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KR20220039820A - 회전가능 샤프트를 구비한 구동 메커니즘을 갖는 수술용 스테이플러 - Google Patents

회전가능 샤프트를 구비한 구동 메커니즘을 갖는 수술용 스테이플러 Download PDF

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KR20220039820A
KR20220039820A KR1020227008460A KR20227008460A KR20220039820A KR 20220039820 A KR20220039820 A KR 20220039820A KR 1020227008460 A KR1020227008460 A KR 1020227008460A KR 20227008460 A KR20227008460 A KR 20227008460A KR 20220039820 A KR20220039820 A KR 20220039820A
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drive shaft
driver
orientation
reverse
handle assembly
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KR1020227008460A
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KR102526549B1 (ko
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아탈 파텔
조나단 코바치
크리스티나 엔. 리드
매튜 엠. 베세라
게리 엠. 존슨
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어플라이드 메디컬 리소시스 코포레이션
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • 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

수술용 스테이플러를 위한 핸들 어셈블리는 회전가능 구동 샤프트를 포함할 수 있다. 구동 샤프트는, 조 어셈블리를 반복가능한 개방 및 폐쇄 모드로 구동할 수 있는 제 1 회전 배향, 조 어셈블리를 스테이플 발사 모드로 구동할 수 있는 제 2 회전 배향, 및 조 어셈블리를 후진 모드로 구동할 수 있는 제 3 회전 배향을 가질 수 있다. 핸들 어셈블리는, 회전가능 구동 샤프트를 회전 배향들 중 하나로 불연속적으로 위치시키도록 구성된 회전 메커니즘을 포함할 수 있다. 회전 메커니즘은, 구동 샤프트를 회전시키기 위한 슬라이드가능 스위치 또는 선택기를 포함함으로써 한손 동작을 위해 구성될 수 있다.

Description

회전가능 샤프트를 구비한 구동 메커니즘을 갖는 수술용 스테이플러{SURGICAL STAPLER HAVING ACTUATION MECHANISM WITH ROTATABLE SHAFT}
관련 출원들에 대한 상호 참조
본 출원은 "SURGICAL STAPLER HAVING ACTUATION MECHANISM WITH ROTATABLE SHAFT"라는 명칭으로 2013년 03월 15일자로 출원되어 현재 계류중인 미국 가특허 출원 일련번호 61/794,700호에 대한 이익을 주장한다. 이러한 선행 출원들의 전부가 이로써 본원에 참조로써 포함된다.
기술분야
본 출원은 전반적으로 수술용 폐색 기구에 관한 것으로서, 더 구체적으로, 수술용 스테이플러에 관한 것이다.
수술용 스테이플러들은 조직을 접근 또는 클램핑(clamp)하고 클램핑된 조직을 함께 스테이플링하는데 사용된다. 이와 같이, 수술용 스테이플러들은 조직이 적절하게 위치되고 캡쳐(capture)되는 것을 보장하며 조직을 관통해 스테이플(staple)들을 드라이브(drive)하기 위한 메커니즘들을 갖는다. 결과적으로, 이는, 예를 들어, 클램핑된 조직의 적절한 스테이플링을 제공하기 위한 복잡한 메커니즘들과 함께 복수의 트리거(trigger)들 및 핸들(handle)들을 초래하였다. 이러한 복잡한 메커니즘들을 이용하면, 수술용 스테이플러들은 디바이스 고장 및 사용자에 대한 혼란에 대한 잠재적인 소스들뿐만 아니라 증가된 제조 부담을 가질 수 있다. 따라서, 복잡한 메커니즘들 없이 클램핑된 조직의 신뢰할 수 있는 스테이플링이 희망된다.
특정 실시예들에 있어, 수술용 스테이플러가 본원에 제공된다. 수술용 스테이플러는 가늘고 긴 샤프트, 조(jaw) 어셈블리, 및 핸들 어셈블리를 포함한다. 가늘고 긴 샤프트는 근위 단부 및 원위 단부를 갖는다. 가늘고 긴 샤프트는 근위 단부와 원위 단부 사이에 종축(longitudinal axis)을 규정(define)한다. 조 어셈블리는 가늘고 긴 샤프트의 원위 단부에 위치된다. 조 어셈블리는 제 1 조, 제 2 조, 및 복수의 스테이플(staple)들을 포함한다. 조 어셈블리는 폐쇄 구성(closed configuration), 개방(open) 구성, 및 발사(firing) 구성 중 하나로 선택적으로 위치될 수 있다. 핸들 어셈블리는 가늘고 긴 샤프트의 근위 단부에 위치된다. 핸들 어셈블리는 고정 핸들, 고정 핸들에 피봇 가능하게(pivotably) 연결된 이동가능 트리거, 및 구동 샤프트를 포함한다. 구동 샤프트는 핸들 어셈블리 내에서 구동 샤프트의 종축에 대하여 길이 방향으로(longitudinally) 슬라이드가능하며(slideable), 핸들 어셈블리 내에서 종축에 대하여 회전가능하다. 구동 샤프트는 조 어셈블리에 동작 가능하게 연결되며, 구동 샤프트는 조 어셈블리의 개방 구성에 대응하는 제 1 위치로부터 조 어셈블리의 폐쇄 구성에 대응하는 제 2 위치로, 그리고 제 2 위치로부터 발사 구성에 대응하는 제 3 위치로 길이 방향으로 슬라이드가능하다. 구동 샤프트는 이동가능 트리거에 동작 가능하게 연결된다. 구동 샤프트는, 트리거의 움직임이 구동 샤프트를 제 2 위치와 제 3 위치 사이에서 움직이는 제 1 배향과 트리거가 구동 샤프트를 제 3 위치로부터 제 1 위치로 움직이는 제 2 배향 사이에서 회전가능하다.
특정 실시예들에 있어, 수술용 스테이플러를 위한 핸들 어셈블리가 제공된다. 수술용 스테이플러는, 근위 단부 및 원위 단부를 갖는 가늘고 긴 샤프트로서, 가늘고 긴 샤프트는 근위 단부와 원위 단부 사이에 종축을 규정하는, 가늘고 긴 샤프트, 및 가늘고 긴 샤프트의 원위 단부에 배치된 조 어셈블리를 포함한다. 핸들 어셈블리는 하우징, 하우징 내에 위치된 구동 메커니즘, 및 커플러를 포함한다. 구동 메커니즘은 전진 드라이버, 후진 드라이버, 및 구동 샤프트를 포함한다. 구동 샤프트는 종축을 따라 연장한다. 구동 샤프트는 종축에 대하여 회전가능하게 하우징에 연결된다. 구동 샤프트는 전진 표면 및 후진 표면을 포함한다. 전진 표면은 구동 샤프트를 따라 길이 방향으로 연장한다. 후진 표면이 구동 샤프트를 따라 길이 방향으로 연장한다. 후진 표면은 전진 표면으로부터 각도적으로 오프셋(offset)된다. 구동 샤프트는 전진 드라이버가 전진 표면과 맞물리는(engage) 제 1 배향과 후진 드라이버가 후진 표면과 맞물리는 제 2 배향 사이에서 회전가능하다. 커플러는 수술용 스테이플러의 가늘고 긴 샤프트와 맞물리도록 적응된다. 핸들 어셈블리의 일부 실시예들에 있어, 핸들 어셈블리는 추가로 하우징 상에 배치된 고정 핸들 및, 하우징에 피봇 가능하게 연결되며 고정 핸들로부터 이격된 개방 위치와 고정 핸들에 인접한 폐쇄 위치 사이에서 피봇가능한 이동가능 핸들을 포함한다. 이동가능 핸들은 하우징에 피봇 가능하게 연결되며, 고정 핸들로부터 이격된 개방 위치와 고정 핸들에 인접한 폐쇄 위치 사이에서 피봇가능하다. 전진 드라이버는 이동가능 핸들에 동작 가능하게 연결되며, 개방 위치로부터 폐쇄 위치로의 이동가능 핸들의 움직임에 응답하여 종축에 대하여 원위로 이동가능(translatable)하다. 후진 드라이버는 이동가능 핸들에 동작 가능하게 연결되고, 개방 위치로부터 폐쇄 위치로의 이동가능 핸들의 움직임에 응답하여 종축에 대하여 근위로 이동가능하다.
특정 실시예들에 있어, 수술용 스테이플러를 위한 핸들 어셈블리가 제공된다. 핸들 어셈블리는 하우징, 하우징에 연결된 구동기, 및 구동 메커니즘을 포함한다. 구동 메커니즘은 포워드 드라이버, 리버스 드라이버, 구동 샤프트, 및 선택기를 포함한다. 포워드 드라이버는 트리거에 동작 가능하게 연결된다. 리버스 드라이버가 트리거에 동작 가능하게 연결된다. 구동 샤프트는 종축을 갖는다. 구동 샤프트는 종축에 대해 회전가능하게 하우징에 연결된다. 구동 샤프트는 포워드 인터페이스 표면 및 포워드 인터페이스 표면으로부터 각도적으로 오프셋된 리버스 인터페이스 표면을 포함한다. 구동 샤프트는, 구동기에 응답하여 구동기 샤프트를 제 1 방향으로 움직이기 위해 포워드 인터페이스 표면이 포워드 드라이버와 맞물리는 제 1 배향과, 구동기에 응답하여 구동기 샤프트를 제 1 방향과 반대되는 제 2 방향으로 움직이기 위해 리버스 인터페이스 표면이 리버스 드라이버와 맞물리는 제 2 배향 사이에서 회전가능하다. 선택기는 구동 샤프트를 제 1 배향과 제 2 배향 사이에서 선택적으로 회전시키기 위해 구동 샤프트에 동작 가능하게 연결된다. 일부 실시예들에 있어, 구동기는 하우징에 피봇 가능하게 연결된 트리거를 포함하며, 제 1 및 제 2 방향들로의 구동 샤프트의 움직임은 트리거의 피봇 움직임에 응답한다.
도 1은 개방 구성의 조들을 갖는 수술용 스테이플링 디바이스의 일 실시예의 사시도이다.
도 2는 폐쇄 구성의 조들을 갖는 도 1의 수술용 스테이플링 디바이스의 카트리지의 일 실시예의 사시도이다.
도 3은 수술용 스테이플링 디바이스에 대한 핸들 어셈블리의 일 실시예의 사시도이다.
도 4는 폐쇄 구성의 이동가능 핸들을 갖는 도 3의 핸들 어셈블리의 사시도이다.
도 5는 제 1 구성의 선택기를 갖는 도 3의 핸들 어셈블리의 평면도이다.
도 6은 제 2 구성의 선택기를 갖는 도 3의 핸들 어셈블리의 평면도이다.
도 7은 도 3의 핸들 어셈블리의 측면도이다.
도 8a는 초기 구성의 도 3의 핸들 어셈블리의 측면 단면도이다.
도 8b는 도 8a의 핸들 어셈블리의 단면 사시도이다.
도 9a는 폐쇄 구성으로 구동된 도 3의 핸들 어셈블리의 측면 단면도이다.
도 9b는 도 9a의 핸들 어셈블리의 단면 사시도이다.
도 10a는 포워드 드라이브 구성의 도 3의 핸들 어셈블리의 측면 단면도이다.
도 10b는 도 10a의 핸들 어셈블리의 단면 사시도이다.
도 11a는 포워드 드라이브 구성의 도 3의 핸들 어셈블리의 측면 단면도이다.
도 11b는 도 11a의 핸들 어셈블리의 단면 사시도이다.
도 12a는 완전히 드라이브된 포워드 구성의 도 3의 핸들 어셈블리의 측면 단면도이다.
도 12b는 도 12a의 핸들 어셈블리의 단면 사시도이다.
도 13a는 리버스 드라이브 구성의 도 3의 핸들 어셈블리의 측면 단면도이다.
도 13b는 도 13a의 핸들 어셈블리의 단면 사시도이다.
도 14a는 완전히 드라이브된 리버스 구성의 도 3의 핸들 어셈블리의 측면 단면도이다.
도 14b는 도 14a의 핸들 어셈블리의 단면 사시도이다.
도 15는 수술용 스테이플링 디바이스를 위한 핸들 어셈블리의 다른 실시예의 측면도이다.
도 16은 도 15의 핸들 어셈블리의 사시도이다.
도 17은 도 15의 핸들 어셈블리의 컷어웨이(cutaway) 측면도이다.
도 18은 도 15의 핸들 어셈블리의 구동 메커니즘을 위한 회전 메커니즘의 평면도이다.
도 19는 제 1 위치의 허브 칼라(hub collar)를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 20은 제 2 위치의 허브 칼라를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 21은 제 3 위치의 허브 칼라를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 22는 제 4 위치의 허브 칼라를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 23은 제 5 위치의 허브 칼라를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 24는 제 6 위치의 허브 칼라를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 25는 제 7 위치의 허브 칼라를 갖는 도 18의 회전 메커니즘의 허브 칼라 및 구동 샤프트의 평면도이다.
도 1 및 도 2를 참조하면, 수술용 스테이플링 디바이스의 실시예가 예시된다. 수술용 스테이플러(10)의 예시된 실시예는 가늘고 긴 샤프트(20), 조 어셈블리(30), 및 핸들 어셈블리(40)를 포함한다. 도 1은 개방 구성의 조 어셈블리(30)를 갖는 수술용 스테이플러(10)를 예시한다. 도 2는 폐쇄 구성의 조 어셈블리(30)를 갖는 수술용 스테이플러(10)의 조 어셈블리(30) 및 가늘고 긴 샤프트(20)를 포함하는 착탈가능 카트리지를 예시한다.
계속해서 도 1 및 도 2를 참조하면, 수술용 스테이플러(10)의 예시된 실시예는 복강경 수술 절차들에서의 사용을 위해 크기가 결정되고 구성될 수 있다. 예를 들어, 가늘고 긴 샤프트(20) 및 조 어셈블리(30)는 액세스 포트 또는 투관침 캐뉼라를 통해 수술 필드 내로 도입될 수 있도록 크기가 결정되고 구성될 수 있다. 일부 실시예들에 있어, 가늘고 긴 샤프트(20) 및 조 어셈블리(30)는, 상대적으로 작은 작업 채널 직경, 예를 들어, 8 mm 미만의 직경을 갖는 투관침 캐뉼라를 통해 삽입될 수 있도록 크기가 결정되고 구성될 수 있다. 다른 실시예들에 있어, 가늘고 긴 샤프트(20) 및 조 어셈블리(30)는 더 큰 작업 채널 직경, 예를 들어, 10 mm, 11 mm, 12 mm, 또는 15 mm와 같은 직경을 갖는 투관침 캐뉼라를 통해 삽입될 수 있도록 크기가 결정되고 구성될 수 있다. 다른 실시예들에 있어, 본원에서 설명되는 수술용 스테이플러들의 특정 측면들이 개복 수술 절차들에서의 사용을 위한 수술용 스테이플링 디바이스 내에 통합될 수 있다는 것이 고려된다.
계속해서 도 1 및 도 2를 참조하면, 예시된 바와 같이, 가늘고 긴 샤프트(20)는 전반적으로 튜브형 부재를 포함한다. 가늘고 긴 샤프트(20)는 근위 단부(22)로부터 원위 단부(24)로 연장한다. 가늘고 긴 샤프트(20)는, 근위 단부(22)와 원위 단부(24) 사이에서 연장하는, 수술용 스테이플러(10)의 중심 종축(longitudinal axis) L을 규정한다.
계속해서 도 1 및 도 2를 참조하면, 예시된 실시예에 있어, 조 어셈블리(30)가 가늘고 긴 샤프트(20)의 원위 단부(24)에서 가늘고 긴 샤프트(20)에 연결된다. 조 어셈블리(30)는 제 1 조(32) 및 제 1 조(32)에 피봇 가능하게 연결된 제 2 조(34)를 포함한다. 예시된 실시예에 있어, 제 1 조가 중심 종축 L을 따라 원위로 연장하고 그리고 가늘고 긴 샤프트(20)에 대해 고정된 상태로 남아 있도록, 제 1 조(32)가 가늘고 긴 샤프트(20)의 원위 단부에 고정된다. 다른 실시예들에 있어, 제 1 및 제 2 조들(32, 34) 둘 모두가 가늘고 긴 샤프트에 대해 피봇 가능한 것이 고려된다. 다른 실시예들에 있어, 조 어셈블리(30)가 가늘고 긴 샤프트(20)에 대해 관절로 이어질 수 있는(articulate) 것이 고려된다. 초기 구성에서, 제 1 조(32)는 그 내부에 배치된 복수의 스테이플들(36)을 포함한다. 일부 실시예들에 있어, 스테이플들은 초기에 제 2 조(34) 내에 위치될 수도 있다.
계속해서 도 1 및 도 2를 참조하면, 예시된 실시예에 있어, 조 어셈블리(30)는, 가늘고 긴 샤프트 내에서 길이 방향으로 슬라이드가능한 빔 또는 구동 부재에 의해 개방 구성(도 1)으로부터 폐쇄 구성(도 2)으로 스테이플링 구성으로 구동될 수 있다. 초기 위치에서, 빔이 가늘고 긴 샤프트(20)의 원위 단부(24)에 위치될 수 있다. 빔이 초기 위치에 있는 상태에서, 제 2 조(34)는 조 어셈블리(30)가 개방 구성이 되도록 제 1 조(32)로부터 멀어지도록 피봇된다. 구동 부재 또는 빔이 종축 L을 따라 원위로 이동하면 구동 빔이 제 2 조(34)와 맞물린다. 구동 빔이 초기 위치로부터 원위로 제 1 거리를 이동하는 것이 조 어셈블리를 개방 구성으로부터 폐쇄 구성으로 구동할 수 있다. 조 어셈블리(30)가 폐쇄 구성에 있는 상태에서, 구동 빔이 조 어셈블리(30)를 개방 구성으로 복귀시키기 위하여 제 1 거리만큼 근위로 복귀될 수 있다. 구동 빔의 원위 단부가 제 1 조(32)로부터 스테이플들을 전개(deploy)하도록 구성된 스테이플 슬라이더를 전진시킬 수 있으며, 그 결과 제 1 거리를 넘는 원위로의 구동 빔의 추가적인 이동이 복수의 스테이플들(36)을 제 1 조(32)로부터 전개한다.
계속해서 도 1 및 도 2를 참조하면, 예시된 실시예에 있어, 핸들 어셈블리가 가늘고 긴 샤프트(20)의 근위 단부(22)에서 가늘고 긴 샤프트(20)에 연결된다. 예시된 바와 같이, 핸들 어셈블리(40)는 고정 핸들(42)을 규정하는 하우징을 갖는 피스톨 그립 구성 및 고정 핸들(42)에 피봇 가능하게 연결된 이동가능 핸들(44) 또는 트리거와 같은 구동기를 갖는다. 다른 실시예들에서, 본원에서 설명되는 측면들을 포함하는 수술용 스테이플러가 다른 구성들, 예를 들어, 가위-그립 구성들, 또는 인-라인(in-line) 구성들과 같은 다른 구성들을 갖는 핸들 어셈블리들을 가질 수 있다는 것이 고려된다. 이하에서 더 상세하게 추가적으로 설명되는 바와 같이, 핸들 어셈블리(40)는 이동가능 핸들(44)의 움직임에 응답하여 구동 샤프트를 선택적으로 전진시키도록 구성된 구동 메커니즘을 하우징한다. 일부 실시예들에 있어, 구동 메커니즘은, 구동 샤프트를 선택적으로 전진시키기 위해 구동될 수 있는 전기 모터와 같은 전원공급형(powered) 구동 메커니즘을 포함할 수 있다. 전기 모터의 구동은 이동가능 핸들(44)의 움직임 또는 트리거, 버튼, 스위치, 또는 전원공급형 메커니즘의 전기 모터에 동작 가능하게 전기적으로 연결된 다른 구동기의 구동을 통해 개시될 수 있다.
일부 실시예들에 있어, 수술용 스테이플러(10)는 일회용 카트리지에 위치된 복수의 스테이플들(36)을 포함할 수 있으며, 반면 핸들 어셈블리(40)는 복수의 스테이플 카트리지들과 재사용되도록 구성된다. 예시된 실시예에 있어, 가늘고 긴 샤프트(20) 및 조 어셈블리(30)가 착탈가능하게 핸들 어셈블리(40)에 연결될 수 있는 일회용 카트리지를 규정한다. 따라서, 예시된 실시예에 있어, 핸들 어셈블리(40)가 그 원위 단부에 커플러(46)를 포함한다. 커플러(46)는 수술용 스테이플러(10)의 가늘고 긴 샤프트(20)와 맞물리도록 적응된다. 커플러(46)는, 핸들 어셈블리(40)를 가늘고 긴 샤프트(20)에 착탈가능하게 연결할 수 있는 외부 커넥터 및 핸들 어셈블리(42)의 구동 샤프트를 가늘고 긴 샤프트(20)의 구동 부재에 착탈가능하게 연결할 수 있는 내부 커넥터를 갖는 베이어넷 연결부(bayonet connection)를 가질 수 있다. 따라서, 수술용 스테이플러(10)는, 핸들 어셈블리(40)가 수술 절차 동안 다수의 일회용 카트리지들을 이용하여 재사용될 수 있도록 구성될 수 있다. 다른 실시예들에 있어, 핸들 어셈블리 및 가늘고 긴 샤프트의 어떤 부분이 재사용이 가능할 수 있으며, 반면 가늘고 긴 샤프트의 나머지 및 조 어셈블리가 일회용 카트리지를 규정하는 것으로 고려된다. 특정한 다른 실시예들에 있어, 핸들 어셈블리 및 가늘고 긴 샤프트가 재사용이 가능할 수 있으며, 반면 조 어셈블리가 일회용 카트리지를 규정한다. 또 다른 실시예들에 있어, 복수의 스테이플들을 하우징하는 조 삽입부(jaw insert)가 일회용 카트리지를 규정할 수 있으며, 반면 수술용 스테이플러의 나머지 부분이 합리적이다.
도 3 내지 도 7은 수술용 스테이플러(10)를 위한 핸들 어셈블리(40)의 일 실시예의 다양한 도면들을 예시한다. 도 3에, 고정 핸들(42)로부터 이격된 개방 위치의 이동가능 핸들(44)을 갖는 핸들 어셈블리(40)의 사시도가 예시된다. 예시된 핸들 어셈블리(40)는, 본원에서 추가로 논의되는 바와 같이 핸들 어셈블리(40) 내에 하우징된 구동 메커니즘에 동작 가능하게 연결된 선택기(72)를 더 포함한다. 도 3에 예시된 바와 같이, 선택기(72)는 제 1 위치에 있다.
도 4를 참조하면, 도 3의 핸들 어셈블리(40)의 다른 사시도가 예시된다. 예시된 바와 같이, 이동가능 핸들(44)이 고정 핸들(42)에 인접하여 위치된 폐쇄 위치에 있으며, 선택기(72)가 제 2 위치에 있다. 도 5 및 도 6은, 제 1 위치에 있는(도 5), 및 제 2 위치에 있는(도 6) 슬라이더(74)와 같은 선택기(72)를 갖는 도 3의 핸들 어셈블리의 평면도를 예시한다. 도 7은 도 3의 핸들 어셈블리(40)의 측면도이다.
도 8a 및 도 8b는 구동 메커니즘(50)의 동작을 보여주는, 초기 구성의 핸들 어셈블리(40)의 단면도들을 예시한다. 예시된 실시예에 있어, 구동 메커니즘(50)은, 조 어셈블리(30)가 개방 구성에 있는 것에 대응하는 제 1 위치로부터 조 어셈블리(30)가 폐쇄 구성에 있는 것에 대응하는 제 2 위치로 구동 샤프트(60)를 선택적으로 이동시키고, 제 2 위치로부터 조 어셈블리(30)를 스테이플링 구성에 위치시키고 복수의 스테이플들(36)을 전개하기 위한 제 3 위치로 구동 샤프트를 선택적으로 이동시키도록 구성된다. 도 8a 및 도 8b에 예시된 초기 구성에서, 구동 메커니즘(50)은, 개방 및 폐쇄 기능을 제공하기 위하여 스테이플들을 전개하지 않으면서 이동가능 핸들(44) 또는 트리거의 움직임에 응답하여 구동 샤프트(60)를 제 1 위치와 제 2 위치 사이에서 반복적으로 이동시킬 수 있다. 이러한 개방 및 폐쇄 기능이, 사용자가 스테이플들을 전개하기 전에 바람직한 스테이플 배치 위치를 찾기 위해 스테이플러(10)를 위치시키며, 조직을 클램핑하고, 스테이플러를 재위치시킬 수 있게 한다.
도 8 내지 도 14를 참조하면, 예시된 실시예에 있어, 구동 메커니즘은 전진 또는 포워드 드라이버(52), 리버스 드라이버(54), 개방 드라이버(58), 전진 표면(62), 후진 표면(64) 및 개방 표면(66)을 포함한다. 포워드 드라이버(52)는, 개방 위치로부터 폐쇄 위치로의 이동가능 핸들(44)의 움직임이, 예를 들어, 핸들 어셈블리(40) 내에서 원위로와 같은 제 1 방향으로 포워드 드라이버(52)를 전진시킬 수 있도록, 이동가능 핸들(44)에 동작 가능하게 연결될 수 있다. 포워드 드라이버(52)는 리세스(recess) 또는 슬롯(slot)과 맞물리도록 구성된 폴(pawl) 또는 투쓰(tooth)를 포함할 수 있다.
리버스 드라이버(54)는, 개방 위치로부터 폐쇄 위치로의 이동가능 핸들(44)의 움직임이 리버스 드라이버(54)를, 예들 들어, 핸들 어셈블리(40) 내에서 근위로와 같은, 제 1 방향에 반대되는 제 2 방향을 전진시킬 수 있도록, 이동가능 핸들(44)에 동작 가능하게 연결될 수 있다. 일부 실시예들에 있어, 이동가능 핸들(44)이 아이들러 기어(idler gear)(56)를 포함하는 기어형 연결부로 리버스 드라이버(54)에 동작 가능하게 연결될 수 있다. 리버스 드라이버(54)는 리세스 또는 슬롯과 맞물리도록 구성된 폴 또는 투쓰를 포함할 수 있다.
개방 드라이버(58)는, 개방 위치로부터 폐쇄 위치로의 이동가능 핸들(44)의 움직임이, 예를 들어, 핸들 어셈블리(40) 내에서 원위로와 같은 제 1 방향으로 개방 드라이버(58)를 전진시킬 수 있도록, 이동가능 핸들(44)에 동작 가능하게 연결될 수 있다. 예시된 실시예에 있어, 개방 드라이버(58)는, 개방 드라이버(58)를 이동가능 핸들(44)에 동작 가능하게 연결하기 위한 핀 및 슬롯 연결부로 아이들러(56)에 연결된다. 개방 드라이버(58)는 리세스 또는 슬롯과 맞물리도록 구성된 폴 또는 투쓰를 포함할 수 있다.
구동 샤프트(60)는 그 안에 형성된 전진 표면(62), 후진 표면(64), 및 개방 표면(66)을 포함한다. 예시된 실시예에 있어, 전진 표면(62)은 구동 샤프트(60)를 따라 길이 방향으로 형성된 복수의 이격된 리세스들 또는 티쓰(teeth), 또는 랙(rack)을 포함한다. 예시된 실시예에 있어, 후진 표면(64)은 구동 샤프트(60)를 따라 길이 방향으로 형성되고 전진 표면(62)으로부터 각도적으로 오프셋된 복수의 이격된 리세스들 또는 티쓰, 또는 랙을 포함한다. 예시된 실시예에 있어, 개방 표면(66)은 구동 샤프트(60) 내에 형성된 리세스를 포함한다.
특정 실시예들에 있어, 구동 샤프트(60)는 스테이플러(10)의 종축에 대하여 핸들 어셈블리 내에서 회전가능하다. 구동 샤프트(60)는 서로에 대하여 독립적으로 회전가능한 근위 부분(65) 및 원위 부분(61)을 포함할 수 있다. 예를 들어, 근위 부분(65)이 회전가능 커플링에서 원위 부분(61)에 연결될 수 있으며, 이는 그들 사이에 자유 회전을 가능하게 하지만 반면 길이 방향 이동에 대해 원위 부분을 근위 부분에 연결한다. 핸들 어셈블리(40)는 핸들 어셈블리(40) 내에서 구동 샤프트(60)의 근위 부분(65)의 선택적 회전을 제공하기 위한 회전 메커니즘(70)을 포함할 수 있다. 구동 샤프트(60)는, 포워드 드라이버(52)가 전진 표면(62)과 맞물리는 제 1 배향과 리버스 드라이버(54)가 후진 표면(64)과 맞물리는 제 2 배향 사이에서 회전가능할 수 있다. 구동 샤프트(60)에 대한 후진 표면(54)으로부터의 전진 표면(52)의 각도적 오프셋으로, 구동 샤프트가 제 1 배향에 있는 상태에서 리버스 드라이버(54)가 후진 표면(64)으로부터 분리(disengage)되며, 구동 샤프트가 제 2 배향에 있는 상태에서 포워드 드라이버(52)가 전진 표면(62)으로부터 분리된다.
계속해서 도 8 내지 도 14를 참조하면, 특정 실시예들에 있어, 회전 메커니즘(70)이 슬라이더와 같은 선택기(72)를 포함한다. 슬라이더는 핸들 어셈블리(40)의 하우징을 관통해 가로로(transversely) 연장할 수 있다. 슬라이더는, 핸들 어셈블리(40)의 일 측(side)로부터 연장하여 슬라이더를 제 1 위치에 위치시키는 것이 구동 샤프트(60)를 제 1 배향에 위치시키도록, 그리고 핸들 어셈블리(40)의 반대 측으로부터 연장하여 슬라이더를 제 2 위치에 위치시키는 것이 구동 샤프트(60)를 제 2 배향으로 회전시킬 수 있도록, 구동 샤프트(60)에 동작 가능하게 연결될 수 있다. 예시된 실시예에 있어, 슬라이더는, 구동 샤프트(60)에 회전가능하게 고정되고 구동 샤프트(60)를 따라 길이 방향으로 슬라이드할 수 있는 기어(78)와 메시 맞물림(meshing engagement)으로(예를 들어, 키 연결부(keyed connection)로와 같이) 랙(76)에 연결된다. 바람직하게는, 예시된 슬라이더를 포함하는 회전 메커니즘(70)이 구동 샤프트(60)를 희망되는 배향으로 불연속적으로(discretely) 위치시키며, 이는 구동 메커니즘(50) 내에서 미스메싱된 기어링(mismeshed gearing)의 발생을 감소시킨다. 일부 실시예들에 있어, 슬라이더가 구동 샤프트(60)의 배향 및 그에 따른 스테이플러의 구동 모드를 사용자에게 표시하기 위한, 화살표들과 같은 시각적 표시기들을 포함할 수 있다.
예시된 실시예에 있어, 전진 표면(62) 및 리버스 표면(64)이 구동 샤프트에 대하여 약 90도만큼 각도적으로 오프셋된다. 따라서, 회전 메커니즘(70)은 제 1 배향과 제 2 배향 사이에서 구동 샤프트를 약 90도 회전시키도록 구성된다. 다른 실시예들에 있어, 구동 표면(62) 및 리버스 표면(64)이, 예를 들어, 120도 또는 70도와 같은 상이한 각도적 오프셋을 가질 수 있고, 회전 메커니즘은 그에 따라 구동 샤프트(60)를 회전시키도록 구성될 수 있다. 더욱이, 핸들 어셈블리(40) 동작의 개방/폐쇄 모드에 대하여 본원에 더 상세하게 설명되는 바와 같이, 예시된 실시예에 있어, 제 2 배향에서 개방 드라이버(58)가 구동 샤프트와 맞물리고, 다른 실시예들에 있어, 구동 샤프트는 개방 드라이버(58)가 구동 샤프트와 맞물리는 제 3 배향으로 회전가능할 수 있다.
도 8 내지 도 14를 참조하면, 핸들 어셈블리(40)의 구동 메커니즘(50)의 전형적인 동작 시퀀스가 예시된다. 도 8a 내지 도 8b 및 도 9a 내지 도 9b는 조 어셈블리(30)에 개방/폐쇄 기능을 제공하는 초기 구성의 핸들 어셈블리(40)의 동작을 예시한다. 도 8a에서, 이동가능 트리거(44)가 개방 위치에 있으며, 구동 샤프트(60)는 가늘고 긴 샤프트(20)의 원위 단부에서의 구동 빔의 제 1 위치에 대응하는 제 1 위치에 있다. 초기 위치에서, 구동 샤프트(60)가 제 2 배향으로 위치되어 리버스 드라이버(54)가 후진 표면(64)과 각도적으로 정렬된다. 구동 샤프트(60)가 제 2 배향에 있는 상태에서, 개방 드라이버(58)가 개방 표면(66) 또는 리세스 내에 위치된다. 개방 위치(도 8a 내지 도 8b)로부터 폐쇄 위치(도 9a 내지 도 9b)로의 이동가능 핸들(44)의 움직임이, 구동 샤프트(60) 내에 형성된 전진 리세스(63)와 맞물리기 위하여 그리고 구동 샤프트(60)를 핸들 어셈블리 내에서 제 2 위치로 드라이브하기 위하여, 포워드 드라이버(52)를 구동 샤프트(60)를 따라 원위로 전진시킨다. 핸들 어셈블리(40) 내의 구동 샤프트(60)의 제 2 위치는 구동 빔의 제 2 위치에 대응하며, 이는 조 어셈블리(30)를 폐쇄 구성으로 위치시킨다.
이동가능 핸들(44)은 코일 스프링(68)(도 11a)과 같은 편향 부재에 의해 개방 위치로 편향될 수 있다. 따라서, 도 9a 내지 도 9b에 예시된 폐쇄 위치로부터 이동가능 핸들(44)을 릴리즈(release)하는 것이 이를 도 8a 내지 도 8b의 개방 위치로 복귀시킬 것이다. 개방 드라이버(58)에 대한 이동가능 핸들(44)의 동작 가능한 연결이, 이동가능 핸들(44)이 개방 위치로 복귀함에 따라, 유사하게 개방 드라이버(58)를 핸들 어셈블리(40) 내에서 근위로 이동시킬 것이다. 구동 샤프트(60)의 제 2 배향에서, 개방 드라이버(58)의 근위로의 움직임이 구동 샤프트(60)를 제 2 위치로부터 제 1 위치로 복귀시키도록, 개방 드라이버(58)가 개방 표면(66)과 맞물리며, 이는 조 어셈블리(30)를 개방 구성으로 복귀시킨다.
사용자는 다양한 위치들에서 조직을 클램핑하기 위하여 조들을 반복적으로 개방 및 폐쇄함으로써 수술 필드 내의 희망되는 스테이플링 위치를 찾을 수 있다. 희망되는 스테이플링 위치가 선택되면, 구동 샤프트(60)를 제 1 배향으로 회전시킴으로써 구동 메커니즘(50)이 스테이플링 또는 발사 모드로 구성될 수 있다. 조 어셈블리가 희망되는 스테이플링 위치에서 폐쇄 구성(도 9a 내지 도 9b에 예시된 바와 같은)인 상태에서, 사용자는 슬라이더를 구동 샤프트(60)의 제 1 배향에 대응하는 제 1 위치(도 10a 내지 도 10b에 예시된 바와 같은)로 슬라이딩함으로써 선택기(72)를 재위치시킬 수 있다. 구동 샤프트(60)의 제 1 배향에서, 포워드 드라이버(52)가 전진 표면(62)과 맞물릴 수 있으며, 후진 드라이버(54)가 후진 표면(64)과 각도적으로 오정렬되고, 개방 드라이버(58)가 개방 표면(66)과 각도적으로 오정렬된다. 구동 샤프트(60)가 제 1 배향에 있는 상태에서, 이동가능 핸들(44)이 개방 위치(도 11a 내지 도 11b)로 릴리즈될 수 있으며, 이는 포워드 드라이버(52)를 전진 표면(62)과 맞물리게 한다.
도 11a 내지 도 11b 및 도 12a 내지 도 12b를 참조하면, 구동 샤프트(60)가 제 1 배향이고, 포워드 드라이버(52)가 전진 표면(62)과 맞물리면, 구동 메커니즘(50)은 스테이플링 또는 발사 모드이다. 개방 위치로부터 폐쇄 위치로 그리고 다시 개방 위치로의 이동가능 핸들(44) 움직임의 몇몇 사이클들이 구동 샤프트(60)를 제 2 위치(도 11a 내지 도 11b)로부터, 구동 샤프트(60)가 핸들 어셈블리(40)에 대해 그 최-원위 한계(distal-most limit)로 이동되는 제 3 위치(도 12a 내지 도 12b)로 전진시킨다. 일부 실시예들에 있어, 구동 메커니즘은 제 3 위치에서 구동 샤프트(60)의 원위로의 이동을 방해하기 위한 중단부(stop)를 포함할 수 있다. 구동 샤프트의 제 2 위치는 조 어셈블리(30) 내의 구동 빔의 제 2 위치에 대응한다. 구동 샤프트의 제 3 위치는 조 어셈블리(30) 내의 구동 빔의 제 3 위치에 대응하며, 이는 복수의 스테이플러들이 제 1 조로부터 전개되는 위치이다. 구동 샤프트를 제 2 위치로부터 제 3 위치로 전진시키기 위해 발사 모드에서 이동가능 핸들(44) 또는 트리거가 움직이면, 결과적으로 포워드 드라이버(52)가 구동 표면(62)의 인접 티쓰 또는 그루브(groove)들을 넘어 래칫-유사 전진(ratchet-like advancement)으로 전진된다.
도 13a 내지 도 13b를 참조하면, 구동 샤프트(60)가 제 3 위치로 전진되고 스테이플러가 조 어셈블리로부터 발사되면, 구동 메커니즘(50)이 리버스 모드로 구성될 수 있다. 따라서, 리버스 표면(64)을 리버스 드라이버(54)와 각도적으로 정렬되도록 위치시키기 위하여 회전 메커니즘(70)이 구동 샤프트(60)를 제 2 배향으로 회전시킬 수 있다. 구동 샤프트를 제 1 배향(도 12a 내지 도 12b)으로부터 제 2 배향(도 13a 내지 도 13b)로 회전시키기 위하여 슬라이더가 제 2 위치로 슬라이드될 수 있다. 구동 샤프트(60)가 제 2 배향에 있는 상태에서, 개방 위치로부터 폐쇄 위치로 그리고 다시 개방 위치로의 이동가능 핸들(44)의 반복되는 사이클들이, 구동 샤프트(60)를 핸들 어셈블리 내에서 근위로 끌어 당기면서(retract), 리버스 드라이버(54)를 래칫-유사 전진으로 후진 표면(64)과 맞물리게 한다. 리버스 드라이버(54)가 구동 샤프트(60)를 제 2 위치(도 14a 내지 도 14b에 예시된)로 근위로 드라이브 하면, 개방 드라이버(58)가 개방 표면(66)과 맞물린다. 이동가능 핸들(44)이 개방 위치로 릴리즈되면, 개방 드라이버(58)는 구동 샤프트(60)를 제 1 위치로 복귀시킨다. (핸들 어셈블리를 도 8a 내지 도 8b에 예시된 구성으로 복귀시킨다). 구동 샤프트(60)가 제 1 위치에 있는 상태에서, 스테이플들이 없는 카트리지가 핸들 어셈블리(40)로부터 분리될 수 있고, 새로운 카트리지가 다른 스테이플링 동작을 개시하기 위하여 핸들 어셈블리에 연결될 수 있다.
도 15 내지 도 25를 참조하면, 수술 스테이플러(10')와 함께 사용하기 위한 핸들 어셈블리(40')의 다른 실시예가 예시된다. 도 15는 핸들 어셈블리(40')의 측면도를 예시하며, 도 16은 핸들 어셈블리(40')의 사시도를 예시한다. 핸들 어셈블리(40')에 있어, 회전 메커니즘(70')의 구동은, 핸들 어셈블리(40') 하우징에 대해 길이 방향으로 슬라이드가능한 슬라이드가능 스위치(80)로 달성된다. 바람직하게는, 이러한 슬라이드가능 스위치 배열이 사용자가 한손 동작으로 구동 샤프트(60)를 용이하게 회전시킬 수 있게끔 할 수 있다.
도 17을 참조하면, 핸들 어셈블리(40')의 단면도가 예시되며, 이는 구동 메커니즘(50') 및 회전 메커니즘(70')을 나타낸다. 구동 메커니즘은, 실질적으로 도 8a, 도 8b 내지 도 14a, 도 14b의 실시예에 대하여 이상에서 설명된 것과 같이, 구동 샤프트(60')를 개방/폐쇄 모드에서 제 1 위치로부터 제 2 위치로, 스테이플링 모드에서 제 2 위치로부터 제 3 위치로, 그리고 리버스 모드에서 제 3 위치로부터 제 1 위치로 전진시키도록 기능한다. 구동 메커니즘(50')은, 실질적으로 도 8a, 도 8b 내지 도 14a 내지 도 14b의 실시예에 대하여 설명된 것과 같은, 이동가능 핸들(44)에 동작 가능하게 연결된 대응하는 포워드, 리버스, 및 개방 드라이버들(52, 54, 58) 및 구동 샤프트(60') 상의 전진(62), 후진, 및 개방 표면들을 포함한다. 그러나, 도 15 내지 도 25에 예시된 실시예에 있어, 구동 샤프트(60')는, 개방 드라이버(58)가 개방 표면(66)과 맞물리는 핸들 어셈블리의 개방/폐쇄 모드에 대응하는 제 1 배향과, 포워드 드라이버(52)가 전진 표면(62)과 맞물리는 스테이플링 위치에 대응하는 제 2 배향과, 리버스 드라이버(54)가 후진 표면과 맞물리는 리버스 위치에 대응하는 제 3 배향 사이에서 불연속적으로 회전 메커니즘(70')에 의해 회전가능하다.
도 17 내지 도 18을 참조하면, 회전 메커니즘(70')의 특정 측면들이 예시된다. 회전 메커니즘(70')은 핸들 어셈블리(40')의 하우징에 대하여 길이 방향으로 슬라이드가능한 슬라이드가능 스위치(80), 스위치(80)에 의해 길이 방향으로 슬라이드가능한 허브 칼라(82), 및 편향 부재 또는 스프링(98)을 포함한다. 예시된 실시예에 있어, 슬라이드가능 스위치(80)는 심(shim) 부재와 같은 얇은 빔으로 허브 칼라(82)에 연결된다. 허브 칼라(82)는 핸들 어셈블리(40')의 하우징에 회전적으로(rotationally) 고정되며, 이에 대하여 길이 방향으로 슬라이드가능하다. 일부 실시예들에 있어, 허브 칼라(82)가, 그들 사이에 상대적인 길이 방향 움직임을 허용하고 상대적인 회전 움직임을 제한하기 위하여, 핸들 어셈블리의 하우징 내의 대응하는 제 1 및 제 2 슬롯들에서 슬라이드할 수 있는 제 1 및 제 2 윙(wing)들을 포함할 수 있다.
허브 칼라(82)는 구동 샤프트(60')를 둘러 배치되는 전반적으로 튜브형의 부재일 수 있다. 허브 칼라(82)는 그 안에 형성된 복수의 램프(ramp)들(86)을 갖는 제 1 에지(84)와 그 안에 형성된 복수의 리세스들(90)을 갖는 제 2 에지(88) 사이에서 연장할 수 있다. 예시된 실시예에 있어, 허브 칼라(82)는 제 1 에지(84) 내에 형성된 3개의 램프들(86)을 포함하며, 각각의 램프는 인접 램프들(86)로부터 대략 120도 이격된다. 예시된 바와 같이, 허브 칼라(82)는 제 2 에지(88) 내에 형성된 3개의 리세스들(90)을 포함하며, 각각의 리세스(90)는 인접 리세스들(86)로부터 대략 120도 이격된다. 다른 실시예들에 있어, 램프들(86) 및 리세스들(90)의 수 및 상대적인 간격이 예시된 실시예의 배향들과 상이한 배향들 사이에서 구동 샤프트(50)를 회전시키기 위해 변화할 수 있다.
일부 실시예들에 있어, 회전 메커니즘(70')은 슬라이드가능 스위치(80) 및 허브 칼라(82)를 핸들 어셈블리(40')의 하우징에 대하여 근위 위치로 편향시키기 위한 스프링(98)을 포함할 수 있다.
계속해서 도 17 내지 도 18을 참조하면, 구동 샤프트(60')는 허브 칼라(82)의 제 1 에지(84)에 인접하여 이로부터 밖으로 방사상으로 돌출하는 제 1 복수의 돌출부들(92)을 가질 수 있다. 예시된 실시예에 있어, 구동 샤프트는 3개의 돌출부들(92)을 가지며, 이들 각각은 인접 돌출부들로부터 약 120도 이격된다. 구동 샤프트(60')는, 허브 칼라(82)의 제 2 에지(88)에 인접한 위치에서 구동 샤프트(60')로부터 밖으로 방사상으로 연장하는 제 2 복수의 돌출부들(94)을 더 포함할 수 있다. 예시된 실시예에 있어, 구동 샤프트(60')는 3개의 돌출부들(94)을 가지며, 이들 각각은 인접 돌출부들로부터 약 120도 이격된다. 다른 실시예들에 있어, 돌출부들(92, 94)의 수 및 간격이 상이한 회전 특성들을 갖는 회전 메커니즘을 달성하기 위해 변화될 수 있다. 일부 실시예들에 있어, 돌출부들(92, 94)이 구동 샤프트(60') 상에 형성될 수 있으며, 반면 다른 실시예들에 있어, 돌출부들(92, 94)이 구동 샤프트(60')에 부착되거나, 또는 이와 키 맞물림을 갖거나, 또는 달리 이에 회전적으로 고정되는 슬리브(sleeve) 상에서와 같이 별개로 형성될 수 있다.
도 19 내지 도 25를 참조하면, 제 1 배향으로부터 제 2 배향으로 구동 샤프트(60')를 회전시키기 위한 회전 메커니즘(70')의 동작 시퀀스가 예시된다. 도 19는 제 1 배향의 허브 칼라(82) 및 구동 샤프트(50')의 개략도를 예시한다. 제 1 배향에서, 제 2 복수의 돌출부들(94)의 제 1 돌출부(94a)가 복수의 리세스들(90)의 제 1 리세스(90a) 내에 있으며, 제 1 복수의 돌출부들의 제 1 돌출부(92a)가 복수의 램프들(86)의 제 1 램프(86a)에 인접하여 위치된다.
도 19 내지 도 22를 참조하면, 슬라이드가능 스위치(80)가 원위로 전진됨에 따른 회전 메커니즘(70')의 동작 시퀀스가 예시된다. 슬라이드가능 스위치(80)가 핸들 어셈블리의 하우징에 대해 원위로 전진됨에 따라, 허브 칼라(82)가 원위로 이동하고, 이는 제 1 복수의 돌출부들(92)을 허브 칼라(82)의 복수의 램프들(86)과 슬라이딩 맞물리게 한다(도 20에 예시됨). 핸들 어셈블리의 하우징에 대한 슬라이드가능 스위치(80) 및 허브 칼라(82)의 원위로의 추가적인 전진이 제 1 복수의 돌출부들(92)을 복수의 램프들(86) 위로 전진시킨다(도 21 및 도 22에 예시됨). 램프들(86)의 각도 프로파일이 캐밍(camming) 표면으로서 역활하여, 복수의 램프들(86)을 따른 제 1 복수의 돌출부들(92)의 이동이 구동 샤프트(60')를 회전시킨다. 슬라이드가능 스위치가 그 이동의 최원위 단부에 도달하면, 스프링(98)이 허브 칼라(82) 및 슬라이드가능 스위치(80)를 핸들 어셈블리(40)의 하우징에 대해 근위로 편향시킨다. 허브 칼라(82)가 근위 위치로 복귀함에 따라, 제 2 복수의 돌출부들(94)이 복수의 리세스들(90)과 맞물린다(도 23 내지 도 25에 예시됨). 도 25에 예시된 바와 같이, 슬라이드가능 스위치(80)의 구동 사이클 이후에, 제 2 복수의 돌출부들(94)의 제 1 돌출부(94a)가 복수의 리세스들의 제 2 리세스(90b) 내에 위치되어, 구동 샤프트(60')가 제 1 배향으로부터 120도 회전된 제 2 배향으로 위치된다. 슬라이드가능 스위치(80)의 후속 구동 사이클들이 불연속적인(discrete) 120도 증분으로 구동 샤프트를 회전시킨다.
다른 실시예들에 있어, 회전 메커니즘이 구동 샤프트에 직접적으로 연결된 핸들을 포함할 수 있다. 예를 들어, 구동 샤프트의 근위 단부가 하우징으로부터 근위로 연장하는 핸들(70")(도 1)에 연결될 수 있다. 종축에 대한 핸들의 회전이 핸들 어셈블리를 개방/폐쇄 모드, 포워드 모드, 또는 리버스 모드 중 하나의 모드로 구성하기 위해 구동 샤프트를 회전시킨다.
본 출원이 특정한 선호되는 실시예들 및 예들을 개시하지만, 본 발명이 특별히 개시된 실시예들을 넘어 다른 대안적인 실시예들 및/또는 본 발명의 용례들 및 자명한 수정예들 및 그 등가물들로 연장한다는 것이 당업자들에 의해 이해될 것이다. 또한, 이러한 발명들의 다양한 특징들이 홀로, 또는 이하에서 명확히 기재되는 것과는 다른 이러한 발명들의 다른 특징들과 함께 사용될 수 있다. 따라서, 본원에서 본 발명들의 범위는 이상에서 설명된 개시된 특정 실시예들에 제한되지 않아야 하며, 오로지 이하의 청구항들의 적절한 해석에 의해 결정되도록 의도된다.

Claims (18)

  1. 수술용 스테이플러에 대한 핸들 어셈블리로서,
    하우징;
    상기 하우징에 피봇가능하게 결합되며, 개방 위치로부터 폐쇄 위치로 이동할 수 있는 이동가능 핸들; 및
    구동 메커니즘을 포함하며, 상기 구동 메커니즘은,
    상기 이동가능 핸들에 의해 이동가능한 포워드 드라이버;
    리버스 드라이버;
    상기 포워드 드라이버를 상기 리버스 드라이버에 결합하는 아이들러(idler); 및
    길이 방향 축을 갖는 구동 샤프트로서, 상기 구동 샤프트는 상기 하우징에 대하여 길이 방향으로 슬라이드할 수 있고, 제 1 배향과 제 2 배향 사이에서 상기 길이 방향 축에 대하여 선택적으로 회전할 수 있는, 상기 구동 샤프트를 포함하는, 핸들 어셈블리.
  2. 청구항 1에 있어서,
    상기 포워드 드라이버는, 상기 구동 샤프트가 상기 제 1 배향에 있는 상태에서 상기 구동 샤프트와 맞물릴 수 있는, 핸들 어셈블리.
  3. 청구항 1에 있어서,
    상기 리버스 드라이버는 상기 제 2 배향에서 상기 구동 샤프트와 맞물릴 수 있는, 핸들 어셈블리.
  4. 청구항 3에 있어서,
    상기 리버스 드라이버는 상기 제 1 배향에서 상기 구동 샤프트로부터 분리되는, 핸들 어셈블리.
  5. 청구항 1에 있어서,
    상기 구동 메커니즘은, 상기 구동 샤프트가 상기 제 2 배향에 있는 상태에서 상기 구동 샤프트와 맞물릴 수 있는 개방 드라이버를 더 포함하는, 핸들 어셈블리.
  6. 청구항 5에 있어서,
    상기 아이들러는 내부에 형성된 슬롯을 포함하며, 상기 개방 드라이버는 상기 아이들러의 상기 슬롯 내에 배치되는 핀을 포함하는, 핸들 어셈블리.
  7. 청구항 5에 있어서,
    상기 구동 샤프트는 상기 구동 샤프트 상에 형성되는 개방 리세스(recess)를 포함하며, 상기 개방 리세스는, 상기 구동 샤프트가 상기 제 2 배향에 있는 상태에서 상기 개방 드라이버와 맞물릴 수 있는, 핸들 어셈블리.
  8. 청구항 1에 있어서,
    상기 아이들러는, 트리거의 움직임이 상기 포워드 드라이버를 제 1 방향으로 움직이고 상기 리버스 드라이버를 상기 제 1 방향에 반대되는 제 2 방향으로 움직이도록 상기 포워드 드라이버를 상기 리버스 드라이버에 결합하는, 핸들 어셈블리.
  9. 청구항 8에 있어서,
    상기 포워드 드라이버는 상기 개방 위치로부터 상기 폐쇄 위치로의 상기 이동가능 핸들의 움직임에 응답하여 상기 길이 방향 축에 대해 원위로 이동가능하고, 상기 리버스 드라이버는 상기 개방 위치로부터 상기 폐쇄 위치로의 상기 이동가능 핸들의 움직임에 응답하여 상기 길이 방향 축에 대해 근위로 이동가능한, 핸들 어셈블리.
  10. 청구항 1에 있어서,
    상기 구동 샤프트는 전진 랙을 포함하며, 상기 포워드 드라이버는, 상기 구동 샤프트가 상기 제 1 배향에 있을 때 상기 전진 랙과 맞물리는, 핸들 어셈블리.
  11. 청구항 10에 있어서,
    상기 구동 샤프트는 후진 랙을 포함하며, 상기 리버스 드라이버는, 상기 구동 샤프트가 상기 제 2 배향에 있을 때 상기 후진 랙과 맞물리는, 핸들 어셈블리.
  12. 청구항 11에 있어서,
    상기 전진 랙은 상기 길이 방향 축에 대하여 상기 후진 랙으로부터 각도적으로 오프셋되는, 핸들 어셈블리.
  13. 청구항 12에 있어서,
    상기 전진 랙은 상기 후진 랙으로부터 약 90도만큼 각도적으로 오프셋되는, 핸들 어셈블리.
  14. 청구항 1에 있어서,
    상기 핸들 어셈블리는 상기 구동 샤프트를 상기 제 1 배향과 상기 제 2 배향 사이에서 선택적으로 회전시키기 위해 상기 구동 메커니즘과 맞물리는 회전 메커니즘을 더 포함하는, 핸들 어셈블리.
  15. 청구항 14에 있어서,
    상기 회전 메커니즘은 상기 하우징을 통해 가로로 연장하는 슬라이더를 포함하며, 상기 슬라이더는, 상기 구동 샤프트가 상기 제 1 배향에 있는 상기 하우징의 제 1 측(side)으로부터 연장하는 제 1 위치에 그리고 상기 구동 샤프트가 상기 제 2 배향에 있는 상기 제 1 측과 반대되는 상기 하우징의 제 2 측으로부터 연장하는 제 2 위치에 위치가능한, 핸들 어셈블리.
  16. 청구항 1에 있어서,
    상기 이동가능 핸들을 상기 개방 위치로 편향시키는 코일 스프링을 더 포함하는, 핸들 어셈블리.
  17. 청구항 1에 있어서,
    상기 포워드 드라이버는 리세스와 맞물리도록 구성된 폴(pawl)을 포함하는, 핸들 어셈블리.
  18. 청구항 1에 있어서,
    상기 리버스 드라이버는 리세스와 맞물리도록 구성된 폴을 포함하는, 핸들 어셈블리.
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