CN220175171U - Surgical instrument - Google Patents

Abstract

There is provided a surgical instrument comprising: a bracket configured to be fixed with one of the staple cartridge or the anvil to shorten a distance between the staple cartridge and the anvil of the tool assembly by moving in a proximal direction, and provided with a first coupling portion and a second coupling portion; and an adjustment mechanism including a first adjustment member and a second adjustment member. The first adjuster is configured to drive the stent in a proximal direction from the first position to the second position in a helical drive of a gear ratio n. The second adjustment member is configured to drive the stent further proximally from the second position in a helical drive of a gear ratio m. Here, the gear ratio n is greater than the gear ratio m. According to this configuration, the surgeon can quickly and conveniently switch the tool assembly from the open state to the closed state and can precisely and continuously adjust the spacing between the staple cartridge and anvil of the tool assembly to be better suited for different thickness tissues.

Description

Surgical instrument

Technical Field

The present disclosure relates to the field of medical devices, and in particular, to a surgical device for stapling (and cutting) tissue during surgery.

Background

In some surgical procedures, it is necessary to use a surgical instrument to apply staples in a staple cartridge of a tool assembly to tissue and cause the staples to be formed under the guidance of an anvil of the tool assembly to staple the tissue of a patient. In operation, after tissue is placed between the staple cartridge and the anvil, the tool assembly can be switched from the open state to the closed state to shorten the distance between the staple cartridge and the anvil. The tool assembly may then be fired to staple the tissue. The spacing of the staple cartridge from the anvil should be suitable to place tissue therebetween when the tool assembly is in the open state. The spacing of the staple cartridge from the anvil should be suitable for good formation of staples and good stapling of tissue when the tool assembly is in the closed condition, and should ensure that the tissue is not damaged by excessive extrusion of the staple cartridge from the anvil.

Conventional surgical instruments are typically only capable of switching the tool assembly directly from an open condition to a closed condition in which the cartridge and anvil have a particular spacing, which results in the particular spacing of the cartridge from the anvil being difficult to accommodate for different thicknesses of tissue when the tool assembly is in the closed condition. If the specific spacing is too large or too small relative to the thickness of the tissue to be treated, it may lead to a number of undesirable consequences, such as poor formation of staples, poor stapling of tissue, or tissue damage due to excessive compression of the tissue by the staple cartridge and anvil.

Disclosure of Invention

In view of the above, the present disclosure provides a surgical instrument for stapling (and cutting) tissue during surgery that is preferably adaptable to different thicknesses of tissue and that is capable of relatively quickly and easily switching a tool assembly from an open state to a closed state.

The present disclosure provides surgical instruments for applying staples in a staple cartridge of a tool assembly to tissue and causing the staples to be formed under the guidance of an anvil of the tool assembly. The surgical instrument includes: a bracket configured to be fixed with one of the staple cartridge or the anvil to shorten a distance between the staple cartridge and the anvil by moving in a proximal direction, and provided with a first coupling portion and a second coupling portion; and an adjustment mechanism including a first adjustment member and a second adjustment member. The first adjuster is configured to drive the stent in a proximal direction from the first position to the second position in a helical drive of a gear ratio n. The second adjustment member is configured to drive the stent further proximally from the second position in a helical drive of a gear ratio m. Here, the gear ratio n is greater than the gear ratio m.

Because the transmission power ratio n is larger than the transmission power ratio m, the first adjusting piece is rotated to drive the bracket to move a distance L ₁ Is greater than the distance L for the driving bracket to move by rotating the second adjusting piece for one circle ₂ . In this way, after placing tissue between the staple cartridge and the anvil, the surgeon can quickly shorten the spacing between the staple cartridge and the anvil by rotating the first adjustment member, i.e., quickly switch the tool assembly from the open state to the pre-closed state; the surgeon may then fine tune the spacing of the staple cartridge from the anvil by rotating the second adjustment member to continuously and finely shorten the spacing of the staple cartridge from the anvil to a thickness that is compatible with the tissue to be treated, i.e., to switch the tool assembly from the pre-closed state to the closed state. According to this configuration, the surgeon can quickly and conveniently switch the tool assembly from the open to the closed state and can precisely and continuously adjust the spacing between the staple cartridge and anvil to be better suited for different thickness tissues.

In one possible implementation, the inner circumference of the first adjusting member is provided with a spiral groove, the first coupling portion is configured as a guide post adapted to extend into the spiral groove, the inner circumference of the second adjusting member is provided with an internal thread, and the outer circumference of the second coupling portion is provided with an external thread adapted to be screwed into the internal thread.

Considering that the cooperation of the first adjusting member and the first coupling portion needs to have a large transmission ratio, if the first adjusting member and the first coupling portion adopt a structure having an internal thread and an external thread, respectively, the internal thread and the external thread need to have a large lead angle. The larger the helix angle, the sharper the profile shape of the thread. Too sharp a profile shape weakens the thread and increases the manufacturing difficulty. In the present implementation, the first adjuster and the first coupler adopt a configuration having a spiral groove and a guide post, respectively, and do not adopt a configuration having an internal thread and an external thread. The adoption of the structure with the spiral groove and the guide post is beneficial to improving the strength and reducing the manufacturing difficulty, thereby being beneficial to prolonging the service life of the surgical instrument and reducing the production cost of the surgical instrument.

In one possible implementation, the second adjustment member and the second engagement portion are configured to disengage during movement of the bracket from the first position to the second position; the first adjustment member and the first engagement portion are configured to disengage after the bracket reaches the second position.

According to this configuration, the second adjustment member and the second engagement portion will not interfere with movement of the stent from the first position to the second position, and the first adjustment member and the first engagement portion will not interfere with further proximal movement of the stent from the second position.

In one possible implementation, the first joint is spaced apart from and distal to the second joint, the first adjustment member is spaced apart from and distal to the second adjustment member, and a transition space is provided between the first adjustment member and the second adjustment member, the transition space being configured to allow the first joint to move therein in the distal-proximal direction.

By this implementation, the second adjustment member and the second coupling portion will not be coupled during movement of the bracket from the first position to the second position; after the stent reaches the second position, the first adjustment member and the first engagement portion will disengage and the first engagement portion into the transition space will not interfere with further proximal movement of the stent.

In one possible implementation, the adjustment mechanism further includes an operating member configured to be operated to rotate the first adjustment member and the second adjustment member together.

According to this configuration, the doctor can switch the tool assembly from the open state to the closed state by simply continuously rotating the operating member without separately driving the first and second adjustment members. It follows that this implementation has the advantage of being convenient to operate.

In one possible implementation, the surgical instrument further comprises a housing defining an axial bore; the adjustment mechanism further includes a connecting member including a pair of shoulders spaced apart and a journal portion therebetween; the journal portion passes through the shaft hole such that the pair of shoulders are located inside and outside the housing, respectively; the operating member is coupled to the connecting member for rotation therewith, and the first adjusting member is coupled to or integrally formed with the connecting member for rotation therewith.

By the coupling member having such a configuration, the operating member and the first regulating member are rotatably supported to the housing and are rotatable together. In particular, in an implementation in which the connecting member and the first adjustment member are integrally formed, the connecting member and the first adjustment member are integrated into one piece, which is advantageous in reducing the number of pieces of the surgical instrument, and thus in reducing the overall size, the overall weight, and the manufacturing cost of the surgical instrument, and in improving the reliability of the surgical instrument.

In one possible implementation, the operating element is provided with a receiving space; the second adjusting piece is configured to be accommodated in the accommodating space in a manner of being slidable in the far-near direction and rotating together with the operating piece; the adjustment mechanism further includes a biasing member configured to bias the second adjustment member in a distal direction.

According to this configuration, the rotation operation member can drive the second regulation member to rotate together therewith. Meanwhile, according to this configuration, when the bracket reaches the second position, the second regulating member will be pressed against the end portion of the second engaging portion by the urging force from the urging member, so that by rotating the operating member, the second regulating member can be caused to engage with the second engaging portion without other additional operations. Thus, this implementation has the advantage of being convenient to operate.

In one possible implementation, the adjustment mechanism further includes an indicator including a main body portion and a flange portion provided at an outer periphery of the main body portion; the operating member is further provided with an exposing hole extending from the accommodating space to the proximal end face of the operating member; the part of the main body part located on the far side of the flange part is suitable for extending into the inner peripheral side of the second adjusting piece, and the part of the main body part located on the near side of the flange part is suitable for extending out of the exposing hole; the urging member is configured as a first compression spring which is sleeved on a proximal portion of the main body portion at the flange portion, and both ends of the first compression spring abut against the flange portion and the inner surface of the operating member, respectively.

According to this configuration, the indicator can assist the surgeon in relatively accurately judging the status of the tool assembly and the spacing of the staple cartridge from the anvil during surgery.

In one possible implementation, the surgical instrument further comprises: a housing; a trigger for operation by a doctor; the switching piece is sleeved on the bracket and is configured to move from a third position to a fourth position in the proximal direction along with the movement of the bracket in the proximal direction; the second pressure spring is sleeved on the bracket and is positioned at the far side of the switching piece, wherein the bracket is provided with a shoulder which is positioned at the near side of the switching piece and is suitable for propping against the switching piece; the abutting piece is fixed with or integrally formed with the shell and abuts against the distal end of the second pressure spring; and a firing mechanism including a pusher member and an action member, the action member passing through the support aperture, the pusher member configured to push the action member in a distal direction to cause firing of the tool assembly. When the switching piece is positioned at the third position, the pushing piece is supported by the switching piece to form a avoiding gap for avoiding the trigger between the pushing piece and the bracket; when the switch is in the fourth position, the pusher is moved toward the bracket against or facing the switch such that the switch can be driven by the trigger to push the pusher in a distal direction.

This implementation can prevent accidental firing of the tool assembly in the open state due to mishandling, thereby improving the reliability and safety of the surgical procedure. In addition, since only the tool assembly needs to be switched from the open state to the closed state, the switching member will move from the third position to the fourth position in the proximal direction following the bracket, so that the surgical instrument is switched from an unfired state to a cocked state without additional operation. Thus, this implementation has the advantage of being convenient to operate.

In one possible implementation, the firing mechanism further includes an action member extending in a distal-proximal direction between the pusher member and the tool assembly; the acting piece is propped against the pushing piece, so that the pushing piece can push the acting piece in the distal direction to trigger the tool assembly; the abutment defines a support aperture through which the acting member passes.

The abutting piece not only effectively supports the acting piece to avoid the acting piece from generating unexpected displacement, but also plays a role of abutting the second pressure spring to match the switching piece. This implementation is advantageous in reducing the number of components of the surgical instrument, and thus in reducing the overall size, overall weight, and manufacturing costs of the surgical instrument, and in improving the reliability of the surgical instrument.

In one possible implementation, the stent includes a frame portion and an elongate portion, the elongate portion extending in a distal-proximal direction, the frame portion being located at a distal end of the elongate portion, the frame portion being configured to be secured to one of the staple cartridge and the anvil, the first and second coupling portions being located at a proximal end of the elongate portion.

In one possible implementation, the ratio n/m of the gear ratio n to the gear ratio m is greater than or equal to 3.

The larger the ratio n/m, the larger the ratio L1/L2. By setting the ratio n/m to be greater than or equal to 3, it can be ensured that the stent is driven by the first adjustment member to move relatively quickly in the proximal direction and the stent is driven by the second adjustment member to move relatively slowly in the proximal direction.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present disclosure, the drawings that are required to be used in the embodiments will be briefly described below.

It is to be understood that the following drawings are only illustrative of certain embodiments of the present disclosure and are not to be construed as limiting the scope.

It should also be understood that the same or similar reference numerals are used throughout the drawings to designate the same or similar elements.

It should also be understood that the drawings are merely schematic and that the dimensions and proportions of the elements in the drawings are not necessarily accurate.

Fig. 1 is a schematic structural view of a surgical instrument according to an embodiment of the present disclosure.

Fig. 2 is a schematic structural view showing an internal configuration of the surgical instrument in fig. 1.

Fig. 3 is another structural schematic diagram showing the internal configuration of the surgical instrument in fig. 1.

Fig. 4 is a schematic structural view of a holder of the surgical instrument of fig. 1.

Fig. 5A to 5D are schematic structural views showing the cooperative relationship of the stand and the adjustment mechanism of the surgical instrument of fig. 1 in switching the tool assembly from the open state to the closed state.

Fig. 6A to 6C are schematic structural views showing a process of switching a tool assembly mounted on the surgical instrument in fig. 1 from an open state to a closed state.

Fig. 7 is a schematic view showing the structure of the adjusting mechanism and the housing of the surgical instrument in fig. 1.

Fig. 8 is a schematic view showing the structure of the first adjuster and the connector of the adjusting mechanism in fig. 8.

Fig. 9A-9D are schematic structural views illustrating a firing process of the surgical instrument of fig. 1.

Fig. 10 is a schematic view showing the structure of a holder, a switching member, a firing mechanism, an abutment member, and the like of the surgical instrument in fig. 1.

Fig. 11 is a schematic view showing the construction of the surgical instrument of fig. 1 with the tool assembly removed.

Fig. 12 is an exploded view of the tool assembly of fig. 11.

Detailed Description

Embodiments of the present disclosure are exemplarily described below with reference to the accompanying drawings. It should be understood that the implementations of the present disclosure may be varied and should not be construed as limited to the embodiments set forth herein, which are presented only for a more thorough and clear understanding of the present disclosure.

Integral structure

Referring to fig. 1, the present disclosure provides a surgical instrument 10 configured to switch a tool assembly 20 disposed thereon from an open state to a closed state and to fire the tool assembly 20. Tool assembly 20 includes a staple cartridge 21 and an anvil 22. The cartridge 21 houses staples to be formed therein. In some examples, a knife for cutting tissue may also be stored within the cartridge 21. In some examples, tool assembly 20 may be provided at a distal end of surgical instrument 10.

When the tool assembly 20 is in the open position, the cartridge 21 is spaced relatively far from the anvil 22 to accommodate placement of tissue therebetween. When the tool assembly 20 is in the closed condition, the cartridge 21 is spaced from the anvil 22 at a small distance to accommodate good staple formation and good stapling of tissue, and to ensure that tissue is not damaged by excessive compression of the cartridge 21 and anvil 22.

In this disclosure, the term "proximal" may be used to generally indicate the end, side, or portion of an element (device, mechanism, member, or portion) that is closer to the physician; the term "distal" may be used to generally indicate the end, side or portion of the element that is farther from the physician. In the drawings of the present disclosure, arrow x+ may be used to indicate a distal direction of the distal-proximal direction, and arrow X "may be used to indicate a proximal direction of the distal-proximal direction.

Referring to fig. 1-3, surgical instrument 10 includes trigger frame 13 and adjustment mechanism 14. In some examples, the surgical device 10 may further include a housing 11, a trigger 12, a toggle 15, a firing mechanism 16, and the like.

Bracket and adjusting mechanism

Referring to fig. 1-3, the bracket 13 may be movably supported by the housing 11 in a distal-proximal direction with respect to the housing 11 and configured to be fixed with the anvil 22, and the cartridge 21 may be configured to be fixed to the housing 11 and located proximal to the anvil 22 such that the spacing between the cartridge 21 and the anvil 22 can be shortened by moving the bracket 13 in the proximal direction, thereby enabling the tool assembly 20 to be switched from the open state to the closed state.

It will be appreciated that in other examples, the staple cartridge 21 may be secured to the support 13, the anvil 22 may be secured to the housing 11, and the staple cartridge 21 may be distal to the anvil 22 and facing the anvil 22. This way the aim is also achieved of shortening the distance between the cartridge 21 and the anvil 22 by moving the support 13 in the proximal direction.

Referring to fig. 4, the bracket 13 may be provided with a first coupling portion 131 and a second coupling portion 132. The first coupling portion 131 and/or the second coupling portion 132 may be a part of the bracket 13 (i.e., integrally formed with the bracket 13), or may be a member independent of the bracket 13 mounted on the bracket 13.

In one example, the bracket 13 may include a frame portion 133 and an elongated portion 134. The elongated portion 134 extends in a distal-proximal direction, the frame portion 133 is located at a distal end of the elongated portion 134, and the first joining portion 131 and the second joining portion 132 are located at a proximal end of the elongated portion 134. The frame portion 133 may be at least partially exposed outside the housing 11. One of the staple cartridge 21 and the anvil 22 is fixed to the frame portion 133, and the other is fixed to the distal end of the housing 11. For example, the frame portion 133 may be generally rectangular, and both the staple cartridge 21 and the anvil 22 may be located inside the frame portion 133.

Referring to fig. 5A to 5D, the adjustment mechanism 14 includes a first adjustment member 141 and a second adjustment member 142. The first adjuster 141 is configured to drive the bracket 13 in a proximal direction from a first position (as shown in fig. 5A) to a second position (as shown in fig. 5B) in a helical drive of a gear ratio n. The second adjuster 142 is configured to drive the bracket 13 further proximally from the second position (i.e., further proximally to the third position in fig. 5D) in a helical drive of a gear ratio m. Here, the gear ratio n is greater than the gear ratio m.

The first, second and third positions of the bracket 13 may correspond to the first, second and third states of the tool assembly 20, respectively. In FIG. 6A, the tool assembly 20 is in a first state, with the cartridge 21 spaced from the anvil 22 by a distance D ₁ . In FIG. 6B, the tool assembly 20 is in a second state, with the cartridge 21 spaced from the anvil 22 by a distance D ₂ . In FIG. 6C, the tool assembly 20 is in a third state, with the cartridge 21 spaced from the anvil 22 by a distance D ₃ . Here, D ₁ Greater than D ₂ And D is ₂ Greater than D ₃ 。

By rotating the first adjustment member 141, the bracket 13 can be driven to move proximally from the first position in fig. 5A to the second position in fig. 5B, thereby switching the tool assembly 20 from the first state to the second state. After the carriage 13 reaches the second position of fig. 5B, the carriage 13 can be driven from the second position of fig. 5B to the third position of fig. 5D in a proximal direction by rotating the second adjustment member 142, thereby switching the tool assembly 20 from the second state to the third state.

In the present disclosure, the first state of the tool assembly 20 may be referred to as an open state, the second state of the tool assembly 20 may be referred to as a pre-closed state, and the third state of the tool assembly 20 may be referred to as a closed state. It should be noted that the third state is not a specific state, but a state when the distance between the staple cartridge 21 and the anvil 22 is adapted to the thickness of the tissue to be treated. In other words, the third state of the tool assembly 20 is determined according to the thickness of the tissue to be treated.

It should be appreciated that when the tool assembly 20 is in the closed state, the spacing between the staple cartridge 21 and the anvil 22 is not equal to zero. The physician can determine the spacing that matches the thickness of the tissue to be treated based on clinical experience. The spacing should not be too large to ensure that tissue does not inadvertently escape from between the staple cartridge 21 and anvil 22, and should not be too small to ensure that tissue is not damaged by being excessively compressed by the staple cartridge 21 and anvil 22. Furthermore, the spacing should be set such that at this spacing, the staples are well formed and the tissue is well stapled. Furthermore, in the example where a knife is provided within the cartridge 21, the spacing should also ensure that the knife is able to effectively sever tissue.

Since the transmission power ratio n is greater than the transmission power ratio m, the distance L by which the bracket 13 is driven to move by rotating the first regulating member 141 one turn ₁ Is greater than the distance L by which the bracket 13 is driven to move by driving the second regulating member 142 to rotate one turn ₂ . After placing tissue between the staple cartridge 21 and the anvil 22, the surgeon can quickly shorten the distance between the staple cartridge 21 and the anvil 22 by rotating the first adjustment member 141, i.e., quickly switch the tool assembly 20 from the open state to the pre-closed state. The surgeon may then fine tune the spacing of the staple cartridge 21 from the anvil 22 by rotating the second adjustment member 142 to continuously and finely shorten the spacing of the staple cartridge 21 from the anvil 22 to match the thickness of the tissue to be treated, i.e., to switch the tool assembly 20 to the closed state. According to this configuration, the surgeon can quickly and conveniently switch the tool assembly 20 from the open to the closed state and can precisely and continuously adjust the spacing between the staple cartridge 21 and anvil 22 to be better suited for different thickness tissues.

In the present disclosure, the transmission ratio n may refer to a distance that the bracket 13 moves in the proximal direction for each rotation of the first adjuster 141; the transmission ratio m may refer to the distance the bracket 13 moves in the proximal direction for each rotation of the second adjuster 142. The values of the transmission ratio n and the transmission ratio m are not particularly limited in the present disclosure, as long as the distance between the staple cartridge 21 and the anvil 22 can be shortened relatively quickly by rotating the first adjusting member 141 and the distance between the staple cartridge 21 and the anvil 22 can be finely adjusted and shortened by rotating the second adjusting member 142.

Illustratively, the ratio n/m of the gear ratio n to the gear ratio m may be greater than or equal to 3. In particular, the ratio n/m of the transmission ratio n to the transmission ratio m may be greater than or equal to 5. The larger the ratio n/m, the larger the ratio L1/L2. By setting the ratio n/m to be greater than or equal to 3, it can be ensured that the stent is driven by the first adjustment member to move relatively quickly in the proximal direction and the stent is driven by the second adjustment member to move relatively slowly in the proximal direction. Of course, in other examples, the ratio n/m may be less than 3.

Referring to fig. 4 to 5D, the inner circumference of the first adjuster 141 may be provided with a spiral groove 1411, and the first coupling portion 131 may be a guide post 131 adapted to extend into the spiral groove 1411. The inner circumference of the second adjuster 142 may be provided with an internal thread, and the outer circumference of the second coupling portion 132 may be provided with an external thread adapted to be screwed with the internal thread. It should be noted that, in this implementation, the ratio n/m may be a ratio of a pitch of the spiral groove 1411 to a pitch of the internal thread of the second adjuster 142.

Considering that the cooperation of the first adjustment member 141 and the first coupling portion 131 needs to have a large transmission ratio, if the first adjustment member 141 and the first coupling portion 131 are constructed with internal and external threads, respectively, the internal and external threads need to have a large lead angle. The larger the helix angle, the sharper the profile shape of the thread. Too sharp a profile shape weakens the thread and increases the manufacturing difficulty.

In the current implementation, the first adjuster 141 and the first coupling part 131 adopt a configuration having the spiral groove 1411 and the guide post 131, respectively, and do not adopt a configuration having the internal thread and the external thread. The use of the configuration of the helical groove 1411 and the guide post 131 facilitates increased strength and reduced manufacturing difficulty, thereby facilitating increased service life of the surgical instrument 10 and reduced manufacturing costs of the surgical instrument 10.

It is understood that the implementation of the first adjusting member 141, the second adjusting member 142, the first combining portion 131 and the second combining portion 132 is not limited to the above. For example, in other examples, the first adjuster 141 may be configured to have an internal thread, and the first coupling portion 131 may be configured to have an external thread. As another example, in other examples, the first and second adjustment members 141 and 142 may have a configuration having external threads, and the first and second coupling parts 131 and 132 may have a configuration having internal threads.

With continued reference to fig. 5A and 5D, the second adjuster 142 and the second coupler 132 may be configured to be uncoupled during movement of the bracket 13 from the first position to the second position; the first adjuster 141 and the first coupling portion 131 may be configured to be separated from each other after the bracket 13 reaches the second position.

According to this configuration, the second adjustment member 142 and the second coupling portion 132 will not interfere with movement of the bracket 13 from the first position to the second position, and the first adjustment member 141 and the first coupling portion 131 will not interfere with movement of the bracket further in the proximal direction from the second position.

With continued reference to fig. 5A and 5D, the first bond 131 may be spaced apart from the second bond 132 and distal to the second bond 132. The first adjustment member 141 may be spaced apart from the second adjustment member 142 and distal to the second adjustment member 142. A transition space S1 may be provided between the first and second adjustment members 141 and 142, and the transition space S1 may be configured to allow the first coupling part 131 to move therein in the distal-proximal direction. In one example, the transition space S1 may be defined by the support 144. The contents of the support 144 will be discussed below.

By this implementation, the second adjuster 142 and the second joint 132 will not be joined during movement of the bracket 13 from the first position to the second position; after the bracket 13 reaches the second position, the first adjuster 141 and the first joint 131 will separate and the first joint 131 entering the transition space S1 will not affect the further proximal movement of the bracket 14.

With continued reference to fig. 5A-5D, the adjustment mechanism 14 may further include an operating member 143, and the operating member 143 may be configured to be operated to rotate the first adjustment member 141 and the second adjustment member 142 together.

According to this configuration, the doctor can switch the tool assembly 20 from the open state to the closed state by simply continuously rotating the operating member 143 without separately driving the first and second adjustment members 141 and 142. It follows that this implementation has the advantage of being convenient to operate.

Referring to fig. 5A-5D, 7 and 8, the housing 11 may define a shaft bore 113 and the adjustment mechanism 14 may further include a connector 144. The connector 144 may include a pair of shoulders 1441,1442 spaced apart and a journal portion 1443 therebetween. The journal portion 1443 may pass through the shaft hole 113 such that a pair of shoulders 1441,1442 are located inside and outside the housing 11, respectively. The operating member 143 can be coupled to the connecting member 114 such that when the operating member 143 rotates, the connecting member 114 rotates with the operating member. The first adjustment member 141 may be integrally formed with the connection member 144 such that when the operation member 143 rotates, the first adjustment member 141 rotates along with the connection member 144 and thus rotates along with the operation member 143. In other examples, the connector 144 may be a separate component from the first adjuster 141, which may be coupled together such that the first adjuster 141 rotates with the connector 144.

By the link 144 having such a configuration, the operating member 143 and the first regulating member 141 are rotatably supported to the housing 11 and are rotatable together. In particular, in an implementation where the connector 144 and the first adjustment member 141 are integrally formed, the connector 144 and the first adjustment member 141 are integrated into one piece, which facilitates reducing a number of pieces of the surgical instrument 10, thereby facilitating reducing an overall size, an overall weight, and a manufacturing cost of the surgical instrument 10, and facilitating improving reliability of the surgical instrument 10.

Referring to fig. 7, the housing 11 may be composed of a pair of half shells 11-1, 11-2. A pair of half shells 11-1,11-2 are detachably assembled together to form a substantially closed interior space. The pair of half shells 11-1,11-2 together define an axial bore 113. When the pair of half shells 11-1,11-2 are assembled together to form the housing 11, the journal portion 1443 is rotatably disposed in the shaft hole 113, and the pair of shoulders 1441,1442 are respectively located on the inner side and the outer side of the housing 11. Thus, the connection member 144 is rotatably supported by the housing 11.

Referring to fig. 8, the connector 144 may also include a pair of posts 1444. Correspondingly, the operating member 143 may be provided with a pair of insertion holes (not shown). A pair of posts 1444 may be respectively inserted into a pair of receptacles of the operating member 143 to couple the connecting member 144 and the operating member 143 together. Of course, in other examples, the connector 144 and the operating member 143 may be coupled together in other ways, so long as the two are secured for rotation together.

Referring again to fig. 5A to 5D, the operating member 143 may be provided with a receiving space 1431. The second adjustment member 142 may be configured to be accommodated in the accommodating space 1431 in a manner slidable in the distal-proximal direction with respect to the operation member 143 and rotatable together with the operation member 143. The adjustment mechanism 14 may further include a force application member 145, and the force application member 145 may be configured to apply a force to the second adjustment member 142 in a distal direction.

According to this configuration, the rotation operation piece 143 can drive the second regulation piece 142 to rotate together therewith. Meanwhile, according to this configuration, when the bracket 13 reaches the second position, the second regulating member 142 will be pressed against the end of the second coupling portion 132 by the urging force from the urging member 145, which makes it possible to cause the second regulating member 142 to be coupled with the second coupling portion 132 without additional operations by rotating the operating member 142. Thus, this implementation has the advantage of being convenient to operate.

Referring again to fig. 5A to 5D (and fig. 7), the operating member 143 may be further provided with an exposing hole 1432 extending from the accommodating space 1431 to the proximal end face of the operating member 143. The adjustment mechanism 14 may further include an indicator 146, the indicator 146 including a main body portion 1461 and a flange portion 1462 provided on an outer periphery thereof. The distal portion of the main body portion 1461 located at the flange portion 1462 is adapted to protrude into the second adjuster 142, and the proximal portion of the main body portion 1461 located at the flange portion 1462 is adapted to protrude out of the exposing hole 1432. The urging member 145 is configured as a first pressure spring 145, the first pressure spring 145 is fitted over a proximal portion of the main body portion 1461 located on the flange portion 1462, and a distal end of the first pressure spring 145 abuts against the flange portion 1462 and a proximal end of the first pressure spring 145 abuts against an inner surface of the operation member 143.

According to this configuration, the indicator 146 can assist the surgeon in relatively accurately judging the condition of the tool assembly 20 and the spacing of the staple cartridge 21 and anvil 22 during surgery. In the following, an example of how the status of the tool assembly 20 is determined based on the position of the indicator 146 is described in connection with the accompanying drawings.

Referring to fig. 5A, when the tool assembly 20 is in the first state, the second adjuster 142 is spaced from the second coupling portion 132, and the indicator 146 is in a contracted state (which is contracted entirely or mostly within the adjustment operator 143) under the urging force of the first compression spring 145. Accordingly, the physician may determine that the tool assembly 20 is currently in the first state.

Referring to fig. 5A and 5B, as the tool assembly 20 is switched from the first state to the second state, the second coupling portion 132 is pressed against the second adjuster 142, so that the first compression spring 145 is compressed, and the portion of the indicator 146 protruding out of the exposing hole 1432 becomes longer. Accordingly, the physician can determine that the tool assembly 20 has been switched to the second state.

Referring to fig. 5B and 5C, as the adjustment operating member 143 continues to be rotated, the second adjustment member 142 starts to be coupled with the second coupling portion 132, so that the second adjustment member 142 gradually moves in the distal direction, and thus the indicator 146 moves in the distal direction under the urging force of the first compression spring 145, and the exposed portion of the indicator 146 gradually decreases in size. During this process, the stent 13 is not moved in the proximal direction. Thus, during this process, the physician can relatively quickly rotate the adjustment operating member 143 to quickly complete the idle stroke of the adjustment mechanism 14.

Referring to fig. 5C and 5D, after the second regulating member 142 reaches the limit position in the distal direction, as the rotation of the regulating operation member 143 is continued, the second regulating member 142 is not moved in the distal direction any more, the indicator 146 is not moved in the distal direction any more, and the indicator 146 starts to be gradually moved in the proximal direction under the urging of the second engaging portion 132. During this process, the exposed portion of indicator 146 does not continue to decrease in size but begins to gradually increase. Accordingly, the surgeon can determine that the stent 13 has begun to move in the proximal direction and that the spacing of the staple cartridge 21 from the anvil 22 has begun to decrease. Based on such a judgment, the doctor can slow down the speed of the rotational adjustment operating member 143 to accurately adjust the spacing between the staple cartridge 21 and the anvil 22, and judge the spacing between the staple cartridge 21 and the anvil 22 based on the size of the exposed portion of the indicator 146.

Referring again to fig. 5A-5D, the adjustment mechanism 14 may further include a blocking member 147, and the blocking member 147 may be positioned between the connecting member 144 and the operating member 143. The blocking member 147 may be annular in shape with a bore Zhou Cexian therethrough. The passage hole is configured such that the bracket 13 can extend from the transition space S1 to the inner circumferential side of the second adjuster 142 therethrough to be coupled with the second adjuster 142, and is configured to prevent the second adjuster 142 from passing therethrough to prevent the second adjuster 142 from falling out of the accommodation space 1431.

Trigger, switching piece and firing mechanism

Referring to FIG. 2, the trigger 12 is configured for manipulation by a physician and is configured to be displaced between an initial position and a final position. The clinician is able to manipulate the trigger 12 from an initial position to a final position. In fig. 2, two positions of the trigger 12 are indicated by a combination of solid and broken lines. Specifically, the trigger 12 shown in solid lines is in the initial position and the trigger 12 shown in phantom lines is in the final position. In the present disclosure, the initial position and the final position of an element are not necessarily two extreme positions of the movable range of the element.

In some examples, the trigger 12 may be pivotally supported by the housing 11 for displacement between an initial position and its end position. In particular, referring to fig. 1, the housing 11 may define a handle 111, the handle 111 being configured for grasping by a physician. Referring to FIG. 2, when the trigger 12 is in the initial position, it is spaced a greater distance from the handle 111; when the trigger 12 is in the end position, it is spaced less from the handle 111.

In the present disclosure, the term "one element is supported by another element" may mean that the former is directly supported by the latter, or that the former is indirectly supported by the latter, that is, the former is supported by an intermediate element which is supported by the latter.

The firing mechanism 16 is configured to be driven by the trigger 12 to cause firing of the tool assembly 20. In particular, referring to fig. 3, 9A-9D, the firing mechanism 16 can include a pusher 161. The pusher 161 is located on one side of the frame 13 in the width direction and is movable in the distal-proximal direction and is configured to move in the distal direction to cause firing of the tool assembly 20. How the pusher member 161 causes the firing of the tool assembly 20 will be described in detail below.

In the present disclosure, the width direction may refer to a direction orthogonal to the far-near direction. In the drawings of the present disclosure, an arrow y+ may be used to indicate one side in the width direction, and an arrow Y-may be used to indicate the other side in the width direction.

The switch 15 is slidably sleeved on the bracket 13, and the switch 15 is configured to move in the proximal direction from the third position in fig. 9A to the fourth position in fig. 9C following the movement of the bracket 13 in the proximal direction. As one implementation, and in conjunction with fig. 4 and 10, the elongate portion 134 may be provided with a shoulder 1341. The switch 15 is sleeved on the elongated portion 134, and the switch 15 is located distally of the shoulder 1341 and abuts the shoulder 1341. The surgical device 10 may also include a second compression spring 171. The second compression spring 171 may be sleeved on the elongated portion 134 and located distally of the switching member 15, with its proximal end abutting the switching member 15. The surgical device 10 also includes an abutment 112. The abutting piece 115 may be fixed to the housing 11 or may be integrally formed with the housing 11. The proximal end of the second compression spring 171 is pressed against the switch 15 and the distal end is pressed against the abutment 112.

In this way, the second compression spring 171 will press the switch 15 against the shoulder 1341 of the elongate portion 134, such that during movement of the bracket 13 in the proximal direction, the switch 15 will follow the movement of the bracket 13 in the proximal direction from the third position to the fourth position. After the switch 15 reaches the fourth position, the clinician may operate the trigger 12 to apply a pushing force to the switch 15 that overcomes the force of the second compression spring 171, causing the switch 15 to move in a distal direction, thereby causing the firing of the tool assembly 20.

According to this configuration, it is achieved that the switch 15 moves proximally from the third position to the fourth position following the proximally-moving carriage 13 and that the switch 15 is allowed to move distally relative to the carriage 13 under the drive of the trigger 12 causing firing of the tool assembly 20.

Referring to fig. 9A and 9B, when the switching member 15 is in the third position, the switching member 15 supports the pushing member 161 such that a relief gap G1 of the relief trigger 12 is formed between the pushing member 161 and the bracket 13. In this case, as trigger 12 is operated from the initial position in FIG. 9A to the final position in FIG. 9B, (the portion of trigger 12 that is used to push other components) will move in the relief gap G1 without pushing the pusher member 161 in the distal direction, thereby not causing the firing of the tool assembly 20.

Referring to fig. 9A and 9C, as the bracket 13 moves in the proximal direction, the switching member 15 moves in the proximal direction from the third position in fig. 9A to the fourth position in fig. 9C. During this process, the pushing member 161 moves in the inward direction (i.e., toward the bracket 13). In this disclosure, the inner direction may refer to a direction toward the bracket 13 in the width direction, and the outer direction may refer to a direction away from the bracket 13 in the width direction. The inner side of a certain member may refer to the side of the element facing the bracket 13 in the width direction; the outer side of a certain member may refer to the side of the element facing away from the bracket 13 in the width direction.

As shown in fig. 9C, when the switching member 15 is in the fourth position, the pushing member 161 abuts or faces the switching member 15. In this case, referring to fig. 9C and 9D, as the trigger 12 is operated to move from the initial position in fig. 9C to the end position in fig. 9D, (the portion of the trigger 12 that is used to push other components) will push the switch 15 to move in the distal direction. In this process, the switch 15 is in abutment with the pusher member 161, and the switch 15 will push the pusher member 161 in a distal direction, thereby causing the firing of the tool assembly 20.

In this implementation, when the tool assembly 20 is in the open state, the switch member 15 is in the third position and supports the pusher member 161 such that a relief gap G1 of the relief trigger 12 is formed between the pusher member 161 and the bracket 13. In this case, even if the trigger 12 is erroneously operated, the trigger 12 moves in the escape gap G1 between the pusher member 161 and the bracket 13 without pushing the pusher member 161 in the distal direction, so that the tool assembly 20 can be prevented from being accidentally fired. As the tool assembly 20 is switched from the open state to the closed state, the switch 15 moves from the third position to the fourth position following the bracket 13. When the switch 15 is in the fourth position, the switch 15 is in a position capable of being pushed by the trigger 12 and capable of pushing the pusher member 161 so that the clinician can cause firing of the tool assembly 20 by operating the trigger.

It follows that this implementation can avoid inadvertent firing of the tool assembly 20 in the open state due to mishandling, thereby improving the reliability and safety of the surgical procedure. Furthermore, in such an implementation, only the tool assembly 20 need be switched from the open state to the closed state, and the switch 15 will move from the third position to the fourth position following the proximal direction of the carriage 13, such that the surgical instrument 10 is switched from the unfired state to the cocked state without additional manipulation. Thus, this implementation has the advantage of being convenient to operate.

Referring again to fig. 9A-9D, the surgical device 10 may further include a spring tab 172, and the spring tab 172 may be located on the outside of the pusher member 161 (i.e., the side facing away from the frame 13) and between the pusher member 161 and the housing 11. In the above implementation, when the switching member 15 reaches the second position, the pushing member 161 will move in the inner direction under the force exerted by the spring plate 172, so that the pushing member 161 abuts against or faces the switching member 15.

Referring to fig. 3 and 10, the firing mechanism 16 also includes an action member 162 that extends in a distal-proximal direction between the pusher member 161 and the tool assembly 20. The action member 162 abuts the pusher member 161 such that the pusher member 161 is configured to push the action member 162 in a distal direction causing firing of the tool assembly 20. The abutment 112 may define a support hole 1121, with the acting member 162 passing through the support hole 1121.

By means of the abutment member 112, both an effective support of the acting member 162 against undesired displacement of the acting member is achieved, and an abutment of the second compression spring 171 against the switching member 15 is achieved. Such an implementation facilitates reducing a number of components of surgical instrument 10, thereby facilitating a reduction in an overall size, an overall weight, and a manufacturing cost of surgical instrument 10, and facilitating an increase in reliability of surgical instrument 10.

Tool assembly

The tool assembly 20 may be removably mounted to the surgical instrument 10 such that the surgical instrument 10 may be used multiple times by exchanging the tool assembly 20. Fig. 11 shows the surgical instrument 10 with the tool assembly 20 removed. Of course, in some examples, tool assembly 20 may be configured to be non-removable therefrom in a manner that does not damage surgical instrument 10, i.e., surgical instrument 10 may also be disposable.

Referring to fig. 12, the tool assembly 20 can include a staple cartridge 21, an anvil 22, and a firing member 23. Staples 24 may be stored within the staple cartridge 21. In some examples, a knife 25 may also be provided within the staple cartridge 21. The knife 25 may be drivingly coupled to the firing member 23 to follow the firing member 23 in a distal-proximal direction.

The firing member 23 may be drivingly coupled to the action member 162 of the firing mechanism 16 to follow the action member 162 in the distal-proximal direction. When the effector 162 is moved in the distal direction, the firing member 23 is moved in the distal direction under the urging of the effector 162 and pushes the staples 24 and knife 25 out of the staple cartridge 21, thereby firing the tool assembly 20. After firing, as the action member 162 moves in a proximal direction, the firing member 23 is driven by the action member 162 to move in a proximal direction and drive the knife 25 back into the cartridge 21 to avoid accidental cutting of tissue by the knife 25.

It should be understood that the term "include" and variations thereof as used in this disclosure are intended to be open-ended, i.e., including, but not limited to. The term "according to" is based, at least in part, on. The term "one embodiment" means "a pair of embodiments"; the term "another embodiment" means "a pair of additional embodiments".

It should be understood that although the terms "first" or "second" etc. may be used in this disclosure to describe various elements (e.g., a first compression spring and a second compression spring), these elements are not provided by these terms, which are merely used to distinguish one element from another element.

The protective scope of the present disclosure is not limited to the embodiments described above, and any person skilled in the art should conceive of changes or substitutions within the technical scope of the present disclosure, which are intended to be covered in the scope of the present disclosure. Therefore, the protection scope of the present disclosure shall be subject to the protection scope of the claims.

Claims (12)

1. A surgical instrument for applying staples in a staple cartridge of a tool assembly to tissue and causing the staples to be formed under the guidance of an anvil of the tool assembly, the surgical instrument comprising:

A bracket configured to be fixed with one of the staple cartridge or the anvil to shorten a distance between the staple cartridge and the anvil by moving in a proximal direction, and provided with a first bonding portion and a second bonding portion; and

the adjusting mechanism comprises a first adjusting piece and a second adjusting piece, wherein the first adjusting piece is configured to drive the bracket to move from a first position to a second position in the proximal direction in a spiral transmission mode with a transmission ratio of n, and the second adjusting piece is configured to drive the bracket to further move from the second position to the proximal direction in the spiral transmission mode with the transmission ratio of m, and the transmission ratio of n is larger than the transmission ratio of m.

2. A surgical instrument as recited in claim 1, wherein the first adjustment member has a spiral groove on an inner periphery thereof, the first engagement portion is configured as a guide post adapted to extend into the spiral groove, the second adjustment member has an inner periphery thereof provided with an internal thread, and the second engagement portion has an outer periphery thereof adapted to be screwed into the internal thread.

3. The surgical instrument of claim 1 or 2, wherein the second adjustment member and the second engagement portion are configured to disengage during movement of the bracket from the first position to the second position; the first adjustment member and the first engagement portion are configured to disengage after the bracket reaches the second position.

4. A surgical instrument as recited in claim 3, wherein the first coupling portion is spaced apart from and distal to the second coupling portion, the first adjustment member is spaced apart from and distal to the second adjustment member, and a transition space is provided between the first and second adjustment members, the transition space being configured to permit movement of the first coupling portion therein in a distal-proximal direction.

5. A surgical instrument as recited in claim 1 or 2, wherein the adjustment mechanism further comprises an operating member configured to be operated to rotate the first and second adjustment members together.

6. The surgical instrument of claim 5, further comprising a housing defining an axial bore; the adjustment mechanism further includes a connector including a pair of shoulders spaced apart and a journal therebetween; the journal portion passing through the shaft hole such that the pair of shoulders are located inside and outside the housing, respectively; the operating member is coupled to rotate with the connecting member, and the first adjusting member is coupled to or integrally formed with the connecting member to rotate therewith.

7. A surgical instrument as recited in claim 5, wherein the operating member defines a receiving space; the second adjusting member is configured to be accommodated in the accommodating space in a manner slidable in the distal-proximal direction and rotatable together with the operating member; the adjustment mechanism further includes a force application member configured to apply a force to the second adjustment member in a distal direction.

8. A surgical instrument as recited in claim 7, wherein the adjustment mechanism further comprises an indicator comprising a body portion and a flange portion disposed on an outer periphery of the body portion; the operating piece is also provided with an exposing hole extending from the accommodating space to the proximal end face of the operating piece; a portion of the main body portion distal to the flange portion is adapted to protrude into an inner peripheral side of the second adjuster, and a portion thereof proximal to the flange portion is adapted to protrude out of the exposure hole; the force application member is configured as a first compression spring which is sleeved on a portion of the main body portion located on the proximal side of the flange portion, and both ends of the first compression spring are abutted against the flange portion and the inner surface of the operation member, respectively.

9. A surgical instrument according to claim 1 or 2, characterized in that the surgical instrument further comprises:

A housing;

a trigger for operation by a doctor;

the switching piece is slidably sleeved on the bracket and is configured to move from a third position to a fourth position in the proximal direction along with the movement of the bracket in the proximal direction;

the second pressure spring is sleeved on the bracket, is positioned on the far side of the switching piece and abuts against the switching piece, and the bracket is provided with a shoulder which is positioned on the near side of the switching piece and is suitable for abutting against the switching piece;

an abutting member fixed to or integrally formed with the housing and abutting against a distal end of the second compression spring; and

a firing mechanism comprising a pusher member configured to move in a distal direction to fire the tool assembly, wherein when the switch member is in the third position, the pusher member is supported by the switch member to form a bypass gap therebetween that bypasses the trigger; when the switch is in the fourth position, the pusher moves toward the bracket against or facing the switch such that the switch can be driven by the trigger to push the pusher in the distal direction.

10. The surgical instrument of claim 9, wherein the firing mechanism further comprises an action member extending in a distal-proximal direction between the pusher member and the tool assembly; the action member is against the pusher member such that the pusher member is configured to push the action member in a distal direction causing firing of the tool assembly; the abutment defines a support aperture through which the reaction member passes.

11. The surgical instrument of claim 1 or 2, wherein the bracket comprises a frame portion and an elongate portion, the elongate portion extending in a distal-proximal direction, the frame portion being located at a distal end of the elongate portion, the frame portion being configured to be secured to the one of the staple cartridge and the anvil, the first and second coupling portions being located at a proximal end of the elongate portion.

12. A surgical instrument according to claim 1 or 2, wherein the ratio n/m of the transmission ratio n to the transmission ratio m is greater than or equal to 3.