CN113876381B - Guide assembly and medical anastomat comprising same - Google Patents
Guide assembly and medical anastomat comprising same Download PDFInfo
- Publication number
- CN113876381B CN113876381B CN202010619305.6A CN202010619305A CN113876381B CN 113876381 B CN113876381 B CN 113876381B CN 202010619305 A CN202010619305 A CN 202010619305A CN 113876381 B CN113876381 B CN 113876381B
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- guide
- cartridge
- state
- liquid
- assembly
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- 239000007788 liquid Substances 0.000 claims abstract description 101
- 125000006850 spacer group Chemical group 0.000 claims abstract description 27
- 239000007787 solid Substances 0.000 claims abstract description 16
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 124
- 238000007789 sealing Methods 0.000 claims description 26
- 230000001050 lubricating effect Effects 0.000 claims description 11
- 238000002955 isolation Methods 0.000 claims description 8
- 210000001519 tissue Anatomy 0.000 abstract description 35
- 210000004877 mucosa Anatomy 0.000 abstract description 3
- 238000004090 dissolution Methods 0.000 description 15
- 239000011248 coating agent Substances 0.000 description 12
- 238000000576 coating method Methods 0.000 description 12
- 238000000034 method Methods 0.000 description 10
- 238000010304 firing Methods 0.000 description 7
- 230000000694 effects Effects 0.000 description 6
- 230000002209 hydrophobic effect Effects 0.000 description 6
- 239000000463 material Substances 0.000 description 5
- 210000004400 mucous membrane Anatomy 0.000 description 4
- 239000002504 physiological saline solution Substances 0.000 description 4
- 210000000813 small intestine Anatomy 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 239000000314 lubricant Substances 0.000 description 3
- 210000000436 anus Anatomy 0.000 description 2
- 238000006243 chemical reaction Methods 0.000 description 2
- 238000007598 dipping method Methods 0.000 description 2
- 239000007884 disintegrant Substances 0.000 description 2
- 229920001971 elastomer Polymers 0.000 description 2
- 239000004744 fabric Substances 0.000 description 2
- 230000002496 gastric effect Effects 0.000 description 2
- 239000007924 injection Substances 0.000 description 2
- 238000002347 injection Methods 0.000 description 2
- 239000006193 liquid solution Substances 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- BVKZGUZCCUSVTD-UHFFFAOYSA-L Carbonate Chemical compound [O-]C([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-L 0.000 description 1
- 229920000297 Rayon Polymers 0.000 description 1
- 230000003872 anastomosis Effects 0.000 description 1
- 229940121363 anti-inflammatory agent Drugs 0.000 description 1
- 239000002260 anti-inflammatory agent Substances 0.000 description 1
- 239000011230 binding agent Substances 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 210000001124 body fluid Anatomy 0.000 description 1
- 239000010839 body fluid Substances 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 239000003085 diluting agent Substances 0.000 description 1
- 239000007938 effervescent tablet Substances 0.000 description 1
- 238000001125 extrusion Methods 0.000 description 1
- ZZUFCTLCJUWOSV-UHFFFAOYSA-N furosemide Chemical compound C1=C(Cl)C(S(=O)(=O)N)=CC(C(O)=O)=C1NCC1=CC=CO1 ZZUFCTLCJUWOSV-UHFFFAOYSA-N 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 239000004615 ingredient Substances 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000000968 intestinal effect Effects 0.000 description 1
- 230000003387 muscular Effects 0.000 description 1
- 150000007524 organic acids Chemical class 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 239000002985 plastic film Substances 0.000 description 1
- 229920006255 plastic film Polymers 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 239000002964 rayon Substances 0.000 description 1
- 230000003252 repetitive effect Effects 0.000 description 1
- 229920006395 saturated elastomer Polymers 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 229920006268 silicone film Polymers 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 229940099259 vaseline Drugs 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physiology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention provides a guide assembly and a medical anastomat comprising the same, wherein the guide assembly comprises: a guide member comprising a first state in which the guide member is solid, and a second state in which the guide member is relatively fixed to the distal end side of the cartridge, the guide member being at least partially dissolved in the liquid to become liquid when the guide member is in contact with the liquid, so that the guide member enters the second state, the guide member being separable from the distal end side of the cartridge when the guide member is in the second state; and a spacer located at an outer sidewall of the guide. Through this guide component, can guide nail storehouse subassembly entering tissue well, protect the tissue mucosa to can at least part dissolve and become liquid after guide piece and the contact of liquid, can conveniently remove from the distal end side of nail storehouse subassembly, operation easy operation, convenient to use.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a guide assembly and a medical anastomat comprising the same.
Background
In the prior art, a medical anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and an anvil component matched with the body. The anastomat body comprises a firing assembly and a nail bin assembly arranged at the far end side. In the operation process, two sections of tissues needing to be anastomosed are placed between a nail anvil of a nail anvil assembly and a nail bin of a nail bin assembly, the distance between the nail anvil and the nail bin is adjusted to gradually clamp the tissues, and then a firing assembly is driven by operating a handle to enable anastomoses to be molded on the nail anvil, so that anastomotic connection of the two sections of tissues is completed.
During actual surgical procedures, the body portion of the medical stapler, i.e., the cartridge portion, is required to enter the tissue tract from one end of the tissue. For example, in low-level rectal surgery, which requires transanal access, it is difficult to insert large diameter instruments into the anus because the anus is a muscular opening and is in a radially contracted state. As another example, in gastric bypass surgery or gastric sleeve surgery, the body of the stapler needs to enter the small intestine through the tissue stump and travel a distance in the small intestine. The small intestine is in a separated state after the pathological tissues are resected in the operation, and the intestinal walls are in a state of being attached together, so that the nail barrel part of the medical anastomat is not easy to enter tubular tissues, meanwhile, the inner wall of the digestive tract is a tissue mucosa, and the mucous membrane is easily damaged when the medical anastomat passes through the small intestine.
In the present invention, the distal end side and the proximal end side are the proximal end side with respect to the operator, and the end closer to the operator, that is, the end closer to the surgical site is the distal end side. In the anastomat, the inner side and the outer side are relative to the axis of the anastomat, the side close to the axis is the inner side, and the side far away from the axis is the outer side.
Disclosure of Invention
In view of the problems of the prior art, it is an object of the present invention to provide a guiding assembly and a medical stapler comprising the same, which can well guide a cartridge assembly into tissue and which at least partially dissolves to become liquid after contact with a liquid, and which can be easily removed from the distal side of the cartridge assembly.
An embodiment of the present invention provides a guide assembly for a cartridge assembly of a medical stapler, the cartridge assembly including a cartridge, the guide assembly comprising:
A guide member comprising a first state in which the guide member is solid, and a second state in which the guide member is relatively fixed to the distal end side of the cartridge, the guide member being at least partially dissolved in the liquid to become liquid when the guide member is in contact with the liquid, so that the guide member enters the second state, the guide member being separable from the distal end side of the cartridge when the guide member is in the second state; and
And the guide piece is positioned on the outer side wall of the guide piece when in the first state, and can be separated from the nail cylinder when in the second state.
Optionally, the guide comprises a guide portion on the distal side and a positioning portion on the proximal side, the positioning portion being located inside the cartridge.
Optionally, in the first state, the positioning portion is in interference fit with the nail barrel, and an outer diameter of the guiding portion is larger than an inner diameter of the nail barrel and smaller than or equal to an outer diameter of the nail barrel.
Optionally, the spacer is a flexible outer sleeve, and the outer sleeve includes a first outer sleeve portion sleeved on the guiding portion and a second outer sleeve portion sleeved on the positioning portion.
Optionally, the outer side wall of the nail barrel is provided with at least one window, the guide assembly further comprises a first water pipe, the distal end side of the first water pipe is provided with a water outlet, the water outlet is located in the nail barrel, and the proximal end side of the first water pipe penetrates through the window of the nail barrel and extends out of the nail barrel.
Optionally, the spacer covers at least part of the proximal end face of the guide, and an opening is provided at a position of the spacer corresponding to the first water pipe.
Optionally, the first water pipe is at least partially located in the opening and is fixedly connected with the spacer in a sealing manner, and when the guide piece is in the second state and the first water pipe is pulled towards the proximal end side direction of the anastomat, the first water pipe can pull the spacer to penetrate through the window of the nail barrel and separate from the nail barrel.
Optionally, a cavity is formed in the guide member, and the distal end side of the first water pipe is located inside the cavity.
Optionally, the guiding assembly further comprises a second water pipe, a water inlet is arranged at the far end side of the second water pipe, the water inlet is located in the opening and is fixedly connected with the isolating piece in a sealing mode, the near end side of the second water pipe penetrates through the window of the nail barrel and extends out of the nail barrel, and the first water pipe, the second water pipe and the isolating piece form a channel.
Optionally, the guiding assembly further comprises a pull rope and a liquid container, the liquid container is arranged in the nail barrel, the liquid container comprises a sealing sleeve and pre-stored liquid stored in the sealing sleeve, and the pull rope is fixedly connected with the sealing sleeve of the liquid container;
when the pull rope is pulled towards the proximal side of the anastomat, the pull rope can pull the sealing sleeve, so that the sealing sleeve releases stored pre-stored liquid, and the guide piece enters a second state;
the stay cord is simultaneously fixedly connected to the isolation piece, and when the guide piece is in the second state, the isolation piece can be pulled to penetrate through the window of the nail barrel and be separated from the nail barrel.
Optionally, the guide is internally provided with a cavity, the liquid container is located inside the cavity, and the length of the cavity extends in the axial direction of the cartridge.
Optionally, at least one window is arranged on the outer side wall of the nail barrel, the pull rope is fixedly connected with the isolation piece, and when the pull rope is pulled towards the proximal side direction of the anastomat, the pull rope can pull the isolation piece to penetrate through the window of the nail barrel and separate from the nail barrel.
Optionally, the spacer is a hydrophobic coating covering the outer side of the guide.
Optionally, the outer side of the spacer is at least partially coated with a lubricating layer.
The embodiment of the invention also provides a medical anastomat, which comprises the guide assembly.
The guide assembly and the medical anastomat provided by the invention have the following advantages:
The invention provides a guide component for a medical anastomat, which is solid before being contacted with liquid, has certain strength, can effectively guide the anastomat into tissues, reduces the damage to the tissues in the moving process of a nail bin component and protects the residual tissues and the mucous membrane layers of the tissues; the guide member is at least partially dissolved and becomes liquid after contacting with the liquid, so that the guide member can be conveniently removed from the distal end side of the staple cartridge assembly after reaching the operation position, the firing process of the anastomat can not be hindered, and the operation is simple and the use is convenient.
Drawings
Other features, objects and advantages of the present invention will become more apparent upon reading of the detailed description of non-limiting embodiments, made with reference to the following drawings.
FIG. 1 is a schematic view of the structure of a cartridge assembly;
FIG. 2 is a schematic view of the guide assembly of the first embodiment of the present invention as applied to a staple cartridge;
FIG. 3 is a schematic view of the structure of a guide assembly according to a first embodiment of the present invention;
FIG. 4 is a schematic view of the guide assembly of the second embodiment of the present invention as applied to a staple cartridge;
FIG. 5 is a schematic structural view of a guide assembly according to a second embodiment of the present invention;
FIG. 6 is a schematic view of a guide assembly of a third embodiment of the present invention applied to a staple cartridge, wherein the guide is in a first state;
FIG. 7 is a schematic view of a guide assembly of a third embodiment of the present invention applied to a staple cartridge, wherein the guide is in a second state;
FIG. 8 is a schematic view of a guide assembly of a fourth embodiment of the present invention applied to a staple cartridge;
FIG. 9 is a schematic view of a guide assembly of a fifth embodiment of the present invention applied to a staple cartridge;
Fig. 10 is a schematic view showing a structure in which a guide assembly according to a sixth embodiment of the present invention is applied to a cartridge.
Reference numerals:
1. Guide 4 second water pipe
11. Distal end side of second water pipe of guide portion 41
12. Proximal side of the second water tube of the positioning portion 42
13. Channel 43 water inlet
14. Cavity 5 liquid container
2. Jacket 51 sealing sleeve
21. The first outer jacket portion 52 pre-stores liquid
22. Second outer sleeve 6 pull rope
23. Distal end side of the connection portion 61 pulling rope
24. Proximal side of opening 62 pull cord
3. First water pipe 9 nail barrel
31. Distal side 91 of the first water tube distal side of the cartridge
32. Proximal side 92 of the first water tube proximal side of the cartridge
33. Water outlet 93 window
Detailed Description
Example embodiments will now be described more fully with reference to the accompanying drawings. However, the exemplary embodiments can be embodied in many forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of the example embodiments to those skilled in the art. The same reference numerals in the drawings denote the same or similar structures, and thus a repetitive description thereof will be omitted.
The invention provides a guide assembly for a medical anastomat and the medical anastomat comprising the guide assembly. The medical anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and an anvil component matched with the body. The anastomat body comprises a firing assembly and a nail bin assembly arranged at the distal end side, and the nail bin assembly comprises a nail cylinder. In operation, the cartridge assembly is required to be advanced into the tissue to reach the surgical site and to interface with the anvil assembly at least partially within another section of tissue. The guide assembly is used to better guide the cartridge assembly into the surgical site. Specifically, the guide assembly includes a guide and a spacer. The guide has a first state in which the guide is solid and a second state.
The guide member is fixed relative to the distal side of the cartridge when in the first state, and the guide member may act as a guide for movement of the cartridge in tissue. The guide is in the first state and when the guide is in contact with a liquid, the guide is at least partially dissolved in the liquid to become liquid so that the guide enters the second state, and when the guide is in the second state, the guide is separable from the distal side of the cartridge. Therefore, after the guide assembly reaches the surgical site with the cartridge assembly, the guide may be dissolved in the liquid by injecting the liquid into the interior of the cartridge such that the guide contacts the liquid, at which time the dissolved guide may be conveniently removed from the distal side of the cartridge without affecting the normal firing of the stapler. When the guide piece is in the first state, the isolation piece is positioned on the outer side wall of the guide piece and used for isolating the outer side wall of the guide piece from liquid, so that the guide effect is prevented from being influenced by contact and dissolution of the outer side wall of the guide piece and the liquid before the guide component reaches a surgical position along with the nail bin component. When the guide member is in the second state, the spacer can be disengaged from the cartridge so as not to interfere with the operation.
The following describes the structure of the guide assembly of various embodiments of the present invention in detail with reference to the accompanying drawings, and it is to be understood that the various embodiments are not limiting of the scope of the present invention. In order to clearly show the structure of the guide device, fig. 2 and 4 show the guide assembly and the cartridge in cross-section, fig. 3 and 5 show the guide assembly in cross-section, and fig. 6 to 10 show the guide assembly in cross-section in a direction parallel to the axial direction of the cartridge 8.
As shown in fig. 1-3, a schematic view of the configuration of the engagement of the guide assembly and cartridge assembly according to a first embodiment of the present invention is shown. Wherein, the nail bin assembly comprises a nail cylinder 9, and at least one window 93 is arranged on the outer side wall of the nail cylinder 9. The guide assembly comprises a guide 1 and a spacer. The guide 1 has a first state and a second state, the guide being solid in the first state. When the guide member 1 is in the first state, the guide member 1 and the distal end side of the nail barrel 9 are relatively fixed, the guide member 1 has a certain strength, and the guide member 1 can play a role in guiding the movement of the nail barrel 9 in tissues.
After the guide assembly reaches the surgical site with the cartridge assembly, the guide 1 may be brought into a second state by injecting a liquid into the interior of the cartridge 9 such that at least a portion of the guide 1 is in contact with the liquid, at which time the guide 1 may be conveniently removed from the distal side 91 of the cartridge 9 without affecting the normal firing of the stapler. The liquid may be a biocompatible liquid injected from outside, such as physiological saline, medical pure water, etc. which are commonly used in an operating room. The portion of the guide 1 that becomes liquid here becomes a solution state that dissolves in the liquid.
When the guide 1 is brought from the first state to the second state, there may be two situations, one being that the guide 1 is completely dissolved to a liquid state, at which time the liquid solution may be expelled from the cartridge 9, thereby effecting removal of the guide 1 from the distal side 91 of the cartridge 9. Another situation is that the guide 1 is partly dissolved in liquid state, while still part remains in solid state, at which time the dissolved liquid solution can be discharged from the cartridge 9, and since the guide 1 partly dissolves, the volume of its solid part will be reduced compared to the first state, and the remaining solid part can thus also be easily detached from the distal side 91 of the cartridge 9.
The spacer is located on the outer side wall of the guide 1 when the guide 1 is in the first state. In particular, the spacer may at least partially cover the outer side wall of the guide 1. In this embodiment, the spacer is a flexible outer sleeve 2, and the outer sleeve 2 is sleeved outside the guide member 1, so as to isolate the outer side wall of the guide member 1 from liquid, and avoid the influence of the contact and dissolution of the outer side wall of the guide member 1 with the liquid before the guide member reaches the operation position along with the cartridge member. The sheath 2 can also be disengaged from the cartridge 9 when the guide 1 is in the second state without affecting the operative effect. For example, the sheath 2 may be pulled proximally, moving the sheath 2 proximally to the window 93 through the cartridge 9 and out of the cartridge 9.
In this embodiment, the distal and proximal sides are proximal sides with respect to the operator, the end closer to the operator, the end farther from the operator, i.e. the end closer to the surgical site, is distal side, the direction along the axis of the stapler is axial, i.e. the direction from the distal side to the proximal side of the stapler, or the direction from the proximal side to the distal side of the stapler. For example, in the view of fig. 1, the distal end side 91 of the cartridge 9 is the upper side, and the proximal end side 92 is the lower side. In the present invention, the inner side and the outer side of one member are the inner side with respect to the axial center of the nail cartridge 9, and the outer side away from the axial center.
As shown in fig. 2 and 3, the guide 1 includes a guide portion 11 on the distal end side of the guide 1 and a positioning portion 12 on the proximal end side of the guide 1, the positioning portion 12 being located inside the cartridge 9. In the first state, the positioning portion 12 is interference-fitted with the cartridge 9, and the outer diameter of the guide portion 11 is larger than the inner diameter of the cartridge 9 and smaller than or equal to the outer diameter of the cartridge 9, so that the guide 1 in the first state can be held on the distal end side of the cartridge 9. In other alternative embodiments, the positioning portion 12 may be connected to the cartridge 9 in other ways, such as with fasteners or the like. In the first state, the entire outer shape of the guide portion 11 may be a shape in which the cross-sectional area gradually increases in the direction from the distal end side to the proximal end side, for example, the shape is: conical, oval, etc., as long as a guided shape is achieved.
The guide 1 may for example take the form of an effervescent tablet which, upon contact with a liquid, undergoes a disintegration reaction and then dissolves in the liquid. The guide 1 may use the reaction of an organic acid and a basic (hydro) carbonate as an effervescent disintegrant, and other ingredients may be added to the guide 1 to be mixed with the disintegrant, for example, an anti-inflammatory agent, a binder, a diluent, etc. In other alternative embodiments, the guide 1 may be made of other materials, as long as it has good biocompatibility and can be dissolved in a liquid.
In the present invention, an initial state when the guide 1 is not in contact with the liquid is referred to as a first state, and a state between a size in which the guide 1 is dissolved to be removable from the distal side of the cartridge 9 (a maximum outer diameter of the guide 1 is smaller than an inner diameter of the distal side 91 of the cartridge 9) and a completion of the dissolution of the guide 1 is referred to as a second state, that is, a state in which a solid portion volume of the guide 1 may be a value varying with a degree of dissolution.
In other alternative embodiments, the second state may not include a state in which the guide 1 is completely dissolved, i.e. it is also possible that the guide 1 is only partially dissolved in the second state. In this embodiment, when the jacket 2 is pulled out of the window 93 through the first water pipe 3, the undissolved portions of the guide 1 may be pulled out of the window 93 together.
Corresponding to the structure of the guide 1, the jacket 2 includes a first jacket portion 21 sleeved on the guide portion 11 and a second jacket portion 22 sleeved on the positioning portion 12. On the one hand, the outer sleeve 2 can play a certain role in blocking liquid on the guide piece 1, and when the nail cartridge assembly moves in tissues and does not reach a surgical position, the outer sleeve 2 can block the guide piece 1 from being in direct contact with the liquid, so that the guide effect is prevented from being influenced by the contact and dissolution of the guide piece 1 in the guide process. On the other hand, the outer sheath 2 may have a smoother outer surface than the guide 1, and may further reduce friction between the guide 1 and tissue, thereby further reducing damage to tissue. Further, in this embodiment, the outer side of the outer sleeve 2 may be at least partially lubricious or coated with a lubricating layer, which may be an aqueous lubricating layer or an oily lubricant coating. For example, the outer surface of the outer jacket 2 is coated with a hydrophilic coating, and before use, the outer surface of the outer jacket 2 becomes very lubricious by dipping with water. Since the guide assembly shown in fig. 2 is shown in cross-section. It will be appreciated that in this embodiment the first outer sleeve portion 21 completely covers the outer side wall of the guide portion 11.
The outer jacket 2 is preferably made of a flexible film, and may further be made of a film having a certain elasticity, but may be made of a film having no elasticity. For example, the outer cover 2 may be made of a flexible rubber material, a silicone material, a plastic material, or the like, and the thickness of the outer cover 2 may be less than 0.2 mm, and further may be less than 0.1mm and more than 0.01mm. In other alternative embodiments, the jacket 2 may take on other thickness dimensions, and is not limited to the ranges set forth herein. The outer jacket 2 may also be made of a flexible fabric, such as a braid, knit, etc., which may be a rayon material or spun yarn obtained by extrusion of a polymer, etc. And the outer jacket 2 is preferably an elastic fabric.
In this embodiment, to further reduce friction when the guide assembly is in contact with tissue, and to reduce damage to the tissue mucosa, the outer side of the housing 2 may be at least partially lubricious or at least partially coated with a lubricious layer to enhance the guiding effect on the cartridge assembly. The lubricating layer can be formed by coating an existing aqueous lubricant or an existing oily lubricant in the prior art, and can also be formed by coating and lubricating solid medical Vaseline and the like. For example, the outer surface of the outer sheath 2 is coated with a hydrophilic coating, and before use, the outer surface of the outer sheath 2 becomes very lubricious by dipping with water, which technique has been widely used in the surgical field.
In order to facilitate the injection of liquid into the interior of the cartridge 9 after the cartridge assembly has reached the operative position, the guide assembly further comprises a first water tube 3, the distal side 31 of the first water tube 3 being provided with a water outlet 33, the water outlet 33 being located inside the cartridge 9, the proximal side 32 of the first water tube 3 protruding outside the cartridge 9 through a window 93 of the cartridge. After the liquid is injected into the inside of the cartridge 9 through the first water pipe 3, the liquid having dissolved the guide 1 can be discharged from the window 93 or other locations. In this embodiment, the distal end side of the first water tube 3 may be fixedly connected to the outer sleeve 2 in a sealing manner, after the first water tube 3 is used to inject the liquid into the nail barrel 9 to dissolve the guide member 1, the solution may be discharged from one end of the first water tube 3, and the doctor may pull the first water tube 3 in a proximal direction, through the first water tube 3, and pull the outer sleeve 2 together through the window 93 of the nail barrel, so that both the first water tube 3 and the outer sleeve 2 are separated from the nail barrel 9.
In other alternative embodiments, the guide assembly may also comprise a separate pull cord, the distal side of which is fixedly connected to the sleeve 2, the proximal side of which extends outside the cartridge 9 through the window 93, and the sleeve 2 is pulled out of the window 93 to disengage from the cartridge 9 when the sleeve 2 needs to be removed.
In this embodiment, as shown in fig. 3, the guide member 1 is provided with a cavity 14, the cavity 14 is connected to the proximal end surface of the guide member 1, and the distal end side 31 of the first water tube 3 is located inside the cavity 14. By providing the cavity 14, the effective solid volume of the guide 1 can be reduced, and the guide 1 can be dissolved more rapidly and the dissolution time can be shortened when the liquid is injected through the first water pipe 3. Further, a channel 13 communicating with the cavity 14 may be further formed in the guide 1, and the channel 13 extends in the axial direction of the nail barrel. When the liquid is injected into the cavity 14 through the first water pipe 3, the liquid is in contact with the guide 1 on the inner wall surface of the cavity 14 and the inner wall surface of the channel 13, and dissolves the guide 1, thereby further accelerating the dissolution rate of the guide 1. The water outlets 33 of the first water pipe 3 may be formed on two sides of the distal end side 31 of the first water pipe 3, and the number of the water outlets 33 may be plural, so that the liquid can be injected more quickly, and the water outlets may be formed on the distal end side or other positions of the first water pipe 3.
Fig. 4 and 5 are schematic structural views showing the cooperation of the guide assembly and the nail barrel according to the second embodiment of the present invention. This embodiment differs from the first embodiment in that: the guide assembly further comprises a second water pipe 4, and the second water pipe 4 is fixedly connected with the outer sleeve 2 in a sealing mode. The distal side 41 of the second water tube 4 is provided with a water inlet 43, and the water inlet 43 is located inside the cartridge 9, and the proximal side 42 of the second water tube 4 protrudes outside the cartridge 9 through the window 93 of the cartridge. After the guide 1 is dissolved by injecting water into the inside of the cartridge 9 through the first water pipe 3, the liquid in which the guide 1 is dissolved can be discharged through the water inlet 43 via the second water pipe 4, so that the liquid flow speed in the inside of the cartridge 9 can be prevented, the guide 1 can be prevented from reaching a solubility saturated state and not being completely dissolved, and thus the dissolution speed of the guide 1 can be increased, and the rapid removal of the guide 1 can be realized. At the same time, the first water pipe 3, the second water pipe 4 and the outer sheath 2 form a channel, liquid is injected into the proximal end of the first water pipe 3, the guide 1 is dissolved in the liquid in the outer sheath 2, and the liquid is discharged from the second water pipe 4. In this embodiment, the volume of the cavity 14 is larger than that of the cavity 14 of the first embodiment, so that the dissolution of the guide 1 can be further accelerated. At the same time, even if gas is generated during dissolution of the guide 1, it is discharged outside the body through the channel without causing clinical risks.
In this embodiment, the first water pipe 3 may be fixedly connected to the outer sleeve 2, and after the guide 1 is dissolved, the outer sleeve 2 is pulled out of the window 93 by pulling the first water pipe 3 and the second water pipe 4 together, or the second water pipe 4 may be fixedly connected to the outer sleeve 2, or both the first water pipe 3 and the second water pipe 4 may be fixedly connected to the outer sleeve 2. The first water pipe 3 and the second water pipe 4 can be fixedly connected, and when the water pipe is removed, the first water pipe 3, the second water pipe 4 and the outer sleeve 2 can be removed from the nail barrel 93 by pulling only one water pipe. The functions of the first water pipe 3 and the second water pipe 4 can be interchanged, or the liquid can enter from the second water pipe 4 and be discharged from the first water pipe 3.
In the above two embodiments, the first water pipe 3 and the second water pipe 4 are fixedly connected with the outer sleeve 2 in a sealing manner, so that the guide member 1 can be dissolved in a sealed space, and risks caused by substances such as gas generated in the dissolution process of the guide member 1 entering the human circulatory system are prevented.
Fig. 6 is a schematic structural view of a guide assembly according to a third embodiment of the present invention applied to a nail cartridge. This embodiment differs from the first embodiment in that the interior of the guide 1 is not provided with a channel 13. In the exemplary embodiment, the fixing of the jacket 2 to the first water line 3 is also shown, i.e. the jacket 2 is fixedly connected to the first water line 3 at the first 23. In this embodiment, the sheath 2 does not cover the proximal face of the guide 1. As shown in fig. 7, a schematic view of the guide 1 in fig. 6 after dissolution is shown. The volume of the solid part of the guide 1 is continuously reduced during dissolution until the solid part becomes 0 after complete dissolution.
Fig. 8 is a schematic structural view of a guide assembly according to a fourth embodiment of the present invention applied to a nail cartridge. This embodiment differs from the third embodiment in that the outer sleeve 2 covers at least part of the proximal end face of the guide 1, and that the outer sleeve 2 is provided with openings 24 at positions corresponding to the first water tubes 3. The first water pipe 3 is at least partially located in the opening 24 and is fixedly connected with the outer sleeve 2 in a sealing manner. In this embodiment, the distal side 31 of the first water tube 3 is located inside the guide 1, and the connection 23 of the outer sheath 2 to the first water tube 3 may also be located at the opening 24 of the proximal surface of the outer sheath 2. This construction can also be applied in the second embodiment described above, wherein an opening is provided in the proximal end face of the outer sleeve 2 at a position corresponding to the first water tube 3 and the second water tube 4, and the second water tube 4 is also at least partially located in the opening 24 and is fixedly connected with the outer sleeve 2 in a sealing manner.
Fig. 9 is a schematic structural view showing the application of the guide assembly according to the fifth embodiment of the present invention to the nail cartridge. This embodiment differs from the second embodiment in that: the distal side 31 of the first water tube 3 is located outside the proximal side of the guide 1. In order to facilitate the contact of the liquid injected by the first water pipe 3 with the surface of the guide member 1, the outer jacket 2 covers at least part of the proximal end surface of the guide member 1, and an opening is provided at a position of the outer jacket 2 corresponding to the first water pipe 3. This structure can also be applied to the second embodiment described above, in which openings are provided at positions of the proximal end face of the jacket 2 corresponding to the first water pipe 3 and the second water pipe 4.
Fig. 10 is a schematic structural view of a guide assembly according to a sixth embodiment of the present invention applied to a nail cartridge. This embodiment differs from the third embodiment in that: the guide assembly further comprises a pull rope 6 and a liquid container 5, the liquid container 5 is arranged inside the nail barrel 9, the liquid container 5 comprises a sealing sleeve 51 and pre-stored liquid 52 stored in the sealing sleeve 51, the distal end side 61 of the pull rope 6 is fixedly connected with the sealing sleeve 51 of the liquid container 5, and the proximal end side 62 of the pull rope 6 penetrates through a window 93 of the nail barrel and extends out of the nail barrel 9. The sealing sleeve 51 is preferably made of a breakable film, for example, a silicone film, a rubber film, a plastic film, etc. having a small thickness may be used. When the pull cord 6 is pulled in the proximal direction of the stapler, the pull cord 6 may pull the sealing sleeve 51 such that the sealing sleeve 51 releases the stored pre-stored liquid 52. After the pre-stored liquid 52 has contacted the guide 1, the guide 1 is at least partially dissolved such that the guide 1 enters a second state. With the structure of the guide assembly of this embodiment, after the cartridge assembly is moved to the surgical site, the seal cover 51 can be ruptured by pulling the pull cord 6 to the proximal side to release the pre-stored liquid 52 without additional injection of liquid, which is very convenient to use. The pre-stored liquid 52 may be physiological saline, medical pure water, etc. The sealing sleeve 51 is finally positioned inside the outer sleeve 2 to be separated.
In this embodiment, the liquid container 5 is arranged inside the guide 1, in particular, the guide 1 is provided with a cavity 14 inside the cavity 14, the liquid container 5 is located inside the cavity 14, and the length of the cavity 14 extends in the axial direction of the cartridge 9. The cavity 14 preferably penetrates the distal and proximal sides of the guide 1, thereby increasing the contact area of the guide 1 with the pre-stored liquid 52 and accelerating the dissolution of the guide 1.
In this embodiment, the pull cord 6 may be further fixedly connected to the casing 2, and when the guide 1 is dissolved to enter the second state, the doctor pulls the pull cord 6 in a proximal direction, and the pull cord 6 may pull the casing 2 through the window 93 of the cartridge to be separated from the cartridge 9.
In each of the above embodiments, the spacer is a flexible outer sleeve. However, the invention is not limited thereto, and in another alternative embodiment the spacer may be a hydrophobic coating covering the outer side of the guide 1. When the cartridge assembly enters the tissue, the hydrophobic coating can isolate the outer wall surface of the guide member 1 from body fluid or other liquid in the tissue, so that the guide member 1 is prevented from being dissolved by the contact of the outer wall surface of the guide member 1 with the liquid to enable the guide member 1 to be in a liquid state and enter the second state when the cartridge assembly does not reach the operation position. The hydrophobic coating applied on the outer side of the guide 1 may be a hydrophobic coating as known in the art, and preferably has a good biocompatibility. Further, a further lubricating layer may be applied to the outside of the hydrophobic coating in order to achieve a better guiding effect. The lubricating layer may be the above-described aqueous lubricating layer, oily lubricating layer, hydrophilic coating, solid lubricating layer, or the like.
In the above embodiment, any one of the first water pipe 3 and the second water pipe 4 may be used as the water inlet pipe or the water outlet pipe. When the liquid is injected, a medical injector can be connected to the distal end of the first water pipe 3 or the second water pipe 4 for injecting water, or other medical droppers can be used for injecting water.
The guide assembly provided in each of the embodiments described above can be placed alone without being mounted to the barrel portion of the stapler before use, and can be selectively mounted as needed by a user, and the operation is relatively simple, only by mounting the guide and the spacer on the distal end side of the barrel; can also be directly arranged on the nail cylinder part of the anastomat without the self-installation of a user.
When the guide assembly provided by the invention is applied to a medical anastomat, the using method of the guide assembly comprises the following steps:
S100: the guide piece in the first state is arranged on the distal end side of the nail barrel, the guide piece and the distal end side of the nail barrel are relatively fixed in the first state, and the isolation piece is positioned on the outer side wall of the guide piece;
S200: operating the stapler such that the guide member enters the inside of the tissue together with the cartridge, the guide member guiding the movement of the cartridge in the tissue;
S300: when the nail cylinder reaches the operation position, the guide piece is at least partially dissolved to be in a liquid state after being contacted with liquid, so that the nail cylinder enters the second state, and when the nail cylinder reaches the operation position, the guide piece can be separated from the distal end side of the nail cylinder, and the separation piece can be separated from the nail cylinder.
Therefore, in the initial state in step S100 and step S200, the guide member is in the first state, and the guide member is fixed relative to the distal end side of the nail barrel, so that a good guiding effect can be provided for the nail barrel to enter the tissue, damage to the tissue in the moving process of the nail cartridge assembly is reduced, and the residual tissue and the mucous membrane layer of the tissue are protected. In step S300, after the cartridge enters the tissue, when the guide member is in contact with the liquid, the guide member is at least partially dissolved and becomes liquid, so that the guide member enters the second state and can be separated from the distal end side of the cartridge, and the spacer can also be separated from the cartridge, thereby not affecting the normal operation of the stapler operation.
Further, when the guide assembly adopts the structure of the guide assembly of the first to fifth embodiments as above, the step S300 further includes the steps of:
S310-A: when the nail cylinder reaches the operation position, injecting liquid (such as physiological saline, medical pure water and the like) into the first water pipe, and enabling the guide piece to be at least partially dissolved after being contacted with the liquid to enter the second state;
S320-A: after the guide piece is dissolved, the first water pipe is pulled towards the proximal end side of the anastomat, and the first water pipe and the outer sleeve penetrate out of the window of the nail cylinder and are separated from the nail cylinder.
Further, when the guide assembly adopts the structure of the guide assembly of the sixth embodiment, the step S300 further includes the steps of:
S310-B: when the nail cylinder reaches the operation position, the stay cord is pulled, so that the sealing sleeve is pulled, pre-stored liquid (such as physiological saline, medical pure water and the like) in the liquid container is released, and the guide piece is at least partially dissolved to enter the second state after being contacted with the pre-stored liquid;
S320-B: after the guide piece is dissolved, the pull rope is pulled towards the proximal end side of the anastomat, and the pull rope and the outer sleeve penetrate out of the window of the nail cylinder and are separated from the nail cylinder.
The guide assembly and the medical anastomat provided by the invention have the following advantages:
The invention provides a guide component for a medical anastomat, which is solid before being contacted with liquid, has certain strength, can effectively guide the anastomat into tissues, reduces the damage to the tissues in the moving process of a nail bin component and protects the residual tissues and the mucous membrane layers of the tissues; the guide member is at least partially dissolved and becomes liquid after contacting with the liquid, so that the guide member can be conveniently removed from the distal end side of the staple cartridge assembly after reaching the operation position, the firing process of the anastomat can not be hindered, and the operation is simple and the use is convenient.
The foregoing is a further detailed description of the invention in connection with the preferred embodiments, and it is not intended that the invention be limited to the specific embodiments described. It will be apparent to those skilled in the art that several simple deductions or substitutions may be made without departing from the spirit of the invention, and these should be considered to be within the scope of the invention.
Claims (14)
1. A guide assembly for a staple cartridge assembly of a medical stapler, the staple cartridge assembly comprising a cartridge having an outer sidewall provided with at least one window, the guide assembly comprising:
A guide member comprising a first state in which the guide member is solid, and a second state in which the guide member is relatively fixed to the distal end side of the cartridge, the guide member being at least partially dissolved in the liquid to become liquid when the guide member is in contact with the liquid, so that the guide member enters the second state, the guide member being separable from the distal end side of the cartridge when the guide member is in the second state; and
The isolating piece is a flexible jacket, when the guide piece is in the first state, the isolating piece is positioned on the outer side wall of the guide piece, the guide piece is dissolved in liquid in the jacket and enters the second state from the first state, and when the guide piece is in the second state, the isolating piece can be separated from the nail barrel.
2. The guide assembly of claim 1, wherein the guide comprises a guide portion on a distal side and a locating portion on a proximal side, the locating portion being located inside the cartridge.
3. The guide assembly of claim 2, wherein in the first state the positioning portion is an interference fit with the cartridge, an outer diameter of the guide portion being greater than an inner diameter of the cartridge and less than or equal to an outer diameter of the cartridge.
4. The guide assembly of claim 2, wherein the outer sleeve includes a first outer sleeve portion that is sleeved over the guide portion and a second outer sleeve portion that is sleeved over the positioning portion.
5. The guide assembly of claim 1, further comprising a first water tube, a distal side of the first water tube being provided with a water outlet, the water outlet being located inside the cartridge, a proximal side of the first water tube extending outside the cartridge through a window of the cartridge.
6. The guide assembly of claim 5, wherein the spacer covers at least a portion of the proximal face of the guide and an opening is provided at a location of the spacer corresponding to the first water tube.
7. The guide assembly of claim 6, wherein the first water tube is at least partially positioned within the opening and is sealingly fixedly connected to the spacer, the guide being in the second state, and the first water tube being pulled in a proximal direction of the stapler to pull the spacer through the window of the cartridge to separate from the cartridge.
8. The guide assembly of claim 5, wherein the guide defines a cavity therein, the distal side of the first water tube being located within the cavity.
9. The guide assembly of claim 6, further comprising a second water tube having a water inlet disposed on a distal side thereof and disposed within the opening and sealingly fixedly connected to the spacer, the proximal side of the second water tube extending outside the cartridge through the window of the cartridge, the first water tube forming a passageway with the second water tube and the spacer.
10. The guide assembly of claim 1, further comprising a pull cord and a liquid container, the liquid container disposed inside the cartridge, the liquid container comprising a sealing boot and a pre-stored liquid stored in the sealing boot, the pull cord being fixedly connected to the sealing boot of the liquid container;
when the pull rope is pulled towards the proximal side of the anastomat, the pull rope can pull the sealing sleeve, so that the sealing sleeve releases stored pre-stored liquid, and the guide piece enters a second state;
the stay cord is simultaneously fixedly connected to the isolation piece, and when the guide piece is in the second state, the isolation piece can be pulled to penetrate through the window of the nail barrel and be separated from the nail barrel.
11. The guide assembly of claim 10, wherein the guide is internally provided with a cavity, the liquid container being located inside the cavity, a length of the cavity extending in an axial direction of the cartridge.
12. The guide assembly of claim 10, wherein the pull cord is fixedly connected to the spacer, the pull cord being configured to pull the spacer through the window of the cartridge to separate from the cartridge when the pull cord is pulled in a proximal direction of the stapler.
13. The guide assembly of claim 1, wherein an outer side of the spacer is at least partially coated with a lubricating layer.
14. A medical stapler comprising the guide assembly according to any one of claims 1 to 13.
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| CN202010619305.6A CN113876381B (en) | 2020-07-01 | 2020-07-01 | Guide assembly and medical anastomat comprising same |
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| CN212382687U (en) * | 2020-07-01 | 2021-01-22 | 天臣国际医疗科技股份有限公司 | Guide assembly and medical anastomat comprising same |
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| JP3893065B2 (en) * | 2002-02-15 | 2007-03-14 | 有限会社 パックス オプティカ ジャパン | Organ anastomosis device |
| US20100076470A1 (en) * | 2008-09-22 | 2010-03-25 | Tyco Healthcare Group Lp | Methods and Devices for Sheath Compression |
| US8353439B2 (en) * | 2009-11-19 | 2013-01-15 | Ethicon Endo-Surgery, Inc. | Circular stapler introducer with radially-openable distal end portion |
| CN209269774U (en) * | 2018-12-25 | 2019-08-20 | 苏州天臣国际医疗科技有限公司 | Circular-pipe anastomat |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN212382687U (en) * | 2020-07-01 | 2021-01-22 | 天臣国际医疗科技股份有限公司 | Guide assembly and medical anastomat comprising same |
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