WO2011087245A2

WO2011087245A2 - Anastomosis device using plurality of links

Info

Publication number: WO2011087245A2
Application number: PCT/KR2011/000153
Authority: WO
Inventors: 김철웅; 양영규
Original assignee: (주)트리플씨메디칼
Priority date: 2010-01-13
Filing date: 2011-01-11
Publication date: 2011-07-21
Also published as: WO2011087245A3; KR101048630B1

Abstract

According to one embodiment of the present invention, an anastomosis device includes: a first jaw; a second jaw adapted to correspond with and face the first jaw such as to allow movement between opening and closing positions relative to the first jaw; at least one anastomosis member disposed on the first jaw at the initial stage; a wedge disposed at the lower portion of the anastomosis member for carrying out transitional motion along the longitudinal direction of the first jaw inside the first jaw, and having a blade for cutting a part of a tissue by the transitional motion and a slanted surface for driving the anastomosis member so that the anastomosis member passes through the tissue towards the second jaw for carrying out the anastomosis of the tissue; and a link member having a plurality of rotatable links connected to each other by connection pins and moving together with the wedge.

Description

Anastomosis device using multiple links

The present invention relates to an anastomosis device, and more particularly, to an anastomosis device capable of anastomosis and cutting using a plurality of links.

If the cancerous tissue is in any position within the colon where the tool is accessible, the operator cuts the large intestine on either side of the cancerous tissue and at the same time the two open ends of the intestine (the distal end facing the anus) Distal end and proximal end closest to the lower intestine are anastomated in a closed state. Such temporary closure is done to minimize contamination.

More specifically, this temporary closure allows the colon to be placed between the linear anastomosis and the plurality of scissors cutting elements at the tip of the cutting tool, whereby the operator presses the trigger on the handle of the device to collect the cutting elements. . Thereafter, another trigger (or secondary operation of the same trigger) is manipulated to drive a series of staples and cutting blades through the clamped ends of the colon, through which the ends are closed and cross cut.

Such a scissor cutting element is inserted into the abdominal cavity of the patient and then rotated along the direction of the large intestine so as to be perpendicular to the longitudinal direction of the large intestine. However, the conventional anastomosis device has a problem in that the rotation angle is limited by the driving method, so that the anastomosis and cutting are not possible at once because the obstruction is arranged obliquely with the longitudinal direction of the colon, thereby requiring 2-3 repetitive operations.

An object of the present invention is to provide an anastomosis device capable of anastomosis and cutting irrespective of the rotation of the upper jaw and the lower jaw.

Another object of the present invention is to provide an anastomosis device capable of securing sufficient rotational displacement of the upper jaw and the lower jaw.

Still other objects of the present invention will become more apparent from the following detailed description and the accompanying drawings.

According to one embodiment of the invention, the anastomosis device comprises: a first jaw; A second jaw disposed to face the first jaw, the second jaw being relatively movable between an open and a closed position with respect to the first jaw; At least one anastomosis member initially disposed in the first jaw; The second anastomosis member and the anastomosis member disposed below the anastomosis member to translate along the longitudinal direction of the first jaw in the first jaw, and to cut a part of the tissue by the translational movement. A wedge having an inclined surface for driving the anastomotic member to pass through the tissue toward the jaw to fix the tissue; And a link member having a plurality of rotatable links connected to each other by connecting pins and moving together with the wedge.

The first jaw is formed in the longitudinal direction of the first jaw inside the first jaw, the upper channel for providing a movement space of the wedge; A lower channel recessed from one surface and providing a movement space of the link connected to the wedge; And it is located between the upper channel and the lower channel, it may have a connection channel for providing a moving space of the connector connecting the wedge and the link.

The first jaw may further include a tray positioned above the upper channel and initially having the anastomotic member.

The anastomosis device further includes a drive unit for driving the link member, the drive unit comprising a handle; And moving along the guide groove formed in the handle, it may include a knob connected to the link.

The anastomosis device further includes a connecting shaft connected to the handle, wherein the links are distal links located on the first jaw and proximal links located on the connecting shaft according to the position of the wedge, and the It may be provided with a distal link and a connection link connecting the proximal end of the distal links and the distal end of the proximal links at a predetermined angle with the proximal links.

The first jaw has a lower channel formed along the longitudinal direction of the first jaw, the distal links move along the lower channel, and the connecting shaft has an anastomosis passage formed along the longitudinal direction of the connecting shaft. The proximal links may move along the anastomosis passage.

The anastomosis device may include a connecting shaft installed to correspond to the proximal ends of the first and second jaws; And a driving unit which rotates one of the first and second jaws relative to the connecting shaft, wherein the driving unit has distal ends connected to any one of the first and second jaws. First and second link bars capable of rotating relative to any one of the first and second jaws; And a rotation member connected to the proximal end portions of the first and second link bars and capable of rotating relative to the first and second link bars so as to rotate the first and second jaws.

The drive unit may further include a handle connected to the proximal end of the connection shaft and a lever connected to the rotating member to rotate together with the rotating member and exposed to the outside of the handle.

The connecting shaft has a rotating passage formed along a longitudinal direction of the connecting shaft, and the first and second link bars may move along the rotating passage by rotating the rotating member.

The drive unit further includes a front joint fixed to one of the first and second jaws, wherein the first and second link bars are formed of the first and second straight bars and the first and second straight bars. It may have a first and second front connecting bar extending from the distal end and bent inward and rotatably connected to the front joint.

According to the present invention, even when the rotational displacement of the upper jaw and the lower jaw is large, anastomosis and cutting can be performed smoothly. In addition, the upper jaw and the lower jaw can secure a sufficient rotational displacement, it is possible to smoothly proceed anastomosis and cutting in a narrow space.

1 is a perspective view schematically showing an anastomosis device according to an embodiment of the present invention.

2 is a perspective view illustrating the upper jaw and the lower jaw shown in FIG.

3 is a cross-sectional view of FIG. 2.

4 is a cross-sectional view illustrating the links illustrated in FIG. 2.

5 is a view illustrating the rear surface of the lower jaw shown in FIG.

FIG. 6 is a perspective view illustrating the first and second link bars and the lever illustrated in FIG. 2.

7A to 7C are views illustrating a change in position of the first and second link bars and the upper jaw according to the operation of the lever.

8 is a view showing the structure of the connecting shaft shown in FIG.

FIG. 9 is a perspective view illustrating first and second link bars and links installed in the housing illustrated in FIG. 8. FIG.

FIG. 10 is a cross-sectional view illustrating the driving unit shown in FIG. 1.

10: cutting anastomosis unit 12: upper jaw

13: staple guide 14: lower jaw

15: upper channel 16: connection slot

17: lower channel 18: wedge

19: connector 20: connecting shaft

24: housing 26: rotation passage

28: anastomosis passage 30: drive unit

31: Link 32: Handle

33,35 link bar 34 lever

36 knob 37 front joint

38: rotating plate 39: rear joint

Hereinafter, preferred embodiments of the present invention will be described in more detail with reference to FIGS. 1 to 10. Embodiments of the invention may be modified in various forms, the scope of the invention should not be construed as limited to the embodiments described below. These embodiments are provided to explain in detail the present invention to those skilled in the art. Accordingly, the shape of each element shown in the drawings may be exaggerated to emphasize more clear explanation.

On the other hand, the following describes the anastomosis and cutting of the large intestine, but those skilled in the art to which the present invention pertains a variety of applications and modifications within the scope of the present invention based on the following description.

Also, below, "proximal" and "distal" are used based on the clinician's grip of the tool. For example, the lower jaw 14 is distal to the handle 32.

1 is a perspective view schematically showing an anastomosis device according to an embodiment of the present invention. The anastomosis device includes a cutting anastomosis unit 10 and a driving unit 30, and a connecting shaft 20 positioned between the cutting anastomosis unit 10 and the driving unit 30.

The cutting anastomosis unit 10 has an upper jaw 12 and a lower jaw 14, and like the scissors, the upper jaw 12 and the lower jaw 14 are rotated relatively to the upper jaw 12 and the lower jaw. Clamp tubular tissue (eg, intestines) located between 14. As described later, the lower jaw 14 is provided with a wedge 18 for anastomosis and cutting, and the wedge 18 anastomizes and cuts tissue through movement.

The drive unit 30 includes a lever 34 and a knob 36 which the operator can operate, and the operator wraps the handle 32 and completes the procedure by operating the lever 34 and the knob 36. . The handle 32 is an angled polygonal shape, which can solve the problem of falling on the operating table. In addition, by forming the plurality of grips 32a in multiple rows on the outer circumferential surface of the handle 32, the grip feeling of the operator can be enhanced.

The lever 34 is installed on the top of the handle 32 and rotates, and the ruler 34a is fixedly disposed around the lever 34. The operator can determine the rotation angle of the lever 34 through the scale indicated by the reference line displayed on the lever 34. As will be described later, the rotation angle of the lever 34 substantially coincides with the rotation angles of the upper jaw 12 and the lower jaw 14. The knob 36 is linearly moved along the guide groove 36a formed on the side of the handle 32, through which the anastomosis and cutting are described later.

FIG. 2 is a perspective view illustrating the upper jaw and the lower jaw shown in FIG. 1, and FIG. 3 is a cross-sectional view of FIG. 2. The upper jaw 12 and the lower jaw 14 are driven similarly to the scissors to allow rotation relative to each other. In the present embodiment, the upper jaw 12 rotates with respect to the lower jaw 14. The upper jaw 12 is switched to the open position and the closed position by the rotation, and in the closed position the upper jaw 12 is placed in parallel with the lower jaw 14 at the top of the lower jaw 14 (see FIG. 1). In the open position, the upper jaw 12 forms a predetermined angle with the lower jaw 14 (see FIG. 2).

At the time of operation, the operator operates a separate operating mechanism (not shown) to rotate the upper jaw 12 with respect to the lower jaw 14, and the upper jaw 12 is separated from the lower jaw 14 by the rotation and is initially operated. The switch is made from the closed position to the open position. When the upper jaw 12 is switched to the open position, the operator places the open end of the viscera between the upper jaw 12 and the lower jaw 14, and rotates the upper jaw 12 against the lower jaw 14 in reverse. To return the upper jaw 12 from the open position to the closed position. In this process the open end can be clamped between the upper jaw 12 and the lower jaw 14.

As shown in FIG. 3, the lower jaw 14 has an upper channel 15, a connecting slot 16, and a lower channel 17, which are formed along the longitudinal direction of the lower jaw 14. The tray 142 is installed above the upper channel 15 and is detachable from the lower jaw 14, and a plurality of staples 152 are initially loaded. Staples 152 operate through wedges 18 that move along upper channel 15 and move toward upper jaw 12 in a closed position.

The upper jaw 12 has a staple guide 13 corresponding to the staple 152 in the tray 142. The staples 152 in the tray 142 move toward the staple guide 13 and then bend and deform by the staple guide 13 to open the open end of the tissue placed between the upper jaw 12 and the lower jaw 14. To close. As described above, when the upper jaw 12 is switched to the open state, the operator may access the tray 142 through a predetermined space formed between the upper jaw 12 and the lower jaw 14, and the tray ( The staples 152 loaded in the 142 may be checked or replaced with a new tray 142.

The wedge 18 moves along the upper channel 15 and has an inclined surface 18a and a blade 18b. The inclined surface 18a is formed to be inclined upward toward the proximal end of the lower jaw 14, and the blade 18b extends from the upper end of the inclined surface 18a toward the upper jaw 12.

Staple 152 has a base that protrudes below tray 142 and a fork that extends toward the top of tray 142. As the wedge 18 moves along the upper channel 15, the blade 18b cuts the tissue, and the inclined surface 18a of the wedge 18 presses the base of the staple 152. The forked of staple 152 passes through the open end of the tissue to contact the staple guide 13, and the staple guide 13 curves the staple 152 to close the open end. Thus, the open end of the tissue is closed with the cut, and when the wedge 18 moves to the distal end of the upper channel 15, the staples 152 are all pushed through the tray 142 and closed. , Through which the open end is anastomated. The wedge 18 then returns to its original position.

The lower channel 17 is formed by recessing from the lower surface of the lower jaw 14 (refer to FIG. 3) (or the opposite surface of the upper jaw 12), and the links 31 to be described below are the lower channel 17. Move along At this time, the wedge 18 is connected to the links 31 by the connector 19 (in FIG. 3 is described as being connected to the link 31 located at the distal end, but is connected to the other link 31 or It may be connected to the connecting pin (P) connecting the fields 31), the wedge 18 moves together as the links 31 move. At this time, the connection slot 16 is formed between the upper channel 15 and the lower channel 17, the connector 19 is moved along the connection slot (16).

2 and 3, the proximal end of the lower jaw 14 is connected to the first and second link bars 33 and 35, and the first and second link bars 33 and 35. And links 31 are mounted inside the connecting shaft 20.

4 is a cross-sectional view showing the links shown in Figure 2, Figure 5 is a view showing the back of the lower jaw shown in FIG. As described above, the links 31 (or link members) move along the lower channel 17, and the wedges 18 are connected to the link members (or links 31) by the connector 19. Move with the link member. As shown in FIG. 4, the link member has a connecting pin P for connecting the links 31 and the links 31 to each other, and the links 31 are rotated around the connecting pin P. FIG. It is possible. That is, the link member may be deformed into various shapes as the links 31 rotate about the connection pin P, and the connection pin P is connected to the links 31 regardless of the rotation of the links 31. ) Keeps the connection.

As shown in FIG. 3, the links 31 move along the lower channel 17, and the connector 19 moves with the wedge 18 along the connecting slot 16. The links 31 are moved by a knob 36 which will be described later, and the links 31 are drawn out through the distal end of the anastomotic passage 28 and move along the lower channel 17. At this time, as shown in Figure 5, when the lower jaw 14 is rotated to form a predetermined angle with the connecting shaft 20, the links 31 are rotated around the connecting pin (P) in a connected state. The links 31 are distal links 311a located on the lower channel 17 of the lower jaw 14 and proximal links 315a located on the anastomosis passage 28, and the distal links. And a connection link 313a connecting the proximal end of the field 311a and the distal end of the proximal links 315a.

FIG. 6 is a perspective view illustrating the first and second link bars and the lever illustrated in FIG. 2, and FIGS. 7A to 7C are views illustrating a change in position of the first and second link bars and the upper jaw according to the operation of the lever. As described above, the proximal end of the lower jaw 14 is connected to the first and second link bars 33 and 35, and the lower jaw 14 is located at the position of the first and second link bars 33 and 35. You can change the direction according to. As shown in FIG. 6, the first link bar 33 has a first straight bar 33a and a first front connecting bar 33b, and the second link bar 35 has a second straight bar 35a. And a second front connecting bar 35b. The first and second

straight bars

33a and 35a are arranged side by side, and the first and second

front connecting bars

33b and 35b are inward from the distal ends of the first and second

straight bars

33a and 35a. It is arranged to be inclined. Since the first and second

front connecting bars

33b and 35b are connected to the front joint 37 via a hinge h, the first and second

front connecting bars

33b and 35b are centered on the hinge h. It is rotatable. The front joint 37 is fixed to the upper surface of the lower jaw 14, the front joint 37 is rotated with the lower jaw 14 in accordance with the movement of the first and second link bar (33, 35).

As shown in FIG. 6, the first link bar 33 has a first rear connecting bar 33c, and the second link bar 35 has a second rear connecting bar 35c. The first rear connecting bar 33c is arranged to be inclined inward from the proximal end of the first straight bar 33a, and the second rear connecting bar 35c is arranged to be inclined inward from the proximal end of the second straight bar 35a. do. Since the first and second rear connection bars 33c and 35c are connected to the rear joint 39 via a hinge h, the first and second rear connection bars 33c and 35c are centered on the hinge h. It is rotatable. The rear joint 39 is fixed to the lower end of the rotary plate 38 having an upper end connected to the lever 34, and the rear joint 39 rotates together with the rotary plate 38 in accordance with the movement of the lever 34.

On the other hand, the front joint 37 and the rear joint 39 are arranged side by side with each other, the rotation angle of the front joint 37 substantially coincides with the rotation angle of the rear joint (39). Therefore, the rotation angle of the front joint 37 generally coincides with the rotation angle of the lever 34.

As shown in FIGS. 7A to 7C, the front joint 37 is fixed to the upper surface of the lower jaw 14, and the front joint 37 rotates together with the lower jaw 14.

As shown in FIG. 7A, when the reference line of the lever 34 points to zero, the lower jaw 14 (and the upper jaw 12) is generally parallel with the first and second

straight bars

33a and 35a. Is placed on.

As shown in FIG. 7B, when the lever 34 is rotated 45 degrees counterclockwise (the reference line of the lever 34 points to 45), the first straight bar 33a (or the first front connecting bar 33b). ) And the distal end of the second straight bar 35a (or the second front connecting bar 35b) is projected so that the front joint 37 (or the lower jaw 14) is counterclockwise. Rotate At this time, the rotation angle of the front joint 37 is 45 degrees, which is the rotation angle of the lever, and the angle formed by the lower jaw 14 (and the upper jaw 12) and the first and second

straight bars

33a and 35a ( θ1) is approximately 45 degrees.

As shown in FIG. 7C, when the lever 34 is rotated 90 degrees counterclockwise (the reference line of the lever 34 points to 90), the front joint 37 rotates counterclockwise so that the first and the first 2 straight bar (33a, 35a) is located side by side, the front joint (37) is in contact with the first straight bar (33a) rotation is limited by the first straight bar (33a), the front joint (37) (or The back joint 39 reaches a maximum value that can no longer be rotated. At this time, the rotation angle of the front joint 37 is the rotation angle of the lever 90 degrees, the angle formed by the lower jaw 14 (and the upper jaw 12) and the first and second straight bar (33a, 35a) ( θ2) is approximately 90 degrees.

According to the above, the lower jaw 14 (and the upper jaw 12) can be rotated to a maximum value of 90 degrees. On the other hand, the foregoing description of the counterclockwise rotation of the lower jaw 14 (and the upper jaw 12) can be equally applied to the clockwise rotation.

FIG. 8 is a view illustrating the structure of the connecting shaft shown in FIG. 1, and FIG. 9 is a perspective view illustrating first and second link bars and links installed in the housing illustrated in FIG. 8. The connecting shaft 20 has a hollow support shaft 22 and a housing 24 inserted into the support shaft 22, and the housing 24 includes a rotation passage 26 and an anastomosis passage ( 28). The first and second link bars 33 and 35 are mounted on the rotation passage 26, and as the lever 34 rotates, the first and second link bars 33 and 35 follow the rotation passage 26. Move. The links 31 are mounted on the anastomosis passage 28, and the links 31 move along the anastomosis passage 28 as the knob 36 described later moves. Rotating passage 26 and anastomosis passage 28 are arranged in a 'T' shape.

FIG. 10 is a cross-sectional view illustrating the driving unit shown in FIG. 1. As shown in FIG. 10, the lever 34 is installed on the upper portion of the handle 32, and the ruler 34a is positioned around the lever 34. The lever 34 is connected to the rear joint 39 through the rotating plate 38, and as the lever 34 rotates, the first and second link bars 33 and 35 move along the rotation passage 26. .

Knob 36 is connected to bracket 362 via horizontal bar 364, which is connected to the proximal end of links 31. When the knob 36 is actuated, the knob 36 moves with the links 31 connected through the horizontal bar 364, and the links 31 move along the anastomosis passage 28.

Although the present invention has been described in detail with reference to preferred embodiments, other forms of embodiments are possible. Therefore, the spirit and scope of the claims set forth below are not limited to the preferred embodiments.

The present invention can be applied to various types of microsurgeries requiring reconstruction by cutaneous flap, anastomosis of amputated blood vessels, and anastomosis of heart disease and other coronary organs.

Claims

First jaw;

A second jaw disposed to face the first jaw, the second jaw being relatively movable between an open and a closed position with respect to the first jaw;

At least one anastomosis member initially disposed in the first jaw;

The second anastomosis member and the anastomosis member disposed below the anastomosis member to translate along the longitudinal direction of the first jaw in the first jaw, and to cut a part of the tissue by the translational movement. A wedge having an inclined surface for driving the anastomotic member to pass through the tissue toward the jaw to fix the tissue; And

And a plurality of links rotatably connected to each other by connecting pins, and including a link member connected to the wedge and moving together with the wedge.
The method of claim 1,

The first jaw is,

An upper channel formed in the first jaw along the longitudinal direction of the first jaw and providing a movement space of the wedge;

A lower channel recessed from one surface and providing a movement space of the link connected to the wedge; And

Located between the upper channel and the lower channel, anastomosis device characterized in that it has a connection channel for providing a moving space of the connector connecting the wedge and the link.
The method of claim 2,

The first jaw is anastomosis device characterized in that it further comprises a tray which is located above the upper channel and has the anastomotic member initially.
The method of claim 1,

The anastomosis device further includes a drive unit for driving the link member,

The drive unit,

handle; And

And a knob connected to the link and moving with the link along a guide groove formed in the handle.
The method of claim 4, wherein

The anastomosis device further includes a connection shaft connected to the handle,

The links are distal links positioned on the first jaw and proximal links located on the connecting shaft according to the position of the wedge, and the distal links and the proximal links have a predetermined angle at the distal links. And a connecting link connecting the proximal end of the links with the distal end of the proximal links.
The method of claim 5,

The first jaw has a lower channel formed along the longitudinal direction of the first jaw, the distal links move along the lower channel,

The connecting shaft has an anastomosis passage formed in the longitudinal direction of the connecting shaft, the proximal links anastomosis device, characterized in that to move along the anastomosis passage.
The method of claim 1,

The anastomosis device,

A connecting shaft installed to correspond to the proximal end portions of the first and second jaws; And

Further comprising a drive unit for rotating any one of the first and second jaw relative to the connecting shaft,

The drive unit,

First and second link bars having distal ends connected to any one of the first and second jaws, the first and second link bars being able to rotate relative to any one of the first and second jaws; And

An anastomosis device connected to the proximal ends of the first and second link bars and having a rotating member capable of rotating relative to the first and second link bars to rotate the first and second jaws. .
The method of claim 7, wherein

And the drive unit further comprises a handle connected to the proximal end of the connecting shaft and a lever connected to the rotating member to rotate together with the rotating member.
The method of claim 7, wherein

The connecting shaft has a rotation passage formed along the longitudinal direction of the connecting shaft,

The first and second link bar anastomosis device, characterized in that to move along the rotation path by the rotation of the rotating member.
The method of claim 7, wherein

The drive unit further includes a front joint fixed to one of the first and second jaws,

The first and second link bars extend from the distal ends of the first and second straight bars and the first and second straight bars, the first and second forward connections being bent inwardly and rotatably connected to the front joints. Anastomosis device characterized in that it has a bar.