WO2015169058A1 - Anvil holding forceps head for stapler used in esophagus during thoracoscopy procedure and holding forceps with the forceps head - Google Patents

Anvil holding forceps head for stapler used in esophagus during thoracoscopy procedure and holding forceps with the forceps head Download PDF

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Publication number
WO2015169058A1
WO2015169058A1 PCT/CN2014/088998 CN2014088998W WO2015169058A1 WO 2015169058 A1 WO2015169058 A1 WO 2015169058A1 CN 2014088998 W CN2014088998 W CN 2014088998W WO 2015169058 A1 WO2015169058 A1 WO 2015169058A1
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WIPO (PCT)
Prior art keywords
clamping
arm
driving
esophageal
anvil
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PCT/CN2014/088998
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French (fr)
Chinese (zh)
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黄宇清
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黄宇清
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Publication of WO2015169058A1 publication Critical patent/WO2015169058A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery

Definitions

  • the utility model relates to the field of medical surgical instruments, in particular to a thoracoscope esophageal anastomat anvil holding pliers.
  • Total thoracoscopic and laparoscopic resection of esophageal cancer is a new international and domestic technology in recent years. It provides possibilities for the implementation of surgery in the continuous updating of minimally invasive devices.
  • the current laparoscopic surgery for the removal of the thoracic portion of esophageal cancer is limited to the following two methods: 1. Only the esophagus is free, and then anastomosis is performed in the neck; 2. After the anastomosis (Ovil) is placed orally, Perform an intrathoracic anastomosis. Due to the high cost of Ovil materials and the long learning curve, domestic applications are not well spread.
  • thoracic surgery endoscopists have begun to try to place stapler anvils in the chest and anastomosis, but usually use conventional instruments according to personal habits.
  • the surgeon needs to use a surgical instrument to place the stapler anvil into the proximal end of the esophagus and fix the stapler anvil at the time of anastomosis to facilitate the docking of the stapler.
  • the thoracoscopic operation hole and the esophagus have a special angle.
  • the open instruments and the endoscopic instruments cannot be placed under the endoscope, and the circular stapler anvil is freely placed into the proximal esophagus end to be anastomosed. And it is not possible to effectively fix the staple anvil during the anastomosis to dock the stapler. Because the chest wall small incision does not retract the rib before the thoracoscopic esophagectomy, the relative operation space is narrow. The existing joint design of the surgical instrument is advanced, and the intraoperative instrument joint enters the thoracic cavity. The opening and closing process of the instrument will be affected by the rib.
  • the opening and closing action is obviously limited, and the 90 degree angle of the end of the fixed jaw can not meet the operation requirements of the surgical operation hole and the window hole and the esophagus to form a special angle, which causes the operation difficulty of the doctor and the extension of the operation time. It is often necessary to additionally increase the chest operation incision, or to extend the operation of the incision, and even have to transfer the chest or add a neck incision to change the neck anastomosis to increase the patient's wound.
  • the technical problem to be solved by the embodiment of the present invention is to provide a thoracoscopic esophageal anastomat anvil holding pliers head and a thoracoscopic esophageal anastomat anvil holding pliers having the same, which can be firmly clamped at a specific angle Hold the anvil, in order to be easy to operate during the operation, safe and reliable, to meet the needs of surgery, and to maintain a small cross-sectional area, Reduce the length required for the surgical incision and reduce the trauma to the human body.
  • a thoracoscopic esophageal anastomat anvil holding pliers comprising: a clamping head fixed axis; and a first clamping arm and a second clamping arm, each having a function a rotating hole that is rotated on the fixed shaft of the clamp head, and the clamping end of the first clamping arm and the clamping end of the second clamping arm are aligned in the same axial direction of the clamping head Bending, and the clamping surface of the clamping end is parallel or in the same plane with the clamping head; the driving end of the first clamping arm is provided with a first driving hole, and the second clamping arm The driving end is provided with a second driving hole, and the first driving hole and the second driving hole are used for applying force through the driving shaft, so that the first clamping arm and the second clamping arm are opened or closure.
  • a thoracoscope esophageal anastomat anvil holding jaw wherein a clamping surface of the first clamping arm and a clamping of the second clamping arm The surface has a symmetrical clamping groove, and when the first clamping arm and the second clamping arm are closed, a clamping hole is formed to match the contour of the outer peripheral surface of the thoracoscope esophagus anvil.
  • a thoracic esophageal anastomat anvil holding jaw wherein a central axis of the clamping hole is opposite to a clamping end of the first clamping arm and The central axis when the grip end of the second gripping arm is closed is perpendicular.
  • a thoracoscope esophageal anastomat anvil holding jaw wherein a clamping end of the first clamping arm and a clamping end of the second clamping arm
  • the same axial bending angle to the jaws ranges from 110 degrees to 130 degrees.
  • a thoracoscopic esophageal anastomat anvil holding jaw wherein a clamping end of the first clamping arm and a clamping end of the second clamping arm The angle of the same axial bending to the jaws is 120 degrees.
  • a thoracoscopic esophageal anastomat anvil grasping forceps may include: any one of claims 1 to 5 a thoracoscope esophageal anastomat anvil holding a pliers head; the caliper body comprising an outer sleeve, a drive rod reciprocally slidable longitudinally within the outer sleeve, and a first drive arm coupled to the first end of the drive rod via a moving shaft And a second driving arm; the first end of the outer sleeve has a prong structure for fixing the clamping head such that the first clamping arm and the second clamping arm are rotatable Connecting with the outer sleeve; a first driving hole provided by the first driving arm and the driving end of the first clamping arm is rotatably connected through the driving shaft, and the second driving arm
  • a thoracoscopic esophageal anastomat anvil holding pliers is provided, wherein The second end of the outer sleeve may also be coupled with a drive for driving the drive rod to reciprocally slide within the outer sleeve.
  • a thoracoscopic esophageal anastomat anvil grasping forceps wherein the driving device may include: a connectable connection with a second end of the outer sleeve Two grip handles; a transfer arm rotatably coupled to a second end of the drive rod and rotatably coupled to a portion of each of the grip hands adjacent the guide rod for The tensioning motion of the two gripping handles translates into a longitudinal reciprocal sliding of the drive rod within the sleeve.
  • a thoracoscope esophageal anastomat anvil grasping forceps is provided, wherein a cleaning hole and a cleaning hole cover are disposed on the outer sleeve near the second end portion for A high pressure liquid or gas is injected from the cleaning hole for cleaning.
  • a thoracoscopic esophageal anastomat anvil grasping forceps is provided, wherein the driving device is an electric driving device or a hydraulic driving device for driving the driving rod for longitudinal sliding .
  • the thoracoscope esophageal anastomat of the utility model holds the clamp head or the holding clamp.
  • the clamp end of the clamp head is bent at a specific angle, so that the doctor can obtain proper operation when performing the operation of the anvil and the stapler.
  • the angle not only solves the problem of firm clamping, but also makes the cross-sectional area of the entire thoracoscopic esophageal anastomat holding jaw or the holding jaw body on the flow line small, so that no large surgical opening is required, and thus Reducing the trauma to the patient; in addition, since the clamping end of the clamping head is provided with a clamping hole, the axis of the clamping hole is perpendicular to the clamping arm where it is located, matching the specific angle described above, thereby clamping the anvil and The stapler can be operated very freely, avoiding the technical problem that the operation of the existing surgical instrument is difficult and the operation hole needs to be opened; at the same time, the thoracoscope esophageal anastomat of the utility model is convenient to operate, and only needs to be operated. The opening of two operating holes in the patient's body improves the efficiency of the operation and greatly reduces the patient's pain.
  • the utility model is directed to the stapler head fixing pliers used in the existing open surgery, and can not change the shape and structure of the device due to various defects such as inconvenience of the device caused by the narrow operation port and the unsuitable angle.
  • the thoracoscope esophageal anastomat anvil provided by the utility model holds the clamp head or the holding clamp to ensure the operation is safe and reliable during the operation.
  • a thoracoscope esophageal stapler grasping forceps including the thoracoscope esophageal anastomat anvil holding jaw is provided, which is located at the back of the forceps
  • the handle forms a double-opening joint of the clamp body, and is suitable for the microscopic operation of the small operation hole of the thoracoscope; 2.
  • the clamping end of the clamp head has a specific angle with the main body at the front, preferably 120 degrees, for facilitating the insertion of the stapler nail
  • the anvil has a suitable angle when fixing the stapler anvil; 3.
  • the clamping end of the clamp head is provided with a clamping groove for the special fitting anvil, and the central axis of the clamping hole formed when closed is vertical
  • the central axis of the body is closed when the clamping end of the clamp head is closed, so as to effectively fix the anvil of the stapler And convenient docking stapler.
  • the double joint is convenient for the instrument for the minimally invasive surgical incision of the thoracoscope, the suitable angle is convenient for avoiding the angle between the incision and the end of the esophagus during the operation, and the clamping hole matching the outer peripheral surface of the stapled anvil of the clamped object is convenient and effective. Hold the stapler anvil.
  • the space in the thoracic cavity is small, and the operation incision and angle are limited.
  • the thoracoscopic esophageal anastomat anvil holding pliers of the present invention can meet the needs of surgery in two aspects: 1. Manually planning the site for esophageal anastomosis The pulp muscle layer is stored for one week, and under the lower part, the part of the esophagus is cut, and the thoracoscope esophageal anastomat anvil is provided by the utility model, and the anvil is held from the front operation port into the chest cavity, and is sent upward from the cut esophagus.
  • FIG. 1 is a side view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 2 is a top plan view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • Figure 3 is a view of the grip end of Figure 2 taken along the F direction;
  • FIG. 4 is a side view of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention
  • FIG. 5 is a top plan view of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention
  • FIG. 6 is a schematic view showing the first end structure of the outer sleeve of the thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 7 is a schematic structural view of a closed end of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention
  • FIG. 8 is a schematic view showing the structure of a thoracoscopic esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 9 is a structural view of a thoracoscope esophageal anastomat anvil holding pliers according to another embodiment of the present invention.
  • a thoracoscopic esophageal staple anvil holding jaw is provided.
  • 1 is a side view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 2 is a top view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • 3 is a view in the F direction of the grip end portion in Fig. 2.
  • the thoracoscope esophageal anastomat anvil gripping head of the present embodiment comprises: a clamping head fixed shaft 10 .
  • the clamping head fixed axis 10 is perpendicular to the drawing.
  • the clamping end of the second clamping arm and the clamping end of the second clamping arm are bent in the same axial direction of the clamping head 10, and in the present embodiment, are bent outward in a direction perpendicular to the drawing paper surface of FIG.
  • the clamping surface of the clamping end is parallel to the clamping shaft 10 or on the same plane, and the situation shown in Fig. 2 can be obtained after bending.
  • the clamping surface is substantially flat, but may be a rough or textured clamping surface for increasing the friction;
  • the driving end of the first clamping arm 201 is provided with a first driving hole 401, and the second clamping arm 202
  • the driving end is provided with a second driving hole 402.
  • the first driving hole 401 and the second driving hole 402 may be collectively referred to as a clamping arm driving hole 4 for applying force through the driving shaft, so that the first clamping arm 201 and the second clamping member
  • the arm 202 is opened or closed.
  • the drive shaft is mounted in each drive hole. It should be noted that, as shown in FIG.
  • the same axial bending angle A of the clamping end to the clamping head 10 can be set to a specific angle according to different models and requirements, and the angular range can be 110 to 130 degrees. It is preferably set to 120 degrees. At 120 degrees, it can meet the positional characteristics of the human esophagus and the general surgical incision, and usually achieves a very smooth operation effect.
  • B is a schematic central axis when the first clamping arm 201 and the second clamping arm 202 are closed.
  • a thoracoscopic esophageal anastomat anvil holding jaw wherein the clamping surface of the first clamping arm 201 and the clamping surface of the second clamping arm 202 are both
  • the symmetrical clamping groove forms a clamping hole 220 that matches the contour of the outer peripheral surface of the thoracoscopic esophageal anastomosis anvil when the first clamping arm 201 and the second clamping arm 202 are closed.
  • the holding hole 220 may also be provided in a shape matching the contour of the outer peripheral surface of any other object to be clamped as needed, thereby preventing the object to be rotated or slipped, and firmly holding the object to be clamped.
  • a thoracoscope esophageal anastomat anvil holding jaw wherein a central axis C of the clamping hole 220 and a clamping end and a second clamping of the first clamping arm
  • the center axis B1 when the grip end of the arm is closed is perpendicular, as shown in FIG.
  • the grip end refers to a portion that is substantially straight near the end, that is, a portion of the end A of the angle A of Fig. 2 where the end B1 is located.
  • the angle between the central axis C of the clamping hole 220 and the other side B2 of the angle A is 30 degrees, so that the clamped thoracoscope esophagus anastomat or anastomosis
  • the tube on the device presents a state that facilitates surgical operation.
  • the central axis C of the clamping hole 220 can also be at other angles with the central axis B1 when the clamping end of the first clamping arm and the clamping end of the second clamping arm are closed to meet the special needs of the operation.
  • the diameter of the holding hole can be set according to the outer diameter of the object to be clamped, for example, the diameter of the holding hole can be 6 to 9 mm.
  • the thoracoscopic esophageal anastomat anvil holding head of the embodiment of the present invention has a flow linear structure. When closed, the cross-sectional area of the flow line is substantially uniform, without increasing the cross-sectional area, and does not need to increase the patient. Major surgical incision. Therefore, the problem of using the welding aid on the existing holding head to increase the surgical incision when the chest is placed is completely overcome.
  • a thoracoscopic esophageal anastomat anvil grasping forceps is provided.
  • 4 is a side view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 5 is a plan view of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention
  • FIG. 7 is a closed view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 8 is a schematic view showing the structure of the thoracoscopic esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 9 is a thoracoscopic esophageal anastomat holding device according to another embodiment of the present invention.
  • the structure of the pliers is a closed view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention.
  • FIG. 8 is a schematic view showing the structure of the thoracoscopic esophageal anastomat anvil holding pliers according to an embodiment of the present invention
  • FIG. 9 is a thoracoscopic esophageal anastomat holding device according to another embodiment of the present invention. The structure of the
  • the thoracoscopic esophageal anastomat anvil grasping forceps comprises: the thoracoscope esophageal anastomat anvil holding the forceps head; the caliper body described in any one of the foregoing embodiments.
  • the caliper body includes an outer sleeve 1, a drive rod 3 that is reciprocally slidable in the longitudinal direction of the outer sleeve 1, and a first drive arm 301 and a second drive arm 302 that are coupled to the first end of the drive rod 3 via a moving shaft;
  • the first end of the tube 1 has a prong structure for fixing the clamp shaft 10 such that the first clamp arm 201 and the second clamp arm 202 are rotatably coupled to the outer sleeve 1; the first drive arm 301
  • the first driving hole 401 provided with the driving end of the first clamping arm 201 is rotatably connected by the driving shaft, and the second driving hole 302 of the second driving arm 302 and the driving end of the second clamping arm 202 is driven by the driving.
  • the shaft is rotatably connected. As shown in Fig. 6, the prong structure of the first end of the outer sleeve 1 can be used to secure the jaw shaft 10. The drawing shows only the prong structure of the first end of the outer sleeve 1 and the position of the clamp shaft 10.
  • the angle of the clamp arm is minimum, and the closing and holding operation is realized; when the first end of the drive rod 3 is away from the fixed shaft 10 of the clamp When the distance is the smallest, the clamping arm opening angle is the most, and the clamping arm opening operation is realized.
  • the clamping arm is closed, the cross-sectional area of the flow line of the overall holding forceps can be made small, and it is not necessary to enlarge the incision when extending into the surgical incision.
  • the outer sleeve 1 and the drive rod 3 can be selected to any length as needed, and there is still no need to change the cross-sectional area of the flow line of the overall holding jaw.
  • a thoracoscopic esophageal anastomotic anvil grasping forceps is provided.
  • the second end of the outer sleeve 1 is also connected with a driving device for driving the drive rod 3 to reciprocally slide in the outer sleeve 1.
  • the driving device may be a hand-held handle like a hand-held pliers, or an electric drive device or a hydraulic drive device, as long as it can be used to drive the drive rod 3 for longitudinal sliding.
  • the driving device when it is a hand-held handle, it may include: two holding handles that are connected to the second end of the outer sleeve 1 in a slidable manner; and the second end of the driving rod 3 is rotatably
  • a transmission arm that is coupled and rotatably coupled to a portion 5 of each of the gripping hands 3 is adapted to convert the kneading movement of the two gripping handles into a longitudinal reciprocal sliding of the drive rod 3 within the sleeve 1.
  • the structure is similar to the drive structure near the first end of the clamp arm, but the function achieved is to convert the tensioning motion of the two grip handles into a longitudinal reciprocation of the drive rod 3 within the sleeve 1.
  • the gripping handle is rotated relative to the fixed shaft on the outer sleeve 1, thereby effecting longitudinal sliding of the drive rod 3 within the outer sleeve 1 during the opening.
  • This structure allows the overall gripping forceps to form a double joint structure.
  • the inside of the two gripping handles may be provided with hooks for hooking each other, and when the gripping jaws are clamped, the handles are fixed to avoid the need to pinch the handles for a long time during operation.
  • a cleaning hole and a cleaning hole cover may be provided on the outer sleeve near the second end for injecting a high-pressure liquid or gas from the cleaning hole for cleaning. Because the surgical instrument is in the process of surgery, blood or other fluids will inevitably enter the outer casing, and it needs to be cleaned with high-pressure liquid or gas. Setting the cleaning hole here does not affect the cross-sectional area of the portion of the entire thoracoscopic esophageal anastoma holder holding the forceps into the surgical incision.
  • a thoracoscopic esophageal stapler holding clamp including a handle at the back of the caliper body, a double-opening joint of the caliper body, suitable for a small operation hole of the thoracoscope The operation under the microscope; 2, the front part of the clamp body has an angle of 120 degrees with the end of the jaw: easy to insert the staple anvil, and the fixed anastomosis anvil has a suitable angle when docking the stapler; 3, the jaw special The groove of the stapler anvil. Vertical to the jaws, it is convenient to effectively fix the staple anvil and facilitate the docking stapler.
  • the double joint facilitates the instrument for the minimally invasive surgical incision of the thoracoscopic surgery, and the appropriate angle facilitates the overcoming of the incision and the end of the esophagus during surgery.
  • a dedicated recess facilitates the effective fixation of the staple anvil.
  • the thoracoscopic esophageal anastomat anvil holding pliers provided by the utility model can meet the needs of the operation in at least two aspects: 1.
  • the part of the esophageal anastomosis is firstly hand-pulverized with a muscle pack for one week. Under the lower part of the esophagus, a part of the esophagus is cut.
  • the thoracoscopic esophageal anastomosis anvil is used to hold the stapler anvil from the front operation port into the chest cavity, and the esophagus is self-cut.

Abstract

An anvil holding forceps head for a stapler used in esophagus during a thoracoscopy procedure and a holding forceps for a stapler used in esophagus during a thoracoscopy procedure with the forceps head. The holding forceps head comprises: a forceps head fixed shaft (10); a first clamping arm (201) and a second clamping arm (202) both provided with rotating holes sleeved on the forceps head fixed shaft (10) for rotation. The clamping end of the first clamping arm (201) and the clamping end of the second clamping arm (202) are bent towards the same axial direction of the forceps head fixed shaft (10), and the clamping surface of each clamping end and the forceps head fixed shaft (10) are parallel or located on the same plane. The driving end of the first clamping arm (201) is provided with a first driving hole (401), and the driving end of the second clamping arm (202) is provided with a second driving hole (402). The first driving hole (401) and the second driving hole (402) are used for exerting force through a driving shaft to make the first clamping arm (201) and the second clamping arm (202) open or close. The holding forceps can clamp the stapler anvil firmly at a specific angle, and have a small cross section, so that the size of an incision required in the operation is reduced, and the injury to a human body is reduced.

Description

胸腔镜食管吻合器钉砧把持钳头和具有该钳头的把持钳Thoracoscopic esophageal anastomat anvil holding pliers head and holding pliers with the same 技术领域Technical field
本实用新型涉及医疗手术器械领域,具体涉及一种胸腔镜食管吻合器钉砧把持钳。The utility model relates to the field of medical surgical instruments, in particular to a thoracoscope esophageal anastomat anvil holding pliers.
背景技术Background technique
全胸腔镜、腹腔镜食管癌切除术是近年来国际、国内新出现的技术,在微创器械的不断更新中,给手术的实施提供了可能性。但目前的食管癌切除胸内部分的腔镜手术还局限于以下两种方式:1、仅作食管游离,之后在颈部做吻合;2、经口置入吻合器钉砧(Ovil)后,进行胸内吻合。因Ovil材料昂贵,并且学习曲线较长,在国内的应用未能很好地普及。因此近年来胸外科腔镜医师开始尝试在胸腔内放置吻合器钉砧并吻合,但通常依据个人习惯使用常规器械。胸腔镜食管切除,胸腔内吻合手术中,医生需要使用手术器械将吻合器钉砧置入食管近端,并于吻合时固定吻合器钉砧,以便于对接吻合器。而胸腔镜手术操作孔与食管成特殊角度,目前现有开放器械及腔镜下器械,均无法在腔镜下,将圆型吻合器钉砧自如地置入需进行吻合的近端食管断端,且无法于吻合时有效固定吻合器钉砧,以对接吻合器。由于胸腔镜食管切除手术前胸壁小切口不牵开肋骨,相对操作空间狭小,现有此类手术器械关节设计偏前,术中器械关节进入胸腔内,器械开合过程会受到肋骨的影响,而使开合动作明显受限,并且固定钳嘴末端的90度角,无法满足手术操作孔和视窗孔与食管形成特殊角度的操作需求,造成了医生的操作困难和手术的时间的延长。往往需要额外增加胸部操作切口,或延长操作切口,甚至不得不中转开胸或加做颈部切口改行颈部吻合增加病人的创伤。Total thoracoscopic and laparoscopic resection of esophageal cancer is a new international and domestic technology in recent years. It provides possibilities for the implementation of surgery in the continuous updating of minimally invasive devices. However, the current laparoscopic surgery for the removal of the thoracic portion of esophageal cancer is limited to the following two methods: 1. Only the esophagus is free, and then anastomosis is performed in the neck; 2. After the anastomosis (Ovil) is placed orally, Perform an intrathoracic anastomosis. Due to the high cost of Ovil materials and the long learning curve, domestic applications are not well spread. Therefore, in recent years, thoracic surgery endoscopists have begun to try to place stapler anvils in the chest and anastomosis, but usually use conventional instruments according to personal habits. In thoracoscopic esophagectomy and intrathoracic anastomosis, the surgeon needs to use a surgical instrument to place the stapler anvil into the proximal end of the esophagus and fix the stapler anvil at the time of anastomosis to facilitate the docking of the stapler. The thoracoscopic operation hole and the esophagus have a special angle. At present, the open instruments and the endoscopic instruments cannot be placed under the endoscope, and the circular stapler anvil is freely placed into the proximal esophagus end to be anastomosed. And it is not possible to effectively fix the staple anvil during the anastomosis to dock the stapler. Because the chest wall small incision does not retract the rib before the thoracoscopic esophagectomy, the relative operation space is narrow. The existing joint design of the surgical instrument is advanced, and the intraoperative instrument joint enters the thoracic cavity. The opening and closing process of the instrument will be affected by the rib. The opening and closing action is obviously limited, and the 90 degree angle of the end of the fixed jaw can not meet the operation requirements of the surgical operation hole and the window hole and the esophagus to form a special angle, which causes the operation difficulty of the doctor and the extension of the operation time. It is often necessary to additionally increase the chest operation incision, or to extend the operation of the incision, and even have to transfer the chest or add a neck incision to change the neck anastomosis to increase the patient's wound.
实用新型内容Utility model content
本实用新型的实施例要解决的技术问题是,提供一种胸腔镜食管吻合器钉砧把持钳头和具有该钳头的胸腔镜食管吻合器钉砧把持钳,可以以特定角度、牢固地夹持合器钉砧,以力求手术过程中得以操作顺手,安全可靠,适应手术的需要,并且保持较小的横截面积, 减小手术切口所需的长度,降低对人体造成的创伤。The technical problem to be solved by the embodiment of the present invention is to provide a thoracoscopic esophageal anastomat anvil holding pliers head and a thoracoscopic esophageal anastomat anvil holding pliers having the same, which can be firmly clamped at a specific angle Hold the anvil, in order to be easy to operate during the operation, safe and reliable, to meet the needs of surgery, and to maintain a small cross-sectional area, Reduce the length required for the surgical incision and reduce the trauma to the human body.
根据本实用新型的第一个方面,提供了一种胸腔镜食管吻合器钉砧把持钳头,其包括:钳头定轴;以及第一夹持臂和第二夹持臂,其均具有用于套在所述钳头定轴上实现转动的转动孔,所述第一夹持臂的夹持端和所述第二夹持臂的夹持端向所述钳头定轴的同一轴向弯折,并且所述夹持端的夹持面与所述钳头定轴平行或者在同一平面上;所述第一夹持臂的驱动端设置有第一驱动孔,所述第二夹持臂的驱动端设置有第二驱动孔,所述第一驱动孔和所述第二驱动孔用于通过驱动轴施加力量,使得所述第一夹持臂和所述第二夹持臂张开或闭合。According to a first aspect of the present invention, a thoracoscopic esophageal anastomat anvil holding pliers is provided, comprising: a clamping head fixed axis; and a first clamping arm and a second clamping arm, each having a function a rotating hole that is rotated on the fixed shaft of the clamp head, and the clamping end of the first clamping arm and the clamping end of the second clamping arm are aligned in the same axial direction of the clamping head Bending, and the clamping surface of the clamping end is parallel or in the same plane with the clamping head; the driving end of the first clamping arm is provided with a first driving hole, and the second clamping arm The driving end is provided with a second driving hole, and the first driving hole and the second driving hole are used for applying force through the driving shaft, so that the first clamping arm and the second clamping arm are opened or closure.
根据本实用新型的第二个方面,提供了一种胸腔镜食管吻合器钉砧把持钳头,其中,所述第一夹持臂的夹持面上和所述第二夹持臂的夹持面上都具有对称的夹持槽,在所述第一夹持臂和所述第二夹持臂闭合时形成与所述胸腔镜食管吻合器钉砧外周面轮廓相匹配的夹持孔。According to a second aspect of the present invention, a thoracoscope esophageal anastomat anvil holding jaw is provided, wherein a clamping surface of the first clamping arm and a clamping of the second clamping arm The surface has a symmetrical clamping groove, and when the first clamping arm and the second clamping arm are closed, a clamping hole is formed to match the contour of the outer peripheral surface of the thoracoscope esophagus anvil.
根据本实用新型的第三个方面,提供了一种胸腔镜食管吻合器钉砧把持钳头,其中,所述夹持孔的中心轴线与所述第一夹持臂的夹持端和所述第二夹持臂的夹持端闭合时的中心轴线垂直。According to a third aspect of the present invention, a thoracic esophageal anastomat anvil holding jaw is provided, wherein a central axis of the clamping hole is opposite to a clamping end of the first clamping arm and The central axis when the grip end of the second gripping arm is closed is perpendicular.
根据本实用新型的第四个方面,提供了一种胸腔镜食管吻合器钉砧把持钳头,其中,所述第一夹持臂的夹持端和所述第二夹持臂的夹持端向所述钳头定轴的同一轴向弯折的角度范围为110度到130度。According to a fourth aspect of the present invention, a thoracoscope esophageal anastomat anvil holding jaw is provided, wherein a clamping end of the first clamping arm and a clamping end of the second clamping arm The same axial bending angle to the jaws ranges from 110 degrees to 130 degrees.
根据本实用新型的第五个方面,提供了一种胸腔镜食管吻合器钉砧把持钳头,其中,所述第一夹持臂的夹持端和所述第二夹持臂的夹持端向所述钳头定轴的同一轴向弯折的角度为120度。According to a fifth aspect of the present invention, a thoracoscopic esophageal anastomat anvil holding jaw is provided, wherein a clamping end of the first clamping arm and a clamping end of the second clamping arm The angle of the same axial bending to the jaws is 120 degrees.
根据本实用新型的第六个方面,提供了一种胸腔镜食管吻合器钉砧把持钳,其中,该胸腔镜食管吻合器钉砧把持钳可以包括:权利要求1到5中任何一项所述的胸腔镜食管吻合器钉砧把持钳头;钳体,其包括外套管、该外套管内可沿纵向往复滑动的驱动杆以及与该驱动杆的第一端部通过动轴连接的第一驱动臂和第二驱动臂;所述外套管的第一端部具有叉耳结构,用于固定所述钳头定轴,使得所述第一夹持臂和所述第二夹持臂以可转动方式与所述外套管连接;所述第一驱动臂与所述第一夹持臂的驱动端设置的第一驱动孔可通过所述驱动轴以可转动方式连接,所述第二驱动臂与所述第二夹持臂的驱动端设置的第二驱动孔可通过所述驱动轴以可转动方式连接。According to a sixth aspect of the present invention, a thoracoscopic esophageal anastomat anvil grasping forceps is provided, wherein the thoracoscopic esophageal anastomat anvil grasping forceps may include: any one of claims 1 to 5 a thoracoscope esophageal anastomat anvil holding a pliers head; the caliper body comprising an outer sleeve, a drive rod reciprocally slidable longitudinally within the outer sleeve, and a first drive arm coupled to the first end of the drive rod via a moving shaft And a second driving arm; the first end of the outer sleeve has a prong structure for fixing the clamping head such that the first clamping arm and the second clamping arm are rotatable Connecting with the outer sleeve; a first driving hole provided by the first driving arm and the driving end of the first clamping arm is rotatably connected through the driving shaft, and the second driving arm A second driving hole provided at a driving end of the second clamping arm is rotatably connected through the driving shaft.
根据本实用新型的第七个方面,提供了一种胸腔镜食管吻合器钉砧把持钳,其中,所 述外套管的第二端部还可连接有用于驱动所述驱动杆在所述外套管内往复滑动的驱动装置。According to a seventh aspect of the present invention, a thoracoscopic esophageal anastomat anvil holding pliers is provided, wherein The second end of the outer sleeve may also be coupled with a drive for driving the drive rod to reciprocally slide within the outer sleeve.
根据本实用新型的第八个方面,提供了一种胸腔镜食管吻合器钉砧把持钳,其中,所述驱动装置可以包括:与所述外套管的第二端部以可张合方式连接的两个握持把手;与所述驱动杆的第二端部以可转动方式连接并与每个所述握持手靠近所述导杆的部分以转动方式连接的传动臂,用于将所述两个握持把手的张合运动转换为所述驱动杆在所述套管内的纵向往复滑动。According to an eighth aspect of the present invention, a thoracoscopic esophageal anastomat anvil grasping forceps is provided, wherein the driving device may include: a connectable connection with a second end of the outer sleeve Two grip handles; a transfer arm rotatably coupled to a second end of the drive rod and rotatably coupled to a portion of each of the grip hands adjacent the guide rod for The tensioning motion of the two gripping handles translates into a longitudinal reciprocal sliding of the drive rod within the sleeve.
根据本实用新型的第九个方面,提供了一种胸腔镜食管吻合器钉砧把持钳,其中,所述外套管上靠近所述第二端部处设置有清洁孔和清洁孔盖,用于从该清洁孔注入高压液体或气体进行清洁处理。According to a ninth aspect of the present invention, a thoracoscope esophageal anastomat anvil grasping forceps is provided, wherein a cleaning hole and a cleaning hole cover are disposed on the outer sleeve near the second end portion for A high pressure liquid or gas is injected from the cleaning hole for cleaning.
根据本实用新型的第十个方面,提供了一种胸腔镜食管吻合器钉砧把持钳,其中,所述驱动装置为电动驱动装置或者液压驱动装置,用于驱动所述驱动杆以进行纵向滑动。According to a tenth aspect of the present invention, a thoracoscopic esophageal anastomat anvil grasping forceps is provided, wherein the driving device is an electric driving device or a hydraulic driving device for driving the driving rod for longitudinal sliding .
本实用新型的胸腔镜食管吻合器钉砧把持钳头或把持钳,由于钳头闭合时,钳头的夹持端弯曲特定角度,从而使医师在进行钉砧和吻合器操作时获得适当的操作角度,不仅解决了牢固夹持的问题,还使得整个胸腔镜食管吻合器钉砧把持钳头或把持钳主体在流线上的横截面积较小,从而不需要造成较大的手术开口,进而减小对病人的创伤;另外,由于钳头的夹持端部设置有夹持孔,夹持孔的轴线垂直于其所在的夹持臂,配合上述的特定角度,从而在夹取钉砧和吻合器时能够非常自如的操作,避免了采用现有手术器械操作困难从而需要增开操作孔的技术问题;同时,本实用新型的胸腔镜食管吻合器钉砧把持钳由于操作的方便,只需在病人的身上开设两个操作孔,提高了手术效率并大大减轻了病人的痛苦。The thoracoscope esophageal anastomat of the utility model holds the clamp head or the holding clamp. When the clamp head is closed, the clamp end of the clamp head is bent at a specific angle, so that the doctor can obtain proper operation when performing the operation of the anvil and the stapler. The angle not only solves the problem of firm clamping, but also makes the cross-sectional area of the entire thoracoscopic esophageal anastomat holding jaw or the holding jaw body on the flow line small, so that no large surgical opening is required, and thus Reducing the trauma to the patient; in addition, since the clamping end of the clamping head is provided with a clamping hole, the axis of the clamping hole is perpendicular to the clamping arm where it is located, matching the specific angle described above, thereby clamping the anvil and The stapler can be operated very freely, avoiding the technical problem that the operation of the existing surgical instrument is difficult and the operation hole needs to be opened; at the same time, the thoracoscope esophageal anastomat of the utility model is convenient to operate, and only needs to be operated. The opening of two operating holes in the patient's body improves the efficiency of the operation and greatly reduces the patient's pain.
本实用新型针对已有开放手术所使用的吻合器头固定钳,无法因适用于操作口狭小,以及角度不适合,而引起的器械使用不便等诸多缺陷,提出了改变器械形状、结构的理念。本实用新型提供的胸腔镜食管吻合器钉砧把持钳头或把持钳,以力求手术过程中得以操作顺手,安全可靠。在本实用新型中:1、除胸腔镜食管吻合器钉砧把持钳头外,还提供包括该胸腔镜食管吻合器钉砧把持钳头的胸腔镜食管吻合器把持钳,其包括位于钳身后部的手柄,形成钳身双开合关节,适用于胸腔镜小操作孔的镜下操作;2、钳身前部有钳头夹持端与主体成特定角度,优选120度,便于置入吻合器钉砧,在对接吻合器时固定吻合器钉砧有合适的角度;3、钳头夹持端部设置有专门嵌合吻合器钉砧的夹持槽,闭合时形成的夹持孔的中心轴线垂直于钳头夹持端部闭合时主体中心轴线,便于有效固定吻合器钉砧 及方便对接吻合器。并且,双关节便于器械用于胸腔镜微创手术切口,合适的角度便于手术中克服切口与食管断端的成角,与被夹持物体吻合器钉砧外周面相匹配的夹持孔便于有效牢固夹持吻合器钉砧。The utility model is directed to the stapler head fixing pliers used in the existing open surgery, and can not change the shape and structure of the device due to various defects such as inconvenience of the device caused by the narrow operation port and the unsuitable angle. The thoracoscope esophageal anastomat anvil provided by the utility model holds the clamp head or the holding clamp to ensure the operation is safe and reliable during the operation. In the utility model: 1. In addition to the thoracoscopic esophageal anastomat anvil holding the forceps head, a thoracoscope esophageal stapler grasping forceps including the thoracoscope esophageal anastomat anvil holding jaw is provided, which is located at the back of the forceps The handle forms a double-opening joint of the clamp body, and is suitable for the microscopic operation of the small operation hole of the thoracoscope; 2. The clamping end of the clamp head has a specific angle with the main body at the front, preferably 120 degrees, for facilitating the insertion of the stapler nail The anvil has a suitable angle when fixing the stapler anvil; 3. The clamping end of the clamp head is provided with a clamping groove for the special fitting anvil, and the central axis of the clamping hole formed when closed is vertical The central axis of the body is closed when the clamping end of the clamp head is closed, so as to effectively fix the anvil of the stapler And convenient docking stapler. Moreover, the double joint is convenient for the instrument for the minimally invasive surgical incision of the thoracoscope, the suitable angle is convenient for avoiding the angle between the incision and the end of the esophagus during the operation, and the clamping hole matching the outer peripheral surface of the stapled anvil of the clamped object is convenient and effective. Hold the stapler anvil.
在手术中胸腔内空间小,操作切口及角度受到限制,但本实用新型的胸腔镜食管吻合器钉砧把持钳,可以在两方面满足手术的需要:1、在计划进行食管吻合的部位先行手工浆肌层荷包一周,于其下方,切开部分食管,使用本实用新型提供的胸腔镜食管吻合器钉砧把持钳夹持吻合器钉砧自前操作口进入胸腔,并自切开的食管向上送入钉砧,结扎荷包线,彻底切断食管。2、在吻合时,由肩胛下之切口置入把持钳,固定钉砧后将吻合器对合。本器械的实用新型使得该两步操作轻而易举。这种设计给胸腔镜下胸腔内食管吻合提供了便捷的操作可能,使得现有的吻合器可以在胸腔镜微创手术切口的前提下顺利进行胸腔内吻合。无需增加手术一次性材料的花费及延长增加手术切口等的无奈选择,使手术操作更加安全、便利,降低手术风险,缩短手术时间,保证吻合效果及手术安全,同时保证了手术操作的灵活性。In the operation, the space in the thoracic cavity is small, and the operation incision and angle are limited. However, the thoracoscopic esophageal anastomat anvil holding pliers of the present invention can meet the needs of surgery in two aspects: 1. Manually planning the site for esophageal anastomosis The pulp muscle layer is stored for one week, and under the lower part, the part of the esophagus is cut, and the thoracoscope esophageal anastomat anvil is provided by the utility model, and the anvil is held from the front operation port into the chest cavity, and is sent upward from the cut esophagus. Into the anvil, ligature the purse line, and completely cut off the esophagus. 2. When the anastomosis is performed, the holding clamp is placed by the incision under the shoulder blade, and the stapler is aligned after the anvil is fixed. The utility model of the device makes the two-step operation a breeze. This design provides a convenient operation for thoracoscopic thoracic esophageal anastomosis, allowing the existing stapler to perform an intrathoracic anastomosis under the premise of a thoracoscopic minimally invasive surgical incision. There is no need to increase the cost of surgical disposable materials and extend the helpless choice of surgical incision, so that the operation is safer and more convenient, reduce the risk of surgery, shorten the operation time, ensure the anastomosis effect and the safety of surgery, and ensure the flexibility of the operation.
附图说明DRAWINGS
为了更清楚地说明本实用新型实施例或现有技术中的技术方案,下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍,显而易见地,下面描述中的附图仅仅是本实用新型的一些实施例,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获得其他的附图。In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings to be used in the embodiments or the description of the prior art will be briefly described below. Obviously, the drawings in the following description It is only some embodiments of the present invention, and those skilled in the art can obtain other drawings according to these drawings without any creative work.
图1是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳头的侧视图;1 is a side view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention;
图2是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳头的俯视图;2 is a top plan view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention;
图3是图2中夹持端部的沿F方向的视图;Figure 3 is a view of the grip end of Figure 2 taken along the F direction;
图4是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的侧视图;4 is a side view of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention;
图5是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的俯视图;5 is a top plan view of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention;
图6是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的外套管的第一端部结构示意图;6 is a schematic view showing the first end structure of the outer sleeve of the thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention;
图7是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的闭合时结构示意图;7 is a schematic structural view of a closed end of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention;
图8是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的张开时结构示意图;以及 8 is a schematic view showing the structure of a thoracoscopic esophageal anastomat anvil holding pliers according to an embodiment of the present invention;
图9是本实用新型的另一实施例的胸腔镜食管吻合器钉砧把持钳的结构图。9 is a structural view of a thoracoscope esophageal anastomat anvil holding pliers according to another embodiment of the present invention.
具体实施方式detailed description
下面将结合本实用新型实施例中的附图,对本实用新型实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本实用新型一部分实施例,而不是全部的实施例。基于本实用新型中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本实用新型保护的范围。The technical solutions in the embodiments of the present invention will be clearly and completely described in conjunction with the drawings in the embodiments of the present invention. It is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. example. All other embodiments obtained by those skilled in the art based on the embodiments of the present invention without creative efforts are within the scope of the present invention.
根据本实用新型的一个实施方式,提供了一种胸腔镜食管吻合器钉砧把持钳头。图1是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳头的侧视图;图2是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳头的俯视图;图3是图2中夹持端部的沿F方向的视图。如图1、图2和图3所示,本实施例的胸腔镜食管吻合器钉砧把持钳头,其包括:钳头定轴10,在本实施例中,钳头定轴10垂直于图纸纸面;以及第一夹持臂201和第二夹持臂202,可以统称为夹持臂2,其均具有用于套在钳头定轴10上实现转动的转动孔,第一夹持臂201的夹持端和第二夹持臂的夹持端向钳头定轴10的同一轴向弯折,在本实施方式中,向垂直于图1的图纸纸面的方向向外弯折,并且夹持端的夹持面与钳头定轴10平行或者在同一平面上,弯折后可以得到图2所示的情形。夹持面大体是平的,但为了增大摩擦力,可以是粗糙或者带纹路的夹持面;第一夹持臂201的驱动端设置有第一驱动孔401,第二夹持臂202的驱动端设置有第二驱动孔402,第一驱动孔401和第二驱动孔402可以统称为夹持臂驱动孔4,用于通过驱动轴施加力量,使得第一夹持臂201和第二夹持臂202张开或闭合。驱动轴安装在各驱动孔内。需要说明的是,如图2所示,夹持端向钳头定轴10的同一轴向弯折角度A可以根据不同型号、需求设置成特定角度,角度大小范围可以是110度到130度,优选设定为120度。120度时,能够满足人体食管与一般手术切口的位置特性,通常能达到非常顺畅的操作效果。图2中,B为第一夹持臂201和第二夹持臂202闭合时的示意性中心轴线。According to one embodiment of the present invention, a thoracoscopic esophageal staple anvil holding jaw is provided. 1 is a side view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention; FIG. 2 is a top view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention; 3 is a view in the F direction of the grip end portion in Fig. 2. As shown in FIG. 1 , FIG. 2 and FIG. 3 , the thoracoscope esophageal anastomat anvil gripping head of the present embodiment comprises: a clamping head fixed shaft 10 . In the embodiment, the clamping head fixed axis 10 is perpendicular to the drawing. The paper surface; and the first clamping arm 201 and the second clamping arm 202, which may be collectively referred to as the clamping arms 2, each having a rotating hole for locking on the fixed shaft 10 of the jaw, the first clamping arm The clamping end of the second clamping arm and the clamping end of the second clamping arm are bent in the same axial direction of the clamping head 10, and in the present embodiment, are bent outward in a direction perpendicular to the drawing paper surface of FIG. And the clamping surface of the clamping end is parallel to the clamping shaft 10 or on the same plane, and the situation shown in Fig. 2 can be obtained after bending. The clamping surface is substantially flat, but may be a rough or textured clamping surface for increasing the friction; the driving end of the first clamping arm 201 is provided with a first driving hole 401, and the second clamping arm 202 The driving end is provided with a second driving hole 402. The first driving hole 401 and the second driving hole 402 may be collectively referred to as a clamping arm driving hole 4 for applying force through the driving shaft, so that the first clamping arm 201 and the second clamping member The arm 202 is opened or closed. The drive shaft is mounted in each drive hole. It should be noted that, as shown in FIG. 2, the same axial bending angle A of the clamping end to the clamping head 10 can be set to a specific angle according to different models and requirements, and the angular range can be 110 to 130 degrees. It is preferably set to 120 degrees. At 120 degrees, it can meet the positional characteristics of the human esophagus and the general surgical incision, and usually achieves a very smooth operation effect. In Fig. 2, B is a schematic central axis when the first clamping arm 201 and the second clamping arm 202 are closed.
根据本实用新型的第二实施方式,提供一种胸腔镜食管吻合器钉砧把持钳头,其中,第一夹持臂201的夹持面上和第二夹持臂202的夹持面上都具有对称的夹持槽,在第一夹持臂201和第二夹持臂202闭合时形成与胸腔镜食管吻合器钉砧外周面轮廓相匹配的夹持孔220。该夹持孔220也可以根据需求,设置成与任何其他被夹持物的外周面轮廓相匹配的形状,从而防止被夹持物的旋转或滑落,牢固夹持被夹持物。 According to a second embodiment of the present invention, a thoracoscopic esophageal anastomat anvil holding jaw is provided, wherein the clamping surface of the first clamping arm 201 and the clamping surface of the second clamping arm 202 are both The symmetrical clamping groove forms a clamping hole 220 that matches the contour of the outer peripheral surface of the thoracoscopic esophageal anastomosis anvil when the first clamping arm 201 and the second clamping arm 202 are closed. The holding hole 220 may also be provided in a shape matching the contour of the outer peripheral surface of any other object to be clamped as needed, thereby preventing the object to be rotated or slipped, and firmly holding the object to be clamped.
根据本实用新型的第三个实施方式,提供一种胸腔镜食管吻合器钉砧把持钳头,其中,夹持孔220的中心轴线C与第一夹持臂的夹持端和第二夹持臂的夹持端闭合时的中心轴线B1垂直,如图2中所示。夹持端指的是靠近端部、大体上是直的部分,即图2中角度A的靠端部的一条边B1所在的部分。当角度A为优选的120度时,此时,夹持孔220的中心轴线C与角度A的另一条边B2的夹角为30度,使得被夹持的胸腔镜食管吻合器钉砧或吻合器上的管体呈现便于进行手术操作的状态。当然,夹持孔220的中心轴线C也可以与第一夹持臂的夹持端和第二夹持臂的夹持端闭合时的中心轴线B1成其他角度,以满足手术的特殊需要。如图3所示,夹持孔的直径可以根据被夹持物外径设定,例如,夹持孔的直径范围可以为6到9毫米。According to a third embodiment of the present invention, a thoracoscope esophageal anastomat anvil holding jaw is provided, wherein a central axis C of the clamping hole 220 and a clamping end and a second clamping of the first clamping arm The center axis B1 when the grip end of the arm is closed is perpendicular, as shown in FIG. The grip end refers to a portion that is substantially straight near the end, that is, a portion of the end A of the angle A of Fig. 2 where the end B1 is located. When the angle A is preferably 120 degrees, at this time, the angle between the central axis C of the clamping hole 220 and the other side B2 of the angle A is 30 degrees, so that the clamped thoracoscope esophagus anastomat or anastomosis The tube on the device presents a state that facilitates surgical operation. Of course, the central axis C of the clamping hole 220 can also be at other angles with the central axis B1 when the clamping end of the first clamping arm and the clamping end of the second clamping arm are closed to meet the special needs of the operation. As shown in Fig. 3, the diameter of the holding hole can be set according to the outer diameter of the object to be clamped, for example, the diameter of the holding hole can be 6 to 9 mm.
本实用新型的各实施方式的胸腔镜食管吻合器钉砧把持钳头具有流线性结构,在闭合时,流线上截面积基本保持均匀,而不会增大横截面积,不需要对病人增大手术切口。因此完全克服了利用现有持钳头上焊接辅助部件、使得置入胸腔时需要增大手术切口的问题。The thoracoscopic esophageal anastomat anvil holding head of the embodiment of the present invention has a flow linear structure. When closed, the cross-sectional area of the flow line is substantially uniform, without increasing the cross-sectional area, and does not need to increase the patient. Major surgical incision. Therefore, the problem of using the welding aid on the existing holding head to increase the surgical incision when the chest is placed is completely overcome.
根据本实用新型的一个实施方式,提供一种胸腔镜食管吻合器钉砧把持钳。图4是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的侧视图;图5是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的俯视图;图6是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的外套管的第一端部结构示意图;图7是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的闭合时结构示意图;图8是本实用新型的一个实施方式的胸腔镜食管吻合器钉砧把持钳的张开时结构示意图;以及图9是本实用新型的另一实施例的胸腔镜食管吻合器钉砧把持钳的结构图。其中,该胸腔镜食管吻合器钉砧把持钳包括:前述任何一个实施方式中所述的胸腔镜食管吻合器钉砧把持钳头;钳体。钳体包括外套管1、该外套管1内可沿纵向往复滑动的驱动杆3以及与该驱动杆3的第一端部通过动轴连接的第一驱动臂301和第二驱动臂302;外套管1的第一端部具有叉耳结构,用于固定钳头定轴10,使得第一夹持臂201和第二夹持臂202以可转动方式与外套管1连接;第一驱动臂301与第一夹持臂201的驱动端设置的第一驱动孔401通过驱动轴以可转动方式连接,第二驱动臂302与第二夹持臂202的驱动端设置的第二驱动孔402通过驱动轴以可转动方式连接。如图6所示,外套管1的第一端部的叉耳结构,可用于固定钳头定轴10。附图仅示出外套管1的第一端部的叉耳结构以及钳头定轴10的位置示意图。结合图7和图8可以看出,当钳头定轴10被固定在外套管1的第一端部的叉耳结构上时,相对于外套管1,第一驱动臂301和第二驱动臂302以及第一夹持臂201的驱动端和第二 夹持臂202的驱动端形成只有一个顶点位置固定而三个顶点位置可变动的四边形,其中驱动杆3在外套管1内往复滑动时,迫使第一驱动孔401和第二驱动孔402靠近或远离驱动杆3所在轴线,实现驱动杆3在外套管1内的往复滑动转换成夹持臂的张合动作。因此,当驱动杆3的第一端部离钳头定轴10的距离最大时,夹持臂张角最小,实现闭合把持操作;当驱动杆3的第一端部离钳头定轴10的距离最小时,夹持臂张角最在,实现夹持臂张开操作。当夹持臂闭合时,整体把持钳的流线上的横截面积可以做到很小,在伸进手术切口时,不需要扩大切口。并且,外套管1和驱动杆3可以根据需要选择任意长度,仍然不需要改变整体把持钳的流线上的横截面积。According to an embodiment of the present invention, a thoracoscopic esophageal anastomat anvil grasping forceps is provided. 4 is a side view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention; and FIG. 5 is a plan view of a thoracoscope esophageal anastomat anvil holding plier according to an embodiment of the present invention; A schematic diagram of a first end structure of an outer cannula of a thoracoscopic esophageal anastomat anvil gripper according to an embodiment of the present invention; FIG. 7 is a closed view of a thoracoscope esophageal anastomat anvil holding pliers according to an embodiment of the present invention; FIG. 8 is a schematic view showing the structure of the thoracoscopic esophageal anastomat anvil holding pliers according to an embodiment of the present invention; and FIG. 9 is a thoracoscopic esophageal anastomat holding device according to another embodiment of the present invention. The structure of the pliers. Wherein, the thoracoscopic esophageal anastomat anvil grasping forceps comprises: the thoracoscope esophageal anastomat anvil holding the forceps head; the caliper body described in any one of the foregoing embodiments. The caliper body includes an outer sleeve 1, a drive rod 3 that is reciprocally slidable in the longitudinal direction of the outer sleeve 1, and a first drive arm 301 and a second drive arm 302 that are coupled to the first end of the drive rod 3 via a moving shaft; The first end of the tube 1 has a prong structure for fixing the clamp shaft 10 such that the first clamp arm 201 and the second clamp arm 202 are rotatably coupled to the outer sleeve 1; the first drive arm 301 The first driving hole 401 provided with the driving end of the first clamping arm 201 is rotatably connected by the driving shaft, and the second driving hole 302 of the second driving arm 302 and the driving end of the second clamping arm 202 is driven by the driving. The shaft is rotatably connected. As shown in Fig. 6, the prong structure of the first end of the outer sleeve 1 can be used to secure the jaw shaft 10. The drawing shows only the prong structure of the first end of the outer sleeve 1 and the position of the clamp shaft 10. As can be seen in conjunction with Figures 7 and 8, when the jaw positioning shaft 10 is secured to the prong structure of the first end of the outer sleeve 1, the first drive arm 301 and the second drive arm relative to the outer sleeve 1, 302 and the driving end and the second of the first clamping arm 201 The driving end of the clamping arm 202 forms a quadrilateral with only one vertex position fixed and three apex positions variable, wherein the driving rod 3 forces the first driving hole 401 and the second driving hole 402 to approach or reciprocately slide in the outer sleeve 1 or Along from the axis of the drive rod 3, the reciprocating sliding of the drive rod 3 in the outer sleeve 1 is converted into a clamping action of the clamping arm. Therefore, when the distance between the first end of the drive rod 3 and the fixed shaft 10 of the clamp is maximum, the angle of the clamp arm is minimum, and the closing and holding operation is realized; when the first end of the drive rod 3 is away from the fixed shaft 10 of the clamp When the distance is the smallest, the clamping arm opening angle is the most, and the clamping arm opening operation is realized. When the clamping arm is closed, the cross-sectional area of the flow line of the overall holding forceps can be made small, and it is not necessary to enlarge the incision when extending into the surgical incision. Also, the outer sleeve 1 and the drive rod 3 can be selected to any length as needed, and there is still no need to change the cross-sectional area of the flow line of the overall holding jaw.
在本实用新型的另一个实施方式中,提供了一种胸腔镜食管吻合器钉砧把持钳。其中,外套管1的第二端部还连接有用于驱动驱动杆3在外套管1内往复滑动的驱动装置。驱动装置可以是如同手持钳一样的手持式把手,也可以电动驱动装置或者液压驱动装置,只要能用于驱动驱动杆3以进行纵向滑动即可。In another embodiment of the present invention, a thoracoscopic esophageal anastomotic anvil grasping forceps is provided. The second end of the outer sleeve 1 is also connected with a driving device for driving the drive rod 3 to reciprocally slide in the outer sleeve 1. The driving device may be a hand-held handle like a hand-held pliers, or an electric drive device or a hydraulic drive device, as long as it can be used to drive the drive rod 3 for longitudinal sliding.
更具体地,驱动装置为手持式把手时,可以包括:与外套管1的第二端部以可张合方式连接的两个握持把手;与驱动杆3的第二端部以可转动方式连接并与每个握持手靠近导杆3的部分5以转动方式连接的传动臂,用于将两个握持把手的张合运动转换为驱动杆3在套管1内的纵向往复滑动。如图9所示,该结构与靠近夹持臂的第一端的驱动结构类似,但实现的功能是将两个握持把手的张合运动转换为驱动杆3在套管1内的纵向往复滑动,握持把手相对于外套管1上的固定轴转动,从而实现张合时使驱动杆3在外套管1内纵向滑动。该结构使整体把持钳形成双关节结构。两个握持把手内侧可以设置有用于彼此钩住的搭钩,在夹持钳夹紧时,固定把手,避免操作时需要长时间使劲捏住把手。More specifically, when the driving device is a hand-held handle, it may include: two holding handles that are connected to the second end of the outer sleeve 1 in a slidable manner; and the second end of the driving rod 3 is rotatably A transmission arm that is coupled and rotatably coupled to a portion 5 of each of the gripping hands 3 is adapted to convert the kneading movement of the two gripping handles into a longitudinal reciprocal sliding of the drive rod 3 within the sleeve 1. As shown in Figure 9, the structure is similar to the drive structure near the first end of the clamp arm, but the function achieved is to convert the tensioning motion of the two grip handles into a longitudinal reciprocation of the drive rod 3 within the sleeve 1. Sliding, the gripping handle is rotated relative to the fixed shaft on the outer sleeve 1, thereby effecting longitudinal sliding of the drive rod 3 within the outer sleeve 1 during the opening. This structure allows the overall gripping forceps to form a double joint structure. The inside of the two gripping handles may be provided with hooks for hooking each other, and when the gripping jaws are clamped, the handles are fixed to avoid the need to pinch the handles for a long time during operation.
另外,在外套管上靠近第二端部处可设置有清洁孔和清洁孔盖,用于从该清洁孔注入高压液体或气体进行清洁处理。因手术器械在手术过程中,不可避免会有血液或其他流体进入外套管,需要用高压液体或气体进行清洁处理。在此处设置清洁孔不影响整个胸腔镜食管吻合器钉砧把持钳进入手术切口内的部分的横截面积。In addition, a cleaning hole and a cleaning hole cover may be provided on the outer sleeve near the second end for injecting a high-pressure liquid or gas from the cleaning hole for cleaning. Because the surgical instrument is in the process of surgery, blood or other fluids will inevitably enter the outer casing, and it needs to be cleaned with high-pressure liquid or gas. Setting the cleaning hole here does not affect the cross-sectional area of the portion of the entire thoracoscopic esophageal anastoma holder holding the forceps into the surgical incision.
更具体地,为实现本实用新型的目的,采用的技术方案如下:1、胸腔镜食管吻合器把持钳,包括位于钳体后部的手柄,钳体双开合关节,适用于胸腔镜小操作孔的镜下操作;2、钳身前部有钳口与端头120度成角:便于置入吻合器钉砧,及对接吻合器时固定吻合器钉砧有合适的角度;3、钳口专门嵌合吻合器钉砧的凹槽。垂直于钳口,便于有效固定吻合器钉砧及方便对接吻合器。双关节便于器械用于胸腔镜微创手术切口,合适的角度便于手术中克服切口与食管断端的成交。专用的凹槽便于有效固定吻合器钉砧。 More specifically, in order to achieve the object of the present invention, the technical solution adopted is as follows: 1. A thoracoscopic esophageal stapler holding clamp, including a handle at the back of the caliper body, a double-opening joint of the caliper body, suitable for a small operation hole of the thoracoscope The operation under the microscope; 2, the front part of the clamp body has an angle of 120 degrees with the end of the jaw: easy to insert the staple anvil, and the fixed anastomosis anvil has a suitable angle when docking the stapler; 3, the jaw special The groove of the stapler anvil. Vertical to the jaws, it is convenient to effectively fix the staple anvil and facilitate the docking stapler. The double joint facilitates the instrument for the minimally invasive surgical incision of the thoracoscopic surgery, and the appropriate angle facilitates the overcoming of the incision and the end of the esophagus during surgery. A dedicated recess facilitates the effective fixation of the staple anvil.
为此,在手术中根据胸腔内空间小,操作切口及角度限制的需要,本实用新型提供的胸腔镜食管吻合器钉砧把持钳,可以在至少两方面满足手术的需要:1、在计划进行食管吻合的部位先行手工浆肌层荷包一周,于其下方,切开部分食管,使用胸腔镜食管吻合器钉砧把持钳夹持吻合器钉砧自前操作口进入胸腔,并自切开的食管向上送入钉砧,结扎荷包线,彻底切段食管。2、在吻合时,由肩胛下之切口置入把持钳,固定钉砧后将吻合器对合。Therefore, in the operation, according to the small space in the thoracic cavity, the operation of the incision and the angle limitation, the thoracoscopic esophageal anastomat anvil holding pliers provided by the utility model can meet the needs of the operation in at least two aspects: 1. The part of the esophageal anastomosis is firstly hand-pulverized with a muscle pack for one week. Under the lower part of the esophagus, a part of the esophagus is cut. The thoracoscopic esophageal anastomosis anvil is used to hold the stapler anvil from the front operation port into the chest cavity, and the esophagus is self-cut. Send the anvil, ligation the purse line, and completely cut the esophagus. 2. When the anastomosis is performed, the holding clamp is placed by the incision under the shoulder blade, and the stapler is aligned after the anvil is fixed.
以上所述的具体实施方式,对本实用新型的目的、技术方案和有益效果进行了进一步详细说明,所应理解的是,以上所述仅为本实用新型的具体实施方式而已,并不用于限定本实用新型的保护范围,凡在本实用新型的精神和原则之内,所做的任何修改、等同替换、改进等,均应包含在本实用新型的保护范围之内。 The specific embodiments of the present invention have been described in detail with reference to the preferred embodiments of the present invention. It is to be understood that the foregoing description is only The scope of the present invention is to be construed as being within the scope of the present invention. Any modifications, equivalent substitutions, improvements, etc. within the spirit and scope of the present invention are intended to be included within the scope of the present invention.

Claims (10)

  1. 一种胸腔镜食管吻合器钉砧把持钳头,其特征在于,包括:A thoracoscopic esophageal anastomat anvil holding pliers head, characterized in that:
    钳头定轴;以及Clamping the shaft; and
    第一夹持臂和第二夹持臂,其均具有用于套在所述钳头定轴上实现转动的转动孔,所述第一夹持臂的夹持端和所述第二夹持臂的夹持端向所述钳头定轴的同一轴向弯折,并且所述夹持端的夹持面与所述钳头定轴平行或者在同一平面上;所述第一夹持臂的驱动端设置有第一驱动孔,所述第二夹持臂的驱动端设置有第二驱动孔,所述第一驱动孔和所述第二驱动孔用于通过驱动轴施加力量,使得所述第一夹持臂和所述第二夹持臂张开或闭合。a first clamping arm and a second clamping arm each having a rotating hole for being sleeved on the fixed shaft of the clamping head, a clamping end of the first clamping arm and the second clamping The clamping end of the arm is bent in the same axial direction of the clamping head, and the clamping surface of the clamping end is parallel or in the same plane with the clamping head; the first clamping arm The driving end is provided with a first driving hole, and the driving end of the second clamping arm is provided with a second driving hole, the first driving hole and the second driving hole are for applying a force through the driving shaft, so that the The first clamping arm and the second clamping arm are opened or closed.
  2. 根据权利要求1所述的胸腔镜食管吻合器钉砧把持钳头,其特征在于,所述第一夹持臂的夹持面上和所述第二夹持臂的夹持面上都具有对称的夹持槽,在所述第一夹持臂和所述第二夹持臂闭合时形成与所述胸腔镜食管吻合器钉砧外周面轮廓相匹配的夹持孔。The thoracoscopic esophageal anastomat anvil holding jaw according to claim 1, wherein the clamping surface of the first clamping arm and the clamping surface of the second clamping arm are symmetric The clamping slot forms a clamping hole that matches the contour of the outer peripheral surface of the thoracoscopic esophageal anastomosis anvil when the first clamping arm and the second clamping arm are closed.
  3. 根据权利要求2所述的胸腔镜食管吻合器钉砧把持钳头,其特征在于,所述夹持孔的中心轴线与所述第一夹持臂的夹持端和所述第二夹持臂的夹持端闭合时的中心轴线垂直。The thoracoscopic esophageal anastomat anvil holding jaw according to claim 2, wherein a central axis of the clamping hole is opposite to a clamping end of the first clamping arm and the second clamping arm The center axis of the clamping end is closed when it is closed.
  4. 根据权利要求3所述的胸腔镜食管吻合器钉砧把持钳头,其特征在于,所述第一夹持臂的夹持端和所述第二夹持臂的夹持端向所述钳头定轴的同一轴向弯折的角度范围为110度到130度。The thoracoscopic esophageal anastomat anvil holding jaw according to claim 3, wherein the clamping end of the first clamping arm and the clamping end of the second clamping arm are directed to the clamping head The same axial bending of the fixed axis ranges from 110 degrees to 130 degrees.
  5. 根据权利要求3所述的胸腔镜食管吻合器钉砧把持钳头,其特征在于,所述第一夹持臂的夹持端和所述第二夹持臂的夹持端向所述钳头定轴的同一轴向弯折的角度为120度。The thoracoscopic esophageal anastomat anvil holding jaw according to claim 3, wherein the clamping end of the first clamping arm and the clamping end of the second clamping arm are directed to the clamping head The angle of the same axial bend of the fixed axis is 120 degrees.
  6. 一种胸腔镜食管吻合器钉砧把持钳,其特征在于,该胸腔镜食管吻合器钉砧把持钳包括:A thoracoscopic esophageal anastomat anvil grasping forceps, characterized in that the thoracoscope esophageal anastomat anvil holding clamp comprises:
    权利要求1到5中任何一项所述的胸腔镜食管吻合器钉砧把持钳头;以及The thoracoscopic esophageal anastomat anvil holding jaw according to any one of claims 1 to 5;
    钳体,其包括外套管、该外套管内可沿纵向往复滑动的驱动杆以及与该驱动杆的第一端部通过动轴连接的第一驱动臂和第二驱动臂;所述外套管的第一端部具有叉耳结构,用于固定所述钳头定轴,使得所述第一夹持臂和所述第二夹持臂以可转动方式与所述外套管连接;所述第一驱动臂与所述第一夹持臂的驱动端设置的第一驱动孔通过所述驱动轴以可转动方式连接,所述第二驱动臂与所述第二夹持臂的驱动端设置的第二驱动孔通过所述驱动轴以可转动方式连接。 a caliper body comprising an outer sleeve, a drive rod reciprocally slidable longitudinally in the outer sleeve, and a first drive arm and a second drive arm coupled to the first end of the drive rod via a moving shaft; One end portion has a forked ear structure for fixing the clamp head fixed shaft such that the first clamp arm and the second clamp arm are rotatably coupled to the outer sleeve; the first drive a first driving hole provided by the arm and the driving end of the first clamping arm is rotatably connected through the driving shaft, and a second driving arm is disposed at a driving end of the second clamping arm Drive holes are rotatably coupled by the drive shaft.
  7. 根据权利要求6所述的胸腔镜食管吻合器钉砧把持钳,其特征在于,所述外套管的第二端部还连接有用于驱动所述驱动杆在所述外套管内往复滑动的驱动装置。The thoracoscopic esophageal anastomat anvil grasping forceps according to claim 6, wherein the second end of the outer sleeve is further connected with a driving device for driving the driving rod to reciprocally slide in the outer sleeve.
  8. 根据权利要求7所述的胸腔镜食管吻合器钉砧把持钳,其特征在于,所述驱动装置包括:与所述外套管的第二端部以可张合方式连接的两个握持把手;与所述驱动杆的第二端部以可转动方式连接并与每个所述握持手靠近导杆的部分以转动方式连接的传动臂,用于将所述两个握持把手的张合运动转换为所述驱动杆在所述套管内的纵向往复滑动。The thoracoscopic esophageal anastomat anvil grasping forceps according to claim 7, wherein the driving device comprises: two gripping handles that are connected to the second end of the outer sleeve in a slidable manner; a transmission arm rotatably coupled to a second end of the drive rod and rotatably coupled to a portion of each of the gripping hands for guiding the two gripping handles The motion is converted into a longitudinal reciprocal sliding of the drive rod within the sleeve.
  9. 根据权利要求8所述的胸腔镜食管吻合器钉砧把持钳,其特征在于,所述外套管上靠近所述第二端部处设置有清洁孔和清洁孔盖,用于从该清洁孔注入高压液体或气体进行清洁处理。The thoracoscopic esophageal anastomat anvil holding pliers according to claim 8, wherein a cleaning hole and a cleaning hole cover are disposed on the outer sleeve near the second end for injecting from the cleaning hole High pressure liquid or gas is cleaned.
  10. 根据权利要求7所述的胸腔镜食管吻合器钉砧把持钳,其特征在于,所述驱动装置为电动驱动装置或者液压驱动装置,用于驱动所述驱动杆以进行纵向滑动。 The thoracoscopic esophageal anastomat anvil grasping forceps according to claim 7, wherein the driving device is an electric driving device or a hydraulic driving device for driving the driving rod for longitudinal sliding.
PCT/CN2014/088998 2014-05-08 2014-10-21 Anvil holding forceps head for stapler used in esophagus during thoracoscopy procedure and holding forceps with the forceps head WO2015169058A1 (en)

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CN109893211A (en) * 2019-01-31 2019-06-18 汕头大学 A kind of minimally invasive abdominal operation equipment clamps together device
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CN107334510A (en) * 2017-06-26 2017-11-10 李印 A kind of medical clamping pincers
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