RU2720163C2 - Surgical circular stapler automatic handle system and surgical circular stapler - Google Patents

Abstract

FIELD: medical equipment.SUBSTANCE: group of inventions refers to an automatic handle of a surgical circular stapler used in a surgical anastomosis, particularly intended for application of intestinal anastomoses. System of automatic handle of surgical circular stapler for connection of fabric fragments consists of handle placed in lugs on housing, fastening element, handle spring, traction system, pusher system. Traction system includes a needle, a tie-rod, a lead screw, which ends with a rotary handle, and a support element of the rotary handle. Pusher system comprises a pusher proximal element, a pusher tube and a pusher distal element. Draft system and pusher system are arranged in the housing. Automatic handle system comprises hook and deadbolt. Hook is made in the form of a bolt with ledge located in contact zone with traction system and is installed with possibility of rotation on pin-bolt in handle. Hook, being in position locking handle, rests on lower surface of housing tube, and being in position, unlocking handle, under pressure cross bar protrudes from housing pipe, which blocks it. Bolt is made in form of protrusion located in traction system at distance selected so that after setting gap between anvil and charge with width of 1 mm, deadbolt presses on hook, unlocking it. Surgical circular stapler for connection of tissue fragments comprises a divider, a connecting unit, a handle, an indicator, a pusher system, as well as the above automatic handle system. Dividing, connecting unit is installed on the body, contains a charge and is connected to the anvil by means of the traction system. Traction system includes a needle, a tie-rod, a dead bolt, a lead screw, which ends with a rotary handle. Pusher system includes a proximal pusher element, a pusher tube and a pusher distal element. Draft system and pusher are arranged in housing.EFFECT: group of inventions is characterized by that it comprises a system for automatic unlocking of the stapler handle, which is simultaneously safe for the operator due to use of the element locking the handle from unintentional and uncontrolled start of the surgical staples.2 cl, 5 dwg

Description

The essence of the invention is a system for the automatic handle of a surgical circular stapler used in a surgical anastomosis, in particular, intended for the application of inter-intestinal anastomoses, the anastomosis being performed using surgical brackets. A subject of the invention is also a circular stapler comprising an automatic pen system.

A circular stapler for stapling is known from EP 2524654 A2, which comprises a drive shaft, a starting belt and a friction reducing element. The drive shaft is designed to set the distance between the anvil system and the staple head system. The trigger belt is designed to start and activate the staple head system in order to release the staples. The trigger belt forms a first contact surface facing the corresponding second contact surface formed on the drive shaft.

From the document US 20150083772, a surgical circular stapler is known which has a housing, a shaft, a stapling unit, an engine, a cam unit and a starting unit. The shaft / body extends distally from the housing. The stapling unit attaches to the far end of the body. The longitudinal movement of the launch block leads to the fact that the stapling block launches many brackets in a circular pattern to provide two lumens of fabric together. The stapling unit may also guide the blade to cut off excess tissue within the circular brace system. The engine is adapted to rotate the cam block. Rotation of the cam block results in a longitudinal movement of the trigger block. Separate rotation of the cam block is adapted to drive the launch block from the proximal position to the distal position and back to the proximal position.

From the description of WO 2014139440, a surgical stapler is known which includes a handle part, an elongated body extending distally from the handle, and a distal part of the head including an anvil and a removable stapling unit. The replaceable stapling unit includes a pusher and many brackets. The pusher is movable to remove the staples from the interchangeable stitching unit. The launch block is located between the handle part and the removable stapling unit and contains a pusher that is detachably coupled to the pusher shaft. The proximity unit is driven to move the support member relative to the interchangeable stapling unit.

Devices known from the prior art consist of a stapling head (a ring inside which there is a cassette for many surgical staples, a concentric anvil mounted on a latch on the movable shaft relative to the ring, the anvil is used to clamp surgical staples and an element that moves the staples out of the ring through The anvil-triggering system consists of a rotary knob that enables movement and determination of the appropriate distance of the anvil / ring, with control with a correctly specified clearance, the anvil / clearance is possible by observing the location of the pointer in an appropriate place in the window, a safety bolt that does not allow the staples to be activated in an uncontrolled manner, while allowing the movement of the anvil and the lever, the movement of which causes the clamp to be clamped. the system is connected using a roller element.

Known devices for stapling using many brackets work as follows: firstly, rotation with the rotary handle provides an appropriate distance between the anvil and the charge, and then the safety bolt is folded, which acts on the lever, which causes the brackets to move through the stitched fabric, and then clamp them in the anvil.

Unfortunately, known solutions have some disadvantages. The handle is manually unlocked, which means that after reaching the appropriate clearance (1 mm), the operator needs to perform additional movement with his second hand to unlock it.

The aim of the invention was to create a system for automatically unlocking the handle of the stapler, which at the same time is safe for the operator through the use of an element that blocks the handle from the unintentional and uncontrolled launch of surgical clips.

The solution according to the invention lies in the fact that the deadbolt is located on the rod, which, when the spindle rotates, moves towards the proximal pusher element and leads to the release of the hook (the element that blocks the handle from unintentional triggering of surgical staples). After unlocking the hook (and therefore the handle), surgical brackets can be triggered. Pressing the handle moves the pusher tube, which acts on the charge pusher, causing the launch of surgical brackets. The springs in the handle strain the hook, which prevents uncontrolled triggering of surgical braces.

The solution according to the invention allows the operator to safely use the circular stapler during the operation of connecting tissues, for example, the intestines, because if the handle is locked, which occurs when the gap is more than 1.5 mm, it is impossible to start surgical braces. Thus, the risk that the stapler starts by accidentally pressing the handle is limited. The need to manually unlock the handle is also eliminated. With the appropriate size of the gap between the anvil and the charge, the handle is active, that is, it is possible to start the charge.

The essence of the invention is a system of an automatic handle of a circular stapler for connecting fragments of tissue, which consists of a handle placed in the ears on the body; fastener; handle springs; traction systems, including a needle, traction, lead screw and support element; rotary knob; as well as a pusher system containing a proximal pusher element, a pusher tube and a distal pusher element, characterized in that it contains a hook made in the form of a bolt with a protrusion located in the zone of contact with the traction system, mounted for rotation on a pin-bolt in the handle moreover, the hook, being in the position blocking the handle, rests on the lower surface of the pipe of the body, but being in the position of the locking handle, under the pressure of the bolt protrudes from the pipe of the body, which blocks it; and also a bolt in the form of a protrusion located in the traction system at a distance selected in such a way that after setting the gap between the anvil and the charge 1 mm wide, the bolt pressed the hook, unlocking it.

Another objective of the present invention is a circular stapler for connecting fragments of tissue, containing a divisible, connecting unit mounted on the housing, containing a charge connected to the anvil using a traction system; a pen, indicator, rotary knob, as well as a pusher system, characterized in that it includes the automatic pen system described above.

The circular surgical stapler is used in general surgery, thoracic surgery, bariatric surgery, in the resection of the colon and rectum, to perform anastomosis end to end, end to side and side to side throughout the gastrointestinal tract. Before the first use, the stapler must be washed away from the remnants of the preservative and sterilized in an autoclave. After each use, the stapler must be washed and sterilized so that it can be used again. This applies only to the device itself, since the charges and anvil are supplied sterile and are intended for single use. The sterile charge should be screwed clockwise onto the distal part of the stapler. Preparation for the use of a stapler requires the application of purse string sutures on both ends connected. Then, using the rotary knob in a clockwise direction, completely hide the needle in the device body. The anvil is inserted into the lumen of the organ and clamps the purse string suture on the section of the purse string suture. Then, a circular stapler with the anvil disconnected is introduced into the second part of the connected organ until the lumen is closed. When turning the rotary knob counterclockwise, pull out the needle completely, piercing the closed organ lumen. The next step is the sliding of the fabric to the base of the needle, revealing the area of bond of the seam. Then connect the body of the anvil with the needle. A prerequisite for proper connection is a clearly audible click. Then, the gap (gap) between the anvil and the charge is determined by turning the rotary knob clockwise. When the indicator indicates the appropriate value (1 mm), the bolt unlocks the hook and then the handle. The stapler is ready to use. To perform the anastomosis, press the handle with a strong and steady movement. Then you should release the handle, which will return to its original position. When turning the rotary knob in a counterclockwise direction, no more than 2 to 3 turns will result in order to remove the anvil from the charge. The stapler should be removed using gentle jerking backward with an oscillating motion. After removal of the single-use stapling unit, the integrity of the anastomosis should be checked, and the tissue resected by the circular knife should be carefully checked to see if it forms a complete ring and also includes all layers around the entire circumference.

The automatic handle system according to the invention includes a handle placed in the ears on the housing, a fastener, a hook, a handle spring and a hook spring, a traction system including a needle, a traction, a deadbolt, a lead screw and a support member, a rotary handle, and a pusher system comprising a proximal pusher member, a pusher tube and a distal pusher member.

The subject matter of the invention is shown as an example of its execution and in the figure in which FIG. 1 is a cross-sectional view of part of a circular stapler, FIG. 2 is a cross-sectional view of a circular stapler spanning a handle system, the hook being in the unlocked position, FIG. 3 is a cross-sectional view of a circular stapler spanning a handle system, the hook being in a locked position, FIG. 4 is a perspective view of a circular stapler according to the invention, FIG. 5 is a cross-sectional view of a portion of the circular stapler in the handle region, taking into account the proximal end of the circular stapler.

The circular stapler contains a divisible disposable unit with the connecting unit 1 located on the traction system of the housing 2. The disposable connecting unit 1 has a charge 3 located opposite the anvil 4 placed on the needle 20. Inside the charge 3 is placed a ring 10 containing a set of surgical staples 15 located opposite the anvil 4 mounted slidably on the housing 2 comprising a handle 5 and a traction system 19, which consists of a needle 20, a traction 22, a bracket for the traction 21, a bolt 23 and a spindle 24 completed with a rotary handle 7, in which topic rods located within the housing 2.

The circular stapler inside the casing 2 also contains a pusher system 25, consisting of a pusher tube 26, a proximal pusher element 27 and a distal pusher element 28, the distal pusher element 28 having a cylindrical shape, and adapted to the inner surface of the casing 2. On the casing 2 in its proximal area is placed automatic pen 5.

The system of the automatic handle of the circular stapler, which consists of a handle 5 placed in the ears 35 on the housing 2, the fastener 31, the hook 30, the spring of the handle 32 and the spring of the hook 33, the traction system 19, consisting of a needle 20, traction 22, lead screw 24 and a support member 21, a rotary handle 7, a pusher system comprising a proximal pusher member 27, a pusher tube 26 and a distal pusher member 28.

The rotation of the rotary knob 7 leads to the movement of the thrust system 19, consisting of a needle 20 (the anvil 4 approaches the charge 3) of the thrust 22, the bolt 23, the supporting elements 21, as well as the bolt 23. After reaching the distance between the anvil 4 and the charge 3 of A 1 mm deadbolt 23 presses on the hook 30, causing it to slide and release, unlocking the handle 5. Obtaining a distance of 1 mm is shown using the pointer 6 shown in FIG. 4 and FIG. 5. Only then is it possible to start surgical staples. When the gap is greater than 1.5 mm, the hook 30 is blocked by the housing 2, and accidental unlocking is prevented by the spring of the hook 33). Pressing the handle 5 located in the proximal element of the pusher 27 leads to the movement of the tube of the pusher 26 and the distal element of the pusher 28. The distal element of the pusher 28 then pushes the charge pusher 11 located in the charge body 9. The charge pusher 11 leads to the pushing out of surgical staples 15 located in the ring 10 and the circular knife 16. The return of the handle to its original position is possible thanks to the springs located in the handle (handle spring 32 and hook spring 33).

Claims (2)

1. The system of the automatic handle of a surgical circular stapler for connecting tissue fragments, which consists of a handle (5) placed in the ears (35) on the body (2); fastener (31); handle springs (32); traction system (19), including a needle (20), traction (22), a spindle (24), which ends with a rotary handle (7), and a support element (21) of a rotary handle (7), as well as a pusher system, comprising a proximal pusher element (27), a pusher tube (26) and a distal pusher element (28), the traction system and the pusher system being placed in the housing (2), characterized in that it comprises a hook (30) made in the form of a bolt with a protrusion located in the contact zone with the traction system, mounted with the possibility of rotation on a pin-bolt in the handle (5), and the hook ( 30), being in the position blocking the handle, rests on the lower surface of the pipe of the body, and being in the position locking the handle, under the pressure of the bolt (23) protrudes from the pipe of the body, which blocks it; and also a bolt (23) in the form of a protrusion located in the traction system (19) at a distance selected so that after setting the gap between the anvil (4) and the charge (3) with a width of 1 mm, the bolt (23) presses on the hook ( 30) by blocking it. 2. A surgical circular stapler for connecting tissue fragments, comprising a divisible, connecting unit mounted on the body, containing a charge connected to the anvil using a traction system that includes a needle, traction, crossbar, lead screw, ending with a rotary handle; a handle, indicator, and also a pusher system, which includes a proximal pusher element, a pusher tube and a distal pusher element, the traction and pusher system being housed in a housing, characterized in that it includes an automatic pen system described in paragraph 1.

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