CN203564287U - 末端执行器、外科手术器械和荷包钳 - Google Patents
末端执行器、外科手术器械和荷包钳 Download PDFInfo
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Abstract
本实用新型涉及医疗器械技术领域，公开了一种末端执行器、外科手术器械和荷包钳，以简化对管腔组织进行外科手术的操作过程，减少手术时间，减轻给手术病人带来的创伤。末端执行器包括：第一钳臂和第二钳臂；缝合机构，设置在第一钳臂和第二钳臂的纵向方向的一侧；荷包缝合机构，设置在第一钳臂和第二钳臂的纵向方向的另一侧；切割机构，设置在缝合机构和荷包缝合机构之间；荷包缝合机构包括：第一钳臂上设置的第一缝钉钉匣，第二钳臂在钳口闭合时与第一缝钉钉匣对应的位置处设置的第一缝钉钉砧，第一缝钉钉匣沿纵向方向上包括内部设置有第一缝钉的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉的开口区域。
Description
技术领域
本实用新型涉及医疗器械技术领域，特别是涉及一种末端执行器、一种外科手术器械和一种荷包钳。
背景技术
胃肠道手术通常需要切断闭合组织管腔，并在断开的一侧管腔处进行荷包缝合，荷包缝合处用于配合安装圆型缝合器的钉砧，以便使用圆型缝合器进行后续的缝合等操作。
荷包缝合是外科手术中一种常见的缝合技术，已知存在两种主要的荷包缝合的方式。一种方式是手工进行荷包缝合，如图1a、图1b所示，医生先围绕管腔组织59的切口用荷包针带着荷包线58穿过组织表面，再收紧荷包线58即可完成荷包缝合。手工缝合的方式操作复杂，操作精度较难把握，并且易因脱线导致缝合失败，目前在外科手术中已经很少被采用。
另一种方式是使用荷包钳辅助进行荷包缝合。如图2a所示，一种荷包钳同样是利用穿针（即荷包针）带线（即荷包线58）的方式进行荷包缝合。
如图2b所示，还有一种荷包钳是通过荷包钉57将荷包线58附着到管腔组织59表面而进行荷包缝合，通常的方式是击发荷包钉57而使其刺入并固定到管腔组织59，而荷包线58或者与荷包钉57之间相互连接，或者被荷包钉57压在管腔组织59和荷包钉57之间，从而将荷包线58附着到管腔组织59，以实现荷包缝合。
通常在对管腔组织进行手术时，除需要对管腔组织的保留端切口进行荷包缝合外，还需要对其病变端进行切割、缝合。而现有荷包钳功能单一，只能完成对保留端的荷包缝合，无法实现对病变端的切割缝合。因此至少还需要配合使用其他切割缝合器等手术器械，更换手术器械的操作较为繁琐，这会导致手术时间较长，增加手术风险以及给手术病人带来的痛苦。
而且，二十世纪八十年代出现了腔镜手术，其为一种主要透过内窥镜及各种显像技术而使外科医生在无需对患者造成巨大伤口的情况下施行手术。相对于开放式手术而言，腔镜手术具有对组织破坏小、术后恢复快等显著的优势，从而成为发展的趋势。在这种情况下，出现了用于腔镜手术的荷包钳，现有的用于腔镜手术的荷包钳同样存在上述功能单一的问题。
实用新型内容
本实用新型的第一个目的是提供一种末端执行器，以简化对管腔组织进行外科手术的操作过程，减少手术时间、手术风险以及患者的痛苦，进一步还可以用于腔镜手术。该末端执行器包括：第一钳臂和第二钳臂，第一钳臂和第二钳臂能够在张开闭合机构的作用下相对运动，以使第一钳臂和第二钳臂所形成的钳口张开或闭合；缝合机构，缝合机构设置在第一钳臂和第二钳臂的纵向方向的一侧；荷包缝合机构，荷包缝合机构设置在第一钳臂和第二钳臂的纵向方向的另一侧；切割机构，切割机构设置在缝合机构和荷包缝合机构之间；荷包缝合机构包括：第一钳臂上设置的第一缝钉钉匣，第二钳臂在钳口闭合时与第一缝钉钉匣对应的位置处设置的第一缝钉钉砧，第一缝钉钉匣沿纵向方向上包括内部设置有第一缝钉的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉的开口区域，第一缝钉能够由第一缝钉推钉机构击发。
在该技术方案中，末端执行器一侧的缝合机构可实现组织的缝合，另一侧的荷包缝合机构可实现组织的荷包缝合，而在缝合机构和荷包缝合机构之间的切割机构则可实现组织的切割，可见，使用本实用新型所提供的末端执行器可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，与现有技术相比，大大简化了对管腔组织进行外科手术的操作过程，减少了手术时间，减轻了给手术病人带来的创伤。
本实用新型的第二个目的是提供一种外科手术器械，包括：手柄和被手柄驱动的如前述技术方案的末端执行器。由于末端执行器具有上述效果，因此该外科手术器械可大大简化对管腔组织进行外科手术的操作过程，减少手术时间，减轻给手术病人带来的创伤。
本实用新型的第三个目的是提供一种荷包钳，该荷包钳包括：第一钳臂和第二钳臂，第一钳臂和第二钳臂能够在张开闭合机构的作用下相对运动，以使第一钳臂和第二钳臂所形成的钳口张开或闭合；荷包缝合机构，包括：第一钳臂上设置的第一缝钉钉匣，第二钳臂在钳口闭合时与第一缝钉钉匣对应的位置处设置的第一缝钉钉砧，第一缝钉钉匣沿纵向方向上包括内部设置有第一缝钉的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉的开口区域，第一缝钉能够由第一缝钉推钉机构击发。
当第一缝钉钉匣内的第一缝钉被全部击发后，管腔组织保留端的切口与缝合区域相对应的部分被缝合，管腔组织保留端的切口与开口区域相对应的部分未被缝合，实现了管腔组织保留端的荷包缝合，并且缝钉与管腔组织的连接较牢靠，有效地降低了荷包钉脱落造成的荷包缝合风险，因此，该荷包钳大大提高了手术的安全性。
附图说明
图1a为管腔组织荷包缝合的截面示意图；
图1b为管腔组织在荷包线收紧后的主视图；
图2a为现有一种荷包钳荷包缝合原理示意图；
图2b为现有另一种荷包钳荷包缝合原理示意图；
图3a为本实用新型实施例的末端执行器立体结构示意图；
图3b为本实用新型实施例的末端执行器钳口闭合时的半剖视结构示意图；
图3c为本实用新型实施例的末端执行器在手术操作时钳口张开的结构示意图；
图3d为本实用新型实施例的末端执行器在手术操作时钳口闭合的截面结构示意图；
图3e为本实用新型实施例的末端执行器的内部结构三维示意图（组织缝合侧，缝钉部分被击发）；
图4为进行切割、组织缝合和荷包缝合后的管腔组织示意图；
图5a为荷包缝合后的管腔组织与圆形缝合器钉砧配合的三维示意图；
图5b为通过圆形缝合器进行管腔组织缝合的三维示意图；
图6为本实用新型实施例的外科手术器械结构示意图。
附图标记：
57-荷包钉 58-荷包线 59-管腔组织
10a-第一钳臂 10b-第二钳臂 11-缝合机构
12-荷包缝合机构 13-切割机构 14-第一缝钉钉匣
15-圆形缝合器钉砧 16-第一缝钉推钉滑块 17-第一缝钉
18-第一缝钉钉砧 19-第二缝钉钉匣 20-第二缝钉
21-第二缝钉推钉滑块 22-第一缝钉推钉器 23-切割刀
24-刀槽 25-第二缝钉钉砧 26-手柄
27-末端执行器 28-细长体 29-传动机构
30-第二缝钉推钉器 31-闭合凸缘
具体实施方式
为了使用同一器械便能够完成荷包缝合、切割和缝合，简化对需要进行荷包缝合的组织（特别是管腔组织）进行外科手术的操作过程，减少手术时间、风险以及患者的痛苦，进一步地能够用于腔镜手术，本实用新型实施例提供了一种末端执行器和一种外科手术器械。在本实用新型技术方案中，末端执行器一侧的缝合机构可实现组织的缝合，另一侧的荷包缝合机构可实现组织的荷包缝合，而在缝合机构和荷包缝合机构之间的切割机构则可实现组织的切割，使用本实用新型实施例所提供的末端执行器或外科手术器械可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，大大简化了对管腔组织进行外科手术的操作过程，减少了手术时间，进一步还可用于腔镜手术。为使本实用新型的目的、技术方案和优点更加清楚，以下举实施例对本实用新型作进一步详细说明。
如图3a至图3d所示，本实用新型实施例的末端执行器，包括：
第一钳臂10a和第二钳臂10b，第一钳臂10a和第二钳臂10b能够在张开闭合机构的作用下相对运动，以使第一钳臂10a和第二钳臂10b所形成的钳口张开或闭合；
缝合机构11，缝合机构11设置在第一钳臂10a和第二钳臂10b的纵向方向的一侧；
荷包缝合机构12，荷包缝合机构12设置在第一钳臂10a和第二钳臂10b的纵向方向的另一侧；
切割机构13，切割机构13设置在缝合机构11和荷包缝合机构12之间；
荷包缝合机构12包括：
第一钳臂10a上设置的第一缝钉钉匣14，第二钳臂10b在钳口闭合时与第一缝钉钉匣14对应的位置处设置的第一缝钉钉砧18，第一缝钉钉匣14沿纵向方向上包括内部设置有第一缝钉17的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉17的开口区域，第一缝钉17能够由第一缝钉推钉机构击发。
在本实用新型各实施例中，“远侧”指该器械被操作时远离使用者的一侧，“近侧”则指该器械被操作时靠近使用者的一侧。“前进”指向远离使用者的方向运动，“后退”则指向靠近使用者的方向运动。本实用新型实施例所提供的末端执行器可以配合驱动机构使用，由驱动机构来提供驱动力。驱动机构的具体结构形式不限，例如，可以直接将现有切割缝合器前端的末端执行器卸下，将本实用新型实施例所提供的末端执行器装上，由现有切割缝合器的驱动机构为张开闭合机构、缝合机构、荷包缝合机构和切割机构提供驱动力。此外，也可以为本实用新型实施例所提供的末端执行器另外设计驱动机构。
本实用新型实施例所提供的末端执行器按照功能可划分为张开闭合机构、缝合机构、荷包缝合机构及切割机构四部分。其中，张开闭合机构用于实现末端执行器的两个钳臂所形成的钳口的张开和闭合，使用时可以驱动钳口张开以将待手术的管腔组织置于其中，然后驱动钳口闭合将管腔组织夹紧以进行荷包缝合、切割、缝合等手术动作，并且当手术动作结束后，可以驱动钳口再次张开以释放组织。切割机构用于实现对组织的切割功能，可以将管腔组织的病变端及保留端切割分离。缝合机构用于实现对组织的缝合功能，可以在管腔组织病变端的切口处进行缝合。荷包缝合机构用于实现对组织的荷包缝合功能，可以在管腔组织保留端的切口处进行荷包缝合，以在后续操作中配合安装圆型缝合器的钉砧，使用圆型缝合器进行缝合等操作。
在本实施例中，在管腔组织保留端的切口处进行荷包缝合后(如图4所示)，将管腔组织病变端的病变组织切除利用管腔组织本身的弹性，如图5a和图5b所示，使圆型缝合器钉砧15通过管腔组织59保留端的开口处进入管腔组织59保留端的内部，并配合圆型缝合器实现管腔组织的端端缝合，由于该技术为本领域技术人员所熟知，因此这里不再详细赘述。下面将分别进一步详细说明这四部分的结构。
在本实用新型实施例的末端执行器中，张开闭合机构、缝合机构、荷包缝合机构和切割机构中可以至少两者被同步驱动；也可以是，张开闭合机构、缝合机构、荷包缝合机构和切割机构被分别驱动。可以根据不同的驱动方式来设计末端执行器的具体结构。
张开闭合机构：
在本实用新型的各实施例中，第一钳臂10a和第二钳臂10b可相对运动，可以均为可转动的活动钳臂；或者，第一钳臂10a为不可转动的固定钳臂，第二钳臂10b为可转动的活动钳臂；或者，第二钳臂10b为不可转动的固定钳臂，第一钳臂10a为可转动的活动钳臂。无论是只有一个活动钳臂还是两个均为活动钳臂，只要两个钳臂能够被驱动使两个钳臂形成的钳口张开和闭合即可。
本实用新型的末端执行器的张开闭合机构可采用现有切割缝合器的末端执行器的张开闭合机构的各种技术方案来实现，例如，套管式张开闭合方案、工字梁式张开闭合方案等。
例如，张开闭合机构可包括闭合杆，闭合杆远侧端设置有闭合凸缘，第一钳臂和第二钳臂之间设置有压簧，当闭合杆被驱动而纵向向远侧运动时，闭合凸缘啮合第一钳臂和/或第二钳臂上的闭合面，使得钳臂克服压簧的弹力而闭合，当闭合杆回退时，钳口可在压簧的复位作用下张开。当闭合杆被驱动而纵向向远侧运动时，闭合凸缘可以仅啮合第一钳臂或第二钳臂上的闭合面，但为了获得较平衡的受力，优选的，闭合凸缘同时啮合第一钳臂和第二钳臂上的闭合面。
其中，闭合杆可以与用于击发第一缝钉的第一缝钉推钉杆、击发第二缝钉的第二缝钉推钉杆或用于驱动切割刀的刀杆为一体结构或者为不同部件相互连接；闭合杆、第一缝钉推钉杆、第二缝钉推钉杆或刀杆也可以分别是不同的部件；闭合杆还可与第一缝钉推钉杆、刀杆和第二缝钉推钉杆中的任意两者为一体结构或者为不同部件相互连接；此外，也可以是闭合杆与第一缝钉推钉杆、刀杆和第二缝钉推钉杆为一体结构（可称为驱动杆）或者为不同部件相互连接。
请结合图3a和图3e所示，在本实用新型的一个具体实施例中，切割刀23与刀杆是一体结构并作为张开闭合机构的闭合杆，第一钳臂10a和第二钳臂10b之间设置有压簧（图中未示出），闭合杆的远侧端在活动钳臂背离钳口的一侧固定有平行于切割方向的闭合凸缘31；当闭合杆前进时，闭合凸缘31推动活动钳臂转动至钳口闭合，当闭合杆后退时，压簧推动活动钳臂转动至钳口打开。这里需要说明的是，在关闭钳口时闭合凸缘31所走的行程并不需要很大。
切割机构：
本实用新型的末端执行器的切割机构可采用现有的切割缝合器的末端执行器的切割机构的各种技术方案来实现。
例如，结合图3a所示，切割机构可包括切割刀23，切割刀23能够在推刀机构的作用下在缝合机构和荷包缝合机构之间运动，以将分别进行缝合的和荷包缝合的组织切割分离，推刀机构可以是推刀杆或其他部件,切割刀23与推刀机构可以是一体的也可以是分体的（此时，切割刀23设置在推刀机构的远侧）。第一钳臂和第二钳臂设置有容纳切割刀23运动的刀槽24（如图3a所示，由于视图角度原因，第二钳臂10b的刀槽图中未示出），以为切割刀23的运动提供导向，使切割运动更加平稳、准确。
缝合机构：
本实用新型的末端执行器的缝合机构可采用现有切割缝合器的末端执行器的缝合机构的各种技术方案来实现。
例如，如图3a所示，并结合图3d和图3e所示，缝合机构可设置在两个钳臂的纵向方向的一侧，一个钳臂设置第二缝钉钉砧25，另一个钳臂设置第二缝钉钉匣19，第二缝钉钉匣19中设置第二缝钉20，第二缝钉20可沿纵向方向设置为一排或多排，第二缝钉20能够由第二缝钉推钉机构击发。用于击发第二缝钉20的第二缝钉推钉机构可包括第二缝钉推钉杆(该实施例中，切割刀23的刀杆作为第二缝钉推钉杆)、第二缝钉推钉滑块21和第二缝钉推钉器30。击发过程可以是第二缝钉推钉杆向远侧纵向运动而驱动第二缝钉推钉滑块21，第二缝钉推钉滑块21的斜面作用于第二缝钉推钉器30而使其横向运动，继而由第二缝钉推钉器30将第二缝钉20推出第二缝钉钉匣19、穿过管腔组织59并抵压第二缝钉钉砧25，第二缝钉20在第二缝钉钉砧25的作用下成型为B字状，从而完成缝合。
第二缝钉20的排数不限，但至少应为一排，优选至少为两排，这样，可在管腔组织的病变端进行至少两道缝合，大大减少了缝合失败的风险。当第二缝钉20沿纵向设置为多排时，可以仅设置一个第二缝钉推钉滑块21推动前方的多个第二缝钉推钉器30。
当切割刀23的刀杆作为第二缝钉推钉杆时，切割刀23的位置可设置为相对于第二缝钉推钉滑块21更加靠后（即更加靠近近侧），使得先缝合后切割，这样可以减少病变端内部组织外流，提高手术的成功率。在一实施例中，第二缝钉推钉滑块21被切割刀23的刀杆推动，在切割刀23的刀刃对组织进行切割之前，第二缝钉推钉滑块21的斜面已经推动前方的第二缝钉推钉器30将第二缝钉20击发，也就是先将前方的管腔组织缝合，因此，切割刀23总是在组织缝合之后才进行切割。
荷包缝合机构：
荷包缝合机构可设置在两个钳臂的纵向方向的另一侧，也就是与缝合机构相对的一侧。
优选的，第一缝钉17沿纵向方向设置至少两排，具体的排数不做限制，这样，可在管腔组织保留端的切口处与两个缝合区域所对应的部分进行至少两道缝合，大大减少了荷包缝合失败的风险。当第一缝钉17沿纵向设置为多排时，可以仅设置一个第二缝钉推钉滑块21推动前方的多个第一缝钉推钉器22。如图4所示的一个实施例中，第一缝钉17沿纵向方向设置三排。
如图3d所示，并结合图3a和3e所示，第一缝钉推钉机构包括：第一缝钉推钉杆、第一缝钉推钉滑块16和第一缝钉推钉器22，当第一缝钉推钉杆向远侧纵向驱动第一缝钉推钉滑块16时，第一缝钉推钉滑块16的斜面横向驱动第一缝钉推钉器22，使第一缝钉推钉器22将第一缝钉17推出第一缝钉钉匣14并在第一缝钉钉砧18的作用下成型。
第一缝钉推钉机构和第二缝钉推钉机构可以被同步驱动，第一缝钉推钉杆和第二缝钉推钉杆与切割刀的刀杆为一体结构（第一缝钉推钉杆、第二缝钉推钉杆和刀杆也可以为不同部件相互连接），第一缝钉推钉滑块16和第二缝钉推钉滑块21为一体结构（或者为不同部件相互连接），例如，推钉滑块被纵向驱动时，推钉滑块可驱动第一缝钉推钉器22和第二缝钉推钉器30，使设置于第一缝钉钉匣14和第二缝钉钉匣19内的缝钉分别被击发。此外，第一缝钉推钉机构和第二缝钉推钉机构可以是相互独立、被分别驱动的两个机构，这时第一缝钉推钉杆和第二缝钉推钉杆分别是不同的部件，第一缝钉推钉滑块和第二缝钉推钉滑块分别是不同的部件。
第一缝钉和第二缝钉可以是结构相同的部件，此外，第一缝钉钉砧和第二缝钉钉砧也可以是结构相同的部件，第一缝钉推钉器和第二缝钉推钉器也可以是结构相同的部件，第一缝钉推钉滑块和第二缝钉推钉滑块也可以是结构相同的部件。
在本实用新型实施例的技术方案中，闭合杆、第一缝钉推钉杆、刀杆和第二缝钉推钉杆可以为一体结构或者为不同部件相互连接以实现同步驱动，例如，在一实施例中，闭合杆、第一缝钉推钉杆、刀杆和第二缝钉推钉杆为一体结构，可称为驱动杆。使用时，驱动杆向远侧运动以进行驱动，首先驱张开闭合机构以闭合钳臂，随着驱动杆的进一步运动，缝合机构和荷包缝合机构被驱动，第一缝钉钉匣中的第一缝钉被依次击发后，管腔组织保留端的切口与两个缝合区域所对应的部分实现缝合，管腔组织保留端的切口与开口区域所对应的部分未实现缝合，即实现了管腔组织保留端的荷包缝合，第二缝钉钉匣内的第二缝钉被依次击发以实现管腔组织病变端的切口处的缝合，同时切割刀在驱动杆的推动下在缝合机构和荷包缝合机构之间对组织进行切割，从而同时完成了切割、缝合和荷包缝合（进行切割、组织缝合和荷包缝合后的管腔组织如图4所示，其中，箭头所示方向为管腔组织的长度方向），这更加简化了对管腔组织进行外科手术的操作过程，减少了手术时间，从而进一步减轻了给手术病人带来的创伤。并且，由于缝钉与管腔组织能够较牢靠地连接，大大改善了荷包缝合的可靠性，提高了手术的安全性。
综上，在本实用新型技术方案中，末端执行器一侧的缝合机构可实现组织的缝合，另一侧的荷包缝合机构可实现组织的荷包缝合，而在缝合机构和荷包缝合机构之间的切割机构则可实现组织的切割，可见，使用本实用新型实施例所提供的末端执行器可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，与现有技术相比，大大减少了更换手术器械的频率，简化了对管腔组织进行外科手术的操作过程，减少了手术时间，减轻了给手术病人带来的创伤。
需要说明的是，在本实用新型的各个实施例中，末端执行器的规格尺寸不限，可以根据具体手术需要进行设计。例如，当末端执行器为具有腔镜规格的末端执行器时，可以配合腔镜使用，使手术兼具安全性高、创面小、痛楚少、恢复快等优点。
如图6所示，本实用新型实施例还提供了一种外科手术器械，包括：手柄26和被手柄26驱动的如前述任一实施例的末端执行器27。
该实施例中还包括内部设置有传动机构29的细长体28，手柄26的远侧通过细长体28与末端执行器27连接，手柄26驱动传动机构29，传动机构29进而将驱动传递给末端执行器27，以为其张开闭合、缝合、切割和荷包缝合提供驱动。具有该结构的外科手术器械可以配合腔镜使用，使手术兼具安全性高、创面小、痛楚少、恢复快等优点。
使用本实用新型实施例所提供的外科手术器械可实现管腔保留端组织的荷包缝合，以及病变端组织的切割和缝合，与现有技术相比，大大简化了对管腔组织进行外科手术的操作过程，减少了手术时间，减轻了给手术病人带来的创伤，进一步还可以用于腔镜手术。
本实用新型实施例还提供了一种荷包钳，包括：
第一钳臂和第二钳臂，第一钳臂和第二钳臂能够在张开闭合机构作用下相对运动，以使第一钳臂和第二钳臂所形成的钳口张开或闭合；
荷包缝合机构，包括：第一钳臂上设置的第一缝钉钉匣，第二钳臂在钳口闭合时与第一缝钉钉匣对应的位置处设置的第一缝钉钉砧，第一缝钉钉匣沿纵向方向上包括内部设置有第一缝钉的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉的开口区域，第一缝钉能够由第一缝钉推钉机构击发。
当第一缝钉钉匣内的第一缝钉被全部击发后，管腔组织保留端的切口与两个缝合区域所对应的部分实现缝合，管腔组织保留端的切口与开口区域所对应的部分未实现缝合，进而实现了管腔组织保留端的荷包缝合。
第一缝钉推钉机构包括：第一缝钉推钉杆、第一缝钉推钉滑块和缝钉推钉器，当第一缝钉推钉杆向远侧纵向驱动所述第一缝钉推钉滑块时，第一缝钉推钉滑块的斜面横向驱动第一缝钉推钉器，使第一缝钉推钉器将第一缝钉推出第一缝钉钉匣并在相对应的第一缝钉钉砧的作用下成型。
优选的，第一缝钉沿纵向方向设置为至少两排。各实施例中的有益效果如前，这里不再重复说明。
本实用新型实施例所提供的荷包钳，钳臂张开闭合机构的具体形式不限，例如，可采用与前述末端执行器类似的结构形式，也可采用普通手术钳的结构形式，第一钳臂和第二钳臂铰接，通过操作者手动操作两个握柄将钳口闭合。当采用与前述末端执行器类似的结构形式时，张开闭合机构和荷包缝合机构可以被同步驱动，这时闭合杆和第一缝钉推钉杆可以为一体结构，或不同部件相互连接以实现同步驱动，此外，张开闭合机构和荷包缝合机构也可以被分别驱动。
显然，本领域的技术人员可以对本实用新型进行各种改动和变型而不脱离本实用新型的精神和范围。这样，倘若本实用新型的这些修改和变型属于本实用新型权利要求及其等同技术的范围之内，则本实用新型也意图包含这些改动和变型在内。
Claims (21)
1.一种末端执行器，其特征在于，包括：
第一钳臂(10a)和第二钳臂(10b)，所述第一钳臂(10a)和所述第二钳臂(10b)能够在张开闭合机构的作用下相对运动，以使所述第一钳臂(10a)和所述第二钳臂(10b)所形成的钳口张开或闭合；
缝合机构(11)，所述缝合机构(11)设置在所述第一钳臂(10a)和所述第二钳臂(10b)的纵向方向的一侧；
荷包缝合机构(12)，所述荷包缝合机构(12)设置在所述第一钳臂(10a)和所述第二钳臂(10b)的纵向方向的另一侧；
切割机构(13)，所述切割机构(13)设置在所述缝合机构(11)和所述荷包缝合机构(12)之间；
所述荷包缝合机构(12)包括：
所述第一钳臂(10a)上设置的第一缝钉钉匣(14)，所述第二钳臂(10b)在钳口闭合时与所述第一缝钉钉匣(14)对应的位置处设置的第一缝钉钉砧(18)，所述第一缝钉钉匣(14)沿纵向方向包括内部设置有第一缝钉(17)的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉的开口区域，所述第一缝钉(17)能够由第一缝钉推钉机构击发。
2.如权利要求1所述的末端执行器，其特征在于，所述第一缝钉(17)沿纵向方向设置至少两排。
3.如权利要求1所述的末端执行器，其特征在于，所述第一缝钉推钉机构包括：第一缝钉推钉杆、第一缝钉推钉滑块(16)和第一缝钉推钉器(22)，当所述第一缝钉推钉杆向远侧纵向驱动所述第一缝钉推钉滑块(16)时，所述第一缝钉推钉滑块(16)的斜面横向驱动所述第一缝钉推钉器(22)，使所述第一缝钉推钉器(22)将所述第一缝钉(17)推出所述第一缝钉钉匣(14)并在所述第一缝钉钉砧(18)的作用下成型。
4.如权利要求3所述的末端执行器，其特征在于，所述缝合机构(11)包括：
所述第一钳臂(10a)上设置的第二缝钉钉匣(19)，所述第二钳臂(10b)在钳口闭合时与所述第二缝钉钉匣(19)对应的位置处设置的第二缝钉钉砧(25)，所述第二缝钉钉匣(19)中设置有第二缝钉(20)，所述第二缝钉(20)能够由第二缝钉推钉机构击发，其中：
所述第二缝钉推钉机构包括：第二缝钉推钉杆、第二缝钉推钉滑块(21)和第二缝钉推钉器(30)，当所述第二缝钉推钉杆向远侧纵向驱动所述第二缝钉推钉滑块(21)时，所述第二缝钉推钉滑块(21)的斜面横向驱动所述第二缝钉推钉器(30)，使所述第二缝钉推钉器(30)将所述第二缝钉(20)推出所述第二缝钉钉匣(19)并在所述第二缝钉钉砧(25)的作用下成型。
5.如权利要求4所述的末端执行器，其特征在于，所述第一缝钉钉推钉杆和第二缝钉推钉杆是一体结构或者是不同部件相互连接，所述第一缝钉推钉滑块(16)和第二缝钉推钉滑块(21)是一体结构或者是不同部件相互连接。
6.如权利要求1所述的末端执行器，其特征在于，所述切割机构(13)包括：能够在推刀机构的作用下在所述缝合机构(11)和所述荷包缝合机构(12)之间运动的切割刀(23)。
7.如权利要求6所述的末端执行器，其特征在于，所述第一钳臂(10a)和所述第二钳臂(10b)具有容纳所述切割刀(23)运动的刀槽(24)。
8.如权利要求1所述的末端执行器，其特征在于，所述第一钳臂(10a)和所述第二钳臂(10b)均为可转动的活动钳臂；或者，所述第一钳臂(10a)为不可转动的固定钳臂，所述第二钳臂(10b)为可转动的活动钳臂；或者，所述第二钳臂(10b)为不可转动的固定钳臂，所述第一钳臂(10a)为可转动的活动钳臂。
9.如权利要求8所述的末端执行器，其特征在于，所述张开闭合机构包括闭合杆，所述闭合杆远侧端设置有闭合凸缘，所述第一钳臂(10a)和所述第二钳臂(10b)之间设置有压簧，当所述闭合杆被驱动而纵向向远侧运动时，所述闭合凸缘（31）啮合第一钳臂（10a）和/或第二钳臂（10b）上的闭合面并使所述钳口克服所述压簧的弹力而闭合，当所述闭合杆回退时，所述钳口可在所述压 簧的复位作用下张开。
10.如权利要求1～9任一项所述的末端执行器，其特征在于，
所述张开闭合机构、所述缝合机构(11)、所述荷包缝合机构(12)和所述切割机构(13)中至少两者被同步驱动；或者，
所述张开闭合机构、所述缝合机构(11)、所述荷包缝合机构(12)和所述切割机构(13)被分别驱动。
11.如权利要求10所述的末端执行器，其特征在于，所述末端执行器为具有腔镜规格的末端执行器。
12.一种外科手术器械，其特征在于，包括：手柄(26)和被所述手柄(26)驱动的如权利要求1～9任一项所述的末端执行器(27)。
13.如权利要求12所述的外科手术器械，其特征在于，还包括内部设置有传动机构(29)的细长体(28)，所述手柄(26)的远侧通过所述细长体(28)与所述末端执行器(27)连接，所述手柄(26)通过所述传动机构(29)为所述末端执行器(27)的张开闭合、缝合、切割和荷包缝合提供驱动。
14.一种外科手术器械，其特征在于，包括：手柄(26)和被所述手柄(26)驱动的如权利要求10所述的末端执行器(27)。
15.如权利要求14所述的外科手术器械，其特征在于，还包括内部设置有传动机构(29)的细长体(28)，所述手柄(26)的远侧通过所述细长体(28)与所述末端执行器(27)连接，所述手柄(26)通过所述传动机构(29)为所述末端执行器(27)的张开闭合、缝合、切割和荷包缝合提供驱动。
16.一种外科手术器械，其特征在于，包括：手柄(26)和被所述手柄(26)驱动的如权利要求11所述的末端执行器(27)。
17.如权利要求16所述的外科手术器械，其特征在于，还包括内部设置有传动机构(29)的细长体(28)，所述手柄(26)的远侧通过所述细长体(28)与所述末端执行器(27)连接，所述手柄(26)通过所述传动机构(29)为所述末端执行器(27)的张开闭合、缝合、切割和荷包缝合提供驱动。
18.一种荷包钳，其特征在于，包括：
第一钳臂和第二钳臂，所述第一钳臂和所述第二钳臂能够在张开闭合机构的作用下相对运动，以使所述第一钳臂和所述第二钳臂所形成的钳口张开或闭合；
荷包缝合机构，包括：所述第一钳臂上设置的第一缝钉钉匣，所述第二钳臂在钳口闭合时与所述第一缝钉钉匣对应的位置处设置的第一缝钉钉砧，所述第一缝钉钉匣沿纵向方向上包括内部设置有第一缝钉的两个缝合区域，以及位于两个缝合区域之间且内部未设置有第一缝钉的开口区域，所述第一缝钉能够由第一缝钉推钉机构击发。
19.如权利要求18所述的末端执行器，其特征在于，所述第一缝钉沿纵向方向设置至少两排。
20.如权利要求18或19所述的荷包钳，其特征在于，
所述张开闭合机构和所述荷包缝合机构被同步驱动；或者，所述张开闭合机构和所述荷包缝合机构被分别驱动。
21.如权利要求18所述的荷包钳，其特征在于，所述第一缝钉推钉机构包括：第一缝钉推钉杆、第一缝钉推钉滑块和第一缝钉推钉器，当所述第一缝钉推钉杆向远侧纵向驱动所述第一缝钉推钉滑块时，所述第一缝钉推钉滑块的斜面横向驱动所述第一缝钉推钉器，使所述第一缝钉推钉器将所述第一缝钉推出所述第一缝钉钉匣并在所述第一缝钉钉砧的作用下成型。
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Address after: 300457 Tianjin Binhai New Area Economic and Technological Development Zone, Fourth Street, No. 5, block B, floor 4 Patentee after: REACH SURGICAL Inc. Address before: 300457 Tianjin Binhai New Area Economic and Technological Development Zone, Fourth Street, No. 5, block B, floor 4 Patentee before: REACH SURGICAL, Inc. |
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