CN110051391B - Endoscopic surgical instrument - Google Patents

Endoscopic surgical instrument Download PDF

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Publication number
CN110051391B
CN110051391B CN201910489341.2A CN201910489341A CN110051391B CN 110051391 B CN110051391 B CN 110051391B CN 201910489341 A CN201910489341 A CN 201910489341A CN 110051391 B CN110051391 B CN 110051391B
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China
Prior art keywords
tube
proximal
proximal tube
handle
surgical instrument
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CN201910489341.2A
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CN110051391A (en
Inventor
冷德嵘
金鸿雁
唐志
李常青
仇卫勤
奚杰峰
李宁
韦建宇
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Micro Tech Nanjing Co Ltd
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Micro Tech Nanjing Co Ltd
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Priority to CN201910489341.2A priority Critical patent/CN110051391B/en
Publication of CN110051391A publication Critical patent/CN110051391A/en
Priority to PCT/CN2020/078454 priority patent/WO2020244267A1/en
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Publication of CN110051391B publication Critical patent/CN110051391B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/00234Surgical instruments, devices or methods for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/12Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/0046Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A61B2017/00469Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable for insertion of instruments, e.g. guide wire, optical fibre
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/12Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B2017/12004Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for haemostasis, for prevention of bleeding

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

Abstract

The present application provides an endoscopic surgical instrument comprising: an operation wire, an outer tube, a rotation mechanism and an operation piece. Wherein the outer tube further comprises a proximal tube and a distal tube, the rotation mechanism being disposed between the proximal tube and the distal tube. The interior of the rotating mechanism is slidably connected with the operation wire so that the operation wire rotates along with the rotating mechanism and can move in the rotating mechanism. In practical application, the angle of the operating element can be adjusted by a nurse through rotating the handle; the angle of the operating member can be adjusted by rotating the proximal tube or the rotating mechanism to further drive the operating wire to rotate by an operator, so that the operating difficulty is reduced, and accurate rotating operation is facilitated.

Description

Endoscopic surgical instrument
Technical Field
The application relates to the technical field of medical instruments, in particular to an endoscopic surgical instrument.
Background
The digestive tract instrument means an instrument capable of entering the digestive tract of a patient, such as a snare, a hemostatic clip, a biopsy forceps, a foreign body forceps, or the like, for performing an in vivo surgical operation. In practical applications, the digestive tract apparatus needs to be operated from outside the body by a doctor, and the operation action is transmitted through an operation wire to control the apparatus positioned in the body to implement the operation action. Taking the hemostatic clip as an example, the mechanical force generated when the hemostatic clip is closed can be utilized to ligate the surrounding tissues and the bleeding blood vessel together, so that the bleeding blood vessel is closed, and the ligature capability of the hemostatic clip to the tissues directly influences the operation quality.
In order to perform effective operation, quick hemostasis and prevention of re-bleeding, a typical hemostatic clip has a clamping function, and most instruments have a rotating function at the same time, so that tissue wound surfaces needing to be closed can be accurately aligned when the hemostatic clip is used. A typical hemostatic clip includes a handle, a catheter, a manipulation wire, and a grip portion. The handle is connected with the clamping part through an operation wire arranged inside the catheter, so that the clamping part is controlled to move through the handle, the handle is movably connected with the end part of the catheter, namely, the handle can rotate relative to the catheter, and the clamping part is driven to rotate when the handle is rotated.
However, in the actual operation process, the hemostatic clamp has the rotating function that an assistant of an operator performs rotating operation to drive the operation wire to rotate so as to realize the rotation of the clamping part. Therefore, in order to accurately clamp the blood vessel or the wound surface to achieve high-efficiency treatment efficiency, a surgical operator and an assistant are required to be closely matched, but the matching of the clinical operator and the assistant cannot always achieve a completely ideal effect at present, so that a hemostatic clamp controlled to rotate by the operator is urgently needed to make up for the defects of the existing instrument.
Disclosure of Invention
The application provides an endoscopic surgical instrument to solve the problems of the conventional digestive tract instrument that the conventional digestive tract instrument performs a rotating operation, which has the disadvantages.
In one aspect, the present application provides an endoscopic surgical instrument comprising: the surgical operation device comprises an operation wire, an outer tube, a rotating mechanism and an operation piece, wherein the operation wire is connected with a handle to transmit surgical actions; the outer tube comprises a proximal tube and a distal tube, and the operation wire penetrates through the interiors of the proximal tube and the distal tube; a rotation mechanism for connecting the proximal tube and the distal tube such that the proximal tube is rotatable relative to the distal tube; and the operating piece is arranged at the distal end part of the distal tube and is connected with the operating wire.
One end of the proximal tube is rotatably connected with the handle, and the other end of the proximal tube is fixedly connected with the proximal end part of the rotating mechanism; the interior of the rotating mechanism is slidably connected with the operation wire so that the operation wire rotates along with the rotating mechanism and moves in the rotating mechanism.
Optionally, the rotating mechanism includes a first driven member fixedly connected to the proximal tube, and a first special-shaped tube wrapped and fixed on the outer surface of the operation wire;
the first follower is slidably connected to the first profiled tube to transmit a rotational moment to the first profiled tube and to enable the first profiled tube to be slidable relative to the first follower. The length of the first special-shaped pipe is larger than or equal to the farthest moving distance of the control sliding block on the handle.
Optionally, the rotating mechanism further comprises a driving member connected to the outer wall of the proximal tube, the driving member can slide along the axial direction of the proximal tube but cannot rotate with the proximal tube, the driving member is in a cylindrical structure, and anti-skidding patterns are arranged on the outer circumferential wall of the driving member.
Optionally, the driving piece comprises a driving bag, a pin shaft and a positioning cap;
the driving bag is of a tubular structure sleeved on the proximal tube; the inner wall of the driving bag is provided with an accommodating groove, and the pin shaft is arranged in the accommodating groove of the driving bag; the positioning cap is arranged at the end part of the driving bag so that the pin shaft is fixed on the outer wall of the proximal tube.
Optionally, the driving piece further includes a compression spring, two pins are disposed in one accommodation groove of the driving bag, and the compression spring is disposed between the two pins.
Optionally, the driving member is integrally formed with the first driven member and/or the proximal tube.
Optionally, the device further comprises a driven mechanism, wherein the proximal tube is rotatably connected with the handle through the driven mechanism;
the driven mechanism comprises a second driven piece and a second special-shaped pipe; the second driven piece is fixedly connected with the proximal tube; the second driven piece is connected with the second special-shaped pipe in a sliding manner; the second special-shaped pipe is fixedly connected to the outer surface of the operation wire.
Optionally, the driven mechanism further comprises a fixing cap screwed at the end part of the handle; the proximal tube penetrates the inside of the fixing cap; the inner core of the handle is provided with a cylindrical hole; the second driven piece is arranged in the cylindrical hole and can rotate in the cylindrical hole.
Optionally, the connection mode between the rotating mechanism and the operation wire is a key connection.
In another aspect, the present application provides an endoscopic surgical instrument comprising: the surgical operation device comprises an operation wire, an outer tube, a rotating mechanism and an operation piece, wherein the operation wire is used for transmitting surgical operation; the outer tube comprises a proximal tube and a distal tube, and the operation wire penetrates through the interiors of the proximal tube and the distal tube; a rotating mechanism connects the proximal tube and the distal tube; an actuator is disposed at an end of the distal tube and is coupled to the operating wire.
A proximal end of the rotation mechanism is rotatably connected with the proximal tube, and a distal end of the rotation mechanism is rotatably connected with the distal tube; the interior of the rotating mechanism is slidably connected with the operation wire so that the operation wire rotates along with the rotating mechanism and can move in the rotating mechanism.
According to the technical scheme, the application provides an endoscopic surgical instrument, which comprises: an operation wire, an outer tube, a rotation mechanism and an operation piece. Wherein the outer tube further comprises a proximal tube and a distal tube, the rotation mechanism being disposed between the proximal tube and the distal tube. The interior of the rotating mechanism is slidably connected with the operation wire so that the operation wire rotates along with the rotating mechanism and can move in the rotating mechanism. In practical application, the operating wire is driven to rotate by rotating the proximal tube or the rotating mechanism so as to adjust the angle of the operating member, and the handle is not required to be rotated to facilitate operation. And moreover, the operation operator can directly operate the proximal tube to rotate, so that the operation difficulty is reduced, and the rotation operation is facilitated.
Drawings
In order to more clearly illustrate the technical solutions of the present application, the drawings that are needed in the embodiments will be briefly described below, and it will be obvious to those skilled in the art that other drawings can be obtained from these drawings without inventive effort.
FIG. 1 is a schematic view of an endoscopic surgical instrument according to the present application;
FIG. 2 is a schematic view of a rotary mechanism according to the present application;
FIG. 3 is a schematic cross-sectional view of the driving member of the present application;
FIG. 4 is a schematic side view of a driving member according to the present application;
FIG. 5 is a schematic side view of another driving member of the present application;
FIG. 6 is a schematic structural view of the driven mechanism of the present application;
fig. 7 is a schematic view of another endoscopic surgical instrument of the present application.
Detailed Description
Reference will now be made in detail to the embodiments, examples of which are illustrated in the accompanying drawings. When the following description refers to the accompanying drawings, the same numbers in different drawings refer to the same or similar elements, unless otherwise indicated. The embodiments described in the examples below do not represent all embodiments consistent with the present application. Merely as examples of systems and methods consistent with some aspects of the present application as detailed in the claims.
In the technical scheme provided by the application, for convenience of description, one end of the whole device placed in a human body is called a distal end, and the end is mainly used for performing operation on tissues; the end located outside the body is called the proximal end and is intended primarily for manipulation by the operator. The distal end of each component is referred to herein as the end proximal to the body side, and the proximal end of each component is referred to herein as the end proximal to the body side, unless otherwise indicated.
Referring to fig. 1, a schematic view of an endoscopic surgical instrument according to the present application is shown.
As shown in fig. 1 and 2, the endoscopic surgical instrument provided in the present application includes: a handle 1, an operation wire 2, an outer tube 3, a rotation mechanism 4 and an actuating element 5. The handle 1 is used for performing a surgical operation, and may include a handle body, a slider, and an operating member. The handle body core is provided with a cavity for introducing the proximal end of the operating wire 2. The sliding block can slide on the handle body, and the sliding block on the handle body is connected with the proximal end of the operating wire 2 to drag the operating wire 2 to move so as to drive the operating member 5 to open and close. The operation part can be two circular rings arranged on the sliding block and a circular ring arranged on the tail end of the handle main body, and in practical application, the two circular rings on the sliding block can be respectively used for inserting two fingers, such as an index finger and a middle finger; the ring on the end is used to insert the thumb to move the slider by the force of the finger pinch.
An operating wire 2 is connected to the handle 1 to transmit surgical actions. In the technical scheme provided by the application, the operation wire 2 is connected with the sliding block on the handle 1 so as to be capable of transmitting operation actions. For example, when the operator adjusts the position of the slider on the handle 1, the operation wire 2 can transmit a pulling force or a pushing force to cause the operation element 5 to perform a corresponding opening and closing operation. In addition, the operation wire 2 can also transmit a rotation moment to cause the operation member 5 to perform a corresponding rotation operation. The length of the operating wire 2 should be ensured to be able to extend from outside the patient's body to inside the body and may also have different length specifications for different patients. Therefore, the operation wire 2 may be a wire rope formed by winding a plurality of stainless steel wires, or may be a monofilament, and the type thereof should be selected according to actual needs.
As shown in fig. 2, the outer tube 3 includes a proximal tube 31 and a distal tube 32, and the manipulation wire 2 penetrates the inside of the proximal tube 31 and the distal tube 32. In the technical solution provided in the present application, the outer tube 3 has three functions, one of which is to guide the operation wire 2 into the patient; secondly, the operation part is used for rotating the operation wire 2; and thirdly, the device is used for transmitting circumferential force and axial force. Thus, the outer tube 3 has two parts, a proximal tube 31 and a distal tube 32, wherein the proximal tube 31 is located in the outer part of the patient during the actual operation and the distal tube 32 extends into the patient. The proximal tube 31 and the distal tube 32 may be plastic hoses made of the same material, and a support spring extending helically is provided in the proximal tube 31 and the distal tube 32, so that the proximal tube 31 and the distal tube 32 can still maintain a tubular state when being extruded by the tissue of the side wall of the digestive tract, and the actions of internal devices are prevented from being influenced.
As can be seen from the above technical solutions, the endoscopic surgical instrument provided in the present application may divide the distal end portion of the outer tube 3 from the proximal end portion, that is, the proximal end tube 31 and the distal end tube 32, so that the proximal end tube 31 located outside the endoscope may generate a degree of freedom of rotation in the circumferential direction with respect to the distal end tube 32, and further transmit the rotational motion to the operation wire 2 in the central portion of the instrument through the proximal end of the proximal end tube 31, and further transmit the rotational motion to the actuating member 5 in the head portion of the instrument, so that the actuating member 5 may precisely rotate.
As shown in fig. 2 and 3, a rotation mechanism 4 is used to connect the proximal tube 31 and the distal tube 32 such that the proximal tube 31 is rotatable relative to the distal tube 32. In the technical scheme that this application provided, rotary mechanism 4 plays the switching effect, can make near-end pipe 31 and distal end pipe 32 in interconnect through rotary mechanism 4 promptly and can also take place to rotate each other, consequently, in the actual operation, can be in whole outer tube 3 input patient's internal back, through the rotation near-end pipe 31 that is located external, drive operating wire 2 and rotate to finally adjust the angle of acting element 5.
In order to achieve the above function, in the technical solution provided in the present application, as shown in fig. 2, one end of the proximal tube 31 is rotatably connected to the handle 1, and the other end is fixedly connected to the end of the rotation mechanism 4; the inside of the rotating mechanism 4 is slidably connected to the operation wire 2 so that the operation wire 2 rotates with the rotating mechanism 4 and moves within the rotating mechanism 4. In practical use, as shown in fig. 1, the end of the handle 1 may be provided with a chute, and the inside of the proximal tube 31 is provided with a protrusion having a shape corresponding to the chute, so that the proximal tube 31 may be connected to the end position of the handle 1 and may rotate relative to the handle 1. The distal end of the proximal tube 31 is fixedly connected to the rotation mechanism 4, and the operation wire 2 in the tube is connected by the rotation mechanism 4, and when the proximal tube 31 is rotated, a rotation moment acting on the proximal tube 31 can be transmitted to the rotation mechanism 4, and further transmitted to the operation wire 2 by the rotation mechanism 4, so that the operation wire 2 is also rotated.
In this application, since the rotation mechanism 4 can rotate relative to the distal tube 32, the distal tube 32 remains stationary while the proximal tube 31 is rotated, i.e., the rotation process is not affected by the tissue in the patient and by the jaws of the endoscopic device. In addition, because adopt sliding connection between rotary mechanism 4 and the operation silk 2, rotary mechanism 4 can drive operation silk 2 and rotate promptly, but the removal of operation silk 2 can not receive rotary mechanism 4's restriction, consequently, in the technical scheme that this application provided, can be under the prerequisite that the operation action was not influenced in the transmission operation of guaranteeing operation silk 2, can realize driving it through proximal tube 31 and rotate.
An operating member 5 disposed at an end of the distal tube 32 and connected to the operating wire 2. The actuating member 5 provided herein may be different depending on the actual operation, for example, the actuating member 5 may be one of a snare, a hemostatic clip, a biopsy forceps, a foreign body forceps, or a cutter.
As can be seen from the above technical solution, the present application may further divide the distal end portion and the proximal end portion of the outer tube 3 of the instrument, and add a rotation mechanism 4 therebetween, where the rotation mechanism 4 has a degree of freedom of rotation in the circumferential direction with respect to the proximal tube 31 and the distal tube 32, and transmits the rotational motion to the operation wire 2 of the central portion of the instrument, and further to the actuating member 5 of the distal end of the instrument, so that the actuating member 5 can be precisely rotated. Thus, the operator or an assistant can control the rotational movement of the actuator 5 by rotating the proximal tube 31, thereby improving the convenience of the instrument operation.
In order to achieve the above function, the rotation mechanism 4 comprises a first follower 41 fixedly connected to the proximal tube 31, and a first special-shaped tube 42 wrapped and fixed on the outer surface of the operation wire 2; the first follower 41 is slidably connected to the first profiled tube 42 to transmit a rotational moment to the first profiled tube 42 and to allow the first profiled tube 42 to slide relative to the first follower 41.
In practice, the first follower 41 may be of a cylindrical configuration with a hole in the middle so that the first follower 41 may extend from the end of the proximal tube 31 into the interior of the tube. The first special-shaped tube 42 may be sleeved on the outer surface of the operation wire 2 and fixed together so as to be rotatable or movable together with the operation wire 2. The first follower 41 and the first profiled tube 42 have a mutually cooperating structure therebetween to transmit a rotational moment. For example, the first special-shaped tube 42 may be a tube structure with a bar-shaped protrusion on an outer wall, and the first follower 41 is a tube structure with a U-shaped groove on an inner wall, and through a limiting function between the bar-shaped protrusion and a groove wall of the U-shaped groove, the first follower 41 can drive the first special-shaped tube 42 to rotate, and the bar-shaped protrusion and the U-shaped groove can also slide relatively along the groove, so that a rotation moment can be transmitted to the operation wire 2 without affecting the movement of the operation wire 2.
In some embodiments of the present application, the connection between the rotation mechanism 4 and the operation wire 2 is a key connection, that is, a flat key, a wedge key spline, or the like, so as to transmit a rotation moment on the premise of ensuring that the rotation moment can slide relative to each other. Further, the cross-sectional shape of the first special-shaped pipe 42 may be regular or irregular, such as "back" shape, diamond shape or polygon shape, etc., and the corresponding first follower 41 also has a shape structure matched with the first follower, so long as it can transmit the rotation moment and ensure the mutual sliding, which can be adopted as the technical scheme adopted by the sliding connection of the present application.
In practical application, the first special-shaped tube 42 needs to slide relative to the first follower 41, and the maximum sliding distance in the operation process is always the same according to the farthest moving distance of the control slider on the handle, so in some embodiments of the present application, the length of the first special-shaped tube 42 is greater than or equal to the farthest moving distance of the control slider on the handle 1, that is, in the process that the control slider on the handle 1 slides from one end to the other end of the handle 1, the first follower 41 can also meet the requirement of moving from one end to the other end of the first special-shaped tube 42, so that the first special-shaped tube 42 cannot be separated from the first follower 41 due to the operation action in the operation process, and smooth operation process is ensured.
In order to facilitate the rotation of the proximal tube 31, in some embodiments of the present application, as shown in fig. 3, the rotation mechanism 4 further includes a driving member 43 fixedly connected to the outer wall of the proximal tube 31, where the driving member 43 has a cylindrical structure, and an anti-slip pattern is disposed on an outer circumferential wall of the driving member 43. In this embodiment, the driving member 43 may be a cylindrical structure sleeved on the outer wall of the proximal tube 31, and may be used for operation by a surgical operator, and the cylindrical structure of the driving member 43 increases the arm of force during rotation, so that a larger rotation moment is generated under the same rotation force. In addition, the slipping phenomenon in the rotation process can be reduced through the anti-slip lines on the driving piece 43, so that the rotation process is more accurate.
Further, as shown in fig. 4, the driving member 43 includes a driving balloon 431, a pin 432, and a positioning cap 433. The driving balloon 431 is a tubular structure sleeved on the proximal tube 31; the inner wall of the driving capsule 431 is provided with a containing groove, and the pin 432 is arranged in the containing groove of the driving capsule 431; the positioning cap 433 is disposed at the end of the driving balloon 431 such that the pin 432 is fixed to the outer wall of the proximal tube 31.
In this embodiment, the driving capsule 431 may be made of plastic or soft plastic material, so as to improve the operation comfort and increase the friction force during the rotation process, and the interaction between the pin shaft 432 and the positioning cap 433 can enable the proximal tube 31 to rotate along with the driving capsule 431, that is, under the condition of maintaining the original structure of the proximal tube 31, the driving member 43 and the proximal tube 31 are matched. Meanwhile, the driving capsule 431 can move on the proximal tube 31 while transmitting the rotation moment through the pin shaft 432 and the positioning cap 433, so that the position of the driving capsule 431 is changed to adapt to the operation habits of different operation operators.
In practical applications, the positioning cap 433 may be connected to the driving balloon 431 by a snap or latch structure, and has a certain elastic function to press the pin 432 against the outer wall of the proximal tube 31 or generate a force towards the outer wall of the proximal tube 31. Further, as shown in fig. 5, the driving member 43 further includes a compression spring 434, two pins 432 are disposed in one receiving groove of the driving capsule 431, and the compression spring 434 is disposed between the two pins 432. A one-way bearing arrangement may be formed within drive balloon 431 by compression spring 434 such that drive balloon 431 may slide relative to proximal tube 31 but not rotate relative to proximal tube 31. In addition, the compression spring 434 may also dampen the rotational torque, reducing the rotational delay. The rotation process is more stable.
It should be noted that, since the driving member 43 is mainly used to perform the rotation operation in the present application, in some embodiments of the present application, the driving member 43 is integrally formed with the first driven member 41 and/or the proximal tube 31. That is, in practical application, the component structure can be simplified through the integrated structure, so that the stability and reliability of the whole apparatus are improved. In addition, other structures that can be suggested in the art based on the above features, such as the case where the driving member 43 is integrated with the first driven member 41, the driving member 43 is integrated with the proximal tube 31, or the driving member 43 is integrated with the first driven member 41 and the proximal tube 31, are all within the scope of protection of the present application.
In some embodiments of the present application, as shown in fig. 6, the endoscopic surgical instrument further comprises a driven mechanism 6, and the proximal tube 31 is rotatably connected to the handle 1 via the driven mechanism 6. The driven mechanism 6 comprises a second driven piece 61 and a second special-shaped pipe 62; the second follower 61 is fixedly connected to the proximal tube 31; the second follower 61 is slidably connected to the second profiled tube 62; the second special-shaped tube 62 is fixedly connected to the outer surface of the operation wire 2. In this embodiment, the driven mechanism 6 may be similar in structure to the rotating mechanism 4 and function in the same manner to achieve the mutual rotation between the proximal tube 31 and the adjacent components.
Further, the driven mechanism 6 also comprises a fixed cap 11 which is screwed on the end part of the handle 1; the proximal tube 31 penetrates the inside of the fixing cap 11; the inner core of the handle 1 is provided with a cylindrical hole 12; the second follower 61 is disposed in the cylindrical bore 12 and is rotatable within the cylindrical bore 12. In practical application, the driven mechanism 6 can be slidably connected with the operation wire 2 at the positions of the two ends of the proximal tube 31 on the premise of realizing the rotation of the proximal tube 31, and the torque transmission effect of the proximal tube 31 can be increased, so that the transmission precision of the rotation motion is improved.
The present application also provides an endoscopic surgical instrument, as shown in fig. 7, comprising: manipulating the wire 2 to transmit surgical actions; the outer tube 3 comprises a proximal tube 31 and a distal tube 32, and the operation wire 2 penetrates the insides of the proximal tube 31 and the distal tube 32; a rotation mechanism 4 connecting the proximal tube 31 and the distal tube 32; an operating element 5 disposed at the distal end of the distal tube 32 and connected to the operation wire 2; wherein the proximal end of the rotation mechanism 4 is rotatably connected to the proximal tube 31, and the distal end of the rotation mechanism 4 is rotatably connected to the distal tube 32; the inside of the rotating mechanism 4 is slidably connected to the operation wire 2 so that the operation wire 2 rotates with the rotating mechanism 4 and is movable within the rotating mechanism 4.
In this embodiment, the proximal tube 31 and the distal tube 32 may not rotate with each other, but the rotation mechanism 4 rotates the operation wire 2. In actual use, the rotating mechanism 4 is arranged at the joint of the proximal tube 31 and the distal tube 32, so that the rotating mechanism 4 is close to the opening position of the endoscope forceps channel, and the operator can directly apply a rotating moment to the operation wire 2 by rotating the rotating mechanism 4, and finally control the brake member 5 to perform rotating operation.
In the technical scheme provided by the application, the application principle of the endoscopic surgical instrument takes the clamping of the stomach wound surface as an example, and can comprise the following steps: performing conventional wound surface closing operation by using an endoscope; taking out an assembled endoscopic surgical instrument, slightly pulling the slider of the handle 1 to close the distal actuating member 5, namely the hemostatic clamp, penetrating the hemostatic clamp into an endoscopic forceps channel to be delivered to a wound surface, and pushing the handle slider to open the hemostatic clamp. If the hemostatic clip is in a non-ideal state, the operator needs to rapidly rotate the driving member 43 or directly rotate the proximal tube 31, so as to drive the hemostatic clip mechanism to do corresponding rotation, and when the hemostatic clip is rotated to a proper position, the assistant releases the hemostatic clip, and other parts of the device are taken out from the endoscope. In practical application, the device can be continuously conveyed according to the steps until the wound surface is completely closed according to the wound surface requirement.
According to the technical scheme, the manufacturing and assembling process of the endoscope surgical instrument is simple, and the endoscope surgical instrument is suitable for various instruments needing to be rotated, such as a rotatable snare, a rotatable hemostatic clamp, a rotatable biopsy forceps or foreign body forceps and other medical instruments. And the operator can independently rotate the proximal tube 31 to drive the distal mechanisms such as the operation wire 2, the operation piece 5 and the like to rotate, so that the matching degree requirement between the operator and an assistant is reduced, the operation time is shortened, the operation process is accurately and efficiently completed, the pain of a patient is reduced, and the risks of shock and even death and the like caused by long-time bleeding of the patient are greatly reduced.
The foregoing detailed description of the embodiments is merely illustrative of the general principles of the present application and should not be taken in any way as limiting the scope of the invention. Any other embodiments developed in accordance with the present application without inventive effort are within the scope of the present application for those skilled in the art.

Claims (9)

1. An endoscopic surgical instrument, comprising:
a handle (1) for performing a surgical action; the handle (1) comprises a handle main body and a sliding block; the sliding block is connected with the handle main body in a sliding way;
an operating wire (2) to transmit surgical actions;
an outer tube (3) comprising a proximal tube (31) and a distal tube (32), the manipulation wire (2) extending through the interiors of the proximal tube (31) and distal tube (32);
a rotation mechanism (4) for connecting the proximal tube (31) and the distal tube (32) such that the proximal tube (31) is rotatable relative to the distal tube (32);
an operating element (5) arranged at the distal end of the distal tube (32) and connected to the operating wire (2);
wherein one end of the proximal tube (31) is rotatably connected with the handle (1), and the other end is fixedly connected with the proximal end of the rotating mechanism (4); the inside of the rotating mechanism (4) is slidingly connected with the operation wire (2) so that the operation wire (2) rotates along with the rotating mechanism (4) and moves in the rotating mechanism (4).
2. Endoscopic surgical instrument according to claim 1, characterized in that the rotation mechanism (4) comprises a first follower (41) fixedly connected to the proximal tube (31), and a first profiled tube (42) wrapped and fixed on the outer surface of the operating wire (2);
the first follower (41) is slidably connected to the first profiled tube (42) to transmit a rotational moment to the first profiled tube (42), and to enable the first profiled tube (42) to be slidable relative to the first follower (41).
3. Endoscopic surgical instrument according to claim 2, characterized in that the rotation mechanism (4) further comprises a driving member (43) fixedly connected to the outer wall of the proximal tube (31), the driving member (43) being of cylindrical structure, the outer circumferential wall of the driving member (43) being provided with anti-slip threads.
4. An endoscopic surgical instrument according to claim 3, wherein the driver (43) comprises a driver balloon (431), a pin (432) and a positioning cap (433);
the driving capsule (431) is a tubular structure sleeved on the proximal tube (31); the inner wall of the driving bag (431) is provided with a containing groove, and the pin shaft (432) is arranged in the containing groove of the driving bag (431); the positioning cap (433) is disposed at an end of the driving balloon (431) such that the pin shaft (432) is fixed to an outer wall of the proximal tube (31).
5. The endoscopic surgical instrument according to claim 4, wherein the driver (43) further comprises a compression spring (434), wherein two pins (432) are provided in one receiving groove of the driver capsule (431), and wherein the compression spring (434) is provided between the two pins (432).
6. An endoscopic surgical instrument according to claim 3, characterized in that the driving member (43) is of unitary construction with the first follower (41) and/or the proximal tube (31).
7. Endoscopic surgical instrument according to claim 1, characterized by further comprising a driven mechanism (6), the proximal tube (31) being rotatably connected to the handle (1) by the driven mechanism (6);
the driven mechanism (6) comprises a second driven piece (61) and a second special-shaped pipe (62); the second driven member (61) is fixedly connected with the proximal tube (31), and the second driven member (61) is slidably connected with the second special-shaped tube (62); the second special-shaped pipe (62) is fixedly connected to the outer surface of the operation wire (2).
8. Endoscopic surgical instrument according to claim 7, characterized in that the driven mechanism (6) further comprises a securing cap (11) screwed at the end of the handle (1); the proximal tube (31) penetrates the inside of the fixing cap (11); a cylindrical hole (12) is formed in the inner core of the handle (1); the second follower (61) is disposed within the cylindrical bore (12) and is rotatable within the cylindrical bore (12).
9. Endoscopic surgical instrument according to claim 1, characterized in that the connection between the rotation mechanism (4) and the operating wire (2) is a key connection.
CN201910489341.2A 2019-06-06 2019-06-06 Endoscopic surgical instrument Active CN110051391B (en)

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