CN102652001A - 具有分立缝钉高度调节和触觉反馈的外科缝合器 - Google Patents

具有分立缝钉高度调节和触觉反馈的外科缝合器 Download PDF

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CN102652001A
CN102652001A CN201080056093XA CN201080056093A CN102652001A CN 102652001 A CN102652001 A CN 102652001A CN 201080056093X A CN201080056093X A CN 201080056093XA CN 201080056093 A CN201080056093 A CN 201080056093A CN 102652001 A CN102652001 A CN 102652001A
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regulating shaft
anvil block
main body
surgical stapling
stapling device
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CN102652001B (zh
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A·O·津曼
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Ethicon Endo Surgery Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2913—Handles transmission of forces to actuating rod or piston cams or guiding means
    • A61B2017/2916—Handles transmission of forces to actuating rod or piston cams or guiding means pins in guiding slots
    • 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
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself

Abstract

在各种实施例中，本发明提供了一种外科缝合器(1)，其可包括：主体(10)；缝合头(30)，所述缝合头(30)可操作地连接到所述主体；砧座(50)，所述砧座(50)相对于所述缝合头被可动地支撑，以便朝着和远离所述缝合头选择性地移动；和砧座调节轴(70)，所述砧座调节轴(70)由所述主体支撑，以用于选择性地调节所述砧座相对于所述缝合头的位置。所述调节轴和/或所述主体能够在所述砧座和所述缝合头之间建立至少一个预定缝钉成形高度，而不论调节轴旋转与否。另外，所述调节轴和/或所述主体能够向旋转所述砧座调节轴的使用者提供触觉反馈，从而在达到合适的缝钉成形高度时向所述使用者提示。本申请所述部件的各种整合也可减少外科缝合器所需的部件数，从而减少组装时间并降低制造成本。

Description

具有分立缝钉高度调节和触觉反馈的外科缝合器
背景技术
本发明实施例总体涉及外科缝合器，并且更具体地讲，涉及包括分立缝钉高度调节的圆形缝合器。
在某些类型的外科手术中，使用外科缝钉已成为连接组织的优选方法，因此已开发了用于这类用途的具有特殊构造的外科缝合器。例如，已经开发了用于被称为吻合的外科手术的腔内或圆形缝合器。用于执行吻合的圆形缝合器在(例如)美国专利号5,104,025、5,205,459、5,285,945和5,309,927以及美国专利申请号12/408,905中有所公开，这些专利各自的全部均以引证方式并入本申请中。
一种类型的吻合包括先切除患病部分然后将肠的各个段连接到一起的外科手术。该手术需要将两个管状部分的末端重新连接到一起，以形成连续的管状通道。以前，这类外科手术既费时又费力。外科医生必须准确切割和对齐肠的两端，并且在通过多次缝合将两端连起来时保持对齐状态。圆形缝合器的开发大大简化了吻合程序，并且也缩短了执行吻合所需要的时间。
一般地，常规圆形缝合器通常由安装于其上的近端驱动机构和远端缝合机构的细长轴构成。远端缝合机构通常由固定的钉仓构成，钉仓内包含构造成同心圆形阵列的多个缝钉。圆形切刀同心安装在钉仓内缝钉以里的位置处以便在其中轴向运动。从钉仓中心处轴向延伸的是可移动的套管针轴，该套管针轴适于缝合砧座可拆卸地连接到其上。当把缝钉驱入其中时砧座能使缝钉的末端成形。钉仓远端表面与缝合砧座之间的距离由调节机构控制，而调节机构安装在缝合器轴近端以控制套管针的轴向运动。当外科医生启动驱动机构时，对夹在钉仓和缝合砧座之间的组织同时进行缝合和切割。
通常，在执行外科吻合缝合手术中，两段腔管或管状组织，例如肠组织，通过缝钉环连接在一起。两段管状组织可以端对端连接，或者一段管状组织可以围绕形成在另一段管状组织侧面中的开口横向连接。在用缝合器械执行吻合的过程中，两段管状组织一起被夹在砧座和钉仓之间。缝钉推动器被推进以将缝钉驱入组织中并且抵靠砧座成形缝钉。另外，圆形刀被推进以切割夹在砧座和缝钉夹持器之间的多余组织。结果是，组织的环形部分被从每个腔管切断并且保留在砧座轴上。通过朝远端推进砧座轴以使砧座移动远离缝钉夹持器，使通过圆形缝钉环连接的管状组织松开。牵引砧座通过由缝钉环连接的管状组织段之间的圆形开口，将缝合器械取出。
此外，使用圆形缝合器执行下部结肠手术时，通常采用常规的外科缝合器缝合肠，这种缝合器在待移除肠的患病部分两侧安置两排缝钉。在缝合相邻末端的同时切除目标段。移除患病部分后，外科医生通常将砧座插入腔管近端，即缝合线近端。这可通过将砧座头部插入外科医生在近腔管切开的入口来完成。有时，可通过将砧座头部放在缝合器的远端并通过直肠插入器械经肛门放置砧座。然后外科医生可用缝合线或其他常规的系结装置将肠的近端系在砧座轴上。接着，外科医生切除邻近系结处多余的组织，并将砧座连接到缝合器的套管针轴上。然后外科医生合拢砧座和钉仓之间的间隙，从而将肠的近端和远端夹紧在间隙中。外科医生随后启动缝合器，驱动若干排缝钉穿过肠的两端并使其成形，从而连接末端并形成管状通道。同时，在驱动并成形缝钉时，可驱动同心的圆形刀片穿过肠组织末端，从而切割邻近内排缝钉的末端。接着，外科医生从肠中取出缝合器，并完成手术。
在上述外科手术期间，希望在缝钉高度范围内正确地成形缝钉，使得它们保留在组织中并防止渗漏和出血，并且希望实现“组织与组织”接触以促进组织愈合。通常，通过控制砧座和钉仓之间的距离或间隙，可以实现更好的缝合和愈合结果。虽然一些外科缝合器装有指示缝钉高度的可视读出器，但外科医生可能需要在手术期间专注于许多不同的事项。此外，一旦砧座已正确定位，就有必要使砧座在击发期间不移动，否则可能负面地影响正确的缝钉成形。
以上讨论仅仅意图说明本发明所属领域的现状，而不应视为是对权利要求范围的否定。
发明内容
在各种实施例中，提供了一种外科缝合器。在至少一个实施例中，外科缝合器可包括主体、缝合头组件、驱动系统、砧座和砧座调节组件。在这些实施例中，主体可包括柄部和从柄部延伸的轴部。此外，在这些实施例中，缝合头组件可以可脱开地连接到轴部，并且缝合头组件也可包括用于支撑一个或多个外科缝钉的钉仓以及至少一个缝钉驱动器用于接合和驱动来自所述钉仓的所述缝钉。此外，在这些实施例中，驱动系统能够施加驱动运动到缝钉驱动器。另外，在这些实施例中，砧座可相对于钉仓被可动地支撑，以便朝着和远离钉仓轴向运动。而且，在这些实施例中，砧座调节组件能够选择性地调节砧座相对于钉仓的轴向位置。此外，在这些实施例中，砧座调节组件可包括调节轴和连接到所述调节轴以与所述调节轴一起行进的套管针，所述套管针能够用于可拆卸地连接到所述砧座。而且，在这些实施例中，调节轴或主体中的一个可包括接合部，并且调节轴或主体中的另一个可包括螺旋表面，该螺旋表面包括至少一个斜坡部分(rampportion)、至少一个停顿部分(dwell portion)和将至少一个停顿部分从至少一个斜坡部分分开的至少一个限定器。另外，在这些实施例中，该至少一个斜坡部分能够可操作地与接合部接合，以在调节轴旋转时，使调节轴相对于主体运动。
在至少一个实施例中，提供了一种外科缝合器，其可包括：主体；缝合头，该缝合头可操作地连接到主体；砧座，该砧座相对于缝合头被可动地支撑，用于选择性地朝着和远离缝合头行进；和砧座调节轴，该砧座调节轴由主体支撑，用于选择性地调节砧座相对于缝合头的位置。此外，在这些实施例中，调节轴或主体中的一个可包括接合部，并且调节轴或主体中的另一个可包括具有第一部分和第二部分的螺旋表面。而且，在这些实施例中，第一部分能够可操作地与接合部接合，以在调节轴旋转时，使调节轴相对于主体运动。另外，在这些实施例中，至少一个限定器可将第一部分与第二部分分开。
在至少一个实施例中，提供了一种外科缝合器，其可包括：主体；缝合头，该缝合头可操作地连接到主体；砧座，该砧座相对于缝合头被可动地支撑，用于选择性地朝着和远离缝合头移动；和砧座调节轴，该砧座调节轴由主体支撑，用于选择性地调节砧座相对于缝合头的位置。此外，在这些实施例中，调节轴或主体中的一个可包括接合部，并且调节轴或主体中的另一个可包括具有至少一个斜坡部分和至少一个停顿部分的螺旋表面。而且，在这些实施例中，至少一个斜坡部分能够可操作地与接合部接合，以在调节轴旋转时，使调节轴相对于主体运动。
附图说明
本申请所述实施例的新颖特征在所附权利要求书中进行了详细描述。然而，对机构和操作方法的实施例而言，皆可以通过参照以下具体实施方式(结合附图)更好地理解。
图1是一种外科缝合器的非限制性实施例的立体图，该缝合器包括圆形缝合头和位于第一位置的砧座。
图2是图1的外科缝合器的立体图，其中示出砧座在第二位置。
图3是图1的外科缝合器的分解图。
图4是图1的外科缝合器的透视图，其中缝合器的主体以虚线显示，以更好地示出主体内的缝合器部件。
图5是图1的外科缝合器的横截面图。
图6是图1的外科缝合器的砧座的后视立体图。
图7A是图1的外科缝合器的缝合头组件的前视立体图。
图7B是图7A的缝合头组件的钉仓的后视立体图，显示两个缝钉被从钉仓的缝钉腔中移出。
图7C是图7A的缝合头组件的切割构件和缝钉驱动器的前视立体图。
图8是图1的外科缝合器的砧座调节轴的侧视图。
图9是图8的砧座调节轴的一部分的立体图。
图10A-10C是图8的砧座调节轴的一部分的一系列侧视图，每一幅图示出了当轴围绕其纵向轴线旋转时螺旋表面的行进情况。
图11A-11C是图1的外科缝合器的砧座和缝合头组件的一系列侧视图，每一幅图分别示出了与图10A-10C所示轴位置相关的分立缝钉成形高度。
图12示出了包括参考标记的砧座调节轴的一部分的非限制性实施例。
图13示出了图12的调节轴的一部分中的三个参考标记。
图14是图1的外科缝合器的触发器的后视立体图；该触发器包括锁定杆。
图15是图3的外科缝合器的一部分的前透视图，示出触发器和锁定杆分别与驱动带和调节轴对接。
图16是包括直的轴部的外科缝合器的非限制性实施例的立体图。
图17是图16的外科缝合器的砧座调节轴的侧视图。
图18是图16的外科缝合器的驱动杆的立体图。
具体实施方式
现在将描述某些实施例，以提供对本发明所公开的结构、功能、制造的原理、设备的用途和方法的全面理解。这些实施例的一个或多个实例在附图中示出。本领域技术人员将会理解，本申请具体描述并在附图中示出的装置和方法是非限制性的实施例，并且这些实施例的范围仅由权利要求书来限定。与一个实施例有关的图示或描述的特征可与其他实施例的特征进行组合。此外，当指出一过程中的步骤顺序时，根据需要，这样的顺序可以重新安排，或者步骤可以同时进行，除非不合逻辑或明确要求所列出的顺序。这样的修改和变型旨在纳入所附权利要求书的范围内。
在下面的描述中，在若干视图中，相同的附图标记指示相同或对应的部件。另外，在下面的描述中，应当理解，诸如“向前”、“向后”、“前”、“后”、“右”、“左”、“在上方”、“在下方”、“向上”、“向下”、“向近端”、“向远端”等词是方便型用语，不应认为是限制性术语。下面的描述是为描述各种实施例之目的，并非意图限制所附权利要求。
各种实施例总体上涉及各种外科缝合器，其被构造成密封组织，并且在至少一个实施例中也可切割组织。此类外科缝合器能够通过诸如肛门、口腔和/或阴道之类的天然孔口或通过切穿体壁的切口工作。此外，此类外科缝合器可设计成内窥镜式工具，包括腹腔镜式工具。
现在关注非限制性实施例，如图1-4中所示，提供了圆形缝合器1，其包括管状或圆形主体10、可操作地连接到主体10的缝合头30、砧座50、由主体10支撑的砧座调节轴70，以及可动地连接到主体10的触发器90。砧座50可相对于缝合头组件被可动地支撑，以便进行朝着和远离缝合头30的选择性行进。此外，砧座调节轴70可由主体10支撑，以选择性地调节砧座相对于缝合头的位置。因此，如下面将进行的更详细的说明，调节轴70可以可操作地连接到砧座50以使砧座移动。例如，调节轴70可经由调节轴的旋钮79围绕其纵向轴线在第一旋转方向(例如顺时针“CW”方向)上旋转，以使轴70和砧座50在远端方向“DD”上相对于主体10从图1所示第一位置移动或平移至图2所示第二位置。同样，调节轴70可以在第二旋转方向(例如逆时针方向“CCW”)上旋转，以使轴70和砧座50在近端方向“PD”上相对于主体10从图2所示第二位置移动或平移至图1所示第一位置。应当理解，砧座50可位于在图1-2所示位置之间或以外的外科缝合器1允许的任何位置。此外，在至少一个实施例中，如下面将进行的更详细的说明，调节轴70能够将砧座50移动至离缝合头至少一预定距离处和/或向使用者提供触觉反馈。
当触发器90被启动时，驱动系统可在主体10内被启动，以使缝钉31(参见图3和图7B)可从缝合头30被排出，以与砧座50成形接触。同时，可操作地支撑在头部30内的切割构件32(参见图7C)将对保持在被缝合组织周围靠里的组织进行切割。然后将缝合器10从组织中拔出，将被缝合的组织保持在原位。此外，触发器90可包括弹簧91，弹簧91从杠杆92延伸，使得当杠杆92被挤压或以其他方式围绕铰链销93朝主体10移动时，杠杆91受偏压远离主体10向后，并且刀70在杠杆92释放时自动回缩。
参见图3，主体10可包括柄部11和弯曲轴部12。虽然本实施例示出了弯曲轴部12，但该轴部也可以是直的或线性的(参见例如下面讨论的图16)。柄部11可适于经由鞍形附件13接纳触发器90，鞍形附件13还可包括用来接纳铰链销93的孔16(参见图3)，铰链销93也可接纳在触发器90的孔96中。柄部11可进一步限定位于主体10顶部的开口14，通过开口14可以定位触发器90的一部分。例如，凸轮表面94和锁定杆95可延伸通过开口14。如下面将进行的更详细的说明，凸轮表面94能够当触发器90相对于柄部11移动时启动驱动系统，以及在砧座50处于合适位置使得缝钉可在砧座50和缝合头30之间成形之前，锁定杆95可防止切割构件32和/或缝钉31意外击发。
参见图3和4，驱动系统可包括驱动带80，驱动带80位于主体的轴部12内部，在触发器的凸轮表面94和缝合头30的接片36之间轴向延伸。驱动带80可包括近端驱动表面81和远端驱动表面82。因此，启动触发器可使凸轮表面94旋转并推动近端驱动表面81，使得驱动带80在轴向上朝着或远离砧座50移动。缝合头的接片36可连接在驱动带的远端驱动表面82内，远端驱动表面82可采用凹口的形式以便可脱开地接纳接片36。
参见图4和7A-7C，缝合头30可包括组件，该组件包括：钉仓33，其用于支撑一个或多个缝钉31；至少一个缝钉驱动器34，用于接合和驱动来自钉仓33的缝钉31；以及切割构件32(例如刀)，其可动地支撑在缝合头30中。在至少一个实施例中，缝钉驱动器34和切割构件32可以一体地连接和/或形成。例如，缝钉驱动器34和切割构件33可从芯35中伸出，并且二者都可由相同材料形成。在任何情况下，驱动带80朝向钉仓33和/或砧座50的动作均可引起缝合头的接片36(可从芯35中伸出)，以及切割构件32和缝钉驱动器34朝砧座50移动。此外，缝合头30也可包括壳体39，该壳体能够保持钉仓33并在其中可动地接纳缝钉驱动器34、切割构件32，和/或芯35。壳体39还可包括释放按钮37，该释放按钮能够柔性地挠曲并允许缝合头30在形成于主体轴部12中的对应孔15(参见图3)处可脱离地连接到主体的轴部12。因此，参见图4，缝合头30可通过以下方式移走：按下按钮37，然后转动头部30，使得接片36从由驱动带80的远端驱动表面82形成的凹口中脱开，最后将缝合头30拉离主体10。
现在关注砧座50的调节，参见图3，在各种实施例中且如上所指，砧座50可相对于钉仓33被可动地支撑，使得砧座可以朝着和远离钉仓33轴向运动。更具体地，外科缝合器1可包括用于选择性地调节砧座50相对于钉仓33的轴向位置的砧座调节组件。砧座调节组件可包括调节轴70和套管针73，该套管针连接到调节轴70，以与调节轴70一起行进。调节轴70可包括近端部分70a和远端部分70b，这两个部分可以连接到一起以形成轴70。作为另外一种选择，近端部分70a和远端部分70b可由同一件材料一体和整体地形成(参见例如图17所示的调节轴170，以及下面的讨论)。另外，调节轴70还可包括位于远端部分70b处的环形凹槽71，该环形凹槽可以被夹住或以其他方式自由连接到砧座调节带72的近端。应当理解，通过自由连接，调节带72在调节轴70旋转时不可以旋转；然而，调节带72仍可以与轴70一起平移。调节带72的远端也可连接到套管针73。因此，调节轴70相对于主体10的轴向运动或平移可使套管针73也相对于主体10轴向运动或平移。
参见图3和4，砧座调节带72和驱动带80中的一者或两者可分别包括接片83和84，这两种接片均弯曲或以其他方式伸向主体10。接片83、84可帮助使带72、80能够行进通过主体的弯曲轴部12，同时填充空间并在其中保持合适的轴向位置。
此外，参见图3和6，如本领域已知，套管针73可通过连接到砧座和/或套管针的簧片或弹簧夹55可拆卸地连接到砧座50。换句话讲，通过按压、拉拔或以其他方式操纵弹簧夹55，可从套管针中移开砧座。反之，通过使套管针移动进入砧座，使得弹簧夹55将砧座可释放地保持在套管针上，可将套管针按扣入砧座中。因此，砧座调节轴70相对于主体10的轴向运动也可以相对于主体10轴向运动或平移砧座50。此外，砧座也可包括连接到砧座主体52的护盖53(参见图3)和在击发切割构件32期间被剪切的垫圈54，如上面所讨论。垫圈54可由塑料制成并可充当切割表面，组织可以抵靠该表面被切断。
现在参见图3-5，砧座调节轴70能够进行旋转(如上面所述)，使得轴70相对于主体10平移。更具体地并且在至少一个实施例中，砧座调节轴70可包括螺旋表面74，该螺旋表面可操作地与主体10的接合部(例如，通过主体中的孔固定到主体10的螺销75)结接合。螺旋表面74可由形成于调节轴70中的槽限定，该槽尺寸加工成和构造成在其中接纳销75的至少一部分。砧座调节轴70可围绕其纵向轴线L旋转(参见图8)，使得螺旋表面74接触并在销75上方移动，从而使砧座调节轴70相对于主体10平移。虽然在本实施例中描述了销75，但可以使用任何其他合适的螺纹配合部分或部件(例如突起、螺纹等)来代替或辅助销75接合螺旋表面。在任何情况下，使调节轴70围绕其纵向轴线旋转可以导致轴70，继而套管针73和砧座50也相对于主体10和/或缝合头30轴向平移或移动。
如上面所提及，在各种实施例中，调节轴70能够使砧座50移动至离缝合头30至少一个预定距离处。更具体地，现在关注图8，其仅示出调节轴70，调节轴的螺旋表面74可包括至少一个斜坡部分和至少一个停顿部分。例如，螺旋表面74可包括第一斜坡部分74a和一个或多个第二停顿部分74b。至少一个限定器，例如限定器76，也可将斜坡部分74a与停顿部分74b分开。如下面将进行的更详细的讨论，斜坡部分74a可允许调节轴相对于主体10平移(参见图4)，停顿部分74b可提供预定距离以维持砧座50距缝合头30的位置(参见图2)，并且限定器76可向旋转砧座调节轴70的使用者提供触觉反馈以及斜坡部分和停顿部分之间的过渡。此外，在至少一个实施例中，斜坡部分74a可以在形状上至少部分是螺旋状。
接着，图8中以虚线画出的圆表示图9和10A-10C中所示砧座调节轴70的近侧端部分。现在关注图9，螺旋表面74的斜坡部分74a可引导进入至少一个停顿部分。如图所示，并且在至少一个实施例中，螺旋表面74还可包括三个停顿部分：第一停顿部分74b′、第二停顿部分74b″和第三停顿部分74b″′。砧座调节轴70围绕其纵向轴线的旋转可使螺旋表面74沿销75而过(参见图5)，使得轴70相对于主体10平移(再次参见图5)。此外，当轴70按(例如)顺时针CW旋转时，螺旋表面74可以沿销75移动，使得销75接触斜坡部分，然后接触第一停顿部分74b′。然后，当轴70再次顺时针CW旋转时，该销可以接触第二停顿部分74b″。之后，轴70按顺时针CW方向继续旋转可使该销接触第三停顿部分74b″′。如下面将进行的更详细的说明，每个停顿部分可以相对于斜坡部分74a处于不同角度构造处。
此外，每个停顿部分74b′、74b″和74b″′可位于沿砧座调节轴70的不同纵向位置处，以提供预定的分立缝钉成形高度。例如，参见图10A，第一停顿部分74b′可位于离轴组件的横向凸缘77第一距离L1处。第二停顿部分74b″可位于离横向凸缘77第二距离L2处，而第三停顿部分74b″′可位于离横向凸缘77第三距离L3处。包括横向凸缘77的任何参考点或参考平面可用于建立上述距离。在任何情况下，第一距离L1可以大于第二距离L2，第二距离可以大于第三距离L3，或者L1＞L2＞L3。作为另外一种选择，虽然未示出，但各距离可具有其他比较顺序，例如，L1＞L3＞L2、L2＞L1＞L3、L2＞L3＞L1、L3＞L2＞L1、或L3＞L1＞L2。此外，在相应停顿部分74b′、74b″和74b″′上的各停顿距离L1、L2和L3可以是均匀的。换句话讲，参见例如图10B，虽然螺旋表面的斜坡部分74a可以相对于调节轴的纵向轴线L倾斜小于90度的斜坡或螺旋角度α，但每个停顿部分(例如，图10B中的74b″)可以基本上垂直于纵向轴线L，或者相对于轴线L限定大约90度的角度θ。此外，参见图9和10A-10C，停顿部分74b′、74b″、74b″′可另外作为限定预定的分立缝钉高度的步骤，如下面所讨论。当测量相对于纵向轴线L的上述角度时，应当理解，此类测量可以相对于这样的平面进行：该平面与螺旋表面74的一部分以及该平面与纵向轴线L相交的点相切，为了清晰起见，纵向轴线L沿图10A-10C中所示砧座调节轴的整个长度显示。例如，再次参见图10B，螺旋角度α在切平面“TP”和纵向轴线L之间限定，其中该切平面垂直于图10B所在的纸面平面。
现在关注图11A-11C，缝合头30和砧座50显示处于与轴的螺旋表面的停顿部分74b′、74b″和74b″′相关联的多个位置。例如，分立的缝钉成形高度D1、D2和D3可以限定在砧座50的缝钉成形表面51和钉仓33的缝钉弹出表面38之间。第一高度D1可以大于第二高度D2，第二高度可以大于第三高度D3，或者D1＞D2＞D3。同时参见图10A-10C和11A-11C，旋转调节轴70的同时，每个停顿部分74b′、74b″和/或74b″′可允许砧座50保持在相应的缝钉成形高度D1、D2和/或D3处，使得停顿部分沿销75移动(参见图5)。例如，每个停顿部分74b′、74b″、74b″′可设计成在轴旋转约60度的时间段内保持砧座的位置。换句话讲，沿每个停顿部分的表面延伸的弧可以在大约60度的角度范围内延伸。
参见图9和10A-10C，在各种实施例中，至少一个过渡部可以分开每个停顿部分74b′、74b″和/或74b″′，从而使得砧座调节轴70能够相对于销75前进到另一个位置(参见图5)。在至少一个实施例中，过渡部可包括另一个斜坡部分和/或部分螺旋表面。然而，在至少一个其他实施例中，过渡部也可包括至少一个限定器。如图10A-10C中可见，第一限定器76′可将螺旋表面的斜坡部分74a与第一停顿部分74b′分开，第二限定器76″可将第一停顿部分74b′与第二停顿部分74b″分开，第三限定器76″′可将第二停顿部分74b″与第三停顿部分74b″′分开。如上所述，每个限定器76′、76″和/或76″′可在使用者旋转砧座调节轴的同时向使用者提供触觉反馈。
更具体地，再次参见图9和10A-10C，每个限定器76′、76″和/或76″′可包括位于螺旋表面中的凸耳或突起。换句话讲，螺旋表面74可限定包括斜坡部分74a与停顿部分74b′、74b″和74b″′的表面形貌，并且每个限定器76′、76″和/或76″′可以是分别位于上述部分之间的表面形貌中的中断部。另外，除了限定器76′、76″和/或76″′之外，位于螺旋表面74的任何部分上的表面形貌都可以是平滑的。例如，参见图5、9和10A-10C，螺旋表面的斜坡部分74a可包括平滑形貌，使得当砧座调节轴70相对于主体10旋转时，螺旋表面74可以相对平滑地移动经过销75。然而，当销75到达斜坡部分74a的末端时，表面形貌可以被第一限定器76′中断。因此，当螺旋表面74在销75上方前进，伴随第一限定器76′接触销75(这归因于螺旋表面74的表面形貌在限定器76′处的中断)，调节轴70(当轴70旋转时，其可以由近端以平滑的方式从主体10中延伸出)可以不连贯或不连续的方式跳动、推动或拉动，或以其他方式向使用者提供触觉反馈。第一限定器76′在销75上方经过的动作可以向旋转轴70的使用者提示销75此时已接纳在第一停顿部分74b′处，第一分立的缝钉成形高度D1(参见图11A)已达到。轴70在停顿期(如上所述，可以为大约60度)内的连续旋转不能调节第一缝钉成形高度D1。因此，使用者不一定需要关注砧座调节轴70所处的准确旋转位置，只要使用者知道第一缝钉成形高度D1在轴70被进一步旋转以使另一个限定器接触销75之前将不会改变。此外，使用者可以来回旋转砧座调节轴70，使得销75沿着第一停顿部分74b′在第一限定器76′和第二限定器76″之间相对移动。因为限定器从第一停顿部分74b′的表面突出，当销75接触位于第一停顿部分74b′相应末端处的第一限定器76′或第二限定器76″时，使用者通过砧座调节轴70可以感觉到，从而让使用者确信已经到达第一缝钉成形高度D1。
参见图5、9和10A-10C，如果使用者希望将缝钉成形高度从第一缝钉成形高度D1改变为第二缝钉成形高度D2(参见图11A-11B)，则使用者可以进一步旋转砧座调节轴70，使得第二限定器76″接触销75。当销75到达第一停顿部分74b′的末端时，表面形貌可被第二限定器76″中断。因此，当螺旋表面74在销75上方前进时，伴随第二限定器76″接触销75(这归因于螺旋表面74的表面形貌在限定器76″′处的中断)，调节轴70(在销75接触第一停顿部分74b′期间，其可以平滑地旋转)可以不连贯或不连续的方式跳动、推动或拉动，或以其他方式向使用者提供触觉反馈。第二限定器76″在销75上方经过的动作可以向旋转轴70的使用者提示销75此时已接纳在第二停顿部分74b″处，第二分立的缝钉成形高度D2(参见图11B)已达到。轴70在停顿期(如上所述，可以为大约60度)内的连续旋转不能调节第二缝钉成形高度D2。因此，使用者不一定需要关注砧座调节轴70所处的准确旋转位置，只要使用者知道第二缝钉成形高度D2在轴70被进一步旋转以使另一个限定器接触销75之前将不会改变。此外，使用者可以来回旋转砧座调节轴70，使得销75沿着第二停顿部分74b″在第二限定器76″和第三限定器76″′之间相对移动。随着限定器从第二停顿部分74b″的表面中突出，使用者通过砧座调节轴70可以感觉到销75何时接触位于第二停顿部分74b″相应末端处的第二限定器76″或第三限定器76″′，从而让使用者确信已经到达第二缝钉成形高度D2。
相似地，仍然参见图5、9和10A-10C，如果使用者希望将缝钉成形高度从第二缝钉成形高度D2改变为第三缝钉成形高度D3(参见图11B-11C)，则使用者可以进一步旋转砧座调节轴70，使得第三限定器76″′接触销75。当销75到达第二停顿部分74b″的末端时，表面形貌可以被第三限定器76″′中断。因此，当螺旋表面74在销75上方前进时，伴随第三限定器76″′接触销75(这归因于螺旋表面74的表面形貌在限定器76″′处的中断)，调节轴70(在销75接触第二停顿部分74b″的同时，其可以平滑地旋转)可以不连贯或不连续的方式跳动、推动或拉动，或以其他方式向使用者提供触觉反馈。第三限定器76″′在销75上方经过的动作可以向旋转轴70的使用者提供指示，提示销75此时已接纳在第三停顿部分74b″′处，第三分立的缝钉成形高度D3(参见图11C)已达到。轴70在停顿期(如上所述，可以为大约60度)内的连续旋转不能调节第三缝钉成形高度D3。因此，使用者不一定需要关注砧座调节轴70所处的准确旋转位置，只要使用者知道第三缝钉成形高度D3在轴70被进一步旋转以使阻挡件78接触销75，从而防止销75相对于螺旋表面74朝阻挡件78进一步移动之前将不会改变。阻挡件78可以是形成在第三限定器部分74b″′末端处的壁。此外，使用者可以来回旋转砧座调节轴70，使得销75沿着第三停顿部分74b″′在第三限定器76″′和阻挡件78之间相对移动。因为阻挡件和限定器76″′从第三停顿部分74b″的表面突出，当销75接触位于第三停顿部分74b″′相应末端处的第三限定器76″′或阻挡件78时，使用者通过砧座调节轴70可以感觉到，从而让使用者确信已经到达第三缝钉成形高度D3。
在各种实施例中，参见图9和15，例如，螺旋表面74可以在斜坡部分74a闭合，而在停顿部分74b′、74b″、74b″′打开。换句话讲，螺旋表面的斜坡部分可包括近端壁和远端壁，而螺旋表面的停顿部分可仅包括近端壁。在使用中，销75可受偏压抵靠停顿部分，这是由于当砧座50位于距离头部30合适的缝钉成形高度处时，组织被夹在砧座50和缝合头30之间，如上面所讨论(参见图11A-11C)。
虽然以上所述至少一个实施例示出限定器76′、76″和/或76″′成形为螺旋表面74中的凸耳或突起，但限定器也可以采用位于螺旋表面中的缺口的形式。另外，限定器可以是与调节轴70分开的部件，使得它们可以连接到调节轴70。在任何情况下，当使用者旋转轴70时，限定器可以向使用者提供触觉反馈。此外，虽然限定器显示为将斜坡部分74a与第一停顿部分74b′等分开，但螺旋表面可以不包括一个或多个停顿部分。在此类实施例中，螺旋表面可包括被至少一个限定器以所需间隔分开的多个斜坡部分。因此，当砧座50和钉仓33之间(参见例如图11A)已经获得合适的缝钉成形高度时，使用者可以通过触觉反馈获知。
除了触觉反馈之外，外科缝合器1可包括可视参考标记，用以在达到缝钉成形高度时向使用者提示。例如，现在参见图12-13，砧座调节轴70可包括印刷或成形在轴表面上的参考标记85，该参考标记通过主体10上的标志86在已达到诸如D1、D2、D3(参见图11A-11C)的分立缝钉成形高度时，提供相应指示。在至少一个实施例中，相应的缝钉成形高度可以是2.5mm、1.8mm和1.0mm，并且参考标记85可以指示这些高度。在任何情况下，将如上面所讨论的可视标记、限定器和/或停顿部分结合到砧座调节轴70中，可以不再需要与轴分开的缝钉高度指示机构。
另外，虽然以上所述至少一个实施例已经将螺旋表面74示出为由形成于砧座调节轴70中的槽限定，但作为另外一种选择，在至少一个实施例中，螺旋表面可由从砧座调节轴70突出的螺纹限定。在此类实施例中，可以采用销75，或者可以使用另一个螺纹配合部件来啮合螺旋表面，例如，从主体10内部伸出的叉状物。
此外，虽然上面讨论的螺旋表面74被描述作为砧座调节轴70的一部分，但应当理解，作为另外一种选择，这样的螺旋表面可作为主体10的一部分。在此类实施例中，诸如销或其他螺纹配合部件的接合部将同样被固定到调节轴70，而不是固定到主体10。在任何情况下，轴70的旋转可使螺旋表面相对于接合部旋转，使得轴70，继而砧座50相对于主体10和/或缝合头30平移。
在各种实施例中，如上面所提及并参见图5，在砧座50处于离钉仓33适当距离处之前，触发器90可与调节轴70配合，以防止触发器90实质上朝主体10移动，或换句话说，防止导致缝钉驱动器34和/或切割构件32被启动，从而防止外科缝合器1的意外击发。换句话讲，触发器可包括锁定器。例如，在至少一个实施例中并参见图8，致动轴70可包括限定第一宽度W1的第一近端部分70a和限定第二宽度W2的第二远端部分70b。此外，参见图14，触发器90可包括从杠杆92中延伸的锁定杆95，该杆95限定具有尺寸S的开口97。锁定杆可类似具有两个尖齿的叉状物或轭。在任何情况下，开口97的尺寸S可以小于近端部分70a的第一宽度W1，但开口97的尺寸S可以大于或等于远端部分70b的第二宽度W2，或者W1＞S≥W2。
现在参见图15，锁定杆95可以被布置成通过主体开口14，使得杆95可操作以接合轴的近端部分70a或者轴的远端部分70b。如果锁定杆95纵向地被布置在近端部分70a上方，则触发杠杆92会由于锁定杆95和轴的近端部分70a之间的干扰作用而被阻止实质上朝主体10移动。换句话讲，由于近端部分的宽度W1(参见图8)大于锁定杆开口97的尺寸S(参见图14)，可以防止触发杠杆92引起驱动带80启动，如上面所述，从而防止缝钉31和/或切割构件32意外击发(参见图3)。然而，如果锁定杆95纵向地被布置在远端部分70b上方，则触发杠杆92会由于锁定杆95和轴的远端部分70b之间没有干扰作用而被允许实质上朝主体10移动。换句话讲，由于远端部分的宽度W2(参见图8)小于或等于锁定杆的开口97的尺寸S(参见图14)，可以允许触发杠杆92移动并导致驱动带80启动，如上面所述，从而击发缝钉31和/或切割构件32(参见图3)。在此类实施例中，开口97可接纳轴的远端部分70b并允许杠杆92朝主体10移动，直到远端部分70b到达开口97的末端。
此外，参见图15，轴的远端部分70b可以沿砧座调节轴70定位，使得远端部分70b与合适的缝钉成形高度相关联。例如，远端部分70b可以沿轴70轴向布置，使得当销75被接纳在停顿部分(例如第一停顿部分74b′)中时，锁定杆95纵向地布置在远端部分70b上方。因此，锁定杆95可以在已达到所需缝钉成形高度时仅允许缝钉驱动器34和/或切割构件32(参见图3)被击发，而不需要与触发器90分开的锁定杠杆或机构。此外，参见图14，锁定杆95可以由与触发器弹簧91相同的同一块材料一体和整体地形成。然而，在至少一个实施例中，锁定杆95、触发器弹簧91和杠杆92可以由同一块材料一体和整体地形成。
在各种实施例中，并且如上面所提及，外科缝合器可以是直的，而不是如上所述弯曲的。因此，现在参见图16，其中示出了一种外科缝合器101。外科缝合器101可包括类似于上面所述的主体110、缝合头130、砧座150、砧座调节轴170和触发器190。然而，主体110的轴部112可以是直的。此外，缝合头130和砧座150可以是线性的，并且远离主体110轴向地伸出。应该指出的是，参见图1和16中分别示出的外科缝合器1和外科缝合器101，由于各缝合头30、缝合头130如上所述可从外科缝合器主体10、外科缝合器主体110移除，缝合头30、缝合头130和砧座50、砧座150可以例如彼此互换。除了上述头部30、头部130和砧座50、砧座150之外，还可以采用其他缝合头构造和砧座构造。
另外，现在参见图17，砧座调节轴170和套管针173可以由同一块材料一体和整体地形成。因此，轴的远端部分170b可从近端部分170a伸出并邻接套管针173。此外，参见图18，其中示出了驱动杆180。驱动杆可允许触发器190(参见图16)移动以朝缝合头130启动驱动杆180，以从中弹出缝钉和/或启动切割构件(未示出)。简而言之，驱动杆可以是细长的通常为管状的形状，并且包括近端驱动表面181和远端驱动表面182。参见图16和18，近端驱动表面181能够接纳来自触发器190的驱动，而远端驱动表面182能够在缝合头130内接合缝钉驱动器和/或切割构件(未示出)，如上所述。另外，驱动杆180可包括通道187，该通道能够接纳穿过其中的砧座调节轴170(参见图17)。在至少一个实施例中，缝合器101可以不包括切割构件，并且可以主要用来缝合或密封组织，而不是横切组织。
应当理解，以上讨论的直缝合器101和弯曲缝合器1(分别参见图16和图1)可包含比市场上可获得的类似现有外科缝合器明显更少的部件。例如，参见直外科缝合器101，特别是参见砧座调节轴，将旋钮179与闭合螺钉或螺旋表面174以及套管针173组合成一个整体部件砧座调节轴170减少了外科缝合器的部件数。通过将斜坡部分174a与停顿部分174b组合成螺旋表面174，可进一步减少部件数。如上面所讨论，螺旋表面的斜坡部分174a可允许轴170相对于主体110的初始快速轴向运动，而停顿部分174b可以在砧座150和缝合头130之间建立至少一个分立的预定缝钉成形高度。总体上，忽略砧座和缝合头部件，相比现有装置中三十个以上的部件，外科缝合器101可以仅包括七个部件。参见图16-18，这七个部件可包括主体110、击发触发器190、将触发器190可枢转地连接到主体110的铰链销193、与锁定杆195一体形成的触发器弹簧191、砧座调节轴170、可操作地接合轴的螺旋表面174的螺销(未示出，参见例如图3所示的螺销75)以及驱动杆180。另外，可以进一步减少部件数。例如，通过将例如铰链止动装置或柔性接片组合到触发器190自身中，即可以取消铰链销193。此外，弹簧191和锁定杆195也可与触发器190一体形成。另外，通过加入从主体110内表面延伸的突起，使得螺旋突起可以接合螺旋表面174，从而可以取消螺销(未示出)。在任何情况下，外科缝合器101的前述部件可以提供与上面所述类似的功能。这种仅使用少许制造技术的简化的缝合器结构可以广泛地应用，并应适用于多用途可消毒装置，该装置相比类似的目前可用的外科缝合器成本明显更低，并且所需制造时间更少。因此，在至少一个实施例中，可以提供包括上述部件而减少砧座和缝合头部件的可重复使用的缝合器。此外，在至少一个实施例中，包括钉仓的砧座和/或缝合头也可以是一次性的。
在至少一个示例性实验中，通过将每个部件与部件标准列表进行对比以查看是否需要该部件，实现上述部件数的最少化。剩下的仅是以上列出和出于组装原因而需要的部件、具有独特材料性质的部件，或者相对于缝合器中其他部件移动的部件。
虽然已经描述了各实施例，但应当知道，掌握了各种实施例的一些或全部优点的本领域技术人员可能会想到这些实施例的各种修改、变型和变通形式。例如，根据各种实施例，单个部件或步骤可被多个部件或步骤代替，并且多个部件或步骤可被单个部件或步骤代替，以执行给定的一个或多个功能或实现给定目的。此外，以上所述各种部件可由多种材料制成。例如，各部件可由金属、塑料和/或生物相容性材料的任何组合制成。而且，诸如触发器、驱动带和砧座调节带的各种部件可由金属片制造和弯曲或折叠而成。因此，在不脱离所附权利要求书的范围和精神的情况下，本专利申请旨在涵盖所有这类修改、变型和变通形式。
本申请公开的装置可被设计为在一次使用之后丢弃，或它们可被设计为多次使用。然而无论是哪种情况，该装置都可在至少使用一次后经过修复再行使用。修复的步骤可包括装置的拆卸、清洗或更换具体部件以及后续重新组装步骤的组合。具体来讲，该装置可以拆卸，并且可以任意组合对任意数目的具体部件或零件进行选择性地更换或移除。清洗和/或更换具体部件后，可在修理厂将器械重新装配，或在紧临外科手术前由外科小组人员将器械重新装配，以供后续使用。本领域技术人员将会知道，修理装置时可以采用多种不同技术来拆卸、清洗/更换和组装。这些技术的使用以及所得的修复装置均在本发明的范围内。
本申请中的所述装置可在手术之前进行处理。首先，获取新的或用过的器械，并根据需要进行清洗。然后可对器械进行消毒。在一种消毒技术中，将器械置于封闭并密封的容器中，例如塑料或TYVEK
Figure BPA00001564211900191
口袋中。然后将容器和器械置于可穿透该容器的辐射场，例如γ辐射、X射线或更高能量的电子辐射。辐射将杀死器械上和容器中的细菌。然后可将消毒后的器械保存在消毒容器中。该密封容器将器械保持在无菌状态下，直到在医疗设施中打开该容器。
以引证方式全部或部分地并入本申请的任何专利、公布、或其他公开材料仅在所并入的材料不与本发明所述的现有定义、陈述、或其他公开材料相冲突的范围内并入本申请。同样地并且在必要的程度下，本申请明确阐述的公开内容取代了以引证方式并入本申请的任何冲突材料。如果任何材料或其部分据述以引证方式并入本申请，但与本申请所述的现有定义、陈述或其它公开材料相冲突，那么仅在所并入的材料和现有公开材料之间不产生冲突的程度下才将其并入本申请。

Claims (20)

1.一种外科缝合器，包括：
主体，所述主体包括：
柄部；和
轴部，所述轴部从所述柄部延伸；
缝合头组件，所述缝合头组件可脱离地连接到所述轴部，所述缝合头组件包括：
钉仓，所述钉仓用于支撑一个或多个外科缝钉；和
至少一个缝钉驱动器，所述至少一个缝钉驱动器用于接合和驱动来自所述钉仓的所述缝钉；
驱动系统，所述驱动系统用于施加驱动运动到所述缝钉驱动器；
砧座，所述砧座相对于所述钉仓被可动地支撑，以便进行朝着和远离所述钉仓的轴向运动；和
砧座调节组件，所述砧座调节组件用于选择性地调节所述砧座相对于所述钉仓的轴向位置，其中所述砧座调节组件包括调节轴和连接到所述调节轴以与所述调节轴一起行进的套管针，所述套管针能够用于可拆卸地连接到所述砧座，其中所述调节轴或所述主体中的一个包括接合部，并且其中所述调节轴或所述主体中的另一个包括：
螺旋表面，所述螺旋表面包括至少一个斜坡部分、至少一个停顿部分和至少一个限定器，所述至少一个限定器将所述至少一个停顿部分与所述至少一个斜坡部分分开，所述至少一个斜坡部分能够可操作地与所述接合部接合，以在所述调节轴旋转时，使所述调节轴相对于所述主体运动。
2.根据权利要求1所述的外科缝合器，还包括可动地连接到所述主体的触发器，所述触发器能够当所述触发器运动时启动所述驱动系统，其中所述调节轴包括限定第一宽度的第一部分和限定第二宽度的第二部分，其中所述触发器还包括限定具有一尺寸的开口的锁定杆，其中所述开口的尺寸小于所述第一宽度，但所述开口大于或等于所述第二宽度。
3.根据权利要求1所述的外科缝合器，其中所述至少一个限定器为凸耳。
4.根据权利要求1所述的外科缝合器，其中所述至少一个限定器为突起。
5.根据权利要求1所述的外科缝合器，其中螺旋表面限定表面形貌，并且其中所述至少一个限定器为所述表面形貌中的中断部。
6.根据权利要求1所述的外科缝合器，其中所述至少一个斜坡部分以相对于所述调节轴的轴线小于90度的角度倾斜，并且所述至少一个停顿部分基本上垂直于所述调节轴的轴线。
7.根据权利要求1所述的外科缝合器，还包括位于所述砧座调节轴上与所述至少一个停顿部分相关联的可视标记。
8.一种外科缝合器，包括：
主体；
缝合头，所述缝合头可操作地连接到所述主体；
砧座，所述砧座相对于所述缝合头被可动地支撑，以便进行朝着和远离所述缝合头的选择性行进；和
砧座调节轴，所述砧座调节轴由所述主体支撑以便选择性地调节所述砧座相对于所述缝合头的位置，其中所述调节轴或所述主体中的一个包括接合部，并且其中所述调节轴或所述主体中的另一个包括：
螺旋表面，所述螺旋表面包括第一部分和第二部分，所述第一部分能够可操作地与所述接合部接合，以在所述调节轴旋转时，使所述调节轴相对于所述主体运动；和
至少一个限定器，所述至少一个限定器将所述第一部分与所述第二部分分开。
9.根据权利要求8所述的外科缝合器，其中所述至少一个限定器为凸耳。
10.根据权利要求8所述的外科缝合器，其中所述至少一个限定器为突起。
11.根据权利要求8所述的外科缝合器，其中螺旋表面限定表面形貌，并且其中所述至少一个限定器为所述表面形貌中的中断部。
12.根据权利要求8所述的外科缝合器，其中所述第一部分以相对于所述调节轴的轴线小于90度的角度倾斜，并且所述第二部分基本上垂直于所述调节轴的轴线。
13.根据权利要求8所述的外科缝合器，还包括可动地连接到所述主体的触发器，所述触发器能够当所述触发器运动时启动所述驱动系统，其中所述调节轴包括限定第一宽度的第一部分和限定第二宽度的第二部分，其中所述触发器还包括限定具有一尺寸的开口的锁定杆，其中所述开口的尺寸小于所述第一宽度，但所述开口大于或等于所述第二宽度。
14.一种外科缝合器，包括：
主体；
缝合头，所述缝合头可操作地连接到所述主体；
砧座，所述砧座相对于所述缝合头被可动地支撑，以便进行朝着和远离所述缝合头的选择性行进；和
砧座调节轴，所述砧座调节轴由所述主体支撑以便选择性地调节所述砧座相对于所述缝合头的位置，其中所述调节轴或所述主体中的一个包括接合部，并且其中所述调节轴或所述主体中的另一个包括：
螺旋表面，所述螺旋表面包括至少一个斜坡部分和至少一个停顿部分，所述至少一个斜坡部分能够可操作地与所述接合部接合，以在所述调节轴旋转时，使所述调节轴相对于所述主体运动。
15.根据权利要求3所述的外科缝合器，其中所述至少一个斜坡部分以相对于所述调节轴的轴线小于90度的角度倾斜，并且所述至少一个停顿部分基本上垂直于所述调节轴的轴线。
16.根据权利要求14所述的外科缝合器，还包括位于所述至少一个斜坡部分和所述至少一个停顿部分之间的至少一个限定器。
17.根据权利要求16所述的外科缝合器，其中所述至少一个限定器为凸耳。
18.根据权利要求16所述的外科缝合器，其中所述至少一个限定器为突起。
19.根据权利要求16所述的外科缝合器，其中所述螺旋表面限定表面形貌，并且其中所述至少一个限定器为所述表面形貌中的中断部。
20.根据权利要求14所述的外科缝合器，还包括可动地连接到所述主体的触发器，所述触发器能够当所述触发器运动时启动所述驱动系统，其中所述调节轴包括限定第一宽度的第一部分和限定第二宽度的第二部分，其中所述触发器还包括限定具有一尺寸的开口的锁定杆，其中所述开口的尺寸小于所述第一宽度，但所述开口大于或等于所述第二宽度。
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US8136712B2 (en) 2012-03-20
US20110139852A1 (en) 2011-06-16
CA2783159C (en) 2018-02-13
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