CN103561664A - 弹性偏置地联接至手持件的外科器械轴 - Google Patents

弹性偏置地联接至手持件的外科器械轴 Download PDF

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Publication number
CN103561664A
CN103561664A CN201180064098.1A CN201180064098A CN103561664A CN 103561664 A CN103561664 A CN 103561664A CN 201180064098 A CN201180064098 A CN 201180064098A CN 103561664 A CN103561664 A CN 103561664A
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assembly
drive member
transmission assembly
transducer
proximal
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CN201180064098.1A
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CN103561664B (zh
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K·L·豪泽
P·A·韦茨曼
F·E·谢尔顿四世
G·S·斯特罗布尔
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Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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Abstract

本发明公开了一种超声外科器械，其包括可重复使用的柄部组件和可移除的一次性轴组件。所述柄部组件包括触发器、外壳和驱动构件，所述外壳具有形成于其远端中的远侧孔，所述驱动构件与触发器连通以致动所述驱动构件。所述轴组件包括近侧轴部分、转子旋钮、传输组件和端部执行器，所述转子旋钮具有联接结构，所述传输组件从近侧轴部分朝远侧延伸，并且所述端部执行器联接至传输组件的远端。柄部组件的驱动构件可移除地联接至轴组件的近侧轴部分。另一个型式包括柄部组件的驱动构件，该柄部组件能够经由偏置构件可移除地接合轴组件的近侧轴部分。另一个型式包括非螺纹联接至换能器的传输组件的波导。

Description

弹性偏置地联接至手持件的外科器械轴
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12日提交的名称为“SURGICALINSTRUMENT SHAFT WITH RESILIENTLY BIASED COUPLING TOHANDPIECE”的美国非临时申请序列号13/271,364的优先权，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侧端部执行器通过套管针的插管设置在所需手术部位处。这些远侧端部执行器（例如，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）可以多种方式接合组织，以达到诊断或治疗的效果。内窥镜式外科器械可包括轴，所述轴位于端部执行器和由临床医生操纵的柄部部分之间。这种轴可允许插入所需深度并围绕所述轴的纵向轴线旋转，由此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实例包括公开于下述专利中的那些：2006年4月13日公布的名称为“Tissue Pad Use with an Ultrasonic Surgical Instrument”的美国专利公布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“Ultrasonic Device for Cutting and Coagulating”的美国专利公布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“Ultrasonic Waveguide and Blade”的美国专利公布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 and Coagulating”的美国专利公布2008/0200940，其公开内容以引用方式并入本文；2011年1月20日公布的名称为“Rotating Transducer Mount for Ultrasonic Surgical Instruments”的美国专利公布2011/0015660，其公开内容以引用方式并入本文；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，其公开内容以引用方式并入本文；以及2011年4月14日公布的名称为“Surgical Instrument Comprising First andSecond Drive Systems Actuatable by a Common Trigger Mechanism”的美国专利公布2011/0087218，其公开内容以引用方式并入本文。另外，这些外科工具可包括无线换能器，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中的无线换能器，其公开内容以引用方式并入本文。另外，外科器械可用于或者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 with UltrasoundCauterizing and Cutting Instrument”的美国专利6,783,524中的机器人辅助的外科手术场景，其公开内容以引用方式并入本文。
尽管已研制出若干系统和方法并用于外科器械，但据信在本发明人之前还无人研制出或使用所附权利要求中描述的发明。
附图说明
本说明书后附的权利要求书特别指出并明确主张本技术，但据信从下面结合附图对某些实例所作的描述将会更好地理解本技术，附图中类似的参考标号表示相同元件，其中：
图1示出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示出了示例性外科器械的局部侧正视图，其中覆盖件的一部分被移除以示出示例性多部件柄部组件的配对外壳部分的内部；
图3示出了示例性换能器的远端的局部透视图；
图4示出了示例性传输组件的透视图；
图5示出了联接至示例性柄部组件的远端的示例性传输组件的近端的局部视图；
图6示出了联接至另一个示例性柄部组件的远端的另一个示例性传输组件的近端的局部视图；
图7示出了包括突出部的示例性转子的正视图；
图8示出了图7所示的示例性转子的局部透视图；
图9示出了联接示例性多部件柄部组件和轴的图7所示的示例性转子的剖视图；
图10示出了将示例性轴连接至驱动构件的替代型式的透视图；
图11示出了在解锁位置将示例性轴连接至驱动构件的替代型式的剖视图；
图12示出了在锁定位置的图11所示的示例性轴和驱动构件；
图13示出了联接柄部组件的远端的传输组件的近端的局部视图；
图14示出了从图13所示的柄部组件脱离的图13所示的传输组件的局部视图；并且
图15示出了具有渐缩的公波导末端的示例性外科器械的正视图，所述渐缩的公波导末端能够非螺纹附接到对应的渐缩的母换能器末端。
附图并非旨在以任何方式进行限制，并且可以预期本技术的各种实施例能够以多种其它方式来执行，包括那些未必在附图中示出的方式。附图并入本说明书中并构成其一部分，示出了本技术的若干方面，并与具体实施方式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
本技术的某些实例的下述描述不应用于限制其范围。通过以下举例说明设想用于实施本技术的最佳方式之一的描述，本技术的其它实例、特征、方面、实施例和优点对于本领域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它的不同和明显方面。因此，附图和具体实施方式应被视为实质上是示例性的，而非限制性的。
I.示例性超声外科系统的概述
图1示出了示例性的超声外科系统10，其包括超声外科器械50、发生器20、以及将发生器20联接至外科器械50的电缆30。在一些型式中，发生器20包括由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的教导内容进行构造，其公开内容以引用方式并入本文。尽管在本文中以超声外科器械来描述外科器械50，但应当理解，本文的教导内容可易于适用于多种外科器械，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，根据本文的教导内容，这对于本领域的普通技术人员将是显而易见的。此外，尽管本实例将参照缆线连接的外科器械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中的无线换能器，其公开内容以引用方式并入本文。例如，外科装置50可包括一体和便携式电源，例如电池等。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“RoboticSurgical Tool with Ultrasound Cauterizing and Cutting Instrument”的美国专利6,783,524中的机器人辅助外科装置。
本实例的外科器械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在其近端处联接至多部件柄部组件60并且从多部件柄部组件60向远侧延伸。在本实例中，传输组件70被构造成细长的、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“Ultrasonic Waveguide 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。本实例的传输组件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远端的端部执行器80。在本实例中，端部执行器80包括机械和声学地联接至波导的刀片82、能够操作以在传输组件70的近端枢转的夹持臂84、以及联接至夹持臂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 Improved ClampArm Pivot Mount”的美国专利5,980,510的教导内容中的至少一些进行构造和操作，其公开内容以引用方式并入本文。端部执行器80和传输组件70的示例性变型将在下文中参照图4所示的实例进行更详细地论述。
在一些型式中，换能器100包括多个压电元件（未示出），所述多个压电元件在第一谐振器（未示出）和第二谐振器（未示出）之间压缩以形成压电元件的叠堆。压电元件可由任何合适的材料制成，例如锆钛酸铅、偏铌酸铅、钛酸铅、和/或例如任何合适的压电晶体材料。换能器100还包括电极，所述电极包括至少一个正极和至少一个负极，所述至少一个正极和至少一个负极能够在一个或多个压电元件上产生电势，以使得压电元件将电力转换成超声振动。超声振动通过传输组件70中的波导传输至刀片82。
本实例的多部件柄部组件60包括配对外壳部分62和下部64。配对外壳部分62能够在其近端容纳换能器100并且在配对外壳部分62的远端容纳传输组件70的近端。在本实例中示出了用于旋转传输组件70和换能器100的旋转旋钮66，但应当理解，旋转旋钮66仅为任选的。配对外壳部分62将在下文中参照图2进行更详细地论述。图1所示的多部件柄部组件60的下部64包括触发器68并且能够供用户使用单手抓紧。下部64的一个仅为示例性的替代型式示于2011年1月20日公布的名称为“RotatingTransducer Mount for Ultrasonic Surgical Instruments”的美国专利公布2011/0015660的图1中，其公开内容以引用方式并入本文。示于本发明的图2中的触发按钮69位于下部64的远侧表面上并且能够操作以利用发生器20来选择性地启动处于不同操作水平的换能器100。例如，第一触发按钮69可启动处于最大能量水平的换能器100而第二触发按钮69可启动处于最小的、非零能量水平的换能器100。当然，触发按钮69能够用于除最大和/或最小能量水平之外的能量水平，根据本文的教导内容，这对于本领域的普通技术人员将是显而易见的。此外，触发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的任何其它位置，并且可提供任意数量的触发按钮。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。这种触发器部分能够操作以启动换能器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、金属、和/或任何其它合适的材料进行构造，根据本文的教导内容，这对于本领域的普通技术人员将是显而易见的。根据本文的教导内容，多部件柄部组件60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进行构造：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。
还应当理解，本文所述的教导内容、表达方式、实施例、实例等中的任何一个或多个可与本文所述的其它教导内容、表达方式、实施例、实例等中的任何一个或多个相结合。因此下述教导内容、表达方式、实施例、实例等不应视为彼此隔离。根据本文的教导内容，其中本文的教导内容可结合的各种合适方式对于本领域普通技术人员将是显而易见的。这种修改形式和变化形式旨在包括在权利要求书的范围之内。
II.用于超声外科器械的示例性联接组件
在一些情况下，从多部件柄部组件60和换能器100拆卸传输组件70可以是有用的。例如，可拆卸的传输组件70可允许多部件柄部组件60被再利用，所述多部件柄部组件60具有包括各种端部执行器80的多种传输组件70。仅以举例的方式，各种端部执行器80可具有不同尺寸和/或形状的刀片82，或者各种端部执行器80可具有完全不同的功能，例如射频端部执行器、缝合端部执行器、切割端部执行器等。此外，可通过下述方式将单个多部件柄部组件60再用于不同操作：由用户拆除变脏的传输组件70、任选地清洁多部件柄部组件60、并且将新传输组件70联接至多部件柄部组件60以用于新操作。因此，对于外科器械50的一些用户而言，构造与多种传输组件70联接的多部件柄部组件60是优选的。
A.示例性的多部件柄部组件
图2示出了多部件柄部组件60的局部侧视图，其中覆盖件61的一部分被移除以示出容纳在配对外壳部分62内以及下部64的一部分内的内部元件。如上文所述，下部64包括可枢转触发器68和一对触发按钮69。本实例的触发器68能够从远端打开位置枢转至近端闭合位置。触发器组件150联接至触发器68并且被可枢转地支撑在多部件柄部组件60内。本实例的触发器组件150包括可围绕销（未示出）枢转的可枢转附接臂152、触发器臂154、中间连杆156、以及致动臂158。致动臂158在其远端联接至触发器托架170。致动臂158包括从其向外延伸的一个或多个安装销160，并且销160的尺寸被设定成可滑动地容纳在形成于覆盖件61中的相应细长沟槽162内。因此，当触发器68从打开位置向近端枢转到闭合位置时，附接臂152和触发器臂154在多部件柄部组件60内枢转。联接至触发器臂154的中间连杆156将这种枢转运动从触发器臂154传递至致动臂158以通过沟槽162内的销160向近端可滑动地平移致动臂158。联接至致动臂158的触发器托架170也向近端平移。在本实例中，触发器托架170联接至力限制机构180，所述力限制机构180又联接至传输组件70以操作内部管状致动构件74，如将在下文更详细描述。图2所示的腔体140能够从形成于覆盖件61中的换能器孔142将换能器100容纳于腔体140中。腔体140能够将换能器100的至少一部分容纳于其中以使得换能器100和传输组件70可联接在一起。根据本文的教导内容，多部件柄部组件60的其它构型对于本领域的普通技术人员将是显而易见的。
B.示例性换能器
如图3所示，本实例的换能器100为经由缆线30联接至发生器20的管状元件，但应当理解，换能器100可替换为无线换能器。例如，根据本文引用的各种参考文献或者其它文献的教导内容，换能器100可改为从容纳在柄部组件60内的电源接收功率。在本实例中，换能器100包括设置在其主体110内的第一导电环102和第二导电环104。在本实例中，第一导电环102包括环构件，所述环构件具有一个或多个电接触件，所述电接触件设置在环构件上并且能够将第一导电环102电联接至电源。第一导电环102设置在主体110和从主体110向远侧延伸的焊头120之间。焊头120包括远端焊头螺纹122以使得焊头120能够联接至波导210，如将在下文中参照图4进行论述。本实例的第一导电环102与凸缘106同轴并且相邻。本实例的凸缘106能够在多部件柄部组件60内进一步地机械联接换能器100。换能器腔体108设置在第一导电环102和第二导电环104之间，以使得第一导电环102与第二导电环104和/或换能器100的其它导电元件电隔离。第一导电环102位于从主体110向远侧延伸的非导电平台上。如图1所示，第一导电环102通过主体110内的一个或多个电线或者导电蚀刻件（未示出）电联接至缆线30。第一导电环102与缆线30的这种电联接可包括滑环以有利于换能器100相对缆线30自由旋转。
换能器100的第二导电环104类似地包括设置在主体110和焊头120之间的环构件。第二导电环104设置在第一导电环102和焊头120之间。如图3所示，第一和第二导电环102,104为同轴构件。第二导电环104同样与第一导电环102和换能器100的其它导电元件电隔离。类似于第一导电环102，第二导电环104从非导电平台延伸。可在第二导电环104和焊头120之间设置一个或多个垫圈形垫片112以使通过焊头120传输的振动与换能器100的其它元件相隔离。如图1所示，第二导电环104也通过主体110内的一个或多个电线或导电蚀刻件（未示出）电联接至缆线30。第二导电环104与缆线30的这种电联接也可包括滑环以有利于换能器100相对缆线30自由旋转。一个仅为示例性的合适超声换能器100为由Ethicon Endo-Surgery,Inc.(Cincinnati,Ohio)出售的型号No.HP054，但应当理解，可使用任何其它合适的换能器。
如本实例所示，换能器100的远端通过焊头120螺纹联接至传输组件的近端。换能器100的远端还通过第一和第二导电环102,104交接至一个或多个电联接件（未示出）以将换能器100电联接至触发按钮69，由此在使用外科器械50时为用户提供用于启动换能器100的手指启动型控制。一个或多个电联接件与第一和第二导电环102,104之间的接合可包括滑环连接部以允许换能器100相对多部件柄部组件60自由旋转。根据本文的教导内容，换能器100的其它构型对于本领域的普通技术人员将是显而易见的。例如，可从换能器100的远端省去第一和第二导电环102,104并且可通过替代性结构来实现换能器100到触发按钮69的电联接，例如通过换能器100近端的导体、沿换能器100的主体110侧面设置的导体、直接通过缆线30、和/或任何其它结构。当通过触发按钮69启动本实例的换能器100时，换能器100能够操作以产生线性振荡或振动形式的、超声频率（例如55.5kHz）下的机械能量。当换能器100通过焊头120联接至传输组件70时，则这些机械振荡通过传输组件70的内部波导传输至端部执行器80。在本实例中，由于刀片82联接至波导，刀片82因而以超声频率振荡。因此，当将组织固定在刀片82和夹持臂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，但根据本文的教导内容，传输组件70和换能器100的其它合适构型对于本领域的普通技术人员将是显而易见的。
C.用于螺纹附接的示例性传输组件
如此前所指出的，在一些情况下，从多部件柄部组件60和换能器100拆卸传输组件70可以是有用的。仅为示例性的情况包括使用具有包括不同尺寸和/或形状的刀片82的多个传输组件70的多部件柄部组件60、使用具有完全不同功能和形态的各种端部执行器80（如，射频端部执行器、缝合端部执行器、切割端部执行器等）、或者再利用多部件柄部组件60以供用户进行多种操作。因此，允许用户为多部件柄部组件60更换传输组件70的型式可以是有用的。
图4示出了一个仅为示例性的传输组件200，其具有近端202、远端204、波导210、内部管状致动构件220、外部护套230、以及位于传输组件200远端的端部执行器240。在本实例中，波导210、内部管状致动构件220、和外部护套230为同轴构件，其中波导230位于中心，内部致动构件220围绕波导210设置，并且外部护套230围绕内部致动构件220设置。
首先参见传输组件200的远端204，端部执行器240包括刀片242、夹持臂244、以及一个或多个任选的夹持垫246。在本实例中，刀片242联接至波导210以使得从换能器100传输至波导210的机械振动也传输至刀片242。刀片242与波导210之间的仅为示例性的联接包括将刀片242焊接至波导210、一体地形成刀片242和波导210、将刀片242机械或化学地联接至波导210、和/或任何其它合适的构型，根据本文的教导内容，这对于本领域的普通技术人员将是显而易见的。在一些型式中，刀片242为弯曲刀片，例如示于图4中的刀片242；并且在一些型式中，刀片242可为直刀片。此外，刀片242可具有多种形状和尺寸。在本实例中，刀片242为渐缩矩形刀片，但应当理解，刀片242可为圆柱形、三角形、半圆柱形、方形、钩形、和/或用于刀片242的任何其它形状。此外，可将附加结构添加至刀片242，包括球形尖端、钩形尖端、方形尖端、锯齿状边缘、和/或任何其它附加结构。根据本文的教导内容，刀片242的其它构型对于本领域的普通技术人员将是显而易见的。
本实例的夹持臂244为对应于刀片242曲率的弯曲构件。夹持臂244可任选地包括夹持垫246以紧靠刀片242来夹持或固定组织。这种夹持垫可根据2006年4月13日公布的名称为“Tissue Pad Use with an UltrasonicSurgical Instrument”的美国专利公布2006/0079874的教导内容中的至少一些进行构造。夹持臂244相对于刀片242的枢转运动是通过夹持臂244上的第一对枢转点248和夹持臂244上的第二组枢转点249来完成的，所述第一对枢转点248枢转地联接至外部护套230，所述第二组枢转点249枢转地联接至内部管状致动构件220。在本实例中，外部护套230可通过旋转旋钮250联接至多部件柄部组件60，由此使外部护套230接地。夹持臂244的第一组枢转点248通过外部护套230上的相应通孔232枢转地连接至外部护套230。在一些型式中，第一组枢转点248包括通孔并且可通过第一组枢转点248和通孔232插入固定销或铆钉以将夹持臂244固定至外部护套230。在此型式中，可将所述销激光焊接至夹持臂244或者可将所述销激光焊接至外部护套230。当然，通孔232可另外为向外延伸的销，并且第一组枢转点248可为通孔。根据本文的教导内容，第一组枢转点248和通孔232的其它构型对于本领域的普通技术人员将是显而易见的。
夹持臂244的第二组枢转点249通过内部管状致动构件220上的相应通孔222枢转地连接至内部管状致动构件220。在一些型式中，第二组枢转点249包括通孔并且可通过第二组枢转点249和通孔222插入固定销或铆钉以将夹持臂244固定至内部管状致动构件220。在此型式中，可将销激光焊接至夹持臂244或者可将销激光焊接至内部管状致动构件220。当然，通孔222可替代为向外延伸的销，并且第二组枢转点249可为通孔。根据本文的教导内容，第二组枢转点249和通孔222的其它枢转构型对于本领域的普通技术人员将是显而易见的。
在夹持臂244如此固定至外部护套230和内部管状致动构件220的情况下，当内部管状致动构件220纵向平移时则夹持臂244能够枢转。在本实例中，内部管状致动构件220可相对于外部护套230的纵向轴线平移并且联接至多部件柄部组件60内的力限制机构180。因此，当力限制机构180通过触发器68和触发器组件150平移时，夹持臂244能够从打开位置枢转至闭合位置。应当理解，如同本文提及的其它部件，夹持臂84,244仅为任选的。同样，触发器68和触发器组件150以及本文所述的用于枢转夹持臂84,244的部件也仅为任选的。因此，端部执行器80,240的一些型式可仅包括刀片82,842和/或其它结构。
如图4所示，可将垫片290插入夹持臂244和刀片242之间以将夹持臂244保持在打开位置。在此实例中，垫片290具有平坦的底部表面292和成角度的顶部表面294。顶部表面294设置成一角度以在底部表面292邻接刀片242时将夹持臂244相对于刀片242保持在打开位置。在一些型式中，底部表面292能够搭扣或夹持到刀片242上以相对于刀片242来固定垫片290。作为另外一种选择，可在垫片290中提供凹槽以使得垫片290可滑动到刀片242上。此外，可将粘合剂涂覆至底部表面292和/或顶部表面294以另外固定垫片290。因此，当将垫片290插入夹持臂244和刀片242之间时，阻止夹持臂244枢转至闭合位置。这可允许用户将传输组件200联接至多部件柄部组件60，同时将夹持臂244和触发器68保持在其各自的打开位置。作为另外一种选择，用户可将传输组件200在不使用垫片290的情况下联接至多部件柄部组件60。例如，用户可将传输组件200的不同部件与柄部组件60的不同部件在不同的时间例如按照下文所述的方式或者其它方式进行联接。
现在参见传输组件200的远端202，旋转旋钮250将外部护套230联接至多部件柄部组件60。在本实例中，旋转旋钮250包括内环部分（未示出），所述内环部分具有从其向近端延伸的一或多个连接器252、外环254、和销（未示出），所述销延伸穿过外环254、外部护套230、内部管状致动构件220、和波导210。因此，当旋转旋钮250的外环254旋转时，波导210、内部管状致动构件220、和外部护套230也旋转。本实例的内环部分和外环254为互补轴承元件，以使得外环254可相对于内环部分旋转。应当理解，销不延伸穿过内环部分。如此前所指出的，内环部分包括连接器252。在本实例中，连接器252示为搭扣配合连接器，但可使用其它合适的连接结构，例如螺纹、粘合剂、销、夹片、搭锁、和/或其它连接器，根据本文的教导内容，这对于本领域的普通技术人员将是显而易见的。当将传输组件200与多部件柄部组件60和换能器100进行组装时，如将在下文所述，本实例的连接器252插入一个或多个凹槽（未示出）并且将旋转旋钮250联接至多部件柄部组件60的覆盖件61。可提供释放机构，例如位于多部件柄部组件60上或旋转旋钮250上的按钮（未示出）以在要拆除传输组件200时使连接器252从覆盖件61脱离。作为另外一种选择，连接器252可被设计为当传输组件200脱离时连接器252脱落。此外，如果使用螺纹，则可旋转旋转旋钮250的内部以从多部件柄部组件60脱离。根据本文的教导内容，旋转旋钮250的其它合适构型对于本领域的普通技术人员将是显而易见的。
仍参见传输组件200的近端202，在内部管状致动构件220的近端处包括外部螺纹228，如图4所示。外部螺纹228拧入力限制机构180的互补螺纹（未示出）内，所述力限制机构180又由触发器组件150驱动。另外，在波导210的近端处包括具有内部螺纹218的凹槽，如图4所示。内部螺纹218拧到焊头螺纹122上以将波导210机械或声学地联接至换能器100。当然，根据本文的教导内容，传输组件200的其它合适构型对于本领域的普通技术人员将是显而易见的。类似地，根据本文的教导内容，传输组件200可与柄部组件60联接的各种其它合适方式对于本领域的普通技术人员将是显而易见的。
III.至柄部部分的示例性可移除轴连接
下文描述的型式讨论了一次性传输组件的连接及用途，所述一次性传输组件是上文所述的传输组件70的替代型式。传输组件70的替代型式包括如下组件：所述组件允许替代的传输组件与例如在超声外科器械的相应的可重复使用的柄部部分中的换能器100可选择性地联接并调节。可提供给选择性地联接至器械50的多部件柄部组件60和换能器100的传输组件70的附加的示例性修正形式将在下文进行更详细的描述。可将下述教导内容结合到器械50内的各种合适方式对于本领域的普通技术人员将是显而易见的。类似地，可将下述教导内容与本文引用的参考文献的各种教导内容进行组合的各种合适方式对于本领域的普通技术人员将是显而易见的。还应当理解，下述教导内容并不限于本文引用的参考文献中教导的器械50或装置。下述教导内容可易于应用至多种其它类型的器械，包括将不被分类为超声外科器械的器械。根据本文的教导内容，可应用下述教导内容的各种其它合适装置和设置对于本领域的普通技术人员将是显而易见的。
A.示例性球闭锁装置连接
图5示出了传输组件70的托架170至力限制机构180的连接。托架170包括捕集在力限制机构180中的凹口302内的杆300。在切割时，杆300传输力，例如大的朝远侧方向的闭合力，以驱动端部执行器的夹持部分，从而达到良好的血管接合；并且传输较小的朝近侧方向的开启力用于解剖。
图6示出了一种替代型式，其在托架306中使用弹簧加载的球闭锁装置组件304而不是杆，以闩锁进限定在传输组件312的近端310内的凹口308中。弹簧加载的球闭锁装置组件304包括附接到偏置构件例如弹簧316的末端的滚珠或闭锁装置314。闭锁装置314有助于将传输组件312连接至外科器械50A的覆盖件61A的配合的外壳部分62A。外科器械50A与上文所述的外科器械50相似，除了下述不同：关于传输组件312分别连接至外科器械50A以及从外科器械50A释放。相同的情况适用于下述及本文所述的外科器械的其它型式。相似地，下述和本文所述的传输组件的型式各自包括旋转旋钮诸如旋钮66A，和轴诸如外部护套317，所述外部护套与传输组件70的外部护套72以及传输组件200的外部护套230相似。外部护套317可相对于器械50A的手持件旋转，但不会相对于所述手持件平移。
当将传输组件312连接至外科器械50A的可重复使用的柄部部分时，组件312的近端310向外推动闭锁装置314并远离组件312直至闭锁装置314与凹口308对齐，此时弹簧316施加偏置力以使闭锁装置314与凹口308配合。该力将组件312可移除地连接至器械50A的托架306。托架306与传输组件70的托架170相似。托架306基于触发器（未示出）相对于手持件的枢转运动在器械50A的手持件内平移，其中所述触发器与传输组件70的触发器68在结构和操作上相似。组件312的近端310包括与传输组件200的内部管状致动构件220相似的内管部分。近端310的内管部分相对于器械50A的手持件在托架306内平移，并且包括延伸穿过外部护套317并在外部护套317内平移的内部管。当内部管沿第一方向（例如，朝近侧）平移时，该内部管朝刀片242枢转夹持臂244。当内部管沿第二相反方向（例如，朝远侧）平移时，该内部管远离刀片242枢转夹持臂244。
在一些其它型式中，当外部护套317朝远侧平移以抵靠刀片242闭合夹持臂244时，内部管可保持固定。作为另一个仅例证性的变型，内部管可接合夹持臂244上的枢轴并且外部护套317可接合固定的驱动销，从而允许内部管的远侧运动以抵靠刀片242闭合夹持臂244。另一个仅例证性的型式涉及：具有定位在夹持臂244的上侧上的枢轴销和驱动销二者，其中驱动销被设置成略高于枢轴销，使得内部管的远侧平移将抵靠刀片242闭合夹持臂244。在另一个型式中，将在下文更详细描述有支架的托架表面318，其可被设置在托架306的远端处并且可包括唇缘，所述唇缘在组件312的近端插入期间由组件312的近端搭锁在唇缘上。当组件312如此附接到托架306时，此类插入和结构将相对于较弱的远侧推动允许强的近侧牵拉工作。根据本文的教导，致动夹持臂244的其它合适的方式对本领域的普通技术人员将是显而易见的。
波导320与传输组件200的波导210相似，并且被同轴定位在外部护套317内和内部管内。波导320与换能器（未示出）联接，并且相对于组件312的近端310朝近侧延伸。
如上相对于图3和4所述，由于组件312可被旋转，因此波导在连接至托架306以后仍可被螺纹连接至换能器中。一旦就位，则组件312的近端310与有支架的托架表面318保持齐平。有支架的托架表面318包括用于容纳组件312的波导320的开口。有支架的托架表面318作为“衬托”用于在组件312的近端310上推动，以及允许对组件312的强的远侧推力和同时的不太强的近侧拉力。然后通过经由托架306牵拉组件512的内管来完成组件512的端部执行器的夹持臂的闭合，组件312的近端310经由有支架的托架表面318与托架306保持齐平，从而如上所述允许足够的力打开所述端部执行器以及从组织松开所述端部执行器。
当端部执行器被打开时，闭锁装置314在组件312的近端310上牵拉，而不会脱离组件312。然而，如果使用者想要替换组件312，则可通过足够用力牵拉来提供足够的力将组件312从器械50A的可重复使用的柄部移除以使止动装置314从组件312脱离。
B.示例性转子连接
图7-12示出了三种型式的至超声外科器械的示例性转子连接，用以提供传输组件与外科器械的柄部部分的附接和分离。图7-9所示的第一型式涉及转子的圆柱部分上的止动装置以及包括回位弹簧的轴连接方法。图10所示的第二型式利用包括保持环的轴连接方法。图11和12所示的第三型式利用包括成多保持臂形式的弹性地偏置的夹持部件的轴连接方法。
1.示例性闭锁装置和回位弹簧型式
图7示出了包括旋钮部分352和近侧部分354的转子350，所述近侧部分354从旋钮部分352横向突出。近侧部分354包括从圆柱部分358突出的突出部356。转子350包括纵向轴线A，所述纵向轴线A在图7中将转子350分成两部分。图8示出了那些部分中的一个的局部透视图。突出部356从弹性臂360的自由端突出。
图9示出了作为插入超声外科器械的远端364的传输组件362的一部分的转子350的剖视图。组件362包括捕获转子350的远侧壁370的一对止挡件366。转子350的远侧壁370和其它外部壁限定内管375从中穿过的内部中空空间372。内管375在外部护套374内平移。当组件362完全插入器械的远端364时，端件376固定地设置在与圆柱部分358的近端对齐的位置处的内管375的近端上。偏置构件诸如弹簧378设置在止挡件366中的一个与端件376之间。端件376将内管375偏置到近侧位置，从而将夹持臂244偏置到闭合位置（朝向刀片242枢转）。
另外，当组件362第一次插入器械的远端364时，突出部356抵靠形成于容纳组件362的远端364中的孔向内压缩。限定孔的圆柱壁380结束于凸缘382。当组件362完全插入器械的远端364时，突出部356离开圆柱壁380并向外弹出，使得每个突出部356的上表面与凸缘382保持齐平，以阻止组件362非期望地从远端364移除。此后，转子350可通过用例如使用者的手指按压突出部356来移除，以允许闭锁装置或突出部356经由壁380限定的孔被清回。
当组件362完全坐置在手持件中时，驱动构件384接合端件376。驱动构件384可如上所述的用于外科器械50的方式经由托架结构致动，从而以闭合连接的端部执行器的方式（也如上所述用于器械50的方式）向远侧压缩弹簧378且推动内管375。释放触发器从压缩状态释放弹簧378，使得弹簧378的偏置力朝近侧驱动内管375以及重新打开夹紧的端部执行器（如上所述）。虽然上述内管375被描述为超声外科器械50的夹持臂致动管，但相似的内部构件可被用作基于射频的外科器械或外科缝合器械（例如，直线切割器等）的击发横梁，包括但不限于本文所引用的各种参考文献中所述的此类器械的变型。
2.示例性环型式
图10示出了将图9所示的端件376连接至图9所示的驱动构件384的方式。保持环404设置在端件376的近侧部分处的沟槽中，介于近端406和止挡件408之间。环404帮助将端件376保持在驱动构件384内，而当器械上的触发器未被释放时仍允许围绕内管375设置的弹簧378沿箭头B的方向将端件376返回至初始的原位置。环404具有径向弹簧特性，从而允许环404在端件376插入驱动构件384时压缩。例如，环404可包括间隙，该间隙允许环404的有效直径在环404被驱动进入驱动构件384的第一内部镗孔部分412时减小，如下所述。
端件376沿箭头B的方向插入驱动构件384。驱动构件384包括设置在第二内部镗孔部分414远侧的第一内部镗孔部分412，所述第二内部镗孔部分比412部分更窄并且经由近端406将会邻接的凸缘416与412部分分离。驱动构件384的第一内部镗孔部分412还包括能够容纳环404的环形沟槽418。环404将具有足够的保持力以从弹簧378传输力，从而使端件376返回至初始的原位置，但是此类保持力可被克服以通过在传输组件362上向远侧牵拉来将端件376从驱动构件384移除。作为另外一种选择，环404可被定位在器械柄部的一部分上而不是端件376上，以用作抵靠端件376中的沟槽的保持装置。
3.示例性保持臂型式
图11-12示出了将另一种型式的轴组件450经由弹性地偏置的夹持部件454连接至驱动构件452的另一种方式，所述轴组件450包括带有内部平移的内管453的外部护套451。例如，图12示出了将一种型式的内管状致动构件220连接至传输组件70的托架170和力限制机构180的一种方式，其中内管453与内管状致动构件220相似。轴组件450仍可用于上文所述的转子350以将传输组件保持至器械。
图11中所示的驱动构件452包括形成于驱动构件452的远端458中的沟槽456。沟槽456能够容纳从组件454的保持臂462向内延伸的楔形物460。保持臂462自然地或弹性地向外偏置。组件454设置在轴组件450的内管453的近端464处。组件454可被模塑成所述形状或可为冲压的金属，诸如弹簧钢或其它此类适合的材料。
如图11所示，当内管453的组件454沿箭头C的方向插入器械的手持件（未示出）的远端468内的圆形的凹槽466时，轴组件450前进直到近端470邻接驱动构件452的远端458上的表面。这时候，包括近侧凹槽部分的转子350A的近端472将围绕组件454的远端474容纳和夹持。限定转子350A的近端472的近侧凹槽部分的内壁将继续在保持臂462之上推进，以向内压缩壁462直到楔形物460容纳在沟槽456内，如图12所示。一旦转子350A完全插入器械的远端468，壁462无法向外打开至自然位置，直到转子350A朝外侧运动出器械的远端468，这时候壁462向外偏置到其自然位置以从轴组件450释放驱动构件452。可提供一个或多个附加组件以将转子350A选择性地固定到器械的远端468。根据本文的教导内容，此类组件可采用的各种合适的形式对本领域的普通技术人员而言将是显而易见的。
C.示例性滚珠压缩锁连接
图13-14示出了另一个传输组件500至外科器械50C的远端504处的柄部部分502的连接。组件500包括轴部分508接入的旋转旋钮506，所述轴部分508包括为传输组件诸如传输组件70的一部分的管。差别是轴部分508连接至旋钮506的滚珠方式。具体地，如图13所示，驱动构件510经由滚珠514连接至内管512。图14示出了沿箭头D方向朝近侧前进的内管512。内管512包括限定内部凹槽518的内部圆形壁516。环形凹口520还被限定在壁516中。凹口520能够容纳滚珠514。
在装配期间，波导522沿箭头E的方向在内管512和驱动构件510内的凹槽中前进。波导522包括渐缩的近端524，使得当渐缩的末端524沿箭头E的方向前进时，滚珠514接合渐缩的末端524以使扩大的倾斜表面向上缩，并且迫使滚珠514经由波导522施加的凸轮力与凹口520接合。强效接合允许与减小的纵向坡度至没有纵向坡度的高负荷配合。另外，内管512可仍相对于驱动构件510旋转。
外管526和内管512经由卡销连接至旋钮506，卡销包括销和狭槽型的紧固件。例如，外管526接地锁进旋转旋钮506中的凹槽环毂（未示出）以相对于作为机械接地组件的旋钮506而固定。连接后，传输组件500的轴组件可一起旋转，并且仍可从柄部部分502移除。另外，本例子的旋钮506可移除地连接至柄部部分502。内管512与传输组件200的内管状致动构件220相似。因此，内管512用于驱动夹持臂以相对于刀片枢转，正如构件220驱动夹持臂244以相对于刀片242枢转一样，如上所述。
D.示例性渐缩的波导连接
在一些型式中，波导可以非螺纹连接方式附接到换能器，以使传输组件与可重复使用的柄部配合。例如，图15示出了在示例性超声外科器械50D中的此类连接。轴组件550包括轴552。波导554从轴552的近端556延伸。波导554包括公末端结构555。在本例子中，公末端结构555为渐缩的，但是根据本文的教导内容应当理解，公末端结构555可具有各种其它合适的形状和形式诸如平坦形式或球体形式，这对本领域的普通技术人员而言将是显而易见的。滑动螺母558围绕轴552设置。滑动螺母558能够接触销560，该销附接在波导554的纵向振动节点处。螺纹顶盖或滑动螺母558压在节点处的节销560上并产生压缩负荷以将波导554联接至换能器566，而不使用波导554和换能器566之间的螺纹连接，如下所述。另外，滑动螺母558可用作密封件。一个可能的密封件位置是在凹口559处，该凹口559形成于滑动螺母558的远端561和螺纹563之间。
滑动螺母558也能够被螺纹旋进器械50D的柄部组件562中。螺纹连接沿箭头F的方向迫使波导554的末端结构555进入腔体564，所述末端结构555在本例子中为渐缩的并被限定在换能器566的焊头内。根据本文的教导内容，腔体564可具有多种其它合适的形状和形式诸如平坦形式或椎体形式，以用于分别容纳诸如平坦形式或球体形式的末端结构555，这对本领域的普通技术人员而言将是显而易见的。具体地，腔体564能够容纳相应地形成的末端结构555。滑动螺母558或换能器566中的弹簧机构（未示出）可用于防止超过期望量的过多的力被传送到波导554和换能器566的连接部。例如，在一些型式中，销560可适配在滑动螺母558的内径内部，滑动螺母558的内部包括压缩弹簧（未示出）。压缩弹簧的远端将抵靠滑动螺母558内的凹槽的近侧部分。驱动板（未示出）将被设置在压缩弹簧的近端处。驱动板将能够上适配在滑动螺母558的凹槽内。驱动板将接触销560，并且经由压缩弹簧将限制施加到销560的力。根据本文的教导内容，其它合适的力限制结构和构型对于本领域的普通技术人员将是显而易见的。
弹簧叠堆垫圈570与传输组件70的力限制机构180相似。当触发器572被按压时，柄部组件568与弹簧叠堆垫圈570交接以致动，从而导致弹簧573被压缩。该压缩导致轴552的内管被向前驱动，从而以与如上所述用于器械50的方式相似的方式闭合端部执行器574。在使用中，轴组件550为一次性的，并能够被迅速附接到器械50D的可重复使用的柄部。
应当理解，本文所述的教导内容、表达方式、实施例、实例等中的任何一个或多个可与本文所述的其它教导内容、表达方式、实施例、实例等中的任何一个或多个相结合。因此下述教导内容、表达方式、实施例、实例等不应视为彼此隔离。根据本文的教导内容，其中本文的教导内容可结合的各种合适方式对于本领域普通技术人员将是显而易见的。这种修改形式和变化形式旨在包括在权利要求书的范围之内。
上文所述的装置的型式可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的手术。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，该专利的公开内容以引用方式并入本文。
上文所述的型式可被设计为单次使用后丢弃，或者它们可被设计为可使用多次。在上述任一种或两种情况下，都可对这些型式进行修复，以便在使用至少一次后重复使用。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进行重新组装。具体地讲，可拆卸所述装置的一些型式，并且可选择性地以任何组合形式来更换或拆除所述装置的任意数量的特定部件或零件。在清洗和/或更换特定零件时，所述装置的一些型式可在修复设施中重新组装或者在即将进行手术前由用户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。
仅以举例的方式，本文所述的型式可在手术之前和/或之后进行消毒。在一种消毒技术中，将装置置于闭合并密封的容器中，诸如置于塑料袋或TYVEK袋中。然后可将容器和装置置于可穿透该容器的诸如γ辐射、X射线或高能电子等辐射的辐射场中。辐射可杀死装置上和容器中的细菌。消毒后的装置随后可存放于无菌容器中，以备以后使用。还可使用本领域已知的任何其它技术对装置消毒，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。
尽管已在本公开中示出和描述了多个型式，但本领域的普通技术人员可在不脱离本发明范围的前提下进行适当修改以对本文所述的方法和系统进行进一步改进。已经提及了若干此类潜在的修改形式，并且其它修改形式对于本领域的技术人员而言将是显而易见的。例如，上文讨论的实例、型式、几何形状、材料、尺寸、比率、步骤等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考虑，并且应理解为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)柄部组件，所述柄部组件包括：
i.触发器，
ii.外壳，所述外壳具有形成于所述外壳的远端中的远侧孔，以及
iv.驱动构件，所述驱动构件与所述触发器连通，使得所述触发器的致动能够沿第一方向致动所述驱动构件；以及
(b)传输组件，所述传输组件包括：
i.近侧轴部分，
ii.转子旋钮，所述转子旋钮具有近侧部分，所述近侧部分具有联接结构，
iii.远侧轴组件，所述远侧轴组件相对于所述转子旋钮朝远侧延伸，
以及
iv.端部执行器，所述端部执行器联接至所述远侧轴组件的远端；
其中所述柄部组件的驱动构件可移除地联接至所述传输组件的近侧轴部分。
2.根据权利要求1所述的外科器械，其中所述转子旋钮的近侧部分上的联接结构包括突出部，当所述传输组件可移除地联接至所述柄部组件时，所述突出部能够邻接限定所述外壳的远侧孔的一部分的凸缘。
3.根据权利要求2所述的外科器械，其中所述突出部被弹性地偏置以邻接所述凸缘。
4.根据权利要求1所述的外科器械，其中所述近侧轴包括设置在所述近侧轴部分上的弹簧。
5.根据权利要求4所述的外科器械，其中当所述驱动构件可移除地联接至所述近侧轴部分时，其中所述触发器能够操作以使所述驱动构件从第一位置朝远侧运动至第二位置以压缩所述第二位置中的弹簧。
6.根据权利要求5所述的外科器械，其中所述触发器还能够操作以释放所述弹簧，从而释放偏置力以使所述驱动构件朝近侧运动回到所述第一位置。
7.根据权利要求1所述的外科器械，还包括弹簧和保持环，所述弹簧设置在所述近侧轴部分上，所述保持环能够设置在限定在所述近侧轴部分中的沟槽内。
8.根据权利要求7所述的外科器械，其中所述驱动构件包括限定在内壁中的凹槽，所述内壁限定凹进的空间。
9.根据权利要求8所述的外科器械，其中所述近侧轴部分能够被容纳在所述驱动构件的所述凹进的空间中。
10.根据权利要求9所述的外科器械，其中当所述近侧轴部分被容纳在所述驱动构件的所述凹进的空间中时，其中所述保持环能够抵靠限定所述凹进的空间的内壁而压缩，直至最终被容纳进所述凹槽中。
11.根据权利要求1所述的外科器械，其中所述近侧轴部分包括设置在所述近侧轴部分上的弹簧和弹性地偏置的夹持部件。
12.根据权利要求11所述的外科器械，其中所述弹性地偏置的夹持部件包括具有末端楔形物的保持臂，所述末端楔形物能够设置在限定在所述驱动构件中的沟槽内。
13.根据权利要求12所述的外科器械，其中所述末端楔形物被弹性地向外偏置。
14.根据权利要求12所述的外科器械，其中当所述转子旋钮被朝向近侧引导入所述远侧孔时，其中所述转子旋钮的近侧部分能够抓持所述夹持部件的保持臂并向内压缩所述保持臂，直至所述保持臂的末端楔形物设置在所述驱动构件的沟槽内。
15.根据权利要求14所述的外科器械，其中当所述末端楔形物设置在所述驱动构件的沟槽内时，所述转子为可移除的，并且能够被朝向远侧引导，使得所述转子的近侧部分释放所述夹持部件的保持臂，以允许所述保持臂返回到弹性地向外偏置的位置。
16.一种外科器械，包括：
(a)柄部组件，所述柄部组件包括：
i.触发器，
ii.外壳，所述外壳具有形成于所述外壳的远端中的远侧孔，
iii.驱动构件，所述驱动构件设置在所述外壳内，其中所述驱动构件与所述触发器连通，以及
iv.偏置构件；以及
(b)传输组件，所述传输组件包括：
i.近侧轴部分，
ii.远侧轴组件，所述远侧轴组件从所述近侧轴部分朝远侧延伸，所述远侧轴组件包括内管；以及
iii.端部执行器，所述端部执行器联接至所述远侧轴组件的远端；
其中所述驱动构件能够经由所述偏置构件可移除地接合所述传输组件的近侧轴部分。
17.根据权利要求16所述的外科器械，
其中所述偏置构件包括设置在托架上的弹簧加载滚珠，所述托架与所述驱动构件以及所述触发器连通，并且其中所述弹簧加载滚珠能够附接到所述近侧轴部分中的凹口；并且
其中有支架的托架表面设置在所述托架内，其中所述有支架的托架表面限定孔，其中该孔的尺寸设定成容纳所述传输组件的波导，其中当所述驱动构件接合到所述传输组件时，所述有支架的托架表面被设置成与所述波导从其伸出的所述传输组件的近端保持齐平，使得所述有支架的托架表面向所述接合的传输组件提供大的远侧推力和对应的小的近侧拉力。
18.根据权利要求16所述的外科器械，其中所述近侧轴部分包括所述传输组件的内管的一部分，其中所述偏置构件包括设置在所述驱动构件上的滚珠，并且其中所述滚珠能够附接到所述内管中的相应凹口。
19.一种外科器械，包括：
(a)柄部组件，所述柄部组件包括：
i.触发器，
ii.外壳，所述外壳具有形成于所述外壳的远端中的远侧孔，以及
iii.换能器组件，所述换能器组件设置在所述外壳中，所述换能器组件包括换能器，所述换能器具有非螺纹远端联接结构；以及
(b)轴组件，所述轴组件包括：
i.近侧轴部分，
ii.传输组件，所述传输组件从所述近侧轴部分朝远侧延伸，所述传输组件包括波导，所述波导具有非螺纹近端联接结构，以及
iii.端部执行器，所述端部执行器联接至所述传输组件的远端；
其中所述波导的非螺纹近端联接结构能够容纳在所述换能器的非螺纹远端联接结构中或者邻接所述换能器的非螺纹远端联接结构。
20.根据权利要求19的外科器械，其中所述远端联接结构和所述近端联接结构中的每一个均为渐缩的，其中所述波导的渐缩的近端联接结构能够被容纳在所述换能器的渐缩的远端联接结构中，所述外科器械还包括设置在所述近侧轴部分上的滑盖，其中所述滑盖能够螺纹接合限定所述外壳的远侧孔的壁。
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