CN114680982A - Guide assembly and circular tube type anastomat - Google Patents

Abstract

The invention provides a guide assembly and a circular tube type anastomat, wherein the guide assembly comprises a guide part, the guide part has a first state and a second state, when the guide part is in the first state, the guide part has a first hardness, and at least part of the guide part is arranged on the distal end side of a nail barrel of the anastomat and is fixed relative to the nail barrel; the guide member has a second hardness at least partially when in the second state, the second hardness being less than the first hardness, the guide member being separable from the cartridge through the window of the cartridge when the guide member is pulled proximally. The guide may provide good guidance of the cartridge assembly into tissue when in the first state and may be easily removed from the distal side of the cartridge assembly after the guide has been brought into the second state.

Description

Guide assembly and circular tube type anastomat

Technical Field

The invention relates to the technical field of medical instruments, in particular to a guide assembly and a circular tube type anastomat.

Background

In the prior art, a circular tube-type anastomat comprises an anastomat body, an operating handle movably connected with the anastomat body and a nail anvil assembly matched with the anastomat body. The anastomat body comprises a firing assembly and a nail bin assembly arranged on the far end side. In the operation process, two sections of tissues to be anastomosed are placed between the nail anvil of the nail anvil assembly and the nail bin of the nail bin assembly, the distance between the nail anvil and the nail bin is adjusted to gradually clamp the tissues, and then the trigger assembly is driven by the operation handle to enable the anastomotic nails to be formed on the nail anvil, so that anastomotic connection of the two sections of tissues is completed.

During the actual operation, the body portion of the circular tube type stapler, i.e., the cartridge portion, needs to enter the tissue lumen from one end of the tissue. For example, in low rectal surgery, access is required through the anus, which is a muscular opening and is in a radially contracted state, making it difficult to insert a large diameter instrument into the anus. As another example, in a gastric bypass or gastric cufflated procedure, the body of the stapler is required to enter the small intestine through the tissue stump and traverse a distance in the small intestine. The small intestine is in a separation state after the pathological tissue is cut off in the operation, and the intestinal walls are in a state of being attached together, so that the nail barrel part of the circular tube type anastomat is not easy to enter the tubular tissue, meanwhile, the inner wall of the digestive tract is a tissue mucosa, and the circular tube type anastomat is easy to damage the mucosa when passing in the small intestine.

In the present invention, the distal side and the proximal side are relative to the operator, and the end closer to the operator is the proximal side, and the end farther from the operator, i.e., the end closer to the surgical site is the distal side. In the stapler, the inner side and the outer side are relative to the axis of the stapler, wherein 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 in the prior art, it is an object of the present invention to provide a guide assembly and a circular tube type stapler, wherein the guide can well guide the cartridge assembly into the tissue when the guide is in the first state, and the guide can be easily removed from the distal end side of the cartridge assembly after the guide is in the second state.

The embodiment of the invention provides a guide assembly, which is used for a nail bin assembly of a circular tube type anastomat, wherein the nail bin assembly comprises a nail barrel, and the side wall of the nail barrel is provided with at least one window;

the guide assembly includes a guide having a first state and a second state, the guide having a first stiffness when in the first state, the guide being at least partially disposed on the distal side of the cartridge and fixed relative to the cartridge;

when the guide piece is in the second state, the guide piece at least partially has a second hardness, the second hardness is smaller than the first hardness, and when the guide piece is pulled towards the proximal side, the guide piece can be separated from the nail barrel through the window.

In some embodiments, the guide enters the second state when the guide is in the first state and the temperature of the guide increases.

In some embodiments, the cartridge further comprises a heating element for passing through the window into the interior of the cartridge to raise the temperature of the guide into the second state.

In some embodiments, when the guide is in the first state and the guide is in contact with a liquid within a set temperature range, the guide increases in temperature and enters the second state.

In some embodiments, the guide is a guide made of bio-plastic.

In some embodiments, the guide is helically wound from a ribbon, the guide is in the second state, and when the guide is pulled proximally, the guide is helically collapsible into a ribbon-like structure to separate from the cartridge through the window.

In some embodiments, the guide comprises: the banded piece is equipped with electric heating wire or electric heating film, electric heating wire or electric heating film circular telegram back, the banded piece temperature rises and gets into the second state, just when the guiding piece received the pulling force towards near-end side, the banded piece with but electric heating wire or electric heating film spiral disintegration together are banded structure and pass the window with the nail section of thick bamboo separation.

In some embodiments, the guide comprises:

a guide portion provided at a distal end side of the cartridge;

the positioning part is positioned inside the nail barrel;

and the pull-out part is fixedly connected with the guide part through the positioning part, and when the pull-out part is pulled towards the proximal side direction of the anastomat, the pull-out part can pull the guide part and the positioning part to move towards the proximal side direction of the anastomat until the guide part is separated from the distal side of the nail barrel.

In some embodiments, the guiding portion and the positioning portion are formed by spirally surrounding the same band, the pulling portion is a part of the band, the guiding member is in the second state, and when the pulling portion is pulled towards the proximal side, the guiding member can be spirally disassembled into a band-shaped structure to be separated from the nail barrel through the window.

In some embodiments, the guide assembly further comprises a flexible outer sleeve, the outer sleeve is sleeved outside the guide part, and the outer sleeve is fixedly connected with the guide part;

the outer cover comprises a first outer cover portion and a second outer cover portion which are integrally formed, the first outer cover portion is sleeved on the outer side of the guide portion, and the second outer cover portion is at least partially sleeved on the outer side of the positioning portion.

In some embodiments, the positioning part comprises an outer sleeve matching part at the far end side and a nail barrel matching part at the near end side, the second outer sleeve part is sleeved outside the outer sleeve matching part, and the outer diameter of the outer sleeve matching part is smaller than that of the nail barrel matching part.

In some embodiments, a clamping part is arranged on the proximal end side of the pulling part, the clamping part is fixed at the window, and the clamping part does not protrude out of the outer side surface of the nail barrel.

In some embodiments, the stapler further comprises an elbow disposed on a proximal side of the cartridge, the guide assembly further comprising a protective sheath at least partially covering an outer side of the elbow;

the proximal end side of the pulling part extends out of the window and extends to the bent pipe, and the part of the pulling part corresponding to the bent pipe is located between the outer side surface of the bent pipe and the inner side surface of the protective sleeve.

In some embodiments, the guide has a maximum outer diameter that is less than or equal to the outer diameter of the distal side of the cartridge;

the distal outer diameter of the guide is smaller than the proximal outer diameter of the guide.

In some embodiments, the outer wall surface of the guide is at least partially coated with a hydrophobic coating.

In some embodiments, the outer wall surface of the guide assembly is at least partially coated with a lubricating layer.

In some embodiments, a cavity is formed in the guide and extends through at least the proximal face of the guide in the axial direction of the cartridge.

In some embodiments, the guide assembly further comprises a water tube, a distal side of the water tube being located inside the cavity, a proximal side of the water tube protruding outside the cartridge.

In some embodiments, at least one water outlet hole is formed in the side wall of the water pipe, located inside the cavity, of the water pipe, and the water outlet holes are sequentially arranged along the extending direction of the water pipe.

In some embodiments, the guide assembly further comprises a pull cord and a liquid container disposed in the cavity, the liquid container comprising a sealed sleeve and a liquid stored in the sealed sleeve within a set temperature range, the pull cord being fixedly connected to the sealed sleeve of the liquid container;

when the pull rope is pulled towards the proximal side direction of the anastomat, the seal sleeve can be pulled by the pull rope, so that the seal sleeve is damaged to release stored liquid.

The guide assembly and the circular tube type anastomat provided by the invention have the following advantages:

the invention provides a guide component for a circular tube type anastomat, wherein the guide component has higher first hardness when being in a first state, can well guide a nail bin component to enter tissues, reduces the damage to the tissues in the movement process of the nail bin component, and protects the stump tissues and the mucosa layer of the tissues; when the guide piece enters the second state, the guide piece can be pulled more easily to move towards the direction of the proximal end side of the anastomat due to the fact that the hardness of the guide piece is reduced, so that the guide piece can be removed from the distal end side of the nail bin assembly conveniently after the guide piece reaches the operation position, the percussion process of the anastomat cannot be obstructed, operation is simple, and use is convenient.

Drawings

Other features, objects and advantages of the present invention will become more apparent upon reading of the following detailed description of non-limiting embodiments thereof, with reference to the accompanying drawings.

FIG. 1 is a schematic structural view of a guide assembly of a first embodiment of the present invention applied to a staple cartridge;

FIG. 2 is a schematic structural view of a guide assembly according to a first embodiment of the present invention;

FIG. 3 is a schematic view of a guide assembly of a second embodiment of the present invention applied to a staple cartridge;

FIG. 4 is a schematic structural view of a guide assembly according to a third embodiment of the present invention;

FIG. 5 is a schematic structural view of a guide assembly of a third embodiment of the present invention applied to a staple cartridge;

FIG. 6 is a schematic structural view of a guide assembly according to a fourth embodiment of the present invention;

FIG. 7 is a schematic structural view of a guide assembly of a fourth embodiment of the present invention applied to a staple cartridge;

FIG. 8 is a schematic structural view of a fifth embodiment of the guide assembly of the present invention applied to a staple cartridge;

FIG. 9 is a schematic structural view of a guide assembly of a sixth embodiment of the present invention applied to a staple cartridge;

FIG. 10 is a schematic structural view of a guide assembly of a seventh embodiment of the present invention applied to a staple cartridge;

FIG. 11 is a schematic view of a protective sheath according to a seventh embodiment of the invention;

FIG. 12 is a schematic structural view of a guide assembly of an eighth embodiment of the present invention applied to a staple cartridge;

FIG. 13 is a schematic structural view of a guide assembly of a ninth embodiment of the present invention applied to a cartridge;

fig. 14 is a schematic structural view of a liquid container according to a ninth embodiment of the present invention;

FIG. 15 is a schematic structural view of a guide assembly of a tenth embodiment of the present invention applied to a staple cartridge;

FIG. 16 is a schematic structural view of a guide assembly of an eleventh embodiment of the present invention applied to a staple cartridge; FIG. 17 is a schematic structural view of a guide assembly according to an eleventh embodiment of the present invention;

fig. 18 is a schematic structural view of a guide assembly according to a twelfth embodiment of the present invention.

Reference numerals:

1 guide 23 fastener

11 guide part 3 pull rope

111 leading portion distal end side 31 pulling the distal end side of the cord

112 proximal side of the guide portion 32 stay proximal side of

113 jacket joint 33 cable end joint

12 positioning part 4 protective sleeve

Distal end side 5 water pipe of 121 positioning part

122 distal side of the proximal side 51 of the positioning section

123 proximal side of fitting 52 water pipe of jacket

124 nail barrel matching part 53 water pipe line head joint

125 chamfer 6 liquid container

13 drawing part 61 liquid container distal end side

131 catch 62 proximal side of liquid container

14 cavity 63 sealing sleeve

141 distal end side 8 cartridge of hollow

142 proximal side of cavity 81 distal side of the cartridge

15 proximal side of heating element 82 cartridge

2 outer cover 83 window

21 distal 9 bend of jacket

22 proximal side of the outer sleeve

Detailed Description

Example embodiments will now be described more fully with reference to the accompanying drawings. Example embodiments may, however, be embodied in many different 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 example embodiments to those skilled in the art. The same reference numerals in the drawings denote the same or similar structures, and thus their repetitive description will be omitted.

The invention provides a guide assembly which is used for a nail bin assembly of a circular tube type anastomat. The guide assembly includes a guide having a first state and a second state, the guide having a first stiffness when the guide is in the first state, the guide being at least partially disposed on the distal side of the cartridge and fixed relative to the cartridge, the guide having a second stiffness when the guide is in the second state, the second stiffness being less than the first stiffness, the guide being separable from the cartridge through the window when the guide is subjected to a pulling force directed toward the proximal side.

In operation, it is desirable to have the staple cartridge assembly enter the interior of tissue, move forward to a surgical position, and interface with an anvil assembly that is at least partially disposed within another section of tissue. At the moment, the guide piece is in the first state, has higher hardness, can keep a certain fixed shape, and is used for better guiding the nail bin assembly to enter a surgical site, reducing the damage to tissues in the movement process of the nail bin assembly and protecting stump tissues and mucosa layers of the tissues. The overall profile of the guide may be an arrangement in which the cross-sectional area gradually increases in the direction from the distal side to the proximal side, for example, in the shape of: conical, oval, etc., as long as the shape that can achieve the guidance is possible. After the nail bin assembly reaches the operation position, the guide piece can be softened and enters the second state, and the guide piece can be conveniently removed from the distal end side of the nail barrel, so that the firing process of the anastomat is not obstructed, the operation is simple, and the use is convenient.

The structure of the guide assembly according to various embodiments of the present invention will be described in detail with reference to the accompanying drawings, and it should be understood that the scope of the present invention is not limited by the embodiments.

Referring to fig. 1 and 2, the guide assembly of the first embodiment of the present invention is shown in a schematic view of the structure of the guide assembly cooperating with the cartridge 8, and the cartridge 8 is provided with a window 83. Wherein the guide assembly is shown in cross-section with a cross-sectional direction parallel to the axial direction of the cartridge 8. Wherein the guide assembly comprises a guide 1. The guide 1 has a first state and a second state, and when the guide 1 is in the first state, the guide 1 has a first hardness, is at least partially disposed on the distal side of the cartridge 8, and is fixed relative to the cartridge 8, and can provide a good guiding function for the cartridge 8 to enter the tissue. After the cartridge 8 is advanced into the tissue, the guide 1 may be softened and brought into a second state, in which the guide 1 has a second hardness, the second hardness being smaller than the first hardness, and in which the guide 1 is pulled in a proximal direction of the stapler, the guide 1 is softened and easily deformed, and the guide 1 may be conveniently pulled in the proximal direction, so that the guide 1 is pulled out of the viewing window 83, and the guide 1 is disengaged from the distal side 81 of the cartridge 8 without affecting the surgical procedure.

In this embodiment, the switching of the guide 1 from the first state to the second state may be such that the guide 1 enters the second state in which the hardness is relatively small when the temperature of the guide 1 is increased by increasing the temperature of the guide 1, that is, when the guide 1 is in the first state and the guide 1 is heated to increase the temperature of the guide 1. In other alternative embodiments, it is further contemplated that the first state of the guide 1 may be switched to the second state in other ways, for example, by contacting the guide 1 with a liquid in a set temperature range, and by exchanging heat between the guide 1 and the liquid, the guide 1 is heated and softened, and enters the second state, which are within the protection scope of the present invention. Here, the set temperature range differs depending on the characteristics of different materials, and it is sufficient that the hardness of the guide 1 becomes small after the temperature is raised and the guide is easily deformed. For example, the set temperature range may be selected to be 30 ℃ to 50 ℃. In this embodiment, the guide 1 has a high hardness in the first state, and can effectively guide and maintain a guiding function even when it is subjected to a pressure of a tissue such as an intestinal tract; meanwhile, the fixing of the guide piece and the nail barrel component is facilitated, when the surgical position is not reached, the process that the anastomat passes through the inside of the tissue is avoided, when the user possibly conducts operations such as direction adjustment, the guide piece and the nail barrel component cannot be separated accidentally, and stable and reliable relative fixed connection is kept. When the guide 1 enters the second state, the rigidity of the guide is reduced, and the guide can be separated from the view window of the nail barrel assembly without influencing the next operation of the operation.

The guide member 1 has a first hardness in a first temperature range, and the guide member 1 becomes soft and has a second hardness smaller when it is heated to reach a second temperature range. The second temperature range is higher than the first temperature range. The guide 1 may be made of, for example, a thermoplastic polymer material, and when the temperature is raised, the molecular chains of the polymer change to lower the hardness. The guide 1 is made of a biocompatible material. In one embodiment, the guide 1 may be made of bio-plastic, such as starch-based bio-plastic, but the invention is not limited thereto.

In this embodiment, the distal side and the proximal side are relative to the operator, the end closer to the operator is the proximal side, the end farther from the operator, i.e. the end closer to the surgical site, is the distal side, and the direction along the axial center of the stapler is the axial direction, 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 perspective of FIG. 1, the distal side 81 is the upper side and the proximal side 82 is the lower side of the cartridge 8. In the present invention, the inside and the outside of one member are relative to the axis of the barrel 8, and the side close to the axis is the inside and the side far from the axis is the outside.

As shown in fig. 1 and 2, in this embodiment, in the first state, the guide member 1 is formed by a band member having a first hardness being spirally wound. When the guide 1 is heated and the temperature rises or is contacted with liquid in a set temperature range and the temperature rises, the belt-shaped member at least partially becomes soft and has a second hardness, the guide 1 enters a second state, the guide 1 is pulled towards the proximal side direction, and the guide 1 can be spirally disassembled into a belt-shaped structure and is separated from the nail barrel through the window. The guide 1 can be gradually spirally disassembled from the distal end side thereof to the proximal end side thereof, or from the proximal end side thereof to the distal end side thereof when spirally disassembled.

In this embodiment, the outer wall surface of the guide 1 may be at least partially lubricious or coated with a lubricious layer to enhance the guiding effect of the cartridge assembly and further reduce the friction between the guide 1 and the tissue. The lubricating layer can be formed by coating with water-based lubricant or oil-based lubricant which is available in the prior art, and can also be coated and lubricated by solid medical vaseline and the like. For example, hydrophilic coating of the outer wall surface of the guide 1, in which the outer surface of the guide 1 is dipped with water before use, becomes very lubricious, has been widely used in the surgical field.

In another alternative embodiment, the outer wall surface of the guide 1 may also be at least partially coated with a hydrophobic coating. When the nail bin assembly enters the tissue, the hydrophobic coating can isolate the outer wall surface of the guide 1 from body fluid or other liquid in the tissue, and the situation that when the nail bin assembly does not reach the operation position, the outer wall surface of the guide 1 is contacted with other liquid with higher temperature, so that the guide effect is affected due to the fact that the guide 1 is partially softened is avoided. After the nail bin assembly reaches the operation position, the guide piece 1 can be heated and softened by injecting liquid with a set temperature range into the nail barrel 8 or putting a heating element into the nail barrel. The hydrophobic coating applied on the outer lateral surface of the guide 1 may be a hydrophobic coating already known in the art, and preferably a hydrophobic coating having a better biocompatibility. Further, in order to achieve a better guiding effect, a lubricating layer may be further coated on the outer portion of the hydrophobic coating layer of the outer wall surface of the guide 1. The lubricating layer may be the above-mentioned aqueous lubricating layer, oil lubricating layer, hydrophilic coating layer, solid lubricating layer, or the like.

As shown in fig. 1 and 2, the guide member 1 includes a guide portion 11, a positioning portion 12, and a pull-out portion 13, and the guide portion 11 and the positioning portion 12 are formed by being surrounded by the same belt, i.e., a proximal end side 112 of the guide portion 11 is connected to a distal end side 121 of the positioning portion 12. The pull-out part 13 may be a part fixedly connected to the positioning part 12 and protruding outwards from the proximal side 122 of the positioning part 12, or may be a part of the strip. When the pulling-out part 13 is pulled towards the proximal side direction of the anastomat, the pulling-out part 13 can pull the positioning part 12 and the guiding part 11 to be spirally disassembled, and simultaneously pull the positioning part 12 and the guiding part 11 to move towards the proximal side direction of the anastomat together, so that the guiding part 11 is separated from the distal end side 81 of the nail barrel 8.

As shown in FIG. 1, the guide assembly may further include a pull cord 3, a distal side 31 of the pull cord 3 being connected to the pull out portion 13, and a proximal side 32 of the pull cord 3 extending from the viewing window 83 of the cartridge 8 beyond the cartridge 8. After the guide 1 reaches the surgical site along with the staple cartridge assembly, the operator pulls the pull cord 3 to the proximal end side, and can pull the guide 1 to the proximal end side through the pull-out portion 13, further pull the pull cord 3, and can pull the guide 1 as a whole out of the staple cartridge 8 through the window 83.

In this embodiment, when the guide 1 is in the first state, the positioning part 12 is located inside the nail barrel 8, and the positioning part 12 is in interference fit with the inner side wall of the nail barrel 8, so that the guide assembly can be conveniently mounted. And after the positioning part 12 is heated and softened, the positioning part 12 can be conveniently removed from the nail barrel 8. In other alternative embodiments, the positioning portion 12 may be detachably connected to the inner side wall of the nail barrel 8 by other means, such as a detachable fastener.

In this embodiment, as shown in FIG. 2, to provide a better guiding effect, the distal side 111 of the guide 11 has a smaller outer diameter than the proximal side 112 of the guide 11 in the first state, so that the cartridge 8 can be better guided into and moved within the tissue. The locating portion 12 may be cylindrical to conform to the internal shape of the cartridge 8. In this embodiment, the place where the outer diameter of the guide 1 is the largest is the position of the proximal end side 112 of the guide portion 11. Further, in the first state, the maximum outer diameter of the guide 1 is smaller than or equal to the outer diameter of the distal side 81 of the cartridge 8, so that the outer diameter of the cartridge 8 is not affected, and the difficulty of moving the cartridge assembly in the tissue is not increased due to the presence of the guide 1.

Fig. 3 is a schematic structural view of the guide assembly according to the second embodiment of the present invention applied to a cartridge. This embodiment differs from the first embodiment in that: the guide assembly further comprises a flexible outer sleeve 2. The outer sleeve 2 is sleeved outside the guide piece 1, so that a certain liquid blocking effect is achieved on the guide piece 1, when the nail cartridge assembly moves in tissues and does not reach a surgical position, the outer sleeve 2 blocks the guide piece 1 from being directly contacted with liquid, and the guide effect is prevented from being influenced by the fact that the guide piece 1 is contacted with the liquid and becomes soft in the guide process. On the other hand, the outer casing 2 may have a smoother outer surface than the guide 1, which may further reduce the friction between the guide assembly and the tissue, thereby further reducing the damage to the tissue. Further, in this embodiment, the outer side of the jacket 2 may be at least partially lubricious or coated with a lubricious layer, which may be an overlying water-based lubricious layer, hydrophilic coating, oil-based lubricious layer, or solid lubricious layer. For example, by hydrophilic coating of the outer surface of the jacket 2, the outer surface of the jacket 2 becomes very lubricious when dipped in water before use.

After the outer sleeve 2 is added, in an initial state, the guide member 1 is in the first state, the maximum outer diameter of the integral structure of the outer sleeve 2 and the guide member 1 is the proximal end side position of the first outer sleeve portion 21, and the maximum outer diameter of the integral structure of the outer sleeve 2 and the guide member 1 is preferably smaller than or equal to the outer diameter of the cartridge magazine 8, so that the outer diameter of the cartridge magazine 8 is prevented from being adversely affected, and the difficulty of movement of the cartridge magazine 8 in the tissue is increased.

The outer casing 2 is preferably made of a flexible film and may further be made of a film having a certain elasticity, but it is also possible that it is not elastic. For example, the outer jacket 2 may be made of a flexible rubber material, a silicone material, a plastic material, or the like, and the thickness of the outer jacket 2 may be less than 0.2 mm, and further may be less than 0.1 mm and greater than 0.01 mm. In alternative embodiments, the jacket 2 may have other thickness dimensions, and is not limited to the ranges set forth herein. The jacket 2 may also be made of a flexible fabric, such as a woven fabric, a knitted fabric, etc., and the material used for the fabric may be a rayon material or a spun yarn obtained by a polymer extrusion method, etc. And the outer casing 2 is preferably made of an elastic fabric.

As shown in fig. 4 and 5, it is a schematic structural view of the guide assembly of the third embodiment of the present invention applied to the cartridge 8. This embodiment differs from the first embodiment in that: a cavity 14 is formed in the guide 1, the cavity 14 extending through at least the proximal end surface of the guide 1 in the axial direction of the cartridge 8. Due to the cavity 14, the filling volume of the guide 1 is greatly reduced, the length of the belt-shaped part of the guide 1 is greatly reduced, and after the guide 1 is heated and softened, a doctor pulls the guide 1 out of the nail barrel 8 through the pull-out part 13 and the pull rope 3, so that more time can be saved. In this embodiment, the proximal side 142 of the cavity 14 is connected to the proximal side 122 of the positioning portion 12, and the distal side 141 of the cavity 14 is connected to the interior of the guiding portion 11. The cavity 14 is arranged, so that the positioning part 12 is a hollow annular structure, the elastic deformation capacity of the positioning part 12 can be increased, the positioning part 12 can yield to the central part when the nail barrel assembly is loaded into the guide part 1, the nail barrel assembly can be more easily entered, and the nail barrel assembly can be more tightly fixed with the nail barrel assembly after entering.

As shown in fig. 6 and 7, the structure of the guide assembly of the fourth embodiment of the invention applied to the nail barrel 8 is schematically shown. This embodiment differs from the third embodiment in that: the distal side 141 of the cavity 14 is further connected to the distal side 111 of the guide 11. In other alternative embodiments, the size, shape and structure of the cavity 14 may be different from those shown in fig. 4 to 7, for example, the cavity 14 may be located entirely in the positioning portion 12 or entirely in the guiding portion 11, and all of them fall within the protection scope of the present invention.

Fig. 8 is a schematic structural diagram of a guide assembly according to a fifth embodiment of the present invention. This embodiment differs from the first embodiment in that: since the proximal end side of the pulling portion 13 protrudes out of the barrel 8 through the window 83 of the barrel 8, the surgeon can directly operate the pulling portion 13 to pull the guide 1 to the proximal end side without providing a separate pull cord.

In the fifth embodiment, the guide assembly further comprises a heating element 15, and the heating element 15 can enter the nail barrel 8 through the window 83 to heat the guide 1 until the guide 1 reaches a temperature range in which the hardness thereof becomes smaller, and then the heating is completed. After the heating is completed, the heating element 15 can be removed from the cartridge 8 through the window 83. The heating member 15 may be, for example, a heating rod wound with an electric heating wire, but the invention is not limited thereto, and in other embodiments, the heating member 15 may be attached to or embedded with other heating elements, and may also have other shapes, which are within the protection scope of the invention. The heating member 15 may also be applied to the first and second embodiments described above, and also to the third and fourth embodiments described above, and when heating is required, the heating member 15 is extended into the cavity 14 of the guide 1, thereby facilitating heat conduction to the guide 1.

In another alternative embodiment, the guiding assembly further comprises a heating element, wherein when the guiding member 1 is formed by spirally winding a belt-shaped member, the heating element may be a flexible electric heating wire embedded in at least a part of the belt-shaped member, a proximal end of the electric heating wire is outside the body, and when the electric heating wire is energized, the temperature of the belt-shaped member may be raised to enter the second state. When the temperature of the tape rises into the second state and the guide 1 is subjected to a pulling force towards the proximal side, the tape together with the electric heating wire can be helically disintegrated into a tape-like structure to be separated from the cartridge 8 through the window 83. The structure of the electric heating wire can be combined with the structures of the guiding components of the first to fifth embodiments, and the combined guiding components are all within the protection scope of the present invention.

In yet another alternative embodiment, the guiding assembly further comprises a heating element, which may be a flexible electrical heating film, covering at least a portion of the outer surface of the strip, which, when energized, raises the temperature of the strip into the second state. When the temperature of the belt-shaped member rises to enter the second state and the guide member 1 is subjected to a pulling force towards the near-end side, the belt-shaped member and the electric heating wire or the electric heating film can be spirally disassembled into a belt-shaped structure together to pass through the window to be separated from the nail barrel. The structure of the electric heating film can be combined with the structures of the guiding assemblies of the first to fifth embodiments, and the combined guiding assemblies are all within the protection scope of the present invention. Fig. 9 is a schematic structural view of the guide assembly according to the sixth embodiment of the present invention applied to the cartridge 8. The difference between this embodiment and the first embodiment is that the proximal end side of the pull-out portion 13 is provided with a catch 131 to detachably fix the pull-out portion 13 to the cartridge 8 when the guide 1 is in the first state, better maintaining the positional stability of the guide 1. In this embodiment, the retainer 131 is fixed at the window 83, and the retainer 131 does not protrude from the outer side of the staple cartridge 8, so as to prevent the tissue from being damaged by the direct contact between the retainer 131 and the tissue when the staple cartridge 8 moves in the tissue.

Fig. 10 and 11 are schematic structural views of a guide assembly according to a seventh embodiment of the present invention. The stapler further comprises an elbow 9 provided at a proximal side of the cartridge 8, the proximal side of the pull-out portion 13 extending to a position of the elbow 9. This embodiment differs from the first embodiment in that the guide assembly further comprises a protective sheath 4 at least partially covering the outer side of the elbow 9, the portion of the pull-out 13 corresponding to the elbow 9 being located between the outer side of the elbow 9 and the inner side of the protective sheath 4. The elbow 9 prevents the pull-out portion 13 from damaging the tissue as the cartridge assembly is advanced into the tissue. The elbow 9 is preferably made of a flexible material, such as rubber, silicone, plastic, etc., and may be made of TPE (Thermoplastic Elastomer) material, for example. The surface of the bent pipe 9 is an arc surface which is matched with the shape of the outer side surface of the bent pipe 9, so that the surface of the bent pipe 9 is better attached.

Fig. 12 is a schematic structural view of the guide assembly according to the eighth embodiment of the present invention applied to the cartridge 8. This embodiment differs from the sixth embodiment in that: the guide assembly further comprises a water pipe 5. The distal side 51 of the water tube 5 is located inside the cavity 14 and the proximal side 52 of the water tube 5 protrudes outside the cartridge 8, the water tube 5 being used to deliver a liquid within a set temperature range to the lead 1.

With the guide assembly of this embodiment, when the cartridge 8 enters and moves in the tissue, the water tube 5 is not filled with liquid, the guide 1 is maintained in the first state, and after the cartridge 8 reaches the surgical site, a liquid (e.g., physiological saline, pure medical water, etc.) of a predetermined temperature range, for example, 30 to 50 ℃ can be filled into the cavity 14 from the proximal end 52 of the water tube 5, but the present invention is not limited to this temperature range, and the guide 1 is brought into contact with the liquid at the cavity 14 and heat-exchanged to thereby be warmed and softened, and then, the guide 1 is brought into the second state, where the pull-out portion 13 is pulled to pull the guide 1 out of the cartridge 8.

In this exemplary embodiment, the water tube 5 is fixedly connected to the extension 13 at a thread end connection 53. Thus, the water tube 5 can function as a pull cord in addition to operating as an injection fluid. After the guide 1 has been brought into the second state, the pull-out part 13 can be moved proximally by pulling the water tube 5 in the proximal direction, gradually pulling the guide 1, so that the guide part 11 of the guide 1 is disengaged from the distal side 81 of the cartridge 8 and the guide 1 can be pulled out together with the water tube 5 further from the viewing window 83. The side wall of the water pipe 5 in the cavity 14 is provided with at least one water outlet hole, so that liquid can be injected into the cavity 14. The water outlet holes may be further distributed along the extending direction of the water pipe 5, and simultaneously, liquid is injected into the cavity 14 from the plurality of water outlet holes, so as to increase the temperature rising speed of the guide member 1 due to heat exchange with the liquid, and the guide member 1 is rapidly brought into the second state.

Fig. 13 and 14 are schematic structural views of the guide assembly of the ninth embodiment of the invention applied to the nail barrel 8. In this embodiment, the guiding assembly further includes a pulling rope 3 and a liquid container 6 disposed in the cavity 14, the liquid container 6 includes a sealing sleeve 63 and a liquid (e.g. physiological saline, pure medical water, etc.) stored in the sealing sleeve 63 within a set temperature range, such as 30-50 ℃, but the invention is not limited to this temperature range, and the pulling rope 3 is fixedly connected to the sealing sleeve 63 of the liquid container 6. The sealing sleeve 63 is preferably made of a readily breakable film, and for example, a thin film of silicone, rubber, plastic, or the like having a small thickness may be used. When the seal sleeve 63 is pulled in the proximal direction by the pull cord 3, the seal sleeve 63 is broken by the pull cord 3, and the liquid stored in the seal sleeve 63 is released.

Further, in order to facilitate the tearing of the sealing sleeve 63, a tear line which is easily torn may be preset on the sealing sleeve 63, the tear line may extend in the axial direction of the nail barrel 8 or in the circumferential direction of the sealing sleeve 63, and when the sealing sleeve 63 is pulled in the proximal direction by the pulling rope 3, the sealing sleeve 63 is broken at the tear line, thereby releasing the liquid stored inside. The guide 1 is contacted with liquid at the cavity 14, so that the temperature is gradually increased and softened by heat exchange, and the second state is entered, at this time, the pulling part 13 can be pulled to pull the guide 1 out of the nail barrel 8.

In this embodiment, the pull cord 3 is fixedly connected to the pull-out section 13 at a cord connection 33. Thus, the pull cord 3 may not only act as a means to break the gland 63 to release the liquid, but may further act as a pull-out means to remove the guide 1 from the cartridge 8. In this embodiment, the shape of the liquid container 6 is adapted to the shape of the cavity 14. The position of the distal side 61 and the proximal side 62 of the liquid container 6 corresponds to the position of the distal side 141 and the proximal side 142 of the cavity 14, respectively. In other alternative embodiments, the liquid container 6 may also take other shapes.

In each of the embodiments shown in fig. 4 to 14, a guide member without the outer cover 2 is described as an example. It will be appreciated that the structural improvements of the various embodiments shown in figures 4 to 14 can also be applied to the structure of the guide assembly with the outer casing 2 in figure 3.

Fig. 15 is a schematic structural view of a guide assembly according to a tenth embodiment of the present invention. This embodiment differs from the first embodiment in that: the guide 1 is of one-piece construction. When the guide member 1 is moved from the first state to the second state, the guide member 1 is softened and can be removed from the window 83 as a whole and separated from the cartridge 8.

Fig. 16 and 17 are schematic structural views of a guide assembly according to an eleventh embodiment of the present invention. This embodiment differs from the tenth embodiment in that: the guide assembly further comprises an outer casing 2. The jacket 2 may be made of the material of the jacket 2 of the second embodiment as described above, and the outer surface of the jacket 2 may be coated with the hydrophobic coating and/or the lubricating layer as described above in the second embodiment.

In this embodiment, the outer jacket 2 is fixedly connected to the guide 1. For example, the jacket 2 may be connected to the guide portion 11 of the guide 1 at a jacket connection 113 by a top tie 23. In other alternative embodiments, the outer jacket 2 and the guide 1 may be connected in other ways at other positions. Since the outer sleeve 2 is fixedly connected to the guide 1, when the pull cord 3 is pulled toward the proximal end side and the guide 1 is pulled out from the magazine 8 by the pull-out portion 13 through the pull-out portion 3, the outer sleeve 2 can be pulled out from the magazine 8 at the same time. The outer jacket 2 is of a thin-walled construction so as not to affect the outer diameter of the guide assembly. In production, the outer sleeve 2 can adopt an injection molding process, so that the fastening buckle 23 and the outer sleeve 2 are integrally formed.

As shown in fig. 16 and 17, in this embodiment, the outer cover 2 includes a first outer cover portion 21 and a second outer cover portion 22 which are integrally formed, the first outer cover portion 21 is disposed on the outer side of the guide portion 11 and has a shape corresponding to the shape of the guide portion 11, and the second outer cover portion 22 is disposed on the outer side of the positioning portion 12 and has a shape corresponding to the shape of the positioning portion 12. The inner side of the top of the first casing section 21 forms a catch 23 which is fixedly connected to the distal end side 111 of the guide section 11. Since the guide assembly shown in fig. 16 and 17 is shown in cross-section. It will be appreciated that the first casing 21 in this embodiment completely covers the outer side wall of the guide 11.

The structure of the jacket 2 and the matching structure of the jacket 2 and the guide 1 according to this embodiment may be combined with the guide assembly structure according to the first to ninth embodiments, and are within the protection scope of the present invention.

Fig. 18 is a schematic structural view of a guide assembly according to a twelfth embodiment of the present invention. This embodiment differs from the eleventh embodiment in that: the height of the second outer sleeve part 22 of the outer sleeve 2 along the axial direction of the nail barrel 8 is smaller than the height of the positioning part 12 along the axial direction of the nail barrel 8, so that the size of the second outer sleeve part 22 can be reduced, and the material use of the outer sleeve 2 is saved. In this embodiment, in order to achieve the engagement of the guide 1 with the outer sleeve 2 and the cartridge 8, the positioners 12 include an outer sleeve engaging portion 123 on the distal end side and a cartridge 8 engaging portion 124 on the proximal end side, the second outer sleeve portion 22 is fitted over the outer sleeve engaging portion 123, and the outer diameter of the outer sleeve engaging portion 123 is smaller than the outer diameter of the cartridge 8 engaging portion 124. Further, in this embodiment, the outer edge of the proximal end side of the positioning part 12 is provided with a chamfer 125, so that the positioning part 12 can be more conveniently mounted inside the cartridge 8 before the operation.

The structures of the first to ninth embodiments described above may be combined with the structures of the tenth to twelfth embodiments. For example, the guides 1 of the tenth to twelfth embodiments may be provided with cavities as in the third or fourth embodiment. The guide assembly of the tenth to twelfth embodiments may also include the heating member 15 of the fifth embodiment, or a structure including an electric heating wire embedded in at least a portion of the guide member 1 or an electric heating film wrapping at least a portion of the guide member 1. The guide assembly of the tenth through twelfth embodiments may also include the catch of the sixth embodiment and/or the elbow of the seventh embodiment. The guide 1 of the tenth to twelfth embodiments may include the water pipe of the eighth embodiment or the liquid container of the ninth embodiment. The structures of the guide assemblies obtained by various combinations belong to the protection scope of the invention.

The guide assembly provided by the invention can be independently placed without being arranged on the nail barrel part of the anastomat before being used, and can be selectively arranged by a user according to the requirement, the operation is simpler, and only the guide piece needs to be arranged on the far end side of the nail barrel; can also be directly arranged on the nail barrel part of the anastomat without being arranged by the user.

When the guide assembly is applied to a anastomat, the use method of the guide assembly comprises the following steps:

s100: disposing the guide in the first state on a distal side of the cartridge while the guide has a first hardness, the guide being at least partially located in the cartridge and fixed relative to the cartridge;

s200: the anastomat is operated, so that the guide piece enters the tissue along with the nail barrel, the guide piece can provide a good guide effect for the nail barrel to enter the tissue, the damage to the tissue in the moving process of the nail bin assembly is reduced, and the stump tissue and the mucous membrane layer of the tissue are protected;

s300: after the nail barrel enters the tissue, the guide piece is softened and enters the second state, and the guide piece has a second lower hardness;

s400: the guide piece is pulled towards the proximal side of the anastomat, the guide piece in the second state is removed from the distal side of the nail barrel, the operation process is not influenced, and the operation is very simple and convenient.

In this embodiment, in the step S300, when the guide is softened, the guide may be heated or a liquid in a set temperature range may be injected so that the guide is heated and the hardness is reduced.

In step S400, the guide may be pulled toward the proximal end of the stapler by a pulling portion provided at the proximal end of the guide, or may be pulled by a water pipe or a pulling rope connected to the pulling portion.

In conclusion, the guide component for the circular tube type anastomat provided by the invention has higher first hardness when being in the first state, can well guide the nail bin component to enter tissues, reduces the damage to the tissues in the movement process of the nail bin component, and protects the stump tissues and the mucosa layer of the tissues; when the guide enters the second state, the guide can be pulled more easily to move towards the direction of the proximal end side of the anastomat due to the fact that the hardness of the guide is reduced, so that the guide can be conveniently removed from the distal end side of the nail bin assembly after reaching the operation position, the firing process of the anastomat cannot be obstructed, operation is simple, and use is convenient.

The foregoing is a more detailed description of the invention in connection with specific preferred embodiments and it is not intended that the invention be limited to these specific details. For those skilled in the art to which the invention pertains, several simple deductions or substitutions can be made without departing from the spirit of the invention, and all shall be considered as belonging to the protection scope of the invention.

Claims (20)

1. The guide assembly is characterized by being used for a nail bin assembly of a circular tube type anastomat, the nail bin assembly comprises a nail barrel, and the side wall of the nail barrel is provided with at least one window;

the guide assembly includes a guide having a first state and a second state, the guide having a first stiffness when in the first state, the guide being at least partially disposed on the distal side of the cartridge and fixed relative thereto;

when the guide piece is in the second state, the guide piece at least partially has a second hardness, the second hardness is smaller than the first hardness, and when the guide piece is pulled towards the proximal side, the guide piece can be separated from the nail barrel through the window.

2. The guide assembly of claim 1, wherein the guide enters the second state when the guide is in the first state and the temperature of the guide increases.

3. The guide assembly of claim 2, further comprising a heating element for passing through the window into the interior of the cartridge to raise the temperature of the guide and into the second state.

4. The guide assembly of claim 1, wherein when the guide is in the first state and the guide is in contact with a liquid within a set temperature range, the guide increases in temperature and enters the second state.

5. The guide assembly of claim 1, wherein the guide is a guide made of bio-plastic.

6. The guide assembly of claim 1, wherein the guide is helically coiled from a ribbon, the guide is in the second state, and the guide is helically collapsible into a ribbon configuration to separate from the cartridge through the window when the guide is pulled proximally.

7. The guide assembly of claim 6, wherein the guide comprises: the banded piece is equipped with electric heating wire or electric heating film, electric heating wire or electric heating film circular telegram back, the banded piece temperature rises and gets into the second state, just when the guiding piece received the pulling force towards near-end side, the banded piece with but electric heating wire or electric heating film spiral disintegration together are banded structure and pass the window with the nail section of thick bamboo separation.

8. The guide assembly of claim 1, wherein the guide comprises:

a guide portion provided at a distal end side of the cartridge;

the positioning part is positioned inside the nail barrel;

and the pull-out part is fixedly connected with the guide part through the positioning part, and when the pull-out part is pulled towards the proximal side direction of the anastomat, the pull-out part can pull the guide part and the positioning part to move towards the proximal side direction of the anastomat until the guide part is separated from the distal side of the nail barrel.

9. The guide assembly of claim 8, wherein the guide portion and the positioning portion are formed by spirally winding the same band, and the pull-out portion is a part of the band, the guide is in the second state, and when the pull-out portion is pulled proximally, the guide is spirally disassembled into a band-like structure to be separated from the cartridge through the window.

10. The guide assembly of claim 8, further comprising a flexible outer sleeve disposed over an exterior of the guide member, the outer sleeve being fixedly coupled to the guide member;

the outer cover comprises a first outer cover portion and a second outer cover portion which are integrally formed, the first outer cover portion is sleeved on the outer side of the guide portion, and the second outer cover portion is at least partially sleeved on the outer side of the positioning portion.

11. The guide assembly of claim 10, wherein the detent portion includes an outer sleeve engaging portion at a distal side and a cartridge engaging portion at a proximal side, the second outer sleeve portion being sleeved outside the outer sleeve engaging portion, the outer sleeve engaging portion having an outer diameter smaller than an outer diameter of the cartridge engaging portion.

12. The guide assembly as claimed in claim 8, wherein a catch is provided on a proximal side of the pull-out portion, the catch being fixed to the window and not protruding from an outer side of the cartridge.

13. The guide assembly of claim 8, wherein the stapler further comprises an elbow disposed on a proximal side of the cartridge, the guide assembly further comprising a protective sheath at least partially covering an outer side of the elbow;

the proximal end side of the pulling part extends out of the window and extends to the bent pipe, and the part of the pulling part corresponding to the bent pipe is located between the outer side surface of the bent pipe and the inner side surface of the protective sleeve.

14. The guide assembly of claim 8, wherein a maximum outer diameter of the guide is less than or equal to an outer diameter of the distal side of the cartridge;

the distal-side outer diameter of the guide portion is smaller than the proximal-side outer diameter of the guide portion.

15. Guide assembly according to claim 1, wherein the outer wall surface of the guide assembly is at least partially coated with a lubricating layer.

16. The guide assembly of claim 1, wherein a cavity is formed in the guide member and extends through at least a proximal face of the guide member in an axial direction of the cartridge.

17. The guide assembly of claim 16, further comprising a water tube, a distal side of the water tube being located inside the cavity, a proximal side of the water tube protruding outside of the cartridge.

18. The guide assembly of claim 17, wherein the side wall of the water pipe located inside the cavity is provided with at least one water outlet hole, and the water outlet holes are sequentially arranged along the extending direction of the water pipe.

19. The guide assembly of claim 16, further comprising a pull cord and a liquid container disposed in the cavity, the liquid container comprising a sealed jacket and a set temperature range of liquid stored in the sealed jacket, the pull cord being fixedly attached to the sealed jacket of the liquid container;

when the pull rope is pulled towards the proximal side direction of the anastomat, the seal sleeve can be pulled by the pull rope, so that the seal sleeve is damaged to release stored liquid.

20. A circular tube-type stapler comprising the guide assembly of any one of claims 1 to 19.

Images