CN106901787B - Tissue closing device, tissue closure component and the medical instrument equipped with the tissue closing device - Google Patents

Abstract

The invention discloses a tissue closing device, a tissue closing assembly and a medical instrument. The tissue closing device includes a base, a pressure plate matched with the base, and a nail pushing piece; the pressure plate is configured to be rotatable relative to the base, and includes an open position and a closed position, when the pressure plate is in the closed position, The pressing plate and the base cooperate to form a first accommodating space that can accommodate a part of the tubular tissue; the nail pushing piece includes an initial position and a firing position, and the initial position is located at the firing position and the first accommodating position. a proximal end of the accommodating space; the tissue closure device further includes a nail placement portion, the nail placement portion is disposed at the distal end of the base and used to place closing nails, and the nail pushing piece and the nail placement portion are provided It is a structure that can cooperatively drive the closed staples located at the staple placement portion to deform. The invention forms a centrally folded bundled purse through a tissue closing device, thereby reducing the risk of fistula and operation cost after subsequent anastomosis with a tubular stapler.

Description

Tissue closure device, tissue closure assembly, and medical device equipped with the tissue closure device therapeutic equipment

technical field

The present invention relates to the technical field of medical devices, in particular to a tissue closure device, a tissue closure assembly and a medical device equipped with the tissue closure device.

Background technique

In the existing alimentary canal anastomosis operation, a linear or arc-shaped stapler is generally used to perform multi-angle anastomosis on tubular tissue, and then a circular tubular stapler is used to perform butt anastomosis on the severed tissue.

However, when a linear or curved stapler is used to perform anastomosis on tubular tissue, since the anastomosis is linear, especially when performing a low rectal position, it is limited by the operating space of the human pelvic floor and its limitations. Due to the limitation of the swing angle of the linear instrument, there will be a phenomenon of cross-pinning. In this way, there will be "cat ears" when using a cylindrical stapler for anastomosis, which not only has the risk of fistula, but also has a high surgical cost.

SUMMARY OF THE INVENTION

The object of the present invention is to provide a tissue closure device, a tissue closure assembly and a medical device equipped with the tissue closure device.

In order to achieve one of the above purposes of the invention, an embodiment of the present invention provides a tissue closure device, comprising a base, a pressure plate matched with the base, and a nail push piece, wherein,

The pressure plate is arranged to be rotatable relative to the base, and includes an open position and a closed position. When the pressure plate is in the closed position, the pressure plate and the base cooperate to form a first portion that can accommodate a portion of the tubular tissue. accommodation space;

The nail push piece includes an initial position and a firing position, and the initial position is located at the firing position and the proximal end side of the first accommodating space;

The tissue closure device further includes a nail placement portion, the nail placement portion is disposed at the distal end of the base and used for placing at least one closure nail, the nail pusher piece and the nail placement portion are configured to cooperatively drive the position at the base. The structure of the closed nail deformation of the nail setting part.

As a further improvement of an embodiment of the present invention, the nail setting portion forms a second accommodating space, the second accommodating space is communicated with the first accommodating space, and the height of the second accommodating space is greater than the height of the first accommodating space.

As a further improvement of an embodiment of the present invention, the nail placement portion and the base are integrally formed, and the inner bottom wall of the nail placement portion and the inner bottom wall of the base smoothly transition.

As a further improvement of an embodiment of the present invention, the second accommodating space includes at least one nail placement slot, and each nail placement slot can accommodate at least a part of a closed nail, so as to fix the closed nail and the nail placement relative position of the part.

As a further improvement of an embodiment of the present invention, when the nail pushing piece moves from the initial position to the firing position, the tubular tissue provided in the first accommodating space gradually moves toward the second accommodating space. The accommodating spaces are folded, and finally all the accommodating spaces are accommodated in the second accommodating space.

As a further improvement of an embodiment of the present invention, the distal end face of the nail push piece is set as an arc-shaped forming groove;

When the nail pushing piece moves from the initial position to the firing position, the arcuate end of the forming groove first contacts the closing nail, and during the continuous movement of the nail pushing piece, the closed nail is given a positive effect on the closing nail. applying pressure to the open end to bend the open end of the closure staple;

When the nail pushing piece reaches the firing position, the forming groove forms a third accommodating space for accommodating part of the tubular tissue.

As a further improvement of an embodiment of the present invention, the tissue closure device further includes a staple cartridge, the staple cartridge is communicated with the staple setting groove of the staple setting portion, and the staple cartridge is provided with a nail pushing structure to The closed staples in the magazine are loaded into the staple slot.

As a further improvement of an embodiment of the present invention, the magazine is provided in the nail setting portion.

To achieve one of the above objectives of the invention, an embodiment of the present invention provides a tissue closure assembly, the tissue closure assembly comprising the tissue closure device described in any one of the above technical solutions, and a closure that can be assembled to the tissue closure device. During the closing process, when the nail push piece is in the initial position, the free end of the closing nail is opposite to the nail push piece, and when the nail push piece is in the firing position, the free end of the closing nail is free The end is bent by the action of the push nail.

As a further improvement of an embodiment of the present invention, the closure nail has an opening, a bottom opposite to the opening, and a side wall connected to the bottom, and the end of the side wall is thorn-shaped.

As a further improvement of an embodiment of the present invention, at least one spiked portion is provided on the bottom of the closure nail.

As a further improvement of an embodiment of the present invention, at least one barb with an end point toward the bottom is provided on the side portion of the closure nail.

In order to achieve one of the above purposes of the invention, an embodiment of the present invention provides a medical device, including a device body and a firing handle connected to the device body, characterized in that the medical device further includes any one of the above technical solutions. The tissue closure device is removably connected to the instrument body.

Compared with the prior art, the present invention has the beneficial effects of forming a centrally folded purse through a tissue closure device, reducing the risk of "cat ears" and fistulas after subsequent anastomosis with a tubular stapler, and at the same time, the operation is simple and easy to use. It is convenient and reduces the cost of surgery.

Description of drawings

1 is a schematic perspective view of a medical device in an embodiment of the present invention;

2 is a schematic perspective view of a tissue closure device according to an embodiment of the present invention;

3 is a cross-sectional view of a tissue closure device in accordance with an embodiment of the present invention;

4 is a schematic perspective view of a tissue closure device according to an embodiment of the present invention;

5 is a schematic perspective view of a tissue closure device according to another embodiment of the present invention;

Figure 6a is a schematic perspective view of a pressure plate of a tissue closure device in an open position according to an embodiment of the present invention;

Figure 6b is a schematic perspective view of the pressure plate of the tissue closure device in a closed position according to an embodiment of the present invention;

Figure 6c is a schematic perspective view of the pusher piece of the tissue closure device in the process of moving from the initial position to the firing position according to an embodiment of the present invention;

Fig. 6d is a schematic perspective view of the pusher piece of the tissue closure device reaching the firing position according to an embodiment of the present invention;

Fig. 7a is a three-dimensional schematic diagram of a closed nail in an embodiment of the present invention;

Figure 7b is a schematic perspective view of the closure nail shown in Figure 7a after bending;

Fig. 7c is a schematic perspective view of a closed staple in another embodiment of the present invention.

Detailed ways

The present invention will be described in detail below with reference to the specific embodiments shown in the accompanying drawings. However, these embodiments do not limit the present invention, and structural, method, or functional changes made by those skilled in the art according to these embodiments are all included in the protection scope of the present invention.

In order to clearly express the positions and directions described in the present invention, with reference to the operator of the instrument, the end close to the operator is the proximal end, and the end away from the operator is the distal end.

As shown in FIG. 1 , the present invention discloses an embodiment of a medical device, which can be used in anastomosis of the digestive tract, which includes an instrument body 10 and a firing handle 20 pivotally connected to the instrument body 10 . , and the tissue closure device 30 removably connected to the instrument body 10 . Typically, the tissue closure device 30 is disposed at the distal end of the instrument body 10 .

The structure of the instrument body 10 can follow the structure of the existing linear or arc-shaped stapler, or can be designed independently. It is understood that the structure of the instrument body 10 can work with the tissue closure device 30 only. That's it. In the following description, the structure of the instrument body of the conventional linear or arcuate stapler will be described as the structure of the instrument body 10 in the present embodiment.

In addition, an embodiment of a tissue closure assembly is also disclosed in the present invention. The tissue closure assembly includes a tissue closure device 30 and a closure staple 50 that can be assembled to the tissue closure device 30 . The structure and usage of the tissue closure device 30 and the closure staple 50 will be described in detail below.

As shown in FIGS. 2 and 3 , the tissue closure device 30 includes a connecting portion 301 , a base 303 , a pressing plate 305 matched with the base 303 , a nail pushing piece 307 , and a nail setting portion 309 .

Wherein, the connecting portion 301 is used for connecting the instrument body 10 . The base 303 is disposed at the distal end of the connecting portion 301 , and can be integrally formed with the base of the connecting portion 301 .

The pressing plate 305 can be pivotally connected to the base 303 so that the pressing plate 305 can rotate relative to the base 303 .

The nail placement portion 309 is disposed at the distal end of the base 303 .

Further, the pressing plate 305 includes an open position and a closed position, for example, two extreme positions of the pivoting of the pressing plate 305 or close to the extreme positions (caused by errors in mechanical cooperation), when the pressing plate 305 is located at In the closed position, the pressing plate 305 and the base 303 can cooperate to form a first accommodating space 401 for accommodating part of the tubular tissue, and the first accommodating space 401 is a cavity with two ends open. During surgery, tubular tissue (eg, intestine, etc.) can be incorporated in the open position, and a portion of the tubular tissue is located between the platen 305 and the base 303 in the closed position.

Further, the nail pushing piece 307 includes an initial position and a firing position, and the initial position is located at the firing position and the proximal end of the first accommodating space 401 (as shown in 6a). Generally, when the nail pushing piece 307 is in the initial position, it can act on the distal end of the pressing plate 305 to move away from the base 303 to reach the open position of the pressing plate 305; When the initial position moves to the firing position, it can act on the distal end of the pressing plate 305 to approach the base 303 to reach the closed position of the pressing plate 305 (as shown in 6b), and its working principle can be referred to as a linear Or the matching structure of the I-shaped knife, the nail cartridge and the nail anvil in the arc-shaped stapler will not be repeated here.

Further, the staple placement portion 309 can be used to place at least one closed staple. The nail pushing piece 307 and the nail setting portion 309 are configured to cooperatively drive the closed nails located in the nail setting portion 309 to deform.

Wherein, the nail pushing piece 307 can be set in various shapes, as long as it can cooperate with the nail setting portion to drive the closure nail to deform to complete the closure of the tissue. In one form, the distal end of the nail pushing piece 307 is provided with a flat forming groove, so that when the nail pushing piece 307 moves from the initial position to the firing position (as shown in 6c) ), the tubular tissue disposed in the first accommodating space 401 is gradually retracted toward the second accommodating space 403 , and finally all accommodated in the second accommodating space 403 . It can be understood that, during the operation, when the nail pushing piece 307 is in the initial position, no matter whether there is tubular tissue placed in the first accommodating space 401 and the second accommodating space 403, or only in the Tubular tissue is placed in the first accommodating space 401. When the nail pusher moves from the initial position to the firing position, the tubular tissue in the first accommodating space 401 will be pushed into the second accommodating space 403. , so that when the nail pushing piece 307 reaches the firing position, the tubular tissue collected in the second accommodating space 403 can be bundled into a purse.

In another way, the distal end face of the nail pushing piece 307 can be set as an arc-shaped forming groove. In this way, when the nail pushing piece 307 moves from the initial position to the firing position, the arc-shaped end of the forming groove first contacts the closing nail, and in the continuous movement of the nail pushing piece 307, the The open ends of the closed staples 50 exert pressure, so that the open ends of the closed staples 50 are bent, and the bundled purse is applied to the gathered tubular tissue. Wherein, the shaping groove can form a third accommodating space 405 for accommodating a part of the tubular tissue. When the nail pushing piece 307 reaches the firing position, the third accommodating space 405 can be in the position of the assembly closing device. The second accommodating space 403 is closed in the axial direction (as shown in 6d), which increases the size of the accommodating space for the tubular tissue. It can be understood that the third accommodating space 405 is actually a part of the first accommodating space 401 .

It can be understood that when the forming grooves of the nail pushing sheet are set to different shapes, the shapes of the formed nails also change accordingly.

In an embodiment of the present invention, the nail setting portion 309 forms a second accommodating space 403, and the second accommodating space 403 communicates with the first accommodating space 401, that is, the second accommodating space The opening of 403 faces the nail pushing piece 307, wherein the height of the second accommodating space 403 is greater than the height of the first accommodating space 401, that is, the distance from the base 303 to the pressing plate 305 is smaller than the height of the first accommodating space 401. The diameter of the opening of the second accommodating space 403 is described.

Further, the nail placement portion 309 and the bottom plate 303 are integrally formed, and the inner bottom wall 3091 of the nail placement portion and the inner bottom wall 3031 of the bottom plate are smoothly transitioned through the arc surface or the inclined surface 3033 .

In this embodiment, the cross section of the nail setting portion 309 is U-shaped.

As shown in FIGS. 4 and 5 , FIG. 4 is an example in which only one closed nail can be placed in the nail placement part at a time, and FIG. 5 is an example in which two closed nails can be placed in the nail placement part at a time. The second accommodating space 403 includes at least one nail placement slot 3093, which can be formed by the inner wall of the nail placement portion 309, or can be provided on the inner wall of the nail placement portion 309,

Further, the tissue closure device 30 further includes a staple cartridge, the staple cartridge communicates with the staple setting slot 3093 of the staple setting portion 309 , and a staple pushing structure (eg, a return spring) is provided in the staple cartridge to remove the staples from the staples. The closed staples in the magazine are filled into the staple slot 3093, so that when there are no closed staples in the staple slot 3093 (for example, after firing is completed and the tissue is taken out), the next staple can be automatically inserted. A closed staple is loaded into the staple slot 3093 .

Further, the magazine is arranged in the staple setting portion 3093, for example, in the main body of the staple setting portion 3093 opposite to the opening of the staple setting portion. Of course, the staple cartridge can also be movably connected to the staple setting portion 3093, so as to facilitate the replacement and filling of closed staples.

As shown in Fig. 7a, in an embodiment of the present invention, the closure staple 50 in the tissue closure assembly has an opening 501, a bottom 503 opposite to the opening, and side walls 505a, 505b connected to the bottom, the The side walls 505a, 505b form the free ends of the closure staple 50 .

In this embodiment, the ends of the side walls 505a and 505b are formed into a spike shape, so as to penetrate the collapsed tubular tissue for closure.

During the closing process, when the deduction piece 307 is at the initial position, the free end of the closing staple 50 is opposite to the deduction piece 307 , and when the pusher piece 307 is at the firing position, the free end of the closing staple 50 is at the firing position. The free end penetrates the collapsed tubular tissue and bends under the action of the push nail to form the closed shape as shown in Figure 7b.

Further, at least one thorn portion 507 is provided on the bottom 503 of the closing nail 50 (Fig. 7a, 7b illustrate the case where one thorn portion is provided), so as to increase the strength of grasping the tissue after closing the tissue, Pierce the mucosal layer of the tissue to prevent slippage of the tissue.

As shown in FIG. 7 c , in another embodiment of the present invention, at least one barb 509 with an end point facing the bottom 503 is further provided on the side walls 505 a and 505 b of the closure nail 50 . It can be understood that, in this embodiment, the bottom 503 of the closure nail 50 may also be provided with at least one thorn portion 507 (Fig. 7c illustrates the case where two thorn portions are provided). Of course, in this embodiment, the spiked portion 507 may not be provided on the bottom 503 of the closure nail 50 .

The closure nails may be metal nails, or may be made of other materials with certain strength and elasticity.

To sum up, the tissue closure device, tissue closure assembly, and medical device of the present invention can form a centrally folded purse, and reduce the risk of "cat ears" and fistulas after subsequent anastomosis with a tubular stapler. When organizing tissue, only one operation is required, which is convenient to use and reduces the operation cost.

It should be understood that although this specification is described in terms of embodiments, not every embodiment only includes an independent technical solution, and this description in the specification is only for the sake of clarity, and those skilled in the art should take the specification as a whole, and each The technical solutions in the embodiments can also be appropriately combined to form other embodiments that can be understood by those skilled in the art.

The series of detailed descriptions listed above are only specific descriptions for the feasible embodiments of the present invention, and they are not used to limit the protection scope of the present invention. Changes should all be included within the protection scope of the present invention.

Claims (13)

1. a kind of tissue closing device, pressing plate and pushing slice of nail including pedestal and base engagement, which is characterized in that

The pressing plate is set as can the relatively described base rotation comprising an open position and a closed position, when the pressing plate When positioned at closed position, the pressing plate and the base engagement form one and can accommodate the first accommodating space of part tubular tissue；

The pushing slice of nail includes an initial position and a firing position, and the initial position is located at the firing position and described the The proximal lateral of one accommodating space；

The tissue closing device further includes setting nail portion, and the nail portion of setting is set to the pedestal distal end and for placing at least one A closure nail, the pushing slice of nail and the nail portion of setting are set as ordinatedly driving the knot for being located at the closure nail deformation for setting nail portion Structure.

2. tissue closing device according to claim 1, which is characterized in that the nail portion of setting forms one second accommodating sky Between, second accommodating space is connected to first accommodating space, and the height of second accommodating space is greater than described the The height of one accommodating space.

3. tissue closing device according to claim 2, which is characterized in that described to set nail portion and pedestal integrated molding And the inside bottom wall of the inside bottom wall for setting nail portion and the pedestal seamlessly transits.

4. tissue closing device according to claim 2, which is characterized in that second accommodating space includes at least one Nailed groove, each nailed groove can accommodate at least part of a closure nail, with the fixation closure nail and the nail portion of setting Relative position.

5. tissue closing device according to claim 2, which is characterized in that when the pushing slice of nail from the initial position to During the firing position is mobile, the tubular tissue in first accommodating space is gradually empty to second accommodating Between collapse, and final be all contained in second accommodating space.

6. tissue closing device according to claim 1, which is characterized in that the distal end end face of the pushing slice of nail is set as arc The forming tank of shape；

When the pushing slice of nail from initial position into firing position moving process, the curved end of the forming tank first with it is described It is closed nail joint touching, and applies pressure to the open end of the closure nail in the lasting movement of the pushing slice of nail, makes the closure The open end of nail is bent；

When the pushing slice of nail reaches firing position, the forming tank forms third accommodating space, to accommodate part tubular tissue.

7. tissue closing device according to claim 1, which is characterized in that the tissue closing device further includes nail kit, The nail kit is connected to the nailed groove for setting nail portion, nail pushing structure is equipped in the nail kit, by the closure in the nail kit Nail is loaded into the nailed groove.

8. tissue closing device according to claim 7, which is characterized in that the nail kit is set to described set in nail portion.

9. a kind of tissue closure component, which is characterized in that the tissue closure component includes any one of claim 1 to 8 The tissue closing device, and it can be assembled to the closure nail of the tissue closing device, in closing course, pushed away when described When nail piece is located at initial position, the free end of the closure nail is opposite with the pushing slice of nail, when the pushing slice of nail is located at percussion position When setting, the free end of the closure nail is acted on by pushing slice of nail to be bent.

10. tissue closure component according to claim 9, which is characterized in that the closure nail has opening portion, with opening The opposite bottom in portion, and the side wall connecting with bottom, the end of the side wall are set as spininess.

11. tissue closure component according to claim 10, which is characterized in that be equipped with extremely on the bottom of the closure nail A few sharp portion.

12. tissue closure component described in 0 or 11 according to claim 1, which is characterized in that the side of the closure nail is equipped with Overhead kick of at least one endpoint towards the bottom.

13. a kind of medical instrument, the percussion handle including instrument body, the connection instrument body, which is characterized in that the doctor Treating instrument further includes tissue closing device as claimed in any of claims 1 to 8 in one of claims, and the tissue closing device is removable Ground connects the instrument body.