WO2017114386A1

WO2017114386A1 - Tissue closing device and medical instrument comprising tissue closing device

Info

Publication number: WO2017114386A1
Application number: PCT/CN2016/112368
Authority: WO
Inventors: 陈望东; 叶艳平; 单腾; 郭毅; 舒拓; 曹元阳
Original assignee: 苏州天臣国际医疗科技有限公司
Priority date: 2015-12-31
Filing date: 2016-12-27
Publication date: 2017-07-06
Also published as: CN106923876B; CN106923876A

Abstract

A tissue closing device (40) and a medical instrument. The assembly comprises: a first clamping portion (405a) and a second clamping portion (405b); at least one pair of bag assemblies (50), respectively cooperating with the first clamping portion (405a) and the second clamping portion (405b); and a connection sheet (60), located on the far ends of the first clamping portion (405a) and/or the second clamping portion (405b) and cooperating with the bag assemblies (50). Clamping surfaces of the first clamping portion (405a) and the second clamping portion (405b) are arranged in a teeth form. Each bag assembly (50) comprises a pinhead (501), a bag thread (503) whose one end is connected to the pinhead (501), and a push rod detachably connected to the pinhead (501). The connection sheet (60) can be connected to the pinhead (501). Each of the first clamping portion (405a) and the second clamping portion (405b) is provided with a passage (4051) allowing the corresponding bag assemblies (50) to move from the near end to the far end of the tissue closing device (40). In the tissue closing device (40), gathered bags are formed in the center, and accordingly follow-up risks of fistula occurring after the closing of a round tube anastomat and surgical costs are reduced.

Description

Tissue closure device and medical device including the tissue closure device

The present application claims the priority of the Chinese patent application entitled "Spin cartridge assembly and medical stapler using the staple cartridge assembly" on December 31, 2015, application number 201511029121.X, the entire contents of which are incorporated herein by reference. This is incorporated herein by reference.

Technical field

The present invention relates to the field of medical device technology, and in particular to a tissue closure device and a medical device including the tissue closure device.

Background technique

In the existing anastomosis of the digestive tract, the linear tissue or the arc-type stapler is generally used to perform the multi-angle separation and anastomosis of the tubular tissue, and then the circular tube-type stapler is used to perform docking and anastomosis of the dissected tissue.

However, when a linear or curved stapler is used to break the anastomosis of the tubular tissue, since the anastomosis is linear, especially when the position of the lower rectum is made, it is limited by the operating space of the pelvic floor. The limitation of the angle of the linear instrument swinging phenomenon will occur, so that there will be a "cat ear" when the round tube type stapler is used for anastomosis, which not only has the risk of paralysis, but also has a high surgical cost.

Summary of the invention

It is an object of the present invention to provide a tissue closure device and a medical device comprising the tissue closure device.

To achieve one of the above objects, an embodiment of the present invention provides a tissue closure device comprising: a first holder and a second holder that are relatively openable and closable, the first holder and the second holder a first clamping portion and a second clamping portion are respectively disposed on opposite sides of the seat, and the clamping faces of the first clamping portion and the second clamping portion are disposed in a tooth shape when the first clamping seat When the second clamping seat is closed, a gap for clamping the tubular tissue is disposed between the first clamping portion and the second clamping portion, and the gap has a wave-shaped cross section;

At least one pair of purse assemblies that are respectively configured to cooperate with the first clamping portion and the second clamping portion and that are drivable from the distal end of the tissue closure device in a proximal direction, each of the purse assemblies comprising: a needle, a purse string connected to the needle at one end, and a push rod removably connecting the needle;

a connecting piece disposed at a distal end of the first clamping portion and/or the second clamping portion in cooperation with the purse assembly, the connecting piece is connected to the needle when the needle is in a firing position ;

Wherein the first clamping portion and the second clamping portion are respectively provided with passages allowing the purse assembly to move from the proximal end to the distal end of the tissue closure device.

Compared with the prior art, the beneficial effects of the invention are: forming a centrally gathered bundled purse through the tissue closure device, Reduce the risk of “cat ears” and sputum after the anastomosis of the subsequent round tube stapler, and at the same time, the operation is simple, the use is convenient, and the operation cost is reduced.

DRAWINGS

1 is a schematic view of a medical device according to an embodiment of the present invention;

2 is a perspective view of the instrument body of the medical device according to an embodiment of the present invention;

3 is a cross-sectional view showing the first holder and the second holder in an open state according to an embodiment of the present invention;

Figure 4 is a cross-sectional view showing the tissue closure device in an initial state in an embodiment of the present invention;

FIG. 5 is a schematic structural view of a purse assembly according to an embodiment of the present invention; FIG.

Figure 6 is a cross-sectional view taken along line A-A of Figure 3;

7 is a perspective view of a first holder in an embodiment of the present invention;

Figure 8 is a cross-sectional view of the purse assembly after being fired in accordance with an embodiment of the present invention;

Figure 9 is a cross-sectional view showing the tissue closure device in a fired state in an embodiment of the present invention;

Figure 10 is a cross-sectional view showing the tissue closure device in a state in which the firing is completed in an embodiment of the present invention.

detailed description

The invention will be described in detail below in conjunction with the specific embodiments shown in the drawings. However, the embodiments are not intended to limit the invention, and the structural, method, or functional changes made by those skilled in the art in accordance with the embodiments are included in the scope of the present invention.

To clearly express the position and orientation described within the present invention, with the instrument operator as a reference, one end near the operator is the proximal end and the end remote from the operator is the distal end.

As shown in FIG. 1 and FIG. 2, the present invention discloses an embodiment of a medical device that can be used in an anastomosis operation of a digestive tract, which includes an instrument body 10 and a firing device connected to the instrument body 10. 20 (e.g., firing handles 201, 203), retraction device 30, and tissue closure device 40 removably coupled to instrument body 10. Generally, the tissue closure device 40 is disposed at a distal end of the instrument body 10.

The tissue closure device 40 includes a connection portion 401, a first clamp seat 403a and a second clamp seat 403b that are pivotally connected and relatively openable and closable. The connecting portion 401 is configured to be connected to the instrument body 10, and the structure to be controlled provided in the connecting portion 401 is associated with the firing device 20, the retracting device 30, and the like of the instrument body.

The device body 10 can be substantially similar to the instrument body structure of the existing linear or curved stapler, or can be separately designed. It can be understood that the structure of the instrument body 10 can be combined with the tissue closure device 40. ,example For example, the tissue closure device 40 can be driven to suture the tissue, or stitch and cut, etc., and will not be described herein. The tissue closure device 40 will be described in detail below.

As shown in FIG. 3 and FIG. 4, the first clamping portion 405a and the second clamping portion 403b are respectively provided with a first clamping portion 405a and a second clamping portion 405b on opposite sides of the first clamping seat 403a.

The first clamping portion 405a and the first clamping seat 403a may be integrally formed or assembled. The second clamping portion 405b and the second clamping seat 403b may be integrally formed or assembled. connection. In the present embodiment, the first clamping portion 405a may be regarded as a part of the first holder 403a, and the second clamping portion 405b may be regarded as a part of the second holder 403b.

The clamping faces of the first clamping portion 405a and the second clamping portion 405b are disposed in a tooth shape. As shown in FIG. 4, when the first clamping seat 403a and the second clamping seat 403b are closed, the first clamping portion 405a and the second clamping portion 405b are provided between the first clamping portion 405a and the second clamping portion 405b for clamping the tubular tissue. In the gap of 100, the cross section of the gap is wave-shaped, and accordingly, the tubular structure 100 held by the first clamping portion 405a and the second clamping portion 405b is also positioned in a wave shape.

It can be understood that when the tubular structure is disposed between the first holder 403a and the second holder 403b, a portion for clamping the tubular tissue 100 is referred to as the first clamping portion 405a and the second clip. a clamping surface of the holding portion 405b, wherein the clamping surface may be the entire surface of the first clamping portion 405a and the second clamping portion 405b, or the first clamping portion 405a and the second portion A portion of the opposing surface of the clamping portion 405b.

In this embodiment, the tissue closure device further includes: respectively engaging the first clamping portion 405a and the second clamping portion 405b and drivingly from the distal end of the tissue closure device to the proximal direction Moving at least one pair of purse packs 50 (ie, one of the pack assemblies 50 of each pair of purse packs is disposed in cooperation with the first grip portion 405a, the other purse pack assembly 50 is disposed in cooperation with the second grip portion 405b), The pouch assembly 50 is mated with a connecting piece 60 disposed at the distal end of the first clamping portion 405a and/or the second clamping portion 405b, and the connecting piece can be used to support the closed first clamping seat 403a and the second clamping member At the same time, the seat 403b can prevent the tubular tissue sandwiched between the first clamping portion 405a and the second clamping portion 405b from overflowing.

As shown in FIG. 5, in the present embodiment, each of the purse packs 50 includes a needle 501, a purse string 503 whose one end is connected to the needle 501, and a push rod that detachably connects the needle 501.

The needle 501 includes an initial position and a firing position, the needle 501 being in an initial position when the tissue closure device is in an initial position, the proximal end of the clamping surface being located; when the tissue closure device is in a firing state Next, the needle 501 is in a firing position, and the needle 501 is located at the distal end of the clamping surface and is connected to the connecting piece 60.

The first clamping portion 405a and the second clamping portion 405b are respectively provided with a channel 4051 allowing the purse assembly to move from the proximal end to the distal end of the tissue closing device, that is, the first clamping a portion 4051 for allowing the needle 501 to move from its initial position to the firing position, respectively, on the portion 405a and the second clamping portion 405b, of course, if necessary, The channel can also allow the purse assembly to move from the distal end of the tissue closure device in a proximal direction. The number of the channels 4051 is the same as the number of the purse packs 50.

Further, in order to facilitate the connection of the needle 501 and the accommodation of the purse string 503, the push rod is provided as a needle sleeve 505 which is open at both ends and is hollow. Of course, the push rod can also be solid or have a circular arc groove as long as the push rod can support the needle 501 to move from the proximal end to the distal end of the tissue closure device.

One end of the purse string 503 of each purse pack 50 is disposed in the corresponding needle sleeve 505 and connected to the corresponding needle, and the other end of the purse string of each purse pack is disposed outside the corresponding needle sleeve 505.

It can be understood that the corresponding needle sleeve and needle 501 refer to the needle sleeve and the needle 501 in the same purse assembly 50.

In this embodiment, the other end of the purse string 503 opposite to the end of the corresponding needle 501 may be a free end, disposed in the connecting portion 401 or the instrument body 10; it may also be connected to the needle of another purse assembly. 501 is connected to facilitate the tightening of the purse, the following will be specifically illustrated by two examples:

In the first example, the tissue closure device is provided with a pair of purse assemblies 50, which are a first purse assembly and a second purse assembly, respectively, and the purse lines of the first and second purse assemblies are continuous The first end of the cable is connected to the needle of the first purse assembly, and the second end of the cable is connected to the needle of the second purse assembly.

In the second example, the tissue closure device is provided with two pairs of purse assemblies 50, which are a first purse assembly, a second purse assembly, a third purse assembly, a fourth purse assembly, the first purse assembly and the The third purse assembly is disposed in cooperation with the first clamping portion 405a, and the second purge assembly and the fourth purse assembly are disposed in cooperation with the second clamping portion 405b;

The first purse assembly and the second purse assembly are provided with a first cable tie, and the first end of the first cable is connected to the needle of the first purse assembly, the first cable The second end is connected to the needle of the second purse assembly;

The charge line of the third purse assembly and the fourth purse assembly is disposed as a continuous second tie, the first end of the second tie is connected to the needle of the third package, the second The second end of the cable is coupled to the needle of the fourth purse assembly. It can be understood that the tissue closure device can also be provided with more than two pairs of purse packs 50 in the same manner as described above.

Further, the tissue closure device further includes a positioning member 507, each of the positioning members 507 corresponding to at least one pair of purse packs 50. The positioning member 507 is used to connect the needle sleeve 505 of the purse assembly 50 to set the two needle sleeves 505 of at least one pair of purse assemblies to be relatively stationary.

In the present embodiment, the positioning member is provided with at least two through holes, each of which is disposed outside a needle sleeve 505, for example, sleeved at a proximal end of the needle sleeve 505.

As shown in FIG. 6, the connecting piece 60 may be disposed on the first clamping seat 403a or on the second clamping seat 403b. Of course, the connecting piece 60 may also include two portions disposed on the first clamping seat 403a and the second clamping seat 403b. When the first clamping seat 403a and the second clamping seat 403b are closed, The two parts constitute the connecting piece 60 in a manner similar to a pin.

The web 60 is provided with a receiving portion 601 that receives the needle 501, the number and position of which are matched to the number and position of the needle 501. The receiving portion can be configured as a through hole having elasticity, and the diameter of the through hole can be large under the action of an external force, and the aperture of the through hole returns to normal after the external force is lost.

When the needle 501 is coupled to the connecting piece 60, the receiving portion 601 limits the needle 501 in the axial direction of the purse assembly. By the restriction of the connecting piece 60, it is convenient to subsequently separate the needle 501 and the needle sleeve 505 when the tissue closing device is switched from the firing state to the firing completion state.

Another function of the tab 60 is to provide a certain strength of support to the distal end of the closure of the first holder 403a and the second holder 403b. Thus, the angle at which the jaws of the first holder 403a and the second holder 403b are closed can be kept fixed. It can be understood that the closing force and the firing force of the instrument can be reduced by setting the height of the connecting piece 60 to form an anti-clamp having a distal gap smaller than the proximal gap.

In the present embodiment, since the first clamping portion 405a and the second clamping portion 405b have similar structures (only the teeth are in a staggered form), the following is merely an example of the first clamping portion 405a. The configuration of the first clamping portion 405a and the second clamping portion 405b will be described.

As shown in FIG. 7, the first clamping portion 405a and the second clamping portion 405b each include a body 4053, and a plurality of protrusions 4057 spaced apart in the longitudinal direction of the body 4053, each of which is opened on the protrusion 4057. There are at least one longitudinally extending slit 4059, and at least a portion of the plurality of slits on the same plane constitute the channel 4051. Here, the longitudinal direction refers to the extending direction of the first and

second clamping portions

405a and 405b at the ends.

As shown in FIG. 7 and FIG. 8 , further, each slit 4059 extends vertically to the bottom of the corresponding protrusion 4057. Thus, the toothed clamping surface formed by the protrusion can make the formed purse more reliable. .

Further, the tissue closure device of the present embodiment can be used alone to charge the tubular tissue, and can also be used to cut the tubular tissue while the purse is being wound or after the purse is wound.

As shown in FIG. 7 and FIG. 9, the tissue closing device in the present embodiment may further include a cutting blade 70, which may be provided as an I-shaped knife to close and open the first clamping seat 403a and the first The second clamping seat 403b has the same principle as the existing linear or curved stapler, and will not be described herein.

Further, the first clamping seat 403a and the second clamping seat 403b are respectively provided with a knife-groove 701 that cooperates with the cutting blade 70, and the cutting groove 701 is composed of the first clamping seat 403a and the The proximal end of the second holder 403b extends distally.

Further, if the tissue closing device includes at least two pairs of purse packs 30, at least two of the channels 4051 are respectively disposed on the first clamping portion 405a and the second clamping portion 405b, and each The channels 4051 on the holder are symmetrically disposed on both sides of the corresponding movement groove 701. In the present embodiment, the channels of the same pair of purse packs are disposed on the same side of the pocket 701.

For example, in the second example, the channels corresponding to the first and third purse assemblies are respectively disposed on the two sides of the first holder 403a; the second and fourth purse assemblies The channels are respectively disposed on two sides of the knife groove 701 on the second clamping seat 403b. In this way, each of the purses on both sides of the cutter is formed by two sets of purse packs, so that the purse has better strength and prevents the purse from spreading and the tissue slipping under the action of external force.

In the course of using the medical device according to an embodiment of the present invention:

As shown in FIG. 3, the first clamping seat 403a and the second clamping seat 403b are in an open state, and a tubular structure is placed between the first clamping portion 405a and the second clamping portion 405b;

As shown in FIG. 4, the first holder 403a and the second holder 403b are closed by the firing device 20 (for example, by firing the handle 201) such that the first holder 403a and the second holder 403b are in a closed state. Holding the tubular tissue 100 while the first holder 403a and the second holder 403b are relatively fixed by the connecting piece, and preventing the overflow of the tubular tissue, at which time the tissue closing device is in an initial state;

As shown in Figure 8, the purse assembly 50 is fired by the firing device 20 (e.g., by firing the handle 201) such that the needle 501 of the purse assembly 50 passes through the undulating tubular tissue 100 and is attached thereto. The sheets 60 are connected to complete the purse stringing, and form a centrally gathered bundled purse on the tubular tissue;

As shown in Figure 9, the cutting blade 70 is fired by the firing device 20 (e.g., by firing the handle 203) to cut the tubular tissue 100 that has been loaded with the purse, at which time the tissue closure device is in a fired state;

As shown in Fig. 10, by the action of the retracting device 30, the cutting blade 70 and the needle sleeve 505 are simultaneously retracted to the position in the initial state of the tissue closing device (the cutting blade 70 is retracted through the knife groove 701, the needle sleeve 505 The first holder 403a and the second holder 403b are opened by the cutting blade 70, and the tissue closing device is in a firing completion state, and the tissue therein can be taken out.

It can be understood that in the present embodiment, the cutting blade 70 may not be assembled, and only the purse stringing may be completed; of course, the purse pack assembly 50 and the cutting blade 70 may also be simultaneously fired to achieve edge-cutting.

Through the above technical solution, the invention reduces the risk of “cat ears” and sputum after the anastomosis of the subsequent round tube type stapler, and in addition, when the tissue is closed, only one operation is needed, and the use is convenient, and the operation cost is reduced.

In addition, in such a purse-like manner, in the gap formed by the undulating clip, the tissue can be evenly tiled, which also allows the needle to penetrate the tissue uniformly; so that the purse string is completely punctured to the mucosal layer of the tubular tissue. The formed purse is more Reliable, so that when the round tube type instrument is used for subsequent anastomosis, the tissue is not easy to slide off in the external force. Moreover, since the volume of the purse string is relatively small, the pouch thus formed does not artificially increase the volume of the purse like the purse formed by other materials such as the strap, so that the purse is more convenient for subsequent accommodation into the tubular device. At the same time, since the clamping space formed by the cooperation of the first clamping portion and the second clamping portion is wavy, the length of the tissue closure assembly is effectively reduced, so that it can better enter the deeper position of the bottom of the human body.

It should be understood that, although the description is described in terms of embodiments, the embodiments are not intended to be construed as a single. The technical solutions in the embodiments may also be combined as appropriate to form other embodiments that can be understood by those skilled in the art.

The series of detailed descriptions set forth above are merely illustrative of the possible embodiments of the present invention, and are not intended to limit the scope of the present invention. Changes are intended to be included within the scope of the invention.

Claims

A tissue closure device, characterized in that the tissue closure device comprises:

a first clamping seat and a second clamping seat that are relatively openable and closable, wherein the opposite sides of the first clamping seat and the second clamping seat are respectively provided with a first clamping portion and a second clamping portion, the first a clamping surface of the clamping portion and the second clamping portion are disposed in a tooth shape, and when the first clamping seat and the second clamping seat are closed, the first clamping portion and the second portion a gap for clamping the tubular tissue is provided between the clamping portions, the gap has a wave-shaped cross section;

At least one pair of purse assemblies that are respectively configured to cooperate with the first clamping portion and the second clamping portion and that are drivable from the distal end of the tissue closure device in a proximal direction, each of the purse assemblies comprising: a needle, a purse string connected to the needle at one end, and a push rod removably connecting the needle;

a connecting piece disposed at a distal end of the first clamping portion and/or the second clamping portion in cooperation with the purse assembly, the connecting piece is connected to the needle when the needle is in a firing position ;

Wherein the first clamping portion and the second clamping portion are respectively provided with passages allowing the purse assembly to move from the proximal end to the distal end of the tissue closure device.
The tissue closure device according to claim 1, wherein said connecting piece is provided with a receiving portion for receiving said needle, said receiving portion being at said purse assembly when said needle is coupled to said connecting piece The needle is axially constrained.
The tissue closure device according to claim 2, wherein the push rod is provided as a needle sleeve that is open at both ends and is hollow, and one end of the purse string of each purse assembly is disposed in the corresponding needle sleeve and Corresponding needle connections are made, and the other end of the purse string of each purse assembly is disposed outside the corresponding needle sleeve.
The tissue closure device according to claim 1, wherein the tissue closure device further comprises a cutting blade, and the first clamping seat and the second clamping seat are respectively provided with a knife groove matching the cutting blade The knife pocket extends distally from the proximal ends of the first and second clamping seats.
The tissue closure device according to claim 4, wherein the tissue closure device comprises at least two pairs of purse packs, and the first holder and the second holder are respectively provided with at least two of the channels. And the channels on each of the holders are symmetrically arranged on both sides of the corresponding movement groove.
The tissue closure device according to claim 1, wherein the first clamping portion and the second clamping portion each comprise a body, and a plurality of protrusions spaced apart in a longitudinal direction of the body, each convex The opening is provided with at least one longitudinally extending slit, and at least a plurality of slits on the same plane constitute the passage.
The tissue closure device of claim 6 wherein each slit extends vertically to a corresponding projection bottom of.
The tissue closure device of claim 1 wherein said tissue closure device is provided with a first purse pack assembly and a second purse pack assembly, the purse lines of said first purse pack assembly and said second purse pack assembly being continuous The wire is connected, the first end of the wire is connected to the needle of the first purse assembly, and the second end of the wire is connected to the needle of the second purse assembly.
The tissue closure device of claim 1 wherein said tissue closure device comprises a first purse assembly, a second purse assembly, a third purse assembly, a fourth purse assembly, said first purse assembly and said The third purse assembly is disposed in cooperation with the first clamping portion, and the second purse assembly and the fourth purse assembly are disposed in cooperation with the second clamping portion;

The first purse assembly and the second purse assembly are provided with a first cable tie, and the first end of the first cable is connected to the needle of the first purse assembly, the first cable The second end is connected to the needle of the second purse assembly;

The charge line of the third purse assembly and the fourth purse assembly is disposed as a continuous second tie, the first end of the second tie is connected to the needle of the third package, the second The second end of the cable is coupled to the needle of the fourth purse assembly.
A medical device comprising an instrument body, a firing device coupled to the device body, wherein the medical device further comprises a tissue closure assembly according to any one of claims 1 to 9, the tissue closure assembly Connected to the instrument body.
The medical device according to claim 10, wherein said medical device further comprises a retracting device that can drive said pusher to disengage from said needle when said needle reaches a firing position .