CN102973300B - 直线形切割吻合器的组织夹持件及其钉仓座 - Google Patents
直线形切割吻合器的组织夹持件及其钉仓座 Download PDFInfo
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Abstract
本发明公开了一种直线形切割吻合器的组织夹持件及其钉仓座，钉仓座的出钉表面的左右两侧分别设有一列与推刀槽平行的阻挡条和阻挡凸起，组织夹持件的抵钉座的抵钉表面的前端部位沿着左右向设置了一排半球形凹孔。使用时阻挡凸起给夹持的人体组织施加与切割刀行进方向相反的作用力，两列阻挡条同时给夹持的人体组织施加与切割刀行进方向相反和向左右向外侧的作用力，从而夹持的组织稳固，不易滑脱；其中，左列阻挡条还向人体组织施加向左的作用力，右列阻挡条还向人体组织施加向右的作用力，因此使得夹持的组织绷紧，切割刀向前推进时切割更加顺利。
Description
技术领域
本发明涉及一种医疗器械，具体涉及一种外科手术用的直线形切割吻合器的组织夹持件及其零件。
背景技术
吻合器为根据订书机原理设计的使用在外科手术中的替代传统手工切割和缝合的特殊手术器械。根据用途和使用部位的不同，吻合器分为多种类型。消化道吻合器的种类通常有三种。第一种是圆形吻合器，第二种是直线形切割吻合器，第三种是直线形缝合器。
圆形吻合器也称为管状吻合器或端-端吻合器，其基本结构分为抵钉座和器身两个部分，其吻合目的是进行管腔器官的端端吻合，也即将两个管状组织的端口固定连接在一起，还可进行管腔器官的端侧和侧侧吻合。所述的端端吻合，先在一个管状组织的侧部开一道侧切口，再将包括钉仓的器身从该侧切口伸入该管状组织的内腔中并从需连接的端口处伸出，并以扎荷包的方式将该管状组织的端口捆扎在器身的节轴上。而将抵钉座也以扎荷包的方式捆扎在需连接的另一个管状组织的端口上。再将节轴的端头插入抵钉座中，再调整吻合器进入击发状态，击发后则在组织上击入呈圆形排列的两排相互交错的缝合钉，并同时以圆筒状手术刀将其内侧的组织，也即两个端口的端头组织切断，被切下的组织片为环状。击发切割完成后，将吻合器的器身连同抵钉座从侧切口退出，被切除的组织因为被夹持在器身与抵钉座之间故一同退出。最后再用手工缝合侧切口，或者采用直线形缝合器缝合侧切口。
直线形缝合器也称为残端闭合器，是一种能够将两排相互交错的缝合钉在组织上成直线钉入的器械，也是被广泛应用替代手工直线缝合的器械之一。直线形缝合器适用于胃、十二指肠、小肠、结肠手术时缝闭残端或切口用等。
直线形切割吻合器简称为切割吻合器，也称为切开缝合器。它包括钉仓部和抵钉部，是一种能在组织的两边各打入1组、合计4排或6排的相互交错排列的缝合钉，并同时以切割刀将缝钉线之间的组织进行离断的器械，即是一种可以同时进行直线吻合和切割的器械。直线形切割吻合器适用于消化道重建及脏器切除手术中，例如胃空肠侧侧吻合，结肠与直肠的侧侧吻合，以及J形贮粪袋的制作等。另外，这类吻合器还包括内镜切割吻合器。该器械是在内镜尤其是腹腔镜手术时不可缺少的，同样适用于胃肠切除和吻合等，且其缝合部具有旋转功能，从而该种吻合器可以称为旋转式直线形切割吻合器。
见图1及图2，美国专利文献US 5865361所公开的“外科手术用吻合器械”即为一种旋转式的直线形切割吻合器。该旋转式直线形切割吻合器由带有手柄的控制部件和带有钉仓的缝合切割部件组成。
所述的控制部件包括控制杆52、后套管124、旋转套28、转向拨钮30、第一驱动板（文献中标号为123）、保险按钮82、复位拨钮32、固定手柄22和活动手柄24。
所述的缝合切割部件包括连接杆组件、割刀组件、枢接板（文献中标号为256）、钉仓组件18以及抵钉座组件20。
连接杆组件包括前套管251、上半连接杆（文献中标号为250）和下半连接杆（文献中标号为252）。上半连接杆和下半连接杆均设有前后向的推刀槽，两者相对贴合在一起而组成连接杆，所述的推刀槽也合并成连接杆的推刀槽。前套管251沿从前至后的方向套在连接杆上，且在后端被连接杆限位。
割刀组件包括驱动梁（文献中标号为266）和切割刀（文献中标号为280）。切割刀固定在驱动梁的前端部位上，且切割刀的刃口朝向前方。驱动梁设置在连接杆的推刀槽中，且驱动梁的前端伸出连接杆。枢接板设置在上半连接杆与下半连接杆之间，且位于右侧。
钉仓组件18包括外壳216、钉仓座（文献中标号为220）、上连接座（文献中标号为236）、下连接座（文献中标号为238）和一对连接片（文献中标号为246）。钉仓座固定在外壳216上，且位于外壳的前部和中部。钉仓座中有两组共六排沿前后向排列的缝合钉，相邻排的缝合钉交错排列。外壳216和钉仓座均设有贯通上下的中央纵向槽。
上连接座和下连接座均设有前后向的推刀槽，且所述推刀槽的前段在上下向上贯穿座体，并且上连接座位于下连接座的上方。上连接座和下连接座均固定在外壳的后端部位上；驱动梁的前端部位的上部位于上连接座的推刀槽的前段中，且由其上部的前端伸出上连接座，该上部前端上固定设有左右向的销轴（文献中标号为286）。驱动梁的前端部位的下部向下依次穿过下连接座的推刀槽的前段和外壳216的推刀槽，并伸入与其紧配合的支持板（文献中标号为287）中。切割刀则位于驱动梁的前端部位的上部和下部之间。枢接板的前端头从上向下套在下连接座的位于右侧的连接柱上。
一对连接片分上下设置，上连接片由其后端部位嵌在上半连接杆的开口向上的且在前后向限位的凹槽中，并由前套管251在周向外侧限位，从而与连接组件固定连接，上连接片的前端部位通过上枢接轴（文献中标号为244）与上连接座转动连接；下连接片由其后端部位嵌在下半连接杆的开口向下的且在前后向限位的凹槽中，并由前套管251在周向外侧限位，从而与连接组件固定连接，下连接片的前端部位通过下枢接轴（文献中标号为244）穿过外壳216底部后与下连接座转动连接。
抵钉座组件20包括固定在一起的抵钉座（文献中标号为204）和盖板208。抵钉座呈板状，抵钉座的主体水平设置，抵钉座的后段基本按照前高后低的方位设置，且抵钉座的主体和后段上均设有贯通上下的推刀槽，并且抵钉座的后段的左右两侧各设有一个枢接部位（文献中标号为211）。枢接部位设置在外壳的开口向上的枢接槽（文献中标号为213）中，而使得抵钉座组件20相对于钉仓组件18的外壳216转动连接。盖板208从上方固定在抵钉座上，且盖板208与抵钉座之间形成具有后端开口的上部空间。驱动梁的前端部位的上部前端从下向上穿过抵钉座的推刀槽而位于所述的上部空间的后端开口的后侧，且所述的销轴从后上方与抵钉座的后段朝向右上方的侧面相接触。
旋转式直线形切割吻合器在使用时，先将缝合切割部件的连接杆的后端头伸入并固定在控制部件的后套管124中，且控制杆52的前端头伸入驱动梁的后端的卡接部位处，枢接板的后端凸出部位伸入第一驱动板的相应的凹槽中。此时，若将旋转套28相对于固定手柄22转动，则后套管124和缝合切割部件随之一同转动。
若将转向拨钮30向左右转动则依次通过转换件（文献中标号为138）和第一驱动板（文献中标号为123）传递动力，向前推动或向后拉回枢接板（文献中标号为256），前者使得钉仓组件18和抵钉座组件20（该两者构成组织夹持件）向左转动，后者使得组织夹持件向右转动。
缝合切割部件导入人体时，其组织夹持件（俗称钉仓钳口）处于关闭状态。当接近手术部位时，将复位拨钮32向后拨到后端起始位置，则使得钉仓钳口处于张开的状态。再使得组织夹持件夹持在待吻合切割的组织之上，握紧活动手柄24，则使得控制杆52向前运动，并推动驱动梁相对于连接杆向前运动，固定在驱动梁上的销轴则从抵钉座的后段运动至抵钉座的主体的上侧面上，而使抵钉座从相对于外壳及钉仓座的张开状态转动至闭合状态，也即使组织被夹持在抵钉座与钉仓座之间，切割刀则对准所夹持的组织。此时，按动保险按钮82解除保险，握紧活动手柄24进行击发，随着击发次数的不断增加，驱动梁不断在连接杆的推刀槽、上下连接座的推刀槽、外壳216和钉仓座的中央纵向槽和抵钉座的推刀槽中向前运动，向前运动的同时，由切割刀对所夹组织进行切割，同时由驱动梁的前端部位的下部前端推动楔形块（文献中标号为234），楔形块则在前行过程中推动各个推钉片（文献中标号为228），每个推钉片使得3个缝合钉穿过组织而在抵钉座的阻挡下变形呈B形，而将推刀槽左右两侧的组织缝合，同时切割刀沿着推刀槽将两侧缝合组织之间割开，在缝合的同时完成切割。
实际使用中，由于切割时切割刀对组织施加远离手柄方向的推力，夹持在钉仓座和抵钉座之间的组织会滑移并向远离手柄的方向移动，使得手术的部位产生偏差，影响缝合和切割操作。
中国专利文献CN 101797173（申请号201010122833.7）公开了一种具有防滑功能的外科直线切割吻合器钉匣，其钉匣的上壁面设有若干横向的相互平行的凹槽或者是点状凹窝或者是其它形状的凹面，从而形成纵向的凹凸防滑面，当切割刀纵向运动时，可以防止组织沿纵向滑动。这种结构的组织接触表面虽然能起到一定的防滑效果，但是凹凸防滑面的存在有时候会使夹持的组织聚合在一起，不易于切割刀的直线推进。
中国专利文献CN 1915180B（申请号200610138870.0）公开了一种包括具有多种缝钉尺寸的钉仓的外科吻合器，在该文献的图7所示的用于执行手术吻合缝合的线型胃肠吻合器中，钉仓包括阶梯状组织接触表面，包括外组织接触表面121a、中间组织接触表面121b和内组织接触表面121c，当从钉仓的底部表面测量它们时，每一个组织接触表面具有不同的高度，组织接触表面时基本上彼此平行的平面结构，但不是彼此共面的；从而实现吻合强度和止血程度间的平衡。但是设有这种组织接触表面的钉仓和抵钉座的结构比较复杂，相应的钉匣和抵钉座的加工成本也较高。
发明内容
本发明所要解决的技术问题是提供一种组织夹持稳固且利于推刀推进的直线形切割吻合器的组织夹持件及其钉仓座。
实现本发明第一目的的技术方案是一种直线形切割吻合器的组织夹持件的钉仓座，包括出钉表面、推刀槽和出钉孔，推刀槽沿纵向设置在钉仓座的中间部位，推刀槽的左右两侧各设1组出钉孔，2组出钉孔按照所处的左右位置的不同分为第一组出钉孔和第二组出钉孔；钉仓座的出钉表面上设有阻挡条。
阻挡条包括位于推刀槽的左侧的第一组阻挡条和位于推刀槽的右侧的第二组阻挡条；第一组阻挡条的各个左阻挡条沿前后向依次等间隔设置而成为一列阻挡条，第二组阻挡条的各个右阻挡条也沿前后向依次等间隔设置而成为另一列阻挡条，并且第一组阻挡条的各个左阻挡条与第二组阻挡条的相应一个右阻挡条以经过推刀槽的前后向的中心线的铅垂面为对称面而对称设置。
第一组阻挡条的各个左阻挡条整体呈V形，均由第一阻挡凸条和第一拉伸凸条相连而构成；第一阻挡凸条沿左右向设置，设置在第一组出钉孔的最左侧的一列出钉孔的相应的两个相邻出钉孔之间；第一阻挡凸条的延伸方向与推刀槽相垂直；各个左阻挡条的第一拉伸凸条从与第一阻挡凸条的连接处向左前方延伸，位于最左侧的一列出钉孔的左侧；第一阻挡凸条与第一拉伸凸条的夹角的锐角θ为5°～75°。
第二组阻挡条的各个右阻挡条的形状与第一组阻挡条的相应一个左阻挡条12a形状对称，各个右阻挡条整体呈V形，均由第二阻挡凸条和第二拉伸凸条相连而构成；第二阻挡凸条沿左右向设置，设置在第二组出钉孔的最右侧的一列出钉孔的相应的两个相邻出钉孔之间；第二阻挡凸条的延伸方向与推刀槽相垂直；各个右阻挡条的第二拉伸凸条从与第二阻挡凸条的连接处向右前方延伸，且各个右阻挡条的第二拉伸凸条位于最右侧的一列出钉孔的右侧；第二阻挡凸条和第二拉伸凸条的夹角的锐角与左阻挡条的第一阻挡凸条和第一拉伸凸条的夹角的锐角θ相等。
优选的，钉仓座的出钉表面上还设有阻挡凸起；阻挡凸起位于推刀槽的前方；所述阻挡凸起有4～8个，其形状为半球形，各个阻挡凸起沿着左右向依次设置。
上述阻挡条相对于出钉表面的高度为0.2mm～2mm，优选0.2mm～1mm，进一步优选0.2mm～0.5mm。
上述阻挡凸起相对于出钉表面的高度为0.2mm～1mm，优选0.2mm～1mm，进一步优选0.2mm～0.5mm。
上述阻挡条的外表面光滑无棱角，外表面的上表面为圆弧形。
第一组出钉孔的最左侧一列的出钉孔的前部还设置一个左阻挡条，最左侧一列的出钉孔的后部还设置一个左阻挡条。
第二组出钉孔的最右侧一列的出钉孔的前部还设置一个右阻挡条，最右侧一列的出钉孔的后部还设置一个右阻挡条。
实现本发明第二目的的技术方案是一种直线形切割吻合器的组织夹持件，由钉仓组件和抵钉座组件组成，钉仓组件包括钉仓座，钉仓座包括出钉表面、推刀槽和出钉孔，推刀槽沿纵向设置在钉仓座的中间部位，推刀槽的左右两侧各设1组出钉孔，2组出钉孔按照所处的左右位置的不同分为第一组出钉孔和第二组出钉孔；抵钉座组件包括抵钉座，抵钉座包括抵钉表面、上推刀槽和抵钉槽；上推刀槽与钉仓座的推刀槽相对应，沿纵向设置在抵钉座的中间部位。
钉仓座的出钉表面上设有阻挡条。
所述阻挡条包括位于推刀槽的左侧的第一组阻挡条和位于推刀槽的右侧的第二组阻挡条；第一组阻挡条的各个左阻挡条沿前后向依次等间隔设置而成为一列阻挡条，第二组阻挡条的各个右阻挡条也沿前后向依次等间隔设置而成为另一列阻挡条，并且第一组阻挡条的各个左阻挡条与第二组阻挡条的相应一个右阻挡条以经过推刀槽的前后向的中心线的铅垂面为对称面而对称设置。
第一组阻挡条的各个左阻挡条整体呈V形，均由第一阻挡凸条和第一拉伸凸条相连而构成；第一阻挡凸条沿左右向设置，设置在第一组出钉孔的最左侧的一列出钉孔的相应的两个相邻出钉孔之间；第一阻挡凸条的延伸方向与推刀槽相垂直；各个左阻挡条的第一拉伸凸条从与第一阻挡凸条的连接处向左前方延伸，位于最左侧的一列出钉孔的左侧；第一阻挡凸条与第一拉伸凸条的夹角的锐角θ为5°～75°。
第二组阻挡条的各个右阻挡条的形状与第一组阻挡条的相应一个左阻挡条形状对称，各个右阻挡条整体呈V形，均由第二阻挡凸条和第二拉伸凸条相连而构成；第二阻挡凸条沿左右向设置，设置在第二组出钉孔的最右侧的一列出钉孔的相应的两个相邻出钉孔之间；第二阻挡凸条的延伸方向与推刀槽相垂直；各个右阻挡条的第二拉伸凸条从与第二阻挡凸条的连接处向右前方延伸，且各个右阻挡条的第二拉伸凸条位于最右侧的一列出钉孔的右侧；第二阻挡凸条和第二拉伸凸条的夹角的锐角与左阻挡条的第一阻挡凸条和第一拉伸凸条的夹角的锐角θ相等。
优选的，钉仓座的出钉表面上还设有阻挡凸起；阻挡凸起位于推刀槽的前方；所述阻挡凸起有4～8个，其形状为半球形，各个阻挡凸起沿着左右向依次设置。
抵钉座的抵钉表面上还设有阻挡凹坑6，阻挡凹坑6设置在抵钉表面的前端部位上；阻挡凹坑6的数量与钉仓座的阻挡凸起的数量相同，各个阻挡凹坑6沿左右向依次设置；阻挡凹坑6形状为半球形，与钉仓座的阻挡凸起的形状相对应。
上述钉仓座的阻挡条相对于出钉表面的高度为0.2mm～2mm，优选0.2mm～1mm，进一步优选0.2mm～0.5mm；阻挡凸起相对于出钉表面的高度为0.2mm～2mm，优选0.2mm～1mm，进一步优选0.2mm～0.5mm。
作为优选的，第一阻挡凸条与第一拉伸凸条的夹角的锐角θ为20°～60°。
上述钉仓座的阻挡条的外表面光滑无棱角，外表面的上表面为圆弧形。
钉仓座的第一组出钉孔的最左侧一列的出钉孔的前部还设置一个左阻挡条，最左侧一列的出钉孔的后部还设置一个左阻挡条。
钉仓座的第二组出钉孔的最右侧一列的出钉孔的前部还设置一个右阻挡条，最右侧一列的出钉孔的后部还设置一个右阻挡条。
本发明具有积极的效果：
（1）本发明的组织夹持件的钉仓座的出钉表面的左右两侧分别设有一列与推刀槽平行的阻挡条，且两列阻挡条以推刀槽为对称轴对称设置，使用时两列阻挡条同时给夹持的人体组织施加与切割刀行进方向相反和向左右向外侧的作用力，从而夹持的组织稳固，不易滑脱；其中，左列阻挡条还向人体组织施加向左的作用力，右列阻挡条还向人体组织施加向右的作用力，因此使得夹持的组织绷紧，切割刀向前推进时切割更加顺利。另外，每列阻挡条的阻挡部位的表面是光滑的，因此不会对人体组织造成伤害。
（2）组织夹持件的钉仓座的出钉表面的前端部位还沿左右向设置了一排半球形凸起，对应地，抵钉座的抵钉表面的前端部位沿着左右向设置了一排半球形凹孔，当夹持人体组织后切割刀向前推进时，由于这一排半球形凸起和一排半球形凹孔共同夹持人体组织，而对应产生出向后的反作用力，进一步稳固地夹持人体组织；另外由于半球形凸起的表面是光滑的，因此不会对人体组织造成伤害。
附图说明
图1为美国专利US 5865361所公开的旋转式的直线形切割吻合器的带有手柄的控制部件的示意图；
图2为美国专利US 5865361所公开的旋转式的直线形切割吻合器的带有钉仓的缝合切割部件；
图3为本发明的组织夹持件的立体示意图；
图4为图3中的钉仓座的立体示意图；
图5为图4的钉仓座的局部放大示意图；
图6为图1中的抵钉座的立体示意图。
上述附图中的标记如下：
钉仓座1，出钉表面11，阻挡条12，左阻挡条12a，第一阻挡凸条12a-1，第一拉伸凸条12a-2，右阻挡条12b，第二阻挡凸条12b-1，第二拉伸凸条12b-2，阻挡凸起13，推刀槽14，出钉孔15，第一组出钉孔15a，第二组出钉孔15b；
抵钉座2，抵钉表面21，上推刀槽23，抵钉槽25，阻挡凹孔26。
钉仓组件18，抵钉座组件20，固定手柄22，活动手柄24，旋转套28，转向拨钮30，复位拨钮32，控制杆52，保险按钮82，后套管124，盖板208，外壳216，前套管251。
具体实施方式
在附图和以下的描述中，术语“后部”表示最接近操作者的直线形切割吻合器的端部，并作为切割刀推进方向的“后部”；术语“前部”表示离操作者最远的端部，并作为切割刀推进方向的“前部”；切割刀的推进方向为从后部向前部推进的方向；术语“左侧”和“右侧”分别位于推刀槽纵向的左端和右端。
（实施例1）
见图3，本实施例的直线形切割吻合器的组织夹持件由钉仓组件和抵钉座组件组成。钉仓组件包括钉仓座1，抵钉座组件包括抵钉座2。钉仓座1为注塑一体件，抵钉座2为钢制一体件。
上述组织夹持件主要由钉仓组件和抵钉座组件组成。钉仓组件中，除钉仓座1外，采用美国专利文献US 5865361中的钉仓组件18。抵钉座组件中，处抵钉座2外，则采用美国专利文献US 5865361中的抵钉座组件20。
钉仓座1包括出钉表面11、推刀槽14和出钉孔15。出钉表面11沿水平面设置。推刀槽14沿前后向也即沿纵向设置在钉仓座1的中间部位，且推刀槽14在上下向上贯穿钉仓座1的座体；出钉孔15分布在推刀槽14的左右两侧，也即推刀槽14的左右两侧各设1组出钉孔15，且2组出钉孔按照所处的左右位置的不同分为第一组出钉孔15a和第二组出钉孔15b。每组出钉孔按照所处的左右位置的不同分为3列，每列出钉孔的各个出钉孔15按照前后向依次排列，并且每个出钉孔15均为上下向的通孔，且沿前后向呈长条状设置。各列出钉孔均与推刀槽14平行，相邻列的出钉孔在前后向上交错设置。
见图4和图5，本实施例的创新点在于：钉仓座1还在其出钉表面11上设有阻挡条12和阻挡凸起13。阻挡凸起13设置在阻挡条12的前部。阻挡条12相对于出钉表面11的高度为0.2mm～2mm（本实施例中为0.3mm）。阻挡凸起13相对于出钉表面11的高度为0.2mm～2mm（本实施例中为0.3mm）。
阻挡条12分为2组，它们是位于推刀槽14的左侧的第一组阻挡条和位于推刀槽14的右侧的第二组阻挡条。第一组阻挡条的各个左阻挡条12a沿前后向依次等间隔设置而成为一列阻挡条，第二组阻挡条的各个右阻挡条12b也沿前后向依次等间隔设置而成为另一列阻挡条，并且第一组阻挡条的各个左阻挡条12a与第二组阻挡条的相应一个右阻挡条12b以经过推刀槽14的前后向的中心线的铅垂面为对称面而对称设置。
第一组阻挡条的左阻挡条12a的外表面光滑无棱角，外表面的上表面为圆弧形。各个左阻挡条12a设置在第一组出钉孔15a的最左侧的一列出钉孔的相应的2个相邻出钉孔15之间，且最左侧一列的出钉孔15的前部还设置一个左阻挡条12a，最左侧一列的出钉孔15的后部还设置一个左阻挡条12a。
各个左阻挡条12a整体呈V形，均由第一阻挡凸条12a-1和第一拉伸凸条12a-2相连而构成。第一阻挡凸条12a-1和第一拉伸凸条12a-2的上部均基本呈半圆柱形、下部均基本呈长条状方形。第一阻挡凸条12a-1沿左右向设置，第一阻挡凸条12a-1的延伸方向与推刀槽14相垂直。第一组阻挡条的最前侧的左阻挡条12a的第一阻挡凸条12a-1位于第一组出钉孔15a的最左侧的一列的出钉孔的前方，第一组阻挡条的其余左阻挡条12a的各自的第一阻挡凸条12a-1则位于该列出钉孔中的相邻的两个出钉孔15之间。各个左阻挡条12a的第一拉伸凸条12a-2从与第一阻挡凸条12a-1的连接处向左前方延伸，也即第一拉伸凸条12a-2从与第一阻挡凸条12a-1的连接处向左前侧延伸，且各个左阻挡条12a的第一拉伸凸条12a-2位于最左侧的一列出钉孔15的左侧。第一阻挡凸条12a-1与第一拉伸凸条12a-2的夹角的锐角θ为5°～75°，优选为20°～60°，本实施例中为30°。
第二组阻挡条的各个右阻挡条12b的形状与第一组阻挡条的相应一个左阻挡条12a形状对称。各个右阻挡条12b设置在第二组出钉孔15b的最右侧的一列出钉孔的相应的2个相邻出钉孔15之间，且最右侧一列的出钉孔15的前部还设置一个右阻挡条12b，最右侧一列的出钉孔15的后部还设置一个右阻挡条12b。
各个右阻挡条12b整体呈V形，均由第二阻挡凸条12b-1和第二拉伸凸条12b-2相连而构成。第二阻挡凸条12b-1和第二拉伸凸条12b-2的上部均基本呈半圆柱形、下部均基本呈长条状方形。第二阻挡凸条12b-1沿左右向设置，第二阻挡凸条12b-1的延伸方向与推刀槽14相垂直。第二组阻挡条的最前侧的右阻挡条12b的第二阻挡凸条12b-1位于第二组出钉孔15b的最右侧的一列的出钉孔的前方，第二组阻挡条的其余右阻挡条12b的各自的第二阻挡凸条12b-1则位于该列出钉孔中的相邻的两个出钉孔15之间。各个右阻挡条12b的第二拉伸凸条12b-2从与第二阻挡凸条12b-1的连接处向右前方延伸，也即第二拉伸凸条12b-2从与第二阻挡凸条12b-1的连接处向右前侧延伸，且各个右阻挡条12b的第二拉伸凸条12b-2位于最右侧的一列出钉孔15的右侧。第二阻挡凸条12b-1和第二拉伸凸条12b-2的夹角的锐角与左阻挡条12a的第一阻挡凸条12a-1和第一拉伸凸条12a-2的夹角的锐角θ相等。
见图3和图5，当需进行手术的人体组织被夹持在钉仓座1的出钉表面10和抵钉座2的抵钉表面21之间后，切割刀在推刀槽14内从后向前推进时，各个左阻挡条12a由各自的第一阻挡凸条12a-1以及右阻挡条12b由各自第二阻挡凸条12b-1同时向组织施加向与切割刀行进方向相反的力F1，也即向组织施加向后的力F1。与此同时，各个左阻挡条12a的第一拉伸凸条12a-2向夹持的组织施加朝向左后方的力F2a，力F2a可以分解成向后的力F21a和向左的力F22a；各个右阻挡条12b的第二拉伸凸条12b-2则向夹持的组织施加朝向右后方的力F2b，力F2b可以分解成向后的力F21b和向右的力F22b。夹持的人体组织在向左的力F22a和向右的力F22b的作用下被绷紧，绷紧后的人体组织有利于切割刀的向前切割行进。
因此，出钉表面11上的阻挡条12不仅能够使得组织夹持组件夹持更稳固，而且不仅不影响切割刀的行进，反而使得切割组织更加容易。
所述出钉表面11上的阻挡凸起13有4～8个（本实施例中为5个），其形状为半球形，各个阻挡凸起13沿着左右向依次设置，且阻挡凸起13位于推刀槽14的前方。
见图6，抵钉座2包括抵钉表面21、上推刀槽23和抵钉槽25和阻挡凹坑26。上推刀槽23沿前后向也即沿纵向设置在抵钉座2的中间部位，且上推刀槽23在上下向上贯穿抵钉座2的座体，并且上推刀槽23与钉仓座1的推刀槽14相对应。抵钉槽25是设置在抵钉表面21上的凹坑，抵钉槽25数量与钉仓座1的出钉孔15的数量相同，且其位置与相应一个出钉孔15的位置相对应。阻挡凹坑26设置在抵钉表面21的前端部位上。阻挡凹坑26的数量与钉仓座1的阻挡凸起13的数量相同，且各个阻挡凹坑26沿左右向依次设置。阻挡凹坑26形状为半球形，且与钉仓座1的阻挡凸起13的形状相对应。
使用时，当人体组织被夹持在钉仓座1的出钉表面10和抵钉座2的抵钉表面21之间时，处于前方的人体组织被夹持在阻挡凸起13和阻挡凹孔26之间，当切割刀由后向前推进时，阻挡凸起13和阻挡凹坑26共同向夹持的人体组织施加向后的力F3，进一步保证切割与缝合过程中稳固地对人体组织进行夹持。
Claims (10)
1.一种直线形切割吻合器的组织夹持件的钉仓座，包括出钉表面（11）、推刀槽（14）和出钉孔（15），推刀槽（14）沿纵向设置在钉仓座（1）的中间部位，推刀槽（14）的左右两侧各设1组出钉孔，2组出钉孔按照所处的左右位置的不同分为第一组出钉孔（15a）和第二组出钉孔（15b）；其特征在于：钉仓座（1）的出钉表面（11）上设有阻挡条（12）；
阻挡条（12）包括位于推刀槽（14）的左侧的第一组阻挡条和位于推刀槽（14）的右侧的第二组阻挡条；第一组阻挡条的各个左阻挡条（12a）沿前后向依次等间隔设置而成为一列阻挡条，第二组阻挡条的各个右阻挡条（12b）也沿前后向依次等间隔设置而成为另一列阻挡条，并且第一组阻挡条的各个左阻挡条（12a）与第二组阻挡条的相应一个右阻挡条（12b）以经过推刀槽（14）的前后向的中心线的铅垂面为对称面而对称设置；
第一组阻挡条的各个左阻挡条（12a）整体呈V形，均由第一阻挡凸条（12a-1）和第一拉伸凸条（12a-2）相连而构成；第一阻挡凸条（12a-1）沿左右向设置，设置在第一组出钉孔（15a）的最左侧的一列出钉孔的相应的两个相邻出钉孔（15）之间；第一阻挡凸条（12a-1）的延伸方向与推刀槽（14）相垂直；各个左阻挡条（12a）的第一拉伸凸条（12a-2）从与第一阻挡凸条（12a-1）的连接处向左前方延伸，位于最左侧的一列出钉孔（15）的左侧；第一阻挡凸条（12a-1）与第一拉伸凸条（12a-2）的夹角的锐角θ为5°～75°；
第二组阻挡条的各个右阻挡条（12b）的形状与第一组阻挡条的相应一个左阻挡条（12a）形状对称，各个右阻挡条（12b）整体呈V形，均由第二阻挡凸条（12b-1）和第二拉伸凸条（12b-2）相连而构成；第二阻挡凸条（12b-1）沿左右向设置，设置在第二组出钉孔（15b）的最右侧的一列出钉孔的相应的两个相邻出钉孔（15）之间；第二阻挡凸条（12b-1）的延伸方向与推刀槽（14）相垂直；各个右阻挡条（12b）的第二拉伸凸条（12b-2）从与第二阻挡凸条（12b-1）的连接处向右前方延伸，且各个右阻挡条（12b）的第二拉伸凸条（12b-2）位于最右侧的一列出钉孔（15）的右侧；第二阻挡凸条（12b-1）和第二拉伸凸条（12b-2）的夹角的锐角与左阻挡条（12a）的第一阻挡凸条（12a-1）和第一拉伸凸条（12a-2）的夹角的锐角θ相等。
2.根据权利要求1所述的直线形切割吻合器的组织夹持件的钉仓座，其特征在于：钉仓座（1）的出钉表面（11）上还设有阻挡凸起（13）；阻挡凸起（13）位于推刀槽（14）的前方；所述阻挡凸起（13）有4～8个，其形状为半球形，各个阻挡凸起（13）沿着左右向依次设置。
3.根据权利要求1所述的直线形切割吻合器的组织夹持件的钉仓座，其特征在于：阻挡条（12）相对于出钉表面（11）的高度为0.2mm～2mm。
4.根据权利要求2所述的直线形切割吻合器的组织夹持件的钉仓座，其特征在于：阻挡凸起（13）相对于出钉表面（11）的高度为0.2mm～2mm。
5.根据权利要求1所述的直线形切割吻合器的组织夹持件的钉仓座，其特征在于：阻挡条（12）的外表面光滑无棱角，外表面的上表面为圆弧形；
第一组出钉孔（15a）的最左侧一列的出钉孔（15）的前部还设置一个左阻挡条（12a），最左侧一列的出钉孔（15）的后部还设置一个左阻挡条（12a）；
第二组出钉孔（15b）的最右侧一列的出钉孔（15）的前部还设置一个右阻挡条（12b），最右侧一列的出钉孔（15）的后部还设置一个右阻挡条（12b）。
6.一种直线形切割吻合器的组织夹持件，由钉仓组件和抵钉座组件组成，钉仓组件包括钉仓座（1），钉仓座（1）包括出钉表面（11）、推刀槽（14）和出钉孔（15），推刀槽（14）沿纵向设置在钉仓座（1）的中间部位，推刀槽（14）的左右两侧各设1组出钉孔，2组出钉孔按照所处的左右位置的不同分为第一组出钉孔（15a）和第二组出钉孔（15b）；抵钉座组件包括抵钉座（2），抵钉座（2）包括抵钉表面（21）、上推刀槽（23）和抵钉槽（25）；上推刀槽（23）与钉仓座（1）的推刀槽（14）相对应，沿纵向设置在抵钉座（2）的中间部位；其特征在于：
钉仓座（1）的出钉表面（11）上设有阻挡条（12）；
所述阻挡条（12）包括位于推刀槽（14）的左侧的第一组阻挡条和位于推刀槽（14）的右侧的第二组阻挡条；第一组阻挡条的各个左阻挡条（12a）沿前后向依次等间隔设置而成为一列阻挡条，第二组阻挡条的各个右阻挡条（12b）也沿前后向依次等间隔设置而成为另一列阻挡条，并且第一组阻挡条的各个左阻挡条（12a）与第二组阻挡条的相应一个右阻挡条（12b）以经过推刀槽（14）的前后向的中心线的铅垂面为对称面而对称设置；
第一组阻挡条的各个左阻挡条（12a）整体呈V形，均由第一阻挡凸条（12a-1）和第一拉伸凸条（12a-2）相连而构成；第一阻挡凸条（12a-1）沿左右向设置，设置在第一组出钉孔（15a）的最左侧的一列出钉孔的相应的两个相邻出钉孔（15）之间；第一阻挡凸条（12a-1）的延伸方向与推刀槽（14）相垂直；各个左阻挡条（12a）的第一拉伸凸条（12a-2）从与第一阻挡凸条（12a-1）的连接处向左前方延伸，位于最左侧的一列出钉孔（15）的左侧；第一阻挡凸条（12a-1）与第一拉伸凸条（12a-2）的夹角的锐角θ为5°～75°；
第二组阻挡条的各个右阻挡条（12b）的形状与第一组阻挡条的相应一个左阻挡条（12a）形状对称，各个右阻挡条（12b）整体呈V形，均由第二阻挡凸条（12b-1）和第二拉伸凸条（12b-2）相连而构成；第二阻挡凸条（12b-1）沿左右向设置，设置在第二组出钉孔（15b）的最右侧的一列出钉孔的相应的两个相邻出钉孔（15）之间；第二阻挡凸条（12b-1）的延伸方向与推刀槽（14）相垂直；各个右阻挡条（12b）的第二拉伸凸条（12b-2）从与第二阻挡凸条（12b-1）的连接处向右前方延伸，且各个右阻挡条（12b）的第二拉伸凸条（12b-2）位于最右侧的一列出钉孔（15）的右侧；第二阻挡凸条（12b-1）和第二拉伸凸条（12b-2）的夹角的锐角与左阻挡条（12a）的第一阻挡凸条（12a-1）和第一拉伸凸条（12a-2）的夹角的锐角θ相等。
7.根据权利要求6所述的直线形切割吻合器的组织夹持件，其特征在于：钉仓座（1）的出钉表面（11）上还设有阻挡凸起（13）；阻挡凸起（13）位于推刀槽（14）的前方；所述阻挡凸起（13）有4～8个，其形状为半球形，各个阻挡凸起（13）沿着左右向依次设置；
抵钉座2的抵钉表面（21）上还设有阻挡凹坑（26），阻挡凹坑（26）设置在抵钉表面（21）的前端部位上；阻挡凹坑（26）的数量与钉仓座（1）的阻挡凸起（13）的数量相同，各个阻挡凹坑（26）沿左右向依次设置；阻挡凹坑（26）形状为半球形，与钉仓座（1）的阻挡凸起（13）的形状相对应。
8.根据权利要求7所述的直线形切割吻合器的组织夹持件，其特征在于：钉仓座（1）的阻挡条（12）相对于出钉表面（11）的高度为0.2mm～2mm；阻挡凸起（13）的相对于出钉表面（11）的高度为为0.2mm～2mm。
9.根据权利要求6所述的直线形切割吻合器的组织夹持件，其特征在于：第一阻挡凸条（12a-1）与第一拉伸凸条（12a-2）的夹角的锐角θ为20°～60°。
10.根据权利要求6所述的直线形切割吻合器的组织夹持件，其特征在于：钉仓座（1）的阻挡条（12）的外表面光滑无棱角，外表面的上表面为圆弧形；
钉仓座（1）的第一组出钉孔（15a）的最左侧一列的出钉孔（15）的前部还设置一个左阻挡条（12a），最左侧一列的出钉孔（15）的后部还设置一个左阻挡条（12a）；
钉仓座（1）的第二组出钉孔（15b）的最右侧一列的出钉孔（15）的前部还设置一个右阻挡条（12b），最右侧一列的出钉孔（15）的后部还设置一个右阻挡条（12b）。
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| US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
| US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
| US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
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| US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
| US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
| US11957344B2 (en) | 2021-09-27 | 2024-04-16 | Cilag Gmbh International | Surgical stapler having rows of obliquely oriented staples |
| US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
| US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
| US11957339B2 (en) | 2021-11-09 | 2024-04-16 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
| US11957795B2 (en) | 2021-12-13 | 2024-04-16 | Cilag Gmbh International | Tissue thickness compensator configured to redistribute compressive forces |
| US11963680B2 (en) | 2022-10-19 | 2024-04-23 | Cilag Gmbh International | Cartridge body design with force reduction based on firing completion |
| US11957345B2 (en) | 2022-12-19 | 2024-04-16 | Cilag Gmbh International | Articulatable surgical instruments with conductive pathways for signal communication |
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| CN102973300A (zh) | 2013-03-20 |
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