FR2542188A1 - Surgical clamp for linear mechanical suturing of viscera of the thoracic and abdominal cavities - Google Patents

Surgical clamp for linear mechanical suturing of viscera of the thoracic and abdominal cavities Download PDF

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Publication number
FR2542188A1
FR2542188A1 FR8304186A FR8304186A FR2542188A1 FR 2542188 A1 FR2542188 A1 FR 2542188A1 FR 8304186 A FR8304186 A FR 8304186A FR 8304186 A FR8304186 A FR 8304186A FR 2542188 A1 FR2542188 A1 FR 2542188A1
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head
extension
characterized
means
support
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FR8304186A
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French (fr)
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FR2542188B1 (en )
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Foures Bernard
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously

Abstract

The invention relates to a surgical clamp for the mechanical and linear suturing by staples of the viscera of the abdominal and thoracic cavities for example, comprising a clamp body 1 extended by a canon 2 used to guide a locking ring 3 of an orientable and removable head 6 provided with a sliding support 17 for a staple loader 19 and an anvil 20, the support 17 being brought up to the anvil in order to clamp the viscera by means of a handle 21 hinged to the body 1, the latter acting on a sliding element 16 held inside the canon 2 extended by a sliding element 18 held inside the extension 12 of the head 6 connected to the support 17, then, after release of the handle 21 when the elements 16 and 18 are locked and lowering of a part 30, the action of the handle acts via the part 30 on the pushers 32 and 34 sliding in the elements 16 and 18 and allowing, by means of the hammer 44, the staples to be ejected and closed on the anvil 20 after piercing the viscera. <IMAGE>

Description

La présente invention concerne une pince chirurgicale pour suturer mécaniquement et de façon linéaire par agrafes, des viscères de cavités abdominales et thoraciques par exemple. The present invention relates to a surgical clamp suturing mechanically and linearly with staples, viscera of abdominal and thoracic cavities for example.

On connais différenles pinces chirurgicales pour la suture mécanique linéaire d'organes des cavités abdominales et thoraciques telles que décrites dans les brevets FR 1 237 035, 1 278 616, 1 448 441, 1 479 134, 1 540 226, DE 618 922, US 3 080 564, les pinces décrites et revendiquées présentent toutes une tête d'agrafage fixée au corps de pince, de ce fait elles ne sont pas interchangeables ni orientables, ce qui limite leur utilisation dans bien des cas, dîautre part elles sont d'un emploi malaisé car elles nécessitent lors de l'intervention une manipulation par les deux mains du praticien. We know différenles surgical clip for linear mechanical suture organs of chest and abdominal cavities as described in patents FR 1,237,035, 1,278,616, 1,448,441, 1,479,134, 1,540,226, DE 618 922, US 3,080,564, the described and claimed clamps all have a stapling head fixed to the gripper body, therefore they are not interchangeable or adjustable, which limits their use in many cases, they are dîautre part of a job difficult because they require during surgery manipulation by both hands of the practitioner.

L'invention a pour but de palier aux inconvénients préce- demment exposes. The invention aims to bearing the disadvantages preceding ously exposed.

L'invention a pour objet une pince chirurgicale pour sutures mécaniques linéaires de viscères de cavités abdominales et thoraciques comportant un corps de pince prolongé par un canon servant de guide à une bague de verrouillage extérieure et intérieurement à un élément coulissant dans lequel est maintenu un poussoir mobile, en l'extrémité du canon une gorge de retenue est aménagée pour recevoir une arete#aména,gée en extrémité du prolongement d'une tête orientable et amovible comportant un support coulissant de chargeur d'agrafes, une enclume et un marteau prolongé par un poussoir coulissant maintenu à l'intérieur d'un élément relié au support, ledit élément est maintenu et coulisse à l'intérieur du prolongement /du canon de la tête, il est en alignement avec l'élément ainsi que les poussoirs entre eux de sorte à ce que par action d'une poignée ~ articulée sur le corps celle-ci provoque en un premier temps le déplacement des éléments pour rapproch The invention relates to a surgical clip for linear mechanical sutures viscera of abdominal and thoracic cavities comprising a clamp body extended by a tube that guides an outer locking ring and inwardly to a sliding member in which is maintained a pusher mobile, in the end of the barrel a retaining groove is arranged to receive an edge # aména Gee end of the extension in a rotatable and detachable head comprising a sliding support of the staple magazine, an anvil and a hammer extended by a sliding plunger retained within an element connected to the support, said member is held and slides within the extension / the barrel of the head, it is in alignment with the element and the pushers to each other so that by the action of a handle ~ articulated on the body thereof causes a first moving elements NEAR tO er et immobiliser par un dispositif de verrouillage continu le support coulissant et le chargeur d'agrafes vers l'enclume jusqu'à pincement du viscère à suturer placé entre le chargeur et l'enclume puis en un deuxième temps aprés retour en arrière au moyen d'un ressort et abaissement d'une pièce solidaire de ladite poignée le déplacement de s poussoir s par action de iite pNpee pour expulser les agrafes du chargeur par le marteau et provoquer leur fermeture sur l'enclume aprés transpercement dlrviscère, lors du déverrouillage les poussoirs et les éléments coulissants étant repoussés à leur position initiale au moyen d'un ressort maintenu à l'intérieur du prolongement de la tête. er and immobilize a continuous locking device the sliding support and the staple magazine toward the anvil to pinch the organ to be sutured placed between the magazine and the anvil and a second time after going back through a spring and lowering of a part integral with said handle moving pusher s s by IITE NEAT action to expel staples charger by the hammer and cause closure of the anvil after piercing dlrviscère, when unlocking the pushers and the sliding members being urged to their initial position by means of a spring held within the extension of the head.

D'autres caractéristiques et avantages de l'invention ressortiront plus clairement de la description qui va suivre faite en regard des dessins joints donnés i titre d'exemple non limitatif > ou Other features and advantages of the invention will become apparent from the following description given with reference to the accompanying drawings i as a non-limiting example> or
- la figure 1 est une vue générale de la pince, - Figure 1 is a general view of the clamp,
- la figure 2 un type de dispositif de verrouillage de la tête, - Figure 2 type locking device of the head,
- la figure 3 une variante de dispositif de verrouillage de la tête, - Figure 3 a locking device variant of the head,
- la figure 4s le détail de verrouillage continu de l'élément permettant le déplacement du support coulissant du chargeur. - Figure 4s continuous locking detail of the element for moving the sliding support of the charger.

Telle que représentée figures 1 2 et 4 > la pince comporte un corps 1 prolongé par un canon 2 sur lequel coulisse une bague de verrouillage 3 celle-ci en sa partie inférieure coté corps 1 est dotée d'une gachette 4 coulissant dans la rainure 5 aménagée dans le corps et ce afin de déverrouiller la tête orientable 6et permettre son orientation, la course de la gachette 4 par action d'un des doigts du praticien étant limitée lorsque celui-ci vient en butée sur le corps 1, de sorte à permettre seulement le déverrouillage de ladite tête sans toutefois permettre son extraction,en extrémité 7 de la bague 3 un ressort de rappel 8 est maintenu afin de pousser la bague 3 lors du relachement de la gachette 4 et ce aprés orientation de la tête 6, le verrouillage de la tête 6 à la position désirée étant obtenu par l'emboftement de dents 9 aménagées sur le pourtour intérieur 10 de la bague 3 dans les rainurés 11 aménagées sur le pourtour extérieur du prolongement 12 d As shown Figures 1 and 4 2> the clamp 1 comprises a body extended by a barrel 2 on which slides a 3 thereof in its lower portion side body 1 locking ring is provided with a trigger 4 sliding in the groove 5 fitted in the body in order to unlock the swivel head 6and allow its orientation, the stroke of the trigger 4 by the action of one of the fingers of the practitioner is limited when the latter abuts on the body 1, so as to allow only the release of said head without allowing its extraction, at the end 7 of the ring 3 a return spring 8 is held to urge the ring 3 upon release of the trigger 4 and that after orientation of the head 6, the locking of the head 6 to the desired position being obtained by the emboftement teeth 9 provided on the inner circumference 10 of the ring 3 in the groove 11 provided on the outer periphery of the extension 12 of e la tête 6. e the head 6.

Afin de permettre la mise en place d'une tête 6 sur le canon 2 la bague coulissante 3 est repoussée manuellement vers le corps 1 de sorte à dégager la gorge de retenue 13 de la tête 6 aménagée sur le canon 2 pour qu'aprés coulissement du prolongement 12 sur le canon 2 l'ar8te 14 en bout dudit prolongement s'emboue dans la gorge de retenue 13 et ce par simple effet de ressort dû à la matière constituant le prolongement 12 et engendré par des rainures 15 disposées sur le pourtour dudit prolongement 12. To enable the establishment of a head 6 of the barrel 2 the sliding ring 3 is pushed manually towards the body 1 so as to disengage the retaining groove 13 of the head 6 provided on the barrel 2 so that after displacement the extension 12 of the barrel 2 ar8te the 14 end of said extension is emboue in the retaining groove 13 and by this simple spring effect due to the material of the extension 12 and generated by the grooves 15 disposed on the periphery of said extension 12.

A l'intérieur du canon 2 coulisse un élément 16,ce dernier a pour foncion de provoquer le déplacement du support 17 de chargeur d'agrafes 19 au moyen de l'élément 18 coulissant dans le prolongement de tête 12 et ce de manière à rapprocher le chargeur d'agrafes 19 vers l'enclume 20, le déplacement de l'élément 16 est obtenu au moyen de la poignée 21 articulée sur le corps 1 dotéed'un ressort de rappel 22, lorsque ladite poignée est actionnée celle-ci en son extrémité 23 prend appui sur un élément coulissant 24 maintenu sur le corps 1 et sur un côté duquel des dents 25 sont aménagées afin de constituer avec le cliquet articulé 26 doté d'un ressort 26A un verrouillage continu durant le déplacement progressif de l'élément 16 relié à l'élément coulissant 24 par l'âme 27, ledit verrouillage pouvant être libéré par action d'un bouton poussoir 23. En fin de rapprochement du support 17 de chargeur d'agrafes 19 sur l'enclume 20, le viscère à suturer placé Inside the bush 2 slides a member 16, the latter for foncion cause movement of the support 17 of the staple magazine 19 by means of the sliding member 18 in the head extension 12 and so as to bring the staple magazine 19 toward the anvil 20, the movement of the member 16 is obtained by means of the handle 21 articulated to the body 1 dotéed'un return spring 22, when said handle is actuated thereof in its end 23 bears on a sliding member 24 held on the body 1 and on one side of which teeth 25 are arranged to form with the articulated pawl 26 with a spring 26A continuous locking during the progressive movement of the element 16 connected to the slider 24 by the core 27, said latch being releasable by the action of a pushbutton 23. in the final approximation of the support 17 of the staple magazine 19 on the anvil 20, the organ to be sutured square entre le chargeur 19 et l'enclume 20 subit une pression obtenue au moyen du ressort de compression 29 maintenu dans l'ëlé- ment coulissant 24, par relachement de la poignée 21 rappelée par le ressort 22, alors que le support 17 de chargeur est maintenu en position de pincement et seulement à ce moment-là, la pièce 30 solidaire et coulissant dans la poignée 21 au moyen du bouton 31 est placée en face du poussoir 32 du corps de pince 1 coulissant dans l'élément 16 de manière à ce que par action de la poignée 21 la pièce 30 prenne appui sur l'extrémité 33 dudit poussoir 32 et provoque son déplace ment ainsi que celui du poussoir 34 solidaire et coulissant dans l'éIe:rnent. between the charger 19 and the anvil 20 is under pressure obtained by the pressure spring 29 kept in sliding ele- ment 24, upon release of the handle 21 biased by the spring 22, while the charger 17 is support maintained in nipping position and only at that time, the part 30 integral with and sliding in the handle 21 by means of the knob 31 is placed in front of the pusher 32 of the clamp body 1 slidably in the element 16 so by action of the handle 21 the part 30 bears on the end 33 of said pusher 32 and causes it to move ment and that of the pusher 34 integral with and sliding in the EIA: rnent. 18 de la tete 6 pour engendrer l'expulsion des agrafes con- tenues dans le chargeur 19 et leur fermeture sur ltenclume 20 aprés transpercement du viscère, par le marteau- 44 fixé en extrémité 45 du poussoir 34, la pièce 30 lors de l'action de la poignée 21 pendant le déplacement du support 17 de.chargeur d'agrafes 19 en position haute permet le libre passage de l'extrémité du poussoir 32. 18 of the head 6 for generating the expulsion of con- staples held in the loader 19 and their fastening ltenclume 20 after piercing of the organ by the marteau- 44 fixed end 45 of the pusher 34, the part 30 during the action of the handle 21 during movement of the support 17 de.chargeur staple 19 in the high position allows free passage of the end of the plunger 32.

De sorte à permettre l'alDaisselnent de dela pièce 30, lors de l'opération de pincement par le support coulissant 17 du chargeur d'agrafes 19, les poussoirs 32 et 34 sont en même temps déplacés et ce grâce à une goupille 35 en appui sur l'cxtrémité 36 d'une lumière 37 aménagée sur l'él~rnent 16 et la goupille 38 solidaire du poussoir 34 en appui sur les extrémités 39 des lumières se faisant face 40, la goupille 38 servant notamment d'appui au ressort 41 de rappel contenu entre l'élément 18 et le prolongement 12 permettant l'ouverture et dégagement du support 17 du chargeur d'agrafes 19 lorsque le cliquet 26 est désolidarisé des dents 25. So as to allow the alDaisselnent dela part 30, during the operation of pinching by the sliding support 17 of the staple magazine 19, the pushers 32 and 34 are simultaneously displaced and this thanks to a pin 35 supported on cxtrémité 36 of a port 37 provided on the el ~ rnent 16 and the pin 38 integral with the pusher 34 bears on the ends 39 of the lumens facing 40, the pin 38 serving as a support in particular the spring 41 return content between the element 18 and the extension 12 permitting the opening and release of the support 17 of the staple magazine 19 when the pawl 26 is disengaged from teeth 25.

Sans sortir du cadre de l'invention et telle que représentée figure 3, l'orientation de la tête et son maintien peuvent être réalisés au moyen d'un ressort à friction 42 logé dans un évidement 43 prévu à cet effet à l'intérieur de la bague 3,de ce fait les dents 9 et rainures il ainsi que la ga#chette 4 sont supprimées. Without departing from the scope of the invention and as shown in FIG 3, the orientation of the head and its maintenance can be carried out by means of a friction spring 42 housed in a recess 43 provided for this purpose inside the ring 3, thereby the teeth 9 and grooves it and the ga chette # 4 are deleted.

Claims (1)

    REVENDIGA TIONS REVENDIGA TION
  1. 1 ) Pince chirurgicale pour sutures mécaniques linéaires des viscères de cavités abdominales et thoraciques caractérisée par le fait qu'elle comporte un corps de pince 1 prolongé par un canon 2 servant de guide à une bague de verrouillage 3 extérieure et intérieurement à un élément coulissant 16 dans lequel est maintenu un poussoir mobile 32, en l'extrémité du canon 2 une gorge de retenue 13 est réalisée pour recevoir une arête 14 aménagée en extrémité du prolongement 12 d'une tête orientable et amovible 6 comportant un support coulissant 17 de chargeur d'agrafes 19, une enclume 20 et un marteau 44 prolongé par un poussoir 34 coulissant et maintenu à l'intérieur dgun élément 18 relié au support 17, ledit élément 18 est maintenu et coulisse à l'intérieur du prolongement 12 de la tête 6, il est en alignement avec l'élément 16 ainsi que les poussoirs 32 et 34 entre eux de sorte à ce que par action d'une poignée 21 articulée sur le corps 1 celle-ci pr 1) surgical forceps for linear mechanical sutures abdominal and thoracic cavities of viscera characterized in that it comprises a gripper body 1 extended by a barrel 2 that guides an outer locking ring 3 and internally to a sliding element 16 in which is maintained a movable pusher 32, in the end of the barrel 2 a retaining groove 13 is formed for receiving a ridge 14 fitted end of the extension 12 of an orientable and removable head 6 comprising a sliding support 17 of charger staple 19, anvil 20 and hammer 44 extended by a tappet 34 and slidably held within DGUN member 18 connected to the support 17, said element 18 is held and slides within the extension 12 of the head 6, it is in alignment with the element 16 and the pushers 32 and 34 between them so that by the action of an articulated handle 21 on the body 1 thereof pr ovoque en un premier temps le déplacement des éléments 16 et 18 pour rapprocher et immobiliser par un dispositif de verrouillage continu le support 17 et chargeur d'agrafes 19 vers l'enclume 20 jusqu'à pincement du viscère à suturer placé entre le chargeur 19 et l'enclume 20 puis en un deuxième temps aprés retour en arrière au moyen d'un ressort 22 et abaissement d'une pièce 30 solidaire de ladite poignée 21 l'action de cette dernière agisse sur les poussoirs 32 et 34 pour expulser les agrafes du chargeur 19 par le marteau 44 et provoquer leur fermeture sur l'enclume 20 aprés transpercement du viscère, lors du déverrouillage les poussoirs 32 et 34 et les éléments 16 et 18 étant repoussés à leur position initiale au moyen d'un ressort 41 maintenu à l'intérieur du prolongement 12. ovoque in initially moving the elements 16 and 18 for positioning and immobilizing a continuous locking device the support 17 and staple magazine 19 toward the anvil 20 to pinch the organ to be sutured placed between the charger 19 and the anvil 20 and then a second time after return back by means of a spring 22 and lowering of a part 30 integral with the said handle 21 the action of the latter acts on the pushers 32 and 34 to expel staples from charger 19 by the hammer 44, causing closure of the anvil 20 after piercing of the organ, when unlocking the pushers 32 and 34 and the elements 16 and 18 being driven back to their initial position by means of a spring 41 maintained in within the extension 12.
    20) Pince chirurgicale selon la revendication 1 caractérisée par llem- boitement de la ba#gue de verrouillage 3 sur le prolongement 12 de la tête 6 une fois l'arête 14 placée dans la gorge de retenue 13 empéchant l'extraction de ladite tête 6. 20) A surgical clip according to claim 1 characterized by limping llem- the ba locking gue # 3 of the extension 12 of the head 6 once the edge 14 placed in the retaining groove 13 preventing the extraction of said head 6 .
    3 ) Pince chirurgicale selon les revendications 1 et 2 caractérisée par le verrouillage de la tête 6 à une position désirée engendrée par l'emboitement de dents 9 aménagées sur le pourtour intérieur 10 de la bague 3 en l'extrémité opposée au corps I dans des rainures Il amé- nagée s sur le pourtour extérieur du prolongement 12 de la tête Ss k déverrouillage de la tête 6 permettant son orientation étant obtenu par le déplacement limité de la bague 3 au moyen d'une gachette 4 coulissant dans une rainure 5 aménagée sur le corps 1. 3) surgical forceps according to claims 1 and 2 characterized by the locking head 6 to a desired position generated by the interlocking teeth 9 provided on the inner circumference 10 of the ring 3 in the opposite end to the body I in It s grooves arranged on the outer periphery of the extension 12 of the head Ss k release head 6 for its orientation being obtained by the limited movement of the ring 3 by means of a trigger 4 sliding in a groove provided on 5 the body 1.
    4 ) Pince chirurgicale selon la revendication 1 caractérisée par le maintien à une orientation désirée de la tête 6 au moyen d'un ressort à friction 42. 4) A surgical clip according to claim 1 characterized by maintaining a desired orientation of the head 6 by means of a friction spring 42.
    5 ) Pince chirurgicale selon la revendication 1 caractérisée par le maintien de la bague 3 sur le prolongement 12 de la tête 6 engendré par un ressort de compression 8 en appui sur l'extrémité du canon Z et en l'extrémité 7 de la bague 3. 5) The surgical clip according to claim 1 characterized by maintaining the ring 3 on the extension 12 of the head 6 produced by a compression spring 8 rests on the end of the barrel and Z in the end 7 of the ring 3 .
    S ) Pince chirurgicale selon la revendication B caractérisée par les poussoirs 32 et 34 se déplaçant en même temps que les éléments 16 et 18 lors du rapprochement du support 17 de chargeur d'agrafes 19 au moyen de goupilles 35 et 38 en appui sur les extrémités 36 et 39 de lumières 37 et 40. S) A surgical clip according to claim B, characterized by the pushers 32 and 34 moving together with the elements 16 and 18 during the approximation of the support 17 of the staple magazine 19 by means of pins 35 and 38 bear against the ends 36 and 39 lights 37 and 40.
    7 ) Pince chirurgicale selon les revendications 1 et 6 caractérisée par la goupille 38 servant d'appui à un ressort de rappel 41 des éléments 16 et 13 et poussoirs 32 et 34 contenu entre l'élément 18 et le prolongement 12 8") Pince chirurgicale selon la revendication I caractérisée par le verrouillage continu lors du déplacement progressif des éléments 16 et 18 et poussoirs 32 et 34 au moyen de dents 25 aménagées sur un élément coulissant 24 maintenu sur le corps 1 et relié à l'élément 16 s'emboitant sur un cliquet articulé 26 maintenu en position par un ressort 26A. 7) A surgical clip according to claims 1 and 6 characterized by the pin 38 serving as a support for a return spring 41 of the elements 16 and 13 and tappets 32 and 34 contained between the element 18 and the extension 12 8 ") Tweezers according to claim I characterized by the continuous locking during progressive displacement of the elements 16 and 18 and tappets 32 and 34 by means of teeth 25 arranged on a sliding member 24 held on the body 1 and connected to the member 16 fitting over a hinged pawl 26 held in position by a spring 26A.
    9 ) Pince chirurgicale selon la revendication 1 caractérisée par la compression du viscère à suturer au moyen d'un ressort de compression 29 maintenu à l'intérieur de l'élément 24 en appui sur le prolongement coulissant de l' me 27 à l'intérieur dudit élément 24. 9) A surgical clip according to claim 1 characterized by the compression of the organ to be sutured by means of a compression spring 29 retained inside the element 24 bears on the slidable extension of me 27 inside said element 24.
FR8304186A 1983-03-11 1983-03-11 Tweezers for linear mechanical suture viscera of the chest and abdominal cavities Expired FR2542188B1 (en)

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FR8304186A FR2542188B1 (en) 1983-03-11 1983-03-11 Tweezers for linear mechanical suture viscera of the chest and abdominal cavities

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EP0479131A1 (en) * 1990-10-05 1992-04-08 United States Surgical Corporation Controlled closure mechanism for a surgical stapling instrument
EP0537571A2 (en) * 1991-10-18 1993-04-21 United States Surgical Corporation Apparatus for applying surgical fasteners
EP0537570A2 (en) * 1991-10-18 1993-04-21 United States Surgical Corporation Apparatus for applying surgical fasteners
EP0539762A1 (en) * 1991-10-30 1993-05-05 American Cyanamid Company Linear surgical stapling instrument
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US5579978A (en) * 1991-10-18 1996-12-03 United States Surgical Corporation Apparatus for applying surgical fasteners
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