WO2013123666A1

WO2013123666A1 - Surgical stapler and stapling method using stapler

Info

Publication number: WO2013123666A1
Application number: PCT/CN2012/071555
Authority: WO
Inventors: 俞晓立; 蔡真真; 吴雄婷; 钟丽红
Original assignee: 广州医学院第二附属医院
Priority date: 2012-02-24
Filing date: 2012-02-24
Publication date: 2013-08-29
Also published as: CN104220011A

Abstract

A surgical stapler and a stapling method using the surgical stapler. A head portion (20) comprises a staple barrel (21) connected at an operation portion (30), a staple pushing column (22) disposed in the stable barrel (21) and capable of being pushed by the operation portion (30), a staple cartridge (23) disposed at an end portion of the staple pushing column (22) and used for accommodating staples, and a cutter (24) supported by the staple pushing column (22) and capable of being pushed by the staple pushing column. An end surface of the staple barrel (21) close to the staple cartridge (23), an end surface of the staple pushing column (22) close to the staple cartridge (23), an end surface of the staple cartridge (23) used for accommodating staples, and a blade end surface of the cutter (24) are elliptic rings fitting each other and perpendicular to the axis; a staple anvil (10) comprises an anvil block (14) and a connection shaft lever (11). A joint surface of the anvil block (14) is an elliptic ring fitting the end surface of the staple cartridge (23) used for accommodating staples. The joint surface of the anvil block (14) is provided with staple positions corresponding to staple holes on the staple cartridge (23). The anastomosis is elliptic anastomosis, so that the anastomotic area is increased, the anastomotic stenosis is less likely to occur, the anastomotic tissues are increased, and the possibility of anastomotic leakage is reduced.

Description

Surgical stapler and anastomosis method using the same

The invention belongs to the field of medical instruments, and in particular relates to a surgical stapler and a kissing method using the same. Background technique

Surgery often requires the matching of two hollow organs and tissues, such as anastomosis of the esophagus with the stomach (or colon), intestinal anastomosis, ureteral anastomosis, fallopian tube anastomosis, biliary anastomosis and vascular anastomosis. The traditional anastomosis technique is to match the two hollow organs and tissues with sutures, and the effect is reliable, but the operation is cumbersome and the technical requirements are high.

In recent years, with the development of the stapler, two hollow organs or tissues can be anastomosed by staples, and the operation is simple and the effect is reliable. However, in the existing stapler, when the two hollow organs and tissues are matched together, the adjacent tissues are nailed together by the staples, which inevitably leads to different degrees of stenosis of the hollow organs and tissues; Will bring local obstructive performance. In order to reduce stenosis, it is required to reduce the stapling of adjacent tissues, which inevitably leads to an increase in the incidence of anastomotic leakage. In order to reduce the incidence of stenosis, it is required to reduce the anastomosis of adjacent tissues; in order to reduce the incidence of anastomotic leakage, it is required to increase the anastomosis of adjacent tissues. This is a contradiction.

To this end, it is desirable to provide an improved stapler and an anastomosis method using the stapler. Summary of the invention

One of the objects of the present invention is to solve the problems in the prior art and to provide a surgical stapler which can reliably connect adjacent tissues, prevent anastomotic leakage, and reduce stenosis and thereby Caused by obstruction.

The above object of the present invention is achieved by the following technical solutions:

A surgical stapler includes an operation portion, a head and an anvil, and is characterized by:

The head includes a nail barrel coupled to the operating portion, a pusher post disposed in the nail barrel and urgable by the operating portion, disposed at an end of the push pin column and configured to place a staple a staple cartridge, a cutter supported by the pusher post and capable of being pushed by the pusher post;

Wherein, the center of the nail cylinder, the pusher post, the staple cartridge and the cutter are on one axis; the staple cartridge is provided with a nail hole for placing a staple, and the pusher column is provided a pusher tooth corresponding to the nail hole on the staple cartridge, the pusher tooth can push the staple through the nail hole under the pushing of the operating portion; the cutter can be Push the nail column to push and cut off the excess tissue after the anastomosis;

An end surface of the nail cylinder adjacent to the staple cartridge, an end surface of the pusher post adjacent to the staple cartridge, an end surface of the staple cartridge for placing the staple, and a blade end surface of the cutter Elliptical rings that are adapted to each other and are perpendicular to the axis;

The anvil includes an anvil and a connecting shaft, the joint surface of the anvil is an elliptical ring that fits an end surface of the staple cartridge for placing a staple, and the joint surface of the anvil is disposed There is a nail position corresponding to the nail hole on the staple cartridge;

The operating portion is provided with a telescopic abutting portion; the abutting portion can axially pass through the middle portion of the nail barrel, the push pin column, the staple cartridge and the cutter, and the anvil The connecting shaft is docked and fixed.

Preferably, the connecting shaft of the anvil is foldably connected to the anvil; the folding direction of the connecting shaft of the anvil is an elliptical long axis of the joint surface of the anvil direction. Preferably, a magnet is disposed on the anvil in a folding direction of the connecting shaft to assist in folding the connecting shaft.

Preferably, the connecting shaft of the anvil is fixedly connected to the anvil.

Preferably, the staple cartridge is provided with 2-5 loops for placing the staple holes of the staple; correspondingly, the joint surface of the anvil has a corresponding 2-5 turns of the staple position, The pusher post includes a corresponding 2-5 turns of the pusher teeth for pushing the staple; each of the staple holes is arranged in an elliptical shape that fits the cross section of the staple cartridge, each circle The nail positions are arranged in an elliptical shape adapted to the nail holes of the corresponding ring, and the push pin teeth of each turn are also arranged in an elliptical shape adapted to the nail holes of the corresponding ring, the nail holes, the The staple position and the pusher teeth are in one-to-one correspondence with each other.

Preferably, the anvil is partially ellipsoidal, the cartridge includes a straight portion connected to the connecting portion and a partial ellipsoid portion abutting the anvil, the anvil and the cartridge The partial ellipsoid can form an integral ellipsoid when fully mated; the shape of the pusher post is adapted to the shape of the lumen of the cartridge.

Another object of the present invention is to provide an anastomosis method using the above-mentioned surgical stapler, which is simple in operation, which can ensure that adjacent tissues are reliably connected, prevent anastomotic leakage, and can reduce stenosis and thereby cause Obstruction phenomenon.

To achieve this, the present invention adopts the following technical solutions:

An anastomosis method using the surgical stapler of claim 1, comprising the steps of:

(1) cutting the port of the first hollow organ or tissue to be anastomosed, thereby forming a beveled incision;

(2) prefabricating the purse string on the oblique cut;

(3) placing the anvil of the surgical stapler from the oblique incision;

(4) tightening the purse string so that the anvil is placed obliquely in the hollow organ or tissue;

(5) inserting the operation portion of the surgical stapler and the head attached thereto from a corresponding incision of a second hollow organ or tissue to be anastomosed, so that the operation portion is The abutting portion is pierced from the wall of the second hollow organ or tissue;

(6) docking the docking portion with the connecting shaft of the anvil;

(7) operating the operating portion such that the anvil of the anvil and the staple cartridge are closed to each other such that the joint surface of the anvil is in contact with the placement staple of the staple cartridge;

(8) operating the operating portion to push the pusher column forward; the pusher post then pushes the staple to staple the staple on the staple cartridge, and the cutter cuts off the excess Tissue, forming an elliptical anastomosis;

(9) After the anastomosis is completed, the entire surgical stapler is withdrawn from the second hollow organ or tissue, and the incision of the second hollow organ or tissue is sutured.

Preferably, the connecting shaft of the anvil is foldably connected to the anvil; in the step (2), the anvil is placed in front of the first cavity organ or tissue, the connection a shaft and the anvil are placed in a folded state, a long axis of the elliptical abutting surface of the anvil corresponding to a long axis of the oblique cut; the connecting shaft is placed along a central axis of the oblique cut .

Preferably, the step (9) further comprises: extending the abutting portion forwardly, the anvil is moved forward, and the anvil is folded under the action of the magnet and the connecting shaft State; then the entire surgical stapler is withdrawn.

The beneficial effects of the invention are as follows: after the stapler and the anastomosis method of the invention, the anastomosis is elliptical, which can increase the area of the anastomosis, and the effect of the anastomosis on the anastomosis is less, and the anastomosis is reduced. It leads to anastomotic stenosis and consequent obstruction; at the same time, because the elliptical shape increases the anastomosis, the nailed tissue increases during anastomosis, which can make the anastomosis tighter and reduce the possibility of anastomotic leakage; and the operation is relatively simple. It can reduce the operation time and reduce the possibility of danger.

Hinged anvil

Connection seat

BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 is an overall perspective view of one embodiment of a rod iron hair surgical stapler;

Figure 2 is an overall schematic view of the surgical stapler of Figure 1, wherein the head is an exploded view; Figure 3 is an exploded view of a partial view of the surgical stapler of Figure 1, showing the anvil and the head; 4 is an exploded view of another embodiment of the anvil and head of the surgical stapler of the present invention, wherein the connecting shaft of the anvil is non-foldable;

Figure 5 is a perspective view of the anvil of Figure 3, wherein the anvil and the connecting shaft are in an open state; Figure 6 is a perspective view of the anvil shown in Figure 5 in a folded state;

Figure 7 is a side elevational view of the anvil shown in Figure 5 in an open state;

Figure 8 is a perspective view of the anvil shown in the embodiment shown in Figure 4;

Figure 9 is a front elevational view of the end of the barrel of the embodiment of Figure 1;

Figure 10 is a longitudinal sectional view of the nail cylinder of the embodiment shown in Figure 1;

Figure 11 is a perspective view of the pusher post in the embodiment of Figure 1;

Figure 12 is a front elevational view of the end of the push pin placed in the embodiment of the embodiment of Figure 1;

Figure 13 is a perspective view of the staple cartridge of the embodiment of Figure 1;

Figure 14 is a schematic view showing the assembly of the nail cartridge with the pusher column and the staple cartridge in the embodiment shown in Figure 1, wherein the left side is the front view of the push pin column mounted in the nail cylinder, and the right side is the bottom view of the staple cartridge. ;

Figure 15 is a front elevational view of the push pin of the embodiment of Figure 1;

Fig. 16-1, Fig. 16-2, Fig. 16-3, Fig. 16_4, Fig. 16_5 respectively show the steps in one embodiment of the anastomosis method of the present invention using a surgical stapler. detailed description

Preferred embodiments of the present invention will be described in detail below with reference to the accompanying drawings.

Among them, the reference numerals are as follows:

10- - Anvil 100 - Pair of joints

11- 12- 13- 14- Butt joint 142 - nail position

20 - head

21——nail barrel 211——tube wall 2110——vertical edge

212, 214 - support plate

213——Hollow cylinder 2130——Edge of hollow cylinder

218 - straight section

219 - ellipsoidal body Pegs 220 - joints 2201 - outer ring push nails 2202 - inner ring push nails

221 - cylindrical joint rod 2210 - longitudinal groove

222 - Transition Department 223 - support surface 2231 - bayonet

23——nail warehouse 231——nail hole

Machining hoop 232 - staple cartridge joint 2321 - outer through groove 2322 - inner through groove

24——Cutter section

30 31——Handle 32——Clip block 33

35 36——Knob 37——Support seat 38

50 60 - stapler anastomosis 80 FIG. 1 and FIG. 2 show the overall structure of the surgical stapler of this embodiment. As can be seen, the surgical stapler comprises three parts: an operation portion 30, a head portion 20, and Anvil 10.

First, the operation unit 30 will be described below.

As shown in Fig. 2, the operating portion 30 includes a casing 33 having a cylindrical shape, and the casing 33 is formed by fastening two outer casings, and the end of the casing is hooped by a ferrule 35. A sleeve 38 is disposed inside the cavity formed by the outer casing 33. A push-pull rod (not shown) is disposed inside the sleeve 38. One end of the push-pull rod is connected with the abutting portion 34 for abutting the anvil, and the other end is connected with the knob. 36; The knob 36 can control the push-pull rod to advance or retreat within the sleeve 38, thereby advancing or retracting the abutment portion 34. As shown in Fig. 2, the abutting portion 34 is specifically a cavity having a fastening means on the peripheral wall.

In this embodiment, the knob 36 and the push-pull rod can reach the shell bobbin through the threaded hole and the screw.

The program, and the thread is divided into a long tooth segment and a short tooth segment, thereby achieving a large movement and a small amplitude movement of the joystick, respectively. Of course, in other embodiments of the present invention, the operating portion 30 can also employ other equivalent structures in the prior art to achieve control of the push-pull rod, particularly the abutment portion 34 of its end.

As shown in Fig. 1 in conjunction with Fig. 2, the operating portion 30 further includes a handle 31, a block 32, and a manipulation piece (not shown). The operating piece is also disposed in the sleeve 38, and has a longitudinal shape adapted to the push-pull rod, and a supporting seat 37 is attached to the end of the operating piece, and the supporting seat 37 can be sleeved on the outer surface of the end of the push-pull rod, thereby The manipulating piece can be advanced or retracted with the push-pull rod. The end face of the support base 37 is adapted to the bottom of the push pin post 22 (described below) in the head 20; after installation, the bottom of the push pin post 22 is fixed to the support base 37.

The other end of the manipulation piece is connected to the handle 31 and is controlled by the handle. When the handle 31 is depressed, the manipulation piece can move forward, so that the support seat 37 of the manipulation piece drives the push column 22 to move forward. The block 32 is used to control the operation of the handle 31: when the block 32 is hit, the handle 31 is clamped so that the handle 31 cannot be pressed; when the block 32 is hit, the handle 31 can be pressed; It avoids the problems caused by accidentally pressing the handle 31 during operation.

Second, the head 20 and the anvil 10 are described below.

1. Introduction to the overall structure of the head 20.

As shown in FIG. 2, the head 20 includes a nail barrel 21 connected to the operation portion 30, a pusher post 22 disposed in the nail cylinder 21, and a staple cartridge 23 disposed at an end of the pusher post 22 and capable of placing a staple. a cutter 24 supported by the pusher post 22 and capable of being pushed by the pusher post. As shown in Fig. 2, the centers of the nail cylinder 21, the pusher post 22, the staple cartridge 23 and the cutter 24 are on one axis X.

One end face of the staple cartridge 23 is provided with a nail hole for placing a staple, and the push pin column 22 is provided with a pusher tooth corresponding to the nail hole on the staple cartridge 23, and the pusher tooth can pass through the push of the operation portion 30. The nail hole pushes the staple; the cutter 24 can be pushed by the pusher post 22 to cut off the excess tissue after the anastomosis. Staple cartridge 23, push pin 22 and cut The specific structure of the knife 24 will be described below.

1 , 2 and 3, the components of the head 20 are mounted in such a manner that the end of the cartridge 21 is connected to the end of the sleeve 38 of the operating portion 30; the pusher post 22 is sleeved in the cartridge 21 Internally, and its corresponding end is joined to the support seat 37 of the end of the operating piece of the operating portion 30; the staple cartridge 23 is sleeved at the top end of the pusher post 22, and the pusher teeth of the push stud 22 and the staple hole of the staple cartridge 23 The positions correspond one-to-one; the cutter 24 passes through the middle of the staple cartridge 23 and is seated on the corresponding support surface of the pusher post 22 to be pushed with the pusher post 22.

Specifically, as shown in FIGS. 2 to 15, the end face (left end face) of the nail cylinder 21 close to the staple cartridge 23, the end face (left end face) of the push pin post 22 adjacent to the staple cartridge 23, and the use of the staple cartridge 23 The section on which the staple is placed and the end face of the cutter 24 (the cross section of the cutting edge) are mutually adapted elliptical rings and are perpendicular to the axis X described above. Therefore, under the action of the manipulation piece of the operation portion 30, the push pin of the push pin 22 pushes the staple in the staple cartridge 23, and the push pin 22 can push the cutter 24 in a direction perpendicular to the port (ie, the X axis) Direction) Advance, ensure port force (pushing force, cutter shear) vertical, uniform, no offset.

The above-described beneficial effects can be further discussed in comparison with U.S. Patent No. 7,422,138, which is also incorporated herein by reference in its entirety, in the U.S. Patent. The vertical force of each staple to its staple position is such that a step is provided on the respective joint faces of the staple cartridge and the anvil, but this obviously increases the damage to the tissue. By using the surgical stapler of the present invention, after docking, it can be ensured that the direction of application of each staple is perpendicular to the nail position of the joint surface of the anvil, and the entire joint surface is flat, without steps, and thus the tissue damage is small. .

2. Introduction to the structure of the anvil 10.

Figures 3, 5, 6, and 7 show a collapsible anvil. As shown, the anvil 10 includes an anvil 14 and a connecting shaft 11, and the connecting shaft 11 is foldably coupled to the anvil 14 via a hinge post 12. Corresponding to the components of the head, the joint surface 141 of the anvil 14 is an elliptical ring that fits the end surface of the staple cartridge 23 for placing the staples; a plurality of staple locations 142 are provided on the joint surface 141, These staple positions 142 correspond one-to-one with the nail holes for placing the staples on the staple cartridge 23, and also correspond one-to-one with the pusher teeth of the pusher post 22.

As shown in the above figure, the direction of the hinge post 12 is perpendicular to the long axis direction of the ellipse, so that the connecting shaft 11 can be folded in the direction of the major axis of the ellipse. On the anvil 14, in accordance with the folding direction of the connecting shaft 11 (that is, in the direction of the long axis of the ellipse), a magnet 13 is further provided, so that the anvil 14 can be connected to the shaft 11 by the magnetic force of the magnet. Folded, as shown in Figure 6. Thus, when moving in a hollow organ or tissue, the width of the entire anvil is small, it is easy to place, and damage to the hollow organ or tissue can be reduced.

In addition, the anvil 10 further includes a pair of joints 100 that interface with the abutting portions 34 of the operating portion 30, and the pair of joints 100, that is, the ends of the shafts 11 are connected; when butted, the pair of joints 100 are inserted into the cavity-like butt joints. The portion 34 is engaged and engaged in the abutting portion 34. A stopper (not shown) for restricting the depth of the mating connector 100 into the abutting portion 34 is also provided correspondingly on the connecting shaft 11, and a suitable device in the prior art can be used here. Of course, in other embodiments of the present invention, the structure of the joint 100 and the abutting portion 34 may be reversed, that is, as long as one is a head and the other is a cavity having a fastening device; of course, in other embodiments, Equivalent structures in the prior art can be employed.

As shown in Fig. 2, in operation, the abutting portion 34 can pass through the middle of the nail cylinder 21, the pusher post 22, the staple cartridge 23, and the cutter 24 to abut the joint 100, and finally form the engaged state shown in Fig. 1.

4 and 8 show another alternative construction of the anvil 10. In this alternative embodiment, the connecting shaft 11 is fixedly attached to the anvil 14 and cannot be folded. Thus, in this anvil 10, there are no two components, the hinge post 12 and the magnet 13, and the other components are the same as the anvil of the embodiment shown in Figs. 5, 6, and 7, and are not described here. Importantly, the abutment surface 141 of its anvil 14 is adapted to the end face of the staple cartridge 23 where the staples are placed. Oval ring.

More preferably, the shape of the head 20 and the anvil 10 may be set such that the anvil 14 of the anvil 10 is partially ellipsoidal in shape; the cartridge 21 includes a straight portion 218 that is coupled to the connecting portion (ie, FIG. 2). 3, the thin end of the nail cylinder in FIG. 4 and a partial ellipsoid portion 219 abutting the anvil 10 (ie, the thick end of the nail cylinder in FIGS. 2, 3, and 4), the anvil 10 and the partial ellipsoid 219 If it is completely butted, an integral ellipsoid can be formed; the shape of the pusher post 22 is adapted to the shape of the magazine 21. Thus the head 20 and the anvil 10 can meet the requirements for obtaining an ellipsoidal suture.

Of course, in other embodiments of the present invention, the head 20 and the anvil 10 may form an outer shape similar to an ellipsoid; or other irregular shapes may be formed as long as the requirements for the end face elliptical ring and the end face are satisfied. The requirement perpendicular to the axis X is sufficient. However, it must be emphasized that regardless of the shape of the head 20 and the anvil 10, in the surgical stapler, the joint surface of the anvil 10 cannot completely conform to the joint surface of the staple cartridge, and a gap must be left in the middle. To accommodate the stapled tissue.

Third, the introduction introduces the nail cylinder 21, the push nail column 22, the staple cartridge 23 and the cutter 24, and the relationship between them.

(1) Nail cartridge 21.

2, FIG. 3 is a perspective view of the nail cylinder 21, FIG. 9 is an end view of the nail cylinder 21, and FIG. 10 is a longitudinal sectional view of the nail cylinder 21.

As shown in Figs. 2, 3, 9, and 10, the nail cylinder 21 includes a cylinder wall 211, and a plurality of longitudinal ribs 2110 are uniformly disposed on the inner side of the cylinder wall 211 in the circumferential direction. At the distance from the end of the cavity formed by the wall 211 to the end of the magazine (the larger diameter end), two support plates 212, 214 in the form of a cross are provided. A hollow cylinder 213 is disposed at a central position of the two support plates 212, 214, and the hollow cylinder 213 actually divides the two support plates 212, 214 into two sections, respectively.

The end faces of the two support plates 212, 214 (the end near the staple cartridge) form the support surface of the push pin 22; the hollow cylinder 213 is used for the passage of the push-pull rod in the operating portion 30. Further, on the inner wall of the hollow cylinder 213, a plurality of ribs 2130 uniformly arranged around the circumference are provided, which can effectively limit the excessive shaking of the push-pull rod.

Further, the thin end portion 218 of the nail cylinder 21 is attached to the end of the sleeve 38 of the operating portion 30, thereby achieving positional fixing.

(2) Push the nail column 22 and the cutter 24.

2, 3, and 4 show a perspective view of the pusher post 22; and Fig. 11 shows a perspective view of the pusher post 22. As shown in Figures 2, 3, 4, and 11, the pusher post 22 includes an engagement bar 221, a joint 220, and a transition 222 therebetween. In general, the shape of the pusher post 22 is adapted to the inner cavity of the cartridge 21.

Wherein, as shown in FIG. 11, the engaging rod 221 is cylindrical, the inner diameter of the barrel is adapted to the outer diameter of the hollow cylinder 213 of the above-mentioned nail cylinder 21; and four longitudinal grooves 2210 are formed along the longitudinal direction of the engaging rod 221, each The slots are separated by 90 degrees. When installed, the cylindrical engagement rod 221 is placed over the outer wall of the hollow cylinder 213 of the nail cylinder 21, and the support plate of the nail cylinder 21 passes through the four longitudinal grooves 2210 of the pusher column 22. Of course, in other embodiments of the present invention, the support plates in the nail cylinders 21 may be three or more, and the longitudinal grooves 2110 of the corresponding push pins 22 are six or corresponding; A considerable technique in the art, as long as the mounting of the pusher post 22 in the magazine 21 can be achieved.

15 is a front elevational view of the pusher post 22, as seen from this view: The joint portion 220 includes two outer ring push pin teeth 2201 and inner ring push pin teeth 2202 spaced apart from each other. The shape and spacing of the pusher teeth 2201, 2202 are adapted to the nail holes 231 on the staple cartridge 23 for placing the staples, and are in one-to-one correspondence. In use, the pusher teeth push the staples through the staple holes in the staple cartridge 23 toward the anvil 14, and are pinned to the corresponding end faces of the staple cartridges 23 and the joint faces 141 of the anvils 14 by a stapler-like principle. Organization. Of course, in this embodiment, there are two rings of staples; in other embodiments, more rings may be used, preferably 2 to 5 rings of staples. Thus, the pusher teeth here are also correspondingly 2-5 turns.

Figure 12 is a front elevational view of the push post 22 after it has been installed in the cartridge 21, as seen in conjunction with Figures 12 and 15: the gap between each of the outer ring push pins 2201 corresponds to the inner wall of the cartridge 21 Edge 2110 for it to pass through. The inner ring push pin gear 2202 and the outer ring push pin tooth 2201 respectively correspond to the inner ring and the outer ring nail hole on the joint end surface of the staple cartridge 23 (see FIG. 13). When installed, the inner ring and the outer ring push pin teeth 2202, 2201 The inner and outer ring nail holes are respectively passed through in one-to-one correspondence; thus, the staple cartridge 23 is mounted at the end of the push pin 22.

As shown in FIG. 11, FIG. 12, FIG. 14, and FIG. 15, a lateral support plate 223 is disposed inside the push pin 22 at a distance from the end of the push pin 22 near the staple cartridge 23 and at a distance from the end. The cutting blade 24 is placed on the supporting plate 223, and four parallel mounting holes 2231 are formed on the supporting plate 223 for engaging with the corresponding protrusions at the bottom end of the cutting blade 24 to realize the locking, thereby fixing the cutting blade 24 to the supporting plate. 223. The position of the support plate 223 and the radial length of the staple cartridge 23 are to satisfy the following requirements: When the end of the staple cartridge 23 is engaged with the end of the anvil 14, when the pusher post 22 is pushed, the staple is nailed to the tissue. At the same time, the cutter 24 is capable of cutting off excess tissue.

(3) Staple cartridge 23.

As shown in Fig. 13, a perspective view of the staple cartridge 23 is shown, from which it can be seen that the staple cartridge 23 includes a joint portion 232 and a nail hole 231 that accommodates the nail. The structure of the engaging portion 232 and the structure of the engaging portion 220 of the push pin 22 cooperate with each other: corresponding to the outer and inner pushing teeth 2201, 2202 of the engaging portion 220 of the push pin 22, the engaging portion 232 is provided with the outer through groove 2321 The inner through slot 2322 is for the outer and inner pusher teeth 2201, 2202 to pass through, as shown in FIG. The staples are mounted on the ports (i.e., the staple holes 231) of the respective slots 2321, 2322. Each of the through grooves is arranged in an elliptical shape corresponding to the end face of the elliptical ring of the staple cartridge 23. The above-mentioned pusher teeth are also arranged in a circle elliptical shape; thus, the staples can be arranged in an elliptical shape and form an ellipse. Shaped anastomosis.

4. An anastomosis method using the above surgical stapler.

The structure and function of the above surgical stapler can also be more clearly understood by the description of the anastomosis method. The following is an example of the anastomosis of the stomach and esophagus. Of course, the method is also applicable to the anastomosis of other types of hollow organs or tissues with other hollow organs or tissues.

As shown in Figs. 16-1 to 16-5, an anastomosis method using a surgical stapler in which the connecting shaft 11 of the anvil 10 is fixedly coupled to the anvil 14 is of a non-foldable type. The method of matching includes the following steps:

(1) making a slanting incision in the stump of the esophagus 80 to be anastomosis;

(2) prefabricating the purse string on the oblique cut;

(3) placing the anvil 10 of the surgical stapler from the oblique incision;

(4) tightening the purse string, the connecting shaft 11 of the anvil 10 is pierced from the purse string, so that the anvil 10 is obliquely placed in the esophagus 80;

(5) The operation portion 30 of the surgical stapler and the head portion 20 attached thereto are inserted from the stomach wall incision on the stomach 90, as shown in Fig. 16-1; the abutting portion 34 of the operation portion 30 is passed out from the stomach wall ;

(6) docking the butt joint 34 with the joint 100 of the anvil 10; as shown in Figure 16-1;

(7) Rotating the knob 36 to close and abut the anvil 14 and the staple cartridge 23 of the anvil 10; as shown in Fig. 16-2 and Fig. 16-3;

(8) Then, the block 32 is lowered, and the handle 31 is pressed; the pusher post 22 is moved forward by the manipulation piece, so that the staple on the staple cartridge 23 is nailed to the tissue, and the cutter 24 cuts off the excess tissue. ; as shown in Figure 16-4;

(9) After the anastomosis is completed, the entire surgical stapler is taken out of the stomach, and the stomach wall is slit Combined; as shown in Figure 16-5.

If the connecting shaft 11 of the anvil 10 is foldably connected to the anvil 14, the above steps are changed as follows:

A. In step (1), the anvil 14 of the anvil 10 is folded into the esophagus 80, and the long axis of the anvil 14 corresponds to the long axis of the oblique incision;

B. In step (4), when the purse string is tightened; the connecting shaft 11 of the anvil 10 is pierced from the purse string; and the knob 36 is rotated, when the nail base of the anvil and the staple cartridge are close to each other, the nail The connecting shaft of the anvil 10 is gradually straightened;

In step C (9), the knob 36 is rotated to separate the nail base of the anvil from the staple cartridge, so that the anvil 14 is folded on the connecting shaft 11 by the action of the magnet 13; and then the entire surgical stapler is used. Take it out of the stomach.

In the above technical solution, since the slit is cut into an elliptical shape, the anvil is obliquely placed along the elliptical slit, and the end surface of the anvil is an elliptical ring, and the end surface of the staple cartridge is also an elliptical ring, so that When the anastomosis is formed, an elliptical anastomosis is formed. Because the elliptical anastomosis is large, the position of the nail is increased during the anastomosis, the anastomosis is tighter, and the anastomotic leakage is prevented. At the same time, the anastomosis is difficult to occur due to the large anastomosis. narrow.

The above description is only the preferred embodiment of the present invention, and of course, the scope of protection of the present invention is not limited thereto; any equivalent substitutions or alterations to the above technical solutions are within the scope of the present invention.

Claims

Rights request

What is claimed is: 1. A surgical stapler comprising an operation portion, a head portion and an anvil, wherein: the head portion includes a nail barrel coupled to the operation portion, is disposed in the nail barrel, and is operable a pusher column pushed by the push, a staple cartridge disposed at an end of the pusher post and used to place a staple, a cutter supported by the pusher post and capable of being pushed by the pusher post;

2. A surgical stapler according to claim 1 wherein: said connecting shaft of said anvil is foldably coupled to said anvil; said connecting shaft of said anvil The folding direction is the long axis direction of the ellipse of the joint surface of the anvil.

3. A surgical stapler according to claim 2, wherein: said anvil is provided with a magnet in a folding direction of said connecting shaft to assist in folding said connecting shaft.

4. A surgical stapler according to claim 1 wherein: said connecting shaft of said anvil is fixedly coupled to said anvil.

The surgical stapler according to any one of claims 1 to 4, wherein: the staple cartridge is provided with 2-5 loops for placing the staple holes of the staple; The engaging surface of the anvil has a corresponding 2-5 turns of the nail position, and the pushpin includes a corresponding 2-5 turns of the pusher teeth for pushing the staple; each turn The nail holes are arranged in an elliptical shape which is adapted to the cross section of the staple cartridge, and the stitches are arranged in an elliptical shape corresponding to the nail holes of the corresponding ring, and the push nail teeth of each ring are also Arranged in an elliptical shape that fits the staple holes of the respective ring, the staple holes, the staple locations, and the pusher teeth are in one-to-one correspondence with each other.

6. A surgical stapler according to claim 1, wherein: said anvil is partially ellipsoidal, said barrel comprising a straight portion connected to said connecting portion and said anvil a partially ellipsoidal portion, the anvil and the partial ellipsoid of the cartridge can form an integral ellipsoid when fully mated; the shape of the pusher post and the lumen of the cartridge Shape fit.

7. An anastomosis method using the surgical stapler of claim 1, comprising the steps of: (1) cutting the port of the first hollow organ or tissue to be anastomized, thereby forming a oblique cut;

(2) prefabricating the purse string on the oblique cut;

(3) placing the anvil of the surgical stapler from the oblique incision;

(6) docking the docking portion with the connecting shaft of the anvil;

8. The method of anastomosis according to claim 7, wherein: the connecting shaft of the anvil is foldably connected to the anvil; in the step (2), the anvil is placed Before the first cavity organ or tissue, the connecting shaft and the anvil are placed in a folded state, and the long axis of the elliptical abutting surface of the anvil corresponds to the long axis of the oblique cutting; A connecting shaft is placed along a central axis of the oblique cut.

9. The method of anastomosis according to claim 8, wherein: the step (9) further comprises: extending the abutting portion forwardly, the anvil is moved forward, the anvil at the magnet Under the action of the connecting shaft, the connecting shaft becomes a folded state; then the entire surgical stapler is withdrawn.