CN104414700A - 具有滑动套筒的砧座组件 - Google Patents

具有滑动套筒的砧座组件 Download PDF

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CN104414700A
CN104414700A CN201410461358.4A CN201410461358A CN104414700A CN 104414700 A CN104414700 A CN 104414700A CN 201410461358 A CN201410461358 A CN 201410461358A CN 104414700 A CN104414700 A CN 104414700A
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anvil
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贾斯汀·威廉斯
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Covidien LP
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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
    • 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
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • 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
    • 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
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head

Abstract

提供了一种具有滑动套筒的砧座组件。砧座组件包括：砧座中心杆；头部组件，其从操作位置至倾斜位置枢转地稳固至砧座中心杆组件；以及套筒，其可滑动地布置在砧座中心杆周围。套筒关联至头部组件使得头部组件从操作位置朝向倾斜位置的运动引起套筒关于砧座中心杆向近侧运动。

Description

具有滑动套筒的砧座组件
技术领域
本公开通常涉及适用于圆形吻合术吻合器的砧座组件。更具体来说，本公开涉及具有带滑动套筒的可倾斜头部的砧座组件。
背景技术
本领域公知圆形吻合术吻合器包括具有可倾斜砧座头部的砧座组件。一个这种圆形吻合术吻合器公开于共有的美国专利申请公开第2008/0230581号(“‘581公开”)中，其全部内容通过引用并入本文。砧座组件包括砧座头部，砧座头部枢转地稳固(secured)在砧座组件的连接柱的远侧端部上。将砧座组件在可操作的适当位置提供给临床医生，即砧座头部垂直于连接柱。
在吻合术程序期间，可以使用荷包缝合线将围绕着砧座组件的连接柱结合在一起的组织的第一和/或第二段连接起来。在圆形吻合术吻合器的击发操作之后，随着砧座头部离开圆形吻合器的钉仓组件，砧座头部绕连接柱的远侧端部枢转以缩小砧座头部的轮廓。砧座组件可以被弹簧加载从而使砧座头部自动倾斜至圆形吻合器和/或砧座头部几何形状所允许的最大角度。倾斜砧座头部以缩小砧座头部在脉管内的轮廓，这样可以使砧座头部和脉管的内壁之间的接触减少到最低限度，以利于将砧座头部穿过由吻合器形成的吻合环移除，吻合环即组织的环形吻合段。
在特定例子中，随着砧座头部枢转，吻合圈(即在吻合术程序期间由吻合组件的环形刀具切断的组织)以及荷包缝合线(如果采用了荷包缝合线来围绕着砧座组件稳固组织段的话)和/或其他组织或者障碍物会被砧座头部挤压(pinched)。当这发生时，砧座头部不能完全倾斜。结果，在将砧座头部穿过吻合环移出期间，砧座头部会大大超出必要程度地接触脉管内部。接触脉管内部会引起不想要的组织破坏(即，破坏吻合环)，和/或会导致在将砧座头部穿过脉管移除期间需要更高的缩回力。
因此，有利的是，砧座组件包括套筒，套筒构造为重新定位吻合圈以防止吻合圈被可倾斜砧座头部挤压，因而，允许砧座头部完全倾斜。
发明内容
因此，提供了改进的砧座组件。所述砧座组件包括砧座中心杆；头部组件，其从操作位置至倾斜位置枢转地稳固至所述砧座中心杆组件；以及套筒，可滑动地布置在所述砧座中心杆周围。所述套筒关联至所述头部组件，使得所述头部组件从所述操作位置朝向所述倾斜位置的运动引起所述套筒关于所述砧座中心杆向近侧运动。
在一些实施例中，所述套筒组件包括布置在所述砧座中心杆组件周围的套筒主体和枢转地连接至所述头部组件的远侧延伸的凸缘。在所述凸缘和所述套筒主体之间形成有活动铰链。所述头部组件可以包括枢转的凸轮卡掣构件，并且所述凸缘枢转地连接至所述凸轮卡掣构件。
在实施例中，所述头部组件可以包括壳体、柱、垫板和凸轮卡掣构件。所述垫板可以定位成在击发手术吻合设备之前防止所述头部组件从所述非倾斜位置至所述倾斜位置的枢转运动。所述垫板可以是能够运动至第二位置的，以允许所述头部组件相对于所述砧座中心杆组件从所述非倾斜位置枢转运动至所述倾斜位置。所述砧座头部组件可以包括枢转地稳固至所述砧座中心杆的柱，所述套筒构件可操作地接合至所述柱。所述套筒构件可操作地定位为：随着所述砧座组件从所述操作位置枢转至所述倾斜位置，所述套筒构件由所述砧座组件接合。
附图说明
下面参考附图公开本公开的倾斜砧座组件的各种实施例，其中：
图1是包括根据本公开实施例的砧座组件的手术吻合设备的侧视立体图；
图2是图1示出的砧座组件的侧视立体图，在击发手术吻合设备之后，头部组件处于第二或者倾斜位置；
图3是图2中示出的砧座组件的分解立体图；
图4是图2和图3中示出的砧座组件的凸轮卡掣构件的放大立体图；
图5是图2和图3中示出的砧座组件的固定构件的放大立体图；
图6是图2至图5中示出的砧座组件的套筒构件的侧视图；
图6A是沿着图6中示出的线6A-6A截取的截面底视图；
图6B是沿着图6中示出的线6B-6B截取的截面顶视图；
图6C是沿着图6中示出的线6C-6C截取的截面端视图；
图6D是沿着图6中示出的线6D-6D截取的截面端视图；
图7是图2至图5中示出的砧座组件的一部分的放大侧视图；
图8是图7中示出的砧座组件的一部分在移除了套筒构件时的放大侧视图；
图9是砧座组件的立体侧视图，示出了头部组件处于第一或者可操作位置；
图10是图9中示出的砧座组件处于击发前的第一或者可操作位置的侧视剖视图；
图11是图9和图10中示出的砧座组件处于击发后的可操作位置的侧视剖视图；
图12是图9至图11示出的砧座组件的剖视立体图，头部组件在第二或者倾斜位置中；
图13是图9至图12中示出的砧座组件的一部分的放大的侧视剖视图；
图14是根据本公开可选实施例的砧座组件处于第一或者可操作位置中的立体侧视图；
图15是图14中示出的砧座组件的侧视剖视图；
图16是图14和图15中示出的砧座组件的滑动构件的侧视图；
图16A是沿着图16中示出的线16A-16A截取的截面底视图；
图16B是沿着图16中示出的线16B-16B截取的截面顶视图；
图16C是沿着图16中示出的线16C-16C截取的截面端视图；
图16D是沿着图16中示出的线16D-16D截取的截面端视图；
图17是图14和图15中示出的砧座组件处于第二或者倾斜位置中的剖视立体图；
图18是图17中示出的砧座组件的侧视剖视图；
图19是根据本公开另一实施例的砧座组件处于第一或者可操作位置中的侧视剖视图；以及
图20是图19中示出的砧座组件处于第二或者倾斜位置中的侧视剖视图。
具体实施方式
现在将参考附图详细描述本公开砧座组件的实施例，在若干附图中的每个图中，类似附图标记指代相同或者对应元件。如本领域中常用的，术语“近侧”指的是靠近用户或者操作员(即外科医生或者临床医生)的部分或部件，而术语“远侧”指的是远离用户的部分或部件。
图1至图13示出了适用于手术吻合设备100的可倾斜砧座组件10，手术吻合设备100用于执行手术程序，诸如，中空的组织器官的圆形吻合以及痔疮外科手术。首先参考图1，手术吻合设备100包括近侧手柄组件102、包括弯曲的细长外管104a的细长中央主体部104、和远侧头部部分106。可替换地，在一些手术程序(例如，治疗痔疮)中，期望具有大致直的、缩短的中央主体部。主体部104和远侧头部部分106的长度、形状和/或直径可以变化以适应特定手术程序。手术吻合器100的详细说明公开于共有的美国专利第7,364,060号和第7,303,106号(“‘060专利”及“‘106专利”)，每个专利的全部内容通过引用并入本文。
参考图2至图5，砧座组件10包括头部组件12、中心杆组件14以及套筒构件15。套筒构件15构造为在手术吻合设备100击发之后，关于中心杆组件14重新定位吻合圈和/或其他组织或者障碍物(未示出)，以允许头部组件12相对于中心杆组件14枢转，而不会挤压头部组件12和中心杆组件14之间的吻合圈，如以下更详细描述的。如上描述的，吻合圈是在使用圆形吻合设备的吻合术程序期间由圆形吻合设备的环形刀具从吻合部位切断的组织。
在一个实施例中，头部组件12包括柱16、壳体18、垫构件或者垫板20、切割环22、切割环盖23、砧座板24、凸轮卡掣构件26以及固定构件27。如示出的，柱16与头部18整体地形成并且居中定位在头部18内。可替换地，柱16以及头部18可以形成为独立的部件，它们使用粘着剂、焊接或者任何其他合适的方法结合在一起。如以下进一步详细描述的，柱16包括一对凸起物16a(图8)，凸起物16a构造为接合砧座中心杆组件14以防止头部组件12相对于砧座中心杆组件14逆时针旋转。砧座板24支撑在壳体18的外环形凹槽28中(图3)，并且包括多个吻合钉变形槽30，它们用于容纳以及使吻合钉变形(未示出)。至少一个短小突出部24a从砧座板24径向向外延伸并且被纳入形成于壳体18的外缘中的切口32内。短小突出部24a和切口32的作用是将砧座板24对准或者适当地定位在壳体18的环形凹槽28内。
尤其参考图3，垫板20包括中央开口34，中央开口34关于在壳体18的内环形凹槽36内的柱16定位，位于柱16以及外环形凹槽28之间。垫板20包括隆起平台20a。切割环22包括开口22a，开口22a具有的构造与平台20a大致相同。在一个实施例中，切割环22由聚乙烯或者其他合适的塑料形成，并且使用例如粘着剂固定地稳固至垫板20以形成垫板/切割环组件。垫板20由硬质材料(例如，金属)形成。可替换地，可以使用其他材料结构来构建垫板20以及切割环22。此外，在可选方案中，垫板20以及切割环22可以形成为单个结构或者单元结构。
切割环盖23可以使用例如粘着剂稳固至切割环22的向外面向表面或者近侧表面40。切割环22以及垫板20可滑动地安装在柱16周围。垫板20包括一对向内延伸的指状物38，以下将对其进一步详细描述。固定构件27定位在内环形凹槽36内，位于垫板20以及壳体18的后壁18a之间，并防止在足以使短小突出部27a变形的预定力已经施加至垫板/切割环组件之前，垫板20以及切割环22运动或者被推动至壳体18的内环形凹槽36中。预定力可以接近但小于手术吻合设备的环形切割刀片接合例如砧座组件10的切割环时所施加的力。当达到预定力时，例如，在切割组织期间，垫板20被推入内环形凹槽36并且压缩固定构件27的短小突出部27a。
砧座中心杆组件14包括中心杆52、柱塞54以及柱塞弹簧56。中心杆52的第一端部具有限定腔室59a的一对臂59。每个臂59具有对准中心杆52的中央纵向轴线的横向通孔58。砧座头部组件12的柱16定尺寸为定位在腔室59a内并且包括横向通孔60。枢转构件62经由通孔58和60将柱16枢转地稳固至中心杆52，使得砧座头部组件12枢转地安装至砧座中心杆组件14。
尤其参考图3和图4，凸轮卡掣构件26包括具有通孔26b的主体26a。通孔26b定尺寸为容纳枢转构件62，使得凸轮卡掣构件26绕枢转构件62枢转地安装在柱16的横向狭槽72(图3)内。如图4所示，凸轮卡掣构件26包括第一主体部26c，第一主体部26c从柱16的狭槽72(图3)部分地延伸出，并且定位成由柱塞54的指状物66接合。凸轮卡掣构件26还包括边缘26f，当砧座头部12处于非倾斜或者操作位置时，边缘26f被柱塞54的指状物66推动成接合垫板20(图10)的内缘。凸轮卡掣构件26进一步包括连接部26g，连接部26g限定通孔26h，通孔26h定尺寸为容纳套筒构件15的枢转构件94(图6)，使得凸轮卡掣构件26枢转地稳固至套筒构件15。可替换地，凸轮卡掣构件26以及套筒构件15可以由枢转构件(未示出)连接，该枢转构件从凸轮卡掣构件26的连接部26g延伸出，与形成在套筒构件15中的开口(未示出)接合。
参考图10，柱塞54可滑动地定位在形成于中心杆52的第一端部中的镗孔64中。柱塞54包括接合指状物66，接合指状物66偏离砧座头部组件12的枢转轴线并且偏置成与凸轮卡掣构件26的边缘26c接合。如以下进一步详细描述的，指状物66与凸轮卡掣构件26的边缘26c的接合会挤压边缘26f抵靠垫板20的内缘及柱16，从而推动砧座头部组件12至关于中心杆52的枢转的或者倾斜的位置(图12)。在击发前位置，形成在垫板20上的指状物38定位成邻近中心杆52的顶表面52a和突起52b，以防止砧座头部组件12绕枢转构件62(图7)枢转。当砧座组件10附接至手术吻合设备100(图1)并且以‘106专利中描述的方式击发该设备时，垫板20以及切割环22被刀具刀片(未示出)沿图11中箭头“A”指示的方向推动到壳体18的在柱16周围的内环形凹槽36中。当这发生时，指状物38离开中心杆52的顶表面52a和突起52b而移入环形凹槽36中，以允许柱塞54(图11)绕枢转构件62枢转砧座头部组件12。固定构件27防止垫板20无意或者过早运动到内环形凹槽36内，从而防止砧座头部组件12的过早或无意地倾斜。
现在参考图3和图10，中心杆52的第二端部包括由多个柔性臂82限定的镗孔80。每个柔性臂82均包括开口82a，开口82a定尺寸为容纳突起，该突起形成在可拆卸套管针(未示出)等上或者连接至可拆卸套管针(未示出)等。每个柔性臂82的远侧端部均包括内肩部84(图10)，内肩部84定尺寸为可释放地接合手术吻合设备100(图1)的砧座固定器(未示出)，以将砧座组件10稳固至手术吻合设备100。多个花键86形成在中心杆52周围。花键86的作用是将砧座组件10对准手术吻合设备100的吻合钉保持部。
现在尤其参考图6至图6D，套筒构件15包括套筒主体90以及从套筒主体90向远侧延伸的凸缘92。套筒主体90是大致管状的，并且构造为容纳在中心杆组件14的中心杆52(图7)的远侧端部附近，并且横跨限定在砧座板24和壳组件108(图1)的远侧端部之间的组织间隙而延伸。套筒主体90定大小且定尺寸为，随着头部组件12相对于砧座中心杆组件14枢转，套筒主体90从当砧座组件10处于第一或者可操作位置(图9)时关于中心杆52的最远侧的第一位置，向近侧滑动(如图13中的箭头“C”所指示的)至关于中心杆52(图13)的近侧位置。
套筒主体90可选地包括分别形成在近侧以及远侧端部上的环形唇缘90a、90b。环形唇缘90a、90b构造为：在头部组件12从可操作位置枢转至倾斜位置期间，随着套筒主体90关于中心杆52向近侧运动，环形唇缘90a、90b将吻合圈和/或其他组织或者障碍物(未示出)维持在套筒主体90周围。如上描述的，在吻合术程序期间，结合在一起的组织的第一和/或第二段(未示出)可以使用荷包缝合线(未示出)稳固至砧座组件10。荷包缝合线利于对吻合圈进行定位并稳固在套筒主体90周围。套筒主体90限定凹口91，凹口91构造为当套筒主体90处于第一最远侧位置(图9)时收纳头部组件12的柱16以及凸轮卡掣构件26(图3)。套筒主体90进一步限定纵向狭槽93，纵向狭槽93构造为当套筒主体90处于第一最远侧位置(图9)时收纳砧座中心杆组件14的柱塞54的指状物66。
凸缘92从套筒主体90向远侧延伸，并且接合头部组件12的凸轮卡掣构件26。凸缘92的第一端部92a与套筒主体90形成活动铰链以允许凸缘92相对于套筒主体90挠曲。凸缘92的第二端部92b枢转地稳固至头部组件12的凸轮卡掣构件26的连接部26g(图4)。如示出的，凸缘92包括枢转构件94，枢转构件94枢转地容纳在形成于凸轮卡掣构件26的连接部26g中的通孔26h内。正如从以上注意到的，在可选实施例中，凸轮卡掣构件26可以改为包括枢转构件(未示出)，该枢转构件构造为容纳在由套筒主体90的凸缘92限定的开口(未示出)内。在头部组件12从第一位置(图9)枢转至第二位置(图12)期间，随着凸轮卡掣构件26受柱塞54的指状物66枢转，凸缘92邻近中心杆52被可滑动地支撑在套筒构件15以及凸轮卡掣构件26之间。随着凸轮卡掣构件26从第一位置枢转至第二位置，连接部26g和凸缘92之间的连接引起套筒主体90向近侧运动，如图13中的箭头“C”所指示的，从关于中心杆52的最远侧位置到达近侧位置。如上描述的，套筒主体90关于中心杆52的向近侧运动重新定位了在吻合术程序期间形成的吻合圈和/或其他组织或者障碍物(未示出)，以防止随着头部组件12枢转至倾斜位置(图12)吻合圈、组织和/或障碍物被头部组件12挤压。
参考图7和图10，当砧座组件10处于击发前的非倾斜位置时，通过固定器27将垫板20与壳体18的后壁18a隔开，并且垫板20的指状物38定位成邻近中心杆52的顶表面52a和突起52b，以防止砧座头部组件12关于枢转构件62倾斜。在非倾斜位置，套筒主体90覆盖可倾斜砧座组件10的倾斜机构，倾斜机构即头部组件12的柱16和凸轮卡掣构件26、中心杆52的臂59以及枢转构件62。
仍参考图10，柱塞54的指状物66受到弹簧56的推动而与凸轮卡掣构件26的主体部26c以及柱16接合，从而使凸轮卡掣构件26以及头部组件12绕枢转构件62沿顺时针方向推动，使得凸轮卡掣构件26的边缘26f接合垫构件20的内缘20b并且砧座头部组件12朝向倾斜位置(图12)运动。可倾斜砧座组件10的倾斜利于将砧座组件插入中空的器官内和/或从中空的器官中移除。
参考图10和图11，当砧座组件10附接至吻合设备100(图1)并且设备被击发时，吻合设备的刀具刀片(未示出)接合切割环22从而将切割环22(图3)以及垫板20沿图11的箭头“A”指示的方向移入砧座头部组件12的壳体18的环形凹槽36。当这发生时，固定器27的可变形的短小突出部27a(图3)抵靠着壳体18的后壁18a而变型，并且垫构件20的指状物38移离中心杆52的顶表面52a以及突起52b。此后，柱塞54与凸轮卡掣构件26以及随后与柱16的接合将凸轮卡掣构件36以及砧座头部组件12朝向倾斜位置(图12)旋转。应该注意的是，在击发吻合设备100(图1)时，砧座头部组件12不会立即倾斜，因为在击发时，砧座头部组件12处于靠近位置，即砧座头部组件12与手术吻合设备100(图1)的壳组件108(图1)紧密对准。这样，当砧座头部组件12和吻合设备100的壳组件108不靠近时，砧座头部组件12将开始倾斜。
参考图12和图13，随着砧座头部组件12朝向其倾斜位置枢转，柱塞54的指状物66维持凸轮卡掣构件26的表面26e接触垫板20，以防止在刀具刀片缩回时垫板20黏住刀具刀片。应该注意的是，凸轮卡掣构件的弯曲表面26e构造为消除任何间隙并且确保凸轮卡掣构件26的表面26e与垫板20之间的接触，从而在刀具刀片缩回期间以及之后将垫板20保持在适当位置，使得切割环以及垫板组件在砧座组件12倾斜期间保持在它们的正确位置。
随着砧座头部组件12朝向倾斜位置枢转，套筒构件15的凸缘92与凸轮卡掣构件26的枢转接合会引起套筒主体90关于砧座中心杆组件14的中心杆52向近侧滑动。尤其，凸轮卡掣构件26的枢转会通过凸缘92向套筒主体90施加向近侧的力，以实现套筒主体90关于中心杆52的线性运动。更具体来说，凸缘92和凸轮卡掣构件26之间的枢转接合以及形成在凸缘92和套筒主体90之间活动铰链允许凸缘92挠曲，从而将凸轮卡掣构件26的枢转运动转换为套筒主体90的近侧线性运动。以这种方式，容纳在套筒主体90周围的吻合圈和/或其他组织或者障碍物(未示出)被向近侧运动离开头部组件12，从而防止挤压头部组件12和砧座中心杆组件14之间的吻合圈和/或其他组织或者障碍物。如上描述的，分别形成在套筒主体90的近侧以及远侧端部上的环形唇缘90a、90b接合吻合圈和/或其他组织或者障碍物，以利于圈/组织/障碍物离开倾斜机构。
虽然套筒构件15的套筒主体90示出以及描述为可操作地连接至凸轮卡掣构件26，但是可以想到的是，套筒构件15的套筒主体90可以改为可操作地连接至砧座组件10的头部组件12的柱16。此外，虽然所示出的是涉及砧座组件10的，但是可以想到的是，本公开的方案可以修改为用于具有砧座头部的任何砧座组件，砧座头部能够从第一、可操作位置枢转至第二、倾斜位置。
现在参考图14至图18，根据本公开的可倾斜砧座组件的可选实施例一般示为砧座组件110。砧座组件110大致类似于上述的砧座组件10，将仅描述它们之间的不同。砧座组件110包括头部组件112、砧座中心杆组件114以及套筒构件115。
头部组件112包括壳体118和柱116。柱116包括短小突出部116a以及接合表面116b。柱116的短小突出部116a构造为当砧座组件110处于第一或者可操作位置(非倾斜位置；见图14和15)时松动地容纳在形成于套筒构件115的套筒主体190中的开口191内。柱116的接合表面116b构造为随着头部组件112相对于砧座中心杆组件114枢转而接合套筒主体190的远侧端部190b。可以想到的是，柱116可以进一步包括用于通过柱塞154(图15)的指状物166接合的凸轮表面。
套筒构件115包括套筒主体190。套筒主体190包括大致管状构件，管状构件构造为以滑动方式可滑动地容纳在砧座中心杆组件114的远侧部分附近。虽然未示出，套筒构件115可以包括形成在近侧及远侧端部190a、190b中一个或者二者周围的唇缘，以利于将吻合圈(未示出)保持在套筒主体190周围。正如从以上注意到的，套筒主体190限定了邻近远侧端部的开口191，开口191构造为选择性地容纳头部组件112的柱116的短小突出部116a。还如从以上注意到的，套筒主体190的远侧端部190b构造为在头部组件112从第一或者可操作位置(图14和图15)枢转至第二或者倾斜位置(图17和图18)期间由头部组件112的柱116的接合部116b接合。可以想到的是，柱116的接合部116b可以定形为凸轮表面。
如以上有关于砧座组件10所描述的，在紧接着击发吻合设备100之后，砧座组件110的头部组件112构造为相对于砧座中心杆组件114枢转。随着头部组件112枢转至第二、倾斜位置，形成在头部组件112的柱116上的短小突出部116a被从形成在套筒组件115的套筒主体190中的开口191内抽出。随着短小突出部116a被从开口191抽出，柱116的接合表面116b接合至套筒主体190的远侧端部190b。通过将套筒主体190与柱116的接合表面116b接合可使套筒主体190向近侧方向运动。以这种方式，容纳在套筒主体190周围的吻合圈(未示出)向近侧运动离开头部组件112，从而在头部组件112枢转至倾斜位置时，防止挤压在头部组件112以及砧座中心杆组件114之间的吻合圈和/或其他组织或者障碍物。
现在参考图19和图20，根据本公开另一实施例的可倾斜砧座组件一般示为砧座组件210。砧座组件210基本类似于上述的砧座组件10和110，因此将仅关于它们之间的不同进行描述。砧座组件210包括头部组件212以及砧座中心杆组件214。如以下进一步详细描述的，砧座组件210可以修改为与上述公开的套筒构件15(图6)、115(图16)的任意一个一起使用。
头部组件212包括壳体218、柱216和凸轮卡掣构件226。柱216以及凸轮卡掣构件226可以是一体地形成。砧座中心杆组件214包括中心杆252、柱塞254以及柱塞弹簧256。头部组件212通过枢转销262枢转地稳固至中心杆252，枢转销262容纳在由柱216和中心杆252的一对臂259所限定的横向通孔(未示出)内。凸轮卡掣构件226限定镗孔258，镗孔258还容纳枢转销262以绕枢转销262枢转地稳固凸轮卡掣构件226。
横向通孔258偏离中心杆252的中央纵向轴线“x”，即，与中心杆252的中央纵向轴线“x”横向隔开，如图19的参考标记“y”指示的。通过将枢转销262相对于中央纵向轴线“x”偏离，增加了枢转销262和柱塞254的指状物266之间的距离，如图19的参考标记“z”指示的。枢转销262和柱塞254之间距离的增加会增加由柱塞254施加至头部组件212的倾斜转矩，而不会增加中心杆252的外径。由柱塞254施加至头部组件212的倾斜转矩的增加会增加砧座组件210的头部倾斜性能。尤其，当布置在头部组件212以及砧座中心杆组件214之间的组织或者其他障碍物可能会阻止头部组件212相对于中心杆组件214枢转时，枢转销262相对于纵向轴线“x”的偏置布置允许头部组件212相对于砧座中心杆组件214枢转。
砧座组件210的操作方式类似上述砧座组件10和110。尤其，在致动手术吻合设备100(图1)之后，柱塞254的指状物266与凸轮卡掣构件226的接合会使凸轮卡掣构件226在壳体218内旋转，使得随着手术吻合设备10(图1)的刀具刀片(未示出)缩回，凸轮卡掣构件226接合垫板220以将垫板220保持在适当位置。随着头部组件212从手术吻合设备10(图1)的壳组件108(图1)移开，柱塞254的指状物266还接合头部组件212的柱216以引起头部组件212相对于砧座中心杆组件214枢转。
在可选实施例中，可以增加中心杆252的外径以收纳具有指状物(未示出)的柱塞(未示出)，该指状物与纵向轴线“x”隔开以增加枢转销262和柱塞的指状物之间的距离，从而增加由指状物施加至头部组件212的倾斜转矩。
上述公开的任何实施例可以修改为用于以下申请中公开的手术吻合仪器：提交于2012年4月12日的共有美国专利申请第13/444,998号，以及提交于2013年6月12日的美国专利申请第13/915,953号，它们的全部内容通过引用并入本文。
应理解的是，可以对本文公开的实施例做出各种修改。例如，本公开的套筒组件可以修改为用于这样的砧座组件上，砧座组件具有的头部组件能够进行120度(120°)倾斜，即在击发之前能够沿逆时针方向枢转以利于将砧座组件定位在内腔内。本领域的技术人员将想到的在附随权利要求的范围和精神内的其他改进。

Claims (10)

1.一种砧座组件，包括：
砧座中心杆组件；
头部组件，其从操作位置至倾斜位置枢转地稳固至所述砧座中心杆组件；以及
套筒，其可滑动地布置在所述砧座中心杆组件周围，所述套筒关联至所述头部组件，使得所述头部组件从所述操作位置朝向所述倾斜位置的运动引起所述套筒关于所述砧座中心杆组件向近侧运动。
2.根据权利要求1所述的砧座组件，其中，所述套筒组件包括布置在所述砧座中心杆组件周围的套筒主体和枢转地连接至所述头部组件的远侧延伸的凸缘。
3.根据权利要求1所述的砧座组件，其中，所述头部组件包括壳体、柱、垫板和凸轮卡掣构件。
4.根据权利要求3所述的砧座组件，其中，所述垫板定位成在击发手术吻合设备之前防止所述头部组件从所述非倾斜位置至所述倾斜位置的枢转运动。
5.根据权利要求4所述的砧座组件，其中，所述垫板能够运动至第二位置，以允许所述头部组件相对于所述砧座中心杆组件从所述非倾斜位置枢转运动至所述倾斜位置。
6.根据权利要求2所述的砧座组件，其中，在所述凸缘和所述套筒主体之间形成有活动铰链。
7.根据权利要求2所述的砧座组件，其中，所述头部组件包括枢转的凸轮卡掣构件，并且所述凸缘枢转地连接至所述凸轮卡掣构件。
8.根据权利要求1所述的砧座组件，其中，所述砧座头部组件包括枢转地稳固至所述砧座中心杆组件的柱，所述套筒构件可操作地接合至所述柱。
9.根据权利要求8所述的砧座组件，其中，所述套筒构件可操作地定位为：随着所述头部组件从所述操作位置枢转至所述倾斜位置，所述套筒构件由所述头部组件接合。
10.根据权利要求1所述的砧座组件，其中，所述头部组件绕枢转销枢转地稳固至所述砧座中心杆组件，其中所述枢转销偏离所述砧座中心杆的纵向轴线。
CN201410461358.4A 2013-09-11 2014-09-11 具有滑动套筒的砧座组件 Pending CN104414700A (zh)

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CN106073845B (zh) * 2015-04-29 2020-03-27 柯惠Lp公司 配有刚性切割构件的切割环组件
CN109381234A (zh) * 2017-08-08 2019-02-26 柯惠Lp公司 可倾斜钉砧组合件
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CN110313956A (zh) * 2018-03-28 2019-10-11 柯惠Lp公司 用于手术缝合器械的手术砧座组件
CN110313957A (zh) * 2018-03-28 2019-10-11 柯惠Lp公司 用于手术缝合器械的手术砧座组件
CN110313958A (zh) * 2018-03-28 2019-10-11 柯惠Lp公司 用于手术缝合器械的手术砧座组件
CN110313956B (zh) * 2018-03-28 2024-01-30 柯惠Lp公司 用于手术缝合器械的手术砧座组件
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CN113164171A (zh) * 2018-12-06 2021-07-23 柯惠有限合伙公司 具有改进的切割环组合件的砧座组合件

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US9693773B2 (en) 2017-07-04

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