CN104159530A - Apparatus for supplying surgical staple line reinforcement - Google Patents
Apparatus for supplying surgical staple line reinforcement Download PDFInfo
- Publication number
- CN104159530A CN104159530A CN201380013429.8A CN201380013429A CN104159530A CN 104159530 A CN104159530 A CN 104159530A CN 201380013429 A CN201380013429 A CN 201380013429A CN 104159530 A CN104159530 A CN 104159530A
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- CN
- China
- Prior art keywords
- support member
- member material
- anastomat
- arm
- base component
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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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
- 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
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
Abstract
An apparatus for supplying surgical buttress material to a surgical stapler is provided. The apparatus has a pivotable area for attaching surgical buttress material. The apparatus may also have an adhesive and a release liner disposed over the buttress material.
Description
the cross reference of related application
The application is the U.S. Patent application the 12/247th of submitting on October 8th, 2008, the partial continuous application of No. 710, and this application has required the U.S. Provisional Patent Application the 60/978th of submitting on October 8th, 2007, the priority of No. 178.
Technical field
The present invention relates to for the device to surgical stapling supply surgical stapling nail row reinforcement material.
Background technology
Surgical stapling device is the device that surgeon uses, with sequentially or side by side by a row or multi-row being applied in tissue such as the such surgical fastener of anastomosis staple or two-piece type securing member, so that systemic each several part is linked together.This stapling apparatus is conventionally by pair of jaws (clamp is in nail bin side, and another clamp is in anvil block side) or arm shape structure composition, and bodily tissue to be linked is placed on this between clamp or arm shape structure.When apparatus activated or when " starting ", the start-up rod vertically moving contacts with the anastomosis staple drive member in a clamp, thus, promote surgical stapling nail through bodily tissue and push the anvil block in relative clamp, it is closed that this anvil block tightens anastomosis staple.If remove tissue, can provide blade to cut between anastomosis staple row.United States Patent (USP) 4,354,628,5,014,899 and 5,040,715 have described the example of apparatus like this, herein to introduce its each content referring to mode.
Surgical stapling device has had application widely in must linking or removing systemic surgical operation, all obesity in this way, knot rectum or thoracic surgery.When in the time that thin tissue is performed the operation, such as thin emophysematous lung tissue, importantly effectively seal the especially easily tissue of escape of air.Prevent from or reduce escape of air reducing significantly the post-operative recovery time.Suppress or prevent that the tearing also of identical cutting part place in aponeurosis region from can reduce recovery time significantly.
Therefore, need to be useful on the structure of surgical stapling device, these structures can be reinforced the sealing of surgical site place and/or be reduced torn tissue.
United States Patent (USP) 5,503,638,5,575,803,5,549,628,5,702,409,5,810,855 and 5,908,427 have described surgical stapling nail row bracing means and with the surgical stapling device of support material in a organized way.
United States Patent (USP) 5,752,965 and United States Patent (USP) 6,939,358 a kind of device has been described, it is used for surgery reinforcement material to be applied on the working surface of surgical stapling, and without removing unnecessary material.
The invention provides a kind of device of long-term needs, it fast and easily not only thin but also flexible surgery reinforcement material is applied on anastomat.
Summary of the invention
The present invention is the modifying device that fast and easily the surgery reinforcement material of Bao Yourou is again applied to anastomat.This device comprises body, and this body has the surgery reinforcement material in a part that is attached to described body, and a part on it with the described body of reinforcement material can pivotable with respect to the remainder of described body.Finishing pad is attachable on this device, or otherwise provides as a part for external member.This device also comprises the fixture that temporarily surgery reinforcement material is fixed to this device.The body of device can be configured to: device body can be with respect to the first side of device body and the second side conversely with respect to the orientation of surgical stapling.
Surgery reinforcement material also can comprise with respect to described body and is positioned at the binding agent in surgery reinforcement material outmost surface.This binding agent can be any suitable binding agent, includes but not limited to pressure sensitive adhesives.
Brief description of the drawings
Fig. 1 is the view of the embodiment of apparatus of the present invention.
Fig. 2 is the view with the embodiment of apparatus of the present invention of hinged body.
Fig. 3 A is the view of the embodiment of reversible device of the present invention, shows the fixture that is projection form.
Fig. 3 B is the view of the embodiment of apparatus of the present invention, shows the fixture and the optional finishing pad (touch-up pad) that are projection form.
Fig. 4 is the view of the embodiment of apparatus of the present invention, shows the optional finishing pad that is attached to body by connecting device.
Fig. 5 A to 5D is the view showing for the different embodiment of finishing pad of the present invention.
Fig. 6 A to 6E is the view of apparatus of the present invention, and wherein, the pivoting portions of this device bends to outside paper.
Fig. 7 is the axonometric chart of the embodiment of the device for applying support member or surgical materials.
Fig. 8 A is the axonometric chart of the embodiment of the device for applying support member or surgery reinforcement material.
Fig. 8 B is the axonometric chart of the base component that installs shown in Fig. 8 A.
Fig. 8 C is the support member that installs shown in Fig. 8 A or the axonometric chart of surgery reinforcement material.
Fig. 9 A is the axonometric chart of the embodiment of the device for applying support member or surgery reinforcement material.
Fig. 9 B is the axonometric chart of the base component that installs shown in Fig. 9 A.
Figure 10 A is the view of the embodiment of the device for applying support member or surgery reinforcement material.
Figure 10 B is the view of the base component that installs shown in Figure 10 A.
Figure 10 C is the end-view that is provided with apparatus of the present invention of surgery support member material on it.
Figure 11 A is the view for apply the embodiment of the device of support member or surgery reinforcement material under restrained condition not.
Figure 11 B is the view of the embodiment of the device for apply support member or surgery reinforcement material under restrained condition.
Figure 12 A is the view of the embodiment of the device for applying support member or surgery reinforcement material.
Figure 12 B is the view of the base component that installs shown in Figure 12 A.
Figure 12 C is the support member that installs shown in Figure 12 A or the view of surgery reinforcement material.
Figure 12 D is the view of the elastomeric element that installs shown in Figure 12 A.
Figure 13 A-E and surgical stapling nail bin reload device combination, for applying a series of axonometric charts and the end-view of an embodiment of device of support member or surgery reinforcement material.
Detailed description of the invention
The invention provides the device for surgery reinforcement material being fed to surgical stapling.
As shown in Fig. 1 to 6, device 1 of the present invention comprises body 2, and being dimensioned at least a portion of the unlimited anastomat arm of surgical stapling (surgical stapler) of this body provides surgery reinforcement material (Fig. 1) to surgical stapling.
Fig. 1 illustrates the schematic diagram of the device that comprises body, and this body has the first side (being shown as in the figure on the top that is oriented in device) and the second side.The body 2 of device also has Part I and Part II.The Part I 4 of body can be with respect to the Part II pivotable of body.For distinct the present invention, should be understood that the Part I 4 that can pivoting portions be considered to device body of body as described hereinafter.Surgery reinforcement material is known as " support member material " hereinafter, and this surgery reinforcement material is also further arranged on the region of Part I 4 of described body.In one embodiment, support member material 3 is fixed to the Part II of body.Surgical stapling is received in being dimensioned to of body as follows, that is, allow support member material 3 to be applied on the clamp of anastomat.
Body has the first side 40 and the second side 50, and for ease of making surgical stapling be loaded with support member material, these both sides can exchange.Although Fig. 1 is illustrated as the pivotable Part I 4 of body 2 the relative center being positioned at respect to the remainder of body 2, should be understood that, can also can be positioned at other desirable position by pivoting portions 4.Body can pivoting portions 4 function be to locate to make this support member material 3 to disconnect in punched areas (such as perforation lug), so support member material is the fixture 7 on disengaging gear easily.For example, the Part I of pivotable, outside at least one direction bends to the plane of device, is prepared to apply to separate support member material 3 at appointed area place.The pivoting portions (Part I 4 of body) of device is shown as rectangle part, however, it is to be understood that, also expects such as bar, ring, line, rigid mesh, strip member or other suitable shape or other shape.Fig. 1 also illustrates the body that is formed with open centre region 8.This open centre region 8 can be brought in body, so that anastomat is with respect to the motion of body.
Support member material 3 and described body 2 can pivoting portions 4 at least one region contact.Being applicable to support member material 3 of the present invention can be by any material manufacture with acceptable biocompatibility and mechanical characteristic.For example, support member material 3 can be formed by any suitable material, and can be synthesize or take from animal.Although synthetic material is first-selected, for example, due to the benefit that synthetic material can do very thinly as described herein and manufacture for other, also can use from animal support member material with it.Support member material 3 can be to be wrapped in device body single-piece around as shown in Figure 1, maybe can be many.
The support member material (for example, such as cattle, pig, horse and people product) of taking from animal can have and the upper relevant many difficulties of the working surface that places it in surgical stapling (for example, anvil block and nail bin clamp surface).The support member material of taking from animal conventionally can not reach consistent and thin profile in keeping the desired strength relevant with the synthetic support member material of first-selection.The invention has the advantages that, from do not allow successfully to place thin support member material traditional to apply card different, the application of the invention device, the support member material 3 that thickness can be less than to 0.5 millimeter accurately and is successfully positioned on the working surface of surgical stapling.
In addition the support member material of, taking from animal conventionally applies binding agent or be actuated on the outer surface of support member material with additional step.For example, some product uses rehydrated technology, and other products uses the binding agent of paste or gel-type, and they need to apply with fairing before use to support member material 3.The binding agent of paste or gel-type allows support member material to slide on the working surface of surgical stapling in loading procedure.In the time preparing to use the binding agent such as pressure sensitive adhesives, the present invention does not need extra applying or actuation step.Can discharge liner owing to removing simply, pressure sensitive adhesives can be ready to for.
The advantage that this device is not expected is, is non-ly less than other material of 0.5 millimeter than the working surface that is more easy to apply to anastomat with traditional bringing device from thinner support member material and particularly thickness the material of animal such as synthetic.Support member material 3 can easily bond or place the crotch of getting back to surgical stapling, and successfully covers anastomosis staple row with this device, because body can do to obtain enough thin crotches that reaches anastomat.The convenience of this placement also allows support member material 3 to be attached on the working surface of anastomat and without pack.
Suitable synthetic support member examples of materials includes but not limited to: can bio-absorbable or biodegradable material or web, abiotic absorbable material or web, such as United States Patent (USP) 5,810, the expanded polytetrafluoroethyl,ne (" ePTFE "), the synthetic material that in 855, disclose, or other suitable support member material.Use an advantage of synthetic support member material to be, before use, do not need rehydrated this synthetic material, they will have more consistent thickness.Support member material 3 also can be at the body with respect to device at least comprising binding agent in outmost surface.This binding agent can be such as the ready-made available binding agent of pressure sensitive adhesives, and can also be maybe needs the binding agent that activates, and it need to be got wet or alternate manner is activated before use.The web of the discharged liner such as PET release film or other coating or sheet can be applied on binding agent to protect it, until that it is ready to is stand-by.Can discharge liner and can be used to cover support member material 3 and apply in advance binding agent, so that liner can easily separate with the binding agent on surgery support member material 3, therefore, keep the integrity of binding agent, and it be stand-by to allow binding agent to be easily ready to.An advantage of this device is, binding agent can apply in advance, and is substantially evenly distributed on support member material.Therefore, gel as being used in traditionally the uneven distribution on support member material or the demand (seeing example 10) of any fairing of the required work of paste binding agent or the operation of dispersion have been eliminated.
Being dimensioned to of device 1 is applied to surgery support member material 3 on surgical stapling.This device can comprise identical material on whole body, maybe can comprise the material that two or more are different, such as but be not restricted to: plastics, metal, hardboard, foam, or any other suitable material.
Device 1 also comprises and support member material 3 is fixed on to the one or more fixtures 7 on device temporarily.Support member material 3 is attached on device by this fixture temporarily, to allow support member material 3 to extend to approximately at least a portion of body Part I 4.In one embodiment, as shown in Figure 1, fixture is the retention tab of the perforated portion that forms with the support member material 3 by adding simply.Optional projection is shown as additional fixture.Fixture 7 in Fig. 3 A, 3B and 4, be further illustrated as comprise near the pivotable Part I 4 of body, multiple projections on each body of location in parallel with each other.Projection can be designed to support member material 3 that tension force is provided, and like this, support member material 3 flattens, and to reduce pack or wrinkling, thereby and provides contact surface to be more uniformly bonded on anastomat arm.Should be understood that, in alternative embodiment, projection can be located each other not parallelly.These projections have suitable dimension and are positioned on body, to coordinate the perforation in surgery support member material 3.Other form of fixture 7 comprises lug, friction interference fit, ultrasonic bonding or thermal weld, the mechanical attachment of binding agent bonding, or support member material is fixed to any other suitable device of body.
As shown in Fig. 3 A, 3B, 4,5A-D and 6A-6E, device of the present invention also can comprise finishing pad 5.Fig. 4 illustrates finishing pad 5, and it can be used as interconnection element for good and all or is removably attached to device.Alternatively, as shown in Figure 3A, this figure shows an embodiment of this device, and it allows the body of device reversibly to insert in surgical stapling, and carries out in insertion structure.The reversible embodiment of this device comprises the body with the first side 40 and the second side 50, no matter which side contacts with the anvil block of anastomat, also, no matter which side contacts with the nail bin of anastomat, all they can be fed in anastomat.This reversible structure can make doctor easily health is loaded on anastomat.Also, as shown in Fig. 3 B and 5, optional finishing pad 5 can for good and all or non-permanently be attached to device body in a side or both sides.Finishing pad is used for making the Surface Contact area maximum between support member material 3 and the working surface of anastomat, and for example, the binding agent 6 in the part of outermost of support member material 3 is bonded to support member material 3 on the relative working surface of surgical stapling.After support member material is directed on device, sometimes wish that support member material is further pressed onto to finishing pad upper, with by support member material binding to the larger surf zone of anastomat.In the time that the binding agent on device is arranged on the pressure sensitive adhesives on surgery support member material, this is particularly advantageous.
As shown in Fig. 5 A to 5D, finishing pad 5 can be undulations uniform or heterogeneous, in addition, finishing pad can comprise one or more, and it (for example can be designed to wedge shape (for example, Fig. 5 A), plain cushion, Fig. 5 B), protruding point (for example, Fig. 5 C) etc.Sometimes wish that finishing spacer has special shape, to reinforce anastomosis staple row surface area around.The material that finishing pad is normally such, such as, but not limited to: Cotton Gossypii, polyester, foam, plastics, metal or any other suitable material.Advantageously allow finishing pad be placed in the region of leaving support member material 3, like this, material being applied in the process of each arm of anastomat, do not have additional thickness or volume relevant to support member material or device.
Fig. 3,4 and 6A to 6E shown in embodiment in, device 1 body is configured as and comprises fingers gripping member 10, with making surgical stapling be convenient to clamp this device in being loaded with the process of surgery support member material 3.The end of the pivotable Part I 4 of the close body of device also comprises anastomat constraint 23.This anastomat constraint 23 be formed for body can pivoting portions 4 on support member material (not shown) initial or receive region.Constraint 23 by contacting with the furcation of anastomat form produce can pivoting portions, it allows the receiving region of body Part I with respect to the plane pivotable of body Part II, so that support member material is fixed to anastomat.
As shown in Fig. 1 and 6A to 6E, support member material 3 is oriented on the body of device, to allow surgical stapling to be clamped on device.Binding agent 6 on support member material 3 is bonded to support member material 3 on the relative working surface of surgical stapling.In the time that the binding agent on device is arranged on the pressure sensitive adhesives on surgery support member material, be favourable.Before use, can utilize can discharge liner 20 and cover pressure sensitive adhesives, and keep the form of binding agent in preparing to use in order to applying.Remove and can discharge liner pressure sensitive adhesives is exposed, therefore, can allow doctor easily and rapidly support member material 3 be navigated on the working surface of surgical stapling.Fig. 6 A illustrates with the device 1 of loading that is arranged on the discharged liner on support member material 3.Fig. 6 B illustrates the device 1 of loading, wherein, can discharge liner and remove from support member material 3, thereby expose the binding agent on support member material, and make it be ready to coordinate with the arm of anastomat.Fig. 6 C illustrate anastomat clamp 90 and device, the binding agent that this device is positioned to expose on support member material will contact with the working surface of anastomat clamp, with by support member material binding to anastomat.Fig. 6 D illustrates the anastomat clamp 90 being clamped on device 1, to contact between the binding agent that allows to expose on support member material and anastomat working surface.Fig. 6 E illustrates the Part I 4 of body, it is pivoted to outside the plane of body Part II, thereby at punched areas place, support member material 3 is ruptured so that the anastomat clamp 90 coordinating with Part I 4 moves, and the fixture 7 of support member material from device thrown off.
Other optional feature can be added body to, comprises the color coding of body so that load; Measurement markers, non-slipper, or the variation of other requirements.Within the feature of human engineering is also incorporated in technical staff's in the art technology, to be applied to this device, such as finger-type keeper, curved surfaces, rib or special relevant to surgical glove additional sense of touch or clamp other protrusion features of convenience.
As mentioned above, device of the present invention provides the straightforward procedure that support member material 3 is applied to various anastomats.By skilled worker, support member material 3 is pre-loaded to the body of device, or buy time be ready to, in order to use embodiment.So-called " prestrain " refers to that support member material 3 is attached in pivotable at least a portion with respect to described body Part II of body.Can discharge liner and remove from support member material, thereby expose the binding agent on the exposing surface of support member material.As shown in Figure 6, then device 1 is inserted between the anastomat arm of opening, and aim at anastomat arm, so that support member material in being applied to the position on anastomat arm by support member material in the time contacting between two arms.Once body can hold support member material by pivoting portions, anastomat arm is just closed, the plane motion of can pivotal area leaving body remainder of body, so, the perforation lug fracture of support member material 3.If necessary, can the surface area maximum of support member material of anastomat arm will be bonded to finishing pad.Then, open anastomat arm, to complete, support member material 3 is transferred to anastomat arm.Then, the body of device is removed and is discarded from anastomat arm, and anastomat is in order to using.
Now forward Fig. 7 A to, install another embodiment of 100 shown in figure, this device 100 is for being applied to anastomat clamp by support member or surgery reinforcement material 102.Fig. 7 B illustrates the device 100 combined with the clamp of surgical stapling.
The device 100 that applies surgery reinforcement material comprises support member material 102, and it has at least a portion 112 that is connected to releasedly the support member material on supporting member or base component 106.Support member material 102 can be fixed to base component with binding agent or with mechanical mechanism.Support member material can comprise along the perforation 108 of support member material 102 length.In the time applying enough power the core of support member material 112 is separated with the edge 110 of support member material 102, the mechanism that is used for the support member material 102 to be fixed to base component 106 must be enough to the edge of support member material 110 to be connected to base component 106.In Fig. 7 A and 7B, support member material 102 is shown as by being connected to base component 106 from the extended projection 114 of base component 106.
Base component 106 can comprise the tensioner arm 116 of pair of flexible.Projection 114 extends from tensioner arm 116.The edge 110 of support member material comprises isolated hole 118, with match from the extended projection 114 of tensioner arm 116.Hole 118 is also partitioned into like this: in the time that support member material is connected to two groups of projections 114, tension force is just applied on tensioner arm 116.Tensioner arm 116 is designed to deflection toward each other, so that support member material 102 can be arranged on base component 106.After support member material 102 is connected to attached projection 114, allow the outside deflection of tensioner arm 116.The outside deflection of tensioner arm 116 is at the interior formation tension force of support member material 102, and this tension force is enough to make support member material 102 to keep smooth.Base component 106 also can have hinge 118.Hinge 118 allows base component 106 bending and distortion between the whole storage life, still keeps support member material 102 under tension force simultaneously.
Base component 106 also can comprise aligning guide, so that support member material suitably aims at anastomat clamp, and guarantees that all anastomosis staple Kongzuis are capped eventually.So aligning guide can comprise flexible tongue, and it is by being fitted in the location that facilitates the degree of depth and edge-to-edge in the privot mechanism of anastomat clamp.So tongue can be positioned on base component at certain some place of support member material end further away from each other.Alternatively, this passage in base component is convenient to the degree of depth of support member material and edge-to-edge's location by the far-end of surgical stapling being inserted in passage, and this passage provides suitable aligning guide.Also having in another embodiment, aligning guide can be the form of plunger, and it coordinates with the feature on anastomat clamp outside or the back side, and this aligning guide can be similarly convenient to the torsion of neutralization prevention support member material in anastomat loading procedure.
In Fig. 8 A-8C, shown in figure for applying the alternative embodiment of device 200 of reinforcement material or support member material 202.Base component 204 can be made up of continuous semi-rigid material sheet.Base component 204 comprises the coupling mechanism that support member material 202 is fixed to base component 204.Support member material 202 can have multiple isolated holes 206, to aim at the multiple projections 208 on base component 204.Support member material also can comprise the perforation 210 along device length.By base component 204 being bent to C-shape and hole 206 being connected to projection 208, support member material 202 is connected to base component 204.Before being loaded on anastomat clamp, base component 204 must enough rigidity, to keep support member material to be tightened up, 210 tear but also can not rigidity must be enough to make to bore a hole.
Comprise any amount of thin plastics or metallic film for continuous semi-rigid material sheet or the suitable material of base component 204.As shown in Fig. 8 A-8C, support member material 202 is shown as by projection 208 and fixes, and can adopt any suitable machinery or chemical bonding mechanism.
Fig. 9 A and 9B illustrate the alternative embodiment of the device 300 for applying reinforcement material or support member material 302.Base component 304 can be the material pieces of extrusion modling, and it is distinguishingly shaped and forms flexible hinge.Base component 304 can comprise at least one pair of tensioner arm or flexible arm 306.In Fig. 9 A, flexible arm 306 is shown as in restrained condition not.Flexible arm 306 can be crowded together and make it be placed in not affined state by being fixed to the support member material 302 of base component 304 as shown in Figure 9 B.Flexible arm 306 will be outwardly-bent towards its not affined state, and provide power to make support member material 302 keep tension or under tension force.Base component 304 is shown as has projection 308 with securing supports material 302, but, can use any suitable maintaining body that support member material 302 is held in place.
Figure 10 A-10C illustrates another the alternative embodiment for reinforcement material or support member material 402 being applied to the device 400 on anastomat clamp.Device 400 has the first rigid arm 404 and the second rigid arm 406, and they are linked together with elastic component 408.Before Figure 10 B is illustrated in support member material 402 is installed on device 400 in the device 400 of constrained state not.Elastic component 408 provides power, and this power makes in open position that the first arm and the second arm 404,406 be biased to as shown in Figure 10 B.As shown in Figure 10 C, support member material 402 is fixed to arm 404,406.When device 400 is during in constrained state not, the distance between the coupling mechanism (not shown) in the each side of support member material 402 is less than the distance between the coupling mechanism 410 in rigid arm 404,406.Support member material 402 is extensible to connect with coupling mechanism 410, thereby rigid arm 404,406 is close together more.Elastic component 408 will provide power, and this power pushes back rigid arm 404,406 towards restrained condition not.This power should be enough to keep support member material 402 under tension force, but also should not be enough to tear any perforation that can be arranged in support member material.
Figure 11 A and 11B illustrate the alternative embodiment of the device 500 for applying reinforcement material or support member material 502.After device 500 is stored in packaging 510, tension force is applied on support member material.In Figure 11 A, device 500 is shown as has pair of flexible arm 504, and they link together by flexible pivot fitting 506.A pair of tensioner arm 508 is formed in the surface of storage package 510.Tensioner arm 508 is spaced apart, so that arm 504 is placed under tension force by the tensioner arm 508 of packaging 510.Packaging 510 can be made up of various materials, such as the polystyrene (HIPS) of polyethylene terephthalate (PETG) or resistance to HI high impact.
Figure 12 A-12D illustrates another the alternative embodiment for reinforcement material or support member material 602 being applied to the device 600 on anastomat clamp.Applicator device 600 can comprise the support member material 602 that is fixed to applicator card 604 by elastomeric element 606.Feature 608 by support member material 602 and be arranged on the feature 610 on applicator card 604, support member material 602 is connected to applicator card 604 by elastomeric element 606.These features 608,610 are shown as hole or aperture, but can be also that elastomeric element 606 can be by any further feature being fixed such as projection or slit.Elastomeric element 606 is used for guaranteeing that support member material is under tension force, like this, in the time being connected on applicator card, keeps any support member material 602 to strain.Support member material 602 can be provided with perforation 612, like this, in the time that device is used for support member material 602 to be applied on anastomat, only removes and covers the required support member quantity of material in anastomat clamp surface from applicator card 604.Applicator card 604 also can comprise pivoting portions 612.In the time that surgeon applies support member material 602 with applicator card 604, this pivoting portions 612 allows the pivoting portions 612 of the bending applicator card 604 of surgeon.
Figure 13 A-E illustrates another embodiment for reinforcement material or support member material 712 being applied to the device 704 on anastomat clamp.Device 704 is integrated into nail bin to be reloaded in device 702.This device is made up of the flexible material with some feature, and these characteristic Design one-tenth are connected to releasedly nail bin at lug 708 places and reload device 702, and support member material 712 is fixed on to pin 706 places, sending under tension force.Support member material 712 be not fixed to this device under constrained state, in this case, there is no tension force in system.In the time that device 704 and nail bin reload device 702 and combine, this system is placed under tension force, thus, support member material 712 is strained and evened up.This material can be perforated 714, thereby can promote that transferring to nail bin from delivery apparatus reloads device 702 nail bin being reloaded when device 702 is delivered to surgical stapling.
example
example 1
The thick card (being of a size of 10cm length × 5.7cm wide) of 30 mils (0.076cm) of constituent apparatus body is made by injection molding Merlon, and is configured to contribute to surgical stapling nail row support member (SLR) material to be applied to the clamp of the anastomat of selling on market.Use razor instrument, can form the pivot of SLR receiving region, anastomat retaining zone and SLR card by three side otch (S1 × S2 × S3) of Merlon card.The length of the longitudinal cut (S1 & S3) on card is about pact～50% of Merlon card (being approximately 4.7cm), and is approximately 0.6cm from one end of card.The Design of length of cross sections (S2) becomes to hold the clamp (being approximately 1cm) of the anastomat of selling on the width of SLR and market.
Receive region to be formed by three sides of S1, S2 and S3 otch.Receive the not cutting side in region to form pivot.The end of the most close pivot of card is anastomat constraint.This constraint forms initial or receiving region.The pivot forming allows SLR to receive the plane pivotable of region with respect to Merlon card.
example 2
A slice SLR material is placed on as on the receiving region of Merlon card of preparation in example 1, and a side of SLR material has pressure sensitive adhesives (PSA) and for covering the discharged liner of PSA.
SLR material is cut into the perforation lug of connection in advance, and these lugs extend beyond the width of receiving region.
SLR material is suitable for installing to be received on region, and can in each side with perforation lug, be attached to Merlon card, and these lugs extend beyond the width of receiving region.The perforation lug of SLR is attached on Merlon card with the 2nd PSA being positioned on the opposite side of a PSA liner.
example 3
To the SLR card of preparing to use, before packaging, SLR is attached to Merlon card.
example 4
After SLR being attached on Merlon card, peel off and remove the discharged liner that covers PSA.Next, the receiving zone location by anastomat against card, is then clamped on the receiving region of the Merlon on the SLR with the binding agent that PSA exposes.This is attached to SLR by anastomat securely.Next, the opposite end place that is stuck in constraint moves perpendicular to anastomat clamp, to disconnect SLR from perforation lug.This makes SLR discharge from card, and allows SLR to transfer to anastomat completely.
example 5
The card (being of a size of 10.5cm length × 3cm wide) that 30 mils (0.076cm) are thick is made by injection molding Merlon, and is configured to contribute to SLR material to be applied in the anastomat of selling on market.Injection mould fabrication is designed to include in SLR in molded design and receives region, anastomat constraint and pivot (in example 1).In addition, deformable projection is included in this design.
Recessed portion (size 2.7cm length × 1.2cm is wide) is received in the design of card, to make this depressed part adjacent with constraint on the opposite side of receiving region.This recessed portion contributes to anastomat clamp receiving docking and location on region.
The SLR material (in example 2) of cutting in advance with perforation lug is suitable for installing on deformable projection by hole.After being positioned on deformable projection, make deformable projection thermal deformation on the receiving region that SLR material is positioned to card and by perforation lug, to catch lug and SLR material is fixed on card.Ultrasonic energy is used for making projection thermal deformation.
Next, be stuck in and receive the opposite end place in region to move perpendicular to anastomat clamp, so that SLR disconnects from perforation lug.This makes SLR discharge from card, and allows SLR to transfer to anastomat completely.
example 6
Use stereolithography apparatus (SLA) to form size and be similar to the card of example 5.The Change In Design of this card is for to receive region to make card be suitable for better surgical stapling by formation, and this far-end that is stuck in card is than thicker in the proximal end of card.In addition, the recessed portion of card is modified as the SLR material that allows card and cut in advance and is positioned in the furcation of anastomat, and covers all nail bins and anvil block hole.
example 7
Comprise finishing pad 2.5 by being further revised as according to the card of example 6 " × 5 " × 4 " (long × wide × thick), this finishing pad is made up of the material identical with cutting in advance SLR.
Three examples are used as comparative example below, show the advantage of the present invention with respect to substituted device.These examples are embodiments of the invention (although they may be) not necessarily, but are used for giving prominence to each importance of the present invention.For example, comparative example 8 has been given prominence to such design: it is preferably for comprising that foam is received the thicker bringing device of needs in region that thin plastics of the present invention apply card.Comparative example 9 has been given prominence to such design: in embodiments of the invention, with the even adhesive coated thin synthetic support member material of making have with such as United States Patent (USP) the 5th, 752, the comparable desired character of bringing device described in No. 965, described device applies binding agent gel that needs foam type flexible balance device to form even bonding etc.
comparative example 8
For the convenience of human engineering, by card around add 0.2 " rib revise according to the card of example 5.Adding rib makes card so not soft.This variation also provides additional rigidity to card, to contribute to expansion, especially in this card of pivotable.
comparative example 9
The card that structure receives region (be approximately 0.125 " thickness) to form by foam, and SLR material and the pressure sensitive adhesives cut are in advance attached to foam by clip.Then SLR is navigated on surgical stapling with mode identical in example 4.In the time that SLR is navigated on anastomat, the thickness of foam card causes SLR material to touch prematurely anastomat, thereby causes SLR material pack not cover whole anastomosis staple rows.
comparative example 10
By with 0.035 " thick polypropylene card replaces foam pad to revise Peri-Strips Dry allotter (the Part No. #73133-07588 of Si Nuosi company (Synovis) of Sao Paulo City, the Minnesota State).Then the binding agent (the Part No. #7300-101023 of Si Nuosi company of Sao Paulo City, the Minnesota State) of supply adds SLR material according to operation instructions to the form of continuous pearl, and assembly is positioned in the working surface of anastomat clamp.The binding agent of supply is gel in essence, and need to exert pressure binding agent is evenly distributed on material.Then, close anastomat (Kanggong department (Ethicon), Proximate75 are treasured in Cincinnati, Ohio), and then open, to check the deployment of SLR on anastomat clamp.In the center of support member material that applies pearl, SLR material is bonded to the working surface of anastomat really, but binding agent does not distribute that equably the edge of SLR is bonded to anastomat on the whole width of SLR.
For the purpose of illustration and description has presented the aforementioned disclosure of embodiment.Do not want exhaustive or limit the invention to disclosed concrete form.In view of above-mentioned disclosure, the many variants and modifications of embodiment described in literary composition are obvious for those skilled in the art.Scope of the present invention is only limited by appended claims and equivalent thereof.
In addition,, in the time describing the representative embodiment of the embodiment of the present invention, description can be used as method and/or the process that particular order of steps represents the present embodiment.But with regard to method or process do not rely on the particular step order of explaining in literary composition, method or process should not be limited to described particular order of steps.It will be understood by those skilled in the art that other sequence of steps is also passable.The particular step order of therefore, explaining in description should not be construed as limitations on claims.In addition, relate to the method for the present embodiment and/or the claim of process and should not be limited to their step of order execution to be write, and those skilled in the art can easily understand that order can change and still stay in the spirit and scope of the present embodiment.
Claims (20)
1. for surgery support member material is applied to the device on surgical stapling, described device comprises:
Base component, described base component comprises at least the first side and the second side;
The first take up member, described the first take up member is stretched from described the first epitaxial lateral overgrowth;
The second take up member, described the second take up member and described the first take up member are spaced apart, and stretch from described the first epitaxial lateral overgrowth;
Be arranged on the surgery support member material on described base component, wherein, at least a portion of the opposite edges of described surgery support member material is connected at least a portion of described the first and second take up member; And
Wherein, before applying, by described the first and second take up member, described surgery support member material is remained under tension force.
2. device as claimed in claim 1, is characterized in that, described surgery support member material also comprises along the perforation of the described opposite edges of described surgery support member material.
3. device as claimed in claim 1, is characterized in that, by described surgery support member material being connected in to described the first and second take up member from the outward extending projection of described the first and second take up member.
4. device as claimed in claim 1, is characterized in that, described base component also comprises aligning guide.
5. device as claimed in claim 1, is characterized in that, also comprises the handle that is connected to described base component.
6. for surgery support member material is applied to the device on surgical stapling, described device comprises:
Flexible, smooth base component substantially, described base component has the first preset width, first surface and second surface; And
Have the surgery support member material of the second preset width, wherein, described the second preset width is less than described the first preset width,
Wherein, at least a portion of the opposite edges of described surgery support member material is connected at least a portion of the opposite edges on the described second surface of described base component, and
Wherein, before applying, described base component remains in the structure of u-shape substantially by described surgery support member material.
7. device as claimed in claim 6, is characterized in that, described surgery support member material also comprises along the perforation of the described opposite edges of described surgery support member material.
8. device as claimed in claim 6, is characterized in that, by the outward extending projection of described second surface from described base component, described surgery support member material is connected in to described base component.
9. device as claimed in claim 6, is characterized in that, described base component also comprises aligning guide.
10. device as claimed in claim 6, is characterized in that, also comprises the handle that is connected in described base component.
11. 1 kinds for being applied to surgery support member material in the device of surgical stapling, described device comprises: base component, described base component comprises void area, elastic part and surgery support member material, wherein, described base component is connected in described surgery support member material in described elastic office, wherein, described surgery support member material traverses described space and arranges, and before applying, remains under tension force.
12. devices as claimed in claim 11, is characterized in that, described base component comprises described elastomeric element.
13. devices as claimed in claim 11, is characterized in that, described surgery support member material comprises described elastic part.
14. devices as claimed in claim 11, is characterized in that, described surgery support member material also comprises the perforation in the region of traversing the support member material that described space arranges.
15. devices as claimed in claim 11, is characterized in that, described base component also comprises from the outward extending projection of described base component.
16. devices as claimed in claim 11, is characterized in that, described base component also comprises aligning guide.
17. devices as claimed in claim 11, is characterized in that, also comprise the handle that is connected in described base component.
18. 1 kinds for being fixed to surgery support member material releasedly the method for surgical stapling, and described method comprises the steps:
A) obtain device as claimed in claim 2;
B) described device is inserted between the anastomat arm of opening;
C) described anastomat arm is oriented at while contact between anastomat arm and makes described support member material in the position to anastomat arm to be applied;
D) anastomat arm is closed on described support member material;
E) exert pressure, described pressure is enough to along surgery support member material described in described buckle tear;
F) open anastomat arm; And
G) from removing described device with the contacting of anastomat arm.
19. 1 kinds for being fixed to releasedly the method on surgical stapling by surgery support member material, and described method comprises the steps:
A) obtain device as claimed in claim 7;
B) described device is inserted between the anastomat arm of opening;
C) described anastomat arm is oriented at while contact between anastomat arm and makes described support member material in the position to anastomat arm to be applied;
D) anastomat arm is closed on described support member material;
E) exert pressure, described pressure is enough to along surgery support member material described in described buckle tear;
F) open anastomat arm; And
G) from remover the contacting of anastomat arm.
20. 1 kinds for being fixed to surgery support member material releasedly the method for surgical stapling, and described method comprises the steps:
A) obtain device as claimed in claim 14;
B) described device is inserted between the anastomat arm of opening;
C) described anastomat arm is oriented at while contact between anastomat arm and makes described support member material in the position to anastomat arm to be applied;
D) anastomat arm is closed on described support member material;
E) exert pressure, described pressure is enough to along surgery support member material described in described buckle tear;
F) open anastomat arm; And
G) from removing described device with the contacting of anastomat arm.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US13/370,403 | 2012-02-10 | ||
| US13/370,403 US20120289979A1 (en) | 2007-10-08 | 2012-02-10 | Apparatus for Supplying Surgical Staple Line Reinforcement |
| PCT/US2013/021841 WO2013119365A1 (en) | 2012-02-10 | 2013-01-17 | Apparatus for supplying surgical staple line reinforcement |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN104159530A true CN104159530A (en) | 2014-11-19 |
Family
ID=47739471
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201380013429.8A Pending CN104159530A (en) | 2012-02-10 | 2013-01-17 | Apparatus for supplying surgical staple line reinforcement |
Country Status (10)
| Country | Link |
|---|---|
| EP (1) | EP2811916A1 (en) |
| JP (1) | JP2015507965A (en) |
| KR (1) | KR20140123101A (en) |
| CN (1) | CN104159530A (en) |
| AU (2) | AU2013217741A1 (en) |
| BR (1) | BR112014019781A8 (en) |
| CA (1) | CA2863898A1 (en) |
| HK (1) | HK1203798A1 (en) |
| RU (1) | RU2014136745A (en) |
| WO (1) | WO2013119365A1 (en) |
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| CN106725679A (en) * | 2016-12-26 | 2017-05-31 | 北京博辉瑞进生物科技有限公司 | One kind kiss/closure mouth reinforcement and repair sub-assembly and its preparation and application |
| CN106821438A (en) * | 2016-12-26 | 2017-06-13 | 北京博辉瑞进生物科技有限公司 | A kind of previous anastomotic reinforces sub-assembly and its application method |
| CN108289685A (en) * | 2015-09-24 | 2018-07-17 | 伊西康有限责任公司 | Equipment for making body lumen be pleated |
| CN108348242A (en) * | 2015-10-29 | 2018-07-31 | 伊西康有限责任公司 | Surgical stapling device supporter component with gel adhesive retainer |
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| US20150134076A1 (en) * | 2013-11-08 | 2015-05-14 | Ethicon Endo-Surgery, Inc. | Hybrid adjunct materials for use in surgical stapling |
| US9700311B2 (en) | 2013-11-08 | 2017-07-11 | Ethicon Llc | Tissue ingrowth materials and method of using the same |
| US10342542B2 (en) | 2015-08-24 | 2019-07-09 | Ethicon Llc | Surgical stapler buttress applicator with end effector actuated release mechanism |
| US10349940B2 (en) * | 2015-08-24 | 2019-07-16 | Ethicon Llc | Surgical stapler buttress applicator with state indicator |
| US10342532B2 (en) * | 2015-08-24 | 2019-07-09 | Ethicon Llc | Surgical stapler buttress applicator with multi-point actuated release mechanism |
| US11039832B2 (en) | 2015-08-24 | 2021-06-22 | Cilag Gmbh International | Surgical stapler buttress applicator with spent staple cartridge lockout |
| US10166023B2 (en) | 2015-08-24 | 2019-01-01 | Ethicon Llc | Method of applying a buttress to a surgical stapler end effector |
| US10639039B2 (en) | 2015-08-24 | 2020-05-05 | Ethicon Llc | Surgical stapler buttress applicator with multi-zone platform for pressure focused release |
| US10085745B2 (en) * | 2015-10-29 | 2018-10-02 | Ethicon Llc | Extensible buttress assembly for surgical stapler |
| US11141150B2 (en) | 2017-02-17 | 2021-10-12 | Cilag Gmbh International | Buttress loader for surgical staplers |
| US10912561B2 (en) * | 2018-07-16 | 2021-02-09 | Ethicon Llc | Buttress applier cartridge for surgical stapler having end effector with deflectable curved tip |
| US11103243B2 (en) * | 2018-12-28 | 2021-08-31 | Cilag Gmbh International | Curved tip surgical stapler buttress assembly applicator with compression layer pocket feature |
| KR102609503B1 (en) * | 2021-04-29 | 2023-12-01 | 스탠다드 베리에트릭스, 인크. | System and method for installing and using a surgical buttress on an end effector |
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Also Published As
| Publication number | Publication date |
|---|---|
| JP2015507965A (en) | 2015-03-16 |
| RU2014136745A (en) | 2016-04-10 |
| WO2013119365A1 (en) | 2013-08-15 |
| BR112014019781A8 (en) | 2017-07-11 |
| HK1203798A1 (en) | 2015-11-06 |
| KR20140123101A (en) | 2014-10-21 |
| CA2863898A1 (en) | 2013-08-15 |
| AU2015249083A1 (en) | 2015-11-12 |
| EP2811916A1 (en) | 2014-12-17 |
| AU2013217741A1 (en) | 2014-08-28 |
| BR112014019781A2 (en) | 2017-06-20 |
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