CN101991448B - 手术吻合装置 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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
- A61B17/07207—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 the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
- A61B2017/00123—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation and automatic shutdown
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
- A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
Abstract
本发明涉及一种手术吻合装置，其具有带有致动器的壳体和从所述壳体延伸而出的细长部件。末端执行器布置在所述细长部件的一端上。所述末端执行器容纳可操作地连接到多个推进部件上的多个紧固件。致动机构可操作地连接到致动器上；所述致动机构包括一可纵向平移的驱动部件和致动滑块。所述致动滑块被配置成用于接合多个推进部件。感压元件也布置在钳夹中的一个中。感压元件将信号传递给控制器。所述信号表示施加在所述感压元件上的压力。所述控制器被配置用于激活反馈响应。
Description
相关申请的交叉引用
本申请要求享有于2009年8月11日提交的序列号为61/232,826的美国临时申请的利益和优先权，该临时申请的全部内容通过引用合并于此。
技术领域
本公开涉及一种手术吻合装置，该手术吻合装置能够将紧固件线施加到组织上同时切割这些紧固件线之间的组织，本发明尤其涉及改善紧固件的部署(deployment)和成型(formation)。
背景技术
由于较小的切口易于缩短术后恢复时间并减少并发症，因此内窥镜和腹腔镜手术装置通常比传统开放式手术装置更受欢迎。腹腔镜或者内窥镜手术操作的使用已相当受欢迎，并为进一步开发该操作提供了额外的诱因。在腹腔镜操作中，通过小切口在腹腔内部实施手术。类似地，在内窥镜操作中，通过由皮肤上的小进入创口插入的窄内窥镜管而在身体的任何空腑脏内实施手术。
腹腔镜和内窥镜操作一般需要对手术区域进行吹气。相应地，任何插入到身体中的仪器都必须被密封以确保气体不会通过切口进入身体或从身体出来。而且，腹腔镜和内窥镜操作经常要求外科医生在远离切口的器官、组织和/或血管上作业。因此，用在这种操作中的装置通常又长又窄，同时要从装置的近侧端上进行功能上的控制。
现已对一系列内窥镜手术装置进行了重要开发，这些装置适合于通过套管针的插管将远侧的末端执行器精确地放置到所希望的手术位置上。这些远侧末端执行器以多种方式接合组织以达到诊断或者治疗效果(例如，内窥切割器、抓紧器、切割器、吻合器、施夹器、进入设备、药品/基因治疗输送设备以及用于超声波、射频、激光等的能量设备)。
公知的手术吻合装置包括末端执行器，所述末端执行器在组织中开一纵向切口，随后在所述切口的相对侧上施加紧固件线。末端执行器包括一对协同操作的钳夹，如果所述装置是用于内窥镜或腹腔镜应用的话，则该对协同操作的钳夹能够穿过插管通道。钳夹之一容纳具有至少两排横向间隔开的紧固件的紧固件钉仓。另一钳夹限定一砧座，该砧座具有与所述紧固件钉仓中的紧固件排对齐的紧固件成型穴。所述装置包括多个往复运动的楔块或凸轮杆，当向远侧驱动所述楔块或凸轮杆时，它们穿过所述紧固件钉仓中的开口并与支撑紧固件的驱动器接合以引起紧固件朝向砧座发射。
依赖不同类型(例如内窥镜)的小型视频示波器能够监控手术吻合装置的合适的定位与操作。在一定程度上有效的同时，可取的是提高对手术吻合装置的操作的监控，尤其是如果这样的监控能够改善由所述手术吻合装置实施的紧固件部署与成型质量的话。在采用每一钉仓载中均包含多个紧固件的吻合设备时，也有利于确定哪些紧固件正被适当地部署和成型。了解成型或进展问题所在是很重要的，这是因为存在会影响紧固件的合适部署和成型的各种不同的间隙和变形问题。
因此，存在对于改进的手术吻合和切割装置的持续需求，该装置具有紧固件部署和成型压力监测能力以确保手术吻合设备的机械和止血一体性。
发明内容
根据本公开，公开了一种手术吻合装置。该手术吻合装置具有：壳体，其具有致动器；细长部件，其从所述壳体延伸而出；末端执行器，其布置在所述细长部件的一端，所述末端执行器包括第一和第二钳夹；多个紧固件，其布置在所述末端执行器中；多个推进部件，其位于所述末端执行器中，所述多个推进部件中的每一推进部件均可操作地连接到数个紧固件上；致动机构，其可操作地连接到所述致动器上，该致动机构包括一可纵向平移的驱动部件和连接到该驱动部件上的致动滑块，所述致动滑块被配置为用于接合多个推进部件；以及感压元件，其布置在钳夹中的一个中，所述感压元件将信号传递给连接至所述手术吻合装置的控制器上，所述信号表示施加到所述感压元件上的压力。
在一个实施例中，在所述致动滑块与推进部件之间的互相作用向所述感压元件施加压力。感压元件包括在电路中的交错排列的压力传感器。所述电路，在某些表现形式中是印制压力电路或者布置在位于钳夹中的一个的通道的表面上的柔性电路。
在另一实施例中，所述手术吻合装置可包括布置在钳夹中的至少一个的外表面上的电路。在这种形式中，吻合装置还包括横梁，该横梁布置在钳夹中的至少一个的外表面上，并安置于布置在钳夹中的至少一个内的凹槽中，这样，所述横梁可被配置沿着所述凹槽平移。所述横梁可以是I型横梁或者E型横梁。
所述电路可在其上具有层压材料层，而且甚至还可以在所述层压材料层上具有润滑涂层。传递给所述控制器的信号将由所述控制器读取，由所述控制器不时地读取不规则(irregular)信号。在这种情况下，控制器将激活例如错误代码、警报的反馈响应，或者其甚至可能一起停止紧固件的部署。可以设想，所述感压元件可通过下述方式中的任何一种来将信号传递给控制器：电压、电阻、阻抗、电磁、射频、电流、电感、电容、红外线、光学方式(optics)或者这些方式的任意组合。
在另一实施例中，可以想到一种被配置成平移通过钳夹以切割组织的刀具。然而，当出现某些预定的不规则情况(irregularity)时，如果这些不规则情况落入预定条件内，所述控制器可阻止刀具进行切割。编码器被配置为识别相对于所施加压力的异常构件位置(irregular component positions)，并将信号发送给控制器。编码器可被配置为识别各种不同构件的异常位置，所述构件包括致动机构、刀具、致动器、致动滑块、推进部件、第一钳夹、第二钳夹或者甚至是这些构件的各种不同的组合。这些编码器可以是线性的或者旋转的。
某些实施例设想了包括钉仓识别元件的电路。其他的实施例可具有被配置成能够为特定负载物(load)或紧固件类型设定位置限制和运行模式的控制器。更进一步地，钳夹中的一个可被配置并定尺寸为容纳非线性的钉仓。
在另一实施例中，所述控制器包括终端用户反馈通讯元件。所述终端用户反馈通讯元件被配置用于将反馈通过诸如听觉的、视觉的、触觉的或者这些感觉的任何组合形式的可感知信号传递给终端用户。
附图说明
参照以下结合附图的详细说明，本发明的上述以及其他方案、特性和优点将变得更加明显。其中：
图1A是动力手术吻合装置的立体图；
图1B是手动手术吻合装置的立体图；
图1C是一种手术吻合装置的末端执行器的放大立体图；
图1D是在紧固件施加操作期间，当楔块平移通过钉仓以便将紧固件从钉仓中相继地发射出并对着钳夹之一驱动紧固件从而成型紧固件时的末端执行器的立体图；
图2是根据本公开的手术吻合系统的示意图；
图3A是图1A和1B所示的手术吻合装置的末端执行器的一部分的侧视剖面图；
图3B是图1A和1B所示的手术吻合装置的末端执行器的一部分的侧视剖面图，为清楚起见移除了钉仓壁；
图4A是当操纵致动器通过一段致动行程以将来自钉仓中的一部分紧固件施加到组织上时的图1B所示的手术吻合装置的侧视图，其中壳体被分段以图示致动机构；
图4B是根据本公开的图4A的手术吻合装置的部分横截面的立体图；
图5是为了成型吻合钉而施加的压力与时间的曲线图；
图6是具有布置于其中的印制压力电路的钉仓的内部通道的立体图；
图7是图1A和图1B所示的可拆卸的末端执行器的立体图，示出了其中一个钳夹中的刀槽；
图8A是示出了压力电路的图7所示的末端执行器的立体图，为清楚起见移除了砧座盖；
图8B是图8A中公开的实施例的放大立体图；
图9是根据本公开的一个实施例的终端用户反馈通讯元件的示意图；
图10是根据本公开的一个实施例的钉仓识别元件的示意图；以及
图11是根据本公开的一个实施例的编码器元件的示意图。
具体实施方式
现在，将参照附图，详细描述在此公开的手术吻合装置的实施例，在每一不同附图中，相同或相应的元件都用相似附图标记标识。
如图所示及以下说明书通篇所描述的，习惯上，在涉及对象物的相对定位时，术语“近侧”指装置的靠近用户的一端，而术语“远侧”指装置的远离用户的一端。在下面的描述中，为避免由于赘述而使本公开变得费解，因而没有对公知的功能或结构进行具体描述。
图1A示出了通常示为100的动力手术吻合装置。图1B示出了通常示为200的手动手术吻合装置。简单地说，手术吻合装置100、200包括具有致动器136的壳体102；从壳体102延伸而出的细长部件104；以及布置在细长部件104的一端上的末端执行器106。在图1C至图1D中，末端执行器106包括第一和第二钳夹108、110；布置在末端执行器106中的多个紧固件114以及位于末端执行器106中的多个推进部件130。多个推进部件130中的每一推进部件130可操作地连接到数个紧固件114上。如在图3A至图4B中可见的那样，手术吻合装置100、200包括可操作地连接到致动器136上的致动机构138。致动机构138包括一可纵向平移的驱动部件140和连接到该驱动部件140上的致动滑块132。所述致动滑块132被配置成接合多个推进部件130。
根据本公开的一个实施例，图2图示出具有手术吻合装置100、200的手术吻合系统，所述手术吻合装置100、200具有感压元件150和控制器120。可想到的是，感压元件布置在钳夹108、110中的一个中(图3A至图3B和图8A至图8B)。感压元件150可将压力信号152(未示出)传递给连接到手术吻合装置100、200上的控制器120。控制器120为能够进行控制、定位、调节状态以及紧固件114质量反馈的微控制器或模拟电路。压力信号152表示施加到感压元件150上的压力。可想到的是，该实施例可包括刀具164或者也可不包括刀具，所述刀具164能够滑动地平移通过刀槽174(图1C)。
参考图5，就像在时间与施加压力曲线图中可见的那样，施加压力可以以波形脉冲的形式来测量。例如，根据覆盖0-t1时间段的曲线图可读取正规样本。如果在某一采样期间波形脉冲显示出低(t2-t3)或高(t1-t2)压力，这可能表明，由于未合适地施加紧固件114合适部署或成型所需的压力分布而导致紧固件114未被合适地部署或成型。可选地，如果波形不是与成功测试波形(t3-t4)相关联的形状，则由控制器120发出错误代码或反馈以便停止部署或成型过程。这使得终端用户能够在继续进行或停止之前适时地获知执行情况的异常性。
如在图3A至图3B中可见的那样，第一钳夹108包括用于容纳钉仓112的钉仓通道128。钉仓112包括多个布置于其中的紧固件114。典型地，紧固件114是多个手术吻合钉的形式。钉仓112容纳多个线性排的紧固件114，所述紧固件可操作地连接到推进部件130上。
现在参考图6，一种表现形式的感压元件150包括电路124，在电路124中，至少一根引接线154连接至少一个压力传感器126。也可以设想，将多个压力传感器126布置在手术吻合装置100、200上。在一个实例中，引接线154沿着纵轴以直线进程延伸跨过多个压力传感器126，其中至少一个压力传感器126与每一紧固件114或推进部件130相对应。每一线性排的紧固件114和/或推进部件130通过沿着线性排和电路124的纵轴延伸的至少一根引接线154连接。电路124是一柔性的或者印制压力电路124。
在该实施例中，电路124附着于钉仓通道128的顶(工作)表面上，这样，电路124可与平移通过钉仓通道128的致动滑块132互相作用。换言之，电路124布置在钉仓通道128内以便在致动滑块132平移通过钉仓通道128(图3A至图3B)时配合地接合该致动滑块132。
图7至图8B示出了手术吻合装置100、200的另一实施例。如在图8A至图8B中可见的那样，手术吻合装置100、200包括感压元件150，该感压元件150包括电路124并布置在钳夹108、110中的至少一个的外表面上。优选地，电路124布置在第二钳夹110的外表面上。该实施例包括横梁162。横梁162布置在钳夹108、110中的至少一个的外表面上。优选地，横梁162布置在第二钳夹110的外表面上。还可以设想，横梁162可滑动地安置于布置在钳夹108、110中的至少一个内的凹槽116中并连接到致动滑块132上(图8A和图8B)。横梁162可滑动地安置于布置在第二钳夹110内的凹槽116中。横梁162被配置成沿着凹槽116平移。所述横梁是I型横梁或者E型横梁。可预想到，电路112相对于手术吻合装置100、200非常地薄，其具有至少在几何上足够薄的尺寸，从而不至于妨碍或者严重影响钉仓112的总体大小或功能。
在一些表现形式中，压力传感器126是交错排列的(图3B、6、8A、8B)。在一种布置中的电路124交错排列并被优化，从而能够获得对于由与它们关联的推进部件130所成型的每一紧固件114或每组紧固件114的详细信息。通过在手术吻合装置100、200中使压力传感器126相对于紧固件114由近侧至远侧交错排列，手术吻合装置100、200可被配置成确定每一紧固件114的部署时间及完成。这对于利用控制器120控制手术吻合装置100、200以检验每一特定钉仓112的夹持、远侧停止或原始位置的限制是有用的。控制器120可具有模拟电路或微电子电路。
当紧固件14的进程展开时，感压元件150通过选自包括下列各项的群组的至少一种通讯方式将压力信号152传递给控制器120：电压、电阻、阻抗、电磁、射频、电流、电感、电容、红外线和光学方式。在操作中，随着在进程中紧固件114被部署并成型，感压元件150跟踪施加的压力。在一些情况下，可以以波形脉冲的形式跟踪施加的压力。当控制器120识别出从感压元件150传递来的压力信号152所表示的不规则的压力分布型式时，控制器120相应地记录下错误并可被配置成发出错误代码、发出警报、停止紧固件114的成型或者甚至停止紧固件114的部署。
感压元件150也可被配置成用于线性与非线性的钉仓112结构。可以预想到，钳夹108、110中的至少一个、优选第一钳夹108包括非线性钉仓。换言之，感压元件150可被用于线性钉仓112手术吻合装置100、200或者非线性钉仓112手术吻合装置100、200，所述非线性钉仓112包括评估紧固件质量或进程状态所需的弯曲、圆形或者任意其他几何形状的钉仓112。
经常地，手术吻合装置100、200可包括刀具164。在本公开的一种表现形式中，手术吻合装置100、200被配置并定尺寸为使得控制器120阻止刀具164进行切割。换言之，控制器120包括编码器166、即刀具防切元件。如图11所示，可设想这样一种结构的编码器166：其被配置为识别手术吻合装置100、200的异常动作(irregular behavior)。在一些例子中，编码器166被配置并定规格为识别相对于所施加压力的构件位置。所述构件选自包括致动机构138、刀具164、致动器136、致动滑块132、推进部件130、第一钳夹108和第二钳夹110或上述构件的任意组合的群组。编码器166可以是旋转式或线性式的。
参考图9，在一些表现形式中，控制器120包括终端用户反馈通讯元件170。终端用户反馈通讯元件170被配置成在接收并译解信号152、191之后通过选自包括下列方式的群组中的至少一种方式将反馈传递给终端用户：听觉的(铃声、语音、蜂鸣声、嘟嘟声等)、视觉的(发光体、发光二极管、液晶显示器或颜色、文字和/或符号变化的电发光屏)以及触觉的(振动)。例如，反馈可被配置成表示任务的成功完成或不成功完成，所述任务比如为初始化紧固件部署进程、完成紧固件的部署和成型、单个紧固件的部署、单个紧固件的成型或者由本领域普通技术人员所识别的其他类似的任务。
为防止电路124撕裂或磨损，并且为了获得精确的、可重复的反馈，一种又薄又坚硬的表面材料可层压在电路124的顶层上，限定一层压材料158，所述表面材料例如为聚酰亚胺薄膜或者钛或钢合金箔或者快速涂敷的镍、铬或氮化物涂层。此外，还可在所述层压材料层上涂覆润滑涂层160。润滑涂层160可以是任何低摩擦塑料、油脂、聚四氟乙烯混合材料或者任何其它相当的润滑剂。润滑剂160有利于获得质量输出压力信号152，并有利于提高工作构件的坚固性。
如图10所示，手术吻合装置100、200可具有包括钉仓识别元件168的电路124。特别地，感压元件150包括至少一个电路124，其中每一电路124均具有特定电气范围或值的电阻、电感或阻抗，该电阻、电感或阻抗的特定电气范围或值可由控制器120读取以确定用于识别所加载的钉仓112或者末端执行器106的精确类型。对于这种特性，手术吻合装置100、200包括被配置为设定钉仓112或紧固件114的特定位置限制和/或运行模式的控制器120。
在操作中，当终端用户(未示出)致动致动器136时，致动机构138使得致动滑块132与推进部件130(图4A)互相作用。在某些变例中，致动器136包括分开的用于致动致动滑块132以及第一和第二钳夹108、110的致动元件。例如，致动滑块致动器136a用于远程地致动致动滑块132，而钳夹致动器136b用于致动第一和第二钳夹108、110。可选地，可采用单个致动器136既致动致动滑块132又致动钳夹108、110。在另一例子中，分开的致动器136连接到各个第一和第二钳夹108、110上。
在致动时，致动滑块132将推进部件130向上挤，迫使紧固件114向上进入对置的第二钳夹110的表面，特别是进入紧固件成型穴156(图1D)。从图1D可见，紧固件114在其初始的结构中其定形为基本上呈U形的结构。在其完全成型的结构中，紧固件114被定形为基本上呈B形的结构。在紧固件114从第一结构到第二结构的变形过程中，第二钳夹110起到砧座的作用，并随着紧固件叉114a、114b接合紧固件成型穴156而将紧固件114相应地压成其第二结构的B形。因此，施加到感压元件150上的合成压力为致动滑块132与推进部件130之间互相作用的结果。
在感压元件150包括布置于钉仓通道128中的电路112的实施例中，第二钳夹对向上驱动的紧固件114、推进部件130和致动滑块132组合的向下力因而引起反作用力沿相反的向下方向穿过紧固件114、推进部件130和致动滑块132组合并且作用到电路112和任何压力传感器126上，所述压力传感器相应地记录下施加的压力。接着，感压元件150将压力信号152传递给控制器120，这里，压力信号152表示施加到感压元件152上的压力。控制器120接收压力信号并基于所述压力信号152选择性地发出响应或反馈。
在感压元件150包括布置在钳夹108、110之一的外表面上的电路112的实施例中，例如，当电路112布置在第二钳夹110的外表面上时，随着横梁162和致动滑块132沿着第一和第二钳夹108、110纵向平移，施加的压力从连接到致动滑块132上的横梁162转移到电路112上。换言之，当致动滑块132平移并接合推进部件130时，推进部件130向上驱动紧固件114进入到第二钳夹110和紧固件成型穴156中。随着致动滑块132由于“从紧固件成型穴156经过紧固件114和推进部件130作用到致动滑块132上的”合成向下反作用力而拉动横梁162，这就必然导致向下的反作用力施加到横梁162上并作用到电路112上。压力传感器126相应地记录下施加的压力。接着，感压元件150将压力信号152传递给控制器120，这里，压力信号152表示施加到感压元件152上的压力。控制器120接收压力信号并基于所述压力信号152选择性地发出响应或反馈。
在包括编码器166的实施例中，编码器166被配置成识别手术吻合装置100、200的构件的异常动作，所述构件选自包括致动机构138、刀具164、致动器136、致动滑块132、推进器130、第一钳夹108以及第二钳夹110的群组。在编码器166被配置用于监测刀具164的位置且编码器166识别刀具的异常位置的一个例子中，编码器166将异常情况(irregularity)通过编码器信号191传递给控制器120，所述信号或者是规则信号191a或者是不规则信号191b。在接收到不规则信号191b时，控制器120记录下错误代码，并且在一些实例中，控制器120被配置为阻止不进行紧固的切割。
编码器166通过至少一种选自包括下列方式的群组中的方式将编码器信号191传递给控制器120：电压、电阻、阻抗、电磁、射频、电流、电感、电容、红外线和光学方式。还可以预想到，控制器120被配置并定规格为接收来自感压元件150的编码器信号191并确定紧固件114的部署与成型相对于构件动作(例如刀具164的异常定位)的差异(disparity)。控制器120还被配置并定规格为初始化错误代码或者修改紧固件114的部署设置。
尽管在附图中示出了本公开的多个描述性的实施例，但并不意味着本公开局限于此，其本意在于本公开的保护范围应当像现有技术所允许的那样宽泛，而且，对于说明书亦因以类似的方式解读。因此，上述说明不应被理解为是对本发明的限制，而只能被理解为各种优选实施例的范例。因此，各实施例的范围应由所附的权利要求以及它们的合法等同物来确定，而不是由给出的实例来确定。
Claims (24)
1.一种手术吻合装置，包括：
壳体，其具有致动器；
细长部件，其从所述壳体延伸而出；
末端执行器，其布置在所述细长部件的一端，所述末端执行器包括第一和第二钳夹；
多个紧固件，其布置在所述第一钳夹中并在手术吻合装置发射时能够与限定在第二钳夹中的紧固件成型穴接合以成型多个紧固件中的至少一个；
多个推进部件，其位于所述第一钳夹中，所述多个推进部件中的每一推进部件均可操作地连接到多个紧固件中的至少一个上；
致动机构，其可操作地连接到所述致动器上，所述致动机构包括一能够纵向平移的驱动部件和连接到所述驱动部件上的致动滑块，所述致动滑块能够与多个推进部件接合，以使多个紧固件与第二钳夹的紧固件成型穴接合；
感压元件，其布置在所述第二钳夹上，所述感压元件将信号传递给连接至所述手术吻合装置的控制器上，所述信号表示施加到所述感压元件上的压力。
2.根据权利要求1所述的手术吻合装置，其中，所述致动滑块与所述推进部件之间的互相作用向所述感压元件施加压力。
3.根据权利要求1所述的手术吻合装置，其中，所述感压元件包括交错排列的压力传感器。
4.根据权利要求2所述的手术吻合装置，其中，所述感压元件包括电路。
5.根据权利要求4所述的手术吻合装置，其中，所述电路包括印制压力电路。
6.根据权利要求4所述的手术吻合装置，其中，所述电路包括柔性电路。
7.根据权利要求1所述的手术吻合装置，其中，所述信号是不规则的时，所述控制器被配置成激活选自包括下列各项的群组中的至少一个反馈响应：发出错误代码、发出警报以及停止紧固件部署。
8.根据权利要求7所述的手术吻合装置，进一步包括刀具，所述控制器具有刀具防切元件。
9.根据权利要求8所述的手术吻合装置，进一步包括编码器，所述编码器被配置为识别相对于施加压力的异常构件位置，所述构件选自包括致动机构、刀具、致动器、致动滑块、推进部件、第一钳夹以及第二钳夹的群组。
10.根据权利要求9所述的手术吻合装置，其中，所述编码器是旋转编码器。
11.根据权利要求9所述的手术吻合装置，其中，所述编码器是线性编码器。
12.根据权利要求4所述的手术吻合装置，其中，所述电路包括钉仓识别元件。
13.根据权利要求1所述的手术吻合装置，其中，所述控制器能够被配置成用于为特定负载物或紧固件类型设定位置限制和运行模式。
14.根据权利要求1所述的手术吻合装置，其中，所述第一和第二钳夹中的至少一个包括非线性钉仓。
15.根据权利要求4所述的手术吻合装置，进一步包括在电路上的层压材料层。
16.根据权利要求15所述的手术吻合装置，进一步包括在所述层压材料层上的润滑涂层。
17.根据权利要求1所述的手术吻合装置，其中，所述感压元件通过选自包括下列方式的群组中的至少一种方式将信号传递给控制器：电压、电阻、阻抗、电磁、射频、电流、电感、电容和光学方式。
18.根据权利要求1所述的手术吻合装置，其中，所述控制器包括终端用户反馈通讯元件。
19.根据权利要求18所述的手术吻合装置，其中，所述终端用户反馈通讯元件被配置成通过选自包括下列方式的群组中的至少一种方式将反馈传递给终端用户：听觉方式、视觉方式以及触觉方式。
20.根据权利要求4所述的手术吻合装置，其中，所述电路布置在所述第二钳夹的外表面上。
21.根据权利要求20所述的手术吻合装置，进一步包括横梁，所述横梁布置在钳夹中的至少一个的外表面上并安置于布置在钳夹中的至少一个内的凹槽中。
22.根据权利要求21所述的手术吻合装置，其中，所述横梁被配置成沿着所述凹槽平移。
23.根据权利要求21所述的手术吻合装置，其中，所述横梁是I型横梁。
24.根据权利要求21所述的手术吻合装置，其中，所述横梁是E型横梁。
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| US6978921B2 (en) * | 2003-05-20 | 2005-12-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an E-beam firing mechanism |
| EP1769756A1 (en) * | 2005-09-30 | 2007-04-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having load sensing control circuitry |
| CN101156793A (zh) * | 2006-10-06 | 2008-04-09 | Tyco医疗健康集团 | 具有塑料表面的外科器械 |
Also Published As
| Publication number | Publication date |
|---|---|
| CA2709777A1 (en) | 2011-02-11 |
| JP2011036656A (ja) | 2011-02-24 |
| AU2010203027B2 (en) | 2014-01-16 |
| CN101991448A (zh) | 2011-03-30 |
| CA2709777C (en) | 2017-08-22 |
| US20130105550A1 (en) | 2013-05-02 |
| JP2014221200A (ja) | 2014-11-27 |
| US8360299B2 (en) | 2013-01-29 |
| US8636190B2 (en) | 2014-01-28 |
| ES2811752T3 (es) | 2021-03-15 |
| US20110036887A1 (en) | 2011-02-17 |
| EP2283781A1 (en) | 2011-02-16 |
| JP5745716B2 (ja) | 2015-07-08 |
| EP2283781B1 (en) | 2020-07-15 |
| AU2010203027A1 (en) | 2011-03-03 |
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