CN103750873B - With the surgical stapling nail grooving of curved nail ditch - Google Patents
With the surgical stapling nail grooving of curved nail ditch Download PDFInfo
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- CN103750873B CN103750873B CN201410044513.2A CN201410044513A CN103750873B CN 103750873 B CN103750873 B CN 103750873B CN 201410044513 A CN201410044513 A CN 201410044513A CN 103750873 B CN103750873 B CN 103750873B
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- anastomosis staple
- grooving
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- ditch
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00526—Methods of manufacturing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical 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
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
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Abstract
A kind of nail of the surgical stapling with curved nail ditch grooving, realize at rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil for rotation axis, when being close to the anastomosis staple guide line of anastomosis staple grooving with the bottom entering groove of rotary body and moving along the anastomosis staple guide line of anastomosis staple grooving, the track curved surface that rotary body is formed in groove is the curved surface of the curved nail ditch of composition anastomosis staple grooving, be particularly suitable for first on the tissue contact surface of nail anvil, processing the not high anastomosis staple grooving of technical requirement, reserve polish chipping allowance, and then on the high speed and precision rotary cutting machine such as carving machine, adopt the bit using above-mentioned rotary body as cutting element to process the curved nail ditch of anastomosis staple grooving, thus processing cost and process time are reduced greatly.
Description
Technical field
The present invention relates to the anastomosis staple grooving used in various surgical stapling, be related specifically to the anastomosis staple grooving used in straight shape anastomat or straight shape Endo-GIA, also the anastomosis staple grooving used in arc-shaped cutting anastomat is related specifically to, also be related specifically to the anastomosis staple grooving used in circular staplers, also be related specifically to the anastomosis staple grooving used in the mirror surgical incision anastomat of chamber, relate more specifically to the anastomosis staple grooving used in various Motorized surgical anastomat.
Background technology
Various surgical stapling adopts the free-hand anastomosis procedure of needlework for replacing in surgical operation, be widely used in the operations such as the end end of human body alimentary canal organ, respiratory tract organ and apparatus urogenitalis official rank Organ and tissue, side and side to side anastomosis, form the operation of the operation of passage, the operation of close incisions and clamping or cutting, be specially adapted to appear the anastomosis operation with the Organ and tissue of operating difficulties, can operating time be reduced, improve surgical quality.
As the straight shape Endo-GIA of United States Patent (USP) publicity 20050222616, the arc-shaped cutting anastomat of United States Patent (USP) publicity 20050247753, the chamber mirror Endo-GIA of United States Patent (USP) publicity 20100200639, the circular staplers of United States Patent (USP) publicity 20110101065, the straight shape anastomat of United States Patent (USP) publicity 20130015230, the various electronic surgical stapling of United States Patent (USP) publicity 20130018361 and other are various manually, or it is electronic, or surge, or introduce in pneumatic surgical stapling: surgical stapling is by nail bin groupware, nail-anvil assembly and operating mechanism composition.The anastomosis staple having nail bin in nail bin groupware and be arranged in nail bin and ejector pin block, and can need cutter are installed according to use.The anastomosis staple grooving formed after the tissue contact surface of the nail anvil in nail-anvil assembly having indent.Anastomosis staple grooving on nail anvil is mutually corresponding with the position of the anastomosis staple in nail bin.Anastomosis staple and the effect of anastomosis staple grooving in the use procedure of surgical stapling of above-mentioned various surgical stapling are: when operating mechanism is by after clamp tissue to be anastomosed is between the tissue contact surface and the tissue contact surface of nail bin of the nail anvil mutually drawn close, anastomosis staple is released by promoting ejector pin block by operating mechanism in nail bin, bending forming on the anastomosis staple grooving making the nail tip of anastomosis staple penetrate after clamped tissue to be anastomosed on nail anvil, reaches the operation object of engaging tissue.
Due to by the requirement of the sealing of anastomosed tissue and hemostasis, the spacing of adjacent two rows or two circle anastomosis staples is limited in less size, namely the spacing of adjacent two rows or two circle anastomosis staple groovings is limited in less size, make the width of anastomosis staple grooving less, therefore when the shape of the anastomosis staple grooving of surgical stapling, when the precision of position and size cannot meet the technical requirement that anastomosis staple is formed accurately, the nail tip of the anastomosis staple in nail bin may be against inappropriate position of the anastomosis staple grooving of nail anvil, beyond the anastomosis staple grooving that even may be against nail anvil, anastomosis staple is caused to be shaped unsuccessfully, the operation object of accurately being coincide by tissue can not be reached.On the other hand, when the surface roughness of the anastomosis staple grooving of surgical stapling is larger, on the shaggy anastomosis staple grooving that the nail tip of the anastomosis staple in nail bin is against nail anvil during bending forming, the resistance of anastomosis staple bending forming obviously increases, both affected anastomosis staple to be formed accurately, cause again the operating physical force of surgical stapling obviously to increase, easily cause operation fatigue; Meanwhile, the noise that the shaggy anastomosis staple grooving that the nail tip of anastomosis staple is against nail anvil sends during bending forming, impels operator to produce tired sensation further.
As in U.S. Patent Publication No. 20080061109 the anastomosis staple grooving rectangular on the tissue contact surface of nail anvil introduced, what introduce in U.S. Patent Publication No. 20060124688 is saddle-shaped anastomosis staple grooving on the tissue contact surface of nail anvil, the anastomosis staple grooving triangular in shape on the tissue contact surface of nail anvil introduced in U.S. Patent Publication No. 20110017799, the leg-of-mutton anastomosis staple grooving be mutually biased in two on the tissue contact surface of nail anvil introduced in U.S. Patent Publication No. 20110084113.The unsatisfactory place of the anastomosis staple grooving of the surgical stapling of this several style is, the shape of anastomosis staple grooving is all very complicated, and on the tissue contact surface of same nail anvil, be often arranged with the anastomosis staple grooving of 40 to 80, need to adopt the method processing such as the compressing and metal powder injection thermal sintering of mould.
If adopt mould method for press forming processing anastomosis staple grooving, because the quantity of anastomosis staple grooving is many, therefore need the press of about 80 tons compressing, again because tissue contact surface and 40 on compressing mould to the shaping contact face of the anastomosis staple grooving of 80 of nail anvil can not contact completely simultaneously, and the narrowest place in the shaping contact face of anastomosis staple grooving is only about 0.3mm, therefore the pressure of about 80 tons of press concentrates on the shaping contact face of indivedual anastomosis staple grooving, first shaping contact facial disfigurement or the damage of this indivedual anastomosis staple grooving is caused, the technical requirement making the precision of the shape and size of the anastomosis staple grooving be processed into subsequently not reach anastomosis staple to be formed accurately, also make the service life of compressing mould very short, also due to when 40 on compressing mould are all pressed in the tissue contact surface of nail anvil to the shaping contact face of the anastomosis staple grooving of 80, there is complicated plastic deformation in nail anvil, may make the anastomosis staple grooving that is processed into and the position at position and the precision of size do not reach the technical requirement that anastomosis staple is formed accurately around, in addition, in order to reach the technical requirement of the surface roughness of anastomosis staple grooving, before employing mould method for press forming processing anastomosis staple grooving, need the tissue contact surface of precise polished nail anvil, this operation adds processing cost and process time.
If adopt metal powder injection thermal sintering method processing anastomosis staple grooving, the precision of the shape of the anastomosis staple grooving be processed into due to metal powder injection thermal sintering, position and size and surface roughness all cannot meet the technical requirement that anastomosis staple is formed accurately, and therefore need to carry out secondary operations to anastomosis staple grooving.
In addition, adopt the method processing such as the compressing and metal powder injection thermal sintering of mould, for the anastomosis staple grooving of the surgical stapling of often kind of specification, often kind of model, all need to be equipped with the very high mould of a set of special required precision, altogether need mold more than 100 just can assort, make processing cost and cost of upkeep quite high.
If adopt metal-cutting machining method processing anastomosis staple grooving, because the shape of existing anastomosis staple grooving is all very complicated, be made up of many curved surfaces, there is the turning of many small curvature radius in the junction of each curved surface, therefore each anastomosis staple grooving needs just can complete processing several times with the feed all around of tiny cutting element, tiny cutting element also easily damages, such that the processing cost of the anastomosis staple grooving of 40 to 80 is quite high, process time is quite long.
Therefore the anastomosis staple grooving of surgical stapling also needs to improve.
As can be seen from obviously above-mentioned, devise now a large amount of not surgical stapling in specie, and the development work of the anastomosis staple grooving of new surgical stapling is still in continuation, to be improved further annual a large amount of surgical stapling used in the world, both reached reliable for tissue operation object of coincideing, reached again easy to use, cost-effective object.
Summary of the invention
The object of the invention is to propose a kind of surgical stapling with curved nail ditch nail grooving, realize at rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil for rotation axis, when being close to the anastomosis staple guide line of anastomosis staple grooving with the bottom entering groove of rotary body and moving along the anastomosis staple guide line of anastomosis staple grooving, the track curved surface that rotary body is formed in groove is the curved surface of the curved nail ditch of composition anastomosis staple grooving, be particularly suitable for first on the tissue contact surface of nail anvil, adopting metal cutting, the shape that the methods such as the compressing or metal powder injection thermal sintering of mould are processed into, the precision of position and size and the not high anastomosis staple grooving of the technical requirement of surface roughness, and reserve polish chipping allowance at the anastomosis staple guide line place of anastomosis staple grooving, and then on the high speed and precision rotary cutting machine such as carving machine, adopt bit using above-mentioned rotary body as Tool in Cutting instrument or grinding tool cutting element, along the curved nail ditch of the anastomosis staple guide line polish anastomosis staple grooving of anastomosis staple grooving, thus make the shape that anastomosis staple grooving of the present invention is processed at anastomosis staple guide line place, the shape that the precision of position and size and surface roughness are all better than adopting the methods such as the compressing and metal powder injection thermal sintering of existing mould to be processed into, the precision of position and size and surface roughness.All machined parameters of the curved nail ditch of various anastomosis staple grooving can be kept in the internal memory of the digital control circuit of the high speed and precision rotary cutting machine such as carving machine, in order to calling at any time and can revising at any time as required, processing cost and process time are reduced greatly.
The object of the invention is to be achieved through the following technical solutions:
Surgical stapling with curved nail ditch nail grooving of the present invention is arranged on the tissue contact surface of nail anvil.Each anastomosis staple grooving is made up of two grooves.The two ends place that the groove that the tissue contact surface of nail anvil is formed after indent is positioned at anastomosis staple grooving being into nail face, being positioned at the center of anastomosis staple grooving for going out nail face.Side, bottom is had to have bottom surface in the both sides of groove.
The bottom surface of groove has from enter nail face extend to out nail face in the curved nail ditch of trench.The bosom entering nail face and go out to follow closely face of curved nail ditch forms the anastomosis staple guide line of anastomosis staple grooving.
Rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil be rotation axis, be close to the anastomosis staple guide line of anastomosis staple grooving with the bottom entering groove of rotary body and move along the anastomosis staple guide line of anastomosis staple grooving time, the track curved surface that rotary body is formed in groove is the curved surface of the curved nail ditch of composition anastomosis staple grooving.
The bottom entering nail anvil of rotary body can be curved surface.The radius of curvature entering the curved surface of the bottom of nail anvil as rotary body is R1, the radius of curvature of the anastomosis staple guide line of anastomosis staple grooving is R2, the radius of curvature being close to the geometric locus of the center of curvature of the curved surface of the bottom of the rotary body of the anastomosis staple guide line of anastomosis staple grooving is R=R1+R2, then when rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil for rotation axis, when moving along geometric locus with the center of curvature of the curved surface of the bottom of rotary body, the track curved surface that rotary body is formed in the groove of nail anvil is the curved surface of the curved nail ditch of the groove of composition anastomosis staple grooving.
The bottom entering nail anvil of rotary body also can be conical surface, then the radius of curvature entering the pinnacle place of the conical surface of the bottom of nail anvil of rotary body is R1=0, namely the geometric locus being close to the pinnacle of the conical surface of the bottom of the rotary body of the anastomosis staple guide line of anastomosis staple grooving overlaps with the anastomosis staple guide line of anastomosis staple grooving, when rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil for rotation axis, when moving along the anastomosis staple guide line of anastomosis staple grooving with the pinnacle of the conical surface of the bottom of rotary body, the track curved surface that rotary body is formed in the groove of nail anvil is the curved surface of the curved nail ditch of the groove of composition anastomosis staple grooving.
The plane at the anastomosis staple guide line place in the curved nail ditch of two grooves of same anastomosis staple grooving in same plane, also can be able to be parallel to each other.
Anastomosis staple guide line in the curved nail ditch of two grooves of same anastomosis staple grooving can be crossing with the intersection point going out to follow closely face in the curved nail ditch of its groove, also can mutually depart from.
Nail anvil of the present invention can be rounded.Multiple anastomosis staple grooving becomes at least two circles at the tissue contact surface alternate of circular nail anvil.Circular nail anvil can than the depth as shallow of circular nail anvil compared with the anastomosis staple grooving in outside compared with the degree of depth of the anastomosis staple grooving of inner side.The anastomosis staple grooving of circular nail anvil goes for the anastomosis staple of the nail beam of 3mm ± 0.3mm width.
Nail anvil of the present invention also can in linear.The tissue contact surface alternate of the online staple anvil of multiple anastomosis staple grooving becomes at least two rows.Linear nail anvil can there is cutter groove.Multiple anastomosis staple grooving is arranged in the both sides of the cutter groove of linear nail anvil.The degree of depth of the anastomosis staple grooving of the cutter groove on closer linear nail anvil can compare the depth as shallow of the anastomosis staple grooving of the cutter groove on deviated line staple anvil.
The surgical stapling nail grooving of various technical scheme of the present invention, according to the requirements of operation of anastomosed tissue, both the surgical stapling nail grooving of a certain technical scheme of the present invention can have been adopted, also the surgical stapling of various technical scheme of the present invention can be adopted to follow closely grooving used in combination, the surgical stapling of various technical scheme of the present invention nail grooving and existing various types of surgical stapling can also be adopted to follow closely grooving used in combination, such as, certain circle or certain row select the surgical stapling nail grooving in various technical scheme of the present invention, another circle or another row select existing various types of surgical stapling nail grooving.
Accompanying drawing explanation
Fig. 1 is the outside drawing of the surgical stapling nail grooving of the rectangle of the preliminary working representing first embodiment of the invention;
Fig. 2 is the outside drawing representing adopted rotary body ball;
Fig. 3 represents that the rotary body ball of Fig. 2 forms the sectional view of the movement locus of the curved nail ditch of surgical stapling nail grooving;
Fig. 4 is the outside drawing of the nail of the surgical stapling with the curved nail ditch grooving representing the first embodiment;
Fig. 5 is the sectional view of the nail of the surgical stapling with the curved nail ditch grooving representing Fig. 4;
Fig. 6 is the outside drawing of the anastomosis staple grooving representing the preliminary working arranging two loop graphs 1 on the tissue contact surface of circular nail anvil;
Fig. 7 is the outside drawing representing the anastomosis staple grooving with curved nail ditch arranging two loop graphs 4 on the tissue contact surface of circular nail anvil;
Fig. 8 is the outside drawing of the rectangle surgical stapling nail grooving of the middle indent of the preliminary working representing second embodiment of the invention;
Fig. 9 represents that the rotary body ball of Fig. 2 forms the sectional view of the movement locus of the curved nail ditch of surgical stapling nail grooving;
Figure 10 is the outside drawing of the nail of the surgical stapling with the curved nail ditch grooving representing the second embodiment;
Figure 11 is the outside drawing of the surgical stapling nail grooving of the preliminary working representing third embodiment of the invention;
Figure 12 to Figure 15 represents that the rotary body ball of Fig. 2 forms outside drawing and the sectional view of the movement locus of the curved nail ditch of surgical stapling nail grooving;
Figure 16 is the outside drawing of the nail of the surgical stapling with the curved nail ditch grooving representing the 3rd embodiment;
Figure 17 is the outside drawing of the anastomosis staple grooving representing the preliminary working arranging three loop graphs 8 and Figure 11 on the tissue contact surface of circular nail anvil;
Figure 18 is the outside drawing representing the anastomosis staple grooving with curved nail ditch arranging three loop graphs 10 and Figure 16 on the tissue contact surface of circular nail anvil;
Figure 19 is the outside drawing of the rectangle surgical stapling nail grooving of the middle indent of the preliminary working representing fourth embodiment of the invention;
Figure 20 is the outside drawing representing adopted rotary body circular cone;
Figure 21 and Figure 22 represents that the rotary body circular cone of Figure 20 forms outside drawing and the sectional view of the movement locus of the curved nail ditch of surgical stapling nail grooving;
Figure 23 is the outside drawing of the nail of the surgical stapling with the curved nail ditch grooving representing the 4th embodiment;
Figure 24 be represent online staple anvil tissue contact surface on the outside drawing of anastomosis staple grooving of preliminary working of arrangement four row Figure 19;
Figure 25 be represent online staple anvil tissue contact surface on the outside drawing of the anastomosis staple grooving with curved nail ditch of arrangement four row Figure 23.
Detailed description of the invention
Use way of example below, state the most preferred embodiment of the surgical stapling with curved nail ditch of the present invention nail grooving by reference to the accompanying drawings.Scope of the present invention will be pointed out in the claims.Will be appreciated that some or all accompanying drawing is all the explanation sketch in order to most preferred embodiment of the present invention is described, and the full-size(d) of part shown in not depicting.With reference to the describing in detail of most preferred embodiment, understand with will be more readily apparent from reach the present invention above-mentioned with the practical ways of other objects and advantages.
For the ease of illustrating the nail of the surgical stapling with the curved nail ditch technical characteristic of grooving of various embodiments of the invention, technical scheme and technique effect, anastomosis staple grooving below in various embodiment only illustrates a part for nail anvil in surgical stapling, and the global shape of anastomosis staple grooving in various surgical stapling, 26S Proteasome Structure and Function can with reference to the contents in each section United States Patent (USP) publicity of quoting in the background technology of this description.
Fig. 1 is the rectangle surgical stapling nail grooving 1 of the preliminary working representing first embodiment of the invention.Anastomosis staple grooving 1 is made up of two grooves 4 and 5 formed after indent on the tissue contact surface 3 of nail anvil 2.Side 6 and 7 is had in the both sides of groove 4 and 5.
As shown in Figure 5, the bottom surface 11 and 12 of the groove 9 and 10 of the accurately machined surgical stapling with the curved nail ditch nail grooving 8 of first embodiment of the invention there is the curved nail ditch 17 and 18 in trench from entering nail face 13 and 14 and extend to out nail face 15 and 16.The bosom entering nail face 13 and 14 and go out nail face 15 and 16 of curved nail ditch 17 and 18 forms the anastomosis staple guide line 19 and 20 of anastomosis staple grooving 8.
As shown in Figures 2 to 5, the radius of curvature 22 entering the curved surface of the bottom of nail anvil 2 as rotary body ball 21 is R1, the radius of curvature 23 of the anastomosis staple guide line 19 and 20 of anastomosis staple grooving 8 is R2, the radius of curvature 26 being close to the geometric locus 24 and 25 of the center of curvature of the curved surface of the bottom of the rotary body ball 21 of the anastomosis staple guide line 19 and 20 of anastomosis staple grooving 8 is R=R1+R2, then when rotary body ball 21 with the axis of the vertical direction of the tissue contact surface 3 of nail anvil 2 for rotation axis, when moving along geometric locus 24 and 25 with the center of curvature of the curved surface of the bottom of rotary body ball 21, the track curved surface 27 and 28 that rotary body ball 21 is formed in the groove 4 and 5 of nail anvil 2 is the curved surface of the curved nail ditch 17 and 18 of the groove 9 and 10 of composition anastomosis staple grooving 8.
As shown in Figure 4 and Figure 5, the plane at anastomosis staple guide line 19 and 20 place of two grooves 9 and 10 of anastomosis staple grooving 8 is in same plane, and the intersection point that anastomosis staple guide line 19 and 20 and its of two grooves 9 and 10 go out nail face 15 and 16 is crossing.
As shown in Figure 6, nail anvil 30 is rounded.The anastomosis staple grooving 31 of multiple preliminary working becomes two circles with 32 at tissue contact surface 33 alternate of circular nail anvil 30.Circular nail anvil 30 is compared with the depth as shallow of the circular nail anvil 30 of the depth ratio of the anastomosis staple grooving 31 of inner side compared with the anastomosis staple grooving 32 in outside.
As shown in Figure 7, multiple accurately machined anastomosis staple grooving 34 becomes two circles with 35 at tissue contact surface 33 alternate of circular nail anvil 30.Circular nail anvil 30 is compared with the depth as shallow of the circular nail anvil 30 of the depth ratio of the curved nail ditch 36 of the anastomosis staple grooving 31 of inner side compared with the curved nail ditch 37 of the anastomosis staple grooving 32 in outside.The anastomosis staple grooving 31 and 32 of circular nail anvil 30 had both gone for the anastomosis staple of the nail beam of 3mm width, had also gone for the anastomosis staple of the nail beam of 4mm width.
Fig. 8 is the rectangle surgical stapling nail grooving 40 of the middle indent of the preliminary working representing second embodiment of the invention.Anastomosis staple grooving 40 is made up of two grooves 43 and 44 formed after indent on the tissue contact surface 42 of nail anvil 41.Side 45 and 46 is had in the both sides of groove 43 and 44.
As shown in Figure 10, the bottom surface 50 and 51 of the groove 48 and 49 of the accurately machined surgical stapling with the curved nail ditch nail grooving 47 of second embodiment of the invention there is the curved nail ditch 56 and 57 in trench from entering nail face 52 and 53 and extend to out nail face 54 and 55.The bosom entering nail face 52 and 53 and go out nail face 54 and 55 of curved nail ditch 56 and 57 forms the anastomosis staple guide line 58 and 59 of anastomosis staple grooving 47.
As shown in Figure 9, the radius of curvature 22 entering the curved surface of the bottom of nail anvil 41 as rotary body ball 21 is R1, the radius of curvature 60 of the anastomosis staple guide line 58 and 59 of anastomosis staple grooving 47 is R2, the radius of curvature 63 being close to the geometric locus 61 and 62 of the center of curvature of the curved surface of the bottom of the rotary body ball 21 of the anastomosis staple guide line 58 and 59 of anastomosis staple grooving 47 is R=R1+R2, then when rotary body ball 21 with the axis of the vertical direction of the tissue contact surface 42 of nail anvil 41 for rotation axis, when moving along geometric locus 61 and 62 with the center of curvature of the curved surface of the bottom of rotary body ball 21, the track curved surface 64 and 65 that rotary body ball 21 is formed in the groove 43 and 44 of nail anvil 41 is the curved surface of the curved nail ditch 56 and 57 of the groove 48 and 49 of composition anastomosis staple grooving 47.
As shown in Figure 10, the plane at anastomosis staple guide line 58 and 59 place of two grooves 48 and 49 of anastomosis staple grooving 47 is in same plane, and the intersection point that anastomosis staple guide line 58 and 59 and its of two grooves 48 and 49 go out nail face 54 and 55 is crossing.
Figure 11 is the surgical stapling nail grooving 70 of the preliminary working representing third embodiment of the invention.Anastomosis staple grooving 70 is made up of two grooves 73 and 74 formed after indent on the tissue contact surface 72 of nail anvil 71.Side 75 and 76 is had in the both sides of groove 73 and 74.
As shown in figure 16, the bottom surface 80 and 81 of the groove 78 and 79 of the accurately machined surgical stapling with the curved nail ditch nail grooving 77 of third embodiment of the invention there is the curved nail ditch 86 and 87 in trench from entering nail face 82 and 83 and extend to out nail face 84 and 85.The bosom entering nail face 82 and 83 and go out nail face 84 and 85 of curved nail ditch 86 and 87 forms the anastomosis staple guide line 88 and 89 of anastomosis staple grooving 77.
As shown in Figure 12 to Figure 16, the radius of curvature 22 entering the curved surface of the bottom of nail anvil 71 as rotary body ball 21 is R1, the radius of curvature 90 of the anastomosis staple guide line 88 and 89 of anastomosis staple grooving 77 is R2, the radius of curvature 93 being close to the geometric locus 91 and 92 of the center of curvature of the curved surface of the bottom of the rotary body ball 21 of the anastomosis staple guide line 88 and 89 of anastomosis staple grooving 77 is R=R1+R2, then when rotary body ball 21 with the axis of the vertical direction of the tissue contact surface 72 of nail anvil 71 for rotation axis, when moving along geometric locus 91 and 92 with the center of curvature of the curved surface of the bottom of rotary body ball 21, the track curved surface 94 and 95 that rotary body ball 21 is formed in the groove 73 and 74 of nail anvil 71 is the curved surface of the curved nail ditch 86 and 87 of the groove 78 and 79 of composition anastomosis staple grooving 77.
As shown in figure 16, the plane at anastomosis staple guide line 88 and 89 place of two grooves 78 and 79 of anastomosis staple grooving 77 is parallel to each other, and the anastomosis staple guide line 88 and 89 of two grooves 78 and 79 goes out nail face 84 and 85 intersection point with it departs from mutually.
As shown in figure 17, nail anvil 100 is rounded.The anastomosis staple grooving 101,102 of multiple preliminary working becomes three circles with 103 at tissue contact surface 104 alternate of circular nail anvil 100.Circular nail anvil 100 is compared with the depth as shallow of the circular nail anvil 100 of the depth ratio of the anastomosis staple grooving 101 of inner side compared with the anastomosis staple grooving 103 in outside.
As shown in figure 18, multiple accurately machined anastomosis staple grooving 105,106 becomes three circles with 107 at tissue contact surface 104 alternate of circular nail anvil 100.Circular nail anvil 100 is compared with the depth as shallow of the circular nail anvil 100 of the depth ratio of the curved nail ditch 108 of the anastomosis staple grooving 105 of inner side compared with the curved nail ditch 109 of the anastomosis staple grooving 107 in outside.The anastomosis staple grooving 105,106 and 107 of circular nail anvil 100 had both gone for the anastomosis staple of the nail beam of 3mm width, had also gone for the anastomosis staple of the nail beam of 4mm width.
Figure 19 is the rectangle surgical stapling nail grooving 110 of the middle indent of the preliminary working representing fourth embodiment of the invention.Anastomosis staple grooving 110 is made up of two grooves 113 and 114 formed after indent on the tissue contact surface 112 of nail anvil 111.Side 115 and 116 is had in the both sides of groove 113 and 114.
As shown in figure 23, the bottom surface 120 and 121 of the groove 118 and 119 of the accurately machined surgical stapling with the curved nail ditch nail grooving 117 of fourth embodiment of the invention there is the curved nail ditch 126 and 127 in trench from entering nail face 122 and 123 and extend to out nail face 124 and 125.The bosom entering nail face 122 and 123 and go out nail face 124 and 125 of curved nail ditch 126 and 127 forms the anastomosis staple guide line 128 and 129 of anastomosis staple grooving 117.
As shown in Figure 19 to Figure 23, the radius of curvature entering the pinnacle place of the conical surface of the bottom of nail anvil 111 of rotary body circular cone 130 is R1=0, namely the geometric locus 131 and 132 being close to the pinnacle of the conical surface of the bottom of the rotary body circular cone 130 of the anastomosis staple guide line 128 and 129 of anastomosis staple grooving 117 overlaps with the anastomosis staple guide line 128 and 129 of anastomosis staple grooving 117, when rotary body circular cone 130 with the axis of the vertical direction of the tissue contact surface 112 of nail anvil 111 for rotation axis, when moving along the anastomosis staple guide line 128 and 129 of anastomosis staple grooving 117 with the pinnacle of the conical surface of the bottom of rotary body circular cone 130, the track curved surface 133 and 134 that rotary body circular cone 130 is formed in the groove 113 and 114 of nail anvil 111 is the curved surface of the curved nail ditch 126 and 127 of the groove 118 and 119 of composition anastomosis staple grooving 117.
As shown in figure 23, the plane at anastomosis staple guide line 128 and 129 place of two grooves 118 and 119 of anastomosis staple grooving 117 is in same plane, and the anastomosis staple guide line 128 and 129 of two grooves 118 and 119 goes out nail face 124 and 125 intersection point with it departs from mutually.
As shown in figure 24, nail anvil 135 is in linear.Linear nail anvil 135 there is cutter groove 136.The both sides of the cutter groove 136 of tissue contact surface 139 alternate on staple anvil 135 of the online staple anvil 135 of anastomosis staple grooving 137 and 138 of multiple preliminary working.The depth ratio of the anastomosis staple grooving 137 of the cutter groove 136 on closer linear nail anvil 135 is compared with the depth as shallow of the anastomosis staple grooving 138 of the cutter groove 136 on deviated line staple anvil 135.
As shown in figure 25, the both sides of the cutter groove 136 on the online staple anvil 135 of tissue contact surface 139 alternate of the online staple anvil 135 of multiple accurately machined anastomosis staple groovings 140 and 141.The depth ratio of the anastomosis staple grooving 140 of the cutter groove 136 on closer linear nail anvil 135 is compared with the depth as shallow of the anastomosis staple grooving 141 of the cutter groove 136 on deviated line staple anvil 135.
Introduce known in detail according to above-mentioned, compared with existing anastomosis staple grooving, the surgical stapling with curved nail ditch of the present invention nail grooving has following technique effect:
Due to by the requirement of the sealing of anastomosed tissue and hemostasis, the spacing of adjacent two rows or two circle anastomosis staples is limited in less size, namely the spacing of adjacent two rows or two circle anastomosis staple groovings is limited in less size, make the width of anastomosis staple grooving less, therefore when the shape of the anastomosis staple grooving of surgical stapling, when the precision of position and size cannot meet the technical requirement that anastomosis staple is formed accurately, the nail tip of the anastomosis staple in nail bin may be against inappropriate position of the anastomosis staple grooving of nail anvil, beyond the anastomosis staple grooving that even may be against nail anvil, anastomosis staple is caused to be shaped unsuccessfully, the operation object of accurately being coincide by tissue can not be reached.On the other hand, when the surface roughness of the anastomosis staple grooving of surgical stapling is larger, on the shaggy anastomosis staple grooving that the nail tip of the anastomosis staple in nail bin is against nail anvil during bending forming, the resistance of anastomosis staple bending forming obviously increases, both affected anastomosis staple to be formed accurately, cause again the operating physical force of surgical stapling obviously to increase, easily cause operation fatigue; Meanwhile, the noise that the shaggy anastomosis staple grooving that the nail tip of anastomosis staple is against nail anvil sends during bending forming, impels operator to produce tired sensation further.
The shape of existing anastomosis staple grooving is all very complicated, and is often arranged with the anastomosis staple grooving of 40 to 80 on the tissue contact surface of same nail anvil, needs to adopt the method processing such as the compressing and metal powder injection thermal sintering of mould.
If adopt mould method for press forming processing anastomosis staple grooving, because the quantity of anastomosis staple grooving is many, therefore need the press of about 80 tons compressing, again because tissue contact surface and 40 on compressing mould to the shaping contact face of the anastomosis staple grooving of 80 of nail anvil can not contact completely simultaneously, and the narrowest place in the shaping contact face of anastomosis staple grooving is only about 0.3mm, therefore the pressure of about 80 tons of press concentrates on the shaping contact face of indivedual anastomosis staple grooving, first shaping contact facial disfigurement or the damage of this indivedual anastomosis staple grooving is caused, the technical requirement making the precision of the shape and size of the anastomosis staple grooving be processed into subsequently not reach anastomosis staple to be formed accurately, also make the service life of compressing mould very short, also due to when 40 on compressing mould are all pressed in the tissue contact surface of nail anvil to the shaping contact face of the anastomosis staple grooving of 80, there is complicated plastic deformation in nail anvil, may make the anastomosis staple grooving that is processed into and the position at position and the precision of size do not reach the technical requirement that anastomosis staple is formed accurately around, in addition, in order to reach the technical requirement of the surface roughness of anastomosis staple grooving, before employing mould method for press forming processing anastomosis staple grooving, need the tissue contact surface of precise polished nail anvil, this operation adds processing cost and process time.
If adopt metal powder injection thermal sintering method processing anastomosis staple grooving, the precision of the shape of the anastomosis staple grooving be processed into due to metal powder injection thermal sintering, position and size and surface roughness all cannot meet the technical requirement that anastomosis staple is formed accurately, and therefore need to carry out secondary operations to anastomosis staple grooving.
In addition, adopt the method processing such as the compressing and metal powder injection thermal sintering of mould, for the anastomosis staple grooving of the surgical stapling of often kind of specification, often kind of model, all need to be equipped with the very high mould of a set of special required precision, altogether need mold more than 100 just can assort, make processing cost and cost of upkeep quite high.
If adopt metal-cutting machining method processing anastomosis staple grooving, because the shape of existing anastomosis staple grooving is all very complicated, be made up of many curved surfaces, there is the turning of many small curvature radius in the junction of each curved surface, therefore each anastomosis staple grooving needs just can complete processing several times with the feed all around of tiny cutting element, tiny cutting element also easily damages, such that the processing cost of the anastomosis staple grooving of 40 to 80 is quite high, process time is quite long.
Process according to surgical stapling nail bending forming: anastomosis staple bending forming completes along the anastomosis staple guide line of the bottom portion of groove of anastomosis staple grooving, therefore in order to reach the object that anastomosis staple is formed accurately, to the shape of anastomosis staple grooving at anastomosis staple guide line place, position and the precision of size and the technical requirement of surface roughness very high; The side of the groove of anastomosis staple grooving is only that the nail tip serving guided anastomosis nail enters the effect at the anastomosis staple guide line place of the bottom portion of groove of anastomosis staple grooving, even if therefore the side shape of the groove of anastomosis staple grooving, position and the precision of size and the technical requirement of surface roughness not bery high, also can not affect anastomosis staple and be formed accurately.
Surgical stapling with curved nail ditch nail grooving of the present invention, realize at rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil for rotation axis, when being close to the anastomosis staple guide line of anastomosis staple grooving with the bottom entering groove of rotary body and moving along the anastomosis staple guide line of anastomosis staple grooving, the track curved surface that rotary body is formed in groove is the curved surface of the curved nail ditch of composition anastomosis staple grooving, be particularly suitable for first on the tissue contact surface of nail anvil, adopting metal cutting, the shape that the method preliminary working such as the compressing or metal powder injection thermal sintering of mould become, the precision of position and size and the not bery high anastomosis staple grooving of the technical requirement of surface roughness, and reserve polish chipping allowance at the anastomosis staple guide line place of anastomosis staple grooving, and then on the high speed and precision rotary cutting machine such as carving machine, adopt bit using above-mentioned rotary body as Tool in Cutting instrument or grinding tool cutting element, along the curved nail ditch of the anastomosis staple guide line polish anastomosis staple grooving of anastomosis staple grooving, thus make the shape that anastomosis staple grooving of the present invention is processed at anastomosis staple guide line place, the shape that the precision of position and size and surface roughness are all better than adopting the methods such as the compressing and metal powder injection thermal sintering of existing mould to be processed into, the precision of position and size and surface roughness.All machined parameters of the curved nail ditch of various anastomosis staple grooving can be kept in the internal memory of the digital control circuit of the high speed and precision rotary cutting machine such as carving machine, in order to calling at any time and can revising at any time as required, processing cost and process time are reduced greatly.
The surgical stapling with curved nail ditch of the present invention is adopted to follow closely grooving: when anastomosis staple is pushed to anastomosis staple grooving, if when the nail tip of anastomosis staple directly enters in the curved nail ditch of the groove of anastomosis staple grooving, then the nail lower limb of anastomosis staple is along the curved nail ditch bending forming of the groove of anastomosis staple grooving; If the nail tip of anastomosis staple depart from the groove of anastomosis staple grooving curved nail ditch, enter anastomosis staple grooving groove side on time, then the nail tip of anastomosis staple slips in the curved nail ditch of the groove of anastomosis staple grooving from the side of the groove of anastomosis staple grooving, and then the nail lower limb of anastomosis staple is along the curved nail ditch bending forming of the groove of anastomosis staple grooving.Because the surgical stapling with curved nail ditch of the present invention nail grooving can to reach very high shape, position and the precision of size and the technical requirement of surface roughness at anastomosis staple guide line place, thus reach the object that anastomosis staple is formed accurately.
So can find out, above-mentioned stated target, comprises by illustrating that those shown targets have been effectively achieved above.The typical best form of implementation of the present patent application that described here is only, can do some change also without prejudice to the spirit and scope of the present invention to said structure.The present invention is not limited to stated detail here, and should to retain as stated in the restriction of claim concerning affiliated field secondary technology personnel be apparent any improvement or remodeling.
Claims (10)
1. the nail of the surgical stapling with a curved nail ditch grooving, described anastomosis staple grooving is arranged on the tissue contact surface of nail anvil, each anastomosis staple grooving is made up of two grooves, the two ends place that the described groove that the tissue contact surface of described nail anvil is formed after indent is positioned at anastomosis staple grooving being into nail face, being positioned at the center of anastomosis staple grooving for going out nail face, has side, bottom to have bottom surface in the both sides of described groove;
It is characterized in that:
The bottom surface of described groove has from described enter nail face extend to described in go out to follow closely face in the curved nail ditch of trench, the bosom entering nail face and go out to follow closely face of described curved nail ditch forms the anastomosis staple guide line of anastomosis staple grooving;
Rotary body with the axis of the vertical direction of the tissue contact surface of nail anvil be rotation axis, be close to the anastomosis staple guide line of described anastomosis staple grooving with the bottom entering groove of described rotary body and move along the anastomosis staple guide line of anastomosis staple grooving time, the track curved surface that rotary body is formed in groove is the curved surface of the curved nail ditch of the described anastomosis staple grooving of composition.
2. the nail of the surgical stapling with curved nail ditch grooving according to claim 1, it is characterized in that, the bottom entering described nail anvil of described rotary body is curved surface, when rotary body with the axis of the vertical direction of the tissue contact surface of described nail anvil be rotation axis, be close to the anastomosis staple guide line of described anastomosis staple grooving with the curved surface of the bottom of rotary body and move along the anastomosis staple guide line of anastomosis staple grooving time, the track curved surface that rotary body is formed in the groove of described nail anvil is the curved surface of the curved nail ditch of the groove forming described anastomosis staple grooving.
3. the nail of the surgical stapling with curved nail ditch grooving according to claim 1, it is characterized in that, the bottom entering described nail anvil of described rotary body is conical surface, when rotary body with the axis of the vertical direction of the tissue contact surface of described nail anvil be rotation axis, move along the anastomosis staple guide line of described anastomosis staple grooving with the pinnacle of the conical surface of the bottom of described rotary body time, the track curved surface that rotary body is formed in the groove of described nail anvil is the curved surface of the curved nail ditch of the groove forming described anastomosis staple grooving.
4. the nail of the surgical stapling with curved nail ditch grooving according to claim 1, it is characterized in that, the anastomosis staple guide line in the curved nail ditch of two described grooves of same described anastomosis staple grooving is in same plane.
5. the nail of the surgical stapling with curved nail ditch grooving according to claim 1, it is characterized in that, the plane at the anastomosis staple guide line place in the curved nail ditch of two described grooves of same described anastomosis staple grooving is parallel to each other.
6. the nail of the surgical stapling with curved nail ditch grooving according to claim 1, it is characterized in that, described nail anvil is rounded, and multiple described anastomosis staple grooving becomes at least two circles at the tissue contact surface alternate of circular nail anvil.
7. the nail of the surgical stapling with curved nail ditch grooving according to claim 6, is characterized in that, described circular nail anvil is compared with the depth as shallow of the circular nail anvil of the depth ratio of the described anastomosis staple grooving of inner side compared with the anastomosis staple grooving in outside.
8. the nail of the surgical stapling with curved nail ditch grooving according to claim 1, it is characterized in that, described nail anvil is linear, and the tissue contact surface alternate of the online staple anvil of multiple described anastomosis staple groovings becomes at least two rows.
9. the nail of the surgical stapling with curved nail ditch grooving according to claim 8, it is characterized in that described linear nail anvil has cutter groove, multiple described anastomosis staple groovings are arranged in the both sides of the cutter groove of described linear nail anvil.
10. the surgical stapling with curved nail ditch according to claim 9 nail grooving, is characterized in that, the depth ratio of the described anastomosis staple grooving of the cutter groove on closer described linear nail anvil is compared with the depth as shallow of the anastomosis staple grooving of the cutter groove on deviated line staple anvil.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201410044513.2A CN103750873B (en) | 2014-01-29 | 2014-01-29 | With the surgical stapling nail grooving of curved nail ditch |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201410044513.2A CN103750873B (en) | 2014-01-29 | 2014-01-29 | With the surgical stapling nail grooving of curved nail ditch |
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| CN103750873B true CN103750873B (en) | 2015-09-09 |
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| CN104905839A (en) * | 2015-07-01 | 2015-09-16 | 陈宗静 | Nail-pushing seat assembly of intracavitary cutting stapling device |
| CN104921771A (en) * | 2015-07-01 | 2015-09-23 | 陈宗静 | Staple holder assembly of cutter stapler |
| CN105615934B (en) * | 2016-03-14 | 2018-04-13 | 常州智康机械有限公司 | A kind of tubular anastomat |
| CN110799115B (en) * | 2017-06-27 | 2024-03-01 | 爱惜康有限责任公司 | Nail forming pocket arrangement |
| US11045192B2 (en) * | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
| US11045193B2 (en) * | 2018-10-11 | 2021-06-29 | Cilag Gmbh International | Anvil assembly for linear surgical stapler |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US5836503A (en) * | 1996-04-22 | 1998-11-17 | United States Surgical Corporation | Insertion device for surgical apparatus |
| US7600663B2 (en) * | 2007-07-05 | 2009-10-13 | Green David T | Apparatus for stapling and incising tissue |
| CN202665607U (en) * | 2011-12-28 | 2013-01-16 | 常州市康迪医用吻合器有限公司 | Surgical M-shaped anastomosis nail and forming groove thereof |
| CN103110442B (en) * | 2013-02-26 | 2014-11-26 | 中国医学科学院北京协和医院 | Pancreiatic duct jejunum anastomat |
| CN203815517U (en) * | 2014-01-29 | 2014-09-10 | 上海创亿医疗器械技术有限公司 | Surgical anastomotic nail forming groove with nail bending groove |
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