CN113616286B - Intestinal section resection tube type anastomotic minimally invasive equipment in intestinal cavity - Google Patents

Intestinal section resection tube type anastomotic minimally invasive equipment in intestinal cavity Download PDF

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Publication number
CN113616286B
CN113616286B CN202111037083.8A CN202111037083A CN113616286B CN 113616286 B CN113616286 B CN 113616286B CN 202111037083 A CN202111037083 A CN 202111037083A CN 113616286 B CN113616286 B CN 113616286B
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intestinal
crawler
nail
seat
track
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CN113616286A (en
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张锡朋
孙轶
江佩师
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Tianjin People Hospital
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Tianjin People Hospital
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3209Incision instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1132End-to-end connections

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  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Surgical Instruments (AREA)

Abstract

The invention relates to a minimally invasive device for intestinal lumen section resection tube anastomosis, which comprises: a piping system and a body system located within the piping system; the subject system includes: between have intestines passageway support nail seat and nail storehouse, be located respectively and support the cutting subassembly and the intussusception subassembly of intestines wall absorption intussusception subassembly of nail seat both sides, the outside of nail storehouse is equipped with extrusion structure, the intussusception subassembly of intestines wall absorption includes two at least track structures and drive each the track structure that resets when stretching out pipe-line system is angle alternate segregation, when retracting pipe-line system. The invention completes the whole process of intestinal section excision and end-to-end anastomosis through the natural cavity of the human body, does not need body surface incision to cut the intestinal canal, and has small wound to the patient.

Description

Intestinal section resection tube type anastomotic minimally invasive equipment in intestinal cavity
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a minimally invasive intestinal anastomosis device for intestinal section resection in an intestinal cavity.
Background
The existing tubular anastomat mainly comprises an instrument rod (comprising a sliding rod and a nail bin) and a nail pushing seat, wherein the instrument rod is inserted into the nail pushing seat after being subjected to purse string suturing on one side of the broken end of an intestinal canal, the broken end of the intestinal canal penetrates out of an intestinal cavity at the other end of the intestinal canal, the purse string suturing is also carried out, the instrument rod and the nail pushing seat are connected, and a nail in the nail bin is extruded through the sliding rod, so that the intestinal canal is anastomosed end to end.
1. The length of the instrument rod is limited, the turning capability is limited, the instrument rod enters from the anus and can only be used for the anastomosis of the rectum anal canal and other digestive tracts which are close to the anal margin, and when the instrument rod is applied to the anastomosis of high-position intestinal canals, an extra incision needs to be made on the intestinal wall near an anastomotic stoma.
2. The device does not have the capability of cutting off the intestinal segment, and the diseased intestinal segment needs to be cut off through an abdominal incision or a laparoscope in the operation and then the tubular anastomat is used.
3. Does not have the capacity of taking out the diseased intestinal section, and when the intestinal section is cut off, an incision needs to be made on the abdomen so as to take out the diseased intestinal section.
Therefore, based on the problems, the invention provides a minimally invasive tubular anastomosis device for intestinal section excision in an intestinal cavity, which can complete the whole process of intestinal section excision and end-to-end anastomosis through a natural cavity of a human body, does not need a body surface incision to cut the intestinal canal, has small wound on a patient, and is used as an important encouragement industry of the government of people in a minimally invasive intervention medical appliance industry.
Disclosure of Invention
The invention aims to solve the problems in the prior art and provides a minimally invasive tubular anastomosis device for intestinal section excision in an intestinal cavity with small wound for a patient, which can complete the whole process of intestinal section excision and end-to-end anastomosis through a natural cavity of a human body without cutting an intestinal tube by a body surface incision.
The technical scheme adopted by the invention for solving the problem is as follows:
an intraluminal intestinal tract resection tube-type anastomotic minimally invasive device, comprising: a piping system and a body system located within the piping system;
the subject system includes: a nail pushing seat and a nail bin of the intestinal channel, a cutting component and an intestinal wall adsorption intussusception component which are respectively positioned at two sides of the nail pushing seat are arranged between the nail pushing seat and the nail bin;
the outside of nail storehouse is equipped with extrusion structure, the intussusception subassembly is adsorbed to the intestinal wall includes two at least track structures and drive each track structure is angle alternate segregation when stretching out pipe-line system, the track drive structure that resets when retracting pipe-line system.
Preferably, the pipe system comprises a hard head and a soft body which are integrated, the hard head is of a hard hollow pipe structure, a metal pipe wall is arranged in the hard head, and the main body system is located in the metal pipe wall and used for supporting and protecting the main body system. The soft body is a soft hollow pipeline structure, and the soft body can be but not limited to a wave shape, a streamline shape and an arc shape. The combination of the hard head and the soft body enables the entire ductwork to be inserted into the alimentary canal of a human body through the entrance of the anus, so that the head reaches the diseased intestine section.
Further preferably, the nail supporting seat is of a cylindrical structure, the two ends of the nail supporting seat are fixedly connected with a first supporting seat and a second supporting seat which are coaxial with the nail supporting seat respectively, the first supporting seat is located on one side, away from the soft body, of the nail supporting seat, and the second supporting seat is located on one side, close to the soft body, of the nail supporting seat. The nail bin surrounds the outer side of the nail abutting seat, and an annular intestinal channel for intestinal tracts to pass through is formed between the nail abutting seat and the nail bin.
Further preferably, the cutting assembly can rotate around the axial direction of the nail abutting seat, and the cutting assembly comprises:
the cutting knife rotating shaft is positioned on the central axis of the nail abutting seat and is rotationally connected with the second supporting seat, the cutting knife rotating shaft is a hollow shaft, and a second hydraulic cylinder is installed on the outer wall of the cutting knife rotating shaft;
the cutting knife is arranged at the output end of the second hydraulic cylinder, rotates around the axis and can cut the intestinal canal and the tied membrane, the cutting knife is attached to the metal pipe wall after the second hydraulic cylinder is pressurized, and the intestinal canal is cut through the motor structure;
and the rotating shaft driving structure drives the rotating shaft of the cutting knife to rotate, and comprises a motor arranged on one side of the second supporting seat, and the motor is in transmission connection with the rotating shaft of the cutting knife through a bevel gear set.
Further preferably, the track structure is located the nail seat and keeps away from one side of soft somatic part, the track structure sets up about stereoplasm head axis symmetry, the track structure includes:
the support body is arranged on the first support seat, and the central axis of the support body is superposed with the central axis of the nail abutting seat;
the two connecting rods are symmetrically arranged about the central axis of the hard head, one end of each connecting rod is hinged with the support body, the other end of each connecting rod is integrally formed with a crawler mounting frame, a driving wheel and a driven wheel are rotatably mounted on the crawler mounting frames, and the driving wheel is in transmission connection with a crawler motor through a bevel gear set so as to provide driving force;
and the flexible crawler belt is sleeved between the driving wheel and the driven wheel and is driven to operate under the rotation of the driving wheel.
Further preferably, the flexible track is hollow track structure, and it includes inside and outside inlayer track and the outer track that sets up, connect through a plurality of spinal branch vaulting poles between inlayer track and the outer track and support, the bracing piece is perpendicular and equidistant arranges between inlayer track and outer track, and the appearance of the track that the bracing piece can maintain flexible material constitutes, inlayer track and action wheel, follow driving wheel contact, evenly distributed has the absorption hole on the outer track, one side of flexible track is equipped with the vacuum aspiration pipe that provides the negative pressure for the flexible track. One end of the negative pressure suction tube extends into the crawler belt mounting frame, namely the flexible crawler belt is positioned at the outer side of the end part of the negative pressure suction tube, the other end of the negative pressure suction tube penetrates through the first supporting seat, the nail abutting seat, the second supporting seat and the cutting knife rotating shaft and extends out of the main body system, and the intestinal wall can be clamped after the negative pressure hole under the negative pressure is contacted with the intestinal wall.
Further preferably, a magnetic closed structure is arranged between the adjacent support rods and corresponds to the positions of the adsorption holes, the magnetic closed structure comprises first magnets which are arranged in one-to-one correspondence with the adsorption holes and have gaps between the first magnets, and the backs of the first magnets are connected with the magnetic closed structure through springs.
Preferably, each negative pressure hole corresponds to 1 magnetic closed structure, and mainly comprises a spring and a first magnet, the negative pressure hole is in an open state at ordinary times, when the negative pressure hole on the crawler rotates to the position of the second magnet on the metal wall, the first magnet closes the negative pressure hole at a specific position of the crawler, the negative pressure hole at the position is closed, the position enables the intestinal wall to be separated from the crawler, and the attracted part of the intestinal canal falls off and continues to move towards the inside of the metal pipe. The spring ensures that the first magnet is separated from the negative pressure hole in a normal state.
Preferably, the inner wall of the hard head is provided with second magnets which are magnetically attracted with the first magnets, and the number of the second magnets is the same as that of the crawler structures and is positioned on the same plane with the crawler structures. When the first magnet and the second magnet are attracted mutually, the first magnet can seal the negative pressure hole at a specific position of the crawler belt, and the position enables the intestinal wall to be separated from the crawler belt.
Further preferably, the track drive structure includes:
the first hydraulic cylinder is arranged on a central axis of the first support seat, the output end of the first hydraulic cylinder is hinged with two driving rods, and the other ends of the two driving rods are respectively hinged with the middle part/middle upper part/middle lower part of the two connecting rods;
the sliding structures are two in number, extend along the axial direction of the hard head respectively, and comprise sliding ways and sliding blocks which are matched with each other in a sliding mode, the sliding ways are arranged on the inner wall of the hard head, and the sliding blocks are connected with the second supporting seat through T-shaped rods; the T-shaped rod comprises a transverse rod and a vertical rod which are vertical to each other, the vertical rod extends into the rotating shaft of the cutting knife and is connected with the second supporting seat, and the transverse rod is connected with the sliding block.
And the output end of the third hydraulic cylinder is connected with one of the slide blocks.
Preferably, an extrusion block and an air bag are arranged in the extrusion structure, the air bag is an annular air bag or a plurality of block-shaped air bags surrounding the outer side of the nail bin at equal intervals, two ends of the extrusion block are respectively contacted with the nail pushing sheet and the air bag, one end of the air bag is connected with a pressurization pipe, and the pressurization pipe pressurizes the air bag.
The invention has the advantages and positive effects that:
1. the invention relates to a minimally invasive device for excision of an intestinal section in a cavity and end-to-end anastomosis, which completes the whole process of excision of the intestinal section and end-to-end anastomosis through a natural cavity channel of a human body, does not need a body surface incision to cut an intestinal canal, and has small wound on a patient.
2. The invention distributes the main system part to each section of the digestive tract through the pipeline system, is suitable for the tubular digestive tracts at different positions and is not limited by the distance between the anastomotic stoma and the anal margin.
Cut the lesion intestinal section in this equipment, can directly take out the lesion intestinal through pipe-line system in from the intestinal, need not extra incision and take out the lesion intestinal canal, can reduce patient's health damage, can avoid the misery that the operation brought again, use safety, be applicable to clinical extensive popularization.
Drawings
The technical solution of the present invention will be described in further detail with reference to the accompanying drawings and examples, but it should be understood that these drawings are designed for illustrative purposes only and thus are not intended to limit the scope of the present invention. Furthermore, unless otherwise indicated, the drawings are intended to be illustrative of the structural configurations described herein and are not necessarily drawn to scale.
FIG. 1 is a schematic structural view of a piping system;
FIG. 2 is a schematic perspective view of the present invention;
FIG. 3 is a schematic structural view of the hard head of FIG. 2;
FIG. 4 is a schematic structural view of the body system;
FIG. 5 is a schematic view of the assembled nail anvil and track structure;
FIG. 6 is a front view of FIG. 5;
FIG. 7 is a front view of the present invention;
FIG. 8 is an enlarged view of the portion A of FIG. 7;
FIG. 9 is an enlarged schematic view of a portion of the magnetic closure structure;
FIG. 10 is a right side view of FIG. 8;
FIG. 11 is a schematic view of the structure of a hard head in example 4;
FIG. 12 is an enlarged schematic view of the track structure and second magnet portion of FIG. 11;
FIG. 13 is a schematic cross-sectional view of the assembled cartridge and compression structure.
In the figure: 1. hard head, 2 soft body, 3 flexible caterpillar band, 4 nail bin, 5 first magnet, 6 extruding structure, 7 nail pushing seat, 8 pressurizing pipe, 9 cutter rotating shaft 10, a cutting knife, 11, an adsorption hole, 12, a magnetic closed structure, 13, a second magnet, 14, a spring, 15, a negative pressure suction tube, 16, a bevel gear set, 17, a driving wheel, 18, a driven wheel 19 supporting rods, 20 first hydraulic cylinders, 21 second hydraulic cylinders, 22 first supporting seats, 23 second supporting seats, 24 motors, 25 supporting bodies, 26 connecting rods, 27 crawler belt mounting frames, 28 driving rods, 29 slide ways, 30 sliding blocks, 31T-shaped rods, 32 third hydraulic cylinders, 33 extrusion blocks, 34 air bags, 35 ejector pin pieces and 36 titanium nails.
Detailed Description
First, it should be noted that the specific structures, features, advantages, etc. of the present invention will be specifically described below by way of example, but all the descriptions are for illustrative purposes only and should not be construed as limiting the present invention in any way. Furthermore, any single feature described or implicit in any embodiment or any single feature shown or implicit in any drawing may still be combined or subtracted between any of the features (or equivalents thereof) to obtain still further embodiments of the invention that may not be directly mentioned herein. In addition, for the sake of simplicity, the same or similar features may be indicated in only one place in the same drawing.
In the present invention, unless otherwise explicitly stated or limited, the terms "mounted," "disposed," "connected," "fixed," "screwed" and the like are to be understood broadly, for example, as being fixedly connected, detachably connected, or integrated; can be mechanically or electrically connected; the terms may be directly connected or indirectly connected through an intermediate, and may be communication between two elements or interaction relationship between two elements, unless otherwise specifically limited, and the specific meaning of the terms in the present invention will be understood by those skilled in the art according to specific situations. The present invention will be described in detail with reference to the accompanying drawings.
Example 1:
an intraluminal intestinal tract resection tube-type anastomotic minimally invasive device, comprising: the pipeline system and the main body system are positioned in the pipeline system; the subject system includes: between have intestines passageway support nail seat and nail storehouse, be located respectively and support the cutting subassembly and the intussusception subassembly of intestines wall absorption intussusception subassembly of nail seat both sides, the outside of nail storehouse is equipped with extrusion structure, the intussusception subassembly of intestines wall absorption includes two at least track structures and drive each the track structure that resets when stretching out pipe-line system is angle alternate segregation, when retracting pipe-line system.
The working principle is as follows: among this technical scheme, the whole accessible anus entry of pipe-line system inserts human alimentary canal, after reacing pathological change intestines section, can drive each through track drive structure be angle alternate segregation when track structure stretches out pipe-line system, reset when retracting pipe-line system, track drive structure can drive track structure and be angle alternate segregation simultaneously and adsorb the intestinal wall in its removal stroke outside pipe-line system promptly, make track structure and intestinal wall contact, adsorb the intestinal wall through the negative pressure hole on track structure surface, it resets at its removal within to pipe-line system to adsorb back track drive structure drive track structure, bring the intestinal wall into the pipe-line system and carry out the intussusception, only rotate through the track, form the intussusception. The intestinal canal in the pipeline system passes through an intestinal channel between the nail abutting seat 7 and the nail bin 4, and finally the intestinal canal is circularly cut by the cutting assembly rotating around the axial direction of the nail abutting seat 7, the titanium nails 36 in the nail bin are extruded under the action of the extrusion structure 6, the nail abutting seat 7 interacts with the titanium nails 36, the titanium nails 36 are deformed to inosculate the intestinal canal end to end, and under the combined action of the nail bin 4 and the nail abutting seat 7, the intestinal canal is used for cutting off a lesion part and mesentery and then is inosculated end to end in an inward turning way, and the intestinal canal is sutured.
Example 2:
embodiment 2 of the present invention is further improved on the basis of embodiment 1 so as to fully exert the technical advantages of the present invention, and this will be exemplified below.
For example: the pipe system comprises a hard head part 1 and a soft body part 2 which are integrated; the main part system, it is located stereoplasm head 1, and it includes between has intestines passageway to nail seat 7 and nail storehouse 4, be located respectively to support cutting assembly and the intussusception subassembly of nail seat 7 both sides, the outside of nail storehouse 4 is equipped with the extrusion structure, the intussusception subassembly is located to support one side that soft somatic part 2 was kept away from to nail seat 7 to the intussusception subassembly is located, the intussusception subassembly includes two at least track structures and drive each track structure is angle alternate segregation, the track drive structure that resets when retracting stereoplasm head 1 when the track structure stretches out stereoplasm head 1.
The working principle is as follows: in the technical scheme, as shown in fig. 1-12, the duct system comprises a hard head part 1 and a soft body part 2 which are integrated, and the combination of the hard head part and the soft body part enables the whole duct system to be inserted into the digestive tract of a human body through an anus entrance, so that the head part reaches a pathological intestinal segment. After arriving pathological change intestines section, can drive each through track drive structure it is angle alternate segregation (reacing slope open position) when stretching out stereoplasm head 1, reset (reacing parallel retraction return) when retracting stereoplasm head 1, track drive structure can drive track structure and be angle alternate segregation simultaneously in its removal stroke outside the stereoplasm head promptly, it can adsorb the intestinal wall to reachd the slope open position, make track structure and alimentary canal inner wall contact, adsorb the intestinal wall through the negative pressure hole on track structure surface, need get back to stereoplasm head 1 inside after the absorption, track drive structure can drive track structure and reset simultaneously in its removal stroke to within the stereoplasm head, return parallel retraction return, bring the intestinal wall into the stereoplasm head and carry out the intussusception, only rotate through the track, attract the intestines tube to the stereoplasm head inside, form the intussusception. The intestinal canal in the hard head passes through an intestinal channel between the nail abutting seat 7 and the nail bin 4, and is finally circularly cut by the cutting assembly rotating around the axial direction of the nail abutting seat 7, the titanium nails in the nail bin 4 are extruded under the action of the extrusion structure 6, the nail abutting seat 7 interacts with the titanium nails, the titanium nails are deformed to be matched with the intestinal canal end to end, and under the combined action of the nail bin and the nail abutting seat, the intestinal canal is matched with the intestinal canal end to end in an inwards turning mode after the lesion part and the mesentery are cut off, and the intestinal canal is sewn.
The technical scheme provides minimally invasive equipment for excision of intestinal sections in cavities and end-to-end anastomosis, the whole process of excision of the intestinal sections and end-to-end anastomosis is completed through a natural cavity of a human body, a body surface incision is not needed for cutting an intestinal canal, and the trauma to a patient is small. The main system part is sent to each section of the digestive tract through the pipeline system, is suitable for the tubular digestive tracts at different positions and is not limited by the distance between the anastomotic stoma and the anal margin. And cut the lesion intestinal section in equipment, can directly take out the lesion intestinal from the intestinal through pipe-line system, need not extra incision and take out the lesion intestinal canal, this equipment can reduce patient's health damage, can avoid the misery that the operation brought again, uses safely, is applicable to clinical extensive popularization.
Further, in this embodiment, it is considered that the hard head 1 is a hard hollow pipe structure, the hard head 1 is provided with a metal pipe wall therein, and the main body system is located in the metal pipe wall, and the metal pipe wall may be made of other hard materials besides metal materials, and is used for supporting and protecting the main body system. The soft body 2 is a soft hollow pipe structure, and the soft body 2 may be, but not limited to, a wave, a streamline, or an arc. The combination of the hard head and the soft body enables the entire ductwork to be inserted into the alimentary canal of a human body through the entrance of the anus, so that the head reaches the diseased intestine section.
It is further considered in this embodiment that the nail supporting seat 7 is a cylindrical structure, two ends of the nail supporting seat 7 are respectively and fixedly connected with a first supporting seat 22 and a second supporting seat 23 which are coaxial with the nail supporting seat, the first supporting seat 22 is located on one side of the nail supporting seat far away from the soft body, and the second supporting seat 23 is located on one side of the nail supporting seat near the soft body. The nail storehouse encircles in the outside of propping nail seat 7, props to be formed with the intestinal passageway that the annular confession intestinal passed between nail seat 7 and the nail storehouse, rotates through the track, attracts the intestines pipe to the inside intussusception that forms of stereoplasm head, and the intestines pipe in the stereoplasm head can carry out the circular cutting to the intestines pipe through cutting assembly through the cutting assembly position through the intestines passageway between nail seat 7 and the nail storehouse.
It is further contemplated in this embodiment that the cutting assembly is rotatable about the axial direction of the anvil seat 7, and the cutting assembly includes:
the cutting knife rotating shaft 9 is positioned on the central axis of the nail abutting seat 7 and is rotationally connected with the second supporting seat 23, the cutting knife rotating shaft 9 is a hollow shaft, and a second hydraulic cylinder 21 is installed on the outer wall of the cutting knife rotating shaft 9;
the cutting knife 10 is arranged at the output end of the second hydraulic cylinder 21, the cutting knife 10 rotates around the axis to cut the sausage tube and the film tying, the cutting knife is attached to the metal tube wall after the second hydraulic cylinder 21 is pressurized, and the sausage tube is cut through the motor structure;
and the rotating shaft driving structure drives the rotating shaft of the cutting knife to rotate, and comprises a motor 24 arranged on one side of the second supporting seat, and the motor 24 is in transmission connection with the rotating shaft of the cutting knife through a bevel gear set. Bevel gear group includes that two bevel gears of engaged with install respectively on the motor shaft of cutting knife axis of rotation and motor, can drive the cutting knife axis of rotation through the motor and rotate on second supporting seat 23, and the second pneumatic cylinder can drive the cutting knife and rotate round the axial direction of nail seat 7, and 21 pressurization back cutting knives of second pneumatic cylinder are pasted to the metal pipe wall, through motor drive cutting intestines tube.
Example 3:
embodiment 3 of the present invention is further improved on the basis of embodiment 2 so as to fully exert the technical advantages of the present invention, and this will be exemplified below.
For example: the track structure is located and supports one side that the nail seat kept away from soft somatic part, the quantity of track structure is two, sets up about 1 axis symmetry in stereoplasm head, the track structure includes:
the support body 25 is arranged on the first support seat 22, and the central axis of the support body 25 is superposed with the central axis of the nail abutting seat;
the number of the connecting rods 26 is two, the connecting rods are symmetrically arranged about the central axis of the hard head 1, one end of each connecting rod is hinged with the supporting body 25, a crawler mounting frame 27 is integrally formed at the other end of each connecting rod, a driving wheel 17 and a driven wheel 18 are rotatably mounted on each crawler mounting frame 27, the driving wheel 17 is in transmission connection with a crawler motor through a bevel gear set so as to provide driving force, the bevel gear set comprises two bevel gears which are meshed with each other, the two bevel gears are respectively mounted on a wheel shaft of the driving wheel and a motor shaft of the crawler motor, and the crawler motor can drive the driving wheel 17 to rotate;
the flexible crawler 3 is sleeved between the driving wheel 17 and the driven wheel 18 and is driven to operate under the rotation of the driving wheel 17, the flexible crawler 3 is driven by the crawler motor to operate between the driving wheel 17 and the driven wheel 18, after the intestinal canal is attracted, the flexible crawler 3 can drive the intestinal canal to intussuscept, and preferably, the two flexible crawlers 3 reversely operate.
It should explain, track structure's quantity also can be more than two, and a plurality of track structures use 1 axis of stereoplasm head to be annular array and evenly arrange as the center, and the quantity of connecting rod is the same with track structure quantity and one-to-one, through track drive structure drive each track structure is angle alternate segregation when stretching out the stereoplasm head, resets when retracting the stereoplasm head, and track structure contacts with a plurality of points of a certain periphery in the intestinal wall respectively when stretching out the stereoplasm head, adsorbs the intestinal wall through the negative pressure hole on track structure surface, need get back to the stereoplasm head after adsorbing inside, and the cooperation of a plurality of track structures does benefit to the better intussusception of carrying on of intestinal wall.
Further, in this embodiment, it can be considered that the flexible track 3 is a hollow track structure, and includes an inner track and an outer track which are arranged inside and outside, the inner track and the outer track are connected and supported by a plurality of support rods 19, preferably twenty to thirty, the support rods 19 are arranged vertically and equidistantly between the inner track and the outer track, the support rods 19 can maintain the shape of the track formed by the flexible material, the inner track is in contact with the driving wheel 17 and the driven wheel 18, the outer track is uniformly distributed with the adsorption holes 11, and one side of the flexible track 3 is provided with the negative pressure suction tube 15 which provides negative pressure for the flexible track. One end of the negative pressure suction tube 15 extends into the crawler belt mounting frame, namely the flexible crawler belt is positioned at the outer side of the end part of the negative pressure suction tube, the other end of the negative pressure suction tube passes through the first supporting seat, the nail abutting seat, the second supporting seat and the cutting knife rotating shaft and extends out of the main body system to be connected with a negative pressure main pipe (not shown in the figure), and the negative pressure hole 11 under negative pressure can be in contact with the intestinal wall to grip the intestinal wall.
Further, in this embodiment, it is considered that a magnetic enclosing structure 12 is disposed between adjacent support rods 19, the magnetic enclosing structure 12 and the adsorption holes 11 are corresponding in position, the magnetic enclosing structure 12 includes first magnets 5 disposed opposite to the adsorption holes 11 one by one with a gap therebetween, and the back of the first magnet 5 is connected to the magnetic enclosing structure 12 through a spring 14. Each negative pressure hole 11 corresponds to 1 magnetic closed structure 12 and mainly comprises a spring 14 and a first magnet 5, the negative pressure holes 11 are normally in an open state, when the negative pressure holes 11 in the crawler belt rotate to the position of a second magnet 13 on the metal wall, the first magnet 5 closes the negative pressure holes 11 in the specific position of the crawler belt, the negative pressure holes 11 in the specific position are closed, the negative pressure holes in the specific position make the intestinal wall separate from the crawler belt, and the attracted part of intestinal canal falls off and continues to move towards the inside of the metal pipe. The spring 14 ensures that the first magnet 5 is separated from the negative pressure hole 11 in a normal state.
It is further contemplated in this embodiment that a second magnet 13 is included, which is mounted on the inner wall of the rigid head 1, in the same number and in the same plane as the track structure. When the first magnet 5 and the second magnet 13 are opposite, the first magnet 5 and the second magnet 13 are attracted magnetically, the first magnet 5 can seal the negative pressure hole 11 at a specific position of the crawler belt, and the part enables the intestinal wall to be separated from the crawler belt.
Still further in this embodiment, it is contemplated that the track drive structure includes:
the first hydraulic cylinder 20 is installed on a central axis of the first support seat 22, the output end of the first hydraulic cylinder is hinged with two driving rods 28, and the other ends of the two driving rods 28 are respectively hinged with the middle part/middle upper part/middle lower part of the two connecting rods 26;
the two sliding structures respectively extend along the axial direction of the hard head 1 and comprise a slideway 29 and a sliding block 30 which are matched with each other in a sliding manner, the slideway 29 is arranged on the inner wall of the hard head 1, and the sliding block 30 is connected with the second supporting seat 23 through a T-shaped rod 31; the T-shaped rod comprises a transverse rod and a vertical rod which are vertical, the vertical rod extends into the rotating shaft 9 of the cutting knife and is connected with the second supporting seat 23, and the transverse rod is connected with the sliding block 30.
A third hydraulic cylinder 32, which is mounted on the inner wall of the hard head 1, has its output end connected to one of the slides 30.
The working principle is as follows: as shown in fig. 11, when the intestinal canal needs to be sucked, the crawler structure needs to have an inclined open position capable of sucking the intestinal wall at the same time in the moving stroke of the crawler structure to the outside of the hard head, the third hydraulic cylinder 32 pushes the slider 30 to slide on the slideway 29 to the outside of the hard head, the slider drives the second supporting seat, the nail-supporting seat, the first supporting seat and the crawler structure to move in the same direction to the outside of the hard head through the T-shaped rod, the crawler structure can extend out of the metal tube wall, meanwhile, the first hydraulic cylinder pushes the driving rod 28 to the outside of the hard head, the two connecting rods 26 incline outwards respectively, the two crawler structures are separated from each other at an angle, an obtuse angle (reaching the inclined open position) is formed between the crawler structures at the two sides, so that the flexible crawler is in contact with the inner wall of the digestive tract, the intestinal wall is sucked through the negative pressure hole on the surface of the crawler, then the intestinal canal needs to be brought into the hard head, the crawler structure needs to have a parallel retraction position capable of bringing the intestinal wall into the hard head for telescoping in the moving process of the crawler structure towards the inside of the hard head, the third hydraulic cylinder 32 pulls the sliding block 30 to slide towards the inside of the hard head on the sliding way 29, the sliding block drives the second supporting seat, the nail abutting seat, the first supporting seat and the crawler structure to move towards the inside of the hard head through the T-shaped rod, the crawler structure can enter the metal tube wall, meanwhile, the first hydraulic cylinder pulls the driving rod 28 towards the inside of the hard head, the two connecting rods 26 incline inwards respectively, the two crawler structures are reset (reach the parallel retraction position), then the intestinal wall is attracted into the inside of the metal head through the operation of the flexible crawler 3, when the first magnet 5 in the flexible crawler 3 rotates to the position of the second magnet 13 to face each other, the first magnet 5 and the second magnet 13 are magnetically attracted, the first magnet 5 can seal the negative pressure hole 11 at a specific position of the caterpillar track, the part can not adsorb the intestinal wall under the negative pressure, so that the intestinal wall can not be separated from the caterpillar track, as shown in fig. 8, the upper right of the flexible caterpillar track 3 adsorbs the intestinal wall under the action of the negative pressure, the intestinal wall enters along with the flexible caterpillar track 3 in the clockwise running process, when the intestinal wall is in the position close to the second magnet, the first magnet and the second magnet are attracted, the first magnet seals the negative pressure hole, the negative pressure hole close to the second magnet can not adsorb the intestinal wall, and under the condition that the upper right of the flexible caterpillar track 3 continuously attracts the intestinal wall and runs with the intestinal wall, the intestinal wall gradually enters the hard head to form intussusception.
Example 4:
embodiment 4 of the present invention is further modified from the above embodiments so as to fully exert the technical advantages of the present invention, and will be exemplified below.
For example: as shown in fig. 13, an extrusion block 33 and an air bag 34 are arranged in the extrusion structure, the extrusion structure 6 is located outside the nail bin 4, the outside of the extrusion structure 6 can be connected with a hard head without limitation, the air bag 34 is an annular air bag or a plurality of block-shaped air bags surrounding the outside of the nail bin 4 at equal intervals, as shown in fig. 13, the extrusion structure is located outside the nail bin, two ends of the extrusion block 33 are respectively contacted/connected with a nail pushing sheet 35 and the air bag 34, one end of the air bag 34 is connected with a pressurization pipe 8, the pressurization pipe 8 pressurizes the air bag, and the pressurization pipe can be connected with a pressurization header pipe (not shown in the figure). Titanium nails (anastomotic nails) are stored in the nail bin 4, the air bag 34 is inflated to extrude the nail pushing sheet 35 through the extruding block 33, the nail pushing sheet 35 extrudes the titanium nails 36 in the nail bin, the titanium nails 36 in the nail bin 4 are extruded from an outlet of the nail bin, the nail abutting seat 7 interacts with the titanium nails 36, the titanium nails 36 are deformed (similar to staples) to anastomose the intestinal canal end to end, and under the combined action of the nail bin 4 and the nail abutting seat 7, the titanium nails are used for cutting off a lesion part and mesentery, and then the intestinal canal is anastomosed end to end in an inward turning manner to sew the intestinal canal.
It should be noted that the installation structure and installation form of the titanium nail in the nail bin are the prior art, and the connection relation and the working principle among the nail bin, the staple and the nail pushing sheet are described in the 'endoscope cutting stapler with ladder type nail bin (201920981305.3)', and detailed description is omitted here.
Example 5:
the operation method of the intestinal lumen section resection tube type anastomotic minimally invasive device comprises the following steps:
the method comprises the following steps: the whole pipe system can be inserted into the digestive tract of a human body through an anus entrance, the digestive tract can be but is not limited to the intestinal tract, and the head reaches the pathological intestinal segment;
step two: the third hydraulic cylinder 32 pushes the sliding block 30 to slide on the slideway 29 towards the outer side direction of the hard head, the sliding block drives the second supporting seat, the nail abutting seat, the first supporting seat and the crawler belt structure to move towards the outer side direction of the hard head through the T-shaped rod, the crawler belt structure can stretch out of the metal pipe wall, meanwhile, the first hydraulic cylinder pushes the driving rod 28 towards the outer side direction of the hard head, the two connecting rods 26 incline outwards respectively, the two crawler belt structures are separated from each other at an angle to reach an inclined opening position, so that the two flexible crawler belts are respectively contacted with the inner wall of the alimentary canal, and the inner wall of the alimentary canal is adsorbed through a negative pressure hole on the surface of the crawler belt;
step three: the third hydraulic cylinder 32 pulls the sliding block 30 to slide on the slide way 29 towards the inner direction of the hard head, the sliding block drives the second supporting seat, the nail abutting seat, the first supporting seat and the crawler belt structure to move towards the inner direction of the hard head together through the T-shaped rod, the crawler belt structure enters the metal pipe wall, meanwhile, the first hydraulic cylinder pulls the driving rod 28 towards the inner direction of the hard head, the two connecting rods 26 incline inwards respectively, and the two crawler belt structures carry the inner wall of the digestive tract to reach parallel retracting positions;
step four: the crawler motor drives the crawler structure to operate, the inner wall of the alimentary canal is sleeved on the two flexible crawlers, when the first magnet 5 in the flexible crawler 3 rotates to the position of the second magnet 13 to be opposite, the first magnet 5 and the second magnet 13 are attracted magnetically, the first magnet 5 can seal the negative pressure hole 11 at the specific position of the crawler, the part cannot adsorb the inner wall of the alimentary canal under negative pressure to enable the inner wall of the alimentary canal to be separated from the crawler, and in the continuous operation of the flexible crawler, the inner wall of the alimentary canal gradually enters the hard head to form the intussusception of the alimentary canal;
step five: the inner wall of the alimentary canal in the hard head passes through an intestinal channel between the nail abutting seat 7 and the nail bin 4, and finally the cutter rotates around the axial direction of the nail abutting seat 7 to perform circular cutting on the intestinal canal;
step six: the air bag is inflated to extrude the nail pushing sheet through the extrusion block, so that the nail pushing sheet extrudes the titanium nails in the nail bin, the nail pushing seat interacts with the titanium nails to deform the titanium nails so as to enable the titanium nails to be matched with the intestinal canal end to end, and under the combined action of the nail bin and the nail pushing seat, the titanium nails are used for cutting off a lesion part and the mesentery and then enabling the intestinal canal to be matched with the intestinal canal end to end in an inward turning manner to suture the intestinal canal;
step seven: the diseased digestive tract is removed from within the digestive tract through the ductal system.
In conclusion, the invention provides the intestinal section resection tube type anastomosis minimally invasive equipment for the intestinal cavity with small wound of a patient, which completes the whole process of intestinal section resection and end-to-end anastomosis through the natural cavity of the human body without cutting the intestinal tube through a body surface incision.
The present invention has been described in detail with reference to the above examples, but the above description is only for the purpose of describing the preferred embodiments of the present invention, and should not be construed as limiting the scope of the present invention. All equivalent changes and modifications made within the scope of the present invention shall fall within the scope of the present invention.

Claims (9)

1. The utility model provides a intestines intracavity intestines section of intestines excision cast minimal access equipment that coincide which characterized in that: it includes:
a piping system and a body system located within the piping system;
the conduit system comprises an integral hard head and soft body;
the subject system includes: a nail pushing seat and a nail bin of an intestinal channel, a cutting component and an intestinal wall adsorption intussusception component which are respectively positioned at two sides of the nail pushing seat are arranged between the nail pushing seat and the nail bin;
the outer side of the nail bin is provided with an extrusion structure, the intestinal wall adsorption intussusception component comprises at least two crawler structures and a crawler driving structure which drives the crawler structures to mutually separate in an angle when extending out of the pipeline system and reset when retracting into the pipeline system;
the crawler structure is positioned on one side, away from the soft body part, of the nail abutting seat, and comprises a support body, a connecting rod and a flexible crawler, the flexible crawler is of a hollow crawler structure and comprises an inner-layer crawler and an outer-layer crawler which are arranged inside and outside, the inner-layer crawler and the outer-layer crawler are connected and supported through a plurality of supporting rods, adsorption holes are uniformly distributed in the outer-layer crawler, a magnetic closed structure is arranged between every two adjacent supporting rods, and the magnetic closed structure corresponds to the adsorption holes;
the magnetic closed structure comprises first magnets which are arranged in one-to-one correspondence to the adsorption holes and have gaps therebetween, the back of each first magnet is connected with the magnetic closed structure through a spring, and second magnets which are magnetically attracted with the first magnets are further arranged on the inner wall of the hard head.
2. The intestinal lumen section resection tube-type anastomotic minimally invasive device according to claim 1, wherein: the stereoplasm head is stereoplasm cavity pipeline structure, soft somatic part is soft cavity pipeline structure.
3. The intestinal lumen section resection tube-type anastomotic minimally invasive device according to claim 2, wherein: the nail pushing seat is of a cylindrical structure, the two ends of the nail pushing seat are fixedly connected with a first supporting seat and a second supporting seat respectively, and the nail bin surrounds the outer side of the nail pushing seat.
4. The intestinal lumen section resection tube-type anastomotic minimally invasive device according to claim 3, characterized in that: the cutting assembly can rotate around the axial direction of nail seat, the cutting assembly includes:
the cutting knife rotating shaft is positioned on the central axis of the nail abutting seat and is rotationally connected with the second supporting seat, the cutting knife rotating shaft is a hollow shaft, and a second hydraulic cylinder is installed on the outer wall of the cutting knife rotating shaft;
the cutting knife is arranged on the output end of the second hydraulic cylinder;
and the rotating shaft driving structure drives the cutting knife rotating shaft to rotate.
5. The intestinal lumen section resection tube-type anastomotic minimally invasive device according to claim 4, which is characterized in that: the track structure is around stereoplasm head axis symmetry setting, the track structure includes:
the support body is arranged on the first support seat, and the central axis of the support body is superposed with the central axis of the nail abutting seat;
the two connecting rods are symmetrically arranged about the central axis of the hard head, one end of each connecting rod is hinged with the support body, the other end of each connecting rod is integrally formed with a crawler mounting frame, a driving wheel and a driven wheel are rotatably mounted on the crawler mounting frames, and the driving wheel is in transmission connection with a crawler motor through a bevel gear set so as to provide driving force;
and the flexible crawler belt is sleeved between the driving wheel and the driven wheel and is driven to operate under the rotation of the driving wheel.
6. The intestinal lumen section resection tube-type anastomotic minimally invasive device according to claim 5, wherein: the inner-layer crawler belt is in contact with the driving wheel and the driven wheel, and a negative pressure suction tube for providing negative pressure for the flexible crawler belt is arranged on one side of the flexible crawler belt.
7. The intestinal lumen section resection tube-type anastomotic minimally invasive device according to claim 6, wherein: the number of the second magnets is the same as that of the crawler structures and is positioned on the same plane with the crawler structures.
8. The minimally invasive device for tubular anastomosis of an endoluminal intestinal sectomy according to any of claims 5 to 7, characterized in that: the track drive structure includes:
the first hydraulic cylinder is arranged on a central axis of the first support seat, the output end of the first hydraulic cylinder is hinged with two driving rods, and the other ends of the two driving rods are respectively hinged with the middle part/middle upper part/middle lower part of the two connecting rods;
the sliding structures are two in number, extend along the axial direction of the hard head respectively, and comprise slideways and sliding blocks which are matched with each other in a sliding manner, the slideways are arranged on the inner wall of the hard head, and the sliding blocks are connected with the second supporting seat through T-shaped rods;
and the output end of the third hydraulic cylinder is connected with one of the slide blocks.
9. The minimally invasive device for tubular anastomosis for resection of an intestinal segment in an intestinal lumen according to any one of claims 1 to 7, wherein: an extrusion block and an air bag are arranged in the extrusion structure.
CN202111037083.8A 2021-09-06 2021-09-06 Intestinal section resection tube type anastomotic minimally invasive equipment in intestinal cavity Active CN113616286B (en)

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ES2396255T3 (en) * 2006-10-26 2013-02-20 Hourglass Technologies, Inc. Devices for the treatment of obesity and gastroesophageal reflux disease (GERD) by intussusception of a part of stomach tissue
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