CN109381236B - Pre-anastomosis pressure magnetic induction tubular anastomat - Google Patents

Pre-anastomosis pressure magnetic induction tubular anastomat Download PDF

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Publication number
CN109381236B
CN109381236B CN201811499419.0A CN201811499419A CN109381236B CN 109381236 B CN109381236 B CN 109381236B CN 201811499419 A CN201811499419 A CN 201811499419A CN 109381236 B CN109381236 B CN 109381236B
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ring
rotating shaft
anastomat
shell
anastomosis
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CN201811499419.0A
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CN109381236A (en
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毛诚晨
刘羊扣
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Jiangsu Celtics Meditech Co ltd
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Jiangsu Celtics Meditech Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation
    • A61B17/1155Circular staplers comprising a plurality of staples

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physiology (AREA)
  • Surgical Instruments (AREA)

Abstract

The utility model provides a pre-anastomosis pressure magnetic induction type tubular anastomat, the anastomat body comprises a firing handle component, an elbow component and a shell, wherein the firing handle component is arranged at the lower side of the shell, and the elbow component is arranged at the front end of the shell; the precompression sensing assembly comprises a cylindrical magnetic ring, a rotating shaft, a rotating handle and a push rod; the rotating shaft is arranged at the rear end of the inside of the shell, and the shaft can rotate around the center of the rotating shaft; the cylindrical magnetic ring is fixed on the rotating shaft; the rotating handle is arranged on the rotating shaft, and a metal ring is arranged at the part of the front end of the rotating handle, which coincides with the cylindrical magnetic ring in the axial direction; one end of the push rod is screwed in the rotating shaft, and the other end of the push rod is connected with the bent pipe assembly. The anastomat is convenient to operate, after the anastomat position is determined, a doctor does not need to manually and repeatedly adjust during the anastomat process, the rotating handle is directly screwed to an idle state, the normal physiological state of human tissues to be anastomosed is well ensured by using a pressure sensing technology, the problems of over-anastomosis or out-of-place anastomosis are prevented, bleeding is less, the tension of an anastomotic stoma is small, and the recovery of the anastomotic site is facilitated.

Description

Pre-anastomosis pressure magnetic induction tubular anastomat
Technical Field
The invention relates to the technical field of medical appliances, in particular to a pre-anastomosis pressure magnetic induction tubular anastomat.
Background
The suturing device for anastomosis of various cavities and tracts of human body is called a tubular anastomat, can come in and go out on human body tissue, forms a plurality of rows of mutually staggered suturing nails which are arranged in the same direction, cuts off the tissue at the inner side of the suturing device by using an annular knife, and can rapidly and conveniently suture the lumen organs.
In the using operation process of the traditional tubular anastomat, whether the tissues are fully extruded or are correctly anastomosed is judged through the interval between the nail propping seat and the nail bin, so that the interval between the nail propping seat and the nail bin needs to be indicated for a doctor to judge. However, since the indicator needle to be observed by the doctor is located in the transparent indicator window on the opposite side from the firing handle, the indicator window is not directed to the doctor's line-of-sight side when the doctor manipulates the instrument due to manipulation or surgical requirements; in order to observe whether the body of the instrument rotates to the triggerable area (green area) or not, and when the body of the instrument is adjusted to the triggerable area, the doctor can influence the coordination of the doctor on the operation of the instrument (eyes, hands, instruments and tissues) when the position of the indicator needle is finely adjusted in the green area according to the thickness of the tissue.
However, the tubular anastomat sold in the market at present does not have the pre-pressure locking function, such as the bent-tube type digestive tract neck anastomat disclosed in Chinese patent No. 201220052990.X, the pointer piece disclosed in Chinese patent No. 201220732744.9, the tubular anastomat provided with the pointer piece, the tubular anastomat disclosed in Chinese patent No. 201220732605.6, the tubular anastomat disclosed in Chinese patent No. 201210582068.6, the tubular anastomat with multiple indication windows disclosed in Chinese patent No. 201820041248.6, and the like, and the scheme of how to determine the pre-anastomosis pressure is not involved. The Chinese patent 201820041248.6 discloses an indication mechanism which can rotate around an anastomat body, but has a complex structure, and cannot accurately judge the pre-anastomosis pressure, and still requires a doctor to have high skill and abundant experience on the interval between a nail abutting seat and a nail bin to judge whether tissues are fully extruded or anastomosed. Because, the mere distance determination of the difference (particularly, the difference in thickness) between the tissues of the intestinal wall or the stomach wall of the human body does not reflect the state of adhesion between the two tissues.
The tubular anastomat disclosed in Chinese patent No. 201220732605.6 describes a great deal of detail about the percussion operation of the anastomat.
The tubular anastomat has many advantages such as no tension of an anastomotic orifice, good blood supply of an anastomotic site, no inflammation, injury, edema or cancer tissue residue of an anastomotic tissue and the like. However, due to the difference of human physique, especially the difference of tissue thickness of the intestinal wall and the stomach wall of the human body, the pre-anastomosis pressure (the tissue wall to be anastomosed needs to be tightly attached together and a certain pressure is kept to realize accurate anastomosis) needs to be completely determined by the experience of doctors, and sometimes the proper pre-anastomosis pressure is determined by repeatedly adjusting the relative position of the nail supporting seat component, so that the anastomotic firing operation can be performed, the efficiency is low, the operation difficulty is high, and the problems of anastomotic stoma and anastomotic bleeding are easily caused; meanwhile, the working intensity of doctors is high and the psychological pressure is high.
Disclosure of Invention
The invention aims to solve the technical problems of overcoming the defects of the prior art, and provides a pre-anastomosis pressure magnetic induction tubular anastomat which directly reflects the pre-compression state between intestinal walls or stomach walls to be anastomosed through the pressure perception design, so that the pre-anastomosis pressure tubular anastomat is direct and efficient, and reduces the labor intensity and psychological pressure of doctors.
In order to achieve the above purpose, the invention adopts the following technical scheme: the pre-anastomosis pressure magnetic induction type tubular anastomat comprises an anastomat body and an anastomat seat assembly, wherein the anastomat seat assembly is arranged at the front end of the anastomat body; the anastomat body comprises a firing handle assembly, an elbow assembly and a shell, wherein the firing handle assembly is arranged at the lower side of the shell, and the elbow assembly is arranged at the front end of the shell; the technical scheme also comprises a precompression sensing assembly arranged at the rear end of the bent pipe assembly, wherein the precompression sensing assembly comprises a cylindrical magnetic ring, a rotating shaft, a rotating handle and a push rod; the rotating shaft is arranged at the rear end of the inside of the shell, and the shaft can rotate around the center of the rotating shaft; the cylindrical magnetic ring is fixed on the rotating shaft; the rotating handle is arranged on the rotating shaft, and a metal ring is arranged at the part, which is overlapped with the cylindrical magnetic ring in the axial direction, of the front end of the rotating handle; one end of the push rod is screwed in the rotating shaft, and the other end of the push rod is connected with the bent pipe assembly.
The nail propping seat assembly comprises a nail propping seat, a sewing and cutting mechanism and an adjusting rod used for driving the nail propping seat and the sewing and cutting mechanism to be close to or far away from each other, and the adjusting rod is movably arranged in the shell along the front-back direction. The adjusting rod is connected with the push rod and is driven by the push rod to move forwards and backwards.
The cylindrical magnetic ring comprises at least 2 permanent magnet blocks, the permanent magnet blocks are fixed on the rotating shaft through injection molding or gluing, and the permanent magnet blocks are arc-shaped blocks.
The metal ring is an iron-titanium alloy ring or a permanent magnet ring, the clearance between the metal ring and the cylindrical magnetic ring is not smaller than 0.5mm, and the preferable clearance is 1 mm-2.5 mm.
The rotating shaft is of a hollow structure and comprises a front slip ring, a middle connecting cylinder and a rear slip ring; the middle connecting cylinder is positioned between the front slip ring and the rear slip ring; a positioning boss is arranged between the front slip ring and the middle connecting cylinder, and a positioning boss is arranged between the rear slip ring and the middle connecting cylinder; the rear end of the rear sliding ring is provided with a magnet installation ring surface, the outer side of the rear part of the rear sliding ring is provided with a round sliding groove, and the rear part of the rear sliding ring is provided with a trapezoid internal thread. The trapezoid internal thread has a self-locking function and prevents abrupt change of precompression before the operation is finished.
The rotating handle is of a hollow structure and comprises a shell and a plurality of sliding pawls arranged at the rear part of the shell, wherein the sliding pawls are matched with the smooth groove in size and can rotate along the smooth groove. The rotary handle is a pre-anastomosis pressure driving mechanism, the rotary shaft is driven to rotate by magnetic force, the rotary shaft drives the push rod to move back and forth through trapezoidal threads, and the push rod is connected with the adjusting rod, so that the relative position between the nail propping seat and the sewing and cutting mechanism is adjusted. When the pressure between the nail propping seat and the human tissue to be anastomosed between the suturing and cutting mechanism exceeds the magnetic force between the cylindrical magnetic ring and the metal ring, the rotary handle starts to idle, and the pre-anastomosis force is kept unchanged. At this time, the firing operation of the stapler can be performed.
The sliding claw comprises a claw root, a claw body and a claw head, wherein the claw root is fixed on the inner wall of the shell, the claw body is vertically fixed on the claw root, and the claw head is vertically fixed on the claw body; the front part of the claw head is an inclined surface. The claw body has certain elasticity, and the friction force between the claw head and the round chute is ensured to be in a relatively stable range.
The push rod comprises a front fork, a rear threaded handle and a middle connecting rod; the front fork is connected with the elbow assembly, and the rear threaded handle is screwed in the rotating shaft.
Due to the application of the technical scheme, compared with the prior art, the invention has the following advantages:
1. the operation is convenient, after the anastomosis position is determined, the rotary handle is directly screwed to an idle state without manual repeated adjustment by a doctor in the anastomosis process, and the efficiency is high.
2. The anastomosis effect is good, the normal physiological state of human tissues to be anastomosed can be better ensured by utilizing the pressure sensing technology, the problems of over anastomosis or out-of-place anastomosis are prevented, bleeding is less, the tension of an anastomotic stoma is smaller, and the recovery of an anastomotic site is facilitated.
Drawings
The technical scheme of the invention is further described below with reference to the accompanying drawings:
FIG. 1 is a schematic diagram of the outline structure of the present invention;
FIG. 2 is a schematic diagram of the overall cross-sectional structure of the present invention;
FIG. 3 is a schematic view of a partially cut-away structure of the present invention;
FIG. 4 is a schematic view of a partially cut-away structure of the present invention;
FIG. 5 is a schematic view of a spindle structure according to the present invention;
FIG. 6 is a schematic diagram of a cross-sectional structure of a spindle according to the present invention;
FIG. 7 is a schematic diagram of a sectional structure of a stem of the present invention;
fig. 8 is a schematic view of the push rod structure of the present invention.
In the figure: 1. a nail supporting seat; 2. a sewing and cutting mechanism; 3. a bent pipe assembly; 4. a housing; 5. an adjusting rod; 6. a firing handle assembly; 7. a rotating handle; 8. a push rod; 9. a rotating shaft; 10. a cylindrical magnetic ring; 11. a metal ring; 12. a front slip ring; 13. a middle connecting cylinder; 14. a rear slip ring; 15. positioning the boss; 16. a magnet mounting annulus; 17. a round chute; 18. trapezoidal internal threads; 19. a claw root; 20. a claw body; 21. a claw head; 22. a metal ring mounting groove; 23. a rear threaded shank; 24. an intermediate connecting rod; 25. a front fork.
Detailed Description
The present invention will be described in further detail with reference to specific examples.
The pre-anastomosis pressure magnetic induction tubular anastomat shown in fig. 1 to 4 simplifies the tightening process of the original manual control anastomat to depend on specific magnetic force control on the basis of the traditional anastomat, wherein the magnetic force is obtained through calculation and test and is generally set to be 15N-25N and corresponds to the specific length and thickness of the cylindrical magnetic ring 10. When the anastomat is used, only the rotating handle 7 is required to rotate according to the required direction, when the anastomat is tightened to a certain extent, the anastomotic tissue of the human body is in a close fit state, at the moment, the magnetic force generated by the cylindrical magnetic ring 10 is insufficient to overcome the pressure peak value for pre-anastomosis, and when the rotating handle 7 is rotated again, an idle phenomenon is generated between the rotating handle 7 and the cylindrical magnetic ring 10, namely: the rotating handle 7 independently rotates around the center of the rotating handle, the cylindrical magnetic ring 10 is stationary, the rotating shaft 9 is also in a stationary state, and the push rod 8 is also in a stationary state.
If the percussion operation of the anastomat is carried out, the structure of the percussion device thereof is shown in the circular tube type anastomat disclosed in Chinese patent number 201220732605.6.
In order to achieve the above-mentioned purpose, the magnetic induction tubular anastomat for pre-anastomosis pressure includes a nail supporting seat assembly and an anastomat body, wherein the nail supporting seat assembly is installed at the front end of the anastomat body, which is the same as the conventional anastomat. The nail seat component and the anastomat body are both in a structure similar to that of a traditional anastomat.
The nail propping seat assembly comprises a nail propping seat 1, a sewing and cutting mechanism 2 and an adjusting rod 5 used for driving the nail propping seat 1 and the sewing and cutting mechanism 2 to be close to or far away from each other, wherein the adjusting rod 5 is movably arranged in the shell 4 along the front-back direction. The adjusting rod 5 is connected with the push rod 8, and is driven by the push rod 8 to move forwards and backwards.
The distance between the nail propping seat 1 and the nail bin of the sewing mechanism 2 is adjustable between 0.5-2.5 mm, the adjusting rod 5 is movably arranged in the shell 1 along the front-back direction, the central line of the adjusting rod 5 extends along the front-back direction, and the front end part of the adjusting rod is specifically connected with the nail propping seat 1 to drive the nail propping seat 1 to move.
The anastomat body comprises a firing handle assembly 6, an elbow assembly 3 and a shell 4, wherein the firing handle assembly 6 is arranged at the lower side of the shell 4, and the elbow assembly 3 is arranged at the front end of the shell 4; the technical scheme further comprises a pre-pressure sensing assembly arranged at the rear end of the bent pipe assembly 3.
The precompression sensing component is the core content of the scheme of the application, and specifically comprises a cylindrical magnetic ring 10, a rotating shaft 9, a rotating handle 7 and a push rod 8; the rotating shaft 9 is arranged at the rear end inside the shell 4, and the shaft 9 can rotate around the center of the rotating shaft; the cylindrical magnetic ring 10 is fixed on the rotating shaft 9; the rotating handle 7 is arranged on the rotating shaft 9, and a metal ring 11 is arranged at the part of the front end of the rotating handle 7, which coincides with the cylindrical magnetic ring 10 in the axial direction; one end of the push rod 8 is screwed in the rotating shaft 9, and the other end is connected with the bent pipe assembly 3.
When the handle 7 is rotated, the metal ring 1 drives the cylindrical magnetic ring 10 to rotate by the magnetic force, the cylindrical magnetic ring 10 drives the rotating shaft 9 to rotate, and the rotating shaft 9 converts the rotating motion into linear motion to drive the push rod 8 to move. The push rod 8 drives the adjusting rod 5 to move linearly, and the adjusting rod 5 drives the nail propping seat 1 to move linearly.
The cylindrical magnetic ring 10 comprises at least 2 permanent magnet blocks which are fixed on the rotating shaft 9 through injection molding or gluing, wherein the permanent magnet blocks are arc-shaped blocks.
The metal ring 11 is an iron-titanium alloy ring or a permanent magnet ring, the clearance between the metal ring 11 and the cylindrical magnetic ring 10 is not less than 0.5mm, and the preferable clearance is 1 mm-2.5 mm.
The rotating shaft 9 is of a hollow structure and comprises a front slip ring 12, a middle connecting cylinder 13 and a rear slip ring 14; the middle connecting cylinder 13 is positioned between the front slip ring 12 and the rear slip ring 14; a positioning boss 15 is arranged between the front slip ring 12 and the middle connecting cylinder 13, and a positioning boss 15 is arranged between the rear slip ring 14 and the middle connecting cylinder 13; the rear end of the rear slip ring 14 is provided with a magnet mounting ring surface 16, the rear outer side of the rear slip ring 14 is provided with a round chute 17, and the rear of the rear slip ring 14 is provided with a trapezoidal internal thread 18. The trapezoid internal thread has a self-locking function and prevents abrupt change of precompression before the operation is finished.
The front slip ring 12 and the rear slip ring 14 are respectively lapped on corresponding bosses in the shell 4, so that the rotating shaft 9 can conveniently rotate around the central line of the rotating shaft.
The rotating handle 7 has a hollow structure and comprises a shell and a plurality of sliding pawls arranged on the inner side of the rear part of the shell, wherein the sliding pawls are matched with the size of the smooth groove 17 and can rotate along the smooth groove 17. The rotary handle is a driving mechanism for pre-anastomosis pressure, the rotary shaft 9 is driven to rotate by magnetic force, the rotary shaft 9 drives the push rod 8 to move back and forth through trapezoidal threads, and the push rod 8 is connected with the adjusting rod 5, so that the relative position between the nail propping seat 1 and the sewing and cutting mechanism 2 is adjusted. When the pressure between the nail propping seat 1 and the human tissue to be anastomosed between the suturing and cutting mechanism 2 exceeds the magnetic force between the cylindrical magnetic ring 10 and the metal ring 11, the rotary handle 7 starts to idle, and the pre-anastomosis force is kept unchanged. At this time, the firing operation of the stapler can be performed.
The sliding claw comprises a claw root 19, a claw body 20 and a claw head 21, wherein the claw root 19 is fixed on the inner wall of the shell 4, the claw body 20 is vertically fixed on the claw root 19, and the claw head 21 is vertically fixed on the claw body 20; the front part of the jaw 21 is an inclined surface. The claw body 20 has certain elasticity, ensures that the friction force between the claw head 21 and the smooth groove 17 is in a relatively stable range, and ensures that the rotary handle 7 rotates smoothly and stably.
The push rod 8 comprises a front fork 25, a rear threaded shank 23 and an intermediate connecting rod 24; the front fork 25 is connected with the adjusting rod 5 of the elbow assembly 3, the end head of the adjusting rod 5 is inserted into the front fork 25, and the front fork 25 and the adjusting rod 5 are fixed by bolts. The rear threaded handle 23 is screwed in the rotating shaft 9, and the rear threaded handle 23 is of a trapezoid external thread structure.
Both the trapezoidal internal thread 18 and the rear threaded shank 23 described above may be replaced with a lead screw arrangement.
The foregoing is merely a specific application example of the present invention, and the protection scope of the present invention is not limited in any way. All technical schemes formed by equivalent transformation or equivalent substitution fall within the protection scope of the invention.

Claims (7)

1. The pre-anastomosis pressure magnetic induction type tubular anastomat comprises an anastomat body and an anastomat seat assembly, wherein the anastomat seat assembly is arranged at the front end of the anastomat body; the anastomat body comprises a firing handle assembly, an elbow assembly and a shell, wherein the firing handle assembly is arranged on the lower side of the shell, and the elbow assembly is arranged at the front end of the shell, and is characterized in that: the pre-pressure induction assembly is arranged at the rear end of the bent pipe assembly and comprises a cylindrical magnetic ring, a rotating shaft, a rotating handle and a push rod; the rotating shaft is arranged at the rear end of the inside of the shell, and the shaft can rotate around the center of the rotating shaft; the cylindrical magnetic ring is fixed on the rotating shaft; the rotating handle is arranged on the rotating shaft, and a metal ring is arranged at the part, which is overlapped with the cylindrical magnetic ring in the axial direction, of the front end of the rotating handle; one end of the push rod is screwed in the rotating shaft, and the other end of the push rod is connected with the bent pipe assembly.
2. The pre-anastomosis pressure magnetic induction tubular anastomat according to claim 1, wherein: the cylinder magnetic ring comprises at least 2 permanent magnet blocks, and is fixed on the rotating shaft through injection molding or gluing.
3. The pre-anastomosis pressure magnetic induction tubular anastomat according to claim 2, wherein: the metal ring is an iron-titanium alloy ring or a permanent magnet ring, and the gap between the metal ring and the cylindrical magnetic ring is not smaller than 0.5mm.
4. The pre-anastomosis pressure magnetic induction tubular anastomat according to claim 1, wherein: the rotating shaft is of a hollow structure and comprises a front slip ring, a middle connecting cylinder and a rear slip ring; the middle connecting cylinder is positioned between the front slip ring and the rear slip ring; a positioning boss is arranged between the front slip ring and the middle connecting cylinder, and a positioning boss is arranged between the rear slip ring and the middle connecting cylinder; the rear end of the rear sliding ring is provided with a magnet installation ring surface, the outer side of the rear part of the rear sliding ring is provided with a round sliding groove, and the rear part of the rear sliding ring is provided with a trapezoid internal thread.
5. The pre-anastomosis pressure magnetic induction tubular anastomat according to claim 4, wherein: the rotating handle is of a hollow structure and comprises a shell and a plurality of sliding pawls arranged at the rear part of the shell, wherein the sliding pawls are matched with the smooth groove in size and can rotate along the smooth groove.
6. The pre-anastomosis pressure magnetic induction tubular anastomat according to claim 5, wherein: the sliding claw comprises a claw root, a claw body and a claw head, wherein the claw root is fixed on the inner wall of the shell, the claw body is vertically fixed on the claw root, and the claw head is vertically fixed on the claw body; the front part of the claw head is an inclined surface.
7. The pre-anastomosis pressure magnetic induction tubular anastomat according to claim 1, wherein: the push rod comprises a front fork, a rear threaded handle and a middle connecting rod; the front fork is connected with the elbow assembly, and the rear threaded handle is screwed in the rotating shaft.
CN201811499419.0A 2018-12-09 2018-12-09 Pre-anastomosis pressure magnetic induction tubular anastomat Active CN109381236B (en)

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CN109381236B true CN109381236B (en) 2024-01-30

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109965928B (en) * 2019-04-27 2024-04-09 江苏凯尔特医疗科技有限公司 Anastomotic stoma inspection repairing device with visual function
CN112826553A (en) * 2021-01-22 2021-05-25 北京天助畅运医疗技术股份有限公司 Tissue recognition module and endoscope anastomat

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CN209499808U (en) * 2018-12-09 2019-10-18 江苏凯尔特医疗科技有限公司 Pre- identical pressure magnetic inductive tube type anastomat

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CN105592807A (en) * 2013-09-25 2016-05-18 柯惠Lp公司 Surgical instrument with magnetic sensor
CN205107795U (en) * 2015-09-28 2016-03-30 医创(厦门)医疗科技有限公司 Take stapler tubulose anastomat and cutting anastomat of intelligent support
CN105496484A (en) * 2015-12-31 2016-04-20 南京大学医学院附属鼓楼医院 Magnetic anastomosis device used for colostomy
CN106236174A (en) * 2016-08-10 2016-12-21 西安交通大学第附属医院 A kind of magnetic anastomat being applicable to Cholangio-jejunostomy under peritoneoscope
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