CN1957852A - 构造为用于医用试剂的泵辅助输送的外科缝合器械 - Google Patents

构造为用于医用试剂的泵辅助输送的外科缝合器械 Download PDF

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CN1957852A
CN1957852A CNA2006101437497A CN200610143749A CN1957852A CN 1957852 A CN1957852 A CN 1957852A CN A2006101437497 A CNA2006101437497 A CN A2006101437497A CN 200610143749 A CN200610143749 A CN 200610143749A CN 1957852 A CN1957852 A CN 1957852A
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CN1957852B (zh
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弗雷德里克·E·谢尔顿四世
杰罗姆·R·摩根
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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
    • 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
    • A61B17/07292—Reinforcements for staple line, e.g. pledgets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00491—Surgical glue applicators
    • A61B2017/00495—Surgical glue applicators for two-component glue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00893—Material properties pharmaceutically effective
    • 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

Abstract

本发明提供了一种医用试剂分配系统和采用医用试剂分配系统的外科器械。该分配系统可被构造为与构造成用于切割和缝合组织的外科切割/缝合器械一起使用。所述分配系统可包括：构造为用于储存至少医用试剂的一种成分的至少一个储存容器和与储存容器连通的泵；与泵连通的输送管，该输送管构造为在泵的操作过程中用于容纳来自储存容器的一定量的医用试剂；和与输送管连通的至少一个试剂管，所述试剂管构造为用于与在外科器械的钉仓或砧座中形成的用于通过其分配医用试剂的至少一个试剂口连通。

Description

构造为用于医用试剂的泵辅助输送的外科缝合器械
技术领域
本发明总的涉及外科器械。本发明尤其涉及与外科器械的使用有关的医用试剂的输送和应用，以促进被切割和缝合的组织的闭合和愈合。
背景技术
传统的可用于同时在组织中形成切口并将缝合线应用到该切口的相对侧的外科缝合器在本领域是已知的。这种器械通常包括一对协作的钳口构件，当用于内窥镜或者腹腔镜应用时，这对钳口构件能够穿过插管通道。其中一个钳口构件通常容纳有钉仓，该钉仓具有至少两排横向间隔开的钉。另一个钳口构件限定了砧座，该砧座具有与钉仓中的成排钉相应地对准的钉形成槽。这种缝合器械还可包括多个往复运动楔形件，所述楔形件在被驱动时穿过钉仓中的开口并且与支承钉的驱动器接合，以便向着砧座击发钉，使钉穿过组织。
在申请号为US2004/0232196A1的美国专利申请中描述了适用于内窥镜应用的外科缝合器的例子。在所述外科缝合器的操作中，医生可在击发或者致动缝合器之前将缝合器的钳口构件闭合或者夹钳在组织上，以便定位组织。一旦医生确定钳口构件在需要的位置夹钳了组织，由医生击发该外科缝合器，以便在组织中形成切口，同时缝合切口周围的组织。缝合器的同时动作避免了并发症，而这在使用不同外科工具顺序(或者在不同时间)进行切割和缝合操作(即，一种装置用于切割组织，然后另一种装置用于缝合组织)时是经常出现的。
一般而言，将一些医用试剂应用于组织切口可促进愈合，降低感染的风险和/或促进切口的正确愈合。如果有所述医用试剂作用的辅助，许多外科缝合器可实现与增强的愈合、改善的抗感染能力和改善的组织切口的愈合有关的更好的外科结果。但是，许多传统的外科缝合器的结构和采用这些缝合器的手术不能实现医用试剂或者分配医用试剂的系统的益处。
考虑到前述问题，需要改进的外科器械和医用试剂分配系统，其能更有效和更高效地促进在涉及外科缝合器的手术期间切割和缝合的组织切口的闭合、治疗和愈合。
发明内容
根据本发明提供了医用试剂分配系统的各种实施方式。该医用试剂分配系统可构造为与构造成用于切割和缝合组织的外科切割/缝合器械一起使用。所述分配系统可包括：构造为用于储存医用试剂的至少一种成分的至少一个储存容器；和与所述储存容器连通的泵。而且，输送管可与泵连通，该输送管被构造为在泵的操作过程中用于容纳来自储存容器的一定量的医用试剂。该分配系统还可包括与输送管连通的至少一个试剂管，所述试剂管被构造为用于与在外科器械的钉仓中形成的用于通过其分配医用试剂的至少一个试剂口连通。
在本发明的一些实施方式中，医用试剂分配系统可被提供为包括构造为用于储存医用试剂的至少一种成分的至少一个储存容器，和与储存容器连通的泵。而且，输送管可与泵连通，所述输送管被构造为在泵的操作过程中用于容纳来自储存容器的一定量的医用试剂。该分配系统还可包括与输送管连通的至少一个试剂管，所述试剂管被构造为用于与在外科器械的砧座中形成的用于通过其分配医用试剂的至少一个试剂口连通。
在本发明的各种实施方式中，外科切割/缝合器械可被提供为包括医用试剂分配系统。该器械可包括手柄部分，该手柄部分具有构造为用于储存医用试剂的至少一种成分的至少一个储存容器。所述手柄部分还可包括与储存容器连通的泵。该器械还可包括与手柄部分相连的轴部分，所述轴部分包括与储存容器连通的输送管，在泵运行期间医用试剂可从储存容器输送到输送管。该器械还可包括可操作地与轴部分相连的端部执行器部分，该端部执行器可包括通道，该通道具有可拆卸地设置在其中的钉仓。所述分配系统还可包括与输送管连通的至少一个试剂管，所述试剂管从轴部分伸出，以与在钉仓中形成的用于通过其分配医用试剂的至少一个试剂口连通。
在本发明的一些实施方式中，外科切割/缝合器械可被提供为包括医用试剂分配系统。该器械可包括手柄部分，该手柄部分具有构造为用于储存医用试剂的至少一种成分的至少一个储存容器和与储存容器连通的泵。该器械还可包括与手柄部分相连的轴部分。该轴部分可包括与储存容器连通的输送管，在泵运行期间医用试剂可从储存容器输送到输送管。该器械还可包括可操作地与轴部分相连的端部执行器部分，其中端部执行器部分具有砧座。该分配系统还可包括与输送管连通的至少一个试剂管，所述试剂管从轴部分伸出，以与在砧座中形成的用于通过其分配医用试剂的至少一个试剂口连通。
更具体的说，本发明涉及如下内容：
(1)一种医用试剂分配系统，其构造为与构造成用于切割和缝合组织的外科切割/缝合器械一起使用，所述分配系统包括：
构造为用于储存医用试剂的至少一种成分的至少一个储存容器；
与所述储存容器连通的泵；
与所述泵连通的输送管，该输送管构造为在泵的操作过程中用于容纳来自储存容器的一定量的医用试剂；以及
与所述输送管连通的至少一个试剂管，所述试剂管构造为用于与在外科器械的钉仓中形成的用于通过其分配医用试剂的至少一个试剂口连通。
(2)如第(1)项所述的分配系统，其中，所述医用试剂包括止血剂。
(3)如第(1)项所述的分配系统，其中，所述医用试剂包括粘结剂。
(4)如第(1)项所述的分配系统，其中，所述泵选自包括旋转泵、蠕动泵或者隔膜泵的组。
(5)如第(1)项所述的分配系统，其中，所述输送管通过横向歧管与试剂管连通。
(6)如第(5)项所述的分配系统，其中，所述试剂管与横向歧管和多个试剂口都连通。
(7)如第(1)项所述的分配系统，还包括与所述输送管连通的至少一个第二试剂管，其中第一试剂管与在钉仓中形成的多个第一试剂口连通，第二试剂管与在钉仓中形成的多个第二试剂口连通。
(8)如第(1)项所述的分配系统，还包括大致靠近钉仓中的至少一个钉孔形成的至少一个试剂口。
(9)如第(1)项所述的分配系统，还包括与所述输送管连通的至少一个第二储存容器，该第二储存容器被构造为用于储存医用试剂的至少一种成分。
(10)如第(9)项所述的分配系统，其中，储存在第一储存容器中的成分和储存在第二储存容器中的成分被设计成结合形成医用试剂。
(11)如第(1)项所述的分配系统，还包括构造为使泵运行的电动机。
(12)一种医用试剂分配系统，其构造为与构造成用于切割和缝合组织的外科切割/缝合器械一起使用，所述分配系统包括：
构造为用于储存医用试剂的至少一种成分的至少一个储存容器，
与所述储存容器连通的泵；
与所述泵连通的输送管，该输送管构造为在泵的操作过程中用于容纳来自储存容器的一定量的医用试剂；以及
与所速输送管连通的至少一个试剂管，所述试剂管构造为用于与在外科器械的砧座中形成的用于通过其分配医用试剂的至少一个试剂口连通。
(13)如第(12)项所述的分配系统，其中，所述医用试剂包括止血剂或粘结剂中的至少一种。
(14)如第(12)项所述的分配系统，其中，所述泵选自包括旋转泵、蠕动泵或者隔膜泵的组。
(15)如第(12)项所述的分配系统，其中，所述输送管通过横向歧管与试剂管连通。
(16)如第(15)项所述的分配系统，其中，所述试剂管与横向歧管和多个试剂口都连通。
(17)如第(12)项所述的分配系统，还包括与输送管连通的至少一个第二试剂管，其中第一试剂管与在砧座的第一试剂口区块中形成的多个第一试剂口连通，第二试剂管与在砧座的第二试剂口区块中形成的多个第二试剂口连通。
(18)如第(12)项所述的分配系统，其中，所述试剂口形成于砧座的试剂口区块中。
(19)如第(18)项所述的分配系统，其中，所述试剂口形成在试剂口区块的表面上大致靠近在砧座中形成的至少一个钉容纳凹陷。
(20)一种包括医用试剂分配系统的外科切割/缝合器械，该器械包括：
手柄部分，该手柄部分具有构造为用于储存医用试剂的至少一种成分的至少一个储存容器，所述手柄部分还包括与储存容器连通的泵；
与所述手柄部分相连的轴部分，该轴部分包括与储存容器连通的输送管，在泵运行期间医用试剂可从储存容器输送到输送管；
可操作地与所述轴部分相连的端部执行器，该端部执行器包括通道，该通道具有可拆卸地设置在其中的钉仓；
与输送管连通的至少一个试剂管，所述试剂管从轴部分伸出，以与在钉仓中形成的用于通过其分配医用试剂的至少一个试剂口连通。
(21)如第(20)项所述的器械，其中，所述泵选自包括旋转泵、蠕动泵或者隔膜泵的组。
(22)一种包括医用试剂分配系统的外科切割/缝合器械，该器械包括：
手柄部分，该手柄部分包括构造为用于储存医用试剂的至少一种成分的至少一个储存容器，该手柄部分还包括与储存容器连通的泵；
与所述手柄部分相连的轴部分，所述轴部分包括与储存容器连通的输送管，在泵运行期间医用试剂可从储存容器输送到输送管；
可操作地与所述轴部分相连的端部执行器，该端部执行器包括砧座；
与输送管连通的至少一个试剂管，所述试剂管从轴部分伸出，以与在砧座中形成的用于通过其分配医用试剂的至少一个试剂口连通。
(23)如第(22)项所述的器械，其中，所述泵选自包括旋转泵、蠕动泵或者隔膜泵的组。
附图说明
包括于本说明书中并构成其一部分的附图示出了本发明的实施方式。附图与这里提供的实施方式的描述一起用于向本领域技术人员解释本发明的原理。
图1描绘了外科器械的三维的、局部剖切的且部分示意性示出的视图，该外科器械可被提供为与根据本发明的医用试剂分配系统的
实施方式相关联；
图2示出了图1的外科器械的端部执行器和轴部分的分解的三维视图；
图3包括图1的外科器械的手柄、轴和端部执行器部分的示意性描述；
图4包括图3的外科器械的轴和端部执行器的一部分的放大图；
图5包括图3的外科器械的轴和手柄部分的一部分的放大三维视图；
图6是图2的外科器械的通道的端视图；
图7包括可根据本发明的各种实施方式采用的泵的示意图；
图8包括可根据本发明的各种实施方式采用的泵的示意图；
图9包括示出了使用本发明的医用试剂分配系统的实施方式的方法的例子的各个方面的程序流程图；
图10示出了可被构造为与本发明的医用试剂分配系统的实施方式相结合的外科器械的端部执行器和轴部分的分解三维视图；
图11包括外科器械的端部执行器的放大的三维视图，其中除去了钉仓；
图12包括外科器械的轴和端部执行器的一些部分的示意图；
图13包括外科器械的轴和端部执行器的一些部分的部分切除的三维视图；
图14包括外科器械的端部执行器的三维视图；
图15包括外科器械的轴和端部执行器的一部分的三维视图；
图16包括外科器械的手柄部分和轴的示意图；以及
图17包括示出了使用本发明的医用试剂分配系统的实施方式的方法的例子的各个方面的程序流程图。
具体实施方式
在本文中使用的术语“组织”可包括各种人类或者动物的组织、膜或者其它有机基质。术语“组织”还可包括任何能够通过这里描述的外科缝合/切割器械的各种实施方式被切割和缝合的物质、基质或者物质成分。
在本文中使用的术语“医用试剂”包括可施加到组织上的各种液体化学物质、或者其它液体形式的物质成分。“医用试剂”的例子包括但不限于止血剂、修补剂、粘结剂、密封剂、抗菌剂、抗感染剂、镇痛剂和各种其它药品或者有益物质。
总体参照附图1-6，并结合本发明的各种实施方式，外科切割/缝合器械10可被构造为具有与执行部分22连接的手柄部分20。执行部分22可包括从手柄部分20向远侧伸出并终止于端部执行器26中的轴24。端部执行器26可包括致动器或者E形梁击发机构(“击发棒”)28，该致动器或者E形梁击发机构28用于控制细长通道30和包括在端部执行器26中的可枢转平移的砧座32之间的间隔。可以看出，通道30和砧座32之间的间隔可被构造为例如在由医生使用外科器械10期间促进组织的有效缝合和切割。
器械10的手柄部分20可包括手枪式握把34，可由医生向着该握把34枢转地拉动闭合触发器36，从而例如引起砧座32向着端部执行器26的通道30夹钳或者闭合。在操作过程中，可通过向着通道30闭合砧座32夹钳例如患者的组织。与闭合触发器36邻近设置的击发触发器38可沿着手枪式握把34的方向被枢转拉动，以便基本上同时缝合和切割夹钳在器械10的端部执行器26中的组织。在外科手术中，医生首先致动闭合触发器36来夹钳例如患者的组织。一旦医生对端部执行器26的定位感到满意，可将闭合触发器36拉回到靠近手枪式握把34的完全闭合和锁定位置。然后可致动器械10的击发触发器38来切割和缝合夹钳的组织。当医生除去施加在击发触发器38上的压力时，击发触发器38可弹性地返回到通常的未致动状态。可由医生按压设置在手柄部分20的近端上的释放按钮40，以便将锁定的闭合触发器36松开，使其回到通常的张开位置(如图1所示)。
在各种实施方式中，轴24的远端可包括闭合管52，其被构造为接收并容纳端部执行器26的部分组成元件，例如砧座32和通道30。闭合管52还可被构造为容纳穿过其延伸的脊骨状件骨状件(spine)54，该脊骨状件骨状件54用于支承具有设置在远侧的切割边缘58的刀干56。刀干56可操作地在其切割边缘58处与击发棒28相互作用。片簧(knife spring)60可被插入到脊骨状件骨状件54中并被构造为具有向下的弹性偏压，该向下的弹性偏压促使刀干56在脊骨状件54中的正确牢固地定位。在操作中，当器械10被击发时，通过刀杆61使刀干56及其切割边缘58运动穿过通道30，以便切割夹钳在砧座32和通道30之间的组织。通道30可被构造为将可除去的钉仓62容纳于其中。钉仓62可具有在其中形成的多个钉孔(例如作为例子示出的代表性钉孔64、66、68)，在器械10被击发时，多个钉(未示出)可被驱动穿过该钉孔，缝合切割的组织。在一些实施方式中，钉仓62可以是例如由Cincinnati，Ohio的EthiconEndo-Surgery，Inc.出售的“ETS45”或者“ETS60”六排钉仓。
在Shelton等人的题为“具有独立的不同闭合和击发系统的外科缝合器械”的美国专利申请公开中(美国专利公开号2004/023196，序列号为10/441,632，2003年5月20提交)公开了可与本发明的实施方式相关地提供的典型的外科缝合器械的结构和操作的例子，该文献的全部内容结合入本申请中作为参考。
关于与外科器械10结合提供的医用试剂分配系统的实施方式，输送管72可设置为穿过脊骨状件54沿纵向延伸，并可从器械10的手柄部分延伸到横向歧管74。一个或多个试剂管78、80可设置成与横向歧管74以及多个试剂口连通，所述多个试剂口(例如作为例子示出的试剂口82、84、86)形成于钉仓62中大致靠近钉仓62的钉孔64、66、68。试剂管78、80可被构造为与钉仓62中的试剂口82、84、86连通，如图6中的钉仓62的端视图所示。虽然显示了定位在靠近通道30的纵向中心线的两侧的一排试剂口82、84、86，可以理解，可在钉仓62中提供或多或少的所述试剂口82、84、86。例如，可提供更多试剂口82、84、86代替在钉仓62中形成的一个或多个钉孔64、66、68。在各种实施方式中，一种或多种结构，例如安装块79、81可包括在通道30中，以利于器械10中的试剂管78、80(单独的)的固定和稳定(见图1)。而且，还可以看出，当试剂管78、80穿过轴24沿纵向延伸时，试剂管78、80(诸如左手侧试剂管78，例如图4中所示的)可被设置成大致与刀干56相邻。
在各种实施方式中，手柄部分20可包括安装在手柄部分20上并与输送管72连通的一个或多个医用试剂储存容器92、94。储存容器92、94可容纳有各种医用试剂或者它们的成分，所述医用试剂或者它们的成分可通过与外科器械10结合使用的分配系统的作用被有益地施加到切割和缝合的组织上。虽然为了便于公开示出了器械10上的多个储存容器92、94，本发明的一些实施方式可仅仅采用例如一个储存容器或者两个以上的储存容器。可以看出，采用多个储存容器92、94可在医用试剂分配系统操作期间促进多成分医用试剂的实时混合。例如，多个储存容器92、94的使用便于例如与器械10中的分配系统相关地结合和使用二元粘合剂。在一些实施方式中，储存在储存容器92、94中的医用试剂可以是相同类型的医用试剂，也可以是不同类型的医用试剂。
而且，在本发明的医用试剂分配系统的各种实施方式中，电动机98可被包括于手柄部分20中，并在操作上与构造为由电动机98驱动的泵100相连。本领域技术人员将会理解，电动机98可以是任何传统的电池驱动或者AC供电的电动机，该电动机提供有电动机98的与外科器械10的运转相关的安全有效的使用说明(例如电动机额定功率)。在一些实施方式中，电动机98可通过传统电路或者元件102致动，该电路或者元件102可操作地与器械10的击发触发器38、释放按钮40和/或单独的手动致动开关102相关联。例如，电路102可被设置成与器械10的击发操作相关联地自动致动电动机98；和/或通过使用当使用器械10时可由例如医生按压的开关104手动致动电动机98。
特别参照图7和8，在一些实施方式中，例如但不作为限制，泵100可包括蠕动泵122(如图7中所示)；隔膜泵124(如图8中所示)；旋转泵；或者可适合用作根据本发明的实施方式的泵100的各种其它类型的泵。
参照图9，程序流程图示出了在组织上进行的外科手术中应用带有医用试剂分配系统的各种实施方式的器械10的方法。在步骤202中，器械10可被如上所述地击发，以便切割组织并将钉施加到在组织中形成的切口的两侧的区域上。在步骤204中，与刀干56从切割/缝合的组织的缩回相关联，电动机98可被致动，以便在步骤206中启动泵100的旋转。在步骤208中，泵100的运动从储存容器92、94中经泵100抽取一定量的医用试剂或者组合形成一定量的医用试剂的成分。在步骤210中，医用试剂由泵100驱动穿过输送管72(以及相连的管)到达横向歧管74。在步骤212中，医用试剂可被驱动穿过试剂管78、80，以便在步骤214中通过在钉仓62中形成的多个试剂口82、84、86被分配。一旦通过多个试剂口82、84、86被分配，医用试剂就可覆盖或者浸渍由在步骤202中通过器械10的作用切割和缝合的组织区域的至少一部分。
总体参照图10到16，外科切割/缝合器械10的实施方式可被构造为具有容纳并保持端部执行器26的闭合管52，该端部执行器26包括改进的砧座254和通道30。通道30可被构造成将标准钉仓256可拆卸地容纳于其中。钉仓256可具有在其中形成的成排的多个钉孔(例如作为代表性的例子示出的钉孔258、260、262、264)，当器械10被击发时，多个钉(未显示)可被驱动穿过所述钉孔，以便缝合切割的组织。在一些实施方式中，钉仓256可以是例如由Cincinnati，Ohio的Ethicon Endo-Surgery，Inc.出售的“ETS45”或者“ETS60”六排钉仓。特别如图11中所示，砧座254可包括多排钉容纳凹陷266、268、270、272，它们与钉仓256的成排钉孔258、260、262、264以对应关系设置。当器械10被击发以缝合组织时，多排钉容纳凹陷266、268、270、272用来容纳被驱动穿过钉孔258、260、262、264的钉。
对于与外科器械10结合提供的医用试剂分配系统的实施方式，输送管274可设置为穿过脊骨状件54纵向延伸到横向歧管276。一个或多个试剂管278、280可设置成与横向歧管276连通，并与在其中(分别)形成多个试剂口(例如作为例子示出的代表性试剂口286、288、290、292)的一个或多个试剂口区块282、284连通。总的说来，图12到15示出了试剂管278、280穿过脊骨状件54到达器械10的砧座254的方式。如图11中所示，试剂口区块282、284可连接于或者形成于砧座254上大致靠近在砧座254中形成的钉容纳凹陷266、268、270、272。试剂口286、288、290、292可在试剂口区块282、284的内部部分282A、284A上形成，以便最大可能地使试剂口286、288、290、292靠近钉容纳凹陷266、268、270、272。可以理解，一旦器械10被击发，钉容纳凹陷266、268、270、272靠近切割/缝合的组织。因此，在试剂口区块282、284中形成的试剂口286、288、290、292的位置和尺寸可构造为将在器械10的操作期间可由通过试剂口286、288、290、292输送的医用试剂覆盖或者浸渍的切割/缝合的组织的部分最大化。
在各种实施方式中，器械10的手柄部分20可包括一个或多个安装于其上并通过泵306与输送管274连通的医用试剂储存容器302、304。特别参照图7、8和16，泵306可例如包括但不限于，蠕动泵122(如图7中所示)；隔膜泵124(如图8中所示)；旋转泵(如图16中所示)；或者可适用于根据本发明的实施方式的各种其它类型的泵。储存容器302、304可容纳有各种医用试剂或者它们的成分，所述医用试剂或者它们的成分可通过与外科器械10结合使用的分配系统有利地施加到切割和缝合的组织上。虽然为了方便公开在器械10上示出了多个储存容器302，304，但是本发明的一些实施方式可以仅仅采用例如一个储存容器，或者两个以上的储存容器。可以看出，采用多个储存容器302、304可在医用试剂分配系统运转期间促进多成分医用试剂的实时混合。例如，一个储存容器302可容纳有第一种液体，其它储存容器304可容纳有第二种液体。第一种液体可以与第二种液体种类相同，或者所述液体可以是不同的医用试剂或者医用试剂的成分。例如，多个储存容器302、304便于设计为在器械10的试剂分配操作过程中结合的二元粘合剂的使用。在操作过程中，储存在储存容器302、304中的医用试剂可通过泵306的作用抽吸到输送管274，并被驱动穿过该输送管274。泵306通过与储存容器302、304连通的容器歧管309从储存容器302、304中抽取医用试剂。
而且，在本发明的医用试剂分配系统的各种实施方式中，电动机310可被包括于手柄部分20中，并在操作上与泵306相连，以便使泵306从储存容器302、304中抽取医用试剂。本领域技术人员将会理解，电动机310可以是任何传统的电池驱动或者AC供电的电动机，所述电动机提供电动机310的与外科器械10的操作相关的安全有效的使用说明(例如电动机额定功率)。在一些实施方式中，电动机310可如上所述地与器械10的击发触发器38、释放按钮40和/或单独的手动致动开关104相关联。另外，如上所述，例如，电路102可被构造为与器械10的击发操作相关联地自动致动电动机310；和/或通过使用当使用器械10时可例如由医生按压的开关104手动致动电动机310。
参照图17，程序流程图示出了在组织上进行的外科手术中使用带有医用试剂分配系统的各种实施方式的器械10的方法。在步骤402中，器械10可被如上所述地击发，以便切割组织并将钉施加到在组织中形成的切口的两侧的区域上。在步骤404中，与刀干56从切割/缝合的组织的缩回相联系，电动机310可被致动，以便在步骤406中启动泵306的运动。在步骤408中，泵306驱动来自储存容器302、304中的一定量的医用试剂或者结合形成一定量的医用试剂的成分，使之通过泵306(以及相连的管)。在步骤410中，医用试剂通过泵306的运动被驱动和输送穿过输送管274到达横向歧管276。在步骤412中，医用试剂可被驱动穿过试剂管278、280，以便在步骤414中通过在砧座254的试剂口区块282、284中形成的多个试剂口286、288、290、292被分配。一旦经过多个试剂口试剂口286、288、290、292分配，医用试剂就可覆盖或者浸渍在步骤402中通过器械10的作用切割和缝合的组织区域的至少一部分。
应理解，术语“近侧”和“远侧”这里用作相对定向的方便术语，诸如以握持器械手柄的医生为参照。例如，所述端部执行器26可被看作相对于“近侧”的手柄20(见图1)位于“远侧”。还应理解，出于公开的方便和清楚起见，相对定向的空间上成对的术语例如“垂直”和“水平”；或者“向下”和“向上”在这里可以附图为参照使用。但是，本领域技术人员将会理解，外科器械可以多种朝向和位置使用，所述术语并不是限制性的和绝对的。
被声称结合入本申请中作为参考的任何专利、公开文本或者其它公开的材料(全部或者部分)仅仅到这样的程度，即，所结合的材料不与在本发明的公开内容的现存定义、陈述或者其它公开的材料相冲突。照此并且是到必要的程度，这里清楚地阐述的公开内容可替代任何结合入本申请中作为参考的相矛盾的材料。被声称结合入本申请中作为参考但是与此处阐述的本发明的公开内容的现存定义、陈述或者其它公开的材料矛盾的任何材料或其部分，仅仅被包含到不引起所包含的材料与现有的公开材料相矛盾的程度。
这里提供的例子旨在向本领域技术人员解释本发明可能的和特定的实现方式。这里包括的例子没有特别的一个或多个方面必须用于对本发明的范围进行限制。
可以理解，本发明的附图和说明书已经被简化，以便阐述与清楚的理解本发明有关的元件，而出于清楚的目的排除了其它元件。但是本领域技术人员将会认识到，这些和其它元件在典型的计算机系统或者数据库系统中是需要的。然而，由于所述元件是本领域公知的，还由于它们不利于更好地理解本发明，在这里没有提供所述元件的讨论。
这里表述为用于执行特定功能的部件的任何元件旨在包括执行所述功能的任何方式，例如包括执行该功能的元件的组合。而且在本发明中，如由部件-加-功能权利要求所限定的那样，存在的事实是各种所述的部件提供的功能以由所附的权利要求书限定的方式组合并结合在一起。因此，可提供所述功能的任何部件都可被看作是这里显示的部件的等同物。
在这里公开的本发明的各种实施方式中，单个元件可被多个元件取代，并且多个元件也可被单个元件取代，来执行给定的一种或多种功能。除非所述替代不能操作来实践本发明的实施方式，所述替代也在本发明的范围内。
虽然已经通过描述一些实施方式对本发明进行了解释，虽然示例性实施方式已经描述得相当详细，申请人并不是想将所附的权利要求书的范围限制得如此详细。其它优点和修改对本领域技术人员来说是可以想到的。本发明按照内镜手术和器械进行了讨论。但是，这里使用的术语例如“内镜”不应解释为将本发明限定为仅仅与内镜导管(即套管针)结合使用的外科缝合和切割器械。相反，应认为，根据本发明构造的外科器械可用于许多外科手术中，包括但不限于腹腔镜手术和开放式手术。此外，当与其它形式的缝合器械结合使用时，本发明的实施方式的独特和新颖的方面可发现是有用的，这也不背离本发明的精神和范围。

Claims (10)

1.一种医用试剂分配系统，其构造为与构造成用于切割和缝合组织的外科切割/缝合器械一起使用，所述分配系统包括：
构造为用于储存医用试剂的至少一种成分的至少一个储存容器；
与所述储存容器连通的泵；
与所述泵连通的输送管，该输送管构造为在泵的操作过程中用于容纳来自储存容器的一定量的医用试剂；以及
与所述输送管连通的至少一个试剂管，所述试剂管构造为用于与在外科器械的钉仓中形成的用于通过其分配医用试剂的至少一个试剂口连通。
2.如权利要求1所述的分配系统，其中，所述医用试剂包括止血剂。
3.如权利要求1所述的分配系统，其中，所述医用试剂包括粘结剂。
4.如权利要求1所述的分配系统，其中，所述泵选自包括旋转泵、蠕动泵或者隔膜泵的组。
5.如权利要求1所述的分配系统，其中，所述输送管通过横向歧管与试剂管连通。
6.如权利要求5所述的分配系统，其中，所述试剂管与横向歧管和多个试剂口都连通。
7.如权利要求1所述的分配系统，还包括与所述输送管连通的至少一个第二试剂管，其中第一试剂管与在钉仓中形成的多个第一试剂口连通，第二试剂管与在钉仓中形成的多个第二试剂口连通。
8.如权利要求1所述的分配系统，还包括大致靠近钉仓中的至少一个钉孔形成的至少一个试剂口。
9.如权利要求1所述的分配系统，还包括与所述输送管连通的至少一个第二储存容器，该第二储存容器被构造为用于储存医用试剂的至少一种成分。
10.如权利要求9所述的分配系统，其中，储存在第一储存容器中的成分和储存在第二储存容器中的成分被设计成结合形成医用试剂。
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BRPI0604522A (pt) 2007-08-28
AU2006230749B2 (en) 2012-03-08
EP1782739B2 (en) 2014-03-05
US7607557B2 (en) 2009-10-27
CA2566672A1 (en) 2007-05-04
ATE470397T1 (de) 2010-06-15
EP1782739B1 (en) 2010-06-09
AU2006230749A1 (en) 2007-05-24
US20070102452A1 (en) 2007-05-10
JP5372321B2 (ja) 2013-12-18
CN1957852B (zh) 2011-06-15
EP1782739A1 (en) 2007-05-09
MXPA06012764A (es) 2007-05-03
DE602006014781D1 (de) 2010-07-22
CA2566672C (en) 2014-08-05

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