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CN108348256B - 具有组织间隙指示器组件的圆形缝合器 - Google Patents

具有组织间隙指示器组件的圆形缝合器 Download PDF

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CN108348256B
CN108348256B CN201580083931.5A CN201580083931A CN108348256B CN 108348256 B CN108348256 B CN 108348256B CN 201580083931 A CN201580083931 A CN 201580083931A CN 108348256 B CN108348256 B CN 108348256B
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surgical stapler
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CN108348256A (zh
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张细良
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Covidien LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0807—Indication means
    • A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

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Abstract

一种外科缝合器包含柄部组件(10)、从所述柄部组件(10)朝远侧延伸的中心主体(14)、砧座组件(18)以及仓组件(16)。所述柄部组件(10)包含限定窗口(48)的固定柄部(22)和组织间隙指示器组件(28、150)，所述组织间隙指示器组件包含支撑通过所述窗口(48)可见的标记(80、180)的玻片(52、152)。所述指示器组件(28、150)包含杠杆(54、154)，所述杠杆将所述玻片(52、152)耦接到所述外科缝合器的驱动螺杆(40)，以将所述驱动螺杆(40)的移动转换成所述玻片(52、152)的移动。所述杠杆(54、154)被配置成并且适于将所述驱动螺杆(40)在距离X1上的移动转换成所述玻片(52、152)在距离X2上的移动，其中X2大于X1。

Description

具有组织间隙指示器组件的圆形缝合器
技术领域
本发明涉及外科缝合器，并且更具体地涉及包含组织间隙指示器组件的圆形缝合器。
背景技术
吻合术是分开的中空器官部分的外科接合。在已知的圆形吻合手术中，器官部分的两个端部通过外科缝合器接合，所述外科缝合器驱动圆形钉阵列穿过每个器官部分，并且同时挖去被驱动的圆形钉阵列内部的任何组织的核心，以释放管状通道。这种装置的示例在美国专利第7,234,624号、第6,945,444号、第6,053,390号、第5,568,579号、第5,119,983号、第4,646,745号、第4,576,167号和第4,473,077号中进行描述，这些专利中每一个的内容通过引用整体并入本文。
通常，圆形缝合装置具有细长轴，所述细长轴具有在近侧端部处的柄部部分和在远侧端部处的钉仓。包含具有附接的砧座头的砧座杆的砧座组件安装到装置的远侧端部。砧座接近以夹持钉仓的钉保持部件和砧座组件的砧座板之间的组织。通过致动柄部部分钉合被夹持的组织，以驱动圆形钉阵列穿过被夹持的组织。同时，通过致动柄部部分推进环形刀以挖去钉阵列内侧的组织的核心。
具有组织间隙指示器组件的圆形缝合装置是常规的，所述组织间隙指示器组件用于提供在钉仓的钉保持部件与砧座组件的砧座板之间限定的间隙的尺寸的视觉指示。在此类装置中，指示器组件通常使临床医生识别钉仓和砧座组件何时已经接近到击发准备区(即，其中仓组件和砧座组件已经足够接近以允许钉的适当形成的区)内。由于小尺寸的钉被弹出，以及因此允许正确的钉形成的小范围的组织间隙，限制了临床医生在击发准备区内接近程度的可视化。
提供一种改进的组织指示器组件将是有利的，所述组织指示器组件在砧座组件和仓组件接近到击发准备区内时允许组织间隙尺寸的更好的可视化。
发明内容
在一个方面，本公开涉及一种外科缝合器，所述外科缝合器包含具有限定窗口的固定柄部的柄部组件和击发触发器。中心主体从柄部组件朝远侧延伸，并且仓组件被支撑在中心主体的远侧端部上。砧座组件邻近中心主体的远侧端部被支撑，并且相对于仓组件在间隔位置和接近位置之间是可移动的。接近机构包含可纵向移动的驱动螺杆，所述驱动螺杆可操作地连接到砧座组件，使得驱动螺杆的纵向移动实现砧座组件相对于仓组件在间隔位置和接近位置之间的移动。驱动螺杆支撑基台。指示器组件包含玻片(slide)和杠杆。玻片具有通过固定柄部中的窗口可见的标记。杠杆与玻片可操作地接合并且定位成当驱动螺杆在固定柄部内朝近侧移动时接合驱动螺杆上的基台，以将驱动螺杆的纵向移动转换成玻片的纵向移动以实现标记在窗口内的纵向移动。杠杆与基台和玻片接合并且被配置成将基台在距离X1上的移动转换成玻片在距离X2上的移动，其中X2大于X1。
在实施例中，指示器组件进一步包含偏压构件，所述偏压构件定位成在固定柄部内朝远侧推动玻片。
在一些实施例中，杠杆围绕限定枢转轴线的柱枢转地安装在固定外壳内，并且包含定位成接合基台的接合表面，所述接合表面与柱的枢转轴线间隔开距离R1。
在某些实施例中，杠杆包含突出部，所述突出部与玻片可操作地接合并且与由柱限定的枢转轴线间隔开距离R2，其中R2大于R1。
在实施例中，杠杆的接合表面包含第一接合构件和第二接合构件。第一接合构件与由柱限定的枢转轴线间隔开距离R1，并且第二接合构件与由柱限定的枢转轴线间隔开距离R1'，其中R1'大于R1但是小于R2。
在一些实施例中，基台限定弯曲的基台表面。
在某些实施例中，玻片具有近侧部分、中心部分和远侧部分，并且中心部分限定容纳杠杆的通道。
在实施例中，玻片的中心部分限定竖直凹槽，并且杠杆包含被容纳在竖直凹槽内的突出部。突出部在竖直凹槽内是可移动的，以在杠杆枢转时促进玻片的纵向移动。
在一些实施例中，偏压构件围绕玻片的近侧部分定位。
在某些实施例中，标记形成在玻片的远侧部分上。
在实施例中，标记包含有色线。
在实施例中，固定柄部限定围绕窗口定位的第二标记，第二标记与玻片上的标记相关联，以使临床医生识别仓组件和砧座组件何时接近击发准备区。
在一些实施例中，接近机构包含旋转旋钮，所述旋转旋钮相对于固定柄部是可旋转的以实现驱动螺杆在固定柄部内的纵向移动。
在某些实施例中，指示器组件包含非刚性联接件，所述非刚性联接件具有附接到杠杆的远侧端部的第一端部和附接到玻片的近侧端部的第二端部。
在实施例中，联接件被支撑在定位在杠杆的远侧端部和玻片的近侧端部之间的支撑柱上。
在一些实施例中，杠杆围绕限定枢转轴线的柱枢转地安装在固定柄部内，并且包含限定接合表面的近侧端部。柱定位在杠杆的近侧端部和远侧端部之间。接合表面定位成与柱的枢转轴线相距距离R1，并且附接到非刚性联接件的杠杆的远侧端部定位成与柱的枢转轴线相距距离R2，其中R2大于R1。
附图说明
本文在下面参考附图描述包含本公开的组织间隙指示器组件的外科缝合器的各种实施例，其中：
图1是具有本公开的组织间隙指示器组件的一个实施例的外科缝合器的透视图；
图2是图1的细节的区域的放大视图；
图3是图1所示的外科缝合器的固定柄部的侧面透视图，其中移除了主体半部分以暴露螺杆止动件和组织间隙指示器组件；
图3A是图3所示的指示器组件的指示器杠杆和指示器玻片的侧面透视横截面剖视图。
图4是图1所示的外科缝合器的固定柄部的顶视图，其示出了在仓组件和砧座组件接近到击发准备区中之前的外科缝合器；
图4A是在仓组件和砧座组件接近到击发准备区中之前图3所示的指示器组件的指示器杠杆和指示器玻片的侧面横截面剖视图；
图5是图1所示的外科缝合器的固定柄部的顶视图，其示出了处于击发准备区的最大组织间隙位置中的外科缝合器；
图5A是在仓组件和砧座组件接近到击发准备区的最大组织间隙位置中之后图3所示的指示器组件的指示器杠杆和指示器玻片的侧面横截面剖视图；
图6是图1所示的外科缝合器的固定柄部的顶视图，其示出了处于击发准备区的最小组织间隙位置中的外科缝合器；
图6A是在仓组件和砧座组件接近到击发准备区的最小组织间隙位置中之后图3所示的指示器组件的指示器杠杆和指示器玻片的侧面横截面剖视图；
图7是随着指示器玻片返回到未致动位置图1所示的外科缝合器的固定柄部侧面剖视图；以及
图8是具有组织间隙指示器组件的本公开的外科缝合器的另一个实施例的侧面透视图。
具体实施方式
现在将参考附图详细描述本公开的外科缝合器，其中相同的附图标记在若干视图中的每一个中表示相同的或对应的元件。在本说明书中，术语“近侧”通常用于指装置的更靠近临床医生的部分，而术语“远侧”通常用于指装置的更远离临床医生的部分。另外，术语“内窥镜”通常用于指通过小切口或插入患者体内的插管进行的内窥镜、腹腔镜、关节镜和任何其他外科手术。最后，术语临床医生通常用于指包含医生、护士和辅助人员的医务人员。
本公开的外科缝合器包含支撑指示器组件的柄部组件，所述指示器组件包含指示器玻片和指示器杠杆。柄部组件限定允许显示器玻片的可视化的窗口。指示器玻片具有通过柄部组件中的窗口可见的标记。指示器杠杆与指示器玻片可操作地接合，以实现指示器玻片从柄部组件内的非致动位置到柄部组件内的致动位置的移动。当指示器玻片在非致动位置和致动位置之间移动时，指示器玻片上的标记在窗口下面移动并且向临床医生提供关于限定在砧座组件和仓组件之间的现有的组织间隙以及砧座组件和仓组件是否在击发准备区中的指示。在本公开的指示器组件中，指示器杠杆将指示器杠杆和驱动螺杆互连并且放大以提供指示器玻片的移动，以允许临床医生更容易地使砧座组件和仓组件接近击发区域内可见。
图1示出了本公开的外科缝合器10的一个实施例。简而言之，外科缝合器10包含柄部组件12、中心主体或细长部分14、壳体或仓组件16以及砧座组件18。虽然中心主体部分14被显示为稍微弯曲，但是应当理解，中心主体部分14可以是直的，或者具有适于执行期望的外科手术的任何程度的曲率。
除非另有说明，缝合器10的部件通常由包含聚碳酸酯的热塑性塑料和包含不锈钢和铝的金属形成。选择以形成特定部件的特定材料将取决于特定部件的强度要求以及部件是可重复使用的还是一次性部件。例如，砧座可由诸如不锈钢的金属形成，而柄部组件12的部分可由诸如聚碳酸酯的热塑性塑料形成。另外，柄部组件12可由耐高压加热的材料形成以允许重新使用，而仓组件的部分可由热塑性塑料形成以允许丢弃。可设想，可使用具有适于外科使用的必需的强度要求的其他材料来形成外科缝合器10的部件。
柄部组件12包含固定柄部22、击发触发器24、接近旋钮26、指示器组件28以及锁定机构30。接近旋钮26用于回缩和推进驱动螺杆40(图3)以相对于钉仓组件16在间隔位置和接近位置之间推进或回缩砧座组件18。锁定机构30用于防止击发触发器24的致动，直到砧座组件18和仓组件16已经接近到击发区域(即其中砧座组件和仓组件之间的组织间隙减小到允许钉的适当形成的位置)中。击发触发器24用于在仓组件16和砧座组件和18已经分别接近到击发区内之后致动推动器(未示出)以从仓组件16中射出钉。
上面所述的柄部组件12中的部件中的每一个基本上如于2007年12月4日发布的标题为《具有视觉指示器的外科缝合装置(Surgical Stapling Device With VisualIndicator)》的美国专利第7,303,106号("'106专利")中所描述的。'106专利通过引用整体并入本文。因此，在本文将仅仅进一步详细地描述与本公开的指示器组件相互作用的柄部组件12的那些部件。本文将不进一步详细描述其余的部件和组件。
参考图2，砧座组件18包含砧座轴或中心杆32和砧座头34。在实施例中，砧座头34固定地安装到砧座轴32的远侧端部。可替换地，砧座头34可枢转地安装到砧座轴32的远侧端部，使得砧座头34可在操作的非倾斜位置到倾斜位置(未示出)之间移动。这在'106专利中有详细描述。
仓组件16被固定到外科缝合器10的中心主体部分14的远侧端部并且包含壳体或外壳38。外壳38支撑推动器(未示出)、刀(未示出)以及容纳一排或多排钉的钉导引件43。在'106专利中提供了仓组件16的部件的细节，所述专利通过引用整体并入本文。
参考图3和图3A，柄部组件12的固定柄部22包含限定窗口48并且支撑组织间隙指示器组件50的外壳44。组织间隙指示器组件50包含玻片52、杠杆54和偏压构件56。玻片52包含近侧部分60、中心部分62和远侧部分64。玻片52的近侧部分60被支撑在托架66的切口66a内，托架66固定地固定到固定柄部22的外壳44的内壁。中心部分62限定近侧肩部68、容纳如下详细讨论的杠杆54的通道70以及竖直凹槽72。偏压构件56定位在托架66与玻片52的中心部分62的近侧肩部68之间，以将玻片52沿远侧方向推动到未致动位置。玻片52的远侧部分64支撑定位在固定柄部22的外壳44的窗口48下方的标记80。在实施例中，标记80可包含有色线(例如黑线)。在一些实施例中，标记80可包含至少部分地延伸到窗口48中的凸起的突出部。凸起的突出部可以是线性的并且是有色的，例如凸起的黑线。如下面详细描述的，玻片52从远侧位置到近侧位置是可移动的，在所述远侧位置中，标记80定位在窗口48的远侧端部处，在所述近侧位置中，标记80定位在窗口48的近侧端部处。
如上面所讨论的，杠杆54被支撑在玻片52的中心部分62的通道70中。杠杆54的下部部分通过柱82被枢转地支撑在固定柄部22的外壳44内。杠杆54的上部部分支撑一对径向延伸的突出部84，突出部84被容纳在限定在限定通道70的外壁中的竖直凹槽72内并且与柱82间隔开。竖直凹槽72允许杠杆54的可旋转或枢转运动以促进玻片52的纵向移动。杠杆54还限定定位成接近柱82的接合表面86。在实施例中，接合表面86包含下面详细描述的两个接合构件86a和86b。
如上面所描述的，接近旋钮26用于回缩和推进驱动螺杆40以相对于钉仓组件16在间隔位置和接近位置之间推进或回缩砧座组件18。螺杆止动件90被固定地支撑在驱动螺杆40上。螺杆止动件90包含基台92，所述基台定位成当驱动螺杆40从前进位置朝向回缩位置移动时接合杠杆54的接合表面86，以使砧座组件18和仓组件16从间隔位置朝向接近位置移动。基台92具有弯曲的接合表面92a，其在基台92围绕柱82枢转杠杆54时允许基台92在杠杆54的第一接合构件86a和第二接合构件86b之间的过渡。
也参考图4和图4A，当砧座组件18和仓组件16处于间隔位置时，基台92定位在杠杆54的接合表面86的远侧。在所述位置中，指示器组件50的偏压构件56朝远侧推动玻片52以将标记80定位在窗口48的远侧端部中。由于杠杆54上的突出部84被容纳在玻片52的中心部分62的竖直凹槽72中，当玻片被推动到其最远侧或未致动位置时，杠杆54沿顺时针方向枢转到在图3中所示的位置。
如图3所示，限定窗口48的固定外壳22的外壳44的外边缘可包含标记96。标记96被定位成与标记80对齐，以向临床医生指示砧座组件18和仓组件16何时处于击发准备区，即其中仓组件16和砧座组件18分别足够地接近以促进钉的正确形成的区。外壳44上的标记96可包含定位成与标记80对齐的有色带96a。当标记80移动到带96a内的位置时，向临床医生提供指示，即仓组件16和砧座组件18足够接近并且处于击发准备区。
参考图5和图5A，当驱动螺杆40回缩以开始接近仓组件16和砧座组件18时(图1)，螺杆止动件90的基台92朝向杠杆54的接合表面86的第一接合构件86a移动并且接合第一接合构件86a，以开始杠杆54围绕柱82沿图5A所示的逆时针方向的枢转运动。当杠杆54枢转时，被容纳在竖直凹槽72中的杠杆54的突出部86与限定竖直凹槽72的壁接合，以使玻片52沿近侧方向纵向移动，以使标记80在窗口48内移动。如图5所示，当达到预定的接近程度时，标记80将与带96a的近侧端部对齐，以向临床医生指示仓组件16和砧座组件18已经到达点火准备区内的最大间隙位置。
参考图6和图6A，随着驱动螺杆40进一步回缩以使仓组件16和砧座组件18朝向完全接近的位置移动，杠杆54继续沿图6A中所示的逆时针方向枢转。在仓组件16和砧座组件18接近期间的某个时间点，螺杆止动件90上的基台92将从杠杆54的第一接合构件86a脱离并且移动成与杠杆54的第二接合构件86b接合以继续杠杆54的枢转运动。当杠杆54枢转时，杠杆54上的被容纳在玻片52的中心部分62的竖直凹槽72中的突出部84继续抵抗偏压构件56的力朝近侧推动玻片52以将标记80移动到固定外壳22的窗口46的近侧端部。如图5所示，当仓组件16和砧座组件18完全接近时，标记80将与带96a的远侧端部对齐，以向临床医生指示仓组件16和砧座组件18已经到达击发准备区内的最小间隙位置。
参考图6A，分别限定在柱82的中心轴线与杠杆54的接合表面86a和86b之间的半径R1和R1'基本上小于限定在柱82的中心轴线与突出部84之间的半径R2。这样，当螺杆止动件90的基台92移动纵向距离X1以使杠杆54围绕由柱82限定的轴线枢转时，杠杆54的枢转运动将实现玻片52在较大的距离X2上的纵向移动。通过提供具有接合构件86a和86b的杠杆54，相比于驱动玻片52的突出部84，接合构件86a和86b被间隔成更靠近杠杆54的枢转轴线，通过螺杆止动件90的基台92和驱动螺杆40的纵向移动实现的玻片52的纵向移动将乘以系数R2/R1或R2/R1'，从而在仓组件16和砧座组件18接近通过击发准备区时允许标记80在窗口48内移动较大距离。这允许临床医生能够更好地观察仓组件和砧座组件接近通过击发准备区的进展。
参考图7，当驱动螺杆40朝远侧移动以使仓组件16和砧座组件18从接近位置移动到间隔位置时，螺杆止动件90的基台92与驱动螺杆40一起朝远侧移动并且移动远离杠杆54。随着基台92朝远侧移动远离杠杆54，偏压弹簧56朝远侧推动玻片52。如上面所讨论的，当玻片52朝远侧移动时，杠杆54与被容纳在玻片52的竖直凹槽72中的突出部84一起沿如图7所示的顺时针方向枢转。玻片52的远侧运动实现标记80移动回到窗口48的远侧端部。
图8示出了用于增加大致示为150的玻片的移动距离的本公开的组织间隙指示器组件的替代实施例。指示器组件150包含玻片152、杠杆154、偏压构件156和联接件158。在实施例中，联接件是非刚性构件(例如弦、绳、缆线等)。玻片152具有延伸穿过形成在托架66中的切口66a的近侧部分160、限定肩部168的中心部分162以及支撑标记180的远侧部分164，标记180定位在固定柄部22的外壳44的窗口48下方。杠杆154围绕被支撑在固定柄部22的外壳44内的柱182被枢转地支撑，并且包含具有接合构件186a的第一端部186和固定到联接件158的近侧端部的第二端部186b。联接件158在被固定地支撑在固定柄部22的外壳44内的支撑柱188上延伸，并且具有固定到玻片152的近侧部分160的近侧端部的远侧端部。偏压构件156围绕玻片152的近侧部分160定位在肩部168和托架66之间以在固定柄部22内朝远侧推动玻片152。
在使用中，当驱动螺杆40回缩以接近仓组件16和砧座组件18时(图1)，螺杆止动件90的基台92朝向杠杆154的接合构件186a移动并且接合接合构件186a，以开始杠杆154围绕柱182沿图8中所示的顺时针方向的枢转运动。当杠杆154围绕柱182枢转时，联接件158被向下拉动越过支撑柱188以在近侧方向上纵向拉动玻片152以使标记180在窗口48内朝近侧移动。如图所示，杠杆154的枢转轴线与杠杆154的接合构件186a之间的距离比杠杆152的枢转轴线与杠杆154的第二端部186b之间的距离短，杠杆154的第二端部186b固定到联接件158的近侧端部。这样，当基台92接合杠杆154的接合构件186a并且杠杆154围绕柱182枢转时，通过杠杆154的枢转运动实现的玻片152的纵向移动被放大或倍增，使得当仓组件16和砧座组件18接近通过击发准备区时标记180在窗口48内的移动距离大于基台92的移动距离。
本领域的技术人员应当理解，在本文具体描述并且在附图中示出的装置和方法是非限制性的示例性实施例。可设想，在不偏离本公开的范围的情况下，结合一个示例性实施例示出或描述的元件和特征可与另一个的元件和特征组合。同样，本领域技术人员将会理解基于上述实施例的本公开的进一步的特征和优点。因此，除了如所附权利要求所指示的以外，本公开不限于已经具体示出和描述的内容。

Claims (16)

1.一种外科缝合器，包括：
柄部组件，其包含固定柄部和击发触发器，所述固定柄部限定窗口；
中心主体，其从所述柄部组件朝远侧延伸；
仓组件，其被支撑在所述中心主体的远侧端部上；
砧座组件，其邻近所述中心主体的所述远侧端部被支撑，所述砧座组件相对于所述仓组件在间隔位置和接近位置之间是可移动的；
接近机构，其包含可纵向移动的驱动螺杆，所述驱动螺杆可操作地连接到所述砧座组件，使得所述驱动螺杆的纵向移动实现所述砧座组件相对于所述仓组件在所述间隔位置和所述接近位置之间的移动，所述驱动螺杆支撑基台；以及
指示器组件，其包含玻片和杠杆，所述玻片具有通过所述固定柄部中的所述窗口可见的标记，所述杠杆与所述玻片可操作地接合，并且定位成当所述驱动螺杆在所述固定柄部内朝近侧移动时接合所述驱动螺杆上的所述基台，以将所述驱动螺杆的纵向移动转换成所述玻片的纵向移动以实现所述标记在所述窗口内的纵向移动，其中所述杠杆与所述基台和所述玻片接合并且被配置成将所述基台在距离X1上的移动转换成所述玻片在距离X2上的移动，其中X2大于X1。
2.根据权利要求1所述的外科缝合器，其中所述指示器组件进一步包含偏压构件，所述偏压构件定位成在所述固定柄部内朝远侧推动所述玻片。
3.根据权利要求1所述的外科缝合器，其中所述杠杆围绕限定枢转轴线的柱枢转地安装在固定外壳内，所述杠杆具有与所述柱的所述枢转轴线间隔开距离R1的接合表面，所述接合表面定位成接合所述基台。
4.根据权利要求3所述的外科缝合器，其中所述杠杆包含与所述玻片可操作地接合的突出部，所述突出部与由所述柱限定的所述枢转轴线间隔开距离R2，其中R2大于R1。
5.根据权利要求3所述的外科缝合器，其中所述杠杆的所述接合表面包含第一接合构件和第二接合构件，所述第一接合构件与由所述柱限定的所述枢转轴线间隔开所述距离R1，并且所述第二接合构件与由所述柱限定的所述枢转轴线间隔开距离R1’，其中所述R1'大于R1但是小于R2。
6.根据权利要求5所述的外科缝合器，其中所述基台限定弯曲的基台表面。
7.根据权利要求2所述的外科缝合器，其中所述玻片具有近侧部分、中心部分和远侧部分，所述中心部分限定容纳所述杠杆的通道。
8.根据权利要求7所述的外科缝合器，其中所述玻片的所述中心部分限定竖直凹槽，并且所述杠杆包含被容纳在所述竖直凹槽内的突出部，所述突出部在所述竖直凹槽内是可移动的，以在所述杠杆枢转时促进所述玻片的纵向移动。
9.根据权利要求7所述的外科缝合器，其中所述偏压构件围绕所述玻片的所述近侧部分定位。
10.根据权利要求7所述的外科缝合器，其中所述标记形成在所述玻片的所述远侧部分上。
11.根据权利要求10所述的外科缝合器，其中所述标记包含有色线。
12.根据权利要求11所述的外科缝合器，其中所述固定柄部限定围绕所述窗口定位的第二标记，所述第二标记与所述玻片上的所述标记相关联，以使临床医生识别所述仓组件和所述砧座组件何时接近击发准备区。
13.根据权利要求1所述的外科缝合器，其中所述接近机构包含旋转旋钮，所述旋转旋钮相对于所述固定柄部是可旋转的以实现所述驱动螺杆在所述固定柄部内的纵向移动。
14.根据权利要求1所述的外科缝合器，其中所述指示器组件进一步包含非刚性联接件，所述非刚性联接件具有附接到所述杠杆的远侧端部的第一端部和附接到所述玻片的近侧端部的第二端部。
15.根据权利要求14所述的外科缝合器，其中所述联接件被支撑在定位在所述杠杆的所述远侧端部和所述玻片的所述近侧端部之间的支撑柱上。
16.根据权利要求14所述的外科缝合器，其中所述杠杆围绕限定枢转轴线的柱枢转地安装在所述固定柄部内，所述杠杆包含限定接合表面的近侧端部，所述柱定位在所述杠杆的近侧端部和远侧端部之间，其中所述接合表面定位成与所述柱的所述枢转轴线相距距离R1，并且附接到所述非刚性联接件的所述杠杆的所述远侧端部定位成与所述柱的所述枢转轴线相距距离R2，其中R2大于R1。
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