CN103976769B - Purse-string suture device and operational approach thereof - Google Patents
Purse-string suture device and operational approach thereof Download PDFInfo
- Publication number
- CN103976769B CN103976769B CN201410217841.8A CN201410217841A CN103976769B CN 103976769 B CN103976769 B CN 103976769B CN 201410217841 A CN201410217841 A CN 201410217841A CN 103976769 B CN103976769 B CN 103976769B
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- Prior art keywords
- clamp
- link
- pincers
- purse
- string suture
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Classifications
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1142—Purse-string sutures
Abstract
The invention discloses purse-string suture device and operational approach thereof.Purse-string suture device comprises rod portion and sewing-end, sewing-end comprises clamp pincers that bare terminal end is oppositely arranged and moves clamp, clamp pincers and move clamp and be respectively equipped with hole of threading a needle along the longitudinal direction, rod portion comprises the nested successively from the inside to the outside and recursion bar that can be movable relatively, enters rotation set pipe and outer tube sleeve; Wherein, the parallel clutch campaign that the link that one end of recursion bar is connected to dynamic clamp clamps relative to clamp to control brake clamp; The link that the one end entering rotation set pipe is connected to clamp pincers with controls clamp clamp the straight horizontal level of rod portion and perpendicular to rod portion upright position between conversion; One end of outer tube sleeve is rotationally connected the link to clamp pincers; And the link of clamp pincers is C type structure, the link of dynamic clamp is arranged in C type structure to carry out the parallel clutch campaign relative to clamp pincers.By the present invention, be conducive to improving procedure efficiency and operability, alleviate patient suffering.
Description
Technical field
The present invention relates to a kind of purse-string suture device, also relate to the operational approach of above-mentioned purse-string suture device.
Background technology
At present, along with improving constantly of surgery operating technology, based on the status increasingly significant of the peritoneoscope Minimally Invasive Surgery of human viscera organ.In laparoscopic surgery, esophagus jejunorrhaphy is then a very typical example.Esophagus jejunorrhaphy normally with peritoneoscope Proximal gastrectomy with the use of.Peritoneoscope far-end total gastrectomy, usually used as a kind of abdominal being used for the treatment of early gastric cancer.But after ablation in order to ensure the complete of system of digesting and assimilating, then need to use esophagus jejunorrhaphy esophagus end is identical with duodenum together with.
For the suturing skill of esophagus jejunorrhaphy, have and directly sew up and purse string suture two kinds of modes.Direct stitching is a kind of traditional suture way.But there are some researches show, use in patient one period after surgery of this suture way, the infection rate of surgery location is higher, and occurs with complication, purse string suture then efficiently avoid the generation of this situation, thus is little by little promoted as a kind of modern suture way.
As a kind of Minimally Invasive Surgery, purse string suture art needs to make a call to five holes at patient's abdominal part: left upper port, hole, lower-left, upper right hole, hole, bottom right, umbilicus lower opening.Wherein two holes on right side are designed by operator doctor; Two holes in left side are designed by assistant.Because the diameter of these perforates is all smaller, so require that operating theater instruments probes into intraperitoneal and must present direct rod shape.And when will realize gripping function in operation process, be then best clamp becomes plumbness during with the rod portion of apparatus.The present invention then combines above-mentioned two kinds of advantages well.
Summary of the invention
The invention provides a kind of purse-string suture device, it is mainly used in micro-wound surgical operation, particularly in esophagus jejunorrhaphy, carries out gripping stitching for postoperative to esophagus.Its objective is in esophagus jejunorrhaphy, make operating theater instruments be smoothly through the narrow and small perforate of patient's abdominal part, the clamp that the lesions position in abdominal cavity of patients then realizes suture head laterally opens, parallel gripping sews up.Additionally provide the operational approach of purse-string suture device, to realize straight tube turnover, horizontal folding, parallel gripping.
To achieve these goals, the present invention is achieved through the following technical solutions.
A kind of purse-string suture device, comprise rod portion and sewing-end, sewing-end comprises clamp pincers that bare terminal end is oppositely arranged and moves clamp, clamp pincers and move clamp and be respectively equipped with hole of threading a needle along the longitudinal direction, rod portion comprises the nested successively from the inside to the outside and recursion bar that can be movable relatively, enters rotation set pipe and outer tube sleeve; Wherein, the parallel clutch campaign that the link that one end of recursion bar is connected to dynamic clamp clamps relative to clamp to control brake clamp; The link that the one end entering rotation set pipe is connected to clamp pincers with controls clamp clamp the straight horizontal level of rod portion and perpendicular to rod portion upright position between conversion; One end of outer tube sleeve is rotationally connected the link to clamp pincers; And the link of clamp pincers is C type structure, the link of dynamic clamp is arranged in C type structure to carry out the parallel clutch campaign relative to clamp pincers.
Preferably, described recursion bar is connected to the link of dynamic clamp by connecting plate, and one end of connecting plate is fixedly attached to recursion bar, and the other end of connecting plate is rotationally connected the link to dynamic clamp.
Preferably, the link of described dynamic clamp comprises the first projection and is arranged on the second projection in the first projection, the other end of described connecting plate comprises the connecting hole being connected to the first projection rotationally, described second projection embeds in the groove of clamp pin, and the groove of clamp pin is arranged on it towards on the end face of sewing-end inside.
Preferably, described first projection is cylindrical protrusion, and described second projection is square projection.
Preferably, one end of described outer tube sleeve comprises by isolated two sidewalls of groove, the link of clamp pincers is connected between two side arms by clamp pin rotationally, the sidewall of the C type structure of clamp pincers is provided with the installing hole being fixedly connected with clamp pin, installing hole outwards has chute, when sewing-end is horizontal, the end of chute is to rod portion direction deflection.
Preferably, described chute becomes 45 degree with the vertical direction of rod portion.
Preferably, described in enter rotation set pipe and be connected to clamp pincers by linking arm, one end of linking arm is fixedly attached to into rotation set pipe, the other end of linking arm be provided with removable pin for embed clamp pincers chute in and can slide wherein.
Preferably, be provided with groove inside two side arms of described outer tube sleeve, when sewing-end goes to upright position by horizontal level, the groove of outer tube sleeve is communicated with chute.
The operational approach of purse-string suture device, is adjusted to straight line by sewing-end and rod portion; Pull back into rotation set pipe, the pin of linking arm is slided in chute, thus make sewing-end be rotated down 90 degree and vertical with rod member parts, then keep into rotation set pipe current location; Pull back recursion bar, thus leave clamp pincers by the dynamic clamp of connecting plate dragging is parallel, reach maximum folding distance; Driven forward recursion bar, is adjusted to dynamic clamp and needs position; Continue driven forward younger brother push rod, clamp will be moved and determine jaws close; Driven forward enters rotation set pipe, thus sewing-end is forwarded to from upright position horizontal level with rod portion in line.
By the present invention, straight tube turnover, horizontal folding, parallel gripping can be realized, be suitable for the feature that Minimally Invasive Surgery wound is little, be conducive to improving procedure efficiency and operability, alleviate patient suffering, there is good development prospect in Minimally Invasive Surgery.
Accompanying drawing explanation
Fig. 1 is the overall appearance figure of purse-string suture device of the present invention.
Fig. 2 is the structural representation sewing up head end.
Fig. 3 is the front view sewing up head end.
Fig. 4 is the top view sewing up head end.
Fig. 5 is the appearance schematic diagram of outer tube sleeve.
Fig. 6 is the appearance schematic diagram of clamp pincers.
Fig. 7 is the appearance schematic diagram of clamp.
Fig. 8 is the appearance schematic diagram of clamp pin.
Fig. 9 is the appearance schematic diagram of connecting plate.
Figure 10 is the appearance schematic diagram of linking arm.
Figure 11 is the appearance schematic diagram into rotation set pipe.
Figure 12 is the appearance schematic diagram of recursion bar.
Reference numeral
1, clamp pincers;
2, dynamic clamp;
3, connecting plate;
4, clamp pin;
5, recursion bar;
6, linking arm;
7, rotation set pipe is entered;
8, outer tube sleeve.
Detailed description of the invention
Of the present invention in micro-wound surgical operation for the esophagus purse-string suture device of esophagus jejunorrhaphy, its major part comprises the rod portion (recursion bar and enter rotation set pipe) of coupling part of outer tube sleeve, handle, sewing-end and itself and handle.Wherein sewing-end part is cut reeded clamp pin by two panels esophagus clamp (clamp clamp and move clamp) and two and is formed.Recursion bar end is connected with dynamic clamp by two connecting plates, for controlling the feed motion of brake clamp; Enter rotation set pipe and linking arm to be embedded in the groove that clamp clamps by two pins of its end, control its rotary motion.The motion of whole mechanism is divided into two steps: be first threaded to upright position by entering the whole sewing-end of rotation set management and control system by horizontal level; Secondly by the horizontal folding spacing of recursion bar control brake clamp, gripping function is realized.
For the operating theater instruments of esophagus jejunorrhaphy in surgical operation---an esophagus purse-string suture device, the connected mode of each parts is as follows:
The design sewing up head end each parts assembling mode is as described below.Clamp pincers 1 are connected with the form of revolute by a pair clamp pin 4 with outer tube sleeve 8.Wherein clamp pin 4 and clamp clamp 1 and are connected by the rigid connection such as welding, to ensure that the two relative sliding does not occur in motor process.The block-like protrusions of dynamic clamp 2 both sides then embeds in the groove of two clamp pins 4 respectively, and its rotation portion then keeps in touch with the end of recursion bar 5 all the time, and is connected with pin connected mode with recursion bar 5 end by two connecting plates 3.The other end of connecting plate 3 is then inserted in the columnar protrusions part of dynamic clamp, is connected with its formation revolute.Clamp clamps on the rotating part that 1 both sides contact with clamp pin 4, and offered chute respectively, it, in vertical direction with 45 degree of layouts, is connected by removable pin with linking arm 6 end.This removable pin can be free to slide in chute.Linking arm 6 head end is then embedded in the groove of rotation set pipe 7 end, and its upper surface is tangent with the inside cylindrical face entering rotation set pipe 7, is again fixed the relative position of the two by rigid connection such as welding.The both sides sidewall of outer tube sleeve 8 head end is milled with groove, provides dynamic clamp 2 sliding rail in the horizontal direction.
Esophagus purse-string suture device can realize two actions: the first step, driving the linking arm 6 of its end to control suture head (clamp clamps 1, moves clamp 2 and a pair clamp pin 4), making it to be rotated down 90o to vertical position by horizontal level by entering rotation set pipe 7; Second step, controls brake clamp 2 by recursion bar 5 and makes it anterior-posterior translation in the horizontal direction, clamps horizontal range between 1 to realize gripping function to regulate itself and clamp.About this two-step action, its specific implementation process is:
The realization of the first action---rotary motion.
Drag into rotation set pipe 7 backward, drive linking arm 6, and then drive the removable pin being fixed on linking arm 6 end, removable pin is moved horizontally backward.This motion can be analyzed to the slip along groove direction and the instantaneous tangential motion perpendicular to groove direction, wherein latter provides the rotary power of clamp pincers 1.And the rotation rotarily driving clamp pin 4 of clamp pincers 1, and then provide the rotary power of dynamic clamp 2, so whole stitching head end is just rotated down by horizontal level under the traction of entering rotation set pipe 7.When it is threaded to upright position, contact and clamp due to linking arm 6 and outer tube sleeve 8 clamps contacting of sliding pin and chute terminal on 1, add enterprising rotation set pipe 7 self to its effect of contraction, and its is understood and fix at vertical position place.This is realize final gripping stitching function to create advantage.
The realization of the second action---feed motion.
When sewing-end rotates to vertical position place, keep motionless to make sewing-end fix into rotation set pipe 7.Under this state, the groove on clamp pin just can be placed in horizontal position, connects together with the groove of outer tube sleeve.Now pull back recursion bar 5, the connecting plate 3 of its end both sides will be driven, and then drive dynamic clamp 2 to skid off clamp pin 4, depart from clamp pincers 1, be free to slide before and after the groove of outer tube sleeve 8 both sides sidewall.The function that gripping spacing is sewed up to realize gripping is regulated neatly in surgical procedures.Due to the effect of contraction of the sliding pair that dynamic clamp 1 both sides block-like protrusions and sidewall notches are formed, dynamic clamp 1, in the process of sliding, can not rock and occur wiggly situation in front and back.The operability of the precise degrees and stitching that greatly improve operation is shortened operating time by this, completes creation essential condition smoothly for operation.
Acting as of clamp pincers 1 drives the rotary motion of whole stitching head end and the important component part as grasping structures.Wherein, rotating part adopts " C " type structural design so that dynamic clamp 2 can be extracted out by level and with its disengaging; And cut and point to the hole heart, with vertical direction angle be the chute of 45 ° at rotating part, to allow removable pin in interior slip to regulate and control its rotary motion; Be chela threading part below rotating part, it have hole of threading a needle and carry out operation stitching to try to make a match.
The effect of dynamic clamp 2 is parallel folding spacing between adjustment two chela and the important component part as grasping structures, and wherein both sides, center of rotation place are designed with columnar protrusions, for forming pin shaft connection structure with connecting plate 3; Each columnar protrusions is designed with block-like protrusions further, for embedding in the groove of clamp pin 4 and outer tube sleeve 8; Be chela threading part equally below rotating part, it have hole of threading a needle and carry out operation stitching to try to make a match.
The effect of connecting plate 3 is the ends connecting dynamic clamp 2 and recursion bar 5, and its half nose circle has macropore, and the columnar protrusions being inserted in dynamic clamp 2 forms pinned connection; Its flush end has aperture, inserts pin and is connected with the end of recursion bar 5 and fixes.This part be for assembling feasibility and design.
Acting as of clamp pin 4 connects clamp pincers 1 and fixedly makes itself and outer tube sleeve 8 form revolute with it, and drives dynamic clamp 2 jointly to complete rotary course, and clamp pin inside cutting is fluted, is formed coordinate with the block-like protrusions of dynamic clamp 2.
The effect of recursion bar 5 is horizontal feed motions of control brake clamp 2.Recursion bar end both sides cylinder is cut flat and is punched in center, to be connected by bearing pin with the flush end of connecting plate 3.
The effect of linking arm 6 connects into rotation set pipe 7 and clamp pincers 1.Linking arm has the shape of approximate Y shape, and two arms that front end separates have aperture by subterminal centre, are connected to removable pin, makes removable pin in the chute of clamp pincers 1, be free to slide to realize the rotary motion of clamp pincers.This part be for processing operability and design.
That enters rotation set pipe 7 act as the rotary motion being controlled clamp pincers 1 by linking arm 6, and then controls the rotary motion of whole sewing-end.Enter to revolve bottom cannula end and have draw-in groove to the inside along bus, formed for itself and linking arm 6 head end and be rigidly connected.
The effect of outer tube sleeve 8 provides frame support for whole mechanism and provides track for the slip of dynamic clamp 2.Outer tube sleeve has the groove of the same length with entering rotation set pipe 7 to the inside bottom the sleeve end be connected with sidewall along bus, for linking arm 6 provides the degree of freedom moved horizontally, and the moving range limiting it is to assist whole mechanism to the positioning action of sewing-end in vertical orientation.
The operational approach of purse-string suture device of the present invention in esophagus jejunorrhaphy is as follows:
After the set-up procedure of 1. performing the operation completes, use, into rotation set pipe, sewing-end and rod portion are adjusted to straight line, purse-string suture device can successfully be arrived near focus through corresponding abdominal part perforate.
2. after arriving lesions position, pull back into rotation set pipe on earth, now sew up head end and will be rotated down 90 ° to the vertical direction with rod portion.At this moment keep the position into rotation set pipe motionless, just sewing-end can be fixed on the party upwards, more accurate, stable with the pinching action after ensureing.Being fed into the conversion of spinning movement, is realized by the relative sliding be fixed between the removable pin of linking arm end and the fluting clamping rotating part both sides in clamp.
3. further, pull back recursion bar, clamp will be moved and laterally drag backward and clamp horizontal separation with clamp.Due to the effect of contraction of the sliding pair that block-like protrusions and the outer tube sleeve two side inner groovy of dynamic clamp both sides are formed, dynamic clamp does not have the phenomenon rocked back and forth and occurs in the process of sliding, and the moment keeps it parallel with the jaw portion that clamp clamps.Like this, by recursion bar enter the slide anteroposterior in rotation set pipe regulate dynamic clamp and clamp clamp between distance, realize sewing up the horizontal folding of head end, gripping function.Bottom the chela that dynamic clamp and clamp clamp, have the hole of threading a needle of bottom-up through caliper.After sewing-end is by clamp tissue to be stapled, penetrates needlework by sewing hole and realize sewing up function.
4., after operation stitching terminates, by fixing for two stitching thread knottings, sewing needle exits hole of threading a needle.Again regulate dynamic clamp to make it again to be pushed in the groove of clamp pin by recursion bar, clamp with clamp and again close up.At this moment keep the position of recursion bar motionless, dynamic clamp is not being slided perpendicular in the horizontal direction of rod member.
5. driven forward enters rotation set pipe, and whole stitching head end is rotated up 90 ° by the position perpendicular to rod member, when enter rotation set pipe hold out against forward after its position of maintenance motionless, to keep whole suture head and rod portion conllinear.
6. esophagus purse-string suture device is extracted out from its corresponding patient's abdominal part perforate, complete whole surgical suturing process.
Claims (8)
1. a purse-string suture device, comprises rod portion and sewing-end, and sewing-end comprises clamp pincers that bare terminal end is oppositely arranged and moves clamp, clamp pincers and move clamp and be respectively equipped with hole of threading a needle along the longitudinal direction, it is characterized in that,
Rod portion comprises the nested successively from the inside to the outside and recursion bar that can be movable relatively, enters rotation set pipe and outer tube sleeve; Wherein, the parallel clutch campaign that the link that one end of recursion bar is connected to dynamic clamp clamps relative to clamp to control brake clamp; The link that the one end entering rotation set pipe is connected to clamp pincers with controls clamp clamp the straight horizontal level of rod portion and perpendicular to rod portion upright position between conversion; One end of outer tube sleeve is rotationally connected the link to clamp pincers; And
The link of clamp pincers is C type structure, and the link of dynamic clamp is arranged in C type structure to carry out the parallel clutch campaign relative to clamp pincers.
2. purse-string suture device according to claim 1, is characterized in that, described recursion bar is connected to the link of dynamic clamp by connecting plate, and one end of connecting plate is fixedly attached to recursion bar, and the other end of connecting plate is rotationally connected the link to dynamic clamp.
3. purse-string suture device according to claim 2, it is characterized in that, the link of described dynamic clamp comprises the first projection and is arranged on the second projection in the first projection, the other end of described connecting plate comprises the connecting hole being connected to the first projection rotationally, described second projection embeds in the groove of clamp pin, and the groove of clamp pin is arranged on it towards on the end face of sewing-end inside.
4. purse-string suture device according to claim 3, is characterized in that, described first projection is cylindrical protrusion, and described second projection is square projection.
5. purse-string suture device according to claim 1, it is characterized in that, one end of described outer tube sleeve comprises by isolated two sidewalls of groove, the link of clamp pincers is connected between two side arms by clamp pin rotationally, the sidewall of the C type structure of clamp pincers is provided with the installing hole being fixedly connected with clamp pin, installing hole outwards has chute, and when sewing-end is horizontal, the end of chute is to rod portion direction deflection.
6. purse-string suture device according to claim 5, is characterized in that, described chute becomes 45 degree with the vertical direction of rod portion.
7. purse-string suture device according to claim 5, it is characterized in that, described enter rotation set pipe be connected to clamp pincers by linking arm, one end of linking arm is fixedly attached to into rotation set pipe, the other end of linking arm be provided with removable pin for embed clamp pincers chute in and can slide wherein.
8. purse-string suture device according to claim 7, is characterized in that, be provided with groove inside two side arms of described outer tube sleeve, when sewing-end goes to upright position by horizontal level, the groove of outer tube sleeve is communicated with chute.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410217841.8A CN103976769B (en) | 2014-05-21 | 2014-05-21 | Purse-string suture device and operational approach thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410217841.8A CN103976769B (en) | 2014-05-21 | 2014-05-21 | Purse-string suture device and operational approach thereof |
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| Publication Number | Publication Date |
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| CN103976769A CN103976769A (en) | 2014-08-13 |
| CN103976769B true CN103976769B (en) | 2015-12-30 |
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| CN201410217841.8A Expired - Fee Related CN103976769B (en) | 2014-05-21 | 2014-05-21 | Purse-string suture device and operational approach thereof |
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Families Citing this family (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106923876B (en) * | 2015-12-31 | 2019-07-09 | 苏州天臣国际医疗科技有限公司 | Tissue closing device and medical instrument including the tissue closing device |
| CN108882931B (en) * | 2016-03-24 | 2021-06-25 | 国立大学法人香川大学 | Suturing device |
| CN105997175B (en) * | 2016-08-08 | 2018-10-16 | 苏州天臣国际医疗科技有限公司 | tissue closing device and medical instrument |
| JP6630868B2 (en) | 2016-08-08 | 2020-01-15 | タッチストーン インターナショナル メディカル サイエンス カンパニーリミテッドＴｏｕｃｈｓｔｏｎｅ Ｉｎｔｅｒｎａｔｉｏｎａｌ Ｍｅｄｉｃａｌ Ｓｃｉｅｎｃｅ Ｃｏ．， Ｌｔｄ． | Tissue closure devices and medical instruments |
| CN108814680B (en) * | 2018-04-10 | 2019-06-25 | 中国人民解放军陆军军医大学第二附属医院 | Purse-string forceps for single-hole laparoscopic surgery |
| CN112704529B (en) * | 2020-12-23 | 2022-02-11 | 王冬 | Tubular esophagus and stomach anastomosis posterior lateral stapling instrument |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US8641729B2 (en) * | 2005-07-13 | 2014-02-04 | Creighton University | Systems and techniques for minimally invasive gastrointestinal procedures |
| CN101756736A (en) * | 2008-11-27 | 2010-06-30 | 苏州天臣国际医疗科技有限公司 | Automatic purse-string suture device |
| CN102525581B (en) * | 2011-10-25 | 2013-09-11 | 王小军 | Disposable purse-string forceps for laparoscope |
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