CN103096818B - 用于外科器械和电池的电源控制装置 - Google Patents
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Abstract
本发明公开了多个实施例,其涉及与外科器械一起使用的电池组。所述电池组可包括多个电池并且包括可平移的放电漏极。当被附接到外科器械时,所述放电漏极可例如通过电阻元件将电池组的阳极电连接到电池组的阴极以便使电池组放电。
Description
背景技术
越来越多的外科器械由一个或多个蓄电池组电池供电。此类器械包括多种电动工具并且可用于多种外科手术环境中。例如,电池供电的外科器械可包括马达驱动式工具,例如切割器、抓紧器和/或缝合器。电池供电的外科器械还可包括非马达驱动式工具,例如RF切割器/凝固器、超声切割器/凝固器、和/或激光切割器/凝固器。电池供电的器械目前也用于多种不同的外科手术环境中,所述外科手术环境包括例如内窥镜式环境、腹腔镜式环境和开放式环境。
电池供电的外科器械通常使用一次电池,其为预充电的并且通常旨在用于单次放电(例如,一次性使用)。使用单次放电电池避免了与对电池再灭菌和再充电相关联的困难。然而,一次电池存在与装运、保存和处理有关的挑战。例如,带电电池如果未进行适当放电则可产生危害性废弃物,因为它们可能仅被使用一次并且仍剩有显著量的电荷。为了降低风险,多个管辖地区具有管理可装运和处理电池的条件的条例。具有较高存储能量的电池(cells)和电池(batteries)需要在较严格并且通常较昂贵的安全措施下进行装运、保存和处理。
发明内容
多个实施例可涉及如下外科器械,所述外科器械具有端部执行器和操作地联接到端部执行器的柄部。柄部可具有致动端部执行器的触发器以及具有突出构件的电池底座。外科器械可包括可附接到电池底座的电池组(battery unit),其中电池组在附接到电池底座时与柄部和端部执行器中的至少一者电接触。电池组可具有壳体以及定位在壳体内的第一阳极和第一阴极。电池组还可具有可平移的放电漏极,其中在电池组附接到电池底座时,突出构件接触放电漏极并且放电漏极相对于壳体平移以将电池组的第一阳极电联接到电池的第一阴极。
另外,多个实施例可涉及具有电池仓的外科器械。外科器械可具有紧邻电池组的电池仓定位的突出构件。电池组可具有壳体以及定位在壳体内的多个电池,其中所述多个电池中的至少一部分彼此不电连接。电池组可具有放电开关,所述放电开关具有打开位置和闭合位置,其中当处于闭合位置时,放电开关将电池组的阳极电联接到电池组的阴极。放电开关可被机械地偏向闭合位置,另外放电开关可通过壳体的非导电部分保持在打开位置。在电池组附接到外科器械的电池仓中时,可通过突出构件将放电开关平移到闭合位置中。
另外,多个实施例可涉及包括具有电池底座的外科装置的外科系统。外科系统还可具有电池组,其中电池组具有第一组电池和第二组电池以及紧邻第一组电池和第二组电池定位的可平移的电池漏极。可平移的电池漏极可具有第一组触点和第二组触点;其中,在第一位置,第一组触点和第二组触点未电联接到第一组电池和第二组电池。在第二位置,第一组触点可电联接到第一组电池并且第二组触点电联接到第二组电池。在电池组附接到电池底座时,可平移的电池漏极可从第一位置平移到第二位置。
附图说明
多个实施例的结构在所附权利要求书中进行了详细描述。然而,参考结合如下附图的下列描述可最好地理解多个实施例(有关手术的组织和方法两者)及其优点:
图1和图2为外科切割和紧固器械的一个实施例的透视图。
图3为图1和图2的外科切割和紧固器械的端部执行器的一个实施例的分解图。
图4和图5为图1和图2的外科切割和紧固器械的端部执行器和轴的一个实施例的分解图。
图6为图1和图2的外科切割和紧固器械的端部执行器的一个实施例的侧视图。
图7为马达驱动式内切割器的一个实施例的分解图。
图8和图9为图7的内切割器的柄部的一个实施例的局部透视图。
图10为图7的内切割器的柄部的一个实施例的侧视图。
图11为外科切割和紧固器械的电路的一个实施例的示意图。
图12为助力电动内切割器的一个实施例的柄部的侧视图。
图13为助力电动内切割器的另一个实施例的柄部的侧视图。
图14和图15示出了闭合触发器锁定机构的一个实施例。
图16示出了闭合触发器锁定机构的另一个实施例。
图17-22示出了闭合触发器锁定机构的另一个实施例。
图23A-B示出了可用于外科器械的关节点处的万向接头(“U型接头”)的一个实施例。
图24A-B示出了可用于外科器械的关节点处的扭转线缆的一个实施例。
图25-31示出了带助力的电动双行程外科切割和紧固器械的另一个实施例。
图32-36示出了带助力的双行程电动外科切割和紧固器械的一个实施例。
图37-40示出了具有此类触觉位置反馈系统的电动外科切割和紧固器械的一个实施例。
图41和图42示出了可用作运转马达传感器的可变传感器的一个实施例的两种状态。
图43为外科器械的局部剖视图,其中为清晰起见移除了多个元件。
图44A和图4B示出了多个操作状态期间的锁定凸轮。
图45A、图45B和图45C示出了多个操作阶段期间的锁定凸轮和齿轮。
图46示出了外科器械的一个实施例。
图47A、图47B和图47C示意性地示出了电池组与器械的附接和分离。
图48为根据一个非限制性实施例的从附接到器械时起测量的电池组的电压水平随时间推移的曲线图。
图49A为包括漏极的电池组的简化电路图的一个实施例。
图49B为包括漏极的电池组的简化电路图的另一个实施例。
图50为包括第一漏极和第二漏极的电池组的简化电路图的一个实施例。
图51-53为电池组的一个实施例的透视图。
图54A和图54B示出了包括可平移漏极的电池组的一个实施例的剖视图。
图55为漏极的一个实施例的透视图。
图56示出了附接到电池底座的电池组,其中为清晰起见移除了多个元件。
图57A和57B示出了电池组,其中为清晰起见移除了多个元件。
图58A和58B示出了电池组,其中为清晰起见移除了多个元件。
图59为单电池型电池组的一个实施例的透视图。
图60A和图60B示出了图59的电池组在多个操作阶段期间的内部视图,其中为清晰起见移除了多个元件。
具体实施方式
多个实施例涉及电池供电的外科器械和包括有利于装运、保存和处理的结构的电池。例如,根据一个实施例,电池组可包括位于限定腔体的壳体内的至少一个电池。电池组可具有紧邻腔体定位的可平移的放电漏极。漏极可在打开位置和闭合位置之间活动。结合电池组使用的外科器械可包括具有突出部分的电池底座、电池仓或其它电池组容纳部分,所述突出部分被电池组的腔体容纳。在附接到外科器械之前,放电漏极可处于打开位置。在电池组附接到外科器械时,突出部分可接触放电漏极以相对于壳体来平移漏极。当使放电漏极活动至其闭合位置时,放电漏极可在例如电池组的阳极、电池组的阴极和电阻元件之间形成放电电路。从附接时起,放电电路消耗来自电池组的能量。在一些实施例中,电池组将例如在约24小时之后就几乎放电完毕或已完全放电。一般来讲,放电漏极的使用有助于确保电池组的电压水平等于或低于用于处理的可接受水平。
在描述电池(cells)、电池(batteries)、电池组和相关外科器械的实施例之前,提供了电池供电的外科器械的示例实施例的详细说明。尽管本文所述的外科器械包括用于切割和缝合的电动工具,但应当理解,本文所述的电池构型可结合任何合适类型的电外科器械来使用,所述电外科器械为例如切割器、抱握器、缝合器、RF切割器/凝固器、超声切割器/凝固器和激光切割器/凝固器等。
图1和图2为外科切割和紧固器械10的一个实施例的透视图。图示实施例是内窥镜式器械,并且一般来讲,本文所述的器械10的实施例是内窥镜式外科切割和紧固器械。然而,应该指出的是,根据其它实施例,器械可为非内窥镜式外科切割和紧固器械,例如腹腔镜式或开放式外科器械。
图1和图2示出的外科器械10包括柄部6、轴8和在关节枢轴14处可枢转地连接至轴8的关节连接的端部执行器12。关节控制部16可邻近柄部6设置,以使端部执行器12围绕关节枢轴14旋转。在图示的实施例中,端部执行器12被构造成用作夹紧、切断和缝合组织的内切割器,但在其它实施例中可采用不同类型的端部执行器,例如用于其它类型的外科器械的端部执行器,例如抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因治疗装置、超声波、射频或激光装置。
器械10的柄部6可包括用于致动端部执行器12的闭合触发器18和击发触发器20。应当理解,具有涉及不同手术任务的端部执行器的器械可具有用于操作端部执行器12的不同数量或类型的触发器或其它合适的控制器。端部执行器12被显示为优选地通过细长轴8与柄部6分开。在一个实施例中,器械10的临床医生或操作者可利用关节控制器16使端部执行器12相对于轴8进行关节动作,如在Geoffrey C.Hueil等人的提交于2006年1月10日的名称为“Surgical Instrument Having An Articulating EndEffector”的、未决的美国专利申请No.11/329,020中对此作了更详细的描述,该专利申请全文以引用方式并入本文中。
在该实例中,除了别的以外,端部执行器12包括钉槽22和可枢转地平移的夹持构件,例如砧24,其以确保有效地缝合和切断被夹持在端部执行器12中的组织的间隔来保持。柄部6包括手枪式夹持件26,由临床医生将闭合触发器18可枢转地拉向手枪式夹持件26,以使得砧24朝向端部执行器12的缝钉槽22夹紧或闭合,从而夹持位于砧24和槽22之间的组织。击发触发器20在闭合触发器18的更外侧。如以下进一步描述的,一旦闭合触发器18被锁定在闭合位置,击发触发器20即可朝向手枪式夹持件26略微旋转,以使得其可由操作者单手触及。然后,操作者可将击发触发器20可枢转地拉向手枪式夹持件26以缝合和切断被夹持在端部执行器12中的组织。在其它实施例中,可使用除砧24之外的不同类型的夹持构件,例如相对的夹具。
应当理解,本申请使用的术语“近侧”和“远侧”是相对于握持器械10的柄部6的临床医生而言的。因此,端部执行器12相对于更近侧的柄部6处于远侧。还应当理解,为便利和清楚起见,本申请结合附图使用例如“竖直”和“水平”之类的空间术语。然而,外科器械在多个取向和位置中使用,并且这些术语并不旨在进行限制,也并不是绝对的。
闭合触发器18可首先被致动。一旦临床医生对于端部执行器12的定位感到满意,则临床医生可将闭合触发器18拉回至其紧邻手枪式夹持件26的完全闭合、锁定的位置。然后,致动击发触发器20。当临床医生移除压力时,击发触发器20返回至打开位置(如图1和图2所示),如下文将更全面描述。位于柄部6上并且在此实例中位于柄部6的手枪式夹持件26上的释放按钮160在被压下时可释放锁定的闭合触发器18。
图3为端部执行器12的一个实施例的分解图。如图示实施例所示,除了先前提到的槽22和砧24之外,端部执行器12还可包括切割器32、滑块33、可移除地安装在槽22中的钉仓34和螺杆轴36。例如,切割器械32可为刀。砧24可在连接至槽22的近端的枢转点25处可枢转地打开和闭合。砧24还可包括位于其近端处的凸块27,所述凸块27插入机械闭合系统(下文进一步描述)的组件中以打开和闭合砧24。当致动(即通过器械10的使用者拉动)闭合触发器18时,砧24可围绕枢转点25枢转至夹紧或闭合位置。如果端部执行器12的夹持令人满意,则操作者可致动击发触发器20,如下文更详细说明的,使刀32和滑块33沿槽22纵向行进,从而切割被夹持在端部执行器12内的组织。滑块33沿着槽22的运动使得钉仓34的缝钉被驱动穿过被切断的组织并且抵靠闭合的砧24,砧24转动缝钉以紧固被切断的组织。名称为“Surgical Stapling Instrument Incorporating An E-Beam Firing Mechanism”的美国专利No.6,978,921提供了关于此类双行程切割和紧固器械的更多细节,该专利以引用方式并入本文中。根据多个实施例,滑块33可为仓34的一体部分,使得当刀32在切割操作之后回缩时,滑块33不回缩。
应该指出的是,虽然本文描述的器械10的实施例使用缝合被切断的组织的端部执行器12,但是在其它实施例中,可使用用于紧固或密封被切断的组织的不同技术。例如,也可使用利用RF能或粘合剂来紧固被切断的组织的端部执行器。名称为“Electrosurgical Hemostatic Device”的美国专利No.5,810,811公开了使用RF能紧固被切断的组织的切割器械,该专利以引用方式并入本文中。名称为“Surgical Stapling Instruments Structured ForDelivery Of Medical Agents”的美国专利申请No.11/267,811和名称为“Surgical Stapling Instruments Structured For Pump-Assisted Delivery OfMedical Agents”的美国专利申请No.11/267,383公开了使用粘合剂紧固被切断的组织的切割器械,这两个专利申请均引用方式并入本文中。因此,虽然本文的描述涉及切割/缝合操作等,但是应当认识到这仅是示例实施例,而并不旨在进行限制。也可使用其它组织紧固技术。
图4和图5为端部执行器12和轴8的一个实施例的分解图,而图6为其侧视图。如图示实施例中所示,轴8可包括由枢轴连接件44可枢转地连接的近侧闭合管40和远侧闭合管42。远侧闭合管42包括开口45,砧24上的凸块27插入开口45中以便打开和闭合砧24,如下文进一步描述。近侧脊管46可设置在闭合管40、42内。通过锥齿轮组件52与次(或远侧)传动轴50连通的主旋转(或近侧)传动轴48可设置在近侧脊管46内。次传动轴50连接到与螺杆轴36的近侧传动齿轮56接合的传动齿轮54。当击发触发器20的使得造成主传动轴48旋转(如下文详细说明)时,锥齿轮组52a-c使次传动轴50旋转,这继而又由于传动齿轮54、56的接合而使得螺杆轴36旋转,这使刀/滑块驱动构件32沿槽22纵向行进而切割被夹紧在端部执行器12内的任何组织。立式锥齿轮52b可位于近侧脊管46远端的开口57中且可在其中枢转。远侧脊管58可用来包封次传动轴50和传动齿轮54、56。在本文中有时将主传动轴48、次传动轴50和关节活动组件(例如锥齿轮组件52a-c)整体称作“主传动轴组件”。
将轴承38螺纹接合在螺旋传动螺杆36上。轴承36还连接到刀32。当螺旋传动螺杆36向前旋转时,轴承38朝远侧穿越螺旋驱动螺杆36,从而驱动切割器械32并且在该过程中驱动滑块33以执行切割/缝合操作。滑块33可由例如塑料制成,并且可具有倾斜的远侧表面。当滑块33穿越槽22时,前倾表面可向上推动或驱动钉仓34中的缝钉穿过被夹紧的组织,并撞击到砧24。砧24使缝钉弯折,从而缝合被切断的组织。当刀32回缩时,刀32与滑块33可脱离,从而使滑块33留在槽22的远端处。
由于缺乏使用者对切割/缝合操作的反馈,因此医生普遍不太接受仅通过按下按钮来致动切割/缝合操作的马达驱动式外科器械。相比之下,多个实施例可提供如下马达驱动式内切割器,所述马达驱动式内切割器具有对端部执行器中的切割器械的部署、加载力和/或位置的使用者反馈。
图7-10示出了马达驱动式内切割器、特别是其柄部6的一个实施例,其提供关于端部执行器中的切割器械的部署和加载力的使用者反馈。此外,该实施例可利用使用者在回缩击发触发器20时提供的动力来对器械供能(所谓的“助力”模式)。如图示实施例中所示,柄部6包括外部下侧件59、60和外部上侧件61、62,它们配合在一起以在整体上形成柄部6的外部。电池64例如锂离子电池可设置在电池底座63中。在一些实施例中,电池64设置在柄部6的手枪式夹持件26中。尽管电池64示为包括连接在一起的多个电池,但应当理解,在一些实施例中电池64可包括单个电池。电池64可对设置在柄部6的手枪式夹持件26上部中的马达65供电。根据多个实施例,马达65可为DC有刷驱动马达,其具有大约5000RPM的最大转速。马达65可驱动包括第一锥齿轮68和第二锥齿轮70的90°锥齿轮组件66。锥齿轮组件66可驱动行星式齿轮组件72。行星式齿轮组件72可包括连接到传动轴76的小齿轮74。小齿轮74可驱动配对的环形齿轮78,该环形齿轮通过传动轴82来驱动螺旋齿轮筒80。环84可螺旋接合在螺旋齿轮筒80上。因此,当马达65旋转时,环84利用介于其间的锥齿轮组件66、行星式齿轮组件72和环形齿轮78而沿螺旋齿轮筒80行进。
柄部6还可包括与击发触发器20连通的马达运转传感器110,其检测击发触发器20何时被操作者朝向柄部6的手枪式夹持件部分26拉回(或“闭合”),从而致动端部执行器12的切割/缝合操作。传感器110可为比例传感器,例如变阻器或可变电阻器。当拉回击发触发器20时,传感器110检测该活动并发出指示要供给马达65的电压(或功率)的电信号。当传感器110为可变电阻器等时,马达65的转速可与击发触发器20的活动量大致成比例。也就是说,如果操作者仅轻微拉动或闭合击发触发器20,则马达65的转速较低。当完全拉回击发触发器20(或处于完全闭合位置)时,马达65的转速为其最大值。换句话讲,使用者越用力拉动击发触发器20,施加到马达65上的电压就越大,从而转速就越大。
柄部6可包括邻近击发触发器20上部的中间柄部件104。柄部6还可包括连接在中间柄部件104上的柱和击发触发器20上的柱之间的偏置弹簧112。偏置弹簧112可将击发触发器20偏置到其完全打开位置。这样,当操作者释放击发触发器20时,偏置弹簧112将击发触发器20拉向其打开位置,由此移除传感器110的致动,从而停止马达65的旋转。此外,借助于偏置弹簧112,每当使用者闭合击发触发器20时,使用者将感受到对闭合操作的阻力,从而向使用者提供有关马达65所施加的旋转量的反馈。另外,操作者可停止回缩击发触发器20以由此将力从传感器100移除,从而使马达65停止。这样,使用者即可停止部署端部执行器12,从而为操作者提供了对切割/紧固操作进行控制的方式。
螺旋齿轮筒80的远端包括驱动环形齿轮122的远侧传动轴120,所述环形齿轮122与小齿轮124配合。小齿轮124连接到主传动轴组件的主传动轴48。这样,马达65的旋转使得主传动轴组件旋转,从而致动端部执行器12,如上所述。
螺纹接合在螺旋齿轮筒80上的环84可包括设置在开槽臂90的槽88内的柱86。开槽臂90在其相对端94上具有开口92,开口92容纳连接在柄部外侧件59、60之间的枢轴销96。枢轴销96还穿过击发触发器20中的开口100和中间柄部件104中的开口102而设置。
另外,柄部6可包括反向马达(或行程结束)传感器130和止动马达(或行程开始)传感器142。在各种实施例中,反向马达传感器130可为位于螺旋齿轮筒80远端处的限位开关,使得螺纹接合在螺旋齿轮筒80上的环84在其到达螺旋齿轮筒80的远端时接触并触动反向马达传感器130。反向马达传感器130在被致动时向马达65发送信号,以使其旋转反向,从而在切割操作后回缩端部执行器12的刀32。
止动马达传感器142可为例如常闭限位开关。在多个实施例中,其可位于螺旋齿轮筒80的近端处,使得环84在其到达螺旋齿轮筒80的近端时触动开关142。
在操作中,当器械10的操作者将击发触发器20拉回时,传感器110检测击发触发器20的部署,并向马达65发送信号以使得马达65以例如与操作者回缩击发触发器20的用力程度成比例的速度正向旋转。马达65的正向旋转继而使得行星式齿轮组件72的远端处的环形齿轮78旋转,从而使得螺旋形齿轮筒80旋转,使螺纹连接在螺旋齿轮筒80上的环84沿螺旋齿轮筒80朝远侧行进。螺旋齿轮筒80的旋转还驱动如上所述的主传动轴组件,这继而部署端部执行器12中的刀32。也就是说,使得刀32和滑块33纵向穿过槽22,从而切割被夹持在端部执行器12中的组织。此外,在使用缝合型端部执行器的实施例中使端部执行器12产生缝合操作。
当端部执行器12的切割/缝合操作完成时,螺旋齿轮筒80上的环84将已到达螺旋齿轮筒80的远端,从而使反向马达传感器130被触动,传感器130将信号发送至马达65以使马达65的旋转反向。这继而使得刀32回缩,并且还使螺旋齿轮筒80上的环84运动回到螺旋齿轮筒80的近端。
中间柄部件104包括与开槽臂90接合的后侧肩106,如图8和图9中清晰显示。中间柄部件104还具有接合击发触发器20的前移阻挡件107。如以上所解释,开槽臂90的运动受马达65旋转的控制。当随着环84从螺旋形齿轮筒80的近端朝远端行进,开有狭槽的臂90逆时针旋转时,中间柄部件104将自由地逆时针旋转。因此,当使用者将击发触发器20拉回时,击发触发器20将与中间柄部件104的正向运动阻挡件107接合,使得中间柄部件104逆时针旋转。然而,由于后侧肩部106接合开有狭槽的臂90,因此中间柄部件104仅在开有狭槽的臂90允许的情况下才能够逆时针旋转。这样,如果马达65由于某种原因应该停止旋转,那么开有狭槽的臂90将停止旋转,使用者将无法进一步拉回击发触发器20,因为中间柄部件104由于开有狭槽的臂90而无法逆时针旋转。
图41和图42示出了可用作运转马达传感器110的可变传感器的一个实施例的两种状态。传感器110可包括表面部分280,第一电极(A)282,第二电极(B)284以及位于电极282、284之间的可压缩的电介质材料286(例如EAP)。传感器110可被定位成使得在回缩时使表面部分280接触击发触发器20。因此,当击发触发器20回缩时,电介质材料286被压缩,如图42中所示,使得电极282、284之间更接近。电极282、284之间的距离“b”直接关系到电极282、284之间的阻抗,距离越大阻抗就越大,距离越小阻抗就越小。这样,由于击发触发器20的回缩而使电介质材料286被压缩的量(图42中以力“F”表示)与电极282、284之间的阻抗成比例,这可用于按比例控制马达65。
图7-10中还示出了用于通过回缩闭合触发器18来闭合(或夹持)端部执行器12的砧24的实例闭合系统的组件。在图示实施例中,闭合系统包括轭250,该轭通过穿过闭合触发器18和轭250中的对齐的开口插入的销251连接到闭合触发器18。闭合触发器18围绕枢轴销252枢转,并且枢轴销252插入穿过闭合触发器18中的另一开口,该开口偏离销251插入穿过闭合触发器18的位置。因此,闭合触发器18的回缩使得通过销251附接到轭250的闭合触发器18的上部逆时针旋转。轭250的远端通过销254连接到第一闭合托架256。第一闭合托架256连接到第二闭合托架258。闭合托架256、258共同限定开口,近侧闭合管40(见图4)的近端被安放和保持在该开口中,使得闭合托架256、258的纵向活动引起近侧闭合管40的纵向活动。器械10还包括设置在近侧闭合管40内部的闭合杆260。闭合杆260可包括窗口261,位于柄部外部件中的一个(例如图示实施例中的外部下侧件59)上的柱263设置在窗口261中,以将闭合杆260固定地连接到柄部6。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,其装配在近侧脊管46中的腔269内并由帽271(见图4)保持在腔内。
在操作中,当轭250由于闭合触发器18的回缩而旋转时,闭合托架256、258使得近侧闭合管40朝远侧(例如,远离器械10的柄部末端)活动,从而使得远侧闭合管42朝远侧活动,由此使得砧24围绕枢转点25旋转至夹紧或闭合位置。当闭合触发器18从锁定位置解锁时,近侧闭合管40朝近侧滑动,从而使得远侧闭合管42朝近侧滑动,继而利用插入远侧闭合管42的窗口45中的凸块27使得砧24围绕枢转点25枢转至打开位置或未夹持位置。这样,通过回缩并锁定闭合触发器18,操作者可将组织夹持在砧24和槽22之间,并能够在切割/缝合操作后通过将闭合触发器18从锁定位置释放来松开该组织。
图11为器械10的电路的一个实施例的示意图。当操作者在锁定闭合触发器18后开始拉回击发触发器20时,传感器110被启动,从而允许电流从中流过。如果常开反向马达传感器开关130打开(表明还未到达端部执行器行程的端部),则电流将流向单刀双掷继电器132。由于反向马达传感器开关130未闭合,则继电器132的线圈134将不通电,因此继电器132将处于其未通电状态。该电路还包括仓闭锁传感器开关136。如果端部执行器12包括钉仓34,则传感器开关136将处于闭合状态,从而允许电流流动。相反,如果端部执行器12不包括钉仓34,则传感器开关136将断开,从而防止电池64为马达65供电。如下文更详细所述,当将电池64插入器械10中时,可将电阻元件65连接到电路中以使电池64放电。
当钉仓34存在时,传感器开关136闭合,从而为单刀单掷继电器138供电。当为继电器138供电时,电流流经继电器138,流过可变电阻器传感器110,并通过双刀双掷继电器140到达马达65,从而为马达65供电并允许其正向旋转。
当端部执行器12到达其行程末尾时,反向马达传感器130被启动,从而闭合开关130并为继电器132供电。这使继电器132处于其通电状态(图11中未示出),从而使得电流绕过仓闭锁传感器开关136和可变电阻器110而流向常闭双刀双掷继电器140并流回马达65,但以使马达65反向旋转的方式经过继电器140。
由于止动马达传感器开关142是常闭的,因此电流将流回至继电器132以保持其通电,直至开关142断开。当刀32完全回缩时,止动马达传感器开关142被启动,使得开关142断开,从而将马达65断电。
在其它实施例中,可使用通断型传感器而不是比例型传感器110。在此类施例中,马达65的转速将不与由操作者施加的力成比例。确切地讲,马达65一般以恒速旋转。但是由于击发触发器20与齿轮传动系啮合,因此操作者仍将感受到力反馈。
图12为根据另一个实施例的助力电动内切割器的柄部6的侧视图。图12的实施例与图7-10的实施例类似,不同的是在图12的实施例中不存在与螺纹接合在螺旋齿轮筒80上的环84连接的开槽臂90。相反,在图12的实施例中,环84包括当环84在螺旋齿轮筒80上向下(和向后)行进时随环84一起活动的传感器部分114。传感器部分114包括凹口116。反向马达传感器130可位于凹口116的远端处,并且止动马达传感器142可位于凹口116的近端处。当环84在螺旋齿轮筒80上向下(和向后)活动时,传感器部分114与其一起活动。此外,如图12所示,中间件104可具有延伸到凹口116中的臂118。
在操作中,当器械10的操作者朝手枪式夹持件26回缩击发触发器20时,运转马达传感器110检测该运动并发送信号以向马达65供电,此外,这还使螺旋齿轮筒80旋转。当螺旋齿轮筒80旋转时,螺纹接合在螺旋齿轮筒80上的环84前进(或者回缩,具体取决于旋转方向)。而且,由于击发触发器20的拉回,中间件104与击发触发器20一起逆时针旋转,这是由于与击发触发器20接合的前移阻挡件107引起的。中间件104的逆时针旋转使臂118随着环84的传感器部分114一起逆时针旋转,使得臂118保持被设置在凹口116中。当环84到达螺旋齿轮筒80的远端时,臂118将接触并因此触动反向马达传感器130。相似地,当环84到达螺旋齿轮筒80的近端时,臂118将接触并因此触动止动马达传感器142。此类动作可分别使马达65反转和停止,如上所述。
图13为根据另一个实施例的助力电动内切割器的柄部6的侧视图。图13的实施例类似于图7-10的实施例,不同的是在图13的实施例中,臂90中没有槽。相反,螺纹接合在螺旋齿轮筒80上的环84包括竖直槽126。臂90包括设置在槽126中的柱128来代替狭槽。当螺旋齿轮筒80旋转时,螺纹接合在螺旋齿轮筒80上的环84前进(或者回缩,具体取决于旋转方向)。当环84由于设置在槽126中的柱128而行进时,臂90逆时针旋转,如图13所示。
如上所述,在使用双行程电动器械时,操作者首先向后拉动并锁定闭合触发器18。图14和图15示出了用于将闭合触发器18锁定到柄部6的手枪式夹持件部分26的闭合触发器18锁定机构的一个实施例。在图示实施例中,手枪式夹持件部分26包括钩150,其由扭转弹簧152偏置以围绕枢轴点151逆时针旋转。此外,闭合触发器18包括闭合杆154。当操作者拉回闭合触发器18时,闭合杆154接合钩150的倾斜部分156,从而向上(或者图14-15中的顺时针)旋转钩150,直到闭合杆154完全通过倾斜部分156、进入钩150的下陷的凹口158中,从而将闭合触发器18锁定就位。操作者可通过向下推动位于手枪式夹持件26的后侧或相对侧上的滑动释放按钮160来释放闭合触发器18。向下推动滑动释放按钮160使钩150顺时针旋转,使得使闭合杆154从下陷的凹口158释放。
图16示出了根据多个实施例的另一种闭合触发器锁定机构。在图16的实施例中,闭合触发器18包括具有箭头部分161的楔形件160。箭头部分161由片簧162向下(或顺时针)偏置。楔形件160和片簧162可由例如模制塑料制成。当闭合触发器18回缩时,箭头部分161能够从柄部6的手枪式夹持件26中的开口164插入。箭头部分161的下斜切表面166接合开口164的下侧壁168,从而促使箭头部分161逆时针旋转。最终下斜切表面166完全通过下侧壁168,从而移除作用在箭头部分161上的逆时针方向的力,使下侧壁168滑入位于箭头部分161后面的凹口170中的锁定位置。
为了将闭合触发器18解锁,使用者按下闭合触发器18相对侧上的按钮172,使箭头部分161逆时针旋转并使得箭头部分161从开口164滑出。
图17-22示出了闭合触发器锁定机构的另一个实施例。如该实施例中所示,闭合触发器18包括纵向柔性臂176,纵向柔性臂176包括从其中延伸的侧销178。臂176和销178可由例如模制塑料制成。柄部6的手枪式夹持件26包括开口180,开口180具有设置在其中的横向延伸的楔形件182。当回缩闭合触发器18时,销178接合楔形件182并且销178由楔形件182的下表面184向下压(例如,臂176顺时针旋转),如图17和18所示。当销178完全穿过下表面184时,作用在臂176上的顺时针方向的力被移除,并且销178逆时针旋转,使得销178停置在楔形件182后面的凹口186中,如图19所示,从而锁定闭合触发器18。销178进一步通过从楔形件184延伸的柔性阻挡件188而在锁定位置中保持就位。
为了将闭合触发器18释放,操作者可进一步挤压闭合触发器18,使销178接合开口180的倾斜后壁190,从而促使销178向上越过柔性阻挡件188,如图20和图21所示。销178然后在开口180中自由地从上部槽192移出,使得闭合触发器18不再被锁定到手枪式夹持件26,如图22所示。
图23A-B示出了可被用于外科器械(例如器械10)的关节点处的万向接头(“U型接头”)195。U型接头195的第二构件195-2在水平面上旋转,第一构件195-1位于该水平面中。图23A示出直线(180°)取向的U型接头195,并且图23B示出呈大约150°取向的U型接头195。可在主传动轴组件的关节点14处用U型接头195代替锥齿轮52a-c(例如见图4),以使端部执行器12进行关节活动。图24A-B示出了扭转缆线197,其可用于代替锥齿轮52a-c和U型接头195,以实现端部执行器12的关节连接。
图25-31示出了带助力的电动双行程外科切割和紧固器械10的另一个实施例。图25-31的实施例类似于图6-10的实施例,不同的是图25-31的实施例包括替代的齿轮驱动组件,而不是螺旋齿轮筒80。图25-31的实施例包括齿轮箱组件200,其包括设置在机架201中的数个齿轮,其中这些齿轮连接在行星式齿轮72与传动轴48近端处的小齿轮124之间。如下文进一步解释,齿轮箱组件200通过击发触发器20为使用者提供关于端部执行器12的部署和加载力的反馈。而且,使用者可通过齿轮箱组件200为系统提供动力,以辅助端部执行器12的部署。在这种意义上,如同上述实施例,图25-31的实施例是另一种助力电动器械10,其向使用者提供关于切割器械32所感受到的加载力的反馈。
在图示实施例中,触发器20包括两个部件:主体部分202和加劲部分204。主体部分202可由例如塑料制成,并且加劲部分204可由更刚性的材料(例如金属)制成。在图示实施例中,加劲部分204邻近主体部分202,但根据其它实施例,加劲部分204可设置在主体部分202的内部。枢轴销207可插入穿过击发触发器构件202、204中的开口并可为击发触发器20围绕其旋转的点。此外,弹簧222可将击发触发器20偏置成沿逆时针方向旋转。弹簧222可具有连接至销224的远端,销224连接至击发触发器20的构件202、204。弹簧222的近端可连接至柄部外部下侧件59、60中的一者。
在图示实施例中,主体部分202和加劲部分204两者在其上端部分处(分别)包括齿轮部206、208。齿轮部206、208接合齿轮箱组件200中的齿轮(如下文所解释),以驱动主传动轴组件并为使用者提供关于端部执行器12部署的反馈。
如在图示实施例中所示,齿轮箱组件200可包括六(6)个齿轮。齿轮箱组件200的第一齿轮210接合击发触发器20的齿轮部206、208。此外,第一齿轮210接合更小的第二齿轮212,更小的第二齿轮212与大的第三齿轮214共轴。第三齿轮214接合更小的第四齿轮216,更小的第四齿轮216与第五齿轮218共轴。第五齿轮218为90°锥齿轮,其接合连接至小齿轮124的配对的90°锥齿轮220(图31中清晰显示),小齿轮124驱动主传动轴48。
在操作时,当使用者回缩击发触发器20时,运转马达传感器(未示出)被启动,其可向马达65提供信号,使之以与操作者回缩击发触发器20的程度或力成比例的速度旋转。这使得马达65以与来自传感器的信号成比例的速度旋转。此实施例中未示出传感器,但其可类似于上述的运转马达传感器110。传感器可位于柄部6中,使得其在击发触发器20回缩时被压缩。此外,可用通/断型传感器而不是比例型传感器。
马达65的旋转使锥齿轮66、70旋转,由此使得行星式齿轮72旋转,从而通过传动轴76使环形齿轮122旋转。环形齿轮122与小齿轮124啮合,所述小齿轮124连接到主传动轴48。因此,小齿轮124的旋转驱动主传动轴48,这致动端部执行器12的切割/缝合操作。
小齿轮124的向前旋转继而使锥齿轮220旋转,从而通过齿轮箱组件200的其它齿轮来使第一齿轮210旋转。第一齿轮210接合击发触发器20的齿轮部206、208,从而在马达65为端部执行器12提供向前的驱动时使击发触发器20逆时针旋转(并且在马达65反向旋转以回缩端部执行器12时逆时针旋转)。这样,使用者通过其握持击发触发器20来感受关于端部执行器12的加载力和部署的反馈。因此,当使用者回缩击发触发器20时,操作者将感受到与端部执行器12受到的加载力有关的阻力。类似地,当操作者在切割/缝合操作后释放击发触发器20,以使得其可返回到其初始位置时,使用者将感受到来自击发触发器20的顺时针旋转力,该力通常与马达65的反向速度成比例。
还应该指出的是,在此实施例中,使用者可施加力(代替或补充来自马达65的力)以通过回缩击发触发器20来致动主传动轴组件(由此致动端部执行器12的切割/缝合操作)。也就是说,击发触发器20的回缩使齿轮部206、208逆时针旋转,由此使得齿轮箱组件200的齿轮旋转,从而使小齿轮124旋转,由此使得主传动轴48旋转。
尽管在图25-31中未示出,但是器械10还可包括反向马达传感器和止动马达传感器。如上所述,反向马达传感器和止动马达传感器可分别检测切割行程的结束(刀32和滑块33的完全部署)和回缩操作的结束(刀32的完全回缩)。与上述图11相关的类似电路可用于为马达65适当供电。
图32-36示出了带助力的双行程电动外科切割和紧固器械10的另一个实施例。图32-36的实施例类似于图25-31的实施例,不同的是在图32-36的实施例中,击发触发器20包括下部228和上部230。下部228、上部230两者均与穿过下部228、上部230设置的枢轴销207连接并围绕其枢转。上部230包括与齿轮箱组件200的第一齿轮210接合的齿轮部232。弹簧222连接至上部230,使得上部被偏移而沿顺时针方向旋转。上部230还可包括下臂234,其与击发触发器20的下部228的上表面接触,使得当使上部230顺时针旋转时下部228也顺时针旋转,并且当下部228逆时针旋转时上部230也逆时针旋转。相似地,下部228包括与上部230的下肩接合的旋转阻挡件238。这样,当使上部230逆时针旋转时下部228也逆时针旋转,当下部228顺时针旋转时上部230也顺时针旋转。
图示实施例还包括给马达65传送信号的运转马达传感器110,在各种实施例中,该信号可使马达65以与操作者回缩击发触发器20时施加的力成比例的速度旋转。传感器110可为例如变阻器或某些其它可变电阻传感器,如本申请所述。此外,器械10可包括在与击发触发器20上部230的前表面242接触时被触动或切换的反向马达传感器130。当被启动时,反向马达传感器130将信号发送至马达65,以使其反向。此外,器械10可包括在与击发触发器20的下部228接触时被触动或驱动的止动马达传感器142。当被启动时,止动马达传感器142发送信号以停止马达65的反向旋转。
在操作中,当操作者使闭合触发器18回缩到锁定位置时,击发触发器20略微回缩(这借助于本领域所知的机构,其中包括名称为“SurgicalStapling Instrument Incorporating An E-Beam Firing Mechanism”的美国专利No.6,978,921和名称为“Surgical Stapling Instrument Incorporating A FiringMechanism Having A Linked Rack Transmission”的美国专利No.6,905,057,这两个专利均以引用方式并入本文中),因此使用者可握持击发触发器20来初始化切割/缝合操作,如图32和图33所示。此时,如图33所示,击发触发器20的上部230的齿轮部232与齿轮箱组件200的第一齿轮210运动接合。当操作者回缩击发触发器20时,根据各种实施例,在触动运转马达传感器110之前,击发触发器20可旋转较小的量(例如5度),如图34中所示。传感器110的启动使马达65以与由操作者施加的回拉力成比例的速度正向旋转。如上所述,马达65正向旋转使得主传动轴48旋转,由此使得端部执行器12中的刀32被部署(例如,开始穿过槽22)。连接至主传动轴48的小齿轮124的旋转使齿轮箱组件200中齿轮210-220旋转。由于第一齿轮210与击发触发器20的上部230的齿轮部232接合,因此使上部230逆时针旋转,由此使得下部228也逆时针旋转。
当刀32被完全部署(例如,在切割行程结束)时,上部230的前表面242触动反向马达传感器130,反向马达传感器130将信号发送至马达65,使其反方向旋转。这使得主传动轴组件反方向旋转以回缩刀32。主传动轴组件反向旋转使齿轮箱组件中的齿轮210-220反转,使得击发触发器20的上部230顺时针旋转,由此使得击发触发器20的下部228顺时针旋转,直到当刀32完全回缩时上部230的前表面242触动或致动止动马达传感器142,从而使马达65停止。这样,使用者通过其握持击发触发器20来感受关于端部执行器12部署的反馈。因此,当使用者回缩击发触发器20时,操作者将感受到与端部执行器12的部署有关的阻力,特别是与由于刀32受到的加载力有关的阻力。类似地,当操作者在切割/缝合操作后释放击发触发器20,以使得其可返回到其初始位置时,使用者将感受到来自击发触发器20的顺时针旋转力,该力通常与马达65的反向速度成比例。
还应该指出的是,在此实施例中,使用者可施加力(代替或补充来自马达65的力)以通过回缩击发触发器20来致动主传动轴组件(由此致动端部执行器12的切割/缝合操作)。也就是说,击发触发器20的回缩使上部230的齿轮部232逆时针旋转,由此使得齿轮箱组件200的齿轮旋转,从而使小齿轮124旋转,由此使得主传动轴组件旋转。
上述实施例采用助力使用者反馈系统,这些系统带或不带用于双行程电动外科切割紧固器械的自适应控制(例如,使用设置在马达、齿轮传动系和端部执行器的闭环系统外部的传感器110、130、142)。也就是说,由于击发触发器20被(直接或间接地)啮合到马达65和主传动轴48之间的齿轮传动系中,由使用者施加的用以回扣击发触发器20的力可被添加到由马达65施加的力。在其它实施例中,可向使用者提供关于端部执行器12中的刀32位置的触觉反馈,但击发触发器20不啮合到齿轮传动系中。图37-40示出了具有此类触觉位置反馈系统的电动外科切割和紧固器械10的一个实施例。
在图37-40示出的实施例中,击发触发器20可具有下部228和上部230,类似于图32-36中示出的器械10。然而,不同于图32-36的实施例,上部230不具有与部分齿轮传动系配合的齿轮部。相反,器械10包括第二马达265,所述第二马达265带有螺纹接合在其中的螺杆266。当马达265旋转时,螺杆266纵向往复进出(取决于旋转方向)马达265。器械10还包括编码器268,其响应主传动轴48的旋转,将主传动轴48(或主传动轴组件的其它零件)的增量角运动转化成例如对应的一系列数字信号。在图示实施例中,小齿轮124包括连接至编码器268的近端传动轴270。
器械10还包括可使用微控制器或一些其它类型的集成电路实现的控制电路(未示出),该控制电路接收来自编码器268的数字信号。基于来自编码器268的信号,控制电路可计算端部执行器12中刀32部署的阶段。也就是说,控制电路可计算刀32是否完全部署、完全回缩或处于中间阶段。基于对端部执行器12部署阶段的计算结果,控制电路可将信号发送至第二马达265以控制其旋转,从而控制螺杆266的往复运动。
在操作中,如图37所示,当闭合触发器18未锁定到夹持位置时,击发触发器20远离柄部6的手枪式夹持件26旋转,使得击发触发器20的上部230的前表面242不与螺杆266的近端接触。当操作者回缩闭合触发器18并将其锁定在夹持位置时,击发触发器20略微朝闭合触发器18旋转,以使得操作者可握持击发触发器20,如图38所示。在此位置,上部230的前表面242接触螺杆266的近端。
当使用者随后回缩击发触发器20时,运转马达传感器110可以在初始旋转量(例如5度的旋转)后被致动,如上所述,使得传感器110将信号发送至马达65,以使其以与由操作者施加到击发触发器20的回缩力的量成比例的正向速度旋转。马达65的正向旋转通过齿轮传动系使主传动轴48旋转,由此使得刀32和滑块33沿着槽22活动并切割夹持在端部执行器12中的组织。控制电路接收来自编码器268的关于主传动轴组件的增量旋转的输出信号,将信号发送到第二马达265以使第二马达265旋转,由此使得螺杆266回缩到马达265中。这允许击发触发器20的上部230逆时针旋转,从而允许击发触发器的下部228也逆时针旋转。这样,由于螺杆266的往复运动与主传动轴组件的旋转相关,因此器械10的操作者通过他/她握持击发触发器20来感受关于端部执行器12位置的触觉反馈。然而,由使用者施加的回缩力不直接影响主传动轴组件的驱动,因为击发触发器20并未啮合到该实施例中的齿轮传动系中。
通过对来自编码器268的输出信号对主传动轴组件的增量旋转进行跟踪,控制电路可计算刀32何时被完全部署(例如,完全伸展)。此时,控制电路可将信号发送至马达65以反转方向,从而使刀32回缩。马达65的反转方向使主传动轴组件反向旋转,这也被编码器268检测。基于编码器268检测到的反向旋转,控制电路将信号发送至第二马达265以使其反转,使得螺杆266开始从马达265纵向延伸。此动作促使击发触发器20的上部230顺时针旋转,由此使得下部228顺时针旋转。这样,操作者可感受来自击发触发器20的顺时针方向的力,由此为操作者提供关于刀32在端部执行器12中的回缩位置的反馈。控制电路可确定刀32何时完全回缩。此时,控制电路可将信号发送至马达65以使其停止旋转。
根据其它实施例,可使用反向马达传感器和止动马达传感器而不是用控制电路来确定刀32的位置,如上所述。此外,可使用通/断开关或传感器而不是用比例传感器110来控制马达65的旋转。在此类实施例中,操作者不能够控制马达65的转速。确切地说,马达将以预编程的速度旋转。
图43为外科器械300的局部剖视图,其中为清晰起见移除了多个元件。外科器械300具有用于驱动端部执行器(未示出)的齿条302(以横截面显示)。小齿轮304与齿条302接合,使得小齿轮304沿逆时针方向的旋转朝远侧平移齿条302并且小齿轮304沿顺时针方向的旋转朝近侧平移齿条302。小齿轮304可围绕轴306旋转并且可由如下马达驱动,所述马达由触发器(未示出)操作地控制。在一个实施例中,小齿轮304可通过偏置构件308而沿第一方向303进行偏置。偏置构件308可为弹簧,如图所示,但可使用任何其它合适的偏置技术。外科器械300可包括杠杆310,所述杠杆310可用于例如外科器械的电源的能量水平低于足够的可操作水平的情况中。在一个实施例中,杠杆310通常利用门312遮蔽以避开使用者,所述门312可被使用者移除以触及杠杆310。杠杆310可围绕枢轴314沿着由箭头316指示的方向旋转。锁定凸轮318可附接到杠杆310,使得杠杆310围绕枢轴314的旋转可使锁定凸轮318旋转。在一些实施例中,锁定凸轮318与杠杆310是一体的。
图44A和44B示出了多个操作状态期间的锁定凸轮318。锁定凸轮318包括主体部分320和弹簧部分322,所述弹簧部分322可围绕铰链部分324而相对于主体部分320进行枢转或换句话讲挠曲。铰链部分324可包括例如活动铰链。在一个实施例中,主体部分320和弹簧部分322是一体的并且由单块材料形成。锁定凸轮318可限定允许弹簧部分322朝向主体部分320枢转的间隙326。弹簧部分322可具有被主体部分320中的凹口321容纳的齿331。在其相应的外周边上,主体部分320可具有第一接触表面328并且弹簧部分322可具有第二接触表面330。在闭合位置(图44A)中,第一接触表面328通常与第二接触表面330对准,使得锁定凸轮318的外周边具有大致连续的凸轮表面。在打开位置(图44B)中,弹簧部分322远离主体部分320枢转以增加间隙326。在第一接触表面328和第二接触表面330之间产生间隙332。
现在参见图43、图44A和图44B,在杠杆310沿着由箭头316指示的方向旋转时,锁定凸轮318被旋转并且弹簧部分322的第二外表面330首先接触小齿轮304的顶部表面342。由于此接触操作,使得弹簧部分322朝向主体部分320枢转以形成大致连续的周边。当锁定凸轮318继续旋转时,第二接触表面330并且随后第一接触表面328将力施加到小齿轮304上以克服由偏置构件308施加的偏置力。因此,当沿着由箭头316指示的方向旋转杠杆310时,可沿着由箭头324指示的方向来推压小齿轮304。小齿轮304的活动使其与齿条320退耦,从而允许齿条320自由地平移。一旦弹簧部分322越过小齿轮304的顶部表面342时,其枢转到打开位置(图44B)以将锁定凸轮318锁定就位。一旦处于打开位置时,将因弹簧部分322与小齿轮304的接合而阻止锁定凸轮318沿着由箭头344指示的方向旋转(图43)。
图45A、图45B和图45C示出了三个操作阶段期间的锁定凸轮418和齿轮404。为清晰起见已移除和/或简化了多个元件。如图所示,锁定凸轮418可由单块材料形成。锁定凸轮418包括可相对于主体部分420枢转的弹簧部分422。图45A示出了处于非接合位置的锁定凸轮418。在此位置,弹簧部分422的远侧部分423与主体部分420分离。如图45B所示,当锁定凸轮418沿着由箭头416指示的方向旋转时,将弹簧部分422拖曳到主体部分420以形成跨越弹簧部分422和主体部分420的大致连续的周边。当锁定凸轮418接触中心毂442时,小齿轮404沿着由箭头443指示的方向活动。当锁定凸轮418继续沿着由箭头416指示的方向旋转时,弹簧部分422最终跨过中心毂442。如图45C所示,当弹簧部分422的远侧部分423与主体部分420分离时,其接合小齿轮404的齿以将锁定凸轮418锁定在接合位置。因此,在多个实施例中,尽管锁定凸轮418可由单块材料形成,但其可充当两个部件(例如,凸轮和锁定机构)。
图46示出了外科器械500的一个实施例。器械500包括柄部502、手枪式夹持件501、触发器504和端部执行器505。根据多个实施例,柄部502、触发器504和端部执行器505可以类似于本文所述的各种柄部6、触发器18、20和端部执行器12的方式工作。除了或取代上文所述的功能,端部执行器501可包括下述外科工具,所述外科工具用于例如切割、夹持、激光切割和/或凝固、RF切割和/或凝固、超声切割和/或凝固。
器械500的柄部502可容纳至少一个电池组506。电池组506可包括单个电池或设置成串联和/或并联构型的多个电池。柄部502可包括可附接电池组506的电池底座508。电池底座508可为用于将电池组506联接到器械500的任何合适结构。例如,电池底座508可为位于柄部502中的被构造成容纳电池组506的至少一部分的腔体,如图所示。在其它实施例中,可利用多种其它结构来实现电池底座508。在一个实施例中,电池底座508为被电池组506容纳的柱。在一个实施例中,手枪式夹持件501包括电池底座508。在任何情况下,如下文更详细所述,电池底座508可包括在电池组506附接到柄部502时与电池组506相互作用的突出部分。一旦附接后,电池组506就可电连接到器械500的电路514并为其供电。电路可位于柄部502中(如图所示)、端部执行器505中、或器械500内的位置的任何组合中。使用时,电路514可为端部执行器505处的至少一个外科工具的操作供电。例如,电路514可包括电动马达,所述电动马达用于操作电动切割器、抱握器、或其它机械装置。除了马达之外或者取代马达,电路514可包括用于实现RF、超声、或其它类型的非马达供能式外科工具的合适电路元件。
图47A、图47B、图47C示意性地示出了电池组506以及器械500的一部分。电池组506可包括在附接到器械500时自动地在电池组506内形成完整电路的漏极。漏极用于随时间推移而缓慢地减少电池组506的电荷。一旦电池组506已被充分放电时,其可作为例如非危害性废弃物进行处理。电池组506可包括电压源510。在一个实施例中,电压源510为锂电池并且包括选自包括CR123电池或CR2电池的组的至少一个电池。应当理解,可使用任何合适的电压源。电池组506还包括在开关516闭合时电联接到电压源510的漏极512。电池组506和器械500各自分别包括在电池组506附接到器械500时设置成接触的导电触点518、520。图47A示出了处于非附接位置的电池。开关516处于打开位置并且电压源510可处于满电量状态。图47B示出了处于附接位置的电池组506。电池组506的导电触点518与器械的触点520电气连通,从而允许电池组506为电路514(图46)提供能量。在附接位置,开关516转换到闭合位置以将电压源510电联接到漏极512。在器械的操作期间,能量将从电压源510流过漏极512。换句话讲,当电池组506为器械500提供可操作功率时,漏极512将同时地从电压源510消耗电荷。如下文更详细所述,在电池组506附接到器械500期间,器械500的一部分可与漏极512进行物理性相互作用以将开关516从打开状态转换到闭合状态。图47C示出了处于非附接位置的电池组506。在一个实施例中,甚至在电池组506已从器械500分离之后,开关516仍处于闭合位置以继续消耗电压源510。
图48为根据一个非限制性实施例的从附接到器械500时起测量的电池组506的电压水平随时间推移的曲线图600。曲线图600示出了电池组506的6V电池的电压水平。曲线图600仅代表电池组506的一个实施例。应当理解,尽管曲线图600示出了6VDC电源,但电池组506可提供任何合适的电压,例如9VDC、12VDC或18VDC。如下文更详细所述,电池组506可包括布置成并联和/或串联构型的多个电池。曲线图600包括三个实例放电曲线602、604、606。如第一放电曲线602所示,电源510的电压在大约28小时之后下降到2.0伏之下。如第二放电曲线604所示,电源510的电压在大约30小时之后下降到2.0伏之下。如第三放电曲线606所示,电源510的电压在大约33小时之后下降到2.0伏之下。放电曲线的整体形状可取决于例如器械500在外科手术期间的活动水平。例如,相比于与放电曲线606相关联的器械,与第一放电曲线602相关联的器械得到更为强烈的使用。在任何情况下,漏极512将电池组506的电压水平在满意水平下保持特定时间段,以确保器械可在外科手术的过程中用于其预期目的。例如,在一个实施例中,将电池组506的电压水平在约6伏下保持大约12小时。在12小时之后,电压水平逐渐地下降到非危害性水平。应当理解,漏极512可进行校正以更快或更慢地耗尽电压源。
在一个实施例中,使用电阻元件来降低电压源的能量水平。图49A为包括漏极612的电池组616的简化电路图。电池组616可例如通过其触点618附接到器械500。在此实施例中,电池组616包括第一组电池610和第二组电池611。在一个实施例中,第一组电池610和第二组电池611为锂电池。第一组电池610和第二组电池611可各自具有布置成并联构型的多个单独电池610a、610b、611a、611b。例如,第一组电池610和第二组电池611可各自为6VDC并且布置成串联构型以在满电量时在电池组616的触点618处产生12VDC。然而,电池610a、610b、611a、611b彼此可以串联形式、或并联形式、或它们的任何其它组合进行电连接。
在一个实施例中,漏极612包括第一电阻元件622和第二电阻元件624。应当理解,在一些实施例中,电池组61可包括例如多个漏极612,所述多个漏极612各自具有多于或少于两个电阻元件或者其它电路。在图示实施例中,第一电阻元件622通过第一开关630联接到第一组电池610第一阳极626和第一阴极628上。第一电阻元件624可通过第二开关636联接到第二组电池611的第二阳极632和第二阴极634上。在电池组616附接到外科器械500时,可闭合第一开关630和第二开关636以便初始化第一组电池610和第二组电池611的放电。
漏极612所用的电阻元件的值可基于具体实施而有所改变。在一个实施例中,第一电阻元件622具有约90欧姆至约110欧姆范围内的阻抗。在一个实施例中,第一电阻元件622具有约97欧姆至约104欧姆范围内的阻抗。在一个实施例中,电阻元件622为102.9欧姆并且具有1瓦特的额定功率。对必需电阻的确定至少部分地取决于电压源的容量、电压源的电压水平和放电曲线的所需时间长度。例如,在一个实施例中,第一组电池610的电池容量为1400mAh,电压水平为6VDC,并且目标放电时间为24小时。用1400mAh除以24小时产生0.0582A的电流。根据欧姆定律,用6V除以0.582A产生102.9欧姆的阻抗。在电流为0.583并且阻抗为102.9欧姆的情况下,该电阻器消耗的功率为.350W。应当理解,不同的电压水平、电池容量和所需放电时间将导致不同的电阻值。
图49B为电池组的另一个实施例的简化电路图。在图49B中,电池组660可附接到具有多组触点的外科器械650。如图所示,外科器械650具有第一组触点652A、652B和第二组触点654A、654B。电池组660具有被构造成接合外科器械650的触点的第一组触点656A、656B和第二组触点658A、658B。在图示实施例中,电池组660包括第一电池662,所述第一电池662与第二电池664串联以通过第一组触点652A、652B向外科器械650提供能量。电池组660还可包括第三电池668,所述第三电池668与第四电池670串联以通过第二组触点654A、654B向外科器械650提供能量。第一电池662、第二电池664、第三电池668和第四电池670可各自在满电量时提供任何合适的电压水平,例如3VDC或6VDC。在一个实施例中,当电池组处于满电量时,电池组660将总计约12VDC递送到外科器械650(例如,其中约6VDC经由第一组触点656A、656B并且约6VDV经由第二组触点658A、658B)。电池组660可包括第一漏极672和第二漏极674。尽管第一漏极672和第二漏极674示意性地示为独立地位于图49A中,但应当理解,漏极672和674可在单个电路板上或通过任何其它合适的实施方式来实现。第一漏极672包括与第一电池662和第二电池664以及第一开关680串联连接的第一电阻元件674。第二漏极674包括与第三电池668和第四电池670以及第二开关684串联连接的第二电阻元件682。第一开关680和第二开关684示出为处于打开位置。当闭合第一开关680(例如,在电池组660附接到外科器械650期间)时,电流从第一电池662和第二电池664流过第一电阻元件678以使这些电池放电。相似地,当闭合第二开关684(例如,在电池组660附接到外科器械650期间)时,电流从第三电池668和第四电池670流过第一电阻元件678以使这些电池放电。
图50为包括第一漏极712和第二漏极713的电池组716的简化电路图。电池组716可例如通过其触点718附接到器械500。在此实施例中,电池组716包括第一组电池710、第二组电池711和第三电池714。第一漏极712包括第一电阻元件722和第二电阻元件724。第二漏极713包括第三电阻元件726。电阻元件722、724、726通过开关730、736和738连接到相应的电池。在电池组716附接到外科器械500时,可闭合开关730、736和738以便初始化第一组电池和第二组电池610、611以及第三电池716的放电。第三电阻元件726的阻抗可类似于或不同于第一电阻元件722和第二电阻元件724的阻抗。如上文所述,第三电阻元件726的阻抗可至少部分地取决于第三电池714的电压和放电曲线的期望特性。
图51-53为实现图49所示的电池组616的示意图的电池组800的透视图。电池组800可包括限定内部腔体810的壳体802。尽管内部腔体810示为位于壳体802的中部,但应当理解,内部腔体810可被定位在任何合适的位置。壳体802可由顶盖804覆盖,所述顶盖804可利用一个或多个机械闩锁806、808固定到壳体802。图52示出了电池组800的一个实施例,其中顶盖804被移除以示出其内的多个电池812。可使用任何合适数量和/或类型的电池812。例如,可使用CR123和/或CR2电池。图53示出了电池组800的一个实施例,其中壳体802的一部分被移除以显示出电池812。
图54A和54B示出了包括可平移的漏极812的电池组800的一个实施例的剖视图。漏极812可被定位在内部腔体810内并且可在内部腔体810内沿箭头815的方向平移。图54A示出了处于打开位置的漏极812并且图54B示出了处于闭合位置的漏极812。漏极812可包括至少两个触点816、818。当漏极812处于打开位置时,触点816、818的一部分可接触壳体802的非导电部分,例如指状物820、822。根据多个实施例,触点816、818可被偏置以紧压指状物820、822施加力,以便抵制漏极812沿箭头815方向的活动。另外,在一些实施例中,指状物820、822可限定一个或多个突出部或逐级下降部分,如图54A和54B所示。电池组800还可包括一个或多个电极,例如第一电极824和第二电极826。第一电极824和第二电极826可各自电联接到被包含在电池组800内的电池的阴极或阳极。在闭合位置(图54B),触点816、818与电极824、826电连接,从而允许电压源通过漏极812来放电。如下文更详细所述,在电池组800附接到外科器械时,漏极812可从打开位置平移到闭合位置。
图55为根据非限制性实施例的漏极812的透视图。漏极812的触点816、818可联接到漏极812的基部830。相似地,漏极812的触点836、838可联接到漏极812的基部830。根据多个实施例,触点816、818可通过安装到电路板832的电阻元件(未示出)而彼此电连接。相似地,触点836、838可通过安装到电路板832的电阻元件而彼此电连接。如图所示,触点816、818、836、838可具有弯曲或曲率,以使得触点在被向内压缩时朝向外位置偏置。另外,在一个实施例中,触点816、818、836、838中的每个的远端可具有向内翻转部分。基部830可包括在电池组800附接到器械时接合器械的接触表面840。通过这种接合,漏极812可相对于壳体800平移。
图56示出了附接到电池底座850的电池组800。为清晰起见,已移除了多个元件。现在参见图54A、图54B、图55和图56,电池底座850包括突出构件858,所述突出构件858的尺寸被设定成被电池组800的腔体810(图51)容纳。在附接之前,漏极812处于打开位置(图54A)。在电池组800附接到电池底座850期间,突出构件858插入腔体810内并且电池组800相对于电池底座850沿着由箭头862指示的方向活动。最终,突出构件858的远端860接触漏极812的接触表面840。当使用者继续附接电池组800时,漏极812相对于壳体802沿着由箭头864指示的方向活动并且活动到闭合位置(图54B)。在此位置,电池组800开始缓慢地放电。当电池组800从电池底座850移除时,漏极812可仍处于图54B所示的位置。这样,电池组800的电池(未示出)可在处理之前或期间而在电阻元件上消耗任何残余的电荷。
应当理解,电池组的可平移的放电漏极并不限于图56所示的具体实施。图57A和图57B例如示出了电池组900和漏极912,其中为了清晰起见移除了多个元件。漏极912可在打开位置(图57A)和闭合位置(图57B)之间平移。在打开位置,触点916、918分别与壳体的非导电部分920、922接合。当漏极912在打开位置和闭合位置之间平移时,其可骑压在轨道914中。图57B示出了在压头958已沿着由箭头964指示的方向平移漏极912之后的处于闭合位置的电池组900。压头958可为例如外科器械的电池底座的元件。在一个实施例中,电池底座包括尺寸被设定成容纳电池组900的腔体,并且将压头958定位在腔体内。在闭合位置,触点916、918与电极924、926电接触。漏极912可包括其上利用例如表面贴装或通孔连接来安装至少一个电阻元件的印刷电路板932。
图58A和图58B示出了根据另一个非限制性实施例的电池组1000。为清晰起见已省去了多个元件。电池组1000包括可在打开位置(图58A)和闭合位置(图58B)之间平移的漏极1012。电池组1000可包括具有触点1025的第一电极1024和具有触点1027的第二电极1026。电极1024、1026可与电池组1000的电池(未示出)接触。在打开位置,漏极1012的触点1016、1018不与电极1024、1026的触点1025、1027接合。当漏极1012在打开位置和闭合位置之间平移时,其可骑压在轨道1014中。图58B示出了在压头1058已沿着由箭头1064指示的方向平移漏极1012之后的处于闭合位置的电池组1000。压头1058可为例如外科器械的电池底座的元件。在闭合位置,漏极1012的触点1016、1018与电极1024、1026的触点1025、1027电接触。漏极1012可包括具有至少一个电阻元件的印刷电路板1032。在一些实施例中,触点1016、1018自身可包括电阻元件。事实上,电阻元件可为具有任何合适的阻抗值和任何合适的机械构型的元件。
图59为电池组1100的透视图。图60A和图60B示出了电池组1100在多个操作阶段期间的内部视图,其中为清晰起见移除了多个元件。电池组1100具有一个电池1102和限定腔体1110的外部壳体1104。外部壳体1104可为非导电的并且具有导电触点,所述导电触点在电池组1100附接到外科器械时为外科器械提供能量。在一个实施例中,电池组1100被外科器械的手枪式夹持件部分中的腔体容纳。电池组1100包括可在打开位置(图60A)和闭合位置(图60B)之间平移的漏极1112。在一个实施例中,漏极1112具有连接到电路板1132的第一触点1116和第二触点1118。电路板1132可包括例如至少一个电阻元件。在一些实施例中,电路板1132包括附加电路。电池组1100包括联接到电池1102的阳极的第一电极1124和联接到电池1102的阴极的第二电极。在电池组1100附接到器械之前,漏极1112处于打开位置(图60A)。在图示实施例中,第一触点1116电联接到第一电极1124并且第二触点1118正位于或换句话讲接触非导电指状物1120上。当电池组1100附接到器械时,器械的突出部分1158可被腔体1110容纳并且接触漏极1112以沿着由箭头1164指示的方向来驱动漏极1112。在闭合位置(图60B),第一触点1116电联接到第一电极1124并且第二触点1118电联接到第二电极1126。在此位置,形成闭合电路以允许电池1102通过漏极1112放电。
有关外科器械和电池组的附加细节在提交于2010年9月17日的名称为“SURGICAL INSTRUMENTS AND BATTERIES FOR SURGICALINSTRUMENTS”的美国专利申请序列号12/884,838中有所描述,所述专利申请全文以引用方式并入本文。
应当理解,本文的附图和描述中的至少一些已被简化以示出适于清楚地理解本公开的元件,同时为清晰起见移除了其它元件。然而,本领域的普通技术人员将认识到,这些和其它元件可为所需的。然而,由于这些元件为本领域所熟知并且由于它们不利于较好地理解本公开,因此本文未提供对这些元件的论述。
虽然已经描述了多个实施例,但应当知道,本领域技术人员在掌握了本公开的一些或全部优点之后可能对这些实施例作出各种修改、改变和改型形式。例如,根据多个实施例,单个组件可替换为多个组件,并且多个组件也可替换为单个组件,以执行给定的一种或多种功能。因此,在不脱离所附权利要求书限定的本公开的范围和精神的情况下,本专利申请旨在涵盖所有此类修改、变型和改型形式。
以引用方式全文或部分地并入本文的任何专利、公布或其它公开材料均仅在所并入的材料不与本公开所述的现有定义、陈述或其它公开材料相冲突的范围内并入本文。由此,在必要的程度下,本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突材料。如果据述以引用方式并入本文但与本文所述的现有定义、陈述或其它公开材料相冲突的任何材料或其部分,仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
Claims (6)
1.一种外科器械,包括:
端部执行器;
操作地联接到所述端部执行器的柄部,其中所述柄部包括致动所述端部执行器的触发器,所述柄部包括电池底座;
所述电池底座包括突出构件;
其特征在于:
能够附接到所述电池底座的电池组,其中所述电池组在附接到所述电池底座时与所述柄部和所述端部执行器中的至少一者电接触,并且其中所述电池组包括:
壳体;以及
定位在所述壳体内的第一阳极和第一阴极;以及
能够平移的放电漏极,其中在所述电池组附接到所述电池底座时,所述突出构件接触所述放电漏极并且所述放电漏极相对于壳体平移以将所述电池组的第一阳极电联接到所述电池的第一阴极。
2.根据权利要求1所述的外科器械,其中所述放电漏极包括第一触点和第二触点,并且至少一个电阻元件电联接到所述第一触点和第二触点,其中在所述电池组附接到所述电池底座时,所述放电漏极通过所述至少一个电阻元件将所述第一阳极电联接到所述第一阴极。
3.根据权利要求2所述的外科系统,其中所述至少一个电阻元件具有在约90欧姆至约110欧姆范围内的阻抗。
4.根据权利要求1所述的外科器械,其中电池组包括定位在所述壳体内的第二阳极和第二阴极,并且其中在所述电池组附接到所述电池底座时,所述放电漏极将所述第二阳极电联接到所述第二阴极。
5.根据权利要求1所述的外科器械,其中所述端部执行器包括至少一个工具,所述工具选自包括切割器、抱握器、缝合器、RF工具、超声工具和激光工具的组。
6.根据权利要求1所述的外科器械,其中电池组包括选自包括CR123电池和CR2电池的组的至少一个电池。
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US12/884,995 | 2010-09-17 | ||
PCT/US2011/051357 WO2012037096A2 (en) | 2010-09-17 | 2011-09-13 | Power control arrangements for surgical instruments and batteries |
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CN103096818A CN103096818A (zh) | 2013-05-08 |
CN103096818B true CN103096818B (zh) | 2015-08-12 |
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CA (1) | CA2810073C (zh) |
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RU2013117455A (ru) | 2014-10-27 |
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CA2810073A1 (en) | 2012-03-22 |
BR112013006377A2 (pt) | 2016-06-28 |
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