CN101507626A - 带用户反馈件的一次性装载单元及使用该单元的外科器械 - Google Patents
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Abstract
本发明公开了一种用于可操作地连接到外科缝合设备的一次性装载单元，更具体地公开了带用户反馈件的一次性装载单元及使用该单元的外科器械。所述一次性装载单元具有已用钉仓指示系统，用于提供装载单元之前是否被击发的指示。还公开了其他实施方式，其利用刀刃监视系统，用于向用户提供有关在切割和缝合过程中刀刃所承受的应变量的反馈。
Description
共同拥有的专利申请
Steven G.Hall等人的与此同日申请的、代理卷号为No.END6216USNP/070333、题为“Disposable Loading Unit With FiringIndicator”的美国专利申请的公开内容被引用于此作为参考。
技术领域
本发明总体上涉及内窥镜外科器械，包括但不限于具有一次性装载单元的外科缝合器械，其能够将缝钉线施加到组织，同时切割在那些缝钉线之间的组织，更具体地说，涉及关于这样的一次性装载单元的改进。
背景技术
内窥镜外科器械通常比传统的开放式外科装置更受到偏爱，这是因为较小的切口易于减少术后恢复时间和并发症。因此，在内窥镜外科器械的领域中已经有了显著发展，该内窥镜外科器械适合于将远端执行器通过套管针的套管精确地放置在所需的手术部位。这些远端执行器以多种方式接合组织以实现诊断或治疗作用(例如，内镜切割器、抓钳、切割器、缝合器、夹具施放器、接触装置、药物/基因治疗输送装置和使用超声波、RF、激光等的能量装置等)。
已知的外科缝合器包括端部执行器，所述端部执行器同时在组织中制造纵向切口和在所述切口的相对侧施加缝钉线。端部执行器包括一对协同操作的钳口构件，如果该器械被指定应用于内窥镜或腹腔镜，所述钳口构件能够穿过套管通道。钳口构件中的一个支撑钉仓，所述钉仓具有至少两个横向间隔的缝钉排。另一个钳口构件限定钉砧，所述钉砧具有与钉仓中的缝钉排对准的缝钉成形槽。该器械通常包括多个往复楔形件，当朝远侧驱动所述往复楔形件时，其穿过钉仓中的开口并且接合支撑缝钉的驱动器以实现缝钉朝着钉砧的击发。
一种类型的外科缝合器械被构造成用一次性装载单元(DLU)操作，所述一次性装载单元被构造成在其中支撑钉仓和刀组件。一旦该程序完成，整个DLU被丢弃。被设计成容纳DLU的这样的器械意在提供的优点在于，器械的每次击发提供“新的”刀刃。这样的外科缝合设备和DLU的例子在Milliman等人的美国专利No.5,865,361中被公开，上述专利的公开内容全文被引用于此作为参考。
一些现有的一次性装载单元在支撑钉仓的承载器通道的底部具有槽。支撑刀刃的驱动梁的一部分通过所述槽伸出并且支撑支脚或构件连接到其上。有编号的线被印刷在承载器的底部上，从而当刀刃被驱动通过钉仓时允许临床医生确认刀刃的进度。尽管这样的布置允许临床医生监视击发进度，但它需要临床医生在操作期间总是能够观察承载器通道的底部。然而，由于这样的单元能够旋转，该单元常常会以阻止观察承载器的底部的方式被定向，从而使这样的系统无用。
而且，现有的外科缝合设备，例如在美国专利No.5,865,361中公开的那些和其他设备，缺少允许外科医生快速确认一次性装载单元先前是否被用过的机构。这样的现有外科缝合设备也缺少用于确定手柄组件被用过多少次的机构。那些现有设备也缺少用于监视在击发过程中生成的击发力的大小的机构。
发明内容
因此，需要一种外科缝合设备，其被构造成与一次性装载单元一起使用，并且也具有用于与所述单元的位置无关地监视一次性装载单元的击发进度的机构。
也需要一种一次性装载单元，其配备有用于确定一次性装载单元是否曾经被击发的机构。
还需要一种利用一次性装载单元的外科缝合设备，所述一次性装载单元具有用于指示外科缝合设备已被击发的次数的机构。
还需要一种外科缝合设备，其具有用于指示在器械的击发期间刀刃所承受的应力大小的机构。
在本发明的各种实施方式的一个总的方面，提供了一种用于连接到外科缝合设备的一次性装载单元。在各种实施方式中，所述一次性装载单元可以包括具有承载器的工具组件，该承载器具有可活动地连接到其上的钉砧组件，该钉砧组件用于相对于承载器在打开位置和闭合位置之间可选择性活动地行进。钉仓支撑在承载器中并且可操作地在其中支撑多个缝钉。致动器构件可活动地支撑在所述工具组件中，并且被构造成当其在所述工具组件中被从起始位置驱动到终止位置时将所述多个缝钉驱动到所述钉仓外。工具组件还包括具有远端部分的轴向驱动组件，所述远端部分被构造成响应从所述外科缝合设备施加到所述轴向驱动组件的驱动运动而运动通过所述工具组件并将所述致动器构件从所述起始位置驱动到所述终止位置。工具组件还可以包括已用钉仓指示系统，其可操作地支撑在所述工具组件中并且与所述致动器构件协作以在至少一些所述缝钉已被驱动到所述钉仓外时提供指示。
在本发明的各种实施方式的又一个总的方面中，提供了一种用于连接到外科缝合设备的一次性装载单元。在各种实施方式中，该一次性装载单元包括承载器，该承载器具有连接到其上的外壳，所述外壳被构造用于可操作地连接到所述外科缝合设备。钉仓可以支撑在所述承载器中，钉砧组件可活动地连接到所述承载器，用于相对于所述钉仓在打开位置和闭合位置之间能够选择性地活动行进。一次性装载单元还可以包括具有支撑刀刃的远端部分的轴向驱动组件，所述远端部分被构造成响应从所述外科缝合设备施加到所述轴向驱动组件的驱动运动沿着远侧方向运动通过所述钉仓。刀刃监视系统可操作地与所述轴向驱动组件相关联并且被构造用于向所述外科器械传输有关所述刀刃所承受的应变的数据，所述一次性装载单元连接在所述外科器械上。
在本发明的各种实施方式的另一个总的方面中，提供了一种外科切割和缝合设备，其可以包括手柄组件，该手柄组件具有可操作地支撑在其中用于选择性地产生驱动运动的驱动系统。处理器可操作地支撑在所述手柄组件中。细长主体可以从所述手柄组件伸出并且被构造用于向连接在其上的一次性装载单元传递所述驱动运动。细长主体还可以被构造成从所述一次性装载单元向所述处理器传输有关在所述一次性装载单元中的刀刃上的应变的应变数据。
本发明具体公开了如下内容：
(1).一种用于连接到外科缝合设备的一次性装载单元，所述一次性装载单元包括：
工具组件，包括：
承载器；
钉砧组件，其可活动地连接到所述承载器，用于相对于所述承载器在打开位置和闭合位置之间能够选择性地活动行进；
支撑在所述承载器中的钉仓，所述钉仓可操作地支撑位于其中的多个缝钉；和
可活动地支撑在所述工具组件中的致动器构件，所述致动器构件被构造成当其在所述工具组件中被从起始位置驱动到终止位置时将所述多个缝钉驱动到所述钉仓外；
具有远端部分的轴向驱动组件，所述远端部分被构造成响应从所述外科缝合设备施加到所述轴向驱动组件的驱动运动而运动通过所述工具组件并将所述致动器构件从所述起始位置驱动到所述终止位置；以及
已用钉仓指示系统，其可操作地支撑在所述工具组件中并且与所述致动器构件协作以在至少一些所述缝钉已被驱动到所述钉仓外时提供指示。
(2).根据第(1)项所述的一次性装载单元，其中，所述已用钉仓指示系统包括指示器销，所述指示器销支撑在所述钉仓的远端中并且能够响应所述致动构件的运动从第一未击发位置运动到击发位置。
(3).根据第(2)项所述的一次性装载单元，其中，所述指示器销可活动地支撑在所述钉仓的所述远端的孔内，并且当所述指示器销处于所述第一未击发位置时，所述指示器销不伸到所述孔之外，当至少一些所述缝钉已被驱动到所述钉仓外时，所述指示器销的至少一部分从所述孔伸出。
(4).根据第(3)项所述的一次性装载单元，其中，所述指示器销被构造成当所述致动器构件到达所述终止位置时，所述指示器销被锁定在伸出位置。
(5).根据第(1)项所述的一次性装载单元，还包括：
指示器基部，其响应所述致动器构件的运动在预击发位置和击发位置之间可活动地支撑在所述工具组件中；和
指示器销，其形成在所述指示器基部的远端上并且容纳在所述钉仓的远端中的孔内，使得当所述指示器基部运动到所述击发位置时，所述指示器销的至少一部分从所述钉仓的所述远端伸出。
(6).根据第(5)项所述的一次性装载单元，其中，所述指示器销被构造成当所述指示器基部运动到所述击发位置时，所述指示器销被保持在相对于所述钉仓的所述远端的所述伸出位置。
(7).根据第(6)项所述的一次性装载单元，其中，所述指示器销具有形成在其上的锥形锁定部分，该锥形锁定部分被构造成当所述指示器基部运动到所述击发位置时锁定地位于所述钉仓的所述远端中的所述孔的一部分内。
(8).根据第(5)项所述的一次性装载单元，还包括在所述致动器构件上的至少一个剪式止动部，所述剪式止动部被构造用于在所述致动器构件被从所述起始位置驱动到所述终止位置时与所述指示器基部驱动接合以向所述指示器基部施加驱动运动，由此将所述指示器基部从所述预击发位置驱动到所述击发位置，所述剪式止动部还被构造成允许所述致动器构件在所述指示器基部已被驱动到所述击发位置之后相对于所述指示器基部运动。
(9).根据第(1)项所述的一次性装载单元，还包括用于测量所述轴向驱动组件的刀刃部分的伸长度的机构。
(10).根据第(1)项所述的一次性装载单元，还包括用于确定在所述轴向驱动组件的远端运动通过所述工具组件时所述轴向驱动组件的所述远端的位置的机构。
(11).一种用于处理外科器械的方法，所述方法包括：
获得如第(1)项所述的一次性装载单元；
对所述一次性装载单元进行消毒；并且
将所述一次性装载单元存储在消毒容器内。
(12).一种与外科缝合设备一起使用的一次性装载单元，所述一次性装载单元包括：
承载器；
外壳，所述外壳连接到所述承载器并且被构造用于可操作地连接到所述外科缝合设备；
支撑在所述承载器中的钉仓；
钉砧组件，其可活动地连接到所述承载器，用于相对于所述钉仓在打开位置和闭合位置之间能够选择性地活动行进；
具有支撑刀刃的远端部分的轴向驱动组件，所述远端部分被构造成响应从所述外科缝合设备施加到所述轴向驱动组件的驱动运动沿着远侧方向运动通过所述钉仓；和
刀刃监视系统，其可操作地与所述轴向驱动组件相关联并且被构造用于向所述外科器械传输有关所述刀刃所承受的应变的数据，所述一次性装载单元连接在所述外科器械上。
(13).根据第(12)项所述的一次性装载单元，其中，所述刀刃监视系统包括安装到所述轴向驱动组件的支撑所述刀刃的一部分上的应变计。
(14).根据第(13)项所述的一次性装载单元，还包括一对应变计引线，该对应变计引线从所述应变计延伸并且安装在所述轴向驱动组件上，用于与所述外科器械中的对应的引线滑动电接触。
(15).一种外科切割和缝合设备，包括：
手柄组件；
驱动系统，其支撑在所述手柄组件中用于选择性地产生驱动运动；
处理器，其可操作地支撑在所述手柄组件中；和
从所述手柄组件伸出的细长主体，其被构造用于向连接在其上的一次性装载单元传递所述驱动运动并且从所述一次性装载单元向所述处理器传输有关在所述一次性装载单元中的刀刃上的应变的应变数据。
(16).根据第(15)项所述的外科切割和缝合设备，还包括连接到所述处理器上用于显示从所述一次性装载单元接收到的所述应变数据的显示器。
(17).根据第(15)项所述的外科切割和缝合设备，还包括振动器，其安装到所述手柄组件并且与所述处理器通信，使得所述处理器响应从所述一次性装载单元接收到的所述应变数据致动所述振动器。
(18).根据第(15)项所述的外科切割和缝合设备，其中，所述一次性装载单元包括应变计，所述应变计安装在可操作地支撑在所述一次性装载单元中的轴向驱动组件的一部分上。
(19).根据第(18)项所述的外科切割和缝合设备，还包括一对应变计引线，该对应变计引线连接到所述应变计并且安装在所述轴向驱动组件上，用于与所述细长主体中的对应的电引线选择性地电接触。
(20).根据第(19)项所述的外科切割和缝合设备，其中，所述对应的电引线支撑在数据传输主体中，所述数据传输主体由所述手柄组件可旋转地支撑。
(21).根据第(20)项所述的外科切割和缝合设备，其中，所述数据传输主体连接到可旋转地安装在所述手柄组件上的可旋转把手并且与所述处理器电通信。
附图说明
从附图及其描述将显而易见本发明的这些和其他目的和优点。
包含在该说明书中并且构成它的一部分的附图示出了本发明的实施方式，并且与上面给出的本发明的各种实施方式的总体描述以及下面给出的实施方式的详细描述一起用于解释本发明的各种原理。
图1是本发明的一次性装载单元的实施方式的透视图。
图2是图1的一次性装载单元的实施方式的一部分的放大透视图。
图3是沿着图1中的线3-3截取的图1和2中的一次性装载单元的实施方式的剖视图。
图3A是承载器的一部分和轴向驱动组件的剖视图。
图3B是图3A的承载器和轴向驱动组件的局部仰视图。
图4是图1-3的一次性装载单元的一部分的分解组装图。
图5是本发明的一次性装载单元的另一个实施方式的透视图。
图6是本发明的一次性装载单元的另一个实施方式的透视图。
图7是本发明的一次性装载单元的另一个实施方式的透视图。
图8是图7的一次性装载单元的实施方式的一部分的放大透视图。
图9是沿着图7中的线9-9截取的图7和8中的一次性装载单元的实施方式的剖视图。
图10是图7-9的实施方式的一次性装载单元的一部分的分解组装图。
图11是本发明的一次性装载单元的另一个实施方式的剖视图。
图12是本发明的另一个一次性装载单元的透视图，其中已用钉仓指示器销伸出。
图13是本发明实施方式的一次性装载单元的一部分的侧向剖视图，为了清楚起见一些部件在全视图中被显示，并且其中已用钉仓指示器销完全接收在钉仓的前端内。
图14是图13的一次性装载单元的所述部分的另一局部侧向剖视图，其中已用钉仓指示器销伸出。
图15是本发明的一次性装载单元的另一种实施方式的透视图。
图16是本发明实施方式的钉仓的一部分的仰视透视图。
图17是本发明的指示器底座的实施方式的局部透视图。
图18是本发明的致动滑车的实施方式的仰视透视图。
图19是本发明实施方式的一次性装载单元的一部分的侧向剖视图，为了清楚起见一些部件在全视图中被显示，并且其中一次性装载单元处于未击发位置。
图20是图19的一次性装载单元的外科钉仓的仰视平面图。
图21是本发明实施方式的一次性装载单元的一部分的侧向剖视图，为了清楚起见一些部件在全视图中被显示，并且钉砧处于闭合位置。
图22是图21的外科钉仓的仰视平面图。
图23是在击发冲程期间本发明实施方式的一次性装载单元的一部分的侧向剖视图，为了清楚起见一些部件在全视图中被显示。
图24是图23的外科钉仓的仰视平面图。
图25是图24的外科钉仓的仰视透视图，其中已用钉仓指示器销已伸出，指示一次性装载单元已被击发。
图26是本发明的外科缝合设备的实施方式的透视图。
图27是本发明的外科钉仓的实施方式的局部剖视图，为了清楚起见它的一些部件被省略。
图28是本发明的外科缝合设备的实施方式的手柄组件的内部的侧视图。
图29是图28的手柄组件的侧视图。
图30是本发明的外科缝合设备的实施方式的透视图。
图31是图30中所示的外科缝合设备的轴向驱动组件的实施方式的俯视图。
图32是图31的轴向驱动组件的侧视图。
图33是本发明的一次性装载单元的实施方式的轴向驱动组件的一部分和外壳的一部分的分解组装图。
图34是图33中所示的外壳的一部分的侧向正视图。
图35是本发明的实施方式的一次性装载单元的一部分、数据传输主体，以及可旋转把手的一部分的分解组装图，为了清楚起见显示了数据传输主体的两个取向。
图36是本发明的实施方式的手柄组件的一部分和可旋转把手的分解组装图。
具体实施方式
参见附图，其中在所有附图中相同的附图标记表示相同的部件，图1描绘了本发明的一次性装载单元16，其可以与例如在美国专利No.5,865,361中公开的外科缝合设备结合使用，上述专利的公开内容被引用于此作为参考。将会理解术语“近侧”和“远侧”用在这里时参照抓握外科缝合设备的手柄组件的临床医生，一次性装载单元16连接到所述手柄组件。因此，一次性装载单元16相对于更近侧的手柄组件在远侧。进一步将会理解，为了方便和清楚起见，空间术语例如“竖直”、“水平”、“上”、“下”、“右”和“左”用在这里时相对于附图。然而，外科器械可以在许多取向上和位置上被使用，并且这些术语并非意味着是限制性的和绝对的。
在图1中可以看到，一次性装载单元16通常可以包括工具组件17，其用于执行诸如切割组织和将缝钉施加到切口的每一侧的外科手术。工具组件17可以包括在其中容纳多个外科缝钉的钉仓组件18。工具组件17也可以包括具有钉砧部分204的缝钉成形钉砧组件20，所述钉砧部分204具有在它的下表面形成的多个缝钉变形凹部(未显示)。盖板208可以固定到钉砧部分204的顶面以在其间限定钉砧腔。钉砧腔的尺寸被确定成接收轴向驱动组件212的远端。轴向驱动组件212可以包括在美国专利No.5,865,361中描述的类型和构造的驱动梁266。纵向槽(未显示)可以延伸通过钉砧部分204以便于轴向驱动组件212的固定凸缘284进入钉砧腔。一对枢转构件211可以形成于钉砧部分204的近端上并且被构造成接收在槽213中，所述槽形成于承载器216中以允许钉砧部分204在打开位置和夹紧组织位置之间枢转。凸轮表面(未显示)可以形成于钉砧部分204的近端上并且被定位成接合轴向驱动组件212以便于钉砧组件20的闭合。
驱动梁266的远端可以包括用于支撑刀刃280的竖直撑杆278，和在缝合手术期间接合致动滑车234的中间部分的抵接表面283。刀刃280可以大体被定位成在致动滑车234后面稍稍平移通过钉仓220中的中间纵向槽，以在缝合身体组织的缝钉排之间形成切口。固定凸缘284可以从竖直撑杆278朝远侧突出并且在其远端支撑凸轮销286。凸轮销286的尺寸和构造可以被确定成接合钉砧部分204上的凸轮表面以抵靠身体组织夹紧钉砧部分204。另外，片簧(未显示)可以设在钉砧部分204的近端和外壳200的远端部分之间，以将钉砧组件20偏压到常开位置。一次性装载单元16还可以包括如美国专利No.5,865,361中所述的闭锁装置288。
一次性装载单元16还可以包括钉仓组件18。钉仓组件18通常可以包括承载器216，所述承载器的尺寸和结构被确定成在其中接收钉仓220。这样的钉仓220支撑多个紧固件(缝钉)和推动器，这在本领域中是已知的。钉仓220可以如美国专利No.5,865,316中所述被构造以容纳致动滑车的直立凸轮楔形件。中间纵向槽可以沿着钉仓220的长度延伸，以便于形成在轴向驱动组件212上的刀刃280通过。在一次性装载单元16的操作期间，致动滑车平移通过钉仓220的纵向槽，以将凸轮楔形件推进成与可操作地支撑在钉仓220中的推动器顺序接触，从而导致推动器在钉仓220内竖直地平移并且将与推动器关联的紧固件(缝钉)驱动到钉砧组件20的缝钉变形腔中。承载器216也可以具有通过其的细长底部槽，竖直撑杆的一部分可以延伸通过所述底部槽以允许临床医生观察驱动梁的远端的击发进度，如美国专利No.5,865,361中所述和所示。另外，击发标记(数字、线等)可以印刷或以另外方式邻近底部槽设在承载器216的底部上，用于在击发程序期间指示驱动梁的远端的位置，这在本领域中是已知的。
在图1中也可以看到，一次性装载单元16也可以具有外壳部分200，所述外壳部分适于咬合或以另外方式连接到承载器216。轴向驱动组件212可以包括细长的驱动梁266，所述驱动梁具有远侧工作头部268和近侧接合部分270。外壳200的近端可以包括接合凸节254，其用于可释放地接合外科缝合设备的细长主体。凸节254与外科缝合设备的细长主体部分的远端形成卡口式连接，如美国专利No.5,865,361中所述。驱动梁266可以由单层材料或优选地由多个叠层构成。接合部分270可以包括一对接合指状部270a和270b，所述接合指状部的尺寸和构造被确定成以可装配的方式接合形成于驱动连接器272中的一对相应的固定槽272a。驱动连接器272可以包括近侧孔口(未显示)，所述孔口被构造成接收控制杆的远端，如美国专利No.5,865,361中所述。控制杆可以以已知方式向轴向驱动组件212施加驱动运动和缩回运动，以将轴向驱动组件212从起始位置驱动到终止位置，在所述起始位置，刀刃未被推进通过任何组织，在所述终止位置，轴向驱动组件212的远端已被推进通过钉仓220以击发其中的所有缝钉并且切断夹在钉仓220和钉砧20之间的组织然后返回到起始位置。
在图1-4中最具体地可以看到，一次性装载单元16也可以包括击发指示器组件300。如上所述，当刀刃被驱动通过钉仓时，现有的单元利用承载器的底部中的槽以允许临床医生确认刀刃的进度。尽管这样的布置允许临床医生监视击发进度，但它需要临床医生总是能够观察操作期间承载器通道的底部。然而，由于这样的单元能够旋转，所述单元常常以会阻止观察承载器的底部的方式被定向，从而使这样的系统无用。本发明的各种实施方式解决了该问题。例如，在本发明的各种实施方式中，击发指示器组件300可以包括沿着外壳200的上死点(top dead center)形成的轴向延伸开口301。在一些实施方式中，透明窗口302可以安装(例如胶粘、咬合等)在开口301中。在其他实施方式中，不设置窗口。在图1-4所示的实施方式中，接合部分270具有形成于其上的指示器310，该指示器适于跨接在开口301中并且可通过窗口302观察。可以包括各种形式的标记322(例如数字、字母、颜色或数字、字母和/或颜色的组合)的击发刻度320可以设在外壳200上。标记322可以位于外壳200上的位置以允许临床医生通过观察指示器310相对于标记322的位置评估击发过程的进度(即，轴向驱动组件212已被轴向推进通过钉仓220的距离)。
本领域的普通技术人员将会理解，击发指示器组件300可以用在也具有通过承载器216的底部的槽217的一次性装载单元上，所述槽217允许竖直撑杆278的一部分延伸通过其中。支撑构件287连接到竖直撑杆278的底部。参见图3A和3B。底部击发标记279可以邻近槽217布置，从而允许临床医生当观察一次性装载单元的底部时也监视轴向驱动组件的推进。通过使这些特征与本发明的击发指示器组件300组合，临床医生不论是否能够观察单元的顶部或单元的底部都能够监视击发进度。
本发明的其他击发指示器布置300’包括通过钉砧盖板208的轴向延伸的钉砧槽209，当轴向驱动组件从起始位置被驱动通过钉仓220到终止位置时，所述槽允许临床医生观察轴向驱动组件212的固定凸缘284。尽管示出了一个连续的轴向槽209，在各种其他实施方式中，槽209可以包括一系列槽区段(未显示)。钉砧击发标记322’可以邻近槽209设在钉砧盖208上。在另外的其他实施方式中，为了增强固定凸缘的可见性，固定凸缘284可以带有不同于钉砧组件20的颜色213的颜色211。
图5示出了又一击发指示器布置300”。在该图中可以看到，当轴向驱动组件212从起始位置被驱动到终止位置时，可活动的击发指示器390保持在钉砧盖208上并且被布置成由固定凸缘284接触。因此，临床医生可以通过观察击发指示器390在钉砧20上的位置来监视击发进度。本领域的普通技术人员将会理解，这样的指示器390也可以用于加强钉砧盖组件208。在替代的实施方式中，指示器390’可活动地安装在槽209内。参见图6。
尽管上述的一次性装载单元包括不可关节运动的装载单元，本领域的普通技术人员将会理解由击发指示器组件300，300’和/或300”提供的优点可以容易地与诸如在美国专利No.5,865,361中公开的和其他的已知的可关节运动的一次性装载单元结合使用。
图7-9示出了另一种一次性装载单元16’，除了下面所述的区别之外，其基本类似于上述的一次性装载单元。例如，在该实施方式中，击发指示器组件300缺少窗口302。在各种实施方式中，开口301可以更多地位于外壳200’的一个侧面并且指示器310’可以实际上通过开口301伸出且具有形成于其上的指示部312以与标记322重合。因此，在该实施方式中，指示器310’脱离外壳200’的上死点以增强临床医生从一次性装载单元16’的一个侧面观察指示器310’的能力。在图9中可以看到，在各种实施方式中指示器310’从驱动连接器272伸出。在如图11中所示的替代的一次性装载单元16”中，第二开口304通过外壳200’设在开口301延伸通过的相对侧面上。第二指示器310”连接到驱动连接器272并且通过开口304伸出。第二指示器310”也可以具有形成于其上的指示部312”，该指示部与邻近第二开口304设置且对应于第一标记322的标记322’重合。这样的布置允许临床医生从一次性装载单元16’的任一侧面评估击发过程的进度。再次地，该实施方式也可以与可关节运动的一次性装载单元结合使用而不脱离本发明的精神和范围。
图12-14示出了本发明的另一个一次性装载单元的实施方式116，除了下面所述的独特和新颖的区别之外，其可以基本类似于上述的一次性装载单元16的实施方式或在美国专利No.5,865,361中所述的那些一次性装载单元。具体地，一次性装载单元116包括具有承载器216的工具组件17’，所述承载器216在其中支撑钉仓220’。钉砧组件20可以以上述方式可枢转地连接到承载器216，用于相对于承载器216在打开位置和闭合位置之间可选择性地活动行进。在各种实施方式中，工具组件17’可以包括本发明的已用钉仓指示系统400。图13和14示出了钉仓220’的远侧部分的剖视图。除了提供已用钉仓指示系统400之外，钉仓220’可以包括在美国专利No.5,865,361中公开的类型和构造的钉仓220。
钉仓220’支撑多个紧固件和推动器，这在本领域中是已知的。多个间隔开的纵向槽可以延伸通过钉仓220’，以容纳致动构件或致动滑车234的直立凸轮楔形件，所述凸轮楔形件可活动地支撑在工具组件17’内并且在其中可以选择性地从起始位置运动到终止位置。中间纵向槽282沿着钉仓220的长度延伸，以利于形成在轴向驱动组件212上的刀刃280的通过。在一次性装载单元116的操作期间，致动滑车234平移通过钉仓220’的纵向槽，以将致动滑车234的凸轮楔形件推进成与可操作地支撑在钉仓220’中的推动器顺序接触，从而导致推动器在钉仓220’内竖直地平移并且将与推动器关联的紧固件(缝钉)驱动到钉砧组件20的缝钉变形腔中。驱动梁266的远端包括用于支撑刀刃280的竖直撑杆278，和在缝合期间接合致动滑车234的中间部分以将驱动运动施加到其上的抵接表面283。表面285位于表面283的基部并且被构造成接收沿着承载器216的底部可滑动地定位的支撑构件287。刀刃280大体被定位成在致动滑车234后面稍稍平移通过钉仓220中的中间纵向槽282，以在缝合身体组织的缝钉排之间形成切口。
在图13和14中可以看到，已用钉仓指示系统400可以包括支撑在钉仓220’的远端410内的已用钉仓指示器销420。指示器销420可以具有由致动滑车234抵接接触的近侧抵接端422，变细中间部分424，和指示器部分426。指示器销420接收在远端410中的孔412中，所述孔具有锥形孔区段414。图13示出了在致动滑车234到达终止位置之前它的位置并且指示器销处于“未击发”位置。当钉仓220’还未被击发时，指示器销420的指示器部分426可以完全接收在钉仓220’的前端410内。当致动滑车234到达终止位置时，致动滑车234推动指示器销420的抵接端422，导致它的变细部分424可锁定地接合孔412的内部锥形部分414。因此，指示器销420的指示器部分426将被推到钉仓220’的远端410之外到达“已击发”位置并且保持在该位置以向临床医生指示钉仓220’已被用过或先前已被击发。参见图14。这样的布置允许临床医生快速确定一次性装载单元116是否先前已被击发。本领域的普通技术人员将会理解，该独特且新颖的已用钉仓指示系统可以有效地与类似的可关节运动和不可关节运动的一次性装载单元结合使用。
图15-25示出了本发明的另一个一次性装载单元516，除了下面所述的独特和新颖的区别之外，其可以基本类似于上述的一次性装载单元16或在美国专利No.5,865,361中所述的那些一次性装载单元。具体地，一次性装载单元516包括具有承载器216的工具组件17，所述承载器在其中支撑钉仓220”。钉砧组件20相对于承载器216可枢转地被支撑并且可以在相对于承载器216的打开位置和闭合位置之间运动。工具组件17还可以包括已用钉仓指示系统400’。除了下面所述的区别之外，钉仓220”可以包括在美国专利No.5,865,361中公开的类型和构造的常规钉仓。
如上所述，钉仓220”支撑多个紧固件(缝钉)和推动器，这在本领域中是已知的。多个间隔开的纵向槽235(图20)延伸通过钉仓220”，以容纳致动元件或致动滑车234’的直立凸轮楔形件232。参见图18。中间纵向槽282沿着钉仓220”的长度延伸以便于形成在轴向驱动组件212上的刀刃280的通过。参见图20。在一次性装载单元516的操作期间，致动滑车234’平移通过钉仓220”的纵向槽235，以将致动滑车234’的凸轮楔形件232推进成与可操作地支撑在钉仓220”中的推动器顺序接触，从而导致推动器在钉仓220”内竖直地平移并且将与推动器关联的紧固件(缝钉)驱动到钉砧组件20的缝钉变形腔中。驱动梁266的远端包括用于支撑刀刃280的竖直撑杆278，和在缝合手术期间接合致动滑车234的中间部分的抵接表面283。参见图19。表面285位于表面283的基部并且被构造成接收沿着承载器216的底部可滑动地定位的支撑构件287。刀刃280大体被定位成在致动滑车234’后面稍稍平移通过钉仓220中的中间纵向槽282以在缝合身体组织的缝钉排之间形成切口。
在各种实施方式中，已用钉仓指示系统400’可以包括可活动地支撑在工具组件17内的指示器底座600，如图16中所示。指示器底座600可以在其中具有纵向槽602，所述槽允许轴向驱动组件212的竖直撑杆278穿过其中。另外，指示器底座600可以具有从其伸出的一对加强导轨604。在各种实施方式中，例如，指示器底座600可以由金属冲压或以另外方式由其他合适的材料制造。在图17中可以看到，指示器底座600的近端606可以交错以容纳致动滑车234’的交错楔形件232。指示器底座600的近端606适于接收在形成于致动滑车234’的底部中的凹部630中。参见图18。在图18中也可以看到，一对剪式止动部632形成在致动滑车234’的底部中，以接合指示器底座600的近端606。更具体地说接合加强导轨604的近端605。
指示器底座600的远端610具有从其朝远侧伸出的已用钉仓指示器销611。指示器销611可以具有远侧部分614和锁定锥形部分612。远侧部分614的尺寸被确定成可滑动地接收在设在钉仓220”的远端410’中的孔414’内。孔414’还具有被定向成接合锁定锥形部分612的锥形部分415’，这将在下面进行论述。
在图16和19中可以看到，当钉仓220”处于未击发位置时，指示器底座600的远端610接收在致动滑车234’中的凹部630内。凸轮表面209形成在钉砧部分204的近端上并且被定位成接合轴向驱动组件212以便于钉砧组件20的闭合。参见图19。如美国专利No.5,865,361中所述，通过沿远侧方向“DD”驱动轴向驱动组件212使得凸轮销286接合凸轮表面209并且枢转钉砧组件20闭合，使钉砧组件20闭合。然而在该过程期间临床医生常常必须多次打开和闭合钉砧组件20以操作组织以及抓住和夹紧钉砧组件20和钉仓220”之间的目标组织。因此，可以在临床医生想要开始击发过程之前打开和闭合钉砧组件20数次。所以在各种实施方式中，为了在打开和闭合动作期间避免指示系统400’的致动，在剪式止动部632和加强导轨604的相应近端605之间设有间隙“G”。参见图20。将会理解，间隙“G”便于轴向驱动组件212和致动滑车234’沿着远侧方向“DD”运动足够的距离，以导致钉砧组件20枢转闭合而不会将指示器底座600从“预击发”位置(图19和20)朝远侧推进到“已击发”位置(图23)。
现在将参考图19-25描述已用钉仓指示系统400’的操作。图19和20示出了在闭合钉砧组件20之前指示器底座600和致动滑车234’的位置。图21和22示出了在轴向驱动组件212已被朝远侧推进以闭合钉砧组件20之后指示器底座600和致动滑车234’的位置。在那些图中可以看到，加强导轨604的近端605邻近它们的相应剪式止动部632。图23和24示出了击发过程开始之后指示器底座600和致动滑车234’的位置。在那些图中可以看到，当轴向驱动组件212沿着远侧方向“DD”被驱动时，剪式止动部632接触指示器底座600上的稳定导轨604的近端605，沿着远侧方向“DD”驱动指示器底座600使得指示器销部分614伸出孔部分414’并且锁定锥形部分612接合钉仓前端410’中的锥形孔部分415’。在锁定锥形部分612位于锥形孔部分415’中之后，轴向驱动组件212沿着远侧方向“DD”进一步推进导致剪式止动部632被剪断离开致动滑车234’(或运动到一个允许致动滑车234’继续相对于指示器底座600朝远侧运动的取向)。参见图24和25。因此，指示器底座600的指示器销614将被推动到钉仓220”的远端410’之外并且保持在那里以向临床医生指示钉仓220”已被用过或先前已被击发。这样的布置允许临床医生快速确定一次性装载单元516之前是否已被击发。本领域的普通技术人员将会理解，该独特且新颖的已用钉仓指示系统可以有效地与类似的可关节运动和不可关节运动的一次性装载单元结合使用。
图26示出了本发明的外科缝合设备1000的实施方式，该外科缝合设备1000具有连接到其上的根据本发明的实施方式的一次性装载单元1016。外科缝合设备1000可以包括手柄组件12，该手柄组件具有从那里伸出的细长主体14。除了下面所述的区别之外，手柄组件12和细长主体14，以及组成这样的元件的部件，通常可以以美国专利No.5,865,361中所述的方式操作。在该实施方式中，一次性装载单元1016利用外科钉仓1220。除了下面所述的改进之外，外科钉仓1220的实施方式可以基本类似于上述的外科钉仓220。特别地，如图27中所示，在该实施方式中，常规开关1224(例如压力开关、磁力开关等)可以被定位在远端1222内，使得当致动构件或致动滑车234接触开关1224或与其紧接时，信号通过一根或多根导线1226被传输到安装在手柄组件12中的指示器1230。电源1240例如电池可以安装在手柄组件12中并且连接到开关1224，使得当开关1224被启动时，允许功率从电源1240通过开关1224传输到指示器1230。指示器1230可以包括灯或其他合适的指示机构，以向临床医生指示一次性装载单元1016已被击发。本领域的普通技术人员将会理解，钉仓1220的实施方式可以有效地与类似的可关节运动和不可关节运动的一次性装载单元结合使用而不会脱离本发明的精神和范围。
图28和29示出了具有手柄组件1312的本发明的外科缝合设备1310的另一种实施方式。位于手柄组件1312内的各种部件的构造和操作在美国专利No.5,865,361中被论述。除了那些部件以外，本发明的手柄组件1312还包括与驱动棘爪42可操作地对接的第一应变计1320，所述驱动棘爪啮合致动轴46上的齿条48。第一应变计1320电耦联到处理器1330，所述处理器接收来自第一应变计1320的输入并且计算与可活动手柄24的每次启动关联的扳机压力的大小(以磅每平方英寸(PSI)计)。该处理器在安装于手柄组件1312中的扳机压力显示器1322上显示计算出的扳机压力。参见图29。
手柄组件1312还可以支撑阻抗棒1340和位移编码器1342，所述位移编码器被约束以在阻抗棒1340上或附近运动。在各种实施方式中，例如，编码器1342可以安装到致动轴46的近端以与其一起运动。因此，当致动轴46沿着远侧方向“DD”被推进时(如美国专利No.5,865,361中所述，这由齿合可活动手柄部分24产生)，来自编码器1342的信号被传输到处理器1330。第一开关1400可以相对于阻抗棒1340被安装，使得当致动轴46朝远侧运动闭合钉砧组件20所需的距离时，第一开关1400可以由编码器1342或安装到致动轴46的其他触发装置触发。第一开关1400可以电耦联到处理器1300，所述处理器可以耦联到安装在手柄组件1312上的指示器灯(未显示)、扬声器1410和/或振动器1420。因此，当钉砧组件20运动到闭合位置时，处理器1300可以通过扬声器1410以声音的形式或通过振动器1420以振动运动的形式向用户提供指示。
在图29中可以看到，手柄组件1312也可以包括光屏或发光二极管屏1350。当在设备1310的击发期间，致动轴46沿着远侧方向“DD”被驱动时，屏1350上的光带1352将沿着远侧方向增长。临床医生于是可以基于光带1352在屏1350上朝远侧延伸的距离远近确定击发期间致动轴46的位置。因此，当致动轴46运动到其最远侧位置并且连接到其上的一次性装载单元完全被击发时，光带1352可以完全延伸整个屏1350。利用来自编码器1342的输入，处理器1330也可以计算手柄组件12被击发的次数并且在显示器1360上显示该信息。参见图29。
图30-36示出了外科缝合器械1500的另一种实施方式，其配备有本发明的刀刃监视系统1700。在图30中可以看到，外科缝合器械1500可以包括上述类型和构造的手柄组件1312，其中包含有本发明的刀刃监视系统1700。在图30中也可以看到，外科缝合器械1500可以包括一次性装载单元1516，该一次性装载单元被构造成可拆卸地连接到从手柄组件12伸出的细长主体14。一次性装载单元1516通常可以包括工具组件17，其用于执行诸如切割组织和将缝钉施加到切口的每一侧这样的外科手术。工具组件17可以包括在其中容纳多个外科缝钉的钉仓组件18。工具组件17也可以包括上述类型和构造的缝钉成形钉砧组件20。一次性装载单元1516也可以包括轴向驱动组件1512，所述轴向驱动组件具有美国专利No.5,865,361中所述的轴向驱动组件的特征并具有下面所述的改进。
在各种实施方式中，例如轴向驱动组件1512包括驱动梁1566。在图32中可以看到，驱动梁1566的远端可以包括用于支撑刀刃1580的竖直撑杆1578。固定凸缘1584可以从竖直撑杆1578朝远侧突出并且在其远端支撑凸轮销1586。凸轮销1586的尺寸和构造可以被确定成接合钉砧组件20上的凸轮表面，从而以已知方式抵靠身体组织夹紧钉砧组件20。驱动梁1566可以由单层材料或优选地由多个叠层构成，并且具有接合端1570。接合端1570可以包括一对接合指状部1570a和1570b，所述接合指状部的尺寸和构造被确定成以可装配的方式接合形成在驱动构件中的一对相应的固位槽，这是已知的。当一次性装载单元1516的近端连接到外科缝合设备1500的细长主体14时，驱动构件有利于驱动梁1566互连到控制杆52。
一次性装载单元1516还可以包括外壳组件1600，所述外壳组件包括互连在一起以形成外壳部分1600的上外壳部分1610和下外壳部分1620。上外壳部分1610和下外壳部分1620可以通过粘合剂、咬合部件、紧固件等互连。在图33中可以看到，上外壳部分1610可以在其中具有细长凹槽1612以在其中接收驱动梁1566的一部分。类似地，下外壳部分1620可以在其中具有细长凹槽1622以在其中接收驱动梁1566的一部分。
在图32中可以更具体地看到，刀刃监视系统1700可以包括应变计1710，该应变计邻近刀刃1580安装到竖直撑杆部分1578。应变计1710可以具有一对应变计引线1712，所述引线沿着驱动梁1566延伸并且邻近驱动梁1566的接合端1570终止于连接终端1714中。当驱动梁1566被接收在细长凹槽1612和1622内时，应变计引线1712被布置成分别与外壳部分1610和1620中的导电迹线1614和1624电接触。在图33和34中可以看到，导电迹线1614终止于设在外壳1600的近端部分1602上的上加载终端1616中。类似地，导电迹线1624终止于设在外壳1600的近端部分1602上的下加载终端1626中。
在各种实施方式中，细长主体14支撑数据传输主体1650，所述数据传输主体被构造成在其中可操作地支撑控制杆52。在图35中可以看到，数据传输主体1650可以具有远端1652，该远端被构造成与外壳1600的近端1602可拆卸地连接，类似于在美国专利No.5,865,361中所述的卡口式连接。在图30和36中可以看到，可旋转把手28可以安装到手柄组件1312的前向端部，以利于围绕缝合设备1500的纵向轴线“L-L”相对于手柄组件1312旋转细长主体14。可旋转把手28可以由把手部分28a和28b形成，所述把手部分通过咬合部件、粘合剂、紧固件等紧固在一起。把手部分28a和28b均可以具有形成于其上的径向突出部132，该突出部适于延伸到细长主体14的外壳体124中的相应开口(未显示)中并且进入数据传输主体1650的近端1660中的凹部1662a、1662b中。突出部132使旋转把手28和细长主体14相对于彼此在纵向上和旋转方向上牢固地固定。因此，旋转把手28相对于手柄组件1312的旋转导致细长主体14围绕纵向轴线L-L相对于手柄组件1312的相应旋转。也将会理解，由于一次性装载单元1516连接到细长主体14的远端，细长主体14的旋转也导致一次性装载单元1516的旋转。
在图35中可以看到，数据传输主体1650具有穿过远端1652以形成主体下穿透点(penetration)1672的右侧数据引线1670，当外壳1600的近端1602连接到数据传输主体1650的远端1652时，所述主体下穿透点被定向成与下加载终端1626电接触。类似地，数据传输主体1650还具有穿过远端1652以形成主体上穿透点1682的左侧数据引线1680，当外壳1600的近端1602连接到数据传输主体1650的远端1652时，所述主体上穿透点被定向成与上加载终端1616电接触。右侧数据引线1670延伸通过数据传输主体1650并且终止于安装凹部1662a中以形成右侧终端1674，而左侧数据引线1680延伸通过数据传输主体1650并且终止于另一安装凹部1662b中以形成左侧终端1684。参见图35。
在图35和36中进一步可以看到，右侧把手部分28a具有支撑在其中的右侧套罩引线1690，所述引线终止于位于近侧的右侧终端1692。右侧套罩引线1690也通过形成于右侧把手部分28a中的突出部132终止，使得当突出部132a延伸到数据传输主体1650的近端1660中的凹部1662a内时，在右侧套罩引线1690和右侧终端1664之间形成电连接。类似地，左侧把手部分28b具有支撑在其中的左侧套罩引线1700，所述引线终止于位于近侧的左侧终端1702。左侧套罩引线1700也通过形成于左侧把手部分28b中的突出部132b终止，使得当突出部132b延伸到凹部1662中时，在左侧套罩引线1700和左侧终端1684之间形成电连接。
在各种实施方式中，手柄组件1312的远端部分1313在其上具有通过引线1812连接到处理器1330的右侧导电环带1810和通过引线1822也连接到处理器的左侧导电环带1820。右侧把手部分28a具有形成于其上的向内延伸连接凸缘部分29a，该凸缘部分适于接收在形成于手柄组件1312的远端1313中的环形凹槽1315内。类似地，左侧把手部分28b具有形成于其上的向内延伸连接凸缘部分29b，该凸缘部分适于接收在环形凹槽1315中。因此，当右侧把手部分28a(通过粘合剂、咬合部件、紧固件等)连接到左侧把手部分28b时，连接凸缘部分29a、29b用于将把手28保持在外壳1312上，同时便于把手28相对于外壳1312可旋转地运动。另外，当把手28可旋转地支撑在手柄组件1312上时，右侧终端与右侧导电环带1810电接触并且左侧终端与左侧导电环带1820电接触。因此，当一次性装载单元1516连接到细长主体14时，在应变计1710和处理器1330之间建立电连接。
当轴向驱动组件1512被朝远侧驱动通过夹在工具组件17中的组织时，刀刃1580将受到力“F”，该力的大小可以取决于夹在工具组件17中的组织量。参见图32。这样的力“F”易于拉长用于支撑刀刃1580的竖直撑杆1578。当力“F”被施加到竖直撑杆1578时，应变计1710将检测竖直撑杆1578受到的应变的大小并且将这样的数据传输到处理器1330。处理器1330然后以已知方式处理应变数据并且将该数据传输到安装于手柄组件1312中的显示器1322上。在其他实施方式中，处理器1330可以启动振动器1420以导致振动器的振动随着竖直撑杆1578和刀刃1580受到的应变大小的增加而增加。因此，刀刃监视系统1700在器械的操作过程中向临床医生提供关于刀刃所承受的应变大小的反馈，所述应变的大小与夹紧在工具组件17内的组织类型和组织量有关。
尽管描述了本发明的一些实施方式，然而应当理解，本领域的普通技术人员可以想到对这些实施方式的各种修改、改变和适应，并且可以获得本发明的一些和所有优点。例如，根据各种实施方式，为了执行指定的一个功能或多个功能，单一部件可以由多个部件替换，并且多个部件可以由单一部件替换。因此，本申请意在覆盖所有这样的修改、改变和适应，而不脱离由所附权利要求限定的本发明的范围和精神。
所述被部分或全部引用于此作为参考的任何专利、公开文献或其他公开资料仅仅在被引用的材料不会与本公开中存在的定义、声明或上述其他公开资料相冲突的程度上被引用于此。因而，并且必要时，在这里清楚阐述的公开内容替代被引用于此作为参考的任何冲突资料。所述引用于此作为参考，但是与现有的定义、声明或在此阐述的其他公开资料相冲突的任何资料或其一部分，将仅仅在被引用资料和现有的公开资料之间不产生冲突的程度上被引用。
希望得到保护的本发明不应当被理解成限制到所公开的特定实施方式。因此，所述实施方式应当被认为是示例性的而不是限制性的。在不脱离本发明精神的情况下，任何人可以对本发明进行改变和变化。因此，明确地希望落入由权利要求书限定的本发明的精神和范围内的所有这样的等同物、改变和变化被包含于此。
Claims (10)
1.一种用于连接到外科缝合设备的一次性装载单元，所述一次性装载单元包括：
工具组件，包括：
承载器；
钉砧组件，其可活动地连接到所述承载器，用于相对于所述承载器在打开位置和闭合位置之间能够选择性地活动行进；
支撑在所述承载器中的钉仓，所述钉仓可操作地支撑位于其中的多个缝钉；和
可活动地支撑在所述工具组件中的致动器构件，所述致动器构件被构造成当其在所述工具组件中被从起始位置驱动到终止位置时将所述多个缝钉驱动到所述钉仓外；
具有远端部分的轴向驱动组件，所述远端部分被构造成响应从所述外科缝合设备施加到所述轴向驱动组件的驱动运动而运动通过所述工具组件并将所述致动器构件从所述起始位置驱动到所述终止位置；以及
已用钉仓指示系统，其可操作地支撑在所述工具组件中并且与所述致动器构件协作以在至少一些所述缝钉已被驱动到所述钉仓外时提供指示。
2.根据权利要求1所述的一次性装载单元，其中，所述已用钉仓指示系统包括指示器销，所述指示器销支撑在所述钉仓的远端中并且能够响应所述致动构件的运动从第一未击发位置运动到击发位置。
3.根据权利要求2所述的一次性装载单元，其中，所述指示器销可活动地支撑在所述钉仓的所述远端的孔内，并且当所述指示器销处于所述第一未击发位置时，所述指示器销不伸到所述孔之外，当至少一些所述缝钉已被驱动到所述钉仓外时，所述指示器销的至少一部分从所述孔伸出。
4.根据权利要求3所述的一次性装载单元，其中，所述指示器销被构造成当所述致动器构件到达所述终止位置时，所述指示器销被锁定在伸出位置。
5.根据权利要求1所述的一次性装载单元，还包括：
指示器基部，其响应所述致动器构件的运动在预击发位置和击发位置之间可活动地支撑在所述工具组件中；和
指示器销，其形成在所述指示器基部的远端上并且容纳在所述钉仓的远端中的孔内，使得当所述指示器基部运动到所述击发位置时，所述指示器销的至少一部分从所述钉仓的所述远端伸出。
6.根据权利要求5所述的一次性装载单元，其中，所述指示器销被构造成当所述指示器基部运动到所述击发位置时，所述指示器销被保持在相对于所述钉仓的所述远端的所述伸出位置。
7.根据权利要求6所述的一次性装载单元，其中，所述指示器销具有形成在其上的锥形锁定部分，该锥形锁定部分被构造成当所述指示器基部运动到所述击发位置时锁定地位于所述钉仓的所述远端中的所述孔的一部分内。
8.根据权利要求5所述的一次性装载单元，还包括在所述致动器构件上的至少一个剪式止动部，所述剪式止动部被构造用于在所述致动器构件被从所述起始位置驱动到所述终止位置时与所述指示器基部驱动接合以向所述指示器基部施加驱动运动，由此将所述指示器基部从所述预击发位置驱动到所述击发位置，所述剪式止动部还被构造成允许所述致动器构件在所述指示器基部已被驱动到所述击发位置之后相对于所述指示器基部运动。
9.根据权利要求1所述的一次性装载单元，还包括用于测量所述轴向驱动组件的刀刃部分的伸长度的机构。
10.根据权利要求1所述的一次性装载单元，还包括用于确定在所述轴向驱动组件的远端运动通过所述工具组件时所述轴向驱动组件的所述远端的位置的机构。
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2008
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2009
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- 2009-02-13 EP EP15156811.0A patent/EP2891461B1/en active Active
- 2009-02-13 PL PL09250403T patent/PL2090255T3/pl unknown
- 2009-02-13 JP JP2009031740A patent/JP5415097B2/ja not_active Expired - Fee Related
- 2009-02-13 PL PL15156811T patent/PL2891461T3/pl unknown
- 2009-02-13 EP EP09250403.4A patent/EP2090255B1/en active Active
- 2009-02-13 RU RU2009105124/14A patent/RU2497466C2/ru not_active IP Right Cessation
- 2009-02-16 CN CN2009100078202A patent/CN101507626B/zh not_active Expired - Fee Related
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| CN108430342A (zh) * | 2015-12-31 | 2018-08-21 | 伊西康有限责任公司 | 具有行程结束指示器的外科缝合器 |
| CN108430342B (zh) * | 2015-12-31 | 2021-07-13 | 伊西康有限责任公司 | 具有行程结束指示器的外科缝合器 |
Also Published As
| Publication number | Publication date |
|---|---|
| BRPI0901746A2 (pt) | 2010-01-26 |
| EP2891461B1 (en) | 2018-01-03 |
| US20090206144A1 (en) | 2009-08-20 |
| RU2009105124A (ru) | 2010-08-20 |
| CN101507626B (zh) | 2012-09-05 |
| HK1136759A1 (zh) | 2010-07-09 |
| EP2891461A1 (en) | 2015-07-08 |
| JP2009189833A (ja) | 2009-08-27 |
| US7913891B2 (en) | 2011-03-29 |
| EP2090255B1 (en) | 2015-04-15 |
| BRPI0901746B8 (pt) | 2021-06-22 |
| EP2090255A1 (en) | 2009-08-19 |
| BRPI0901746B1 (pt) | 2019-07-16 |
| JP5415097B2 (ja) | 2014-02-12 |
| PL2891461T3 (pl) | 2018-06-29 |
| PL2090255T3 (pl) | 2015-09-30 |
| RU2497466C2 (ru) | 2013-11-10 |
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