CN103889343A - Devices and methods for minimally invasive suturing - Google Patents

Abstract

Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable, of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the. Pointed end of the suturing needle is positioned within the suture, head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Description

Equipment and the method sewed up for Wicresoft

the cross reference of related application

The application submits and is published as on August 9th, 2011 U.S. Patent number 7 on October 21st, 2010,993,354 U.S. Patent Application Serial Number 12/909,606 part continuation application and require the interests of its priority, it requires the interests of the priority of the U.S. Patent Application Serial Number 61/388,648 of submitting on October 1st, 2010 then.The application also relates to the international application no PCT/US2009/006212 of submission on November 20th, 2009, and it requires the priority of the U.S. Provisional Application serial number 61/200,180 of submitting on November 25th, 2008 then.The application also relates to the U.S. Patent Application Serial Number 11/231,135 of JIUYUE in 2005 submission on the 20th, and it requires the interests of the priority of the U.S. Provisional Application serial number 60/611,362 of JIUYUE in 2004 submission on the 20th then.The international application no PCT/US2008/06674 that present patent application also relates on May 23rd, 2008 to be submitted to, it requires the priority of the U.S. Provisional Application serial number 60/939,887 of submitting on May 24th, 2007 then.The U.S. Patent Application Serial Number 12/175,442 that present patent application also relates on July 17th, 2008 to be submitted to.The mode that above-mentioned each application is quoted is in full incorporated herein.

Technical field

Embodiment disclosed herein relates to a kind of armarium for suture tissue, and relate more specifically to a kind ofly for sewing up manipulate in Wicresoft and controlling the equipment of sewing needle, manufacture the method for this equipment and use the method for this equipment suture tissue.

Background technology

Minimally Invasive Surgery (MIS) has allowed doctor to implement many surgical operations, has less pain and disability compared with the operation of conventional open formula.Thereby different from the conventional open formula operation that easily arrives surgery location permission easily observation of surgeon and manipulation of tissue and apparatus by large otch, MIS needs surgeon to insert and operating apparatus by little perforation (" keyhole operations ") or by natural hole (comprising for example vagina, esophagus or anus), and remotely performs the operation.

In MIS, conventionally in human body, form little perforation.Insert medical apparatus and instruments by sleeve pipe subsequently.Sleeve pipe has common 5-10 millimeter (mm) and sometimes up to 20 millimeters (mm) or above little internal diameter.For any given operation, a large amount of this sleeve pipes can be inserted in human body.Minimally Invasive Surgery apparatus must be less, and also conventionally longer, and thereby be more difficult to accurately operate.

In MIS, may the most debatable surgical tasks be to sew up.Sew up the little pin and stitching thread (especially in the time only can obtaining indirectly two-dimensional video imaging) and the conventional multiple apparatuses (comprise needle drivers and pick up pincers) for sewing up with hands that need two hands coordinated manipulations to be difficult to observe.Being characterized as in the limited environment of limited space, video picture finite sum mobility, many surgeon find that it is very difficult carrying out with hands that Wicresoft sews up, and are usually impossible surgical tasks almost.

In the method for optimizing of sewing up with hands, by the hand-held grasping pincers of surgeon (" needle drivers "), and described grasping pincers are for grasping needle bent at Aculeata.The inward turning driving needle of surgeon's wrist enters tissue.In the time that the tip of needle bent occurs from tissue, surgeon is release pin from the holding of needle drivers, and uses another pincers (" pick-up ") to grasp described tip.Subsequently, surgeon is by the preferably drawing needle bent on the circular path along pin curvature radian of tip of pin, to pass through tissue along the most AT path, until the whole length of pin has been left tissue.While stitch being set, just drive needle bent around complete annular radian at every turn.Arrange the stitch of independent (interruption) by the cloth postpone opposite joint zygonema knotting to along each stitch.By repeatedly repeatedly driving needle bent until arranged the stitching thread of Len req and the stitch of requirement with complete annular radian, can arrange the stitch of (continuing) continuously.In order to arrange extra interruption or lasting stitch, surgeon must decontrol the most advanced and sophisticated of pin and again grasp pin near Aculeata.

In above-mentioned manual suture technology, straightforward manipulation pin may cause pin unexpectedly to penetrate surgeon or nurse's glove, cause the infected possibility of surgeon, nurse, staff and patient risk, or make pin be subject to the pollution of pathogenetic bacteria, this may cause infection in suture location.Also there is pin puncture internal or blood vessel and cause the serious and risk of fatal infection normally.

It is the U.S. Patent Application No. 5 of " Methods and Apparatus for Suturing Tissue " at title, 643, 295, title is the U.S. Patent number 5 of " Needle Driving Apparatus and Methods of Suturing Tissue ", 665, 096, title is the U.S. Patent number 5 of " Methods and Apparatus for Suturing Tissue ", 665, 109, title is the U.S. Patent number 5 of " Suturing Instrument with Rotatably Mounted Needle Driver and Catcher ", 759, 188, title is the U.S. Patent number 5 of " Endoscopic Suturing Devices and Methods ", 860, 992, title is the U.S. Patent number 5 of " Suturing Instrument with Rotatably Mounted Needle Driver and Catcher ", 954, 733, title is the U.S. Patent number 6 of " Endoscopic Suturing Device ", 719, 763, and title is the U.S. Patent number 6 of " Endoscopic Suturing Device ", 755, the various device of sewing up for MIS has been described in 843, the mode that all these patents are introduced is in full incorporated herein instruction content wherein.

Assignee's U.S. Patent number 5,437,681, U.S. Patent number 5; 540,705 and U.S. Patent number 6,923; 819 disclose the robotic suturing device with thread management, and it comprises protection cylinder, sewing needle and pin rotating driver, and its disclosure is incorporated herein by reference.The equipment of describing in above-mentioned patent and patent application comprises the mechanism for driving protected pin, but pin rotates around being parallel to the axle of described equipment axis.In addition, the orientation of robotic suturing device and size make to be difficult to observe and be not easy to for MIS.

Thereby, in this area, still needing a kind of Wicresoft robotic suturing device, it is easy to operate in the sleeve pipe of minor diameter, plays a role being characterized as in limited space, video picture is limited and mobility is limited environment; The preferred sewing method that simulation is used by surgeon; Allow surgeon fast and fix and tie a knot with controlled tension force; Arrange continuous stitch; And avoid user to be subject to unexpected acupuncture in pin operating period, and avoid internal and blood vessel to be subject to acupuncture unintentionally.

Summary of the invention

Herein disclosed is the equipment and the method that are sewn to inside of human body tissue for Wicresoft.

According to each side as herein described, a kind of armarium of the opening for closed patient's inside of human body is provided, it critically imitates or has reappeared the manual suture operation of surgeon's enforcement.In Minimally Invasive Surgery, with surgeon use conventional method compared with, this equipment provides multiple advantages, is that it provides the hand-held suture instruments that does not need exterior power source.Embodiment disclosed herein makes surgeon be easy to use one-handed performance.

According to each side as herein described, sewing-end assembly can be connected to removedly to the actuating mechanism of robotic suturing device.The diameter of equipment is enough little, to be arranged in some embodiments in the sleeve pipe of 5mm, thereby make equipment in endoscope or other MIS operation very easily in handling and sewing up.In operation process, need to form the least possible otch, and should be as far as possible little for those otch.Like this, the equipment that profile is less is highly beneficial.Similarly, once the sewing-end assembly of equipment is in sleeve pipe inner side, just laterally chain connection is to center left, right side, center, upper and lower, and this is desirable for the use in the endoscopic surgery and other minimal invasive surgical procedures that comprise peritoneoscope, thoracoscope and arthroscope.

The equipment of embodiment disclosed herein critically imitates or reappears the manual suture operation that surgeon implements.For example, during with hands manual suture, pin is fixed in pincers, and unimpededly advances in circular arc mode in circular arc.The design of the robotic suturing device of embodiment disclosed herein allows not have the obstruction at arc center during sewing up.In other words, there is no wheel hub at the circular arc center of sewing needle.Whole region in the circular arc of pin is hindered.Different from existing mechanical stitch method, this allows user to observe better at intra-operative, keeps the control that pin is moved simultaneously.

The advantage that the robotic suturing device of embodiment disclosed herein provides be described equipment allow to handle suture material in the substantially similar mode of the mode that uses hands to carry out with surgeon through tissue cut.Particularly, first some embodiments of robotic suturing device promote sewing needle and order about needle point through tissue from Aculeata.Subsequently, described equipment picks up the needle point through tissue, and the remainder of drawing sewing needle and the stitching thread that is connected to sewing needle are by tissue.Thereby sewing needle all the time with pin through the mode of the minimal damage of tissue along with the radian of pin self curve, this is preferred sewing method.The advantage of the robotic suturing device of embodiment disclosed herein be sewing needle along each stitch and by fully drawing of stitching thread by the tissue part just sealing.In the time using the robotic suturing device of embodiment disclosed herein, without such as needle lock, the assistive device that picks up pincers etc. or instrument to complete stitching.Can use pincers or grasp apparatus so that toe-in becomes tight.

According to each side as herein described, a kind of embodiment of robotic suturing device is provided, it comprises the sewing needle of being protected by shell, described sewing needle is not exposed to user or is directly operated by user, prevents thus unexpectedly acupuncture.The structure of the robotic suturing device of embodiment disclosed herein also prevents pin unexpectedly puncture internal or blood vessel, and reason is that shell serves as the guard shield between organ and pin.

In one embodiment, robotic suturing device is equipped with sewing-end.Sewing-end comprises the shell and the extensible needle track that are defined in wherein at least one passage.Extensible needle track is arranged in shell, and needle track is suitable for and is configured to be substantially arranged on storage or the contraction state shell from needle track wherein, launch or extend to needle track wherein and stretch out to form from shell the state that stretches or launched of bending needle track.Described equipment also comprises the arc or the circular needle that are arranged in deployable needle track, and described needle set has the main body of first end, the second end and general toroidal.Described equipment also comprises driver, for making pin advance the path of approximately 360 °, pin during in deployed condition around needle track at extensible needle track.Driver is suitable for and is configured to when extensible or extensile needle track is in launching or in extended configuration time, advancing pin in the multiple 360 ° of rotations around needle track, and without removing pin from needle track.Driver optionally engage with pin and with its disengaging, to advance pin around 360 ° of rotations.

According to other side, the shell of robotic suturing device can be general cylindrical shape, and the about 5.0mm of its external diameter.The diameter 10mm of the circular path of needle track.If needed, pin can have non-circular cross sections.Preferably, described equipment also comprises for needle track is launched into the device of deployed condition from storing state.In the time that needle track launches, needle track can occupy approximately 270 ° of 360 ° of pin paths.But, should be appreciated that, present disclosure relates to a kind of deployable or equipment of extensile needle track angularly that has, and described needle track can extend to the final degree that is greater than or less than 270 °, is 1 degree such as increment.For example, a kind of needle track can be provided, and it extends to approximately 190 °, approximately 200 °, approximately 210 °, approximately 220 °, approximately 230 °, approximately 240 °, approximately 250 °, approximately 260 °, approximately 270 °, approximately 280 °, approximately 290 °, approximately 300 °, approximately 310 °, approximately 320 ° or approximately 300 ° etc. from approximately 180 °.For example, according to the size of the diameter of equipment and needle track, may only need to there is guide rail, it makes the angle of needle track never launch (not stretching) structure increases approximately 10 °, approximately 20 °, approximately 30 °, approximately 40 °, approximately 50 °, approximately 60 °, approximately 70 °, approximately 80 °, approximately 90 °, approximately 100 °, approximately 110 °, approximately 120 °, approximately 130 °, approximately 140 °, approximately 150 ° or approximately 160 °, to launching (stretching) structure.Driver can comprise elongated resilient members, and its longitudinal axis along equipment is reciprocal.When about shell and proximad while advancing elongated resilient members, driver can joint pin or is advanced pin along needle track.Pin can comprise the first and second recesses along pin inner surface, is arranged on shell and the deployable needle track anti-rotation mechanism on one of at least for engaging.Pin can also comprise recess on pin end face, and for engaging with a part for driver, wherein the recess on pin end face is with to be arranged on one of recess on pin inner surface crossing.

According to a preferred embodiment, extensible needle track comprises at least one arc-shaped guide rail, and it is suitable for launching along curved path from shell.Preferably, extensible needle track comprises a pair of arc-shaped guide rail, and it is suitable for launching along curved path from shell.Preferably, by drawing first, to bracing wire and from shell along curved path, expansion is described to arc-shaped guide rail, wherein on each guide rail, connects a bracing wire.Described guide rail is preferably also suitable for and is configured to, by drawing second, bracing wire, in retraction shell, is wherein connected to a bracing wire in second pair of bracing wire on each guide rail.First pair of bracing wire is preferably connected to second pair of bracing wire, and to form a pair of continuous mechanical circuit, wherein loop is connected to guide rail at far-end, and near-end is connected to a pair of handle, and wherein the movement of handle causes the movement of guide rail.

The present invention also provides a kind of sewing needle, it has the arc main body with front tip and tail end, wherein arc main body defines along the first recess of the inner diameter zone of pin, and arc main body also defines second recess with projection, described projection is positioned at the plane that the flexural center axis of pin defines, and wherein the first recess and the second recess intersect.If needed, pin can also comprise roughly foursquare cross section.Pin main body can comprise the part with circular cross section, described in there is circular cross section part by the major part with the pin of square cross section roughly with there is the roughly afterbody part of square cross section and separate.Pin also can define the 3rd recess in pin approaching its tail end place, for receiving a part that drives ratchet.And pin can define arcuate ridges rib along its length, the movement with stabilization needle in robotic suturing device.

According to each side as herein described, provide a kind of during Minimally Invasive Surgery the method for suture tissue, it comprises the far-end of robotic suturing device is inserted in human body, described robotic suturing device has is with cuspidated sewing needle; Key approximation suture pin is to cross over the tissue segments of multiple separation; Initial activation trigger with make the tip of sewing needle extend beyond cylinder protecting sheathing to engage the tissue segments of multiple separation; And activate for the second time trigger to make sewing needle complete once rotation, and the suture that drawing is extended from sewing needle is by the tissue segments of multiple separation, to form stitch.

According to another aspect, provide the robotic suturing device with sewing-end.Sewing-end comprises the shell that defines wherein at least one passage, and shell has near-end, far-end and connects the peripheral side of near-end and far-end.Described head also comprises the deployable needle track being arranged at least partly in shell, needle track is suitable for and is configured to be launched into deployed condition from storing state, in storing state, needle track substantially arranges in the enclosure and has an angular range of approximately 180 °, and in deployed condition, needle track has and is greater than the angular range of 180 ° and stretches out from the peripheral side of shell, to form the arc needle track that is arranged in the plane parallel with the longitudinal axis of shell.Preferably, needle track can stretch angularly along the circular path that defines pin travel path, thereby track extends to extended configuration angularly around circular path from contraction state.Described sewing-end also comprises the arc pin being arranged in deployable needle track, and described needle set has the main body of first end, the second end and general toroidal.Sewing-end also comprises driver, for advancing pin around needle track in multiple 360 ° of rotations when deployable needle track during in deployed condition, wherein driver optionally joint pin and with its disengaging, to advance pin around the rotation of 360 °.

According on the other hand, shell is general cylindrical shape, and diameter is about 5.0mm, and the path diameter of needle track is about 10mm.But, should be appreciated that, as required, diameter can be greater or lesser.Pin can have substantially circular cross section, circular cross section, non-circular cross sections, square or triangular cross section, or the cross section of pin is along its length variations and from a shape transition to another, such as extremely square to circle from square.Described equipment preferably also comprises for needle track is launched into the device of deployed condition from storing state.In the time that needle track launches, needle track preferably occupies approximately 270 ° of 360 ° of pin paths, and the angular range of needle track can be greater than or less than 270 ° as required, for example, with the increment of 1 degree.

According on the other hand, driver preferably includes the elongated resilient members reciprocal along the longitudinal axis of equipment.When elongated resilient members about shell proximad while advancing, preferably joint pin and advance pin along needle track of driver.Deployable needle track preferably includes at least one arc-shaped guide rail, and it is suitable for launching along curved path from shell.Preferably, deployable needle track comprises a pair of arc-shaped guide rail, and it is suitable for launching along curved path from shell.Preferably, by drawing first to bracing wire, and from shell along curved path launch described to arc-shaped guide rail, wherein on each guide rail, connect a bracing wire.Described arc-shaped guide rail is preferably also suitable for and is configured to, by drawing second, bracing wire, in retraction shell, is wherein connected to a bracing wire in second pair of bracing wire on each guide rail.First pair of bracing wire is preferably connected to second pair of bracing wire, and to form a pair of continuous mechanical circuit, wherein loop is connected to guide rail at far-end, and near-end is connected to a pair of handle, and wherein the movement of handle causes the movement of guide rail.

In another embodiment, robotic suturing device is equipped with sewing-end.Sewing-end comprises elongate housing, the peripheral side that it has near-end, far-end and connects near-end and far-end, and its housing has defined the longitudinal axis from its near-end to its far-end.Sewing-end also comprises the deployable needle track being arranged at least partly in shell, at least a portion of needle track is suitable for and is configured to being expanded to deployed condition with deployed condition along curved path and never, wherein in deployed condition not, needle track has the arc areas of approximately 180 degree and substantially arranges in the enclosure, and needle track has the arc area that exceedes 180 degree in deployed condition, and wherein needle track is positioned at the plane that is parallel to the shell longitudinal axis.Described sewing-end also comprises the arc pin being arranged in deployable needle track, and described needle set has the main body of first end, the second end and general toroidal.Sewing-end also comprises driver, for advancing pin around needle track in multiple 360 ° of rotations when deployable needle track during in deployed condition, wherein driver optionally joint pin and with its disengaging, to advance pin around 360 ° of rotations.

According to another aspect, as required, shell can be general cylindrical shape or rectilinear.Deployable or extensible needle track can comprise one or more arc-shaped guide rails, and it is suitable for launching along curved path from shell.Deployable or extensile needle track can comprise a pair of arc-shaped guide rail, and it is suitable for launching along curved path from shell.Therefore, to bracing wire, can launch from shell along curved path describedly to arc-shaped guide rail by drawing first, wherein on each guide rail, connect a bracing wire.In one embodiment, when needle track is during in extended configuration, deployable or extensible needle track occupies approximately 270 ° of 360 ° of pin paths, and the angular range of needle track can be greater than or less than 270 ° as required, for example, with the increment of 1 degree.

By embodiment hereinafter described, these and other advantage of embodiment of the present invention is described.Embodiment of the present invention correspondingly comprises below in detail specifications the setting of the combination of illustrational architectural feature, element and parts.

Accompanying drawing explanation

To embodiment of the present disclosure be described with further reference to accompanying drawing, wherein in multiple accompanying drawings, identical Reference numeral is indicated identical structure.Accompanying drawing nonessential drafting in proportion, and the general instead principle of Special attention will be given to embodiment of the present invention, wherein:

Fig. 1-3 show robotic suturing device constructed in accordance generally.

Fig. 4-32 and 47(A)-47(D) show the each side of the first embodiment of the sewing-end of robotic suturing device constructed in accordance.

Figure 33-37 show the each side of the embodiment of pin loader constructed in accordance.

Figure 38-40 show the each side of the first embodiment of sewing needle constructed in accordance.

Figure 41-44 show the each side of the second embodiment of sewing needle constructed in accordance.

Figure 45 shows the each side of the 3rd embodiment of sewing needle constructed in accordance.

Figure 46 shows the each side of the 4th embodiment of sewing needle constructed in accordance.

Figure 47 (E)-55 shows the each side of the second embodiment of the sewing-end of robotic suturing device constructed in accordance.

Figure 56-59 show the each side of the zone line of the robotic suturing device shown in Fig. 1-3.

Figure 60-122 show the each side of the handle portion of the robotic suturing device shown in Fig. 1-3.

Figure 123-131 show Fig. 4-32 and 47(A)-47(D) the operation of sewing-end.

Although accompanying drawing shows embodiment of the present invention, just as described herein, also can expect other embodiment.With explanation, unrestriced mode shows schematic embodiment in the present invention.Those skilled in the art can design a large amount of other modifications and embodiment in the scope and spirit of the principle of embodiment of the present invention.

The specific embodiment

With detailed reference to the preferred embodiments of the invention, the example of each embodiment is shown in the drawings.In connection with the detailed description to system, and method and the corresponding steps of disclosed embodiment are described.

In a broad sense, the feature of the embodiment of robotic suturing device provided by the invention allows this device build become to have size less compared with being incorporated to by reference with prior art neutralization the embodiment of discussing in patent application herein and have less profile.Particularly, built embodiment formed according to the present invention, it is suitable for and is configured to be applicable to the trocar by 5mm.Advantageously, embodiment of the present invention is still used relatively large sewing needle, allows thus substantially to capture tissue at intra-operative, forms effectively and sews up.

The nonrestrictive object for explanation, as embodied, figure 1 illustrates the typical embodiments of robotic suturing device 1000 herein.Equipment 1000 comprises three regions, comprises sewing-end 100, zone line 500 and handle 600.Below in detail each of these regions will be discussed.Fig. 2-3 show the equipment 1000 that has removed some part.Particularly, Fig. 2 shows the equipment 1000 that has removed pin loader (below will further discuss), and Fig. 3 shows the equipment 1000 of the specific part that has removed handle casing.

The non-limiting object for explanation, has illustrated the sewing-end 100 separating with equipment 1000 remainders in Fig. 4.Sewing-end 100 comprises near-end 102, far-end 104, and forms by three the main case members (106,108,112) that together cooperate, and described three main case members define the gap 110 for receiving patient tissue to be stitched together.Sewing-end 100 is suitable for and is configured to guide semi-circular pin (300,350,400) around semicircular tracks and crosses over gap 110, to form a series of stitchings by treating suture tissue.

Before advancing pin leap gap 110, sewing-end 100 must convert deployment configuration to from sending structure.As shown in Figures 4 and 5, sewing-end 100 is provided as at first and has predetermined transverse dimensions or diameter

compact form.Described lateral dimension

can be any required size, and be preferably approximately 5 millimeters.Particularly, preferably select size

thereby for example, during laparoscopic surgery, sewing-end 100 can enter patient abdominal cavity by the trocar of standard 5mm (trocar).Fig. 5 shows the sewing-end 100 of ground opposite angles compared with Fig. 4, and it comprises pivot bosses 114, and described pivot bosses 114 is mated with the mid portion 500 of equipment 1000.

Figure 6 illustrates sewing-end 100 in deployed configuration.As shown in Figure 6, in deployed configuration, nearly side rails 120 and distally guide rail 130 outwards move from their cover holding position, and described position is defined by 106,108 of case members, below will discuss in more detail it.While expansion in as Fig. 6, guide rail 120,130 has defined circular needle path or needle track 140, and it is positioned at the plane P of the longitudinal axis X that is parallel to equipment 1000.In addition, as shown in the figure, pull by engaging along the ratchet 125 being positioned on nearside guide rail 120 of the recess 306 of pin 300 inner surface settings, and advance slightly the front tip 302 of pin 300, as discussed in detail below.

After deployed condition and needle track 140 are defined, can advance pin 300 at guide rail 120,130 by ratchet 160 is advanced into far-end along its reciprocal path.Fig. 7 illustrates and crosses over the pin 300 in gap 110, and wherein the pin 300 of approximately 180 ° of radians is roughly positioned at the outside of the encapsulated member being defined by shell section 106,108,112.

Fig. 8-10 show the function of sewing-end 110 from the opposite side of sewing-end.Fig. 8 shows sewing-end 100 in delivery configuration, and its middle guide 120,130 is retracted.As visible, engagement pawl 160 is drawn back to the proximal position of pin 300, and the tail end 304 of pin 300 is visible.Fig. 9 shows in the sewing-end of deployed configuration, and its middle guide 120,130 launches.As shown in Figure 9, far-end guide rail 130 has defined arc recess 135, and far-end that described arc recess 135 moves back and forth at it is received ratchet 160, as shown in can the best in Figure 10.As being obvious from Figure 10, as ratchet 160, the recess 158 in driver part 150 is boosted in far end party.

Figure 11 (A)-1l(D) show the structure of engagement pawl 160.Ratchet 160 comprises that connection (for example welding) is to the shell 166 on the far-end 154 of driver part 150.Shell 166 is tubular metal structure preferably, and is contained in the ratchet spring 164 of bias voltage between removable pin 168 and cap portion 162.Cap 162 is preferably connected to shell 166 such as welding.

Figure 12 shows sewing-end 100, has wherein removed cover 106, thereby manifests reciprocal guide rail path and guide rail 120,130 that driver part 150 and ratchet 160 follow.Four axis of thrust, cable or silk 172,174,176,178 by guiding around a series of boss in housing parts 106, be advanced into deployed configuration by guide rail 120,130 from delivery configuration.Particularly, each guide rail 120,130 comprises curled portion 120a, 120b, 130a, 130b, and it is formed integrally as the end of each guide rail 120,130.Each curled portion comprises the passage being formed at wherein, for receiving the end of line 172-178.Line 172-178 can take the form of any appropriate, most preferably is diameter .009 " multiply 300 series stainless steel cables.Subsequently, these ends are curling, bonding or be connected to curled portion.Subsequently, by the every centering that is connected to each guide rail line is applied to tension force, sewing-end 100 is drawn in or pulled out to guide rail 120,130.

Figure 13 shows guide rail 120,130 in deployed condition, and considers not shown line 172-178 for simplifying.Figure 14 shows driver part 150, has ratchet 160 in its distal-most end of advancing, and described driver part 150 straddles in the groove 135 of guide rail 130 sides.The height 130e of wall 130d can increase, and can thicken to conform to groove 135, thereby is provided for the enhancing load-bearing surface of ratchet 160.Retainer (not shown) is preferably provided as the form that is positioned at the convex surfaces on guide rail 120,130 and case member, to contribute to preventing that guide rail 120,130 from departing from from sewing-end.

It is equally evident that, when guide rail is during in deployed condition, the groove 125 of guide rail 120 sides becomes the passage that can enter ratchet.As shown in Figure 14, guide rail 150 is across the curved path along guide rail, and edge is with the path of pin.Figure 15 shows the spatial relationship of driver part 150 and pin, has wherein removed miscellaneous equipment parts.Figure 16 shows pin 300 about anti-rotation spring 115 and the relative position that is contained in the drive pin 168 in ratchet 160.Figure 17 shows in detail drive pin 168, wherein sells 168 and comprises: the distal face 168a of the main body of contact pin; Circumference is roughly columnar 168b, the recessed surfaces in its far-end contact pin 100 or the far-end 304 of pin; The proximal end face 168d of contact ratchet spring 164; The head part 168c amplifying; And circumference distal face 168e, the narrow of the shell 166 of its contact ratchet 160, in case shotpin 168 landing from shell 166.

Figure 18-21st, the additional views of sewing-end 100, shows progressively removing of parts.Figure 18 shows complete sewing-end 100, and Figure 19-20 show boss 106a, the 106b on housing parts 106, the location of 106c, and it has defined for guide rail cable 172,174,176,178(not shown) the strong point.Can also provide spacer 106d to keep the required separation distance between each case member 106,108, to allow at the interior moving-member of sewing-end 100, and spacer 106d can also act as line 176,178(Figure 29) supporting surface.Figure 20-21 show and remove preventer 109, the inner support device that it provides guide rail 120,130 to bear against.Guide rail 120,130 straddles by parts 106,108 and 109 common cooperations and is defined in curved channel.

Figure 22 show with Figure 21 in there is near-end guide rail 120 and the far-end guide rail 130 of same space relation.At Figure 23 (A)-23(B) in the view of near-end guide rail 120 has been shown.Guide rail 120,130 preferably by assembling, such as being made by metal material by a series of metal sublayer parts of laser weld, once and just form an entirety after assembling.Can think that guide rail has towards " top " of driver part 150 face, and towards " end " of housing parts 108 face.Near-end guide rail 120 has defined the bending channel 125 that is arranged in its end face 122.Nearside guide rail 120 has also defined and has wherein defined below groove 124b 124, born against the inner face 126 of preventer 109 inner surfacies and support the outside 128 against case member 106,108.As Figure 24 (A)-24(B) as shown in, far-end guide rail 130 defines bending channel 135 in end face 132, for guiding ratchet 160.Far-end guide rail 130 also defined and wherein defined below groove 134b 134, support against the inner face 136 of the inner surface of preventer 109 and bear against the outside 138 of case member 106,108.

Figure 25-32 show the cooperation between line/silk 172-178 and guide rail 120,130.As shown in these figures, line/silk 172,174,176 and 178 cooperates with other parts of boss 106a, 106b, 106c and sewing-end 100, to allow selectively to advance and retract guide rail 120,130.Line 178 stops in the curled portion 130b of guide rail 130.To being wrapped in boss 106a(Figure 28) on line 178 apply tension force, thereby propelling track 120 shifts out sewing-end 100.By contrast, at guide rail 130(Figure 30) curled portion 130a in the line 176 that stops apply tension force, make in guide rail 130 retraction sewing-ends 100.Similarly, apply tension force to the line 172 that is wrapped in boss 106c and is connected to guide rail 120 at curled portion 120b place, make propelling track 120 shift out sewing-end, and apply tension force to the line 174 that is wound around boss 106c in the direction contrary with line 172, the junction point at drawing curled portion 120a place, thus make guide rail 120 draw back in shell.

Figure 33-37 show and are configured for the embodiment that sewing needle (300,350,400) is loaded into the pin loader 180 in sewing-end 100.Pin loader 180 has two critical pieces, comprises main part 182 and propulsive units 184.The pin 184a of propulsive units is received in the opening 182a of main part 182.Main part 182 has defined groove 182f, for receiving sewing needle (300,350,400).Main part 182 comprises core 182d and is arranged on retained part 182c, the 182e on sewing-end 100.If needed, retained part 182c, 182e can be suitable for snapping on sewing-end 100.Provide far-end check plate 182b, to contribute to axially aligning of loader 180 and sewing-end 100.Propulsive units 184 rotates in the opening 182a of main part 182, and comprises that pin advances arm 186.In operation, pin is arranged in pin rail 184f, and wherein suture material is connected to tail end, as discussed herein.Subsequently loader 180 is snapped on sewing-end.Preferably, the now tail end of close pin of arm 186.Subsequently, arm 186 rotates, thereby pin (300,350,400) is pushed to needle track 140.If needed, because arm 186 is sized to respectively by groove 124b, the 134b of far-end guide rail 130 and near-end guide rail 120, pin (300,350,400) can return and push in pin loader 180.

Figure 38-40 show the first embodiment of sewing needle 300.Pin 300 comprises the arc main body being defined by front tip 302, tail end 304 and general toroidal surface 305.Pin 300 comprises the opening 312 that is formed on multiple recesses wherein 306,308,310 and is arranged in tail end 304, and it is for receiving one end of length of suture material 312a.Recess 306,308 is positioned in the inner diameter zone 322 of pin, and recess 310 has be positioned at the center curvature axis X by the pin projection of ' define plane P '.Recess 310 comprises the part 310b and the sloping portion 310c that are substantially perpendicular to plane P in ' Part I 310a and be located substantially on plane P '.Recess 306,308 has the plane P of being substantially perpendicular to ' projection.Part I 306a, the 308a of recess 308,306 is arranged essentially parallel to the cross section of pin in described position, and sloping portion 306b, 308b are angle (such as 60 degree) about part 306a, 308a.Recess 308,310 intersects the function to contribute to sewing-end as herein described 100,100 ' particular.

Figure 41-44 show the second embodiment of sewing needle 350.Pin 350 comprises the arc main body being defined by front tip 352, tail end 354 and general toroidal surface 355.Pin 350 comprises the opening 362 that is formed on multiple recesses wherein 356,358,360 and is arranged in tail end 354, and it is for receiving one end of suture material length.Recess 356,358 is positioned in the inner diameter zone 372 of pin, and recess 360 have be positioned at the plane P being defined by the flexural center axis X ' of pin ' projection.Recess 360 comprises the part 360b and the sloping portion 360c that are substantially perpendicular to plane P in ' Part I 360a and be located substantially on plane P '.Recess 356,358 has the plane P of being substantially perpendicular to ' projection.Part I 356a, the 358a of recess 358,356 is arranged essentially parallel to the cross section of pin in described position, and sloping portion 356b, 358b are angle (such as 60 degree) about part 356a, 358a.Recess 358,360 intersects the function to contribute to sewing-end as herein described 100,100 ' particular.Pin 350 also comprises foursquare cross section substantially, and it has annular section 366 and afterbody part 364, it also has annular cross section.In other words, pin main body comprises the part with annular cross section 366, its by the major part with the pin of square cross section substantially with there is the afterbody part 364 of square cross section substantially and separate.It is believed that and use the pin with square cross section to contribute to pin 350 to cross over the gap 110 of sewing-end, and enter again in sewing-end with good Aligning degree compared with pin 300.

Figure 45 shows the 3rd embodiment of sewing needle 400.Pin 400 comprises the arc main body being defined by front tip 402, tail end 404 and general toroidal surface 405.Pin 400 comprises the opening 412 that is formed on multiple recesses wherein 406,408,410 and is arranged in tail end 404, and it is for receiving one end of suture material length.Recess 406,408 is positioned in the inner diameter zone 422 of pin, and recess 410 have be positioned at the plane P being defined by the flexural center axis X ' of pin ' projection.Recess 406,408,410 is substantially similar to about described in pin 300.Main difference between pin 300,400 is the additional recesses 415 that has increased incision pin and approach its tail end 404 places.Recess 415 have be arranged in plane P ' projection, and shape is suitable for receiving the shell 166 of ratchet 160.It is believed that and use the pin with recess 415 to contribute to pin 400 to cross over the gap 110 of sewing-end, and enter again in sewing-end with good Aligning degree compared with pin 300.

Figure 46 shows the 4th embodiment of sewing needle 450.Pin 450 is substantially identical with pin 300, and difference is that it also comprises arcuate ridges rib 475 or convex surfaces along its length.Ridge rib 475 is suitable for and is configured to straddle in groove 124b, the 134b of guide rail 120,130, when crossing over the gap 110 of sewing-end along with pin 450 and to enter again in sewing-end with good Aligning degree (compared with pin 300) by stable pin 450.

Figure 47 (F)-55 shows the each side of the alternative embodiment of sewing-end 100 ' constructed in accordance.Main difference between sewing-end 100 and sewing-end 100 ' is the travel path of driving element 150.

The embodiment 100 of sewing-end comprises driver part 150, and it has defined narrow or notched region 158, for example as shown in Figure 12.In operation, in the time that ratchet 160 is positioned at its far-end in groove 135 movings range of far-end guide rail 130, notched region 158 is positioned to and boss 106W, 108W(Figure 47 (A)-47(D)) conform to.When in described position, driver part 150 extends into nearside guide rail 120(Figure 14) groove 125 in.But, once apply tension force to make ratchet 160(and pin 300) proximad ground is along needle track, the narrow zone 158 of driver part 150 slips over boss 106W, 108W, thereby in the time that proximad ground is mobile, ratchet 160 exceedes the lower carriage of path 10 6T by advancing, until it is through boss 106W and occurring from passage, start another cycle preparing.In other words, boss 106W, 108W form passage betwixt, allow narrow zone 158 to slip over, but the remainder of parts 150 or ratchet 160 can not slip over.Thereby, narrow zone 158 allow driver part 150 when distally advancing along advancing to upper pathway on boss 106W, 108W, and when region 158 with boss to sliding past on time boss 106W, 108W, thereby allow driver part 150 and ratchet 160 along the downward path under boss 106W, 108W and proximad mobile.In Figure 47 (E), housing parts 112 is shown.

Therefore, should be appreciated that, driver part 150 should be metal ideally.Preferably, parts 150 are made (it has been heat-treated to HR900) by the rustless steel hardening, and can have chrome coating, such as can be from

of Illinois, 118Simonds Avenue, DeKalb, IL60115, the Armoloy that (815) 758-6691 business obtains

preferably, parts 150 are 17-7PH rustless steels, and state is " C ", and it is hardened to condition C H900, and is covered with subsequently

coating.Preferably, after 900 heat treatments, apply

coating.The operating sequence of manufacture component 150 comprises provides 17-7PH stripe shape materials in storage, and its known method by any amount (such as spark machined (" EDM "), shearing, edging etc.) is processed into suitable size.Rotating band is heat-treated, and is cleaned subsequently to remove heat treatment surface oxide, and after-applied coating.As another example, the material that 17-7PH state is " A " can be heat-treated to RH950.In other embodiments, for example can be by being called with commodity shape-memory material Deng the Nitinol of selling is made driver part 150.In another embodiment, parts 150 are made up of polymeric material.In one aspect, parts 150 can comprise high-intensity pet material or nylon material.If needed, can use the layered product of plastics and metal material or multiple material.As another example, parts 150 can comprise a bundle line or silk, solid wire or silk, or have any material of permission driving needle around any configuration of needle track.

Other assembly that comprises the sewing-end 100 of pin (300 etc.) is preferably formed by metal injection (" MIM ") technology, as known in the art, adopts various materials, is preferably rustless steel.According to preferred embodiment, preferably use 17-4PH type stainless steel alloy.Preferably disposable apparatus of equipment 1000, and handle component is preferably made up of injection-moulded plastic in required part.

The another embodiment of sewing-end 100 ' has been shown in Figure 47 (F)-55.Main difference between sewing-end 100 ' and sewing-end 100 is compared with the alternate path with embodiment 100, the driver part 150 of sewing-end 100 ' during back and forth along single-pathway.Figure 47 (F) shows the sewing-end 100 ' that comprises pin 300, and its middle guide 120 ', 130 ' is in deployed configuration.Guide rail 120 ', 130 ' only shows part, and not as the embodiment 100 of early discussing, be illustrated in its end and there is the curled portion for mating with expansion or retraction cable.Sewing-end 100 ' has defined the guide rail path 153 ' being positioned between case member 106 ', 112 ' (Figure 48), is similar to sewing-end 100 at case member 106 and 112(Figure 21) between define the mode in guide rail path.Figure 48 also show can by so revise parts 106 ', 112 ' and by driver part 150 ' across alternate path 1001, by remove act as the material 112a ' of ratchet retainer and in parts 106 ' interpolation material 106 ' b to act as new ratchet retainer.Described final result is that driver part 150 enters with different angles.

Figure 49 shows " left side " case member 108 ' from different perspectives, and Figure 50 (A)-50(E) show " right side " case member from different perspectives.From figure clearly, driver part 150 ' and ratchet 160 ' the accompanying path 153 ' of (not shown).Should be appreciated that, driver part 150 ' and ratchet 160 ' can be substantially identical with embodiment 150,160, but without having notched region 158 because for ratchet 160 ' across single-pathway jointly defined by case member 106 ', 108 '.Figure 51 (A)-51(B) in preventer 109 ' has been shown, and show the position of ratchet 115 ', it helps and prevents that pin (for example 300) from moving against required direction of advancing.Only for schematic object, Figure 52 show guide rail 120 ', 130 ' two different positions the spatial relationship about pin face 168a ' and ratchet 160 '.Figure 53 (A)-53(D) show each view of housing parts 112 '.Figure 54-55 show the direction in space of guide rail 120 ', 130 ' (substantially identical with guide rail 120,130) about ratchet 115 ', and showing guide rail retainer 117 ', it contributes to guide rail 120 ', 130 ' in the time of deployed condition not, to stop at precalculated position.

Figure 56-59 show the each side of the zone line 500 of equipment 1000.Zone line 500 comprises elongated preferable alloy pipe 510, and it has near-end and far-end 514.The far-end 514 of pipe 510 is connected to knuckle assembly 520, and knuckle assembly 520 is connected to sewing-end 110 pivotly at pivot 114 places then.Pulley 515 is positioned at pivot 114 using the area supported as the chain connection cable 532,534 engaging, and cable 532,534 is preferably connected to pulley 515 to be provided for realizing the leverage of chain connection mode.Chain connection cable 532,534 can be taked any suitable form, and most preferred diameters is .020 " multiply 300 series stainless steel cables.By chain connection cable of drawing, sewing-end 100 will be about zone line 500 and around pivotal point 114 chain connections.Knuckle 520 comprises the form of being taked bracket 524a, 524b by the separated near-end 522 of zone line 526 and far-end 524(, for receiving sewing-end 100).Zone line 526 has defined by vertical passage 528 wherein, for receiving driver part 150.Preferably, parts 150 are at described joint area to pull bar 151, and the cross-sectional profile of passage 528 is suitable for holding this geometry, as shown in FIG..Also define opening 523 for reception part 532,534.And, also provide opening 525,527 to allow by drawn wire/cable 172,174,176,178 for controlling the movement of guide rail 120,130.The near-end of tubular part 510 is connected to hinge jointing type rotating mechanism, and described rotating mechanism rotates the pipe 510 of sewing-end 100 about the handle 600 of equipment, as discussed below.Pipe 510 far-end 514a can extend slightly, with along with driving element 150 is controlled driving element 150 more closely by zone line 500.

For schematic and non-limiting object, Figure 60-122 show the handle 600 of equipment 1000.Handle 600 comprises for operating sewing-end 100,100 ' many parts and system.Figure 61 shows the front view of handle, has wherein removed pipe 510, shows hinge jointing type rotary handle 620, and wherein handle 620 will make sewing-end 100, the 100 ' rotation about handle 600 with respect to the relative rotary motion of handle 600.Figure 60 shows the rearview of handle 600.Figure 62 shows the handle that has removed rotary handle 620, and shows near-end cable guide rail 606, left side pipeloop 634 and right side pipeloop 642.632,634 cooperations of pipeloop part are with the near-end 512 of capture duct 510, and this near-end can for example but not be limited to the rustless steel hypotube (hypotube) of 5mm nominal outside diameter.What illustrate equally is chain connection handle 630, and it can be for making sewing-end 100 around its pivotal point chain connection, as discussed above.Shell 600 comprises two main shell half portions, comprises right side 612 and left side 614.Figure 63 shows the handle 600 that has removed pipeloop 632,634.Nearside cable guide rail 606 is such as passing through interference fit rivet clasp in hypotube.The distal basin 606b of nearside cable guide rail 606 and cable dish 648(Figure 71-72) between represent warped regions along pipe 510 fore-and-aft distance, in the time that sewing-end hinge jointing type rotates, all by path can be about rotation and distortion each other through pipe 510 cable, or rotate about handle 600.Warped regions preferably between the length of three to six inches, most preferably from about four inches long.In preferred embodiments, the mobile total angle scope of sewing-end is about 270 degree about handle 600, is about 135 degree ideally on any direction in home position shown in the figure.The brake (Figure 64) of hinge jointing type rotary handle 620 is suitable for and is configured to engage (Figure 79 (A)) with the ratchet 614g being contained in the opening of left side handle part 614.

Pipeloop (Figure 66-67) is mirror image (the median vertical line face of striding equipment 1000) substantially each other, and cooperation is to define hollow, inside cylindraceous roughly, for receiving the proximal end 512 of pipe 510.Particularly, provide hangers 632a, 634a to mate (Figure 69) with near the opening 518 with the proximal end 512 of pipe 510.Pipeloop has also defined retainer 632b, 634b radially along its proximal side, to mate (Figure 68) with the raised area 644b on the distal face of Roticulator plate 644.Roticulator plate 644 also comprises the portions of proximal 644c with square cross section, for being received by left side and right side shell side part 612,614.

Roticulator plate 644 as cable dish 648 at adjacent rib 614r(Figure 70) between be received in shell 614.Cable dish 648(Figure 71-72) define the circumferential groove 648b for mating with rib 614r around its periphery, and cable dish 648 has defined the circular passage 648a for receiving hinge jointing type rotating spring 646 in its distal face.Spring 646 is suitable for and is configured to order about roticulator plate contacting retainer 632b, 634b, in rotary moving step by step to contribute to, cable dish 648 has also defined by multiple opening 648c wherein, to allow cable/line 172,174,176,178,532,534 and 551 to pass through.

As shown in Figure 73-74, cable path guide rail 650 is provided, pass through handle 600 for guide wire cable 172,174,176,178,532,534.Particularly, guide rail 650 provide for first group of guide rail 654 of guide wire cable 172,174,176,178 and for guide wire cable 532,534 by second group of guide rail or the boss 652,654 of handle 600.In guide rail 650, provide groove 658 for receiving rib 612r(Figure 79 (D) of right side housing parts 612).

Figure 75-76 show the Partial Resection view of handle 600, have wherein removed right side housing parts 612, to allow to observe the internal part of handle 600.Figure 75 shows trigger 700 or the trigger in latched position, but Figure 76 shows in the trigger 700 of off-position, wherein can depression of trigger, thereby advance pin (for example 300) around needle track 140.As shown in Figure 75-76, handle comprises trigger 700, drawing cable/with 710, trigger spring jacket 720, trigger reset spring 730, drawing cable 727, pulley 750 and the brake handle 800 for preventing that chain connection knob 810 from rotating.In the time that trigger 700 locks, in left side shell 614, define stop surfaces 614s, to define the abut for trigger 700.Right side shell 612 comprises similar stop component 612s(Figure 79 (D)).Chain connection knob 810(Figure 77 (E)) comprise handle portion 812, slender axles 814(Figure 83 for engaging with braking rotation accessory 830) and preferably there is screw thread to receive distal portions 816(Figure 90 of hex nut 886).Right side and left side handle cap portion 616,618(Figure 77 (A)-77(D)) boss 616a, 618a be equipped with, for receiving and support edge 835b(Figure 84 of tripping spring 835).The supporting part 835a of tripping spring 835 bears against braking rotation accessory 830, and braking rotation accessory 830 orders about the axle 814 of braking rotation accessory 830 against knob 810 then.The part 814 of knob 810 preferably includes elastic layer or coating, it can grasp the serrated portion 834 of accessory 830, wherein the rotation of knob 810 causes accessory 830, and thereby cause cable 532,534 to advance along the direction in nearside-distally about equipment 1000, thereby cause sewing-end 100,100 ' chain connection.Figure 78 shows the handle 600 that has removed parts 810,616,618.Figure 79 (A)-79(D) show the interior external view of left side handle part 612 and right side handle portion 614.Figure 80-81 show the internal work region of handle 600, have wherein removed two handle portions 612,614, and trigger 700 locks respectively and discharges.Figure 82 shows the close-up illustration in the internal work region of handle 600, shows and removes top brake lining 820, manifest the location of accessory 830 and spring 835 completely, and trigger 700 discharges.Also show knuckle pulley 842, it is supported by knuckle pulley holder 840, and the described knuckle pulley holder against support 870 by guide rail spring 845 then, to keep the tension force on cable 532,534.Figure 83-85 also show accessory 830, spring 835 and spring 845.

Figure 86 (A)-86(B) show shuttle 888(Figure 99 (A)-99(B)), its proximad after discharging trigger 700 moves.The proximad of shuttle 888 moves and prevents that handle 892r is by chain connection, and this has prevented from advancing when starting trigger 700 pin (for example 300) around annular needle track 140, guide rail 120,130 is retracted in sewing-end 100,100 ' 140 ' time then.Parts 830,835 in Figure 86, are removed so that bottom brake lining 850 to be shown better.Brake lining 820,850 is preferably made up of elasticity and slightly compressible material, such as silicones.Figure 87 (A) also shows bottom brake lining 850, and Figure 87 (B)-87(D) show brake holder 860.Support 860 has defined annular boss 862 thereon, for receiving bottom brake lining 850 and brake handle parts 882,884,884a(Figure 91 (B)).Figure 88-89(A) show all the other internal work regions of handle, remove brake lining (Figure 88), but also removed pulley holder 840 and brake holder 860.Figure 89 (A)-89(B) also show and connect knuckle 872, it comprises the longitudinal opening 872a with narrow 872c, narrow 872c enough wide with allow cable 532,534 by, but wide not to allow cable terminal 874 to pass through (Figure 91).By contrast, opening 872b enough, greatly to allow terminal 874 by entering knuckle 872, thereby is connected to cable 534 by cable 532, and closed-loop path is provided, to contribute to the chain connection by means of chain connection and brake control 800.Can drawing brake trigger 884, top part by moving handle parts 882 (and corresponding component) on equipment left side causes cam effect to contacting bottom brake lining 850, makes brake lining 850 compress the parts 830 between upper and lower brake lining 820,850.

Figure 92-102 show the each side for the locking mechanism of the operation of guide rail 120,130 and control and trigger 700.By rotary handle 892, make guide rail 120,130 launch or return.Cable 172-178 connects up on guide rail 885, it is fixing in place by case member 612,614, and be divided into two pairs of lines, wherein one group of line is guided downward around spring-loaded pulley 894a, 896a, and be routed to handle 192, wherein all four cables 172,174,176,178 are held in place in the opening 892b in handle 892 by tapered dowel 893 always.Another directly enters handle 892 around guide rail 887 by path to cable.Guide rail 885(Figure 93 (B)) be the flat components with the basic bending of multiple cable guide rail 885a, wherein cable 172-178 they to the routing path upper support of handle 892 on the upper surface of the flat components of described basic bending.Figure 93 (A) shows guide rail 887 and 885 in position with respect to the relation of other internal part of handle 600.Guide rail 887(Figure 93 (C)-93(D)) comprise by the boss 887a being received by housing parts 612,614 and by the groove 887b that is used to cable/line to provide the fin 887c in path to define.Handle 892 comprises grip part 892a and groove 802c and enters passage 892d(Figure 94 (A)-94(E of opening 892b for guide wire cable/line)).The form of two handles 892 can be substantially the same.

Guide rail handle 892 also acts on and discharges trigger lock 780, allows thus trigger 700 to start the movement (for example 300) of pin.As Figure 95 (A)-95(B) as shown in, trigger lock 780 is connected to cable at lasso 781 places, described lasso 781 is arranged on trigger lock (Figure 95 (C)-95(D)) the opening 783 at bifurcated 782 places in.Trigger lock 780 is slidably disposed on cylinder track 786, and by spring 787 bias voltages towards latched position.The bifurcated 784 at the opposite end place of trigger lock 780 is suitable for and is configured to interlocking with trigger 700.In the time of cable (Figure 95 (B)) that the lasso 781 of boosting by rotary handle 892L connects, the bifurcated 784 of trigger lock 780 departs from trigger 700, thereby allows trigger to move freely.Handle 892L, 892R are arranged on (Figure 96,122) in axle 891 pivotly.Figure 97-101 also show the supplementary features of the actuating system of guide rail 120,130, have removed step by step optional feature, so that other parts and relative position thereof to be shown better.Figure 102 also shows additional aspect and the view of parts 840,894,896.

Figure 103-113 show the each side of the operation of reciprocal trigger mechanism 700.Figure 103 shows the relative position of trigger 700, drawing cable/with 710, trigger spring housing 720, trigger reset spring 730, drawing cable 727 and pulley 750.Figure 103 has removed parts 786,787 and handle 700 so that lasso 752 to be shown, described lasso 752 is fixed to the terminal of drawing cable 727 and is arranged in the opening 701 (Figure 105) of handle 700.At Figure 106 (A)-106(B) in, show trigger 700 from two additional angle, show point fork bracket 702 that approaches trigger 700 tops.By using interference fit and/or ultra-sonic welded, the mode such as bonding that bolt 704a is fixed in the 700a of hole, and bay cover 704 is received in trigger handle 700.Bracket 702 and bay cover 704 have defined opening 702a, 704a therein, for receiving boss 888a(Figure 99 (B) of shuttle link 888).Figure 107 (A) shows the inside of jacket 720, has shown clutch spring 724.Figure 107 (B)-107(C) show housing parts 720a, it mates with housing parts 720b.Housing parts 720b is the identical mirror image of part 720a, so only show 720a.In Figure 108, remove clutch spring 724, clearly show that drawing cable 727, clutch spring lasso 723 and clutch washer 726.Assembly shown in Figure 109, has removed spring 730 and housing parts 720b.Figure 110 shows driver part 710 and is connected to the feature of assembly 720, shows the inserted sheet 711,712 of driver part 710 proximal ends bending and be inserted through the mode of the groove 721a in washer plate 721.In Figure 104 and 109, illustrate it can is the O shape ring 720 of silicones or other suitable material.O shape ring 729 provides against the sealing member of shell segments 612,614.Lasso 723 is fixed to cable 727.Figure 111-113 provide respectively the more close view of lasso 723, washer plate 721 and parts 710 near-ends.

Figure 114-120 also show the connection between driver part 710 and driver part 150/151.As shown in Figure 114, nearside driver part can comprise the band element 150 that is connected to middle cable 551 parts at zone line 500 as above, described nearside driver part is received by lasso 910, described lasso 910 is in position after terminal 930 is connected, and cable/bar 551 is positioned in the chamber 922 in connector 920 by the groove 924 in connector 920.The fillet part 932 of terminal is towards far-end, thus the movement of permission between parts 551 and connector 920.As shown in Figure 115-117, terminal 930 has defined by wherein therein for receiving the passage 936 of cable 551, and has defined roughly proximal part 934 cylindraceous.Lasso 910 has defined by wherein for receiving the passage 912 of cable 551 and by opening 914 wherein, and described opening 914 is such as for receiving brazing or soldering material or for lasso being held in place in to other material on cable 551.Connector 920 comprises proximal end face 922a, distal face 928 and passes through hole 922 wherein.As shown in Figure 114 and Figure 118-120 are collaborative, male fitting 940 is received in the screw thread openings 922 of connector, and on described male fitting 940, receives and keep hex nut 950.The near-end 943 of accessory 940 is towards nearside, and in described accessory 940, defined distal tip 717 chamber 946 used of receiving rotating band/cable 710.Insert in chamber 946 tip 717, until retainer 719 contacts distal face 943.On accessory 940 and nut 950, define screw thread 942,952.Parts 940,710 can connect by the mode of any appropriate, include but not limited to interference fit and/or welding, soldering, brazing, binding agent etc.Figure 121-122 show torsion spring 960 and guide rail spring 970 and they location about other parts in handle 600.Spring the 960, the 970th, a part for controlling organization, for launching and retraction guide rail 120,130.Back-moving spring 895,897 has been shown in Figure 121 (C).

The illustrative methods that sewing-end 100 operates has been shown in Figure 123-131.Figure 123 shows the excision view of the sewing-end 100 in delivery configuration, and wherein pin 300 is arranged in sewing-end, and guide rail 120,130 is retracted.Pin 300 is completely contained in equipment 1000, and ratchet spring 115b prevents that pin 300 from moving in the counterclockwise direction.Similarly, the inner circumferential surface 322 of ratchet spring 115a against pin, contributes to prevent that pin from rotating in the clockwise direction.As shown in Figure 123-131, it is evident that by the disclosure, the drive system of equipment 1000 is suitable for and is configured to, with when needle track is during in deployed condition, advancing pin 300 to carry out multiple 360 ° of rotations around needle track.Also clearly, needle track is approximately 180 ° of scopes before launching, and angular range is greater than 180 ° after launching.

Figure 124 shows the initial deployment situation of guide rail.Along the dilatory ratchet 115a in surface 322 of pin 300, until ratchet 115a engages with recess 308, and ratchet 115b engages with recess 306.Subsequently, in Figure 125, guide rail is retracted completely, and is arranged in the dilatory in the clockwise direction pin 300 of ratchet 115a of guide rail 120, so that pin 300 is rendered as the state for sewing up.Meanwhile, ratchet 160 is advanced into its distal-most end along its arc track on guide rail 120,130, the recess 158 in driver part 150 is aimed at boss 108a, and ratchet 115b bears against the surface 122 of pin 300.In the time of the driver part 150 of proximad drawing subsequently, the notched region 158 of driver part 150 slides past boss 106a, 108a, and driver part 150 falls into the local lower passage being defined by path 10 8T.The further proximad of driver part 150 moves the downside that makes to bear against with the wider portion of 150 far-ends boss 106a, 108a, and the tail end of ratchet 160 contact pins 300, and pin is pushed into approximately 180 °, as shown in Figure 126.Subsequently, repeat moving to far-end of ratchet 160, thus the recess 310 in ratchet 160 joint pins 300.Region 158 as front boss 106a, the 108a of usually slipping over, and along the front tip 302 of arc needle track 140 drawing ratchets 160 and pin, can make pin return to its starting point, as shown in Figure 128.Figure 129 shows the local retraction of guide rail 120,130, thereby pin moves widdershins, until recess 306 engages with ratchet 115b.Figure 130 shows guide rail 120,130 and further retracts, show and how ratchet 115a is pulled out from recess 308, and the surface 322 along pin is dilatory, prevent the further mobile counterclockwise of pin 300 by the ratchet 115b being locked in recess 306.Figure 131 shows again in sending or remove the sewing-end 110 in structure, and its middle guide 120,130 is retracted completely.Thereby, a kind of equipment is provided herein, it can rotate disclosed pin by 180 °, 360 ° or any other multiple of 180 ° as required.If needed, the angle step of propelling can be the increment that is greater than or less than 180 ° of setting as required.

The robotic suturing device of embodiment of the present invention be can use and for laparoscopic surgery, peritoneoscope colostomy, colectomy, adrenalectomy, splenectomy, the reparation of side esophageal hernia, inguinal hernia reparation, abdominal hernia reparation, Unisem fundoplication, hepalobectomy, gastrectomy, resection of small intestine, the little intestinal obstruction for the treatment of, far-end pancreatectomy, the nephrectomy and gastric bypass included but not limited to.One of skill in the art will appreciate that embodiment of the present invention can be for other laparoscopic surgery.

In the time using the equipment of embodiment of the present invention, use gas to be blown into abdominal cavity to form user's work space.Arbitrary gas as known in the art be can use, nitrogen or carbon dioxide included but not limited to.Form and enter entrance at each position use trocar, to adapt to particular procedure process.Subsequently, various operating theater instruments can be entered to human body by these nearly entrance/sleeve pipes.Subsequently, user is in the distal portions lead-in bushing of robotic suturing device, then connecting sewing syncephalon assembly (for example 100,100 ') actively.Sewing-end is with respect to the tissue/blood vessel being stitched together is located subsequently, and user preferably locks sewing-end assembly in place.Subsequently, user is positioned at multiple tissue parts that separate in the opening of distal portion office that is defined in sewing-end assembly by operation robotic suturing device.User only uses the one hand can operating equipment, the sewn closed otch of starting handle to continue simultaneously, and its stitch can accurately and equably further respectively along the length of sewing up, and is similar in a usual manner and manual suture.User can adopt the single suture or the many sutures that extend whole incision length.Thereby, the tissue part and the starting handle that cut by device spanning is set, robotic suturing device allows user that continuous stitch or the stitch of interruption are set, and with timeliness mode closing tissue otch.One of skill in the art will appreciate that and described equipment can be used in to any conventional process for carrying out laparoscopic surgery.

The small-scale structure design of sewing-end assembly allows user clearly, not to be obstructed and to observe sewing needle during advancing past tissue part during sew application at sewing needle, allow thus accurately to arrange robotic suturing device so that uniform stitching to be provided, and got rid of the risk of too tearing tissue near notching edge owing to arranging.Subsequently, along otch, robotic suturing device is advanced to short distance, and repeat aforementioned operation to form another stitch that comprises suture material or line.

User can continue to operate robotic suturing device, alternately advances and starts pin around the rotation of axle that is arranged essentially parallel to direction of propulsion, can extend through the lasting stitching of the whole length of otch or the stitch of a series of interruptions to form.After each independent stitch is set, strain stitch by implement pulling force on suture material or line, thereby along cut tissue part length and equably tension form stitching.Thereby, complete the tight closure to various piece, and minimized hemorrhage and torn tissue.Once be provided with suture material or the line 246 of appropriate amount, user can use pin holder with the stitch of tension formation and to its knotting.

All patents, patent application and the disclosed list of references of quoting is herein incorporated to by reference in full at this.Should be appreciated that, above-disclosed various and further feature and function, or alternative, can be combined into many other different systems or application as required.Those skilled in the art can one after the other carry out various current imprevisions or not expected alternative, modification, variation or improvement, and these also should be thought and comprise in the present invention.

Claims (5)

1. a sewing needle, it has the arc main body with front tip and tail end, wherein said arc main body defines the first recess and second recess with projection along the inner diameter zone of pin, described projection is positioned at the plane being defined by the center curvature axis of described pin, and wherein said the first recess and the second recess intersect.

2. sewing needle according to claim 1, wherein said pin also comprises roughly foursquare cross section.

3. sewing needle according to claim 2, wherein said pin main body comprises the part with circular cross section, described in there is circular cross section part by the major part with square cross section roughly of described pin with there is the roughly afterbody part of square cross section and separate.

4. sewing needle according to claim 1, wherein said pin is also defined near the 3rd recess in the described pin at its tail end place, to receive a part that drives ratchet.

5. sewing needle according to claim 1, it also defines the arcuate ridges rib along its length.

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