CN112515746A - Surgical instrument for piercing tissue - Google Patents

Abstract

The present invention relates to a surgical instrument for penetrating tissue, comprising an outer member defining a longitudinal axis and having a peripheral wall; an inner member at least partially disposed within the outer member, the inner member including a perforated member adjacent the outer member distal end; the inner member being movable in a longitudinal direction relative to the outer member and enabling penetration through tissue in a state in which the piercing member is at least partially exposed from the peripheral wall; compared with the prior art, the invention has the advantage that the movable part at least partially deforms along the radial outward expansion, so that the elastic membrane is expanded, a structure similar to an air bag or a saccule is formed, and the effect of fixing a surgical instrument for penetrating tissues on the body wall of a patient is achieved.

Description

Surgical instrument for piercing tissue

Technical Field

The present invention relates to a surgical instrument for minimally invasive surgery, such as endoscopic or laparoscopic surgery, and more particularly to a surgical instrument for piercing tissue, such as a puncture instrument.

Background

Laparoscopic surgery is currently the most widely used minimally invasive surgical procedure in clinical practice. In the operation, a laparoscope puncture outfit is used to puncture the body wall (chest, abdomen, waist and other parts) of a human body through the skin, the front end of a sheath tube of the puncture outfit is kept in the body cavities of an abdominal cavity, a thoracic cavity or a posterior abdominal cavity and the like, and then a surgical instrument is placed in a channel in the puncture sheath tube to carry out corresponding operation on the tissues and organs in the body cavities. The laparoscope puncture outfit is an instrument which must be used in the operation, the prior laparoscope puncture outfit has no effective fixing device after the sheath tube is punctured into a body cavity, and the puncture sheath tube is often separated from the body and goes deep into the body in the operation process. The puncture outfit sheath is placed too deeply, so that the risk of damaging visceral organs is caused, the visual field of an endoscope can be shielded, and the operation of surgical instruments is difficult, such as various forceps, clamps, ultrasonic knife heads, needle holders and the like can not be opened; the puncture outfit sheath tube is frequently taken out, so that an operator has to repeatedly puncture and place the cannula, the operation progress and quality are seriously influenced, and the trauma of a patient is aggravated. In addition, in laparoscopic surgery, carbon dioxide gas is required to be filled into the body cavity of a human body to expand the body cavity so as to facilitate the operation of surgical instruments. As a large gap can exist between the sheath tube of the puncture outfit currently used and the body wall puncture channel, the leakage of gas in the cavity is easy to cause. The body cavity is decompressed and collapsed due to a large amount of gas leakage, and the operation is seriously disturbed; the overflowed gas enters the subcutaneous loose fat tissue gap to form extensive subcutaneous emphysema, which increases the pain of the patient.

Currently, the most clinically applied puncture device sheath tube fixing measure is a skin suture method, namely, a method for fixing the puncture device sheath tube by knotting a suture after the suture passes through a side hole preset on the wall of the puncture device tube after the suture is sewn on the skin of a puncture site. The fixing mode is simple and convenient, can cut off and really prevent the sheath from being separated, but can not solve the problems that the sheath is placed too deeply and gas leaks outside. Aiming at the current situation that the puncture outfit used in the laparoscopic surgery lacks perfect fixing measures, different researchers design a plurality of puncture outfit auxiliary fixing structures or devices with fixing functions. For example, in the "laparoscope puncture cannula fixing seat" of the chinese utility model with patent number ZL201520070627.4 (publication number CN204428128U), the fixing seat includes an elastic rubber fixing disk which can be sleeved outside the sheath of the puncture device, when in use, the disk and the sheath are fixed relatively by the elastic tightening action of the rubber material, and the disk bottom and the skin of the puncture site of the body wall are fixed by suture. Or the Chinese utility model 'a laparoscope puncture outfit positioning snap ring' adopting the similar external fixing method, such as patent number ZL201420300864.0(CN203915028U), discloses the relative fixing between the puncture outfit sheath tube and the external fixing device by bolts, the design of the external fixing method can play a certain role in preventing the puncture outfit sheath tube from being placed too deeply and/or getting out, but the puncture outfit sheath tube is repeatedly twisted and pushed and pulled in the actual operation, the sheath tube and the fixing device of the outer sleeve still have a large risk of getting out, and the outer sleeve fixing device must limit the rotation angle of the puncture outfit sheath tube to a certain extent, thereby interfering the operation of surgical instruments, which is particularly remarkable when a relatively deep and far body cavity, such as a posterior abdominal cavity instrument is operated. Therefore, after the puncture outfit of the Chinese utility model patent with the patent number ZL201520146655.X (the publication number is CN204581447U) enters the abdominal cavity, gas or liquid is filled into the inflation/liquid pipeline through the inflation/liquid port to expand the saccule, thereby achieving the purpose of fixing the apparatus; the puncture outfit can expand the saccule by filling gas or liquid after entering the abdominal cavity, the puncture outfit is provided with the inflation/liquid port and the inflation/liquid pipeline, so that the diameter of the sheath tube of the puncture outfit is easily increased, and meanwhile, the manufacturing cost and the use cost of the puncture outfit with the saccule are higher, so that the prior puncture outfit needs to be further improved.

In addition, in clinical practice, the balloon puncture outfit is also used in laparoscopic transgastric cavity surgery, and the balloon puncture outfit is directly punctured into the gastric cavity through the abdominal wall in the laparoscopic transgastric cavity surgery, on one hand, the puncture outfit with the air bag is needed, the cost is high, and the popularization is unchanged; meanwhile, in order to inflate the air bag, an inflation pipeline needs to be reserved on the tube wall, the tube wall thickness needs to be increased, and the diameter of the puncture outfit is increased, so that the damage to the abdominal wall and the stomach wall is increased during puncture, and the tube wall is thick and cannot be made of transparent materials, so that the operation visual field is influenced, the operation risk is increased, and the air bag is not popularized at present; on the other hand, after the stomach cavity is inflated, partial gas is bound to flow into the intestinal tract, abdominal distension is caused to a postoperative patient, the recovery of the intestinal tract function of the patient is not facilitated, and after the partial gas overflows from the oral cavity, the operation space in the stomach cavity is affected, and the exposure and the operation of a focus are not facilitated; meanwhile, in the process of cutting off the lump on the stomach wall, the stomach wall is cut through, so that gas in the stomach cavity overflows into the abdominal cavity, the maintenance of the operation of the stomach cavity is influenced, more importantly, gastric juice and tumor pollute the abdominal cavity, and the basic principle of surgical sterility and tumor-free is violated. For this reason, a puncture instrument dedicated to the laparoscopic transgastric cavity operation, which is inflatable without puncture of the gastric cavity, has become obviously necessary.

Disclosure of Invention

A first technical problem to be solved by the present invention is to provide a surgical instrument for puncturing tissue, which can fix a cannula into which a surgical instrument is inserted without inflating gas or liquid, in view of the above-mentioned prior art.

A second technical problem to be solved by the present invention is to provide a surgical instrument for puncturing tissue for performing a gastric cavity operation while minimizing the suction of pneumoperitoneum gas in view of the above-mentioned state of the art.

The technical scheme adopted by the invention for solving the first technical problem is as follows: the surgical instrument for piercing tissue comprises:

an outer member defining a longitudinal axis and having an outer peripheral wall;

an inner member at least partially disposed within the outer member, the inner member including a perforated member adjacent the outer member distal end;

the inner member being movable in a longitudinal direction relative to the outer member and enabling penetration through tissue in a state in which the piercing member is at least partially exposed from the peripheral wall;

the method is characterized in that: also includes:

the movable piece is arranged on the peripheral wall of the external member and is provided with a movable foot which can extend into the peripheral wall;

the actuating part is arranged on the outer surface of the inner component and is provided with a socket into which a movable foot can be inserted; and

a bladder for covering the moving member;

the movable member is deformable to expand radially outwardly at least partially upon movement of the inner member relative to the outer member in a direction away from the distal end of the outer member, thereby effecting deployment of the bladder.

In order to better achieve the expansion of the bladder, it is preferable that the peripheral wall of the outer member is provided with a limiting notch that limits the path of movement of the movable foot of the movable member, the inner member is circumferentially deflected by itself when moving relative to the outer member in a direction away from the distal end of the outer member, and the movable member is deformed to expand radially outward at least partially upon actuation of the deflecting force. The puncture is made through the body wall of the patient when the inner member is moved in a longitudinal direction relative to the outer member to expose the puncture member (defined as the forward direction of the inner member), and then the socket of the actuating portion of the inner member and the movable foot which can drive the movable member are deformed to expand radially outwardly when the inner member is moved in a backward direction (i.e., the inner member is moved in a direction away from the distal end of the outer member relative to the outer member), and actuation of the deflection force is configured to cause a "turn" of the inner member to expand the bladder, and a "turn" of the inner member is reversed to withdraw the inner member from the outer member, so that the operation can be performed using the surgical instrument inserted into the outer member.

Furthermore, the limiting notch comprises a first notch parallel to the longitudinal axis direction of the outer member and a second notch perpendicular to the longitudinal axis direction of the outer member, and the first notch is communicated with the second notch; the movable foot of the movable member is movable from the first notch into the second notch in a state in which the inner member is capable of deflecting itself circumferentially when moving relative to the outer member in a direction away from the distal end of the outer member. The movable foot of the movable piece moves from the first notch to the second notch, so that the inner component rotates to expand the bladder.

Further, the movable member includes at least two sub-movable members surrounding a circle along the outer peripheral wall of the external member, each sub-movable member includes a fixed portion adjacent to the distal end of the external member and a free portion away from the distal end of the external member, the movable member further includes a movable ring for connecting the fixed portions of the sub-movable members together, correspondingly, the movable ring has a first annular groove for connecting the fixed portions of the sub-movable members together, each sub-movable member includes a corresponding movable leg connected to the movable ring, and the movable leg of each sub-movable member has an inclined surface deflecting along the circumferential direction. The movable pin of each sub-movable part is provided with an inclined surface which deflects along the circumferential direction, and can better move from the first gap to the second gap.

Furthermore, the outer peripheral wall of the external member further comprises a limiting ring adjacent to the free portion of each sub-moving member, and the free portion of each sub-moving member abuts against the limiting ring, so that the internal member can drive each sub-moving member to deform along the radial direction and expand outwards by applying force to the free portion of each sub-moving member through the limiting ring.

In order to achieve expansion of the bladder, it is preferred that the stop ring has a second annular groove at a distal end remote from the outer member and the mobile ring has a third annular groove at a proximal end adjacent to the outer member, the two peripheral portions of the bladder being connected to the second and third annular grooves, respectively.

Further, the inner member further comprises an operating portion which is far from the distal end of the outer member and is used for operating the inner member by a surgeon to move relative to the outer member, the outer peripheral wall of the outer member is provided with a mounting hole for mounting the perforated member, the inner member is provided with at least two projections which protrude out of the outer surface of the inner member and annular convex rings which are positioned at the tail ends of the projections, and gaps between the adjacent projections and the annular convex rings jointly form a socket for inserting a movable foot.

Further, the lug is a first lug parallel to the longitudinal axis direction of the inner component and a second lug extending from the first lug to the longitudinal axis direction of the inner component, the width of the second convex blocks extending along the circumferential direction is smaller than that of the first convex blocks, a first inserting opening is formed between the adjacent first convex blocks, a second inserting opening is formed between the adjacent second convex blocks and between the annular convex rings, the movable foot of each said secondary mover enters the first socket of said inner member as said inner member moves relative to the outer member in a direction away from the distal end of the outer member, and under the state that the internal component deflects circumferentially, the movable foot of each sub-movable piece can enter the second socket of the internal component, so that the movable foot of the movable piece moves from the first notch to the second notch, and finally the movable piece can be at least partially deformed in a manner of expanding outwards in the radial direction.

When each sub-moving part enters the second socket of the inner part, the sub-moving feet of each moving part can move along the first notch along with the movement of the inner part relative to the outer part in the direction far away from the far end of the outer part, and then the inner part rotates 'one turn', so that the sub-moving feet of each moving part move into the second notch, namely the bladder can be spread, and then the moving part can be at least partially deformed to expand outwards along the radial direction. Specifically, when the inner member moves relative to the outer member in the longitudinal direction, the first insertion opening of the inner member slides along the movable foot of each sub-movable member to expose the perforation member, the second insertion opening of the inner member just aligns with the position of each sub-movable member, and when the puncture on the body wall of the patient is completed, the inner member is in a state of circumferential deflection so that each sub-movable member can fall into the second insertion opening, then when the inner component moves towards the backward direction (namely the inner component moves relative to the outer component in the direction far away from the far end of the outer component), the sub-movable feet of each movable component can move along the first notch, and then the inner component is rotated, the sub-moving feet of each moving part move into the second notches, and then the moving parts apply force to the free parts of the sub-moving parts due to the limitation of the limiting rings, so that the sub-moving parts are driven to deform along the radial direction and expand outwards.

In order to solve the second technical problem, it is preferable that the movable members have two and are spaced apart along a longitudinal axis of the outer member, and a space between adjacent movable members is provided with a locking rib engageable with tissue. For the operation of the gastric cavity, when the perforating member is pierced through the body wall of the patient and then the stomach wall is pierced, since the movable member has two, wherein "rotation" of the inner member causes the first movable member to expand the first bladder, the outer member is better connected to the stomach wall by the locking ribs, whereupon the inner member is turned "one turn" in the opposite direction to draw the inner member away from the outer member while the stomach wall is drawn into the body wall of the patient under the distraction action of the first balloon, at this point, a further "turn" of the inner member causes the second movable member to expand the second bladder, at which point a further "turn" of the inner member is reversed to completely withdraw the inner member from the outer member, so as to facilitate the operation by using the operation instrument inserted into the external component, and avoid the hidden trouble caused by the operation of inflating in the stomach cavity.

Furthermore, the peripheral wall of the external component is also provided with a propping piece which can move relative to the movable piece, and the propping piece and the expanded saccule form a clamping space for clamping the abdominal wall of the patient together. The external component can be fixed on the abdominal wall of a patient more stably through the arrangement of the abutting piece, and the situation that a surgical instrument for penetrating tissues is often out of the body and deep into the body in the operation process is avoided.

The advantage of the invention over the prior art is that the bladder is expanded by the inner member for puncturing being capable of deforming the movable member to expand radially outwardly at least in part when moved relative to the outer member in a direction away from the distal end of the outer member. Thereby forming a structure similar to a 'balloon or a saccule' and further playing a role of fixing the surgical instrument for puncturing tissues on the body wall of a patient, omitting the operation of filling gas or liquid, and having more convenient use and lower manufacturing and using cost.

Drawings

FIG. 1 is a schematic structural view of a surgical instrument for piercing tissue (with a single bladder) in an embodiment of the present invention;

FIG. 2 is an exploded view of FIG. 1;

FIG. 3 is a schematic structural view of a surgical instrument for piercing tissue for performing gastric cavity surgery in accordance with an embodiment of the present invention (with dual bladders);

FIG. 4 is a schematic view of the inner member of FIG. 3 in an at least partially radially outwardly expanding deformed state as the movable member is moved relative to the outer member in a direction away from the distal end of the outer member;

FIG. 5 is an exploded view of FIG. 4;

FIG. 6 is a partial schematic view of an outer member according to an embodiment of the present invention;

FIG. 7 is an exploded view of FIG. 3;

FIG. 8 is a schematic view of the partially exploded structure of FIG. 4;

FIG. 9 is a partially exploded view of FIG. 7 (showing the moveable leg of the moveable member disposed in the first notch in a condition where the perforated member is at least partially exposed from the peripheral wall);

FIG. 10 is the partially exploded view of FIG. 8 (showing the moveable member in a deformed condition in which the moveable member is at least partially expanded radially outward with the moveable leg of the moveable member disposed in the second notch);

FIG. 11 is a cross-sectional view of FIG. 3;

fig. 12 is a cross-sectional view of fig. 4.

Detailed Description

The invention is described in further detail below with reference to the accompanying examples.

As shown in FIGS. 1 to 12, the preferred embodiment of the present invention is shown. The surgical instrument for piercing tissue of the present embodiment comprises an outer member 1, the outer member 1 defining a longitudinal axis and having an outer peripheral wall 11; and an inner member 2 comprising a piercing member 21 adjacent the distal end 10 of the outer member 1, the inner member 2 being at least partially disposed within the outer member 1, the inner member 2 being movable in a longitudinal direction relative to the outer member 1 and enabling penetration through tissue in a state in which the piercing member 21 is at least partially exposed from the peripheral wall 11; the outer member also comprises a movable piece 3 arranged on the outer peripheral wall 11 of the outer member 1, wherein the movable piece 3 is provided with a movable foot 31 which can extend into the outer peripheral wall 11; and an actuating portion 22 provided on the outer surface of the inner member 2 and having a socket 221 into which the movable foot 31 can be inserted, and a bladder 6 for covering the movable member 3, wherein the movable member 3 is deformable at least partially so as to expand radially outwards when the inner member 2 is moved relative to the outer member 1 in a direction away from the distal end 10 of the outer member 1, thereby expanding the bladder 6. When the inner member 2 for puncture moves relative to the outer member 1 in a direction away from the far end 10 of the outer member 1, the movable member 3 can be deformed to expand outwards along the radial direction at least partially, so that the saccule 6 can be expanded, a structure similar to an air sac or a saccule can be formed, the effect of fixing a surgical instrument for puncturing tissues on the body wall of a patient is achieved, the operation of filling gas or liquid is omitted, and the use is more convenient.

In particular, in order to better achieve the expansion of the bladder 6, the peripheral wall 11 of the outer element 1 is provided with a stop notch 112 that limits the path of movement of the mobile foot 31 of the mobile element 3, the inner element 2 being itself deflected circumferentially when it moves relative to the outer element 1 in a direction away from the distal end 10 of the outer element 1, under the actuation of this deflection force, so that the mobile element 3 is deformed so as to expand radially outwards at least in part. When the inner member 2 is moved in the longitudinal direction relative to the outer member 1 to expose the piercing member 21 (defined as the forward direction of the inner member 2), a puncture can be made through the body wall of the patient, and then when the inner member 2 is moved in the backward direction (i.e., when the inner member 2 is moved in a direction away from the distal end 10 of the outer member 1 relative to the outer member 1), the socket 221 of the actuating portion 22 of the inner member 2 and the movable leg 31 of the movable member 3 are deformed to expand radially outward, and the actuation of the biasing force is provided so as to form a "turn" of the inner member 2 to expand the bladder 6, and a "turn" of the inner member 2 is reversed to withdraw the inner member 2 from the outer member 1, so as to facilitate the operation using the surgical instrument inserted into the outer member 1. The limiting notch 112 comprises a first notch 112a parallel to the longitudinal axis direction of the external member 1 and a second notch 112b perpendicular to the longitudinal axis direction of the external member 1, and the first notch 112a is communicated with the second notch 112 b; the movable leg 31 of the movable element 3 can move from the first notch 112a into the second notch 112b in a state in which the inner member 2 can itself deflect circumferentially when moving relative to the outer member 1 in a direction away from the distal end 10 of the outer member 1. The bladder 6 is expanded by the inner member 2 "one turn" as the movable foot 31 of the movable member 3 moves from the first notch 112a to the second notch 112 b. The movable member 3 includes at least two sub-movable members 30 surrounding the outer peripheral wall 11 of the outer member 1 to form a circle, each sub-movable member 30 includes a fixed portion 301 adjacent to the distal end 10 of the outer member 1 and a free portion 302 away from the distal end 10 of the outer member 1, the movable member 3 of the present embodiment further includes a movable ring 33 for connecting the fixed portions 301 of the sub-movable members 30 together, correspondingly, the movable ring 33 has a first annular groove for connecting the fixed portions 301 of the sub-movable members 30 together, each sub-movable member 30 includes a corresponding movable leg 31 connected to the movable ring 33, and the movable leg 31 of each sub-movable member 30 has an inclined surface 311 deflecting along the circumferential direction. The fixed portion 301 of each of the sub moving members 30 is connected to the movable ring 33 by using the movable ring 33 as a reference, the free end of each of the sub moving members 30 can be deformed to expand outward in the radial direction with the respective fixed portion 301 as a supporting point, and the movable leg 31 of each of the sub moving members 30 has an inclined surface 311 deflecting in the circumferential direction, and can be better moved from the first notch 112a to the second notch 112 b. The outer peripheral wall 11 of the outer member 1 further includes a retaining ring 5 adjacent to the free portion 302 of each of the sub-moving members 30, and the free portion 302 of each of the sub-moving members 30 abuts against the retaining ring 5, so that the inner member 2 can drive each of the sub-moving members 30 to deform and expand radially outward by applying a force to the free portion 302 of each of the sub-moving members 30 through the retaining ring 5. The stop ring 5 further has a second annular groove 51 at the distal end 10 away from the outer member 1, the movable ring 33 has a third annular groove 333 at the proximal end adjacent to the outer member 1, two peripheral edges of the bladder 6 are respectively connected to the second annular groove 51 and the third annular groove 333, when the free portion 302 of each of the sub-movable members 30 abuts against the stop ring 5, the free portion can drive each of the sub-movable members 30 to deform in an outward radial expansion manner, and at this time, the movable ring 33 approaches the stop ring 5, so that the second annular groove 51 and the third annular groove 333 approach each other, and the bladder 6 is expanded.

In addition, the inner member 2 further comprises an operating part 20 which is far from the far end 10 of the outer member 1 and is used for operating the inner member 2 to move relative to the outer member 1 by a surgeon, the outer peripheral wall 11 of the outer member 1 is provided with a mounting hole 110 for mounting a perforated member 21, the inner member 2 is provided with at least two projections 24 which protrude out of the outer surface of the inner member 2 and annular convex rings 25 which are positioned at the tail ends of the projections 24, and gaps between the adjacent projections 24 and the annular convex rings 25 jointly form a socket 221 which can be inserted by the movable foot 31. The projection 24 is a first projection 241 parallel to the longitudinal axis direction of the inner member 2 and a second projection 242 extending from the first projection 241 continuously to the longitudinal axis direction of the inner member 2, the width of the second projection 242 extending along the circumferential direction is smaller than that of the first projection 241, a first socket 221 is formed between adjacent first projections 241, a second socket 222 is formed between adjacent second projections 242 and between the annular convex rings 25, when the inner member 2 moves relative to the outer member 1 in the direction away from the distal end 10 of the outer member 1, the movable foot 31 of each sub-movable member 30 enters the first socket 221 of the inner member 2, and in the state that the inner member 2 deflects itself circumferentially, the movable foot 31 of each sub-movable member 30 can enter the second socket 222 of the inner member 2, so that the movable foot 31 of the movable member 3 moves from the first notch 112a to the second notch 112b, finally, the moving part 3 is deformed so as to expand radially outwards at least in regions. When the inner member 2 moves in the longitudinal direction relative to the outer member 1, the first insertion opening 221 of the inner member 2 slides along the movable leg 31 of each of the sub-movable members 30 to expose the through hole member 21, the second insertion opening 222 of the inner member 2 is aligned with the position of each of the sub-movable members 30, when the puncture of the body wall of the patient is completed, the inner member 2 is deflected circumferentially so that each of the sub-movable members 30 can fall into the second insertion opening 222, and then when the inner member 2 moves in the retreating direction (i.e., the inner member 2 moves in the direction away from the distal end 10 of the outer member 1 relative to the outer member 1), the movable leg 31 falling into the second insertion opening 222 of the inner member 2 can move from the first notch 112a to the second notch 112b, so that the movable member 3 exerts a force on the free portion 302 of each of the sub-movable member 30 due to the restriction of the retainer ring 5, thereby driving the respective sub-moving members 30 to deform in an expanding manner radially outward, and thus, the bladder 6 is expanded.

The outer member 1 of the present embodiment is cannula-shaped and the distal end 10 of the outer member 1 is provided with a seal assembly preferably releasably mounted on a cannula housing 100 at the distal end 10 of the outer member 1, the means for releasably connecting the seal assembly to the cannula housing may comprise a bayonet coupling, a screw coupling, a snap fit or the like, the seal assembly comprising a seal housing and at least one inner seal adapted to form a fluid sealing membrane 1001 around an instrument inserted through the seal assembly or a valve body structure, which may or may not be a component of the cannula assembly, which closes in the absence of a surgical instrument, and which is adapted to prevent pneumoperitoneum gases from passing through the outer member 1, the seal assembly of the present embodiment being the sealing membrane 1001 and the piercing member 21 being of a pointed or truncated conical configuration. When the inner member 2 is moved in the longitudinal direction relative to the outer member 1 during the laparoscopic surgery, the first insertion opening 221 of the inner member 2 slides along the movable leg 31 of each of the plurality of sub-moving members 30 to expose the piercing member 21, the second insertion opening 222 of the inner member 2 is aligned with the position of each of the plurality of sub-moving members 30, when the puncture of the body wall of the patient is completed, the inner member 2 is deflected in the circumferential direction so that each of the plurality of sub-moving members 30 can fall into the second insertion opening 222, and then when the inner member 2 moves in the retreating direction (i.e., the inner member 2 moves in the direction away from the distal end 10 of the outer member 1 relative to the outer member 1), the movable leg 31 falling into the second insertion opening 222 of the inner member 2 can move from the first notch 112a to the second notch 112b, so that the movable member 3 exerts a force on the free portion 302 of each of the plurality of sub-moving members 30 due to the restriction of the, thereby driving each sub-moving part 30 to generate the deformation expanding outwards along the radial direction, further realizing the expansion of the saccule 6, then moving the propping part 4 on the peripheral wall 11 of the external component 1 to the abdominal wall of the patient, and the propping part 4 and the expanded saccule 6 together form a clamping space for clamping, thereby avoiding the situation that the surgical instrument for puncturing the tissue is frequently out of the body and goes deep into the body in the operation process.

Finally, the surgical instrument for piercing tissue of the present embodiment is capable of performing gastric cavity procedures (see fig. 3-12) in which two of the movers 3 are required to be disposed and spaced apart along the longitudinal axis of the outer member 1, and the space between adjacent movers 3 is provided with a locking rib 111 engageable with tissue. For the operation of the gastric cavity, when the puncture member 21 punctures the gastric wall through the body wall of the patient and then punctures the gastric wall, because of the two moving members 3, one turn of the inner member 2 causes the first moving member 3 ' to expand the first bladder 6 ', the outer member 1 can be better connected with the gastric wall by the locking rib 111, at this time, the inner member 2 is turned back again to turn back again to pull the inner member 2 from the outer member 1 partially and simultaneously pull the gastric wall to the body wall of the patient under the expanding action of the first bladder 6 ', at this time, the other turn of the inner member 2 causes the second moving member 3 "to expand the second bladder 6", at this time, the inner member 2 is turned back again to turn back to pull the inner member 2 from the outer member 1 completely, so as to facilitate the operation using the operation instrument inserted into the outer member 1, avoiding the hidden trouble caused by the operation of inflating in the stomach cavity. The outer peripheral wall 11 of the external component 1 is further provided with a supporting piece 4 capable of moving relative to the moving piece 3, the supporting piece 4 and the expanded saccule 6 together form a clamping space for clamping the abdominal wall of the patient, and finally the external component 1 can be fixed on the abdominal wall of the patient more stably through the arrangement of the supporting piece 4, so that the situation that surgical instruments for penetrating tissues are frequently out of the body and deeply into the body in the operation process is avoided. When the operation is over, the first and second bladders 6 ', 6 "are also required to be closed back by the inner member 2, as opposed to being opened for the first and second bladders 6', 6".

Claims (10)

1. A surgical instrument for piercing tissue comprising:

an outer member (1), the outer member (1) for defining a longitudinal axis and having an outer peripheral wall (11);

an inner member (2), the inner member (2) being at least partially arranged within the outer member (1), the inner member (2) comprising a perforated member (21) adjacent the distal end (10) of the outer member (1);

the inner member (2) being movable in a longitudinal direction relative to the outer member (1) and enabling penetration through tissue in a state in which the piercing member (21) is at least partially exposed from the peripheral wall (11);

the method is characterized in that: also includes:

a movable member (3) provided on the outer peripheral wall (11) of the outer member (1) and having a movable leg (31) that can be inserted into the outer peripheral wall (11);

an actuating portion (22) provided on an outer surface of the inner member (2) and having a socket (221) into which a movable foot (31) can be inserted; and

an elastic membrane (6) for wrapping the mobile element (3);

when the inner member (2) moves relative to the outer member (1) in a direction away from the far end (10) of the outer member (1), the movable member (3) can be deformed to expand outwards along the radial direction at least partially, so that the elastic membrane (6) is expanded.

2. A surgical instrument for piercing tissue as recited in claim 1, wherein: the outer peripheral wall (11) of the outer member (1) is provided with a limiting notch (112) for limiting the moving path of the moving foot (31) of the moving member (3), the inner member (2) can deflect circumferentially when moving relative to the outer member (1) in the direction away from the far end (10) of the outer member (1), and the moving member (3) can be deformed to expand outwards in the radial direction at least partially under the actuation of the deflection force.

3. A surgical instrument for piercing tissue as recited in claim 2, wherein: the limiting notch (112) comprises a first notch (112a) parallel to the longitudinal axis direction of the external member (1) and a second notch (112b) perpendicular to the longitudinal axis direction of the external member (1), and the first notch (112a) is communicated with the second notch (112 b); the movable foot (31) of the movable element (3) can be moved from the first recess (112a) into the second recess (112b) in a state in which the inner element (2) can deflect itself in the circumferential direction when moved relative to the outer element (1) in a direction away from the distal end (10) of the outer element (1).

4. A surgical instrument for piercing tissue as recited in claim 3, wherein: the movable element (3) comprises at least two sub-movable elements (30) which surround the outer peripheral wall (11) of the outer element (1) to form a circle, each sub-movable element (30) comprises a fixed part (301) adjacent to the far end (10) of the outer element (1) and a free part (302) far away from the far end (10) of the outer element (1), wherein the movable element (3) further comprises a movable ring (33) for connecting together the fixed portions (301) of the respective sub-movable elements (30), correspondingly, the movable ring (33) has a first annular groove connecting the fixed portions (301) of the respective sub-movable members (30) together, each sub-movable part (30) comprises a corresponding movable foot (31) connected to the movable ring (33), and the movable leg (31) of each sub-movable member (30) has an inclined surface (311) that deflects in the circumferential direction.

5. The surgical instrument for piercing tissue of claim 4, wherein: the outer peripheral wall (11) of the outer component (1) further comprises a limiting ring (5) adjacent to the free portion (302) of each sub-moving part (30), and the free portion (302) of each sub-moving part (30) abuts against the limiting ring (5), so that the inner component (2) can drive each sub-moving part (30) to deform in a manner of expanding outwards in the radial direction by applying force to the free portion (302) of each sub-moving part (30) through the limiting ring (5).

6. The surgical instrument for piercing tissue of claim 5, wherein: the limit ring (5) is provided with a second annular groove (51) at the far end (10) far away from the external member (1), the movable ring (33) is provided with a third annular groove (333) at the near end close to the external member (1), and two peripheral parts of the elastic membrane (6) are respectively connected in the second annular groove (51) and the third annular groove (333).

7. A surgical instrument for piercing tissue as claimed in any one of claims 3 to 6, wherein: the inner member (2) further comprises an operating part (20) which is far away from the far end (10) of the outer member (1) and is used for operating the inner member (2) to move relative to the outer member (1) by a surgeon, the outer peripheral wall (11) of the outer member (1) is provided with a mounting hole (110) for mounting the perforated member (21), the inner member (2) is provided with at least two lugs (24) which protrude out of the outer surface of the inner member (2) and annular convex rings (25) which are positioned at the tail ends of the lugs (24) adjacent to the mounting hole (110), and gaps between the adjacent lugs (24) and the annular convex rings (25) jointly form a socket (221) which can be inserted by the movable foot (31).

8. The surgical instrument for piercing tissue of claim 7, wherein: the lug (24) is a first lug (241) parallel to the longitudinal axis direction of the inner member (2) and a second lug (242) extending from the first lug (241) to the longitudinal axis direction of the inner member (2), the width of the second lug (242) extending along the circumferential direction is smaller than that of the first lug (241), a first socket (221) is formed between the adjacent first lugs (241), a second socket (222) is formed between the adjacent second lugs (242) and between the annular convex rings, when the inner member (2) moves relative to the outer member (1) in the direction far away from the far end (10) of the outer member (1), the movable foot (31) of each sub-movable piece (30) enters the first socket (221) of the inner member (2) and the inner member (2) deflects circumferentially by itself, the movable foot (31) of each sub-movable part (30) can enter the second socket (222) of the inner member (2), and then the movable foot (31) of the movable part (3) can move from the first notch (112a) to the second notch (112b), and finally the movable part (3) can be at least partially deformed in a manner of expanding outwards in a radial direction.

9. The surgical instrument for piercing tissue of claim 8, wherein: the moving parts (3) are provided with two parts and are arranged at intervals along the longitudinal axis of the external component (1), and the intervals between the adjacent moving parts (3) are provided with locking ribs (111) capable of being engaged with tissues.

10. A surgical instrument for piercing tissue as claimed in claim 8 or 9, wherein: the outer wall (11) of the external component (1) is also provided with a propping piece (4) which can move relative to the moving piece (3), and the propping piece (4) and the stretched elastic membrane (6) jointly form a clamping space for clamping the abdominal wall of a patient.

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