CN213129673U - Stitching chopping board of endoscope stitching device for implementing gastric fundus folding operation - Google Patents

Stitching chopping board of endoscope stitching device for implementing gastric fundus folding operation Download PDF

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Publication number
CN213129673U
CN213129673U CN202021079923.8U CN202021079923U CN213129673U CN 213129673 U CN213129673 U CN 213129673U CN 202021079923 U CN202021079923 U CN 202021079923U CN 213129673 U CN213129673 U CN 213129673U
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nail
titanium
anvil
bending guide
titanium nail
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Chinese (zh)
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夏金雁
汪元林
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Miaos Medical Technology Shanghai Co ltd
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Miaos Medical Technology Shanghai Co ltd
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Abstract

The utility model discloses a stitching chopping block of an endoscope stitching device for implementing fundus ventriculi folding operation, which comprises a chopping block body, wherein the surface of the chopping block body is arc-shaped; the arc surface of the anvil plate body is matched with the side part of the rigid section; a plurality of groups of titanium nail bending guide grooves are distributed on the surface of the anvil plate body, and each group of titanium nail bending guide grooves comprises two parallel bending guide grooves; the positions of the titanium nail bending guide grooves of each group correspond to the titanium nail accommodating grooves of the nail bin seat one by one; the groove bottom of each bending guide groove is arc-shaped. The utility model discloses can provide the deformability of bending for a plurality of titanium nails that jet out from the titanium nail storage tank of rigidity section, the nail leg of titanium nail is under the guide effect of the tank bottom of the guide recess of bending, and two nail legs of same titanium nail can take place twice and inwards bend to warp and become the nail state of closing. The titanium nail in the nailing state can tightly fix two layers of tissues together, so that a new acute angle His angle is formed, the gastroesophageal valve clack is restored, and an effective barrier for preventing gastroesophageal reflux is established.

Description

Stitching chopping board of endoscope stitching device for implementing gastric fundus folding operation
Technical Field
The utility model relates to an accessory of minimally invasive surgery treatment instrument, in particular to a nailing chopping block of an endoscope nailing device for implementing stomach fundus folding operation.
Background
Gastroesophageal reflux disease (GERD) refers to the reflux of excess contents of the stomach or duodenum into the esophagus, causing symptoms such as acid regurgitation, heartburn, and the like, and may cause esophagitis and tissue damage other than the esophagus, such as the pharynx, larynx, trachea, and the like. Gastroesophageal reflux disease (GERD) is a common disease in Western countries, and studies have shown that the incidence rate of gastroesophageal reflux disease in Western countries is about 10% -20%, Australia is about 11.6%, and Asian is about 5% in recent years. The incidence rate increases with the age, and the age of 40-60 years is the peak incidence age, and men and women have no difference, but patients with reflux esophagitis are more male than female. With the improvement of the living standard of residents, the requirements of people on the quality of life are continuously improved, and the gastroesophageal reflux prevalence rate is 5.77 percent in China according to the statistics of the digestive disease society of the Chinese medical society. Patients with gastroesophageal reflux disease in general can be cured by changing lifestyle or medication. However, some patients with cardia laxity or hiatal hernia have poor effects after drug treatment, some patients can only solve part of symptoms after drug treatment, and some patients need to insist on taking the medicine for a long time, and the patients need to be treated by surgical operation. Studies have shown that about 25% to 30% of patients with GERD have poor drug therapy or are intolerant of long-term medication and require surgical treatment.
The existing surgical treatment of gastroesophageal reflux disease generally adopts laparoscopic fundoplication or endoscopic suturing technology and radio frequency ablation technology, although the problem of repeated attack of symptoms can be solved, postoperative complications are often accompanied, and the postoperative quality of life is greatly influenced, so the mode of surgical treatment of gastroesophageal reflux disease is not popularized, and once the gastroesophageal reflux disease is suffered, the quality of life of a patient is obviously reduced.
SUMMERY OF THE UTILITY MODEL
The utility model aims to solve the technical problem that a scope stapling device's of implementation stomach end folding art nailing chopping block is provided, it can lead to the direction of bending of titanium nail at the stapling in-process, makes the titanium nail after the nailing operation warp to the nailing state.
In order to solve the technical problem, the utility model discloses the technical solution who implements scope stapling device of stomach fundus fold art's nailing chopping block does:
comprises a chopping block body 6-2-0, wherein the surface of the chopping block body 6-2-0 is arc-shaped; the arc surface of the anvil plate body 6-2-0 is matched with the side part of the rigid section 4; a plurality of groups of titanium nail bending guide grooves are distributed on the surface of the anvil plate body 6-2-0, and each group of titanium nail bending guide grooves comprises two parallel bending guide grooves; the positions of the titanium nail bending guide grooves of each group correspond to the titanium nail accommodating grooves 4-3-1 of the nail bin seat 4-3 one by one; the groove bottom of each bending guide groove is arc-shaped.
In another embodiment, the groove bottom of the bending guide groove is in an arc shape with two high ends and a low middle part.
In another embodiment, the two arc-shaped groove bottoms of each group of titanium nail bending guide grooves are symmetrically arranged.
In another embodiment, the bending guide groove is large at the top and small at the bottom in the width direction.
In another embodiment, the bending guide grooves of the titanium nail bending guide grooves of each group correspond to the nail legs of the titanium nails 4-4 arranged in the titanium nail accommodating grooves 4-3-1 one by one; the two bending guide grooves of each group of titanium nail bending guide grooves respectively correspond to the two nail legs of the same titanium nail 4-4.
In another embodiment, the length of the bending guide groove is less than the length of the nail leg of the titanium nail 4-4; the length difference between the nail legs and the bending guide grooves is the nailing thickness of the titanium nail.
In another embodiment, the arc shape of the surface of the anvil body 6-2-0 extends along the length of the anvil body 6-2-0; the length direction of the anvil plate body 6-2-0 corresponds to the circumferential direction of the nail bin seat 4-3.
In another embodiment, the anvil plate 6-2-0 is provided with anvil screw holes 6-2-1 at both ends thereof, the anvil screw holes 6-2-1 are movably provided with anvil screws 6-3 therein, and the anvil screws 6-3 are connected to the anvil screw driving mechanism.
In another embodiment, two stop lugs are arranged on the side part of the anvil body 6-2-0, the first stop lug 6-2-7 is positioned on the upper outer side of the LED lamp 9, and the second stop lug 6-2-8 is positioned on the upper outer side of the micro-camera 8.
In another embodiment, the first baffle lug 6-2-7 is positioned right above the water outlet hole, and the second baffle lug 6-2-8 is positioned right above the air outlet hole; the bottom surface of the first baffle lug 6-2-7 is vertical to the water outlet hole, and the bottom surface of the second baffle lug 6-2-8 is vertical to the air outlet hole.
In another embodiment, the anvil body 6-2-0 is made of a metal material.
The utility model discloses the technological effect that can reach is:
the utility model discloses can provide the deformability of bending for a plurality of titanium nails that jet out from the titanium nail storage tank of rigidity section, the nail leg of titanium nail is under the guide effect of the tank bottom of the guide recess of bending, and two nail legs of same titanium nail can take place twice and inwards bend to warp and become the nail state of closing. The titanium nail in the nailing state can tightly fix two layers of tissues together, so that a new acute angle His angle is formed, the gastroesophageal flap valve is restored, and an effective barrier for preventing gastroesophageal reflux is established.
The utility model discloses an arc surface is identical with the lateral part of rigidity section, and when the nail closing mechanism was in the nail closing state, the utility model discloses can provide even deformation force of bending for a plurality of titanium nails that the titanium nail storage tank from the rigidity section jetted out, make a plurality of titanium nails can take place same deformation simultaneously to can provide even nail to two-layer tissue and join in marriage.
The utility model discloses a titanium nail guide slot of bending can retrain the bending deformation direction and the deflection of titanium nail, and the titanium nail after making the nailing warp to the nailing shape of regulation.
Drawings
It is to be understood by those skilled in the art that the following description is merely exemplary in nature and that the principles of the present invention may be applied in numerous ways to achieve many different alternative embodiments. These descriptions are only used to illustrate the general principles of the teachings of the present invention and are not meant to limit the inventive concepts disclosed herein.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the general description given above and the detailed description of the drawings given below, serve to explain the principles of the invention.
The invention will be described in further detail with reference to the following drawings and detailed description:
FIG. 1 is a schematic view of an endoscopic stapling device for performing fundoplication in accordance with the present invention;
fig. 2 to 7 are schematic views of the operation process of the present invention;
fig. 8 is a schematic view of a titanium nail according to the present invention, the titanium nail being shown in an original state;
FIG. 9 is a schematic view of a titanium nail according to the present invention, shown in a nailed condition;
fig. 10 is a schematic view of a rigid section of the present invention;
fig. 11 is an exploded schematic view of the rigid section assembly of the present invention;
FIG. 12 is a schematic cross-sectional view of the rigid section assembly of the present invention with the titanium staple firing mechanism in an unfired state;
FIG. 13 is a schematic view of a titanium staple firing member of the present invention;
FIG. 14 is an exploded view of the cartridge holder assembly of the present invention;
fig. 15 is a front view of the cartridge holder of the present invention;
fig. 16 is a schematic view of a propeller of the present invention;
FIG. 17 is a schematic view of the titanium nail firing mechanism of the present invention in an unfired state relative to the titanium nails;
FIG. 18 is a schematic view of the titanium staple firing mechanism of the present invention showing the titanium staples and the pusher in the cartridge seat in an unfired state;
FIG. 19 is a schematic view of the titanium staple firing mechanism of the present invention during firing;
FIG. 20 is a schematic view of the titanium staple firing mechanism and one of the titanium staples in the firing process according to the present invention;
FIG. 21 is a schematic cross-sectional view of the rigid section of the present invention, with the titanium staple firing mechanism in a fired state and the titanium staples exiting the staple magazine base;
FIG. 22 is a schematic view of the titanium nail firing mechanism of the present invention in a fired state relative to the titanium nails
FIG. 23 is a schematic view of the relative positions of the titanium nails and the pusher with respect to the nail magazine base in the cocked state of the titanium nail cocking mechanism of the present invention;
fig. 24 is a schematic view of the tip end portion of the present invention;
fig. 25 is a schematic end view of the tip end portion of the present invention;
FIG. 26 is a schematic sectional view A-A of FIG. 25;
figure 27a is a schematic view of an anvil of the present invention;
figure 27b is a schematic view of another angle of the anvil of the present invention;
figure 27c is a schematic cross-sectional view of an anvil of the present invention;
fig. 28 is an exploded schematic view of the tip end portion of the present invention;
fig. 29 is a schematic sectional view of the tip portion of the present invention.
The reference numbers in the figures illustrate:
100 is an endoscope nailing device which comprises a nail head,
1 is a handle, 2 is a conical protective sleeve,
3 is an insertion tube, 4 is a rigid section,
5 is a bending part, 6 is a top end part,
an angle tracking sensor 7, a miniature camera 8,
9 is an LED lamp, 10 is an ultrasonic detector,
the positioning pin 11 is an end positioning pin,
4-1 is a rigid section shell, 4-2 is a sensor positioning disk,
4-3 is a nail bin seat, 4-4 is a titanium nail,
4-5 are ultrasonic wave reflecting mirrors,
4-2-1 is a sensor positioning groove,
4-3-1 is a titanium nail accommodating groove, 4-3-2 is a reflector accommodating groove,
4-3-3 is a positioning pin hole, 4-3-4 is a chopping board screw matching hole,
4-6-1 is a propeller main body, 4-6-2 is a chute,
4-6-3 is a guide part, 4-6-4 is a limit part,
4-6-11 is a titanium nail limiting surface, 4-6-12 is a guide inclined surface,
4-7-1 is a percussion plate, 4-7-2 is a steel wire connecting part,
4-7-11 is a first plane, 4-7-12 is an inclined plane,
4-7-13 is a second plane,
6-1 is a top seat, 6-2 is a chopping block,
6-3 is a chopping board screw, 6-4 is a chopping board driving shaft,
6-5 is a driven gear, 6-6 is a screw guide seat of the chopping board,
6-7 are driven gear positioning pins, 6-8 are chopping block positioning pins,
6-1-1 is a top seat body, 6-1-2 is a chopping block positioning groove,
6-1-3 is a cutting board driving shaft through hole, 6-1-4 is a driven gear shaft through hole,
6-1-5 is an LED lamp positioning hole, 6-1-6 is a micro camera positioning hole,
6-1-7 is an ultrasonic detector mounting hole, 6-1-8 is an end positioning pin accommodating hole,
6-1-9 is a driven gear positioning pin through hole, 6-1-10 is a limit boss,
6-2-0 is the chopping block body, 6-2-1 is the chopping block screw through hole,
6-2-2, 6-2-3, 6-2-4, 6-2-5 and 6-2-6 are titanium nail bending guide grooves,
6-2-7 is a first baffle lug, 6-2-8 is a second baffle lug,
7-1 is an angle tracking sensor signal line,
9-1 is an LED lamp shade,
the esophagus 201 and the stomach 202 are shown.
Detailed Description
In order to make the purpose, technical solution and advantages of the embodiments of the present invention clearer, the drawings of the embodiments of the present invention are combined below to clearly and completely describe the technical solution of the embodiments of the present invention. It is to be understood that the embodiments described are only some of the embodiments of the present invention, and not all of them. All other embodiments, which can be obtained by a person skilled in the art without any inventive work based on the described embodiments of the present invention, belong to the protection scope of the present invention. Unless defined otherwise, technical or scientific terms used herein shall have the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs.
As shown in fig. 1, the endoscope stapling device 100 for performing fundoplication comprises a handle 1, a tapered protective sleeve 2, an insertion tube 3, a rigid section 4, a bending portion 5, and a top portion 6, wherein the front end of the handle 1 is fixedly connected with the insertion tube 3 through the tapered protective sleeve 2, and the front end of the insertion tube 3 is sequentially and fixedly connected with the rigid section 4, the bending portion 5, and the top portion 6; the side surface of the rigid section 4 and the end surface of the top end part 6 form a nailing mechanism;
the outer diameters of the insertion tube 3, the rigid section 4, the bending section 5 and the tip section 6 are smaller than the inner diameter of the esophagus 201, so that the front end of the endoscopic stapling apparatus can be inserted into the stomach 202 through the esophagus 201 through the oral cavity;
the handle 1 is provided with a bending angle control mechanism which can control the bending angle of the bending part 5, so that the included angle between the top end part 6 at the two ends of the bending part 5 and the rigid section 4 is changed within the range of 0-270 degrees, and the end surface of the top end part 6 is driven to move relative to the side surface of the rigid section 4;
in the initial state, the bending angle of the bending part 5 is 0 degrees, and then the top end part 6, the bending part 5 and the rigid section 4 are on the same straight line; the front end of the endoscopic stapling device 100 (i.e., the tip portion 6, the bending portion 5 and the rigid section 4) is inserted into the stomach 202 through the mouth via the esophagus 201, and the inside of the stomach 202 (e.g., mucosal structure) can be observed by the micro-camera 8 of the tip portion 6, as shown in FIG. 2;
when the rigid segment 4 is positioned at the bottom of the esophagus 201, as shown in fig. 3, the bending angle control mechanism of the handle 1 is manipulated to gradually bend the bending portion 5 to move the tip portion 6 relative to the rigid segment 4, thereby changing the relative position between the end surface of the tip portion 6 and the side surface of the rigid segment 4;
when the bending angle of the bending part 5 reaches 180 degrees, the end face of the top end part 6 is pressed against the inner wall of a part of the fundus stomach; in the course of increasing the bending angle of the bending portion 5 from 180 ° to 270 °, the portion of the fundus is pushed by the end face of the tip portion 6 to move toward the esophageal direction, as shown in fig. 4;
when the bending angle of the bending portion 5 is 270 °, the portion of the fundus is pushed by the end surface of the tip portion 6 to overlap with the lower section of the esophagus, thereby achieving folding of the portion of the fundus with the esophagus, as shown in fig. 5; when the side surface of the rigid section 4 is opposite to the end surface of the top end part 6, the ultrasonic reflector 4-5 of the rigid section 4 can reflect all ultrasonic signals emitted by the ultrasonic detector 10 of the top end part 6 and send the reflected ultrasonic signals to the ultrasonic detector 10, the bending part 5 is bent to the position, and the top end part 6 is in a nailing state;
the end positioning pin 11 is driven by the positioning pin driving motor to extend outwards, so that the tip of the end positioning pin 11 of the top end part 6 passes through two layers of tissues of the fundus and esophagus and extends into the positioning pin hole 4-3-3 of the rigid section 4, the top end part 6 is kept in a nailing state, and the position positioning between the top end part 6 and the rigid section 4 is realized; because the hole depth of the positioning pin hole 4-3-3 is smaller than the extension length of the end positioning pin 11, when the end positioning pin 11 extends to the right position, a distance H1 is formed between the end surface of the top end part 6 and the side surface of the rigid section 4, and the distance H1 is the thickness of two layers of tissues;
then, the two chopping board screws 6-3 are driven by the chopping board screw driving mechanism to extend outwards, so that the tip ends of the chopping board screws 6-3 at the top end part 6 penetrate through the two layers of tissues and are screwed into the chopping board screw matching holes 4-3-4 of the nail bin seat 4-3 of the rigid section 4; in the process that the chopping board screws 6-3 are screwed inwards, the two chopping board screws 6-3 respectively penetrate through the two layers of tissues along the thickness direction and extrude the two layers of tissues together; because the hole depth of the anvil screw fitting hole 4-3-4 is smaller than the extension length of the anvil screw 6-3, when the anvil screw 6-3 extends in place, a distance H2 is formed between the end surface of the top end portion 6 and the side surface of the rigid section 4, and the distance H2 is the nailing thickness of the titanium nail 4-4; h1 > H2; after the chopping board screw 6-3 extends to the right position, the end positioning pin 11 can be retracted;
starting a titanium nail firing mechanism, simultaneously ejecting five titanium nails 4-4 (at the moment, the titanium nails 4-4 are in the shape shown in fig. 8, and the legs of the titanium nails 4-4 are outward) of the nail bin assembly, wherein the titanium nails 4-4 sequentially penetrate through the lower esophageal section and part of the fundus tissue after being ejected, and are subjected to the reaction force of the cutting board 6-2 on the end surface of the top end part 6, so that the two legs of the titanium nails 4-4 are bent inwards to form a B shape shown in fig. 9, and at the moment, the titanium nails 4-4 can nail the lower esophageal section and part of the two layers of fundus tissue together to form a folded nailing part 200 as shown in fig. 6, so that the part is nailed and fixed;
replacing a new nail bin seat assembly, rotating the handle 1 by an angle around the axial direction to enable the end surface of the top end part 6 to contact the inner wall of the other stomach fundus, and realizing the folding and nailing of the other stomach fundus and the lower esophagus segment as shown in fig. 7; according to the practical situation, a plurality of (such as three) folds and staples are implemented around the circumference of the esophagus, so that the circle of His angle alpha around the esophagus is restored to an acute angle, the gastroesophageal flap valve is restored, and an effective barrier for preventing the gastroesophageal reflux is established.
The utility model discloses a tip locating pin 11 realizes the relative position location between top portion 6 and the rigidity section 4 before the stitching to can realize treating the preliminary location of the tissue of stitching, with avoid or reduce the skew that takes place the locating position at the in-process tissue of stitching, thereby improve the operation precision.
The utility model discloses a tissue that the chopping block screw 6-3 was treated to the nailing is extruded and is fixed a position to make the leg of a nail of titanium nail 4-4 in the nailing process after bending titanium nail 4-4 can closely fix two-layer tissue together and can not take place to separate, thereby can ensure that newly formed His angle (gastroesophageal angle) can not change for a long time. Furthermore, the utility model discloses a chopping block screw 6-3 confirms the nailing thickness of titanium nail 4-4 to ensure that titanium nail 4-4 can accurately launch to chopping block 6-2 titanium nail guide slot of bending, make the device can be applicable to different crowds, even the thickness that leads to individual stomach end and the two-layer tissue of esophagus is different because the physique is different, also can not produce the phenomenon that the nailing is not firm, the operation effect descends.
The utility model precisely controls the extending stroke of the chopping board screw 6-3 through the chopping board screw driving mechanism, so that the thickness of the two-layer tissue between the end surface of the top end part 6 and the side surface of the rigid section 4 is gradually reduced and reaches the nailing thickness of the titanium nail 4-4 which can carry out nailing; the thickness variation of the two layers of tissue can be monitored by the ultrasonic detector 10, so that the thickness of the stapled tissue can be accurately controlled.
The utility model discloses well bent angle control mechanism that is used for controlling flexion 5 is prior art, and is no longer repeated here.
As shown in fig. 10 to 12, the rigid section 4 includes a rigid section housing 4-1, one end of the rigid section housing 4-1 is fixedly connected to a sensor positioning plate 4-2, a sensor positioning groove 4-2-1 is formed in a side portion of the sensor positioning plate 4-2, and an angle tracking sensor 7 is fixedly arranged in the sensor positioning groove 4-2-1; the angle tracking sensor 7 is connected with one end of an angle tracking sensor signal line 7-1, and the other end of the angle tracking sensor signal line 7-1 is connected with the main board to realize synchronous transmission and feedback of signals;
a nail bin seat groove 4-1-1 extending along the axial direction is formed in the side part of the rigid section shell 4-1, a titanium nail firing part 4-7 is movably arranged in the nail bin seat groove 4-1-1, and the length of the titanium nail firing part 4-7 is smaller than that of the nail bin seat groove 4-1-1; one end of the titanium nail firing part 4-7 is fixedly connected with one end of the launching steel wire 4-8, and the other end of the launching steel wire 4-8 is connected with the handle 1; the launching steel wire 4-8 can be pulled through the control handle 1, so that the titanium nail firing part 4-7 is driven to move back and forth along the nail bin seat groove 4-1-1;
a nail bin seat assembly is arranged in the nail bin seat groove 4-1-1, five titanium nail accommodating grooves 4-3-1 are formed in the nail bin seat assembly, and the titanium nail accommodating grooves 4-3-1 are used for accommodating titanium nails 4-4 and a propeller 4-6; the propeller 4-6 is abutted against the bottom of the titanium nail 4-4;
as shown in FIG. 13, the titanium staple firing member 4-7 comprises three firing plates 4-7-1 arranged side by side, with the three firing plates 4-7-1 corresponding to five titanium staples 4-4, such that the five titanium staples 4-4 can simultaneously contact the titanium staple firing member 4-7;
the firing plate 4-7-1 is provided with a first plane 4-7-11, a pushing inclined plane 4-7-12 and a second plane 4-7-13, the second plane 4-7-13 is higher than the first plane 4-7-11, and the height difference between the second plane 4-7-13 and the first plane 4-7-11 is the firing stroke of the titanium nail 4-4;
one end of the titanium nail firing part 4-7 forms a steel wire connecting part 4-7-2, and the titanium nail firing part 4-7 is fixedly connected with one end of the launching steel wire 4-8 through the steel wire connecting part 4-7-2.
As shown in FIG. 14, the cartridge holder assembly comprises a cartridge holder 4-3, the surface of the cartridge holder 4-3 is a partial circumference of the rigid section housing 4-1 (i.e., the arc-shaped surface of the cartridge holder 4-3 is a partial circumference of the rigid section housing 4-1);
as shown in fig. 15, five titanium nail accommodating grooves 4-3-1 are formed in the nail bin seat 4-3, and the titanium nail accommodating grooves 4-3-1 are communicated in the radial direction (i.e., the thickness direction of the nail bin seat 4-3), so that the titanium nail firing member 4-7 positioned at the inner side of the nail bin seat 4-3 can contact the pusher 4-6 in the titanium nail accommodating groove 4-3-1; the titanium nail accommodating groove 4-3-1 is internally provided with a titanium nail 4-4 and a propeller 4-6; the propeller 4-6 is positioned at the bottom of the titanium nail 4-4;
the back of the nail bin seat 4-3 is provided with a titanium nail firing part guide groove 4-3-5, and the titanium nail firing part guide groove 4-3-5 is in one-to-one correspondence with a firing plate 4-7-1 of the titanium nail firing part 4-7; the outer edge of the trigger plate 4-7-1 extends into the titanium nail trigger guide groove 4-3-5, and when the titanium nail trigger 4-7 moves along the nail bin seat groove 4-1-1, the titanium nail trigger guide groove 4-3-5 can guide the titanium nail trigger 4-7;
the nail bin seat 4-3 is also provided with a reflector containing groove 4-3-2, an ultrasonic reflector 4-5 is arranged in the reflector containing groove 4-3-2, and the ultrasonic reflector 4-5 is used for receiving an ultrasonic signal sent by the ultrasonic detector 10 and reflecting the received ultrasonic signal to the ultrasonic detector 10;
the nail bin seat 4-3 is also provided with a positioning pin hole 4-3-3 corresponding to the end positioning pin 11 and two chopping board screw matching holes 4-3-4 corresponding to the chopping board screws 6-3; the hole depth of the positioning pin hole 4-3-3 is smaller than the extension length of the end positioning pin 11, and the hole depth of the chopping board screw matching hole 4-3-4 is smaller than the extension length of the chopping board screw 6-3.
As shown in fig. 16, the pusher 4-6 comprises a pusher body 4-6-1, a sliding groove 4-6-2 is formed at the bottom of the pusher body 4-6-1, and the width of the sliding groove 4-6-2 is matched with the thickness of the firing plate 4-7-1, so that the pusher 4-6 can straddle the firing plate 4-7-1, and the relative sliding between the pusher 4-6 and the firing plate 4-7-1 can be realized; the rear part of the propeller main body 4-6-1 is provided with a guide part 4-6-3, the bottom of the guide part 4-6-3 is provided with a guide inclined plane 4-6-12, the inclination of the guide inclined plane 4-6-12 is matched with the push inclined plane 4-7-12 of the trigger plate 4-7-1, and the titanium nail trigger 4-7 can push the propeller 4-6 to move outwards through the push inclined plane 4-7-12 in the moving process;
the front part of the propeller main body 4-6-1 forms a limiting part 4-6-4; when the titanium nail firing part 4-7 moves until the second plane 4-7-13 contacts the pusher 4-6, the second plane 4-7-13 of the titanium nail firing part 4-7 contacts the bottom surface of the limiting part 4-6-4.
4-7 parts of titanium nail firing part, 4-8 parts of launching steel wire and 4-6 parts of propeller form a titanium nail firing mechanism; in an initial state, the titanium nail firing part 4-7 is positioned at the rear end of the nail bin seat groove 4-1-1; at the moment, the titanium nails 4-4 and the pusher 4-6 in the nail bin seat 4-3 are positioned above the first plane 4-7-11 of the trigger plate 4-7-1; to avoid false firing, a gap is formed between the pusher 4-6 and the first plane 4-7-11, as shown in fig. 12 and 17; at this time, the titanium nail 4-4 is positioned in the titanium nail accommodating groove 4-3-1, and the propeller 4-6 is positioned at the bottom of the titanium nail accommodating groove 4-3-1, as shown in fig. 18;
when in percussion, the launching steel wire 4-8 is pulled to drive the titanium nail percussion piece 4-7 to move forward for a section of stroke along the nail bin seat groove 4-1-1; during the forward movement of the titanium staple firing member 4-7, the pusher ramp 4-7-12 of the titanium staple firing member 4-7 contacts the pusher 4-6, thereby pushing the titanium staple 4-4 outward by the pusher 4-6, as shown in FIGS. 19 and 20; when the titanium staple firing member 4-7 moves to the front end of the staple cartridge pocket 4-1-1, the second flat surface 4-7-13 of the titanium staple firing member 4-7 contacts the pusher 4-6 and the titanium staple 4-4 completes the firing stroke, as shown in FIG. 21 and as shown in FIG. 22; at the moment, the titanium nail firing part 4-7 pushes the pusher 4-6 to the top of the titanium nail accommodating groove 4-3-1, the pusher 4-6 pushes the titanium nail 4-4 out of the titanium nail accommodating groove 4-3-1, and as shown in fig. 23, five titanium nails 4-4 are simultaneously ejected;
in the process that the titanium nails 4-4 leave the titanium nail accommodating grooves 4-3-1, the nail legs of the titanium nails 4-4 contact the surface of the chopping board 6-2, the chopping board 6-2 provides bending reaction force for the titanium nails 4-4, the nail legs are guided by the bottoms of the bending guide grooves, so that the two nail legs of the same titanium nail 4-4 are bent inwards twice, the titanium nails 4-4 are deformed into a nailing shape as shown in fig. 10, and the titanium nails 4-4 can tightly fix two layers of tissues together, so that a new acute angle His angle alpha is formed.
The utility model discloses a launch steel wire 4-8 and drive titanium nail percussion piece 4-7 along nail storehouse seat slot 4-1-1 forward motion, at titanium nail percussion piece 4-7 forward motion's in-process, rely on the inclined plane cooperation that titanium nail percussion piece 4-7 and the guide part 4-6-3 of propeller 4-6 formed, promote titanium nail 4-4 outward movement through propeller 4-6 to realize the percussion of titanium nail 4-4. Because the percussion stroke of the titanium nail 4-4 is determined by the height of the inclined plane of the titanium nail percussion part 4-7, the percussion stroke of the titanium nail 4-4 can not be influenced even if the force for pulling the launching steel wire 4-8 is too large, therefore, the utility model can accurately control the percussion stroke of the titanium nail 4-4, and the nailing effect can not be influenced due to different force of different operators.
The utility model discloses set up ultrasonic reflector 4-5 in near titanium nail storage tank 4-3-1, set up ultrasonic detection instrument 10 in the terminal surface of top portion 6, under the assistance of ultrasonic detection instrument 10, can accurately confirm the nail close point to can improve the operation precision of stomach fundus fold art by a wide margin.
The utility model discloses be provided with angle tracking sensor 7 on rigidity section 4, when handle 1 pivoting when rotatory, rigidity section 4 takes place the axial deflection thereupon, then angle tracking sensor 7 also takes place the deflection thereupon together, and angle tracking sensor 7 transmits the mainboard with the deflection angle signal in real time, and after this deflection angle signal was received to the mainboard, finally show in the display picture directly perceivedly. The utility model discloses a relative position of top portion 6 and esophagus can accurately be confirmed to angle tracking sensor 7 to confirm the concrete position of another stomach fundus, provide accurate, audio-visual guide for the stomach fundus folding art.
As shown in fig. 24 to 26, the top end portion 6 comprises a top end seat 6-1, an end face of the top end seat 6-1 is provided with a cutting board 6-2, a micro camera 8, an LED lamp 9, an ultrasonic detector 10 and an end portion positioning pin 11, the cutting board 6-2 is fixedly arranged in the middle of the end face, the length of the cutting board 6-2 extends in the longitudinal direction, and the surface of the cutting board 6-2 protrudes out of the end face of the top end seat 6-1, so that a bending force can be provided for the titanium nails 4-4; the miniature camera 8 and the LED lamp 9 are positioned on one side of the chopping board 6-2, and the ultrasonic detector 10 and the end positioning pin 11 are positioned on the other side of the chopping board 6-2; the LED lamp 9 is used for providing an illumination light source, and the micro camera 8 is used for collecting images; the ultrasonic detector 10 is used for transmitting and receiving ultrasonic signals; the ultrasonic detector 10 is matched with the ultrasonic reflector 4-5 of the rigid section 4, the ultrasonic detector 10 emits an ultrasonic signal, the ultrasonic signal is reflected back to the ultrasonic detector 10 through the ultrasonic reflector 4-5, and the ultrasonic detector 10 judges whether the top end part 6 is perfectly matched with the position of the nail bin seat 4-3 of the rigid section 4 according to the strength change condition of the received signal; when the ultrasonic signal is stable, the end positioning pin 11 extends outwards and is matched with the positioning pin hole 4-3-3 of the rigid section 4, so that the tissue is positioned;
the middle part of the end part positioning pin 11 is provided with an external thread 11-1, and the end part positioning pin 11 is connected with the top end seat 6-1 through a thread; the free end of the end positioning pin 11 is a tip end, and the fixed end of the end positioning pin 11 is connected with a positioning pin driving motor; the end positioning pin 11 is driven to rotate by the positioning pin driving motor, so that the end positioning pin 11 can move in a telescopic manner relative to the top seat 6-1; the free end of the end positioning pin 11 is matched with the positioning pin hole 4-3-3 of the rigid section 4, so that tissue positioning can be carried out, and the deviation of the positioning position of the tissue in the operation process is avoided or reduced.
Since the side surface of the rigid segment 4 is opposed to the end surface of the distal end portion 6 in the stapled state, the view angle of the micro-camera 8 positioned at the distal end portion 6 is blocked by the fundus tissue, and therefore image information cannot be acquired, resulting in a blind area in the entire stapled state. The utility model discloses be provided with ultrasonic reflector 4-5 and ultrasonic wave detection instrument 10 respectively at the side of rigidity section 4 and the terminal surface of top portion 6, can monitor the relative position between rigidity section 4 and the top portion 6 in the process of nailing to make the operator still can observe the positional information between rigidity section 4 and the top portion 6 directly perceivedly under the state of nailing.
As shown in figures 27a to 27c, the anvil 6-2 comprises an anvil body 6-2-0 having an arc-shaped surface, the arc-shaped surface of the anvil body 6-2-0 being in conformity with the side of the rigid section 4; the length direction of the anvil body 6-2-0 corresponds to the circumferential direction (namely the arc length direction) of the nail bin seat 4-3; when the top end part 6 is in a nailed state, the surface of the chopping block body 6-2-0 is matched with the side part of the rigid section 4;
two ends of the anvil plate body 6-2-0 are respectively provided with anvil plate screw penetrating holes 6-2-1, anvil plate screws 6-3 are movably arranged in the anvil plate screw penetrating holes 6-2-1, and the anvil plate screws 6-3 are connected with an anvil plate screw driving mechanism arranged in the top seat 6-1; the chopping board screw 6-3 can perform telescopic motion relative to the chopping board body 6-2-0 under the action of the chopping board screw driving mechanism;
five groups of titanium nail bending guide grooves 6-2-2, 6-2-3, 6-2-4, 6-2-5 and 6-2-6 are distributed on the surface of the anvil plate body 6-2-0 (five different patterns are used for respectively representing the groove bottoms of the five groups of titanium nail bending guide grooves in the figure); each group of titanium nail bending guide grooves comprises two parallel bending guide grooves, and each bending guide groove corresponds to one nail leg of the titanium nail 4-4; the bottom of each bending guide groove is in an arc shape with two high ends and a low middle part along the length direction; the arc-shaped groove bottoms of the bending guide grooves of each group of titanium nails are symmetrically arranged along the length direction; each bending guide groove is large in the upper part and small in the lower part along the width direction; the bending guide groove can guide the bending direction of the nail legs of the titanium nails 4-4.
Two stop lugs are arranged on the side part of the anvil plate body 6-2-0, and the first stop lug 6-2-7 is positioned on the outer side above the LED lamp 9 and right above the water outlet hole; the second stop lug 6-2-8 is positioned at the outer side above the miniature camera 8 and right above the air outlet, as shown in fig. 25; the bottom surfaces of the two baffle lugs are respectively vertical to the water outlet hole and the air outlet hole; when the water outlet hole sprays water, the first baffle lug 6-2-7 reflects water flow, so that the water flow is sprayed to the miniature camera 8 and the LED lamp 9, and the lens of the miniature camera 8 and the LED lamp 9 are washed; when the air outlet is exhausted, the second baffle lug 6-2-8 reflects the air flow, so that the air flow is sprayed to the micro-camera 8 and the LED lamp 9, and the lens of the micro-camera 8 and the LED lamp 9 are blown and swept.
As shown in fig. 28 and 29, the anvil screw driving mechanism comprises an anvil driving shaft 6-4, and the anvil driving shaft 6-4 can rotate under the driving of power; a driving gear is arranged on the chopping board driving shaft 6-4, and two sides of the driving gear are respectively meshed with a driven gear 6-5; two driven gears 6-5 are respectively fixedly connected with chopping board screws 6-3;
the bottom of the chopping board 6-2 is fixedly provided with two chopping board screw guide seats 6-6, and the chopping board screw guide seats 6-6 are connected with chopping board screws 6-3 through threads; the chopping board screw guide seats 6-6 and the driven gears 6-5 are in one-to-one correspondence and are coaxially arranged;
the bottom of the driven gear 6-5 is provided with a driven gear positioning pin 6-7; the driven gear positioning pin 6-7 is longitudinally arranged in a driven gear positioning pin hole 6-1-9 of the top seat 6-1 in a penetrating manner; the driven gear positioning pin 6-7 can limit the driven gear 6-5, so that the driven gear 6-5 is prevented from axial displacement, and the transmission precision of the chopping board screw driving mechanism is ensured;
the chopping board driving shaft 6-4 drives the two driven gears 6-5 to synchronously rotate, so as to drive the chopping board screw 6-3 to do telescopic motion relative to the chopping board 6-2; the anvil screw guide seat 6-6 can guide the anvil screw 6-3, thereby precisely controlling the stroke of the anvil screw 6-3.
It will be apparent to those skilled in the art that various modifications and variations can be made in the present invention without departing from the spirit and scope of the invention. Thus, if such modifications of the present invention fall within the scope of the claims and their equivalent technologies, the present invention is also intended to include such modifications and variations.

Claims (10)

1. A stapling chopping block of an endoscope stapling device for implementing fundoplication is characterized by comprising a chopping block body (6-2-0), wherein the surface of the chopping block body (6-2-0) is arc-shaped; the arc surface of the anvil plate body (6-2-0) is matched with the side part of the rigid section (4); a plurality of groups of titanium nail bending guide grooves are distributed on the surface of the anvil plate body (6-2-0), and each group of titanium nail bending guide grooves comprises two parallel bending guide grooves; the positions of the titanium nail bending guide grooves of each group correspond to the titanium nail accommodating grooves (4-3-1) of the nail bin seat (4-3) one by one; the groove bottom of each bending guide groove is arc-shaped.
2. The anvil plate of an endoscopic stapling device for performing fundoplication according to claim 1, wherein the bottom of the bending guide groove has an arc shape with two high ends and a low middle.
3. The anvil plate of an endoscopic stapling device for performing fundoplication according to claim 1, wherein the two curved groove bottoms of the titanium staple bending guiding grooves of each set are symmetrically disposed.
4. The anvil plate of an endoscopic stapling device for performing fundoplication according to claim 1, wherein said bending guide groove is large at the top and small at the bottom in the width direction.
5. The stapling anvil for an endoscopic stapling device for performing fundoplication according to claim 1, wherein the bending guide grooves of the titanium staple bending guide grooves of each set correspond to the staple legs of the titanium staples (4-4) disposed in the titanium staple receiving grooves (4-3-1) one by one; the two bending guide grooves of each group of titanium nail bending guide grooves respectively correspond to the two nail legs of the same titanium nail (4-4).
6. The stapling anvil of an endoscopic stapling device for performing fundoplications according to claim 1, wherein the length of the bending guide groove is smaller than the leg length of a titanium staple (4-4); the length difference between the nail legs and the bending guide grooves is the nailing thickness of the titanium nail.
7. The stapling anvil for an endoscopic stapling device for performing fundoplications according to claim 1, wherein the arc of the surface of the anvil body (6-2-0) extends along the length of the anvil body (6-2-0); the length direction of the anvil plate body (6-2-0) corresponds to the circumferential direction of the nail bin seat (4-3).
8. The stapling anvil plate of an endoscope stapling device for performing fundoplication according to claim 1, wherein the anvil plate body (6-2-0) is provided with anvil screw through holes (6-2-1) at both ends thereof, the anvil screw through hole (6-2-1) is movably provided with an anvil screw (6-3), and the anvil screw (6-3) is connected with an anvil screw driving mechanism.
9. The anvil plate of an endoscopic stapling device for performing fundoplication according to claim 1, wherein the side of said anvil body (6-2-0) is provided with two stop ears, the first stop ear (6-2-7) being located on the upper outer side of the LED lamp (9) and the second stop ear (6-2-8) being located on the upper outer side of the micro camera (8).
10. The anvil plate of an endoscopic stapling device for performing fundoplications according to claim 9, wherein said first stop lug (6-2-7) is located directly above the apopore and the second stop lug (6-2-8) is located directly above the apopore; the bottom surface of the first baffle lug (6-2-7) is vertical to the water outlet hole, and the bottom surface of the second baffle lug (6-2-8) is vertical to the air outlet hole.
CN202021079923.8U 2020-06-12 2020-06-12 Stitching chopping board of endoscope stitching device for implementing gastric fundus folding operation Active CN213129673U (en)

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CN202021079923.8U CN213129673U (en) 2020-06-12 2020-06-12 Stitching chopping board of endoscope stitching device for implementing gastric fundus folding operation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202021079923.8U CN213129673U (en) 2020-06-12 2020-06-12 Stitching chopping board of endoscope stitching device for implementing gastric fundus folding operation

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