CN214414859U - Instrument for accurately suturing outer side of esophagus and stomach after anastomosis - Google Patents

Abstract

An instrument for accurately suturing the outer side of an esophagus and a stomach after anastomosis comprises an extension tube, a nailing part which extends out of a mouth-like suturing structure with an opening and is arranged at the front end of the extension tube, and an operation part which extends out of the rear end of the extension tube; the nailing part comprises a nail bin integrally connected with the extension pipe, a pressing structure for pressing nails out of the bin, and a moving block which drives the pressing structure to move downwards and is operated by the operation part to move; the reciprocating motion of the moving block drives the pushing structure to repeatedly push down and return, the longitudinal direction of the nail bin is consistent with the longitudinal direction of the extending pipe, two sides of the front end of the nail bin are provided with blocking plates for blocking suturing nails, and openings for allowing the suturing nails to move downwards and move out of the nail bin are arranged below the inner side of each blocking plate; the extension tube corresponds to the front section of the rear wall of the opening, and a notch is arranged at the lower part of the nail bin; the middle of the front part of the nail bin is provided with a T-shaped support, and the T-shaped support comprises a first cross beam and a longitudinal support beam; therefore, the stitching nail is moved downwards through the pressing structure, and the transverse rod of the T-shaped support is bent to form a mouth-shaped stitching structure to stitch the tissue.

Description

Instrument for accurately suturing outer side of esophagus and stomach after anastomosis

Technical Field

The utility model belongs to the technical field of medical instrument for the digestive endoscopy operation, concretely relates to is the accurate sutural apparatus in the back outside that esophagus and stomach coincide.

Background

Generally, before the esophagus and the stomach are cut and sutured on the outer side, a suturing machine is used for performing anastomosis suturing on the periphery inside the esophagus, but after only one circle of anastomosis suturing on the inner layer, liquid in the esophagus flows out at the needle eye of the suturing part before the esophagus is completely healed, so that anastomotic leakage can be caused.

The problems of the prior art are as follows: since the suture is placed in close proximity to the heart and a loop of suture is required, the heart needs to be lifted slightly upward during the procedure to avoid damage to the heart. Meanwhile, the abdominal diaphragm muscle is in the middle, so that great difficulty is caused, the corresponding suture position cannot be seen quickly in actual operation, the suture position is difficult to be accurate, and the blood vessel is easy to break without paying attention to the suture position, so that secondary injury is caused to a patient. In addition, due to the limited position, the requirement on the operation capability of doctors is high, and the shorter the operation time is, the safer the operation time is, so that doctors with particularly abundant operation experience can be required to suture, and doctors in many hospitals are difficult to achieve the operation capability of suturing the esophagus and the outside of the stomach, so that many hospitals cannot perform the operation.

If an instrument similar to the skin nailing operation can be used for completing the nailing in vivo, because the nailing does not need too large space, the operation difficulty can be greatly reduced, and the operation time can be shortened.

The utility model discloses it is dangerous high to sew up in esophagus and the stomach outside among the prior art, require highly to the doctor operation, do not have the technical problem of effective apparatus and accomplish the operation fast, provide an accurate sutured apparatus in the outside after esophagus and stomach coincide.

SUMMERY OF THE UTILITY MODEL

An instrument for accurately suturing the outer side of an esophagus and a stomach after anastomosis comprises an extension tube, a suturing part which extends out of the front end of the extension tube and can open a mouth-like suturing structure with an opening, and an operating part which is arranged at the rear end of the extension tube and used for controlling the suturing of the suturing part; the nailing part comprises a nail bin integrally connected with the extension pipe, a pressing structure for pressing nails out of the bin, and a moving block which drives the pressing structure to move downwards and is operated by the operation part to move; the reciprocating motion of the moving block drives the downward pressing structure to repeatedly press down and return, the stitching nails in the nail bin are bonded together, the longitudinal direction of the nail bin is consistent with the longitudinal direction of the extending pipe, two sides of the front end of the nail bin are provided with blocking plates for blocking the stitching nails, the distance between the blocking plates at two sides is larger than the length of the upper side of the stitching structure similar to the shape of the Chinese character kou, and an opening for the stitching nails to move down and move out of the nail bin is arranged below the inner side of the blocking plates; the extension tube corresponds to the front section of the rear wall of the opening, and a notch is arranged at the lower part of the nail bin; the middle of the front part of the nail bin is provided with a T-shaped support, and the T-shaped support comprises a first cross beam and a longitudinal support beam; the length of the first cross beam of the T-shaped support is equal to that of the upper side of the mouth-shaped suture structure, the length of the nails inserted into the two sides of the suturing nails is equal to or less than that of the upper side of the mouth-shaped suture structure, so that the suturing nails are moved downwards through the pressing structure and bent at the transverse rod of the T-shaped support to form the mouth-shaped suture structure for suturing tissues. Through the arrangement, the suturing nail can be ensured to be effectively sutured and effectively separated from the suturing nail.

Furthermore, the distance between the lower edge of the blocking plate and the upper plane of the bottom of the nail bin is greater than one half of the side wall of the nail bin, and the arrangement can effectively ensure that the nail which is not successfully punched is taken out, so that the following operation is facilitated.

Further, the length of the nail inserted into the two sides of the stitching nail is not more than the length of the upper side of the mouth-like stitching structure.

Further, the four sides of the herringbone sewing structure are equal.

Further, one side and the nail storehouse body coupling of "T" type support, one side stretches into opening center, and the height of the vertical support beam of "T" type support equals or is greater than the inserting nail unanimous of sewing up the nail, and this kind of setting can guarantee effectual formation "mouth" word suture structure and guarantee to use before the sewing up nail contracts in the nail storehouse.

Further, a closing baffle is arranged behind the nail bin, a nail pushing spring is arranged in front of the baffle, and a nail pushing plate is arranged in front of the nail pushing spring, so that nails can be effectively pushed through the arrangement.

Furthermore, the nail pushing plate is arranged in front of the nail pushing plate, the two sides of the nail pushing plate are inserted at the two sides, the nail inserting height and the two sides of the nail pushing plate are consistent, and the push plate is stretched out.

Furthermore, in order to prevent the fracture of the joint of the nails in the nail pushing process, a covering cover which is connected with the nail bin and covers the nail bin is arranged above the nail bin, the part of the nail bin which is forwards from the opening is not covered by the covering cover, and the distance range of the upper cover plate of the covering cover to the nail sewing beam is 0.5-2 mm. The arrangement can effectively ensure that the suturing nail combination layer cannot be broken or stretched out.

Furthermore, the pushing structure comprises two pushing teeth arranged on two sides of a first cross beam supported by the T-shaped support, the distance between the inner side edges of the pushing teeth is equal to the length of the first cross beam, and the gaps on the two side edges are opposite to the first cross beam supported by the T-shaped support.

Furthermore, the two lower pressing teeth are connected together through the second cross beam above the lower pressing teeth, and the arrangement can conveniently realize the control of the lower pressing teeth to move downwards through the control of the downward movement of the cross beam, so that the control is more convenient.

Furthermore, the width of the two outer side edges of the two pressing teeth is larger than the spacing distance between the two blocking plates, so that the two pressing teeth can be effectively ensured to move in the blocking plates in the downward moving process, and the position deviation is prevented.

Furthermore, two extending plates which form two downward pressing tooth moving tracks extend out of the side wall of the extending pipe, and a gap between the two extending plates is the moving distance of the two downward pressing teeth.

Furthermore, return springs extending to the side wall of the extension pipe are arranged on two sides of the beam II, and the arrangement ensures automatic return after the pressing teeth move downwards.

Further, the moving blocks are of different thicknesses, the blocking block integrally connected with the extending pipe is arranged above the moving blocks, the end with the small thickness of the moving blocks is in contact with the blocking block, the pressing-down structure does not realize pressing-down at the upper part, the end with the large thickness of the moving blocks is in contact with the blocking block, and the pressing-down structure presses out stitching nails at the lower part to stitch wounds; the downward movement control of the downward movement structure is realized by the longitudinal movement or the transverse movement of the extending pipe. The end with small thickness and the end with large thickness of the moving block are controlled to contact with the blocking block through the operation structure, so that the downward movement of the pressing structure is realized, and the suturing nails are pressed out one by one.

Furthermore, the contact position of the blocking block and the moving block is provided with a rolling shaft for reducing the moving resistance, and the rolling shaft is in contact with the moving block, so that the moving resistance can be effectively reduced, and the scheme is guaranteed to be effectively implemented.

Furthermore, the front end of the moving block is provided with an operating rope connected with the operating part, repeated pressing of the pressing structure is realized through transverse movement of the moving block, the side wall of the stretching pipe is provided with an operating rope turning hole, and the operating rope is changed from horizontal pulling into vertical pulling along the longitudinal setting of the stretching pipe when passing through the turning hole.

Furthermore, different turning holes are longitudinally formed in the extension pipe, so that the effective traction track of the operation rope is guaranteed.

Further, the rear end of the moving block is provided with a reset structure for resetting the moving block in a non-pulling state, wherein the reset structure is preferably integrally connected with the side wall of the extension pipe by a reset spring.

Further, the stop block is arranged right above the pressing structure, and the arrangement is convenient to operate.

Furthermore, the diversion hole is arranged on the inner side wall of the pipe extending into the horizontal position after being pressed down by the pressing structure, so that the downward movement pulling of the operation rope is facilitated, and the pressing structure is guaranteed to be pressed down to a proper position.

Furthermore, the inner side wall of the extension pipe also extends out of the limiting plates on two sides of the moving block, and the gap between the limiting plates is a track for ensuring the moving block to move according to a set direction.

Further, the operation part is connected with the operation rope, and the operation part is a structure capable of pulling and releasing the operation rope.

Further, the operation portion comprises a control structure and a rotating motor, the operation rope is wound on a rotating shaft of the rotating motor, the rotating motor is connected with a power supply through the control structure, and the control structure controls the rotating motor to rotate forwards and backwards. The positive and negative rotation of the motor is controlled by the control structure to realize the traction and the release of the operation generator, so as to realize a series of downward pressing and upward moving motions in front of the extension pipe,

furthermore, the control structure comprises a switch button, and the control structure controls the switch button to be pressed to complete one suture resetting action.

Further, the operating part is arranged inside the handheld handle at the rear end of the extension tube, and the switch knob is arranged on one side face of the handheld part, which is convenient to operate.

Further, the motor side outside of rotating electrical machines sets up the back up coat, guarantees the motor structure at the inside stability of operating handle, guarantees the effective tractive to the place ahead structure.

Furthermore, the extension pipe is a hard pipe, and the hard pipe is convenient for corresponding movement operation along with the movement of hands of an operator.

During the use, borrow the centre gripping earlier and hold the position of lifting need sewing up by the centre gripping pincers centre gripping, make the position of sewing up stretch into the breach in, once sew up through pressing the button completion, whole process operation is simple quick, and need not make a round trip to carry the needle, very big reduction to operating doctor's technical requirement, whole operation degree of difficulty diminishes, and because the position of sewing up of holder centre gripping makes to sew up accurately, very big solution clinical problem.

Drawings

FIG. 1 is a schematic view of the overall structure of the present invention;

FIG. 2 is a schematic view of the front end structure of the extension tube of the present invention;

FIG. 3 is a schematic view of the structure of the nail bin with a cover of the present invention;

FIG. 4 is a schematic view of a partial structure of the nail cartridge of the present invention;

FIG. 5 is a schematic view of the rear end structure of the nail cartridge of the present invention;

FIG. 6 is a schematic structural view of a pressing structure part of the present invention;

fig. 7 is a schematic view of a structure of a moving block part of the present invention;

FIG. 8 is a structural schematic view of the rear side view of the operation portion of the present invention;

fig. 9 is a schematic structural view of the outer side of the operation portion of the present invention;

FIG. 10 is a cross-shaped sewing structure of the present invention;

in the figure, 1, an inlet pipe; 2. a staple cartridge; 21. a blocking plate; 22. an opening; 23. a notch; 24. a "T" shaped support; 241. a first cross beam; 242. a longitudinal support beam; 25. suturing nails; 26. a structure similar to a Chinese character 'kou' shaped suture; 27. closing the baffle; 271. a nail pushing spring; 272. a nail pushing plate; 273. extending the push plate; 28. a cover lid; 3. a press-down structure; 31. pressing the teeth; 32. a second cross beam; 33. extending the plate; 34. a return spring; 4. a moving block; 41. a return spring; 42. a limiting plate; 5. a blocking block; 51. a roll axis; 61. operating a rope; 62. a turning hole; 63. a control structure; 64. a rotating electric machine; 65. a rotating shaft; 66. a switch knob; 67. A handle; 68. and a reinforcing layer.

Detailed Description

Example 1 apparatus for accurate lateral suturing after anastomosis of esophagus and stomach

An instrument for accurately suturing the outer side of an esophagus after being anastomosed with a stomach comprises an extension tube 1, a suturing part which extends out of the front end of the extension tube 1 and can open a similar square-shaped suturing structure 26 with an opening 22, and an operating part which is arranged at the rear end of the extension tube 1 and used for controlling the suturing of the suturing part; the nailing part comprises a nail bin 2 integrally connected with the extension pipe 1, a pressing structure 3 for pressing nails out of the bin, and a moving block 4 for driving the pressing structure 3 to move downwards and being operated by the operation part to move; the reciprocating motion of the moving block 4 drives the downward pressing structure 3 to repeatedly press down and return, the suturing nails 25 in the nail bin 2 are adhered together, the longitudinal direction of the nail bin 2 is consistent with the longitudinal direction of the extending pipe 1, two sides of the front end of the nail bin 2 are provided with blocking plates 21 for blocking the suturing nails 25, the distance between the blocking plates 21 at two sides is larger than the length of the upper side of a similar square-shaped suturing structure 26, and an opening 22 for enabling the suturing nails 25 to move down and move out of the nail bin 2 is arranged below the inner side of each blocking plate 21; the extension tube 1 corresponds to the front section of the rear wall of the opening 22, and a notch 23 is arranged at the lower part of the nail bin 2; a T-shaped support 24 is arranged in the middle of the front part of the nail bin 2, and the T-shaped support 24 comprises a first cross beam 241 and a longitudinal support beam 242; the length of the first beam 241 of the T-shaped support 24 is equal to the length of the upper side of the square-like stitching structure 26, the length of the nails inserted into the two sides of the stitching nail 25 is equal to or less than the length of the upper side of the square-like stitching structure 26, and thus the stitching nail 25 is moved downwards by the pressing structure 3, and is bent at the transverse rod of the T-shaped support 24 to form the square-like stitching structure 26 for stitching tissues. Through this arrangement, effective suturing of the suturing nail 25 and effective detachment after suturing can be ensured.

The distance from the lower edge of the blocking plate 21 to the upper plane of the bottom of the nail bin 2 is greater than one half of the side wall of the nail bin 2, and the arrangement can effectively ensure that the unsuccessfully-punched nails can be taken out, so that the subsequent operation is convenient.

The staple 25 is inserted on both sides of the staple for a length not greater than the length of the upper side of the jaw-like shaped suture construct 26.

One side of the T-shaped support 24 is integrally connected with the nail bin 2, one side of the T-shaped support extends into the center of the opening 22, and the height of the longitudinal support beam 242 of the T-shaped support 24 is equal to or greater than the height of the inserted nail of the suturing nail 25, so that the arrangement can ensure that an effective 'mouth' shaped suturing structure is formed and the suturing nail 25 is retracted in the nail bin 2 before use.

The rear part of the nail bin 2 is provided with a closing baffle 27, a nail pushing spring 271 is arranged in front of the baffle, and a nail pushing plate 272 is arranged in front of the nail pushing spring 271.

The nail pushing plate 272 is arranged at the front of the two sides of the push plate 273, the heights of the inserted nails at the two sides and the width of the inserted nails are consistent, and the nail pushing is realized more effectively in this way.

The pressing structure 3 comprises two pressing teeth 31 arranged on two sides of a first cross beam 241 of the T-shaped support 24, the distance between the inner side edges of the pressing teeth 31 is equal to the length of the first cross beam 241, and gaps between the two side edges are over against the first cross beam 241 of the T-shaped support 24, so that the first cross beam 241 can be effectively bent. The two lower pressing teeth 31 are connected together through the second cross beam 32, and the arrangement can conveniently control the downward movement of the lower pressing teeth 31 through controlling the downward movement of the cross beam, so that the control is more convenient. The width of the two outer side edges of the two pressing teeth 31 is larger than the spacing distance between the two stop plates 21, and the arrangement can effectively ensure that the two pressing teeth 31 move in the stop plates 21 in the downward moving process, so that the position deviation is prevented. Two extending plates 33 which form a moving track of the two pressing teeth 31 extend out of the side wall of the extending pipe 1, and the space between the two extending plates 33 is the moving distance of the two pressing teeth 31. And return springs 34 extending to the side wall of the inlet pipe 1 are arranged on two sides of the second cross beam 32, and the arrangement ensures the automatic return of the downward pressing teeth 31 after moving downwards.

The moving block 4 is a moving block 4 with different thicknesses, a blocking block 5 integrally connected with the extension pipe 1 is arranged above the moving block 4, the end with small thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 does not realize pressing-down at the upper part, the end with large thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 presses out a suturing nail 25 at the lower part, and a wound is sutured; the downward movement control of the downward movement structure is realized by the transverse movement of the extension tube 1. The thickness small section and the thickness large end of the moving block 4 are controlled by the operation structure to contact with the blocking block 5, so that the downward movement of the downward pressing structure 3 is realized, and the suturing nails 25 are pressed out one by one. The stop block 5 is arranged right above the pressing structure 3, and the arrangement is convenient to operate.

The front end of the moving block 4 is provided with an operating rope 61 connected with an operating part, repeated pressing of the pressing structure 3 is realized through transverse reciprocating movement of the moving block 4, the side wall of the extension pipe 1 is provided with a turning hole 62 of the operating rope 61, and the operating rope 61 is changed from horizontal pulling into vertical pulling along the longitudinal direction of the extension pipe 1 when passing through the turning hole 62. Different direction-changing holes 62 are longitudinally arranged on the extension pipe 1, so that the effective traction track of the operation rope 61 is ensured. The rear end of the moving block 4 is provided with a resetting structure for resetting the moving block 4 in a non-pulling state, wherein the resetting structure is preferably integrally connected with the side wall of the extension pipe 1 by a resetting spring 41.

Diversion hole 62 sets up the pipe 1 inside wall that stretches into with pushing down structure 3 back horizontal position of pushing down, and this kind of setting makes things convenient for moving down of operation rope 61 to stimulate, guarantees to push down structure 3 to suitable position.

The inner side wall of the extension pipe 1 also extends out of the limit plates 42 at two sides of the moving block 4, and the gap between the limit plates 42 is a track for ensuring the moving block 4 to move according to a set direction.

The operation portion is connected to the operation cord 61, and the operation portion is configured to pull and release the operation cord 61. The operation part comprises a control structure 63 and a rotating motor 64, the operation rope 61 is wound on a rotating shaft 65 of the rotating motor 64, the rotating motor 64 is connected with the control structure 63, and the control structure 63 controls the rotating motor 64 to rotate forwards and backwards. The control structure 63 controls the motor to rotate forward and backward to realize the traction and the release of the operation generator, so that a series of downward pressing and upward moving motions are realized in front of the extension tube 1, the control structure 63 comprises a switch button 66, and the control structure 63 controls to press the switch button 66 to finish one-time stitching and resetting actions. The operating part is provided inside a handle 67 at the rear end of the extension tube 1, and the switch knob 66 is provided on a side of the handle that is convenient to operate.

The extending pipe 1 is a hard pipe, and the hard pipe is convenient for corresponding movement operation along with the hand movement of an operator.

Example 2 apparatus for accurate lateral suturing after anastomosis of esophagus and stomach

An instrument for accurately suturing the outer side of an esophagus after being anastomosed with a stomach comprises an extension tube 1, a suturing part which extends out of the front end of the extension tube 1 and can open a similar square-shaped suturing structure 26 with an opening 22, and an operating part which is arranged at the rear end of the extension tube 1 and used for controlling the suturing of the suturing part; the nailing part comprises a nail bin 2 integrally connected with the extension pipe 1, a pressing structure 3 for pressing nails out of the bin, and a moving block 4 for driving the pressing structure 3 to move downwards and being operated by the operation part to move; the reciprocating motion of the moving block 4 drives the downward pressing structure 3 to repeatedly press down and return, the suturing nails 25 in the nail bin 2 are adhered together, the longitudinal direction of the nail bin 2 is consistent with the longitudinal direction of the extending pipe 1, two sides of the front end of the nail bin 2 are provided with blocking plates 21 for blocking the suturing nails 25, the distance between the blocking plates 21 at two sides is larger than the length of the upper side of a similar square-shaped suturing structure 26, and an opening 22 for enabling the suturing nails 25 to move down and move out of the nail bin 2 is arranged below the inner side of each blocking plate 21; the extension tube 1 corresponds to the front section of the rear wall of the opening 22, and a notch 23 is arranged at the lower part of the nail bin 2; a T-shaped support 24 is arranged in the middle of the front part of the nail bin 2, and the T-shaped support 24 comprises a first cross beam 241 and a longitudinal support beam 242; the length of the first beam 241 of the T-shaped support 24 is equal to the length of the upper side of the square-like stitching structure 26, the length of the nails inserted into the two sides of the stitching nail 25 is equal to or less than the length of the upper side of the square-like stitching structure 26, and thus the stitching nail 25 is moved downwards by the pressing structure 3, and is bent at the transverse rod of the T-shaped support 24 to form the square-like stitching structure 26 for stitching tissues. Through this arrangement, effective suturing of the suturing nail 25 and effective detachment after suturing can be ensured.

The distance from the lower edge of the blocking plate 21 to the upper plane of the bottom of the nail bin 2 is greater than one half of the side wall of the nail bin 2, and the arrangement can effectively ensure that the unsuccessfully-punched nails can be taken out, so that the subsequent operation is convenient.

The staple 25 is inserted on both sides of the staple for a length not greater than the length of the upper side of the jaw-like shaped suture construct 26. The "square" like suture structures 26 are equal on all sides.

One side of the T-shaped support 24 is integrally connected with the nail bin 2, one side of the T-shaped support extends into the center of the opening 22, and the height of the longitudinal support beam 242 of the T-shaped support 24 is equal to or greater than the height of the inserted nail of the suturing nail 25, so that the arrangement can ensure that an effective 'mouth' shaped suturing structure is formed and the suturing nail 25 is retracted in the nail bin 2 before use.

The rear part of the nail bin 2 is provided with a closing baffle 27, a nail pushing spring 271 is arranged in front of the baffle, and a nail pushing plate 272 is arranged in front of the nail pushing spring 271.

The nail pushing plate 272 is arranged at the front of the two sides of the push plate 273, the heights of the inserted nails at the two sides and the width of the inserted nails are consistent, and the nail pushing is realized more effectively in this way.

In order to prevent the fracture of the joint of the nails in the nail pushing process, a covering cover 28 which is connected with the nail cabin 2 and covers the nail cabin 2 is arranged above the nail cabin 2, the covering cover 28 does not cover the part of the nail cabin 2 which is forwards from the opening 22, and the distance between the upper cover plate of the covering cover 28 and the cross beam 241 of the nail 25 ranges from 0.5 mm to 2 mm. The arrangement can effectively ensure that the binding layer of the suturing nail 25 cannot be broken or stretched out.

The pressing structure 3 comprises two pressing teeth 31 arranged on two sides of a first cross beam 241 of the T-shaped support 24, the distance between the inner side edges of the pressing teeth 31 is equal to the length of the first cross beam 241, and gaps between the two side edges are over against the first cross beam 241 of the T-shaped support 24, so that the first cross beam 241 can be effectively bent. The two lower pressing teeth 31 are connected together through the second cross beam 32, and the arrangement can conveniently control the downward movement of the lower pressing teeth 31 through controlling the downward movement of the cross beam, so that the control is more convenient. The width of the two outer side edges of the two pressing teeth 31 is larger than the spacing distance between the two stop plates 21, and the arrangement can effectively ensure that the two pressing teeth 31 move in the stop plates 21 in the downward moving process, so that the position deviation is prevented. Two extending plates 33 which form a moving track of the two pressing teeth 31 extend out of the side wall of the extending pipe 1, and the space between the two extending plates 33 is the moving distance of the two pressing teeth 31. And return springs 34 extending to the side wall of the inlet pipe 1 are arranged on two sides of the second cross beam 32, and the arrangement ensures the automatic return of the downward pressing teeth 31 after moving downwards.

The moving block 4 is a moving block 4 with different thicknesses, a blocking block 5 integrally connected with the extension pipe 1 is arranged above the moving block 4, the end with small thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 does not realize pressing-down at the upper part, the end with large thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 presses out a suturing nail 25 at the lower part, and a wound is sutured; the downward movement control of the downward movement structure is realized by the transverse movement of the extension tube 1. The thickness small section and the thickness large end of the moving block 4 are controlled by the operation structure to contact with the blocking block 5, so that the downward movement of the downward pressing structure 3 is realized, and the suturing nails 25 are pressed out one by one. The stop block 5 is arranged right above the pressing structure 3, and the arrangement is convenient to operate.

The contact position of the stop block 5 and the moving block 4 is provided with a rolling shaft 51 for reducing the moving resistance, and the rolling shaft 51 is in contact with the moving block 4, so that the moving resistance can be effectively reduced, and the scheme is ensured to be effectively implemented.

The front end of the moving block 4 is provided with an operating rope 61 connected with an operating part, repeated pressing of the pressing structure 3 is realized through transverse reciprocating movement of the moving block 4, the side wall of the extension pipe 1 is provided with a turning hole 62 of the operating rope 61, and the operating rope 61 is changed from horizontal pulling into vertical pulling along the longitudinal direction of the extension pipe 1 when passing through the turning hole 62. Different direction-changing holes 62 are longitudinally arranged on the extension pipe 1, so that the effective traction track of the operation rope 61 is ensured. The rear end of the moving block 4 is provided with a resetting structure for resetting the moving block 4 in a non-pulling state, wherein the resetting structure is preferably integrally connected with the side wall of the extension pipe 1 by a resetting spring 41.

Diversion hole 62 sets up the pipe 1 inside wall that stretches into with pushing down structure 3 back horizontal position of pushing down, and this kind of setting makes things convenient for moving down of operation rope 61 to stimulate, guarantees to push down structure 3 to suitable position.

The inner side wall of the extension pipe 1 also extends out of the limit plates 42 at two sides of the moving block 4, and the gap between the limit plates 42 is a track for ensuring the moving block 4 to move according to a set direction.

The operation portion is connected to the operation cord 61, and the operation portion is configured to pull and release the operation cord 61.

The operation part comprises a control structure 63 and a rotating motor 64, the operation rope 61 is wound on a rotating shaft 65 of the rotating motor 64, the rotating motor 64 is connected with the control structure 63, and the control structure 63 controls the rotating motor 64 to rotate forwards and backwards. The control structure 63 controls the motor to rotate forward and backward to realize the traction and the release of the operation generator, so that a series of downward pressing and upward moving motions are realized in front of the extension tube 1, the control structure 63 comprises a switch button 66, and the control structure 63 controls to press the switch button 66 to finish one-time stitching and resetting actions. The operating part is provided inside a handle 67 at the rear end of the extension tube 1, and the switch knob 66 is provided on a side of the handle that is convenient to operate. The extending pipe 1 is a hard pipe, and the hard pipe is convenient for corresponding movement operation along with the hand movement of an operator.

EXAMPLE 3 apparatus for accurate lateral suturing after anastomosis of esophagus and stomach

An instrument for accurately suturing the outer side of an esophagus after being anastomosed with a stomach comprises an extension tube 1, a suturing part which extends out of the front end of the extension tube 1 and can open a similar square-shaped suturing structure 26 with an opening 22, and an operating part which is arranged at the rear end of the extension tube 1 and used for controlling the suturing of the suturing part; the nailing part comprises a nail bin 2 integrally connected with the extension pipe 1, a pressing structure 3 for pressing nails out of the bin, and a moving block 4 for driving the pressing structure 3 to move downwards and being operated by the operation part to move; the reciprocating motion of the moving block 4 drives the downward pressing structure 3 to repeatedly press down and return, the suturing nails 25 in the nail bin 2 are adhered together, the longitudinal direction of the nail bin 2 is consistent with the longitudinal direction of the extending pipe 1, two sides of the front end of the nail bin 2 are provided with blocking plates 21 for blocking the suturing nails 25, the distance between the blocking plates 21 at two sides is larger than the length of the upper side of a similar square-shaped suturing structure 26, and an opening 22 for enabling the suturing nails 25 to move down and move out of the nail bin 2 is arranged below the inner side of each blocking plate 21; the extension tube 1 corresponds to the front section of the rear wall of the opening 22, and a notch 23 is arranged at the lower part of the nail bin 2; a T-shaped support 24 is arranged in the middle of the front part of the nail bin 2, and the T-shaped support 24 comprises a first cross beam 241 and a longitudinal support beam 242; the length of the first beam 241 of the T-shaped support 24 is equal to the length of the upper side of the square-like stitching structure 26, the length of the nails inserted into the two sides of the stitching nail 25 is equal to or less than the length of the upper side of the square-like stitching structure 26, and thus the stitching nail 25 is moved downwards by the pressing structure 3, and is bent at the transverse rod of the T-shaped support 24 to form the square-like stitching structure 26 for stitching tissues. Through this arrangement, effective suturing of the suturing nail 25 and effective detachment after suturing can be ensured.

The distance from the lower edge of the blocking plate 21 to the upper plane of the bottom of the nail bin 2 is greater than one half of the side wall of the nail bin 2, and the arrangement can effectively ensure that the unsuccessfully-punched nails can be taken out, so that the subsequent operation is convenient.

The staple 25 is inserted on both sides of the staple for a length not greater than the length of the upper side of the jaw-like shaped suture construct 26.

One side of the T-shaped support 24 is integrally connected with the nail bin 2, and the other side extends into the center of the opening 22 "

The height of the longitudinal support beam 242 of the T-shaped support 24 is equal to or greater than the height of the inserted staples 25, which ensures that the "square" shaped staple structure is effectively formed and that the staples 25 are retracted within the cartridge 2 before use.

The rear part of the nail bin 2 is provided with a closing baffle 27, a nail pushing spring 271 is arranged in front of the baffle, and a nail pushing plate 272 is arranged in front of the nail pushing spring 271.

The nail pushing plate 272 is arranged at the front of the two sides of the push plate 273, the heights of the inserted nails at the two sides and the width of the inserted nails are consistent, and the nail pushing is realized more effectively in this way.

In order to prevent the fracture of the joint of the nails in the nail pushing process, a covering cover 28 which is connected with the nail cabin 2 and covers the nail cabin 2 is arranged above the nail cabin 2, the covering cover 28 does not cover the part of the nail cabin 2 which is forwards from the opening 22, and the distance between the upper cover plate of the covering cover 28 and the cross beam 241 of the nail 25 ranges from 0.5 mm to 2 mm. The arrangement can effectively ensure that the binding layer of the suturing nail 25 cannot be broken or stretched out.

The pressing structure 3 comprises two pressing teeth 31 arranged on two sides of a first cross beam 241 of the T-shaped support 24, the distance between the inner side edges of the pressing teeth 31 is equal to the length of the first cross beam 241, and gaps between the two side edges are over against the first cross beam 241 of the T-shaped support 24, so that the first cross beam 241 can be effectively bent. The two lower pressing teeth 31 are connected together through the second cross beam 32, and the arrangement can conveniently control the downward movement of the lower pressing teeth 31 through controlling the downward movement of the cross beam, so that the control is more convenient. The width of the two outer side edges of the two pressing teeth 31 is larger than the spacing distance between the two stop plates 21, and the arrangement can effectively ensure that the two pressing teeth 31 move in the stop plates 21 in the downward moving process, so that the position deviation is prevented. Two extending plates 33 which form a moving track of the two pressing teeth 31 extend out of the side wall of the extending pipe 1, and the space between the two extending plates 33 is the moving distance of the two pressing teeth 31. And return springs 34 extending to the side wall of the inlet pipe 1 are arranged on two sides of the second cross beam 32, and the arrangement ensures the automatic return of the downward pressing teeth 31 after moving downwards.

The moving block 4 is a moving block 4 with different thicknesses, a blocking block 5 integrally connected with the extension pipe 1 is arranged above the moving block 4, the end with small thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 does not realize pressing-down at the upper part, the end with large thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 presses out a suturing nail 25 at the lower part, and a wound is sutured; the downward movement control of the downward movement structure is realized by the longitudinal movement of the extension tube 1. The thickness small section and the thickness large end of the moving block 4 are controlled by the operation structure to contact with the blocking block 5, so that the downward movement of the downward pressing structure 3 is realized, and the suturing nails 25 are pressed out one by one. The stop block 5 is arranged right above the pressing structure 3, and the arrangement is convenient to operate.

The contact position of the stop block 5 and the moving block 4 is provided with a rolling shaft 51 for reducing the moving resistance, and the rolling shaft 51 is in contact with the moving block 4, so that the moving resistance can be effectively reduced, and the scheme is ensured to be effectively implemented.

The front end of the moving block 4 is provided with an operation rope 61 connected with the operation part, repeated pressing of the pressing structure 3 is realized through longitudinal reciprocating movement of the moving block 4, the side wall of the stretching pipe 1 is provided with an operation rope 61 hole for ensuring front and back movement, the smaller end of the moving block 4 is arranged at the front end of the stretching pipe 1, and the moving block 4 is driven by the operation rope 61 to move backwards to enable the pressing structure 3 to move downwards. Different arrangement holes are longitudinally arranged on the extension pipe 1, so that the effective traction track of the operation rope 61 is ensured. The rear end of the moving block 4 is provided with a resetting structure for resetting the moving block 4 in a non-pulling state, wherein the resetting structure is preferably integrally connected with the side wall of the extension pipe 1 by a resetting spring 41.

Diversion hole 62 sets up the pipe 1 inside wall that stretches into with pushing down structure 3 back horizontal position of pushing down, and this kind of setting makes things convenient for moving down of operation rope 61 to stimulate, guarantees to push down structure 3 to suitable position.

The inner side wall of the extension pipe 1 also extends out of the limit plates 42 at two sides of the moving block 4, and the gap between the limit plates 42 is a track for ensuring the moving block 4 to move according to a set direction.

The operation portion is connected to the operation cord 61, and the operation portion is configured to pull and release the operation cord 61.

The operation part comprises a control structure 63 and a rotating motor 64, the operation rope 61 is wound on a rotating shaft 65 of the rotating motor 64, the rotating motor 64 is connected with the control structure 63, and the control structure 63 controls the rotating motor 64 to rotate forwards and backwards. The control structure 63 controls the motor to rotate forward and backward to realize the traction and the release of the operation generator, so that a series of downward pressing and upward moving motions are realized in front of the extension tube 1, the control structure 63 comprises a switch button 66, and the control structure 63 controls to press the switch button 66 to finish one-time stitching and resetting actions.

The operating part is provided inside a handle 67 at the rear end of the extension tube 1, and the switch knob 66 is provided on a side of the handle that is convenient to operate.

The reinforcing layer 68 is arranged outside the motor side of the rotating motor 64, so that the stability of the motor structure inside the operating handle is guaranteed, and the effective traction of the front structure is guaranteed.

The extending pipe 1 is a hard pipe, and the hard pipe is convenient for corresponding movement operation along with the hand movement of an operator.

EXAMPLE 4 apparatus for accurate lateral suturing after anastomosis of esophagus and stomach

An instrument for accurately suturing the outer side of an esophagus after being anastomosed with a stomach comprises an extension tube 1, a suturing part which extends out of the front end of the extension tube 1 and can open a similar square-shaped suturing structure 26 with an opening 22, and an operating part which is arranged at the rear end of the extension tube 1 and used for controlling the suturing of the suturing part; the nailing part comprises a nail bin 2 integrally connected with the extension pipe 1, a pressing structure 3 for pressing nails out of the bin, and a moving block 4 for driving the pressing structure 3 to move downwards and being operated by the operation part to move; the reciprocating motion of the moving block 4 drives the downward pressing structure 3 to repeatedly press down and return, the suturing nails 25 in the nail bin 2 are adhered together, the longitudinal direction of the nail bin 2 is consistent with the longitudinal direction of the extending pipe 1, two sides of the front end of the nail bin 2 are provided with blocking plates 21 for blocking the suturing nails 25, the distance between the blocking plates 21 at two sides is larger than the length of the upper side of a similar square-shaped suturing structure 26, and an opening 22 for enabling the suturing nails 25 to move down and move out of the nail bin 2 is arranged below the inner side of each blocking plate 21; the extension tube 1 corresponds to the front section of the rear wall of the opening 22, and a notch 23 is arranged at the lower part of the nail bin 2; a T-shaped support 24 is arranged in the middle of the front part of the nail bin 2, and the T-shaped support 24 comprises a first cross beam 241 and a longitudinal support beam 242; the length of the first beam 241 of the T-shaped support 24 is equal to the length of the upper side of the square-like stitching structure 26, the length of the nails inserted into the two sides of the stitching nail 25 is equal to or less than the length of the upper side of the square-like stitching structure 26, and thus the stitching nail 25 is moved downwards by the pressing structure 3, and is bent at the transverse rod of the T-shaped support 24 to form the square-like stitching structure 26 for stitching tissues. Through this arrangement, effective suturing of the suturing nail 25 and effective detachment after suturing can be ensured.

The distance from the lower edge of the blocking plate 21 to the upper plane of the bottom of the nail bin 2 is greater than one half of the side wall of the nail bin 2, and the arrangement can effectively ensure that the unsuccessfully-punched nails can be taken out, so that the subsequent operation is convenient.

The staple 25 is inserted on both sides of the staple for a length not greater than the length of the upper side of the jaw-like shaped suture construct 26. The "square" like suture structures 26 are equal on all sides.

One side of the T-shaped support 24 is integrally connected with the nail bin 2, one side of the T-shaped support extends into the center of the opening 22, and the height of the longitudinal support beam 242 of the T-shaped support 24 is equal to or greater than the height of the inserted nail of the suturing nail 25, so that the arrangement can ensure that an effective 'mouth' shaped suturing structure is formed and the suturing nail 25 is retracted in the nail bin 2 before use.

The rear part of the nail bin 2 is provided with a closing baffle 27, a nail pushing spring 271 is arranged in front of the baffle, and a nail pushing plate 272 is arranged in front of the nail pushing spring 271.

The nail pushing plate 272 is arranged at the front of the two sides of the push plate 273, the heights of the inserted nails at the two sides and the width of the inserted nails are consistent, and the nail pushing is realized more effectively in this way.

In order to prevent the fracture of the joint of the nails in the nail pushing process, a covering cover 28 which is connected with the nail cabin 2 and covers the nail cabin 2 is arranged above the nail cabin 2, the covering cover 28 does not cover the part of the nail cabin 2 which is forwards from the opening 22, and the distance between the upper cover plate of the covering cover 28 and the cross beam 241 of the nail 25 ranges from 0.5 mm to 2 mm. The arrangement can effectively ensure that the binding layer of the suturing nail 25 cannot be broken or stretched out.

The pressing structure 3 comprises two pressing teeth 31 arranged on two sides of a first cross beam 241 of the T-shaped support 24, the distance between the inner side edges of the pressing teeth 31 is equal to the length of the first cross beam 241, and gaps between the two side edges are over against the first cross beam 241 of the T-shaped support 24, so that the first cross beam 241 can be effectively bent. The two lower pressing teeth 31 are connected together through the second cross beam 32, and the arrangement can conveniently control the downward movement of the lower pressing teeth 31 through controlling the downward movement of the cross beam, so that the control is more convenient. The width of the two outer side edges of the two pressing teeth 31 is larger than the spacing distance between the two stop plates 21, and the arrangement can effectively ensure that the two pressing teeth 31 move in the stop plates 21 in the downward moving process, so that the position deviation is prevented. Two extending plates 33 which form a moving track of the two pressing teeth 31 extend out of the side wall of the extending pipe 1, and the space between the two extending plates 33 is the moving distance of the two pressing teeth 31. And return springs 34 extending to the side wall of the inlet pipe 1 are arranged on two sides of the second cross beam 32, and the arrangement ensures the automatic return of the downward pressing teeth 31 after moving downwards.

The moving block 4 is a moving block 4 with different thicknesses, a blocking block 5 integrally connected with the extension pipe 1 is arranged above the moving block 4, the end with small thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 does not realize pressing-down at the upper part, the end with large thickness of the moving block 4 is in contact with the blocking block 5, the pressing-down structure 3 presses out a suturing nail 25 at the lower part, and a wound is sutured; the downward movement control of the downward movement structure is realized by the transverse movement of the extension tube 1. The thickness small section and the thickness large end of the moving block 4 are controlled by the operation structure to contact with the blocking block 5, so that the downward movement of the downward pressing structure 3 is realized, and the suturing nails 25 are pressed out one by one. The stop block 5 is arranged right above the pressing structure 3, and the arrangement is convenient to operate.

The contact position of the stop block 5 and the moving block 4 is provided with a rolling shaft 51 for reducing the moving resistance, and the rolling shaft 51 is in contact with the moving block 4, so that the moving resistance can be effectively reduced, and the scheme is ensured to be effectively implemented.

The front end of the moving block 4 is provided with an operating rope 61 connected with an operating part, repeated pressing of the pressing structure 3 is realized through transverse reciprocating movement of the moving block 4, the side wall of the extension pipe 1 is provided with a turning hole 62 of the operating rope 61, and the operating rope 61 is changed from horizontal pulling into vertical pulling along the longitudinal direction of the extension pipe 1 when passing through the turning hole 62. Different direction-changing holes 62 are longitudinally arranged on the extension pipe 1, so that the effective traction track of the operation rope 61 is ensured. The rear end of the moving block 4 is provided with a resetting structure for resetting the moving block 4 in a non-pulling state, wherein the resetting structure is preferably integrally connected with the side wall of the extension pipe 1 by a resetting spring 41. Diversion hole 62 sets up the pipe 1 inside wall that stretches into with pushing down structure 3 back horizontal position of pushing down, and this kind of setting makes things convenient for moving down of operation rope 61 to stimulate, guarantees to push down structure 3 to suitable position.

The inner side wall of the extension pipe 1 also extends out of the limit plates 42 at two sides of the moving block 4, and the gap between the limit plates 42 is a track for ensuring the moving block 4 to move according to a set direction. The operation portion is connected to the operation cord 61, and the operation portion is configured to pull and release the operation cord 61.

The operation part comprises a control structure 63 and a rotating motor 64, the operation rope 61 is wound on a rotating shaft 65 of the rotating motor 64, the rotating motor 64 is connected with the control structure 63, and the control structure 63 controls the rotating motor 64 to rotate forwards and backwards. The control structure 63 controls the motor to rotate forward and backward to realize the traction and the release of the operation generator, so that a series of downward pressing and upward moving motions are realized in front of the extension tube 1, the control structure 63 comprises a switch button 66, and the control structure 63 controls to press the switch button 66 to finish one-time stitching and resetting actions. The operating part is provided inside a handle 67 at the rear end of the extension tube 1, and the switch knob 66 is provided on a side of the handle that is convenient to operate. The reinforcing layer 68 is arranged outside the motor side of the rotating motor 64, so that the stability of the motor structure inside the operating handle is guaranteed, and the effective traction of the front structure is guaranteed. The extending pipe 1 is a hard pipe, and the hard pipe is convenient for corresponding movement operation along with the hand movement of an operator.

The above description of the embodiments is only intended to illustrate the present invention. It should be noted that, for those skilled in the art, without departing from the principle of the present invention, several modifications can be made to the present invention, and these modifications will fall within the protection scope of the claims of the present invention.

Claims (10)

1. An instrument for accurately suturing the outer side of an esophagus and a stomach after anastomosis comprises an extension tube, a suturing part which extends out of the front end of the extension tube and can open a mouth-like suturing structure with an opening, and an operating part which is arranged at the rear end of the extension tube and used for controlling the suturing of the suturing part; the nail pressing device is characterized in that the nailing part comprises a nail bin integrally connected with the extension pipe, a pressing structure for pressing nails out of the nail bin, and a moving block which drives the pressing structure to move downwards and is operated by the operation part to move; the reciprocating motion of the moving block drives the downward pressing structure to repeatedly press down and return, the stitching nails in the nail bin are bonded together, the longitudinal direction of the nail bin is consistent with the longitudinal direction of the extending pipe, two sides of the front end of the nail bin are provided with blocking plates for blocking the stitching nails, the distance between the blocking plates at two sides is larger than the length of the upper side of the stitching structure similar to the shape of the Chinese character kou, and an opening for the stitching nails to move down and move out of the nail bin is arranged below the inner side of the blocking plates; the extension tube corresponds to the front section of the rear wall of the opening, and a notch is arranged at the lower part of the nail bin; the middle of the front part of the nail bin is provided with a T-shaped support, and the T-shaped support comprises a first cross beam and a longitudinal support beam; the length of the first cross beam of the T-shaped support is equal to that of the upper side of the mouth-shaped suture structure, the length of the nails inserted into the two sides of the suturing nails is equal to or less than that of the upper side of the mouth-shaped suture structure, the suturing nails are moved downwards through the pressing structure and bent at the transverse rod of the T-shaped support, and the mouth-shaped suture structure is formed to suture tissues.

2. The apparatus according to claim 1, wherein the lower edge of the blocking plate is spaced from the upper plane of the bottom of the cartridge by a distance greater than one-half of the sidewall of the cartridge.

3. The instrument for precise lateral suturing after anastomosis of esophagus and stomach as claimed in claim 2, wherein the length of the nail inserted into both sides of the suturing nail is equal to the length of the upper side of the mouth-like suturing structure.

4. The apparatus for precision lateral suturing after anastomosis of esophagus and stomach according to claim 2, wherein the four sides of the "square" like suture structure are equal.

5. The apparatus for precision lateral suturing after anastomosis of esophagus and stomach according to claim 2, wherein one side of the "T" shaped support is integrally connected with the nail magazine, one side of the "T" shaped support extends into the center of the opening, and the height of the longitudinal support beam of the "T" shaped support is equal to or greater than the height of the inserted nail of the suturing nail.

6. The instrument for precise lateral suturing after anastomosis of the esophagus and the stomach as claimed in claim 5, wherein a closing baffle is arranged behind the nail bin, a nail pushing spring is arranged in front of the baffle, and a nail pushing plate is arranged in front of the nail pushing spring.

7. The apparatus for precise lateral suturing after anastomosis of esophagus and stomach as claimed in claim 2, wherein the pressing structure comprises two pressing teeth disposed on two sides of a first cross beam of the "T" shaped support, the distance between the inner sides of the lower teeth is equal to the length of the first cross beam, and the gap between the two sides is opposite to the first cross beam of the "T" shaped support.

8. The instrument for accurately suturing the outer side of the esophagus after the esophagus and the stomach are anastomosed according to claim 2, wherein the moving blocks are moving blocks with different thicknesses, the blocking blocks integrally connected with the extending pipe are arranged above the moving blocks, the end with the small thickness of the moving blocks is in contact with the blocking blocks, the downward pressing structure does not realize downward pressing above the moving blocks, the end with the large thickness of the moving blocks is in contact with the blocking blocks, and the downward pressing structure presses suturing nails below the downward pressing structure to suture wounds; the downward movement control of the downward movement structure is realized by the longitudinal movement or the transverse movement of the extending pipe.

9. The instrument for accurately suturing the outer side of the esophagus after the anastomosis of the esophagus and the stomach as claimed in any one of claims 2 to 8, wherein the front end of the moving block is provided with an operating rope connected with the operating part, the downward pressing structure is repeatedly pressed through the transverse movement of the moving block, the side wall of the insertion tube is provided with an operating rope turning hole, and the operating rope is changed from horizontal pulling to vertical pulling along the longitudinal direction of the insertion tube during the same turning hole.

10. The instrument for precise suturing of the outside of the esophagus after the anastomosis of the esophagus and the stomach as claimed in claim 9, wherein the operation portion comprises a control structure and a rotating motor, the operation rope is wound on a rotating shaft of the rotating motor, the rotating motor is connected with a power supply of the control structure, and the control structure controls the rotating motor to rotate forward and backward.

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