WO2013026400A1 - 引导附件 - Google Patents

引导附件 Download PDF

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Publication number
WO2013026400A1
WO2013026400A1 PCT/CN2012/080503 CN2012080503W WO2013026400A1 WO 2013026400 A1 WO2013026400 A1 WO 2013026400A1 CN 2012080503 W CN2012080503 W CN 2012080503W WO 2013026400 A1 WO2013026400 A1 WO 2013026400A1
Authority
WO
WIPO (PCT)
Prior art keywords
guiding
flexible strip
distal end
guide
type binding
Prior art date
Application number
PCT/CN2012/080503
Other languages
English (en)
French (fr)
Inventor
陈望东
孙敏
单腾
裴永旺
丁水澄
王宗顺
刘凯
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
Priority claimed from CN201110243513.1A external-priority patent/CN102949221B/zh
Priority claimed from CN201210291706.9A external-priority patent/CN103584896B/zh
Priority claimed from CN201210291684.6A external-priority patent/CN103584895B/zh
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 ES12825929T priority Critical patent/ES2705976T3/es
Priority to PL12825929T priority patent/PL2752162T3/pl
Priority to EP12825929.8A priority patent/EP2752162B1/en
Priority to US14/240,558 priority patent/US9629634B2/en
Priority to JP2014526376A priority patent/JP6045586B2/ja
Priority to EP18189126.8A priority patent/EP3434202B1/en
Publication of WO2013026400A1 publication Critical patent/WO2013026400A1/zh

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • 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
    • A61B17/3205—Excision instruments
    • A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/345—Cannulas for introduction into a natural body opening
    • A61B2017/3452—Cannulas for introduction into a natural body opening for the rectum, e.g. for hemorrhoid surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F04—POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
    • F04C—ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS
    • F04C2270/00—Control; Monitoring or safety arrangements
    • F04C2270/04—Force
    • F04C2270/042—Force radial
    • F04C2270/0421—Controlled or regulated

Definitions

  • the present invention relates to a surgical aid for a round tube type binding apparatus, and more particularly to a guiding attachment for a round tube type binding apparatus.
  • the round tube type binding instrument is a surgical instrument widely used for round tube type tissue slitting surgery, which consists of a round nail head assembly and a firing assembly; and two tube-shaped tissues that need to be connected are placed in the nail head assembly. Between the anvil and the staple cartridge, the distance between the anvil and the staple cartridge is adjusted to gradually clamp the tissue, and then the firing assembly is operated to shape the staples to complete the connection of the two sections of tissue.
  • a round tube type binding instrument of two kinds of surgery namely low rectal surgery and gastric bypass surgery.
  • the first low rectal procedure used a 33 mm diameter round tube binder that required an anus surgery.
  • the second type of gastric bypass surgery uses a 25 mm diameter round tube type binding instrument that requires access to the small intestine for surgery. Since the small intestine is the digestive pipe of the human body, there are many mucous membranes on the inner wall, and the round tube type binding device has a large end face, and the surface is not smooth enough due to structural reasons, and it is easy to damage the mucous membrane in the small intestine.
  • An object of the present invention is to solve the above technical problems and to provide a guide attachment which is simple in structure and convenient in operation.
  • a guiding attachment is coupled to a round tube type binding device, the round tube type binding device comprising an anvil assembly and a staple cartridge assembly; the cartridge assembly comprising a staple cartridge and a staple cartridge fixed to each other, the guiding attachment
  • the utility model at least includes a sleeve portion for being sleeved on a distal end of the round tube type binding device, and a guiding portion disposed at a distal end of the sleeve portion, the maximum outer diameter of the guiding portion being equal to the sleeve portion
  • the minimum outer diameter, the guiding portion is a spiral member, and one end of the thread of the spiral member is connected to a pulling member, and the other end is connected to the sleeve portion.
  • the outer contour of the guiding portion is conical, and the inner cavity of the conical shape is hollow.
  • the sleeve portion has a cylindrical shape or a semi-cylindrical shape, and an inner diameter of the sleeve portion is larger than an outer diameter of the barrel.
  • the guiding attachment further comprises an outwardly-arranged convex edge for holding at the proximal end of the sleeve.
  • a set of reinforcing ribs are vertically disposed between adjacent thread lines of the spiral member.
  • one end of the traction member is connected to the most distal center of the thread.
  • the traction member passes through the wire hole of the nail cylinder, and the other end of the traction member is provided with a pull ring.
  • the spiral member is two spaced apart threaded wires, one ends of the two threaded wires are connected to each other, and the other end is connected to the sleeve portion.
  • the traction member is hooked on the ends of the two threaded wires that are joined together.
  • the present invention also discloses another guiding attachment that is coupled to a round tube type binding apparatus, the round tube type binding apparatus including an anvil assembly and a cartridge assembly; the cartridge assembly includes a nail barrel and a nail fixed to each other a guiding device comprising at least a sleeve portion for being sleeved on a distal end of the tube-type binding device, and a guiding portion disposed at a distal end of the sleeve portion, a maximum outer diameter of the guiding portion And a minimum outer diameter of the sleeve, the guiding portion is a integrally molded flexible U-shaped rotating member, the U-shaped rotating member has a U-shaped central cross section, and the guiding portion includes a proximal end. And a distal end, the outer diameter of the distal end being less than or equal to the outer diameter of the proximal end.
  • the guiding portion and the sleeve portion are an integrally molded flexible U-shaped rotating member, and the flexible U-shaped rotating member is disassembled when being pulled by an external force, and finally formed into a detachable round tube type binding device.
  • Banded body is an integrally molded flexible U-shaped rotating member, and the flexible U-shaped rotating member is disassembled when being pulled by an external force, and finally formed into a detachable round tube type binding device.
  • the sleeve portion is a thin wall that is sleeved on an outer circumference of the staple cartridge.
  • the thin wall is provided with a clamp fixed to the staple cartridge.
  • the invention also discloses another guiding attachment, which is matched on a round tube type binding device, and the round tube correction page (Article 91)
  • the stapler includes an anvil assembly and a staple cartridge assembly; the cartridge assembly includes a staple cartridge and a staple cartridge fixed to each other, and an anvil pull rod disposed in the staple cartridge, the guide attachment at least including a sleeve for the sleeve a sleeve portion of the distal end of the round tube type binding device, and a guiding portion disposed at a distal end of the sleeve portion, the maximum outer diameter of the guiding portion being equal to the minimum outer diameter of the sleeve portion, the guiding The portion is a conical cavity flexible plastic piece, the guiding portion comprises a proximal end and a distal end, the outer diameter of the distal end to the proximal end is gradually increased, and the plastic piece is pulled by an external force.
  • the press is disintegrated in a spiral from the far and near
  • the sleeve portion is a thin wall that is sleeved on the outer circumference of the staple cartridge, and the guide portion and the sleeve portion are an integrally molded spiral flexible plastic member.
  • a distal end of the distal end of the hollow inner cavity of the guiding portion is convexly provided with a central cylinder, and an inner diameter of the central cylinder is equal to an outer diameter of the distal end of the anvil rod.
  • a proximal end wall of the central cylinder is provided with a traction hole, and the proximal end of the central cylinder is one end of the entire flexible plastic member.
  • the round tube type binding device cartridge is provided with at least one guiding hole, and the guiding portion of the strip body is separated from the guiding tube by the tubular binding device.
  • the present invention also discloses another guiding attachment that is coupled to a round tube type binding apparatus, the round tube type binding apparatus including an anvil assembly and a cartridge assembly; the cartridge assembly includes a nail barrel and a nail fixed to each other a shank and an anvil pull rod disposed in the staple cartridge, the guiding attachment at least comprising a sleeve portion disposed on a distal end of the round tube type binding device, and a distal end portion disposed at the distal end of the sleeve portion a guiding portion, a maximum outer diameter of the guiding portion is equal to a minimum outer diameter of the sleeve portion, the guiding portion is a hollow flexible plastic piece having a conical shape, the guiding portion comprises a proximal end and a distal end The outer diameter of the distal end to the proximal end gradually increases; the conical wall of the guiding portion includes a first flexible strip and a second flexible correction sheet (Article 91) a strip, the first flexible strip and the second flexible
  • the sleeve portion includes a first flexible strip and a second flexible strip, the first flexible strip and the second flexible strip are spirally disposed and closely spaced, and the first flexible strip and the second flexible strip of the sleeve portion
  • the flexible strips are integrally formed with the first flexible strip and the second flexible strip of the guiding portion, respectively.
  • the wall thickness of the sleeve portion is smaller than the wall thickness of the guide portion.
  • the first flexible strip is made of a hard material
  • the second flexible strip is made of a soft material
  • the first flexible strip and the second flexible strip are bonded or overmolded with each other. Made.
  • the distal end of the first flexible strip is provided with a traction member.
  • the traction member is an extension of the distal end of the first flexible strip, and the free end of the traction member extends toward the proximal end of the circular binder; or the traction member is fixed at the A pull line at the distal end of the first flexible strip.
  • the present invention also discloses another guiding attachment that is coupled to a round tube type binding apparatus, the round tube type binding apparatus including an anvil assembly and a cartridge assembly; the cartridge assembly includes a nail barrel and a nail fixed to each other a shank and an anvil pull rod disposed in the staple cartridge, the guiding attachment at least comprising a sleeve portion disposed on a distal end of the round tube type binding device, and a distal end portion disposed at the distal end of the sleeve portion a guiding portion, wherein a maximum outer diameter of the guiding portion is equal to a minimum outer diameter of the sleeve portion, the guiding portion is a hollow flexible plastic member having a conical shape, the guiding portion comprises a proximal end and a The distal end, the outer diameter of the distal end to the proximal end gradually increases; the conical wall of the guiding portion comprises two inner and outer layers, the first layer is a spiral body wound by a first flexible strip, and the second layer is
  • the first flexible strip is tightly spirally disposed, and the second film layer covers only the outer side or the inner side of the conical wall.
  • the first flexible strip is spirally disposed
  • the second film layer is coated on the outer side or the inner side of the conical wall, and a part of the second film layer protrudes into the spiral of the first flexible strip. Between the lines, the first flexible strip and the second film layer are spirally disposed and closely spaced.
  • the sleeve portion is a first flexible strip
  • the first flexible strip of the sleeve portion is integrally formed with the first flexible strip of the guiding portion.
  • the second film layer is coated on the outer side of the first flexible strip of the sleeve portion and the guiding portion.
  • the wall thickness of the sleeve portion is smaller than the wall thickness of the guide portion.
  • the first flexible strip is made of a hard material
  • the second film layer is made of a soft material; the first flexible strip and the second film layer are bonded or overmolded with each other. Made.
  • the distal end of the first flexible strip is provided with a traction member.
  • the traction member is an extension of the distal end of the first flexible strip, and the free end of the traction member extends toward the proximal end of the circular binder; or the traction member is fixed at the A pull line at the distal end of the first flexible strip.
  • part or all of the guiding attachment can be drawn out of the round tube type binding device in a long strip shape, and the operation is convenient; the guiding accessory can be directly set on the round tube type binding during the operation The outside of the instrument is used, so no additional parts are required for the round tube type binder.
  • Figure 1 Schematic diagram of the first embodiment of the present invention.
  • Figure 2 A plan view of a first embodiment of the invention.
  • Fig. 3 is a schematic view showing the assembly of the first embodiment of the present invention to a round tube type binding device.
  • Fig. 4 is a cross-sectional view showing a first embodiment of the present invention.
  • Figure 5 is a schematic view showing the structure of a second embodiment of the present invention.
  • Figure 6 is a cross-sectional view showing a second embodiment of the present invention.
  • Figure 7 is a schematic view showing the structure of a third embodiment of the present invention.
  • Figure 8 is a front elevational view of a third embodiment of the present invention.
  • Figure 9 A cross-sectional view along A-A in Figure 8.
  • Figure 10 is a schematic view showing the structure of a fourth embodiment of the present invention.
  • Figure 11 is a cross-sectional view showing a fourth embodiment of the present invention.
  • Figure 12 is a schematic view showing the structure of a fifth embodiment of the present invention.
  • Figure 13 A plan view of a fifth embodiment of the present invention.
  • Figure 14 is a schematic view showing the structure of a sixth embodiment of the present invention.
  • Figure 15 is a schematic view showing the structure of a seventh embodiment of the present invention.
  • Figure 16 Front view of a seventh embodiment of the present invention.
  • Figure 17 is a plan view of a seventh embodiment of the present invention.
  • Figure 18 is a partially enlarged schematic view showing the tearing of the seventh embodiment of the present invention.
  • Figure 19 is a schematic view showing the structure of an eighth embodiment of the present invention.
  • Figure 20 is a schematic view showing the structure of a ninth embodiment of the present invention.
  • Correction page Article 91
  • Figure 21 Front view of a ninth embodiment of the present invention.
  • Figure 22 A plan view of a ninth embodiment of the present invention.
  • Figure 23 is a schematic view showing the structure of a tenth embodiment of the present invention. among them:
  • the present invention discloses an auxiliary instrument for a round tube type binding device, and more particularly, a guide attachment for guiding a tubular type binding device into the body.
  • a prior art round tube type binding apparatus includes an anvil assembly, a cartridge assembly, and a circular tube fixed to a proximal end of the cartridge assembly; the cartridge assembly includes a staple cartridge 1 and a staple cartridge 2 that are fixed to each other, The proximal end of the cartridge 1 is provided with at least one wire hole 3.
  • the guiding attachment includes: a sleeve portion 4 for being sleeved on the distal end of the tube-type binding device, and is disposed on the sleeve portion 4
  • the distal guiding portion 6 and the outwardly diverging convex edge 5 for holding at the proximal end of the sleeve portion 4.
  • the sleeve portion 4 is cylindrical and has an inner diameter larger than the outer diameter of the barrel so that the entire guide attachment can be easily sleeved on the outside of the barrel.
  • the outer contour of the 1 guide portion 6 is a conical shape, and the conical inner cavity is hollow.
  • the maximum outer diameter of the guiding portion 6 is equal to the minimum outer diameter of the sleeve portion, the guiding portion 6 is a spiral member, and one end of the thread line 61 of the spiral member is connected with a pulling member 7, and the other end is The sleeve portion 4 is connected.
  • a pair of reinforcing ribs 62 are vertically disposed between the adjacent threaded lines 61 of the spiral member, and the connection between the guiding portion 6 and the sleeve portion 4 also depends on the reinforcing rib 62.
  • the rib 62 is a plastic piece having a narrow and small end, which is similar to a beverage bottle cap and can be easily torn off.
  • the guide portion 6 and the sleeve portion 4 are lost from each other and are separated from each other.
  • one end of the pulling member 7 is connected to the most distal center of the thread 61.
  • the pulling member 7 passes through the wire hole 3 of the nail barrel, and the other end of the pulling member 7 is provided with a pull ring 8.
  • the guiding accessory is sleeved on the outer side of the cartridge assembly, and the tubular shape binding device is guided through the conical structure into the surgical position in the human body; then the pulling member is pulled through the pull ring to make the connection
  • the spiral 61 of the pulling member is forced and the rib 62 is torn off, so that the spiral 61 of the entire guiding portion is drawn out of the wire hole 3 from the wire hole 3 in a strip shape at a time.
  • the hand-held flange 5 pulls the sleeve portion 4, which is placed outside the cartridge, toward the proximal end of the tube-type binder to cause it to withdraw from the body. In this way, the round tube type binding instrument can perform the operation.
  • Figures 5 and 6 disclose a second embodiment of the present invention, the sleeve portion being semi-cylindrical.
  • the biggest feature of this example is that the spiral is a two-threaded thread 61 that is similar to the existing mosquito coils.
  • One ends of the two threaded wires 61 are connected to each other, and the other end is connected to the sleeve portion via a rib 62.
  • the traction member 7 is hooked on the joined ends of the two threads.
  • the guiding attachment is sleeved on the outer side of the cartridge assembly, and the tubular shape binding device is guided through the conical structure into the surgical position in the human body; then the traction member is pulled, and the two threaded wires are connected. The end is stressed and the rib 62 is broken, so that the entire guide portion of the spiral 61
  • Correction page (Article 91) It is drawn out of the wire hole 3 in a strip shape at a time out of the round tube type binding device. Since the two spiral wires 61 are simultaneously deformed and pulled out of the round tube type binding device, the operation time is faster than that of the first embodiment.
  • the hand-held flange 5 pulls the sleeve portion 4 that is sleeved outside the cartridge to the proximal end of the tube-type binder to be withdrawn from the body. In this way, the round tube type binding instrument can perform the operation.
  • the guiding portion 6 is a integrally molded flexible U-shaped rotating member, the U-shaped rotating member has a U-shaped central cross section, and the guiding portion 6 includes a proximal end 17 and A distal end 15, the outer diameter of the distal end 15 is less than or equal to the outer diameter of the proximal end 17, and the outer diameter of the proximal end 17 is equal to the outer diameter of the staple cartridge 3 or the cartridge 1.
  • the biggest difference between this example and the foregoing embodiment is the circumferential shape of the "helix" of the guide portion.
  • the shape of the "spiral" of the guide attachment of the present invention is not important.
  • other shapes may be used as long as it is surrounded by a complete plastic strip. That is, the U-shaped convoluted plastic member of the third embodiment can also be used in the first embodiment.
  • the proximal end 17 of the guiding portion is a flat surface 25 that is in contact with the surface of the staple cartridge
  • the sleeve portion 4 is a thin wall that is sleeved on the outer periphery of the staple cartridge
  • the thin wall and the guiding portion 6 are A flexible U-shaped rotator that is integrally molded.
  • the thin wall is provided with a clamp 39 fixed to the staple cartridge.
  • Figures 10 and 11 disclose a fourth embodiment of the present invention.
  • This embodiment is similar to the first embodiment.
  • the guiding portion 6 is a spiral flexible plastic member formed integrally with the surrounding portion, that is, the guiding portion 6 is a spiral object surrounded by a flexible plastic member. spring.
  • the guiding portion 6 is a section of "spring line”.
  • Correction page (Article 91)
  • a central cylinder 21 is protruded inwardly from the bottom of the distal end 15 of the hollow inner cavity of the guiding portion 6, and the inner diameter of the central cylinder 21 is equal to the outer diameter of the distal end of the anvil rod.
  • a proximal end wall of the central cylinder 21 is provided with a traction hole 23, and the proximal end of the central cylinder is one end of the entire flexible plastic member, that is, one end of the "spring line".
  • the proximal end of the guiding portion 6 is a flat surface 25 that fits the staple cartridge face 5.
  • the sleeve portion 4 is a thin wall that is sleeved on the outer periphery of the staple cartridge, and the thin wall and the guide portion 6 are a spiral-shaped flexible plastic member integrally molded.
  • the guiding accessory is sleeved at the distal end of the cartridge assembly, then the round tube type binding device is guided into the human body, and then the pulling wire connected to the traction hole is pulled to make the guiding accessory as a whole strip.
  • the shape is drawn out of the tube-type binder at one time, similar to pulling the "spring line" into a straight line.
  • the guiding portion of the above embodiment can extract the guide from the inside of the binding device, that is, the round tube type binding device can be provided with at least one guiding hole, and the guiding portion of the strip body is from the guiding hole.
  • the middle tube is separated from the round tube type binding device.
  • the above embodiment can also be withdrawn from the outside of the stapler as long as the position of the traction member on the guide is changed.
  • the guiding attachment of the embodiment is a hollow flexible plastic part which is generally conical, because the flexible plastic part for enclosing the guiding attachment can be made of rubber or other plastic, according to the degree of the process, the guiding attachment can be ""
  • the spring wires are made in different thicknesses, resulting in different sizes of the guide attachments.
  • the guiding portion 6 of the guiding attachment includes a proximal end 17 and a distal end 15, and the outer diameter of the distal end 15 to the proximal end 17 gradually increases.
  • the diameter of the inner wall of the proximal end 17 is greater than or equal to the maximum outer diameter of the cartridge 1 such that when the guiding attachment is mated to the tubular binder, the guiding attachment may be placed over the On the outer circumference of the nail cylinder 1.
  • the conical wall of the guiding portion 6 comprises a first flexible strip 63 and a second flexible strip 64, which are wound in parallel to form a spiral body, the first flexible strip 63 and the second flexible strip
  • the 64-space spiral is set and snug.
  • the first flexible strip 63 is made of a relatively hard material, that is, the strength is high and the hardness is high; and the second flexible strip 64 is made of a relatively soft material, that is, the strength is poor and the tear is easy to tear. Since there are many types of medical plastics, such as PVC, PE, PP, PET, PU, PS, PC, PTFE, etc., as long as the above strength conditions are met.
  • the first flexible strip 63 and the second flexible strip 64 are bonded or overmolded with each other.
  • the sleeve portion 4 includes a first flexible strip 63 and a second flexible strip 64.
  • the first flexible strip 63 and the second flexible strip 64 are spirally disposed and closely spaced, and the first flexible strip of the sleeve portion 4
  • a second flexible strip is integrally formed with the first flexible strip and the second flexible strip of the guiding portion 6, respectively. Since the first flexible strip 63 and the second flexible strip 64 are closely entangled with each other, the strength of the conical wall of the entire guide portion 6 is large, and does not collapse when the guide tube type binding device is guided into the patient's body.
  • the outer side of the conical wall of the entire guiding portion 6 is relatively smooth, and the outer wall does not become the guide tube type binding device when entering the patient. Scratching the tissue is much better than a single spiral flexible strip.
  • the distal end of the first flexible strip 63 is further provided with a pulling member 7.
  • the traction member 7 is an extension of the distal end of the first flexible strip 63, and the free end of the traction member 7 extends toward the proximal end of the tubular binder.
  • the traction member 7 may also be fixed to the distal end of the first flexible strip 63.
  • Correction page (Article 91) Traction line. That is, as long as it plays a traction role.
  • the round tube type binding device cartridge is provided with at least one guiding hole, and the pulling member 7 passes through the guiding hole in an initial state.
  • the guide member of the preferred embodiment is first sleeved at the distal end of the cartridge assembly, and then the tubular binder is guided into the body, at which time the free end of the traction member 7 passes through the guide hole and is exposed to the patient. in vitro. Then pulling the traction member 7 to spirally disassemble the first flexible strip 63 in a far and near order, and finally form a strip body composed of a first flexible strip and a second flexible strip and be disposable The ground is drawn from the guide hole out of the round tube type binder, similar to pulling the "spring line" into a straight line.
  • the second flexible strip 64 is inferior in strength, it is easily pulled off, and the broken body is pulled out of the first flexible strip 63 out of the round tube type binding apparatus.
  • the above embodiment can also be withdrawn from the outside of the stapler as long as the position of the traction member on the guide is changed.
  • Fig. 14 discloses a sixth embodiment of the present invention.
  • the wall thickness of the sleeve portion 4 is relatively large, the outer diameter of the tube-type binder is significantly increased, thereby affecting the insertion of the tube-type binder and increasing the pain of the patient. Therefore, in the sixth embodiment, the wall thickness of the sleeve portion 4 is smaller than the wall thickness of the guide portion 6. This greatly reduces the impact of wall thickness.
  • Other structures and operation methods of the sixth embodiment are the same as those of the fifth embodiment, and are not described herein again.
  • the conical wall of the guiding attachment comprises two inner and outer layers
  • the first inner layer is a spiral body wound by the first flexible strip 63
  • the outer second layer is covered with The second film layer 65 outside the first layer.
  • first flexible strip 63 is wound out of the spiral and the second film layer 65 is covered within the first layer are not excluded from the scope of the present invention.
  • the first flexible strip 63 is tightly spirally arranged, and the second film layer 65 only covers the correction page (Article 91) On the outer side of the conical wall 51.
  • the first flexible strip 63 is spirally disposed, and the second film layer 65 is wrapped around the outer side of the conical wall 51, and is partially second.
  • the film layer 65 extends between the spirals of the first flexible strip 63 such that the first flexible strip 63 and the second film layer 65 are spirally disposed and closely spaced.
  • the first flexible strip 63 is made of a relatively hard material, that is, the strength is high and the hardness is high; and the second film layer 65 is made of a relatively soft material, that is, the strength is poor and the tear is easy to tear.
  • the first flexible strip 63 and the second film layer 65 are bonded or overmolded with each other.
  • the sleeve portion 4 is an extension of the first flexible strip, and the first flexible strip of the sleeve portion 4 and the first flexible strip 63 of the guide portion 6 are integrally formed. Forming.
  • the second film layer 65 covers the outside of the first flexible strip of the sleeve portion and the guiding portion.
  • the distal end of the first flexible strip 63 is further provided with a pulling member 7.
  • the traction member 7 is an extension of the distal end of the first flexible strip 63, and the free end of the traction member 7 extends toward the proximal end of the tubular binder.
  • the traction member 7 may also be a traction wire fixed to the distal end of the first flexible sheath 63. That is, as long as it plays a traction role.
  • the round tube type binding device is provided with at least one guiding hole, and the pulling member 7 passes through the guiding hole in an initial state.
  • the first flexible strip 63 is tightly wound in the seventh embodiment; in the ninth embodiment, the portions of the first flexible strip 63 and the second flexible layer 65 are tightly wound together, so that the conical wall of the entire guide portion The strength is large, and it will not collapse when guiding the round tube type binding device into the patient.
  • the second film layer 65 is integrally wrapped on the outer side of the first flexible strip 63, the outer side of the conical wall 51 of the entire guiding attachment is relatively smooth, and the outer wall does not scrape when guiding the circular tube type binding device into the patient. Damage, the effect is much better than a single spiral flexible strip.
  • the operation modes of the seventh embodiment and the ninth embodiment are the same, and the seventh embodiment is the correction page (Article 91) example.
  • the guide member of the preferred embodiment is first sleeved at the distal end of the cartridge assembly, and then the tubular binder is guided into the body, at which time the free end of the traction member 7 passes through the guide hole and is exposed to the patient. in vitro.
  • the pulling member 7 is then pulled, and the second film layer 65 is spirally disassembled in the order of far and near with the first flexible strip 63, finally formed into a strip and is once and from the guiding hole. It is similar to pulling the "spring wire" into a straight line, except for the round tube type binding machine. In this process, since the strength of the second film layer 65 is poor, it is easily broken. As shown in FIG.
  • the second film layer 65 is generated near the two spirals adjacent to the first flexible strip 63.
  • a tear line 67 the broken body will be pulled out of the round tube type binder along with the first flexible strip 63.
  • the above embodiment can also be withdrawn from the outside of the stapler as long as the position of the traction member on the guide is changed.
  • Fig. 19 discloses an eighth embodiment of the present invention, which differs from the seventh embodiment in that the wall thickness of the sleeve portion 4 is smaller than the wall thickness of the guide portion 6. This greatly reduces the impact of wall thickness.
  • Other structures and operation methods of the eighth embodiment are the same as those of the seventh embodiment, and are not described herein again.
  • Fig. 23 discloses a tenth embodiment of the present invention, which differs from the ninth embodiment in that the wall thickness of the sleeve portion 4 is smaller than the wall thickness of the guide portion 6. This greatly reduces the impact of wall thickness.
  • Other structures and operation methods of the tenth embodiment are the same as those of the ninth embodiment, and are not described herein again.
  • a color area different from the whole of the guiding attachment is provided at the proximal end of the guiding attachment, especially for the bright yellow color, generally adopting a spraying method for prompting the doctor to guide the accessories to be completely removed.
  • the round tube type binding instrument Due to the presence of the yellow area, when the doctor sees the yellow area, it proves that the guide attachment has been pulled all the way out of the round binder.
  • Correction page (Article 91)
  • the operation of the present invention is simple, and the guide attachment can be detached from the round tube type binding device in one step.
  • the prior art requires a multi-step operation, and the spring wire cannot be detached in a long strip shape, and it is easy to scratch the tissue.
  • the present invention has various specific embodiments, and all technical solutions formed by equivalent replacement or equivalent transformation are within the scope of the present invention.

Abstract

一种引导附件，配接于圆管型装订仪上，圆管型装订仪包括钉砧组件、钉仓组件；钉仓组件包括相互固定的钉筒（1）和钉仓（2），引导附件至少包括用于套设于圆管型装订仪的远端的套设部（4），以及设于套设部（4）远端的引导部（6），引导部（6）的最大外径等于套设部（4）的最小外径，引导部（6）为螺旋件，在受到外力牵拉时即按由远及近的顺序呈螺旋解体，最终成为一条可脱离圆管型装订仪的带状体，引导附件的部分或全部能成条状一次性地被抽出于圆管型装订仪，该引导附件可以在手术时直接套设在圆管型装订仪的外侧使用，没有额外的部件需要装配。

Description

引导附件
本申请要求如下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：
1 ) 2011年 8月 24日提交中国专利局、 申请号为 201110243513.1、 发 明名称为"引导附件"的中国专利申请。
2 ) 2012年 08月 16 日提交中国专利局、 申请号为 201210291684.6、 发明名称为 "双螺旋引导件 "的中国专利申请。
3 ) 2012年 08月 16 日提交中国专利局、 申请号为 201210291706.9、 发明名称为"引导件 "的中国专利申请。 技术领域
本发明涉及一种圓管型装订仪的手术辅助件， 尤其涉及一种圓管型装 订仪的引导附件。
背景技术
圓管型装订仪是一种广泛用于圓管型组织缝切手术的外科器械， 由圆 形的钉头组件与击发组件组成； 将两段需要连接起来的圓管型组织放置在 钉头组件的钉砧与钉仓之间， 调整钉砧与钉仓的距离来逐渐夹紧组织， 然 后操作击发组件使钉成形， 完成两段组织的连接。 在实际的手术操作中，有两种手术的圆管型装订仪进入管道比较困难， 分别是低位直肠手术与胃旁路手术。 第一种低位直肠手术， 采用的是直径 为 33毫米的圓管型装订仪，需经肛门进行手术。由于肛门为一个肌性开口， 正常状况其直径较小， 将大直径器械插入到肛门比较困难。 第二种胃旁路 手术， 采用的是直径为 25毫米的圆管型装订仪， 需进入小肠进行手术。 由 于小肠为人体的消化管道， 内壁有很多粘膜， 而圓管型装订仪由于端面较 大， 且由于结构原因表面不够圓滑， 在小肠内穿行易对粘膜造成损伤。
更正页 （细则第 91条) 目前解决上述问题的现有技术为美国专利申请 US20090204108 和 US20110114698 揭示的若干种套设在圓管型装订仪钉仓组件外周的辅助器 械， 可以引导圓管形装订仪的钉仓组件进入人体并穿过肠道， 在其到达手 术预定位置之后可以把这个辅助器械从钉仓组件上卸掉， 不影响圓管型装 订仪的后续操作。 这些辅助器械可帮助医生将装订仪的头部顺利地放入到 预定的位置， 但是目前此辅助器械需使用较大的力撕裂拖出， 易误伤组织 且使用体验不佳。 发明内容
本发明的目的在于解决上述的技术问题， 提供一种结构简单、 操作方 便的引导附件。
本发明的目的通过以下技术方案来实现：
一种引导附件， 配接于圓管型装订仪上， 所述圆管型装订仪包括钉砧 组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和钉仓， 所述引导附 件至少包括用于套设于所述圓管型装订仪的远端的套设部， 以及设于所述 套设部远端的引导部，所述引导部的最大外径等于所述套设部的最小外径， 所述引导部为螺旋件， 所述螺旋件的螺紋线的一端与一牵引件连接， 另一 端与所述套设部连接。
优选的， 所述引导部的外轮廓为圓锥形， 所述圓锥形的内腔呈中空设 置。
优选的， 所述套设部为圆筒形或半圓筒形， 所述套设部的内径大于所 述钉筒的外径。
更正页 （细则第 91条) 优选的， 所述引导附件还包括一设于所述套设部近端的向外发敢议直 的用于握持的凸边。
优选的， 所述螺旋件的相邻的螺紋线之间均垂直设有一组加强筋。 优选的， 所述牵引件的一端连接于螺纹线的最远端中心。
优选的， 所述牵引件从所述钉筒的线孔穿过， 所述牵引件的另一端设 有一拉环。
优选的， 所述螺旋件为两条间隔围绕的螺紋线， 该两条螺紋线的一端 相互连接在一起， 另一端均与所述套设部连接。
优选的， 所述牵引件钩在所述两条螺纹线的连接在一起的端部上。 本发明还揭露了另一种引导附件， 配接于圆管型装订仪上， 所述圆管 型装订仪包括钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和 钉仓， 所述引导附件至少包括用于套设于所述圓管型装订仪的远端的套设 部， 以及设于所述套设部远端的引导部， 所述引导部的最大外径等于所述 套设部的最小外径， 所述引导部为一整体注塑而成的柔性 U型回旋件， 所 述 U型回旋件的中心横截面为 U型，所述引导部包括一个近端和一个远端， 所述远端的外径小于等于近端的外径。
优选的， 所述引导部和套设部为一整体注塑而成的柔性 U型回旋件， 所述柔性 U型回旋件在受到外力牵拉时解体， 最终形成为一条可脱离圓管 型装订仪的带状体。
优选的， 所述套设部为套设于所述钉仓外周的薄壁。
优选的， 所述薄壁上设有固接于钉仓上的卡箍。
本发明还揭露了另一种引导附件， 配接于圓管型装订仪上， 所述圓管 更正页 （细则第 91条) 型装订仪包括钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和 钉仓、 及设于钉仓内的钉砧拉杆， 所述引导附件至少包括用于套设于所述 圆管型装订仪的远端的套设部， 以及设于所述套设部远端的引导部， 所述 引导部的最大外径等于所述套设部的最小外径， 所述引导部为一整体呈圓 锥形空腔柔性塑胶件， 所述引导部包括一个近端和一个远端， 所述远端到 近端的外径逐渐增大， 所述塑胶件在受到外力牵拉时按即由远及近的顺序 呈螺旋解体， 最终形成为一条可脱离圓管型装订仪的带状体。
优选的， 所述套设部为套设于所述钉仓外周的薄壁， 所述引导部和套 设部为一整体注塑而成的螺旋形柔性塑胶件。
优选的， 所述引导部的中空内腔的远端底部向内凸设有一个中心筒， 所述中心筒的内径等于所述钉砧拉杆的远端外径。
优选的， 所述中心筒的近端壁上开设有一个牵引孔， 所述中心筒的近 端为整个柔性塑胶件的一端。
优选的， 所述圓管型装订仪钉筒上设有至少 1个引导孔， 所述的呈带 状体的引导部从所述引导孔中脱离所述圆管型装订仪。
本发明还揭露了另一种引导附件， 配接于圓管型装订仪上， 所述圆管 型装订仪包括钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和 钉仓、 及设于钉仓内的钉砧拉杆， 所述引导附件至少包括用于套设于所述 圆管型装订仪的远端的套设部， 以及设于所述套设部远端的引导部， 所述 引导部的最大外径等于所述套设部的最小外径， 所述引导部为一整体呈圆 锥形的空腔柔性塑胶件， 所述引导部包括一个近端和一个远端， 所述远端 到近端的外径逐渐增大； 所述引导部的圆锥形壁包含第一柔性条和第二柔 更正页 （细则第 91条) 性条， 所述第一柔性条和第二柔性条间隔螺旋设置并紧贴， 所述圆锥形壁 在受到外力牵拉时即按由远及近的顺序呈螺旋解体， 最终形成为一条可脱 离圆管型装订仪的由第一柔性条和第二柔性条组成的带状体。
优选的， 所述套设部包含第一柔性条和第二柔性条， 所述第一柔性条 和第二柔性条间隔螺旋设置并紧贴， 所述套设部的第一柔性条和第二柔性 条分别与所述引导部的第一柔性条和第二柔性条一体成形。
优选的， 所述套设部的壁厚小于所述引导部的壁厚。
优选的， 所述第一柔性条采用硬质材料制得， 所述第二柔性条采用软 质材料制得， 所述第一柔性条和第二柔性条相互之间为粘接或二次注塑而 成。
优选的， 所述第一柔性条的远端设有一个牵引件。
优选的， 所述牵引件为所述第一柔性条的远端的延伸段， 所述牵引件 的自由端伸向圓管型装订仪的近端； 或者， 所述牵引件为固定在所述第一 柔性条的远端的牵引线。
本发明还揭露了另一种引导附件， 配接于圆管型装订仪上， 所述圓管 型装订仪包括钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和 钉仓、 及设于钉仓内的钉砧拉杆， 所述引导附件至少包括用于套设于所述 圆管型装订仪的远端的套设部， 以及设于所述套设部远端的引导部， 所述 引导部的最大外径等于所述套设部的最小外径， 所述引导部为一整体呈圓 锥形的空腔柔性塑胶件， 所述引导部包括一个近端和一个远端， 所述远端 到近端的外径逐渐增大； 所述引导部的圆锥形壁包含内外两层， 第一层为 由第一柔性条缠绕而成的螺旋体， 第二层为包覆在第一层上的第二膜层， 更正页 （细则第 91条) 在外力牵引时， 所述第二膜层伴随第一柔性条按由远及近的顺序呈螺旋解 体， 最终形成为一条可脱离圆管型装订仪的带状体。
优选的， 所述第一柔性条紧密螺旋设置， 所述第二膜层仅包覆于所述 圓锥形壁的外侧或内側。
优选的， 所述第一柔性条间隔螺旋设置， 所述第二膜层包覆于所述圓 锥形壁的外侧或内側， 且部分第二膜层伸入到所述第一柔性条的螺旋线之 间， 使所述第一柔性条和第二膜层间隔螺旋设置并紧贴。
优选的， 所述套设部为第一柔性条， 所述套设部的第一柔性条与所述 引导部的第一柔性条一体成形。
优选的， 所述第二膜层包覆于所述套设部和引导部的第一柔性条的外 側。
优选的， 所述套设部的壁厚小于所述引导部的壁厚。
优选的， 所述第一柔性条采用硬质材料制得， 所述第二膜层采用软质 材料制得； 所述第一柔性条和第二膜层相互之间为粘接或二次注塑而成。
优选的， 所述第一柔性条的远端设有一个牵引件。
优选的， 所述牵引件为所述第一柔性条的远端的延伸段， 所述牵引件 的自由端伸向圓管型装订仪的近端； 或者， 所述牵引件为固定在所述第一 柔性条的远端的牵引线。
本发明的有益效果主要体现在： 引导附件的部分或全部能呈长条状一 次性地被抽出于圓管型装订仪， 操作方便； 该引导附件可以在手术时直接 套设在圆管型装订仪的外側使用， 因此对于圆管型装订仪来讲， 没有额外 的部件需要装配。 更正页 （细则第 91条) 附图说明
下面结合附图对本发明技术方案作进一步说明:
图 1： 本发明第一实施例的结构示意图。
图 2： 本发明第一实施例的俯视图。
图 3: 本发明第一实施例装配到圓管型装订仪上的示意图 图 4： 本发明第一实施例的剖视图。
图 5： 本发明第二实施例的结构示意图。
图 6： 本发明第二实施例的剖视图。
图 7 : 本发明第三实施例的结构示意图。
图 8 : 本发明第三实施例的主视图。
图 9 : 图 8中沿 A- A的剖视图。
图 10: 本发明第四实施例的结构示意图。
图 11 : 本发明第四实施例的剖视图。
图 12： 本发明第五实施例的结构示意图。
图 13: 本发明第五实施例的俯视图。
图 14： 本发明第六实施例的结构示意图。
图 15: 本发明第七实施例的结构示意图。
图 16: 本发明第七实施例的主视图。
图 17 : 本发明第七实施例的俯视图。
图 18: 本发明第七实施例的撕裂时的局部放大示意图。 图 19: 本发明第八实施例的结构示意图。
图 20: 本发明第九实施例的结构示意图。 更正页 （细则第 91条) 图 21: 本发明第九实施例的主视图。
图 22: 本发明第九实施例的俯视图。
图 23: 本发明第十实施例的结构示意图。 其中：
Figure imgf000010_0001
实施方式
本发明揭示了一种圆管型装订仪的辅助器械， 尤其是一种用于引导圓 管型装订仪进入体内的引导附件。
现有技术的圆管型装订仪包括钉砧组件、 钉仓组件、 固定于所述钉仓 组件近端的圓管； 所述钉仓组件包括相互固定的钉筒 1和钉仓 2 , 所述钉 筒 1的近端设有至少一个线孔 3。
如图 1至图 4所示的第一实施例中， 所述引导附件包括： 用于套设于 所述圓管型装订仪的远端的套设部 4 , 设于所述套设部 4远端的引导部 6 , 以及设于所述套设部 4近端的向外发散设置的用于握持的凸边 5。
所述套设部 4为圆筒形， 其内径大于所述钉筒的外径， 这样整个引导 附件可以很容易地套设在钉筒的外侧。
更正页 （细则第 91条) 所述 1导部 6的外轮廓为一个圆锥形，所述圆锥形的内腔呈中空设置。 所述引导部 6的最大外径等于所述套设部的最小外径， 所述引导部 6为螺 旋件， 所述螺旋件的螺紋线 61的一端与一牵引件 7连接， 另一端与所述套 设部 4连接。 所述螺旋件的相邻的螺纹线 61之间均垂直设有一组加强筋 62， 所述引导部 6与套设部 4之间的连接也是依靠该加强筋 62。 所述加强 筋 62为一端窄而小的塑胶件， 类似于饮料瓶盖， 很容易被扯断。 当引导部 6与套设部 4之间的加强筋 62被扯断后， 所述引导部 6与套设部 4之间就 失去连接， 相互脱离。
本例中， 所述牵引件 7的一端连接于螺紋线 61的最远端中心。所述牵 引件 7从所述钉筒的线孔 3穿过， 所述牵引件 7的另一端设有一拉环 8。
第一实施例在操作时， 先将引导附件套在钉仓组件的外侧， 通过其圓 锥形的结构引导圆管型装订仪进入人体内的手术位置； 然后通过拉环拉扯 牵引件， 使连接于牵引件的螺旋线 61受力并扯断加强筋 62 , 这样整个引 导部的螺旋线 61呈条状一次性地从线孔 3中被抽出于圓管型装订仪外。接 着， 手持凸边 5将套在钉筒外的套设部 4向圓管型装订仪的近端拉， 使其 退出于人体内。 这样， 圓管型装订仪即可进行手术。
图 5、 图 6揭示了本发明的第二实施例， 其套设部为半圓筒形。 本例 中最大的特点在于： 所述螺旋件为两条间隔围绕的螺纹线 61 , 类似于现有 的蚊香。该两条螺纹线 61的一端相互连接在一起， 另一端均与所述套设部 通过加强筋 62连接。所述牵引件 7钩在所述两条螺紋线的连接在一起的端 部上。
第二实施例在操作时， 先将引导附件套在钉仓组件的外侧， 通过其圆 锥形的结构引导圓管型装订仪进入人体内的手术位置； 然后拉扯牵引件， 两条螺纹线的连接端受力并扯断加强筋 62， 这样整个引导部的螺旋线 61
更正页 （细则第 91条) 呈条状一次性地从线孔 3中被抽出于圓管型装订仪外。 由于两条螺旋线 61 同时变形并拉出于圓管型装订仪外， 所以其操作时间较第一实施例快。 接 着， 手持凸边 5将套在钉筒外的套设部 4向圆管型装订仪的近端拉动退出 于人体内。 这样， 圓管型装订仪即可进行手术。
图 7至图 9揭示了本发明的第三实施例。 该实施例的特点在于： 所述 引导部 6为一整体注塑而成的柔性 U型回旋件， 所述 U型回旋件的中心横 截面为 U型， 所述引导部 6包括一个近端 17和一个远端 15， 所述远端 15 的外径小于等于近端 17的外径， 所述近端 17的外径等于钉仓 3或钉筒 1 的外径。 本例与前述实施例的最大区别在于引导部的 "螺旋线" 的环绕形 状。
因此表明， 本发明的引导附件的 "螺旋线" 的形状不是重点， 除了本 发明揭示的螺旋状、 U 型回旋状， 还可以是其他的形状， 只要是一条完整 的塑胶条围设的即可， 即该第三实施例的 U型回旋状塑胶件也可以用于第 一实施例。
本例中， 所述引导部的近端 17为一与钉仓面贴合的平面 25 , 套设部 4 为套设于所述钉仓外周的薄壁， 所述薄壁和引导部 6为一整体注塑而成的 柔性 U型回旋件。 所述薄壁上设有固接于钉仓上的卡箍 39。
由于操作方法与第一实施例大致相同， 因此在此不再赘述。
图 10和图 1 1揭示了本发明的第四实施例。 本实施例与第一实施例类 似， 所述引导部 6为一整体环绕而形成的螺旋形柔性塑胶件， 即该引导部 6 是由一个柔性塑胶件整体环绕围成的螺旋形物件， 类似于弹簧。 所述的 引导部 6即为一段 "弹簧线"。 更正页 （细则第 91条) 本实施例中，所述引导部 6的中空内腔的远端 15的底部向内凸设有一 个中心筒 21， 所述中心筒 21 的内径等于所述钉砧拉杆的远端外径。 这样 在初始状态时， 所述引导附件可以通过中心筒 21套设在钉砧拉杆上，使所 述引导附件配接于所述圆管型装订仪上。
所述中心筒 21 的近端壁上开设有一个牵引孔 23， 所述中心筒的近端 为整个柔性塑胶件的一端， 即为 "弹簧线" 的一端。
所述引导部 6的近端为一与钉仓面 5贴合的平面 25。 套设部 4为套设 于所述钉仓外周的薄壁， 所述薄壁和引导部 6为一整体注塑而成的螺旋形 柔性塑胶件。
该实施例在操作时， 先将引导附件套接在钉仓组件的远端， 然后引导 圓管型装订仪进入人体内， 接着拉扯连接于牵引孔的牵引线， 使所述引导 附件整体呈条状一次性地被抽出于圓管型装订仪， 类似于将 "弹簧线" 拉 成一直线。
上述的实施例的引导部都可从装订仪内部将引导器抽出， 即圆管型装 订仪钉筒上设有至少 1个引导孔， 所述的呈带状体的引导部从所述引导孔 中脱离所述圆管型装订仪。 当然上述的实施例也可以从装订仪外侧抽出， 只要改变牵引件位于引导器上的连接位置即可。
图 12至图 13揭示了本发明的第五实施例。 本实施例的引导附件为一 整体呈圓锥形的空腔柔性塑胶件， 因为用于围设引导附件的柔性塑胶件可 以采用橡胶或其他塑胶， 根据其工艺的程度， 可以将引导附件的 "弹簧线" 制成不同的粗细， 导致引导附件的内腔大小不一。 所述引导附件的引导部 6包括一个近端 17和一个远端 15，所述远端 15到近端 17的外径逐渐增大，
更正页 （细则第 91条) 所述近端 17的内壁的直径大于或等于所述钉筒 1的最大外径，这样， 当所 述引导附件配接于所述圓管型装订仪时， 所述引导附件可以套在所述钉筒 1的外周上。
本实施例的特点在于： 所述引导部 6 的圓锥形壁包含第一柔性条 63 和第二柔性条 64 , 两者平行缠绕形成一个螺旋体， 所述第一柔性条 63和 第二柔性条 64间隔螺旋设置并紧贴。 所述第一柔性条 63采用相对硬质材 料制得， 即强度较好、硬度较高； 所述第二柔性条 64采用相对软质材料制 得， 即强度较差、 易撕拉。 由于医用塑料的种类很多， 例如 PVC、 PE、 PP、 PET、 PU、 PS、 PC、 PTFE 等， 只要符合上述的强度条件即可。 所述第一柔 性条 63和第二柔性条 64相互之间为粘接或二次注塑而成。 所述套设部 4 包含第一柔性条 63和第二柔性条 64 , 所述第一柔性条 63和第二柔性条 64间隔螺旋设置并紧贴， 所述套设部 4的第一柔性条和 第二柔性条分别与所述引导部 6的第一柔性条和第二柔性条一体成形。 由于第一柔性条 63和第二柔性条 64相互紧密地缠绕在一起， 所以整 个引导部 6的圆锥形壁的强度较大， 在进行引导圓管型装订仪进入病人体 内时不会坍塌。 另由于第一柔性条 63和第二柔性条 64相互紧密地缠绕在 一起， 导致整个引导部 6的圆锥形壁的外側相对平滑， 在进行引导圆管型 装订仪进入病人体内时该外壁不会刮伤组织， 其效果比单一螺旋型柔性条 要好很多。
所述第一柔性条 63的远端还设有一个牵引件 7。 所述牵引件 7为所述 第一柔性条 63的远端的延伸段，所述牵引件 7的自由端伸向圓管型装订仪 的近端。或者， 所述牵引件 7也可以是固定在所述第一柔性条 63的远端的
更正页 （细则第 91条) 牵引线。 即只要起到牵引作用即可。 所述圆管型装订仪钉筒上设有至少 1 个引导孔， 所述牵引件 7在初始状态时从所述引导孔中穿过。
在操作时， 先将本优选实施例的引导件套接在钉仓组件的远端， 然后 引导圆管型装订仪进入人体内， 此时牵引件 7的自由端穿过引导孔并露出 于病人体外。 接着拉扯所述牵引件 7 , 使所述第一柔性条 63按由远及近的 顺序呈螺旋解体， 最终形成为一条由第一柔性条和第二柔性条组成的带状 体并被一次性地从所述引导孔中被抽出于圆管型装订仪外， 类似于将 "弹 簧线"拉成一直线。 在此过程中， 由于第二柔性条 64的强度较差， 很容易 被拉断， 其断体会随着第一柔性条 63—起拉出于圓管型装订仪外。 当然上 述的实施例也可以从装订仪外侧抽出， 只要改变牵引件位于引导件上的连 接位置即可。
图 14揭示了本发明的第六实施例。 当套设部 4的壁厚相对较大时，会 明显增加圓管型装订仪的外径， 从而影响圓管型装订仪的插入， 同时也会 增加病人的痛苦。 因此第六实施例中， 所述套设部 4的壁厚小于所述引导 部 6的壁厚。 这样大大减小了因壁厚带来的影响。 第六实施例的其他结构 和操作方法与第五实施例相同， 在此不再赘述。
图 15至图 18揭示了本发明的第七实施例。 本实施例的特点在于： 所 述引导附件的圓锥形壁包含内外两层， 居内的第一层为由第一柔性条 63 缠绕而成的螺旋体，居外的第二层为包覆在第一层外的第二膜层 65。当然， 第一柔性条 63缠绕而成的螺旋体居外、 覆在第一层内的第二膜层 65居内 的实施例也不排除在本发明的范围之外。
本例中， 所述第一柔性条 63紧密螺旋设置， 所述第二膜层 65仅包覆 更正页 （细则第 91条) 于所述圆锥形壁 51的外侧。如图 20至图 22所示的第九实施例中， 所述第 一柔性条 63间隔螺旋设置，所述第二膜层 65包覆于所述圓锥形壁 51的外 侧， 且部分第二膜层 65伸入到所述第一柔性条 63的螺旋线之间， 使所述 第一柔性条 63和第二膜层 65间隔螺旋设置并紧贴。
所述第一柔性条 63采用相对硬质材料制得， 即强度较好、 硬度较高； 所述第二膜层 65采用相对软质材料制得， 即强度较差、 易撕拉。 所述第一 柔性条 63和第二膜层 65相互之间为粘接或二次注塑而成。
第七实施例和第九实施例中， 所述套设部 4为第一柔性条的延伸， 所 述套设部 4的第一柔性条与所述引导部 6的第一柔性条 63—体成形。所述 第二膜层包 65覆于所述套设部和引导部的第一柔性条的外侧。
所述第一柔性条 63的远端还设有一个牵引件 7。 所述牵引件 7为所述 第一柔性条 63的远端的延伸段，所述牵引件 7的自由端伸向圆管型装订仪 的近端。或者， 所述牵引件 7也可以是固定在所述第一柔性奈 63的远端的 牵引线。 即只要起到牵引作用即可。 所述圆管型装订仪钉筒上设有至少 1 个引导孔， 所述牵引件 7在初始状态时从所述引导孔中穿过。
由于第七实施例中， 第一柔性条 63紧密缠绕； 第九实施例中， 第一柔 性条 63和第二膜层 65的部分紧密地缠绕在一起， 所以整个引导部的圓锥 形壁的强度较大， 在进行引导圓管型装订仪进入病人体内时不会坍塌。 另 由于第二膜层 65整体地包覆于第一柔性条 63外側， 导致整个引导附件的 圆锥形壁 51的外侧相对平滑，在进行引导圓管型装订仪进入病人体内时该 外壁不会刮伤组织， 其效果比单一螺旋型柔性条要好很多。
第七实施例和第九实施例的操作方式是一致的， 以下以第七实施例为 更正页 （细则第 91条) 例。
在操作时， 先将本优选实施例的引导件套接在钉仓组件的远端， 然后 引导圆管型装订仪进入人体内， 此时牵引件 7的自由端穿过引导孔并露出 于病人体外。接着拉扯所述牵引件 7 , 所述第二膜层 65伴随第一柔性条 63 按由远及近的顺序呈螺旋解体， 最终形成为带状体并被一次性地从所述引 导孔中被抽出于圓管型装订仪外， 类似于将 "弹簧线" 拉成一直线。 在此 过程中， 由于第二膜层 65的强度较差， 很容易被拉断， 具体如图 18所述， 第二膜层 65会在第一柔性条 63相邻的两条螺旋线附近产生一撕裂线 67 , 其断体会随着第一柔性条 63—起拉出于圓管型装订仪外。当然上述的实施 例也可以从装订仪外側抽出， 只要改变牵引件位于引导件上的连接位置即 可。
图 19揭示了本发明的第八实施例， 与第七实施例的区别在于： 所述套 设部 4的壁厚小于所述引导部 6的壁厚。 这样大大减小了因壁厚带来的影 响。 第八实施例的其他结构和操作方法与第七实施例相同，在此不再赘述。
图 23揭示了本发明的第十实施例， 与第九实施例的区别在于： 所述套 设部 4的壁厚小于所述引导部 6的壁厚。 这样大大减小了因壁厚带来的影 响。 第十实施例的其他结构和操作方法与第九实施例相同，在此不再赘述。
上述的实施例中都能与第一实施例一样， 在引导附件近端设有区别于 引导附件整体的颜色区域， 特别为色彩鲜艳的黄色， 一般采用喷涂方式， 用于提示医生引导附件全部移出于圆管型装订仪。 由于黄色区域的存在， 当医生看见该黄色区域的时候证明已经将引导附件全部拉出于所述圓管型 装订仪外。 更正页 （细则第 91条) 本发明的操作简单， 只需一步就可以实现引导附件脱离所述圆管型装 订仪。 而现有技术需要多步骤操作， 而且其弹簧线不能呈长条状脱离， 很 容易会刮伤组织。 本发明尚有多种具体的实施方式， 等同替换或者等效变换而形成的所 有技术方案， 均落在本发明要求保护的范围之内。
更正页 （细则第 91条)

Claims

权 利 要 求
1、一种引导附件， 配接于圓管型装订仪上， 所述圓管型装订仪包括钉 砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和钉仓， 其特征在 于：
所述引导附件至少包括用于套设于所述圆管型装订仪的远端的套设 部， 以及设于所述套设部远端的引导部， 所述引导部的最大外径等于所述 套设部的最小外径，
所述引导部为螺旋件， 所述螺旋件的螺纹线的一端与一牵引件连接， 另一端与所述套设部连接。
2. 根据权利要求 1所述的引导附件， 其特征在于： 所述引导部的外轮 廓为圓锥形， 所述圆锥形的内腔呈中空设置。
3. 根据权利要求 1所述的引导附件， 其特征在于： 所述套设部为圓筒 形或半圆筒形， 所述套设部的内径大于所述钉筒的外径。
4. 根据权利要求 1所述的引导附件， 其特征在于： 所述引导附件还包 括一设于所述套设部近端的向外发散设置的用于握持的凸边。
5. 根据权利要求 1所述的引导附件， 其特征在于： 所述螺旋件的相邻 的螺紋线之间均垂直设有一组加强筋。
6. 根据权利要求 1所述的引导附件， 其特征在于： 所述牽引件的一端 连接于螺紋线的最远端中心。
7. 根据权利要求 6所述的引导附件， 其特征在于： 所述牽引件从所述 钉筒的线孔穿过， 所述牵引件的另一端设有一拉环。
8. 根据权利要求 1所述的引导附件， 其特征在于： 所述螺旋件为两条
更正页 （细则第 91条) 间隔围绕的螺紋线， 该两条螺紋线的一端相互连接在一起， 另一端均与所 述套设部连接。
9. 根据权利要求 8所述的引导附件， 其特征在于： 所述牵引件钩在所 述两条螺纹线的连接在一起的端部上。
10. 一种引导附件， 配接于圆管型装订仪上， 所述圆管型装订仪包括 钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和钉仓， 其特征 在于：
所述引导附件至少包括用于套设于所述圆管型装订仪的远端的套设 部， 以及设于所述套设部远端的引导部， 所述引导部的最大外径等于所述 套设部的最小外径，
所述引导部为一整体注塑而成的柔性 U型回旋件， 所述 U型回旋件的 中心橫截面为 U型， 所述引导部包括一个近端和一个远端， 所述远端的外 径小于等于近端的外径。
11. 根据权利要求 10所述的引导附件， 其特征在于： 所述引导部和套 设部为一整体注塑而成的柔性 ϋ型回旋件， 所述柔性 U型回旋件在受到外 力牵拉时解体， 最终形成为一条可脱离圆管型装订仪的带状体。
12. 根据权利要求 10或 11所述的任一引导附件， 其特征在于： 所述 套设部为套设于所述钉仓外周的薄壁。
13. 根据权利要求 12所述的引导附件， 其特征在于： 所迷薄壁上设有 固接于钉仓上的卡箍。
14. 一种引导附件， 配接于圓管型装订仪上， 所述圓管型装订仪包括 钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和钉仓、 及设于 更正页 （细则第 91条) 钉仓内的钉砧拉杆， 其特征在于：
所述引导附件至少包括用于套设于所述圓管型装订仪的远端的套设 部， 以及设于所述套设部远端的引导部， 所述引导部的最大外径等于所述 套设部的最小外径，
所述引导部为一整体呈圓锥形空腔柔性塑胶件， 所述引导部包括一个 近端和一个远端， 所述远端到近端的外径逐渐增大， 所述塑胶件在受到外 力牵拉时按即由远及近的顺序呈螺旋解体， 最终形成为一条可脱离圆管型 装订仪的带状体。
15. 根据权利要求 14所述的引导附件， 其特征在于： 所述套设部为套 设于所述钉仓外周的薄壁， 所述引导部和套设部为一整体注塑而成的螺旋 形柔性塑胶件。
16. 根据权利要求 15所述的引导附件， 其特征在于： 所述引导部的中 空内腔的远端底部向内凸设有一个中心筒， 所述中心筒的内径等于所述钉 砧拉杆的远端外径。
17. 根据权利要求 16所述的引导附件， 其特征在于： 所述中心筒的近 端壁上开设有一个牵引孔， 所述中心筒的近端为整个柔性塑胶件的一端。
18. 根据权利要求 17所述的引导附件， 其特征在于： 所述圓管型装订 仪钉筒上设有至少 1个引导孔， 所述的呈带状体的引导部从所述引导孔中 脱离所述圆管型装订仪。
19. 一种引导附件， 配接于圆管型装订仪上， 所述圆管型装订仪包括 钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和钉仓、 及设于 钉仓内的钉砧拉杆， 其特征在于： 更正页 （细则第 91条) 所述引导附件至少包括用于套设于所述圓管型装订仪的远端的套设 部， 以及设于所述套设部远端的引导部， 所述引导部的最大外径等于所述 套设部的最小外径，
所述引导部为一整体呈圆锥形的空腔柔性塑胶件， 所述引导部包括一 个近端和一个远端， 所述远端到近端的外径逐渐增大； 所述引导部的圓锥 形壁包含第一柔性奈和第二柔性条， 所述第一柔性条和第二柔性条间隔螺 旋设置并紧贴， 所述圆锥形壁在受到外力牵拉时即按由远及近的顺序呈螺 旋解体， 最终形成为一条可脱离圆管型装订仪的由第一柔性条和第二柔性 条组成的带状体。
20. 根据权利要求 19所述的引导附件， 其特征在于： 所述套设部包含 第一柔性条和第二柔性条， 所述第一柔性条和第二柔性条间隔螺旋设置并 紧贴， 所述套设部的第一柔性条和第二柔性条分别与所述引导部的第一柔 性条和第二柔性条一体成形。
21. 根据权利要求 19所述的引导附件， 其特征在于： 所述套设部的壁 厚小于所述引导部的壁厚。
22. 根据权利要求 19所述的引导附件， 其特征在于： 所述第一柔性条 采用硬质材料制得， 所述第二柔性条采用软质材料制得， 所述第一柔性条 和第二柔性条相互之间为粘接或二次注塑而成。
23. 根据权利要求 19所述的引导附件， 其特征在于： 所述第一柔性条 的远端设有一个牵引件。
24. 根据权利要求 23所述的引导附件， 其特征在于： 所述牵引件为所 述第一柔性条的远端的延伸段， 所述牵引件的自由端伸向圓管型装订仪的 更正页 （细则第 91条) 近端； 或者， 所述牵引件为固定在所述第一柔性条的远端的牵引线。
25. 一种引导附件， 配接于圓管型装订仪上， 所述圓管型装订仪包括 钉砧组件、 钉仓组件； 所述钉仓组件包括相互固定的钉筒和钉仓、 及设于 钉仓内的钉砧拉杆， 其特征在于：
所述引导附件至少包括用于套设于所述圓管型装订仪的远端的套设 部， 以及设于所述套设部远端的引导部， 所述引导部的最大外径等于所述 套设部的最小外径，
所述引导部为一整体呈圆锥形的空腔柔性塑胶件， 所述引导部包括一 个近端和一个远端， 所述远端到近端的外径逐渐增大； 所述引导部的圓锥 形壁包含内外两层， 第一层为由第一柔性条缠绕而成的螺旋体， 第二层为 包覆在第一层上的第二膜层， 在外力牽引时， 所述第二膜层伴随第一柔性 条按由远及近的顺序呈螺旋解体， 最终形成为一条可脱离圓管型装订仪的 带状体。
26. 根据权利要求 25所述的引导附件， 其特征在于： 所述第一柔性条 紧密螺旋设置， 所述第二膜层仅包覆于所述圆锥形壁的外侧或内側。
27. 根据权利要求 25所述的引导附件， 其特征在于： 所述第一柔性条 间隔螺旋设置， 所述第二膜层包覆于所述圆锥形壁的外侧或内側， 且部分 第二膜层伸入到所述第一柔性条的螺旋线之间， 使所述第一柔性条和第二 膜层间隔螺旋设置并紧贴。
28. 根据权利要求 25至 27所述的任一种引导附件， 其特征在于： 所 述套设部为第一柔性条， 所述套设部的第一柔性条与所述引导部的第一柔 性条一体成形。 更正页 （细则第 91条)
29. 根据权利要求 28所述的引导附件， 其特征在于： 所述第二膜层包 覆于所述套设部和引导部的第一柔性条的外側。
30. 根据权利要求 29所述的引导附件， 其特征在于： 所述套设部的壁 厚小于所述引导部的壁厚。
31. 根据权利要求 28所述的引导附件， 其特征在于： 所述第一柔性条 采用硬质材料制得， 所述第二膜层采用软质材料制得； 所述第一柔性条和 第二膜层相互之间为粘接或二次注塑而成。
32. 根据权利要求 28所述的引导附件， 其特征在于： 所述第一柔性条 的远端设有一个牵引件。
33. 根据权利要求 31所述的引导附件， 其特征在于： 所述牵引件为所 述第一柔性条的远端的延伸段， 所述牵引件的自由端伸向圆管型装订仪的 近端； 或者， 所述牵引件为固定在所述第一柔性条的远端的牵引线。
更正页 （细则第 91条)
PCT/CN2012/080503 2011-08-24 2012-08-23 引导附件 WO2013026400A1 (zh)

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