CN105266862A - 一次性外科针仓 - Google Patents
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- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
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- A—HUMAN NECESSITIES
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Abstract
本发明公开了一种一次性外科针仓,所述一次性外科针仓能够附接到外科缝合装置以及与外科缝合装置分离,所述一次性仓包括:弧形针轨道;弧形针,所述弧形针定位在所述针轨道中,所述针包括前端和后端;一定长度的缝合线,所述一定长度的缝合线连接至所述针;往复式针驱动器,所述往复式针驱动器操作以接合所述针并且使所述针在所述针轨道中运动;传动装置,所述传动装置操作地连接至所述针驱动器;以及扭转接口,所述扭转接口能够将所述传动装置联接至所述外科缝合装置中的旋转传动件;其中所述往复式针驱动器和所述传动装置完全被封入所述仓中。其中所述外科缝合装置为可重复使用的。
Description
本申请是于2015年7月24日进入中国国家阶段的题为“圆形针施放器”且中国申请号为201380071324.8的国际申请PCT/US2013/074866的分案申请。
相关专利申请
本申请要求2012年12月13日提交的临时申请61/736678(案卷号END7216USPSP)、2012年12月13日提交的临时申请61/736682(案卷号END7217USPSP)、2012年12月13日提交的临时申请61/736690(案卷号END7218USPSP)以及2012年12月13日提交的临时申请61/736696(案卷号END7219USPSP)的权益,临时申请的内容以引用方式并入本文。
背景技术
本发明一般涉及外科装置和手术,并且更具体地涉及外科缝合。
缝合线通常用于广泛多种外科手术。手动缝合通常通过外科医生使用一对细小的镊子抓取并保持缝合针、用针刺穿组织、松开针、然后重新抓紧针以牵拉针和伴随的缝合线穿过要缝合的组织来完成。此类针通常是弯曲的,其中缝合线附接到针的后端。已经尝试了多种自动缝合装置来加速缝合的过程并且有助于精细缝合或显微镜式、腹腔镜式或关节镜式外科手术期间的缝合。虽然自动缝合装置是公知的,但是先前没有人已经制成或使用根据本发明的外科缝合装置。
发明内容
在一个实施例中,外科缝合装置具有细长轴,细长轴具有近侧端部、远侧端部以及位于近侧端部和远侧端部之间的纵向轴线。致动器连接至细长轴的近侧端部。圆形针施放器连接至细长轴的远侧端部。细长轴在圆形针施放器的近侧关节运动,并且圆形针施放器围绕纵向轴线旋转。
致动器可包括手动柄部。柄部可包括选择性地致动圆形针施放器的第一输入端。外科装置还可包括选择性地使轴关节运动的第二输入端。外科装置还可包括选择性地使圆形针施放器围绕纵向轴线旋转的第三输入端。细长轴可围绕接头关节运动。圆形针施放器可围绕轴承旋转。
在另一个实施例中,外科缝合装置具有细长轴,细长轴具有近侧端部、远侧端部以及位于近侧端部和远侧端部之间的纵向轴线。致动器连接至细长轴的近侧端部。圆形针施放器位于细长轴的远侧端部上。圆形针施放器具有弧形针和针驱动器,针驱动器操作地连接至致动器以使弧形针在圆形路径中旋转。接头定位在细长轴的近侧端部和远侧端部之间。接头操作地连接至致动器以选择性地使轴关节运动。轴承位于轴上、定位在接头的远侧。轴承操作地连接至致动器以选择性地使圆形针施放器围绕纵向轴线旋转。
在另一个实施例中,外科缝合装置包括细长轴,细长轴具有近侧端部、远侧端部以及位于近侧端部和远侧端部之间的纵向轴线。致动器连接至细长轴的近侧端部。圆形针施放器连接至细长轴的远侧端部。一个装置使细长轴关节运动,并且一个装置使圆形针施放器围绕纵向轴线旋转。外科缝合装置还可包括致动圆形针施放器的装置。
在另一个实施例中,外科缝合系统包括可重复使用的轴和致动器。一次性仓包括:外科针;一定长度的缝合线,该一定长度的缝合线连接至外科针;以及针驱动器,该针驱动器操作以接合针并且使针相对于仓运动。一次性仓还可包括操作地连接至针驱动器的传动装置。可重复使用的轴和致动器可以为耐高压加热的。可重复使用的轴和致动器可重复用于至少50次操作。可重复使用的轴和致动器可重复用于至少150次操作。可重复使用的轴和致动器可重复用于至少200次操作。
在另一个实施例中,外科缝合系统包括具有近侧端部和远侧端部的可重复使用的轴,远侧端部具有接收器和旋转传动件。可重复使用的致动器连接至轴的近侧端部。一次性仓能够附接到接收器以及与接收器分离。仓包括:弧形轨道;弧形针,该弧形针定位在轨道中、具有前端和后端;一定长度的缝合线,该一定长度的缝合线连接至后端;往复式针驱动器,该往复式针驱动器操作以接合针并且使针在弧形圆轨道中运动;以及传动装置,该传动装置操作地连接至针驱动器、具有能够联接至旋转传动件的旋转输入端。可重复使用的轴和致动器可以为耐高压加热的。
在另一个实施例中,一次性外科针仓能够附接到外科缝合装置以及与外科缝合装置分离。一次性仓包括:弧形针轨道;弧形针,该弧形针定位在针轨道中、具有前端和后端;一定长度的缝合线,该一定长度的缝合线连接至针;往复式针驱动器,该往复式针驱动器操作以接合针并且使针在针轨道中运动;传动装置,该传动装置操作地连接至针驱动器;以及扭转接口,该扭转接口能够将传动装置联接至外科缝合装置中的旋转传动件。往复式针驱动器和传动装置完全被封入仓中。外科缝合装置可以为可重复使用的。外科缝合装置可包括细长轴,该细长轴带有近侧端部、远侧端部以及能够与仓交接的接收器。一次性外科针仓还可包括外科缝合装置。
在另一个实施例中,外科缝合系统包括轴,该轴具有近侧端部、远侧端部、位于近侧端部和远侧端部之间的纵向轴线、以及接收器,该接收器位于带有旋转传动件的远侧端部上。仓能够选择性地附接到接收器以及与接收器分离。仓具有:外科针;一定长度的缝合线,该一定长度的缝合线连接至针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;传动装置,该传动装置操作地连接至针驱动器;以及扭转接口,该扭转接口旋转地将旋转传动件联接至传动装置。
旋转传动件可通过扭转接口向传动装置传送围绕横向于轴的纵向轴线的轴线的扭矩。旋转传动件可通过扭转接口传送围绕垂直于轴的纵向轴线的轴线的扭矩。旋转传动件可包括齿条和小齿轮。接收器可包括与轴的纵向轴线轴向偏离的朝远侧延伸的臂。臂可包括面朝内侧的平台。旋转传动件可至少部分地定位在臂中。
外科缝合系统还可包括与轴的纵向轴线轴向偏离的朝远侧延伸的第二臂,这些臂限定尺寸设定成并能够接收仓的空间。外科缝合系统还可包括能够操作以将仓锁定至接收器和解锁仓的闩锁。通过使仓相对于接收器纵向滑动,仓可附接到接收器以及与接收器分离。
在另一个实施例中,外科缝合系统包括轴,该轴具有近侧端部、远侧端部以及位于近侧端部和远侧端部之间的纵向轴线。接收器位于轴的远侧端部上。接收器具有限定空间的朝远侧延伸的一对臂。通过使仓在空间中纵向滑动,仓能够选择性地附接到接收器以及与接收器分离。仓具有:外科针;一定长度的缝合线,该一定长度的缝合线连接至针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动。闩锁选择性地将仓锁定在接收器中和解锁仓。
外科缝合系统还可包括至少部分地定位在臂中的一个中的旋转传动件。外科缝合系统还可包括:位于仓中的传动装置,该传动装置操作地连接至针驱动器;以及扭转接口,该扭转接口旋转地将旋转传动件联接至传动装置。
在另一个实施例中,外科缝合系统包括轴,该轴具有近侧端部、远侧端部、位于近侧端部和远侧端部之间的纵向轴线、以及接收器,该接收器位于带有旋转传动件的远侧端部上。仓能够选择性地附接到接收器以及与接收器分离。仓具有:外科针;一定长度的缝合线,该一定长度的缝合线连接至针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及传动装置,该传动装置操作地连接至针驱动器。装置旋转地将旋转传动件联接至传动装置。外科缝合系统还可包括用于使仓附接到接收器以及与接收器分离的装置。外科缝合系统还可包括用于将仓锁定在接收器中和解锁仓的装置。
在另一个实施例中,外科缝合装置包括弧形针轨道。弧形针定位在针轨道中,针具有前端、后端、内侧面和外侧面。一定长度的缝合线连接至针。弧形载体轨道与针轨道隔开。往复式针驱动器具有定位在载体轨道中的载体以及驱动器,该驱动器定位在针轨道中并且操作以接合针并且使针在针轨道中运动。传动装置操作以使载体在载体轨道中往复运动。
外科缝合装置还可包括将载体轨道与针轨道分开的壁。外科缝合装置还可包括穿过壁的开槽开口,该槽使载体轨道和针轨道之间连通。针驱动器可延伸穿过开槽开口并且延伸至针轨道中。开槽开口可与弧形针轨道的内侧边缘相邻。开槽开口可与弧形针轨道的外侧边缘相邻。弧形针轨道和弧形载体轨道可以为同轴的。针轨道和载体轨道可沿共享轴线彼此偏离。针轨道和载体轨道可以为同径的。针还可包括尺寸设定成并能够由驱动器接合的阶梯。阶梯可位于针的内侧面上。阶梯可位于针的外侧面上。
在另一个实施例中,外科缝合装置包括弧形针轨道。弧形针定位在针轨道中。针具有前端、后端、内侧面和外侧面。一定长度的缝合线连接至针。弧形载体轨道沿共享轴线与弧形针轨道偏离。壁将弧形针轨道与弧形载体轨道分开。壁具有使弧形载体轨道和弧形针轨道之间连通的开槽开口。往复式针驱动器具有定位在弧形载体轨道中的载体以及定位在弧形针轨道中的驱动器,该驱动器操作以接合针并且使针在针轨道中运动。传动装置操作以使载体在载体轨道中往复运动。
在另一个实施例中,外科缝合装置包括弧形针轨道、定位在针轨道中的弧形针以及连接至针的一定长度的缝合线。往复式针驱动器操作以接合针并且使针在针轨道中运动。旋转输入端围绕轴线旋转。连杆具有连接至旋转输入端的近侧端部以及连接至针驱动器的远侧端部。旋转输入端在第一角方向上的旋转使针驱动器在与第一角方向相反的第二角方向上平移。
连杆还可包括插置在近侧端部和远侧端部之间的纵向槽,该纵向槽接收销,连杆围绕销纵向平移和枢转。远侧端部可以枢转地连接至针驱动器。针驱动器和连杆远侧端部之间的连接部可在具有第一半径的弧形路径中平移。连杆的近侧端部可在与扭转传动轴线相距第二半径处连接至旋转输入端,并且第一半径可大于第二半径。旋转输入端、连杆和针驱动器可不具有不动点。旋转输入端可包括接收连接至连杆的近侧端部的销的径向槽。外科缝合装置还可包括:细长轴,该细长轴具有近侧端部和远侧端部;致动器,该致动器连接至轴近侧端部;旋转传动件,该旋转传动件操作地连接至致动器;以及扭转接口,该扭转接口旋转地将旋转传动器联接至旋转输入端。旋转传动件可包括齿条和小齿轮。旋转输入端可具有往复式旋转运动。针驱动器可在弧形轨道中往复运动至少180度。针驱动器可使针在至少部分地由针轨道限定的圆形路径中旋转。旋转输入端和针可在平行平面内旋转。
在另一个实施例中,外科缝合装置包括针,该针具有前端、后端以及位于前端和后端之间的弧形主体。一定长度的缝合线连接至针。针驱动器能够接合针并且使针在圆形路径中在第一旋转方向上旋转。棘爪能够接合针的后端,以阻止针在与第一旋转方向相反的第二旋转方向上旋转。
针可在平面内旋转,并且棘爪可以横向于该平面的角度弹性地偏转。棘爪可基本上垂直于该平面弹性地偏转。针可在平面内旋转,并且棘爪可基本上在该平面内弹性偏转。棘爪可定位在针的外侧。棘爪可定位在针的内侧。棘爪可具有:第一端部,棘爪围绕第一端部枢转;以及第二端部,该第二端部具有接合针的后端的边缘。外科缝合装置还可包括第二棘爪,该第二棘爪能够接合针的后端以阻止针在与第一旋转方向相反的第二旋转方向上旋转。棘爪可沿圆形路径彼此对跖。后端可包括接收缝合线的筒体,该筒体具有界定缝合线的后面,并且棘爪可接合后面以阻止针在与第一旋转方向相反的第二旋转方向上旋转。棘爪沿垂直于针路径的路径平移,并且棘爪还可包括使棘爪偏置在针路径中的弹簧。棘爪还可包括斜坡,该斜坡能够由针接合以使棘爪偏转离开针路径并且允许针经过棘爪。棘爪沿横向于由圆形针路径限定的平面的路径平移。
在另一个实施例中,外科缝合装置包括针,该针具有前端、后端、位于前端和后端之间的弧形主体、以及在主体上位于对跖位置处的两个台阶。一定长度的缝合线连接至针。针驱动器在驱动位置和返回位置之间往复运动至少180度。针驱动器能够接合针阶梯以使针在圆形路径中在第一旋转方向上旋转。棘爪与针驱动器的驱动位置相邻定位。棘爪能够接合针阶梯,以阻止针在与第一旋转方向相反的第二旋转方向上旋转。
外科装置还可包括使棘爪偏置在针路径中的弹簧。棘爪还可包括斜坡,该斜坡能够由针和针驱动器接合以使棘爪偏转离开针路径并且允许针和针驱动器经过棘爪。棘爪可在由圆形针路径限定的平面内偏转。棘爪可具有:第一端部,棘爪围绕第一端部枢转;第二端部,该第二端部具有接合针阶梯的边缘;以及弹簧,该弹簧使第二端部偏置到针路径中。在驱动位置,针驱动器可插置在棘爪和针之间。外科装置还可包括第二棘爪,该第二棘爪与针驱动器的返回位置相邻定位,第二棘爪能够接合针阶梯以阻止针在与第一旋转方向相反的第二旋转方向上旋转。
在另一个实施例中,外科缝合装置包括针,该针具有前端、后端、位于前端和后端之间的弧形主体、以及在主体上位于对跖位置处的两个台阶。一定长度的缝合线连接至针。针驱动器在驱动位置和返回位置之间往复运动至少180度。针驱动器能够接合针阶梯以使针在圆形路径中在第一旋转方向上旋转。棘爪与针驱动器的返回位置相邻定位。棘爪能够接合针阶梯,以阻止针在与第一旋转方向相反的第二旋转方向上旋转。
外科装置还可包括使棘爪偏置在针路径中的弹簧。棘爪还可包括近侧斜坡,该近侧斜坡能够由针和针驱动器接合以使棘爪偏转离开针路径并且允许针和针驱动器经过棘爪。棘爪还可包括远侧斜坡,该远侧斜坡能够由针驱动器接合以使棘爪偏转离开针路径并且允许针驱动器经过棘爪。远侧斜坡可定位在针路径下方。棘爪可在由圆形针路径限定的平面内偏转。
在另一个实施例中,外科缝合装置包括针,该针具有前端、后端、位于前端和后端之间的弧形主体、以及在主体上位于对跖位置处的两个台阶。一定长度的缝合线连接至针。针驱动器在驱动位置和返回位置之间往复运动至少180度。针驱动器能够接合针阶梯以使针在圆形路径中在第一旋转方向上旋转。装置接合针阶梯以阻止针在与第一旋转方向相反的第二旋转方向上旋转。该装置可包括棘爪。该装置可包括片簧。
在另一个实施例中,用于在圆形针施放器中使用的外科针包括前端、后端以及位于前端和后端之间的弧形主体。主体具有内侧面和外侧面。主体上的多个阶梯能够由圆形针施放器接合。阶梯是通过在不移除材料的情况下使主体塑性地变形来形成的。一定长度的缝合线连接至后端。
阶梯可位于内侧面上。阶梯可位于外侧面上。阶梯可通过挤压操作形成。阶梯可通过轧制操作形成。多个阶梯可包括两个对跖的阶梯。主体可具有为至少180度的角跨度。弧形主体可包括围绕原点的基本上恒定的标称半径。
在另一个实施例中,用于在圆形针施放器中使用的外科针包括具有锥体的前端、具有筒体的后端以及在锥体和筒体之间延伸的弧形主体。主体具有内侧面、外侧面以及能够由圆形针施放器接合的多个阶梯。主体在锥体和筒体之间具有基本上恒定的截面积。一定长度的缝合线连接在筒体中。
阶梯可位于内侧面上。多个阶梯可包括位于内侧面上的两个对跖的阶梯。阶梯可位于外侧面上。多个阶梯可包括位于外侧面上的两个对跖的阶梯。阶梯可在没有从主体移除材料的情况下形成。阶梯可通过挤压操作形成。阶梯可通过轧制操作形成。多个阶梯可包括两个对跖的阶梯。主体可具有为至少180度的角跨度。
在另一个实施例中,用于在圆形针施放器中使用的外科针包括远侧前端、近侧后端以及位于前端和后端之间的弧形主体。主体具有内侧面和外侧面。主体上的第一阶梯能够由圆形针施放器接合。第一阶梯定位在前端的远侧。纵向平部从第一阶梯朝近侧延伸。平部在主体中限定大体D形截面形状。主体上的第二阶梯能够由圆形针施放器接合。第二阶梯定位成与第一阶梯相距约180度。一定长度的缝合线连接至后端。
针可具有在约210度和约270度之间的从前端到后端的角跨度。第一阶梯和第二阶梯可位于内侧面上。第一阶梯和第二阶梯可位于外侧面上。弧形主体可包括围绕原点的基本上恒定的标称半径。标称半径可在约0.170英寸至约0.210英寸之间。平部可从第一阶梯朝近侧延伸约20度和约40度之间。平部可从第一阶梯朝近侧延伸约100度和约150度之间。主体还可包括位于平部的近侧端部上的斜坡部分,使得主体中的截面形状从大体D形形状转变成大体圆形形状。主体还可包括从第二阶梯朝近侧延伸的第二纵向平部,该第二平部在主体中限定大体D形截面形状。第二平部可从第二阶梯朝近侧延伸约8度和约30度之间。主体还可包括位于第二平部的近侧端部上的斜坡部分,使得主体中的截面形状从大体D形形状转变成大体圆形形状。前端可包括锥体并且后端可包括筒体,并且主体可在锥体和筒体之间具有基本上恒定的截面积。
在另一个实施例中,用于外科针的封装包括仓,该仓具有外科针和针驱动器,该针驱动器操作以接合针并且使针相对于仓运动。封装具有线轴和一定长度的缝合线,该一定长度的缝合线连接至针并且缠绕在线轴周围。封装还可包括包封仓、线轴和缝合线的外壳。外壳可包括折叠在仓和线轴上面的材料片。封装还可包括弹性地保持仓的平台。线轴可以为旋转卷轴。仓可包括限定大体U形远侧端部的一对臂,并且封装可具有插置在臂之间的阻挡件。封装还可包括包封仓、线轴和缝合线的壳体和顶片。
在另一个实施例中,用于外科针的封装具有壳体以及可释放地保持在壳体中的仓。仓具有外科针和针驱动器,该针驱动器操作以接合针并且使针相对于仓运动。线轴在壳体中。一定长度的缝合线连接至针并且缠绕在线轴周围。仓、线轴和缝合线可被包封在壳体内。仓可包括限定大体U形远侧端部的一对臂,并且封装还可包括附接到壳体并且在臂之间延伸的阻挡件。壳体可限定间隙,并且仓可至少部分地定位在间隙中。
在另一个实施例中,用于外科针的封装包括具有间隙的壳体。仓可释放地保持在壳体中并且延伸至间隙中。仓具有:外科针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及一对臂,这一对臂限定大体U形远侧端部。阻挡件附接到壳体并且在臂之间延伸。旋转卷轴在壳体中。一定长度的缝合线连接至针并且缠绕在线轴周围。仓、线轴和缝合线被包封在壳体内。
附图说明
尽管本说明书包括特别指出并明确要求本发明权利的权利要求书,但据信,根据以下结合示出本发明的一些非限制性实例的附图的描述,将会更好地理解本发明。除非另外指明,否则附图未必按比例绘制,而是为了示出本发明的原理。
图1描绘外科缝合装置的透视图;
图2描绘用于外科缝合装置的致动器的侧视图;
图3A描绘轴处于直构型的透视图;
图3B描绘轴处于关节运动构型的透视图;
图3C描绘轴处于关节运动且旋转构型的透视图;
图4描绘轴轴承的分解图;
图5描绘示出轴中的连接件的局部剖面图;
图6描绘仓接收器的透视图;
图7描绘旋转传动件的透视图;
图8描绘从接收器拆卸下来的仓的透视图;
图9描绘从接收器拆卸下来的仓的透视图;
图10A描绘用于驱动针的传动装置在其行程的一个端部处的透视图;
图10B描绘用于驱动针的传动装置在中间行程处的透视图;
图10C描绘用于驱动针的传动装置在其行程的另一端部处的透视图;
图11描绘位于载体轨道中的针驱动器的透视图;
图12描绘针驱动器的透视图;
图13描绘位于载体轨道中的针驱动器以及位于针轨道中的针的剖视图;
图14A描绘弧形针的平面图;
图14B描绘弧形针的透视图;
图15A描绘弧形针的平面图;
图15B描绘弧形针的透视图;
图16A描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其返回位置;
图16B描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其驱动位置;
图16C描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其返回位置;
图16D描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其驱动位置;
图17描绘仓接收器的透视图;
图18描绘旋转传动件的透视图;
图19描绘闩锁的透视图;
图20描绘从接收器拆卸下来的仓的透视图;
图21描绘从接收器拆卸下来的仓的透视图;
图22A描绘用于驱动针的传动装置在其行程的一个端部处的透视图;
图22B描绘用于驱动针的传动装置在中间行程处的透视图;
图22C描绘用于驱动针的传动装置在其行程的另一端部处的透视图;
图23A描绘针驱动器的透视图;
图23B描绘针驱动器的透视图;
图24描绘位于载体轨道中的针驱动器以及位于针轨道中的针的剖视图;
图25A描绘弧形针的平面图;
图25B描绘弧形针的透视图;
图26A描绘弧形针的平面图;
图26B描绘弧形针的透视图;
图27A描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其返回位置;
图27B描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其驱动位置;
图27C描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其返回位置;
图27D描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其驱动位置;
图28描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其驱动位置;
图29A描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其返回位置;
图29B描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其驱动位置;
图29C描绘棘爪机构的透视图;
图29D描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其返回位置;
图30A描绘针施放器的平面图,其中针处于其伸展位置并且针驱动器处于其驱动位置;
图30B描绘棘爪机构的透视图;
图31A描绘针施放器的平面图,其中针处于其回缩位置并且针驱动器处于其返回位置;
图31B描绘棘爪机构的透视图;
图31C描绘棘爪机构的剖视图;
图32描绘从接收器拆卸下来的仓的透视图;
图33描绘从接收器拆卸下来的仓的透视图;
图34描绘仓封装的分解图;
图35描绘附接到缝合装置轴的仓的透视图;以及
图36描绘仓封装的透视图。
具体实施方式
图1示出外科缝合装置的实施例。细长轴20具有近侧端部21、远侧端部22以及在其间延伸的纵向轴线。致动器10连接至轴20的近侧端部21。在该实施例中,致动器10是手动手枪式握把柄部;然而,也可使用多种其它的手动致动器,包括剪刀式握把柄部、注射器式握把柄部、内窥镜式旋钮等。致动器10也可采用机器人式接口诸如DAVINCI弹力盘,包括齿轮或滑轮、伺服机构等的壳体的形式。
圆形针施放器30连接至轴20的远侧端部22。圆形针施放器30使弧形针在圆形路径中旋转,使得外科医生能够选择性地施加缝合线。圆形针施放器30可与轴20和致动器10整合成旨在用于单次外科手术的一体的一次性器械。圆形针施放器30也可与轴20和致动器10整合成可重复使用的器械。任选地,圆形针施放器30可体现在一次性仓中,并且轴20和致动器10也可以为一次性的。在另一个变型中,圆形针施放器30可体现在一次性仓中,并且轴20和致动器10可以为可重复使用的。带有可重复使用的部件的实施例旨在经清洁、消毒并且重复用于多次外科手术。可重复使用的器械的优选寿命周期为至少50次操作,更优选地至少150次操作,并且最优选地至少200次操作。可重复使用的部件可使用能够经受至少135摄氏度的高压釜消毒温度的材料来构建,但低温材料也可与本领域中已知的低温消毒技术一起使用。
图2示出手动致动器10的一个实施例。第一输入端12,这里显示为在断开位置和闭合位置之间枢转的触发器,可用于选择性地致动圆形针施放器30。触发器可弹簧偏置以使触发器返回至其断开位置。第二输入端14,这里显示为旋钮,可用于选择性地使轴20关节运动。第三输入端16,这里显示为旋钮,可用于选择性地使圆形针施放器30围绕轴20旋转。第四输入端18,这里显示为开关,可用于选择性地使圆形针施放器30附接到轴20以及与轴分离。自然地,输入端12,14,16和18的数量、类型、构型和操作可改变。
图3A-3B示出轴20响应于第二输入端14的致动而关节运动。在该实施例中,轴20具有有助于关节运动的关节运动接头23。轴20包括定位在接头23远侧的轴承24。图3B-3C示出圆形针施放器30即使在轴20关节运动时也响应于第三输入端16的致动而在轴承24处旋转。
图4-5示出合适的关节运动接头23和旋转轴承24的一个示例。轴承24包括固定到圆形针施放器30的周向凸缘24A。凸缘24A被捕获在轴承支撑件24B,24C之间,使得凸缘24A能够旋转但阻止轴向运动。柔性同轴扭转管28穿过接头23。扭转管28具有外部护套和内部缆线。扭转管28的外部护套固定到凸缘24A并且操作地连接至第三输入端16。第三输入端16的致动将使护套旋转并且继而使圆形针施放器30旋转。同轴扭转管28的内部缆线穿过周向凸缘24A并且操作地连接至第一输入端12,以提供致动圆形针施放器30的轴向推动负载和牵拉负载。侧向撑条25将接头23支撑在轴20中。销29将杆27连接至关节26,关节26在与接头23的轴线偏离的位置处。杆27操作地连接至第二输入端14以相对于撑条25推动和牵拉杆27,这继而将使轴20围绕接头23关节运动。
图6示出位于轴20的远侧端部22处的接收器40的一个示例。接收器40的尺寸设定成并能够接收且保持容纳圆形针施放器30的一次性仓。仓可容纳:外科针;一定长度的缝合线,该一定长度的缝合线连接至外科针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及传动装置,该传动装置操作地连接至针驱动器。轴向偏离的臂41从轴20朝远侧延伸。臂41具有面朝内侧的平台49,其中一对纵向槽44位于平台49的下方并在平台49的两侧。弹簧加载的闩锁43能够选择性地将仓锁定至接收器40和解锁仓。任选地,闩锁43能够操作地联接至第四输入端18。
图7示出具有齿条45和小齿轮47的旋转传动件,该旋转传动件部分地定位在臂41中并且位于平台49的下方。同轴扭转管28的内部缆线连接至齿条45的近侧端部46,使得闭合第一输入端12的触发器将朝近侧牵拉齿条45,并且断开第一输入端12的触发器将朝远侧推动齿条45,断开第一输入端12的触发器可借助于回位弹簧进行。因此,致动第一输入端12将使小齿轮47旋转地往复运动。键48将往复式旋转平移至仓中的传动装置。
图8-9示出能够附接到接收器40的一次性仓50的一个示例。仓50能够朝近侧滑动到接收器40上,这样两个平台49,59平行并且面向彼此,直到闩锁43接合凹槽53。仓50由下部壳体51、上部壳体52和针罩90封装。下部壳体51具有尺寸设定成与槽44交接并且配对的一对纵向槽54。槽58的尺寸设定成在仓50滑动到接收器40上时接收键48。当仓50完全安置到接收器40中时,小齿轮47与形成仓50中的传动装置的一部分的旋转输入端67轴向对准,并且键48定位在槽68中,从而提供旋转地联接小齿轮47和旋转输入端67的扭转接口。
因此,轴20中的旋转传动件向仓50中的传动装置传送围绕垂直于轴20的纵向轴线的轴线的操作扭矩。操作扭矩也可沿与轴20的纵向轴线平行或共线、或相对于轴20的纵向轴线成另一个横向角度的轴线来传送。另外,可使用除键48和槽68实施例之外的本领域中已知的其它扭转接口,诸如十字形、星形、正方形、花键形等。
图10A-10C示出仓50中用于在圆形路径中驱动针的传动装置的一个示例。针驱动器70在弧形载体轨道55中往复运动并且操作以接合弧形针并使弧形针旋转。连杆60将旋转输入端67连接至针驱动器70。销71枢转地将连杆60的远侧端部连接至针驱动器70。旋转输入端67具有槽68,槽68与键48配对以便接收来自旋转传动件的往复式旋转。旋转输入端67具有带有径向槽66的径向延伸臂65。销64定位在槽66中,从而将连杆60的近侧端部连接至旋转输入端67。在适应一些相对径向运动的同时,槽66旋转地将销64约束至臂65。连杆60具有接收固定销62的纵向槽61,连杆60围绕固定销62既纵向平移又枢转。销71,62为共面的,但销66位于偏离平面中。连杆60包括屈曲节段63以适应偏离。除在该实施例中包括带有槽68的旋转输入端67的面的扭转接口之外,整个传动装置完全封装在仓50内。
图10A示出针驱动器70,针驱动器70定位在其在载体轨道55中的行程的一个端部处。如图10B所示,旋转输入端67的逆时针旋转将使针驱动器70沿载体轨道55顺时针平移。销71的旋转半径大于销64的旋转半径。如图10C所示,旋转输入端67的继续逆时针旋转将继续使针驱动器70顺时针平移,直到针驱动器70达到其在载体轨道55中的行程的另一端部。旋转输入端67、连杆60和针驱动器70不具有不动点,所以旋转输入端67的旋转将使得针驱动器70在整个行程中无束缚地在相反旋转方向上平移。
可通过使旋转输入端67顺时针旋转来颠倒顺序,使旋转输入端67顺时针旋转将使针驱动器70在载体轨道55中逆时针平移。因此,第一输入端12的致动将使得针驱动器70沿载体轨道55来回往复运动。
图11-13示出针驱动器70及其操作的一个示例。上部壳体52具有弧形针轨道56和弧形载体轨道55。在该实施例中,针轨道56和载体轨道55均具有源自公共轴线的标称曲率半径。因此,针轨道56和载体轨道55为同轴的。另外,在该实施例中,轨道55,56在径向尺寸上彼此至少部分地重叠,所以它们也是同径的。轨道55,56沿共享轴线彼此偏离,其中壁将轨道55,56分开。槽57穿过壁打开,并且允许载体轨道55和针轨道56之间的连通。在该实施例中,槽57与针轨道56的外侧边缘相邻打开。
针驱动器70具有尺寸设定成以可滑动的方式配合在载体轨道55中的载体75。在该实施例中,载体75具有匹配载体轨道55的弧的弯曲主体。销71从载体75延伸以接合连杆60。针驱动器70延伸穿过槽57并且延伸至针轨道56中。载体75具有尺寸设定成配合在槽57中的凸缘77。驱动器76附接到载体75并且定位在针轨道中,并且操作以接合针80并且使针80在针轨道56中运动。驱动器76是带有置于形成载体75的两件之间的一个腿部76C的L形金属叶片。驱动器76可作为悬臂式片簧从凸缘77偏转,并且还可弹性偏置以接合针80的外侧面。在该实施例中,驱动器76具有驱动面76A和返回面76B。驱动面76A具有在驱动行程期间操作以接合针80上阶梯的边缘。当这样接合时,针80将在针轨道56中与驱动器70一致地滑动。返回面76B为倾斜的,以有助于驱动器76在返回行程时在针80上面滑动。
下部壳体51约束连杆60以接合销71,并且还将载体75约束在载体轨道55中。针罩90将针80约束在针轨道56中。针罩90还沿针轨道56的长度限定窗口91。窗口91的尺寸设定成接收缝合线。当针80在针轨道56中旋转时,缝合线可穿过窗口91延伸出来。然而,窗口91的尺寸设定成小于针80,以便将针80约束在针轨道56中。
图14A-14B示出针80的一个实施例,针80具有带有尖锐的渐缩尖端83的远侧前端81。在前端81处可采用多种几何形状,包括锥体、有叶片的、钝的、切削刀头、渐缩切削刀头等。近侧后端82具有固定地接收一定长度的缝合线89的管状筒体84。后面88界定缝合线89。可采用多种不同类型的缝合线89,包括使用多种材料的编织缝合线、单丝缝合线和带倒钩缝合线,多种材料包括丙交酯乙交酯共聚酯(例如,VICRYL)、聚卡普隆(例如,MONOCRYL)、聚二氧六环酮(例如,PDS)、外科肠线、聚酯(例如,ETHIBOND)、丝绸(例如,PERMA-HAND)、聚丙烯(例如,PROLENE)、其它可吸收或不可吸收材料等。
前端81和后端82之间的角跨度可在约210度和约270度之间。弧形主体85在渐缩尖端83和筒体84之间延伸。主体85可以为具有基本上恒定的曲率半径的弧。标称曲率半径可在约0.170英寸至约0.210英寸之间,优选地在约0.180英寸至约0.205英寸之间,并且更优选地在约0.190英寸至约0.200英寸之间;然而,其它尺寸也是可以的。
远侧阶梯86A定位在主体85的外侧面上。远侧阶梯86A可定位成与前端81相距在约20度和约30度之间。近侧阶梯87A定位在主体85的外侧面上。近侧阶梯87A与远侧阶梯86A相距约180度。因此,阶梯86A,87A在针80上位于对跖位置处。阶梯86A,87A能够由针驱动器70的驱动器76接合。阶梯86A,87A的高度优选地在约0.003英寸和0.010英寸之间,但其它尺寸也是可以的。平部86B,87B从阶梯86A,87A朝远侧延伸并且在主体85中限定大体D形截面形状。远侧平部86B与远侧阶梯86A具有在约20度和约40度之间的角跨度。近侧平部87B与远侧阶梯87A具有在约8度和约30度之间的角跨度。平部86B,87B可有助于减小针驱动器70的返回行程期间针80和驱动器76之间的尺寸干涉作用。斜坡86C,87C与平部86B,87B的近侧端部相邻定位,使得主体85的截面形状从大体D形转变成大体圆形形状。在针驱动器70的返回行程期间,斜坡86C,87C减小驱动器76在针80上荒磨的可能性。
阶梯、平部和斜坡特征结构86A,87A,86B,87B,86C,87C可通过使主体85塑性地变形来制成。例如,可在挤压或轧制操作中在直的线材原料上使用模具以形成主体85上的特征结构。然后,可将直的原料屈曲成其弧形形状。虽然主体85的截面形状将沿主体85的长度改变,但椎体83和筒体84之间的截面积将保持基本上恒定。这优于有凹口针设计,其中材料在诸如切削或磨削操作中被移除以形成凹口,从而产生较弱的针。此外,塑性地形成主体85中的特征结构是更可靠且可再现的,并且能够更快地生产。
图15A-15B示出针80的与图14A-14B中基本上相同的另一个实施例;然而,远侧平部86B与远侧阶梯86A具有在约100度和约150度之间的角跨度。
图16A-16D示出使弧形针80在圆形路径中旋转的圆形针施放器30的一个实施例。缝合线在附图中已被隐藏以更好地示出装置操作。一对臂94,95在圆形针施放器30上限定大体U形远侧端部。针轨道56具有位于臂94中的出口92以及位于臂95中的入口93。片簧96,97允许针80逆时针旋转,但阻止针80顺时针旋转。片簧97延伸至针轨道56中,并且当接合针80的外侧面时朝外侧弹性地偏转,从而允许逆时针运动。片簧96延伸至针轨道56中,并且当接合针80的内侧面时朝内侧弹性地偏转,从而允许逆时针运动。但当针180经过片簧96,97中的一个时,该一个片簧将偏转到路径中以交接并且接合后面88,从而阻止针80顺时针旋转。
图16A示出处于其初始位置的装置。针80处于其回缩位置并且完全容纳在针轨道56中。针驱动器70具有位于返回位置和驱动位置之间的往复式行程。在此附图中,驱动器76处于其位于臂95中的返回位置。驱动器76与近侧阶梯87A相邻。片簧96弹性接合针80,同时片簧97与后面88相邻从而阻止针80顺时针旋转。
当第一输入端12被压下从而闭合触发器时,针驱动器70将被致动通过其驱动行程,在驱动行程中,针驱动器70逆时针旋转至少约180度到达驱动位置,如图16B所示。在驱动行程期间,驱动器76接合近侧阶梯87A并且将一致地使针80旋转约180度到达其伸展位置。针80将跨越臂94,95、位于出口92和入口93之间。插置在臂94,95之间的组织将由针80的前端81拼合。
当第一输入端12被释放并且回位弹簧断开触发器时,针驱动器70往复运动通过其返回行程,在返回行程中,针驱动器70顺时针旋转约180度回到图16C所示的返回位置。在返回行程期间,驱动器76在针80上面滑动,并且片簧96接合后面88从而阻止针80顺时针旋转。驱动器76与远侧阶梯86A相邻。
当第一输入端12再次被压下从而再次闭合触发器时,针驱动器70将再次被致动通过其驱动行程,在驱动行程中,针驱动器70逆时针旋转至少约180度到达驱动位置,如图16D所示。在驱动行程期间,驱动器76接合远侧阶梯86A并且将一致地使针80旋转约180度回到其回缩位置。缝合线将沿循针80并且被穿过拼合的组织。
当第一输入端12再次被释放并且回位弹簧断开触发器时,针驱动器70再次往复运动通过其返回行程,在返回行程中,针驱动器70顺时针旋转约180度回到其返回位置,如图16A所示。在返回行程期间,驱动器76在针80上面滑动,并且片簧97接合后面88从而阻止针80顺时针旋转。因此,针80在完整的圆形路径中被驱动。顺序可按外科医生的需要来重复以实现期望的缝合任务。
图17-21示出位于轴20的远侧端部22上的接收器140的另一个实施例。接收器具有均具有纵向槽144的轴向偏离下臂141和轴向偏离上臂142。弹簧加载的闩锁143能够选择性地将仓150锁定在接收器140中和解锁仓150。齿条145和小齿轮147旋转传动件定位在下臂141中。同轴扭转管28的内部缆线连接至齿条145的近侧端部146。齿条145屈曲以适应下臂141的轴向偏离。键148与槽168配对以将小齿轮147的往复式旋转平移至仓150中的旋转输入端168。
一次性仓150能够附接到接收器140。仓150可在接收器140的臂141,142之间朝近侧滑动,直到闩锁143接合阶梯152。阶梯154与下臂141中的纵向槽144配对,并且阶梯152与上臂142中的纵向槽144配对。槽158的尺寸设定成在仓150滑动到接收器140上时接收键148。当仓50完全安置在接收器140中时,小齿轮147与旋转输入端167轴向对准,并且键148定位在槽168中,从而旋转地将旋转传动件联接至旋转输入端167。
图22A-22C示出仓150中用于在圆形路径中驱动针的传动装置的一个示例。针驱动器170在弧形载体轨道155中往复运动。直的连杆160将旋转输入端167连接至针驱动器170。销171枢转地将连杆160的远侧端部连接至针驱动器170。旋转输入端167具有径向槽166。在连杆160下方隐而不见的销164定位在槽166中以将连杆160的近侧端部连接至旋转输入端167。在适应一些相对径向运动的同时,槽166旋转地约束销164。连杆160具有接收固定销162的纵向槽161,连杆160围绕固定销162既纵向平移又枢转。针驱动器170和旋转输入端167为共面的。齿165接合仓中的止动件以限制旋转输入端167的旋转行程。
图22A示出针驱动器170,针驱动器170定位在其在载体轨道155中的行程的一个端部处。如图22B所示,旋转输入端167的顺时针旋转将使针驱动器170沿载体轨道155逆时针平移。如图22C所示,旋转输入端167的继续顺时针旋转将继续使针驱动器170逆时针平移,直到针驱动器170达到其在载体轨道155中的行程的另一端部。旋转输入端167、连杆160和针驱动器170不具有不动点,所以旋转输入端167的旋转将使得针驱动器170在整个行程中无束缚地在相反旋转方向上平移。可通过使旋转输入端167逆时针旋转来颠倒顺序,使旋转输入端67逆时针旋转将使针驱动器170在载体轨道55中顺时针平移。
图23A示出针驱动器170的一个实施例。载体175的尺寸设定成以能够滑动的方式配合在载体轨道155中。载体175可以为带有弧形形状的部件。销171从载体175延伸。驱动器176从载体175延伸穿过槽157并且延伸至针轨道156中。驱动器176为带有具有孔的一个腿部176C的L形金属叶片,腿部176C配合在销171上面并且抵靠载体175安置。驱动器176具有驱动面176A和返回面176B。在该实施例中,驱动面176A和返回面176B大体共面且对称。图23B示出另一个实施例,其中驱动面176A朝向针180屈曲。
如图24所示,针轨道156和载体轨道155同轴且同径。轨道155,156沿共享轴线彼此偏离,其中壁将轨道155,156分开。槽157穿过壁打开,并且允许载体轨道155和针轨道156之间的连通。在该实施例中,槽157与针轨道156的内侧边缘相邻打开。针180以能够滑动的方式配合在针轨道156中,并且载体175以能够滑动的方式配合在载体轨道155。驱动器176延伸穿过槽157并且延伸至针轨道156中。驱动器176被布置为弹性接合针180的内侧面的悬臂片簧。当针180在针轨道156中旋转时,缝合线可穿过窗口191延伸出来。
图25A-25B示出针180的实施例,针180具有带有尖锐的渐缩尖端183的远侧前端181。近侧后端182具有固定地接收一定长度的缝合线189的管状筒体184。后面188界定缝合线189。弧形主体185在渐缩尖端183和筒体184之间延伸。远侧阶梯186A定位在主体185的内侧面上。远侧阶梯186A可定位成与前端181相距在约20度和约30度之间。近侧阶梯187A定位在主体185上的内侧面上、与远侧阶梯186A相距约180度。阶梯186A,187A能够由针驱动器170的驱动器176接合。平部186B,187B从阶梯186A,187A朝远侧延伸并且在主体185中限定大体D形截面形状。远侧平部186B与远侧阶梯186A具有在约20度和约40度之间的角跨度。近侧平部187B与远侧阶梯187A具有在约8度和约20度之间的角跨度。斜坡186C,187C与平部186B,187B的近侧端部相邻定位,使得主体185的截面形状从大体D形转变成大体圆形形状。阶梯186A,187A、平部186B,187B和斜坡186C,187C可通过使主体185塑性地变形来制成。除以上讨论的优点之外,塑性地形成远侧阶梯186A的过程可部分地使渐缩尖端183朝内侧屈曲,这有助于在将直的原料屈曲成其弧形形状时沿期望的曲率半径定位前端181。
图26A-26B示出针180的与图25A-25B中基本上相同的另一个实施例;然而,远侧平部186B与远侧阶梯186A具有在约120度和约150度之间的角跨度。
图27A-27D示出使弧形针180在圆形路径中旋转的圆形针施放器30的一个实施例。缝合线在附图中已被隐藏以更好地示出装置操作。一对臂194,195在圆形针施放器30上限定大体U形远侧端部。针轨道156具有位于臂194中的出口192以及位于臂195中的入口193。片簧196,197允许针180逆时针旋转,但阻止针180顺时针旋转。片簧197延伸至针轨道156中,并且当接合针180的外侧面时朝外侧弹性地偏转。片簧196延伸至针轨道156中,并且当接合针180的外侧面时朝外侧弹性地偏转。片簧196,197与彼此间隔约180度。
图27A示出处于其初始位置的装置。针180处于其回缩位置并且完全容纳在针轨道156中。针驱动器170处于其在臂195中的返回位置。驱动器176与近侧阶梯187A相邻。片簧197与后面188相邻,从而阻止针180顺时针旋转。
当针驱动器170被致动通过其驱动行程时,针驱动器170逆时针旋转约180度到达驱动位置,如图27B所示。在驱动行程期间,驱动器176接合近侧阶梯187A并且将一致地使针180旋转约180度到达其伸展位置。针180将跨越臂194,195、位于出口192和入口193之间。插置在臂194,195之间的组织将由针180的前端181拼合。
当针驱动器170往复运动通过其返回行程时,针驱动器170顺时针旋转约180度回到图27C所示的返回位置。在返回行程期间,驱动器176在针180上面滑动,并且片簧196接合后面188从而阻止针180顺时针旋转。
当针驱动器170被致动通过其驱动行程时,针驱动器170逆时针旋转约180度到达驱动位置,如图27D所示。在驱动行程期间,驱动器176接合远侧阶梯186A并且将一致地使针180旋转约180度回到其回缩位置。缝合线将沿循针180并且被穿过刺穿的组织。
当针驱动器170往复运动通过其返回行程时,针驱动器170顺时针旋转约180度回到其返回位置,如图27A所示。在返回行程期间,驱动器176在针80上面滑动,并且片簧197接合后面188从而阻止针80顺时针旋转。因此,针180在完整的圆形路径中被驱动。
图28示出变型,该变型使用棘爪206,207以允许针180逆时针旋转,但阻止针180顺时针旋转。每个棘爪206,207大体上为“泪滴”形的,具有倒圆端部和带有边缘的尖的端部。棘爪206,207围绕倒圆端部在与针180相同的平面内枢转,使得尖的端部可旋转进出针轨道156。弹簧206B,207B使尖的端部朝内侧偏置到针轨道156中。尖的端部延伸至针轨道156中,并且当接合针180的外侧面时朝外侧弹性地偏转,从而允许逆时针运动。但当针180经过棘爪206,207中的一个时,尖的端部将朝内侧偏转到路径中以交接并且接合后面188,从而阻止针180顺时针旋转。
图29A-29D示出圆形针施放器30的另一个实施例。棘爪216,217允许针180在针轨道156中逆时针旋转,但阻止针180顺时针旋转。在该实施例中,棘爪216,217与针驱动器170一样接合并且作用于针180的相同特征结构。虽然示出具有两个棘爪216,217,但应当理解,它们的功能是冗余的,并且装置能够在仅存在棘爪216,217中的一个的情况下进行操作。
棘爪216与驱动器176的驱动位置大体上对准。棘爪216横向于针180路径并且在针180的平面内平移。弹簧216B使棘爪216朝外侧偏置到针轨道156中。当针180逆时针旋转时,针180或驱动器176将接合斜坡216A以使棘爪216朝内侧偏转,从而允许逆时针运动。棘爪217与驱动器176的返回位置大体上对准。棘爪217可在针180的平面内径向平移。弹簧217B使棘爪217朝外侧偏置到针轨道156中。当针180逆时针旋转时,针180或驱动器176将接合斜坡217A以使棘爪217朝内侧偏转,从而允许逆时针运动。
图29A示出处于其初始位置的装置。针180处于其缩回位置,并且针驱动器170处于其返回位置。棘爪216与远侧阶梯186A相邻,并且棘爪217与近侧阶梯187A相邻,两者均阻止顺时针旋转。
当针驱动器170被致动通过其驱动行程时,针驱动器170逆时针旋转约180度到达驱动位置,如图29B所示。在驱动行程期间,驱动器176接合近侧斜坡217A并且使棘爪217朝内侧移位,然后接合近侧阶梯187A,并且然后一致地使针180旋转约180度到达其伸展位置。在伸展位置中,棘爪217与远侧阶梯186A相邻从而阻止针180顺时针旋转。当驱动器176达到驱动位置时,驱动器176将接合斜坡216A并且使棘爪216朝内侧移位。在驱动位置,驱动器176将保持插置在棘爪216和针180之间。
当针驱动器170往复运动通过其返回行程时,针驱动器170顺时针旋转约180度回到图29D所示的返回位置。当驱动器176经过时,棘爪216偏转成与近侧阶梯187A相邻,从而阻止针180顺时针旋转。如图29C所示,棘爪217具有定位在针阶梯186A,187A下方的远侧斜坡217C。例如,当近侧斜坡217A定位在针轨道156中时,远侧斜坡217C可定位在槽157中。在返回行程期间,驱动器176接合近侧斜坡216C并且使棘爪216朝内侧移位。当驱动器176经过时,棘爪217偏转成与远侧阶梯186A相邻,从而阻止针180顺时针旋转。
然后可重复该顺序,以将针180驱动约180度到达其缩回位置。
图30A-30B示出棘爪226,227的变型,棘爪226,227与针驱动器170一样接合并且作用于针180的相同特征结构。虽然示出具有两个棘爪226,227,但应当理解,它们的功能是冗余的,并且装置能够在仅存在棘爪226,227中的一个的情况下进行操作。
棘爪226与驱动器176的驱动位置大体上对准。棘爪226大体上为“泪滴”形的,并且与棘爪206,207类似地起作用。扭转弹簧226B使尖的端部朝外侧偏置到针轨道156中。当驱动器176达到驱动位置时,驱动器176将接合棘爪226的尖的端部并且使尖的端部朝内侧移位。在驱动位置,驱动器176将保持插置在棘爪226和针180之间。当针驱动器170往复运动通过其返回行程时,驱动器176经过并且棘爪226偏转成与近侧阶梯187A相邻,从而阻止针180顺时针旋转。棘爪226可替换在构造上与片簧96,97类似的片簧,片簧96,97将与针驱动器170一样接合并且作用于针180的相同特征结构。
棘爪227朝外侧偏置到针轨道156中,并且在棘爪227在驱动器176和针180之间进行接合的顺序方面,棘爪227与棘爪217类似地起作用。近侧斜坡227A定位在针轨道156中,并且在针180和驱动器176逆时针旋转时,允许它们经过。远侧斜坡227C定位在槽157中,使得在返回行程期间,驱动器176接合近侧斜坡216C并且使棘爪216朝内侧移位。
图31A-31C示出允许针180逆时针旋转但阻止针180顺时针旋转的棘爪236,237的另一个实施例。棘爪236为大体上椭圆形的,具有部分地与边缘成角度的一个端部。棘爪236围绕倒圆端部在与针180相同的平面内枢转,使得边缘可旋转进出针轨道156。扭转弹簧使边缘朝内侧偏置到针轨道156中。在棘爪236接合针180和后面188的顺序方面,棘爪236与棘爪206类似地起作用。
棘爪237定位在臂195中、与入口193相邻。棘爪237定位在针轨道156下方,并且以横向于针180的平面的角度并任选地垂直于该平面平移。弹簧237B使棘爪237向上偏置到针轨道156中。当针180逆时针旋转时,针180接合斜坡237A以使棘爪237向下偏转,从而允许逆时针运动。但当针180经过棘爪237时,棘爪237将偏转到路径中以交接并且接合后面188,从而阻止针180顺时针旋转。
图32示出仓250和接收器240的另一个实施例。仓250可类似于先前描述的任何仓,并且容纳:外科针;一定长度的缝合线,该一定长度的缝合线连接至外科针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及传动装置,该传动装置操作地连接至针驱动器。接收器240具有轴向偏离下臂141和轴向偏离上臂142。下臂242比上臂241更加朝外侧延伸。下臂242具有与仓250上的对应沟槽配对的纵向脊244。旋转传动件机构位于下臂242中。一对带倒钩叉臂253从仓250延伸。仓250通过以下方式来附接到接收器240:使仓250在臂241,242之间滑动,直到叉臂253安置在孔243中,由此将仓250锁定在接收器240中。仓250可通过推挤夹持部分254来解锁和移除,夹持部分254将使叉臂253朝内侧偏转,直到叉臂253从孔243分离,此时仓250可从接收器240被拉出。
图33示出仓350和接收器340的另一个实施例。仓350可类似于先前描述的任何仓,并且容纳:外科针;一定长度的缝合线,该一定长度的缝合线连接至外科针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及传动装置,该传动装置操作地连接至针驱动器。接收器340具有纵向平台,通过纵向平台,键348将旋转传动件的往复式旋转平移至仓350中的传动装置。一对间隔开的凸缘341与平台349的远侧端部相邻。每个凸缘341具有销孔342。仓350通过将销353按扣到销孔342中来附接到接收器340。然后可围绕销353旋转仓350,直到仓350接合平台349。止动器机构343接合仓350中的匹配凹槽以将仓350锁定在接收器340中。仓350可通过颠倒顺序来解锁和移除。
图34示出用于仓450的封装400的实施例。仓450可类似于先前描述的任何仓,并且容纳:外科针;一定长度的缝合线489,该缝合线489连接至外科针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及传动装置,该传动装置操作地连接至针驱动器。封装400具有包括壳体402和顶片401的外壳。仓450中的针处于针的缩回位置。仓450由臂405可释放地保持。阻挡件406定位在仓450上的U形远侧端部中并且阻止针离开仓450。仓450延伸至间隙404中。缝合线489从仓450延伸并且缠绕在线轴408周围,线轴408在这里显示为能够围绕轮轴407旋转的动态卷轴。另选地,线轴408可采取缝合线489可缠绕的静态线轴诸如栓或轨道的形式。
如图35所示,封装400有助于将仓400组装到缝合装置420上。封装400提供人体工程学有益的格式以在保持针安全地与使用者隔离的同时,操纵、对准仓400并且将仓400组装到缝合装置的轴420上。一旦组装并且附接,取出轴420将会将仓400从封装400拉出并且缝合线489将从线轴408放出并且可供使用。
图36示出用于仓550的封装500的另一个实施例。仓550可类似于先前描述的任何仓,并且容纳:外科针;一定长度的缝合线589,该缝合线589连接至外科针;针驱动器,该针驱动器操作以接合针并且使针相对于仓运动;以及传动装置,该传动装置操作地连接至针驱动器。仓550可释放地在平台503上保持在臂505之间,其中阻挡件506被插入仓550的U形远侧端部中。缝合线589从仓550延伸并且缠绕在线轴508周围。封装500具有为塑料片或纸片形式的外壳501。小翼片502折叠在线轴508和仓550上面,大翼片503折叠在小翼片502上面,从而包封仓550、线轴508和缝合线589。
本文已经示出和描述了本发明的多个实施例和实例,在不脱离本发明的范围的情况下,通过本领域普通技术人员进行适当的修改,可以实现本文描述的方法和设备的进一步改进。已经提及若干此类潜在修改形式,并且其它修改形式对于本领域的技术人员而言将会显而易见。例如,附图中的具体材料、量纲和比例将会被理解为非限制性实例。因此,本发明的范围应该以下面的权利要求书考虑,并且应被理解为不限于说明书和附图所示和所述的结构、材料或操作细节。
Claims (4)
1.一种一次性外科针仓,所述一次性外科针仓能够附接到外科缝合装置以及与外科缝合装置分离,所述一次性仓包括:
弧形针轨道;
弧形针,所述弧形针定位在所述针轨道中,所述针包括前端和后端;
一定长度的缝合线,所述一定长度的缝合线连接至所述针;
往复式针驱动器,所述往复式针驱动器操作以接合所述针并且使所述针在所述针轨道中运动;
传动装置,所述传动装置操作地连接至所述针驱动器;以及
扭转接口,所述扭转接口能够将所述传动装置联接至所述外科缝合装置中的旋转传动件;
其中所述往复式针驱动器和所述传动装置完全被封入所述仓中。
2.根据权利要求1所述的一次性外科针仓,其中所述外科缝合装置为可重复使用的。
3.根据权利要求1所述的一次性外科针仓,其中所述外科缝合装置包括细长轴,所述细长轴具有近侧端部、远侧端部以及能够与所述仓交接的接收器。
4.根据权利要求1所述的一次性外科针仓,还包括外科缝合装置。
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US9839419B2 (en) | 2015-06-16 | 2017-12-12 | Ethicon Endo-Surgery, Llc | Suturing instrument with jaw having integral cartridge component |
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US10321905B2 (en) | 2015-10-21 | 2019-06-18 | Ethicon Llc | Suturing instrument with jaw having integral needle cover |
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2013
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- 2013-03-15 US US13/832,986 patent/US20140172015A1/en not_active Abandoned
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