WO2020125746A1 - 圆管型吻合器 - Google Patents

圆管型吻合器 Download PDF

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Publication number
WO2020125746A1
WO2020125746A1 PCT/CN2019/126923 CN2019126923W WO2020125746A1 WO 2020125746 A1 WO2020125746 A1 WO 2020125746A1 CN 2019126923 W CN2019126923 W CN 2019126923W WO 2020125746 A1 WO2020125746 A1 WO 2020125746A1
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WO
WIPO (PCT)
Prior art keywords
stapler
pointer
impact
position area
firing
Prior art date
Application number
PCT/CN2019/126923
Other languages
English (en)
French (fr)
Inventor
陈志�
郭毅
林江
Original Assignee
天臣国际医疗科技股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 天臣国际医疗科技股份有限公司 filed Critical 天臣国际医疗科技股份有限公司
Priority to AU2019408495A priority Critical patent/AU2019408495B2/en
Priority to EP19900362.5A priority patent/EP3900647A4/en
Priority to BR112021010627-8A priority patent/BR112021010627A2/pt
Priority to US17/311,206 priority patent/US20220031329A1/en
Priority to KR1020217019900A priority patent/KR102596648B1/ko
Priority to CA3122139A priority patent/CA3122139C/en
Priority to JP2021535924A priority patent/JP7209841B2/ja
Publication of WO2020125746A1 publication Critical patent/WO2020125746A1/zh

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/326—Circumcision apparatus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • 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
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • 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
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • 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
    • A61B2017/1132—End-to-end connections
    • 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
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0807—Indication means

Definitions

  • the invention relates to the technical field of medical equipment, in particular to a circular tube type stapler.
  • Gastrointestinal diseases are one of the most common diseases in humans.
  • a circular tube-type stapler is often used to replace the doctor's manual operation to anastomize the digestive tract and other physiological tissues.
  • the round tube stapler is a common surgical instrument. Most of them use axial inward binding. During the operation, they form an end-to-end or end-to-side anastomosis of the esophagus, stomach, intestine and other physiological tissues.
  • the segmental tissues are contained and contained in the stapler, and after the firing is completed, a circular anastomosis is formed on the tissue to reconstruct the human body channel.
  • a round tube type stapler includes a stapler body, an operation handle movably connected to the stapler body, and a nail anvil assembly cooperating with the body.
  • the stapler body includes a staple cartridge assembly disposed at a distal end, the staple cartridge assembly includes a ring-shaped staple cartridge, a cutter; and a knob disposed at a proximal end of the body, the knob can rotate relative to the body, and the stapler
  • the interior of the body also includes a nail anvil shaft disposed from the proximal end to the distal end.
  • the distal end and the proximal end are relative to the operator.
  • the end closer to the operator is the proximal end, and the end farther from the operator, that is, the end closer to the operation position is the distal end.
  • the inside and the outside are relative to the axis of the stapler, the side near the axis is the inside, and the side away from the axis is the outside.
  • the nail anvil assembly includes a nail anvil, a nail anvil cap disposed at a distal end of the nail anvil, and a knife anvil disposed inside the nail anvil.
  • the nail anvil assembly may be directly connected to the distal end of the nail anvil shaft or connected through a nail anvil shaft connection .
  • the nail anvil shaft penetrates from the purse of the stump tissue and is located at the distal end of the stapler body. Rotate the knob to gradually reduce the distance between the nail anvil assembly and the nail cartridge After reaching a suitable distance, it can reach the firing state, and then the operating handle can be used to complete the anastomosis.
  • the round tube stapler is also more and more widely used in the treatment of diseases such as hemorrhoids.
  • the circumcision stapler is also described in the prior art, and its structure is similar to the above-mentioned digestive tract circular tube-type stapler, except that the glans cap assembly is matched with the body.
  • the glans cap assembly includes a nail anvil, a glans cap fixedly connected to the nail anvil, a knife anvil, and a central rod detachably connected to the stapler body.
  • the doctor often cannot visually see the firing state of the stapler after pressing the handle assembly, nor can he feel whether the firing is completed from the tactile sense, and the doctor's use experience is not high.
  • the object of the present invention is to provide a round tube-type stapler, when the firing is completed, the first end of the pointer returns from the second position area to the first position area, and will collide with the impact part to issue an impact Sound, through the sound to remind the operator that the firing has been successfully completed.
  • An embodiment of the present invention provides a round tube-type stapler including a stapler body, a handle assembly movably connected to the stapler body, and a push rod provided in the body of the stapler, the push rod has an initial Position and a firing position, the handle assembly can push the push rod into the firing position from the initial position;
  • the body of the stapler is also provided with a pointer and an impact part, and the pointer is rotatably connected to the body of the stapler;
  • the first end of the pointer When the stapler is in the initial state, the first end of the pointer is located in the first position area, and the first end of the pointer is opposite to the impact portion; when the stapler is in the firing state, the first One end moves to the second position area, the first end of the pointer is away from the impact portion; when the stapling is completed, the first end of the pointer returns from the second position area to the first Position area, and the first end of the pointer collides with the impact part and emits an impact sound.
  • an elastic stopper is provided on the body of the stapler, the free end of the stopper faces and bears against the first end of the pointer, and the first end of the pointer is located in the first position area Does not resist the impact part.
  • the elastic limiter is a spring.
  • the first end of the pointer is connected to the distal end of the pull tab, and the pull tab causes the first end of the pointer to move from the first position area to the second position area .
  • the stapler body includes two stapler housings respectively located on both sides of the stapler, and the first end and the second end of the striking portion are fixed to the two stapler housings respectively On the inner surface, the middle of the impact portion protrudes toward the proximal end of the stapler.
  • an inner surface of each of the stapler housings is provided with a rib plate and a fixing plate, a fixing groove is formed between the rib plate and the fixing plate, and two ends of the impact part are respectively inserted into two In the fixing groove.
  • the striking portion is a metal sheet bent in the middle toward the proximal end of the stapler.
  • the impact portion is a hollow sphere or a hemisphere with a spherical surface facing the proximal end of the stapler.
  • the impact part includes a bell and a bracket, and the bell is fixed to the stapler body through the bracket.
  • the stapler body includes two stapler housings on two sides, and two ends of the bracket are respectively fixed to the stapler housings on both sides.
  • a groove is respectively formed on the inner side of the stapler housing, and both ends of the bracket are respectively inserted into the grooves on both sides.
  • the bell is a hollow cylinder with an open lower side
  • the bracket includes a connecting portion, and first and second side arms located on both sides of the connecting portion, the connecting portion of the bracket and the bell
  • the middle of the upper side is fixedly connected, and the end of the first side arm and the end of the second side arm of the bracket are respectively fixed to the stapler housings on both sides.
  • the pointer further includes a positioning portion, and the pointer is rotatably fixed to the stapler body through the positioning portion.
  • a firing portion is provided at the first end of the pointer, the firing portion protrudes toward the distal end of the stapler, and when the stapler firing is completed, the pointer returns from the second position area to the In the first position area, the firing portion of the pointer collides with the impact portion and emits an impact sound.
  • a positioning pin is penetrated in the positioning part, and a pointer return torsion spring is sleeved on the positioning pin.
  • the stapler body includes two stapler housings on two sides, the positioning portion is fixed to the stapler housing on one side, and the first end of the pointer includes an indicator portion, the indicator The part protrudes towards the stapler housing on the other side.
  • the stapler body includes a stapler housing, and a position of the stapler housing corresponding to the impact part is provided with at least one sound-emitting hole.
  • the invention provides a circular tube-type stapler, which is provided with an impact part in the body of the stapler.
  • the first end of the pointer moves from the first position area to the second position area, away from the impact part, when the firing is completed ,
  • the first end of the pointer returns from the second position area to the first position area, and it will collide with the impact part to make an impact sound, and use the sound to remind the operator that the firing has been successfully completed.
  • the operator can grasp the firing status of the stapler in time to improve Use experience.
  • FIG. 1 is a schematic structural view of a conventional round-tube stapler according to an embodiment of the present invention
  • FIG. 2 is a schematic structural diagram of a conventional stapler and handle assembly according to an embodiment of the present invention
  • FIG. 3 is a schematic structural diagram of a foreskin stapler according to an embodiment of the present invention.
  • FIG. 4 is a schematic structural view of a circular tube-type stapler in an initial state according to an embodiment of the present invention
  • FIGS. 5 to 6 are schematic diagrams of a structure in which a shell on one side of a circular tube-type stapler cooperates with a metal sheet according to an embodiment of the present invention
  • FIG. 7 is an enlarged view of A in FIG. 6;
  • FIG. 8 is a schematic structural view of a metal sheet according to an embodiment of the invention.
  • FIG. 9 is a schematic structural view of a circular tube-type stapler according to another embodiment of the present invention when it is in an initial state
  • FIG. 10 is an enlarged view of B in FIG. 9;
  • FIG. 11 is a cross-sectional view in the direction A1-A1 in FIG. 9;
  • FIG. 12 is a schematic view of the external structure of a circular tube-type stapler according to another embodiment of the present invention.
  • FIG. 13 is a schematic structural diagram of a pointer according to another embodiment of the present invention.
  • FIGS. 14 to 15 are schematic structural views of the handle assembly of the circular tube-type stapler according to an embodiment of the present invention in an initial state;
  • 16 is a schematic diagram of the structure of the cooperation between the pointer and the pull tab in the initial state of an embodiment of the present invention
  • FIG. 17 is a schematic structural view of a handle assembly of a circular tube-type stapler according to an embodiment of the present invention in a failed state;
  • FIG. 18 is a schematic structural diagram of the cooperation between the pointer and the pull-tab in the failure state according to an embodiment of the present invention.
  • FIG. 19 is a schematic diagram of the puller pulling the pointer to rotate according to an embodiment of the invention.
  • FIG. 20 is a schematic structural view of a round tube-type stapler in a firing state according to an embodiment of the present invention
  • FIG. 21 is a schematic structural view of a pull-tab of an embodiment of the invention.
  • the present invention provides a round tube-type stapler, including a stapler body, a handle assembly movably connected to the stapler body, and a push rod provided in the stapler body ,
  • the push rod has an initial position and a firing position, the handle assembly can push the push rod from the initial position into the firing position;
  • the stapler body is also provided with a pointer and an impact part, the The pointer is rotatably connected to the stapler body.
  • the first end of the pointer When the stapler is in the initial state, the first end of the pointer is located in the first position area, and the first end of the pointer is opposite to the impact portion; when the stapler is in the firing state, the first One end moves to the second position area, the first end of the pointer is away from the impact portion; when the stapling is completed, the first end of the pointer returns from the second position area to the first position area, and The first end of the pointer collides with the impact part and emits an impact sound. Therefore, by sound to remind the operator that the firing has been successfully completed, the operator can timely grasp the firing state of the stapler and improve the user experience.
  • the stapler includes a stapler body, a handle assembly movably connected to the stapler body, and a nail push rod 75 provided in the body of the stapler.
  • the nail push rod 75 has an initial position and a firing position.
  • the handle assembly can push the nail push rod 75 from the initial position into the firing position.
  • the distal end of the stapler body is provided with a staple anvil assembly 73 and a staple cartridge assembly 72 cooperating with the staple anvil assembly 73, and the proximal end is provided with a knob 71 held by an operator. Only an optional structure of the stapler is shown here, but it should not be taken as a limitation of the protection scope of the present invention.
  • the present invention further provides a pointer 5 and an impact portion inside the stapler body.
  • the pointer 5 is rotatably connected to the stapler body, and the first end 51 of the pointer 5 is in the unfireable state and In the fireable state, they are located in the first position area and the second position area, respectively, the first position area includes the initial position of the first end 51 of the pointer 5 (non-fireable), and the second position area includes the first end of the pointer 5 51 is in a position that can be fired.
  • a window is provided on the stapler body corresponding to the first position area and the second position area for observing the position of the first end 51 of the pointer during use, when the first end 51 of the pointer is in the first position area Is in a safe state, at this time the stapler cannot be fired.
  • the stapler can fire.
  • the window corresponds to the firable
  • the two-position area is a green area, which has been disclosed in the prior art.
  • the pointer 5 may collide with the impact part or may have a certain gap between the impact parts;
  • the first end 51 of the pointer 5 moves to the second position area, and the first end of the pointer 5 rotates toward the proximal end of the stapler to move away from the impact portion;
  • the stapler is completed, the first end of the pointer 5 51 returns from the second position area to the first position area, and the first end 51 of the pointer 5 collides with the impact portion and makes an impact sound. Through this impact sound, the operator can know that the current stapler has been fired.
  • the present invention can be applied not only to the conventional round tube type stapler, but also to the circumcision stapler.
  • FIG. 3 the structure of the foreskin stapler body 8 to which the handle assembly is applied is shown.
  • the distal end of the foreskin stapler body 8 includes a staple cartridge assembly 81, and a glans cap assembly (not shown in the figure) that is matched with the staple cartridge assembly 81 is also provided.
  • the handle assembly is movably connected to one end of the foreskin stapler.
  • One end of the handle assembly is matched with the push nail component of the foreskin stapler.
  • the handle assembly pushes the push nail component to achieve the foreskin anastomosis Fired.
  • the impact portion in this embodiment is a structure of a metal sheet 77. Specifically, for the structure of the impact portion in this embodiment, refer to FIGS. 4-8.
  • the stapler body includes two stapler housings 74 on both sides, and the manner in which the striking portion and the one side stapler housing 74 are fitted is shown in FIGS. 5 and 6, respectively.
  • the first end 771 and the second end 772 of the metal sheet 77 are respectively fixed to the inner surfaces of the two stapler housings 74, and the middle of the metal sheet 77 protrudes toward the proximal end of the stapler to form a convex portion 773, forming a hollow structure,
  • a loud sound can be produced, and a better prompt effect can be achieved.
  • each stapler housing 74 is provided with a rib 741 and a fixing plate 742, and a fixing groove 743 is formed between the rib 741 and the fixing plate 742, and the two ends of the metal sheet 77 are inserted respectively In two fixing grooves 743.
  • the fixing plate 742 may be a bending plate that is bent toward the rib plate 741 on both sides. After being fixed to the rib plate 741, a cavity formed between the two forms a fixing groove 743.
  • the striking portion may be a metal piece whose middle portion is bent toward the pointer, but the present invention is not limited to this.
  • the impact portion may also be a hollow sphere or a hemispherical structure with a spherical surface facing the proximal end of the stapler, or other materials such as plastic, acrylic, etc., all falling within the protection scope of the present invention.
  • the striking portion is selected as a bell assembly.
  • the structure of the bell assembly may refer to FIGS. 9 to 13.
  • the impact portion includes a bell 91 and a bracket 92, and the bell 91 is fixed to the stapler housing 74 through the bracket 92.
  • the first end 51 of the pointer 5 is opposite to the bell 91, and at this time, the first end 51 of the pointer 5 and the bell 91 may be in conflict, or may be between the first end of the pointer 5 and the bell 91 without contact There is a gap between them.
  • the housing 74 is provided with an elastic stopper 78 in the direction of the pointer.
  • the first end of the pointer 5 is not in contact with the bell 91.
  • the first end 51 of the pointer 5 moves toward the proximal end of the stapler away from the bell 91.
  • the first end 51 of the pointer 5 returns from the second position area to the first position area ,
  • the striking bell 91 emits a striking sound, which can also realize the effect of reminding the operator of the firing by sound.
  • the first end 51 of the pointer 5 is not in contact with the bell 91 through the elastic stopper 78, which will cause the pointer 5 to strike the bell 91 and leave the bell 91 immediately after the firing is completed, which does not hinder the vibration of the bell 91 and cause the bell 91 to occur.
  • the timbre and sound quality are better, and the ring tone is longer.
  • the elastic stopper 78 is a spring
  • the distal end of the spring is fixedly disposed on the housing 74
  • the free end of the spring bears against the first of the pointer 5 ⁇ 51 ⁇ End 51.
  • the proximal end of the spring may be fixed to the first end 51 of the pointer 5, and the free end may bear against the housing 74.
  • the stapler body includes two stapler housings 74 on both sides, and both ends of the bracket 92 are fixed to the stapler housings 74 on both sides.
  • a groove 745 is respectively formed on the inner side of the stapler housing 74, and both ends of the bracket 92 are respectively inserted into the grooves 745 on both sides.
  • the bell 91 is a hollow cylinder with an open lower side.
  • the bracket 92 includes a connecting portion 923 and first and second side arms 921 and 922 located on both sides of the connecting portion 923.
  • the connecting portion 923 of the bracket 92 is The middle of the upper side of the bell 91 is fixedly connected, and the end of the first side arm 921 and the end of the second side arm 922 of the bracket 92 are respectively fixed to the stapler housing 74 on both sides.
  • the connection portion 923 of the bracket 92 and the bell 91 can be connected by bolts, rivets, or other fasteners, or the bracket 92 can be directly connected to the bell 91 by welding or other connection methods, which are all within the protection scope of the present invention.
  • a sound hole 744 is further provided on the stapler housing 74.
  • the sound hole 744 may be opened on one side of the housing 74 or on both sides of the housing 74.
  • Bell 91 corresponds to increase the volume of the bell when it is struck.
  • the structure of the pointer 5 can be seen in FIGS. 13 to 18.
  • the pointer 5 is rotatably fixed to the stapler body through a positioning portion 53.
  • a positioning pin 55 is inserted through the positioning portion 53.
  • a pointer reset torsion spring 56 is sleeved on the positioning pin 55.
  • the pointer reset torsion spring 56 The two ends of the are respectively touching the pointer 5 and the stapler body.
  • the pointer 5 In the initial state and the completed firing state, the pointer 5 is in a balanced state under the joint action of the elastic stopper 78 and the pointer return torsion spring 56, and is held in the first position area.
  • the pointer 5 When the first end 51 of the pointer 5 receives an external force toward the proximal end of the stapler and moves to the second position area, the pointer return torsion spring 56 deforms, and when the external force of the pointer 5 disappears, the restoring force of the pointer return torsion spring 56 can be pushed The pointer 5 returns to the first position area again to collide with the impact part. During the impact, the first end 51 of the pointer 5 needs to overcome the role of the elastic stopper 78 and quickly move to the distal end to collide with the impact part.
  • the first end 51 of the pointer 5 includes a firing portion 511 that protrudes toward the distal end of the stapler to better cooperate with the impact portion.
  • the first end 51 of the pointer 5 also includes an indicator portion 512, which can correspond to the window position of the stapler. Observing the position of the indicator portion 512 through the window position can determine the current position of the first end 51 of the pointer 5 And determine whether the stapler is ready to fire.
  • the initial position of the firing portion 511 is not in contact with the bell 91.
  • the pointer torsion spring 56 undergoes a first torsional deformation. After the stapler is fired, the first end of the pointer 5 When 51 loses the external force, the deformation restoring force of the pointer return torsion spring 56 will cause the first end 51 of the pointer 5 to quickly swing towards the distal end of the stapler.
  • the firing portion 511 of the pointer 5 After the firing portion 511 of the pointer 5 moves to the initial position, it will continue to anastomotic with the current acceleration The distal end of the device swings a short distance to collide with the bell 91. In this short distance that continues to rotate with the current acceleration, the pointer return torsion spring 56 will undergo a relatively small second torsional deformation. After the firing part 511 collides with the bell 91, the deformation recovery force of the pointer return torsion spring 56 will be Pull the firing part 511 back to the initial position, further under the action of the elastic stopper 78, it quickly detaches from the surface of the bell 91 and no longer comes into contact with the bell 91, and keeps the firing part 511 from colliding with the bell 91 again .
  • the first position area is a range of positions, including the initial position of the firing portion 511, the impact position where the firing portion 511 hits the bell 91, and the position interval between the initial position and the impact position.
  • the second position area may also be a position range within which the stapler can be fired, not necessarily a specific position point.
  • the pointer 5 may not be provided with the firing portion 511.
  • the indicator portion 512 of the pointer 5 collides with the impact portion and emits an impact sound.
  • the push rod 75 is located between the first end 51 of the pointer 5 and the positioning portion 53.
  • the indicator portion 512 of the pointer 5 protrudes toward the push rod 75. It can be seen from FIG. 15 that the length of the protruding portion 512 of the pointer 5 is substantially the same as the protruding portion of the middle of the metal sheet 77, that is, the contact area where the pointer 5 and the metal sheet 77 collide can be increased.
  • a structure for avoiding the push rod 75 is formed between the indicating portion 512 of the pointer 5 and the positioning section 53, which can arrange the position of the pointer 5 and the push rod 75 inside the stapler body more reasonably and flexibly, reducing the anastomosis The overall thickness of the device body, thereby achieving a compact and compact structure of the stapler.
  • the inside of the stapler is also provided with a pull tab 6 and a pointer 54 is provided with a protrusion 54.
  • the pull tab 6 can pull the protrusion 54 of the pointer 5 so that The first end 51 of the pointer 5 moves from the first position area to the second position area.
  • the pull tab 6 includes a pull hook 61 corresponding to the protruding portion 54 and a tail 62 fixed on the screw 76. When the screw 76 rotates in a certain direction, the pull tab 6 can be driven to move proximally.
  • the pointer 5 can control the firing state of the stapler by controlling the working state of the handle assembly.
  • the handle assembly includes a first handle 1 and a second handle 2.
  • the first end 11 of the first handle 1 is a holding end, and the second end 12 is rotatably connected to the first end 21 of the second handle 2.
  • a handle 1 can rotate in the first direction under external force, the second end 22 of the second handle 2 is in contact with the push rod 75, and the first end 51 of the pointer 5 is in the first position area, the first handle 1 and the second handle 2 Without linkage, even if the first handle 1 rotates, the second handle 2 will not push the push rod 75 to fire.
  • the first direction is the counterclockwise direction shown in FIGS.
  • the present invention is not limited to this. Therefore, when the doctor holds the first handle 1, the first handle 1 can be easily rotated, but the second handle 2 is not triggered. At the same time, because the air is in an empty firing state, the force of holding the first handle 1 is very small. The doctor can also learn through this operation experience that the current status of the stapler is in the unfired state, and will not cause the case of the stapler to rupture.
  • the first handle 1 and the second handle 2 are linked.
  • the rotation of the first handle 1 can drive the rotation of the second handle 2 to push the push rod 75 into the firing position, and then drive Fire the stapler.
  • the first handle 1 has a first cavity 13, and in the initial state, the second handle 2 is partially located inside the first cavity 13.
  • the first handle 1 is provided with a slide slot 41, which includes a first segment and a second segment communicating with each other, a slide 42 is slidably disposed in the slide slot 41, and the second end of the second handle 2 has a handle abutting portion;
  • the slider 42 is located in the first section of the slide slot 41.
  • the handle 2 continues to enter the first cavity 13 of the first handle 1; when the first end 51 of the pointer 5 moves toward the second position area, the second end 52 of the pointer 5 pushes the slider 42 toward the second of the slide slot 41 When the segment moves, the slider 42 interferes with the second handle 2.
  • the slider 42 interferes with the handle abutting portion of the second handle 2 and pushes the second handle 2 to rotate.
  • first section and the second section of the chute 41 in the present invention are a relative concept, not necessarily the two ends of the chute 41, that is, in the perspective shown in FIG. 14,
  • the first section of the chute 41 is located to the right of the second section.
  • the slider 42 will not interfere with the second handle 2 when it is located in the first section of the slide slot 41, and will interfere with the second handle 2 when it is located in the second section of the slide slot 41.
  • the first handle 1 and the second handle 2 are simultaneously provided with a first pin 31, the first pin 31 is fixed to the housing 74 of the stapler, and the first torsion spring 32 is sleeved thereon .
  • the two ends of the first torsion spring 32 respectively contact the housing 74 of the stapler and the second handle 2.
  • the restoring force of the first torsion spring 32 can change the second Reset handle 2.
  • a second pin 33 is also provided in the housing 74 of the stapler.
  • the second pin 33 is fixed to the housing 74 of the stapler, and a second torsion spring 34 is sleeved on it. Both ends of the second torsion spring 34 respectively abut against the housing 74 of the stapler and the first handle 1.
  • the handle assembly may adopt other structures, such as not distinguishing between the first handle and the second handle, or changing between the first handle and the second handle.
  • 17 to 18 show the structure when the stapler of this embodiment is in a failure state.
  • the pull tab 6 does not pull the pointer 5, so the position of the pointer 5 does not change.
  • the first end 51 of the pointer 5 is located in the first position area, and the slider 42 is still located in the first section of the slide slot 41.
  • the slider 42 and the handle abutting portion of the second handle 2 do not interfere.
  • the slider 42 in the initial position, the slider 42 is located at the end of the first section of the slide slot 41 away from the second section, which is the right end of the figure, under the action of the slider return spring.
  • the second end 52 of the pointer 5 may limit the initial position of the slider 42.
  • the device is in an insurance state. Since the torsion force of the second torsion spring 34 is much smaller than the firing force, the first handle 1 can be rotated counterclockwise around the first pin 31 when the first handle 1 is under a small holding force, and the second handle 2 continues Entering the cavity of the first handle 1, that is, the first handle 1 and the second handle 2 are not linked, and the second handle 2 does not rotate.
  • the first handle 1 can be easily rotated, but it does not drive the rotation of the second handle 2 and the firing of the stapler cannot be completed.
  • the operator can also get tactile feedback at this time, knowing that the first end 51 of the current pointer 5 has not reached the second position area and has not fired.
  • the first handle 1 is reset by the second torsion spring 34.
  • the pointer 5 since the pointer 5 does not actually move, the first end 51 of the pointer 5 still fits the impact portion.
  • the slider 42 is displaced along with the rotation of the first handle 1 and the relative position to the second end 52 of the pointer 5 is changed.
  • FIG. 20 shows a schematic structural view of the stapler of this embodiment in the firing state.
  • the second end 52 of the pointer 5 rotates clockwise, thereby pushing the slider 42 to move toward the second stage of the slide slot 41.
  • the slider 42 interferes with the handle abutting portion and blocks the second handle 2 from continuing to enter the internal cavity of the first handle 1.
  • the second handle 2 and the first handle 1 become linked.
  • the second handle 2 rotates counterclockwise with the first handle 1, and the second end 22 of the second handle 2 pushes the push rod 75 toward the distal end of the stapler to complete firing of the stapler.
  • the pull-tab contact portion 23 of the second handle 2 will be in contact with the pull-tab 6 to lift the pull-tab 6 upward to disengage it from the protrusion 54 of the pointer 5, forming a diagram 21 status. Therefore, after the firing is completed, since the pull-tab 6 no longer pulls the pointer 5, the first end 51 of the pointer 5 will return to the first position area with the restoring force of the pointer return torsion spring 56 and collide with the impact portion, causing an impact Sound to remind the operator that the firing has been successfully completed.
  • the operator After the operator hears the impact sound, it can judge that the stapling is completed, and then release the first handle 1. Since the first end 51 of the pointer 5 returns to the first position area, the second end 52 of the pointer 5 is separated from the slider 42 after releasing the first handle 1. Then, after the external force of the pointer 5 is lost, the deformation force of the slider return spring when it returns to its original state will push the slider 42 to slide toward the first stage of the sliding groove 41 again and return to the original position. The second handle 2 is also reset under the restoring force of the first torsion spring 32. Since the first handle 1 is engaged with the second handle 2 under the action of the slider 42, it first returns with the second handle 2 and at the same time returns under the action of the second torsion spring 34.
  • the invention provides a circular tube-type stapler, which is provided with an impact part in the body of the stapler.
  • the first end of the pointer moves from the first position area to the second position area, away from the impact part, when the firing is completed ,
  • the first end of the pointer returns from the second position area to the first position area, and it will collide with the impact part to make an impact sound, and use the sound to remind the operator that the firing has been successfully completed.
  • the operator can grasp the firing status of the stapler in time to improve Use experience.

Abstract

一种圆管型吻合器，其中包括吻合器本体、把手组件以及推钉杆(75)；吻合器本体内还设置有一指针(5)和一撞击部，指针(5)可旋转连接至吻合器本体；吻合器处于初始状态时，指针(5)位于第一位置区域，指针(5)与撞击部抵触；吻合器处于击发状态时，指针(5)移动至第二位置区域，指针(5)与撞击部脱离；吻合器击发完成时，指针(5)从第二位置区域返回至第一位置区域，且与撞击部碰撞并发出撞击音。在吻合器本体内设置撞击部，在击发完成时，指针(5)从第二位置区域返回第一位置区域，并且会与撞击部碰撞发出撞击音，通过声音以提示操作者已经顺利完成击发，操作者可以及时掌握吻合器的击发状态，提高使用体验。

Description

圆管型吻合器 技术领域
本发明涉及医疗器械技术领域，具体涉及一种圆管型吻合器。
背景技术
消化道疾病是人类高发的疾病之一，在治疗过程中，常使用圆管型吻合器代替医生的手工操作对消化道等生理组织进行吻合。圆管型吻合器是一种常见的外科手术器械，大多采用轴向内装订方式，在手术时对食管、胃、肠道等生理组织形成端对端的、或者端对侧的吻合，吻合时两段组织内敛收容于吻合器内，击发完成后在组织上形成圆形吻合口，重建了人体通道。
现有技术中，圆管型吻合器包括吻合器本体、活动连接所述吻合器本体的操作把手以及与所述本体配合的钉砧组件。所述吻合器本体包括设于远端的钉仓组件，所述钉仓组件包括环形钉仓、切刀；以及设于本体近端的旋钮，所述旋钮可相对于本体旋转，所述吻合器本体的内部还包括从近端向远端设置的钉砧轴。此处远端和近端是相对于操作者来说的，距离操作者较近的一端为近端，距离操作者较远的一端，即更靠近手术位置的一端为远端。在吻合器中，内侧与外侧是相对与吻合器的轴心来说的，靠近轴心的一侧为内侧，远离轴心的一侧为外侧。所述钉砧组件包括钉砧、设置在钉砧远端的钉砧帽和设置在钉砧内部的刀砧，钉砧组件可以与钉砧轴的远端直接连接或通过钉砧轴连接件连接。在肿瘤手术过程中，离断去除肿瘤组织后，钉砧轴从残端组织的荷包穿出，配置于吻合器本体的远端，旋转旋钮，使钉砧组件和钉仓之间的距离逐渐减小达到一个合适的距离后，达到可击发状态，才能握持操作把手击发器械完成吻合。随着医疗器械的不断发展，圆管型吻合器也越来越广泛地应用于痔疮等疾病的治疗。
同时，在泌尿外科领域治疗包皮过长及包茎的手术中，也出现了另外一种形式的圆管型吻合器，即包皮吻合器。包皮吻合器在现有技术中也有描述，其结构类似于上述的消化道圆管型吻合器，区别仅在于与所述本体配合的是 龟头帽组件。相似的，所述龟头帽组件包括钉砧、与钉砧固定连接的龟头帽、刀砧，以及与吻合器本体可拆卸地连接的中心杆。在手术过程中，把待切除的包皮组织固定在龟头帽上，然后把中心杆配置于吻合器本体的远端，旋转旋钮，使龟头帽与钉仓之间的距离逐渐减小达到一个合适的距离后，达到可击发状态，才能握持把手击发器械完成吻合。
然而在使用过程中，医生在按压把手组件后，往往无法直观地看到吻合器的击发状态，也无法从触觉来感受到是否完成击发，医生的使用体验不高。
发明内容
针对现有技术中的问题，本发明的目的在于提供一种圆管型吻合器，当完成击发时，指针的第一端从第二位置区域返回第一位置区域，会与撞击部碰撞发出撞击音，通过声音来提示操作者已经顺利完成击发。
本发明实施例提供一种圆管型吻合器，包括吻合器本体、活动连接所述吻合器本体的把手组件以及设置于所述吻合器本体内的推钉杆，所述推钉杆具有一初始位置和一击发位置，所述把手组件可推动所述推钉杆从所述初始位置进入所述击发位置；
所述吻合器本体内还设置有一指针和一撞击部，所述指针可旋转连接至所述吻合器本体；
所述吻合器处于初始状态时，所述指针的第一端位于第一位置区域，所述指针的第一端与所述撞击部相对；所述吻合器处于击发状态时，所述指针的第一端移动至第二位置区域，所述指针的第一端远离所述撞击部；所述吻合器击发完成时，所述指针的第一端从所述第二位置区域返回至所述第一位置区域，且所述指针的第一端与所述撞击部碰撞并发出撞击音。
可选地，所述吻合器本体上设有弹性限位件，所述限位件的自由端朝向并抵持于所述指针的第一端，所述指针的第一端位于第一位置区域时不与所述撞击部抵持。
可选地，所述弹性限位件为弹簧。
可选地，所述指针的所述第一端连接于拉片的远端，所述拉片带动所述指针的所述第一端从所述第一位置区域向所述第二位置区域移动。
可选地，所述吻合器本体包括分别位于所述吻合器两侧的两个吻合器壳体，所述撞击部的第一端和第二端分别固定至所述两个吻合器壳体的内表面，所述撞击部的中部朝向吻合器的近端方向突出。
可选地，各个所述吻合器壳体的内表面设置有一筋板和一固定板，所述筋板和固定板之间形成有一固定槽，所述撞击部的两端分别插设于两个所述固定槽中。
可选地，所述撞击部为中部朝向吻合器的近端方向弯折的金属片。
可选地，所述撞击部为空心球或球面朝向吻合器的近端方向的半球形。
可选地，所述撞击部包括铃铛和支架，所述铃铛通过所述支架固定于所述吻合器本体。
可选地，所述吻合器本体包括分别位于两侧的两个吻合器壳体，所述支架的两端分别固定于两侧的所述吻合器壳体。
可选地，所述吻合器壳体的内侧面分别开设有一凹槽，所述支架的两端分别插设于两侧的所述凹槽的内部。
可选地，所述铃铛为下侧面开口的中空圆柱体，所述支架包括连接部以及位于连接部两侧的第一侧臂和第二侧臂，所述支架的连接部与所述铃铛的上侧面的中部固定连接，所述支架的第一侧臂的末端和第二侧臂的末端分别固定于两侧的所述吻合器壳体。
可选地，所述指针还包括定位部，所述指针通过所述定位部可旋转固定于所述吻合器本体。
可选地，所述指针的第一端设置有击发部，所述击发部朝向吻合器的远端突出，所述吻合器击发完成时，所述指针从所述第二位置区域返回至所述第一位置区域，所述指针的击发部与所述撞击部碰撞并发出撞击音。
可选地，所述定位部中穿设有一定位销轴，所述定位销轴上套设有一指针复位扭簧。
可选地，所述吻合器本体包括分别位于两侧的两个吻合器壳体，所述定位部固定于一侧的吻合器壳体，所述指针的第一端包括指示部，所述指示部朝向另一侧的吻合器壳体突出。
可选地，所述吻合器本体包括吻合器壳体，所述吻合器壳体与所述撞击 部对应的位置开设有至少一个发声孔。
本发明所提供的圆管型吻合器具有下列优点：
本发明提供了一种圆管型吻合器，在吻合器本体内设置撞击部，击发时，指针的第一端从第一位置区域移动至第二位置区域，与撞击部远离，在击发完成时，指针的第一端从第二位置区域返回第一位置区域，并且会与撞击部碰撞发出撞击音，通过声音以提示操作者已经顺利完成击发，操作者可以及时掌握吻合器的击发状态，提高使用体验。
附图说明
为了更清楚地说明本发明实施例中的技术方案，下面将对实施例描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本发明的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1是本发明一实施例的常规圆管型吻合器的结构示意图；
图2是本发明一实施例的常规吻合器和把手组件配合的结构示意图；
图3是本发明一实施例的包皮吻合器的结构示意图；
图4是本发明一实施例的圆管型吻合器处于初始状态时的结构示意图；
图5～6是本发明一实施例的圆管型吻合器一侧壳体与金属片配合的结构示意图；
图7是图6中A处放大图；
图8是本发明一实施例的金属片的结构示意图；
图9是本发明另一实施例的圆管型吻合器处于初始状态时的结构示意图；
图10是图9中B处放大图；
图11是图9中A1-A1方向剖视图；
图12是本发明另一实施例的圆管型吻合器的外部结构示意图；
图13是本发明另一实施例的指针的结构示意图；
图14～15是本发明一实施例的圆管型吻合器的把手组件处于初始状态的结构示意图；
图16是本发明一实施例的初始状态时指针和拉片配合的结构示意图；
图17是本发明一实施例的圆管型吻合器的把手组件处于失效状态的结构示意图；
图18是本发明一实施例的失效状态时指针和拉片配合的结构示意图；
图19是本发明一实施例的拉片拉动指针旋转的示意图；
图20是本发明一实施例的圆管型吻合器处于击发状态的结构示意图；
图21是本发明一实施例的拉片被顶起的结构示意图。
具体实施方式
为使本发明实施例的目的、技术方案和优点更加清楚，下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例是本发明一部分实施例，而不是全部的实施例。
下面将参考附图并结合实施例，来详细说明本发明。
为了解决现有技术中的技术问题，本发明提供了一种圆管型吻合器，包括吻合器本体、活动连接所述吻合器本体的把手组件以及设置于所述吻合器本体内的推钉杆，所述推钉杆具有一初始位置和一击发位置，所述把手组件可推动所述推钉杆从初始位置进入击发位置；所述吻合器本体内还设置有一指针和一撞击部，所述指针可旋转连接至所述吻合器本体。
所述吻合器处于初始状态时，所述指针的第一端位于第一位置区域，所述指针的第一端与所述撞击部相对；所述吻合器处于击发状态时，所述指针的第一端移动至第二位置区域，所述指针的第一端远离所述撞击部；所述吻合器击发完成时，所述指针的第一端从第二位置区域返回至第一位置区域，且所述指针的第一端与所述撞击部碰撞并发出撞击音。因此，通过声音以提示操作者已经顺利完成击发，操作者可以及时掌握吻合器的击发状态，提高使用体验。
如图1和图2示出了本发明一实施例的常规吻合器处于初始状态的结构。该吻合器包括吻合器本体、活动连接所述吻合器本体的把手组件以及设置于所述吻合器本体内的推钉杆75，所述推钉杆75具有一初始位置和一击发位置，所述把手组件可推动所述推钉杆75从初始位置进入击发位置。在该实施 例中，吻合器本体的远端设置有与钉砧组件73以及与钉砧组件73配合的钉仓组件72，近端设置有操作者握持的旋钮71。此处仅示出了吻合器的一种可选的结构，但不应作为本发明的保护范围的限制。
当推钉杆75移动至击发位置时，可以进一步推动吻合器的推钉片和环形切刀，对进行手术的组织进行缝合和切割。为了提示操作者吻合器的击发状态，本发明进一步在吻合器本体的内部设置有一指针5和一撞击部，指针5可旋转连接至吻合器本体，指针5的第一端51在不可击发状态和可击发状态下，分别位于第一位置区域和第二位置区域，第一位置区域包括指针5的第一端51初始状态(不可击发)的初始位置，第二位置区域包括指针5的第一端51位于可击发位置。其中在吻合器本体上对应于第一位置区域和第二位置区域处设有一视窗，用于观察指针第一端51在使用过程中所处的位置，指针第一端51在第一位置区域时，是处于保险状态的，此时吻合器不能击发，当指针第一端51处于第二位置区域时，吻合器可以击发，为了更直观地给医生以提示，在视窗上对应于可击发的第二位置区域即为绿色区域，现有技术已经有揭示。吻合器处于初始状态时，指针5的第一端51位于第一位置区域，指针5与撞击部相对，此时指针5可以与撞击部抵触，也可以与撞击部之间有一定的间隙；吻合器处于击发状态时，指针5的第一端51移动至第二位置区域，指针5的第一端朝向吻合器近端旋转从而与撞击部远离；吻合器击发完成时，指针5的第一端51从第二位置区域返回至第一位置区域，且指针5的第一端51与撞击部碰撞并发出撞击音。通过此撞击音，操作者即可获知当前吻合器已经击发完成。
本发明不仅可以应用于常规的圆管型吻合器，还可以应用于包皮吻合器。例如图3所示，示出了应用该把手组件的包皮吻合器本体8的结构。包皮吻合器本体8的远端包括钉仓组件81，另外还设置有与钉仓组件81配合的龟头帽组件(图中未示出)。采用包皮吻合器时，把手组件活动连接到包皮吻合器的一端，把手组件的一端与包皮吻合器的推钉部件相配合，当满足可击发条件时，把手组件会推动推钉部件，实现包皮吻合器的击发。
该实施例中的撞击部为一个金属片77的结构，具体地，该实施例的撞击部的结构可以参见图4～8。在该实施例中，所述吻合器本体包括分别位于两 侧的两个吻合器壳体74，图5和图6中分别示出了撞击部与一侧吻合器壳体74的配合方式。金属片77的第一端771和第二端772分别固定至两个吻合器壳体74的内表面，金属片77的中部朝向吻合器近端突出形成凸起部773，形成一个中空的结构，在指针5敲击金属片77的凸起部773时，可以发出较大的声音，实现较好的提示效果。
如图7所示，各个吻合器壳体74的内表面设置有一筋板741和一固定板742，筋板741和固定板742之间形成有一固定槽743，金属片77的两端分别插设于两个固定槽743中。具体地，固定板742可以是一个两侧朝向筋板741弯曲的弯折板，与筋板741固定后，两者之间围成的空腔即形成固定槽743。
在该实施例中，撞击部可选为中部朝向指针弯折的金属片，但本发明不限于此。在其他实施方式中，该撞击部还可以为空心球或球面朝向吻合器近端的半球形结构，或者采用其他材质，例如塑料、亚克力等等，均属于本发明的保护范围之内。
在本发明另一实施例中，撞击部选择为一个铃铛组件。具体地，铃铛组件的结构可以参照图9～13所示。在该实施例中，撞击部包括铃铛91和支架92，所述铃铛91通过所述支架92固定于所述吻合器壳体74。在初始状态时，指针5的第一端51与铃铛91相对，此时指针5的第一端51与铃铛91可以是抵触的，也可以不接触而在指针5的第一端和铃铛91之间有空隙，在此，所述壳体74上设有朝向指针方向的弹性限位件78，初始状态时，使所述指针5的第一端与铃铛91不接触。在吻合器击发时，指针5的第一端51向吻合器近端移动而远离铃铛91，在吻合器击发完成后，指针5的第一端51从第二位置区域返回至第一位置区域时，撞击铃铛91发出撞击音，同样可以实现通过声音来提醒操作者击发已完成的效果。通过弹性限位件78使所述指针5的第一端51与铃铛91不接触，会使击发完成后指针5撞击铃铛91后立刻离开铃铛91，不阻碍铃铛91的震动，使铃铛91发生的音色与音质更好，铃音更绵长。
如图10所示，本实施例中，所述弹性限位件78为弹簧，所述弹簧的远端固定设于所述壳体74，弹簧的自由端抵持于所述指针5的第一端51。当然 也可以是所述弹簧的近端固定设于所述指针5的第一端51，所述自由端抵持于所述壳体74。
如图11所示，在该实施例中，所述吻合器本体包括分别位于两侧的两个吻合器壳体74，所述支架92的两端分别固定于两侧的吻合器壳体74。具体地，在所述吻合器壳体74的内侧面分别开设有一凹槽745，所述支架92的两端分别插设于两侧的凹槽745的内部。
所述铃铛91为下侧面开口的中空圆柱体，所述支架92包括连接部923以及位于连接部923两侧的第一侧臂921和第二侧臂922，所述支架92的连接部923与所述铃铛91的上侧面的中部固定连接，所述支架92的第一侧臂921的末端和第二侧臂922的末端分别固定于两侧的吻合器壳体74。支架92的连接部923与铃铛91的连接可以通过螺栓、铆钉等紧固件，也可以将支架92直接与铃铛91焊接连接，或采用其他连接方式，均属于本发明的保护范围之内。
如图12所示，在吻合器壳体74上还开设有发声孔744，发声孔744可以开设在一侧壳体74上，也可以开设在两侧壳体74上，发声孔744的位置与铃铛91相对应，以提高铃铛被撞击时的音量。
指针5的结构可以参见图13至图18。该实施例中，指针5通过定位部53可旋转固定于吻合器本体，定位部53中穿设有一定位销轴55，定位销轴55上套设有一指针复位扭簧56，指针复位扭簧56的两端分别抵触指针5和吻合器本体。初始状态及击发完成状态下，指针5在弹性限位件78与指针复位扭簧56的共同作用下处于平衡状态，保持于所述第一位置区域。指针5的第一端51受到朝向吻合器近端的外力时并移动至第二位置区域时，指针复位扭簧56变形，在指针5的外力消失时，指针复位扭簧56的恢复力可以推动指针5重新返回至第一位置区域，以与撞击部碰撞。撞击时，指针5的第一端51需克服弹性限位件78的作用，快速向远端运动与撞击部碰撞。指针5的第一端51包括一个击发部511，击发部511朝向吻合器远端突出，以更好地与撞击部配合。指针5的第一端51还包括一个指示部512，指示部512可以对应于吻合器的视窗位置，通过视窗位置观察指示部512的位置即可以确定指针5的第一端51当前所处的位置，并判断吻合器是否做好击发准备。
具体地，在初始状态时，击发部511的初始位置不与铃铛91接触。当指针5的第一端51受到朝向吻合器近端的外力时并移动至第二位置区域时，指针复位扭簧56发生第一扭转变形，在吻合器击发完成后，指针5的第一端51失去外力，指针复位扭簧56的变形恢复力会使得指针5的第一端51迅速向吻合器远端摆动，指针5的击发部511移动到初始位置后，会凭借当前的加速度继续向吻合器远端摆动一小段距离，以与铃铛91发生碰撞。这一段凭借当前的加速度继续旋转的一小段距离中，指针复位扭簧56会发生一个比较小的第二扭转变形，在击发部511与铃铛91碰撞之后，指针复位扭簧56的变形恢复力会将击发部511拉回到初始位置，进一步地在弹性限位件78的作用下，快速脱离铃铛91表面而不再与铃铛91接触，并保持击发部511不会再次与铃铛91发生二次撞击。在该实施例中，第一位置区域是一个位置范围，包括击发部511的初始位置、击发部511撞击铃铛91的撞击位置以及初始位置和撞击位置之间的位置区间。第二位置区域也可以是一个位置范围，在该位置范围内，吻合器可击发，而不一定是一个具体的位置点。
在其他实施方式中，指针5也可以不设置击发部511，在指针5的第一端51从第二位置区域返回至第一位置区域时，指针5的指示部512与撞击部碰撞并发出撞击音。采用此种指针的结构可以参见图15，推钉杆75位于指针5的第一端51和定位部53之间，指针5的指示部512朝向推钉杆75的方向突出。从图15中可以看出，指针5的指示部512突出的部分与金属片77中部突出的部分的长度基本相同，即可以增加指针5和金属片77碰撞的接触面积。同时，指针5的指示部512和定位部53之间形成了一个避让推钉杆75的结构，可以更加合理和灵活地安排吻合器本体内部的指针5和推钉杆75的位置，减小吻合器本体的整体厚度，从而实现吻合器紧凑小巧的结构。
吻合器的内部还设置有拉片6，指针5上设置有突出部54，把手组件未旋转且拉片6向吻合器的近端移动时，拉片6可以拉动指针5的突出部54，使指针5的第一端51从第一位置区域向第二位置区域移动。在该实施例中，拉片6包括与突出部54对应的拉钩61和固定于丝杆76上的尾部62，丝杆76沿一定方向转动时，可带动拉片6向近端移动。
进一步地，指针5可以通过控制把手组件的工作状态来控制吻合器的击 发状态。在该实施例中，把手组件包括第一把手1和第二把手2，第一把手1的第一端11为握持端，第二端12与第二把手2的第一端21可旋转连接，第一把手1在外力下可沿第一方向旋转，第二把手2的第二端22与推钉杆75抵触，指针5的第一端51处于第一位置区域时，第一把手1和第二把手2不联动，第一把手1即使旋转，第二把手2也不会推动推钉杆75击发。在该实施例中，第一方向为图17和20中示出的逆时针方向，但本发明不限于此。因此，医生握持第一把手1时，可以轻易地使第一把手1旋转，但却不会触发第二把手2，同时因为此时是空击发状态，握持第一把手1的力是非常小的。医生也可以通过此操作体验了解到当前吻合器的状态是处于未击发状态，并且不会造成吻合器的机壳破裂。
指针5的第一端51处于第二位置区域时，第一把手1和第二把手2联动，第一把手1的旋转可带动第二把手2的旋转，以推动推钉杆75进入击发位置，进而驱动击发吻合器。
具体地，第一把手1具有第一腔体13，在初始状态时，第二把手2部分位于第一腔体13的内部。第一把手1上设置有滑槽41，滑槽41包括相互连通的第一段和第二段，滑槽41中可滑动设置有一滑块42，第二把手2的第二端具有把手抵触部；指针5的第一端51处于第一位置区域时，滑块42位于滑槽41的第一段，第一把手1被握持逆时针旋转时，滑块42和第二把手2不抵触，第二把手2继续进入到第一把手1的第一腔体13中；指针5的第一端51向第二位置区域移动时，指针5的第二端52会推动滑块42向滑槽41的第二段移动，滑块42会与第二把手2干涉，第一把手1逆时针旋转时，滑块42与第二把手2的把手抵触部抵触，并且推动第二把手2旋转。
需要注意的是，本发明中所述滑槽41的第一段和第二段是一个相对概念，而不一定是滑槽41的两个端部，即在图14中示出的视角中，滑槽41的第一段位于第二段的右侧。滑块42位于滑槽41的第一段时，不会与第二把手2干涉，而位于滑槽41的第二段时，将会与第二把手2干涉。
在该实施例中，第一把手1和第二把手2中同时穿设有第一销轴31，第一销轴31固定于吻合器的壳体74，且其上套设有第一扭簧32。第一扭簧32的两端分别抵触所述吻合器的壳体74和所述第二把手2，在第二把手2旋转 后，如果解除外力，第一扭簧32的恢复力可以将第二把手2复位。为了第一把手1的复位，在吻合器的壳体74内还设置有第二销轴33，第二销轴33固定于吻合器的壳体74，且其上套设有第二扭簧34。第二扭簧34的两端分别抵触吻合器的壳体74和第一把手1。
此处仅给出了把手组件的一种可选的结构，在实际应用中，把手组件可以采用其他的结构，例如不区分第一把手和第二把手，或者变更第一把手和第二把手之间的连接方式等等，均属于本发明的保护范围之内。
如图17～18示出了该实施例的吻合器位于失效状态时的结构。该状态下，拉片6未拉动指针5，因此指针5的位置没有变动，此时指针5的第一端51位于第一位置区域，滑块42仍然位于滑槽41的第一段，在第一把手1的旋转路径上，滑块42与第二把手2的把手抵触部不发生干涉。要说明的是，初始位置时滑块42在滑块复位弹簧的作用下位于滑槽41第一段的远离第二段的尽头即图示的右端位置。当然也可以是由指针5的第二端52来对滑块42的初始位置进行限位。此时，器械处于保险状态。由于第二扭簧34的扭力较击发力要小得多，第一把手1在受到操作者较小的握持力时，即可绕第一销轴31逆时针旋转时，第二把手2继续进入第一把手1的腔体内部，即第一把手1和第二把手2不联动，第二把手2不发生旋转。操作者握紧第一把手1时，可以轻易地使第一把手1旋转，但是却不会带动第二把手2的转动，也就无法完成吻合器的击发。操作者此时也能得到触觉反馈，了解到当前指针5的第一端51未达到第二位置区域，没有击发。当外力解除时，第一把手1在第二扭簧34的作用下复位。
从图18可以看出，由于指针5实际上并没有移动，因此指针5的第一端51仍然是贴合撞击部的。滑块42随第一把手1的旋转产生位移，与指针5的第二端52的相对位置发生改变。
如图19所示，当操作者准备击发吻合器时，可以将旋钮71旋转，带动丝杆76旋转，从而带动拉片6向吻合器的近端移动。拉片6的拉钩61与指针5的突出部54抵触并且拉动指针5顺时针旋转，使得指针5的第一端51从第一位置区域进入第二位置区域。
图20中示出了该实施例的吻合器位于击发状态的结构示意图。该过程 中，指针5的第二端52顺时针旋转，进而推动滑块42向滑槽41的第二段移动。在操作者握紧第一把手1时，第一把手1逆时针旋转，滑块42与把手抵触部抵触并且阻挡第二把手2继续进入第一把手1的内部腔体中。由此，第二把手2和第一把手1变成联动状态。第二把手2随第一把手1逆时针旋转，第二把手2的第二端22推动推钉杆75向吻合器的远端方向运动，完成吻合器的击发。
如图20所示，在击发的过程中，第二把手2的拉片抵触部23会与拉片6抵触，将拉片6向上顶起，使其与指针5的突出部54脱离，形成图21的状态。因此，在击发完成后，由于拉片6不再拉动指针5，指针5的第一端51会随指针复位扭簧56的恢复力而返回至第一位置区域，与撞击部发生撞击，产生撞击音，以此提示操作者已经顺利完成击发。
在操作者听到撞击音后，可以判断吻合器击发完成，进而松开第一把手1。由于指针5的第一端51返回至第一位置区域，在松开第一把手1后指针5的第二端52与滑块42脱离。然后，在失去指针5的外力后，滑块复位弹簧在恢复原状时的变形力会推动滑块42重新向滑槽41的第一段滑动，恢复到初始位置。第二把手2也在第一扭簧32的恢复力下复位。第一把手1由于是和第二把手2在滑块42的作用下啮合的，因此其首先随着第二把手2复位，同时又在第二扭簧34的作用下复位。
本发明所提供的圆管型吻合器具有下列优点：
本发明提供了一种圆管型吻合器，在吻合器本体内设置撞击部，击发时，指针的第一端从第一位置区域移动至第二位置区域，与撞击部远离，在击发完成时，指针的第一端从第二位置区域返回第一位置区域，并且会与撞击部碰撞发出撞击音，通过声音以提示操作者已经顺利完成击发，操作者可以及时掌握吻合器的击发状态，提高使用体验。
以上内容是结合具体的优选实施方式对本发明所作的进一步详细说明，不能认定本发明的具体实施只局限于这些说明。对于本发明所属技术领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干简单推演或替换，都应当视为属于本发明的保护范围。

Claims (17)

  1. 一种圆管型吻合器，其特征在于，包括吻合器本体、活动连接所述吻合器本体的把手组件以及设置于所述吻合器本体内的推钉杆，所述推钉杆具有一初始位置和一击发位置，所述把手组件可推动所述推钉杆从所述初始位置进入所述击发位置；
    所述吻合器本体内还设置有一指针和一撞击部，所述指针可旋转连接至所述吻合器本体；
    所述吻合器处于初始状态时，所述指针的第一端位于第一位置区域，所述指针的第一端与所述撞击部相对；所述吻合器处于击发状态时，所述指针的第一端移动至第二位置区域，所述指针的第一端远离所述撞击部；所述吻合器击发完成时，所述指针的第一端从所述第二位置区域返回至所述第一位置区域，且所述指针的第一端与所述撞击部碰撞并发出撞击音。
  2. 根据权利要求1所述的圆管型吻合器，其特征在于，所述吻合器本体上设有弹性限位件，所述限位件的自由端朝向并抵持于所述指针的第一端，所述指针的第一端位于第一位置区域时不与所述撞击部抵持。
  3. 根据权利要求2所述的圆管型吻合器，其特征在于，所述弹性限位件为弹簧。
  4. 根据权利要求1所述的圆管型吻合器，其特征在于，所述指针的所述第一端连接于拉片的远端，所述拉片带动所述指针的所述第一端从所述第一位置区域向所述第二位置区域移动。
  5. 根据权利要求1所述的圆管型吻合器，其特征在于，所述吻合器本体包括分别位于所述吻合器两侧的两个吻合器壳体，所述撞击部的第一端和第二端分别固定至所述两个吻合器壳体的内表面，所述撞击部的中部朝向吻合器的近端方向突出。
  6. 根据权利要求5所述的圆管型吻合器，其特征在于，各个所述吻合器壳体的内表面设置有一筋板和一固定板，所述筋板和固定板之间形成有一固定槽，所述撞击部的两端分别插设于两个所述固定槽中。
  7. 根据权利要求1所述的圆管型吻合器，其特征在于，所述撞击部为中 部朝向吻合器的近端方向弯折的金属片。
  8. 根据权利要求1所述的圆管型吻合器，其特征在于，所述撞击部为空心球或球面朝向吻合器的近端方向的半球形。
  9. 根据权利要求1所述的圆管型吻合器，其特征在于，所述撞击部包括铃铛和支架，所述铃铛通过所述支架固定于所述吻合器本体。
  10. 根据权利要求9所述的圆管型吻合器，其特征在于，所述吻合器本体包括分别位于两侧的两个吻合器壳体，所述支架的两端分别固定于两侧的所述吻合器壳体。
  11. 根据权利要求10所述的圆管型吻合器，其特征在于，所述吻合器壳体的内侧面分别开设有一凹槽，所述支架的两端分别插设于两侧的所述凹槽的内部。
  12. 根据权利要求10所述的圆管型吻合器，其特征在于，所述铃铛为下侧面开口的中空圆柱体，所述支架包括连接部以及位于连接部两侧的第一侧臂和第二侧臂，所述支架的连接部与所述铃铛的上侧面的中部固定连接，所述支架的第一侧臂的末端和第二侧臂的末端分别固定于两侧的所述吻合器壳体。
  13. 根据权利要求2所述的圆管型吻合器，其特征在于，所述指针还包括定位部，所述指针通过所述定位部可旋转固定于所述吻合器本体。
  14. 根据权利要求13所述的圆管型吻合器，其特征在于，所述指针的第一端设置有击发部，所述击发部朝向吻合器的远端突出，所述吻合器击发完成时，所述指针从所述第二位置区域返回至所述第一位置区域，所述指针的击发部与所述撞击部碰撞并发出撞击音。
  15. 根据权利要求13所述的圆管型吻合器，其特征在于，所述定位部中穿设有一定位销轴，所述定位销轴上套设有一指针复位扭簧。
  16. 根据权利要求13所述的圆管型吻合器，其特征在于，所述吻合器本体包括分别位于两侧的两个吻合器壳体，所述定位部固定于一侧的吻合器壳体，所述指针的第一端包括指示部，所述指示部朝向另一侧的吻合器壳体突出。
  17. 根据权利要求1所述的圆管型吻合器，其特征在于，所述吻合器本 体包括吻合器壳体，所述吻合器壳体与所述撞击部对应的位置开设有至少一个发声孔。
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