CN114376642A - 用于圆形缝合器械的密封组合件 - Google Patents
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Abstract
本公开涉及用于圆形缝合器械的密封组合件,并提供一种圆形缝合器械,其包含:具有管状主体的适配器组合件、安置于所述管状主体的远侧部分上的壳体组合件以及支撑于所述管状主体上的密封组合件。所述密封组合件包含安置于所述壳体组合件近侧的可充气构件,其中所述可充气构件在处于放气状态时包含第一直径并且在处于充气状态时包含第二直径,所述第二直径大于所述第一直径。
Description
相关申请的交叉引用
本申请主张2020年10月2日提交的第63/087,132号美国临时专利申请的权益和优先权,所述美国临时专利申请的内容以全文引用的方式并入本文中。
技术领域
本公开涉及具有冲洗导管的圆形缝合器械。更具体地,本公开涉及与具有冲洗导管的圆形缝合器械一起使用的密封组合件。
背景技术
圆形缝合器械可用于内窥镜手术、腹腔镜手术中或用于穿过自然的身体孔口以紧固组织。圆形缝合器械可为电动或手动操作的,且可包含工具组合件,所述工具组合件被配置成可操作地联接到从手柄组合件,例如适配器组合件延伸的细长构件的远侧末端。手柄组合件可以是可重复使用的,且工具组合件可以是一次性的。工具组合件可包含砧座组合件和其中容纳一个或多个紧固件的仓组合件。
在使用时,圆形缝合器械(或圆形外科手术缝合器)可用于将此前横切的直肠部分重新接合。在此实例中,医生可将圆形缝合器械的远侧末端(包含砧座组合件)插入到患者的直肠中,并且在患者的结肠道朝向横切的直肠部分向上操纵远侧末端。医生也可以将圆形缝合器械的其余部分(包含仓组合件)经由切口且朝向横切的直肠部分插入。砧座组合件和仓组合件朝向彼此接近,且缝合钉从仓组合件朝向砧座组合件射出以在组织中形成缝合钉,从而实现端对端吻合。
在形成端对端吻合之后,且在将圆形缝合器械从外科手术部位取出之前,可以使用冲洗导管或其它附件对吻合进行泄漏测试。在对吻合进行压力测试时,由于肛门周围缺乏密封,会损失一些压力。
因此,提供一种用于圆形缝合器械的密封组合件可能是有益的,所述密封组合件有助于在圆形缝合器械与患者之间形成密封。
发明内容
圆形缝合器械包含适配器组合件,所述适配器组合件包含管状主体、安置于管状主体的远侧部分上的壳体组合件以及支撑于管状主体上的密封组合件。密封组合件包含安置于壳体组合件近侧的可充气构件。当可充气构件处于放气状态时,可充气构件包含第一直径,且当可充气构件处于充气状态时,可充气构件包含第二直径。第二直径大于第一直径。
在本公开的某些方面,圆形缝合器械进一步包含冲洗组合件。冲洗组合件可包含柔性管。可充气构件可收纳在冲洗组合件的柔性管周围。
在本公开的其它方面中,当处于放气状态时,可充气构件可滑动地安置于适配器组合件的管状主体周围。壳体组合件可包含具有第三直径的横截面。第三直径可大于第一直径。第二直径可大于第三直径。密封组合件可进一步包含充气管,所述充气管用于将流体提供到可充气构件。可充气构件可大体上是环形的。可充气构件可以是可充气套囊或可充气套筒。
一种在缝合手术之后密封管状主体器官以执行泄漏测试的方法包含:将圆形缝合器械的壳体组合件的远侧部分插入到管状主体器官的入口中;执行缝合手术;以及给壳体组合件近侧的可充气构件充气,以在圆形缝合器械的远侧部分与管状主体器官之间形成密封。
附图说明
结合附图,根据以下具体实施方式,本公开的上述和其它方面、特征和优点将是显而易见的,所述附图并入本说明书中并构成本说明书的一部分,其中:
图1是根据本公开的各方面的包含冲洗组合件和密封组合件的圆形缝合器械的透视图;
图2是图1中所展示的圆形缝合器械和密封组合件的远侧部分的透视图;
图3是图1中所展示的所指示细节区域的放大视图,其中图1中所展示的密封组合件的可充气套囊处于放气状态;
图4是图1中所展示的所指示细节区域的放大视图,其中图1中所展示的密封组合件的可充气套囊处于充气状态;
图5是图1中所展示的包含密封组合件的圆形缝合器械的远侧部分的侧视图,所述远侧部分被收纳在患者的肛门内且可充气套囊处于其放气状态;
图6是图5中所展示的圆形缝合器械的远侧部分的侧视图,所述远侧部分被收纳在患者的肛门内且可充气套囊处于其充气状态;
图7是图1中所展示的圆形缝合器械的远侧部分的侧视图,其包含根据本公开的另一方面的密封组合件,所述远侧部分被收纳在患者的肛门内且密封组合件的可充气套筒处于放气状态;以及
图8是图7中所展示的圆形缝合器械的远侧部分的侧视图,所述远侧部分被收纳在患者的肛门内且可充气套筒处于充气状态。
具体实施方式
现在将参考附图详细描述本公开的各方面,其中相同的参考数字表示相似或相同的元件。贯穿本说明书,术语“近侧”是指较靠近用户的结构的部分或其部件,且术语“远侧”是指距用户较远的结构的部分或其部件。方向性参考术语,如“顶部”、“底部”、“侧”等用于简化方面的描述,且并不旨在对结构或其任何部分的最终朝向具有任何限制作用。在以下描述中,未详细描述公知的功能或构造,以避免在不必要的细节上模糊本公开。
图1说明了根据本公开的各方面的电动圆形缝合器械10。一般来说,圆形缝合器械10包含具有致动器14的外壳或手柄组合件12,以及从手柄组合件12向远侧延伸且可释放地紧固到手柄组合件12的适配器组合件16。如所展示,适配器组合件16包含弯曲的管状主体16a。然而,应设想到适配器组合件16的管状主体16a可以是直线的,以符合特定外科手术的要求,例如粘膜切除术、痔疮切除术。工具组合件18(例如,多次使用式装载单元或单次使用式装载单元)联接到或被配置成可操作地联接到适配器组合件16的远侧末端,并且包含末端执行器20。在本公开的某些方面,工具组合件18的近侧部分与适配器组合件16形成为单个部件。尽管关于电动圆形缝合器械10展示和描述了本公开的各方面,但是应设想到,本公开的各方面同样适用于手动圆形缝合器械。
工具组合件18的末端执行器20包含被配置成支撑仓组合件24的壳体组合件22。仓组合件24支撑多个紧固件(图中未展示)和对应多个推动器构件(图中未展示),所述推动器构件可操作地与多个紧固件接合,以从仓组合件24射出多个紧固件。
工具组合件18的末端执行器20还包含砧座组合件26,其经支撑以相对于仓组合件24在间隔位置与接近位置之间移动。砧座组合件26包含多个凹穴或凹陷(图中未展示),当多个紧固件从仓组合件24中推出时,所述凹穴或凹陷各自被配置成收纳且形成多个紧固件中的一个紧固件。
适配器组合件16包含冲洗/抽吸组合件50和密封组合件100。冲洗组合件50支撑于适配器组合件16的远侧部分上且可操作地与工具组合件18的壳体组合件22接合。更具体地,冲洗组合件50包含柔性管52、紧固到柔性管52的远侧部分的远侧联接件54,和紧固到柔性管52的近侧部分的近侧联接件56。远侧联接件54被配置成将柔性管52与壳体组合件22连接,并且近侧联接件56被配置成将柔性管52与冲洗流体源(图中未展示)和抽吸源(图中未展示)连接。应设想到,冲洗流体源和抽吸源可以是相同的。
在本公开的某些方面,冲洗组合件50的远侧联接件54与壳体组合件22一体地形成。替代地,冲洗组合件50可形成可释放地紧固到适配器组合件16和/或壳体组合件22的附件。
冲洗组合件50的柔性管52至少部分地沿着适配器组合件16的管状主体16a(图1)纵向延伸并且可以经由未明确展示的一种或多种合适的紧固方法(例如,低粘性粘合剂、固定夹、带、压力配合或摩擦配合等)牢固地紧固到圆形缝合器械10的一部分(例如,壳体组合件22、适配器组合件16和/或手柄组合件12)。应进一步设想到,柔性管52可以是任何合理长度的并且可延伸超出圆形缝合器械10。尽管如所描述的那样展示为柔性的,但是应设想到柔性管52可以是刚性的。
提供冲洗组合件50以在缝合手术之后对吻合进行压力测试。还可提供冲洗组合件50以便于将末端执行器20插入到患者的管状主体中。关于示例性冲洗组合件的结构和功能的详细描述,请参考第10,561,422号(以下称为“'422专利”)美国专利,所述美国专利的全部内容以引用的方式并入本文中。
图2说明与适配器组合件16分离的密封组合件100。如所展示,密封组合件100限定了可以选择性地紧固到圆形缝合器械10的适配器组合件16(图1)的附件。替代地,密封组合件100可并入到适配器组合件16和冲洗组合件50中的任一个或两个中。
密封组合件100包含可充气套囊110和紧固到可充气套囊110的充气管120。可充气套囊110被配置成被收纳在适配器组合件16的管状主体16a和冲洗组合件50的柔性管52周围。应设想到,在给可充气套囊110充气之前,可充气套囊110可与管状主体16a和柔性管52形成流体紧密密封。
在本公开的某些方面,且如所展示,为了容纳适配器组合件16的管状主体16a和冲洗组合件50的柔性管52,并确保可充气套囊110与适配器组合件16之间的流体紧密密封,可充气套囊110包含中心开口111,其经设定大小以收纳适配器组合件16的管状主体16a;及与中心开口111流体连通的通道113,其经设定大小以收纳冲洗组合件50的柔性管52。更具体地,中心开口111包含与管状主体16a的横截面形状对应的大体圆形形状,且通道113包含与柔性管52的横截面形状对应的大体半圆形形状。应设想到,中心开口111可具有与管状主体16a的替代配置对应的任何形状,且通道113可具有与柔性管52的替代配置对应的任何形状。当密封组合件100被适当地紧固到适配器组合件16时,管状主体16a被安置于可充气套囊110的中心开口111内且柔性管52被安置于可充气套囊110的通道113内。
可充气套囊110可由任何合适材料形成。尽管展示为由在放气状态与充气状态之间伸展的弹性材料形成,但应设想到,可充气套囊110可替代地形成可折叠袋(图中未展示),所述可折叠袋可安置于可撕开的覆盖物中。在本公开的其它方面,可充气套囊110经纹理化、涂布或以其它方式被配置成在可充气套囊110与适配器组合件16的管状主体16a以及冲洗组合件50的柔性管52之间(例如向内)和/或在可充气套囊110与例如患者“P”的肛门“An”的管状器官之间(例如向外)形成流体紧密密封。应设想到,可充气套囊110可在可充气套囊110处于放气状态时沿着适配器组合件16的管状主体16a移动,且在可充气套囊110处于充气状态时相对于管状主体16a固定。
充气管120的远侧部分以任何合适的方式紧固到可充气套囊110。应设想到,充气管120可并入到柔性管52和/或远侧联接件54和近侧联接件56中。充气管120的近侧部分被配置成紧固到充气流体源(图中未展示)。应设想到,可充气套囊110可以用液体(例如,生理盐水)和/或气体(例如,氮气)进行充气。充气可以手动地进行,例如,橡胶球,或自动地进行,例如,加压气体。密封组合件100可包含用于选择性释放充气流体的阀门(图中未展示)。
图3说明具有可充气套囊110的密封组合件100,所述可充气套囊可操作地安置于适配器组合件16的管状主体16a和冲洗组合件50的柔性管52周围,并且处于放气状态。应设想到,密封组合件100可以与适配器组合件16一起提供或作为单独附件提供。替代地,密封组合件100可以与适配器组合件16和/或冲洗组合件50一体地形成。当作为单独附件提供时,可通过如橡胶带一般伸展可充气套囊110并将其引导到末端执行器20上,将密封组合件100收纳在适配器组合件16的管状主体16a周围。可充气套囊110沿着适配器组合件16的管状主体16a的位置可以根据正在执行手术的患者“P”的大小进行调整。
在放气状态下,可充气套囊110的外径测量第一长度“d1”。第一长度“d1”小于壳体组合件22的横截面的直径的长度或尺寸。以此方式,可充气套囊110被保持在壳体组合件22的直径内并且不需要患者的管状器官的任何进一步扩张。
图4说明具有处于充气状态的可充气套囊110的密封组合件100。在充气状态下,可充气套囊100的外径测量第二长度“d2”。第二长度“d2”大于第一长度“d1”,并且如所展示,可以大于壳体组合件22的横截面直径。充气的可充气套囊110包含具有圆形或光滑表面的环形形状。
图5说明圆形缝合器械10的末端执行器20,包含收纳在例如患者“P”的肛门“An”的管状器官内的冲洗组合件50和密封组合件100。密封组合件100的可充气套囊110可以经涂布、包含覆盖物,或以其它方式被配置成便于将可充气套囊110定位在患者“P”的肛门“An”内。根据吻合的位置和/或患者“P”的大小,可调整可充气套囊110在适配器组合件16的管状主体16上的位置。如所展示,可充气套囊110沿着适配器组合件16a的管状主体16定位,使得可充气套囊110在肛门“An”的入口内。应设想到,可充气套囊110可替代地完全收纳在肛门“An”内。
图6说明具有处于充气状态的密封组合件100的可充气套囊110。在充气状态下,可充气套囊110在适配器组合件16的管状主体16a与患者“P”的肛门“An”之间形成密封。可充气套囊110可在处于肛门“An”中时被充气,或者可充气套囊110可被充气,且接着由临床医生使用手柄组合件12压入肛门“An”。
应设想到,外科缝合手术将在密封组合件100的可充气套囊110充气之前执行。以此方式,密封组合件100的可充气套囊110无需沿着适配器组合件16的管状主体16a定位于任何特殊位置内。
一旦充气,就如在'422专利中所描述执行泄漏测试,以测试新形成的吻合或其它缝合手术的完整性。由于密封组合件100的可充气套囊110可防止任何泄漏,因此可在不考虑适配器组合件16的管状主体16a周围的压力损失的情况下执行吻合的泄漏测试。
泄漏测试完成后,密封组合件100的可充气套囊110可以放气并且从肛门“An”移除圆形缝合器械10的末端执行器20(图1)。应设想到,可充气套囊110可用作扩张器以便于移除末端执行器20。
冲洗组合件50和密封组合件100可作为具有外科手术缝合器械(例如,圆形缝合器械10(图1))的套组的一部分提供。
图7和8说明可操作地定位于患者的肛门“An”内的密封组合件200。可充气套筒210大体类似于上文所描述的可充气套囊110,且因此仅将在涉及其间的差异时进行详细描述。
密封组合件200包含可充气套筒210。可充气套筒210安置于适配器组合件16的管状主体16a周围,并且可在放气状态(图7)与充气状态(图8)之间转换。
在使用中,密封组合件200的可充气套筒210在充气之前插入患者的肛门“An”内。以此方式,临床医生不必向圆形缝合器械10(图1)提供任何外部压力以确保适配器组合件16与患者“P”之间的密封。
根据前文并且参看各种图式,本领域的技术人员将了解在不脱离本发明的范围的情况下,还可以对本发明外科手术缝合器械作出某些修改。虽然已在附图中展示若干方面,但是并不旨在将本公开限于此,而是旨在使本公开与本领域所允许的范围一样广泛并且以同样方式阅读本说明书。因此,以上描述不应被解释为限制性的,而仅仅是作为特定方面的例证。本领域的技术人员将设想在本文所附的权利要求书的范围内的其它修改。
Claims (11)
1.一种圆形缝合器械,其包括:
适配器组合件,其包含具有远侧部分的管状主体;
壳体组合件,其安置于所述管状主体的所述远侧部分上;以及
密封组合件,其支撑于所述管状主体上,所述密封组合件包含安置于所述壳体组合件近侧的可充气构件,其中所述可充气构件在处于放气状态时包含第一直径并且在处于充气状态时包含第二直径,所述第二直径大于所述第一直径。
2.根据权利要求1所述的圆形缝合器械,其中所述圆形缝合器械进一步包含冲洗组合件,所述冲洗组合件包含柔性管。
3.根据权利要求2所述的圆形缝合器械,其中所述可充气构件被收纳在所述冲洗组合件的所述柔性管周围。
4.根据权利要求1所述的圆形缝合器械,其中当处于所述放气状态时,所述可充气构件可滑动地安置于所述适配器组合件的所述管状主体周围。
5.根据权利要求1所述的圆形缝合器械,其中所述壳体组合件包含具有第三直径的横截面,所述第三直径大于所述第一直径。
6.根据权利要求5所述的圆形缝合器械,其中所述第二直径大于所述第三直径。
7.根据权利要求1所述的圆形缝合器械,其中所述密封组合件进一步包含充气管,所述充气管用于将流体提供到所述可充气构件。
8.根据权利要求1所述的圆形缝合器械,其中所述可充气构件大体上是环形的。
9.根据权利要求1所述的圆形缝合器械,其中所述可充气构件是可充气套囊。
10.根据权利要求1所述的圆形缝合器械,其中所述可充气构件是可充气套筒。
11.一种密封管状主体器官以执行泄漏测试的方法,所述方法包括:
将圆形缝合器械的壳体组合件的远侧部分插入到所述管状主体器官的入口中;
执行缝合手术;以及
给所述壳体组合件近侧的可充气构件充气,以在所述圆形缝合器械的所述远侧部分与所述管状主体器官之间形成密封。
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- 2021-09-28 CN CN202111157774.1A patent/CN114376642A/zh active Pending
- 2021-09-30 EP EP21200053.3A patent/EP3977944A1/en active Pending
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US11712509B2 (en) | 2023-08-01 |
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