CN104434252B - 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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- CN104434252B CN104434252B CN201310438121.XA CN201310438121A CN104434252B CN 104434252 B CN104434252 B CN 104434252B CN 201310438121 A CN201310438121 A CN 201310438121A CN 104434252 B CN104434252 B CN 104434252B
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- nail
- tong arm
- purse
- kit
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—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
Abstract
The invention relates to the technical field of medical equipment, and discloses an end effector, a surgical operating instrument, purse-string forceps and purse-string nails. The end effector and the surgical operating instrument can simplify the operation process of an operation, relieve trauma brought to a surgery patient and further make the purse-string nails connected with lumen tissue firmly. 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 first forceps arm and the second forceps arm, the purse-string suture mechanism is arranged on the other side of the longitudinal direction of the first forceps arm and the second forceps arm 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 and a second purse-string nail box arranged on the second forceps arm, and the purse-string nails are arranged in the first purse-string nail box and the second purse-string nail box respectively.
Description
Technical field
The present invention relates to technical field of medical instruments, more particularly to a kind of end effector, a kind of surgical operating instrument,
A kind of purse-string forceps and a kind of pocket nail.
Background technology
Gastrointestinal surgery typically requires cut-out closure tissue lumen, and carries out purse string suture at the side tube chamber disconnecting,
It is used for the nail anvil that round anastomat is installed in cooperation, carry out follow-up identical grade using round anastomat to grasp at purse string suture
Make.
Purse string suture be in surgical operation a kind of common suturing skill it is known that exist two kinds of main purse string sutures side
Formula.A kind of mode is to carry out purse string suture by hand, and as shown in Figure 1 a, 1 b, doctor first uses lotus around the otch of lumen organization 59
Bag pin passes 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 complicated, the more difficult assurance of performance accuracy, and easily because off-line leads to suture unsuccessfully, seldom adopted in the section's of being out at present operation
With.
Another way is to carry out purse string suture using purse-string forceps auxiliary.As shown in Figure 2 a, a kind of purse-string forceps are equally profits
With threading a needle（I.e. pocket pin）Band wire（I.e. purse wire 58）Mode carry out purse string suture.
As shown in Figure 2 b, also a kind of purse-string forceps are, by pocket nail 57, purse wire 58 is attached to lumen organization 59 surface
And carrying out purse string suture, common mode is that percussion pocket is followed closely 57 and so that it is pierced and be fixed to lumen organization 59, and purse wire
58 or with pocket nail 57 between be connected with each other, or by pocket nail 57 be pressed in lumen organization 59 and pocket nail 57 between, thus
Purse wire 58 is attached to lumen organization 59, to realize purse string suture.
Generally when performing the operation to lumen organization, except needing that purse string suture is carried out to the remaining end otch of lumen organization
Outward in addition it is also necessary to its pathological changes end is carried out cutting, sutured.And existing purse-string forceps single function, can be only done the pocket to remaining end
Suture is it is impossible to realize the cutting suture to pathological changes end.Therefore 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 lead to 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, using no nail anvil forming technique, purse wire 58 is fixed on pipe
Using this purse-string forceps, cavity tissue 59 surface, often occurs that the phenomenon of avulsion followed closely by pocket, thus leading to purse string suture failure, this
Also operation risk and the misery brought to surgical patient can be increased.
And, the 1980s occurs in that endoscope-assistant surgery, and it is a kind of mainly through endoscope and various imaging
Technology and so that surgeon is performed a surgical operation in the case of patient need not being caused with huge wound.With respect to open surgery
Speech, endoscope-assistant surgery has the significant advantages such as little to disorganization, post-operative recovery is fast, thus becoming 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.
Content of the invention
First purpose of the present invention is to provide a kind of end effector, carries out surgical operation to simplify to lumen organization
Operating process, reduces operating time, and further pocket nail is difficult avulsion, and the safety of operation is higher.
End effector includes：First tong arm and the second tong arm, the first tong arm and the second tong arm can be in opening and closing machines
Relative motion in the presence of structure, so that the jaw that the first tong arm and the second tong arm are formed opens or closes；Suturing mechanism, suture
Mechanism is arranged on the side of the longitudinal direction of the first tong arm and the second tong arm；Purse string suture mechanism, purse string suture mechanism is arranged on
The opposite side of the longitudinal direction of the first tong arm and the second tong arm；Cutting mechanism, cutting mechanism is arranged on suturing mechanism and pocket seam
Close between mechanism；Purse string suture mechanism includes：First pocket nail nail kit of setting, the of setting on the second tong arm on first tong arm
It is respectively arranged with pocket nail, pocket nail is followed closely by pocket in two pocket nail nail kits, the first pocket nail nail kit and the second pocket nail nail kit
Ejector pin mechanism fires, and nail kit followed closely by the first pocket and the second pocket is followed closely nail kit and the surface of jaw is provided with positioned at pocket nail two
Purse wire between individual nail leg.
In this technical scheme, the suturing mechanism of end effector side can achieve the suture of tissue, the pocket of opposite side
Suturing mechanism can achieve the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism then can achieve
That organizes cuts it is seen then that can achieve the purse string suture of tube chamber remaining end tissue using end effector provided by the present invention,
And pathological changes end tissue cutting and suture, compared with prior art, enormously simplify and surgical operation is carried out to lumen organization
Operating process, decreases operating time, alleviates the wound brought to surgical patient.
Preferably, at least one nail leg of pocket nail has barb structure.This end effector can make pocket nail and pipe
Cavity tissue more firmly connects, and substantially improves the phenomenon that easy avulsion followed closely by pocket, improves the safety of operation.
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.Because end effector has the effect above, therefore this surgical operating instrument can letter significantly
Change the operating process that lumen organization is carried out with surgical operation, reduce operating time, mitigate the wound brought to surgical patient, enter one
Step can also make pocket nail more firmly be connected with lumen organization, improves the safety of operation.
Third object of the present invention is to provide a kind of purse-string forceps, and pocket nail can be made with lumen organization to be connected more firm, lotus
Bao Ding is difficult avulsion, substantially increases the safety of operation.Purse-string forceps include：First tong arm and the second tong arm, the first tong arm and
Second tong arm can in the presence 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：First pocket nail nail kit of setting, setting on the second tong arm on first tong arm
It is respectively arranged with pocket nail, pocket is followed closely at least in second pocket nail nail kit, the first pocket nail nail kit and the second pocket nail nail kit
One nail leg has barb structure, and pocket nail is by the percussion of pocket nail ejector pin mechanism, the first pocket nail nail kit and the second pocket nail nail
Casket is provided with the purse wire between two nail legs of pocket nail towards the surface of jaw.
When pocket nail is pierced lumen organization by percussion, barb structure can stop nail leg from being deviate from from lumen organization, therefore,
It is more firm that this purse-string forceps can make pocket nail be connected with lumen organization, substantially increases the safety of operation.
Fourth object of the present invention is to provide a kind of pocket nail, using the surgical operating instrument pair comprising this pocket nail
When lumen organization carries out surgical operation, it is more firm that pocket nail is connected with lumen organization, is difficult avulsion, therefore improves the peace of operation
Quan Xing.
In the pocket nail that the embodiment of the present invention is provided, at least one nail leg of pocket nail has barb structure.Work as pocket
When nail is pierced lumen organization by percussion, this barb structure can stop nail leg from being deviate from from lumen organization, and therefore, pocket is followed closely and tube chamber
The connection of tissue is more firm, substantially increases the safety of operation.
Brief description
Fig. 1 a is the schematic cross-section of lumen organization's purse string suture；
Fig. 1 b is front view after purse wire is tightened up for the lumen organization；
Fig. 2 a is a kind of existing purse-string forceps purse string suture principle schematic；
Fig. 2 b is existing another kind 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 that the end effector jaw of the embodiment of the present invention closes schematic diagram；
Fig. 3 c be the embodiment of the present invention end effector after operation technique jaw open schematic diagram；
Fig. 4 is the structural representation of the first tong arm in the embodiment of the present invention；
Fig. 5 a is the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Tissue apposition side, staple is not
Fired）；
Fig. 5 b is the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Tissue apposition side, staple portion
Divide and fired）；
Fig. 6 a is the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Purse string suture side, pocket is followed closely
Do not fired）；
Fig. 6 b is the internal structure schematic three dimensional views of the end effector of the embodiment of the present invention（Purse string suture side, pocket is followed closely
Part is fired）；
Fig. 7 is the cross section structure schematic diagram of the end effector of the embodiment of the present invention（Pocket nail is not fired）；
Fig. 8 be carry out cutting, the lumen organization's schematic diagram after tissue apposition and purse string suture；
Fig. 9 is the pocket pin structure schematic diagram of one embodiment of the invention；
Figure 10 is the surgical operating instrument structural representation of the embodiment of the present invention.
Reference：
58- purse wire 59- lumen organization followed closely by 57- pocket
10a- the first tong arm 10b- the second tong arm 11- suturing mechanism
Nail kit followed closely by 12- purse string suture mechanism 13- cutting mechanism 14- the first pocket
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 bodiess 29- drive mechanism
571- nail leg 571a- barb structure 572- crown
Specific embodiment
In order that purse string suture, cutting and suture just can be completed with same apparatus, simplify to needing to carry out purse string suture
Tissue（Particularly lumen organization）Carry out the operating process of surgical operation, reduce the misery of operating time, risk and patient,
Further can be used in endoscope-assistant surgery, 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 achieve the suture of tissue, the purse string suture of opposite side
Mechanism can achieve the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism then can achieve tissue
Cutting, the end effector being provided using the embodiment of the present invention or surgical operating instrument can achieve tube chamber remaining end tissue
Purse string suture, and pathological changes end tissue cutting and suture, enormously simplify the operation that lumen organization is carried out with surgical 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.
As shown in Fig. 3 a to Fig. 3 c, 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
In the presence of relative motion 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：
First pocket nail nail kit 14 of setting on first tong arm 10a, the second pocket nail nail kit of setting on the second tong arm 10b
（In figure is not shown）, first pocket nail nail kit 14 and the second pocket nail nail kit in be respectively arranged with pocket nail 57, pocket nail 57 by
The percussion of pocket nail ejector pin mechanism, the first pocket nail nail kit 14 and the second pocket nail nail kit are provided with positioned at lotus towards the surface of jaw
Purse wire 58 between two nail legs of bag nail 57.
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." advance " points to the direction motion away from user, and " retrogressing " is then pointed to and 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 is providing driving force.The specific constructive form of drive mechanism does not limit, for example, it is possible to directly by existing stapler front end
End effector unload, the end effector that the embodiment of the present invention is 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 for originally
The end effector other design driven mechanism that inventive embodiments are provided.
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 used for realizing two tong arm institutes of end effector
The opening and closing of the jaw being formed, using when jaw can be driven to open lumen organization to be performed the operation is placed in one, so
Rear-guard movable clamp port closure clamps lumen organization to carry out the surgical action such as purse string suture, cutting, suture, and works as surgical action
After end, jaw can be driven to open again to discharge tissue.Cutting mechanism is used for realizing the cutting function to tissue, can be by
The pathological changes end of lumen organization and remaining end cutting separate.Suturing mechanism is used for realizing the suture function to tissue, can be in tube chamber
The incision at lesion tissue end is sutured.Purse string suture mechanism is used for realizing the purse string suture function to tissue, can be in pipe
The incision of cavity tissue remaining end carries out purse string suture, installs the nail anvil of round anastomat with cooperation in subsequent operation, uses
Round anastomat carries out coincideing and waits operation.Further described this tetrameric structure below respectively.
In the end effector of the embodiment of the present invention, opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting
Can at least both synchronously be driven in mechanism；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 can be movable relatively, and can be and can turn
Dynamic movable tong arm；Or, the first tong arm 10a is non-rotatable fixing tong arm, and the second tong arm 10b is rotatable adjustable clamp
Arm；Or, the second tong arm 10b is non-rotatable fixing tong arm, and the first tong arm 10a is rotatably movable tong arm.Either
Only one of which activity tong arm or two are movable tong arm, as long as the pincers that two tong arms can be made two tong arms be formed by driving
Mouth opening and closing.
The opening and closing mechanism of the end effector of the present invention can adopt opening of the end effector of existing stapler
Open the various technical schemes of close mechanism to realize, for example, bushing type opening and closing scheme, I-shaped beam type opening and closing scheme
Deng.
For example, opening and closing mechanism may include closure bar, and closure 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 second the closing face on tong arm so that tong arm overcomes the elastic force of stage clip to close, when closing bar rollback, jaw can be in 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 second closing face on tong arm, but in order to obtain relatively balance stress it is preferred that closure flange be simultaneously engaged the first tong arm and
Closing face on second tong arm.
Wherein, closure bar can be with the staple ejector pin bar for firing staple, the pocket nail ejector pin for firing pocket nail
Bar or be connected with each other for driving the knife bar of cutter to be structure as a whole or for different parts；Closure bar, staple ejector pin bar, knife
Bar or pocket nail ejector pin bar can also be different parts respectively；Closure bar also can be pushed 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 closure bar is pushed 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 it is connected with each other for different parts.
Incorporated by reference to shown in Fig. 5 a and 5b, in one particular embodiment of the present invention, cutter 23 and knife bar are one knots
Structure the closure bar as opening and closing mechanism, are provided with stage clip between the first tong arm 10a and the second tong arm 10b（In figure is not shown
Go out）, the side that the distal end portion of closure bar deviates from jaw in movable tong arm is fixed with the closure flange 25 parallel to cut direction；When
When closure bar advances, closure flange 25 promotion activity tong arm turns to jaw closure, when closing bar retrogressing, stage clip promotion activity
Tong arm turns to jaw and opens.Need exist for illustrating, the stroke that closure flange 25 is walked when closing jaw does not need
Very big.
Cutting mechanism：
The cutting mechanism of the end effector of the present invention can adopt the cutting of the end effector of existing stapler
The various technical schemes of mechanism are realizing.
For example, in conjunction with shown in Fig. 4, Fig. 5 a and Fig. 5 b, cutting mechanism may include cutter 23, and cutter 23 can be in push broach
Move between suturing mechanism and purse string suture mechanism in the presence of mechanism, by group that sutured respectively and purse string suture
Knit cutting to separate, push broach mechanism can be push broach bar or miscellaneous part, 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（As shown in Figure 4）, provide guiding with the motion for cutter 23, make cutting movement more steadily,
Accurately.
Suturing mechanism：
The suturing mechanism of the end effector of the present invention can adopt the sewing machine of the end effector of existing stapler
The various technical schemes of structure are realizing.
For example, 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
It is set to a row or multi-row to direction, staple 20 can be fired by staple ejector pin mechanism.For firing the staple ejector pin of staple 20
Mechanism may 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, pass through lumen organization 59 and compress staple nail anvil 18, staple 20 molding in the presence of staple nail anvil 18
For B shape, thus completing to suture.
The row of staple 20 does not limit, but at least should be a row, more preferably at least two rows, so, can be in the disease of lumen organization
Become end and carry out at least twice suture, greatly reduce the risk of suture failure.When staple 20 longitudinally disposed for multiple rows of when, permissible
Only one staple ejector pin slide block 21 of setting 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 with respect to staple ejector pin
Slide block 21 is more rearward（I.e. closer to nearside）So that first suture cutting afterwards, so can reduce outside the interior tissue of pathological changes end
Stream, improves the success rate of operation.In one embodiment, staple ejector pin slide block 21 is cut the knife bar promotion of knife 23, in cutter
Before 23 blade cuts to tissue, the inclined-plane of staple ejector pin slide block 21 has promoted the staple nail pushing device 22 in front will stitch
Nail 20 percussion, that is, first the lumen organization in front is sutured, 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, that is, relative with suturing mechanism
Side.Preferably, the second pocket nail nail kit that setting on nail kit and the second tong arm followed closely by the first pocket the first tong arm being arranged exists
During jaw closure, position relatively, so can obtain preferable purse string suture effect.
As shown in figures 6 a and 6b, pocket nail ejector pin mechanism includes：Ejector pin bar followed closely by pocket, and for each pocket nail
Pocket nail ejector pin slide block 16 set by nail kit and pocket nail nail pushing device 17；Follow closely nail kit for each pocket, when pocket nail pushes away
Nail rod distad zigzag tread patterns pocket nail ejector pin slide block 16 when, the inclined-plane laterally driven pocket nail ejector pin of ejector pin slide block 16 followed closely by pocket
Device 17, makes pocket follow closely nail pushing device 17 and pocket nail 57 is released pocket nail nail kit, at this moment pocket nail 57 can pierce lumen organization 59, with
Lumen organization 59 connects.
Pocket follow closely ejector pin mechanism and staple ejector pin mechanism can be separate, the Liang Ge mechanism that is 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
Same part, additionally, pocket nail ejector pin mechanism and staple ejector pin mechanism can synchronously be driven, as shown in Figure 6 b, pocket nail pushes away
Nail rod and staple ejector pin bar are structure as a whole with the knife bar of cutter（Pocket nail ejector pin bar, staple ejector pin bar and knife bar can also
It is connected with each other for different parts）, ejector pin slide block 16 followed closely by pocket and staple ejector pin slide block 21 is structure as a whole（Or for different parts
It is connected with each other）, for example, when ejector pin slide block is by zigzag tread patterns, nail pushing device 17 He can be followed closely by laterally driven pocket in the inclined-plane of ejector pin slide block
Staple nail pushing device 22, makes pocket follow closely and is fired respectively with staple.
As shown in figure 4, the positioning mode in nail kit surface for the purse wire 58 does not limit it is preferred that nail kit 14 He followed closely by the first pocket
Second pocket nail nail kit is respectively arranged with line card 15 towards the surface of jaw, and purse wire 58 is arranged in line card 15.Purse wire is arranged
Between two nail legs of pocket nail, when pocket nail is pierced lumen organization by percussion, purse wire is crushed on the crown of pocket nail
And lumen organization between, when pocket nail percussion finishes, when the jaw of end effector opens, nail kit followed closely by purse wire and the first pocket
Follow closely nail kit with the second pocket to separate.
In order that purse wire 58 is more smooth, be reliably positioned nail kit surface it is preferred that nail kit 14 followed closely by the first pocket
It is provided with least two line cards 15 between two neighboring pocket nail 57；Second pocket is followed closely between the two neighboring pocket nail 57 of nail kit
It is provided with least two line cards 15.The particular number of line card 15 can determine according to the arranging distance of pocket nail 57, does not make here
Concrete restriction.
As shown in figures 7 and 9 it is preferred that at least one nail leg 571 of pocket nail 57 has barb structure 571a.Work as pocket
Nail 57 by percussion pierce lumen organization 59 when, this barb structure 571a can stop nail leg from tissue deviate from, therefore, pocket nail with
The connection of lumen organization is more firm, substantially increases the safety of operation.
Preferably, two nail legs 571 of pocket nail are respectively provided with barb structure 571a, the barb structure of two nail legs 571
571a is symmetrical, the stress of pocket nail so can be made more to balance, the effect of anti-avulsion is lifted further.
The particular type of barb structure 571a and quantity do not limit, preferably include at least one dorsad nail leg 571 end fall
Hook.Due to purse wire be crushed on pocket nail crown and lumen organization between, when purse wire takes out tight, pocket nail will be subject to
The outer power extracted of tissue, at this moment at least one barb is tight with tissue hook, and nail leg can be stoped to deviate from from tissue.
Preferably, nail leg 571 end is wedge shape, and when pocket nail is fired, wedge shape nail leg can accurately and rapidly be pierced
Tissue, and deflection is less, and this is conducive to improving the success rate of purse string suture.
In the technical scheme of the embodiment of the present invention, closure 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 synchronous driving for different parts, for example, in one embodiment, closure bar, staple push away
Nail rod, knife bar and pocket nail ejector pin bar are structure as a whole, and can be described as drive rod.During use, drive rod distal motion is to carry out
Drive, drive opening and closing mechanism first to close tong arm, with motion further, suturing mechanism and the purse string suture of drive rod
Mechanism is driven, and staple is fired to realize suturing successively, and pocket nail is fired piercing tissue successively to realize purse string suture, with
When cutter between suturing mechanism and purse string suture mechanism, tissue is cut under the promotion of drive rod, thus simultaneously complete
Cutting, suture and purse string suture are become（Carry out cutting, the lumen organization after tissue apposition and purse string suture as shown in figure 8, its
In, direction shown in arrow is the length direction of lumen organization）, this is further simplified the operation that lumen organization is carried out with surgical operation
Process, decreases operating time, thus further mitigating the wound brought to surgical patient.
To sum up, in technical solution of the present invention, the suturing mechanism of end effector side can achieve the suture of tissue, another
The purse string suture mechanism of side can achieve the purse string suture of tissue, and the cutting mechanism between suturing mechanism and purse string suture mechanism
Then can achieve the cutting of tissue it is seen then that can achieve tube chamber remaining end group using the end effector that the embodiment of the present invention is provided
The purse string suture knitted, and pathological changes end tissue cutting and suture, compared with prior art, greatly reduce replacing operating theater instruments
Frequency, simplify the operating process that lumen organization is carried out with surgical operation, decrease operating time, alleviate to surgical patient
The wound brought.And, because pocket nail has barb structure, this end effector can make pocket nail more firm with lumen organization
Connect by ground, substantially improve the phenomenon that easy avulsion followed closely by pocket, improve the safety of operation.
It should be noted that in various embodiments of the present invention, the specification of end effector does not limit, can basis
Concrete operation needs are designed.For example, when end effector is the end effector with hysteroscope specification, can be with mating cavity
Mirror use, so that operation is had concurrently safe, wound surface is little, pain is few, recover fast the advantages of.
As shown in Figure 10, the embodiment of the present invention additionally provides a kind of surgical operating instrument, including：Handle 26 and by handle 26
The end effector 27 as aforementioned any embodiment driving.
Also include being internally provided with the slender bodiess 28 of drive mechanism 29 in this embodiment, slender bodiess are 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 by driving pass to end execution
Device 27, to provide driving for its opening and closing, suture, cutting and purse string suture.The surgical operating instrument with this structure is permissible
Cooperation hysteroscope use, so that operation is had concurrently safe, wound surface is little, pain is few, recover fast the advantages of.
Can achieve the purse string suture of tube chamber remaining end tissue using the surgical operating instrument that the embodiment of the present invention is provided, with
And pathological changes end tissue cutting and suture, compared with prior art, enormously simplify the behaviour that lumen organization is carried out with surgical operation
Make process, decrease operating time, and pocket nail can be made more firmly to be connected with lumen organization, improve the safety of operation
Property, alleviate the wound brought to surgical patient, can be also used for endoscope-assistant surgery further.
As shown in figure 9, the pocket that the embodiment of the present invention is provided is followed closely in 57, at least one nail leg 571 of pocket nail 57 has
There is barb structure 571a.
Preferably, barb structure 571a includes the barb of at least one dorsad nail leg 571 end.
Preferably, two nail legs 571 of pocket nail 57 are respectively provided with barb structure 571a, the barb structure of two nail legs 571
571a is symmetrical.
Preferably, nail leg 571 end is wedge shape.
Beneficial effect in various embodiments above is as it was previously stated, be not repeated herein explanation.
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 the effect of opening and closing mechanism relatively
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：First pocket nail nail kit of setting, the second of setting on the second tong arm on first tong arm
Pocket follow closely nail kit, first pocket nail nail kit and the second pocket nail nail kit in be respectively arranged with pocket nail, pocket nail at least one
Nail leg has barb structure, and pocket nail is by the percussion of pocket nail ejector pin mechanism, the first pocket nail nail kit and the second pocket nail nail kit face
The surface of jaw is provided with the purse wire between two nail legs of pocket nail.
When pocket nail is pierced lumen organization by percussion, barb structure can stop nail leg from being deviate from from lumen organization, therefore,
It is more firm that this purse-string forceps can make pocket nail be connected with lumen organization, substantially increases the safety of operation.
Preferably, barb structure includes the barb of at least one dorsad nail leg end；Two nail legs of pocket nail are respectively provided with
Barb structure, the barb structure of two nail legs is symmetrical；Nail leg end is preferably wedge shape.The beneficial effect of these embodiments is such as
Front described, explanation is not repeated herein.
Pocket nail ejector pin mechanism includes：Ejector pin bar followed closely by pocket, and follows closely the pocket set by nail kit for each pocket
Nail ejector pin slide block and pocket nail nail pushing device；Follow closely nail kit for each pocket, when ejector pin bar distad zigzag tread patterns lotus followed closely by pocket
During bag nail ejector pin slide block, the inclined-plane laterally driven pocket nail nail pushing device of ejector pin slide block followed closely by pocket, makes pocket follow closely nail pushing device by pocket
Pocket nail nail kit released by nail, and at this moment pocket nail can pierce lumen organization, is connected with lumen organization.
Preferably, the first pocket nail nail kit and the second pocket nail nail kit are respectively arranged with line card, lotus towards the surface of jaw
Envelope curve is arranged in line card.It is provided with least two line cards, the second pocket between the two neighboring pocket nail of the first pocket nail nail kit
It is provided with least two line cards between the two neighboring pocket nail of nail nail kit.Beneficial effect in each embodiment is as before, here not
Repeat explanation.
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 limit, and for example, can adopt
The version similar with aforementioned end effector, may also be employed the version of general surgery pincers, the first tong arm and the second pincers
Arm is hinged, is closed 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 synchronously be driven, and at this moment closure bar and pocket ejector pin bar can be
Integrative-structure or different part are connected with each other to realize synchronous driving, 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 the various changes and modification essence without deviating from the present invention to the present invention
God and scope.So, if these modifications of the present invention and modification belong to the scope of the claims in the present invention and its equivalent technologies
Within, then the present invention is also intended to comprise these changes and modification.
Claims (25)
1. a kind of end effector is it is characterised in that include：
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 in the presence 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) includes：
First pocket nail nail kit (14) of the upper setting of described first tong arm (10a), the second of the upper setting of described second tong arm (10b)
Nail kit followed closely by pocket, is respectively arranged with pocket nail (57) in described first pocket nail nail kit (14) and described second pocket nail nail kit,
By the percussion of pocket nail ejector pin mechanism, nail kit followed closely by described first pocket nail nail kit (14) and described second pocket to described pocket nail (57)
Surface towards jaw is provided with the purse wire (58) between two nail legs of described pocket nail (57).
2. end effector as claimed in claim 1 is it is characterised in that at least one nail leg of (57) followed closely by described pocket
(571) there is barb structure (571a).
3. end effector as claimed in claim 2 is it is characterised in that described barb structure (571a) includes at least one back of the body
Barb to described nail leg (571) end.
4. end effector as claimed in claim 2 is it is characterised in that two nail legs (571) of described pocket nail (57) are equal
There is barb structure (571a), the barb structure (571a) of described two nail legs (571) is symmetrical.
5. end effector as claimed in claim 2 is it is characterised in that described nail leg (571) end is wedge shape.
6. end effector as claimed in claim 1 is it is characterised in that described first pocket follows closely nail kit (14) and described second
Pocket nail nail kit is respectively arranged with line card (15) towards the surface of jaw, and described purse wire (58) is arranged in described line card (15).
7. end effector as claimed in claim 6 is it is characterised in that the two neighboring of nail kit (14) followed closely by described first pocket
It is provided with line card described at least two (15), the two neighboring described of nail kit followed closely by described second pocket between described pocket nail (57)
It is provided with line card described at least two (15) between pocket nail (57).
8. end effector as claimed in claim 1 is it is characterised in that described pocket nail ejector pin mechanism includes：Pocket nail pushes away
Nail rod, and pocket nail ejector pin slide block (16) and pocket nail nail pushing device (17) set by nail kit is followed closely for each pocket；
Follow closely nail kit for each pocket, when described pocket nail ejector pin bar distad pocket nail ejector pin slide block described in zigzag tread patterns
(16), when, laterally driven described pocket nail nail pushing device (17) in inclined-plane of ejector pin slide block (16) followed closely by described pocket, makes described pocket nail
Described pocket nail (57) is released described pocket and is followed closely nail kit by nail pushing device (17).
9. end effector as claimed in claim 1 is it is characterised in that described suturing mechanism (11) includes：
The staple nail anvil (18) of the upper setting of described first tong arm (10a), described second tong arm (10b) when jaw closes with described
At the corresponding position of staple nail anvil (18), the staple nail kit (19) of setting, is provided with staple (20) in described staple nail kit (19),
Described staple (20) can be fired by 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
Distad described in zigzag tread patterns during staple ejector pin slide block (21), the inclined-plane of described staple ejector pin slide block (21) laterally drives nail ejector pin bar
Move described staple nail pushing device (22), make described staple nail pushing device (22) by described staple (20) release described staple nail kit (19) and
Molding in the presence of described staple nail anvil (18).
10. end effector as claimed in claim 1 is it is characterised in that described cutting mechanism (13) includes：Can be in push broach
The cutter (23) moving between described suturing mechanism (11) and described purse string suture mechanism (12) in the presence of mechanism.
11. end effectors as claimed in claim 10 are it is characterised in that described first tong arm (10a) and described second clamps
Arm (10b) has the cutter groove (24) that the described cutter of receiving (23) is moved.
12. end effectors as claimed in claim 1 are it is characterised in that described first tong arm (10a) and described second tong arm
(10b) it is rotatably movable tong arm；Or, described first tong arm (10a) is non-rotatable fixing tong arm, described second
Tong arm (10b) is rotatably movable tong arm；Or, described second tong arm (10b) is non-rotatable fixing tong arm, described the
One tong arm (10a) is rotatably movable tong arm.
13. end effectors as claimed in claim 12 are it is characterised in that described opening and closing mechanism includes closing bar, institute
State closure bar distal end portion and be provided with closure flange (25), arrange between described first tong arm (10a) and described second tong arm (10b)
There is stage clip, when described closure 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 closure bar
During rollback, described jaw can open under the reset response of described stage clip.
14. end effectors as described in any one of claim 1～13 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 synchronously driven；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.
15. end effectors as claimed in claim 14 are it is characterised in that described end effector is to have hysteroscope specification
End effector.
A kind of 16. surgical operating instruments are it is characterised in that include：Handle (26) and by described handle (26) drive as right
Require the end effector (27) described in 1～15 any one.
17. surgical operating instruments as claimed in claim 16 are it is characterised in that also include being internally provided with drive mechanism (29)
Slender bodiess (28), the distally of described handle (26) is connected with described end effector (27) by described slender bodiess (28), institute
State the opening and closing that handle (26) is described end effector (27) by described drive mechanism (29), suture, cutting and pocket
Suture provides and drives.
A kind of 18. purse-string forceps are it is characterised in that include：
First tong arm and the second tong arm, described first tong arm and described second tong arm can in the presence 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：First pocket nail nail kit of setting, setting on described second tong arm on described first tong arm
It is respectively arranged with pocket nail in second pocket nail nail kit, described first pocket nail nail kit and described second pocket nail nail kit, described
At least one nail leg of pocket nail has barb structure, and described pocket nail is by the percussion of pocket nail ejector pin mechanism, described first pocket
Nail nail kit and described second pocket are followed closely nail kit and are provided between two nail legs of described pocket nail towards the surface of jaw
Purse wire.
19. purse-string forceps as claimed in claim 18 are it is characterised in that described barb structure (571a) includes at least one dorsad
The barb of described nail leg (571) end.
20. purse-string forceps as claimed in claim 18 are it is characterised in that two nail legs (571) of described pocket nail (57) all have
There is barb structure (571a), the barb structure (571a) of described two nail legs (571) is symmetrical.
21. purse-string forceps as claimed in claim 18 are it is characterised in that described nail leg (571) end is wedge shape.
22. purse-string forceps as claimed in claim 18 are it is characterised in that described first pocket nail nail kit and described second pocket are followed closely
Nail kit is respectively arranged with line card towards the surface of jaw, and described purse wire is arranged in described line card.
23. purse-string forceps as claimed in claim 22 are it is characterised in that the two neighboring described lotus of nail kit followed closely by described first pocket
It is provided with line card described at least two between Bao Ding, arrange between the two neighboring described pocket nail of described second pocket nail nail kit
There is line card described at least two.
24. purse-string forceps as any one of claim 18～23 it is characterised in that
Described opening and closing mechanism and described purse string suture mechanism are synchronously driven；Or, described opening and closing mechanism and described
Purse string suture mechanism is driven separately.
25. purse-string forceps as claimed in claim 24 are it is characterised in that described pocket nail ejector pin mechanism includes：Ejector pin followed closely by pocket
Bar, and pocket nail ejector pin slide block and the pocket nail nail pushing device set by nail kit is followed closely for each pocket；
Follow closely nail kit for each pocket, when described pocket nail ejector pin bar distad pocket nail ejector pin slide block described in zigzag tread patterns
When, nail pushing device followed closely by the laterally driven described pocket in inclined-plane that ejector pin slide block followed closely by described pocket, and making described pocket follow closely nail pushing device will be described
Pocket nail is released described pocket and is followed closely nail kit.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310438121.XA CN104434252B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310438121.XA CN104434252B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
Publications (2)
| Publication Number | Publication Date |
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| CN104434252A CN104434252A (en) | 2015-03-25 |
| CN104434252B true CN104434252B (en) | 2017-02-08 |
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| CN201310438121.XA Active CN104434252B (en) | 2013-09-23 | 2013-09-23 | End effector, surgical operating instrument and purse-string forceps |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US10492790B2 (en) * | 2015-09-24 | 2019-12-03 | Ethicon Llc | Apparatus and method for cinching a straight staple line |
| US10588630B2 (en) * | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical tool assemblies with closure stroke reduction features |
| US11779342B2 (en) | 2020-02-19 | 2023-10-10 | Covidien Lp | Laparoscopic purse string suture device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8011555B2 (en) * | 2007-03-06 | 2011-09-06 | Tyco Healthcare Group Lp | Surgical stapling apparatus |
| US8371491B2 (en) * | 2008-02-15 | 2013-02-12 | Ethicon Endo-Surgery, Inc. | Surgical end effector having buttress retention features |
| CN203564292U (en) * | 2013-09-23 | 2014-04-30 | 瑞奇外科器械(中国)有限公司 | End effector, surgical operating instrument, purse-string forceps and purse-string nails |
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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. |