KR20090108168A - Mechanical anastomosis apparatus for tubular organ - Google Patents

Abstract

PURPOSE: A mechanical anastomosis apparatus for tubular organs is provided to rapidly anastomose tubular organs. CONSTITUTION: A mechanical anastomosis apparatus for tubular organs includes a first rod, a second rod(34), and a coupling unit. A first holder and a second holder(32) for fixing a first anastomosis ring and a second anastomosis ring(40) are connected to a front end of the first rod and the second rod. The coupling unit moves the first rod toward the second rod, moves the second rod toward the first rod, and includes a first lever, a second lever(20), a first rack gear, a second rack gear, a pinion shaft, and a pinion gear. The first lever and the second lever are connected to the first rod and the second rod, and move one of the first rod and the second rod. The first rack gear and the second rack gear are connected to the first rod and the second rod. The pinion shaft is installed between the first rod and the second rod.

Description

MECHANICAL ANASTOMOSIS APPARATUS FOR TUBULAR ORGAN}

The present invention relates to an apparatus for anastomosis of coronary organs (such as blood vessels), and more particularly, to an anastomosis device using an anastomosis ring.

Due to lack of exercise and westernization of diet, the incidence of vascular diseases is increasing year by year. In particular, most of the heart diseases are myocardial infarction and angina caused by ischemia, which is clogging the blood vessels that provide nutrition and oxygen to the heart. As a method for treating such closed vessels or almost closed vessels, drug therapy using a muscle relaxant or anticalculator that dilates vascular muscles and surgical treatments are used. Drug therapy is useful for early stage treatment, but it is significantly less effective and not a fundamental measure for vessels that have already undergone a significant degree of closure. Therefore, many surgical therapies, which are direct treatments for occluded blood vessels, have been performed.

Surgical treatment is largely a medical method and a surgical method, which is a method of treating a closed area by inserting a stent into a closed area through a blood vessel such as a femoral vein and expanding the metal network there. to be. Devices required for methods of using such expanded metal meshes are disclosed in US Pat. No. 3,416,531 and the like. However, after some time after the surgery in this way, the lesion tissue is splattered between the metal mesh and the new granular tissue grows inside the metal mesh, there is a problem that the closing process is in progress again. Therefore, as a more fundamental solution, surgical procedures are mainly performed in which open heart surgery is opened and bypassed blocked areas using blood vessels (mainly leg veins) taken from elsewhere. At this time, one end of the leg vein is end-to-end or end-to-side to an internal mammary artery (IMA) that supplies blood to the chest and abdominal tissue and muscles. And end-to-side or side-to-side to the blood vessel beyond the closure site.

The blood vessels are largely composed of the inner layer (Intima), the middle layer (Media) and the outer layer (Adventitia). When the anastomosis of the two blood vessels, the inner layers must be connected to the inner layers in an outward connection. In addition to the treatment of heart disease as described above, as a reconstruction method by flap transfer or anastomosis of the cut blood vessels, a microsurgical surgeon secures the surgical field enlarged by a microscope or a high magnification magnifier by using a suture directly. The method of sealing together is used. However, sutures can only be performed by highly skilled physicians and require a lot of time and effort. In particular, it is very difficult to suture the anastomosis of blood vessels in the region where the periodic rhythm is continuously performed, such as the heart. Therefore, during cardiac surgery, it is necessary to artificially cause a heart attack for a long time to stop the heartbeat. Therefore, a number of vascular anastomosis devices have been devised to avoid suturing blood vessels directly by hand using sutures.

SUMMARY OF THE INVENTION An object of the present invention is to provide a pusher and anastomosis method capable of easily and quickly anastomulating a coronary organ (such as a blood vessel).

Other objects of the present invention will become more apparent from the following detailed description and the accompanying drawings.

According to the present invention, the anastomosis device includes: first and second rods to which first and second holders respectively fixing the first and second anastomosis rings at the front end thereof are connected; And a fastening unit which moves the first rod toward the second rod and moves the second rod toward the first rod, wherein the fastening unit is connected to the first and second rods, respectively. First and second levers for moving either one of the first and second rods; First and second rack gears disposed on outer circumferential surfaces of the first and second rods, respectively, and moving together with the first and second rods; A pinion shaft installed between the first and second rods; And a pinion gear connected to the pinion shaft and engaged with the first and second rack gears to rotate by the movement of the first and second rack gears.

The anastomosis device further includes a case surrounding the fastening unit, wherein the first and second levers are formed to be generally parallel to the moving direction of the first and second levers, and the first and second guide tips provided in the case. It may have first and second guide slots inserted therein.

The fastening unit has first and second handles respectively connected to rear ends of the first and second rods and having a plurality of fixing holes into which the first and second stoppers respectively provided in the first and second levers are inserted. It may further include.

The fixing holes may be disposed on concentric circles with respect to the rotation centers of the first and second handles to achieve a predetermined angle.

The first and second rods have first and second support slots formed along the longitudinal direction of the first and second rods, and the first and second handles are respectively inside the first and second handles. The first and second support shafts may be connected to penetrate the first and second support slots, respectively, and move along the first and second support slots.

The anastomosis device may further include a first support bar connected to the first holder and inserted into a first insertion hole formed at a front end of the first rod.

The first support bar has a first stop groove recessed from an outer circumferential surface, the first rod is inserted into the first stop groove to prevent the first support bar is separated from the first insertion port and the It may be provided with a first release button for disengaging the first stopper from the first stop groove.

The anastomosis device further includes a separation unit for separating the first and second anastomosis rings from the first and second holders, respectively, the separation unit comprising: a separation lever; The first and second anastomosis rings are connected to the separation lever and move together with the separation lever from the first and second holders through first and second through holes respectively formed in the first and second holders. It may include a push bar to push together.

According to the present invention, coronary organs (such as blood vessels) can be easily and quickly anastomated.

Hereinafter, preferred embodiments of the present invention will be described in more detail with reference to FIGS. 1 to 11. Embodiments of the invention may be modified in various forms, the scope of the invention should not be construed as limited to the embodiments described below. These embodiments are provided to explain in detail the present invention to those skilled in the art. Accordingly, the shape of each element shown in the drawings may be exaggerated to emphasize a more clear description.

On the other hand, it will be described below by taking a blood vessel as an example, the technical spirit and scope of the present invention is not limited to this, it can be applied to other coronary organs of the human body other than the blood vessel. For example, coronary organs include organs with tubular structures, such as fallopian tubes, bile ducts, intestines, parotid glands, urethra and ureters, finishing, pancreatic ducts, total hepatic ducts, bile ducts, fallopian tubes, lymphatic vessels, and the like. In addition, the present invention can be applied to various kinds of surgery requiring anastomosis of coronary organs such as blood vessels such as liver, kidney, pancreas, heart transplant.

1 is a view schematically showing an anastomotic device according to the present invention, Figure 2 is an exploded view of FIG. 1 and 2, since the anastomosis apparatus described later is generally symmetrical, the description of the configuration located on one side with respect to the center is generally the same as the description of the configuration located on the other side. In addition, below, a component having a 'first' attached to the dark is located on the left side, and a component having a 'second' attached to the dark is located at the right side.

As shown in FIGS. 1 and 2, the anastomosis device includes a case 10, a lever 20, a holder 32, and rods 34 and 35. The case 10 includes an upper case 12 and a lower case 14, and provides a space in which internal components including the lever 20 and the rods 34 and 35 are installed to protect them from the outside. The lever 20 is provided on both sides of the lower case 14 (or the upper case 12), and when the user grabs the lever 20 by hand, the lever 20 moves toward the center of the lower case 14. do. The lever 20 has a plurality of guide slots 24a, 24b and 24c, and the plurality of guide tips 18a, 18b and 18c provided in the upper case 12 (or lower case 14) are guide slots. Are inserted into the fields 24a, 24b, and 24c, respectively. The guide slots 24a, 24b, and 24c are generally formed in parallel with the moving direction of the lever 20 (or the moving direction of the rods 34 and 35 to be described later) to guide the movement of the lever 20.

One side of the lever 20 is provided with a protective tube 22, the inside of the protective tube 22 is inserted into the jude 35. At this time, the rear end of the main rod 35 is exposed to the outside of the rear end of the protective tube 22. At the rear end of the judo 35, a handle 36 and an elastic body 38 are provided.

The rack gears 35a and 35b are connected to the protective tube 22. Axial supports 16a and 16b are installed between the first and second protection tubes 22, and pinion shafts 53 are provided on the shaft supports 16a and 16b. Both ends of the pinion shaft 53 are connected to the pinion gear 54 meshed with the rack gears 35a and 35b, respectively.

As shown in FIG. 2, the auxiliary rod 34 is connected to the front end of the jude 35. A supporting rod 33 is inserted into the auxiliary rod 34, and a holder 32 fixing the anastomosis ring 40 is connected to one end of the supporting bar 33. A moving hole 19 is formed on the upper case 12, and the separation lever 62 moves along the moving hole 19. The separation lever 62 is connected to the push bar 64 by the connection bar 63, and the push bar 64 moves together with the movement of the separation lever 62.

Hereinafter, each component will be described in detail. 3A and 3B show the rotation of the rods 34, 35 using the handle 36 of FIG. 1. 4 shows the rear end of the rod 35 of FIG. 1, and FIG. 5 shows the handle 36 of FIG. 1. As described above, the handle 36 and the elastic body 38 are installed at the rear end of the jude 35. As shown in FIG. 5, the handle 36 has an internal space 36a, and a support shaft 37 is installed in the internal space 36a. At the rear end of the judo 35, a support slot 35c is formed along the longitudinal direction of the jude 35, and the support shaft 37 is installed through the support slot 35c. The support shaft 37 moves along the support slot 35c and transmits the rotational force of the handle 36 to the jude 35 to rotate the jude 35 together with the hams 36. One end of the elastic body 38 is in contact with the bottom surface of the internal space 36a, and the other end of the elastic body 38 is in contact with the support shaft 37 passing through the support slot 35c. The elastic body 38 returns the support shaft 37 moved along the support slot 35c to its original position, thereby returning the handle 36 moved together with the support shaft 37.

As shown in FIG. 4, a stopper 26 is provided at the rear end of the lever 20. The stopper 26 protrudes from the rear end surface of the lever 20 and is selectively inserted into fixing holes 36b and 36c of the handle 36 to be described later to prevent the rotation of the handle 36. A plurality of fixing holes 36b and 36c are formed at the front end of the handle 36 facing the rear end of the lever 20. The fixing holes 36b and 36c are disposed on concentric circles with respect to the center of the handle 36 and form a predetermined angle α. The predetermined angle is determined by the rotational displacement of the rods 34 and 35 (or the rotational displacement of the anastomosis ring 40). In order to fasten the two anastomosis ring 40, the fixing pin 44 and the fastening hole 46 of the anastomosis ring 40 to be described later and the fastening hole 46 and the fixing pin 44 of the mating anastomosis ring 40 are mutually The anastomosis ring 40 should be disposed to face each other. That is, the anastomosis ring 40 should be disposed to face each other after rotation, and the rotational displacement of the anastomosis ring 40 is the first arrangement of the anastomosis ring 40 (the anastomosis ring 40 is installed in the holder 32 or the anastomosis ring). And the position after the rotation (position for fixing the anastomosis ring 40) after rotation. The predetermined angle is determined according to the rotational displacement of the anastomosis ring 40 (or the rotational displacement of the rods 34 and 35).

As shown in FIG. 3A, when the stopper 26 is inserted into the first fixing hole 36c, the handle 36 may not rotate due to the stopper 26, and the anastomosis ring 40 faces the front side. Is placed. At this time, when the handle 36 is pulled out, the first fixing hole 36c is separated from the stopper 26, and the support shaft 37 moves along the support slot 35c. Thereafter, as shown in FIG. 3B, when the handle 36 is rotated, the rods 34 and 35 are rotated by the support shaft 37, which causes the anastomosis ring 40 to rotate to face each other. At this time, the rotation displacement 36 of the handle 36 is determined by the angle formed by the first fixing hole 36c and the second fixing hole 36b, and the stopper 26 and the second fixing hole 36b correspond to each other. The handle 36 is rotated to a position where the stopper 26 can be inserted into the second fixing hole 36b, and then the pulled handle 36 is released. The elastic body 38 compressed by the support shaft 37 moved along the support slot 35c is expanded by the elastic force and returns the support shaft 37 to its original position. For this reason, the handle 36 is also returned to its original position, and the stopper 26 is inserted into the second fixing hole 36b to prevent the handle 36 from rotating.

6A and 6B are diagrams illustrating a state in which the anastomosis ring 40 is fastened using the lever 20 of FIG. 1. As described above, when the user grabs the lever 20 by hand, the lever 20 moves toward the center of the lower case 14, and the protective tube 22 connected to the lever 20 also moves together with the lever 20. Move. At this time, the rack gears 35a and 35b move together with the protective tube 22, and the pinion gears 54a and 54b engaged with the rack gears 35a and 35b rotate by the movement of the rack gears 35a and 35b. At this time, the upper rack gear and the lower rack gear (35a, 35b) has the same configuration (the number of teeth, pitch, etc.), the upper pinion gear and the lower pinion gear (54a, 54b) has the same configuration (the number of teeth, pitch, etc.) The upper and lower portions of the protective tube 22 move the same distance at the same speed, and the first and second protective tubes 22 may move the same distance at the same speed.

7A and 7B are views showing the operation of the main button 72 and the auxiliary button 76, and FIG. 8 is a view showing the operation of separating the support bar 33 of FIG. 2 from the rod 34. As shown in Figure 7a and 7b, the front end of the auxiliary rod 34 is formed with an insertion hole (34a) is inserted into the support bar 33 is installed, thereby the holder 32 is the front end of the auxiliary rod 34 Is fixed to. In addition, each auxiliary rod 34 is provided with an auxiliary button 76, the upper body of the auxiliary button 76, the pressing body 74 and the main button 72 is installed. When the user presses the main button 72, the pressing body 74 is pressed together with the main button 72, which causes the auxiliary button 76 to be pressed. As shown in FIG. 8, the support bar 33 has a stop groove 33a. The auxiliary button 76 is connected to the rotatable rotary bar 78, and a stopper 78a is provided at the end of the rotary bar 78. The stopper 78a is inserted into the stop groove 33a to prevent the support bar 33 from being separated from the insertion hole 34a. When the user presses the auxiliary button 76 (or the main button 72), the stopper 78a stops. The support bar 33 is separated from the groove 33a so as to be separated from the insertion hole 34a. On the other hand, the main button 72 and the pressing body 74 is connected to the elastic body 75, and is returned to the original position by the elastic body (75).

9 is a view schematically showing the holder 32 and the anastomosis ring 40 of FIG. Holder 32 is formed on the inner side has a sliding groove (32a) is inserted into the anastomosis ring 40, has a through hole (32b) formed on the lower surface. The anastomosis ring 40 has a ring 42 shape corresponding to the blood vessel, and has a plurality of fixing pins 44 and a plurality of fastening holes 46. The fixing pins and the fastening holes 44 and 46 are respectively arranged to form an angle (not shown, but about 60 °) with respect to the center of the anastomosis ring 40, and are alternately disposed. The blood vessel is inserted into the central opening of the anastomosis ring 40 and then fixed to the fixing pin 44 in an inverted state, and the fixing pin 44 penetrates the vessel to prevent the vessel from escaping from the anastomosis ring 40. . An upper end of the fixing pin 44 is provided with an anchor for preventing the passage of blood vessels through. In addition, the anastomosis ring 40 further includes a guide 48 that slides along the sliding groove 32a to fix the anastomosis ring 40 on the holder 32. Guides 48 are provided on both sides of the ring 42.

Meanwhile, the anastomosis ring 40 fixed to the first holder 32 positioned on the left side and the anastomosis ring 40 fixed to the second holder 32 positioned on the right side have a fixing pin 44 and Each of the fastening holes 46 is provided. That is, the two anastomosis rings 40 are fastened to each other by the fixing pin 44 is inserted into the fastening hole 46, the two anastomosis ring 40 is the fastening hole 46 is located at the fixed pin 44 position When the fixing pin 44 or the fastening hole 46 is located at the same position, the anastomosis ring 40 cannot be fastened to each other.

FIG. 10 is a view illustrating a state in which the anastomosis ring 40 of FIG. 1 is installed in a blood vessel, and FIG. 11 is a diagram illustrating an anastomosis method using the anastomosis ring 40 of FIG. 1. As shown in FIG. 10, the anastomosis ring 40 is installed at the end of the open blood vessel, and the fixing pin 44 prevents the vessel from separating from the anastomosis ring 40. By installing each anastomosis ring 40 in two vessels and fastening the anastomosis ring 40, the vessels are anastomated.

Although the present invention has been described in detail with reference to preferred embodiments, other forms of embodiments are possible. Therefore, the spirit and scope of the claims set forth below are not limited to the preferred embodiments.

1 is a view schematically showing an anastomotic device according to the present invention.

2 is an exploded view of FIG. 1.

3A and 3B are views illustrating the rotation of the rod using the handle of FIG. 1.

4 is a view illustrating the rear end of the rod of FIG. 1.

5 is a view illustrating the handle of FIG. 1.

6A and 6B are views illustrating a state in which the anastomosis ring is fastened using the lever of FIG. 1.

7A and 7B are views illustrating operations of the main button and the auxiliary button.

8 is a view illustrating an operation of separating the support bar of FIG. 2 from a rod.

9 is a view schematically showing the holder and the anastomosis ring of FIG.

FIG. 10 is a view illustrating a state in which the anastomosis ring of FIG. 1 is installed in a blood vessel. FIG.

11 is a diagram illustrating an anastomosis method using the anastomosis ring of FIG. 1.

<Description of Symbols for Main Parts of Drawings>

10 case 16 shaft support

18: guide tip 19: moving hole

20: lever 22: protective tube

24: guide slot 26: stopper

32: holder 33: support bar

33a: stop groove 34: auxiliary rod

34a: insertion hole 35: mainly

35a, 35b: Rack Gear 35c: Support Slot

36: handle 36a: interior space

36b, 36c: fixing hole 40: anastomosis ring

42: ring 44: fixed pin

46: fastening hole 48: guide

54: pinion gear 62: release lever

63: connecting bar 64: push bar

72: main button 74: pressing body

76: auxiliary button 78: rotation bar

78a: stopper

Claims (8)

First and second rods having first and second holders respectively fixing the first and second anastomosis rings at the front end thereof; And It includes a fastening unit for moving the first rod toward the second rod, the second rod toward the first rod, The fastening unit, First and second levers respectively connected to the first and second rods to move one of the first and second rods; First and second rack gears connected to the first and second rods to move together with the first and second rods, respectively; A pinion shaft installed between the first and second rods; And And a pinion gear connected to the pinion shaft and engaged with the first and second rack gears to rotate by movement of the first and second rack gears. The method of claim 1, The anastomosis device further includes a case surrounding the fastening unit, The first and second levers have first and second guide slots formed generally parallel to the moving directions of the first and second levers, and into which the first and second guide tips provided in the case are inserted. Anastomosis device. The method of claim 1, The fastening unit has first and second handles respectively connected to rear ends of the first and second rods and having a plurality of fixing holes into which the first and second stoppers respectively provided in the first and second levers are inserted. The anastomosis device further comprising. The method of claim 3, The fixing holes are anastomosis device characterized in that formed on a concentric circle with respect to the center of rotation of the first and second handle to form a predetermined angle. The method of claim 3, The first and second rods have first and second support slots formed along the longitudinal direction of the first and second rods, The first and second handles are respectively connected to the inside of the first and second handles to penetrate the first and second support slots, respectively, and move along the first and second support slots, respectively. An anastomosis device comprising a support shaft each. The method of claim 1, The anastomosis device is a anastomosis device further comprises a first support bar connected to the first holder and inserted into the first insertion hole formed in the front end of the first rod. The method of claim 6, The first support bar has a first stop groove recessed from the outer circumferential surface, The first rod is inserted into the first stop groove to prevent the first support bar from being separated from the first insertion hole, the first stopper and the first stopper to the first stopper. The anastomosis device characterized in that it comprises a first release button to be separated from the stop groove. The method of claim 1, The anastomosis device further includes a separation unit that separates the first and second anastomosis rings from the first and second holders, respectively. The separation unit, Release lever; And The first and second anastomosis rings from the first and second holders through the first and second through holes respectively connected to the separation levers and move together with the separation levers. Anastomotic device comprising a push bar pushed together.

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