CN109984790B

CN109984790B - Nail bin assembly and surgical instrument

Info

Publication number: CN109984790B
Application number: CN201811121158.9A
Authority: CN
Inventors: 孙宝峰
Original assignee: Fengh Medical Co ltd
Current assignee: Fengh Medical Co ltd
Priority date: 2017-12-31
Filing date: 2018-09-25
Publication date: 2022-09-02
Anticipated expiration: 2038-09-25
Also published as: CN109984790A

Abstract

A nail bin assembly comprises a nail bin body and staples, wherein the staples are contained in nail cavities, and the nail cavities are arranged in the nail bin body in a penetrating mode; the nail bin body is provided with a groove for discharging tissue fluid. According to the nail bin assembly and the surgical instrument thereof, the groove is formed in the top end face of the nail bin assembly, so that the squeezing force of tissues is dispersed, tissue fluid is discharged, the time for squeezing the tissues to the specified thickness is effectively shortened, the condition that the tissues are squeezed insufficiently is avoided, and the forming effect of the anastomosis nails is further ensured.

Description

Nail bin assembly and surgical instrument

Technical Field

The invention relates to a surgical instrument, in particular to a nail bin assembly and a surgical instrument, and belongs to the field of medical instruments.

Background

The surgical cutting anastomat is a surgical instrument which can suture wounds of patients and simultaneously remove redundant tissues, and is widely applied to tissue removal and anastomosis in minimally invasive operations of abdominal surgery, gynecology, pediatrics, thoracic surgery and the like. The surgical cutting anastomat enters a patient body through a sleeve of a puncture outfit accurately positioned at a surgical site, the surgical cutting anastomat comprises an end effector, the end effector comprises a nail bin seat and a nail pushing seat, the nail bin seat is used for containing a nail bin assembly, and the nail bin assembly comprises a nail bin body and anastomotic nails arranged in the nail bin body.

And placing the target tissue between the nail abutting seat and the nail bin assembly in the nail bin seat, closing the end effector, and squeezing the target tissue for a period of time to enable tissue fluid to gradually flow out of the target tissue. The stapler can be fired when the target tissue between the cartridge assembly and the staple holder reaches a thickness range for effective stapling, which in turn creates a longitudinal incision in the tissue and applies staples on opposite sides of the incision. The anastomotic nails in the nail bin assembly move upwards in the nail cavity to pierce and suture target tissues (namely, the anastomotic nails are taken out of the nails), and the U-shaped anastomotic nails are molded into a B shape under the action of the interference molding of the nail abutting seats, so that the tissues are sutured. The target tissue refers to the tissue to be cut and sutured, i.e. the tissue to be pressed.

For the existing surgical cutting anastomat, an end effector containing a nail bin assembly does not have a tissue fluid discharging structure, the tissue fluid in target tissue between the nail bin assembly and a nail abutting seat is discharged slowly, the tissue needs to be compressed to a certain thickness for a long time (generally, more than 15 seconds), so that after the end effector is closed, a period of time is required to wait until the required squeezing thickness is reached, the surgical cutting anastomat can be fired, and the operation time is prolonged. This causes inconvenience to the operator of the stapler. In actual use, operators of staplers desire to have the squeezing time as short as possible to meet their operating habits and to enhance the use experience. However, if the time from closing the end effector to firing the surgical cutting stapler (i.e., the squeezing time) is short and less than 15 seconds required by the instrument, since the tissue fluid cannot be sufficiently discharged from the target tissue, the tissue fluid is difficult to be compressed, so that the target tissue containing a large amount of tissue fluid is also difficult to be compressed, the thickness of the target tissue between the staple cartridge assembly and the staple abutting seat cannot reach the safe range of effective suturing, the tissue is insufficiently squeezed, the phenomena of inconsistent formed staples, secondary staple formation and the like occur, and therefore postoperative symptoms such as bleeding at the cutting position, tissue leakage, tissue necrosis and the like are caused, the smooth operation of the operation is affected, and unnecessary pain is caused to the patient.

Disclosure of Invention

Aiming at the defects of the prior art, the invention aims to provide a nail bin assembly and a surgical instrument, which can accelerate the discharge of tissue fluid at a target tissue and have good squeezing effect. The invention is realized by the following technical scheme:

a cartridge assembly comprises a cartridge body and staples; the anastomosis nails are contained in nail cavities, the nail cavities are arranged in the nail bin body in a penetrating mode, and the nail bin body is provided with a groove used for containing and discharging tissue fluid.

Preferably, the staple cartridge assembly further comprises a staple driver and a staple pusher; the staple driver comprises an accommodating part and a guide part, wherein the accommodating part is used for accommodating a part of the staples, and the guide part is used for being matched with the staple pushing block.

Preferably, the cartridge body comprises a top end surface, and the groove is arranged on the top end surface.

Preferably, one end of the groove intersects with the outer side surface of the nail box body to form an opening of the groove.

Preferably, the recess comprises a monomer slot.

Preferably, the groove comprises a double body groove.

Preferably, the bottom surface of the groove is a slope.

A surgical instrument comprising a staple holder and a staple cartridge holder, the staple holder being pivotally connected to the staple cartridge holder; the surgical instrument further comprises a staple cartridge assembly of any of the above, the staple cartridge assembly being received in the staple cartridge seat.

Preferably, the surgical instrument is a surgical cutting stapler.

According to the nail bin assembly and the surgical instrument, the groove is formed in the top end face of the nail bin assembly, so that the squeezing force of the tissue is dispersed, the tissue liquid is discharged towards two sides, the time for squeezing the tissue to the specified thickness is effectively shortened, the operation time is shortened, the situation that the tissue is not squeezed sufficiently is avoided, and the forming effect of the anastomosis nail is further ensured.

Drawings

FIG. 1 is a schematic structural view of a staple cartridge assembly according to an embodiment of the present invention;

FIG. 2 is a schematic structural view of a staple cartridge body according to an embodiment of the present invention;

FIG. 3 is a schematic view of another angular configuration of the cartridge assembly body according to an embodiment of the present invention;

FIG. 4 is an exploded schematic view of a staple cartridge assembly according to an embodiment of the present invention;

FIG. 5 is a schematic structural view of an initial state of a staple in accordance with an embodiment of the present invention;

FIG. 6 is a schematic structural view of an end effector in an unclosed state, according to an embodiment of the present invention;

FIG. 7 is a schematic structural view of a closed end effector state according to an embodiment of the present invention;

FIG. 8a is a transverse cross-sectional view of a staple cartridge body along a recess according to an embodiment of the present invention;

FIG. 8B is an enlarged view of the structure at B in FIG. 8 a;

FIG. 9a is an enlarged view of the structure at A in FIG. 2;

FIG. 9b is an enlarged view of an alternative configuration at A in FIG. 2;

FIG. 9c is an enlarged view of the third structure at A in FIG. 2;

FIG. 9d is an enlarged view of a fourth feature at A in FIG. 2;

fig. 9e is an enlarged view of the fifth structure at a in fig. 2.

Detailed Description

The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention.

As shown in FIG. 1, the cartridge assembly 3 of the present embodiment comprises a cartridge body 31, a cartridge protection cover 30 and a support 38. As shown in fig. 2 and 3, the cartridge body 31 includes a cartridge insertion end 311, a staple pushing groove 34, a top end surface 312, and a bottom end surface 313. For convenience of description and simplicity of description, in the present embodiment, the direction close to the cartridge insertion end 311 is referred to as "front" based on the orientation or positional relationship shown in fig. 1 and 2; the direction away from the cartridge insertion end 311 is referred to as "rear", and the front-rear direction is referred to as "length" or longitudinal direction; the direction toward the cartridge protection cap 30 is referred to as "up", the direction toward the bottom end surface 313 is referred to as "down", and the up-down direction is referred to as "height"; the direction toward the staple tray 34 is referred to as "inner" or "middle", and the direction away from the staple tray 34 is referred to as "outer". A direction perpendicular to both the front-rear direction and the up-down direction is referred to as a lateral direction.

In order to prevent the staples 35 from being separated from the cartridge body 31 from the upper ends of the staple cavities 32 due to extrusion or external force during storage and transportation, as shown in fig. 1, the cartridge protection cover 30 of the cartridge assembly 3 according to the embodiment of the present invention is detachably mounted on the cartridge body 31 before being used. With the cartridge module 3 assembled into the end effector of the surgical instrument, as shown in FIG. 2, and with the cartridge guard 30 removed, the surgical cutting stapler can be advanced into the patient through the cannula of the penetrator precisely positioned at the surgical site to perform the surgical stapling operation upon closing the end effector.

As shown in fig. 4, cartridge assembly 3 includes a cartridge protection cover 30, a cartridge body 31, staples 35, staple drivers 36 driving the staples 35, staple pusher blocks 37 of staple drivers 36, and buttresses 38. A plurality of through holes are vertically arranged in the nail bin body 31 in a penetrating manner, the through holes form a nail cavity 32, at least one part of a nail driver 36 and the anastomosis nails 35 are positioned in the nail cavity 32, and a nail pushing block 37 is arranged at the rear end of the nail bin body 31. Because at least a part of the nail driver 36 is arranged in the nail cavity 32, the nail cavity 32 limits the nail driver 36 and the anastomotic nails 35 to only move up and down relative to the nail box body 31, and the support piece 38 is arranged below the nail box body 31, so that the nail driver 36 can be prevented from being separated from the nail box body 31, and the strength of the nail box body 31 can be enhanced. The cartridge body 31 further includes a top end surface 312 and a bottom end surface 313 arranged opposite to the top end surface 312, and the top end surface 312 and the bottom end surface 313 are parallel to each other. To prevent staples 35 from falling out of the staple cavities during storage, transport or assembly to the end effector of the surgical instrument, a cartridge protection cover 30 is preferably provided over cartridge body 31. Under the precondition that the end effector 100 is closed, the staple pushing block 37 moves from the rear end of the staple cartridge body 31 to the front end of the staple cartridge body 31 under the action of external force, and the staple pushing block 37 pushes the staple driver 36 to move upwards in the staple cavity 32 in the moving process, so that the staples 35 move upwards, pierce through the tissue of the patient, and suture the wound of the patient until the staples 35 are separated from the staple cavity 32. How to open or close the end effector 100 is the same as the prior art and will not be described in detail herein.

As shown in fig. 5, staple 35 includes legs and a connecting portion 352, with a tip 351 at an end of the legs and connecting portion 352 between the legs. The sharp structure of the staple points 351 facilitates the staples 35 to more easily penetrate into the body tissue, and the connection portion 352 is linear. When unfired, staples 35 are positioned within staple cavities 32 with staple tips 351 not higher than top end surface 312 of cartridge body 31, staples 35 are generally "U" shaped, and connecting portions 352 of staples 35 are positioned within staple drivers 36. The target tissue is placed between the nail bin assembly 3 and the nail abutting seat 2 in the nail bin seat, the nail bin assembly 3 and the nail abutting seat 2 are closed, the target tissue is squeezed for a period of time, tissue liquid gradually flows out of the target tissue, and when the target tissue between the nail bin assembly 3 and the nail abutting seat 2 reaches a safe range of effective suturing, the anastomat can be fired, then a longitudinal incision is made in the tissue, and simultaneously anastomotic nails are applied to the opposite side of the incision. After being fired, staple drivers 36 drive staples 35 upwardly within staple cavities 32 until they are free of staple cavities 32, pierce and staple the target tissue (i.e., the staples are driven out), compressing the staples from the "U" shape into a "B" shape, and stapling the tissue. The tissue fluid in the present invention refers to a fluid that can be discharged from the inside of a tissue, and specifically refers to an extracellular fluid.

Fig. 6 is a schematic view of an open end effector state, and fig. 7 is a schematic view of a closed end effector 100 state. When the nail abutting seat 2 is in the opening position, the nail box component 3 is arranged in the nail box seat 1 of the end effector 100, the nail box protective cover 30 is taken down, and the nail abutting seat 2 is closed. After the end effector 100 of the surgical instrument is introduced into the patient, the anvil 2 is opened, the target tissue is clamped between the top end surface 312 of the cartridge module 3 in the end effector and the anvil 2, and thus the end effector 100, is closed. As shown in fig. 2 and 6, the groove 39 formed on the top end surface of the nail cartridge component 3 forms a tissue fluid discharge channel, so that the tissue fluid discharge speed is increased; due to the provision of the groove 39, the discharge of the tissue fluid becomes smooth. Further, as shown in FIG. 8a, the staple cavity 32 forms a staple outlet through the top end surface 312, and the outside of the top end surface 312 is provided with a groove 39 that opens outward. The grooves 39 are uniformly distributed along the outer side of the top end surface 312, and the opening of the groove 39 extends to intersect with the outer side surface of the cartridge body 31, that is, one end of the groove 39 is formed by being recessed downward from the top end surface 312, and the recess extends to intersect with the outer side surface of the cartridge body 31 along a substantially outward direction, and the intersection is the other end of the groove 39 (i.e., the opening of the groove 39). The grooves 39 form small spaces for holding tissues in the pressing space, and the held tissues are subjected to a small pressing force and a small degree of pressing, so that the held tissues can hold tissue fluid discharged from other pressed tissues not held in the grooves 39. Further, the concave groove 39 is formed on the top end surface 312 and extends outward to intersect with the outer side surface of the cartridge body 31, so that the concave groove 39 connects the inside and the outside of the pressing space, and the tissue accommodated in the concave groove 39 forms a passage for discharging the tissue fluid of the tissue to be pressed in the pressing space to the outside of the pressing space and the tissue not to be pressed, thereby increasing the flow capacity of the tissue fluid between the inside and the outside of the pressing space. The squeezing space is a space formed between the top end surface 312 of the magazine body 31 and the nail abutment 2 in a state where the magazine assembly 3 and the nail abutment 2 are closed. The groove 39 does not intersect with the staple outlet and the staple cavity 32, so that the groove 39 can play a role, the discharge of tissue fluid is accelerated, and the suturing of the anastomotic staples 35 is not interfered. FIGS. 9 a-9 e are enlarged views of the structure of FIG. 2 at A; the groove 39 comprises a single body groove having one groove body and a double body groove having two groove bodies, the single body groove can be in a shape of "U" (as shown in fig. 9 a), arc (as shown in fig. 9 b) and "S" (as shown in fig. 9 d), and the double body groove can be in a shape of "herringbone" (as shown in fig. 9 c) and "octal" (as shown in fig. 9 e).

Preferably, the bottom surface 391 of recess 39 is a sloped surface defining the vertical distance of the bottom surface of recess 39 from the plane of tip end surface 312 as the "depth" of recess 39, and further, the depth of recess 39 laterally further from staple magazine 34 is increased as compared to the depth of recess 39 laterally closer to staple magazine 34, in other words, the depth of recess 39 is greater the further the recess 34 is laterally away. FIG. 8a is a cross-sectional view of a staple cartridge assembly taken along a recess in accordance with an embodiment of the present invention, and FIG. 8B is an enlarged view of feature B in FIG. 8 a. As shown in FIG. 8b, the depth of the groove 39 near the staple pushing groove 34 is H1, and the depth of the groove 39 far from the staple pushing groove 34 is H2, wherein H1 < H2. Therefore, the inclined direction of the inclined plane is high inside and low outside, which accords with the hydrodynamics and is beneficial to discharging the tissue fluid. Tissue rich in interstitial fluid is also difficult to squeeze because the fluid is difficult to compress. Therefore, the tissue fluid at the target tissue is discharged quickly, the time for pressing the tissue to the designated thickness can be effectively shortened, and a small space for containing the tissue fluid and a tissue fluid discharge channel are formed by arranging the groove 39 on the top end surface of the nail bin assembly, so that the tissue fluid discharge speed of the pressed tissue is improved.

By providing the groove 39 on the top end surface of the cartridge assembly, the groove 39 constitutes a tissue fluid accommodating space and a discharge passage, and the discharge speed of the tissue fluid is increased. Due to the arrangement of the groove 39, the discharge of tissue fluid becomes smooth, further enhancing the effect of fluid gradient. Therefore, the invention can effectively shorten the time for squeezing the tissue to the designated thickness, the natural time from closing the end effector 100 to triggering the surgical cutting and hair anastomat can meet the time required by squeezing, special waiting is not required, the operation continuity of doctors is met, the operation time is shortened, the situation of insufficient tissue squeezing is avoided, and the forming effect of the anastomosis nail is further ensured.

Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and that variations, modifications, substitutions and alterations can be made to the above embodiments by those of ordinary skill in the art within the scope of the present invention.

Claims

1. A nail bin assembly comprises a nail bin body and anastomotic nails, wherein the nail bin body comprises a top end surface, a nail pushing groove and a nail cavity; the anastomosis nail is contained in a nail cavity, and the nail cavity is arranged in the nail bin body in a penetrating manner; the tissue biopsy device is characterized in that the nail bin body is provided with a groove for containing and discharging tissue fluid; the groove is arranged on the outer side of the top end face and is opened outwards, the nail cavity penetrates through the top end face to form a nail outlet, and the groove does not intersect with the nail outlet and the nail cavity; one end of the groove is intersected with the outer side face of the nail bin body to form an opening of the groove, and the bottom face of the groove is an inclined plane.

2. The staple cartridge assembly of claim 1, further comprising a staple driver and a staple pusher block; the staple driver comprises an accommodating part and a guide part, wherein the accommodating part is used for accommodating a part of the staples, and the guide part is used for being matched with the staple pushing block.

3. The staple cartridge assembly of any one of claims 1-2, wherein said recess comprises a single slot.

4. The staple cartridge assembly of any one of claims 1-2, wherein said recess comprises a double body slot.

5. A surgical instrument comprising a staple holder and a staple cartridge holder, the staple holder being pivotally connected to the staple cartridge holder; the surgical instrument further comprising a staple cartridge assembly according to any one of claims 1 to 4 housed in said staple cartridge seat.

6. The surgical instrument of claim 5, wherein the surgical instrument is a surgical cutting stapler.