CN110755122B - Endoscope cutting anastomat - Google Patents
Endoscope cutting anastomat Download PDFInfo
- Publication number
- CN110755122B CN110755122B CN201911006634.7A CN201911006634A CN110755122B CN 110755122 B CN110755122 B CN 110755122B CN 201911006634 A CN201911006634 A CN 201911006634A CN 110755122 B CN110755122 B CN 110755122B
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- rod
- groove
- push rod
- cutter
- cutter bar
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- 238000005520 cutting process Methods 0.000 title claims abstract description 78
- 230000001681 protective effect Effects 0.000 claims abstract description 44
- 230000005284 excitation Effects 0.000 claims description 63
- 229910000639 Spring steel Inorganic materials 0.000 claims description 40
- 230000006835 compression Effects 0.000 claims description 8
- 238000007906 compression Methods 0.000 claims description 8
- 238000001356 surgical procedure Methods 0.000 claims description 2
- 208000019300 CLIPPERS Diseases 0.000 claims 4
- 208000021930 chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids Diseases 0.000 claims 4
- 230000000916 dilatatory effect Effects 0.000 claims 1
- 230000007246 mechanism Effects 0.000 description 11
- 238000010586 diagram Methods 0.000 description 9
- 230000009471 action Effects 0.000 description 5
- 210000000436 anus Anatomy 0.000 description 5
- 238000005452 bending Methods 0.000 description 4
- 230000009286 beneficial effect Effects 0.000 description 4
- 230000010339 dilation Effects 0.000 description 4
- 210000001215 vagina Anatomy 0.000 description 3
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 2
- 230000003872 anastomosis Effects 0.000 description 2
- 230000001788 irregular Effects 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 210000000664 rectum Anatomy 0.000 description 2
- 238000009958 sewing Methods 0.000 description 2
- 229910052719 titanium Inorganic materials 0.000 description 2
- 239000010936 titanium Substances 0.000 description 2
- 206010011409 Cross infection Diseases 0.000 description 1
- 206010016717 Fistula Diseases 0.000 description 1
- 206010019909 Hernia Diseases 0.000 description 1
- 206010029803 Nosocomial infection Diseases 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 238000012790 confirmation Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000003238 esophagus Anatomy 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 230000003890 fistula Effects 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 208000014617 hemorrhoid Diseases 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 210000004072 lung Anatomy 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 230000000451 tissue damage Effects 0.000 description 1
- 231100000827 tissue damage Toxicity 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Images
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
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
Abstract
An endoscope cutting anastomat comprises a main rod, an auxiliary rod and a cutter bar, wherein the main rod and the auxiliary rod are oppositely arranged and combined into a hollow cylindrical structure, and the cutter bar is arranged in the hollow cylindrical structure in a relatively movable mode; cylindrical connecting rods are arranged outside the main rod and the auxiliary rod, and protective covers are arranged outside the connecting rods; the cutter bar is provided with a plurality of cutter bar grooves, a positioning convex rod is arranged in the protective cover, and the positioning convex rod penetrates through a hole formed in the connecting rod and is inserted into one of the cutter bar grooves; a protective cover buckle is also arranged in the protective cover; a push rod groove is arranged on the main rod, a push rod is arranged in the push rod groove, a push rod clamping piece is arranged at the end part of the push rod, and at least one part of the push rod clamping piece is clamped and pressed on the protective cover clamping buckle; a spring is arranged between the end part of the push rod and the end part of the push rod groove. The blade is reliably locked before the trigger handle is assembled, so that false triggering is prevented, and the safety performance and the operation convenience of the cutting anastomat are improved.
Description
Technical Field
The invention relates to a medical instrument, in particular to an endoscope cutting anastomat which is used for cutting a focus or suturing a fistula in an anus or vagina operation.
Background
Staplers are devices used in medicine to replace manual suturing, the main working principle being the detachment or anastomosis of tissue by titanium staples, similar to staplers. According to different application ranges, the surgical stapler can be mainly divided into a skin stapler, a circular stapler for digestive tracts (esophagus, stomach and intestine and the like), a rectal stapler, a circular hemorrhoid stapler, a circumcision stapler, a blood vessel stapler, a hernia stapler, a lung cutting stapler and the like. Compared with the traditional manual suture, the instrument suture has the following advantages: the operation is simple and convenient, and the operation time is saved. The disposable is disposable, and cross infection is avoided. The titanium nail or the stainless steel nail (skin suturing device) is used for suturing tightly and with moderate tightness. Has few side effects and can effectively reduce the surgical complications and the like. The cutting anastomat is provided with a blade, can be used for cutting and suturing at the same time, and can be used for cutting and suturing. Staplers are commonly used in conjunction with an activation handle. The cutting anastomat is provided with the blade, so that the false triggering prevention is required to be guaranteed, if the blade can be reliably locked before the exciting handle is assembled, the false triggering is prevented, and when the exciting handle is installed for operation, the locking mechanism can be conveniently detached, so that the safety performance and the operation convenience of the cutting anastomat can be greatly improved.
In addition, the existing anastomat is a straight-head endoscope, the linear structure of the existing anastomat cannot guarantee effective action on a focus part, normal tissue damage within a linear range is often caused in use, and improvement is needed to improve the pertinence in cutting and anastomosis. At the same time, it is also necessary to improve the convenience of identification and confirmation of lesion tissues in use.
Disclosure of Invention
In view of the above circumstances, in order to solve the problems in the prior art, the present invention provides an endoscopic cutting stapler, including a main rod, an auxiliary rod and a knife bar, wherein the main rod and the auxiliary rod are oppositely disposed and combined into a hollow cylindrical structure, and the knife bar is movably disposed in the hollow cylindrical structure; cylindrical connecting rods are arranged outside the main rod and the auxiliary rod, and protective covers are arranged outside the connecting rods; the cutter bar is provided with a plurality of cutter bar grooves, a positioning convex rod is arranged in the protective cover, and the positioning convex rod penetrates through a hole formed in the connecting rod and is inserted into one of the cutter bar grooves; a protective cover buckle is also arranged in the protective cover; a push rod groove is formed in the main rod, a push rod is arranged in the push rod groove, a push rod clamping piece is arranged at the end part of the push rod, and at least one part of the push rod clamping piece is clamped and pressed on the protective cover clamping buckle; and a spring is also arranged between the end part of the push rod and the end part of the push rod groove.
The positioning convex rod is inserted into the cutter rod groove to limit the axial movement of the cutter rod, and when the protective cover is not removed, the cutter at the top end of the cutter rod cannot be pushed out, so that misoperation is avoided. Through the cooperation of push rod card and visor buckle, the radial movement and the rotation of restriction visor. The movement and the rotation of the protective cover are limited through the matching of the positioning convex rod and the protective cover buckle, and the protective cover can be prevented from being separated from the connecting rod, so that the axial movement of the cutter bar is limited. The spring is used for propping against the end part of the push rod, so that the position of the push rod clamping piece is positioned on the protective cover clamping buckle. When the endoscope cutting anastomat is arranged on the excitation handle (or the excitation rod or the excitation gun), the push rod is pushed by the connecting part to compress the spring to move forwards, so that the push rod clamping piece moves out of the protective cover clamping buckle, the protective cover is unlocked and can be taken down from the connecting rod, the limitation of the positioning convex rod on the cutter bar groove is removed, and the cutter bar can move under the excitation of the excitation rod. Through the arrangement of the mechanism, when the endoscope cutting anastomat is not correctly installed on the excitation handle, the excitation rod or the excitation gun, the protective cover cannot be taken down, so that misoperation is prevented. When the endoscope cutting anastomat is correctly installed on the excitation handle or the excitation rod or the excitation gun for use, the locking can be released under the action of the push rod, the protective cover is taken down, and the motion limitation on the cutter bar is released.
Preferably, the push rod is further provided with a locking guide chute, and the cutter bar is further provided with a cutter bar side groove; the locking mechanism is characterized in that a locking ring piece is further arranged outside the main rod, a locking guide rod and a locking rod are arranged in the locking ring piece, the locking guide rod is arranged in the locking guide chute, and the locking rod penetrates through a notch formed in the main rod and is embedded into the side groove of the cutter rod.
Preferably, the locking guide chute is inclined in a direction such that, when the push rod is not pushed, the locking guide rod is located at the front end of the locking guide chute, and the locking rod penetrates through a notch formed in the main rod and is embedded into the cutter bar side groove; after the push rod is pushed forwards, the locking guide rod is located at the rear end of the locking guide chute, and the locking ring piece is guided to rotate until the locking rod is separated from the cutter bar side groove.
Through setting up locking ring piece and relevant mechanism, can make the axial displacement of lock pole restriction cutter arbor. When the endoscope cutting anastomat is not correctly installed on the excitation handle or the excitation rod or the excitation gun, the push rod is not pushed, and the locking ring plate locks the cutter bar side groove, so that misoperation is prevented. When the endoscope cutting anastomat is correctly installed on an excitation handle or an excitation rod or an excitation gun for use, the locking can be released under the action of the push rod, the locking rod is separated from the cutter bar side groove, and the motion limitation on the cutter bar is released. The reliability against the erroneous operation is further enhanced.
Preferably, a forceps head seat is arranged in the front end of the connecting rod, a through groove is formed in the forceps head seat, a cutter is arranged at the front end of the cutter bar, and the cutter is arranged in the through groove in a relatively movable manner; the nail-cutting pliers are characterized in that the pliers head seat is also provided with a pliers head seat shaft, the pliers head seat shaft is relatively rotatably provided with a nail bin cover and a nail anvil, and the nail bin is clamped in the nail bin cover.
Preferably, the nail box cover and the nail anvil are of arc-shaped structures. Preferably, the nail bin cover and the nail anvil are respectively provided with a nail bin cover connecting hole and a nail anvil connecting hole and are respectively arranged on the forceps head seat shaft through the nail bin cover connecting hole and the nail anvil connecting hole. Preferably, a nail anvil plate is arranged in the nail anvil, and a nail anvil guide groove is arranged between the nail anvil plate and the bottom of the nail anvil; the lower part of the cutter is provided with a nail anvil guide plate which can be arranged in the nail anvil guide groove in a relatively movable way.
Preferably, the middle part of the chopping board is provided with a cutter guide groove for the cutter to move through. Preferably, an anvil pushing spring is arranged on the nail bin, and the other end of the anvil pushing spring pushes the anvil plate; the end part of the nail anvil is provided with a nail anvil positioning plate which can be contacted with the main rod when the nail anvil is pushed away.
Preferably, the upper part of the cutter is provided with a push plate, the middle part of the nail bin is provided with a nail pushing groove, and the nail pushing groove is internally provided with an inclined push block which is used for pushing and pressing a nail pushing sheet to enable a suturing nail to be in pressure joint with a nail anvil so as to suture tissues.
Preferably, a nail bin guide piece is arranged on the upper portion of the push plate on the upper portion of the cutting knife, and the nail bin guide piece can be attached to the inner wall of the nail bin cover in a relatively movable mode. Preferably, a nail bin cover groove is formed in the nail bin cover, an inclined pushing guide block is arranged on the inclined pushing block, and the inclined pushing guide block is arranged in the nail bin cover groove. Preferably, the head holder is provided with a head holder clamping block, and the head holder clamping block is clamped in a clamping groove formed in the connecting rod.
Preferably, the cutter bar comprises an excitation seat and a plurality of spring steel sheets connected and arranged on the excitation seat, and a cutter is arranged at the front end of each spring steel sheet; the excitation seat is provided with a compression joint groove and a clamping column for connecting the upper side and the lower side of the compression joint groove, the rear end of the spring steel sheet is in compression joint with the compression joint groove, and at least one part of the rear end of the spring steel sheet is provided with a clamping groove and is clamped around the clamping column through the clamping groove.
Preferably, the spring steel sheets connected and arranged on the excitation seat are provided with four spring steel sheets, at least one part of the rear ends of the four spring steel sheets is overlapped and pressed in the pressing groove, the rear ends of the two spring steel sheets positioned in the middle are provided with opening clamping grooves, and the opening clamping grooves are clamped around the clamping columns.
The anti-dropping and reliability of connection are guaranteed through the connection of the opening clamping grooves of the two spring steel sheets inside and the clamping columns, the two spring steel sheets outside can move axially relatively, so that the yield force can be reduced when all the spring steel sheets are connected in the clamping grooves and the clamping columns, the bending of the cutter bar is facilitated, and the design of the nail bin, the nail bin cover and the nail anvil into arc-shaped structures is facilitated. Because the other end, namely the front end of the spring steel sheet, is riveted and/or welded with the blade, under the condition that the length size of the spring steel sheet is certain, the structure can not only prevent the spring steel sheet from falling apart, but also ensure the bending property, so as to match the design of an arc structure.
Preferably, the two spring steel sheets in the middle have a corrugated structure. The spring steel sheet is convenient to bend. When the excitation seat is used for installing the endoscope cutting anastomat on an excitation handle (or an excitation rod or an excitation gun) for use, the excitation rod of the excitation handle pushes the excitation seat to drive the cutter bar to drive the cutter to move forwards so as to perform cutting operation. Meanwhile, the sewing operation is carried out by pushing a mechanism such as an inclined push block.
Preferably, the endoscope cutting anastomat further comprises an expander, the expander is of a round-head cylindrical structure, an expanding window is arranged on the expander, and the front portion of the endoscope cutting anastomat is arranged in the expander during surgery.
Preferably, the dilator is internally provided with a dilator inner plug which can be removed in a sliding way. In use, the dilator inner plug is firstly inserted into the dilator, and then the dilator is inserted into the anus or the vagina, so that the dilation window is positioned at the focus position. Then the inner plug of the dilator is drawn out, the position of the dilator is adjusted, the focus part is exposed in the dilation window, and the endoscope cutting anastomat is inserted into the dilator for operation. The larger diameter of the dilator and the dilated window provide a better intraoperative viewing field for ease of manipulation. After the technology provided by the invention is adopted, the endoscope cutting anastomat provided by the embodiment of the invention has the following beneficial effects:
1) the blade can be reliably locked before the excitation handle is assembled, so that false triggering is prevented; when the trigger handle is installed for operation, the locking mechanism can be conveniently detached, and the safety performance and the operation convenience of the cutting anastomat are greatly improved.
2) Compared with a linear type, the arc-shaped structure is more beneficial to being placed into the jaw, and the tissue positioning and operation are convenient to carry out. The straight line type can only cut and sew the tissues in the same direction, and the arc type can selectively cut and sew only partial tissues. In addition, the arc-shaped structure can adapt to the irregular shape of the rectum, and is more beneficial to deep operation.
3) Through expander (anus expander) and expansion window, can predetermine the focus position effectively, improve the convenience of confirming the focus tissue discernment when using to cavity mirror cutting anastomat operates in the expander that relative diameter is great, has better observation field of vision, promotes the accuracy nature of operation.
Drawings
Fig. 1 is an overall structure diagram of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 2 is an exploded view of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 3 is a view of the positioning convex rod position structure of the protective cover of the endoscopic cutting stapler according to the embodiment of the present application;
FIG. 4 is a block diagram of a protective cover of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 5 is a block diagram of a locking ring of the endoscopic cutting stapler according to an embodiment of the present application;
FIG. 6 is a block diagram of the locking ring at another angle of the endoscopic cutting stapler according to the embodiment of the present application;
FIG. 7 is a block diagram of a locking ring at another angle of the endoscopic cutting stapler according to an embodiment of the present application;
FIG. 8 is another perspective overall view of a laparoscopic cutting stapler according to an embodiment of the present application;
FIG. 9 is an exploded view of a staple cartridge and a staple anvil of the endoscopic cutting stapler according to the embodiment of the present application;
FIG. 10 is a block diagram of a forceps head of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 11 is an exploded view of a staple cartridge and an anvil at another angle of the laparoscopic cutting stapler of the present embodiment;
FIG. 12 is an exploded view of a staple cartridge and an anvil at another angle of the laparoscopic cutting stapler of the present embodiment;
FIG. 13 is a diagram of a bevel block of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 14 is a view of a tool bar of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 15 is a partial view of a tool bar of an endoscopic cutting stapler according to an embodiment of the present application;
FIG. 16 is a block diagram of an endoscopic cutting stapler dilator according to an embodiment of the present application;
fig. 17 is a schematic view of a laparoscopic cutting stapler dilator in use according to an embodiment of the present application. Wherein, the reason is
The structure of the endoscopic cutting anastomat is complex, and in a structural diagram partially showing relative positions, only parts which have the matching relation with related parts in the embodiment of the application are expressed, and other parts are omitted.
Description of reference numerals:
Crimp groove 230 jaw seat clamping block 50 ejector pin sheet 79
Nail anvil positioning plate 811 with nail bin guide sheet 672 of positioning convex rod 31
Locking ring piece 35 oblique push block 68 expander 9
Locking guide 351 pushes guide block 680 to expand window 90
Locking rod 352 nail bin 7 dilator inner plug 9
Push rod 4 magazine cover 70
Detailed Description
The present invention will be described in further detail with reference to embodiments shown in the drawings. The described embodiments include various specific details to aid understanding, but they are to be construed as merely illustrative, and not a full and partial description of the invention. Unless defined otherwise, technical or scientific terms used herein shall have the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. Meanwhile, in order to make the description more clear and concise, a detailed description of functions and configurations well known in the art will be omitted.
As shown in fig. 1-5.
An endoscope cutting anastomat comprises a main rod 11, an auxiliary rod 12 and a cutter bar 2, wherein the main rod 11 and the auxiliary rod 12 are oppositely arranged and combined into a hollow cylindrical structure, and the cutter bar 2 is movably arranged in the hollow cylindrical structure; a cylindrical connecting rod 10 is arranged outside the main rod 11 and the auxiliary rod 12, and a protective cover 3 is arranged outside the connecting rod 10; a plurality of cutter bar grooves 20 are formed in the cutter bar 2, a positioning convex rod 31 is arranged in the protective cover 3, and the positioning convex rod 31 penetrates through a hole formed in the connecting rod 10 and is inserted into one cutter bar groove 20 in the plurality of cutter bar grooves 20; a protective cover buckle 32 is also arranged in the protective cover 3; a push rod groove is formed in the main rod 11, a push rod 4 is arranged in the push rod groove, a push rod clamping piece 41 is arranged at the end part of the push rod 4, and at least one part of the push rod clamping piece 41 is clamped and pressed on the protective cover clamping buckle 32; a spring 42 is also arranged between the end part of the push rod 4 and the end part of the push rod groove.
The positioning convex rod 31 is inserted into the cutter bar groove 20 to limit the axial movement of the cutter bar 2, so that the cutter at the top end of the cutter bar 2 cannot be pushed out when the protective cover 3 is not removed, and misoperation is avoided. The radial movement and rotation of the protective cover 3 are restricted by the cooperation of the pusher card 41 and the protective cover catch 32. The matching of the positioning convex rod 31 and the protective cover buckle 32 limits the movement and the rotation of the protective cover 3, and can prevent the protective cover 3 from being separated from the connecting rod 10, thereby limiting the axial movement of the cutter bar 2. The spring 42 is used to hold the end of the pusher 4 so that the pusher card 41 is positioned over the protective cover catch 32. When the endoscope cutting anastomat is installed on an excitation handle (or an excitation rod or an excitation gun), the push rod 4 is pushed by a connecting part to compress the spring 42 to move forwards, so that the push rod clamping piece 41 moves out of the protective cover clamping buckle 32, the protective cover is unlocked and can be taken down from the connecting rod 10, the limitation of the positioning convex rod 31 on the cutter rod groove 20 is removed, and the cutter rod 2 can move under the excitation of the excitation rod. Through the arrangement of the mechanism, when the endoscope cutting anastomat is not correctly installed on the excitation handle, the excitation rod or the excitation gun, the protective cover cannot be taken down, so that misoperation is prevented. When the endoscope cutting anastomat is correctly installed on the excitation handle or the excitation rod or the excitation gun for use, the locking can be released under the action of the push rod, the protective cover is taken down, and the motion limitation on the cutter bar is released.
As shown in fig. 5-7.
The push rod 4 is also provided with a locking guide chute 43, and the cutter bar 2 is also provided with a cutter bar side groove 21; the locking mechanism is characterized in that a locking ring piece 35 is further arranged outside the main rod 11, a locking guide rod 351 and a locking rod 352 are arranged in the locking ring piece 35, the locking guide rod 351 is arranged in the locking guide chute 43, and the locking rod 352 penetrates through a notch formed in the main rod 11 and is embedded into the cutter bar side groove 21.
The locking guide chute 43 is inclined in such a direction that, when the push rod 4 is not pushed, the locking guide rod 351 is positioned at the front end of the locking guide chute 43, and the locking rod 352 passes through a notch formed in the main rod 11 and is inserted into the knife bar side groove 21; after the push rod 4 is pushed forward, the locking guide 351 is located at the rear end of the locking guide chute 43, and the locking ring piece 35 is guided to rotate until the locking lever 352 is disengaged from the blade bar side groove 21. The locking rod 352 may be configured to limit axial movement of the tool shaft 2 by providing a locking ring tab 35 and associated mechanisms. When the endoscope cutting anastomat is not correctly installed on the excitation handle or the excitation rod or the excitation gun, the push rod is not pushed, and the locking ring piece 35 locks the cutter bar side groove 21, so that misoperation is prevented. When the endoscope cutting anastomat is correctly arranged on the excitation handle or the excitation rod or the excitation gun for use, the locking can be released under the action of the push rod, the locking rod 352 is separated from the cutter bar side groove 21, and the motion limitation of the cutter bar is released. The reliability against the erroneous operation is further enhanced.
As described below in conjunction with fig. 8-13.
A forceps head seat 5 is arranged in the front end of the connecting rod 10, a through groove is formed in the forceps head seat 5, a cutter 6 is arranged at the front end of the cutter bar 2, and the cutter 6 is arranged in the through groove in a relatively movable manner; the jaw head seat 5 is further provided with a jaw head seat shaft 51, the jaw head seat shaft 51 is relatively rotatably provided with a nail bin cover 70 and a nail anvil 8, and the nail bin cover 70 is internally provided with a nail bin 7 in a clamping manner.
The nail bin 7, the nail bin cover 70 and the nail anvil 8 are of arc-shaped structures.
The magazine cover 70 and the anvil 8 are respectively provided with a magazine cover connection hole 701 and an anvil connection hole 801, and are respectively mounted on the bit holder shaft 51 through the magazine cover connection hole 701 and the anvil connection hole 801.
A nail anvil 81 is arranged in the nail anvil 8, and a nail anvil guide groove 82 is arranged between the nail anvil 81 and the bottom of the nail anvil 8; the lower part of the cutting knife 6 is provided with an anvil guide blade 682, and the anvil guide blade 682 is relatively movably arranged in the anvil guide slot 82.
The middle part of the nail chopping board 81 is provided with a cutter guide groove for the cutter 6 to move through. An anvil pushing spring 78 is arranged on the nail bin 7, and the other end of the anvil pushing spring 78 pushes against the nail anvil plate 81; the end of the nail anvil 8 is provided with a nail anvil positioning plate 811 which can contact with the main rod 11 when the nail anvil is pushed away. The upper part of the cutting knife 6 is provided with a push plate 67, the middle part of the nail bin 7 is provided with a nail pushing groove 71, and the nail pushing groove 71 is internally provided with an inclined push block 68 which is used for pushing a nail pushing sheet 79 to enable a suturing nail to be in pressure joint with the nail anvil 8 so as to suture tissue.
A nail bin guide sheet 672 is arranged on the upper portion of the push plate 67 on the upper portion of the cutting knife 6, and the nail bin guide sheet 672 can be attached to the inner wall of the nail bin cover 70 in a relatively movable mode.
The magazine cover 70 is provided with a magazine cover groove 702, the inclined push block 68 is provided with an inclined push guide block 680, and the inclined push guide block 680 is arranged in the magazine cover groove 702. The head holder 5 is provided with a head holder clamping block 50, and the head holder clamping block 50 is clamped in a clamping groove formed in the connecting rod 10.
As will be shown below in conjunction with figures 14 and 15.
The cutter bar 2 comprises an excitation seat 23 and a plurality of spring steel sheets 24 connected and arranged on the excitation seat 23, and a cutter 6 is arranged at the front end of each spring steel sheet 24; the excitation seat 23 is provided with a press connection groove 230 and a clamping column 231 for connecting the upper side and the lower side of the press connection groove 230, the rear end of the spring steel sheet 24 is press-connected in the press connection groove 230, and at least one part of the rear end of the spring steel sheet 24 is provided with a clamping groove and clamped around the clamping column 231 through the clamping groove. The four spring steel sheets 24 connected and arranged on the excitation seat 23 are provided, at least one part of the rear ends of the four spring steel sheets 24 is overlapped and pressed in the pressing groove 230, wherein the two spring steel sheets in the middle are
The rear end of the sheet 24 is provided with an opening slot, which is clamped around the clamping column 231. The anti-dropping and reliability of connection are guaranteed through the connection of the opening clamping grooves of the two spring steel sheets inside and the clamping columns, the two spring steel sheets outside can move axially relatively, so that the yield force can be reduced when all the spring steel sheets are connected in the clamping grooves and the clamping columns, the bending of the cutter bar 2 is facilitated, and the design of the nail bin 7, the nail bin cover 70 and the nail anvil 8 which are of arc-shaped structures is facilitated.
Because the other end, namely the front end of the spring steel sheet, is riveted and/or welded with the blade, under the condition that the length size of the spring steel sheet is certain, the structure can not only prevent the spring steel sheet from falling apart, but also ensure the bending property, so as to match the design of an arc structure.
The two spring steel sheets 24 in the middle are in a corrugated structure. The spring steel sheet is convenient to bend.
The excitation seat 23 is used for installing the endoscope cutting anastomat on an excitation handle (or an excitation rod or an excitation gun) for use, and the excitation rod of the excitation handle pushes the excitation seat 23 to drive the cutter bar 2 to drive the cutter 6 to move forwards so as to perform cutting operation. Meanwhile, the sewing operation is carried out by pushing a mechanism such as an inclined push block.
As will be shown below in conjunction with figures 16 and 17.
Still include expander 9, expander 9 is round head cylindrical structure, is equipped with expansion window 90 on the expander 9, and the anterior portion of chamber mirror cutting anastomat is located during the operation in expander 9. The dilator 9 is provided with a dilator inner plug 91 which can be removed in a sliding way. In use, the dilator inner plug 91 is first inserted into the dilator 9, and then the dilator 9 is inserted into the anus or vagina with the dilation window 90 located at the lesion site. Then the dilator inner plug 91 is drawn out, the position of the dilator 9 is adjusted, the focus part is exposed in the dilation window 90, and the endoscope cutting anastomat is inserted into the dilator 9 for operation. The larger diameter of dilator 9 and the expanded window 90 provide better intraoperative viewing for ease of manipulation.
According to the endoscope cutting anastomat, the front or back direction is that the working part of the endoscope cutting anastomat, namely the end where the cutter or the nail bin and the nail anvil are located, is the front end, and the end connected with the excitation handle is the back end unless otherwise specified.
According to the endoscope cutting anastomat, the blade can be reliably locked before the excitation handle is assembled, and false triggering is prevented; when the trigger handle is installed for operation, the locking mechanism can be conveniently detached, and the safety performance and the operation convenience of the cutting anastomat are greatly improved.
According to an endoscope cutting anastomat of this application, relative linear type, the arc structure more is favorable to putting into keeping silent, conveniently organizes location and operation. The straight line type can only cut and sew the tissues in the same direction, and the arc type can selectively cut and sew only partial tissues. In addition, the arc-shaped structure can adapt to the irregular shape of the rectum, and is more beneficial to deep operation.
According to the endoscope cutting anastomat, the focus position can be effectively determined in advance through the dilator (the anus dilator) and the expansion window of the dilator, the convenience of identifying and confirming focus tissues in use is improved, and the endoscope cutting anastomat operates in the dilator with the larger relative diameter, so that the endoscope cutting anastomat has a better observation visual field, and the accuracy of an operation is improved.
The terms "upper", "lower" or "above", "below" or the like are used herein in a relative relationship with respect to a normal use in a placed state, i.e., a positional relationship as generally shown in the drawings of the present application. When the placement state changes, for example, when the placement state is turned over, the corresponding positional relationship should be changed accordingly to understand or implement the technical solution of the present application.
Claims (9)
1. The endoscope cutting anastomat is characterized by comprising a main rod (11), an auxiliary rod (12) and a cutter bar (2), wherein the main rod (11) and the auxiliary rod (12) are oppositely arranged and combined into a hollow cylindrical structure, and the cutter bar (2) is movably arranged in the hollow cylindrical structure relatively; a cylindrical connecting rod (10) is arranged outside the main rod (11) and the auxiliary rod (12), and a protective cover (3) is arranged outside the connecting rod (10); a plurality of cutter bar grooves (20) are formed in the cutter bar (2), a positioning convex rod (31) is arranged in the protective cover (3), and the positioning convex rod (31) penetrates through a hole formed in the connecting rod (10) and is inserted into one cutter bar groove (20) of the cutter bar grooves (20); a protective cover buckle (32) is also arranged in the protective cover (3); a push rod groove is formed in the main rod (11), a push rod (4) is arranged in the push rod groove, a push rod clamping piece (41) is arranged at the end part of the push rod (4), and at least one part of the push rod clamping piece (41) is clamped and pressed on the protective cover buckle (32); a spring (42) is further arranged between the end part of the push rod (4) and the end part of the push rod groove, a locking guide chute (43) is further arranged on the push rod (4), and a cutter bar side groove (21) is further arranged on the cutter bar (2); the mobile jib is characterized in that a locking ring piece (35) is further arranged outside the mobile jib (11), a locking guide rod (351) and a locking rod (352) are arranged in the locking ring piece (35), the locking guide rod (351) is arranged in the locking guide chute (43), and the locking rod (352) penetrates through a notch formed in the mobile jib (11) and embedded into the side groove (21) of the cutter rod.
2. An endoscopic cutting stapler according to claim 1, wherein the inclined direction of the locking guide chute (43) is set such that, when the push rod (4) is not pushed, the locking guide rod (351) is located at the front end of the locking guide chute (43), and the locking rod (352) passes through the notch provided on the main rod (11) and is inserted into the knife bar side groove (21); after the push rod (4) is pushed forwards, the locking guide rod (351) is positioned at the rear end of the locking guide inclined groove (43), and the locking ring piece (35) is guided to rotate until the locking rod (352) is separated from the cutter rod side groove (21).
3. The endoscope cutting anastomat according to any one of claims 1 or 2, wherein a forceps head seat (5) is arranged in the front end of the connecting rod (10), a through groove is formed in the forceps head seat (5), a cutter (6) is arranged at the front end of the cutter rod (2), and the cutter (6) is arranged in the through groove in a relatively movable mode; the improved nail clipper is characterized in that a clipper head seat shaft (51) is further arranged on the clipper head seat (5), a nail bin cover (70) and a nail anvil (8) are arranged on the clipper head seat shaft (51) in a relatively rotating mode, and the nail bin (7) is arranged in the nail bin cover (70) in a clamping mode.
4. An endoscopic cutting stapler according to claim 3, characterized in that said cartridge (7), said cartridge cover (70) and said anvil (8) are of an arc-shaped configuration.
5. The endoscope cutting anastomat according to any one of claims 1 or 2, wherein the cutter rod (2) comprises an excitation seat (23) and a plurality of spring steel sheets (24) which are connected and arranged on the excitation seat (23), and a cutter (6) is arranged at the front end of each spring steel sheet (24); the excitation seat (23) is provided with a compression joint groove (230) and clamping columns (231) which connect the upper side and the lower side of the compression joint groove (230), the rear end of the spring steel sheet (24) is in compression joint with the compression joint groove (230), and the rear end of at least one part of the spring steel sheet (24) is provided with a clamping groove and is clamped around the clamping columns (231) through the clamping groove.
6. The endoscopic cutting stapler according to claim 5, wherein the number of the spring steel sheets (24) connected to the excitation base (23) is four, at least a part of the rear ends of the four spring steel sheets (24) are overlapped and pressed in the pressing groove (230), wherein the rear ends of the two spring steel sheets (24) in the middle are provided with open slots, and the open slots are clamped around the clamping column (231).
7. An endoscopic cutting stapler according to claim 6, wherein the two spring steel sheets (24) in the middle are corrugated.
8. An endoscopic cutting stapler according to any one of claims 1 or 2, further comprising a dilator (9), wherein the dilator (9) is a round cylindrical structure, a dilating window (90) is provided on the dilator (9), and the front part of the endoscopic cutting stapler is provided in the dilator (9) during surgery.
9. An endoscopic cutting stapler according to claim 8, wherein said dilator (9) is provided with a dilator inner plug (91) which can be removed by relative sliding.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911006634.7A CN110755122B (en) | 2019-10-22 | 2019-10-22 | Endoscope cutting anastomat |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911006634.7A CN110755122B (en) | 2019-10-22 | 2019-10-22 | Endoscope cutting anastomat |
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| CN110755122B true CN110755122B (en) | 2020-10-23 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN111904513A (en) * | 2020-09-07 | 2020-11-10 | 常州安康医疗器械有限公司 | Intracavity cutting anastomat with puncture head |
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| CN204364048U (en) * | 2014-12-30 | 2015-06-03 | 苏州天臣国际医疗科技有限公司 | A kind of Endo-GIA |
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| US5413268A (en) * | 1989-05-26 | 1995-05-09 | United States Surgical Corporation | Apparatus and method for placing stables in laparoscopic or endoscopic procedures |
| US6109500A (en) * | 1996-10-04 | 2000-08-29 | United States Surgical Corporation | Lockout mechanism for a surgical stapler |
| CN201668441U (en) * | 2010-04-01 | 2010-12-15 | 江苏瑞安贝医疗器械有限公司 | Safety mechanism of linear cutting stapler |
| CN202537568U (en) * | 2011-12-21 | 2012-11-21 | 常州市康迪医用吻合器有限公司 | Clamping hook of surgical linear cutting stapler |
| CN103860226B (en) * | 2012-12-18 | 2016-03-09 | 苏州天臣国际医疗科技有限公司 | Linear stapling cutter and anti-secondary firing lock thereof |
| CN107440759B (en) * | 2017-09-22 | 2023-04-07 | 江苏孜航精密五金有限公司 | Disposable endoscopic incision anastomat |
| CN208511086U (en) * | 2017-09-30 | 2019-02-19 | 常州安克医疗科技有限公司 | Operation on anus surgery auxiliary expansion instrument |
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|---|---|---|---|---|
| US5878938A (en) * | 1997-08-11 | 1999-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapler with improved locking mechanism |
| CN1957854A (en) * | 2005-11-04 | 2007-05-09 | 伊西康内外科公司 | Lockout mechanism and surgical instruments including same |
| CN101507643A (en) * | 2008-02-14 | 2009-08-19 | 伊西康内外科公司 | Surgical stapling apparatus with interlockable firing system |
| CN204364048U (en) * | 2014-12-30 | 2015-06-03 | 苏州天臣国际医疗科技有限公司 | A kind of Endo-GIA |
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| CN110755122A (en) | 2020-02-07 |
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Denomination of invention: A laparoscopic cutting stapler Granted publication date: 20201023 Pledgee: Bank of Jiangsu Co.,Ltd. Changzhou Branch Pledgor: CHANGZHOU ANKER MEDICAL TECHNOLOGY Co.,Ltd. Registration number: Y2024980005636 |
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