CN105997176A - Tissue closing device and medical equipment - Google Patents

Abstract

The invention provides a tissue closing device. The tissue closing device comprises a first clamp holder, a second clamp holder, a pouch component and a closing component, wherein the first clamp holder and the second clamp holder can be relatively opened/closed; the pouch component is provided with an initial position positioned in the near end of the tissue closing device, and a percussion position positioned in the far end of the tissue closing device; when the pouch component moves to the percussion position from the initial position, the pouch component closes part of tissue positioned in a containing cavity into a pouch at a non-tightened state; the closing component is provided with an initial position positioned in the near end of the tissue closing device, and a percussion position positioned in the far end of the tissue closing device; when the closing component moves to the percussion position from the initial position, the closing component closes part of tissue positioned in the containing cavity into a pouch at a non-tightened state. The tissue closing device can simultaneously form a closed pouch to close the end part of pathological tissue, and the closed but not tightened pouch is convenient for subsequent operation.

Description

Tissue closing device and medical apparatus and instruments

Technical field

The present invention relates to technical field of medical instruments, particularly relate to a kind of tissue closing device and there is the medical apparatus and instruments of this tissue closing device.

Background technology

In existing gastrointestinal cancer patients, an otch passage to be opened on stomach wall again and could cut tumor tissues be taken out external；Sufferer the most unsightly, and can be caused bigger wound by so many otch.

Separately, in existing gastral anastomosis operation, the detachment the most first using linear type or arc line type anastomat that human body tubular tissue carries out multi-angle is coincide, and re-uses circular-pipe anastomat and the tissue after detachment carries out docking coincide.But, after when using linear type or arc line type anastomat to carry out human body tubular tissue, detachment coincide, owing to anastomotic stoma is wire, especially doing low rectal position when, owing to being limited by working place at the bottom of human body basin and the limiting of linear type apparatus pivot angle, there will be intersection nail phenomenon, so, re-use and can exist " cat ear " when circular-pipe anastomat coincide, the most only the risk of fistula, and repeatedly to coincide when tumor is positioned at low level, perform the operation relatively costly.

Summary of the invention

It is an object of the invention to provide a kind of tissue closing device and there is the medical apparatus and instruments of this tissue closing device.

For achieving the above object, the invention provides a kind of tissue closing device, described tissue closing device includes relatively the first holder of opened/closed, the second holder, described first holder and described second holder to form receiving chamber after closing；Described tissue closing device also includes along described tissue closing device width spaced pocket assembly, closing assembly；Described pocket assembly, the firing position there is the initial position being positioned at described tissue closing device near-end, being positioned at described tissue closing device far-end, described pocket assembly is when initial position to firing position, and described pocket assembly will be located in accommodating the portion of tissue of intracavity and draws in the non-pocket tightening up state；Described closing assembly, the firing position there is the initial position being positioned at described tissue closing device near-end, being positioned at described tissue closing device far-end, described closing assembly is when initial position to firing position, and described closing assembly will be located in accommodating the portion of tissue of intracavity and draws and formed the pocket of Guan Bi in.

As a further improvement on the present invention, being respectively provided with on the clamping face that described first holder, described second holder are relative from the spaced some projections of proximate, described projection is provided with and runs through described projection and the needle tray connected with described receiving chamber from proximate；Projection on described first holder and described second holder shifts to install from proximate, and when described first holder and described second holder Guan Bi, the projection on described first holder and described second holder forms the clamping gap of undaform；Described pocket assembly has the first pedestal, a pair syringe needle being movably connected on described first pedestal, connects the purse wire of the near-end of syringe needle described in a pair, is fixed on described first holder and/or described second holder far-end and the connector coordinated with syringe needle described in a pair；The firing position that described pocket assembly has the initial position being positioned at described tissue closing device near-end, is positioned at described tissue closing device far-end, described pocket assembly is when initial position to firing position, and described syringe needle penetrates to be positioned at and accommodates the portion of tissue of intracavity and be connected with described connector.

As a further improvement on the present invention, described first holder and described second holder all include pod, the first grip block of being fixed in each described pod and coordinating with described pocket assembly, between described pod and described first grip block and from the passage of proximate extension；Have on described first grip block and arrange and connect described passage and some openings in described receiving chamber, described projection from proximate interval and be positioned at described opening and can be at described opening along be perpendicular to the direction of described grip block closer or far from described pod；Described tissue closing device also includes drivingly being moved gradually to drive the described projection on described first grip block towards deviating from the pushing block that the direction of described pod is moved from proximate in described passage, described pushing block is after far-end moves, and the projection being positioned at described pushing block near-end departs from described pushing block.

As a further improvement on the present invention, in described opening and described projection is provided with at least one orientation post, and another is provided with the guide slot matched with described orientation post；Described orientation post matches with described guide slot to guide described projection close or deviate from described pod to move.

As a further improvement on the present invention, described projection includes relative and spaced first wall and the second wall, connects described first wall and the connection wall of described second wall, and described first wall, the second wall and described connection wall enclose to set to be formed and face away from the needle tray that the side of described connection wall opens;Described connection wall is provided with at least one banking stop from the side outward of described connection wall, deviates from described banking stop when described pod moves at described projection and rides over the edge of described opening and play its effect continued to move to of restriction.

As a further improvement on the present invention, each described projection has proximally-located inclined plane, is positioned at the plane of described inclined plane far-end towards the side of described pod；Described pushing block has the planar portions being positioned at far-end and the inclined plane part coordinated with described inclined plane, being positioned at described inclined plane part near-end.

As a further improvement on the present invention, described planar portions width along proximate direction is more than described projection width along proximate direction.

As a further improvement on the present invention, described pocket assembly also includes being located on described first pedestal to fix a pair needle sleeve of a pair syringe needle, described needle sleeve both ends open and in hollow form, and each described needle hub has towards the cable tray that is open and that extend from proximate of needle hub another described.

As a further improvement on the present invention, the far-end of at least one described first grip block is provided with the first binding block that another described first grip block protrudes out；Described first binding block has along described first spaced a pair wall of grip block width, a pair wall is cooperatively provided with the insertion slot for described connector of planting, after described connector inserts in described insertion slot, in described connecting hole gap between a pair wall and described connecting hole is from the through described connector of proximate.

As a further improvement on the present invention, described first holder and described second holder all include pod, the second grip block coordinated with closing assembly in being fixed on each described pod；Described closing assembly includes the nail anvil can followed closely by the second pedestal drivingly moved from proximate at described receiving intracavity, Guan Bi, make described Guan Bi nail close, one in described Guan Bi nail and described nail anvil is arranged at described second pedestal far-end, and another is arranged at described first holder and/or the far-end of described second holder；The firing position that described closing assembly has the initial position being positioned at described tissue closing device near-end, is positioned at described tissue closing device far-end, when described pocket assembly is positioned at firing position, described Guan Bi nail draws in be positioned at and accommodates the portion of tissue of intracavity and form Guan Bi pocket.

As a further improvement on the present invention, the far-end of at least one described second grip block is provided with the second binding block that another described second grip block protrudes out, described second binding block includes the matrix that the second grip block from the second holder protrudes out, the ennation proximally extended towards one end of the first holder from matrix towards the first holder, and another described second grip block has the portion that steps down stepped down to described ennation；Described Guan Bi nail is fixed on described ennation, described matrix, has between described second grip block of described matrix, and described nail anvil is fixed on the far-end of described second pedestal.

As a further improvement on the present invention, described Guan Bi nail include the first nail foot with first nail foot parallel second nail foot, first nail foot and second nail foot between the 3rd nail foot, connect first nail foot and second nail foot and the 3rd nail foot connected nail foot；Described matrix is fixed on the second grip block of the second holder, and the second grip block of described first holder has the portion that steps down stepped down to described ennation；The second grip block opening of described second holder it is provided with to house the first accepting groove of described first nail foot on described ennation, described matrix is provided with the near-end opening connection accepting groove with the described connected nail foot of collecting, and the second grip block of described second holder is provided with ennation opening to house the second accepting groove of the second nail foot.

As a further improvement on the present invention, described tissue closing device also includes the first catch bar, the second catch bar being respectively used to promote described pocket assembly, closing assembly to move from proximate.

As a further improvement on the present invention, described tissue closing device is also included in near-end and connects described first pedestal and the base joint of the second pedestal, proximally acts on the catch bar that described base joint moves from proximate to drive described pocket assembly and described closing assembly.

As a further improvement on the present invention, described tissue closing device also includes that cutter, the far-end of described cutter are designed to blade；Described first holder and described second holder are respectively provided with the tool slot extended from proximate, and described pocket assembly, described closing assembly are divided into the both sides of described tool slot；When described cutter are in non-firing position, described blade is between described pocket assembly, described closing assembly；When described cutter are in firing position, described blade exceeds described pocket assembly, described closing assembly from proximate.

As a further improvement on the present invention, described cutter are I-shaped cutter, and described cutter include the first close out sheet, the second close out sheet, connect described first close out sheet and the cutting edge of described second close out sheet, and described blade is positioned at the far-end of described cutting edge；After described cutter assemble with described first holder and the second holder, described cutting edge is positioned at described tool slot, described first close out sheet is positioned at described first holder and deviates from the side of described second holder, and described second close out sheet is positioned at described second holder and deviates from the side of described first holder.

As a further improvement on the present invention, described tissue closing device also includes that the far-end being positioned at each described passage is to drive described pushing block towards deviating from the shell fragment that the direction of described pod is moved；Described tissue closing device also includes that cutter, the far-end of described cutter are designed to blade；Described cutter include being distally-oriented to, from described blade, the first push rod and described second push rod that far-end protrudes out, and described first push rod, described second push rod promote described pushing block to move from proximate in the passage of described first holder, the passage of described second holder.

As a further improvement on the present invention, described tissue closing device also includes the 3rd catch bar for promoting described cutter to move from proximate.

For achieving the above object, present invention also offers a kind of medical apparatus and instruments, the tissue closing device including instrument body, being removably attachable to described instrument body far-end, be connected in described instrument body fire the percussion lock of described tissue closing device.

The invention has the beneficial effects as follows: the tissue closing device of the present invention passes through pocket assembly and closing assembly and forms two pockets in the side of pathological tissues, in particular by closing assembly at one the Guan Bi pocket of a formation near pathological tissues, close pathological tissues end；By pocket assembly the tubular tissue of opposite side carried out threading but do not closes, until pathological tissues from natural passage take out external after, then carry out take-up and close and form pocket, it is simple to the operation of next step anastomosis.

Accompanying drawing explanation

Fig. 1 is the structural representation of the medical apparatus and instruments of the present invention one better embodiment.

Fig. 2 is the schematic diagram when the first holder and the second holder close of the tissue closing device shown in Fig. 1.

Fig. 3 is that the tissue closing device shown in Fig. 2 is in the schematic diagram of another angle.

Fig. 4 is that the tissue closing device shown in Fig. 3 is in the schematic diagram of another angle.

Fig. 5 is the Fig. 4 partial sectional view along B-B direction.

Fig. 6 is the Fig. 4 partial sectional view along D-D direction.

Fig. 7 is tissue closing device sectional view along the local, D-D direction shown in Fig. 4 during forming pocket.

Fig. 8 is the shown tissue closing device schematic diagram when the first holder and the second holder are opened.

Fig. 9 is that the tissue closing device shown in Fig. 8 is in the schematic diagram of another angle.

Figure 10 is the partial enlarged drawing of Fig. 8.

Figure 11 is the pocket assembly in one embodiment of the invention and the closing assembly schematic diagram when not forming pocket.

Figure 12 is the pocket assembly shown in Figure 11 and the closing assembly schematic diagram when forming pocket.

Figure 13 is the pocket assembly in one embodiment of the invention, closing assembly, cutter cooperation schematic diagram before formation pocket but tissue are not cut.

Figure 14 is the pocket assembly shown in Figure 13, closing assembly, cutter cooperation schematic diagram after cutting tissue.

Figure 15 is the schematic diagram of the pocket using the tissue closing device of the present invention to be formed.

Figure 16 is the pocket schematic diagram in another angle of Figure 15.

Detailed description of the invention

Describe the present invention below with reference to detailed description of the invention shown in the drawings.But these embodiments are not limiting as the present invention, structure, method or conversion functionally that those of ordinary skill in the art is made according to these embodiments are all contained in protection scope of the present invention.

Clearly to express position described in the present invention and direction, with exercises on apparatus author as reference, being near-end near one end of operator, the one end away from operator is far-end.

As shown in Figure 1, for the medical apparatus and instruments 100 of better embodiment of the present invention, the tissue closing device 2 including instrument body 1, being removably attachable to described instrument body 1 far-end, it is connected in described instrument body 1 fire the percussion lock 3 of described tissue closing device 2.It will be appreciated by persons skilled in the art that the concrete structure of described instrument body 1 and described percussion lock 3 does not limits, as long as described tissue closing device 2 can be fired ordinatedly；The most described instrument body 1 can be continued to use but be not limited to instrument body 1 mechanism of linear type or arc line shaped anastomat.

As shown in Fig. 2 ~ Figure 14, the tissue closing device 2 of better embodiment of the present invention is mainly used in human body tubular tissue 200 and excises the anastomosis of lesion portion, such as alimentary tract anastomosis operation；And the pathological tissues two ends of excision are all closed into pocket, may utilize the original natural passage of human body, such as anus simultaneously, use apparatus after pathological tissues is taken out, to carry out next step operation again.

Typical human body tubular tissue 200 includes but not limited to: blood vessel, including tremulous pulse and vein；Digestive tract, including esophagus, stomach, small intestinal, colon, rectum；Bile duct and pancreas；Urinary tract, including ureter, bladder and urethra；And fallopian tube etc..It is understood that described tissue closing device 2 can be used in same human body the tubular tissue 200 or the most of the same race human body tubular tissue 200 that coincide.Such as, during the mid portion generation pathological changes of colon, described tissue closing device 2 is for the two parts connecting colon that coincide, and the tubular track re-created is that colon itself is interior；And lesion portion is sigmoid colon, it is directly to rectum, and described tissue closing device 2 connects colon and rectum for coincideing, and the tubular track re-created is between rectum and colon.

On the whole, described tissue closing device 2 include being connected to described tissue closing device 2 described instrument body 1 transfer connector 21, can parts such as the first holder 22 of opened/closed and the second holder 23, cutter 24 of matching with described first holder 22 and described second holder 23 along described tissue closing device 2 width spaced pocket assembly 25 and closing assembly 26/ relatively.It will be appreciated by persons skilled in the art that miscellaneous part that each parts is not limited to describe with the present invention with the use of, it is possible to the miscellaneous part of exclusive list non-with the present invention with the use of.

After described transfer connector 21 is connected with described instrument body 1, the structure needing to control within described transfer part associates with percussion lock 3.

Described first holder 22 and described second holder 23 close back cover and form receiving chamber 27.Described first holder 22 can relative be opened with described second holder 23, enters in described receiving chamber 27 for human body tubular tissue 200；Described first holder 22 and described second holder 23 closing formation afterwards and accommodates chamber 27, this part human body tubular tissue 200 is i.e. held in described receiving chamber 27 by the first holder 22 and the second holder 23, to facilitate subsequent operation.It will be appreciated by persons skilled in the art that so-called subsequent operation includes but not limited to: make this part human body tubular tissue 200 form the boundling pocket that center is drawn in；Cutting human body tubular tissue 200 etc..

In the present embodiment, the near-end of described first holder 22 is pivotally connected with the near-end of described second holder 23, and the far-end of described first holder 22, the far-end of the second holder 23 are split type can to accommodate chamber 27 described in opened/closed；When the far-end of described first holder 22, the far-end of described second holder 23 separate, described first holder 22 and described second holder 23 are in approximation V-type opening.

Specifically, described first holder 22 and described second holder 23 all include the pod 28 of channel-shaped, in being fixed on each described pod 28 and along spaced first grip block 29, second grip block 20 of width of described pod 28.Described first grip block 29 and described second grip block 20 are in the same plane, and form the passage 2a extended from proximate between described first grip block 29 and/or described second grip block 20 and described pod 28.

Described first grip block 29 is identical with the connected mode of described second grip block 20 and described pod 28 with the connected mode of described pod 28, to illustrate as a example by the connected mode of described first grip block 29 and described pod 28 below: described first grip block 29 and described pod 28 can be split setting, in described pod 28 and described first grip block 29 is provided with some fixing posts (not shown), another is provided with and fixes groove (not shown) one to one with described fixing post.After described pod 28 is fixed together with described first grip block 29, described pod 28 is enclosed with described first grip block 29 to set and is formed the passage 2a extended from proximate direction.Certainly, described pod 28 can also be arranged in integral type with described first grip block 29.

The near-end of the pod 28 of described first holder 22 is provided with pivot (non-label), and the pod 28 of described second holder 23 is provided with the pivot hole (non-label) matched with described pivot near the position of near-end；When described pivot inserts in described pivot hole and described first holder 22 and described second holder 23 close, described first holder 22 and the far-end flush of described second holder 23, and the near-end of the pod 28 of described second holder 23 is beyond the near-end of the pod 28 of described first holder 22, assemble with other apparatus structures to facilitate.

Have from the spaced some projections 292 of proximate on described first grip block 29, some described projection 292 on described first grip block 29 is inline, and described projection 292 is provided with and runs through described projection 292 and the needle tray 293 connected with described receiving chamber 27 from proximate；Projection 292 on described first holder 22 and described second holder 23 shifts to install from proximate, and described first holder 22 and described second holder 23 are when closing, the projection 292 on described first holder 22 and described second holder 23 forms the clamping gap of undaform.

Further, described first grip block 29 has and arrange and connect described passage 2a and some openings 291 in described receiving chamber 27, described projection 292 from proximate interval and be positioned at described opening 291 and can be at described opening 291 closer or far from described pod 28.It will be appreciated by persons skilled in the art that spaced some openings 291 can be spaced some independent openings 291；Spaced some described openings 291 can also connect in a big opening 291 from proximate.

When described first holder 22 closes with described second holder 23, the first grip block 29 in described first holder 22 is parallel with the first grip block 29 in described second holder 23, and the projection 292 on described first holder 22 and described second holder 23 shifts to install from proximate.When described first holder 22 closes with described second holder 23, when not firing, due to the active force of tubular tissue 200, the some projections 292 on described first holder 22, described second holder 23 are partly hidden in the described passage 2a that described first holder 22, described second holder 23 and described grip block are formed respectively.Wherein, so-called parallel refer to almost parallel, not refer in particular to the parallel of proper two planes, such as, can be to form the distal jaw anti-jaw more than near-end jaw from the direction of proximate, to reduce percussion force.

In described opening 291 and described projection 292 one is provided with at least one orientation post 294, and another is provided with the guide slot 295 matched with described orientation post 294.Described orientation post 294 matches with described guide slot 295 to guide described projection 292 close or deviate from described pod 28 to move, it can be appreciated that described projection 292 near or when deviating from described pod 28, described orientation post 294 moves Sloped rotating during to prevent described projection 292 from moving in described guide slot 295.In the present embodiment, described projection 292 being provided with two guide slots 295 being oppositely arranged, described opening 291 inwall is provided with two orientation posts 294.

Specifically, described projection 292 includes relative and spaced first wall 2921 and the second wall 2922, connects described first wall 2921 and the connection wall 2923 of described second wall 2922, and described first wall the 2921, second wall 2922 and described connection wall 2923 enclose to set to be formed and face away from the class v type needle groove 293 that the side of described connection wall 2923 opens.

The near-end of the outside wall surface that described connection wall 2923 deviates from described needle tray 293 has inclined plane 2924, moves to facilitate the near-end described projection 292 of driving from described projection 292 to deviate from described pod 28.Further, the outside wall surface of described connection wall 2923 also has and is positioned at the plane 2925 of described inclined plane 2924 far-end, is positioned at described plane 2925 far-end and symmetrical inclined plane 2926 symmetrically arranged with described inclined plane 2924, thus described projection 292 proximally and distally can exchange installation, and whether exchange installation and can realize proximally driving described projection 292 to deviate from described pod 28 and move.Certainly, described inclined plane 2924, described plane 2925 and described symmetrical inclined plane 2926 can also be to be collectively forming a cambered surface, reach same effect.

Described connection wall 2923 is provided with at least one banking stop 2927 from the side outward of described connection wall 2923, deviate from described banking stop 2927 when described pod 28 moves at described projection 292 to ride over the edge of described opening 291 and play its effect continued to move to of restriction so that the outside wall surface of described connection wall 2923 is always positioned in described passage 2a.In the present embodiment, described connection wall 2923 has far-end banking stop 2927b, the near-end banking stop 2927a extended respectively from far-end, near-end to two ends, when described projection 292 deviate from described pod 28 move time, described far-end banking stop 2927b, near-end banking stop 2927a ride over the edge of described opening 291 and play its effect continued to move to of restriction.

Additionally, described pod 28 is provided with to house and the stopper slot (not shown) of outside wall surface of spacing described connection wall 2923, when described projection 292 moves towards described pod 28, described stopper slot is supported described connection wall 2923 and is played and limit its effect continued to move to so that described first wall 2921 and the second wall 2922 deviate from one end of described connection wall 2923 and be always positioned in described receiving chamber 27.When described projection 292 is near described pod 28, described far-end banking stop 2927b, near-end banking stop 2927a are positioned at outside described stopper slot.

Described first wall 2921 deviates from the outside wall surface of described needle tray 293 and described second wall 2922 deviates from and is equipped with at least one guide slot 295 in the outside wall surface of described needle tray 293, has the orientation post 294 matched with described guide slot 295 in described opening 291；When described projection 292 is close or deviates from described pod 28, described orientation post 294 moves in described guide slot 295, to ensure that described projection 292 moves along the direction being perpendicular to described grip block, prevents projection 292 run-off the straight when mobile.

Further, described tissue closing device 2 also includes to be moved, from proximate, the pushing block 2b that gradually drives the some described projection 292 on described grip block to move towards the direction deviating from described pod 28 in drivingly described passage 2a between the first grip block 29 and described pod 28.Described pushing block 2b is after far-end moves, and the projection 292 being positioned at described pushing block 2b near-end departs from described pushing block 2b and can be returned to passage 2a by tissue, moves from proximate for other mechanisms conceding receiving chamber 27.

Specifically, described projection 292 has proximally-located inclined plane 2924, is positioned at the plane 2925 of described inclined plane 2924 far-end towards the side of described pod 28；Described pushing block 2b has planar portions 2b2 being positioned at far-end and the inclined plane part 2b1 coordinated with described inclined plane 2924, being positioned at described inclined plane part 2b1 near-end；When described pushing block 2b moves from proximate in described passage 2a, described inclined plane part 2b1 acts on described inclined plane 2924 and moves and support with described planar portions 2b2 to described plane 2925 driving described projection 292 to deviate from described pod 28, and the most described banking stop 2927 is overlapped on the edge of described opening 291.In the present embodiment, described planar portions 2b2 is designed to along the length of proximate bearing of trend, it is positioned at planar portions 2b2 of pushing block 2b of described first holder 22 when supporting with plane 2925 phase of one of them projection 292, be positioned at described second holder 23 pushing block 2b planar portions 2b2 also simultaneously plane 2925 phase with one of them projection 292 support, and these two projections 292 are adjacent.

Further, described planar portions 2b2 is at the width on proximate direction, it is greater than described projection 292 at near-end width on distal direction, make when percussion, can ensure that there is projection 292 described at least two by jack-up on each described first grip block 29 simultaneously, and with being collectively forming corrugated tissue folder by the described projection 292 of jack-up and close face, so that through needle tray 293 passage 2a can be formed in ensureing the tissue clamped by described projection 292 under the effect of pushing block 2b in opposite directions；And when pushing block 2b continues distal movement, it is positioned at the projection 292 of described pushing block 2b near-end owing to losing the effect of described pushing block 2b and return, do not hinder other mechanism's distal movement.

Further, described tissue closing device 2 also includes that the far-end being positioned at described passage 2a is to drive described pushing block 2b towards deviating from the shell fragment 2c that the direction of described pod 28 is moved.Specifically, described shell fragment 2c is positioned at the far-end of all described projection 292 on described first grip block 29, after described pushing block 2b promotes all described projections 292 to move away from described holder, described shell fragment 2c drives described pushing block 2b to move towards the direction deviating from described pod 28, such that it is able to concede passage 2a, it is simple to the operation of other apparatuses.

Further, the far-end of at least one described first grip block 29 is provided with the first binding block 296 that another described first grip block 29 protrudes out, in order to support the first holder 22 and the second holder 23 of Guan Bi, the tubular tissue 200 being simultaneously also possible to prevent to be held between two the first grip blocks 29 overflows.The far-end of at least one described second grip block 20 is provided with the second binding block 201 that another described second grip block 20 protrudes out, in order to support the first holder 22 and the second holder 23 of Guan Bi, the tubular tissue 200 being simultaneously also possible to prevent to be held between two the second grip blocks 20 overflows.

Specifically, the far-end of first grip block the 29, second grip block 20 of described first holder 22 is provided with first binding block the 296, second binding block 201 that described second holder 23 protrudes out respectively, when first holder 22 and the second holder 23 close, described first binding block 296, described second binding block 201 are held in respectively on first grip block the 29, second grip block 20 of described second holder 23 and close described receiving chamber 27, prevent tubular tissue 200 from overflowing simultaneously.In other embodiments, described first binding block the 296, second binding block 201 can also be respectively arranged at the far-end of first grip block the 29, second grip block 20 of described second holder 23.Or, described first binding block 296 includes the two parts being divided on the first grip block 29 described in a pair, and when the first holder 22 and the second holder 23 close, these two parts support to close the described receiving chamber 27 between a pair first grip blocks 29 in opposite directions.Described first binding block 296 includes the two parts being divided on the second grip block 20 described in a pair, and when the first holder 22 and the second holder 23 close, these two parts support to close the described receiving chamber 27 between a pair second grip blocks 20 in opposite directions.

When described first holder the 22, second holder 23 is opened, human body tubular tissue 200 can enter in described receiving chamber 27 from V-type opening；By apparatus or manually make described first holder 22 and described second holder 23 close in opposite directions, until described first binding block 296, described second binding block 201 close described receiving chamber 27, play both restrictions and continue the effect of Guan Bi, prevent human body tubular tissue 200 to excessive simultaneously.

Additionally, described first holder 22 and described second holder 23 the most also have the tool slot 2d run through along described first holder 22 to described second holder 23 direction, and described tool slot 2d extends from proximate, described first grip block 29, described second grip block 20 are divided into the both sides of described tool slot 2d.

It is different from above-described embodiment, the first grip block 29 can also be not provided with in described first holder 22, described second holder 23, being respectively provided with on the clamping face that the most described first holder 22, described second holder 23 are relative from the spaced some projections 292 of proximate, described projection 292 is provided with and runs through described projection 292 and the needle tray 293 connected with described receiving chamber 27 from proximate；Projection 292 on described first holder 22 and described second holder 23 shifts to install from proximate, and when described first holder 22 and described second holder 23 close, the projection on described first holder 22 and described second holder 23 forms the clamping gap of undaform.

Described tissue closing device 2 also includes pocket assembly 25, the closing assembly 26 matched respectively with a pair first grip blocks 29, a pair second grip blocks 20, forms two pockets with side at the tubular tissue 200 with pathological changes simultaneously；Therefore when cutting human body tubular tissue 200 between these two pockets, closedown is tightened by pocket in the end of the tubular tissue 200 with pathological changes, it is difficult to disengage, it is simple to follow-up taking-up is external.

The firing position that described pocket assembly 25 has the initial position being positioned at described tissue closing device 100 near-end, is positioned at described tissue closing device 100 far-end, described pocket assembly 25 is when initial position to firing position, and the portion of tissue 200 that described pocket assembly 25 will be located in accommodating in chamber 27 is drawn in the non-pocket tightening up state.

Described pocket assembly 25 includes a pair needle sleeve 252 that by the first pedestal 251 drivingly moved from proximate, can be positioned at the first pedestal 251 far-end, the syringe needle 253 being movably connected on each described sleeve pipe, connects the purse wire 255 of the near-end of syringe needle 253 described in a pair and be fixed on described first holder 22 and/or described second holder 23 far-end and the connector 254 coordinated with syringe needle described in a pair 253, and described connector 254 has to house the connecting hole 2541 of each described syringe needle 253.After described syringe needle 253 is connected with described connector 254, described syringe needle 253 is carried out spacing in the axial direction of described pocket assembly 25 by described connecting hole 2541.

In the present embodiment, described first binding block 296 has along described first spaced a pair wall 2961 of grip block 29 width, a pair wall 2961 be cooperatively provided with towards the gap open in the middle of a pair wall 2961 for described connector 254 insertion slot (non-label) of planting.Described connector 254 inserts after in described insertion slot, in the described connecting hole 2541 gap between a pair wall 2961 and described connecting hole 2541 is from the through described connector 254 of proximate.

Described connector 254 is fixed on described first binding block 296, and described in a pair, connecting hole 2541 is corresponding with syringe needle described in a pair 253.And when described first binding block 296 includes being respectively arranged at the two parts on the first grip block 29 described in a pair, described connector 254 can also include the two parts being respectively arranged on two the first binding blocks 296, these two parts are fixed by modes such as latches.

Described needle sleeve 252 both ends open and in hollow form, and each described needle sleeve 252 has towards needle sleeve another described 252 cable tray 2521 that is open and that extend from proximate, when described syringe needle 253 moves from proximate in described needle sleeve 252, described purse wire 255 is moved out described needle sleeve 252 from proximate in described cable tray 2521.

The far-end of described syringe needle 253 has and radially-inwardly caves in the some ring for fixings 2531 matched with described connecting hole 2541 along described syringe needle 253, and some described ring for fixings 2531 are proximally spaced setting from far-end.Described connecting hole 2541 is for having resilient through hole, when described syringe needle 253 far-end protrudes in described connecting hole 2541, described springhole is variable greatly, and when described connecting hole 2541 is positioned at the position that described medicated pillow is provided with described ring for fixing 2531, described springhole shrinks and is stuck at described ring for fixing 2531, described syringe needle 253 far-end is stably connected with described connector 254, be easy to follow-up when described tissue closing device 2 from firing position be converted to percussion complete position time, described syringe needle 253 separates with described needle sleeve 252, can be with Manual tightening pocket.

nullDrive described first pedestal 251 when proximate moves，Gradually drive the projection 292 of described first holder 22 from proximate simultaneously、The projection 292 of described second holder 23 moves and compresses human body tubular tissue 200 within accommodating chamber 27，Syringe needle 253 described in a pair is respectively at the needle tray 293 of projection 292 of described first holder 22、Move and thrust human body tubular tissue 200 in the needle tray 293 of the projection 292 of described second holder 23，Human body tubular tissue 200 is gradually pushed to far-end draw in，To the connecting hole 2541 of the far-end described connector 254 of insertion of syringe needle described in a pair 253，The human body tubular tissue 200 made to be placed in described in a pair between first grip block 29 is arranged on purse wire 255，After syringe needle 253 separates with described needle sleeve 252，Tighten up purse wire 255 again and form the boundling pocket that center is drawn in.

The firing position that described closing assembly 26 has the initial position being positioned at described tissue closing device 100 near-end, is positioned at described tissue closing device 100 far-end, described closing assembly 26 is when initial position to firing position, and described closing assembly 26 will be located in accommodating the portion of tissue 200 in chamber 27 and draws and formed the pocket of Guan Bi in.

Described closing assembly 26 includes the nail anvil 262 that by the second pedestal 261 drivingly moved from proximate, can be positioned at described second pedestal 261 far-end, is fixed on described first holder 22 and/or described second holder 23 far-end and the Guan Bi nail 263 coordinated with described nail anvil 262.

Described Guan Bi nail 263 in class " mountain " font, including the first nail foot 2,631 second nail foot 2633 parallel with the first nail foot 2631, the 3rd nail foot 2632 between the first nail foot 2631 and the second nail foot 2633, connecting the first nail foot 2631 and the second nail foot 2633 and connected nail foot 2634 of the 3rd nail foot 2632, the length of described first nail foot 2631 and described second nail foot 2633 is more than the length of described 3rd nail foot 2632.First nail foot 2631, second follows closely foot 2633 and connected nail foot 2634 surrounds the gathering chamber 2635 for drawing human body tubular tissue 200 in, and described 3rd nail foot 2632 protrudes in described gathering chamber 2635 from connected nail foot 2634.

Correspondingly, described nail anvil 262 has follows closely a pair nail forming tank 2621 that foot 2633 matches respectively with the first nail foot 2631, second, when described first pedestal 251 moves from proximate, the first nail foot 2631 and the second nail foot 2633 in opposite directions and bend away from one end of described connected nail foot 2634 towards described 3rd nail foot 2632 in described nail forming tank 2621 and make described Guan Bi nail 263 formation B fonts be closed at described gathering chamber 2635.

In the present embodiment, described second binding block 201 includes the matrix 2011 that the second grip block 20 from the second holder 23 protrudes out, the ennation 2012 proximally extended towards one end of the first holder 22 from matrix 2011 towards the first holder 22, and the second grip block 20 of described first holder 22 has the portion that steps down (non-label) stepped down to described ennation 2012.The second grip block 20 being provided with described second holder 23 on described ennation 2012 is open to house the first accepting groove of described first nail foot 2631, described matrix 2011 is provided with the near-end opening connection accepting groove with the described connected nail foot 2634 of collecting, and it is open to house the second accepting groove of the second nail foot 2633 that the second grip block 20 of described second holder 23 is provided with ennation 2012.

After described Guan Bi nail 263 is assemblied on described second grip block 20, described first nail foot 2631 is contained in described first accepting groove, and described second nail foot 2633 is contained in described second accepting groove；Thus when described first holder 22 and described second holder 23 close, described first nail foot 2631 and described second nail foot 2633 do not protrude in described receiving chamber 27, and described gathering chamber 2635 connects with described receiving chamber 27.

Drive described second pedestal 261 to move to the first nail foot 2631 and the second nail foot 2633 from proximate to be all resisted against in described nail forming tank 2621 internal procedure, described nail anvil 262 gradually will be located in the human body tubular tissue 200 between a pair second grip blocks 20 and pushes far-end gathering to, and the most described 3rd nail foot 2632 penetrates human body tubular tissue 200 inside from far-end in making this part tubular tissue 200 be all introduced into described gathering chamber 2635, and the first nail foot 2631 and the second nail foot 2633 will not penetrate in tissue.

261 continuation of described second pedestal are moved to far-end, and described first nail foot 2631 and the second nail foot 2633 bending make Guan Bi nail 263 formation B font, form the pocket of a Guan Bi on tubular tissue 200 simultaneously.Owing to nail anvil 262 described during this simply promotes human body tubular tissue 200 to move to far-end, the percussion force of needs is little；Make described Guan Bi nail 263 formation B font in described tubular tissue 200 all being pushed described gathering chamber 2635 again, so that human body tubular tissue 200 is entirely located in described Guan Bi nail 263, without the risk of fistula simultaneously；And described 3rd nail foot 2632 thrusts tubular tissue 200, it is possible to prevent Guan Bi nail 263 axially to come off along it with tubular tissue 200.

Certainly, in other embodiments, it is also possible to described Guan Bi nail 263 is arranged on described second pedestal 261, described nail anvil 262 is arranged at described first holder 22 and/or the far-end of the second holder 23, and structurally does adaptation.Driving described second pedestal 261 when proximate moves, tissue progresses into the 3rd Guan Bi nail 263 described in the inscribe of gathering chamber 2635 and penetrates tissue, and final Guan Bi nail 263 and nail anvil 262 cooperatively form the pocket of a Guan Bi.

Further, described first pedestal 251 and described second pedestal 261 connect into an entirety by base joint 256, such that it is able to move from proximate while of firing described first pedestal 251 and described second pedestal 261 by a catch bar.

Additionally, have towards the gap being located along the same line with described tool slot 2d between described first pedestal 251 and described second pedestal 261, described needle sleeve 252 is positioned at described first pedestal 251 and deviates from the side of described second pedestal 261, and described nail anvil 262 is positioned at described second pedestal 261 and deviates from the side of described first pedestal 251.

Further, in order to cut human body tubular tissue 200 after while forming pocket or forming pocket, described tissue closing device 100 also includes that cutter 24, the far-end of described cutter 24 are designed to blade.When described cutting edge 243 is in non-firing position, described blade is positioned at the gap of described first pedestal the 251, second pedestal 261；At Guan Bi nail 263 formation B font, and after a pair syringe needle 253 is connected with described connector 254, when described cutter 24 continue move to far-end and be in firing position, described cutting edge 243 moves to far-end in described gap, described blade forms two pockets from proximate beyond described first pedestal the 251, second pedestal 261, cutting tissue.

In the present embodiment, described cutter 24 are I-shaped cutter, can simultaneously work as closing described first holder 22 and the effect of the second holder 23.Specifically, described cutter 24 include first close out sheet the 241, second close out sheet 242, connect described first close out sheet 241 and the cutting edge 243 of described second close out sheet 242, and described blade is positioned at the far-end of described cutting edge 243.Described first close out sheet 241 and described second close out sheet 242 protrude out towards both sides or side from the two ends that described cutting edge 243 is opposing, and described cutter 24 are in " work " font or in " [" type.After described cutter 24 assemble with described first holder 22 and the second holder 23, described cutting edge 243 is positioned at described tool slot 2d, described first close out sheet 241 is positioned at described first holder 22 and deviates from the side of described second holder 23, and described second close out sheet 242 is positioned at described second holder 23 and deviates from the side of described first holder 22.

Owing to described first holder 22 is shorter than described second holder 23, when described second close out sheet 242 is positioned at the described pivot hole on described second holder 23 near the side of near-end, described first close out sheet 241 is positioned at the side that described first holder 22 is proximally facing, the most described first holder 22 and described second holder 23 and can open.By apparatus or manually promote described cutter 24 when proximate moves, described cutting edge 243 is positioned at described tool slot 2d, and described first close out sheet 241, described second close out sheet 242 are respectively acting on first holder the 22, second holder 23 can close described receiving chamber 27.

Further, described cutter 24 also include the far-end being positioned at described cutting edge 243 and the first push rod 244 protruded out towards distal direction and described second push rod 245.When, after described cutter 24 with described first holder 22 and the assembling of the second holder 23, described first push rod 244, described second push rod 245 protrude into the passage 2a of described first holder 22, the passage 2a of described second holder 23 respectively；Thus when described cutter 24 move from proximate, described first push rod 244, described second push rod 245 drive the pushing block 2b in the pushing block 2b of described first holder 22, described second holder 23 to move from proximate respectively.

Further, described tissue closing device 2 also includes being positioned at the first catch bar that transfer connector 21 moves from proximate, the second catch bar, the 3rd catch bar 211 for promoting described pocket assembly 25, closing assembly 26, cutter 24, and described first catch bar, the second catch bar, the 3rd catch bar 211 are connected with percussion lock 3.Connect in an overall embodiment at described first pedestal 251 and described second pedestal 261 by base joint 256, described first catch bar and the second catch bar can be a catch bar 212 can also be two catch bars 212, it is preferred to use a catch bar 212 also acts on described base joint 256.

The use process of the medical apparatus and instruments 100 of the present invention is: instrument body 1, percussion lock 3, tissue closing device 2 are assembled, before not firing, described cutter 24, described pocket assembly 25, closing assembly 26 are respectively positioned on initial position, and the most described first holder 22 and described second holder 23 can be opened.

Described first holder 22 separates with the far-end of described second holder 23, and the part tubular tissue 200 that will be located in pathological tissues side is inserted in described receiving chamber 27, and described closing assembly 26 compares described pocket assembly 25 closer to pathological tissues；Being moved from proximate by apparatus or the described cutter 24 of manual promotion, described first close out sheet 241, described second close out sheet 242 are respectively acting on first holder the 22, second holder 23 can close described receiving chamber 27.Now, tubular tissue 200 acts on described projection 292 and described projection 292 is all moved towards described pod 28, thus less power can close described tissue closing device 2.

Described cutter 24 are driven to move from proximate by the 3rd catch bar 211, described first push rod 244, described second push rod 245 promote the pushing block 2b in the passage 2a of described first holder 22, described second holder 23 to move from proximate respectively, described pushing block 2b gradually drives from proximate described projection 292 to deviate from described pod 28 and moves, and described projection 292 acts on human body tubular tissue 200 makes it be undaform.

Meanwhile, promote base joint 256 that first pedestal 251 and the second pedestal 261 are moved from proximate by catch bar 212.First pedestal 251 in proximate moving process, syringe needle 253 described in a pair respectively described first holder 22, the projection 292 of described second holder 23 needle tray 293 in move with the mucous layer of penetrating tubular tissue 200 by phased manner；Promote tubular tissue 200 to move to far-end, until a pair syringe needle 253 is connected with connector 254 simultaneously；When described pushing block 2b continues to move to far-end, form corrugated described projection 292 owing to losing the support of described pushing block 2b before, and return back to again under the pressure of tissue in the passage 2a that described first grip block 29 and described first holder 22 or described second holder 23 are formed, and do not hinder other mechanisms to continue distal movement.The most described nail anvil 262 promotes tubular tissue 200 to move to far-end and all draws in described gathering chamber 2635, is bent to form B font to Guan Bi nail 263, forms the pocket of Guan Bi in nail forming tank 2621.

Treat that syringe needle 253 is connected through human body tubular tissue 200 to a pair syringe needle 253 accommodated in chamber 27 with described connector 254, and described Guan Bi nail 263 formation B fonts after, described shell fragment 2c promotes described pushing block 2b to move towards the direction deviating from described pod 28 and steps down to described first push rod 244 and described second push rod 245, described 3rd catch bar 211 continues to press on described cutter 24 and moves to far-end, and described tubular tissue 200 is cut off between two pockets by described blade；Return pocket assembly 25, closing assembly 26 cutter 24, forming the pocket of a Guan Bi near the side of pathological tissues, the port of pathological tissues can be closed；Concurrently forming a threading but not fully closed pocket, the state of two pockets is as shown in Figure 15 ~ Figure 16.

Opposite side at pathological tissues implements above-mentioned steps, thus forms another threading but not closed pocket, and the two ends of pathological tissues are all closed；Pathological tissues, after natural passage taking-up is external, can manually be strained purse wire 255, form the boundling pocket that a center is drawn in, it is simple to follow-up anastomosis operation.When it will be appreciated by persons skilled in the art that the tissue connecting two sections of detachments for example with circular-pipe anastomat, pipe anastomat can be inserted in not closed pocket, then the purse wire 255 that manually furthers.

In sum, the tissue closing device 2 of the present invention forms two pockets by pocket assembly 25 and closing assembly 26 in the side of pathological tissues, in particular by closing assembly 26 at one the Guan Bi pocket of a formation near pathological tissues, closes pathological tissues end；By pocket assembly 25 tubular tissue 200 of opposite side carried out threading but do not closes, until pathological tissues from natural passage take out external after, then carry out take-up and close and form pocket, it is simple to the operation of next step anastomosis.

It is to be understood that, although this specification is been described by according to embodiment, but the most each embodiment only comprises an independent technical scheme, this narrating mode of description is only for clarity sake, those skilled in the art should be using description as an entirety, technical scheme in each embodiment can also form, through appropriately combined, other embodiments that it will be appreciated by those skilled in the art that.

The a series of detailed description of those listed above is only for illustrating of the feasibility embodiment of the present invention; they also are not used to limit the scope of the invention, and all equivalent implementations or changes made without departing from skill of the present invention spirit should be included within the scope of the present invention.

Claims (19)

1. a tissue closing device, described tissue closing device includes relatively the first holder of opened/closed, the second holder, described first holder and described second holder to form receiving chamber after closing；It is characterized in that, described tissue closing device also includes along described tissue closing device width spaced pocket assembly, closing assembly；

Described pocket assembly, the firing position there is the initial position being positioned at described tissue closing device near-end, being positioned at described tissue closing device far-end, described pocket assembly is when initial position to firing position, and described pocket assembly will be located in accommodating the portion of tissue of intracavity and draws in the non-pocket tightening up state；

Described closing assembly, the firing position there is the initial position being positioned at described tissue closing device near-end, being positioned at described tissue closing device far-end, described closing assembly is when initial position to firing position, and described closing assembly will be located in accommodating the portion of tissue of intracavity and draws and formed the pocket of Guan Bi in.

Tissue closing device the most according to claim 1, it is characterized in that: be respectively provided with from the spaced some projections of proximate on the clamping face that described first holder, described second holder are relative, described projection is provided with and runs through described projection and the needle tray connected with described receiving chamber from proximate；Projection on described first holder and described second holder shifts to install from proximate, and when described first holder and described second holder Guan Bi, the projection on described first holder and described second holder forms the clamping gap of undaform；

Described pocket assembly has the first pedestal, a pair syringe needle being movably connected on described first pedestal, connects the purse wire of the near-end of syringe needle described in a pair, is fixed on described first holder and/or described second holder far-end and the connector coordinated with syringe needle described in a pair；The firing position that described pocket assembly has the initial position being positioned at described tissue closing device near-end, is positioned at described tissue closing device far-end, described pocket assembly is when initial position to firing position, and described syringe needle penetrates to be positioned at and accommodates the portion of tissue of intracavity and be connected with described connector.

Tissue closing device the most according to claim 2, it is characterized in that: described first holder and described second holder all include pod, the first grip block of being fixed in each described pod and coordinating with described pocket assembly, between described pod and described first grip block and from the passage of proximate extension；Have on described first grip block and arrange and connect described passage and some openings in described receiving chamber, described projection from proximate interval and be positioned at described opening and can be at described opening along be perpendicular to the direction of described grip block closer or far from described pod；Described tissue closing device also includes drivingly being moved gradually to drive the described projection on described first grip block towards deviating from the pushing block that the direction of described pod is moved from proximate in described passage, described pushing block is after far-end moves, and the projection being positioned at described pushing block near-end departs from described pushing block.

Tissue closing device the most according to claim 3, it is characterised in that: in described opening and described projection is provided with at least one orientation post, and another is provided with the guide slot matched with described orientation post；Described orientation post matches with described guide slot to guide described projection close or deviate from described pod to move.

Tissue closing device the most according to claim 3, it is characterized in that: described projection includes relative and spaced first wall and the second wall, connects described first wall and the connection wall of described second wall, described first wall, the second wall and described connection wall enclose to set to be formed and face away from the needle tray that the side of described connection wall opens;Described connection wall is provided with at least one banking stop from the side outward of described connection wall, deviates from described banking stop when described pod moves at described projection and rides over the edge of described opening and play its effect continued to move to of restriction.

Tissue closing device the most according to claim 3, it is characterised in that: each described projection has proximally-located inclined plane, is positioned at the plane of described inclined plane far-end towards the side of described pod；Described pushing block has the planar portions being positioned at far-end and the inclined plane part coordinated with described inclined plane, being positioned at described inclined plane part near-end.

Tissue closing device the most according to claim 6, it is characterised in that: described planar portions width along proximate direction is more than described projection width along proximate direction.

Tissue closing device the most according to claim 1, it is characterized in that: described pocket assembly also includes being located on described first pedestal to fix a pair needle sleeve of a pair syringe needle, described needle sleeve both ends open and in hollow form, and each described needle hub has towards the cable tray that is open and that extend from proximate of needle hub another described.

Tissue closing device the most according to claim 2, it is characterised in that: the far-end of at least one described first grip block is provided with the first binding block that another described first grip block protrudes out；Described first binding block has along described first spaced a pair wall of grip block width, a pair wall is cooperatively provided with the insertion slot for described connector of planting, after described connector inserts in described insertion slot, in described connecting hole gap between a pair wall and described connecting hole is from the through described connector of proximate.

Tissue closing device the most according to claim 1, it is characterised in that: described first holder and described second holder all include pod, the second grip block coordinated with closing assembly in being fixed on each described pod；Described closing assembly includes the nail anvil can followed closely by the second pedestal drivingly moved from proximate at described receiving intracavity, Guan Bi, make described Guan Bi nail close, one in described Guan Bi nail and described nail anvil is arranged at described second pedestal far-end, and another is arranged at described first holder and/or the far-end of described second holder；The firing position that described closing assembly has the initial position being positioned at described tissue closing device near-end, is positioned at described tissue closing device far-end, when described pocket assembly is positioned at firing position, described Guan Bi nail draws in be positioned at and accommodates the portion of tissue of intracavity and form Guan Bi pocket.

11. tissue closing devices according to claim 10, it is characterized in that: the far-end of at least one described second grip block is provided with the second binding block that another described second grip block protrudes out, described second binding block includes the matrix that the second grip block from the second holder protrudes out, the ennation proximally extended towards one end of the first holder from matrix towards the first holder, and another described second grip block has the portion that steps down stepped down to described ennation；Described Guan Bi nail is fixed on described ennation, described matrix, has between described second grip block of described matrix, and described nail anvil is fixed on the far-end of described second pedestal.

12. tissue closing devices according to claim 11, it is characterised in that: described Guan Bi nail include the first nail foot with first nail foot parallel second nail foot, first nail foot and second nail foot between the 3rd nail foot, connect first nail foot and second nail foot and the 3rd nail foot connected nail foot；Described matrix is fixed on the second grip block of the second holder, and the second grip block of described first holder has the portion that steps down stepped down to described ennation；The second grip block opening of described second holder it is provided with to house the first accepting groove of described first nail foot on described ennation, described matrix is provided with the near-end opening connection accepting groove with the described connected nail foot of collecting, and the second grip block of described second holder is provided with ennation opening to house the second accepting groove of the second nail foot.

13. tissue closing devices according to claim 1, it is characterised in that: described tissue closing device also includes the first catch bar, the second catch bar being respectively used to promote described pocket assembly, closing assembly to move from proximate.

14. tissue closing devices according to claim 1, it is characterised in that: described tissue closing device is also included in near-end and connects described first pedestal and the base joint of the second pedestal, proximally acts on the catch bar that described base joint moves from proximate to drive described pocket assembly and described closing assembly.

15. tissue closing devices according to claim 1, it is characterised in that: described tissue closing device also includes that cutter, the far-end of described cutter are designed to blade；Described first holder and described second holder are respectively provided with the tool slot extended from proximate, and described pocket assembly, described closing assembly are divided into the both sides of described tool slot；When described cutter are in non-firing position, described blade is between described pocket assembly, described closing assembly；When described cutter are in firing position, described blade exceeds described pocket assembly, described closing assembly from proximate.

16. tissue closing devices according to claim 15, it is characterized in that: described cutter are I-shaped cutter, described cutter include the first close out sheet, the second close out sheet, connect described first close out sheet and the cutting edge of described second close out sheet, and described blade is positioned at the far-end of described cutting edge；After described cutter assemble with described first holder and the second holder, described cutting edge is positioned at described tool slot, described first close out sheet is positioned at described first holder and deviates from the side of described second holder, and described second close out sheet is positioned at described second holder and deviates from the side of described first holder.

17. tissue closing devices according to claim 3, it is characterised in that: described tissue closing device also includes that the far-end being positioned at each described passage is to drive described pushing block towards deviating from the shell fragment that the direction of described pod is moved；Described tissue closing device also includes that cutter, the far-end of described cutter are designed to blade；Described cutter include being distally-oriented to, from described blade, the first push rod and described second push rod that far-end protrudes out, and described first push rod, described second push rod promote described pushing block to move from proximate in the passage of described first holder, the passage of described second holder.

18. according to the tissue closing device described in any one in claim 15 ~ 17, it is characterised in that: described tissue closing device also includes the 3rd catch bar for promoting described cutter to move from proximate.

19. 1 kinds of medical apparatus and instruments, the tissue closing device that including instrument body, is removably attachable to described instrument body far-end, it is connected in described instrument body fire the percussion lock of described tissue closing device, it is characterised in that: described tissue closing device is the tissue closing device in claim 1 ~ 18 described in any one.