CN109199488B - Surgical instrument - Google Patents

Surgical instrument Download PDF

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Publication number
CN109199488B
CN109199488B CN201710535784.1A CN201710535784A CN109199488B CN 109199488 B CN109199488 B CN 109199488B CN 201710535784 A CN201710535784 A CN 201710535784A CN 109199488 B CN109199488 B CN 109199488B
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Prior art keywords
assembly
surgical instrument
handle
drive
link
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CN109199488A (en
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孙宝峰
任义唐
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Jiangsu Fengh Medical Equipment Co Ltd
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Jiangsu Fengh Medical Equipment Co Ltd
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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
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like

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

Abstract

The invention discloses a surgical instrument, which comprises a handle assembly, a rod body assembly, an end effector and a transmission mechanism, wherein the transmission mechanism is at least partially positioned in the handle body assembly; a power supply assembly and a manual reset device are arranged in the handle assembly, and the power supply assembly provides a power source for the surgical instrument; the manual reset device can rotate along a first direction or a second direction, so that the transmission mechanism can be driven to move from a far end to a near end, and the transmission function of the transmission mechanism can be recovered; wherein the second direction is opposite to the first direction. According to the surgical instrument, when a circuit is broken down, the functions of manually retracting the cutting component and recovering the transmission mechanism can be realized by one-hand operation, so that the surgical cutting anastomat can be normally used. The control device of the invention has simple operation, safety, stability and reliability, and effectively reduces the secondary damage to the human body.

Description

Surgical instrument
Technical Field
The invention relates to a surgical instrument, and belongs to the field of medical instruments.
Background
An anastomat suitable for surgical operation is a surgical cutting anastomat which can suture wounds of patients and excise redundant tissues, and is widely applied to excision and anastomosis of tissues in minimally invasive operations of abdominal surgery, gynecology, pediatrics, thoracic surgery and the like. Surgical cutting staplers are advanced into the body through the cannula of a trocar precisely positioned at the surgical site, followed by making a longitudinal incision in the tissue and applying staples on opposite sides of the incision, thereby severing and stapling the tissue, similar to a stapler. A surgical cutting stapler includes an end effector including a staple cartridge seat for receiving a staple cartridge and a staple anvil; the surgical cutting stapler also includes a cutting member operably supported relative to the cartridge seat, the cutting member including a bearing that enters the staple seat slot of the staple seat when the end effector is closed. Once the clinician has determined that the end effector is properly grasping tissue and in the closed position, the surgical cutting stapler can be fired to cut and staple the tissue.
The motor can provide a power source for the surgical cutting anastomat, so that the operation is time-saving and labor-saving. When a doctor fires the surgical cutting anastomat, the cutting component can move from the initial position to the firing position in the end effector of the surgical cutting anastomat due to the firing force provided by the forward rotation of the motor, the cutting component synchronously pushes the nail pushing block of the nail bin assembly to move from the initial position to the firing position, and the effect of suturing the cut tissue while cutting redundant tissue is achieved. The motor is also configured to reverse to provide a force in a direction opposite the firing force to return the cutting member to the initial position to withdraw the bearing portion from the staple holder slot of the staple holder to open the end effector, release the tissue, close the end effector, and remove the surgical cutting stapler from the puncture cannula.
However, when the motor fails to rotate or the battery or other power source supplying power to the motor fails, insufficient power is supplied to the surgical instrument, etc., the instrument must be immediately removed and replaced with a new one. At this time, the end effector of the surgical cutting stapler is likely to be still in a locked state, the cutting member is in the end effector, the end effector cannot be opened, the clamped tissue cannot be separated from the end effector, the surgical cutting stapler cannot be taken out from the puncture cannula, and at this time, the puncture hole needs to be enlarged or the surgical operation needs to be performed, even a medical accident is caused.
Accordingly, there is a need for a device that can urgently retract the cutting member to the home position to retract the bearings from the staple holder slots of the staple holder to open the end effector, release the tissue, close the end effector, and remove the surgical cutting stapler from the puncture cannula.
The existing emergency control structure works on the principle that a transmission rack is separated from a gear forcibly, and after the transmission rack moves towards the near end, the surgical cutting anastomat is taken out of a puncture cannula from the body of a patient. Then, even if the malfunction is cleared, the surgical cutting stapler cannot be normally used because the transfer cannot be performed.
Disclosure of Invention
In view of the deficiencies of the prior art, the present invention provides a surgical instrument that enables both manual retraction of the cutting member and restoration of the function of the drive mechanism after the fault has been cleared in the event of a circuit failure. The invention is realized by the following technical scheme:
a surgical instrument comprising a handle assembly, a shaft assembly extending longitudinally from the handle assembly, and an end effector disposed at a distal end of the shaft assembly; the handle assembly comprises a head housing, a fixed handle extending downward from the head housing; a movable cutting member disposed within the end effector, the cutting member for cutting tissue disposed within the end effector; the cutting member is movable between an initial position and a fired position; the surgical instrument further comprises a transmission mechanism at least partially located within the handle body assembly; a power supply assembly and a manual reset device are arranged in the handle assembly, and the power supply assembly provides a power source for the surgical instrument; the manual reset device can rotate along a first direction or a second direction, so that the transmission mechanism can be driven to move from a far end to a near end, and the transmission function of the transmission mechanism can be recovered; wherein the second direction is opposite to the first direction.
Further, the manual resetting device comprises a driving assembly and a link mechanism, at least one part of the link mechanism is fixedly connected in the head shell, the rest part of the link mechanism can move relative to the head shell, and the link mechanism has a first position and a second position; at least a portion of the drive assembly is coupled within the head housing and is capable of rotating in a first direction or a second direction about a pivot located on the head housing; the drive assembly is configured to drive the movable portion of the linkage mechanism between a first position and a second position.
Further, the drive assembly comprises a first drive assembly and a second drive member; the first drive assembly is capable of rotating around the pivot shaft along a first direction so as to drive the movable part of the linkage mechanism to move from a first position to a second position; the first drive assembly is capable of rotating about the pivot shaft in a second direction while the second drive member is capable of driving the movable portion of the linkage from the second position to the first position.
Further, the first driving assembly is a handle assembly which is connected with one end of the head shell through a pivot and can rotate around the pivot along a first direction or a second direction; the second driving piece is an elastic piece, one part of the elastic piece is fixedly connected to the other end of the head shell, and the rest part of the elastic piece can be deformed under compression.
Further, the first driving assembly comprises a handle, a cam and a push rod, wherein the cam and the handle are connected to the head shell through the pivot; the push rod is rotatably connected with the handle, and the other end of the push rod is abutted against the link mechanism.
Furthermore, a first through hole is formed in the handle, a third through hole is formed in the cam, and the pivot penetrates through the first through hole and the third through hole.
Furthermore, the handle is provided with a protrusion, the cam is provided with a notch, the protrusion is located in the notch, and the handle controls the cam to move through the cooperation of the protrusion and the notch.
Furthermore, the cam also comprises an arc-shaped edge, and when the first driving assembly rotates along the first direction, the arc-shaped edge drives the link mechanism to move to the second position
Further, still be equipped with the second through-hole on hand, be equipped with the pivot on the push rod, the second through-hole with the pivot cooperation is connected.
Furthermore, one end of the push rod is provided with a protruding part, and the protruding part is matched with the transmission mechanism.
Further, the link mechanism comprises four components and is a plane four-bar mechanism.
Further, the driving component drives the link mechanism means that the arc-shaped edge of the cam is matched with the fourth link of the link mechanism and the elastic piece is matched with the second link.
Further, the first direction is a clockwise direction, and the second direction is a counterclockwise direction.
Further, the transmission mechanism includes a transmission gear that transmits power of the power supply assembly to the transmission shaft, and a transmission shaft that transmits the power to an end effector.
Further, the transmission shaft is provided with a first transmission tooth and a second transmission tooth; the first transmission gear is matched with the gear, and the second transmission gear is matched with the push rod.
Further, each tooth of the second drive tooth is in the shape of a right triangle or an obtuse triangle.
Further, the manual reset device is located within the head housing of the handle assembly.
Further, a cover plate is arranged above the handle, and the cover plate is detachably connected with the head shell.
In accordance with the surgical instrument of the present invention, in the event of a circuit failure, manual retraction of the cutting member to the initial position is achieved by one-handed operation of the handle assembly to retract the bearing portion from the staple holder slot of the staple holder to open the end effector, and, after tissue is released, close the end effector and remove the surgical cutting stapler from the puncture cannula. And after the fault is eliminated, the function of the transmission mechanism can be recovered by operating the handle assembly with one hand, so that the surgical cutting anastomat is normally used, and the secondary injury to the human body is reduced.
Drawings
FIG. 1 is a schematic illustration of an open end effector of a surgical cutting stapler, in accordance with an embodiment of the present invention;
FIG. 2 is a schematic diagram of an end effector closure of a surgical cutting stapler, in accordance with an embodiment of the present invention;
FIG. 3 is a schematic structural view of an end effector of a surgical cutting stapler, in accordance with an embodiment of the present invention;
FIG. 4 is a schematic structural view of a cutting member of a surgical cutting stapler, according to an embodiment of the invention
FIG. 5 is a schematic diagram of an initial state of a transmission control apparatus according to an embodiment of the present invention;
FIG. 6 is a schematic diagram of the configuration of the transmission control apparatus at retraction according to an embodiment of the present invention;
FIG. 7 is a schematic structural view of a rack of a transmission control apparatus according to an embodiment of the present invention;
FIG. 8 is an enlarged partial schematic view of a rack of the transmission control apparatus according to an embodiment of the present invention;
FIG. 9 is a schematic structural view of a handle of the transmission control apparatus according to an embodiment of the present invention;
FIG. 10 is a schematic diagram of the construction of the cam of the transmission control apparatus according to the embodiment of the present invention;
FIG. 11 is a schematic view of a handle and cam engagement of a transmission control device according to an embodiment of the present invention;
FIG. 12 is a schematic structural view of a push rod of the transmission control apparatus according to an embodiment of the present invention;
fig. 13 is a schematic view of an initial state of the link mechanism of the transmission mechanism control apparatus according to the embodiment of the invention;
fig. 14 is another state diagram of the link mechanism of the transmission mechanism control apparatus according to the embodiment of the invention.
Detailed Description
Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings. In the description of the present invention, it is to be understood that the terms "central," "longitudinal," "lateral," "length," "width," "thickness," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," "clockwise," "counterclockwise," "axial," "radial," "circumferential," and the like are used in the orientations and positional relationships indicated in the drawings for convenience in describing the invention and to simplify the description, and are not intended to indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be considered limiting of the invention.
Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.
The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention.
Referring to FIG. 1, a surgical cutting and stapling instrument 1000 in accordance with an embodiment of the present invention includes a handle assembly 200, a shaft assembly 300 extending longitudinally from the handle assembly 200, an end effector 400 disposed at one end of the shaft assembly 300, a motor 600 that converts electrical energy to mechanical energy, and a battery assembly 500 that provides electrical energy to the motor 600. For ease of description and simplicity of description, in embodiments of the present invention, the terms "proximal" and "distal" are used herein with respect to a clinician manipulating handle assembly 200 of surgical instrument 1000 based on the orientation or positional relationship illustrated in FIG. 1. The term "proximal" refers to the portion that is closer to the clinician, and the term "distal" refers to the portion that is further from the clinician. I.e., handle assembly 200 is proximal and end effector 400 is distal, as the proximal end of a component is shown relatively close to one end of handle assembly 200 and the distal end is shown relatively close to one end of end effector 400. It should be noted that spatial terms such as "vertical", "horizontal", "right", "left", etc. are given with reference to fig. 1. In fig. 1, the longitudinal direction means the vertical direction.
Referring to fig. 1 and 2, the handle assembly 200 includes a head housing and a closure trigger 210 that extends downwardly at an acute angle from the bottom of the handle assembly 200, and the closure trigger 210 can be manipulated to position and close the end effector 400. The end effector 400 is attached to the distal end of the shaft assembly 300. The end effector 400 includes a cartridge seat 410 and an anvil 420 pivotally coupled to the cartridge seat 410, the cartridge seat 410 for operably supporting a staple cartridge (not shown) therein, the anvil 420 being selectively movable between an open position and a closed position. Pressing the closure trigger 210 toward the stationary handle 270 of the handle assembly 200 may cause the staple holder 420 to pivot by the shaft assembly 300 to close the end effector 400 to position, clamp, staple, and cut tissue. In a preferred embodiment, the surgical instrument 1000 further comprises a release button 250, and the closure trigger 210 can be released by operation of the release button 250 to open the end effector 400 for readjustment, grasping and positioning of tissue. When tissue to be treated enters between the cartridge dock 410 and the anvil 420, the surgeon may depress the closure trigger 210 until it locks, thereby placing the anvil 420 in the closed position, i.e., the end effector 400 is in the closed state.
As shown in fig. 4, the cutting member 440 includes a catching portion 442, the catching portion 442 being located at a distal lower side of the cutting member 440 and having an i-shape; the upper side of the distal end of the cutting member 440 is provided with a bearing part 441; the catching portion 442 corresponds to the position of the support portion 441. Referring to FIG. 3, cartridge mount 410 and anvil mount 420 of end effector 400 cooperate to support cutting member 440 and provide a channel for firing and retraction of cutting member 440. Staple holder 420 has staple holder slot 421 therein, and cartridge holder 410 has cartridge holder slot 411 therein; the positions of the nail bin seat slot 411 and the nail abutting seat slot 421 correspond; correspondingly, a staple pushing groove (not shown) is arranged on the staple cartridge 430, and the structure of the staple cartridge 430 can refer to the "staple cartridge assembly" (application number: 201710212521.7) of the invention applied by the applicant, which is not described herein again. The magazine seat slot 411, the staple abutting seat slot 421 and the staple pushing slot together provide a receiving space and a path guide for the cutting member 440. Since the cutting member 440 of the minimally invasive surgery is small and sharp, the positioning of the target tissue is precise, and accordingly, the cartridge seat slot 411 and the staple abutting seat slot 421 are both slender and narrow. The supporting part 441 is matched with the nail abutting seat groove 421 in a shape, and the shape matching of the supporting part and the nail abutting seat groove can avoid shaking; the clamping portion 442 accommodates the left side and the right side of the nail bin seat slot 411 into an I-shaped accommodating space, and the clamping connection mode is favorable for the bidirectional limiting cutting member 440 when the nail abutting seat 420 is opened and closed.
The lower side of the distal end of cutting member 440, at its snap 442, is placed in cartridge housing slot 411, and the upper side of the distal end of cutting member 440, at its bearing portion 441, enters into anvil housing slot 421, so that cutting member 440 can move along the slots on both the upper and lower sides, cutting the tissue to be treated distally. When cutting member 440 is subjected to a firing or retraction force, bearing portion 441 is in staple cartridge seat slot 421 and catch portion 442 is reciprocable in cartridge seat slot 411 in response to the applied force; that is, cutting member 440 can reciprocate within end effector 400 in response to an applied firing or retraction force.
A staple cartridge 430 and a cutting member 440 are disposed within end effector 400, cutting member 440 including opposing proximal and distal ends, wherein the proximal end of cutting member 440 is connected to a spindle (not shown) disposed within shaft assembly 300, and the distal end of cutting member 440 is connected to end effector 400, which is comprised of staple cartridge mount 410 and staple abutment mount 420, and is movable from one end of end effector 400 to the other end of end effector 400. The manner in which the proximal end of the cutting member 440 is connected to the mandrel, and the location and connection of the mandrel to the shaft assembly 300, is the same or similar to the prior art and will not be described in detail herein. In general, cutting member 440 can be subjected to a firing force transmitted by firing trigger 220 to move cutting member 440 from an unfired position to a distally fired position; and may also be retracted from the fired position to the unfired position in response to a retraction force applied to cutting member 440. The conversion from the striking force to the retracting force can be realized by the steering knob 260, and the structure and the working mode of the steering knob 260 are the same as or similar to those of the prior art, and are not described again. It should be noted that the firing and retraction motions of cutting member 440 must be allowed to occur with the end effector 400 closed, i.e., firing trigger 220 may be actuated only when the closure trigger 210 is locked to the stationary handle 270 such that the anvil 420 is in the closed position, to prevent accidental cutting of non-target tissue by cutting member 440 due to inadvertent pressing of the firing trigger 220 during a surgical procedure. Similarly, the prior art discloses or teaches what structures to implement the function of preventing accidental activation of the firing trigger 220 and is not described in detail herein.
As shown in fig. 5 to 6, the transmission mechanism includes a motor, a gear 6, and a transmission rack 4. As shown in fig. 7, the gear rack 4 comprises a first gear tooth 41 and a second gear tooth 42 perpendicular to the first gear tooth 41. The first transmission teeth 41 mesh with the teeth 62 of the gear wheel 6 and the second transmission teeth 42 cooperate with the protrusions 32 of the push rod 3. Referring to FIG. 8, the second drive teeth 42 include a plurality of teeth, each tooth including a first face 428 that is substantially perpendicular to a horizontal plane and a second face 429 that is at an acute angle to the first face 428.
The end effector 400 is closed, the surgical severing and stapling instrument 1000 is advanced through the cannula assembly of the penetrator into a target location in the body of a patient, and the release button 250 is actuated to release the closure trigger 210, thereby opening the anvil 420 of the end effector 400 to position and clamp tissue. When the target tissue is positioned between the cartridge seat 410 and the anvil 420 of the end effector 400, the closure trigger 210 is pulled toward the stationary handle 270 to a fully closed position to lock the target tissue. After the trigger lock 230 is opened, the trigger 220 is triggered, the battery assembly 500 provides electric energy for the motor 600, the motor 600 rotates forwards to convert the electric energy into mechanical energy, a motor shaft is coaxial with a gear shaft of the gear 6, teeth 62 of the gear 6 are meshed with first transmission teeth 41 of the transmission rack 4, the gear 6 is driven to rotate by the forward rotation of the motor 600, the gear 6 drives the transmission rack 4 to move from a near end to a far end through the first transmission teeth 41, and the mandrel and the cutting member 440 are sequentially driven to move from the near end to the far end; the cartridge 430 located in the cartridge holder 410 is driven by the cutting member 440 moving towards the distal end, wherein the staples (not shown) are pushed out by the wedge-shaped pusher (not shown) against which the cutting member 440 abuts, penetrating the tissue to be stapled, and since the distance between the cartridge holder 410 and the anvil 420 is smaller than the height of the staples, the tips of the staples are bent after contacting the staple abutting surface 422 of the anvil 420 and form a specific shape along the staple abutting surface 422 of the anvil 420, thereby stapling the severed tissue. The distal end of the cutting member 440 is located in the staple pushing groove of the staple cartridge 430, and the tissue is cut by the proximal-to-distal movement, so that the tissue of the patient is cut while being sutured, and the structure of the staple cartridge 430 can refer to the invention "staple cartridge assembly" (application number: 201710212521.7) applied by the applicant, and the detailed description thereof is omitted.
Normally, when the cutting member 440 is moved to the distal end of the staple cartridge 430 in the end effector 400, the position sensor senses and transmits a signal to a computer board (not shown) in the handle assembly 200, which controls the motor 600 to rotate in reverse; or when the cutting length is less than the length of the nail bin and the knife needs to be withdrawn, and after the cutting is finished, the cutting member 440 does not move to the distal end of the nail bin 430, as shown in fig. 1 or fig. 2, the doctor toggles the switch 260, so that the motor 600 rotates reversely to convert the electric energy into the mechanical energy; the motor 600 rotates reversely to drive the gear 6 to rotate reversely, the gear 6 is meshed with the first transmission gear 41 to drive the transmission rack 4 to move from the far end to the near end, the mandrel and the cutting member 440 are sequentially driven to move from the far end to the near end, the retracting function is realized, until the supporting part 441 of the cutting member 440 is separated from the nail seat supporting groove 421, the release button 250 is operated, the locked closing trigger 210 is released, the nail seat supporting seat 420 can rotate around the rotating shaft 423 in the direction far away from the nail seat 410, the end effector 400 is opened, the target tissue in the end effector 400 is released, and then the closing trigger 210 is closed again, so that the surgical cutting anastomat 1000 can be taken out from the body of the patient through the puncture cannula. The position of the position sensor, how to transmit signals to the computer board, the operating principles of the computer board, and how to release the button 250 to effect opening of the end effector 400 are disclosed or taught in the prior art and will not be described in detail herein.
However, when there is a problem with the motor 600 failing to rotate or the battery assembly 500 or other power source supplying power to the motor 600 failing, failing to provide sufficient power to the surgical cutting stapler 1000, etc., the instrument must be immediately removed and replaced with a new one. At this time, the end effector 400 of the surgical cutting stapler 1000 is likely to be in a locked state, the cutting member 440 is in the end effector 400, the supporting portion 441 of the cutting member 440 is located in the staple abutting seat groove 421, the clamping portion 442 accommodates the left and right sides of the staple cartridge seat groove 411 in the i-shaped accommodating space, and the staple abutting seat 420 is fixed by the supporting portion 441, so that the end effector 400 cannot be opened, the clamped tissue cannot be disengaged from the end effector 400, and the surgical cutting stapler 1000 cannot be taken out from the puncture cannula. Referring to fig. 5 to 6, the manual reset device 100 includes a handle 1, a cam 2, a push rod 3, a planar linkage 5, and an elastic member 7, wherein the cam 2 and the elastic member 7 are located at both sides of the planar linkage 5 and the cam 2, the planar linkage 5, and the elastic member 7 are located in the same plane. As shown in fig. 9, the handle 1 includes a handle body 13, a disc 14 integrally formed or fixedly connected with the handle body 13; further, the disc 14 includes a first through hole 11, a second through hole 12, and a protrusion 15. As shown in fig. 10, the cam 2 is a disc cam, and includes a third through hole 21, a notch 22, and an arc-shaped edge 23. The first through hole 11 and the third through hole 21 are connected with the head shell 9 through a pivot 8 on the head shell 9, the protrusion 15 can move in the notch 22, and the handle 1 controls the rotation of the cam 2 through the matching of the protrusion 15 and the notch 22.
As shown in fig. 12, the push rod 3 includes a push rod body 31, a rotating shaft 33 cooperating with the second through hole 12 of the handle 1, an arc 35 movable around the outer wall of the pivot 8, and a stopper 34 suspended on the third link 53 of the planar linkage mechanism 5, and a protrusion 32 is further provided below the stopper 34, and the protrusion 32 can cooperate with the second transmission tooth 42 of the transmission rack 4. In a preferred embodiment of the invention, the push rod 3 is integrally formed.
Referring to fig. 13 to 14, the planar linkage 5 includes four links, two adjacent links are relatively movable, and end points of the two adjacent links are hinged to each other by a connecting shaft; the joint of the fourth link 54 and the first link 51 is defined as point a, the joint of the first link 51 and the second link 52 is defined as point B, the joint of the second link 52 and the third link 53 is defined as point C, and the joint of the third link 53 and the fourth link 54 is defined as point D. The four links of the planar linkage 5 are sequentially hinged at four vertices of ABCD to form a quadrilateral, wherein the second link 52 further comprises a rod 521 substantially perpendicular to the body of the second link 52, and the rod 521 is integrally formed with the body of the second link 52. The planar linkage 5 has a plurality of degrees of freedom. In the preferred embodiment of the present invention, the planar linkage 5 has two degrees of freedom, and further, A, B is fixed in two points relative to the head housing.
In the initial state, the stopper 34 of the push rod 3 abuts against the third link 53 of the planar link mechanism 5, and the protrusion 32 is separated from the transmission rack 4; the connecting line of four vertexes ABCD of the plane link mechanism 5 is in a parallelogram shape, and the vertical distance between the first connecting rod 51 and the third connecting rod 53 is H1The third link 53 holds up the stopper 34 to prevent the protrusion 32 from contacting the transmission rack 4. The planar linkage 5 is in motionA link 51 is relatively stationary, i.e., A, B two points are relatively stationary; the projection 15 of the handle 1 is located in the notch 22 of the cam 2.
Manual retraction may be performed when end effector 400 of surgical cutting stapler 1000 is in a locked state, requiring retraction to remove surgical cutting stapler 1000, and motor 600 fails or other power source fails to provide sufficient power to surgical cutting stapler 1000. Specifically, the cover plate 280 above the handle assembly 200 is opened, the handle body 13 of the handle 1 is rotated counterclockwise, the one end 151 of the protrusion 15 of the handle 1 abuts against the one end 221 of the notch 22 of the cam 2, as shown in fig. 11, the handle 1 drives the cam 2 to rotate counterclockwise synchronously around the pivot 8 through the protrusion 15, and the cam 2 applies an acting force to the fourth link 54 to deform the planar link mechanism 5. Specifically, the curved edge 23 of the cam 2 abuts against the fourth link 54 of the planar linkage 5 and transmits the force to the fourth link 54, and the fourth link 54 is subjected to the proximally-directed force F1Then, the acting force is transmitted to the third connecting rod 53 through the point D at the hinged position of the third connecting rod 53, and the third connecting rod 53 is driven to move towards the near end and downwards; then the third link 53 transmits the acting force to the second link 52 through the point C at the hinge joint with the second link 52 and drives the second link 52 to move proximally; namely, the fourth link 54 and the second link 52 move proximally to a position approximately perpendicular to the first link 51 at two points A, B respectively, and the rod 521 approximately perpendicular to the body of the second link 52 moves downward until abutting against the push rod body 31, pressing the push rod 3 to prevent the push rod 3 from moving upward, so that the engagement between the protrusion 32 of the push rod 3 and the transmission rack 4 is more reliable. In fig. 13 and 14, the right side is the proximal direction.
Because the rotating shaft 33 of the push rod 3 is matched with the second through hole 12 of the handle 1, when the handle 1 is rotated anticlockwise, the handle 1 drives the push rod 3 to rotate around the rotating shaft 33, and because the stopping part 34 of the push rod 3 abuts against the third connecting rod 53 and is positioned in the plane connecting rod mechanism 5, when the stopping part 34 moves to be in contact with the first connecting rod 51 of the plane connecting rod mechanism 5, the first connecting rod 51 prevents the push rod 3 and the handle 1 from synchronously rotating continuously, so that the handle 1 and the push rod 3 generate relative movement. At this time, the elastic member 7 positioned at the right side of the planar linkage 5 is compressed by the second link 52. Inverse directionWhen the hour hand rotates the handle 1, because the rotating shaft 33 of the push rod 3 is matched with the second through hole 12 of the handle 1, the handle 1 drives the push rod 3 to rotate around the rotating shaft 33, the cambered surface 35 moves along the outer wall of the pivot 8, and because the third connecting rod 53 moves towards the near end and downwards, the stopping part 34 of the push rod 3 on the third connecting rod 53 synchronously moves downwards until the third connecting rod 53 is not higher than the transmission rack 4, and the protruding part 32 is contacted with the transmission rack 4 and falls between two adjacent second transmission teeth 42; continuing to rotate the handle 1 counterclockwise, the push rod 3 pushes the second driving gear 42 through the protrusion 32 to further push the driving rack 4 to move towards the proximal end, the driving rack 4 sequentially drives the mandrel and the cutting member 440 to move towards the proximal end until the supporting portion 441 of the cutting member 440 is separated from the staple abutting seat slot 421 of the staple abutting seat 420, the release button 250 is operated, the locked closing trigger 210 is released, the staple abutting seat 420 can rotate around the rotating shaft 423 towards the direction far away from the staple cartridge seat 410, the end effector 400 is opened, and after the target tissue in the end effector 400 is released, the closing trigger 210 is closed again, so that the surgical cutting stapler 1000 can be taken out of the patient through the puncture cannula. At this time, as shown in fig. 14, the connecting lines of the four vertices ABCD of the planar link mechanism 5 are substantially rectangular, and the vertical distance between the first link 51 and the third link 53 is H2，H2Is substantially equal to the height of the fourth link 54, where H1Is less than H2。
When the surgical cutting stapler 1000 is taken out and the circuit fault is eliminated by replacing the battery assembly, the manual reset device 100 can be reset, so that the function of the surgical cutting stapler 1000 is restored, the current operation or the subsequent operation after the current operation or the disinfection can be carried out, the scrappage of the instrument is reduced, and the operation cost is reduced. Specifically, as shown in fig. 11 and 14, the handle body 13 of the handle 1 is rotated clockwise, the other end 152 of the protrusion 15 of the handle 1 abuts against the other end 222 of the notch 22 of the cam 2, the handle 1 drives the cam 2 to rotate clockwise around the pivot 8, the arc-shaped edge 23 of the cam 2 is gradually separated from the fourth link 54 of the planar link mechanism 5, the handle 1 drives the push rod 3 to rotate around the rotation shaft 33, the arc-shaped surface 35 moves along the outer wall of the pivot 8, the fourth link 54 has a degree of freedom of movement towards the distal end, and the elastic element 7 is released to produce a release effectGenerates an elastic restoring force and applies the elastic restoring force to the second link 52, the second link 52 being subjected to a proximally acting force F2Then, through the point C at the hinge joint with the third link 53, the acting force is transmitted to the third link 53 and drives the third link 53 to move distally and upwardly, and then the third link 53 transmits the acting force to the fourth link 54 through the point D at the hinge joint with the fourth link 54 and drives the fourth link 54 to move distally, i.e. the second link 52 and the fourth link 54 move distally around B, A two points respectively, until the initial state shown in fig. 13 is restored. Meanwhile, the rod 521, which is substantially perpendicular to the body of the second connecting rod 52, moves upward, gradually separates from the push rod body 31, the pressure applied to the push rod 3 disappears, the third connecting rod 53 lifts upward, the protrusion 32 separates from the second transmission gear 42, the resistance of the transmission rack 4 moving to the far end disappears, the force transmitted by the gear 6 can be continuously received, the transmission mechanism returns to normal, and the surgical cutting stapler 1000 can be normally used.
In accordance with the surgical instrument of the present invention, in the event of a circuit failure, manual retraction of the cutting member to the initial position is achieved by one-handed operation of the handle assembly to retract the bearing portion from the staple holder slot of the staple holder to open the end effector, and, after tissue is released, close the end effector and remove the surgical cutting stapler from the puncture cannula. And after the fault is eliminated, the function of the transmission mechanism can be recovered by operating the handle assembly with one hand, so that the surgical cutting anastomat can be normally used. The operation is simple, safe, stable and reliable, and the secondary damage to the human body is effectively reduced.
In the present invention, unless otherwise expressly stated or limited, the terms "mounted," "connected," "secured," and the like are to be construed broadly and can, for example, be fixedly connected, detachably connected, or integrally formed; may be mechanically coupled, may be electrically coupled or may be in communication with each other; they may be directly connected or indirectly connected through intervening media, or they may be connected internally or in any other suitable relationship, unless expressly stated otherwise. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and that variations, modifications, substitutions and alterations can be made to the above embodiments by those of ordinary skill in the art within the scope of the present invention.

Claims (16)

1. A surgical instrument comprising a handle assembly, a shaft assembly extending longitudinally from the handle assembly, and an end effector disposed at a distal end of the shaft assembly; the handle assembly comprises a head housing, a fixed handle extending downward from the head housing; a movable cutting member disposed within the end effector, the cutting member for cutting tissue disposed within the end effector; the cutting member is movable between an initial position and a fired position; the surgical instrument further comprises a transmission mechanism located at least partially within the handle assembly;
the method is characterized in that: a power supply assembly and a manual reset device are arranged in the handle assembly, and the power supply assembly provides a power source for the surgical instrument; the manual reset device can rotate along a first direction or a second direction, so that the transmission mechanism can be driven to move from a far end to a near end, and the transmission function of the transmission mechanism can be recovered; wherein the second direction is opposite the first direction;
the manual resetting device comprises a driving assembly and a link mechanism, at least one part of the link mechanism is fixedly connected in the head shell, the rest part of the link mechanism can move relative to the head shell, and the link mechanism has a first position and a second position; at least a portion of the drive assembly is coupled within the head housing and is capable of rotating in a first direction or a second direction about a pivot located on the head housing; the drive assembly is capable of driving the movable portion of the linkage mechanism to move between a first position and a second position; the driving assembly comprises a first driving assembly, the first driving assembly comprises a handle, a cam and a push rod, and the cam and the handle are connected to the head shell through the pivot; the push rod is rotatably connected with the handle, and one end of the push rod is abutted against the connecting rod mechanism; when the first driving component rotates along a first direction, the cam drives the connecting rod mechanism to move to the second position; when the link mechanism moves to the second position, the push rod is pressed.
2. The surgical instrument of claim 1, wherein the drive assembly further comprises a second driver; the first drive assembly is capable of rotating around the pivot shaft along a first direction so as to drive the movable part of the linkage mechanism to move from a first position to a second position; the first drive assembly is capable of rotating about the pivot shaft in a second direction while the second drive member is capable of driving the movable portion of the linkage from the second position to the first position.
3. The surgical instrument of claim 2, wherein the first drive assembly is a handle assembly connected to one end of the head housing by a pivot and rotatable about the pivot in a first direction or a second direction; the second driving piece is an elastic piece, one part of the elastic piece is fixedly connected to the other end of the head shell, and the rest part of the elastic piece can be deformed under compression.
4. The surgical instrument of claim 1, wherein a first through hole is provided in the handle, a third through hole is provided in the cam, and the pivot shaft passes through the first and third through holes.
5. The surgical instrument of claim 1, wherein the handle includes a protrusion and the cam includes a notch, the protrusion being located within the notch, the handle controlling the movement of the cam by the protrusion cooperating with the notch.
6. The surgical instrument of claim 1, wherein the cam further comprises an arcuate edge that drives the linkage mechanism toward the second position when the first drive assembly is rotated in a first direction.
7. The surgical instrument of claim 1, wherein the handle further comprises a second through hole, the push rod further comprises a rotating shaft, and the second through hole is connected with the rotating shaft in a matching manner.
8. The surgical instrument of claim 1, wherein one end of the push rod is provided with a protrusion that mates with the transmission mechanism.
9. A surgical instrument as recited in claim 3, wherein the linkage mechanism includes four members, being a planar four-bar mechanism.
10. The surgical instrument of claim 9, wherein the drive assembly drives the linkage mechanism by the arcuate edge of the cam interacting with a fourth link of the linkage mechanism and the resilient member interacting with a second link of the linkage mechanism.
11. The surgical instrument of claim 1, wherein the first direction is a clockwise direction and the second direction is a counterclockwise direction.
12. The surgical instrument of claim 1, wherein the transmission mechanism comprises a drive gear that transmits power of the power module to the drive shaft and a drive shaft that transmits the power to an end effector.
13. The surgical instrument of claim 12, wherein the drive shaft has a first drive tooth and a second drive tooth; the first transmission gear is matched with the gear, and the second transmission gear is matched with the push rod.
14. The surgical instrument of claim 13, wherein each tooth of the second drive tooth is right triangular or obtuse triangular.
15. The surgical instrument of claim 1 wherein said manual reset device is located within said head housing of said handle assembly.
16. The surgical instrument of claim 15 wherein a cover plate is disposed over the handle, the cover plate being removably coupled to the head housing.
CN201710535784.1A 2017-07-03 2017-07-03 Surgical instrument Active CN109199488B (en)

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