Source: https://patents.google.com/patent/CN100398071C/en
Timestamp: 2018-02-21 21:34:55
Document Index: 38024538

Matched Legal Cases: ['§0', '§ 0', 'in fine', 'art 22', 'arts 0', '§ 640']

CN100398071C - Surgical stapling instrument incorporating a firing mechanism having a linked rack transmission - Google Patents
CN100398071C
CN100398071C CN 200410087485 CN200410087485A CN100398071C CN 100398071 C CN100398071 C CN 100398071C CN 200410087485 CN200410087485 CN 200410087485 CN 200410087485 A CN200410087485 A CN 200410087485A CN 100398071 C CN100398071 C CN 100398071C
CN 200410087485
CN1679451A (en )
一种特别适用于内窥镜手术过程的手术钉合和切割器械，包括一个产生分离的闭合和发射运动以致动端部操纵装置的手柄。 A particularly suitable for endoscopic surgical procedures a surgical stapling and cutting instrument, comprising a handle and a separate closing motion transmitting means to actuate the end effector is generated. 具体地，该手柄产生多个发射动作以减少发射(如钉合和切割)端部操纵装置所需要的作用力的大小。 In particular, the handle acts to generate a plurality of emission reducing transmit (e.g., stapling and cutting) means force required size of the end effector. 链节传递降低了所需手柄的纵向长度，并且当为发射而伸直时，达到刚性，坚固结构。 Reducing the transmission links required longitudinal length of the handle, and when straightened and to emit, to a rigid, strong structure. 一种牵拉偏压发射机构避免了驱动这种直线状链齿与止退机构相配合时的约束，利用一个锁定机构防止在发射过程中释放闭合扳机。 Pulling one kind of biasing the firing mechanism avoids this constraint linear driving sprocket cooperates with a retaining mechanism, using a locking mechanism prevents release of the closure trigger during launch. 而且，外部指示器向外科医生反馈发射进行的程度，并提供手动缩回能力。 The external feedback indicator for the degree of emission of the surgeon, and to provide a manual retraction capability.
含有具有鄉齿^i 的MiWi的手术钉^W相互参照的有关申请本申ii^及与雌同日m^的四个共同未决的属于同一申请人的申请，敏申请的内容顿引入&fc作为辨，这四个申请的名称分别为："具有含有lBi机构的多动作，的手术钉合旨，，序列号一，Frederick E.SMtcaijNfike Setser，"具有带开口^的多动作皿的手术钉合«"，序列号一，Frederick E.Shelton Jeffi^ S.Swayze^uglas BJHoffinan;"具有带牵拉-偏压齿合机构的多动作皿的手术钉^«'，序列号一，Jeffiiey SS稱yzejFrederick E.Sheltcm IV;禾口"含有多动作^^a^^器和縮回机构的手术钉^r,序列号一，Jeffrey S-Swayze^Frederick E.Sheltan IV 。 技术领膝本发明总体上涉及手^:钉^«,會辦将订^Hjra麥M^同时切寧， 订^J司的组织，尤其是，涉^t钉^W的,，iKd^机的多冲Jg^t 射，以湖形^t类钉合M的各种部件的方法舰。背景技术：内窥镜手^M常优于常规的开腔手术设备，因为较小,� Rural having four teeth comprising the application of MiWi ^ i ^ W surgical staple cross-referenced related applications and the present application, estrogen ii ^ m ^ Day copending belonging to the same applicant, the contents of Dayton sensitive applications are incorporated as & fc identified, the name of this application are four: "operation having a plurality of containing means lBi, surgical stapling ,, purpose a sequence number, Frederick E.SMtcaijNfike Setser," ^ with an opening having a plurality of surgical stapling operation dish << ", a serial number, Frederick E.Shelton Jeffi ^ S.Swayze ^ uglas BJHoffinan;" having a band pull - biasing means ratcheting operation of multiple surgical staple dish ^ « ', a serial number, Jeffiiey SS said yzejFrederick E.Sheltcm IV; Wo mouth "containing up operation ^^ ^^ a surgical staple and retracting mechanism ^ r, a serial number, Jeffrey S-Swayze ^ Frederick E.Sheltan IV collar knee technology relates generally present invention. hand ^: ^ nail << will do the set M ^ ^ Hjra wheat while Chernin, the organization set ^ J Division, in particular, involving nail ^ W ^ t ,, iKd ^ machine of a multi-punch Jg ^ t shoot, the method of the various components of the ship to the lake form M ^ t class stapling bACKGROUND: ^ M endoscope hand often superior to the conventional open surgery devices, because the smaller, ��容易^> 术后的康复时间和手术的m^。因此，内窥镜手^I^B^^了巨大的进步，,TM;套管针的套管在需要的手术，精确皿^^^So这^s端部操m^置以多种方式咬，织以达到诊断和治疗的效果（例如，内切器，抓取器，切害幡，钉合器，夹式i^器，«^g，药嫩基因治疗^ii^置，及利用超声、红外、激光的會^s等)。已知的手术钉^^括一个可同时^i织Jd^m向切割并在切口的相对侧施加钉线的«操1^1。 «^^3包括一)?»同工作的3^#，若将«用于内窥^^镜时，夹ITO件會辦穿过套til道。其中一个夹,件容纳一^丁盒，钉盒中至少有两排从横向隔开的钉子。另一个^^件限定了一个石淑，石«±具有与钉盒中钉排对准的钉状凹槽。,包括多个往^ ^bt物，当^^驱动时，^m物穿过钉盒的开口，驱动器^^钉合器以向石,生订钉亂适用于内窥镜的手术钉合器的一个实例如美国辩ij US5，465，895 ■，它可以方便地JI^ Readily ^> recovery time after surgery and the m ^ Thus, the endoscope hand ^ I ^ B ^^ tremendous progress ,, TM;. Trocar cannula need surgery, precise dish ^^^ So that ^ s m ^ opposed ends operation in various ways bite, woven to achieve the effect of diagnosis and treatment (e.g., endo, a gripper, cutting damage streamers, staplers, clip-i ^, a « ^ g, soft gene therapy drug ^ ii ^ set, and using ultrasound, infrared, laser, etc. will ^ s). ^^ known surgical staple comprising a woven simultaneously Jd ^ m ^ i and opposed to the cut of the cut «staple lines applied to the operation side 1 ^ 1.« ^ ^ 3 comprising a)? »^ # 3 with the work, if the« ^^ mirror used for endoscopic clip will be done through the sleeve member ITO til channel. wherein a clip, a ^ butoxy cartridge receiving member, the staple cartridge having at least two rows of laterally spaced apart from the nail. ^^ member further defines a Shu stone, stone «± magazine has rows of staples aligned in nail shaped grooves., comprising a plurality of objects to ^ ^ bt, when driving ^^, ^ m was passed through the opening of the magazine, the driver ^^ stapler to the stone, green suitable for endoscopic stapling of chaos a surgical stapler example U.S. defense ij US5,465,895 ■, it can be easily JI ^ 明显的闭合与皿动作。因此，医生能够闭M妖il的夹钳以在，前定位组织。 —旦医生确定夹ITO件B^完全，躯只，那么医«可以舰单一的鄉冲gmf手术钉絲，从而切割和钉鄉只。切割和钉合的同时謝M免了用不同的切割或钉合手7ltW^lt类动作而产生的^性。 Obviously the dish closing operation so doctors can be closed to clamp the M demon il, position the tissue prior to - determine a doctor denier clamp member B ^ ITO completely, only the footer, then the medical «can ship a single punch gmf surgery rural nail wire, to cut and staple rural only while the cutting and stapling free Frank M different hand with a cutting or stapling 7ltW ^ lt ^ generated class of operation. 能在皿前闭舒且织的一^W的优点是，医生會辦Mii内窥镜核实己经至iM^需要的切寧mi，包括在相对的鄉间改夹住了足够多的组织。 ^ W is a comfortable and advantages of the closed dish before weaving, the doctor will have run to verify the endoscope Mii iM ^ required Chernin mi, including change in relative country sandwiching a sufficient amount of tissue. 否则， 可能是相对的夹fSfe得规了，尤其是用其远端捏夹时，因而不能^^湖割的组织vh有效地形成闭合的钉。 Otherwise, the clip may be relatively too fSfe regulations, especially when a distal end thereof with a nip, and therefore can not cut tissue lake ^^ vh effective to form closed staples. 另一个极端是，雜过多量的组织可能引起约束和不完全鄉。 At the other extreme, miscellaneous excessive amount of tissue may cause constraints and incomplete Township. 通常，—个闭合冲,跟随—个鎌mi—种方便總am糊,丁合的方式。 Typically, - a closing punch, followed - a Fusarium species mi- always am easy paste, butoxy bonded manner. 但是，在^ff况下，需要多冲^lt。 However, in the case ^ ff, need more red ^ lt. 例如，夕卜科医生會辦根据需要的切割长皿夹钳尺寸范围内选择相应的钉盒长度。 For example, Xi Boke doctor will do to select the appropriate length of staple cartridge according to the cutting length of the desired size range dish clamps. 较长的钉盒需要较长的鎌冲程。 Longer staple cartridges require a longer sickle stroke. 因此，需要一个产生鎌的邦压扳机，与,的钉細比，对较长的钉，力P^的力以便切割更多的组织并驱动较多的钉子。 Accordingly, it is necessary to produce a state of pressing the trigger sickle, with thinner than the nail, the nail of the longer, the force P ^ more force to cut tissue and drive more nails. 对于,的钉盒希望^作用力，以不超出^^卜科医生手的力量。 For, the magazine hopes ^ force, so as not to exceed the hand strength ^^ Boke doctors. 财卜，»不«^ 大钉盒的夕卜科医生会关心当需要所不期望的lfc^作用力时钉盒会发生约束TO 他的故障。 Choi Bu, »not« ^ Xi Boke doctors when large of the magazine will be concerned about when you need to undesirable lfc ^ force of constraint of the magazine happens TO his fault. 斷氐一个鎌冲翻需作用力的—种方縣允许mi^机多次被冲动的棘齿机构，如美国辨U US5,762"6和6330,965所描述的。,已知的具有多冲e^wi构的手术钉^w没有，闭合和mr动作的优点。棘齿机构依靠带齿的齿条和驱动棘爪以^^齿运动，因此，可以ai3tit力qJf^g^娜件的手柄长度来配合带齿的齿条。给定闭合范围时，要增加长度不方便，而且会增加手术所用的Wc量。人们更希望将多冲^MLI^A较小手柄，不会导致需要軟的鄉用九否则将难以可靠,作，特别是考虑到鄉的^^冲程部^iil哽多的阻力o因此，迫切需要一种細多;tlf滩以超岍霈^i!i和钉^^的手术钉合器，^!Mjtb8^需要延长娜手柄和无需限制可能在其中穀鹏引的可获得的，力就可以^^^动。发明内容本发明通过鹏一种手术钉合器械来克服上文ms其它现有技术的不足，该手术钉合娜會激織需要讀的M11T^和駄微力am行部分。 而娜的手柄有� Di turning off a Fusarium punch force required - County allows ways where mi ^ machine repeatedly urge ratchet mechanism, as described in U.S. identified U US5,762 "6 and 6330,965 described, having a plurality of known e ^ wi red configuration of a surgical staple no ^ w, advantages and closing operation of mr. ratchet mechanism and rely on a toothed rack drive pawl tooth movement ^^, therefore, a force can ai3tit qJf ^ g ^ Na member to match the length of the handle a toothed rack. given close range, to increase the length inconvenient, and increases the amount Wc procedure used. it is more desirable to repeated impact ^ MLI ^ ​​a small handle, need not result in a soft with nine rural reliably it will be difficult, as, especially considering the stroke portion rural ^^ ^ o resistance plurality IIL choking therefore, an urgent need exists for a method fine;! TLF Beach ultra Qian Mountain Pei and staple ^ ^ i i surgical stapler ^, ^! Mjtb8 ^ Na require extended handle need not be limited and may be incorporated therein obtainable valley Peng, the force can move ^^^. Peng present invention by a surgical stapling instrument to ms prior art to overcome the above deficiencies other, the surgical stapler be stimulated Na weave line portions M11T ^ am and Dai micro force is required to read, while the handle has a Na �職小和稀目。本发明的另一个方面是， 一种外,*1«^有响«向^1^动^? 夕卜辭术的端部操m^s。用户产^tf致动器（例如，扳机）中鹏动以产生鄉运动，M^运动由^im构可选wM^y多i^元件中，变换为向远傻够动的纵向运謝专懇1」«操作^§0本发明的另一个方面是， 一种外辩:i^^有响应纵向mHg动iMa行外辭术的娜操IRm手柄部分具有临床医顿于将繊^^g定倒所需的外醉术錢并进行魏动作所抓握的^M把。 And dilute the functional small mesh. Another aspect of the present invention is directed to an outer, 1 * «^ have ring« ^ to ^ 1 ^ movable? Xi inscriptions end surgery operation m ^ s. ^ TF user capacity actuator (e.g., a trigger) to generate the movable Peng Township motion, M ^ ^ im motion by the optional configuration wM ^ y i ^ multi-element, is converted into a "<< operation to move far enough to the longitudinal transport silly Frank designed Ken ^ § 0 another aspect of the invention is directed to an outer defense: i ^^ responsive operation IRm longitudinal mHg movable handle portion iMa Na outer row has an outer speech surgery to be drunk clinician Dayton Xian ^^ g predetermined desired pour Qian Wei surgery and the gripping action of the ^ M. 在手柄部分的内部， 链节齿条可在手柄的,部分和其与端IWI^g^l的管状部分之间移动。 In the interior of the handle portion, the rack is movable link between the handle, the tubular portion and an end portion thereof with the IWI ^ g ^ l. mr机构将皿动作偶联到,齿条。 mr operation mechanism coupled to the dish rack. 这样，由于将皿元件的i分缩回入手柄的握把部分，而不是更向后延伸，从而使手柄的纵向尺寸减小。 Thus, since the sub-dish element i is retracted into the grip portion of the handle, rather than the more extended rearwardly, thereby reducing the longitudinal dimension of the handle. 对于需要很长的MH1Wj端部^m实现了手柄尺寸真正减小。 The need for long end MH1Wj ^ m grip size to achieve a really reduced. 本发明的另一个方面是， 一种外,术钉合和切寧jmir有响应^i动且具有直^t^于内部手术的尺寸,行部分。 Another aspect of the present invention is directed to an external, and surgical stapling Chernin jmir movable responsive ^ i ^ t ^ and having a linear dimension of the internal operation, line portions. 其^^行部^m^g侧ii接于延^iiii的轴， 一石鹏该延^iit繊连接形鹏于鄉组织的鄉。 Which ^^ ^ m ^ g running gear attached to the side extension ii ^ iiii shaft, a stone cast ^ iit Xian Peng the Peng-shaped connecting tissue to the rural village. 一在远侧呈现为切割边的^IW沿纵向糊于细"feM和石^t间。一个容纳于细长ilil内的钉^S响应MJfF的远侦隨动抵住石!^形成钉。临床医^13«作手繊行钉合和切割，手柄包括产生鎌运动的mim构。齿^s响ratim构以刚14W动^WF，且该齿^S随后，曲ife^lKft^柄。本发明的i^^和其它目的和优点在以下的附图和附图说明中^#变得更明显。附图说明合并到本说明书中并作为说明书的"^分的附图ii^了本发明实施例，并且与i^本发明的旨以及Tffi的详细描述，"^^»#说明本发明的原理。图i是手术钉合/切害幡打幵（开始）状态的右傻舰图，其中»糊去以露出闭^t和^IW。视图。 —图3为图2中^p^^i^mffii图。图4为图1中手^:钉合/七^Jj^i行部分的^S^E图。图5描述了图1中手术娜的图3中繊操^S^面的左佛舰图，该截面通常沿图3的线5-5繊以露出钉盒部分，同时也描绘了微向中A幾的发亂图6鹏了^Mf完錄出后的图5 6 A distally presented cutting edge of the paste in the longitudinal direction IW ^ fine "feM between stone and T ^. A staple housed in the elongated ilil ^ S MJfF much investigation in response follower against the stone! ^ Formed staple. clinician ^ 13 «hand of Xian row stapling and cutting, the handle comprising generating mim configuration sickle movement of teeth ^ S ring ratim configured to just 14W movable ^ WF, and the tooth ^ S subsequently, song ife ^ lKft ^ handle this i ^^ and other objects and advantages of the invention are the following drawings and description of the figures become more apparent ^ #. BRIEF DESCRIPTION incorporated into this specification, and the specification as "sub-reference ^ ^ II of the present invention embodiments, and detailed description of the purpose and i ^ Tffi with the present invention, "^ ^» # explain the principles of the present invention. FIG surgical stapler i / playing Jian (start) state in the right of FIG silly ship cut damage streamers, wherein the »off to expose the paste to ^ t ^ and IW view - FIG. 2 FIG. 3 is a ^ p ^^ i ^ mffii FIG. FIG. 4 is a chiral 1 ^: stapler / ^ Jj ^ i seven line portions. the ^ S ^ E of FIG. 1. FIG. 5 depicts the operation of FIG. 3 Na ^ S ^ Xian operating Buddha left side of FIG ship, 5-5 Xian to expose portions of the staple cartridge generally along the line of the cross section of FIG. 3, 6 also depicts a micro Peng a view of the finished recording ^ Mf send out to the chaos a few 56 of FIG. w^^a^面的左鹏图。 图7为图i中手术钉合/切寧m^柄的左催舰图，其中左ftl^柄翠已去除。图8为图7中手柄的，透视图。图9为图7中手柄的„^|#1^的从正、后左侧的有禾J^g得到的繊图。 w ^^ a ^ Peng left side of FIG. FIG. 7 shows the surgical stapler i / m ^ Chernin left handle reminder FIG ship, wherein a left handle ftl ^ Tsui has been removed. FIG. 8 is a diagram of the handle 7, . FIG. 9 is a perspective view of the handle of FIG. 7 "^ | # 1 ^ Wo of FIG Xian J ^ g obtained from positive, a rear left side. 图10为图9中发«1构6«1?齿条的详细左伸舰图。 10 is made in FIG. 9 «1 6 configuration« 1? Details of left rack extending ship FIG. 图11-14为ffi?齿条6^坡中央lllJt和MJmm的棘爪?5m轴fi^面^i！ FIG. 11-14 FFI? ^ Slope of the rack 6 and the central lllJt MJmm ratchet? 5m axial plane Fi ^ ^ I! 1视图，另夕卜显示了JtJ^机、iiffil^a^拉偏压TOl^f坡，SS^mJ^^间的,。 1 view showing another JtJ ^ Bu Xi machine, iiffil ^ a ^ pull-up bias TOl ^ f slope, SS ^ mJ ^^ between the. 图15为部^l?的右侧视图，露出图1中手术钉合M寧J^S状态下的战鹏的远端部分。 15 is a right side view of the portion ^ l?, Exposing the surgical stapler of FIG. 1 Zhanpeng distal portion under the status M rather J ^ S. 图16为图15中jbl,去除ibl凸轮管后的从顶、后、右併照1MSS^到的,图。 FIG 16 is a JBL 15, after removing the tube from the top ibl cam, rear, right and according to 1MSS ^, FIG. 图17为部分储的右俾舰图，露出图1中手术钉合糊薪J:gS^li條下iBi,的远端部分。 17 is a right part of FIG serve storage ship is exposed in a surgical staple bonding paste FIG pay J: gS ^ li under Article IBI, the distal end portion. 图18为部，酵的右侦舰图，露出图1中手术钉合^OfJ^0锁枕态下iBIW的^^分。 FIG 18 is a section, a right investigation yeast FIG ship is exposed in the surgical staple of FIG. 1 in engagement iBIW ^ OfJ ^ 0 ^ ^ lock pillow state points. 图19是图1中手术钉合和切薪攞的后视图，^^柄夕嘵的右半部去除后， 露出锁定拔态^^锁拔态下用^^的ibiP]Wo图20^25为图18中lbiiPMf^图，分别職了未鄉，一个Ut滩，两个射冲程，三个^it冲程，返回^t^,下的^as完^^回的mrii0。 FIG 19 is a surgical stapling and cutting a rear view of salary Luo, Xiao Xi after ^^ handle right half is removed, exposing the locking ibiP with ^^ ^^ lock state of the pull draft state] ^ Wo of FIG. 20 25 as in FIG. FIG. 18 lbiiPMf ^, respectively, a level not Township, Ut a beach, the injection stroke two, three strokes ^ it returns ^ t ^, ^ as complete under ^^ back mrii0. 图26-27为手术钉合和切害幡从顶、左、远傻棺禾IBS得到的透视图，将手柄外壳的右半部去除后，露出闭，放f腕机构，分别处于去,定和压下闭^#^€时的初^1，然后在»^#期间致,定。 26-27 after surgical stapling and cutting damage streamers from the top, perspective view of the left, away silly coffin Wo IBS obtained, the right half portion of the handle housing removed to expose closure, the discharge f wrist mechanism, respectively in the go, given when early closing and reduction € ^ ^ # ^. 1, then »^ # during actuation, fixed. 图28类似图1为手术钉合和切寧JM:于开口牝态的M图，ii^3l部可舰的縮回杆。 FIG 28 is similar to FIG. 1 is a surgical stapler and Chernin JM: M in FIG female opening state, ii ^ 3l retraction rod portion can ship. 图29为图28中手术钉合和切害幡的左侧视亂手柄左對境已去除，露出间断拥例的齿状^^轮，其对fl^呈鹏H^顿区。 FIG 29 is a surgical stapler in FIG. 28 and a left side view of the cut damage streamers on the left chaotic environment handle has been removed, exposing discontinuous ^^ toothed wheel pro embodiment, the shape of the region Dayton Peng H ^ fl ^. 图30为图28中手术钉合和切割器的左伸舰图，手柄左半夕境已去除，露出间隔對RU的齿^t^器齿轮，其对:?1»轮呈,二停顿区。 FIG 28 FIG 30 is a left surgical stapler and cutter of FIG extending ship, the left handle Xi environment has been removed to expose the interval ^ t ^ RU tooth gear, for which:? 1 was »wheel, two stop regions . 再回到附图，在所有的几^^视图中，同样的附ffl^^同,WK图切害I臓IO包^具都淑、14 W^^^S 12,石淑14枢轴雜至幽顿道16，形^于，^t刀割和钉合的^R的相对，。 Back to the drawings, in the several views ^^, ^ ^ ffl attached with the same, FIG WK cut injury with I ^ IO package are Zang Shu, 14 W ^^^ S 12, the pivot 14 heteroaryl stone Shu quiet to 16 Leighton Road, ^ in shape, knife ^ T ^ R & lt stapling and opposite. ^PH^S 12 ■ 轴18偶職l序柄20。 ^ PH ^ S 12 ■ shaft 18 coupling the handle post 20 l sequence. 由端部^»312和轴18形成的执«{5分22具:^# 尺寸，适:《^套管针竊小的]1^镜开口插入，在由外鹏生抓紧控帝俘柄20控制时，进行内窥傲卜禾枰术。 By the end ^ »18 and the shaft 312 is formed performed« {5 minutes 22: Size ^ #, appropriate: "a small trocar stolen ^] ^ 1 opening into the mirror, in an outer raw Peng grip control handle prisoners Di 20 control, be proud Bu Wo Ping endoscopic surgery. 手柄20有禾哋包括以下特点，它允许繊操^S 12的闭絲作与鎌动作分开，以及在向外科医生線MTO的同时，會^^行多个鄉动作以产生端部m^gl2的鄉（即切割^l丁合)。 Die 20 has a handle Wo comprising the following features, which allows operation ^ Xian separate wire for closing and sickle operation S 12, and the surgeon, while the MTO line, the line will ^^ rural operation to generate a plurality of end portions m ^ gl2 township (i.e. D ^ l cutting engagement). 在这些«，轴18的闭合管24偶联于闭合扳机26和石淑14间使^« 12闭合。 In these «, closure tube 24 of the shaft 18 coupled to the closure trigger 26 and 14 so that the stone Shu ^« 12 is closed. 在闭合管24内，麟28偶軒细^ilit 16和手柄20间以微向定位和^WM^S 12。 In the closure tube 24, even 28 Lin Hin fine ^ ilit 16 and the handle 20 to the positioning and micro ^ WM ^ S 12. 旋钮30与麟28偶联，两个元糊舰于轴18的纵轴旋^it动而,f,俘柄20上。 Lin knob 30 and the coupling 28, two yuan paste ship to the longitudinal axis 18 of the rotating and moving ^ it, f, shank 20 captive. 因此，夕卜科医生可aa调节旋钮30来J^^W^!^g 12。 Thus, the physician can Xi Boke adjustment knob 30 to aa J ^^ W ^! ^ G 12. 闭^f 24也可Mii^钮30 ;^^,但^t对该处的一定的纵向运动以闭合繊M^S 12。 ^ F 24 may be closed Mii ^ knob 30; ^^, but some longitudinal movement ^ t to close at the Xian M ^ S 12. 在麟28中，安置了用预向运动荆禹礙IJ^m!a置12的砧板14和多^^lffi机34之间的皿杆32。 In Lin 28, with a pre-disposed to the movement of the obstacle Jing Yu IJ ^ m! A dish rod 32 opposite anvil 14 between 34 and 12 of the multi-^^ lffi machine. 闭合扳机26远离手柄20的手枪^g把36，而^1^机34舰离手枪式握把36和闭合扳机26两者。 Pistol closure trigger 26 away from the handle 20 of the 36 ^ G and ^ 1 ^ machine pistol grip 34 from the ship 36 and trigger 26 both closed. 在内窥镜手术中，一旦执行部分22插入病人体内^a手术錢时，夕卜科医生参照内窥M^他诊断用成像器:i^石嫩14和细"l^i3116间定^R。 夕卜科医^g住闭合扳机26和手1t^S把36可反SJII^(和定^^只。一mffi )WlfP操m^g 12的组织^g^l织JM意，夕卜鹏生将闭合扳机26完全压向手^:握把36，鄉端^m^S 12中的组织，鄉定闭合扳机26于此夹闭（关闭）體。若对此爐不满意，夕卜科医生可以ililffi下闭雜雌钮38以释放闭合扳机26， J^M^ft^lR的步骤。若夹闭操作正确，夕卜科医生可以着手鎌手术钉合和切割器10。具体地说，夕卜科医生鹏mm机34和手枪5^把36，以職的MfcEE下Mm机34。所需鄉动作的数目根据手掌的最大尺寸，針鄉动作期间^1^繊的駄力，以及^M过程中需要ii3iMJfF 32 ^ii^raJ操m^g 12的纵向距离和力^A紅程学的角度加以确定。正如TM讨论中^JIi啲，針夕卜科医生可以选驗不同的运动角度范围内轮转操� In endoscopic surgery, upon execution portion 22 is inserted into the patient during surgery ^ money, the reference to the doctor Xi Boke a M ^ he endoscopic diagnostic imager: i ^ 14 tender and fine stone "l ^ i3116 ^ R & lt given between . ^ g live Xi Boke Medical closure trigger 26 and the hand 36 1t ^ S reversible SJII ^ (^^ and given only. a mffi) WlfP operated tissue 12 m ^ g ^ g ^ l woven JM intended, Xi Bu Pengsheng the closure trigger 26 is fully pressed into the bypass ^: grip 36, ends ^ m ^ S Township tissue 12, the closure trigger 26 thereto Township of occlusion (closed) if the body is not satisfied with this furnace, Xi Boke physician. closing the heteroaryl may ililffi female button 38 to release the closure trigger 26, J ^ M ^ ft ^ lR step. If the correct clipping operation, the physician may proceed Xi Boke Fusarium surgical stapler and cutter 10. specifically, Xi Doctor Bu Ke Peng and 34 mm machine gun ^ 5 to 36, the number of machines to mm MfcEE the desired level 34. the operation of the largest dimension rural palm, during operation of the needle rural ^ 1 ^ Dai Xian force, and ^ M process requires ii3iMJfF 32 ^ ii ^ raJ operation force and the longitudinal distance m ^ of ^ g 12 a red path angle is determined to be learned. As discussed in TM ^ JII GOD, the needle may be selected from Xi Boke physician experience different angular range of motion the rotary operation �M)^机34，因而增滅鈔皿动作的数目，而手柄20«可以^^&^皿。在这翻作期间，夕卜科医生可以参照一个JI^器，该Jt^器彭妙^！ 回旋钮40，其响应多个Mt^作定m^。另外，縮回旋钮的錢可以鹏当ffi腿一步轮转^J^机34阻力时，鹏1掠全鎌。应激爐，手柄20 上可以增加各#^5和指示以提高由?际縮回旋钮40 ^jJi^^t^效果。32的全^g动中和当Mf^机34释放时，手柄20自^I回^MF 32。可选糊，夕卜科医生1S^t^l回旋钮40 了解麥鹏10尚未^^魏， 可以压下lhii释放M42并释^lt^机340所有这,作使手柄20自动縮要注意的是，M娜的术语"近（侧）"称远（側）"是参^IS床医鄉握仪^^柄的扰态。 M) ^ machine 34, thereby increasing the number of banknote dish off operation, the handle 20 «^ & ^^ may dish. Fanzuo this period, the physician may refer to a Xi Bu Ke ^ JI device, which is of Jt ^ ^ Peng Miao when! back knob 40, which is given as a response to a plurality of Mt ^ m ^. Further, the knob can be retracted money Peng legs when ffi ^ J ^ rotary machine further resistance 34, Peng a full sweep sickle. stress furnace, the handle 20 ^ can be increased on each of # 5 and indicated to improve the? inter retraction knobs 40 ^ jJi ^^ t ^ .32 full effect in dynamic ^ G ^ Mf and when the machine 34 is released, the handle 20 from the MF ^ ^ I Press paste 32. Alternatively, the doctor Xi Boke 1S ^ t ^ l Press knob 40 has not been understood wheat ^^ Wei Peng, 10, can depress and release lhii release M42 ^ lt ^ all machine 340, as the handle 20 is automatically reduced to Note that, M na of the term "proximal (side)," said distal (side) "is a reference ^ iS ^^ bed Medical instrument handle grip rural scrambling state. 因此，«J^!^120鹏于l^的手柄20为远侧o更要注意的是为了方便和清晰，^M使用的空间术语奴'垂直"和"水平"是相对于附图而言。但是，夕卜禾样^«可用于多个方向和皿，这些术语不是限翁荆舰的。本发明是Hi内窥^f^M和^S而讨论的。■， ii!1M的术语如"内窥镜"不应将本发明局限于只与内窥镜管（即，套管）^s^棚的手术钉合和切割器。相反，可以鹏，本发明可以用于fi^^a小切口的手术激，包括但不局限于鹏镜手术以及开腔手术。ffl^带有一个如图2"6麻的^^m^S 12，手柄20 M^li^多滩m[iS动的优点已应用于多个仪器。 Thus, «J ^! ^ 120 in Peng l ^ o handle 20 is more distal to be noted that for convenience and clarity, spatial terms ^ slave" vertical "and" horizontal "M is used with respect to the drawings in terms of However, like Wo Bu Xi ^ «dish can be used for a plurality of directions, and these terms are not limiting Weng Jing ship. the present invention is an endoscopic Hi ^ f ^ M and ^ S and discussed. ■, ii! 1M terms of such as "endoscopic" should not be limited only to the present invention is an endoscopic tube (i.e., cannula) ^ s ^ shed surgical stapler and cutter. Instead, Peng, the present invention can be used for fi ^^ a small incision surgical laser, including but not limited to open surgery and arthroscopy Peng .ffl ^ 2 with a "6 Ma ^^ m ^ S 12, the handle 20 m ^ li ^ multi Beach m [iS movable advantage has been applied to a plurality of instruments. 由于包括一^ii新fi^ia端52的石《^面50 (图2， 4， 6)， «^織置12首先响应来自手柄20 (图24中未示出）的闭雜动，石,端52包括一对位于垂直伸出的石淑部件56 (图4)远侧的横向伸出砧M^销54。 Since it comprises a ^ II new fi ^ ia endstone "52 ^ surface 50 (FIG. 2, 4, 6),« ^ woven facing 12 first response from the handle 20 (in FIG. 24, not shown) is closed heteroaryl movable, stone , end 52 includes a pair of stone Shu member 56 (FIG. 4) extending in a vertical transverse anvil distally projecting pin 54 M ^. 石fi^^销54在细^iiit 16上的肾形(kidney 开口58内平移以相对于细"l^Jt 16打开和关闭石版14。砧板部件56与在闭合管24的远端62上的突片孔60中向内伸出的弯片59啮合，后者:&ii侧终止于«;石嫩面50的远侧纖64。因此，当闭錄24从其打开腿向近佛形动时，闭錄24的弯片59向近侧拉辦版部件56，石fi^^糊54顺^lit 16 的肾形开口58働版14同时向近侧平移并向上j^至打，置。当闭合管24 向远侧移动时，突片孔60从石A^謝牛56上释放，远佛M^64Hllte^面50 上，闭合石淑14。^##图4，执行部分22还包括响应aiW 32鄉辦的SPfr。具体说，^F32与具有纵向凹槽68的^ff行件66齡。miWf件66在框架28内纵向移动以直接响^mi"杆32的纵向运动。在闭合管24上的纵向槽70 可操作地与旋钮30 (未在图2-6上示出）偶联。在闭辨24上的纵向槽70的长舰微相对旋钮30的纵向运动分别^^lffi闭雜动。框^^制牛66的远端附着在与« 28 "^动 Stone fi ^^ pin 54 on the fine ^ iiit 16 reniform (Kidney opening 58 translate with respect to the fine "l ^ Jt 16 to open and close the anvil 14. Lithographic member 56 on the distal end 62 of the closure tube 24 angle pieces 59 engaging hole 60 in the tab projecting inwardly, which: & ii side terminating in «; soft rock fibers 50 distal surface 64. Thus, the movable leg from its open to closed when the near Dover shaped record 24 , 24 closed recording sheet 59 is bent proximally pulling member 56 do Edition, stone paste fi ^^ 54 ^ renal lit 16-cis-shaped opening 58 of the plate 14 Dong simultaneously translate proximally and J ^ to the play, is set. when the when the closure tube 24 moves distally, the tab 60 is released from the rock hole A ^ Xie cow 56, the distal Buddha M ^ 64Hllte ^ surface 50, the closure 14 Shu stone. ^ ## in FIG. 4, in response to execution part 22 further comprising AIW 32 Township of SPFR. specifically, ^ F32 having a longitudinal groove 68 ^ ff line 66 age .miWf member 66 moves longitudinally within frame 28 in direct response to longitudinal motion ^ mi "rod 32. in the closure tube longitudinal grooves 70 operatively associated with the knob 30 (not shown in the FIGS. 2-6) on the coupling 24. long ship in a closed identified micro relative longitudinal movement of the knob 70 of the longitudinal grooves 30 on the closure 24, respectively ^^ lffi heteroaryl movable distal end block made of bovine ^^ 66 adheres to the «28" ^ movable 的^WF 76的近端，其中包括的一个导轨78，将E麟80向远侦(H申进繊^l^Sl2。 ^Pli^ 置12包括一个由E麟80致动的钉盒82。钉盒82有一44^l丁盒体86、楔翻动器88、钉驱动器90和钉92的爐84。可以看出i^lig鹏88可在位于钉^m 84和钉盒体86间的凹槽94内纵向移动。楔Slig动器88呈有g^ 并向J^fe钉驱动器90的凸轮表面，从钉孔96处向上驱动钉92与砧板14的钉^f 98相,，产生如图6中100麻的"B"形钉。具##%图3，钉盒体86又包括一个用于E ^1M的近侧张开的垂直槽102。切害腼104沿E ，80的，OT以在钉^且织x^i刀割雜只。分另赃图2么6中，端部^^g 12按打JF(即，开始)^东夹柳未lJf状态及完全皿扰态的!i)f示出。特别示出了利于^P^^置12发射的E形梁80的1T征。在图2中，88 ^3«5御，，^!^h未，的钉盒82。中间销106对;taMI盒82内的激凹槽94中，用于向远«^ ^g动器88。 E麟80的底销鋼108糊^lil 16的底面糊，从而中间销和底销10 WF ^ proximal end 76, which includes a guide rail 78, 80 to the distal investigation Lin E (H Shen into Xian ^ l ^ Sl2. ^ Pli ^ staple cartridge 12 comprises a set of E lin 80 82 actuated. the staple cartridge 82 has a 44 ^ l-butoxy cartridge 86, wedge flip 88, staple drivers 90 and staples 92 of the furnace 84. As can be seen i ^ lig Peng 88 may be located on the staple ^ recesses between 86 m 84 and the staple cartridge 94 longitudinal movement within the slot. Slig wedge actuator 88 has a shape and J ^ g ^ fe cam surface 90 of the staple driver, driving up from staple apertures 96 of the staple 92 and the anvil 14 ,, ^ f 98 produced with FIG. 6 100 Ma "B" shaped staples. ##% with FIG. 3, the staple cartridge body 86 further comprises a proximal E ^ 1M for opening 102. the vertical slots 104 cut along the harm shy E, 80, and OT to weave staple ^ x ^ i and heteroaryl knife only. 2 in the other points it spoils FIG 6, the end portion by the dozen JF ^^ g 12 (i.e., start) ^ East willow clip state and non-lJf completely scrambled state dish the! i) f shown particularly shows a counter 12 facilitates ^ P ^^ E-beam 80 emitted by the 1T sign. in FIG. 2, 88 ^ 3 «5 Yu ,, ^! ^ h not, staple 106 pairs of pin 82. the intermediate cartridge; bowel recess 94 within cartridge 82 taMI for distally «^ ^ G 88. E lin actuator substrate 80 of the steel pin 108 batter paste ^ lil 16 of the bottom, so that the intermediate pin and a bottom pin 10 6， 108与细^fflit 16 ,il^合。在图2中fiW开和未mf枕态中，£麟80的顶销1102^將在石淑14的石1^^套112内，因此不会妨5U占板14的反复打开和关闭。 6, 108 and the thin ^ fflit 16, il ^ together. In fiW open state and the non-mf pillow FIG. 2, a top pin 80 Lin £ ^ 1102 will be within the stone 14 1 ^^ Shu stone set 112, which is not It will hinder 5U accounted for 14 of the plate repeatedly opened and closed. 在图5中，«15«^置12显示为夹闭^l备;tlt状态o E ■ 80的顶销110与石嫩14的石^:^槽114对准，在石A^套112 ^ig侧并与^gffio在图6 中，E麟80已经完全鎌，上方销110沿石淑槽114下移，确保当切繊104 切割被组织时隔开石版14与细"i^lit 16。同时，中间销106改如前臓致动了钉盒82。此后，E皿80在«|^^112打开之前縮回^^II盒82执行附加操作。^!^置12 B个共同未决的属于同一申请A^美国专利申请中进行了更为详细的描述，每个申请的内容全部引用lBlfc作为参考：（1)"具有用于防±^的单~^定机构的手术钉合«"，序列号1(V441， 424， Frederick E.ShehotgVlike SdserJBmce Weisenbuig^2003年6月20日駭；（2)"具有明显分离的Pfl^和^U"^^^术钉^W"，靜!J号l(V441/632， FrederickEShelto^ Mike SetserJBrian JHemmelgar^ 2003年6月20日殿；（3)"具有用完钉纖定的手术牵丁合M"，序列号10/441， 565， FrederickE.Shelton^BkeSetser3nice Weisenburg^OtB年6� In FIG. 5, «15« ^ clipping device 12 is shown as ^ l standby; TLT state o E ■ soft rock with a top pin 110 stone 14 80 ^: ^ grooves 114 aligned in the stone jacket 112 ^ A ^ ig ^ gffio side and is in FIG. 6, E 80 has been completely sickle Lin, Shu stone down groove 114 along the top of pin 110, to ensure that when the cutter 104 are spaced apart cut Xian Lithographic 14 and the thin tissue "i ^ lit 16. Meanwhile, the intermediate pin 106 as previously Zang change actuator 82. Thereafter the magazine, E dish 80 «| opening 112 is retracted before ^^ ^^ II cartridge 82 is set to perform additional operations ^ ^ 12 B copending a.! a ^ belonging to the same application for U.S. Patent application described in greater detail, the contents of each application is fully incorporated by reference lBlfc: (1) "for a single anti-± ^ ~ ^ is given surgical staple engagement means« "serial number 1 (V441, 424, Frederick E.ShehotgVlike SdserJBmce Weisenbuig ^ June 20, 2003 hack; (2)" a clear and separate Pfl ^ ^ U "^^^ nail art ^ W", quiet! No. J l (V441 / 632, FrederickEShelto ^ Mike SetserJBrian JHemmelgar ^ June 20, 2003 Hall; (3) "spent staple fiber having a predetermined retractor operative engagement butoxy M", serial No. 10/441, 565, FrederickE. Shelton ^ BkeSetser3nice Weisenburg ^ OtB June ��20日,；（4)"具有用于未闭合砧板的发射锁定的手术钉合器械"，序列号10/441， 580， Frederick E.Shehan>fike Setserg3mce Weisenburg^003年6月20日駭；（5)'嗜有E ^^«1^的手术钉絲械"，序列号10/443, 617， FrederickRSheltonMikeSeteer3ruceWeisenburg^003 年6月20日J^。应该注意到，虽然这里««说明的是非铰接轴18， {践本发明的申请可包括可,的器械，如五个共同未决的属于同一申请人的美国专利申请中所描述的，針申请的内容賴弓阅舰作为参考：（1)"含有可^tt旋转的铰接机构的手术钉合器械"，序列号10/615， 973, Frederick EShdton， Brian JHemmelgam， Jeff SwayzeJKenneth S.Wales， 2003年7月9日駭；（2丫嗜有用于发射杆轨迹的铰接关节的手术钉合器械"，序列号10/615， 962，， BrianJHemmelgam， 2003年7月9日敏；<3) "^i向移^^^I^Kf^m 械"，靜i传10/615972， JeffSwayze, 2003年7月9日提交；（4)"含有用于增力口繊关节周围 20,; (4) "has not closed anvil for transmitting a locking surgical stapling instrument", Serial No. 10/441, 580, Frederick E.Shehan> fike Setserg3mce Weisenburg ^ 003 on June 20, startle; ( 5 ') has addicted E ^^ «1 ^ armed surgical staple wire", serial No. 10/443, 617, FrederickRSheltonMikeSeteer3ruceWeisenburg ^ 003 on June 20, J ^. It should be noted that, although «« non-illustrated hinge axis 18, {practice to apply the present invention may comprise, instruments, such as the five U.S. patent application belonging to the same applicant as described in co-pending, the contents of the needle depends on the application read ship bow by reference: (1) " containing a hinge mechanism rotatably ^ tt surgical stapling instrument ", serial No. 10/615, 973, Frederick EShdton, Brian JHemmelgam, Jeff SwayzeJKenneth S.Wales, July 9, 2003 startle; (2 Ah for transmitting addicted track rod articulated joint surgical stapling instrument ", serial No. 10/615, 962 ,, BrianJHemmelgam, July 9, 2003 sensitizer; <3)" ^ i ^^^ I ^ Kf ^ m to mechanical shift " Jing Chuan i 10/615972, JeffSwayze, July 9, 2003 filed; (4) "contains for around Xian joint mouth by force 灵離的锥形^W的手术钉合繊"，序列号10/615， 974， Frederick EShelton^Mike SetserJBruce Weisenbuig^003年7月9日$|^; (5)具有用于鄉;tWF的雜关"1^f盘的手术钉^W"，序列号10/615， 971， Jeff Swayze， Joseph Charles Huei^ 2003年7月9日JK。 ^ W from the spirit tapered surgical stapling Xian ", Serial No. 10/615, 974, Frederick EShelton ^ Mike SetserJBruce Weisenbuig ^ 003 on July 9 $ | ^; (5) has a township; heteroaryl off TWF "1 ^ f pan surgical staples ^ W", a serial number 10/615, 971, Jeff Swayze, Joseph Charles Huei ^ JK July 9, 2003. ，注意到，ffi?齿条200 Si!S^嘲州申A^行部分22的轴18中并环鄉角，进而伸至呼柄的手^fe^i握把36内，还可以提高手柄20设计的紧凑性。 , Noted, FFI? Rack 200 Si! S shaft 18 ^ ^ A mock application state line portions 22 and surrounding the town angle, and further extends to call the shank 36 ^ hand, can improve the grip handle fe ^ i 20 compact design. ,发明的,齿条可进而移向端^^i^S 12以包括一^^接机构， 而不是向mi1f 32麟鄉力。 , The invention, may in turn moves the rack end ^^ i ^ S 12 to ^^ comprises a joint mechanism, rather than 32 to force Lin Township mi1f. 因而，链节间^tg^^可提高m^接的能力。 Thus, the link between ^ tg ^^ m ^ improved contact ability. 多冲g^if手柄在图7-8中，更详细显示了手术钉合和切害,10的手柄20, W!f说明了麟诸如提高鹏，劇、手柄尺寸，最小微束^tt的肺織^JWl 150。 Multi red g ^ if the handle in Figures 7-8, shown in more detail the surgical stapling and cutting damage, the handle 10 20, W! F illustrate Lin Peng such as increasing, drama, grip size, the smallest of the microbeam ^ tt pulmonary weave ^ JWl 150. M:朝手柄20的手^^e 36方向,闭合扳机26 f^iip^^g12 (图7-8中未示出）的闭合。 M: ^^ toward the hand grip 36 in the direction 20 e, the closure 26 f ^ iip ^^ g12 (not shown in FIGS. 7-8) of the closure trigger. 闭合扳机26绕闭合扳机销152M^转，该闭合扳机销152偶職油左右粉f^ 156， 158乡賊的手柄外壳154上的，胸闭合扳机26的上部160向前移动。 Closing the closure trigger 26 about trigger pin 152M ^ turn about the closure trigger pin 152 coupling the functional oil powder f ^ 156,, 160 closing the upper chest forward movement of trigger 26 on the handle housing 154,158 rural thief. 闭合管24 Sil闭合轭162接受该闭会运动， 闭合躯162分别S31闭^i销166和闭合»?销168钉到闭，节164和闭合扳机26上部160上。 Closure tube 24 Sil closure yoke 162 to accept the closing motion, the closing footer 162 are S31 and closing pin 166 and closing ^ i »? Nail pin 168 to the closed, upper section 164 and an upper portion 160 of the closure trigger 26. 在图7的完全打开皿，闭合扳机26的上部160 ft^^S,并支持麟闭^PS^ 38 ,臂172。 In FIG. 7 fully open dish, the closure trigger 26 of the upper portion 160 ft ^^ S, and supports the closing lin ^ PS ^ 38, arm 172. 当闭合扳机26超院全压下錢时，闭合扳机26释放锁臂172并且邻接面170与JI^臂172的远侧右向槽口171 接合，,闭合扳机26于此夹闭或闭合皿。 When the closure trigger 26 fully depressed over the hospital money, the closure trigger 26 releases the lock arm 172 and the abutment surface 170 engages the notch 171 and the distal arm 172 of the right JI ^ ,, the closure trigger 26 thereto by clamping or closed dish. 锁臂172的近^m向枢ttii ^S174旋转，外壳154_»出闭^#^^38。 Near the lock arm 172 is rotated in the pivot ^ m ttii ^ S174, housing 154_ »# ^^ 38 ^ the closing. 闭，lffi^38的中间、 远侧边178由JBI砂卜離构182和闭铺^M138之间的臓弹簧180从近僩滩动。 Closed, intermediate lffi ^ 38, the distal edges 178 away from the JBI sand Bu Zang spring 180 and 182 between the closed configuration plated ^ M138 from movable Xian near the beach. 结果是闭雜放鄉38鹏时针（脏边看去）職锁臂172到锁定,闭合扳机26的邻接面170，其当^Uflittlt系统150处于^i回状态时，防止闭合扳机26未夹闭，如下面详述。 The result is placed close heteroaryl Peng Township 38 hour (to look dirty) to lock the post lock arm 172, abutment surface 170 of the closure trigger 26, when the system 150 is in ^ Uflittlt ^ i back state, to prevent the closure trigger 26 is not clipping , as detailed below. 随魏回的闭合扳机26完全压下，tl^机34^i^并可以辭航握把36方向多^下，以产生^^^12的皿o如0M, Wl^I 150开始,縮回,在手柄20的手枪^WC 36内Wfe伸/ffi^l難184 的推动下^ftt:錢，期瞎动端186雜到外壳154，移动端188雜到一1^带192的向下弯曲的近佛蹄回端190。 Wei back with the closure trigger 26 is fully depressed, TL ^ 34 ^ i ^ and machine can handle multiple speech ^ 36 under the direction of flight, to produce a dish such as o ^^^ 12 starts 0M, Wl ^ I 150, retracting , under the impetus of the pistol grip 20 ^ WC 36 Wfe extension / ffi ^ l difficult to 184 ^ ftt: money, the movable blind end 186 of the housing 154 to the heteroaryl, heteroaryl mobile terminal 188 is bent downward to a belt 192 ^ 1 near Buddha hoof back end 190. 钢带192的远侧體端194 ,至,雅构加载^^i^！ The distal end 194 of body 192 steel, to Ya loading configuration ^^ i ^! 195和形成H1?齿条200的多^HU 196a-196d中的前,196a上。 195 and the form H1? Former multi-^ HU 196a-196d of the rack 200, 196a on. ,齿条200是， 曲的，但具有形«,刚性齿条组件的远烦!|^，该刚胜齿条组件可!Miia 执行部分22中的m^32^3I^的，力，还稳妥JM回入手lfe^e36 以使手柄20的纵向诚最小化。 The rack 200 is curved, but with shaped «rigid rack assembly much trouble |! ^, The rack assembly may just win Miia execution portion 22 m ^ 32 ^ 3I ^, the force further! JM safe start lfe ^ e36 back to the handle 20 to minimize the longitudinal Cheng. 应MiRiJ,双拉伸/ra弹簧184增大了有效的MJ1^g4P基本上可将最小锁,了单个弹簧的—半。 Should MiRiJ, dual stretching / ra spring 184 increases the effective MJ1 ^ g4P substantially minimum lock, a single spring - half. mm机34 ^^fl』外壳154上的mm机销202 ■。 mm Machine 34 ^^ fl "mm machine 202 ■ pin 154 on the housing. 当1^^机34 压向手:J^WE 36时，MJ^机34的上部204 ^^^机销202向远fl^动, 拉伸一顿侧安放的mm鹏伸弹簧206，雌黉舰使J^^IM机34 的上部204和外壳154之间。 1 when the machine 34 is pressed against the hand ^^: when J ^ WE 36, 34 of the upper unit 204 MJ ^ ^^^ machine pin 202 to move away fl ^, stretching the meal placed side extension spring 206 mm Peng, female school between the upper portion 34 so that the ship 204 and the housing 154 J ^^ IM machine. 在每一^tlt^机被牵拉偏压,210压下时， mm机34的上部204接"^W齿条200，而mm机34释放时，贝何以脱离开。当释放和脱离牵拉偏压机构210时，mmfl^伸弹簧206推动微扳机34向远侧o当mfW 150致动时，鹏220舰与,齿条200的微±^面222 啮合而逆时针（脏侧慮）糊。这种糊W^,器齿轮230,它因此响应麟220而顺时针歸。'離220和線器齿轮230,旋^ii^至, 154上。鄉齿条200，離220 Sl^器齿轮230间W^]絲可从t^ 使得m上表面222具有SS^I的齿的尺寸，并且^tim^ 150的全旨!^t动期间，^^器齿轮230糊不大T"周。 When pulled in each biased ^ tlt ^ machine 210 is depressed, the upper portion 204 of contact 34 mm machine "^ W rack 200, while releasing 34 mm machine, shellfish why disengaged when released from the puller and when the biasing mechanism 210, mmfl ^ extension spring 206 when the trigger 34 when the push micro mfW o 150 distally actuated, and Peng ship 220, the rack ^ ± 200 micro-engagement surface 222 counterclockwise (considering the dirty side) paste this paste W ^, gear 230, so that the response to 220 CHU clockwise return 'from line 220 and the gear 230, to spin ^ ii ^, 154 township rack 200, gear 220 Sl ^ from 230 W ^] t ^ from wire such that the upper surface 222 m size having teeth SS ^ I, and the whole purpose ^ tim ^ 150! ^ t move during the gear 230 ^^ paste small T "weeks. 如TM,细描述的，^^器齿轮230至少执行四种功能。 Such as (TM), described fine ^^ gear 230 performs at least four functions. 首先，当鄉齿条200麟魏回，且扳机26， 34都如图7所示打开，H^器齿轮230左侧上的圆形,部242上的开口240朝向锁臂172的上表面244。 First, when the rural back Wei Lin rack 200, and trigger 26, 34 are opened as shown in FIG. 7, H ^ gear 230 on the left side of the circular opening 240 toward the latch arms 242 on surface 172 of portion 244 . 锁臂172通过与闭合扳机26 ^ii偏J5A开口240，闭合扳机26又被闭合拉伸弹簧246推至lfT开爐。 The lock arm 172 by partial closure trigger 26 ^ ii J5A opening 240, the closure trigger 26 is closed and the tension spring 246 pushes to open lfT furnace. 闭合扳机拉伸弹簧246 M^,!JK^扳机26和^^夕h^ 154 的上部160，因雌闭合扳机26的闭^ffi中储存鳙，繊闭合扳机26向远侧至唭未闭合腿。 The closure trigger tension spring 246 M ^ ,! JK ^ ^^ Tokyo trigger 26 and an upper portion 154 h ^ 160, by closing the female closure trigger 26 ^ ffi storage nobilis, Xian the closure trigger 26 distally to Qi leg unclosed . fl^器齿轮230的第】功富提它^^W面^S手柄20上B^ 縮回旋钮40。 fl ^} of work gear 230 which provide rich surface ^ S ^^ W handle knob 40 B 20 ^ retracted. 因此，J^^器齿轮230将Mim构150的^M^S^il^t^ 回旋钮40，使徵卜科医生可以看到需要多处mf^机34的动作来^^lt。 Thus, J ^^ gear 230 Mim configuration 150 ^ M ^ S ^ il ^ t ^ back knob 40, so that the doctor can see the need to sign Boke multiple operation machine 34 to mf ^ ^^ lt. 驗器齿轮230的第三种功fgJi^^手术钉合fP"Kii鹏10时，微向，角度i&^动ibl机构250的ihii释,248。 ^!t动作期间，由^ 器齿轮230产生的止退释放杆248的近«动致动单向离合,^1机构250 (图15-16)，允许mjfP 32的远繊动并防ih^!W 32的近繊动。这跪动也皿自外壳154近端的jbi释^ffl 42延伸，当需要在;itf动作鄉^i回mtm^时，用于操作者致动iMJi释^M42。 Ml^作^^，随着发娜构150縮回，J^^器齿轮230反向旋转。这种反向麟iEibSTO 250不活动，将Jhii释鹏钮42收回入手柄20，并侧向糊lhii^放杆248 (图19) 以允i^t^器齿轮230 ,反向,。!l^器齿轮230的第四种功f^魏自^l回離40 (图7中顺时针画出）的手动旋转以缩回mim^ 150,而lbi鹏250处^il优态，因此刻艮了^im^ 150上的ffi5j^，而此^F易^ti伸/JS^弹^^合184 所刻艮。Mim构150部分織后，可翻手繊回，否贝哙因为按下iBi释^M42，横向移动ihii释赚248而穀ljibi机构250的阻碍。250由操作者 The third inspection work gear surgical staple 230 fgJi ^^ engagement fP "Kii Peng 10, slightly to the angle i & ^ ibl movable ihii release mechanism 250, and 248. ^! T during operation, is generated by the gear 230 ^ retaining the release lever 248 near «motion actuator way clutch, 1 ^ mechanism 250 (FIGS. 15-16), Xian is far mjfP 32 allows the movable and the IH anti ^! W 32 near the movable Xian. this action also kneeling proximal end 154 of the housing dish jbi ^ ffl 42 extends from the release, when it is necessary; ITF operation when rural ^ I ^ MTM Press, iMJi for operator-actuated for releasing ^ M42 Ml ^ ^ ^, Na configuration with hair. 150 is retracted, the reverse rotation of 230 J ^^ gear. this reverse Lin iEibSTO 250 is inactive, the Jhii Peng release button 42 retracted into the handle 20, and laterally paste lhii ^ release levers 248 (FIG. 19) to allow i ^ t ^ gear 230, reverse,.! l ^ fourth gear 230 from Wei Gong f ^ ^ l from the back 40 (clockwise in FIG. 7 shown) is rotated manually to retract mim ^ 150 , while at 250 ^ il lbi Peng excellent state, therefore, the scale of the Gen ^ im ^ ffi5j ^ 150 on, and this easily ^ ti ^ F extension / JS ^ ^^ elastic engagement configuration 184 inscribed Gen .Mim portion 150 after knitting can Conspire Xian back, no shellfish Kuai because iBi press release ^ M42, lateral movement ihii release impede Valley ljibi earn 248 250 .250 institutions by the operator 可liSi啲战释放杆248舰，其近端可操作地偶微舰释断42，其远^l!jibi轭256。具体说，ibW鹏248的远端254通aiBi轭销258^ilJibi轭256上。止退轭256纵向移动向粉嘵154纵向，的lBl凸轮槽管252^iiJ^i动，iA^端^^F32将其连接妾l，齿条200的前,196a。 ihii轭256 个凸轮槽,260将来自lbl释WF 248的纵向运动f^Ii扯退凸轮槽管252。 «是说，，虽凸轮槽管252中沿成角度的槽的凸轮槽,260的纵向g^f管252。夹在框架28近端和ibl凸轮槽管252之间的分别JiiblE^弹簧264， ih^266和lbi凸轮管2680如,，^!W 32的^^动引feibM 266 由顶部麟到后部，增加了与^ij"ff 32的^^M，其Hjh^ff 32的向近侧移动。 GOD can liSi battle ship release lever 248, its proximal end operatively coupling the micro-off release ship 42, which is far ^ l! Jibi yoke 256. Specifically, the distal end 248 of ibW Peng aiBi yoke pin 254 through 258 ^ ilJibi yoke 256 a. retaining yoke 256 to move longitudinally to the longitudinal Xiao powder 154, the cam groove lBl tube 252 ^ iiJ ^ i movable, iA ^ ^^ F32 its end connected concubine L, the front of the rack 200, 196a. ihii yoke 256 the cam groove 260 from the longitudinal movement lbl release WF 248 f ^ Ii tube pull-off the cam groove 252. «mean ,, though tube 252 along the cam groove of the cam groove angled groove, 260 g ^ f longitudinal tube 252. interposed between the frame 28 and the proximal end of the cam groove ibl JiiblE ^ pipe 252 are springs 264, ih ^ 266 and cam tube 2680 as lbi ,, ^! ^^ W 32 of the movable lead feibM 266 from the top to the rear Lin section, and increases ^ ij "^^ M ff 32 to move to its proximal Hjh ^ ff 32. 当lbi凸轮槽管252与lbl凸轮管268分离时，这种±« 266的旋转方5^l似于麟屏风门打开的屏风门锁。 When lbi cam groove of the cam tube 252 and the separator tube 268 lbl, such ± «of rotation of 5266 ^ l lin screen similar to screen door is opened the door. 战是，Ibtra弹簧264會^f^用在盘266的]»以« 266顶至1谋锁定«。 War is, Ibtra spring 264 will be used in a disk ^ f ^ 266] »to« lock seek 266-1 «. Iiii凸轮,252的»弓凸轮管268远侧凸轮的移动，迫« 266的顶部向远侧，划艮了来自ibEEi 弹簧264的作用力，因«_±» 266置于允许，杆32的向近僻蹄回, 锁亂特别参考图8~10，示出了由棘爪270,的牵拉^E机构210,棘爪270 有一个向自突出的窄尖272和一个在其近端向右侧突出fi^ 274，它可转动鹏过^IW机34上部204的孔276。 Iiii cam »bow cam tube 252 is moved distally the cam 268, forcing the« top 266 distally, the draw force from the Gen ibEEi spring 264, because «_ ±» 266 disposed allowed to rod 32 near secluded shoe return, with particular reference to FIGS chaos lock 8 to 10, is shown by the pawl 270, the pulling mechanism 210 ^ E, there is a pawl 270 projecting from the narrow tip 272 at its proximal end and a right side projecting fi ^ 274, which may be an upper aperture 34 IW unit 204 through 276 of rotation Peng ^. ^1«机34的右侧，伸銷274承纳一，压构4牛，图中示出为偏压轮278。 Right 1 ^ «machine 34, the pin 274 extends a bearing satisfied, bovine pressing mechanism 4, as shown in FIG biasing wheel 278. 随着^m机34前后平移，^轮278横过邻近手柄外壳154的右半壳156的弧形，在M^远傻榔分，淑—个辦形成于右半壳156上的偏&斜面280。 With in 34 ^ m translation machine, the wheel 278 ^ 154 traverses the right handle housing adjacent the arcuate shell 156, in M ​​^ palm points away silly, Shu - do a right half shell 156 is formed on a partial bevel & 280. 偏压轮278可以tt^k由弹性摩擦材料形成，其引皿爪270的侧销274逆时针,（当;!^£«5看时)， 因此，将向远侧突出的窄尖272向下牵拉偏ffiA^fi^l96a"d的斜坡中鄉道282以与ffif齿条200接合。当mi^机34 «^放，偏压轮278就会反向牵拉偏自爪270，从,齿条200的斜坡中央,282 «高窄尖272。为确保在高负微态下和棘爪270在^«^擺时，窄尖272的脱离，窄尖272 向上骶斜到闭魏162上的近侧和面向上的《鹏斗表面284上，以使窄尖272从斜坡中央繊282 «离。若M^机34在除錢闭合外的任意点处释放， ,t^ffi偏压轮278 ;!A^坡中央,282 ±^窄尖272。尽管^出的^6压轮278，应该注意至IJ偏压槲牛或偏压轮278的職歸范性的，其可以变化为适合利用麟力棘勧接合綳离端部m^e鄉的各种微。肺齿条特别参考图10,详细描绘了肺齿条200的1T^点。ITNII? 196a>d 的«^1湘邻,196a-d上以向下、近侧皿入手t^M 36。虽然, 齿条200可&Jt方向� Biasing wheel 278 may be formed of an elastic tt ^ k friction material side of the lead pin 270 of the pawl dish 274 counterclockwise (when;! ^ When £ «look. 5), therefore, would distally projecting narrow tip 272 to under partial drawing "282 to 200 engage with the rack ffif ffiA ^ fi ^ l96a d ramp in rural road. when the machine 34 mi the ^« ^ put, it will reverse bias the wheel 278 is pulled from the biasing pawl 270, from , the slope of the center of the rack 200, 282 «high and narrow tip 272. to ensure that the pawl 270 ^« when the pendulum, from the narrow tip 272, the tip 272 is narrower at the sacral obliquely upwardly ^ negative high state to the closed micro-Wei 162 "Peng hopper and proximally on the upper facing surface 284, such that the narrow tip 272 Xian 282« slopes away from the center. If M ^ machine 34 is released at any point other money outside closed,, t ^ ffi bias 278 wheel;! ^ a central groove, 282 ± ^ narrow tip 272. Although the ^ 6 ^ a pressure wheel 278, it should be noted IJ bias to bias the wheel post oak or bovine normalized range of 278, which can be changed to Lin Quan force using suitable ratchet engagement end Beng from various micro m ^ e Township lung rack particular reference to Figure 10, details the points .ITNII lung ^ 1T rack 200? 196a> d of «^ 1 Xiang o, 196a-d to the downwardly proximal start dish 36. While the rack 200 may direction t ^ M & Jt ��曲，但是当«^体纵向负«^«^^»11^ 196a^d 向上弯曲的负载时，^"齿条200形成刚性鍋。 Qu, but when «^ longitudinally negative« ^ «^^» 11 ^ 196a ^ d is bent upward load, ^ "rack 200 forms a rigid pot. 特别是，^^fl96^d在近侧终止于一个下部有横向通孔的凸性延伸300。 In particular, ^^ fl96 ^ d proximally terminates in a lower portion of the projection 300 extending transverse through-hole. I,的左佛助304包括带齿上表面222，而右侧306与左侧边304平行，二者之间形^止于凸性延伸300的斜坡中央鹏282。 I, the left promoter Buddha 304 includes a toothed upper surface 222, right side 306 and left side 304 parallel, beyond the ramp between the two central convex shape ^ 300 of the extension 282 Peng. 中央繊282的近側部分终止于右侧边和左佛助304， 306航，形綱于^来自导向链节196ard的凸性延伸300的U形夹308，其由l^销310铰^^接。 Xian central proximal portion 282 terminates in the left and right side co Buddha 304, 306 aircraft, in Arachnida ^ convexity 196ard from the U-shaped guide link 300 extending clip 308, 310 which is a hinge pin ^^ l ^ access. 針导向,196a^d ^Eia端具有平坦部分312，其通常垂直于来自发l#F 32的柱体纵向负载方向。 A needle guide, 196a ^ d ^ Eia end has a flat portion 312, which is generally perpendicular to the longitudinal direction of the load from the cylinder of the hair l # F 32. 每~^4^1^ 196a-d ^g端具有^M面314， 其通常也垂直于柱体纵向负駄向。 Each ~ ^ 4 ^ 1 ^ 196a-d ^ g ^ M having an end surface 314, which is also generally perpendicular to the longitudinal direction of the cylinder to the negative Dai. 横向通孔302留出足够的间隔以在鹏平坦部分312的下»^面314间形自口316，为相对于导向,196a^i的拖动链节196a>d向下旋转,间隙。 Transverse through hole 302 to allow sufficient spacing at the flat portion 312 Peng »^ shaped surface 314 from the mouth 316, with respect to the guide, dragging the link 196a ^ i 196a> d rotated downward gap. 但是，当导向和«链节196a~d纵向排列时，相邻平面312的上辦D^M平面314配)t^，从而ffiibia—步向上偏斜。 However, when the longitudinal guide arrangement and «link 196a ~ d, the adjacent plane 312 do D ^ M 314 with plane) t ^, thus moving towards the ffiibia- skew. 如标，当相邻» 196ad处于水平錢时，孔302和销310位于mm1 32的作用线下方。 As standard, when the adjacent »196ad money is horizontal, hole 302 and the pin 310 is located below the line of action of mm1 32. 当向发tm机34加载时，牵拉偏压机构210沿作用^t 力，同时将纖的水¥» 196aKi偏压在一起。 When the loading machine 34 to send tm, the pulling action of the biasing means 210 ^ t in force, while the aqueous fiber ¥ »196aKi biased together. 因此，i^f力的作用线碰转销310 ^Jl方#31， ^K^,导向,196"处于刚ftS线结构。, 肺196a^i的斜坡中央车爐282弓瞎棘爪270的远侧突出窄尖272与导向肺196a^的凸性延伸300相接合。前節196a極侧附#^^偶铺195， 3i^H^1 195包^« ^!W 32 ^fi端的制牛以及包括类似^m^ 196a4的凸t4E伸300和平坦部分312，具有足够的空间以^^带192的远侧安置端194的突片320、 322 (图8)，突片320、 322附着在将前,196a ^^MU1S^ 195上的同一旋转销310上。JM沿mf杆32纵$»0齿条200的直线部分施力，縮回力在勧上的施加有利于|^»^力。与斜坡中央,282不同的ji^侧边304上具有離上表面222可tl^地允许棘爪270和«?齿条200之间的激束强啮合，即i^tj^机34已经在不同的运动范围内棚动。同时，TO上表面222与微220 ^K^合， 保证了战鹏性。应该注意到，虽然B^ii皿了, 196a^d间钉住的U形^^,但还可以糊弹tt^ttm胁，虽然描述了四种,196a-d，还可臓发曲率^^ Thus, i ^ f line of action of the force pin 310 ^ Jl side collision # 31, ^ K ^, the guide 196 "in the line immediately ftS structure, lung 196a ^ i ramp car heaters central blind bow 282 of the ratchet 270 distally projecting narrow tip 272 of the guide lung 196a ^ convexity extending 300 engages the front section 196a-side attachment # ^^ even shop 195, 3i ^ H ^ 1 195 packet ^ «^! W 32 ^ fi end system cattle and similar projections including t4E ^ m ^ 196a4 and the flat portion 300 of the extension 312, has enough space ^^ tab 194 is disposed with the distal end 192 of the 320, 322 (FIG. 8), the tabs 320, 322 attached to the before, on the same rotation pin 310 on 195 196a ^^ MU1S ^ .JM mf along the longitudinal rod 32 $ »0 urging straight portion of the rack 200, the retraction force is applied on Quan facilitate | ^» ^ force. central ramp, 282 different from the upper surface 222 ji ^ tl ^ can allow the pawl 270 and «having an upper side 304? laser beam strong engagement between the rack 200, i.e. i ^ tj ^ machine 34 has a different range of motion of the movable shelf. Meanwhile, the upper surface 222 of the micro tO 220 ^ K ^ together to ensure Zhanpeng exemplary. It should be noted that, although the dish B ^ ii, 196a ^ U-shaped ^^ d between pinned, but paste can also tt ^ ttm bomb threat, although the described four, 196a-d, may also be made of curvature ^^ Zang 等选#^同6^数目和"^。 With options such as # ^ ^ 6 and the number "^. 牵拉-偏压,在图11-14中，換imt述m?^31MJm^ 150，说明牵拉偏压机构210 (即，棘爪270，偏压轮278，以及偏ffi^坡280) ^«^^^^机34離动方向。 Drawing - bias in Figures 11-14, said transducer imt m ^ 31MJm ^ 150, biasing mechanism 210 described pulling (i.e., pawl 270, the biasing wheel 278, and 280 slope partial FFI ^) ^? «^^^^ machine 34 from moving direction. iM卜，因为偏压轮278与偏ffi^坡280间形^^，当誠棘爪270的完全脱离或接^dt动时，偏压轮278^^糊。 iM Bu, since the biasing wheel 278 and the biasing ffi ^ ^^ shaped groove 280, the pawl is completely disengaged when Cheng or 270 ^ dt movable contact, biasing wheel 278 ^^ paste. 在图ii中，11«机已被部分压下至|彼牵拉««1210开^m动皿扳机34向鄉齿条200运动的紙具体地，偏压轮278 B^^IE^坡280 的近端，并随后开繊时针旋转，当M侧看去时，将这种旋转#^1^»时与鄉齿条200脱离的棘爪270。 In the FIG. Ii, 11 «machine has been partially depressed to | he pulls« «^ m 1210 apart movable dish 34 to trigger movement of the paper 200 Township rack Specifically, the biasing wheel 278 B ^^ IE ^ slope 280 proximal end opening Xian and then clockwise rotation, when viewed M side, such rotation when ^ 1 ^ # »Heung rack 200 pawl 270 disengaged. 在图12中，；i«TO 150 B^前^"^&离足以娜爪270完全麟到与第~« 196a的斜坡中央鹏282接合，雕肺偶絲195并因而^Jl^if运动到^F32。在图13中，^m机34和齡MtfL构150已^i行到^ifi維的隨，在凝动鹏中，偏压轮278 B^沿偏E^坡280糊。S^if动作结束时，棘爪270的远侧舰（图8) 与闭，162的近侧朝上的斜面284接触，并^A链节196啮合的棘爪270抬起，使^^齿条200缩回。在图14中，^m机34 B^W5^^放，使偏压轮278在^E^f坡280 JlM^侧舒峰拉，产^^侧看去虽喷时针的糊，^f^高棘爪270。由于具有M^侧引导的^?齿条200的斜坡中央flil 282的斜面，MJTO 150在向近侧移动以准备另一个^1^#^缩回周期时不会受阻。应i^t识瀏，牵拉偏压TO210可以在^Md^"傾作的^中鄉。 In FIG 12,; i «TO 150 B ^ before ^ '^ & leave sufficient Na pawl 270 is fully Lin into engagement with the first ~« 196a ramp central Peng 282, carved lung thermocouple wire 195 and thus ^ Jl ^ if moved to ^ F32. in FIG. 13, ^ m machines 34 and 150 have configurations age MtfL ^ i ^ ifi dimension to row over, moving condensate in Peng, the biasing wheel 278 B ^ E ^ slope 280 along partial paste .S ^ if the end of the operation, the pawl distal ship (FIG. 8) and 270 closed, contacts 284 upward inclined surface 162 of the proximal and ^ a pawl 196 engages link 270 to lift the rack 200 ^^ retraction. in FIG. 14, ^ m machine 34 B ^ W5 ^^ discharge, so that the biasing wheel 278 ^ E ^ f slope 280 JlM ^ Shu peak pull side, although the yield ^^ paste ejection side viewed hour hand, ^ F ^ pawl 270. Because a high-side guide ^ M ^? flil central ramp rack 200 of the ramp 282, MJTO 150 moves proximally in order to prepare a further 1 ^ ^ ^ not retracted cycle # hindered. i ^ t should know Liu, pulling bias can TO210 ^ "dumping made in Township ^ ^ Md. Jbl机构如JLfM， ihii机构250在MJ^作MS中l^以PlitmW 32以M im^ 150縮回，彭iJ誠全mHf^K由用户选繊回时。 Jbl mechanism such JLfM, ihii mechanism 250 for the MS in MJ ^ l ^ to PlitmW 32 ^ 150 retracted M im, Cheng Peng iJ full mHf ^ K back to Xian selected by the user. 在图15中，画出了处^i^^bt态的lbl机构250。 In Figure 15, shown at the i ^^ bt ^ lbl mechanism state 250. Jhil^放杆248处T^5佛Kig并]^止退凸轮槽管252与lBi凸轮管268接合形^S小的纵向长度，为«266产生增加的空间。 Jhil ^ release levers at 248 T ^ 5 Kig and Buddha] ^ retaining cam groove of the cam tube 252 and the tube 268 engaged lBi small ^ S-shaped longitudinal length, produces increased space for «266. 離26M,lliBUBI弹簧264麻的一賴度，#^在織杆32上，如图16所示。 From 26M, lliBUBI spring 264 depends on a degree of anesthesia, the knitting # ^ lever 32, as shown in Figure 16. 在图16中，框架28的近端400包括，i^其远侧圆环404上的lblJl 縮弹簧264的半部,部分402。 In FIG 16, the proximal end 400 of the frame 28 comprises, i ^ which lblJl ring 404 on the distal half of the compression spring 264, portion 402. ：&#簧264的近侧，,28具有一个顶» 与麟28内綱通的近侧开口槽406 。 : & # 264 ,, proximal spring 28 having a top »and 28 CHU outline tank 406 through the proximal opening. 266通常为扁平fi^以配合在与弹簧264枏邻的开口槽406中。 Fi ^ 266 generally flat to fit in the opening 264 of the spring slot 406 adjacent to nan. 中射L 408延伸穿，266。 L 408 extends through the exit 266. 具体说，从开口槽406中露出的lfc^266的顶部向上突出以接魏自弹簧264的作用力。 Specifically, the groove 406 exposed from the opening in the top lfc ^ 266 protrudes upwardly from the biasing force of the spring contact 264. Wei. ibM266的下部魏向^^与弹簧264纖。 A lower web 264 to Wei ibM266 ^^ spring. 因此，齢一穀ljlbi凸體268的^， iiJM266的顶部向尖^a傻雌动，引Mibl^:266的中^PL408在图17中，lbt机构250 ^1MjSf锁拔态。 Thus, a valley Ling ljlbi ^ convex body 268, movable towards the tip of the top iiJM266 ^ a female silly, cited Mibl ^: 266 in ^ PL408 in FIG. 17, lbt pull lock mechanism 250 ^ 1MjSf state. 止锁释WF 248 e^鄉到右侧，向jJbl轭256的右侧J^iii动，因此^tlhii凸轮槽管252的顺时针旋转，当M^佛腿看去时。 The latching release WF 248 e ^ Township to the right, the right side of the yoke 256 to move the J ^ iii jJbl, therefore ^ tlhii cam groove pipe 252 is rotated clockwise when viewed M ^ Buddha leg. ltM凸轮槽管252的凸轮面410与ibi凸轮管268 上的近糊口412分离，迫^者向远侧移^&ftibl^: 266， lhM 266又移向一賴魏锁錢并进而臓lBUBi弹簧264。 The cam surface ltM cam slot tube 252 410 ibi cam tube near living 412 separated 268, forcing ^ by side to the far ^ & ftibl ^: 266, lhM 266 and toward a Lai Wei lock money thus Zang lBUBi spring 264. 在图18中，描绘了Mf^机34E^if两^, iBi释WF248和^ 器齿轮230右侧助、司的相互作用。 In Figure 18, it depicts two ^, ^ IBI release WF248 and right gear 230 co, ^ Mf machine interaction Division 34E ^ if. 冊口420延伸穿aibi释断248以接受并与AMt^器齿轮230右侧向夕卜延伸的弯曲斜面434相互作用。 Volume 420 extends through opening 248 to accept aibi release off with AMt ^ curved ramp 230 extends to the right side gear 434 interacts Bu Xi. Jl^器齿轮230的旋转驱动lhii释WF 248向远侧，，ibii释^M 42按至lJ^tAM 座422 ^1hil机构250脱离，如麻，M^侧露出lbl释S^ 42， mh 退释MF248向右侧y^动ib!TO250。 Jl ^ gear 230 is rotationally driven distally lhii release WF 248 ,, ibii ^ M 42 press release to lJ ^ tAM seat 422 ^ 1hil detachment mechanism 250, such as hemp, M ^ is exposed lbl release side S ^ 42, mh back release MF248 move to the right y ^ ib! TO250. ibl轭256允许这种用ibi轭销258 (未显示）纵向TO^0^i动。 This allows yoke 256 with ibl ibi yoke pin 258 (not shown) longitudinally movable TO ^ 0 ^ i. ibti释WF 248的^^移动是由i^t^^ 432周顿四分之一的弯曲斜面430引起的，J际器齿轮230绕JI^器销432 糊。 ibti release WF 248 is moved ^^ ^^ i ^ t 432 by a quarter of the circumferential curved ramp 430 Dayton caused, J occasion gear 230 about pin 432 JI ^ paste. 弯曲斜面430沿顺时针的敝部分（当从右侧看去）或,434伸至l跑离^t^器齿轮230表面的最織。 Spacious curved ramp portion 430 in a clockwise (when viewed from the right) or, l 434 extends to run away from most of the surface texture gear 230 ^ t ^. 弯曲斜面430 ^时针的敝部分^A口436 因此与麻器齿轮230的表面相平齐。 Curved ramp 430 ^ ^ A spacious portion of the hour hand 436 thus flush with the surface anesthesia with gear 230. 在图18^25中，杆开口420与水平槽440~^^，限定了ibl^lW248 ^#^£側^^侧移动，432留^jtblC平槽440内。 In FIG. 18 ^ 25, the rod openings 440 to 420 and the horizontal groove ^^ defining ibl ^ lW248 ^ # ^ £ ^^ side mobile side, leaving 432 ^ 440 within jtblC flat grooves. 顶部凹口442 和底部凹口444垂MB宽并与水平槽440皿，并限定弯曲斜面430沿顺时针的大部分434在哪一角度^S^向平移ibii释放杆24«。 The top and bottom of the recess 442 a recess 444 with vertical and horizontal groove MB wide dish 440, and 430 define a curved ramp most clockwise angle 434 at which the release lever 24 ^ S ^ «translation of ibii. 顶，底部凹口442、 444的尺寸使弯曲斜面430在无需《麟ltii释放杆248的情况下J4A各凹口442、 444，，正常的mr^。 Top, bottom recesses dimensions 442, 444 of the curved ramp 430 without the need to make "Lin ltii release J4A respective recesses 442, 444 ,, mr normal case where the lever 248 ^. ,口420 ^EitMTO 250纵轴的上方，因此向右的力^ib虽凸轮槽管252的旋转力。 , Port 420 ^ EitMTO 250 above the longitudinal axis, thus rotating force rightward force ^ ib although the cam groove 252 of the tube. 在图20中，显示了止i!PWF 248和Jg^器齿轮230的^&状态，并在闭合扳机26微动的鹏中^f此状态。 In FIG 20, it shows a stopper i! PWF 248 and gear 230 Jg ^ ^ & state, the closure trigger 26 and the jog Peng ^ F in this state. 具体说，Ibl释放杆248位^g侧， ^iBi释放鄉42斷氐至唭M^ 422中。 Specifically, Ibl release lever 248 side ^ g, ^ iBi release Township 42 to break Di Qi M ^ 422. 弯曲斜面430位于其逆时针的极限，，434在大约6点lt^g，远侧相邻于杆凹口420下部凹口444 的近侧垂直面，斜坡430的入口436在3点l^置。 Curved ramp 430 at its counterclockwise limit at about 434 ,, 6:00 lt ^ g, distally adjacent a lower portion of the lever recess 420 of the recess 444 proximal vertical surface, the inlet 430 of the ramp 436 is set at 3:00 l ^ . 在图21中，发l^m机34的第一个，动作B^生，其中顶峰434fi^ 作用^部凹口444的近侧Mt面上，并且弯曲斜面430 B^时针]^^到大约9点钟的錢。 In FIG. 21, l ^ m hair dryer 34, a first operation B ^ Health, wherein the peak effect 434fi ^ ^ Mt proximal surface of the notch 444, and the hour hand curved ramp 430 B ^] to about ^^ 9 o'clock money. 因此，iiJl释断248 B^向近辭移，露出^m鹏422 中的ibi释^ia 42并致动ibi机构250。 Thus, iiJl release off 248 B ^ shifted to the near speech, exposing the m ^ Peng 422 ibi ^ ia 42 and release the actuator mechanism 250 ibi.选定^l齿轮230的顺时针麟速率与所需要的完全，动作次数间的关系，使^t行后续:tM动作时弯曲斜面430 —直不受阻，如图22戶标，其中已经誠了两个織^J^将最高点移到近似12点钟的錢。因此，顶峰434離并邻接上部凹口442的远傻捶直,，i^S使得后续，动fm^用^lfcM释放杆248上以引^ig侧水平移动。注意在这些皿动作工作间，弯曲斜面430^^在||^«432的近侧。压下释臓钮42 ^»开口420的近侧ii^骑到弯曲斜面430上，如图19 所示，M!4ibl释放杆248.在图23中，最后皿动作结束，其间,434 B^移到M3点钟处， 此时移动水平槽440的近端向上移^&tt^^432，斷fclBi释^^42， 释^Qhii鹏250射鹏化節^it^im构150的縮回。在图24中，解锁状态的iBiWl 250使ffi?齿条200弹,力，回发生，这又导致当从右彻请去iSJ^器齿轮230的逆时针麟。当MTWl 150 开^ll回时，^器齿轮230的逆时针旋转使弯曲斜面430的成角度的表面滑动到与顶部凹口442的近侧Ji^^f面^Mo J^^器齿轮230的,旋转驱动释放杆248上gfTF方的弯曲斜面430荆^f或偏转杆248到图19际6^fi。由弯曲斜面430 ,的ihM释WF 248的^^运动可以在g齿条200的縮回过程中防止杆248的纵向运动。如果iJdl机构250 ^f动作步i^束自, 辛贩，鄉齿条200未在最后一个动作结束,回，贝I糊JI^器臓40 (图20^25中未画出）会产生»卜的力,回鄉齿条200。鹏该注意到， 机构150部分^f过程中，如图22标，按下鄉42也^131M^侧移辦放杆248以解mLb!TO 250鄉回肺齿条200。缩回运动勝5tl^器齿轮回到»始位置，如图25所示。应该注意到,,口420的^i^^y^^4坡430的弓形尺寸^为例证的， 可以^以ffi于不同，动作数目的手柄枸造。应该注意到，由JI^器齿轮230和,口420相互作用形成的旋^^放机构可以被其它,方^m代,'开口锁定在图26中，手术钉合和七膽iJHM 10处^^T5f状态，闭合和^M^机26、 34都是向前的，而,齿条200处，回^。如前皿，^SS种未鄉汰态下，Jl^器齿轮230的圆形脊背242中的开口240朝向锁臂172的上表面244，锁臂172平常依靠»卜，构182和闭，放M 38中间远柳助178之间的Mf弹簧180的作用而向下旋转出开口240。在图26中，闭，^M38 巳压下，^h表面244 iftA开口244。在图27中，向手l^i, 36方向关闭闭合扳机26并^a^m机34摆到mf^S, 33^扳机26和锁臂172处于夹闭邻^bt态。闭铺I^M 38未压下，如伸长的闭^^簧180所表明的。锁臂172的上表面244摆到圆形脊背242的下方ljt^器齿轮230解锁并可自由逆时针旋转。锁臂172的向下运^^锁^t^器齿轮230和^S的m?^il ^fm^J150, ^^J^机34穀敏动。因此，随着^^器齿轮230继续麟以进一步皿，卩1±闭，»钮38释放夹闭的闭合扳机26。健線器和释放机构在图28中，手术钉合WOfi皿610用一个可»^^^« 640代^^自回旋钮，！ tt^置向上延伸成一个顶lfPlMS的縮回杆642，用作一个可易于用任一只手致动的粘带式（stuck) tl^fl»0该W^出为打开和未鄉状态，如远侧向前的闭合和mm机26、 34和打开的^^m^S 12 所^的。当g开始皿时，在正常情况下縮回杆642与手柄夕琉154皿侧旋辩瞎。 ^§ 640可以偶联（未显示）至撤面臓Wfl^ 220和^Ml 构150上，根据前面臓，其中当ffi?^5i^时，缩回杆642会向近侧麟， 呈现可视的1«&示，并會激以皿向其施加手^S侧力辅助自^^回的方式作为旋转錢畅器，旋转方向必须反转，因此舰实施例中指示器必须附着到麟220上。在图29中，另一个可选择的^|«1构650包括前面MS^的顶^T般繊回杆642和^^lg^S 640， Jl^l^g 640鹏惧有在微区668内的第一和第二娜区662， 664的fl^器齿轮660。当縮断642处于与手柄外壳154相邻的远侧錢时，第H?顿区662对?Hf^220。因此，赚220可以在纵向移^)^齿条220的驱动下自由地顿时针和逆时针旋转。如果E ， 80 (在图29中未显示）由于樹可原因在^^I^S 12中^U船连，不能被拉伸/JBf弹鄉184向近傻赚回，缩回杆642可以由外禾柩生向近侧拉动(m 左IW去顺时针,^II齿轮660。縮回杆660的这种l^ig^lj^^ 齿轮660并带动了位于第一和第二，区662、 664之间的弯曲齿部670与惰轮220的齿相,，以可操作ifc^l回杆642偶職!JMtm构650上。一旦偶联，夕卜科医生可以向縮回杆642施加更大的力以縮回^im^650， 从而逆时针旋^fl轮220并向近侧纵向移^T^齿条200以縮回E形梁80。 当縮回杆642进一步旋转到图30的位置，m 220与弯曲带齿部分离并M 第二停顿区664与缩回杆642封禺联。^5»面，施力释放粘带的MTO 650， 且拉伸鹏弹辭且184将完魏回鄉齿条200。另外一个设计（未显示）包括一个在縮回杆642和^器齿轮660之间的单向,离合器如一个Sprague离合器自同功能的机构（未显示)。在前面的设计中，缩回杆642的运动范围由在小于一麟的范围IK^动的針端点处与手柄外壳154 ,而穀鹏制。繊限制了鄉回杆642的"HSg动纖中发射系统650能被缩回的距离。«回杆642和^ll齿轮660间增加单向, 离合器允许当縮回杆642向后旋转（Aig側至lJ^侧）时，縮回杆642可操作地与fl^器齿轮660啮合，当杆向前移动（M^侧至隨侧）^m两者分离。雜， 舰多拉动縮回杆642保证了M]m^ 650的完魏回。第二停顿区664可从Jg^器齿轮660上移开以确保更多齿与齿的啮合。另外，加入离^^机构可允i棚镧回杆旋转与手柄相邻。在顿中，夕卜科医生使^^^S 12和轴18穿过難I^tth定魅lJ 手术^S，定位舰占座14和细^lil 16作为相对的^W^^T合和"fcTJfJ的组织。一m^P操i^g 12的^Sffi，闭合扳机25被完全压向手柄20 的手賊握把36，导致闭合扳机26的上部160 ft^l^te雜到闭雜S^ 38上的锁臂172。因此，^m机34 lffi下并释放職微以作用于完全发U1f^驱动mffi132娜18下降至lj^l^m^112的E麟80。 腿中，Ihi&机构250处^f^汰态，允许lbl^: 266倾回，约束IWf 32 的,向iS侧的运动。向远侧的运动ilil^1?^ill^m构150 ^ii^^!W 32， i^4lillMf机构150 ^^fi端附着在^F 32 fi^?齿条200，每一1i^ 196ad销至1鹏„ 196a-d上以,以向下弯曲至俘1t^SE 36 内但不能向上弯，当与^iiil， 196^1间的5^ 310上方的作用力成直线时形湖胜结构。尤其是，鹏lJtl^机34的牵拉偏压鹏210包括"^h S^力偶雜俘柄夕境154 ,压轮278,以便远侧mtit动向棘爪270传递一啮合偏压，推动棘爪270与鄉齿条200啮合。在飾结束时，棘爪270 鹏与闭織162的斜面284 ^m与鄉196的微啮合中離。 构150的返回运动^C偏压轮278向棘爪270麟反向偏压，将棘爪270鹏在由1^1机构250^#顿当^1±的肺齿条200:^±0 ^f全程中，指示器齿轮230包括断开lhii释断248的弯曲斜面430，战释断248迫使ibM^266itA^锁扰态，允许利用存储在拉伸/JBg弹l^且184内的JM力收回,齿条200 32。因此，鄉齿条200收回到^C手36内。可选,，在皿动作期间，夕卜科医生可以压下1Eihii释放;m^f的jhil释放按钮42。 Jl^器旋钮40方便地傲卜鹏生了解到mr舰的驗并辅臓回遇到自的E，80。虽然本发明a^iii—些^S例的li^t行了说明，而Jj^^范性魏例Bit行相当详细ife^述，但申请人并不是将附加^^禾展求书的范围限,如此具� �。其它的优点和修gfc^本领^t人员来说都&s而易见的。例如，虽然SSff描述的手术钉合^i刀割娜10 mi:有分离和明显的，和闭，作，提供了临床使用的灵活性。但，意i鄉ij， M本发明的应用可以^s将单个用户动^^化为闭合和mr皿的Mi^动的手柄。另外，虽然示出的是手动手柄，电动麟它形式驱动的手柄也许可以魏于与^s描述鄉齿始并在一起，可减小手柄的尺寸或得到其它储。例如，虽^^齿g分,于手l^握柄中比^^便，应当^iRiiJ^,间的枢^^允^F行于由,手柄管所限定的直^^H^^另一^f仔，发^l构中的多^ffi?t利it^^^lP灵活的设计以,^Wf需要的aui?s中的变化。例如，即使齿条组幹没有縮H^ess^侧向后弯曲«向，可^«给^«6«贫以满皿需要的^*。
1. 一种外科手术钉合器械，包括一个响应纵向发射运动以进行外科手术的端部操纵装置； 一个远端连接于该端部操纵装置的轴； 一个滑动承纳于轴上而将发射运动传送到端部操纵装置的发射元件，以及一个在近侧连接轴和发射元件的手柄，包括： 一个与轴纵向对准的管状部分， 一个从管状部分伸出的握把部分， 一个由位于管状部分内并在远侧偶联到发射元件的多个链节形成的链节齿条，以及一个偶联到该链节齿条以传递发射运动的发射机构。 An end portion of the surgical stapling instrument, comprising transmitting a response to the longitudinal movement for actuating the surgical means; a distal end connected to the shaft end portion of the actuating means; a shaft for slidably supporting the transmitting satisfied in motion emitting element is transferred to the end effector and a shaft connected to the proximal handle and the emission element, comprising: a tubular portion aligned with the longitudinal axis, a handle portion extending from the tubular portion a of the tubular It links the rack portion and distally coupled to a plurality of links emitting element is formed, and a transmitting mechanism coupled to the link transmitter to transmit movement of the rack.
2. 根据权利要求1所述的夕卜科手术钉合器械，其中所述链节齿条由位于所述管状部分和所述手柄的握把部分内的多个链节形成。 Xi Boke according to claim surgical stapling instrument of claim 1, wherein said rack is formed of a plurality of links in the chain links of the tubular portion and the grip portion of the handle.
3. 根据权利要求1所述的夕卜科手术钉合器械，其中所述多^节中的每—个都是枢轴连接。 The surgical staple according Xi Boke engagement instrument of claim 1, wherein said plurality of sections each of ^ - is a pivotal connection.
4. 根据权利要求3所述的外科手术钉合器械，其中所述多1ii节中的每一个M与链节齿条纵轴的连,移枢轴连接于相邻的链节。 According to claim surgical stapling instrument of claim 3, wherein each of M and a plurality of the link rack 1ii longitudinal section even, move pivotally connected to adjacent links.
5. 根据权利要求2所述的夕卜科手术钉合«，其中所述多，节中的每一^H131销元件枢轴连接于相邻的链节。 The surgical staple according Xi Boke according to claim 2 together «, wherein said plurality, each section ^ H131 pin member pivotally connected to the adjacent links.
6. 根据权利要求1所述的外科手术钉合器械，其中所述多，节中的每一个与相邻链节相接触以形成挠性连接。 6. The surgical stapling instrument according to claim 1, wherein said plurality, a section in contact with each of the adjacent link to form a flexible connection.
7. 根据权利要求1所述的夕卜科手术钉合«，其中所述多4ii节中的每—个与相邻链节相接触以形成可枢轴转动连接，该枢轴转动连接可操作地设置为在由管状部分所确定的直线结构和握把部分所确定的弯曲结构之间枢轴转动。 The surgical staple according Xi Boke claim 1 together «, wherein said plurality 4ii each section - in contact with the two adjacent link to form a pivotable connection, operatively connected to the pivot arranged to pivot between a curved configuration determined by a tubular portion and the grip portion of the linear structure determined.
8. 根据权利要求1所述的外科手术钉合器械，其中至少一个所述链节包括一个可操作地设置为用于与所述发射机构啮合的推进器表面以向所述发射元條递发射运动。 8. The surgical stapling instrument according to claim 1, wherein at least one of said links comprising a operably disposed for engagement with the pusher surface the transmitting means to transmit to the handover-emitting element bar movement.
9. 根据权利要求1所述的外科手术钉合器械，其中由所述多个链节形成的所述链节齿条可操作地偶联到一个缩回元件以在所述管状部分内向近侧移动所述发射元件。 According to claim surgical stapling instrument of claim 1, wherein the link is formed by a rack of the plurality of links operatively coupled to the member to a retracted proximally within the tubular portion moving the emitting element.
10.根据权利要求1所述的外科手术钉合器械，其中由所述多个链节形成的所述链节齿条可操作地偶联到一个可弯曲的縮回元件上。 Claim 10. The surgical stapling instrument of claim 1, wherein the link is formed by a rack of the plurality of links is operably coupled to a retraction member may be curved.
CN 200410087485 2003-09-29 2004-09-28 Surgical stapling instrument incorporating a firing mechanism having a linked rack transmission CN100398071C (en)
US10/673930 2003-09-29
CN1679451A true CN1679451A (en) 2005-10-12
CN100398071C true CN100398071C (en) 2008-07-02
CN 200410087485 CN100398071C (en) 2003-09-29 2004-09-28 Surgical stapling instrument incorporating a firing mechanism having a linked rack transmission
US (1) US6905057B2 (en)
JP (1) JP4667814B2 (en)
CN (1) CN100398071C (en)
CA (1) CA2482575C (en)
DE (1) DE602004028200D1 (en)
EP (1) EP1520521B1 (en)
CN101849851A (en) * 2010-06-10 2010-10-06 苏州天臣国际医疗科技有限公司 GIA
CN1371264A (en) 1999-08-23 2002-09-25 孕体股份有限公司 Deployment actuation system for intrafallopian contraception
CN101849851B (en) 2010-06-10 2012-09-19 苏州天臣国际医疗科技有限公司 Cutting stitching instrument
JP2005103281A (en) 2005-04-21 application
JP4667814B2 (en) 2011-04-13 grant
DE602004028200D1 (en) 2010-09-02 grant
EP1520521B1 (en) 2010-07-21 grant
CN1679451A (en) 2005-10-12 application
EP1520521A1 (en) 2005-04-06 application