CN103732157B - 手术紧固件施加装置 - Google Patents

手术紧固件施加装置 Download PDF

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CN103732157B
CN103732157B CN201280038897.6A CN201280038897A CN103732157B CN 103732157 B CN103732157 B CN 103732157B CN 201280038897 A CN201280038897 A CN 201280038897A CN 103732157 B CN103732157 B CN 103732157B
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哈肖坦·辛格·达卡德
马诺耶·库马尔·阿加瓦尔
尼基·R·卡特雷
基兰·加里基帕蒂
奇尼西·P·瓦尔格斯
阿尔温德·库马尔·古普塔
维纳扬·维韦卡南丹
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Abstract

用于施加紧固件至身体组织的手术紧固件施加装置，该装置包括限定了细长通道构件的钉仓接收半段，所述细长通道构件构造为可释放地接收发射组件的固定壳体。所述固定壳体定尺寸为在其中可释放地接收单次使用加载单元，并且包括闭锁结构，所述闭锁结构可在所述单次使用加载单元未安装在所述固定壳体中的情况下防止将所述固定壳体插入所述钉仓接收半段。

Description

手术紧固件施加装置
该申请要求提交于2011年8月8日的临时申请61/521,078的优先权，其整个内容通过引用合并于此。
技术领域
本公开涉及手术紧固件施加装置，尤其涉及具有可重复使用部件及一次性部件的手术紧固件施加装置。
背景技术
本领域公知这样的手术紧固件施加装置，其中，首先将组织抓取或者夹紧于对置的钳夹结构之间，然后依靠手术紧固件结合组织。在一些这种装置中，设置刀具以切割已经用紧固件结合的组织。紧固件典型地呈手术吻合钉的形式，但是还可以使用其他手术紧固件，诸如例如，夹子或者两部件式聚合手术紧固件。
手术紧固件施加装置典型地包括两个细长梁构件，两个细长梁构件用来在其间捕获或者夹紧组织。典型地，一个梁构件承载一次性的钉仓组件，钉仓组件收纳布置成至少两横排的多个吻合钉，而另一梁构件包括砧座，砧座限定一表面，该表面用于当吻合钉从钉仓组件驱动出来时使吻合钉钉腿成形。在使用两部件式紧固件的情况下，包括砧座的梁构件承载两部件式紧固件的匹配部，例如接收器。通常，吻合钉成形处理受到一个或多个纵向移动的凸轮构件与一系列独立的吻合钉推进器之间相互作用的影响。随着凸轮构件纵向行进通过钉仓承载梁构件，各个推进器构件向上偏置到支撑于钉仓组件中的吻合钉的钉冠，以从钉仓顺序地射出吻合钉。刀具可以设置成在吻合钉排之间随凸轮构件一起行进以切割成形的吻合钉排之间的组织。这种器械的例子公开于美国专利7,631,794，其整体通过参考并入此处。
因为与不适当消毒关联的危险，所以紧固件施加装置典型地是在使用之后就丢弃。虽然钉仓组件可以被替换以对单个患者执行多次紧固件施加操作，但是典型地在手术程序已经完成之后丢弃吻合钉施加装置。这种使用后丢弃的要求会增加与手术程序关联的成本。虽然已经开发了可重复使用的紧固件施加装置，但是这种装置会是过于复杂的，而且经证实也很难消毒。
本领域中需要一种紧固件施加装置，其包括可重复使用的部件，不过于复杂并且构造为利于在手术程序中使用之后进行适当消毒。
发明内容
本公开涉及用于施加手术紧固件至组织的手术紧固件施加装置。在一个方案中，手术紧固件施加装置包括：砧座半段，其包括远侧砧座部；钉仓接收半段，其限定了细长通道构件；以及固定壳体。所述固定壳体构造为可释放地支撑在所述钉仓接收半段的所述细长通道构件内。所述固定壳体支撑所述装置的发射部件。所述固定壳体还定尺寸为可释放地接收单次使用加载单元。闭锁结构在所述单次使用加载单元未安装在所述固定壳体中的情况下防止将所述固定壳体完全插入所述钉仓接收半段。
在一些实施例中，所述闭锁结构可以限定第一位置和第二位置，所述第一位置防止将所述固定壳体插入所述钉仓接收半段，所述第二位置允许将所述固定壳体插入所述钉仓接收半段。
在一些实施例中，所述闭锁结构包括响应于所述单次使用加载单元插入到所述固定壳体中而能够从所述第一位置移动到所述第二位置的挠性构件。在一个实施例中，所述挠性构件包括延伸超出所述固定壳体的底表面的突起并且所述钉仓接收半段在其中限定槽以接收所述挠性构件的所述突起。因此，在该实施例中，当所述挠性构件处在所述第一位置时，所述挠性构件的所述突起相对于所述钉仓接收半段的所述槽不对准，并且当所述挠性构件处在所述第二位置时，所述挠性构件的所述突起相对于所述钉仓接收半段的所述槽对准并能够易于插入到所述槽中。
在另一实施例中，所述挠性构件限定凹槽，所述凹槽构造为当所述挠性构件处在所述第二位置时，将所述钉仓接收半段的侧壁的顶边缘接收在所述凹槽中。在该实施例中，当所述挠性构件处在所述第一位置时，由所述挠性构件限定的所述凹槽相对于所述钉仓接收半段的顶边缘不对准，并且当所述挠性构件处在所述第二位置时，由所述挠性构件限定的所述凹槽相对于所述钉仓接收半段的顶边缘对准并且所述凹槽构造为易于接收所述钉仓接收半段的顶边缘。
在另一方案中，本公开提供了一种手术紧固件施加装置，包括可重复使用的砧座半段、可重复使用的钉仓接收半段以及一次性发射组件，所述一次性发射组件构造为可释放地支撑在所述钉仓接收半段内。所述发射组件包括一次性的推进器组件以及能够安装至所述推进器组件的一次性的单次使用加载单元，其中，只要所述发射组件包含所述单次使用加载单元，所述发射组件就能够完全插入到所述钉仓接收半段中。
该装置可以进一步包括阻挡构件，所述阻挡构件能够在所述第一位置和所述第二位置之间移动，所述第一位置防止将所述发射组件完全插入所述钉仓接收半段，所述第二位置允许将所述发射组件完全插入所述钉仓接收半段。
在一些实施例中，所述阻挡构件是从所述推进器组件的壳体的壁延伸出并且被偏置所述第一位置的挠性构件，并且当所述单次使用加载单元安装到所述发射组件上时所述单次使用加载单元对所述挠性构件施力以使所述挠性构件移动至所述第二位置，从而使所述发射组件能够完全插入。
在一些实施例中，所述挠性构件包括延伸超出所述推进器组件的壳体的底表面以接触所述钉仓接收半段的表面的突起，并且所述钉仓接收半段在其中限定槽以在所述单次使用装载单元被安装至所述推进器组件上时接收所述挠性构件的所述突起，当所述单次使用装载单元未被安装到所述推进器组件上时，所述挠性构件的所述突起相对于所述钉仓接收半段的所述槽不对准。在其他实施例中，所述挠性构件包括钩，所述钩限定凹槽，所述凹槽构造为当所述挠性构件处在所述第二位置时将所述钉仓接收半段的侧壁的顶边缘接收在其中，并且构造为当所述挠性构件处在所述第一位置时抵接所述顶边缘。
在另一方案中，本公开提供了一种与手术紧固件施加装置一起使用的一次性发射组件，所述一次性发射组件包括一次性的单次使用加载单元和一次性的推进器组件。所述发射组件能够插入到所述紧固件施加装置的钉仓接收半段中，所述单次使用加载单元能够可操作地安装至所述推进器组件，其中，所述发射组件包括闭锁构件，所述闭锁构件能够从第一阻挡位置和第二非阻挡位置移动，所述第一阻挡位置防止将所述发射组件可操作地插入所述紧固件施加装置，所述第二非阻挡位置能够使所述发射组件完全可操作地插入所述紧固件施加装置。
在一些实施例中，所述闭锁构件被偏置所述第一位置，并且当所述单次使用加载单元被安装至所述推进器组件时，所述单次使用加载单元对所述闭锁构件施力以将其移动到所述第二位置。
在一些实施例中，所述闭锁构件包括突起，当所述闭锁构件处在所述第二位置时，所述突起能够与所述紧固件施加装置中的槽接合，在所述闭锁构件的第一位置上，所述突起相对于所述槽不对准。在其他实施例中，所述闭锁构件包括凹槽，所述凹槽构造为当所述闭锁构件处在所述第二位置时，接收所述紧固件施加装置的所述钉仓接收半段的侧壁的顶边缘，并且构造为当所述闭锁构件处在所述第一位置时抵接所述顶边缘。
附图说明
现在将参考附图描述本公开手术紧固件施加装置的各种实施例，其中：
图1是从处于夹紧位置的本公开手术紧固件施加装置的一个实施例的远侧端部看的侧视立体图；
图2是从处于夹紧位置的图1所示的手术紧固件施加装置的近侧端部看的侧视立体图；
图2A是图1所示的手术紧固件施加装置处于打开位置的侧视立体图；
图2B是图2A所示的标示细节区域的放大图；
图3是图1所示的手术紧固件施加装置的部件分离的侧视立体图；
图3A是图1所示的紧固件施加装置的夹紧杆的侧视剖视图；
图4是图1所示的手术紧固件施加装置的钉仓接收半段的侧视立体图，单次使用加载单元和发射组件支撑在钉仓接收半段内；
图5是图4所示的标示细节区域的放大图；
图6是从手术紧固件施加装置的钉仓接收半段上方看的立体图，SULU和发射组件支撑在其中；
图7是图6所示的标示细节区域的放大图；
图8是从图3所示的手术紧固件施加装置的发射组件的上方看的前端立体图；
图9是图8所示的标示细节区域的放大图；
图9A是通道构件的俯视立体图，发射组件可释放地固定在其中；
图9B是图9A所示的标示细节区域的放大图；
图9C是通道构件的中央部的俯视立体图；
图10是从图8所示的发射组件的上方看的后端立体图；
图11是图10所示的标示细节区域的放大图；
图12是图10所示的发射组件的部件分离的侧视立体图；
图12A是图12所示的发射组件的凸轮杆的仰视立体图；
图12B是图12所示的发射组件的发射杆的仰视立体图；
图13是图1所示的手术紧固件施加装置的SULU的侧视立体图；
图14是图13所示的标示细节区域的放大图；
图15是图13所示的SULU的前视立体图；
图16是图15所示的标示细节区域的放大图；
图17是图15所示的SULU的部件分离的侧视立体图；
图18是图1所示的手术紧固件施加装置处于打开位置的侧视剖视图；
图19是图18所示的标示细节区域的放大图；
图20是图18所示的标示细节区域的放大图；
图21是图18所示的处于打开位置的手术紧固件施加装置的近侧端部的立体图；
图22是图18所示的标示细节区域的放大图；
图23是从图1所示的手术紧固件施加装置的夹紧杆的近侧端部下方看的立体图；
图24是图1所示的手术紧固件施加装置处于夹紧位置的侧视立体图；
图25是图24所示的处于夹紧位置的手术紧固件施加装置的侧视剖视图；
图26是图25所示的标示细节区域的放大图；
图27是图25所示的标示细节区域的放大图；
图28是沿着图26的剖线28-28截取的剖视图；
图29是随着发射组件移动通过致动行程以从紧固件施加装置射出紧固件，图1所示的手术紧固件施加装置的俯视图；
图30是图29所示的手术紧固件施加装置的侧视剖视图，发射组件处于致动位置；
图31是图30所示的标示细节区域的放大图；
图32是图30所示的标示细节区域的放大图；
图33是图1所示的手术紧固件施加装置在该装置已经发射并且移至打开位置之后的侧视剖视图；
图34是图33所示的标示细节区域的放大图；
图35是发射组件的固定壳体的替换实施例的立体图；
图35A是图35所示的标示细节区域的放大图；
图36是用于接收图35的固定壳体的钉仓接收半段的替换实施例的示意图；
图36A是图36所示的标示细节区域的放大图；
图37是发射组件的固定壳体的另一替换实施例的立体图；
图37A是未完全接收在钉仓接收半段中的图37的固定壳体的侧视剖视图；以及
图37B是完全接收在钉仓接收半段中的图37的固定壳体的侧视剖视图。
具体实施方式
现在将参考附图详细描述本公开手术紧固件施加装置的实施例，其中，相同附图标记指代类似或者相同结构元件。如此处使用的，如传统的，术语“近侧”指的是装置较靠近用户的一端，术语远侧指的是装置较远离用户的一端。
图1-34图示了本公开手术紧固件施加装置的一个实施例，其通常称作手术吻合器10。尤其参考图1-3，手术吻合器10包括砧座半段12、钉仓接收半段14、夹紧杆16、单次使用加载单元18（下文“SULU”）和发射组件20。在一个实施例中，砧座半段12、钉仓接收半段14和夹紧杆16被构造为可重复使用的部件，这样，由适于消毒和重复使用的生物相容材料制成，例如不锈钢。相反，SULU18和发射组件20被构造为一次性的，这样，可以由具有所需强度特性的任何合适的生物相容材料制成，例如塑料、金属及它们的组合。
参考图3-7，钉仓接收半段14限定细长通道构件22，细长通道构件22限定大致U形通道24，U形通道24具有定尺寸为可释放地接收SULU18的远侧部24a和定尺寸为可释放地接收发射组件20的近侧部24b。发射组件20包括固定壳体26（还见图12），固定壳体26具有近侧端部，近侧端部包括开口28，开口28接收枢轴构件29（图12）的端部。枢轴构件29将锁定构件206可枢转地支撑在固定壳体26的近侧端部上，并且延伸通过开口28进入形成在钉仓接收半段14的近侧部中的凹槽30，以可释放地将发射组件20的近侧端部固定在通道构件22的近侧部24b内，下文将进一步详细讨论。发射组件20的远侧端部限定三角形切口64d。切口64d定位成接收形成在通道构件22的内壁上的突起65（见图9A-9C），以可释放地将发射组件20的远侧端部固定在通道构件22内。发射组件20的结构还将在下文进一步详细讨论。同样地，SULU18包括一对远侧突起32，它们定位在形成于通道构件22的远侧端部处的切口34中，以可释放地将SULU18固定在通道构件22的远侧部24a内。在组装期间，在SULU18插入到通道构件22的远侧部24a中之前，发射组件20必须插入通道构件22的近侧部24b，如以下将讨论的。为了将SULU18定位在通道构件22中，SULU18上的突起32定位在切口34内，同时SULU18定位在通道构件22上方且与通道构件22成角度。此后，SULU18能够向下旋转至U形通道24的远侧部24a中。这允许发射组件20的驱动部件适当地对准SULU18的部件，还利于发射组件20与支撑在SULU18内的刀具40（图17）接合。SULU18的近侧端部包括向外延伸的锯齿状表面42（图7）以利于抓握SULU18的近侧端部，从而允许从通道构件22移除和/或替换SULU18。在移动吻合器10至夹紧位置之前，如以下将讨论的，锯齿状抓握表面42将不完全安置于通道构件22的远侧部24a内。
参考图8-12，发射组件20包括固定壳体26、刀具致动杆44、凸轮杆46、引导块48、发射杆50、滑动块52、踏板54和枢转锁定构件206（图12）。在一个实施例中，固定壳体26包括U形框架60，U形框架60包括底壁62和一对侧壁64。每个侧壁64的远侧端部限定近侧台阶64b、远侧成角度部64c（图9）和三角形切口64d。如以上讨论的，三角形切口64d被定位成接收形成在通道构件22的内壁上的突起65（图9B）。每个侧壁64的近侧端部包括一对横向延伸的可变形壁部66（图11），它们与滑动块52的近侧端部隔开，并且在壁部66和滑动块52之间限定了用于枢转地接收锁定构件206的区域，下文将进一步详细讨论。
引导块48包括限定了三个纵向狭槽70a-c的主体和一对向外延伸的突起72。在一个实施例中，每个突起72是大致柱形并且包括锥形部72a（图9）。可替换地，可以想到其他突起构造。突起72定尺寸为接收在形成于固定壳体26的侧壁64中的开口74（图12）中，以将引导块48轴向固定在固定壳体26的远侧端部内。突起72允许引导块48在U形框架60内一定程度的枢转移动。如下文将进一步详细讨论的，响应于吻合器10移动至夹紧位置，引导块48从第一位置（图19）枢转至第二位置（图26），在第一位置，其锁定与刀具致动杆44的凹口49和51的接合，在第二位置，其与刀具致动杆44的凹口49和51脱离。扭转弹簧围绕突起72设置以推动引导块48锁定接合凹口49和51。每个狭槽70a和70c定尺寸为可滑动地接收凸轮杆46的相应侧壁114。类似地，狭槽70b定尺寸为可滑动地接收刀具致动杆44。
滑动块52包括毂80，毂80包括有弹性的指状部80a，指状部80a构造为搭扣配合到形成在发射杆50中的枢轴孔82中。当滑动块52处于收缩位置时发射杆50绕毂80枢转以利于从吻合器10的任一侧致动发射组件20。踏板54可往复运动地接收在形成于滑动块52中的孔84内。踏板54包括分体式主体部54a，分体式主体部54a构造为跨装于刀具致动杆44的近侧端部102上。在一个实施例中，分体式主体部54a包括成角度远侧表面86。销88从踏板54向上延伸通过滑动块52中的孔84。偏置构件90定位在分体式主体部54a和滑动块52之间，围绕销88以向下推动踏板54离开滑动块52而到达延伸位置。在滑动块52的收缩位置上，踏板54被接收在形成于通道构件22的底壁22a中的切口55中（图20）。
发射杆50包括第一和第二指状部接合构件50a和50b，它们中的任一个能够被选择性地接合以从吻合器10的任一侧将发射杆50移动通过发射行程。弓形凹槽94（图12B）形成在可滑动地接收踏板54的销88的发射杆50的底表面中，以限定发射杆50能够绕滑动块52的毂80枢转的旋转范围。如此处使用的，发射行程定义为发射杆50从完全收缩位置（图25）移动至完全前进位置（图30）。停止凹槽94a形成在弓形凹槽94的每个端部处。停止凹槽94a构造且定尺寸为接收踏板54的销88的端部，以防止在手术吻合器10的发射行程期间发射杆50绕毂80枢转运动。更具体来说，当发射组件20被致动以使滑动块52在固定壳体26内向远侧前进时，踏板54的成角度远侧表面86接合通道构件22并且做凸轮运动离开切口55（图27）以推动销88向上进入停止凹槽94a，从而在发射杆50移动通过发射行程期间防止发射杆50的枢转运动。很明显，销88必须定位在停止凹槽94a之下以允许踏板54从切口55向上提升，从而允许发射杆50移动通过发射行程。因而，在发射杆50能够移动通过发射行程之前，发射杆50必须枢转到发射组件20的一侧或另一侧。
刀具致动杆44包括近侧端部，近侧端部具有阶状部100，阶状部100包括具有第一高度的近侧第一台阶102和具有第二高度的第二台阶104，第二高度大于第一高度。致动杆44的远侧端部包括上弯钩部106以及上、下凹口49和51。指状部108在第一台阶102和第二台阶104之间从刀具致动杆44向上伸出。如图27所示，指状部108可滑动地接收在形成于滑动块52底侧的凹槽110内。当滑动块52在固定壳体26内向远侧前进时，指状部108在凹槽110内移动，使得滑动块52相对于刀具致动杆44移动，直到指状部108接合壁112（图32），壁112限定了凹槽110的近侧端部。当指状部108接合壁112时，滑动块52的进一步向远侧移动还将引起刀具致动杆44的向远侧移动。如以下将明显的，这种布置允许吻合钉在切割组织之前从SULU18射出。
参考图12和图12A，凸轮杆46包括一对侧壁114和基壁116（图12A）。每个侧壁114的近侧端部114a包括隆起壁部118。每个隆起壁部118构造为固定地接收在形成于滑动块52下侧的狭槽（未示出）内，以牢固地固定凸轮杆46的近侧端部至滑动块52。可替换地，滑动块52可以模制在刀具致动杆44的近侧端部周围。每个侧壁114的远侧端部包括成角度的凸轮表面114b。基壁116限定了：向远侧延伸的细长狭槽123（图12A），细长狭槽123从凸轮杆46的远侧端部沿着凸轮杆46的大体长度延伸；以及向近侧延伸的纵向狭槽121。狭槽121定位成当滑动块52处于收缩位置时利于踏板54通过通道构件22的切口55。见图27。
凸轮杆46的侧壁114可滑动地定位在引导块48的狭槽70a和70c中，刀具致动杆44可滑动地定位在引导块48的纵向狭槽70b中。当发射组件20支撑在通道构件22中并且发射杆50枢转至固定壳体26一侧并且被向远侧推动时，滑动块52在固定壳体26内向远侧移动。随着滑动块52开始向远侧移动，踏板54的锥形表面86接合通道构件22的限定了切口55的近侧边缘，以推动踏板54向上移出切口55、通过凸轮杆46的狭槽121，并到达发射组件20的固定壳体26的内表面上（图27）。当这发生时，踏板54的销88移入停止凹槽94a以防止发射杆50进一步的枢转运动。在发射杆50不枢转至使销88定位在停止凹槽94a之下的位置的情况下，将阻止踏板54向上移出切口55以及阻止发射杆50移动通过发射行程。随着发射杆50向远侧移动，指状部108在凹槽110内移动，使得随着凸轮杆46向远侧前进，刀具致动杆44保持静止。当指状部108接合限定了凹槽110的近侧壁112时，刀具致动杆44与滑动块52和凸轮杆46向远侧移动。如以下将讨论的，当凸轮杆46和刀具致动杆44在发射组件20的固定壳体26及通道构件22内向远侧移动时，凸轮杆46的成角度的凸轮表面114b移动通过SULU18以从SULU18射出紧固件。同时，虽然具有等于凹槽110（图32）长度的预设延迟，但是刀具致动杆44驱动刀具刀片40通过SULU18以分割组织。
美国专利No.7,631,794（“'794专利”）公开了一种手术紧固件施加装置，其包括类似于上述的发射组件。'794专利的整个内容通过参考并入此处。
图13-17图示了SULU18。参考图17，SULU18包括主体120、多个吻合钉推进器122（仅示出一个）、底盖124、具有成角度尖导缘或刀片40a的刀具40、多个吻合钉126（仅示出一个）、以及枢转地安装的安全闭锁件128。主体120的近侧端部包括挠性指状部120a，挠性指状部120a稍微突出于限定了主体120的外壁。指状部120a摩擦接合通道构件22的内壁以当SULU18可释放地定位在通道构件22内时将SULU18的近侧端部保持在通道构件22内。如本领域公知的，主体120具有：多排吻合钉保持狭槽130，例如，四个、六个等；以及居中地布置在主体120中的线性狭槽刀具轨道132。手术吻合器10能够定尺寸为接收或者容纳不同吻合钉线长度的SULU，包括，例如，60mm、80mm和100mm。刀具40包括下弯钩部40b，下弯钩部40b定位成当SULU18定位在通道构件22内时接合刀具致动杆44的上弯钩部106（图12）。
在图示的实施例中，主体120包括形成在线性狭槽刀具轨道132任一侧的两个错排的狭槽130。错排的狭槽130延伸超出刀具轨道132的远侧端部，以利于吻合钉成形超出刀具刀片40的行程的远侧端部。
吻合钉推进器122可以构造为延伸入一个或多个狭槽130。在一个实施例中，单个推进器与每个狭槽130关联。可替换地，如图17图示的，每个推进器122能够构造为延伸入两个相邻狭槽130，并且定位在保持于狭槽130中的相应吻合钉126下方。如本领域公知的，每个推进器122包括下凸轮表面122a，下凸轮表面122a定位成接合凸轮杆46的远侧端部上的凸轮表面114b（图12）之一，使得凸轮杆46通过SULU18的移动将顺序提升相应一个或多个狭槽130内的每个相应推进器122以从狭槽130射出吻合钉。
底盖124局部封闭形成在钉仓主体120内的通道125（图18）。纵向脊134形成在底盖124的上表面上，并且提供了用于刀具支撑构件136的支承表面，刀具支撑构件136固定至刀具40的底部边缘。刀具40可以经由销、焊接或者其他公知紧固技术固定至支撑构件136。在发射行程期间，随着发射杆50前进通过通道构件22，刀具40沿着刀具轨道132被引导。一对狭槽138限定在脊134的侧面以及钉仓主体120的外壁之间。纵向脊134定位在主体120内，并且定尺寸为可滑动地接收在凸轮杆46的细长狭槽120（图12A）内，使得凸轮杆46能够绕纵向脊134可滑动地移动通过钉仓主体120，从而从SULU18射出吻合钉126。
安全闭锁件128枢转地布置在主体120的上近侧端部上，并且绕枢轴构件150从锁定方位（图26）枢转到解锁方位（图34）。枢轴构件150接收在主体120中的开口154中。偏置构件（例如，弹簧152）定位在刀具支撑构件136和安全闭锁件128之间以朝向解锁方位推动安全闭锁件128。安全闭锁件128包括近侧钩156，近侧钩156定位成当刀具40处于收缩位置时（图19）接收形成在刀具40上的接合构件158以保持安全闭锁件128处于锁定方位。当在发射行程期间刀具40移向前进位置时，接合构件158移开近侧钩156以允许安全闭锁件128响应于弹簧152的推动而朝向解锁位置枢转。应该注意的是，当砧座半段12和钉仓接收半段14处于夹紧位置时，防止安全闭锁件128枢转至解锁位置，因为安全闭锁件128的顶表面128a接合砧座半段12的内表面以防止安全闭锁件128的枢转。安全闭锁件128限定了定尺寸为可滑动地接收刀具40的狭槽160。在刀具40的收缩位置，刀具40的导缘40a被约束在安全闭锁件128的狭槽160内，以防止刀具40的导缘40a意外碰到和伤害医疗人员。
再次参考图2-3，砧座半段12包括近侧手柄部12A和远侧砧座部12b。砧座部12b包括吻合钉变形部198，如本领域公知的，吻合钉变形部198包括多个吻合钉变形凹槽，并且当SULU18定位在通道构件22中时其面向SULU18的顶表面。还如本领域公知的，吻合钉变形部198包括中央纵向狭槽（未示出），随着刀具40移动通过SULU18，中央纵向狭槽用于接收刀具40（图17）。吻合钉变形部198能够与砧座半段12一体形成，或者在替换例中通过紧固处理诸如焊接固定至砧座半段12。一对定位指状部170（图3）定位成邻近砧座部12b的吻合钉变形部198的近侧端部。当该装置处于夹紧位置时，定位指状部170接收在SULU18的槽内以使SULU18与吻合钉确定部198适当地对准。
砧座半段12的中央部包括一对柱形横向支撑构件172。在砧座半段12和钉仓接收半段14的组装期间，横向支撑构件172支撑在限定于钉仓接收半段14的中央部173（图28）中的U形凹槽174中。中央部173的远侧壁173a限定组织止挡部（图3）。横向支撑构件172还定位成当夹紧杆16移至夹紧位置（图2B）时接收在形成于夹紧杆16的间隔凸缘部178上的切口176中。近侧手柄部12a是以符合人体工程学地方式形成的，并且包括拇指接合抵接部180以及抓握部182。手柄部12a的近侧端部包括向下延伸的指状部184，向下延伸的指状部184包括一对对置的泪滴形状突起186，将在下文进一步详细讨论。可替换地，突起186可以呈现各种构造。
钉仓接收半段14包括间隔的、居中布置的U形凹槽174，U形凹槽174定位成支撑砧座半段12的横向支撑构件172。钉仓接收半段14的近侧端部包括一对垂直支撑构件188。每个垂直支撑构件188包括具有圆底面的细长垂直狭槽188a。垂直狭槽188a定尺寸为当组装期间砧座半段12支撑在钉仓接收半段14上时接收形成在砧座半段12的指状部184（图21）上的突起186。通过将突起186定位在垂直狭槽188a内，砧座半段12能够相对于钉仓接收半段14以剪刀状方式在打开位置和关闭位置之间枢转。在一个实施例中，突起186具有泪滴轮廓。钉仓接收半段14的至少一个侧壁包括凹陷189（见图3），将在下文进一步详细讨论。
夹紧杆16还包括具有把手190a和拇指接合抵接部192的手柄部190。如以上讨论的，一对间隔的凸缘部178支撑在夹紧杆16的远侧端部上。每个凸缘部178限定切口176，切口176定尺寸为当吻合器10移向夹紧位置时（图2B）时接收砧座半段12的相应的横向支撑构件172。夹紧杆16的远侧端部还限定一对开口194，开口194定尺寸为接收枢轴构件187。枢轴构件187定尺寸为延伸通过钉仓接收半段14中的开口195和夹紧杆16中的开口194，以枢转地固定夹紧杆16至钉仓接收半段14。
如图3A所示，夹紧杆16的内壁包括突起201。突起201定位在形成于钉仓接收半段14的侧壁中的凹陷189（图2A）内，以可释放地保持夹紧杆16处于非夹紧位置或者打开位置（图2A）。
为了将发射组件20加载入通道构件22的近侧部24b，发射组件20的固定壳体26通过通道构件22的近侧端部滑入通道构件22，直到枢轴构件29被接收在形成于通道构件22的近侧端部中的凹槽30中。在发射组件20被加载之后，SULU18能够以与上述类似的方式被加载入远侧部24a。
参考图2和图2B，在SULU18和发射组件20加载入通道构件22之后，砧座段12能够组装至钉仓接收半段14。为了将砧座半段12附接至钉仓接收半段14，指状部184的突起186定位在钉仓接收半段14的垂直支撑构件188的垂直狭槽188a中。此后，砧座半段12朝向钉仓接收半段14旋转以将横向支撑构件172定位在U形凹槽174中。
为了将手术吻合器10定位于夹紧位置，夹紧杆16从图2A示出的位置沿逆时针方向旋转。随着夹紧杆16旋转，横向支撑构件172被接收在凸缘部178的切口176中（图2）并且朝向钉仓接收半段14做凸轮运动。如图3所示，弹簧构件200固定至夹紧杆16的内表面（诸如通过焊接）处于接合钉仓接收部14的位置以推动夹紧杆16至图2A示出的非夹紧位置。在图1示出的夹紧位置，吻合钉变形部198定位成紧密接近SULU18的顶表面。
参考图3、图3A和图12，如以上讨论的，枢转锁定构件206枢转地支撑在发射组件20的固定壳体26的近侧端部上。枢转锁定构件206包括枢轴构件29，枢轴构件29延伸通过限定在固定壳体26中的开口28。指状部接合构件212定位在锁定构件206的一个端部上，卡掣部210定位在锁定构件206的另一端部上。卡掣部206包括钩构件210a。偏置构件214定位在枢轴构件29周围以朝向发射组件20的固定壳体26向内推动卡掣部210。当锁定构件206固定在发射组件26上时，卡掣部210向下延伸通过固定壳体26的近侧端部中的开口216而到达通道构件22的底表面下方的位置（图20）。如以上讨论的，枢轴构件29的端部被接收在形成于钉仓接收半段14的近侧端部中的切口30中，以可释放地将发射组件20固定在通道构件22的近侧通道部24b内（图21）。切口30由下弯指状部220局部限定以将发射组件26保持在通道构件22内（图3）。
参考图3A，夹紧杆16的近侧端部包括接合构件（例如，柱形杆218），柱形杆218定位成当夹紧杆16移至夹紧位置时（图27）被卡掣部210的钩构件210a接合。虽然图示了杆，但是可以想到其他接合构件的构造。如通过观察图27能够看到的，随着夹紧杆16移向夹紧位置，卡掣部210的成角度面222接合杆218。该接合引起锁定构件206绕枢轴构件29枢转，使得卡掣部210的钩构件210a通过，然后卡入而与杆218接合。为了从杆218释放卡掣部210，锁定构件206的接合构件212被压下以使卡掣部210枢转而不与杆218接合。当这发生时，弹簧构件200推动夹紧杆16至非夹紧位置。
参考图3、图12、图19和图26，如以上讨论的，引导块48枢转地支撑在发射组件20的固定壳体26中。引导块48包括向远侧延伸的鼻部220（图12和图26），当SULU18支撑在通道构件22中时鼻部220搁置在SULU18下方。引导块48的内表面包括锁定表面222（图19），当吻合器10处于非夹紧位置时锁定表面222被接收在刀具致动杆44的凹口49和51中。当SULU18定位在通道构件22中时，在夹紧杆16移动至夹紧位置之前，SULU18定位在鼻部220上方并且不完全安置于通道构件22中，如以上讨论的。当吻合器10移至夹紧位置时，定位指状部170（图3）接合SULU18的主体120的顶表面以将SULU18完全安置于通道构件22中。如以上讨论的，定位指状部170被接收在SULU18的槽中以将SULU18相对于砧座部12b适当地定位。随着SULU18完全安置于通道构件22中，SULU18下压引导块48的鼻部220以使引导块48绕突起72枢转。当引导块48枢转时，锁定表面222从凹口49和51移开以解锁刀具致动杆44（图26）。该构造可防止在夹紧之前刀具致动杆44相对于引导块48的移动，以确保在使用之前刀具致动杆44和SULU刀具40保持于用于操作接合的适当位置。
参考图24-28，当吻合器10处于夹紧、非发射位置时，发射组件20的滑动块52在通道构件22的近侧端部和固定壳体26处处于收缩位置。见图27。在该位置，踏板54定位在通道构件22的切口55中，踏板54的销88定位在发射杆50的弓形凹槽94中，位于停止凹槽94a下方。这样，发射杆50能够枢转以利于从吻合器10的任一侧致动吻合器10。另外，在滑动块52的该位置，刀具致动杆44的指状部108定位成邻近滑动块52的凹槽110的远侧壁。锁定构件206的卡掣部210还接合杆218以保持夹紧杆16处于夹紧位置。
参考图26，当滑动块52处于收缩位置时，刀具40和凸轮杆46的凸轮表面114b定位在SULU18的近侧端部，安全闭锁件128的近侧钩156定位成与刀具40的接合构件158接合以保持安全闭锁件128处于锁定方位。此外，刀具40的下弯钩部40b与刀具致动杆44的上弯钩部106接合以将发射组件20连接至SULU18的刀具40。
参考图29-32，当发射杆50沿图29的箭头“A”所示方向向远侧前进时，滑动块52在发射组件20的固定壳体26内向远侧移动以引起凸轮杆46的对应移动和刀具致动杆44的延迟移动。如以上讨论的，刀具致动杆44的延迟移动等于滑动块52的凹槽110的长度，并且由于刀具致动杆44的指状部108在滑动块52的凹槽110内的移动引起。当指状部108抵接凹槽110的近侧壁112时，刀具致动杆44随滑动块52的移动开始。随着凸轮杆46向远侧移动通过发射组件20的固定壳体26，凸轮杆46的侧壁114上的凸轮表面114b前进通过SULU18以顺序接合推进器122从而从主体120的狭槽130射出吻合钉126。同时，因为刀具致动杆44的远侧端部接合刀具40，所以刀具40在预设延迟之后前进通过SULU18以切割吻合钉线之间的组织。
如图32的虚线所示，当滑动块52在固定壳体26内向远侧移动时，踏板54架在通道构件22上并且沿着发射组件20的固定壳体26的内表面移动。当这发生时，踏板54的销88移入停止凹槽94a以防止发射杆50的进一步枢转移动。
参考图31和图32，当刀具40在SULU18内向远侧移动时，刀具40的接合构件158与安全闭锁件128的近侧钩156脱离。
参考图33和图34，当发射杆50返回其最近侧位置以收缩凸轮杆46和刀具40、并且锁定构件206被压下以使卡掣部210从杆218脱离时，弹簧200推动夹紧杆16到其非夹紧位置以允许吻合器10移动至打开位置。在打开位置，砧座半段12与钉仓接收半段14隔开，并且弹簧152（图17）使安全闭锁件128在图34的箭头B指示的方向上绕枢轴构件150枢转到其解锁位置，使得安全闭锁件128从SULU18向上伸出。在解锁位置，安全闭锁件128防止吻合器10移回夹紧位置。为了再次使用吻合器10，已使用的SULU18必须被新的SULU18替换。
在手术程序期间，SULU18能够被多次替换以利于对单个患者多次使用吻合器10。因为每个SULU18设置有新刀具40，所以最小化对组织的撕扯。在手术程序之后，已使用的SULU18和发射组件20能够从通道构件22移除并且以适当方式处置。砧座半段12、钉仓接收半段14和夹紧杆16现在能够被消毒（诸如通过高压灭菌法），并且与类似方式消毒后的SULU18和发射组件20一起再次使用。因为锁定构件206形成了发射组件20的一部分并且是一次性的，所以可重复使用的部件上会捕获组织和流体的区域较少。这样，能够更易于将该装置的可重复使用的部件进行消毒。
在上述手术吻合器中，SULU18和发射组件20是分别独立固定并且从钉仓接收半段14的通道构件22独立移除的。在图35-37B图示的可选实施例中，SULU18和发射组件20构造为形成单体式一次性单元，钉仓接收半段构造为接收单体式一次性单元。尤其，发射组件的固定壳体支撑手术吻合器10的SULU和发射部件，例如图8-12示出的刀具致动杆、凸轮杆、引导块和滑动块。当固定壳体被插入到钉仓接收半段的通道构件22中时，SULU和发射部件同时安装至钉仓接收半段。固定壳体包括闭锁结构，在SULU未首先安装在固定壳体内的情况下，闭锁结构防止将固定壳体插入钉仓接收半段。因而，SULU必须在将固定壳体插入钉仓接收半段之前插入到固定壳体中。以下讨论固定壳体的具体实施例。
图35-35A图示了与发射组件520关联的用附图标记526标示的固定壳体的替换实施例。固定壳体526能够限定的长度大致类似钉仓接收半段14（图3）。固定壳体526整体构造为可释放地接收在图4的钉仓接收半段14的通道构件22内。固定壳体526包括近侧部530、远侧部532以及它们之间的中央部540。固定壳体526进一步限定了在其中的通道566，通道566被限定在固定壳体526的侧壁之间。
固定壳体526的近侧部530构造为支撑图8-12示出的手术吻合器10的发射部件，与固定壳体26的方式相同，这种发射部件包括刀具致动杆、凸轮杆、引导块及滑动块（未示出于图35）。
固定壳体526的远侧部532和中央部340总共的长度大致类似图3所示的SULU18的长度。远侧部532和中央部340一起构造为可释放地接收图3的SULU18。
固定壳体526的中央部540具有一对侧壁542，它们限定了切口546，切口546构造为接收钉仓接收半段的图9B-9C所示的突起65。远侧部532具有U形框架560，U形框架560包括底表面562和一对侧壁564。
远侧部532包括至少一个挠性构件533，挠性构件533能够在U形框架560中限定的至少一个切口536内移动。如图35-35A所示，远侧部532可以包括能够在切口536内移动的形成在侧壁564中的一对挠性构件533，优选地，切口536对称地限定在U形框架560中。每个切口536具有L形构造，其包括纵向开口537和横向开口538，纵向开口537限定在U形框架560的侧壁564上，横向开口538限定在U形框架560的底表面562上。每个挠性构件533都具有挠性且有弹性的本质，并且都包括第一部分534，第一部分534铰接地附接至其关联侧壁564的上端。第一部分534从其关联侧壁564的上端向内延伸，并且向下突出（在图35的方位上），逐渐远离纵向开口537。第一部分534的向下倾斜便于SULU18沿向下方向插入到固定壳体526中。每个挠性构件533还包括第二部分535，第二部分535以与其关联侧壁564大致平行的关系从第一部分534延伸出，并且第二部分535具有突起539，突起539向下突起超出横向开口538，并超出底表面562。由于在每个挠性构件533和其关联的侧壁564之间的铰接连接，每个挠性构件533的第一部分534能够相对于关联侧壁564枢转，并且第二部分535能够移动地穿过横向开口538。挠性构件533优选地与侧壁564一体形成，但是，可替换地，它们可以是附接至侧壁564的独立部件。
挠性构件533限定了如图35A所示的第一位置，在第一位置处每个挠性构件533相对于其关联侧壁564不对准。在该位置上，挠性构件533的第二部分535间隔地向内远离其关联的侧壁564。挠性构件533还限定了第二位置，在第二位置处，每个挠性构件533相对于其关联侧壁564大致对准。在第二位置上，每个第一部分534在其关联切口536的纵向开口537内移动，并且每个挠性构件533整体上大致位于与其关联侧壁564相同的平面中。挠性构件533通常假设它们的第一位置不受到任何外力或压力。诸如通过将SULU18插入固定壳体526的向外的力的施加，由于挠性构件533的挠性本质，使挠性构件533向外挠曲（沿远离固定壳体526的纵轴线方向），使挠性构件533从它们的第一位置移动到它们的第二位置。一旦移除力，例如，从固定壳体526中移除SULU18，由于挠性构件533的弹性本质，它们就回到它们的第一位置。
图36-36A示出用于与固定壳体526一起使用的钉仓接收半段514的替换实施例。钉仓接收半段514限定了细长通道构件522，细长通道构件522构造为接收固定壳体526。特别地，钉仓接收半段514包括近侧部524b、远侧部524a以及中央部573，它们构造为分别接收固定壳体526的近侧部530、远侧部532以及中央部540。钉仓接收半段514包括一对侧壁527和底表面528，底表面528在其中限定了至少一个槽或凹槽570。
如图36-36A所示，钉仓接收半段514可以限定一对槽570，它们大致平行于通道构件522的纵轴线而纵向地延伸。每个槽570的长度足以容纳其中一个挠性构件533的突起539。
当固定壳体526适当地接收在钉仓接收半段514内时，固定壳体526的底表面562布置为抵靠钉仓接收半段514的底表面528，并且挠性构件533的突起539定位在钉仓接收半段514的槽570内。
这对槽570布置为紧邻近于钉仓接收半段514的这对侧壁527。由于槽570与侧壁527之间的紧密接近，仅当挠性构件533处在它们的第二位置时，槽570接收挠性构件533的突起539。也就是说，当挠性构件533处在它们的第二位置时，突起539相对于槽570对准并因此能够插入槽570中。
另一方面，当挠性构件533处在它们的第一位置时，突起539相对于槽570不对准。在这种情况下，突起539抵靠钉仓接收半段514的底表面528，并且防止固定壳体526完全插入到钉仓接收半段514中。
因而，当挠性构件533处在它们的第一位置时，不存在SULU，固定壳体526不能完全地并且可操作地插入到钉仓接收半段514中。相反地，当挠性构件533处在它们的第二位置时，存在SULU，固定壳体526能够完全地并且可操作地插入到钉仓接收半段514中。
在操作期间，用户首先将SULU18定位到固定壳体526的中央部540和远侧部532中。随着SULU18沿向下方向进入固定壳体526，SULU18对每个挠性构件533均施加向外的力，并且使挠性构件533从第一位置偏置到第二位置。在SULU18被放置在固定壳体526中之后，SULU18、固定壳体526以及由固定壳体526承载的发射部件一起形成单体式一次性单元。用户随后通过将固定壳体526放置到钉仓接收半段514的通道构件522中来将该单体式一次性单元安装到钉仓接收半段514中。
如果用户尝试在没有首先将SULU18插入到固定壳体526的情形下来将固定壳体526安装到钉仓接收半段514中，则固定壳体526的挠性构件533处在如上所述的它们的第一位置，从而防止了固定壳体526安装到钉仓接收半段514中。
图37-37B图示出用附图标记626标示的固定壳体的另一替换实施例。在该实施例中，固定壳体626的远侧部632限定至少一个切口674，切口674允许具有挠性、弹性本质的至少一个挠性构件670在至少一个切口674中枢转或移动。在一个实例中，远侧部632可以包括在形成一对挠性构件670的每个侧壁664的上端处的一对切口674。切口674可以对称地布置在侧壁664上。可替换地，挠性构件670可以是附接至侧壁664的独立部件。
每个挠性构件670从关联侧壁664延伸出并且绕该关联侧壁664中限定的切口674定位。每个挠性构件670具有第一部分672，第一部分672在切口674的下边缘676处铰接地附接至其关联侧壁664。第一部分672的高度“H”等于或大致类似于切口674的高度。此外，每个挠性构件670包括第二部分678，第二部分678呈现在其中限定有凹槽679的钩形的、U形的或凹形的构造，并且面向相反的径向方向。每个凹槽679面向大致向下的方向，如在图37的方位上观察到的。每个凹槽679构造为将钉仓接收半段614的侧壁627的顶边缘628接收在其中。
由于在每个挠性构件670与其关联侧壁664之间的铰接连接，每个挠性构件670能够相对于其关联侧壁664枢转。特别地，挠性构件670具有第一部分，如图37A所示，其中每个挠性构件670的第一部分672相对于其关联侧壁664不对准。在该第一位置，该对第一部分672朝向彼此向内倾斜。当挠性构件670处在第一位置时，每个凹槽679相对于钉仓接收半段614的侧壁627的相应顶边缘628不对准。如图37A所示，如果用户尝试在挠性构件670处在第一位置时将固定壳体626安装到钉仓接收半段614中，则挠性构件670的第二部分678抵接钉仓接收半段614的侧壁627的顶边缘628并且防止了将固定壳体626完全插入钉仓接收半段614。
此外，挠性构件670限定了第二位置，如图37B所示，其中每个第一部分672偏置到其关联切口674中而与其关联侧壁664对准。在第二位置，由第二部分678限定的凹槽679相对于钉仓接收半段614的相应顶边缘628对准，并且凹槽679被定位为易于将顶边缘628接收在其中。
挠性构件670在没有对其施加任何力或压力时通常呈现在它们的第一位置。然而，诸如通过将SULU618（类似于SULU18）插入固定壳体626的对挠性构件670施加任何外力，将每个挠性构件670从第一位置推动到第二位置。由于挠性构件670的弹性本质，从固定壳体626中移除SULU618使挠性构件670从第二位置返回到第一位置。
因而，当挠性构件670处在第二位置时，固定壳体626能够完全并且可操作地插入到钉仓接收半段614中。比较而言，当当挠性构件670处在第一位置时，固定壳体626不能完全地插入到钉仓接收半段614中。
在操作期间，用户首先将SULU（例如，SULU618、18）定位到固定壳体626中，将挠性构件670从它们的第一位置移动到它们的第二位置，使得固定壳体626能够易于被钉仓接收半段614接收。在SULU618完全插入到固定壳体626中后，SULU618、固定壳体626以及由固定壳体626承载的发射组件一起形成单体式一次性单元。用户随后通过将固定壳体626放置到钉仓接收半段614的通道构件622中来将该单体式一次性单元安装到钉仓接收半段614中。
如果用户尝试在没有首先将SULU618插入到固定壳体626的情形下来将固定壳体626安装到钉仓接收半段614中，则固定壳体626的挠性构件670将抵接钉仓接收半段614的侧壁627的顶边缘628，以防止固定壳体626进入钉仓接收半段614。
如图35-35A所示的挠性构件533和如图37-37B所示的挠性构件670都是闭锁结构的示例性实施例，其能够用于在SULU未首先安装到固定壳体的情况下防止将固定壳体插入钉仓接收半段。因此，SULU和推进器组件（例如，固定壳体）必须在插入到装置的钉仓接收半段之前一起形成（一起形成发射组件）。
应理解的是，可以对此处公开的手术紧固件施加装置的实施例做出各种修改。因此，上述说明不应该视为限制，而仅是作为实施例的范例。本领域的技术人员将想到在本公开的范围和精神内的其他修改。

Claims (16)

1.一种手术紧固件施加装置，包括：
砧座半段，其包括远侧砧座部；
钉仓接收半段，其限定了细长通道构件；以及
固定壳体，其构造为可释放地支撑在所述钉仓接收半段的所述细长通道构件内，所述固定壳体支撑所述装置的发射部件，所述固定壳体定尺寸为可释放地接收单次使用加载单元，所述固定壳体包括闭锁结构，所述闭锁结构防止在所述单次使用加载单元未安装在所述固定壳体中的情况下将所述固定壳体完全插入所述钉仓接收半段；
其中，所述闭锁结构能够在第一位置和第二位置之间移动，所述第一位置防止将所述固定壳体插入所述钉仓接收半段，所述第二位置允许将所述固定壳体插入所述钉仓接收半段；所述闭锁结构包括从所述固定壳体的侧壁延伸出的至少一个挠性构件，所述挠性构件响应于所述单次使用加载单元插入到所述固定壳体中而从所述第一位置移动到所述第二位置。
2.根据权利要求1所述的手术紧固件施加装置，其中所述挠性构件包括延伸超出所述固定壳体的底表面的突起。
3.根据权利要求2所述的手术紧固件施加装置，其中所述钉仓接收半段在其中限定槽以接收所述挠性构件的所述突起。
4.根据权利要求3所述的手术紧固件施加装置，其中当所述挠性构件处在所述第一位置时，所述挠性构件的所述突起相对于所述钉仓接收半段的所述槽不对准。
5.根据权利要求3-4中任一项所述的手术紧固件施加装置，其中当所述挠性构件处在所述第二位置时，所述挠性构件的所述突起相对于所述钉仓接收半段的所述槽对准并能够易于插入到所述槽中。
6.根据权利要求1-4中任一项所述的手术紧固件施加装置，其中所述挠性构件限定凹槽，所述凹槽构造为接收所述钉仓接收半段的侧壁的顶边缘。
7.根据权利要求6所述的手术紧固件施加装置，其中当所述挠性构件处在所述第一位置时，由所述挠性构件限定的所述凹槽相对于所述钉仓接收半段的顶边缘不对准。
8.根据权利要求6所述的手术紧固件施加装置，其中当所述挠性构件处在所述第二位置时，由所述挠性构件限定的所述凹槽相对于所述钉仓接收半段的顶边缘对准并且被构造为易于将所述钉仓接收半段的顶边缘接收在其中。
9.根据权利要求1-4中任一项所述的手术紧固件施加装置，其中所述发射部件包括刀具致动杆和凸轮杆。
10.手术紧固件施加装置，其包括：可重复使用的砧座半段、可重复使用的钉仓接收半段以及一次性发射组件，所述一次性发射组件构造为可释放地支撑在所述钉仓接收半段内，所述发射组件包括一次性的推进器组件以及能够安装至所述推进器组件的一次性的单次使用加载单元，其中，只要所述发射组件包含所述单次使用加载单元，所述发射组件就能够完全插入到所述钉仓接收半段中；
所述手术紧固件施加装置进一步包括阻挡构件，所述阻挡构件能够在第一位置和第二位置之间移动，所述第一位置防止将所述发射组件完全插入所述钉仓接收半段，所述第二位置允许将所述发射组件完全插入所述钉仓接收半段；所述阻挡构件是从所述推进器组件的壳体的壁延伸出并且其偏置到所述第一位置的挠性构件，并且当所述单次使用加载单元被安装到所述发射组件时，所述单次使用加载单元对所述挠性构件施力以使所述挠性构件移动到所述第二位置从而使所述发射组件能够完全插入所述钉仓接收半段。
11.根据权利要求10所述的手术紧固件施加装置，其中所述挠性构件包括延伸超出所述壳体的底表面以接触所述钉仓接收半段的表面的突起，并且所述钉仓接收半段在其中限定槽以接收所述挠性构件的所述突起。
12.根据权利要求10所述的手术紧固件施加装置，其中所述挠性构件包括钩，所述钩限定凹槽，所述凹槽构造为当所述挠性构件处在所述第二位置时将所述钉仓接收半段的侧壁的顶边缘接收在其中，并且构造为当所述挠性构件处在所述第一位置时抵接所述顶边缘。
13.一种与手术紧固件施加装置一起使用的一次性发射组件，所述一次性发射组件包括一次性的单次使用加载单元和一次性的推进器组件，所述发射组件能够插入到所述紧固件施加装置的钉仓接收半段中，所述单次使用加载单元能够可操作地安装至所述推进器组件，其中所述发射组件包括闭锁构件，所述闭锁构件能够从第一位置和第二位置移动，所述第一位置防止将所述发射组件可操作地插入所述紧固件施加装置，所述第二位置能够使所述发射组件完全可操作地插入所述紧固件施加装置。
14.根据权利要求13所述的一次性发射组件，其中所述闭锁构件被偏置到所述第一位置，并且当所述单次使用加载单元被安装至所述推进器组件时，所述单次使用加载单元对所述闭锁构件施力以将其移动到所述第二位置。
15.根据权利要求13-14中任一项所述的一次性发射组件，其中所述闭锁构件包括突起，当所述闭锁构件处在所述第二位置时，所述突起能够与所述紧固件施加装置中的槽接合，在所述闭锁构件的第一位置上，所述突起相对于所述槽不对准。
16.根据权利要求13-14中任一项所述的一次性发射组件，其中所述闭锁构件包括凹槽，所述凹槽构造为当所述闭锁构件处在所述第二位置时，接收所述紧固件施加装置的钉仓接收半段的侧壁的顶边缘，并且构造为当所述闭锁构件处在所述第一位置时抵接所述顶边缘。
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AU2012294733A1 (en) 2014-01-23
JP2014528755A (ja) 2014-10-30
WO2013022703A1 (en) 2013-02-14
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US20170325811A1 (en) 2017-11-16
CA2843617A1 (en) 2013-02-14
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US10517588B2 (en) 2019-12-31
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