CN113208679A - Anastomat - Google Patents

Abstract

The present application relates to an anastomat for performing a first treatment on lesion tissue and a second treatment on the lesion tissue, which comprises a first part and a second part movably connected in a first direction, wherein the first part can be used for completing the first treatment on the lesion tissue after extending into a patient body and freeing up a space in a direction crossing the extending direction of the anastomat, and then the second part can be used for extending into the patient body by using the vacated space so as to perform the second treatment in a subsequent step. The anastomat is ingenious in structure and convenient to use, and operation space perpendicular to the insertion direction of the anastomat can be saved.

Description

Anastomat

Technical Field

The application relates to the field of medical equipment, in particular to an anastomat.

Background

The anastomat is a device used in medicine to replace manual suture, and the main working principle is to use titanium nails to separate or anastomose lesion tissues, similar to a stapler. Prior to severing or stapling the lesion tissue, the stapler typically clamps the lesion components together.

Some conventional staplers, such as the anorectal stapler described in the publication CN111789652A, have the same clamping direction of the head clamping assembly, the same stapling direction of the staples, and the same cutting movement direction of the cutter as the extending direction of the stapler head, so that the anorectal stapler requires less anorectal radial space when in use. That is, the conventional stapler head holding assembly clamps and fixes a lesion tissue such as the hemorrhoidal tissue shown in fig. 1 in a length direction thereof, staples the lesion tissue in the length direction thereof, and cuts the lesion tissue in the length direction thereof. However, the length of the focal tissue is typically large, such as the hemorrhoid tissue 100 in FIG. 1, which is typically substantially elongated in the anal intestine 200 of the patient, and the length of which extends substantially along the length of the anal intestine, the length of the hemorrhoid tissue 100 is typically several times the width. Hemorrhoid surgery generally requires that the lesion tissue be as small as possible in the clamping direction to facilitate stapling of the staples. After the clamping component of the head of the anastomat clamps and fixes the focal tissue in the length direction of the focal tissue, the clamped focal tissue generates larger deformation compared with the initial state, so that the pain of a patient is increased, and the operation risk is increased due to the excessively deformed focal tissue.

Thus, there is no disclosure: the inventors have conducted extensive studies and have come to the mind that the above problems should be alleviated to some extent if lesion tissues to be cut are fixed by clamping in a direction crossing the length of the lesion tissues. However, if the clamping assembly of the stapler head is designed to clamp and fix the focal tissue in a non-length direction, the clamping assembly occupies more anorectal radial space in the non-clamped open state, which may result in insufficient assembly space for other functional elements of the stapler head, such as the pushing elements of the staples and the knife.

Disclosure of Invention

The technical problem that this application was solved is: provides an anastomat which is ingenious in structure and convenient to use and aims to save the operation space perpendicular to the insertion direction of the anastomat.

The technical scheme of the application is as follows:

an anastomat for performing a first treatment and a second treatment on lesion tissues in a patient body,

the stapler includes a first portion and a second portion that articulate in a first direction;

the first portion having a first leading end portion projecting forwardly in the first direction and, in use, projecting into the patient generally along the first direction for the first treatment of the lesion tissue, the first leading end portion including a first mover operable to move between a first position and a second position, the first position having a first amount of displacement relative to the second position in a second direction transverse to the first direction;

said second portion having a second leading end portion projecting forwardly in said first direction and intended, in use, to project into the patient's body at a first relative position to said first leading end portion for said second treatment of said lesion tissue;

when the first leading end portion is not in a state of the first treatment of the lesion tissue, the first mover is in the first position that blocks the second leading end portion from advancing in the first direction to the first relative position; when the first leading end portion is in a state of performing the first treatment on the lesion tissue, the first mover is in the second position where the blockage of the second leading end portion is released by the first displacement amount.

On the basis of the technical scheme, the method can further comprise one or more of the following preferable schemes:

when the second front end portion and the first front end portion are in the first relative position, the second front end portion and the first mover at least partially overlap in the first direction.

When the second front end portion and the first front end portion are in the first relative position, the second front end portion and the first mover at least partially overlap in the first direction.

The second front end portion and the first moving member cooperatively perform the second treatment on the lesion tissue.

When the first mover is in the first position, a projection of at least a part of the first mover in the first direction and a projection of at least a part of the second leading end portion in the first direction overlap with each other, thereby blocking the second leading end portion from advancing in the first direction to the first relative position;

when the first mover is at the second position, a projection of the at least a portion of the first mover in the first direction does not overlap a projection of the at least a portion of the second leading end portion in the first direction, thereby releasing the blocking of the second leading end portion.

The at least a part of the first mover includes a rear end surface of the first mover in the first direction, and the at least a part of the second leading end portion includes a leading end surface of the second leading end portion in the first direction.

The first portion further comprising a second mover operable to move between a third position and a fourth position to move the first mover between the first position and the second position, the second mover having an extracorporeal portion that, in use, remains extracorporeal to the patient, the third position having a second amount of displacement in the second direction relative to the fourth position;

when the first leading end portion is not in a state of the first treatment of the lesion tissue, the extracorporeal portion is in the third position that blocks the second leading end portion from advancing in the first direction and blocks the second leading end portion outside the patient; when the first leading end portion is in a state of performing the first treatment on the lesion tissue, the second mover is in the fourth position where the blockage of the second leading end portion is released by the second displacement amount.

The second moving member is fixed with the first moving member, and the second moving member extends straight rearward from the first moving member in the first direction.

The first front end part comprises a fixed clamping seat and a movable clamping seat contained in the first moving part;

the first processing includes:

clamping the lesion tissue between the movable clamp seat and the fixed clamp seat in the second direction.

The second direction is substantially perpendicular to the first direction.

The first part comprises a manually operated clamping actuator which is in transmission connection with the movable clamping seat through the second moving part and is used for driving the movable clamping seat to move towards the fixed clamping seat so as to clamp the lesion tissue between the movable clamping seat and the fixed clamping seat (3) in the second direction.

The second processing includes:

stapling the focal tissue in a third direction substantially parallel to the second direction.

The movable clamping seat is provided with a nail outlet hole for receiving and guiding anastomosis nails to move in the third direction so as to staple the lesion tissues, the first front end part further comprises a push plate movably connected with the movable clamping seat, and the push plate is arranged on one side of the movable clamping seat, which deviates from the fixed clamping seat in the second direction;

the second front end portion comprises a pushing block used for pushing the pushing plate to push the staples out of the staple outlet hole;

the second part comprises a manually operated push button, and the push button is in transmission connection with the push block to drive the push block to push the push plate.

The second processing further includes: resecting the focal tissue in a fourth direction substantially parallel to the second direction;

the movable clamping seat is provided with a knife outlet hole for accommodating and guiding the cutting knife to move in the fourth direction so as to cut the lesion tissue, and the push block is also used for pushing the push plate so as to push the cutting knife out of the knife outlet hole.

The application has at least the following beneficial effects:

the present application designs the anorectal stapler as two large sections that are movably connected and each include a front end portion that needs to be inserted into the patient for relevant treatment at the time of use. The head of the anastomat is broken into parts, and the parts are divided into a first head assembly and a second head assembly. The first head assembly is used to perform a first prior treatment of the lesion tissue and, after performing the first treatment, just vacates the body space perpendicular to the direction of insertion of the stapler, freeing up sufficient room for a second head assembly to provide a second subsequent treatment (e.g., stapling, cutting).

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings of the embodiments will be briefly introduced below, and it is apparent that the drawings in the following description only relate to some embodiments of the present application and are not limiting on the present application.

FIG. 1 is a schematic view of hemorrhoidal tissue.

Fig. 2 is a schematic perspective view of an anorectal stapler according to an embodiment of the present application, wherein the clamping assembly is in a clamping state, and the staple and the cutting knife are in a state of waiting for staple ejection and a state of waiting for knife ejection, respectively.

Fig. 3 is a schematic cross-sectional view of the anorectal stapler of fig. 2.

Fig. 4 is an enlarged view of the X1 portion of fig. 3.

Fig. 5 is a schematic view of the anorectal stapler of fig. 3 after the push button has been advanced to push out the staple and knife.

Fig. 6 is an enlarged view of the X2 portion of fig. 5.

FIG. 7 is a schematic view of the first portion of the anorectal stapler of FIG. 2 after the push button has been retracted to an extreme position.

FIG. 8 is a schematic view of the second portion of the anorectal stapler of FIG. 2.

FIG. 9 is a schematic view of the first portion of the anorectal stapler of FIG. 2 with the clamping assembly in an undamped condition.

Fig. 10 is an enlarged view of the X3 portion of fig. 9.

FIG. 11 is a schematic view of the first portion of the anorectal stapler of FIG. 2 in a clamped state in the clamping assembly.

Fig. 12 is an enlarged view of the X4 portion of fig. 11.

FIG. 13 is a top view of the staple knife push plate of FIG. 11 with the plate removed.

Fig. 14 is an enlarged view of the X5 portion of fig. 13.

Fig. 15 is an exploded view of the anorectal stapler of fig. 2.

Fig. 16 is a partially enlarged view of fig. 15.

Fig. 17 is a schematic structural diagram of a cutting knife in the first embodiment of the present application.

FIG. 18 is an illustration of the use of a straight cutting blade to cut hemorrhoidal tissue.

FIG. 19 is a schematic view of the hemorrhoid tissue structure of FIG. 18 after the cutting is completed.

FIG. 20 is a diagrammatic view of a cutter of the first embodiment of the present application cutting relatively thin hemorrhoidal tissue.

FIG. 21 is a schematic view of the hemorrhoid tissue structure after completion of the cutting action of FIG. 20.

FIG. 22 is an illustration of the use of the first knife of the present application to cut thick hemorrhoidal tissue.

FIG. 23 is a schematic view of the hemorrhoid tissue structure after completion of the cutting action of FIG. 22.

Fig. 24 is a schematic structural view of a stapler according to a second embodiment of the present application, which has not yet performed a first treatment on lesion tissue.

FIG. 25 is a schematic view of a stapler according to a second embodiment of the present application configured to perform a first treatment on lesion tissue without performing a second treatment.

Fig. 26 is a schematic view of a stapler according to a second embodiment of the present application in preparation for a second treatment of lesion tissue.

Description of reference numerals:

1000-first part, 2000-second part;

1001-first front end, 2001-second front end;

100-hemorrhoid tissue, 200-anorectum, 300-human body;

101-a connecting part of a hemorrhoid tissue cutting section and an uncut section, and 102-a cutting seam between the hemorrhoid tissue cutting section and the uncut section;

d 1-first direction, d 2-second direction, d 3-third direction, d 4-fourth direction;

1-anastomotic nail, 2-cutter, 3-fixed holder, 4-movable holder, 5-clamping actuator, 6-first shell, 7-nail knife push plate, 8-nail knife actuator, 9-second shell, 10-push block, 11-first connecting rod, 12-second connecting rod, 13-third connecting rod, 14-driving belt, 15-push rod, 16-sliding pin, 17-safety bolt, 18-extension rod, 19-rolling shaft and 20-rolling wheel;

4 a-nail outlet hole, 4 b-cutter outlet hole;

6 a-handle, 6 b-clamping groove and 6 c-push button guiding hole;

7 a-nail pushing part, 7 b-knife pushing part;

9 a-jack, 9 b-rib, 9 c-guide groove;

10 a-chute, 10 b-bevel;

1501-front rod, 1502-rear rod, 15 a-push rod guide hole.

Detailed Description

In order to make the objects, technical solutions and advantages of the present application clearer, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the drawings of the embodiments of the present application. It should be apparent that the described embodiments are only some of the embodiments of the present application, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the described embodiments of the application without any inventive step, are within the scope of protection of the application. It will be understood that some of the technical means of the various embodiments described herein may be replaced or combined with each other without conflict.

In the description of the present application and claims, the terms "first," "second," and the like, if any, are used solely to distinguish one from another as between described objects and not necessarily in any sequential or technical sense. Thus, an object defined as "first," "second," etc. may explicitly or implicitly include one or more of the object. Also, the use of the terms "a" or "an" and the like, do not denote a limitation of quantity, but rather denote the presence of at least one of the two, and "a plurality" denotes no less than two. As used herein, the term "plurality" means not less than two.

In the description of the present application and in the claims, the terms "connected," "mounted," "secured," and the like are used broadly, unless otherwise indicated. For example, "connected" may be a separate connection or may be integrally connected; may be directly connected or indirectly connected through an intermediate. The specific meaning of the foregoing terms in the present application can be understood by those skilled in the art as appropriate.

In the description of the present application and in the claims, if there is an orientation or positional relationship indicated by the terms "upper", "lower", "horizontal", etc. based on the orientation or positional relationship shown in the drawings, it is only for the convenience of clearly and simply describing the present application, and it is not indicated or implied that the elements referred to must have a specific direction, be constructed and operated in a specific orientation, and these directional terms are relative concepts for the sake of description and clarification and may be changed accordingly according to the change of orientation in which the elements in the drawings are placed. For example, if the device in the figures is turned over, elements described as "below" other elements would then be oriented "above" the other elements.

In the description of the specification and claims, the terms "based on" and "based on," if any, are used to describe one or more factors that affect the determination. The term does not exclude additional factors that influence the determination. That is, the determination may be based solely on these factors or at least partially on these factors. For example, the phrase "determining a based on B," in which case B is a factor that affects the determination of a, such phrases do not exclude that the determination of a may also be based on C.

In the description of the present specification and claims, the term "configured to" if present is generally interchangeable with "… capable" or "designed to" or "for" or "capable" depending on the context.

Embodiments of the present application will now be described with reference to the accompanying drawings.

The first embodiment is as follows: anorectal anastomat

Figures 2 and 3 show an anorectal stapler for excising haemorrhoidal tissue in the anorectum of a patient. Like some conventional anorectal staplers, this anorectal stapler also has a head which, in use, extends partially or fully into the anorectum of the patient. The head has a length dimension extending in the first direction d1, or, alternatively, the head projects forward from the stapler body along the first direction d 1. The head is provided with: in use, the clamping assembly clamps the hemorrhoidal tissue in the second direction d2, moves the staples 1 in the third direction d3 to staple the hemorrhoidal tissue, and moves the cutter 2 in the fourth direction d4 to excise the hemorrhoidal tissue. In use, the head of the stapler is inserted into the anorectal tract of the patient substantially along the aforesaid first direction d1, and, in combination with external operations, the relevant treatment is carried out on the haemorrhoidal tissue by means of the aforesaid relevant elements provided on the head.

In the present embodiment, the second direction d2 is substantially perpendicular to the first direction d 1.

It will be appreciated that after the head of the stapler is inserted into the affected part of the anorectum, the length of the affected part of the anorectum will be arranged along the length of the head of the stapler, i.e. the first direction d 1. In most cases, a sheath is placed in the anorectum in advance to open the anorectal section to be operated on, the length of the sheath and the length of the affected anorectum also following the first direction d 1. Then a second direction d2, which is substantially perpendicular to the first direction d1, is substantially perpendicular to the anorectal length. The background art of the application has already explained: the hemorrhoidal tissue 100 within the anorectum is generally elongate in configuration extending along the length of the affected area, the length of the hemorrhoidal tissue 100 in the first direction d1 being several times its width in the second direction d 2.

When the stapler is used, after the insertion depth of the head of the stapler is in place, the angle of the head clamping assembly is adjusted to align the head clamping assembly with the hemorrhoidal tissue 100 to be excised in the anorectum, and then the hemorrhoidal tissue 100 is clamped in the width direction of the hemorrhoidal tissue 100, so that preparation is provided for the stapling and excision of the hemorrhoidal tissue. Thereafter, by operating to move staples 1 in the third direction d3 to staple the clamped hemorrhoidal tissue 100, the knife 2 is moved in the fourth direction d4 to cut the hemorrhoidal tissue 100 which has been stapled and which is located outside the staples.

Since the width dimension of the hemorrhoidal tissue 100 is smaller than the length dimension, when the clamping assembly clamps the hemorrhoidal tissue 100 in the width direction of the hemorrhoidal tissue (second direction d2), the patient's pain is less than with the conventional solution of clamping the hemorrhoidal tissue in the length direction (first direction d1), and clamping a small width of the hemorrhoidal tissue 100 in the width direction is easier to handle.

As shown in fig. 4, 6, 10, and 12 with reference to fig. 3, 5, 7, 9, and 11, in the present embodiment, the clamping assembly includes a fixed clamping seat 3 and a movable clamping seat 4 that are engaged with each other, and the movable clamping seat 4 and the fixed clamping seat 3 are arranged in the second direction d 2. The clamping action of the clamping assembly is driven by a manually operated clamping actuator 5. The clamping actuating piece 5 is connected with the movable clamping seat 4 through a first transmission component. In use, the operator manually actuates the aforementioned clamping actuator 5, and the clamping actuator 5 drives the movable clamp holder 4 to move towards the fixed clamp holder 3 through the first transmission assembly, so as to clamp and fix the hemorrhoid tissue 100 to be excised between the movable clamp holder 4 and the fixed clamp holder 3 along the aforementioned second direction d 2.

In order to facilitate the operation and the installation of the related components, the anorectal stapler of the embodiment is further provided with a first shell 6 with a handle 6 a. The gripping actuator 5 is embodied as a trigger having a first end, i.e. the upper end in fig. 3, extending into the first housing 6 and being pivotally connected to the first housing 6 and a second end, i.e. the lower end in fig. 3, extending outside the first housing 6 for manual operation. An extension bar 18 extending forward in the first direction d1 is fixedly connected to the first housing 6, and the movable holder 4 is integrally fixed to a front end portion of the extension bar 18.

Referring again to fig. 3, the first transmission assembly is mainly composed of a first link 11, a second link 12, a third link 13, and a transmission belt 14. Wherein: the first link 11 extends in the first direction d1, and the left end of the first link 11 in fig. 3 is fixed to the movable holder 4. A first end, i.e., an upper end in fig. 3, of the second link 12 is pivotally connected to the first link 11, and a second end, i.e., a lower end in fig. 3, is pivotally connected to the first housing 6. A first end, i.e., an upper end in fig. 3, of the third link 13 is pivotally connected to the first link 11, and a second end, i.e., a lower end in fig. 3, is pivotally connected to the first housing 6. A drive belt 14 connects a first end of the trigger and a second end of the third link 13. When the first end of the trigger is rotated, the second end of the third link 13 is driven to rotate by the transmission belt 14.

When the device is used, the trigger in fig. 9 is pulled, so that the first end of the trigger rotates anticlockwise around the switching part between the first end of the trigger and the first shell 6, the second end of the third connecting rod 13 is driven to rotate anticlockwise through the transmission belt 14, and the first connecting rod 11 is driven to move leftwards and move downwards. The movable holder 4 fixed to the left end of the first link 11 is pressed against the fixed holder 3 to clamp and fix the hemorrhoidal tissue between the movable holder 4 and the fixed holder 3, as shown in fig. 11.

To prevent the transmission belt 14 from slipping during operation, a gear body may be provided at the first end of the trigger and the second end of the third link 13, respectively, and correspondingly, the transmission belt 14 may be provided as a toothed belt structure in meshing connection with the two gear bodies.

In order to enable the cartridge 4 to move back automatically in figure 11 after the user releases the trigger, the present embodiment is further provided with a return torsion spring, not shown, connected between the first end of the trigger and the first housing 6. The return torsion spring applies a clockwise spring force to the first end of the trigger in fig. 3. Obviously, the aforementioned return torsion spring may be disposed at other positions, for example, between the second end of the second link 12 and the first housing 6, or between the second end of the third link 13 and the first housing 6.

Furthermore, a locking element can be arranged on the first transmission assembly, so that the movable clamp seat 4 and the fixed clamp seat 3 can be locked in a clamping state, and the gripping force of a user on the trigger is released. When the movable clamping seat 4 needs to return, the locking element is unlocked. The locking element may take various configurations known to those skilled in the art and will not be described in detail herein.

Referring to fig. 4, 6, 10, 12 and 14 again, the movable clamping seat 4 is provided with a plurality of nail holes 4a and a cutter hole 4 b. Among them, the staple discharging holes 4a are for receiving the staples 1 and guiding the staples 1 to move in the third direction d3, and the knife discharging holes 4b are for receiving the staples 1 and guiding the knife 2 to move in the fourth direction d 4. It can be seen that the movable clamp holder 4 has substantially the same structure and function as a cartridge in a conventional stapler, and is used for clamping the hemorrhoidal tissue and guiding the stapling direction and the cutting direction of the staples 1 and the cutting knife 2, so that the movable clamp holder 4 can also be referred to as a cartridge. The fixed clamping seat 3 is similar to a nail abutting seat in the traditional anastomat.

Those skilled in the art will appreciate that the nail outlet 4a and the cutter outlet 4b may have various configurations to achieve the above-described functions. For example, the nail hole 4a is a hole penetrating through the movable holder 4 in the third direction d3, and the cutter hole 4b is a hole penetrating through the movable holder 4 in the fourth direction d 4; for another example, only a partial hole segment of the nail hole 4a is configured to extend in the third direction d3, and only a partial hole segment of the cutter hole 4b is configured to extend in the fourth direction d 4.

The hemorrhoid tissue 100 is clamped in the second direction d2, so that the hemorrhoid tissue 100 in the clamped state has a smaller dimension in the second direction d 2. If the staples 1 staple the hemorrhoidal tissue in the clamping direction of the hemorrhoidal tissue 100, the stapling force exerted on the hemorrhoidal tissue during the stapling operation is small, which is not only easy to implement, but also the secondary deformation of the clamped hemorrhoidal tissue and the pain of the patient during the stapling process are small. Thus, the present embodiment provides the stapling direction of staples 1, i.e., the third direction d3, to be substantially parallel to the second direction d2, i.e., the stapling direction of staples 1 substantially coincides with the clamping movement direction of the clamping assembly.

In addition, in order to simplify the structural design of the stapler and improve the structural compactness of the stapler, the cutting movement direction of the cutting knife 2, i.e., the fourth direction d4, is also set to be substantially parallel to the second direction d2 in the present embodiment. It can be seen that the second direction d2, the third direction d3 and the fourth direction d4 are substantially the same direction and are all substantially perpendicular to the protruding direction of the stapler head, the first direction d 1.

In order to facilitate the surgical personnel to push out the staple holes 4a and the knife holes 4b of the staple 1 and the knife 2 from the driven holder 4, the present embodiment is further provided with a staple knife pushing plate 7, a staple knife actuating member 8, and a second transmission assembly connecting the staple knife actuating member 8 and the staple knife pushing plate 7. Wherein:

referring again to fig. 4 and 6 in combination with fig. 3 and 5, the staple knife pushing plate 7 is disposed on the side of the movable holder 4 facing away from the fixed holder 3 in the second direction d2, and the staple knife pushing plate 7 and the fixed holder 3 are respectively disposed on the two back sides of the movable holder 4 in the second direction d 2. A manually operated staple knife actuator 8 is operatively connected to the staple knife push plate 7 by a second transmission assembly. In use, the staple knife actuating member 8 is manually actuated, and the staple knife actuating member 8 drives the staple knife pushing plate 7 to move towards the movable clamping seat 4 through the second transmission assembly, so that the staples 1 and the cutting knife 2 are respectively pushed out from the staple outlet hole 4a and the knife outlet hole 4 b. It can be seen that the movement of the staples 1 and the knife 2 is driven by the same set of components.

In order to ensure the smooth implementation of the cutting operation, the hemorrhoid tissue needs to be stapled first, and then the stapled hemorrhoid tissue needs to be cut off. The staple discharging operation of the staple 1 precedes the knife discharging operation of the knife 2. Thus, the present embodiment makes such a design for the staple-cutter push plate 7:

referring again to fig. 4, 6, 10 and 12, the staple pusher plate 7 includes a pusher portion 7b and a staple pushing portion 7a, wherein the staple pushing portion 7a is formed to protrude from the pusher portion 7b toward the movable holder 4. The nail pushing part 7a operatively extends into the nail hole. As such, in the process of moving the staple pusher plate 7 toward the movable jaw 4, the staple pushing portion 7a contacts and pushes the staple 1 first, and then the knife pushing portion 7b contacts and pushes the cutter 2. The plurality of staple pushing portions 7a are provided to push the plurality of staples 1, respectively.

Preferably, the nail pushing part 7a always extends into the nail outlet hole 4a both when the nail is pushed and when the nail is not pushed, so as to reduce the possibility that the nail pushing part 7a cannot smoothly enter the nail outlet hole to push the nail due to the nail pushing operation, as shown in fig. 4 and 10.

In this embodiment, the knife actuator 8 is a push button that is movable in a first direction d 1. The second transmission assembly mainly comprises a push block 10 and a push rod 15. Wherein: the push block 10 is disposed on the side of the staple knife push plate 7 facing away from the movable jaw 4 in the second direction d2, i.e., the push block 10 and the movable jaw 4 are disposed on the two opposite sides of the staple knife push plate 7 in the second direction d2, respectively. As mentioned above, the third direction d3 and the fourth direction 4 are substantially parallel to the second direction d2, so that the push block 10 and the movable clamp seat 4 are also disposed on two opposite sides of the staple knife push plate 7 in the third direction d3 and the fourth direction d4, respectively. Moreover, the push block 10 is formed with a chute 10a arranged to intersect the first direction d1, i.e., the extending direction of the chute 10a intersects the first direction d 1.

The push rod 15 has a length extending in the first direction d1, a rear end fixedly connected to a push button as the staple-knife actuator 8, and a front end pivotally connected to the roller 19 movably disposed in the inclined groove 10 a. When the push button is moved forward in the first direction d1, the roller 19 rolls along the inclined groove 10a and presses the push block 10 toward the staple pusher plate 7. The roller 19 and the chute 10a are in rolling fit instead of sliding fit, so that the friction force is small, and the push block 10 moves more smoothly.

As shown in fig. 4 and 6, in order to reduce the possibility that the roller 19 is stuck in the chute 10a to be difficult to move during use, the present embodiment further has a roller 20 having a diameter larger than that of the roller coaxially attached to the roller 19. Correspondingly, a bevel 10b is provided on the pusher 10, which cooperates in contact with the aforesaid roller 20 and is arranged parallel to the chute 10 a. When the push rod 15 is moved to the left in fig. 4, the roller 20 has come into contact with and pressed the inclined surface 10b downward while the roller 19 has not yet come into contact with or slightly comes into contact with the lower groove wall of the inclined groove 10a downward, so that the push block 10 is pushed downward mainly by the roller 20. That is, the downward movement of the pushing block 10 in fig. 4 is mainly achieved by the pressure of the roller 20 on the inclined surface 10b instead of the pressure of the roller 19 on the inclined groove 10 a. In this case, the mutually cooperating chute 10a and roller 19 are mainly used to define the connection between the push rod 15 and the push block 10, preventing the push block 10 from being detached from the push rod 15, while the roller 19 only plays the role of movably connecting the push rod and the push block, which can be replaced by a "connecting shaft" without "rolling" function. In other embodiments, the inclined surface 10b may be provided only on the push block 10 without the inclined groove 10a, and correspondingly, the roller 20 engaged with the inclined surface 10b is provided at the front end of the push rod 15.

Two rollers 19 and two chutes 10a are provided. The second housing 9 is further provided with a guiding structure for limiting the push block 10 to move only along the second, third or fourth direction, for example, in fig. 8, the second housing 9 is integrally formed with a guide groove 9c in contact fit with the push block 10, and the groove depth of the guide groove 9c extends in the second direction.

The stapler is further provided with a second housing 9 connected to the first housing 6. The push rod 15 is movably connected with the second housing 9 in a manner that it can move along the first direction d1, so as to better define the moving direction of the push rod 15. Specifically, the method comprises the following steps: the push rod 15 is formed with a long push rod guide hole 10a extending in the first direction d1, and the second housing 9 is connected with a slide pin 16 movably inserted in the push rod guide hole 15 a.

Further, the sliding pins 16 are configured with two in total to better define the matching angle of the push rod 15 and the second housing 9.

To prevent the push button as the staple knife actuator 8 from moving to the left in fig. 2, which is not subjective, resulting in accidental staple ejection and accidental knife ejection, the present embodiment is provided with the following safety structure:

the second housing 9 is formed with an insertion hole 9a extending in a direction perpendicular to the first direction d 1. A safety pin 17 is removably inserted into the insertion hole 9a and the push rod guide hole 15a of the push rod 15. When in the aforementioned assembled condition, safety latch 17 defines the limit of forward travel of pusher 15, preventing staple 1 or knife 2 from being pushed out without the need for both ejection and knife ejection. When it is desired to staple and cut the hemorrhoidal tissue, the safety catch 17 is withdrawn.

If the staple knife push plate 7 is completely independently disposed at the side of the movable jaw 4, the staple knife push plate 7 is easily dropped and lost from the movable jaw 4 after the second part 2000 of the stapler is separated from the first part 1000. Therefore, the nail knife push plate 7 is movably connected with the movable clamping seat 4 in the embodiment.

It can be understood that, when the clamping assembly is in the unclamped state, the larger the distance between the movable clamp holder 4 and the fixed clamp holder 3 in the second direction d2, the more the hemorrhoid tissue 100 with larger width can be clamped, thereby increasing the operation range of the anorectal stapler. However, the radial dimension of the anorectum is limited, so that the distance between the movable clamp holder 4 and the fixed clamp holder 3 cannot be increased without any limit. As mentioned above, the push block 10 is disposed on the side of the staple pushing plate 7 facing away from the movable holder 4 in the second direction d2, so that the push block 10 occupies the space of the clamping assembly portion in the second direction d2, which is not favorable for increasing the distance between the movable holder 4 and the fixed holder 3. Therefore, the present embodiment provides the second housing 9 and the first housing 6 as two independent elements, which are detachably engaged to eliminate the occupation of the relevant space by the pushing block 10, and the following descriptions are specifically provided:

in operation, the second housing 9 with the push block 10 is detached from the first housing 6, and the operator holds only the "remaining part" of the stapler as shown in fig. 4 and inserts the distal end portion (left end portion in fig. 4) of the remaining part into the anal intestine of the affected part of the patient. For convenience of description, the aforementioned "remaining portion" will be referred to as a first portion 1000 of the stapler, and the second housing 9 with the push block 10 will be referred to as a second portion 2000 of the stapler. Before the above steps, a sheath for opening the anorectal section to be operated on can be placed in the anorectal section in advance, and the sheath is provided with a notch for allowing the hemorrhoid tissue to be cut to extend into the sheath from the notch, so that the clamping, stapling and cutting of the hemorrhoid tissue can be facilitated while the operation safety is improved. At this time, since there is no push block 10 occupying the space in the second direction d2 (i.e., the space in the radial direction of the anorectum) at the front end of the first portion, the distance between the movable holder 4 and the fixed holder 3 can be set to be large, so that the hemorrhoid tissue 100 having a larger width can be clamped and fixed. Then, the hemorrhoid tissue 100 to be cut is aligned with the distance between the movable holder 4 and the fixed holder 3, and the trigger is pulled to cause the movable holder 4 and the fixed holder 3 to clamp the hemorrhoid tissue 100 in the second direction d2, i.e. the width direction of the hemorrhoid tissue. At this time, the movable holder 4 and the fixed holder 3 have been moved close to each other by a certain distance, so that the front end of the first part is reduced in size in the second direction d2, thereby leaving a sufficient fitting space for the second part. That is, the dimension in the second direction d2 of the clamping assembly in the clamped state at this time < the dimension in the second direction d2 of the clamping assembly in the non-clamped state previously. Thereafter, the second housing 9 is engaged with the first housing 6 and loaded into the second portion of the stapler such that the pusher block 10 is positioned on the side of the staple knife pusher plate 7 facing away from the movable jaw 4 in the second direction d2 in preparation for pushing the staple knife pusher plate 7.

It can be seen that the second portion of the stapler is loaded after the forward end of the first portion has been extended into the patient's anorectum. In order to ensure that the pushing block 10 and other elements at the front end of the second part can smoothly extend into the anorectum in the process of assembling the second part into the first part, so as to ensure the smooth implementation of the operation. The second housing 9 and the first housing 6 adopt the separable connection structure:

as shown in fig. 4 and 5 with reference to fig. 2 and 3, the first housing 6 is provided with a card slot 6b extending in the first direction d1, and the second housing 9 is provided with a card rib 9b extending in the first direction d 1. When assembled, the rib 9b of the second housing 9 is pushed forward in the first direction d1 into the notch 6b of the first housing 6, thereby engaging the second housing 9 with the first housing 6. When the card edge 9b is separated, a force is applied to withdraw the card edge from the card slot 6b in the first direction d 1.

If the push rod 15 and the push button as the staple knife actuator 8 are both attached to the second housing 9, they will be removed and inserted together with the second housing 9 during use, resulting in a larger number of parts and a larger size of the second part. This does not facilitate the use of the anorectal stapler and presents certain design difficulties. Therefore, the present embodiment will further optimize the structure of the anorectal stapler as follows:

the first housing 6 is formed with an elongated push button guide hole 6c extending in the first direction d1, and a push button as the driver actuator 8 is slidably connected to the push button guide hole 6 c. The push rod 15 is composed of a front rod 1501 and a rear rod 1502 which are detachably connected, the front rod 1501 and the rear rod 1502 being arranged in a first direction d1 and both extending along a first direction d 1. The push rod guide hole 15a is specifically disposed on the front rod 1501. Thus, the front lever 1501 is connected to the second housing 9 via the push lever guide hole 15a and the slide pin 16. The rear rod 1502 is secured to a push button as the staple knife actuator 8, thereby connecting the rear rod 1502 to the first housing 6.

It can be seen that the push button as the staple knife actuator 8 and the rear rod 1502 of the push rod 15 belong to the above-mentioned first part of the stapler. The front body 1501 of the push rod 15 belongs to the above-mentioned second part of the stapler. When the second housing 9 is detached from the first housing 6, the front rod 1501 and the push block 10 are detached together with the second housing 9, and the rear rod 1502 and the push button remain on the first housing 6.

In order to protect the rear rod 1502 of the push rod 15 after the second portion is detached, the rear rod can be completely received in the first housing 6. In this embodiment, the push button guiding hole 6c is lengthened backward, so that the rear rod 1502 can be completely locked inside the first housing 6 after the push button is moved backward to the extreme position.

To better accommodate the hemorrhoid cutting procedure, the depth of insertion of the stapler head into the body (including the depth of insertion of the first portion nose and the depth of insertion of the second portion nose) is generally not less than 35 mm. Therefore, the length of the push button guide hole 6c in the first direction d1 should not be less than 35mm, preferably 50-100 mm. It is intended to guarantee: when the push button is moved to the right in fig. 2 to the extreme position and the front rod 1501 of the second portion is connected to the rear rod 1502 of the first portion, the distance between the front end of the second portion and the front end of the first portion in the first direction d1 is not less than the depth of the first portion inserted into the body.

The anorectal stapler may be capable of being withdrawn from the body in its entirety when the first and second parts are in an assembled state. However, as will be appreciated from the above description, in this embodiment the second housing 9 is removable from the first housing 6 in such a way that it can be pushed backwards (to the right in fig. 3) in the first direction d1, thereby allowing the first and second parts of the anorectal stapler to be withdrawn from the patient one after the other, which expands the usage of the anorectal stapler.

In this embodiment, the push rod 15 and the extension rod 18 are both of a slender plate-like structure, and the cross sections of the push rod and the extension rod are rectangular.

As shown in fig. 16, in the present embodiment, the front rod 1501 and the rear rod 1502 are detachably connected in this way: the rear end of the front rod body 1501 is provided with a clamping head 1501a, the front end of the rear rod body 1502 is provided with a clamping hole 1502a matched with the clamping head 1501a, and the clamping head 1501a is detachably connected with the clamping hole 1502 a.

The hemorrhoidal tissue 100 within the anorectum is generally curved in shape, and some hemorrhoidal tissues 100 have an excessive length. For such a hemorrhoid tissue 100 with a large length and/or a curved shape, it is not possible to perform a single resection, and it is necessary to perform a multiple resection. When the hemorrhoid tissue 100 is cut off in sections, if the cutter 2 with a straight structure is adopted, the pain and the bitterness of the patient are increased, and the operation difficulty is increased. This is mainly due to the difficulty of a straight cutter cutting each surgical section completely, and the large connecting area between the anterior segment tissue and the tissue body that is not completely cut, which can seriously interfere with the cutting of the next surgical section, as shown in fig. 18 and 19. Therefore, the structure of the cutter 2 is optimally designed in the embodiment as follows:

as shown in fig. 17 with reference to fig. 14 and 16, the cutting knife 2 is substantially L-shaped and is seen in the aforementioned second direction d 2. Specifically, the cutter 2 includes: the first blade section 2a extending substantially in the first direction d1 has a second blade section 2b bent and protruding from a front end thereof. The term "bent" as used herein in "bent out" may be interpreted as "angled".

As shown in fig. 20 and 21, the cutter 2 having a specific angle section in the L-shaped structure has a cutting edge, i.e., the second cutter section 2b, in the thickness direction of the hemorrhoidal tissue 100, so that it can completely cut off each surgical section of the hemorrhoidal tissue 100, thereby not only reducing the pain of the patient, but also facilitating the operation. If the thickness of the hemorrhoidal tissue 100 is larger, although the L-shaped cutter 2 cannot completely cut off a small section of tissue, the connection area between the tissue which is not separated after cutting and the tissue body is small, so that the previous section of tissue can be easily pulled away, and the next section of tissue can be conveniently cut, as shown in fig. 22 and 23.

In order to maximize the cutting thickness of the second blade section 2b in relation to the hemorrhoid tissue 100, in the case of a limited length dimension of the second blade section 2b, the direction of extension of the second blade section 2b (i.e., the direction in which the first blade section is bent "out" from the front end) is not only substantially perpendicular to the first direction d1, but also substantially perpendicular to the fourth direction d 4.

The present embodiment provides the cutting blade 2 as a sheet-like structure substantially parallel to the fourth direction d2, so that the cutting blade 2 can be better guided to move along the fourth direction d4 when in use.

In order to facilitate the processing and manufacturing of the cutting knife 2, and more importantly, in order to reduce the risk of false cutting in the surgical process, the first cutting section 2a and the second cutting section 2b are in arc transition connection in the embodiment.

It will be understood that, in the case of a sufficiently large radial space of the anorectum in which the hemorrhoidal tissue is to be cut, the greater the dimension of the second segment 2b of the cutting blade 2 in the direction of extension, the easier it is for a single cutting action to completely cut off the hemorrhoidal tissue. However, the radial space of the anorectal is limited and the dimension of the second blade section 2b in the protruding direction is therefore limited. The space of the anorectal in the length direction is larger than the radial space, so that the first section 2a of the cutter 2 can be arranged to be relatively long, and the hemorrhoid tissues which are as long as possible can be cut off in a single time on the premise of ensuring the operation quality. Therefore, the present embodiment sets the dimension of the second blade section 2b in the projecting direction thereof to be smaller than the dimension of the first blade section 2a in the first direction d 1.

It will be appreciated that the anorectal stapler is capable of treating a large width of hemorrhoid tissue 100 as long as the first and second parts of the anorectal stapler are relatively movable in the first direction d1 with a sufficiently large movement stroke, and there is no requirement that the first and second parts must be separable from each other.

In the present embodiment, the "length", "width" and "thickness" of the hemorrhoidal tissue 100 can be respectively interpreted as "the dimension of the hemorrhoidal tissue in the length direction of the anal intestine", "the dimension of the hemorrhoidal tissue in the circumferential direction of the anal intestine" and "the dimension of the hemorrhoidal tissue in the radial direction of the anal intestine".

It should be noted that the direction of cutting of the hemorrhoidal tissue 100 by the cutting blade 2 is in the third direction d3, which is substantially perpendicular to the first direction d1, and that it is not necessary to presuppose that the clamping assembly is in the second direction d2, which is substantially perpendicular to the first direction d 1. As long as the tissue to be excised, which is ready (e.g. clamped and stapled), has a certain size in the first direction d1, it is possible to achieve an advantageous effect close to the one described above when it is excised with the above-described L-shaped cutter 2.

It should be noted that, as can be understood by those skilled in the art, for the anorectal region with a very limited space for the surgical operation, the pushing block 10 for pushing the nail-knife pushing plate, which occupies a space, is configured to be a rear-loading structure, so that after the stapler body clamps and fixes the tissue to be resected so as to vacate a corresponding space, the vacated space is utilized to load the pushing block 10 to push the nail-knife pushing plate, and the anorectal region stapler with the other structure may also be applied. This solution is applied, which is not premised on the second direction d2 being substantially perpendicular to the first direction d 1. The aforementioned solution can be applied as long as the clamping direction crosses the extension direction of the stapler head, in order to treat haemorrhoidal tissue having a larger dimension in the clamping direction.

Example two: anastomat

It will be understood that other types of staplers for performing other surgical operations, such as a digestive tract stapler and a nasal cavity stapler, may be designed using the same concept as that of the first embodiment, as long as the stapler performs a plurality of sequential processes on the lesion tissue, for example, a first process (for example, a process of clamping and fixing a lesion component) on the lesion tissue and a second process (for example, a process of stapling and cutting the lesion component) on the lesion tissue, and the internal space occupied by the relevant parts is changed before and after the first process is performed on the lesion tissue by the stapler. For example, the stapler can be designed into the structure shown in fig. 24, fig. 25 and fig. 26, and the structure of the stapler in fig. 24-fig. 26 is substantially the same as that of the stapler in the first embodiment, so the reader is referred to the content of the first embodiment for understanding the following description:

the stapler of fig. 24 comprises a first portion 1000 and a second portion 2000 articulated in a first direction d 1. The first portion 1000 has a first leading end 1001 extending forwardly in a first direction d1, and in use the first leading end of the first portion extends generally along the first direction d1 into a patient for a first treatment of lesion tissue. The first front end portion comprises a first movement member operable to move between a first position and a second position, the first movement member being generally a key element for performing the aforementioned first process, such as the moving jaw 4 described in the first embodiment. And the first position has an amount of displacement with respect to the second position in a direction crossing the first direction d1 (e.g., the second direction d2 described in the first embodiment). That is, the first mover at the first position is displaced in a direction intersecting the first direction d1 with respect to the first mover at the second position. The second portion 2000 has a second leading end portion projecting forwardly in the first direction d1 and intended, in use, to project into the patient's body at a first relative position to the first leading end portion for performing the second treatment on the lesion tissue. That is, the second portion 2000 has the second distal end portion 2001 which projects forward in the first direction d1, and the second distal end portion is required to project into the patient in use and also to be located at a first relative position with respect to the first distal end portion 1001, such as the relative positional relationship between the second distal end portion and the first distal end portion shown in fig. 26, so that the aforementioned second treatment can be performed on the lesion tissue. That is, when the second treatment is performed on the lesion tissue, the second distal end portion 2001 of the second portion 2000 is required not only to extend into the patient but also to reach a position relative to the first distal end portion 1001 (see fig. 26). When the first tip portion 1001 is not in a state of first treating the lesion tissue, the first mover is in the aforementioned first position that blocks the second tip portion 2001 from advancing to the aforementioned first relative position in the first direction d 1. Explanation: when the first tip portion 1001 is not in a state of performing the first treatment on the lesion tissue (refer to fig. 9 of the first embodiment), the first moving member is correspondingly in the first position, and the first moving member in the first position blocks the second tip portion 2001 from moving forward in the first direction d1 to the first relative position. The aforementioned "blocking" occurs generally because, when the first moving member is in the first position, a projection of at least a portion of the first moving member in the first direction d1 and a projection of at least a portion of the second leading end portion in the first direction d1 overlap each other, thereby blocking the second leading end portion from moving forward in the first direction d1 to the first relative position, as shown in fig. XXX. Illustratively, when the first moving member is at the first position, the projection of the rear end surface of the first moving member in the first direction d1 and the projection of the front end surface of the second front end portion in the first direction d1 overlap each other. In the description of the present application and the claims, unless otherwise specified, the terms "front" and "rear" refer to the first direction d1, for example, in the above embodiment-fig. 2, the left direction is "front" along the first direction d1, and the right direction is "rear" along the first direction d 1. Thus, the aforementioned "rear end surface of the first moving element" refers to the rear end surface of the first moving element in the first direction d1, for example, the right end surface of the movable clamping seat 4 in fig. 2; the "second distal end surface" refers to a distal end surface of the second distal end portion in the first direction d1, for example, a left end surface of the second housing 9 in fig. 2. When the first distal end portion 1001 is in a state where the lesion tissue is first treated, the first mover is in the second position where the blockage of the second distal end portion is released by the first displacement amount. Explanation: when the first tip 1001 is in a state of performing the first treatment on the lesion tissue, the first moving member is correspondingly located at the second position, and the first moving member at the second position releases the blocking because the first displacement amount in the second direction d2 (instead of the displacement in the first direction d1) is generated, and the projection of the corresponding portion of the first tip and the corresponding portion of the second tip in the first direction does not overlap, so that the second tip 2001 can move forward to the first relative position, that is, the position where the second treatment can be performed on the lesion tissue, and the second treatment on the lesion tissue is prepared, as shown in fig. 25 and 26.

Thus, first portion 1000 and second portion 2000 of the stapler are advanced into the patient in tandem. Specifically, after the first portion is subjected to the first treatment of the lesion tissue and a space in a second direction d2 intersecting the extending direction of the stapler is made available, the second portion is extended into the patient by using the made available space to perform a subsequent second treatment. The device is very suitable for performing the shell operation on human tissues with very limited space in the direction vertical to the extending direction of the anastomat, such as the alimentary canal, the nasal passage and the like. Of course, the aforementioned second process may be performed by the second front end portion 2001 of the second portion 2000 alone; it is also possible that the second front end portion and the first front end portion cooperate with each other to perform together when the second front end portion moves to a position at least partially overlapping the first mover in the first direction d1, such as the stapling and cutting in the first embodiment described above are performed by cooperating a pusher, a movable holder, and the like.

Since the first treatment and the second treatment are both treatments for the same focal tissue, in many cases, it is required that the second distal end portion 2001 and the first distal end portion 1001 overlap at least partially in the first direction d1 when they are at the first relative position, and that both treatments are at substantially the same position. The first moving member is usually a key component for performing the first process, and more specifically, when the second front end portion 2001 and the first front end portion 1001 are in the first relative position, the second front end portion usually at least partially overlaps with the first moving member in the first direction d1, such as the push block 10 and the movable clamp seat 4 in the first embodiment. By "at least partially overlap in the first direction d 1", it is meant that the two have an overlapping portion in the first direction d1 (rather than a projection in the first direction d 1).

In some embodiments, the first portion of the stapler can further comprise a second motion member that: the second moving part is connected with the first moving part to drive the first moving part to move between the first position and the second position, and the second moving part is at least partially left outside the patient body when in use. I.e. the second mobile element has an extracorporeal part which, in use, remains outside the patient's body, such as the first link 11 described above. When the first leading end portion is not in a state of performing the first treatment on the lesion tissue, that is, when the first mover treats the first position, the second mover is located at the third position. When the first leading end portion is in a state of performing a first treatment on the lesion tissue, that is, when the first mover treats the second position, the second mover is located at the fourth position. The second mover is operable to move between a third position and a fourth position, the third position also having a second amount of displacement in the second direction d2 relative to the fourth position. The element for operating the movement of the second movement member between the third position and the fourth position is typically a manual element, such as the trigger described in the first embodiment.

When the first leading end portion 1001 is not in a state of first treating the lesion tissue, the extracorporeal portion of the second mover is in the aforementioned third position that blocks the second leading end portion from advancing in the first direction d1 and blocks the second leading end portion outside the patient. That is, when the first distal end portion 1001 is not in a state of performing the first treatment on the lesion tissue, the second mover is in the third position, and the extracorporeal portion of the second mover in the third position blocks the second distal end portion 2001 from advancing in the first direction d1, and since the extracorporeal portion is outside the patient, it normally blocks the second distal end portion 2001 outside the patient, as shown in fig. 24. Similarly, the aforementioned "blocking in vitro" occurs generally because, when the second moving member is in the third position, the projection of at least a part of the outside portion of the second moving member in the first direction d1 and the projection of at least a part of the second leading end portion in the first direction d1 overlap each other, thereby blocking the second leading end portion from moving forward in the first direction d1 into the body, particularly to the first relative position described above, as shown in fig. 24. When the first distal end portion is in a state of performing the first treatment on the lesion tissue, the second mover is in the fourth position where the "in vitro block" of the second distal end portion is released by the second displacement amount. Explanation: when the first distal end portion 1001 is in a state of performing the first treatment on the lesion tissue, the second mover is correspondingly located at the fourth position, and the second mover at the fourth position releases the "external blocking" because the first displacement amount in the second direction d2 is generated, so that the second distal end portion 2001 can be moved forward into the patient over the second mover to further follow the first relative position, as shown in fig. 25 and 26.

For example, the second moving member may be fixed (integrally fixed or separately fixed) with the first moving member, and the second moving member extends straight rearward from the first moving member in the first direction d1, such as the first link 11 in the first embodiment.

In the description of the present application and in the claims, the term "substantially parallel" may be interpreted as parallel, nearly parallel, or at a predetermined angle; "substantially perpendicular" may be interpreted as perpendicular, nearly perpendicular, or at a predetermined angle.

The above are exemplary embodiments of the present application only, and are not intended to limit the scope of the present application, which is defined by the appended claims.

Claims (14)

1. An anastomat for performing a first treatment and a second treatment on lesion tissues in a patient body,

the stapler comprises a first portion and a second portion articulated in a first direction (d 1);

the first portion having a first leading end portion projecting forwardly in the first direction (d1) and projecting into the patient's body generally along the first direction (d1) in use for the first treatment of the lesion tissue, the first leading end portion including a first mover operable to move between a first position and a second position, the first position having a first amount of displacement in a second direction (d2) intersecting the first direction (d1) relative to the second position;

said second portion having a second leading end portion projecting forwardly in said first direction (d1) and intended, in use, to project into the patient's body in a first relative position to said first leading end portion for said second treatment of said lesion tissue;

when the first leading end portion is not in a state of the first treatment of the lesion tissue, the first mover is in the first position that blocks the second leading end portion from advancing in the first direction (d1) to the first relative position; when the first leading end portion is in a state of performing the first treatment on the lesion tissue, the first mover is in the second position where the blockage of the second leading end portion is released by the first displacement amount.

2. The stapler of claim 1, wherein the second leading end portion at least partially overlaps the first motile in the first direction (d1) when the second leading end portion and the first leading end portion are in the first relative position.

3. The stapler of claim 2, wherein the second leading end portion at least partially overlaps the first motile in the first direction (d1) when the second leading end portion and the first leading end portion are in the first relative position.

4. The stapler of claim 3, wherein the second leading end portion cooperatively engages the first motion member to perform the second treatment on the lesion tissue.

5. The stapler of claim 1,

when the first mover is in the first position, a projection of at least a portion of the first mover in the first direction (d1) and a projection of at least a portion of the second leading end portion in the first direction (d1) overlap each other, thereby blocking the second leading end portion from advancing in the first direction (d1) to the first relative position;

when the first mover is in the second position, a projection of the at least a portion of the first mover in the first direction (d1) does not overlap a projection of the at least a portion of the second leading end portion in the first direction (d1), thereby releasing the blocking of the second leading end portion.

6. The stapler of claim 5, wherein the at least a portion of the first mover comprises a rear end face of the first mover in the first direction (d1), and at least a portion of the second leading end comprises a leading end face of the second leading end in the first direction (d 1).

7. The stapler of claim 1,

the first portion further comprising a second mover operable to move between a third position and a fourth position to thereby move the first mover between the first position and the second position, the second mover having an extracorporeal portion that, in use, remains extracorporeal to the patient, the third position having a second amount of displacement in the second direction (d2) relative to the fourth position;

when the first leading end portion is not in a state of performing the first treatment on the lesion tissue, the extracorporeal portion is in the third position at which the second leading end portion is blocked from advancing in the first direction (d1) and the second leading end portion is blocked outside the patient; when the first leading end portion is in a state of performing the first treatment on the lesion tissue, the second mover is in the fourth position where the blockage of the second leading end portion is released by the second displacement amount.

8. The stapler of claim 7, wherein the second mover is fixed with the first mover, and the second mover extends linearly rearward from the first mover in the first direction (d 1).

9. The stapler according to any one of claims 1 to 8, characterized in that said first front end comprises a fixed jaw seat (3) and a movable jaw seat (4) contained in said first kinematic component;

the first processing includes:

clamping the focal tissue between the movable clamp holder (4) and the stationary clamp holder (3) in the second direction (d 2).

10. The stapler of claim 9, wherein the second direction (d2) is substantially perpendicular to the first direction (d 1).

11. The stapler according to claim 10, when claim 9 is appended to claim 7 or 8, wherein said first portion comprises a manually operated grip actuator (5), said grip actuator (5) being in driving connection with said movable clamp holder (4) through said second kinematic member for driving said movable clamp holder (4) towards said fixed clamp holder (3) so as to clamp said lesion tissue between said movable clamp holder (4) and said fixed clamp holder (3) in said second direction (d 2).

12. The stapler of claim 10, wherein the second process comprises:

stapling the focal tissue in a third direction (d3) substantially parallel to the second direction (d 2).

13. The stapler of claim 12,

the movable clamp holder (4) is provided with a staple outlet (4a) for receiving and guiding staples (1) to move in the third direction (d3) to staple the lesion tissue, the first front end further comprises a push plate movably connected with the movable clamp holder (4), and the push plate is arranged on one side of the movable clamp holder (4) departing from the fixed clamp holder (3) in the second direction (d 2);

the second front end portion comprises a push block (10) for pushing the push plate to push the staples (1) out of the staple outlet holes (4 a);

the second part comprises a manually operated push button, and the push button is in transmission connection with the push block (10) to drive the push block (10) to push the push plate.

14. The stapler of claim 13,

the second processing further includes: cutting the lesion tissue in a fourth direction (d4) substantially parallel to the second direction (d 2);

the movable clamping seat (4) is provided with a knife outlet hole (4b) for accommodating and guiding the cutting knife (2) to move in the fourth direction (d4) so as to cut the lesion tissue, and the push block (10) is also used for pushing the push plate so as to push the cutting knife (2) out of the knife outlet hole (4 b).

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