RU2013119977A - SURGICAL CUTTING AND STITCHING TOOLS WITH SEPARATE AND SEPARATE SYSTEMS FOR FASTENING FASTENING ELEMENTS AND CUTTING TISSUE - Google Patents

SURGICAL CUTTING AND STITCHING TOOLS WITH SEPARATE AND SEPARATE SYSTEMS FOR FASTENING FASTENING ELEMENTS AND CUTTING TISSUE Download PDF

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RU2013119977A
RU2013119977A RU2013119977/14A RU2013119977A RU2013119977A RU 2013119977 A RU2013119977 A RU 2013119977A RU 2013119977/14 A RU2013119977/14 A RU 2013119977/14A RU 2013119977 A RU2013119977 A RU 2013119977A RU 2013119977 A RU2013119977 A RU 2013119977A
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specified
trigger
surgical instrument
scalpel
jaw
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RU2013119977/14A
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Russian (ru)
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RU2599210C2 (en
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Джером Р. МОРГАН
IV Фредерик Э. ШЕЛТОН
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Этикон Эндо-Серджери, Инк.
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Priority claimed from US12/894,351 external-priority patent/US9113864B2/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation

Abstract

1. Хирургический инструмент, содержащий:узел рукоятки;удлиненную цапфу, функционально соединенную с указанным узлом рукоятки и выступающую из него;рабочий инструмент, имеющий проксимальный конец, функционально соединенный с указанной удлиненной цапфой, причем указанный рабочий инструмент имеет первую браншу, выполненную с возможностью избирательного перемещения относительно второй бранши под действием сообщаемых ей пусковых движений;рабочий элемент, поддерживаемый с возможностью перемещения относительно указанной удлиненной цапфы и выполненный с возможностью избирательного сообщения указанных пусковых движений указанной второй бранше указанного рабочего инструмента для перемещения указанной второй бранши из открытого положения в закрытые положения;пусковой крючок, поддерживаемый указанным узлом рукоятки и функционально взаимодействующий с указанным рабочим элементом, заставляя указанный рабочий элемент сообщать указанные пусковые движения указанной второй бранше; исистему рассечения, выполненную с возможностью избирательного приведения в действие и содержащую:скальпель, поддерживаемый с возможностью перемещения относительно указанной удлиненной цапфы и выполненный с возможностью перемещения из неактивированного положения рядом с указанным проксимальным концом указанного рабочего инструмента в активированное положение на дистальном конце указанного рабочего инструмента под действием сообщаемого ему рассекающего движения, которое независимо от указанного пускового движения; испусковой механизм продвижения скальпеля, поддерживаемый указанным узлом рукоятки и функционально в1. A surgical tool comprising: a handle assembly; an elongated trunnion operably connected to and protruded from said handle assembly; a working instrument having a proximal end operably connected to said elongated trunnion, said working tool having a first jaw configured to selectively movement relative to the second jaw under the action of triggering movements communicated to it; a working element supported with the ability to move relative to the specified elongated pins s and configured to selectively communicate said starting movements of said second branch of said working tool to move said second branch from open to closed positions; a trigger hook supported by said handle assembly and operably interacting with said working element, causing said working element to communicate said starting the movement of the specified second branch; a dissection system configured to selectively actuate and comprising: a scalpel supported to move relative to said elongated trunnion and configured to move from an inactive position near said proximal end of said working tool to an activated position on the distal end of said working tool the cutting motion that is communicated to him, which is independent of the specified starting motion; a scalpel emitting mechanism supported by said handle assembly and functionally in

Claims (20)

1. Хирургический инструмент, содержащий:1. A surgical instrument containing: узел рукоятки;handle assembly; удлиненную цапфу, функционально соединенную с указанным узлом рукоятки и выступающую из него;an elongated trunnion, functionally connected to and indicated from the handle assembly; рабочий инструмент, имеющий проксимальный конец, функционально соединенный с указанной удлиненной цапфой, причем указанный рабочий инструмент имеет первую браншу, выполненную с возможностью избирательного перемещения относительно второй бранши под действием сообщаемых ей пусковых движений;a working tool having a proximal end operably connected to said elongated trunnion, said working tool having a first jaw configured to selectively move relative to the second jaw under the action of triggered movements communicated to it; рабочий элемент, поддерживаемый с возможностью перемещения относительно указанной удлиненной цапфы и выполненный с возможностью избирательного сообщения указанных пусковых движений указанной второй бранше указанного рабочего инструмента для перемещения указанной второй бранши из открытого положения в закрытые положения;a working element supported with the ability to move relative to the specified elongated trunnion and configured to selectively communicate the indicated starting movements of the specified second branch of the specified working tool to move the specified second branch from the open position to the closed position; пусковой крючок, поддерживаемый указанным узлом рукоятки и функционально взаимодействующий с указанным рабочим элементом, заставляя указанный рабочий элемент сообщать указанные пусковые движения указанной второй бранше; иa trigger supported by the specified node of the handle and functionally interacting with the specified work item, forcing the specified work item to report the specified trigger movements to the specified second branch; and систему рассечения, выполненную с возможностью избирательного приведения в действие и содержащую:a dissection system configured to selectively actuate and comprising: скальпель, поддерживаемый с возможностью перемещения относительно указанной удлиненной цапфы и выполненный с возможностью перемещения из неактивированного положения рядом с указанным проксимальным концом указанного рабочего инструмента в активированное положение на дистальном конце указанного рабочего инструмента под действием сообщаемого ему рассекающего движения, которое независимо от указанного пускового движения; иa scalpel supported with the ability to move relative to the specified elongated trunnion and made with the ability to move from an inactive position near the specified proximal end of the specified working tool to the activated position at the distal end of the specified working tool under the action of the cutting movement that is communicated to it, which is independent of the specified starting movement; and спусковой механизм продвижения скальпеля, поддерживаемый указанным узлом рукоятки и функционально взаимодействующий с указанным скальпелем, необязательно сообщая ему указанное рассекающее движение.the trigger mechanism for promoting the scalpel, supported by the specified node of the handle and functionally interacting with the specified scalpel, optionally informing him the specified cutting movement. 2. Хирургический инструмент по п. 1, в котором указанная первая бранша выполнена с возможностью функционально удерживать в себе кассету со скобами.2. The surgical instrument according to claim 1, wherein said first branch is configured to functionally hold a cassette with brackets. 3. Хирургический инструмент по п. 2, в котором указанные закрытые положения по меньшей мере содержат максимальное фиксирующее положение, в котором указанная вторая бранша расположена относительно верхней поверхности кассеты со скобами для обеспечения фиксации между ними ткани без формирования скоб в кассете со скобами, и полностью активированное положение, в котором скобы полностью сформированы.3. The surgical instrument according to claim 2, wherein said closed positions at least comprise a maximum locking position in which said second jaw is located relative to the upper surface of the cassette with staples to allow tissue to be fixed between them without forming staples in the cassette with staples, and completely activated position in which the braces are fully formed. 4. Хирургический инструмент по п. 3, дополнительно содержащий средство для предотвращения непреднамеренной дальнейшей активации указанного пускового крючка после перемещения указанной второй бранши в указанное максимальное фиксирующее положение.4. The surgical instrument according to claim 3, further comprising means for preventing unintentional further activation of said trigger after moving said second jaw to said maximum locking position. 5. Хирургический инструмент по п. 4, в котором указанное средство для предотвращения представляет собой рабочий освобождающий элемент, поддерживаемый с возможностью перемещения на указанном узле рукоятки и выполненный с возможностью избирательного перемещения между положением зацепления, в котором указанный пусковой крючок защищен от непреднамеренной активации после перемещения указанной второй бранши в указанное максимальное фиксирующее положение, и положением расцепления, в котором указанный пусковой крючок может быть активирован.5. The surgical instrument according to claim 4, wherein said means for preventing is a working release member supported to move on said handle assembly and configured to selectively move between the engaging position, wherein said trigger hook is protected against unintentional activation after movement the specified second jaw to the specified maximum locking position, and the release position in which the specified trigger can be activated n 6. Хирургический инструмент по п. 3, в котором указанный пусковой крючок выполнен с возможностью избирательного перемещения из исходного положения, соответствующего указанному открытому положению указанной второй бранши, в конечное положение, соответствующее указанному полностью активированному положению, и причем указанный хирургический инструмент дополнительно содержит конструкцию фиксации пускового крючка для фиксации с возможностью высвобождения указанного пускового крючка в указанном конечном положении.6. The surgical instrument of claim 3, wherein said trigger is selectively movable from a starting position corresponding to said open position of said second jaw to an end position corresponding to said fully activated position, and wherein said surgical tool further comprises a locking structure trigger for fixing with the possibility of releasing the specified trigger in the specified end position. 7. Хирургический инструмент по п. 6, в котором указанный спусковой механизм продвижения скальпеля невозможно активировать, пока указанный пусковой крючок находится в указанном конечном положении.7. The surgical tool according to claim 6, in which the specified trigger mechanism for advancing the scalpel cannot be activated while the specified trigger is in the specified end position. 8. Хирургический инструмент по п. 6, дополнительно содержащий элемент блокировки скальпеля, функционально поддерживаемый указанным узлом рукоятки и взаимодействующий с возможностью перемещения с указанным спусковым механизмом продвижения скальпеля и указанным пусковым крючком таким образом, что указанный элемент блокировки скальпеля зацепляет с возможностью блокировки указанный спусковой механизм продвижения скальпеля во время активации указанного пускового крючка и расцепляет указанный спусковой механизм продвижения скальпеля при перемещении указанного пускового крючка в указанное конечное положение.8. The surgical instrument according to claim 6, further comprising a scalpel blocking element operably supported by said handle assembly and cooperating with the possibility of moving with said scalpel trigger and said trigger in such a way that said scalpel blocking element locks said trigger advancing the scalpel during activation of said trigger and disengages said trigger mechanism for advancing the scalpel When moving the trigger in said specified end position. 9. Хирургический инструмент по п. 1, в котором указанный проксимальный конец указанного рабочего инструмента выполнен с возможностью съемного соединения с указанной удлиненной цапфой, и причем рабочий элемент выполнен с возможностью избирательного перемещения в соединенное положение, в котором указанный рабочий элемент удерживает указанный проксимальный конец указанного рабочего инструмента в сцеплении с указанной цапфой.9. The surgical instrument according to claim 1, wherein said proximal end of said working tool is removably connected to said elongated trunnion, and wherein the working element is selectively moved to a connected position in which said working element holds said proximal end of said working tool in coupling with the specified pin. 10. Хирургический инструмент по п. 9, дополнительно содержащий узел блокировки рабочего инструмента для блокировки с возможностью высвобождения указанного рабочего элемента в указанном соединенном положении.10. The surgical instrument according to claim 9, further comprising a locking unit for the working tool for locking with the possibility of releasing said working element in said connected position. 11. Хирургический инструмент, содержащий:11. A surgical instrument containing: первую браншу, выполненную с возможностью функционального поддерживания в ней имплантируемой кассеты со скобами;the first jaw made with the possibility of functional support in it of an implantable cassette with brackets; вторую браншу, поддерживаемую с возможностью перемещения относительно указанной первой бранши и выполненную с возможностью избирательного перемещения из открытого положения, в котором указанная вторая бранша находится на расстоянии от указанной имплантируемой кассеты со скобами в указанной первой бранше, в закрытые положения, в которых указанная вторая бранша сжимает указанную имплантируемую кассету со скобами между указанными первой и второй браншами под действием сообщаемого ей пускового движения; иa second jaw supported to move relative to said first jaw and selectively moved from an open position in which said second jaw is spaced from said implantable cassette with brackets in said first jaw to closed positions in which said second jaw compresses the specified implantable cassette with brackets between the specified first and second branches under the action of the triggered movement; and скальпель, функционально поддерживаемый относительно указанных первой и второй браншей и выполненный с возможностью избирательного перемещения из неактивированного положения на первом конце указанной первой бранши в активированное положение на втором конце указанной первой бранши под действием сообщаемого ему рассекающего движения, которое независимо от указанного пускового движения.a scalpel functionally supported with respect to said first and second branches and made with the possibility of selective movement from an inactive position at the first end of said first branch to an activated position at the second end of said first branch under the action of a cutting motion that is communicated to him, which is independent of said starting motion. 12. Хирургический инструмент по п. 11, в котором указанное пусковое движение избирательно сообщается указанной второй бранше взаимодействующей с ней режуще-сшивающей системой.12. The surgical instrument according to claim 11, wherein said starting movement is selectively communicated to said second branch by a cutting-crosslinking system interacting with it. 13. Хирургический инструмент по п. 12, в котором указанная режуще-сшивающая система выполнена с возможностью активации посредством пускового крючка, приводимого в действие вручную.13. The surgical instrument of claim 12, wherein said cutting and stitching system is operable by manual activation of a trigger hook. 14. Хирургический инструмент по п. 13, в котором указанное рассекающее движение избирательно сообщается указанному скальпелю взаимодействующей с ним системой рассечения.14. The surgical instrument of claim 13, wherein said dissecting movement is selectively communicated to said scalpel by an dissection system interacting with it. 15. Хирургический инструмент по п. 14, в котором указанная система рассечения содержит:15. The surgical instrument of claim 14, wherein said dissection system comprises: зубчатую передачу привода системы рассечения, функционально взаимодействующую с указанным скальпелем; иa gear drive of the dissection system drive, functionally interacting with the specified scalpel; and спусковой механизм продвижения скальпеля, функционально взаимодействующий с указанной зубчатой передачей привода системы рассечения, причем указанный спусковой механизм продвижения скальпеля функционально не зависит от указанного пускового крючка.the trigger mechanism for promoting the scalpel, functionally interacting with the specified gear transmission of the drive of the dissection system, and the trigger mechanism for promoting the scalpel is functionally independent of the specified trigger. 16. Хирургический инструмент по п. 12, в котором указанные закрытые положения по меньшей мере содержат максимальное фиксирующее положение, в котором указанная вторая бранша расположена относительно верхней поверхности кассеты со скобами для обеспечения фиксации между ними ткани без формирования скоб в кассете со скобами, и полностью активированное положение, в котором скобы полностью сформированы.16. The surgical instrument of claim 12, wherein said closed positions at least comprise a maximum locking position in which said second jaw is located relative to the upper surface of the cassette with staples to secure tissue between them without forming staples in the cassette with staples, and completely activated position in which the braces are fully formed. 17. Хирургический инструмент по п. 16, дополнительно содержащий предохранитель режуще-сшивающей системы, взаимодействующий с указанной режуще-сшивающей системой для предотвращения непреднамеренной дальнейшей активации указанной режуще-сшивающей системы после перемещения указанной второй бранши в указанное максимальное фиксирующее положение.17. The surgical instrument according to claim 16, further comprising a fuse for the cutting-crosslinking system interacting with said cutting-crosslinking system to prevent inadvertent further activation of said cutting-crosslinking system after moving said second jaw to said maximum locking position. 18. Хирургический инструмент по п. 16, в котором указанное рассекающее движение сообщается системой рассечения, которая взаимодействует с указанным скальпелем, причем указанная система рассечения остается неактивированной, пока указанная вторая бранша находится в указанном полностью активированном положении.18. The surgical instrument of claim 16, wherein said dissecting movement is communicated by a dissection system that interacts with said scalpel, wherein said dissection system remains inactive while said second jaw is in said fully activated position. 19. Хирургический инструмент, содержащий:19. A surgical instrument comprising: узел рукоятки;handle assembly; узел удлиненного ствола, прикрепленный с возможностью вращения к указанному узлу рукоятки и выполненный с возможностью избирательного вращения вокруг продольной оси относительно указанного узла рукоятки, причем указанный узел удлиненного ствола содержит:the node of the elongated barrel, mounted rotatably to the specified node of the handle and made with the possibility of selective rotation around the longitudinal axis relative to the specified node of the handle, and the specified node of the elongated barrel contains: удлиненную цапфу, имеющую дистальный конец; иan elongated trunnion having a distal end; and рабочую трубку, выполненную с возможностью аксиального перемещения по указанной удлиненной цапфе, и причем указанный хирургический инструмент дополнительно содержит:a working tube made with the possibility of axial movement along the specified elongated trunnion, and moreover, the specified surgical instrument further comprises: рабочий инструмент, содержащий:work tool containing: удлиненный канал, выполненный с возможностью соединения с указанным дистальным концом указанной удлиненной цапфы для совместного перемещение с возможностью вращения вокруг указанной продольной оси; иan elongated channel, made with the possibility of connection with the specified distal end of the specified elongated axle for joint movement with the possibility of rotation around the specified longitudinal axis; and упор, поддерживаемый с возможностью перемещения относительно указанного удлиненного канала и выполненный с возможностью перемещения между открытым положением и закрытыми положениями под действием пусковых движений, сообщаемых ему указанной рабочей трубкой, и причем указанный хирургический инструмент дополнительно содержит:an emphasis supported with the possibility of movement relative to the specified elongated channel and made with the possibility of movement between the open position and the closed positions under the action of the starting movements communicated to him by the specified working tube, and wherein said surgical instrument further comprises: пусковой крючок, функционально поддерживаемый на указанном узле рукоятки и взаимодействующий с указанной рабочей трубкой таким образом, что активация указанного пускового крючка воздействует на указанную рабочую трубку для сообщения пусковых движений указанному упору;trigger, functionally supported on the specified node of the handle and interacting with the specified working tube so that the activation of the specified trigger acts on the specified working tube to communicate the starting movements of the specified stop; скальпель, поддерживаемый с возможностью перемещения внутри указанного удлиненного ствола и выполненный с возможностью избирательного перемещения из неактивированного положения рядом с указанным дистальным концом указанной цапфы в активированное положение на дистальном конце указанного удлиненного канала под действием сообщаемого ему рассекающего движения, которое независимо от указанного пускового движения; иa scalpel supported with the ability to move inside the specified elongated shaft and made with the possibility of selective movement from an inactive position near the specified distal end of the specified trunnion to the activated position at the distal end of the specified elongated channel under the action of the cutting movement that is communicated to it, which is independent of the specified starting motion; and спусковой механизм продвижения скальпеля, функционально поддерживаемый на указанном узле рукоятки и взаимодействующий с указанной трубкой скальпеля для избирательного сообщения ей указанного рассекающего движения.the trigger mechanism for promoting the scalpel, functionally supported on the specified node of the handle and interacting with the specified tube of the scalpel to selectively communicate to it the specified dissecting movement. 20. Хирургический инструмент по п. 19, в котором указанный удлиненный канал выполнен с возможностью удерживать в себе имплантируемую в него кассету со скобами. 20. The surgical instrument of claim 19, wherein said elongated channel is configured to hold an implantable cassette with brackets therein.
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