CN109419543A - A kind of end effector and its surgical instruments - Google Patents
A kind of end effector and its surgical instruments Download PDFInfo
- Publication number
- CN109419543A CN109419543A CN201710778523.2A CN201710778523A CN109419543A CN 109419543 A CN109419543 A CN 109419543A CN 201710778523 A CN201710778523 A CN 201710778523A CN 109419543 A CN109419543 A CN 109419543A
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- China
- Prior art keywords
- nail
- resist
- staple
- nailed seat
- staple cartridge
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07242—Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
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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 kind of end effector and its surgical instruments, and including staple cartridge tray, resist-nailed seat and the nail bin groupware being removably installed in the staple cartridge tray, the resist-nailed seat is pivotly connect with the staple cartridge tray;The resist-nailed seat includes supporting nail face and resist-nailed seat slot, and the nail face of supporting of resist-nailed seat slot two sides is equipped with several nail shaping grooves, and the nail shaping groove is set in a row in described support on nail face;Remoter from the resist-nailed seat slot, distance is bigger between nail shaping groove and the top end face of the staple cartridge body.End effector and its surgical instruments according to the present invention, same size and the anastomosis staple of shape can be formed into the staple line for having different nails high while cutting to tissue and be applied to tissue, both it had been able to achieve coincideing for wound, it can be reduced the bleeding at engaging tissue again, the blood supply of organization healing needs can also be provided, the time for shortening organization healing, be conducive to postoperative rehabilitation.
Description
Technical field
The present invention relates to a kind of surgical instruments to belong to medical treatment more particularly to a kind of end effector and its surgical instruments
Instrument field.
Background technique
Stapler suitable for surgical operation be it is a kind of can while patient wound is sutured by excess tissue cut off
Surgical incision anastomat, be widely used in the excision organized in the Minimally Invasive Surgeries such as abdominal surgery, gynaecology, paediatrics and thoracic surgery and
It coincide.Surgical incision anastomat is by entering patient's body in the casing of the pinpoint puncture outfit of operative site, then in group
It knits middle manufacture longitudinal cut and applies anastomosis staple in the opposite side of notch, to carry out detachment to tissue and coincide.Surgery cuts
Stapler includes end effector, and the end effector includes staple cartridge tray and resist-nailed seat, and the staple cartridge tray is for receiving nail bin
Component;Nail bin groupware includes staple cartridge body and the anastomosis staple that is arranged in staple cartridge body, is provided with several be used in staple cartridge body
The staple cavity of anastomosis staple is stored, staple cartridge body includes top end face, and top end face is equipped with and is formed by the staple cavity through top end face
Nail mouth.
Once doctor determines that end effector has clamped destination organization, so that it may surgical incision anastomat is fired, to cut
Break and sutures tissue.When suture, top end face is contacted with tissue is sewn, and the cutting element in surgical incision anastomat pushes nail bin
Interior wedge nail-pushing part movement is pierced so that the anastomosis staple coincideing in staple drivers driving nail bin be made to move upwards out of staple cavity
It wears and sutures destination organization (i.e. anastomosis staple goes out to follow closely).
And existing surgical cutting and stapling instrument, the staple formation height after coincideing are identical.Because needing to control after suture
The wound bleeding of cut place is realized generally by the nail forming height for reducing cut place, that is to say, that close to cut place
Anastomosis staple forming height it is lower, the amount of bleeding of wound is fewer.However, the forming height of anastomosis staple is lower, the blood of suture
Impacted, blood supply needed for wound healing can not be obtained is flowed, wound healing is slower.Hence it is highly desirable to a kind of surgery cuts kiss
Clutch, can be formed with different forming heights at nail, not only can be reduced the bleeding at engaging tissue, but also tissue can be provided and be cured
Close the blood supply needed.
Summary of the invention
In view of the deficiencies of the prior art, the present invention provides a kind of surgical incision anastomat tool, can to organize into
While row cutting will there is mutually level anastomosis staple to form different forming heights, be applied to tissue.The present invention by with
Lower technical solution is realized:
A kind of end effector, including staple cartridge tray, resist-nailed seat and the nail bin group being removably installed in the staple cartridge tray
Part, the nail bin groupware include staple cartridge body and anastomosis staple, and the staple cartridge body has ejector pin slot and nail cavity, sets in each nail cavity
There is an anastomosis staple;The resist-nailed seat is pivotly connect with the staple cartridge tray, with open position and closed position and can
It selectively moves between the open and the closed positions;The resist-nailed seat includes supporting nail face and resist-nailed seat slot, described to support nail
The nail face of supporting of seat slot two sides is equipped with several nail shaping grooves, and the nail shaping groove is in a row set in described support on nail face
It sets;Remoter from the resist-nailed seat slot, distance is bigger between nail shaping groove and the top end face of the staple cartridge body.
Preferably, the nail face of supporting is cambered surface, inclined-plane or stairstepping face.
Preferably, the anastomosis staple have first state and the second state, and can from the first state stress deformation at
Second state.
Preferably, in the first state, the size and shape of the anastomosis staple are identical;In second state,
The forming height of the anastomosis staple is different;Remoter from the resist-nailed seat slot, the forming height of the anastomosis staple is bigger.
Preferably, the nail bin groupware further includes position limiting structure, and the position limiting structure is located at the symmetrical of the staple cartridge body
On axis.
Preferably, the position limiting structure is integrally formed or is fixedly connected with the staple cartridge body.
Preferably, the height of the position limiting structure is equal to the minimum forming height of the anastomosis staple.
Preferably, the staple cartridge body is equipped with six nail chambers, and the nail face of supporting is equipped with six nail shaping grooves.
Preferably, the adjacent two rows nail shaping groove is staggered.
A kind of surgical instruments further includes above-mentioned including Handleset, the shaft member longitudinally extended from the Handleset
Described in any item end effectors, the end effector are set to the shaft member distal end.
End effector and its surgical instruments according to the present invention, can while being cut to tissue by size and
The identical anastomosis staple of shape forms the staple line for having different nails high and is applied to tissue.It is remoter from the resist-nailed seat slot, it is described to support nail
The distance of nail bin top end face described in slot distance is bigger.Closest to cutting line nail forming height than the nail farthest apart from cutting line
Forming height it is small, closest to cutting line at nail for providing hemostatic barrier, and the outside with larger forming height at
Nail provides the clamping effect of adjacent part of the tissue from the hemostasis section transitions of tight compression to not close compression.According to this
The end effector and its surgical instruments of invention be not only able to achieve coincideing for wound, but also can be reduced the bleeding at engaging tissue, moreover it is possible to
The blood supply that organization healing needs is provided, shortens the time of organization healing, is conducive to postoperative rehabilitation.
Detailed description of the invention
Fig. 1 is the structural schematic diagram of surgical incision anastomat according to an embodiment of the present invention;
Fig. 2 is the schematic diagram of the end effector opening state of surgical incision anastomat according to an embodiment of the present invention;
Fig. 3 is the signal that the end effector of surgical incision anastomat according to an embodiment of the present invention opens another angle
Figure;
Fig. 4 is the structural schematic diagram of the staple cartridge tray of surgical incision anastomat according to an embodiment of the present invention;
Fig. 5 is the decomposition diagram of the nail bin of surgical incision anastomat according to an embodiment of the present invention;
Fig. 6 is the structural schematic diagram of the anastomosis staple original state of surgical incision anastomat according to an embodiment of the present invention;
Fig. 7 is the structural schematic diagram of the identical staple drivers of surgical incision anastomat according to an embodiment of the present invention;
Fig. 8 is the structural representation of the identical staple drivers of surgical incision anastomat in accordance with another embodiment of the present invention
Figure;
Fig. 9 is the structural schematic diagram of the push nails of surgical incision anastomat according to an embodiment of the present invention;
Figure 10 is the structural schematic diagram of the cutting element of surgical incision anastomat according to an embodiment of the present invention;
Figure 11 is the structural schematic diagram of the resist-nailed seat of surgical incision anastomat according to an embodiment of the present invention;
Figure 12 is the longitudinal sectional view of the end effector of surgical incision anastomat according to an embodiment of the present invention;
Figure 13 is the transverse sectional view of the end effector of surgical incision anastomat according to an embodiment of the present invention;
Figure 14 is the transverse sectional view of the end effector of surgical incision anastomat in accordance with another embodiment of the present invention;
Figure 15 is the transverse sectional view of the end effector of surgical incision anastomat in accordance with another embodiment of the present invention;
Figure 16 is the schematic diagram after the staple formation of surgical incision anastomat according to an embodiment of the present invention.
Appended drawing reference
1000 surgical incision anastomats
100 end effector, 1 staple cartridge tray, 11 nail bin seat slots
Nail face, 22 resist-nailed seat slots, 23 nail shaping grooves, 24a, 24b, 24c are supported to staple line in 2 resist-nailed seats, 21
3 nail bin groupwares, 31 staple cartridge bodies, 311 insertion ends, 32 nail cavities, 312 top end faces, 313 bottom faces, 34 ejector pin slots, nail
Storehouse protection cap 30
35 anastomosis staples, nail tip 351, fixing end 352
36 identical staple drivers, 361 support portions, 362 guide parts, 363 extension blocks, 364 limit slot
37 push nails, cam part 372, limited block 371, supporting element 38, position limiting structure 39
4 cutting elements, 41 supporting parts, 42 clamping portions, cutting edge 43, driving portion 44
5 anastomosis staples, 51 nail tips, 52 fixing ends
200 Handlesets, 210 closure triggers, 220 firing triggers, 230 head shells,
240 rotary switches, 250 release buttons, 260 change-over switches, 270 fixed handles, 280 cover boards
300 shaft members
Specific embodiment
The embodiment of the present invention is described below in detail, examples of the embodiments are shown in the accompanying drawings.It is retouched in of the invention
In stating, it is to be understood that term " center ", " longitudinal direction ", " transverse direction ", " length ", " width ", " thickness ", "upper", "lower",
"front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom" "inner", "outside", " clockwise ", " counterclockwise ", " axis
To ", " radial direction ", the orientation or positional relationship of the instructions such as " circumferential direction " be to be based on the orientation or positional relationship shown in the drawings.
In addition, term " first ", " second " are used for descriptive purposes only and cannot be understood as indicating or suggesting relative importance
Or implicitly indicate the quantity of indicated technical characteristic.Define " first " as a result, the feature of " second " can be expressed or
Implicitly include at least one this feature.In the description of the present invention, the meaning of " plurality " is at least two, such as two, three
It is a etc., unless otherwise specifically defined.The embodiments described below with reference to the accompanying drawings are exemplary, it is intended to for solving
The present invention is released, and is not considered as limiting the invention.
With reference to attached drawing 1, the surgical cutting and stapling instrument 1000 of the embodiment of the present invention, including Handleset 200, from handle group
Shaft member 300 that part 200 longitudinally extends, the end effector 100 for being set to 300 one end of shaft member.For ease of description
The present invention and simplified description are based on attached orientation or positional relationship shown in FIG. 1, terms used herein in embodiments of the present invention
" nearside " and " distal side " is for the clinician of the Handleset 200 of manipulation surgical instruments 1000.Term is " close
Side " refers to that, close to the part of clinician, term " distal side " then refers to the part far from clinician.I.e. Handleset 200 is
Nearside, end effector 100 are distal side, if the proximal end of some components indicates one end of relatively close Handleset 200, far
Side then indicates one end of relatively close end effector 100.It should be noted that spatial terminology for example "vertical", "horizontal",
" right side ", " left side " etc. are to provide with reference to attached drawing 1.In Fig. 1, longitudinally refer to vertical direction.
With reference to Fig. 1, Handleset 200 includes head shell 230 and extends downwardly from the bottom of Handleset 200 is at an acute angle
Closure trigger 210, and closure trigger 210 can be manipulated to position and be closed end effector 100.End effector
100 are connected to the distal end portion of shaft member 300.End effector 100 includes staple cartridge tray 1 and is pivotably connected to staple cartridge tray 1
Resist-nailed seat 2 and the nail bin groupware 3 that is removably installed in staple cartridge tray 1.Resist-nailed seat 2 can be in open position and closed position
Between selectively move.Closure trigger 210 is pressed towards the fixed handle 270 of Handleset 200, shaft member can be passed through
300 make resist-nailed seat 2 pivot closed end portion actuator 100 in turn, with positioning, clamping, suture and cutting tissue.Preferred real
It applies in mode, surgical instruments 1000 further includes release button 250, can discharge closure trigger by operating release button 250
210, to open end effector 100 to readjust, clamp and position tissue.When pending tissue enters staple cartridge tray
When between 1 and resist-nailed seat 2, surgeon can press closure trigger 210 until being locked, so that resist-nailed seat 2 be made to be in
Closed position, i.e. end effector 100 are in closed state.
As shown in Fig. 2, end effector 100 includes the staple cartridge tray 1 and resist-nailed seat 2 of cooperating, resist-nailed seat 2 is pivotly
It is connect with staple cartridge tray 1, resist-nailed seat 2 has open position and closed position, and can select between the open and the closed positions
Move to property.About the connection type and end effector 100 of staple cartridge tray 1 and resist-nailed seat 2 and the position of nail bin groupware 3 and
Connection relationship is the same as those in the prior art or close, is not elaborated herein.When resist-nailed seat 2 is in an open position, will follow closely
Storehouse component 3 is packed into the end effector 100 of surgical incision anastomat 1000, removes nail bin protection cap 30, is closed resist-nailed seat 2.
After the end effector 100 of surgical incision anastomat 1000 enters patient's body, resist-nailed seat 2 is opened, when destination organization is located at
When between the staple cartridge tray 1 and resist-nailed seat 2 of end effector 100, closure resist-nailed seat 2 and then closure end effector 100.
Referring to figs. 2 to Fig. 4, Figure 10 to Figure 11, the clamping portion 42 of the downside of 4 distal end portion of cutting element is placed in nail bin seat slot
In 11, the supporting part 41 on the upside of 4 distal end portion of cutting element enters in resist-nailed seat slot 22, allows cutting element 4 upper and lower two
The resist-nailed seat slot 22 and nail bin seat slot 11 of side are mobile, and proximally distad pending tissue is cut in end motion.End effector 100
Staple cartridge tray 1 and the collaboration support cutting element 4 of resist-nailed seat 2, and provide the channel of percussion and retraction for cutting element 4.Resist-nailed seat 2
With the resist-nailed seat slot 22 being located therein, staple cartridge tray 1 has the nail bin seat slot 11 being located therein;Nail bin seat slot 11 and resist-nailed seat slot
22 position is corresponding.Nail bin seat slot 11, resist-nailed seat slot 22 and ejector pin slot 34 provide accommodating space and path jointly for cutting element 4
Guiding.Since the cutting element 4 of Minimally Invasive Surgery is small and sharp keen, the positioning for destination organization is more accurate, thus correspondingly, nail
Storehouse seat slot 11 and resist-nailed seat slot 22 are elongated and narrow;Further, nail bin seat slot 11, ejector pin slot 34 and resist-nailed seat slot 22 are common
The operation channel of cutting element 4 is formed, the center line of three is in the same plane.
Nail bin groupware 3 includes staple cartridge body 31, anastomosis staple 35, the identical staple drivers 36 for driving anastomosis staple 35, driving kiss
The push nails 37 of dowel driver 36.As shown in figure 5, several through-holes are set up and down in staple cartridge body 31, the through-hole shape
At least part at nail cavity 32, the staple drivers 36 that coincide is located in the nail cavity 32 with anastomosis staple 35, after staple cartridge body 31
End is additionally provided with push nails 37.Since a part for the staple drivers 36 that coincide is arranged in nail cavity 32, nail cavity 32 limits the anastomosis staple
Driver 36 is only capable of opposite staple cartridge body 31 and moves up and down, when the leading to identical staple drivers 36 of cam part 372 of push nails 37
When applying active force to face, the staple drivers 36 that coincide are only capable of opposite staple cartridge body 31 with anastomosis staple 35 and move up.Staple cartridge body
31 lower section is additionally provided with supporting element 38, can not only prevent the disengaging staple cartridge body 31 of staple drivers 36 of coincideing in this way, but also can enhance nail
The intensity of storehouse ontology 31.Staple cartridge body 31 further includes top end face 312 and the bottom face being disposed opposite to each other with top end face 312 313, top
Face 312 is parallel to each other with bottom face 313.In order to prevent anastomosis staple 35 in storage, the end of transporting or be assembled to surgical instruments holds
It falls off during row device from staple cavity, preferably, there is nail bin protection cap 30 in the top of staple cartridge body 31.In end effector
Under the premise of 100 closures, by the effect of external force, push nails 37 are transported from the rear end of staple cartridge body 31 to the front end of staple cartridge body 31
Dynamic, push nails 37 push the staple drivers 36 that coincide to move up in nail cavity 32 in the process of movement, to make anastomosis staple 35
The tissue of patient is moved up, pierced, and sutures the wound of patient, until anastomosis staple 35 is detached from nail cavity 32.As to how opening
Or closure end effector 100 is the same as those in the prior art or close, is not elaborated herein.
As shown in fig. 6, anastomosis staple 35 includes nail tip 351 and fixing end 352, the specific structure of anastomosis staple 35 can refer to this Shen
Ask someone application utility model " a kind of anastomosis staple " (application No. is: CN201220632813.9), details are not described herein again.Nail tip
351 sharp structures are conducive to anastomosis staple 35 and are more easily pierced into tissue, and fixing end 352 is of a straight line type and and top end face
312 is parallel.When not fired, anastomosis staple 35 is located in nail cavity 32, and nail tip 31 is no more than the top end face of staple cartridge body 31, coincide
Nail 35 is substantially in "U" shaped, and the fixing end 352 of anastomosis staple 35, which is located at, coincide in staple drivers 36.
Identical staple drivers 36 are equipped in each nail cavity 32, with reference to Fig. 7 to Fig. 8, the staple drivers 36 that coincide include support
Portion 361 and with the integrally formed guide part 362 of the support portion 361.The upward projection in the two sides of support portion 361 is formed with extension block
363, extension block 363, support portion 361, which enclose, to be set to form the anastomosis staple restriction slot 364 for limiting anastomosis staple 35, is equipped in each nail cavity 32
One anastomosis staple limits slot 364;That is, being equipped with an anastomosis staple 35 and a corresponding anastomosis staple limit in each nail cavity 32
Determine slot 364.The fixing end 352 of anastomosis staple 35 is set in anastomosis staple limiting slot 364.The cam part of guide part 362 and push nails 37
372 adaptations.As shown in fig. 7, each identical staple drivers 36 have an anastomosis staple to limit slot 364, anastomosis staple driving each in this way
Device 36 can accommodate an anastomosis staple 35;Or as shown in figure 8, each identical staple drivers 36 can also there are two anastomosis staples to limit
Slot 364, each identical staple drivers 36 ' can accommodate two anastomosis staples 35 in this way.The structure and packet of each identical staple drivers 36
The quantity for limiting slot 364 containing anastomosis staple can also be varied as desired, and be able to satisfy accommodating and pushed anastomosis staple 35, herein not
It is illustrated one by one.The two sides of the ejector pin slot 34 of nail bin groupware 3 are equipped with several nail cavities 32, and nail cavity 32 is in staple cartridge body 31
Interior perforation setting, upper surface are flushed with the top end face 312 of staple cartridge body 31, and anastomosis staple 35 is located in nail cavity 32 and needle point 351
No more than the upper surface (i.e. the top end face of staple cartridge body) of nail cavity 32.In embodiments of the present invention, nail cavity 32 is set in a row;Ejector pin
The two sides of slot 34 are equipped with N1Nail chamber 32, wherein N1≥2.For the convenience of describing the present invention and simplifying the description, of the invention one
In a embodiment, every side of ejector pin slot 34 is equipped with three nail chambers 32, ipsilateral to be staggered per adjacent two rows of nail cavities 32, such as schemes
Shown in 2;Preferably, each anastomosis staple driving in the nail cavity 32 of one row 33c of outermost (row i.e. farthest from ejector pin slot 34)
Device 36 is equipped with an anastomosis staple as shown in Figure 7 and limits slot 364;The adjacent two rows in inside are (i.e. near a row 33a of ejector pin slot 34
Staple drivers 36 are equipped with, equipped with identical staple drivers 36 as shown in Figure 8, each coincideing in the nail cavity 32 of one row 33b of centre)
Two anastomosis staples limit slot 364 ';Six row's anastomosis staples 35 and the identical staple drivers 36 of four rows are equipped in i.e. each nail bin groupware 3.
Fig. 9 shows a kind of embodiment of the push nails 37 of the embodiment of the present invention.Push nails 37 include that bottom plate (is not schemed
Show), upwardly extended from bottom plate the cam part 372 to be formed and from bottom plate (not shown) upwardly extend type formation limited block 371, limit
Position block 371 with the driving portion 44 of cutting element 4 for engaging.Bottom plate (not shown) is clamped in supporting element 38 and staple cartridge body 31
Bottom face 313 between, cam part 372 is located in the sliding conduit (not shown) of staple cartridge body 31, and can the relatively described sliding
Conduit is mobile.Limited block 371 is located in ejector pin slot 34 and can move in ejector pin slot 34, to prevent in push nails 37 with respect to nail bin
When ontology 31 is mobile, push nails 37 deviate moving direction or shaking.In one embodiment of the invention, push nails 37 are by structure
It causes that the identical staple drivers 36 of four rows can be driven to move simultaneously.In this case, this four bevelled cam parts 372 of tool
Distal end portion be configured to contact this four row simultaneously and coincide and staple drivers 36 and they parallel are promoted into surfaces along four
It is promoted, so that these coincide, staple drivers 36 reach identical height simultaneously;Optionally, the size on the inclined-plane of cam part 372 and
Shape is identical, and four inclined convex wheel portions 372 can contact the guide part 362 of the identical staple drivers 36 of four rows simultaneously as a result, and will
The identical staple drivers 36 of four rows promote identical height.
When push nails 37 are by external force, the guide part 362 of the cam part 372 of push nails 37 and identical staple drivers 36
It contacts, move up identical staple drivers 36 after 362 stress of guide part and then pushes anastomosis staple accommodation groove 361 in nail cavity 32
Movement.Since nail cavity 32 is to be arranged up and down, the staple drivers 36 that coincide are arranged in nail cavity 32, and nail cavity 32 limits anastomosis staple and drives
Dynamic device 36 is only capable of opposite staple cartridge body 31 and moves up and down, therefore when the inclined-plane of cam part 372 applies active force to guide part 362,
The staple drivers 36 that coincide are only capable of opposite staple cartridge body 31 and move up;At this point, anastomosis staple limits slot 364 with 362 phase of guide part
Staple cartridge body 31 is moved up, so that anastomosis staple 35 be pushed to move up with respect to staple cartridge body 31, and then is driven in nail cavity 32
Anastomosis staple 35 moved from its non-firing position to firing position, that is, realize out and follow closely.Under the action of by external force, push nails 37 can be with
The front end of staple cartridge body 31 is moved to from the rear end of staple cartridge body 31, supporting element 38 is fixedly connected with staple cartridge body 31, to prop up
Coincide staple drivers 36 and push nails 37 are supportted, to prevent anastomosis staple driver 36 or push nails 37 to be detached from staple cartridge body 31, and are increased
The strong intensity of staple cartridge body 31.
As shown in figure 11, cutting element 4 includes supporting part 41 and clamping portion 42, and clamping portion 42 is located at the remote of cutting element 4
End downside, in I-shaped;The upside of 4 distal end portion of cutting element is equipped with supporting part 41;The position pair of clamping portion 42 and supporting part 41
It answers.With reference to figures 13 to Figure 15, nail bin seat slot 11 and 42 shape of clamping portion match setting, resist-nailed seat slot 22 and 41 shape of support portion and match setting,
In order to being respectively that clamping portion 42 and supporting part 41 provide moving conduit;Specifically, the clamping of the downside of 4 distal end portion of cutting element
Portion 42 is placed in nail bin seat slot 11, and the supporting part 41 on the upside of 4 distal end portion of cutting element enters in resist-nailed seat slot 22, so that cutting
Component 4 can be mobile in the resist-nailed seat slot 22 and nail bin seat slot 11 of upper and lower two sides, and proximally distad end motion cutting is to be processed
Tissue.When cutting element 4 is by percussion force or withdrawal force, supporting part 41 in resist-nailed seat slot 22, clamping portion 42 is in staple cartridge tray
The power that may be in response to apply in slot 11 moves back and forth;I.e. cutting element 4 can respond the percussion force being subject to or withdrawal force and hold
It is moved back and forth in portion's actuator 100.Supporting part 41 is matched with 22 phase shape of resist-nailed seat slot, and the two shape is shaken with avoidable;Clamping portion 42
The left and right sides of nail bin seat slot 11 is accommodated into I-shaped accommodating space, the connection type of clamping is conducive to open in resist-nailed seat 2
Bidirectionally limited cutting element 4 when conjunction.Cutting element 4 further include cutting edge 43 for cutting tissue and for nail bin groupware 3
The driving portion 44 that push nails 37 cooperate.
The proximal end of cutting element 4 is connected with the mandrel (not shown) being set in shaft member 300, and cutting element
4 distal end portion is connected in the end effector 100 being made of staple cartridge tray 1 and resist-nailed seat 2, and can be from end effector 100
One end moves to the other end of end effector 100.About cutting element 4 proximal end and the mandrel connection type, with
And the position and connection relationship of the mandrel and shaft member 300, it is same as the prior art or close, it does not explain in detail herein
It states.In short, cutting element 4 can be made cutting element 4 by not firing position by the percussion force transmitted by firing trigger 220
The firing position set distad is mobile;It can also be retracted into response to the withdrawal force being applied on cutting element 4 by firing position
Non- firing position.Percussion force can be realized, as the structure and work for turning to button 260 to the conversion of withdrawal force by turning to button 260
Mode, it is same same as the prior art or similar, also repeat no more.It should be noted that the percussion campaign and contracting of cutting element 4
It backhauls and moves and must just allow to occur in the case where end effector 100 is closed, i.e., be only locked in closure trigger 210
When on fixed handle 270 so that resist-nailed seat 2 is in the close position, firing trigger 220 can be just activated, to prevent surgical procedure
In due to press firing trigger 220 accidentally and cause cutting element 4 cut non-target tissues accident.Similarly, as with
Which kind of structure realizes that the function of preventing firing trigger 220 from surprisingly being touched, the prior art have announcement or enlightenment, herein no longer
It repeats.
Figure 10 is the structural schematic diagram of resist-nailed seat 2.Resist-nailed seat 2 has the resist-nailed seat slot 22 being located therein, and cuts for providing
Cut the moving conduit of the supporting part 41 of component 4;Resist-nailed seat 2, which also has, supports nail face 21, for the top end face 312 with nail bin groupware 3
Common clamping pending tissue.In embodiments of the present invention, nail shaping groove 23 is set in a row;The two sides of resist-nailed seat slot 22 are all provided with
There is N2Nail shaping groove 23, wherein N2>=2, N1=N2.Accordingly, preferably, every side of resist-nailed seat slot 22 is equipped with three
Nail shaping groove 23, it is ipsilateral to be staggered per adjacent two nails shaping groove 23, in vertical direction with the nail of nail bin groupware 3
Chamber 32 corresponds.
Figure 12 be end effector 100 along a wherein nail shaping groove 23 longitudinal sectional view, depict resist-nailed seat 2 with
Matching relationship between each component.Resist-nailed seat 2 is pivotly connect with staple cartridge tray 1, and resist-nailed seat 2 has open position and closure position
It sets, and can selectively move between the open and the closed positions.In the initial state, the size and shape of anastomosis staple 35
Identical, easy to process in this way and assembly, the anastomosis staple 35 that can effectively prevent different size are loaded in mixture.Staple cartridge tray 1 and resist-nailed seat 2 are assisted
With support cutting element 4, when destination organization is positioned at staple cartridge tray 1 and resist-nailed seat 2 between, by closure trigger 210 to fixation hand
The direction of handle 270, which is tensioned to, to be closed completely with lock onto target tissue.Firing trigger 220 is triggered, successively (in figure not with moving mandrel
Show), cutting element 4 moves by proximate;Push nails 37 are located in the nail bin groupware 3 of staple cartridge tray 1, cutting element 4
Driving portion 44 drives push nails 37 to be moved by proximate;Specifically, push nails 37 are moved by proximate, push nails 37
The cam part 372 of wedge contacted with the guide surface 362 of identical staple drivers 36, push the fortune upwards of staple drivers 36 of coincideing
It is dynamic, and then anastomosis staple 35 is driven to move up relative to staple cartridge body 31, anastomosis staple 35 progressively disengages nail cavity 32, and nail tip 351 is worn
Between saturating staple cartridge tray 1 and resist-nailed seat 2 after destination organization to be stapled, pressed after being contacted with the nail shaping groove 23 for supporting nail face 21
It is curved, and specific shape is formed along nail shaping groove 23, to realize the suture of tissue;Meanwhile the cutting edge 43 of cutting element 4
Destination organization is cut, is cut while to realize the suture of the tissue cut.
Figure 13 to Figure 15 is the longitudinal sectional view of resist-nailed seat 2, in order to clearly show that position and the connection relationship of resist-nailed seat 2,
It is omitted in figure and is clamped in destination organization and parts thereof between 3 top end face 312 of nail face 21 and nail bin groupware.When supporting
It is remoter from resist-nailed seat slot 22 when nail seat 2 is located at the closed position, follow closely top end face 312 of the shaping groove 23 apart from nail bin groupware 3
Distance it is bigger, in this way, the compressed degree of destination organization closer to resist-nailed seat slot 22 is bigger, then the thickness after being sewn is got over
It is small.Several nail shaping grooves 23 are equipped with to nail face 21, the every side of resist-nailed seat slot 22 is equipped with three nail shaping grooves 23, that is, supports
Nail face 21 is equipped with six nail shaping grooves 23, and nail shaping groove 23 is configured to that anastomosis staple 35 is made to become any suitable
Shape, support nail face 21 on set in a row, Open Side Down.
In one embodiment of the invention, as shown in figure 13, resist-nailed seat 2 support nail face 21 it is arc-shaped, curved surfaces compared with
It is smooth, it will not injury tissue when clamping tissue without sharp protrusion.When resist-nailed seat 2 is in the close position, support nail face 21 with
The molding space of anastomosis staple 35 is formed between the top end face 312 of nail bin groupware 3;Remoter apart from resist-nailed seat slot 22, the molding is empty
Between height it is higher.When resist-nailed seat 2 is located at the closed position, one row of most inner side supports staple line 24a (i.e. from resist-nailed seat slot 22
A nearest row) it is H at a distance from the top end face 312 of nail bin groupware 31, intermediate top of the row to staple line 24b and nail bin groupware 3
The distance of end face 312 is H2, one row of outermost is to staple line 24c (i.e. from a farthest row for resist-nailed seat slot 22) and nail bin groupware 3
Top end face 312 distance be H3, wherein H3> H2> H1。
Figure 14 discloses another embodiment of the invention, and the nail face 21 of supporting of resist-nailed seat 2 is in scarf, the surface of scarf
It is more smooth, it will not injury tissue when clamping tissue without sharp protrusion.When resist-nailed seat 2 is in the close position, nail face 21 is supported
The molding space of anastomosis staple 35 is formed between the top end face 312 of nail bin groupware 3;It is remoter apart from resist-nailed seat slot 22, the molding
The height in space is higher.When resist-nailed seat 2 is located at the closed position, one row of most inner side supports staple line 24a (i.e. from resist-nailed seat slot 22
A nearest row) be H with the top end face 312 of nail bin groupware 3 at a distance from1, an intermediate row is to staple line 24b and nail bin groupware 3
The distance of top end face 312 is H2, one row of outermost is to staple line 24c (i.e. from a farthest row for resist-nailed seat slot 22) and nail bin groupware
The distance of 3 top end face 312 is H3, wherein H3> H2> H1。
In another embodiment of the present invention, as shown in figure 15, the nail face 21 of supporting of resist-nailed seat 2 is stepped.It is followed closely when supporting
When seat 2 is in the close position, to the molding space for forming anastomosis staple 35 between nail face 21 and the top end face 312 of nail bin groupware 3;Away from
Remoter from resist-nailed seat slot 22, the height of the molding space is higher.When resist-nailed seat 2 is located at the closed position, most inner side one
It is H at a distance from the top end face 312 of nail bin groupware 3 that row, which supports staple line 24a (i.e. from a nearest row for resist-nailed seat slot 22),1, intermediate
It is H at a distance from the top end face 312 of nail bin groupware 3 that one row, which supports staple line 24b,2, one row of outermost is to staple line 24c (i.e. from resist-nailed seat
A farthest row for slot 22) it is H at a distance from the top end face 312 of nail bin groupware 33, wherein H3> H2> H1。
As shown in Figures 3 to 5, nail bin groupware 3 is additionally provided with position limiting structure 39, and position limiting structure 39 is located at pair of nail bin groupware 3
Claiming on axis, it is preferable that position limiting structure 39 is located at the distal end of ejector pin slot 34, is integrally formed or is fixedly connected with staple cartridge body 31, Gu
Fixed connection refers to that two components for having connection relationship are independent from each other component, including be detachably connected with non-dismountable connection,
Concrete mode is common mode in the art, such as threaded connection, bonding, melting and engaging.The height etc. of position limiting structure 39
Staple line 24a (i.e. from a nearest row for resist-nailed seat slot 22) is supported at a distance from the top end face 312 of nail bin groupware 3 in one row of most inner side
H1.In this way, first contacting, being limited by position limiting structure 39, Wu Faji with position limiting structure 39 to nail face 21 when being closed resist-nailed seat 2
Continuous closure compression goal tissue downwards, is damaged with preventing the destination organization from being compressed by transition.
End effector and its surgical instruments 1000 according to the present invention overcomes existing surgical cutting and stapling instrument kiss
Height is identical after anastomosis staple 35 after conjunction forms, is unfavorable for the problem of wound healing.If the nail after molding of anastomosis staple 35 is high too low,
The tissue of cut edge be will lead to because being made blood flow be obstructed by excessive compression and then being led to ischemic, can not be obtained needed for wound healing
Blood supply;If the height after molding of anastomosis staple 35 is too high, the problems such as suturing stomatorrhagia can be caused.Surgery cuts according to the present invention
Coinciding machine 1000 can have same size and the formation of the anastomosis staple of shape 35 while cutting to destination organization
Difference nail height is applied to tissue.Figure 16 is the schematic diagram after molding of anastomosis staple 35 when completing suture, and anastomosis staple 35 is followed closely high after forming
Incremented by successively by row, the anastomosis staple 35 of the outboard row 33c apart from resist-nailed seat slot 22 farthest (i.e. farthest away from cutting line) has larger
Forming height H3, so that the tissue after suturing is obtained better blood supply, be conducive to improve tissue sewing effect;One row 33b's of centre
35 forming height H of anastomosis staple2Forming height H less than 33c3And it is greater than the forming height H of 33a1, tissue is provided from not close
It is compressed to the transition effect for being gradually clamped compression;Closest to the inboard row 33a of resist-nailed seat slot 22 (i.e. near cutting line)
The nail height that anastomosis staple 35 is formed is lower, and for providing hemostatic barrier, organized layer can reach preferable haemostatic effect after being sewn.This
Sample had not only been able to achieve the effective of wound and had coincide, but also can be reduced the bleeding at engaging tissue, moreover it is possible to the blood supply of organization healing needs is provided,
The time for shortening organization healing, be conducive to the postoperative rehabilitation of patient.
In the present invention unless specifically defined or limited otherwise, term " installation ", " connected ", " connection ", " fixation " etc.
Term shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or integral;It can be mechanical connect
It connects, is also possible to be electrically connected or can communicate each other;It can be directly connected, can also indirectly connected through an intermediary, it can be with
It is the interaction relationship of the connection or two elements inside two elements, unless otherwise restricted clearly.For this field
For those of ordinary skill, the specific meanings of the above terms in the present invention can be understood according to specific conditions.
In the present invention unless specifically defined or limited otherwise, fisrt feature in the second feature " on " or " down " can be with
It is that the first and second features directly contact or the first and second features pass through intermediary mediate contact.Moreover, fisrt feature exists
Second feature " on ", " top " and " above " but fisrt feature be directly above or diagonally above the second feature, or be merely representative of
First feature horizontal height is higher than second feature.Fisrt feature can be under the second feature " below ", " below " and " below "
One feature is directly under or diagonally below the second feature, or is merely representative of first feature horizontal height less than second feature.
In the description of this specification, reference term " one embodiment ", " some embodiments ", " example ", " specifically show
The description of example " or " some examples " etc. means specific features, structure, material or spy described in conjunction with this embodiment or example
Point is included at least one embodiment or example of the invention.In the present specification, schematic expression of the above terms are not
It must be directed to identical embodiment or example.Moreover, particular features, structures, materials, or characteristics described can be in office
It can be combined in any suitable manner in one or more embodiment or examples.In addition, without conflicting with each other, the skill of this field
Art personnel can tie the feature of different embodiments or examples described in this specification and different embodiments or examples
It closes and combines.
Although the embodiments of the present invention has been shown and described above, it is to be understood that above-described embodiment is example
Property, it is not considered as limiting the invention, those skilled in the art within the scope of the invention can be to above-mentioned
Embodiment is changed, modifies, replacement and variant.
Claims (10)
1. a kind of end effector, including staple cartridge tray, resist-nailed seat and the nail bin groupware being removably installed in the staple cartridge tray;
The nail bin groupware includes staple cartridge body and anastomosis staple, and the staple cartridge body has ejector pin slot and nail cavity, is equipped in each nail cavity
One anastomosis staple;The resist-nailed seat is pivotly connect with the staple cartridge tray, with open position and closed position and can be
It is selectively moved between open position and closed position;It is characterized in that, the resist-nailed seat includes supporting nail face and resist-nailed seat slot,
The nail face of supporting of resist-nailed seat slot two sides is equipped with several nail shaping grooves, and the nail shaping groove supports nail face described
On set in a row;It is remoter apart from the resist-nailed seat slot, distance between nail shaping groove and the top end face of the staple cartridge body
It is bigger.
2. end effector according to claim 1, which is characterized in that the nail face of supporting is cambered surface, inclined-plane or stairstepping
Face.
3. according to claim 1,2 described in any item end effectors, which is characterized in that the anastomosis staple has first state
With the second state, and second state can be shaped to from the first state stress.
4. end effector according to claim 3, which is characterized in that in the first state, the anastomosis staple
Size and shape are identical;In second state, the forming height of the anastomosis staple is different, remoter from the resist-nailed seat slot,
The forming height of the anastomosis staple is bigger.
5. according to claim 1,2 described in any item end effectors, which is characterized in that the nail bin groupware further includes limit
Structure, the position limiting structure are located on the symmetry axis of the staple cartridge body.
6. end effector according to claim 5, which is characterized in that the position limiting structure and staple cartridge body one
It forms or is fixedly connected.
7. end effector according to claim 6, which is characterized in that the height of the position limiting structure is equal to described coincide
The minimum forming height of nail.
8. according to claim 1,2 described in any item end effectors, which is characterized in that the staple cartridge body is equipped with six rows
Nail cavity, the nail face of supporting are equipped with six nail shaping grooves.
9. according to claim 1, end effector described in 2 any tops, which is characterized in that the adjacent two rows nail shaping groove
It is staggered.
10. a kind of surgical instruments, including Handleset, the shaft member longitudinally extended from the Handleset, which is characterized in that
It further include the described in any item end effectors of claim 1-9, the end effector is set to the remote of the shaft member
End.
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CN201710778523.2A CN109419543A (en) | 2017-08-31 | 2017-08-31 | A kind of end effector and its surgical instruments |
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CN201710778523.2A CN109419543A (en) | 2017-08-31 | 2017-08-31 | A kind of end effector and its surgical instruments |
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CN113081124A (en) * | 2021-03-17 | 2021-07-09 | 苏州贝诺医疗器械有限公司 | Anastomat with nail anvil attaching, suturing and nail bending structure |
CN114451944A (en) * | 2022-02-09 | 2022-05-10 | 天津瑞奇外科器械股份有限公司 | Surgical instrument and nail bin assembly thereof |
WO2023030042A1 (en) * | 2021-09-01 | 2023-03-09 | 江苏风和医疗器材股份有限公司 | Staple cartridge assembly and surgical instrument |
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