WO2021077513A1 - Instrument chirurgical - Google Patents

Instrument chirurgical Download PDF

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Publication number
WO2021077513A1
WO2021077513A1 PCT/CN2019/119606 CN2019119606W WO2021077513A1 WO 2021077513 A1 WO2021077513 A1 WO 2021077513A1 CN 2019119606 W CN2019119606 W CN 2019119606W WO 2021077513 A1 WO2021077513 A1 WO 2021077513A1
Authority
WO
WIPO (PCT)
Prior art keywords
cutting knife
cutting
staple cartridge
nail
groove
Prior art date
Application number
PCT/CN2019/119606
Other languages
English (en)
Chinese (zh)
Inventor
张翚
杜运峰
刘殿臣
Original Assignee
苏州英途康医疗科技有限公司
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 CN201911134668.4A external-priority patent/CN111466981B/zh
Application filed by 苏州英途康医疗科技有限公司 filed Critical 苏州英途康医疗科技有限公司
Publication of WO2021077513A1 publication Critical patent/WO2021077513A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0023—Surgical instruments, devices or methods, e.g. tourniquets disposable
    • 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
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter

Definitions

  • the invention relates to a surgical instrument.
  • the linear cutting stapler is a surgical tool that is often used to complete the cutting and anastomosing function of the tissue. It is a device used in medicine to replace manual suture.
  • the existing linear cutting stapler passes The firing push rod pushes the nail pusher arranged in the staple cartridge to start the firing action of the titanium nails.
  • the firing push rod and the cutting knife push rod move at the same time.
  • the squeezing of the titanium nails does not form a staple shape.
  • the immediate cutting action pulls the sutured tissue to cause tissue displacement, which affects the height and consistency of the staples.
  • the purpose of the present invention is to provide a surgical instrument for realizing nailing first and then cutting.
  • a surgical instrument comprising a handle, a nail anvil assembly and a nail cartridge bracket arranged side by side at one end of the handle and oppositely arranged, and a nail mounted on the nail cartridge bracket Cartridge assembly, a closing pressing rod provided on the handle for driving the nail anvil and the staple cartridge support to close, a nail pushing rod and a knife rod provided in the handle, and a knife rod provided on the handle
  • a drive assembly that drives the nail push rod and the knife rod to move along the lengthwise direction of the nail anvil assembly, the nail anvil assembly or the nail cartridge assembly is provided with a cutting knife, and the nail anvil assembly and the nail cartridge assembly are both It has a suture surface, the staple cartridge component and the staple anvil component both have opposite distal and proximal ends, the proximal end is arranged closer to the handle than the distal end, and the driving component drives the push nail Rod and the knife rod move, and when the knife rod is close to the distal end, the cutting
  • the staple cartridge assembly includes a staple cartridge body and suture staples arranged in the staple cartridge body, a staple pusher that pushes the staples, a pusher block that pushes the staples, and a cutting blade holder body ,
  • the cutting knife holder body is arranged at the distal end of the staple cartridge body, the cutting knife is arranged on the cutting knife holder, and the cutting knife holder body includes a side plate and a butt joint for clamping and cooperating with the knife bar Part, when the driving assembly drives the push rod to move to the distal end, the push rod drives the pull rod to move to the distal end, so that the pull rod and the cutting tool holder The body clamps and fits.
  • the staple cartridge body includes a staple cartridge suture surface for contacting the sutured tissue, and an elastic member is formed on the side plate for driving the cutting blade to not protrude from the staple cartridge suture surface, After the knife rod is butted with the cutting knife holder body, the elastic member is driven to deform so that the cutting edge of the cutting knife protrudes out of the suture surface of the staple cartridge.
  • an elastic member is formed on the side plate to drive the blade of the cutting knife to not protrude from the cutting knife holder body.
  • a rotating shaft is arranged on the side plate, the cutting knife is sleeved on the rotating shaft, and the elastic member is a torsion spring sleeved on the rotating shaft.
  • the butting portion is formed on the side plate.
  • the side plates are two oppositely arranged, and a butting groove for accommodating the cutting knife is formed between the two side plates.
  • the butting portion is an elastic buckle formed by bending from the side plate toward the butting groove.
  • the broaching rod is provided with a slot that matches with the elastic buckle.
  • the nail anvil assembly includes a nail anvil body, a cutting knife holder body arranged in the nail anvil body, the cutting knife is arranged on the cutting knife holder body, and the cutting knife holder body is arranged on the At the distal end of the nail anvil body, the cutting blade holder body includes a side plate and a butting portion that is engaged with the broach bar, and the nail anvil body is formed with a cutting tool extending along the longitudinal direction of the nail anvil body. Groove, after the knife rod is butted with the cutting knife holder body, the knife rod pulls the cutting knife holder body and the cutting knife to move from the distal end to the proximal end in the cutting groove.
  • the anvil body includes an anvil suture surface for contacting with the sutured tissue, and an elasticity is formed on the side plate for driving the cutting blade to not protrude from the anvil suture surface.
  • the side plates are two oppositely arranged, and a butting groove for accommodating the cutting knife is formed between the two side plates.
  • a rotating shaft is provided on the side plate, and the cutting knife is sleeved on the rotating shaft.
  • the butting portion is an elastic buckle formed by bending from the side plate toward the butting groove, and a groove for engaging with the elastic buckle is formed on the broach bar.
  • the cutting groove includes an accommodating portion disposed near the distal end and a sliding portion extending from the accommodating portion toward the proximal end, and the groove width of the accommodating portion is larger than the groove width of the sliding portion,
  • the suture surface of the nail anvil assembly is a suture surface of the nail anvil used to contact the sutured tissue; a cutting groove is formed in the longitudinal direction of the nail anvil assembly, and a pushing portion is formed in the cutting groove, The pushing portion is located on a side of the cutting groove close to the distal end; the knife rod has a movable end inserted into the cutting groove and movable in the cutting groove, and the movable end is movably provided with A cutting knife, the cutting knife and the movable end are connected by a rotating shaft, and the cutting knife can be turned relative to the movable end around the rotating shaft; a formation is formed between the movable end and the cutting knife to keep the cutting knife at In the first position and the second position of the clamping assembly, when the cutting knife is in the first position, the blade of the cutting knife does not protrude from the suture surface of the nail anvil; when the cutting knife is in the second position, The cutting edge of the cutting knife protrudes from the suture surface of the nail anvil
  • a pushing groove corresponding to the cutting groove is provided on the staple cartridge assembly.
  • the staple cartridge assembly includes a staple cartridge body and suture staples arranged in the staple cartridge body, a staple pusher that pushes the staples, and a pusher block that pushes the staples.
  • the suture surface of the component is the suture surface of the staple cartridge that is in contact with the sutured tissue;
  • a pushing groove is formed in the longitudinal direction of the staple cartridge body, and a pushing portion is formed in the pushing groove, and the pushing portion is located on the side of the pushing groove close to the distal end;
  • the movable end in the advancing groove and movable in the advancing groove, the movable end is movably provided with a cutting knife, and the cutting knife is connected with the movable end through a rotating shaft, and the cutting knife can rotate around the rotating shaft.
  • a clamping assembly is formed between the movable end and the cutting knife to keep the cutting knife in the first position and the second position.
  • the cutting knife When the cutting knife is in the first position, the The blade of the cutting knife does not protrude beyond the suture surface of the staple cartridge; when the cutting knife is in the second position, the blade of the cutter protrudes beyond the suture surface of the staple cartridge; a pushing portion is formed in the pushing groove, so The knife bar pushes the cutting knife to touch the pushing portion to change the cutting knife from the first position to the second position.
  • the nail anvil assembly is provided with a cutting groove corresponding to the pushing groove.
  • an elastic member is provided between the cutting knife and the knife bar, and the elastic member applies a rotational force to the cutting knife when the cutting knife changes from the first position to the second position.
  • the elastic member is a torsion spring sleeved on the rotating shaft.
  • the clamping component includes a buckle and a first groove which is respectively matched with the buckle to make the cutting knife in a first position and a second groove which is matched with the buckle to make the cutting knife in a second position. Card slot.
  • first slot and the second slot are arranged on the cutting knife, and the buckle is arranged on the movable end.
  • the movable end of the knife bar includes two opposite side plates, the cutting knife is clamped between the two side plates, and the buckle is formed on each side plate.
  • the cutting edge of the cutting knife is perpendicular to the knife bar.
  • the beneficial effect of the present invention is that the surgical instrument of the present invention is provided with a cutting knife in the nail anvil assembly or the staple cartridge assembly, and the driving assembly drives the nail pushing rod and the knife rod to move, and when the knife rod is close to the distal end , The cutting knife is turned over to protrude out of the suture surface, and then the knife bar drives the cutting knife to pull back to cut the sutured tissue.
  • Fig. 1 is a schematic structural diagram of a staple cartridge assembly according to an embodiment of the present invention
  • FIG. 2 is a schematic structural diagram of the staple cartridge body in the staple cartridge assembly according to an embodiment of the present invention
  • Figure 3 is a schematic structural diagram of a push block in a staple cartridge assembly according to an embodiment of the present invention.
  • FIGS. 4 and 5 are structural schematic diagrams of the cutting blade holder body in the staple cartridge assembly according to an embodiment of the present invention.
  • FIGS. 6 and 7 are schematic diagrams of the structure of a surgical instrument according to an embodiment of the present invention.
  • Figure 8 is a schematic structural diagram of a surgical instrument according to another embodiment of the present invention.
  • FIG. 9 is a schematic diagram of the structure of a broach bar according to an embodiment of the present invention.
  • Figure 10 is a schematic structural view of a nail anvil according to another embodiment of the present invention.
  • Figure 11 is a schematic structural diagram of a surgical instrument according to an embodiment of the present invention.
  • Figure 12 is a partial structural diagram of the nail anvil of Figure 11;
  • Figure 13 is a schematic diagram of the structure of the broach bar in Figure 11;
  • Figure 14 is an enlarged view of circle A in Figure 13;
  • Figure 15 is an assembly diagram of the pull rod, torsion spring, and cutting knife in Figure 11, with the cutting knife in the first position;
  • Figure 16 is an assembly view of the pull rod, torsion spring, and cutting knife in Figure 11, with the cutting knife in the second position;
  • Fig. 17 is an assembly diagram of the cutting knife and the torsion spring in Fig. 11.
  • the staple cartridge assembly (that can be referred to as: a staple cartridge or a staple cartridge for surgical instruments) shown in an embodiment of the present invention includes a staple cartridge body 1 and a staple cartridge provided in the staple cartridge.
  • a cover plate (not shown) can also be covered on the top of the staple cartridge body 1, thereby preventing the suture nail 10 (titanium nail) from falling during the operation or preventing dust from entering the suture. Nail within 10.
  • the frame body 12 and the cover plate are connected to the staple cartridge body 1 through a common mechanical connection method, such as a snap connection, a threaded connection, and the like.
  • the staple cartridge body 1 has opposite distal and proximal ends (taking FIG. 1 as an example, the proximal end referred to in the present invention is the direction indicated by arrow A, and the distal end is the direction opposite to A), and the distal end is relative to the proximal The end enters the sutured tissue first.
  • the staple cartridge assembly is installed on the surgical instrument, the staple cartridge assembly is installed first and then the cover plate is removed.
  • the distal end of the staple cartridge body 1 is referred to as the distal end of the staple cartridge
  • the proximal end is referred to as the proximal end of the staple cartridge.
  • the staple cartridge body 1 is provided with a channel 13 in the longitudinal direction for the pushing block 2 to move, and the staple cartridge body 1 takes the channel 13 as the axis of symmetry in the longitudinal direction.
  • An inner suture cavity 14 and an outer suture cavity 15 are provided symmetrically on the left and right sides.
  • the inner suture cavity 14 is arranged close to the channel 13 relative to the outer suture cavity 15, and the nail pusher 11 includes the inner sutures respectively arranged thereon.
  • the suture nail 10 includes an inner suture nail arranged in the inner suture cavity 14 and an outer suture nail arranged in the outer suture cavity 15.
  • the inner suture nail and the outer suture nail are respectively installed with an inner push nail and Extrapolate on the nail piece.
  • the outer suture nail is used to suture the area close to the tissue anastomosis
  • the inner suture nail is used to suture the area inside the tissue relative to the outer suture nail.
  • the nail pusher 11 has an existing structure, and the installation method of the suture nail 10 is also an existing conventional method, which will not be described here.
  • the pushing block 2 includes a bottom plate 21, two first cam groups 22 arranged in parallel perpendicular to the bottom plate 21 and two second cam groups 23 arranged in parallel, and a limit position perpendicular to the bottom plate 21 Block 24, the two first cam groups 22 are located between the two second cam groups 23, and the limiting block 24 is arranged between the two first cam groups 22.
  • the end of the first cam group 22 is located on the front side of the end of the second cam group 23.
  • the staple cartridge body 1 is also provided with a plurality of sliding grooves 16 for accommodating the first cam group 22 and the second cam group 23, and the first cam group 22 and the second cam group 23 can move relative to the sliding groove 16 ,
  • the limiting block 24 is arranged in the channel 13 to prevent the pushing block 2 from deviating or shaking when the pushing block 2 moves relative to the staple cartridge body 1.
  • the first cam group 22 pushes the inner push nail piece to fire, so that the inner suture nail is ejected; the second cam group 23 pushes the outer push nail piece to fire, so that the outer suture nail is ejected.
  • first cam set 22 Since the end of the first cam set 22 is located on the front side of the end of the second cam set 23, when the pushing block 2 moves toward the distal end, it will first push the pusher nail piece to fire, thereby ensuring that it is located in the inner suture cavity
  • the inner staples in 14 are faster than the outer staples.
  • the staple cartridge body 1 includes a staple cartridge suture surface 110 for contact with the sutured tissue.
  • a distance d1 is formed between the stem end of the inner suture staple and the staple cartridge suture surface 110
  • a distance d2 is formed between the staple stem end of the outer staple and the staple cartridge suture surface 110, where d1 is less than d2, that is, the nail shaft of the inner suture nail is arranged closer to the suture surface 110 of the staple cartridge than the nail shaft of the outer suture nail.
  • the inner suture nail of the rod, or, a combination of the two, or the inner suture cavity 14 is set higher than the outer suture cavity 15.
  • the staple cartridge body 1 is further provided with a cutting knife holder body 3 and a cutting knife 30 arranged on the cutting knife holder body 3, and the cutting knife holder body 3 is arranged at the distal end.
  • the cutting blade holder body 3 includes a side plate 31 and a butting portion 32 that is clamped and matched with the broach bar.
  • the side plate 31 is provided with a rotating shaft 33, and the cutting knife 30 is sleeved on the rotating shaft 33. on.
  • the side plate 31 is formed with an elastic member 34 that drives the blade of the cutting knife 30 not to protrude beyond the staple cartridge suture surface 110.
  • the elastic member 34 drives the The blade (not shown) of the cutting knife 30 does not protrude from the cutting knife holder body 3, and the blade of the cutting knife 30 does not protrude from the cutting knife holder body 3 due to the elastic member 34, and the cutting knife holder body 3 is arranged at Inside the staple cartridge body 1, therefore, the blade of the cutting knife 30 does not protrude from the staple cartridge suture surface 110.
  • the elastic member 34 is a torsion spring sleeved on the rotating shaft 33.
  • the abutting portion 32 is formed on the side plate 31, the side plates 31 are two oppositely arranged, and a function is formed between the two side plates 31 to accommodate the cutting knife. 30 of the butt slot 311.
  • the mating portion 32 is an elastic buckle formed by bending from the side plate 31 toward the mating groove 311.
  • the present invention also provides a surgical instrument, including the above-mentioned staple cartridge assembly, the staple anvil assembly 4 butted with the staple cartridge assembly, connecting the staple anvil assembly 4 and the nail
  • a surgical instrument including the above-mentioned staple cartridge assembly, the staple anvil assembly 4 butted with the staple cartridge assembly, connecting the staple anvil assembly 4 and the nail
  • a firing push button 52 connected to the driving assembly and operated.
  • the handle 5 is also provided with a nail push rod 53 and a knife rod 54 which are connected to the drive assembly, and the knife rod 54 and the pushing block 2 are arranged at the front end of the nail rod 53 , And the broaching bar 54 is provided with a slot 541 that cooperates with the elastic buckle 32 so that the broaching bar 54 and the cutting tool holder body 3 can be engaged with each other.
  • the broaching The rod 54 and the cutting tool holder body 3 can be engaged with other structures in the prior art.
  • the handle 5 includes a staple cartridge support side handle 55 and a staple anvil side handle 56 fixedly connected to the staple cartridge assembly and the staple anvil assembly 4, respectively.
  • the working principle of the surgical instrument of the present invention is:
  • the closing pressing rod 51 is pressed to close the jaws (the tissue to be sutured is clamped by the staple cartridge assembly and the staple anvil assembly 4).
  • Pushing the proximal firing push button 52 drives the push rod 53 and the knife rod 54 to move at the same time.
  • the push rods 53 on both sides push the nail pusher 11 inside the staple cartridge assembly through the distal head slope to move vertically downwards to realize the suture.
  • the sequential compression and deformation of 10 finally form a B-type staple to suture the tissue.
  • the pulling bar 54 Because the pulling bar 54 is lagging behind and hidden inside the staple cartridge assembly, it will not contact the tissue between the staple cartridge suture surface 110 and the staple anvil surface during the staple formation process.
  • the pulling knife rod 54 contacts the cutting blade holder body 3 inside the distal end of the nail cartridge assembly. Since the cutting knife 30 is mounted on the cutting knife holder body 3 through the rotating shaft 33, when the knife bar 54 is inserted into the docking groove 311, the cutting knife 30 will be rotated and ejected, and the elastic buckle 32 on the side plate 31 will be deformed. Then buckle the slot 541 of the pull bar 54.
  • the firing of the suture nail 10 is completed, and the pulling-back process of the firing push button 52 will drive the cutting knife 30 that has protruded from the inside of the cutting knife holder body 3 to cut the tissue from the distal end to the proximal end.
  • the cutting knife 30 finishes cutting the tissue and runs to the proximal end of the staple cartridge assembly, a step (not shown) at the proximal end of the staple cartridge assembly blocks the cutting knife holder body 3.
  • the groove (not shown) on the proximal side of the staple cartridge assembly allows the elastic buckle 32 to be deformed and disengaged, so that the knife bar 54 is separated from the cutting knife holder body 3.
  • the torsion spring 34 arranged on the rotating shaft 33 allows the cutting knife 30 to retract automatically, preventing the exposed cutting knife 30 from accidentally scratching the user.
  • a surgical instrument shown in another preferred embodiment of the present invention includes a handle 5, an anvil assembly 4, a firing push button (not labeled), and a staple cartridge mounting bracket 6.
  • Push rod 7, pull knife 54 and drive assembly (not labeled).
  • the staple cartridge mounting bracket 6 is a part of the side handle of the staple cartridge bracket as shown in the first embodiment.
  • the staple cartridge mounting bracket 6 may be a separate component.
  • the anvil assembly includes an anvil body 41, a cutting knife holder body 3 and a cutting knife 30; the anvil body 41 has opposite distal and proximal ends, and the proximal end of the anvil body 4 is connected to the handle 5.
  • the distal end is the end away from the handle 5.
  • the proximal end of the anvil body 4 is referred to as the proximal end of the anvil
  • the distal end is referred to as the distal end of the anvil.
  • the cutting knife holder body 3 and the cutting knife 30 are arranged at the distal end of the nail anvil body 41; the cutting knife holder body 3 includes a side plate 31 and a butting portion 32 that is engaged with the knife bar 54; the side plate 31
  • the two side plates 31 are opposed to each other, and a butting groove 311 for accommodating the cutting knife 30 is formed between the two side plates 31.
  • the side plate 31 is provided with a rotating shaft 33, and the cutting knife 30 is sleeved on the rotating shaft 33.
  • the mating portion 32 is an elastic buckle 32 formed by bending from the side plate 31 toward the mating groove 311, and the broaching lever 54 is formed with a groove 541 that cooperates with the elastic buckle 32.
  • the anvil body 41 includes an anvil suture surface 108 for contacting the sutured tissue, and the side plate 31 is formed with a blade that drives the cutting knife 30 not to protrude from the anvil suture surface 108
  • the elastic member 34 is abutted with the cutting knife holder body 3 to drive the elastic member 34 to deform so that the cutting edge of the cutting knife 54 protrudes from the suture surface 108 of the nail anvil.
  • the elastic member 34 is a torsion spring 34 sleeved on the rotating shaft 33, one end of which abuts the cutting knife 30, and the other end of the torsion spring 34 abuts the cutting knife holder body 3.
  • the shape of the cutting knife 30 is similar to the Arabic numeral 7.
  • the cutting knife 30 is rotated and ejected so that the cutting edge protrudes out of the contact.
  • the elastic buckle 32 on the side plate 31 is deformed to buckle the groove 541 of the broach 54.
  • the anvil body 41 is formed with a cutting groove 105 extending along the longitudinal direction of the anvil body 41 (in the direction indicated by arrow A in FIG. 8), and the cutting groove 105 has oppositely arranged groove walls 106 and ⁇ 107.
  • the cutting groove includes a receiving portion (not labeled) disposed near the distal end and a sliding portion (not labeled) extending from the receiving portion toward the proximal end.
  • the groove width of the accommodating portion is greater than the groove width of the sliding portion.
  • the groove width of the accommodating portion is larger than the deformation space required for the elastic buckle 32 to deform when the broach bar 54 is inserted into the cutting tool holder body 3, and the groove width of the sliding portion is smaller than that when the broach bar 54 is inserted into The deformation space required for the elastic buckle 32 to deform when the knife holder body 3 is cut.
  • the staple cartridge mounting bracket 6 is equipped with a staple cartridge assembly.
  • the staple cartridge assembly has a prior art structure and will not be described in detail.
  • the staple cartridge assembly roughly includes a staple cartridge body 1, a staple, a nail pusher 11, a push block 2, a staple cartridge bracket, and a cover plate (not shown); the staples are arranged in the staple cartridge body 1, and the nail push rod 7
  • the pushing block 2 is pushed, the pushing block 2 pushes the nail pushing piece 11, and the nail pushing piece 11 pushes out the suture nails to suture the tissue.
  • the staple cartridge assembly has a distal end and a proximal end that are relatively arranged.
  • the distal end of the staple cartridge body 1 is called the staple cartridge distal end
  • the proximal end is called the staple cartridge proximal end.
  • the staple cartridge body 1 is provided with a channel for the pushing block 2 to move in the longitudinal direction. The channel corresponds to the cutting groove 105.
  • the staple cartridge body 1 is provided with an inner suture cavity and an outer suture cavity symmetrically in the longitudinal direction with the groove as the axis of symmetry, and the inner suture cavity is disposed close to the groove relative to the outer suture cavity.
  • the nail pusher 11 includes an inner nail pusher set in the inner suture cavity and an outer nail pusher set in the outer suture cavity, respectively.
  • the suture nails include inner suture nails arranged in the inner suture cavity and outer suture nails arranged in the outer suture cavity.
  • the inner suture nails and the outer suture nails are respectively installed with an inner push nail piece and an outer push nail. Chip.
  • the outer suture nail is used to sew the area close to the tissue anastomosis, and the inner suture nail sews the area inside the tissue relative to the outer suture nail.
  • the staple cartridge body 1 has a contact surface that contacts the sutured tissue.
  • the pushing block 2 and the nail pushing piece 11 are of the existing structure, and the installation method of the suture nail is also the existing conventional method.
  • a cover plate (not shown) can also be covered on the top of the staple cartridge body 1.
  • the staple cartridge bracket and the cover plate are connected to the staple cartridge body 1 through a common mechanical connection, such as a snap connection, a threaded connection, and the like.
  • the staple cartridge body 1 and the staple anvil body 41 are arranged side by side and opposite to one end of the handle 5; the closing pressing rod 51 is installed on the handle 5 through a guide pin 510 to drive the staple anvil assembly 4 and the staple cartridge mounting bracket 6 is closed; the nail push rod 7 and the knife rod 54 are arranged in the handle 5; the driving assembly is arranged in the handle 5 for driving the nail push rod 7 and the knife rod 54 along the anvil body 41 moves in the longitudinal direction.
  • the drive assembly drives the push rod 7 to move away from the handle, the push rod 7 pushes the push block 2, the push block 2 pushes the push piece 11, and the push piece 11 pushes out the suture nail to suture the tissue;
  • the drive assembly drives the knife rod 54 at the proximal end of the anvil body 41 to move in the distal direction.
  • the drive assembly simultaneously drives the nail rod 53 and the knife rod 54 to pull at the distal end of the anvil body 41.
  • the knife bar 54 is docked with the cutting knife holder body 3.
  • the pulling knife bar 54 pushes the cutting knife 30, and its thrust is greater than the elastic force of the tension spring 34, the cutting knife 30 in the shape of the Arabic numeral 7 is rotated and ejected, and the blade protrudes
  • the drive assembly drives the knife rod 54 to pull back, and the cutting knife holder body 3 and the cutting knife 30 move in the cutting groove 105 from the distal end of the nail anvil body 41 toward the proximal end, Complete the cutting of the tissue.
  • the cutting knife holder body and the cutting knife are arranged on the staple cartridge body or the staple anvil body, and they are arranged at the distal end of the staple cartridge body or the staple anvil body.
  • the The knife bar is connected with the cutting knife holder body, and the tissue is cut back from the distal end to the proximal end to ensure that the suture nail is completely formed before cutting, so as to achieve a uniform nail height and shape, and reduce the bleeding of the anastomosis. The purpose of leaking.
  • the surgical instrument shown in a preferred embodiment of the present invention includes a handle 1, a nail anvil 2 arranged side by side at one end of the handle 1 and opposite to each other (the nail anvil 2 may also be referred to as a nail anvil) Component) and the staple cartridge holder 3, the staple cartridge assembly 4 installed on the staple cartridge holder 3, the closing pressing rod 5 arranged on the handle 1 to drive the staple anvil 2 and the staple cartridge holder 3, and the closing lever 5 arranged in the handle 1.
  • the nail push rod 6 and the knife rod 7, the cutting knife 8 arranged on the knife rod 7, and the handle 1 to drive the nail rod 6 and the knife rod 7 to move along the longitudinal direction of the nail anvil 2. ⁇ drive assembly9.
  • the driving assembly 9 drives the push rod 6 and the pull rod 7 to move simultaneously.
  • the handle 1, the closing pressing rod 5, and the driving assembly 9 all adopt existing designs, so they will not be described in detail here.
  • the anvil 2 has a distal end 21 and a proximal end (the distal end 21 may be referred to as the distal end of the anvil, and the proximal end may be referred to as the proximal end of the anvil).
  • the handle 1 is connected, and the distal end 21 is the end away from the handle 1.
  • the anvil 2 includes a first suture surface 23 (that is, the anvil suture surface) for contact with the sutured tissue (not shown).
  • the nail anvil 2 is provided with a cutting groove 24 extending along the longitudinal direction of the nail anvil 2 (the direction indicated by the arrow A as shown in FIG. 11 ).
  • a pushing portion 25 is formed in the cutting groove 24, and a pushing portion 25 is provided on a side of the cutting groove 24 close to the distal end 21.
  • the abutting portion 25 is the front end wall of the cutting groove 24, and its shape is a sloped surface.
  • the broach bar 7 has a movable end 71 inserted into the cutting groove 24 and movable in the cutting groove 24.
  • the broach bar 7 includes a rod body 72 extending along the longitudinal rectangle of the nail anvil 2 and A knife body mounting portion formed at the front end of the rod body portion 72 is a movable end 71, and the end of the rod body portion 72 away from the movable end 71 is connected to the driving assembly 9.
  • the movable end 71 of the broach rod 7 includes two side plates 711 respectively extending forward from the rod body portion 72.
  • the two side plates 711 are arranged opposite to each other, and an accommodating cavity 712 is formed between the two side plates 711.
  • the cutting knife 8 is movably arranged on the movable end 71. Specifically, the cutting knife 8 is clamped between the two side plates 711 and is located in the accommodating cavity 712.
  • the cutting knife 8 and the movable end 71 are connected by a rotating shaft 85, and the cutting knife 8 can be turned around the rotating shaft 85 relative to the movable end 71.
  • the rotating shaft 85 is formed on the cutting blade 8.
  • a clamping assembly that keeps the cutting knife 8 in a first position (position shown in FIG. 16) and a second position (position shown in FIG. 15), when When the cutting knife 8 is in the first position, the cutting edge 81 of the cutting knife 8 does not protrude from the first suture surface 23; when the cutting knife 8 is in the second position, the cutting edge 81 of the cutting knife 8 protrudes Extend the first suture surface 23; the knife bar 7 pushes the cutting knife 8 to touch the pushing portion 25 so that the cutting knife 8 changes from the first position to the second position.
  • the cutting edge 81 of the cutting knife 8 when the cutting knife 8 is in the first position, that is, the initial position, the cutting edge 81 of the cutting knife 8 is parallel to the pulling bar 7; when the cutting knife 8 is in the second position, the cutting edge 81 of the cutting knife 8 is parallel to the pulling bar 7 7 Vertical.
  • the clamping assembly includes a buckle 74 and a first groove 82 that is respectively matched with the buckle 74 to make the cutting knife 8 in the first position, and a first groove 82 that is matched with the buckle 74 to make the cutting knife 8The second card slot 83 in the second position.
  • the buckle 74 is formed on each side plate 711, and the first and second grooves 82 and 83 are provided on the cutting knife 8.
  • the buckle 74 is a protrusion protruding inward from the side plate 711 and is located in the longitudinal direction of the broach 7 (the longitudinal direction of the broach 7 is the same as the longitudinal direction of the nail anvil 2),
  • the cross section of the bump is trapezoidal.
  • the buckle 74 can also be provided on the cutting knife 8, and the first locking slot 82 and the second locking slot 83 are provided on the movable end 71 of the broach bar 7, as long as the movable end 71 can be connected to the cutting knife.
  • a clamping assembly is formed between the knives 8 to keep the cutting knives 8 at the first position and the second position, so that the object of the present invention can be achieved.
  • An elastic member 10 is arranged between the cutting knife 8 and the knife bar 7, and the elastic member 10 applies a rotational force to the cutting knife 8 when the cutting knife 8 changes from the first position to the second position.
  • the elastic member 10 is a torsion spring sleeved on the rotating shaft 85. One end of the torsion spring 10 abuts the cutting knife 8 and the other end abuts the pull rod 7. It should be noted that, in the position of FIG. 11, the pulling rod 7 drives the cutting knife 8 to move to a position that is about to approach the pushing portion 25. At this time, the cutting knife 8 is in the first position.
  • the cutting groove 24 has two groove walls 241 opposite to each other.
  • the cutting groove 24 includes a receiving portion 242 disposed near the distal end 21 and a sliding portion 243 extending from the receiving portion 242 toward the proximal end.
  • the groove width of the accommodating portion 242 is greater than the groove width of the sliding portion 243, and the pushing portion 25 is located in the accommodating portion 242.
  • the groove width of the accommodating portion 242 is larger than the deformation space required for the deformation of the buckle 74 when the buckle 74 on the side plate 711 separates from the first groove 82 and slides toward the second groove 83.
  • the groove of the sliding portion 243 The width is smaller than the deformation space required for the deformation of the buckle 74 when the buckle 74 on the side plate 711 is separated from the first groove 82 and slides to the second groove 83. With this arrangement, the two groove walls 241 are clamped during cutting. Holding it down, the buckle 74 of the knife bar 7 is locked into the second locking slot 83 without being separated.
  • the staple cartridge assembly 4 is an existing conventional structure.
  • the staple cartridge assembly 4 includes a staple cartridge body, and the staple cartridge body has a second suture surface (not numbered) in contact with the sutured tissue (that is, the staple cartridge suture surface). ), the staple cartridge body is formed with a propulsion groove (not shown) extending along the longitudinal direction of the staple cartridge body (the direction indicated by arrow A as shown in FIG. 11), and the propulsion groove penetrates the second suture surface .
  • the advancing groove is arranged corresponding to the cutting groove 24, and when the cutting knife 8 is cutting, the blade 81 of the cutting knife 8 penetrates into the advancing groove, so as to better complete the cutting.
  • the operating mode of the surgical instrument is as follows: a closing pressing rod 5 is installed on the handle 1 through a guide pin (not labeled) to drive the nail anvil 2 and the nail cartridge bracket 3 to close; a nail pushing rod 6 and a broach The rod 7 is arranged in the handle 1; pressing the closing lever 5 closes the nail anvil 2 and the nail cartridge bracket 3, and then the nail anvil 2 and the nail anvil 2 assembly on the nail cartridge bracket 3 clamp the tissue;
  • the driving assembly 9 drives the push rod 6 and the knife rod 7 at the same time, the driving assembly 9 drives the push rod 6 to move away from the handle 1, and pushes out the staples in the staple cartridge assembly 4 to suture the tissue; the driving assembly 9 drives The knife rod 7 moves at the proximal end of the anvil 2 toward the distal end 21.
  • the cutting knife 8 continues to move forward under the drive of the driving assembly 9 to touch the pushing portion 25.
  • the cutting knife 8 rotates relative to the movable end 71 to disengage the first slot 82 from the buckle 74.
  • the cutting knife 8 is quickly turned over and the assembly is driven at the same time 9 will still drive the cutting knife 8 to move toward the pushing portion 25.
  • the cutting knife 8 is turned over to the second position, and the second slot 83 and the buckle 74 is clamped, the blade 81 of the cutting knife 8 protrudes out of the first suture surface 23 and partially penetrates into the pushing groove; after that, the driving assembly 9 drives the knife rod 7 to pull back, and the cutting knife 8 is in the cutting groove 24
  • the distal end 21 of the inner nail anvil 2 moves toward the proximal end to complete the cutting of the tissue.
  • the broach bar 7 moves in the nail anvil 2.
  • the broach bar 7 can be set to move in the staple cartridge. This surgical instrument is different from the previous embodiment. ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
  • FIGS his Only “ The movable end of the movable end, the movable end is movably provided with a cutting knife, the cutting knife and the movable end are connected by a rotating shaft, the cutting knife can be turned relative to the movable end around the rotating shaft; the movable end and A clamping assembly is formed between the cutting knives to keep the cutting knives in the first position and the second position.
  • the blade of the cutting knives When the cutting knives are in the first position, the blade of the cutting knives does not protrude beyond the second suture surface When the cutting knife is in the second position, the cutting edge of the cutting knife protrudes out of the second suture surface; a pushing portion is formed in the pushing groove, and the pulling rod pushes the cutting knife and the The abutting portion touches to make the cutting knife change from the first position to the second position.
  • the nail anvil is provided with a cutting groove corresponding to the pushing groove.
  • the surgical instrument can be a disposable product.
  • the cutting knife is set at the movable end of the pull rod through the rotating shaft, and it is turned up to the second position under the action of the pushing part at the distal end of the cutting groove, and the blade part penetrates into the pushing groove.
  • Pulling back from the distal end to the proximal end for tissue cutting ensures that the suture nail is completely formed and then cut, so as to achieve a uniform nail height and shape, and reduce the bleeding and leakage of the anastomosis.

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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

La présente invention concerne un instrument chirurgical, utilisé pour d'abord agrafer puis pour couper. L'instrument chirurgical comprend une poignée (5), un ensemble enclume d'agrafe (4) et un support de cartouche d'agrafes qui sont disposés côte-à-côte par rapport à une extrémité de la poignée (5) et disposés de manière opposée, un ensemble cartouche d'agrafes monté sur le support de cartouche d'agrafes, une tige de pression de fermeture (51) disposée sur la poignée (5) et utilisée pour entraîner une enclume d'agrafe et le support de cartouche d'agrafes à fermer, une tige de poussée d'agrafe (53) et une tige de traction de couteau (54) qui sont disposées dans la poignée (5), et un ensemble d'entraînement disposé sur la poignée (5) et utilisé pour entraîner la tige de poussée d'agrafe (53) et la tige de traction de couteau (54) pour se déplacer le long du sens de la longueur de l'ensemble enclume d'agrafe (4). Un couteau de coupe (30) est disposé dans l'ensemble enclume d'agrafe (4) ou l'ensemble cartouche d'agrafes. À la fois l'ensemble enclume d'agrafe (4) et l'ensemble cartouche d'agrafes présentent des surfaces de suture (108, 110). À la fois l'ensemble cartouche d'agrafes et l'ensemble enclume d'agrafe (4) sont disposés relativement aux extrémités distales et proximales. Les extrémités proximales sont disposées plus près de la poignée (5) que les extrémités distales. L'ensemble d'entraînement entraîne la tige de poussée d'agrafe (53) et la tige de traction de couteau (54) à se déplacer, et lorsque la tige de traction de couteau (54) est proche des extrémités distales, le couteau de coupe (30) est tourné par-dessus pour faire saillie depuis les surfaces de suture (108, 110), et ensuite la tige de traction de couteau (54) entraîne le couteau de coupe (30) à effectuer une traction vers l'arrière afin de couper un tissu suturé.
PCT/CN2019/119606 2019-10-23 2019-11-20 Instrument chirurgical WO2021077513A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CN201911012977.4 2019-10-23
CN201911012977.4A CN112690847A (zh) 2019-10-23 2019-10-23 外科手术器械
CN201911134668.4A CN111466981B (zh) 2019-01-24 2019-11-19 钉仓组件及外科手术器械
CN201911134668.4 2019-11-19

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WO2021077513A1 true WO2021077513A1 (fr) 2021-04-29

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CN216060619U (zh) * 2021-09-06 2022-03-18 江苏风和医疗器材股份有限公司 钉仓组件和外科器械

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US20130240604A1 (en) * 2010-07-20 2013-09-19 Cardica, Inc. Surgical stapler with cartridge-adjustable clamp gap
CN103945783A (zh) * 2011-11-15 2014-07-23 直观外科手术操作公司 具有收起的刀片的手术器械
CN102429694A (zh) * 2011-12-31 2012-05-02 北京中法派尔特医疗设备有限公司 一种采用回拉方式的直线切割缝合器
CN103417253A (zh) * 2012-05-25 2013-12-04 柯惠Lp公司 包括能替换的钉仓组件的手术紧固件施加装置
CN206285130U (zh) * 2016-08-08 2017-06-30 南京迈迪欣医疗器械有限公司 一种腔镜切割缝合机构
CN209661714U (zh) * 2019-01-24 2019-11-22 苏州英途康医疗科技有限公司 用于外科手术器械的钉仓及外科手术器械

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