CN103565487B - 机电手术系统 - Google Patents

机电手术系统 Download PDF

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CN103565487B
CN103565487B CN201310306670.1A CN201310306670A CN103565487B CN 103565487 B CN103565487 B CN 103565487B CN 201310306670 A CN201310306670 A CN 201310306670A CN 103565487 B CN103565487 B CN 103565487B
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gear
end effector
rotation
lock ring
distal
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贾斯汀·威廉斯
保罗·A·西里卡
欧内斯特·奥拉尼
斯坦尼斯洛娃·科斯切夫斯基
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Covidien LP
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07292Reinforcements for staple line, e.g. pledgets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00305Constructional details of the flexible means
    • A61B2017/00314Separate linked members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00318Steering mechanisms
    • A61B2017/00323Cables or rods
    • A61B2017/00327Cables or rods with actuating members moving in opposite directions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477Coupling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681Aspects not otherwise provided for
    • A61B2017/00734Aspects not otherwise provided for battery operated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07278Stapler heads characterised by its sled or its staple holder
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07285Stapler heads characterised by its cutter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2902Details of shaft characterized by features of the actuating rod
    • A61B2017/2903Details of shaft characterized by features of the actuating rod transferring rotary motion
    • FMECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F04POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
    • F04CROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS
    • F04C2270/00Control; Monitoring or safety arrangements
    • F04C2270/04Force
    • F04C2270/041Controlled or regulated

Abstract

本发明提供一种机电手术系统,所述机电手术系统包括:手持式手术器械;末端执行器;以及轴组件,其用于选择性地将末端执行器与手术设备相互连接。轴组件包括:变速箱壳体;管状外主体;远侧颈部壳体,其用于将手术器械的可旋转驱动构件和支撑在末端执行器中的旋转接纳构件相互连接,其中,远侧颈部壳体包括至少一个齿轮系统,其被配置为将可旋转驱动构件的旋转输入转换成至末端执行器的至少两个输出力;以及关节式运动颈部组件,其将管状主体与远侧颈部壳体相互连接。关节式运动颈部组件被配置为使远侧颈部组件能够进行离轴关节式运动,并且其中可旋转驱动构件延伸通过关节式运动颈部组件。

Description

机电手术系统
相关申请的交叉引用
本申请要求2012年7月20日提交的申请号为61/673,792的美国临时申请的权益和优先权,将上述公开的全部内容通过引用并入本文。
技术领域
本公开涉及用于执行内窥镜手术操作的手术装置、设备和/或系统,以及其使用方法。更具体地,本公开涉及用于机电的、手持式的手术装置、设备和/或系统的可选齿轮箱,所述手术装置、设备和/或系统被配置成用于与可移除的一次性装载单元和/或单次使用装载单元一起使用,以用于夹紧组织、切割组织和/或吻合组织。
背景技术
若干手术设备的制造商已经开发出具有适用于操作和/或操纵机电手术设备的专用驱动系统的产品线。一些机电手术设备包括可重复使用的手柄组件,以及可替换的装载单元和/或单次使用装载单元等,在使用前,所述装载单元可以选择性地连接到所述手柄组件上,然后,在使用后,与所述手柄组件断开连接,以便被处置或在一些实例中被消毒以重复使用。
这些机电手术设备中有许多对于制造、购买和/或操作来说都是相对昂贵的。制造商和终端用户希望开发出制造、购买和/或操作相对廉价的机电手术设备。
因此,对于开发及制造、储存以及运输相对经济的以及对于从终端用户的角度看购买和使用经济和便利的机电手术装置、设备和/或系统存在需求。
对于并入齿轮箱的机电手术装置存在额外的需求,所述齿轮箱减少延伸通过关节式运动颈部组件的驱动线缆的数量。
发明内容
本公开涉及用于机电的、手持式的手术装置、设备和/或系统的可选齿轮箱,所述手术装置、设备和/或系统被配置成用于与可移除的一次性装载单元和/或单次使用装载单元一起使用,用于夹紧组织、切割组织和/或吻合组织。
根据本公开的方案,提供一种机电手术系统,并且所述机电手术系统包括:手持式手术器械,其包括限定连接部的器械壳体,所述连接部用于与轴组件选择性地连接,所述手术器械具有至少一个可旋转驱动构件;末端执行器,其被配置为执行至少一个功能;以及轴组件,其被布置为用于选择性地将所述末端执行器与所述手术设备相互连接。
所述轴组件包括:变速箱壳体,其被配置为并且适于选择性地连接至所述手术设备的所述连接部并且与所述手术设备的所述至少一个可旋转驱动构件中的每一个可操作地连通;管状外主体,其具有被所述变速箱壳体支撑的近侧端和被配置为并且适于与所述末端执行器可操作地连接的远侧端;远侧颈部壳体,其用于将所述手术器械的可旋转驱动构件与支撑在所述末端执行器中旋转接纳构件相互连接。所述远侧颈部壳体包括能够连接到所述手术器械的一个可旋转驱动轴的第一端部和能够连接到所述末端执行器的所述旋转接纳构件的第二端部。力传递组件将所述手术器械的所述可旋转驱动构件的旋转传递至所述末端执行器的所述旋转接纳构件。远侧颈部组件包括:至少一个齿轮系统,其被配置为将所述可旋转驱动构件的旋转输入转换成至所述末端执行器的至少两个输出力。轴组件还包括关节式运动颈部组件,其将所述管状外主体与所述远侧颈部壳体相互连接,其中所述关节式运动颈部组件被配置为使所述远侧颈部组件能够做离轴关节式运动,并且其中所述可旋转驱动构件延伸通过所述关节式运动颈部组件。
所述远侧颈部壳体的所述至少一个齿轮系统的第一输出力可以引起所述末端执行器的发射。所述远侧颈部壳体的所述至少一个齿轮系统的第一输出力可以引起所述末端执行器相对于所述轴组件的旋转。
所述远侧颈部壳体可以非可旋转地且可滑动地支撑锁环齿轮(lock collargear),其中所述锁环齿轮包括第一位置,在所述第一位置上所述远侧颈部壳体的所述至少一个齿轮系统的第一输出力引起所述末端执行器的发射,并且其中所述远侧颈部壳体的所述至少一个齿轮系统的第一输出力引起所述末端执行器相对于所述轴组件的旋转。
所述远侧颈部壳体可以包括:管状外壳体,其限定从其径向地向内延伸的至少一个齿;以及第一齿轮系统,其支撑在所述管状外壳体中。所述第一齿轮系统可以包括:第一太阳齿轮,其能够被所述手术器械的所述一个可旋转驱动构件驱动;第一环形齿轮,其可旋转地支撑在所述管状外壳体中;至少一个第一行星齿轮,其插置在所述第一太阳齿轮与所述第一环形齿轮之间并且将所述第一太阳齿轮与所述第一环形齿轮相互啮合;以及承载器,其可旋转地支撑在所述管状外壳体中,所述承载器包括可旋转地支撑各个第一行星齿轮的相应的柱。在使用中,当第一太阳齿轮使各个第一行星齿轮绕第一太阳齿轮的旋转轴线旋转时,可以使所述末端执行器发射。同样在使用中,当所述第一太阳齿轮使各个第一行星齿轮绕相应的旋转轴线旋转时,可以旋转所述末端执行器。
远侧颈部壳体可以包括:冠状齿轮,其非可旋转地连接至所述承载器;以及锁环齿轮,其轴向地、非可旋转地且可滑动地支撑在所述管状外壳体中。所述锁环齿轮可以包括第一位置,在所述第一位置上所述锁环齿轮啮合所述冠状齿轮并且防止所述冠状齿轮旋转,其中所述冠状齿轮的非旋转容许所述末端执行器的旋转。所述锁环齿轮可包括第二位置,在所述第二位置上所述锁环齿轮与所述冠状齿轮分离并且容许所述冠状齿轮旋转,其中所述冠状齿轮的旋转容许所述末端执行器的发射。
所述远侧颈部壳体包括非可旋转地支撑在管状外壳体中的旋转毂以及支撑在所述旋转毂中的第二齿轮系统。所述第二齿轮系统可以包括:第二太阳齿轮,其非可旋转地连接至所述承载器;以及至少一个第二行星齿轮,其可旋转地支撑在所述旋转毂中并且与所述第二太阳齿轮相互啮合;以及发射连接器,其连接至所述至少一个第二行星齿轮中的一个,其中所述发射连接器被配置为接合所述末端执行器的力接收构件。在使用中,当所述承载器旋转时,所述第二太阳齿轮可被旋转以旋转所述至少一个第二行星齿轮并且使所述末端执行器发射。
所述远侧颈部壳体可以包括第一离合器机构,当所述锁环齿轮处于所述第一位置时,所述第一离合器机构插置在所述锁环齿轮与所述冠状齿轮之间并且将所述锁环齿轮与所述冠状齿轮相互连接。所述远侧颈部壳体可以包括第二离合器机构,当所述锁环齿轮处于所述第二位置时,所述第二离合器机构插置在所述锁环齿轮与所述第一环形齿轮之间并且将所述锁环齿轮与所述第一环形齿轮相互连接。所述第一离合器机构和所述第二离合器机构中的至少一个离合器机构可以包括插置在相应的锁环齿轮与冠状齿轮之间以及锁环齿轮与第一环形齿轮之间的摩擦增强材料。
所述手持式手术器械还可以包括:至少一个驱动电动机,其支撑在所述器械壳体中并且被配置为旋转所述至少一个可旋转驱动构件;电池,其被布置在所述器械壳体内,用于为所述至少一个驱动电动机提供电力;以及电路板,其被布置在所述器械壳体内,用于控制从所述电池输送至所述电动机的电力。
所述末端执行器可以包括上钳夹和下钳夹,所述上钳夹和所述下钳夹中的至少一个能够相对于所述上钳夹和所述下钳夹中的另一个移动。
所述机电手术系统还可以包括至少一个手术支持件,其可释放地固定至所述上钳夹和所述下钳夹中的至少一个的组织接触表面。
所述机电手术系统还可以包括驱动梁,其能够平移通过所述上钳夹和所述下钳夹中的至少一个以使所述下钳夹相对于所述上钳夹移动。
所述末端执行器可以包括:上钳夹和下钳夹,所述上钳夹和所述下钳夹中的至少一个能够相对于所述上钳夹和所述下钳夹中的另一个移动;钉仓组件,其支撑在所述下钳夹中,所述钉仓组件在其中包括多个吻合钉;至少一个手术支持件,其可释放地固定至所述上钳夹和所述下钳夹中的至少一个的组织接触表面,所述至少一个手术支持件通过至少一根缝合线固定到所述上钳夹和所述下钳夹中的至少一个,所述上钳夹和所述下钳夹中的至少一个被配置为接收所述至少一根缝合线的一部分。
所述末端执行器的下钳夹可被配置为选择性地接纳钉仓组件。所述钉仓组件可以包括:钉仓主体,其限定纵向延伸的刀具狭槽;多个吻合钉,其布置在各个吻合钉固持狭槽中,所述各个吻合钉固持狭槽形成在所述钉仓主体中,其中所述吻合钉固持狭槽被安置为布置在所述刀具狭槽的相对的横向侧的多个纵向延伸排;致动滑块,其可滑动地支撑在所述钉仓主体中并且被配置为在所述致动滑块从最近侧位置向远侧移动时从所述钉仓主体排出所述多个吻合钉中的至少一部分;以及刀具滑块,其可滑动地支撑在所述钉仓主体中在所述致动滑块近侧的位置,其中所述刀具滑块包括延伸进入所述刀具狭槽的刀片。在使用中,当所述钉仓组件被布置在所述下钳夹中并且当所述驱动梁被推进时,所述驱动梁可以接合所述刀具滑块和所述致动滑块。
在所述驱动梁的任何缩回之后,所述钉仓组件的致动滑块可保持在向远侧推进的位置。
所述钉仓组件的刀具滑块可以包括从其延伸出的闭锁弹簧,其中所述刀具滑块的闭锁弹簧接合限定在所述钉仓主体中的闭锁凹口以抑制所述刀具滑块的推进。
在使用中,当所述致动滑块和所述刀具滑块处于最近侧位置时,所述致动滑块可以阻止所述刀具滑块的所述闭锁弹簧与所述钉仓主体的闭锁凹口的接合。
在所述驱动梁的任何缩回时,所述钉仓组件的刀具滑块可以被缩回。所述驱动梁可以包括从所述驱动梁延伸出的锁定夹子,其中,在所述驱动梁的任何远侧推进时所述驱动梁的锁定夹子接合所述刀具滑块,使得所述刀具滑块在所述驱动梁缩回时缩回。
末端执行器的至少一个旋转接纳构件可以包括可旋转地支撑在下钳夹中的驱动螺杆,并且其中,驱动梁可以螺纹地支撑在驱动螺杆上,由此驱动螺杆的旋转引起驱动梁的轴向平移。
末端执行器的至少一个旋转接纳构件可以包括可旋转地支撑在下钳夹中的驱动螺杆,并且其中,驱动梁可以螺纹地支撑在驱动螺杆上,由此驱动螺杆的旋转引起驱动梁的轴向平移。
轴组件的至少一个力传递组件可以包括第一齿轮系系统,所述第一齿轮系系统将手术器械的至少一个可旋转驱动构件与末端执行器的至少一个旋转接纳构件相互连接。第一齿轮系系统将手术器械的至少一个可旋转驱动构件与末端执行器的至少一个旋转接纳构件之间的旋转速率和手术器械的至少一个可旋转驱动构件与末端执行器的至少一个旋转接纳构件之间的旋转轴线中的至少一个改变。
所述轴组件可以包括关节式运动颈部组件,并且其中所述第一齿轮系系统被布置在所述关节式运动颈部组件的近侧。
所述轴组件可以包括被布置在所述关节式运动颈部组件的远侧的颈部壳体。远侧颈部壳体可以支撑所述至少一个力传递组件的颈部第一齿轮系。颈部第一齿轮系可以将第一齿轮系系统的输出与末端执行器的至少一个旋转接纳构件相互连接。在使用中,颈部第一齿轮系可以将第一齿轮系系统的输出与末端执行器的至少一个旋转接纳构件之间的旋转速率和第一齿轮系系统的输出与末端执行器的至少一个旋转接纳构件之间的旋转轴线中的至少一个改变。
末端执行器的至少一个旋转接纳构件可以包括可旋转地支撑在下钳夹中的驱动螺杆。驱动梁可以螺纹地支撑在驱动螺杆上,由此驱动螺杆的旋转引起驱动梁的轴向平移。
末端执行器的至少一个旋转接纳构件可以包括可旋转地支撑在下钳夹中的驱动螺杆。驱动梁可以螺纹地支撑在驱动螺杆上,由此驱动螺杆的旋转引起驱动梁的轴向平移。
轴组件的至少一个力传递组件可以包括第二齿轮系系统,所述第二齿轮系系统将手术器械的至少一个可旋转驱动构件的另一个可旋转驱动构件与可旋转地支撑在颈部壳体的远侧端处的旋转毂相互连接。在使用中,第二齿轮系系统可以将手术器械的另外的至少一个可旋转驱动构件与轴组件的旋转毂之间的旋转速率和手术器械的另外的至少一个可旋转驱动构件与轴组件的旋转毂之间的旋转轴线中的至少一个改变。
轴组件还可以包括:关节式运动颈部组件,其支撑在外管的远侧端处;远侧颈部壳体,其支撑在关节式运动颈部组件的远侧端处;以及第一和第二完全相对的关节式运动线缆,其至少部分地沿着颈部组件延伸,其中每个关节式运动线缆包括锚固至所述远侧颈部壳体的远侧端以及延伸进入所述外管的近侧端,每个关节式运动线缆的近侧端都固定至相应的第一齿条和第二齿条,每个齿条都通过正齿轮彼此可操作地连接。
第一齿条在第一方向上的轴向位移可以引起相应的第一关节式运动线缆在所述第一方向上的轴向位移,引起颈部组件在第一离轴方向上的关节式运动,以及引起第二关节式运动线缆在与第一方向相反的方向上的轴向位移。
轴组件可以进一步包括:从第一齿条向近侧延伸的螺纹杆;以及螺纹轴,所述螺纹轴螺纹连接至从所述第一齿条延伸出的所述螺纹杆,所述螺纹轴连接至手术器械的另外的至少一个驱动构件。在使用中,手术器械的另外的至少一个驱动构件的旋转传递旋转至所述螺纹轴,以及依次至螺纹杆和第一齿条的轴向位移。
轴组件可以进一步包括:关节式运动颈部组件,其支撑在外管的远侧端处,所述颈部组件限定中心轴线并且能够在第一平面中进行关节式运动;远侧颈部壳体,其支撑在所述关节式运动颈部组件的远侧端处;第一和第二完全相对的关节式运动线缆,其至少部分地沿着所述颈部组件延伸;第一驱动线缆,其至少部分地沿着所述颈部组件延伸并且限定与所述中心轴线间隔径向距离的第一驱动轴线,所述第一驱动轴线由与所述第一平面正交延伸的第一驱动平面限定;以及第二驱动线缆,其至少部分地沿着所述颈部组件延伸并且限定与所述中心轴线间隔径向距离的第二驱动轴线,所述第二驱动轴线由与所述第一平面正交延伸的第二驱动平面限定。所述第一驱动线缆和第二驱动线缆可以彼此完全相对。
根据本公开的另一个方案,提供了一种机电手术系统。所述机电手术系统包括手持式手术器械,所述手持式手术器械包括限定连接部的器械壳体,所述连接部用于与轴组件选择性地连接,所述手术器械具有至少一个可旋转驱动构件。所述机电手术系统包括被配置为执行至少一种功能的末端执行器。所述轴组件被设置成选择性地将所述末端执行器和所述手术设备相互连接。
所述轴组件包括:变速箱壳体,其被配置为并且适于选择性连接至所述手术设备的连接部并且与所述手术设备的至少一个可旋转驱动构件中的每一个可操作地连通;管状外主体,其具有被所述变速箱壳体支撑的近侧端和被配置为并且适于与所述末端执行器可操作地连接的远侧端;以及远侧颈部壳体,其用于将所述手术器械的可旋转驱动构件与支撑在所述末端执行器中的旋转接纳构件相互连接,其中所述远侧颈部壳体包括能够连接到所述手术器械的一个可旋转驱动轴的第一端部和能够连接到所述末端执行器的旋转接纳构件的第二端部,其中,力传递组件将所述手术器械的可旋转驱动轴的旋转传递至所述末端执行器的旋转接纳构件。
所述远侧颈部组件包括:管状外壳体,其限定从其径向地向内延伸的至少一个齿;以及第一齿轮系统,其支撑在所述管状外壳体中。所述第一齿轮系统包括:第一太阳齿轮,其能够被所述手术器械的一个可旋转驱动构件驱动;第一环形齿轮,其可旋转地支撑在所述管状外壳体中;至少一个第一行星齿轮,其插置在所述第一太阳齿轮与所述第一环形齿轮之间并且将所述第一太阳齿轮与所述第一环形齿轮相互啮合;以及承载器,其可旋转地支撑在所述管状外壳体中,所述承载器包括可旋转地支撑各个第一行星齿轮的相应的柱。
根据本公开的一个方案,在一种操作模式中,当所述第一太阳齿轮被旋转时,使得各个第一行星齿轮绕所述第一太阳齿轮的中心轴线旋转,引起所述末端执行器的发射。而且根据本公开的一个方案,在另一种操作模式中,当所述第一太阳齿轮被旋转时,使得各个第一行星齿轮绕其旋转的相应的轴线旋转,引起所述末端执行器的旋转。
远侧颈部组件包括:冠状齿轮,其非可旋转地连接至所述承载器;以及锁定销,其轴向地、非可旋转地且可滑动地支撑在所述管状外壳体中。所述锁定销包括第一位置,在所述第一位置上所述锁定销啮合所述冠状齿轮并且防止所述冠状齿轮旋转,其中所述冠状齿轮的非旋转容许所述末端执行器的旋转,并且所述锁定销包括第二位置,在所述第二位置上所述锁定销与所述冠状齿轮分离并且容许所述冠状齿轮旋转,其中所述冠状齿轮的旋转容许所述末端执行器的发射。
下面参照附图更详细地描述本发明的示例性实施例的进一步细节和方案。
附图说明
这里参照附图描述了本公开的各种实施例,其中:
图1是根据本公开的实施例的机电手术系统的立体图;
图2是图1的机电手术系统的部件分离的立体图;
图3是图1和图2的机电手术系统的轴组件和动力手术器械的后视立体图,图示了轴组件与动力手术器械之间的连接;
图4是图1至图3的轴组件的部件分离的立体图;
图5是轴组件的变速箱壳体的部件分离的立体图;
图6是被支撑在变速箱壳体中的第一齿轮系系统的立体图;
图7是被支撑在变速箱壳体中的第二齿轮系系统的立体图;
图8是被支撑在变速箱壳体中的第三驱动轴的立体图;
图9是轴组件的颈部组件的立体图,其以直的取向显示;
图10是图9的颈部组件的立体图,其以关节式运动状态显示;
图11是图9和图10的颈部组件的在螺纹螺母与颈部组件分离情况下的立体图;
图12是图9至图11的颈部组件的部件分离的立体图;
图13是图9至图12的颈部组件的沿图9的13-13截取的剖视图;
图14是图9至图12的颈部组件的远侧颈部壳体的放大的远侧立体图;
图15是图14的远侧颈部壳体的放大的近侧立体图;
图16是图14和图15的远侧颈部壳体的部件分离的立体图;
图17和图18是图14至图16的远侧颈部壳体的在管状外壳体从其拆除的情况下的立体图;
图19是远侧颈部壳体的沿图18的19-19截取的剖视图;
图20是远侧颈部壳体的沿图18的20-20截取的剖视图;
图21是远侧颈部壳体的沿图18的21-21截取的剖视图;
图22是远侧颈部壳体的沿图15的22-22截取的剖视图,图示出处于旋转构造的远侧颈部壳体;
图23是远侧颈部壳体的沿图15的23-23截取的剖视图,图示出处于旋转构造的远侧颈部壳体;
图24是图22的指示的细节区域的放大图;
图25是远侧颈部壳体的沿图15的22-22截取的剖视图,图示出处于发射构造的远侧颈部壳体;
图26是图25的指示的细节区域的放大图;
图27至图29是图示出末端执行器与图14至图26的远侧颈部壳体的连接的立体图;
图30是末端执行器的沿图27的30-30截取的剖视图;
图31是根据本公开另一个实施例的远侧颈部壳体的沿图15的22-22截取的剖视图,图示出根据本公开另一个实施例的冠状齿轮和锁环齿轮;
图32是图31的指示的细节区域的放大图;
图33是图31和图32的冠状齿轮的正视立体图;
图34是图33的指示的细节区域的放大图;
图35是图31和图32的冠状齿轮的后视立体图;
图36是沿图35的36-36截取的剖视图;
图37是根据本公开又另一个实施例的远侧颈部壳体的后视立体图;
图38是图37的远侧颈部壳体的锁定销的俯视立体图;
图39是图37和图38的远侧颈部壳体的沿图37的39-39截取的剖视图;
图40是图39的指示的细节区域的放大图;
图41是图37和图38的远侧颈部壳体的沿图37的39-39截取的剖视图,其中部件从远侧颈部壳体拆除;
图42是图41的远侧颈部壳体的平面图;以及
图43是图42的指示的细节区域的放大图。
具体实施方式
现在将参照附图详细描述本公开的机电手术系统、和/或装置的实施例,其中在几幅附图的每幅附图中相同附图标记表示相同的或对应的元件。在本文中使用时,术语“远侧”是指所述机电手术系统、装置和/或设备或其部件的较远离用户的部分,而术语“近侧”是指所述机电手术系统、装置和/或设备或其部件的较接近用户的部分。
首先参照图1至图3,根据本公开的一个实施例,显示了一种机电的、手持式、电动手术系统且一般指代为10。机电手术系统10包括一种手术装置或设备,为机电的、手持式、电动手术器械100的形式,其被配置用于经由轴组件200选择性地将多个不同的末端执行器400附接于此,每一个末端执行器都被配置为通过所述电动手持式机电手术器械100来致动和操纵。特别地,手术器械100被配置来选择性地连接轴组件200,并且依次地,轴组件200配置为选择性地连接多个不同的末端执行器400中的任何一个末端执行器。
对于示例性机电的、手持式、电动手术器械100的结构和操作的详细说明,可以参考于2008年9月22日提交、申请号为PCI/US2008/077249的国际申请(国际公开号为WO2009/039506)和于2009年11月20日提交的序列号为12/622,827的美国专利申请,每个申请的全部内容通过引用合并于此。
如图1至图3所示,通常,手术器械100包括器械壳体102,器械壳体102包括下壳体部分104、中壳体部分106以及上壳体部分108,其中,中壳体部分106从下壳体部分104延伸出和/或被支撑在下壳体部分104上,上壳体部分108从中壳体部分106延伸出和/或被支撑在中壳体部分106上。手术器械100具有控制器,控制器用于控制手术系统的一些功能、收集数据、以及执行其他功能。器械壳体102在其内限定空腔,电路板(未显示)和驱动机构(未显示)布置在所述空腔中。
如以下更详细地讨论所述,电路板被配置为控制手术器械100的各种操作。根据本公开,器械壳体102提供了壳体,可再充电的电池(未显示)可移除地布置在所述壳体中。电池被配置为手术器械100的任何电气部件供应电力。
器械壳体102的上壳体部分108限定了突出部分或连接部分108a,突出部分或连接部分108a被配置为接受轴组件200的变速箱壳体212的对应的轴联接组件214。如图3所示,手术器械100的上壳体部分108的连接部分108a具有筒状凹部108b,当轴组件200与手术器械100匹配时,筒状凹部108b接收轴组件200的变速箱壳体212的轴联接组件214。手术器械100的连接部分108a具有至少一个可旋转驱动构件。特别地,连接部分108a容纳三个可旋转的驱动构件或连接器118、120、122,每个驱动构件或连接器都能够被容纳在器械壳体102内的驱动机构(未显示)独立地致动和旋转。
器械壳体102的上壳体部分108提供了布置有驱动机构(未显示)的壳体。为了实施手术器械100的各种操作,配置驱动机构来驱动轴和/或齿轮部件。特别地,驱动机构被配置为驱动轴和/或齿轮部件,以便相对于轴组件200选择性地移动末端执行器400;以便使得砧座组件200和/或末端执行器400相对于器械壳体102绕纵向轴线“X”(参见图1和图2)旋转;以便相对于末端执行器400的下钳夹或钉仓组件432来移动末端执行器400的上钳夹或砧座组件442;以便使轴组件做关节式运动和/或旋转;和/或以便在末端执行器400的钉仓组件432内发射吻合切割钉仓。
轴组件200具有用于将手术器械的至少一个驱动构件与末端执行器的至少一个旋转接纳构件相互连接的力传递组件。力传递组件具有能够连接到所述至少一个可旋转驱动构件的第一端部以及能够连接到所述末端执行器的至少一个旋转接纳构件的第二端部。当轴组件200与手术器械100匹配时,手术器械100的可旋转的驱动构件或连接器118、120、122中的每一个与轴组件200的对应的可旋转的连接器套管218、220、222相联接(参见图3和图5)。在这点上,对应的第一驱动构件或连接器118和第一连接器套管218之间的交接、对应的第二驱动构件或连接器120和第二连接器套管220之间的交接,以及对应的第三驱动构件或连接器122和第三连接器套管222之间的交接都是键联接,以便于手术器械100的驱动构件或连接器118、120、122中的每一个的旋转都会引起轴组件200的对应的连接器套管218、220、222的对应的旋转。
手术器械100的驱动构件或连接器118、120、122与轴组件200的连接器套管218、220、222的匹配允许经由三个相应的连接器交接中的每一个独立地传递旋转力。手术器械100的驱动构件或连接器118、120、122被配置为通过驱动机构独立地旋转。在这点上,控制器具有驱动机构的功能选择模块(未显示),所述驱动机构的功能选择模块会选择由驱动机构的输入驱动部件(未显示)来驱动手术器械100的哪个驱动构件或连接器118、120、122。
因为手术器械100的驱动构件或连接器118、120、122中的每一个都是与轴组件200的相应的连接器套管218、220、222进行键联接和/或基本上非可旋转的交接,所以当轴组件200被联接到手术器械100时,会选择性地将旋转力从手术器械100的驱动机构传递给轴组件200,以及传递至末端执行器400上,如下面将更详细地讨论。
手术器械100的驱动构件或连接器118、120和/或122的选择性的旋转允许手术器械100选择性地致动末端执行器400的不同功能。如下面更详细地讨论,手术器械100的第一驱动构件或连接器118的选择性的且独立的旋转对应于末端执行器400的选择性的且独立的打开和闭合,以及对应于末端执行器400的吻合/切割部件的驱动。同样,手术器械100的第二驱动构件或连接器120的选择性的且独立的旋转对应于横向于纵向轴线“X”(参照图1)的末端执行器400的选择性的且独立的关节式运动。另外,手术器械100的第三驱动构件或连接器122的选择性的且独立的旋转对应于末端执行器400相对于手术器械100的器械壳体102的绕纵向轴线“X”(参照图1)的选择性的且独立的旋转。
根据本公开,驱动机构可以包括:选择齿轮箱组件(未显示);在选择齿轮箱组件的近侧定位的功能选择模块(未显示),功能选择模块的功能为选择性地移动选择齿轮箱组件内的齿轮元件来使其与第二电动机(未显示)接合。驱动机构可被配置为在给定时间选择性地驱动手术器械100的驱动构件或连接器118、120、122中的一个。
如图1和图2所示,器械壳体102支撑一对手指致动的控制按钮124、126和/或摇杆装置130(仅一个摇杆装置被显示)。控制按钮124、126和摇杆装置128、130中的每一个均包括由操作者的致动来移动的相应的磁体(未显示)。此外,对于控制按钮124、126和摇杆装置130中的每一个,容纳在器械壳体102中的电路板(未显示)都包括由控制按钮124、126和摇杆装置130中磁体的移动来致动的相应的霍尔效应开关(未显示)。特别地,位置紧邻近控制按钮124的是相应的霍尔效应开关(未显示),当操作者致动控制按钮124时,控制按钮124内的磁体就会移动,就会致动相应的霍尔效应开关(未显示)。对应于控制按钮124的霍尔效应开关(未显示)的致动会引起电路板给驱动机构的功能选择模块和输入驱动部件提供适当的信号来闭合末端执行器400和/或发射末端执行器400内的吻合/切割钉仓。
同样,位置紧邻近控制按钮126的是相应的霍尔效应开关(未显示),当操作者致动控制按钮126时,控制按钮126中的磁体就会移动,就会致动相应的霍尔效应开关(未显示)。对应于控制按钮126的霍尔效应开关的致动会使得电路板给驱动机构的功能选择模块和输入驱动部件提供适当的信号来打开/闭合末端执行器400。
此外,位置紧邻近摇杆装置130的是相应的霍尔效应开关(未显示),当操作者致动摇杆装置130时,摇杆装置130内的磁体(未显示)就会移动,就会致动相应的霍尔效应开关(未显示)。对应于摇杆装置130的霍尔效应开关的致动会使得电路板给驱动机构的功能选择模块和输入驱动部件提供适当的信号,以使得末端执行器400相对于轴组件200旋转或者使得末端执行器400和轴组件200相对于手术器械100的器械壳体102旋转。特别地,摇杆装置130在第一方向上的移动会使得末端执行器400和/或轴组件200相对于器械壳体102在第一方向上旋转,而摇杆装置130在相反方向(如第二方向)上的移动会使得末端执行器400和/或轴组件200相对于器械壳体102在相反方向(如第二方向)上旋转。
现在转向图1至图29,将详细地显示并且描述轴组件200。轴组件200被配置为将手术器械100的第一、第二和第三可旋转驱动构件118、120和122的旋转力传送至末端执行器400。如上所述,轴组件200被配置为选择性连接至手术器械100。
如图1、图2和图4所示,轴组件200包括:细长的、基本上刚性的管状外主体210,所述管状外主体210具有近侧端210a和远侧端210b;变速箱壳体212,其连接至管状主体210的近侧端210a并且被配置为选择性连接至手术器械100;以及关节式运动颈部组件230,其连接至细长主体部分210的远侧端210b。
变速箱壳体212被配置为在其中容纳一对齿轮系系统,用于在旋转速度/旋转力传递至末端执行器400之前将手术器械100的第一、第二和/或第三可旋转驱动构件或连接器118、120、和/或122的旋转速度/旋转力改变(例如增加或减少)。
轴组件200的变速箱壳体212被配置为并且适于连接至手术器械100的上壳体部分108的连接部分108a。如图3至图5所示,轴组件200的变速箱壳体212包括支撑其近侧端处的轴联接组件214。
如图5所示,变速箱壳体212和轴联接组件214可旋转地支撑第一近侧或输入驱动轴224a、第二近侧或输入驱动轴226a、以及第三驱动轴228。
轴联接组件214被配置为分别可旋转地支撑第一、第二以及第三连接器套管218、220和222。连接器套管218、220和222中的每个连接器套管被配置为与手术器械100的相应的第一、第二和第三驱动构件或连接器118、120和122匹配,如上文所述。连接器套管218、连接器套管220和连接器套管222中的每个连接器套管进一步被配置为与相应的第一输入驱动轴224a、第二输入驱动轴226a以及第三驱动轴228的近侧端匹配。
轴驱动联接组件214包括布置在相应的第一连接器套管218、第二连接器套管220和第三连接器套管222的远侧的第一偏置构件218a、第二偏置构件220a和第三偏置构件222a。围绕相应的第一近侧驱动轴224a、第二近侧驱动轴226a和第三驱动轴228分别布置第一偏置构件218a、第二偏置构件220a和第三偏置构件222a中的每一个。当轴组件200被连接到手术器械100上时,偏置构件218a、220a和222a作用在相应的连接器套管218、220、222上从而有助于保持连接器套管218、220、222与手术器械100的相应的可旋转驱动构件或连接器118、120、122的远侧端相接合。
特别地,第一偏置构件218a、第二偏置构件220a和第三偏置构件222a的功能是在近侧方向上偏置相应的连接器套管218、连接器套管220、连接器套管222。以这种方式,在连接轴组件200到手术器械100的过程中,如果第一连接器套管218、第二连接器套管220和/或第三连接器套管222与手术器械100的驱动构件或连接器118、120、122不对准,则第一偏置构件218a、第二偏置构件220a和/或第三偏置构件222a被压缩。因此,当手术器械100的驱动机构被接合时,手术器械100的驱动构件或连接器118、120、122将旋转,并且第一偏置构件218a、第二偏置构件220a和/或第三偏置构件222a将使得相应的第一连接器套管218、第二连接器套管220和/或第三连接器套管222向近侧向后滑动,有效地将手术器械100的驱动构件或连接器118、120、122联接到第一输入驱动轴224a、第二输入驱动轴226a和第三驱动轴228。
在使用中,在手术器械100的校准过程中,手术器械100的驱动连接器118、120、122中的每个都会分别旋转,并且当实现正确对准时,在连接器套管218、220、222上的偏置会使连接器套管218、220、222正确就位于手术器械100相应的驱动连接器118、120、122的上方。
轴组件200包括:第一齿轮系系统240和第二齿轮系系统250,其分别布置在变速箱壳体212和管状主体210内;以及邻近的联接组件214。如上所述,每个齿轮系系统240、250均被配置为并且适于在旋转速度/旋转力传递至末端执行器400之前将手术器械100的第一和第二可旋转的驱动连接器118和120的旋转速度/旋转力改变(例如,增加或减少)。
如图5和图6所示,第一齿轮系系统240包括第一输入驱动轴224a以及被键联接至第一输入驱动轴224a的第一输入驱动轴正齿轮242a。第一齿轮系系统240还包括可旋转地支撑在变速箱壳体212中的第一传动轴244、键联接至第一传动轴244并且与第一输入驱动轴正齿轮242a啮合的第一输入传动正齿轮244a、以及键联接至第一传动轴244的第一输出传动正齿轮244b。第一齿轮系系统240还包括可旋转地支撑在变速箱壳体212和管状主体110中的第一输出驱动轴246a、以及键联接至第一输出驱动轴246a并且与第一输出传动正齿轮244b啮合的第一输出驱动轴正齿轮246b。
根据本公开,第一输入驱动轴正齿轮242a包括10个齿;第一输入传动正齿轮244a包括18个齿;第一输出传动正齿轮244b包括13个齿;以及第一输出驱动轴正齿轮246b包括15个齿。如这样所构造的,第一输入驱动轴224a的输入旋转以1:2.08的比率被转换成第一输出驱动轴246a的输出旋转。
如上所述,第一输入驱动轴224a的近侧端被配置为支撑第一连接器套管218。
在操作中,随着第一输入驱动轴正齿轮242a旋转,由于第一连接器套管258和第一输入驱动轴224a的旋转,作为手术器械100的相应的第一驱动连接器118旋转的结果,第一输入驱动轴正齿轮242a啮合第一输入传动正齿轮244a而引起第一输入传动正齿轮244a旋转。随着第一输入传动正齿轮244a旋转,第一传动轴244旋转,并因而引起被键联接到第一传动轴244的第一输出驱动轴正齿轮246b旋转。随着第一输出驱动轴正齿轮246b旋转,因为第一输出驱动轴正齿轮246b与其啮合,所以第一输出驱动轴正齿轮246b也被旋转。随着第一输出驱动轴正齿轮246b旋转,因为第一输出驱动轴正齿轮246b被键联接至第一输出驱动轴246a,所以第一输出驱动轴246a被旋转。
正如将在下面更详细讨论的,包括第一齿轮系统240的轴组件200起到将来自手术器械100的操作力传递至末端执行器400以便操作、致动和/或发射末端执行器400的作用。
如图5和图7所示,第二齿轮系系统250包括第二输入驱动轴226a以及被键联接至第二输入驱动轴226a的第二输入驱动轴正齿轮252a。第二齿轮系系统250还包括可旋转地支撑在变速箱壳体212中的第一传动轴254、键联接至第一传动轴254并且与第二输入驱动轴正齿轮252a啮合的第一输入传动正齿轮254a、以及键联接至第一传动轴254的第一输出传动正齿轮254b。
第二齿轮系系统250还包括可旋转地支撑在变速箱壳体212中的第二传动轴256、键联接至第二传动轴256并且与第一输出传动正齿轮254b啮合的第二输入传动正齿轮256b、以及键联接至第二传动轴256的第二输出传动正齿轮256b,其中第一输出传动正齿轮254b被键联接至第一传动轴254。
第二齿轮系系统250还包括可旋转地支撑在变速箱壳体212和管状主体210中的第二输出驱动轴258a,以及键联接至第二输出驱动轴258a并且与第二输出传动正齿轮256b啮合的第二输出驱动轴正齿轮258b。
根据本公开,第二输入驱动轴正齿轮252a包括10个齿;第一输入传动正齿轮254a包括20个齿;第一输出传动正齿轮254b包括10个齿;第二输入传动正齿轮256a包括20个齿;第二输出传动正齿轮256b包括10个齿;以及第二输出驱动轴正齿轮258b包括15个齿。如这样所构造的,第二输入驱动轴226a的输入旋转以1:6的比率被转换成第二输出驱动轴258a的输出旋转。
如上所述,第二输入驱动轴226a的近侧端被配置为支撑第二连接器套管220。
在操作中,随着第二输入驱动轴正齿轮252a旋转,由于第二连接器套管260和第二输入驱动轴226a的旋转,作为手术器械100的相应的第二驱动连接器120旋转的结果,第二输入驱动轴正齿轮252a啮合第一输入传动正齿轮254a而引起第一输入传动正齿轮254a旋转。随着第一输入传动正齿轮254a旋转,第一传动轴254旋转,并因而引起被键联接到第一传动轴254的第一输出传动正齿轮254b旋转。随着第一输出传动正齿轮254b旋转,因为第二输入传动正齿轮256a与其啮合,所以第二输入传动正齿轮256a也被旋转。随着第二输入传动正齿轮256a旋转,第二传动轴256旋转,并因而引起被键联接到第二传动轴256的第二输出传动正齿轮256b旋转。随着第二输出传动正齿轮256b旋转,因为第二输出驱动轴正齿轮258b与其啮合,所以第二输出驱动轴正齿轮258b也被旋转。随着第二输出驱动轴正齿轮258b旋转,因为第二输出驱动轴正齿轮258b被键联接至第二输出驱动轴258a,所以第二输出驱动轴258a被旋转。
正如将在下面更详细讨论的,包括第二齿轮系统250的轴组件200起到将来自手术器械100的操作力传递至末端执行器400以便使轴组件200和/或末端执行器400相对于手术器械100旋转的作用。
如上所述,并且如图5和图8所示,变速箱壳体212和轴联接组件214可旋转地支撑第三驱动轴228。第三驱动轴228包括被配置为支撑第三连接器套管222的近侧端228a、以及延伸至并且操作性地连接至关节式运动组件270的远侧端228b,将在下面更详细地讨论。
如图4所示,轴组件200的细长的、管状外主体210包括第一半体211a和第二半体211b,当半体211a、211b彼此匹配时,第一半体211a和第二半体211b限定了通过管状外主体210的至少三个纵向延伸的通道。这些通道被配置为并且被定尺寸为在第一输出驱动轴246a、第二输出驱动轴258a、以及第三驱动轴228从变速箱壳体212延伸至关节式运动颈部组件230时可旋转地接纳并且支撑第一输出驱动轴246a、第二输出驱动轴258a、以及第三驱动轴228。第一输出驱动轴246a、第二输出驱动轴258a、以及第三驱动轴228中的每个都是细长的并且充分地有刚性以将来自变速箱壳体220的旋转力传递至关节式运动颈部组件230。
现在转向图4和图9至图13,显示并且描述了关节式运动颈部组件230。关节式运动颈部组件230包括近侧颈部壳体232、连接至近侧颈部壳体232并且从近侧颈部壳体232串联地延伸出的多个连杆234、以及连接至多个连杆234的最远侧连杆并且从多个连杆234的最远侧连杆延伸出的远侧颈部壳体236。
每个连杆234都包括形成在其近侧表面234a和远侧表面234b中的每个表面上的配合的转向节和U形夹。近侧颈部壳体232包括与最近侧连杆的转向节和/或U形夹可操作地啮合的转向节和/或U形夹。远侧颈部壳体236包括可操作地啮合最远侧连杆的转向节和/或U形夹的转向节和/或U形夹。相邻的颈部壳体232和颈部壳体236和连杆234的转向节和/或U形夹可操作地彼此啮合以限定颈部组件230的关节式运动的方向和程度。
颈部组件230被配置为使末端执行器400能够在基本上线性构造与基本上成角度的、离轴的或关节式运动的构造之间移动。根据本公开,可以预期到,颈部组件230能够在单个平面内进行关节式运动并且能够进行大约90°或者甚至大于90°的关节式运动。
每个连杆234在其中限定了:第一管腔234c(参见图12),以用于远侧驱动线缆271通过;第一对相对的管腔234d1、234d2,以用于一对关节式运动线缆262、264通过;以及与第一管腔234c相对的第二管腔234e。如图12所示,第一管腔234c和第二管腔234e彼此完全相对,并且相对于管腔234d1、234d2偏移90°。第一驱动线缆或移位线缆266包括经由联接构件247a键联接至第一输出驱动轴246a(图4)的远侧端的近侧端。第二驱动线缆268被支撑在颈部组件230中并且包括经由联接构件247b键联接至第二输出驱动轴258a(图4)的远侧端的近侧端。第一驱动线缆266和第二驱动线缆268以及远侧驱动线缆271中的每一个由既柔性又扭转地硬质的材料(能够传递旋转力或转矩)制备,诸如例如,不锈钢等。
如图13所示,颈部组件230的近侧颈部壳体232支撑被配置为并且适于传递关节式运动至颈部组件230和/或末端执行器400的关节式运动组件270。关节式运动组件270包括一对相对的齿条272、274,齿条272、274与小齿轮276啮合并且在小齿轮276的相对的侧上。齿条272、274在轴向上可滑动地支撑在近侧颈部壳体232中并且小齿轮276可旋转地支撑在近侧颈部壳体232中。
如图12和图13所示,齿条274附接至从其向近侧延伸的并且与内螺纹螺母278的远侧端螺纹啮合的螺纹轴272a。螺纹螺母278可旋转地支撑并且轴向地固定在形成在近侧颈部壳体232的凹处232a内。螺纹螺母278的近侧端被键联接至第三驱动轴228的远侧端。尽管螺纹轴272a被显示从齿条274延伸出,但是应当理解的是,在本公开的范围内,螺纹轴可以从齿条272延伸出而不背离本公开的原理。
关节式运动线缆262、264包括紧固到齿条272、274的相应的远侧端并且从齿条272、274的相应的远侧端延伸出的近侧端。每个关节式运动线缆262、264都包括延伸通过连杆234的相应的相对的管腔234d1,234d2并且固定或锚定在远侧颈部壳体234中的远侧端。
在操作中,为了使颈部组件230在第一方向上进行关节式运动,第三驱动轴228在第一方向上旋转,如上所述,以旋转螺纹螺母278并且在轴向上向远侧移置螺纹轴272a从而轴向地向远侧移置齿条274。随着齿条274在远侧方向上被轴向地移置,齿条274使得小齿轮276旋转并且从而作用在齿条272上,从而在近侧方向上轴向地移置齿条272。随着齿条272在近侧方向上被轴向地移置,齿条272使得关节式运动线缆262在近侧方向上被拉伸并且由此使颈部组件230做关节式运动。因为齿条274在远侧方向上的轴向移置引起关节式运动线缆264的轴向的、向远侧的位移,所以颈部组件230被允许进行关节式运动。
现在转向图14至图29,远侧颈部壳体236起作用为齿轮箱并且支撑第一或近侧行星齿轮系统280和第二或远侧柱状齿轮系统290。第一行星齿轮系统280和远侧柱状齿轮系统290起作用为彼此配合以将第一驱动线缆或移位线缆266或者第二驱动线缆268的相应的平移/旋转传递至末端执行器400,以便既实现末端执行器400的发射又实现末端执行器400的旋转。换言之,第一或近侧行星齿轮系统280和第二或远侧柱状齿轮系统290被配置为将单个可旋转驱动构件(即,第一驱动线缆或移位线缆266、第二驱动线缆268)的旋转输入转换成至末端执行器400的至少两个输出力,实现末端执行器400的发射的第一输出力以及实现末端执行器400的旋转的第二输出力。
远侧颈部壳体236包括在其近侧端附近在其内表面上限定一组径向的齿轮齿237a的管状外壳体237。
在实施例中,第二驱动线缆268的远侧端可旋转地啮合被支撑在远侧颈部壳体236中的齿轮副269,其中齿轮副269将旋转传递至远侧驱动线缆271。远侧驱动线缆271选择性地啮合支撑在远侧颈部壳体236上的第一正齿轮238a。第一正齿轮238a与非可旋转地支撑在中央远侧驱动轴239上的第二正齿轮238b啮合,其中远侧驱动轴239被可旋转地支撑在关节式运动颈部组件230的远侧颈部壳体236中。
如图16至图20和图22至图26所示,远侧颈部壳体236的第一行星齿轮系统280包括非可旋转地支撑在远侧驱动轴239上的第一太阳齿轮282、围绕第一太阳齿轮282的第一环形齿轮284、以及插置在第一正齿轮282和第一行星齿轮284之间并且使第一正齿轮282和第一行星齿轮284相互啮合的多个第一行星齿轮286。多个第一行星齿轮286可旋转地支撑在承载器288的相应的柱288a上。承载器288可旋转地支撑在远侧颈部壳体236中。承载器288非可旋转地将冠状齿轮289支撑在柱288a上,使得冠状齿轮289的旋转引起承载器288和第一行星齿轮286的旋转。冠状齿轮289限定了在径向上绕其外缘的多个齿289a,其中齿289a仅仅延伸通过冠状齿轮289的远侧表面或从冠状齿轮289的远侧表面延伸出。
如图16至图18和图21至图26所示,远侧颈部壳体236的远侧柱状齿轮系统290包括非可旋转地支撑在承载器288上并且从承载器288延伸出的第二太阳齿轮292、以及与第二太阳齿轮292啮合的至少一个第二行星齿轮296。在实施例中,可以预期到,环状凸缘从第一环形齿轮284延伸出以向远侧延伸超出远侧柱状齿轮系统290从而非可旋转地啮合(例如,彼此焊接、彼此用螺栓固定、彼此压入配合)末端执行器联接组件310的旋转毂311,使得第一环形齿轮284的旋转引起末端执行器联接组件310的毂311的旋转。
返回到图16至图20和图22至图26,远侧颈部壳体236支撑在其上的锁环齿轮240。锁环齿轮240被支撑在远侧颈部壳体236上并且包括多个径向向外延伸的齿240a(以正齿轮的形式)以及多个面向远侧的齿240b(以冠状齿轮形式),其中齿240a与管状壳体237的齿237a啮合,齿240b径向地向锁环齿轮240的最内表面之内延伸。锁环齿轮240能够相对于冠状齿轮289在与第一行星齿轮系统280的冠状齿轮289啮合的近侧位置与从冠状齿轮289脱离的远侧位置之间非可旋转地滑动。
在操作中,当锁环齿轮240与冠状齿轮289处于近侧啮合位置时,如图17、图18和图22至图24所示,其面向远侧并且向内伸的齿240b与冠状齿轮289的冠状齿289a啮合,使得防止了由于锁环齿轮240的径向向外延伸的齿240a与管状壳体237的齿237a啮合而使冠状齿轮289和承载器288旋转。
而且,在操作中,当锁环齿轮240处于与冠状齿轮289向远侧脱离的位置时,如图25和图26所示,其面向远侧并且向内伸的齿240b与冠状齿轮289的冠状齿289a分离,使得冠状齿轮289和承载器288由于正齿轮282的旋转而旋转。在锁环齿轮240与冠状齿轮289分离的情况下,冠状齿轮289以及因此承载器288被允许旋转。
在整个操作中,如图15至图21所示,随着第二驱动线缆268旋转,由于第二输出驱动轴258a(如上所述)的旋转,所述旋转被传递至齿轮副269和远侧驱动线缆271。随着远侧驱动线缆271旋转,因为中央远侧驱动轴239被非可旋转地固定到远侧驱动线缆271,所述旋转被直接传递至中央远侧驱动轴239。
取决于锁环齿轮240相对于第一行星齿轮系统280的冠状齿轮289的定位,中央远侧驱动轴239的旋转将引起末端执行器400的闭合/发射和打开/缩回,或末端执行器400的旋转。例如,在实施例中,当锁环齿轮240位于远侧位置、与冠状齿轮289脱离并且被锁定成与第一环形齿轮284啮合时(如上所述并且如图25和图26所示),中央远侧驱动轴239的旋转将引起末端执行器400的闭合/发射和打开/缩回。而且,在实施例中,当锁环齿轮240位于近侧位置、与冠状齿轮289啮合并且与第一环形齿轮284脱离时(如上所述并且如图17、图18和图22至图24所示),中央远侧驱动轴239的旋转将引起末端执行器400的旋转。
继续所述操作的讨论,为了使末端执行器400旋转,如图17、图18和图22至图24所示,锁环齿轮240被移动至近侧位置以与冠状齿轮289啮合,并且因为冠状齿轮289经由柱288a非可旋转地连接至承载器288,所以承载器288的非旋转引起冠状齿轮289的非旋转。因此,在冠状齿轮289不能够旋转的情况下,中央远侧驱动轴239的旋转被传递至第一太阳齿轮282并且引起第一太阳齿轮282的旋转,并且接下来引起多个第一行星齿轮286绕由承载器288的柱288a限定的其相应的中心轴线的旋转。随着第一行星齿轮286绕由承载器288的柱288a限定的其相应的中心轴线旋转,第一行星齿轮286陷入第一环形齿轮284的齿284a以将所述旋转传递至第一环形齿轮284。
在锁环齿轮240锁入冠状齿轮289的情况下,第一环形齿轮284能够相对于管状壳体237旋转。正如这样所定位的,中央远侧驱动轴239的旋转将使第一太阳齿轮282旋转,引起第一行星齿轮286绕它们相应的中心轴线(由承载器288的柱288a限定)旋转。随着第一行星齿轮286旋转,第一行星齿轮286驱动第一环形齿轮284,第一环形齿轮284紧固地或非可旋转地固定到远侧壳体或旋转毂311。因此,当末端执行器400连接至轴组件200时,并且更具体地,当末端执行器400的对准柱424a、424b连接至旋转毂311时,旋转毂311的旋转引起末端执行器400的旋转。
继续所述操作的讨论,为了闭合/发射和打开/缩回末端执行器400,如图25和图26所示,锁环齿轮240被移动至远侧位置以与冠状齿轮289脱离并且锁定成与第一环形齿轮284啮合。因此,在冠状齿轮289被允许旋转的情况下,中央远侧驱动轴239的旋转引起承载器288的旋转。
随着承载器288旋转,承载器288传递所述旋转至远侧柱状齿轮系统290的第二太阳齿轮292。随着第二太阳齿轮292旋转,第二太阳齿轮292传递所述旋转至所述至少一个第二齿轮296。随着第二齿轮296旋转,第二齿轮296传递所述旋转至发射连接器297,发射连接器297被配置为与末端执行器400的驱动轴426(参见图27、图29和图30)选择性地啮合以由此实现末端执行器400的发射和闭合。
根据本公开的实施例,可以预期到,锁环齿轮240被偏置至远侧位置,其中锁环齿轮240与冠状齿轮289啮合。这样的布置充当破损安全,其中轴组件200将默认为发射(或缩回)模式。可以预期到,远侧颈部壳体236可以包括偏置构件244,偏置构件244被定位成作用在锁环齿轮240上并且将锁环齿轮240推进至近侧位置。
根据本公开的实施例,如图9、图10、图12、图14至图16、图18、和图24至图28所示,可以预期到,轴组件200的第一驱动线缆或移位线缆266包括附接至锁环齿轮240的第一端和延伸通过轴组件200以从手术场或手术腔的外部的位置能够接近的第二端。特别地,移位线缆266的远侧端可以紧固至锁环齿轮240,并且移位线缆266的螺纹近侧端266a可以螺纹连接至可旋转地支撑在近侧颈部壳体232中的细长的联接构件274a(为螺丝螺母的形式)。以此方式,随着螺纹螺母247a在第一方向上旋转,由于通过第一输出驱动轴266a,螺纹螺母247a作用在移位线缆266的螺纹近侧端266a上以在第一轴向方向上(向近侧或向远侧)移动移位线缆从而在相随的轴向方向上移动锁环齿轮240。而且,随着螺纹螺母247a在第二方向(与第一方向相反)上旋转,由于通过第一输出驱动轴266a,螺纹螺母247a作用在移位线缆266的螺纹近侧端266a上以在第二轴向方向(与第一轴向方向相反)上移动移位线缆从而在相随的轴向方向上移动锁环齿轮240。
在另一个实施例中,可以预期到,移位线缆266也可以向远侧位置偏置。在实施例中,与移位线缆266相关联的偏置构件的弹簧比率/弹簧常数大于与锁环齿轮240相关联的偏置构件244的弹簧比率/弹簧常数。
因为这样构造,移位线缆266能够被完全地拉动(向近侧移动),即使锁环齿轮240的齿240b与冠状齿轮289的齿289a对准从而防止啮合,与移位线缆266相关联的偏置构件将抵靠冠状齿轮289保持锁环齿轮240直到远侧颈部壳体236的远侧驱动轴239旋转,其中转矩将使第一太阳齿轮282和冠状齿轮289旋转,由此允许锁环齿轮240的齿240b与冠状齿轮289的齿289a啮合。
当移位线缆266从近侧位置释放时,发生相反的情况。在朝向冠状齿轮289弹簧加载锁环齿轮240的情况下,即使锁环齿轮240的齿与冠状齿轮289的齿对准从而防止啮合,偏置构件242将抵靠冠状齿轮289保持锁环齿轮240直到远侧颈部壳体236的远侧驱动轴239旋转,其中转矩将使第一太阳齿轮282和冠状齿轮289旋转,由此允许锁环齿轮240的齿与冠状齿轮289的齿啮合。
通过在远侧颈部壳体236中设置第一齿轮系统280和第二齿轮系统290(在关节式运动颈部组件230和末端执行器400之间的位置处),仅仅需要单个可旋转的驱动器通过关节式运动颈部组件230被驱动/或旋转。此外,与由一系列复合齿轮构成的齿轮系统相比较,第一行星齿轮系统和第二行星齿轮系统的使用允许在轴向更短的组件中实现更大的转矩减小。
如图14、图15以及图27至图29所示,轴组件200进一步包括被支撑在关节式运动颈部组件230的远侧颈部壳体236的远侧端处的末端执行器联接组件310。末端执行器联接组件310包括可旋转地支撑在远侧颈部壳体236上并且从远侧颈部壳体236向远侧延伸并且向第一径向部偏置的轴环312。轴环312能够从第一径向位置旋转到第二径向位置,其中末端执行器400能够与末端执行器联接组件310匹配,并且通过偏置的方式返回至第一径向位置以将末端执行器400锁定至轴组件200。在实施例中,偏置可以通过布置在形成在旋转毂311中的外环状凹槽中的并且作用在设置在轴环312中的凸块或其他特征上的压缩弹簧来实现。
可以预期到,轴环312包括从其内表面径向地向内延伸的至少一个小块312a,用于接纳形成在末端执行器400的外表面中的相应的互补结构422a以便以卡口式连接的方式将末端执行器400连接至轴组件200。可以预期到,其他形式的连接,诸如棘爪、螺纹连接等等。
现在转向图27至图30,示出了与手术器械100和轴组件200一起使用的示例性的末端执行器400。对于末端执行器400的构造和操作的详细的讨论,可以参考于2011年10月25日提交、序号为13/280,898的美国专利申请,该申请的全部内容通过引用合并于此。如图27至图30所示,末端执行器组件400包括驱动轴426,驱动轴426可旋转地支撑并且从联接构件422向近侧伸出并且被配置为在末端执行器400与轴组件200联接时与远侧颈部壳体236的发射连接器297匹配接合。驱动轴426起作用为将来自轴组件200的远侧颈部壳体236的发射连接器297的旋转驱动力传递至末端执行器400的钳夹组件的下钳夹的驱动螺杆464。
如图27至图30所示,联接构件422包括从其向近侧伸出的一对间隔开的对准柱424a、424b,用于接纳形成在末端执行器联接组件310的远侧表面中的相应的对准镗孔310a、310b。
在实施例中,可以预期到,轴组件200可以设置有至少一个离合器机构(未显示),从而减少终端用户过转矩远侧颈部壳体236的齿轮的事故。可以预期到,至少一个离合器机构包括第一离合器机构(未显示)以及第二离合器机构(未显示),其中当锁环齿轮540处于近侧位置时,第一离合器机构插置在锁环齿轮540与冠状齿轮589之间,而当锁环齿轮540处于远侧位置时,第二离合器机构插置在锁环齿轮540与第一环形齿轮584之间。以此方式,如果用户手动地抓握末端执行器并且相对于转接器组件旋转末端执行器,则末端执行器的导螺杆不移位。
可以预期到,在实施例中,每个离合器机构可以包括摩擦增强材料,诸如例如,钢上钢(steel on steel)、或者橡胶或硅酮包覆件(overmold)。在本实施例中,可通过移位线缆246施加在锁环齿轮540上的张力的量来控制锁环齿轮540与冠状齿轮589之间的离合器力。尤其是当施加至锁环齿轮540上的张力相对大时,离合器力相对大(即:需要相对大的转矩使锁环齿轮540相对于冠状齿轮589旋转)。紧接着在施加至锁环齿轮540上的张力相对小时,离合器力相对小(即:需要相对小的转矩使锁环齿轮540相对于冠状齿轮589旋转)。
此外,在锁环齿轮540与第一环形齿轮584之间的离合器力可以受施加在锁环齿轮540上的任何向远侧定向力的量控制。尤其是在施加至锁环齿轮540上的向远侧定向力相对大时,离合器力相对大(即:需要相对大的转矩使锁环齿轮540相对于第一环形齿轮584旋转)。紧接着在施加至锁环齿轮540上的向远侧定向力相对小时,离合器力相对小(即:需要相对小的转矩使锁环齿轮540相对于第一环形齿轮584旋转)。
在另外的实施例中,进一步可以预期到,如图31至图36所示,轴组件200可以设置有离合器机构,所述离合器机构包括形成在锁环齿轮540的内表面上/中的一系列倾斜的齿轮齿540b和形成在冠状齿轮589的外表面上/中的一系列倾斜的齿轮齿589a。在本实施例中,离合器力可以受齿轮齿540b、589a的数目、齿轮齿540b、589a的尺寸等等控制。
尤其是,锁环齿轮540的每个倾斜的齿轮齿540b的近侧表面以一角度被挖槽,而冠状齿轮589的每个倾斜的齿轮齿589a的远侧表面以一角度被挖槽。可以预期到,锁环齿轮540的每个倾斜的齿轮齿540b的近侧表面的角度大体上与冠状齿轮589的每个倾斜的齿轮齿589a的远侧表面的角度互补。
更特别地,锁环齿轮540的每个倾斜的齿轮齿540b的近侧表面包括沿着从锁环齿轮540的中心轴线径向地延伸的平面在彼此相反的方向上延伸的一对表面,其中一对表面在远侧方向上彼此分开。此外,冠状齿轮589的每个倾斜的齿轮齿589a的远侧表面包括沿着从冠状齿轮589的中心轴线径向地延伸的平面在彼此相反的方向上延伸的一对表面,其中一对表面在近侧方向上彼此分开。
如上所述,在使用中,远侧颈部壳体236的齿轮接收手术器械100的转矩或旋转力。尽管这个转矩高度地受控并且可以精确地限制,可能的是在锁环齿轮540处于近侧旋转位置时(如上所述),用户可以强制地(即:手动地)旋转末端执行器400或在末端执行器400上施加转矩,因此可能损坏手术器械100的电动机或其他部件和/或颈部组件200。离合器机构的倾斜的齿轮齿540b、589a的角度起到限制终端用户能够过加载转矩的量的作用。使离合器机构滑移所需要的转矩的量取决于齿轮齿540b、589a的数目、锁环齿轮540的每个倾斜的齿轮齿540b的近侧表面对的倾斜角、以及冠状齿轮589的每个倾斜的齿轮齿589a的远侧表面对的倾斜角等等。
在操作中,当锁环齿轮540处于远侧位置或发射位置时,来自手术器械100的转矩通过远侧颈部壳体236的齿轮传递以使末端执行器400的驱动轴426(参见图27、图29和图30)旋转从而实现末端执行器400的发射和闭合。在这种情形下,终端用户不能通过推动末端执行器400的刀具杆来引发过多的外部转矩。
然而,通过增加离合器机构至末端执行器400的驱动轴426(未显示),可以减少或消除由于手术器械100的电动机的过转矩引起的手术器械100的故障模式。
在进一步的实施例中,可以预期到,如图37至图43所示,轴组件200的锁环齿轮540已经被平移地支撑在远侧颈部壳体236中的锁定销560替换,从而当处于推进位置时选择性地啮合第一环形齿轮584而当处于缩回位置时选择性地啮合冠状齿轮589。
如图38所示,锁定销560包括限定远侧端562a的柱状主体562以及近侧端562b。柱状主体562的远侧端562a限定了形成在其侧表面中的扁平部或凹部562c。锁定销560包括支撑在或一体地形成在柱状主体562的远侧端562a处的齿564。齿564包括从柱状主体562的最远侧端向远侧延伸的远侧部564a。齿564包括从柱状主体562的最远侧端向近侧延伸并且伸入柱状主体562的扁平部562c中的近侧部564b。齿564的近侧部564b限定了锥形部或类似物。
如图39至图43所示,锁定销560支撑在远侧颈部壳体236中使得冠状齿轮589布置在锁定销560的扁平部562c的内并且邻近齿564的近侧锥形部564b。
继续参照图39至图43,第一环形齿轮584设置有形成在其最近侧表面中的凹口584b的环形阵列。各个凹口584b被配置为并且定尺寸为选择性地接纳锁定销560的齿564的远侧部564a。
在操作中,锁定销560能够在缩回位置与推进位置之间平移,其中在缩回位置处锁定销560的齿564的近侧部564b啮合在冠状齿轮589的齿589a中,而在推进位置处锁定销560的齿564的远侧部564a被布置在第一环形齿轮584的凹口584a中。
通过被紧固到锁定销560的近侧端的推/拉式或移位线缆246来使得锁定销560在缩回位置与推进位置之间平移。特别的,可以预期到,锁定销560的近侧端可以被卷曲到移位线缆246的远侧端上。以此方式,随着移位线缆246在缩回位置与推进位置之间轴向地平移,移位线缆246使锁定销560在相应的缩回位置与推进位置之间平移。
在操作中,当锁定销560处于缩回或近侧位置而与冠状齿轮589啮合时,锁定销560的齿564的近侧部564b与冠状齿轮589的冠状齿589a啮合,使得防止冠状齿轮589和承载器288由于锁定销560的主体562与管状壳体237的齿237a啮合而旋转(参见图37)。
同样在操作中,在锁定销560处于推进或远侧位置而与冠状齿轮589分离时,锁定销560的齿564的近侧部564b与冠状齿轮589的冠状齿589a分离,使得冠状齿轮589和承载器288由于正齿轮282的旋转而旋转。在锁定销560与冠状齿轮589分离的情况下,允许冠状齿轮589以及因此承载器288旋转。
此外,当锁定销560处于推进或远侧位置时,锁定销560的远侧部564a与冠状齿轮589分离并且被锁定成与第一环形齿轮584啮合。因此,在允许冠状齿轮589旋转的情况下,中央远侧驱动轴239的旋转引起承载器288的旋转。随着承载器288旋转,承载器288传递所述旋转至远侧柱状齿轮系统290的第二太阳齿轮292。随着第二太阳齿轮292旋转,第二太阳齿轮292传递所述旋转至所述至少一个第二齿轮296。随着第二齿轮296旋转,第二齿轮296传递所述旋转至发射连接器297,发射连接器297被配置为与末端执行器400的驱动轴426(参见图27、图29和图30)选择性地啮合以由此实现末端执行器400的发射和闭合。
取决于锁定销560相对于第一行星齿轮系统280的冠状齿轮589的定位,中央远侧驱动轴239的旋转将引起末端执行器400的闭合/发射和打开/缩回,或末端执行器400的旋转。例如,在实施例中,当锁定销560位于推进或远侧位置而与冠状齿轮589分离时(如上所述),中央远侧驱动轴239的旋转将引起末端执行器400的闭合/发射和打开/缩回。而且,在实施例中,当锁定销560位于缩回或近侧位置而与冠状齿轮589啮合时(如上所述),中央远侧驱动轴239的旋转将引起末端执行器400的旋转。
继续所述操作的讨论,为了使末端执行器400旋转,锁定销560被移动至缩回位置或近侧位置以与冠状齿轮589啮合,并且因为冠状齿轮589经由柱288a非可旋转地连接至承载器288,所以承载器288的非旋转引起冠状齿轮589的非旋转。因此,在冠状齿轮589不能够旋转的情况下,中央远侧驱动轴239的旋转被传递至第一太阳齿轮282并且引起第一太阳齿轮282的旋转,并且依次引起多个第一行星齿轮286绕被承载器288的柱288a限定的其相应的中心轴线的旋转。随着第一行星齿轮286绕由承载器288的柱288a限定的其相应的中心轴线旋转,第一行星齿轮286与第一环形齿轮284的齿284a啮合以将所述旋转传递至第一环形齿轮284。
在锁环齿轮540锁定至冠状齿轮589的情况下,第一环形齿轮284能够相对于管状壳体237旋转。正如这样所定位的,中央远侧驱动轴239的旋转将使第一太阳齿轮282旋转,这引起第一行星齿轮286绕其相应的中心轴线(由承载器288的柱288a限定)旋转。随着第一行星齿轮286旋转,第一行星齿轮286驱动第一环形齿轮284,第一环形齿轮284固定地或非可旋转地紧固到远侧壳体或旋转毂311。因此,当末端执行器400连接至轴组件200时,并且更具体地,当末端执行器400的对准柱424a、424b连接至旋转毂311时,旋转毂311的旋转引起末端执行器400的旋转。
继续所述操作的讨论,为了闭合/发射和打开/缩回末端执行器400,锁定销560被移动至远侧位置以与冠状齿轮589分离并且锁定成与第一环形齿轮284啮合。因此,在允许冠状齿轮589旋转的情况下,中央远侧驱动轴239的旋转引起承载器288的旋转。
随着承载器288旋转,承载器288传递所述旋转至远侧柱状齿轮系统290的第二太阳齿轮292。随着第二太阳齿轮292旋转,第二太阳齿轮292传递所述旋转至所述至少一个第二齿轮296。随着第二齿轮296旋转,第二齿轮296传递所述旋转至发射连接器297,发射连接器297被配置为与末端执行器400的驱动轴426(参见图27、图29和图30)选择性地啮合以由此实现末端执行器400的发射和闭合。
可以预期到,在锁定销560处于在远侧位置与近侧位置之间的“中间”位置时,可以执行更少限制性的闭合/发射和旋转的功能。
将要理解的是可以对这里公开的所述实施例进行各种修改。例如,手术器械100和/或钉仓组件410不需要使用吻合钉,而是可以使用本领域都知道的两件式紧固件。此外,可以修改吻合钉或紧固件线性排的长度来满足特殊手术操作的要求。于是,吻合钉钉仓组件内吻合钉和/或紧固件的线性排的长度可以相应地改变。因此,上述说明书不应该视为限制,仅仅是一些优选实施例的例证。本领域的技术人员在这里所附的权利要求书的范围和精神内将设想其他的修改。

Claims (17)

1.一种机电手术系统,包括:
手持式手术器械,其包括限定连接部的器械壳体,所述连接部用于与轴组件选择性地连接,所述手术器械具有至少一个可旋转驱动构件;
末端执行器,其被配置为执行至少一种功能;并且
所述轴组件被布置为选择性地将所述末端执行器和所述手术器械相互连接,所述轴组件包括:
变速箱壳体,其被配置为并且适于选择性连接至所述手术器械的所述连接部并且与所述手术器械的所述至少一个可旋转驱动构件中的每一个可操作地连通;
管状外主体,其具有被所述变速箱壳体支撑的近侧端和被配置为并且适于与所述末端执行器可操作地连接的远侧端;
远侧颈部壳体,其用于将所述手术器械的可旋转驱动构件与支撑在所述末端执行器中的旋转接纳构件相互连接,其中所述远侧颈部壳体包括能够连接到所述手术器械的一个可旋转驱动构件的第一端部和能够连接到所述末端执行器的所述旋转接纳构件的第二端部,其中,力传递组件将所述手术器械的所述可旋转驱动构件的旋转传递至所述末端执行器的所述旋转接纳构件,远侧颈部组件包括:
至少一个齿轮系统,其被配置为将所述可旋转驱动构件的旋转输入转换成至所述末端执行器的至少两个输出力;以及
关节式运动颈部组件,其将所述管状外主体与所述远侧颈部壳体相互连接,其中所述关节式运动颈部组件被配置为使所述远侧颈部组件能够进行离轴关节式运动,并且其中所述可旋转驱动构件延伸通过所述关节式运动颈部组件,其中
所述远侧颈部壳体的所述至少一个齿轮系统的第一输出力引起所述末端执行器的发射;
所述远侧颈部壳体的所述至少一个齿轮系统的第一输出力引起所述末端执行器相对于所述轴组件的旋转;并且
所述远侧颈部壳体非可旋转地且可滑动地支撑锁环齿轮,其中所述锁环齿轮包括第一位置,在所述第一位置上所述远侧颈部壳体的所述至少一个齿轮系统的所述第一输出力引起所述末端执行器的发射,并且其中所述远侧颈部壳体的所述至少一个齿轮系统的所述第一输出力引起所述末端执行器相对于所述轴组件的旋转。
2.根据权利要求1所述的机电手术系统,其中所述远侧颈部壳体包括:
管状外壳体,其限定从其径向地向内延伸的至少一个齿;以及
第一齿轮系统,其被支撑在所述管状外壳体中,所述第一齿轮系统包括:
第一太阳齿轮,其能够被所述手术器械的一个可旋转驱动构件驱动;
第一环形齿轮,其可旋转地支撑在所述管状外壳体中;
至少一个第一行星齿轮,其插置在所述第一太阳齿轮与所述第一环形齿轮之间并且将所述第一太阳齿轮与所述第一环形齿轮相互啮合;以及
承载器,其可旋转地支撑在所述管状外壳体中,所述承载器包括可旋转地支撑每个第一行星齿轮的相应的柱;
其中,在一种操作模式中,当所述第一太阳齿轮被旋转时,使得每个第一行星齿轮绕所述第一太阳齿轮的中心轴线旋转,引起所述末端执行器的发射;并且
其中,在另一种操作模式中,当所述第一太阳齿轮被旋转时,使得每个第一行星齿轮绕其相应的旋转轴线旋转,引起所述末端执行器的旋转。
3.根据权利要求2所述的机电手术系统,其中所述远侧颈部壳体包括:
冠状齿轮,其非可旋转地连接至所述承载器;以及
锁环齿轮,其轴向地、非可旋转地且可滑动地支撑在所述管状外壳体中,
其中,所述锁环齿轮包括第一位置,在所述第一位置上所述锁环齿轮啮合所述冠状齿轮并且防止所述冠状齿轮旋转,其中所述冠状齿轮的非旋转容许所述末端执行器的旋转,并且
其中,所述锁环齿轮包括第二位置,在所述第二位置上所述锁环齿轮与所述冠状齿轮分离并且容许所述冠状齿轮旋转,其中所述冠状齿轮的旋转容许所述末端执行器的发射。
4.根据权利要求3所述的机电手术系统,其中所述远侧颈部壳体包括:
旋转毂,其非可旋转地支撑在管状外壳体中;以及
第二齿轮系统,其支撑在所述旋转毂中,所述第二齿轮系统包括:
第二太阳齿轮,其非可旋转地连接至所述承载器;以及
至少一个第二行星齿轮,其可旋转地支撑在所述旋转毂中并且与所述第二太阳齿轮相互啮合;以及
发射连接器,其连接至所述至少一个第二行星齿轮中的一个,其中所述发射连接器被配置为接合所述末端执行器的力接收构件;
其中当所述承载器旋转时,所述第二太阳齿轮被旋转以旋转所述至少一个第二行星齿轮并且使所述末端执行器发射。
5.根据权利要求3所述的机电手术系统,其中所述远侧颈部壳体包括第一离合器机构,当所述锁环齿轮处于所述第一位置时,所述第一离合器机构插置在所述锁环齿轮与所述冠状齿轮之间并且将所述锁环齿轮与所述冠状齿轮相互连接。
6.根据权利要求5所述的机电手术系统,其中所述远侧颈部壳体包括第二离合器机构,当所述锁环齿轮处于所述第二位置时,所述第二离合器机构插置在所述锁环齿轮与所述第一环形齿轮之间并且将所述锁环齿轮与所述第一环形齿轮相互连接。
7.根据权利要求6所述的机电手术系统,其中,所述第一离合器机构和所述第二离合器机构中的至少一个包括插置在相应的锁环齿轮与冠状齿轮之间以及锁环齿轮与第一环形齿轮之间的摩擦增强材料。
8.根据权利要求1所述的机电手术系统,其中所述手持式手术器械还包括:
至少一个驱动电动机,其支撑在所述器械壳体中并且被配置为旋转所述至少一个可旋转驱动构件;
电池,其被布置在所述器械壳体内,用于为所述至少一个驱动电动机提供电力;以及
电路板,其被布置在所述器械壳体内,用于控制从所述电池输送至所述电动机的电力。
9.根据权利要求1所述的机电手术系统,其中所述末端执行器包括:
上钳夹和下钳夹,所述上钳夹和所述下钳夹中的至少一个能够相对于所述上钳夹和所述下钳夹中的另一个移动。
10.根据权利要求9所述的机电手术系统,还包括:
至少一个手术支持件,其可释放地固定至所述上钳夹和所述下钳夹中的至少一个的组织接触表面。
11.根据权利要求9所述的机电手术系统,还包括驱动梁,所述驱动梁能够平移通过所述上钳夹和所述下钳夹中的至少一个以使所述下钳夹相对于所述上钳夹移动。
12.根据权利要求11所述的机电手术系统,其中所述末端执行器包括:
上钳夹和下钳夹,所述上钳夹和所述下钳夹中的至少一个能够相对于所述上钳夹和所述下钳夹中的另一个移动;
钉仓组件,其被支撑在所述下钳夹中,所述钉仓组件在其内包括多个吻合钉;
至少一个手术支持件,其可释放地固定至所述上钳夹和所述下钳夹中的至少一个的组织接触表面,所述至少一个手术支持件通过至少一根缝合线固定到所述上钳夹和所述下钳夹中的至少一个,所述上钳夹和所述下钳夹中的至少一个被配置为接收所述至少一根缝合线的一部分。
13.根据权利要求12所述的机电手术系统,其中所述末端执行器的所述下钳夹被配置为选择性地接纳钉仓组件,其中所述钉仓组件包括:
钉仓主体,其限定纵向延伸的刀具狭槽;
多个吻合钉,其布置在形成于所述钉仓主体中的各个吻合钉固持狭槽中,其中所述吻合钉固持狭槽被安置成布置在所述刀具狭槽的相对的横向侧上的多个纵向延伸的排;
致动滑块,其可滑动地支撑在所述钉仓主体中并且被配置为在所述致动滑块从最近侧位置向远侧移动时从所述钉仓主体排出所述多个吻合钉中的至少一部分;以及
刀具滑块,其可滑动地支撑在所述钉仓主体中的在所述致动滑块近侧的位置处,其中所述刀具滑块包括延伸进入所述刀具狭槽的刀片;
其中,当所述钉仓组件被布置在所述下钳夹中时并且当所述驱动梁被推进时,所述驱动梁接合所述刀具滑块和所述致动滑块。
14.根据权利要求13所述的机电手术系统,其中,在所述驱动梁的任何缩回之后,所述钉仓组件的所述致动滑块保持在向远侧推进的位置上。
15.根据权利要求13所述的机电手术系统,其中,所述钉仓组件的所述刀具滑块包括从其延伸出的闭锁弹簧,其中所述刀具滑块的所述闭锁弹簧接合限定在所述钉仓主体中的闭锁凹口以抑制所述刀具滑块的推进。
16.根据权利要求15所述的机电手术系统,其中,当所述致动滑块和所述刀具滑块处于最近侧位置时,所述致动滑块阻止所述刀具滑块的所述闭锁弹簧与所述钉仓主体的闭锁凹口的接合。
17.根据权利要求16所述的机电手术系统,其中,在所述驱动梁的任何缩回时,所述钉仓组件的所述刀具滑块缩回。
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US9402604B2 (en) 2016-08-02
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