CN104434245B - End effector, surgical operating instrument and purse-string forceps - Google Patents
End effector, surgical operating instrument and purse-string forceps Download PDFInfo
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- CN104434245B CN104434245B CN201310438924.5A CN201310438924A CN104434245B CN 104434245 B CN104434245 B CN 104434245B CN 201310438924 A CN201310438924 A CN 201310438924A CN 104434245 B CN104434245 B CN 104434245B
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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
- A61B17/07207—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 the staples being applied sequentially
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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
- A61B17/04—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
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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
- A61B2017/07228—Arrangement of the staples
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1142—Purse-string sutures
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- General Health & Medical Sciences (AREA)
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- Surgical Instruments (AREA)
Abstract
The invention relates to the technical field of medical equipment, and discloses an end effector, a surgical operating instrument and purse-string forceps. By means of the end effector, the surgical operating instrument and the purse-string forceps, purse-string nails can be made to be connected with lumen tissue firmly, and the risk that the lumen tissue is pierced through is completely avoided; the end effector and the surgical operating instrument can further simplify the operation process of an operation and relieve trauma brought to a surgery patient. The end effector comprises a first forceps arm, a second forceps arm, a suture mechanism, a purse-string suture mechanism and a cutting mechanism, wherein the suture mechanism is arranged on one side of the longitudinal direction of the two forceps arms, the purse-string suture mechanism is arranged on the other side of the longitudinal direction of the two forceps arms and the cutting mechanism is arranged between the suture mechanism and the purse-string suture mechanism. The purse-string suture mechanism comprises a first purse-string nail box arranged on the first forceps arm, a second purse-string nail box arranged on the second forceps arm and a double-sided nail anvil located between the two purse-string nail boxes, the purse-string nails are arranged in the two purse-string nail boxes respectively, and the surfaces, facing the double-sided nail anvil, of the two purse-string nail boxes are provided with purse-string lines.
Description
Technical field
The present invention relates to technical field of medical instruments, particularly relate to a kind of end effector, a kind of surgical operating instrument
With a kind of purse-string forceps.
Background technology
Gastrointestinal surgery typically requires cut-out Guan Bi tissue lumen, and carries out purse string suture at the side tube chamber disconnected,
For coordinating the nail anvil installing round anastomat at purse string suture, in order to use round anastomat to carry out follow-up identical grade and grasp
Make.
Purse string suture is a kind of common suturing skill in surgical operation, it is known that there is the side of two kinds of main purse string sutures
Formula.A kind of mode is the manual purse string suture that carries out, and as shown in Figure 1 a, 1 b, doctor first uses lotus around the otch of lumen organization 59
Bag pin through tissue surface with purse wire 58, then tightens up purse wire 58 and can complete purse string suture.The mode of manual suture is grasped
Make complexity, the more difficult assurance of performance accuracy, and easily cause sewing up unsuccessfully because of off-line, the section's of being out at present operation is seldom adopted
With.
Another way is to use purse-string forceps auxiliary to carry out purse string suture.As shown in Figure 2 a, a kind of purse-string forceps is profit equally
Purse string suture is carried out by the mode of (i.e. pocket pin) band wire (i.e. purse wire 58) of threading a needle.As shown in Figure 2 b, also has a kind of purse-string forceps
Being by pocket nail 57, purse wire 58 to be attached to lumen organization 59 surface and carry out purse string suture, common mode is percussion lotus
Bag nail 57 and make it thrust and be fixed to lumen organization 59, and purse wire 58 or and pocket nail 57 between be connected with each other, or
It is pressed between lumen organization 59 and pocket nail 57 by pocket nail 57, thus purse wire 58 is attached to lumen organization 59, to realize
Purse string suture.
Generally when lumen organization is performed the operation, except needing the remaining end otch of lumen organization is carried out purse string suture
Outward, in addition it is also necessary to its pathological changes end is cut, sews up.And existing purse-string forceps function singleness, can be only done the pocket to remaining end
Sew up, it is impossible to realize the cutting to pathological changes end and sew up.The most at least also need to the use of surgical devices such as other staplers
Tool, the operation changing operating theater instruments is relatively complicated, and this can cause operating time longer, increases operation risk and to surgical patient
The misery brought.
In prior art shown in Fig. 2 b, pocket nail 57 needs use, without nail anvil forming technique, purse wire 58 are fixed on pipe
Cavity tissue 59 surface, uses this purse-string forceps pocket nail avulsion often occur or by through for lumen organization phenomenon, thus
Causing purse string suture failure, this also can increase operation risk and the misery brought to surgical patient.
And, the 1980s occurs in that endoscope-assistant surgery, and it is a kind of main through endoscope and various imaging
Technology and make surgeon without performing a surgical operation in the case of patient causes huge wound.Relative to open surgery
Speech, endoscope-assistant surgery has the significant advantages such as little to disorganization, post-operative recovery is fast, thus becomes the trend of development.This
In the case of, occur in that the purse-string forceps for endoscope-assistant surgery, the existing purse-string forceps for endoscope-assistant surgery equally exist above-mentioned functions
Single problem.
Summary of the invention
First purpose of the present invention is to provide a kind of end effector, carries out operating to simplify to lumen organization
Operating process, reduces operating time, and pocket nail is the most firm with the connection of lumen organization, does not exist lumen organization through
Risk, the safety of operation is higher.
This end effector includes: the first tong arm and the second tong arm, the first tong arm and the second tong arm can be at opening and closings
Relative motion under the effect of mechanism, so that the jaw that the first tong arm and the second tong arm are formed opens or closes；Suturing mechanism, seam
Close the side that mechanism is arranged on the longitudinal direction of the first tong arm and the second tong arm；Purse string suture mechanism, purse string suture mechanism is arranged
At the first tong arm and the opposite side of the longitudinal direction of the second tong arm；Cutting mechanism, cutting mechanism is arranged on suturing mechanism and pocket
Between suturing mechanism；Purse string suture mechanism includes: the first pocket nail nail kit arranged on the first tong arm, and the second tong arm is arranged
Second pocket nail nail kit, and follow closely the two-sided nail anvil between nail kit and the second pocket nail nail kit, wherein, first at the first pocket
Pocket is followed closely in nail kit and the second pocket nail nail kit and is respectively arranged with pocket nail, and pocket nail is followed closely ejector pin mechanism by pocket and fired, and first
Faced by pocket nail nail kit and the second pocket nail nail kit, the surface configuration of two-sided nail anvil has between two nail lower limbs of pocket nail
Purse wire.
In this technical scheme, the suturing mechanism of end effector side can realize the stitching of tissue, the pocket of opposite side
Suturing mechanism can realize the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism then can realize
The cutting of tissue, it is seen then that use end effector provided by the present invention can realize the purse string suture of tube chamber remaining end tissue, with
And the cutting of pathological changes end tissue and stitching, compared with prior art, enormously simplify and lumen organization is carried out operating behaviour
Make process, decrease operating time, alleviate the wound brought to surgical patient.In this end effector, purse string suture mechanism
Pocket nail through two-sided nail anvil effect molding, molding qualification rate is high, it is possible to the connection more firm with lumen organization, and, due to
The stop of two-sided nail anvil, has thoroughly stopped through for lumen organization risk, and the safety of operation is higher.
Second object of the present invention is to provide a kind of surgical operating instrument, including: handle and by handle drives as front
State the end effector of technical scheme.Owing to end effector has the effect above, therefore this surgical operating instrument can letter significantly
Change and lumen organization is carried out operating operating process, reduce operating time, alleviate the wound brought to surgical patient, and energy
Enough making pocket nail more firmly be connected with lumen organization, do not exist through for lumen organization risk, the safety of operation is higher.
Third object of the present invention is to provide a kind of purse-string forceps, pocket nail can be made to be connected with lumen organization more firm, lotus
Bao Ding is difficult to avulsion, substantially increases the safety of operation.Purse-string forceps includes: the first tong arm and the second tong arm, the first tong arm and
Second tong arm can under the effect of opening and closing mechanism relative motion so that the jaw that the first tong arm and the second tong arm are formed
Open or close；Purse string suture mechanism, including: the first pocket nail nail kit arranged on the first tong arm, the second tong arm is arranged
Second pocket nail nail kit, and follow closely the two-sided nail anvil between nail kit and the second pocket nail nail kit, wherein, first at the first pocket
Pocket is followed closely in nail kit and the second pocket nail nail kit and is respectively arranged with pocket nail, and pocket nail is followed closely ejector pin mechanism by pocket and fired, and first
Faced by pocket nail nail kit and the second pocket nail nail kit, the surface configuration of two-sided nail anvil has between two nail lower limbs of pocket nail
Purse wire.
The pocket nail of the program is through two-sided nail anvil effect molding, and molding qualification rate is high, it is possible to more firm with lumen organization
Connect, and, due to the stop of two-sided nail anvil, thoroughly to stop through for lumen organization risk, the safety of operation is higher.
Accompanying drawing explanation
Fig. 1 a is the schematic cross-section of lumen organization's purse string suture；
Fig. 1 b is lumen organization's front view after purse wire tightens up；
Fig. 2 a is existing a kind of purse-string forceps purse string suture principle schematic；
Fig. 2 b is existing another kind of purse-string forceps purse string suture principle schematic；
Fig. 3 a is the end effector perspective view of the embodiment of the present invention；
Fig. 3 b is the otch schematic diagram that in the embodiment of the present invention, two-sided nail anvil inserts lumen organization；
Fig. 3 c is two-sided nail anvil fixed form schematic diagram in the embodiment of the present invention；
Fig. 3 d is the cross section structure schematic diagram of the end effector of the embodiment of the present invention；
Fig. 4 is the structural representation of the first tong arm in the embodiment of the present invention；
Fig. 5 a is that (tissue apposition side, staple is not for the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention
Fired)；
Fig. 5 b is internal structure schematic three dimensional views (tissue apposition side, the staple portion of the end effector of the embodiment of the present invention
Divide and fired)；
Fig. 6 be the end effector of the embodiment of the present invention internal structure schematic three dimensional views (purse string suture side, pocket follow closely not
Fired)；
Fig. 7 be carry out cutting, lumen organization's schematic diagram after tissue apposition and purse string suture；
Fig. 8 is the surgical operating instrument structural representation of the embodiment of the present invention.
Reference:
57-pocket nail 58-purse wire 59-lumen organization
10a-the first tong arm 10b-the second tong arm 11-suturing mechanism
12-purse string suture mechanism 13-cutting mechanism 14a-the first pocket nail nail kit
14b-the second pocket nail nail kit 56-two-sided nail anvil 59a-otch
15-line card 16-pocket nail ejector pin slide block 17-pocket nail nail pushing device
18-staple nail anvil 19-staple nail kit 20-staple
21-staple ejector pin slide block 22-staple nail pushing device 23-cutter
24-cutter groove 25-closure flange 26-handle
27-end effector 28-slender bodies 29-drive mechanism
30-jointed shaft
Detailed description of the invention
In order to use same apparatus just can complete purse string suture, cut and sew up, simplify and needs are carried out purse string suture
Tissue (particularly lumen organization) carry out operating operating process, reduce operating time, risk and the misery of patient,
Can be used in endoscope-assistant surgery further, embodiments provide a kind of end effector and a kind of surgical operating instrument.
In technical solution of the present invention, the suturing mechanism of end effector side can realize the stitching of tissue, the purse string suture of opposite side
Mechanism can realize the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism then can realize tissue
Cutting, use the end effector that provided of the embodiment of the present invention or surgical operating instrument can realize tube chamber remaining end tissue
Purse string suture, and the cutting of pathological changes end tissue and stitching, enormously simplify and lumen organization is carried out operating operation
Journey, decreases operating time, is yet further useful for endoscope-assistant surgery.For making the object, technical solutions and advantages of the present invention more
Clear, by the following examples the present invention is described in further detail.
Shown in Fig. 3 a to Fig. 3 d, the end effector of the embodiment of the present invention, including:
First tong arm 10a and the second tong arm 10b, the first tong arm 10a and the second tong arm 10b can be in opening and closing mechanisms
The lower relative motion of effect, so that the jaw that the first tong arm 10a and the second tong arm 10b is formed opens or closes；
Suturing mechanism 11, suturing mechanism 11 is arranged on the side of the longitudinal direction of the first tong arm 10a and the second tong arm 10b；
Purse string suture mechanism 12, purse string suture mechanism 12 is arranged on the first tong arm 10a and the longitudinal direction of the second tong arm 10b
Opposite side；
Cutting mechanism 13, cutting mechanism 13 is arranged between suturing mechanism 11 and purse string suture mechanism 12；
Purse string suture mechanism 12 includes:
The first pocket nail nail kit 14a arranged on first tong arm 10a, the second pocket nail nail that the second tong arm 10b is arranged
Casket 14b, and follow closely the two-sided nail anvil 56 between nail kit 14a and the second pocket nail nail kit 14b, wherein, first at the first pocket
Being respectively arranged with pocket nail 57 in pocket nail nail kit 14a and the second pocket nail nail kit 14b, pocket nail 57 is followed closely ejector pin mechanism by pocket
Percussion, the first pocket nail nail kit 14a and the second pocket nail nail kit 14b are positioned at pocket nail 57 in the face of the surface configuration of two-sided nail anvil has
Two nail lower limbs between purse wires 58.
In various embodiments of the present invention, " distally " refers to side when this apparatus is operated away from user, and " nearside " then refers to
Near the side of user when this apparatus is operated." advancing " and point to the direction motion away from user, " retrogressing " is then pointed to and is leaned on
The direction motion of nearly user.The end effector that the embodiment of the present invention is provided can coordinate drive mechanism to use, by driving
Mechanism provides driving force.The specific constructive form of drive mechanism does not limits, for example, it is possible to directly by existing stapler front end
End effector unload, the end effector embodiment of the present invention provided is loaded onto, by the driving of existing stapler
Mechanism is opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting mechanism provide driving force.In addition it is also possible to be this
Inventive embodiments is provided end effector other design driven mechanism.
The end effector that the embodiment of the present invention is provided according to function can be divided into opening and closing mechanism, suturing mechanism,
Purse string suture mechanism and cutting mechanism four part.Wherein, opening and closing mechanism is for realizing two tong arm institutes of end effector
The opening and closing of jaw formed, jaw can be driven during use to open to be placed in one lumen organization to be performed the operation and incite somebody to action
The otch of the laterally inserted lumen organization of two-sided nail anvil, then drive jaw Guan Bi by lumen organization clamping with carry out purse string suture,
The surgical action such as cutting, stitching, and after surgical action terminates, jaw can be driven again to open to discharge tissue.Cutting
The pathological changes end of lumen organization and remaining end, for realizing the cutting function to tissue, can be cut and separate by mechanism.Suturing mechanism
For realizing the stitching function to tissue, can sew up in the incision of lumen organization's pathological changes end.Purse string suture mechanism uses
In realizing the purse string suture function to tissue, purse string suture can be carried out in the incision of lumen organization's remaining end, with follow-up
Operation coordinates the nail anvil installing round anastomat, uses round anastomat to carry out identical grade and operate.Below will the most further
Describe this tetrameric structure in detail.
In the end effector of the embodiment of the present invention, opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting
Mechanism can at least both be driven by synchronization；Can also be, opening and closing mechanism, suturing mechanism, purse string suture mechanism and cut
Cutting mill structure is driven separately.The concrete structure of end effector can be designed according to different type of drive.
Opening and closing mechanism:
In the various embodiments of the invention, the first tong arm 10a and the second tong arm 10b is and can rotate relative to two-sided nail anvil 56
Movable tong arm.The opening and closing mechanism of the end effector of the present invention can use the end effector of existing stapler
The various technical schemes of opening and closing mechanism realize, such as, and bushing type opening and closing scheme, I-shaped beam type opening and closing scheme
Deng.
Such as, opening and closing mechanism can include closing bar, and Guan Bi bar distal end portion is provided with closure flange, the first tong arm and the
Be provided with stage clip between two tong arms, when close bar and driven and during longitudinal distal motion, closure flange engage the first tong arm and/
Or the closing face that second on tong arm so that tong arm overcomes the elastic force of stage clip to close, and when closing bar rollback, jaw can be at stage clip
Reset response under open.When closing bar and driven and during longitudinal distal motion, closure flange can only engage the first tong arm
Or the closing face that second on tong arm, but in order to obtain the stress relatively balanced, it is preferred that closure flange be simultaneously engaged the first tong arm and
Closing face on second tong arm.
Wherein, Guan Bi bar can with for fire staple staple ejector pin bar, for fire pocket nail pocket nail ejector pin
Bar or for driving the knife bar of cutter to be structure as a whole or being connected with each other for different parts；Guan Bi bar, staple ejector pin bar, cutter
Bar or pocket nail ejector pin bar can also be different parts respectively；Guan Bi bar also can push away with staple ejector pin bar, knife bar and pocket nail
In nail rod arbitrarily both are structure as a whole or are connected with each other for different parts；In addition it is also possible to be that Guan Bi bar pushes away with staple
Nail rod, knife bar and pocket nail ejector pin bar are structure as a whole (can be described as drive rod) or are connected with each other for different parts.
Incorporated by reference to shown in Fig. 3 a, Fig. 5 a and 5b, in one particular embodiment of the present invention, cutter 23 and knife bar are one
Body structure the Guan Bi bar as opening and closing mechanism, be provided with stage clip (in figure between the first tong arm 10a and the second tong arm 10b
Not shown), the distal end portion of Guan Bi bar is fixed with the closure flange being parallel to cut direction in the side that movable tong arm deviates from jaw
25；When closing bar and advancing, closure flange 25 promotion activity tong arm turns to jaw Guan Bi, and when closing bar and retreating, stage clip pushes away
Dynamic movable tong arm turns to jaw and opens.Needing exist for explanation, the stroke that closure flange 25 is walked when closing jaw is also
Need not the biggest.
Cutting mechanism:
The cutting mechanism of the end effector of the present invention can use the cutting of the end effector of existing stapler
The various technical schemes of mechanism realize.
Such as, shown in Fig. 4, Fig. 5 a and Fig. 5 b, cutting mechanism can include cutter 23, and cutter 23 can be in push broach
Move between suturing mechanism and purse string suture mechanism under the effect of mechanism, so that sew up and purse string suture group will be carried out respectively
Knitting cutting to separate, push broach mechanism can be push broach bar or miscellaneous part, and cutter 23 and push broach mechanism can be also may be used of one
To be split (now, cutter 23 are arranged on the distally of push broach mechanism).First tong arm and the second tong arm are provided with receiving and cut
The cutter groove 24(of cutter 23 motion is as shown in Figure 4), think that the motion of cutter 23 provides and guide, make cutting movement more steadily,
Accurately.
Suturing mechanism:
The suturing mechanism of the end effector of the present invention can use the sewing machine of the end effector of existing stapler
The various technical schemes of structure realize.
Such as, as shown in figure 5 a and 5b, suturing mechanism may be provided at the side of the longitudinal direction of two tong arms, pincers
Arm arranges staple nail anvil 18, and another tong arm arranges staple nail kit 19, arranges staple 20 in staple nail kit 19, and staple 20 can be along vertical
Be set to a row or multi-row to direction, staple 20 can be by the percussion of staple ejector pin mechanism.For firing the staple ejector pin of staple 20
Mechanism can include staple ejector pin bar (in this embodiment, the knife bar of cutter 23 is as staple ejector pin bar), staple ejector pin slide block 21
With staple nail pushing device 22.Percussion process can be staple ejector pin bar distad lengthwise movement and drive staple ejector pin slide block 21, seam
The ramp effect of nail ejector pin slide block 21 makes its transverse movement in staple nail pushing device 22, then by staple nail pushing device 22 by staple 20
Release staple nail kit 19, through lumen organization 59 and compress staple nail anvil 18, staple 20 is at the effect compacted under of staple nail anvil 18
For B shape, thus complete to sew up.
The row of staple 20 does not limits, but at least should be a row, more preferably at least two rows, so, and can be in the disease of lumen organization
Become end and carry out at least twice stitching, greatly reduce and sew up failed risk.When staple 20 is longitudinally disposed for time multiple rows of, permissible
One staple ejector pin slide block 21 is only set and promotes multiple staple nail pushing devices 22 in front.
When the knife bar of cutter 23 is as staple ejector pin bar, the position of cutter 23 may be configured as relative to staple ejector pin
Slide block 21 is more rearward (i.e. closer to nearside) so that first sews up and cuts afterwards, so can reduce outside pathological changes end interior tissue
Stream, improves the success rate of operation.In one embodiment, staple ejector pin slide block 21 is cut the knife bar promotion of cutter 23, at cutter
Before tissue is cut by the blade of 23, the inclined-plane of staple ejector pin slide block 21 has promoted the staple nail pushing device 22 in front to stitch
Nail 20 percussion, the most first sews up the lumen organization in front, and therefore, cutter 23 are always just cut after tissue apposition
Cut.
Purse string suture mechanism:
Purse string suture mechanism may be provided at the opposite side of the longitudinal direction of two tong arms, namely relative with suturing mechanism
Side.
As shown in Figure 3 a and Figure 3 b shows, two-sided nail anvil 56 has two nail anvil faces.This end effector is used to carry out pocket seam
During conjunction, need to open a kerf 59a(as shown in Figure 3 b along the length direction of lumen organization 59, otch 59a length be usually 8～
10mm), two-sided nail anvil 56 is inserted in otch 59a the inwall with lumen organization and abuts, then close jaw, fire the first pocket
Pocket nail in nail nail kit and the second pocket nail nail kit, makes pocket nail at effect compacted under (i.e. first pocket of two-sided nail anvil 56
Pocket nail in nail nail kit is followed closely double at the first nail anvil face effect compacted under of two-sided nail anvil, the pocket in the second pocket nail nail kit
Second nail anvil face effect compacted under of face nailing anvil), thus complete purse string suture.Preferably, the anvil structure phase in two nail anvil faces
Staggered arrangement arranges, and so can improve the bulk strength of two-sided nail anvil 56.
The fixed form of two-sided nail anvil 56 does not limits, as shown in Figure 3 c, in the preferred embodiment, and the first tong arm 10a and
Two tong arm (not shown)s are rotating movable tong arm, two-sided nail anvil 56 and the first tong arm 10a and the second tong arm hinged
Axle 30 realizes being relatively fixed (two-sided nail anvil can also directly fixing with jointed shaft be connected), when the first tong arm by other structural member
When 10a and the second tong arm turn to jaw Guan Bi, two-sided nail anvil 56 is sandwiched between the first tong arm 10a and the second tong arm.
In the prior art, pocket nail uses without nail anvil forming technique molding, pocket nail avulsion often occurs or incites somebody to action
Lumen organization is the phenomenon of (that is, the pocket nail of side penetrates two layers of tissue) to wearing, and in this programme, pocket nail penetrates one layer of pipe
Cavity tissue the effect compacted under (such as, be shaped to B shape) in nail anvil face, pocket nail is the most firm with the connection of lumen organization
Lean on, few phenomenon that pocket nail avulsion occurs, and, due to the stop of two-sided nail anvil, thoroughly stop lumen organization wearing
Risk.
As shown in Figure 6, pocket nail ejector pin mechanism includes: ejector pin bar followed closely by pocket, and follows closely nail kit institute for each pocket
The pocket nail ejector pin slide block 16 arranged and pocket nail nail pushing device 17；For each pocket follow closely nail kit, when pocket nail ejector pin bar to
During the zigzag tread patterns pocket nail ejector pin slide block 16 of distally, the inclined-plane laterally driven pocket nail nail pushing device 17 of pocket nail ejector pin slide block 16,
Make pocket nail nail pushing device 17 that pocket nail 57 release pocket is followed closely nail kit the effect compacted under at two-sided nail anvil 56.
Pocket nail ejector pin mechanism and staple ejector pin mechanism can be Liang Ge mechanisms separate, that be driven separately, at this moment
Pocket nail ejector pin bar and staple ejector pin bar are different parts respectively, and pocket nail ejector pin slide block and staple ejector pin slide block are not respectively
With parts, additionally, pocket nail ejector pin mechanism and staple ejector pin mechanism can be driven by synchronization, as shown in Figure 5 b, pocket nail pushes away
The knife bar of nail rod and staple ejector pin bar and cutter is structure as a whole, and (pocket nail ejector pin bar, staple ejector pin bar and knife bar can also
It is connected with each other for different parts), pocket nail ejector pin slide block 16 and staple ejector pin slide block 21 are structure as a whole (or for different parts
It is connected with each other), such as, when ejector pin slide block is by zigzag tread patterns, the inclined-plane of ejector pin slide block can laterally driven pocket nail nail pushing device 17 He
Staple nail pushing device 22, makes pocket nail and staple be fired respectively.
As shown in Figure 4, purse wire 58 does not limits in the location mode on nail kit surface, it is preferred that the first pocket nail nail kit and the
Two pocket nail nail kits are respectively arranged with line card 15 in the face of the surface of two-sided nail anvil, and purse wire 58 is arranged in line card 15.Purse wire sets
Put between two nail lower limbs of pocket nail, when pocket nail is thrust lumen organization the effect compacted under at two-sided nail anvil by percussion
After, purse wire is crushed between crown and the lumen organization of pocket nail, when nail kit followed closely by the first pocket nail nail kit and the second pocket
Pocket nail percussion is complete, when the jaw of end effector opens, and purse wire and the first pocket nail nail kit and the second pocket nail nail kit
Separate, take out tight purse wire and can complete purse string suture, operate the easiest.
In order to make, purse wire 58 is the most smooth, be positioned nail kit surface reliably, it is preferred that the phase of the first pocket nail nail kit
It is provided with at least two line card 15 between adjacent two pockets nail, is provided with between adjacent two pockets nail of the second pocket nail nail kit
At least two line card 15.The particular number of line card 15 can determine according to the arranging distance of pocket nail, is not especially limited here.
In the technical scheme of the embodiment of the present invention, Guan Bi bar, staple ejector pin bar, knife bar and pocket nail ejector pin bar can be
Integrative-structure or be connected with each other to realize synchronizing to drive for different parts, such as, in one embodiment, Guan Bi bar, staple push away
Nail rod, knife bar and pocket nail ejector pin bar are integrated, and can be described as drive rod.During use, drive rod distal motion to be driven,
First driving opening and closing mechanism to close tong arm, further along with drive rod moves, suturing mechanism and purse string suture mechanism
Being driven, staple is fired to realize sewing up successively, and pocket nail is thrust tissue to realize purse string suture by percussion successively, cuts simultaneously
Tissue is cut under the promotion of drive rod between suturing mechanism and purse string suture mechanism by cutter, thus completes simultaneously
Cutting, sew up and purse string suture (carry out cutting, lumen organization after tissue apposition and purse string suture as it is shown in fig. 7, wherein, arrow
Direction shown in head is the length direction of lumen organization)), this further simplify and lumen organization is carried out operating operation
Journey, decreases operating time, thus further mitigates the wound brought to surgical patient.
To sum up, in technical solution of the present invention, the suturing mechanism of end effector side can realize the stitching of tissue, another
The purse string suture mechanism of side can realize the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism
Then can realize the cutting of tissue, it is seen then that the end effector using the embodiment of the present invention to be provided can realize tube chamber remaining end group
The purse string suture knitted, and the cutting of pathological changes end tissue and stitching, compared with prior art, greatly reduce replacing operating theater instruments
Frequency, simplify and lumen organization carried out operating operating process, decrease operating time, alleviate to surgical patient
The wound brought.In this end effector, the pocket of purse string suture mechanism is followed closely through two-sided nail anvil effect molding, molding qualification rate
High, it is possible to the connection more firm with lumen organization, and, due to the stop of two-sided nail anvil, thoroughly stop lumen organization pair
The risk worn, the safety of operation is higher.
It should be noted that in various embodiments of the present invention, the specification of end effector does not limits, can basis
Concrete operation needs are designed.Such as, when end effector is the end effector with chamber mirror specification, can be with mating cavity
Mirror uses, and makes operation have the advantages such as safety is high, wound surface is little, pain is few, recovery is fast concurrently.
As shown in Figure 8, the embodiment of the present invention additionally provides a kind of surgical operating instrument, including: handle 26 with by handle 26
Drive such as the end effector 27 of aforementioned any embodiment.
Also including the slender bodies 28 being internally provided with drive mechanism 29 in this embodiment, slender bodies is passed through in the distally of handle 26
28 are connected with end effector 27, handle 26 drive transmission device 29, drive mechanism 29 so that driving is passed to end perform
Device 27, think its opening and closing, sew up, cut and purse string suture provide drive.The surgical operating instrument with this structure is permissible
Mating cavity mirror uses, and makes operation have the advantages such as safety is high, wound surface is little, pain is few, recovery is fast concurrently.
The surgical operating instrument using the embodiment of the present invention to be provided can realize the purse string suture of tube chamber remaining end tissue, with
And the cutting of pathological changes end tissue and stitching, compared with prior art, enormously simplify and lumen organization is carried out operating behaviour
Make process, decrease operating time, and pocket nail can be made more firmly to be connected with lumen organization, do not exist lumen organization pair
The risk worn, the safety of operation is higher, can be also used for endoscope-assistant surgery further.
The embodiment of the present invention additionally provides a kind of purse-string forceps, including:
First tong arm and the second tong arm, the first tong arm and the second tong arm can be transported under opening and closing mechanism acts on relatively
It is dynamic, so that the jaw that the first tong arm and the second tong arm are formed opens or closes；
Purse string suture mechanism, including: the first pocket nail nail kit arranged on the first tong arm, second that the second tong arm is arranged
Pocket nail nail kit, and follow closely the two-sided nail anvil between nail kit and the second pocket nail nail kit, wherein, the first pocket at the first pocket
Being respectively arranged with pocket nail in nail nail kit and the second pocket nail nail kit, pocket nail is followed closely the percussion of ejector pin mechanism, the first pocket by pocket
Faced by nail nail kit and the second pocket nail nail kit, the surface configuration of two-sided nail anvil has the pockets between two nail lower limbs of pocket nail
Line.
When using this purse-string forceps to carry out purse string suture, the length direction along lumen organization is needed to open a kerf, by two-sided nail
Anvil inserts in otch and abuts with the inwall of lumen organization, then closes jaw, fires the first pocket nail nail kit and the second pocket nail
Pocket nail in nail kit, makes pocket follow closely the effect compacted under at two-sided nail anvil, thus completes purse string suture.The pocket nail of the program
Through two-sided nail anvil effect molding, molding qualification rate is high, it is possible to the connection more firm with lumen organization, and, due to two-sided nail anvil
Stop, thoroughly stopped through for lumen organization risk, the safety of operation is higher.
Pocket is followed closely ejector pin mechanism and is included: pocket nail ejector pin bar, and for the pocket set by each pocket nail nail kit
Nail ejector pin slide block and pocket nail nail pushing device；Nail kit is followed closely, when ejector pin bar distad zigzag tread patterns lotus followed closely by pocket for each pocket
During bag nail ejector pin slide block, the inclined-plane laterally driven pocket nail nail pushing device of pocket nail ejector pin slide block, make pocket nail nail pushing device by pocket
Nail releases pocket nail nail kit the effect compacted under at two-sided nail anvil.
Preferably, the first pocket nail nail kit and the second pocket nail nail kit are respectively provided with wired in the face of the surface of two-sided nail anvil
Card, purse wire is arranged in line card.At least two line card it is provided with between adjacent two pockets nail of the first pocket nail nail kit, second
It is provided with at least two line card between adjacent two pockets nail of pocket nail nail kit.Beneficial effect in each embodiment as before, this
In explanation is not repeated.
The purse-string forceps that the embodiment of the present invention is provided, the concrete form of tong arm opening and closing mechanism does not limits, and such as, can use
The version similar with aforementioned end effector, it is possible to use the version of general surgery pincers, the first tong arm and the second pincers
Arm is hinged, is closed by jaw by two levers of operator's manual operation.When using the structure similar with aforementioned end effector
During form, opening and closing mechanism and purse string suture mechanism can be driven by synchronization, and at this moment Guan Bi bar and pocket ejector pin bar can be
Integrative-structure or different parts are connected with each other to realize synchronizing to drive, additionally, opening and closing mechanism and purse string suture mechanism also may be used
To be driven separately.
Obviously, those skilled in the art can carry out various change and the modification essence without deviating from the present invention to the present invention
God and scope.So, if these amendments of the present invention and modification belong to the scope of the claims in the present invention and equivalent technologies thereof
Within, then the present invention is also intended to comprise these change and modification.
Claims (18)
1. an end effector, it is characterised in that including:
First tong arm (10a) and the second tong arm (10b), described first tong arm (10a) and described second tong arm (10b) can opened
Open relative motion under the effect of close mechanism, so that the pincers that described first tong arm (10a) and described second tong arm (10b) are formed
Mouth opens or closes；
Suturing mechanism (11), described suturing mechanism (11) is arranged on described first tong arm (10a) and described second tong arm (10b)
The side of longitudinal direction；
Purse string suture mechanism (12), described purse string suture mechanism (12) is arranged on described first tong arm (10a) and described second pincers
The opposite side of the longitudinal direction of arm (10b)；
Cutting mechanism (13), described cutting mechanism (13) is arranged on described suturing mechanism (11) and described purse string suture mechanism (12)
Between；
Described purse string suture mechanism (12) including:
Upper the first pocket nail nail kit (14a) arranged of described first tong arm (10a), described second tong arm (10b) is upper arrange the
Two pockets nail nail kit (14b), and be positioned at described first pocket nail nail kit (14a) and described second pocket follow closely nail kit (14b) it
Between two-sided nail anvil (56), wherein, described first pocket nail nail kit (14a) and described second pocket nail nail kit (14b) are distinguished
Be provided with pocket nail (57), described pocket nail (57) by pocket nail ejector pin mechanism percussion, described first pocket nail nail kit (14a) and
Described second pocket nail nail kit (14b) is positioned at the two of described pocket nail (57) in the face of the surface configuration of described two-sided nail anvil (56) has
Purse wire (58) between individual nail lower limb.
2. end effector as claimed in claim 1, it is characterised in that described first pocket nail nail kit (14a) and described the
Two pockets nail nail kit (14b) are respectively arranged with line card (15), described purse wire (58) in the face of the surface of described two-sided nail anvil (56)
It is arranged in described line card (15).
3. end effector as claimed in claim 2, it is characterised in that adjacent the two of described first pocket nail nail kit (14a)
Being provided with line card described at least two (15) between individual described pocket nail (57), the adjacent of nail kit (14b) followed closely by described second pocket
It is provided with line card described at least two (15) between two described pockets nail (57).
4. end effector as claimed in claim 1, it is characterised in that described pocket is followed closely ejector pin mechanism and included: pocket nail pushes away
Nail rod, and for pocket nail ejector pin slide block (16) set by each pocket nail nail kit and pocket nail nail pushing device (17)；
Nail kit is followed closely, when pocket nail ejector pin slide block described in described pocket nail ejector pin bar distad zigzag tread patterns for each pocket
(16) time, the inclined-plane laterally driven described pocket nail nail pushing device (17) of described pocket nail ejector pin slide block (16), make described pocket follow closely
Described pocket nail (57) is released described pocket nail nail kit the effect compacted under described two-sided nail anvil (56) by nail pushing device (17).
5. end effector as claimed in claim 1, it is characterised in that described suturing mechanism (11) including:
The upper staple nail anvil (18) arranged of described first tong arm (10a), described second tong arm (10b) when jaw closes with described
The staple nail kit (19) that the position that staple nail anvil (18) is corresponding is arranged, is provided with staple (20) in described staple nail kit (19),
Described staple (20) can be by the percussion of staple ejector pin mechanism, wherein:
Described staple ejector pin mechanism includes: staple ejector pin bar, staple ejector pin slide block (21) and staple nail pushing device (22), when described seam
Described in nail ejector pin bar distad zigzag tread patterns during staple ejector pin slide block (21), the inclined-plane of described staple ejector pin slide block (21) laterally drives
Dynamic described staple nail pushing device (22), make described staple nail pushing device (22) described staple (20) is released described staple nail kit (19) and
Effect compacted under described staple nail anvil (18).
6. end effector as claimed in claim 1, it is characterised in that described cutting mechanism (13) including: can be in push broach
The cutter (23) moved between described suturing mechanism (11) and described purse string suture mechanism (12) under the effect of mechanism.
7. end effector as claimed in claim 6, it is characterised in that described first tong arm (10a) and described second tong arm
(10b) there is the cutter groove (24) that the described cutter of receiving (23) is moved.
8. end effector as claimed in claim 1, it is characterised in that described first tong arm (10a) and described second tong arm
(10b) the movable tong arm that can rotate it is relative to described two-sided nail anvil (56).
9. end effector as claimed in claim 8, it is characterised in that described opening and closing mechanism includes closing bar, described
Guan Bi bar distal end portion is provided with closure flange (25), is provided with between described first tong arm (10a) and described second tong arm (10b)
Stage clip, when described Guan Bi bar is driven and during longitudinal distal motion, described closure flange (25) engages the first tong arm (10a)
And/or second closing face on tong arm (10b) make described jaw overcome the elastic force of described stage clip to close, when described Guan Bi bar
During rollback, described jaw can open under the reset response of described stage clip.
10. the end effector as described in any one of claim 1～9, it is characterised in that
Described opening and closing mechanism, described suturing mechanism (11), described purse string suture mechanism (12) and described cutting mechanism (13)
In at least both driven by synchronization；Or,
Described opening and closing mechanism, described suturing mechanism (11), described purse string suture mechanism (12) and described cutting mechanism (13)
It is driven separately.
11. end effectors as claimed in claim 10, it is characterised in that described end effector is to have chamber mirror specification
End effector.
12. 1 kinds of surgical operating instruments, it is characterised in that including: handle (26) and by described handle (26) drive such as right
Require the end effector (27) described in 1～11 any one.
13. surgical operating instruments as claimed in claim 12, it is characterised in that also include being internally provided with drive mechanism (29)
Slender bodies (28), the distally of described handle (26) is connected with described end effector (27) by described slender bodies (28), institute
State handle (26) by opening and closing that described drive mechanism (29) is described end effector (27), sew up, cut and pocket
Sew up to provide and drive.
14. 1 kinds of purse-string forceps, it is characterised in that including:
First tong arm and the second tong arm, described first tong arm and described second tong arm can under the effect of opening and closing mechanism phase
To motion, so that the jaw that described first tong arm and described second tong arm are formed opens or closes；
Purse string suture mechanism, including: the first pocket nail nail kit arranged on described first tong arm, described second tong arm is arranged
Second pocket nail nail kit, and the two-sided nail anvil between described first pocket nail nail kit and described second pocket nail nail kit,
Wherein, being respectively arranged with pocket nail in described first pocket nail nail kit and described second pocket nail nail kit, described pocket is followed closely by lotus
The percussion of Bao Ding ejector pin mechanism, described first pocket nail nail kit and described second pocket nail nail kit are in the face of the surface of described two-sided nail anvil
It is provided with the purse wire between two nail lower limbs that described pocket is followed closely.
15. purse-string forceps as claimed in claim 14, it is characterised in that described first pocket nail nail kit and described second pocket nail
Nail kit is respectively arranged with line card in the face of the surface of described two-sided nail anvil, and described purse wire is arranged in described line card.
16. purse-string forceps as claimed in claim 15, it is characterised in that adjacent two described lotuses of described first pocket nail nail kit
It is provided with line card described at least two between Bao Ding, arranges between adjacent two described pockets nail of described second pocket nail nail kit
There is line card described at least two.
17. purse-string forceps as according to any one of claim 14～16, it is characterised in that
Described opening and closing mechanism and described purse string suture mechanism are synchronized to drive；Or, described opening and closing mechanism and described
Purse string suture mechanism is driven separately.
18. purse-string forceps as claimed in claim 17, it is characterised in that described pocket is followed closely ejector pin mechanism and included: pocket nail ejector pin
Bar, and for the pocket nail ejector pin slide block set by each pocket nail nail kit and pocket nail nail pushing device；
Nail kit is followed closely, when pocket nail ejector pin slide block described in described pocket nail ejector pin bar distad zigzag tread patterns for each pocket
Time, the inclined-plane laterally driven described pocket nail nail pushing device of described pocket nail ejector pin slide block, make described pocket nail nail pushing device by described
Pocket nail releases described pocket nail nail kit the effect compacted under at described two-sided nail anvil.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310438924.5A CN104434245B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310438924.5A CN104434245B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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| CN104434245A CN104434245A (en) | 2015-03-25 |
| CN104434245B true CN104434245B (en) | 2017-01-11 |
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Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107320144B (en) * | 2017-07-28 | 2023-06-13 | 广西壮族自治区人民医院 | Linear purse-string suture cutting closer |
| CN108433768A (en) * | 2018-04-17 | 2018-08-24 | 重庆邮电大学 | A kind of 3-degree-of-freedom electrical type stapler driving device |
| CN109199500B (en) * | 2018-10-24 | 2023-09-26 | 汕头大学 | Nail pushing device of endoscopic purse-string suture device |
| US11779342B2 (en) | 2020-02-19 | 2023-10-10 | Covidien Lp | Laparoscopic purse string suture device |
| CN113749714A (en) * | 2021-10-19 | 2021-12-07 | 四川大学华西第二医院 | Clamping arm component for closer |
| CN114305559B (en) * | 2022-02-23 | 2023-08-04 | 四川大学华西第二医院 | Closer provided with separated push-type knife assembly |
| CN114343761A (en) * | 2022-02-23 | 2022-04-15 | 四川大学华西第二医院 | Non-closed closer |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5242457A (en) * | 1992-05-08 | 1993-09-07 | Ethicon, Inc. | Surgical instrument and staples for applying purse string sutures |
| ES2109539T3 (en) * | 1993-04-20 | 1998-01-16 | United States Surgical Corp | SURGICAL STAPLER. |
| CN101669833A (en) * | 2008-09-11 | 2010-03-17 | 苏州天臣国际医疗科技有限公司 | Automatic purse-string device |
| CN202313536U (en) * | 2011-09-28 | 2012-07-11 | 潘凯 | Cutting and closing pouch suture instrument for laparoscopic surgery |
| CN202740058U (en) * | 2012-04-13 | 2013-02-20 | 北京中法派尔特医疗设备有限公司 | Nail warehouse component and suture instrument with knife using same |
| CN202982106U (en) * | 2012-12-29 | 2013-06-12 | 苏州天臣国际医疗科技有限公司 | Surgical operating instrument |
| CN203564294U (en) * | 2013-09-23 | 2014-04-30 | 瑞奇外科器械(中国)有限公司 | End effector, surgical operating instrument and purse-string forceps |
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Address after: 300457 Tianjin Binhai New Area Economic and Technological Development Zone, Fourth Street, No. 5, block B, floor 4 Patentee after: Tianjin Ricky surgical instruments Limited by Share Ltd Address before: 300457 Tianjin Binhai New Area Economic and Technological Development Zone, Fourth Street, No. 5, block B, floor 4 Patentee before: Reach Surgical Instrument (China) Co.,Ltd. |
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