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CN111481252A - 手持式手术用手柄组件、手术用手柄组件和手术用末端执行器之间使用的手术用接合器 - Google Patents

手持式手术用手柄组件、手术用手柄组件和手术用末端执行器之间使用的手术用接合器 Download PDF

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CN111481252A
CN111481252A CN202010305659.3A CN202010305659A CN111481252A CN 111481252 A CN111481252 A CN 111481252A CN 202010305659 A CN202010305659 A CN 202010305659A CN 111481252 A CN111481252 A CN 111481252A
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戴维·尼古拉斯
约翰·比尔兹利
拉塞尔·普里巴尼奇
迈克尔·热姆洛克
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Abstract

本发明公开一种手持式手术用手柄组件、手术用手柄组件和手术用末端执行器之间使用的手术用接合器。一种接合器组件，包括：壳体，其限定了纵轴线并被配置为可释放地联接到手柄组件；第一驱动元件，其可旋转地支撑在所述壳体中并且平行于所述纵轴线，所述第一驱动元件具有远侧部和被配置为与所述手柄组件的第一驱动轴相啮合的近侧部；螺母，其被连接到所述第一驱动元件的所述远侧部，使得所述第一驱动元件的旋转使所述螺母在平行于所述纵轴线的方向上平移；关节式运动套管；关节式运动轴承，其联接到所述关节式运动套管的远侧部并且被配置为响应于所述关节式运动套管的所述远侧部的平移而平移；以及关节式运动连杆。

Description

手持式手术用手柄组件、手术用手柄组件和手术用末端执行 器之间使用的手术用接合器
本申请是申请号为201710701920X、申请日为2013年6月3日、分案提交日为2017年8月16日、发明名称为“手持式手术用手柄组件、手术用手柄组件和手术用末端执行器之间使用的手术用接合器”的专利申请的分案申请。而上述申请是申请号为201310217662X、申请日为2013年6月3日、发明名称为“手持式手术用手柄组件、手术用手柄组件和手术用末端执行器之间使用的手术用接合器及使用方法”的专利申请的分案申请。
相关申请的交叉引用
本申请要求递交于2012年6月1日、序列号为61/654，191的美国临时专利申请的权益和优先权，其全部内容通过引用合并于此。
技术领域
本公开涉及手术装置和/或系统、手术用接合器以及它们的使用方法。更特别地，本公开涉及手持式动力手术装置、手术用接合器和/或接合器组件，所述手术用接合器和/或接合器组件在动力、旋转和/或关节式运动手术装置或手柄组件与用于夹紧、切割和/或吻合组织的末端执行器之间使用并且用于将其相互连接。
背景技术
一种类型的手术装置是一种线性夹紧、切割和吻合装置。在外科手术操作中，可以使用这样的装置来切除胃肠道中癌变的或异常的组织。传统的线性夹紧、切割和吻合器械包括具有细长轴和远侧部的手枪握柄样式的结构。远侧部包括一对剪刀样式的夹持元件，其夹紧闭合结肠的开口端。在该装置中，两个剪刀样式的夹持元件中的一个元件(如砧座部)相对于整个结构移动或枢转，而另一个夹持元件相对于整个结构保持固定。该剪取装置的致动(砧座部的枢转)是由保持在手柄中的握持柄扳机来控制的。
除了剪取装置以外，远侧部还包括吻合机构。剪取机构的固定夹持元件包括吻合钉钉仓接纳区域和用来驱动吻合钉紧靠砧座部向上穿过组织的被夹紧端部从而密封先前开口端部的机构。剪取元件可以与所述轴整体形成或者是可以拆卸的使得各种剪取元件和吻合元件可以互换。
许多手术装置的生产商已经开发出具有适用于操作和/或操纵所述手术装置的专用驱动系统的产品线。在许多实例中，所述手术装置包括：可重复使用的手柄组件；以及一次性末端执行器或同类物，其可以在使用前选择性地被连接到所述手柄组件上，然后在使用后再从所述末端执行器断开连接以便于被处置或在一些实例中被消毒以重复使用。
与许多现有的手术装置和/或手柄组件一起使用的许多现有的末端执行器都是由线性力来驱动。例如，适合于执行胃肠内吻合术操作、端对端吻合术操作以及横向吻合术操作的末端执行器通常均需要线性驱动力以便于被操作。因此，这些末端执行器与使用旋转运动来传递动力等的手术装置和/或手柄组件无法配合使用。
为了使所述线性驱动的末端执行器与使用旋转运动来传递动力的手术装置和/或手柄组件互相配合使用，对于在所述线性驱动的末端执行器与所述旋转驱动的手术装置和/或手柄组件之间进行交接并且将其相互连接的接合器和/或接合器组件存在需求。
发明内容
本公开涉及一种手术装置，所述手术装置包括装置壳体，至少一个驱动电动机、电池、电路板、末端执行器、以及接合器组件。所述装置壳体限定了选择性地与所述接合器组件连接的连接部。所述至少一个驱动电动机被支撑在所述装置壳体内且被配置以旋转至少一个驱动轴。所述电池被布置以与至少一个驱动电动机的电连通。所述电路板被布置在所述壳体内用来控制从所述电池输送到所述至少一个驱动电动机的电力。所述末端执行器被配置以执行至少一种功能且包括至少一个可轴向平移驱动构件。所述接合器组件用来选择性地将所述末端执行器和所述装置壳体相互连接，并且所述接合器组件包括旋钮壳体以及至少一个驱动转换器组件。所述旋钮壳体被配置且适于选择性地连接到所述装置壳体并且与所述至少一个可旋转驱动轴中的每一个可操作地连通。所述至少一个驱动转换器组件用于将所述至少一个可旋转驱动轴中的相应一个和所述末端执行器的所述至少一个可轴向平移驱动构件中的一个相互连接。所述至少一个驱动转换器组件将所述可旋转驱动轴的旋转转换并传递成所述末端执行器的所述至少一个可轴向平移驱动构件的轴向平移。所述至少一个驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括第一驱动元件、螺母、关节式运动套管、关节式运动轴承、以及关节式运动连杆。所述第一驱动元件被旋转地支撑在所述旋钮壳体中。所述第一驱动元件的近侧端能够与所述可旋转驱动轴啮合。所述螺母被螺纹连接到所述第一驱动元件的螺纹远侧部。所述关节式运动套管的近侧部被布置以与所述螺母机械配合。所述关节式运动轴承被布置以与所述关节式运动套管远侧部机械配合。所述关节式运动连杆的近侧部被布置以与所述关节式运动轴承机械配合。所述关节式运动连杆的远侧部被配置用来选择性地与所述末端执行器所述至少一个可轴向平移驱动构件啮合。所述可旋转驱动轴的旋转引起所述第一驱动元件的旋转。所述第一驱动元件的旋转引起所述螺母、所述关节式运动套管、所述关节式运动轴承、所述关节式运动连杆、以及所述末端执行器的所述至少一个可轴向平移驱动构件的轴向平移。
在所公开的实施例中，所述关节式运动轴承被配置以能够相对于所述旋钮壳体轴向地和旋转地运动。
在所公开的实施例中，所述关节式运动套管的远侧部被布置以与所述关节式运动轴承的径向内部机械配合。在这里，被公开的是所述关节式运动连杆的近侧部被布置以与所述关节式运动轴承的径向外部机械配合。
在所公开的实施例中，包括第二驱动转换器组件，所述第二驱动转换器组件包括第二驱动元件、第一齿轮、第二齿轮、以及齿圈。所述第二驱动元件被旋转地支撑在所述旋钮壳体中。所述第二驱动元件的近侧端能够连接到所述手术装置的第二可旋转驱动轴上。所述第一齿轮被布置以与所述第二驱动元件的远侧部机械配合。所述第二齿轮被布置与所述第一齿轮机械配合。所述齿圈被布置以与所述第二齿轮机械配合且被布置以与所述末端执行器机械配合。所述齿圈相对于所述旋钮壳体被固定而不能旋转。所述第二可旋转驱动轴的旋转引起所述第一齿轮的旋转，所述第一齿轮的旋转引起所述第二齿轮的旋转，所述第二齿轮的旋转引起所述齿圈的旋转，而所述齿圈的旋转引起所述末端执行器的旋转。在这里，被公开的是所述旋钮壳体包括驱动联接壳体，所述驱动联接壳体能够相对于所述旋钮壳体的余部(remainder)旋转。在这里，被公开的是包括旋转轴承，且所述驱动联接壳体被旋转地固定到所述旋转轴承。所述旋钮壳体能够相对于所述旋转轴承旋转。在这里，被公开的是所述齿圈包括围绕其内周布置的多个齿。
在所公开的实施例中，所述关节式运动连杆的远侧部包括被配置在其中用于可释放地接受所述末端执行器的至少一个可轴向平移驱动构件的一部分的狭槽。在这里，被公开的是所述狭槽包括锥形开口。
本公开还涉及一种接合器组件，其用来选择性地将手术用末端执行器和具有至少一个可旋转驱动轴的手柄组件相互连接。所述接合器组件包括旋钮壳体，以及至少一个驱动转换器组件。所述旋钮壳体被配置且适于选择性地连接到手柄组件上。所述旋钮壳体包括驱动联接壳体。所述至少一个驱动转换器组件用来所述至少一个可旋转驱动轴中的相应一个和手术用末端执行器一部分相互连接。所述至少一个驱动转换器组件将所述可旋转驱动轴的旋转转换并传递成所述末端执行器的所述至少一个可轴向平移驱动构件的轴向平移。所述至少一个驱动转换器组件包括第一驱动转换器组件，所述第一驱动转换器组件包括驱动元件、第一齿轮、第二齿轮、齿圈和旋转轴承。所述驱动元件被旋转地支撑在所述接合器壳体中。所述第一齿轮被布置以与所述驱动元件的远侧部机械配合。所述第二齿轮被布置以与所述第一齿轮机械配合。所述齿圈被布置以与所述第二齿轮机械配合且被布置以与所述接合器组件的末端执行器啮合部机械配合。所述齿圈相对于所述接合器壳体被固定而不能旋转。所述驱动联接壳体被旋转地固定到所述旋转轴承，且所述旋钮壳体能够相对于所述旋转轴承旋转。所述驱动元件的旋转引起所述第一齿轮的旋转；所述第一齿轮的旋转引起所述第二齿轮的旋转；所述第二齿轮的旋转引起所述齿圈的旋转；而所述齿圈的旋转引起所述接合器组件的末端执行器啮合部的旋转。
在所公开的实施例中，所述齿圈包括围绕其内周布置的多个齿。
在所公开的实施例中，所述驱动联接壳体能够相对于所述旋钮壳体的余部旋转。
在所公开的实施例中，包括第二驱动转换器组件，所述第二驱动转换器组件包括第二驱动元件、螺母、关节式运动套管、以及关节式运动连杆。所述第二驱动元件被旋转地支撑在所述旋钮壳体中。所述螺母被螺纹连接到所述第二驱动元件的螺纹远侧部。所述关节式运动套管的近侧部被布置以与所述螺母机械配合。所述关节式运动轴承被布置以与所述关节式运动套管的远侧部机械配合。所述关节式运动连杆的近侧部被布置以与所述关节式运动轴承机械配合。所述关节式运动连杆的远侧部被配置用来选择性地与所述末端执行器的一部分啮合。所述第二驱动元件的旋转引起所述螺母、所述关节式运动套管、所述关节式运动轴承以及所述关节式运动连杆的轴向平移。在这里，被公开的是所述关节式运动轴承被配置以能够相对于所述旋钮壳体轴向地和旋转地运动。在这里，被公开的是所述关节式运动套管的远侧部被布置以与所述关节式运动轴承的径向内部机械配合。在这里，被公开的是所述关节式运动连杆的近侧部被布置以与所述关节式运动轴承的径向外部机械配合。
附图说明
这里参照附图描述了本公开的各种实施例，其中：
图1是根据本公开实施例的部件分离的手术装置和接合器的立体图，图示了其与末端执行器的连接；
图2是图1中手术装置的立体图；
图3是部件分离的图1和图2中手术装置的立体图；
图4是用于图1至图3的手术装置中的电池的立体图；
图5是去除其壳体的图1至图3中手术装置的立体图；
图6是手术装置和接合器中每一个的连接端部的立体图，图示了它们之间的连接；
图7是通过图2的7-7取得的图1至图3中的手术装置的剖视图；
图8是通过图2的8-8取得的图1至图3中的手术装置的剖视图；
图9是部件分离的图1至图3中手术装置的扳机壳体的立体图；
图10是图1中的接合器的立体图；
图11是通过图10的11-11取得的图1和图10中的接合器的剖视图；
图12是图11中细节指示区域的放大图；
图13是图11中细节指示区域的放大图；
图14是接合器和装载单元一部分的省略一些零件的立体图；
图15是图14中细节指示区域的放大图；
图16是图14中细节指示区域的放大图；
图17是与装载单元啮合的接合器的远侧端的立体图；
图18和图19是省略零件的接合器部分的立体图；
图20是通过图10的20-20取得的图1和图10中接合器的剖面图；
图21是图20中的细节指示区域的放大图；
图22是图20中的细节指示区域的放大图；
图23是接合器的远侧部的立体图；
图24是从如图23所示的接合器的远侧部向远侧看的剖切立体图；
图25是省略零件的接合器的一部分的立体图；
图26是与本公开手术装置和接合器一起使用的示例性末端执行器的部件分离的立体图；以及
图27是LED输出的示意图；电动机选择的示意图(选择夹紧/切割，旋转或关节式运动)；以及执行所选定功能的所述驱动电动机选择的示意图。
具体实施方式
现在将参照附图详细描述本公开的手术装置，以及适用于手术装置和/或手柄组件的接合器组件的实施例，其中在几幅附图的每幅附图中相同附图标记指代相同的或对应的元件。在本文中使用时，术语“远侧”是指所述接合器组件或手术装置或其部件的较远离用户的部分，而术语“近侧”是指所述接合器组件或手术装置或其部件的较接近用户的部分。
根据本公开的实施例，手术装置总体被指定为100，且为一种动力手持式机电器械的形式，其被配置用来选择性地将多个不同的末端执行器附接于此，每一个末端执行器均被配置为通过所述动力手持式机电手术器械来实现致动和操纵。
如图1所图示，手术装置100被配置为用来选择性地连接接合器200，然后，依次地，接合器200被配置为选择性地连接末端执行器或单次使用装载单元300。
如图1至图3所图示，手术装置100包括手柄壳体102，手柄壳体102包括下壳体部104、中间壳体部106以及上壳体部108，其中，中间壳体部106从下壳体部104延伸出和/或被支撑在下壳体部104上，上壳体部108从中间壳体部106延伸出和/或被支撑在中间壳体部106上。中间壳体部106和上壳体部108被分离成远侧半部110a和近侧半部110b，其中，远侧半部110a从下壳体部104延伸出且与下壳体部104整体形成，近侧半部110b通过采用多个紧固件可与远侧半部110a相连接。当接合时，远侧半部110a与近侧半部110b限定了手柄壳体102，手柄壳体102内有空腔102a，电路板150和驱动机构160被设置在空腔102a中。
远侧半部110a与近侧半部110b沿着横切如图3所示的上壳体部108的纵轴线“X”的平面被分开。
手柄壳体102包括垫圈112，垫圈112完全地在远侧半部110a和/或近侧半部110b的缘边的周围延伸且被插入在远侧半部110a和近侧半部110b之间。垫圈112密封远侧半部110a和近侧半部110b的周边。垫圈112的功能是在远侧半部110a和近侧半部110b之间形成气密密封以便于在消毒和/或清洗操作时保护电路板150和驱动机构160。
以这种方式，手柄壳体102的空腔102a沿着远侧半部110a的周边密封，并且近侧半部110b还被配置为使得能够更轻松、更高效地将电路板150和驱动机构160装配在手柄壳体102中。
手柄壳体102的中间壳体部106提供了电路板150被设置在其中的壳体。将在下面额外详细阐明，配置电路板150来控制手术装置100的各种操作。
手术装置100的下壳体部104限定了在其上表面中形成的孔隙(未显示)并且孔隙位于中间壳体部106的下方或内部。下壳体部104的孔隙提供了可供导线152穿过的通道以将位于下壳体部104中的电气部件(如图4中所图示的电池156、如图3中所图示的电路板154等)与位于中间壳体部106和/或上壳体部108中的电气部件(电路板150、驱动机构160等)相互电连接。
手柄壳体102包括被布置在下壳体部104(未显示)的孔隙内的垫圈103，因而在允许导线152穿过下壳体部104的孔隙的同时还堵塞或密封下壳体部104的孔隙。垫圈103的功能是在下壳体部106和中间壳体部108之间形成气密密封以便于在消毒和/或清洗操作时保护电路板150和驱动机构160。
正如图所示，手柄壳体102的下壳体部104提供了可拆卸地位于其中的可再充电电池156。电池156被配置为给手术装置100的电气部件中的任何一个部件提供电力。下壳体部104限定了电池156被插入其中的空腔(未显示)。下壳体部104包括枢转地连接于其上的门105，门105用来封闭下壳体部104的空腔并将电池156保持在空腔中。
参照图3和图5，上壳体部108的远侧半部110a限定了鼻部或连接部108a。鼻锥114被支撑在上壳体部108的鼻部108a上。鼻锥114是由透明材料制造。照明构件116被布置在鼻锥114内使得透过鼻锥114可见照明构件116。照明构件116采用发光二极管印刷电路板(LEDPCB)的形式。照明构件116被配置为使用与独特离散事件关联的特定颜色图案来照亮多种颜色。
手柄壳体102的上壳体部108提供了驱动机构160位于其中的壳体。如图5所示，配置驱动机构160来驱动轴和/或齿轮部件以便于执行手术装置100的各种操作。特别地，配置驱动机构160来驱动轴和/或齿轮部件，以便于相对于末端执行器300的近侧主体部302，选择性地移动末端执行器300的工具组件304(参照图1和图20)，从而使得末端执行器300相对于手柄壳体102绕纵轴线“X”(参照图3)旋转，以使得砧座组件306相对于末端执行器300的钉仓组件308移动，和/或击发在末端执行器300的钉仓组件308内的吻合切割钉仓。
驱动机构160包括相对紧邻接合器200定位的选择变速箱组件(selectorgearboxassembly)162。邻近选择变速箱组件162的是具有第一电动机164的功能选择模块163，第一电动机164的功能为选择性地移动选择变速箱组件162内的齿轮元件以与具有第二电动机166的输入驱动部件165相啮合。
如图1至图4所示，且如上所述，上壳体部108的远侧半部110a限定了连接部108a，连接部108a配置为接受接合器200的对应的驱动联接组件210。
如图6至图8所示，当接合器200与手术装置100匹配时，手术装置100的连接部108a具有用来接纳接合器200的驱动联接组件210的柱形凹槽108b。连接部108a容纳三个可旋转驱动连接器118、120、122。
当接合器200与手术装置100匹配时，手术装置100的可旋转驱动连接器118、120、122中的每一个均与接合器200的对应的可旋转连接器套管218、220、222相联接。(参照图6)。在这点上，对应的第一驱动连接器118和第一连接器套管218之间的交接、对应的第二驱动连接器120和第二连接器套管220之间的交接，以及对应的第三驱动连接器122和第三连接器套管222之间的交接都是键联接，以便于手术装置100的驱动连接器118、120、122中的每一个的旋转都会引起接合器200的对应的连接器套管218、220、222的对应的旋转。
手术装置100的驱动连接器118、120、122与接合器200的连接器套管218、220、222的匹配允许经由三个对应的连接器交接中的每一个独立地传输旋转力。手术装置100的驱动连接器118、120、122被配置为通过驱动机构160独立地旋转。在这点上，驱动机构160的功能选择模块163会选择由驱动机构160的输入驱动部件165来驱动手术装置100的驱动连接器118、120、122中的哪一个或多个驱动连接器。
因为手术装置100的驱动连接器118、120、122中的每一个驱动连接器都是与接合器200的相应的连接器套管218、220、222进行键联接和/或基本上非可旋转地相接，当接合器200被联接到手术装置100时，会选择性地将旋转力从手术装置100的驱动机构160传递到接合器200。
手术装置100的驱动连接器118、120和/或122的选择性的旋转允许手术装置100选择性地致动末端执行器300的不同功能。如下面更详细地讨论，手术装置100的第一驱动连接器118的选择性的且独立的旋转对应于末端执行器300的工具组件304的选择性的且独立的打开和闭合，以及对应于末端执行器300的工具组件304的吻合/切割部件的驱动。同样，手术装置100的第二驱动连接器120的选择性的且独立的旋转对应于横切于纵轴线“X”(参照图3)的末端执行器300的工具组件304的选择性的且独立的关节式运动。另外，手术装置100的第三驱动连接器122的选择性的且独立的旋转对应于末端执行器300相对于手术装置100的手柄壳体102的绕纵轴线“X”(参照图3)的选择性的且独立的旋转。
如上所述且如图5和图8所图示，驱动机构160包括选择变速箱组件162；邻近选择变速箱组件162定位的功能选择模块163，功能选择模块163的功能为选择性地移动选择变速箱组件162内的齿轮元件以与第二电动机166相啮合。这样，驱动机构160就在给定时间选择性地驱动手术装置100的驱动连接器118、120、122中的一个驱动连接器。
如图1至图3和图9所示，手柄壳体102在中间壳体部108的远侧表面或远侧上支撑扳机壳体107。与中间壳体部108配合的扳机壳体107支撑一对手指致动的控制按钮124、126和摇杆装置128、130。特别地，扳机壳体107限定了上孔隙124a以用于可滑动地接纳第一控制按钮124，以及下孔隙126b以用于可滑动地接纳第二控制按钮126。
控制按钮124、126和摇杆装置128、130中的每一个均包括由操作者的致动来移动的相应的磁体(未显示)。此外，对于控制按钮124、126和摇杆装置128、130中的每一个，电路板150都包括靠控制按钮124、126和摇杆装置128、130中磁体的移动来致动的相应的霍尔效应开关150a-150d。特别地，位置紧邻控制按钮124的是第一霍尔效应开关150a(参照图3和图7)，在操作者致动控制按钮124时，控制按钮124中的磁体就会移动，从而致动第一霍尔效应开关150a。对应于控制按钮124的第一霍尔效应开关150a的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来闭合末端执行器300的工具组件304和/或击发末端执行器300的工具组件304内的吻合/切割钉仓。
同样，位置紧邻摇杆装置128的是第二霍尔效应开关150b(参照图3和图7)，在操作者致动摇杆装置128时，摇杆装置128中的磁体(未显示)就会移动，从而致动第二霍尔效应开关150b。对应于摇杆装置128的第二霍尔效应开关150b的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来使得工具组件304相对于末端执行器300的主体部302进行关节式运动。有利的是，摇杆装置128在第一方向上的移动会引起工具组件304相对于主体部302在第一方向上进行关节式运动，而摇杆装置128在相反方向(如第二方向)上的移动会引起工具组件304相对于主体部302在相反方向(如第二方向)上进行关节式运动。
此外，位置紧邻控制按钮126的是第三霍尔效应开关150c(参照图3和图7)，在操作者致动控制按钮126时，控制按钮126中的磁体(未显示)就会移动，从而致动第三霍尔效应开关150c。对应于控制按钮126的第三霍尔效应开关150c的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来打开末端执行器300的工具组件304。
此外，位置紧邻摇杆装置130的是第四霍尔效应开关150d(参照图3和图7)，在操作者致动摇杆装置130时，摇杆装置130中的磁体(未显示)就会移动，从而致动第四霍尔效应开关150d。对应于摇杆装置130的第四霍尔效应开关150d的致动会使得电路板150向功能选择模块163和驱动机构160的输入驱动部件165提供适当的信号来使末端执行器300相对于手术装置100的手柄壳体102旋转。特别地，摇杆装置130在第一方向上的移动会引起末端执行器300相对于手柄壳体102在第一方向上旋转，而摇杆装置130在相反方向(如第二方向)上的移动会引起末端执行器300相对于手柄壳体102在相反方向(如第二方向)上旋转。
如图1至图3所示，手术装置100包括被支撑在中间壳体部108和上壳体部之间且被定位于扳机壳体107上方的击发按钮或安全开关132。在使用中，根据需要和/或要求，末端执行器300的工具组件304在打开状态和闭合状态之间被致动。为了击发末端执行器300，为了当末端执行器300的工具组件304处于闭合状态时从其中射出紧固件，按下安全开关132，从而指示手术装置100：末端执行器300准备从其中射出紧固件。
如图1和图10至图25所示，手术装置100被配置为用来选择性地与接合器200相连接，然后，依次地，接合器200被配置为用来选择性地与末端执行器300相连接。
配置接合器200用来将手术装置100的驱动连接器120和122中任何一个驱动连接器的旋转转换成用于操作末端执行器300的驱动组件360和关节式运动连杆366的轴向平移，如图26所示且将在下面更详细地讨论。
接合器200包括用于将手术装置100的第三可旋转驱动连接器122与末端执行器300的第一可轴向平移驱动构件360相互连接的第一驱动传递/转换组件，其中，第一驱动传递/转换组件将手术装置100的第三可旋转驱动连接器122的旋转转换并传递成末端执行器300的第一可轴向平移的驱动组件360的轴向平移以便进行击发。
接合器200包括用于将手术装置100的第二可旋转驱动连接器120和末端执行器300的第二可轴向平移驱动构件366相互连接的第二驱动传递/转换组件，其中，第二驱动传递/转换组件将手术装置100的第二可旋转驱动连接器120的旋转转换并传递成末端执行器300的关节式运动连杆366的轴向平移以便进行关节式运动。
现在转向图10，接合器200包括旋钮壳体202和从旋钮壳体202的远侧端延伸出的外管206。旋钮壳体202和外管206被配置和定尺寸为容纳接合器200的部件。外管206被定尺寸为用于内窥镜插入，特别地，外管可通过典型的套管针口、插管或同类物。旋钮壳体202的尺寸无法进入套管针口、插管或同类物。
旋钮壳体202被配置且适于连接到手术装置100的远侧半部110a的上壳体部108的连接部108a。
如图10、11和图14所示，接合器200包括在其近侧端处的手术装置驱动联接组件210和在其远侧端处的末端执行器联接组件230。驱动联接组件210包括旋转地支撑(至少部分地)在旋钮壳体202中的驱动联接壳体210a。驱动联接组件210在其中可旋转地支撑第一可旋转近侧驱动轴或元件212、第二可旋转近侧驱动轴或元件214以及第三可旋转近侧驱动轴或元件216(例如，参见图15)。
如图19所示，驱动联接壳体210a被配置为分别可旋转地支撑第一连接器套管218、第二连接器套管220和第三连接器套管222。如上所述，连接器套管218、220、222中的每个均配置为分别与手术装置100相应的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122匹配。连接器套管218、220、222中的每个均进一步配置为分别与相应的第一近侧驱动轴或元件212、第二近侧驱动轴或元件214和第三近侧驱动轴或元件216的近侧端匹配。
特别参照图19和图22，近侧驱动联接组件210包括布置在相应的第一连接器套管218、第二连接器套管220和第三连接器套管222的远侧的第一偏置构件224、第二偏置构件226和第三偏置构件228。围绕相应的第一可旋转近侧驱动轴212、第二可旋转近侧驱动轴214和第三可旋转近侧驱动轴216分别布置偏置构件224、226、228中的每一个。当接合器200被连接到手术装置100上时，偏置构件224、226、228作用在相应的连接器套管218、220、222上从而有助于保持连接器套管218、220、222与手术装置100的相应的可旋转驱动的驱动连接器118、120、122的远侧端相啮合。
特别地，第一偏置构件224、第二偏置构件226和第三偏置构件228的功能是在近侧方向上偏置相应的连接器套管218、220、222。以这种方式，在装配接合器200到手术装置100的过程中，如果第一连接器套管218、第二连接器套管220和/或第三连接器套管222与手术装置100的驱动连接器118、120、122不对准，则第一偏置构件224、第二偏置构件226和/或第三偏置构件228被压缩。因此，当手术装置100的驱动机构160被啮合时，手术装置100的驱动连接器118、120、122将旋转，并且第一偏置构件224、第二偏置构件226和/或第三偏置构件228将引起相应的第一连接器套管218、第二连接器套管220和/或第三连接器套管222向近侧向后滑动，有效地将手术装置100的驱动连接器118、120、122联接到近侧驱动联接组件210的第一近侧驱动轴212、第二近侧驱动轴214和/或第三近侧驱动轴216。
当校准手术装置100时，手术装置100的驱动连接器118、120、122中的每个都旋转，并且当实现正确对准时，在连接器套管218、220、222上的偏置会使连接器套管218、220、222正确就位于手术装置100相应的驱动连接器118、120、122的上方。
如图11、14和20所示，接合器200包括分别被布置在手柄壳体202和外管206内的第一驱动传递/转换组件240、第二驱动传递/转换组件250和第三驱动传递/转换组件260。驱动传递/转换组件240、250、260分别被配置且适于将手术装置100的第一驱动连接器118、第二驱动连接器120和第三驱动连接器122的旋转转换并传递成接合器200的远侧驱动构件248和驱动杆258(或者关节式运动杆)的轴向平移，从而实现末端执行器300的闭合、打开、关节式运动和发射；或者传递或转换接合器200的齿圈266的旋转，从而实现接合器200的手柄壳体202的旋转。
如图11至图13所示，第一驱动传递/转换组件240包括被可旋转地支撑在壳体202和外管206内的第一远侧驱动轴242。第一远侧驱动轴242的近侧端部242a从第一近侧驱动轴212向远侧延伸。第一远侧驱动轴242还包括具有螺纹外轮廓或表面的螺纹部242b。
第一驱动传递/转换组件240还包括驱动联接螺母244，驱动联接螺母244可旋转地联接到第一远侧驱动轴242的螺纹远侧端部242b，且将驱动联接螺母244可滑动地布置在外管206中。驱动联接螺母244被键联接到外管206的内壳体管206a上从而防止其随第一远侧驱动轴242的旋转而旋转。如此，随着第一远侧驱动轴242旋转，驱动联接螺母244会纵向地平移通过外管206的内壳体管206a和/或沿着外管206的内壳体管206a平移。
第一驱动传递/转换组件240还包括与驱动联接螺母244机械啮合的远侧驱动构件248，使得驱动联接螺母244的轴向运动引起远侧驱动构件248的相应量的轴向运动。更特别地，驱动联接螺母244的远侧端包括与被布置在远侧驱动构件248(参见图11)的近侧部上的至少一个对应凹槽249相啮合的至少一个向内悬垂的突起245。远侧驱动构件248的远侧端部支撑连接构件247，连接构件247被配置和定尺寸为选择性地与末端执行器300的驱动组件360的驱动构件374啮合。
在操作中，随着第一可旋转近侧驱动轴212旋转，由于第一连接器套管218的旋转，作为手术装置100的相应的第一驱动连接器118旋转的结果，第一远侧驱动轴242旋转。随着第一远侧驱动轴242旋转，引起驱动联接螺母244沿着第一远侧驱动轴242轴向平移。随着引起驱动联接螺母244沿着第一远侧驱动轴242轴向平移，引起远侧驱动构件248相对于外管206的内壳体管206a轴向平移。随着远侧驱动构件248轴向平移，由于连接构件247被连接到远侧驱动构件248并且与末端执行器300的驱动组件360的驱动构件374相啮合，远侧驱动构件248引起末端执行器300的驱动构件374同时进行轴向平移，从而实现工具组件304的闭合和末端执行器300的工具组件304的击发。
参照图13至图22，接合器200的第二驱动转换器组件250包括被旋转地支撑在驱动联接组件210内的第二可旋转近侧驱动轴216。第二可旋转近侧驱动轴216包括被配置与第二连接器或联接器222相连接的非圆形或某种形状的近侧端部，第二连接器或联接器222被连接到手术装置100的相应的第二连接器120。第二可旋转近侧驱动轴216还包括具有螺纹外轮廓或表面的远侧端部216b。
近侧驱动轴216的远侧端部216b通过螺纹与螺母252啮合。螺母252被布置以与关节式运动套管254的近侧部254a机械配合。例如，螺母252延伸穿过关节式运动套管254内的凹槽255。关节式运动套管254的远侧部254b被布置以与关节式运动轴承261，且特别是与关节式运动轴承261的内套管262机械配合(例如，被附接或被联接)。关节式运动轴承261的外套管264被机械联接到关节式运动杆258的近侧部258a。关节式运动杆258的远侧部258b在其中包括狭槽272，狭槽272被配置用来接受装载单元300的一部分(例如，标志、关节式运动连杆366等)。另外，狭槽272包括锥形的进入部274，进入部274被配置以减小装载单元300和关节式运动杆258之间的间隙，从而有利于它们之间的对准和/或啮合。
进一步关于关节式运动轴承261，关节式运动轴承261既能够旋转又能够纵向平移。另外，可以设想到，当装载单元300的钳夹构件306、308处于接近位置时和/或当钳夹构件306、308做关节式运动时，关节式运动轴承261允许装载单元300自由的、无障碍的旋转运动。另外，由于关节式运动的和/或接近的钳夹构件一般在旋转的和/或关节式运动系统上产生显著大的负荷，所以关节式运动轴承261减少了典型地与关节式运动的和/或接近的钳夹构件的旋转有关的摩擦量。
在操作中，随着驱动轴216由于第二连接器套管222的旋转而旋转，作为手术装置100的第二驱动连接器120的旋转的结果，引起螺母252沿着近侧驱动轴216的螺纹远侧端部216b轴向平移，这依次会引起关节式运动套管254相对于旋钮壳体202轴向平移。随着关节式运动套管254轴向平移，引起关节式运动轴承261轴向平移。相应地，随着关节式运动轴承261轴向平移，引起关节式运动杆258轴向平移，这同时引起末端执行器300的关节式运动连杆366的轴向平移，从而实现工具组件304的关节式运动。
如图20至图25所示且如上所述，接合器200包括被支撑在旋钮壳体202中的第三驱动传递/转换组件260。第三驱动传递/转换组件260包括管组件400、旋转轴承410、旋转齿圈420、空转齿轮430和正齿轮440。管组件400包括壳体末端402、管206和管联接器406。壳体末端402被远侧地布置成与连接构件247相邻。管联接器406被布置成与管组件400的近侧端相邻。管206在壳体末端402和管联接器406之间延伸。如图24所示，管联接器406被机械地联接邻近上部和下部手柄的远侧端或旋钮壳体202。旋钮壳体202的近侧部被定位在旋转轴承410的周围，这允许它们之间的旋转。
进一步关于旋转轴承410，旋转轴承410相对于驱动联接壳体210a是非可旋转的，但相对于旋钮壳体202既能旋转又能纵向平移。另外，可以设想到的是，当装载单元300的钳夹构件306、308处于接近位置时和/或当钳夹构件306、308做关节式运动时，旋转轴承410允许装载单元300自由的、无障碍的旋转运动。另外，由于关节式运动的和/或接近的钳夹构件一般在旋转的和/或关节式运动系统上产生显著大的负荷，旋转轴承410减少了典型的与关节式运动的和/或接近的钳夹构件的旋转有关的摩擦量。
旋转齿圈420被布置在旋转轴承410的远侧，且相对于旋钮壳体202是非可旋转的(例如，由于齿圈420的突起421被旋钮壳体202中对应凹槽捕捉到)。旋转齿圈420包括围绕其内周布置的多个齿422。空转齿轮430能够绕销434旋转且包括围绕其外周布置的多个齿432，齿432被配置和定位为与旋转齿圈420的齿422相啮合。正齿轮440包括围绕其外周布置的多个齿442，齿442被配置和定位为与空转齿轮430的齿432相啮合。另外，正齿轮440被附接到第二可旋转近侧驱动轴214。
在操作中，手术装置100的第二驱动连接器120的旋转引起第二连接器套管220和驱动轴214旋转。驱动轴214的旋转引起正齿轮440旋转。正齿轮440的旋转引起空转齿轮430的旋转，这会引起齿圈420也旋转。因为齿圈420相对于旋钮壳体202是非可旋转的，齿圈420的旋转引起旋钮壳体202旋转。另外，由于旋钮壳体202和管联接器406之间的啮合，旋钮壳体202的旋转引起管联接器406、管206、壳体末端402、以及远侧联接组件230绕由接合器200限定的纵轴线“A-A”(参见图1)旋转。随着远侧联接组件230旋转，同样也引起被连接到远侧联接组件230的末端执行器300绕接合器200的纵轴线旋转。
参照图21和图22，接合器200还包括用来固定远侧驱动构件248的轴向位置和径向方位的锁定机构280。锁定机构280包括滑动地支撑在旋钮壳体202上的按钮282。锁定按钮282被连接到纵向延伸通过外管206的致动杆284。将致动杆284插入在外管206和内壳体管206a之间。当锁定按钮282移动时，致动杆284就移动。在锁定按钮282移动预定量时，致动杆284的远侧端284a就移动而与闭锁件286相接触，这会引起闭锁件286使得凸轮构件288从在远侧驱动构件248的凹槽249进行凸轮运动。当凸轮构件288与凹槽249相啮合时(例如，至少部分在凹槽249内)，凸轮构件288和远侧驱动构件248之间的啮合有效地锁定了与连接构件247相啮合的末端执行器300的轴向和旋转位置。
在操作中，为了锁定远侧驱动构件248的位置和/或方位，用户将锁定按钮282从远侧位置移动到近侧位置，从而引起闭锁件286向近侧移动，以使得闭锁件286的远侧面286a移动而脱离与凸轮构件288的接触，这会引起凸轮构件288凸轮运动进入远侧驱动构件248的凹槽249。以这种方式，防止了远侧驱动构件248的远侧和/或近侧运动。当锁定按钮282从近侧位置移向远侧位置时，致动杆284的远侧端284a向远侧移动而进入闭锁件286，克服偏置构件289的偏置，以迫使凸轮构件288移出凹槽249，从而允许远侧驱动构件248无障碍的轴向平移和径向移动。当驱动构件248已经平移以开始工具组件304的闭合时，无法致动锁定按钮282且在工具组件304被重新打开前无法移除末端执行器300。
如图6所示，接合器200包括一对电触销290a、290b，一对电触销290a、290b与被布置在手术装置100的连接部108a中的对应的电插头190a、190b电连接。电触销290a、290b用来允许经由被电连接到电路板150上的电气插头190a、190b校准和传递生命周期信息给手术装置100的电路板150。接合器200还包括被支撑在旋钮壳体202中且与电触销290a、290b电连通的电路板。
当用户激活手术装置的按钮时，软件会核对预定义的条件。如果符合条件，则软件会控制电动机并且将机械驱动传递给附接的手术吻合器，然后根据按下的按钮的功能，手术吻合器随后能够进行打开、闭合、旋转、关节式运动或发射。软件还通过按照定义的方式打开或熄灭彩色灯给用户提供反馈，从而指示出手术装置100、接合器200和/或末端执行器300的状态。
在如下示意图“A”中显示了系统的高级电气结构视图，并且显示了至各个硬件和软件接口的连接情况。在示意图“A”左侧上，显示了来自按钮124、126的按压和来自驱动轴的电动机编码器的输入。微型控制器包含操作手术装置100、接合器200和/或末端执行器300的装置软件。微型控制器接收微型局域网(MicroLAN)、超级ID(Ultra ID)芯片、电池ID(Battery ID)芯片以及接合器ID(Adaptor ID)芯片的输入以及发送输出给它们。微型局域网、超级ID芯片、电池ID芯片以及接合器ID芯片如下控制手术装置100、接合器200和/或末端执行器300：
Figure BDA0002455701230000171
在图27中呈现的示意图的右侧指示了：至LED的输出；电动机的选择(选择夹紧/切割、旋转或关节式运动)；以及执行所选择功能的驱动电动机的选择。
如图1和图26所示，末端执行器被指示为300。末端执行器300被配置和定尺寸为内窥镜插入通过插管、套管针或同类物。特别地，在图1和图26所图示的实施例中，当末端执行器300处于闭合状态下时，末端执行器300可以通过插管或套管针。
末端执行器300包括近侧主体部302和工具组件304。近侧主体部302被可释放地附接到接合器200的远侧联接组件230，而工具组件304可枢转地附接到近侧主体部302的远侧端。工具组件304包括砧座组件306和钉仓组件308。钉仓组件308相对于砧座组件306枢转并且能够在打开或未夹紧位置与闭合或夹紧位置之间移动以便于插入通过套管针的插管。
近侧主体部302至少包括驱动组件360和关节式运动连杆366。
参照图26，驱动组件360包括挠性驱动梁364以及近侧啮合部368，挠性驱动梁364具有被固定到动力夹紧构件365的远侧端。啮合部368包括限定台肩370的阶状部。啮合部368的近侧端包括沿直径对置的向内延伸的指状件372。指状件372与中空的驱动构件374啮合从而将驱动构件374牢固地固定到梁364的近侧端上。驱动构件374限定近侧孔口376，近侧孔口376用来当末端执行器300被附接到接合器200的远侧联接组件230时接纳接合器200的第一驱动转换器组件240的驱动管246的连接构件247。
当驱动组件360在工具组件304内被向远侧推进时，夹紧构件365的上梁在砧座板312和砧座盖310之间限定的通道内移动，而且下梁移动到托架316外表面的上方来闭合工具组件304并从其中发射吻合钉。
末端执行器300的近侧主体部302包括关节式运动连杆366，关节式运动连杆366具有从末端执行器300的近侧端延伸出的带钩近侧端366a。当末端执行器300被固定到接合器200的远侧壳体232时，关节式运动连杆366的带钩近侧端366a与接合器200的驱动杆258的联接钩258c相啮合。当接合器200的驱动杆258如上被推进或缩回时，末端执行器300的关节式运动连杆366会在末端执行器300内被推进或缩回以使得工具组件304相对于近侧主体部302的远侧端枢转。
如图26所示，工具组件304的钉仓组件308包括可支撑在托架316中的吻合钉钉仓305。吻合钉钉仓305限定中央纵向狭槽305a，以及被安置在纵向狭槽305a每一侧上的三个线性排吻合钉保持狭槽305b。每一个吻合钉保持狭槽305b接纳单个吻合钉307和吻合钉推动器309的一部分。在操作手术装置100期间，驱动组件360抵靠致动滑块并推动致动滑块通过钉仓305。随着致动滑块移动通过钉仓305，致动滑块的凸轮楔顺序地与吻合钉推动器309相啮合，从而在吻合钉保持狭槽305b内垂直地移动吻合钉推动器309并从其中顺序地发射单个吻合钉307以紧靠着砧座板312成形。
可以参考递交于2009年8月31日、名称为“手术吻合装置的工具组件(TOOLASSEMBLY FOR ASURGICAL STAPLING DEVICE)”、公开号为2009/0314821的美国专利中对于末端执行器300的结构和操作的详细讨论。
将要理解的是可以对这里公开的接合器组件的实施例进行各种修改。例如，电池156可以被更换成交替的电源，例如线路电压(AC或者DC)或者燃料电池。因此，上述说明不应该视为限制，而仅仅是一些特定实施例的示范。本领域技术人员将在本公开的范围和精神内构想出其他的修改。

Claims (12)

1.一种接合器组件，包括：
壳体，其限定了纵轴线并被配置为可释放地联接到手柄组件；
第一驱动元件，其可旋转地支撑在所述壳体中并且平行于所述纵轴线，所述第一驱动元件具有远侧部和被配置为与所述手柄组件的第一驱动轴相啮合的近侧部；
螺母，其被连接到所述第一驱动元件的所述远侧部，使得所述第一驱动元件的旋转使所述螺母在平行于所述纵轴线的方向上平移；
关节式运动套管，其具有远侧部和联接到所述螺母并且被配置为响应于所述螺母的平移而平移的近侧部；
关节式运动轴承，其联接到所述关节式运动套管的远侧部并且被配置为响应于所述关节式运动套管的所述远侧部的平移而平移；以及
关节式运动连杆，其能被所述关节式运动轴承移动，所述关节式运动连杆具有被配置为与装载单元的第一驱动连杆相啮合的远侧部。
2.根据权利要求1所述的接合器组件，其中，所述螺母被螺纹联接到所述第一驱动元件的所述远侧部。
3.根据权利要求1所述的接合器组件，进一步包括关节式运动杆，所述关节式运动杆具有远侧部和联接到所述关节式运动轴承的近侧部。
4.根据权利要求3所述的接合器组件，其中，所述关节式运动杆的远侧部限定了狭槽并且被配置为可释放地联接到末端执行器的关节式驱动元件。
5.根据权利要求4所述的接合器组件，其中，所述狭槽包括锥形开口。
6.根据权利要求1所述的接合器组件，其中，所述关节式运动轴承具有环形，所述环形具有内径向部和外径向部，所述关节式运动套管的远侧部被布置成与所述关节式运动轴承的内径向部机械配合。
7.根据权利要求6所述的接合器组件，其中，所述关节式运动连杆的近侧部被布置成与所述关节式运动轴承的所述外径向部机械配合。
8.根据权利要求1所述的接合器组件，其中，所述第一驱动元件沿着所述纵轴线布置。
9.根据权利要求1所述的接合器组件，进一步包括：
第二驱动元件，其可旋转地支撑在所述壳体中并且包括远侧部和被配置为与所述手柄组件的第二驱动轴相啮合的近侧部；
第一齿轮，其被配置为响应于所述第二驱动元件的所述远侧部的旋转而旋转；
第二齿轮，其与所述第一齿轮以啮合方式接合；以及
齿圈，其与所述第二齿轮以啮合方式接合，所述齿圈相对于所述壳体可旋转地固定，所述齿圈的旋转使所述装载单元绕所述纵轴线相对于所述壳体旋转。
10.根据权利要求1所述的接合器组件，其中，所述壳体包括能相对于所述壳体旋转的驱动联接件。
11.根据权利要求10所述的接合器组件，进一步包括可旋转地固定到所述驱动联接件的旋转轴承。
12.根据权利要求9所述的接合器组件，其中，所述齿圈包括围绕其内周布置的多个齿。
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