WO2017133205A1 - 电动吻合器 - Google Patents

电动吻合器 Download PDF

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Publication number
WO2017133205A1
WO2017133205A1 PCT/CN2016/092395 CN2016092395W WO2017133205A1 WO 2017133205 A1 WO2017133205 A1 WO 2017133205A1 CN 2016092395 W CN2016092395 W CN 2016092395W WO 2017133205 A1 WO2017133205 A1 WO 2017133205A1
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Prior art keywords
closing
occlusion
height
control unit
firing
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PCT/CN2016/092395
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English (en)
French (fr)
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WO2017133205A9 (zh
Inventor
张翚
杜运峰
刘殿臣
黄爱玉
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苏州英途康医疗科技有限公司
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Priority to ES16889020T priority Critical patent/ES2964742T3/es
Priority to US15/567,164 priority patent/US10595865B2/en
Priority to EP16889020.0A priority patent/EP3412224B1/en
Publication of WO2017133205A1 publication Critical patent/WO2017133205A1/zh
Publication of WO2017133205A9 publication Critical patent/WO2017133205A9/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00734—Aspects not otherwise provided for battery operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter

Definitions

  • the present invention relates to the field of medical device technology, and in particular to an electric stapler.
  • the medical stapler is a medical device that is often used in the surgical operation of the gastrointestinal tract. In the general surgery, the stapler is often used to complete the cutting and suturing of the tissue. The stapler performs a "close, anastomosis, and cutting" operation on the physiological tissue as a manual operation or an electric operation.
  • the manual operation realizes the closing action between the nail anvil head and the staple cartridge and the firing action of the anastomosis tissue in a purely mechanical manner.
  • the firing process requires a large firing force to complete the cutting and closing of the anastomosis mouth, and the requirements for the user are extremely high.
  • the lack of power will affect the closure effect of the tissue, resulting in incomplete cutting and closing, which ultimately leads to surgical failure and high risk. As long as the electric stapler has sufficient power, there is no risk of insufficient force.
  • the approximate appearance of the mechanical structure enlargement shows that there is a large error in the height of the indication window display and the actual tissue closure height due to the manufacturing error of the mechanical parts. Therefore, only by observing the closed height window to determine the thickness of the tissue press, the postoperative effect of different patients is more discrete, which not only affects the efficiency of the operation, but also the phenomenon of inconsistent nail formation, secondary nailing, etc., resulting in tissue leakage, tissue Postoperative symptoms such as necrosis.

Abstract

一种电动吻合器，包括：手柄（110），包括手柄本体（112）、驱动电机（113）和控制驱动电机（113）工作的控制单元（114）；工作头（120），包括钉砧头（121）、钉仓（122）、闭合机构、击发机构、安装闭合机构和击发机构的壳体（125），还包括闭合限位开关（128、138、144）、用以向控制单元（114）发送闭合高度控制档位信息的闭合高度调整拨档开关（127、133、143）；其中，闭合时，控制单元（114）控制闭合机构运动直至闭合限位开关（128、138、144）被触发使钉砧头（121）、钉仓（122）的闭合距离至预设闭合高度，控制单元（114）在接收到闭合限位开关（128、138、144）发送的信息后控制闭合机构的运动，使钉砧头（121）和钉仓（122）之间的闭合距离调整为与闭合高度调整拨档开关（127、133、143）当前档位所对应的预设闭合距离一致。由于预先闭合一定距离，传动机构中的间隙都已消除，能实现精确设置和实现期望的闭合高度。

Description

电动吻合器 技术领域
本发明涉及医疗器械技术领域，特别是涉及一种电动吻合器。
背景技术
医用吻合器是对消化道生理组织施行外科手术时经常使用的一种医疗器械，在普外科手术治疗中，吻合器常被用于完成组织的切割、缝合。吻合器在对生理组织实施“闭合、吻合、切割”的操作过程为手动操作或电动操作。
手动操作是以纯机械方式实现钉砧头和钉仓之间的闭合动作和对吻合组织的击发动作，击发过程需要巨大的击发力才能完成吻合口的切割闭合，对使用者的要求极高，一旦技巧和力度掌握的不佳很容易造成器械击发不动或只能击发一半，而击发力不足会影响组织闭合效果，导致切割闭合不完全，最终导致手术失败，风险极高。而电动吻合器只要电量足够，则不存在发力不够的风险。
医生需要在手术时针对不同病人的组织特征选择合理的组织压榨程度(绿区范围内从1.5-2.5mm)，而现有的纯机械式吻合器的绿区范围指示窗显示的闭合高度是经过机械结构放大的近似显示，由于机械零件的制造误差，指示窗显示的高度与实际组织闭合高度存在较大的误差。所以仅凭观察闭合高度视窗判定组织压榨厚度的误差造成不同病人术后效果离散型较大，不仅影响手术的效率，还会出现成钉不一致、二次成钉等现象，从而出现组织泄露，组织坏死等术后症状。同时对于线性闭合器及切割器，目前普遍的做法是通过使用不同钉高的钉仓来实现统一器械闭合高度下的不同成型钉高。这一做法造成配套的钉仓数目及型号过多，不仅影响手术效率还会由于器械管理的复杂性造成特定场合下使用错误的钉仓类型实施手术。
发明内容
基于此，有必要提供一种能有效确保期望达到的组织闭合高度与实际的

Claims (1)

  1. 组织压榨厚度精确一致的电动吻合器。
    一种电动吻合器，包括：手柄，包括手柄本体、驱动电机和控制驱动电机工作的控制单元；工作头，包括钉砧头、钉仓、闭合机构、击发机构、安装闭合机构和击发机构的壳体，还包括向控制单元发送所述闭合机构的闭合行程信息的闭合限位开关、用以向所述控制单元发送闭合高度控制档位信息的闭合高度调整拨档开关；其中，闭合时，所述控制单元控制所述闭合机构运动直至闭合限位开关被触发使钉砧头、钉仓的闭合距离至预设闭合高度，所述控制单元在接收到闭合限位开关发送的信息后控制所述闭合机构的运动，使钉砧头和钉仓之间的闭合距离调整为与闭合高度调整拨档开关当前档位所对应的预设闭合距离一致。
    上述电动吻合器，当利用闭合限位开关检测钉砧头、钉仓之间的闭合距离至预设高度后，控制单元根据闭合高度调整拨档开关所在的档位信息控制闭合机构继续运动以调整闭合距离，当闭合距离与高度调整拨档开关当前档位所对应的闭合距离相符时，控制单元才发出击发指令，不会出现过度压榨或压榨不够的情况，由此能确保无论组织厚薄均能压榨到位，进而保证稳定的成钉效果。由于预先闭合至最大高度即闭合光电开关被触发的位置，传动机构中的间隙都已消除，后续基于此闭合高度的调整均能实现精确设置和实现期望的闭合高度，替代了原来的手动调整闭合高度的操作，对于要调整高度的案例，医生只要拨动闭合高度到相应档位即可，进而保证稳定的成钉效果。
    此外，还能够减少手术时器械备货复杂性，使用同一把器械通过设定不同的闭合高度即可实现不同成钉高度，不需要使用具有多种闭合高度的钉仓，从而简单有效的保证术后效果。
    在其中一个实施例中，所述工作头还包括用以向所述控制单元发送击发行程信息的击发限位开关，所述击发限位开关被触发时，所述控制单元使所述驱动电机停转。
    在其中一个实施例中，所述工作头还包括击发保险开关，所述击发保险开关具有第一位置和第二工作位置，其中在所述第一位置，所述击发保险开
PCT/CN2016/092395 2016-02-03 2016-07-29 电动吻合器 WO2017133205A1 (zh)

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ES16889020T ES2964742T3 (es) 2016-02-03 2016-07-29 Grapadora eléctrica
US15/567,164 US10595865B2 (en) 2016-02-03 2016-07-29 Electric surgical stapler
EP16889020.0A EP3412224B1 (en) 2016-02-03 2016-07-29 Electrical stapler

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CN201610076148.2A CN105496488B (zh) 2016-02-03 2016-02-03 电动吻合器
CN201610076148.2 2016-02-03

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EP (1) EP3412224B1 (zh)
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WO (1) WO2017133205A1 (zh)

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