WO2017028361A1 - Single-handed-operation surgical instrument and operation method thereof - Google Patents

Abstract

Provided are a single-handed-operation surgical instrument and operation method thereof, the surgical instrument comprising an actuator (300), an intermediate connector (200), and a controller (100). The actuator (300), the intermediate connector (200) and the controller (100) are connected to one another in sequence. The actuator (300) comprises a staple cartridge component (3002), a staple anvil component (3001), and a driving component (3003). The controller (100) comprises a firing trigger mechanism, a firing safety mechanism, and an automatic reset mechanism. The surgical instrument has an automatic-reset function: if the firing safety mechanism is locked, the actuator (300) of the surgical instrument grasps a tissue when a doctor operates a firing trigger (111); when the doctor releases the firing trigger (111), the actuator (300) of the surgical instrument automatically resets and releases the grasped tissue. Such a function of the surgical instrument enables the doctor to single-handedly adjust a position where a stapler grasps the tissue, and further facilitates enhanced thickness uniformity of the grasped tissue by the doctor repeatedly grasping the same part of the tissue, thereby improving stapling and cutting effects.

Description

Surgical instrument capable of single hand operation and operation method thereof Technical field

The present invention relates to surgical instruments, and more particularly to a surgical stapler, and in particular to an improved surgical instrument, and more particularly to a controller thereof and method of operation thereof, which can be operated with one hand to achieve a particular function.

Background technique

The principle of the surgical stapler is to close the tissue by two corresponding jaws (commonly referred to as the anvil assembly and the cartridge assembly), and then push the metal staples in the stapler cartridge to form the tissue. Together. In some staplers, a cutting knife is also provided for cutting the stitched tissue.

The stapler having the above functions includes an actuator, an intermediate connector, and a controller. The actuator consists of an anvil assembly, a cartridge assembly and a drive assembly. The anvil assembly includes a nail forming surface, the nail forming surface includes a plurality of rows of nail grooves, and the nail groove is used for forming a metal staple. The cartridge assembly generally includes a staple cartridge, a staple, a pusher block, and a pusher slider and a staple cartridge. The upper surface of the staple cartridge is a tissue contacting surface, and the staple cartridge is mounted in the staple cartridge holder. The anvil assembly is movably coupled proximally to the proximal end of the cartridge assembly and is switchable between an open state and a closed state. The drive assembly is coupled to the transmission mechanism for converting the firing trigger action into an actuator closing, firing, and opening action. Typically, the anvil assembly and the cartridge holder each also include a longitudinal slot for receiving the drive assembly. When the drive assembly is moved toward the distal end of the actuator through the longitudinal slot, the anvil assembly and the cartridge assembly are driven from the open state to the closed state, and the pusher slider and the pusher block are driven out of the staple and Formed in the staple groove of the nail forming surface of the anvil assembly. Typically, the drive assembly also includes a cutting knife for cutting tissue between rows of staple lines after the tissue is stitched by the staples. The controller is used for manually controlling the operating instrument, and generally includes a fixed handle, a firing trigger that is movably coupled to the fixed handle, a transmission mechanism that transmits the firing trigger to the actuator, and a manual reset assembly. Operating the manual reset assembly can urge the cartridge assembly and the anvil assembly to return to an open state when the cartridge assembly and the anvil assembly of the actuator are in a closed state. The intermediate connector is movably coupled to the distal end of the controller and coupled to the proximal end of the actuator, the intermediate connector forming a connecting passage for effecting the action of firing the trigger to the actuator.

For example, US Pat. No. 2014/0001233 A1 discloses a stapler which is capable of converting an anvil assembly and a cartridge assembly of an actuator from an open state to a closed state by performing a firing trigger to perform a press, a firing, and the like. , the other hand needs to use the other hand to pull back the manual reset component to drive the cartridge assembly Restore the open state with the anvil assembly. The technical solution does not fire the insurance mechanism, can not effectively prevent the false hitting, and the coherent process from pressing the tissue to firing the firing trigger for a continuous pressing operation cannot make the medical practitioner clearly perceive that the control performs the pressing and firing actions respectively.

Further, for example, a suturing device disclosed in the Chinese patent document CN202950702U, which has a firing safety device, but an operation button for controlling the firing safety device is located on the side of the suturing device, resulting in the operation button and the firing wrench The distance is too far, making it difficult to operate with one hand. To take a step back, even if the doctor's finger is long, the doctor still needs to operate the trigger button and the operation button of the safety device through the index finger and the thumb, in the process, Since the thumb and the other four fingers are on different sides of the stapler handle, the slack of the thumb tends to cause the gripper to be unstable. Moreover, the suturing device does not have an automatic resetting mechanism, and the medical practitioner needs to use another hand to pull the manual resetting structure back to the initial position of the proximal end after performing a pressing action, so as to drive the staple cartridge assembly and the anvil assembly to open. State, therefore, in fact, the stapler still requires two hands to operate when it is necessary to repeatedly press the tissue, and cannot achieve one-handed operation.

For example, the Endo GIA Universal cutting stapler from Tyco Healthcare (later renamed Covidien) and the Echelon cutting stapler from Ethicon Endo-Surgery in the United States are representative products for achieving the above functions. The above products have been sold for many years and have been proven by the market to have good clinical application effects. However, the design of these devices still needs to be perfected. For example, during the operation of the device, some operations require hands to complete, which is not conducive to the surgeon operating the device during the operation.

For example, in U.S. Patent No. 5,865,361, Tyco Healthcare describes the function and design of the Endo GIA Universal cutting stapler (hereafter referred to as the Endo GIA stapler). When the firing trigger of the Endo GIA stapler is fired, the anvil assembly and the cartridge assembly of the stapler will transition from the open state to the closed state, clamping the target tissue. During surgery, if the doctor believes that the position of the gripping tissue needs to be adjusted, the doctor needs to pull back the manual reset assembly with the other hand to drive the cartridge assembly and the anvil assembly back to open. In actual surgery, the target tissue of the stapler includes tissues such as stomach, lung, large intestine, etc., wherein the tissues of the stomach and the large intestine are generally thick, and the inner lumen of the tissue is rich in wrinkles, and the surface may have adipose tissue that is not completely separated; There are a large number of alveoli in the lung tissue. Therefore, when the stapler actuator closes and holds the tissue for the first time, the tissue is generally difficult to be compressed due to the thickness of the tissue, wrinkles, adipose tissue or bubbles in the tissue. To the desired uniform thickness. By repeatedly clamping the tissue at the same part, the tissue compression unevenness caused by the above factors can be effectively eliminated, so that the titanium stapler has a uniform height and good anastomosis effect when the stapler is subsequently driven to the titanium nail to anastomosed tissue and the tissue is cut, and the tissue cutting edge is good. smooth. To repeatedly hold the tissue in the same tissue, the doctor needs to loosen the instrument held by the other hand, repeatedly using both hands to operate the Endo GIA stapler's firing trigger and Manually reset the trigger. In addition, after the actuator of the Endo GIA stapler is properly clamped, the doctor first needs to use the other hand to assist in pressing the firing button of the stapler to open the firing safety device before deciding to match and cut the tissue. The operation of the firing trigger performs subsequent actions, which causes inconvenience to the operation of the instrument and brings additional risks to the operation. In minimally invasive surgery, doctors sometimes operate different instruments with two hands. If a device requires both hands to operate at the same time, the doctor needs to loosen the other device that is held. In minimally invasive surgery, the controller outside the device that is not under the control of the doctor may be displaced due to an accidental touch during the procedure. A small displacement of the instrument controller may cause a large amount of actuators at the distal end of the instrument. Controlled displacement; because the actuator at the distal end of the instrument is in close proximity to the tissue and organs within the target area of the instrument, uncontrolled displacement of the actuator may damage nearby tissues and organs. In the temporary operation of the instrument room, some doctors will take the device out of the body to avoid the risk; in some cases, the device will be temporarily held by another doctor; sometimes, the doctor just releases the device and the distal end of the device Pressing on certain tissues or in the interstitial spaces of the tissue may either extend the operation time or risk the damage to tissues and organs.

If the doctor can operate the stapler with one hand, the function of repeatedly clamping the same part of the tissue can be realized, which is very beneficial for the doctor to perform the operation, improve the thickness uniformity of the target tissue to be clamped, and thereby improve the anastomosis and cutting effect. If the doctor can open the firing insurance mechanism with one hand without sacrificing safety, it will also reduce the risk during the operation and shorten the operation time.

Summary of the invention

It is an object of the present invention to provide an improved surgical instrument controller. In particular, it relates to a cutting stapler that can be applied under open surgery or laparoscopic surgery. The device according to the present invention (hereinafter referred to as an anastomat) can realize tissue clamping to realize the molding of at least one row of staples; under certain application conditions, tissue cutting can also be performed, and tissue is arranged between multiple rows of staple lines Cut open.

A single-handed surgical instrument according to the present invention includes an actuator, an intermediate connector and a controller, the actuator, the intermediate connector, and the controller being sequentially connected, the actuator including a cartridge assembly, a nail An anvil assembly and a drive assembly, the controller including a firing trigger mechanism, a firing safety mechanism, an automatic reset mechanism, and a rack, wherein:

The automatic reset mechanism is detachably engaged with the rack of the controller and applies a force to the rack to drive the rack back to the initial position when engaged;

The safety trigger of the firing safety mechanism is rotatably mounted on the firing trigger of the firing trigger mechanism;

When the firing trigger is in the operating position, the safety trigger can be driven to disengage the automatic reset mechanism from the rack by being rotated.

Preferably, the safety trigger is located directly in front of the distal end of the firing trigger.

Preferably, the drive train between the safety trigger and the automatic reset mechanism is disconnected when the firing trigger is in the inoperative position.

Preferably, the automatic reset mechanism comprises an automatic reset slider and an elastic energy storage assembly, the automatic reset slider is provided with a reset tooth and is movably mounted in a longitudinal rail of the controller housing, and the reset tooth of the automatic reset slider is The rack is detachably engaged; the elastic energy storage assembly is fixed at one end to the controller housing and at the other end to the automatic reset slider to provide an elastic force that urges the rack back to the original position.

Preferably, the rack is detachably engaged with the reset teeth of the automatic reset slider by one of the slots.

Preferably, the longitudinal stroke of the automatic reset mechanism is limited by the limit of the limit boss in the controller, the block limit is such that the maximum longitudinal travel of the rack when engaged with the automatic reset mechanism is L1;

The safety trigger drives the automatic reset mechanism to disengage from the rack while driving the automatic reset mechanism to avoid the blocking of the limit boss, so that the maximum longitudinal stroke of the rack when disengaged from the automatic reset mechanism is L2;

Wherein, the length of L2 is greater than the length of L1, and the distal position of L2 is located at the distal end of the distal position of L1.

Preferably, the firing safety mechanism includes a safety rotating block, wherein the safety rotating block is rotatably mounted on the controller housing;

When the firing trigger is in the operating position, the safety trigger can rotate along the firing trigger, and the first driving boss of the safety trigger and the second driving boss of the safety rotating block drive the corresponding rotating motion of the safety rotating block, and the safety rotating block is The rotary motion drives the third drive boss of the safety rotary block to push the automatic reset slider of the automatic reset mechanism to raise, so that the automatic reset slider is disengaged from the rack.

Preferably, the automatic reset slider is raised such that the automatic reset mechanism avoids the blocking limit of the limit boss.

Preferably, when the firing trigger is in the inoperative position, the second drive boss of the safety rotary block is not within the reachable range of the first drive boss of the safety trigger, ie between the first drive boss and the second drive boss The drive drive chain is disconnected.

Preferably, the safety trigger has a safety trigger return spring, the safety trigger return spring always keeps the safety trigger in a resilient state of returning to the initial position; the safety rotating block has a safety rotating block return spring, and the safety rotating block return spring has a safety rotating block at all times Maintain a resilient trend toward the initial position.

Preferably, the controller comprises a toothed drive assembly (such as a rack), and the action of operating the firing trigger is transmitted to the drive assembly through the toothed drive assembly; the toothed drive assembly includes at least a first set of teeth, a first set of teeth At least one tooth is included, and the toothed drive assembly is used to transmit the motion of the firing trigger to the actuator.

Preferably, the toothed transmission component is any one of a rack, a gear, a ratchet gear or any of a plurality of types The combination.

Preferably, the elastic energy storage component of the automatic reset mechanism is of any one of a tension spring, a compression spring, a torsion spring, a scroll spring, a profile spring, a serpentine spring, and a disc spring.

Preferably, the automatic reset mechanism further comprises an energy storage component connector, the energy storage component connector comprises at least one tooth, the energy storage component connector is connected with the elastic energy storage component, the energy storage component connector and the toothed transmission component Separably meshed together, movement of the toothed drive assembly can drive the energy storage assembly connection to move and drive the elastic energy storage component to accumulate energy.

Preferably, the toothed drive assembly includes a second set of teeth, the second set of teeth including at least one tooth, the teeth of the energy storage assembly connection being movably engaged with the second set of teeth of the toothed drive assembly.

Preferably, the fire-fighting mechanism includes an insurance firing assembly (the safety firing assembly preferably includes a safety trigger), and when the safety firing assembly is operated, the safety firing assembly moves in any of the following manners: linear motion, curved motion, center The fixed rotational motion of the shaft, the rotational motion of the central axis along a linear motion, the rotational motion of the central axis along a curved motion, and the multi-axis rotational motion of the segment.

Preferably, the controller comprises a manual reset component.

A method of operating a single-handed surgical instrument according to the present invention, comprising:

Operating the firing trigger mechanism will drive the rack to move longitudinally to the distal end, the movement of the rack thereby driving the cartridge assembly and the anvil assembly of the actuator from an open state to a closed state;

In the case where the fire-fighting mechanism is not operated, when the firing trigger mechanism is released, the automatic reset mechanism, the drive assembly of the actuator, the cartridge assembly and/or the anvil assembly of the actuator sequentially constitute the driving force transmission chain The automatic reset mechanism will drive the drive assembly to move longitudinally proximally, thereby converting the cartridge assembly and the anvil assembly of the actuator from a closed state to an open state;

After operating the firing safety mechanism, the automatic reset mechanism disengages from the drive force transmission chain, and when the firing trigger mechanism is released, the cartridge assembly and the anvil assembly of the actuator remain closed.

Preferably, the firing trigger can only travel part of the stroke when the firing trigger mechanism drives the cartridge assembly and the anvil assembly of the actuator from the open state to the closed state without operating the firing safety mechanism. The drive assembly is caused to move only a portion of the distal end of the stroke; after the firing of the firing mechanism, the firing trigger can continue to operate in the same firing operation until the entire stroke is traveled, driving the drive assembly to move further distally.

Preferably, the elastic energy storage component accumulates energy when the firing trigger mechanism is actuated to drive the cartridge assembly and the anvil assembly of the actuator from an open state to a closed state; when the firing safety mechanism is not operated, the loosening Upon firing the trigger, the energy accumulated by the elastic energy storage component drives the actuator assembly of the actuator to move proximally proximally.

Preferably, when the cartridge assembly and the anvil assembly are transitioned from the open state to the closed state, operating the firing safety mechanism will drive the energy storage assembly connector (eg, the automatic reset slider) from the toothed transmission assembly (eg, the rack) from The meshing state is separated and the elastic energy storage component releases the accumulated energy.

Preferably, in the case where the cartridge assembly and the anvil assembly of the actuator are in an open state, when the firing safety mechanism is operated, the energy storage assembly connector is driven to remain in mesh with the toothed transmission assembly.

Preferably, the manual reset assembly of the operating controller can urge the cartridge assembly and the anvil assembly to return to an open state when the cartridge assembly and the anvil assembly are in a closed state.

Preferably, pulling the manual reset assembly proximally will cause the staple cartridge assembly and the anvil assembly to return to an open condition when the cartridge assembly and the anvil assembly are in the closed state.

Preferably, operating the manual reset assembly will urge the automatic reset mechanism to return to the initial state when the cartridge assembly and the anvil assembly are in the closed state.

Preferably, operating the manual reset assembly will drive the firing safety mechanism back to an initial state when the cartridge assembly and the anvil assembly are in a closed state.

Preferably, when the firing trigger is operated, the firing trigger moves in any one of the following manners: linear motion, curved motion, fixed rotational motion of the central shaft, rotational motion of the central axis along a linear motion, and rotation of the central axis along a curved motion. Motion, segmented multi-center axis rotary motion.

More specifically, the controller 100 includes a controller housing, a firing trigger mechanism, a toothed transmission assembly, a toothed transmission assembly reset mechanism, a firing insurance mechanism, and an automatic reset mechanism, wherein:

The firing trigger mechanism includes a firing trigger 111, a trigger return spring 112, a tooth extraction 113, a tooth extraction pin 114, and a tooth extraction spring 115, wherein the spindle hole 1112 of the firing trigger 111 and the trigger return spring 112 are concentrically mounted on the controller housing. On the rotating shaft 1011, the trigger return spring 112 has a resilient tendency to always keep the firing trigger 111 in the returning initial position, and the pulling teeth 113 are rotatably coupled to the firing trigger 111 by the tooth extraction pin 114, the tooth extraction spring 115 and the tooth extraction pin 114 concentrically and always keeping the firing teeth 1131 of the extraction teeth 113 toward the elastic tendency of the toothed drive assembly;

The toothed drive assembly is movably mounted in a longitudinal rail of the controller housing, the toothed drive assembly including a first set of teeth 1051 and a second set of teeth 1052, wherein the first set of teeth 1051 and the firing teeth 1131 of the extracted teeth 113 Separable engagement, the second set of teeth 1052 is detachably engaged with the automatic reset mechanism; when the firing trigger 111 is operated, the rotational movement of the firing trigger 111 is passed through the firing teeth 1131 of the extraction teeth 113 and the first set of teeth of the toothed drive assembly The engagement of the 1051 is transmitted to the toothed drive assembly to drive the toothed drive assembly to move longitudinally to the distal end;

a toothed drive assembly reset mechanism for returning the toothed drive assembly moving to the distal end to an initial position;

The firing insurance mechanism includes a safety trigger 116, a safety trigger return spring 117, a safety rotating block 118 and insurance Rotating block return spring 119, wherein the safety trigger 116 is rotatably fixed to the firing trigger 111, the safety trigger return spring 117 always keeps the safety trigger 116 resilient to the initial position, and the safety rotating block 118 is rotatably fixed to the controller On the housing, the safety rotating block return spring 119 has a resilient tendency to always keep the safety rotating block 118 back to the initial position, and the third driving boss 1181 of the safety rotating block 118 and the dislocation boss 1204 of the automatic resetting slider 120 are in operation. In the initial state, the second driving boss 1182 of the safety rotating block 118 and the first driving boss 1161 of the safety trigger 116 are in a standby state, and the safety trigger return spring 117 drives the first driving boss 1161 of the safety trigger 116 to be pressed. Abutting the firing trigger 111, the operation of the safety trigger 116 at this time does not drive the safety rotary block 118 to move. When the trigger 111 is operated, the safety trigger 116 is rotated along the rotation axis A1 of the firing trigger 111, and the first transmission boss 1161 of the safety trigger 116 enters the second transmission boss 1182 of the safety rotary block 118. Position, at this time, the safety trigger 116 is operated, and the safety trigger 116 is rotated along the A2 axis, and the safety rotation block 118 is driven along the first transmission boss 1161 of the safety trigger 116 and the second transmission boss 1182 of the safety rotation block 118. The half shaft 1013 on a fixed handle 101 rotates correspondingly, and the rotational movement of the safety rotary block 118 causes the second drive boss 1182 of the safety rotary block 118 to push the dislocation boss 1204 of the automatic reset slider 120 to be raised.

The automatic reset mechanism includes an automatic reset slider 120 and an automatic return spring 121. The automatic reset slider 120 is provided with a reset tooth 1201, two symmetric first slide pins 1202, a second slide pin 1203, and a dislocation boss 1204. The reset tooth 1201 of the automatic reset slider 120 is detachably engaged with the second set of teeth 1052 of the toothed drive assembly, and the first slide pin 1202 and the second slide pin 1203 are movably mounted in the longitudinal rail of the controller housing. The automatic return spring 121 is fixed at one end to the controller housing, and the other end is connected to the automatic reset slider 120. The automatic return spring 121 has a resilient tendency to always keep the automatic reset slider 120 back to the initial position.

Preferably, the toothed transmission assembly is any one of the following devices or a combination of any of the following:

- rack 105;

-gear;

- Ratchet gear.

Preferably, the automatic return spring 121 is any of the following devices:

- tension spring;

-compressed spring;

- a torsion spring;

- scroll spring;

- shaped spring;

- a serpentine spring;

- Disc springs.

Preferably, when the safety trigger 116 is operated, it moves in any of the following ways:

- linear motion;

- curve motion;

- a fixed rotational movement of the central shaft;

- a rotational movement of the central axis along a linear motion;

- a rotational movement of the central axis along the curve;

- Segmented multi-center axis rotary motion.

Preferably, when the firing trigger 111 is operated, it moves in any of the following ways:

- linear motion;

- curve motion;

- a fixed rotational movement of the central shaft;

- a rotational movement of the central axis along a linear motion;

- a rotational movement of the central axis along the curve;

- Segmented multi-center axis rotary motion.

The single-handed surgical instrument includes an actuator 300 and an intermediate connector 200, and further includes the controller 100 described above, wherein the actuator 300, the intermediate connector 200, and the controller 100 Connected in sequence, the toothed drive assembly of the controller 100 is capable of transmitting motion of the operational firing trigger 111 to the actuator 300 through the intermediate connector 200.

Preferably, the actuator comprises an anvil assembly 3001, a cartridge assembly 3002, a drive assembly 3003, the actuation firing trigger 111 will drive the drive assembly 3003 to move, and the movement of the drive assembly 3003 thereby drives the anvil assembly 3001 and the cartridge assembly 3002 from The open state is converted to a closed state;

In the case where the firing safety mechanism is not operated, the reset tooth 1201 of the automatic reset slider 120 is in meshing state with the second set of teeth 1052 of the toothed drive assembly, and the automatic reset mechanism automatically drives the nail when the firing trigger 111 is released. The cartridge assembly 3002 and the anvil assembly 3001 are transitioned from a closed state to an open state;

After operating the firing safety mechanism, the safety trigger 116 drives the reset tooth 1201 of the automatic reset slider 120 and the second set of teeth 1052 of the toothed drive assembly to be separated from the engaged state. When the firing trigger 111 is released, the anvil assembly 3001 The staple cartridge assembly 3002 remains closed.

Preferably, operating the firing trigger 111 drives the anvil assembly 3001 and the cartridge assembly 3002 from an open state When the switch is in the closed state, the firing trigger 111 can only travel part of the stroke. Further, after the firing safety mechanism is operated, the firing trigger 111 can continue to operate in the same firing operation until the entire stroke is traveled to drive the drive. Component 3003 moves further.

Preferably, the controller 100 further includes a manual reset assembly, wherein the operation of the manual reset assembly can drive the cartridge assembly 3002 and the anvil assembly 3001 to open when the cartridge assembly 3002 and the anvil assembly 3001 are in a closed state. .

Preferably, when the cartridge assembly 3002 and the anvil assembly 3001 are in the closed state, pulling the manual reset assembly proximally will drive the cartridge assembly 3002 and the anvil assembly 3001 back into an open state.

Preferably, operating the manual reset assembly will urge the automatic reset mechanism to return to the initial state when the cartridge assembly 3002 and the anvil assembly 3001 are in the closed state.

Preferably, operating the manual reset assembly will urge the firing safety mechanism to return to the initial state when the cartridge assembly 3002 and the anvil assembly 3001 are in the closed state.

Compared with the prior art, the present invention has the advantages of:

1. The surgical instrument has an automatic reset function: when the firing safety mechanism is not opened, when the doctor operates the firing trigger, the actuator of the surgical instrument will clamp the tissue; when the doctor releases the firing trigger, the actuator of the surgical instrument will be automatically reset. And release the clamped tissue. This function of the surgical instrument is convenient for the doctor to adjust the position of the tissue held by the stapler with one hand, and also helps the doctor to improve the uniformity of the thickness of the thick tissue when it is finally clamped by repeatedly clamping the same part of the tissue, thereby improving the anastomosis and Cutting effect.

2. In the present invention, the safety trigger 116 is located directly in front of the distal end of the firing trigger 111 so that the medical practitioner can use both the index finger and simultaneously operate the safety trigger 116 and the firing trigger 111.

3. The invention only needs one index finger operation in the process of performing repeated clamping and pressing, opening the firing trigger, preparing for firing, and firing, and realizes the purpose of one-hand operation, and realizes the one-handed index finger. The purpose of the operation.

DRAWINGS

Other features, objects, and advantages of the present invention will become apparent from the Detailed Description of Description

1 is a schematic block diagram of an improved one-handed surgical instrument in accordance with one embodiment of the present invention;

2 and 3 are schematic views showing an exploded structure of the surgical instrument shown in Fig. 1;

Figure 4 is a schematic view showing the structure of the surgical instrument shown in Figure 1 in an initial state;

Figure 5 is a schematic view showing the structure of the controller of the surgical instrument shown in Figure 1 after operating the firing trigger;

Figure 6 is a cross-sectional structural view of the controller shown in Figure 5 at A-A;

Figure 7 is a rear perspective view showing the state of the controller shown in Figure 5;

8 , FIG. 15( a ), FIG. 15( b ), and FIG. 16 together illustrate a structure in which the controller of the surgical instrument illustrated in FIG. 1 is disengaged from the moment when the safety trigger assembly is disengaged when the safety trigger is operated after the trigger is operated. Figure 16 is an enlarged view of a portion D of Figure 15;

Figure 9 is a rear perspective view showing the state of the controller shown in Figure 8;

10, FIG. 17(a), FIG. 17(b), and FIG. 18 are a schematic view showing the structure of the controller of the surgical instrument shown in FIG. 1 when the automatic reset mechanism fails after the trigger is operated after the trigger trigger is operated; Figure 18 is an enlarged view of a portion G of Figure 17;

Figure 11 is a rear perspective view showing the state of the controller shown in Figure 10;

12 is a schematic structural view of the controller of the surgical instrument shown in FIG. 1 when the safety trigger is operated but the firing trigger is not operated;

Figure 13 is a rear perspective view showing the state of the controller shown in Figure 12;

Figure 14 is a schematic view showing the structure of the controller of the surgical instrument shown in Figure 1 during manual reset after firing.

A1 denotes a central axis of the rotating shaft 1011 on the first fixed handle 101, and the firing trigger 111 can rotate along the axis;

A2 represents the central axis of the pin 1111 on the firing trigger 111 along which the firing safety trigger 116 can be rotated.

detailed description

The invention will now be described in detail in connection with specific embodiments. The following examples are intended to further understand the invention, but are not intended to limit the invention in any way. It should be noted that a number of variations and modifications may be made by those skilled in the art without departing from the inventive concept. These are all within the scope of protection of the present invention.

The invention is applied to a controller for a surgical instrument using a special combination of parts to achieve an automatic reset function of the actuator of the surgical instrument.

1 through 14 illustrate schematic views of an improved one-handed surgical stapling instrument in accordance with one embodiment of the present invention.

Specifically, in the present embodiment, referring to FIG. 1 - FIG. 3, the single-handed surgical instrument includes a controller 100, an intermediate connector 200, and an actuator 300, wherein the controller 100, the intermediate connector 200, The actuators 300 are sequentially connected. The actuator 300 includes a cartridge assembly 3002, an anvil assembly 3001, and a drive assembly 3003.

In the present embodiment, referring to FIGS. 1-6, the controller 100 includes a first fixed handle 101, a second fixed handle 102, a firing trigger 111, a rack 105, an automatic reset mechanism, and a firing insurance mechanism.

The first fixed handle 101 and the second fixed handle 102 are connected by welding or other secure means into an integral controller housing to form the inner cavity of the controller 100. The firing trigger 111 is movably mounted on the rotation axis A1 of the inner cavity of the controller 100. In the present embodiment, the spindle hole 1112 of the firing trigger 111 is concentrically mounted with the trigger return spring 112 on the rotating shaft 1011 of the first fixed handle 101, and the trigger return spring 112 always maintains the firing trigger 111 in a resilient tendency to return to the initial position. The extraction tooth 113 is rotatably coupled to the firing trigger 111 by the extraction pin 114. The extraction spring 115 is concentric with the extraction pin 114 and always maintains the firing tooth 1131 of the extraction tooth 113 toward the elastic tendency of the rack 105.

A rack (or toothed drive assembly) 105 is movably mounted in a longitudinal rail formed by the first fixed handle 101 and the second fixed handle 102. In the present embodiment, the rack 105 includes a first set of teeth 1051 and a second set of teeth 1052, wherein the first set of teeth 1051 is detachably engaged with the firing teeth 1131 of the extracted teeth 113, and the second set of teeth 1052 is automatically reset. The mechanism is detachably engaged. When the firing trigger 111 is operated, the rotational movement of the firing trigger 111 is transmitted to the rack 105 by the engagement of the firing teeth 1131 of the extraction teeth 113 with the first set of teeth 1051 of the rack 105, driving the rack 105 to move distally in the longitudinal direction. The first set of teeth 1051 and the second set of teeth 1052 can be teeth at different locations on one rack.

Typically, the controller 100 also includes a rack reset mechanism for returning the rack 105 after completion of the instrument function to the initial position. In this embodiment, as shown in FIG. 2 , the rack reset mechanism includes a first reset cap 103 , a second reset cap 104 , a tooth release trip piece 106 , a first positioning pin 107 , and a second positioning pin 108 . The reset pin 109 and the rack return spring 110. The tooth releasing trip piece 106 has two pin slots extending at an angle to the longitudinal direction. The first positioning pin 107 and the second positioning pin 108 pass through the two pin slots to move the tooth releasing trip piece 106. Attached to the rack 105, the lower end surface 1061 of the tooth take-off tab 106 will produce a downward movement as the tooth releasing tab 106 moves longitudinally proximally. When the rack 105 is not in the initial position, the operator pulls the first reset cap 103 and the second reset cap 104 to the proximal end, and firstly drives the tooth lift tripping piece 106 to move proximally and proximally through the reset pin 109. The lower end surface 1061 of the cleat 106 moves downward to drive the firing tooth 1131 of the extraction tooth 113 to disengage from the rack 105. When the first reset cap 103 and the second reset cap 104 are continuously pulled, the reset pin 109 continues to retreat until the rack is retracted. 105 rigid contact, then the rack 105 is moved together proximally until the initial position is restored.

In the present embodiment, referring to FIGS. 2 and 4, the automatic reset mechanism includes an automatic reset slider 120 and an automatic return spring 121. The automatic reset slider 120 is provided with a reset tooth 1201, two symmetrical first slide pins 1202, a second slide pin 1203, and a dislocation boss 1204. The reset tooth 1201 of the automatic reset slider 120 and the second set of teeth 1052 of the rack 105 The detachable engagement, the first sliding pin 1202, and the second sliding pin 1203 are movably mounted in a longitudinal rail formed by the first fixed handle 101 and the second fixed handle 102. The one end of the automatic return spring 121 is fixed to the fixing pin 1012 of the first fixed handle 101, and the other end is connected to the automatic reset slider 120, so that the automatic reset slider 120 always maintains the elastic tendency of returning to the initial position.

In the present embodiment, referring to FIGS. 2 and 4, the firing safety mechanism includes a safety trigger 116, a safety trigger return spring 117, a safety rotating block 118, and a safety rotating block return spring 119. The safety trigger 116 is rotatably secured to the firing trigger 111, which always maintains the safety trigger 116 in a resilient tendency to return to the initial position. The safety rotary block 118 is rotatably fixed to the first fixed handle 101, and the safety rotary block return spring 119 always keeps the safety rotary block 118 in a resilient tendency to return to the initial position.

In the present embodiment, referring to FIGS. 1 and 3, the intermediate connector 200 is coupled to the distal end of the controller 100. The intermediate connecting body 200 includes: a first rotating joint 201, a second rotating joint 202, a gun casing 203, a barrel 204, a nail casing 205, a first nail inner tube 206, and a second nail inner tube 207. , transmission rod 208 and other components. The first rotary joint 201 and the second rotary joint 202 are integrally connected by welding or other safety means. The integral proximal end is connected to the distal end of the controller 100, and the distal end is fixedly coupled with the barrel 204. A gun sleeve 203 having a smooth and rustproof function is mounted on the outside of the tube 204, and the axis of the barrel 204 constitutes the longitudinal direction as described in this embodiment. The distal end of the barrel 204 is detachably coupled to the second inner tube 207, and at the same time, in order to avoid the surgical risk of the second inner tube 207 being detached from the distal end of the barrel 204 during surgery, The distal end of the barrel 204 is designed with a detachment prevention mechanism including a load limiting piece 209, a rotation stop block 210 and a loading spring 211. When the second magazine inner tube 207 is loaded at the distal end of the barrel 204, the loading limiting piece 209 prevents the second nail inner tube 207 from being detached from the barrel 204 by the biasing force exerted by the loading spring 211. Unless the load limiter 209 is manually removed from the home position.

After the first nail inner tube 206 and the second nail inner tube 207 are held together, the two nails are connected together by the nail sleeve 205, and the first nail inner tube 206 and the second nail inner tube 207 are combined. The axis of the lumen is coaxial with the longitudinal direction. The transmission rod 208 is disposed in the inner cavity formed by the barrel 204 and the first inner tube 206 and the second inner tube 207, and is reciprocally movable in the longitudinal direction. The proximal end of the drive rod 208 is coupled to the rack 105 and the distal end is coupled to the proximal end of the drive assembly 3003 of the actuator 300 for transmitting longitudinal motion of the rack 105 to the drive assembly 3003.

The actuator 300 can be designed as a plurality of application examples, and the embodiment cites the actuator of the surgical stapler described in the Chinese invention patent application CN201210349356.7. As shown in FIGS. 1 and 3, the actuator 300 is mainly composed of an anvil assembly. 3001, a cartridge assembly 3002 and a drive assembly 3003. The anvil assembly 3001 is mainly formed by a back cover 301, a nail anvil 302 and a nail anvil 303. The lower surface of the anvil assembly 3001 is a staple molding surface. The cartridge assembly 3002 generally includes a staple cartridge 304, a plurality of staples 305, a plurality of pusher blocks 306, a staple cartridge holder 307, and a push pin Slider 308. The upper surface of the staple cartridge 304 is a tissue contacting surface with a guide groove in the middle and is mounted in the cartridge holder 307. The anvil return spring 309 is mounted at the distal end of the intermediate connector 200, always maintaining the anvil assembly 3001 and the cartridge assembly 3002 in an elastic tendency to open. The driving assembly 3003 is disposed in the inner cavity formed by the guiding groove of the staple cartridge 304 and the first inner tube 206 and the second inner tube 207, and is reciprocally movable in the longitudinal direction. The distal end of the drive assembly 3003 further includes an upper beam 3101, a lower beam 3102, and a cutting edge 3103. When the drive assembly 3003 is moved distally, the upper beam 3101 and the lower beam 3102 of the drive assembly 3003 will drive the anvil assembly 3001 and the cartridge assembly 3002 from the open state to the closed state, thereby driving the pusher slider 308, pushing The staple block 306 creates motion that pushes the staple 305 from the staple cartridge 304 toward the staple forming surface of the anvil assembly 3001 and is shaped like a B-shape therein. During the driving of the staple forming process, the cutting edge 3103 of the driving assembly 3003 cuts the already stitched tissue to complete the stitching and cutting function of the instrument.

Referring to FIG. 1 and FIG. 4, when the controller of the surgical instrument according to the embodiment is in an initial state, the second set of teeth 1052 of the rack 105 is in mesh with the reset tooth 1201 of the automatic reset slider 120 of the automatic reset mechanism.

Referring to FIGS. 5-7, when the firing trigger 111 is operated, the firing trigger 111 drives the rack 105 through the pulling teeth 113, and the transmission rod 208 moves longitudinally to the distal end, thereby driving the driving assembly 3003 to move distally; the driving assembly 3003 is directed to Movement of the distal end drives the anvil assembly 3001 and the cartridge assembly 3002 from an open state to a closed state.

During the operation of firing the trigger 111, the second set of teeth 1052 of the rack 105 drives the automatic reset slider 120 to move distally by the engagement with the reset teeth 1201 of the automatic reset slider 120, at which time the automatic return spring 121 is pulled. Long and accumulate elastic energy.

In the event that the firing trigger 116 is not operated, the second set of teeth 1052 of the rack 105 remains in mesh with the reset teeth 1201 of the automatic reset slider 120. When the firing trigger 111 is released, the firing trigger 111 is driven back to the initial position by the trigger return spring 112, and the teeth 113 are disengaged from the first set of teeth 1051 of the rack 105. The rack 105, the transmission rod 208 and the drive assembly 3003 The proximal returning tension is generated only by the frictional resistance and the elastic return spring 121 accumulating the elastic energy in the longitudinal direction. When the return tension of the automatic return spring 121 is greater than the rack 105, the transmission rod 208 and the drive assembly 3003 are only subjected to frictional resistance in the longitudinal direction, the above-mentioned components including the drive assembly 3003 will move proximally until returning to the original position; The 3003 reverting to the proximal end of the motion causes the anvil assembly 3001 and the cartridge assembly 3002 to return to the open state from the closed state.

In the case where the firing trigger 116 is not operated, referring to Figures 5-7, the distal movement of the rack 105 is subjected to the first limit boss 1014 of the first fixed handle 101 and the second fixed by the automatic reset slider 120. The obstruction of the second limiting boss 1024 of the handle 102 can only fire a part of the stroke of the complete firing stroke when the trigger 111 is fired, and the rack 105 can only travel a distance L1. At this time, referring to Fig. 16, the upper beam 3101 of the tool holder 310 is moved distally along the inclined curved surface of the inner rail at the proximal end of the nail anvil 302 until it approaches the inclined curved end point 3021.

At this time, when the firing trigger 116 is operated, the firing safety mechanism will be opened. At the moment of operating the firing trigger 116, referring to FIGS. 5, 8, and 9, the firing trigger 116 is rotated along the pin 1111 on the firing trigger 111. The first drive boss 1161 of the firing trigger 116 drives the safety rotary block 118 to perform a corresponding rotational movement along the half shaft 1013 of the first fixed handle 101. The rotation of the safety rotary block 118 causes the second drive boss of the safety rotary block 118. 1182 pushes the dislocation boss 1204 of the automatic reset slider 120 to drive the distal end of the automatic reset slider 120 to rotate along its symmetrical first sliding pin 1202 and the second sliding pin 1203, so that the reset tooth 1201 of the automatic reset slider 120 is The second set of teeth 1052 of the rack 105 are separated from the engaged state.

At this time, referring to FIG. 10 and FIG. 11, the elastic energy accumulated by the automatic return spring 121 pulls the automatic reset slider 120 back to the original position, and the automatic reset mechanism can no longer drive the drive assembly 3003 to return to the original position, thereby failing to drive the anvil assembly. The 3001 and cartridge assembly 3002 are returned from the closed state to the open state. Since the rack 105 is no longer limited by the automatic reset slider 120, the firing trigger 111 can operate a complete firing stroke to drive the rack 105 to travel L2. At this time, referring to Fig. 18, the upper beam 3101 of the tool holder 310 travels along the inner rail of the nail anvil 302 to over the inclined curved end point 3021.

Referring to Figures 12 and 13, in the case where the firing trigger 111 is not operated, when the firing trigger 116 is operated, since the pin 1111 of the firing trigger 116 is not in the set position, the first driving boss of the safety trigger 116 is fired. 1161 can not drive the safety rotating block 118 to perform corresponding rotational movement, nor can it drive the reset tooth 1201 of the automatic reset slider 120 and the second set of teeth 1052 of the rack 105 to be separated from the meshing state, that is, the firing safety mechanism cannot be opened, and the automatic reset mechanism is enabled. Invalid.

Referring to FIG. 10, after the firing trigger 111 is operated and the firing trigger 116 is operated to open the firing safety mechanism, the firing trigger 111 and the firing trigger 116 are released, and then the firing trigger 111 is repeatedly operated to drive the assembly 310 to continue moving distally. The staples 305, which are then mounted in the staple cartridge 304, are driven into the staple forming surface of the anvil assembly 3001. The cutting edge 3103 of the drive assembly 3003 cuts the already stapled tissue to complete the suturing and cutting function of the instrument.

After opening the firing safety mechanism, whether or not the instrument has been operated to complete the suturing and cutting function, or if the instrument is not further operated, when the device is required to return to the original state, referring to FIG. 14, the first reset cap 103 and the second reset are manually pulled proximally. The cap 104 drives the firing teeth 1131 of the extraction teeth 113 out of engagement with the rack 105 to urge the rack 105 to move proximally until the initial position is restored. During the movement of the rack 105 to return to the initial position, the reset tooth 1201 of the automatic reset slider 120 resumes meshing with the second set of teeth 1052 of the rack 105, causing the automatic reset mechanism to return to the initial state.

The specific embodiments of the present invention have been described above. It should be understood that the present invention is not limited to the above Various modifications and changes may be made by those skilled in the art without departing from the scope of the invention.

Claims (18)

1. A single-handed surgical instrument includes an actuator, an intermediate connector, and a controller, wherein the actuator, the intermediate connector, and the controller are sequentially connected, and the controller includes a firing trigger mechanism, a firing insurance mechanism, and an automatic reset The mechanism and the rack are characterized by:

   The automatic reset mechanism is detachably engaged with the rack (105) of the controller, and applies a force to the rack to drive the rack back to the initial position when engaged;

   The safety trigger (116) of the firing safety mechanism is rotatably mounted on the firing trigger (111) of the firing trigger mechanism;

   When the firing trigger is in the operating position, the safety trigger can be driven to disengage the automatic reset mechanism from the rack by being rotated.
2. The one-handed surgical instrument of claim 1 wherein the safety trigger (116) is located directly forward of the distal end of the firing trigger (111).
3. The one-handed surgical instrument of claim 1 wherein the drive train between the safety trigger and the automatic reset mechanism is disconnected when the firing trigger is in the inoperative position.
4. The one-handed surgical instrument of claim 1 wherein said automatic reset mechanism comprises an automatic reset slider (120) and an elastic energy storage assembly (121), and an automatic reset slider (120) is provided The reset tooth (1201) is movably mounted in the longitudinal rail of the controller housing, and the reset tooth (1201) of the automatic reset slider (120) is detachably engaged with the rack; the elastic energy storage component is fixed at one end of the controller The other end of the housing is coupled to the automatic reset slider (120) to provide an elastic force that urges the rack back to its original position.
5. The one-handed surgical instrument of claim 4 wherein the rack is detachably engaged with the reset teeth (1201) of the automatic reset slider (120) by a slot.
6. The one-handed surgical instrument of claim 1 wherein the longitudinal travel of the automatic reset mechanism is limited by a restriction of a limit boss (1014, 1024) within the controller, the barrier limiting such that the rack The maximum longitudinal stroke when engaged with the automatic reset mechanism is L1;

   The safety trigger drives the automatic reset mechanism to disengage from the rack while driving the automatic reset mechanism to avoid the blocking of the limit boss, so that the maximum longitudinal stroke of the rack when disengaged from the automatic reset mechanism is L2;

   Wherein, the length of L2 is greater than the length of L1, and the distal position of L2 is located at the distal end of the distal position of L1.
7. The one-handed surgical instrument of any of claims 1-6, wherein the firing safety mechanism comprises a safety rotating block (118), wherein the safety rotating block (118) is rotatably mounted In control On the housing

   When the firing trigger is in the operating position, the safety trigger (116) is rotatable along the firing trigger (111) through the first drive boss (1161) of the safety trigger (116) and the second drive projection of the safety rotary block (118) The cooperation of the table (1182) drives the corresponding rotation movement of the safety rotating block (118), and the rotational movement of the safety rotating block (118) drives the third driving boss (1181) of the safety rotating block (118) to push the automatic reset sliding of the automatic reset mechanism. The block (120) is raised such that the automatic reset slider (120) is disengaged from the rack.
8. The one-handed surgical instrument of claim 7, wherein the automatic reset slider (120) is raised such that the automatic reset mechanism avoids the blocking limit of the limit boss (1014, 1024).
9. The one-handed surgical instrument of claim 7, wherein the second drive boss (1182) of the safety swivel block (118) is not in the safety trigger (116) when the firing trigger is in the inoperative position Within the accessible range of the first drive boss (1161), the drive train between the first drive boss (1161) and the second drive boss (1182) is disconnected.
10. The one-handed surgical instrument of claim 7 wherein the safety trigger has a safety trigger return spring (117) that maintains the safety trigger (116) in an initial position. Elastic tendency; the safety rotary block has a safety rotary block return spring (119), and the safety rotary block return spring (119) has a resilient tendency to always keep the safety rotary block (118) back to its original position.
11. A method of operating a one-handed surgical instrument according to any of claims 1-10, wherein:

    Operating the firing trigger mechanism will drive the rack to move longitudinally to the distal end, the movement of the rack thereby driving the cartridge assembly and the anvil assembly of the actuator from an open state to a closed state;

    In the case where the fire-fighting mechanism is not operated, when the firing trigger mechanism is released, the automatic reset mechanism, the drive assembly of the actuator, the cartridge assembly and/or the anvil assembly of the actuator sequentially constitute the driving force transmission chain The automatic reset mechanism will drive the drive assembly to move longitudinally proximally, thereby converting the cartridge assembly and the anvil assembly of the actuator from a closed state to an open state;

    After operating the firing safety mechanism, the automatic reset mechanism disengages from the drive force transmission chain, and when the firing trigger mechanism is released, the cartridge assembly and the anvil assembly of the actuator remain closed.
12. The method of operating a one-handed surgical instrument according to claim 11 wherein, in the event that the firing safety mechanism is not operated, operating the firing trigger mechanism drives the cartridge assembly and the anvil assembly of the actuator from When the open state is switched to the closed state, the firing trigger can only travel a partial stroke, so that the driving assembly only moves the partial stroke to the distal end; after the firing insurance mechanism is operated, the firing trigger can be in the same firing operation It is sufficient to continue the operation until the entire stroke is traveled, driving the drive assembly to move further distally.
13. The method of operating a one-handed surgical instrument according to claim 11, wherein when the firing trigger mechanism is actuated to drive the cartridge assembly and the anvil assembly of the actuator from an open state to a closed state, The elastic energy storage component accumulates energy; when the firing safety mechanism is not operated, after the firing trigger is released, the energy accumulated by the elastic energy storage component drives the actuator assembly of the actuator to move proximally in the longitudinal direction.
14. The method of operating a one-handed surgical instrument according to claim 11 wherein the operation of the firing safety mechanism drives the automatic reset slider when the cartridge assembly and the anvil assembly transition from the open state to the closed state The 120 is separated from the rack by the engaged state, and the elastic energy storage assembly releases the accumulated energy.
15. The method of operating a single-handed surgical instrument according to claim 11, wherein in the case where the cartridge assembly and the anvil assembly of the actuator are in an open state, when the firing insurance mechanism is operated, the storage is driven The component assembly is in meshing engagement with the toothed drive assembly.
16. The method of operating a one-handed surgical instrument according to claim 11 wherein the manual reset assembly of the operating controller drives the cartridge assembly and the anvil when the cartridge assembly and the anvil assembly are in a closed state The component returns to an open state.
17. The method of operating a one-handed surgical instrument according to claim 11 wherein operating the manual reset assembly will urge the automatic reset mechanism to return to an initial state when the cartridge assembly and the anvil assembly are in a closed state.
18. The method of operating a one-handed surgical instrument according to claim 11 wherein operating the manual reset assembly will urge the firing safety mechanism to return to an initial state when the cartridge assembly and the anvil assembly are in a closed state.

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