CN103584912A - 具有提供清洗通路的结构的手术器械 - Google Patents
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Abstract
本发明涉及一种手术器械,其构造为便于接近内部部件以用于清洗和整修目的。器械包括壳体组件、细长轴杆组件和末端执行器。壳体组件包括致动器,细长轴杆组件包括可操作地联接至致动器的内部控制构件。细长轴杆组件还包括具有第一罩构件和第二罩构件的外罩以及铰链,所述铰链将第一罩构件和第二罩构件联接至彼此,以使得外罩可选择地在闭合构造和打开构造之间运动,在所述闭合构造中,内部控制构件包封在外罩中,在所述打开构造中,内部控制构件暴露。末端执行器支撑在细长轴杆组件的远端处,并可操作地关联至内部控制构件。
Description
技术领域
本发明总体上涉及一次性的手术器械或可重复使用的手术器械的领域。特别地,本发明涉及具有便于器械清洁和整修以供再使用的结构的器械。
背景技术
诸如电外科钳的器械通常用于开放式外科手术和内窥镜式外科手术中,以凝结、烧灼和封闭组织。该外科钳通常包括一对钳口,能够由医生控制所述钳口,以夹紧目标组织,诸如血管。所述钳口能够靠近以施加机械夹持力至组织,并与至少一个电极表面关联,以允许输送电外科能量至组织。机械夹持力和电外科能量的组合已经被证实为结合钳口之间所捕获的毗邻的组织层。在毗邻的组织层包括血管壁时,封闭所述组织会导致止血。此后,可通过推进刀穿过钳口来横切所封闭的组织。可在Dycus等人的美国专利号7,255,697中找到电外科钳使用的详细论述。
在使用中,电外科钳的各种组织接触部件倾向于被污染或降级。例如,当部分被治疗的组织粘附至电极的组织接触面时,会污染电极。同样,即使在单个外科手术中,刀刃在重复使用后会变钝,并且无法有效于横切封闭的组织。为了向特定的外科手术提供清洁的电极和锋利的刀具,通常使用全新的器械。一旦完成该手术,则丢弃所使用的器械。
一次性的器械或可重复用于多个手术的器械减少了每次手术的器械成本。然而提供一种可重复使用的电外科钳带来各种挑战。例如,电外科钳的复杂性倾向于产生相当耗费人工的清洁程序来准备外科钳以用于后续使用。不恰当的清洁会产生引入手术部位的危险污染。同样,一些可重复使用的外科钳具有为每次使用提供清洁表面的可拆卸和可更换部件。这些器械中的一些需要费力的拆卸和重装程序,这需要广泛的训练并且会阻碍器械的使用。
发明内容
本发明描述了一种用于治疗组织的手术器械。所述手术器械包括:壳体组件,所述壳体组件包括致动器;以及细长轴杆组件,所述细长轴杆组件限定纵向轴线,并从壳体组件延伸。细长轴杆组件包括内部控制构件和外罩,所述内部控制构件可操作地联接至致动器,所述外罩包括第一罩构件和第二罩构件。铰链将第一罩构件和第二罩构件彼此联接,以使得外罩可选择地在闭合构造和打开构造之间运动,在所述闭合构造中,内部控制构件被包封在外罩中,在所述打开构造中,内部控制构件被暴露至器械外部。所述手术器械还包括末端执行器,所述末端执行器被支撑在细长轴杆组件的远端处,末端执行器可操作地关联至内部控制构件。
铰链可沿限定在第一罩构件和第二罩构件之间的纵向接缝延伸,以及末端执行器被可释放地支撑在细长轴杆组件的远端处。在外罩处于打开构造时,末端执行器可在横向方向上不受阻碍地运动,并且在外罩处于闭合构造时,末端执行器的运动可被外罩阻碍。细长轴杆组件还可包括用于将外罩可选择地维持在闭合构造中的闩锁。
内部控制构件可以是响应致动器的操纵而能够纵向运动的往复运动构件。末端执行器可包括一对钳口构件,所述一对钳口构件能够从打开构造运动至闭合构造,在所述打开构造中,钳口构件相对彼此基本间隔开,在所述闭合构造中,钳口构件响应于内部控制构件的纵向运动而更加靠近在一起。
铰链还可以沿第一罩构件和第二罩构件的远侧边缘限定,以及细长轴杆组件还可包括在壳体组件和末端执行器之间延伸的结构支撑件。结构支撑件维持壳体组件和末端执行器之间的固定纵向距离,并且设置成使得当外罩处于闭合构造中时所述结构支撑件被包封在外罩中。
根据本发明的另一个方面,手术器械包括:壳体组件,所述壳体组件包括致动器;以及细长轴杆组件,所述细长轴杆组件限定纵向轴线,并从壳体组件延伸。细长轴杆组件包括可操作地联接至致动器的内部控制构件。末端执行器支撑在细长轴杆组件的远端处,并可操作地关联至内部控制构件。可操作铰链以选择性地接近内部控制构件以用于清洁,并且在器械操作期间选择性地限制接近内部控制构件。
细长轴杆组件可包括第一罩构件和第二罩构件,并且铰链可布置在轴杆组件的第一罩构件和第二罩构件之间。可替代的或另外的,壳体组件可包括第一壳体构件和第二壳体构件,并且铰链可布置在壳体组件的第一壳体构件和第二壳体构件之间。第一壳体构件和第二壳体构件中的至少一个可包括绕其周缘布置的顺从材料,以在与第一壳体构件和第二壳体构件中的另一个接合时形成气密密封。铰链可被定位成允许第一壳体构件和第二壳体构件沿基本垂直于细长轴杆组件的平面打开。内部控制构件可在其近端处包括连接件,以用于在壳体内接合近侧驱动构件,并且近侧驱动构件可操作地关联至致动器。壳体组件还可包括闩锁,以用于将第一壳体构件和第二壳体构件保持在闭合构造,并用于保持连接件与近侧驱动构件的接合。
手术器械还可包括从壳体组件延伸的线缆。该线缆可连接至电外科能量源,并且连接件在其上包括电触点,以用于从线缆接收电外科能量。
附图说明
结合进说明书并构成该说明书一部分的附图示意了本发明的实施方式,并与下面给出的实施方式的详细描述一起,用于解释本发明的原理。
图1是根据本发明实施方式的内窥镜式手术器械的透视图,其具有铰接的轴杆组件;
图2是根据本发明可替代实施方式的内窥镜式手术器械的侧视图,其具有翻盖式轴杆组件;
图3是根据本发明可替代实施方式的开口、U形轴杆组件的截面图;
图4是根据本发明可替代实施方式的内窥镜式手术器械的侧视图,其具有铰接的壳体组件;
图5是根据本发明可替代实施方式的内窥镜式手术器械的侧视图,其具有铰接的壳体组件以及可更换的轴杆组件;
图6A是根据本发明可替代实施方式的内窥镜式手术器械的侧视图,其具有可与器械壳体分离的可释放往复运动构件;
图6B是可释放机构的局部示意图,可释放机构便于图6A的往复运动构件与器械壳体的可释放连接;
图7是根据本发明可替代实施方式的内窥镜式手术器械的示意图,其具有可移除和可拆卸轴杆组件;
图8是根据本发明可替代实施方式的连接机构的局部示意图,其便于轴杆组件与器械壳体的可释放连接;
图9是具有壳体的内窥镜式手术器械的示意图,所述壳体具有流体端口以允许清洗溶液穿过壳体内部的循环;以及
图10是具有构架状外部轴杆的内窥镜式手术器械的示意图,其包括暴露的往复运动构件。
具体实施方式
本发明涉及具有便于器械清洁和整修以供再使用的结构的器械。本文描述的许多器械包括接近内部部件的结构,所述内部部件在外科手术中可能被污染。
首先参照图1,描绘了电外科器械10的实施方式。器械10包括壳体或手柄组件12,用于通过细长轴杆组件16远程地控制末端执行器14。虽然该构造通常与腹腔镜式或内窥镜式外科手术使用的器械相关,但是本发明的各个方面可通过传统开放式器械,以及结合腔内手术来实施。
器械10联接至电外科能量源,例如电外科发生器18。发生器18可包括诸如Covidien所销售的血管封闭发生器和Force发生器的设备。线缆20在手柄组件12和发生器18之间延伸,并包括用于将器械10联接至外部发生器18的连接件22。在其他实施方式中(未示出),可提供电池供电的器械,其中,发生器和连接件可在器械10内部或集成至器械10。连接件22包括两个叉形构件22a和22b,叉形构件22a和22b的尺寸被设计为将器械10物理地电气地连接至相反的端子,例如与发生器18关联的正极端子或有源端子(+)和负极端子或返回端子(-)。因此,可通过器械10提供双极能量。可替代的,器械10可构造为输送单极性能量至组织。在单极性构造中,器械10输送来自有源端子如(+)的电外科能量,而返回垫(未示出)通常置于患者下方,并提供通向发生器18的相反端子如(-)的返回路径。
为了控制末端执行器14,手柄组件12包括固定手柄24和可动手柄26。可动手柄26可相对于固定手柄24分离和靠近,以分别打开和关闭所述末端执行器14。旋钮28设置在手柄组件12上,以允许细长轴杆组件16和末端执行器14绕由细长轴杆组件16限定的纵向轴线X-X转动。触发器30也布置在手柄组件12上,并可操作成穿过末端执行器14延伸和缩回刀具204(例如参见图7)。可提供脚踏开关(未示出),以启动和终止电外科能量至末端执行器14的输送。
细长轴杆组件16包括铰接的外罩32,外罩32具有下方构件32a和上方构件32b。下方构件32a固定至旋钮28,上方构件32b绕纵向铰链32c枢转地连接至下方构件32a,所述铰链32c平行于纵向轴线X-X。外罩32因此可在闭合构造和所描绘的打开构造之间运动,在所述闭合构造中,外罩32具有大致的圆形截面。外罩32包括闩锁32d,闩锁32d在器械10使用期间将罩32保持在闭合构造。在罩32处于闭合构造时,在外罩32的下方构件32a和上方构件32b之间建立气密密封。下方构件32a和上方构件32b中的一个或两个可包括沿其边缘或周缘的顺从材料(例如参见图4),以使得在下方构件32a和上方构件32b彼此接合时形成气密密封。
穿过外罩32延伸的是一对控制构件或往复运动构件36和38。往复运动构件36可操作地联接至可动手柄26,并且往复运动构件38可操作地联接至触发器30,从而可动手柄26和触发器30的相应动作引起往复运动构件36、38穿过外罩32的纵向运动。往复运动构件36的远端包括波状梯形轮廓,以允许往复运动构件36与从末端执行器14延伸的驱动构件42的相应成形近端进行互锁,从而传递纵向运动至末端执行器。类似的,往复运动构件38的远端包括波状梯形轮廓,以允许往复运动构件38与从末端执行器14延伸的驱动构件44的相应成形近端进行互锁。驱动构件42可操作成在所描绘的打开构造和闭合构造(参见图9)之间移动末端执行器14。驱动构件44可操作成推进刀穿过末端执行器14。
在使用中,医生或操作者通过使末端执行器14在沿轴线Y-Y(其横向于纵向轴线X-X)的横向方向上靠近轴杆组件16,来将末端执行器14可操作地连接至可动手柄26和触发器30,以使往复运动构件36与驱动构件42接合,以及使往复运动构件38与驱动构件44接合。还可以通过电连接件(未示出)在末端执行器14和手柄组件12之间来建立电气连接。闭合和闩锁外罩32,这将保持往复运动构件36、38与驱动构件42、44的接合,原因在于在外罩32处于闭合构造时外罩32的上方构件32b妨碍末端执行器14的横向运动。器械10可随后用于外科手术中,所述外科手术倾向于污染内部部件,如往复运动构件36和38。在该手术后,外罩32可被解锁和打开,以释放末端执行器14。在打开构造中,往复运动构件36、38露出,并可容易地擦洗、冲洗和/或消毒。末端执行器14可消毒或更换,以预备器械10用于后续使用。
参照图2,器械50包括细长轴杆组件52,细长轴杆组件52采用替换的机制来接近内部轴杆部件。细长轴杆组件52包括翻盖式外罩54,外罩54包括下翻盖式构件54a和上翻盖式构件54b。外罩54包括相互卡扣接合的连接件54c,用于将上翻盖式构件54a和下翻盖式构件54b彼此选择性地联接。细长轴杆组件52包括在壳体62和末端执行器64之间延伸的结构支撑件60。当往复运动构件66a和66b(以虚线示意性描绘)移动以激活末端执行器64和刀(未示出)时,结构支撑件60将末端执行器64保持在距壳体62的固定纵向距离处。电信号可传输通过结构支撑件60,以向末端执行器64提供电外科能量。
电信号可通过与器械50关联的单极、双极、或多极布置来传输。在单极传输情形中,电信号经由布置在末端执行器64上的一个或多个电极经过末端执行器64,经过组织、并到达返回电极,诸如返回垫(未示出)。在双极布置的情形中,电信号可从布置在末端执行器64上的第一电极(未示出)穿过组织,并进入布置在末端执行器64另一部分上的第二电极(未详细示出)。多电极的器械可结合布置在末端执行器64上或电气接近末端执行器64的三个或更多个电极,从而可以在手术期间修改或选择电信号的电气路径。
结构支撑件60还在其远端处包括止挡件68。止挡件68接收翻盖式构件54a、54b的远端,并便于翻盖式构件54a、54b朝向彼此枢转,以闭合外罩54。因此,止挡件68用作限定在翻盖式构件54a、54b远侧边缘处的铰链。
器械50还可包括刀组件(图2中末示出),所述刀组件布置在翻盖式构件54a、54b中,并构造为切割由末端执行器64保持的组织。细长轴杆组件53、末端执行器64、结构支撑件60、往复运动构件66a、66b、以及翻盖式构件54a、54b还可构造为相对于壳体62旋转。
在使用中,外罩54可在外科手术期间闭合,以保护结构支撑件60和往复运动构件66a、66b。卡扣配合连接件54c可随后脱离,以打开外罩54并暴露内部部件60、66a、66b,从而便于器械50的清洗。
现在参照图3,细长轴杆组件74包括U形的细长结构支撑件76。结构支撑件76限定纵向通道78,往复运动构件80和一对电线82a及82b在纵向通道78中延伸。结构支撑件76提供对往复运动构件80和电线82a、82b的保护,并提供开口侧84,以接近这些内部部件80和82a、82b用于清洗。该开口结构可减少拆卸轴杆组件74用于清洗的需求,并还可便于轴杆组件74在制造和/或整修期间的组装。虽然在图3中未具体示出,支撑件76中还可以包括其他设备,诸如但不限于吹入管、抽吸管、以及布置在往复运动构件80中或以任何其他合适方式布置以用于切割由末端执行器(图3未示出)保持的组织的刀组件。同样,虽然示出了一对电线82a和82b,但是可使用更多或更少的电线,以用单极、双极或多极的方式传输电信号。例如,在单极情形中,电线82a和82b传输电流至末端执行器(图3未示出)上的一个或多个电极,所述电流行进穿过组织并进入诸如外部返回垫的返回电极。
现在参照图4,器械88包括铰接的外罩90。外罩90包括通过铰链90c彼此联接的下方壳体构件90a和上方壳体构件90b。外罩90可闭合以形成器械88的固定手柄92,并可打开(如所描绘)以接近器械88的内部用于器械清洗。弹性或其他顺从材料的带90d绕上方壳体构件90b的周缘设置,以在外罩90闭合时接合下方壳体构件90b的周缘。因此,外罩90在闭合时形成气密密封,以阻碍污染物进入外罩90的内部。外罩90可由金属或其他耐用材料构成,以使得外罩90可经受住多次外科手术使用和整修周期。
下方壳体构件90a绕枢转点96枢转地支撑可动手柄94。杆构件102从可动手柄94延伸并接合往复运动构件104,用于在可动手柄94的枢转运动时在往复运动构件104上施加纵向运动。限定在往复运动构件104的近端处的室108包括弹簧110,用于对往复运动构件104施加偏压力,以将可动手柄94维持在相对于固定手柄92的分离位置中(并因此,将末端执行器112维持在开口构造)。室108还提供用于联接至电外科线缆120的电连接件114。室108可填充有环氧树脂或其他保护性物质,以防止这些内部部件110、114受到污染。因此,可具有复杂外部几何形状并难以清洗的这些部件(即,弹簧110和电连接件113)可不需要直接清洗来预备器械88用于后续使用。环氧树脂的外表面可以清洗,或这些部件110、114可被简单地更换。
器械88还可包括刀组件(图4未示出),所述刀组件构造以切割由末端执行器112保持的组织。类似于上面已公开的实施方式,细长轴杆组件、末端执行器112、结构支撑件60、和/或往复运动构件104可构造为相对罩90旋转。器械88还可构造用于单极、双极或多极用途。
现参照图5,器械126包括铰接的外罩130。外罩130包括通过铰链130c彼此联接的近侧壳体构件130a和远侧壳体构件130b。设置闩锁130d,以允许外罩130保持在闭合构造(未示出)。铰链130c定位成允许铰接的外罩130沿基本垂直于细长轴杆组件132的平面打开。该布置允许细长轴杆组件132枢转到与驱动构件140对准。
细长轴杆组件132由远侧壳体构件130b支撑,并包括至少一个往复运动构件136和在其近端处的连接件138。近端壳体构件130a支撑近侧驱动构件140,近侧驱动构件140响应可动手柄142的枢转运动而纵向可动。该近侧驱动构件140在其远端处包括连接件142,用于在外罩130运动至闭合构造时接合往复运动构件136的连接件138。连接件138、142的接合允许纵向运动在往复运动构件136和近侧驱动构件140之间传递。连接件138、142还可包括电气端子(未示出),所述电气端子允许电流从支撑在近侧壳体构件130a上的电外科线缆144传输至由远侧壳体构件130b支撑的细长轴杆130b。闩锁130d保持连接件138、142的接合,以及保持外罩130处于闭合构造中。
器械126还可包括刀组件(图5末示出),所述刀组件构造为切割由末端执行器(图5未示出)所保持的组织。类似于上述实施方式,细长轴杆组件132、末端执行器(图5未示出)、和/或往复运动构件136可构造为相对近侧壳体构件130a和/或远侧壳体构件130b旋转。器械126还可构造为单极、双极或多极用途。
在使用中,在外罩130处于闭合位置的情况下器械126可用于外科手术。此后,为整修器械126,外罩130可打开以接近细长轴杆组件132。往复运动构件136、或整个细长轴杆组件可从其外部远端或内部近端从远侧壳体构件130b移除。细长轴杆组件132然后可容易地清洗和更换。
现在参照图6A和6B,器械150包括用于选择性地释放细长轴杆组件154的内部部件的按钮释放机构152。细长轴杆组件154包括从壳体160延伸的外部轴杆构件158,以及延伸穿过外部轴杆构件158的至少一个往复运动构件162。类似于上述实施方式,细长轴杆组件154、末端执行器、和/或往复运动构件162可构造为相对壳体160旋转。器械150还可构造为单极、双极或多极用途。
通过按压按钮166,释放机构152允许往复运动构件162选择性地释放与外部轴杆构件158的接合。在箭头“A”的横向方向上相对壳体可动的按钮166接合滑板168,滑板168通过诸如弹簧170的偏压构件在反向于箭头“A”的方向上被偏压。滑板168包括对置的钩状端部168a和168b,钩状端部168a和168b允许滑板168接合往复运动构件162和近侧驱动构件172。近侧驱动构件172可操作地联接至可动手柄174(参见图6A),以允许响应手柄174的枢转运动而例如在箭头“B”方向上的纵向运动到那里。弹簧170通常维持滑板168与往复运动构件162及近侧驱动构件172的接合。滑板168在箭头“B”的纵向方向上可动,以使得纵向运动可以在往复运动构件162及近侧驱动构件172之间传递。
在抵抗簧170的偏压按压按钮166时,引起滑板168在箭头“A”方向上运动,从而脱离往复运动构件162与近侧驱动构件172。往复运动构件162随后可拆卸以用于清洗或更换。在释放按钮166时,滑板168与近侧驱动构件172重新接合。为了将往复运动构件162重新连接至滑板168,往复运动构件162可在箭头“B”的纵向方向上与滑板168靠近。滑板168的钩状端部168a的斜面提供了导入区,以便于往复运动构件162的重新连接。
释放机构152可容纳另外的往复运动构件,例如176。滑板168可布置成接收多个平行布置的往复运动构件172、176。刀组件(图6A和6B未示出)还可滑动地布置在往复运动构件162中,所述刀组件构造为切割由末端执行器保持的组织。刀组件(图6A和6B未示出)还可构造为经由类似于往复运动构件162的释放机构152或经由单独的释放机构(未示出)来释放。
现在参照图7,器械180包括轴杆组件182,轴杆组件182可通过闩锁186选择性地从壳体184释放。一旦从壳体184释放,轴杆组件182可容易地拆卸为其构成部件。例如,为了拆卸轴杆组件182,枢转销190可从外轴杆构件192及钳口构件194、196移除,并且偏心销198可从往复运动管202和刀204移除。轴杆组件182的拆卸允许清洗和/或评估每个构成部件的外部表面,以用于更换需求。该枢转销190和偏心销198可随后被重新组装,以建立如在Dycus等人的美国专利号7,255,697中所描述的钳口构件194、196的操作。类似于上述实施方式,细长轴杆组件182和/或钳口构件194、196可构造为相对壳体184旋转。器械180还可构造为单极、双极或多极用途。
现在参照图8,描绘了用于将可动轴杆组件212选择性紧固至器械壳体214的连接机构210。机构210包括偏心销216,随着轴杆组件212的锥形近侧端222纵向靠近,偏心销216绕轴线218枢转。偏心销216在壳体214中紧固轴杆组件212,同时允许轴杆组件212响应旋钮224的转动而进行旋转运动。轴杆组件212上的圆形电触头226允许在轴杆组件212旋转时轴杆组件212和壳体214之间保持电气连接。连接机构210还可构造为与刀组件(图8未示出)一起使用,所述刀组件构造为切割由末端执行器(图8未示出)所保持的组织。连接机构210还可构造为允许单极、双极或多极用途。
现在参照图9,器械230包括流体端口232和234,以允许清洗溶液循环穿过壳体236a。流体端口232、234a构造为接收流体导管(例如导管238),并可包括用于选择性打开和关闭流体端口232、234a的阀。在端口232、234a闭合时,壳体236a可以是基本气密密封的。在端口232、234a打开时,在压力下输送至流体端口232的清洗溶液或消毒流体可以循环穿过壳体236a、经过内部部件(示意性描绘为240),并从端口234a抽出。内部部件240可包括往复运动构件、电气部件、和/或连接机构等,以便于器械230的操作。壳体236可在其中包括使清洗溶液朝向内部部件240循环的翅片242或其他障碍物。
端口234a布置在壳体236a上。另外的或可替代的端口234b也可布置在从壳体236a延伸的轴杆构件236b上。端口234b可定位在沿轴杆构件236b的任意位置,包括轴杆构件236b的近端和远端。
现参照图10,器械250包括构架轴杆252。轴杆252包括从固定手柄256延伸的结构支撑件254,以及与可动手柄262联接以致动末端执行器262的一对往复运动构件258、260。往复运动构件258、260可由金属丝或细杆构成,并暴露至器械250的外部。因此,构架轴杆252是具有相对较低复杂性的机构,其可以在无需器械250任何拆卸的情况下容易清洗。
本文公开的各个实施方式还可构造为与自动手术系统一起工作,并且通常被称为“远距离手术”。该系统利用各种自动元件来辅助手术室中的医生,并允许外科仪器的远程操作(或部分远程操作)。各种自动臂、齿轮、凸轮、滑轮、电动和机械马达等可用于该目的,并且可与自动手术系统设计在一起,以在手术或治疗期间辅助医生。该自动系统可包括远程可操纵系统、自动柔性手术系统、远程柔性手术系统、远程连接手术系统、无线手术系统、模块化或可选择构造的远程操作手术系统等。
自动手术系统可与靠近手术室或定位在远程位置中的一个或多个控制台一起使用。在该情形中,一个医生或护士团队为患者准备手术,并用本文所述的一个或多个器械来配置自动手术系统,而另一医生(或医生团队)通过自动手术系统远程地控制这些器械。可以理解的是,高技能的医生可以在不离开他/她远程控制台的情况下执行多个位置的多个手术,这有经济上的优势,同时对于患者或一系列患者也有益处。
手术系统的自动臂通常通过控制器来联接至一对主手柄。该手柄可通过医生移动,以产生任何类型手术器械的工作端(例如,末端执行器、夹持器、刀、剪刀等)的相应运动,这可以补充本文所述的一个或多个实施方式的用途。主手柄的运动可以按比例调节,从而工作端具有与通过医生的操作手执行的运动相比不同、更小、或更大的相应运动。可以调节比例因子或齿轮齿数比,以使得操作者能够控制手术器械的工作端的分辨能力。
主手柄可包括各种传感器,以用于向医生提供关于各种组织参数或状况的反馈,例如由于操纵、切割或其他处理引起的组织阻力、器械作用在组织上的压力、组织温度、组织阻抗等。能够理解的是,这些传感器为医生提供模拟真实手术条件的增强的触觉反馈。主手柄还可以包括用于精密组织操纵或处理的各种不同的致动器,以进一步增强了医生模拟真实操作条件的能力。
虽然前述公开出于清楚或理解的目的已经通过示意和实例进行了相当详细地描述,明显的是可以在所附权利要求书范围的情况下实施某些变化或修改。
Claims (16)
1.一种手术器械,所述手术器械包括:
壳体组件,所述壳体组件包括致动器;
细长轴杆组件,所述细长轴杆组件限定纵向轴线,并从壳体组件延伸,细长轴杆组件包括内部控制构件和外罩,所述内部控制构件可操作地联接至致动器,所述外罩包括第一罩构件和第二罩构件以及铰链,所述铰链将第一罩构件和第二罩构件彼此联接,以使得外罩可选择地在闭合构造和打开构造之间运动,在所述闭合构造中,内部控制构件被包封在外罩中,在所述打开构造中,内部控制构件被暴露;以及
末端执行器,所述末端执行器被支撑在细长轴杆组件的远端处,末端执行器可操作地关联至内部控制构件。
2.根据权利要求1所述的手术器械,其中,铰链沿限定在第一罩构件和第二罩构件之间的纵向接缝延伸。
3.根据权利要求2所述的手术器械,其中,末端执行器被可释放地支撑在细长轴杆组件的远端处,以使得在外罩处于打开构造时,末端执行器在横向方向上不受阻碍地运动,并且其中,在外罩处于闭合构造时,末端执行器的运动被外罩阻碍。
4.根据权利要求3所述的手术器械,其中,细长轴杆组件包括用于将外罩可选择地维持在闭合构造中的闩锁。
5.根据权利要求1所述的手术器械,其中,内部控制构件是响应致动器的操纵而能够纵向运动的往复运动构件。
6.根据权利要求5所述的手术器械,其中,末端执行器包括一对钳口构件,所述一对钳口构件能够从打开构造运动至闭合构造,在所述打开构造中,钳口构件相对彼此基本间隔开,在所述闭合构造中,钳口构件响应于内部控制构件的纵向运动而更加靠近在一起。
7.根据权利要求1所述的手术器械,其中,铰链沿第一罩构件和第二罩构件的远侧边缘限定。
8.根据权利要求7所述的手术器械,其中,细长轴杆组件还包括在壳体组件和末端执行器之间延伸的结构支撑件,结构支撑件维持壳体组件和末端执行器之间的固定纵向距离。
9.一种手术器械,所述手术器械包括:
壳体组件,所述壳体组件包括致动器;
细长轴杆组件,所述细长轴杆组件限定纵向轴线,并从壳体组件延伸,细长轴杆组件包括可操作地联接至致动器的内部控制构件;
末端执行器,所述末端执行器支撑在细长轴杆组件的远端处,末端执行器可操作地关联至内部控制构件;以及
铰链,可操作所述铰链以选择性地接近内部控制构件以用于清洁,并且在器械操作期间选择性地限制接近内部控制构件。
10.根据权利要求9所述的手术器械,其中,细长轴杆组件包括第一罩构件和第二罩构件以及铰链,所述铰链布置在轴杆组件的第一罩构件和第二罩构件之间,以便于第一罩构件和第二罩构件之间的相对运动。
11.根据权利要求9所述的手术器械,其中,壳体组件包括第一壳体构件和第二壳体构件,以及其中,铰链布置在壳体组件的第一壳体构件和第二壳体构件之间。
12.根据权利要求11所述的手术器械,其中,第一壳体构件和第二壳体构件中的至少一个包括绕其周缘布置的顺从材料,以在与第一壳体构件和第二壳体构件中的另一个接合时形成气密密封。
13.根据权利要求11所述的手术器械,其中,铰链被定位成允许第一壳体构件和第二壳体构件沿基本垂直于细长轴杆组件的平面打开。
14.根据权利要求13所述的手术器械,其中,内部控制构件在其近端处包括连接件,以用于在壳体内接合近侧驱动构件,近侧驱动构件可操作地关联至致动器。
15.根据权利要求14所述的手术器械,其中,壳体组件包括闩锁,以用于将第一壳体构件和第二壳体构件保持在闭合构造,并用于保持连接件与近侧驱动构件的接合。
16.根据权利要求15所述的手术器械,还包括从壳体组件延伸的线缆,其中,线缆构造为连接至电外科能量源。
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- 2013-06-26 CN CN201710699216.5A patent/CN107320176B/zh not_active Expired - Fee Related
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CN107072706B (zh) * | 2014-07-30 | 2019-08-06 | 柯惠有限合伙公司 | 能够选择性地拆卸以便于更换一次性部件和/或消毒可重复使用部件的外科器械 |
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Also Published As
Publication number | Publication date |
---|---|
CN103584912B (zh) | 2017-08-29 |
US20130345701A1 (en) | 2013-12-26 |
EP2679192A3 (en) | 2017-07-12 |
CN107320176B (zh) | 2021-03-16 |
EP2679192A2 (en) | 2014-01-01 |
US20170049506A1 (en) | 2017-02-23 |
US10588686B2 (en) | 2020-03-17 |
US9510891B2 (en) | 2016-12-06 |
CN107320176A (zh) | 2017-11-07 |
EP2679192B1 (en) | 2020-07-22 |
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