WO2020135564A1 - Dispositif d'anastomose médical - Google Patents

Dispositif d'anastomose médical Download PDF

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Publication number
WO2020135564A1
WO2020135564A1 PCT/CN2019/128627 CN2019128627W WO2020135564A1 WO 2020135564 A1 WO2020135564 A1 WO 2020135564A1 CN 2019128627 W CN2019128627 W CN 2019128627W WO 2020135564 A1 WO2020135564 A1 WO 2020135564A1
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WO
WIPO (PCT)
Prior art keywords
assembly
position area
guide
stapler
anvil
Prior art date
Application number
PCT/CN2019/128627
Other languages
English (en)
Chinese (zh)
Inventor
傅开芬
郭毅
陈志�
陈伟娜
王翌
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
Priority claimed from CN201822221992.7U external-priority patent/CN209347125U/zh
Priority claimed from CN201822221808.9U external-priority patent/CN209269778U/zh
Priority claimed from CN201822228095.9U external-priority patent/CN209347126U/zh
Priority claimed from CN201811613639.1A external-priority patent/CN111374729A/zh
Priority claimed from CN201822221611.5U external-priority patent/CN209347124U/zh
Priority claimed from CN201811615570.6A external-priority patent/CN111374731A/zh
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
Publication of WO2020135564A1 publication Critical patent/WO2020135564A1/fr

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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
    • 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

Definitions

  • the invention relates to the field of medical instruments, in particular to a medical stapler.
  • Medical stapler is a medical device that is often used when performing surgical suture on esophagus, intestinal tract and other digestive tracts and foreskin and other physiological tissues.
  • anastomosis the two sections of tissue are restrained, forming an annular anastomotic ring inside the tissue.
  • the body bleeding produced during the process is discharged with the contents, and the tissue is more likely to heal after the operation.
  • Existing medical staplers for treating the digestive tract, foreskin, etc. generally include an stapler body, a firing handle that is rotationally connected to the stapler body, and an anvil assembly provided at the distal end of the stapler body.
  • the stapler body includes a casing, a nail cartridge assembly provided at the distal end of the casing to cooperate with the anvil assembly, and a nail pushing rod provided in the casing and linked with the firing handle.
  • the medical stapler When the anvil assembly is closed in place, the medical stapler reaches a fireable state.
  • a general surgeon judges whether a medical stapler has reached a fireable state based on his own feeling, and fires a staple and a cutter after the medical stapler reaches a fireable state.
  • the object of the present invention is to provide a medical stapler.
  • a medical stapler including:
  • the stapler body includes a casing and a firing mechanism arranged on the casing;
  • anvil assembly the anvil assembly can move along the axial direction of the stapler body
  • the medical stapler further includes: an insurance mechanism movably provided between the anvil assembly and the firing mechanism, the insurance mechanism switches the firing mechanism between an unfireable state and a fireable state, and the Insurance institutions have:
  • the insurance component is movably arranged in the housing, and has a first position area that makes the firing mechanism in an unfireable state and a second position area that is in a fireable state;
  • a transmission member is provided between the anvil assembly and the safety assembly. During the movement of the anvil assembly in the proximal direction, the anvil assembly acts on the transmission member by driving the transmission member to move, In turn, the safety component is driven to move from the first position area to the second position area.
  • the firing mechanism includes a nail push rod movably provided in the housing, and a firing handle pivotally connected to the housing, the nail push rod can move along the axial direction of the stapler body;
  • the fuse assembly is a linkage assembly. When the linkage assembly is located in the first position area, the firing handle and the nail push rod are in an unlinked unfireable state; when the linkage assembly is located in the second position area, The firing handle and the nail pushing rod are in a fireable state that can be linked.
  • the firing handle can act on the nail push rod through the linkage assembly.
  • the stapler body also has a guide channel located in the yield space, when the linkage component is located in the first position area, the linkage component is located outside the guide channel, and the linkage component is located In the second position area, at least part of the structure of the linkage assembly extends into the guide channel.
  • the nail push rods are provided with extension walls on opposite sides in the axial direction, the extension walls protrude toward the firing handle in the axial direction, and the guide channel is formed between the extension walls.
  • first position area and the second position area are arranged along the lateral direction of the stapler body; the linkage assembly has a base movably connected in the lateral direction along the lateral direction, and the Linkage with the base.
  • the linkage is movably connected to the base and can move along the axial direction of the stapler body.
  • the first position area is closer to the axis of the stapler body than the second position area;
  • the fuse assembly has a base, connected to the base to connect with the firing mechanism With the locking portion, when the fuse assembly is in the first position area, the locking portion locks the firing mechanism, and when the fuse assembly is in the second position area, the locking portion unlocks the firing mechanism .
  • the safety mechanism further has a lateral guide structure that guides the safety assembly to move between the first position area and the second position area along the lateral direction of the stapler body.
  • the lateral guide structure includes a first guide member provided on the housing, a second guide member provided on the fuse assembly, the first guide member and the second The guides cooperate to move the safety assembly along the lateral direction of the stapler body.
  • first guide member and the second guide member are a sliding groove and a slider that cooperate with each other, and the sliding groove extends in a lateral direction of the stapler body.
  • the fuse assembly has a base movably connected to the housing, and the second guide is provided on the base.
  • the anvil assembly includes an anvil, an anvil shaft connected to the proximal end of the anvil, and a protrusion provided on the outer periphery of the anvil shaft, the protrusion acting on the transmission member to cause the transmission The piece moves proximally.
  • the transmission member includes a resisting portion sleeved on the anvil shaft, a transmission rod extending proximally from the resisting portion, and the safety component is disposed at the proximal end of the transmission rod;
  • the convex block acts on the resisting portion to drive the transmission rod to move toward the proximal end, and drives the safety component to move from the first position area to the second position area.
  • the stapler body further includes a staple cartridge assembly provided at the distal end of the housing, and a guide groove penetrating in the axial direction is provided on the staple cartridge assembly; the transmission rod is movably provided on the guide Inside the slot.
  • first position area and the second position area are arranged along the lateral direction of the stapler body;
  • the safety assembly has a base movably connected in the lateral direction along the lateral direction; the base
  • the distal end of the seat is provided with a first guide structure
  • the proximal end of the transmission rod is provided with a second guide structure adapted to the first guide structure.
  • the second position area is closer to the axis of the stapler body than the first position area;
  • the first guide structure is a first guide slope, and the first guide slope is away from the axis The distance gradually decreases from the proximal end to the distal end;
  • the second guide structure is a second guide slope, and the distance of the second guide slope from the axial center gradually decreases from the proximal end to the distal end.
  • the safety mechanism further has a guide structure for guiding the transmission member to move along the axial direction of the stapler body.
  • the shaft guide structure is a matching groove and a guide block.
  • the transmission member has a resisting portion cooperating with the anvil assembly, a transmission rod extending proximally from the resisting portion, the penetration groove is provided on the transmission rod, and the penetration The groove extends in the axial direction;
  • the stapler body further includes a staple cartridge assembly provided at the distal end of the housing, the guide block is provided on the staple cartridge assembly and at least part of the structure protrudes into the penetration slot.
  • the safety mechanism further includes a limit structure provided in the body of the stapler.
  • the limit structure limits the movement of the transmission member to the distal end.
  • the limiting structure is a first resisting surface provided at the distal end of the housing, and when the safety component is located in the first position area, the transmission member resists the first resisting surface .
  • the transmission member has a resisting portion cooperating with the anvil assembly, and a transmission rod extending proximally from the resisting portion; the transmission rod is provided parallel to the first resisting surface Moreover, when the fuse component is located in the first position area, the second abutment surface is relatively arranged, the second abutment surface and the first abutment surface conform to each other, so as to limit the distal movement of the transmission member .
  • the transmission member has a resisting portion that cooperates with the anvil assembly, and a transmission rod extending proximally from the resisting portion;
  • the stapler body further includes a staple cartridge disposed at the distal end of the housing Assembly, the nail cartridge assembly includes a nail cylinder, a limit cylinder disposed in the nail cylinder; the limit structure is disposed at a proximal end of the limit cylinder, when the safety component is located in the first position area , The resisting portion resists the limiting structure and restricts the transmission member to move to the distal end.
  • the fuse assembly has a base movably connected in the housing, the fuse mechanism further includes a reset mechanism, the reset mechanism connects the base and the housing; the reset mechanism is used to drive The safety component moves from the second position area to the first position area.
  • the reset mechanism is an elastic member connecting the fuse assembly and the housing.
  • the medical stapler is a circumcision stapler.
  • the beneficial effect of the present invention is that the medical stapler of the present invention, by providing a safety mechanism, only when the anvil assembly is closed in place, the safety mechanism will make the firing handle and the nail push rod in the firable In this state, it is possible to effectively prevent the doctor from firing the staples and cutters when the anvil assembly is not closed in place, and to prevent poorly formed staples or medical accidents.
  • FIG. 1 is a schematic diagram of the structure of a medical stapler in a first embodiment of the present invention.
  • FIG. 2 is a schematic structural view of the medical stapler shown in FIG. 1 at another angle.
  • FIG. 3 is a cross-sectional view taken along line A-A of the medical stapler of FIG. 2 when the anvil assembly is not closed in place.
  • FIG. 4 is an enlarged view at B in FIG. 3.
  • FIG. 5 is a schematic structural diagram of the insurance mechanism in FIG. 4.
  • FIG. 6 is a schematic view of the structure of the medical stapler shown in FIG. 1 after removing the housing.
  • FIG. 7 is a schematic structural view of a push rod in the medical stapler shown in FIG. 1.
  • FIG. 8 is a cross-sectional view taken along line A-A of the medical stapler of FIG. 2 after the anvil assembly is closed in place and the handle is held.
  • FIG. 9 is a cross-sectional view taken along line A-A of the medical stapler of FIG. 2 after the anvil assembly is closed in place.
  • FIG. 10 is a cross-sectional view taken along line A-A of the medical stapler of FIG. 2 after the anvil assembly is closed in place and the handle is held.
  • FIG. 11 is a schematic view of the structure of the medical stapler in the second embodiment of the present invention.
  • FIG. 12 is a cross-sectional view taken along line C-C of the medical stapler of FIG. 11 when the anvil assembly is not closed in place.
  • FIG. 13 is an enlarged view at D in FIG. 12.
  • FIG. 14 is a schematic structural view of the insurance mechanism in FIG.
  • 15 is a cross-sectional view taken along line C-C of the medical stapler of FIG. 11 when the anvil assembly is closed in place.
  • FIGS. 1 to 15 for preferred embodiments of the present invention.
  • these embodiments do not limit the present invention, and the equivalent changes or replacements of functions, methods, or structures made by those of ordinary skill in the art according to these embodiments are within the protection scope of the present invention.
  • the words used to express the position and direction described in the present invention refer to the instrument operator, the end near the instrument operator is the proximal end, and the end away from the instrument operator is the distal end;
  • the axial direction in the present invention means The longitudinal direction of a component refers to the direction perpendicular to the axial direction.
  • first, second, etc. in the present invention are used for descriptive purposes only, and cannot be understood as indicating or implying relative importance or implicitly indicating the number of technical features indicated.
  • the medical stapler 100 is used to apply a plurality of staples to the physiological tissue of the human body, while cutting the corresponding physiological organization.
  • the medical stapler 100 in the present invention is a circular tube type stapler, which is specifically described by taking the circumcision stapler used for circumcision operation as an example.
  • the circumcision stapler is used to apply multiple staples
  • the corresponding physiological tissue is cut to the physiological tissue of the human body (here, the foreskin).
  • the technical spirit involved in the following embodiments can be alternatively applied to other types of staplers, such as a round-tube stapler with double handles.
  • the circumcision stapler 100 includes an stapler body 1, an anvil assembly 2 that is axially movably connected to the stapler body 1, and a safety mechanism 3 movably disposed in the stapler body 1.
  • the stapler body 1 includes a housing 11, a firing mechanism provided on the housing 11, a staple cartridge assembly 14 provided on the distal end of the housing 11, and a proximal end provided on the housing 11 To drive the anvil assembly 2 to move the knob 15 along the axial direction of the stapler body 1.
  • the housing 11 is formed by joining two sub-housings.
  • the firing mechanism includes a nail push rod 12 movably disposed in the housing 11 and a firing handle 13 pivotally connected to the housing 11.
  • the nail push rod 12 can be along the stapler body 1. Axial movement to act on the staple cartridge assembly 14 to achieve firing of the staple and/or cutter, that is, firing of the medical stapler 100.
  • two firing handles 13 are provided symmetrically on opposite sides of the housing 11, but not limited to this, only one firing handle 13 may be provided.
  • the firing handle 13 includes a rotating portion 131 pivotally connected to the housing 11, a second engaging portion 132 for driving the push rod 12, and an operation for medical personnel to operate ⁇ 133.
  • the firing handle 13 is held, and the second engaging portion 132 directly or indirectly resists the push rod 12 to drive the push rod 12 to the distal end Directional movement to achieve firing of the circumcision stapler 100. It can be understood that the manner of linkage between the firing handle 13 and the nail push rod 12 is not limited to this.
  • the nail cartridge assembly 14 includes a nail barrel 141 provided at the distal end of the housing 11, a nail push piece 142 provided in the nail barrel 141, and a nail push piece provided in the nail barrel 141
  • the cutter on 142 and the nail magazine 143 at the distal end of the nail cylinder 141 The structures of the components in the staple cartridge assembly 14 and the cooperation relationship between them are all existing in the art, and will not be repeated here.
  • the proximal end of the nail pushing piece 142 is connected to the distal end of the nail pushing rod 12 so that the nail pushing rod 12 can drive the nail pushing piece 142 to move synchronously.
  • the anvil assembly 2 includes an anvil 21 that cooperates with the staple cartridge assembly 14 and an anvil shaft 22 connected to the proximal end of the anvil 21, and the anvil shaft 22 passes through the stapler In the body 1, and the proximal end of the anvil shaft 22 is screwed to the knob 15, by turning the knob 15, the anvil assembly 2 is driven to move along the axial direction of the stapler body 1, so that The anvil 21 moves toward or away from the staple cartridge assembly 14, and when the anvil assembly 2 is closed in place, the anvil 21 and the staple cartridge 143 clamp physiological tissue to facilitate subsequent anastomosis and cutting, And can improve the anastomosis effect.
  • the anvil shaft 22 includes a segmented anvil shaft body 221 and a screw 222, the anvil shaft body 221 is fixedly connected to the anvil 21, and the screw 222 is connected to the Anvil shaft body 221 and the knob 15.
  • the anvil body 221 and the screw 222 may also be integrally provided.
  • the distal end of the anvil assembly 2 is further provided with a glans cavity for accommodating the glans.
  • the insurance mechanism 3 is movably provided between the anvil assembly 2 and the firing mechanism in the axial direction.
  • the insurance mechanism 3 has a safety assembly 31 movably provided in the housing 11 and is provided in the axial direction.
  • the fuse assembly 31 can move in the first position area and the second position area.
  • the firing mechanism is in an unfireable state, and the fuse assembly 31 is in the second position In the area, the firing mechanism is in a fireable state.
  • the anvil assembly 2 acts on the transmission member 32 and drives the safety assembly 31 from the first position area to the second position through the transmission member 32
  • the safety assembly 31 moves to the second position area, so that the firing mechanism is in a fireable state, which is convenient for subsequent anastomotic cutting. That is, the firing mechanism can perform a firing motion only when the anvil assembly 2 is closed in place, which can effectively prevent a doctor from holding the firing handle 13 to staple and cut when the anvil assembly 2 is not closed properly
  • the firing of the knife avoids the occurrence of poorly formed staples or medical accidents.
  • the safety assembly 31 is a linkage assembly capable of switching the firing handle 13 and the push rod 12 between an unlinked first state and a second state that can be linked, That is, the second engagement portion 132 indirectly resists the nail push rod 12 for firing movement through the linkage assembly.
  • the nail push rod 12 is provided with a first engagement portion 121.
  • the second engaging portion 132 indirectly resists and pushes the push rod 12 to perform a firing movement, when the above firing mechanism is in an unfireable state, it refers to the firing handle 13 and the The push rods 12 are in a non-linked first state.
  • the second engaging portion 132 cannot directly or indirectly act on it The nail push rod 12, so that the nail push rod 12 can not be fired; accordingly, when the above firing mechanism is in a fireable state, it means that the firing handle 13 and the nail push rod 12 are in linkage In the second state, at this time, the firing handle 13 is held, and during the rotation of the firing handle 13, the second engaging portion 132 will indirectly act on the nail push rod 12 to make the nail push rod 12 Perform a firing exercise.
  • the first engaging portion 121 is disposed at the proximal end of the push rod 12.
  • the first engaging portion 121 may be disposed at the push rod 12 At any position in the axial direction of, as long as the firing handle 13 and the nail push rod 12 are in the second interlockable state, rotating the firing handle 3 can act on the first engaging portion 121 by It is sufficient to drive the push rod 12 to move distally.
  • the firing handle 13 and the push rod 12 there is a space between the firing handle 13 and the push rod 12, that is, the firing handle 13 and the push rod 12 are along the axial direction of the stapler body 1 It can be understood that the space is located between the first engaging portion 121 and the second engaging portion 132.
  • the linkage component when the linkage component is located in the first position area, the linkage component is away from the yield space, so that the firing handle 13 is in an empty firing state, that is, rotating During the firing handle 13, the second engaging portion 132 cannot directly or indirectly act on the nail push rod 12, so that the circumcision stapler 100 cannot be fired.
  • the firing handle 13 and the The push rod 12 is in an unlinked first state, that is, the firing mechanism is in an unfireable state; when the linkage assembly is located in the second position area, at least part of the structure of the linkage assembly extends into the In the yield space, the firing handle 13 can indirectly act on the nail push rod 12 through at least part of the structure of the linkage assembly.
  • the firing handle 13 and the nail push rod 12 are in the interlockable third Two states, that is, the firing mechanism is in a fireable state, and by rotating the firing handle 13 to act on the linkage assembly, the nail push rod 12 can be driven to move in a distal direction to fire the staple and cutter .
  • first position area and the second position area are arranged along the lateral direction of the stapler body 1, and in this embodiment, the second position area is defined relative to the The first position area is closer to the axis of the stapler body 1, that is, the second position area is closer to the push rod 12 than the first position area.
  • first position area and the second position area are arranged along the lateral direction of the stapler body 1, and in this embodiment, the second position area is defined relative to the The first position area is closer to the axis of the stapler body 1, that is, the second position area is closer to the push rod 12 than the first position area.
  • the linkage assembly has a base 311 movably connected to the housing 11 and a linkage 312 cooperating with the base 311.
  • the base 311 can move in the lateral direction. 2
  • the anvil assembly 2 acts on the transmission member 32 to drive the base 311 to move in the lateral direction, and the base 311 pushes the linkage member 312 to make the linkage member
  • At least part of the structure of 312 extends into the yield space, so that the firing handle 13 and the nail push rod 12 are switched to the second state, that is, the firing handle 13 can be indirectly driven by the linkage 312
  • the nail push rod 12 performs a firing movement to facilitate subsequent firing.
  • the linking member 312 is movably connected to the base 311, and the linking member 312 can move along the axial direction of the stapler body 1, in When the linkage assembly is located in the second position area, at least a part of the structure of the linkage member 312 is located in the yield space to engage the first engagement portion 121 and the second engagement portion 132. Holding the firing handle 13, the firing handle 13 pushes the linkage 312 to move in the distal direction, and the linkage 312 drives the push rod 12 to move in the distal direction to fire the staple and Cutter.
  • the linking member 312 may also be movably connected to the push rod 12. It can be understood that as long as the linking member 312 is arranged to be able to move laterally in the first position area and the first It is only necessary to move between the two positions and can move in the distal direction in synchronization with the nail push rod 12.
  • the stapler body 1 further has a guide channel 18 located in the yield space, that is, the guide channel 18 is located between the first engaging portion 121 and the second engaging portion 132, the linkage
  • the guide channel 18 guides the linkage 312 to move in the lateral direction of the stapler body 1 and restricts the position of the linkage 312.
  • the linkage assembly is located in the second position area, at least part of the structure of the linkage member 312 is located in the guide channel 18 to engage the first engagement portion 121 and the second engagement portion 132 to achieve
  • the linkage between the firing handle 13 and the nail push rod 12, and during the rotation of the firing handle 13, the guide channel 18 can limit the shaking of the linkage 312 to make the firing movement more stable.
  • the linkage member 312 when the linkage assembly is located in the first position area, the linkage member 312 is located outside the guide channel 18, so that the first engagement portion 121 and the second engagement portion 132 At intervals, the firing handle 13 and the nail push rod 12 are in a first state.
  • the first engaging portion 121 has extending walls 122 on opposite sides in the axial direction, and the extending wall 122 protrudes toward the second engaging portion 132 along the circumferential direction,
  • the guide channel 18 is formed between the extension walls 122.
  • the circumcision stapler 100 has two insurance mechanisms 3 that respectively cooperate with the firing handle 13, and the two insurance mechanisms 3 are divided On the opposite sides of the nail push rod 12, and two safety mechanisms 3 are provided integrally to enhance the effect of the safety mechanism 3.
  • the specific number of the insurance institutions 3 is not limited to the above two, and may be set according to specific conditions; or the two insurance institutions 3 may be set separately.
  • the safety mechanism 3 further includes a lateral guide structure 4 for guiding the safety component 31 to move in the lateral direction of the stapler body 1, so that the transmission member 32 can drive the safety component 31 in the lateral direction Movement between the first position area and the second position area enhances the stability of the movement of the insurance component 31 and enhances the insurance effect of the insurance component 31.
  • the lateral guide structure 4 is provided between the fuse assembly 31 and the housing 11, and the lateral guide structure 4 includes a first guide member provided on the housing And a second guide provided on the fuse assembly 31, the first guide and the second guide cooperate, so that the fuse assembly 31 is along the stapler body 1 Lateral movement.
  • the safety component 31 is a linkage component and has a base 311 movably connected in the housing 11 and a linkage 312 cooperating with the base 311, the second guide Set on the base 311.
  • two lateral guide structures 4 arranged symmetrically with each other are provided between the insurance component 31 and the housing 11 to further enhance the stability of the lateral movement of the insurance component 31,
  • the lateral guiding structure 4 may be provided only on one side of the fuse assembly 31.
  • the first guide member and the second guide member are a sliding groove 41 and a slider 42 that cooperate with each other, and the sliding groove 41 extends along the lateral direction of the stapler body 1, In order to slidingly connect the safety assembly 31 to the housing 11 in the lateral direction.
  • the lateral guiding structure 4 only needs to be configured to be able to slidely connect the safety assembly 31 to the housing 11 in the lateral direction.
  • the slider 42 is provided on the fuse assembly 31, that is, on the base 311, and the slide slot 41 is provided on the housing 11, of course, this is not the case
  • the slider 42 may be protrudingly provided on the housing 11, and at this time, the sliding groove 41 is provided on the safety component 31.
  • the transmission member 32 is movably disposed in the stapler body 1, and when the anvil assembly 2 moves in the proximal direction, the anvil assembly 2 acts on the transmission member 32 to drive the transmission member 32 toward the proximal end, the transmission member 32 drives the linkage assembly to move from the first position area to the second position area, converts the axial movement of the transmission member 32 into the lateral movement of the linkage assembly, and
  • the anvil assembly 2 is closed in place, at least part of the structure of the linking member 312 extends into the guide channel 18 to realize the linkage between the firing handle 13 and the nail push rod 12, so that only When the anvil assembly 2 is closed in place, the firing handle 13 and the nail pushing rod 12 are in the second state, that is, the firing handle 13 and the nail pushing rod 12 can only be linked, and at this time,
  • the circumcision stapler 100 is in a fireable state, which can effectively prevent the doctor from holding the firing handle 13 when the anvil assembly 2 is not closed in position, and firing the staples and the cutter to avoid poor formation
  • the above-mentioned firable state means that the anvil assembly 2 is closed in place, so that the foreskin to be cut of the staple cartridge assembly 14 and the anvil 21 has been clamped in place, and the firing handle 13 and the push rod 12 is also in the state in the second state that can be linked.
  • the transmission member 32 is located between the anvil assembly 2 and the base 311, and when the anvil assembly 2 moves in the proximal direction, the anvil assembly 2 acts on the The transmission member 32 drives the base 311 to move to the second position region in the lateral direction through the transmission member 32 to drive the linkage member 312 to extend into the guide channel 18.
  • the anvil assembly 2 further includes a protrusion 23 provided on the outer periphery of the anvil shaft 22, and the transmission member 32 is provided on the proximal end of the protrusion 23 when the anvil assembly 2 moves toward the proximal end ,
  • the protrusion 23 resists the transmission member 32 and drives the transmission member 32 to move proximally.
  • the transmission member 32 is sleeved on the anvil shaft 22, and the protrusion 23 is ring-shaped to resist the transmission member 32.
  • the protrusion 23 may not be provided in a ring shape. It can be understood that the protrusion 23 only needs to be able to resist the transmission member 32.
  • the protrusion 23 may be provided on the outer periphery of the anvil shaft body 221 or on the wire The outer circumference of the rod 222.
  • the outer diameter of the anvil shaft body 221 is generally larger than the outer diameter of the screw rod 222. Therefore, in the embodiment where the protrusion 23 is provided on the outer periphery of the anvil shaft body 221, the The protrusion 23 may be a part of the anvil shaft body 221.
  • the protrusion 23 is the proximal end of the anvil shaft body 221.
  • the anvil The proximal end of the shaft body 221 abuts on the transmission member 32, and pushes the transmission member 32 and the anvil assembly 2 to move in the proximal direction synchronously to drive the linkage assembly from the first position area to the first Two position area movement.
  • the protrusion 23 may also be provided at other parts of the anvil shaft body 221 in the axial direction, as long as the anvil assembly 2 moves in the proximal direction, the protrusion 23 It suffices to drive the transmission member 32 to move synchronously in the proximal direction.
  • the transmission member 32 includes a resisting portion 321 sleeved on the anvil shaft 22, a transmission rod 322 extending proximally from the resisting portion 321, the resisting portion 321 and the protrusion
  • the blocks 23 are matched against each other.
  • the protrusion 23 resists against the resisting portion 321, driving the transmission rod 322 to move toward the proximal end, driving the linkage assembly Movement from the first location area to the second location area.
  • the staple cartridge assembly 14 is provided with a guide slot 144 that is axially penetrated, and the transmission rod 322 enters the housing 11 from the inside of the staple cartridge assembly 14 through the guide slot 144, Cooperating with the base 311, that is, the proximal end of the transmission rod 322 is in abutting cooperation with the base 311.
  • the inner side of the staple cartridge assembly 14 refers to the side of the staple cartridge assembly 14 close to the axis of the staple cartridge assembly 14, and more specifically, the nail pusher 142 is close to its axis Side. It can be understood that the guide groove 144 simultaneously penetrates the nail cylinder 141 and the nail pushing piece 142 so that the transmission rod 322 can pass through the guide groove 144 from the inside of the nail cartridge assembly 14 Into and out of the housing 11.
  • the transmission rod 322 moves along the guide groove 144 to guide and limit the movement of the transmission member 32.
  • the safety mechanism also has an axial guide structure for guiding the transmission member 32 to move along the axial direction of the stapler body 1.
  • the axial guide structure is provided between the transmission member 32 and the stapler body 1.
  • the axial guide structure is a through slot 3221 and a guide block 1411 that cooperate with each other.
  • the slot 3221 moves along the guide block 1411 to guide and limit the movement of the transmission member 32.
  • the guide block 1411 is provided on the staple cartridge assembly 14, and at least part of the structure of the guide block 1411 protrudes into the through slot 3221.
  • the through slot 3221 is provided on The transmission rod 322 extends in the axial direction to guide the transmission member 32 to move in the axial direction and enhance the stability of the transmission member 32 movement.
  • the transmission rod 322 extends in the axial direction to guide the transmission member 32 to move in the axial direction and enhance the stability of the transmission member 32 movement.
  • the guide block 1411 is provided on the staple cartridge assembly 14, and at least part of the structure of the guide block 1411 protrudes into the through slot 3221.
  • the through slot 3221 is provided on The transmission rod 322 extends in the axial direction to guide the transmission member 32 to move in the axial direction and enhance the stability of the transmission member 32 movement.
  • the transmission rod 322 extends in the axial direction to guide the transmission member 32 to move in the axial direction and enhance the stability of the transmission member 32 movement.
  • the guide block 1411 is disposed on the nail barrel 141 and is located in the guide groove 144, that is, the guide block 1411 divides the guide groove 144 into two independent guides A slot for the transmission rod 322 to pass through.
  • the guide block 1411 may also be provided on the housing 11 as long as it can guide and cooperate with the through slot 3221.
  • the resisting portion 321 and the transmission rod 322 are detachably connected to facilitate the assembly of the transmission member 32 into the stapler body 1.
  • the transmission rod 322 may be fixedly connected to the resisting portion 321.
  • the two transmission members 32 share one resisting portion 321, and the resisting portion 321 is sleeved on the anvil On the shaft 22, and the two transmission rods 322 are connected to opposite ends of the resisting portion 321, and when the anvil assembly 2 moves in the proximal direction, the anvil assembly 2 acts on the resisting On the portion 321, the two transmission rods 322 are driven to move in the proximal direction synchronously, and the corresponding fuse assembly 31 is synchronously driven to move to the second position area.
  • the drive of the anvil assembly 2 can drive the two transmission members 32 to move synchronously in the proximal direction.
  • a first guide structure 313 is provided on the linkage assembly
  • a second guide structure 323 adapted to the first guide structure 313 is provided on the transmission member 32
  • the proximal end of the transmission member 32 During movement, the first guide structure 313 and the second guide structure 323 cooperate to move the linkage assembly 31 to the second position area in the lateral direction.
  • a guide structure may be provided on the linkage assembly 31 or the transmission member 32, as long as the relative movement between the transmission member 32 and the linkage assembly 31 can be guided.
  • first guide structure 313 is provided at the distal end of the base 311, and the second guide structure 323 is provided at the proximal end of the transmission rod 322.
  • first guide structure 313 is provided at the distal end of the base 311
  • second guide structure 323 is provided at the proximal end of the transmission rod 322.
  • the first guide structure 313 is a first guide slope
  • the second guide structure 323 is a second guide slope, that is, the base 311 and the transmission rod 322
  • the guide slopes are used to match, the structure is relatively simple, and the cooperation is stable. Of course, not limited to this.
  • the first guide slope and the second guide slope are away from the axis
  • the distance of the center is gradually reduced from the proximal end to the distal end.
  • the staple cartridge assembly 14 further includes a limit cylinder 145 provided in the staple cartridge 141, and when the anvil assembly 2 moves along the axial direction of the stapler body 1, the anvil assembly 2 moves along The movement of the limiting cylinder 145 can guide the movement of the anvil assembly 2 to prevent the anvil assembly 2 from shaking during the movement.
  • the transmission member 32 is located at the proximal end of the limiting cylinder 145.
  • the anvil shaft 22 has an anvil shaft body 221 and a screw rod 222 arranged in sections, in the proximal direction of the anvil assembly 2 During the movement, the proximal end of the anvil shaft body 221 penetrates from the proximal end of the limiting cylinder 145 and acts on the transmission member 32 to push the transmission member 32 in synchronization with the anvil assembly 2 The proximal direction moves to drive the linkage assembly 31 to move from the first position area to the second position area.
  • a first matching portion 223 is provided on the anvil shaft body 221, and a second matching portion 1451 is provided on the limiting cylinder 145.
  • the first matching portion 223 is The second engaging portion 1451 cooperates to restrict the anvil assembly 2 from continuing to move in the proximal direction to prevent over-tightening of the closure, so as not to over-press the foreskin tissue.
  • the first engaging portion 223 is a stepped portion provided at the distal end of the anvil shaft body 221, and the second engaging portion 1451 is the distal end surface of the limiting cylinder 145.
  • the proximal end surface of the step portion bears against the distal end surface of the limiting cylinder 145 to restrict the anvil assembly 2 from continuing to move in the proximal direction to prevent over-tightening so as not to The foreskin tissue is over-squeezed.
  • the second matching portion 1451 may also be provided at the proximal end of the limiting cylinder 145 and protrude toward the centerline of the limiting cylinder 145; it can be understood that The first engaging portion 223 and the second engaging portion 1451 only need to be configured to restrict the anvil assembly 2 from continuing to move in the proximal direction when the anvil assembly 2 is closed in place.
  • the safety mechanism 3 further includes a reset mechanism 33, and during the movement of the anvil assembly 2 in the distal direction, the reset mechanism 33 drives the linkage assembly from the second position area to the first position The area moves to switch the firing handle 13 and the nail push rod 12 to the first state to prevent accidental firing.
  • the reset mechanism 33 is located between the housing and the base 311 to drive the base 311 in a lateral direction
  • the movement of the first position area drives the linkage 312 to move synchronously away from the guide channel 18.
  • the reset mechanism 33 can be disposed between the linking member 312 and the push rod 12
  • the reset mechanism 33 can drive the linkage 312 away from the guide channel 18, so that the firing handle 13 and the push The nail bar 12 is switched to the first state to prevent accidental firing.
  • the reset mechanism 33 is an elastic member connecting the base 311 and the housing 11, preferably a tension spring.
  • the reset mechanism 33 may also be It is a structure such as an elastic block, as long as it can drive the linkage assembly to move from the second position area to the first position area.
  • the tension spring gradually stretches, so that when the anvil assembly 2 moves in the distal direction, the transmission member 32 cancels the application
  • the pressure on the linkage assembly 31 is driven by the biasing force of the tension spring, the linkage assembly moves from the second position area to the first position area, and at the same time, the linkage assembly drives the transmission member 32 moves in the distal direction.
  • the safety mechanism 3 further includes a limit structure 35 provided in the stapler body 1, and when the safety component 31 is located in the first position area, the limit structure 35 is used to limit the transmission The member 32 moves distally to enhance the stability of the transmission member 32, so that when the transmission member 32 moves proximally, it can act on the safety assembly 31.
  • the limiting structure 35 includes a first resisting surface provided at the distal end of the housing 11, and when the linkage assembly is located in the first position area, the transmission rod 322 resists the first The abutment surface restricts the distal movement of the transmission member 32.
  • the transmission rod 322 is provided with a second abutment surface 3222 parallel to and opposite to the first abutment surface.
  • the The second abutting surface 3222 is in conformity with the first abutting surface, restricting the movement of the transmission member 32 to the distal end, and at the same time, enhancing the stability of the transmission member 32.
  • the position-limiting mechanism 35 further includes a receiving portion 351 provided at the proximal end of the nail barrel 145, and at least part of the structure of the resisting portion 321 is received when the safety component 31 is located in the first position area In the receiving portion 351, and the resisting portion 321 resists the proximal end of the nail barrel 145, restricting the transmission member 32 to move distally, and also restricting the transmission member 32 from rotating.
  • a first return spring 16 is sleeved on the nail push rod 12, and is in a second state between the firing handle 13 and the nail push rod 12, holding the firing handle 13 to drive the During the movement of the push rod 12 in the distal direction, the first return spring 16 is gradually compressed. When the holding force exerted on the firing handle 13 is cancelled, driven by the biasing force of the first return spring 16, the push rod 12 is returned to the initial position proximally.
  • a convex portion may be provided on the nail push rod 12, the proximal end of the first return spring 16 bears against the convex portion, and the distal end of the first return spring 16 bears against the nail
  • the nail barrel of the cartridge assembly 14 is not limited to this.
  • the distal end of the first return spring 16 can also bear against the housing 11 as long as the first return spring 16 can be far away The end position is sufficient.
  • the convex portion is a part of the first engaging portion 121 to simplify the structure of the push rod 12, in this case, the first engaging portion 121 (convex portion) is provided on the push nail In the embodiment of the proximal end of the rod 12, the nail push rod 12 is T-shaped from the proximal end to the distal end. Of course, not limited to this.
  • a second reset elastic member 17 is provided between the firing handle 13 and the housing 11, and in the process of holding the firing handle 13 to rotate the firing handle 13, the second reset elasticity The piece 17 is gradually compressed, and when the holding force exerted on the firing handle 13 is cancelled, the firing handle 13 is reset to the initial position under the action of the biasing force of the second return elastic member 17.
  • the second reset elastic member 17 is a spring. Of course, it is not limited thereto, and the second reset elastic member 17 may also be an elastic block.
  • the insurance mechanism 3 is provided with a marking portion 34, and the casing 11 is provided with an observation port 111 through which the marking portion 34 is exposed to observe the position of the insurance mechanism 3, so that medical personnel The position of the safety mechanism 3 can be intuitively recognized through the observation port 111, so as to determine whether the anvil assembly 2 is closed in place.
  • the marking portion 34 includes a first marking portion 341 spaced apart and a second marking portion 342 different from the first marking portion 341.
  • the first marking portion 341 is exposed from the observation port 111; when the insurance mechanism 3 is located in the second position area, the second marking portion 342 is exposed from the observation port 111, so that medical personnel can pass through the The observation port 111 intuitively recognizes the position of the safety mechanism 3, so as to determine whether the anvil assembly 2 is closed in place.
  • the marking portion 34 is provided on the base 311, and the first marking portion 341 and the second marking portion 342 are provided on the base 311 along the horizontal interval at the base When the seat 311 moves laterally, the first marking portion 341 or the second marking portion 342 can be exposed to the observation port 111.
  • the marking portion 34 may also be provided on the transmission rod 322.
  • the first marking portion 341 and the second marking portion 342 are spaced apart in the axial direction On the transmission rod 322, when the transmission rod 322 moves in the axial direction, the first marking portion 341 or the second marking portion 342 can be exposed from the observation port 111.
  • the first marking portion 341 is red, and the second marking portion 342 is green; of course, it is not limited to this, and the first marking may be distinguished by other colors or other methods, such as patterns, etc. 341 and the second marking portion 342.
  • the first marking portion 341 and the second marking portion 342 may be It is provided on the slider 42 to simplify the structure of the base 311.
  • this is the second embodiment of the medical stapler of the present invention.
  • the second engaging portion 132 directly resists the push Nail bar 12, when the safety assembly 31 is in the first position area, the anvil assembly 2 is not closed in place, at this time, the safety assembly 31 locks the firing mechanism, and at this time, the firing mechanism is in an unfireable position
  • the insurance component 31 unlocks the firing mechanism, and at this time, the firing mechanism is in a fireable state.
  • the first position area is closer to the axis of the stapler body 1 than the second position area, that is, the first position area is closer to the second position area
  • the push rod 12 the distance between the first guide slope and the second guide slope from the axis is gradually increased from the proximal end to the distal end, so that when the transmission member 32 moves toward the proximal end, it can drive the The fuse assembly 31 moves from the first position area to the second position area further away from the axis.
  • the safety assembly 31 further has a locking portion 314 that protrudes from the base 311 toward the firing mechanism.
  • the locking portion 314 locks the push rod 12 to restrict the distal movement of the push rod 12. It can be understood that at this time, Even if a rotational force is applied to the firing handle 13, the locking portion 314 restricts the movement of the nail push rod 12 in the distal direction, so the firing handle 13 against the nail push rod 12 cannot rotate.
  • the locking portion 314 may also be configured to lock the firing handle 13 to restrict the firing handle 13 from rotating, thereby indirectly preventing the push pin Rod 12 is fired.
  • the nail push rod 12 further has a resisting block 123 that cooperates with the locking portion 314.
  • the safety assembly 31 is located in the first position area, and the The locking portion 314 resists the distal end of the resisting block 123, locks the nail push rod 12, and prevents the firing movement of the nail push rod 12.
  • the locking manner by which the locking portion 314 locks the push rod 12 is not limited to this, for example, the locking portion 314 may be provided as a groove, and the fuse assembly 31 is located at the first position In the area, at least part of the structure of the resisting block 123 is accommodated in the locking portion 314 (groove) to lock the push rod 12; or a limiting groove is directly provided on the push rod 12, When the safety assembly 31 is in the first position, at least a part of the structure of the locking portion 314 is limited in the limiting groove to lock the nail push rod 12.
  • the resisting block 123 is provided at the proximal end of the push rod 12 and extends in the lateral direction, and the locking portion 314 extends from the base 311 in the proximal direction to form Cooperate with the resisting block 123.
  • the resisting block 123 may also be connected to any other position in the longitudinal direction of the push rod 12 as long as the anvil assembly 2 is not closed in place, it can be connected to the locking portion 314 is matched, and the nail push rod 12 can be locked.
  • the firing mechanism is unlocked, and the nail push rod 12 can be fired to fire the staples and/or cutters. It can be understood that when the safety assembly 31 is located in the second position area, the locking portion 314 is not on the movement path of the push rod 12 nor on the rotation path of the firing handle 13, so that The firing handle 13 can be rotated to drive the nail push rod 12 to perform a firing motion to complete the firing of the medical stapler 100.
  • the medical stapler 100 of the present invention by providing the safety mechanism 3, only when the anvil assembly 2 is closed in place, the safety mechanism 3 will make the firing mechanism in a fireable state, It can effectively prevent the doctor from firing the staples and the cutter when the anvil assembly 2 is not closed properly, thereby avoiding the occurrence of poorly formed staples or medical accidents.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif d'anastomose médical (100), comprenant un corps de dispositif d'anastomose (1) ayant un mécanisme de déclenchement, un composant d'enclume (2), et un mécanisme de sécurité (3). Le mécanisme de sécurité (3) est pourvu d'un élément de sécurité (31) et d'un élément d'entraînement (32). Lorsque le composant d'enclume (2) se déplace vers la direction d'extrémité proximale, celui-ci agit sur l'élément d'entraînement (32) de sorte que le composant de sécurité (31) est amené à se déplacer d'une zone de première position dans laquelle le mécanisme de déclenchement est dans un état désactivé à une zone de seconde position dans laquelle le mécanisme de déclenchement est dans un état activé. Un mécanisme de sécurité (3) est disposé dans le dispositif d'anastomose médical (100) pour empêcher efficacement le déclenchement du dispositif d'anastomose médical (100) lorsque le composant d'enclume (2) n'est pas bien fermé.
PCT/CN2019/128627 2018-12-27 2019-12-26 Dispositif d'anastomose médical WO2020135564A1 (fr)

Applications Claiming Priority (12)

Application Number Priority Date Filing Date Title
CN201822228095.9 2018-12-27
CN201822221808.9 2018-12-27
CN201822221992.7U CN209347125U (zh) 2018-12-27 2018-12-27 医用吻合器
CN201822221808.9U CN209269778U (zh) 2018-12-27 2018-12-27 医用吻合器
CN201822228095.9U CN209347126U (zh) 2018-12-27 2018-12-27 医用吻合器
CN201811615570.6 2018-12-27
CN201811613639.1A CN111374729A (zh) 2018-12-27 2018-12-27 医用吻合器
CN201822221611.5 2018-12-27
CN201822221611.5U CN209347124U (zh) 2018-12-27 2018-12-27 医用吻合器
CN201811615570.6A CN111374731A (zh) 2018-12-27 2018-12-27 医用吻合器
CN201811613639.1 2018-12-27
CN201822221992.7 2018-12-27

Publications (1)

Publication Number Publication Date
WO2020135564A1 true WO2020135564A1 (fr) 2020-07-02

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ID=71129171

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2019/128627 WO2020135564A1 (fr) 2018-12-27 2019-12-26 Dispositif d'anastomose médical

Country Status (1)

Country Link
WO (1) WO2020135564A1 (fr)

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090173767A1 (en) * 2008-01-09 2009-07-09 Milliman Keith L Raised Boss for Staple Guide
CN102697532A (zh) * 2012-06-05 2012-10-03 北京中法派尔特医疗设备有限公司 一种具有新型保险装置的吻合器
CN103987330A (zh) * 2011-12-16 2014-08-13 伊西康内外科公司 重新接合组织缝合器的安全开关的结构
CN205041502U (zh) * 2015-09-30 2016-02-24 天津天耀金属制品有限公司 一种带区间保险的包皮环切吻合器
CN106037890A (zh) * 2016-08-03 2016-10-26 重庆爱众医疗器械有限公司 一种一次性使用包皮切割吻合器
CN106963442A (zh) * 2017-05-05 2017-07-21 江苏孜航精密五金有限公司 一次性肛肠选择切割吻合器
CN209269779U (zh) * 2018-12-27 2019-08-20 苏州天臣国际医疗科技有限公司 医用吻合器
CN209269778U (zh) * 2018-12-27 2019-08-20 苏州天臣国际医疗科技有限公司 医用吻合器
CN209347126U (zh) * 2018-12-27 2019-09-06 苏州天臣国际医疗科技有限公司 医用吻合器
CN209347125U (zh) * 2018-12-27 2019-09-06 苏州天臣国际医疗科技有限公司 医用吻合器
CN209347124U (zh) * 2018-12-27 2019-09-06 苏州天臣国际医疗科技有限公司 医用吻合器

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090173767A1 (en) * 2008-01-09 2009-07-09 Milliman Keith L Raised Boss for Staple Guide
CN103987330A (zh) * 2011-12-16 2014-08-13 伊西康内外科公司 重新接合组织缝合器的安全开关的结构
CN102697532A (zh) * 2012-06-05 2012-10-03 北京中法派尔特医疗设备有限公司 一种具有新型保险装置的吻合器
CN205041502U (zh) * 2015-09-30 2016-02-24 天津天耀金属制品有限公司 一种带区间保险的包皮环切吻合器
CN106037890A (zh) * 2016-08-03 2016-10-26 重庆爱众医疗器械有限公司 一种一次性使用包皮切割吻合器
CN106963442A (zh) * 2017-05-05 2017-07-21 江苏孜航精密五金有限公司 一次性肛肠选择切割吻合器
CN209269779U (zh) * 2018-12-27 2019-08-20 苏州天臣国际医疗科技有限公司 医用吻合器
CN209269778U (zh) * 2018-12-27 2019-08-20 苏州天臣国际医疗科技有限公司 医用吻合器
CN209347126U (zh) * 2018-12-27 2019-09-06 苏州天臣国际医疗科技有限公司 医用吻合器
CN209347125U (zh) * 2018-12-27 2019-09-06 苏州天臣国际医疗科技有限公司 医用吻合器
CN209347124U (zh) * 2018-12-27 2019-09-06 苏州天臣国际医疗科技有限公司 医用吻合器

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