SU659146A1 - Surgical instrument for placing anastomoses between hollow organs - Google Patents

Surgical instrument for placing anastomoses between hollow organs

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Publication number
SU659146A1
SU659146A1 SU742002442A SU2002442A SU659146A1 SU 659146 A1 SU659146 A1 SU 659146A1 SU 742002442 A SU742002442 A SU 742002442A SU 2002442 A SU2002442 A SU 2002442A SU 659146 A1 SU659146 A1 SU 659146A1
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USSR - Soviet Union
Prior art keywords
head
pusher
bracket
spring
knife
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SU742002442A
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Russian (ru)
Inventor
Владимир Павлович Золин
Сергей Михайлович Ерошин
Вадим Самсонович Лукьяненко
Валерий Александрович Пыжов
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Организация П/Я М-5237
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Priority to SU742002442A priority Critical patent/SU659146A1/en
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Publication of SU659146A1 publication Critical patent/SU659146A1/en

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Изобретение относитс к медицинской технике, а именно к хирургическим сшивающим инструментам, и иредиазначено дл наложени круговых анастомозов на пищеварительном тракте. The invention relates to medical technique, namely surgical stapling instrument and for superimposing irediaznacheno circular anastomoses on the digestive tract.

Известен хирургический аппарат дл наложени анастомозов на пищеварительном тракте, содержащий скобочную головку с пазами дл скобок, закрепленную в цилиндрическом корпусе, цилиндрический нож и толкатель, жестко закрепленные между собой, расположенные в скобочной головке, съемную упорную головку с матрицей дл загиба скобок с лунками, регул тор зазора, привод толкател и ножа и гибкую трубку 1. Known surgical instrument for anastomosis of the digestive system, comprising the bracket head with slots for staples mounted in the cylindrical body, the cylindrical knife and pusher rigidly fastened to each other, located in staple head, a removable abutment head with a matrix for bending staples with holes, regulator gap torus, drive pusher and a knife and a flexible tube 1.

При использовании аппарата руко тку привода упорной головки, ножа и толкател необходимо вращать вручную последовательно в разных направлени х, с переключением муфты привода путем периодической подачи руко тки вдоль оси. When using the machine handle drive abutment head, the knife and pusher must be manually rotated successively in different directions, with the switching clutch actuator by intermittent feeding of the handle along the axis. Аппарат не позвол ет накладывать швы при крутых перегибах сшиваемых полых органов, а замедленное отведение упорной головки от скобочной зат гивает и осложн ет работу с аппаратом. The device does not allow the suture at sharp bends crosslinkable hollow organs, and slow retraction of the thrust head of the bracket tightens and complicates the work of the machine.

Целью изобретени вл етс обеспечение возможности наложени швов при крутых перегибах сшиваемых полых органов, а также ускорение отвода упорной головки от скобочной. The aim of the invention is to provide the possibility of suturing at the bends steep crosslinkable hollow bodies as well as acceleration retraction abutment of the head of the bracket.

Поставленна цель достигаетс тем, что привод толкател и ножа размещен в скобочной головке и выполнен в виде цилиндрической пружины и подпружиненных фиксаторов , св занных с толкателем и ножом, на боковой поверхности рабочей головки выполнены отверсти , через которые проведены концы подпружиненных фиксаторов , заканчивающиес кнопками управлени , механизм изменени зазора прошивани расположен в скобочной головке и выполнен в виде зубчатых подпружиненных рычагов с кнопкамп управлени и зубчатой рейки, наход щихс в зацеплении. This aim is achieved in that the drive pusher and the knife is placed in the bracket head and configured as a coil spring and spring biased detents associated with the pusher and the knife, on the side surface of the working head are provided with openings through which held the ends of the spring-loaded clamps, terminating control buttons varying the gap stitching mechanism is disposed in the head and the bracket is formed as a spring-loaded lever with a jagged knopkamp control and the rack meshed.

Кроме того, между упорной и скобочной головками расположена пружина сжати . Furthermore, between the abutment head and the bracket is a compression spring.

этом поверхность скобочной головки имеет эластичное покрытие. This surface of the bracket head has a resilient coating.

На фиг. FIG. 1 изображен хирургический аппарат дл наложени анастомозов между полымп органами, продольный разрез; 1 shows a surgical apparatus for anastomosis between polymp bodies, longitudinal section; на фиг. FIG. 2 - сечение А-А фиг. 2 - section A-A of FIG. 1. one.

Аппарат содержит цилиндрический корпус 1, скобочную головку 2, толкатель 3, нож 4, пружину 5, фиксаторы 6, рычаги 7, упорную головку 8, шток 9 с зубчатой рейкой 10, промежуточную втулку 11, крышку 12, упорную втулку 13, пружину 14, гибкую The device comprises a cylindrical body 1, the bracket head 2, a pusher 3, the knife 4, a spring 5, the latches 6, the arms 7, a thrust head 8, the rod 9 with the rack 10, the spacer 11, a cover 12, a thrust bushing 13, a spring 14, flexible

трубку 15, эластичное покрытие в виде гибких полимерных пленок 16 и 17. К цилиндрическому корпусу 1 жестко креп тс при помощи винтов 18 скобочна головка 2, упорна втулка 13, промеж)точна втулка 11 и крып1ка 12. Движение толкател 3 и круглого ножа 4 направл ет скобочна головка 2. tube 15, a flexible coating in the form of flexible polymeric films 16 and 17. By the cylindrical body 1 is rigidly affixed by means of screws 18, the bracket head 2, sleeve abutment 13, interm) exact kryp1ka sleeve 11 and 12. The movement of the pusher 3 and 4, a circular knife guide a staple head 2.

Толкатель 3 скобок имеет два радпал1 ио расположенны.х глухих отверсти , в которые вставлены фиксаторы 6 в виде штырей, содержаи ие пружииы 19. Соответственно в корпусе 1 имеютс сквозпые отверсти , которые снаружи защищены гибкой иолимерной пленкой 16. Дл удобства нажати на фиксаторы 6 указанные отверсти имеют зенковку. The pusher 3 has two brackets radpal1 uo raspolozhenny.h blind hole into which the clips 6 are inserted in the form of pins comprising ue pruzhiiy 19. Accordingly, the housing 1 there are skvozpye openings which are protected from the outside iolimernoy flexible film 16. For convenience, pressing the said clamps 6 openings have a countersink. При вхождении фиксаторов 6 в отверсти цилиндрического корпуса 1 толкатель 3 фиксируетс в строго определенном положении. When entering retainers 6 into the holes of the cylindrical body 1, the pusher 3 is fixed in a precise position. Круглый нож 4 жестко нрикреплен к толкателю 3. Между упорной втулкой 13 и толкателем 3 смонтирована пружина 5 сжати . Round knife 4 nrikreplen rigidly to the plunger 3. Between the retaining sleeve 13 and the pusher 3 is mounted a compression spring 5. Аккумулированна энерги пружины 5 используетс дл перемещени толкател 3 совместно с ножом 4. Упорна втулка 13 содержит два двуплечих рычага 7, которые удерживаютс на ос х 20. Одни концы рычагов 7 имеют зубцы , при иомощи которых происходит сцепление с зубчатой рейкой 10, другие концы рычагов скруглены и выход т в виде кнопок управлени в отверсти цилиндрического корпуса 1. Рычаги 7 снабжены пружинами 21, которые удерживают рычаги в сцеплении с двусторонней рейкой 10. Во избежание случайного попадани посторонних частиц в зазоры рычагов 7 над раззенкован Energy storage spring 5 is used to move the pusher 3 together with a knife 4. The retaining sleeve 13 comprises two double-armed levers 7 which are held on shafts 20. One ends of the arms 7 have teeth, which occurs when iomoschi clutch with the rack 10, the other ends of the levers are rounded and are emitted in the form of control buttons in the holes of the cylindrical body 1. The arms 7 are provided with springs 21 which keep the levers in engagement with bilateral rack 10. to prevent accidental ingress of foreign particles into the gaps 7 on the levers counterbored ными отверсти ми корпуса 1 установлена гибка иолимерна нленка 17. Эта иленка предохран ет также от случайного срабатывани рычага при нажатии на него с малым усилием. GOVERNMENTAL apertured housing 1 is mounted the flexible iolimerna nlenka ilenka 17. This also prevents the lever from accidental actuation by pressing on it with a small force. Упорна головка 8 иод действием гайки 22 может перемещатье на щтоке 9, на котором затем фиксируетс при помощи винта 23. Дл обеспечени положени упорных лунок 24 против пазов скобок 25 на штоке 9 предусмотрены щпонки 26 и 27. Гайка 22 на своем фланце имеет лимб, по которому можно вести настройку зазора между упорной и скобочной головками . Abutment head 8 under the action of the nut 22 may peremeschatsya schtoke to 9, which is then fixed by means of screws 23. To provide the position of thrust against the holes 24 of brackets 25, the grooves 9 are provided on the rod schponki 26 and 27. The nut 22 has a flange at its limb by which can lead the setting of the gap between the bracket and hard heads. В расточку упорной головки 8 вставлена прокладка 28. Шток 9 содержит двустороннюю зубчатую рейку 10. Шток 9 заканчиваетс прорезью дл обеспечени иружинени выступов 29 при их прохождении через втулку 30. Величина сблил ени между упорной головкой 8 и скобочной головкой 2 ограничиваетс винтом 31. Промежуточна втулка 11 имеет ступенчатую цилиндрическую полость, в которой наход тс скольз ща втулка 30 и пружина 14. При сн том щтоке 9 втулка 30 под действием нружины 14 отводитс к упорной втулке 13. К крышке 12 крепитс гибка полимерна трубка 15, с помощью которой The bore of the thrust of the head 8 is inserted into the gasket 28. The rod 9 comprises a double-sided toothed rack 10. The rod 9 terminates in a slot to provide iruzhineni protrusions 29 as they pass through the sleeve 30. The quantity sblil tim between the abutment head 8 and the bracket head 2 is limited screw 31. The intermediate sleeve 11 has a stepped cylindrical cavity in which are within the sliding bush 30 and spring 14. When removed is 9 schtoke sleeve 30 under the action nruzhiny 14 is retracted to the stop sleeve 13. to the cover 12 is secured a flexible polymeric tube 15, through which

аппарат извлекают из сщитого пищеварительного тракта. sschitogo apparatus is recovered from the digestive tract.

Аппарат работает следующим образом. The device operates as follows. Перед наложением анастомозов взвод т Before applying the platoon t anastomoses

пружину 5 путем нажати через отверстие 32 на диск толкател 3, при этом фиксаторы () под дсйств 1ем иружппы 19 вход т li отверстие цилиндрического корпуса 1, удержива таким образом толкатель скобок во взведенном положении. spring 5 by pressing through opening 32 in the pusher disc 3, wherein the clips () under dsystv 1em iruzhppy 19 li m entrance opening of the cylindrical housing 1, thereby retaining the plunger in the cocked position the brackets. В пазы скобочных гпезд вставл ют скобки 25. Замер ют толщину сщиваемых тканей и устанавливают зазор между упорной головкой и скобочной головкой при помощи вращени гайки 22, пользу сь при этом лимбовым устройством. The grooves bracketed gpezd inserted into brackets 25. Metering dissolved sschivaemyh tissue thickness and set the gap between the abutment head and the staple head by means of rotating the nuts 22, wherein the benefit Referring limb device. Далее упорную головку 8 со щтоком 9 ввод т в просвет конца кишки , предварительно наметанного кисетным щвом, который затем зат гиваетс . Further abutment head 8 with schtokom 9 is introduced into the lumen of the intestine end, previously trained schvom purse string which is then tightened. Через Through

естественное отверстие (рот, пр мую кищку ) ввод т цилиндрический корпус 1, после чего конец присоедин емого органа зат гивают кисетным щвом на направл ющей втулке штока скобочной головки 2. Далее natural orifice (mouth, straight kischku) is introduced the cylindrical body 1, whereupon the end attached emogo body tightened to purse string schvom guide rod bushing staple head 2. Further

ирисоедин ют к скобочной головке 2 упорную головку 8. Дл этого шток 9 упорной головкн 8 продвигают во втулку 33 скобочной головки 2, при этом зубчата рейка 10 за счет косой пилообразной формы зубьев irisoedin added to a staple head 2 thrust head 8. For this purpose the thrust rod 9 golovkn 8 is advanced into the sleeve 33, the bracket head 2, the rack 10 by an oblique sawtooth teeth

раздвигает рычаги 7, причем выступы 29 отвод т втулку 30 к упору, сжима пружину 14. Как только втулка 30 коснетс упора, то выступы 29 ирижмутс и пройдут сквозь отверстие втулки 30. Па выходе из Spreads levers 7, wherein the protrusions 29 is retracted against the stop sleeve 30, compressing the spring 14. Once the sleeve 30 contacts the abutment, the projections 29 and irizhmuts pass through the sleeve bore 30. The outlet of Pa

втулки выступы 29 разжимаютс и вход т в зацеиление с ее торцовой поверхностью. razzhimayuts sleeve protrusions 29 and the entrance into zatseilenie with its end surface. К этому моменту рычаги 7 своими зубь ми вход т в зубчатое зацепление рейки 10 и удерживают шток 9 е упориой головкой 8 At this point the levers 7 with their teeth are within the rack gearing 10 and hold the rod 9 th focusing head 8

от выдвижени . by extension. Аппарат готов дл наложени кругового аиаетомоза. The machine is ready for stacking circular aiaetomoza.

Хирург через ткань пищеварительного тракта нажимает на фиксаторы 6, утаплива их в глухие отверсти толкател 3; The surgeon through the digestive tract tissue presses the retainers 6, pushing it into their blind holes pusher 3; как as

только фиксаторы 6 выйдут из зацеплени , пружина 5 сработает и переместит толкатель 3 с ножом 4 в сторону упорной головки 8. В это врем толкатель 3 продвигает скобки 25, производ сщивание ткани, заправленной между головками 2 и 8. Одновременно осуществл етс кругова вырезка ткани ножом 4. После наложени кругового анасто.моза через ткань пищеварительного тракта пажимают на концы рычагов 7, Only retainers 6 come out of the engagement spring 5 operates and moves the pusher 3 towards the knife 4, the thrust of the head 8. At this time, the pusher 3 advances the brackets 25, the fabric is produced sschivanie, tucked between the heads 2 and 8. Simultaneously accomplished circular cutting knife tissue 4. After applying a circular anasto.moza through the digestive tract tissue pazhimayut at the end of the lever 7,

прогиба при этом указанную ткань и полимерную пленку 17. Рычаги 7 своими зубь ми вывод тс из зацеплени с зубчатой рейкой 10. После разведени рычагов 7 от зубчатой рейки пружипа 14 через втулку deflection while said fabric and a polymeric film 17. The levers 7, its teeth are removed from the engagement with the rack 10. After dilution levers 7 of the rack bar 14 through sleeve pruzhipa

30, шток 9 отводит упорную головку 8 от скобочной головки 2 на определенное рассто ние , гарантирующее сохранение целостноети иаложенного шва при протаскивании через него упорной головки (последн при 30, the rod 9 removes stubborn head 8 from the staple head 2 for a certain distance guaranteeing the preservation tselostnoeti ialozhennogo suture therethrough when dragging of the thrust of the head (the latter at

этом удерживаетс от продольного перемещени выступами 29). This is supported by the longitudinal movement of the protrusion 29). Извлечсн е аппарата из сшитого пищевапителыпго ргкта осуществл етс при помощи гибкой трубки 15. E Izvlechsn apparatus of crosslinked pischevapitelypgo rgkta is effected by a flexible tube 15.

Claims (3)

1. Хирургический аппарат дл наложени анастомозов между полыми органами, содержащий скобочную головку с пазами дл скобок, упорную головку с матрицей дл загиба скобок, толкатель, нож, механизм изменени зазора прошивани , нривод толкател и иожа, о т л и ч а о и; 1. A surgical apparatus for anastomosis between the hollow bodies containing the bracket head with slots for staples abutment head with a matrix for bending staple pusher, knife, mechanism variations stitching gap nrivod pusher and iozha of m and n and o and h; и и с тем, что, с целью возможнскти )1ало ;-;сп;1 швов при крутых перегибах сшиваемых полых органов, привод толкател и ножа размещен в скобочной головке и выполнен в виде цилиндрической пружины и подпружиненных фиксаторов, св занных с толкателем и ножом, на боковой поверхности and with the fact that, in order vozmozhnskti) 1alo; -; cn; 1 seams at sharp bends crosslinkable hollow organs drive pusher and knife placed in the staple head and configured as a coil spring and spring biased detents associated with the pusher and knife on the side surface
голожи выполнены отверсти , чере ксггоыс проведены концы подпружиненных фиксаторов, заканчивающиес кнопками управлени , механизм изменени зазора прошивани расположен в скобочной головке и выполнен в виде зубчатых подпружиненных рычагов с кнопками управлени и зубчатой рейки, наход щихс в зацеплепни. golozhi formed holes alternation ksggoys conducted ends spring-loaded detents terminating control buttons, stitching gap varying mechanism located in the head and the bracket is formed as a spring-loaded arm with a toothed control rack and button in a schihs zatseplepni.
2. Аппарат по п. 1, отличающийс тем, что. 2. Apparatus according to Claim. 1, characterized in that. с целью }ткореии отвода упорной головки от скобочной, между ними расиоложена пружина сжати . the purpose} tkoreii retraction abutment of the head of the bracket, between rasiolozhena compression spring.
3. Аппарат ио и. 3. The device Io. 1, о т л и ч а ю HUI йс 1, l and m of h and w HUI dc
тем, что иоверхность скобочной головки имеет гмасгичное покрытие. in that the bracket head has ioverhnost gmasgichnoe coating.
1-1сточникп информац1 и, прин те во внимание при экспертизе 1. Авторское евидетельетво СССР 1-1stochnikp informats1 and received those into account in the examination 1. Copyright evideteletvo USSR
№ 284833, кл. Number 284 833, Cl. А 61В 17/11, 1968. A 61B 17/11 1968.
-lAt; -lAt;
28 28
i/ f.-W i / f.-W
27 27
IIII IIII
Я 25 3 2/ 20 ID 30 I March 25 2/20 ID 30
f3 7 17 li f3 July 17 li
12 12
15 15
г g
18 29 18 29
Фиг Figures
Фиг.2 2
SU742002442A 1974-02-12 1974-02-12 Surgical instrument for placing anastomoses between hollow organs SU659146A1 (en)

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US5653374A (en) * 1994-08-05 1997-08-05 United States Surgical Corporation Self-contained powered surgical apparatus
US5680981A (en) * 1994-05-05 1997-10-28 United States Surgical Corporation Self-contained powered surgical apparatus
US5779130A (en) * 1994-08-05 1998-07-14 United States Surgical Corporation Self-contained powered surgical apparatus
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US7770774B2 (en) 1995-08-28 2010-08-10 Tyco Healthcare Group Lp Surgical stapler
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