CN106667537B

CN106667537B - Surgical cutting anastomat

Info

Publication number: CN106667537B
Application number: CN201710107202.XA
Authority: CN
Inventors: 向长林; 陆坚; 王叶挺; 王亮
Original assignee: Suzhou Frankenman Medical Equipment Co Ltd
Current assignee: Suzhou Frankenman Medical Equipment Co Ltd
Priority date: 2017-02-27
Filing date: 2017-02-27
Publication date: 2023-04-07
Anticipated expiration: 2037-02-27
Also published as: CN116138828A; CN106667537A

Abstract

The invention discloses a surgical cutting anastomat, wherein a staple and a knife pad are positioned on the same side of cut tissue and can be integrally replaced, so that the assembly replacement operation is simplified. The surgical cutting anastomat comprises an execution head, the execution head comprises an anvil component and a nail bin component, the nail bin component comprises a nail bin shell, a nail positioned in the nail bin shell, a nail pushing component which is arranged in the nail bin shell in a front-back sliding mode and used for pushing the nail out of the nail bin shell, the nail bin component further comprises a knife pad arranged in the nail bin shell, the anvil component further comprises a cutter which is arranged on a front frame in a front-back sliding mode, a cutting part positioned in front of the knife pad is formed in the front of the cutter, the execution head further comprises a reversing transmission mechanism used for driving the cutter to move from front to back, the surgical cutting anastomat further comprises a driving mechanism used for driving the nail pushing component to move from back to front, the driving mechanism is connected between the execution head and a handle component, and the reversing transmission mechanism is connected between the driving mechanism and the rear part of the cutter.

Description

Surgical cutting anastomat

Technical Field

The invention belongs to the field of medical instruments, and particularly relates to a surgical cutting anastomat.

Background

The traditional straight-head and arc-shaped transverse cutting anastomat is mainly used for the creation of an anastomotic stoma and the closure of a stump or an incision in the digestive tract reconstruction and the organ resection operation which are difficult to expose in the operative field. At present, the transverse cutting anastomat is generally used in the following process: after the locking handle positions and locks tissues, the firing handle is pushed, the cutter hidden in the nail bin assembly is pushed by the center rod driven by the firing handle, the other side of the tissues to be cut is a nail abutting seat and a cutter pad providing a tissue cutting platform, and the whole cutting process of the driven straight cutter is to cut off the cutter pad to represent that the cutting task is completed. The severed shim is generally not reusable.

The operation of the same patient can not be completed through one incision, and multiple incisions are needed, and if the instrument is changed for each incision, the treatment cost of the patient is increased, so that the instrument capable of changing the components is needed in general, and the cost can be reduced under the condition that the health of the patient is not influenced. The existing device for replacing the components is usually replaced by the nail abutting seat, the knife pad and the nail bin component, the difficulty in replacing the components together is very high, the components are not fixed into a whole, the position of each component of the components needs to be moved by a component replacing person, the degree of freedom among the components is higher, misoperation can easily occur, people who are not trained can not replace the components well, the trained people can replace the components with great effort, and the energy and the operation time of doctors are wasted in the component replacing process.

For example, chinese patent CN101966093B discloses an endoscopic surgical cutting stapler with a replaceable cartridge component, an executing head of the endoscopic surgical cutting stapler comprises an executing frame, a sliding bar, a cartridge component and a nail anvil component, a nail groove, a nail pushing hole, a sliding plate groove and a knife pushing groove are arranged in a cartridge shell, an end face of the nail anvil component is provided with an anastomotic nail forming groove corresponding to the position of anastomotic nails in the cartridge component and a cutting groove corresponding to the position of the knife pushing groove in the cartridge shell, a cutting knife is arranged in the knife pushing groove of the cartridge shell, an arc-shaped sliding groove is arranged at the proximal end of the cartridge shell, when the cartridge component is in use, the sliding bar moves from the proximal end to the distal end of the cartridge component, and the nail pushing sliding plate pushes a nail pushing block to push out anastomotic nails from the nail groove when the nail pushing block moves in the nail pushing hole by means of an inclined plane of the nail pushing sliding plate. Although the nail bin assembly is convenient to replace, the nail bin assembly and the nail anvil assembly provided with the knife pad still need to be replaced respectively after one-time sewing, and the use is not convenient enough.

Disclosure of Invention

In view of the above problems, it is an object of the present invention to provide a surgical cutting stapler in which staples and a knife pad are located on the same side of the tissue to be cut and can be replaced integrally, thereby simplifying the assembly replacement operation.

In order to achieve the purpose, the invention adopts the technical scheme that:

the utility model provides a surgical cutting anastomat, is including the executor head that is located the front end, the handle subassembly that is located the rear end, the executor head includes the fore-stock, locates nail anvil subassembly and the nail storehouse subassembly on the fore-stock, the nail storehouse subassembly includes the nail storehouse shell, is located the nail in the nail storehouse shell, can set up with sliding around being used for in the nail storehouse shell will the nail is pushed out the staple pusher of nail storehouse shell, the nail anvil subassembly is including fixed locating support nail seat on the fore-stock, support be formed with on the terminal surface of nail seat with the nail shaping groove that the nail corresponds, the nail storehouse subassembly is still including locating the shim in the nail storehouse shell, the nail anvil subassembly is still including establishing with sliding around can cutter on the fore-and-aft cutter on the fore-stock, the front portion of cutter is formed with being located cutting portion before the shim, the executor head still including being used for driving the cutter is from the preceding switching-over drive mechanism that moves to the back, this surgical cutting anastomat still includes being used for driving the staple pusher is from the back to the antedisplacement drive mechanism, drive mechanism connect in between the executor head and the handle subassembly the switching-over drive mechanism.

Preferably, the reversing transmission mechanism comprises a gear or a gear set which can be driven to rotate by the driving mechanism, a first rack part is arranged at the rear part of the cutter, a plurality of teeth are sequentially arranged in the front direction of the cutter in the first rack part, and the gear or the gear set is meshed with the first rack part and is respectively positioned at two opposite sides of the gear or the gear set.

More preferably, the driving mechanism includes a center rod slidable in a front-rear direction, a front portion of the center rod has a second rack portion provided with a plurality of teeth arranged in sequence in the front-rear direction, the first rack portion and the second rack portion are respectively located on opposite sides of the gear or the gear set, and the surgical cutting stapler has a cutting state in which the first rack portion and the second rack portion are respectively engaged with opposite sides of the gear or the gear set when the surgical cutting stapler is in the cutting state.

Further, the driving mechanism further comprises a push rod which can slide along the front-back direction and is used for pushing the nail pushing piece forwards, a transmission assembly which is connected between the push rod and the central rod and enables the push rod to slide along with the central rod, the surgical cutting anastomat further has a nail hitting state, when the surgical cutting anastomat is in the nail hitting state, the second rack portion is disengaged from the gear or the gear set, and the nails are pushed out of the magazine shell by the nail pushing piece.

Still further, the drive assembly is including forming on the well core rod and along the first spout that the fore-and-aft direction extends, slide and set up first axle, the front end in the first spout with the rear end of ejector pin pole passes through first articulated rod that the first axle rotates the connection mutually, form and be in well core rod on and along the second spout that the upper and lower direction slope extends, can slide and set up second axle in the second spout, the front end with the rear end of first articulated rod pass through the second axle rotate the second articulated rod of connection mutually, form and be in well core rod on and along the third spout that the fore-and-aft direction extends, slide and set up the third axle in the third spout, the rear end of second articulated rod pass through the third axle with the subassembly frame rotate and be connected mutually.

Further, the surgical cutting stapler has an initial state in which the second rack portion of the center rod is located a distance behind the front end portion of the push rod.

Furthermore, the driving mechanism further comprises a rear shell, a firing handle which is rotatably arranged on the rear shell, and a firing piece which is connected to the firing handle and can rotate along with the firing handle, wherein the firing piece is provided with a position which is abutted against the rear end of the central rod to push the central rod to slide forwards.

More preferably, the reversing gear mechanism further comprises a torsion spring for returning the gear or set of gears.

Preferably, the nail pushing piece comprises a plurality of rows of nail pushing needles which are respectively arranged on the left side and the right side of the knife pad.

Preferably, the front frame is provided with a positioning pin, the cutter is provided with a long groove extending along the front-back direction, and the positioning pin can be slidably inserted into the long groove along the front-back direction.

Compared with the prior art, the invention has the following advantages by adopting the technical scheme:

the knife pad and the nail bin assembly are positioned at the same side of the cut tissue, so that the nail bin assembly which is fixed as a whole and contains the nail and the knife pad can be changed when the assembly is changed, the nail and the knife pad can be replaced through simple operation, the instrument is simple and convenient to replace, and the assembly replacement operation is simplified. The problem of among the prior art shim and the nail storehouse subassembly separation be located the position that needs to be cut tissue both sides respectively, eliminated when trading the subassembly many aspects difficulties such as many location positions and quilt change subassembly unstability, improved the use physical examination of trading the subassembly and reduced the probability of making mistakes when trading the subassembly is solved.

Drawings

In order to more clearly illustrate the technical solution of the present invention, the drawings needed to be used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on the drawings without creative efforts.

FIG. 1 is a schematic view of a surgical cutting stapler of the present invention in an initial state;

FIG. 2 is a schematic view of a staple cartridge assembly of the present invention;

FIG. 3 is a schematic view of a cutting blade according to the present invention;

FIG. 4 is a schematic view of the actuator head shown in FIG. 1 in a nailing state;

FIG. 5 is a schematic view of the actuator head shown in FIG. 4 with the left anvil omitted;

FIG. 6 is a schematic view of the actuator head of FIG. 1 in a cutting state;

figure 7 is a schematic illustration of the actuator head of figure 6 without the left anvil.

In the above-described figures of the drawings,

1. an execution head; 2. a handle assembly; 3. a drive mechanism;

11. a front frame; 110. positioning pins; 12. a nail anvil component; 13. a staple cartridge assembly; 14. a gear; 15. a torsion spring;

121. a nail abutting seat; 122. a cutter; 1220. a cutting section; 1221. a first rack portion; 1222. a long groove;

131. a magazine housing; 132. a nail pushing piece; 133. a shim;

30. a rear housing; 31. a center pole; 310. a second rack portion; 32. a push rod; 33. a firing handle; 34. a firing member; 3a, a first chute; 3b, a first shaft; 3c, a first hinge lever; 3d, a second chute; 3e, a second shaft; 3f, a second hinge lever; 3g, a third chute; 3h, and a third shaft.

Detailed Description

Preferred embodiments of the present invention will be described in detail below with reference to the accompanying drawings so that the advantages and features of the invention may be more readily understood by those skilled in the art. It should be noted that the description of the embodiments is provided to help understanding of the present invention, and is not intended to limit the present invention. In addition, the technical features involved in the embodiments of the present invention described below may be combined with each other as long as they do not conflict with each other.

The terms of orientation such as front and back are defined according to the conventional viewing angle of a person skilled in the art and for convenience of description, and are not limited to a specific direction. E.g., front and back, respectively, correspond to the left and right sides of the page in fig. 1.

As shown in FIGS. 1-7, a surgical cutting and stapling instrument includes an implement head 1 at a front end, a handle assembly 2 at a rear end, and a drive mechanism 3 for coupling the implement head 1 and the handle assembly 2.

The execution head 1 comprises a front frame 11, an anvil assembly 12 arranged on the front frame 11 and a cartridge assembly 13 arranged on the front frame 11. The nail bin assembly 13 is detachably arranged with the front frame 11, a containing groove matched with the nail bin assembly 13 is formed in the front frame 11, and the nail bin assembly 13 can be inserted into the containing groove in a front-back sliding mode to be sutured and can be detached and replaced after one-time suturing.

The cartridge module 13 includes a cartridge housing 131 having a cavity therein, a plurality of staples located in the cartridge housing 131 for suturing tissue, a plurality of staple slots formed on the cartridge housing 131 for ejecting the staples, and a staple pusher 132 slidably disposed in the cartridge housing 131 along the front-back direction for pushing the staples out of the staple slots. The nail bin assembly 13 further comprises a knife pad 133 which is arranged in the nail bin shell 131 and can be matched with the cutter, the knife pad 133 is specifically arranged on the nail pushing piece 132, a plurality of rows of nail pushing pins are arranged on the nail pushing piece 132, and at least one row of nail pushing pins are correspondingly arranged on the left side and the right side of the knife pad 133 respectively.

The anvil assembly 12 comprises a nail abutting seat 121 capable of cooperating with the staples, and a staple forming groove corresponding to the staples is formed on the rear end surface of the nail abutting seat 121. After the staples are pushed out of the cartridge housing 131 and through the tissue, the staples contact the anvil 121 and are bent by the staple forming slot. The nail box component 13 is positioned behind the nail anvil component 12, and the nail box component and the nail anvil component are arranged oppositely and have a certain interval. The anvil assembly 2 further includes a cutter 122 slidably disposed on the front frame 11, and a cutting portion 1220 is formed at a front portion of the cutter 122 in front of the knife pad 133. At least one nail abutting seat 121 is respectively arranged on the left side and the right side of the cutter 122 corresponding to the nail pushing piece 132. Specifically, the front frame 11 is provided with a positioning pin 110, the cutter 122 is provided with a long groove 1222 extending in the front-back direction, and the positioning pin 110 is slidably inserted in the long groove 1222 in the front-back direction. The long grooves 1222 are plural and are opened at different positions of the cutter 122.

The driving mechanism 3 is used to drive the staple pusher 132 to move from back to front to push out the staples for suturing. The execution head 1 further comprises a reversing transmission mechanism for driving the cutting knife 122 to move from front to back, and the other function of the driving mechanism 3 is to drive the cutting knife 122 to move from front to back in a reverse direction through the reversing transmission mechanism for cutting. The reversing transmission mechanism is connected between the driving mechanism 3 and the rear part of the cutter 122. The reversing transmission mechanism comprises a gear 14 or a gear set which can be driven by the driving mechanism 3 to rotate, the rear part of the cutting knife 122 is provided with a first rack part 1221, the upper edge of the first rack part 1221 is provided with a plurality of teeth which are sequentially arranged along the front direction, the lower part of the gear 14 or the gear set is meshed with the first rack part 1221, and the first rack part 1221 and the driving mechanism 3 are respectively positioned at the upper and lower opposite sides of the gear 14 or the gear set. The reversing gear further comprises a torsion spring 15 for resetting the gear 14 or gear set.

The driving mechanism 3 includes a center rod 31 slidable in the front-rear direction, a second rack portion 310 is provided at a front portion of the center rod 31, a plurality of teeth are provided at a lower edge of the second rack portion 310 in a sequential order in the front-rear direction, a first rack portion 1221 and the second rack portion 310 are respectively located at opposite sides of the gear 14 or the gear set, and the surgical cutting stapler has a cutting state in which the first rack portion 1221 and the second rack portion 310 are respectively engaged with the opposite sides of the gear 14 or the gear set when the surgical cutting stapler is in the cutting state.

The driving mechanism 3 further includes a pusher 32 slidable in the forward-backward direction for pushing the pusher 132 forward, a transmission assembly connected between the pusher 32 and the center rod 31 so that the pusher 32 is slidable along the center rod 31, and the surgical cutting stapler further has a staple-striking state in which the second rack 310 and the gear 14 or the gear train are disengaged and staples are pushed out of the cartridge housing 131 by the pusher 132 when the surgical cutting stapler is in the staple-striking state.

The surgical cutting stapler has an initial state in which the second rack portion 310 of the center bar 31 is located a distance behind the front end portion of the push bar 32. Thus, as the center rod 31 is fired and slid forward, the surgical cutting stapler is first transitioned from the initial state to the stapling state and then to the cutting state.

The transmission assembly includes a first sliding groove 3a formed in the central rod 31 and extending in the front-rear direction, a first shaft 3b slidably disposed in the first sliding groove 3a, a first hinge rod 3c having a front end portion rotatably connected to the rear end portion of the push rod 32 via the first shaft 3b, a second sliding groove 3d formed in the central rod 31 and extending obliquely in the up-down direction, a second shaft 3e slidably disposed in the second sliding groove 3d, a second hinge rod 3f having a front end portion rotatably connected to the rear end portion of the first hinge rod 3c via the second shaft 3e, a third sliding groove 3g formed in the central rod 31 and extending in the front-rear direction, and a third shaft 3h slidably disposed in the third sliding groove 3g, and a rear end portion of the second hinge rod 3f is rotatably connected to the rear housing 30 via the third shaft 3 h. The upper end of the second chute 3d communicates with the front end of the third chute 3g, the second chute 3d extends obliquely upward from front to rear, and the first chute 3a and the second chute 3d are on the same straight line. When the surgical cutting stapler is in a staple hitting state, under the action of the transmission device, namely the second shaft 3e slides in the second chute 3d, the first hinge rod 3c and the second hinge rod 3f are in the same straight line, so that the sliding distance of the push rod 32 is greater than that of the central rod 31, and staples are pushed out of the casing 131 by the push piece 132, and the cutting knife 122 is located in the casing 131; when the surgical cutting stapler is in a cutting state, the central rod 31 continues to slide forward, and the second rack portion 310 and the gear 14 or the gear set engage to drive the cutter 122 to cut from front to back, because the first shaft 3b slides in the first slide groove 3a, and the second shaft 3e and the third shaft 3h slide in the third slide groove 3 g.

The driving mechanism 3 further comprises a firing handle 33 rotatably connected to the handle assembly 2, and a firing member 34 connected to the firing handle 33 and rotatable with the rotation of the firing handle 33, wherein an upper end of the firing member 34 has a position abutting against a rear end surface of the central rod 3131 to push the central rod 31 to slide forward.

After the central rod 31 is pushed forward to a certain position, the central rod 31 is meshed with the gear 14 or the gear set, the gear 14 or the gear set drives the cutter 122 to move, and the cutter 122 moves from the nail abutting seat 121 side to the nail cartridge assembly 13 side to cut the tissue until the cutter pad 133 is cut off. After cutting, releasing and resetting are carried out, the cutting knife 122 and the nail bin assembly 13 reset, and the instrument cannot be fired again. The component replacement process comprises the following steps: the nail bin assembly is pulled out, then the assembly which needs to be replaced is taken out, the aligning instrument is meshed with the nail bin assembly, the inserting and pulling port is pressed in the direction of the instrument body, the feedback of clicking sound is heard, and the action of replacing the assembly is completed.

The above-mentioned embodiments are merely illustrative of the technical concepts and features of the present invention, and are preferred embodiments, which are intended to enable those skilled in the art to understand the contents of the present invention and implement the present invention, and not to limit the scope of the present invention. All equivalent changes or modifications made according to the spirit of the present invention should be covered within the protection scope of the present invention.

Claims

1. The utility model provides a surgical cutting anastomat, includes the execution head that is located the front end, is located the handle components of rear end, the execution head includes the front bezel, locates nail anvil subassembly and nail storehouse subassembly on the front bezel, the nail storehouse subassembly includes the magazine shell, is located the sewing nail in the magazine shell, can set up with sliding around can be in be used for in the magazine shell will the sewing nail is pushed out the nail ejecting piece of magazine shell, the nail anvil subassembly is including fixed locating support the nail seat on the front bezel, support to be formed with on the terminal surface of nail seat with the sewing nail shaping groove that the sewing nail corresponds, its characterized in that: the nail bin assembly further comprises a knife pad arranged in the nail bin shell, the nail anvil assembly further comprises a cutter which is arranged on the front frame in a front-back sliding mode, a cutting part located in front of the knife pad is formed in the front portion of the cutter, the execution head further comprises a reversing transmission mechanism used for driving the cutter to move from front to back, the surgical cutting anastomat further comprises a driving mechanism used for driving the nail pushing piece to move from back to front, the driving mechanism is connected between the execution head and the handle assembly, and the reversing transmission mechanism is connected between the driving mechanism and the rear portion of the cutter;

the reversing transmission mechanism comprises a gear or a gear set which can be driven by the driving mechanism to rotate, a first rack part is arranged at the rear part of the cutter, a plurality of teeth which are sequentially arranged along the front direction are arranged on the first rack part, the gear or the gear set is meshed with the first rack part, and the first rack part and the driving mechanism are respectively positioned at two opposite sides of the gear or the gear set;

the driving mechanism comprises a center rod which can slide along the front-back direction, the front part of the center rod is provided with a second rack part, the second rack part is provided with a plurality of teeth which are sequentially arranged along the front-back direction, the first rack part and the second rack part are respectively positioned at two opposite sides of the gear or the gear set, the surgical cutting anastomat has a cutting state, and when the surgical cutting anastomat is in the cutting state, the first rack part and the second rack part are respectively meshed with two opposite sides of the gear or the gear set;

the driving mechanism further comprises a push rod which can slide along the front-back direction and is used for pushing the nail pushing piece forwards, and a transmission assembly which is connected between the push rod and the central rod so that the push rod can slide along with the central rod, the surgical cutting anastomat further has a nail beating state, when the surgical cutting anastomat is in the nail beating state, the second rack part is disengaged from the gear or the gear set, and the nails are pushed out of the cartridge shell by the nail pushing piece;

the driving assembly comprises a first sliding groove formed on the central rod and extending along the front-back direction, a first shaft arranged in the first sliding groove in a sliding manner, a first hinged rod, a second sliding groove, a second shaft, a second hinged rod, a third sliding groove and a third shaft, wherein the front end part of the first hinged rod is rotatably connected with the rear end part of the push rod through the first shaft;

the surgical cutting stapler has an initial state in which the second rack portion of the center rod is located a distance behind the leading end portion of the push rod.

2. The surgical cutting stapler of claim 1, wherein: the driving mechanism further comprises a firing handle rotatably arranged on the rear shell, and a firing piece which is connected to the firing handle and can rotate along with the firing handle, wherein the firing piece is provided with a position which is abutted against the rear end of the central rod to push the central rod to slide forwards.

3. The surgical cutting stapler of claim 1, wherein: the reversing gear further comprises a torsion spring for resetting the gear or gear set.

4. The surgical cutting stapler of claim 1, wherein: the nail pushing piece comprises a plurality of rows of nail pushing needles which are respectively arranged on the left side and the right side of the knife pad.

5. The surgical cutting stapler of claim 1, wherein: the front frame is provided with a positioning pin, the cutter is provided with a long groove extending along the front-back direction, and the positioning pin can be inserted into the long groove in a sliding manner along the front-back direction.