RU2066128C1 - Surgical suture appliance - Google Patents
Surgical suture appliance Download PDFInfo
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- 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
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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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Abstract
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-
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
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
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
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
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
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
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
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
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
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
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-
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.
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RU9393032430A RU2066128C1 (en) | 1993-06-21 | 1993-06-21 | Surgical suture appliance |
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RU9393032430A RU2066128C1 (en) | 1993-06-21 | 1993-06-21 | Surgical suture appliance |
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RU93032430A RU93032430A (en) | 1995-11-20 |
RU2066128C1 true RU2066128C1 (en) | 1996-09-10 |
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RU9393032430A RU2066128C1 (en) | 1993-06-21 | 1993-06-21 | Surgical suture appliance |
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