CN103732156B - 手术紧固件施加装置 - Google Patents
手术紧固件施加装置 Download PDFInfo
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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
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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
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0686—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying below the tissue during stapling
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
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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
- A61B2017/07214—Stapler heads
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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
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2946—Locking means
Abstract
用于施加紧固件至身体组织的手术紧固件施加装置。该装置包括限定了细长通道构件的钉仓接收半段，所述细长通道构件构造为可释放地接收发射组件的固定壳体。所述固定壳体定尺寸为在其中可释放地接收单次使用加载单元，并且包括闭锁结构，所述闭锁结构可防止在固定壳体安装至钉仓接收半段之后将单次使用加载单元插入固定壳体。
Description
该申请要求提交于2011年8月8日的临时申请61/521,074的优先权，其整个内容通过引用合并于此。
技术领域
本公开涉及手术紧固件施加装置，尤其涉及具有可重复使用部件及一次性部件的手术紧固件施加装置。
背景技术
本领域公知这样的手术紧固件施加装置，其中，首先将组织抓取或者夹紧于对置的钳夹结构之间，然后依靠手术紧固件结合组织。在一些这种装置中，设置刀具以切割已经用紧固件结合的组织。紧固件典型地呈手术吻合钉的形式，但是还可以使用其他手术紧固件，诸如例如，夹子或者两部件式聚合手术紧固件。
手术紧固件施加装置典型地包括两个细长梁构件，使用它们来在其间捕获或者夹紧组织。典型地，一个梁构件承载一次性的钉仓组件，钉仓组件收纳布置成至少两横排的多个吻合钉，而另一梁构件包括砧座，砧座限定一表面，该表面用于当吻合钉从钉仓组件驱动出来时使吻合钉钉腿成形。当使用两部件式紧固件时，包括砧座的梁构件承载两部件式紧固件的匹配部，例如接收器。通常，吻合钉成形处理受到一个或多个纵向移动的凸轮构件与一系列独立的吻合钉推进器之间相互作用的影响。随着凸轮构件纵向行进通过钉仓承载梁构件，各个推进器构件向上偏置到支撑于钉仓组件中的吻合钉的钉冠，以从钉仓顺序射出吻合钉。刀具可以设置成在吻合钉排之间随凸轮构件一起行进以切割成形的吻合钉排之间的组织。这种器械的例子公开于美国专利7,631,794，其整体通过参考并入此处。
因为与不适当消毒关联的危险，所以装置典型地是在使用之后就丢弃。虽然钉仓组件可以被替换以对单个患者执行多个紧固件施加操作，但是典型地在手术程序已经完成之后丢弃吻合钉施加装置。这种丢弃要求会增加与手术程序关联的成本。虽然已经开发了可重复使用的紧固件施加装置，但是这种装置会是过于复杂的，而且经证实也很难消毒。
本领域中需要一种紧固件施加装置，其包括可重复使用的部件，不过于复杂并且构造为利于在手术程序中使用之后进行适当消毒。
发明内容
本发明涉及用于施加手术紧固件至组织的手术紧固件施加装置。在本公开的一个方案中，提供一种手术紧固件施加装置，包括：砧座半段，其包括远侧砧座部和近侧手柄部；钉仓接收半段，其限定了细长通道构件；以及固定壳体。所述固定壳体构造为可释放地支撑在所述钉仓接收半段的所述细长通道构件内。所述固定壳体支撑所述装置的发射部件。所述固定壳体还定尺寸为可释放地接收单次使用加载单元。所述固定壳体包括闭锁结构，所述闭锁结构防止在所述固定壳体安装在所述钉仓接收半段中之后将所述单次使用加载单元完全插入所述固定壳体。
在一些实施例中，所述闭锁结构可以限定第一位置和第二位置，所述第一位置防止将所述单次使用加载单元插入所述固定壳体，所述第二位置允许将所述单次使用加载单元插入所述固定壳体。所述闭锁结构构造为在所述第一位置和所述第二位置之间移动。但是，当所述固定壳体定位在所述细长通道构件内时，阻止所述闭锁结构从所述第一位置移动至所述第二位置。
在一个实施例中，所述闭锁结构定位在所述固定壳体的中央部上。在一些实施例中，所述闭锁结构包括一对侧壁和从每个侧壁的顶部延伸出的一对凸缘，使得当所述闭锁结构处于所述第一位置时，所述侧壁彼此大致平行，并且所述凸缘之间限定横向尺寸或开口，所述横向尺寸或开口小于所述单次使用加载单元的横向尺寸，以防止所述单次使用加载单元进入其中，而当所述闭锁结构处于所述第二位置时，所述侧壁倾斜而彼此远离，并且所述凸缘之间限定横向尺寸或开口，所述横向尺寸或开口大于所述单次使用加载单元的横向尺寸，以允许所述单次使用加载单元进入其中。
在一些实施例中，中央部的所述侧壁通过活铰链连接至所述固定壳体的近侧部和远侧部，使得中央部的所述侧壁能够相对于所述近侧部和远侧部枢转。在其他实施例中，所述闭锁结构包括底表面，所述侧壁用铰链附接至所述底表面。
在另一方案中，本公开提供了一种手术紧固件施加装置，包括可重复使用的砧座半段、可重复使用的钉仓接收半段以及一次性发射组件，所述一次性发射组件构造为可释放地支撑在所述钉仓接收半段内。所述发射组件包括一次性的推进器组件以及能够可操作地安装至所述推进器组件的一次性的单次使用加载单元，其中，如果所述推进器组件安装在所述钉仓接收半段中，则所述单次使用加载单元不能够可操作地安装至所述推进器组件。
在一些实施例中，所述手术紧固件装置进一步包括从所述推进器组件延伸出的第一和第二构件，所述第一和第二构件能够在第一位置和第二位置之间移动，所述第一位置具有定尺寸为防止插入所述单次使用加载单元的第一间隙，所述第二位置具有大于所述第一间隙且定尺寸为接收所述单次使用加载单元的第二间隙。在一些实施例中，所述第一和第二构件从所述推进器组件的第一和第二侧壁延伸出。在一些实施例中，所述第一和第二构件通常处于第二位置。
在另一方案中，本公开提供了一种与手术紧固件施加装置一起使用的一次性发射组件，所述一次性发射组件包括一次性的单次使用加载单元和一次性的推进器组件。所述发射组件能够插入所述紧固件施加装置的钉仓接收半段中，所述单次使用加载单元能够可操作地安装至所述推进器组件，其中，所述推进器组件包括闭锁构件，所述闭锁构件能够从第一阻挡位置和第二位置移动，所述第一阻挡位置防止所述单次使用加载单元可操作地插入其中，所述第二位置能够使所述单次使用加载单元可操作地插入其中。
在一些实施例中，所述闭锁构件偏置至第一位置，当所述推进器组件安装在所述钉仓接收半段内时防止所述闭锁构件移动至所述第二位置。在一些实施例中，所述闭锁构件包括第一和第二构件，所述第一和第二构件朝向所述推进器组件的纵向轴线向内延伸并且能够移动以改变它们之间的间隙。在一些实施例中，所述第一和第二构件从大致垂直于所述纵向轴线的位置枢转至相对于所述纵向轴线倾斜的第一位置。
附图说明
现在将参考附图描述本公开手术紧固件施加装置的各种实施例，其中：
图1是从处于夹紧位置的本公开手术紧固件施加装置的一个实施例的远侧端部看的侧视立体图；
图2是从处于夹紧位置的图1所示的手术紧固件施加装置的近侧端部看的侧视立体图；
图2A是图1所示的手术紧固件施加装置处于打开位置的侧视立体图；
图2B是图2A所示的标示细节区域的放大图；
图3是图1所示的手术紧固件施加装置的部件分离的侧视立体图；
图3A是图1所示的紧固件施加装置的夹紧杆的侧视剖视图；
图4是图1所示的手术紧固件施加装置的钉仓接收半段的侧视立体图，单次使用加载单元和发射组件支撑在钉仓接收半段内；
图5是图4所示的标示细节区域的放大图；
图6是从手术紧固件施加装置的钉仓接收半段上方看的立体图，SULU和发射组件支撑在其中；
图7是图6所示的标示细节区域的放大图；
图8是从图3所示的手术紧固件施加装置的发射组件的上方看的前端立体图；
图9是图8所示的标示细节区域的放大图；
图9A是通道构件的俯视立体图，发射组件可释放地固定在其中；
图9B是图9A所示的标示细节区域的放大图；
图9C是通道构件的中央部的俯视立体图；
图10是从图8所示的发射组件的上方看的后端立体图；
图11是图10所示的标示细节区域的放大图；
图12是图10所示的发射组件的部件分离的侧视立体图；
图12A是图12所示的发射组件的凸轮杆的仰视立体图；
图12B是图12所示的发射组件的发射杆的仰视立体图；
图13是图1所示的手术紧固件施加装置的SULU的侧视立体图；
图14是图13所示的标示细节区域的放大图；
图15是图13所示的SULU的前视立体图；
图16是图15所示的标示细节区域的放大图；
图17是图15所示的SULU的部件分离的侧视立体图；
图18是图1所示的手术紧固件施加装置处于打开位置的侧视剖视图；
图19是图18所示的标示细节区域的放大图；
图20是图18所示的标示细节区域的放大图；
图21是图18所示的处于打开位置的手术紧固件施加装置的近侧端部的立体图；
图22是图18所示的标示细节区域的放大图；
图23是从图1所示的手术紧固件施加装置的夹紧杆的近侧端部下方看的立体图；
图24是图1所示的手术紧固件施加装置处于夹紧位置的侧视立体图；
图25是图24所示的处于夹紧位置的手术紧固件施加装置的侧视剖视图；
图26是图25所示的标示细节区域的放大图；
图27是图25所示的标示细节区域的放大图；
图28是沿着图26的剖线28-28截取的剖视图；
图29是随着发射组件移动通过致动行程以从紧固件施加装置射出紧固件，图1所示的手术紧固件施加装置的俯视图；
图30是图29所示的手术紧固件施加装置的侧视剖视图，发射组件处于致动位置；
图31是图30所示的标示细节区域的放大图；
图32是图30所示的标示细节区域的放大图；
图33是图1所示的手术紧固件施加装置在该装置已经发射并且移至打开位置之后的侧视剖视图；
图34是图33所示的标示细节区域的放大图；
图35是插入SULU之前发射组件的固定壳体的替换实施例的立体图；
图35A是图35的固定壳体的中央部的侧视剖视图，处于防止SULU插入其中的位置；
图35B是图35的固定壳体的中央部的侧视剖视图，处于允许SULU插入其中的位置；
图36是在SULU插入其中之前发射组件的固定壳体的另一替换实施例的示意图；
图36A是图36的固定壳体的中央部的侧视剖视图，处于防止SULU进入其中的位置；以及
图36B是图36的固定壳体的中央部的侧视剖视图，处于允许SULU进入其中的位置。
具体实施方式
现在将参考附图详细描述本公开手术紧固件施加装置的实施例，其中，相同附图标记指代类似或者相同结构元件。如此处使用的，如传统的，术语“近侧”指的是装置较靠近用户的一端，术语远侧指的是装置较远离用户的一端。
图1-34图示了本公开手术紧固件施加装置的一个实施例，其通常称作手术吻合器10。尤其参考图1-3，手术吻合器10包括砧座半段12、钉仓接收半段14、夹紧杆16、单次使用加载单元18（下文“SULU”）和发射组件20。在一个实施例中，砧座半段12、钉仓接收半段14和夹紧杆16被构造为可重复使用的部件，这样，由适于消毒和重复使用的生物相容材料制成，例如不锈钢。相反，SULU18和发射组件20被构造为一次性的，这样，可以由具有所需强度特性的任何合适的生物相容材料制成，例如塑料、金属及它们的组合。
参考图3-7，钉仓接收半段14限定细长通道构件22，细长通道构件22限定大致U形通道24，U形通道24具有定尺寸为可释放地接收SULU18的远侧部24a和定尺寸为可释放地接收发射组件20的近侧部24b。发射组件20包括固定壳体26（还见图12），固定壳体26具有近侧端部，近侧端部包括开口28，开口28接收枢轴构件29（图12）的端部。枢轴构件29将锁定构件206可枢转地支撑在固定壳体26的近侧端部上，并且延伸通过开口28进入形成在钉仓接收半段14的近侧部中的凹槽30，以可释放地将发射组件20的近侧端部固定在通道构件22的近侧部24b内，下文将进一步详细讨论。发射组件20的远侧端部限定三角形切口64d。切口64d定位成接收形成在通道构件22的内壁上的突起65（见图9A-9C），以可释放地将发射组件20的远侧端部固定在通道构件22内。发射组件20的结构还将在下文进一步详细讨论。同样地，SULU18包括一对远侧突起32，它们定位在形成于通道构件22的远侧端部处的切口34中，以可释放地将SULU18固定在通道构件22的远侧部24a内。在组装期间，在SULU18插入通道构件22的远侧部24a之前，发射组件20必须插入通道构件22的近侧部24b，如以下将讨论的。为了将SULU18定位在通道构件22中，SULU18上的突起32定位在切口34内，同时SULU18定位在通道构件22上方且与通道构件22成角度。此后，SULU18能够向下旋转至U形通道24的远侧部24a中。这允许发射组件20的驱动部件适当地对准SULU18的部件，还利于发射组件20与支撑在SULU18内的刀具40（图17）接合。SULU18的近侧端部包括向外延伸的锯齿状表面42（图7）以利于抓握SULU18的近侧端部，从而允许从通道构件22移除和/或替换SULU18。在移动吻合器10至夹紧位置之前，如以下将讨论的，锯齿状抓握表面42将不完全安置于通道构件22的远侧部24a内。
参考图8-12，发射组件20包括固定壳体26、刀具致动杆44、凸轮杆46、引导块48、发射杆50、滑动块52、踏板54和枢转锁定构件206（图12）。在一个实施例中，固定壳体26包括U形框架60，U形框架60包括底壁62和一对侧壁64。每个侧壁64的远侧端部限定近侧台阶64b、远侧成角度部64c（图9）和三角形切口64d。如以上讨论的，三角形切口64d被定位成接收形成在通道构件22的内壁上的突起65（图9B）。每个侧壁64的近侧端部包括一对横向延伸的可变形壁部66（图11），它们与滑动块52的近侧端部隔开，并且在壁部66和滑动块52之间限定了用于枢转地接收锁定构件206的区域，下文将进一步详细讨论。
引导块48包括限定了三个纵向狭槽70a-c的主体和一对向外延伸的突起72。在一个实施例中，每个突起72是大致柱形并且包括锥形部72a（图9）。可替换地，可以想到其他突起构造。突起72定尺寸为接收在形成于固定壳体26的侧壁64中的开口74（图12）中，以将引导块48轴向固定在固定壳体26的远侧端部内。突起72允许引导块48在U形框架60内一定程度的枢转移动。如下文将进一步详细讨论的，响应于吻合器10移动至夹紧位置，引导块48从第一位置（图19）枢转至第二位置（图26），在第一位置，其锁定与刀具致动杆44的凹口49和51的接合，在第二位置，其与刀具致动杆44的凹口49和51脱离。扭转弹簧围绕突起72设置以推动引导块48锁定接合凹口49和51。每个狭槽70a和70c定尺寸为可滑动地接收凸轮杆46的相应侧壁114。类似地，狭槽70b定尺寸为可滑动地接收刀具致动杆44。
滑动块52包括毂80，毂80包括有弹性的指状部80a，指状部80a构造为搭扣配合到形成在发射杆50中的枢轴孔82中。当滑动块52处于收缩位置时发射杆50绕毂80枢转以利于从吻合器10的任一侧致动发射组件20。踏板54可往复运动地接收在形成于滑动块52中的孔84内。踏板54包括分体式主体部54a，分体式主体部54a构造为跨装于刀具致动杆44的近侧端部102上。在一个实施例中，分体式主体部54a包括成角度远侧表面86。销88从踏板54向上延伸通过滑动块52中的孔84。偏置构件90定位在分体式主体部54a和滑动块52之间，围绕销88以向下推动踏板54离开滑动块52而到达延伸位置。在滑动块52的收缩位置上，踏板54被接收在形成于通道构件22的底壁22a中的切口55中（图20）。
发射杆50包括第一和第二指状部接合构件50a和50b，它们中的任一个能够被选择性地接合以从吻合器10的任一侧将发射杆50移动通过发射行程。弓形凹槽94（图12B）形成在可滑动地接收踏板54的销88的发射杆50的底表面中，以限定发射杆50能够绕滑动块52的毂80枢转的旋转范围。如此处使用的，发射行程定义为发射杆50从完全收缩位置（图25）移动至完全前进位置（图30）。停止凹槽94a形成在弓形凹槽94的每个端部处。停止凹槽94a构造且定尺寸为接收踏板54的销88的端部，以防止在手术吻合器10的发射行程期间发射杆50绕毂80枢转运动。更具体来说，当发射组件20被致动以使滑动块52在固定壳体26内向远侧前进时，踏板54的成角度远侧表面86接合通道构件22并且做凸轮运动离开切口55（图27）以推动销88向上进入停止凹槽94a，从而在发射杆50移动通过发射行程期间防止发射杆50的枢转运动。很明显，销88必须定位在停止凹槽94a之下以允许踏板54从切口55向上提升，从而允许发射杆50移动通过发射行程。因而，在发射杆50能够移动通过发射行程之前，发射杆50必须枢转到发射组件20的一侧或另一侧。
刀具致动杆44包括近侧端部，近侧端部具有阶状部100，阶状部100包括具有第一高度的近侧第一台阶102和具有第二高度的第二台阶104，第二高度大于第一高度。致动杆44的远侧端部包括上弯钩部106以及上、下凹口49和51。指状部108在第一台阶102和第二台阶104之间从刀具致动杆44向上伸出。如图27所示，指状部108可滑动地接收在形成于滑动块52底侧的凹槽110内。当滑动块52在固定壳体26内向远侧前进时，指状部108在凹槽110内移动，使得滑动块52相对于刀具致动杆44移动，直到指状部108接合壁112（图32），壁112限定了凹槽110的近侧端部。当指状部108接合壁112时，滑动块52的进一步向远侧移动还将引起刀具致动杆44的向远侧移动。如以下将明显的，这种布置允许吻合钉在切割组织之前从SULU18射出。
参考图12和图12A，凸轮杆46包括一对侧壁114和基壁116（图12A）。每个侧壁114的近侧端部114a包括隆起壁部118。每个隆起壁部118构造为固定地接收在形成于滑动块52下侧的狭槽（未示出）内，以牢固地固定凸轮杆46的近侧端部至滑动块52。可替换地，滑动块52可以模制在刀具致动杆44的近侧端部周围。每个侧壁114的远侧端部包括成角度的凸轮表面114b。基壁116限定了：向远侧延伸的细长狭槽123（图12A），细长狭槽123从凸轮杆46的远侧端部沿着凸轮杆46的大体长度延伸；以及向近侧延伸的纵向狭槽121。狭槽121定位成当滑动块52处于收缩位置时利于踏板54通过通道构件22的切口55。见图27。
凸轮杆46的侧壁114可滑动地定位在引导块48的狭槽70a和70c中，刀具致动杆44可滑动地定位在引导块48的纵向狭槽70b中。当发射组件20支撑在通道构件22中并且发射杆50枢转至固定壳体26一侧并且被向远侧推动时，滑动块52在固定壳体26内向远侧移动。随着滑动块52开始向远侧移动，踏板54的锥形表面86接合通道构件22的限定了切口55的近侧边缘，以推动踏板54向上移出切口55、通过凸轮杆46的狭槽121，并到达发射组件20的固定壳体26的内表面上（图27）。当这发生时，踏板54的销88移入停止凹槽94a以防止发射杆50进一步的枢转运动。如果发射杆50不枢转至使销88定位在停止凹槽94a之下的位置，则将阻止踏板54向上移出切口55以及阻止发射杆50移动通过发射行程。随着发射杆50向远侧移动，指状部108在凹槽110内移动，使得随着凸轮杆46向远侧前进，刀具致动杆44保持静止。当指状部108接合限定了凹槽110的近侧壁112时，刀具致动杆44与滑动块52和凸轮杆46向远侧移动。如以下将讨论的，当凸轮杆46和刀具致动杆44在发射组件20的固定壳体26及通道构件22内向远侧移动时，凸轮杆46的成角度的凸轮表面114b移动通过SULU18以从SULU18射出紧固件。同时，虽然具有等于凹槽110（图32）长度的预设延迟，但是刀具致动杆44驱动刀具刀片40通过SULU18以分割组织。
美国专利No.7,631,794（“'794专利”）公开了一种手术紧固件施加装置，其包括类似于上述的发射组件。'794专利的整个内容通过参考并入此处。
图13-17图示了SULU18。参考图17，SULU18包括主体120、多个吻合钉推进器122（仅示出一个）、底盖124、具有成角度尖导缘或刀片40a的刀具40、多个吻合钉126（仅示出一个）、以及枢转地安装的安全闭锁件128。主体120的近侧端部包括柔性指状部120a，柔性指状部120a稍微突出于限定了主体120的外壁。指状部120a摩擦接合通道构件22的内壁以当SULU18可释放地定位在通道构件22内时将SULU18的近侧端部保持在通道构件22内。如本领域公知的，主体120具有：多排吻合钉保持狭槽130，例如，四个、六个等；以及居中地布置在主体120中的线性狭槽刀具轨道132。手术吻合器10能够定尺寸为接收或者容纳不同吻合钉线长度的SULU，包括，例如，60mm、80mm和100mm。刀具40包括下弯钩部40b，下弯钩部40b定位成当SULU18定位在通道构件22内时接合刀具致动杆44的上弯钩部106（图12）。
在图示的实施例中，主体120包括形成在线性狭槽刀具轨道132任一侧的两个错排的狭槽130。错排的狭槽130延伸超出刀具轨道132的远侧端部，以利于吻合钉成形超出刀具刀片40的行程的远侧端部。
吻合钉推进器122可以构造为延伸入一个或多个狭槽130。在一个实施例中，单个推进器与每个狭槽130关联。可替换地，如图17图示的，每个推进器122能够构造为延伸入两个相邻狭槽130，并且定位在保持于狭槽130中的相应吻合钉126下方。如本领域公知的，每个推进器122包括下凸轮表面122a，下凸轮表面122a定位成接合凸轮杆46的远侧端部上的凸轮表面114b（图12）之一，使得凸轮杆46通过SULU18的移动将顺序提升相应一个或多个狭槽130内的每个相应推进器122以从狭槽130射出吻合钉。
底盖124局部封闭形成在钉仓主体120内的通道125（图18）。纵向脊134形成在底盖124的上表面上，并且提供了用于刀具支撑构件136的支承表面，刀具支撑构件136固定至刀具40的底部边缘。刀具40可以经由销、焊接或者其他公知紧固技术固定至支撑构件136。在发射行程期间，随着发射杆50前进通过通道构件22，刀具40沿着刀具轨道132被引导。一对狭槽138限定在脊134的侧面以及钉仓主体120的外壁之间。纵向脊134定位在主体120内，并且定尺寸为可滑动地接收在凸轮杆46的细长狭槽120（图12A）内，使得凸轮杆46能够绕纵向脊134可滑动地移动通过钉仓主体120，从而从SULU18射出吻合钉126。
安全闭锁件128枢转地布置在主体120的上近侧端部上，并且绕枢轴构件150从锁定方位（图26）枢转到解锁方位（图34）。枢轴构件150接收在主体120中的开口154中。偏置构件（例如，弹簧152）定位在刀具支撑构件136和安全闭锁件128之间以朝向解锁方位推动安全闭锁件128。安全闭锁件128包括近侧钩156，近侧钩156定位成当刀具40处于收缩位置时（图19）接收形成在刀具40上的接合构件158以保持安全闭锁件128处于锁定方位。当在发射行程期间刀具40移向前进位置时，接合构件158移开近侧钩156以允许安全闭锁件128响应于弹簧152的推动而朝向解锁位置枢转。应该注意的是，当砧座半段12和钉仓接收半段14处于夹紧位置时，防止安全闭锁件128枢转至解锁位置，因为安全闭锁件128的顶表面128a接合砧座半段12的内表面以防止安全闭锁件128的枢转。安全闭锁件128限定了定尺寸为可滑动地接收刀具40的狭槽160。在刀具40的收缩位置，刀具40的导缘40a被约束在安全闭锁件128的狭槽160内，以防止刀具40的导缘40a意外碰到和伤害医疗人员。
再次参考图2-3，砧座半段12包括近侧手柄部12A和远侧砧座部12b。砧座部12b包括吻合钉变形部198，如本领域公知的，吻合钉变形部198包括多个吻合钉变形凹槽，并且当SULU18定位在通道构件22中时其面向SULU18的顶表面。还如本领域公知的，吻合钉变形部198包括中央纵向狭槽（未示出），随着刀具40移动通过SULU18，中央纵向狭槽用于接收刀具40（图17）。吻合钉变形部198能够与砧座半段12一体形成，或者在替换例中通过紧固处理诸如焊接固定至砧座半段12。一对定位指状部170（图3）定位成邻近砧座部12b的吻合钉变形部198的近侧端部。当该装置处于夹紧位置时，定位指状部170接收在SULU18的槽内以使SULU18与吻合钉确定部198适当地对准。
砧座半段12的中央部包括一对柱形横向支撑构件172。在砧座半段12和钉仓接收半段14的组装期间，横向支撑构件172支撑在限定于钉仓接收半段14的中央部173（图28）中的U形凹槽174中。中央部173的远侧壁173a限定组织止挡部（图3）。横向支撑构件172还定位成当夹紧杆16移至夹紧位置（图2B）时接收在形成于夹紧杆16的间隔凸缘部178上的切口176中。近侧手柄部12a是以符合人体工程学地方式形成的，并且包括拇指接合抵接部180以及抓握部182。手柄部12a的近侧端部包括向下延伸的指状部184，向下延伸的指状部184包括一对对置的泪滴形状突起186，将在下文进一步详细讨论。可替换地，突起186可以呈现各种构造。
钉仓接收半段14包括间隔的、居中布置的U形凹槽174，U形凹槽174定位成支撑砧座半段12的横向支撑构件172。钉仓接收半段14的近侧端部包括一对垂直支撑构件188。每个垂直支撑构件188包括具有圆底面的细长垂直狭槽188a。垂直狭槽188a定尺寸为当组装期间砧座半段12支撑在钉仓接收半段14上时接收形成在砧座半段12的指状部184（图21）上的突起186。通过将突起186定位在垂直狭槽188a内，砧座半段12能够相对于钉仓接收半段14以剪刀状方式在打开位置和关闭位置之间枢转。在一个实施例中，突起186具有泪滴轮廓。钉仓接收半段14的至少一个侧壁包括凹陷189（见图3），将在下文进一步详细讨论。
夹紧杆16还包括具有把手190a和拇指接合抵接部192的手柄部190。如以上讨论的，一对间隔的凸缘部178支撑在夹紧杆16的远侧端部上。每个凸缘部178限定切口176，切口176定尺寸为当吻合器10移向夹紧位置时（图2B）时接收砧座半段12的相应的横向支撑构件172。夹紧杆16的远侧端部还限定一对开口194，开口194定尺寸为接收枢轴构件187。枢轴构件187定尺寸为延伸通过钉仓接收半段14中的开口195和夹紧杆16中的开口194，以枢转地固定夹紧杆16至钉仓接收半段14。
如图3A所示，夹紧杆16的内壁包括突起201。突起201定位在形成于钉仓接收半段14的侧壁中的凹陷189（图2A）内，以可释放地保持夹紧杆16处于非夹紧位置或者打开位置（图2A）。
为了将发射组件20加载入通道构件22的近侧部24b，发射组件20的固定壳体26通过通道构件22的近侧端部滑入通道构件22，直到枢轴构件29被接收在形成于通道构件22的近侧端部中的凹槽30中。在发射组件20被加载之后，SULU18能够以与上述类似的方式被加载入远侧部24a。
参考图2和2B，在SULU18和发射组件20加载入通道构件22之后，砧座段12能够组装至钉仓接收半段14。为了将砧座半段12附接至钉仓接收半段14，指状部184的突起186定位在钉仓接收半段14的垂直支撑构件188的垂直狭槽188a中。此后，砧座半段12朝向钉仓接收半段14旋转以将横向支撑构件172定位在U形凹槽174中。
为了将手术吻合器10定位于夹紧位置，夹紧杆16从图2A示出的位置沿逆时针方向旋转。随着夹紧杆16旋转，横向支撑构件172被接收在凸缘部178的切口176中（图2）并且朝向钉仓接收半段14做凸轮运动。如图3所示，弹簧构件200固定至夹紧杆16的内表面（诸如通过焊接）处于接合钉仓接收部14的位置以推动夹紧杆16至图2A示出的非夹紧位置。在图1示出的夹紧位置，吻合钉变形部198定位成紧密接近SULU18的顶表面。
参考图3、图3A和图12，如以上讨论的，枢转锁定构件206枢转地支撑在发射组件20的固定壳体26的近侧端部上。枢转锁定构件206包括枢轴构件29，枢轴构件29延伸通过限定在固定壳体26中的开口28。指状部接合构件212定位在锁定构件206的一个端部上，卡掣部210定位在锁定构件206的另一端部上。卡掣部206包括钩构件210a。偏置构件214定位在枢轴构件29周围以朝向发射组件20的固定壳体26向内推动卡掣部210。当锁定构件206固定在发射组件26上时，卡掣部210向下延伸通过固定壳体26的近侧端部中的开口216而到达通道构件22的底表面下方的位置（图20）。如以上讨论的，枢轴构件29的端部被接收在形成于钉仓接收半段14的近侧端部中的切口30中，以可释放地将发射组件20固定在通道构件22的近侧通道部24b内（图21）。切口30由下弯指状部220局部限定以将发射组件26保持在通道构件22内（图3）。
参考图3A，夹紧杆16的近侧端部包括接合构件（例如，柱形杆218），柱形杆218定位成当夹紧杆16移至夹紧位置时（图27）被卡掣部210的钩构件210a接合。虽然图示了杆，但是可以想到其他接合构件的构造。如通过观察图27能够看到的，随着夹紧杆16移向夹紧位置，卡掣部210的成角度面222接合杆218。该接合引起锁定构件206绕枢轴构件29枢转，使得卡掣部210的钩构件210a通过，然后卡入而与杆218接合。为了从杆218释放卡掣部210，锁定构件206的接合构件212被压下以使卡掣部210枢转而不与杆218接合。当这发生时，弹簧构件200推动夹紧杆16至非夹紧位置。
参考图3、图12、图19和图26，如以上讨论的，引导块48枢转地支撑在发射组件20的固定壳体26中。引导块48包括向远侧延伸的鼻部220（图12和图26），当SULU18支撑在通道构件22中时鼻部220搁置在SULU18下方。引导块48的内表面包括锁定表面222（图19），当吻合器10处于非夹紧位置时锁定表面222被接收在刀具致动杆44的凹口49和51中。当SULU18定位在通道构件22中时，在夹紧杆16移动至夹紧位置之前，SULU18定位在鼻部220上方并且不完全安置于通道构件22中，如以上讨论的。当吻合器10移至夹紧位置时，定位指状部170（图3）接合SULU18的主体120的顶表面以将SULU18完全安置于通道构件22中。如以上讨论的，定位指状部170被接收在SULU18的槽中以将SULU18相对于砧座部12b适当地定位。随着SULU18完全安置于通道构件22中，SULU18下压引导块48的鼻部220以使引导块48绕突起72枢转。当引导块48枢转时，锁定表面222从凹口49和51移开以解锁刀具致动杆44（图26）。该构造可防止在夹紧之前刀具致动杆44相对于引导块48的移动，以确保在使用之前刀具致动杆44和SULU刀具40保持于用于操作接合的适当位置。
参考图24-28，当吻合器10处于夹紧、非发射位置时，发射组件20的滑动块52在通道构件22的近侧端部和固定壳体26处处于收缩位置。见图27。在该位置，踏板54定位在通道构件22的切口55中，踏板54的销88定位在发射杆50的弓形凹槽94中，位于停止凹槽94a下方。这样，发射杆50能够枢转以利于从吻合器10的任一侧致动吻合器10。另外，在滑动块52的该位置，刀具致动杆44的指状部108定位成邻近滑动块52的凹槽110的远侧壁。锁定构件206的卡掣部210还接合杆218以保持夹紧杆16处于夹紧位置。
参考图26，当滑动块52处于收缩位置时，刀具40和凸轮杆46的凸轮表面114b定位在SULU18的近侧端部，安全闭锁件128的近侧钩156定位成与刀具40的接合构件158接合以保持安全闭锁件128处于锁定方位。此外，刀具40的下弯钩部40b与刀具致动杆44的上弯钩部106接合以将发射组件20连接至SULU18的刀具40。
参考图29-32，当发射杆50沿图29的箭头“A”所示方向向远侧前进时，滑动块52在发射组件20的固定壳体26内向远侧移动以引起凸轮杆46的对应移动和刀具致动杆44的延迟移动。如以上讨论的，刀具致动杆44的延迟移动等于滑动块52的凹槽110的长度，并且由于刀具致动杆44的指状部108在滑动块52的凹槽110内的移动引起。当指状部108抵接凹槽110的近侧壁112时，刀具致动杆44随滑动块52的移动开始。随着凸轮杆46向远侧移动通过发射组件20的固定壳体26，凸轮杆46的侧壁114上的凸轮表面114b前进通过SULU18以顺序接合推进器122从而从主体120的狭槽130射出吻合钉126。同时，因为刀具致动杆44的远侧端部接合刀具40，所以刀具40在预设延迟之后前进通过SULU18以切割吻合钉线之间的组织。
如图32的虚线所示，当滑动块52在固定壳体26内向远侧移动时，踏板54架在通道构件22上并且沿着发射组件20的固定壳体26的内表面移动。当这发生时，踏板54的销88移入停止凹槽94a以防止发射杆50的进一步枢转移动。
参考图31和图32，当刀具40在SULU18内向远侧移动时，刀具40的接合构件158与安全闭锁件128的近侧钩156脱离。
参考图33和图34，当发射杆50返回其最近侧位置以收缩凸轮杆46和刀具40、并且锁定构件206被压下以使卡掣部210从杆218脱离时，弹簧200推动夹紧杆16到其非夹紧位置以允许吻合器10移动至打开位置。在打开位置，砧座半段12与钉仓接收半段14隔开，并且弹簧152（图17）使安全闭锁件128在图34的箭头B指示的方向上绕枢轴构件150枢转到其解锁位置，使得安全闭锁件128从SULU18向上伸出。在解锁位置，安全闭锁件128防止吻合器10移回夹紧位置。为了再次使用吻合器10，已使用的SULU18必须被新的SULU18替换。
在手术程序期间，SULU18能够被多次替换以利于对单个患者多次使用吻合器10。因为每个SULU18设置有新刀具40，所以最小化对组织的撕扯。在手术程序之后，已使用的SULU18和发射组件20能够从通道构件22移除并且以适当方式处置。砧座半段12、钉仓接收半段14和夹紧杆16现在能够被消毒（诸如通过高压灭菌法），并且与类似方式消毒后的SULU18和发射组件20一起再次使用。因为锁定构件206形成了发射组件20的一部分并且是一次性的，所以可重复使用的部件上会捕获组织和流体的区域较少。这样，能够更易于将该装置的可重复使用的部件进行消毒。
在上述手术吻合器中，SULU18和发射组件20是分别独立固定并且从钉仓接收半段14的通道构件22独立移除的。在图35-36B图示的可选实施例中，SULU18和发射组件20构造为形成单体式一次性单元，钉仓接收半段构造为接收单体式一次性单元。尤其，发射组件的固定壳体，构造为支撑手术吻合器10的SULU和发射部件，例如图8-12示出的刀具致动杆、凸轮杆、引导块和滑动块。当固定壳体被插入钉仓接收半段的通道构件22时，SULU和发射部件同时安装至钉仓接收半段。固定壳体包括闭锁结构以在固定壳体已经插入钉仓接收半段之后防止SULU插入固定壳体。因而，在这些实施例中，SULU必须在固定壳体插入钉仓接收半段之前插入固定壳体。以下讨论固定壳体的具体实施例。
图35示意地图示了与发射组件320关联的固定壳体326的替换实施例。固定壳体326能够限定的长度大致类似钉仓接收半段14（图3）。固定壳体326构造为可释放地接收在钉仓接收半段14的通道构件22内（还见图3）。固定壳体326包括近侧部330、远侧部332以及它们之间的中央部340。
固定壳体326的近侧部330构造为支撑图8-12示出的手术吻合器10的发射部件，与固定壳体26的方式相同，这种发射部件包括刀具致动杆、凸轮杆、引导块及滑动块（未示出于图35）。
固定壳体326的远侧部332和中央部340总共的长度大致类似SULU（单次使用加载单元）318，一起构造成可释放地接收SULU318。固定壳体326具有第一位置和第二位置，所述第一位置防止SULU318完全可操作地插入固定壳体326的远侧部332和中央部340，所述第二位置允许SULU318完全可操作地插入固定壳体326的远侧部332和中央部340。
固定壳体326的远侧部332具有包括底壁362和一对侧壁364的U形框架360。近侧部330可以具有与远侧部332相同或者类似的结构。另一方面，中央部340不具有底壁，但是具有一对侧壁342，它们经由柔性且有弹力的活铰链334铰接地附接至近侧部330和远侧部332。中央部340的每个侧壁342能够绕活铰链334枢转。
如图35-35A图示的，当固定壳体326处于第一位置时，中央部340的侧壁342对应地处于它们的第一、未偏置位置，在该位置上，侧壁342处于彼此大致平行的关系，并且侧壁342大致对准远侧部332的侧壁364。相反，当固定壳体326处于第二位置时，中央部340的侧壁342对应地处于它们的第二、倾斜位置，如图35B所示，在该位置上，侧壁342倾斜而彼此远离。在没有任何外力或者压力时，侧壁342自然呈现它们的第一位置，基于相同原因，固定壳体326自然呈现其第一位置。由于活铰链334的柔性本质，施加力会使侧壁342绕活铰链334枢转或挠曲，使得侧壁342从第一位置移动至第二、倾斜位置，相应地，固定壳体326从其第一位置移动至其第二位置。在移除力时，由于活铰链334的弹性本质，侧壁342恢复它们的第一位置，同时固定壳体326返回其第一位置。
还可想到的是，在替换实施例中，侧壁形成为使得它们需要人工施加力以在第一位置和第二位置之间枢转。可替换地，侧壁342能够偏置到非阻挡位置，钉仓接收半段的侧壁将侧壁342移动至阻挡位置。
每个侧壁342包括向下延伸部346，向下延伸部346能够延伸超出远侧部332的底表面362，并且每个侧壁342用作手动构件以利于手动操纵侧壁342。在一个实施例中，向下延伸部346均具有半圆形构造。可替换地，可想到其他构造。例如，通过用户手指对一对向下延伸部346朝向固定壳体326的纵向轴线施加向内的压力会引起侧壁342从第一、未偏置位置枢转移动至第二、倾斜位置。在释放向内的压力时，侧壁342返回第一、未偏置位置。向下延伸部346可以进一步包括从其向外突出的多个脊348以利于在手动操纵期间用户手指与向下延伸部346之间的摩擦接合。
每个侧壁342具有从其顶部径向向内延伸的顶凸缘344，顶凸缘344之间限定了开口（间隙）。当如图35A图示中央部340的侧壁342处于它们的第一位置时，两个顶凸缘344为大致共面构造，并且两个顶凸缘344之间限定横向尺寸或者开口“Wl”，其小于SULU318的横向尺寸“W2”，从而防止SULU318进入固定壳体326。当如图35B图示，通过部分346上的向内压力使得中央部340的侧壁342移动至它们的第二、倾斜位置时，两个凸缘344在图35B的“B”的方向上移开，从而形成加大的横向尺寸“W3”，其大于SULU318的横向尺寸或者开口（间隙）“W2”，从而允许SULU318进入固定壳体326。
相应地，当侧壁342处于它们的第一位置时，顶凸缘344防止SULU318完全插入固定壳体326中的可操作位置。当侧壁342处于它们的第二、倾斜位置时，顶凸缘344隔开以允许SULU318完全插入固定壳体326而到达与推进器组件协作的可操作位置，如此能够发射SULU318中包含的吻合钉。在SULU318定位在固定壳体326中之后，释放部分346上的压力，从而使得侧壁342返回它们的第一位置，以防止SULU318从固定壳体326移除。当SULU318可靠地保持在固定壳体326内时，固定壳体326同时支撑SULU318以及手术吻合器10的发射部件。结果，固定壳体326、SULU138和手术吻合器10的发射部件一起形成单体式一次性单元。
在操作期间，用户首先将固定壳体326的向下延伸部346朝向彼此挤压以将中央部340的侧壁342调节到它们的第二、倾斜位置，从而使固定壳体326移动至其第二位置以方便将SULU318接受于其中。接下来，用户将SULU318定位在固定壳体326的中央部340和远侧部332内。在SULU318成功定位在固定壳体326内之后，用户释放半圆形部346，引起侧壁342返回它们的第一正常位置，同时固定壳体326移动至其第一位置。一旦固定壳体326恢复其第一位置，固定壳体326可靠地保持SULU318于其中。在发射部件已经加载在固定壳体326的近侧部330中从而形成推进器组件、并且SULU318加载在固定壳体326的中央部340和远侧部332中的情况下，发射部件、SULU318和固定壳体326一起形成单体式一次性的加载单元。然后，用户通过将固定壳体326放入钉仓接收半段的通道构件中来将该单体式一次性单元安装至钉仓接收半段中。
如果用户在没有首先将SULU318插入固定壳体326的情况下安装固定壳体326至钉仓接收半段中，那么钉仓接收半段的壁将约束中央部340的侧壁342到它们的第一位置，从而形成锁定或者阻挡结构，防止或者阻挡SULU318后续进入固定壳体326。也即，侧壁342不具有足够空间倾斜以加宽其间的开口，因为它们的移动受阻了。在这种情况下，必须从钉仓接收半段移除固定壳体326，然后使侧壁342倾斜以允许将SULU318定位在固定壳体326中。结果，需要在固定壳体326插入吻合器之前将SULU318插入固定壳体326中。
图36-36B图示了发射组件420的固定壳体426的另一替换实施例。固定壳体426包括近侧部430、远侧部432和它们之间的中央部440。近侧部430和远侧部432具有的结构和功能分别类似于固定壳体326的近侧部和远侧部330、332，如上描述的。
中央部440限定U形构造，包括：一对侧壁442；一对凸缘444，每个均从其关联的侧壁442（朝向固定壳体426的纵向轴线）大致垂直地延伸；以及底表面446。底表面446永久地附接至远侧部432的底表面462和近侧部430的底表面461，或者可替换地与远侧部432的底表面462和近侧部430的底表面461一体地形成。每个侧壁442铰接地附接至底表面446，并且能够相对于底表面446枢转。
类似于固定壳体326，固定壳体426也具有如图36A图示的第一位置和如图36B图示的第二位置，第一位置防止或者阻挡SULU418进入其中，第二位置允许SULU418进入其中。在一些实施例中，第一位置能够是正常的偏置位置。
当固定壳体426处于图36A图示的其第一位置时，一对侧壁442对应地处于第一位置，在该位置每个侧壁442大致垂直于底表面446，并且顶凸缘444彼此大致共面，限定横向尺寸或者开口（间隙）“Wl”，其小于SULU418的横向尺寸“W2”，从而形成闭锁结构以防止SULU418插入固定壳体426。
当固定壳体426处于其图36B图示的第二位置时，一对侧壁442对应地处于第二位置，在该位置，侧壁442倾斜而彼此远离。每个侧壁442现在相对底表面446限定钝角角度，例如“θ”。在该位置，顶凸缘444之间具有横向尺寸“W3”，其大于SULU418的横向尺寸或者开口（间隙）“W2”，从而允许SULU418进入固定壳体426而处于与推进器组件协作的可操作位置，如此能够发射SULU418中包含的吻合钉。应该注意的是，SULU418（和SULU318）能够与SULU18相同。
在操作期间，用户可以先向外枢转每个侧壁442以调节它们至如图36B所示的第二位置。用户然后将SULU418放置到固定壳体462的中央部440和远侧部432。接下来，用户释放（或者，在侧壁不偏置到第一位置的实施例中，将侧壁枢转回第一位置）每个侧壁442以使其向内返回至如图36A所示的第一位置，从而将SULU418固定在固定壳体426内。此时，SULU418、固定壳体426和固定壳体426所承载的发射部件一起形成单体式一次性单元。用户然后通过将固定壳体426放入钉仓接收半段14的通道构件（图3）而将该单体式一次性单元安装至钉仓接收半段14（图3）。如果用户在没有首先将SULU418插入固定壳体426的情况下而将固定壳体426安装至钉仓接收半段中，那么钉仓接收半段将约束固定壳体426的中央部440的侧壁442到它们的第一位置，因而形成锁定结构以防止或者阻挡SULU418后续插入固定壳体426。也即，侧壁442被钉仓接收半段的侧壁阻碍，故它们不具有足够空间来枢转或者倾斜，因而阻挡了SULU418进入其间。
应该注意的是，侧壁442能够形成为通常处于第一位置。侧壁能够可替换地形成为通常处于非阻挡位置并且通过接合钉仓接收半段的侧壁而可移至阻挡位置。在其他替换实施例中，侧壁442能够形成为使得侧壁442需要手动施加力以在第一位置和第二位置之间枢转。
正如能够认识到的，图35-36B图示了闭锁结构的不同实施例，其能够使用以防止如果在SULU插入固定壳体之前固定壳体安装至钉仓接收半段的话将SULU插入固定壳体326或者426。在优选实施例中，SULU和相应的固定壳体326、426是一次性的，并且钉仓以及钻座接收段是可重复使用的。
SULU和固定壳体326或者426能够一起视为发射组件（分别为图35和图36的320和420），固定壳体包含推进器组件以将吻合钉从SULU推出（发射）。
应理解的是，可以对此处公开的手术紧固件施加装置的实施例做出各种修改。因此，上述说明不应该视为限制，而仅是作为实施例的范例。本领域的技术人员将想到在本公开的范围和精神内的其他修改。
Claims (19)
1.一种手术紧固件施加装置，包括：
砧座半段，其包括远侧砧座部和近侧手柄部；
钉仓接收半段，其限定了细长通道构件；
固定壳体，其构造为可释放地支撑在所述钉仓接收半段的所述细长通道构件内，所述固定壳体支撑所述装置的发射部件，所述固定壳体定尺寸为可释放地接收单次使用加载单元，所述固定壳体包括闭锁结构，所述闭锁结构防止在所述固定壳体安装在所述钉仓接收半段中之后将所述单次使用加载单元完全插入所述固定壳体。
2.根据权利要求1所述的手术紧固件施加装置，其中，所述闭锁结构能够在第一位置和第二位置之间移动，所述第一位置防止将所述单次使用加载单元插入所述固定壳体，所述第二位置允许将所述单次使用加载单元插入所述固定壳体，其中，当所述固定壳体支撑在所述细长通道构件内时，阻止所述闭锁结构从所述第一位置移动至所述第二位置。
3.根据权利要求2所述的手术紧固件施加装置，其中，所述闭锁结构包括一对侧壁和从每个侧壁的顶部延伸出的一对凸缘。
4.根据权利要求3所述的手术紧固件施加装置，其中，当所述闭锁结构处于所述第一位置时，所述侧壁彼此大致平行，并且所述凸缘之间限定第一横向尺寸，所述第一横向尺寸小于所述单次使用加载单元的横向尺寸。
5.根据权利要求3或4所述的手术紧固件施加装置，其中，当所述闭锁结构处于所述第二位置时，所述侧壁倾斜而彼此远离，并且所述凸缘之间限定第二横向尺寸，所述第二横向尺寸大于所述单次使用加载单元的横向尺寸。
6.根据权利要求3或4所述的手术紧固件施加装置，其中，中央部的侧壁通过活铰链连接至所述固定壳体的近侧部和远侧部，使得所述中央部的所述侧壁能够相对于所述近侧部和远侧部枢转。
7.根据权利要求3或4所述的手术紧固件施加装置，其中，所述闭锁结构包括底表面，所述侧壁用铰链附接至所述底表面。
8.根据权利要求1至4中任一项所述的手术紧固件施加装置，其中，当所述单次使用加载单元定位在所述固定壳体内时，所述固定壳体、所述发射部件和所述单次使用加载单元形成单体式一次性单元。
9.根据权利要求1至4中任一项所述的手术紧固件施加装置，其中，所述发射部件包括刀具致动杆、凸轮杆、引导块和滑动块。
10.根据权利要求1至4中任一项所述的手术紧固件施加装置，其中，所述闭锁结构定位在所述固定壳体的中央部上。
11.根据权利要求2-4中任一项所述的手术紧固件施加装置，其中，所述闭锁结构通常处于所述第一位置。
12.一种手术紧固件施加装置，包括可重复使用的砧座半段、可重复使用的钉仓接收半段以及一次性的发射组件，所述发射组件构造为可释放地支撑在所述钉仓接收半段内，所述发射组件包括一次性推进器组件以及能够可操作地安装至所述推进器组件的单次使用加载单元，其中，如果所述推进器组件安装在所述钉仓接收半段中，则所述单次使用加载单元不能够可操作地安装至所述推进器组件。
13.根据权利要求12所述的手术紧固件施加装置，进一步包括从所述推进器组件延伸出的第一和第二构件，所述第一和第二构件能够在第一位置和第二位置之间移动，所述第一位置具有定尺寸为接收所述单次使用加载单元的第一间隙，所述第二位置具有小于所述第一间隙且定尺寸为防止插入所述单次使用加载单元的第二间隙。
14.根据权利要求13所述的手术紧固件施加装置，其中，所述第一和第二构件从所述推进器组件的第一和第二侧壁延伸出。
15.根据权利要求13或14所述的手术紧固件施加装置，其中，所述第一和第二构件通常处于所述第二位置。
16.一种与手术紧固件施加装置一起使用的一次性发射组件，所述一次性发射组件包括一次性的单次使用加载单元和一次性的推进器组件，所述推进器组件能够插入所述紧固件施加装置的钉仓接收半段中，所述单次使用加载单元能够可操作地安装至所述推进器组件，其中，所述推进器组件包括闭锁构件，所述闭锁构件能够从第一位置和第二位置移动，所述第一位置防止所述单次使用加载单元可操作地插入其中，所述第二位置能够使所述单次使用加载单元可操作地插入其中。
17.根据权利要求16所述的一次性发射组件，其中，所述闭锁构件通常处于所述第一位置，当所述推进器组件安装在所述钉仓接收半段内时防止所述闭锁构件移动至所述第二位置。
18.根据权利要求16或17所述的一次性发射组件，其中，所述闭锁构件包括第一和第二构件，所述第一和第二构件朝向所述推进器组件的纵向轴线向内延伸并且能够移动以改变它们之间的间隙。
19.根据权利要求18所述的一次性发射组件，其中，所述第一和第二构件从大致垂直于所述纵向轴线且与所述闭锁构件的所述第一位置对应的第一位置枢转至相对于所述纵向轴线倾斜且与所述闭锁构件的所述第二位置对应的第二位置。
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| US8074859B2 (en) | 2010-03-31 | 2011-12-13 | Tyco Healthcare Group Lp | Surgical instrument |
| US8397972B2 (en) * | 2011-03-18 | 2013-03-19 | Covidien Lp | Shipping wedge with lockout |
| US9451959B2 (en) * | 2011-06-09 | 2016-09-27 | Covidien Lp | Surgical fastener applying apparatus |
| US9271728B2 (en) * | 2011-06-09 | 2016-03-01 | Covidien Lp | Surgical fastener applying apparatus |
| US9724095B2 (en) * | 2011-08-08 | 2017-08-08 | Covidien Lp | Surgical fastener applying apparatus |
| US9539007B2 (en) * | 2011-08-08 | 2017-01-10 | Covidien Lp | Surgical fastener applying aparatus |
| US9155537B2 (en) | 2011-08-08 | 2015-10-13 | Covidien Lp | Surgical fastener applying apparatus |
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| US9757126B2 (en) * | 2014-03-31 | 2017-09-12 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
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2012
- 2012-07-11 US US13/546,976 patent/US9155537B2/en active Active
- 2012-08-02 ES ES12745973.3T patent/ES2617218T3/es active Active
- 2012-08-02 JP JP2014525066A patent/JP2014528756A/ja active Pending
- 2012-08-02 WO PCT/US2012/049347 patent/WO2013022704A1/en active Application Filing
- 2012-08-02 AU AU2012294734A patent/AU2012294734A1/en not_active Abandoned
- 2012-08-02 EP EP12745973.3A patent/EP2741685B1/en active Active
- 2012-08-02 CN CN201280038896.1A patent/CN103732156B/zh active Active
- 2012-08-02 CA CA 2843629 patent/CA2843629A1/en not_active Abandoned
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2015
- 2015-07-27 US US14/809,552 patent/US10123797B2/en active Active
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|---|---|
| AU2012294734A1 (en) | 2014-01-23 |
| US10123797B2 (en) | 2018-11-13 |
| CN103732156A (zh) | 2014-04-16 |
| EP2741685B1 (en) | 2017-01-18 |
| EP2741685A1 (en) | 2014-06-18 |
| ES2617218T3 (es) | 2017-06-15 |
| US20130037597A1 (en) | 2013-02-14 |
| US20150327855A1 (en) | 2015-11-19 |
| US9155537B2 (en) | 2015-10-13 |
| JP2014528756A (ja) | 2014-10-30 |
| WO2013022704A1 (en) | 2013-02-14 |
| CA2843629A1 (en) | 2013-02-14 |
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