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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agraffe
bracket
legs
plane
casing
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RU9393032430A
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Russian (ru)
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RU93032430A (en
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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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Priority to RU9393032430A priority Critical patent/RU2066128C1/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
    • A61B2017/07214—Stapler heads
    • A61B2017/07228—Arrangement of the staples

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  • Surgical Instruments (AREA)

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 equipment and is intended for applying a mechanical stitch when suturing stumps of 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 приводом [1]
Однако известное устройство имеет большие габариты рабочей части, что ограничивает возможность его применения в условиях эндоскопической хирургии и ограниченных размерах операционного поля.Known surgical stapler, comprising a bracket body with a handle, two removable magazines with bracket grooves and pushers located in them, a thrust housing, a movable thrust sponge with a matrix for bending brackets, a trough-like removable fabric stopper connected with it through two axes and closed curly grooves, a mechanism for feeding pushers with three plate wedges, a circular knife for cutting fabric and a screw drive connected to them, a mechanism for closing the bracket and thrust housings with a screw ivodom [1]
However, the known device has large dimensions of the working part, which limits the possibility of its use in endoscopic surgery and the 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 aim of the invention is to reduce the size of the working part of the apparatus, expanding the functionality, simplifying the design of the sewing part and increasing 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 goal is achieved by the fact that each bracket hole is made with exit surfaces oriented in opposite directions, and is located along the longitudinal axis of the apparatus, which are oriented perpendicular to the bracket grooves made in the bracket case, moreover, that the back of the bracket is made arcuate, and the beveled surfaces are located in planes whose intersection line coincides with the plane of the legs.

На фиг. 1 изображен хирургический сшивающий аппарат с разнонаправленным формообразованием скобок, вид сбоку; на фиг.2 вид сверху; на фиг.3 вид сбоку аппарата в раскрытом виде; на фиг; 4 сечение А-А на фиг.1; на фиг.5 - сечение Б-Б на фиг.1; на фиг.6 сечение В-В на фиг.1; на фиг.7 сечение Г-Г на фиг. 11; на фиг.8 сечение Д-Д на фиг.1; на фиг.9 скобка в плане с прямой спинкой; на фиг.10 скобка в плане с арочной спинкой; на фиг.11 скобка, вид сбоку; на фиг. 12 схема деформации скобок; на фиг.13 расположение скобок в шве, вид сбоку; на фиг.14 расположение скобок в шве, вид сверху. In FIG. 1 shows a surgical stapler with multidirectional shaping of brackets, side view; figure 2 is a top view; figure 3 is a side view of the apparatus in an open form; on fig; 4 section AA in figure 1; figure 5 is a section bB in figure 1; figure 6 section bb in figure 1; in Fig.7 section GG in Fig. eleven; in Fig.8 section DD in Fig.1; Fig.9 bracket in plan with a straight back; figure 10 bracket in plan with an arched back; figure 11 bracket, side view; in FIG. 12 brace deformation diagram; on Fig the location of the brackets in the seam, side view; on Fig the location of the brackets in the seam, 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 apparatus contains a trough-shaped bracket body 1 with a handle 2 fixed on it, bracket grooves 3 for the brackets 4, a thrust housing 5 with a matrix 6, on which are located the holes 7 for bending the brackets 4, the fabric stop 8, the screw drive 9 for bringing together the working sewing parts, screw drive 10 for applying brackets 4, knife 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. The screw drive 9 for the information of the working sewing parts is made in the form of a screw with a knurled cylindrical head and a circular groove 12 connected by a thread to the thrust housing 5.

Скобочный корпус 1 имеет корытообразное сечение. 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. Bracket housing 1 has a trough-shaped section. On the side walls 13 of the bracket body 1 there are longitudinal grooves 14 and transverse 15. In the rear part of the body 1 there are longitudinal grooves 16 and a groove 17 for engagement with the circular 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. The thrust housing 5 is made integral with a movable thrust jaw 18, on the lateral surfaces of which there are axes 19 and 20 installed in closed curly 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 thrust jaw 18 there is a socket in which the elastic substrate 23 is placed. The front end of the housing 5 is made in the form of a fork 24, in which the tail of the movable thrust jaw 18 is placed. The housing has protrusions 25 and 26 on both sides that are longitudinal grooves 14 and 16 of the bracket body 1. The tail of the bracket body is connected to the 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 applying brackets 4 consists of a threaded rod 27 connected to the internal thread of the wing nut 28, which is meshed with the screw 9. On the shaft 27 are mounted two plate-shaped wedges-pushers 29 and a circular knife 11 between them with the possibility of rotation relative 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. The cylindrical knurling part of the screw 9 is rotated counterclockwise until it stops, while the axes 19 and 20, sliding along the closed grooves 21 and 22, cause the movable sponge 18 to rotate relative to the axis 19 located in the groove 15 of the bracket body 1.

Губка 18 отходит от переднего конца 30 скобочного корпуса 1, освобождая гнездо 31. Аппарат раскрыт. Скодочные пазы заряжают П-образными металлическими скобками. В таком виде аппарат стерилизуют для операции по ушиванию органов и тканей. The sponge 18 moves away from the front end 30 of the bracket body 1, freeing the socket 31. The device is open. The transverse grooves are charged with U-shaped metal brackets. In this form, the apparatus is sterilized for surgery to suture organs and tissues.

На операции аппарат вводят в узкую и глубокую рану в закрытом виде. Подойдя к оперируемому органу аппарат раскрывают. 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 скобочного корпуса 1, соединяя упорный и скобочный корпуса. Ткань сжимается поверхностями конца 30 скобочного корпуса 1 и матрицей 6 до зазора прошивания. 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. For operations, the apparatus is inserted into a narrow and deep wound in a closed form. Approaching the operated organ, the apparatus is opened. The sutured body is located in the socket 31 of the bracket body 1. The cylindrical knurled part of the screw 9 is rotated clockwise, with the circular groove 12 located in the groove 17, and the axis 19 located at its ends in the transverse grooves 15, and the axis 20, sliding along the figured grooves 21 and 22 of the movable thrust housing 5 cause the movable thrust lip 18 to lower relative to the bracket body 1, bringing the front end of the thrust lip 18 closer to the front end 30 of the bracket housing 1. The protrusions 25 and 26 of the thrust housing 5 are included in the longitudinal grooves 14 and 16 with kobochnogo housing 1, connecting the thrust and bracket housing. The fabric is compressed by the surfaces of the end 30 of the bracket body 1 and the matrix 6 to the flashing gap. Rotating the wing nut 28 in a clockwise direction, the bracket feeding mechanism 9 is fed towards the front end 30 of the bracket body 1. The plate pushing wedges 29, passing under the backs 32 of the brackets 4, push the brackets along the slots 3 towards 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. The legs 33 of the brackets pierce the fabric and rest in the holes 7 of the matrix 6. Each pair of holes for each bracket has an opposite direction perpendicular to the plane of the bracket, and the legs of the brackets have a special sharpening in the form of beveled surfaces 34 made on opposite sides of the plane of the bracket, thus that the directions of the bevels coincide with the directions of the output surfaces of the holes in each pair 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 are U-shaped and can be made with a straight back 32 (Fig. 9), and also to increase the stiffness, the back 32 can be arched (Fig. 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 due to the special direction of the holes in each pair for each bracket, the legs of the brackets are bent into rings in two parallel planes in the opposite direction (Figs. 12, 13 and 14) along the seam axis, firmly connecting the fabric.

Одновременно с прошиванием происходит прорезание ткани. 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. Simultaneously with the stitching, tissue cutting occurs. When the plate wedges-pushers 29 move, the knife 11 cuts partially into the elastic substrate 23. Further movement causes it to rotate due to friction between the substrate 23 and the knife 11. In the seam area, the knife 11 rolls onto the fabric, lifting it under itself and cutting it securely on the elastic the substrate.

После прошивания аппарат раскрывается и извлекается из операционной раны. After flashing, the device opens and is 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. Аппарат обеспечивает герметичность и гемостаз за счет равномерного по всей длине шва зазора прошивания и перекрытия скобочных стежков. The device allows two homogeneous mechanical stitching sutures to be placed on the organs with simultaneous intersection of the tissue between the sutures and provides passage to sutured organs and tissues through trocars and narrow, deep wounds. The device provides tightness and hemostasis due to the uniform stitching gap along the entire length of the seam and overlapping stitch stitches.

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 скобочные пазы, выполненные в скобочном корпусе. 1. A surgical stapler comprising a trough-shaped bracket body with a thrust housing, two pusher wedges with a circular knife, a matrix installed in the thrust housing for bending brackets with two parallel rows of bracket holes, bracket grooves opposite the holes, a sewing clearance selection mechanism and a drive, characterized in that each bracket hole is made with exit surfaces oriented in opposite directions and is located along the longitudinal axis of the apparatus, perpendicular to which are oriented with 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. A bracket containing legs located on the same plane with pointed beveled surfaces on opposite sides and connected to the legs by an arched back located in the plane of the legs, characterized in that the back is arched and the beveled surfaces are located in planes whose intersection line coincides with the plane legs.
RU9393032430A 1993-06-21 1993-06-21 Surgical suture appliance RU2066128C1 (en)

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