CN116999108A

CN116999108A - Manual anastomat

Info

Publication number: CN116999108A
Application number: CN202210475726.5A
Authority: CN
Inventors: 孙宝峰; 杨庆辉
Original assignee: Fengh Medical Co ltd
Current assignee: Fengh Medical Co ltd
Priority date: 2022-04-29
Filing date: 2022-04-29
Publication date: 2023-11-07

Abstract

The invention discloses a manual anastomat, which comprises a cutting driving piece, a cutting knife assembly connected with the cutting driving piece, and a knife returning mechanism, wherein the knife returning mechanism is used for driving the cutting driving piece to retreat and further driving the cutting knife assembly to retreat; the cutter return mechanism comprises a first cutter return mechanism and a second cutter return mechanism independent of the first cutter return mechanism, wherein the first cutter return mechanism and the second cutter return mechanism both have a driving state and a non-driving state, and in the driving state, the first cutter return mechanism or the second cutter return mechanism is operated to drive the cutting driving piece to retreat; in either position of the first and second return mechanisms in the driven state, the other of which is switchable between the driven and non-driven states. The knife return mechanism of the manual anastomat can not only save labor and knife return efficiency, but also simplify operation, facilitate the use of doctors and further save operation time.

Description

Manual anastomat

Technical Field

The invention relates to the technical field of surgical instruments, in particular to a manual anastomat.

Background

Surgical cutting staplers are a commonly used instrument in medicine to replace manual suturing, and the main working principle is to use a cutting knife to separate tissues and use titanium nails to anastomose the tissues, similar to a stapler. A variety of staplers are classified according to the suitability for different body parts, and for surgical incision staplers, the working principle is to enter the patient's body through the cannula of the puncture outfit positioned precisely at the surgical site, then make a longitudinal incision in the tissue and apply staples on opposite sides of the incision, thereby performing dissection and anastomosis of the tissue. When the severing and stapling of the tissue is completed, the cutting blade needs to be returned to its original position.

Endoluminal staplers are well known and have found widespread use in intra-luminal procedures such as abdominal cavity. The stapler includes a jaw assembly, a cutter assembly, and a cartridge assembly, with the jaw assembly first closed to grasp tissue, and then the cutter assembly is driven to cut the tissue while the cutter assembly pushes the cartridge assembly out of the staples to staple the tissue. It is important to note that the tissue has a certain thickness and tissue fluid is contained in the tissue, if the stapler clamps the tissue, the tissue is cut and sutured immediately, the tissue fluid is not squeezed sufficiently, the thickness of the target tissue cannot reach the safe range of effective suturing, phenomena such as inconsistent nails, secondary nails forming and the like can occur, and postoperative symptoms such as bleeding at the cutting suture position can be caused. And in the pressed state, after the tissue is sufficiently pressed, the tissue can generate a larger reaction force on the nail bin assembly, and the thicker the tissue is, the larger the reaction force is. The reaction force is transmitted to the cutter assembly through the nail supporting seat of the jaw assembly, and the reaction force needs to be overcome when the cutter assembly is driven to return by the cutter return mechanism; in addition, in the operation process, the operation time has an important influence on the postoperative recovery of the patient, the time and the amount of the gunpowder used by the patient can be reduced by shortening the operation time, the wound time is reduced, and the postoperative recovery of the patient is benefited. However, when the cutter returning mechanism in the prior art drives the cutter component to return the cutter, labor saving and cutter returning efficiency cannot be considered to meet the operation requirement.

Disclosure of Invention

Aiming at the defects of the prior art, the invention aims to provide a manual anastomat. The invention is realized by the following technical scheme:

the manual anastomat comprises a cutting driving piece, a cutting knife assembly connected with the cutting driving piece, and a knife returning mechanism, wherein the knife returning mechanism is used for driving the cutting driving piece to retreat and further driving the cutting knife assembly to retreat; the cutter back mechanism comprises a first cutter back mechanism and a second cutter back mechanism independent of the first cutter back mechanism, wherein the first cutter back mechanism and the second cutter back mechanism are in a driving state and a non-driving state, and in the driving state, the first cutter back mechanism or the second cutter back mechanism is operated to drive the cutting driving piece to retreat; in either position of the first and second return mechanisms in the driven state, the other of which is switchable between the driven state and the non-driven state.

Further, the cutting driving piece comprises a body, a first driving part and a second driving part, wherein the first driving part and the second driving part are arranged at different positions of the body, the first cutter return mechanism acts on the first driving part to drive the cutting driving piece to retreat, and the second cutter return mechanism acts on the second driving part to drive the cutting driving piece to retreat.

Further, the first driving part is positioned above the body; the second driving part is positioned at the side of the body.

Further, the cutting driving piece comprises a rack, and the first driving part is a plurality of first tooth grooves arranged above the rack; the first cutter returning mechanism comprises a pawl and a first cutter returning operation piece, and the pawl drives the rack to retract through the plurality of first tooth grooves under the action of the first cutter returning operation piece.

Further, the second cutter returning mechanism comprises a second cutter returning operation piece, and the second cutter returning operation piece is operated to drive the second driving part to move when moving towards the proximal end so as to drive the cutting driving piece to retract.

Further, the second operating member includes a pull button assembly and a second biasing member, wherein a first end of the second biasing member is connected to the cutting drive member, a second end of the second biasing member is connected to the pull button assembly, and the second biasing member stores energy when the pull button assembly moves proximally.

Further, the pull button assembly includes a pull button and a connection shaft, the pull button is disposed at an end portion of the connection shaft, and a second end of the second biasing member is connected with the connection shaft.

Further, the first cutter returning mechanism comprises a first cutter returning driving piece which is used for driving the cutting driving piece to retreat, and when the first cutter returning mechanism is in the non-driving state, the first cutter returning driving piece is positioned at an initial position; when the first cutter return mechanism is in the driving state, the first cutter return driving piece is positioned at a disengaging position; when the first cutter return mechanism is switched from the driving state to the non-driving state, the first cutter return driving piece is reset to the initial position from the disengaging position.

Further, the first knife return mechanism comprises a first knife return operation piece which is pivotally connected with the machine body of the manual anastomat, and the first knife return driving piece is pivotally connected with the first knife return operation piece; the first cutter return mechanism further comprises a return mechanism, and in the non-driving state, the return mechanism is connected with the first cutter return driving piece so that the first cutter return driving piece is limited at the initial position; in the driving state, the return mechanism is separated from the first cutter back driving piece so as to enable the first cutter back driving piece to be in the disengaging position; a movement of the first return operating member from a closed position towards an open position causes the first return mechanism to switch from the non-driven state to the driven state; the first return operating member is moved from the open position to the closed position such that the first return mechanism is switched from the driven state to the non-driven state.

Further, the first knife return mechanism is pivotally connected with the body of the manual anastomat, and the first knife return mechanism drives the cutting driving piece to retreat along the pivoting direction of the first knife return mechanism; the second cutter back mechanism drives the cutting driving piece to retreat along the longitudinal direction.

Further, the first knife return mechanism is connected with the machine body of the manual anastomat and arranged above the cutting driving piece, and the second knife return mechanism is connected with the cutting driving piece and arranged below the first knife return mechanism.

Further, in an initial state, the second cutter back mechanism is connected to the proximal end of the cutting drive, and the first cutter back mechanism is located distally of the second cutter back mechanism.

Further, in the initial state, the first cutter back mechanism extends in the longitudinal direction, and the second cutter back mechanism extends in the transverse direction.

Further, the first cutter back mechanism is combined with the cutting driving piece intermittently, and the second cutter back mechanism is combined with the cutting driving piece continuously.

Compared with the prior art, the invention has the beneficial effects that: according to the technical scheme, a doctor can freely select the first cutter returning mechanism and/or the second cutter returning mechanism to drive the cutter assembly to retreat, the first cutter returning mechanism saves labor when driving the cutter assembly to retreat compared with the second cutter returning mechanism, and the second cutter returning mechanism has higher cutter returning efficiency when driving the cutter assembly to retreat compared with the first cutter returning mechanism, so that the cutter returning mechanism can give consideration to labor saving and cutter returning efficiency, and further meets various actual operation requirements; further, a doctor can switch the first cutter returning mechanism and the second cutter returning mechanism at any time, labor saving and cutter returning efficiency are achieved, operation is simplified, use of the doctor is facilitated, and operation time is further saved.

Drawings

Fig. 1 is a schematic perspective view of a manual stapler according to a first embodiment of the present invention;

FIG. 2 is a front elevational view of the manual stapler of FIG. 1 with a portion of the housing hidden;

FIG. 3 is a schematic perspective view of a portion of the drive mechanism of the manual stapling instrument shown in FIG. 1;

FIGS. 4-9 are schematic views of the connection of the sleeve and jaw assembly of the manual stapler of FIG. 1;

FIGS. 10-12 are schematic views of a change in state of a portion of the drive mechanism of the manual stapling instrument shown in FIG. 1;

FIG. 13 is an exploded perspective view of a portion of the drive mechanism and jaw locking mechanism of the manual stapler shown in FIG. 1;

FIG. 14 is a schematic view of the firing drive mechanism of the manual stapling instrument of FIG. 1 in an initial state;

FIG. 15 is a schematic view of the firing drive mechanism of the manual stapling instrument shown in FIG. 1 in a fired state;

FIG. 16 is an exploded perspective view of a portion of the firing drive mechanism of the manual stapler illustrated in FIG. 1;

FIG. 17 is an exploded perspective view of the firing handle and feed pawl of the manual stapling instrument shown in FIG. 1;

FIG. 18 is an exploded perspective view of a first knife return mechanism of the manual stapling instrument shown in FIG. 1;

FIGS. 19-21 are schematic views showing a change in state of the first knife back mechanism driving the cutting drive shown in FIG. 18;

FIGS. 22-23 are schematic views showing a change in state of a second knife return mechanism driven cutting drive of the manual stapling instrument shown in FIG. 1;

fig. 24 to 25 are schematic views showing a state change of the cutting driving member driven by the first knife back mechanism and the second knife back mechanism of the manual anastomat shown in fig. 1;

fig. 26 to 28 are schematic views showing a state change of a part of a transmission mechanism of a manual anastomat according to a second embodiment of the present invention;

fig. 29 is a schematic view of a first knife return mechanism of a manual anastomat according to a third embodiment of the present invention in an initial state;

FIG. 30 is a schematic view of the first knife back mechanism of FIG. 29 in an initial position from another perspective;

FIG. 31 is a schematic view of the first knife return mechanism of FIG. 29 from a viewing angle after it has been operated;

FIG. 32 is a schematic view of the first knife return mechanism of FIG. 31 from another perspective after it has been operated;

FIG. 33 is an exploded perspective view of the first knife return mechanism shown in FIG. 29;

fig. 34 is a schematic view of a knife return mechanism of a manual anastomat according to a fourth embodiment of the present invention in an initial state;

FIG. 35 is a schematic view of the cutting drive of the manual stapler shown in FIG. 34;

FIG. 36 is a partial cross-sectional view of the manual stapler shown in FIG. 34 at A-A;

Fig. 37 is a schematic view of the manual stapling instrument of fig. 36 with a second knife return mechanism operated to disengage the cutting drive.

Detailed Description

The present invention will be described in further detail with reference to the drawings and examples, in order to make the objects, technical solutions and advantages of the present invention more apparent. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the scope of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.

It is to be understood that the terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle of a stapler. The term "proximal" refers to the portion proximal to the clinician, and the term "distal" refers to the portion distal to the clinician. I.e., the handles are proximal and the jaw assembly is distal, e.g., the proximal end of a component represents an end relatively close to the handles and the distal end represents an end relatively close to the jaw assembly. The terms "upper" and "lower" refer to the relative positions of the staple abutment and the cartridge abutment of the jaw assembly, specifically the staple abutment being "upper" and the cartridge abutment being "lower". However, the stapler can be used in many orientations and positions, and thus these terms expressing relative positional relationships are not limiting and absolute.

In the present invention, unless explicitly specified and limited otherwise, the terms "connected," "connected," and the like are to be construed broadly, and may be fixedly connected, detachably connected, movably connected, or integrated, for example; can be directly connected or indirectly connected through an intermediate medium, and can be communication between the two elements or interaction relationship between the two elements such as abutting. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances. It should be noted that, when the terms "connected" and "connected" are used in the meanings defined by the corresponding terms, only the cases where the terms are clearly required are excluded, and other possible cases are not excluded, such as "detachably connected" means detachably connected, not including being integrated, but movable connection and the like are not excluded.

The embodiments described below by referring to the drawings are illustrative and intended to explain the present invention and should not be construed as limiting the invention. The term "longitudinal" as used herein refers to the length direction of the sleeve 126 and "transverse" refers to the width direction of the sleeve 126.

As shown in fig. 1 to 25, a manual stapler 100 according to a first embodiment of the present invention includes a main body 10, a shaft assembly 20, and an end effector 30 connected in sequence, and a cutter assembly 40 (see fig. 16) connected to a distal end of the shaft assembly 30. Manual stapling instrument 100 further includes a transmission mechanism for driving movement of shaft assembly 20 to drive movement of cutting blade assembly 40 and/or for driving movement of end effector 30 to perform a cutting stapling operation and/or clamping and unclamping tissue. The body 10 includes a head housing 101 and a handle assembly 102 extending downwardly from the head housing 101, at least a portion of the transmission mechanism being housed in the head housing 101. The handle assembly 102 includes a fixed handle 103, a closure handle 104, and a firing handle 105. The power source of the drive mechanism of the manual stapler 100 is manual, such as by a clinician manually actuating the firing handle 105 and/or the closure handle 104, and power is output to the drive mechanism through the firing handle 105 and/or the closure handle 104 to move through the shaft assembly 20 to drive the cutting blade assembly 40 and/or to drive the end effector 30.

The shaft assembly 20 includes a mandrel 301 (see fig. 16)) and a sleeve 126 that fits over the mandrel 301. The mandrel 301 and sleeve 126 are part of a transmission mechanism. The specific structure of the shaft assembly 20 is prior art and will not be described in detail herein.

The end effector 30 includes a jaw assembly and a cartridge assembly (not shown). The jaw assembly includes a cartridge housing 133 and a staple abutment 134 pivotally connected to the cartridge housing 133. The cartridge seat 133 includes an installation space for installing a cartridge assembly detachably installed in the installation space of the cartridge seat 133. The abutment seat 134 is selectively movable between an open position and a closed position to cooperate with the cartridge seat 133 and cartridge assembly to clamp or unclamp tissue. The cartridge assembly is provided with knife slots (not shown) in which the cutting knife assembly 40 is movable, the cutting knife assembly 40 moves distally within the knife slots, cutting tissue during movement, and staples (not shown) housed in the cartridge assembly are pushed out to staple the tissue. The specific structure of the cartridge assembly is prior art and will not be described in detail herein.

Referring to fig. 4 to 9, a motion conversion mechanism is disposed between the sleeve 126 and the abutment 134 of the jaw assembly, and converts the linear motion of the sleeve 126 into a pivoting motion of the abutment 134, so as to pivot the abutment 134 relative to the cartridge seat 133 to close or open the jaw assembly. Specifically, as the sleeve 126 moves proximally, the motion-altering mechanism drives the anvil 134 to pivot upward to open the jaw assembly, and as the sleeve 126 moves distally, the motion-altering mechanism drives the anvil 134 to pivot downward to close the jaw assembly.

Specifically, the sleeve 126 includes a body 254 and a drive tube 256 connected, the drive tube 256 driving the anvil 134 to pivot upward or downward to open or close the jaw assembly. The body 254 and the drive tube 256 are connected by a hinge, or may be integrally formed. The motion changing mechanism includes a first driving member 258 and a second driving member 260 disposed on the driving tube 256, and a first driven portion 262 and a second driven portion 264 disposed on the anvil 134. The first driver 258 drives the anvil 134 open, and the first driver 258 is a projection provided on the driving tube 256, the projection extending obliquely along the lower right. The second driver 260 drives the anvil 134 closed, and the second driver 260 is a driving surface for driving the distal end of the tube 256. Correspondingly, the first driven portion 262 may be coupled to the first driving member 258, where the first driven portion 262 is a protrusion disposed on the nail holder 134, and the protrusion extends upward. The second driven portion 264 may be coupled to the second driving member 260, where the second driven portion 264 is an abutment surface against the proximal end of the nail seat 134. A guide mechanism is further provided between the staple holder 134 and the cartridge holder 133, the guide mechanism including a pin 266 provided on the staple holder 134, a kidney slot 268 provided on the cartridge holder 133, the kidney slot 268 extending obliquely upward in a proximal direction toward a distal direction.

Referring to fig. 9-8 for a state change, when the end effector 30 is to be closed, the body 254 of the sleeve 126 pushes the driving tube 256 to move distally, the second driving member 260 on the driving tube 256 abuts the second driven portion 264 on the abutment 134, the pin 266 moves from the proximal lower end to the distal upper end of the kidney-shaped slot 268, the abutment 134 pivots downwardly, and the jaw assembly is closed.

Referring to fig. 8-9, when the jaw assembly is to be opened, the body 254 of the sleeve 126 pulls the driving tube 256 to move proximally, the first driving member 258 on the driving tube 256 abuts the first driven portion 262 on the abutment 134, the pin 266 moves from the distal upper end to the proximal lower end of the kidney 268, the abutment 134 pivots upwardly, and the jaw assembly is opened.

The transmission mechanism comprises a jaw driving mechanism and a firing driving mechanism, wherein the proximal end of the jaw driving mechanism is connected with the closing handle 104, and the distal end of the jaw driving mechanism is connected with the jaw assembly; the closure handles 104 are operated to drive movement of the jaw drive mechanism and, in turn, the jaw assembly. Wherein the jaw driving mechanism comprises a jaw driving member, the proximal end of the jaw driving member is connected with the closing handle 104, and the distal end is connected with the jaw assembly through a motion changing mechanism; the jaw driving member includes a jaw driving member and a jaw driven member driven by the jaw driving member. Specifically, as shown in fig. 3, the jaw driving member includes a link 120, and the jaw driven member includes a compression ring 122 and a sleeve 126; one end of the compression ring 122 is connected with the sleeve 126, and the other end is connected with the connecting rod 120; the link 120 is coupled to the closure handle 104 and the sleeve 126 is coupled to the jaw assembly via a motion-altering mechanism. The closure handle 104 drives the link 120 in motion, and the link 120 drives the compression ring 122, sleeve 126, and motion-altering mechanism in sequence to drive the jaw assembly closed. The jaw drive mechanism further includes a resilient member 124. The resilient member 124 compresses energy during closure of the jaw assembly, and after the closure handle 104 is released, the resilient member 124 drives the compression ring 122, the link 120, in sequence, proximally, the compression ring 122 proximally moving driving sleeve 126 proximally and driving the jaw assembly open by the motion-altering mechanism described above. The firing drive mechanism includes a cutting drive 300, the distal end of the cutting drive 300 being coupled to the cutting blade assembly 40 and the proximal end being operably coupled to the firing handle 105, the firing handle 105 being operable to drive the firing drive forward and thereby the cutting blade assembly 40 forward. The transmission mechanism further includes a knife back operating member 308 (shown in fig. 3) coupled to the cutting drive member 300, the knife back operating member 308 being coupled to the cutting drive member 300 for driving the cutting drive member 300 and thus the cutting knife assembly 40 back. Specific details regarding how the firing handle 105 drives the advancement of the cutting blade assembly 40 via the cutting drive 300 will be described in detail below.

As noted above, the closure handle 104 is coupled to the jaw assembly for driving the jaw assembly closed; when the closure handle 104 is operated to move from the open position to the closed position, the jaw assembly is closed. In this embodiment, the manual stapling instrument 100 further comprises a jaw locking mechanism 400, the jaw locking mechanism 400 having a locked position and an unlocked position; the return operating member 308 is also operable to drive the jaw locking mechanism 400 from the locked position to the unlocked position; in the locked position, the jaw locking mechanism 400 cooperates with the closure handle 104 in the closed position to lock the closure handle 104 in the closed position; in the unlocked position, the jaw locking mechanism 400 is disengaged from the closure handle 104 to unlock the closure handle 104. By the arrangement, the jaw assembly is not opened after the jaw assembly is closed and when the manual stapler 100 is in the firing state. Specifically, when the cutting driving member 300 is in the firing state, the knife-returning operation member 308 cannot drive the jaw locking mechanism 400, and the jaw assembly cannot be opened, so that the jaw assembly cannot be opened in the firing state; that is, by the cooperation of the return knife operating member 308 and the jaw locking mechanism 400, the jaw assembly can not be opened in the firing state without other complicated structures; the whole device has simple and compact structure and is safe and reliable. Meanwhile, the return knife operating member 308 can be fully utilized, and not only can be used for driving the cutting driving member 300 to retreat, thereby driving the cutting knife assembly 40 to retreat, but also can be matched with the jaw locking mechanism 400 to unlock the closing handle 104, so that the dual-purpose of the return knife operating member 308 is realized. In addition, the machine body of the manual anastomat 100 is provided with numerical scale marks for indicating the cutting progress, and in the process that the cutter back operation member 308 advances along with the cutting driving member 300, the current cutting progress can be known by observing the position relationship between the cutter back operation member 308 and the numerical scale marks, so that a doctor can intuitively know the cutting length conveniently, and a proper cutting length can be selected according to the operation requirement.

In this embodiment, the jaw locking mechanism 400 comprises a lock, wherein the lock comprises a stop element 402 and a trigger element 404 coupled to the stop element 402; the locking member has a locked position in which the stop element 402 abuts the closure handle 104 in the closed position and an unlocked position in which the stop element 402 is separated from the closure handle 104 and the knife back operator 308 moves proximally to drive the trigger element 404 and thus the stop element 402 from the locked position to the unlocked position. More specifically, the closure handle 104 includes a connecting end 106 connected to the link 120 and an abutment end 108 extending outwardly from the connecting end, with the jaw locking mechanism 400 in a locked position, the closure handle 104 in an open position, the abutment end 108 being separated from the stop member 402 in the initial state, as shown in FIG. 10; when the user manipulates the closure handle 104 from the open position to the closed position, the abutment end 108 thereof abuts the stop member 402, and the stop member 402 provides a torque to the closure handle 104 that prevents clockwise rotation thereof, such that the closure handle 104 is locked in the closed position, as shown in fig. 11; when the closing handle 104 needs to be unlocked, the return knife operating member 308 is operated proximally to drive the trigger element 404 to move, and the trigger element 404 is connected with the limiting element 402, so that the movement of the trigger element 404 drives the limiting element 402 to move, and when the limiting element 402 moves from the locking position to the unlocking position, the limiting element 402 is separated from the abutting end 108 of the closing handle 104 again, and the closing handle 104 is unlocked, as shown in fig. 12. The jaw locking mechanism is simple in structure and matched with the closing handle and the return knife operating piece, so that the whole operation process is simple and convenient, easy to realize, safe and reliable.

Jaw locking mechanism 400 further includes a shaft 406, trigger member 404 and stop member 402 being pivotally mounted to the body of manual stapling instrument 100 via shaft 406; the limiting element 402 and the triggering element 404 are integrally formed, and together form a body of the jaw locking mechanism 400, and the body is provided with a shaft hole; the side of the body of the manual stapler 100 is provided with a shaft hole, one end of the rotating shaft 406 is positioned in the shaft hole of the body of the jaw locking mechanism 400, and the other end is fixedly installed in the shaft hole of the side of the body of the manual stapler 100, so that the jaw locking mechanism 400 is installed in the manual stapler 100. Of course, the limiting element 402 and the triggering element 404 may be formed in a non-integral manner, the triggering element 404 is provided with a shaft hole, the rotating shaft 406 passes through the shaft hole of the triggering element 404, and the proximal end of the limiting element 402 is connected with the distal end of the triggering element 404. In this embodiment, the trigger element 404 and the limiting element 402 are disposed at an included angle, which is beneficial to the force applied to the trigger element 404 by the return operation member 308, and can save the installation space of the jaw locking mechanism 400, and the overall structure is more compact.

The jaw locking mechanism 400 further includes a biasing member that biases the locking member to maintain the closure handle in the locked position, and is compressed to store energy when the locking member is driven from the locked position to the unlocked position, such that the stop member 402 is reset to the locked position by the biasing member when in the unlocked position. The presence of the biasing member allows the surgeon to again lock the closure handle 104 each time after unlocking the closure handle 104, further ensuring the safety of the procedure. In particular, the biasing member is an elastic element. In this embodiment, the biasing member is a torsion spring 408, the middle portion of the torsion spring 408 is sleeved on the rotating shaft 406 of the jaw locking mechanism 400, one end of the torsion spring 408 is installed in the trigger element 404, and the other end abuts against the body of the manual anastomat 100. Jaw locking mechanism 400 further includes a stop 410 disposed on the body of manual stapling instrument 100, stop 410 being configured to stop member 402 of jaw locking mechanism 400 when in the locked position. The provision of the stop makes the jaw locking mechanism more stable for better locking of the closure handle.

In this embodiment, the knife back operating member 308 is movably coupled to the cutting drive member 300 such that the knife back operating member 308 is operable to move proximally to drive the jaw locking mechanism 400 from the locked position to the unlocked position. The arrangement accords with the operation habit of doctors, so that the operation is smoother and simpler. Specifically, as shown in fig. 13, the return operation member 308 includes a knob assembly including a knob 310 and a connection shaft 312, the connection shaft 312 being movably connected with the cutting driving member 300, the knob 310 being provided at an end of the connection shaft 312; the knob assembly, when operated for proximal translational movement, drives the jaw locking mechanism 400 from the locked position to the unlocked position. More specifically, the proximal end of the cutting driver 300 is provided with a mounting groove 318, the middle portion of the connecting shaft 312 passes through the mounting groove 318, the two end portions extend outwards to form the mounting groove 318, and the two pull buttons 310 are symmetrically arranged at the two end portions of the connecting shaft 312. By the arrangement, the whole structure is more compact, and the doctor can operate with one hand conveniently. When the surgeon pulls knob 310 proximally, drive shaft 312 translates proximally within mounting slot 318 into contact with trigger member 404, and continued movement drives trigger member 404 to move stop member 402 to the unlocked position, thereby unlocking closure handle 104. The return operating member 308 further includes an elastic member (not shown) having a first end coupled to the cutting driving member 300 and a second end coupled to the coupling shaft 312, and the elastic member stores energy when the knob assembly moves proximally, thereby allowing the knob assembly to return to an initial position under the action thereof for use next time.

In this embodiment, the firing drive mechanism further comprises a mandrel 301, the distal end of the mandrel 301 being connected to the cutter assembly 40 and the proximal end thereof being connected to the cutting drive 300; the cutting drive 300 drives the mandrel 301 to move so that the cutter assembly 40 performs a firing or retracting action. Specifically, as shown in fig. 16, the cutter assembly 40 includes a cutter bar 302, a cutter head 303 coupled to the cutter bar 302. Cutting drive 300 is connected to the proximal end of mandrel 301, and the slot at the distal end of mandrel 301 is snapped into engagement with the projection at the proximal end of knife bar 302. The cutting drive 300 drives the mandrel 301 forward under the action of the firing operator 105 and the mandrel 301 rearward under the action of the return operator 308. Forward movement of the mandrel 301 may cause the cutter assembly 40 to move forward, cutting tissue and pushing staples of the cartridge assembly out of the staples to staple the tissue. The spindle 301 moves rearward to bring the cutter assembly 40 to a rearward position for restoration to the original position.

During cutting and stapling, the knife head 303 is positioned in the space formed between the cartridge housing 133 and the anvil 134 of the jaw assembly. Specifically, the staple holder 134 has a staple holder pocket (not shown) therein, and the cartridge holder 133 has a cartridge holder pocket (not shown) therein; the nail bin seat groove corresponds to the position of the nail abutting seat groove. The nail bin seat groove, the nail abutting seat groove and the feed groove of the nail bin assembly jointly provide accommodating space and path guide for the cutting knife assembly. As shown in fig. 16, the cutter head 303 includes a support portion 304 and a locking portion 305, and the support portion 304 and the locking portion 305 form an i shape. The shape of the nail bin seat groove is matched with that of the clamping part 305, the shape of the nail abutting seat groove is matched with that of the supporting part 304, the clamping part is arranged in the nail bin seat groove, the supporting part enters the nail abutting seat groove, so that the cutter head 303 can move in the nail abutting seat groove and the nail bin seat groove at the upper side and the lower side, and the cutter head can move from the proximal end to the distal end to cut and anastomose human tissues. When the cutter assembly 40 is subjected to a firing or retraction force, the support 304 and the catch 305 can reciprocate within the cartridge pocket in response to the applied force, i.e., the cutter assembly 40 can reciprocate within the end effector 30 in response to the firing or retraction force. When the cutter assembly 40 is in the end position or in the intermediate position, the supporting portion 304 of the cutter head 303 is located in the staple cartridge seat, and the clamping portion 305 is located in the staple cartridge seat and is limited by the cutter head 303, at this time, the jaw assembly cannot be opened, and if the jaw assembly is forcibly opened at this time, the manual stapler 100 is damaged. To open the jaw assembly, the cutter assembly 40 should be brought to the initial position, in which the support 304 is disengaged from the abutment recess, and the opening of the jaw assembly is no longer limited by the cutter head 303.

As shown in fig. 14-17, the firing drive mechanism further includes a knife feed drive 110 coupled to the firing operator 105, the knife feed drive 110 driving the cutting drive 300 forward under the action of the firing operator 105, thereby driving the mandrel 310 forward and thus the cutting knife assembly 40 forward. As can be seen from the above, the knife back operating member 308 is connected to the cutting drive member 300, so that when the cutting drive member 300 is driven by the feeding drive member 110 to move forward, the knife back operating member 308 also moves forward along with the cutting drive member 300, and thus cannot be operated to unlock the jaw locking mechanism, thereby ensuring that the jaw assembly cannot be opened in the firing state.

The feed drive 110 includes a feed pawl 107 and a pawl bias 109, the feed pawl 107 being pivotally connected to the firing operating member 105; the feed pawl 107 includes a claw portion 111 and a tail portion 113; in the initial state, the tail portion 113 abuts against the abutment portion 115 provided on the body of the manual stapler 100, and the claw portion 111 is separated from the cutting drive 300, as shown in fig. 14; when the firing operating member 105 drives the feed pawl 107, the tail 113 thereof disengages from the abutment 115 and the pawl portion 111 engages the cutting drive 300 under the influence of the pawl bias 109 to thereby drive the cutting drive 300 forward, as shown in FIG. 15. Specifically, the feed drive 110 further includes a mounting shaft 117, and the feed pawl 107 is coupled to the firing operating member 105 via the mounting shaft 117. The pawl bias 109 always provides a bias force to the feed pawl 107 toward the cutting drive 300, and in the initial state, the tail 113 of the feed pawl 107 abuts against the abutment 115 to counteract the bias force, so that the pawl portion 111 is separated from the cutting drive 300; when the tail 113 of the feed pawl 107 is disengaged from the abutment 115, its pawl portion 111 is engaged with the cutting drive 300 by the pawl bias 109. In this embodiment, the pawl bias member 109 is a pawl torsion spring, the middle of which is sleeved on the mounting shaft 117, one end of the pawl torsion spring abuts against the inside of the feed pawl 107, and the other end abuts against the body of the firing operating member 105. In this embodiment, the cutting driving member 300 is a rack, a plurality of tooth slots 314 matched with the feed pawl 107 are disposed below the rack, the firing operation member 105 drives the feed pawl 107 to drive the rack to advance, specifically, the firing operation member 105 moves towards the fixed handle 103 to drive the feed pawl 107, the feed pawl 107 moves away from the fixed handle 103 by being matched with one of the tooth slots 314 of the rack to drive the rack, the firing operation member 105 moves away from the fixed handle 103 to drive the feed pawl 107 to move out of the tooth slot 314 along the inclined plane of the tooth slot 314 and into the next tooth slot 314 adjacent to the tooth slot 314, and then drive the feed pawl 107 to continue moving, so repeatedly until the cutting knife assembly 40 moves to the most distal position, thereby completing the firing action. The driving manner of the feed pawl 107 and the rack is a conventional technical means in the mechanical field, and will not be described herein.

As shown in fig. 18 to 21, in the present embodiment, the manual anastomat 100 further comprises a first knife-returning mechanism 500 for driving the cutter assembly 40 to retreat; the first return mechanism 500 includes a first return operation member 502, a first return driving member 504, and a return mechanism; wherein the first return operating member 502 has a first pivot end pivotally connected to the body of the manual stapling instrument 100 and a free end extending outwardly from the first pivot end, the first return driving member 504 has a second pivot end pivotally connected to the first return operating member 502, the second pivot end being located between the first pivot end and the free end; the first cutter back operation member 502 drives the cutting driving member 300 to retreat by the first cutter back driving member 504; the first cutter return mechanism 500 has a first state and a second state, and in the first state, the return mechanism is connected with the first cutter return driving piece 504 so as to limit the first cutter return driving piece 504 to an initial position; in the second state, the return mechanism is disengaged from the first return drive 504 such that the first return drive 504 is in the disengaged position; the first return operator 502 is operated to move from the closed position toward the open position such that the first return mechanism 500 switches from the first state to the second state and in the second state drives the first return driver 504 to move, thereby driving the cutter assembly 40 to retract; the first return operating member 502 is operated to move from the open position to the closed position such that the first return mechanism 500 is switched from the second state to the first state. The first return driving piece 504 is pivotally connected with the first return operating piece 502, and the pivoting end of the first return driving piece 504 is located between the pivoting end and the free end of the first return operating piece 502, and according to the lever principle, the power arm is larger than the resistance arm, so that the lever is a labor-saving lever. Thus, the doctor can save effort when operating the first retracting operation member 502 to drive the first retracting driving member 504 to move and further drive the cutting blade assembly 300 to retract, and particularly when encountering thick tissues, the retracting can be easily realized, thereby shortening the operation time; meanwhile, due to the existence of the return mechanism, the first cutter return mechanism 500 can be reused after one cutter return is completed, the operation requirement is met, and the whole structure is simple, safe and reliable.

The first return operating member 502 further includes a pivot shaft 508 that passes through the first pivot end of the first return operating member 502 such that the first return operating member 502 is pivotally disposed at the body of the manual stapling instrument 100 and is operable to reciprocate between its closed and open positions. The first return actuator 504 further includes a pin 512 that passes through the second pivot end of the first return actuator 504 such that the first return actuator 504 is pivotally mounted to the first return operator 502, the pin 512 being located between the pivot shaft 508 and the free end of the first return operator 502. Preferably, in order to enhance the strength of the first return operation member 502, a reinforcement member 514 is embedded in the first return operation member, and the pivot shaft 508 is installed on the body of the manual anastomat 100 through a shaft hole of the reinforcement member 514; the first backhoe drive 504 is mounted to the stiffener 514 via a pin 512. Meanwhile, in order to provide a space for avoiding the movement of the pin shaft 512 along with the first retracting operation member 502, optionally, a fixing member 510 is arranged in the body of the manual anastomat 100, an avoiding groove is formed in the fixing member 510 to provide a space for avoiding the movement of the pin shaft 512, and the pivot shaft 508 sequentially passes through a first side portion of the first retracting operation member 502, the first reinforcing member 514, the first fixing member 510, the second reinforcing member 514 and a second side portion of the first retracting operation member 502 corresponding to the first side portion, so that the first retracting operation member 502 and the body are mounted; the pin shaft 512 sequentially passes through the first reinforcement 514, the first fixing member 510, the body of the first return driving member 504, the second fixing member 510, and the second reinforcement 514 to mount the first return driving member 504 and the first return operating member 502. By the arrangement, the reliability is improved, and the whole structure is more compact.

Defining a distance L1 between the first pivot end of the first return operating member 502 and the second pivot end of the first return driving member 504, the length of the first return operating member 502 in the longitudinal direction when in the closed position is L2. The force of the doctor operating the first return operation member 502 is F1, the resistance of the tissue to the first return driving member 504 is F2, and according to the lever principle, the larger the ratio of L2 to L1 is when the resistance F2 is fixed, the smaller the force F1 of the doctor operating the first return operation member 502 is. Therefore, in order to make it more labor-saving for the doctor to operate the first return operation member 502 to drive the cutter assembly 40 to retreat by the first return driving member 504 while considering the influence on the size of the whole machine and the operation frequency, it is preferable that the L2 is 2 times or more the L1 and the L2 is 25 times or less the L1. In the embodiment, the value interval of L1 is 5mm-10mm, and the value interval of L2 is 80mm-100mm. Of course, other values are possible, as long as effort saving can be achieved, i.e. F1 is smaller than F2, where L2 is greater than L1, i.e. the pivoting end of the first return driving member 504 is located between the pivoting end and the free end of the first return operating member 502. More preferably, L2 is 5 times or more of L1, and L2 is 15 times or less of L1. In an embodiment, L1 is about 6mm, and L2 is about 90mm, laborsaving about 95%, reduced doctor's required strength of operating cutting knife subassembly back knife greatly, promote doctor's product experience sense to can improve operation efficiency, save operation time, do benefit to patient postoperative and resume.

The first return mechanism 500 further includes a first biasing member 520 for providing a biasing force of the first return driver 504 toward the cutting driver 300 to improve stability of the first return driver 504 in engagement with the cutting driver 300. In this embodiment, the first return driver 504 includes a return pawl that passes through the second pivot end via a pin 512 to be pivotally mounted to the first return operator 502; from the foregoing, the manual stapler 100 further includes a cutting drive 300, wherein the cutting drive 300 is connected to the cutting blade assembly 40; the first return operating member 504 drives the cutting drive 300 to retract by the return pawl, thereby driving the cutting blade assembly 40 to retract. More specifically, the cutting drive 300 includes a rack including a plurality of first tooth slots 316, and a knife back pawl drives the first tooth slots 316 to drive the rack back. Preferably, a plurality of first tooth slots are located above the rack to facilitate operation of the first knife return mechanism 500 by a physician.

The return mechanism comprises a limiting piece 506 fixedly connected with or integrally formed with the body of the manual anastomat 100; in the first state, the first cutter back driving piece 504 is connected with the limiting piece, and at this time, the first cutter back driving piece 504 is limited at the initial position by the limiting piece 506; in the second state, the first return driving member 504 is separated from the limiting member 506, at this time, the first return driving member 504 is in the disengaged position, and the first return operating member 502 is operated to move from the closed position toward the open position, so that the first return driving member 504 and the limiting member 506 are switched from the connected state to the separated state; the first return operating member 502 is operated to move from the open position to the closed position such that the first return driving member 504 and the stopper are switched from the separated state to the connected state. Thus, without other complicated designs, only the cooperation of the limiting piece 506 and the first cutter back driving piece 504 is needed, so that when the first cutter back operating piece 502 is not operated, the first cutter back driving piece 504 is kept in place, and when the first cutter back operating piece 502 is operated towards the open position, the first cutter back driving piece 504 can move from the initial position to the separation position under the action of the first cutter back operating piece 502, and then the cutter back assembly 40 is driven to retract under the action of the first cutter back operating piece 502; while also enabling a re-reset of the first return actuator 504 after closing the first return operator 502. That is, the design makes the first cutter back mechanism 500 reusable, meets the requirements of surgery, and has a simple, compact and reliable overall structure.

In this embodiment, one of the limiter 506 and the first return driver 504 includes a recess: the other of which includes a protrusion, the connection and disconnection of the first return drive 504 and the limiter 506 being accomplished by the protrusion mating with the recess. In this embodiment, the limiting member 506 includes a recess, and the first knife-return driving member 504 includes a protrusion 516, preferably, in order to further improve the stability of the cooperation between the limiting member 506 and the first knife-return driving member 504, the recess includes a first recess and a second recess symmetrically disposed at two sides of the body of the manual anastomat 100; the protrusions include a first protrusion and a second protrusion symmetrically disposed to the first return driver 504; the first blade return driver 504 also includes a drive end extending outwardly from the second pivot end for driving the cutter assembly 40 with the protrusion 516 disposed between the second pivot end and the drive end.

Fig. 19 to 21 are schematic views showing a state change of the first knife back mechanism 500 driving the cutting driving member 300 in this example. As shown in fig. 19, in the initial state, the first cutter back operation member 502 is located at the closed position, and the first cutter back driving member 504

The protrusion 516 of the return mechanism cooperates with the stop 506 such that the first knife back drive 504 is limited to the initial position, and the first knife back drive 504 in the initial position cannot cooperate with the cutting drive 300. As shown in fig. 20, when the first knife back operating member 502 is operated to move from the closed position toward the open position, the first knife back driving member 504 is driven to move such that the protrusion 516 is separated from the stop 506 of the return mechanism, at which time the first knife back driving member 504 is in the disengaged position and the driving end of the first knife back driving member 504 enters the first tooth slot 316 of the proximal most end of the cutting driving member 300. Continuing to operate the first return operator 502 toward the open position, under the influence of the first return operator 502, the first return driver 504 drives the cutter assembly 40 back by driving the first tooth slot 316 at the proximal end of the cutting driver 300 into motion, as shown in fig. 21. Continuing to drive the first return operating member 502 from the position shown in fig. 21 in the direction of the closed position, the drive end of the first return operating member 504 moves distally from the first tooth slot 316 at the proximal end of the cutting driving member 300 to the next first tooth slot 316 adjacent to the first tooth slot 316 at the proximal end of the cutting driving member 300, and likewise continuing to drive the first return operating member 502 in the direction away from the closed position, the first return operating member 504 drives the next first tooth slot 316 under the action of the first return operating member 502 to drive the cutting blade assembly 40 to continue to retract; in this way, the retraction of the cutter assembly 40 to its initial position is ultimately achieved. In this example, the first cutter back driving member 504 includes a cutter back pawl, the cutting driving member 300 includes a rack, and the driving manner of the cutter back pawl and the rack is a conventional technical means in the mechanical field, which is not described herein. During the driving of the cutter assembly 40 back, if the first return mechanism 500 is not required, the first return operating member 502 may be operated such that it moves from the open position to its closed position, at which point the protrusion 516 of the first return driving member 504 is again connected to the stopper 506, and the first return driving member 504 is again returned to its original position, as shown in fig. 19. The whole operation process is simple and smooth, and a doctor can use the first knife return mechanism 500 for multiple times according to the needs so as to meet the needs of the operation.

In this example, the manual anastomat 100 further comprises a second knife return mechanism, and the second knife return mechanism comprises a second knife return operation member, namely the knife return operation member 308. As can be seen from the above description, the second retracting operation member is connected to the cutting driving member 300 to drive the cutting driving member 300 to retract. Fig. 22 and 23 are schematic views showing a state change of the second cutter back mechanism driving the cutting driving member. As shown in fig. 22, in the feeding completion state, the second cutter back operation member moves to the distal position along with the rack, and when the cutter assembly 40 is required to retract, the pull button 310 of the second cutter back operation member is pulled to move proximally, so as to drive the cutting driving member 300 to retract, thereby realizing the retraction of the cutter assembly 40 to the initial position, as shown in fig. 23. In this way, since the doctor can directly drive the cutter assembly 40 to retract by pulling the second retracting operation member of the second retracting mechanism, the cutter assembly 40 can be more rapidly driven to retract than the first retracting mechanism 500, so as to complete the retracting action.

When the jaw assembly is aligned with the target tissue, the closing handle 104 is operated to drive the jaw assembly to close so as to clamp the tissue, when the jaw assembly is closed to the bottom, the manual stapler 100 immediately enters a squeezing state, the combined liquid in the clamped tissue is squeezed and discharged in the squeezing state, the jaw assembly keeps the jaw assembly closed state under the action of the jaw locking mechanism 400, and the manual stapler 100 keeps the jaw assembly closed state until the firing handle 105 of the manual stapler 100 is operated to drive the cutting drive member 300 to perform firing motion so as to cut and stitch the tissue, namely, the manual stapler 100 exits from the squeezing state once fired. The pressing state is generally continued for a certain period of time, such as 15s, in order to allow the tissue fluid to be sufficiently discharged to enhance the effect of the tissue being cut and stapled. After the tissue is fully pressed, a reaction force is generated on the nail bin assembly, the thicker the tissue is, the larger the reaction force is, and the reaction force is sequentially transmitted to the cutting knife assembly 40 and the cutting driving piece 300 through the nail supporting seat 134, so that the resistance is larger when the second back knife mechanism which is directly pulled manually is adopted to drive the cutting knife assembly 40 to retreat, and particularly when the thick tissue is encountered, the situation that the cutting knife assembly cannot be pulled possibly occurs; at this time, a labor-saving cutter-returning mechanism is needed. When the tissue is thin, the reaction force generated by the cutting driving mechanism is relatively small after the tissue is sufficiently pressed, and a quick cutter returning mechanism is needed to improve cutter returning efficiency; or when the cutter assembly 40 is driven to retract by a distance by a labor-saving cutter-returning mechanism, the reaction is reduced, and a quick cutter-returning mechanism is needed to improve cutter-returning efficiency. Thus, a knife return mechanism that can achieve both efficiency and labor-saving is particularly important.

In order to solve the above-mentioned problems, the manual anastomat 100 of the present embodiment includes a knife retracting mechanism for driving the cutting driving member 300 to retract, thereby driving the cutting knife assembly 40 to retract. The closure handle 104 drives the jaw assembly closed by the jaw drive described above; the cutter returning mechanism comprises the first cutter returning mechanism 500 and the second cutter returning mechanism; the first and/or second knife back mechanisms 500, 500 are operated to drive the cutting drive 300 back when the jaw assembly is in the closed condition. Through this technical scheme, doctor can freely select first back cutter mechanism 500 and/or second back cutter mechanism drive cutting knife assembly 40 to retreat to give consideration to laborsaving and back cutter efficiency, thereby satisfy different operation needs, and can improve operation efficiency, save operation time, do benefit to patient postoperative and resume.

In this embodiment, the first cutter back mechanism 500 and the second cutter back mechanism each have a driving state and a non-driving state, in which either the first cutter back mechanism 500 or the second cutter back mechanism is operated to drive the cutting driver 300 to retreat; in either position of the first and second return mechanisms in the driven state, the other of which is switchable between the driven and non-driven states. The non-driving state is a state in which the first cutter back mechanism 500 or the second cutter back mechanism does not drive the cutting driver 300. Through the design that one of the first cutter return mechanism and the second cutter return mechanism is in any position in a driving state, and the other one of the first cutter return mechanism and the second cutter return mechanism can be switched between the driving state and a non-driving state, the first cutter return mechanism and the second cutter return mechanism are ensured not to interfere with each other; it will of course be appreciated that in either position one of the first and second return mechanisms is in the non-driven state, the other of which is also switchable between the driven and non-driven states. The doctor can switch the first cutter return mechanism 500 and the second cutter return mechanism at any time, so that labor saving and cutter return efficiency are achieved, the operation is simplified, the doctor can use the cutter conveniently, and the operation time is further reduced.

In the present embodiment, when the first cutter back mechanism 500 is in the non-driving state, the first cutter back driving member 504 is located at the initial position; when the first cutter back mechanism 500 is in the driving state, the first cutter back driving member 504 is located at the disengaging position; when the first return mechanism 500 is switched from the driving state to the non-driving state, the first return driving member 504 is reset from the disengaged position to the initial position. As can be seen from the foregoing, the first retracting mechanism 500 includes a first retracting operation member 502 pivotally connected to the body of the manual stapler 100, and a first retracting driving member 504 is pivotally connected to the first retracting operation member 502; the first cutter return mechanism 500 further includes a return mechanism, and in a non-driving state, the return mechanism is connected to the first cutter return driving member 504, so that the first cutter return driving member 504 is limited at an initial position; in the actuated state, the return mechanism is disengaged from the first knife back drive 504 such that the first knife back drive 504 is in the disengaged position; movement of the first return operating member 502 from its closed position towards its open position causes the first return mechanism 500 to switch from the non-driven state to the driven state; the first return operating member 502, when moved from the open position to its closed position, causes the first return mechanism 500 to switch from the driven state to the non-driven state. The specific structure of the return mechanism is the same as that described above, and will not be described here again.

Further, the cutting driving piece 300 includes a main body, and a first driving portion and a second driving portion disposed at different positions of the main body, wherein the first cutter back mechanism 500 acts on the first driving portion to drive the cutting driving piece 300 to retract, and the second cutter back mechanism acts on the second driving portion to drive the cutting driving piece 300 to retract. In this embodiment, the first drive section is located above the body of the cutting drive 300; the second driving part is located at the side of the body of the cutting driving part 300. Therefore, a larger operation space is provided, and the operation of doctors is facilitated so as to be better switched to a required cutter returning mode at any time according to the operation requirement. Specifically, the cutting drive 300 includes a rack, and the first driving portion is a plurality of first tooth slots 316 disposed above the rack; as can be seen from the above description, the first cutter back mechanism 500 includes a cutter back pawl and a first cutter back operating member 502, and the cutter back pawl drives the rack to retract through the plurality of first tooth slots 516 under the action of the first cutter back operating member 502, and the first cutter back mechanism 500 is intermittently combined with the cutting driving member 300. A second return operation member 308 of the second return mechanism is connected with the body of the cutting driving member 300, and drives the second driving portion to move when the second return operation member is operated to move proximally, so that the cutting driving member 300 retreats; the second cutter back mechanism is continuously coupled with the cutting drive 300. In this embodiment, the second driving portion is a mounting groove 318 provided at the proximal end of the cutting driving member 300. The second cutter back operation member includes a pull button assembly and a second biasing member (i.e., the resilient member described above), the first end of the second biasing member being coupled to the cutting drive member 300, the second end being coupled to the pull button assembly, the second biasing member storing energy when the pull button assembly is moved proximally. The pull button assembly includes a pull button 310 and a connection shaft 312, the pull button 310 is disposed at an end of the connection shaft 312, and a second end of the second biasing member is connected to the connection shaft. When the knob 310 is driven to move proximally, the connecting shaft 312 of the knob assembly abuts the proximal wall of the mounting groove 318, thereby driving the proximal wall of the mounting groove 318 to move and thus the cutting driver 300 to retract. As can be seen from the foregoing, the second cutter back operating member can be operated to drive the jaw locking mechanism 400 to move and unlock the jaw assembly when the cutting driving member 300 is at the initial position, so that the second cutter back operating member can be operated to not only drive the cutting blade assembly 40 to retract, but also unlock the jaw assembly, thereby functioning as one piece.

As can be seen from the above description, the first knife-returning mechanism 500 is pivotally connected to the body of the manual anastomat 100, and the first knife-returning mechanism 500 drives the cutting driving member 300 to retract along the pivoting direction thereof; the second cutter back mechanism drives the cutting drive 300 to retreat in the longitudinal direction. The first knife return mechanism 500 is connected with the machine body of the manual anastomat 100 and is arranged above the cutting driving piece 300, and the second knife return mechanism is connected with the cutting driving piece 300 and is arranged below the first knife return mechanism 500. The arrangement is more reasonable in overall arrangement, compact in structure and convenient for doctors to operate. In the initial state, a second cutter back mechanism is coupled to the proximal end of the cutting drive 300, the first cutter back mechanism being distal to the second cutter back mechanism. By the arrangement, the volume of the cutting driving piece 300 can be reduced on the premise of ensuring the strength of the cutting driving piece 300, so that the whole structure is more compact.

In the embodiment, in an initial state, the first cutter returning mechanism extends along the longitudinal direction, and the second cutter returning mechanism extends along the transverse direction, so that the whole machine has high space utilization rate, small volume and compact structure.

Fig. 24 to 25 are schematic views showing the state change of the cutting driving member 300 driven by the first cutter back mechanism 400 and the second cutter back mechanism in the present embodiment. As shown in fig. 24, when the doctor pulls the pull button 310 of the second cutter back mechanism to drive the cutting driving member 300 to retract a certain distance, and then wants to drive the cutting driving member 300 in a more labor-saving manner, the doctor can switch to the first cutter back mechanism 500 at any time, and when the first cutter back operating member 502 is operated to move in a direction away from the closing position, the first cutter back driving member 504 moves from its initial position to the disengaging position, and at this time, the first cutter back driving member 504 is combined with the cutting driving member 300. As shown in fig. 25, continued operation of the first return operating member 502 moves away from its closed position and the first return driving member 504 drives the cutting driving member 300 to continue to retract under the influence of the first return operating member 502. At this time, the doctor can switch to the second cutter back mechanism again as required, and the pulling button 310 of the second cutter back mechanism is pulled to drive the cutting driving member 300 to continue to retreat. Here, the first return mechanism 500 is switched by using the second return mechanism, and similarly, the first return mechanism 500 may be used first and then the second return mechanism may be switched as required, and the description will not be repeated here. Because the first knife return mechanism and the second knife return mechanism are operated, the first knife return mechanism and the second knife return mechanism can not generate any interference, a doctor can switch the first knife return mechanism and the second knife return mechanism at any time when taking the labor saving and the knife return efficiency into consideration according to the needs, the operation is smooth, and the experience is better.

Referring to fig. 26 to 28, a second embodiment of the present invention is the same as the first embodiment, and the present embodiment relates to a manual stapler.

This embodiment differs from the first embodiment in that the knife back operating member 308 is pivotally connected to the cutting drive member 300, and the knife back operating member 308 is operated to move pivotally proximally to drive the jaw locking mechanism 400 from the locked position to the unlocked position. The return operating member 308 includes an operating knob assembly including an operating knob 320 and a connecting shaft 312, the connecting shaft 312 being pivotally connected to the cutting drive member 300, the operating knob 310 being disposed at an end of the connecting shaft 312, the operating knob assembly being operated to move pivotally proximally to drive the jaw locking mechanism 400 from the locked position to the unlocked position to effect unlocking of the jaw assembly. By the cooperation of the return knife operating member 308 and the jaw locking mechanism 400, the jaw assembly can not be opened in a firing state without other complex structures; the whole device has simple and compact structure and is safe and reliable. Meanwhile, the return knife operating member 308 can be fully utilized, and not only can be used for driving the cutting driving member 300 to retreat, thereby driving the cutting knife assembly 40 to retreat, but also can be matched with the jaw locking mechanism 400 to unlock the closing handle 104, so that the dual-purpose of the return knife operating member 308 is realized. Meanwhile, the return knife operating member 308 is pivotally connected to the cutting drive member 300, and the jaw locking mechanism 400 is driven to move to the unlocking position by the pivotal movement, so that the overall structure can be more compact than the translational movement for unlocking.

Specifically, the connecting shaft 312 is pivotally connected to the cutting driving member 300, two operation buttons 320 are symmetrically disposed at two ends of the connecting shaft 312, and a protruding portion 322 is disposed at one side of the connecting shaft 312. In the initial state, the jaw locking mechanism 400 is in the locked position, the closure handle 104 is in the open position, and the abutment end 108 is separated from the stop member 402, as shown in fig. 26; when the user operates the closure handle 104 to move from the open position to the closed position, the abutment end 108 thereof abuts the stop member 402, and the closure handle 104 is locked in the closed position, as shown in fig. 27. When the knife back operating member 308 is driven to pivot proximally, the protrusions 322 act on the trigger element 404 of the jaw locking mechanism 400 to drive the trigger element 404 and, in turn, the stop element 402 to an unlocked position to unlock the closure handle 104, as shown in FIG. 28. The return operating member 308 further includes a reset member (not shown) by which the operating knob assembly can be reset to an initial position for use next time.

Referring to fig. 29 to 33, a third embodiment of the present invention is the same as the first embodiment, and the present embodiment relates to a manual stapler.

This embodiment differs from the first embodiment in that the return mechanisms of the two are different. The return mechanism in the embodiment has a first position and a second position; the first return operator 502 further includes a trigger that is coupled to the return mechanism to limit the first return actuator 504 to the initial position when in the first position; in the second position, the trigger is disengaged from the return mechanism such that the first knife back drive 504 is in the disengaged position; movement of the first return operating member 502 from the closed position toward the open position causes the trigger and return mechanism to switch from the engaged state to the disengaged state, and in the disengaged state, the first return operating member 502 drives the first return driving member 504 to move, thereby driving the cutter assembly 40 to retract; the first return operating member 502 is operated to move from the open position to the closed position such that the trigger and return mechanism are switched from the disengaged state to the engaged state.

In this embodiment, the return mechanism includes a pivot member 522 pivotally coupled to the body of manual stapling instrument 100, pivot member 522 including a first end 524 and a second end 526 coupled to first end 524; in the first position, the trigger is coupled to the first end 524 such that the second end 526 is coupled to the first return actuator 504 to limit the first return actuator 504 to the initial position, as shown in fig. 29 and 30; in the second position, the trigger is disengaged from the first end 524 such that the first knife back drive 504 is in the disengaged position, as shown in fig. 31, 32. In order to reduce the parts and make the structure more compact, the triggering piece is the first reinforcing piece 514 in this embodiment. More specifically, as shown in fig. 31 to 33, the first cutter back driving member 504 includes a protrusion 516, and the first end 524 of the pivot member 522 is provided with an abutment 528, and in the first position, the first reinforcing member 514 is connected, specifically, abuts, to apply a force to the abutment so that the second end 526 of the pivot member 522 is lifted upward to be connected with the protrusion 516, so as to limit the first cutter back driving member 504 to the initial position; when the first return operating member 502 is operated to move towards the open position, the first reinforcement member 514 is separated from the abutment 528 of the pivot member 522, i.e. no longer acts on the abutment 528, at which time the pivot member 522 is rotated such that the second end 526 is separated from the first return driving member 504 such that the first return driving member 504 is in the disengaged position. Of course, it will be understood by those skilled in the art that when the first reinforcement member 514 is no longer applied to the pivot member 522, i.e., the first reinforcement member 514 is separated from the abutment 528, the first knife back driving member 504 may not be separated from the second end 526 of the pivot member 522, and the first knife back driving member 504 may be applied to the second end 526 of the pivot member to drive rotation thereof while still connected to the first knife back driving member 504. The existence of the return mechanism enables the first cutter return mechanism 500 to be reused, meeting the surgical needs.

In another embodiment, the return mechanism comprises a trigger member disposed on the first knife back operating member 502, and a pivot member 522 pivotally coupled to the body of the manual stapling instrument 100, the pivot member 522 comprising a first end 524 and a second end 526 coupled to the first end 524; in the first state, the trigger is connected to the first end 524, such that the second end 526 is connected to the first return driving member 504 to limit the first return driving member 504 to the initial position; in the second state, the trigger is disengaged from the first end 524 such that the first knife back drive 504 is in the disengaged position; movement of the first return operating member 502 from the closed position toward the open position causes the trigger member to switch from the connected state to the disconnected state with the first end 524, such that movement of the first return driving member 504 from the initial position switches to the disengaged position; the first return operating member 502 moves along an open position to its closed position such that the trigger and the first end 524 switch from a disconnected state to a connected state. In order to reduce the parts and make the structure more compact, the triggering piece is the first reinforcing piece 514 in this embodiment. More preferably, the pivot member 522 is disposed between the trigger member and the first cutter back driving member 504, that is, between the first reinforcing member 514 and the first cutter back driving member 504, so that the space utilization is higher, and the first cutter back mechanism 500 is smaller in size and more compact in structure. Also, the presence of the return mechanism enables the first knife return mechanism 500 to be reused, thereby meeting surgical needs.

Referring to fig. 34 to 37, a fourth embodiment of the present invention is the same as the first embodiment, and the present embodiment relates to a manual stapler.

This embodiment differs from the first embodiment in that the first cutter back mechanism and the second cutter back mechanism can only be operated alternatively to drive the cutting drive member to retreat. Manual stapler 100 has a first state in which first knife return mechanism 500 is coupled to cutting drive 300 and a second state in which second knife return mechanism is decoupled from cutting drive 300; in the second state, the second cutter back mechanism is combined with the cutting driving piece 300, and the first cutter back mechanism is separated from the cutting driving piece 300; bonding here includes gap bonding. The doctor can selectively select the first cutter back mechanism 500 and the second cutter back mechanism to combine with the cutting driving piece 300 to drive the cutting cutter assembly 40 to retreat, so that the first cutter back mechanism and the second cutter back mechanism are switched, and labor saving and cutter back efficiency are both considered.

In this embodiment, the cutting driver 300 includes a body, a first driving portion and a second driving portion disposed on the body, wherein the second driving portion is located above the first driving portion; in the first state, the first cutter return mechanism is combined with the first driving part, and the second cutter return mechanism is separated from the second driving part; in the second state, the second cutter returning mechanism is combined with the second driving part, and the first cutter returning mechanism is separated from the first driving part. Specifically, the cutting drive 300 includes a rack, and the first driving portion is a plurality of first tooth slots 316 disposed above the rack; the second driving part is a fixing piece 324 arranged above the rack; the first cutter back driving piece 504 drives the rack to retract through the first tooth slot 316 under the action of the first cutter back operating piece 502; the second return mechanism includes a second return operating element, the second driving portion 324 is provided with a mounting portion 326, and in the first state, the second return operating element is not mounted to the mounting portion 326. Specifically, as can be seen from the foregoing, the second cutter back operation member includes a pull button assembly including the pull button 310 and the connecting shaft 312, the mounting portion 326 is provided with a mounting hole, and the connecting shaft 312 is not inserted into the mounting hole, so that the second cutter back mechanism is separated from the second driving portion, as shown in fig. 37; in the second state, the second return operating piece is attached to the mounting portion 326, and at this time, the connecting shaft 312 of the second return operating piece is inserted into the mounting hole of the second driving portion 324, as shown in fig. 36. According to the actual needs, when the doctor encounters thick tissues, the second cutter returning mechanism cannot drive the cutter assembly 40 to retreat or the second cutter returning mechanism is used for driving the cutter assembly 40 to retreat, so that the pull button assembly can be pulled outwards to be separated from the mounting part 326, and the second cutter returning mechanism is prevented from obstructing or interfering with the movement of the first cutter returning mechanism 500, so that the first cutter returning mechanism 500 which is relatively labor-saving to operate is used for driving the cutter assembly 40 to retreat. When the first cutter back mechanism 500 is operated to move for a while, the first cutter back mechanism 500 may be restored to the closed position to prevent the first cutter back mechanism from obstructing or interfering with the movement of the second cutter back mechanism 500 in order to improve the retracting efficiency of the cutter assembly 40, and the second cutter back operation member is again coupled with the cutter driving member 300 by inserting the coupling shaft 312 of the knob assembly into the mounting hole of the second driving portion 324 again, and the cutter assembly 40 is driven to retract rapidly by pulling the knob assembly proximally. That is, a doctor can switch the first cutter returning mechanism and the second cutter returning mechanism according to the operation requirement, so that labor saving and cutter returning efficiency are considered, operation efficiency is improved, operation time is saved, and postoperative recovery of a patient is facilitated.

In this embodiment, the body of the manual stapling instrument 100 is provided with an open slot (not shown) in a position corresponding to the trigger element 404 of the jaw locking mechanism, which may be an arcuate slot or a slot of another shape. When the jaw assembly needs to be unlocked, the connecting shaft 312 of the second knife back operating member extends into the machine body through the opening slot to be in contact with the trigger element 404 of the jaw locking mechanism 400, and when the second knife back operating member is driven proximally, the connecting shaft 312 moves in the opening slot and acts on the trigger element 404 to drive the trigger element 404 to move, so that the limiting element 402 of the jaw locking mechanism 400 is driven to move from the locking position to the unlocking position. When the stop element 402 moves from the locked position to the unlocked position, the stop element 402 is again separated from the abutment end 108 of the closure handle 104 and the closure handle 104 is unlocked. The second knife return operator can be fully utilized, which can be used to not only drive the cutting drive 300 back, and thus the cutting knife assembly 40 back, but also cooperate with the jaw locking mechanism 400 to unlock the closure handle 104, achieving a dual purpose knife return operator.

It should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is for clarity only, and that the skilled artisan should recognize that the embodiments may be combined as appropriate to form other embodiments that will be understood by those skilled in the art.

The above list of detailed descriptions is only specific to practical embodiments of the present invention, and they are not intended to limit the scope of the present invention, and all equivalent embodiments or modifications that do not depart from the spirit of the present invention should be included in the scope of the present invention.

Claims

1. The manual anastomat comprises a cutting driving piece, a cutting knife assembly connected with the cutting driving piece, and a knife returning mechanism, wherein the knife returning mechanism is used for driving the cutting driving piece to retreat and further driving the cutting knife assembly to retreat; wherein the cutter back mechanism comprises a first cutter back mechanism and a second cutter back mechanism independent of the first cutter back mechanism, the first cutter back mechanism and the second cutter back mechanism both have a driving state and a non-driving state, and in the driving state, the first cutter back mechanism or the second cutter back mechanism is operated to drive the cutting driving piece to retreat; in either position of the first and second return mechanisms in the driven state, the other of which is switchable between the driven state and the non-driven state.

2. The manual stapler according to claim 1, wherein the cutting drive comprises a body, and a first drive portion and a second drive portion disposed at different positions of the body, wherein the first cutter return mechanism acts on the first drive portion to drive the cutting drive to retract, and the second cutter return mechanism acts on the second drive portion to drive the cutting drive to retract.

3. The manual stapler according to claim 2, wherein said first drive portion is located above said body; the second driving part is positioned at the side of the body.

4. The manual stapler of claim 2, wherein the cutting drive comprises a rack, the first drive being a plurality of first tooth slots disposed above the rack; the first cutter returning mechanism comprises a pawl and a first cutter returning operation piece, and the pawl drives the rack to retract through the plurality of first tooth grooves under the action of the first cutter returning operation piece.

5. The manual stapler according to claim 2, wherein the second return mechanism includes a second return operation member, which when operated to move proximally, drives the second drive portion in motion, thereby driving the cutting drive member to retract.

6. The manual stapler of claim 5, wherein the second operation member includes a pull button assembly and a second biasing member, a first end of the second biasing member being coupled to the cutting drive member and a second end being coupled to the pull button assembly, the second biasing member accumulating energy when the pull button assembly is moved proximally.

7. The manual stapler of claim 6, wherein the pull button assembly includes a pull button and a connection shaft, the pull button being disposed at an end of the connection shaft, the second end of the second biasing member being coupled to the connection shaft.

8. The manual stapler of claim 1, wherein the first cutter return mechanism includes a first cutter return drive for driving the cutting drive back, the first cutter return drive being in an initial position when the first cutter return mechanism is in the non-driven state; when the first cutter return mechanism is in the driving state, the first cutter return driving piece is positioned at a disengaging position; when the first cutter return mechanism is switched from the driving state to the non-driving state, the first cutter return driving piece is reset to the initial position from the disengaging position.

9. The manual stapler of claim 8, wherein the first knife return mechanism includes a first knife return operating member pivotally connected to the body of the manual stapler, the first knife return driving member pivotally connected to the first knife return operating member; the first cutter return mechanism further comprises a return mechanism, and in the non-driving state, the return mechanism is connected with the first cutter return driving piece so that the first cutter return driving piece is limited at the initial position; in the driving state, the return mechanism is separated from the first cutter back driving piece so as to enable the first cutter back driving piece to be in the disengaging position; a movement of the first return operating member from a closed position towards an open position causes the first return mechanism to switch from the non-driven state to the driven state; the first return operating member is moved from the open position to the closed position such that the first return mechanism is switched from the driven state to the non-driven state.

10. The manual stapler of claim 1, wherein the first knife return mechanism is pivotally connected to the body of the manual stapler, the first knife return mechanism driving the cutting drive back generally along a direction of its pivoting; the second cutter back mechanism drives the cutting driving piece to retreat along the longitudinal direction.

11. The manual stapler of claim 1, wherein the first knife return mechanism is coupled to a body of the manual stapler and disposed above the cutting drive, and the second knife return mechanism is coupled to the cutting drive and disposed below the first knife return mechanism.

12. The manual stapler of claim 11, wherein in an initial state, the second cutter-back mechanism is coupled to the proximal end of the cutting drive, and the first cutter-back mechanism is distal to the second cutter-back mechanism.

13. The manual stapler of claim 1, wherein in an initial state, the first cutter back mechanism extends in a longitudinal direction and the second cutter back mechanism extends in a lateral direction.

14. The manual stapler of claim 1, wherein the first cutter back mechanism is intermittently coupled to the cutting drive and the second cutter back mechanism is continuously coupled to the cutting drive.