BRPI0903067B1 - unidade de carga descartável para aparelho de grampeamento cirúrgico e aparelho de grampeamento cirúrgico - Google Patents
unidade de carga descartável para aparelho de grampeamento cirúrgico e aparelho de grampeamento cirúrgico Download PDFInfo
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Abstract
a presente invenção refere-se a unidade de carga descartável para fixação operável em um aparelho de grampeamento cirúrgico. a unidade de carga descartável pode ter um transportador que suporta um cartucho de grampos e um conjunto de bigorna que é acoplada de modo móvel no transportador. as várias modalidades podem ainda ter um conjunto de acionamento axial que é configurada para conferir um movimento de fechamento no conjunto de bigorna e também suporta uma lâmina de corte na mesma, o conjunto de acionamento axial é configurado para receber movimentos de disparo e movimentos de retração do aparelho de grampeamento cirúrgico. várias modalidades têm um conjunto de liberação de bigorna que permite que o conjunto de bigorna seja liberado de uma operação de sujeição na eventualidade de que a lâmina de corte se torne emperrada durante a operação.
Description
CAMPO DA INVENÇÃO
A presente invenção refere-se em geral a instrumentos cirúrgicos endoscópicos incluindo, mas não limitado a, aparelhos de grampeamento cirúrgicos que têm unidades de carga descartáveis que são capazes de aplicar linhas de grampos no tecido enquanto cortam o tecido entre aquelas linhas de grampo e, mais particularmente, a aperfeiçoamentos relacionados a tais unidades de carga descartáveis.
ANTECEDENTES
Instrumentos cirúrgicos endoscópicos são frequentemente preferidos sobre dispositivos cirúrgicos abertos desde que uma incisão menor tende a reduzir o tempo de recuperação pós-operatório e complicações. Consequentemente, desenvolvimento significante tem se dedicado a uma faixa de instrumentos cirúrgicos endoscópicos que são adequados para colocação precisa de um efetuador de extremidade distal em um local cirúrgico desejado através de uma cânula de um trocarte. Estes efetuadores de extremidade distal engatam o tecido em um número de maneiras para obter um efeito diagnóstico ou terapêutico (por exemplo, endocortador, garra, cortador, grampeadores, aplicador de grampo, dispositivo de acesso, dispositivo de distribuição de terapia de fármaco/gene, e dispositivo de energia usando ultrassom, RF, laser, etc.).
Grampeadores cirúrgicos conhecidos incluem um efetuador terminal que simultaneamente faz uma incisão longitudinal no tecido e aplica linhas de grampos em lados opostos da incisão. O efetuador terminal inclui um par de elementos de garra cooperando que, se o instrumento é pretendido para aplicações endoscópicas ou laparoscópicas, são capazes de passar através de uma passagem de cânula. Um dos elementos de garra suporta um cartucho de grampos que tem pelo menos duas fileiras de grampos lateralmente espaçadas. O outro elemento de garra define uma bigorna tendo bolsos formando grampos alinhados com as fileiras de grampos no cartucho.
Petição 870190032949, de 05/04/2019, pág. 7/16
O instrumento inclui comumente uma pluralidade de cunhas alternadas que, quando acionadas distalmente, passam através das aberturas no cartucho de grampos e engatam acionadores suportando os grampos para efetuar o disparo dos grampos na direção da bigorna.
- 5 Tipos diferentes de grampeadores cirúrgicos para aplicações endoscópicas são conhecidos. Por exemplo, um tipo de instrumento de grampeamento cirúrgico é configurado para operar com unidades de carga descartáveis (DLUs) que são construídas para suportar um cartucho de grampos e conjunto de faca nas mesmas. Uma vez que o procedimento está 10 completo, a DLU inteira é descartada. Tais instrumentos que são designados para acomodar o conteúdo da DLU para oferecer a vantagem de uma lâmina de faca nova para cada disparo do instrumento. Exemplos de tais aparelhos de grampeamento cirúrgicos e DLUs são descritos na Patente U.S. N°. 5.865.361 para Milliman e outros, a descrição da qual é incorporada aqui em 15 sua totalidade.
Aparelhos de grampeamento cirúrgicos anteriores, tais como aqueles descritos na Patente U.S. N°. 5.865.361, sofrem da incapacidade de ser disparados em tecidos mais espessos (por exemplo, tecidos com espessuras maiores que 3,5 mm) devido às cargas aumentadas aplicadas em 20 seus sistemas de disparo. Tais cargas aumentadas, por exemplo, podem aumentar a probabilidade de que o sistema de disparo falhe quando a lâmina está ainda na bigorna e pode portanto exigir que o conjunto de ferramenta do mesmo seja cortado do tecido o que pode levar a sérias consequências de ferimento para o paciente.
Assim, existe uma necessidade de uma unidade de carga descartável que pode ser facilmente aberta na eventualidade da lâmina se tornar emperrada na medida em que é acionada através do tecido que está preso na unidade.
SUMÁRIO
Em um aspecto geral de várias modalidades da presente invenção é fornecida uma unidade de carga descartável para fixação em um aparelho de grampeamento cirúrgico. A unidade de carga descartável pode compreender um cartucho de grampos que é suportado em um transportador que é acoplável de modo operável no aparelho de grampeamento cirúrgico. Um conjunto de bigorna pode ser acoplado de modo móvel no transportador para deslocamento móvel seletivo entre as posições aberta e fe5 chada com relação ao cartucho de grampos. A unidade de carga descartável pode ainda compreender um conjunto de acionamento axial que tem uma parte de extremidade distal que é construída para mover em uma direção distal através de uma fenda no cartucho de grampos em resposta a um movimento de acionamento conferido ao conjunto de acionamento axial a partir 10 do aparelho de grampeamento cirúrgico e também mover em uma direção proximal através da fenda no cartucho de grampos em resposta a um movimento de retração aplicado ao conjunto de acionamento axial do aparelho de grampeamento cirúrgico. A parte de extremidade distal do conjunto de acionamento axial pode ser configurada para conferir uma força de fechamento 15 no conjunto de bigorna na medida em que o conjunto de acionamento axial é acionada na direção distal na fenda no cartucho de grampos. A unidade de carga descartável pode ainda incluir um conjunto de liberação de bigorna que coopera de modo operável com a parte de extremidade distal do conjunto de acionamento axial e o conjunto de bigorna para fazer seletivamente a 20 parte de extremidade distal do conjunto de acionamento axial descontinuar, conferindo a força de fechamento no conjunto de bigorna independente de onde a parte de extremidade distal do conjunto de acionamento axial está localizada dentro da fenda no cartucho de grampos.
Em ainda outro aspecto geral das várias modalidades da presen25 te invenção, é fornecida uma unidade de carga descartável para fixação em um aparelho de grampeamento cirúrgico. Em várias modalidades, a unidade de carga descartável inclui um cartucho de grampos que é suportado em um transportador que é acoplável de modo operável no aparelho de grampeamento cirúrgico. Uma parte de bigorna é pivotantemente acoplada ao trans30 portador para deslocamento pivotável seletivo entre as posições aberta e fechada com relação ao cartucho de grampos. A parte de bigorna tem uma fenda de bigorna axial através da mesma. Uma cobertura de bigorna pode ser fixada na parte de bigorna para definir uma cavidade de bigorna entre as mesmas. A unidade de carga descartável pode ainda incluir um conjunto de acionamento axial que tem uma parte de extremidade distai que é construída para mover em uma direção distai através de uma fenda de cartucho no car5 tucho de grampos bem como a fenda de bigorna em resposta a um movimento de acionamento conferido ao conjunto de acionamento axial do aparelho de grampeamento cirúrgico e também mover em uma direção proximal através da fenda de cartucho e a fenda de bigorna em resposta a um movimento de retração aplicado ao conjunto de acionamento axial a partir do a10 parelho de grampeamento cirúrgico. Um pino de bigorna transverso pode ser suportado de modo destacável em uma parte de flange de retenção do conjunto de acionamento axial tal que o pino de bigorna é recebido de modo móvel na cavidade de bigorna e atravessa a fenda de bigorna. Um elemento de desengate pode ser fornecido no pino de bigorna transverso e é orientado 15 para engatar pelo menos uma parte de pelo menos uma da cobertura de bigorna e da parte de bigorna quando um movimento de retração é aplicado ao conjunto de acionamento axial independente de onde a parte de extremidade distai do conjunto de acionamento axial está localizada dentro da fenda do cartucho para desse modo fazer o pino de bigorna ser desacoplado do 20 conjunto de acionamento axial.
Em outro aspecto geral das várias modalidades da presente invenção é fornecido um aparelho de grampeamento cirúrgico. Em várias modalidades, o aparelho de grampeamento cirúrgico compreende um conjunto de manipulo que tem um corpo alongado acoplado de modo operável na 25 mesma. Uma unidade de carga descartável é operavelmente acoplada ao corpo alongado. Várias modalidades da unidade de carga descartável podem compreender um transportador que é operavelmente acoplável a uma extremidade distai do corpo alongado. Várias modalidades da unidade de carga descartável podem compreender um transportador que é operavel30 mente acoplável a uma extremidade distai do corpo alongado. Um cartucho de grampos pode ser suportado no transportador. Um conjunto de bigorna pode ser acoplada de modo móvel no transportador para deslocamento mó vel seletivo entre as posições aberta e fechada com relação ao cartucho de grampos. A unidade de carga descartável pode ainda compreender um conjunto de acionamento axial que tem uma parte de extremidade distal que é construída para mover em uma direção distal através de uma fenda no cartucho de grampos em resposta a um movimento de acionamento conferido no conjunto de acionamento axial do conjunto de manipulo e também mover em uma direção proximal através da fenda no cartucho de grampos em resposta a um movimento de retração aplicado no conjunto de acionamento axial a partir do conjunto de manipulo. A parte de extremidade distal do conjunto de acionamento axial pode ser configurada para conferir uma força de fechamento no conjunto de bigorna quando o conjunto de acionamento axial é acionado na direção distal na fenda no cartucho de grampos. Um par de barras de suporte pode ser suportado de modo móvel dentro de uma fenda axial no conjunto de bigorna. As barras de suporte podem ser espaçadas uma da outra para permitir que a parte de extremidade distal do conjunto de acionamento axial passe de modo móvel entre as mesmas. As barras de suporte podem ser seletivamente móveis entre a primeira posição em que as barras de suporte suportam um pino de bigorna fixado na parte de extremidade distal do conjunto de acionamento axial e posições retraídas em que o pino de bigorna não é suportado pelas barras de suporte e é permitido desengatar o conjunto de bigorna. Uma articulação de conexão pode ser acoplada nas barras de suporte e uma articulação de retração pode ser suportada de modo operável no corpo alongado e configurada para engatar de modo operável na articulação de conexão. Um botão atuador pode ser suportado de modo operável no corpo alongado tal que pode interagir com a articulação de retração para permitir que movimentos de retração sejam aplicados na articulação de retração e articulação de conexão na atuação do botão atuador.
BREVE DESCRIÇÃO DAS FIGURAS
Os desenhos anexos, que são incorporados e constituem uma parte deste relatório, ilustram modalidades da invenção, e, junto com a descrição geral das várias modalidades da invenção dada acima, e a descrição detalhada das modalidades fornecida abaixo, servem para explicar vários princípios da presente invenção.
A figura 1 é uma vista de conjunto explodida de uma unidade de carga descartável não-articulável.
A figura 2 é uma vista de conjunto explodida de uma unidade de 1 carga descartável articulável.
A figura 3 é uma vista de conjunto explodida parcial da junta de articulação de uma unidade de carga descartável articulada anterior da figura 2.
A figura 4 é uma vista em perspectiva de uma modalidade de unidade de carga não-articulável da presente invenção acoplada a um aparelho de grampeamento cirúrgico.
A figura 5 é uma vista em perspectiva de uma modalidade de unidade de carga descartável articulável da presente invenção acoplada a 15 um aparelho de grampeamento cirúrgico.
A figura 6 é uma vista lateral aumentada de uma parte de um conjunto de acionamento axial, pino de bigorna e presilha de pino de várias modalidades da presente invenção.
A figura 7 é uma vista em perspectiva de uma modalidade de 20 presilha de pino da presente invenção.
A figura 8 é uma vista em elevação em seção transversal parcial de uma modalidade de unidade de carga descartável da presente invenção, em que várias posições do conjunto de acionamento axial são ilustradas em linhas tracejadas.
A figura 9 é uma vista plana de uma parte da modalidade de unidade de carga descartável da figura 8 com uma parte da cobertura de bigorna removida por clareza.
A figura 10 é uma vista em seção transversal do conjunto de bigorna representado na figura 9, tomada ao longo da linha 10-10 na figura 9.
A figura 11 é uma vista lateral parcial de uma parte de uma modalidade de unidade de carga descartável da presente invenção prendendo o tecido entre o conjunto de bigorna e o cartucho de grampos.
A figura 12 é uma vista lateral parcial de uma parte de uma modalidade de conjunto de acionamento axial da presente invenção.
A figura 13 é uma vista lateral parcial de uma parte de outra modalidade de conjunto de acionamento axial da presente invenção.
A figura 14 é uma vista lateral parcial de uma parte de outra modalidade de conjunto de acionamento axial da presente invenção.
A figura 15 é uma vista lateral parcial de uma parte de outra modalidade de conjunto de acionamento axial da presente invenção.
A figura 16 é uma vista lateral parcial de uma parte de outra mo10 dalidade de conjunto de acionamento axial da presente invenção.
A figura 17 é uma vista lateral parcial de uma parte de outra modalidade de conjunto de acionamento axial da presente invenção.
A figura 18 é uma vista em seção transversal do conjunto de acionamento axial da figura 17 tomada ao longo da linha 18-18 na figura 17 15 com o pino de bigorna mostrado antes da fixação no conjunto de acionamento axial.
A figura 19 é uma vista em perspectiva de outra modalidade de unidade de carga descartável da presente invenção.
A figura 20 é uma vista em perspectiva de uma parte da unidade 20 de carga descartável da figura 19 com alguns componentes removidos por clareza.
A figura 21 é uma vista em seção transversal da unidade de carga descartável representada na figura 20 tomada ao longo da linha 21-21 na figura 20.
A figura 22 é uma vista em perspectiva parcial da unidade de carga descartável das figuras 19-21 com partes de um aparelho de grampeamento cirúrgico no qual é fixada, mostrada em linhas tracejadas.
A figura 23 é uma vista em perspectiva de uma modalidade de unidade de carga descartável da presente invenção em que o conjunto de 30 acionamento axial é parcialmente através de seu percurso de disparo.
A figura 24 é outra vista em perspectiva da parte da unidade de carga descartável representada na figura 23 com o conjunto de acionamento axial na extremidade de seu percurso de disparo.
A figura 25 é outra vista em perspectiva da parte de unidade de carga descartável representada nas figuras 23 e 24 depois que o conjunto de retentor foi desengatado do conjunto de acionamento axial.
A figura 26 é uma vista em perspectiva parcial de uma parte de • outra unidade de carga descartável da presente invenção com alguns componentes removidos por clareza.
A figura 27 é uma vista de conjunto explodida da parte de unidade de carga descartável representada na figura 26.
A figura 28 é uma vista em seção transversal de uma parte do conjunto de acionamento axial representado na figura 27.
A figura 29 é uma vista em elevação lateral da unidade de carga descartável das figuras 26-28 com alguns componentes da mesma removidos por clareza.
A figura 30 é uma vista lateral da unidade de carga descartável da figura 29, em que o tecido foi preso entre o conjunto de bigorna do mesmo e o cartucho de grampos.
A figura 31 é outra vista lateral da unidade de carga descartável das figuras 29 e 30 em que o conjunto de acionamento axial foi retraído para 20 começar a liberar o pino de bigorna da alavanca de bigorna.
A figura 32 é outra vista lateral da unidade de carga descartável das figuras 29-31, em que o pino de bigorna foi completamente desengatado da alavanca de bigorna.
DESCRIÇÃO DETALHADA
Voltando aos desenhos, em que numerais iguais indicam componentes iguais por todas as várias vistas, a figura 1 representa uma unidade de carga descartável não-articulável 16 que pode ser usada em conexão com um aparelho de grampeamento cirúrgico tal como descrito em Patente U.S. N°. 5.865.361, a descrição da qual foi incorporada aqui por referência.
Será apreciado que os termos proximal e distal são usados aqui com referência a um médico agarrando um conjunto de manipulo 12 do aparelho de grampeamento cirúrgico Assim, a unidade de carga descartável 16 é distal com respeito ao conjunto de manipulo mais proximal. Será ainda apreciado que, por conveniência e clareza, os termos espaciais tais como vertical, horizontal, para cima, para baixo, direita, e esquerda são usados aqui com respeito aos desenhos. No entanto, instrumentos cirúrgicos são usados em muitas orientações e posições, e estes termos não pretendem ser limitantes ou absolutos.
Como pode ser visto na figura 1, a unidade de carga descartável não-articulável 16 pode em geral compreender um conjunto de ferramenta 17 para realizar procedimentos cirúrgicos tais como cortar tecido e aplicar grampos em cada lado do corte. Em particular, o conjunto de ferramenta inclui um conjunto de cartucho 18 que aloja uma pluralidade de grampos cirúrgicos na mesma. O conjunto de ferramenta 17 também inclui um conjunto de bigorna de formação de grampo 20 que tem uma parte de bigorna 204 que tem uma pluralidade de concavidades de deformação de grampo (não mostradas) formadas na superfície inferior da mesma. Uma placa de cobertura 208 é comumente presa em uma superfície de topo da parte de bigorna 204 para definir uma cavidade de bigorna entre as mesmas. A cavidade de bigorna é dimensionada para receber uma extremidade distal de um conjunto de acionamento axial 212. Uma fenda longitudinal 214 se estende através da parte de bigorna 204 para facilitar a passagem de flange de retenção 284 do conjunto de acionamento axial 212 dentro da cavidade de bigorna. Uma superfície de came 209 é formada em uma extremidade proximal da parte de bigorna 204 e é posicionada para engatar o conjunto de acionamento axial 212 para facilitar o fechamento do conjunto de bigorna 20.
O conjunto de cartucho 18 em geral inclui um transportador 216 que define um canal de suporte alongado 218. O canal de suporte alongado 218 é dimensionado e configurado para receber um cartucho de grampos 220 no mesmo. Tal cartucho de grampos 220 suporta uma pluralidade de prendedores e impulsores como é conhecido na técnica. Uma pluralidade fendas longitudinais 230 afastadas se estendem através do cartucho de grampos 220 para acomodar cunhas de came eretas 232 de um carrinho de atuação 234. Uma fenda central longitudinal 282 se estende ao longo do comprimento do cartucho de grampos 220 para facilitar a passagem de uma lâmina de faca 280 formada no conjunto de acionamento axial 212. Durante a operação da unidade de carga descartável 16, o carrinho de atuação 234 translada através das fendas 230 do cartucho de grampos 220 para avançar as cunhas de came 232 em contato sequencial aos impulsores que são operavelmente suportados no cartucho 220 para fazer os impulsores transladar verticalmente dentro do cartucho 220 e impelir os prendedores (grampos) associados com os impulsores dentro das cavidades de deformação de grampos do conjunto de bigorna 20. Um par de elementos pivô 211 é formado na extremidade proximal da parte de bigorna 204 e é configurado para ser recebido em fendas 213 que são formadas no transportador 216 para permitir que a parte de bigorna 204 pivote entre as posições aberta e de sujeição de tecido.
Como pode também ser visto na figura 1, a unidade de carga descartável 16 também tem uma parte de alojamento 200 que é adaptada para encaixar em ou de outro modo ser fixada no transportador 216. O conjunto de acionamento axial 212 inclui uma alavanca de acionamento alongada 266 que tem um cabeçote de trabalho distal 268 e uma seção de engate proximal 270. Como é conhecido, a alavanca de acionamento 266 pode ser construída a partir de uma folha única de material ou, de preferência, a partir de múltiplas folhas empilhadas. A seção de engate 270 inclui um par de dedos de engate 270a e 270b que são dimensionados e configurados para engatar de modo montado um par de fendas de retenção correspondentes 272a formadas em um elemento de acionamento 272. O elemento de acionamento 272 pode incluir um orifício proximal (não mostrado) que é configurado para receber a extremidade distal de uma haste de controle como discutido na Patente U.S. N°. 5.865.361.
A extremidade distal da alavanca de acionamento 266 inclui um tirante de suporte vertical 278 que suporta a lâmina de faca 280 e uma superfície de contra-apoio 283 que engata a parte central do carrinho de atuação 234 durante o procedimento de grampeamento. A superfície 285 está localizada na base da superfície 283 e é configurada para receber um ele mento de suporte 287 que é deslizantemente posicionado ao longo do fundo do transportador 216. A lâmina de faca 280 é em geral posicionada para transladar ligeiramente atrás do carrinho de atuação 234 através de uma fenda longitudinal central 282 no cartucho de grampos 220 para formar uma incisão entre as fileiras do tecido corporal grampeado.
Um flange de retenção 284 pode se projetar distalmente do tirante vertical 278 e suportar um pino de came 286 em sua extremidade distal. O pino de came 286 pode ser dimensionado e configurado para engatar a superfície de came na parte de bigorna 204 para prender a parte de bigorna 204 contra o tecido corporal. Em adição, um feixe de molas 207 (nãomostrado) pode ser fornecido entre a extremidade proximal da parte de bigorna 204 e a parte terminal distal do alojamento 200 para orientar o conjunto de bigorna 20 para uma posição normalmente aberta. A unidade de carga descartável 16 pode ainda incluir um dispositivo de travamento 288 como descrito na Patente U.S. N°. 5.865.361.
A figura 2 ilustra uma unidade de carga descartável articulável 16' que inclui um conjunto de ferramenta 17 que tem um conjunto de bigorna 20 e um conjunto de cartucho 18. O conjunto de bigorna 20 inclui uma parte de bigorna 204 que tem uma pluralidade de concavidades de deformação de grampo (não mostradas) formadas na superfície inferior da mesma. Uma placa de cobertura 208 é presa em uma superfície de topo da parte de bigorna 204 para definir uma cavidade de bigorna entre as mesmas. A cavidade de bigorna é dimensionada para receber uma extremidade distal de um conjunto de acionamento axial 212. Uma fenda longitudinal 214 se estende através da parte de bigorna 204 para facilitar a passagem de flange de retenção 284 do conjunto de acionamento axial 212 dentro da cavidade de bigorna. Uma superfície de came 209 formada na parte de bigorna 204 pode ser posicionada para engatar o conjunto de acionamento axial 212 para facilitar a sujeição do tecido entre o conjunto de bigorna 20 e o cartucho 18.
O conjunto de cartucho 18 inclui um transportador 216 que suporta um cartucho de grampos 220 no mesmo. O cartucho de grampos 220 inclui fendas de retenção 225 para receber uma pluralidade de prendedores (grampos) e impulsores. Uma pluralidade de fendas longitudinais afastadas 230 se estendem através do cartucho de grampos 220 para acomodar cunhas de came eretas 232 de um carrinho de atuação 234. Uma fenda longitudinal central 282 se estende ao longo do comprimento de cartucho de grampos 220 para facilitar a passagem de uma lâmina de faca 280. Durante a operação da unidade de carga descartável 16’ o carrinho de atuação 234 translada através de fendas longitudinais 230 do cartucho de grampos 220 para avançar as bordas de came 232 em contato sequencial com os impulsores que são operavelmente suportados no cartucho 220 para fazer os impulsores impelir os prendedores nas cavidades de deformação de grampos do conjunto de bigorna 20. Um par de elementos pivô 211 é formado na parte de bigorna 204 e é posicionado dentro de fendas 213 formadas no transportador 216 para guiar a parte de bigorna 204 entre as posições aberta e de sujeição de tecido.
A unidade de carga articulável 16' ainda inclui uma parte de alojamento 200 que compreende uma metade superior de alojamento 250 e uma metade inferior de alojamento. A extremidade proximal da metade de alojamento 250 pode incluir protuberâncias de engate 254 para engatar de modo liberável o corpo alongado 14. As protuberâncias 254 formam um acoplamento do tipo baioneta com a extremidade distal do corpo 14 como descrito na Patente U.S. N° 5.865.361. Como pode também ser visto na figura 2, o conjunto de acionamento axial 212 inclui uma alavanca de acionamento alongada 266 que tem um cabeçote de trabalho distal 268 e uma seção de engate proximal 270. A alavanca de acionamento 266 pode ser construída a partir de uma folha única de material, ou, de preferência, de múltiplas folhas empilhadas. A seção de engate 270 inclui um par de dedos de engate 270a e 270b que são dimensionados e configurados para engatar de modo montado um par de fendas de retenção correspondentes 27a formado em um elemento de acionamento 272. O elemento de acionamento 272 inclui um orifício proximal (não mostrado) configurado para receber a extremidade distal da haste de controle 52 quando a extremidade proximal da unidade de carga descartável 16' está engatada com o corpo alongado 14 de um apare13
Iho de grampeamento cirúrgico como descrito na Patente U.S. N°.
5.865.361. A extremidade distal da alavanca de acionamento 266 é definida por um tirante de suporte vertical 278 que suporta uma lâmina de faca 280, e uma superfície de contra-apoio 283 que engata a parte central de carrinho de atuação 234 durante um procedimento de grampeamento. A superfície 285 na base da superfície 283 pode ser configurada para receber um elemento de suporte 287 que é deslizantemente posicionado ao longo do fundo do transportador 216. A lâmina de faca 280 é em geral posicionada para transladar ligeiramente atrás do carrinho de atuação 234 através de uma fenda longitudinal central 282 no cartucho de grampos 220 para formar uma incisão entre as fileiras de tecido corporal grampeado. Para fornecer suporte para a alavanca de acionamento 266 dentro do alojamento 200 quando a alavanca de acionamento 266 é avançada axialmente, um elemento de estabilização de lâmina 290 é montado dentro do alojamento 200. Um flange de retenção 284 se projeta distalmente a partir do tirante vertical 278 e suporta um par de rolos de came cilíndricos 286 em sua extremidade distal. Os rolos de came 286 são dimensionados e configurados para engatar a superfície de came 209 na parte de bigorna 204 para prender a parte de bigorna 204 contra o tecido corporal.
Como pode ser visto nas figuras 2 e 3, a unidade de recarga articulável 16' inclui uma junta de articulação 340 que inclui um conjunto de montagem 202 que compreende uma parte de montagem superior 236 e uma parte de conjunto inferior 238. Um pino pivô 244 é formado em cada uma das partes de montagem 236, 238 e serve para definir um eixo pivô A1-A1 que pode ser substancialmente perpendicular ao eixo longitudinal L-L da unidade de carga descartável articulável 16'. O conjunto de conjunto 202 é pivotantemente acoplado à extremidade distal do conjunto de alojamento 200 por um par de elementos de acoplamento 246. Os elementos de acoplamento 246, cada, têm um furo 247 através dos mesmos para receber um pino correspondente 244 através dos mesmos. A extremidade proximal 248 de cada elemento de acoplamento 246 é configurada para ser recebida de modo travado em uma ranhura correspondente 251 formada na extremi dade distal da metade superior de alojamento 250 e a extremidade distal da metade inferior de alojamento 252. Um par de molas 207 é fornecido entre a extremidade proximal da parte de bigorna 204 e a parte de conjunto superior 236 para orientar o conjunto de bigorna 20 para uma posição normalmente aberta. Um elo de articulação 256 pode ser fornecido para articular o conjunto de ferramenta 17 em torno do eixo de articulação A1-A1 com relação ao conjunto de alojamento 200 como é mostrado na Patente U.S. N°.
5.865.361.
Unidades de carga descartáveis anteriores podem sofrer da incapacidade de serem disparadas em tecidos mais espessos (por exemplo, tecidos com espessuras maiores que 3,5 mm) devido às cargas aumentadas aplicadas em seus sistemas de disparo. Tais cargas aumentadas, por exemplo, podem aumentar a probabilidade de que o sistema de disparo falhe quando a lâmina 280 está ainda no conjunto de bigorna e pode portanto exigir que o conjunto de ferramenta 17 seja cortado do tecido tal modo de falha pode levar a sérias consequências de ferimento para o paciente.
A figura 4 ilustra uma unidade de carga descartável 116 da presente invenção empregada em conexão com um aparelho de grampeamento cirúrgico 10. A figura 5 ilustra uma unidade de carga descartável articulável 116' da presente invenção empregada em conexão com um aparelho de grampeamento cirúrgico 10. A unidade de carga descartável não-articulável 116 da presente invenção é similar à unidade de carga não-articulável 16 descrita acima, exceto pelos aperfeiçoamentos da presente invenção discutidos em detalhe abaixo. A unidade de carga descartável articulável 116' é similar à unidade de carga descartável articulável 16' descrita acima exceto pelos aperfeiçoamentos da presente invenção descritos abaixo. O aparelho de grampeamento cirúrgico 10 pode incluir um conjunto de manipulo 12 e um corpo alongado 14 e ser do tipo e construção descritos na Patente U.S. N°. 5.865.361, que foi incorporada aqui por referência.
As figuras 6-12 ilustram um conjunto de liberação de bigorna única e nova 400 da presente invenção que pode ser empregada com sucesso com a unidade de carga descartável não-articulável 116 e a unidade de carga descartável articulável 116' da presente invenção. Nestas modalidades, um pino de came único 286 é empregado. O pino de came 286 encaixa em um soquete 410 formado no flange de retenção 284 de conjunto de acionamento axial 212. Ver figura 6. O conjunto de liberação de bigorna 400 pode ainda incluir um elemento de desengate na forma de uma presilha de pino 401 do tipo representado na figura 7. Como pode ser visto nesta figura, a presilha de pino 401 pode incluir pelo menos uma parte de presilha superior 402 e pelo menos uma parte de presilha inferior 404. Um reforçador 406 pode ser fornecido na extremidade distal da presilha de pino 400. A presilha de pino 401 pode ser configurada para encaixar em ou de outro modo ser fixada no pino de came 286. Como pode ser visto na figura 6, quando a presilha de pino 401 é fixada no pino de came 286, as extremidades superiores das partes de presilha superiores 402 se estendem além de uma superfície superior 267 da parte de flange de retenção 284 do conjunto de acionamento axial 212 uma distância curta U e as partes de presilha inferiores 404 se estendem além de uma superfície inferior 269 da parte de flange de retenção 284 do conjunto de acionamento axial 212 uma distância curta L. Em várias modalidades, por exemplo, U e L podem, ser de aproximadamente 0,05 a 0,10 cm (0,02 a 0,04 polegada).
A operação das unidades de carga descartáveis 116 e 116' será explicada com referência às figuras 8 e 11. A figura 8 ilustra várias posições do conjunto de acionamento 212 e do pino de came 286 e a presilha de pino 401 quando é acionada distalmente através do conjunto de ferramenta 17. Nenhum tecido é mostrado na figura 8. A figura 11 ilustra o tecido T preso entre a parte de bigorna 204 e o cartucho de grampos 220. Nesta figura, no entanto, muito tecido T foi preso no conjunto de ferramenta 17 desse modo fazendo o conjunto de acionamento 212 se tornar emperrado quando é acionado através do tecido T na direção distal DD. Neste ponto, o médico simplesmente retrai o conjunto de acionamento 212 na direção proximal PD. Quando o conjunto de acionamento axial 212 é retraído, as partes de presilha superior e inferior 402, 404, respectivamente penetram na cobertura de bigorna 208' e a base de bigorna 204, respectivamente. Quando a força de retração continua a ser aplicada no conjunto de acionamento axial 212, o pino de came 286 é desalojado do soquete 410 formado no flange de retenção 284 do conjunto de acionamento axial 212 desse modo permitindo que o conjunto de acionamento axial 212 continue na direção proximal PD e também permitindo que o conjunto de bigorna 20 pivote aberto (seta P) para liberar o tecido T do conjunto de ferramenta 17. Ver figura 11. Aqueles versados na técnica apreciarão que o pino de came 286 e o soquete 410 devem ser dimensionados com relação um ao outro tal que o pino 286 seja desalojado do soquete 410 quando o conjunto de acionamento 212 é retraído durante um emperramento. Igualmente, as partes de presilha superiores 402 e as partes de presilha inferiores 404 devem ser configuradas para penetrar ou de outro modo engatar a cobertura 208' e a base de bigorna 204, respectivamente como descrito acima. Será entendido que quando o pino de bigorna 286 é destacado do conjunto de acionamento axial 212, o pino 286, com a presilha de pino 401 fixada no mesmo, permanece preso dentro da cavidade de bigorna 210 formada entre a cobertura de bigorna 208 e a parte de bigorna 204 para impedir o pino 286 de se tornar perdido no paciente.
As configurações alternativas de conjunto de acionamento e soquete são representadas nas figuras 12-18. Configurações similares são descritas no Pedido de Patente U.S. N° de série 11/820.077 Comumente cedido, depositado em 18 de junho de 2007, intitulado Surgical Stampling and Cutting Instrument with Improved Anvil Opening Features, para Richard W, Timm, Frederick E. Shelton, IV e Jeffrey S. Swayze, a descrição da qual é aqui incorporada por referência. Por exemplo, o conjunto de acionamento axial 1212 da figura 12 é substancialmente idêntico à modalidade das figuras 6-11, exceto que a fenda 1410 se estende dentro da extremidade distal do flange de retenção 284. O conjunto de acionamento axial 2212 da figura 13 é também similar às modalidades das figuras 6-11, exceto que o flange de retenção 284 do conjunto de acionamento axial 2212 tem um elemento de reforço 2214 formado no mesmo. Na modalidade da figura 14, o flange de retração 284 do conjunto de acionamento axial 3212 tem uma parte rebaixada 3214 e a fenda 3410 é inicialmente torcida fechada. Quando o conjunto de acionamento axial 3212 é retraído, a presilha de pino 400 penetra como descrito acima, a parte de fundo 3216 formando a fenda 3410 é permitida se curvar para baixo para liberar o pino 286. Na modalidade representada na figura 15, o flange de retenção 284 do conjunto de acionamento axial 4212 tem uma fenda 4410 que é definida por uma aba curvável 4216 que pode ser curvada ou deformada para abrir a fenda 4410 para permitir que o pino 286 seja removido da mesma. O flange de retenção 284 do conjunto de acionamento axial 5212 representado na figura 16 tem uma segunda fenda 5412 que se comunica com a primeira fenda de pino 5410 que permite que a primeira fenda de pino 5410 seja aberta em um ponto onde o pino 286 pode ser liberado da mesma. Na modalidade representada nas figuras 6-16, o pino 286 tem um formato de seção transversal substancialmente circular. Na modalidade representada nas figuras 17 e 18, o pino 6286 tem uma parte com um formato de seção transversal dimensionado para ser recebido na fenda 6210 e também tem asas laterais ou gussês 6288 para fornecer suporte adicional ao pino 6286 e minimizar qualquer probabilidade do pino 6286 se curvar quando o conjunto de acionamento axial 6212 é acionado na direção distai DD.
As figuras 19-22 ilustram outra unidade de carga descartável 7016 da presente invenção que pode ser substancialmente similar à unidade de carga descartável não-articulável 16 descrita acima, exceto para aperfeiçoamentos únicos e novos descritos abaixo. Como pode ser visto nas figuras 19 e 20, a unidade de carga descartável 7016 inclui um conjunto de ferramenta 17 que inclui um cartucho de grampos 220 que aloja uma pluralidade de grampos cirúrgicos no mesmo. O conjunto de ferramenta 17 também inclui um conjunto de bigorna de formação de grampos 7020. Tal unidade de carga descartável 7016 pode realizar procedimentos cirúrgicos tais como tecido de corte e aplicar grampos em cada lado do corte. O conjunto de bigorna 7020 em geral inclui uma parte de bigorna 7204 que tem uma pluralidade de concavidades de deformação de grampo (não mostrada) formadas na superfície inferior da mesma. Uma placa de cobertura 208 é comumente presa em uma superfície de topo da parte de bigorna 7204 para definir uma cavidade de bigorna 210 entre as mesmas. A cavidade de bigorna 210 é dimensionada para receber uma extremidade distal de um conjunto de acionamento axial 7212. Uma superfície de came 7209 é formada em uma extremidade proximal da parte de bigorna 7204 e é posicionada para engate por um pino de came 7286 que é fixado em um flange de retenção 7284 do conjunto de acionamento axial 7212 para facilitar o fechamento do conjunto de bigorna 7020.
A unidade de carga descartável 7016 também inclui um transportador 7216 que suporta o cartucho de grampos 220 em uma maneira descrita acima. A parte de alojamento 7200 pode ser adaptada para encaixar em ou de outro modo ser fixada no transportador 7216. O conjunto de acionamento axial 7212 pode incluir um braço de acionamento alongado 7266 que tem um cabeçote de trabalho distal 7268 e uma seção de engate proximal 7270. A alavanca de acionamento 7266 pode ser construída a partir de uma folha única de material ou, de preferência a partir de múltiplas folhas empilhadas. A seção de engate 7270 inclui um par de dedos de engate 7270a e 7270b que são dimensionados e configurados para engatar de modo montado um elemento de acionamento como foi discutido acima. Como notado acima, o elemento de acionamento pode incluir um orifício proximal configurado para receber a extremidade distal de uma haste de controle.
Como mostrado na figura 21, a extremidade distal da alavanca de acionamento 7266 inclui um tirante de suporte vertical 7278 que suporta a lâmina de faca 7280, e uma superfície de contra-apoio 7283 que engata a parte central de um carrinho de atuação durante o procedimento de grampeamento. A superfície 7285 na base de superfície 7283 é configurada para receber um elemento de suporte 7287 que é posicionado de modo deslizante ao longo do fundo do transportador 7216. A lâmina de faca 7280 é em geral posicionada para transladar ligeiramente atrás do carrinho de atuação através de uma fenda longitudinal central no cartucho de grampos 220 para formar uma incisão entre as fileiras de tecido corporal grampeados.
Um flange de retenção 7284 se projeta distalmente do tirante vertical 7278 e suporta um pino de came 7286 em sua extremidade distal. O pino de came 7286 é dimensionado e configurado para engatar a superfície de came 7209 na parte de bigorna 7204 para prender a parte de bigorna 7204 contra o tecido corporal. Em adição, um feixe de molas pode ser fornecido entre a extremidade proximal da parte de bigorna 7204 e a parte terminal distal do alojamento 7200 para orientar o conjunto de bigorna 7020 para uma posição normalmente aberta.
As modalidades representadas nas figuras 19-22 empregam um conjunto de liberação de bigorna 400' que inclui um conjunto de suporte de bigorna retrátil novo e único 7300 que pode compreender um par de barras de suporte de bigorna 7302 que são recebidas em uma abertura 7305 na parte de bigorna 7204 e são suportadas em ressaltos correspondentes 7207 formados na mesma. Ver figura 21. As barras de suporte de bigorna 7302 são suportadas em relação espaçada uma com a outra para definir uma fenda alongada 7309 entre as mesmas para receber o tirante de suporte vertical 7278 e a lâmina de faca 7280 através da mesma. Como pode ser visto nesta figura, quando as barras de suporte de bigorna 7302 são suportadas em seus ressaltos respectivos 7207, o pino de came 7286 se desloca nas mesmas para forçar o conjunto de bigorna 7020 dentro da posição de sujeição de tecido para o cartucho de grampos 220. A extremidade proximal 7304 de cada barra de suporte de bigorna 7302 pode ser fixada em uma base deslizante 7310 que é configurada para deslizar axialmente dentro do transportador 7216 e do alojamento 7200. A base deslizante 7310 pode compreender uma parte esquerda 7312 e uma parte direita 7314 que são localizadas em lados opostos do conjunto de acionamento 7212. Uma articulação de conexão de liberação 7400 é fixada na base deslizante 7310, que pode ter um detentor 7402 em sua extremidade proximal.
A unidade de carga descartável 7016 pode ser usada em conexão com um aparelho de grampeamento cirúrgico convencional 10 do tipo descrito na Patente U.S. N°. 5.865.361 que foi modificado da seguinte maneira. Em particular, o aparelho de grampeamento cirúrgico 10 tem um botão rotativo 28 que tem um corpo alongado 14 fixado no mesmo. O corpo alongado 14 é configurado para interfacear de modo operável com os detentores
254 na extremidade proximal da unidade de carga descartável 7016 em uma maneira conhecida. No entanto, um botão atuador 7500 é deslizantemente recebido no corpo alongado 14 do aparelho de grampeamento cirúrgico 10 e é fixado em uma barra atuadora 7510 que é recebida dentro do corpo alongado 14 e tem uma extremidade proximal 7512 que se estende através de uma fenda axial (não mostrada) no corpo alongado 14. A barra atuadora 7510 também tem uma extremidade distal 7514 que tem um gancho 7516 que é adaptado para engatar de modo liberável o detentor 7402 na articulação de conexão 7400 quando a unidade de carga descartável 7016 é acoplada na extremidade distal do corpo alongado 14. Ver figura 22.
Durante o uso, as barras de suporte retráteis 7302 são posicionadas como ilustrado nas figuras 20 e 21. Quando nesta posição, as barras de suporte 7302 suportam o pino de came 7286 nas mesmas tal que o pino de came retém o conjunto de bigorna 7020 na posição de sujeição de tecido. Como pode ser visto na figura 20, as barras de suporte 7302 são recebidas na abertura na parte de bigorna 7204 e servem para definir uma abertura de recepção de pino na parte de bigorna 7204 para o pino de came se estender através da mesma quando o conjunto de acionamento axial 7212 atingiu a extremidade do percurso de disparo (por exemplo, em sua posição mais distal) para permitir que o conjunto de bigorna 7020 pivote para a posição aberta para liberar o tecido da mesma. Se, no entanto, durante o percurso de disparo, o conjunto de acionamento axial 7212 se tornar emperrado, o médico pode liberar o tecido do conjunto de ferramenta 17 simplesmente agarrando o botão atuador 7500 e movendo-o axialmente no corpo alongado 14 na direção proximal PD. Quando o botão atuador 7500 é movido na direção proximal PD, as barras de suporte 73021 são também retraídas a um ponto em que as barras de suporte 7302 não suportam mais o pino de came 7286 e permite assim que o pino de came 7286 passe através da fenda se estendendo axialmente 7205 na parte de bigorna 7204. Quando o pino de came 7286 passa através da fenda 7205, o conjunto de bigorna 7020 é permitido se mover para a posição aberta em que o conjunto de ferramenta pode ser liberado do tecido. Como pode ser visto na figura 19, a unidade de carga descartável 7016 é mais longa que uma unidade de carga descartável convencional 16 por uma distância D que é a distância exigida para fornecer uma quantidade desejada de folga para retrair as barras de suporte 7302 dentro do conjunto de alojamento 7200. Assim, o médico pode liberar o conjunto de bigorna 7020 (por exemplo, soltar o tecido) se o conjunto de acionamento axial 7212 se tornar emperrado em qualquer ponto durante o percurso de disparo.
As figuras 23-25 ilustram uma parte de uma unidade de carga descartável alternativa 8016 que pode ser substancialmente idêntica às unidades de carga descartáveis 16, 16' exceto pelos aperfeiçoamentos únicos e novos discutidos abaixo. Por exemplo, esta modalidade emprega um conjunto de liberação de bigorna 400 que compreende um conjunto de retentor móvel 8100. Em várias modalidades, o conjunto de retentor 8100 pode compreender um corpo de retentor 8101 que tem um pino de bigorna 8102 e um pino retentor 8104 montados no mesmo. O conjunto de retentor 8100 é dimensionado para deslizar dentro da fenda axial 214 na parte de bigorna 204 e é configurado para engatar de forma liberável um entalhe 8285 correspondente na parte de retentor 8284 do conjunto de acionamento axial 8212. O conjunto de acionamento axial 8212 pode de outro modo ser similar ao conjunto de acionamento axial 212 como foi descrito acima. O conjunto de retentor 8100 e o entalhe 8285 são configurados tal que o conjunto de retentor é frouxamente acoplado quando o conjunto de acionamento axial 8212 é acionado através do cartucho de grampos, ainda quando o conjunto de acionamento axial 8212 é retraído, as forças friccionais entre o conjunto de retentor 8100 e a parte de bigorna 204 retêm o conjunto de retentor 8100 em posição e desse modo permitem que o conjunto de acionamento axial 8212 desacople do mesmo. Quando o conjunto de acionamento axial 8212 desacopla do conjunto de retentor 8100, o conjunto de bigorna 8020 é permitido pivotar para a posição aberta. Assim se o conjunto de acionamento axial 8212 se torna emperrado em qualquer ponto durante o percurso de disparo, o médico pode simplesmente retrair o conjunto de acionamento axial 8212 que o faz desacoplar do conjunto de retentor 8100 e desse modo permite que o conjunto de bigorna 8020 pivote aberto e libere o tecido no mesmo. Como pode ser visto nas figuras 24 e 25, quando o conjunto de acionamento axial 8212 atingiu o fim do percurso de disparo, o pino de bigorna 8102 cai dentro da fenda transversa 215 na parte de bigorna 204 e desse modo facilita o desacoplamento do conjunto de acionamento axial 8212 do conjunto de retentor 8100 para permitir que o conjunto de bigorna 8020 pivote para a posição aberta. Será apreciado que quando o conjunto de bigorna 8020 pivota para a posição aberta, o conjunto de retentor 8100 permanece com a parte de bigorna 204, porque o pino retentor 8104 é maior que a fenda transversa 215. Assim o conjunto de retentor 8100 se tornará desacoplado do conjunto de bigorna 8020 e possivelmente se tornará perdida no paciente.
As figuras 26-32 ilustram uma parte de uma unidade de carga descartável alternativa 9016 que pode ser substancialmente idêntica às unidades de carga descartáveis 16, 16' exceto pelos aperfeiçoamentos únicos e novos discutidos abaixo. Por exemplo, esta modalidade emprega um conjunto de liberação de bigorna 9000 que inclui um braço de bigorna pivotável 9100 que é adaptado para engatar de modo liberável um pino de bigorna 9102. A alavanca de bigorna pivotável 9100 é dimensionado para ser recebido dentro de uma fenda 9215 formada em uma extremidade distal bifurcada 9213 de um conjunto de acionamento axial 9212. O conjunto de acionamento axial 9212 pode de outro modo ser similar ao conjunto de acionamento axial 212 como foi descrito acima. Mais especificamente e com referência à figura 28, a extremidade distal 9213 pode ser formada com um batente de empuxo 9217, um ressalto distal 9219 e uma fenda pivô 9220. Como pode ser visto na figura 27, a alavanca de bigorna pivotável 9100 tem um munhão 9104 que se projeta de cada lateral do mesmo para ser recebido na fenda pivô 9220. O topo da alavanca de bigorna pivotável 9100 tem um entalhe de empuxo 9106 formado no mesmo para engate com o batente de empuxo 9217 no conjunto de acionamento axial 9212. A extremidade distal superior da alavanca de bigorna pivotável 9100 também tem um entalhe de pino 9108 formado no mesmo para engate com o pino de bigorna 9102. O pino de bi goma 9102 pode ser fornecido com uma ranhura (não mostrada) adaptada para receber de modo friccional uma parte da alavanca de bigorna pivotável 9100 para acoplar de modo liberável o pino de bigorna 9102 da alavanca de bigorna pivotável 9100. Outros métodos podem ser empregados para acoplar de modo liberável o pino de bigorna 9102 na alavanca de bigorna pivotável 9100 sem se afastar do espírito e escopo da presente invenção.
A operação da unidade de carga descartável 9016 será agora descrita com referência às figuras 30-32. A figura 30 ilustra uma parte do tecido T preso na unidade de carga descartável 9016 em que o conjunto de acionamento axial 9212 se tornou emperrada. Como pode ser visto nesta figura, o pino pivô 9104 está localizado na extremidade proximal da fenda 9220 e a força F que é gerada pelo tecido localizado entre a parte de bigorna 204 e o cartucho de grampos 220 está empurrando para cima no pino de bigorna 9102. Para liberar o tecido T, o médico retrai o conjunto de acionamento axial 9212 na direção proximal PD que permite que a alavanca de bigorna 9100 pivote como ilustrado pela seta p na figura 31. Quando o conjunto de bigorna 9020 pivota para cima, a força F no pino de bigorna 9102 se dissipa. O movimento do conjunto de acionamento axial 9212 na direção proximal a uma distância que é substancialmente igual ao comprimento da fenda 9220 permite que o pino pivô seja completamente liberado da alavanca de bigorna 9100 como ilustrado na figura 32 para desse modo permitir que o conjunto de bigorna 9020 pivote para a posição aberta. Quando isto acontece, o pino de bigorna 9102 é retido dentro da cavidade de bigorna 210 formada entre a parte de bigorna 204 e a placa de cobertura de bigorna 208.
Enquanto várias modalidades da invenção foram descritas, deve ser evidente, no entanto, que várias modificações, alterações e adaptações naquelas modalidades podem ocorrer a pessoas versadas na técnica com a obtenção de algumas ou todas as vantagens da invenção. Por exemplo, de acordo com as várias modalidades, um componente único pode ser substituído por múltiplos componentes, e múltiplos componentes podem ser substituídos por um único componente, para realizar uma função dada ou funções.
Esta aplicação portanto pretende cobrir todas as modificações, alterações e adaptações sem se afastar do escopo e espírito da invenção descrita como definida pelas reivindicações anexas.
Qualquer patente, publicação, ou outro material de descrição, no todo ou em parte, que é dito ser incorporado por referência aqui, é incorporado somente na medida em que os materiais incorporados não conflitem com as definições, regras existentes, ou outro material de descrição apresentado nesta descrição. Como tal, na medida necessária, a descrição como explicitamente apresentada aqui substitui qualquer material conflitante incorporado aqui por referência. Qualquer material, ou parte do mesmo, que é dito ser incorporado por referência aqui, mas que conflita com definições existentes, regras ou outro material de descrição apresentado aqui será somente incorporado na medida em que nenhum conflito surja entre este material incorporado e o material de descrição existente.
A invenção que pretende ser protegida, não deve ser construída como limitada pelas modalidades particulares descritas. As modalidades são portanto vistas como ilustrativas em vez de restritivas. Variações e mudanças podem ser feitas por outros sem se afastar do espírito da presente invenção. Consequentemente, é expressamente pretendido que todos os equivalentes, variações e mudanças que se encontram dentro do espírito e escopo da presente invenção como definida nas reivindicações sejam abrangidos pela mesma.
REIVINDICAÇÕES
Claims (7)
1. Unidade de carga descartável (116, 116') para fixação em um aparelho de grampeamento cirúrgico (10), a dita unidade de carga descartável caracterizada pelo fato de que compreende:
um cartucho de grampos (220) suportado em um transportador (216) acoplável de modo operável no aparelho de grampeamento cirúrgico (10);
um conjunto de bigorna (20) acoplado de modo móvel no dito transportador (216) para deslocamento móvel seletivo entre as posições aberta e fechada com relação ao dito cartucho de grampos (220);
um conjunto de acionamento axial (212) que tem uma parte de extremidade distal construída para mover em uma direção distal através de uma fenda (282) no dito cartucho de grampos (220) em resposta a um movimento de acionamento conferido ao dito conjunto de acionamento axial (212) a partir do aparelho de grampeamento cirúrgico (10), e também mover em uma direção proximal através da dita fenda (282) no dito cartucho de grampos (220) em resposta a um movimento de retração aplicado no dito conjunto de acionamento axial (212) a partir do aparelho de grampeamento cirúrgico (10), a dita parte de extremidade distal do dito conjunto de acionamento axial (212) configurado para conferir uma força de fechamento no dito conjunto de bigorna (20) na medida em que o dito conjunto de acionamento axial (212) é acionado na dita direção distal na dita fenda (282) no dito cartucho de grampos (220); e um conjunto de liberação de bigorna (400) que coopera de modo operável com a dita parte de extremidade distal do dito conjunto de acionamento axial (212) e o dito conjunto de bigorna (20) para fazer seletivamente com que a dita parte de extremidade distal do dito conjunto de acionamento axial (212) descontinue, conferindo a dita força de fechamento no dito conjunto de bigorna (20) independentemente de onde a dita parte de extremidade distal do dito conjunto de acionamento axial (212) está localizada dentro da dita fenda (282) no dito cartucho de grampos (220);
em que o dito conjunto de liberação de bigorna (400) compreenPetição 870190032949, de 05/04/2019, pág. 8/16 de:
um pino de bigorna (286, 6286) acoplado de modo liberável na dita parte de extremidade distal do dito conjunto de acionamento axial (212) e posicionado para conferir a dita força de fechamento no dito conjunto de 5 bigorna (20) a medida que a dita parte de extremidade distal do dito conjunto de acionamento axial (212) é acionada na dita direção distal; e um elemento de desengate (401) interfaceando com o dito pino de bigorna (286, 6286) para desacoplar o dito pino de bigorna (286, 6286) da dita parte de extremidade distal do dito conjunto de acionamento axial (212) 10 na aplicação do movimento de retração no dito conjunto de acionamento axial (212).
2. Unidade de carga descartável (116, 116'), de acordo com a reivindicação 2, caracterizada pelo fato de que o dito elemento de desengate (401) compreende uma presilha de pino fixada no dito pino de bigorna
15 (286, 6286) e configurado para engatar pelo menos uma parte do dito conjunto de bigorna (20) quando o movimento de retração é aplicado no dito conjunto de acionamento axial (212) e desse modo fazer o dito pino de bigorna (286, 6286) ser desacoplado do mesmo.
3. Unidade de carga descartável (116, 116'), de acordo com a 20 reivindicação 1, caracterizada pelo fato de que um conjunto de bigorna (20) compreende uma parte de bigorna (204) pivotantemente acoplada ao dito transportador (216) para deslocamento pivotável seletivo entre as posições aberta e fechada com relação ao dito cartucho de grampos (220), a dita parte de bigorna tendo uma fenda de bigorna axial (214) através da mesma; e 25 uma cobertura de bigorna (208) fixada na dita parte de bigorna para definir uma cavidade de bigorna (210) entre as mesmas;
em que a parte de extremidade distal do conjunto de acionamento axial (212) é construída para mover na direção distal através de ambas a fenda de cartucho (282) no dito cartucho de grampos (220) e a dita fenda de 30 bigorna (214) em resposta a um movimento de acionamento conferido ao dito conjunto de acionamento axial (212) a partir do aparelho de grampeamento cirúrgico (10) e também para mover em uma direção proximal através
Petição 870190032949, de 05/04/2019, pág. 9/16 de ambas a dita fenda de cartucho (282) e a dita fenda de bigorna (214) em resposta a um movimento de retração aplicado ao dito conjunto de acionamento axial (212) a partir do aparelho de grampeamento cirúrgico (10);
em que o pino de bigorna é um pino de bigorna (286, 6286) transverso suportado de modo destacável em uma parte de flange de retenção (284) do dito conjunto de acionamento axial (212) tal que o dito pino de bigorna (286, 6286) é recebido de modo móvel na dita cavidade de bigorna (210) e atravessa a dita fenda de bigorna (214); e em que o elemento de desengate (401) no dito pino de bigorna (286, 6286) transverso é orientado para engatar pelo menos uma parte de pelo menos uma da dita cobertura de bigorna (208) e da dita parte de bigorna quando um movimento de retração é aplicado ao dito conjunto de acionamento axial (212) independentemente de onde a dita parte de extremidade distal do dito conjunto de acionamento axial (212) está localizada dentro da dita fenda do cartucho (282) para desse modo fazer o dito pino de bigorna (286, 6286) ser desacoplado do dito conjunto de acionamento axial (212).
4. Unidade de carga descartável (116, 116'), de acordo com a reivindicação 3, caracterizada pelo fato de que o dito elemento de desengate (401) compreende uma presilha de pino (401) fixável no dito pino de bigorna (286, 6286) e tendo pelo menos uma parte de presilha superior (402) orientada para engatar por retenção uma parte da dita cobertura de bigorna (208) e pelo menos uma parte de presilha inferior (404) orientada para engatar por retenção uma parte da dita parte de bigorna (204).
5. Unidade de carga descartável (116, 116'), de acordo com a reivindicação 3, caracterizada pelo fato de que o dito pino de bigorna (286, 6286) é retido dentro da dita cavidade de bigorna (210) quando o dito pino de bigorna (286, 6286) foi destacado do dito conjunto de acionamento axial (212).
6. Unidade de carga descartável (116, 116'), de acordo com a reivindicação 3, caracterizada pelo fato de que o dito pino de bigorna (286) é suportado em uma fenda de extremidade aberta (410, 1410, 2410, 5410) na dita parte de flange de retenção (284) do dito conjunto de acionamento
Petição 870190032949, de 05/04/2019, pág. 10/16 axial (212).
7. Aparelho de grampeamento cirúrgico (10), caracterizado pe- lo fato de que compreende:
um conjunto de manípulo (12);
5 um corpo alongado (14) acoplado de modo operável no dito conjunto de manípulo; e a unidade de carga descartável (116, 116') como definida em qualquer uma das reivindicações 1 a 6 operavelmente acoplada ao dito corpo alongado (14).
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| BRPI0903067B1 true BRPI0903067B1 (pt) | 2019-08-13 |
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| BRPI0903067A BRPI0903067B8 (pt) | 2008-02-14 | 2009-02-13 | unidade de carga descartável para aparelho de grampeamento cirúrgico e aparelho de grampeamento cirúrgico |
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-
2008
- 2008-02-14 US US12/031,539 patent/US7857185B2/en active Active
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2009
- 2009-02-13 JP JP2009030899A patent/JP5430965B2/ja not_active Expired - Fee Related
- 2009-02-13 EP EP09250385A patent/EP2090247B1/en active Active
- 2009-02-13 RU RU2009105058/14A patent/RU2492819C2/ru not_active IP Right Cessation
- 2009-02-13 BR BRPI0903067A patent/BRPI0903067B8/pt active IP Right Grant
- 2009-02-16 CN CN2009100078147A patent/CN101584596B/zh active Active
Also Published As
| Publication number | Publication date |
|---|---|
| EP2090247B1 (en) | 2012-09-05 |
| JP2009189826A (ja) | 2009-08-27 |
| CN101584596A (zh) | 2009-11-25 |
| HK1135872A1 (en) | 2010-06-18 |
| CN101584596B (zh) | 2012-07-04 |
| JP5430965B2 (ja) | 2014-03-05 |
| US7857185B2 (en) | 2010-12-28 |
| BRPI0903067A2 (pt) | 2010-06-22 |
| EP2090247A1 (en) | 2009-08-19 |
| RU2009105058A (ru) | 2010-08-20 |
| BRPI0903067B8 (pt) | 2021-06-22 |
| US20090206134A1 (en) | 2009-08-20 |
| RU2492819C2 (ru) | 2013-09-20 |
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