the pressing button, for example, display lamp can glimmer as the response to emergency with the speed that constantly increases gradually.Display lamp can also be indicated various states with different colours.
Diverse location at anastomat 1 uses cam to promote limit switch, and described limit switch provides positional information to processor.By using the linear cam of all lengths, can the desired location scope.Also can replace limit switch (absolute and location that increase progressively) with encoder.Limit switch is binary: switch on and off.Can replace binary system that positional information is provided with encoder (for example optical encoder).The motor end that provides the another kind of method of position feedback information to be included in the driven element molectron is installed pulse generator.By the ratio of count pulse and understanding motor rotary speed and straight line moving, can derive the absolute position.
Set up the ability of storage data with processor.For example, can store important mount message in advance, such as can storage device serial number and software version.Also can record data with memorizer when using anastomat 1.Pressing button, limit switch conversion each time, the percussions, the percussion of finishing each time etc. of abort each time each time can store, and are provided with back retrieval and diagnosis.By program mouth or retrieve data wirelessly.In one embodiment, can be set to diagnostic mode by handle assembly by pressing a series of buttons.At this diagnostic mode, the technical staff can be to anastomat 1 some data of inquiry or some data of transmission/output.The response of 1 pair of this inquiry of anastomat can be LED flash, if display screen is perhaps arranged, display of visually character data or electronic data.As mentioned above, can and provide acceptable strain band with strain gauge simulation output.Another kind method is mechanically to set strain band with second additional springs and support unit.
The example of the control algolithm of a single percussion anastomat 1 can comprise the following steps:
Energized.
The checking home position and if necessary or needs, get back to the home position.
Operation is stretched out/retract button (lamp is bright) and make the suturing nail firing button can not move (lamp does not work).
Only stretching out (nail supporting base unloads) fully and subsequently with could running suture nail firing button after keeping the stretching out of operation/retract button withdrawal.
In case starting suturing nail firing button, the nail supporting base withdrawal is started up to the power switch.
Begin to count down and along with the approaching flash speed that increases of percussion circulation with the flicker of the light emitting diode of firing button.Continue monitoring force switch and withdrawal nail supporting base, so that the switch of exerting all one's strength keeps starting.
In suturing nail percussion cyclic process, button press can stop suturing nail percussion program arbitrarily.
If before the starting of suturing nail percussion motor abort takes place, the percussion circulation stops, and nail supporting base reaches the home position, and the suturing nail firing button keeps can moving and preparing pulling the trigger again.
Another kind of situation is that the percussion circulation stops if at percussion motor moving process generation abort, the withdrawal of percussion motor, and nail supporting base is got back to the home position, and firing button becomes and can not move.Therefore, anastomat (or nail bin) can not use.
Finish the percussion count down after, suturing nail scope limit switch is asked the position.As suturing nail scope limit switch started-meaned nail supporting base in acceptable suturing nail percussion scope-suturing nail percussion motor operation then, percussion circulation beginning.Do not started as suturing nail scope limit switch, then pull the trigger the circulation abort, nail supporting base is got back to the home position, and the suturing nail firing button keeps operation, prepares percussion again and attempts.
Finish after the suturing nail percussion, nail supporting base remains on make position and only stretches out button and keeps operation.In case nail supporting base reaches at least to the home position, stretch out and two buttons of withdrawing can move.Finish after the suturing nail percussion, the suturing nail firing button keeps and can not move.
In above-mentioned whole typical recycling, pressing button, on off state, abort and/or percussion can be recorded.
In surgical procedures, anastomat is non-return device.But in test model, the experimenter need have the ability as required with the trocar 410 and nail supporting base 60 backward and move forward.It is that test objective enters manual mode that the energized structure allows user.This test model can be separated and anastomat reset in the use pattern and packed and shipping.
In order to pack, wish that (but be not must) be placed on nail supporting base 60 to leave nail bin 50 certain distances.Therefore, the return to primitive age sequence of positions can be programmed, cut off the electricity supply pack with shipping before, nail supporting base 60 is placed from the position of nail bin 50 1 centimetres (for example).
When electronic anastomat took out from packing and prepares to be used for operation, user was connected anastomat power supply (switch 12).Any time before the tissue compression state that reaches correct suturing nail firing position and requirement, should not allow to pull the trigger suturing nail.Therefore, the stretching out of nail supporting base/trocar/the withdrawal function is unique function of being moved.In this state, stretch out with retract button 20,21 lamps bright, suturing nail percussion switch 22 lamps do not work (namely can not move).
Before using in the patient body, the trocar 410 stretches out, and nail supporting base 60 is removed.Coincide (for example) if anastomat is used for colon, the trocar 410 is withdrawn in the nail supporting base neck 30, and nail bin 50 and nail supporting base neck 30 insert colon cutting section downstream one side from anus.In contrast, nail supporting base 60 is inserted and placed on cutting section upstream one side by the upstream laparoscopic incision.Nail supporting base 60 is connected to 410, two parts of the trocar to nail bin 50 withdrawals, enters SBR up to suturing nail.As mentioned above, nail supporting base moves to does not have compress tissue basically, do not make the distance of tissue dewatering specifically.In this position, can pull the trigger suturing nail when needed.
By starting suturing nail percussion switch 22 beginning suturing nail percussion programs.In any time of percussion program, though before movement (in (blanching) cyclic process that bleaches) or moving process (no matter suturing nail whether begin form), can stop the suturing nail percussion.Software programming begins the suturing nail percussion and counts down in proper order, because program knows that tissue needs compression and dewaters before the suturing nail percussion.Therefore, suturing nail percussion switch 22 is by after the starting, and nail supporting base 60 is close to the tissue in the middle of being positioned at, the beginning compress tissue.Suturing nail percussion program comprises that best group knits that compression (OTC) is measured and feedback control strategies, makes to have only when being compressed in required pressure scope (being called the OTC scope) and through time enough, making when removing liquid in the compressed tissue, could pull the trigger suturing nail.According to the known features of compressed tissue between nail supporting base 60 and the nail bin 50, know OTC scope (the power switch can be regulated, and is used for the OTC scope of different tissues) in advance.Power switch 400 provides OTC to measure and provides information to microprocessor just.Indicate the OTC of this particular organization to reach.For example, can be with light emitting diode to user indication OTC state.
When the percussion program began, the lamp of suturing nail percussion switch 22 glimmered with given speed, and flash speed is more and more faster then, up to pulling the trigger.If do not excite abort in this waiting time, during the incision of pre-programmed, will keep the OTC state and produce the suturing nail percussion in the end back that counts down.In the example of the colon that coincide with the annulus dowel, coincideing of cutting section takes place at the cutting section center simultaneously with the tissue cutting.This cutting guarantees that suturing nail annulus middle part has effective cross-section, finishes the opening that metapedes enough is formed for normal colon function in operation.
Along with liquid is removed from the compress tissue that is clipped in the middle, structural compression stress can reduce naturally.In some cases, may be reduced to outside the OTC scope.Therefore, the closed loop nail supporting base compression control that comprises the continuous measurement value that depends on that power switch 400 provides in the program.Because this feedback is arranged, compressed tissue still remains in the OTC scope in whole process even after dehydration.
Pull the trigger cycle period at suturing nail, user starts any gauge tap can both make suturing nail percussion program exception end.If before 210 startings of suturing nail percussion motor abort takes place, the percussion circulation stops, and nail supporting base 60 is withdrawn into the home position, and suturing nail percussion switch 22 keeps and can move, and prepares to pull the trigger trial if desired again.Another kind of situation is that the percussion circulation stops if at suturing nail percussion motor 210 moving process generation aborts, and suturing nail percussion motor 210 causes nail supporting base 60 to reach the home position.In this position, suturing nail percussion switch 22 becomes and can not move.Therefore, anastomat (or specific nail bin) can not re-use (unless changing nail bin).
Should be noted that the suturing nail limit switch is asked the relative position about nail bin 50 and nail supporting base 60 before the suturing nail percussion takes place.If suturing nail scope limit switch is started-is meaned nail supporting base 60 and is in that acceptable suturing nail percussion scope-then suturing nail percussion motor 210 can be moved and allow to begin the percussion circulation.If suturing nail scope limit switch is not started, then pull the trigger the circulation abort, nail supporting base 60 returns to the home position, and suturing nail percussion switch 22 keeps and can move, and prepares percussion again and attempts.
The power train power supply of any part (for example nail supporting base or anastomat/sickle) to motor and/or end effector is described below.Should be known in that this power supply is not limited to user by the one push start button, also be not limited to once power to the motor power supply.Control to any motor in the device can require user to press starting button several times, for example, starting button makes the part of end effector move first 1/3rd position for the first time, for the second time starting button moves second 1/3rd, for the third time starting button move last 1/3rd.More precisely, for operation anastomat, typical starting for the first time can mobile suturing nail balladeur train or blade by lock, for the second time typical starting can make part move to tissue, typical starting for the third time can make balladeur train pass through all suturing nails and arrive nail bin ends.Similarly, also need not be lasting to the motor power supply, for example begin mobile powering to motor when moving to terminal point continuously from blade.On the contrary, can move motor with pulse mode, when first kind of example is included in drive end executor's function regularly by power supply to motor power supply and outage.More precisely, for anastomat, when suturing nail/cutter move to distal-most position from proximal location/start position, motor can have the running of 10 subpulses each second.This pulse can directly be controlled or by microprocessor control, two kinds of methods can both adjustable pulse frequency.As a kind of alternative, perhaps in addition, motor can be handled (pulse width or pulse frequency) with impulse modulation, and pulse generation is at very short time (for example 1/10th, one of percentage, one thousandth or microsecond).Therefore, when power supply, motor and/or power train are described as powering, can predict and comprise above-mentioned any pattern and other possible operational mode here.
After once complete suturing nail percussion, nail supporting base 60 remains on make position, only stretches out switch 20 and keeps moving (all other switches were lost efficacy).In case nail supporting base 60 reaches the home position at least, stretch out switch 20 and can move with withdrawal switch 21, but the switch 21 of withdrawing does not allow the closure of nail supporting base 60 to surpass the home position.Suturing nail percussion switch 22 keeps losing efficacy after once complete suturing nail percussion.
As mentioned above, the straight line force switch 400 that links to each other with the trocar 410 is housed in the nail supporting base neck 30.Switch 400 is calibrated to switch starting when applying given pulling force.Given pulling force is set in corresponding to coincideing the pressure that requires of particular organization takes place to be applied to before.Switch 400 is connected with the processor interface, can guarantees to pull the trigger suturing nail and can only occur in the OTC scope.
Following content is the program listing according to a kind of typical device manner of execution of invention described herein.Following content only provides a kind of example, and the people who is familiar with this technology should be known in according to programmed method of the present invention and can adopt many different forms to reach identical functions.
′Circular?Stapler?Program?using?the?rev?3c?board(cb280?chipset)V8.03
(CS-3c-080306.CUL)
′8-3-06
′Modified?program?to?abort?with?only?fire?button，added?pbcount?variable
′Added?PWM?ramping
′7-28-06
′final?tweaks-stan?is?now?an?integer?etc.
′7-17-06This?version?written?for?the?3c?board.
′7-14DEBUGGING?VERSION
′Program?written?for?3c?board?using?the?Cubloc?280?chipset
′Note：this?program?is?a?modified?version?of?the?ones?noted?below.All?changes
not?related?to?the?addition?of?the?E/R?limit?switches
′apply.The?programs?below?were?written?to?deal?with?the＂gray?logic＂of?the?1
cm?switch.This?version?uses
′a?limit?switch?at?either?end?of?the?extend/retract?stage.
′V6.20?Final?Version?of?Gray?Logic?program?as?used?in?prototype?0，serial
number?100
′V6.05
′modified?the?extend?to?cm?1?and?retract?to?cm?1?routines?to?makesure?that
when?they?are?called?that?they?move?the?motor?until?the?cm
′switch?is?closed；ie：When?the?anvil?is?all?the?way?out?and?the?retract?button?is
pressed，retract?the?anvil?until?the?cm?limit?switch
′is?closed?regardless?of?whether?the?retract?button?is?released?before?the?cm
switch?is?closed.Same?change?for?when?the?anvil?is
′extended?from?the?1?cm?position，
′made?changes?to?comments?in?the?extend/retract?routines
′
′V6.02
′added?loop?requiring?the?release?of?both?buttons?to?exit?jog?routine，and?a?1
second?delay?at?the?end?of?jog?subroutine?before
′going?back?to?main?routine
′reformatted?datadump?labels
′added?variables?for?high?and?low?speed?pwm?values
′added?extend?only?capability?at?end?of?completed?fire?to?prevent?crushing
stapled?tissue
′NOT?WORKING-REMOVED?added?checks?To?ensure?1?cm?switch?Is?made
when?extending?Or?retracting?from?the?1?cm?And?fully?extended?positions
respectively
′V6.01
′All?prior?versions?were?made?for?testing?the?program?on?the?Cubloc
development?board.All?outputs?were?pulled?LOW.The?actual?device
′requires?all?the?outputs?to?be?pulled?high(+5V).This?version?is?set-up?to?run
on?the?actual?device.
′limited?the?values?of?the?EEPROM?data?to?255?max
′added?delays?before?changes?in?motor?direction，made?program?run?smoother
′removed?pwmoff?commands.They?were?not?allowing?the?motors?to?stay?on
when?changing?subroutines(for?some?reason)
′V5.27
′added?the?recording?of?jog?routine?button?presses
′added?the?recording?of?datadump?requests
′V5.26
′added?the?recording?of?Extend/Retract?button?presses
′added?serial?number?field?in?eeprom
′the?datadump?routine?now?keeps?running?total?of?data?as?it?is?read?from
eeprom
′V5.25(circular-stapler-5-25.cul)
′added?code?to?allow?storage?of?data?each?power?on?cycle?in?eeprom
′V5.24?works?well，no?known?bugs(circular-stapler-5-24.cul)
′
′KMS?Medical?LLC(c)2006
′MAP
′P10?Extend?Button
′P11?Retract?Button
′P12?Fire?Button
′P13?Extend?Limit
′P14?Retract?Limit
′P15?Fire?Forward?Limit
′P16?Fire?Back?Limit
′P17?1?cm?Limit?Switch
′P18?Staple?Range?Limit?Switch
′P19?Force?Switch
′P20?Extend?Button?LED
′P21?Retract?Button?LED
′P22?Fire?Button?LED′P23?Force?LED(blue)
′P24?Not?USED
′P25?Not?USED
′P26?Not?USED
′P27?Not?USED
′P28?Not?USED
′P29?Staple?Range?LED(green)
Const?Device＝cb280′Comfile?Tech.Cubloc?CB280?chipset
Dim?ver?As?String*7
ver＝＂3C-8.03＂′set?software?version?here
Dim?extendbutton?As?Byte
Dim?retractbutton?As?Byte
Dim?firebutton?As?Byte
Dim?firstout?As?Byte
Dim?firstback?As?Byte?Dim?cmstatus?As?Byte′1cm?limit?switch?status
Dim?srstatus?As?Byte′staplerange?limit?switch?status
Dim?x?As?Integer
Dim?powerons?As?Byte′store?in?eeprom?address?2
Dim?cycnumfires?As?Byte′store?in?eeprom(powerons*5)
Dim?cycabortfires?As?Byte′store?in?eeprom(powerons*5)+1
Dim?cycers?As?Byte′store?in?eeprom，number?of?cycle?extend/retract?presses
Dim?cycjogs?As?Byte
Dim?armAs?Byte
Dim?completefire?As?Byte
Dim?staplerangestatus?As?Byte
Dim?bail?As?Byte
Dim?ds?As?Integer′eeprom?data?start?location?for?individual?cycle?data?writing
Dim?fast?As?Integer
Dim?slow?As?Integer
Dim?extendonly?As?Byte
Dim?extlimit?As?Byte
Dim?retlimit?As?Byte
Dim?speed?As?Integer
Dim?dracula?As?Byte
′initalize?outputs
Out?20，0′extend?button?LED
Out?21，0′retract?button?led
Out?22，0′fire?button?led
Out?23，0′force?led
Out?29，0′staple?range?led
′initialize?variables
firstout＝0
firstback＝0
completefire＝0
arm＝0
bail＝0
cycnumfires＝0
cycabortfires＝0
cycers＝0
cycjogs＝0
extendonly＝0
′CHANGE?PWM?VALUES?HERE
fast＝60000′highspeed?pwm?value
slow＝60000′lowspeed?pwm?value
speed＝0
Output5′turns?on?pwm?output?for?PINCH
Output6′turns?on?pwm?output?for?FIRE
′read?totals?from?eeprom
powerons＝Eeread(2，1)
Incr?powerons′incrementtotal?power?on?number
If?powerons>＝255?Then?powerons＝255′limit?number?of?recorded?powerons
to?an?integer?of?one?byte?max
Eewrite2，powerons，1′write?total?power?on?number?to?eeprom
ds＝powerons*5
′JOG?and?DATADUMP?Check
′push?any?button?within?2(or?so)seconds?to?go?to?jog?routine
′hold?all?three?buttons?on?at?startup?to?dump?the?data
For?x＝1?To?50
If?Keyin(10，20)＝0?And?Keyin(11，20)＝0?And?Keyin(12，20)＝0?Then
datadump′write?allstored?data?to?the?debug?screen
Exit?For
Elseif?Keyin(10，20)＝0?Or?Keyin(11，20)＝0?Or?Keyin(12，20)＝0?Then
′either?e/r?button?or
the?fire?button?pressed
jog
Exit?For
End?If
Delay?20
Next
′-----------------------------------------------------------------
′HOMING?SEQUENCES
′-----------------------------------------------------------------
cmstatus＝Keyin(17，20)′read?the?status?of?the?1cm?limit?switch
If?cmstatus＝0?Then
homeretract
Elseif?cm?status＝1?Then
homeextend
End?If
′Return?fire?motor?to?back?position
homefire′this?returns?the?fire?motor?to?the?full?retracted?condition(P6?limit
switch)
′************************************************************
**********
′Main?Loop
′************************************************************
**********
Do
′Debug＂Main?Loop＂，Cr
′Delay?1000
cmstatus＝Keyin(17，20)′read?the?1?cm?switch
′staplerangestatus＝Keyin(5，20)′read?the?staplerange?limit?switch
extendbutton＝Keyin(10，20)
retractbutton＝Keyin(11，20)
firebutton＝Keyin(12，20)
If?cmstatus＝0?And?Keyin(13，20)<>0?Then
Out?20，1′turn?extend?led?on
Out?21，1′turn?retract?led?on
Elseif?cmstatus＝0?And?Keyin(13，2O)＝O?Then
Out20，0′turn?off?extend?led?because?extend?limit?met
Out21，1′turn?on?retract?limit
Elseif?cmstatus＝1?Then
Out?20，1
Out?21，0
End?If
′check?firebutton?led?status
If?firstout＝1?And?firstback＝1?And?arm＝1?And?completefire<>1?And
cmstatus<>0Then
Out?22，1′turn?on?fire?button?led
Else
Out?22，0′turn?off?fire?Ied
End?If
′check?for?extend?retract?button?press
If?extendbutton＝0?And?cmstatus＝0?Then
extend
Elseif?cmstatus＝1?And?extendbutton＝0?Then
extend
End?If
If?retractbutton＝0?And?cmstatus＝0?Then′And?extendonly＝0
retract
End?If
′check?for?firebutton?press
If?firebutton＝0?And?firstout＝1?And?firstback＝1?And?arm＝1?And
completefire<>1?And?cmstatus<>0?Then?initialfire
Loop′keeplooping?til?powerdown
End′End?of?program
′************************************************************
′
′SUBROUTINES
′
′************************************************************
HOME：retract?to?cm?switch＝not?pressed
′************************************************************
Sub?homeretract()′retract?until?1?cm?switch?is?open
′Dbug＂Homeretract＂，Cr
′Delay?1000
Pwm?0，slow，60000
Do?Until?Keyin(17，20)＝1′retract?until?1?cm?switch?is?open
Out?31，1′ER?motorreverse
Loop
Out?31，0′er?motor?off
Out?21，0′turn?retract?led?Off
Out?20，1′turn?extend?led?On
Pwmoff?0′turnpwm?off
End?Sub
′----------------------------------------------------------------------------
′HOME：extend?to?cm?switch＝pressed
′-----------------------------------------------------------------------------
Sub?homeextend()′extend?until?1cm?switch?is?closed
′Debug′Homextend＂，Cr
′Delay?1000
Pwm?0，slow，60000
If?Keyin(17，20)＝1?Then
Do?Until?Keyin(17，20)＝0′now?the?1cm?switch?is?pressed
Out?30，1′ER?motor?forward?DDD
Loop
End?If
Out?30，0′DDD
Pwmoff?0
Delay?300
homeretract′once?the?switch?is?made，call?homeretract
End?Sub
′------------------------------------------------------------------------------
′Fire?motor?homing?routine′
′------------------------------------------------------------------------------
Sub?homefire()
′Debug＂Homefire＂，Cr
′Delay?1000
Pwm1，slow，60000
Do?Until?Keyin(16，20)＝0′retract?firing?stage?until?back?switch?is?closed
Out?33，1
Loop
Out?33，0
Pwmoff?1
End?Sub
′-----------------------------------------------------------------------------
′JOG?Routine′
′----------------------------------------------------------------------------
Sub?jog()
Out?20，1
Out?21，1
Do
Delay?25
If?Keyin(10，20)＝0?And?Keyin(11，20)＝0?Then?Exit?Do′if?both?buttons
pressed，exit?jog?routine?and?start?homing?routine?after?1?second?delay
If?Keyin(10，20)＝0?And?Keyin(11，20)<>0?And?Keyin(12，20)<>0?Then
Pwm?0，slow，60000
Out?30，1′extend?motor?forward
Do?Until?Keyin(10，20)<>0?Or?Keyin(13，20)＝0
Out?30，1′extend?motor?on?forward?DDD
Loop
Out?30，0′extend?motor?off?forward?DDD
Pwmoff?0
Incr?cycjogs
If?cycjogs>＝255?Then?cycjogs＝255
Eewrite?ds+3，cycjogs，1
End?If
If?Keyin(11，20)＝0?And?Keyin(10，20)<>0?And?Keyin(12，20)<>0?Then
Pwm?0，slow，60000
Do?Until?Keyin(11，20)<>0?Or?Keyin(14，20)＝0
Out?31，1′extend?motor?reverse
Loop
Out?31，0′extend?motor?off?reverse
Pwmoff?0
Incr?cycjogs
If?cycjogs>＝255?Then?cycjogs＝255
Eewrite?ds+3，cycjogs，1
End?If
If?Keyin(12，20)＝0?And?Keyin(10，20)＝0?Then′jog?the?fire?motor?forward
Pwm?1，slow，60000
Do?Until?Keyin(10，20)<>Or?Keyin(12，20)<>0?Or?Keyin(15，20)＝0
Out?32，1′fire?motor?forward
Loop
Out?32，0′fire?motor?off?forward
Pwmoff?1
Incr?cycjogs
If?cycjogs>＝255?Then?cycjogs＝255
Eewrite?ds+3，cycjogs，1
End?If
If?Keyin(12，20)＝0?And?Keyin(11，20)＝0?Then′jog?the?fire?motor?reverse
Pwm?1，slow，60000
Do?Until?Keyin(11，20)<>0?Or?Keyin(12，20)<>0?Or?Keyin(16，20)＝0
Out?33，1′fire?motor?reverse
Loop
Out?33，0′fire?motor?off?reverse
Pwmoff?1
Incr?cycjogs
If?cycjogs>＝255?Then?cycjogs＝255
Eewrite?ds+3，cycjogs，1
End?If
Loop
Do?Until?Keyin(10，20)＝1?And?Keyin(11，20)＝1′let?off?both?buttons?before
exiting?jog?routine
Delay?10
Loop
Out?20，0′turn?on?e/r?button?leds
Out?21，0
Delay?1000
End?Sub
′----------------------------------------------------------------------------
′Extend?until?extend?limit?is?met
′----------------------------------------------------------------------------
Sub?extend()
Out?22，0′turn?off?fire?button?led?while?extending
Out?21，0′turn?off?retract?button?led?while?extending
Pwm?0，fast，60000
Do?Until?Keyin(10，20)＝1?Or?Keyin(13，20)＝0′extend?until?either?the?extend
limit?is?closed?or?the?extend?button?is?released
Out?30，1′ER?motor?forward?DDD
Loop
Out?30，0′DDD
If?firstout＝0?Then′this?will?keep?the?extend?motor?going?on?the?first?extension
until?the?anvil?is?all?the?way?out
Do?Until?Keyin(13，20)＝0
Out?30，1′DDD
Loop
End?If
Out?30，0′DDD
Pwmoff?0
Incr?cycers
If?cycers>＝255?Then?cycers＝255
Eewrite?ds+2，cycers，1
If?Keyin(13，20)＝0?Then
firstout＝1′set?the?firstout?flag?to?enable?fire?button
Out?20，0′turn?off?extend?led
End?If
End?Sub
′----------------------------------------------------------------------------
′Retract?until?cm?switch?is?open
′----------------------------------------------------------------------------
Sub?retract()
Out?22，0′turn?off?fire?button?led?while?retracting
Out?20，0′turn?off?extend?button?led?while?retracting
Pwm?0，fast，60000
Do?Until?Keyin(11，20)＝1?Or?Keyin(17，20)＝1′retract?until?either?the?1cm
switch?goes?open?or?the?extend?button?is?released
Out?31，1′ER?motor?reverse
Loop
Out?31，0
Pwmoff?0
Incr?cycers
If?cycers>＝255?Then?cycers＝255
Eewrite?ds+2，cycers，1
If?Keyin(17，20)＝1?Then
firstback＝1
Out?21，0′turn?retract?led?off
End?If
If?firstout＝1?And?firstback＝1?Then?arm＝1′set?the?arm?flag?to?arm?the?fire
button
End?Sub
′-----------------------------------------------------------------------------
′DATADUMP?Routine
′-----------------------------------------------------------------------------
Sub?datadum()
Dim?chef?As?Byte
Dim?tf?As?Byte′total?fires
Dim?ta?As?Byte′total?aborts
Dim?ers?As?Integer
Dim?tj?As?Byte
Dim?tdd?As?Byte
Dim?stan?As?Integer
Dim?kyle?As?Byte
Dim?token?As?Byte
Dim?ike?As?Byte
Dim?kenny?As?Byte
Dim?sn?As?Byte
tf＝0
ta＝0
ers＝0
tj＝0
tdd＝0
Eewrite?ds+4，1，1′write?1?to?the?ds+4?eeprom?register?denoting?that?datadump
was?accessed
Delay?1000
sn＝Eeread(0，1)
Debug＂Circular?Stapler?Stored?Data＂，Cr
Debug＂Version＂，ver，Cr
Debug＂KMS?Medical?LLC＂，Cr
Debug＂------------------------＂；Cr
Debug?Cr
Debug＂Serial?Number：＂，Dec?sn，Cr
powerons＝Eeread(2，1)
If?powerons>＝255?Then?powerons＝255
Debug＂Total?Cycles：＂，Dec?powerons，Cr
Debug?Cr
Debug＂---------------------------＂，Cr
Debug?Cr
For?stan＝5?To(powerons*5)Step?5
Debug＂Cycle＂，Dec(stan/5)，Cr
Debug＂---------------------------＂，Cr
chef＝Eeread(stan，1)
tf＝chef+tf
Debug＂Completed?Fires：＂，Dec?chef，Cr
kyle＝Eeread(stan+1，1)
ta＝kyle+ta
Debug＂Aborted?Fires：＂，Dec?kyle，Cr
token＝Eeread(stan+2，1)
ers＝token+ers
Debug＂E/Rs：＂，Dec?token，Cr
ike＝Eeread(stan+3，1)
tj＝ike+tj
Debug＂Jogs：＂，Dec?ike，Cr
kenny＝Eeread(stan+4，1)
tdd＝kenny+tdd
Debug＂Datadumps：＂，Dec?kenny，Cr
Debug?Cr
Next′stan
Debug＂---------------------------＂，Cr
Debug＂Cycle?Totals＂，Cr
Debug?Cr
Debug＂Completed?Fires：＂，Dec?tf，Cr
Debug＂Aborted?Fires：＂，Dec?ta，Cr
Debug＂E/R?Presses：＂，Dec?ers，Cr
Debug＂Jog?Presses：＂，Dec?tj，Cr
Debug＂Datadumps：＂，Dec?tdd，Cr
Debug?Cr
Delay?1000
For?x＝1?To?tf′blink?the?number?of?completed?firing?cycles
Out?22，1
Delay?500
Out?22，0
Delay?500
Next′x
Do?Until?Adin(0)>800?And?Keyin(3，20)＝1′wait?until?datadump?buttons?are
released
Loop
End?Sub
′----------------------------------------------------------------------------
′Initial?fire
′----------------------------------------------------------------------------
Sub?initialfire()
Dim?f?As?Integer
Dim?p?As?Integer
Dim?t?As?Integer
Dim?y?As?Integer
Dim?z?As?Integer
Dim?q?As?Integer
Dim?timmy?As?Integer
Dim?butter?As?Integer
Dim?numblinks?As?Integer
Dim?fbcount?As?Integer
Debug?clr，Cr
′turn?off?extend?and?retract?buttons?to?show?that?they?are?not?active?for?abort？
Out?20，0′extend?button
Out?21，0′retract?button
bail＝0
t＝15′total?blink?time
p＝3′number?of?blink?periods
Pwm?0，fast，6000
′start?blink?and?adjust?pinch?motor?to?force
f＝(t*1000)/p
fbcount＝0
If?Keyin(12，20)＝1?Then?fbcount＝1
For?y＝1?To?p
numblinks＝(t*y)/p
For?z＝1?To?numblinks
timmy＝f/numblinks
butter＝timmy/50′calibrate?this?to?seconds
If?timmy＝0Then?timmy＝1
If?Keyin(12，20)＝0?And?fbcount＝1?Then
bail＝1′set?abortfire?flag
Exit?For
End?If
If?Keyin(12，20)＝1Then?fbcount＝1
Do?Until?Keyin(19，20)＝0?Or?Keyin(14，20)＝0′retract
until?force?switch?met?or?retract?limit?met
Out?31，1
If?Keyin(12，20)＝0?And?fbcount＝1?Then
bail＝1′set?abortfire?flag
Exit?Do
End?If
If?Keyin(12，20)＝1?Then?fbcount＝1
Loop
If?bail＝1?Then?Exit?For
Out?31，0
Out?23，1′force?led
Out?22，1′fire?button?led
For?q＝0?To?butter
Delay?10
If?Keyin(12，20)＝0?And?fbcount＝1?Then
bail＝1′set?abortfire?flag
Exit?For
End?If
If?Keyin(12，20)＝1?Then?fbcount＝1
If?Keyin(19，20)＝1?Then?Out?23，0
Next′q
If?bail＝1?Then?Exit?For
Do?Until?Keyin(19，20)＝0?Or?Keyin(14，20)-0′retract?until?force
switch?met?or?tetract?limit?met
Out?31，1
If?Keyin(12，20)＝0?And?fbcount＝1?Then
bail＝1′set?abortfire?flag
Exit?Do
End?If
If?Keyin(12，20)＝1?Then?fbcount＝1
Loop
Out?31，0
Out?23，1
If?Keyin(12，20)＝0?And?fbcount＝1?Then
bail＝1′set?abortfire?flag
Exit?For
End?If
If?Keyin(12，20)＝1?Then?fbcount＝1
Out?22，0
For?q＝0?To?butter
Delay?10
If?Keyin(12，20)＝0?And?fbcount＝1?Then
bail＝1′set?abcrtfire?flag
Exit?For
End?If
If?Keyin(12，20)＝1?Then?fbcount＝1
If?Keyin(19，20)＝1?ThenOut?23，0
Next′q
If?bail＝1?Then?Exit?For
Next′z
′Debug?Dec？fbcount，Cr
If?bail＝1?Then?Exit?For
Next′y
Pwmoff?0
If?bail＝1?Then
abortfire
Else
′staplerangecheck
finalfire
End?If
End?Sub
′----------------------------------------------------------------------------
′Staple?Range?Check?Routine
′----------------------------------------------------------------------------
Sub?staplerangecheck()
srstatus＝Keyin(29，20)′read?the?staplerange?limit?switch
If?srstatus＝0?Then
finalfire
Else
abortfire
End?If?End?Sub
′---------------------------------------------------------------------------
′Final?Fire?Routine
′---------------------------------------------------------------------------
Sub?finalfire()
Out?23，0′turn?force?led?off
Out?20，0′turn?extend?led?off
Out?21，0′turn?retract?led?off
Out22，1′Turn?on?fire?led?to?signify?final?fire?abort?ready
Pwmoff?1
′Pwm?1，fast，60000
′Out?32，1′fire?motor?forward?DDD
completefire＝1
Do?Until?Keyin(15，20)＝0′fire?forward?until?forward?limit?is?met
If?speed>＝60000?Then?speed＝60000
If?speed<60000?Then
speed＝speed+10000
End?If
Pwm?1，speed，60000
Out?32，1
Delay?50
If?Keyin(12，20)＝0?Then?Or?Keyin(10，20)＝0?Or?Keyin(11，20)＝0?bail＝1
Exit?Do
End?If
Loop
Out?32，0′fire?motor?fwd?off?DDD
speed＝0
Delay?250
Do?Until?Keyin(16，20)＝0′retract?fire?motor
If?speed>＝60000?Then?speed＝60000
If?speed<60000?Then
speed＝speed+10000
End?If
Pwm?1，speed，60000
Out?33，1
Delay?50
Loop?speed＝0
Out?33，0
Pwmoff?1
Out?22，0′turn?fire?led?off
Out?21，0′turn?off?retract?led
extendonly＝1?Incr?cycnumfires
If?cycnumfires>＝255?Then?cycnumfires＝255
Eewrite?ds，cycnumfires，1′write?the?current?cycle?number?of?fires?to?the
eeprom
Delay?200
End?Sub′return?to?the?main?routine
′----------------------------------------------------------------------------
′Abort?fire
′----------------------------------------------------------------------------
Sub?abortfire()
′Debug＂Fire?aborted?before?firing!!″，Cr
Out?31，0′turn?retract?motor?off
Out?32，0′turn?fire?forward?off?DDD
Out?23，0′turn?force?led?off
Pwm?1，fast，60000
Delay?250
Do?Until?Keyin(16，20)＝0′retract?fire?motor
Out?33，1
Loop
Out?33，0
Pwmoff?1
Out?22，0′turn?fire?led?off
Incr?cycabortfires
If?cycabortfires>＝255?Then?cycabortfires＝255
Eewrite?ds+1，cycabortfires，1′write?the?current?cycle?abortfires?to?the?eeprom
Delay?200?homeextend′extend?to?1cm
End?Sub
Also mention the probability of the recognition device that uses the end effector that has detachable and/or interchangeable parts above.This recognition device can be used for following the tracks of using and the stock.
A kind of typical recognition device adopts radio frequency, is known as RFID.In a kind of typical example, the medical treatment anastomat adopts and can refill, interchangeable nail bin, and anastomat 1 as described herein, and RFID can be contained in the nail bin, to guarantee and specific anastomat fit that the RFID reader that is used for the suitable nail bin of perception can contact with handle.In this structure, the RFID in the nail bin is loaded in the reader inquiry.RFID answers with the unique code of anastomat checking.If nail bin as verify labelling, then anastomat becomes and can move, and prepare to use.If nail bin is rejected, then anastomat sends refusal indication (for example LED flash, audible signal, visual signal).For fear of near the nail bin unexpected or the incorrect reading, can build the antenna of RFID reader, only read this RFID during in nail bin is installed in anastomat or very near (best position is at the far-end of device).Use RFID only to allow a percussion circulation to guarantee each nail bin in conjunction with the mechanical lock locking apparatus.RFIDs has shortcoming, because reader cost height requires antenna ratio bigger, reading distance is closer, generally with a centimetre metering.
Can take other radio to differentiate measure.Can use movable RFIDs.Equally, can use infrared ray (IR) transmitting device.But these two kinds of methods require to produce power at receiving terminal, and the high and big shortcoming of size of cost is arranged.
Another kind of typical recognition device adopts to be encrypted.Needing after the encryption has the processing number, is to use process chip (for example microprocessor) with this calculating contacts earlier, and wherein a kind of is to be contained on the removable part, for example nail bin or removable end effector axle.This encryption chip has certain characteristic, can analyze for the optimization of operating theater instruments of the present invention.At first, removable part does not meet the requirements with independent power supply.This power supply not only increases cost, and gains in weight and the position that takies other structure maybe can not obtain the position.Therefore, the power supply of this part should be from existing power supply in the handle.And should guarantee to power any time.Because removable part is smaller, encryption chip should be correspondingly little.In addition, handle and replaceable part form discardable part, and therefore, the cost of two encryption processors should allow to discard.At last, between the corresponding encryption device of the encryption device of replaceable part and handle be connected should be minimum.As discussed below, encryption device according to the present invention provides the characteristic of all these requirements, limits unwanted characteristic.
The device that is used for encrypting identification can have been bought on market.Wherein a kind of is that dallas semiconductor company produces for the device of encrypting, and is called DS 2432 chips.DS 2432 chips not only provide the encryption identification between reader and the responder, and also have memorizer, can the distinctive information of storage device, and this information and use and will describe in detail below.The advantageous feature of DS 2432 is that this is a single wire device.This means that power supply and input and output signal pass through the same line.With the such single wire device of DS2432, in order to connect handle and end effector, only need solid wire to pass through handle body 10 to the removable nail bin 50 of distance arrival of nail supporting base neck 30.This structure satisfies the characteristics that are electrically connected minimum number and reduce manufacturing cost.It also is true that DS 2432 chips need earth lead, but the nail supporting base neck 30 of metal is electric conductor, can be connected to the earth lead of stapling apparatus 1, therefore, the typical example of DS 2432 chip ground connection be by conductor directly with nail supporting base neck 30 electric contacts, or the earth lead of chip directly is connected with nail supporting base neck 30.
A kind of typical encrypted circuit is that (for example nail bin) adorns first encryption chip on removable part.Ground connection being of first encryption chip is connected electrically to the metal part of replaceable part, and this metal part is electrically connected the earth lead of auto levelizer again, and for example the nail supporting base neck 30.The single line of DS 2432 chips connects the contact solder joint that is electrically connected to certain position on the replaceable part, but is not connected with earth lead.For example, if removable part is 60 millimeters nail bins of wire, DS 2432 can be attached to or be embedded into the nail bin far-end of the electric insulation of last suturing nail group.Encryption chip can be embedded into the nail bin side opposite with the suturing nail surface of emission, so that chip neither is exposed to working surface in use, also is not exposed to the tissue of exposure.The earth lead of DS 2432 chips can be connected electrically to the metal outer frame frame of nail bin, and the metal outer frame frame is connected electrically to the earth lead of anastomat.The single line lead-in wire is connected electrically to first electric installation (for example solder joint, lead-in wire or boss) with the insulation of nail bin metal framework.The single lead that insulated hull arranged is connected to circuit board or is connected on the control electronic device suitable in the handle at stapling apparatus at near-end.The insulation of the other parts of this root lead and anastomat especially with the frame insulation of ground connection, is extended from handle, by the nail supporting base neck, arrives the receiving chamber of replaceable part.At far-end, the lead of insulation comes out, and is connected electrically to second electric installation (for example solder joint, lead-in wire or boss), and the shape of second electric conductor guarantees can contact reliably first electric installation on the nail bin when nail bin is locked in end effector.In this structure, whenever replaceable part (for example nail bin) is inserted into end effector, two electric installations form directly and are electrically connected; In a kind of particular instance, have only correct insertion part just may contact.
DS 2432 chips have only several square millimeters area, make chip be easy to be installed on the little replaceable part, and for example nail bin satisfies the requirement of minimized in size simultaneously.Be worth pointing out that DS 2432 chips are more cheap.For keep with can not be from whole communication of DS 2432 chips of external inspection, the encrypted transmission information that can will accept from DS 2432 with DS 2460 (also being to be made by dallas semiconductor company) and the expected results of internal calculation compare.The characteristic of these two chips explains that by the operating instruction 3675 of dallas semiconductor company this paper with its full content as a reference.The DS2460 chip is much more expensive than DS 2432 chips, but DS 2432 also is not inexpensive as to the discarded degree of handle.Should be noted that the removable discarded number of parts of medical treatment device (for example operating theater instruments of the present invention) is usually considerably beyond the handle quantity that replaceable part is installed.Therefore, if DS 2432 chips are contained on the removable part, DS 2460 chips are contained on the handle, meet low cost encrypted characteristic.At Fig. 2 of operating instruction 3675, explained a kind of alternative circuit structure that uses DS 2432 chips, sort circuit has been cancelled somewhat expensive DS 2460 chips, compares with local microprocessor (for example microprocessor 2000).In this structure, increase the cost of encrypting in the stapling apparatus 1 and be lowered, but just as explained above, this structure has been abandoned some aspect of safety, can check two numerals that are compared.
Carry out the representative instance description of the identical process of the replaceable part of electronically validating with DS 2432 chips and DS 2460 chips at medical treatment device with encrypting.The typical control circuit of encryption device is illustrated in Figure 30.This representative instance adopts the straight line anastomat description that contains the circuit board of microprocessor 2000 at handle.A free I/O the pin 2010 of microprocessor 2000 is connected to first lead-in wire 2110 of DS 2460, and another I/O pin 2020 is connected to second lead-in wire 2120.Each replaceable part 2200 has the 3rd the I/O pin that DS 2432 chips and single line lead-in wire is connected to microprocessor 2000.
For start-up routine, removable part 2200 is connected to device, contact with the single line lead-in wire with earth lead.When microprocessor 2000 detected new parts 2200 and has been connected to device 1, routine was differentiated in the microprocessor operation.At first, microprocessor 2000 starts random number, by first communication pin 2012 request DS 2460.DS 2460 has the password of pre-programmed, and is identical with the password of pre-programmed of each sheet DS 2432 chip on being stored in replaceable part 2200.Therefore, when identical random number offered DS 2432 chips and DS 2460 chips, the output of two chips came to the same thing.DS 2460 produces a random number, offers microprocessor 2000 by second pin 2020, and microprocessor is transmitted to DS 2432 chips by pin 2030 and single line lead-in wire.When DS 2432 receives random number, use its SHA-1 algorithm (by national industrial technology ANSI exploitation) and cryptographically generate a hash-coding answer.This hash-coding is answered by the single line lead-in wire and is passed microprocessor 2000 back and be forwarded to DS 2460 through pin 2010 or 2020.During this period, DS 2460 also answers in the hash-coding of calculating oneself.At first, DS 2460 will the random number identical with being dealt into DS 2432 in inside be applied to the SHA-1 algorithm of oneself and answers in the hash-coding that internal reservoir generates.DS 2460 is also storing and is passing through microprocessor 2000 by the hash-coding answer of DS 2432 transmission.Two hash-codings are answered and are compared, if identical, then replaceable part 2200 is identified through differentiating.If hash-coding is had any different between answering, then part 2200 is rejected, and installs or is in part 2200 out of use states, only perhaps is in and is satisfying the state that could use after certain protection.For example, can be stored about the characteristic of data such as time, date, environment and the part that is not identified, be provided with the back or pass to manufacturer or agency simultaneously, inform that manufacturer plans to use or used uncommitted part 2200 about the user at device.If information is not encrypted, then authentication information may be intercepted and captured and be forged, be illegally copied, or undelegated part 2200 may be used, rather than buys part 2200 from authorised dealer.In typical encrypted instance described herein, the unique information that can check that transmits by circuit is that single random number and single hash-coding are answered.As everyone knows, the answer that deciphering SHA-1 generates can need the centuries, has therefore reduced the motivation to reverse-engineering.
Because each sheet chip of Shi Yonging has safe storage in this example, safe storage only could be visited after differentiating, the programming of safe storage can be adopted many privacy keys to deposit at every turn.For example, if DS 2460 stores a plurality of keys, each part 2200 has only a key of selecting from the key of these storages, and then DS 2460 can play " master key " to " the general key " of part 2200.
By differentiating the replaceable part of operating theater instruments of the present invention, can obtain many positive results.At first, apparatus manufacturer can prevent that the user from using unwarranted part, the part that assurance can only use authority.This not only guarantees manufacturer's patented power usage charges from sell replaceable part, and manufacturer's part that can guarantee to perform the operation keeps high-quality.Because encrypted circuit has memorizer, the invention provides huge interests.For example, if single-ended executor of a straight line anastomat can adorn 30mm, 60mm and 120mm nail bin, the nail bin of each size can have personalized key, and the programming of handle can store and use this three keys.Answer in case receive corresponding to the hash-coding of a key, rather than the answer of the hash-coding of two other internal calculation, handle will know that any nail bin has inserted anastomat.Each nail bin can also comprise the distinctive parameter of nail bin in its memorizer, for example therefore the different movable lengths of the suturing nail balladeur train of different size nail bin, according to detected nail bin, cause the effect difference of handle.The parameter of checking out can also illustrate the correction grade of specific component.For example the nail bin of 1 grade of correction may have some parameter to use, and by detecting this specific nail bin, program may cause handle not allow to use the nail bin of 1 grade of correction, and allows to use the nail bin of 2 grades of corrections, or vice versa.
Encryption chip has memorizer also to allow nail bin to keep following the tracks of other categorical data.For example, nail bin can store the identity of its each handle that connects, the identity of pulling the trigger the handle of nail bin, use and/or connection time, date and other temporal data, percussion nail bin with how long, start several times and many other similar parameters in percussion suturing nail process.May store a special parameter when the nail bin mistake is pulled the trigger, this can determine whether manufacturer is that nail bin is made mistakes or user's mistake, and for example, the latter can investigate, and helps user's correction or carries out other training.By providing memorizer at handle, can store other parameter relevant with handle, for example the duration of each program, pull the trigger the load that moment of torsion that the speed of suturing nail, each percussion produces and/or each percussion are born at every turn.Memorizer can be only with the lithio storage battery power supply several years that is contained in the handle.Therefore can guarantee the chronicity of handle data.Memorizer can be used for storing whole operating positions and relevant calendar data of particular handle.For example, if only ratifying handle uses at an operation process, but the percussion of handle data show nail bin is several days or a few week at interval, when handle is recycling when returning manufacturer at last, it is incorrect and may use handle insecurely that manufacturer can detect user (hospital, doctor, clinic etc.).Encrypt discriminating and also can be used for detachable accumulator.And can increase sensor in any part of device, be used for the information communication that the encryption chip memory inside stores.The temperature of operating room when for example temperature sensor can transmit nail bin and pulled the trigger.If this temperature reading can be used for determining whether infection afterwards is because the incorrect temperature control of operating process (for example in the rural area that does not have air-conditioning).
Anastomat taking place under rare situation can not operate in use, provide machinery and substitute device or emergency set (bail-out), allows manually will install in the patient body to take out.All emergency sets use the memorizer record on enough these encryption chips of energy.And can store to point out to need to use emergent data to be provided with the back inspection why.In order to ensure the quality of products, when detecting when emergent, handle can be programmed, and indication should be issued client/user with the proof letter, informs that they use about emergent.
As mentioned above, the invention is not restricted to above anastomosis ring applicator as representative instance, can be applied to any surgical operation identical head, for example straight line stapling apparatus.Therefore, in the various representative instance contents of back, use the straight line anastomat.Use the straight line anastomat but use the straight line anastomat should not be considered to be only limited in this section in the content.
Described above is that these parts form the control combination part 200 that coincide along the parts of straight line anastomat and 80 existence of the identical control of anastomosis ring applicator axis.As previously described, suitably launch suturing nail and cut and organize needed power and may surpass 200 pounds, reach 250 pounds probably.Determine that with the straight line electric operation anastomat tissue (for example colon) effectively being coincide with the needed minimum force of cutting function is:
1) in about 3 seconds, carries about 54.5kg (120 pounds) power by about 60mm stroke; Or
2) in about 8 seconds, carry about 82kg (180 pounds) power by about 60mm stroke.
Electric hand linear surgical stapling apparatus of the present invention can satisfy this requirement, because as described below, it reaches optimization with the method for novelty.
In order to produce the power of the necessity that meets above-mentioned requirements, the peak power of mechanical assemblies (watt) need calculate according to the maximum limit of these requirements: in 3 seconds, carry 82kg power by the 60mm stroke.By the mathematics conversion, these numerals need the most about 16 watts mechanical output at the outfan of power train.It is not 1 to 1 that electrical power converts mechanical output to, because the efficient of motor is lower than 100%, the efficient of power train also is lower than 100%.The product of these two efficient gradings forms aggregate efficiency.Produce the inverse that 16 watts of mechanical outputs multiply by aggregate efficiency, needed electrical power is greater than 16 watts.In case determined needed electrical power, can check power supply whether to satisfy the lowest power requirement.Therefore, can carry out check and the optimization of different electrical power.Below in detail this analysis will be described in detail.
The coupling of power supply and motor or optimization comprise each characteristic of investigating the two.When check electro-motor characteristic, bigger motor can be carried out given workload with higher efficient with respect to less motor.In addition, the band rare-earth magnet or do not have the motor of core structure can be with the identical power of less size output, but price is higher.In general, if motors designs is the identical power of output in preset time, big motor is lower than fractional motor cost.But when being used for surgical stapling apparatus, big motor has undesirable characteristic, because the restriction that the grip size of motor is subjected to operator's hands is installed.The doctor wishes to use less and lighter device, rather than bigger and heavier device.Consider that based on these using cost, size and the weight of motor in operation anastomat of the present invention is the factor that can optimize.
The motor that can use in doctor's hands comprises the motor with comparatively cheap ceramagnet and has the motor of somewhat expensive rare earth (being neodymium) magnet.But the latter and the former are relatively, and the increase of power does not have the increase of cost many.Therefore, can select the ceramagnet motor in handle, to use.For example the standard size of typical motor (diameter) is 27.5mm and 24mm.About 60% (size according to load is reduced to 30% or lower) of the rated efficiency of these motors.About 30,000 rev/mins of the zero load rotating speed of this motor (between 20,000 rev/mins and 40,000 rev/mins).
Even this traditional motor can use, also wish further to reduce size.For this purpose, the inventor finds that centreless, brush type, d.c. motor can produce similar power output, but size significantly reduces.For example almost the output with the standard motor of diameter 24mm is identical for the output of the core free motor of diameter 17mm.Different with the standard motor, the efficient of core free motor is up to 80%.Core free motor is nearly all used rare-earth magnet.
In view of this conditional volume and the mechanical output that needs, require to select to have the mechanical gear system of peak efficiency.With rack-and-pinion molectron last controlled stage as power train, compare than screw drive and in drivetrain, to be provided with an efficient afterbody, because in general the rack-and-pinion transmission efficiency is near 95%, and screw driven peak efficiency approximately is 80%.For the straight line electric anastomat, when the 60mm nail bin is housed (operable nail bin size is from 30mm to 100mm, but 60mm is used in explanation for example in this example), identical/cutting mechanism has 60mm displacement.With this displacement, total traveling time in 3 seconds, the extension speed that makes rack-and-pinion are 0.8 inch of per second.For the rack-and-pinion molectron with reasonable size realizes this speed, gear train should decelerate to motor rotary speed near 60 rev/mins.Because the motor output speed is near 30,000 rev/mins, the speed reducing ratio of power train is near 500 to 1.In order to reach this speed reducing ratio, select 5 grades of power trains.The efficient of known this each grade of power train is near 97%.Therefore, with efficient 95% combination of rack-and-pinion, the aggregate efficiency of power train is (0.95) (0.97) 5Or 82%.With moyor 60% and 82% combination of power train aggregate efficiency, draw total electronic efficient to final mechanical efficiency ratio near 49.2%.Know after this aggregate efficiency scoring that when mensuration was operated the needed electrical power of anastomat on request, the electrical power of actual needs almost was the twice of the electrical power of/cutting force calculating identical for producing.
Satisfy the necessary power of above-mentioned requirements in order to produce, the power of mechanical assemblies (watt) can calculate according to mobile 60mm needs 82kg power in 3 seconds, the result is near 16 watts.Known total mechanical efficient is 49.2%, so power supply need provide 32.5 watts of power (32.5 watts of electrical power of 16 watts of mechanical output ≈ * 0.492 aggregate efficiency).This needed minimum electrical power has been arranged, just can determine to drive the battery types of anastomat, comprising the high-energy lithium storage battery.Known high-energy lithium storage battery characteristic (for example CR123 or CR2 accumulator) is that each accumulator produces 5 watts of peak powers.Therefore, need six accumulator series connection could produce desired 32.5 watts of electrical power at least, be transformed into 16 watts of mechanical outputs again.This step does not finish optimizing process, because each model high-energy lithium storage battery of making has different characteristics for sending peak power, these characteristics are different for the load that applies.
Different battery characteristics can be distinguished a kind of accumulator of first manufacturer and the another kind of accumulator of second manufacturer.The important battery characteristics that is used for comparing is the characteristic of those power of sending of restriction accumulator, comprising:
Electrolytical type in the accumulator;
Electrolytical concentration and chemical property;
Plate and cathode plate are (chemical constituent and the mechanical realizations) how to make;
Type and the structure of resistance positive temperature coefficient (PTC) device.
Test one or multinomial these characteristics and can obtain valuable information for the accumulator that meets the requirements most of selecting stapling apparatus.Have been found that check last characteristic-PTC equipment energy characteristic-can optimize is for the battery types of carrying out the work that requires.
Most of power supplys need relatively determined for a long time and carry out effectively and many times work.When design and manufacturing power supply, for the short time uses with the few combination selection power supply of access times not representative.But the power supply of electronic stapling apparatus is only few in short time use and access times.In using each time, motor need bear peak load and not work with makeing mistakes.In other words, for operation anastomat, coincide/only cut and carry out in the seance process, circulate at most 10 to 20 times, using each time needs the possible peak load of holder.After a program, device withdraws from and uses and go out of use.Therefore, power supply of the present invention need be made differently with any other conventional power source.
Compare with the expection useful life longevity of the accumulator that is not used in stapling apparatus, device of the present invention is manufactured with limited accumulator useful life longevity.After such manufacturing, device is at " life span " expection work of determining number of times seldom.As everyone knows, self-powered (for example accumulator) has recovery capability after some uses.In order to make optimization of the present invention, device is made within certain parameter, correspondingly carries out the program of determining, if but surpass this program service time, will limit and maybe can not continue to carry out.Though device may recover and might be reused for different programs, device is designed to be used in accumulator, makes that they probably can not be in single scope service time that surpasss the expectation in addition much or exceed total and use outside the scope service time.Consider this point, the useful life longevity of power supply or device or clinical life-span determine that this life-span also can be described as expection and use.Should be known in that this useful life longevity or clinical life-span are not included as the affirmation device and can be operated in interior service time of experimental period on request.Life-span does not comprise that device is activated At All Other Times yet beyond the program of expection, namely be not to be activated according to surgical procedure.
The conventional accumulators that provides on the market designs for two kinds of usings method: (1) provides bigger power (for example high power consumption digital device as the video camera) or (2) that small-power (for example clock backup of computer) is provided for a long time at short notice.If do not observe any using method, accumulator will be generated heat.If the heating accumulator is not checked, may generate heat causes the temperature of great damage to chemical substance, for example blast.Obviously, should avoid accumulator explosion.Prevent with the PTC device in these extremities of traditional storage battery, this is a kind of device that (resistance positive temperature coefficient) made for restriction accumulator conduction when battery temp increases.The PTC device is at overcurrent and high-temperature situation protection accumulator and/or circuit.Significant is, the PTC device is protection accumulator during short circuit outside, and accumulator can work on after short circuit is eliminated.Some accumulator provides short circuit and/or overtemperature protection with disposable electric fuse.But the accident short circuit of this electric fuse accumulator causes electric fuse to disconnect, and accumulator is become can not be used.The accumulator of PTC protection has advantage than the accumulator of electric fuse protection, because after short circuit is eliminated " resetting " automatically, make accumulator recovery operate as normal.The characteristic of understanding PTC device among the present invention is even more important, because motor will be exported the high several times electric current that arrives than seen in the high power consumption application of typical case.
The PTC device is connected with plate and cathode plate, forms a partially conductive layer between two conductive layers.(according to the circuit condition of using the PTC device, for example from room temperature to 40 ℃) PTC device is in low resistance state when normal working temperature.When owing to forming short circuit or over-discharge and cause unusual big electric current to produce high temperature (according to the circuit condition of using the PTC device, for example from 60 ℃ to 130 ℃), the PTC device switches to high resistance mode.In brief, when comprising PTC device and abnormal current by circuit in the circuit, this device enters the higher temperature state, thereby switches to higher-resistivity state, will be reduced to floor level by the electric current of circuit, so the electrical equipment in the holding circuit and accumulator.Minimum current level (for example approximately peak point current 20%), accumulator can be cooled to " safety " degree, at this moment can export bigger power.The partially conductive layer of PTC device for example is the composite of carbon dust and polyolefin plastics.Because these devices have been described technically and are well-known, repeat no more.
Because the PTC circuit of different manufacturers is worked with different characteristic behaviors, the present invention utilizes this characteristics, and the particular battery that mates for optimized choice and specific motor and specific purposes provides a kind of method.The time of checking the PTC device to switch to higher-resistivity state can be used as the indication of the optimization of specific motor and power train and accumulator.The time of knowing the switching of PTC device meets the requirements, so that when anastomat normally used, the PTC device did not switch.
Typical charge in batteries is to various degree, near 3 amperes near 8 amperes.When high electric current, the PTC device changes to high resistance state immediately, makes too high for this electric current of CR123 accumulator of standard.Determine that for 4 to 6 Ampere currents, the accumulator of a manufacturer starts very fast than the accumulator ptc device of another manufacturer.The longest ptc device of second manufacturer switch the persistent period for 4 amperes greater than 3 minutes, for 5 amperes near 2 minutes, almost be 50 seconds for 6 amperes.These persistent period are significantly greater than desired 8 seconds of peak load.Therefore, can determine to compare with the accumulator of first manufacturer, the accumulator of second manufacturer is the optimum selection of using at peak point current.
The electric current that initial deduction is higher and lower or constant voltage should make the bigger power of accumulator output.According to the form of 6 accumulator series connection, crest voltage can reach 18 volts, and peak point current has only 6 amperes.With the accumulator parallel connection, in theory bigger peak point current should be arranged, 3 * 2 forms (three series connection accumulator of two groups of parallel connections) should be by 9 volts of crest voltages and maximum 12 amperes of peak point currents.
Investigated different single accumulator, confirmed lower voltage (about 1.5 to 2 volts) and produce maximum power wattage near 4 to 6 Ampere currents.Checked the form of two groups of 6 accumulator: one group of 6 * 1 form series connection and one group of 3 * 2 parallel connection.3 * 2 forms produce peak inrush current near 10 amperes.6 * 1 forms produce 6 amperes of peak point currents, and single accumulator can produce 5-6 ampere peak point current before PTC device transition stage.This information indication, any single accumulator can start the PTC device in the series connection group, thus the electric current of restricted passage whole battery group.Therefore, kept the predictive conclusion that obtains peak point current with 3 * 2 forms in low-voltage.
Three kinds of different CR123 accumulator forms are tested: 4 * 1,6 * 1 and 3 * 2, for 120# and 180# load and given typical geared system, to understand pinion promotion tooth bar how soon (per second inch (" IPS ")) arranged.This actual dynamic load result of the test is presented in the table of Fig. 3, loads for 120#:
4 * 1 accumulator batteries are near 2.5 Ampere currents and can be with about each second of 0.6IPS moving load during near 8 volts of voltages;
6 * 1 accumulator batteries are near 2.5 Ampere currents and can be with about each second of 0.9IPS moving load during near 13 volts of voltages;
3 * 2 accumulator batteries are near 2.5 Ampere currents and can be with about each second of 0.4IPS moving load during near 6 volts of voltages.
Load for 180#:
4 * 1 accumulator batteries are near 4 Ampere currents and can be with about each second of 0.65IPS moving load during near 7.5 volts of voltages;
6 * 1 accumulator batteries are near 4 Ampere currents and can be with about each second of 0.9IPS moving load during near 12 volts of voltages;
3 * 2 accumulator batteries are near 4 Ampere currents and can be with about each second of 0.4IPS moving load during near 7 volts of voltages.
Very clear, peak point current is limited, and load is depended in this restriction.No matter this test discloses for given load power supply, motor output less current, but voltage changes according to battery forms.For two kinds of loads, as was expected, and 6 * 1 form power output is maximum, rather than 3 * 2 forms.The general power of definite set of cells is determined by voltage thus, rather than is determined by electric current, so parallel form (3 * 2) is not the approach of optimizing power supply.
According to tradition, when designing the technical performance of motor, the working voltage coupling of the winding of motor and motor expection.This coupling is considered the persistent period of each circulation and the product entire life of hope.For electronic stapling apparatus, motor only uses very short circulation and has only the very short life-span, and the result that traditional matching process draws is lower than optimum.The motor rated voltage that motor manufacturer provides is corresponding to the winding number of turns.The number of turns is more few, and rated voltage is more low.In given motor winding size range, the less number of turns can be used thicker lead, and therefore the less number of turns causes lower winding resistance, and the more number of turns causes higher resistance.This characteristic limitations the maximum current that flows out of motor, this maximum current produces most heat and destruction when motor overload.For the present invention, the form that meets the requirements will have minimum winding resistance, from power supply (being accumulator battery) output maximum current.By to be higher than motor rated voltage running motor far away, the similar motor of size can be exported the power that enlarges markedly.With near identical and core free motor verification experimental verification just winding resistance difference (so number of turns difference) this characteristic.For example, with the motor of 12 volts of 6 accumulator (i.e. 19.2 volts of voltages) runnings rated voltages and 6 volts.4 watts of the motor output peak powers that rated voltage is 12 volts, voltage only is reduced to 18 volts when accumulator is exported 0.7 Ampere currents.By contrast, 15 watts of the motor output peak powers that rated voltage is 6 volts, voltage is reduced to 15 volts, but exports 2 Ampere currents.Therefore, select the lower winding of resistance to export enough power from accumulator.Should be noted that the motor winding should with specific accumulator battery balance, in order to can not be enough to start the electric current of PTC device from accumulator output at the stall conditions motor, this situation will postpone use electric operation anastomat in operation, this is unallowed.
6 * 1 set of cells seem to exceed and enough satisfy electronic stapling apparatus requirement.However, at this moment can further be optimized accumulator, to determine whether to have 6 accumulator to carry out desired work.Carry out the test of 4 accumulator for this reason, determine that motor/power train can not move tooth bar the 60mm distance in 3 seconds under the 120# load.6 accumulator are tested, determined that motor/power train can move the 60mm distance with tooth bar in 2.1 seconds under the 120# load, more faster than 3 seconds that require.Determined further that also motor/power train can move the 60mm distance with tooth bar in 2.5 seconds under the 180# load, more faster than 8 seconds that require.At this moment, need to optimize power supply and mechanical layout, to guarantee not having coincideing/cutting of " out of control "; In other words, if load significantly less than desired 180# peak load or even less than the 120# peak load, then to move be undesirable to tooth bar too soon.
Gear reduction ratio and drive system need to optimize, in order to keep motor near peak efficiencies at the percussion stroke.The mobile 60mm stroke in 3 seconds that requires means that the tooth bar minimum speed is 20mm/sec (～0.8 outstanding person/second).In order to reduce the variable quantity of optimizing process, the speed reducing ratio of setting gear-box is 333 to 1.Last speed reducing ratio is finished by the output shaft 214 of gear-box and the gear between the tooth bar 217, and wherein this gear comprises angular wheel 215 and pinion 216 (being used for driving tooth bar), and the example of simplification shown in figure 32.
These variablees can be with the output shaft 214 of 333 to 1 gear-box each change the inch number that tooth bars move and be combined.If gear-box output (rpm) is constant all the time, each changes the inch number (" IPR ") and output rpm coupling that tooth bar moves to make output shaft, is very simple function to obtain desired speed:
(60rpm → 1 revolutions per second (rps); 1rps @ 0.8IPR commentaries on classics → 0.8in/sec).
At this ideal situation, if draw the curve of IPR according to speed, will produce straight line.Speed at one section fixed range can further be reduced to the percussion time.Therefore, in this ideal state, the curve of percussion time and IPR also is straight line.But, motor output (rev/min) and so the gear-box output speed do not fix because this rotating speed changes with load.The size of load determines the size that motor can output.Along with load increases, rpm reduces and efficient changes.According under the different load to the check of efficient, determined that efficiency peak has only 60%.But the voltage and current in this efficiency peak correspondence is different with the voltage and current at power peak point.Along with load increases, power continues to increase, and is fast until the reduction specific power increase of efficient.Along with IPR increases, expectation speed will increase, but the increase of corresponding IPR reduces mechanical advantage, thereby increases load.Correspondingly reduce owing to increase load efficient gradually, the load of this increase means point of existence, and the tooth bar speed higher in this point can not have higher IPR.This specific character is reflected as the straight line that the curve chart of IPR is departed from expectation in the percussion time (second).The boundary line that the experiment of system of the present invention discloses between unnecessary mechanical advantage and the not enough mechanical advantage occurs near 0.4IPR.
From this IPR numerical value, the final gear ratio that might select angular wheel 215 now is the number of teeth approximately more three times (3 to 1) of the gear of output shaft.This gear ratio conversion becomes about 0.4 IPR.
Since angular wheel 215 has been optimized, can check set of cells again, determine whether 6 accumulator to be reduced to 5 or even 4 accumulator, this will reduce cost and significantly reduce the needed volume of power supply in the handle.Approximately the constant load of 120# is used for motor, power train, angular wheel, the rack-and-pinion of optimization, finds that making tooth bar move 60mm with 4 accumulator uses almost 5 times in second.With 5 accumulator time decreased near 3.5 seconds.With 6 accumulator, the time is 2.5 seconds.Therefore, inserting this curve, to draw minimum accumulator form be 5.5 accumulator.Because accumulator quantity can only be integer, need satisfy the requirement of electronic stapling apparatus with 6 accumulator.
Accordingly, the minimal power volume can calculate as a fixed value, unless can enough accumulator that the different size of same electrical power characteristic is provided.Model is that the lithium battery of CR2 has the electrical power characteristic similar to CR123, but less.Therefore, with 6 CR2 battery feeds, requisite space reduces more than 17%.
As mentioned above, provide the aggregate efficiency of the power output that meets the requirements for finishing surgical procedure in the time window that requires, power supply (being accumulator), power train and motor are optimised.The efficient of each power supply, power train and motor is selected the type of power supply, power train and motor then through check according to check, so as in the time that requires Maximum Power Output.In other words, the check given time memory full power condition (voltage and current) and do not start PTC device (for example about 15 seconds).The present invention determines voltage-to-current-performance number, and described value is optimized accumulator to the mode of motor output.Even after this optimization, can also carry out other and change, to improve the characteristic of electronic anastomat 1.
Can use another kind of power supply, be called " mixing " accumulator.In this form, chargeable lithium-ion battery or lithium-polymer battery are connected to (but perhaps perhaps being the less one-level accumulator with similar or high voltage of another size) on one or more above-mentioned optimization accumulator.In this form, the lithium-ion battery is to coincideing/power supply of cutting motor, because the energy that contains a CR2 accumulator enough many times charges to lithium-ions battery, but the output of one-shot battery is limited.Lithium-ion battery and lithium-polymer battery internal resistance are very little, can export very high electric current at short notice.In order to utilize this favourable characteristic, one-shot battery (for example CR123, CR2 or other accumulator) can charge to secondary accumulator battery with 10 to 30 seconds, and secondary accumulator battery forms the additional supply of motor in the percussion process.The alternate example of lithium-ion accumulator is to use capacitor; But the volume efficiency of capacitor is low.Even so, can adorn ultracapacitor in the motor electric power system; Before determining to need additional supply, the operator can not connect.The operator will connect capacitor when the needs additional supply, as additional " power-assisted " of energy.
As mentioned above, if set point is passed through in the increase of motor load, efficient begins to reduce.In this case, can use the multiple gear ratios variator, in order to change the power of in the time that requires, exporting.When the ambassador's efficient of loading reduces, can use multiple gear ratios variator change gear speed ratio, make motor get back to the greater efficiency point, can provide for example 180# power at least at greater efficiency point.But should be noted that motor of the present invention need rotate and reverse.In reversing mode, motor must coincide/cutting device from the separate tissue of " chucking ".Therefore, counter-rotating is favourable than the living bigger power of just changing the line of production.
Because the load of significant change, for example from very little poundage to up to 180 pounds, may strength excessive at the low side transmission group component of load range.Therefore the present invention can comprise arrangements for speed regulation.Possible arrangements for speed regulation comprise expendable (initiatively) speed regulator and passive speed regulator.A kind of typical passive speed regulator is flywheel, for example authorizes the energy storage element 56,456 that discloses in people's such as Palmer No. 2005/0277955 patent application of the U.S..The passive speed regulator of operable another kind is " flying " paddle wheel.The wind resistance speed governing of this device because accelerate along with rotating, can absorb more power, thereby speed-regulating function is provided when revolution is too fast.Another kind of speed regulator can be the compression spring, and motor is pressed onto compressive state lentamente with spring.When needs start, unclamp compressed spring, allow whole energy to be delivered to power train within a short period of time.Another typical speed regulator example comprises multipole switch, and switches at different levels are connected to different branch set of cells respectively.When the little power of needs, can start first or first's switch, only insert the minority accumulator at power circuit.Along with the power increase of needs, user (or automatic computing equipment) can increase the accumulator that inserts at power circuit.For example in 6 accumulator forms, preceding 4 accumulator connect power circuit in first position of the switch, and the 5th accumulator is connected with second position of the switch, and the 6th accumulator is connected with the 3rd position of the switch.
Electro-motor produces certain noise in use with relevant gear-box.Anastomat of the present invention in order to reduce sound and vibration characteristics, thereby reduces total noise that operating process produces with motor and/or motor power train and handle isolation.In first kind of example, damping material is contained in handle body and motor and transmits between the system.Material can be foam, for example latex, polyester, plant type material, polyethers, Polyetherimide, polyimides, polyolefin, polypropylene, phenolic aldehyde, polyisocyanate, polyurethane, polysiloxanes, nylon, vinylite, ethylene copolymer, expanded polystyrene, fluoropolymer or foamed polystyrene.Material can be elastomer, for example polysiloxanes, polyurethane, chlorobutadiene, butyl rubber, polybutadiene, neoprene, natural rubber or isoprene rubber.Foam can be sealing cellular, open wide cellular, flexible, mesh-shape or syntactic foam.Material can be contained in position given between handle and the motor/gear-box or fill up whole motor/gear-box cavity on every side.In second kind of example, motor and power train are isolated in another nido box structure, are called " Chinese case " or " Russia nest doll " sometimes.In this structure, around motor/gear-box, superscribe damping material, then motor/gear-box is contained in first case, gearbox shaft is stretched out from first case.Then first case is contained in " second case "-handle body-damping material is contained between first case and the handle inside.
Electronic anastomat of the present invention can be used for surgical operation.Most of stapling apparatus are disposable, can dispose after a medical procedure, because cost is relatively low.But Motorized surgical operation anastomat cost is higher, and handle need use more than a medical procedure at least.Therefore, use the back that the sterilization of handle component is become a problem.Sterilization before using is also very important.Because the electronic unit that electronic anastomat comprises does not pass through the sterilization process (being steam or gamma ray) of standard, anastomat need be with the sterilization of other method (expense is higher probably), for example ethylene oxide gas.But low than using the gaseous sterilization cost to the anastomat sterilization with gamma ray, be desirable.Known that electronic unit can use in the space, the space is the environment that electronic unit is exposed to gamma ray.But in this application, electronic unit need be worked under exposed state.In contrast, electronic anastomat does not need work when being exposed to the gamma sterilization ray.When adopting quasiconductor, even cut off the power supply of electronic unit, gamma ray also has adverse effect to the record that stores.These parts only need stand this radiation and have only to stop being exposed to radiation just preparation use afterwards.Know this point, can take the electronic unit in many measure gamma sclerosis handles.At first, replace using the MOSFET memorizer, such as the bin that can use fusibleness to connect.For sort memory, in case fuse is incorporated into the program (namely blowing), memorizer just becomes nonvolatil and anti-gamma ray sterilization.Second kind of measure, memorizer can be the mask programmings.If memorizer does not have adverse effect with the hard programming of mask, medical treatment sterilization gamma ray intensity to program.The third measure is sterilized when volatile memory is unloaded, can for example can use radio link by various measures to memory program after the sterilization, comprises infrared ray, radio, ultrasound wave or Bluetooth communication.Another method is that this conductor can be to memory program at cleaning ambient contact outer electrode.Last a kind of measure provides radiopaque shielding (for example with molybdenum or tungsten manufacturing) around the parts to the gamma ray sensitivity, prevent that these component exposed are in the radiation that potential damage is arranged.
As mentioned above, the characteristic of accumulator, power train and motor is verified and optimizes, and is used for electronic anastomat.The power that can produce in the electric current that can provide and/or the certain hour will be provided the particular design of accumulator (being chemical property and positive temperature coefficient PTC).The alkaline storage battery that has settled the standard can not produce needed high power at short notice, in order to drive electronic stapling apparatus effectively.Determined that also some lithium-Er Yangization Manganese accumulator can not satisfy the needs that drive electronic stapling apparatus.Therefore, need the structural feature of some lithium-Er Yangization Manganese accumulator of check, for example electrolyte and ptc device.
We know that traditional lithium-manganese dioxide accumulator (for example CR123 and CR2) is long-time load design.SUREFIRE for example
Figure G2007800177940D0062162816QIETU
Sell flash lamp and this accumulator, the regulation accumulator continues 20 minutes to several hrs (3 to 6 hours) at the maximum output lumen-hour of flash lamp.The load of accumulator is not near the power capacity of accumulator during this.Therefore do not reach the critical current rate of accumulator, thereby not because of danger overheated or blast.If this use is not continuous, accumulator can stand many circulations (being hundreds of) with same total power output.
In brief, this accumulator is not to be 10 seconds or shorter, the load in 5 seconds design for example, neither for access times seldom, for example ten times to 15 times designs.The work that the present invention does is configuration power supply, power train and motor, optimize to be used for access times few, use elapsed time to be less than 10 seconds and to be significantly higher than the power supply (being accumulator) of rated load at every turn.
All lithium storage batteries that are verified all have the critical current rate of being determined by separately positive temperature coefficient (PTC) and/or chemical property and internal structure.If use a period of time more than the critical current rate, accumulator is with overheated and may explode.Cycle-index is few when running into very high power requirement (near the PTC threshold value), and the voltage and current characteristic curve is different with the performance that original technical standard is used.Have been found that some accumulator has positive temperature coefficient (PTC) device, prevent the desired power of anastomat of the present invention, but other accumulator can produce desirable power (can provide this electric current a voltage) for driving electronic stapling apparatus.This means concrete chemical property, structure and/or positive temperature coefficient (PTC) according to accumulator, critical current rate difference.
Designing power supply of the present invention is operated more than critical current rate scope, is called " supercritical current rate " in this article.Should be noted that in the definition of supercritical current rate it also is an average current through ovennodulation that is provided by the power supply that surpasses the critical current rate.Because accumulator can not continue for a long time with the power supply of supercritical current rate, so shorten the service time of accumulator.Be called " supercritical pulsed discharge phase " this service time that shortens with the supercritical current rate of accumulator at this paper, and the whole time that power supply uses is called " pulsed discharge phase ".In other words, the supercritical pulsed discharge phase is less than or equal to the pulsed discharge phase, and current rate is higher than the critical current rate of accumulator during this.The supercritical pulsed discharge phase of the present invention was less than about 6 seconds, and is in other words big in half second to 15 seconds scope, for example, and between 2 to 4 seconds, more particularly, about 3 seconds.In the lifetime of stapling apparatus, power supply may stand the supercritical current rate at least one times and be less than 20 times in the pulsed discharge phase in clinical course, for example, greatly between five times to 15 times, especially in five minutes between ten times to 15 times.Therefore, compare with the standard purposes several hrs power supply of power supply, the present invention had about 200 to 300 seconds at the most, and especially about 225 seconds total is used, and is called " adding up to the burst length ".It should be noted that, in starting process, stapling apparatus may not need surpass in certain procedure or surpasses the supercritical current rate all the time, because the load that device runs into depends on concrete clinical practice (be some tissue than other tissue density's height, high density will increase the load of device).But the design of anastomat can have certain number of times to surpass the supercritical current rate in the surgical operation of expection uses.When this supercritical pulsed discharge phase work, device can be operated time enough, and finishing the operation technique of requirement, but the time can not be very long, because require the electric current power supply of power supply to strengthen.
When the current range that increases is operated, the original manual anastomat of force rate that is produced by device (for example electronic anastomat 1) enlarges markedly.In fact power is big to damaging anastomat itself.In a kind of typical case used, motor and transmission group component can be operated to and prevent the safety device that blade 1060 advances when the nail bin that damages blade locking device-in not having nail bin or nail bin seat 1030 has been pulled the trigger.This structure is presented at Figure 33.Cross just as discussed, have only when suturing nail balladeur train 102 to appear at cocked position, namely be in the position of Figure 33 when balladeur train 102, just allow blade 106 to move to far-end.If balladeur train 102 this means one of two kinds of situations not in this position, perhaps in nail bin seat 1030, do not have nail bin, perhaps balladeur train 102 to far-end move-in other words, the nail bin of loading has taken place partially or completely to pull the trigger.Like this, should not allow blade 1060 to move, maybe should limit it and move.Therefore, in order to guarantee that balladeur train 102 has locking contact surface 104 at percussion state balladeur train 102 supporting blades 1060, blade 1060 has the contact head 1069 of respective shapes.Should be noted that at this before blade 1060 moved through edge 1035 to far-end, following guide vane 1065 was not close to the base plate 1034 of nail bin seat 1030.Because this structure, if balladeur train 102 does not support contact head 1069 at the far-end of blade 1060, descending guide vane 1065 so is not in base plate 1034 reach, but moves and run into edge 1035 along the groove 1037 near edge 1035, prevents that blade 1060 from continuing to move forward.Help when not having (being called as " locking ") at balladeur train 102 this contact, nail bin 1030 to have flat spring 1090 (being installed by at least 1 rivet 1036) to be used for skew blade 1060.Because flat spring 1090 is bent upwards and pushes down ring flange 1067 (at least up to the far-end of ring flange 1067 away from flat spring 1069) downwards, downward power is applied to blade 1060, will descend guide vane 1065 to press downward to groove 1037.Therefore, when blade 1060 moves and balladeur train 102 when not existing to far-end, following guide vane 1065 moves along the lower curve of groove 1037, when the remote edge of guide vane 1065 is run into edge 1035 instantly, stops to continue to move to far-end.
As long as the power that blade 1062 is delivered to blade 1060 not greatly to enough from blade 1060 guide vane 1065 of tearing down, this safety device just works according to description.With the power that power supply of the present invention, motor and power train can produce, blade 1060 can effectively be promoted to far-end, so that will descend guide vane 1065 to tear.If this thing happens, just can not prevent that blade 1060 or balladeur train 102 from moving to far-end.Therefore, the invention provides a kind of method, infra guide vane 1065 is by reducing the power that can be applied to down guide vane 1065 before the edge 1035.In other words, the upper limit that can be applied to the power of blade 1060 in the first (by edge 1035) of blade trip reduces, and the power that can be applied to blade 1060 after guide vane 1065 leaves edge 1035 and leans against on the base plate 1034 instantly increases.More precisely, first representative instance of the generation limiter of this two parts power adopts a kind of circuit form, first at identical/cutting stroke, one or several accumulator in the power supply is connected to motor, coincideing/cut the second portion of stroke, most or whole accumulator are connected to motor in the power supply.First kind of canonic form of sort circuit as shown in figure 34.In this example, when switch during in " A " position, power supply only has an accumulator 602 (four accumulator may be arranged in this example) to motor (motor 210 for example coincide) power supply.Yet, when switch in the position when " B ", power supply 600 all 4 accumulator 602 are to the motor power supply, the power that therefore offers blade 1060 increases.The control of switch 1100 between position " A " and " B " can be with carrying out along blade control combination part or second switch installing along certain position of balladeur train 102, and guide vane 1065 is by after the edge 1035 instantly, and second switch sends signal to controller.First example that should be noted that control circuit only is example, and any similar execution molectron can both provide locking protection for device, for example second representative instance shown in Figure 36.
First canonic form that motor rotates and reverse control circuit is illustrated in Figure 35.First representative instance double-throw double-pole switch 1200.Switch 1200 under normal circumstances is biased to the centre position with spring, and double-pole is disconnected.Illustrated motor M can represent identical motor 210 of the present invention.As we can see from the figure, starting drive must energized switch 1210.Certainly this switch is selectable unit.When wishing that motor M is just changeing, switch 1200 places right positions, as shown in figure 35, to the motor power supply, it is rotated to first direction, is defined as just changeing, because the positive pole "+" of accumulator is connected to the positive pole "+" of motor M.Motor M drove blade 1060 and moves to far-end when switch was put in positive transposition.Suitable sensor or switch indication blade 1060 or balladeur train 102 desirable foremost position are installed can be used for controlling travel switch 1220 forward, switch 1220 interrupts powering to motor M, at least as long as switch 1220 stays open, just can prevent from continuing to move forward.Circuit can be programmed, and never allows switch 1220 closed and form loops, or has only and for example just allow switch 1220 to reset when loading onto new nail bin.
When needs motor M reversed, switch 1200 placed leftward position, shown in 35, to the motor power supply, it was rotated to second direction, was defined as counter-rotating, because the negative pole "-" of accumulator is connected to the positive pole "+" of motor M.Switch motor M when backward position drives blade 1060 and moves to near-end.The indication of suitable sensor or switch knife plate 1060 or balladeur train 102 desirable rearmost end positions are installed be can be used in and control travel switch 1230 backward, switch 1230 interrupts powering to motor M, at least as long as switch 1230 stays open, just can prevent from continuing mobile backward.Should be noted that to provide other switch (indication of with dashed lines arrow) in circuit, selectively prevent from rotating to both direction in order to be independent of travel switch 1220,1230.
Should be noted that the enough very big power gear train of motor energy, driving force is transformed into high rotator inertia.Therefore, when any switch of mentioning in Figure 34 and 35 stopped revolution, gear may not stop operating.On the contrary, rotator inertia continuation driving tooth bar 217 moves to mobile direction when motor cuts off the power supply.This movement is disadvantageous aspect a lot.By suitable configuration power supply and motor, the mobile circuit in this outage back can be definitely eliminated in formation, thereby makes the user can control starting better.
Figure 36 shows a kind of typical example, and when just changeing/reversing the control termination, motor (motor 210 for example coincide) is prevented from being rotated further.Figure 36 shows that also another kind just changes/reverse control and multistage power supply example.The circuit of Figure 36 has the motor braking parallel circuit of an employing motor short circuit curve.More precisely, motor M is by short circuit, in order to make the electromagnetic field of foundation opposite with permanent-magnetic field, and the therefore motor to prevent that significantly the speed that surpasses stroke that inertia is induced from slowing down and still rotating.How can brake motor M for the circuit of explaining Figure 36, the explanation to forward-reverse switch 1300 is provided.Can see that forward-reverse switch 1300 has three positions, the switch 1200 of erect image Figure 35 is the same.When placing right positions, motor M just changes, when placing leftward position, and motor M counter-rotating.When switch 1300 inoperation (as shown in figure 36), motor M is by short circuit.Short circuit line is illustrated in the upper part of switch 1300.Should be noted that the mode that the handoff procedure of brake switch wishes to delay time takes place, and is called the break-before-make switch forms.When switching to motor M braking from motor M rotation, double-pole double-throw forward-reverse switch 1300 is opened before the motor short circuit comes into force.Conversely, when switching to motor M rotation from motor M braking, short circuit is opened before switch 1300 starters.Therefore, in when operation, when user disconnects three-pointswitch 1300 from the forward or reverse position, motor M is very fast by short circuit and braking.
Other device of circuit 36 is explained at Figure 35.For example, an on and off switch 1210 is arranged.Also has a power supply locking switch 1100, only power to motor with an accumulator 602 ' at given actuating section (beginning or any part that other needs of stroke at stroke), power to motor M with whole accumulator 602 (for example 6 accumulator) in the other parts of stroke.
The new limit switch 1320,1330 of a kind of rotating prevents that motor M continuation after just changeing limit switch 1320 action from just changeing.When reaching restriction site, just changeing limit switch 1320 startings, switch moves to second position.At this state, motor is not just changeing power supply, but can supply motor counter-rotating power supply.Just changeing toggle-switch that limit switch can be sequencing or the disposable use switch of nail bin.More precisely, switch 1320 will remain on second position, up to resetting with more renewing nail bin generation switch.Therefore, before more renewing nail bin, can only be to motor M counter-rotating power supply.If switch only is a trigger, then have only when retreating into when leaving console switch 1320, power supply can recover, and continues mobile.
Counter-rotating limit switch 1330 can form with similar approach.When reaching the counter-rotating restriction site, switch 1330 moves to second position and is parked in the there, resets up to generation.Should be noted that in this position motor M is prevented that by short circuit motor from rotating to any direction.Because this form, the operation of anastomat is limited in one-stroke as far as prosodetic position processed, and single retreats as far as back restriction site.When either way taking place, motor can not rotate, and resets up to two switches 1320.
More than describe and description of drawings principle of the present invention, preferred examples and operator scheme.More precisely, the present invention has described optimization power supply, motor and the power train about the surgical operation anastomat.But the present invention should not be interpreted as being limited in indivedual example discussed above.For this area and power supply or electric current output irrelevant with operation device but need be advanced, in short time and conditional time, with the technical staff in battery-driven other field of limited power or electric current output, can recognize other modification of above-mentioned embodiment.As diagram and description, under the optimized conditions according to the present invention, limited power supply can produce the power of lifting force, thrust, pulling force, towing tension, retentivity and other type, is enough to mobile sizable weight, for example surpasses 82kg.
Above-described example is property as an illustration, rather than restrictive.In addition, should be appreciated that being familiar with this operator can change those examples under the prerequisite that does not break away from the determined scope of the present invention of following claim.

Claims (40)

1. operating theater instruments comprises:
Have the operation end effector that at least one drives molectron, when driving, implement operation technique;
Electro-motor with rated operational voltage, motor has work to be connected with end effector, drives described at least one driving molectron;
A power supply, described power supply and motor be electric to be connected and selectively powers to motor, drive molectron work at least 1 time and be less than 16 times in order to drive at least one at least one clinical lifetime of end effector, motor and power supply, described power supply has following feature:
Has the accumulator that at least one has the critical current rate;
When to the power supply of described motor and drive described at least one when driving molectron, at least one accumulator is less than about 16 seconds non-zero supercritical pulsed discharge phase in the persistent period and moves with the supercritical current rate;
During described supercritical pulsed discharge to be higher than the rated operational voltage described motor that turns round.
2. operating theater instruments according to claim 1, wherein the supercritical pulsed discharge phase continues about 0.5 second to 15 seconds.
3. operating theater instruments according to claim 1, wherein the supercritical pulsed discharge phase continues about 1.5 seconds to 4 seconds.
4. according to the described operating theater instruments of 1 claim, wherein the supercritical pulsed discharge phase continues about 3 seconds.
5. operating theater instruments according to claim 2, wherein at least one accumulator was moved with the supercritical current rate in the whole supercritical pulsed discharge phase in the power supply.
6. operating theater instruments according to claim 1, wherein said at least one accumulator is at least one lithio accumulator.
7. operating theater instruments according to claim 1, wherein at least one accumulator is the lithium-manganese dioxide accumulator.
8. operating theater instruments according to claim 1 is wherein selected described accumulator to move under the supercritical current rate and is no more than about 300 seconds total burst length.
9. operating theater instruments according to claim 1, the total total time of the supercritical pulsed discharge phase in wherein said clinical life-span is no more than about 300 seconds.
10. operating theater instruments according to claim 1, wherein:
Described accumulator has the ptc device that has the PTC threshold value;
Described accumulator was worked with the supercritical current rate with below the PTC threshold value in the described supercritical pulsed discharge phase.
11. operating theater instruments according to claim 1, wherein said motor are the impulse modulation motors.
12. operating theater instruments according to claim 1, the efficient of wherein said motor are greatly between 60% and 90%.
13. operating theater instruments according to claim 12, wherein motor is centreless, brush type d.c. motor.
14. operating theater instruments according to claim 12, wherein the zero load rotating speed of motor is greatly about 20, and 000rpm to 40 is between the 000rpm.
15. operating theater instruments according to claim 1, wherein power supply produces about 32 watts of electrical power supply motors.
16. operating theater instruments according to claim 1 also comprises the intermediate actuator that described motor is connected to described at least one driving molectron, this intermediate actuator produces about 16 watts of mechanical outputs and supplies with described at least one driving molectron.
17. operating theater instruments according to claim 16, the power output that wherein said power supply, motor and intermediate actuator produce are enough to move about 82kg quality by about 60mm distance in 3 seconds.
18. operating theater instruments according to claim 17, wherein the peak power of intermediate actuator selection can move about 82kg quality by about 60mm distance in 3 seconds.
19. operating theater instruments according to claim 1, wherein said motor and power supply have an aggregate efficiency, and this aggregate efficiency is enough to drive molectron at least one provides about 16 watts of mechanical outputs.
20. operating theater instruments according to claim 1, wherein motor has the efficient gear train between 85% to 99% greatly.
21. operating theater instruments according to claim 20, wherein said gear train has final transmission, and described final transmission is the rack-and-pinion molectron.
22. according to 21 described operating theater instruments of claim, wherein said motor drive rack-and-pinion molectron moves with the speed of 0.8 inch of about per second.
23. operating theater instruments according to claim 21, wherein said rack-and-pinion molectron is directly connected at least a portion of end effector.
24. operating theater instruments according to claim 20, wherein motor and gear train have electricity-final mechanically operated aggregate efficiency of about 49%.
25. operating theater instruments according to claim 20, wherein gear train is decelerated to about 60rpm with motor rotary speed.
26. operating theater instruments according to claim 20, wherein the speed reducing ratio of gear train approximately is 500 to 1.
27. operating theater instruments according to claim 1, wherein:
Described at least one driving molectron is the first and second driving molectrons;
Described power supply produces the electrical power that equals the mechanical output twice, to drive one of described driving molectron.
28. operating theater instruments according to claim 27, wherein said power supply produce about 32 watts of electrical power in 3 seconds, a described driving molectron produces about 16 watts of mechanical outputs.
29. operating theater instruments according to claim 27 wherein drives a power setting that drives molectron and in about 3 seconds about 82kg quality is moved about 60mm.
30. operating theater instruments according to claim 1, wherein said power supply is connected with four and six accumulator of selecting from a group storage battery that comprises CR123 and CR2.
31. operating theater instruments according to claim 1, wherein at least one accumulator has about 4 amperes PTC starting at least 3 minutes.
32. operating theater instruments according to claim 1, wherein at least one accumulator has about 2 minutes about 5 amperes PTC starting.
33. operating theater instruments according to claim 1, wherein at least one accumulator has about 50 seconds about 6 amperes PTC starting.
34. operating theater instruments according to claim 1, wherein:
Described motor has peak efficiencies and gear train;
Select described gear train, so that motor was kept greatly about described peak efficiencies in the whole supercritical pulsed discharge phase.
35. operating theater instruments according to claim 1, wherein:
Described motor has a gear train;
This gear train has:
Output shaft with certain rotational speed;
Final transmission with rack-and-pinion molectron form;
Described output shaft rotates under a rotating speed, and each changes the inch number that tooth bar moves to described rotational speed optimization at whole described output shaft of supercritical pulsed discharge phase.
36. operating theater instruments according to claim 1, wherein:
Described motor has power train;
Described power supply, power train and motor are optimized for the aggregate efficiency of peak power was provided in the time that requires.
37. operating theater instruments according to claim 1, wherein power supply be comprise mutual connection once with the mixing accumulator of secondary lithio accumulator.
38. according to the described operating theater instruments of claim 37, a wherein said accumulator is powered to motor, described secondary accumulator battery is to a charge in batteries.
39. according to the described operating theater instruments of claim 38, wherein an accumulator is at least one chargeable lithium-ions battery, secondary accumulator battery is at least one lithium-manganese dioxide accumulator.
40. according to the described operating theater instruments of claim 38, wherein an accumulator is at least one capacitor, secondary accumulator battery is at least one lithium-manganese dioxide accumulator.
CN2007800177940A 2006-05-19 2007-05-31 Electrical surgical instrument Active CN101448463B (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201110150657.2A CN102309352B (en) 2006-05-19 2007-05-31 Electrical surgical instrument
CN201110152302.7A CN102293673B (en) 2006-05-19 2007-05-31 Electrical surgical instrument

Applications Claiming Priority (15)

Application Number Priority Date Filing Date Title
US80198906P 2006-05-19 2006-05-19
US60/801,989 2006-05-19
US81027206P 2006-06-02 2006-06-02
US60/810,272 2006-06-02
US85811206P 2006-11-09 2006-11-09
US60/858,112 2006-11-09
US11/705,381 US8038046B2 (en) 2006-05-19 2007-02-12 Electrical surgical instrument with optimized power supply and drive
US11/705,381 2007-02-12
US11/705,246 US8028885B2 (en) 2006-05-19 2007-02-12 Electric surgical instrument with optimized power supply and drive
US11/705,246 2007-02-12
US11/705,334 US8573462B2 (en) 2006-05-19 2007-02-12 Electrical surgical instrument with optimized power supply and drive
US11/705,334 2007-02-12
US90253407P 2007-02-21 2007-02-21
US60/902,534 2007-02-21
PCT/US2007/070085 WO2007137304A2 (en) 2006-05-19 2007-05-31 Electrical surgical instrument

Related Child Applications (4)

Application Number Title Priority Date Filing Date
CN201110158716.0A Division CN102319094B (en) 2006-05-19 2007-05-31 Electrical surgical instrument
CN201110150657.2A Division CN102309352B (en) 2006-05-19 2007-05-31 Electrical surgical instrument
CN201110152302.7A Division CN102293673B (en) 2006-05-19 2007-05-31 Electrical surgical instrument
CN2011101589984A Division CN102247183A (en) 2006-05-19 2007-05-31 Electrical Surgical Instrument

Publications (2)

Publication Number Publication Date
CN101448463A CN101448463A (en) 2009-06-03
CN101448463B true CN101448463B (en) 2013-08-07

Family

ID=40735940

Family Applications (2)

Application Number Title Priority Date Filing Date
CN2007800183265A Active CN101454855B (en) 2006-05-19 2007-05-21 Force switch
CN2007800177940A Active CN101448463B (en) 2006-05-19 2007-05-31 Electrical surgical instrument

Family Applications Before (1)

Application Number Title Priority Date Filing Date
CN2007800183265A Active CN101454855B (en) 2006-05-19 2007-05-21 Force switch

Country Status (1)

Country Link
CN (2) CN101454855B (en)

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8627995B2 (en) * 2006-05-19 2014-01-14 Ethicon Endo-Sugery, Inc. Electrically self-powered surgical instrument with cryptographic identification of interchangeable part
CN102247182A (en) * 2011-04-29 2011-11-23 常州市康迪医用吻合器有限公司 Electric anastomat for surgical department
US8967448B2 (en) * 2011-12-14 2015-03-03 Covidien Lp Surgical stapling apparatus including buttress attachment via tabs
CN103829982B (en) * 2012-11-26 2016-12-21 天津瑞贝精密机械技术研发有限公司 Electric linear anastomat
CN102940513B (en) * 2012-11-26 2017-05-31 天津瑞贝精密机械技术研发有限公司 Motor-driven ring-cutting anastomat
US20140249557A1 (en) * 2013-03-01 2014-09-04 Ethicon Endo-Surgery, Inc. Thumbwheel switch arrangements for surgical instruments
US9750503B2 (en) * 2013-07-11 2017-09-05 Covidien Lp Methods and devices for performing a surgical anastomosis
US9833235B2 (en) * 2013-08-16 2017-12-05 Covidien Lp Chip assembly for reusable surgical instruments
US9713469B2 (en) * 2013-09-23 2017-07-25 Ethicon Llc Surgical stapler with rotary cam drive
US10251649B2 (en) * 2015-10-29 2019-04-09 Ethicon Llc Surgical stapler buttress applicator with data communication
EP3926653A1 (en) * 2020-06-15 2021-12-22 ABB Power Grids Switzerland AG Contact bounce reduction system

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4255698A (en) * 1979-01-26 1981-03-10 Raychem Corporation Protection of batteries
US5467911A (en) * 1993-04-27 1995-11-21 Olympus Optical Co., Ltd. Surgical device for stapling and fastening body tissues
US5779130A (en) * 1994-08-05 1998-07-14 United States Surgical Corporation Self-contained powered surgical apparatus
US5796188A (en) * 1995-10-05 1998-08-18 Xomed Surgical Products, Inc. Battery-powered medical instrument with power booster
US6076018A (en) * 1998-09-04 2000-06-13 Woodside Biomedical, Inc Method and apparatus for low power regulated output in battery powered electrotherapy devices

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2770694A (en) * 1952-07-12 1956-11-13 Mercier Jean Pressure switch
DE3480971D1 (en) * 1983-08-16 1990-02-08 Omron Tateisi Electronics Co ELECTRIC SWITCH.
US6981628B2 (en) * 2003-07-09 2006-01-03 Ethicon Endo-Surgery, Inc. Surgical instrument with a lateral-moving articulation control

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4255698A (en) * 1979-01-26 1981-03-10 Raychem Corporation Protection of batteries
US5467911A (en) * 1993-04-27 1995-11-21 Olympus Optical Co., Ltd. Surgical device for stapling and fastening body tissues
US5779130A (en) * 1994-08-05 1998-07-14 United States Surgical Corporation Self-contained powered surgical apparatus
US5796188A (en) * 1995-10-05 1998-08-18 Xomed Surgical Products, Inc. Battery-powered medical instrument with power booster
US6076018A (en) * 1998-09-04 2000-06-13 Woodside Biomedical, Inc Method and apparatus for low power regulated output in battery powered electrotherapy devices

Also Published As

Publication number Publication date
CN101454855A (en) 2009-06-10
CN101454855B (en) 2012-05-30
CN101448463A (en) 2009-06-03

Similar Documents

Publication Publication Date Title
CN101686832B (en) Cryptographic identification type electrically self-powered surgical instrument with interchangeable part
CN102319094B (en) Electrical surgical instrument
CN101448463B (en) Electrical surgical instrument
CN102083373B (en) Electrically self-powered surgical instrument with manual release
JP6798857B2 (en) Electric surgical instruments
JP2009539420A5 (en)
AU2018267607A1 (en) Electrically self-powered surgical instrument with manual release
AU2019246825B2 (en) Electrically self-powered surgical instrument with cryptographic identification of interchangeable part
AU2014250664B2 (en) Electrically self-powered surgical instrument with cryptographic identification of interchangeable part
AU2012203920B2 (en) Electrically self-powered surgical instrument with manual release
AU2017232066A1 (en) Electrical surgical instrument

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
C14 Grant of patent or utility model
GR01 Patent grant