Specific embodiment
Disclosed herein is embodiment of the present invention, it should be understood, however, that disclosed embodiment is only of the inventionExample, the present invention can be realized by different modes.Therefore, this disclosure is not to be construed to be restrictive, andIt is the basis only as claim, and how uses basis of the invention as introduction those skilled in the art.
With reference to Fig. 1-4, for convenience of stating, the side of subsequent all Proximity operation persons is defined as proximal end, and far from operatorOne side is defined as distal end.
As shown in Figure 1-3, working as casing especially in endoscope-assistant surgery carrying out surgical operation in conjunction with described in foregoing backgroundComponent (not shown) is inserted in place, and various Minimally Invasive Surgery instruments, such as surgery hand-held apparatus 10 can pass through sheath assembly shapeAt channel be inserted into body cavity.Possibility needs while the one or more sheath assemblies of use in surgical procedure, and surgery handerTool 10 also needs to configure one or more progress according to operation while operating.Fig. 1 is a kind of typical surgery hand of the prior artHolder tool 10, the working head 106 including distal end, proximal handle 11 and the lengthening bar portion 105 extended therebetween；The handle packetContaining front handlebar 101, rear handle 102 and the arm pivot post 103 for connecting it, the front handlebar 101 and rear handle 102 can be relative toThe arm pivot post 103 rotates；The front handlebar 101 includes preceding finger loop 110, and the rear handle 102 includes thumbCircle 120, preceding 111 bottom of finger loop is provided with support arm 112.The upside setting unlock trigger 115 of the preceding finger loop 111For realizing the locking and unlocking of the front handlebar 101 and rear handle 102.
Current endoscope-assistant surgery generally includes operation on gallbladder, laparoscopic inguinal hernia repair, peritoneoscope stomach bottom folding handArt, laparoscopic splenectomy, the operation such as laparoscopic appendectomy operation.The whole operation difficulty of endoscope-assistant surgery is larger, usesWhen it is longer, operative doctor needs 1~3 hour in lasting surgical procedure.In order to mitigate operation Chinese medicine growth time with difficult postureInstrument is operated, existing surgery hand-held apparatus is a degree of to consider Human Engineering Principle, can usually support a variety of holdGimmick is held, it is a degree of to reduce extreme operation posture and the sense that lessens fatigue.Finger grip gimmick and such as Fig. 3 as shown in Figure 2Shown in palm grip gimmick be most common two kinds of gimmicks.
It is pulled as Fig. 1 and Fig. 2 illustrate operative doctor using typical surgical hand-held apparatus 10 with finger grip gimmickThe grip state of organ or grasping tissue: the third finger of a certain hand of operative doctor passes through the preceding finger loop 111, middle finger patchIn 115 position of unlock trigger of the upside of preceding finger loop 111, medial surface of little finger is pressed on the support arm 112；Its thumbReferring to rotates back and forth the rear handle 102 around the arm pivot post 103 across the thumb circle 120 movement thumb, and by instituteState bar portion 105 will it is described after the movement of handle 102 be converted into the movement of the distal end working head 106.
It is pulled as Fig. 1 and Fig. 3 illustrate operative doctor using typical surgical hand-held apparatus 10 with palm grip gimmickThe grip state of organ or grasping tissue: the palm of a certain hand of operative doctor is adjacent to the side of the handle 11, and thumb is pressedIt stops handle 11 rear handle 102 is clamped in palm by side, forms a U-shaped clamping, little finger of toe presses before describedOn the support arm 112 of handle 101, the third finger passes through the preceding finger loop 110, and middle finger is attached to the preceding finger loop 110115 position of unlock trigger of upside, movement rotate back and forth the front handlebar 101 around the arm pivot post 103, and by describedThe movement of handle 102 is converted into the movement of the distal end working head after bar portion 105 will be described.
In clinical application, the finger gripping is enforced the law of equal importance with palm grip method, and usually requires frequent switching.Such as when needing to carry out tissue removing and appear blood vessel in clinical operation, one hand of operating doctor holds ultrasound knife or elastic separating plier is smallThe heart it is thriving carry out tissue removing, another hand generally has to hold nipper operation organ or tissue, forms synergistic effect, sideTissue strip operation can accurately be completed.When operative site does not appear sufficiently, or carry out tissue removing position it is shortWhen variation spatial extent in time is larger, operative doctor generallys use finger gripping and enforces the law to operate instrument, and needs lock machineStructure is set as invalid state.Those skilled in the art is to be understood that be enforced the law and latch mechanism invalid state using finger grippingWhen, operation instrument is the most flexible, therefore can open and close instrument quickly to grab, and clamp draws organ or tissue, flexiblyMobile organ or tissue, so as to matching tissue removing nimbly and freely.However it is enforced the law using finger gripping and there is no secondary lockingWhen, the finger of operative doctor is quite tired.It is not moved when the position short time that operative site sufficiently appears or carry out tissue removingWhen, operative doctor is it is generally desirable to quickly be switched to lock function effective status, by the coupling mechanism force clamp tightly of instrument itselfOrgan or tissue pulls or stirs the organ or tissue of block vision.Under lock function effective status, instrument progress is not operated usuallyMultiple quick opening and closing movement.When the organ or tissue of crawl or drawing is larger or heavier, operative doctor or assistant are logicalIt often is switched to palm grip method, because palm grip method tends to force and the freer diastole of posture, facilitates and is grasped energeticallyMake or can reduce fatigue.
It is inconvenient that the latch mechanism effective status and invalid state of the surgical instrument 10 of the prior art described in Fig. 1 switch, especiallyThe extremely difficult switching for carrying out effective status and invalid state when being using palm grip method.Further, since middle finger is exerted oneself, position is justIt is 115 position of unlock trigger of the upside of preceding finger loop 111, when operating instrument progress organ crawl, if middle finger is slightly exerted oneself, holdsIt easily causes middle finger to keep handle 11 in the unlocked state by trigger squeeze 115, that is, latch mechanism false triggering is easy to cause to unlock.
A kind of surgical instrument 20 of the embodiment of the present invention is illustrated in detail in Fig. 4-9, includes distal end working head 23, proximal end scissorsType handle 21 and the lengthening bar portion 22 extended therebetween；The handle 21 includes front handlebar 206, rear handle 202 and connects itsArm pivot post 261, and the front handlebar 206 and rear handle 202 can rotate relative to the arm pivot post 261；It is describedArm pivot post 261 and 206 integrated injection molding of front handlebar simultaneously pass through shaft hole 222, and front handlebar 206 and rear handle 202 are flexibly connected.The arm pivot post 261 may be set to be independent part for being flexibly connected front handlebar 206 and rear handle 202.The lengtheningBar portion 22 includes runner 214, outer bar portion 213 and draw-in bar 215, and the outer bar portion 213 and runner 214 are fixed together and installIn front handlebar 206, described 215 one end of draw-in bar is connect with the driving mechanism 211 and its other end is connect with rear handle 202And it is fixed in rear 202 fixation hole 221 of handle by fixing axle 218.
The working head 23 includes a pair of of binding clip 210 and the driving mechanism that is attached thereto, and the driving mechanism includes theOne link block 217, the second link block 216, sliding block 212, actuating arm 211 and pin 219.First link block 217, theTwo link blocks 216 respectively with the connection symmetrical above and below of a pair of of binding clip 210 and be fitted into actuating arm 211 together with sliding block 212 and use pin219 is fixed.215 distal end of draw-in bar is connect with sliding block 212, drives the movement of the draw-in bar 215 band movable slider 212 to move, with cunningFirst link block 217 that block 212 is cooperatively connected, the second link block 216 drive a pair of of binding clip 210 to realize opening and closing.This fieldTechnical staff it is readily conceivable that other link mechanisms for having disclosed, slide way mechanism or simple adaptation is done based on the prior artProperty modification, may be used to the substitution invention working head 23 and realize the same or similar function.20 basis of hand-held apparatusThe working head 23 configures difference, can be divided into the operating scissors with scissors head, the nipper with serration friction clamp head, band curved forcepsThe hoe scaler etc. on head.With the development of surgery hand-held apparatus, in order to cooperate different operation needs, occur more and more notThe working head of same type is within the scope of the invention, and is no longer enumerated one by one herein.
In a kind of case study on implementation, the front handlebar 206 includes preceding finger loop 262, it is described after handle 202 include thumb circle224.It operates the front handlebar 206 and rear handle 202 and rotates relative to the arm pivot post 261 and be converted into draw-in bar215 linear motion, and make driving mechanism 211 that binding clip 210 be driven to realize closure or unclamp.The handle 21 also includes latch mechanism24, the latch mechanism 24 includes effective model and invalid mode.Under invalid mode, the front handlebar 206 and rear handle 202 canIt rotates relative to the arm pivot post 261 and realizes the opening and closing of working head 23；Under effective model, described precedingHand 206 and rear handle 202 can rotate relative to the arm pivot post 261, and handle 202 is towards front handlebar 206 after permissionClose up and handle 202 is opened away from front handlebar 206 after limiting, as lock function；It is rotated when applying outer power drive trigger shaft,Handle 202 is opened away from front handlebar after permission, as unlocking function.
Those skilled in the art is to be understood that in laparoscopic surgery, due to the limitation of operative space, operative doctorIt is frequently necessary to for a long time with difficult gesture operation instrument, doctor is easy fatigue, or even induces arthritis, the risks such as scapulohumeral periarthritis.Therefore meet ergonomics or the laparoscope hand-held apparatus for mankind's Ergonomy (Ergonomics), can support a variety of grippingsGimmick reduces extreme operation posture and the sense that lessens fatigue, is even more important.It is published about the relevant mankind's function of laparoscopic surgeryIt is many to imitate the correlative study learned: representational research includes being published in Journal of Healthcare EngineeringNo. 4 the 587-603 pages of volume 3 of a review of the ergonomic issues in the in 2012Laparoscopic operating rom details mankind's Ergonomy harm of laparoscopic surgical instruments, other more parts of documentsIn also refer to the both effectiveness defect of the mankind and its harm of hysteroscope instrument, but do not provide solution.It is published in Journal2001 years of of laparoendoscopic& advanced surgical techniques volume 11 the 1stTechnical report,new ergonomic design criteria for handles of laparoscopicSome human efficiency subject's evaluation measures are listed in dissection forceps, however its evaluation measures is confined to based on human bodySurveying counts the decreased food size obtained, finger loop size design suggestion, and rough giving and evaluates existing handleThe method that difference holds experience, however do not provide design recommendation relevant for functional performance or hint.
Ergonomics is an extremely complex subject, according to international ergonomics association (IEA) definition,Ergonomics be one " anatomy of the research people in certain working environment, physiology and in terms of it is various becauseElement；Study the interaction of people and machine and environment；Research people is at work, how family life neutralization unified consider when having a holidayWorking efficiency, the health of people, safety and it is comfortable the problems such as subject.However up to the present, few in disclosed patented technologyIt is disclosed about laparoscope hand-held apparatus ergonomic applications case or correlative study.The present invention is former using ergonomicsReason, using the test and statistical research of the interdisciplinary studies such as anthropometry, biomethanics, time and work sutdy, proposesA kind of laparoscope hand-held apparatus meeting ergonomics and its design method, application method.
Briefly, surgical instrument 20 is substantially carried out subregion by the present invention as shown in Figure 5: after definition arm pivot post 261 arrives224 center position length of thumb circle of handle 202 be D, lengthen bar portion 22 include first axle 1000, cross arm pivot post 261 withSecond axis 2000 is arranged in 1000 vertical direction of first axle, and the first axle 1000 and second axis 2000 intersect at intersection point1001, intersection point 1001 is along 1000 proximate direction of first axle and along second axis 2000 by intersection point to handle rotor shaft directionThe square area that length is D is set, by square area along 1000 liang of equal parts (D/2) of first axle, along second axis 2000Trisection (D/3) is set as the region A1, the region A2, the region A3 and the region B1, the region B2, the region B3.It needs furtherIt points out, aforementioned " 224 center position length of thumb circle of arm pivot post 261 to rear handle 202 is D ", the specific value of D is notDefinite value, numerical value change in a lesser section.Experimental study and system are carried out based on anthropometry and biomechanical principleIt is 60≤D≤70 (unit: millimeter) that meter, which obtains optimal D value section,.
The hand-type of different crowd and different gripping gimmicks in order to balance in a kind of optional scheme, are arranged in the region A1Control effective model and when invalid mode switching state the first button 237, setting trigger 205 in the region A2, A3 sets in regionMiddle finger pressing area is set, while runner 214 is set in the region B1.In another preferred technical solution, first button237 settings are arranged in the region A1 in the corresponding region A1 of handle 21, the second button 237a along second axis 2000 and described firstThe position symmetric position A1-1 for the plane that axis 1000 is formed, operating the first button 237 or the second button 237a can controlThe switching of handle 21 realization effective model and invalid mode.
The working principle of button, trigger and roller position design is described more particularly below.Such as Fig. 6-8, when using finger grippingWhen holding gimmick, by taking the operation of the right hand of operative doctor as an example, the third finger passes through the preceding finger loop 262, and middle finger is attached to preceding fingerThe region A3 of the upside of circle 262, index finger can flexibly control the region A1, the region A2 or the region B1.The index finger is in the area A1Mainly play the role of primarily serving along proximate, or the first button of promotion 237 of distal end proximally in the region A2 in domainPressing control trigger 205 is primarily served in the region B1 and is fiddled with the effect of rotating wheel 214 along 214 direction of rotation of runner.
When further, using finger grip gimmick, index finger reaches the region B1 and is substantially at straight configuration.In stretchingThe index finger of state does push action or does front and back pushing action along 1000 direction of first axle, it has not been convenient to exert a force in the region B1It has an effect, therefore status button should not be set.Index finger comfortably can do rotary dial fortune along 214 direction of rotation of runner in the region B1It is dynamic.For index finger at the region A1 and the region A2, finger is in bending state, it is possible to comfortably be pressed or be pushed and is dynamicMake.By the setting of the first button 237 in the region A1, and trigger 205 is arranged in the region A2, and runner 214 is arranged in the region B1,This set make index finger can easily stir with rotating wheel 214, while the first button 237 can easily be pushed to realize effectivelyThe switching of mode and invalid mode, while easily can press or pull trigger 205 and realize cutting for lock state and unlocked stateIt changes.Those skilled in the art is to be understood that surgical field especially endoscope-assistant surgery field, the index finger of operative doctorCommonly known as index finger, selection of the index finger usually not as output operating force operation handle, index finger is commonly used to controlInstrument direction processed or switching state button etc..Aforementioned various states, the switching or operation of function are quite frequent, and in abdomenIn endoscope-assistant surgery, since the eyes of operative doctor usually will pay close attention to the monitor in front horizontal direction closely, and have no time to bowOneself manipulation hand or patient region are observed, therefore the switching manipulation convenience of this various states is extremely important.
As shown in figure 9, when the right hand of operative doctor is enforced the law by finger gripping and switches to palm grip gimmick, surgical operation doctorRaw palm is adjacent to the side of the scissorstype handle 21, thumb pin scissorstype handle 21 to side by rear handle 202It is clamped in palm, forms a U-shaped clamping.At this point, stirring of still can be convenient of its index finger and rotating wheel 214, togetherWhen easily can press or pull trigger 205 realize lock state and unlocked state switching；At this time since the clamping of palm hindersGear, index finger can not operate the first button 237 of switching state in the region A1, however the thumb of operative doctor just presses at this timeThe region A1-1, therefore can easily push the switching of the second button 237a realization effective model and invalid mode.
In currently preferred technical solution, first button 237 and the second button 237a are relative to along the second axisThe plane that line 2000 and the first axle 1000 are formed it is substantially symmetric, those skilled in the art it will be easily understood that thisKind symmetric relation makes doctor with left-hand finger clinch or palm grip method operation instrument 20, uses the present invention with the right handSurgical instrument 20 operation it is substantially equivalent, therefore repeat no more.
In conclusion the positional relationship of the first button of the present invention, the second button, trigger and runner is arranged, it can be sameWhen meeting the right hand (left hand) finger grip gimmick index finger be conveniently accomplished runner rotation, effective model and invalid mode switching,Lock state and unlocked state switching.Index finger is conveniently accomplished runner when can also meet the right hand (left hand) palm grip gimmick simultaneouslyRotation, lock state and unlocked state switching, thumb complete the switching of effective model and invalid mode.Moreover, this position is closedThe setting of system, can also meet simultaneously finger gripping enforce the law and finger gripping enforce the law between facilitate switching.Its advantages can be simpleThe description of summary are as follows: can only rely on the touch feedback of operative doctor, convenient and efficient progress finger gripping is enforced the law to be become with palm grip methodIt changes, conveniently operates runner rotation, effective model and invalid mode switching, lock state and unlocked state switching.
Studies have shown that up to the present, there are no patented technology or document disclose laparoscopic instrument of the present invention andIts design method, application method.Also without any enterprise, group or personal disclosure, or production, or sale abdomen of the present inventionHysteroscope instrument.It is disclosed in the prior art, common laparoscopic surgical instruments by its latch mechanism state switching push button setting existThe region B1 (such as structure of U.S. patent Nos US5626608 disclosure), the mass production similar with this patented technology, and makeLaparoscopic surgical instruments (such as with laparoscope grasping forceps series of Auto Suture brand sale), latch mechanism state is pressedButton is arranged in the region B1, is enforced the law when operating this kind of instrument using finger gripping, the comfort of effective model and invalid mode switchingIt is not good enough, and be inconvenient to support the effective model under palm grip gimmick and invalid mode switching.Another common laparoscopeSurgical instrument be locked/unlock trigger be arranged in the region B2 and only comprising two states of lock state and invalid state (such asThe structure that U.S. patent Nos US6117158 is disclosed), the mass production similar with this patented technology and the laparoscope hand usedArt instrument (such as with ENDOPATH brand sale laparoscope grasping forceps series), be locked/unblock button be arranged in the area B2Domain, is enforced the law using finger gripping or when palm grip method operates be inconvenient to carry out the correlation of lock function and switches.It is another commonLaparoscopic surgical instruments will lock the setting of locking/unlocking trigger and be arranged in the region A3 and by invalidating mode switch button in the area A2Domain (such as structure of U.S. patent Nos US8551077, American invention application US20060004406 disclosure), with this patent skillThe similar mass production of art, and use laparoscopic surgical instruments (such as with CLICKline brand sell laparoscope grasping forcepsSeries), it is arranged by the setting of lock locking/unlocking trigger in the region A3 and by invalidating mode switch button in the region A2.It is this to setMeter need to usually carry out lock locking/unlocking switching with middle finger operating trigger, carry out invalidating mould with middle finger or index finger operation buttonFormula switching, operates and switches uncomfortable.It may cause inconvenience in the region A3 it is important to note that being arranged trigger.Most common problem mainly includes, and when the instrument is in the lock state, operative doctor either finger gripping is enforced the law or palmClinch, when operation instrument (nipper) clamps organ or tissue and pulls mobile, middle finger is almost required for assisting force, thisTrigger is easily touched under kind state, leads to false triggering, so that instrument is unexpectedly switched to unlocked state from lock state, leads to deviceOfficial or tissue slip, and cause clinical use inconvenient, or even induce malpractice.
Figure 10-22 depicts a kind of embodiment of surgical instrument 20 in more detail.The surgical instrument 20 includes latch mechanism24, Figure 10-18 depict the Nomenclature Composition and Structure of Complexes of latch mechanism 24.As shown in Figure 10 and Figure 17, the latch mechanism 24 includes trigger205, locking plate 208, the anodontia cantilever 226 being linked together with rear handle 202.The anodontia cantilever 226 include from rear handle 202 toThe anodontia cantilever 223 of outer protrusion and anodontia cantilever distal end 227.The anodontia cantilever 223 is set as arcuate structure, includingThe shape of cantilever inner wall 229 and cantilever outer wall 228, the cantilever inner wall 229 and cantilever outer wall 228 is substantially connected from handle 202Place is that the center of circle extends the anodontia cantilever 223 into composition isocentric circular arc along arm pivot post 261.223 material of anodontia cantileverMaterial includes the plastic material that integrated injection molding is carried out with rear handle 202, and it is even soft to be also possible to other semi-rigid or rigid materialsProperty material is made.The latch mechanism 24 also includes button assembly 25 and elastic element 250, the trigger 205, elastic element 250It is installed along in the front handlebar 206 with button assembly 25.The elastic element 250 drives trigger 205 to carry out after pressingIt realizes and resets.The trigger 205 controls locking plate 208 and locking and unlocking are realized in the cooperation of anodontia cantilever 226.In the prior art usuallyUsing lock strap with teeth, the lock tooth of the lock strap is easy to expose outside handle, is likely to result in operative doctor finger or gloves scratch.TogetherWhen lock strap with teeth when in use, the density degree for locking tooth determines the spacing of each lock tooth, and then determines the work of surgical instrumentThe degree of head grip tissue organ.It should be appreciated by those skilled in the art that in drawing operation energetically, in order to keep continuing folderTight drawing, if dynamics is inadequate, hold mode when can not achieve drawing energetically is easy to appear histoorgan landing, influences to perform the operationProcess, or even cause operative failure；If on the other hand working head excessively clamps, and may cause the damage of histoorgan,It is unfavorable for patient's recovery.The lock strap by encryption lock tooth although can adjust working head clamping degree, due to lockTooth is too small may to make latch mechanism unreliable, cause latch mechanism failure mode, and keeps certain lock space width may cause and wantClamping force is inadequate or clamping force is excessive.Anodontia cantilever 223 and locking plate 208 of the invention cooperates, and any position may be implementedThe locking set meets the clamping requirement that chucking power conforms exactly to different operations and different tissues organ site, realizes electrodeless variation,Surgical instrument 20 is set to keep suitable chucking power position and clamping force.
As shown in figs. 10-12, the button assembly 25 includes button sliding block 203 and the first button 237 and the second button237a.The button block 203 includes the slide body 230 with limiting slot 231, and the slide body 230 includes slider side wall 234(235) and limited block 233.The slider side wall 234 (235) and limited block 233 limit limiting slot 231 together.It is describedSlider side wall 234 (235) extends outward the button mounting post fixed with the first button 237 and the second button 237a cooperation232, push the first button 237 or the second button 237a to can be used for driving the button sliding block 203 from distally proximally slidingOr proximally slided to distal end, and then the trigger 205 is pushed to rotate, realize the switching of effective model and invalid mode.It is describedFirst button 237 includes the fricting strip 238 with cambered surface, can be convenient finger force.
As shown in figure 13, the trigger 205 includes trigger shaft hole 258 and connect trigger shaft with front handlebar 206269, the first cam surface 251, the second cam surface 255 and finger buckle 259.The trigger 205 includes the trigger for being substantially in crescent shapeBody 254, the setting of the first cam surface 251 is in 254 side of trigger body, and finger buckle 259 is arranged in 254 other side of trigger body.The trigger body 254 is used for elastic elements 250 close to the 251 position providing holes 257 of the first cam surface.The trigger turnsAxis hole 258 is arranged between the first cam surface 251 and finger buckle 259 through the trigger body 254.First cam surface 251Including cam curve section 253 and cam planarea 252.When promoting button component 25 is proximally mobile to distal end, the buttonThe limited block 233 of component 25 contacts match respectively with the cam curve section 253 of the first cam surface 251 and cam planarea 252It closes, and then the rotation of trigger 205 is pushed to realize that effective model switches to invalid mode.Second cam surface 255 is along the triggerThe side of body 254 extends outwardly, second cam surface 255 with locking plate 208 described in 205 rotation forces of trigger withThe anodontia cantilever 226 realizes locking and unlocking.
As shown in figure 14, the locking plate 208 includes the lockhole 284 to match with anodontia 226 shape of cantilever and size,The anodontia cantilever 226 penetrates the lockhole 284.The locking plate 208 includes the first sheet body 281, the second sheet body 283, Yi JilianThe changeover portion 282 of the two, first sheet body 281, the second sheet body 283 and set of transitions are connect into the locking plate for being substantially in " Z " font208.Locking plate spring 204 is arranged in the proximal end face of second sheet body 283.Second sheet body 283 can pass through with locking plate spring 204The modes such as welding, or movable axis limit connect.The lockhole 284 of first sheet body 281 includes the first lockhole wall 285 and secondOutside the cantilever inner wall 229 and cantilever of lockhole wall 286, the first lockhole wall 285 and the second lockhole wall 286 and anodontia cantilever 226Wall 228 is substantially matching, and the distance between the first lockhole wall 285 and the second lockhole wall 286 are greater than outside cantilever inner wall 229 and cantileverThe distance between wall 228.208 material of locking plate includes rigid material, such as metal material, thermoset plastic material, can also be withIt is made including semi-rigid type.When trigger 205 255 property of can choose of the second cam surface with the contact of the locking plate 208, applyFinger buckle 259 described in outer power drive rotates the trigger 205 around trigger shaft 269, and the second cam surface 255 drives instituteState locking plate 208 movement, be allowed to anodontia 226 clearance fit of cantilever, after permission handle 206 away from front handlebar 202 opening；One kind canThe mode of choosing, when first sheet body 281 is substantially vertical with the anodontia cantilever 226, the first lockhole wall 285 in cantilever229 clearance fit of wall, the second lockhole wall 286 and 228 clearance fit of cantilever outer wall, the anodontia cantilever 226 is around arm pivot post261 rotations, the anodontia cantilever 226 be free to pass through from the lockhole 284, and corresponding at this time is unlocked state or nothingEffect mode.When first sheet body 281 is with anodontia 226 inclination contact of cantilever, the locking plate spring 204 drives the lockPiece 208 is allowed to be pressed into contact with anodontia 226 tight fit of cantilever, the first lockhole wall 285 with cantilever inner wall 229, the second lockholeWall 286 is pressed into contact with cantilever outer wall 228, and the anodontia cantilever 226 is rotated around arm pivot post 261,202 direction of handle after permissionFront handlebar 206 closes up and handle 202 is opened away from front handlebar 206 after limiting, and is at this time lock function.
The front handlebar 206 for installing fixed latch mechanism 24 is depicted as shown in Fig. 5, Figure 10 and Figure 15-17.The front handlebar206 further include front handlebar lid 209 engaged therewith.The front handlebar 206 removes preceding 262 part of finger loop, with front handlebar lid209 be substantially in symmetrical structure.In the substantially region A1-1 and the region A1, the front handlebar lid 209 and front handlebar 206 are respectively symmetrically setFirst sliding groove 297 and second sliding slot 267 are set, the first sliding groove 297 and second sliding slot 267 limit 203 edge of button sliding blockSliding slot direction is moved back and forth.In the present embodiment, the first sliding groove 297 and second sliding slot 267 are long and narrow sliding slots, described narrowThe direction of long sliding slot is basically parallel to the lengthening bar portion 22, and it should be appreciated by those skilled in the art the first sliding grooves 297It may be set to be arc chute with second sliding slot 267.As it was noted above, index finger is at the region A1 and the region A2, fingerIn bending state, it is possible to pressing or pushing action are comfortably carried out, and index finger is pushed in experience using arc not as good as straightThe promotion in line direction is comfortable.Therefore it is not so good as using the operating experience of arc chute using the linear type for being roughly parallel to bar portion directionLong and narrow sliding slot.The first sliding groove 297 and 267 proximal openings 297a (267a) of second sliding slot and distal openings 297b (267b) rulerIt is very little can be identical, a preferred technical solution, the proximal openings size 297a (267a) be greater than distal openings size 297b(267b) can further promote operating experience in sliding using this mode, give when effective model and invalid mode are convertedOperative doctor significantly prompts.
In the substantially region A1-1 and the region A1, the front handlebar 206 turns comprising arm pivot post 261 and trigger fixed theretoAxis 269, the arm pivot post 261 and trigger shaft 269 can be set to independent part and the installation of front handlebar 206 is fixed, can alsoA part is molded into front handlebar 206.The front handlebar lid 209 is set with arm pivot post 261 and 269 corresponding position of trigger shaftSet fixed column 291 (299).A kind of optional technical solution, the trigger shaft 269 and the trigger shaft hole 269 of trigger 205 are setIt is set to an entirety, trigger 205 includes trigger shaft 269, and the front handlebar lid 209 turns with the setting of 206 corresponding position of front handlebarAxis hole.In the substantially region B1 and its symmetrical region, the front handlebar 206 also includes the runner mounting groove 265 of remote location, describedFront handlebar lid 209 includes runner mounting groove 295.The runner mounting groove 265 (295) limits runner together and does rotation fortune in slotIt is dynamic.The front handlebar 206 and front handlebar lid 209 include the cantilever groove 263 that the anodontia cantilever 226 of handle 202 passes through after accommodating(293), the cantilever groove 263 (293) forms complete cantilever opening, and the cantilever opening size is greater than outside anodontia cantilever 226Shape size, and when anodontia cantilever 226 is rotated around arm pivot post, does not contact with the cantilever groove 263 (293).The front handlebar 206With the cantilever storehouse 266 (296) that front handlebar lid 209 further includes for avoiding anodontia cantilever 226, the cantilever storehouse 266 (296) existsWhen surgical instrument 20 is closed up, anodontia cantilever 226, a kind of optional technical solution can be accommodated, the cantilever storehouse 266 (296) existsThe front handlebar 206 and front handlebar lid 209 show as the hollow storehouse outwardly protruded.The front handlebar 206 and front handlebar lid 209 are alsoThe support slot 264 (294) of lever motion, the rib that the support slot 264 (294) is protruded by two sides are done including limiting locking plate 208260 (290) limit.The rib 260 (290) of the support slot 264 (294) is when locking plate 208 makes rotating motion as rotationTurn supporting point.The front handlebar 206 and front handlebar lid 209 further include the spring groove 268 (298) for limiting locking plate spring 204,204 one end of locking plate spring is connect with locking plate 208, and the other end is limited in spring groove 268 (298) in compressive state.
As the careful latch mechanism 24 that depicts of Fig. 5 and Figure 17-20 switches between effective model and invalid mode.Work as fingerClinch, for the right hand operation of operative doctor, the third finger passes through the preceding finger loop 262, and middle finger is attached to preceding finger loopThe region A3 of 262 upside, index finger can flexibly control the region A1, the region A2 or the region B1.When surgical instrument 20 needsWhen being rapidly performed by closure and opening operation, typically such as at this moment just need when operation on gallbladder carries out blood vessel exfoliation by handArt instrument 20 is switched to invalid mode by effective model.The index finger is in the region A1 by along proximate promoting button component 25The first button 237 it is mobile, first button 237 drives button block 203 along the first sliding groove 297 and second sliding slot 267It is mobile.203 limited block 233 of button block interacts with first cam surface 251, and the trigger 205 is driven to surroundTrigger shaft 269 rotates clockwise, and in the process, the second cam surface 255 of the trigger 205 is with 205 up time of triggerSecond sheet body 283 of needle rotation forces locking plate 208 tilts and the lockhole along rotation counterclockwise, the rotation of the first sheet body 281284 with anodontia 226 clearance fit of cantilever.When limited block 233 is moved to the cam planarea 252 of first cam surface 251When, the trigger 205 forms self-locking with the button block 203, and the elastic element 250 is not capable of resetting.At this time latch mechanism 24 byEffective model is switched to invalid mode, and it should be appreciated by those skilled in the art under invalid mode, due to the lockhole 284It is in clearance fit state always with anodontia 226 clearance fit of cantilever, so the front handlebar 206 and rear handle 202 of handle 21 canEasily to be closed up and be opened, meet the needs for the tissue removed and sheared when finger gripping is enforced the law.And when operationDoctor, which is enforced the law using the right hand by finger gripping, to be switched palm grip gimmick and carries out pulling organ or tissue energetically and when realizing occlusion, thisWhen just need surgical instrument 20 being switched to effective model by invalid mode.The palm of surgeon is adjacent to the scissors-typeThe side of handle 21, thumb pin scissorstype handle 21 rear handle 202 is clamped in palm to side, form a UThe clamping of type.Since the clamping of palm stops, index finger is unable to control the first button 237 of switching state in the region A1, and at this timeJust thumb press is in the region A1-1, it is possible to carry out the second button 237a of convenient promotion distally proximally by thumbMovement is pushed, the second button 237a drives button block 203 to move along the first sliding groove 297 and second sliding slot 267.InstituteIt states 203 limited block 233 of button block to interact with first cam surface 251, drives the trigger 205 around trigger shaft269 rotations counterclockwise, in the process, the trigger 205 does resetting movement under the action of elastic element 250, and described secondWith the trigger 205, rotation drives the second sheet body 283 and drives 281 edge of the first sheet body of the locking plate cam surface 255 counterclockwiseReset is rotated clockwise, first sheet body 281 and anodontia 226 inclination contact of cantilever, the locking plate spring 204 drive instituteIt states locking plate 208 to be allowed to be pressed into contact with anodontia 226 tight fit of cantilever, the first lockhole wall 285 with cantilever inner wall 229, secondLockhole wall 286 is pressed into contact with cantilever outer wall 228, and the anodontia cantilever 226 is rotated around arm pivot post 261, handle after permission202 close up and handle 202 is opened away from front handlebar 206 after limiting towards front handlebar 206.At this point, operative doctor can pass throughThe locking plate 208 is allowed to realize 23 snap-lock of working head with the pressing friction of anodontia cantilever 226, avoids clamping for a long timeFirmly cause the fatigue of palm.It should be appreciated by those skilled in the art, between above-mentioned effective model and invalid mode mutually intoRow switching is either enforced the law using finger gripping or when palm grip gimmick, singlehanded can freely be operated.
In addition, the operative doctor when lefthanded is completed mutually to switch between above-mentioned effective model and invalid modeWhen operation, whole operation process is similar, difference mainly the right hand carry out finger gripping enforce the law when, what index finger was stirred be first byButton 237, when using palm grip gimmick, that thumb is stirred is the second button 237a；And left hand carries out finger gripping when enforcing the law, index fingerThat stir is the second button 237a, and when using palm grip gimmick, what thumb was stirred is the first button 237.The technology of this fieldOn the one hand personnel may be used it should be understood that by the way that the first button 237 and the second button 237a is arranged in the region A1 of handle 21 and A1-1So that operative doctor is in different surgical environments, for example, need to be rapidly performed by closure and opening strip operation or it is long whenBetween drawing organ operation etc., can easily carry out mutually switching between effective model and invalid mode using the same hand,Do not need an other hand carry out cooperation or other people carry out cooperation complete operation；On the other hand either right-handed is also metOr the operative doctor that is operated of lefthanded can a hand realize the mutual switching of effective model and invalid mode.
As Fig. 5, Figure 14 and Figure 19-22 it is careful depict latch mechanism 24 under effective model, lock function and unlock functionSwitching between energy.The first button 237 or the second button 237a for first confiring that handle 21 are in proximal location, i.e. surgical instrument20 under effective model.As shown in figs. 17-18, it when needing to carry out pulling organ energetically for a long time, is used with operative doctorIt is sketched for palm grip gimmick.The palm of surgeon is adjacent to the side of the scissorstype handle 21, thumbScissorstype handle 21 rear handle 202 is clamped in palm to side is pinned, a U-shaped clamping is formed, rear handle 202 is madeFor fixed handle, little finger of toe is pressed on the support arm 264 of the front handlebar 206, and the third finger passes through the preceding finger loop 262,Its middle finger is attached to the upper side position of the preceding finger loop 262, and by middle finger, nameless and little finger of toe is exerted oneself together, drives front handlebarClosing up for handle 21 is realized in 206 rotations, and then realizes working head 23 and closure clamping.In the process, front handlebar 206 is by remoteClockwise rotary motion is proximally done at end, and the rear handle 202 does rotary motion counterclockwise, institute relative to front handlebar 206It states anodontia cantilever 226 to rotate around arm pivot post 261, first sheet body 281 does counterclockwise movement, the second sheet body 283 by promotionPush compression locking plate spring 204, the first lockhole wall 285 is contacted with cantilever inner wall 229 at this time, the second lockhole wall 286 with hangArm outer wall 228 contacts, but handle 202 closes up towards front handlebar 206 after not influencing.
Once stopping closing movement, since the compressed reaction force of the locking plate spring 204 drives the locking plate 208 to makeWith anodontia 226 tight fit of cantilever, first sheet body 281 and anodontia 226 inclination contact of cantilever, the first lockhole wall285 are pressed into contact with cantilever inner wall 229, and the second lockhole wall 286 is pressed into contact with cantilever outer wall 228, and handle 202 deviates from after limitationFront handlebar 206 opens.At this point, operative doctor can be allowed to the pressing friction with anodontia cantilever 226 by the locking plate 208It realizes 23 snap-lock of working head, avoids clamping the fatigue for firmly causing palm for a long time.
As shown in Figure 10 and Figure 19-22, when needing to unlock operation, by taking operative doctor is using palm grip gimmick as an exampleIt is sketched.The palm of surgeon is adjacent to the side of the scissorstype handle 21, and thumb pins scissorstype handle 21Rear handle 202 is clamped in palm by side, formed a U-shaped clamping, rear handle 202 be used as fixed handle, little finger of toePressing on the support arm 264 of the front handlebar 206, the third finger pass through the preceding finger loop 262, middle finger be attached to it is described beforeThe upper side position of finger loop 262 applies finger buckle 259 described in outer power drive by index finger pressing first and rotates clockwise, drivesSecond cam surface 255 is rotated with the trigger 205, and the second cam surface 255 of the trigger 205 is suitable with the trigger 205Second sheet body 283 of hour hands rotation forces locking plate 208 tilts and the lock along rotation counterclockwise, the rotation of the first sheet body 281Hole 284 and anodontia 226 clearance fit of cantilever.Second sheet body 283 pushes compression locking plate spring 204, at this time first lockHole wall 285 is not contacted with cantilever inner wall 229, and the second lockhole wall 286 is not also contacted with cantilever outer wall 228, and handle 202 is carried on the back after permissionIt is opened from front handlebar 206, as unlocking function.In the case where keeping index finger to press 205 state of trigger, the handle 202 is with beforeHandle 206 can freely be closed up and opening operation.When index finger unclamps the finger buckle 259, the trigger 205 is in bulletIt automatically resets under the action of property element 250, second cam surface 255 is separated with the second sheet body 283, and the locking plate 208 is being lockedIt automatically resets under the rebound effect of flat spring 204, the locking plate 208 is allowed to the compression with anodontia cantilever 226.
It should be appreciated by those skilled in the art the present invention realizes surgical instrument 20 using anodontia cantilever 226 and locking plate 208Unlocking function and lock function the locking of any position may be implemented during handle 21 closes up, meet chucking power justThe clamping requirement for meeting different operations and different tissues organ site, realizes electrodeless variation, and the drawback for overcoming lock strap with teeth makesSurgical instrument 20 can keep suitable chucking power position and clamping force.
If Figure 23-25 depicts another embodiment, surgical instrument 30 is roughly the same with surgical instrument 20, primarily directed toAnodontia cantilever 226 and locking plate 208 of the latch mechanism 24 for locking are replaced, and are cooperated using cantilever 326 with teeth and trigger 305Realize lock function and unlocking function.
The surgical instrument 30 include comprising distal end working head 23, proximal end scissorstype handle 31 and extend therebetween plusLong bar portion 22；The handle 31 includes front handlebar 206, rear handle 202 and the arm pivot post 261 for connecting it, and the front handlebar206 and rear handle 202 can rotate relative to the arm pivot post 261.The handle 31 includes latch mechanism 34, the lockMechanism 34 and latch mechanism 24 all include effective model and invalid mode, and the two switching mode is substantially equivalent, is not repeated herein.InstituteStating latch mechanism 34 includes realizing locking from cantilever 326 made of the extension of rear handle 202 and the cooperation of trigger 305.The cantilever 326 wrapsContaining multiple first lock teeth 325, and the trigger 305 includes the second lock tooth 342 to match with the sawtooth；When the lock machineWhen structure 34 is effective model, the elastic element 350 drives the trigger 305 to make the first lock tooth 325 and the second lock tooth342 are mutually twisted, and handle 202 closes up towards front handlebar 206 after permission and handle is opened away from front handlebar after limiting, and as lockFunction；Applying outer power drive finger buckle 259 rotates the trigger 305 around trigger shaft, makes the first lock 325 He of toothSecond lock tooth 342 is mutually disengaged, and handle is opened away from front handlebar after permission, as unlocking function.
Many different embodiments and example of the invention are had shown and described.One ordinary skill of this fieldPersonnel can make adaptive improvement to the method and instrument by suitably modified without departing from the scope of the invention.Several kinds of amendment schemes are referred, and for those skilled in the art, other amendment schemes are also to be contemplated that.Therefore the scope of the present invention should be according to accessory claim, while being understood not to be shown and recorded by specification and attached drawingStructure, the particular content of material or behavior limited.