CN101102713A - 用于柔性器械的铰接护套 - Google Patents
用于柔性器械的铰接护套 Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
Abstract
一种用于远程转向、导向和/或操纵包括例如内窥镜的柔性器械的护套,该柔性器械被接纳通过该护套。
Description
技术领域
本发明涉及用于柔性器械例如内窥镜的远程转向、引导、导行和操纵的护套。
背景技术
内窥镜检查术通常使用从身体外部的位置操纵在目标器官或组织内或者朝向目标器官或组织的内窥镜器械。内窥镜检查术的示例包括乙状结肠镜检查、结肠镜检查、食管胃十二指肠镜检查和支气管镜检查。通常将具有柔性插入管的柔性内窥镜用于这种手术。内窥镜的插入管通过被推进而前进并通过向后拉而缩回。管的尖端可通过扭动和大致向上/向下以及向左/向右运动被引导。此有限的运动范围常常会使得难以转过锐角,会导致患者不舒适并且增加损伤周围组织的危险。
内窥镜还可用于腹腔镜检查术。这种检查通常包括将套管针引入患者身体并然后通过该套管针将内窥镜管插到预期位置。在腹腔镜检查术中更经常使用刚性内窥镜-即具有柔性较小且刚性较强的插入管的内窥镜(有时也称为腹腔镜),因为这种内窥镜不太需要前进通过狭窄的解剖结构。这样配置的内窥镜的可操纵性有限,并且难以独立于移动的插入套管针操纵内窥镜。
已做出许多努力来设计可操纵性较高的内窥镜以及导液管,但它们的运动范围通常有限。例如,Sato的US3557780、Ailinger等的US5271381、Alotta等的US5916146以及Sakai的US6270453说明了具有可通过致动一组丝线而被弯曲的一个或多个柔性部分的内窥镜器械。这些丝线通过旋转小齿轮(Sato)、操纵旋钮(Ailinger等)、可转向的臂(Alotta等)或者通过滑轮机构(Sato)从器械的近端被致动。Boury等人的US5916147公开了一种具有四个丝线的可转向导液管,所述丝线在导液管的壁内行进。每个丝线在导液管的不同部分终止。丝线的近端从套管针松弛地延伸出从而可被医生拉动。医生能够通过选择性地拉紧丝线来使导液管成形并从而操纵该导液管。
与不可转向的柔性内窥镜或刚性内窥镜相比,可转向的内窥镜具有增大的运动范围,但是它们的运动范围通常仍受限。此外,这些设备难以使用,如Boury等的专利内那样单独拉动每个丝线,并且如在旋钮和滑轮机构的情况下,需要大量训练来熟练操纵设备通过患者的身体。另外,可转向的内窥镜的维护成本较高。因此,提供一种更易于使用、更加成本高效的系统以改进传统柔性内窥镜的转向、导行、引导和操纵。
发明内容
本发明提供了一种护套,该护套可接纳柔性器械例如柔性内窥镜、吸引管、冲洗管和具有柔性轴的工具例如内窥检查工具(即适于输送通过内窥镜的工作通道的工具)、激光和能量源,并且可使该器械沿一定路线通过护套从而器械的一部分可延伸到或越过护套的远端。护套可被从其近端手动操纵以远程转向、引导、操纵和/或指引护套远端处的插入管。
在本发明的一个变型中,提供了一种具有细长轴和近端区段与远端区段的护套,所述区段具有多对链节,其中一对链节中的一个部件位于该近端区段上而该对链节中的另一个位于远端区段上。护套还包括至少部分地延伸通过该轴并且开口通向该轴的远端区段的管腔。与管腔连通的入口位于护套的近端和远端区段之间。入口和轴管腔允许内窥镜的插入管通过该轴延伸到护套的远端。护套还包括使至少一个分离对的链节中的链节相互连接的一组或多组缆索,从而连接对中的一个链节的运动(移动)会导致该对的另一个链节进行相应的相关运动(relative movement)。在另外的变型中,包括多组缆索,其中每组缆索连接分离对的链节。近端区段的运动导致远端区段进行相应的运动。
可使用宽范围的链节系统来形成护套的近端和远端区段。在本发明的一个变型中,提供其中链节形成柔性节段的链节系统。柔性节段包括至少一个链节和至少一个柔性铰链的组合件,并且相邻的柔性节段通过柔性铰链相接合。成对的柔性节段形成近端和远端区段。缆索使至少一个分离对的柔性节段相互连接,从而该连接对的一个柔性节段的运动会导致该对的另一个柔性节段进行相应的相关运动。
本发明还提供了通过在预期位置引入护套并使内窥镜通过入口并前进到护套内来将例如柔性内窥镜引入患者身体的方法。在一些变型中,可通过使用套管针来进行护套的引入。
附图说明
图1是位于铰接位置的根据本发明一个实施例的护套的透视图,其中柔性内窥镜穿过该护套;
图2是图1的护套的侧视图;
图2A和2B分别是被指定为2A和2B的图2的护套的远端区段和近端区段的放大视图;
图3A-3C分别示出形成图2A的远端区段的一部分的柔性节段的透视图、侧视图和端视图;
图4示出图1的护套和内窥镜的俯视图,其中部分断开并且护套处于未铰接位置;
图5示出图1的护套和内窥镜的俯视图,其中部分断开并且护套处于铰接位置;
图6是图2的护套的俯视图;
图7是沿由线7-7指定的平面截取的图6的护套的横截面视图;
图8是指定为8的图7的护套的一部分的放大横截面视图,其中更详细地示出护套的远端区段部分;
图9是指定为9的图7的护套的一部分的放大横截面视图,其中更详细地示出护套的手柄部的一部分;
图10是图2的护套的手柄部的分解透视图;以及
图11A和11B分别是设置在图10的手柄部内的缆索引导件的侧视图和透视图。
具体实施方式
如前文所述的,根据本发明的护套构型成接纳柔性器械并使之穿过该护套,从而器械的尖端可从护套的远端显露出来。护套的近端区段和远端区段适合于使得近端区段的运动或铰接产生对应的远端区段的运动或铰接。仅为了说明,下文将针对这种护套与柔性内窥镜的共同使用来说明这种护套,但应当理解,该护套可用于多种柔性器械。通常对于与柔性内窥镜的共同使用,护套被插入患者身体的期望部位,并且将柔性内窥镜引入护套。或者,可首先将内窥镜引入护套并使它们一起向前。受近端区段控制的护套远端区段的移动使内窥镜插入管的尖端移动,从而移动内窥镜的尖端。因此,可通过近端区段的简单操作容易地转向、操纵和引导内窥镜,大大简化了标准柔性内窥镜的导行,并当内窥镜用于例如患者身体内时,不管是传统内窥镜应用还是腹腔镜应用均允许容易且增强的可操纵性。
护套通常包括将近端区段和远端区段分开的细长轴。该轴对于腹腔镜应用可比较硬或刚性,而对于内窥镜应用则可比较柔性。近端和远端区段通常具有许多对链节,一对链节中的一个位于近端区段而该对中的另一个位于远端区段。文中使用的术语“链节”是指在护套一端的分离部分或限定区域,其与在护套的相对端的另一个分离部分或限定区域相对应。链节通常但并不必须是柱形的,并且通常在未铰接的状况下沿轴向相互对齐。在任何情况下,护套将包含多个作为分离对的部件的链节或节段,并且每对中的一个链节位于近端区段而另一个链节或节段位于远端区段。成套的连接缆索使分离对的链节相互连接,从而一对中的一个链节的运动会使得该对中的另一个链节或节段进行相应的运动。多种链接系统和连接缆索适合于形成护套的近端和远端区段,它们包括但不局限于申请人的下列未决申请中所述的系统:2003年5月23日提交的美国申请No.10/444769、2004年8月26日提交的美国申请No.10/928479、2004年9月24日提交的美国申请No.10/948911以及2004年11月23日提交的标题为“ArticulatingMechanisms and Link Systems With Torque Transmission In RemoteManipulation of Instruments and Tools”的美国申请,这些专利申请全文结合在此以作参考。文中使用术语“活动链节”或“活动链节对”是指通过缆索组直接相互连接的链节。术语“间隔链节”或“间隔链节对”是指没有通过缆索组直接连接的链节。然而,间隔链节可设置在活动链节之间并且为连接活动链节的缆索组提供通路。独立操纵各个链节的能力使得近端和远端区段能容易地形成复杂的三维构型和几何形状,以便容易地引导和导行内窥镜插入管。
在本发明的一些变型中,护套的远端和近端区段将包括多对柔性节段,例如本申请人2004年9月24日提交的未决的美国申请No.10/948911内所述的节段。这种柔性节段通常包括一个或通过弯曲或挠曲的柔性铰链连接的多个相邻链节。具有单自由度的能够在二维空间内运动的柔性节段可具有连接两个链节的单个柔性铰链。或者,两个或多个柔性铰链可连接两个链节,其中铰链并行排列。具有二自由度的能够在三维空间内运动的柔性节段可具有连接到三个链节的相互成锐角地定向的两个柔性铰链。为了实现最大的三维运动范围,该角度可以是直角。柔性节段对是指位于护套的一个端部区段的柔性节段以及位于护套的另一端部区段的对应柔性节段。为了在三维空间内实现最大的运动自由度,护套的至少一个柔性铰链被定向成垂直于机构的至少一个其它铰链。但是,本发明还可设计成其中柔性铰链平行地定向或者以任何锐角偏离的构型。如文中使用的,术语“活动柔性节段”或“活动柔性节段对”是指通过缆索组直接相互连接的柔性节段。术语“间隔柔性节段”或“间隔柔性节段对”是指没有通过缆索组直接连接的柔性节段。然而,间隔柔性节段可设置在活动柔性节段之间并且为连接活动柔性节段的缆索组提供通路。
图1示出根据本发明的护套的一个实施例,其中内窥镜穿过该护套。护套100包括细长轴150、手柄170、近端区段125和远端区段126。内窥镜10包括摄像机/视频耦合器16、用于进入内窥镜的工作通道的端口14以及从内窥镜的体部15延伸出的插入管12。入口172从手柄170延伸出,并接纳内窥镜10的插入管12。插入管穿过入口172和轴150,其中该插入管12的尖端从护套的远端区段126伸出。如图1所示,护套100示出处于铰接位置,其中与近端区段对应的远端区段处于铰接位置。图2示出处于直线的、未铰接构型的护套。
图2A和2B更详细地示出近端和远端区段125和126。近端和远端区段125和126由多个柔性节段形成。柔性节段111和112、113和114、115和116、117和118、119和120以及121和122分别为分离对的部件,并且一对中的一个柔性节段(111、113、115、117、119或121)位于近端区段125,而另一个柔性节段(112、114、116、118、120或122)位于远端区段126。如图所示,近端区段125处的柔性节段111由通过相互垂直地定向的柔性铰链107和109连接的链节101、103和105形成。缆索通道位于且穿过每个链节的周缘以便承受缆索组的通过和连接。远端区段柔性节段还包括中央通道128,该通道穿过远端区段的柔性节段的纵向轴线延伸以适于内窥镜通过,下面将进一步详细说明。图3A-3C更详细地示出柔性节段112,并且更清楚地示出柔性节段的中央通道128和缆索通道129。远端区段126处的成对的柔性节段112类似地由通过相互垂直地定向的柔性铰链108和110连接的链节102、104和106形成,并且同样包括类似的缆索通道,并且还可包括中央通道。近端区段的其它柔性节段(113、115、117、119和121)和远端区段的其它柔性节段(114、116、118、120和122)具有相同的构型,并且一个节段的最后一个链节还用作下一个节段的第一个链节。如图所示,每个柔性铰链均定向为垂直于相邻的铰链。如前文指出的,这种构型的柔性节段以二自由度运动,并且可在三维空间内运动。近端柔性节段(111、117、119和121)分别通过缆索组131、137、139和141连接到远端柔性节段(112、118、120和122)。从而这些柔性节段对是活动节段。柔性节段113和114以及115和116没有通过缆索组直接连接,从而用作间隔节段。所示的活动节段和间隔节段的构型仅用于说明,并且应理解,这些设置和组合可根据应用改变。
护套近端区段处的每个活动柔性节段通过至少一个并且优选两个或更多缆索连接到其对应的在远端区段处的活动柔性节段。每个缆索组可由至少一个并且优选地为两个或多个缆索构成。如指出的,一个活动柔性节段对的运动由其对应的缆索组控制并且独立于任何其它柔性节段对。在一些变型中,例如,缆索组将包括相互隔开120度的三个缆索。通过使用一组三个缆索来连接具有垂直于至少一个其它柔性铰链的至少一个柔性铰链的活动柔性节段,每个活动柔性节段对可独立于任何其它活动对被以三自由度操纵或移动。这些三自由度包括上下运动、左右运动和旋转或“转动”运动(不管柔性节段是直的还是弯曲的构型)。通过组合多个活动柔性节段,可实现多自由度,从而允许护套的近端和远端区段形成各种复杂构型。
在近端和远端区段125和126使用柔性节段具有一些优点。一个优点是柔性节段提供的灵活性。为了获得更大的灵活性,可使用在链节之间结合两个柔性铰链的柔性节段,例如申请人在2004年9月24提交的未决美国申请No.10/948911内所述的柔性节段,该申请全文结合在此以作参考。另一优点是易于制造和组装,因为近端和远端区段可作为具有通过柔性铰链连接的多个链节的连续件被制造。再一优点是沿护套传递力矩的能力增加。但是,在本发明的护套中也可使用其它传递力矩的链节系统,包括但不局限于如申请人在2004年11月23日提交的标题为“ArticulatingMechanisms and Link Systems With Torque Transmission In RemoteManipulation of Instruments and Tools”的未决美国申请中所述的链节系统,该申请全文结合在此以作参考。
护套的变型还可包括可包含用于接纳锁杆的通道的近端区段链节或节段,该锁杆用于将护套的近端固定并保持在固定位置。除了锁杆之外,可将锁紧套管装在护套的近端上以将该近端固定并保持在固定位置。在一旦通过使用护套将内窥镜指引到位置就希望将内窥镜保持在固定位置的情况下,这是有利的。其它用于将护套锁定在固定、铰接位置的机构包括但不局限于2004年8月26日提交的美国申请No.10/928479内所述的机构,该申请全文结合在此以作参考。
图4和5还更详细地示出护套100,其中近端和远端处于直的、未铰接的构型(图4)或处于弯曲的、铰接的构型(图5)。如图可见,远端区段进行与近端区段对应的、互逆的运动。此外,远端区段的弯曲或挠曲程度成比例地大于近端区段。运动的成比例缩放可通过增加或减小在近端或远端的链节或柔性节段内的缆索通道图案半径来实现,申请人的未决美国申请No.10/948911对此进行了进一步说明,该申请全文结合在此以作参考。如图4和5可见,缆索距近端区段的节段的中心轴线的径向距离大于在远端区段的径向距离。结果,身体的小的、受控的向外运动使得在远端区段进行更大程度的运动,这在身体内引导和操纵被保持的内窥镜时是有利的。
在护套100的近端和远端区段,存在柔性节段的一对一的或对称的对应。这并不必总是如此,而是可存在希望护套在近端和远端区段具有链节或柔性节段的不对称设置的应用。例如,可向近端或远端区段添加额外的间隔链节或柔性节段,这是为近端或远端区段提供附加长度所希望的。另外,在近端或远端区段包含额外(或者较大相对数)的间隔链节或柔性节段允许对应的另一区段的运动或动作成比例缩放。例如,在近端区段包含额外的间隔链节或柔性节段(或较大相对数的间隔链节或柔性节段)则需要用户在近端区段进行过大的运动以在远端区段实现预期的运动。这在希望精细、细致地控制运动的情况下,例如在用户不具有在缺少这种远端区段运动或动作的成比例缩放时执行希望的过程所必需的灵巧性的情况下是有利的。或者,可在远端区段设置额外的间隔链节或柔性节段(或较大相对数的间隔链节或柔性节段),在此情况下远端区段的运动程度将成比例地大于近端区段,这也是特定应用所希望的。间隔链节或柔性节段通常无约束,即,当护套的远端区段包含各个间隔链节或间隔柔性节段时,该远端区段将不能抵抗由于横向施加的力导致的移动(与活动链节或柔性节段相反,其被限制成抵抗由于横向施加的力导致的移动)。因此,设置间隔链节或柔性节段会降低在包含这种间隔链节或柔性节段的那些区域的近端或远端区段的刚性,这是在通过或在敏感或脆弱的解剖结构附近引导护套时所希望的。
如图4和5可见,得到的远端区段126的定向运动相对于近端区段125反向。在其它变型中,可通过在缆索组通过护套时将缆索组扭动或转动180度来实现镜像的运动。可通过将缆索扭动或转动0-360度之间的任何量来实现运动上的其它改变。
现在转到图6-9,可以看出,轴150包括用于确定接纳的内窥镜的路线的通路。如图9更具体地示出的,手柄170包含与轴管152的内腔连通的端口172。轴管152从入口延伸进入手柄170并通过轴150直至在该轴的远端终止,在该处该轴管紧靠并固定在柔性节段122的链节106上,这在图8中更清楚地示出。或者,链节106可包括埋头孔以接纳轴管152。连接近端和远端区段125和126的柔性节段的包括缆索131的连接缆索从近端区段125进入手柄,其中缆索在管腔151内环绕轴管152、通过导架160然后通过轴150延伸,该管腔由轴150的内壁和轴管152的外壁之间的空间形成。导架160安置在手柄170内以在轴管152进入轴时给轴管定中心和定向,以及在缆索环绕轴管并进入轴的内腔151时给缆索定向。在远端区段,链节106连接并固定在轴150和轴管152上。柔性管156延伸通过远端区段126的柔性节段的中央通道并紧靠轴管154,从而柔性管的管腔158和轴管的管腔154形成用于使柔性内窥镜的插入管通过的连续管腔,该连续管腔从入口172延伸通过手柄170、轴150和远端区段126并且在远端区段的远端开口。柔性管156固定在轴管152和/或链节106上,并且尺寸形成为滑动配合在远端区段的柔性节段的中央通道128(见图3C)内,从而当远端区段弯曲时,形成远端区段的柔性节段的链节可相对于柔性管移动。
轴管152在从入口172和手柄170延伸通过轴150时可具有可变的柔性或硬度。在一些变型中,轴管的从入口172延伸通过手柄的部分将比较刚性以在内窥镜插入管从入口进入轴时帮助引导该插入管通过最初的弯曲路径。当轴管延伸通过轴时,该轴管的相对柔性或硬度可随轴的柔性或硬度而变化。在一些情况中,希望轴比较硬,这本质上是向另外通过护套设置的柔性内窥镜提供刚性。这例如在腹腔镜检查术中是有利的,在该检查术中使用具有刚性轴的护套将实质上将柔性内窥镜转变成刚性内窥镜。在其中轴是柔性的变型中,作为使缆索通过公共管腔151的替换方案,设置单独的管腔以通过轴传送缆索也是有利的。这种构型可帮助实现可能由轴的弯曲导致的缆索的局部移动和展开。另一方面,不管轴的柔性如何,柔性管156都需要保持足够的柔性,以便不会限制远端区段126的运动和铰接。在其中远端区段使用具有完全封闭的中央通道的链接系统的变型中柔性管156并不是必需的。应理解,轴长度本身可根据应用改变。在一些变型中,轴本身可由链节或柔性节段形成。
图10更详细地示出手柄组件。手柄170由通过螺钉175紧固在一起的手柄体部174和手柄板176形成。手柄体部174在近端包含开口177。近端区段125的柔性节段121连接在开口177处。手柄体部174的远端处的开口178具有类似的构造以便接纳和连接轴150(见图9)。手柄体部174还包括导向槽186和184(见图9),而手柄板176包括接纳并固定导架160的臂的导向槽182。图11A和11B内更详细地示出导架160。导架160包括中心环162,该中心环具有分别从中心环延伸出的水平臂和垂直臂164和166。臂164和166固定在导槽184、182和186内。轴管152被接纳通过导架160的中心环162以被支持和定向通过轴150。在轴管152通过导架的中心环就位的情况下,凹槽168与管152的外壁一起形成在连接缆索进入管腔151时引导和定向连接缆索的单个的导向通道。或者,可将这种导向通道一体形成在手柄170的远端的面179内。在此情况中,也可在该面内设置定中心通道以定向轴管152。
应理解,尽管设置手柄172和入口172会增加一定程度的方便性,但是这并不是必须的。根据本发明的护套的替代变型方案,远端区段可直接连接到轴上,并且入口从轴本身延伸出。在其它变型中,入口不需要从轴延伸出,而是可简单地为与轴表面平齐的通向轴管管腔的开口。
与上述考虑一致,根据目的的不同,护套还可以为任何大小和形状。链节通常但不是必须地为柱形,并且如前文所述地包括用于使连接柔性节段对的缆索通过的通道以及用于被接纳的内窥镜的通道。根据应用,链节和轴的尺寸可设计成容纳用于接纳通过同一护套的多个器械的多个管。缆索通道的直径通常稍大于缆索的直径,从而形成滑动配合。对于典型的内窥镜,链节的代表性直径对于小型内窥镜在约1mm到约3mm的范围内,对于中等尺寸的内窥镜在约4mm到约8mm的范围内,而对于大型内窥镜在约9mm到约15mm的范围内。链节的总长度通常可根据链节之间的预期弯曲半径而变化。缆索直径还可根据应用改变。对于典型的内窥镜应用,代表性直径可在约0.1mm到约3mm的范围内。
护套可由现有技术已知的多种材料形成并且可根据应用改变。为了易于制造,可使用可注射成型的聚合物,例如聚乙烯或其共聚物、聚对苯二甲酸乙二醇酯或其共聚物、尼龙、聚硅氧烷、聚氨酯、含氟聚合物、聚乙烯(乙烯基氯)以及它们的组合,或者现有技术已知的其它适当材料。另外,对于刚性管或轴可使用不锈钢。
对于一些应用,如果希望有助于护套前进则可在护套上设置光滑的涂层。光滑涂层可包括亲水聚合物例如聚乙烯吡咯烷酮、含氟聚合物例如四氟乙烯或聚硅氧烷。护套的远端区段上可包含不透射线的标记以在射线照相成像时指示护套的位置。通常,可通过荧光检查来检测该标记。
缆索柔性例如可通过缆索材料的类型和织法或通过物理或化学处理来改变。通常,可根据护套的预期应用的要求来改变缆索硬度或柔性。缆索可以是由下列材料制成的单股或多股丝线,该材料包括但不局限于生物适应性材料例如镍钛合金、不锈钢或任何其合金、超弹性合金、碳纤维、聚合物例如聚乙烯(乙烯基氯)、聚氧化乙烯、聚对苯二甲酸乙二醇酯和其它聚酯、聚烯烃、聚丙烯以及它们的共聚物,尼龙,丝和它们的组合,或者现有技术已知的其它合适材料。
缆索可根据现有技术已知的方式例如使用粘合剂或通过钎焊、软钎焊、焊接等固定在活动对的链节或柔性节段上,所述方式包括申请人的未决专利申请No.10/444769、No.10/928479和No.10/948911内所述的方式,该专利申请全文结合在此以作参考。
尽管附图中示出的许多护套具有一定数量的柔性节段和柔性节段对,但是这仅用于说明目的。根据诸如预期应用和希望的护套长度的因素,可使用任意数量的链节和链节对或柔性节段和柔性节段对。
文中引用的所有公告、专利和专利申请全文结合在此以作参考,这在作用上与每个公告、专利或专利申请均被特别和单独指明以这样并入作为参考文献相同。尽管为了清楚地理解较详细地说明了作为例证和示例的前面的发明,但是本领域普通技术人员根据本发明的教导可容易地看到,可对其进行改变和修改而不会背离所附权利要求的精神和范围。
Claims (16)
1.一种用于柔性器械的输送和导向的护套,该护套包括:
细长的轴;
具有多对链节的近端区段和远端区段,每对链节中的每个链节保持与该对链节中的另一链节相互间隔开;
一组或多组缆索,每组缆索使分离的链节对的链节相连,从而一对链节中一个链节的运动会导致该对链节中另一个链节进行相应的相关运动;
至少部分地延伸通过该轴并开口通向该远端区段的远端的管腔;以及
位于近端区段和远端区段之间的入口,该入口与该管腔连通,该管腔和入口构造成接纳柔性器械并使柔性器械通过。
2.根据权利要求1的护套,其特征在于,所述两个或多个相邻的链节通过柔性铰链相接合。
3.根据权利要求2的护套,其特征在于,至少一个柔性铰链定向成垂直于该轴的纵向轴线。
4.根据权利要求2的护套,其特征在于,至少一个柔性铰链定向成与至少一个其它柔性铰链成锐角。
5.根据权利要求2的护套,其特征在于,至少一个柔性铰链定向成垂直于至少一个其它柔性铰链。
6.根据权利要求2的护套,其特征在于,柔性铰链定向成相互平行。
7.根据权利要求1的护套,其特征在于,该近端区段的运动导致远端区段进行相应的相关运动。
8.根据权利要求7的护套,其特征在于,所述远端区段的相应的相关运动与该近端区段的运动互逆。
9.根据权利要求7的护套,其特征在于,所述远端区段的相应的相关运动镜像该近端区段的运动。
10.根据权利要求1的护套,其特征在于,成对的链节包括用于接纳与相邻的成对链节相关联的缆索组并使该缆索组通过的通道。
11.根据权利要求1的护套,其特征在于,该护套还包括没有通过分离的缆索组连接的一个或多个额外链节。
12.根据权利要求1的护套,其特征在于,连接一对链节的缆索距离该对中的第一链节的中心的径向距离与距该对中的第二链节的中心的径向距离不同。
13.根据权利要求1的护套,其特征在于,该护套还包括用于将近端区段和远端区段锁定在固定位置的锁定机构。
14.一种用于将柔性内窥镜引入患者身体内的预期位置的方法,该方法包括以下步骤:
使根据权利要求1的护套前进到患者身体内的预期位置;以及
使柔性内窥镜通过该护套前进。
15.根据权利要求14的方法,其特征在于,该方法还包括操纵护套的近端区段以推进内窥镜的移动的步骤。
16.一种用于执行内窥镜检查的系统,该系统包括:
根据权利要求1的护套;以及
通过该护套的管腔接纳的内窥镜,该内窥镜的远端从该护套的远端区段延伸出。
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2004
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- 2005-09-15 JP JP2007543031A patent/JP5007374B2/ja active Active
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN110177594A (zh) * | 2016-11-22 | 2019-08-27 | 波士顿科学国际有限公司 | 抗压缩和/或拉伸的医疗装置轴 |
CN110730628A (zh) * | 2017-03-30 | 2020-01-24 | 施菲姆德控股有限责任公司 | 医疗工具定位装置、系统及使用和制造方法 |
CN110730628B (zh) * | 2017-03-30 | 2022-05-13 | 纽维拉医疗公司 | 医疗工具定位装置、系统及使用和制造方法 |
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DE602005022351D1 (de) | 2010-08-26 |
US8277375B2 (en) | 2012-10-02 |
EP1833356B1 (en) | 2010-07-14 |
WO2006057700A1 (en) | 2006-06-01 |
JP2008520341A (ja) | 2008-06-19 |
US20060111615A1 (en) | 2006-05-25 |
US20120323070A1 (en) | 2012-12-20 |
JP5007374B2 (ja) | 2012-08-22 |
ATE473675T1 (de) | 2010-07-15 |
CN101102713B (zh) | 2010-08-11 |
EP1833356A1 (en) | 2007-09-19 |
EP2335558A1 (en) | 2011-06-22 |
US7785252B2 (en) | 2010-08-31 |
US20110087071A1 (en) | 2011-04-14 |
US9155449B2 (en) | 2015-10-13 |
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