CN101224117A - 外科器械的消毒后编程装置和方法 - Google Patents

外科器械的消毒后编程装置和方法 Download PDF

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CN101224117A
CN101224117A CNA2008100026186A CN200810002618A CN101224117A CN 101224117 A CN101224117 A CN 101224117A CN A2008100026186 A CNA2008100026186 A CN A2008100026186A CN 200810002618 A CN200810002618 A CN 200810002618A CN 101224117 A CN101224117 A CN 101224117A
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CN101224117B (zh
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J·S·斯韦兹
F·E·谢尔顿四世
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Ethicon Endo Surgery Inc
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    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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Abstract

公开了外科器械的消毒后编程装置和方法，具体公开了具有可编程控制单元的外科器械和用于在外科器械处于无菌容器中时对控制单元进行编程的方法。该方法可以包括在容器包装外科器械，然后在外科器械处于容器中时对外科器械进行消毒。该方法还可以包括在外科器械处于容器中而编程装置位于容器之外时对外科器械进行编程。

Description

外科器械的消毒后编程装置和方法
相关申请的交叉引用
本申请与下列同时提交的美国专利申请相关，这些专利申请的内容通过引用并入本文：
(1)J.Giordano等人的题为“在控制单元和传感器转发器之间能够无线通信的外科器械”(SURGICAL INSTRUMENT WITH WIRELESSCOMMUNICATION BETWEEN CONTROL UNIT AND SENSOR TRANSPONDERS)的美国专利申请(律师档案号060338/END5923USNP)；
(2)J.Giordano等人的题为“在控制单元和远程传感器之间能够无线通信的外科器械”(SURGICAL INSTRUMENT WITH WIRELESSCOMMUNICATION BETWEEN CONTROL UNIT AND REMOTE SENSOR)的美国专利申请(律师档案号060339/END5924USNP)；
(3)J.Giordano等人的题为“在控制单元和端部执行器之间具有通信元件的外科器械”(SURGICAL INSTRUMENT WITH ELEMENTS TOCOMMUNICATE BETWEEN CONTROL UNIT AND END EFFECTOR)的美国专利申请(律师档案号060340/END5925USNP)；
(4)F.Shelton等人的题为“对仓重新用在外科器械中的防止”(PREVENTION OF CARTRIDGE REUSE IN A SURGICAL INSTRUMENT)的美国专利申请(律师档案号060341/END5926USNP)；
(5)F.Shelton等人的题为“互锁机构和包含互锁机构的外科器械”(INTERLOCK AND SURGICAL INSTRUMENT INCLUDING SAME)的美国专利申请(律师档案号060343/END5928USNP)；和
(6)F.Shelton等人的题为“具有增强的电池性能的外科器械”(SURGICAL INSTRUMENT WITH ENHANCED BATTERY PERFORMANCE)的美国专利申请(律师档案号060347/END5931USNP)。
技术领域
本发明涉及外科器械的消毒后编程装置和方法。
背景技术
与传统的开放式外科器械相比，内窥镜外科器械通常更受青睐，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，各种内窥镜外科器械已经有了显著的发展，这些器械适于通过套管针的插管将远侧端部执行器精确放置在所需的手术部位。这些远侧端部执行器(例如，内切割器、抓钳、切割器、缝合器、夹具施放器、进入装置、药物/基因治疗输送装置、以及使用超声波、RF、或激光等的能量装置)以各种方式与组织接合，达到诊断或治疗的效果。
已知的外科缝合器包括端部执行器，该端部执行器在组织中形成纵向切口的同时在切口的相对两侧上施加多排缝钉。所述端部执行器包括一对相配合的钳口构件，如果器械用于内窥镜或者腹腔镜应用，这对钳口构件能够穿过插管通道。钳口构件中的一个装纳具有至少两个横向间隔的缝钉排的钉仓。另一个钳口构件限定了具有缝钉成形凹口的钉砧，所述凹口与钉仓中的缝钉排对准。该器械包括多个往复运动的楔形件，这些楔形件在被向远侧驱动时穿过钉仓中的开口并与支撑缝钉的驱动器接合，向着钉砧击发缝钉。
在美国专利No.5465895中描述了适用于内窥镜应用的外科缝合器的例子，其披露了具有不同闭合和击发动作的内切割器。使用该装置的临床医生可在击发之前闭合组织上的钳口构件来定位组织。一旦临床医生确定钳口构件正确地夹持了组织，则临床医生就可用单个击发行程击发外科缝合器，由此缝合和切割组织。同时切割和缝合避免了在使用分别仅仅进行切割或缝合手术的不同外科工具顺序地进行所述动作时引起的并发症。
可在击发之前在组织上闭合的一个具体的优点在于，临床医生可以通过内窥镜确认到达了需要切割的部位，包括确认已经在相对的钳口之间捕获了足量的组织。否则，相对的钳口会被拉得太近，特别是在其远端夹紧，不能在切割的组织中有效成形闭合的缝钉。用于外科缝合器的可多次使用的端部执行器通常是有利的。在另一极端，夹紧过量的组织可导致故障和不完全的击发。
每一代内窥镜缝合器/切割器不断增加复杂性和功能。一个主要的原因是为了满足低击发力(FTF)的要求，使所有或大多数外科医生能够处理。降低FTF的一种已知方案是采用CO2马达或电动马达。这些装置比传统的手动功能装置并不具有明显优势，但原因不同。外科医生通常青睐感受与在成形缝钉时由端部执行器承受的力成比例的立，以确保切割/缝合周期完成，上限在大多数外科医生的能力范围内(通常大约15-30lbs)。他们通常希望保持控制缝钉的展开，并希望能够在感到装置的手柄中的力太大或因为其他一些临床原因随时停止。
为了满足这种需求，已经开发了所谓的“动力辅助”内窥镜外科器械，其中附加的功率源辅助器械的击发。例如，在一些动力辅助设备中，马达向使用者通过按压击发扳机输入的动力提供附加的电功率。这样的设备能够向操作者提供负载力反馈和控制，以减小为了完成切割操作而需要操作者施加的击发力。一种这样的动力辅助设备描述在Shelton等人于2006年1月31日提交的题为“Motor-driven surgical cutting and fastening instrument with loadingforce feedback”(“‘573申请”)的美国专利申请No.11/343573中，通过引用将其包含在这里。
这些动力辅助设备通常包括一些纯机械的内窥镜外科器械所不具有的其他部件，例如传感器和控制系统。在外科器械中使用这些电子器件的一个难题是向传感器输送功率和/或信息并从传感器获取数据，特别是在外科器械中存在自由旋转接头时。
发明内容
在一个总的方面，本发明涉及一种外科器械，例如内窥镜或腹腔镜器械。根据一种实施方式，该外科器械包括具有至少一个无源驱动的传感器转发器的端部执行器。该外科器械还包括：轴，其远端连接到所述端部执行器上；以及手柄，其连接到所述轴的近端上。所述手柄包括控制单元(例如微控制器)，其通过至少一个电感耦合与所述传感器转发器通信。另外，该外科器械可包括用于旋转轴的旋转接头。在这种情况下，该外科器械可包括：位于轴中且位于旋转接头远侧的第一感应元件，其感应耦合到控制单元上；以及第二感应元件，其位于轴中远侧并感应耦合到至少一个传感器转发器上。第一和第二感应元件可通过接线物理连接。
这样，控制单元可与端部执行器中的转发器通信，在难以保持接线连接的位置无须通过复杂机械接头例如旋转接头来直接接线连接。另外，由于感应元件之间的距离是固定的和已知的，可以最优化耦合以感应传送能量。另外，这些距离可以较短，使得可使用较低功率的信号，由此最小化与器械使用环境中其他系统的干涉。
在本发明另一总的方面，外科器械的导电轴可用作用于控制单元的天线，以将信号无线传送到传感器转发器或者从其传送信号。例如，传感器转发器可位于端部执行器的非导电部件上或者布置在其中，所述非导电部件例如是塑料仓，由此使传感器与端部执行器的导电元件和轴绝缘。此外，手柄中的控制单元可以电连接到轴。这样，轴和/或端部执行器可用作用于控制单元的天线，从控制单元发射信号到传感器和/或从传感器接收发射的信号。这种设计尤其适用于具有复杂机械接头(例如旋转接头)的外科器械，所述机械接头使得难以在传感器和控制单元之间采用直接接线连接来传送数据信号。
在另一实施方式中，轴和/或端部执行器的部件可用作用于传感器的天线，将信号发送到控制单元并从控制单元接收发送的信号。根据该实施方式，控制单元与轴和端部执行器电绝缘。
在另一总的方面，本发明涉及一种外科器械，其包括可编程的控制单元，该控制单元可在器械被包装和消毒之后通过编程装置进行编程。在该实施方式中，编程装置可对控制单元无线编程。控制单元可在编程操作期间由来自编程装置的无线信号无源驱动。在另一实施方式中，无菌容器可包括连接接口，使得编程单元可连接到外科器械上同时外科器械处于无菌容器中。
具体而言，本发明公开了如下内容：
(1).一种系统，包括：
外科器械，其具有控制单元；和
远程编程装置，用于对所述控制单元进行无线编程。
(2).如第(1)项所述的系统，还包括用于容纳所述外科器械的容器，所述远程编程装置位于所述容器之外。
(3).如第(2)项所述的系统，其中，所述控制单元包括：
驱动电路，用于利用从所述远程编程装置接收的无线信号来无源地驱动所述控制单元；
存储器，用于储存从所述远程编程装置接收的代码；和
处理器，用于执行储存在所述存储器中的代码。
(4).如第(3)项所述的系统，其中，所述存储器还储存由所述处理器执行的启动加载序列。
(5).如第(1)项所述的系统，其中，所述控制单元和所述远程编程装置电感耦合。
(6).如第(1)项所述的系统，其中，所述控制单元和所述远程编程装置电容耦合。
(7).如第(2)项所述的系统，其中，所述外科器械包括：
容纳所述控制单元的手柄；
连接到所述手柄上的轴；和
连接到所述轴上的端部执行器。
(8).如第(7)项所述的系统，其中，所述端部执行器包括切割器械。
(9).如第(8)项所述的系统，其中，所述手柄还包括：
与所述控制单元通信的马达；和
用于为所述马达供电的电池。
(10).一种方法，包括：
将外科器械包装在容器中；
在所述外科器械处于容器中时对所述外科器械进行消毒；以及
在所述外科器械处于容器中而编程装置处于容器之外时，对所述外科器械进行编程。
(11).如第(10)项所述的方法，其中，对所述外科器械进行编程包括用所述编程装置对所述外科器械进行无线编程。
(12).如第(10)项所述的方法，其中，对所述外科器械进行编程的步骤是在对所述外科器械进行消毒的步骤之后进行的。
(13).如第(12)项所述的方法，其中，对所述外科器械进行消毒的步骤包括使所述外科器械经受辐射。
(14).如第(13)项所述的方法，其中，所述辐射包括伽马辐射。
(15).如第(12)项所述的方法，其中，对所述外科器械进行消毒的步骤包括用环氧乙烷来处理所述外科器械。
(16).如第(10)项所述的方法，其中，所述外科器械包括可编程控制单元。
(17).如第(10)项所述的方法，其中：
所述外科器械包括外部连接接口；
所述容器包括连接接口，当所述外科器械容纳在所述容器中时，所述连接接口与所述外部连接接口配合；并且
对所述外科器械进行编程包括将所述编程装置连接到所述容器的连接接口上。
(18).一种系统，包括：
具有手柄的外科器械，其中，所述手柄包括：
位于所述手柄中的控制单元；和
用于所述控制单元的外部连接接口；和
用于容纳所述外科器械的容器，其中，所述容器包括：
连接接口，所述连接接口的内端与所述外科器械的外部连接接口配合，所述连接接口的外端位于所述容器之外。
(19).如第(18)项所述的系统，还包括编程装置，所述编程装置能够连接到所述容器的连接接口的外端。
(20).一种外科器械，包含无线可编程的控制单元。
(21).如第(20)项所述的外科器械，其中，所述无线可编程的控制单元包括天线，用于从远程的无线编程装置接收编程代码。
(22).如第(20)项所述的外科器械，还包括：
与所述控制单元通信的马达；和
用于为所述马达供电的电池。
(23).如第(22)项所述的外科器械，还包括端部执行器，所述端部执行器包括传感器，所述传感器与所述无线可编程的控制单元进行通信。
(24).如第(20)项所述的外科器械，其中，所述控制单元包括：
驱动电路，用于利用从远程编程装置接收的无线信号来无源地驱动所述控制单元；
存储器，用于储存从所述远程编程装置接收的代码；和
处理器，用于执行储存在所述存储器中的代码。
(25).如第(24)项所述的外科器械，其中，所述存储器还储存由所述处理器执行的启动加载序列。
(26).如第(20)项所述的外科器械，其中，所述外科器械包括内窥镜外科器械。
(27).如第(23)项所述的外科器械，其中，所述端部执行器还包括切割器械。
附图说明
结合附图通过例子的方式描述本发明的各种实施方式，其中：
图1和2是根据本发明各种实施方式的内窥镜外科器械的透视图；
图3-5是根据本发明各种实施方式的器械的端部执行器和轴的分解图；
图6是根据本发明各种实施方式的端部执行器的侧视图；
图7是根据本发明各种实施方式的器械的手柄的分解图；
图8和9是根据本发明各种实施方式的手柄的局部透视图；
图10是根据本发明各种实施方式的手柄的侧视图；
图11、13-14、16和22是根据本发明各种实施方式的外科器械的透视图；
图12和19是根据本发明各种实施方式的控制单元的框图；
图15是根据本发明各种实施方式的包括传感器转发器的端部执行器的侧视图；
图17和18是根据本发明各种实施方式的位于无菌容器中的器械的视图；
图20是根据本发明各种实施方式的远程编程装置的框图；
图21是根据本发明各种实施方式的包装的器械的视图。
具体实施方式
本发明的各种实施方式总体涉及外科器械，其具有至少一个远程传感器转发器和用于从控制单元传送功率和/或数据信号到转发器(一个或多个)的装置。本发明可以与包括至少一个传感器转发器的任何类型的外科器械一起使用，例如内窥镜或腹腔镜外科器械，但是特别适用于一些特征(例如自由旋转接头)防止或者不利于使用接线连接到传感器(一个或多个)的外科器械。在描述系统的各个方面之前，首先通过示例的方式来描述可以使用本发明的一种外科器械——内窥镜缝合和切割器械(也就是内切割器)。
图1和2示出了内窥镜外科器械10，内窥镜外科器械10包括手柄6、轴8和在关节运动枢轴14处枢转连接到轴8上的关节运动端部执行器12。可以通过对手柄6的控制来辅助端部执行器12的正确定位和定向，手柄6包括(1)：旋钮28，用于在轴8的自由旋转接头29处旋转闭合管(以下将结合图4-5更详细地描述)以旋转端部执行器12；和(2)关节运动控制器16，以实现端部执行器12绕关节运动枢轴14的旋转关节运动。在所示的实施方式中，端部执行器12能够用作内切割器，用于夹紧、切割和缝合组织，但是在其他实施方式中，可以使用其他类型的端部执行器，例如用于其他类型的外科装置的端部执行器，如抓钳、切割器、缝合器、夹具施放器、进入装置、药物/基因治疗输送装置、超声、RF、或激光装置等。
器械10的手柄6可包括闭合扳机18和击发扳机20，用于致动端部执行器12。应当理解，具有用于不同手术任务的端部执行器的器械可具有不同数量和类型的扳机或者其他适合的控制器，用于操作端部执行器12。所示的端部执行器12通过优选的细长轴8与手柄6分离。在一种实施方式中，器械10的临床医生或者操作者可以通过利用关节运动控制器16使端部执行器12相对于轴8做关节运动，如Geoffrey C.Hueil等人2006年1月10日提交的名称为“SurgicalInstrument Having An Articulating End Effector”的待审美国专利申请No.11/329020中更详细地描述的一样，该申请通过引用并入本文。
在该示例中，除了别的以外，端部执行器12包括缝钉通道22和可枢转平移的夹紧构件如钉砧24等，它们之间保持确保有效缝合和切割夹紧在端部执行器12中的组织的间距。手柄6包括手枪式握把26，临床医生向着手枪式握把26枢转地拉动闭合扳机18，使钉砧24朝着端部执行器12的缝钉通道22夹紧或者闭合，从而夹紧定位在钉砧24和缝钉通道22之间的组织。击发扳机20在闭合扳机18更远的外侧。一旦闭合扳机18锁定在闭合位置，击发扳机20可朝着手枪式握把26稍微转动，从而操作者可用一只手触及。然后操作者可以向着手枪式握把26枢转地拉动击发扳机20，从而缝合和切割端部执行器12中夹紧的组织。‘573申请描述了用于锁定和解锁闭合扳机18的各种构造。在其他实施方式中，可以使用除钉砧24之外的不同类型的夹紧构件，例如，相对的夹钳等。
应当理解，此处使用的术语“近侧”和“远侧”是相对于握持手柄6的临床医生而言。因此，相对于更近侧的手柄6而言，端部执行器12位于远侧。还应当理解，为了方便和清楚起见，使用的空间术语例如“垂直”和“水平”是相对附图而言。但是，可以多种方位和位置使用外科器械，这些术语并不意味着限制和绝对化。
可以首先致动闭合扳机18。一旦临床医生对端部执行器12的定位满意，医生可将闭合扳机18拉回到邻近手枪式握把26的其完全闭合的锁定位置。然后致动击发扳机20。当医生从击发扳机20移除压力时，击发扳机20返回打开位置(图1和2所示)。按压手柄6上(在该示例中是手柄的手枪式握把26上)的释放按钮30时可释放锁定的闭合扳机18。
图3是根据各种实施方式的端部执行器12的分解图。如图示实施方式所示，除了前面描述的通道22和钉砧24之外，端部执行器12还可包括切割器械32、滑块33、钉仓34以及螺旋轴36，钉仓34可移除地安置于通道22中。切割器械32例如可以是刀。钉砧24可以在连接到通道22的近端上的枢转点25处可枢转地打开和闭合。钉砧24还可在近端包括突起27，突起27插入机械闭合系统(下面将进一步描述)的部件中，以打开和关闭钉砧24。当致动闭合扳机18时，即当器械10的用户拉动闭合扳机18时，钉砧24可以围绕枢转点25枢转到夹紧或者闭合位置。如果端部执行器12的夹紧是满意的，操作者可致动击发扳机20(下面将更详细地描述)，使得刀32和滑块33沿着通道22纵向运动，由此切割夹紧在端部执行器12中的组织。滑块33沿着通道22的运动使得钉仓34的缝钉被驱动通过切割的组织，靠在闭合的钉砧24上，使得缝钉紧固切割的组织。名称为“Surgical stapling instrument incorporating an E-beam firingmechanism”的美国专利No.6,978,921更详细地描述了这种双行程式切割和紧固器械，该专利通用引用并入本文。滑块33可以是钉仓34的部件，使得当刀32在切割操作后缩回时，滑块33不会缩回。通道22和钉砧24可由导电材料(例如金属)制成，使得它们作为可与端部执行器中的传感器(一个或多个)通信的部分天线，下面将更详细描述。仓34可以由非导电材料(例如塑料)制成，传感器可连接到或者布置在仓34中，下面将进一步描述。
应当注意，尽管这里描述的器械10的实施方式采用缝合切割的组织的端部执行器12，在其他实施方式中可以采用其他技术来紧固或者密封切割的组织。例如，也可采用利用RF能量或者粘结剂来紧固切割的组织的端部执行器。Yates等人的名称为“ElectrosurgicalHemostatic Device with Recessed and/or Offset Electrodes”的美国专利No.5,688,270和Yates等人的名称为“Electrosurgical Hemostatic Device”的美国专利No.5,709,680披露了利用RF能量来紧固切割的组织的切割器械，这两篇专利通过引用并入本文。Morgan等人的美国专利申请No.11/267,811和Shelton等人的美国专利申请No.11/267,363公开了采用粘结剂来紧固切割的组织的切割器械，这两篇申请通过引用并入本文。因此，尽管这里的描述涉及切割/缝合操作和下面的类似操作，应当理解，这只是示例性的实施方式，并不因为这限制。可采用其他组织紧固技术。
图4和5是根据各个实施方式的端部执行器12和轴8的分解视图，而图6是其侧视图。如图示的实施方式所示，轴8可包括由枢转连接件44枢转连接的近侧闭合管40和远侧闭合管42。远侧闭合管42包括开口45，钉砧24上的突起27插入该开口45，以打开和闭合钉砧24。近侧脊管46可设置在闭合管40、42内。主旋转(或近侧)驱动轴48可设置在近侧脊管46内，驱动轴48通过锥齿轮组件52与第二(远侧)驱动轴50连接。副驱动轴50连接到驱动齿轮54上，驱动齿轮54接合螺旋轴36的近侧驱动齿轮56。垂直锥齿轮52b可安座于近侧脊管46的远端的开口57中，并可在该开口57中枢转。远侧脊管58可用于装纳副驱动轴50和驱动齿轮54、56。主驱动轴48、副驱动轴50和关节运动组件(例如锥齿轮组件52a-c)有时整体称作“主驱动轴组件”。闭合管40、42可以由导电材料(例如金属)制成，从而它们可以用作天线的部件，下面将进一步描述。主驱动轴组件的部件(例如驱动轴48、50)可以由绝缘材料(例如塑料)制成。
位于钉通道22远端的轴承38接收螺旋传动螺杆36，允许螺旋传动螺杆36相对于通道22自由旋转。螺旋轴36可以与刀32的螺纹开口(未示出)互相作用，使得轴36的旋转引起刀32向远侧或近侧(根据旋转的方向)移动穿过钉通道22。由此，当主驱动轴48由于击发扳机20的致动而旋转时(如下更详细的描述)，锥齿轮组件52a-c使副驱动轴50旋转，由于驱动齿轮54、56的接合，这又使得螺旋轴36旋转，这引起刀32沿着通道22纵向移动，以切割夹在端部执行器中的任何组织。滑块33可例如由塑料制成，并可具有倾斜的远侧表面。当滑块33横过通道22时，倾斜向上的表面可向上推动或驱动钉仓中的缝钉通过夹紧的组织，靠在钉砧24上。钉砧24转动缝钉，由此缝合切割的组织。当刀32缩回时，刀32和滑块33可脱离接合，由此使滑块33留在通道22的远端。
根据各种实施方式，如图7至10所示，外科器械可以在手柄6中包含电池64。图示的实施方式提供了有关端部执行器12中的切割器械的展开和加载力的用户反馈。另外，该实施方式可采用用户在缩回击发扳机20时提供的能量，以对器械10供能(所谓的动力辅助模式)。如该示例性实施方式所示，手柄6包括外部下侧件59、60和外部上侧件61、62，它们相互配合整体上形成手柄6的外部。手柄件59-62可以由电绝缘材料例如塑料制成。电池64可设置在手柄6的手枪式握把26中。电池64对设置在手柄6的手枪式握把26的上部中的马达65供电。电池64可以根据任何合适的结构或者化学方式来构造，例如包括诸如LiCoO2或LiNiO2之类的Li离子化学电池、镍金属氢化物化学电池等。根据各种实施方式，马达65可以是DC电刷驱动马达，其最大转速为大约5000至100000RPM。马达65可驱动包括第一锥齿轮68和第二锥齿轮70的90°的锥齿轮组件66。锥齿轮组件66可驱动行星齿轮组件72。行星齿轮组件72可包括连接到驱动轴76上的小齿轮74。小齿轮74可驱动相配合的环形齿轮78，环形齿轮78通过驱动轴82驱动螺旋齿轮鼓80。环84可拧在螺旋齿轮鼓80上。因此，当马达65转动时，通过中间夹设的锥齿轮组件66、行星齿轮组件72和环形齿轮78使环84沿着螺旋齿轮鼓80运动。
手柄6还可包括与击发扳机20连通的马达运行传感器110，当操作者朝着手柄6的手枪式握把26拉近(或者“关闭”)击发扳机20时，马达运行传感器110进行检测，由此通过端部执行器12致动切割/缝合操作。传感器110可以是比例传感器，例如变阻器或者可变电阻器。当拉近击发扳机20时，传感器110检测运动并发出电信号，其表示待供给马达65的电压(或功率)。当传感器110是可变电阻器等时，马达65的转速可以与击发扳机20的运动量大致成比例。也就是说，如果操作者仅轻微拉动或者关闭击发扳机20，马达65的转速较低。当完全拉近击发扳机20(或者处于完全关闭位置)时，马达65的转速为其最大值。换句话说，用户越用力拉动击发扳机20，施加到马达65上的电压越多，产生更大的转速。在另一实施方式中，例如，控制单元(后面将进一步描述)可根据来自传感器110的输入来输出PWM控制信号到马达65以控制马达65。
手柄6可包括位于击发扳机20的上部附近的中间手柄件104。手柄6还可包括偏压弹簧112，其连接在中间手柄件104上的柱和击发扳机20上的柱之间。偏压弹簧112可将击发扳机20偏压到其完全打开位置。这样，当操作者释放击发扳机20时，偏压弹簧112将击发扳机20拉到其打开位置，由此去除传感器110的致动，从而停止马达65的转动。此外，借助于偏压弹簧112，每当用户关闭击发扳机20时，用户会感到关闭操作的阻碍，由此提供给用户有关马达65转动量的反馈。另外，操作者可停止缩回击发扳机20，以从传感器110移除力，由此停止马达65。同样，用户可停止展开端部执行器12，由此为操作者提供对切割/紧固操作的控制的测量。
螺旋齿轮鼓80的远端包括驱动环形齿轮122的远侧驱动轴120，该环形齿轮122与小齿轮124啮合。小齿轮124连接到主驱动轴组件的主驱动轴48上。这样，马达65的转动使得主驱动轴组件转动，从而致动端部执行器12，如上面所描述的一样。
拧在螺旋齿轮鼓80上的环84可包括设置在带槽臂90的槽88中的柱86。带槽臂90的相对端部94具有开口92，其装纳连接在手柄外侧件59、60之间的枢轴销96。枢轴销96还穿过击发扳机20中的开口100和中间手柄件104中的开口102。
另外，手柄6可包括反转马达(或行程结束)传感器130和停止马达(行程开始)传感器142。在各种实施方式，反转马达传感器130可以是位于螺旋齿轮鼓80远端的限制开关，使得当环84到达螺旋齿轮鼓80的远端时拧在螺旋齿轮鼓80上的环84接触和断开(trip)反转马达传感器130。反转马达传感器130在启动时对控制单元发送信号，控制单元发动信号至马达65，以倒转其转动方向，由此在切割操作之后缩回端部执行器12的刀32。
停止马达传感器142例如可以是常通限制开关。在各种实施方式中，停止马达传感器142可以位于螺旋齿轮鼓80的近端，使得当环84到达螺旋齿轮鼓80的近端时环84断开开关142。
在操作中，当器械10的操作者拉回击发扳机20时，传感器110检测击发扳机20的展开并对控制单元发送信号，控制单元向马达65发送信号，使得马达65例如以与操作者拉回击发扳机20所用力的程度成比例的速度向前旋转。马达65的向前旋转又使得行星齿轮组件72远端的环形齿轮78旋转，由此使得螺旋齿轮鼓80转动，从而使拧在螺旋齿轮鼓80上的环84沿着螺旋齿轮鼓80向远侧运动。螺旋齿轮鼓80的转动还驱动如上所述的主驱动轴组件，这又使得端部执行器12中的刀32展开。也就是说，使得刀32和滑块33纵向运动经过通道22，由此切割夹紧在端部执行器12中的组织。此外，在使用缝合式端部执行器的实施方式中使端部执行器12产生缝合操作。
当端部执行器12的切割/缝合操作完成时，螺旋齿轮鼓80上的环84到达螺旋齿轮鼓80的远端，由此使反转马达传感器130断开，对控制单元发送信号，控制单元向马达65发送信号以使马达65倒转其转动方向。这使得刀32缩回，从而使螺旋齿轮鼓80上的环84运动回到螺旋齿轮鼓80的近端。
如图8和9中最清楚地显示的一样，中间手柄件104包括后侧肩部106，后侧肩部106接合带槽臂90。中间手柄件104还具有接合击发扳机20的向前运动挡块107。带槽臂90的运动如上所述受马达65的转动控制。当环84从螺旋齿轮鼓80的近端朝远端运动时，在带槽臂90逆时针转动(CCW)的情况下，中间手柄件104自由逆时针转动。因此，当用户拉近击发扳机20时，击发扳机20接合中间手柄件104的向前运动挡块107，使得中间手柄件104逆时针转动。由于后侧肩部106接合带槽臂90，中间手柄件104仅能够在带槽臂90允许的范围内逆时针转动。这样，如果马达65由于一些原因停止转动，带槽臂90也会停止转动，用户就不能进一步拉近击发扳机20，因为带槽臂90使得中间手柄件104不能自由逆时针转动。
图7-10还显示出了用于通过缩回闭合扳机18闭合(或夹紧)端部执行器12的钉砧24的示例性闭合系统的部件。在该示例性实施方式中，闭合系统包括轭250，其通过销251连接到闭合扳机18上，销251通过闭合扳机18和轭250中对准的开口插入。枢轴销252通过闭合扳机18中的另一个孔插入，该孔偏离销251插入闭合扳机18中的那个孔，闭合扳机18围绕枢轴销252枢转。这样，闭合扳机18的缩回使得闭合扳机18的上部逆时针转动，轭250通过销251连接到闭合扳机18的所述上部上。轭250的远端通过销254连接到第一闭合支架256上。第一闭合支架256连接到第二闭合支架258上。闭合支架256、258整体限定了一个开口，近侧闭合管40(参见图4)的近端安座并保持在该开口中，从而闭合支架256、258的纵向运动使得近侧闭合管40纵向运动。器械10还包括设置在近侧闭合管40内的闭合杆260。闭合杆260可包括窗口261，手柄外部件中的一个(例如该示例性实施方式中的外部下侧件59)上的柱263设置在窗口261中，以将闭合杆260固定地连接到手柄6上。这样，近侧闭合管40能够相对于闭合杆260纵向运动。闭合杆260还可包括远侧轴环267，轴环267装配到近侧脊管46的腔269中并通过帽271(参见图4)保持在其中。
在操作中，当由于闭合扳机18缩回使得轭250转动时，闭合支架256、258使近侧闭合管40向远侧(远离器械10的手柄端部)运动，这使得远侧闭合管42向远侧运动，从而使钉砧24围绕枢转点25转动到夹紧或者闭合位置。当闭合扳机18从锁定位置解锁时，使近侧闭合管40向近侧滑动，这又通过插在远侧闭合管42的窗口45中的突起27使得远侧闭合管42向近侧滑动，从而使钉砧24围绕枢转点25转动到打开或者松开位置。这样，通过缩回和锁定闭合扳机18，操作者可夹紧钉砧24和通道22之间的组织，并且可以在切割/缝合操作之后通过从锁定位置解锁闭合扳机18来松开组织。
控制单元(以下进一步描述)可以接收来自行程结束传感器和行程开始传感器130、142以及马达运行传感器110的输出，并可以基于输入来控制马达65。例如，当操作者在锁定闭合扳机18之后首次拉击发扳机20时，马达运行传感器110被启动。当钉仓34存在于端部执行器12中时，仓锁定传感器(未示出)可以关闭，在这种情况下，控制单元可以向马达65输出控制信号以使马达65在向前方向上旋转。当端部执行器12到达其行程末端时，反转马达传感器130被启动。控制单元可以从反转马达传感器130接收该输出并使马达65的转向反向。当刀32完全回缩时，停止马达传感器开关142启动，使得控制单元停止马达65。
在其他实施方式中，可以使用开-关式传感器而不是比例式传感器110。在这些实施方式中，马达65的转动速度与操作者施加的力不成比例。马达65是以大致恒定的速度转动。但是操作者还是感到力的反馈，因为击发扳机20连接在齿轮传动系统中。
器械10可以在端部执行器12中包括大量传感器转发器，用于感测与端部执行器12相关的各种状态，例如用于确定钉仓34(或者根据外科器械的类型而变化的其他类型的仓)的状态的传感器转发器、在闭合和击发过程中用于确定缝合器进程的传感器转发器等。传感器转发器可以通过感应信号来无源地驱动，下面将进一步描述，但是在其他实施方式中，转发器可以通过远程电源驱动，例如端部执行器12中的电池。传感器转发器(一个或多个)可例如包括磁阻、光学、机电、RFID、MEMS、运动或压力传感器。这些传感器转发器可与如图11所示例如可容纳在器械10的手柄6中的控制单元300通信。
如图12所示，根据各种实施方式，控制单元300可包括处理器306和一个或多个存储单元308。通过执行存储在存储单元308中的指令代码，处理器306可根据从各个端部执行器传感器转发器和其他传感器(例如马达运行传感器110、行程结束传感器130和行程开始传感器142)接收的输入信号来控制器械10的各个部件，例如马达65或者用户显示器(未示出)。在手术中使用器械10期间，控制单元300可通过电池64来驱动。控制单元300可包括感应元件302(例如线圈或天线)来从传感器转发器拾取无线信号，下面将更详细描述。由用作接收天线的感应元件302接收的输入信号可通过解调器310解调或者通过解码器312解码。输入信号可包括来自端部执行器12中的传感器转发器的数据，处理器306可利用这些数据来控制器械10的各个方面。
为了将信号发送给传感器转发器，控制单元300可包括用于对信号进行编码的编码器316和用于根据调制方案对信号调制的调制器318。感应元件302可用作发射天线。控制单元300可利用任何适合的无线通信协议和任何适合的频率(例如ISM频带)与传感器转发器通信。而且，控制单元300可以以不同于从传感器转发器接收的信号的频率范围的频率范围发射信号。此外，尽管图12中仅示出了一个天线(感应元件302)，在其他实施方式中控制单元300可具有独立的接收天线和发射天线。
根据不同的实施方式，控制单元300可包括微控制器、微处理器、现场可编程门阵列(FPGA)、一个或多个其他类型的集成电路(例如RF接收器和PWM控制器)、和/或分立无源元件。控制单元还可例如实施为片上系统(SoC)或者封装系统(SIP)。
如图11所示，控制单元300可容纳在器械10的手柄6中，用于器械10的一个或多个传感器转发器368可位于端部执行器12中。为了从端部执行器12中的传感器转发器368或者向其传送能量和/或发送数据，控制单元300的感应元件302可电感耦合到位于轴8中且在旋转接头29远侧的第二感应元件(例如线圈)320上。第二感应元件320优选与导电轴8电绝缘。
第二感应元件320可通过导电且外部绝缘的线322耦合到位于端部执行器12附近优选位于关节运动枢轴14远侧的远侧感应元件(例如线圈)324上。线322可由导电的聚合物和/金属(例如铜)制成并且可以具有充足的柔性以便能够穿过关节运动枢轴14并且不会在关节运动时损坏。远侧感应元件324可电感耦合到例如位于端部执行器12的仓34中的传感器转发器368上。下面更详细描述的转发器368可包括：天线(或线圈)，以电感耦合到远侧线圈324；以及传感器和集成控制电子元件，以接收和发射无线通信信号。
转发器368可利用从远侧感应元件324接收的感应信号的一部分能量来对转发器368无源驱动。一旦转发器368由感应信号充足地驱动，可通过如下手段接收和发送数据到手柄6中的控制单元300：(i)转发器368和远侧感应元件324之间的电感耦合；(ii)线322；以及(iii)第二感应元件320和控制单元300之间的电感耦合。这样，控制单元300可与端部执行器12中的转发器368通信，无须通过复杂的机械接头(例如旋转接头29)的直接接线连接，和/或无须从轴8到端部执行器12的直接接线连接，这些地方难以保持这种接线连接。另外，因为感应元件之间的距离(例如(i)转发器368和远侧感应元件324之间；和(ii)第二感应元件320和控制单元300之间的间距)是固定的并且已知的，可最优化耦合关系以感应传送能量。另外，这些距离可较短，从而较低功率的信号可用来最小化与器械10的使用环境中的其他系统的干涉。
在图12所示的实施方式中，控制单元300的感应元件302相对靠近控制单元300。根据其他实施方式，如图13所示，控制单元300的感应元件302可离旋转接头29更近，从而离第二感应元件320更近，由此减小该实施方式中的电感耦合的距离。或者，控制单元300(因而感应元件302)可定位得离第二感应元件320更近，以减小间距。
在其他实施方式中，可以使用多于或者少于两个感应元件。例如，在一些实施方式中，外科器械10可使用手柄6中的控制单元300和端部执行器12中的转发器368之间的单个电感耦合，从而省略感应元件320、324和线322。当然，在该实施方式中，由于手柄6中的控制单元300和端部执行器12中的转发器368之间的更长的距离，需要更强的信号。另外，可使用两个以上电感耦合。例如，如果外科器械10具有难以保持直接接线连接的多个复杂的机械接头，可以采用电感耦合来跨接这些接头。例如，可以在旋转接头29的两侧和关节运动枢轴14的两侧使用电感耦合器，其中，如图14所示，通过线322将旋转接头29远侧上的感应元件321连接到关节运动枢轴近侧的感应元件324上，线323连接关节运动枢轴14远侧上的感应元件325、326。在该实施方式中，感应元件326可与传感器转发器368通信。
另外，转发器368可包括多个不同的传感器。例如，它可包括传感器阵列。另外，端部执行器12可包括与远侧感应元件(因而与控制单元300)通信的多个传感器转发器368。另外，感应元件320、324可包括铁芯或者不具有铁芯。如前所述，它们优选与器械10的导电外轴(或框架)(例如闭合管40、42)电绝缘，线322也优选由外轴8电绝缘。
图15是端部执行器12的视图，其包括保持或嵌置在仓34中位于通道22远端的转发器368。转发器368可通过合适的粘结材料例如环氧树脂连接到仓34。在该实施方式中，转发器368包括磁阻传感器。钉砧24还可在其远端包括基本上面向转发器368的永磁体369。在该示例性实施方式中，端部执行器12还包括连接到滑块33上的永磁体370。这允许转发器368检测端部执行器的打开/关闭(由于当钉砧24打开和关闭时永磁体369运动离转发器更远或更近)以及缝合/切割操作的完成(由于当滑块33横过通道22(作为一部分切割操作)时永磁体370移向转发器368)。
图15还示出了缝钉380和钉仓34的缝钉驱动器382。如前所述，根据不同的实施方式，当滑块33横过通道22时，滑块33驱动缝钉驱动器382，缝钉驱动器382驱动缝钉380进入保持在端部执行器12中的切割的组织，缝钉380抵靠钉砧24成形。如前所述，这种外科切割和紧固器械是本发明有利地采用的一种类型的外科器械。本发明的各种实施方式可用于具有一个或多个传感器转发器的任何类型的外科器械中。
在上述实施方式中，电池64对器械的击发操作(至少部分地)驱动。这样，器械可以是所谓的“动力辅助”设备。动力辅助设备的更多细节和其他实施方式在美国专利申请11/343,573中进行了描述，该申请通过引用结合于本文。但是，应当理解，器械10不一定是动力辅助设备，其仅仅是可利用本发明的方面的一个例子。例如，器械10可包括用户显示器(例如LCD或LED显示器)，其由电池64驱动并由控制单元300控制。来自端部执行器12中的传感器转发器368的数据可显示在这种显示器上。
在另一实施方式中，器械10的轴8(例如包括近侧闭合管40和远侧闭合管42)可整体用作用于控制单元300的部分天线，对传感器转发器368发射信号并从传感器转发器368接收发射的信号。这样，可通过器械10的轴8来传送来自端部执行器12中的远程传感器的信号或发送到该传感器。
近侧闭合管40可在其近端通过由例如塑料的非导电材料制成的外部下侧和上侧件59-62接地。在近侧和远侧闭合管40、42内的驱动轴组件的部件(包括主驱动轴48和副驱动轴50)也可由例如塑料的非导电材料制成。另外，端部执行器12的部件(例如钉砧24和通道22)可电连接(直接或间接电接触)到远侧闭合管42，从而它们可用作部分天线。另外，传感器转发器368可定位成使得其与轴8和端部执行器12的用作天线的部件绝缘。例如，传感器转发器368可定位在由例如塑料的非导电材料制成的钉仓34中。由于轴8的远端(例如远侧闭合管42的远端)和端部执行器12的用作天线的部分可相对靠近传感器368，用于发送的信号的能量可保持在低水平，由此最小化或者减小了与器械10的使用环境中的其他系统的干涉。
在该实施方式中，如图16所示，控制单元300可通过导电连接件400(例如导线)电连接到器械10的轴8例如近侧闭合管40上。轴8的部分例如闭合管40、42因此可用作用于控制单元300的部分天线，对传感器368发送信号并从传感器368接收发出的信号。控制单元300接收的输入信号可通过解调器310解调并通过解码器312解码(参见图12)。输入信号可包括来自端部执行器12中的传感器368的数据，处理器306可利用这些数据来控制器械10的各个方面，例如马达65或者用户显示器。
为了发送数据到端部执行器12中的转发器368或者从其传送数据，连接件400可将控制单元300连接到器械10的轴8的部件上，例如近侧闭合管40上，其可电连接到远侧闭合管42上。远侧闭合管42优选与远程传感器368电绝缘，该传感器368可定位在塑料仓34中(参见图3)。如前所述，端部执行器12的部件例如通道22和钉砧24(参见图3)可以是导电的并且与远侧闭合管42电接触，从而它们也可用作天线的部件。
由于轴8用作用于控制单元300的天线，控制单元300可与端部执行器12中的传感器368通信，无须直接接线连接。另外，由于轴8和远程传感器368之间的距离是固定的并且是已知的，可将功率水平最优化成低水平，由此最小化与器械10的使用环境中的其他系统的干涉。如前所述，传感器368可包括用于发射信号到控制单元300和从控制单元300接收信号的通信电路。通信电路可以与传感器368集成在一起。
在其他实施方式中，轴8和/或端部执行器12的部件可用作用于远程传感器368的天线。在该实施方式中，远程传感器368电连接到轴(例如电连接到远侧闭合管42，其可电连接到近侧闭合管40)，控制单元300与轴8绝缘。例如，传感器368可连接到端部执行器的导电部件(例如通道22)，该导电部件又连接到轴8的导电部件(例如闭合管40、42)。或者，端部执行器12可包括线(未示出)，其连接远程传感器368和远侧闭合管42。
通常，例如器械10的外科器械在使用前进行清洁和消毒。在一种消毒技术中，器械10放置在闭合且密封的容器280中，例如塑料或者TYVEK容器或者袋，如图17和18所示。该容器和器械然后放置在射线场中，射线能穿透容器，射线例如有伽马射线、X射线或者高能电子束。射线杀死器械10上和容器280中的细菌。消毒的器械10可存储在无菌容器280中。密封的无菌容器280保持器械10无菌，直到其在医疗室或者其他使用环境中打开。也可使用其他消毒器械10的手段来代替射线，例如，环氧乙烷或者蒸汽。
当例如伽马射线的射线用来消毒器械10时，控制单元300的部件，特别是存储器308和处理器306可被损害和变得不稳定。这样，根据本发明各种实施方式，可在包装和消毒器械10之后对控制单元300编程。
如图17所示，可手持的远程编程装置320可与控制单元300无线通信。远程编程装置320可发射无线信号，该信号由控制单元300接收，以对控制单元300编程并在编程操作期间驱动控制单元300。这样，电池64不必在编程期间驱动控制单元300。根据不同的实施方式，下载到控制单元300中的程序码可相对较小，例如1MB或更少，从而如果需要的话可使用具有较低数据传输率的通信协议。另外，远程编程装置320可物理靠近外科器械10，从而可使用较低的功率信号。
回到图19，控制单元300可包括感应线圈402，以拾取来自远程编程装置320的无线信号。一部分接收的信号可被供电电路404使用，以当控制单元300没有被电池64驱动时驱动控制单元300。
由用作接收天线的线圈402接收的输入信号可以通过解调器410解调并可以通过解码器412解码。输入信号可包括编程指令(例如代码)，其可存储在存储器308的非易失性存储部分中。当器械10操作时处理器306可执行代码。例如，代码可根据从传感器368接收的数据使处理器306输出控制信号到器械10的各个子系统，例如马达65。
控制单元300还可包括非易失性存储单元414，其包括用于由处理器306执行的启动序列码。当控制单元300在消毒后程序运算期间从来自远程编程单元320的信号接收足够的功率时，处理器306首先执行启动序列码(“引导装入程序”)414，其可为处理器306装载操作系统。
控制单元300还可将信号发回到远程编程单元320，这些信号例如确认和握手信号。控制单元300可包括：编码器416，用于将信号编码，然后编码信号被发送到编程装置320；以及调制器418，用于根据调制方案调制信号。线圈402可用作发射天线。控制单元300和远程编程装置320可利用任何适合的的无线通信协议(例如蓝牙)和任何适合的频率(例如ISM频带)通信。而且，控制单元300可以以不同于从远程编程单元320接收的信号的频率范围的频率范围发射信号。
图20是根据本发明各种实施方式的远程编程装置320的简图。如图20所示，远程编程装置320可包括主控制板230和升压天线板232。主控制板230可包括控制器234、电源模块236和存储器238。存储器238可存储用于控制器234的操作指令和待发送到外科器械10的控制单元300的编程指令。电源模块236可从内部电池(未示出)或者外部AC或DC电源(未示出)对远程编程装置320的部件提供稳定的DC电压。
升压天线板232可包括耦合器电路240，其例如通过I2C总线与控制器234通信。耦合器电路240可通过天线244与外科器械的控制单元300通信。耦合器电路240可处理调制/解调和编码/解码操作以与控制单元之间进行传输。根据其他实施方式，远程编程装置320可具有分离的调制器、解调器、编码器和解码器。如图20所示，升压天线板232可包括传送功率放大器246、用于天线244的匹配电路248和用于接收信号的过滤器/放大器249。
根据其他实施方式，如图20所示，远程编程装置可以例如通过USB和/或RS232接口与计算机装置460，例如PC或便携式电脑通信。在这种构造中，计算机装置460的存储器可存储待发送到控制单元300的编程指令。在另一实施方式中，计算机装置460可构造有无线传送系统以将编程指令发送到控制单元300。
另外，根据其他实施方式，代替在控制单元300和远程编程装置320之间使用电感耦合，可使用电容耦合。在该实施方式中，控制单元300可具有板而不是线圈，远程编程单元320也是如此。
在另一实施方式中，代替在控制单元300和远程编程装置320之间使用无线通信连接，编程装置320可以物理连接到控制单元300同时器械10处于无菌容器280中，器械10保持无菌。图21是根据该实施方式的包装的器械10的视图。如图22所示，器械10的手柄6可包括外部连接接口470。容器280还可包括连接接口472，当器械10包装在容器280中时该接口472与器械10的外部连接接口470配合。编程装置320可包括外部连接接口(未示出)，该接口可在容器280的外部连接到连接接口472，由此在编程装置320和器械10的外部连接接口470之间提供接线连接。
已经结合切割式外科器械描述了本发明的各种实施方式。但是，应当注意，在其他实施方式，这里公开的发明的外科器械不必需是切割式外科器械，而是可以用在包括远程传感器转发器的任何类型外科器械中。例如，其可以是非切割的内窥镜器械、抓钳、缝合器、夹具施放器、进入装置、药物/基因治疗输送装置、以及使用超声波、RF、或激光等的能量装置。此外，本发明例如可以是腹腔镜器械。本发明还可以应用于传统的内窥镜器械和开放式外科器械以及机械手辅助的外科手术。
这里公开的设备也可以被设计成在单次使用后被处置，或者它们可以被设计成多次使用。然而，在任一情况中，在至少一次使用之后设备可以被整修以供再使用。整修可以包括以下步骤的任何组合：拆卸设备，然后清洁或替换特殊零件，随后再组装。特别地，设备可以被拆卸，并且设备的许多特殊零件或部分可以在任何组合中选择性地被替换或去除。一旦清洁和/或替换特殊部分，在外科操作将要开始之前设备可以在整修设备或者由手术团队再组装供随后使用。本领域的技术人员将会理解设备的整修可以利用拆卸、清洁和/或替换和再组装的多种技术。这种技术的使用以及形成的整修的装置都在本申请的范围内。
尽管本发明已经对一些公开的实施方式进行了描述，但可以对这些实施方式进行许多改进和变型。例如，可以使用不同类型的端部执行器。此外，对于公开的用于一些部件的材料，可以采用其他的材料。前述说明和后附的权利要求书旨在覆盖所有这些改进和变型。
通过引用而全部或者部分并入本文中的任何专利、公开出版物或者其它公开的材料，仅限于不会与在本申请中公开的定义、陈述或者其它公开的材料相矛盾的部分。如此一来，必要时这里明显阐述的公开内容替代任何通过引用而并入本文中的相矛盾的材料。被声称通过引用并入本文中但是与本发明公开的定义、陈述或者其它公开的材料矛盾的任何材料或其部分将只并入不会使得所并入的材料与本发明公开的材料相矛盾的部分。

Claims (10)

1.一种系统，包括：
外科器械，其具有控制单元；和
远程编程装置，用于对所述控制单元进行无线编程。
2.如权利要求1所述的系统，还包括用于容纳所述外科器械的容器，所述远程编程装置位于所述容器之外。
3.如权利要求2所述的系统，其中，所述控制单元包括：
驱动电路，用于利用从所述远程编程装置接收的无线信号来无源地驱动所述控制单元；
存储器，用于储存从所述远程编程装置接收的代码；和
处理器，用于执行储存在所述存储器中的代码。
4.如权利要求3所述的系统，其中，所述存储器还储存由所述处理器执行的启动加载序列。
5.如权利要求1所述的系统，其中，所述控制单元和所述远程编程装置电感耦合。
6.如权利要求1所述的系统，其中，所述控制单元和所述远程编程装置电容耦合。
7.如权利要求2所述的系统，其中，所述外科器械包括：
容纳所述控制单元的手柄；
连接到所述手柄上的轴；和
连接到所述轴上的端部执行器。
8.如权利要求7所述的系统，其中，所述端部执行器包括切割器械。
9.如权利要求8所述的系统，其中，所述手柄还包括：
与所述控制单元通信的马达；和
用于为所述马达供电的电池。
10.一种方法，包括：
将外科器械包装在容器中；
在所述外科器械处于容器中时对所述外科器械进行消毒；以及
在所述外科器械处于容器中而编程装置处于容器之外时，对所述外科器械进行编程。
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