CN114451944B - Surgical instrument and nail bin assembly thereof - Google Patents
Surgical instrument and nail bin assembly thereof Download PDFInfo
- Publication number
- CN114451944B CN114451944B CN202210122724.8A CN202210122724A CN114451944B CN 114451944 B CN114451944 B CN 114451944B CN 202210122724 A CN202210122724 A CN 202210122724A CN 114451944 B CN114451944 B CN 114451944B
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- China
- Prior art keywords
- cartridge
- surgical instrument
- clamping plate
- staple
- nail bin
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- 239000000463 material Substances 0.000 claims description 5
- 229920001296 polysiloxane Polymers 0.000 claims description 3
- 239000012858 resilient material Substances 0.000 claims 1
- 239000002699 waste material Substances 0.000 abstract description 3
- 210000001519 tissue Anatomy 0.000 description 68
- 239000012636 effector Substances 0.000 description 22
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 6
- 229910052719 titanium Inorganic materials 0.000 description 6
- 239000010936 titanium Substances 0.000 description 6
- 230000005540 biological transmission Effects 0.000 description 5
- 230000000694 effects Effects 0.000 description 4
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 3
- 230000003872 anastomosis Effects 0.000 description 3
- 238000013016 damping Methods 0.000 description 3
- 238000010304 firing Methods 0.000 description 3
- 239000000741 silica gel Substances 0.000 description 3
- 229910002027 silica gel Inorganic materials 0.000 description 3
- 230000006378 damage Effects 0.000 description 2
- 239000007943 implant Substances 0.000 description 2
- 210000004185 liver Anatomy 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 230000000451 tissue damage Effects 0.000 description 2
- 231100000827 tissue damage Toxicity 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 239000003086 colorant Substances 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 239000013013 elastic material Substances 0.000 description 1
- 239000013536 elastomeric material Substances 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 238000002054 transplantation Methods 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
Classifications
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses a surgical instrument and a nail bin assembly thereof, and belongs to the field of medical instruments. The staple cartridge assembly includes: the nail bin is internally provided with a chute suitable for the movement of the cutting knife, and the chute extends from the proximal end to the distal end of the nail bin and divides the nail bin into a first area and a second area; a plurality of nail outlet holes are formed in a first area of the nail bin and used for accommodating a nail driver, and an opening is formed in a second area of the nail bin; a clamping plate movably connected to the second region of the staple cartridge, one side of the clamping plate away from the staple cartridge for engaging tissue; and the pushing part comprises a first pushing part and a second pushing part, when the pushing part moves from the proximal end to the distal end of the nail bin, the first pushing part pushes the staples in the staple driver to move into tissues outside the nail bin along the staple outlet, and the second pushing part pushes the clamping plate to clamp the tissues. The invention solves the problem of waste of transplanted tissue caused by the condition that the traditional surgical anastomat is used for transplanting operation.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a surgical instrument and a nail bin assembly thereof.
Background
The surgical anastomat is used as a surgical instrument for cutting and suturing tissues, and the main working principle is that the titanium nails are used for separating and anastomosing the tissues, so that bleeding from soft tissues can be reduced or eliminated in the process of cutting the tissues. A surgical stapler includes a handle assembly, a transport assembly, and an end effector. Wherein, the end effector includes nail storehouse subassembly, supports nail seat and cutting knife, is provided with the spout that can make the cutting knife pass through on the nail storehouse in the nail storehouse subassembly, is provided with trigger, button or the push button that is used for controlling the cutting knife on the handle subassembly. When the device works, tissues are placed between the nail bin assembly and the nail propping seat, the nail propping seat of the end effector is pivoted to the side of the nail bin assembly to clamp the tissues by pulling the trigger, and after the tissues are clamped, the push button is triggered to control the cutting knife to move along the sliding groove of the nail propping seat so as to cut off the tissues; simultaneously, the suture nail driver implants titanium nails positioned at two sides of the nail bin into the tissue to realize tissue suture.
At present, the nail bins of the surgical anastomat are of symmetrical structures, the cutting knife is centered, and two or three rows of titanium nails are distributed left and right. When the surgical anastomat is used for transplanting operations, such as liver transplantation, tissue is taken from a healthy liver donation human body through the anastomat, titanium nails are arranged on two sides of a cutting knife of a nail bin, so that the side of the tissue to be implanted is also provided with the stitching nails, and the portion of the healthy tissue with the stitching nails is required to be cut off before implantation, so that the waste of limited resources is caused.
Disclosure of Invention
The invention aims to solve the technical problem that the prior surgical stapler causes the waste of transplanted tissues when being used for the transplanting operation.
Aiming at the technical problems, the invention provides the following technical scheme:
a staple cartridge assembly of a surgical instrument, comprising: the nail bin is internally provided with a chute suitable for moving the cutting knife, and the chute extends from the proximal end to the distal end of the nail bin and divides the nail bin into a first area and a second area; a plurality of nail outlet holes are formed in a first area of the nail bin and used for accommodating a nail driver, and an opening is formed in a second area of the nail bin; a clamping plate movably connected to the second region of the staple cartridge, wherein a side of the clamping plate away from the staple cartridge is used for being matched with tissue; the pushing part comprises a first pushing part positioned in a first area of the nail bin and a second pushing part positioned in a second area of the nail bin, when the pushing part moves from the proximal end to the distal end of the nail bin, the first pushing part pushes the staples in the staple driver to move into tissues outside the nail bin along the staple outlet, and the second pushing part pushes the clamping plate to clamp the tissues.
In some embodiments of the present invention, a buffer member is disposed between the clamping plate and the second pushing portion, and the second pushing portion acts on the clamping plate through the buffer member when moving along the proximal end to the distal end of the cartridge.
In some embodiments of the present invention, the buffer portions of the buffer member are in one-to-one correspondence with the positions of the staple discharging holes of the staple cartridge, so that the first pushing portion pushes the staple driver while the second pushing portion pushes the buffer portion.
In some embodiments of the present invention, the buffer member includes a spring extending along a length direction of the clamping plate, where the spring includes a plurality of buffer portions and connection portions sequentially arranged, the connection portions are abutted to the clamping plate, and a buffer gap is formed between the buffer portions and the clamping plate.
In some embodiments of the present invention, the buffer portion is formed as an arc-shaped piece, a wedge-shaped piece, or a trapezoid-shaped piece protruding toward the cartridge side.
In some embodiments of the invention, the cushioning member comprises a plurality of cushioning blocks coupled to the clamping plate, the cushioning blocks being formed of an elastomeric material.
In some embodiments of the present invention, the buffer block is formed as a hemispherical bump protruding toward the cartridge side.
In some embodiments of the invention, the cushioning member is fixedly attached to a side of the clamping plate proximate the staple cartridge.
In some embodiments of the present invention, the cushioning member is attached to the second region of the staple cartridge.
In some embodiments of the present invention, the clamping plate has at least one limiting rib on a side surface near the staple cartridge, the limiting rib extends along a length direction of the clamping plate, and the limiting rib is inserted into the opening in the second area of the staple cartridge, and limits a maximum movement position of the clamping plate relative to the staple cartridge through a limiting structure.
In some embodiments of the present invention, the limiting structure includes a snap protrusion disposed on the limiting rib and a limiting step surface disposed on the lower side of the opening of the nail bin; when the clamping plate moves in the direction away from the nail bin, the limiting step surface stops the buckle bulge from moving.
In some embodiments of the present invention, the buffer member is connected to the stop rib.
In some embodiments of the present invention, the side of the clamping plate facing away from the staple cartridge has a lower surface than the side of the first region of the staple cartridge facing away from the staple cartridge.
In some embodiments of the present invention, the plate surface of the clamping plate far away from the side of the nail bin is provided with a plurality of protruding parts.
In some embodiments of the present invention, the pushing portion includes a pushing slider, where the pushing slider includes a connecting plate, and two wedge blocks disposed on the connecting plate at intervals, and the first pushing portion and the second pushing portion are respectively formed.
In some embodiments of the present invention, a stop is disposed between two wedge blocks of the pushing slide, the cutting knife is pushed against a proximal end of the stop, and when the cutting knife slides from the proximal end to the distal end of the chute, the pushing slide is pushed against the stop to move synchronously with the cutting knife.
In some embodiments of the present invention, the cartridge further comprises a cartridge base, wherein the cartridge is detachably connected to the cartridge base.
In some embodiments of the invention, the splint is an elastic sheet of material that is adaptively tissue compressible.
The present invention also provides a surgical instrument comprising: above-mentioned nail storehouse subassembly and support the nail seat, support the nail seat can relative the nail storehouse subassembly pivot or the nail storehouse subassembly can relative support the nail seat pivot.
In some embodiments of the present invention, the nail propping seat includes a nail propping shell, and a first seat body and a second seat body located in the nail propping shell, wherein the first seat body is matched with a first area of the nail bin, and the second seat body is matched with a second area of the nail bin, wherein a surface of the second seat body is coated with silica gel.
In some embodiments of the present invention, the exposed portion of the cartridge assembly and/or the staple supporting seat is provided with a mark for indicating the area where the staples are located.
Compared with the prior art, the technical scheme of the invention has the following technical effects:
in the surgical instrument and the nail bin assembly thereof provided by the invention, a movable clamping plate is arranged in a region on one side of the nail bin assembly, no stitching nails are arranged on the clamping plate side, when the pushing part moves from the proximal end to the distal end of the nail bin, the stitching nails in the first pushing part positioned in the first region of the nail bin push the stitching nails in the tissue outside the nail bin along the nail outlet holes, and the second pushing part positioned in the second region of the nail bin push the clamping plate to clamp the tissue. So that one side of the cut tissue is sealed by stitching, the other side is not stitched, the unstitched tissue can be directly subjected to the transplanting operation, and the problem that the tissue is wasted due to the fact that the titanium nails are cut at the side when the tissue stitched at the two sides is subjected to the transplanting operation is avoided.
Drawings
The objects and advantages of the present invention will be better understood by describing in detail preferred embodiments thereof with reference to the accompanying drawings in which:
FIG. 1 is a schematic view of one embodiment of a surgical instrument of the present invention;
FIG. 2 is a schematic view of one embodiment of an end effector of the surgical instrument of the present invention;
FIG. 3 is an exploded view of one embodiment of an end effector of the surgical instrument of the present invention;
FIG. 4 is a schematic view of the structure of one embodiment of a staple cartridge of the surgical instrument of the present invention;
FIG. 5 is a schematic view of the structure of one embodiment of the pushing portion of the surgical instrument of the present invention;
FIG. 6 is a perspective and front view of one embodiment of a splint of the surgical instrument of the present invention;
FIG. 7 is a rear view of one embodiment of a staple cartridge of the surgical instrument of the present invention;
FIG. 8 is an assembly view of one embodiment of a clamping plate and cushioning member of a surgical instrument of the present invention;
FIG. 9 is an enlarged partial view of a cushioning member of the surgical instrument of the present invention;
FIG. 10 is a schematic view of an embodiment of a staple holder of a surgical instrument of the present invention;
FIG. 11 is a schematic view of an embodiment of a staple holder of a surgical instrument of the present invention.
Detailed Description
The following description of the embodiments of the present invention will be made apparent and fully in view of the accompanying drawings, in which some, but not all embodiments of the invention are shown. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In the description of the present invention, it should be noted that the directions or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. are based on the directions or positional relationships shown in the drawings, are merely for convenience of describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, it should be noted that, unless explicitly specified and limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be either fixedly connected, detachably connected, or integrally connected, for example; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
In addition, the technical features of the different embodiments of the present invention described below may be combined with each other as long as they do not collide with each other.
In various embodiments of the present invention, "distal" refers to the end of the surgical instrument that is distal from the operator when operated, and "proximal" refers to the end/side of the surgical instrument that is proximal to the operator when operated.
Fig. 1 is a schematic view of a specific embodiment of a surgical instrument 100 provided by the present invention. The illustrated embodiment is an endoscopic instrument and, in general, an example of a surgical instrument 100 described herein is an endoscopic surgical cutting anastomosis instrument. However, it should be noted that the surgical instrument may also be a non-endoscopic surgical cutting anastomosis instrument, such as an open surgical instrument for open surgery.
Specifically, fig. 1 illustrates a surgical instrument 100 that includes a handle assembly 10, a transmission assembly 20, and an end effector 30. Wherein the handle assembly 10 is adapted to allow an operator to manipulate the surgical instrument, the handle assembly 10 may control movement of the end effector via the transmission assembly 20 to perform surgical procedures, such as clamping/closing, stapling/stapling, cutting, etc. of tissue. The handle assembly 10 includes a handle body 12 that may be capable of being grasped by a user in a conventional manner. In a specific embodiment, the surgical instrument is manipulated by trigger 11 to close and fire the end effector; in one embodiment, the surgical instrument can also be used for controlling the end effector to close and fire by pushing a button, a push button and the like on a handle so as to enable the end effector to perform cutting and stitching operations; in one embodiment, the surgical instrument can also be operated to open the jaws of the end effector by means of a trigger, push button, or the like provided on the handle to release tissue. The transmission assembly 20 is elongate and tubular in shape defining a longitudinal axis C, the transmission assembly 20 transmitting the driving force of the handle to the distal end of the surgical instrument.
One embodiment of an end effector 30 of the present invention is shown in fig. 2 and 3. The end effector 30 includes a cartridge assembly 31 and a anvil 32 coupled to a distal end of the delivery assembly 20, the cartridge assembly 31 and anvil 32 being relatively closeable to form a jaw for grasping tissue. In a particular embodiment, the abutment 32 of the end effector 30 can pivot toward the cartridge assembly 31 until the jaws of the end effector 30 are closed to grasp tissue; the abutment 32 is pivoted away from the cartridge assembly 31 until the jaws of the end effector 30 are opened to release tissue. In yet another specific embodiment, the cartridge assembly 31 of the end effector 30 can be pivoted toward the abutment 32 until the jaws of the end effector 30 are closed to grasp tissue.
Referring now to fig. 3 and 4, which illustrate one embodiment of the cartridge assembly 31 of the present invention, the cartridge assembly 31 includes a cartridge 312, and the cartridge 312 is driven by the delivery assembly 20 for operation. The cartridge assembly 31 further includes a cartridge mount 311, the cartridge mount 311 being coupled to the delivery assembly 20, and a cartridge 312 as a disposable component that is detachably coupled within the cartridge mount 311. In other alternative embodiments, the cartridge mount 311 of the cartridge assembly 31 is fixedly connected to the cartridge 312 or integrally formed therewith, and is detachably connected to the delivery assembly 20 as a component.
With continued reference to fig. 3, the cartridge base 311 is formed into an open housing structure with a U-shaped or semicircular cross section, which is connected to the distal end of the transmission assembly 20, and the cartridge 312 is inserted into the cartridge base 311 by fastening or the like. The cartridge 312 is shaped as an elongated seat extending along the longitudinal axis C of the surgical instrument, a side of which remote from the cartridge base 311 is adapted to engage tissue, and a contact surface of the cartridge 312 adapted to engage tissue is provided with a chute 312a extending along the proximal to distal end of the cartridge 312, the chute 312a being adapted for the passage of a cutting knife 33 to cut tissue clamped between the contact surface and the abutment 32 along the proximal to distal end of the cartridge 312. In an alternative embodiment, the chute 312a is located at a middle position of the upper surface of the staple cartridge 312; the staple cartridge 312 is divided by the chute 312a into a first region a and a second region b. The first area a of the staple cartridge 312 is provided with a plurality of staple outlets 312b, the staple outlets 312b are arranged along the longitudinal axis C of the staple cartridge 312, and one, two, three or more rows may be provided according to different surgical conditions; the staple ejection hole 312b is configured to accommodate a staple 314 and a staple driver 313, and the staple driver 313 is provided with the staple 314 on a side facing the staple ejection hole 312 b; staple drivers 313 can implant staples 314 into tissue to effect stapling. The second region b of the cartridge 312 has an opening 312c where no stapling mechanism (e.g., staples or sutures, etc.) is located at the opening 312 c.
The cartridge assembly 31 further comprises a clamping plate 315 movably connected to the second region b of the cartridge 312, the clamping plate 315 being located on the side of the opening 312c and communicating with the inside of the cartridge 312 through the opening 312c, a side surface of the clamping plate 315 remote from the cartridge 312 being adapted to engage tissue.
The cartridge assembly 31 further includes a pusher portion 316 movable along the proximal to distal end of the cartridge 312 under the influence of a drive mechanism, including a first pusher portion 316 located in a first region a of the cartridge 312 and a second pusher portion 316 located in a second region b of the cartridge 312. When the user activates the firing trigger, button, or push button on the handle assembly 10, the pushing portion 316 moves proximally to distally along the staple cartridge 312, the first pushing portion 316 pushes the staples 314 in the staple drivers 313 along the staple exit holes 312b into the tissue outside of the staple cartridge 312, and the second pushing portion 316 pushes the clamping plate 315 to clamp the tissue. So that one side of the cut tissue is sealed by stitching, and the other side is not stitched, so that the unstitched tissue can be directly subjected to the transplanting operation, and the problem that the tissue is wasted due to the fact that the titanium nails are cut when the tissue stitched at two sides is subjected to the transplanting operation is avoided.
The surgical instrument is operated by placing tissue between the cartridge assembly 31 and the abutment 32, and pulling the trigger 11 of the handle assembly 10, the abutment 32 pivots toward the cartridge assembly 31 or the cartridge assembly 31 pivots toward the abutment 32 until the jaws of the end effector 30 are closed to clamp the tissue; triggering a trigger, firing button or push button on the handle assembly 10 to move a firing member (comprising a cutting knife 33 and a pushing portion 316) located within the cartridge assembly 31 along the proximal to distal end of the end effector to effect tissue cutting and stapling of tissue on one side thereof; finally, the open button on the handle assembly 10 is actuated, and the staple cartridge 32 is pivoted away from the staple cartridge assembly 31 or the staple cartridge assembly 31 is pivoted away from the staple cartridge 32, opening the jaws of the end effector 30, releasing tissue.
Referring to fig. 3, the cartridge assembly 31 further includes a pushing rail 318, the pushing portion 316 slides along the pushing rail 318, the pushing portion 316 is a pushing slider, as shown in fig. 5, the pushing slider includes a connecting plate 3161, the connecting plate 3161 is slidably matched with the pushing rail 318, the pushing slider further includes two wedge blocks disposed on the connecting plate 3161 at intervals, and the first pushing portion 3163 and the second pushing portion 3162 are respectively formed. The pushing block 3164 is disposed between the two wedge blocks, the cutter 33 is pushed against the proximal end of the block 3164, and when the cutter 33 slides along the proximal end to the distal end of the chute 312a, the pushing block 3164 is pushed to enable the pushing block and the cutter 33 to move synchronously.
Referring to fig. 7, the clamping plate 315 and the staple cartridge 312 are movably mounted and fixed by adopting the following specific structure. The clamping plate 315 is provided with at least one limiting rib 315a on a side surface close to the nail bin 312, the limiting rib 315a extends along the length direction of the clamping plate 315, the opening 312c of the nail bin 312 in the second area b is formed into a strip-shaped opening 312c, the width of the strip-shaped opening is slightly larger than that of the limiting rib 315a, two ends of the limiting rib 315a are provided with buckling protrusions 315b, the width of the limiting rib 315a at the buckling protrusions 315b is slightly larger than that of the strip-shaped opening 312c, and when the clamping plate is installed, the limiting rib 315a of the clamping plate 315 is integrally inserted into the inner side of the opening 312c through deformation of a part area of the strip-shaped opening 312c, so that the clamping plate 315 and the nail bin 312 are fixed.
To define the maximum protruding position of the clamping plate 315 relative to the staple cartridge 312, in an alternative embodiment, the staple cartridge assembly 31 further includes a limiting structure including the snap protrusion 315b disposed on the limiting rib 315a and a limiting step surface 312d disposed on the lower side of the opening 312c of the staple cartridge 312, where in the initial state, the limiting step surface 312d and the snap protrusion 315b have a set gap, and when the clamping plate 315 moves in a direction away from the staple cartridge 312, the limiting step surface 312d can block the snap protrusion 315b to limit the clamping plate 315 to move further toward the tissue side, thereby protecting the tissue from being damaged by the clamping plate 315 and preventing the clamping plate 315 from being separated from the staple cartridge 312.
In order to avoid damage to the tissue caused by excessive pressing force of the clamping plate 315 on the tissue during the movement of the pushing portion 316, in an alternative embodiment, a buffer member 317 is disposed between the clamping plate 315 and the second pushing portion 3162, and the acting force of the clamping plate 315 on the tissue is kept stable by the buffer member 317 when the second pushing portion 3162 moves along the proximal end to the distal end of the staple cartridge 312.
Since the first pushing portion 3163 acts on the staple driver 313 and the second pushing portion 3162 acts on the clamping plate 315 through the buffer member 317 when the pushing portion 316 moves, in order to avoid the uneven stress of the pushing portion 316 from tilting, in an alternative embodiment, the buffer portion 317a of the buffer member 317 corresponds to the position of the staple hole 312b of the staple cartridge 312 one by one, so that the first pushing portion 3163 pushes the staple driver 313 and the second pushing portion 3162 pushes the buffer portion 317a at the same time, and further, the reaction force acting on the first pushing portion 3163 and the second pushing portion 3162 is substantially consistent, so that the problem that the stapling effect of the staples 314 is poor due to the tilting of the pushing portion 316 is avoided. More specifically, in order to further substantially conform the stress conditions of the first pushing portion 3163 and the second pushing portion 3162, the first pushing portion 3163 and the second pushing portion 3162 are formed into a wedge-shaped block having a substantially uniform shape, and the second pushing portion 3162 is smaller than the first pushing portion 3163 as a whole, that is, the top of the second pushing portion 3162 is lower than the top of the first pushing portion 3163. The buffer portion 317a of the buffer member 317 has an inclined portion along its length direction, which can be engaged with the inclined surface of the wedge, and the inclined portion may be a straight surface or an arc surface, and the maximum deformation position of the inclined portion engaged with the second pushing portion 3162 is consistent with the position of the first pushing portion 3163 where the maximum displacement of the staple driver 313 is located.
A specific structure of the buffer member 317 is specifically shown with reference to fig. 9. The buffer member 317 includes a spring extending along the length direction of the clamping plate 315, the spring has a buffer portion 317a and a connection portion 317b sequentially arranged along the length direction, the connection portion 317b is a flat plate-shaped sheet, the extension surfaces of adjacent connection portions 317b are on the same plane, and the buffer portion 317a is an arc-shaped sheet, a wedge-shaped sheet or a trapezoid-shaped sheet protruding toward the side away from the clamping plate 315. The inclined planes of the wedge-shaped thin sheets and the trapezoid thin sheets are matched with the inclined planes of the wedge-shaped blocks.
In an alternative embodiment, the damping member 317 includes a plurality of damping blocks coupled to the clamping plate 315, the damping blocks being made of an elastic material, such as elastic rubber. Specifically, the positions of the buffer blocks respectively correspond to the positions of the nail outlet holes 312b in the first area a of the nail bin 312, and the buffer blocks may be fixed on the inner side surface of the clamping plate 315 by bonding or other fixing connection. More specifically, the buffer block is formed as a hemispherical protrusion protruding toward the cartridge 312 side or an arc or wedge-shaped protrusion of other similar shape to make the movement of the inclined surface of the second pushing portion 3162 smoother in sliding engagement therewith.
The mounting connection manner of the buffer member 317 is not unique, specifically, in one embodiment, the buffer member 317 is directly connected to the clamping plate 315; as shown in fig. 8, the buffer member 317 is connected to the stopper rib 315 a. More specifically, the buffer member 317 is a spring, the spring is provided with a jack 317c on the connection portion 317b, a plurality of connection posts 315c are correspondingly disposed on the limit rib 315a, and the spring is tightly matched with the connection posts 315c through the jack 317c to achieve connection and fixation with the clamping plate 315.
In another embodiment, the buffer member 317 is fixedly connected to the staple cartridge 312; the buffer member 317 is formed as the above-mentioned spring, two ends of the spring are fixed on the housing of the proximal end and the distal end of the staple cartridge 312, the main body of the spring is located at the opening 312c of the second area b of the staple cartridge 312, the connecting portion 317b of the spring abuts against the clamping plate 315, and the second pushing portion 3162 acts on the clamping plate 315 through the spring.
To further reduce tissue damage during cutting of the surgical instrument, in an alternative embodiment, the clamping plate 315 is a resilient sheet material that is adaptively compressible to tissue, for example, the clamping plate 315 may be a resilient sheet of medium durometer silicone material; alternatively, the clamping plate 315 may be a plate material with a surface coated with a silicone layer. As shown in fig. 6, the clamping plate 315 is provided with a plurality of protruding parts 315d on a side surface matched with the tissue, and the protruding parts 315d are preferably arc-shaped protruding parts, so that on one hand, friction force between the clamping plate and the tissue can be increased, and slippage of the tissue relative to the end effector 30 when the tissue is cut can be reduced; on the other hand, the curved convex surface is smooth and has less damage to the tissue when contacting the tissue.
In an alternative embodiment, the plate surface of the side of the clamping plate 315 away from the staple cartridge 312 is lower than the upper surface of the first region a of the staple cartridge 312, preferably, the height difference a between the two is 0-3mm, and preferably, the height difference a between the two is 0.5-1.5mm. So that when the tissue cutting and anastomosis operation is performed, the clamping force is lower than the clamping force of the side of the stitching nails when the non-stitched side clamps the pressed tissue, and the tissue in the second area b is slightly pressed, so that the tissue is less damaged or not damaged, and the tissue to be transplanted is fully protected.
As shown in fig. 10, the nail propping seat 32 includes a nail propping shell 321, and a first seat body 322 and a second seat body 323 located in the nail propping shell 321, the first seat body 322 is matched with a first area a of the nail bin 312, the second seat body 323 is matched with a second area b of the nail bin 312, wherein a plurality of nail buds 322a are arranged on the surface of the first seat body 322, the nail buds 322a are in one-to-one correspondence with positions of the nail outlet holes 312b on the nail bin 312, and when the tissues are anastomosed, the staples 314 in the nail outlet holes 312b are propped against the nail buds 322 a. The surface of the second seat 323 is coated with a silica gel layer 323a, which can fully protect tissues to avoid tissue damage due to the elasticity of the silica gel.
To facilitate the physician's determination of which specific portion of the cartridge assembly is the portion of the cartridge where the staples 314 are disposed and which portion is the portion of the cartridge where the staples 314 are not disposed, the exposed portions of the cartridge assembly 31 and/or the abutment 32 are provided with indicia for indicating the area in which the staples 314 are disposed.
In an alternative embodiment, the exposed side of the nail supporting seat 32 is provided with a stitching mark or a non-stitching mark, as shown in fig. 11, the exposed portion of the first seat body 322 of the nail supporting seat 32 is provided with a stitching mark 324, so that a doctor can determine which portion of tissue is stitched, and misuse is prevented. In particular, the suture tag 324 may be an initial shape of the suture 314, a shape of the suture formation, a graphic/image of tissue suturing, and the like. Or, the exposed part of the second seat 323 of the nail-abutting seat 32 is provided with a non-stitching mark, so that a doctor can determine that the part of tissue is not stitched, and misuse is prevented. In particular, the non-stitched indicia may be various colors, alert indicia, graphics/graphics that are tissue non-stitched, and the like.
In another alternative embodiment, the exposed portion of the cartridge assembly 31 is provided with stitching and/or non-stitching indicia. Specifically, the distal-most portion of the cartridge 312 has an exposed beveled portion and/or a side of the cartridge base 311 remote from the abutment 32 provided with the above-mentioned stapling and/or non-stapling indicia.
It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. While obvious variations or modifications are contemplated as falling within the scope of the present invention.
Claims (21)
1. A staple cartridge assembly for a surgical instrument, comprising:
the nail bin is internally provided with a chute suitable for moving the cutting knife, and the chute extends from the proximal end to the distal end of the nail bin and divides the nail bin into a first area and a second area; a plurality of nail outlet holes are formed in a first area of the nail bin and used for accommodating a nail driver, and an opening is formed in a second area of the nail bin;
a clamping plate movably connected to the second region of the staple cartridge, wherein a side of the clamping plate away from the staple cartridge is used for being matched with tissue;
the pushing part comprises a first pushing part positioned in a first area of the nail bin and a second pushing part positioned in a second area of the nail bin, when the pushing part moves from the proximal end to the distal end of the nail bin, the first pushing part pushes the staples in the staple driver to move into tissues outside the nail bin along the staple outlet, and the second pushing part pushes the clamping plate to clamp the tissues.
2. The surgical instrument cartridge assembly of claim 1, wherein a cushioning member is disposed between the clamping plate and the second pusher portion, the second pusher portion acting upon the clamping plate via the cushioning member as it moves along the proximal to distal end of the cartridge.
3. The surgical instrument cartridge assembly of claim 2, wherein the cushioning portion of the cushioning member corresponds one-to-one with the staple cartridge staple ejection hole locations such that the first pushing portion pushes the staple driver while the second pushing portion pushes the cushioning portion.
4. The surgical instrument cartridge assembly of claim 3, wherein the cushioning member comprises a spring extending along a length of the clamping plate, the spring comprising a plurality of cushioning portions and connecting portions arranged in sequence, wherein the connecting portions abut against the clamping plate, and a cushioning gap is provided between the cushioning portions and the clamping plate.
5. The surgical instrument cartridge assembly of claim 4, wherein said bumper is shaped as an arcuate, wedge or trapezoidal tab projecting toward said cartridge side.
6. A surgical instrument cartridge assembly according to claim 3, wherein the cushioning member comprises a plurality of cushioning blocks connected to the clamping plate, the cushioning blocks being formed of a resilient material.
7. The surgical instrument cartridge assembly of claim 6, wherein said bumper is shaped as a hemispherical protrusion protruding toward said cartridge side.
8. The surgical instrument cartridge assembly of claim 2, wherein said cushioning member is fixedly attached to a side of said clamping plate proximate said cartridge.
9. The surgical instrument cartridge assembly of claim 2, wherein said cushioning member is coupled to a second region of said cartridge.
10. The surgical instrument cartridge assembly of claim 2, wherein said clamping plate has at least one stop rib on a side proximate said cartridge, said stop rib extending along a length of said clamping plate, said stop rib being inserted into said opening in said second region of said cartridge and limiting a maximum movement position of said clamping plate relative to said cartridge by a stop structure.
11. The surgical instrument cartridge assembly of claim 10, wherein the stop feature comprises a snap tab disposed on the stop bar and a stop step surface disposed on an underside of the opening of the cartridge; when the clamping plate moves in the direction away from the nail bin, the limiting step surface stops the buckle bulge from moving.
12. The surgical instrument cartridge assembly of claim 10, wherein said cushioning member is coupled to said stop bar.
13. The surgical instrument cartridge assembly of claim 1, wherein a side of the clamping plate facing away from the cartridge is lower than a surface of the first region of the cartridge facing away from the cartridge.
14. The surgical instrument cartridge assembly of claim 1, wherein the deck of the side of the clamping plate remote from the cartridge is provided with a plurality of bosses.
15. The surgical instrument cartridge assembly of claim 1, wherein the pusher comprises a pusher block comprising a web and two wedge blocks spaced apart on the web, the first pusher and the second pusher being formed, respectively.
16. The surgical instrument cartridge assembly of claim 15, wherein the pusher shoe defines a stop between the two wedge blocks, the cutting blade being urged against the proximal end of the stop, the cutting blade sliding along the proximal to distal end of the chute, the pushing of the stop causing the pusher shoe to move in unison with the cutting blade.
17. The surgical instrument cartridge assembly of claim 1, further comprising a cartridge mount, wherein the cartridge is removably coupled to the cartridge mount.
18. The surgical instrument cartridge assembly of claim 1, wherein said clamping plate is an elastic sheet material that is adaptively tissue compressible.
19. A surgical instrument, comprising:
the cartridge assembly of any one of claims 1-18 and a staple holder, said staple holder being pivotable relative to said cartridge assembly or said cartridge assembly being pivotable relative to said staple holder.
20. The surgical instrument of claim 19, wherein the staple holder comprises a staple holder housing and a first and a second holder disposed within the staple holder housing, the first holder being mated with a first region of the staple cartridge and the second holder being mated with a second region of the staple cartridge, wherein a surface of the second holder is coated with a silicone.
21. A surgical instrument as claimed in claim 19, wherein the exposed portion of the cartridge assembly and/or the abutment is provided with indicia for indicating the area of staples.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
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| CN202210122724.8A CN114451944B (en) | 2022-02-09 | 2022-02-09 | Surgical instrument and nail bin assembly thereof |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202210122724.8A CN114451944B (en) | 2022-02-09 | 2022-02-09 | Surgical instrument and nail bin assembly thereof |
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| CN114451944A CN114451944A (en) | 2022-05-10 |
| CN114451944B true CN114451944B (en) | 2024-02-23 |
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| CN114451944A (en) | 2022-05-10 |
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Effective date of registration: 20220922 Address after: No. 120, Xinxing Road, West District, Binhai New Area Development Zone, Tianjin 300462 Applicant after: REACH SURGICAL Inc. Applicant after: WEST CHINA HOSPITAL, SICHUAN University Address before: No. 120, Xinxing Road, West District, Binhai New Area Development Zone, Tianjin 300462 Applicant before: REACH SURGICAL Inc. |
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