CN104902826A - 具有增大的刀间隙的外科手术钉仓 - Google Patents
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- 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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- A61B17/28—Surgical forceps
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- A61B17/295—Forceps for use in minimally invasive surgery combined with cutting implements
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Abstract
本发明涉及一种具有细长轴的外科手术器械，该细长轴具有轴远端和轴近端。端部执行器联接到轴远端并且包括相对的钳爪。其中一个钳爪中包括外壳，外壳具有外壳近端、外壳远端、上表面、具有在上表面上方延伸的横向表面的远侧停放区和延伸通过上表面的多个钉子开口。刀构件支承在外壳内用于向远侧移动。刀构件可移动到预定停止位置使得切割刀片的第一部分移置到上表面的下方而第二部分保持移置到上表面的上方。在预定停止位置中在横向面与第二部分之间有足够的横向间隙来容纳被取走的钉子。
Description
背景技术
本申请要求于2012年12月31日提交的美国临时申请No.61/747,970的权益，其通过引用并入本文。
微创外科手术技术旨在减少在诊断或外科手术程序期间受损的外部组织的数量，从而缩短患者的恢复时间、减轻患者的不适，并且减少有害的副作用。因此，对于使用微创外科技术的标准外科手术而言，可显著缩短平均的住院天数。而且，使用微创外科手术，还可缩短患者的恢复时间、减轻患者的不适、减少外科手术副作用，并且缩短离开工作的时间。
微创外科手术的常见形式为内窥镜检查，而内窥镜检查的常见形式为腹腔镜检查，腹腔镜检查为在腹腔内部的微创检查和微创外科手术。在标准的腹腔镜外科手术中，向患者的腹部吹入气体，并且插管套穿过小(大约1/2英寸或更小)切口以为腹腔镜检查器械提供入口。
腹腔镜检查外科手术器械一般包括内窥镜(例如，腹腔镜)，用于查看外科手术区和用于在外科手术部位工作的工具。除了每个工具的工作端或端部执行器通过伸缩管(又称为，例如，器械轴或主轴)与其手柄分离之外，工作工具通常类似于在常规(开腔)外科手术中使用的那些工具。端部执行器可包括，例如，夹具、抓紧器、剪刀、缝合器、烧灼工具、线性切割器或针拖。
为执行外科手术程序，外科医生通过插管套将工作工具传送到内部的外科手术部位并且从腹部的外部对它们进行操纵。外科医生从监视器中查看该过程，监视器显示从内窥镜所取的外科手术部位的图像。类似的内窥镜检查技术用于，例如，关节镜检查、后腹腔镜检查、盆腔镜检查、肾镜检查、膀胱镜检查、池囊镜检查、窦镜检查、子宫镜检查、尿道镜检查等等。
正在开发的微创远程外科手术机器人系统用于在作用于内部外科手术部位时增加外科医生的敏捷度，以及允许外科医生从远距离(在 无菌场所外部)对患者进行手术。在远程外科手术系统中，外科医生通常在控制台具有外科手术部位的图像。当查看在适当的观察器或显示器上的外科手术部位的三维图像时，外科医生通过操纵控制台的主输入或控制设备对患者执行外科手术程序。主输入设备中的每个均控制伺服机械致动/铰接的外科手术器械的运动。在外科手术程序期间，远程外科手术系统可提供具有端部执行器的各种外科手术器械或工具的机械致动和控制，端部执行器响应主输入设备的操纵为外科医生执行各种功能，例如，保持或驱动针、抓取血管、解剖组织等。
这些端部执行器的操纵和控制为机器人外科手术系统的特别有利的一方面。为此，期望提供外科手术工具，这些外科手术工具包括提供端部执行器的旋转运动的三个自由度的机构，以模仿外科医生手腕的自然动作。此类机构应具有适当的尺寸用于在微创手术中使用，并且设计要相对简单以减少可能的故障点。另外，此类机构应提供足够的运动范围以允许在各种位置操纵端部执行器。
外科手术夹紧和切割器械(例如，非机器人线性夹紧、缝合和切割设备，也称为外科手术缝合器；以及电外科血管密封设备)已经用于许多不同的外科手术程序中。例如，外科手术缝合器可用于从胃肠道中切除生癌组织或异常组织。许多已知的外科手术夹紧和切割器械，包括已知的外科手术缝合器，具有夹紧组织的相对的钳爪和切割被夹紧组织的铰接刀。
外科手术夹紧和切割器械通常被部署到限制性体腔(例如，通过到骨盆内部的插管)。因此，为最佳到达外科手术部位并且最佳可见外科手术部位，就期望外科手术夹紧和切割器械既紧凑又容易操作。然而，已知的外科手术夹紧和切割器械未能既紧凑又容易操作。例如，已知的外科手术缝合器可缺少关于多个自由度(例如，滚动、俯仰和偏转)的操作性和相关的期望运动范围。通常，已知的外科手术缝合器的俯仰运动范围比期望小，并且无偏转运动。
另外，外科手术夹紧和切割器械有时可未能完全致动(例如，由于阻塞刀路径的硬障碍物)。在这种情况下，就期望刀片不处于可表示关于从外科手术部位移除外科手术器械的危险的位置。然而，已知的外科手术夹紧和切割器械可未能避免潜在的刀危险，并且未能同时 紧凑并且可操作。
因此，相信需要改善的外科手术夹紧和切割器械以及相关的方法。此类外科手术夹紧和切割器械应当是紧凑且可操作的并且使用刀，该刀在外科手术器械未能完全致动时不表示关于从外科手术部位移除外科手术器械的危险。
发明内容
本发明公开了改善的外科手术夹紧和切割器械(例如，外科手术缝合器和电外科血管密封设备)以及相关的方法。本文所述的外科手术夹紧和切割器械使用到远侧刀运动的近端，从而使刀片定向以大大减少无意切割组织的可能性，同时在外科手术器械未能完全致动的情况下将外科手术器械从外科手术部位中移除。本文所述的外科手术夹紧和切割器械在外科手术器械腕部的远侧定位刀和相关的驱动机构，从而允许提供高可操作性的高运动腕部的使用。并且本文所述的外科手术夹紧和切割器械使用在驱动机构和刀之间的相对运动，从而减小外科手术器械的长度。进一步地，本文所述的外科手术夹紧和切割器械使用防止被移位的钉子或来自先前外科手术的钉子将刀与器械的其他部分一起卡在暴露位置的唯一特征结构。因此，防止了与无意暴露的刀片相关的偶然伤害。
因此，在一方面，本发明公开了致动在外科手术器械中的切割刀片的方法。该方法包括将具有切割刀片的刀构件支承在器械的外壳内。外壳具有带多个钉子开口的上表面、近端和远端。刀构件从外壳的近端远侧移动到外壳的远端，使得在刀构件的运动期间，刀构件暴露并且在上表面的上方。在刀构件运动期间多个钉子离开上表面。刀构件放置于在外壳远端处的预定停止位置，使得刀构件的第一部分移置到上表面的下方，而第二部分保持移置到上表面的上方。第二部分侧向面对在上表面上方延伸的停放区(garage)。在停放区与第二部分之间的预定停止位置中有足够的侧向间隙来容纳被移位的钉子。
在另一方面，本发明公开了外科手术器械。外科手术器械包括，具有轴远端和轴近端的细长轴，和联接到轴远端并且包括相对钳爪的端部执行器。外壳包括在钳爪中的其中一个中，该外壳包括外壳近端、 外壳远端、在外壳近端与远端之间延伸的上表面、具有在上表面上方延伸的横向表面的远侧停放区，和延伸通过上表面的多个钉子开口。刀构件支承在外壳内，用于远侧运动，该刀构件具有切割刀片，切割刀片经配置在刀构件远侧移动时进行切割。刀构件可移动到在外壳远端处的预定停止位置，使得切割刀片的第一部分移置到上表面的下方，而第二部分保持移置到上表面的上方。第二部分侧向面对停放区的横向面。在横向面与第二部分之间的预定停止位置中有足够的侧向间隙来容纳被移位的钉子。
在另一方面，本发明公开了外科手术器械的可拆卸附接仓。该仓包括可拆卸附接到外科手术器械的端部执行器的外壳。该外壳包括外壳近端、外壳远端、在外壳近端与远端之间延伸的上表面、具有在上表面上方延伸的横向表面的远侧停放区，和延伸通过上表面的多个钉子开口。刀构件支承在外壳内，用于远侧运动，该刀构件具有切割刀片，切割刀片经配置在刀构件远侧移动时进行切割。刀构件可移动到在外壳的远端处的预定停止位置，使得切割刀片的第一部分移置到上表面的下方，而第二部分保持移置到上表面的上方。第二部分侧向面对停放区的横向面。在横向面与第二部分之间的预定停止位置中有足够的侧向间隙来容纳被移位的钉子。
在许多实施例中，第二部分包括切割刀片的切割刀头。
在许多实施例中，停放区具有横向表面，该横向表面在预定停止位置中面向刀片的切割刀头。
在许多实施例中，在预定停止位置中，刀片的切割刀头移置到横向表面的下方。
在许多实施例中，刀构件通过驱动构件执行。
在许多实施例中，在预定停止位置中，驱动构件完全移置在外壳的远端内。
在许多实施例中，切割刀片的第二部分在处于预定停止位置时由停放区侧向保护。
在许多实施例中，在将刀构件移置到预定停止位置期间，刀构件将多个钉子中的一个钉子至少部分地拖入停放区。在刀构件处于预定停止位置时，钉子可保持在刀构件和停放区的横向表面之间，或者在 将刀构件放置到预定停止位置时，钉子可通过与停放区的至少一个钉子喷射表面碰撞而射出。
在许多实施例中，停放区包括至少一个钉子喷射表面。
在许多实施例中，至少一个钉子喷射表面横向于分叉横向面。
在许多实施例中，至少一个钉子喷射表面非平行与上表面。
在许多实施例中，至少一个钉子喷射表面关于上表面成从30°到60°范围内的角度。
在许多实施例中，在预定停止位置，驱动构件完全移置在外壳的远端内。
在许多实施例中，横向面分叉以形成凹口。
在许多实施例中，横向面成从25°到45°的角度分叉。
在许多实施例中，在预定停止位置，横向面与刀构件的第二部分间隔超过钉线的最大直径，例如，0.25mm。
附图说明
图1为根据许多实施例的正在用于执行外科手术的微创机器人外科手术系统的平面图。
图2为根据许多实施例的用于机器人外科手术系统的外科医生的控制台的透视图。
图3为根据许多实施例的机器人外科手术系统电子推车的透视图。
图4用图表示出根据许多实施例的机器人外科手术系统。
图5A为根据许多实施例的机器人外科手术系统的患者侧推车(手术机器人)的前视图。
图5B为根据许多实施例的机器人外科手术系统工具的前视图。
图6为根据许多实施例的包括端部执行器的机器人外科手术系统工具的透视图，端部执行器具有相对的夹紧钳爪。
图7为根据许多实施例的具有六行钉子的线性缝合和切割外科手术器械的拆卸附接仓的透视图。
图8为根据许多实施例的图7的仓和附接的钉子保持器的透视图。
图9为示出根据许多实施例的在图7的仓和端部执行器组件之间的附接细节的截面图。
图10为示出图7的仓的部件的分解透视图。
图11A和图11B为示出图7的仓的印刷电路组件的透视图。
图12为根据许多实施例的线性缝合和切割外科手术器械的可拆卸附接仓的截面图。
图13A为根据许多实施例的具有四行钉子的线性缝合和切割外科手术器械的可拆卸附接仓的钉子部署相关部件的部分透视图。
图13B为图13A的仓的驱动构件的透视图。
图13C包括图13A的仓的钉子推进器的透视图。
图14A示出图7的仓的外壳的远端。
图14B包括图7的仓的钉子推进器的透视图。
图14C为图7的仓的驱动构件的透视图。
图14D为图7的仓的驱动构件的平面图。
图14E为图7的仓的驱动构件的侧视图。
图14F为图7的仓的驱动构件的远端视图。
图14G示出如在图14D中限定的图7的仓的驱动构件的截面AA。
图14H示出如在图14D中限定的图7的仓的驱动构件的截面BB。
图15A为图7的仓的刀构件的透视图。
图15B为图7的仓的刀构件的侧视图。
图15C为图7的仓的刀构件的平面图。
图15D-图15G分别示出根据许多实施例的刀构件的部分侧视图。
图15H示出根据许多实施例的刀构件的顶视图。
图16A示出图7的仓的刀构件的致动。
图16B示出根据许多实施例的接纳刀构件突出部以在驱动构件的向远侧运动期间限制刀构件向远侧移动的外壳插座。
图16C示出根据许多实施例的在驱动构件向远侧驱动刀构件时，与驱动构件联接的刀构件。
图16D示出根据许多实施例的在已经沿着外壳的凸轮表面驱动刀构件的远端以使刀的远端升高从而使刀的切割刀片降低到外壳中之后，在致动行程结束时的刀构件。
图16E示出根据许多实施例的处于远侧停放区的预定停止位置的刀构件。
图17列出根据许多实施例的用于从在线性缝合和切割外科手术器械的切割刀片中部署钉子的方法以及在该外科手术器械中铰接切割刀片的方法的动作。
具体实施方式
在以下说明中，将描述本发明的各种实施例。为解释的目的，阐述了具体配置和细节，以便提供对实施例的全面理解。然而，对本领域中的技术人员也显而易见的是，本发明可在无这些具体细节的情况下进行实践。此外，为了不模糊将要描述的实施例，可省略或简化众所周知的特征结构。
微创机器人外科手术
现在参考附图，在其中相同的附图标记贯穿若干图形代表相同的部件，图1为微创机器人外科手术(MIRS)系统10的平面图解，该系统通常用于在平躺在手术台14上的患者12身上执行微创诊断或外科手术程序。该系统能够包括用于在手术期间由外科医生18使用的外科医生的控制台16。一个或多个助手20也可以参与到手术中。MIRS系统10能够进一步包括患者侧推车22(外科手术机器人)和电子推车24。在外科医生18通过控制台16查看外科手术部位的同时，患者侧推车22能够操纵至少一个可移除的被联接的工具组件26(在下文中简称为“工具”)通过在患者12身上的微创切口。外科手术部位的图像可通过诸如立体内窥镜的内窥镜28获得，其能够由患者侧推车22操纵以定向内窥镜28。电子推车24能够被用来处理外科手术部位的图像，以用于通过外科医生的控制台16随后显示给外科医生18。一次使用的外科手术工具26的数量一般取决于诊断或外科手术程序和在手术室内的空间约束以及其他因素。如果必须改变在手术期间所使用的工具26中的一个或多个，则助手20可将工具26从患者侧推车22移除，并且用来自在手术室中的托盘30的另一个工具26将其取代。
图2为外科医生的控制台16的透视图。外科医生的控制台16包括左眼显示器32和右眼显示器34，以用于将能够实现深度感知的手术部位的协调立体图呈现给外科医生18。控制台16进一步包括一个或更多个输入控制设备36，输入控制设备36进而导致患者侧推车22(如图1 所示)操纵一个或更多个工具。输入控制设备36能够提供与其关联的工具26(如图1所示)相同的自由度从而提供给外科医生远程呈现或提供输入控制设备36与工具26成为一体的感知，使得外科医生具有直接控制工具26的强烈感觉。为此，可以使用位置传感器、力传感器和触觉反馈传感器(未示出)以通过输入控制设备36将位置、力和触觉感觉从工具26传输回至外科医生的手中。
外科医生的控制台16通常位于和患者相同的房间内，使得外科医生可以直接监控手术程序，如果必要，外科医生可以亲自到场，并且直接对助手讲话而不是通过电话或其他通信媒介。不过，外科医生能够在和患者不同的房间内、完全不同的建筑物内或其他远程位置，从而允许远程外科手术程序。
图3为电子推车24的透视图。电子推车24能够与内窥镜28联接，并且能够包括处理器以用于处理捕获的图像从而用于随后在外科医生的控制台上或在位于本地和/或远程的另一台合适的显示器上显示给诸如外科医生。例如，在使用立体型内窥镜的情况下，电子推车24能够处理所捕获的图像，以将手术部位的协调立体图像呈现给外科医生。此类协调能够包括在相对的图像之间的对齐，并且能够包括调整立体型内窥镜的立体工作距离。作为另一示例，图像处理能够包括使用预先确定的相机校正参数，来补偿图像捕捉设备的成像误差，诸如光学像差。
图4图解示出机器人外科手术系统50(诸如图1中的MIRS系统10)。如上所讨论，外科医生的控制台52(诸如图1中的外科医生的控制台16)能够由外科医生使用，以便在微创手术程序期间控制患者侧推车(外科手术机器人)54(诸如图1中的患者侧推车22)。患者侧推车54能够使用成像设备，诸如立体内窥镜，来捕捉手术程序部位的图像并且将捕获的图像输出到电子推车56(诸如图1中的电子推车24)。如上所讨论，在任何随后的显示之前，电子推车56能够以各种方式处理所捕捉的图像。例如，在经由外科医生的控制台52将组合图像显示给外科医生之前，电子推车56能够用虚拟控制界面叠覆于所捕捉的图像。患者侧推车54能够将捕捉的图像输出以用于在电子推车56外部进行处理。例如，患者侧推车54能够将捕捉的图像输出到处理器 58，处理器58能够被用于处理捕捉的图像。图像也能够由电子推车56和处理器58的组合进行处理，电子推车56和处理器58能够联接在一起以便共同、相继地和/或组合地处理捕捉的图像。一个或更多个独立的显示器60也能够与处理器58和/或电子推车56联接，以用于本地和/或远程显示图像，诸如手术程序部位的图像，或其他相关图像。
图5A和图5B分别示出患者侧推车22和外科手术工具62。外科手术工具62是外科手术工具26的示例。所示患者侧推车22提供用于操纵三个外科手术工具26和成像设备28，诸如用于捕捉手术程序部位图像的立体内窥镜。具有数个机器人关节的机器人机构提供操纵。成像设备28和外科手术工具26能够被定位且操纵通过在患者身上的切口，使得运动学远程中心维持在切口处，从而最小化切口的尺寸。当外科手术工具26的远端被定位在成像设备28的视野内时，手术部位的图像能够包括外科手术工具26远端的图像。
组织抓取端部执行器
图6示出了外科手术工具70，其包括近侧底座72、器械轴74和具有钳爪78的远侧端部执行器76，钳爪78能够被铰接成抓取患者组织。近侧底座包括输入耦合器，输入耦合器经配置与患者侧推车22的对应输出耦合器接口并且被其驱动。输入耦合器与设置在器械轴74内的驱动轴驱动联接。驱动轴与端部执行器76驱动联接。
线性缝合和切割外科手术器械
图7示出了根据许多实施例的线性缝合和切割外科手术器械的可拆卸附接仓100。仓100经配置可移除地附接到端部执行器的钳爪。仓具有附接到端部执行器钳爪的近端102和设置在端部执行器钳爪的对应远端处的远端104。仓100包括六行钉子开口106、纵向狭槽108、近侧刀停放区110、远侧刀停放区112和转动输入114。在许多实施例中，钉子设置在钉子开口中的每个中以用于从其展开/部署。纵向狭槽108容纳刀构件的切割刀片(未示出)，当刀构件从近侧刀停放区110移动到远侧刀停放区112时，刀构件的切割刀片从纵向狭槽108中延伸。在操作中，钉子在仓近端102开始被部署并且一直继续到仓远端104。切割刀片运动跟着组织的缝合，以确保仅切割完全缝合的组织。图8示出了具有附接的钉子保持器116的仓100，钉子保持器116在使 用仓100之前被移除。
图9为示出根据许多实施例的将仓100附接到端部执行器118的细节的截面图。端部执行器118包括下钳爪120、上钳爪122、两个自由度的腕部124、转动驱动的夹紧机构126和弹簧加载联接件128。下钳爪120经配置容纳并且支承仓100，并且相对于弹簧加载联接件128定位仓100。上钳爪122与下钳爪120枢转联接以相对于下钳爪120铰接从而夹持组织。上钳爪122包括相对于钉子开口106配置并且定位的钉子形成凹口，以便一旦钉子被部署则将钉子成形为“B”形。
提供两个自由度的腕部124用于将端部执行器118附接到细长器械轴130，以相对于器械轴130围绕两个正交轴线铰接端部执行器118。于2010年11月12日提交的题目为“具有两个自由度的腕部的外科手术工具(SURGICAL TOOL WITH A TWO DEGREE OF FREEDOM WRIST)”的美国申请No.12/945,748(代理人案号ISRG02350/US)中公开了一种合适的具有两个自由度的腕部的细节，其全部公开通过引用在此并入本文。
转动驱动的夹紧机构126相对于下钳爪120致动上钳爪122，以将组织牢固地夹持在上钳爪与下钳爪之间。夹紧机构126由设置在器械轴130内部的第一驱动轴132转动驱动。于2010年11月12日提交的题目为“具有冗余关闭机构的端部执行器(END EFFECTOR WITH REDUNDANT CLOSING MECHANISMS)”的美国申请No.12/945,541(代理人案号ISRG02330US)中公开了可使用的合适的转动驱动夹紧机构的细节，其全部公开通过引用在此并入本文。
弹簧加载联接件128将仓100的导螺杆134转动联接于延伸轴136，延伸轴136通过由设置在器械轴130内部的第二驱动轴138驱动。弹簧加载联接件128包括螺旋弹簧140和联接件配件142。在所示的实施例中，联接件配件142使用三叶花键插座，其与转动输入114和延伸轴136的三面外表面配合。弹簧加载联接件142适应在将仓100安装到端部执行器118内时会发生的三叶花键的角偏差。弹簧加载联接件142在转动到角对准时完全接合三叶花键。导螺杆134的转动用于平移仓100的驱动构件144。所产生的驱动构件144的运动用于部署钉子并且使仓100的刀构件146向远侧前进，以沿着被部署的钉子的行的中 心切下被夹紧的组织。
端部执行器118包括第一万向接头组件148和第二万向接头组件150。第一万向接头组件148将夹紧机构126转动联接到第一驱动轴132。第二万向接头组件150将延伸轴136转动联接到第二驱动轴138。第一万向接头组件148和第二万向接头组件150中的每个均经配置通过适用于端部执行器118相对于器械轴130的俯仰和偏转范围的某一角度范围传输转矩。于2010年11月12日提交的题目为“双万向接头(DOUBLE UNIVERSAL JOINT)”的美国申请No.12/945,740(代理人案号ISRG02340/US)中公布了可使用的合适的万向接头组件的细节，其全部公开通过引用在此并入本文。
第一驱动轴132和第二驱动轴138偏离器械轴130的中心线设置，该器械轴130可独立转动。于2010年11月12日提交的题目为“用于在独立转动构件内平行驱动轴的马达接口(MOTOR INTERFACE FOR PARALLEL DRIVE SHAFTS WITHIN AN INDEPENDENTLY ROTATING MEMBER)”的美国申请No.12/945,461(代理人案号No.ISRG02360US)中公开了可用于致动第一驱动轴132和第二驱动轴138的合适驱动机构的细节，其全部公开通过引用在此并入本文。
图10为示出仓100的部件的分解透视图。所示部件包括保持器116、66、钉子152、印刷电路组件(PCA)弹簧154、PCA 156、仓体158、22、钉子推进器160、刀构件146、导螺杆134、驱动构件144、推力垫圈162、导螺母164和封盖166。仓体158具有布置成6行的66个钉子开口106，其中在纵向狭槽108的每一侧上设置3行钉子开口106。保持器116可移除地附接到仓100并且覆盖钉子开口106以便在使用仓100之前保持钉子152。钉子推进器160与钉子152配合并且与仓体158滑动配合。通过随着驱动构件144朝向远端104运动，驱动构件144的面向远端的斜表面176相对于仓体158向上驱动钉子推进器160以部署钉子152，驱动构件144沿着导螺杆134的运动导致钉子推进器160的接合。刀构件146包括近侧突出168和远侧突出170。封盖166附接到仓体158。
图11A和图11B进一步示出PCA 156和PCA弹簧154。PCA弹簧154与仓体158配合并且保持PCA 156。PCA弹簧154包括弹簧钩172， 其勾在仓体158上以保持PCA弹簧154。当仓100附接到端部执行器118时，端部执行器118的器械插脚174在PCA 156的下方滑动并且提升PCA 156，从而将PCA 156与器械插脚174电气连接并且允许使用增加的相关联的公差。然而，只要器械插脚174与PCA 156做出适当接触即可，这种布置并非关键所在。因此，在某些实施例中，PCA 156能够被放到边缘，以致所示薄片离开加载路径。PCA 156能够用于电子储存与仓100相关的识别信息、配置信息和/或使用信息。
仓100能够使用以下装配序列进行装配。首先，在仓体158处于“底部向上”取向的情况下，将钉子推进器160安装到钉子开口106内。接下来，将刀构件146安装到近侧停放区110，其中刀构件146的近侧突出168被放置在仓体158中的近侧插座中。接下来，将驱动构件144、推力垫圈162和导螺母164安装到导螺杆134上，并且导螺母134齐平地激光焊接到导螺杆134的端部。然后，将所得到的导螺杆组件安装到仓体158内，其中驱动构件144被定位在导螺杆134的近端处。接下来，将封盖166安装在仓体158上。然后，通过例如将所得到的组件浸泡到润滑剂中来润滑所得到的组件。接下来，将该组件翻转到“顶部向上”的取向并且安装PCA 156。接下来，将PCA弹簧154推到仓体158上直到PCA弹簧钩172勾住。接下来，将钉子152安装到钉子开口106内并且然后安装保持器116。最后，将数据安装到PCA 156中。
图12示出了与从开始位置(示出)到结束位置(未示出)致动刀构件146相关的仓100的部件，其中在开始位置，刀构件146由近侧停放区110遮蔽，在结束位置，刀构件146由远侧停放区112遮蔽。导螺杆134经安装用于相对于仓体158转动，并且沿着仓体158的长度延伸。驱动构件144内部带螺纹并且与导螺杆134联接，并且可滑动地安装在仓体158中用于响应导螺杆134的转动沿着导螺杆134平移。驱动构件144包括一个或多个面向远侧的斜面176，其经配置成当驱动构件144朝向仓体100的远端104前进时接合钉子推进器160。刀构件146包括切割刀片178、主体部分180、从主体部分180的相反侧延伸的近侧突出168以及也从主体部分180的相反侧延伸的远侧突出170。如将在以下更详细描述，当驱动构件144从其所示的开始位置向 远侧前进时，刀构件146相对于仓体158保持静止直到驱动构件144接触远侧突出170，然后，通过远侧突出170，刀构件146被驱动构件144向远侧驱动。在驱动构件144的向远侧行程的末尾附近，沿着仓体158的凸轮表面182驱动刀构件146的远端，从而提升刀构件146的远端以将切割刀片178降低到仓体158的上表面184下方并且进入远侧停放区112。刀构件主体部分180受到限定纵向狭槽108的仓体158的相反表面约束。刀的近侧突起168和远侧突起170从刀构件主体部分180的相反侧延伸超出纵向狭槽108的宽度，从而用来相对于仓体158和驱动构件144竖直地约束刀构件146。
图13A-13C示出根据许多实施例的具有四行钉子的线性缝合和切割外科手术器械的钉子部署相关部件。类似于仓100，内部带螺纹的驱动构件144-4与导螺杆134联接并且可滑动安装在仓体(未示出)中，用于响应导螺杆134的转动沿着导螺杆134平移。驱动构件144-4包括面向远侧的双线性斜面176-4，其在驱动构件144-4沿着导螺杆134向远侧前进时接合钉子推进器160-4。钉子推进器160-4中的每个均经配置推动单个钉子(未示出)。钉子推进器160-4中的每个均具有双线性斜表面186-6，其经配置与驱动构件144-4的相应倾斜双线性斜面176-4配合。钉子推进器160-4中的每个均具有端部188-4，端部188-4的形状设定成与在仓体中的钉子开口滑动配合。
驱动构件144-4经配置容纳刀构件146并且与刀构件146配合，从而最初相对于刀构件146向远侧移动，然后驱动刀构件146朝向仓体的远端，并且沿仓体158的远侧斜面182上推刀构件146的远端。与刀构件146配合的驱动构件144-4特征包括中央狭槽190、近侧插座192、顶表面194和远侧表面196。贯穿刀构件146从其在近侧停放区110的开始位置到在远侧停放区112的结束位置的行程，中心狭槽190容纳刀主体部分180。在驱动构件144-4向远侧驱动刀构件146时，近侧插座192容纳刀构件近侧突出168。顶表面194与近侧突出168配合以在驱动构件144-4的初始向远侧运动期间(其中驱动构件144-4相对于仓体158和刀构件146两者远侧移动)牢固地接合在近侧突出168和在仓体中的插座之间，并且经由在近侧突出168和相关联的仓体插座之间的接合，刀构件146相对于仓体158保持静止。在驱动构件144-4 相对于刀构件146的初始相对向远侧运动之后，驱动构件远侧表面196与刀构件远侧突出170配合以向远侧驱动刀构件146，并且与在纵向狭槽108的两侧上与仓体158的表面结合，在向远侧驱动刀构件146时控制远侧突出170的竖直位置。当沿凸轮表面182向上驱动刀构件146的远侧部分时，远侧突出170分离于远侧表面196，并且然后，驱动构件近侧插座192的近侧壁驱动刀构件146，其中该近侧壁与刀构件近侧突出168配合以沿着凸轮表面182驱动刀构件146，从而将切割刀片178收入远侧停放区112。
图14A示出仓体158的远端。图14B示出钉子推进器160中一个的顶视图和透视图。如图所示，钉子开口106和钉子推进器160具有互补的形状，使得钉子推进器160中的每个均容纳在钉子开口106中的一个内，用于在驱动构件144朝向仓远端104平移时响应被驱动构件144驱动而在钉子开口106内平移。
图14C-14H提供了驱动构件144的附加说明。图14C示出了驱动构件144的透视图。图14D示出了驱动构件144的顶视图。图14E示出了驱动构件144的侧视图。图14F示出了驱动构件144的远端视图。图14G示出了如在图14D中限定的截面图AA。而图14H示出了如在图14D中限定的截面图BB。
图15A-15C提供了刀构件146的附加说明。在许多实施例中，切割刀片178与刀构件主体部分180一体形成。近侧突出168和远侧突出170能够与刀构件主体部分180一体，或者通过将插脚压装到在刀构件主体部分180中的横向孔中形成。主体部分180和插脚能够由适当的材料形成，例如，17-4PH、440A、420或465不锈钢。
切割刀片178在其两侧上均斜切成开刃边缘，但是能够为具有开刃边缘的平面，或者仅在一侧上斜切而在另一个侧上开刃。可执行附加的研磨以在切割刀片178的每一侧上产生多个角。
刀构件146的配置为切割刀片178提供了稳健支撑，当切割刀片178用于切入除软组织以外的某物时，这种支撑特别有利。例如，可能发生的是，仓100用于部署钉子穿过先前缝合的组织，从而可能在切割刀片178的路径中放置现有的钉子，使得切割刀片178必须切割(或拖拽)现有的钉子。
图15D示出刀构件146的可选配置。在许多实施例中，刀构件具有带钩状尖端179的切割刀片178。钩状尖端是钝的并且充分向远侧突出越过切割刀片的最顶端切割边缘且充分地在该最顶端切割边缘上方横向突出。钩状尖端179能够有助于通过防止组织越过(climbing over)切割刀片178的高度来确保切割完整厚度的组织。钩状尖端也能够减少在设备故障使切割刀片178暴露的情况下伤害手术室工作人员的可能。
图15E示出刀构件146的另一可选配置。在许多实施例中，刀构件具有带钝尖端181的切割刀片178。钝尖端稍微向远侧突出越过(或与其共线)切割刀片179的最顶端切割边缘，不过充分地在切割刀片的最顶端上方横向突出。与图15D的切割刀片178的钩状尖端179类似，切割刀片179的钝尖端181可帮助防止组织越过并且减少意外伤害的可能。
图15F示出刀构件146的另一可选配置。在许多实施例中，刀构件具有带钝尖端的弧形切割刀片183。钝尖端稍微向远侧突出越过(或与其共线)切割刀片183的最顶端切割边缘，不过充分地在切割刀片的最顶端上方横向突出。弧形切割刀片183的钝尖端能够帮助防止组织越过并且减少意外伤害的可能。通过将组织集中并且居中在其最中心部分内，弧形切割刀片183也能够进一步有助于上述目的。经由居中动作，这也能够有助于防止组织阻塞最下部的刀片/仓界面。切割刀片183在其两侧上均斜切成开刃边缘，但是也能够是具有开刃边缘的平面，或者仅在一侧上斜切而在另一个侧上开刃。可执行附加的研磨以在切割刀片183的每一侧上产生多个角。
图15G示出刀构件146的另一可选配置。在许多实施例中，刀构件具有弧形切割刀片185，其与图15F的弧形切割刀片183大体相同，并且因此共有同样的特征。然而，弧形切割刀片185不包括钝尖端，因为在一些应用中，仅切割刀片185的弯曲就可防止组织越过。
图15H示出刀构件146的另一可选配置。在此，刀构件146与在一侧上横向延伸的插脚187一体形成。插脚187分别提供阳联接表面以用于以与图15C的插脚168和170类似的方式将刀构件146附接到仓100的其他部分。可通过以下方式来形成插脚187，例如：冲压单件 原材料以与插脚187一体形成刀构件146；将插脚187焊接/按压/粘结到分离的刀构件146；或者通过与插脚187一体模制(如果需要的话就使用附加的锻造)刀构件146。插脚187也能够在所示的相反侧上从刀构件146的两侧延伸，或者插脚能够在刀构件146的不同或相同近侧部分和远侧部分从刀构件146的每一侧延伸。形成盲孔的锯齿状表面189也可以与插脚相反地通过上述过程形成或稍后机器加工到刀构件中。锯齿状表面189分别提供阴联接表面，以用于将刀构件146附接到仓100的其他部分。应该清楚，这种插脚配置可应用到本文所公开的刀片设计中的任何一种。
图16A-16D示出了在刀构件146从其在近侧停放区110中的开始位置到其在远侧停放区112中的最终位置的致动期间的仓100的部件的相互作用/配合。图16A示出了刀构件146相对于仓体158的三个不同位置，具体为开始的最近侧位置、中间位置和恰在刀构件146的远端沿着仓体凸轮表面182被抬高之前的远侧位置。
如图16A和图16B所示，在开始的最近侧位置，驱动构件144被定位在导螺杆134的近端，而刀构件近侧突出168被置于在仓体158中的插座198内。驱动构件上表面194与刀构件近侧突出168配合以将近侧突出168保持在仓体插座198中，从而实现近侧突出168与仓体插座198之间的牢固接合。刀构件远侧突出170和刀片的远端被陷入仓体158的中央腔顶板200和导螺杆134之间，并且刀构件主体部分180被设置在纵向狭槽108内，从而相对于仓体158将刀构件146约束在基本固定的位置和取向。
从开始的最近侧位置，导螺杆134的转动沿着导螺杆134向远侧驱动驱动构件144。在驱动构件144沿着导螺杆134的向远侧运动的整个开始的“无效运动”部分，通过驱动构件上表面194，近侧突出168保持陷入仓体插座198内。当驱动构件144已经向远侧移动到其中驱动构件远侧表面196接触刀构件远侧突出170的点时，驱动构件近侧插座192就位于仓体插座198的下方，从而允许刀构件146转动，以将近侧突出168从仓体插座198转移到驱动构件近侧插座192。为促进该转移，仓体插座198的远侧表面202如图所示倾斜，从而在刀构件远侧表面196经由与刀构件远侧突出170的接触而向远侧驱动刀构件 146时，通过在近侧突出168上施加向下力分量来增强该转移。
图16C示出了在驱动构件144沿着导螺杆134的向远侧运动的“无效运动”部分之后，在驱动构件144、刀构件146和仓体158之间的相互作用。在驱动构件远侧表面196与刀构件远侧突出170接触，使得刀构件146转动从而将近侧突出168转移到驱动构件近侧插座192之后，导螺杆134的继续转动导致驱动构件144的继续向远侧运动和刀构件146的对应的继续向远侧运动。在这种继续向远侧运动期间，刀构件146受到驱动构件远侧突出170与仓体158的顶板200配合和刀构件主体部分180在仓体158的纵向狭槽108内配合二者的约束。
图16A和图16D示出了在驱动构件144沿着导螺杆134的向远侧运动的最终部分期间，在驱动构件144、刀构件146和仓体158(特别是仓体158的凸轮表面182)之间的相互作用。当驱动构件144在其沿着导螺杆134的行程末端附近向远侧前进时，刀构件146的远端与凸轮表面182接触并且随后沿着凸轮表面182被驱动直到到达在图16D中所示的结束的最远侧位置，在该位置中，驱动构件144已经到达其沿着导螺杆134的行程的末端。由于沿着向上倾斜凸轮表面182驱动刀构件146的远端，所以刀构件146近似围绕刀构件近侧突出168转动，从而使切割刀片178下降到远侧停放区112内。
图16E示出了在到达在图16D中所示的结束的最远侧位置之后，在刀构件146与仓体158之间的关系。在最远侧位置，驱动构件144将刀构件146移动到在远侧停放区112内的预定停止位置。在那个位置中，刀构件146的下部被遮罩在仓体158内，而包括尖端的上部204保持在上表面206的上方移置。然而，刀构件146上部的所有切割边缘均由远侧停放区112横向保护免于意外碰触。
远侧停放区具有横向表面208，其在此形成凹口，防止在移除仓100或以另外的方式处理仓100时用户意外割伤。这通过使用远侧停放区112的横向表面208围绕上部204的所有切割边缘来实现。此外，面向刀构件146上部的停放区112的横向表面208与刀构件146间隔得足够远(超过钉线的最大直径，例如，0.25mm)，以便在其间容纳被取出的钉子。在横向表面的最远侧部分内提供了附加间距，这使得从上方看去时横向表面类似于钥匙图案。在此为圆形的附加远侧间距 允许存放在刀构件146与横向表面208之间的钉子的直径收缩(并且因此，当将刀构件被完全带入预定停止位置时，被强制收缩)。这样，被取走的钉子能够围绕刀构件146“包绕”。
如图所示，远侧停放区112的横向表面208能够以从25°到45°范围的角度分叉，以形成V形凹口或U形凹口。与更远侧位置相比，分叉的横向表面208在它们的最近侧间隙处关于纵向狭槽108间隔更宽。当通过刀构件146使钉子与最近侧间隙接触时，该间隙允许刀构件146的切割边缘向桥接最近侧间隙的钉子施加显著的弯曲力，而较小的间隙会导致堵塞。因此，如果钉子落入且被拖拽到停放区中，则在刀构件146的上部和横向表面208之间就有足够的横向空隙来容纳钉子的截面宽度，同时允许刀构件146完全接合到预定的停止位置。因此，如果钉子以这种方式被存放，则用户安全就不会受到暴露的切割边缘的影响。
远侧停放区112还包括至少一个钉子喷射表面210。在此，钉子喷射表面210被形成为是横向于横向表面208的对称倾斜表面，类似于切面。钉子喷射表面210的虚拟平面延伸与仓体的上表面206不平行并且关于上表面206形成从30°到60°范围内的角度。在使用中，当刀构件146向远侧移动时，钉子喷射表面能够使被捕获的钉子沿着刀构件146的切割边缘向上移动，因此，在一些情况下，随着在刀构件146的顶部上推动钉子，喷射钉子。
线性缝合和切割方法
图17示出了根据许多实施例的用于从在线性缝合和切割外科手术器械的切割刀片中部署钉子的方法212和在该外科手术器械中铰接切割刀片的方法212的动作。任何适当的线性缝合和切割外科手术器械均能够被用于实践方法212。例如，本文所述的线性缝合和切割外科手术器械和仓可用于实践方法212。
在动作214中，具有切割刀片的刀构件被支撑在线性缝合和切割外科手术器械的外壳内。外壳具有近端和远端。切割刀片经配置在刀构件向远侧移动时进行切割。
在动作216中，驱动构件从外壳的近端向远侧移动到外壳的远端，使得切割刀片变得暴露。在刀构件的运动期间，多个钉子离开上表面。
在动作218中，刀构件被置于在外壳的远端处的预定停止位置。 在该位置，切割刀片的第一部分变成被移置到上表面下方。切割刀片的第二部分保持在上表面的上方，但是横向面对在上表面上方延伸的停放区。在预定停止位置中有足够的横向空隙来容纳被强制放置在刀构件与横向表面之间的被取走的钉子。
本文所公开的方法可用于任何适当的应用中。例如，本文所公开的方法可在用于开放或微创(单个端口或多端口)手术过程的手动或电动的、手持或机器人的、被直接控制或被远程控制的外科手术器械中使用。
其他变化均在本发明的精神内。因此，尽管本发明易于有各种修改和替换构造，但其某些说明的实施例在图中被示出并且已经在以上被详细描述。然而，应该清楚，并非旨在将本发明限制到具体的形式或所公开的形式，反而相反地，本发明将覆盖属于如随附权利要求所限定的本发明的精神和保护范围内的全部修改、替换的构造和等价物。
除非本文另外指出或由上下文清楚否认，否则术语“力”应解释为包括力和转矩两者(尤其在随附权利要求的上下文中)。除非本文另外指出或由上下文清楚否认，否则在描述本发明的上下文中(尤其在随附权利要求的上下文中)，术语“一种/个”和“该”和类似的指示对象的使用应解释为包括单数和复数两者。除非另有说明，否则术语“包含”、“具有”、“包括”和“含有”应解释为开放式术语(即，意味着“包括，但不限于”)。术语“被连接”应解释为部分或完全包含在、附接到或结合在一起，即使某物介入其间。除非本文另外指出，否则本文对值的范围的详述仅仅旨在用作个别地指属于范围内的每个单独值的速记法，并且每个单独值被并入到本说明书中，好似在本文被个别列举出。除非本文另外指出或由上下文另外清楚否认，否则本文描述的全部方法可以以任何合适的顺序执行。除非另外声明，否则任何和全部实例，或在此提供的示例性语言(例如，“诸如”)的使用，仅仅旨在更好地说明该发明的实施例，且并不造成对该发明保护范围的限制。在说明书中的语言均不可解释为将任何非要求的要素指定为对该发明的实践必不可少的要素。
本文描述的本发明的优选实施例，包括用于实施该发明的对发明者已知的最优模式。一旦阅读以上描述，这些优选实施例的变化对本领域 的技术人员就可变得显而易见的。发明者期望熟练的工匠视情况使用此类变化，并且发明者希望该发明除如在此所具体描述外能够得以实践。相应地，如由适用法律所允许的，本发明包括在所附权利要求中列举的主题的全部修改和等价物。此外，除非另外指出或由上下文另外清楚否认，否则在其全部可能变化中的上述要素的任何组合均由该发明包含。
通过引用并入本申请的在此援引的所有参考，包括出版物、专利申请与专利和犹如每个参考被个别且特别指出通过引用被并入是一样的程度，并且作为整体在此阐述。
Claims (35)
1.一种在外科手术器械中铰接切割刀片的方法，所述方法包括：
将具有切割刀片的刀构件支撑在所述器械的外壳内，所述外壳具有带多个钉子开口的上表面、近端和远端；
将所述刀构件从所述外壳的所述近端向远侧移动到所述外壳的所述远端，使得在向远侧移动所述刀构件期间，所述刀构件被暴露并且在所述上表面的上方，并且其中在向远侧移动所述刀构件期间多个钉子离开所述上表面；以及
将所述刀构件放置在所述外壳的所述远端处的预定停止位置，使得所述刀构件的第一部分移置到所述上表面的下方，而第二部分保持被移置到所述上表面的上方，所述第二部分横向面对在所述上表面上方延伸的停放区，其中在所述停放区与所述第二部分之间在所述预定停止位置有足够的横向空隙来容纳被取走的钉子。
2.根据权利要求1所述的方法，其中所述第二部分包括所述切割刀片的切割刀头。
3.根据权利要求2所述的方法，其中所述停放区包括横向表面，所述横向表面在所述预定停止位置中面向所述刀片的所述切割刀头。
4.根据权利要求3所述的方法，其中在所述预定停止位置中，所述刀片的所述切割刀头被移置到所述横向表面的下方。
5.根据权利要求3所述的方法，其中所述停放区包括至少一个钉子喷射表面。
6.根据权利要求1所述的方法，其中所述刀构件被驱动构件携带。
7.根据权利要求6所述的方法，其中在所述预定停止位置，所述驱动构件被完全移置到所述外壳的所述远端内。
8.根据权利要求1所述的方法，其中所述切割刀片的所述第二部分在处于所述预定停止位置时由所述停放区横向保护。
9.根据权利要求8所述的方法，其中在将所述刀构件放置到所述预定停止位置期间，所述刀构件将所述多个钉子中的一个钉子至少部分地拖入所述停放区。
10.根据权利要求9所述的方法，其中在所述刀构件处于所述预定停止位置的同时，该一个钉子保持在所述刀构件与所述停放区的横向表面之间。
11.根据权利要求9所述的方法，其中在将所述刀构件放置到所述预定停止位置的同时，该一个钉子通过与所述停放区的至少一个钉子喷射表面碰撞而被射出。
12.一种外科手术器械，其包括：
具有轴远端和轴近端的细长轴；
联接到所述轴远端并且包括相反钳爪的端部执行器；
包括在所述钳爪中的一个内的外壳，所述外壳包括外壳近端、外壳远端、在所述外壳近端与远端之间延伸的上表面、具有在所述上表面上方延伸的横向表面的远侧停放区以及延伸通过所述上表面的多个钉子开口；
被支撑在所述外壳内用于向远侧运动的刀构件，所述刀构件具有切割刀片，所述切割刀片经配置在所述刀构件向远侧移动时进行切割；以及
其中所述刀构件可移动到在所述外壳的所述远端处的预定停止位置，使得所述切割刀片的第一部分移置到所述上表面的下方，而第二部分保持被移置到所述上表面的上方，所述第二部分横向面对所述停放区的横向面，其中在所述横向面与所述第二部分之间在所述预定停止位置有足够的横向间隙来容纳被取走的钉子。
13.根据权利要求12所述的外科手术器械，其中所述第二部分包括所述切割刀片的切割刀头。
14.根据权利要求12所述的外科手术器械，其中在所述预定停止位置中，所述刀片的所述切割刀头移置到所述横向表面下方。
15.根据权利要求12所述的外科手术器械，其中所述停放区包括至少一个钉子喷射表面。
16.根据权利要求15所述的外科手术器械，其中所述至少一个钉子喷射表面横于所述分叉的横向面。
17.根据权利要求15所述的外科手术器械，其中所述至少一个钉子喷射表面不平行于所述上表面。
18.根据权利要求17所述的外科手术器械，其中所述至少一个喷射表面关于所述上表面成从30°到60°范围内的角度。
19.根据权利要求12所述的外科手术器械，其中所述刀构件被驱动构件携带。
20.根据权利要求19所述的外科手术器械，其中在所述预定停止位置，所述驱动构件被完全移置在所述外壳的所述远端内。
21.根据权利12所述的外科手术器械，其中所述横向面分叉以形成凹口。
22.根据权利21所述的外科手术器械，其中所述横向面以从25°到45°的角度分叉。
23.根据权利要求12所述的外科手术器械，其中在所述停止位置，所述横向面与所述刀构件的所述第二部分间隔超过0.25mm。
24.一种外科手术器械的可拆卸附接仓，所述仓包括：
可拆卸附接到所述外科手术器械的端部执行器的外壳，所述外壳包括外壳近端、外壳远端、在所述外壳近端与远端之间延伸的上表面、具有在所述上表面上方延伸的横向表面的远侧停放区以及延伸通过所述上表面的多个钉子开口；
被支撑在所述外壳内用于向远侧运动的刀构件，所述刀构件具有切割刀片，所述切割刀片经配置在所述刀构件向远侧移动时进行切割；以及
其中所述刀构件可移动到在所述外壳的所述远端处的预定停止位置，使得所述切割刀片的第一部分移置到所述上表面的下方，而第二部分保持被移置到所述上表面的上方，所述第二部分横向面对所述停放区的所述横向面，其中在所述横向面与所述第二部分之间在所述预定停止位置有足够的横向空隙来容纳被取走的钉子。
25.根据权利要求24所述的仓，其中所述第二部分包括所述切割刀片的切割刀头。
26.根据权利要求24所述的仓，其中在所述预定停止位置中，所述刀片的所述切割刀头移置到所述横向表面的下方。
27.根据权利要求24所述的仓，其中所述停放区包括至少一个钉子喷射表面。
28.根据权利要求27所述的仓，其中所述至少一个钉子喷射表面横于所述分叉的横向面。
29.根据权利要求27所述的仓，其中所述至少一个钉子喷射表面不平行于所述上表面。
30.根据权利要求29所述的仓，其中所述至少一个钉子喷射表面关于所述上表面成从30°到60°范围内的角度。
31.根据权利要求24所述的仓，其中所述刀构件被所述驱动构件携带。
32.根据权利要求31所述的仓，其中在所述预定停止位置，所述驱动构件被完全移置到所述外壳的所述远端内。
33.根据权利要求24所述的仓，其中所述横向面分叉以形成凹口。
34.根据权利要求33所述的仓，其中所述横向面以从25°到45°的角度分叉。
35.根据权利要求34所述的仓，其中在所述停止位置，所述横向面与所述刀构件的所述第二部分间隔超过0.25mm。
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- 2013-12-31 EP EP13867527.7A patent/EP2938273A4/en active Pending
- 2013-12-31 US US14/145,855 patent/US9498215B2/en active Active
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| WO2014106275A1 (en) | 2014-07-03 |
| US10194908B2 (en) | 2019-02-05 |
| JP2016501691A (ja) | 2016-01-21 |
| KR20150103062A (ko) | 2015-09-09 |
| JP6297060B2 (ja) | 2018-03-20 |
| EP2938273A4 (en) | 2016-08-17 |
| CN107518926B (zh) | 2020-04-17 |
| JP2019217416A (ja) | 2019-12-26 |
| US9498215B2 (en) | 2016-11-22 |
| JP6887472B2 (ja) | 2021-06-16 |
| US20170079651A1 (en) | 2017-03-23 |
| CN107518926A (zh) | 2017-12-29 |
| EP2938273A1 (en) | 2015-11-04 |
| US10918387B2 (en) | 2021-02-16 |
| CN104902826B (zh) | 2017-10-27 |
| JP2018086380A (ja) | 2018-06-07 |
| US20140183244A1 (en) | 2014-07-03 |
| JP6602411B2 (ja) | 2019-11-06 |
| KR102194979B1 (ko) | 2020-12-28 |
| US20190133579A1 (en) | 2019-05-09 |
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