CN106535797A - Surgical fastener applying apparatus, kits and methods for endoscopic procedures - Google Patents

Abstract

An endoscopic surgical device (200) is provided and includes a handle assembly (210), an elongated tube (500a) and a loading unit (400a). The handle assembly (210) includes a handle housing (212) and a trigger (214) operatively connected to the handle housing (212), and a drive mechanism which is actuated by the trigger (214). The elongated tube (500a) is selectively connectable to the handle assembly (210). The loading unit (400a) is selectively connectable to the elongated tube (500a). The loading unit (400a) includes an outer tube (310), an inner tube (320) and a plurality of surgical anchors (100). The outer tube (310) defines a lumen (310c) therethrough and has a helical thread (330) disposed within the lumen (310c) thereof. The inner tube (320) is rotatably supported in the outer tube (310) and operatively connectable to the drive mechanism, the inner tube (320) defines a splined distal end (320b), the splined distal end (320b) of the inner tube (320) is defined by a pair of opposed longitudinally extending tines (320b1) and a pair of opposed longitudinally extending channels (320b2); The plurality of surgical anchors (100) are loaded in the splined distal end (320b) of the inner tube (320).

Description

Surgical fasteners application devices, external member and endoscopic surgery method

Background

1. technical field

The present invention relates to be used for implementing the surgical device of endo-surgical, device and/or system, and its user Method.More particularly, the present invention relate to implement the surgical fasteners application devices of endo-surgical, device and/or be System, it can be loaded with the disposable endoscope loading unit comprising absorbable or permanent surgical fasteners, the invention further relates to it External member and using method.

2. background technology

Various surgical operations require to apply fastener so as to forming tissue attachment or object being fixed to group to tissue The apparatus knitted.For example, during hernia reparation, it is often desirable to which mesh sheet is fixed to bodily tissue.(the such as abdomen in some hernias The straight hernia of butt crack or oblique hernia), the breach protrusion on the trans-abdominal wall of a part of intestinal is so as to forming hernical sac.The breach can be using opening Formula operation is repaired, and wherein forms relatively large otch, then passes through sewn closed hernia on the outside of stomach wall.Mesh sheet is by seam Conjunction is attached on the opening of stomach wall, so as to provide reinforcing.

Micro-wound surgical operation (such as endoscopic surgery or laparoscopic surgery) can be used for repairing hernia at present.In peritoneoscope In operation, operation is done in abdominal part by a little otch, and in endoscopic surgery, operation is by little on Jing bodies The narrow endoscope tube or sleeve pipe that otch is inserted into is done.Peritoneoscope and endoscopic surgery typically adopt long and narrow apparatus, described Long and narrow apparatus can reach internal remote area and be configured to be sealed using the otch or pipe of their insertions.In addition, described Apparatus is allowed for by remotely actuating (i.e., in vitro).

At present, the minimally invasive surgical techniques of hernia reparation use surgical fasteners, such as surgical staples, suturing nail and Mesh sheet is fixed to tissue by fixation clamp, so as to provide the structure reinforced and stimulate tissue in-growth.Surgical fasteners are generally led to Cross elongated delivery instrument and be applied to mesh sheet, and operated outside body cavity.

In some operations, permanent fastener can be required, and in other operation, biological absorbable can be required Fastener, or both can be required.Peritoneoscope or endoscopic instrument have typically been loaded permanent fastener or biology can Absorb fastener.In addition, after operation process, these peritoneoscopes or endoscopic instrument are typically dropped.In addition, specific The quantity of the fastener required for surgical operation is different.

It is therefore desirable to a kind of endoscope or laparoscopic surgical devices, the endoscope or laparoscopic surgical devices can be according to need Want or the permanent fastener of demand loading or biological absorbable fastener, and at least partially can be sterilized for operation Reuse afterwards.In addition, it is necessary to can coordinate that same Handleset uses comprising relatively fewer fastener (for example, 5 Fastener) jacket and shorts carrier unit and comprising more fastener (for example, 20 fasteners) long load units.

The content of the invention

The present invention relates to implement the surgical device of endo-surgical, external member and using method, surgical device can add Carry the disposable endoscope load units comprising absorbable or permanent fastener.

According to an aspect of the present invention, there is provided a kind of endoscopic surgical device, it includes：With handle casing and operated Be connected to handle casing trigger and can by the Handleset of the drive mechanism of trigger-actuated, can be selectively connectable with Elongated tubular to Handleset, the load units that elongated tubular can be selectively connected to.Load units include：Define tube chamber and Has threaded outer tube in tube chamber, outer tube is defined proximally and distally；The inner tube being rotatably supported in outer tube, inner tube Define tube chamber and with near-end and the distal end for splining, wherein the distal end for splining of inner tube is by a pair opposed longitudinal extensions The opposed longitudinally extending channels of prong and a pair are limited；Multiple surgery anchorings in the tube chamber of the inner tube for being loaded in load units Device, wherein each anchor include threaded main part and define a pair opposed radial direction external screw threads and a pair it is opposed Radial depressions portion head, the wherein the pair of radial depressions portion of each head receives the corresponding prong of inner tube, wherein often The pair of opposed radial direction external screw thread of individual head is projected and is engaged from the pair of opposed longitudinally extending channels of inner tube The internal spiral threads of outer tube.

Endoscopic surgical device can include adapter, and adapter is with being non-rotatably connected to the outer of load units The near-end of pipe and it is non-rotatably connected to the outconnector component of Handleset；It is non-rotatably connected to load units Inner tube near-end and be non-rotatably connected to the female connector component of drive mechanism, wherein outconnector component and Nei Lian Device component is connect with regard to being rotatable each other.

Handle casing can include from its surface the tooth for projecting, and can include passage wherein in outconnector component.When When elongated tubular is connected to Handleset, the passage of outconnector component can receive the tooth of handle casing.When trigger is caused When moving the female connector component to rotate elongated tubular, the tooth can suppress the rotation of outconnector component.

Handleset can include removably and being rotatably connected to the lasso of handle casing.Can be with lasso The hole that restriction is operatively aligned with the drive mechanism of Handleset.Lasso can include the tooth in the hole for being radially into lasso.

Lasso can have first position, and the wherein tooth of lasso is axially aligned with the tooth of handle casing；And second Put, wherein the tooth of lasso and the tooth footpath of handle casing are to misalignment.

In use, when lasso is in first position, elongated tubular can be connected with Handleset or be disconnected.

The passage of outconnector component can be formed in its outer radial surface, and can be along its whole length Degree axially extends.During be connected to, lasso Tooth can along outconnector component passage pass through.

The lasso can rotate to the 3rd position, and now lasso can be disconnected with handle casing.

Handleset can include the safe lock set being supported on handle casing.Safe lock set can include being set The near-end put in handle casing and operatively associate with drive mechanism, and project from handle casing and operatively close with lasso The distal end of connection.

In use, when lasso is in first position, safe lock set may be at first position, so that safety lock The near-end of component can engage drive mechanism, so as to prevent the operation of drive mechanism.Still in use, when lasso is in second During position, safe lock set may be at the second position, so that the near-end of safe lock set is departed from drive mechanism, so as to permit Perhaps the operation of drive mechanism.

When lasso it first position and the second position between move when, lasso can be at the first of safe lock set Put and activate safe lock set and the second position between.

Safe lock set can include the lockplate for being supported on its near-end and proximally radially stretching out.Lockplate can With the profile with substantially cheese.Drive mechanism can include the gear for defining groove.In use, when lasso is in first When putting, the lockplate of safe lock set can be arranged in the groove of the gear of drive mechanism.

Drive mechanism can include multiple gears, and wherein at least one gear is by trigger-actuated, wherein at least one tooth Wheel activates the drive shaft stretched out from handle casing.Drive shaft can have key, so as to be selectively connected to be supported on inner tube Proximal end female connector component.

The invention further relates to a kind of surgical kit, including：With handle casing and being operatively coupled to handle casing The Handleset of trigger and the drive mechanism by trigger-actuated；It is selectively connected to the long of Handleset and loads single Unit；It is selectively connected to the elongated tubular of Handleset；And the jacket and shorts carrier unit of elongated tubular is selectively connected to, wherein often Individual load units include：Define tube chamber and with the outer tube for being arranged on intraluminal screw thread and be rotatably supported Inner tube in outer tube, outer tube define that proximally and distally inner tube defines tube chamber and has proximally and distally.The surgical kit Also including the surgery anchor of the first quantity in the tube chamber of the inner tube for being loaded in long load units, and it is loaded in jacket and shorts The surgery anchor of the second quantity in the tube chamber of the inner tube of carrier unit, wherein the first quantity are more than the second quantity.

In the embodiment being disclosed, the anchor of the first quantity includes about 30 anchors, the anchoring of the second quantity Device includes about five anchors.

It is reusable to also disclose the elongated tubular.

In addition, the surgical kit can include multiple jacket and shorts carrier units.

The other details and aspect refer to the attached drawing of the example embodiment of the present invention are described in more detail.

Description of the drawings

Refer to the attached drawing is described herein embodiments of the invention, wherein：

Fig. 1 is the perspective view of the surgery anchor according to the present invention used in endoscopic surgical device；

Fig. 2 is the lateral elevational view of the surgery anchor of Fig. 1；

Fig. 3 is the distal end view of the surgery anchor of Fig. 1 and 2；

Fig. 4 is partly cut-away's lateral elevational view of the surgery anchor of Fig. 1-3；

Fig. 5 is the perspective view of endoscopic surgical device of the invention；

Fig. 6 is the top plan view of the surgical device of Fig. 5；

Fig. 7 is the lateral elevational view of the surgical device of Fig. 5 and 6；

Fig. 8 is the rear perspective view of the surgical device of Fig. 5-7, illustrates Handleset separated from one another and endoscope's group Part；

Fig. 9 is the right front perspective view of the surgical device of Fig. 5-8, illustrates the first half sections of the Handleset that is disassembled；

Figure 10 is the front left perspective view of the surgical device of Fig. 5-8, illustrates the second half sections of the Handleset that is disassembled；

Figure 11 be the part of the surgical device of Fig. 5-8 by detached front left perspective view, illustrate the handle group being disassembled The second half sections of part；

Figure 12 is the front, perspective view of the surgical device of Fig. 5-8, illustrates the lasso being disassembled；

Figure 13 is the enlarged drawing of the details area being labeled in Figure 12；

Figure 14 is the enlarged drawing of the details area being labeled in Fig. 5, illustrates the lasso being in the locked position；

Figure 15 is the enlarged drawing of the details area being labeled in Fig. 6, illustrates the lasso being in the locked position；

Figure 16 is the sectional view cut open of 16-16 lines along Fig. 6；

Figure 17 is the front, perspective view of the first angular wheel of the locked component of the present invention and gear train；

Figure 18 is the rear perspective view of the first angular wheel of the locked component of the present invention and gear train；

Figure 19 is the positive plane graph of the first angular wheel of the locked component of the present invention and gear train；

Figure 20 is the part of the endoscope assembly of the surgical device of the present invention by detached perspective view；

Figure 21 is the rear perspective view of the endoscope assembly of the present invention；

Figure 22 is the rear perspective view of the endoscope assembly of the present invention, illustrates the shipment for being connected to endoscope assembly Plug；

Figure 23 is the perspective view of the shipment plug of the present invention；

Figure 24 is the perspective view of the distal portions of the endoscope assembly that outer tube and helical spring are removed, and is depicted outer in figure Section's anchor is loaded in outer tube；

Figure 25 is the perspective view of the distal portions of the endoscope assembly that outer tube and helical spring are removed, and is depicted outer in figure Section's anchor is separated with outer tube；

Figure 26 is the lateral elevational view of the Handleset after half section of shell is disassembled, and is illustrated in endoscopic surgical device Handleset during firing stroke；

Figure 27 is the enlarged drawing of the details area being labeled of Figure 26；

Figure 28 is the sectional view of the distal portions of the endoscope assembly of the 28-28 lines along Fig. 8, is depicted in endoscopic surgical Endoscope assembly during the firing stroke of device；

Figure 29 is by the figure of the surgery anchor of present invention surgery mesh sheet in position；

Figure 30 is the enlarged drawing of the details area being labeled of Fig. 6, illustrates and just is rolled over exchanging position from latched position The lasso put；

Figure 31 is the sectional view of the 31-31 lines along Fig. 6, illustrates the set for being just rolled over exchange position from latched position Circle；

Figure 32 is the enlarged drawing of the details area being labeled of Fig. 6, illustrates the lasso after being rolled over exchange position；

Figure 33 is the sectional view of the 33-33 lines along Fig. 6, illustrates the lasso for being rolled over exchange position；

Figure 34 is the rear perspective view of the first angular wheel of the locked component of the present invention and gear train, illustrates and is rotated Lasso to after exchange position；

Figure 35 is the positive plane graph of the first angular wheel of the locked component of the present invention and gear train, illustrates and is rotated To the lasso of exchange position；

Figure 36 is the front, perspective view of Handleset, illustrates the lasso for being rolled over exchange position；

Figure 37 is the front, perspective view of Handleset and endoscope assembly, illustrates endoscope assembly and is connected to handle group Part；

Figure 38 is the front, perspective view of Handleset and endoscope assembly, illustrate endoscope assembly be fully connected it is in one's hands Handle component；

Figure 39 is the front, perspective view of Handleset (lasso is removed) and endoscope assembly, illustrates endoscope assembly quilt It is fully connected to Handleset；

Figure 40 is the front, perspective view of Handleset and endoscope assembly, illustrates and is fully connected in Handleset Sight glass component, also illustrates the lasso for being just rolled over latched position；

Figure 41 is the enlarged drawing of the details area being labeled of Fig. 6, illustrates the lasso for being rolled over off-position；

Figure 42 is the perspective view of the 42-42 lines along Fig. 6, illustrates the lasso for being rolled over off-position；

Figure 43 is the rear perspective view of the first angular wheel of the locked component of the present invention and gear train, illustrates and is rotated To the lasso of off-position；

Figure 44 is the positive plane graph of the first angular wheel of the locked component of the present invention and gear train, illustrates and is rotated To the lasso of off-position；

Figure 45 is the front, perspective view of the surgical device of Fig. 5-8, illustrates the lasso being disassembled；

Figure 46 is the rear perspective view of lasso, illustrates the internal structure of lasso；

Figure 47 is amplification view (part is dotted line), illustrates the handle casing relative to Handleset in release The lasso of position；

Figure 48 is the perspective view of a part for external member of the present invention, illustrates long load units, jacket and shorts carrier unit and elongated tubular；

Figure 49 is sectional view, illustrates the jacket and shorts carrier unit of load or unload elongated tubular；

Figure 50 is the enlarged drawing in the region being labeled in Figure 49；

Figure 51 is sectional view, illustrates the jacket and shorts carrier unit with elongated tubular locking；

Figure 52 is the enlarged drawing in the region being labeled in Figure 51；And

Figure 53 A-53C illustrate the bayonet type coupling between jacket and shorts carrier unit and elongated tubular.

Specific embodiment

The embodiment of the endoscopic surgical device of the present invention is described in detail by referring to the drawings, identical is attached in multiple accompanying drawings Icon note represents identical or corresponding element.As herein, by using, term " distally " refers to that endoscopic surgical is filled The part away from user put, and term " nearside " refers to the part of the close user of endoscopic surgical device.

Referring first to Fig. 1-4, illustrate and coordinate the surgery of the present invention to apply the surgery anchor that nail device is used, and substantially subscript It is shown as anchor 100.As shown in figs. 1-4, anchor 100 include head section 110, mesh sheet maintaining segment 120, and threaded group Knit seizure section 130.Head section 110 includes a pair opposed thread segment 112a, 112b, and they have the spiral of corresponding radial outside The opposed opening of head thread 114a, 114b and a pair or slotted line 116a, 116b.The distal surface of head section 110 is formed in net It is on the near-end of piece maintaining segment 120 or integrally formed with near-end.

The mesh sheet maintaining segment 120 of anchor 100 is located at the near-end that the distal end or surface of head section 110 and tissue catch section 130 Between, and from the distal end or surface of head section 110 extend to tissue catch section 130 near-end.Mesh sheet maintaining segment 120 is in anchor 100 are threaded into mesh sheet reaches the depth that a tissue for crossing tissue seizure section 130 catches the recent side part 138 of screw thread 132 Afterwards, serve and surgery mesh sheet (not shown) is locked, is anchored or is remained to the effect on anchor 100.This is implemented and is because No screw thread in mesh sheet maintaining segment 120, in mesh sheet maintaining segment, no screw thread allows anchor 100 to be screwed out or exit net Piece.

Mesh sheet maintaining segment 120 has the cross-sectional profiles of cylinder or cone.Mesh sheet maintaining segment 120 is included relative to anchor Gu the cross-section radial dimension of the longitudinal center axis of device 100, the cross-section radial dimension less than head section 110 cross-section radial dimension, The cross-section radial dimension of the recent side part 138 of screw thread 132 is caught again smaller than tissue.

The threaded tissue of anchor 100 catches the spiral spiral shell that section 130 includes being formed on tapered butt main paragraph 134 Stricture of vagina 132.The point or tip 136 in distally defines that the tissue of farthest side catches the terminal of screw thread 132.

As shown in Figure 4, the main paragraph 134 that tissue catches section 130 is tapered, i.e., catch section towards threaded tissue 130 distal end diminishes, and before the summit or tip for reaching anchor 100 terminates or cut at distally butt point " TP " place Go.Main paragraph 134 includes concave cone, hence for given length for, approximately less than 0.01 inch of minimum diameter main paragraph 134 are limited in its butt portion.

Anchor 100 includes that threaded tissue catches the lateral dimension " D " of the farthest side screw thread of section 130, the horizontal chi It is very little according to design code will equal to or approximately more than 0.040 inch.According to the present invention, little butt main diameter and big " D " value Minimize will tissue recess.Tissue catches screw thread 132 and terminates at distal tip 136, and the distal tip is located at main paragraph 134 Butt point " TP " distally.

For comparing the anchor with the non-butt main body with taper thread, section 130 is caught by providing towards tissue The distal tip 136 of the distal extension of butt point " TP ", anchor 100 penetrates mesh sheet becomes easy, makes net by anchor 100 Piece is minimized into the recess of the tissue of flexible relative.

For be applied to by surgeon surgery mesh sheet specified active force, so as to apply nail device on apply distally active force For, the diameter " D " of anchor 100 is bigger, forms the distally effect applied needed for recess on subcutaneous tissue and surgery mesh sheet Power is less.

Anchor 100 is non-cannula type, and is made up of suitable bioabsorbable material, and such as polylactic acid, poly- second are handed over Ester.Anchor 100 is by sale monopoly bio-compatible copolymer (Lactomer USS L1, Boehringer Ingelheim LR 704S or Boehringer Ingelheim LG-857) make.Anchor can be with by suitable not-bio-absorbable material Material or permanent material make, such as rustless steel, titanium, or the like.

Referring to Fig. 5-47, endoscopic surgical device (apply nail device in endoscopic surgical or apply the form of nailing machine) is generally by table It is shown as 200.Apply nail device 200 include Handleset 210, and dismountable endoscope assembly 300 it is (for example, disposable Load units SULU), the endoscope assembly stretched out from Handleset 210, and be configured to store and selectively discharge from which Or the mesh sheet " M " that the multiple anchors 100 of percussion are entered above tissue " T " is (Figure 29).

As shown in Fig. 5-15, Handleset 210 is included by the first half sections of 121a being connected to each other and the second half sections of 212b The handle casing 212 for being constituted.The first half sections of 212a of handle casing 212 and the second half sections of 212b can utilize art technology Known to personnel, method is connected to each other, including but not limited to ultra-sonic welded, fastener (such as screw), or the like.Outside handle The first half sections of 212a of shell 212 and the second half sections of 212b are connected to each other so as to provide liquid-tight seal therebetween.

Handle casing 212 defines the fixed handle portion 216 with free end 216a.Handleset 210 is included in handle Pivot point in shell 212 is pivotally connected to the trigger 214 of handle casing 212.Trigger 214 is included in trigger 214 in stretch out or during non-actuating state with the free end 214a spaced apart of fixed handle portion 216.Trigger 214 is wrapped The hub switch side 214b for extending and entering handle casing 212 by the side of handle casing 212 is included from which.

Liquid-tight seal can be arranged between the hub switch side 214b of trigger 214 and handle casing 212.According to the present invention, X Shape ring or the like ((not shown) such as including O-ring) can be used in trigger 214 hub switch side 214b and handle casing 212 it Between.

As shown in Fig. 9-19, Handleset 210 is in 212 inner support gear train 220 of handle casing.Gear train 220 includes It is bonded or is non-rotatably connected to the trigger or drive gear 222 of the hub switch side 214b of trigger 214.Drive gear 222 It is the double gear comprising the first drive gear 222a and the second drive gear 222b.First drive gear 222a can be fan-shaped There is radially outer rim to be formed and along the first drive gear for the form of gear or the like, described sector gear or the like Multiple gear teeth 222a1 that the arc length of 222a extends.First drive gear 222a is included in the nearside position of gear teeth 222a1 Put from the radially-protruding handle of the first drive gear or backstop 223a.Second drive gear 222b defines that radially outer rim is formed Multiple gear teeth 222b1.

Gear train 220 also includes the driving gear component 224 being pivotally supported in handle casing 212.Travelling gear Component 224 is comprising the first travelling gear 224a, the second travelling gear being pivotally supported on common pivot axis The three toothrow wheels of 224b and the 3rd travelling gear 224c.First travelling gear 224a can be the shape of little gear or the like Formula, described little gear or the like are formed with radially outer rim and are nibbled with the gear teeth 222a1 of the first drive gear 222a The multiple gear teeth 224a1 for closing.Second travelling gear 224b can be the form of sector gear or the like, the sector gear Or the like with radially outer rim formed and along the second travelling gear 224b arc length extend multiple gear teeth 224b1.3rd travelling gear 224c can be the form of little gear or the like, and described little gear or the like is with along its footpath The multiple gear teeth 224c1 for being formed to outer rim and being engaged with the gear teeth 224b1 of the second travelling gear 224b.

Gear train 220 also includes pivotly and being slidably supported on the pivot axis 227a of handle casing 212 Clutch gear 226.Clutch gear 226 can be the form of little gear or the like, described little gear or the like tool There are multiple gear teeth 226a1 that radially outer rim is formed and engaged with the gear teeth 224b1 of the second travelling gear 224b.Clutch Device gear 226 is biased component 227b (Figure 10 and 11) and is biased into and engaged with the second travelling gear 224b.Clutch gear 226 is wrapped Include and be radially therefrom the arm 226b for stretching out, and the cam that stretches out/project from arm 226 or slope 226c (Figure 11).Cam 226c bags Front end and tail end is included, front end has the height for defining shoulder, and tail end is tapered in arm 226b.

Gear train 220 also includes pivotly and being slidably supported on the pivot axis 227 of handle casing 212 First angular wheel 228.First angular wheel 228 can be the form of ring gear or the like.First angular wheel 228 with from Clutch gear 226 is operatively engaged/is associated.First angular wheel 228 defines the arc being formed on its first surface 228d Groove 228a, for selectively receiving and engaging the cam 226c of clutch gear 226.Groove 228a include being configured to engage from The front bulkhead of the front end of the cam 226c of clutch gear 226, and groove shoaled along its length, so as to the first angular wheel 228 First surface is flushed.

In operation, after trigger 214 for applying nail device 200 are activated, trigger 214 makes drive gear 222 along first party To rotation.When drive gear 222 is rotated in a first direction, drive gear 222 causes the first travelling gear 224a and second to pass Moving gear 224b surrounds their pivotal axis in the first direction.When the second travelling gear 224b is rotated in a first direction When, the second travelling gear 224b causes clutch gear 226 to surround its pivotal axis in the first direction.

When clutch gear 226 is rotated in a first direction, the front end edge first party of the cam 226c of clutch gear 226 To rotation, till the front end engagement of cam 226c or the front bulkhead of the groove 228a for contacting the first angular wheel 228.In clutch After the front bulkhead of the front end engagement of the cam 226c of device gear 226 or the groove 228a for contacting the first angular wheel 228, clutch teeth The continuation rotation in the first direction of wheel 226 causes the adjoint rotation in the first direction of the first angular wheel 228.Now, the first cone Shape gear 228 continues to be rotated in a first direction, as long as trigger 214 is actuated to closure or fully actuated state.

When actuating trigger 214 is stopped, before fully actuated or it is fully actuated after, 228 edge of the first angular wheel The rotation of first direction also stops.After the completion of the part or all of actuating of trigger 214 and when discharging, trigger 214 is caused Drive gear 222 is (contrary with first direction) in a second direction to be rotated.When drive gear 222 is rotated in a second direction, drive Gear causes the first travelling gear 224a and the second travelling gear 224b to surround their pivotal axis in a second direction.When When second travelling gear 224b is rotated in a second direction, the second travelling gear 224b causes clutch gear 226 in a second direction Rotate around pivot axis 227a.When clutch gear 226 is rotated in a second direction, the tail end of its cam 226c is along first The groove 228a of angular wheel 228 slides, and if rotation in a second direction is fully skids off the first angular wheel 228 Groove 228a, then along the first surface 228d slips of the first angular wheel 228.When the cam 226c of clutch gear 226 is along When the groove 228a of one angular wheel 228 slides, clutch gear 226 axially slides along pivot axis 227a and compresses partially Pressure component 227b.

If trigger 214 is fully actuated, the release completely of trigger 214 will cause clutch gear 226 along second Direction completes the rotation of a whole circle, until the groove of the first angular wheel 228 is crossed in the front end of the cam 226c of clutch gear 226 The front bulkhead of 228b, is thus again introduced into the groove 228b of the first angular wheel 228.Specifically, when the cam of clutch gear 226 When the front bulkhead of the groove 228b of the first angular wheel 228 is crossed in the front end of 226c, biasing member 227b is along pivot axis 227a axles Clutch gear 226 is oppressed to ground, and the cam 226c of clutch gear 226 returns to the groove 228b of the first angular wheel 228 It is interior.

As shown in Figure 11 and 26, Handleset 210 includes being configured to maintaining trigger 214 in stretching out or do not activate The biasing member 225 of position.Biasing member 225 be also configured to have the partial or complete actuating metapedes in trigger 214 with Trigger 214 is returned to into the spring constant of unactuated position.Biasing member 225 includes being fixedly attached to handle casing First end 225a in 212 and the second end 225b of the handle 223a for stretching out is connected to from the first drive gear 222a.

Referring to Fig. 9-11,26 and 27, Handleset 210 include being supported in handle casing 212 and with drive gear 222 The audition being operatively connected/sense of touch feedback mechanism 250.Specifically, audition/sense of touch feedback mechanism 250 includes being pivotably supported Driver plate 252 in handle casing 212.Driver plate 252 includes from driver plate the tooth 252a for stretching out.Driver plate 252 has been spring-biased to Beginning position.Audition/sense of touch feedback mechanism 250 also includes from the second drive gear 222b tooth or the handle 223b for stretching out.In operation, When trigger 214 activated and the second drive gear 222b is rotated, the handle 223b contact driver plates of the second drive gear 222b 252 tooth 252a, so that driver plate 252 resists the biased rotation of spring member 254.As the handle 223b of the second drive gear 222b When crossing the tooth 252a of driver plate 252, driver plate 252 returns or jumps back to the start bit of oneself due to the bias of spring member 254 Put.After its original position of 252 rebound of driver plate, driver plate 252 produces audition/sense of touch response.

As shown in Fig. 9,11,18 and 19, the Handleset 210 for applying nail device 200 is provided with ratchet mechanism 260, the ratchet machine Structure is configured to suppress after anchor 100 has partly been driven in tissue or prevents inner tube 320 (Figure 20,24 and 25) Exit or fall back.As shown in figs. 9 and 11, ratchet mechanism 260 includes being formed on the back side or second table of the first angular wheel 228 Multiple ratchet 228f on face.

Ratchet mechanism 260 also includes the alligator clamp 262 being fixed in Handleset 210.Alligator clamp 262 includes being configured With the jerk-finger 262a engaged with the ratchet 228f being formed on the rear surface of the first angular wheel 228.

In operation, the jerk-finger 262a of alligator clamp 262 is engaged with the ratchet 228f of the first angular wheel 228 so that when When first angular wheel 228 is rotated in a first direction, the jerk-finger 262a of alligator clamp 262 is stirred on ratchet 228f and is allowed One angular wheel 228 rotates.If additionally, the first angular wheel 228 start in a second direction it is (contrary with first direction) rotation, The jerk-finger 262a of alligator clamp 262 stops along ratchet 228f, so as to prevent or suppress the first angular wheel 228 to revolve in a second direction Turn.So, during driving or firing schedule, suppress or prevent the anchor 100 of endoscope assembly 300 or appointing for inner tube 320 What reverses or " exiting " (being easily caused the first angular wheel 228 to rotate in a second direction).

Referring to Figure 10,11 and 26, Handleset 210 also includes being rotatably supported in the distal end of handle casing 212 Second or bevel pinion 230.Bevel pinion 230 includes and the gear being formed on before the first angular wheel 228 Tooth 228c is operatively engaged or meshed gears tooth 230a.Bevel pinion 230 is fixed non-rotatably to from handle casing 212 drive shafts 232 stretched out towards distally.Drive shaft 232 is configured with sizing with the female connector of engaged endoscope component 300 Component 344 (Figure 20 and 21).In one embodiment, drive shaft 232 defines multiple axially extending ribs in its far-end 232a。

In operation, when trigger 214 is extruded, gear train 220 causes bevel pinion 230 to be rotated in a first direction. When bevel pinion 230 is rotated in a first direction, bevel pinion 230 transmits the rotation to the inner tube of endoscope assembly 300 320。

Referring to Fig. 5-16, Handleset 210 is included by rotatably and the set that is releasably supported on handle casing 212 Circle or eckband 234.Lasso 234 is defined and 232 axially aligned distal openings 234a of drive shaft.Lasso 234 includes radially stretching Enter the backstop in distal openings 234a or tooth 234b.

Lasso 234 can (anchor holding/propulsion assembly 300 be locked into Handleset 212, applies nail device in latched position 200 prepare percussion, Figure 14-16)；(anchor holding/propulsion assembly 300 can be connected or break with Handleset 212 exchange position Open, applying nail device 200 can not be fired, Figure 30-33)；And (lasso 234 can be split from handle casing 212 for lasso off-position Unload, handle casing 212 can be cleaned or be sterilized, Figure 41 and 42) between rotate.

As shown in Figure 45-47, handle casing 212 and lasso 234 can include complementary engage each other feature and/or knot Structure, this engage each other feature and/or structure can lock or fixed lasso 234 relative to handle casing 212 location/position.Set Circle 234 includes the fritter 234c for inwardly stretching in opposed footpath, and handle casing 212 includes being formed on the outer surface of its nose 212c A pair of L-shaped groove 212d.Shell defines the annular shoulder 212e of the near-end around nose 212c.Shoulder 212e is defined and is formed in A pair of depressed part 212f, 212g in the distal surface of shoulder 212e.

Referring to Figure 10,12,13 and 36-40, the nose 212c of handle casing 212 is included around the distal end of drive shaft 232 Annular wall 212h towards distal extension.Annular wall 212h includes being radially therefrom the tooth 212i for inwardly stretching out.When lasso 234 is in During exchange position, the backstop of lasso 234 or tooth 234b are radially aligned with the tooth 212i of annular wall 212h.When lasso 234 is in lock When positioning is put, the backstop of lasso 234 or the tooth 234b and tooth 212i of annular wall 212h are radially staggered.

Lasso 234 includes from its proximal face the second tooth 234d for stretching out.Tooth 234d is configured to relatively outer in lasso 234 The depressed part 212f of shell 212 is engaged when shell 212 is rotated, selected one in 212g.Tooth 234d is biased to from lasso 234 Near-end project.

Such as Fig. 9-13,16-19,30-35 and 42-44, Handleset 210 includes safe lock set 240, the safety lock group Part is supported on handle casing 212, and be configured to allow and suppress the actuating of trigger 214 and for peeping in realizing Loading/holding and release/dismounting of the mirror assembly 300 to handle casing 212.Safe lock set 240 is operatively closed with lasso 234 Connection, and as lasso 234 is activatable relative to the rotation of handle casing 212.Safe lock set 240 is included by the twelve Earthly Branches that slide The stop pin 242 stretched out towards distally is supportted in handle casing 212 and from handle casing 212.Pin 242 include from pin stretch out it is horizontal Head 242a.The head 242a of stop pin 242 is operatively disposed the inwall 234e (and of Figure 16,31,33,42 of lasso 234 46) in or between inwall.

Safe lock set 240 includes the lockplate 244 being supported on the near-end 242b of stop pin 242.Lockplate 244 has There is substantially pie shape profile.In use, as the inwall 234e of the lasso 234 when 234 opposite handle shell of lasso 212 rotates makees On the head 242a of pin 242, lockplate 244 is also rotated when stop pin 242 is rotated.In operation, when lasso 234 is turned When moving exchange position or cocked position, now trigger 214 is in complete unactuated position, and lockplate 244 is rotated to It is formed in the radial slot 228g on the first angular wheel 228, thus prevents the first angular wheel 228 from rotating.In addition, in lasso After 234 are rotated to latched position, lockplate 244 is rotated away from the radial slot 228g of the first angular wheel 228, thus allows One angular wheel 228 rotates.

Safe lock set 240 also includes biasing member 246, the biasing member be configured to the head 242a of pin 242 and Lockplate 244 is biased into postrotational latched position.

Referring to Fig. 5,8-10 and 20-25, as illustrated, endoscope assembly 300 includes outer tube 310, can be rotatably set in Inner tube 320, the guidance coil being arranged between outer tube 310 and inner tube 320 or spring 330 in outer tube 310, it is loaded in inner tube Multiple anchors 100 in 310, and be supported on outer tube 310 and inner tube 320 proximal end adapter 340.

The outer tube 310 of endoscope assembly 300 includes near-end 310a and distal end 310b, and defines the tube chamber by which 310c.As described above, endoscope assembly 300 also includes being fixedly disposed leading at least distal part of outer tube 310 To coil or spring 330.

Endoscope assembly 300 also includes the inner tube 320 being rotationally disposed in coil 330.Inner tube 320 includes near-end The part 320a and distal portions 320b for splining, and define the tube chamber 320c by which.

The distal portions 320b of inner tube 320 is slotted, opposed so as to define a pair opposed prong 320b1 and a pair Passage 320b2.The distal portions 320b of inner tube 320 can be contained in multiple anchors 100 in inner tube 320.Specifically, anchor 100 are loaded onto in endoscope assembly 300, so that a pair opposed thread segment 112a of anchor 100,112b are extended through Respective channel 320b2 of the distal portions 320b of inner tube 320, and be slidably disposed in the groove of coil 330, inner tube A pair of prong 320b1 of 320 distal portions 320b are arranged on a pair of slotted line 116a of anchor 100, in 116b.

In use, when inner tube 320 is rotated with regard to coil 330 around its longitudinal axis, a pair of prongs of inner tube 320 320b1 transmits the rotation to anchor 100, and due to the head thread 114a of anchor 100,114b is engaged with coil 330 and incited somebody to action Anchor 100 is advanced towards distally.

Specifically shown in such as Figure 20 and 21, endoscope assembly 300 includes adapter 340, and the adapter has and can not be revolved It is connected to the outconnector component 342 of the near-end 310a of outer tube 310 with turning, and is non-rotatably connected to inner tube 320 The female connector component 344 of near-end 320a.Female connector component 344 is nested in outconnector component 342.Outconnector structure Part 342 is substantial cylindrical, and defines the outer radial groove 342a of at least one longitudinal extension for extending through its near-end, with And at least one longitudinal extension internal channel 342b.Outconnector component 342 is sized and shaped to be inserted into handle group Annular wall 212h of the nose 212c of the distal openings 234a and handle casing 212 of the lasso 234 of part 210.

Female connector component 344 is substantial cylindrical, and defines that being radially into its intraluminal at least one longitudinal direction prolongs The interior side rib 344a for stretching.

Endoscope assembly 300 is connected to into Handleset 210 in the case of in order to exchange position is in lasso 234, outward The outer radial groove 342a of connector members 342 is aligned with the backstop of lasso 234 or tooth 234b first, and with nose 212c's The tooth 212i alignments of annular wall 212h.Then, outconnector component 342 is fully inserted into lasso 234 and annular wall 212h, nose The tooth 212i of annular wall 212h of 212c is arranged in the outer radial groove 342a of outconnector component 342, lasso 234 only Gear or tooth 234b are arranged on the distally of outconnector component 342.

After outconnector component 342 is fully inserted into lasso 234 and annular wall 212h, the distal end of drive shaft 232 enters Female connector component 344 so that the interior side rib 344a of at least one longitudinal extension of female connector component 344 be arranged on drive The multiple axially extending rib 232a of the far-end of moving axis 232 is mechanically engaged or engages.

In the case where outer connector members 342 are fully inserted into lasso 234 and annular wall 212h, lasso 234 is from exchange Position is rolled over latched position, and thus the backstop of lasso 234 or tooth 234b are rolled over the external diameter with outconnector component 342 To the radial position of groove 342a misalignment, so as to stop outconnector component 342 from lasso 234 and from handle casing Exit in annular wall 212h of 212 nose 212c.

As shown in Figure 20-23, endoscope assembly 300 includes the dress for being configured to be selectively connected to adapter 340 Fortune wedge, stopper or lid 350.Lid 350 includes end wall 352, at least one leg 354 and handle (not shown), described at least one Stretch out from end wall 352 and be configured with sizing to be selectively housed in the corresponding longitudinal direction of outconnector component 342 in individual leg In outer radial groove 342a (Figure 21) of extension, the handle stretches out from end wall 352 and is configured and is dimensioned to selectively It is accommodated in the inner in connector members 344, for engaging with side rib 344a in the longitudinal extension of female connector component 344.Work as lid When son 350 is fixed to adapter 340, at least one leg 354 of lid 350 and the handle engage outconnector component 342 with female connector component 344, so as to prevent them to be rotated relatively to each other.

Lid 350 is used for fixing radial position of the inner tube 320 relative to outer tube 310, and therefore ensures in endoscope's group Before part 300 is connected to Handleset 210, the heap of surgery anchor 100 will not prematurely be advanced through endoscope assembly 300.Such as Piling up before endoscope assembly 300 is connected to Handleset 210 for fruit surgery anchor 100 is advanced through endoscope assembly 300, The percussion timing for so applying nail device 200 may be impacted, and thus the complete each time stroke of trigger 214 may be from interior Sight glass component 300 fully fires surgery anchor 100 or may start to fire the second surgery anchor from endoscope assembly 300 Gu device 100.

In the operation that surgery applies nail device 200, as shown in Figure 26-28,36 and 37, operated in endoscope assembly 300 Ground connection and in the case of locking onto Handleset 210 (as described above), when drive shaft 232 is due to the actuating of trigger 214 During rotation (equally as described above), the multiple axially extending ribss for being rotated through the far-end for being arranged on drive shaft 232 The engagement of the interior side rib 344a of at least one longitudinal extension of 232a and female connector component 344 and be delivered to endoscope The inner tube 320 of component 300.

Equally, when inner tube 320 is rotated with regard to coil 330 around its longitudinal axis, due to the head thread of anchor 100 114a, 114b are engaged with coil 330, and a pair of prong 320a1 of inner tube 320 transmit the rotation to 100 heap of whole anchor, and will Whole 100 heap of anchor is advanced towards distally.

According to the present invention, surgery applies nail device 200 and the component of anchor 100 is dimensioned, so that trigger 214 Single is complete and thoroughly activates and produces single anchor 100 and (that is, be loaded in 100 heap of anchor in endoscope assembly 300 Farthest side anchor) percussion from endoscope assembly 300.

Surgery is applied nail device 200 and repeatedly can be fired to fire anchor from endoscope assembly 300, until surgery handss Till art is completed or endoscope assembly 300 exhausts all anchors 100.If endoscope assembly 300 exhausts anchor 100, And if also needing to extra anchor completes surgical operation, the endoscope assembly 300 for having exhausted (such as can be filled by new 100) endoscope assembly 300 is replaced to have carried anchor.Alternatively, if it is desired to change the anchoring just used in surgical operation The type of device 100, unspent endoscope assembly 300 (loading first kind anchor 100) can be by other endoscope assemblies 300 (loading different Second Type anchors 100) are replaced.

As shown in Figure 14-19 and 30-33, in order to change endoscope assembly 300 with other endoscope assemblies 300, such as , in the case where trigger 214 is in complete unactuated position, surgeon is by lasso 234 from latched position (figure for as described before 14-19) activate or turn to exchange position (Figure 30-33), so as to discharge the endoscope assembly 300 for being loaded or being connected, make Endoscope assembly 300 from Handleset 210 departs from or exits, and loads or be connected to handle group by new endoscope assembly 300 Then lasso 234 is activated from exchange position or turns to latched position, so as to new endoscope assembly 300 is kept by part 210 In Handleset 210.

After surgical operation, lasso 234 can be disassembled or disconnect with handle casing 212, so that lasso 234 and handss The remainder of handle component 210 can be cleaned by modes such as sterilization, washing, wiping, autoclave, chemical treatments.Referring to figure 30-33 and 41-47, in order to lasso 234 is disconnected with handle casing 212, lasso 234 is from exchange position (Figure 30-33) quilt Off-position (Figure 41-44) is turned to, wherein 234 opposite handle shell 212 of lasso is rotated, until the footpath of lasso 234 is inwardly stretched Fritter 234c be located at handle casing 212 nose 212c L-shaped groove 212d long leg end.Now, lasso 234 can be with It is axially separated from handle casing 212.

It is according to the present invention, expectable to be, multiple different endoscope assemblies 300, wherein endoscope assembly can be provided The surgery anchor manufactured by different materials (for example, biological absorbable, permanent etc.), or endoscope assembly can be loaded There can be different length (for example, short, medium, long, etc.), the endoscope assembly of wherein length-specific is mounted with The surgery anchor of respective quantity.So, according to specific surgical operation (for example, hernia operations), surgeon can be selected Endoscope assembly or combination required for any one, surgeon can be exchanged between surgery average of operation periods as needed or be changed Endoscope assembly.

In one embodiment, expectable to be, all of endoscope assembly can be provided with identical length, but be filled Carry the surgery anchor of varying number.In this way, surgeon can be according to the choosing of the type of the surgical operation that will implement Take the endoscope assembly for being mounted with less or more anchor.

Referring to Figure 48-53C, the invention further relates to including applying for Handleset 210 follows closely device 200, as described above, this applies nail Device can coordinate the first endoscope assembly 300 with long load units 400 and the second endoscope with jacket and shorts carrier unit 400a Component 300a is used.As shown in Figure 48, when nail cooperation the second endoscope assembly 300a uses of device 200 are applied, elongated tubular 500a Handleset 210 (referring to Fig. 5) and jacket and shorts carrier unit 400a are connected with each other.It is reusable that elongated tubular 500a can be predicted 's.It is appreciated that, short length load units 400a (comprising less nail or anchor 100) is than length load units 400 The low cost of manufacture of (comprising more nails or anchor 100).So, when surgical operation needs (or surgeon selection) relative During few nail 100, the second endoscope assembly 300a is used as cost-effective measure.

Further, since the disposable essence of load units, (it only may be loaded on a small quantity longer load units 400 Nail being intended for single use 100) cause to waste.Make sense, jacket and shorts carrier unit 400a and reusable elongated tubular The use of 500a contributes to reducing waste.

Elongated tubular 500a includes the near-end 502a for being configured to be releasably engaged the Handleset 210 for applying nail device 200.Separately Outward, the near-end 502a of elongated tubular 500a includes the feature of similar endoscope assembly 300, so as to realize the set with Handleset 210 The interconnection of circle 234.Specifically, elongated tubular 500a is included in the adapter 340a at its near-end 502a.So, such as retouch in detail before State like that, also realize the lock between endoscope assembly 300 and Handleset 210 between elongated tubular 500a and Handleset 210 Locking/unlocking ability and function connects.

More specifically, for example, when the actuating of trigger 214 causes the inner tube 320 of the endoscope assembly 300 for correctly being engaged When rotating around its longitudinal axis, as described above, the actuating of trigger 214 also causes the second endoscope assembly for correctly being engaged Inner tube 210a of the elongated tubular 500a of 300a is rotated around its longitudinal axis.

In addition, the elongated tubular 500a of endoscope assembly 300a is configured to be releasably engaged at the loading of its proximate distal ends Unit 400a.Referring specifically to Figure 49-52, the engagement between elongated tubular 500a and load units 400a is drawn.In Figure 49-50 In, load units 500a is drawn the distal end relative to elongated tubular 500a and is loaded/unloads.In Figure 51 and 52, load units 400a is drawn the position for being loaded in the distal end relative to elongated tubular 500a and being locked.

Referring also to Figure 49-52, the distal end of elongated tubular 500a includes that inner tube 510, outer tube 520a and flexibility refer to 530a.It is soft Property refers to 530a from inner tube 510a towards distal extension, and can engage with outer tube 520a.More specifically, flexibility refers to that 530a includes being set In the hook 532a of its far-end.Hook 532a can be engaged with the depressed part 522a in outer tube 520a.Can be it is envisioned that hook 532a be towards interior The radial center of bore 512a limited by pipe 510a is biased.

Referring specifically to Figure 49 and 50 (wherein load units 400a is drawn and is just loaded/unloads), because referring to 530a (bags Including 532a containing hook) and engagement amount " E " between outer tube 520a less than parts of the load units 400a near hook 532a with it is outer Gap " G1 " between the inwall 524a of pipe 520a, load units 400a energy relatively thin long tube 500a longitudinally translate.

Referring specifically to Figure 51 and 52 (wherein load units 400a is drawn to be in and is loaded and is locked position), because referring to 530a (comprising hook 532a) and the engagement amount " E " between outer tube 520a are more than portions of the load units 400a near hook 532a Divide and the gap " G2 " between the inwall 524a of outer tube 520a, it is freely longitudinal that load units 400a is unable to relatively thin long tube 500a Translation.So, load units 400a and elongated tubular 500a is by effectively longitudinally locked.In addition, the nearside of load units 400a prolongs Extending portion 410a is configured to frictionally engage the inwall 514a of inner tube 510a.As illustrated, proximal extension 410a includes taper End 412a, so that be conducive to the engagement between proximal extension 410a and inner tube 510a.Proximal extension 410a and inner tube 510 Between frictional engagement be configured to it is very firm so that the rotary motion of inner tube 510a is (as described above, by triggering The actuating of device 214 is implemented) directly pass to the proximal extension 410a of load units 400a.In addition, hook 532a towards In the embodiment that the radial center of bore 512a of inner tube 510a is biased, this bias is also by load units 400a and elongated tubular 500a is linked up.

As shown in Figure 49 and 51, load units 400a also includes female connector component 444a.Female connector component 444a's Portions of proximal 445a is arranged in the distal openings 414a of proximal extension 410a and is rotatably fixed with distal openings.Institute So that the rotation of proximal extension 410a causes the corresponding rotation of female connector component 444a.It is appreciated that, load units 400a Other parts similar to endoscopic portion 300 those, as described above, so that the rotation of female connector component 444a is drawn Act the injection of the nail or anchor 100 being maintained in load units 400a.

In addition, as shown in Figure 53 A-53C, bayonet socket coupling 600a is used to aid in the outer tube 520a of elongated tubular 500a Fix with load units 400a.That is, outer tube 520a can relative to load units 400a translate and rotate, so as to by elongated tubular 500a with Load units 400a locks locking/unlocking, so that on the outer tube 520a of the boss 450a Jing elongated tubular 500a on load units 400a L-shaped groove 550a advance.

The invention also discloses a kind of surgical kit.The external member includes Handleset 210 (such as reusable), many It is individual long load units 400 (such as disposable), multiple jacket and shorts carrier unit 400a (such as disposable), and at least one thin Long tube 500a (such as reusable).In published embodiment, comprising nail or anchoring in load units 400 and 400a Device 100.For example, it is foreseeable that, comprising about 30 anchors 100 in long load units 400, include in jacket and shorts carrier unit 400a About five anchors 100.In addition, can be it is envisioned that the total length of long load units 400 be no better than jacket and shorts carrier unit 400a's Length of the length plus elongated tubular 500a.

According to the present invention, moreover it is possible to expected, Handleset 210 can be substituted by Electromechanical Control module, the Electromechanical Control module It is configured to drive the inner tube of anchor holding/propulsion assembly, so as to firing or activating surgical device.Electromechanical Control module can be with Including at least one microprocessor, at least one motor controlled by least one microprocessor and for giving The power supply that at least one microprocessor and at least one motor are powered.

It will be clear that, various changes can be made to the embodiments described herein.For example, suturing nail or fastener In line length can be altered to meet the requirement of particular surgeries.Therefore, suturing nail in the nail kit component and/or The in line length of fastener can change accordingly.So, above description is understood not to limit, and only various realities Apply the demonstration of example.Those skilled in the art will predict other changes in the scope and spirit of appended claim.

Claims (18)

1. a kind of endoscopic surgical device, including:

Handleset, the Handleset include handle casing and be operatively coupled to handle casing trigger and can be by The drive mechanism of trigger-actuated；

The elongated tubular of Handleset can be selectively connected to；With

The load units of elongated tubular can be selectively connected to, the load units include：

Outer tube, the outer tube defines the tube chamber by which and has and is arranged on its intraluminal screw, and outer tube is defined Proximally and distally；

The inner tube being rotatably supported in outer tube, inner tube define the tube chamber by which and have proximally and distally, wherein The distal end for splining of inner tube is limited by the passage of the prong and a pair opposed longitudinal extensions of a pair opposed longitudinal extensions；

Multiple surgery anchors in the tube chamber of the inner tube for being loaded in load units, wherein each anchor includes threaded Main part and the head in a pair opposed radial direction external screw threads and a pair opposed radial depressions portions is defined, wherein per head The pair of radial depressions portion in portion receives the corresponding prong of inner tube, the wherein the pair of opposed outside spiral shell in footpath of each head Stricture of vagina is projected from the pair of opposed longitudinally extending channels of inner tube and engages the internal spiral threads of outer tube.

2. endoscopic surgical device according to claim 1, also including adapter, the adapter has outconnector structure Part and female connector component, the outconnector component are non-rotatably connected to the near-end and energy of the outer tube of load units Handleset is non-rotatably connected to, the female connector component is non-rotatably connected to the inner tube of load units Near-end and drive mechanism can be non-rotatably connected to, wherein outconnector component and female connector component are with regard to being each other It is rotatable.

3. endoscopic surgical device according to claim 2, wherein handle casing include from its surface the tooth for projecting, wherein Outconnector component includes passage formed therein, wherein when elongated tubular is connected to Handleset, outconnector component Channel reception handle casing tooth, when wherein activateding the female connector component to rotate elongated tubular when trigger, tooth suppress The rotation of outconnector component.

4. endoscopic surgical device according to claim 3, wherein Handleset are included by removably and rotatably The lasso of handle casing is connected to, lasso limits the hole being operatively aligned with the drive mechanism of Handleset, lasso bag wherein The tooth in the hole for being radially into lasso is included, lasso has：

First position, in first position, the tooth of lasso is axially aligned with the tooth of handle casing；And

The second position, in the second position, the tooth of lasso is with the tooth footpath of handle casing to misalignment.

5. endoscopic surgical device according to claim 4, wherein when lasso is in first position, elongated tubular energy and handss Handle component connects or disconnects.

6. endoscopic surgical device according to claim 5, the passage of wherein outconnector component are formed in outconnector In the outer radial surface of component, and the whole length along outconnector component axially extends, and

Wherein elongated tubular being connected to Handleset and by elongated tubular during the Handleset disconnection, the tooth of lasso is along outer The passage of connector members is passed through.

7. endoscopic surgical device according to claim 4, wherein lasso can rotate to the 3rd position, in the 3rd position, Lasso can be disconnected with handle casing.

8. endoscopic surgical device according to claim 4, wherein Handleset include being supported on handle casing Safe lock set, safe lock set include being arranged on the near-end that associates in handle casing and operatively with drive mechanism and The distal end for projecting from handle casing and operatively associating with lasso.

9. endoscopic surgical device according to claim 8, wherein

When lasso is in first position, safe lock set is in first position, so that the near-end engagement of safe lock set is driven Motivation structure, so that prevent the operating of drive mechanism；And

When lasso is in the second position, safe lock set is in the second position, so that the near-end of safe lock set and driving Mechanism departs from, so as to allow the operation of drive mechanism.

10. endoscopic surgical device according to claim 9, wherein lasso are dimensioned, so as to lasso its first When moving between position and the second position, lasso activates safety lock group between the first position of safe lock set and the second position Part.

11. endoscopic surgical devices according to claim 9, wherein safe lock set include being supported on its near-end and The lockplate for proximally radially stretching out, wherein lockplate have the profile of substantially cheese, and wherein drive mechanism includes defining The gear of groove, and

Wherein when lasso is in first position, the lockplate of safe lock set is arranged in the groove of the gear of drive mechanism.

12. endoscopic surgical devices according to claim 11, wherein drive mechanism include multiple gears, wherein at least one The drive shaft that individual gear is stretched out from handle casing by trigger-actuated, wherein at least one gear actuation, wherein drive shaft have Key, so that be selectively connected to the female connector component of the proximal end for being supported on inner tube.

A kind of 13. surgical kits, including：

Handleset, the Handleset have handle casing and are operatively coupled to trigger, the Yi Jineng of handle casing By the drive mechanism of trigger-actuated；

The long load units of Handleset can be selectively connected to；

The elongated tubular of Handleset can be selectively connected to；And

The jacket and shorts carrier unit of elongated tubular can be selectively connected to, wherein each load units include：

Outer tube, the outer tube defines the tube chamber by which and has and is arranged on intraluminal screw, and outer tube is defined closely End and distal end；

The inner tube being rotatably supported in outer tube, inner tube define the tube chamber by which and have proximally and distally；And

The surgery anchor of the first quantity in the tube chamber of the inner tube for being loaded in long load units, and it is loaded in jacket and shorts load The surgery anchor of the second quantity in the tube chamber of the inner tube of unit, wherein the first quantity are more than the second quantity.

14. surgical kits according to claim 13, the anchor of wherein the first quantity include about 30 anchors.

15. surgical kits according to claim 14, the anchor of wherein the second quantity include about five anchors.

16. surgical kits according to claim 15, wherein elongated tubular are reusable.

17. surgical kits according to claim 13, wherein elongated tubular are reusable.

18. surgical kits according to claim 17, also including multiple jacket and shorts carrier units.