CN113967064A - Hot-melt welding knife capable of enhancing blood vessel sealing function - Google Patents
Hot-melt welding knife capable of enhancing blood vessel sealing function Download PDFInfo
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- CN113967064A CN113967064A CN202010231809.0A CN202010231809A CN113967064A CN 113967064 A CN113967064 A CN 113967064A CN 202010231809 A CN202010231809 A CN 202010231809A CN 113967064 A CN113967064 A CN 113967064A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00607—Coagulation and cutting with the same instrument
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00619—Welding
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- Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
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- Heart & Thoracic Surgery (AREA)
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Abstract
The invention discloses a hot-melting welding knife for enhancing a blood vessel sealing function, which comprises a forceps holder first working end provided with an electric heating device, a corresponding forceps holder second working end, a hinge part, a connecting rod, a control handle and a power supply, wherein a naked tissue cutting electric heating wire is arranged in the middle of a working surface of the forceps holder first working end along a longitudinal axis, blood vessel sealing electric heating wires with heat transfer sleeves are respectively arranged at two sides of the tissue cutting electric heating wires, the tissue cutting electric heating wires protrude outwards compared with the blood vessel sealing electric heating wires, and high-temperature resistant anti-adhesion materials are arranged outside the blood vessel sealing electric heating wires and the heat transfer sleeves thereof; a high-temperature resistant anti-adhesion insulating layer is tightly attached and arranged between the tissue cutting electric heating wire and the blood vessel sealing electric heating wire with the heat transfer sleeve and the working surface of the first working end of the forceps clamp; the area of the clamped tissue vessel is enlarged, the whole vessel sealing and tissue cutting operation is completed by one continuous inertia motion through the action of pressurized heat fusion welding, and the operation is simple, quick and efficient, and has the effect of preventing the cutter head from being adhered.
Description
Technical Field
The present invention belongs to an electric surgical equipment, in particular, it relates to an operation equipment for electric heating welding to seal blood vessel and cut tissue.
Background
Cutting and hemostasis are important steps in surgery. Modern medicine has numerous cutting methods and hemostatic techniques, but still fails to meet clinical needs. Electrosurgical techniques, for example, have evolved from cold blade techniques in order to improve efficiency and reduce bleeding and trauma. The most common electrosurgical devices are high-frequency monopolar electrosurgical devices and bipolar coagulation forceps, which are designed to pass high-frequency high-density current through the surgical site where the electrodes contact, thereby causing tissue to undergo high-temperature vaporization, cutting and thermal coagulation hemostasis. The monopolar electric knife has good cutting effect but poor hemostatic effect, and can cause some adverse reactions. For example: the high-temperature vaporization tissue can generate a large amount of harmful gas and cause large-scale heat damage by applying electric spark (high-frequency high-voltage current discharges between an electrode and the tissue to generate high-temperature plasma electric arc light); the high-voltage current of the high-frequency electrotome needs to pass through a human body and a negative plate loop which is in contact with the human body, so that the high-frequency electrotome is very easy to cause accidental injury of patients, particularly the patients with metal implants or pacemakers on the bodies, and is forbidden. The bipolar electrocoagulation high-frequency high-voltage current passes through the conductive tissue with certain impedance between the two electrodes to generate high temperature to coagulate tissue protein, has good hemostatic effect but poor cutting effect, and needs to be matched with a single-pole electric knife or a cold instrument (knife or scissors) to cut the tissue. The current density of bipolar coagulation is not easy to control, when the power is adjusted to be large and the contact area is small, high-temperature carbonization and charring of tissues can be generated, and the tissues are adhered to electrodes. When the power is reduced and the contact area is larger, the current density passing through the tissue is too small to reach the temperature required by the tissue protein coagulation, and the hemostatic effect is not good. There have been many prior art designs which have improved upon bipolar coagulation, such as the more recent U.S. patents US9861430, US9532829, US9610091, bipolar coagulation forceps which use radio frequency current to create a heat coagulation vessel seal in the clamped tissue, and mechanical means to move a tubular cutter included on the elongate shaft to cut the tissue. Another US patent 9,833,285 discloses sealing a blood vessel with a first energy and cutting tissue with a second energy on a bipolar forceps. The two corresponding working electrodes used to clamp the tissue mass generally do not produce a uniform thermal effect in the tissue, regardless of whether the clamped tissue is thin or very thick, as the radio frequency energy density in the tissue increases, the temperature rises, the moisture in the tissue evaporates and dehydrates, the surface dries, the resistance increases, the current and the electric power decrease, and the fusion welding effect is reduced. When the radio frequency voltage is increased and the tissue impedance is increased, local drying and charring of the tissue can be generated instantly, so that fusion welding sealing of blood vessels in the tissue is possibly nonuniform, and the hemostatic effect is not good. When the high voltage is electrified for a long time, the radio frequency current can also transversely diffuse from the clamped tissues in the working electrode, so that the tissues beside the clamp can generate larger thermal injury, and further adverse reactions and complications are generated. Accordingly, there remains a need for improved electrosurgical instruments and working ends that are currently used to fusion seal blood vessels and cut tissue by modern surgical and medical engineers. The laser technology can be used for cutting the tissue and solidifying and sealing the blood vessel, but the heat damage is large, the price is high, and the sealing effect on the large blood vessel is not good. Currently, the ultrasonic knife technology is mostly applied in clinical endoscopic surgery, such as US patent No. US9872699 and chinese application No. CN 200580034395. In ultrasonic tissue heaters, a very high frequency (ultrasonic) vibrating element and conductive metal rod are held in contact with the tissue. The rapid vibration generates heat, which causes the protein in the tissue to coagulate and decompose, achieving the purpose of hemostasis and cutting. The ultrasonic scalpel has good technical effect, but the required working time is longer, the heat damage is larger, the equipment material consumption is high, and the medical expense is increased.
US patents US6626901, US6860880, US6908463, US7211079, US7211080, US7588566, US8016820 disclose a series of electric heating devices and methods for closing and joining or cutting tissue. The device consists of two opposite working units with proximal and distal working surfaces, at least one of which has a resistive wire heating element on its surface for sealing and cutting tissue and a high temperature resistant insulating sleeve on its surface. The working unit can be forceps or forceps with two openable or closable holding arms or jaws for clamping the tissue and heating. When the tissue is heated above 100 degrees celsius, the tissue between the jaws or forceps is broken down and "cut". When the tissue is heated to 50 to 90 degrees celsius, the tissue is simply "sealed" or "welded" to the adjacent tissue. The device utilizes a combination of heat and pressure to fusion weld the adjacent tissues and minimize collateral tissue thermal damage. Chinese invention patent applications CN200920102971 and CN200620047879 are similar to the above patent technologies. US patents US7011656, US7329255, US7771424, US8100908, PCT patent application WO9838935 and Chinese patent applications CN200480040297 and CN200680014510, improved upon the above electrothermal devices and methods for fusion welding closed or cut tissue. The main improvement is that a heat conducting plate is added between the clamping surface of the first clamping arm and the resistance wire, and the heating distribution is improved. Another improvement is to change the resistance wire heating element to a metallized ceramic heating element. Such thermal bonded closed cutting devices are manufactured by Starion Instruments, california, currently converted to MICROLINE SURGICAL, inc, and are marketed in china under the name of electrothermal SURGICAL systems, commonly known as thermal knives. When the heat knife works, no current passes through human tissues, and the blood vessel closing and the tissue cutting are completed only by direct heat conduction and the pressure of the knife head. The wound is small and safe, can be used for open surgery and endoscopic surgery of multiple departments such as general surgery, extrasecretion, gynecology, extrathoracic surgery, otolaryngology, cardiovascular surgery and the like, can perform operations such as cutting, hemostasis, great vessel closure and the like, and is particularly suitable for tonsillectomy and radial artery and great saphenous vein extraction (for heart bypass). In this device, the resistance wire heating element is on one of the two opposing working unit surfaces of the forceps or tweezers, and the vessel to be occluded or cut is between the opposing working units of the electrodes. When the resistance wire is heated by electricity, the tissue blood vessel adjacent to the resistance wire is heated to a temperature exceeding 100 ℃, and the tissue protein structure is decomposed, so that the tissue blood vessel is cut at the position. On both sides of this "cutting zone", the tissue will only be heated to 50 to 90 degrees celsius. At this lower temperature, the tissue proteins denature and are thus welded together. The principle of such thermal welding is: when the two opposing working surfaces are properly pressed by mechanical action, the heat-denatured tissue therebetween "fuses" together, thereby creating a central "cutting zone" and two "sealing zones" effect. At these two closure zones, the ends of the vessel will be closed, corresponding to vessel ligation.
When heating on a resistance wire in direct contact with tissue, the actual heating temperature depends on the watt density of the resistance wire. To achieve higher local temperatures, high watt densities are required, particularly in the "cutting" temperature range (over 100 degrees celsius). Because of the limitations imposed by small, lightweight dc power supplies, smaller diameter resistance wires are required to achieve sufficiently high resistance and to produce high watt densities, particularly for tissue cutting temperatures. One disadvantage of using a small diameter resistance wire for tissue sealing and cutting is that the contact area between the resistance wire and the surrounding tissue is small, and heat from the resistance wire is applied to only a small area of the tissue, which is not conducive to sealing the severed end of the blood vessel. The tissue heating area should be increased to create a larger "seal" at the vessel end to ensure that the vessel remains sealed to stop bleeding. US patent US8,100,908 and chinese patent application CN200480040297 provide a way to add a heat conducting plate to solve the above problem. US7918848, US8961503 and US9636163, all based on the above technology of electrothermal welding, have devised a device which provides an efficient separation and extraction of the radial and great saphenous veins (for cardiac bypass) while ensuring minimal thermal damage to the surrounding tissues, while at the same time providing a safe vessel cutting and sealing. The invention comprises an elongated shaft having first and second relatively movable elongated jaws at a distal end thereof. The surface of the first jaw provides a first heating element for fusion welding the tissue to be sealed and a second heating element for severing the tissue. Chinese patent applications CN200510076125, CN201710025315.5, CN201380068384.4 and CN201380071755, U.S. patent US7329257 and the like disclose techniques in which a resistance pattern is formed on an insulating substrate, electricity is applied to generate heat, the heat is conducted to a clamped tissue through a heat transfer plate, and the tissue is cut with a metal blade after blood vessels are coagulated and sealed.
Commercial products such as electrothermal surgical systems produced according to the above patented technology still find many drawbacks and deficiencies in clinical applications. For example, the heat energy knife used for tonsil operation in otolaryngological department is in the shape of a lengthened gun-shaped forceps, the front end is straight and can not be opened, the tissue is clamped tightly, only the small part at the front end can contact the tissue in the operation process, the efficiency is low, and the effects of cutting the tissue and sealing the blood vessel are not good enough. Especially, when the tonsillar pole is reached in the operation, the forceps are not opened, and the hemostatic effect is not good when bleeding occurs. Another type of forceps used for laparoscopic surgery is relatively long and large, and is not suitable for tonsil or palatopharyngeal shaping surgery. In addition, the existing electrothermal energy operation system adopts an external low-voltage power supply for power supply, if the voltage is too low, the consumption proportion on a circuit is too large, and the power is insufficient when the voltage reaches an electrothermal element. If the voltage is increased, the resistance heating wire is thin, so that the resistance is increased, and the overlarge heating power is avoided. Too thin resistance heating wire can lead to the heating area not enough, and the heat is too concentrated, and it is not good to organize the fusion welding effect, and the blood vessel is not tightly closed, and resistance heating wire is overheated fragile. The existing electric hot-melt welding cutting device has another defect that the structure is too complex, particularly, two jaw parts at the front ends of the jaws need to be provided with movable joints, shaft rods, connecting rods, circuit lines and other devices, the size and the diameter need to be larger, and the device is easy to damage. Excessive bulk also affects delicate surgical procedures. The first heating element and the second heating element adopted for improving the fusion welding effect of the blood vessel need two circuit systems (if the first system is used for heating and sealing the blood vessel by radio frequency, and the second system is used for cutting tissues by a resistance heating wire), the structure is complex, and the operation action and the difficulty are increased. The existing similar technical products mostly adopt a first working end (arm) and a second working end (arm) structure with joints, and are added with circuits and heating elements, so that the design and the manufacture are very complicated. And because the opening and closing of the forceps holder working end (arm) with the joint form a certain angle, the tissue strength and thickness of the forceps holder are uneven, and the effect is influenced to a certain extent when tissue blood vessel heating fusion welding and cutting are carried out. In view of the above problems, the inventors previously filed 2 invention applications: a low temperature electric heat welding knife (application No. 201810222964.9), a clamp type electric heat welding knife (application No. 201910291420.2) to improve the problems.
Disclosure of Invention
In order to solve the problems in the prior art, the invention mainly aims to design a surgical instrument which can efficiently, simply and conveniently seal the blood vessel and cut the tissue in the surgical operation, namely a hot-melt welding knife for enhancing the blood vessel sealing function; thereby further enhancing the vessel sealing function in the operation.
The invention is realized by the following technical means:
the utility model provides an strengthen vascular function hot melt welding sword that seals, includes the first work end of pincers that is equipped with electric heating element, the pincers second work end that corresponds, articulated portion, connecting rod, brake valve lever and power, its characterized in that: the middle of the working surface of the first working end of the forceps clip is provided with a naked tissue cutting electric heating wire along the longitudinal axis, two sides of the tissue cutting electric heating wire are respectively provided with a blood vessel sealing electric heating wire with a heat transfer sleeve, the tissue cutting electric heating wire protrudes outwards compared with the blood vessel sealing electric heating wire, and the blood vessel sealing electric heating wire and the heat transfer sleeve are externally provided with high-temperature resistant anti-adhesion materials; a high-temperature resistant anti-adhesion insulating layer is tightly attached and arranged between the tissue cutting electric heating wire and the blood vessel sealing electric heating wire with the heat transfer sleeve and the working surface of the first working end of the forceps clamp; the far ends of the tissue cutting electric heating wire and the blood vessel sealing electric heating wire are connected in parallel at the far end of the first working end of the forceps holder and are electrically connected with the loop lead, and the near ends of the tissue cutting electric heating wire and the blood vessel sealing electric heating wire are electrically connected with the near end of the first working end of the forceps holder. When the cross-sectional areas and the lengths of 1 tissue cutting heating wire and 2 blood vessel sealing heating wires are equal, the currents passing through the heating wires in a parallel connection mode are equal, and the watt density and the heating power are equal. The tissue cutting electric heating wire is exposed, the heat effect of the tissue cutting electric heating wire is concentrated on the clamped narrow tissue, the fibrin of the tissue is heated and denatured, and the tissue is separated under the action of proper pressure extrusion to generate the cutting action. The heat transfer sleeve is externally added to the blood vessel sealing electric heating wire, the heat transfer sleeve is externally provided with a high temperature resistant anti-adhesion material, the heat effect of the heat transfer sleeve is uniformly distributed on a wider tissue clamped at two sides of the tissue cutting electric heating wire, and the tissue fibrin is heated and denatured to generate fusion welding sealing effect under the action of proper pressure extrusion. The temperature of the tissue cutting electric heating wire is high, about 200 ℃ to 300 ℃, the tissue cutting electric heating wire is not easy to adhere to the tissue, the tissue cutting electric heating wire can be exposed, and the heat effect conduction is good. The temperature of the heat transfer sleeve additionally arranged outside the blood vessel sealing electric heating wire is low, about 100 ℃ to 200 ℃, the heat transfer sleeve is easy to adhere to tissues, and a high-temperature resistant anti-adhesion material is required to be additionally arranged. The tissue cutting electric heating wire protrudes outwards compared with the blood vessel sealing electric heating wire, so that the pressure extrusion to the tissue is increased, and the separation and cutting effects are generated. The second working end of the forceps holder and the first working end of the forceps holder have the same structure, and a loop lead of the forceps holder is connected with a lead of the first working end of the forceps holder in parallel at the hinged part through a flexible structure lead and then connected with a power interface through a lead and a power switch. The connecting rod between the first working end of the forceps holder and the second working end of the forceps holder and the control handle is composed of an inner sleeve and an outer sleeve which can move back and forth mutually, the far end of the inner sleeve is fixedly connected with the first working end of the forceps holder provided with an electric heating wire, the far end of the outer sleeve is movably connected with the second working end of the forceps holder with a joint, a trigger which enables the inner sleeve to move back and forth relative to the outer sleeve is arranged on the control handle, and the inner sleeve moves back and forth relative to the outer sleeve and is linked with the joint and the hinged part to enable the first working end of the forceps holder and the second working end of the forceps holder to be clamped or opened mutually. The forceps holder first working end and the forceps holder second working end are rigidly connected with the corresponding first forceps handle, the second forceps handle, the first ring and the second finger ring through hinge parts, the near ends of the tissue cutting electric heating wire and the blood vessel sealing electric heating wire are welded or clamped and fastened with the near end of the forceps holder first working end, and the far end is connected with a low-impedance lead at the far end turning back side of the forceps holder first working end. The wire is clung to the back of the first working end of the forceps holder through a high-temperature-resistant insulating material and is electrically connected with the positive electrode of a direct-current power supply interface arranged at the positions of the first forceps handle and the first ring, the negative electrode of the direct-current power supply interface is electrically connected with the metal near end of the first working end of the forceps holder through a power switch, and an indicator lamp and a buzzer are arranged on the power switch and the direct-current power supply interface. The heating wire is a high-impedance metal wire, preferably a cr20ni80 nickel-chromium alloy heating wire, the section of the tissue cutting heating wire is pentagonal, triangular, semicircular or circular, preferably pentagonal, the vertex angle is 90-120 degrees, preferably 110 degrees, the arc polishing is carried out, the bottom side length is 0.4-1 mm, the diameter of the semicircle or the circle is 0.2-0.4 mm, the section of the blood vessel sealing heating wire is circular, the diameter is 0.2-0.4 mm, the length of the tissue cutting heating wire is 10-30 mm, the bottom surface of the tissue cutting heating wire is tightly attached to a high-temperature-resistant insulating material on the working surface of the first working end of the forceps holder, and the vertex angle of the pentagonal or triangular, and the semicircular or circular protruding surface face the working surface of the second working end of the arc forceps holder. A thin layer of high-temperature-resistant insulating material is arranged between the blood vessel sealing electric heating wire and the heat transfer sleeve, and the heat transfer sleeve can be made of a metal material with better heat conduction, such as: copper, aluminum or stainless steel, the thin layer of high temperature resistant insulating material can be directly made of the oxide layer of the metal material, the high temperature resistant insulating material on the surface of the heat transfer sleeve can be made of polytetrafluoroethylene, and the high temperature resistant insulating material tightly adhered between the tissue cutting electric heating wire, the blood vessel sealing electric heating wire with the heat transfer sleeve, the lead and the working surface of the first working end of the forceps holder is ceramic, silica gel or polytetrafluoroethylene, and is prefabricated into a sleeve shape or other special shapes. The low-impedance lead is made of single-stranded or multi-stranded metal wires and is made into a flat belt shape or a cylindrical shape, the back face of the first working end of the forceps holder and the prefabricated groove of the first forceps handle are pasted by high-temperature insulating glue, a high-temperature-resistant insulating sleeve can be sleeved outside the high-temperature-resistant insulating sleeve, the hollow pipeline prefabricated by the first working end of the forceps holder and the first forceps handle passes through the high-temperature-resistant insulating sleeve, one end of the high-temperature-resistant insulating sleeve is connected with the electric heating wire, and the other end of the high-temperature-resistant insulating sleeve is connected with the direct-current power supply interface. The first working end of the forceps holder is detachably connected with the hinge part and the first forceps handle, the detachable connection adopts a bolt type or a nut type, and the first working end of the forceps holder is provided with a positioning bayonet for preventing the first working end of the forceps holder from axially rotating and an electric connection socket of a lead. The power supply is supplied by an adjustable direct current power supply externally provided with an isolation transformer and a rectifying circuit, and is provided with a voltage and current adjusting knob, the input voltage is 220V alternating current, the output voltage is 0-12V adjustable direct current, the direct current is 0-15A adjustable direct current, a positive output interface and a negative output interface of the power supply are respectively connected with a positive electrode and a negative electrode of a direct current power supply interface of the hot-melting welding knife with the enhanced blood vessel sealing function through connecting wires and plugs, a display screen for outputting voltage, current and power is arranged on a panel of the direct current power supply, and the whole machine meets the medical safety standard.
The power supply can adopt a medical low-voltage isolation transformer to output a low-voltage direct-current power supply, the power supply voltage is 0-12V, and the current is 0-15A. The device is provided with a control circuit and a foot switch, can select continuous power-on current output or intermittent power-on current output, and has good intermittent power-on blood vessel sealing effect and good continuous power-on cutting effect. The cutting and coagulation working states can be indicated and displayed by different sound and light. The circuit of the invention is designed into an extra-low voltage direct current circuit which is far lower than the safety voltage specified by the state, and no current passes through human tissues when in use, so that the parts of the instrument contacted with the human body do not need to be insulated and isolated particularly, and accidental thermal injury can not occur as long as short circuit does not occur. Is safer, simpler and more practical than other types of electrosurgical devices.
The invention has the advantages that the blood vessel sealing area of the clamped tissue is enlarged, and the blood vessel sealing and hemostasis effect is obviously improved through the action of pressurized hot melt welding. The circuit and the mechanical design are simple and reliable, when the tissue with rich blood vessels is clamped or the blood vessels with larger size are clamped directly, the switch is started, the tissue cutting electric heating wire and the blood vessel sealing electric heating wire with the heat transfer sleeve are electrified and heated at the same time, the blood vessels are fully welded and sealed by the blood vessel sealing electric heating wires with the heat transfer sleeve at the two sides of the tissue cutting electric heating wire, the tissue is cut off and separated by the tissue cutting electric heating wire along the midline, the whole operation of blood vessel sealing and tissue cutting is completed by one continuous and inertial motion, the operation is simple, fast and efficient, and the effect of preventing the cutter head from being adhered is achieved.
Drawings
Fig. 1 is a schematic view of an embodiment of a gun-type structure according to the present invention.
FIG. 2 is a schematic view of a pincer structure according to an embodiment of the present invention
Figure 3 is a cross-sectional view of the first and second working ends of the jaws of the present invention.
Fig. 4 is a cross-sectional view of another embodiment of the jaws of the present invention with the first working end and the second working end.
Figure 5 is a cross-sectional view of another embodiment of the first working end and the second working end of the jaws of the present invention.
Figure 6 is a perspective cross-sectional view of a first working end of a jaw of the present invention.
Fig. 7 is a perspective, cross-sectional view of another embodiment of the jaws of the present invention at the first working end thereof.
Fig. 8 is a schematic view of a first working end circuit of a clamp according to the present invention.
Detailed Description
The following describes embodiments of the present invention in further detail with reference to the accompanying drawings.
In order to specifically understand the technical solutions provided by the present invention, the technical solutions of the present invention will be described and illustrated in detail in the following examples. It is apparent that the embodiments provided by the present invention are not limited to the specific details familiar to those skilled in the art. The following detailed description of the preferred embodiments of the invention is intended to provide further embodiments of the invention in addition to those described herein.
Referring to fig. 1, 2, 3, 4, 5, 6, 7 and 8, the embodiment of the present invention relates to a hot-melt welding knife with enhanced vessel sealing function, which comprises a first working end 13 of a jaw provided with an electric heating device, a second working end 14 of a corresponding jaw, a hinge portion 15, a connecting rod 16, a control handle 17 and a power source 20, and is characterized in that: the center of the working surface of the first working end 13 of the forceps holder is provided with a naked tissue cutting electric heating wire 6 along the longitudinal axis, two sides of the tissue cutting electric heating wire 6 are respectively provided with a blood vessel sealing electric heating wire 7 with a heat transfer sleeve 8, the tissue cutting electric heating wire 6 protrudes outwards compared with the blood vessel sealing electric heating wire 7, and the blood vessel sealing electric heating wire 7 and the heat transfer sleeve 8 thereof are externally provided with a high-temperature resistant anti-adhesion material 9; a high-temperature resistant anti-adhesion insulating layer 3 is tightly attached and arranged between the tissue cutting electric heating wire 6 and the blood vessel sealing electric heating wire 7 with the heat transfer sleeve 8 and the working surface 4 of the first working end 13 of the forceps holder; the distal ends of the tissue cutting heating wire 6 and the blood vessel sealing heating wire 7 are connected in parallel at the distal end of the first working end 13 of the forceps holder and electrically connected with the loop wire 5, and the proximal ends of the tissue cutting heating wire 6 and the blood vessel sealing heating wire 7 are electrically connected with the proximal end of the working surface 4 of the first working end 13 of the forceps holder. When the cross section area and the length of the one tissue cutting electric heating wire 6 and the two blood vessel closed electric heating wires 7 on the two sides of the one tissue cutting electric heating wire are equal, the current passing through the tissue cutting electric heating wire is equal by adopting a parallel connection mode, and the watt density and the heating power are also equal. The electric heating wire 6 for tissue cutting is exposed, the heat effect is concentrated on the clamped narrow tissue, the fibrin of the tissue is heated and denatured, and the tissue is separated under the action of proper pressure extrusion to generate the cutting action. The blood vessel sealing electric heating wire 7 is externally provided with a heat transfer sleeve 8, the heat transfer sleeve 8 is externally provided with a high temperature resistant anti-adhesion material 9, the heat effect of the high temperature resistant anti-adhesion material is uniformly distributed on the wider tissue clamped at the two sides of the tissue cutting electric heating wire 6, and the tissue fibrin is heated and denatured to generate fusion welding sealing effect under the action of proper pressure extrusion. As shown in fig. 3, 4 and 5, the vessel wall 2 and the open vessel cavity 1 generate fusion welding sealing effect under the action of the pressurizing and heating of the vessel sealing heating wire 7 externally provided with the heat transfer sleeve 8, and a wider vessel sealing end 10 is formed. In the center of the two closed ends 10 of the blood vessel, a cutting separation effect is generated by the higher temperature and the higher pressure of the tissue cutting heating wire 6. The tissue cutting electric heating wire 6 has high temperature of about 200 to 300 ℃, is not easy to adhere to the tissue, can be exposed and has good heat effect conduction. The temperature of the blood vessel sealing electric heating wire 7 and the heat transfer sleeve 8 is low, about 100 ℃ to 200 ℃, the blood vessel sealing electric heating wire is easy to adhere to tissues, and a high-temperature resistant anti-adhesion material 9 is required to be arranged outside the blood vessel sealing electric heating wire. The tissue cutting heating wire 6 protrudes outwards compared with the blood vessel sealing heating wire 7 so as to increase the pressure extrusion to the tissue and generate the separation and cutting function. The section area and the length of the tissue cutting electric heating wire 6 and the two blood vessel sealing electric heating wires 7 at the two sides thereof can be properly adjusted according to the needs so as to meet the operation needs of different parts.
In another embodiment, the second working end 14 of the jaw and the first working end 13 of the jaw have the same structure, as shown in fig. 4, the loop wire is connected in parallel with the wire of the first working end 13 of the jaw at the hinge portion 15 through a flexible structure wire, and then connected with the power interface 20 through the wire 5 and the power switch 18. The embodiment applies pressure and heat to both sides of the clamped blood vessel or the tissue rich in the blood vessel, so that the tissue cutting and blood vessel sealing efficiency of the hot-melt welding knife with the function of enhancing blood vessel sealing can be improved. In the embodiment of the hot-melt welding knife (as shown in fig. 1) adopting the robbing type enhanced blood vessel sealing function, the connecting rod 16 between the first working end 13 of the forceps holder and the second working end 14 of the forceps holder and the control handle 17 is composed of an inner sleeve and an outer sleeve which can move back and forth, the distal end of the inner sleeve is fixedly connected with the first working end 13 of the forceps holder provided with an electric heating wire, the distal end of the outer sleeve is movably connected with the second working end 14 of the forceps holder with a joint, the control handle 17 is provided with a trigger which enables the inner sleeve to move back and forth relative to the outer sleeve, and the inner sleeve moves back and forth relative to the outer sleeve and is linked through the joint and the hinge part 15 to enable the first working end 13 of the forceps holder and the second working end 14 of the forceps holder to be clamped or opened.
In the embodiment (as shown in fig. 2) of the hot-melt welding knife with the forceps-type blood vessel sealing enhancement function, the first working end 13 and the second working end 14 of the forceps holder are rigidly connected with the corresponding first forceps handle, the second forceps handle, the first finger ring and the second finger ring through the hinge portion 15, the proximal ends of the tissue cutting heating wire 6 and the blood vessel sealing heating wire 7 are welded or clamped and fastened with the proximal end of the first working end 13 of the forceps holder, and the distal end is connected with the low-impedance lead 5 by turning to the back side at the distal end of the first working end 13 of the forceps holder. The lead 5 is clung to the back of the first working end 13 of the forceps holder through a high-temperature-resistant insulating material and is electrically connected with the positive electrode of a direct-current power supply interface 20 arranged at the positions of the first forceps handle and the first ring, the negative electrode of the direct-current power supply interface 20 is electrically connected with the metal near end of the first working end 13 of the forceps holder through a power switch 18, and an indicator light and a buzzer 19 are arranged on the power switch 18 and the direct-current power supply interface 20. The above examples may also refer to 2 invention applications previously filed by the inventors: a low-temperature electric hot welding knife (application No. 201810222964.9), a clamp type electric hot welding knife (application No. 201910291420.2). The heating wire described in the embodiments is a high-resistance wire, preferably cr20ni80 nichrome heating wire, the tissue cutting heating wire 6 has a cross section in a pentagon, triangle, semicircle or circle shape, preferably a pentagon shape, a vertex angle of 90 ° to 120 °, preferably 110 ° with arc polishing, a bottom side of 0.4 to 1mm, and a diameter of the semicircle or circle of 0.2 to 0.4 mm. When the section of the tissue cutting electric heating wire 6 is selected to be pentagonal or triangular, the pressure intensity generated on the clamped tissue can be improved, and the tissue cutting and separation are facilitated. The section of the blood vessel sealing electric heating wire 7 is circular, the diameter is 0.2-0.4 mm, the length of the tissue cutting electric heating wire 6 is 10-30 mm, the bottom surface of the blood vessel sealing electric heating wire is tightly attached to the high-temperature resistant insulating material 3 on the working surface 4 of the first working end 6 of the forceps holder, and one surface of the pentagonal or triangular vertex angle, the semicircular or circular protrusion faces the working surface of the second working end 14 of the forceps holder. A thin layer of high-temperature-resistant insulating material is arranged between the blood vessel sealing electric heating wire 7 and the heat transfer sleeve 8, and the heat transfer sleeve 8 can be made of a metal material with better heat conduction, such as: copper, aluminum or stainless steel, and the thin high-temperature-resistant insulating material can be directly an oxide layer of the metal material. Since the voltage on the blood vessel sealing heating wire 7 is very low (the voltage drop between the front and back is about 3 to 5 volts), when the heating wire 7 and the heat transfer sleeve 8 are subjected to high-temperature oxidation treatment in advance, the oxide layer formed between the blood vessel sealing heating wire 7 and the heat transfer sleeve 8 can sufficiently exert a corresponding insulation effect. The heat transfer jacket 8 can also be designed as in the embodiment of fig. 7, pressed from a thin metal tube which conducts heat better. The high temperature resistant insulating material 9 on the surface of the heat transfer sleeve 8 can be made of polytetrafluoroethylene, the tissue cutting electric heating wire 6, the blood vessel sealing electric heating wire 7 with the heat transfer sleeve 8 and the high temperature resistant insulating material tightly adhered between the lead 5 and the working surface of the first working end 13 of the clamp can be made of ceramic, silica gel or polytetrafluoroethylene, and a complete set of tubular shapes or other special shapes are prefabricated. The low-impedance lead 5 is made of single-stranded or multi-stranded metal wires, preferably copper or silver alloy, is made into a flat belt shape or a cylindrical shape, is pasted on the back of the first working end 13 of the clamp and the prefabricated groove of the first clamp handle by high-temperature insulating glue, can be sheathed with a high-temperature-resistant insulating sleeve, passes through the prefabricated hollow pipeline of the first working end 13 of the clamp and the first clamp handle, and has one end connected with the electric heating wire and the other end connected with the direct-current power supply interface 20. The first working end 13 of the forceps holder is detachably connected with the hinge part 15 and the first forceps handle, the detachable connection adopts a bolt type or a nut type, and the first working end 13 of the forceps holder is provided with a positioning bayonet for preventing the axial rotation of the first working end 13 of the forceps holder and an electric connection socket of a lead 5. The power supply is supplied by an adjustable direct current power supply externally provided with an isolation transformer and a rectifying circuit, and is provided with a voltage and current adjusting knob, the input voltage is 220V alternating current, the output voltage is 0-12V adjustable direct current, the direct current is 0-15A adjustable direct current, a positive output interface and a negative output interface of the power supply are respectively connected with a positive electrode and a negative electrode of a direct current power supply interface of the hot-melting welding knife with the enhanced blood vessel sealing function through connecting wires and plugs, a display screen for outputting voltage, current and power is arranged on a panel of the direct current power supply, and the whole machine meets the medical safety standard. The power supply is provided with a control circuit and a foot switch, continuous power-on current output or intermittent power-on current output can be selected, the intermittent power-on blood vessel sealing effect is good, and the continuous power-on cutting effect is good. The cutting and coagulation working states can be indicated and displayed by different sound and light. The circuit of the invention is designed into an extra-low voltage direct current circuit which is far lower than the safety voltage specified by the state, and no current passes through human tissues when in use, so that the parts of the instrument contacted with the human body do not need to be insulated and isolated particularly, and accidental thermal injury can not occur as long as short circuit does not occur. Is safer, simpler and more practical than other types of electrosurgical devices.
The invention has the advantages that the closed area of the blood vessel of the clamped tissue is enlarged, and the tissue fusion welding effect is generated by pressurizing and heating, so that the blood vessel closing and bleeding stopping effect is obviously improved. The circuit and the mechanical design are simple and reliable, when the hot-melting welding knife with the enhanced blood vessel sealing function is used, after rich tissues in blood vessels are clamped by the working face 4 of the first working end 13 of the clamp and the working face 11 of the second working end 14 of the clamp with the high-temperature-resistant anti-adhesion insulating layer 12 or thick blood vessels are directly clamped by the clamp, the switch is started, the tissue cutting heating wire 6 and the blood vessel sealing heating wire 7 with the heat transfer sleeve 8 are simultaneously electrified for heating, the blood vessel sealing heating wires 7 with the heat transfer sleeve 8 on the two sides of the tissue cutting heating wire 6 are used for fully performing fusion welding sealing on the blood vessels, the tissue is cut and separated by the tissue cutting heating wire 6 along the midline, the whole blood vessel sealing and tissue cutting operation is completed by one continuous and inertial motion, and the operation is simple, fast and efficient, and has the effect of preventing the knife head from adhesion.
Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; such modifications and substitutions do not depart from the spirit and scope of the present invention, and they should be construed as being included in the following claims and description.
Claims (10)
1. The utility model provides an strengthen vascular function hot melt welding sword that seals, includes the first work end of pincers that is equipped with electric heating element, the pincers second work end that corresponds, articulated portion, connecting rod, brake valve lever and power, its characterized in that: the middle of the working surface of the first working end of the forceps clip is provided with a naked tissue cutting electric heating wire along the longitudinal axis, two sides of the tissue cutting electric heating wire are respectively provided with a blood vessel sealing electric heating wire with a heat transfer sleeve, the tissue cutting electric heating wire protrudes outwards compared with the blood vessel sealing electric heating wire, and the blood vessel sealing electric heating wire and the heat transfer sleeve are externally provided with high-temperature resistant anti-adhesion materials; a high-temperature resistant anti-adhesion insulating layer is tightly attached and arranged between the tissue cutting electric heating wire and the blood vessel sealing electric heating wire with the heat transfer sleeve and the working surface of the first working end of the forceps clamp; the far ends of the tissue cutting electric heating wire and the blood vessel sealing electric heating wire are connected in parallel at the far end of the first working end of the forceps holder and are electrically connected with the loop lead, and the near ends of the tissue cutting electric heating wire and the blood vessel sealing electric heating wire are electrically connected with the near end of the first working end of the forceps holder.
2. The hot melt welding knife with the function of enhancing the vessel sealing function as claimed in claim 1, wherein: the second working end of the forceps holder and the first working end of the forceps holder have the same structure, and a loop lead of the forceps holder is connected with a lead of the first working end of the forceps holder in parallel at the hinged part through a flexible structure lead and then connected with a power interface through a lead and a power switch.
3. A hot-melt welding knife with the function of enhancing the vessel sealing function according to claim 1 or 2, characterized in that: the connecting rod between the first working end of the forceps holder and the second working end of the forceps holder and the control handle is composed of an inner sleeve and an outer sleeve which can move back and forth mutually, the far end of the inner sleeve is fixedly connected with the first working end of the forceps holder provided with an electric heating wire, the far end of the outer sleeve is movably connected with the second working end of the forceps holder with a joint, a trigger which enables the inner sleeve to move back and forth relative to the outer sleeve is arranged on the control handle, and the inner sleeve moves back and forth relative to the outer sleeve and is linked with the joint and the hinged part to enable the first working end of the forceps holder and the second working end of the forceps holder to be clamped or opened mutually.
4. A hot-melt welding knife with the function of enhancing the vessel sealing function according to claim 1 or 2, characterized in that: the forceps holder first working end and the forceps holder second working end are rigidly connected with the corresponding first forceps handle, the second forceps handle, the first ring and the second finger ring through hinge parts, the near ends of the tissue cutting electric heating wire and the blood vessel sealing electric heating wire are welded or clamped and fastened with the near end of the forceps holder first working end, and the far end is connected with a low-impedance lead at the far end turning back side of the forceps holder first working end.
5. The hot melt welding knife with the function of enhancing the vessel sealing function as claimed in claim 4, wherein: the wire is clung to the back of the first working end of the forceps holder through a high-temperature-resistant insulating material and is electrically connected with the positive electrode of a direct-current power supply interface arranged at the positions of the first forceps handle and the first ring, the negative electrode of the direct-current power supply interface is electrically connected with the metal near end of the first working end of the forceps holder through a power switch, and an indicator lamp and a buzzer are arranged on the power switch and the direct-current power supply interface.
6. A hot-melt welding knife with the function of enhancing the vessel sealing function according to claim 1 or 2, characterized in that: the heating wire is a high-impedance metal wire, preferably a cr20ni80 nickel-chromium alloy heating wire, the section of the tissue cutting heating wire is pentagonal, triangular, semicircular or circular, preferably pentagonal, the vertex angle is 90-120 degrees, preferably 110 degrees, the arc polishing is carried out, the bottom side length is 0.4-1 mm, the diameter of the semicircle or the circle is 0.2-0.4 mm, the section of the blood vessel sealing heating wire is circular, the diameter is 0.2-0.4 mm, the length of the tissue cutting heating wire is 10-30 mm, the bottom surface of the tissue cutting heating wire is tightly attached to a high-temperature-resistant insulating material on the working surface of the first working end of the forceps holder, and the vertex angle of the pentagonal or triangular, and the semicircular or circular protruding surface of the forceps holder face the working surface of the second working end.
7. The hot melt welding knife with the function of enhancing the blood vessel sealing as claimed in claim 6, wherein: a thin layer of high-temperature-resistant insulating material is arranged between the blood vessel sealing electric heating wire and the heat transfer sleeve, and the heat transfer sleeve can be made of a metal material with better heat conduction, such as: copper, aluminum or stainless steel, the thin layer of high temperature resistant insulating material can be directly made of the oxide layer of the metal material, the high temperature resistant insulating material on the surface of the heat transfer sleeve can be made of polytetrafluoroethylene, and the high temperature resistant insulating material tightly adhered between the tissue cutting electric heating wire, the blood vessel sealing electric heating wire with the heat transfer sleeve, the lead and the working surface of the first working end of the forceps holder is ceramic, silica gel or polytetrafluoroethylene, and is prefabricated into a sleeve shape or other special shapes.
8. A hot-melt welding knife with the function of enhancing the vessel sealing function according to claim 1 or 2, characterized in that: the low-impedance lead is made of single-stranded or multi-stranded metal wires, preferably copper or silver alloy, is made into a flat belt shape or a cylindrical shape, is pasted on the back of the first working end of the forceps holder and the prefabricated groove of the first forceps handle by high-temperature insulating glue, can be sheathed with a high-temperature-resistant insulating sleeve, passes through the first working end of the forceps holder and the prefabricated hollow pipeline of the first forceps handle, has one end connected with the electric heating wire and has the other end connected with a direct-current power supply interface.
9. A hot-melt welding knife with the function of enhancing the vessel sealing function according to claim 1 or 2, characterized in that: the first working end of the forceps holder is detachably connected with the hinge part and the first forceps handle, the detachable connection adopts a bolt type or a nut type, and the forceps holder is provided with a positioning bayonet for preventing the first working end of the forceps holder from axially rotating and an electric connection socket of a wire.
10. The hot melt welding knife with the function of enhancing the blood vessel sealing function according to claim 8, wherein: the power supply adopts an adjustable direct current power supply externally provided with an isolation transformer and a rectifying circuit, and is provided with a voltage and current adjusting knob, the input voltage is 220V alternating current, the output voltage is 0-12V adjustable direct current, the direct current is 0-15A adjustable direct current, a positive output interface and a negative output interface of the power supply are respectively connected with the positive electrode and the negative electrode of a direct current power supply interface of the hot-melt welding knife for enhancing the blood vessel sealing function through connecting wires and plugs, and a display screen for outputting the voltage, the current and the power is arranged on a panel of the direct current power supply.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010231809.0A CN113967064A (en) | 2020-03-27 | 2020-03-27 | Hot-melt welding knife capable of enhancing blood vessel sealing function |
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| CN202010231809.0A CN113967064A (en) | 2020-03-27 | 2020-03-27 | Hot-melt welding knife capable of enhancing blood vessel sealing function |
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