WO2012075895A1 - 直线型切割缝合器 - Google Patents

直线型切割缝合器 Download PDF

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Publication number
WO2012075895A1
WO2012075895A1 PCT/CN2011/083111 CN2011083111W WO2012075895A1 WO 2012075895 A1 WO2012075895 A1 WO 2012075895A1 CN 2011083111 W CN2011083111 W CN 2011083111W WO 2012075895 A1 WO2012075895 A1 WO 2012075895A1
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WO
WIPO (PCT)
Prior art keywords
piece
linear cutting
lower jaw
cutting stapler
staple cartridge
Prior art date
Application number
PCT/CN2011/083111
Other languages
English (en)
French (fr)
Inventor
陈望东
舒拓
裴永旺
Original Assignee
苏州天臣国际医疗科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 苏州天臣国际医疗科技有限公司 filed Critical 苏州天臣国际医疗科技有限公司
Priority to EP11846162.3A priority Critical patent/EP2649947B1/en
Priority to JP2013542353A priority patent/JP5680763B2/ja
Priority to ES11846162.3T priority patent/ES2556121T3/es
Priority to US13/991,535 priority patent/US9433414B2/en
Publication of WO2012075895A1 publication Critical patent/WO2012075895A1/zh

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Classifications

    • 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
    • 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
    • A61B17/07207—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 the staples being applied sequentially
    • 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
    • A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • 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
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • 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
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • 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
    • A61B2017/07285—Stapler heads characterised by its cutter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320052—Guides for cutting instruments

Definitions

  • the invention relates to a linear cutting and stapling device, belonging to the technical field of medical instruments.
  • Linear cutting staplers are widely used in surgical procedures for wound suturing, internal tissue suturing and cutting.
  • Typical linear cutting staplers are disclosed in U.S. Patent No. 5,129,570, which has both suturing and cutting functions for wound suturing.
  • the linear cutting stapler generally comprises two upper and lower jaws, and a closing handle for closing the upper and lower jaws, and an anvil and a staple cartridge opposite to the front ends of the upper and lower jaws, and are arranged in the staple cartridge.
  • the firing piece and the cutter are simultaneously moved relative to the staple cartridge, and a push button for driving the firing piece and the cutter movement. Studs are arranged in the staple cartridge, and the firing sheets sequentially push the pusher tabs and push the staples toward the anvil, which cuts the tissue between the staple cartridge and the anvil.
  • the staple cartridge of the device can be replaced multiple times. In clinical use, it is often necessary to suture the tissue several times, so it is necessary to replace the staple cartridge several times during the operation. In the case where the staple cartridge is not placed, the push button can be pushed forward arbitrarily, and the cutter will be pushed out, causing serious consequences of cutting only without sewing. Therefore, the prior art linear cutting stapler is provided with a safety mechanism.
  • U.S. Patent No. 5,129,570 discloses an insurance mechanism in which a safety block with a cutter passage and a push rod passage is provided in the middle of the instrument, and a shrapnel is disposed under the cutter.
  • the shrapnel will bounce the cutter, so that the cutter can not pass through the cutter passage, which acts as an insurance;
  • the staple cartridge presses the top of the knife, so that the cutter overcomes the elastic force of the elastic piece and returns to the state of alignment with the cutter passage.
  • the insurance is released and the device can be used for firing.
  • U.S. Patent No. 7,057,730 discloses another type of insurance mechanism, which is provided in the middle of the device.
  • a safety block with a pusher rod passage and a push rod passage, the safety block is rotatable about the instrument under the action of a torsion spring.
  • the safety block When the instrument is in the open position (ie, the upper and lower jaws are not closed), the safety block is twisted, so that the pusher bar and the pusher bar cannot pass through the passage, thereby playing an insurance role; when the instrument is mounted on the staple cartridge, and After the upper and lower jaws are closed, the staple cartridge presses the safety block to overcome the elastic force of the torsion spring, and both the rod and the pusher rod can pass through the safety block, and the insurance is released, and the device can be fired and used.
  • An object of the present invention is to provide a linear cutting stapler having a fuse mechanism of a single structure.
  • a linear cutting stapler comprising: upper and lower jaws that can be closed or opened to each other, a distal end of the lower jaw is provided with a staple cartridge, the lower jaw is U-shaped, and is slidably disposed therein
  • the linear cutting stapler further includes a securing mechanism, the securing mechanism includes a securing member, and an opening disposed on the firing piece for receiving the securing member,
  • the mounting or removal of the staple cartridge can drive the safety member to move in a direction perpendicular to the axis of the lower jaw, thereby disengaging or snapping the safety member from the opening of the firing tab.
  • the securing member is a limiting block, and the limiting block comprises a latching portion, and an outer contour of the engaging portion is the same as an inner contour of the opening of the firing piece.
  • the limiting block further includes a welded portion for being driven by the staple cartridge. Further, the welding portion and the engaging portion are respectively disposed at two sides of the limiting block.
  • a top surface of the welded portion is higher than a top surface of the engaging portion.
  • soldering portion is fixedly connected to a top surface of a spring piece, and a bottom surface of the elastic piece is fixed on an inner bottom surface of the lower jaw, and an axis of the elastic piece intersects with an axis of the lower jaw.
  • the bottom surface of the welded portion is higher than the bottom surface of the elastic piece.
  • the fixing manner of the elastic piece and the limiting block and the lower jaw are both welded and fixed.
  • a spacer is disposed on the inner bottom surface of the lower jaw, and the spacer includes a long slot, and the elastic piece passes through the long slot.
  • Figure 1 is a schematic view showing the structure of the lower jaw of the present invention, and the staple cartridge is not shown.
  • Figure 2 is an enlarged view of a portion A of Figure 1.
  • Figure 3 is a schematic exploded view of the lower jaw of the present invention.
  • Figure 4 is a cross-sectional view of the lower jaw of the present invention with the staple cartridge not loaded.
  • Figure 5 is a cross-sectional view of the lower jaw of the present invention with the staple cartridge loaded.
  • the present invention provides an insurance mechanism for a linear cutting stapler.
  • the linear cutting stapler comprises a plastic outer casing, upper and lower jaws which can be closed or opened to each other, and an anvil (not shown) is provided at the distal end of the upper jaw, and the lower jaw 1 is A staple cartridge 2 is provided at the distal end.
  • anvil not shown
  • a staple cartridge 2 is provided at the distal end.
  • the positions of the upper and lower jaws can be interchanged, and the present invention is so defined for clarity of presentation.
  • the lower jaw 1 is U-shaped, and a distal end is slidably provided with a firing piece 5 and a pusher bar (not shown) for respectively firing the pusher piece and cutting the tissue.
  • a firing piece 5 and a pusher bar (not shown) for respectively firing the pusher piece and cutting the tissue.
  • place the tissue between the anvil and the staple cartridge then close the upper and lower jaws, close the handle, clamp the upper and lower jaws, and then push the firing at the proximal end of the upper and lower jaws.
  • the push button With the push button, the stitching and cutting of the tissue can be performed.
  • the invention is characterized in that the linear cutting stapler comprises a new type of insurance mechanism.
  • the securing mechanism includes a securing member and an opening 52 disposed on the firing piece 5 for receiving the securing member.
  • the opening 52 is adjacent to the firing end 51 of the firing piece 5.
  • the securing member is a limiting block 4, the limiting block includes a latching portion 41, and the outer contour of the latching portion 41 and the opening 52 of the firing piece 5
  • the mounting or removal of the staple cartridge 2 can drive the limiting block 4 to move in a direction perpendicular to the axis of the lower jaw 1 , thereby causing the engaging portion 41 of the limiting block 4 to The opening 52 of the firing piece 5 is disengaged or snapped, and the function of the insurance release and the insurance opening is realized.
  • the engaging portion 41 is caught in the opening 52 for restricting the movement of the firing piece 5 relative to the lower jaw 1.
  • the snap portion 41 is detached from the firing piece 5 after being pressed by the staple cartridge 2, which causes the firing piece 5 to move relative to the lower jaw 1.
  • the limiting block 4 further includes a welding portion 42 for being driven by the staple cartridge 2, and the welding portion 42 and the engaging portion 41 are respectively disposed at two sides of the limiting block 4. That is, the other end of the stopper 4 can be driven in addition to the staple cartridge 2 which can directly drive the latching portion 41.
  • the top surface of the soldering portion 42 is higher than the top surface of the latching portion 41.
  • the staple cartridge 2 preferably touches the welded portion 42, and since the stopper 4 is rigid, the welded portion 42 can drive the engaging portion 41. Disengaged from the opening 52 of the firing piece 5.
  • the soldering portion 42 is fixedly coupled to the top surface 32 of a resilient piece 3, and the bottom surface 32 of the elastic piece 3 is fixed to the inner bottom surface 11 of the lower jaw 1.
  • the self-axis of the elastic piece 3 intersects the axis of the lower jaw 1 , that is, the elastic piece 3 is obliquely disposed in the lower jaw 1 , so that the bottom surface of the welded portion 42 is higher than the elastic piece 3 .
  • the bottom surface 31 has a height difference between the welded portion 42 and the inner bottom surface 11 of the lower jaw 1 to ensure the moving distance of the stopper 4.
  • the spacer 6 Since some of the inner bottom surface 11 of the lower jaw 1 may be provided with a spacer 6, the spacer 6 must include a long slot 61 through which the elastic piece 3 passes, and if there is no spacer 6, A groove can be provided where the shrapnel and the jaw are welded, and the shrapnel is welded to the outer surface of the jaw.
  • the fixing manner of the elastic piece 3, the limiting block 4 and the lower jaw 1 is welded and fixed.
  • the structure of the invention is simple, easy to process, safe and reliable, and has good promotion value.
  • the present invention has various embodiments, and all technical solutions formed by equivalent transformation or equivalent transformation are within the scope of the present invention.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Portable Nailing Machines And Staplers (AREA)

Description

直线型切割缝合器 本申请要求于 2010 年 12 月 10 日提交中国专利局、 申请号为 201010581557.0、 发明名称为"直线型切割缝合器"的中国专利申请的优先 权， 其全部内容通过引用结合在本申请中。 技术领域
本发明涉及一种直线型切割缝合器， 属于医疗器械技术领域。
背景技术
直线型切割缝合器被广泛用于外科手术中用于伤口缝合、 内部组织缝 合与切割， 典型的直线型切割缝合器如美国专利 US5129570所揭示， 具有 缝合与切割两个功能， 在进行伤口缝合的同时， 将多余的组织切除。 该类 直线型切割缝合器一般包括上、 下两个钳夹， 以及用于闭合上、 下钳夹的 闭合把手， 相对设置在上、 下钳夹前端的釘砧和釘仓， 设于釘仓内并可同 时相对所述釘仓移动击发片和切刀， 以及用于驱动所述击发片和切刀移动 的推钮。 所述釘仓内排列设置有缝合釘， 所述击发片依次推动推釘片并将 缝合釘推向釘砧， 所述切刀将位于釘仓和釘砧之间的组织切断。
该器械的釘仓是可以更换多次使用的。 在临床使用时， 经常需要多次 缝合切割组织， 因此在手术时需要多次更换釘仓。 在没有放入釘仓的情况 下， 推钮可以被任意向前推动， 进而切刀会被推出， 会造成只切割而未缝 合的严重后果。 因此， 现有技术的直线型切割缝合器都会设置一种保险机 构。
美国专利 US5129570号揭示了一种保险机构，在器械的中部设置一个 带有切刀通道与推釘杆通道的保险块， 在切刀下面设置弹片。 当器械处于 打开位置 （即上、 下两个钳夹未闭合） 时， 弹片将切刀弹起， 使切刀无法 通过切刀通道， 起到保险作用； 当器械装上釘仓， 且上、 下两个钳夹闭合 后， 釘仓压迫切刀顶部， 使切刀克服弹片的弹力并恢复到与切刀通道对准 的状态， 这时保险解除， 器械可以击发使用。
美国专利 US7055730号揭示了另一种保险机构，在器械的中部设置一 个带有推刀杆通道与推釘杆通道的保险块， 该保险块在扭簧作用下可绕器 械转动。 当器械处于打开位置 （即上、 下两个钳夹未闭合） 时， 保险块发 生扭转， 使推釘杆与推刀杆都无法通过通道， 起到保险作用； 当器械装上 钉仓, 且上、 下两个钳夹闭合后， 釘仓压迫保险块使其克服扭簧的弹力而 杆与推刀杆都可通过保险块， 这时保险解除， 器械可以击发使用。
以上几种结构均非常复杂， 加工组装困难， 价格昂贵。 发明内容
本发明的目的是提出一种具有筒单结构的保险机构的直线型切割缝合 器。
本发明的目的， 将通过以下技术方案得以实现：
一种直线型切割缝合器， 包括： 可相互闭合或打开的上、 下钳夹， 所 述下钳夹的远端设置有釘仓， 所述下钳夹为 U形， 其内可滑动地设有击发 片和推刀杆， 所述直线型切割缝合器还包括一个保险机构， 所述保险机构 包括一保险件， 及设置于所述击发片上的用于收容所述保险件的开口， 所 述釘仓的安装或移除可驱动所述保险件沿垂直于所述下钳夹的轴线的方向 移动， 进而使所述保险件与所述击发片的开口脱离或卡接。
进一步地， 所述保险件为一限位块， 所述限位块包括一个卡接部， 所 述卡接部的外轮廓与所述击发片的开口的内轮廓相同。
进一步地， 所述限位块还包括一个用于被所述釘仓驱动的焊接部。 进一步地， 所述焊接部和卡接部分别设置在限位块的两侧。
进一步地， 所述焊接部的顶面高于所述卡接部的顶面。
进一步地， 所述焊接部固定连接于一弹片的顶面， 所述弹片的底面固 定于所述下钳夹的内底面上， 所述弹片的自身轴线与所述下钳夹的轴线相 交使所述焊接部的底面高于所述弹片的底面。
进一步地， 所述弹片与限位块、 下钳夹的固定方式均为焊接固定。 进一步地， 所述下钳夹的内底面上设置有一垫片， 所述垫片包括一个 长槽， 所述弹片穿过所述长槽。 本发明的有益效果主要体现在： 结构筒单， 加工方便， 安全可靠， 具 有很好的推广价值。
附图说明
图 1是本发明的下钳夹的结构示意图， 未显示釘仓。
图 2是图 1中 A部分的放大图。
图 3是本发明的下钳夹的爆炸示意图。
图 4是本发明的下钳夹的剖视图， 此时未装上釘仓。
图 5是本发明的下钳夹的剖视图， 此时已装上釘仓。
其中：
1 下钳夹 11 内底面 2 釘仓
3 弹片 31 底面 32 顶面
4 限位块 41 卡接部 42 焊接部
5 击发片 51 击发端 52 开口
6 垫片 61 长槽
具体实施方式 如图 1-3所示， 本发明提供了一种直线型切割缝合器的保险机构。 与 现有技术一致， 所述直线型切割缝合器包括塑料外壳， 可相互闭合或打开 的上、 下钳夹， 上钳夹的远端设有釘砧（未示出）， 下钳夹 1的远端设有釘 仓 2。 当然， 上下钳夹的位置可以互换， 本发明为了表达清楚才如此定义。
所述下钳夹 1为 U形， 其远端可滑动地设有击发片 5和推刀杆（未示 出 ), 分别用于击发推釘片和切割组织。 使用时， 将组织放在釘砧与釘仓之 间， 然后对合上、 下钳夹， 闭合把手， 使上、 下钳夹夹紧组织， 然后推动 设置在上、 下钳夹近端的击发推钮， 即可实施组织的缝合和切割。
本发明的特点在于：所述直线型切割缝合器包括一个新型的保险机构， 所述保险机构包括一保险件， 及设置于所述击发片 5上的用于收容所述保 险件的开口 52, 所述开口 52靠近于所述击发片 5的击发端 51。 在本优选 实施例中， 所述保险件为一限位块 4, 所述限位块包括一个卡接部 41 , 所 述卡接部 41的外轮廓与所述击发片 5的开口 52的内轮廓相同， 所述釘仓 2的安装或移除可驱动所述限位块 4沿垂直于所述下钳夹 1的轴线的方向 移动， 进而使所述限位块 4的卡接部 41与所述击发片 5的开口 52脱离或 卡接， 实现保险解除与保险打开的作用。
结合图 4所示， 所述卡接部 41卡在所述开口 52内， 用于限制所述击 发片 5相对于下钳夹 1的移动。 结合图 5所示， 所述卡接部 41被釘仓 2 下压后， 与所述击发片 5脱离， 这样导致所述击发片 5可相对于下钳夹 1 移动。
进一步地， 所述限位块 4还包括一个用于被所述釘仓 2驱动的焊接部 42, 所述焊接部 42和卡接部 41分别设置在限位块 4的两侧。 即： 除了釘 仓 2可直接驱动所述卡接部 41之外， 或还可以驱动限位块 4的另一端。
优选的， 如图 3所示， 所述焊接部 42的顶面高于所述卡接部 41的顶 面。 这样， 当釘仓 2被安装到下钳夹 1上时， 釘仓 2会优选碰触到所述焊 接部 42, 由于限位块 4为刚性的， 所以该焊接部 42可带动卡接部 41从所 述击发片 5的开口 52中脱离。
本优选实施例中， 所述焊接部 42固定连接于一弹片 3的顶面 32, 所 述弹片 3的底面 32固定于所述下钳夹 1的内底面 11上。 所述弹片 3的自 身轴线与所述下钳夹 1的轴线相交，即所述弹片 3斜设于所述下钳夹 1内， 进而使所述焊接部 42的底面高于所述弹片 3的底面 31 , 使所述焊接部 42 与所述下钳夹 1的内底面 11有一个高度差，确保所述限位块 4的移动距离。 由于一些下钳夹 1的内底面 11上可能会设置有一垫片 6, 所以该垫片 6必 须包括一个长槽 61 , 供所述弹片 3穿过所述长槽 61 , 如果没有垫片 6, 可 以在弹片与钳夹焊接的地方设置一个槽， 弹片焊接在钳夹的外表面。
进一步地， 本优选实施例中， 所述弹片 3与限位块 4、 下钳夹 1的固 定方式均为焊接固定。 本发明结构筒单， 加工方便， 安全可靠， 具有很好 的推广价值。 本发明尚有多种实施方式， 凡采用等同变换或者等效变换而形成的所 有技术方案， 均落在本发明的保护范围之内。

Claims

权 利 要 求
1. 一种直线型切割缝合器， 包括： 可相互闭合或打开的上、 下钳夹， 所述下钳夹的远端设置有釘仓， 所述下钳夹为 u形， 其内可滑动地设有击 发片和推刀杆，其特征在于： 所述直线型切割缝合器还包括一个保险机构， 所述保险机构包括一保险件， 及设置于所述击发片上的用于收容所述保险 件的开口， 所述釘仓的安装或移除可驱动所述保险件沿垂直于所述下钳夹 的轴线的方向移动， 进而使所述保险件与所述击发片的开口脱离或卡接。
2. 根据权利要求 1所述的直线型切割缝合器， 其特征在于： 所述保险 件为一限位块， 所述限位块包括一个卡接部， 所述卡接部的外轮廓与所述 击发片的开口的内轮廓相同。
3. 根据权利要求 2所述的直线型切割缝合器， 其特征在于： 所述限位 块还包括一个用于被所述釘仓驱动的焊接部。
4. 根据权利要求 3所述的直线型切割缝合器， 其特征在于： 所述焊接 部和卡接部分别设置在限位块的两侧。
5. 根据权利要求 4所述的直线型切割缝合器， 其特征在于： 所述焊接 部的顶面高于所述卡接部的顶面。
6. 根据权利要求 5所述的直线型切割缝合器， 其特征在于： 所述焊接 部固定连接于一弹片的顶面， 所述弹片的底面固定于所述下钳夹的内底面 于所述弹片的底面。
7. 根据权利要求 6所述的直线型切割缝合器， 其特征在于： 所述弹片 与限位块、 下钳夹的固定方式均为焊接固定。
8. 根据权利要求 7所述的直线型切割缝合器， 其特征在于： 所述下钳 夹的内底面上设置有一垫片， 所述垫片包括一个长槽， 所述弹片穿过所述 长槽。
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JP5680763B2 (ja) 2015-03-04
US20130264372A1 (en) 2013-10-10
CN101991453B (zh) 2012-07-18
CN101991453A (zh) 2011-03-30
US9433414B2 (en) 2016-09-06
EP2649947A1 (en) 2013-10-16
ES2556121T3 (es) 2016-01-13

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