CN103315789B - Executing assembly of cutting anastomat applicable to minimally invasive surgery - Google Patents

Executing assembly of cutting anastomat applicable to minimally invasive surgery Download PDF

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Publication number
CN103315789B
CN103315789B CN201310265504.1A CN201310265504A CN103315789B CN 103315789 B CN103315789 B CN 103315789B CN 201310265504 A CN201310265504 A CN 201310265504A CN 103315789 B CN103315789 B CN 103315789B
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Prior art keywords
nail
gia
endo
executive module
binding clip
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CN103315789A (en
Inventor
吉荣
虞国安
刘兴芳
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Changzhou Kangdi Medical Stapler Co Ltd
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Changzhou Kangdi Medical Stapler Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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 the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B2017/07214Stapler heads
    • A61B2017/07271Stapler heads characterised by its cartridge
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself

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  • 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 an executing assembly of a cutting anastomat applicable to minimally invasive surgery. The executing assembly comprises a jaw, a sleeve, an elastic push plate and two joint connecting plates; a nail bin, a nail abutting seat, a nail pushing sheet and a cutting knife are arranged on the jaw; the front end of the sleeve is hinged with the jaw, and a connecting portion is arranged at the rear end of the sleeve; the elastic push plate can axially slide in the sleeve, and the front end of the elastic push plate is connected with the cutting knife; the two joint connecting plates can axially slide in the sleeve and are positioned on the left side and the right side of the elastic push plate, and the front ends of the two joint connecting plates are hinged with the jaw. The executing assembly of the cutting anastomat has the advantages that the sleeve is hinged with the jaw, the jaw can swing left and right under the forward and backward actions of the two joint connecting plates, and accordingly the flexibility of cutting and anastomosis operation can be greatly improved during minimally invasive surgery; the executing assembly comprises the elastic push plate, and the elastic push plate can be bent when the jaw swings left and right, so that nail pushing and cutting power can be continuously transmitted, and the executing assembly is simple and reliable in structure.

Description

Be applicable to the Endo-GIA executive module of Minimally Invasive Surgery
Technical field
The present invention relates to operation medical instruments field, specifically, relate to a kind of executive module, the identical and cutting of performing the operation after being loaded into Endo-GIA, can be carried out simultaneously.
Background technology
Minimally Invasive Surgery is mainly through endoscope and various imaging technique, and make that surgeon is real when without the need to causing huge wound to patient to operate on, its basic process is: after anesthesia of patient, doctor makes a call to the aperture of 3 ~ 4 diameter 0.5 cm at the stomach wall of patient, microcam is put in one of them hole, be connected on telescreen by microcam, other several stomach wall apertures then put into shears, the operating theater instruments such as pliers, operation process is basic the same with abdominal, doctor look at screen and carries out clamp to the tissue of pathological changes, coincide, the sequence of operations such as cutting.
Minimally Invasive Surgery is a kind of brand-new Therapeutic Method, and Minimally Invasive Surgery is identical with the step doing traditional operation, but wound can be relatively little, and major advantage has: 1. post-operative recovery of performing the operation is fast, and the hospital stays is short; 2. quality of life is high, and operative incision is hidden, does not stay obvious cicatrix, and local is attractive in appearance, and stomach wall is tough and tensile; 3. scope photographic head has amplification, can know the fine structure of display body inner tissue, compared with Tradtional laparotomy, the visual field is more clear, therefore performs the operation more accurate, meticulous, effectively prevent internal organs beyond operative site and is subject to unnecessary interference, and intraoperative hemorrhage is few, perform the operation safer; 4. operation wound is little, and postoperative pain is light; 5. early postoperation can arbitrarily stand up, movable, intestinal function recovery is fast, greatly reduces the generation of intestinal adhesion.
The scope Endo-GIA and the executive module thereof that are applicable to Minimally Invasive Surgery are that a kind of multiple anastomosis staple intermeshing arrangement can being in line in tissue hammers into, and simultaneously with the apparatus that the tissue between anastomosis staple line cuts off by cutter, also be one of apparatus being widely used in Minimally Invasive Surgery, the excision being mainly used in organizing in the open or endoscopic surgery of abdominal surgery, gynecological, department of pediatrics and thoracic surgery, cross-section and identical.
Such as Chinese invention patent 200610003733.6 discloses a kind of surgical instruments.Comprise: end effector, its response is longitudinally launched motion and is carried out surgical procedures; The axle be connected with described end effector; Launch component, it is received slidably by described axle, will launch Motion Transmission to end effector between non-emissive position and complete transmitting site; Be fixed on the tooth bar launched on component; Trigger mechanism, it is operationally formed in firing stroke and engages with tooth bar and make its distal motion, and is being disengaged subsequently; With described tooth bar meshed gears mechanism; Comprise the hands handle of tooth bar, trigger mechanism and gear mechanism; And return component, it is arranged in handle outer to rotate, and be connected on gear mechanism to rotate, wherein, described gear mechanism comprises ratchet further, when tooth bar distal motion, this ratchet rotates along first direction, and when tooth bar proximal motion, this ratchet rotates along second direction, and described in return component and comprise gear and return bar and return ratchet, this is return ratchet and to be positioned at when actuation gear returns bar engages ratchet to be rotated in a second direction, ratchet, thus returns tooth bar and launch component.
But the end effector of this Endo-GIA can only rotate around described axle, and can not swing relative to described axle, this can make troubles to the operation of Minimally Invasive Surgery.
Summary of the invention
The technical problem to be solved in the present invention is to provide a kind of executive module of Endo-GIA, during for Minimally Invasive Surgery, operation technique can be made more flexible, to overcome the above-mentioned defect of prior art.
In order to solve the problems of the technologies described above, the present invention adopts following technical scheme: a kind of Endo-GIA executive module being applicable to Minimally Invasive Surgery, and comprise with lower component: binding clip, binding clip is provided with nail bin, nail supporting base, pushing slice of nail and cutter; Sleeve pipe, front end and described binding clip are hinged, and rear end is provided with connecting portion; Elastic pusher, can slide axially in sleeve pipe, and the front end of elastic pusher is connected with described cutter; Two articular link plates, can slide axially in sleeve pipe, are positioned at the left and right sides of elastic pusher, and the front end of two articular link plates is all hinged with described binding clip.
Preferably, the front end of described sleeve pipe extends two articulated jibs, and described binding clip rear end is provided with projection and described articulated jib is hinged.
More preferably, be provided with two pins in described binding clip, the front end of described articular link plate is provided with slotted hole, and is hinged on two pins respectively, and the axis of described pin parallels with the axis of described projection.
Preferably, be also provided with interior pipe in sleeve pipe, interior pipe is provided with for described elastic pusher and articular link plate chute in axial sliding.
Preferably, the rear end of described elastic pusher is connected with a connecting pin.
Preferably, described binding clip also comprises a pedestal, and the rear end of described nail supporting base is rotatably connected on pedestal, and described nail bin, pushing slice of nail and cutter are installed in pedestal, nail bin is positioned at the top of pushing slice of nail, a slidably wedge between pushing slice of nail and cutter.
More preferably, the top of cutter and bottom are respectively provided with a T-shaped boss, the T-slot matched with described T-shaped boss together with described nail supporting base is respectively provided with the middle part of pedestal, and the middle part of described nail bin is provided with the tool slot matched with described cutter together.
More preferably, the rear end of described pedestal fixedly mounts a back-up block, and be provided with the chute passed through for described elastic pusher bottom back-up block, the both sides of chute are provided with two rollers, and described roller contacts with the side of elastic pusher.
More preferably, the rear end of described nail supporting base is provided with the curved afterbody upwarped.
Preferably, described binding clip is also provided with bin cover and protective sleeve.
Compared with prior art, the present invention has following beneficial effect.
In Endo-GIA executive module of the present invention, sleeve pipe and binding clip are hinged, and utilize the front and back action of two articular link plates, and binding clip can be made to swing, and when carrying out Minimally Invasive Surgery, greatly can improve the motility of cutting anastomosis procedure.Present invention employs elastic pusher, when binding clip swings, elastic pusher can bend, and can continue the power transmitting ejector pin and cutting, and this structure is simple and reliable.
Accompanying drawing explanation
Fig. 1 is the three-dimensional structure diagram that the present invention is applicable to the Endo-GIA executive module of Minimally Invasive Surgery.
Fig. 2 is the structural representation that executive module of the present invention is in original state.
Fig. 3 is the structural representation that executive module of the present invention is in swing state.
Fig. 4 is the structural representation of binding clip part in the present invention.
Fig. 5 is the STRUCTURE DECOMPOSITION schematic diagram of executive module of the present invention.
Fig. 6 is the assembly relation schematic diagram of cutter and elastic pusher in the present invention.
Fig. 7 is the structural representation of a kind of sleeve pipe in the present invention.
Fig. 8 is the structure front view of the present invention under nail supporting base closure state.
Fig. 9 is the structure sectional view of I-I cross section in Fig. 8.
Figure 10 is the structure sectional view of II-II cross section in Fig. 8.
Figure 11 is the structure sectional view of III-III cross section in Fig. 8.
Figure 12 is the structure front view of nail supporting base in the present invention.
Figure 13 is the working state schematic representation of pushing slice of nail, wedge in the present invention.
Figure 14 is the perspective view of a kind of executive module with protective sleeve of the present invention.
Figure 15 is the structural representation of executive module of the present invention when being carried on Endo-GIA.
Figure 16 is the assembly structure schematic diagram of socket joint and joint push rod.
Figure 17 is the structure sectional view of the present invention at nail supporting base open configuration.
Figure 18 is the structure sectional view of the present invention at nail supporting base closure state.
Figure 19 is the structure sectional view of the present invention at anastomosis staple shaped state.
Detailed description of the invention
Be described in further detail the present invention below in conjunction with the drawings and specific embodiments, those skilled in the art can more clearly understand other advantages of the present invention and effect thus.
It should be noted that, the structure that Figure of description illustrates, ratio, size etc., only in order to coordinate detailed description of the invention, more clearly understand design of the present invention for those skilled in the art, and be not used to limit the scope of the invention.The adjustment of the modification of any structure, the change of proportionate relationship or size, when not affecting effect of the present invention and object reaches, all should still drop within protection scope of the present invention.For convenience of description, hereinafter alleged " on ", D score direction is described according to the Butut direction of Figure of description, hereinafter alleged " front " side refers to the direction of motion of the elastic pusher when carrying out ejector pin, cutting action, and hereinafter alleged " afterwards " side refers to the backhaul direction of elastic pusher.
As shown in Figure 1, a kind of Endo-GIA executive module 2 being applicable to Minimally Invasive Surgery of the present invention comprises binding clip 3 and a sleeve pipe 32, and binding clip 3 is provided with nail bin 20, nail supporting base 23, pedestal 24, pushing slice of nail and cutter etc.; The front end of sleeve pipe 32 extends two articulated jibs 221, and articulated jib 221 is hinged by the rear end of projection 223 with binding clip 3, and the rear end of sleeve pipe 32 is provided with connecting portion, can be connected with Endo-GIA.
As shown in Figure 2, an elastic pusher 27 can slide axially in sleeve pipe 32, the front end of elastic pusher 27 is connected with cutter 26, the rear end of elastic pusher 27 is connected with a connecting pin 35, connecting pin 35 can be connected, for the driving force of Endo-GIA is passed to elastic pusher 27 with the connecting rod in Endo-GIA.Separately there are two articular link plates 28 also can slide axially in sleeve pipe 32, two articular link plates 28 lay respectively at the left and right sides of elastic pusher 27, two pins 30 are provided with in binding clip 3, the front end of articular link plate 28 is provided with slotted hole 281 and is hinged on these two pins 30, and the axis of pin 30 parallels with the axis of above-mentioned projection 223.The rear end of articular link plate 28 can be connected with the joint push pedal in Endo-GIA.
As shown in Figure 3, when in two articular link plates 28 piece travels forward, when another root moves backward, can promote binding clip 3 and swing to the left or to the right, namely no longer point-blank, elastic pusher 27 is flexural deformation thereupon also for binding clip 3 and sleeve pipe 32.
As shown in Figure 4, the rear end of nail supporting base 23 is provided with a locating shaft 210, and locating shaft 210 is connected rotationally with the locating hole of on pedestal 24 206.
As shown in Figure 5, described nail bin 20, pushing slice of nail 21 and cutter 26 are installed in pedestal 24, and nail bin 20 is fixed on pedestal 24, and pushing slice of nail 21 is positioned at below nail bin 20.Also be provided with a wedge 22 in pedestal 24, wedge 22 is between pushing slice of nail 21 and cutter 26, and cutter 26 can promote wedge 22 and travel forward, and wedge 22 promotes pushing slice of nail 21 more further and moves upward.A back-up block 25 is fixedly mounted in the rear end of pedestal 24, the chute passed through for described elastic pusher 27 is provided with bottom back-up block 25, as shown in Figure 3, two rollers 29 are provided with in the both sides of chute, roller 29 contacts with the side of elastic pusher 27, in the motor process of elastic pusher 27, between the side of roller 29 and elastic pusher 27, produce rolling friction, the effect reduced friction can be reached.Meanwhile, two rollers 29 also can, to the effect of elastic pusher 27 clamp standoff, avoid elastic pusher 27, in power transmission process, less desirable flexural deformation occurs.
As shown in Figure 6, a T-shaped boss 200,203 is respectively provided with at the top of cutter 26 and bottom, the rear portion of cutter 26 is connected by the front end of dovetail groove 204 with elastic pusher 27, the cutting edge 201 of cutter is located at the position near top T shape boss 200, the front end face 202 of cutter 26 is for abutting against with the rear end face of above-mentioned wedge 22, to transmit motive force.
As shown in Figure 7, be also provided with interior pipe in described sleeve pipe 32, further, this interior pipe can be put together by upper tube half 33 and lower tube half 34, and upper tube half 33 and the cylinder of lower tube half 34 are provided with pin 220 and are connected with the hole 222 on sleeve pipe 32.
As seen in figs. 8-10, the T-slot 209 matched with the T-shaped boss 200 at cutter 26 top is together provided with at the middle part of nail supporting base 23, be provided with the T-slot 258 matched with the T-shaped boss 203 bottom cutter 26 together at the middle part of pedestal 24, the middle part of described nail bin 20 is provided with the tool slot 271 matched with described cutter together.When cutter 26 move in above-mentioned T-slot 209,258 and tool slot 271, nail supporting base 23, nail bin 20 and pedestal 24 are linked together, keep jaw closed, coincide so that carry out cutting to tissue.
As shown in Fig. 8, Figure 11, interior pipe 33,34 is provided with confession elastic pusher 27 chute 41 and confession articular link plate 28 chute 42 in axial sliding in axial sliding.
As shown in figure 12, be provided with the curved afterbody 262 upwarped in the rear end of nail supporting base 23, the left and right sides, rear end of nail supporting base 23 is provided with the baffle plate 212 to downward-extension.When the convex platform of cutter slide into nail supporting base 23 afterbody 262 above time, order about nail supporting base 23 and rotate around locating shaft 210, thus executive module jaw is opened.
As shown in Fig. 5, Figure 13, wedge 22 is made up of two groups of little inclined tab and middle boss, and the certain distance that staggers before and after two groups of little inclined tab is to reduce the resistance driving pushing slice of nail 21 to rise.Three sections of being at least divided into slope different in the inclined-plane of wedge 22, slope reduces gradually from top to bottom, and that is, bottom one section of inclined-plane 263 and the angle α of bottom surface are greater than the angle β of middle one section of inclined-plane 264 and bottom surface, topmost one section 265 then parallel with bottom surface.Wherein inclined-plane 263 is for scooping up pushing slice of nail 21, and inclined-plane 264 rises for driving pushing slice of nail 21, and the plane 265 at top is for the final shaping of anastomosis staple.
As shown in figure 14, in order to protect still untapped executive module, bin cover 37 can be set on nail bin 20, prevent anastomosis staple from coming off from the nail groove of nail bin; Can arrange protective sleeve 38 between bin cover 37 and nail supporting base 23, and arrange protective sleeve 39 in the bottom of pedestal 24, protective sleeve 38,39 can prevent executive module from producing unexpected firing action.
As shown in figure 15, executive module 2 of the present invention is for being loaded in the front end of Endo-GIA 1, Endo-GIA 1 is provided with the swivel head 13 for making executive module 2 rotate around the axis of sleeve pipe 32, and swivel head 13 is provided with can the joint knob 12 that swings of the binding clip of executive module 2.
As shown in figure 16, joint knob can drive a socket joint 51 to rotate, and two bearing pins 52 in socket joint 51 are connected with two joint push rods 53, when socket joint 51 is rotated, a joint push rod 53 can be with to travel forward, and another root joint push rod 53 moves backward.These two joint push rods 53 are connected with the articular link plate of two in the present invention 28, an articular link plate 28 is travelled forward, and another root articular link plate 28 moves backward, thus binding clip is swung.
As in figs. 17-19, connecting pin 35 is subject to the driving of Endo-GIA, promote elastic pusher 27, the convex platform 200 being fixed on the cutter 26 of the front end of elastic pusher 27 enters the T-slot 209 of nail supporting base 23, executive module jaw is closed, and the front end face 202 of cutter 26 promotes the rear end face 246 of wedge 22, and wedge 22 drives pushing slice of nail 21 to rise, pushing slice of nail 21 drives anastomosis staple 36 again, and anastomosis staple 36 runs into the grooving 261 of nail supporting base 23 and curling shaping.Retract connecting pin 35, the convex platform 200 of cutter 26 slides into the afterbody 262 of nail supporting base 23, and order about nail supporting base 23 and rotate around locating shaft 210, executive module jaw is opened.
The using method of executive module of the present invention is as follows.
Executive module 2 of the present invention is loaded into after on Endo-GIA 1, pull the trigger of Endo-GIA once, close the jaw of executive module 2, executive module 2 is inserted body cavity by perforator or transducer, then elastic pusher 27 is pulled back, open the jaw of executive module 2, stirring joint knob 12 can make the binding clip 3 of executive module 2 swing, stirring swivel head 13 can make executive module 2 rotate around the axis of sleeve pipe 32, to treat that the tissue of osculating is inserted in the jaw of executive module 2, cocking once again, close the jaw of executive module 2, then cocking continuously, after pending assembly 2 completes identical cutting action, Endo-GIA 1 is resetted, the jaw of executive module is opened, reset joint knob 12 completely, cocking once again, close the jaw of executive module, apparatus is taken out in body cavity, executive module 2 is unloaded from Endo-GIA 1, complete in once-through operation so simultaneously and coincide and cut and organize, in same operation, Endo-GIA 1 can be changed executive module 2 and reuse.

Claims (8)

1. be applicable to an Endo-GIA executive module for Minimally Invasive Surgery, it is characterized in that, comprise with lower component:
Binding clip, binding clip is provided with nail bin, nail supporting base, pushing slice of nail and cutter;
Sleeve pipe, front end and described binding clip are hinged, and rear end is provided with connecting portion, and the front end of described sleeve pipe extends two articulated jibs, and described binding clip rear end is provided with projection and described articulated jib is hinged;
Elastic pusher, can slide axially in sleeve pipe, and the front end of elastic pusher is connected with described cutter;
Two articular link plates, can slide axially in sleeve pipe, be positioned at the left and right sides of elastic pusher, the front end of two articular link plates is all hinged with described binding clip, two pins are provided with in described binding clip, the front end of described articular link plate is provided with slotted hole, and is hinged on two pins respectively, and the axis of described pin parallels with the axis of described projection.
2. Endo-GIA executive module according to claim 1, is characterized in that, is also provided with interior pipe in described sleeve pipe, and interior pipe is provided with for described elastic pusher and articular link plate chute in axial sliding.
3. Endo-GIA executive module according to claim 1, is characterized in that, the rear end of described elastic pusher is connected with a connecting pin.
4. Endo-GIA executive module according to claim 1, it is characterized in that, described binding clip also comprises a pedestal, the rear end of described nail supporting base is rotatably connected on pedestal, described nail bin, pushing slice of nail and cutter are installed in pedestal, nail bin is positioned at the top of pushing slice of nail, is provided with a slidably wedge between pushing slice of nail and cutter.
5. Endo-GIA executive module according to claim 4, it is characterized in that, the top of described cutter and bottom are respectively provided with a T-shaped boss, the T-slot matched with described T-shaped boss together with described nail supporting base is respectively provided with the middle part of pedestal, the middle part of described nail bin is provided with the tool slot matched with described cutter together.
6. Endo-GIA executive module according to claim 4, it is characterized in that, the rear end of described pedestal fixedly mounts a back-up block, is provided with the chute passed through for described elastic pusher bottom back-up block, the both sides of chute are provided with two rollers, and described roller contacts with the side of elastic pusher.
7. Endo-GIA executive module according to claim 4, is characterized in that, the rear end of described nail supporting base is provided with the curved afterbody upwarped.
8. Endo-GIA executive module according to claim 1, is characterized in that, described binding clip is also provided with bin cover and protective sleeve.
CN201310265504.1A 2013-06-27 2013-06-27 Executing assembly of cutting anastomat applicable to minimally invasive surgery Active CN103315789B (en)

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CN104873238B (en) * 2015-05-12 2017-06-20 湖州源研生物医学工程有限公司 The curved motivation structure of binding clip of Endo-GIA
CN110477984A (en) * 2019-09-09 2019-11-22 舒拓 Flexible shaking device for stapler
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CN112494090B (en) * 2020-11-26 2022-02-08 苏州法兰克曼医疗器械有限公司 Cutting anastomat suitable for minimally invasive surgery
CN115363660B (en) * 2021-05-19 2024-01-30 欣格誉科技(无锡)有限公司 Anastomat
CN113509227B (en) * 2021-06-09 2022-12-13 吉林大学 Intestinal anastomat under scope
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