CN207949843U - A kind of previous anastomotic reinforcing and repairing sub-assembly - Google Patents

Abstract

The utility model is related to a kind of previous anastomotic reinforcing and repairing sub-assembly, the nail anvil or nail bin of the previous anastomotic reinforcing and repairing sub-assembly and stapler are used cooperatively, it is characterised in that：The previous anastomotic reinforcing and repairing sub-assembly includes reinforcing and repairing piece, backing, line and fixed part；The line is used in two side edges that the reinforcing and repairing piece and backing is detachably connected；The fixed part has sleeve-like structure, can cover the end for being connected to the stapler nail anvil or nail bin.Above-mentioned reinforcing and repairing sub-assembly its enough intensity can be provided for pending tissue；Prevent previous anastomotic from tearing；Prevent Anastomotic bleeding, gas leakage, sepage；Prevent reinforcing and repairing piece from turnup and fold occur during installation or use；It is capable of providing and smooth is covered in structural reinforcing and repairing piece to be repaired.

Description

A kind of previous anastomotic reinforcing and repairing sub-assembly

Technical field

The utility model belongs to the field of medical instrument technology, more particularly to a kind of previous anastomotic reinforcing and repairing sub-assembly, more More particularly to a kind of reinforcing and repairing sub-assembly for linear anastomat.

Background technology

Surgical stapling because its can the same time quickly cutting and closed histoorgan in patient body, compared to First being opened with scalpel/shearing for routine operation, largely reduces the risk of such surgical procedure, and shortens operation Time, thus have very extensive application in surgical operation.There are one jaw formula structures for general surgery bracing means, generally include Two sseparated arms.One arm is cartridge arm, and it is nail anvil arm, tool to have nail bin face, including two or more pieces staple line, another arm There is nail anvil face.Surgery bracing means can be with or without the cutter device with dissection.

In certain operations, naked nail is directly used, be exactly that anastomosis staple directly contacts with the tissue of patient is practicable.Cause For before healing, completely tissue can inherently prevent anastomosis staple to be detached from from tissue to patient, and compensate crack.However, It performs the operation to other, it is too fragile really that patient, which needs the tissue sutured, it is difficult to which anastomosis staple is fixed on corresponding position. For example, the operation of lung, the lung tissue of special lesion occurs in some, and it is very fragile to need identical tissue, under extreme case, Concordant profipole without protection, which is easy to happen, completely to be torn.With the day for using surgery ruggedized equipment in the operation of the lung tissue of lesion Beneficial extensive, the fragile tissue of protection that takes measures has become from being stapled nail tearing or being torn in surgery sewing process It is more and more important.Furthermore when using stapler, bleeding and sepage problem around anastomosis staple are also required to solve.Such as stomach and intestine Road is performed the operation in early stage cause of bleeding, most commonly Anastomotic bleeding, accounts for about 90% or more；Occur when especially rebuilding previous anastomotic Intraoperative hemorrhage, bleeding part are common in gastrointestinal anastomosis, stump of stomach previous anastomotic and duodenal stump.The bleeding of previous anastomotic will be big It is big to extend operating time, increase the risk that postoperative complication occurs for patient.

Safeguard measure known to a kind of is to use enhancing or reinforcement material, and the operation principle of this kind of enhancing or reinforcement material is One layer of absorbable reinforcement material is assembled in the nail bin of stapler and nail anvil face, while completing to cut stitching, by the material Material is fixed in previous anastomotic, protects fragile tissue from being stapled nail tearing, the naked nail of closing and tissue or intervascular gap, To play reinforcing previous anastomotic, the complication risks such as Anastomotic bleeding, gas leakage, sepage are reduced.For linear cutting anastomat, When into body cavity, reinforcing and repairing piece may touch tissue cut edge, lead to the turnup of previous anastomotic reinforcing and repairing piece or move back Contracting.

And perform the operation for chamber endoscopic stapler device, puncture outfit must also be used other than using stapler.Puncture outfit is a kind of energy Enough establish the medical instrument of the inside and outside operation instrument channel of unicom human body.Puncture outfit includes sealed valve, which can protect Hold abdominal cavity air pressure.In chamber endoscopic stapler device surgical procedure, after previous anastomotic reinforcing and repairing piece is fixed to stapler front end, band There is the pipeline that the stapler front end of previous anastomotic reinforcing and repairing piece must pass through puncture outfit to provide to enter human body.For the kiss with backing Heal up reinforcing and repairing piece, when across the pipeline, due to puncture outfit tube wall or valve and reinforcing and repairing piece and backing it Between friction force effect, patch or backing turn down or shrink back backward, causes reinforcing and repairing piece turnup or the fold on stapler. When there is these turnups or fold, previous anastomotic reinforcing and repairing piece cannot entirely cover pending tissue.It is repaiied at this time due to reinforcing Sticking patch comes into vivo and can not be readjusted so that its is smooth.If firing stapler by force, due to these The presence of fold and turnup, anastomosis staple perfect can not shape, the result is that previous anastomotic is unable to tight closure and causes in art or postoperative Bleeding, gas leakage or sepage.At this point, stapler front end can only be made to exit puncture outfit, reinforcing and repairing piece is rearranged.However lead to again When crossing puncture outfit, turnup or buckling problems it is possible to occurring and influencing procedure again.

Utility model content

Technical problem to be solved in the utility model is：A kind of previous anastomotic reinforcing and repairing sub-assembly is provided, can be Pending tissue provides enough intensity；Prevent previous anastomotic from tearing；Prevent Anastomotic bleeding, gas leakage, sepage；Prevent reinforcing and repairing There is turnup and fold during installation or use in piece；It is capable of providing and smooth is covered in structural reinforcing and repairing to be repaired Piece.

It is described to solve the problems, such as said one or a kind of multiple, previous anastomotic reinforcing and repairing sub-assembly of the utility model offer The nail anvil or nail bin of previous anastomotic reinforcing and repairing sub-assembly and stapler are used cooperatively, it is characterised in that：The previous anastomotic reinforcing and repairing Sub-assembly includes reinforcing and repairing piece, backing, line and fixed part；The line be used for two side edges by the reinforcing and repairing piece with Backing is detachably connected；The fixed part has sleeve-like structure, can cover the end for being connected to the stapler nail anvil or nail bin Place.

It can utilize backing and line that reinforcing and repairing piece is firmly secured on nail bin face or nail anvil face using above structure, Prevent previous anastomotic reinforcing and repairing piece from shrinking back and turnup.The nail anvil and nail bin of stapler have end.Add in installation previous anastomotic Admittedly repair sub-assembly, fixed part, which has, is similar to sleeve-like structure, which is connected to the end of nail anvil and nail bin so that Previous anastomotic reinforcing and repairing sub-assembly is fixed with respect to nail bin or nail anvil, is not slid when external force is touched.In particular, working as stapler When being inserted into puncture outfit, since the stapler with previous anastomotic reinforcing and repairing sub-assembly is suitable with puncture outfit inside dimension, thus add Friction is generated between sub-assembly and puncture outfit inner wall admittedly repairing, and causes the resistance moved to reinforcing and repairing sub-assembly.It fixes at this time Transmission of the interaction force through sleeve-like structure, backing and line between the sleeve-like structure in portion and the end of stapler so that above-mentioned Resistance is overcome or offsets, thus reinforcing and repairing sub-assembly will not shrink back and turnup.

At least part of the fixed part is integrated with the backing；Or the fixed part and the backing are phases Mutual independent component, and the fixed part is connected with each other with the backing.Fixed part at least part (such as first fix Portion) between backing can be integrated, it can once reserve the material used in the first fixed part using back lining materials；It should Reserved material, which forms to have, is similar to nested structure fixed part.Or pass through the materials such as setting line, band, piece on reserved material The fixed part similar to nested structure of stapler end can be socketed on by being formed.Can also be to detach between fixed part and backing, Fixed part can select different materials from backing at this time, be connected fixed part and backing by modes such as sewing, bonding or hot pressing It connects.

The fixed part includes the first fixed part and the second fixed part, and second fixed part and first fixed part are extremely Small part is overlapped；Second fixed part is connected with each other with first fixed part.

Fixed part can be formed using one piece material, and the second fixed part is curved to reinforcing and repairing piece direction with respect to the first fixed part Folding, then using bond, suture or heat bonding in the way of by the first fixed part and the second fixed part mutually in side edge at least portion Divide ground connection, is formed similar to the structure covered.Fixed part can also be spliced using multiple materials, and multiple materials are connected with each other Form the structure similar to set.Above structure is for covering the end for being connected to the stapler nail anvil or nail bin.Such structure makes When the proper external world has obstruction, which can prevent backing and/or previous anastomotic reinforcing and repairing piece from moving back to pulling force is provided Contracting and turnup.

Second fixed part is set to be fixed to each other at least partly in the side edge of lap with first fixed part, Fixed form between second fixed part and first fixed part is dismountable or non-removable.It is preferably described Fixed form can be the mode or combination thereof of bonding, suture or heat bonding.

The line is additionally arranged at the side edge of first fixed part and the second fixed part lap, makes described One fixed part and second fixed part are connected with each other at least partly.It is connect with the line of reinforcing and repairing piece using fixed backing First and second fixed parts can simplify structure, avoid excessive use component.And dismantling fixed part is can contribute to, favorably In the taking-up of fixed part.

The sleeve-like structure is the through-hole being arranged on the fixed part, and the fixed part is enable to be socketed on described coincide The nail anvil of device or the end of nail bin.The through-hole is socketed on the nail bin of stapler or the end of nail anvil, and fixed part is logical at this time Transmission of the interaction force through sleeve-like structure, backing and line between hole and stapler end so that resistance is overcome or offsets, Thus reinforcing and repairing sub-assembly will not shrink back and turnup.

The fixed part with the sleeve-like structure includes open end and at least partly closed blind end, the opening End can accommodate the stapler nail anvil or at least part of nail bin enters the inner space that the sleeve-like structure is formed, described Blind end can prevent the end of the stapler nail anvil or nail bin from passing completely through the inner space that the sleeve-like structure is formed.Set Shape structure has open running-on and at least partly closing set bottom, the end for being socketed nail anvil and nail bin.

The fixed part includes the first fixed part and the second fixed part, and second fixed part includes an at least fixing line Or fixed band；The fixing line or fixed band are arranged on first fixed part, the fixing line or fixed band and described the One fixed part forms fixed structure, so that the fixed part is covered and is connected to the stapler nail anvil or nail bin end.

Fixing line used in fixed part can be able to be that same root line can also with the line used in backing and reinforcing and repairing piece Use mutually independent line.Set or net are formed with above-mentioned fixing line or fixed band sewing fixed part, fixed part is enable to be socketed on nail Storehouse or nail anvil end.

The fixed part is integrally formed.The fixed part can be integrally formed as sleeve-like structure with homogenous material, use In the end for being socketed in nail bin and nail anvil.

The reinforcing and repairing piece is degradation material, preferably degradable high polymer material or degradable biomaterial.It is described The material of reinforcing and repairing piece is non-immunogenicity and the material that can degrade in vivo, has three-dimensional netted porous structure, can reinforce Previous anastomotic is matched with stapler, such as high molecular material or biomaterial.Degradable high polymer material can be poly- breast Acid, polyglycolic acid, glycol acid and the copolymer of lactic acid, the copolymer of lactic acid and caprolactone, glycol acid and caprolactone Copolymer, polycaprolactone, polydioxanone or their mixture.Degradable biomaterial includes that non-crosslinked Collagen Type VI is fine Dimension, mucopolysaccharide, growth factor and glycoprotein sheet remove antigen animal sources cell epimatrix material.

The reinforcing and repairing piece is the biological tissue through immunogene removal processing, such as tissue coating, inner membrance.It can select Pericardium or submucous layer of small intestine, preferably de- cell submucous layer of small intestine host material.

The length of the reinforcing and repairing piece is identical as nail anvil face or nail bin face length.Reinforcing and repairing piece can cover whole nails Hole or whole nail anvils hole.Portion of tissue needs two or more nail bin groupwares that could complete to cut, and multiple nail bin groupwares are Sequence uses, i.e. a nail bin groupware is replaced by after being fired on stapler new does not fire nail bin groupware, new staple cartridge component Cutting will be continued to complete along former previous anastomotic direction, therefore reinforcing and repairing piece is long that the part of new staple cartridge will be caused to be clamped more than two The reinforcing and repairing piece of layer, causes in uneven thickness, influences staple formation.And too short reinforcing and repairing piece then cannot be reinforced effectively Previous anastomotic.

Previous anastomotic is stomach previous anastomotic, esophagus previous anastomotic, duodenum previous anastomotic, small intestine anastomosis mouth, stump after pneumonectomy It is closed mouth, Bronchial Stump after Pneumonectomy previous anastomotic, biliary anastomosis mouth, the postoperative stump closure mouth of pancreatectomy, colorectal anastomosis mouth, blood vessel kiss It heals up.

The side of the reinforcing and repairing piece includes one or more notch.

The one or more holes of axis direction setting of the reinforcing and repairing piece.

Reinforcing and repairing piece can have various shapes.Such as can one or more notch, Huo Zhe be set in side edge The one or more holes of axis direction setting of reinforcing and repairing piece.Notch can be square, rectangle, triangle, trapezoidal, semicircle Or the various shapes such as half elliptic.The various shapes such as hole can be square, rectangle, round or ellipse.Due to being kissed It heals up during reinforcing and repairing, reinforcing and repairing piece is implanted in vivo, and in order to reduce the total amount of implantation material, above-mentioned notch can be arranged The hole and.In addition, when stapler fires, cutter also cut reinforcing and repairing piece while cutting tissue, thus pass through setting Hole on axis direction can reduce the Cutting Drag of cutter.

The line is unremovably connect with the backing or the fixed part.By can not by line and backing or fixed part It releasably connects, is conducive to take out backing and fixed part from internal by the pull line.

The previous anastomotic reinforcing and repairing sub-assembly of the utility model can be adapted for the stapler of different model.For nail bin face And/or nail anvil face is that nonplanar situation is equally applicable.

The previous anastomotic reinforcing and repairing sub-assembly of the utility model uses the structure with fixed part, using fixed part and coincide The mode that the end of device nail bin and nail anvil socket-connects prevents previous anastomotic reinforcing and repairing sub-assembly from occurring due to sliding, shrinking back, turn down The turnup and fold of generation.

Description of the drawings

Figure 1A is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model first embodiment；

Figure 1B is to be assembled into stapler according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model first embodiment Diagrammatic cross-section on nail bin and nail anvil；

Fig. 1 C are in Figure 1B along the diagrammatic cross-section in the directions A-A；

Fig. 1 D are in Figure 1B along the diagrammatic cross-section in the directions B-B；

Fig. 2A is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model second embodiment；

Fig. 2 B are to be assembled into stapler according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model second embodiment Diagrammatic cross-section on nail bin and nail anvil；

Fig. 3 A are the schematic diagrames according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model third embodiment；

Fig. 3 B are according to the schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of the utility model third embodiment, wherein solid Determine portion and is in dismantling state；

Fig. 4 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the 4th embodiment of the utility model；

Fig. 5 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the 5th embodiment of the utility model；

Fig. 6 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model sixth embodiment；

Fig. 7 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the 7th embodiment of the utility model；

Fig. 8 A are the schematic diagrames according to the previous anastomotic reinforcing and repairing sub-assembly of the 8th embodiment of the utility model；

Fig. 8 B are according to the schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of the 8th embodiment of the utility model, wherein solid Determine portion and is in dismantling state；

Fig. 9 A are the schematic diagrames according to the previous anastomotic reinforcing and repairing sub-assembly of the 9th embodiment of the utility model；

Fig. 9 B are according to the schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of the 9th embodiment of the utility model, wherein solid Determine portion and is in dismantling state；

Figure 10 is will be solid between previous anastomotic reinforcing and repairing sub-assembly and backing according to a kind of embodiment of the utility model The sewing schematic diagram of fixed line；

Figure 11 is will be between previous anastomotic reinforcing and repairing sub-assembly and backing according to the utility model another embodiment The sewing schematic diagram of fixed line.

Specific implementation mode

Figure 1A is according to the schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of the utility model first embodiment, wherein wrapping Include previous anastomotic reinforcing and repairing piece 11, backing 12, line 13 and fixed part 14.Using line 13 by reinforcing and repairing piece 11 and backing 12 Two sides are sutured, which is detachable suture (such as by sewing device or sewing manually) so that reinforcing and repairing It is detachable connection between piece 11 and backing 12.By pulling the end of line 13 sewed, can by line 13 nondestructively from It removes on reinforcing and repairing sub-assembly 10, while being completely separated between reinforcing and repairing piece 11 and backing 12.Such structure can guarantee After stapler is fired, backing 12 can smoothly take out.Method used by suture includes that can utilize machine sewn or hand Seam.The details of sewer method may refer to Figure 10 and Figure 11.

Attached drawing 1B is to be assembled into stapler according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model first embodiment Nail bin and nail anvil on diagrammatic cross-section.It is respectively repaiied using a previous anastomotic reinforcing on the nail bin 16 and nail anvil 17 of stapler 15 Mend sub-assembly 10.The nail bin 16 and nail anvil 17 of stapler 15 are each passed through previous anastomotic in previous anastomotic reinforcing and repairing sub-assembly 10 and reinforce The cartridge type space that patch 11 is surrounded with backing 12.The fixed part 14 of previous anastomotic reinforcing and repairing sub-assembly 10 includes the first fixation Portion 141 and the second fixed part 142, the second fixed part 142 are bent to 11 direction of reinforcing and repairing piece, and form shell-like knot through sewing Structure covers the end for being connected to nail bin 16 or nail anvil 17 in fig. ib.This makes previous anastomotic reinforcing and repairing sub-assembly 10 by steadily solid Determine onto stapler 15.When across puncture outfit or because of other situations by advance resistance, still be able to stablize, do not occur turnup and It shrinks back.First fixed part 141 and the second fixed part 142 and backing 12 are integrated, and are extended forward from backing 12.Work as stapler After 15 percussions, reinforcing and repairing piece 11 is set to be detached with backing 12 by pulls wire 13, then backing 12 and fixed part 14 are by from internal It takes out.

Backing 12 and the first fixed part 141 are located substantially at the reflecting surface of nail bin 16 and nail anvil 17 to opposite, and second fixes Portion 142 is located at the end of nail bin 16 and nail anvil 17 to opposite, and previous anastomotic reinforcing and repairing piece 11 is located substantially at nail bin 16 and nail anvil 17 on opposite.The size of nail bin 16 is typically larger than the size of nail anvil 17, thus for the reinforcing and repairing sub-assembly of nail bin 16 10 size is more than the reinforcing and repairing sub-assembly 10 applied to nail anvil 17.But it is substantially the same with the structure.

First fixed part 141 and the second fixed part 142 can also be mutually independent component, have set by suturing to be formed The fixed part of shape structure.

Fig. 1 C are in Figure 1B along the diagrammatic cross-section in the directions A-A.Wherein the sectional view is complete nail bin sectional view.Nail bin 16 be only schematic diagram, and internal structure is omitted herein.Nail bin 16 passes through the tubular that previous anastomotic reinforcing and repairing piece 11 is formed with backing Space, reinforcing and repairing piece 11 and backing 12 wrap up nail bin 16, backing 12 and reinforcing and repairing piece 11 and are realized removably by line 13 Connection.

Fig. 1 D are in Figure 1B along the diagrammatic cross-section in the directions B-B；Wherein the sectional view is complete nail anvil sectional view.Nail anvil 17 be only schematic diagram, and internal structure is omitted herein.Nail anvil 17 passes through the tubular that previous anastomotic reinforcing and repairing piece 11 is formed with backing Space, reinforcing and repairing piece 11 and backing 12 wrap up nail anvil 17, backing 12 and reinforcing and repairing piece 11 and are realized removably by line 13 Suture.

Fig. 2A is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model second embodiment.Reinforcing is repaiied It includes reinforcing and repairing piece 21, backing 22, line 23 and fixed part 24 to mend sub-assembly 20.Wherein fixed part 24 includes the first fixed part 241, the first fixed part 241 is equipped with through-hole 28, and the through-hole 28 and nail bin 26 or 27 end of nail anvil socket-connect cooperation.

Fig. 2 B are to be assembled into stapler according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model second embodiment Diagrammatic cross-section on nail bin and nail anvil.26 end of nail bin has wedge-type shape, from tip to 26 main direction thickness of nail bin It gradually increases, which is dimensioned to be less than cartridge body size, thus fixed part 24 can be connected to nail bin end Place.Previous anastomotic reinforcing and repairing sub-assembly 20 for nail anvil 27 has similar structures.Therefore, 20 quilt of previous anastomotic reinforcing and repairing part It is stably mounted on stapler.When across puncture outfit or because of other situations by advance resistance, previous anastomotic reinforcing and repairing group Component 20 still is able to be stably fixed on stapler, and turnup does not occur and shrinks back.After stapler 25 fires, pass through pulls wire 23 make reinforcing and repairing piece 21 be detached with backing 22, and then backing 22 and fixed part 24 are taken out from internal.

The size of nail bin 26 is typically larger than the size of nail anvil 27, thus the ruler of the reinforcing and repairing sub-assembly 20 for nail bin 26 The very little reinforcing and repairing sub-assembly 20 being more than applied to nail anvil 27, while the size of through-hole 28 is also variant.But their structure It is substantially the same.

Fig. 3 A are the schematic diagrames according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model third embodiment.Reinforcing is repaiied It includes previous anastomotic reinforcing and repairing piece 31, backing 32, line 33 and fixed part 34 to mend sub-assembly 30.34 one end of sewing rear fixed part has The constricted end portion structure that width is gradually reduced, but still retain one fixed width to form sleeve-like structure, it is socketed on for reduction identical Device end material therefor makes it easier to enter in puncture outfit and body to reduce the space occupied.

Reinforcing and repairing piece 31 and backing 32 are sutured using fixing line 343, which is detachable suture, such as Pass through sewing device or sewing manually.It, can be by line 33 nondestructively from reinforcing and repairing by pulling the end of the line 33 sewed It removes on piece 31, while being detached between reinforcing and repairing piece 31 and backing 32.Such structure can guarantee after stapler is fired, Backing 32 can smoothly take out.Method used by suture includes that machine sewn or hand can be utilized to stitch.

Fig. 3 B are according to the schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of the utility model third embodiment, wherein solid Determine portion and is in dismantling state.The part that wherein the first fixed part 341 is connected with the second fixed part 342 has notch, keeps them right Crease can form the fixed part 34 for the constricted end portion structure being gradually reduced with width after closing.On the one hand the fixed part can be reduced The space occupied on the other hand due to there is the coupling part not cut off, thus has enough intensity, can guarantee that previous anastomotic is reinforced Repair piece is stable, is securely fastened to the end of nail bin or nail anvil, breakage will not occur.First fixed part 341 and second is fixed Portion 342 and backing 32 are integrated, and are extended forward from backing 32.It is to reinforce to repair by pulls wire 33 after stapler fires Sticking patch 31 is detached with backing 32, and then backing 32 and fixed part 34 are taken out from internal.The size of nail bin is typically larger than nail anvil Size, thus the size of the reinforcing and repairing sub-assembly for nail bin is more than the reinforcing and repairing sub-assembly applied to nail anvil.But its It is substantially the same with the structure.

First fixed part 341 and the second fixed part 342 can also be mutually independent component, have set by suturing to be formed The fixed part of shape structure.

Fig. 4 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the 4th embodiment of the utility model.Shown in Fig. 4 Previous anastomotic reinforcing and repairing sub-assembly include previous anastomotic reinforcing and repairing piece 41, backing 42, line 43 and fixed part 44.Utilize line 43 Reinforcing and repairing piece 41 and backing 42 are sutured, which is detachable suture, such as passes through sewing device or manual seam System.By pulling the end of the line 43 sewed, line 43 can nondestructively be removed from reinforcing and repairing piece 41, while reinforcing and repairing It is detached between sticking patch 41 and backing 42.Such structure can guarantee that after stapler is fired, backing 42 can smoothly take out. Method used by suture includes that machine sewn or hand can be utilized to stitch.

Fixed part 44 includes the first fixed part 441 and fixing line 443.First fixed part 441 and backing 42 are integrated, and Extend forward from backing 42.Fixing line 443 can form line set to be stitch-bonded to the first fixed part 441 compared with large span, the line set with The sleeve-like structure of fixed part 44 is collectively formed in first fixed part 441.When being installed on the nail bin or nail anvil of stapler, nail bin or nail The end of anvil is inserted into the sleeve-like structure of fixed part, and the structure which is collectively formed with fixing line 443 makes previous anastomotic add Gu patch 40 is fixed on the nail bin or nail anvil of stapler.

Its center line 443 can use same root line that can also use different lines from line 43.The preferably medical seam of the material of line Zygonema.

Fig. 5 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the 5th embodiment of the utility model.The implementation In mode in previous anastomotic reinforcing and repairing sub-assembly and the 4th embodiment previous anastomotic reinforcing and repairing sub-assembly have it is essentially identical Structure.The wherein sewing mode of the fixing line 543 of fixed part 54 and the sewing mode of Fig. 4 illustrated embodiments center line 443 has not Together.

Although Fig. 4 and Fig. 5 only provide the sewing mode of one and two fixing line, more line or belt shapes can also be used At above-mentioned sleeve-like structure.

Fig. 6 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the utility model sixth embodiment.The implementation The one side that backing 62 and reinforcing and repairing piece 61 are faced each other to side in mode is known as their inner surface, by backing and reinforcing and repairing The opposing face that piece faces each other side is known as their outer surface.In present embodiment, the both sides of the inner surface of backing 62 and reinforcing The outer surface both sides of patch 61 are mutually close to being used in combination line to carry out detachable suture.

The fixed part 64 of previous anastomotic reinforcing and repairing sub-assembly 60 include the first fixed part 641 and the second fixed part 642, second Fixed part 642 is bent to 61 direction of reinforcing and repairing piece, and forms sleeve-like structure through sewing, and set is connected to the end of nail bin or nail anvil. Fixed part 64 is folded state in Fig. 6, and when installation is on nail bin or nail anvil, the open side of fixed part 64 is opened, make nail bin or Nail anvil enters inside the sleeve-like structure, realizes socket.This makes previous anastomotic reinforcing and repairing sub-assembly 60 be stably fixed kiss In clutch.It when across puncture outfit or because of other situations by advance resistance, still is able to stablize, turnup does not occur and shrinks back.The One fixed part 641 and the second fixed part 642 and backing 62 are integrated, and are extended forward from backing 62.After stapler fires, Reinforcing and repairing piece 61 is set to be detached with backing 62 by pulls wire 63, then backing 62 and fixed part 64 are taken out from internal.

Although in present embodiment the outer surface both sides of the both sides of the inner surface of backing 62 and reinforcing and repairing piece 61 mutually close to, It is used in combination line to carry out detachable suture；It can also be by the inner surface both sides of the both sides of the outer surface of backing 62 and reinforcing and repairing piece 61 Mutually close to being used in combination line to carry out detachable suture.

Fig. 7 is the schematic diagram according to the previous anastomotic reinforcing and repairing sub-assembly of the 7th embodiment of the utility model.Wherein plus Gu patch 71 can have various shapes.Such as can one or more notch 77 be set in side edge, or repaiied in reinforcing The axis direction setting one or more hole 78 of sticking patch.Notch 77 can be square, rectangle, triangle, it is trapezoidal, semicircle or The various shapes such as half elliptic.The various shapes such as hole 78 can be square, rectangle, round or ellipse.Due to being kissed It heals up during reinforcing and repairing, reinforcing and repairing piece 71 is implanted in vivo.In order to reduce the total amount of implantation material, above-mentioned cut can be set Mouth 77 and hole 78.In addition, when stapler fires, cutter also cut reinforcing and repairing piece while cutting tissue, thus logical The hole 78 crossed on setting axis direction can reduce the Cutting Drag of cutter.

Fig. 8 A are the schematic diagrames according to the previous anastomotic reinforcing and repairing sub-assembly of the 8th embodiment of the utility model.Fig. 8 B are According to the schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of the 8th embodiment of the utility model, wherein fixed part 84 is in dismantling State.According to Fig. 8 A and 8B, in present embodiment, fixed part 84 is the independent part for constituting previous anastomotic reinforcing and repairing sub-assembly 80 Part.When forming reinforcing and repairing sub-assembly 80, fixed part 84 is fixed to each other with backing 82, the shell-like knot that fixed part 84 is formed at this time Previous anastomotic reinforcing and repairing sub-assembly can be fixed on nail bin or nail anvil by structure.

For fixed part 84 and 82 phase of backing each other individual components the case where, the two can use identical or different material Material.In addition, for the case where fixed part 84 is individual components, fixed part can independently make.For example, single sheet may be used Material sews or the modes such as bonding make fixed part, can also be fabricated to sleeve-like structure using integrally formed mode.Fixed part Connection between 84 and backing 82 can be realized by modes such as suture, bonding or heat bondings.

Fixed part 84 can make previous anastomotic reinforcing and repairing sub-assembly 80 be stably fixed the nail bin or nail anvil of stapler On.It when across puncture outfit or because of other situations by advance resistance, still is able to stablize fixation, turnup does not occur and shrinks back.

Fig. 9 A are the schematic diagram of the 9th embodiment of the utility model；Fig. 9 B are according to the 9th embodiment party of the utility model The schematic diagram of the previous anastomotic reinforcing and repairing sub-assembly of formula, wherein fixed part are in dismantling state.Fixed part as individual components 94 include the first fixed part 941 and the second fixed part 942.After 942 doubling of first fixed part 941 and the second fixed part, first Fixed part 941 and the second fixed part 942 are fixed to each other at least partly in side edge.On the one hand the fixed part can reduce occupancy Space, on the other hand due to there is a coupling part not cut off, thus there is enough intensity, can guarantee previous anastomotic reinforcing and repairing Part is stable, is securely fastened to the end of nail bin or nail anvil, breakage will not occur.After stapler fires, pass through pulls wire 93 Reinforcing and repairing piece 91 is set to be detached with backing 92, then backing 92 and fixed part 94 are taken out from internal.The size of nail bin is usually big In the size of nail anvil, thus the size of the reinforcing and repairing sub-assembly for nail bin is more than the reinforcing and repairing combination applied to nail anvil Part.But it is substantially the same with the structure.

In addition, fixation portions 94 makes for homogenous material；First fixed part 941 and the second fixed part 942 can also be Mutually independent component forms the fixed part with sleeve-like structure by suturing.The fixed part 94 can also be more independent parts Part is spliced.

In aforesaid plurality of embodiment, the fixed part in previous anastomotic reinforcing and repairing sub-assembly can be with mutual indepedent with backing Or be arranged with the mode of backing one, the fixed part of each embodiment can be replaced mutually.Although reinforcing and repairing material is safety , however in order to reduce indwelling in internal reinforcing and repairing material, fixing part structure is not set to reinforcing and repairing on piece.Do not exist Mode as fixed part is arranged in reinforcing and repairing on piece, moreover it is possible to the patch of previous anastomosis procedure be avoided to remain end to the latter It is negatively affected caused by the anastomosis staple forming of anastomosis procedure.

Figure 10 is the reinforcing and repairing piece by previous anastomotic reinforcing and repairing sub-assembly according to a kind of embodiment of the utility model The sewing schematic diagram of fixed line between backing.The structure that the sewing mode is formed is by sewing initiating terminal to sewing end It is divided into the first free segment 1031, first semi-open section 1032 of the n interconnected (n is positive integer), section 1033 is pulled, protects Section 1034, lock segments 1035, the first releasing section 1036 are held, each first semi-open section 1032 rope sling surrounded integrally connects Logical string holes 1037 on reinforcing and repairing piece 101 and on backing 102 string holes 1038, described first semi-open section 1032 Open end be located at backing side, the lock segments 1035 pass through described first semi-open section 1032 rope sling surrounded；By weaving Initiating terminal to braiding end, first first semi-open section 1032 of opening close to one end of braiding initiating terminal with it is described First free segment connection 1031, n-th first semi-open section 1032 of opening close to braiding end one end with it is described One end connection of section 1033, the other end for pulling section 1033 is pulled to be connect with one end of the maintaining segment 1034, the guarantor The other end for holding section 1034 is connect with one end of the lock segments 1035, the other end of the lock segments 1035 and described first Releasing section 1036 connects.

First free segment 1031 can be sewed on backing 102 in a manner of non-removable, or with non-removable side Formula is sewed in fixed part, such as passes through the modes such as repeatedly sew or knot.String holes 1037 and string holes 1038 can be pre-set On reinforcing and repairing piece 101 or backing 102, it can also be generated in sewing.

Figure 11 is the reinforcing and repairing by previous anastomotic reinforcing and repairing sub-assembly according to the utility model another embodiment The sewing schematic diagram of fixed line between piece and backing.The structure that the sewing mode is formed by braiding initiating terminal to braiding end according to The secondary n for being divided into the second free segment 1131, concatenating mutually (n is positive integer) second semi-open section of 1132, second releasing section 1133； By braiding initiating terminal to braiding end, first second semi-open section 1132 of opening is close to one end of braiding initiating terminal It is connect with second free segment 1131, the one end of n-th of second semi-open section 1132 of opening close to braiding end It is connect with second releasing section 1133, each described second semi-open section 1132 both passes through positioned at the reinforcing and repairing piece 111 String holes 1137 and string holes 1138 positioned at backing 112, and from second second semi-open section 1132, each described the second half The rope sling that open segment 1132 is surrounded is integrally through its previous second semi-open section 1132 rope sling surrounded.

First free segment 1131 can be sewed on backing 112 in a manner of non-removable, or with non-removable side Formula is sewed in fixed part, such as passes through the modes such as repeatedly sew or knot.String holes 1137 and string holes 1138 can be pre-set On reinforcing and repairing piece 111 or backing 112, it can also be generated in sewing.

Wherein previous anastomotic reinforcing and repairing piece can use degradable high molecular material.Previous anastomotic reinforcing and repairing piece can be with It is made using the extracellular matrix through immunogene removal processing, such as is made using de- cell submucous layer of small intestine host material. The preferred pig of submucous layer of small intestine or calf intestinal intestinal submucosa matrix.Backing can use medical textile or medical non-woven fabrics, synthesis High molecular material, the special one or more combinations defended in strong paper, medical synthetic paper.Sterilized line can be selected in line, selects medical Suture.

The utility model preferred embodiment is described above, but is not to be construed as limiting the scope of the invention. The utility model is not only limited to above example, and concrete structure is allowed to vary, all in the utility model demand for independence Various change is within the protection scope of the present utility model made by protection domain.

Claims (10)

1. the nail anvil or nail bin of a kind of previous anastomotic reinforcing and repairing sub-assembly, the previous anastomotic reinforcing and repairing sub-assembly and stapler are matched It closes and uses, it is characterised in that：The previous anastomotic reinforcing and repairing sub-assembly includes reinforcing and repairing piece, backing, line and fixed part；The line For in two side edges that the reinforcing and repairing piece and backing is detachably connected；The fixed part has sleeve-like structure, energy Enough sets are connected to the end of the stapler nail anvil or nail bin.

2. previous anastomotic reinforcing and repairing sub-assembly according to claim 1, it is characterised in that：At least one of the fixed part It is integrated to divide with the backing；Or the fixed part and the backing are independent from each other component, and the fixed part with The backing is connected with each other.

3. previous anastomotic reinforcing and repairing sub-assembly according to claim 2, it is characterised in that：The fixed part includes first solid Determine portion and the second fixed part, second fixed part and first fixed part are least partially overlapped；Second fixed part with First fixed part is connected with each other.

4. previous anastomotic reinforcing and repairing sub-assembly according to claim 3, it is characterised in that：Make second fixed part and institute The side edge that the first fixed part is stated in lap is connected with each other at least partly, and second fixed part is fixed with described first Connection type between portion is dismountable or non-removable.

5. previous anastomotic reinforcing and repairing sub-assembly according to claim 3, it is characterised in that：The line is additionally arranged at described The side edge of one fixed part and the second fixed part lap makes first fixed part and second fixed part at least Partly it is connected with each other.

6. previous anastomotic reinforcing and repairing sub-assembly according to claim 1 or 2, which is characterized in that the sleeve-like structure be with One kind in lower structure：

The sleeve-like structure is the through-hole being arranged on the fixed part, and the fixed part is enable to be socketed on the stapler The end of nail anvil or nail bin；

The fixed part with the sleeve-like structure includes open end and at least partly closed blind end, the open end energy At least part for enough accommodating the stapler nail anvil or nail bin enters the inner space that the sleeve-like structure is formed, the closing End can prevent the end of the stapler nail anvil or nail bin from passing completely through the inner space that the sleeve-like structure is formed；Or

The fixed part includes the first fixed part and the second fixed part, and second fixed part is including an at least fixing line or admittedly Determine band；The fixing line or fixed band are arranged on first fixed part, and the fixing line or fixed band and described first are consolidated Determine portion and form fixed structure, so that the fixed part is covered and be connected to the stapler nail anvil or nail bin end.

7. previous anastomotic reinforcing and repairing sub-assembly according to claim 1 or 2, it is characterised in that：The fixed part is one It is molding.

8. the previous anastomotic reinforcing and repairing sub-assembly according to any one of claim 1-5, which is characterized in that the reinforcing The length of patch is identical as nail anvil face or nail bin face length.

9. the previous anastomotic reinforcing and repairing sub-assembly according to any one of claim 1-5, which is characterized in that the reinforcing Patch further includes with one or both of lower structure：

The side of the reinforcing and repairing piece includes one or more notch；And

The one or more holes of axis direction setting of the reinforcing and repairing piece.

10. the previous anastomotic reinforcing and repairing sub-assembly according to any one of claim 1-5, which is characterized in that the line It is unremovably connect with the backing or the fixed part.