SU728848A1 - Хирургический сшивающий аппарат - Google Patents
Хирургический сшивающий аппарат Download PDFInfo
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(54) ХИРУРГИЧЕСКИЙ СШИВАЮЩИЙ АППАРАТ
4 магазина 3,упорный корпус 8 с матрицей 9 дл загиба скобок, механизм 10 дл подачи толкателей 6, нож 11 дл прорезани -ткани , механизм смыкани скобочного и упорного корпусов, выполненный в виде винта 12 с накатанной цилиндрической головкой и круговой проточкой 13, соединенного с упорным корпусом 8.
Скобочный корпус 1 имеет корытообразное сечение. Передний конец 14 корпуса 1 срезан дл наложени боковых желудочнокишечных анастомозов. На боковых станках выступа 15 скобочного корпуса 1 выполнены продольные пазы 16 и поперечные пазы 17. В хвостовой части корпуса 1 имеютс продольные пазы 18 и паз 19 дл зацеплени с круговой проточкой 13.
На корпусе 1 установлен съемный ограничитель 20 корытообразного сечени . На переднем конце ограничител имеютс выступы 21 дл ограничени ткани при ушивании от выползани за зону шва при выборе зазора прошивани . На противоположном конце ограничител расположен замок 22 дл креплени с руко ткой 2 скобочного корпуса 1.
Упорный корпус 8 выполнен составным с подвижной упорной губкой 23, на боковых поверхност х которой имеютс оси 24 и 25, установленные в замкнутых фигурных пазах 26 корпуса 8.
В центре подвижной упорной губки 23 имеетс гнездо, в котором помещаетс эластична подложка 27. Передний конец корпуса 8 выполнен в виде вилки 28, в которой размешена хвостова часть подвижной упорной губки 23. Корпус 8 с двух сторон имеет выступы 29, которые вход т в продольные пазы 16 скобочного корпуса 1. Хвостова часть корпуса 8 соединена с винтом 12. Механизм 10 подачи толкателей состоит из резьбового стержн 30, соединенного с внутренней резьбой гайки-барашка 31, котора находитс в зацеплении с винтом 12. На стержне 30 укреплены три пластинчатый клина 32. На среднем пластинчатом клине установлен дисковый нож 11 с возможностью вращени относительно своей оси. Аппарат работает следующим образом. Цилиндрическую накатную часть винта 12 вращают против часовой стрелки до упора , при этом оси 24 и 25, скольз по замкнутым фигурным пазам 26, заставл ют подвижную губку 23 поворачиватьс относительно поперечного паза 17 скобочного корпуса 1. Губка 23 отходит от переднего конца 14 скобочного корпуса, освобожда гнездо 33. Аппарат раскрыт. Освобождают замок 22 от руко тки 2 и снимают ограничитель 20 с аппарата. Сменные магазины 3 извлекают из аппарата, зар жают П-образными скобками и став т на место. Присоедин ют ограничитель 20 и фиксируют его замком 22 на руко тке 2 скобочного корпуса 1. В таком виде аппарат стерилизуют дл операций по ушиванию органов и ткани.
На операции аппарат ввод т в узкую и глубокую рану и закрытом виде. Подойд к органу аппарат раскрывают. Ушиваемый орган располагают в гнезде 33 скобочного корпуса 1. Цилиндрическую накатанную J часть винта 12 вращают по часовой стрелке, при этом кругова проточка 13 находитс в пазу 19, а ось 24, расположенна своими концами в поперечдых пазах 17, и ось 25, скольз по замкнутым фигурным пазам 26, заставл ют подвижную упорную губку 23
0 опускатьс относительно скобочного корпуса 1, сближа передний конец упорного корпуса 8 с передним концом 14 скобочного корпуса 1. При этом выступы 29 упорного корпуса 8 вход т в продольные пазы 16 и 18 скобочного корпуса 1, соедин упорный и
скобочный корпуса. Ткань сжимаетс поверхност ми магазина 3 и матрицы 9 дл зазора прошивани . Враща гайку-барашек 31 по часовой стрелке механизм 10 подачи толкателей подаетс в сторону передJ , него конца 14 скобочного корпуса 1. Пластинчатые клинь 32 воздействуют на упоры
7толкателей 6. При этом пластинчатые клинь 32 располагаютс между продольными выступом 5 магазина 3 и упором 7 толкател 6. Усилие от прощивани через упор 7
5 передаетс на пластинчатые клинь 32 и далее на продольный выступ 5 магазина 3. Таким образом, усили от прошивани замыкаютс на самих магазинах, которые остаютс неподвижными относительно скобочного корпуса.
движении клиньев 32 вдоль аппарата толкатели 6 перемещаютс вдоль скобочного паза 4 магазина 3, выталкива скобы, которые своими ножами прокалывают ткань и, упира сь в лунки матрицы 9, загибаютс в В-образную форму, прочно соедин ткань.
Одновременно с прошиванием происходит прорезание ткапи. При движении пластинчатых клиньев 32 пож 11 врезаетс частично в эластичную подложку 27. Дальнейшее движение вызывает его вращение из-за трени между подложкой 27 и ножом 11.
8зоне шва нож 11 накатываетс на ткань, подмина ее под себ и надежно прореза ткань на эластичной подложке.
После прошивани аппарат раскрываетс и извлекаетс из операционной раны.
Дл операций по наложению боковых кишечных анастомозов аппарат используют без съемного ограничител 20.
Claims (2)
- Аппарат позвол ет накладывать на органы и ткани два двухр дных механических скобочных шва с одновременным пересечением между швами и обеспечивает подход через узкие и глубокие раны без вскрыти плевральной полости (например, при операции по окклюзии бронхов). Аппарат обеспечивает герметичность и гемостаз за счет равномерного по всей длине зазора прошивани , поэтому уменьшаетс количество врем пребывани больного в стационаре и литальность исхода операции. Формула изобретени 1. Хирургический сшивающий аппарат, со держащий скобочный корпус с руко ткой, сменный магазин с пазами дл скобок, расположенный в свободном корпусе, толкатели с упорами, расположенные в скобочных пазах магазина, упорный корпус с матрицей механизм подачи толкател с дисковым ножом , механизм смыкани скобочного и упорSioro корпусов, отличающийс тем, что, с целью обеспечени возможности наложени линейных щвов н боковых анастомозов на полые органы с регулируемым зазором прощивани , упорный корпус имеет подвижную упорную губку, котора соединена с упорным корпусом с возможностью поворота относительно скобочного корпуса и параллельного перемещени относительно его в интервале зазоров прошивани путем закреплени на губке двух параллельных осей перпендикул рно продольной оси губки и выполнени на упорном корпусе двух фигурных па зов и поперечных пазов на скобочном корпусе , причем одна ось расположена в одном из фигурных пазов упорного корпуса и поперечных пазах скобочного корпуса, а друга - во втором фигурном пазу упорного корпуса, а на свободном корпусе установлен съемный ограничитель.
- 2. Аппарат по п. 1, отличающийс тем, что, с целью удобства подведени аппарата к ушиваемому органу, съемный ограничитель выполнен корытообразным. Источники информации, прин тые во внимание при экспертизе 1. Авторское свидетельство СССР по за вке № 2130062/13, кл. А 61 В 17/11, 1975.Фиг./А-АФиг. 2Фиг. 4)Вид Г
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SU772489237A SU728848A1 (ru) | 1977-05-24 | 1977-05-24 | Хирургический сшивающий аппарат |
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SU772489237A SU728848A1 (ru) | 1977-05-24 | 1977-05-24 | Хирургический сшивающий аппарат |
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US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
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US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
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US11576671B1 (en) | 2021-08-20 | 2023-02-14 | Covidien Lp | Small diameter linear surgical stapling apparatus |
US11707277B2 (en) | 2021-08-20 | 2023-07-25 | Covidien Lp | Articulating surgical stapling apparatus with pivotable knife bar guide assembly |
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US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
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