CN103298419A - 具有模块化轴和端部执行器的外科器械 - Google Patents

具有模块化轴和端部执行器的外科器械 Download PDF

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Publication number
CN103298419A
CN103298419A CN201180063919XA CN201180063919A CN103298419A CN 103298419 A CN103298419 A CN 103298419A CN 201180063919X A CN201180063919X A CN 201180063919XA CN 201180063919 A CN201180063919 A CN 201180063919A CN 103298419 A CN103298419 A CN 103298419A
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China
Prior art keywords
assembly
end effector
surgical instruments
coupling assembly
axle
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CN201180063919XA
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CN103298419B (zh
Inventor
K·L·豪泽
C·G·金博尔
G·M·蒙森
R·W·蒂姆
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Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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Abstract

本发明公开了一种能够操作以切断组织的外科器械，其包括主体组件和能够选择性地联接的端部执行器组件。所述端部执行器组件可包括传输组件、端部执行器和旋转旋钮，所述旋转旋钮能够操作以使传输组件和端部执行器旋转。所述主体组件包括触发器和壳体，所述壳体具有能够容纳端部执行器组件的一部分的远侧孔。第一联接机构部分和第二联接机构部分协作地将端部执行器组件联接到主体组件以供使用。所述联接可通过多种联接机构将端部执行器组件机械地联接到和/或电联接到主体组件。例如，螺纹滑动螺母可联接到主体组件内的螺纹。在一种构型中，端部执行器组件可具有锁定接片，所述锁定接片旋转进入主体组件的旋转凹槽。锁定接片可包括电触头和/或光学上可感知的指示器。

Description

具有模块化轴和端部执行器的外科器械
Kevin L.Houser
Cory G.Kimball
Gavin M.Monson
Richard W.Timm
优先权
本专利申请要求2010年11月5日提交的名称为“Energy-BasedSurgical Instruments”的美国临时申请序列号61/410,603的优先权，其公开内容以引用方式并入本文。
本专利申请还要求2011年5月19日提交的名称为“Energy-BasedSurgical Instruments”的美国临时申请序列号61/487,846的优先权，其公开内容以引用方式并入本文。
本专利申请还要求2011年10月10日提交的名称为“SurgicalInstrument with Modular Shaft and End Effector”的美国非临时申请序列号13/269,870，其公开内容以引用方式并入本文。
背景技术
在一些情况下，内窥镜式外科器械可优于传统的开放式外科装置，因为较小的切口可减少术后恢复时间和并发症。因此，一些内窥镜式外科器械可适于将远端执行器通过套管针的插管设置在期望的手术部位处。这些远端执行器（例如，直线切割器、抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因治疗递送装置、以及使用超声、射频、激光等的能量递送装置）可按多种方式接合组织，以达到诊断或治疗效果。内窥镜式外科器械可包括轴，所述轴位于端部执行器与由临床医生操纵的柄部部分之间。此类轴可使得插入期望深度并围绕所述轴的纵向轴线旋转成为可能，从而有利于将端部执行器定位在患者体内。
内窥镜式外科器械的例子包括公开于下述专利中的那些：2008年8月26日公布的名称为“Motor-Driven Surgical Cutting and Fastening Instrumentwith Loading Force Feedback”的美国专利7,416,101，其公开内容以引用方式并入本文；2010年6月15日公布的名称为“Post-SterilizationProgramming of Surgical Instruments”的美国专利7,738,971，其公开内容以引用方式并入本文；2006年4月13日公布的名称为“Tissue Pad for Usewith an Ultrasonic Surgical Instrument”的美国公布2006/0079874，其公开内容以引用方式并入本文；2007年8月16日公布的名称为“UltrasonicDevice for Cutting and Coagulating”美国公布2007/0191713，其公开内容以引用方式并入本文；2007年12月6日公布的名称为“UltrasonicWaveguide and Blade”美国公布2007/0282333，其公开内容以引用方式并入本文；2008年8月21日公布的名称为“Ultrasonic Device for Cutting andCoagulating”美国公布2008/0200940，其公开内容以引用方式并入本文；2009年6月4日公布的名称为“Cordless Hand-held Ultrasonic CauteryCutting Device”美国专利公布2009/0143797，其公开内容以引用方式并入本文；2009年8月20日公布的名称为“Motorized Surgical Cutting andFastening Instrument Having Handle Based Power Source”美国公布2009/0209990，其公开内容以引用方式并入本文；2010年3月18日公布的名称为“Ultrasonic Device for Fingertip Control”美国公布2010/0069940，其公开内容以引用方式并入本文；以及2011年1月20日公布的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国公布2011/0015660，其公开内容以引用方式并入本文。类似地，医疗装置可适于包括便携式电源的多种方式公开于2010年11月5日提交的名称为“Energy-Based Surgical Instruments”的美国临时专利申请序列号61/410,603中，其公开内容以引用方式并入本文。
附加的示例性内窥镜式外科器械的例子包括公开于下述专利中的那些：2002年12月31日公布的名称为“Electrosurgical Systems andTechniques for Sealing Tissue”的美国专利6,500,176，其公开内容以引用方式并入本文；2006年9月26日公布的名称为“Electrosurgical Instrumentand Method of Use”的美国专利7,112,201，其公开内容以引用方式并入本文；2006年10月24日公布的名称为“Electrosurgical Working End forControlled Energy Delivery”的美国专利7,125,409，其公开内容以引用方式并入本文；2007年1月30日公布的名称为“Electrosurgical Probe andMethod of Use”的美国专利7,169,146，其公开内容以引用方式并入本文；2007年3月6日公布的名称为“Electrosurgical Jaw Structure for ControlledEnergy Delivery”的美国专利7,186,253，其公开内容以引用方式并入本文；2007年3月13日公布的名称为“Electrosurgical Instrument”的美国专利7,189,233，其公开内容以引用方式并入本文；2007年5月22日公布的名称为“Surgical Sealing Surfaces and Methods of Use”的美国专利7,220,951，其公开内容以引用方式并入本文；2007年12月18日公布的名称为“Polymer Compositions Exhibiting a PTC Property and Methods ofFabrication”的美国专利7,309,849，其公开内容以引用方式并入本文；2007年12月25日公布的名称为“Electrosurgical Instrument and Method ofUse”的美国专利7,311,709，其公开内容以引用方式并入本文；2008年4月8日公布的名称为“Electrosurgical Instrument and Method of Use”的美国专利7,354,440，其公开内容以引用方式并入本文；2008年6月3日公布的名称为“Electrosurgical Instrument”的美国专利7,381,209，其公开内容以引用方式并入本文；2011年4月14日公布的名称为“Surgical InstrumentComprising First and Second Drive Systems Actuatable by a Common TriggerMechanism”的美国公布2011/0087218，其公开内容以引用方式并入本文；以及2011年6月2日提交的名称为“Motor Driven ElectrosurgicalDevice with Mechanical and Electrical Feedback”的美国专利申请13/151,181，其公开内容以引用方式并入本文。
另外，外科器械可用于或可适用于机器人辅助的外科手术场景，例如公开于2004年8月31日公布的名称为“Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument”的美国专利6,783,524中的那些，其公开内容以引用方式并入本文。
尽管已研制出多种系统和方法并已将其用于外科器械，但据信在本发明人之前尚无人研制出或使用所附权利要求中描述的发明。
附图说明
尽管本说明书以特别指出并明确要求保护本技术的权利要求书作出结论，但据信通过以下结合附图对某些例子所作的描述将会更好地理解本技术，附图中类似的附图标号表示相同元件，其中：
图1描绘了包括外科器械和发生器的示例性外科系统的透视图；
图2描绘了另一个示例性外科器械的柄部的侧剖面图；
图3A描绘了图2所示的外科器械的端部执行器示为处于打开位置时的侧正视图；
图3B描绘了图3A所示的端部执行器示为处于闭合位置时的侧正视图；
图4描绘了图3A所示的端部执行器的下钳口的顶部平面图；
图5A描绘了第一示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图5B描绘了图5A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图6A描绘了第二示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图6B描绘了图6A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图7A描绘了第三示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图7B描绘了图7A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图8A描绘了第四示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图8B描绘了图8A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图9A描绘了第五示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图9B描绘了图9A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图10A描绘了第六示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图10B描绘了图10A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图11A描绘了第七示例性联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了脱离的端部执行器组件；
图11B描绘了图11A所示的联接机构的侧正视图，其示出了联接到柄部组件的端部执行器组件；
图12描绘了适用于第八示例性联接机构的示例性端部执行器组件的侧剖面图；
图13描绘了图12所示的端部执行器组件的后正视图；
图14描绘了能够容纳图12的端部执行器组件的柄部组件的前正视图；
图15描绘了第一电联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了联接的端部执行器组件；
图16描绘了第二电联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了联接的端部执行器组件；并且
图17描绘了第三电联接机构的侧正视图，其中柄部组件的一部分被移除以示出其内部并且其示出了联接的端部执行器组件；
附图并非旨在以任何方式进行限制，并且预期本技术的各种实施例能够以多种其他方式来执行，包括那些并不一定描绘于附图中的方式。附图并入本说明书中并构成其一部分，其示出了本技术的多个方面，并与说明书一起用于说明本技术的原理；然而，应当理解，本技术不限于所示出的明确布置方式。
具体实施方式
对本技术的某些例子的下述描述不应用于限制其范围。通过以下说明设想用于实施本技术的最佳方式之一的描述，本技术的其他例子、结构、方面、实施例和优点对于本领域的技术人员将变得显而易见。应当认识到，本文所述的技术包括不脱离本技术的所有其他的不同和明显方面。因此，附图和说明书应被视为实质上是示例性的，而非限制性的。
应当理解，以下的教导内容可容易地应用于本文所引用的任一个参考文献中。可将下述教导内容与本文引用的参考文献组合的各种合适方式对于本领域的普通技术人员而言将是显而易见的。
I.示例性超声外科系统的概述
图1示出了示例性超声外科系统10，其包括超声外科器械50、发生器20和缆线30，该缆线能够操作以将发生器20联接到外科器械50。合适的发生器20为由Ethicon Endo-Surgery,Inc.（Cincinnati,Ohio）出售的GEN300。仅以举例的方式，发生器20可根据2011年4月14日公布的名称为“Surgical Generator for Ultrasonic and Electrosurgical Devices”的美国公布2011/0087212的教导内容来构造，其公开内容以引用方式并入本文。应该指出的是，将参考超声外科器械来描述外科器械50；然而，应当理解下文所述的技术可用于多种外科器械，包括但不限于直线切割器、抓紧器、切割器、缝合器、施夹钳、进入装置、药物/基因治疗递送装置、以及使用超声、射频、激光等的能量递送装置、和/或它们的任何组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。此外，尽管本例将参照电缆连接的外科器械50进行描述，但应当理解，外科器械50可适于无线操作，例如公开于2009年6月4日公布的名称为“Cordless Hand-held Ultrasonic Cautery Cutting Device”的美国专利公布2009/0143797中的那些，其公开内容以引用方式并入本文。此外，外科装置50也可用于或适用于机器人辅助外科装置，例如公开于2004年8月31日公布的名称为“Robotic Surgical Tool with Ultrasound Cauterizing andCutting Instrument”的美国专利6,783,524中的那些。
本例中的外科器械50包括多部件柄部组件60、细长的传输组件70和换能器100。传输组件70在其近端处连接至多部件柄部组件60并且从多部件柄部组件60朝远侧延伸。在本例中，传输组件70能够为细长的、细管状组件以用于内窥镜式用途，但应当理解，作为另外一种选择，传输组件70可为短组件，例如公开于2007年12月6日公布的名称为“UltrasonicWaveguide and Blade”的美国专利公布2007/0282333，以及2008年8月21日公布的名称为“Ultrasonic Device for Cutting and Coagulating”的美国专利公布2008/0200940中的那些，其公开内容以引用方式并入本文。本例中的传输组件70包括外部护套72、内部管状致动构件（未示出）、波导（未示出）、以及位于传输组件70的远端上的端部执行器80。在本例中，端部执行器80包括联接至波导的刀片82、能够操作以在传输组件70的近端处枢转的夹持臂84、以及可选的一个或多个联接至夹持臂84的夹持垫86。还应当理解，夹持臂84以及相关的结构可根据1999年11月9日公布的名称为“Ultrasonic Clamp Coagulator Apparatus Having ImprovedClamp Arm Pivot Mount”的美国专利5,980,510的教导内容中的至少一些来构造和操作，其公开内容以引用方式并入本文。能够将超声能量从换能器100传输到刀片82的波导可为柔性、半柔性或刚性的。一种仅为示例性的超声换能器100为由Ethicon Endo-Surgery,Inc.（Cincinnati,Ohio）出售的型号HP054。如本领域中所熟知，波导也可为能够将通过波导传输到刀片82的机械振动放大。波导还可具有控制沿波导的纵向振动增益的结构，并且具有将波导调谐至系统谐振频率的结构。
在本例中，刀片82的远端被设置在波腹附近，以便在声学组件未被组织加载时将其调谐至优选的共振频率fo。当换能器100通电时，刀片82的远端能够在例如大约10至500微米峰间范围内、并且优选地在约20至约200微米的范围内以例如55.5kHz的预定振动频率fo纵向运动。当本例中的换能器100被激活时，这些机械振荡通过波导被传输到端部执行器80。在本例中，联接到波导的刀片82在超声频率下振荡。因此，当将组织固定在刀片82与夹持臂84之间时，刀片82的超声振荡可同时切割组织并且使相邻组织细胞中的蛋白质变性，由此提供具有相对较少热扩散的促凝效果。也可通过刀片82和夹持臂84提供电流以另外烧灼组织。尽管已描述出传输组件70和换能器100的一些构型，但参考本文的教导内容，传输组件70和换能器100的其他合适构型对于本领域的普通技术人员而言将是显而易见的。
本例中的多部件柄部组件60包括配对外壳部分62和下部64。配对外壳部分62能够在其近端处容纳换能器100并且在其远端处容纳传输组件70的近端。在配对外壳部分62的远端上设有将在下文更详细地描述的孔，用于各种传输组件70的插入。在本例中示出了用于旋转传输组件70和/或换能器100的旋转旋钮66，但应当理解，旋转旋钮66仅为可选的。多部件柄部组件60的下部64包括触发器68并且能够由用户使用单手抓握。下部64的一种仅示例性替代构型描绘于2011年1月20日公布名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国的专利公布2011/0015660的图1中，其公开内容以引用方式并入本文。开关按钮（未示出）可位于下部64的远侧表面上，并且能够操作以利用发生器20以不同操作水平激活换能器100。例如，第一开关按钮可激活处于最大能量水平的换能器100而第二开关按钮可激活处于最小、非零能量水平的换能器100。当然，开关按钮可为能够用于除最大和/或最小能量水平之外的能量水平，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。此外，开关按钮可位于多部件柄部组件60上、换能器100上、和/或远离外科器械50的任何其他位置，并且可提供任意数量的开关按钮。尽管已参照两个不同部分62,64来描述多部件柄部组件60，但应当理解，多部件柄部组件60可为两个部分62,64结合在一起的一体组件。作为另外一种选择，多部件柄部组件60可分成多个分立元器件，例如单独的触发器部分（可通过用户的手或脚来操作）和单独的配对外壳部分62。触发器部分可为能够操作以激活换能器100并且可远离配对外壳部分62。多部件柄部组件60可由耐用塑料（例如聚碳酸酯或液晶聚合物）、陶瓷、和/或金属、或任何其他合适的材料来构造，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。参考本文的教导内容，多部件柄部组件60的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，器械50可作为机器人系统的一部分进行操作。参考本文的教导内容，多部件柄部组件60的其他构型对于本领域的普通技术人员也将是显而易见的。仅以举例的方式，外科器械50可根据下述专利的教导内容中的至少一些来构造：美国专利5,980,510、美国专利公布2006/0079874、美国专利公布2007/0191713、美国专利公布2007/0282333、美国专利公布2008/0200940、美国专利公布2011/0015660、美国专利6,500,176、美国专利公布2011/0087218、和/或美国专利公布2009/0143797中所述。
用于外科器械50的附加可选的构型和结构描述于与本专利同一天提交的名称为“Ultrasonic Surgical Instrument with Modular End Effector”的美国专利申请序列号[代理人案卷号END7012USNP.0587824]，其公开内容以引用方式并入本文。
II.示例性射频(RF)外科器械的概述
尽管一些外科器械适于使用超声能量在组织上进行操作，但是其他外科器械例如示出于图2-3B中的外科器械150，能够向患者的组织提供能量，例如电能和/或热能。外科器械150包括柄部组件152、传输组件170、以及联接到传输组件170的远端的端部执行器200（示出于图3A-3B）。如下文更详细地所述，柄部组件152可包括一个或多个开关和/或触发器以将电能提供至端部执行器200、和/或在端部执行器200内推进刀或切割构件210（同样示出于图3A-3B）以横切被定位在端部执行器200内的组织。
A.示例性柄部组件
参见图2，柄部组件152包括与电源（未示出）可操作地联接的一个或多个电输入端160，所述电源为例如发生器20和/或任何其他电源，包括例如容纳在柄部组件152内的电源。传输组件170从柄部组件152朝远侧延伸并且包括联接到传输组件170的远端的端部执行器200。电源向外科器械150提供电流，并且电源可为能够操作以控制电流的量级、持续时间、波形、和/或频率，以向外科器械150提供所需量的能量。本例中的柄部组件152包括柄部主体154，所述柄部主体能够支撑开关或触发器156以使电输入端160与延伸穿过传输组件170的第一导体220电联接，使得提供至输入端160的电流可被传输至端部执行器200。如图2所示，柄部主体154包括两个纵向均分部分，所述两个纵向均分部分组装在一起以形成柄部主体154。如图2所绘，一个部分已被省略以示出柄部组件152的多个内部部件中的一些。在各种实施例中，柄部主体154的两个半块可搭扣配合、按扣配合、焊接在一起、附着在一起、和/或彼此扣紧，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。此外，柄部组件152可为一体式部件，而不是两个离散的半块。在另一个供选择的替代方案中，所述部分可不为半块，而仅为离散的可联接部件，例如具有可移除顶部和/或侧部的柄部主体154。参考本文的教导内容，柄部主体154的其他构型对于本领域的普通技术人员而言将是显而易见的。
第一导体220包括线材，例如绝缘电线，所述线材在触发器156与第一电极230（示出于图3A-3B中的端部执行器200中）之间并且也在触发器156与输入端160之间延伸。在本例中，尽管第一导体220联接到上钳口206中的第一电极230和下钳口208中的第一电极230，但是应当理解第一电极230可仅在上钳口206中或仅在下钳口208中。第一滑环176将延伸穿过传输组件170的第一导体220的一部分电联接到容纳在柄部组件152内的第一导体220的一部分。柄部组件152还包括第二导体222，所述第二导体通过输入端160也电联接到电源并且延伸穿过传输组件170至端部执行器200至第二电极232。在本例中，尽管第二导体222联接到上钳口206中的第二电极232和下钳口208中的第二电极232，但是应当理解第二电极232可仅在上钳口206中或仅在下钳口208中。传输组件170包括外部护套172，所述外部护套与轴174共轴并且围绕轴174设置，使得轴174容纳在外部护套172内。第二导体222包括具有绝缘塑性夹套或护套的线材，以使第二导体222相对于第一导体220、轴174、和/或第一电极230绝缘。第二滑环178能够将延伸穿过传输组件170的第二导体222的一部分电联接到容纳在柄部组件152内第二导体222的一部分。本例中的滑环176,178包括被安装到柄部主体154的圆形或至少半圆形触头并且其与被安装到传输组件170的一部分的对应圆形或至少半圆形触头保持接触。滑环176,178因此允许传输组件170相对于柄部组件152旋转，而仍提供穿过传输组件170的用于第一导体220和第二导体222的电路经。
当然，柄部组件152和外科器械150可包括其他构型。例如，柄部组件152和/或外科器械150可包括组织切割元件以及将双极性射频能量传输至组织（例如，以凝结或密封组织）的一个或多个元件。此类装置的一个例子是由Ethicon Endo-Surgery,Inc.(Cincinnati,Ohio)制造的
Figure BDA00003450541500101
组织密封装置。此类装置的其他例子以及相关理念公开于下列美国专利中：2002年12月31公布的名称为“Electrosurgical Systems and Techniques forSealing Tissue”的美国专利6,500,176，其公开内容以引用方式并入本文；2006年9月26日公布的名称为“Electrosurgical Instrument and Method ofUse”的美国专利7,112,201，其公开内容以引用方式并入本文；2006年10月24日公布的名称为“Electrosurgical Working End for Controlled EnergyDelivery”的美国专利7,125,409，其公开内容以引用方式并入本文；2007年1月30日公布的名称为“Electrosurgical Probe and Method of Use”的美国专利7,169,146，其公开内容以引用方式并入本文；2007年3月6日公布的名称为“Electrosurgical Jaw Structure for Controlled Energy Delivery”的美国专利7,186,253，其公开内容以引用方式并入本文；2007年3月13日公布的名称为“Electrosurgical Instrument”的美国专利7,189,233，其公开内容以引用方式并入本文；2007年5月22日公布的名称为“SurgicalSealing Surfaces and Methods of Use”的美国专利7,220,951，其公开内容以引用方式并入本文；2007年12月18日公布的名称为“PolymerCompositions Exhibiting a PTC Property and Methods of Fabrication”的美国专利7,309,849，其公开内容以引用方式并入本文；2007年12月25日公布的名称为“Electrosurgical Instrument and Method of Use”的美国专利7,311,709，其公开内容以引用方式并入本文；2008年4月8日公布的名称为“Electrosurgical Instrument and Method of Use”的美国专利7,354,440，其公开内容以引用方式并入本文；2008年6月3日公布的名称为“Electrosurgical Instrument”的美国专利7,381,209，其公开内容以引用方式并入本文；2011年4月14日公布的名称为“Surgical InstrumentComprising First and Second Drive Systems Actuatable by a Common TriggerMechanism”的美国公布2011/0087218，其公开内容以引用方式并入本文；以及2011年6月2日提交的名称为“Motor Driven ElectrosurgicalDevice with Mechanical and Electrical Feedback”的美国专利申请13/151,181，其公开内容以引用方式并入本文。
B.示例性射频端部执行器
本例中的端部执行器200包括上钳口206和下钳口208。上钳口206能够相对于下钳口208枢转并且能够操作以经由轴174的致动来夹紧上钳口206与下钳口208之间的组织。轴174的致动可经由触发器156的致动、通过第二触发器、通过按钮、通过马达、通过螺线管、和/或通过任何其他合适的方法来完成。本例中的上钳口206和下钳口208两者均包括第一电极230，所述第一电极在端部执行器200（示出于图3A-3B中）的近端202与远端204之间延伸。如图4所示，本例中的第一电极230包括沿上钳口206和下钳口208两者的第一侧面延伸的第一侧向部分、沿上钳口206和下钳口208两者的第二侧面延伸的第二侧向部分、以及联接用于上钳口206和下钳口208两者的第一侧向部分和第二侧向部分的横向端部。本例中的上钳口206和下钳口208还包括第二电极232，所述第二电极具有类似于第一电极230的形状，但与第一电极230绝缘并且嵌入第一电极230。在一些型式中，对于上钳口206第一电极230可被嵌入第二电极232，而对于下钳口208第二电极232被嵌入第一电极230，或者反之亦然。在其他型式中，上钳口206包括仅第一电极230并且下钳口208包括仅第二电极232，或者反之亦然。在另一中构型中，第二电极232可为能够利用切割构件210致动。上钳口206和下钳口208两者均包括纵向槽（未示出），所述纵向槽能够允许切割构件210在其中纵向地平移。端部执行器200的其他构型公开于下列专利中：美国专利6,500,176、美国专利7,112,201、美国专利7,125,409、美国专利7,169,146、美国专利7,186,253、美国专利7,189,233、美国专利7,220,951、美国专利7,309,849、美国专利7,311,709、美国专利7,354,440、美国专利7,381,209、美国专利公布2011/0087218、和/或提交于2011年6月2日的名称为“Motor Driven Electrosurgical Device with Mechanical and ElectricalFeedback”的美国专利申请13/151,181，其公开内容以引用方式并入本文。
在本例中，触发器156（示出于图2）能够操作以夹紧上钳口206与下钳口208之间的组织以及通过第一导体220将来自电源的能量选择性地提供至第一电极230，尽管这仅为可选的。在一些型式中，触发器156可为能够操作以夹紧组织，同时按钮经由第一导体220将来自电源的能量选择性地提供至第一电极230。第二电极232可当电源被联接到电输入端160时经由第二导体222保持持续地联接到电源，或作为另外一种选择，第二触发器和/或按钮可将电力选择性地提供至第二电极232。因此，当触发器156被致动时，电流从第一电极230流至第二电极232以烧灼它们之间的组织。这种热量可使组织内的胶原变性，并且与由端部执行器200的钳口206,208提供的夹紧压力合作，变性的胶原可在组织内形成密封。在本例中，端部执行器200能够使用双极性射频能量以密封组织，但是应当理解在其他型式中可使用单极性射频能量和/或热量加热元件。作为促使电流流动的触发器156的另外一种选择，单独的按钮157可被用于向电极230,232提供电力。例如，触发器156可仅被用于将钳口206,208机械地夹紧在一起；而按钮157将信号发送至电源例如发生器20，以向电极230,232提供电流。除此之外或作为另外一种选择，按钮157可向触发器156提供机械锁定或机电锁定，使得触发器156不能够完全地被致动，除非按钮157同时被按下。除此之外或作为此类功能的另外一种选择，触发器156还可向按钮157提供锁定。
在本例中，电极230,232的第一侧面能够在组织内形成第一密封并且电极230,232的第二侧面能够在组织内形成第二密封。当然，其他构型可包括多个电极、和/或多个电极部分，其可在组织内形成任何合适数量的密封。随着组织在上钳口206和下钳口208的纵向槽的任一端上被密封，切割构件210朝远侧被致动以切断组织的两个被密封的部分。在一些型式中，切割构件210可在密封组织之后被致动。除此之外或作为上述的另外一种选择，可将射频能量提供至切割构件210以进一步帮助切断组织。实际上，在一些型式中，切割构件210可为钝的并且通过将射频能量提供至该钝的切割构件210并且朝远侧推进切割构件210来切断组织。此外，切割构件210可通过第二触发器（未示出）来致动，或作为一种选择，通过另外致动触发器156来致动。在本例中，切割构件210包括在刀片的相对端上的上凸缘和下凸缘，从而形成I形构件。随着切割构件210朝远侧被致动，所述凸缘帮助抵靠下钳口208来压缩上钳口206。
当然，端部执行器200和外科器械150也可包括其他构型，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。
III.用于模块化轴和端部执行器的示例性联接机构
在一些情况下，可能有用的是在使用相同柄部组件60,152的同时，在各种轴长度和/或各种类型的端部执行器80,200之间作出改变。例如，在一些手术中，可能需要切割大量的组织，从而要求不同长度的端部执行器80,200和/或用于传输组件70,170的轴。此类可互换的轴和/或端部执行器80,200可能允许将共同的柄部组件60,152用于多种外科手术（例如短轴用于开放性外科手术，长轴用于微创腹腔镜式外科手术等）。此外，与使用具有不同长度轴的新外科器械50,150相比，更换轴和/或端部执行器80,200而重复使用相同柄部组件60,152可能更节省时间和/或成本。仅以举例的方式，此类轴和/或端部执行器80,200可包括彩色代码以区分不同长度和/或类型。在另一个实例中，柄部组件60,152可为能够采用不同类型的端部执行器，例如柄部组件60,152可包括多个部件以操作超声端部执行器80和/或射频端部执行器200。因此，改变具有共同柄部组件60，152的轴和端部执行器80,200可节省时间和/或成本。因此，下文描述了用于将模块化轴联接到柄部组件60,152的多种联接机构。应当理解，在其中使用超声端部执行器80的型式中，换能器100的至少一部分可与轴和端部执行器80成整体，并且因此可与柄部组件60选择性地联接。作为另外一种选择，换能器100可与柄部组件60成整体，使得当轴和端部执行器80与柄部组件60选择性地联接时，轴和端部执行器80与换能器100选择性地联接。
A.轴上的示例性弹性的接片
第一示例性联接机构300包括接片302，所述接片从示例性端部执行器组件310（示出于图5A-5B中）的轴320的可插入部分延伸。在本例中，端部执行器组件310包括传输组件312、旋转旋钮314以及相对于旋转旋钮314朝近侧延伸的轴320。应当理解，旋转旋钮314仅为可选的并且可被省略。在其他型式中，旋转旋钮314可联接到柄部组件340并且端部执行器310可被插入穿过旋转旋钮314。旋转旋钮314能够操作以使传输组件312相对于柄部组件340和/或轴320旋转。端部执行器（未示出）联接到传输组件312的远端。端部执行器可包括超声端部执行器80、射频端部执行器200、和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。在超声端部执行器例如端部执行器80的实例中，穿过轴320的轴向孔（未示出）可允许传输组件312通过轴320机械地联接到柄部组件340内的部件，其可按与上述多部件柄部组件60类似的方式来构造。在射频端部执行器例如端部执行器200的情况下，轴向孔可允许传输组件312的一部分至少部分地延伸穿过轴320。传输组件312可包括内滑环连接器，所述内滑环连接器能够电联接到轴320的内部上的互补滑环连接器，使得可形成从柄部组件340至端部执行器的电联接。在另一个供选择的替代方案中，也可经由穿过轴320和/或端部执行器组件310上别处的孔形成流体联接。
在本例中，一对弹性的接片302从轴320向外延伸。弹性的接片302可包括弹性的非导电材料，例如塑料，或者弹性的接片302可包括导电材料，例如金属材料。如果弹性的接片302为导电的，那么其还能够操作以将端部执行器的部件电联接到柄部组件340内的部件。例如，弹性的接片302可电联接前述第一导体220和第二导体222的部分。当然，此类电联接仅为可选的。如图5A-5B中所示，随着弹性的接片302朝远侧延伸，其靠近轴320的近端联接到轴320并且从轴320的纵向轴线向外延伸。在本例中，柄部组件340被示出为具有远侧孔342，所述远侧孔形成于外壳344内并且能够容纳端部执行器组件310的轴320。柄部组件340还可根据2011年1月20日公布的名称为“Rotating Transducer Mount for UltrasonicSurgical Instruments”的美国专利公开2011/0015660、或2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for SealingTissue”的美国专利6,500,176中的用于多部件柄部组件60、用于柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。在本例中，解锁滑块318位于传输组件312的近侧部分上并且联接到内部可致动构件322（以虚线显示），所述内部可致动构件联接到接片302。解锁滑块318能够操作以朝向轴320向内牵拉弹性的接片302，从而允许使用者朝远侧经过壳体344来移除轴320。作为另外一种选择，解锁滑块318可位于旋转旋钮314上。此外，柄部组件340可包括一个或多个释放按钮（未示出），当端部执行器组件310将从柄部组件340脱离时，所述一个或多个释放按钮按下弹性的接片302。
如图5A-5B中的顺序所示，当端部执行器组件310的轴320插入远侧孔342时，弹性的接片302压靠轴320，同时端部执行器310被插入。一旦弹性的接片302的远端穿过远侧孔342通过壳体344，弹性的接片302就回弹至它们的初始方向，从而将端部执行器组件310在纵向上联接到柄部组件340。在一些情况下，使用者可致动滑块318以在弹性的接片302插入远侧孔342期间手动地回缩该弹性的接片。在超声器械的实例中，端部执行器组件310的轴320可螺纹连接到换能器例如上述换能器100的焊头上。此类螺纹连接可与压缩弹性的接片302同时地发生，或在弹性的接片302已通过壳体344之后发生。作为另外一种选择，在射频器械的实例中，轴320可联接到一个或多个电连接器（未示出），以将端部执行器联接到电源。参考图15-17，示出和描述了仅示例性的电联接件。如图5B所示，端部执行器组件310在纵向上有效地固定到柄部组件340，同时允许轴320、旋转旋钮314和/或传输组件312相对于壳体314旋转运动。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件310从柄部组件340脱离时，使用者朝远侧滑动解锁滑块318直到弹性的接片302被充分地压靠轴320，以允许使用者使轴320通过远侧孔342滑过壳体344。然后，使用者可将新的端部执行器组件310联接到柄部组件340。
当然，参考本文的教导内容，第一联接机构300的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，弹力构件302可包括膨胀弹簧以迫使接片302从轴320向外。此外，一个或多个弹性地偏置的凸轮可替换弹性的接片302。在其他型式中，弹性的接片302可能为可变形的弹性体式楔，以允许插入端部执行器组件310。此外，尽管描绘了两个弹性的接片302，但单个弹性的接片302或多于两个弹性的接片302可与第一联接机构300一起使用。此外，端部执行器组件310不必一定为能够从柄部组件340移除的。在所述实例中，使用者在外科手术后可仅处理端部执行器组件310和柄部组件340两者。如根据本文其后公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构也可与第一联接机构300组合。
B.示例性柔性柄部组件部分
第二示例性联接机构400包括壳体444的弹性地偏置的部分450，其能够捕获可供选择的示例性端部执行器组件410（示出于图6A-6B中）的轴420。在本例中，端部执行器组件410包括传输组件412、旋转旋钮414以及相对于旋转旋钮414朝近侧延伸的轴420。应当理解，旋转旋钮414仅为可选的并且可被省略。旋转旋钮414能够操作以使传输组件412相对于柄部组件440和/或轴420旋转。端部执行器（未示出）联接到传输组件412的远端。端部执行器可包括超声端部执行器80、射频端部执行器200、和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的技术人员将是显而易见的。在超声端部执行器例如端部执行器80的实例中，穿过轴420的轴向孔（未示出）可允许传输组件412通过轴420机械地联接到柄部组件440内的部件，其可按与上述多部件柄部组件60类似的方式来构造。在射频端部执行器例如端部执行器200的情况下，轴向孔可允许传输组件412的一部分至少部分地延伸穿过轴420。传输组件412可包括内滑环连接器，该内滑环连接器能够电联接到轴420的内部上的互补滑环连接器，使得可形成从柄部组件440到端部执行器的电联接。在另一个供选择的替代方案中，也可经由穿过轴420和/或端部执行器组件410上别处的孔形成流体联接。
在本例中，轴420包括周边斜坡422和周边凹槽424，该周边凹槽位于周边斜坡422的远侧但邻近旋转旋钮414。在本例中，柄部组件440被示出为具有远侧孔442，该远侧孔形成于壳体444内并且能够容纳端部执行器组件410的轴420。柄部组件440还可根据2011年1月20日公布的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国专利公开2011/0015660，或2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for Sealing Tissue”的美国专利6,500,176中的用于多部件柄部组件60、用于柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。在本例中，柄部组件440包括位于柄部组件440的远端处的一个或多个弹性地偏置的部分450。如图6A-6B中所示，一个或多个柄部452联接到弹性地偏置的部分450，以允许使用者在轴420的插入期间或为了释放轴420而手动地打开柄部组件440的远端。
如图6A-6B中的顺序所示，当端部执行器组件410的轴420插入远侧孔442时，柄部组件440的弹性地偏置的部分450在轴420的周边斜坡422的影响下向外凸出。一旦弹性地偏置的部分450的末端遇到凹槽424，弹性地偏置的部分450就回弹至它们的初始位置，从而在旋转旋钮414与周边斜坡422的远侧壁之间将端部执行器组件410联接到柄部组件440。如图6B所示，端部执行器组件410在纵向上有效地固定到柄部组件440，同时允许轴420、旋转旋钮414、和/或传输组件412相对于壳体444旋转运动。在超声器械的实例中，端部执行器组件410的轴420可螺纹连接到换能器例如上述换能器100的焊头上。此类螺纹连接可与偏转弹性地偏置的部分450同时地发生，或在弹性地偏置的部分450已回弹至凹槽424中之后发生。作为另外一种选择，在射频器械的实例中，轴420可联接到一个或多个电连接器（未示出），以将端部执行器联接到电源。参考图15-17，示出和描述了仅示例性的电联接件。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件410从柄部组件440脱离时，使用者向外牵拉弹性地偏置的部分450的一个或多个柄部452，直到弹性地偏置的部分450的端部通过周边斜坡422的远侧壁，从而允许使用者使周边斜坡422和轴420滑动经过弹性地偏置的部分450并且穿过现已扩张的远侧孔442。然后，使用者可将新的端部执行器组件410联接到柄部组件440。在一些型式中，可提供接片（未示出）以使弹性地偏置的部分450枢转打开。因此，使用者可仅需按压接片以使远侧孔442扩张。
当然，参考本文的教导内容，第二联接机构400的其他构型对于本领域的普通技术人员而言将是显而易见的。在一个可供选择的构型中，弹性地偏置的部分450可省略弹簧，并且相反可为壳体444的弹性的可偏转部分。作为另外一种选择，周边斜坡422可包括围绕轴420设置的离散的斜坡，而不是单个连续的周边斜坡。此外，示出于图5A-5B中的弹性的接片302可被用于代替周边斜坡422。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构也可与第二联接机构400组合。
C.示例性滑锁
第三示例性联接机构500包括壳体544的滑动锁定部550，其能够捕获另一个示例性端部执行器组件510（示出于图7A-7B中）的轴520。在本例中，端部执行器组件510包括传输组件512、旋转旋钮514、以及相对于旋转旋钮514朝近侧延伸的轴520。应当理解，旋转旋钮514仅为可选的并且可被省略。旋转旋钮514能够操作以使传输组件512相对于柄部组件540和/或轴520旋转。端部执行器（未示出）联接到传输组件512的远端。端部执行器可包括超声端部执行器80、射频端部执行器200和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。在超声端部执行器例如端部执行器80的实例中，穿过轴520的轴向孔（未示出）可允许传输组件512通过轴520机械地联接到柄部组件540内的部件，其可按与上述多部件柄部组件60类似的方式来构造。在射频端部执行器例如端部执行器200的情况下，轴向孔可允许传输组件512的一部分至少部分地延伸穿过轴520。传输组件512可包括内滑环连接器，该内滑环连接器能够电联接到轴520的内部上的互补滑环连接器，使得可形成从柄部组件540到端部执行器的电联接。在另一个供选择的替代方案中，也可经由穿过轴520和/或端部执行器组件510上别处的孔形成流体联接。
在本例中，轴520包括具有凹槽524的环形凸缘522，该凹槽位于环形凸缘522的远侧但邻近旋转旋钮514。滑动锁定部550包括凹口552（以虚线显示），当滑动锁定部550以能够滑动的方式被平移到锁定位置中时该凹口能够固定端部执行器组件510的轴520。凹口552可类似于图11A中所示的凹口952来构造。柄部组件540还可根据2011年1月20日公布的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国专利公开2011/0015660、或2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for Sealing Tissue”的美国专利6,500,176中的用于多部件柄部组件60、用于柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。在本例中，滑动锁定部550位于柄部组件540的远端处并且能够在打开位置（示出于图7A中）与锁定位置（示出于图7B中）之间可滑动地平移，在打开位置中开口形成于壳体544中，轴520和环形凸缘522可被插入该开口中。尽管本例中的滑动锁定部550为可手动平移的部分，但是应当理解滑动锁定部550可包括返回弹簧偏置件以使滑动锁定部返回至锁定位置。在本例中，滑动锁定部550包括接片（未示出），该接片容纳在形成于壳体544中的竖直槽（未示出）内，从而限制滑动锁定部550使其在槽内竖直平移的运动。滑动锁定部550还可包括卡扣，该卡扣能够操作以当滑动锁定部处于锁定位置时将滑动锁定部550联接到壳体544的上部。
如图7A-7B中的顺序所示，滑动锁定部550最初可滑动地向下平移以形成开口，轴520和环形凸缘522进入该开口可被插入柄部组件540。在超声器械的实例中，端部执行器组件510的轴520可螺纹连接到换能器例如上述换能器100的焊头上。此类螺纹连接可在滑动锁定部550滑入锁定位置之前、与其同时地、或之后发生。作为另外一种选择，在射频器械的实例中，轴520可联接到一个或多个电连接器（未示出），以将端部执行器联接到电源。参考图15-17，示出和描述了仅示例性的电联接件。如果采用可手动操作的滑动锁定部550，则使用者可滑动地向上平移滑动锁定部550，使得凹口552与轴520的凹槽524对齐。如图7B所示，端部执行器组件510通过滑动锁定部分550、环形凸缘522和旋转旋钮514的组合在纵向上有效地被固定到柄部组件540，同时还允许轴520、旋转旋钮514、和/或传输组件512相对于壳体544旋转运动。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件510从柄部组件540脱离时，使用者可滑动地向下平移滑动锁定部分550，直到环形凸缘522和轴520可通过滑动锁定部分550和/或凹口552。然后，使用者可将新的端部执行器组件510联接到柄部组件540。
当然，根据本文的教导内容，第三联接机构500的其他构型对于本领域的普通技术人员而言将是显而易见的。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构可与第三联接机构500组合。
D.示例性螺纹滑动螺母
第四示例性联接机构600包括围绕示例性端部执行器组件610（示出于图8A-8B）的轴620设置的螺纹滑动螺母630。在本例中，端部执行器组件610包括传输组件612、旋转旋钮614、以及相对于旋转旋钮614朝近侧延伸的轴620。应当理解，旋转旋钮614仅为可选的并且可被省略。旋转旋钮614能够操作以使传输组件612相对于柄部组件640和/或轴620旋转。端部执行器（未示出）联接到传输组件612的远端。端部执行器可包括超声端部执行器80、射频端部执行器200和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。在超声端部执行器例如端部执行器80的实例中，穿过轴620的轴向孔（未示出）可允许传输组件612通过轴620机械地联接到柄部组件640内的部件，其可按与上述多部件柄部组件60类似的方式来构造。在射频端部执行器例如端部执行器200的情况下，轴向孔可允许传输组件612的一部分至少部分地延伸穿过轴620。传输组件612可包括内滑环连接器，该内滑环连接器能够电联接到轴620的内部上的互补滑环连接器，使得可形成从柄部组件640到端部执行器的电联接。在另一个供选择的替代方案中，也可经由穿过轴620和/或端部执行器组件610上别处的孔形成流体联接。
在本例中，螺纹滑动螺母630围绕轴620可滑动地设置。螺纹滑动螺母630包括在螺纹滑动螺母630的近端处的键槽632（以虚线显示）。应当理解，作为另外一种选择，键槽632可位于螺纹滑动螺母630的远端上。本例的键槽632仅部分地延伸穿过螺纹滑动螺母630，但是作为另外一种选择，键槽632可完全延伸穿过螺纹滑动螺母630。如图8A-8B所示，键槽632能够容纳轴620的带键部分622。在本例中，轴620的带键部分622位于轴620的近端附近，并且从轴620向外延伸，但是应当理解，作为另外一种选择，带键部分622可朝远侧位于旋转旋钮614的附近或轴620的中点处。在一个仅可供选择的例子中，带键部分622可例如通过滑块（例如，示出于图5A-5B中的滑块318）的致动而相对于轴620滑动，以使带键部分622滑入键槽632。轴620还包括近侧凸缘624，该近侧凸缘位于轴620的近端上，并且其尺寸设定成防止螺纹滑动螺母630朝近侧滑离轴620。如下所述，当使用者期望将螺纹滑动螺母630螺纹连接到柄部组件640的内螺纹650时，带键部分622能够插入键槽632。然后，本例的螺纹滑动螺母630可在轴620上朝远侧滑动，以使带键部分622从键槽632脱离，从而允许轴620、旋转旋钮614和/或传输组件612相对于螺纹滑动螺母630和/或柄部组件640自由地旋转。
在某个实例中，螺纹滑动螺母630以能够滑动的方式被设置在内管上，例如上述内部管状致动构件。在这样的构型中，螺纹滑动螺母630能够螺纹连接到轭中，例如触发器轭185，其可见于2011年1月20日公开的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国专利公开2011/0015660，其公开内容以引用方式并入本文。刀片例如上述刀片82可联接到换能器，例如上述换能器100。内部管状致动构件可通过螺纹滑动螺母630联接到轭而被致动。因此，夹持臂例如上述夹持臂84可为能够操作以抵靠刀片来夹持组织。
在本例中，柄部组件640被示出为具有远侧孔642，该远侧孔形成于壳体644内，并且能够容纳端部执行器组件610的轴620和螺纹滑动螺母630。柄部组件640还可根据2011年1月20日公开的名称为“RotatingTransducer Mount for Ultrasonic Surgical Instruments”的美国专利公开2011/0015660、或2002年12月31日公布的名称为“ElectrosurgicalSystems and Techniques for Sealing Tissue”的美国专利6,500,176中的用于多件式柄部组件60、柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。在本例中，柄部组件640包括构件648，该构件围绕构件孔652设有内螺纹650。内螺纹650和螺纹滑动螺母630能够螺纹连接在一起，以将端部执行器组件610固定到柄部组件640。
如图8A-8B中的顺序所示，本例的螺纹滑动螺母630朝近侧滑动，使得轴620的带键部分622接合螺纹滑动螺母630的键槽632。随着螺纹滑动螺母630的旋转自由度受限于带键部分622和键槽632的接合，使用者随后将螺纹滑动螺母630螺纹连接到柄部组件640的内螺纹650。例如，L形垫片工具可被用来在轴620上抵靠凸缘624朝近侧推压螺纹滑动螺母630，同时使用者将螺纹滑动螺母630螺纹连接到内螺纹650。作为另外一种选择，使用者可手动地朝近侧推压螺纹滑动螺母630。此外，如上所述，滑块可接合螺纹滑动螺母630的一部分，以朝近侧推压螺纹滑动螺母630。当然，参考本文的教导内容，朝近侧推压螺纹滑动螺母630以接合带键部分622和键槽632的其他方法对于本领域的普通技术人员而言将是显而易见的。例如，弹簧（未示出）可围绕轴620被设置在滑动螺母630的远侧和旋转旋钮614的近侧，从而朝近侧偏压滑动螺母630，使得键槽632与带键部分622接合。当使用者期望旋转端部执行器组件610时，使用者抓握旋转旋钮614并且朝近侧推动端部执行器组件610，直到带键部分622从键槽632脱离。
一旦螺纹滑动螺母630已经充分螺纹连接到内螺纹650中（例如可使用转矩限制工具），端部执行器组件610就朝近侧滑动，以使带键部分622从键槽632脱离。端部执行器组件610可手动地朝远侧滑动，或者在一个供选择的替代方案中，位于凸缘624和螺纹滑动螺母630之间的弹簧（未示出）可朝远侧推压端部执行器组件610。在超声器械的实例中，端部执行器组件610的轴620可螺纹连接到换能器例如上述换能器100的焊头上。此类螺纹连接可在螺纹滑动螺母630螺纹连接到内螺纹650中之前、与其同时地或之后发生。作为另外一种选择，在射频器械的实例中，轴620可联接到一个或多个电连接器（未示出），以将端部执行器联接到电源。参考图15-17，示出和描述了仅示例性的电联接件。如图8B所示，端部执行器组件610在纵向上有效地被固定到柄部组件640，同时允许轴620、旋转旋钮614和/或传输组件612旋转运动。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件610从柄部组件640脱离时，使用者朝远侧牵拉端部执行器组件610，直到轴620的带键部分622接合螺纹滑动螺母630的键槽632。作为另外一种选择，L形垫片工具可被楔入螺纹滑动螺母630与旋转旋钮614之间，以朝近侧推压螺纹滑动螺母630。随着带键部分622和键槽632接合，使用者随后可从内螺纹650旋开螺纹滑动螺母630，从而使端部执行器组件610从柄部组件640脱离。然后，使用者可将新的端部执行器组件610联接到柄部组件640。
当然，根据本文的教导内容，第四联接机构600的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，螺纹滑动螺母630可位于轴620的凸缘624与另一个环形凸缘（未示出）例如示出于图7A-7B中的环形凸缘522之间。在本例中，带键部分622可从轴620的凹槽（未示出）内的初始位置径向地向外致动到带键部分622与螺纹滑动螺母630的键槽632接合的位置。例如，带键部分622可通过凸轮构件致动，该凸轮构件联接到位于传输组件612和/或旋转旋钮614上的滑块，例如示出于图5A-5B中的滑块318。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构可与第四联接机构600组合。
E.示例性T形连接器
第五示例性联接机构700包括具有一个或多个周边凸缘728,730,732的一个或多个轴722,724,726，所述一个或多个周边凸缘形成用于示例性端部执行器组件710（示出于图9A-9B中）的一个或多个T形可插入连接器734,736,738。在本例中，端部执行器组件710包括传输组件712、旋转旋钮714、以及相对于旋转旋钮714朝近侧延伸的一个或多个轴722,724,726。应当理解，旋转旋钮714仅为可选的并且可被省略。旋转旋钮714能够操作以使传输组件712相对于柄部组件740和/或该一个或多个轴722,724,726旋转。端部执行器（未示出）联接到传输组件712的远端。端部执行器可包括超声端部执行器80、射频端部执行器200和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。
本示例性端部执行器组件710被构造用于射频端部执行器，例如端部执行器200。柄部组件740包括具有远侧孔742的壳体744，端部执行器组件710的近端可被插入该远侧孔。在本例中，柄部组件740还包括位于远侧孔742的近侧的一对可偏转的远侧接片748，第一致动机构760、第二致动机构770、以及电联接构件750。远侧接片748能够操作以接合远侧T形连接器734，以当端部执行器组件710被插入柄部组件740时限制端部执行器组件710的纵向运动。端部执行器组件710的近侧凸缘732包括一个或多个电触头720，该一个或多个电触头能够操作以电联接到电联接构件750上的互补触头752。互补触头752还联接到电源例如发生器20或柄部组件740内的内部电源，以向端部执行器提供电力。此类触头720,752可为互补滑环触头、环形环触头、公母连接器、和/或任何其他合适的转动或非转动的电连接件。在本例中，触头720,752包括带刷滑环电连接件。
如上所述，端部执行器组件710包括近侧T形连接器738、中间T形连接器736和远侧T形连接器734。本例中的近侧T形连接器738和中间T形连接器736能够操作以分别联接第一致动机构760和第二致动机构770。第一致动机构760和第二致动机构770能够操作以分别致动上钳口例如上钳口206和切割机构例如切割构件210。在本例中，第一致动机构760和第二致动机构770的远端各自包括倾斜的部分762,772，该倾斜的部分能够操作以当端部执行器组件710的T形连接器736,738被插入柄部组件740时使第一致动机构760和第二致动机构770的远端向外凸出。一旦T形连接器736,738通过倾斜的部分762,772的近端，近侧轴726和中间轴724，就可通过联接具有第一致动机构760和第二致动机构770的T形连接器736,738而朝近侧被致动。
此外，远侧T形连接器734能够操作以与可偏转远侧接片748联接，以在纵向上将端部执行器组件710固定到柄部组件740。如对于本领域的普通技术人员将显而易见的是，联接T形连接器734,736,738与可偏转远侧接片748、第一致动机构760、和/或第二致动机构770还允许端部执行器组件710即使在被联接到柄部组件740时仍自由地旋转。柄部组件740还可根据2011年1月20日公开的名称为“Rotating Transducer Mount forUltrasonic Surgical Instruments”的美国专利公开2011/0015660、或2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for SealingTissue”的美国专利6,500,176中的用于多件式柄部组件60、柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。
如图9A-9B中的顺序所示，当端部执行器组件710的T形连接器734,736,738被插入远侧孔742时，可偏转远侧接片748、第一致动机构760、和/或第二致动机构770向外偏转，直到T形连接器734,736,738被捕获在其中。如图9B所示，端部执行器组件710在纵向上被有效地固定到柄部组件740，同时允许轴722,724,726、旋转旋钮714、和/或传输组件712相对于柄部组件740旋转运动。触头720,752还可电联接以向本例中的端部执行器提供电力。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件710从柄部组件740脱离时，使用者可简单地向外牵拉端部执行器组件710，直到T形连接器734,736,738从可偏转远侧接片748、第一致动机构760、和/或第二致动机构770脱离。然后，使用者可将新的端部执行器组件710联接到柄部组件740。作为另外一种选择，在本例中，柄部组件740的释放结构780可由使用者按下或滑动，以向外致动第一致动机构760和/或第二致动机构770和/或以使远侧接片748偏转。例如，释放结构780可包括一个或多个楔形构件（未示出），该楔形构件能够操作以使第一致动机构760和/或第二致动机构770凸出和/或使远侧接片748偏转打开以允许T形连接器734,736,738通过。当然，也可实现其他释放机构。例如，键槽可形成于凸缘728,730,732中以允许T形连接器734,736,738通过，或作为另外一种选择，凸缘728,730,732可为能够操作以当移除端部执行器组件710时分离。如果凸缘728,730,732能够操作以分离，那么这对于使用者也可作为端部执行器组件710在前已被使用过的指示。根据本文的教导内容，其他释放机构对于本领域的普通技术人员而言将是显而易见的。
当然，根据本文的教导内容，第五联接机构700的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，如果包括超声端部执行器，例如端部执行器80，那么近侧轴726和/或凸缘732可通过螺纹联接到柄部组件740内的换能器，例如换能器100。远侧轴722和中间轴724还可机械地联接到柄部组件740内的其他部件以供使用，例如以操作上述夹持臂84，尽管这仅为可选的。在这种情况下，柄部组件740还可按与上述多部件柄部组件60类似的方式来构造。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构也可与第五联接机构700组合。
F.示例性弹性地偏置的轴承
第六示例性联接机构800包括设置在柄部组件840内的一对弹性地偏置的滚珠轴承构件850并且能够接合示例性端部执行器组件810（示出于图10A-10B中）的轴820的周边凹槽822。在本例中，端部执行器组件810包括传输组件812、旋转旋钮814、以及相对于旋转旋钮814朝近侧延伸的轴820。应当理解，旋转旋钮814仅为可选的并且可被省略。旋转旋钮814能够操作以使传输组件812相对于柄部组件840和/或轴820旋转。端部执行器（未示出）联接到传输组件812的远端。端部执行器可包括超声端部执行器80、射频端部执行器200和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。在超声端部执行器例如端部执行器80的实例中，穿过轴820的轴向孔（未示出）可允许传输组件812通过轴820机械地联接到柄部组件840内的部件，其可按与上述多部件柄部组件60类似的方式来构造。就射频端部执行器例如端部执行器200而言，轴向孔可允许传输组件812的一部分至少部分地延伸穿过轴820。传输组件812可包括内滑环连接器，该内滑环连接器能够电联接到轴820的内部上的互补滑环连接器，使得可形成从柄部组件840到端部执行器的电联接。例如，滚珠852可电联接到电源并且可联接到凹槽822内的触头，如下文将描述的。在另一个供选择的替代方案中，也可经由穿过轴820和/或端部执行器组件810上别处的孔形成流体联接。
在本例中，轴820包括形成于轴820近端的远侧的周边凹槽822。凹槽822可包括电触头例如铜环，以使端部执行器组件810与滚珠852电联接，尽管这仅为可选的。在本例中，柄部组件840包括壳体844、形成于壳体844中的远侧孔842、以及位于远侧孔842的近侧的一对弹性地偏置的滚珠轴承构件850。远侧孔842能够将轴820容纳在其中。弹性地偏置的滚珠轴承构件850每个包括在滚珠轴承构件850的端部处的凹槽中的滚珠852和偏动簧片854。柄部组件840还可根据2011年1月20日公开的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国专利公开2011/0015660、或2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for Sealing Tissue”的美国专利6,500,176中的用于多部件柄部组件60、柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。
如图10A-10B中的顺序所示，当轴820插入穿过远侧孔842时，轴820最初抵靠偏动簧片854推压滚珠852。继续抵靠偏动簧片854来推压滚珠850，直到滚珠850遇到凹槽822。然后，偏动簧片854将滚珠852推入凹槽822，从而将滚珠轴承构件850联接到轴820。如图10B所示，端部执行器组件810通过滚珠轴承构件850与凹槽822的组合而在纵向上有效地被固定到柄部组件840，同时还允许轴820、旋转旋钮814、和/或传输组件812相对于柄部组件840旋转运动。在超声器械的实例中，端部执行器组件810的轴820还可被螺纹连接到换能器例如上述换能器100的焊头上。此类螺纹连接可在滚珠852遇到凹槽822之前、与其同时地或之后发生。作为另外一种选择，在射频器械的实例中，轴820可被联接到一个或多个电连接器（未示出），以将端部执行器联接到电源。参考图15-17，示出和描述了仅示例性电联接件。作为另外一种选择，滚珠852和/或偏动簧片854可为能够将端部执行器电联接到电源。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件810从柄部组件840脱离时，使用者牵拉端部执行器组件810，直到滚珠852压靠偏动簧片854并且允许轴820通过滚珠852。然后，使用者可将新的端部执行器组件810联接到柄部组件840。
当然，参考本文的教导内容，第六联接机构800的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，尽管本例中仅示出了两个滚珠轴承构件850，但可在柄部组件840内周向地设置一圈弹性地偏置的滚珠轴承构件850。作为另外一种选择，就一圈滚珠轴承构件850而言，偏动簧片854可被省略并且凸轮圆柱套管（未示出）可为能够操作以将该一圈滚珠852向内致动到轴850的凹槽822中。此类圆柱套管可被弹性地偏置或通过壳体844上的外部滑块手动地致动。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构可与第三联接机构800组合。
G.示例性锁键组件
第七示例性联接机构900包括可插入锁键950，该可插入锁键能够插入柄部组件940的壳体944中的狭槽946。当另一个示例性端部执行器组件910（示出于图11A-11B中）的近侧组件920被插入穿过壳体944中的远侧孔942时，锁键950能够在纵向上固定近侧组件920。在本例中，端部执行器组件910包括传输组件912、联接到传输组件910的齿轮916、以及位于齿轮916近侧的近侧组件920。在一个仅示例性构型中，近侧组件920包括与超声端部执行器（例如上述端部执行器80）一起使用的波形弹簧组件。作为另外一种选择，近侧组件920可包括可致动部件，例如参考图9A-9B所描述的T形连接器和轴，以用于操作端部执行器组件910的机械部件。此外，近侧组件920可包括电触头以将端部执行器组件910电联接到电源，例如发生器20或柄部组件940内的电源。在另一个供选择的替代方案中，也可经由近侧组件920和/或在端部执行器组件910上别处形成流体联接。如上所述，端部执行器（未示出）联接到传输组件912的远端。端部执行器可包括超声端部执行器80、射频端部执行器200和/或任何其他端部执行器或多个端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。
柄部组件940包括壳体944、形成于壳体944中的远侧孔942、能够相对于壳体944旋转的旋转旋钮914、轭组件948、以及狭槽946，该狭槽形成于壳体944中并且位于远侧孔942的近侧。轭组件948机械地联接到触发器例如触发器68，并且能够操作以致动端部执行器组件910的一个或多个部件。在本例中，轭组件948包括锁槽949，锁键950的一部分能够插入该锁槽。轭组件948还可根据与本专利申请同一天提交的名称为“Ultrasonic Surgical Instrument with Modular End Effector”的美国专利申请序列号[代理人案卷号END7012USNP.0587824]、和/或2011年1月20日公开的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”美国专利公开2011/0015660的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。尽管本例将狭槽946示出为壳体944的顶侧面上的狭槽，但应当理解狭槽946可位于壳体944上的其他位置处，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。本例中的旋转旋钮914包括齿状物，该齿状物与齿轮916的那些互补并且形成于旋转旋钮914的圆柱形凹槽中，使得当端部执行器组件910联接到柄部组件940时齿轮916能够插入其中并且接合旋转旋钮914。当然，参考本文的教导内容，用于柄部组件940的其他构型和结构对于本领域的普通技术人员而言将是显而易见的。
本例中的锁键950包括半圆形凹口952，当端部执行器910被插入柄部组件940并且锁键950被插入狭槽946时，该半圆形凹口能够部分地环绕传输组件912。凹口952的尺寸设定成小于近侧组件920，使得当锁键950接合传输组件912时近侧组件920可不被朝远侧平移。在一个供选择的替代方案中，凹口952可为能够部分地环绕近侧组件920的一部分。此外，凹口952可为矩形凹口，其能够接合传输组件912和/或近侧组件920上的平坦部分（未示出）。例如，近侧组件920的旋转运动可由锁键950的矩形凹口限制，并且近侧组件920可通过将锁键950插入狭槽946和锁槽949而同时联接到轭组件948。当然，参考本文的教导内容，锁键950、端部执行器组件910、和/或柄部组件940的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，柄部组件940还可根据2011年1月20日公开的名称为“Rotating Transducer Mount for Ultrasonic SurgicalInstruments”的美国专利公开2011/0015660、或2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for Sealing Tissue”的美国专利6,500,176中的用于多部件柄部组件60、柄部组件152的教导内容中的至少一些来构造，所述专利的公开内容以引用方式并入本文。
如图11A所示，锁键950最初从柄部组件940被移除。然后，近侧组件920和传输组件912的近侧部分被插入穿过旋转旋钮914中的开口，直到齿轮916遇到旋转旋钮914。然后使齿轮916旋转，直到有可能将其插入旋转旋钮914的圆柱形凹槽中的互补齿状物。一旦齿轮916被插入旋转旋钮914，近侧组件920就可任选地向下被扭转到换能器（例如上述换能器100）的焊头上、电联接到柄部组件940中的电连接件、和/或换句话讲联接于此。参考图15-17，示出和描述了仅示例性的电联接件。此类螺纹连接、电联接、和/或其他方式可在将齿轮916插入旋转旋钮914之前、与其同时或之后发生。如果传输组件912和/或近侧组件920上包括有平坦部分，那么可旋转旋转旋钮914和/或传输组件912以使该平坦部分与狭槽946对齐。在本例中，不需要旋转旋转旋钮914，因为凹口952是半圆形凹口，其能够装配在传输组件912的周围。锁键950然后被插入狭槽946和锁槽949以将端部执行器组件910固定到柄部组件940和/或将轭组件948固定于此。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件910从柄部组件940脱离时，使用者移除锁键950并拉出端部执行器组件910。然后，使用者可将新的端部执行器组件910联接到柄部组件940。
当然，参考本文的教导内容，第七联接机构900的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，锁键950可包括卡扣（未示出）和/或密封件以将锁键950联接和/或密封到壳体944。锁键950还可包括弹性的端部以按扣在传输组件912和/或近侧组件920的周围。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构可与第七联接机构900组合。
H.示例性锁定接片组件
第八示例性联接机构包括端部执行器组件1000，该端部执行器组件具有从螺栓部分1040的相对侧延伸的一对锁定接片1050，其旋转地锁定到柄部组件1100的旋转凹槽1110中，如图12-14中所示。首先参考图12，端部执行器组件1000包括传输组件1010、旋转部分1020、以及螺栓部分1040。如图12中的横截面所示，传输组件1010被固定地固定到旋转部分1020并延伸穿过旋转部分1020。应当理解，旋转部分1020仅为可选的，并且传输组件1010可被固定地联接到螺栓部分1040或联接成使得传输组件1010可相对于螺栓部分1040旋转。旋转部分1020包括旋转旋钮1022，该旋转旋钮能够操作以使传输组件1010相对于柄部组件1100和/或螺栓部分1040旋转。端部执行器（未示出）联接到传输组件1010的远端。端部执行器可包括超声端部执行器80、射频端部执行器200、和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。在所示出的例子中，导电线材1012延伸穿过传输组件1010并联接到安装在旋转部分1040的外表面上的第一滑环1024，该旋转部分位于端部执行器组件1000的近端附近处。
螺栓部分1040包括被安装到螺栓部分1040的内表面的滑环触头1044（例如刷、插脚等），该螺栓部分电联接到第一滑环1024，使得第一滑环1024和第二滑环1044电联接，同时允许旋转部分1020相对于螺栓部分1040旋转360度。在本例中，螺栓部分1040为围绕旋转部分1020的一部分设置的共轴管状圆柱体，如图12-13所示。旋转部分1020上的近侧凸缘1026、螺栓部分1040的近端1042处的近侧凸缘1046、旋转部分1020上的远侧凸缘1028、以及螺栓部分1040的远端1041处的远侧凸缘1048限制螺栓部分1040相对于旋转部分1020纵向运动，同时允许螺栓部分1040和/或旋转部分1020相对于其他部分和/或柄部组件1100旋转。
螺栓部分1040还包括从螺栓部分1040的相对侧上螺栓部分1040向外延伸的一对锁定接片1050。尽管图12-13中示出的是一对锁定接片1050，但应当理解，可包括单个锁定接片1050或多于两个的锁定接片1050。例如，在一些仅示例性供选择的替代方案中，三个接片1050或四个接片1050可从螺栓部分1040延伸。本例中的锁定接片1050包括一个或多个电触头1052，该电触头电联接到第二滑环1044，使得当将电源联接到电触头1052时电触头1052可向端部执行器提供电力。锁定接片1050还包括一个或多个光学上可感知的指示器1054（例如开口），该指示器能够操作以当其被联接到柄部组件1100时识别该端部执行器组件1000。例如，在凹槽1110处可包括一个或多个光电传感器1116（示出于图14中），以在锁定接片1050上的各种位置处检测是否存在指示器1054。此类缺失和/或检测可被转化成一些数据，这些数据可用来识别端部执行器组件1000的类型、尺寸、和/或其他特征。作为另外一种选择，光学上可感知的指示器1054可能被配置成将数据从端部执行器处一个或多个传感器传输至光电传感器1116（例如，光纤传输装置）。此外，指示器1054可能被RFID部件替换，并且光电传感器1116可被RFID读取器替换。例如，可使用近场RFID系统。仅以举例的方式，此类数据和/或信息可用来调节发生器20、柄部组件1100内的控制模块的控制设置、和/或任何其他可调电子元件的设置。例如，可根据所附接的端部执行器的类型和/或尺寸来调节开关按钮1120（示出于图14中）的操作设置。在一些型式中，指示器1054和光电传感器1116（或其变型，例如RFID部件）可为能够鉴定端部执行器组件1000是否为合适的和/或被授权与柄部组件1100一起使用的端部执行器组件。
柄部组件1100（示出于图14中）包括壳体1102、能够容纳端部执行器1100的近端的远侧孔1104、一个或多个开关按钮1120、触发器1130、以及位于远侧孔1104的近侧的一对旋转凹槽1110（以虚线显示）。尽管远侧孔1104包括圆形部分1106和竖直接片部分1108，但应当理解，接片部分1108可为水平取向的或成任何其他角度。旋转凹槽1110被示出为相对于竖直接片部分1108具有大约45度的旋转角度，使得当锁定接片1050被插入远侧孔1104并旋转到旋转凹槽1110中时，旋转凹槽1110和锁定接片1050防止端部执行器组件1000朝远侧平移出远侧孔1104。应当理解，旋转凹槽1110可延伸穿过大约10度至180度的角度范围。在一些构型中，旋转凹槽1110的角度范围可小于10度，例如1度，如果此类旋转度防止端部执行器组件1000朝远侧平移出远侧孔1104的话。闭锁装置1112（也以虚线显示）被设置在旋转凹槽1110的一部分上以抵制锁定接片1050的旋转运动，从而进一步将锁定接片1050固定在旋转凹槽1110内。应当理解，闭锁装置1112仅为可选的。一个或多个电触头1114以及光电传感器1116联接到旋转凹槽1110的内部旋转面，以分别联接到和/或感知电触头1052和/或光学上可感知的指示器1054。当然，此类部件可被省略。此外，弹簧（未示出）可被设置在柄部组件1100内的近侧壁上以当端部执行器组件1100被插入时接合螺栓部分1040和/或旋转部分1020的近端1042。因此，该弹簧可提供远侧偏压以有利于使螺栓部分1040从柄部组件1100内单手移除。
当使用者期望根据当前描述的第八示例性联接机构将端部执行器组件1000联接到柄部组件1100时，使用者最初使锁定接片1050与远侧孔1104的竖直部分1108对齐并且将端部执行器组件1000的近端插入远侧孔1104。如果在近侧壁处设有弹簧，那么螺栓部分1040和/或旋转部分1020的近端1042可接合该弹簧。随着使用者进一步插入端部执行器组件1000，该弹簧压缩。当旋转螺栓部分1040时，弹簧可处于压缩状态以将锁定接片1050锁入旋转凹槽1110。在一些型式中，使用者可抓握螺栓部分1040的远侧部分（其可包括滚花、脊皱、凹坑等）以旋转锁定接片1050使其进入锁定凹槽1110。本例中的锁定接片1050旋转经过由闭锁装置1112提供的阻力并且被固定，使得一个或多个电触头1114联接到电触头1052，并且光电传感器1116感测指示器1054。然后，使用者可使用组装的外科器械以用于手术。当使用者期望使端部执行器组件1000从柄部组件1100脱离时，使用者旋转螺栓部分1040以克服闭锁装置1112的阻力。一旦锁定接片1050与远侧孔1104的竖直部分1108竖直地对齐时，那么使用者就将端部执行器组件1000从柄部组件1100拉出。如果弹簧已被包括在近侧壁上，那么该弹簧可有助于端部执行器组件1000从柄部组件1100弹出。然后，使用者可将新的端部执行器组件1000联接到柄部组件1100。
在一种与超声端部执行器例如端部执行器80一起使用的构型中，传输组件1010可朝近侧延伸到螺栓部分1040的近侧面1042之外。传输组件1010可机械地联接到换能器例如换能器100的焊头、和/或柄部组件1100内的其他机械联接件例如致动夹持臂84，其可按与上述多部件柄部组件60类似的方式来构造。就射频端部执行器例如端部执行器200而言，传输组件1010可机械地联接到和/或电联接到柄部组件1100内的部件。作为另外一种选择，如上所述，锁定接片1050可通过联接到电触头1052的电触头1114来向射频端部执行器提供电力。在另一种变型中，锁定接片1050可锁入轭组件，例如上述轭组件948。参考本文的教导内容，端部执行器组件1000和/或柄部组件1100的另外的构型对于本领域的普通技术人员而言将是显而易见的。例如，在一种仅示例性供选择的构型中，旋转凹槽1110可为能够螺旋状成型的凹槽，其从竖直部分1108朝近侧延伸，使得在端部执行器组件1000被推入柄部组件1100时锁定接片1050遵循该螺旋状路径。闭锁装置1112可固定螺旋状凹槽内的锁定接片1050。
当然，根据本文的教导内容，第八联接机构的其他构型对于本领域的普通技术人员而言将是显而易见的。如根据本文在前和其后的公开内容将变得显而易见的是，各种其他电和/或机械联接机构和/或结构可与第八联接机构组合。例如，光学上可感知的指示器1054和光电传感器1116可被结合到本文所述的任何端部执行器组件和柄部组件中。
虽然前述联接机构集中于具有柄部组件的各种端部执行器组件的机械联接（尽管也描述了各种电联接件），但是对于多种端部执行器，也可包括电联接。因此，下列描述内容描述了各种电联接机构，其可全部地或部分地与前述联接机构和/或任何其他联接机构结合。
I.示例性螺纹电极连接件
示例性第一电联接机构1200包括在端部执行器组件1210上的一个或多个螺纹电极1230，其旋入柄部组件1240内的螺纹构件1250的互补螺纹1252，如图15中所示。在本例中，示例性端部执行器组件1210包括传输组件1212、旋转旋钮1214、以及相对于旋转旋钮1214朝近侧延伸的轴1220。应当理解，旋转旋钮1214仅为可选的并且可被省略。旋转旋钮1214能够操作以使传输组件1212相对于柄部组件1240和/或轴1220旋转。端部执行器（未示出）联接到传输组件1212的远端。端部执行器可包括超声端部执行器80、射频端部执行器200、和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。
在本例中，第二轴1222从轴1220朝近侧延伸。一个或多个螺纹电极1230联接到第二轴1222并且能够旋入柄部组件1240内的螺纹构件1250的互补螺纹1252。如果包括多于一个的螺纹电极1230（例如，与电极1230纵向地和/或径向地间隔开），那么绝缘体（未示出）可将相邻的电极1230分开。接线柱1224从螺纹电极1230朝近侧延伸。相反极性的触头1232联接到接线柱1224的近端并且能够电联接到螺纹构件1250内的对应的触头1256。一个或多个绝缘线材可延伸穿过接线柱1224、第二轴1222、轴1220、和/或传输组件1212以将端部执行器电联接到螺纹电极1230和/或触头1232。在本例中，螺纹构件1250为在远端处具有互补螺纹1252的管状构件。螺纹构件1250围绕共轴管状绝缘体1254设置，该共轴管状绝缘体继而围绕对应的触头1256设置。在本例中，螺纹构件1250为导电部件，其电联接到电源的阴极并且对应的触头1256电联接到电源的阳极。当然，可使极性反向。绝缘体1254使螺纹构件1250与对应的触头1256分离。
当端部执行器组件1210联接到柄部组件1240（通过前述联接机构中的一者和/或其他方式）时，螺纹电极1230被旋入互补螺纹1252，从而使螺纹电极1232与螺纹构件1250电联接。螺纹电极1230可继续旋入互补螺纹1252，直到触头1232邻接并电联接到对应的触头1256。因此，电力可被提供至端部执行器组件1200的端部执行器。
当然，可使用第一电联接机构1200的其他构型。实际上，在一种供选择的替代方案中，触头1232和对应的触头1256可为互补的螺纹部件并且螺纹电极1230可为阀盘，其能够邻接螺纹构件1250并电联接到螺纹构件1250。触头1232和螺纹电极1230可均为螺纹部件或可均为接触式电连接件。根据本文的教导内容，第一联接机构1200的其他构型对于本领域的普通技术人员而言将是显而易见的。如根据本文的公开内容显而易见的是，各种其他电和/或机械联接机构和/或结构也可与第一电联接机构1200组合。
J.示例性弹性地偏置的电连接件
示例性第二电联接机构1300包括位于柄部组件1340内的一个或多个弹簧加载的触头1350以接触和电联接到另一个示例性端部执行器组件1310（示出于图16中）上的对应的触头1322,1324。在本例中，示例性端部执行器组件1310包括传输组件1312、旋转旋钮1314、以及相对于旋转旋钮1314朝近侧延伸的轴1320。应当理解，旋转旋钮1314仅为可选的并且可被省略。旋转旋钮1314能够操作以使传输组件1312相对于柄部组件1340和/或轴1320旋转。端部执行器（未示出）联接到传输组件1312的远端。端部执行器可包括超声端部执行器80、射频端部执行器200和/或任何其他端部执行器或端部执行器的组合，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。
在本例中，触头1322,1324为联接到轴1320并围绕轴1320周向地设置的环触头。如图16所示，弹簧加载的触头1350被弹簧1352偏压朝向轴1320。当端部执行器1310被插入柄部组件1340并且在纵向上对齐（例如通过本文所述的联接机构中的一个）时，那么第一弹簧加载的触头1350电联接到对应的触头1322并且第二弹簧加载的触头1350电联接到另一个对应的触头1324。因此，可通过使弹簧加载的触头1350与触头1322,1324电联接来向端部执行器组件1310的端部执行器提供电力，即使当端部执行器组件1310相对于柄部组件1340旋转时也是如此。在一些型式中，可使用偏置片簧触头，而不是弹簧加载的触头1350。
当然，可使用第二电联接机构1300的其他构型。实际上，在一个供选择的替代方案中，在图17中描绘了第三电联接机构1400。类似于第二电联接机构1300，一对弹簧加载的触头1450被安装在外壳组件1440中，尽管在本例中，弹簧加载的触头1450为水平地安装的。端部执行器组件1410包括轴1420，与轴1420的轴线共轴的环形触头1422以及位于轴1420的轴线上的中心触头1424在该轴的近端上。当端部执行器组件1410被插入外壳组件1440时，第一弹簧加载的触头1450电联接到环形触头1422并且第二弹簧加载的触头1450电联接到中心触头1424。因此，可通过使弹簧加载的触头1450与触头1422,1424电联接向端部执行器组件1410的端部执行器提供电力，即使当端部执行器组件1410旋转时也是如此。参考本文的教导内容，第二电联接机构1300和/或第三电联接机构1400对于本领域的普通技术人员而言将是显而易见的。如根据本文的公开内容显而易见的是，各种其他电和/或机械联接机构和/或结构也可与第二电联接机构1300和/或第三电联接机构1400组合。
对于前述例子，应当理解，柄部组件和/或端部执行器可为可重复使用的、耐高压灭菌的和/或一次性的。例如，前述端部执行器可为一次性的，而柄部组件为可重复使用的和/或耐高压灭菌的。此外，如果内部电源用于前述柄部组件，那么该内部电源可为可再充电的。例如，通过移除电池和对电池再充电，通过感应，和/或通过任何其他方法，柄部组件可以插上电源再充电，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。此外，可包括对准结构或引导件，以帮助端部执行器与柄部组件的对准和联接。这样的引导件可能有助于在外科器械组装期间防止对端部执行器和/或柄部组件的损坏。
尽管已描述出示例性外科器械的某些构型，但参考本文的教导内容，其中可构造外科器械的各种其他方式对于本领域的普通技术人员而言将是显而易见的。仅以举例的方式，本文提及的外科器械可根据下列专利的教导内容中的至少一些来构造：美国专利6,500,176、美国专利6,783,524、美国专利7,416,101、美国专利7,738,971、美国专利6,783,524、美国公布2006/0079874、美国公布2007/0191713、美国公布2007/0282333、美国公布2008/0200940、美国公布2009/0209990、美国公布2009/043797、美国公布2010/0069940、和/或美国临时申请序列号61/410,603，所述专利的公开内容以引用方式并入本文。
应当理解，所述以引用方式并入本文中的任何专利、专利公开或其他公开材料，无论是全文或部分，仅在并入的材料与本公开中给出的定义、陈述或其他公开材料不冲突的范围内并入本文。由此，在必要的程度下，本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突材料。如果据述以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
本发明的一些实施例可被应用于常规的内窥镜检查和开放性手术器械以及机器人辅助手术中。例如，本领域的普通技术人员将认识到，本文的各种教导内容可易于与2004年8月31日公布的名称为“Robotic SurgicalTool with Ultrasound Cauterizing and Cutting Instrument”的美国专利6,783,524的各种教导内容相结合，其公开内容以引用方式并入本文。
仅以举例的方式，可在外科手术前对本文所述的实施例进行处理。首先，可获取新的或用过的器械，并根据需要清洗。然后可对器械消毒。在一种消毒技术中，将该器械放置在闭合且密封的容器中，例如塑料或TYVEK袋中。然后可将容器和器械放置在可穿透该容器的辐射场，例如γ辐射、X射线或高能电子中。辐射可将器械上和容器中的细菌杀死。然后可将消毒后的器械存储在消毒容器中。该密封容器可将器械保持在无菌状态，直到在医疗设施中打开该容器。还可使用本领域已知的任何其他技术对装置消毒，所述技术包括但不限于β辐射或γ辐射、环氧乙烷或蒸汽消毒。
本文所公开的装置的实施例可在至少一次使用之后进行修复以供再使用。修复可包括以下步骤的任意组合：拆卸装置、然后清洗或更换特定部件以及随后重新组装。具体地讲，可对本文所公开的装置的实施例进行拆卸，并且可选择性地、以任何组合更换或拆除装置的任意数量的具体部件或零件。在清洗和/或更换特定零件时，装置的实施例可在修复设施中重新组装或者在即将进行外科手术前由外科手术团队重新组装，以供随后使用。本领域的技术人员将会知道，修复装置时可利用多种技术进行拆卸、清洗/更换和重新组装。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。
已经示出和描述了本发明的多个实施例，可由本领域的普通技术人员进行适当修改来实现本文描述的方法和系统的进一步改进而不脱离本发明的范围。已经提及了多种此类潜在的修改形式，并且其他修改形式对于本领域的技术人员将显而易见。例如，上面讨论的例子、实施例、几何形状、材料、尺寸、比率、步骤等均是示例性的而非必需的。因此，本发明的范围应以下面的权利要求书进行考虑，并且应理解为并不限于说明书和附图中示出和描述的结构和操作细节。

Claims (20)

1.一种外科器械，包括：
(a)主体组件，所述主体组件包括：
i.触发器，
ii.壳体，所述壳体具有形成于所述壳体的远端中的远侧孔，和
iii.第一联接组件部分；和
(b)端部执行器组件，所述端部执行器组件包括：
i.近侧轴，
ii.传输组件，所述传输组件从所述近侧轴朝远侧延伸，
iii.端部执行器，所述端部执行器联接到所述传输组件的远端，和
iv.第二联接组件部分；
其中所述第二联接组件部分能够插入所述远侧孔，其中所述第二联接组件部分能够操作以可拆卸地联接到所述第一联接组件部分，并且其中通过将所述第一联接组件部分联接到所述第二联接组件部分来防止所述端部执行器组件朝远侧平移。
2.根据权利要求1所述的外科器械，其中所述端部执行器组件还包括可旋转旋钮，所述可旋转旋钮联接到所述传输组件并且被设置在所述近侧轴的远侧，其中所述可旋转旋钮能够操作以使所述传输组件相对于所述主体组件旋转。
3.根据权利要求1所述的外科器械，其中所述第一联接组件部分和所述第二联接组件部分能够操作，以当所述第一联接组件部分和所述第二联接组件部分联接在一起时，将所述端部执行器的可致动部分机械地联接到所述主体组件。
4.根据权利要求1所述的外科器械，其中所述第一联接组件部分和第二联接组件部分能够操作，以当所述第一联接组件部分和所述第二联接组件部分联接在一起时，将所述端部执行器的一部分电联接到电源。
5.根据权利要求1所述的外科器械，其中所述第一联接组件部分和所述第二联接组件部分能够操作，以当所述第一联接组件部分和所述第二联接组件部分联接在一起时：
(a)将所述端部执行器的可致动部分机械地联接到所述主体组件，以及
(b)将所述端部执行器的一部分电联接到电源。
6.根据权利要求1所述的外科器械，其中所述第一联接机构部分包括所述壳体的一部分，并且所述第二联接机构部分包括从所述近侧轴向外延伸的一个或多个弹性的接片。
7.根据权利要求1所述的外科器械，其中所述第一联接组件部分包括所述壳体的一个或多个弹性地偏置的部分，并且所述第二联接组件部分包括从所述近侧轴向外延伸的周边斜坡。
8.根据权利要求1所述的外科器械，其中所述第一联接组件部分包括所述壳体的可平移部分，并且所述第二联接组件部分包括在所述近侧轴上的环形凸缘。
9.根据权利要求1所述的外科器械，其中所述第一联接组件部分包括所述壳体内的螺纹构件，并且所述第二联接组件部分包括围绕所述近侧轴设置的螺纹螺母。
10.根据权利要求9所述的外科器械，其中所述近侧轴包括一个或多个带键部分以及位于所述近侧轴的近端上的凸缘，其中所述螺纹螺母以能够滑动的方式被设置在所述凸缘的远侧，并且其中所述螺纹螺母包括键槽。
11.根据权利要求1所述的外科器械，其中所述第一联接组件部分包括一个或多个弹性地偏置的轴承构件，并且所述第二联接机构部分包括形成于所述近侧轴的一部分中的周边凹槽。
12.根据权利要求1所述的外科器械，其中所述第一联接组件部分包括锁键，并且所述第二联接组件部分包括所述传输组件的近侧区段，其中所述壳体包括能够容纳所述锁键的一部分的狭槽，其中所述锁键联接到所述传输组件的所述近侧区段并且限制所述近侧轴的远侧平移。
13.根据权利要求12所述的外科器械，其中所述主体组件包括具有锁槽的轭组件，所述锁槽能够容纳所述锁键的一部分，其中所述轭组件能够操作以当所述锁键插入所述锁槽时朝近侧致动所述近侧轴。
14.根据权利要求1所述的外科器械，其中所述端部执行器包括超声端部执行器。
15.根据权利要求1所述的外科器械，其中所述端部执行器包括射频电外科端部执行器。
16.一种外科器械，包括：
(a)主体组件，所述主体组件包括：
i.触发器，
ii.壳体，所述壳体具有形成于所述壳体的远端中的远侧孔，和
iii.一个或多个旋转凹槽，所述一个或多个旋转凹槽被设置在所述远侧孔的近侧；和
(b)端部执行器组件，所述端部执行器组件包括：
i.螺栓部分，所述螺栓部分具有从所述螺栓部分向外延伸的一个或多个锁定接片，
ii.传输组件，所述传输组件联接到所述螺栓部分并且从所述螺栓部分朝远侧延伸，和
iii.端部执行器，所述端部执行器联接到所述传输组件的远端；
其中所述螺栓部分的具有一个或多个锁定接片的部分能够插入穿过所述壳体的所述远侧孔，并且其中所述螺栓部分能够操作以使所述一个或多个锁定接片旋转进入所述一个或多个旋转凹槽。
17.根据权利要求16所述的外科器械，其中所述一个或多个锁定接片包括电触头，其中所述一个或多个旋转凹槽包括互补电触头，其中所述电触头和所述互补电触头能够当所述一个或多个锁定接片旋转进入所述一个或多个旋转凹槽时电联接。
18.根据权利要求16所述的外科器械，其中所述端部执行器组件还包括一个或多个指示器，其中所述主体组件还包括一个或多个传感器，其中所述一个或多个传感器能够操作以当所述端部执行器组件联接到所述主体组件时感知所述一个或多个指示器。
19.根据权利要求16所述的外科器械，其中所述端部执行器组件还包括旋转部分，所述旋转部分联接到所述传输组件并且能够操作以使所述传输组件相对于所述主体组件旋转。
20.一种外科器械，包括：
(a)主体组件；
(b)端部执行器组件；和
(c)联接组件，所述联接组件能够操作以将所述端部执行器组件选择性地联接到所述主体组件；
其中所述联接组件能够操作以将所述端部执行器组件机械地联接到所述主体组件；
其中所述端部执行器组件相对于所述主体组件在纵向上固定，并且所述端部执行器组件能够相对于所述主体组件旋转；并且
其中所述联接组件还能够操作以将所述端部执行器组件电联接到电源。
CN201180063919.XA 2010-11-05 2011-11-03 具有模块化轴和端部执行器的外科器械 Active CN103298419B (zh)

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