CN218186862U - Anorectal stapler and push nail and push knife mechanism thereof - Google Patents

Abstract

The utility model relates to a provide anus intestines anastomat and ejector pin and push-type broach mechanism thereof, ejector pin and push-type broach mechanism include: the nail bin is provided with a nail outlet hole for accommodating and guiding the anastomotic nail to move in a third direction and a cutter outlet hole for accommodating and guiding the cutter to move in a fourth direction; a staple knife push plate disposed at one side of the staple cartridge in a third direction, the staple knife push plate comprising: the cutter pushing part extends from the cutter pushing part towards the nail bin and movably extends into the nail outlet hole; a push button operable to move in a first direction, the push button being operably connected to the staple knife push plate via a transmission assembly to drive the staple knife push plate toward the staple cartridge; wherein the first direction intersects the third direction. The operation direction of the actuating piece in the push nail and push knife mechanism is not consistent with the movement direction of the anastomosis nail and the cutter, so that the application range of the anorectal anastomosis stapler can be expanded.

Description

Anorectal anastomat and nail pushing and knife pushing mechanism thereof

Technical Field

The utility model relates to the field of medical equipment, especially, relate to an anorectal anastomosis ware and push pin and push-type broach mechanism thereof.

Background

Hemorrhoids (hemorrhoids) are the most common anal diseases. As shown in FIG. 1, the hemorrhoidal tissue 100 is generally elongated in shape at the patient's anorectum 200 and has a length that extends generally along the length of the anorectum, with the length of the hemorrhoidal tissue 100 typically being several times the width.

An anorectal stapler is a medical instrument for excising hemorrhoids that has a head that needs to extend into the anorectum of a patient in order to perform the relevant procedure on a surgical site when in use.

In order to achieve the above "correlation process", the head of the stapler is generally provided with: the clamping assembly is used for clamping to fix the hemorrhoid tissue, the anastomosis nail is used for stapling the clamped hemorrhoid tissue, and the cutter is used for cutting the stapled hemorrhoid tissue. The staple and the cutter are accommodated in a staple bin of the head, and when the staple and the cutter are used, the staple and the cutter are pushed to move by a manually operated braking element so as to discharge the staples and the cutter.

In a traditional anorectal stapler, the moving direction of each element of an assembly for driving a stapling nail and a cutter to move, particularly a braking piece and a push rod is consistent with the moving direction of the stapling nail or the cutter. The staple and pusher mechanisms of this construction have limited application scenarios.

Disclosure of Invention

The utility model provides a technical problem be: provides a push nail and push knife mechanism with the operating direction of an actuating piece inconsistent with the moving direction of an anastomotic nail and a cutter, and an anorectal anastomat provided with the push nail and push knife mechanism so as to expand the application range of the anorectal anastomat.

The technical scheme of the utility model is that:

in a first aspect, the utility model provides a nail pushing and knife pushing mechanism of anorectal anastomat, which comprises a nail bin, wherein the nail bin is provided with a nail pushing mechanism

A staple exit hole for receiving and guiding movement of staples in a third direction, an

The cutter outlet hole is used for accommodating and guiding the cutter to move in the fourth direction;

further comprising:

a staple knife push plate disposed at one side of the staple cartridge in the third direction, the staple knife push plate comprising: the cutter pushing part extends from the cutter pushing part towards the nail bin and movably extends into the nail outlet hole;

a push button operatively movable in a first direction and operatively coupled to the knife pusher plate via a transmission assembly to drive the knife pusher plate toward the cartridge to eject the staples and the cutting knife from the staple exit hole and the knife exit hole, respectively, wherein the first direction intersects the third direction.

The first aspect of the present invention may further include one or more of the following preferred embodiments on the basis of the above technical solutions:

the first direction is substantially perpendicular to the third direction.

The transmission assembly includes:

the pushing block is arranged on one side, away from the movable clamping seat, of the nail cutter pushing plate in the third direction, and is provided with a chute which is crossed with the first direction;

the push rod extends in the first direction, the rear end of the push rod is connected with the push button, and the front end of the push rod is pivotally connected with a rolling shaft movably arranged in the chute in a penetrating mode.

The coaxial connection diameter of the rolling shaft is larger than that of the roller of the rolling shaft, and the push block is provided with an inclined plane which is in contact fit with the roller and is arranged in parallel with the chute.

The two chutes and the two rollers are respectively arranged.

The transmission assembly includes:

the pushing block is arranged on one side, deviating from the movable clamping seat, of the nailing knife pushing plate in the third direction, and is provided with an inclined plane which is crossed with the first direction;

and the push rod extends in the first direction, the rear end of the push rod is connected with the push button, and the front end of the push rod is pivotally connected with a roller which is in contact fit with the inclined surface.

The third direction is substantially parallel to the fourth direction.

The nail outlet hole is a through hole penetrating through the nail bin in the third direction.

The knife outlet hole is a through hole penetrating through the nail bin in the fourth direction.

In a second aspect, the present invention provides an anorectal anastomosis device, comprising a push pin and a push knife mechanism according to the first aspect.

The utility model discloses following beneficial effect has at least:

the utility model discloses push pin and push-type broach mechanism among the anorectal anastomosis stapler, the direction of motion of the operating direction of its actuated part and the push rod as main drive assembly, the direction of motion of the anastomosis nail of roughly perpendicular to and cutter provides a new design concept for the push pin and the push-type broach mechanism of anorectal anastomosis stapler especially anorectal anastomosis stapler, and then provides new direction for extension anorectal anastomosis stapler application scene.

Drawings

In order to illustrate the technical solutions of the embodiments of the present invention more clearly, the drawings of the embodiments will be briefly described below, and it is obvious that the drawings in the following description only relate to some embodiments of the present invention, and are not intended to limit the present invention.

Fig. 1 is a schematic illustration of tissue.

Fig. 2 is a schematic view of the three-dimensional structure of the anorectal stapler in the embodiment of the present invention, wherein the clamping assembly is in the clamping state, and the staple and the cutter are respectively in the state of waiting for staple ejection and the state of waiting for cutter ejection.

Fig. 3 is a schematic cross-sectional view of the anorectal stapler of fig. 2.

Fig. 4 is an enlarged view of the X1 portion of fig. 3.

FIG. 5 is a schematic view of the anorectal stapler of FIG. 3 after the push button has been advanced to push out the staple and cutter.

Fig. 6 is an enlarged view of the X2 portion of fig. 5.

FIG. 7 is a schematic view of the first portion of the anorectal stapler of FIG. 2 after the push button has been retracted to an extreme position.

FIG. 8 is a schematic view of the second portion of the anorectal stapler of FIG. 2.

FIG. 9 is a schematic view of the first portion of the anorectal stapler of FIG. 2 with the clamping assembly in an undamped condition.

Fig. 10 is an enlarged view of the X3 portion of fig. 9.

FIG. 11 is a schematic view of the first portion of the anorectal stapler of FIG. 2 in a clamped state in the clamping assembly.

Fig. 12 is an enlarged view of the X4 portion of fig. 11.

Figure 13 is a top view of the staple knife push plate of figure 11 removed.

Fig. 14 is an enlarged view of the X5 portion of fig. 13.

FIG. 15 is an exploded view of the anorectal stapler of FIG. 2.

Fig. 16 is a partially enlarged view of fig. 15.

Fig. 17 is a schematic structural view of a cutter in an embodiment of the present invention.

FIG. 18 is an illustration of the use of a straight cutting blade to cut hemorrhoidal tissue.

FIG. 19 is a schematic view of the hemorrhoid tissue structure of FIG. 18 after the cutting is completed.

Fig. 20 is a diagram showing the use of the cutter of the embodiment of the present invention to cut thin hemorrhoidal tissues.

FIG. 21 is a schematic view of the hemorrhoid tissue structure after completion of the cutting action of FIG. 20.

Fig. 22 is a representation of the use of the cutter of the present invention to cut thick hemorrhoidal tissue.

FIG. 23 is a schematic view of the hemorrhoid tissue structure after completion of the cutting action of FIG. 22.

Description of the reference numerals:

1000-first part, 2000-second part;

100-hemorrhoid tissue, 200-anorectum, 300-human body;

101-a connecting part of a hemorrhoid tissue cutting section and an uncut section, and 102-a cutting seam between the hemorrhoid tissue cutting section and the uncut section;

d 1-first direction, d 2-second direction, d 3-third direction, d 4-fourth direction;

1-anastomotic nail, 2-cutter, 3-fixed holder, 4-movable holder, 5-clamping actuator, 6-first shell, 7-nail knife push plate, 8-nail knife actuator, 9-second shell, 10-push block, 11-first connecting rod, 12-second connecting rod, 13-third connecting rod, 14-driving belt, 15-push rod, 16-sliding pin, 17-safety bolt, 18-extension rod, 19-rolling shaft and 20-rolling wheel;

4 a-nail outlet hole, 4 b-cutter outlet hole;

6 a-handle, 6 b-clamping groove and 6 c-push button guiding hole;

7 a-a nail pushing part, 7 b-a cutter pushing part;

9 a-jack, 9 b-rib, 9 c-guide groove;

10 a-chute, 10 b-bevel;

1501-front rod body, 1502-rear rod body and 15 a-push rod guide and shift hole.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention clearer, the drawings of the embodiments of the present invention are combined below to clearly and completely describe the technical solutions of the embodiments of the present invention. It is to be understood that the embodiments described are some, not all embodiments of the invention. 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. It will be understood that some of the technical means of the various embodiments described herein may be replaced or combined with each other without conflict.

In the description of the present invention and in the claims, the terms "first", "second", and the like, if any, are used only for distinguishing the described objects, and do not have any sequential or technical meaning. Thus, an object defined as "first," "second," etc. may explicitly or implicitly include one or more of the object. Also, the use of the terms "a" or "an" and the like, do not denote a limitation of quantity, but rather denote the presence of at least one, and the terms "a" or "an" denote the presence of no less than two. The said "plurality" of the utility model means that no less than two.

In the description of the present invention and in the claims, the terms "connected," "mounted," "fixed," and the like are used broadly unless otherwise indicated. For example, "connected" may be a separate connection or may be integrally connected; may be directly connected or indirectly connected through an intermediate. The specific meaning of the foregoing terms in the present invention can be understood by those skilled in the art as appropriate.

In the description of the present invention and in the claims, if there are any terms such as "upper", "lower", "horizontal", etc., indicating orientations or positional relationships based on the orientations or positional relationships shown in the drawings, it is merely for convenience of clearly and concisely describing the present invention, and it is not intended to indicate or imply that the elements so referred to must have a particular orientation, be constructed and operated in a particular orientation, and that these directional terms are relative terms, which are used for descriptive and clarifying purposes, and may be changed accordingly depending on the orientation in which the components in the drawings are placed. For example, if the device in the figures is turned over, elements described as "below" other elements would then be oriented "above" the other elements.

In describing and claiming the present invention, the terms "based on" and "based on," if any, are used to describe one or more factors that affect the determination. The term does not exclude additional factors that influence the determination. That is, the determination may be based solely on these factors or at least partially on these factors. For example, the phrase "determining a based on B," in which case B is a factor that affects the determination of a, such phrases do not exclude that the determination of a may also be based on C.

In the description of the present specification and claims, the term "configured to" if present, may generally be interchangeable with "having" \823030, "capability" or "designed to" or "for" or "capable," depending on the context.

Embodiments of the present invention will now be described with reference to the accompanying drawings.

Figures 2 and 3 show an anorectal stapler for excising haemorrhoidal tissue in the anorectum of a patient. Like some conventional anorectal staplers, this anorectal stapler also has a head which, in use, extends partially or fully into the anorectum of the patient. The head has a length dimension extending in the first direction d1, or the head projects forward from the stapler body along the first direction d1. The head is provided with: in use, the clamping assembly clamps hemorrhoidal tissue in a second direction d2, the staples 1 are moved in a third direction d3 to staple the hemorrhoidal tissue, and the cutter 2 is moved in a fourth direction d4 to cut the hemorrhoidal tissue. In use, the head of the stapler is inserted into the anorectal tract of the patient substantially along the first direction d1, and, in combination with external operations, the hemorrhoid tissue is subjected to the related treatments by means of the related elements provided on the head.

In the present embodiment, the second direction d2 is substantially perpendicular to the first direction d1.

It will be appreciated that when the head of the stapler is inserted into the affected part of the anorectum, the length of the affected part of the anorectum will be arranged along the length of the head of the stapler, i.e. the first direction d1. In most cases, a sheath for opening the anorectal section to be operated is placed in the anorectal section in advance, and the length of the sheath and the length of the anorectal section at the affected part are also oriented in the first direction d1. Then a second direction d2, which is substantially perpendicular to the first direction d1, is substantially perpendicular to the anorectal length. The background art of the utility model has been explained: the hemorrhoidal tissue 100 within the anorectum is generally an elongated structure extending along the length of the affected part anorectum, the length of the hemorrhoidal tissue 100 in the first direction d1 being several times its width in the second direction d2.

When in use, after the head of the anastomat is inserted to the proper depth, the angle of the head clamping component is adjusted to align to the hemorrhoid tissue 100 to be excised in the anorectum, and then the hemorrhoid tissue 100 is clamped in the width direction of the hemorrhoid tissue 100 to prepare for the stapling and excision of the hemorrhoid tissue. Thereafter, the staples 1 are moved in the third direction d3 to staple the clamped hemorrhoidal tissue 100, and the cutter 2 is moved in the fourth direction d4 to cut the stapled hemorrhoidal tissue 100 outside the staples.

Since the hemorrhoid tissue 100 has a width dimension smaller than a length dimension, when the clamping assembly clamps the hemorrhoid tissue 100 in the width direction of the hemorrhoid tissue (second direction d 2), the patient's pain is less than in the conventional solution of clamping hemorrhoid tissue in the length direction (first direction d 1), and it is easier to handle clamping hemorrhoid tissue 100 of a small width in the width direction.

As shown in fig. 4, 6, 10, 12 and fig. 3, 5, 7, 9 and 11, in the present embodiment, the clamping assembly includes a fixed clamping seat 3 and a movable clamping seat 4 which are matched with each other, and the movable clamping seat 4 and the fixed clamping seat 3 are arranged in the second direction d2. The clamping action of the clamping assembly is driven by a manually operated clamping actuator 5. The clamping actuating piece 5 is connected with the movable clamping seat 4 through a first transmission component. In use, the operator manually actuates the clamping actuator 5, and the clamping actuator 5 drives the movable clamp holder 4 to move towards the fixed clamp holder 3 through the first transmission assembly, so as to clamp and fix the hemorrhoidal tissue 100 to be excised between the movable clamp holder 4 and the fixed clamp holder 3 along the second direction d2.

In order to facilitate the operation and the installation of the related components, the anorectal stapler of the embodiment is further provided with a first shell 6 with a handle 6 a. The gripping actuator 5 is embodied as a trigger having a first end, i.e. the upper end in fig. 3, extending into the first housing 6 and being pivotally connected to the first housing 6 and a second end, i.e. the lower end in fig. 3, extending outside the first housing 6 for manual operation. An extension rod 18 extending forward along the first direction d1 is fixedly connected to the first housing 6, and the movable holder 4 is integrally fixed to a front end portion of the extension rod 18.

Referring to fig. 3 again, the first transmission assembly is mainly composed of a first link 11, a second link 12, a third link 13, and a belt 14. Wherein: the first link 11 extends in the first direction d1, and the left end of the first link 11 in fig. 3 is fixed to the movable holder 4. A first end, i.e., an upper end in fig. 3, of the second link 12 is pivotally connected to the first link 11, and a second end, i.e., a lower end in fig. 3, is pivotally connected to the first housing 6. A first end, i.e., an upper end in fig. 3, of the third link 13 is pivotally connected to the first link 11, and a second end, i.e., a lower end in fig. 3, is pivotally connected to the first housing 6. A drive belt 14 connects a first end of the trigger and a second end of the third link 13. When the first end of the trigger is rotated, the second end of the third link 13 is driven to rotate by the transmission belt 14.

When the device is used, the trigger in fig. 9 is pulled, so that the first end of the trigger rotates anticlockwise around the switching part between the first end of the trigger and the first shell 6, the second end of the third connecting rod 13 is driven to rotate anticlockwise through the transmission belt 14, and the first connecting rod 11 is driven to move leftwards and move downwards. The movable holder 4 fixed to the left end of the first link 11 is pressed against the fixed holder 3 to clamp and fix the hemorrhoidal tissue between the movable holder 4 and the fixed holder 3, as shown in fig. 11.

To prevent the transmission belt 14 from slipping during operation, a gear body may be provided at the first end of the trigger and the second end of the third link 13, respectively, and correspondingly, the transmission belt 14 may be provided as a toothed belt structure in meshing connection with the two gear bodies.

In order to enable the cartridge 4 to move back automatically in figure 11 after the user releases the trigger, the present embodiment is further provided with a return torsion spring, not shown, connected between the first end of the trigger and the first housing 6. The return torsion spring applies a clockwise spring force to the first end of the trigger in fig. 3. Obviously, the aforementioned return torsion spring may be disposed at other positions, for example, between the second end of the second link 12 and the first housing 6, or between the second end of the third link 13 and the first housing 6.

Furthermore, a locking element can be arranged on the first transmission assembly, so that the movable clamp seat 4 and the fixed clamp seat 3 can be locked in a clamping state, and the gripping force of a user on the trigger is released. When the movable clamping seat 4 needs to return, the locking element is unlocked. The locking element may take various configurations known to those skilled in the art and will not be described in detail herein.

Referring to fig. 4, 6, 10, 12 and 14 again, the movable clamping seat 4 is provided with a plurality of nail holes 4a and a cutter hole 4b. Among them, the staple discharging holes 4a are used to receive the staples 1 and guide the staples 1 to move along the third direction d3, and the knife discharging holes 4b are used to receive the staples 1 and guide the knife 2 to move along the fourth direction d4. It can be seen that the movable clamp holder 4 has substantially the same structure and function as a cartridge in a conventional stapler, and is used for clamping hemorrhoidal tissues and guiding the stapling direction and the cutting direction of the staples 1 and the cutting knife 2, so that the movable clamp holder 4 can also be called a cartridge. The fixed clamping seat 3 is similar to a nail abutting seat in the traditional anastomat.

Those skilled in the art will appreciate that the nail hole 4a and the cutter hole 4b may have various configurations to achieve the above-described functions. For example, the nail hole 4a is a hole penetrating through the movable holder 4 in the third direction d3, and the cutter hole 4b is a hole penetrating through the movable holder 4 in the fourth direction d 4; for another example, only a part of the hole segments of the nail outlet hole 4a is arranged to extend in the third direction d3, and only a part of the hole segments of the cutter outlet hole 4b is arranged to extend in the fourth direction d4.

The hemorrhoidal tissue 100 is clamped and folded in the second direction d2, so that the dimensions of the hemorrhoidal tissue 100 in the clamped state in the second direction d2 are smaller. If the staples 1 staple the hemorrhoidal tissue in the clamping direction of the hemorrhoidal tissue 100, the stapling force exerted on the hemorrhoidal tissue during the stapling operation is small, which is not only easy to implement, but also the secondary deformation of the clamped hemorrhoidal tissue and the pain of the patient during the stapling process are small. Thus, the present embodiment sets the stapling direction of the staples 1, i.e., the third direction d3, substantially parallel to the second direction d2, i.e., the stapling direction of the staples 1 substantially coincides with the clamping movement direction of the clamping assembly.

In addition, in order to simplify the structural design of the stapler and improve the structural compactness of the stapler, the cutting movement direction of the cutter 2, i.e. the fourth direction d4, is also set to be substantially parallel to the second direction d2 in the present embodiment. It can be seen that the second direction d2, the third direction d3 and the fourth direction d4 are substantially the same direction and are all substantially perpendicular to the first direction d1, which is the protruding direction of the stapler head.

In order to facilitate the surgical personnel to push out the staple outlet hole 4a and the knife outlet hole 4b of the staple 1 and the cutter 2 from the driven holder 4, the present embodiment is further provided with a staple knife push plate 7, a staple knife actuating member 8, and a second transmission assembly connecting the staple knife actuating member 8 and the staple knife push plate 7. Wherein:

referring to fig. 4 and 6 in combination with fig. 3 and 5, the staple knife pushing plate 7 is disposed on a side of the movable holder 4 facing away from the fixed holder 3 in the second direction d2, and the staple knife pushing plate 7 and the fixed holder 3 are respectively disposed on two opposite sides of the movable holder 4 in the second direction d2. A manually operated staple knife actuator 8 is operatively connected to the staple knife push plate 7 by a second transmission assembly. In use, the staple knife actuating member 8 is manually actuated, and the staple knife actuating member 8 drives the staple knife pushing plate 7 to move towards the movable clamping seat 4 through the second transmission assembly, so that the staples 1 and the cutting knife 2 are respectively pushed out from the staple outlet hole 4a and the knife outlet hole 4b. It can be seen that the movement of the staples 1 and the knife 2 is driven by the same set of components.

In order to ensure the smooth implementation of the cutting operation, the hemorrhoid tissue needs to be stapled first, and then the stapled hemorrhoid tissue needs to be cut off. The staple discharging operation of the staple 1 precedes the knife discharging operation of the knife 2. Thus, the present embodiment makes such a design for the staple-cutter push plate 7:

referring again to fig. 4, 6, 10 and 12, the staple pusher plate 7 includes a pusher portion 7b and a staple pushing portion 7a, wherein the staple pushing portion 7a is formed to protrude from the pusher portion 7b toward the movable holder 4. The nail pushing part 7a operatively extends into the nail hole. As such, in the process of moving the staple pusher plate 7 toward the movable jaw 4, the staple pushing portion 7a contacts and pushes the staple 1 first, and then the knife pushing portion 7b contacts and pushes the cutter 2. The plurality of staple pushing portions 7a are provided to push the plurality of staples 1, respectively.

Preferably, the nail pushing part 7a always extends into the nail outlet hole 4a both when the nail is pushed and when the nail is not pushed, so as to reduce the possibility that the nail pushing part 7a cannot smoothly enter the nail outlet hole to push the nail due to the nail pushing operation, as shown in fig. 4 and 10.

In this embodiment, the knife actuator 8 is a push button that is movable in a first direction d1. The second transmission assembly mainly comprises a push block 10 and a push rod 15. Wherein: the push block 10 is disposed on a side of the staple-cutter push plate 7 facing away from the movable holder 4 in the second direction d2, that is, the push block 10 and the movable holder 4 are respectively disposed on two opposite sides of the staple-cutter push plate 7 in the second direction d2. As mentioned above, the third direction d3 and the fourth direction 4 are substantially parallel to the second direction d2, so that the push block 10 and the movable holder 4 are also disposed on two opposite sides of the staple pushing plate 7 in the third direction d3 and the fourth direction d4, respectively. Moreover, the push block 10 is formed with a diagonal groove 10a arranged to intersect the first direction d1, that is, the extending direction of the diagonal groove 10a intersects the first direction d1.

The push rod 15 extends in the first direction d1, has a rear end fixedly connected to a push button as the staple knife actuator 8, and has a front end pivotally connected to a roller 19 movably inserted into the inclined groove 10 a. When the push button is moved forward in the first direction d1, the roller 19 rolls along the inclined groove 10a and presses the push block 10 toward the staple pusher plate 7. The roller 19 and the chute 10a are in rolling fit instead of sliding fit, so that the friction force is small, and the push block 10 moves more smoothly.

As shown in fig. 4 and 6, in order to reduce the possibility that the roller 19 is stuck in the chute 10a to be difficult to move during use, the present embodiment further has a roller 20 having a diameter larger than that of the roller coaxially attached to the roller 19. Correspondingly, a bevel 10b is provided on the pusher 10, which cooperates in contact with the aforesaid roller 20 and is arranged parallel to the chute 10 a. When the push rod 15 is moved leftward in fig. 4, the roller 20 has come into contact with and pressed against the inclined surface 10b downward while the roller 19 has not yet or slightly come into contact with the lower wall of the chute 10a downward, thereby pushing the push block 10 downward mainly by the roller 20. That is, the downward movement of the pushing block 10 in fig. 4 is mainly achieved by the pressing force of the roller 20 to the inclined surface 10b, not the pressing force of the roller 19 to the inclined groove 10 a. In this case, the mutually cooperating chute 10a and roller 19 are mainly used to define the connection between the push rod 15 and the push block 10, preventing the push block 10 from being detached from the push rod 15, while the roller 19 only plays the role of movably connecting the push rod and the push block, which can be replaced by a "connecting shaft" without "rolling" function. In other embodiments, the inclined surface 10b may be provided only on the push block 10 without the inclined groove 10a, and correspondingly, the roller 20 engaged with the inclined surface 10b is provided at the front end of the push rod 15.

Two rollers 19 and two chutes 10a are provided. The second housing 9 is further provided with a guiding structure for limiting the push block 10 to move only along the second, third or fourth direction, for example, in fig. 8, the second housing 9 is integrally formed with a guiding groove 9c in contact fit with the push block 10, and the groove depth of the guiding groove 9c extends in the second direction.

The stapler is further provided with a second housing 9 connected to the first housing 6. The push rod 15 is movably connected with the second housing 9 in a manner that the push rod can move along the first direction d1, so that the moving direction of the push rod 15 is better defined. Specifically, the method comprises the following steps: the push rod 15 is formed with a long bar-shaped push rod guide hole 10a extending in the first direction d1, and the second housing 9 is connected with a slide pin 16 movably inserted in the push rod guide hole 15a.

Further, the sliding pins 16 are configured with two in total to better define the matching angle of the push rod 15 and the second housing 9.

To prevent the push button as the staple knife actuator 8 from moving to the left in fig. 2, which is not subjective, resulting in accidental staple ejection and accidental knife ejection, the present embodiment is provided with the following safety structure:

the second housing 9 is formed with an insertion hole 9a extending in a direction perpendicular to the first direction d1. A safety pin 17 is removably inserted into the insertion hole 9a and the push rod guide hole 15a of the push rod 15. When in the aforementioned assembled state, the safety catch 17 defines the limit position of the forward movement of the pusher 15, so as to prevent the staples 1 or the cutting knife 2 from being pushed out without the need for both staple and knife ejection. When it is desired to staple and cut the hemorrhoidal tissue, the safety catch 17 is withdrawn.

If the staple knife push plate 7 is completely independently disposed at the side of the movable cartridge 4, the staple knife push plate 7 is easily dropped and lost from the movable cartridge 4 after the second part 2000 of the stapler is separated from the first part 1000. Therefore, the nail knife push plate 7 is movably connected with the movable clamping seat 4 in the embodiment.

It can be understood that, when the clamping assembly is in the unclamped state, the larger the distance between the movable clamp holder 4 and the fixed clamp holder 3 in the second direction d2 is, the more the hemorrhoid tissue 100 with the larger width can be clamped, thereby increasing the operation range of the anorectal stapler. However, the radial dimension of the anorectum is limited, so that the distance between the movable clamp holder 4 and the fixed clamp holder 3 cannot be increased without any limit. As mentioned above, the push block 10 is disposed on the side of the nail cutter push plate 7 facing away from the movable clamping seat 4 in the second direction d2, so that the push block 10 occupies the space of the clamping component in the second direction d2, which is not favorable for increasing the distance between the movable clamping seat 4 and the fixed clamping seat 3. Therefore, the present embodiment provides the second housing 9 and the first housing 6 as two independent elements, which are detachably engaged to eliminate the occupation of the relevant space by the pushing block 10, and the following descriptions are specifically provided:

in operation, the second housing 9 with the push block 10 is detached from the first housing 6, and the operator holds only the "remaining part" of the stapler as shown in fig. 4 and inserts the distal end portion (left end portion in fig. 4) of the remaining part into the affected part of the anorectal of the patient. For the sake of convenience of description, the aforementioned "remaining part" will be referred to as the first part 1000 of the stapler, and the second housing 9 with the push block 10 will be referred to as the second part 2000 of the stapler. Before the above steps, a sheath for opening the anorectal section to be operated on can be placed in the anorectal section in advance, and the sheath is provided with a notch for allowing the hemorrhoid tissue to be cut to extend into the sheath from the notch, so that the clamping, stapling and cutting of the hemorrhoid tissue can be facilitated while the operation safety is improved. At this time, since the pushing block 10 occupying the space in the second direction d2 (i.e., the space in the radial direction of the anorectal region) does not exist in the distal end portion of the first portion, the distance between the movable holder 4 and the fixed holder 3 can be set to be large, and the hemorrhoidal tissue 100 having a larger width can be clamped and fixed. Then, the hemorrhoid tissue 100 to be cut is aligned with the distance between the movable clamp seat 4 and the fixed clamp seat 3, and the trigger is pulled to make the movable clamp seat 4 and the fixed clamp seat 3 clamp the hemorrhoid tissue 100 in the second direction d2, namely the width direction of the hemorrhoid tissue. At this time, the movable holder 4 and the fixed holder 3 have been moved close to each other by a certain distance, so that the front end of the first part is reduced in size in the second direction d2, thereby leaving a sufficient fitting space for the second part. That is, the dimension of the clamping assembly in the second direction d2 in the clamped state at this time < the dimension of the clamping assembly in the second direction d2 in the non-clamped state previously. Thereafter, the second housing 9 is engaged with the first housing 6, and the second portion of the stapler is loaded such that the push block 10 is positioned at a side of the staple knife push plate 7 facing away from the movable jaw 4 in the second direction d2, ready for pushing the staple knife push plate 7.

It can be seen that the second portion of the stapler is loaded after the forward end of the first portion has been extended into the patient's anorectum. In order to ensure that the push block 10 and other elements at the front end part of the second part can smoothly extend into the anorectal cavity in the process of assembling the second part into the first part, so as to ensure the smooth implementation of the operation. The second housing 9 and the first housing 6 adopt the separable connection structure:

as shown in fig. 4 and 5 with reference to fig. 2 and 3, the first housing 6 is provided with a card slot 6b extending in the first direction d1, and the second housing 9 is provided with a card rib 9b extending in the first direction d1. When assembled, the clipping ribs 9b on the second housing 9 are pushed forward in the first direction d1 into the clipping grooves 6b on the first housing 6, thereby achieving the engagement of the second housing 9 with the first housing 6. When the card edge 9b is separated, a force is applied to withdraw the card edge from the card slot 6b in the first direction d1.

If the push rod 15 and the push button as the staple knife actuator 8 are both attached to the second housing 9, they will be removed and inserted together with the second housing 9 during use, resulting in a larger number of parts and a larger size of the second part. This does not facilitate the use of the anorectal stapler and presents certain design difficulties. Therefore, the present embodiment will further optimize the structure of the anorectal stapler as follows:

the first housing 6 is formed with an elongated push button guide hole 6c extending in the first direction d1, and a push button as the driver 8 is slidably connected to the push button guide hole 6c. The push rod 15 is composed of a front rod 1501 and a rear rod 1502 which are detachably connected, and the front rod 1501 and the rear rod 1502 are arranged in the first direction d1 and both extend along the first direction d1. The push rod guide hole 15a is specifically provided in the front rod 1501. In this way, the front rod 1501 is connected to the second casing 9 via the push rod guide hole 15a and the slide pin 16. The rear rod 1502 is secured to a push button as the staple knife actuator 8, thereby connecting the rear rod 1502 to the first housing 6.

It can be seen that the push button as the staple knife actuator 8 and the rear rod 1502 of the push rod 15 belong to the above-mentioned first part of the stapler. The front body 1501 of the push rod 15 belongs to the above-mentioned second part of the stapler. When the second housing 9 is detached from the first housing 6, the front rod 1501 and the push block 10 are detached together with the second housing 9, and the rear rod 1502 and the push button remain on the first housing 6.

In order to protect the rear rod 1502 of the push rod 15 after the second portion is detached, the rear rod can be completely accommodated in the first housing 6. In this embodiment, the push button guiding hole 6c is lengthened backward, so that the rear rod 1502 can be completely locked inside the first housing 6 after the push button is moved backward to the extreme position.

To better accommodate the hemorrhoid cutting procedure, the depth of insertion of the stapler head into the body (including the depth of insertion of the first portion nose and the depth of insertion of the second portion nose) is generally not less than 35mm. Therefore, the length of the push button guide hole 6c in the first direction d1 should not be less than 35mm, preferably 50 to 100mm. It is intended to ensure: when the push button is moved to the right in fig. 2 to the limit position and the front rod 1501 of the second portion is connected to the rear rod 1502 of the first portion, the distance between the front end of the second portion and the front end of the first portion in the first direction d1 is not less than the depth of the first portion inserted into the body.

The anorectal stapler can be integrally drawn out of a human body when the anorectal stapler is assembled at the first part and the second part. However, as can be seen from the above description, in this embodiment the second housing 9 can be removed from the first housing 6 in such a way that it is pushed backwards in the first direction d1 (to the right in fig. 3), so that the first and second parts of the anorectal stapler can be withdrawn from the patient one after the other, which expands the usage of the anorectal stapler.

In this embodiment, the push rod 15 and the extension rod 18 are both of a slender plate-like structure, and the cross sections of the push rod and the extension rod are rectangular.

As shown in fig. 16, in the present embodiment, the front rod 1501 and the rear rod 1502 are detachably connected in this way: the rear end of the front rod 1501 is formed with a tab 1501a, the front end of the rear rod 1502 is formed with a catch hole 1502a adapted to the tab 1501a, and the tab 1501a is detachably connected to the catch hole 1502 a.

The hemorrhoidal tissue 100 within the anorectal tract is generally curved in shape, and some hemorrhoidal tissues 100 have an excessively long length. For such a hemorrhoid tissue 100 with a large length and/or a curved shape, it is not possible to perform a single resection, and it is necessary to perform a multiple resection. When the hemorrhoid tissue 100 is removed in a segmented manner, if the cutter 2 with a straight structure is adopted, the pain of the patient is increased, and the operation difficulty is increased. This is mainly due to the difficulty of a straight cutter cutting each surgical section completely, and the large connecting area between the anterior segment tissue and the tissue body that is not completely cut, which can seriously interfere with the cutting of the next surgical section, as shown in fig. 18 and 19. Therefore, the structure of the cutter 2 is optimally designed in the embodiment as follows:

as shown in fig. 17 with reference to fig. 14 and 16, the cutter 2 is viewed in the aforementioned second direction d2, and is approximately L-shaped. Specifically, the cutter 2 includes: a first blade segment 2a extending substantially along the first direction d1, and a second blade segment 2b bent and protruding from a front end of the first blade segment. The term "bent" as used herein in "bent out" may be interpreted as "angled".

As shown in fig. 20 and 21, the cutter 2 having a specific angle section of the L-shaped structure has a cutting edge in the thickness direction of the hemorrhoidal tissue 100, i.e., the second cutter section 2b, so that it is possible to completely cut each surgical section of the hemorrhoidal tissue 100, not only to relieve the pain of the patient, but also to facilitate the performance of the surgery. If the thickness of the hemorrhoidal tissue 100 is large, although the L-shaped cutter 2 cannot completely cut off a small section of tissue, the connection area between the tissue which is not separated after cutting and the tissue body is small, so that the previous section of tissue can be easily pulled away, and the next section of tissue can be conveniently cut, as shown in fig. 22 and 23.

In order to cut the hemorrhoid tissue 100 as much as possible with the second blade section 2b having a limited length, the second blade section 2b is extended in a direction (i.e., the direction in which the first blade section is bent to "extend" from the front end) substantially perpendicular to the first direction d1 and the fourth direction d4.

The present embodiment provides the cutting blade 2 as a sheet-like structure substantially parallel to the fourth direction d2, so as to better guide the cutting blade 2 to move along the fourth direction d4 when in use.

In order to facilitate the processing and manufacturing of the cutting knife 2, and more importantly, in order to reduce the risk of false cutting in the surgical process, the first cutting section 2a and the second cutting section 2b are in arc transition connection in the embodiment.

It will be understood that, in the case of a sufficiently large radial space of the anorectum in which the hemorrhoidal tissue is to be cut, the greater the dimension of the second segment 2b of the cutting blade 2 in the direction of extension, the easier it is for a single cutting action to completely cut off the hemorrhoidal tissue. However, the radial space of the anorectal canal is limited and the dimension of the second blade section 2b in the protruding direction is therefore limited. The space of the anorectal in the length direction is larger than the radial space, so that the first section 2a of the cutter 2 can be arranged to be relatively long, and the hemorrhoid tissues which are as long as possible can be cut off in a single time on the premise of ensuring the operation quality. Therefore, the present embodiment sets the dimension of the second segment 2b in the projecting direction thereof to be smaller than the dimension of the first segment 2a in the first direction d1.

It will be appreciated that the anorectal stapler is capable of treating a large width of hemorrhoid tissue 100 as long as the first and second parts of the anorectal stapler are relatively movable in the first direction d1 and have a sufficiently large movement stroke, and there is no requirement that the first and second parts must be separable from each other.

In the present embodiment, the "length", "width" and "thickness" of the hemorrhoidal tissue 100 can be respectively interpreted as "the dimension of the hemorrhoidal tissue in the length direction of the anal intestine", "the dimension of the hemorrhoidal tissue in the circumferential direction of the anal intestine" and "the dimension of the hemorrhoidal tissue in the radial direction of the anal intestine".

It should be noted that the direction of cutting of the hemorrhoidal tissue 100 by the cutting blade 2 is the third direction d3 which is substantially perpendicular to the first direction d1, but it is not necessarily premised on the clamping assembly being in the second direction d2 which is substantially perpendicular to the first direction d1. If the tissue to be excised, which is already ready (e.g. clamped and stapled), has a certain size in the first direction d1, it is possible to achieve an advantageous effect close to the one described above when it is excised with the above-described L-shaped cutter 2.

It should be noted that, as can be understood by those skilled in the art, for the anorectal region with a very limited space for the surgical operation, the pushing block 10 for pushing the nail-knife pushing plate, which occupies a space, is configured to be a rear-loading structure, so that after the stapler body clamps and fixes the tissue to be resected so as to vacate a corresponding space, the vacated space is utilized to load the pushing block 10 to push the nail-knife pushing plate, and the anorectal region stapler with the other structure may also be applied. The application of this solution does not presuppose that the second direction d2 and the first direction d1 are substantially perpendicular. The aforementioned solution can be applied as long as the clamping direction crosses the extension direction of the stapler head, in order to treat haemorrhoidal tissue having a larger dimension in the clamping direction.

Claims (10)

1. A nail pushing and knife pushing mechanism of an anorectal anastomat, which comprises a nail bin, wherein the nail bin is provided with

A staple exit hole for receiving and guiding movement of staples in a third direction, an

The cutter outlet hole is used for accommodating and guiding the cutter to move in the fourth direction;

it is characterized in that the push pin and push broach mechanism further comprises:

a staple knife push plate disposed at one side of the staple cartridge in the third direction, the staple knife push plate comprising: the cutter pushing part extends from the cutter pushing part towards the nail bin and movably extends into the nail outlet hole;

a push button operatively movable in a first direction and operatively coupled to the knife pusher plate via a transmission assembly to drive the knife pusher plate toward the cartridge to eject the staples and the cutting knife from the staple exit hole and the knife exit hole, respectively, wherein the first direction intersects the third direction.

2. The push pin and push knife mechanism of claim 1 wherein the first direction is substantially perpendicular to the third direction.

3. The push pin and push knife mechanism of claim 1 wherein said drive assembly comprises:

the pushing block is arranged on one side, away from the movable clamping seat, of the nailing knife pushing plate in the third direction, and is provided with a chute which is crossed with the first direction;

the push rod extends in the first direction, the rear end of the push rod is connected with the push button, and the front end of the push rod is pivotally connected with a rolling shaft movably penetrating through the chute.

4. The push pin and push broach mechanism according to claim 3, characterized in that the roller has a larger diameter than the roller of the roller in coaxial connection, and the push block is formed with an inclined surface which is in contact fit with the roller and is arranged in parallel with the inclined groove.

5. The push pin and push broach mechanism according to claim 3, in which there are two of the angled slots and the rollers, respectively.

6. The push pin and push knife mechanism of claim 1 wherein said drive assembly comprises:

the pushing block is arranged on one side, away from the movable clamping seat, of the nail cutter pushing plate in the third direction, and an inclined plane which is crossed with the first direction is formed on the pushing block;

and the push rod extends in the first direction, the rear end of the push rod is connected with the push button, and the front end of the push rod is pivotally connected with a roller which is in contact fit with the inclined surface.

7. The push pin and push knife mechanism according to any one of claims 1 to 6 wherein the third direction is substantially parallel to the fourth direction.

8. The staple pushing and pusher mechanism of claim 1 wherein said staple exit aperture is a through-hole through said staple cartridge in said third direction.

9. The staple pushing and knife mechanism of claim 1 wherein said knife exit aperture is a through hole through said staple cartridge in said fourth direction.

10. An anorectal stapler comprising a push pin and push knife mechanism according to any one of claims 1 to 9.

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