JP2007175126A - Surgical stapler - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a surgical stapler capable of opening and closing a fixed clamping body and a movable clamping body smoothly. <P>SOLUTION: When the surgical stapler 10 clamps objects to be sutured 100A and 100B, the fixed clamping body 17 located on the distal end of an elongated base member 14 is pushed down by the movable clamping body 15. At the same time, a moment load using the front end of a working tube member 16 as a fulcrum is applied to the elongated base member to push up the rear end of the elongated base member 14. In the surgical stapler, however, a connection member 80 connected to the elongated base member 14 within the working tube member 16 has a tilt regulating projection 85 that abuts the inner surface of the working tube member 16 to regulate tilting of the elongated base member 14 and the connection member 80. With such a configuration, the working tube member 16 moves linearly and smoothly relative to the elongated base member 14 and the connection member 80, and smooth opening and closing of the fixing and opening clamping bodies 17 and 15 are achieved. In addition, a variation of operating force necessary for opening and closing is also suppressed. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a surgical stapler that can hold an object to be sutured and can be sutured with staples.

Conventionally, as this type of surgical stapler, the one shown in FIG. 18 is known. This surgical stapler is provided with an elongated base member 4 and a communication shaft 3 </ b> S inserted through a support cylinder member 2 extending from the operation unit 1. A portion of the elongated base member 4 that extends forward from the front end of the support cylinder member 2 is a fixed clamping body 5, and a movable clamping body 6 that faces the fixed clamping body 5 is rotatable to an intermediate portion of the elongated base member 4. It is connected to. The action cylinder member 3 is connected to the front end of the communication shaft 3 </ b> S, and the action cylinder member 3 covers a connecting portion between the elongated base member 4 and the movable holding member 6. And the elongate base member 4 is fixed to the housing 1H of the operation part 1, and the action | operation cylinder member 3 moves ahead with the connection shaft 3S by operation of the operation part 1. FIG. Then, the movable holding body 6 is pushed down to the fixed holding body 5 side by the action cylinder member 3, and a suture object is held between them (for example, refer to Patent Document 1).
Japanese Patent No. 2525073 (FIGS. 1 and 5A)

  By the way, in contrast to the above-described conventional surgical stapler, the inventor of the present application eliminates the communication shaft 3S and the support cylinder member 2 and provides a surgical stapler having a structure in which the action cylinder member 3 is pivotally supported on the housing 1H. developed. However, in this surgical stapler, the axial force applied to the action cylinder member 3 presses the fixed clamping body 5 which is the front end portion of the elongated base member 4 via the movable clamping body 6 and the suture object, and the elongated base The member 4 receives a moment load with the opening edge of the working cylinder member 3 as a fulcrum. For this reason, the part (not shown) which connects the elongate base member 4 and the housing 1H inclines in the action cylinder member 3, and the situation where the fixed clamping body 5 and the movable clamping body 6 were not opened and closed smoothly could arise.

  The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a surgical stapler capable of smoothly opening and closing a fixed holding body and a movable holding body.

  In order to achieve the above object, the surgical stapler according to the first aspect of the present invention is configured such that an elongated base member is inserted into an action cylinder member extending from an operation portion, and from the front end of the action cylinder member of the elongated base member. A portion extending forward is used as a fixed clamping body, and a rear end portion of the movable clamping body facing the fixed clamping body is rotatably connected to an intermediate portion of the elongated base member. In a surgical stapler that moves forward relative to an elongated base member, pushes down the movable sandwiching body toward the fixed sandwiching body, and sandwiches an object to be sutured between the movable sandwiching body and the stationary sandwiching body. The rear end portion is always accommodated inside the action cylinder member, and the rear end portion of the elongated base member and the operation portion are connected by a connecting member. The connecting member is connected to the inner surface of the action cylinder member. Abut It has a feature where the tilt regulating part for regulating the tilt of the elongated base member for the tubular member is provided.

  According to a second aspect of the present invention, in the surgical stapler according to the first aspect, the elongate base member has a grooved structure with the movable clamping body open, and a pair of side walls at the rear end of the elongate base member An engaging recess is formed in a notch, and a groove fitting portion that is housed inside the elongated base member is formed on the front end side of the connecting member, and a pair of protrusions projecting from both side surfaces of the groove fitting portion. The engagement protrusion is unevenly engaged with the pair of engagement recesses, and the tilt restricting portion is characterized in that it is disposed on the opposite side of the elongated base member in the groove fitting portion.

  The invention of claim 3 is characterized in that, in the surgical stapler according to claim 1 or 2, the tilt restricting portion is constituted by a tilt restricting protruding portion protruding from the connecting member.

  According to a fourth aspect of the present invention, in the surgical stapler according to the third aspect, the action cylinder member is formed in a cylindrical shape, and the tilt regulating protrusion is in contact with the inner surface of the action cylinder member, and It is characterized in that arc surfaces having substantially the same curvature are formed.

  According to a fifth aspect of the present invention, in the surgical stapler according to any one of the first to fourth aspects, the operation portion includes a housing that covers the outside, and an inner slider that moves linearly in the axial direction of the working cylinder member inside the housing. The working cylinder member is coupled to the inner slider so as to be able to move and rotate directly with respect to the housing, and the elongated base member is not movable and rotatable with respect to the housing. It is characterized by being connected to.

[Invention of Claim 1]
According to the configuration of the first aspect, when the object to be sewn is clamped, the fixed clamp as the front end of the elongated base member is pushed down by the movable clamp and receives a moment load with the front edge of the working cylinder member as a fulcrum. The rear end portion of the elongated base member is pushed up. However, since the tilt restricting portion of the connecting member connected to the elongated base member in the action cylinder member abuts on the inner surface of the action cylinder member and restricts the tilting of the elongated base member and the connecting member, the action cylinder member becomes the elongated base. Smoothly linearly moves relative to the member and the connecting member, making it possible to smoothly open and close the fixed holding body and the movable holding body, and to suppress variations in operating force required for the opening and closing operation. it can.

[Invention of claim 2]
According to the configuration of the second aspect, when the groove fitting portion provided on the front end side of the connecting member is fitted to the elongated base member, the engaging protrusion of the connecting member engages with the concave portion of the elongated base member. Then, the connecting member and the elongated base member are fixed in the axial direction. Here, when the elongated base member receives a moment load by the clamping operation, the groove fitting portion of the connecting member receives a force from the elongated base member. Since the tilt restricting portion is disposed in the groove fitting portion, the force that the connecting member receives from the elongated base member and the reaction force that the connecting member receives from the acting cylinder member through the tilt restricting portion are arranged on substantially the same line. It is possible to prevent a moment load from being generated.

[Invention of claim 3]
When the surgical stapler according to the present invention is clamped, the connecting member slides on the inner surface of the working cylinder member. Here, the sliding resistance of the connecting member with respect to the action cylinder member varies with variations in surface roughness, shape, and the like of the contact portion between the connection member and the action cylinder member. Here, according to the configuration of the third aspect, since the tilt restricting protrusion protruding from the connecting member comes into contact with the inner surface of the working cylinder member, the connecting member as a whole comes into contact with the inner surface of the working cylinder member. The area of the contact portion is reduced, and variations in the surface roughness and shape of the contact portion are suppressed. As a result, the variation in the sliding resistance of the connecting member relative to the action cylinder member is reduced, and the variation in the operating force required for the opening / closing operation of the fixed holding member and the movable holding member can be suppressed.

[Invention of claim 4]
According to the configuration of the fourth aspect of the present invention, the portion of the tilt restricting protrusion that contacts the inner surface of the working tube member is an arc surface having substantially the same curvature as the inner surface of the working tube member. Within stable.

[Invention of claim 5]
According to the structure of Claim 5, the opposing direction with a fixed clamping body and a movable clamping body can be changed into arbitrary directions by rotating an action cylinder member and an elongate base member with respect to an operation part.

  Hereinafter, an embodiment in which the present invention is applied to a surgical stapler 10 will be described with reference to FIGS. As shown in FIG. 1, the surgical stapler 10 of this embodiment includes an action part 11 and an operation part 30. Hereinafter, the operation unit 11 side (the right side in FIG. 1) of the surgical stapler 10 is referred to as the front, and the operation unit 30 side (the left side in FIG. 1) is referred to as the rear. Moreover, in the operation part 30, the side provided with the handle part 32 described below is referred to as the lower side, and the opposite side is referred to as the upper side.

  The operation unit 30 includes various movable parts (for example, a lever connection link 33L, a speed increasing gear 51, and the like) inside the housing 31. The housing 31 has a pistol shape as a whole, and can be divided into a pair of housing divided bodies 31A and 31B with the center in the width direction (vertical direction in FIG. 2) as a boundary. A handle portion 32 is provided at the rear end portion of the housing 31, and the cylindrical nozzle 21 is held at the front end portion of the housing 31 between the housing divided bodies 31 </ b> A and 31 </ b> B.

  As shown in FIG. 1, an opening / closing operation lever 33 and a cam operation lever 35 are provided in front of the handle portion 32 in the housing 31. The opening / closing operation lever 33 and the cam operation lever 35 have a rotation center at the same position. The opening / closing operation lever 33 and the cam operation lever 35 are each urged to the side away from the handle portion 32 by a torsion spring, and in a state before the surgical stapler 10 is used, as shown in FIG. An opening / closing operation lever 33 is disposed at a predetermined angle in front of the handle portion 32, and a cam operation lever 35 is disposed at a predetermined angle in front of the opening / closing operation lever 33.

  As shown in FIG. 3, an inner slider 90 is coupled to a protruding portion of the opening / closing operation lever 33 that protrudes upward from the rotation fulcrum via a lever coupling link 33 </ b> L. The inner slider 90 has a rectangular frame shape that is elongated in the front-rear direction as a whole. Further, as shown in FIG. 5, the housing divided body 31 </ b> A is provided with a pair of rail portions 91, 91 extending in the front-rear direction and spaced apart from each other, and the inner slider 90 is interposed between the rail portions 91, 91. Is housed. As shown in FIG. 3, the lever connecting link 33L is pivotally connected to the rear end portion of the inner slider 90. When the opening / closing operation lever 33 is pulled toward the handle portion 32, the inner slider 90 is moved to the rail portions 91, 91. And move from the rear end position (see FIG. 3) to the front end position (see FIG. 4).

  Note that the opening / closing operation lever 33 is held by the lever lock 33R (see FIG. 1) while being pulled toward the handle portion 32 side. Further, the cam operation lever 35 is also drawn toward the handle portion 32 side in conjunction with the operation of the opening / closing operation lever 33 being drawn toward the handle portion 32.

  As shown in FIG. 7, the cam operation lever 35 includes a gear portion 35G above the rotation fulcrum. Further, a rear end portion of the crank rack 45 is disposed above the cam operation lever 35. The crank rack 45 is engaged with the housing 31 so as to be slidable in the front-rear direction. A rear gear portion 45G1 is formed on the lower surface of the rear end portion, and a front gear portion 45G2 is formed on the lower surface of the front end portion. Yes. The gear portion 35G of the cam operation lever 35 is separated rearward from the rear gear portion 45G1 of the crank rack 45 while the cam operation lever 35 is interlocked with the opening / closing operation lever 33. Therefore, while the cam operation lever 35 is interlocked with the opening / closing operation lever 33, the cam operation lever 35 rotates idly with respect to the crank rack 45. When the cam operation lever 35 is pulled toward the handle portion 32 side with the opening / closing operation lever 33 engaged with the lever lock 33R, the gear portion 35G of the cam operation lever 35 is moved to the rear gear portion 45G1 of the crank rack 45. The crank rack 45 is moved forward by meshing.

  A speed increasing gear 51 is rotatably supported in front of the cam operation lever 35 in the housing 31. As shown in FIG. 8, the speed increasing gear 51 includes a small-diameter gear portion 51G1 and a large-diameter gear portion 51G2 coaxially, and the front gear portion 45G2 of the crank rack 45 meshes with the small-diameter gear 51G1. ing. Further, a gear portion 26G of a rack shaft 26 (described later) provided in the action portion 11 is engaged with the large-diameter gear portion 51G2 of the speed increasing gear 51 from above. When the cam operating lever 35 is pulled toward the handle portion 32, the rack shaft 26 is pushed forward.

  Next, the action part 11 will be described. FIG. 9 shows only the action cylinder member 16, the elongated base member 14, and the connecting member 80 according to the present invention in the action part 11. The elongate base member 14 is formed by bending a sheet metal into a groove shape having a U-shaped cross section. On both side walls of the elongate base member 14, a rotation support portion 14 </ b> A (FIG. 9 shows one side) (Only the rotation support portion 14A on the side is shown) is overhanging. A rear end portion of the movable holding body 15 shown in FIG. 1 is pivotally supported between both the rotation support portions 14A. Further, the staple holding block 18 shown in FIG. 10 is accommodated in the elongate base member 14 in front of the rotation support portion 14A to constitute a fixed clamping body 17 (see FIG. 1). Hereinafter, in the action part 11, the opposing direction of the movable clamping body 15 and the fixed clamping body 17 is defined as the vertical direction, and the side (upper side in FIG. 1) provided with the movable clamping body 15 is defined as the upper side.

  The staple storage block 18 has a rear end portion disposed in the vicinity of the rotation support portion 14 </ b> A in the elongated base member 14, and a front end portion protruding forward from the elongated base member 14. As shown in FIG. 10, a cutter guide slit 18A is formed in the center in the width direction of the staple storage block 18 over substantially the entire length. A plurality of staple accommodating slits 18B are formed in a pair of rows on both sides of the cutter guide slit 18A. The elevating tip 18C shown in FIG. 11 is accommodated in the back side of each staple accommodating slit 18B, and the staple 19 is placed on the upper surface of the elevating tip 18C. The staple 19 is formed by bending a wire into a square U shape and sharpening the tip. Then, the bottom of the staple 19 is brought into contact with the upper surface of the elevating tip 18C, and the pair of tips are directed upward, and are accommodated in the staple accommodating slit 18B.

  A slide cutter 22 is provided inside the elongated base member 14 so as to correspond to the cutter guide slit 18A. The slide cutter 22 is configured by raising a blade portion 22B obliquely frontward and upward from the front end of a strip plate 22A extending along the elongated base member 14. Then, the blade portion 22B protrudes from the upper surface of the staple storage block 18 and moves from the rear end side to the front end side of the cutter guide slit 18A.

  A pair of slide cams 23, 23 are provided on both sides of the slide cutter 22 so as to correspond to each row of the staple accommodating slits 18 </ b> B group. The slide cam 23 is formed by forming an angle cam protrusion 23B at the tip of a strip 23A extending along the elongated base member 14. The chevron cam projection 23B is disposed in front of the blade 22B, and passes below each row of staple storage slits 18B. Then, the raising / lowering tip 18C received in each staple accommodating slit 18B is pushed up while being in sliding contact with the inclined portion of the angle cam protrusion 23B, and the staple 19 is pushed out from the staple accommodating slit 18B toward the movable holding member 15.

  A cutter guide slit (not shown) is formed on the surface of the movable clamping body 15 (see FIG. 1) facing the fixed clamping body 17 so as to face the cutter guide slit 18A of the staple storage block 18 and accommodates the staples. A caulking portion (not shown) is formed in correspondence with the slit 18B group. Then, the upper end portion of the blade portion 22 </ b> B protruding from the staple storage block 18 moves within the cutter guide slit of the movable holding body 15. Further, both ends of the staple 19 discharged from the fixed clamping body 17 are abutted against the caulking portion and are pushed down toward each other (see FIG. 13B).

  The action cylinder member 16 includes a hood portion 16B at the front end portion of the circular tube 16A. As shown in FIG. 17, the upper end of the hood portion 16B is stepped and narrow, and the rear end portion of the movable holding body 15 is accommodated in the narrow portion. Moreover, the upper end part of 14 A of rotation support parts in the elongate base member 14 is faced | matched by the level | step difference surface 16V below the narrow part among the food | hood parts 16B (refer FIG. 9). Further, the hood portion 16B is provided with a flat inner lower surface 16X, and a groove 16Y is formed at the center of the inner lower surface 16X. And the protrusion from which the lower surface of the elongated base member 14 protrudes fits in the groove 16Y, and both side portions of the lower surface of the elongated base member 14 are laid on the inner lower surface 16X.

  Further, the narrow portion of the hood portion 16 </ b> B and the position of the movable holding body 15 that is slightly away from the rotation center are connected by the opening / closing link 20. Thereby, when the action cylinder member 16 is positioned on the rear side (the operation unit 30 side) relative to the elongated base member 14, as shown in FIG. 3 and FIG. When the sandwiching body 17 is opened and the action cylinder member 16 is positioned on the front side relative to the elongated base member 14, as shown in FIGS. 4 and 12B, the movable sandwiching body 15 and the fixed sandwiching body 17. Are closed, and the sewing objects 100A and 100B (see FIG. 12B) are held between the movable holding body 15 and the fixed holding body 17.

  The connection structure of the action part 11 and the operation part 30 is as follows. The action cylinder member 16 of the action part 11 is rotatably connected to the inner slider 90 in the operation part 30. Specifically, as shown in FIG. 14, an engagement groove 16 </ b> M is formed in the rear end portion of the working cylinder member 16 along the circumferential direction. On the other hand, the front end of the inner slider 90 is provided with a front-side holding wall 93 that has a square U shape and can be engaged with the engaging groove 16M in three directions. The inner slider 90 is provided with a substantially U-shaped rear holding wall 94 behind the front holding wall 93, and the action cylinder member 16 is interposed between the rear holding wall 94 and the front holding wall 93. An annular protrusion 16N located behind the engagement groove 16M is sandwiched. Thereby, the action cylinder member 16 is fixed to the inner slider 90 in the axial direction and connected to be rotatable about the axis.

  The elongated base member 14 of the action portion 11 is connected to the housing 31 of the operation portion 30 via the connecting member 80 so as not to be able to move directly and to be rotatable. Specifically, the connecting member 80 has a substantially cylindrical shape as a whole, and flat surfaces 80A and 80A are formed over the entire longitudinal direction on both side portions of the outer peripheral surface spaced apart by 180 degrees. Yes. A groove fitting portion 82 (see FIG. 16) corresponding to the inner shape of the elongated base member 14 is formed at the front end portion of the connecting member 80 by cutting away both side portions and the lower portion deeper than the flat surfaces 80A and 80A. ing. On both side surfaces of the groove fitting portion 82, rectangular engagement protrusions 83, 83 protrude on both sides. On the other hand, rectangular engagement recesses 89 and 89 are cut out on both side walls at the rear end of the elongated base member 14. Then, the groove fitting portion 82 is fitted into the elongated base member 14 from above, and the engaging projections 83 and 83 are engaged with the engaging recesses 89 and 89 of the elongated base member 14, respectively. Further, the rear end edge of the elongated base member 14 is abutted against the stepped portion on the rear end side of the groove fitting portion 82 in the connecting member 80. Thus, the connecting member 80 and the elongated base member 14 are fixed in the axial direction and connected so as to be integrally rotatable.

  A shaft insertion hole 81 is formed through the shaft center portion of the connecting member 80. The rack shaft 26 is inserted into the shaft insertion hole 81. The rack shaft 26 has a round bar shape as a whole, and a cam fixing member 25A accommodated in the elongated base member 14 is connected to the front end portion thereof as shown in FIG. Further, the rear end portions of the pair of slide cams 23, 23 are fixed to the cam fixing member 25A, and the slide cutters 23, 23 are provided with a slide cutter via a collecting member 25B at an intermediate portion in the longitudinal direction. 22 are connected. Furthermore, a gear portion 26G is formed on the rear end side of the lower surface of the rack shaft 26 as shown in FIG. As described above, the gear portion 26G of the rack shaft 26 meshes with the large-diameter gear portion 51G2 of the speed increasing gear 51 from above as shown in FIG. As a result, the slide cutter 22 and the slide cam 23 move directly together with the rack shaft 26 by the turning operation of the cam operation lever 35.

  As shown in FIG. 14, an engagement groove 84 is formed at the rear end portion of the connecting member 80. On the other hand, a fixed protruding wall 95 is formed so as to protrude from a region sandwiched between rail portions 91 and 91 (see FIG. 5) in the housing 31 of the operation unit 30. Then, as shown in FIGS. 6 and 15, the fixed projecting wall 95 is engaged with the concave and convex portions in the engaging groove 84 of the connecting member 80. Thereby, the connecting member 80 is fixed to the housing 31 in the axial direction and connected to be rotatable about the axis. The fixed protruding wall 95 is just fitted to the inner portion of the inner slider 90, and the fixed protruding wall 95 also plays a role of guiding the inner slider 90 in cooperation with the rail portions 91 and 91. Further, an arcuate recess 95A corresponding to the inner surface of the engaging groove 84 is formed on the front end surface of the fixed protruding wall 95, and the bottom of the holding wall 94 of the inner slider 90 corresponds to the outer peripheral surface of the connecting member 80. An arcuate recess 94A is formed. Then, the connecting member 80 is centered with respect to the action cylinder member 16 by the arc-shaped concave portions 94A and 95A.

  Now, on the upper surface of the groove fitting portion 82 of the connecting member 80, a tilt regulating projection 85 is formed to project. Specifically, the tilt restriction protrusion 85 has a front end that is flush with the front end surface of the connecting member 80 and a rear end that is semicircular. Further, as shown in FIG. 16, the upper surface of the tilt regulating projection 85 is an arc surface 85A concentric with the outer peripheral surface of the connecting member 80, and the curvature of the arc surface 85A is substantially the same as the inner surface of the working cylinder member 16. It is the same. The connecting member 80 is arranged concentrically with the action cylinder member 16 when assembled at the normal position in the action cylinder member 16, and the arcuate surface 85A of the tilt restricting projection 85 is provided with the action cylinder as shown in FIG. While contacting or adjoining the inner surface of the member 16, the lower surface of the connecting member 80 is separated from the inner surface of the working cylinder member 16.

Next, the operation of the present embodiment configured as described above will be described.
The surgical stapler 10 according to the present embodiment is used in a surgical operation in which, for example, a stomach wall, an intestinal wall, and the like are sutured objects. First, as preparations for using the surgical stapler 10, the staples 19 are respectively stored in the staple storage slits 18B of the staple storage block 18 shown in FIG. 10, and the opening / closing operation lever 33 is handled as shown in FIG. The leg 32 is opened from the portion 32 by a predetermined angle, and the cam operation lever 35 is opened from the opening / closing operation lever 33 by a predetermined angle. Thereby, the space between the movable holding body 15 and the fixed holding body 17 is opened in a V shape, and the slide cutter 22 and the slide cam 23 are arranged on the rear end side of the fixed holding body 17.

  If necessary, the entire action part 11 may be rotated around the axis of the action cylinder member 16 with respect to the housing 31 at an arbitrary angle.

  When the surgical stapler 10 is used, as shown in FIG. 13 (A), for example, two suture objects 100A and 100B are stacked, and as shown in FIG. 12 (A), these suture objects 100A and 100B. Is arranged between the movable holding body 15 and the fixed holding body 17. Then, the open / close operation lever 33 is clamped so as to be pulled toward the handle portion 32 side.

  Then, the turning force of the opening / closing operation lever 33 is converted into the axial force of the action cylinder member 16 by the lever connecting link 33 </ b> L, and the action cylinder member 16 moves forward with respect to the housing 31. Here, since the elongated base member 14 in the working cylinder member 16 is connected to the housing 31 through the connecting member 80 so as not to move directly, the working cylinder member 16 is elongated along with the turning operation of the opening / closing operation lever 33. It moves forward relative to the base member 14. Then, the applied axial force of the action cylinder member 16 is turned obliquely forward by the opening / closing link 20 connected to the hood portion 16B at the front end of the action cylinder member 16, and the movable holding body 15 becomes the fixed holding body 17. It is pushed down. Thereby, the sewing objects 100A and 100B are sandwiched between the movable sandwiching body 15 and the fixed sandwiching body 17.

  At this time, a pressing force (see F <b> 1 in FIG. 9) is applied to the fixed clamping body 17 as the front end portion of the elongated base member 14 from the action cylinder member 16 through the opening / closing link 20. For this reason, a moment load is applied with the opening edge of the acting cylinder member 16 opposite to the movable clamping body 15 as a fulcrum (see P in FIG. 9), and the rear end portion of the elongated base member 14 together with the connecting member 80 acts on the acting cylinder. It is pushed upward in the member 16. However, the tilting restricting protrusion 85 provided on the connecting member 80 that connects the elongated base member 14 and the operation unit 30 abuts against the inner surface of the working cylinder member 16 to tilt the elongated base member 14 and the connecting member 80. Since the action cylinder member 16 moves smoothly and relatively linearly with respect to the elongated base member 14 and the connecting member 80, the fixed clamping body 17 and the movable clamping body 15 can be smoothly opened and closed. .

  Specifically, if the tilt restriction protrusion 85 is not provided on the connecting member 80, the working cylinder member 16 is moved linearly while the elongated base member 14 and the connecting member 80 are tilted with respect to the working cylinder member 16. Thus, the fixed clamping body 17 and the movable clamping body 15 are opened and closed. In this case, in addition to the force that linearly moves the action cylinder member 16, a force that corrects the inclination of the elongated base member 14 and the connecting member 80 is required. However, in this embodiment, since the tilt restriction protrusion 85 is provided on the connecting member 80, it is not necessary to correct the inclination of the elongated base member 14 and the connecting member 80. As a result, as described above, the working cylinder member 16 moves smoothly and relatively linearly with respect to the elongated base member 14 and the connecting member 80, and a smooth opening and closing operation is possible.

  Further, since the tilt restricting protrusion 85 is disposed on the upper surface of the groove fitting portion 82 that receives an upward force from the elongated base member 14 in the connecting member 80, the force received by the connecting member 80 from the elongated base member 14 is The reaction force that the connecting member 80 receives from the action cylinder member 16 through the tilt restricting protrusion 85 is arranged on the substantially same line, and the moment load on the connecting member 80 can be prevented.

  Furthermore, since the tilt restricting projection 85 protrudes from the upper surface of the connecting member 80, only the tilt restricting projecting portion 85 of the connecting member 80 contacts the inner surface of the working cylinder member 16. The action cylinder member 16 and the connection member 80 slide in a state where the connection member 80 is in contact with the inner surface of the action cylinder member 16. By the way, the sliding resistance between the connecting member 80 and the action cylinder member 16 varies with variations in surface roughness, shape, and the like of the contact portion between the connection member 80 and the action cylinder member 16. Here, in the present embodiment, since the tilt restricting protrusion 85 protruding from the connecting member 80 abuts on the inner surface of the working cylinder member 16, the connecting member 80 as a whole abuts against the inner surface of the acting cylinder member 16. Thus, the area of the contact portion is reduced, and variations in the surface roughness and shape of the contact portion can be suppressed. As a result, the variation in the sliding resistance of the connecting member 80 with respect to the action cylinder member 16 is reduced, and the variation in the operating force necessary for clamping the suture object can be suppressed. In addition, an arc surface 85A having substantially the same curvature as that of the inner surface of the action cylinder member 16 is formed in a portion of the tilt regulating protrusion 85 that contacts the inner surface of the action cylinder member 16. The connecting member 80 is stabilized. Even if the connecting member 80 is slightly inclined in the working cylinder member 16, the lower surface of the connecting member 80 and the inner surface of the working cylinder member 16 are separated from each other, so that the lower surface of the connecting member 80 contacts the inner surface of the working cylinder member 16. In this respect, the sliding resistance can be suppressed.

  When the sewing objects 100A and 100B are clamped between the movable clamping body 15 and the fixed clamping body 17 as described above, the cam operation lever 35 is pulled toward the handle portion 32 side. Then, the rotational force of the cam operation lever 35 is converted into the axial force of the rack shaft 26 via the crank rack 45 and the speed increasing gear 51, and the rack shaft 26 moves forward. At this time, the rack shaft 26 linearly moves in the shaft insertion hole 81 provided in the connecting member 80. As described above, the connecting member 80 is prevented from being tilted by the abutment of the tilt restricting protrusion 85 and the working cylinder member 16. Therefore, the rack shaft 26 can move linearly smoothly in the shaft insertion hole 81. Then, the slide cutter 22 and the slide cam 23 together with the rack shaft 26 move to the front end side of the action portion 11 of the fixed clamping body 17, and the staple 19 group is pushed out from the fixed clamping body 17 to the movable clamping body 15 side. The tips of the staples 19 are tilted inward by a caulking portion (not shown) provided in the movable holding body 15, and two rows of stitching portions 101 and 101 (see FIG. 13B) are formed on the stitching objects 100 </ b> A and 100 </ b> B. The Then, an incision is made between the stitched portions 101 and 101 by the slide cutter 22.

  In order to remove the surgical stapler 10 from the suture objects 100A and 100B, the hand is released from the cam operation lever 35 and the lever lock 33R is released. Then, the rack shaft 26, the working cylinder member 16 and the like are returned to their original positions together with the opening / closing operation lever 33 and the cam operation lever 35 by the elastic force of the torsion spring. This return operation can be performed smoothly as in the above-described advance operation.

  As described above, according to the surgical stapler 10 of the present embodiment, the slant base member 14 and the connection to the working cylinder member 16 are connected by the tilt regulation protrusion 85 provided on the coupling member 80 being in contact with the inner surface of the working cylinder member 16. The tilting of the member 80 is prevented, and the working cylinder member 16 moves smoothly and linearly relative to the elongated base member 14. Thereby, the fixed clamping body 17 and the movable clamping body 15 can be smoothly opened and closed, and variations in the operating force required for the opening and closing operation can be suppressed.

[Other Embodiments]
The present invention is not limited to the above-described embodiment. For example, the embodiments described below are also included in the technical scope of the present invention, and various other than the following can be made without departing from the scope of the invention. It can be changed and implemented.
(1) In the above-described embodiment, the tilt restricting protrusion 85 protrudes only from the upper surface of the groove fitting portion 82 of the connecting member 80, but the tilt restricting protrusion according to the present invention is, for example, the upper face of the connecting member 80. It is good also as a protrusion structure extended over the whole longitudinal direction.

(2) In the above-described embodiment, only one tilt regulating protrusion 85 is provided for the connecting member 80, but a plurality of tilt regulating protrusions 85 may be provided on the connecting member 80.

1 is a side sectional view of a surgical stapler according to an embodiment of the present invention. Cross section of surgical stapler Side cross-sectional view of a surgical stapler showing the part linked to the opening / closing lever Side cross-sectional view of a surgical stapler showing the part linked to the opening / closing lever Photo of the housing divided body and inner slider viewed from the side Photo of the inner slider etc. assembled to the housing divided body Side view of cam control lever and crank rack Front section of surgical stapler Partially cutaway side view of working cylinder member, elongated base member and connecting member Top view of staple storage block Perspective view of slide cutter and slide cam (A) Side sectional view of the surgical stapler before clamping the suture object (B) Side sectional view of the surgical stapler after clamping the suture object (C) Surgical stapler after sewing the suture object Side sectional view of (A) Perspective view of an object to be sutured before being sutured (B) Perspective view of an object to be sutured after being sutured Exploded perspective view of working cylinder member, elongated base member and connecting member The perspective view of the state which assembled | attached the action cylinder member, the elongate base member, and the connection member Front sectional view of connecting member Front view of working cylinder member A perspective view of a conventional surgical stapler

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Surgical stapler 14 Elongated base member 15 Movable clamping body 16 Action cylinder member 17 Fixed clamping body 30 Operation part 31 Housing 80 Connection member 82 Groove fitting part 83 Engagement projection part 85 Tilt regulation projection part (Tilt regulation part)
85A Arc surface 89 Engaging recess 90 Inner slider 100A, 100B Sewing object

Claims (5)

An elongated base member is inserted into the inside of the working cylinder member extending from the operating portion, and a portion of the elongated base member extending forward from the front end of the working cylinder member is used as a fixed clamping body and is opposed to the fixed clamping body. The rear end portion of the movable sandwiching body is pivotally connected to the middle portion of the elongated base member, and the operation cylinder member is moved forward relative to the elongated base member by the operation of the operation portion. In the surgical stapler that pushes down the movable sandwiching body toward the fixed sandwiching body, and sandwiches the suture object between the movable sandwiching body and the fixed sandwiching body,
The rear end portion of the elongated base member is always accommodated inside the working cylinder member, and the rear end portion of the elongated base member and the operation portion are connected by a connecting member,
The surgical stapler according to claim 1, wherein the connecting member is provided with a tilt restricting portion that is in contact with an inner surface of the working cylinder member and regulates the tilting of the elongated base member with respect to the working cylinder member. The elongated base member has a groove-shaped structure with the movable sandwiching body open, and a pair of engaging recesses are cut out on both side walls at the rear end of the elongated base member.
On the front end side of the connecting member, a groove fitting portion accommodated in the elongated base member is formed, and a pair of engaging protrusions protruding from both side surfaces of the groove fitting portion are the above-described one. Concave and convex engagement with the pair of engagement recesses,
The surgical stapler according to claim 1, wherein the tilt restricting portion is disposed on the opposite side of the elongated base member in the groove fitting portion.   The surgical stapler according to claim 1 or 2, wherein the tilt restricting portion is configured by a tilt restricting protrusion protruding from the connecting member.   The action cylinder member has a cylindrical shape, and the tilt regulating protrusion is formed with an arc surface that is in contact with the inner surface of the action cylinder member and has substantially the same curvature as the inner surface of the action cylinder member. The surgical stapler according to claim 3. The operation portion includes a housing that covers the outside, and an inner slider that moves linearly in the axial direction of the working cylinder member inside the housing,
The working cylinder member is connected to the inner slider so as to be linearly movable and rotatable with respect to the housing,
The surgical stapler according to any one of claims 1 to 4, wherein the elongate base member is connected to the housing so as to be incapable of direct movement and rotatable with respect to the housing.