CN106236174B - Magnetic anastomat suitable for celioscope liner-intestine anastomosis - Google Patents
Magnetic anastomat suitable for celioscope liner-intestine anastomosis Download PDFInfo
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- CN106236174B CN106236174B CN201610711585.7A CN201610711585A CN106236174B CN 106236174 B CN106236174 B CN 106236174B CN 201610711585 A CN201610711585 A CN 201610711585A CN 106236174 B CN106236174 B CN 106236174B
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- 230000003872 anastomosis Effects 0.000 title claims abstract description 79
- 239000002184 metal Substances 0.000 claims description 25
- 230000000149 penetrating effect Effects 0.000 claims description 5
- 230000003068 static effect Effects 0.000 claims description 3
- 230000005389 magnetism Effects 0.000 claims 2
- 238000001125 extrusion Methods 0.000 claims 1
- 230000003886 intestinal anastomosis Effects 0.000 claims 1
- 238000005516 engineering process Methods 0.000 abstract description 12
- 230000008901 benefit Effects 0.000 abstract description 5
- 238000000034 method Methods 0.000 description 11
- 210000000013 bile duct Anatomy 0.000 description 8
- 230000000968 intestinal effect Effects 0.000 description 7
- 238000010586 diagram Methods 0.000 description 6
- 208000031481 Pathologic Constriction Diseases 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 2
- 210000003445 biliary tract Anatomy 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 210000000813 small intestine Anatomy 0.000 description 2
- 230000036262 stenosis Effects 0.000 description 2
- 208000037804 stenosis Diseases 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 230000003187 abdominal effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000000232 gallbladder Anatomy 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 210000004185 liver Anatomy 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 230000008855 peristalsis Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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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
- A61B2017/00831—Material properties
- A61B2017/00876—Material properties magnetic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1142—Purse-string sutures
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Abstract
The invention discloses a magnetic anastomat suitable for laparoscopic liner-intestine anastomosis, which comprises a magnetic anastomat body, wherein the magnetic anastomat body comprises a magnetic anastomat head and an anastomat matched with the magnetic anastomat head for use; the magnetic anastomosis head can be replaced and used; the anastomat can be reused; the magnetic anastomosis head comprises a first magnetic ring body and a second magnetic ring body; the anastomat comprises an operating handle, an anastomat rod, a magnetic ring releasing device, an anastomat rod steering adjusting device and a thread adjusting device. The invention provides a magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis, which combines the minimally invasive characteristic of the laparoscopic technology with the advantages of the magnetic squeezing anastomosis technology, and can realize the laparoscopic biliary-intestinal anastomosis with high speed, safety and no foreign matter residue at an anastomotic site.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis.
Background
In many operations of hepatobiliary surgery, it is important to perform anastomosis between the bile duct and the small intestine to restore the continuity of the digestive tract. The size of the abdominal incision brings different psychological stress to the patient and affects patient recovery and quality of life. The laparoscopic technique is a minimally invasive surgery technique, which avoids the defect of large incision in the traditional liver and gall surgery and meets the aesthetic requirement. However, the traditional method (i.e. suture) is still adopted for performing the biliary-intestinal anastomosis under the laparoscope at present, so that the surgical operation is a very difficult operation, and the complications such as anastomotic stoma leakage, anastomotic stoma stenosis, anastomotic stoma foreign matter residues and the like after the operation have very high probability, and the life of a patient is endangered. Even though physicians trained in many years of specialized laparoscopic techniques perform laparoscopic biliary-intestinal anastomosis with absorbable sutures, there is still a high incidence of complications. Therefore, the suture suturing under the laparoscope for performing the biliary-intestinal anastomosis is greatly limited in clinical practical application and is difficult to popularize. The magnetic pressing anastomosis technology is one of the pressing anastomosis technologies, the anastomosis pressure of the tissues to be anastomosed is provided by magnetic force, and after the anastomotic stoma is formed, anastomosis is tight and no foreign matter remains. Experiments and applications of magnetic pressing anastomosis are repeatedly proved that compared with the traditional anastomosis technology, the magnetic pressing anastomosis technology has the advantages of rapidness, safety, no foreign matter residue at the anastomosis, narrow anastomosis, low occurrence rate of anastomosis leakage and the like.
However, currently, there is no laparoscopic biliary-intestinal magnetic anastomosis apparatus designed for laparoscopic biliary-intestinal anastomosis, so that the technique of biliary-intestinal magnetic anastomosis cannot be widely popularized and the technique is beneficial to patients under the world.
Disclosure of Invention
The invention aims to provide a magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis, which combines the minimally invasive characteristic of the laparoscopic technology with the advantages of the magnetic pressing anastomosis technology, and can realize the laparoscopic biliary-intestinal anastomosis with high speed, safety and no foreign matter residue at an anastomotic site.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows: a magnetic anastomat suitable for celioscope liner-intestine anastomosis, which comprises a magnetic anastomat body,
the magnetic anastomat body comprises a magnetic anastomat head and an anastomat matched with the magnetic anastomat head for use; the magnetic anastomosis head can be replaced and used; the anastomat can be reused;
the magnetic anastomosis head comprises a first magnetic ring body and a second magnetic ring body;
the first magnetic ring body comprises a first magnetic ring, a first magnetic ring shielding shell and a central tube;
the first magnetic ring shielding shell is coated on the outer side wall and the far-end section of the first magnetic ring; the central tube is arranged in the center of the first magnetic shielding shell, wherein the inner diameter of the central tube is larger than the outer diameter of a puncture rod of the anastomat; a boss is arranged on the inner wall of the central tube and is embedded with a groove at the top end of the puncture rod;
the second magnetic ring body comprises a second magnetic ring and a second magnetic shielding shell;
the second magnetic ring shielding shell is coated on the outer side wall and the near-end section of the second magnetic ring; the center of the cross section of the second magnetic shielding shell is provided with a through hole which is consistent with the inner diameter of the second magnetic ring and is used for the central tube of the first magnetic ring body to pass through;
the fixing device also comprises a fixing shell, wherein the fixing shell comprises a circular clamping groove and two clamping feet arranged in the circular clamping groove; one end of the circular clamping groove, which is far away from the clamping foot, is uniformly provided with a plurality of tooth-shaped grooves along the circumferential direction; the toothed groove is matched with the second magnetic shielding shell for use; the convex groove on the clamping foot is matched with the axial groove at the head end of the anastomat for use;
the fixed shell is sleeved on the outer side wall of the second magnetic ring shielding shell and slides with the second magnetic shielding shell, and the maximum static friction force of the fixed shell and the second magnetic shielding shell is larger than the maximum suction force when the first magnetic ring and the second magnetic ring are attached;
the anastomat comprises an operating handle, an anastomat rod, a magnetic ring releasing device, an anastomat rod steering adjusting device and a thread adjusting device;
the anastomat rod comprises a first rod body far away from the operating handle and a second rod body close to the operating handle; a steering joint for controlling the steering of the first rod body is arranged between the first rod body and the second rod body; the head end of the first rod body is matched with the magnetic anastomosis head for use; the tail end of the second rod body is inserted into the operating handle;
the head end of the first rod body is provided with an axial groove which is connected with the fixed shell in a matching way and can be detached; a lever-like structure is also arranged in the lumen of the head end of the first rod body; the lever-like structure is excited and extrudes a fork-shaped structure of the tail section of the puncture rod by the forward movement of the release rod of the magnetic ring, so that the puncture rod is folded and closed;
a magnetic ring releasing device, a anastomat rod steering adjusting device and a thread adjusting device are arranged in the operating handle;
the magnetic ring release device is used for controlling the release of the magnetic anastomosis head;
the anastomat rod steering adjusting device is used for controlling the rotation of the head end of an anastomat rod of the anastomat;
the thread adjusting device can control the reciprocating motion of the puncture rod.
The magnetic anastomat suitable for the celioscope liner-intestine anastomosis comprises the magnetic ring release device, the magnetic ring release handle and the magnetic ring release safety;
the magnetic ring release rod is of a tubular structure and is arranged in the lumen of the first rod body in the operating handle; the tail end of the first rod body is provided with a V-shaped groove which interacts with a lever-like structure in the first rod body; the tail end of the magnetic ring release rod extends out of the first rod body to be in contact with the second magnetic shielding shell, and the other end of the magnetic ring release rod is associated with a magnetic ring release safety and a magnetic ring release handle through the steering joint, the inner cavity of the tube of the second rod body and the steering joint by metal wires; when the magnetic ring release rod moves forwards, the slope surface of the magnetic ring release rod can enable the lever-like structure to move around the fulcrum of the magnetic ring release rod to press down one tuning fork-shaped foot of the puncture rod and enable the tuning fork-shaped structure of the puncture rod to be folded; the tuning fork-shaped structure of the puncture rod can be separated from the central tube of the first magnetic shielding shell after being folded and is used for pushing and releasing the first magnetic ring, the second magnetic ring, the first magnetic shielding shell and the second magnetic shielding shell after being attracted.
The magnetic ring release handle is connected with the magnetic ring release safety and magnetic ring release handle through the steering joint, the inner cavity of the tube of the second rod body and the steering joint by metal wires; after the magnetic ring release safety is opened, pressing the magnetic ring release handle can drive the magnetic ring release rod to reciprocate in the pipe cavity of the first rod body;
the magnetic ring releases the insurance, is the movable protuberance located on the outer casing of the operating handle, there are two states of locking and releasing; the magnetic ring release handle can be prevented from moving in a locking state, and can be driven to reciprocate in the lumen of the first rod body after being pressed in the releasing state.
The magnetic anastomat suitable for celioscope liner-intestine anastomosis is disclosed, wherein the anastomat rod steering adjusting device comprises a steering control button and a steering trigger;
a steering control button provided on the housing of the operation handle; penetrating through two side surfaces of the shell main body; the locking state and the steering state are adopted; when the steering control button is in the middle position in the locking state, the steering trigger is locked at the moment, and the steering trigger cannot be pressed to trigger the steering joint to move and steer; the steering control button is pressed to enable the steering control button to be in a steering state, the steering trigger is in an activated state at the moment, the steering trigger is pressed to enable the steering joint to move, and the first rod body is turned to the direction indicated by the steering control button.
The steering trigger is controlled by a steering control button in a motion state, and when the steering trigger is in an activated state, the steering trigger can be pressed to trigger the steering joint to move, so that the first rod body and the second rod body are angled.
The magnetic anastomat suitable for the laparoscopic biliary-enteric anastomosis comprises a threaded adjusting device, a threaded connecting rod and a threaded connecting rod, wherein the threaded adjusting device comprises a threaded adjusting handle and a puncture rod;
the thread adjusting handle is arranged at the proximal end of the operating handle and is connected with the puncture rod in the lumen of the first rod body through a metal wire by a threaded rod positioned in the operating handle main body; the puncture rod can be controlled to reciprocate by rotating the threaded adjusting handle;
the puncture rod penetrates through the magnetic ring release rod, and the tail end of the puncture rod extends out of the first rod body in a tuning fork structure; the outer side wall of the tuning fork-shaped structure is provided with an annular groove; the tuning fork-shaped structure of the puncture rod can be connected with the central tube of the first magnetic shielding shell and can be embedded and fixed by a boss in the central tube and a groove of the tuning fork-shaped structure; the other end of the puncture rod is connected with the threaded rod after penetrating through the steering joint, the second rod body and the steering joint and extending through the operating handle by a metal wire, and the puncture rod can be controlled to reciprocate by rotating the threaded adjusting handle.
The magnetic anastomat suitable for celioscope liner-intestine anastomosis is characterized in that the operating handle is made of medical hard plastic or light non-magnetic metal; different appearance designs are provided according to the human body mechanics,
the magnetic ring release handle is made of medical hard plastic or metal;
the screw thread adjusting handle is made of hard medical plastic or metal;
the piercing rod is made of magnetically hard metal.
Compared with the prior art, the invention has the beneficial effects that:
1. the magnetic anastomat for the laparoscopic biliary tract anastomosis, disclosed by the invention, can realize the rapid, safe and laparoscopic biliary tract anastomosis without foreign matter residues at an anastomotic stoma by combining a laparoscopic instrument with a magnetic squeezing anastomosis technology, and also reduces the technical requirements on an operating doctor;
2. the magnetic anastomat suitable for celioscope liner-intestine anastomosis can accelerate postoperative recovery, reduce infection risk and shorten anastomosis period;
3. the laparoscope technology has the characteristics of minimally invasive, clear and fine visual field and the like; the magnetic squeezing anastomosis technique has the advantages of simplicity, no foreign matter residue at the anastomosis, low incidence rate of complications such as anastomotic stoma leakage and the like.
Drawings
FIG. 1A is a schematic diagram of a magnetic anastomosis head according to the present invention;
FIG. 1B is a schematic view of a second magnetic ring body of the present invention in use with a stationary housing;
FIG. 2 is a schematic view of the stapler of the present invention;
FIG. 3A is a side view of the operating handle of the present invention after installation of the magnetic anastomosis head;
FIG. 3B is a top view of the operating handle of the present invention after installation of the magnetic anastomosis;
FIG. 4A is a schematic view of the open state of the lancing lever of the lever-like structure of the present invention;
FIG. 4B is a schematic illustration of the puncturing lever of the lever-like structure of the present invention in a closed position;
FIG. 5 is a schematic diagram of a purse string suture operation of the magnetic anastomosis head of the present invention (the first magnetic ring body is not yet embedded in the bile duct);
FIG. 6 is a schematic diagram of a magnetic anastomosis head purse string suture operation of the present invention (with the first magnetic ring body embedded in the bile duct);
FIG. 7 is a schematic diagram of a biliary-enteric anastomosis procedure (after the stapler is connected to the second magnetic ring body, the piercing rod is poked out through the small intestinal lumen);
FIG. 8 is a schematic diagram of a biliary-enteric anastomosis procedure (with the piercing rod connected to the first magnetic shield central tube) according to the present invention;
fig. 9 is a schematic diagram of the biliary-enteric anastomosis operation (the magnetic anastomosis head is released after suction, the anastomat body is taken out, and the anastomosis process is ended) according to the present invention.
Reference numerals illustrate:
1. first magnetic ring 2, second magnetic ring 3, first magnetic shield case
4. Second magnetic shield shell 5, center tube 6, and fixed housing
7. Operating handle 8, first rod 9, steering joint
10. Second rod 11, steering trigger 12 and magnetic ring release handle
13. Screw thread adjusting handle 14, magnetic ring releasing insurance 15 and steering control button
16. Slope 17, magnetic ring release rod 18 and puncture rod
19. Fulcrum 20, lever-like structure 21, bile duct
22. Intestinal canal 23, circular clamping groove 24 and clamping foot
25. Toothed groove
Detailed Description
The present invention will now be described in further detail with reference to examples for the purpose of facilitating understanding of the objects, technical solutions and effects thereof.
As shown in fig. 1A, 1B and 2, the magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis comprises a magnetic anastomat body, wherein the magnetic anastomat body comprises a magnetic anastomat head and an anastomat matched with the magnetic anastomat head; the magnetic anastomosis head can be replaced and used; the anastomat can be reused.
As shown in fig. 1A and 1B, the magnetic anastomosis head comprises a first magnetic ring 1 body and a second magnetic ring 2 body;
the first magnetic ring 1 body comprises a first magnetic ring 1, a first magnetic ring 1 shielding shell and a central tube 5; the shielding shell of the first magnetic ring 1 is coated on the outer side wall of the first magnetic ring 1; the central tube 5 is arranged in the center of the first magnetic shielding shell 3, wherein the inner diameter of the central tube 5 is larger than the outer diameter of a puncture rod 18 of the anastomat; a boss is arranged on the inner wall of the central tube 5 and is embedded with a groove at the top end of the puncture rod 18;
the second magnetic ring 2 body comprises a second magnetic ring 2 and a second magnetic shielding shell 4; the shielding shell of the second magnetic ring 2 is coated on the outer side wall and the near-end section of the second magnetic ring 2; the center of the cross section of the second magnetic shielding shell 4 is provided with a through hole which is consistent with the inner diameter of the second magnetic ring 2 and is used for the central tube 5 of the first magnetic ring 1 to pass through; the fixing device also comprises a fixing shell 6, wherein the fixing shell 6 comprises a circular clamping groove 23 and two clamping feet 24 arranged in the circular clamping groove; a plurality of tooth-shaped grooves 25 are uniformly formed in the end, far away from the clamping pin 24, of the circular clamping groove 23 along the circumferential direction; the toothed groove 25 is matched with a tuning fork structure in the first rod body 8 for use; the convex groove on the clamping foot 24 is matched with the axial groove of the first rod body 8 for use; the fixed shell 6 is sleeved on the outer side wall of the shielding shell of the second magnetic ring 2, and slides with the second magnetic shielding shell 4, and the maximum static friction force of the fixed shell is larger than the maximum suction force when the first magnetic ring 1 is attached to the second magnetic ring 2;
as shown in fig. 2, the structure of the anastomat of the invention is schematically shown; the anastomat comprises an operating handle 7, an anastomat rod, a magnetic ring releasing device, an anastomat rod steering adjusting device and a thread adjusting device; the stapler bar comprises a first bar body 8 far from the operating handle 7 and a second bar body 10 close to the operating handle 7; a steering joint 9 for controlling the steering of the first rod body 8 is arranged between the first rod body 8 and the second rod body 10; the head end of the first rod body 8 is matched with the magnetic anastomosis head for use; the tail end of the second rod body 10 is inserted into the operating handle 7; the head end of the first rod body 8 is provided with an axial groove, and is connected with the fixed shell 6 in a matching way and can be detached; a lever-like structure 20 is also arranged in the lumen of the head end of the first rod body 8; the lever-like structure 20 is excited and extrudes a fork-shaped structure of the tail section of the puncture rod 18 by the forward movement of the magnetic ring release rod 17, so that the puncture rod is folded and closed; a magnetic ring releasing device, a anastomat rod steering adjusting device and a thread adjusting device are arranged in the operating handle 7; the magnetic ring release device is used for controlling the release of the magnetic anastomosis head; the anastomat rod steering adjusting device is used for controlling the rotation of the head end of an anastomat rod of the anastomat; the thread adjusting means may control the reciprocating movement of the piercing rod 18.
As shown in fig. 3A, 3B, 4A and 4B, the magnetic ring release device of the present invention is suitable for a laparoscopic biliary-intestinal anastomosis magnetic stapler, and comprises a magnetic ring release lever 17, a magnetic ring release handle 12 and a magnetic ring release safety 14;
the magnetic ring release rod 17 is of a tubular structure and is arranged in the lumen of the first rod body 8 in the operating handle 7; the end of which is provided with a V-shaped groove which interacts with a lever-like structure 20 in the first rod body 8;
the tail end of the magnetic ring release rod 17 extends out of the first rod body 8 to be in contact with the second magnetic shielding shell 4, and the other end of the magnetic ring release rod is related to the magnetic ring release safety 14 and the magnetic ring release handle 12 through the steering joint 9, the inner cavity of the first rod body 8 and the steering joint 9 by metal wires; when the magnetic ring release rod 17 moves forward, the slope 16 of the magnetic ring release rod can enable the lever-like structure 20 to move around the pivot 19 of the magnetic ring release rod to press down one tuning fork-shaped foot of the puncture rod 18 and fold the tuning fork-shaped structure of the puncture rod 18; the tuning fork structure of the puncture rod 18 can be separated from the central tube 5 of the first magnetic shielding shell 3 after being folded, and is used for pushing and releasing the first magnetic ring 1, the second magnetic ring 2, the first magnetic shielding shell 3 and the second magnetic shielding shell 4 after being attracted.
A magnetic ring release handle 12 which is associated with the magnetic ring release safety 14 and the magnetic ring release handle 12 through the steering joint 9, the lumen of the second rod body 10 and the steering joint 9 by metal wires; after the magnetic ring release safety 14 is opened, the magnetic ring release handle 12 is pressed to drive the magnetic ring release rod 17 to reciprocate in the lumen of the first rod body 8;
the magnetic ring release safety 14 is a movable protrusion positioned on the shell of the operating handle 7 and has two states of locking and releasing; the magnetic ring release handle 12 can be prevented from moving in the locking state, and the magnetic ring release handle 12 can drive the magnetic ring release rod 17 to reciprocate in the lumen of the first rod body 8 after being pressed in the release state.
As shown in fig. 3A and 3B, the magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis of the present invention, the anastomat rod steering adjusting device comprises a steering control button 15 and a steering trigger 11;
a steering control button 15 provided on the outer casing of the operation handle 7; penetrating through two side surfaces of the shell main body; the locking state and the steering state are adopted; the steering control button 15 is positioned at the middle position when the steering trigger 11 is locked, and the steering joint 9 cannot be triggered to move and steer by pressing the steering trigger 11; pressing the steering control button 15 brings it into a steering state, in which the steering trigger 11 is in an activated state, and pressing the steering trigger 11 moves the steering joint 9, turning the first lever 8 in the direction indicated by the steering control button 15.
The steering trigger 11, the movement state of which is controlled by the steering control button 15, and the pressing in the activated state can trigger the steering joint 9 to move, so that the first rod body 8 and the second rod body 10 are angled.
As shown in fig. 3A and 3B, the magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis of the present invention, the thread adjusting device comprises a thread adjusting handle 13 and a puncture rod 18;
a screw thread adjusting handle 13 arranged at the proximal end of the operating handle 7 and connected with a puncture rod 18 in the lumen of the first rod body 8 through a metal wire by a threaded rod positioned in the main body of the operating handle 7; rotating the screw thread adjusting handle 13 can control the puncture rod 18 to reciprocate;
the puncture rod 18 penetrates through the magnetic ring release rod 17, and the tail end of the puncture rod extends out of the first rod body 8 in a tuning fork-shaped structure; the outer side wall of the tuning fork-shaped structure is provided with an annular groove; the tuning fork-shaped structure of the puncture rod 18 can be connected with the central tube 5 of the first magnetic shielding shell 3 and can be embedded and fixed by a boss in the central tube 5 and a groove of the tuning fork-shaped structure; the other end of the puncture rod 18 is connected with a threaded rod after passing through the steering joint 9, the second rod body 10, the steering joint 9 and the operating handle 7 by metal wires, and the puncture rod 18 can be controlled to reciprocate by rotating the threaded adjusting handle 13.
As shown in fig. 3A, the magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis is provided, wherein the operating handle 7 is made of medical hard plastic or light non-magnetic metal; different appearance designs are provided according to the human body mechanics,
the magnetic ring release handle 12 is made of medical hard plastic or metal and has different sizes and outer tube designs;
the screw thread adjusting handle 13 is made of hard medical plastic or metal and has different appearance designs;
the piercing rod 18 is made of magnetically hard metal.
As shown in fig. 4A, 4B, 5, 6, 7, 8 and 9, the working principle of the present invention is:
first step (fig. 5 and 6): the first magnetic ring 1 body and the residual end of the bile duct 21 to be anastomosed are subjected to purse string suture, so that the parts of the first magnetic ring 1 and the first magnetic shielding shell 3 except the central tube 5 are embedded into the cavity of the bile duct 21, and only part of the tail end of the central tube 5 is exposed;
second step (fig. 7): the fixed shell 6 of the second magnetic ring 2 body is connected and fixed with the tail end of the anastomat rod of the operating handle 7; then the puncture rod 18 is inserted through the residual end opening of the intestinal canal 22 of the small intestine, so that the puncture rod 18 is poked out by the intestinal wall of the intestinal canal 22 to be anastomosed;
third step (fig. 8): the puncture rod 18 is fixedly connected with the exposed central tube 5 of the exposed first magnetic shielding shell 3 after the bile duct 21 is subjected to pouch suture embedding; the puncture rod 18 can drive the first magnetic ring 1 and the first magnetic shielding shell 3 to reciprocate by rotating the screw thread adjusting handle 13; after the residual end of the bile duct 21 is firmly attached to the side wall of the residual end of the intestinal canal 22, the magnetic ring release handle 12 is pressed to enable the magnetic ring release rod 17 to move forwards, and the trigger lever-like structure 20 presses the tuning fork-like structure of the puncture rod 18 to enable the tuning fork-like structure to shrink and separate from the central shaft 5; continuing to press the magnetic ring release handle 12 to continuously move the magnetic ring release lever 17 forward to contact the second magnetic shielding shell 4, and pushing the second magnetic shielding shell 4 to be separated from the fixed shell 6; namely, the first magnetic ring 1, the first magnetic shielding shell 3, the second magnetic ring 2 and the second magnetic shielding shell 4 are separated from the operating handle 7, so that anastomosis is completed;
as shown in fig. 9, after the anastomosis is completed, the first magnetic ring 1, the first magnetic shielding shell 3, the second magnetic ring 2 (2) and the second magnetic shielding shell 4 are remained at the anastomotic stoma to perform a magnetic pressing anastomosis, and the rest components of the device are taken out along with the withdrawal of the operating handle 7; when the anastomotic stoma heals, the first magnetic ring 1, the first magnetic shielding shell 3, the second magnetic ring 2 and the second magnetic shielding shell 4 can fall off and can be removed from the body along with intestinal peristalsis, so that the anastomotic stoma is anastomosed without foreign matters.
The invention discloses a magnetic anastomat suitable for laparoscopic biliary-intestinal anastomosis, which is designed by combining a magnetic squeezing anastomosis technology and a laparoscopic technology, and can realize rapid and reliable suture-free biliary-intestinal anastomosis. The device can reduce the operation difficulty of realizing the biliary-intestinal anastomosis under the laparoscope and increase the operation safety; at the same time, the occurrence of complications such as anastomotic stoma foreign matters, anastomotic stoma stenosis, anastomotic stoma leakage, anastomotic stoma bleeding and the like caused by the traditional anastomosis method is avoided. After the device realizes the magnetic anastomosis of the gall bladder and the intestines, the operating handle 7 can be taken out for disinfection and then used repeatedly, so that the medical cost can be reduced and the medical resources can be saved; meanwhile, the magnetic ring can be discharged out of the body, no metal residues remain in the body, and the benefit of patients is maximized.
The present invention has been further described with reference to the examples, but the present invention is not limited to the above embodiments, and various changes can be made within the knowledge of those skilled in the art without departing from the spirit of the present invention.
Claims (2)
1. The utility model provides a magnetism anastomat suitable for laparoscopic liner intestinal anastomosis, includes magnetism anastomat body, its characterized in that:
the magnetic anastomat body comprises a magnetic anastomat head and an anastomat matched with the magnetic anastomat head for use; the magnetic anastomosis head can be replaced and used; the anastomat can be reused;
the magnetic anastomosis head comprises a first magnetic ring body and a second magnetic ring body;
the first magnetic ring body comprises a first magnetic ring, a first magnetic shielding shell and a central tube;
the first magnetic shielding shell is coated on the outer side wall and the far-end section of the first magnetic ring; the central tube is arranged in the center of the first magnetic shielding shell, wherein the inner diameter of the central tube is larger than the outer diameter of a puncture rod of the anastomat; a boss is arranged on the inner wall of the central tube and is embedded with a groove at the top end of the puncture rod;
the second magnetic ring body comprises a second magnetic ring and a second magnetic shielding shell;
the second magnetic ring shielding shell is coated on the outer side wall and the near-end section of the second magnetic ring; the center of the cross section of the second magnetic shielding shell is provided with a through hole which is consistent with the inner diameter of the second magnetic ring and is used for the central tube of the first magnetic ring body to pass through;
the fixing device also comprises a fixing shell, wherein the fixing shell comprises a circular clamping groove and two clamping feet arranged in the circular clamping groove; one end of the circular clamping groove, which is far away from the clamping foot, is uniformly provided with a plurality of tooth-shaped grooves along the circumferential direction; the toothed groove is matched with the second magnetic shielding shell for use; the convex groove on the clamping foot is matched with the axial groove at the head end of the anastomat for use;
the fixed shell is sleeved on the outer side wall of the second magnetic ring shielding shell and slides with the second magnetic shielding shell, and the maximum static friction force of the fixed shell and the second magnetic shielding shell is larger than the maximum suction force when the first magnetic ring and the second magnetic ring are attached;
the anastomat comprises an operating handle, an anastomat rod, a magnetic ring releasing device, an anastomat rod steering adjusting device and a thread adjusting device;
the anastomat rod comprises a first rod body far away from the operating handle and a second rod body close to the operating handle; a steering joint for controlling the steering of the first rod body is arranged between the first rod body and the second rod body; the head end of the first rod body is matched with the magnetic anastomosis head for use; the tail end of the second rod body is inserted into the operating handle;
the head end of the first rod body is provided with an axial groove which is connected with the fixed shell in a matching way and can be detached; a lever-like structure is also arranged in the lumen of the head end of the first rod body; the lever-like structure is excited and extrudes a fork-shaped structure of the tail section of the puncture rod by the forward movement of the release rod of the magnetic ring, so that the puncture rod is folded and closed;
a magnetic ring releasing device, a anastomat rod steering adjusting device and a thread adjusting device are arranged in the operating handle;
the magnetic ring release device is used for controlling the release of the magnetic anastomosis head;
the anastomat rod steering adjusting device is used for controlling the rotation of the head end of an anastomat rod of the anastomat;
the thread adjusting device can control the reciprocating motion of the puncture rod;
the magnetic ring release device comprises a magnetic ring release rod, a magnetic ring release handle and a magnetic ring release safety;
the magnetic ring release rod is of a tubular structure and is arranged in the lumen of the first rod body in the operating handle; the tail end of the first rod body is provided with a V-shaped groove which interacts with a lever-like structure in the first rod body; the tail end of the magnetic ring release rod extends out of the first rod body to be in contact with the second magnetic shielding shell, and the other end of the magnetic ring release rod is associated with a magnetic ring release safety and a magnetic ring release handle through the steering joint, the inner cavity of the tube of the second rod body and the steering joint by metal wires; when the magnetic ring release rod moves forwards, the slope surface of the magnetic ring release rod can enable the lever-like structure to move around the fulcrum of the magnetic ring release rod to press down one tuning fork-shaped foot of the puncture rod and enable the tuning fork-shaped structure of the puncture rod to be folded; the tuning fork-shaped structure of the puncture rod can be separated from the central tube of the first magnetic shielding shell after being folded and is used for pushing and releasing the first magnetic ring, the second magnetic ring, the first magnetic shielding shell and the second magnetic shielding shell after being attracted;
the magnetic ring release handle is connected with the magnetic ring release safety and magnetic ring release handle through the steering joint, the inner cavity of the first rod body and the steering joint by metal wires; after the magnetic ring release safety is opened, pressing the magnetic ring release handle can drive the magnetic ring release rod to reciprocate in the pipe cavity of the first rod body;
the magnetic ring releases the insurance, is the movable protuberance located on the outer casing of the operating handle, there are two states of locking and releasing; the magnetic ring release handle can be prevented from moving when in a locking state, and can be driven to reciprocate in the lumen of the first rod body after being pressed in the releasing state;
the anastomat rod steering adjusting device comprises a steering control button and a steering trigger;
a steering control button provided on the housing of the operation handle; penetrating through two side surfaces of the shell main body; the locking state and the steering state are adopted; when the steering control button is in the middle position in the locking state, the steering trigger is locked at the moment, and the steering trigger cannot be pressed to trigger the steering joint to move and steer; the steering control button can be pressed to be in a steering state, the steering trigger is in an activated state at the moment, the steering trigger can be pressed to enable the steering joint to move, and the first rod body is turned to the direction indicated by the steering control button;
the steering trigger is controlled by a steering control button in a motion state, and extrusion can trigger the steering joint to move in an activated state to cause the first rod body and the second rod body to form an angle;
the thread adjusting device comprises a thread adjusting handle and a puncture rod;
the thread adjusting handle is arranged at the proximal end of the operating handle and is connected with the puncture rod in the lumen of the first rod body through a metal wire by a threaded rod positioned in the operating handle main body; the puncture rod can be controlled to reciprocate by rotating the threaded adjusting handle;
the puncture rod penetrates through the magnetic ring release rod, and the tail end of the puncture rod extends out of the first rod body in a tuning fork structure; the outer side wall of the tuning fork-shaped structure is provided with an annular groove; the tuning fork-shaped structure of the puncture rod can be connected with the central tube of the first magnetic shielding shell and can be embedded and fixed by a boss in the central tube and a groove of the tuning fork-shaped structure; the other end of the puncture rod is connected with the threaded rod after penetrating through the steering joint, the second rod body and the steering joint and extending through the operating handle by a metal wire, and the puncture rod can be controlled to reciprocate by rotating the threaded adjusting handle.
2. A magnetic anastomosis device adapted for laparoscopic biliary-intestinal anastomosis according to claim 1, characterized in that:
the operating handle is made of medical hard plastic or light non-magnetic metal; different appearance designs are provided according to the human body mechanics,
the magnetic ring release handle is made of medical hard plastic or metal and has different sizes and outer tube designs;
the screw thread adjusting handle is made of hard medical plastic or metal and has different appearance designs;
the piercing rod is made of magnetically hard metal.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610711585.7A CN106236174B (en) | 2016-08-10 | 2016-08-10 | Magnetic anastomat suitable for celioscope liner-intestine anastomosis |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610711585.7A CN106236174B (en) | 2016-08-10 | 2016-08-10 | Magnetic anastomat suitable for celioscope liner-intestine anastomosis |
Publications (2)
| Publication Number | Publication Date |
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| CN106236174A CN106236174A (en) | 2016-12-21 |
| CN106236174B true CN106236174B (en) | 2024-01-30 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201610711585.7A Active CN106236174B (en) | 2016-08-10 | 2016-08-10 | Magnetic anastomat suitable for celioscope liner-intestine anastomosis |
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| CN (1) | CN106236174B (en) |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109381236B (en) * | 2018-12-09 | 2024-01-30 | 江苏凯尔特医疗科技有限公司 | Pre-anastomosis pressure magnetic induction tubular anastomat |
| CN110141331B (en) * | 2019-06-03 | 2024-06-11 | 西安交通大学医学院第一附属医院 | Uterine manipulator with uterine cup cover capable of preventing scattering by magnetic squeezing |
| CN110269657B (en) * | 2019-06-12 | 2021-07-06 | 西安交通大学医学院第一附属医院 | High-position magnetic biliary-enteric anastomosis device |
| CN110537951A (en) * | 2019-08-09 | 2019-12-06 | 西安迈格纳特医疗科技有限公司 | Magnetic pressing anastomosis system for laparoscopic choledochostomy |
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| CN106236174A (en) | 2016-12-21 |
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