JPH0246834A - Medical stapler - Google Patents

Abstract

PURPOSE:To make it possible to freely set the speed ratio of the rapid reciprocating movement to slow reciprocating movement of a ram regardless of the form and size of a lever, by forming a cum face on either one of respective contact portions of the lever and the ram with each other, the cum face for allowing the reciprocating movement of the ram. CONSTITUTION:A cum mechanism 28 is provided between a lever 27 and a ram 26 both provided to its main body 11, and in the case of suturing a wound, etc., the thumb is put on a pressing portion 27b longitudinally from its rear end to front end while the other fingers are urged to grip the main body 11. The pressing portion 27b is thus pressed to turn the lever 27 to close the device, so that the inclined faces 27c, 27d of the lever press a circular face 29a in sequence, thereby putting the ram 26 in a reciprocating movement toward a stable 19; if the momentum of the lever 27 during turning movement by which it approaches the main body 11 is set to a constant, the inclined face 27c (acutely)accelerates the reciprocating movement of the ram 26 at the beginning of the turning movement of the lever 27 during which movement it approaches the main body 11, but the inclined face 27d decelerates the reciprocating movement of the ram 26 just before the ram 26 makes contact with the staple 19, the angle theta2 of inclination of the inclined face 27d being bigger than the angle theta1 of inclination of the inclined face 27c. Also, the angles theta1, theta2 of inclination of the inclined faces 27c, 27d can be freely set respectively regardless of the form and size of the lever 27. The speed ratio of the rapid reciprocating movement to slow reciprocating movement of the ram can therefore be freely set.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application 1] The present invention relates to a medical stapler used for suturing wounds and the like.

[Prior Art 1] Conventional medical staplers of this type include, for example, Japanese Patent Laid-Open No. 51-64782 and Japanese Patent Laid-Open No. 55-68363.
Publication No. 57-46854, Japanese Patent Application Publication No. 1983-46854
Various staplers are known, such as those described in Japanese Patent Publication No. 164050 and Japanese Patent Publication No. 61-38692. Generally, they include a stapler body, a ram provided on the stapler body so as to be able to reciprocate, an anvil located in front of the ram and fixed to the stapler body, and a ram that is displaceable on the stapler body. By moving the lever toward the main body of the stapler, the ram is moved forward, and the ram and anvil work together to bend the stable (needle). It is configured to suture wounds etc.

By the way, there are two types of ram driving methods using a lever: One method is, for example,
Like the one described in Japanese Patent No. 38692, the intermediate portion of the lever is rotatably provided on the stapler body.

In this device, when the stapler body and one end of the lever are grasped and one end of the lever is rotated so as to approach the stapler body, the other end of the lever presses the ram in the forward direction. It looks like this. Another method, as described in Japanese Patent Publication No. 57-46854, uses a lever whose middle part is bent to be elastically deformable and formed into a "<" shape. One end of the lever is rotatably provided on the stapler body, and the other end is provided movably in the same direction as the reciprocating direction of the ram while in contact with the ram. In this device, when you grip the stapler body and press the bent part of the lever closer to the stapler body, the lever becomes more straight, and the other end of the lever moves away from the one end. The other end of the lever moves the ram forward.

[Problem to be solved by the invention 1 The ram is separated from the anvil before forward movement,
When it moves a preset distance, it comes into contact with the stable (which is placed in contact with the anvil), and when it moves further after that, it cooperates with the anvil to bend the stable.

Therefore, when moving the ram forward, it is recommended to move the ram quickly at the beginning of the forward movement, and then move it slowly after contacting the stable, in order to improve work efficiency and reduce the force required to displace the lever. desirable in

However, in the former of the above two drive systems, the amount of rotation of one end of the lever relative to the amount of rotation of the other end is always constant. For this reason, if the amount of rotation of one end of the lever relative to the other end is increased in order to rapidly move the ram forward, a large amount of force is required when bending the stable, and conversely, the amount of rotation of the other end relative to one end is increased. If you reduce
There is a problem in that the forward movement speed of the ram becomes slow and work efficiency decreases.

In this regard, in the case of the latter drive method, as the lever bent in the shape of a "<" character becomes closer to a straight line, the separation speed of both ends becomes slower.

Therefore, the ram can be moved quickly at the beginning of the approach displacement of the lever, and then moved at a low speed.

However, in this case, once the shape and dimensions of the lever are determined, it is impossible to change the speed ratio between the initial forward speed and the subsequent forward speed, resulting in a narrow degree of freedom in design. be.

This invention was made in consideration of the above circumstances, and it is possible to move the ram rapidly forward at the beginning of displacement of the lever, and to move the ram forward at a slow speed after the lever has been displaced a predetermined distance. It is an object of the present invention to provide a medical stapler in which the speed ratio between forward speed and low forward speed can be freely set regardless of the shape and dimensions of the lever.

[Means for Solving the Problems] In order to achieve the above object, the present invention includes a stapler of the lever on either one of the contact parts between the lever and the ram.
A cam surface is formed that causes the ram to move forward by approaching the main body.

In the above configuration, the cam surface is preferably formed such that the forward movement distance of the ram relative to the approach displacement distance of the lever is long at the beginning of the approach displacement and becomes short thereafter. Further, the lever may be provided on the stapler body so as to be movable in a direction perpendicular to the reciprocating direction of the ram, and one end thereof may be provided so as to be rotatable.

When one end of the lever is rotatably provided, the other end of the lever should be arranged so as to extend in the forward movement direction of the ram, and be brought into contact with the ram at the middle part of the lever, for reasons described later. It is desirable to do so. moreover,
It is desirable to attach a follower to the ram that prevents movement in the direction in which the lever approaches, and to make contact with the lever through this follower. The ram is moved forward by the cam action of the formed cam surface. In this case, by appropriately setting the shape of the cam surface, the speed at each position during forward movement of the ram can be set to a desired speed.

In particular, if the distance of the forward movement of the ram relative to the distance of the approach displacement of the lever is formed so that it is long at the beginning of the approach displacement of the lever and becomes short thereafter, the ram is forced to move rapidly forward at the beginning of the approach displacement of the lever, and then is forced to move forward at a low speed. It will be done. Moreover,
The speed ratio between the forward movement speed of the ram at the beginning of the approach displacement of the lever and the forward movement speed of the ram after that can be changed as desired regardless of the shape and dimensions of the lever by appropriately changing the shape of the cam surface. Gade Island.

Further, if one end of the lever is rotatably provided on the stapler body, the @ end of the lever is extended along the forward movement direction of the ram, and the intermediate part of the lever is brought into contact with the ram.
In order to move the lever toward each other, the other end of the pressing island lever will be located close to the 7-bar, which is the suturing work section. Therefore, suturing work becomes easier to perform.

Furthermore, when a follower is attached to the ram, only the force that causes it to move forward acts on the ram, and no force acts on the ram in the direction that causes the lever to move toward the ram.Therefore, the force that moves the lever toward the ram acts on the ram. can be prevented from being deformed or displaced.

[Embodiment 1] Hereinafter, an embodiment of the present invention will be described with reference to FIGS. 1 to 10.

1 to 9 show a medical stapler A which is an embodiment of the present invention.
The stapler main body (hereinafter simply referred to as main body) has a hollow rectangular parallelepiped shape.

This main body 11 consists of a left main body part 12 (see FIG. 2) and a right main body part (see FIG. 3), each molded by an injection molding method, which are adhesively fixed to face each other. A storage hole 14 is formed extending along the front wall portion 11a. The lower end of this storage hole 14 is open to the front by forming a notch 15 in the lower end of the front wall 11a. Similarly, a notch 16 is formed in the front end of the lower wall portion 11b forming the lower bottom of the storage hole 14, so that the center portion of the lower end of the storage hole 14 is opened downward.

Furthermore, an anvil 17 extending along the storage hole 14 is inserted into the storage hole 14 . This 7 building 1
7 has leg portions 17a on both sides thereof, as shown in FIG.
17a is formed, and a projecting piece 17b is formed at one end in the longitudinal direction.
is formed, and an action piece 17c is formed at the other end in the longitudinal direction. The anvil 17 is fixed by press-fitting the protruding piece 17b into a fixing slit 18 formed at the upper bottom of the storage hole 14. In the fixed state, leg 1? a comes into contact with the outer wall surface of the storage hole 14, and the action piece 1? c is the notch 15 at the lower end of the storage hole 14.
It is located opposite to.

Furthermore, a large number of staples 19 are provided inside the storage hole 14.
is located. This staple 19 is approximately U-shaped and consists of a straight main body 19m and leg parts 19b, 19b formed at both ends perpendicular to the main body 19a. , are arranged between the anvil 17 and the inner wall surface of the storage hole 14 so as to straddle the anvil 17.

In addition, in the range from the intersection of the front wall 11g and the top wall 11c to the center of the top wall 11c, there is a curve at the intersection of the front wall 11a and the top wall 11c, and from there the top wall Part 1
A guide slit 20 is formed extending along 1c. This guide sleeve 20 is continuous with the upper end of the storage hole 14.

In the range between the guide 20 and the upper part of the storage hole 14,
A pressing member 21 for pressing down the staple 19 is inserted movably in the direction in which the slit 20 extends. This pressing member 21 is made of resin such as nylon, and as shown in FIG. is in the shape of two characters, which is almost the same as the staple 19, and is arranged so as to straddle the anvil 17, and is brought into contact with the staple 19 located at the top. on the other hand,
The flexible portion 21b is formed in the shape of a band whose thickness is approximately the same as the width of the guide slit 20, and a large number of grooves 21c extending from one end to the other end in the width direction are formed on the inwardly facing surface thereof. . By forming this groove 21c, the flexible portion 21b is able to bend freely and move along the guide slit 20. Furthermore, a protrusion 21d is formed at the center of the inwardly facing surface of the flexible portion 21b.

This protrusion 21cl protrudes into the internal space from a notch 822 formed in the inner wall facing the entire range of the storage hole 14 from the end of the guide sleeve 20 on the storage hole 14 side, and its protruding tip is The staple 19 is urged downward by the spring 23.

Note that a hole 24 facing the rear end of the guide slit 20 is formed in the earthen wall portion 11c, and the rear end of the pressing member 21 or a mark (not shown) attached to the pressing member can be accessed through the hole 24. The remaining amount of staples 19 can be confirmed by visually observing the position of the staples 19.

Further, on the lower wall portion 11b of the main body 11, a leg portion 1 of the staple 19 is provided opposite to the staple 19 located at the lowest position.
A holding slit 25 is formed extending in the same direction as 9b. A ram 26 is slidably inserted into this holding slit 25. As shown in FIG. 8, the ram 26 has a rectangular flat plate shape, and pressure protrusions 26a, 26a are formed at the tip portion protruding from the holding slit 25. These two pressurizing projections 26a, 26a are equally spaced from both sides in the width direction of the action portion 17c of the anvil 17, and the distance between them is approximately the same as the diameter of the main body portion 19a of the staple 19, or It is set slightly larger than that. Therefore, when the ram 26 moves forward, the pressurizing protrusion 26a and the acting portion 17c bend the main body portion 19a protruding from the acting portion 17c so as to sandwich it therebetween. An engagement hole 26b is formed at the rear end of the ram 26.The main body 11 is also provided with a lever 27 for moving the ram 26 forward. As shown in FIG. 4, this lever 27 has a detail 27a formed at one end thereof and a pressing portion 27b formed at the other end. The lever 27 is rotatably mounted on the main body 11 by having a detail 27a formed at one end thereof rotatably held by the respective rear ends of the left main body part 12 and the right main body part 13. It is being

On the other hand, the other end of the lever 27 passes through an insertion hole 13a formed in the right main body part 13 and protrudes to the outside of the main body 11, and a pressing part 27b formed there is directed toward the distal end side of the main body 11. It extends.

Note that the axis of the detail 27a is the leg portion 19 of the staple 19.
1] are perpendicular to the direction in which the rams 2G approach each other (direction of arrow X in FIG. 1(B)) and the direction in which the ram 2G moves forward (direction of arrow Y in FIG. 1(B)).

Further, in order to move the ram 26 forward by rotation of the lever 27, the lever 27 must be opened to open the lever 27 and the ram 26.
A cam mechanism 28 is provided for converting the rotational motion of the ram into a linear motion and transmitting the linear motion to the ram 26.

That is, on the surface of the lever 27 facing the ram 26@, there is a first inclined surface (cam surface) 27c that gradually slopes upward as the ram 26 moves forward in the forward direction.
A 22nd inclined surface (cam surface) 27d continuous with this first inclined surface 27c is formed. In this case, the first inclined surface 2? The inclination angle θ1 of c is smaller than the inclination angle θ2 of the second inclined surface 27d. Further, a follower 29 is provided inside the main body 11 so as to be slidable in the same direction as the moving direction of the ram 26, and is prevented from moving in the direction in which the lever 27 approaches and rotates. An arcuate surface 29a is formed at the rear end of the arrow 29 and is in line contact with the first or second inclined surface 27c or 27d. On the other hand, a slit 29b is formed at the tip of the 7t lower 29, and a protrusion 29c is formed at the slit adjacent to the slit 29b.

The rear end portion of the ram 26 is inserted into the slit 29b, and the protrusion 29c is inserted into the engagement hole 26b of the ram 26. When the 7-face 29 moves forward, the ram 26 is pushed by the bottom of the slide 29b, while the force member 28
When the ram 26 moves backward, the ram 26 is pushed by the protrusion 29c,
This allows the follower 29 and the ram 26 to move together.

Note that the slit (2) facing from the upper surface of the protrusion 29c
Although the distance to the wall surface of the slit 9b is made smaller than the thickness of the ram 26, the ram 26 can be inserted into the slit 29b by elastically deforming both walls forming the slit 29b.

Further, the follower 291 and the return spring 301 bias the ram 26 in the retreating direction, and the biasing force of the return spring 30 causes the lever 27 to move through the insertion hole 13a.
It abuts against the inclined surface 13b of.

When the lever 27 is in contact with the inclined surface 13b, the arcuate surface 29a is in contact with the first inclined surface 27c.

When suturing a wound or the like with the medical stapler of the above structure t, the thumb is placed vertically on the pressing portion 27b from the rear end toward the distal end, and the main body 11 is gripped with the other fingers. Then, the pressing portion 27b of the lever 27 is pressed toward the main body 1@, and the lever 27 is rotated to close. Then,
The first and second inclined surfaces 27c and 27d are sequentially arranged on the arcuate surface 2.
9a to move the ram 26 forward toward the staple 19 via the 7-rower 29.

Here, since the angle of inclination θ2 of the second inclined surface 27d is larger than the angle of inclination θ1 of the first inclined surface 27c, when the amount of rotation of the lever 27 toward the main body 11 is constant, the angle of inclination of the lever 27 is At the beginning of the approach rotation, the ram 26 ascends the first inclined surface 27c and is rapidly moved forward. Immediately before contacting the staple 19, the ram 26 is caused to move forward at a low speed by the second inclined surface 27d. Therefore, the efficiency of the suturing operation can be improved, and the pressing force of the lever 27 required to bend the staple 19 can be reduced. Further, the inclination angles θ and θ2 of the first and @2 inclined surfaces 27c and 27d can be arbitrarily set regardless of the shape and dimensions of the lever 27. Therefore, the speed ratio between the rapid forward movement speed and the slow forward movement speed can be freely set.

Further, since the follower 29 is provided in the main body 11 in a state where the movement of the lever 27 in the approach rotation direction is prevented,
When the lever 27 presses the ram 26 in the forward movement direction, the follower 29 receives the pressing force in the approaching rotation direction by the lever 27, and the ram 26 does not receive any pressing force in the same direction.

Therefore, it is possible to prevent the ram 26 from being deformed or displaced.

When the ram 26 moves forward and its pressing protrusions 26a, 26a abut against the staple 19, it cooperates with the anvil 17 to bend the main body 19a of the staple 19, as shown in FIG. Then, the legs 19b, 19 of the staple 19
b rotates around the bent portion of the main body portion 19a,
The tips of the legs 19a, 19a move closer to each other. As a result, the staple 19 becomes rectangular, thereby completing the suturing operation.

When the lever 17 is released after the suturing operation is completed, the ram 26 is moved back together with the follower 29 by the biasing force of the return spring 30, and the lever 27 is rotated apart. The whole is then returned to its original state.

Moreover, FIGS. 10(A) and 10(B) show other embodiments of the present invention. In this embodiment, lever 2
7A is provided so as to be movable in a direction toward and away from the main body 11 and in a direction orthogonal to the reciprocating direction of the ram 26. The other configurations are the same as those in the above embodiment, and similar parts are given the same reference numerals and explanations thereof will be omitted.

In each of the embodiments described above, a follower 29 is attached to the ram 26 that reciprocates together with the ram 26, and the ram 26 is brought into contact with the lever 27.degree. 27A via the follower 29. 27A may be contacted directly. Also, a cam surface 27c is attached to the lever 27.27A.
, 27d, but the follower 29 may be formed with a cam surface, and if the ram 26 is brought into direct contact with the lever 27.27A, the ram 26 may be formed with a cam surface.

Furthermore, although two cam surfaces 27c and 27d are formed as cam surfaces, three or more cam surfaces may be formed, or they may be curved surfaces so that the inclination angle changes continuously.

[Effects of the Invention] As explained above, according to the medical stapler of the present invention, a cam surface that moves the ram forward when the lever approaches the ram is provided at the 0-shift of the contact portion between the lever and the ram. Therefore, regardless of the shape and dimensions of the lever, the forward movement distance of the ram relative to the approach displacement distance of the lever can be set arbitrarily. In particular, by forming the cam surface so that the ram's forward movement distance relative to the lever's approach displacement distance is long at the beginning of the lever's approach displacement and shortened at the latter stage of the lever's approach displacement, the forward movement speed of the ram is controlled by the ram's forward movement distance when the ram contacts the stable. You can miss by opening slowly when you want to do so, and opening quickly after contacting the stable. Moreover, the speed at each position during forward movement can be arbitrarily set regardless of the shape and dimensions of the lever.

Further, if one end of the lever is rotatably provided, the other end is extended along the forward movement direction of the ram, and the lever is brought into contact with the ram at an intermediate portion thereof,
The other end to be pressed when rotating the ram is located close to the anvil, which is the bending part of the stable. Therefore, when suturing a wound or the like, the hand can be positioned close to the suturing site, and therefore the suturing work can be performed easily and accurately.

Furthermore, when a follower is attached to the ram, it is possible to prevent the ram from being deformed or displaced.

[Brief explanation of the drawing]

1 to 9 show an embodiment of the present invention, FIG. 1(A) is a plan view with the right main body section removed, and FIG. 1(B) is a plan view of FIG. 1(A). BB-B arrow sectional view, Figure 1 (C) is a C arrow view of Figure 1 (A), Figure 1 (D) is the 1st
Figure 2 (A) is a plan view showing the left main body part; Figure 2 (B) is a view viewed from arrow B in Figure 2 (A); Figure 2 (C), (D), and (E) are cross-sectional views taken along the lines C-C, D-D, and E-E in FIG. 2(A), respectively;
Fig. 3(A) is a plan view showing the right main body part, Fig. 3(B) is a view taken from arrow 8 in Fig. 3(A), Fig. 3(C), (D), (
E) are cross-sectional views taken along C-C, D-D, and E-E in FIG. 3(A), respectively. FIG. 4(A) is a front view of the lever, and FIG. 4(B) is a cross-sectional view of the lever. Figure 4 (A) B arrow view, Figure 5 (A
) is a front view of the follower, FIGS. 5(B) and 5(C) are views viewed from arrow B and arrow C in FIG. 5(A), respectively, and FIG. 6(A) is a plan view of the pressing member. Figure (B) is a view in the direction of arrow B in Figure 6 (A), Figure 6 (C) is a view in the direction of arrow C in Figure 6 (B), and Figure 7 (
A) is the front view of the anvil, Figure 7 (B) is Figure 7 (A)
Fig. 7 (C) is a view from C arrow in Fig. 7 (B),
FIG. 8 is a plan view of the ram, FIGS. 9(A) and 9(B) are diagrams showing how the stable is bent by the ram and anvil,
Figure 10 shows an embodiment of the pond of this invention.
FIG. 1(A) is a diagram similar to FIG. 1(A), and FIG. 10(B) is a diagram similar to FIG. 1(B). 11... Stapler main body, 17... Anvil, 1
9...Stable, 26...Ram, 27.27A・
...Lever, 27c...First inclined surface (cam surface), 2
7d...second inclined surface (cam surface), 29...7t lower.

Claims (1)

[Scope of Claims] (1) A stapler main body, a ram provided on the stapler main body so as to be able to reciprocate, and a ram located in front of the ram in the forward movement direction and fixed to the stapler main body and cooperates with the ram. an anvil that bends the staple by bending the stapler; and a lever that is provided on the stapler body so as to be freely displaceable in a direction toward and away from the stapler body, and presses and moves the ram in the forward direction when displaced in the approaching direction. A medical stapler characterized in that a cam surface is formed on one of the contact portions between the lever and the ram to move the ram forward when the lever approaches the stapler body. . (2) The cam surface is formed such that the forward movement distance of the ram with respect to the approach displacement distance of the lever is long at the beginning of the approach displacement of the lever, and becomes short thereafter. Medical stapler. (3) The lever is characterized in that one end thereof is rotatably provided on the stapler, and the other end is displaced toward the stapler body.
) or the medical stapler according to (2). (4) The medical stapler according to claim 3, wherein the other end of the lever extends in the forward movement direction of the ram and is brought into contact with the ram at an intermediate portion thereof. . (5) The medical stapler according to claim 1, wherein the lever is provided on the stapler main body so as to be movable in a direction perpendicular to a reciprocating direction of the ram. (6) A follower is attached to the ram and is provided on the stapler main body so as to be movable in the reciprocating direction of the ram while the lever is prevented from moving in the approach displacement direction, and the follower is attached to the lever. The medical stapler according to any one of claims 1 to 5, wherein the stapler is in contact with the stapler.