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CN119405370B - End execution assembly adapted for surgical instrument and surgical instrument - Google Patents

End execution assembly adapted for surgical instrument and surgical instrument

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Publication number
CN119405370B
CN119405370B CN202310947483.5A CN202310947483A CN119405370B CN 119405370 B CN119405370 B CN 119405370B CN 202310947483 A CN202310947483 A CN 202310947483A CN 119405370 B CN119405370 B CN 119405370B
Authority
CN
China
Prior art keywords
distal
proximal
end effector
effector assembly
assembly
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN202310947483.5A
Other languages
Chinese (zh)
Other versions
CN119405370A (en
Inventor
李帅帅
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Reach Surgical Inc
Original Assignee
Reach Surgical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Reach Surgical Inc filed Critical Reach Surgical Inc
Priority to CN202310947483.5A priority Critical patent/CN119405370B/en
Priority to PCT/CN2024/108020 priority patent/WO2025026246A1/en
Publication of CN119405370A publication Critical patent/CN119405370A/en
Application granted granted Critical
Publication of CN119405370B publication Critical patent/CN119405370B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • 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
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • A61B2017/07285—Stapler heads characterised by its cutter

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

本发明公开一种外科器械及其端部执行组件，属于医疗器械领域。端部执行组件，包括近侧主体部，近侧主体部限定纵向轴线，包括弯转构件与击发构件；远侧执行部，远侧执行部通过关节组件与近侧主体部枢转连接，关节组件包括：近侧连接件，固定连接于近侧主体部的远端；远侧连接件，固定连接于远侧执行部的近端，远侧连接件与近侧连接件接合连接，远侧连接件上设有至少一个驱动弯转部，弯转构件可操作地驱动驱动弯转部运动，以使远侧执行部相对近侧主体部弯转；保持件，保持件分别与近侧连接件和远侧连接件可枢转地连接，保持件具有用于容纳击发构件的保持通道。本发明的外科器械能够适配狭小空间且击发构件移动可靠性高。

The present invention discloses a surgical instrument and its end effector assembly, which belongs to the field of medical instruments. The end effector assembly includes a proximal main body portion, which defines a longitudinal axis and includes a bending member and a firing member; a distal effector portion, which is pivotally connected to the proximal main body portion via a joint assembly, the joint assembly including: a proximal connector fixedly connected to the distal end of the proximal main body portion; a distal connector fixedly connected to the proximal end of the distal effector portion, the distal connector being engaged and connected to the proximal connector, the distal connector being provided with at least one driving bending portion, the bending member being operable to drive the driving bending portion to move so that the distal effector portion is bent relative to the proximal main body portion; a retainer, the retainer being pivotally connected to the proximal connector and the distal connector, respectively, and the retainer having a holding channel for accommodating the firing member. The surgical instrument of the present invention can adapt to narrow spaces and the firing member has high reliability in movement.

Description

End effector assembly for adapting to surgical instrument and surgical instrument
Technical Field
The present invention relates to the field of surgical instruments, and more particularly to a clamping, cutting and stapling surgical instrument and an end effector assembly therefor.
Background
Surgical stapling instruments are commonly used in laparoscopic procedures and are adapted to stapling and cutting tissue. Which generally includes a handle assembly, an elongated body, and an end effector assembly. In use, a portion of the elongate body assembly and the end effector assembly are advanced into the patient through the passageway created by the penetrator, and a surgeon may bend the end effector assembly through an angle relative to the elongate body assembly by manipulating the handle assembly to accommodate different tissue cutting and stapling positions. In certain surgical environments, it is often desirable for the end effector assembly to provide a greater deflection angle to achieve a smaller incision, fewer staple locations, and thus reduce the probability of anastomotic leakage.
In order to increase the bending angle of the end effector, the end effector designed in the prior art realizes large-angle bending by double joints and even multiple joints, and the bending angle is increased by adopting a mode of progressively bending a plurality of pivot shafts, but the length of a joint part is increased, the bending radius of the end effector is increased, and the end effector still cannot be adapted to a narrow surgical environment such as a pelvic cavity. In the prior art, an end execution unit is also arranged in the prior art, wherein the end execution unit is bent by a single pivot, a firing member formed by a plurality of metal sheets forms a large bending at the single pivot, for example, when the end is bent by 90 degrees, the firing member also needs to be bent by 90 degrees at the single pivot, and when the operation is performed in the state, the firing member can easily jump out from a joint or a pivot or be stacked at the joint or the pivot without a limit mechanism or an unreasonable limit mechanism structure.
Disclosure of Invention
To this end, the present invention provides a surgical instrument with a small bending radius that can fit in small spaces and with reliable movement of the firing member.
Aiming at the technical problems, the invention provides the following technical scheme:
An end effector assembly for adapting a surgical instrument, comprising:
A proximal body portion defining a longitudinal axis including a deflection member and a firing member;
Distal effector portion, including nail storehouse subassembly and nail anvil subassembly, the surface that nail storehouse subassembly and nail anvil subassembly set up relatively forms the clamping face that is used for centre gripping tissue, distal effector portion passes through joint subassembly and proximal body portion pivoted connection, the joint subassembly includes:
a proximal connector fixedly connected to a distal end of the proximal body portion;
A distal link fixedly connected to a proximal end of the distal actuating portion, the distal link being in engagement with the proximal link, the distal link being provided with at least one drive flexure, the flexure member being operable to drive movement of the drive flexure to cause the distal actuating portion to flex relative to the proximal body portion;
A holder pivotally connected to the proximal and distal links, respectively, the holder having a holding channel for receiving the firing member.
In some embodiments of the invention, the retaining channel includes a first support wall and a second support wall forming an arcuate channel, the first support wall and the second support wall being curved in the same direction.
In some embodiments of the present invention, the distal end of the proximal connector has a tooth-shaped structure, the proximal end of the distal connector has a tooth-shaped structure engaged with the proximal connector, the engagement position of the distal connector and the proximal connector forms a pivot of the distal actuator, and the driving bending portion is not coincident with the longitudinal axis when the distal actuator extends along the longitudinal axis.
In some embodiments of the present invention, the retainer is provided with a proximal pivot shaft and a distal pivot shaft, the proximal pivot shaft of the retainer is pivotally matched with the proximal pivot hole of the proximal connector, the distal pivot shaft of the retainer is pivotally matched with the distal pivot hole of the distal connector, and an axis connecting line of the proximal pivot shaft and the distal pivot shaft is located in the retaining channel.
In some embodiments of the present invention, the joint assembly further includes a first connecting piece, two connecting holes are provided on the first connecting piece, and the proximal pivot shaft and the distal pivot shaft of the retainer respectively pass through the proximal pivot hole of the proximal connecting piece and the distal pivot hole of the distal connecting piece and are riveted to the connecting holes of the connecting pieces.
In some embodiments of the present invention, the proximal body portion includes an outer cannula and a support body within the outer cannula, the proximal connector being fixedly connected to the support body.
In some embodiments of the present invention, the distal connector is provided with a first driving deflection portion and a second driving deflection portion, and the deflection member is connected to the first driving deflection portion and the second driving deflection portion, respectively, by a transmission assembly.
In some embodiments of the invention, the transmission assembly includes:
the device comprises a first rack and a first bending transmission member fixedly connected with the first rack, wherein the proximal end of the first rack is connected with the bending member, and the first bending transmission member is connected with one driving bending part of a distal connecting piece;
The second rack and the second bending transmission member are fixedly connected with the second rack, the second rack and the first rack are arranged in a spaced opposite mode, and the second bending transmission member is connected with the other driving bending part of the distal connecting piece;
the at least one gear is positioned between the first rack and the second rack and is respectively connected with the first rack and the second rack in a meshed manner.
In some embodiments of the invention, the first drive flexure and the second drive flexure are configured as a pivot fixedly connected to the distal link, the first or second flex transmission member being riveted or sleeved on the pivot.
In some embodiments of the invention, the first drive deflection part of the distal connection is configured as a pivot with an axial direction perpendicular to the clamping surface, the distal end of the first deflection transmission member is provided with a connecting sleeve, and the first deflection transmission member is sleeved on the first drive deflection part through the connecting sleeve.
In some embodiments of the invention, the second drive deflection of the distal connection is embodied as a projection with an axial direction parallel to the clamping surface, the distal end of the second deflection transmission member being provided with a rivet hole, and the second drive deflection being connected to the second deflection transmission member via the rivet hole.
In some embodiments of the present invention, two distal connectors are provided, namely an upper distal connector and a lower distal connector, the lower distal connector is connected with the anvil assembly, and the upper distal connector is connected with the cartridge assembly.
In some embodiments of the present invention, the support body includes a first half support body and a second half support body, two proximal connectors are provided, respectively, an upper proximal connector and a lower proximal connector, the upper proximal connector is connected with the first half support body, and the lower proximal connector is connected with the second half support body.
In some embodiments of the present invention, the joint assembly further includes a second connecting piece, two connecting holes are provided on the second connecting piece, and the lower proximal connecting piece and the lower distal connecting piece are riveted with the second connecting piece through a rotating shaft respectively.
In some embodiments of the present invention, the first support wall is adapted to support an outer sidewall of the firing member and the second support wall is adapted to support an inner sidewall of the firing member when the firing member is bent to a maximum angular position, the arc length of the first support wall being less than the arc length of the second support wall.
In some embodiments of the present invention, the portion of the first supporting wall of the holder is a first supporting area, the portion of the second supporting wall of the holder is a second supporting area, the proximal end face of the first supporting area is located far away from the proximal end face of the second supporting area, and the distal end face of the first supporting area is located near the distal end face of the second supporting area.
In some embodiments of the present invention, the distal edge of the first support wall is substantially aligned with the inner wall of the firing channel of the distal actuation portion when the distal actuation portion extends in the direction of the longitudinal axis, and the proximal end of the first support wall is substantially aligned with the inner wall of the channel in the proximal body portion that supports relative sliding movement of the firing member.
In some embodiments of the present invention, the distance between the proximal edge of the first support wall and the axis of the proximal pivot shaft is smaller than a first set value, and the distance between the distal edge of the first support wall and the axis of the distal pivot shaft is smaller than a second set value.
In some embodiments of the present invention, when the distal actuating portion extends in the direction of the longitudinal axis, the distal end of the first support wall is in clearance fit with the proximal end of the firing channel of the distal link, and the proximal end of the first support wall is in clearance fit with the distal end of the firing channel of the proximal link.
In some embodiments of the invention, the proximal connector is provided with a first stop projection on a side facing the holder, the first stop projection being opposite the proximal face of the first support zone and having a first gap.
In some embodiments of the invention, the distal connector is provided with a second stop projection on a side facing the holder, the second stop projection being opposite the distal face of the first support zone and having a second gap.
In some embodiments of the present invention, the first limiting protrusion and the second limiting protrusion respectively have a first side surface opposite to the first supporting area and a second side surface opposite to the firing member, and an included angle between the first side surface and the second side surface is 80 ° -100 °.
In some embodiments of the present invention, the second side of the first and second stop bumps is parallel to the longitudinal axis when the distal actuating portion extends in the direction of the longitudinal axis.
In some embodiments of the present invention, when the distal actuating portion extends in the longitudinal axis direction, the first side surface of the first limiting protrusion is disposed parallel to the proximal end surface of the first supporting region of the holder, and the first side surface of the second limiting protrusion is disposed parallel to the distal end surface of the first supporting region of the holder.
In some embodiments of the invention, the first and/or second bending transmission members are shaped as elastically deformable spring structures.
In some embodiments of the present invention, the first and/or second curved transmission members are formed as a chain structure formed by a plurality of pivotally connected rods.
In some embodiments of the invention, the distal actuating portion is angled at an angle other than 0 ° relative to the longitudinal axis when the end effector is in the to-be-loaded position.
In some embodiments of the present invention, the firing member includes at least one firing beam and a firing connector proximal to the firing beam, the proximal end of the firing beam being connected to the firing connector.
In some embodiments of the present invention, a first hooking portion and a second hooking portion are disposed on a proximal side of the firing beam, and a firing connecting portion is disposed on the firing connecting member, where the first hooking portion and the second hooking portion are hooked on two opposite sides of the firing connecting portion.
In some embodiments of the present invention, the firing connector includes a guide slide at a distal end of the firing connector, the guide slide extending in a longitudinal axis direction and adapted to limit the position of the firing beam.
In some embodiments of the present invention, the first half supporting body and the second half supporting body are provided with guide grooves on opposite surfaces thereof, and the firing member is slidably connected to the guide grooves.
In some embodiments of the invention, the guide slot extends in the direction of the longitudinal axis and extends through the entire extension surface of the support body.
The present invention also provides a surgical instrument comprising a handle assembly, an elongate body assembly, and an end effector assembly selectively coupled to the elongate body assembly, connected in sequence from a proximal end to a distal end, the end effector assembly employing the end effector assembly.
Compared with the prior art, the technical scheme of the invention has the following technical effects:
In the surgical instrument and the end execution assembly thereof provided by the invention, the joint assembly is mutually meshed and matched with the distal connecting piece through the proximal connecting piece to form the pivot position of the distal execution part, so that large-angle bending can be realized under the condition of smaller bending radius. Meanwhile, the driving bending part is arranged on the distal connecting piece, a set interval is arranged at the relative pivoting part of the driving bending part, and under the condition of the same bending moment, the bending driving force is smaller, so that the bending driving is easy to realize. In addition, the retainer is connected to the proximal connector and the distal connector through the two pivot shafts, so that the center distance between the proximal connector and the distal connector is constant, and the consistency of the firing stroke in the bent state and the straight state can be ensured to the greatest extent.
Drawings
The objects and advantages of the present invention will be better understood by describing in detail preferred embodiments thereof with reference to the accompanying drawings in which:
FIG. 1 is a schematic view of the structure of one embodiment of a surgical instrument of the present invention;
FIG. 2 is a schematic structural view of one embodiment of an end effector assembly of the surgical instrument of the present invention;
FIG. 3 is an exploded view of one embodiment of an end effector assembly of the surgical instrument of the present invention;
FIG. 4 is an exploded view of a portion of the structure of one embodiment of an end effector assembly of the present invention;
FIG. 5 is an exploded view of a portion of the structure of one embodiment of an end effector assembly of the present invention;
FIG. 6 is a schematic view of the structure of one embodiment of a holder in a surgical instrument of the present invention;
FIG. 7 is a schematic view of one embodiment of a first distal link in a surgical instrument of the present invention;
FIG. 8 is a schematic view of a distal actuating portion of one embodiment of an end effector assembly of the present invention extending in a longitudinal axis direction;
FIG. 9 is an enlarged view of a portion of the structure of FIG. 8;
FIG. 10 is a schematic view of a portion of the joint assembly with the distal effector of the present invention in the direction of the longitudinal axis;
FIG. 11 is a schematic view of the distal effector of the surgical instrument of the present invention being bent to a maximum bend angle;
FIG. 12 is an enlarged view of a portion of the structure of FIG. 11;
FIG. 13 is a schematic view of a portion of a joint assembly of the distal actuator of the present invention at a maximum flexion angle;
FIG. 14 is a schematic view of the end effector assembly of the present invention in an unloaded state;
FIG. 15 is an enlarged view of a portion of the structure of FIG. 14;
FIG. 16 is a schematic view of a portion of the articulation assembly of the present invention in an unloaded state;
FIG. 17 is a schematic view of a portion of the articulation assembly of the end effector assembly of the present invention in a flexed condition;
FIG. 18 is a schematic view of another embodiment of a lower proximal connector of the present invention;
FIG. 19 is a schematic view of another embodiment of a lower distal connector of the present invention;
FIG. 20 is an enlarged view of a portion of the structure of a distal effector portion of another embodiment of a surgical instrument according to the present invention as it extends in the direction of the longitudinal axis;
FIG. 21 is a schematic view of a portion of a joint assembly with a distal actuator in a longitudinal axis according to another embodiment of the present invention;
FIG. 22 is a schematic view of one embodiment of an end effector assembly of a surgical instrument of the present invention;
FIG. 23 is an enlarged view of a portion of FIG. 4;
FIG. 24 is a schematic view of an embodiment of a first support body in an end effector assembly of the present invention;
FIG. 25 is another construction of the first and second bend transmission members of the end effector assembly of the present invention;
FIG. 26 is a schematic view of another embodiment of an end effector assembly of the present invention with a distal effector extending in a longitudinal axis;
fig. 27 is an enlarged view of a part of the structure of fig. 26.
Detailed Description
The following description of the embodiments of the present invention will be made apparent and fully in view of the accompanying drawings, in which some, but not all embodiments of the invention are shown. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In the description of the present invention, it should be noted that the directions or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. are based on the directions or positional relationships shown in the drawings, are merely for convenience of describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, unless explicitly stated and limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, directly connected, or indirectly connected through an intermediary, or may be in communication with the interior of two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
In addition, the technical features of the different embodiments of the present invention described below may be combined with each other as long as they do not collide with each other.
In various embodiments of the present invention, "distal/side" refers to the end of the surgical instrument that is distal to the operator when operated, and "proximal/side" refers to the end/side of the surgical instrument that is proximal to the operator when operated.
The following is a specific embodiment of a surgical instrument. Generally, an embodiment of the surgical instrument described herein is an endoscopic surgical cutting anastomosis instrument. However, it should be noted that the surgical instrument may also be a non-endoscopic surgical cutting anastomosis instrument, such as an open surgical instrument for open surgery.
The surgical instrument 100 illustrated in fig. 1 includes a handle assembly 10, an elongate body assembly 20, and an end effector assembly 30. Wherein the handle assembly 10 is adapted to allow an operator to manipulate the surgical instrument 100, the handle assembly 10 may control movement of the end effector assembly 30 via the elongate body assembly 20 to perform surgical procedures, such as clamping/closing, stapling/stapling, cutting, etc. of tissue.
The handle assembly 10 includes a handle housing 11 that may be capable of being grasped by a user in a conventional manner. In one embodiment, the surgical instrument 100 is configured to operate the end effector assembly 30 to close and fire via a trigger, in one embodiment, the surgical instrument 100 is configured to operate the end effector assembly to close and fire via a push button, or the like provided on the handle to cause the end effector assembly 30 to perform cutting and stapling operations, and in another alternative embodiment, the surgical instrument 100 is configured to operate the end effector assembly 30 to open via a trigger, push button, or the like provided on the handle assembly 10 to release tissue. The handle housing 11 is generally T-shaped overall, comprising a main body portion extending in a longitudinal axis C and a grip portion extending in a direction substantially perpendicular to or inclined at an angle to the longitudinal axis C, said main body portion and grip portion forming an installation space for the drive mechanism.
As shown in FIG. 1, the elongate body assembly 20 includes a tubular housing 21 defining a longitudinal axis C. Within the tubular housing 21, a drive rod set (not shown) is disposed, the proximal end of which is coupled to the output end of the drive mechanism within the handle assembly 10, and the distal end of which is coupled to the firing member 35 and the deflection member 36 of the end effector assembly 30, as shown in FIG. 3, for transmitting the driving force of the drive mechanism to the end effector assembly 30. Specifically, the transmission rod set includes a firing rod and a bending drive rod, where the firing rod is used to transmit the driving force of the firing drive to the firing member 35 of the end effector assembly 30 to implement the firing operation of the end effector assembly 30. The bend drive lever is used to transmit the drive force of the bend drive assembly to the bend member 36 of the end effector assembly 30 to effect bending of the end effector assembly 30.
As shown in FIG. 1, the surgical instrument 100 according to the present embodiment further includes a rotator head 13, the rotator head 13 being mounted distally of the handle assembly 10 and disposed proximally of the elongate body assembly 20, and being configured to rotate the elongate body assembly 20 and the end effector assembly 30 together when the rotator head 13 is operated to rotate about the longitudinal axis C of the surgical instrument 100.
The end effector assembly 30 is configured to manipulate tissue to perform specific surgical procedures, such as clamping, stapling/stapling, cutting, etc., of the tissue. To effect bending of the end effector assembly 30a set angle relative to the longitudinal axis C of the elongate body assembly 20, as shown in fig. 2, the end effector assembly 30 includes a proximal main body portion 30a and a distal effector portion 30b, the proximal main body portion 30a and the distal effector portion 30b being pivotally connected by a joint assembly 38. Accordingly, the surgical instrument 100 further includes a bend drive assembly for driving the articulation assembly 38 to bend and a bend transmission assembly, as shown in FIG. 3, including a bend member 36 operably coupled to the bend drive assembly. The bend drive assembly includes a bend knob 12 mounted on the rotary head 13 and a bend drive rod (not shown) located within the elongate body assembly 20, the bend drive rod being connected to the bend member 36. The operator manipulates the turn knob 12 to rotate and may drive the turn driving lever to move. Specifically, when the turning knob 12 is turned from the initial position in the clockwise direction, the turning driving rod drives the turning member 36 to move distally, and when the turning knob 12 is turned from the initial position in the counterclockwise direction, the turning driving rod drives the turning member 36 to move proximally, or vice versa.
One specific embodiment of an end effector assembly 30 of a surgical instrument 100 in accordance with the present invention is described in detail below in conjunction with FIG. 2, with the end effector assembly 30 being removably mounted to the distal end of the elongate body assembly 20 of the surgical instrument 100. As previously described, the end effector assembly 30 includes the proximal and distal body portions 30a, 30b, with the proximal and distal body portions 30a, 30b being pivotally connected by the joint assembly 38. The proximal body portion 30a of the end effector assembly 30 is insertable into the elongate body assembly 20 in a bayonet manner and rotates relative to the housing of the elongate body assembly 20 to lock the end effector assembly 30 thereto. The distal effector 30b includes a cartridge assembly 31 and an anvil assembly 32, the cartridge assembly 31 and anvil assembly 32 being relatively movable to close the jaws to grip tissue jaws, the surfaces of the cartridge assembly 31 disposed opposite the anvil assembly 32 forming a gripping surface for gripping tissue. In a specific embodiment, the anvil assembly 32 is operable to pivot toward the cartridge assembly 31 until the jaws of the end effector assembly 30 are closed to grasp tissue, and the anvil assembly 32 is pivoted away from the cartridge assembly 31 until the jaws of the end effector assembly 30 are opened to release tissue. In an alternative embodiment, the cartridge assembly 31 of the end effector assembly 30 is operable to pivot the anvil assembly 32 until the jaws of the end effector assembly 30 are closed to clamp tissue, and the cartridge assembly 31 is operable to pivot away from the cartridge assembly 31 until the jaws of the end effector assembly 30 are opened to release tissue.
Specifically, as shown in FIGS. 2 and 3, the proximal body portion 30a of the end effector assembly 30 is removably attached to the distal end of the elongate body assembly 20, the proximal body portion 30a including an elongate outer tube 33, a support body 34 disposed within the outer tube 33, a firing member 35 slidably disposed within the support body 34, and a crimping member 36, wherein the outer tube 33 has a longitudinal axis C extending in a direction generally parallel to the tubular housing 21 of the elongate body assembly 20, the support body 34 includes a first support body half 34a and a second support body half 34b, the proximal end of the second support body half 34b includes an engagement portion 34C for attachment to the elongate body assembly 20, the engagement portion 34C having an engagement tab thereon for releasably engaging the elongate body assembly 20 in a snap-fit connection. The firing member 35 includes an elongate firing beam 351, which firing beam 351 may be constructed from a single piece of material, or from a plurality of stacked sheets. Wherein, the working portion 352 of the firing member 35 is shaped as an I-beam structure with a partial area thereof abutting against the staple pusher sled and integrally slidable toward the distal end of the cartridge assembly 31 for performing a corresponding surgical procedure. For example, as the firing member 35 is driven distally from the proximal end, a partial region of the working portion 352 of the firing member 35 moves distally together with the staple pusher sled acting on the staple drivers to push staples out of the cartridge assembly 31 to effect an anastomosis operation on tissue while the cutting knife 354 on the working portion 352 cuts the tissue.
Further, the end effector assembly 30 of the present embodiment defines a guide slot 341 (see fig. 23, 24) between the first and second support body halves 34a, 34b for slidably receiving the firing member 35 to form a sliding channel. The firing member 35 includes an elongated firing beam 351 slidably coupled to a guide slot 341, where the guide slot 341 extends along the longitudinal axis and extends through the extension regions of the first and second support halves 34a and 34b, so that the proximal and distal ends of the support body 34 are both capable of constraining the firing beam 351.
The proximal end of the firing beam 351 is hooked and connected to the firing connector 353, specifically, as shown in fig. 22 and 23, the firing connector 353 is formed into a sleeve structure with an opening, the proximal end of the firing beam 351 is configured to have an opening structure, the proximal end of the firing beam 351 has a first hooking portion 3511 and a second hooking portion 3512 disposed opposite to each other, the firing connector 353 is provided with a firing connector 3531, the first hooking portion 3511 and the second hooking portion 3512 are hooked on opposite sides of the firing connector 3531, the distal end of the firing connector 3531 is provided with a guiding slideway 3532, the guiding slideway 3532 extends along the longitudinal axis direction and is suitable for limiting the positions of the two sides of the firing beam 351 perpendicular to the longitudinal axis direction, for example, when the firing beam 351 is configured to be stacked sheets, the guiding slideway 3532 is used for cooperating with the sheet surfaces on two sides of the firing beam 351 to limit the positions thereof to avoid shifting when the stacked sheet-shaped firing beam 351 turns. The proximal end of the firing link 353 is provided with an aperture configured to receive the distal end of the firing bar 22 when the proximal end of the end effector assembly 30 is engaged with the elongate body assembly 20.
Referring to fig. 3, in the distal actuating portion 30b of the end effector assembly 30, the cartridge assembly 31 includes a cartridge 312, a cartridge base 311, and a pusher block disposed in a cavity between the cartridge 312 and the cartridge base 311, the proximal end of the firing member 35 is coupled to a firing bar in the elongate body assembly 20, and the distal end of the firing member 35 abuts against the pusher block and is integrally slidable/movable in the direction of the longitudinal axis to perform a corresponding surgical procedure. The cartridge assembly 31 further includes a staple pusher and staples disposed within the cartridge 312, and when the firing member 35 is driven to move from the proximal end to the distal end, the staple pusher sled is pushed to move, the staple pusher sled acting on the staple pusher to push the staples out of the cartridge 312, effecting stapling of tissue. The anvil assembly 32 comprises an anvil housing 321 and a staple supporting seat 322 positioned in the anvil housing 321, wherein the staple supporting seat 322 cooperates with the staple cartridge 312 to realize bending operation of staples, a plurality of staple buds are arranged on the surface of the staple supporting seat 322, the staple buds correspond to the positions of the staple outlet holes on the staple cartridge 312 one by one, and the staples in the staple outlet holes are abutted against the staple buds when tissue is anastomosed.
Referring to fig. 3-5, the joint assembly 38 includes a proximal connector 381a fixedly attached to the distal end of the proximal body portion 30a, a distal connector 382a fixedly attached to the distal actuator portion 30b, and specifically, the proximal connector 381a is fixedly attached to the support body 34 by a mating structure of a positioning protrusion and a positioning slot, or in alternative embodiments, the proximal connector 381a is integrally formed with the support body 34 by a process such as welding, injection molding, or the like. As shown in fig. 4, the distal end of the proximal connector 381a and the proximal end of the distal connector 382a have a tooth structure that is engaged with each other, the engaged position of the distal connector 382a and the proximal end of the distal connector 382a forms a pivot point a of the distal actuator 30b, the distal connector 382a is provided with at least one driving turning part connected with the turning member 36, and when the turning member 36 slides relative to the support body 34, the driving turning part of the distal connector 382a can be directly or indirectly acted on, so that the distal connector 382a can swing around the engaged position of the distal connector 382a and the distal connector 382a under the action of the engaging teeth, thereby realizing turning of the distal actuator 30b relative to the proximal body 30 a. when the distal actuating portion 30b extends in the direction of the longitudinal axis C (see fig. 4), the drive curve is spaced from the longitudinal axis C and is distal to the pivot a, i.e., the drive curve is not coincident with the longitudinal axis C. Other joint connection modes can be adopted between the proximal connector 381a and the distal connector 382a to realize the bending or swinging of the distal connector 382a around the proximal connector 381a, and meanwhile, the two connectors can be supported relatively stably, so that the swing generated by the bending or swinging of the joint in the firing process of the surgical instrument is reduced, and the damage of the tissue caused by traction is avoided. In a specific embodiment, referring to fig. 26 and 27, the region of the proximal connector 381a opposite to the distal connector 382a is provided with an engagement portion, which is a friction wheel with a relatively high friction force, and the proximal connector 381a is connected to the distal connector 382a by a connecting piece 385 'with a groove/slit, and the connecting piece 385' is configured in the form of a spring sheet with a certain elastic deformation, which can expand or contract the groove/slit under the action of an external force to realize elastic deformation. The connection piece 385 'is provided with two connection holes, the connection holes are respectively connected with the proximal connection piece 381a and the distal connection piece 382a through pin shafts, the distance between the two connection holes of the connection piece 385' is slightly smaller than the axial distance between the proximal connection piece 381a and the distal connection piece 382a in an initial state, after the connection piece 385 'is respectively connected with the proximal connection piece 381a and the distal connection piece 382a, the connection piece 385' is stretched and deformed, and a shrinkage tension force is applied to the proximal connection piece 381a and the distal connection piece 382a, so that the proximal connection piece 381a is tightly contacted with the distal connection piece 382a, the opposite friction force is increased, and the positioning of the bending position of the distal connection piece 382a is ensured.
To ensure stability of distal movement of the firing member 35 after the distal effector portion 30b is deflected relative to the proximal body portion 30a, and to avoid problems of the firing member 35 being deflected out of or stacked upon the partially sheet-like firing beam 351 due to excessive deflection force of the firing member 35 (i.e., biasing force of the firing member 35 to deflect), the articulation assembly 38 further includes a retainer 384 for receiving the deflected position of the firing member 35, the retainer 384 being coupled to the cooperating proximal and distal links 381a, 382a by two pivot axes, as shown in FIGS. 3-6. As shown particularly in fig. 10, 13 and 16, the retainer 384 is connected to the proximal pivot hole 51 of the proximal link 381a by the proximal pivot shaft 41 and to the distal pivot hole 52 of the distal link 382a by the distal pivot shaft 42 so as to be capable of pivotal movement with the distal link 382a about the proximal pivot shaft 41 relative to the proximal link 381 a. The joint assembly 38 further includes a first connection piece 385 to which the ends of the proximal pivot shaft 41 and the distal pivot shaft 42 of the holder 384 are riveted. As shown in fig. 2 and 3, the first connecting piece 385 has two connecting holes, and the ends of the proximal pivot shaft 41 and the distal pivot shaft 42 of the holding member 384 are riveted to the connecting holes of the first connecting piece 385. The retainer 384 has a retaining channel 43, and the axis of the proximal pivot shaft 41 and the distal pivot shaft 42 are positioned within the retaining channel 43, and are adapted to receive at least a portion of the firing beam 351 of the firing member 35 such that it extends through the retaining channel 43 and is movable in its direction of extension.
In the end effector assembly 30 according to the embodiment of the present invention, the holding channel 43 of the holding member 384 is configured in an arc-shaped structure, as shown in fig. 6, the holding channel 43 is formed by a first supporting wall 43a and a second supporting wall 43b located at both sides of the firing beam 351, and the curved directions of the first supporting wall 43a and the second supporting wall 43b are the same, the first supporting wall 43a is adapted to cooperate with the maximum curved extrados of the firing beam 351, and the second supporting wall 43b is adapted to cooperate with the maximum curved intrados of the firing beam 351.
Referring to FIG. 9, the proximal connector 381a includes a firing channel 53 having a proximal end opposite the firing channel of the proximal body portion 30a and a distal end opposite the retention channel 43 of the retention member 384. Correspondingly, the distal connector 382a also has a firing channel 54 with a distal end opposite the firing channel of the distal implement portion 30b and a proximal end opposite the retention channel 43 of the retention member 384. When the distal effector 30b extends in the direction of the longitudinal axis C, the firing channel 53 of the proximal link 381a extends in the same direction as and opposite to the firing channel 54 of the distal link 382a, and is adapted to extend in a straight direction from the firing beam 351. Since the first and second support walls 43a, 43b of the retention channel 43 are both curved to the same side, the firing beam 351 of the firing member 35 can be allowed to bend to as large an angle as possible, providing better support and spacing for its intrados and extrados, respectively, when the firing beam 351 is at the single-sided maximum bend angle, enabling the distal effector 30b to achieve a larger single-sided bend angle. It will be appreciated that while both the first and second support walls 43a, 43b of the retention channel 43 are curved to the same side to provide support and stop for the firing beam 351 when the distal effector 30b is in the single-sided maximum deflection position, the retention channel 43 still allows the distal effector 30b to be deflected in the opposite direction by a certain angle due to the certain width of the retention channel 43, enabling an overall asymmetric deflection angle of the end effector 30.
More specifically, the portion of the first support wall 43a of the holding member 384 is a first support region 384a, and the portion of the second support wall 43b of the holding member 384 is a second support region 384b. To avoid interference of the holder 384 with the firing member 35, the proximal link 381a, or the distal link 382a during operation, the arc length of the first support wall 43a is less than the arc length of the second support wall 43 b. Wherein the proximal end face of the first support region 384a is distal to the proximal end face of the second support region 384b, and the distal end face of the first support region 384a is proximal to the distal end face of the second support region 384b. Thus, as shown in fig. 12, when the distal execution portion 30b is bent to the maximum bending angle, the first support wall 43a of the holding member 384 has a certain gap between the both ends thereof and the proximal link 381a and the distal link 382 a. Wherein, as shown in FIG. 9, the gap between the proximal end of the first support wall 43a and the distal end of the firing channel 53 of the proximal link 381a is t1 and the gap between the distal end of the first support wall 43a and the proximal end of the firing channel 54 of the distal link 382a is t2. wherein, as shown in FIG. 9, As shown in FIG. 10, when the distal actuating portion 30b extends along the longitudinal axis C, the distal edge of the first support wall 43a is substantially aligned with the inner wall of the firing channel of the distal actuating portion 30b and the firing channel 54 of the distal connecting member 382a, and as the firing beam 351 extends along the firing channel of the proximal main body portion 30a to the firing channel of the distal actuating portion 30b, i.e., the distal edge of the first support wall 43a is positioned in a line that can abut or approach the outer side wall of the firing beam 351, i.e., a position that is closer to the axis of the proximal pivot shaft 41 and the distal pivot shaft 42, and more specifically, the proximal edge of the first support wall 43a is less than a first set point that is 0.1-2mm from the axis of the proximal pivot shaft 41, the proximal edge of the first support wall 43a is positioned in a line that can abut or approach the outer side wall 381 of the firing channel 53 of the proximal main body portion 30a, i.e., a position that can abut or approach the proximal pivot shaft 41 and a position that is closer to the axis of the proximal pivot shaft 41. The distance between the distal edge of the first supporting wall 43a and the axis of the distal pivot shaft 42 is smaller than a second set value, and the second set value is 0.5-1mm. Thus, during the bending of the distal effector 30b, the gap t1 between the proximal end of the first support wall 43a and the distal end of the firing channel of the proximal link 381a remains unchanged or changes slightly, as does the gap t2 between the distal end of the first support wall 43a and the proximal end of the firing channel of the upper distal link 382 a. The problem that the firing member 35 cannot be effectively limited due to the large change of the clearance between the holding piece 384 and the proximal connector 381a and the distal connector 382a in the bending process of the distal execution part 30b is avoided. In an alternative embodiment, the firing beam 351 may be effectively restrained by further reducing the gap t2 between the distal end of the first support wall 43a and the proximal end of the firing channel 54 of the distal connector 382a, and the gap t1 between the proximal end of the first support wall 43a and the distal end of the firing channel 53 of the proximal connector 381 a. For example, when the distal effector 30b extends along the longitudinal axis C, the distal end of the first buttress wall 43a is in clearance engagement with, i.e., very small clearance between, the proximal end of the firing channel 54 of the distal connector 382a and the proximal end of the first buttress wall 43a is in clearance engagement with, i.e., very small clearance between, the distal end of the firing channel 53 of the proximal connector 381 a. which allows for a smaller gap between the retaining member 384 and the proximal and distal connectors 381a, 382a when the first position of the distal execution assembly 30b extending in the direction of the longitudinal axis C is swung to the maximum bend position.
The end effector assembly 30 according to the present embodiment has a joint assembly 38 that is capable of performing a large angle of bending with a small bending radius by forming the pivot a of the distal effector 30b by the engagement of the proximal link 381a with the distal link 382 a. Meanwhile, the distal connecting member 382a is provided with a driving bending portion, which has a larger distance from the engagement point (pivot a) between the proximal connecting member 381a and the distal connecting member 382a, and has a smaller bending driving force under the same bending moment, so that the bending driving is easy to realize. In addition, since the holding member 384 is pivotally connected to the proximal link 381a and the distal link 382a by the two proximal pivot shafts 41, the center-to-center distance between the proximal link 381a and the distal link 382a is constant, so that the consistency of the firing stroke in the bent state and the straightened state can be ensured to the greatest extent, and the formation of the most distal row of staples can be ensured for the electric stapler.
In order to further improve the bending stability of the distal actuating portion 30b, the distal connecting member 382a is provided with two driving bending portions, the bending member 36 is connected to the two driving bending portions through the transmission assembly 39, the two driving bending portions are respectively located at two opposite sides of the longitudinal axis C, one side of the distal connecting member 382a is subjected to a force towards the distal end, the other side is subjected to a force towards the proximal end, and the driving force of bending member 36 is further reduced by providing driving bending portions 383 at two sides of the distal connecting member 382a, so that the bending stability of the distal connecting member 382a can be better.
Referring to fig. 4 and 5, the transmission assembly 39 includes a first rack 391 connected to the turning member 36, the first rack 391 being mounted on the support body 34 inside the proximal body section 30a (see fig. 3 and 4, not shown), a first turning transmission member 393 fixedly connected to the first rack 391, the first turning transmission member 393 being connected to a first driving turning part 383a of the distal link 382a, a second rack 392 provided on the support body 34, the second rack 392 being disposed opposite the first rack 391 with a spacing therebetween, and a second turning transmission member 394 fixedly connected to the second rack 392, the second turning transmission member 394 being connected to a second driving turning part 383b of the distal link 382a, and two gears 395 between the first rack 391 and the second rack, the two gears 395 being rotatably connected to a gear support 396 of the support body 34. In the embodiment shown in fig. 4, the gear 395 includes two gears 395 respectively engaged with the first rack 391 and the second rack 392. When the bending member 36 is operated to move distally, the first rack 391 and the first bending transmission member 393 are pushed to move distally, and the movement of the gear 395 drives the gear 395 to rotate and move the second rack 392 proximally, so that the second bending transmission member 394 is driven to move proximally, and the distal connector 382a is bent.
As an alternative embodiment, as shown in fig. 8 and 9, the first driving bending part 383a of the distal connecting member 382a is configured as a pivot structure with an axial direction perpendicular to the clamping surface, and the second driving bending part 383b is configured as a bump structure with an axial direction parallel to the clamping surface. Correspondingly, a connecting sleeve 393a is arranged at the distal end of the first bending transmission member 393, the first bending transmission member 393 is sleeved on the first driving bending part 383a through the connecting sleeve 393a, a riveting hole 394a is arranged at the distal end of the second bending transmission member 394, and the second driving bending part 383b is matched with the riveting hole 394a to realize the riveting of the second bending transmission member 394 and the distal connector 382 a. Wherein, when the distal execution portion 30b is operatively bent, the bending radius of the position of the first driving bending portion 383a (i.e. the bending radius of the first bending transmission member 393 connected to the first driving bending portion 383 a) is smaller than the bending radius of the position of the second driving bending portion 383b (i.e. the bending radius of the second bending transmission member 394 connected to the second driving bending portion 383 b).
Because the end effector assembly 30 according to the present embodiment is mainly operated to bend to a large angle toward one side of the longitudinal axis C, the bending radius of the first driving bending portion 383a of the distal connector 382a is always smaller than that of the second driving bending portion 383b, resulting in a larger deformation amount of the first bending transmission member 393 than that of the second bending transmission member 394, and the connection reliability of the first bending transmission member 393 and the distal connector 382a can be improved by the way of sleeving the connection sleeve 393a on the first driving bending portion 383 a.
As an alternative embodiment, fig. 25 shows another structural form of the first bending transmission member 393 and the second bending transmission member 394, specifically, the first bending transmission member 393 and the second bending transmission member 394 are configured as a chain formed by a plurality of rod bodies pivotally connected, which can be turned along with the distal execution part 30b in a large angle with respect to the proximal main body part 30a, and the structure in the chain form rotates each rod body between the pivot shafts, so that the rod bodies can adapt to a large bending deformation amount, and the problems of fracture and the like caused by exceeding the elastic deformation amount when the elastic material is used in a large bending angle can be avoided.
Figures 8-13 illustrate the articulation process of the end effector assembly 30 provided by embodiments of the present invention. As shown in fig. 8-10, when the distal actuating portion 30b extends along the longitudinal axis C, that is, when the distal actuating portion 30b extends in the same direction as the proximal main body portion 30a, the angle between the distal actuating portion 30b and the longitudinal axis C is 0 ° or about 0 °, and the first driving turning portion 383a and the second driving turning portion 383b of the distal connector 382a are located at the distal end of the pivot a, respectively. The turning knob 12 of the surgical instrument 100 is operated to move the turning member 36 proximally, bringing the first and second drive turning portions 383a, 383b to pivot about pivot point a, causing the distal effector 30b to turn in a direction gradually away from the longitudinal axis C and eventually to a single-sided maximum turning angle position, as shown in fig. 11-13. It will be appreciated that the engagement position of proximal link 381a with distal link 382a (i.e., pivot point a) does not remain fixed during the bending of distal implement portion 30b relative to proximal body portion 30a, but rather varies with the position of the engaged teeth.
In a specific embodiment, the joint assembly 38 may implement the bending action of the distal execution portion 30b by adopting one proximal connector 381a and one distal connector 382a, and as an alternative embodiment, referring to fig. 3-5, two proximal connectors 381a and 381ab are provided, and two distal connectors 382a and 382ab are provided. In this embodiment, an upper proximal connector 381a extends distally from the distal end of the first support body half 34a and is fixedly connected, such as by a snap fit, with a snap fit protrusion, and a lower proximal connector 381ab extends distally from the distal end of the second support body half 34b, with the lower proximal connector 381ab fixedly connected with the second support body half 34b with a snap fit, with the upper distal connector 382a connected with the cartridge assembly 31 and the lower distal connector 382ab connected with the anvil assembly 32. The bending stability of the distal effector 30b may be further enhanced by providing two sets of proximal links and two sets of distal links.
Specifically, the upper distal connector 382a is connected to the cartridge base 311 by a positioning pin, so that the upper distal connector 382a is fixedly connected to the cartridge base 311 in a non-bendable manner, and the lower distal connector 382ab is connected to the anvil housing 321 by a positioning pin, so that the lower distal connector 382ab is fixedly connected to the anvil housing 321 in a non-bendable manner. In addition, the upper distal connecting piece 382a is connected with the lower distal connecting piece 382ab through a positioning pin, so that the upper distal connecting piece 382a is fixedly connected with the lower distal connecting piece 382ab, and the staple cartridge assembly 31 and the anvil assembly 32 are driven to realize synchronous bending. It will be appreciated that upper distal connector 382a and lower distal connector 382ab are fixedly connected to cartridge assembly 31 and anvil assembly 32 such that they are non-deflectable, and that cartridge assembly 31 and/or anvil assembly 32 are pivotally movable in closing and opening directions relative to upper distal connector 382a and lower distal connector 382 ab. The upper and lower proximal connectors and the distal connector are respectively arranged, so that the bending synchronism of the anvil component 32 and the cartridge component 31 of the distal execution part 30b is better, the bending action position is more symmetrical, and the bending is stable. It will be understood, of course, that one proximal connector 381a and one distal connector 382a may be provided, respectively, which may also enable the distal effector 30b to be bent about the pivot point a formed by the proximal connector 381a and the distal connector 382 a.
Further, in this embodiment, the holder 384 is received in the installation space formed by the area between the upper and lower distal links 382a, 382b and the upper and lower proximal links 381a, avoiding its exposure to the outside to ensure the movement stability of the firing member 35. Specifically, as shown in fig. 10, the upper proximal link 381a is provided with a proximal pivot hole 51, the upper distal link 382a is provided with a distal pivot hole 52, the proximal pivot shaft 41 of the holder 384 passes through the proximal pivot hole 51 of the upper proximal link 381a, the distal pivot shaft 42 of the holder 384 passes through the distal pivot hole 52 of the upper distal link 382a, and the ends of the proximal pivot shaft 41 and the distal pivot shaft 42 are riveted to the first connection piece 385. Wherein, the first connection piece 385 is provided with two connection holes, and the ends of the proximal pivot shaft 41 and the distal pivot shaft 42 of the holding piece 384 are riveted to the connection holes of the first connection piece 385.
The joint assembly 38 further includes a second connection piece 386, as shown in fig. 3, and the lower proximal connector 381ab and the lower distal connector 382ab are respectively riveted to the second connection piece 386 by a rotation shaft. The second connecting piece 386 is provided with two connecting holes, and the rotating shaft ends of the lower proximal connecting piece 381ab and the lower distal connecting piece 382ab are riveted on the connecting holes of the second connecting piece 386.
To better accommodate the firing member 35 within the joint assembly 38, the firing beam 351 of the firing member 35 is prevented from jumping out of the joint or stacking, in an alternative embodiment, the lower proximal link 381ab is further provided with a first stop tab 61 on a side facing the holder 384, a portion of the side of the first stop tab 61 further limiting the bending position of the firing member 35, the first stop tab 61 being opposite the proximal face of the first support zone 384a of the holder 384 and having a first gap t1', in particular t1' < t1. The first gap t1' is constant or varies with a small extent when the distal actuating portion 30b swings from a first position extending in the longitudinal axis direction to a maximum bent position. As shown in fig. 21, the first limit projection 61 has a first side surface disposed opposite to the proximal side surface of the first support region 384a and a second side surface disposed opposite to the firing member 35, the first side surface being disposed perpendicular to the second side surface. In other alternative embodiments, the first side and the second side of the first stop tab 61 may be angled between 80 ° and 100 ° depending on the maximum bend angle of the distal actuating portion 30 b. By the arrangement of the first limiting projection 61, the first gap t1' between the holding piece 384 and the first limiting projection 61 is always smaller at the proximal side of the joint assembly 38 in the process of the end effector assembly from the straightened state to the maximum turning angle, and the firing beam 351 is reliably turned under the limiting action of the holding piece 384 and the first limiting projection 61.
Correspondingly, as shown in fig. 19, the lower distal link 382ab is provided with a second spacing protrusion 62 on a side facing the holder 384, a portion of the side of the second spacing protrusion 62 further limiting the bending position of the firing member 35, the second spacing protrusion 62 being opposite the distal end face of the first support region 384a of the holder 384 with a second gap t2', in particular t2' < t2. The second gap t2' is constant or varies with a small extent when the distal actuating portion 30b swings from the first position extending in the longitudinal axis direction to the maximum bending position. As shown in fig. 21, the second limiting projection 62 also has a first side surface opposite to the first supporting region 384a and a second side surface opposite to the firing member 35, and the first side surface is perpendicular to the second side surface. In other alternative embodiments, the angle between the first side and the second side is between 80 ° -100 ° depending on the maximum bending angle of the distal effector 30 b. By the arrangement of the second limiting projection 62, the distal side of the joint assembly 38 always has a smaller second gap t2' between the holding piece 384 and the first limiting projection 61 during the process from the straightened state to the maximum bending angle of the end effector assembly, and the firing beam is reliably bent under the limiting actions of the holding piece 384 and the second limiting projection 62.
It will be appreciated that in other alternative embodiments, the first stop tab 61 may also be disposed on the proximal connector 381a and the second stop tab 62 may also be disposed on the distal connector 382 a.
Further, as shown in fig. 21, when the distal actuating portion 30b extends in the longitudinal axis direction, the second sides of the first and second stopper protrusions 61 and 62 are parallel to the longitudinal axis. The first side of the first limiting projection 61 is disposed parallel to the proximal end surface of the first supporting region 384a of the holder 384, and the first side of the second limiting projection 62 is disposed parallel to the distal end surface of the first supporting region 384a of the holder 384.
In order for the end effector assembly 30 of the present embodiment to be adapted to the body portion (including the handle assembly and the elongate body assembly) of a prior art surgical instrument 100, that is, the end effector assembly 30 of the present embodiment is adapted to fit the body portion (including the handle assembly and the elongate body assembly) of the same surgical instrument 100 as the end effector assembly of the present design, in an alternative embodiment, the end effector assembly 30 is pre-set with a certain angle of deflection when it is not initially loaded onto the surgical instrument. For example, as shown in fig. 14, the distal actuating portion 30b is disposed at a set first angle α 1 to the longitudinal axis C when the end effector assembly 30 is in the to-be-loaded position.
Specifically, upon mounting the end effector assembly 30 in the to-be-loaded position on the elongate body assembly 20 of the surgical instrument 100, the turn member 36 is moved proximally a first distance by operation of the turn knob 12 of the handle assembly 10, which in turn causes the distal effector portion 30b of the end effector assembly 30 to be further turned away from the longitudinal axis C to a second angle a 2 based on having been turned a first angle a 1, as shown in fig. 11 and 12. Similarly, upon mounting the end effector assembly 30 in the to-be-loaded position on the elongate body assembly 20 of the surgical instrument 100, the turn member 36 is moved distally a second distance by operation of the turn knob 12 of the handle assembly 10, which in turn causes the distal effector portion 30b of the end effector assembly 30 to pivot further toward the longitudinal axis C, and ultimately at 0 or substantially 0 to the longitudinal axis C, based on the turned first included angle α 1, as shown in fig. 8, 9. The first distance and the second distance may be the same or different.
When the end effector assembly 30 of the present embodiment is adapted to a prior art surgical instrument 100, the first distance may correspond to the distance that the turn member 36 moves when the end effector assembly 30 is turned right to a maximum angle, and the second distance may correspond to the distance that the turn member 36 moves when the end effector assembly 30 is turned left to a maximum angle. By the arrangement of the end effector 30, the versatility and suitability of the end effector according to the embodiments of the present invention are further improved.
It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. While obvious variations or modifications are contemplated as falling within the scope of the present invention.

Claims (33)

1. An end effector assembly for adapting a surgical instrument, comprising:
A proximal body portion defining a longitudinal axis including a deflection member and a firing member;
Distal execution portion, including nail storehouse subassembly and nail anvil subassembly, the relative surface that sets up of nail storehouse subassembly and nail anvil subassembly forms the clamping face that is used for centre gripping tissue, distal execution portion passes through joint subassembly and proximal body portion pivoted connection, its characterized in that, joint subassembly includes:
a proximal connector fixedly connected to a distal end of the proximal body portion;
A distal link fixedly connected to a proximal end of the distal actuating portion, the distal link being in engagement with the proximal link, the distal link being provided with at least one drive flexure, the flexure member being operable to drive movement of the drive flexure to cause the distal actuating portion to flex relative to the proximal body portion;
A holder pivotally connected to the proximal and distal links, respectively, the holder having a holding channel for receiving the firing member.
2. The end effector assembly of claim 1, wherein the retention channel comprises first and second support walls forming an arcuate channel, the first and second support walls being curved in the same direction.
3. The end effector as set forth in claim 1 wherein said distal end of said proximal link has a toothed configuration and said proximal end of said distal link has a toothed configuration for mating engagement with said proximal link, the location of engagement of said distal link with said proximal link forming a pivot for said distal effector, said drive flexure being disposed offset from said longitudinal axis as said distal effector extends in the direction of said longitudinal axis.
4. The end effector assembly of claim 2, wherein the holder has a proximal pivot shaft and a distal pivot shaft, respectively, wherein the proximal pivot shaft of the holder is pivotally coupled to the proximal pivot hole of the proximal link, wherein the distal pivot shaft of the holder is pivotally coupled to the distal pivot hole of the distal link, and wherein an axial line of the proximal pivot shaft and the distal pivot shaft is located within the holder channel.
5. The end effector assembly of claim 4, further comprising a first connecting tab having two connecting apertures therein, wherein the proximal and distal pivot axes of the retainer are respectively threaded through the proximal and distal pivot apertures of the proximal and distal links and are riveted to the connecting apertures of the links.
6. The end effector assembly of claim 1, wherein the proximal body portion comprises an outer sleeve and a support body within the outer sleeve, the proximal connector being fixedly attached to the support body.
7. The end effector assembly of claim 1, wherein the distal link has first and second drive bends, and wherein the bend member is coupled to the first and second drive bends, respectively, by a transmission assembly.
8. The end effector assembly of claim 7, wherein the drive assembly comprises:
the device comprises a first rack and a first bending transmission member fixedly connected with the first rack, wherein the proximal end of the first rack is connected with the bending member, and the first bending transmission member is connected with one driving bending part of a distal connecting piece;
The second rack and the second bending transmission member are fixedly connected with the second rack, the second rack and the first rack are arranged in a spaced opposite mode, and the second bending transmission member is connected with the other driving bending part of the distal connecting piece;
the at least one gear is positioned between the first rack and the second rack and is respectively connected with the first rack and the second rack in a meshed manner.
9. The end effector assembly of claim 8, wherein the first drive flexure and the second drive flexure are configured as a pivot fixedly coupled to the distal link, the first or second articulation transmission member being riveted or sleeved on the pivot.
10. The end effector assembly of claim 8, wherein the first drive bend of the distal link is configured as a pivot axis oriented perpendicular to the clamping surface, the distal end of the first bend transfer member being provided with a connecting sleeve, the first bend transfer member being sleeved over the first drive bend by the connecting sleeve.
11. The end effector assembly of claim 8, wherein the second drive turn of the distal link is configured as a tab with an axial direction parallel to the clamping surface, the distal end of the second turn transmission member being provided with a staking hole through which the second drive turn is connected to the second turn transmission member.
12. The end effector assembly of claim 6, wherein said distal connectors are provided in two, an upper distal connector and a lower distal connector, respectively, said lower distal connector being coupled to said anvil assembly and said upper distal connector being coupled to said cartridge assembly.
13. The end effector assembly of claim 12, wherein the support body comprises a first support body half and a second support body half, wherein the proximal connectors are provided in two, an upper proximal connector and a lower proximal connector, respectively, the upper proximal connector being connected to the first support body half and the lower proximal connector being connected to the second support body half.
14. The end effector assembly of claim 13, wherein the articulation assembly further comprises a second connecting tab having two connecting apertures therein, the lower proximal and distal connecting members being riveted to the second connecting tab by a swivel axis, respectively.
15. The end effector assembly of claim 2, wherein the first support wall is adapted to support an outer sidewall of the firing member and the second support wall is adapted to support an inner sidewall of the firing member when the firing member is bent to a maximum angular position, the arc length of the first support wall being less than the arc length of the second support wall.
16. The end effector assembly of claim 15, wherein the portion of the first support wall of the holder is a first support region and the portion of the second support wall of the holder is a second support region, the proximal surface of the first support region being distal to the proximal surface of the second support region and the distal surface of the first support region being proximal to the distal surface of the second support region.
17. The end effector assembly of claim 2, wherein the distal edge of the first buttress wall is substantially aligned with an inner wall of a firing channel of the distal effector when the distal effector is extended in the direction of the longitudinal axis and the proximal end of the first buttress wall is substantially aligned with an inner wall of a channel of the proximal body portion that supports firing member for relative sliding.
18. The end effector assembly of claim 4 wherein a proximal edge of the first support wall is less than a first set point from an axial center of the proximal pivot axis and a distal edge of the first support wall is less than a second set point from an axial center of the distal pivot axis.
19. The end effector assembly of claim 18, wherein the distal end of the first buttress wall is in clearance engagement with the proximal end of the firing channel of the distal attachment member when the distal effector is extended in the direction of the longitudinal axis.
20. The end effector assembly of claim 16, wherein the proximal connector has a first stop tab on a side facing the holder, the first stop tab being opposite the proximal face of the first support region and having a first gap.
21. The end effector assembly of claim 20, wherein the distal link is provided with a second stop tab on a side facing the holder, the second stop tab being opposite the distal end face of the first support region and having a second gap.
22. The end effector assembly of claim 21, wherein the first and second stop tabs each have a first side disposed opposite the first support region and a second side disposed opposite the firing member, the first and second sides having an included angle of between 80-100 degrees.
23. The end effector assembly of claim 21, wherein the second sides of the first and second stop tabs are parallel to the longitudinal axis when the distal effector is extended in the direction of the longitudinal axis.
24. The end effector assembly of claim 22, wherein the first side of the first stop tab is disposed parallel to the proximal face of the first support region of the holder and the first side of the second stop tab is disposed parallel to the distal face of the first support region of the holder when the distal effector is extended in the direction of the longitudinal axis.
25. The end effector assembly of claim 8, wherein the first and/or second bend transfer members are formed as elastically deformable spring structures.
26. The end effector assembly of claim 8, wherein the first and/or second curved drive members are formed as a chain of pivotally connected rod segments.
27. The end effector assembly of any one of claims 1-26, wherein the distal effector is at an angle other than 0 ° relative to the longitudinal axis when the end effector assembly is in a to-be-loaded position.
28. The end effector assembly of claim 1, wherein said firing member comprises at least one firing beam and a firing connector proximal to the firing beam, a proximal end of said firing beam being connected to said firing connector.
29. The end effector assembly of claim 28, wherein a first catch and a second catch are disposed on a proximal side of the firing beam in opposition, and wherein a firing connection is disposed on the firing connection, the first catch and the second catch being hooked on opposite sides of the firing connection.
30. The end effector assembly of claim 29, wherein said firing link defines a guide slide at a distal end of the firing link, said guide slide extending in a longitudinal axis direction and adapted to limit the position of said firing beam.
31. The end effector assembly of claim 13, wherein said first support body half and said second support body half are provided with guide slots on opposite sides thereof, said firing member being slidably coupled to said guide slots.
32. The end effector assembly of claim 31, wherein the guide slot extends in a longitudinal axis direction and extends through an entire extension surface of the support body.
33. A surgical instrument comprising a handle assembly, an elongate body assembly, and an end effector assembly selectively coupled to the elongate body assembly, connected in sequence from a proximal end to a distal end, wherein the end effector assembly employs the end effector assembly of any one of claims 1-32.
CN202310947483.5A 2023-07-28 2023-07-28 End execution assembly adapted for surgical instrument and surgical instrument Active CN119405370B (en)

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CN202310947483.5A CN119405370B (en) 2023-07-28 2023-07-28 End execution assembly adapted for surgical instrument and surgical instrument
PCT/CN2024/108020 WO2025026246A1 (en) 2023-07-28 2024-07-28 Surgical instrument and end effector assembly thereof

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