CN101912284B - 弧形切割吻合器 - Google Patents

弧形切割吻合器 Download PDF

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CN101912284B
CN101912284B CN2010102533394A CN201010253339A CN101912284B CN 101912284 B CN101912284 B CN 101912284B CN 2010102533394 A CN2010102533394 A CN 2010102533394A CN 201010253339 A CN201010253339 A CN 201010253339A CN 101912284 B CN101912284 B CN 101912284B
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李东瑞
李翔
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Jiangsu jianruibao Medical Technology Co., Ltd
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李东瑞
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Abstract

一种弧形切割吻合器，包括吻合钉成型机构、推钉组件、击发手柄、抵钉座、抵钉座的底座、垫刀圈和两个夹板，所述推钉组件包括切割刀、推钉片、钉仓和导向柱，在推钉片的端部且位于切割刀的两侧均设有若干个靠近切割刀的内推钉齿片和远离切割刀的外推钉齿片，所述切割刀与推钉片一次性注塑成型而固定在一起；所述推钉片上的各个外推钉齿片的外侧设有加强筋，推钉片上的各个内推钉齿片的内侧设有加强筋；推钉齿片的第一导向面两端均通过内凹弧形连接面分别与推钉齿片第一、二接触面连接，第二导向面两端均通过内凹弧形连接面分别与第一、二接触面连接，第一、第二接触面均与钉仓的推钉齿片孔的内壁接触。本发明击发吻合成型效果好、安全性高。

Description

弧形切割吻合器
技术领域
本发明属于医疗器械技术领域，具体涉及一种弧形切割吻合器。
背景技术
市场上已有各种类型的吻合器，在外科手术中被广泛地用于吻合人体的各部分组织，可以减少手术时间，提高手术质量，吻合口牢固可靠，止血效果好。目前一次性使用的弧形切割吻合器主要适用直肠低位前切除手术。现有的弧形切割吻合器存在一定缺点：第一方面，切割刀固定在刀座上，刀座与推钉片固定连接，医生在操作过程中，吻合器击发时，推钉片、切割刀和刀座三者需同步向前运动，由于装配的推钉片和刀座之间存在缝隙，因而造成推钉片、切割刀和刀座三者运动不同步或者导致切割刀未完全切断组织的现象；又由于推钉片、切割刀和刀座的工件较小，因而装配难度大，若推钉片、切割刀和刀座三者未装配牢固时，切割刀在切割组织时可能会出现晃动，且导致出现斜切或切割组织不完整等现象；第二方面，医生在操作过程中，推钉片在推动吻合钉击穿组织时所产生的阻力，可能导致推钉片端部的推钉齿片的断裂，实践中很难保证推钉齿片的强度，往往造成击发吻合成型的效果不好，大大降低了手术的安全性；第三方面，内、外推钉齿片的表面分别与相应的钉仓的推钉齿片孔全部接触，即内、外推钉齿片相应的第一导向面、第二导向面、第一接触面和第二接触面四个面均与推钉片齿孔的内壁接触，这种结构接触面积大，摩擦也就增大，同时用来推动推钉板的力就增大，不方便击发。
发明内容
本发明的目的是：提供一种击发吻合成型效果好、安全性高的弧形切割吻合器。
为了达到上述目的，本发明的技术方案是：一种弧形切割吻合器，包括吻合钉成型机构、推钉组件、击发手柄、抵钉座、抵钉座的底座、垫刀圈和两个夹板，所述吻合钉成型机构包括组件支架和推钉板，推钉板插装在组件支架内且与组件支架滑动配合，所述击发手柄与组件支架和推钉板驱动连接，以及与两个夹板固定连接，抵钉座固定在垫刀圈上，垫刀圈固定在抵钉座的底座上，抵钉座的底座固定连接在两个夹板上，推钉组件装在组件支架上且与抵钉座相对，所述推钉组件包括切割刀、推钉片、钉仓和导向柱，在推钉片的端部且位于切割刀的两侧均设有若干个靠近切割刀的内推钉齿片和远离切割刀的外推钉齿片，所述切割刀与推钉片一次性注塑成型而固定在一起，且切割刀的刀刃露在内、外推钉齿片顶端之外；所述推钉片上的各个外推钉齿片的外侧设有加强筋，推钉片上的各个内推钉齿片的内侧设有加强筋；内、外推钉齿片均具有第一导向面、第二导向面、第一接触面和第二接触面，第一接触面和第二接触面为外凸弧面，内、外推钉齿片的第一导向面两端均通过内凹弧形连接面分别与内、外推钉齿片相应的第一接触面和第二接触面连接，第二导向面两端均通过内凹弧形连接面分别与相应的第一接触面和第二接触面连接，第一接触面和第二接触面均与钉仓的推钉齿片孔的内壁接触。
所述钉仓与导向柱一次性注塑成型而固定在一起，导向柱上具有导向槽，切割刀与推钉片均装在钉仓内，切割刀的一侧端插在导向柱的导向槽内，且与导向槽滑动配合。
所述钉仓的内壁上设有若干个凹槽，推钉片上的与外推钉齿片相连的加强筋与凹槽滑动配合。
所述位于切割刀的两侧的内推钉齿片和外推钉齿片的数量分别在7～50对范围内。
所述推钉片的尾部具有与推钉片连为一体的倒扣。
所述抵钉座的底座内还装有保险组件，保险组件包括保险块、保险块弹簧片和保险挡块，保险块弹簧片的一端与保险块固定连接，另一端与保险挡块相抵，保险块的一端位于组件支架的前端，且可与组件支架相抵或分离，保险挡块上具有卡装孔，抵钉座的底座上设有凸台，凸台插在保险挡块的卡装孔中。
所述切割刀的刀刃的两侧壁均呈弧形，两侧壁形成的顶部夹角α为20°～70°。
所述切割刀的刀刃顶部的两侧壁形成锐角，刀刃的顶部侧壁与下侧壁弧形过渡，顶部的两侧壁形成的顶部夹角β为20°～70°。
本发明所具有的有益效果是：由于切割刀与推钉片一次性注塑成型而固定在一起，且切割刀的刀刃露在内、外推钉齿片顶端之外，切割刀和推钉片装配牢固性好，可靠性高，因而，医生在操作过程中，避免了推钉片和切割刀运动不同步或切割刀未完全切断组织的现象，防止切割刀在切割组织时可能出现晃动的现象，且也避免了出现斜切现象和切割组织部完整的现象，手术安全性高，使得手术切割后组织的吻合处均匀；由于所述推钉片上的各个外推钉齿片的外侧设有加强筋，以及各个内推钉齿片的内侧设有加强筋，因而，能够有效防止推钉片端部的推钉齿片的断裂，增强推钉片的推钉齿片的强度，使得吻合器在击发时需要的力度相对较小；此外，推钉片运动时，加强筋亦起到一定的导向作用，使得手术的成型效果好；又由于第一接触面和第二接触面为外凸弧面，内、外推钉齿片的第一导向面两端均通过内凹弧形连接面分别与内、外推钉齿片相应的第一接触面和第二接触面连接，第二导向面两端均通过内凹弧形连接面分别与相应的第一接触面和第二接触面连接，第一接触面和第二接触面均与钉仓的推钉齿片孔的内壁接触，因而减少了内、外推钉齿片分别与钉仓的推钉齿片孔的接触面积，只有第一接触面和第二接触面与钉仓的推钉齿片孔的内壁接触，因此减少了推出推钉片的阻力，方便了击发。
附图说明
图1是本发明弧形切割吻合器的结构示意图；
图2是本发明弧形切割吻合器头部的爆炸示意图；
图3是本发明弧形切割吻合器中的推钉组件的结构示意图；
图4是图3的俯视图；
图5是图3的仰视图；
图6是图4中沿A-A方向的剖视图；
图7是图4中沿B-B方向的剖视图；
图8是图3中导向轴的结构示意图；
图9是图4中I部放大示意图；
图10是本发明弧形切割吻合器中的推钉片和切割刀的结构示意图；
图11是图10的俯视图；
图12是图11中沿C-C方向的剖视并逆时针旋转90度图；
图13是图11中沿D-D方向的剖视并顺时针旋转90度图；
图14是本发明弧形切割吻合器中的保险组件未启动时的状态示意图(去除夹板)；
图15是本发明弧形切割吻合器中的保险组件启动时的状态示意图(去除夹板)；
图16是本发明弧形切割吻合器中的保险组件的结构示意图；
图17是保险组件中的保险挡块的立体示意图；
图18是本发明弧形切割吻合器中的切割刀的刀刃第一种结构示意图；
图19是本发明弧形切割吻合器中的切割刀的刀刃第二种结构示意图。
具体实施方式
以下结合附图给出的实施例，对本发明作进一步的详细说明。
如图1～19所示，一种弧形切割吻合器，包括吻合钉成型机构1、推钉组件2、击发手柄3、抵钉座4、抵钉座的底座6、垫刀圈9和两个夹板5，所述吻合钉成型机构1包括组件支架1-1和推钉板1-2，推钉板1-2插装在组件支架1-1内且与组件支架1-1滑动配合，所述击发手柄2与组件支架1-1和推钉板1-2驱动连接，以及与两个夹板5固定连接，抵钉座4固定在垫刀圈9上，垫刀圈9固定在抵钉座的底座6上，抵钉座的底座6固定连接在两个夹板5上，推钉组件2装在组件支架1-1上且与抵钉座4相对，所述推钉组件2包括切割刀2-1、推钉片2-2、钉仓2-3和导向柱2-4，在推钉片2-2的端部且位于切割刀2-1的两侧均设有若干个靠近切割刀2-1的内推钉齿片2-2-1和远离切割刀2-1的外推钉齿片2-2-1’，所述切割刀2-1与推钉片2-2一次性注塑成型而固定在一起，且切割刀2-1的刀刃2-1-1露在内、外推钉齿片2-2-1、2-2-1’顶端之外；所述推钉片2-2上的各个外推钉齿片2-2-1’的外侧设有加强筋2-2-2，推钉片2-2上的各个内推钉齿片2-2-1的内侧设有加强筋2-2-2；内、外推钉齿片2-2-1、2-2-1’均具有第一导向面2-2-1-1、2-2-1’-1、第二导向面2-2-1-2、2-2-1’-2、第一接触面2-2-1-3、2-2-1’-3和第二接触面2-2-1-4、2-2-1’-4，第一接触面2-2-1-3、2-2-1’-3和第二接触面2-2-1-4、2-2-1’-4为外凸弧面，内、外推钉齿片2-2-1、2-2-1’的第一导向面2-2-1-1、2-2-1’-1两端均通过内凹弧形连接面7分别与内、外推钉齿片2-2-1、2-2-1’相应的第一接触面2-2-1-3、2-2-1’-3和第二接触面2-2-1-4、2-2-1’-4连接，第二导向面2-2-1-2、2-2-1’-2两端均通过内凹弧形连接面7’分别与相应的第一接触面2-2-1-3、2-2-1’-3和第二接触面2-2-1-4、2-2-1’-4连接，第一接触面2-2-1-3、2-2-1’-3和第二接触面2-2-1-4、2-2-1’-4均与钉仓2-3的推钉齿片孔2-3-1的内壁接触。
如图1、2、3、4、5、6、7、8所示，为了防止切割刀2-1或导向柱2-4出现晃动，提高切割刀2-1到达切割组织的精确性，以及减小击发力，所述钉仓2-3与导向柱2-4一次性注塑成型而固定在一起，导向柱2-4上具有导向槽2-4-1，切割刀2-1与推钉片2-2均装在钉仓2-3内，切割刀2-1的一侧端插在导向柱2-4的导向槽2-4-1内，且与导向槽2-4-1滑动配合，其目的是针对现有的导向轴的一端固定在垫刀圈上，另一端为悬空状态，并且导向轴的一端穿入在钉仓的安装孔中，使得在导向过程中由于机械力而出现导向轴晃动和切割刀不能准确到达切割组织的现象，而采取的措施。
如图5所示，为了使得加强筋2-2-2在推钉片2-2向前运动时起到导向作用，有利于手术的成型效果，所述钉仓2-3的内壁上设有若干个凹槽2-3-2，推钉片2-2上的与外推钉齿片2-2-1’相连的加强筋2-2-2与凹槽2-3-2滑动配合。
如图4、11所示，为了适用不同类型和规格的吻合器，所述位于切割刀2-1的两侧的内推钉齿片2-2-1和外推钉齿片2-2-1’的数量分别在7～50对范围内。
如图3、5、6、10、12所示，为了便于与推钉板1-2装配，吻合器击发完成后，便于推钉板1-2拉回推钉片2-2，同时拉回切割刀2-1，避免对组织的二次伤害，所述推钉片2-2的尾部具有与推钉片2-2连为一体的倒扣2-2-3。
如图1、2、14、15、16、17所示，所述抵钉座的底座6内还装有保险组件8，保险组件8包括保险块8-1、保险块弹簧片8-2和保险挡块8-3，保险块弹簧片8-2的一端与保险块8-1固定连接，另一端与保险挡块8-3相抵，保险块8-1的一端位于组件支架1-1的前端，且可与组件支架1-1相抵或分离，保险挡块8-3上具有卡装孔8-3-1，抵钉座的底座6上设有凸台6-1，凸台6-1插在保险挡块8-3的卡装孔8-3-1中。其优点在于：当钉仓2-3未装到组件支架1-1内的正确位置时，保险块8-1的一端位于组件支架1-1的前端，且与组件支架1-1相抵，使得组件支架1-1不能向前运动，保险组件8起到阻止击发的作用，使得操作人员不会出现误击现象；当钉仓2-3正确插入组件支架1-1内时，推钉片2-2的一端向下挤压保险块8-1，保险弹簧片8-2向下弯曲，保险块8-1向下运动，保险快8-1的一端与组件支架1-1分离，在扳动击发手柄3运动时，组件支架1-1能够顺利向前运动，当组件支架1-1向前运动一段距离后，此时，保险块8-1与组件支架1-1不接触，保险组件8复位，这样就杜绝切割吻合后发生无钉击发的危险。
如图18、19所示，为了增加切割刀2-1的受力面积，增强刀刃2-1-1的强度，而且也减少刀刃2-1-1的磨损，有效防止刀刃2-1-1出现断裂的现象，所述切割刀2-1的刀刃2-1-1的两侧壁2-1-2均呈弧形，两侧壁2-1-2形成的顶部夹角α为20°～70°。其中，刀刃2-1-1的两侧壁2-1-2形成的顶部夹角α的角度为60°最佳；或者所述切割刀2-1的刀刃2-1-1顶部的两侧壁2-1-2形成锐角，刀刃2-1-1的顶部侧壁2-1-2与下侧壁2-1-3弧形过渡，顶部的两侧壁2-1-2形成的顶部夹角β为20°～70°，其中，顶部的两侧壁2-1-2形成的顶部夹角β的角度为60°最佳。
本发明使用时，扳动击发手柄3，推动吻合钉成型机构1的组件支架1-1向前运动，此时，弧形切割吻合器调整至待击发状态，再次扳动击发手柄，推动吻合钉成型机构1的推钉板1-2向前运动，此时，推钉片2-2在推钉板1-2的推动下向前运动，吻合钉从钉仓2-3的推钉齿片孔2-3-1内推出缝合组织，同时切割刀2-1沿着导向柱2-4的导向槽2-4-1向前运动并且切断多余组织，击发结束，本发明的弧形切割吻合器不仅吻合效果好，而且手术安全性高，减小了手术风险。

Claims (8)

1.一种弧形切割吻合器，包括吻合钉成型机构(1)、推钉组件(2)、击发手柄(3)、抵钉座(4)、抵钉座的底座(6)、垫刀圈(9)和两个夹板(5)，所述吻合钉成型机构(1)包括组件支架(1-1)和推钉板(1-2)，推钉板(1-2)插装在组件支架(1-1)内且与组件支架(1-1)滑动配合，所述击发手柄(2)与组件支架(1-1)和推钉板(1-2)驱动连接，以及与两个夹板(5)固定连接，抵钉座(4)固定在垫刀圈(9)上，垫刀圈(9)固定在抵钉座的底座(6)上，抵钉座的底座(6)固定连接在两个夹板(5)上，推钉组件(2)装在组件支架(1-1)上且与抵钉座(4)相对，所述推钉组件(2)包括切割刀(2-1)、推钉片(2-2)、钉仓(2-3)和导向柱(2-4)，在推钉片(2-2)的端部且位于切割刀(2-1)的两侧均设有若干个靠近切割刀(2-1)的内推钉齿片(2-2-1)和远离切割刀(2-1)的外推钉齿片(2-2-1’)，其特征在于：
a、所述切割刀(2-1)与推钉片(2-2)一次性注塑成型而固定在一起，且切割刀(2-1)的刀刃(2-1-1)露在内、外推钉齿片(2-2-1、2-2-1’)顶端之外；
b、所述推钉片(2-2)上的各个外推钉齿片(2-2-1’)的外侧设有加强筋(2-2-2)，推钉片(2-2)上的各个内推钉齿片(2-2-1)的内侧设有加强筋(2-2-2)；
c、内、外推钉齿片(2-2-1、2-2-1’)均具有第一导向面(2-2-1-1、2-2-1’-1)、第二导向面(2-2-1-2、2-2-1’-2)、第一接触面(2-2-1-3、2-2-1’-3)和第二接触面(2-2-1-4、2-2-1’-4)，第一接触面(2-2-1-3、2-2-1’-3)和第二接触面(2-2-1-4、2-2-1’-4)为外凸弧面，内、外推钉齿片(2-2-1、2-2-1’)的第一导向面(2-2-1-1、2-2-1’-1)两端均通过内凹弧形连接面(7)分别与内、外推钉齿片(2-2-1、2-2-1’)相应的第一接触面(2-2-1-3、2-2-1’-3)和第二接触面(2-2-1-4、2-2-1’-4)连接，第二导向面(2-2-1-2、2-2-1’-2)两端均通过内凹弧形连接面(7’)分别与相应的第一接触面(2-2-1-3、2-2-1’-3)和第二接触面(2-2-1-4、2-2-1’-4)连接，第一接触面(2-2-1-3、2-2-1’-3)和第二接触面(2-2-1-4、2-2-1’-4)均与钉仓(2-3)的推钉齿片孔(2-3-1)的内壁接触。
2.根据权利要求1所述的弧形切割吻合器，其特征在于：所述钉仓(2-3)与导向柱(2-4)一次性注塑成型而固定在一起，导向柱(2-4)上具有导向槽(2-4-1)，切割刀(2-1)与推钉片(2-2)均装在钉仓(2-3)内，切割刀(2-1)的一侧端插在导向柱(2-4)的导向槽(2-4-1)内，且与导向槽(2-4-1)滑动配合。
3.根据权利要求1所述的弧形切割吻合器，其特征在于：所述钉仓(2-3)的内壁上设有若干个凹槽(2-3-2)，推钉片(2-2)上的与外推钉齿片(2-2-1’)相连的加强筋(2-2-2)与凹槽(2-3-2)滑动配合。
4.根据权利要求1所述的弧形切割吻合器，其特征在于：所述位于切割刀(2-1)的两侧的内推钉齿片(2-2-1)和外推钉齿片(2-2-1’)的数量分别在7～50对范围内。
5.根据权利要求1所述的弧形切割吻合器，其特征在于：所述推钉片(2-2)的尾部具有与推钉片(2-2)连为一体的倒扣(2-2-3)。
6.根据权利要求1所述的弧形切割吻合器，其特征在于：所述抵钉座的底座(6)内还装有保险组件(8)，保险组件(8)包括保险块(8-1)、保险块弹簧片(8-2)和保险挡块(8-3)，保险块弹簧片(8-2)的一端与保险块(8-1)固定连接，另一端与保险挡块(8-3)相抵，保险块(8-1)的一端位于组件支架(1-1)的前端，且可与组件支架(1-1)相抵或分离，保险挡块(8-3)上具有卡装孔(8-3-1)，抵钉座的底座(6)上设有凸台(6-1)，凸台(6-1)插在保险挡块(8-3)的卡装孔(8-3-1)中。
7.根据权利要求1所述的弧形切割吻合器，其特征在于：所述切割刀(2-1)的刀刃(2-1-1)的两侧壁(2-1-2)均呈弧形，两侧壁(2-1-2)形成的顶部夹角α为20°～70°。
8.根据权利要求1所述的弧形切割吻合器，其特征在于：所述切割刀(2-1)的刀刃(2-1-1)顶部的两侧壁(2-1-2)形成锐角，刀刃(2-1-1)的顶部侧壁(2-1-2)与下侧壁(2-1-3)弧形过渡，顶部的两侧壁(2-1-2)形成的顶部夹角β为20°～70°。
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