RU2066128C1 - Surgical suture appliance - Google Patents

Surgical suture appliance Download PDF

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Publication number
RU2066128C1
RU2066128C1 RU9393032430A RU93032430A RU2066128C1 RU 2066128 C1 RU2066128 C1 RU 2066128C1 RU 9393032430 A RU9393032430 A RU 9393032430A RU 93032430 A RU93032430 A RU 93032430A RU 2066128 C1 RU2066128 C1 RU 2066128C1
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Russia
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agraffe
legs
bracket
plane
casing
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RU9393032430A
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Russian (ru)
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RU93032430A (en
Inventor
Иван Александрович Корольков
Тофик Аскерович Султанов
Сергей Владимирович Колядин
Юрий Вячеславович Копыленко
Валерий Викторович Кузин
Original Assignee
Иван Александрович Корольков
Тофик Аскерович Султанов
Сергей Владимирович Колядин
Юрий Вячеславович Копыленко
Валерий Викторович Кузин
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Application filed by Иван Александрович Корольков, Тофик Аскерович Султанов, Сергей Владимирович Колядин, Юрий Вячеславович Копыленко, Валерий Викторович Кузин filed Critical Иван Александрович Корольков
Priority to RU9393032430A priority Critical patent/RU2066128C1/en
Publication of RU93032430A publication Critical patent/RU93032430A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07228Arrangement of the staples

Abstract

FIELD: medicine, for suture of stumps of hollow organs. SUBSTANCE: surgical suture appliance comprises trough-shaped agraffe casing 1 with thrust casing 5, two wedge-pushers with disc-knife 11 and drive 15, die 6 installed in thrust casing 5 and used for bending of agraffes 4 with two parallel rows of agraffe hollows, agraffe slots 3 positioned opposite the hollows. and mechanism 9 for selection of suture gap; each agraffe hollow has outlet surfaces oriented to opposite sides, and positioned along the appliance longitudinal axis, oriented perpendicularly to which are agraffe slots 3 made in agraffe casing 1. An agraffe has legs located in the same plane with sharpened tapered surfaces on the opposite sides, and an arch back connected to the legs located in the plane of the legs; the leg is arc-shaped, and the tapered surfaces are positioned in planes whose line of intersection coincides with the plane of the legs. EFFECT: enhanced convenience in use. 2 cl, 14 dwg

Description

Изобретение относится к медицинской технике и предназначено для наложения механического скобочного шва при ушивании культей полых органов. The invention relates to medical engineering and is intended for applying mechanical seam at the bracket stump suturing hollow organs.

Известен хирургический сшивающий аппарат, содержащий скобочный корпус с рукояткой, два сменных магазина со скобочными пазами и расположенными в них толкателями, упорный корпус, связанную с ним посредством двух осей и замкнутых фигурных пазов подвижную упорную губку с матрицей для загиба скобок, корытообразный съемный ограничитель ткани, механизм для подачи толкателей с тремя пластинчатыми клиньями, соединенным с ними дисковым ножом для разрезания ткани и винтовым приводом, механизм смыкания скобочного и упорного корпусов с винтовым п Known surgical stapling apparatus comprising the bracket body with a handle and two removable magazine from the bracket slots and disposed therein tappets, thrust housing associated with it by means of two axes and closed shaped grooves movable abutment sponge matrix for bending staples trough-shaped removable stopper tissue a mechanism for feeding pushers with three plate wedges, connected with them a circular blade for cutting tissue and screw drive mechanism and closing the clevis thrust screw housings n иводом [1] ivodom [1]
Однако известное устройство имеет большие габариты рабочей части, что ограничивает возможность его применения в условиях эндоскопической хирургии и ограниченных размерах операционного поля. However, the known device has a large size of the working part, which limits its applicability in terms of endoscopic surgery and limited size of the surgical field.

Целью изобретения является уменьшение размеров рабочей части аппарата, расширение функциональных возможностей, упрощение конструкции шьющей части и повышение ее надежности. The invention aims at reducing the size of the working part of the machine, extension of functional opportunities, to simplify the design stitch parts and improving its reliability.

Данная цель достигается тем, что каждая скобочная лунка выполнена с выходными поверхностями, ориентированными в противоположные стороны, и расположена вдоль продольной оси аппарата, перпендикулярно которой ориентированы скобочные пазы, выполненные в скобочном корпусе, еще тем, что спинка скобой выполнена дугообразной, а скошенные поверхности расположены в плоскостях, линия пересечения которых совпадает с плоскостью ножек. This object is achieved in that each Bracket hole configured to output surfaces oriented in opposite directions and positioned along the longitudinal machine axis perpendicular which are oriented parenthesis grooves formed in the bracket housing by the fact that the back rest bracket is arcuate and tapered surfaces arranged in planes the intersection line of which coincides with the plane of the legs.

На фиг. FIG. 1 изображен хирургический сшивающий аппарат с разнонаправленным формообразованием скобок, вид сбоку; 1 shows a surgical stapler with staples multidirectional shaping, side view; на фиг.2 вид сверху; Figure 2 a top view; на фиг.3 вид сбоку аппарата в раскрытом виде; 3 a side view of the apparatus in an expanded form; на фиг; FIG; 4 сечение А-А на фиг.1; 4 shows a section A-A in Figure 1; на фиг.5 - сечение Б-Б на фиг.1; 5 - section B-B in Figure 1; на фиг.6 сечение В-В на фиг.1; 6 the cross section B-B of Figure 1; на фиг.7 сечение Г-Г на фиг. 7 the cross section YY in FIG. 11; eleven; на фиг.8 сечение Д-Д на фиг.1; 8 the cross section D-D in Figure 1; на фиг.9 скобка в плане с прямой спинкой; 9 parenthesis in terms of the straight-backed; на фиг.10 скобка в плане с арочной спинкой; 10 on the bracket in the plan with an arched back; на фиг.11 скобка, вид сбоку; bracket 11, a side view; на фиг. FIG. 12 схема деформации скобок; 12 circuit brackets deformation; на фиг.13 расположение скобок в шве, вид сбоку; 13 arrangement of staples in the seam, side view; на фиг.14 расположение скобок в шве, вид сверху. 14 location brackets in the joint, the top view.

Аппарат содержит корытообразный скобочный корпус 1 с укрепленной на нем рукояткой 2, скобочными пазами 3 для скобок 4, упорный корпус 5 с матрицей 6, на которой расположены лунки 7 для загиба скобок 4, ограничитель ткани 8, винтовой привод 9 для сведения рабочих шьющих частей, винтовой привод 10 для наложения скобок 4, нож 11 для прорезания ткани. The device comprises a trough-shaped the bracket housing 1 with a strengthened thereon handle 2, the bracket slots 3 staple 4, the thrust body 5 with the matrix 6 on which are arranged holes 7 for bending the brackets 4, limiter tissue 8, the screw actuator 9 for information workers sewing portions, a screw drive 10 for stapling 4, blade 11 for cutting tissue.

Винтовой привод 9 для сведения рабочих шьющих частей выполнен в виде винта с накатанной цилиндрической головкой и круговой проточкой 12, соединенного резьбой с упорным корпусом 5. Screw actuator 9 for information workers sewing portions is formed as a knurled cylindrical head and a circumferential groove 12 connected to the thrust threaded body 5.

Скобочный корпус 1 имеет корытообразное сечение. Brace body 1 has a trough-shaped cross section. На боковых стенках 13 скобочного корпуса 1 выполнены продольные пазы 14 и поперечные 15. В хвостовой части корпуса 1 имеются продольные пазы 16 и паз 17 для зацепления с круговой проточкой 12 винта 9. On the side walls 13 of the bracket housing 1 there are longitudinal grooves 14 and transverse portion 15. In the rear of the housing 1 there are longitudinal grooves 16 and the groove 17 for engaging a circumferential groove 12 of the screw 9.

Упорный корпус 5 выполнен составным с подвижной упорной губкой 18, на боковых поверхностях которой имеются оси 19 и 20, установленные в замкнутых фигурных пазах 21 и 22. Thrust body 5 made integral with the movable abutment jaw 18, on the side surfaces of which are axis 19 and 20 mounted in closed curved grooves 21 and 22.

В центре подвижной упорной губки 18 имеется гнездо, в котором помещается эластичная подложка 23. Передний конец корпуса 5 выполнен в виде вилки 24, в которой размещена хвостовая часть подвижной упорной губки 18. Корпус имеет с двух сторон выступы 25 и 26, которые входят в продольные пазы 14 и 16 скобочного корпуса 1. Хвостовая часть скобочного корпуса соединена с винтом 9. In the center of the movable abutment jaw 18 has a slot in which is placed an elastic substrate 23. The front end of the housing 5 is designed as a fork 24, which is placed in the tail portion of the movable jaw abutment 18. The housing has two sides with protrusions 25 and 26 that are provided in the longitudinal grooves 14 and 16 of the bracket body 1. The rear part of the bracket body is connected to a screw 9.

Винтовой привод 10 для наложения скобок 4 состоит из резьбового стержня 27, соединенного с внутренней резьбой гайки-барашка 28, которая находится в зацеплении с винтом 9. На стержне 27 укреплены два пластинчатых клина-толкателя 29 и дисковый нож 11 между ними с возможностью вращения относительно своей оси. The screw drive 10 for stapling 4 consists of a threaded rod 27 connected to the internally threaded nut a wing 28 which is engaged with a screw 9. On rod 27 fastened two wedge plate-pusher 29 and the circular knife 11 between them rotatably with respect to its axis.

Аппарат работает следующим образом. The device operates as follows.

Цилиндрическую накатку часть винта 9 вращают против часовой стрелки до упора, при этом оси 19 и 20, скользя по замкнутым пазам 21 и 22, заставляют подвижную губку 18 поворачиваться относительно оси 19, находящейся в пазу 15 скобочного корпуса 1. Knurled cylindrical part of the screw 9 is rotated counter-clockwise until it stops, the axes 19 and 20, sliding on the closed grooves 21 and 22, cause the movable jaw 18 to rotate about the axis 19 located in the groove 15, the bracket body 1.

Губка 18 отходит от переднего конца 30 скобочного корпуса 1, освобождая гнездо 31. Аппарат раскрыт. Sponge 18 extends from the front end of the bracket 30 of the body 1, releasing the socket 31. The device is disclosed. Скодочные пазы заряжают П-образными металлическими скобками. Skodochnye grooves charged U-shaped metal brackets. В таком виде аппарат стерилизуют для операции по ушиванию органов и тканей. As such, the apparatus is sterilized for operation of suturing tissues and organs.

На операции аппарат вводят в узкую и глубокую рану в закрытом виде. In operation the apparatus is introduced into a narrow and deep wound in a closed form. Подойдя к оперируемому органу аппарат раскрывают. Going to the affected organ disclose apparatus. Ушиваемый орган располагают в гнезде 31 скобочного корпуса 1. Цилиндрическую накатанную часть винта 9 вращают по часовой стрелке, при этом круговая проточка 12 находится в пазу 17, а ось 19, расположенная своими концами в поперечных пазах 15, и ось 20, скользя по фигурным пазам 21 и 22 перемещающегося упорного корпуса 5 заставляют подвижную упорную губку 18 опускаться относительно скобочного корпуса 1, сближая передний конец упорной губки 18 с передним концом 30 скобочного корпуса 1. При этом выступы 25 и 26 упорного корпуса 5 входят в продольные пазы 14 и 16 с Sutured body disposed in the clevis slot 31 of the housing 1. The cylindrical part of the knurled screw 9 is rotated clockwise, the circular groove 12 is located in the groove 17 and axis 19 is located at its ends in transverse slots 15 and the axle 20, sliding on the shaped grooves 21 and 22 moving the thrust casing 5 causes the movable thrust lip 18 to descend relative to the bracket body 1, bringing together the front end of the abutment jaw 18 with the front end 30 of the bracket body 1. When the projections 25 and 26 are of hard body 5 in the longitudinal grooves 14 and 16 with кобочного корпуса 1, соединяя упорный и скобочный корпуса. kobochnogo body 1, connecting the thrust and the bracket body. Ткань сжимается поверхностями конца 30 скобочного корпуса 1 и матрицей 6 до зазора прошивания. The fabric compressed the end surfaces of the bracket 30 of the body 1 and the die 6 to needling gap. Вращая гайку-барашек 28 по часовой стрелке, механизм 9 подачи скобок подается в сторону переднего конца 30 скобочного корпуса 1. Пластинчатые клинья-толкатели 29, проходя под спинки 32 скобок 4, выталкивают скобки по пазам 3 в сторону матрицы 6 с лунками 7. Rotating the wing nut 28 clockwise, the feeder 9 is supplied brackets toward the front end of the bracket 30 of the housing 1. The plate-pushers wedges 29, passing under the backrest 32 of brackets 4, push brackets along the grooves 3 in the side of the matrix 6 with holes 7.

Ножки 33 скобок прокалывают ткань и упираются в лунки 7 матрицы 6. Каждая пара лунок для каждой скобки имеет противоположное направление, перпендикулярное плоскости скобки, а ножки скобок имеют специальную заточку в виде скошенных поверхностей 34, выполненных с противоположных сторон от плоскости скобки, таким образом, что направления скосов совпадают с направлениями выходных поверхностей лунок в каждой паре для каждом скобки. Feet 33 staples pierce the tissue and the wells abut matrix 7 6. Each pair of holes for each bracket has an opposite direction perpendicular to the plane of the brackets, and the brackets have legs in the form of a special grinding beveled surfaces 34 formed on opposite sides of the plane of the bracket, thus that the bevel directions coincide with the directions of the exit surface in each pair of holes for each bracket.

Скобки имеют П-образную форму и могут быть выполнены с прямой спинкой 32 (фиг.9), а также для увеличения жесткости спинка 32 может иметь арочную форму (фиг.10). The brackets have a U-shape and can be formed with a straight back 32 (Figure 9), as well as to increase the rigidity rest 32 may have an arched shape (Figure 10).

Под воздействием клина-толкателя и благодаря специальному направлению лунок в каждой паре для каждом скобки, ножки скобок загибаются в кольца в двух параллельных плоскостях в противоположном направлении (фиг.12, 13 и 14) вдоль оси шва, прочно соединяя ткань. Under the influence of the wedge-pusher and through special holes in each direction for each pair of brackets, the brackets are bent into rings legs in two parallel planes in the opposite direction (Figures 12, 13 and 14) along the weld axis, fixedly connecting the fabric.

Одновременно с прошиванием происходит прорезание ткани. Simultaneously with stitching going on fabric cutting. При движении пластинчатых клиньев-толкателей 29 нож 11 врезается частично в эластичную подложку 23. Дальнейшее движение вызывает его вращение из-за трения между подложкой 23 и ножом 11. В зоне шва нож 11 накатывается на ткань, поднимая ее под себя и надежно прорезая на эластичной подложке. When driving rocker-plate wedges 29 blade 11 cuts partially into the elastic substrate 23. Further movement causes it to rotate due to the friction between the substrate 23 and the knife 11. The seam blade 11 is rolled onto the fabric by lifting it by himself and reliable cutting through to the elastic substrate.

После прошивания аппарат раскрывается и извлекается из операционной раны. After flashing the device is opened and removed from the surgical wound.

Аппарат позволяет накладывать на органы два однородных механических скобочных шва с одновременным пересечением ткани между швами и обеспечивает проход к ушиваемым органам и тканям через троакары и узкие, глубокие раны. The device allows to impose on the bodies of two homogeneous weld mechanical bracketed with simultaneous intersection seams between the fabric and provides a passageway to the organs and tissues are sutured through the trocars and narrow, deep wounds. Аппарат обеспечивает герметичность и гемостаз за счет равномерного по всей длине шва зазора прошивания и перекрытия скобочных стежков. The device provides sealing and hemostasis due to uniform throughout the length of the weld gap and overlap sewing stitch bracketed.

Claims (2)

1. Хирургический сшивающий аппарат, содержащий корытообразный скобочный корпус с упорным корпусом, два клина-толкателя с дисковым ножом, установленную в упорном корпусе матрицу для загиба скобок с двумя параллельными рядами скобочных лунок, размещенные напротив лунок скобочные пазы, механизм выбора зазора пришивания и привод, отличающийся тем, что каждая скобочная лунка выполнена с выходными поверхностями, ориентированными в противоположные стороны, и расположена вдоль продольной оси аппарата, перпендикулярно которой ориентированы с 1. A surgical stapler, comprising a trough-shaped casing with the bracket abutment body, two wedge-follower rotary knife mounted in the thrust housing matrix for bending the brackets with two parallel rows bracketed holes arranged opposite holes parenthesis grooves selection mechanism sewing gap and an actuator characterized in that each hole is formed with Bracket output surfaces oriented in opposite directions and positioned along the longitudinal axis of the apparatus, which are oriented perpendicularly with обочные пазы, выполненные в скобочном корпусе. obochnye grooves formed in the bracket body.
2. Скобка, содержащая размещенные в одной плоскости ножки с заостренными скошенными поверхностями на противоположных сторонах и соединенную с ножками арочную спинку, расположенную в плоскости ножек, отличающаяся тем, что спинка выполнена дугообразной, а скошенные поверхности расположены в плоскостях, линия пересечения которых совпадает с плоскостью ножек. 2. The bracket comprising arranged coplanar legs with sharpened beveled surfaces on opposite sides of and connected to the back legs of the arch, located in the plane of the legs, characterized in that the back rest is arcuate, and beveled surfaces disposed in planes the intersection line of which coincides with the plane legs.
RU9393032430A 1993-06-21 1993-06-21 Surgical suture appliance RU2066128C1 (en)

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