WO2021169634A1 - 一种可弯转腔镜下直线切割吻合器及其组件 - Google Patents

一种可弯转腔镜下直线切割吻合器及其组件 Download PDF

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Publication number
WO2021169634A1
WO2021169634A1 PCT/CN2021/071122 CN2021071122W WO2021169634A1 WO 2021169634 A1 WO2021169634 A1 WO 2021169634A1 CN 2021071122 W CN2021071122 W CN 2021071122W WO 2021169634 A1 WO2021169634 A1 WO 2021169634A1
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Prior art keywords
inner core
assembly
stapler
push
connecting block
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PCT/CN2021/071122
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English (en)
French (fr)
Inventor
刘青
范宏利
黄战川
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北京派尔特医疗科技股份有限公司
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Application filed by 北京派尔特医疗科技股份有限公司 filed Critical 北京派尔特医疗科技股份有限公司
Priority to BR112022017141A priority Critical patent/BR112022017141A2/pt
Priority to US17/800,507 priority patent/US20230078358A1/en
Priority to EP21760002.2A priority patent/EP4088668B1/en
Publication of WO2021169634A1 publication Critical patent/WO2021169634A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • 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
    • A61B2017/07221—Stapler heads curved
    • 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
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter

Definitions

  • the invention relates to the field of medical equipment, in particular to a linear cutting stapler under a bendable endoscope and its components.
  • Endoscopic stapler plays the most critical role in surgery. Due to the limitation of the space in the abdominal cavity or thoracic cavity, the traditional linear laparoscopic stapler cannot fully and effectively reach the required surgical site to clamp, transect, and anast Seat) elbow stapler that can be turned. In a straight state, this turnable elbow stapler enters the thoracic cavity or abdominal cavity through the trocar, and controls the jaws of the stapler to bend a certain angle through the bending control mechanism on the handle outside the body, and clamps and crosses the surgical site. , Anastomosis and a series of operations. After the operation is completed, it becomes straight again and exits the body.
  • the stapler jaws in the control assembly are rotated to the left and right to complete different operations.
  • Posture in a style environment the prior art endoscopic linear cutting stapler assembly includes a stapler jaw 1, an assembly inner core 2, a steering link 3, and the stapler jaw 1 passes through an upper rotating head assembly 4, an upper and lower connecting piece 5 is rotatably connected with the inner core 2 of the assembly, through the connection between the head end hole 31 of the steering link 3 and the steering knob pin 41 of the upper rotating head assembly 4, push or pull the steering link 3 with the aid of the hand
  • the stapler jaw 1 at the front end of the assembly swings around the axis of rotation to form a maximum 45° turn on the left and right sides, as shown in Figures 2 and 3.
  • the technical problem to be solved by the present invention is to provide a bendable endoscope linear cutting stapler and its components that can reduce the firing force during the cutting and anastomosis process and increase the bending angle, so that the doctor has better Operating feel and operating space.
  • the present invention adopts the following technical solutions:
  • a straight-line cutting stapler assembly under a bendable cavity mirror comprising a stapler jaw, a steering connecting block, an assembly inner core, and a cutting knife assembly;
  • the assembly inner core includes an inner core shell and is fixedly installed in the inner core shell The inner core connecting block;
  • the front end of the steering connecting block is hinged with the rear end of the stapler jaws, the hinge forms a first vertical rotation axis, the rear end of the steering connecting block is hinged with the front end of the inner core connecting block, and the hinge forms the first Two vertical rotating shafts;
  • the cutting knife assembly passes through the inner core connecting block, the steering connecting block and the jaws of the stapler and can slide back and forth.
  • the present invention also includes left and right turning pieces and push-pull rods;
  • the left and right turning pieces are U-shaped, the rear turning part is turned by the inner core connecting block, and the two free ends of the front end are from back to front Pass through the steering connecting block and then be fixedly connected with the rear end of the stapler jaw;
  • the left or right side of the left and right turning piece is connected with the front end of the push-pull rod, which can drive the stapler jaw to go around the first under the push-pull action of the push-pull rod.
  • a vertical rotation axis and a second vertical rotation axis turn left and right.
  • the stapler jaws include a nail cartridge assembly located on the upper part and a nail abutment seat connected to the nail cartridge assembly and located at the lower part, and a nail abutment seat positioning member located inside the rear of the nail abutment seat; the left and right sides
  • the free end of the turning piece is fixedly connected between the nail abutment seat positioning member and the rear part of the nail abutment seat through a transverse connecting pin, and the cutting knife assembly passes through the nail abutment seat positioning member.
  • the steering connection block is connected to the positioning block connecting shaft provided on the positioning member of the nail seat through a vertical positioning block connection hole provided at the front end; the steering connection block is connected through a vertical inner core provided at the rear end The block positioning hole is connected with the inner core connecting shaft provided at the front end of the inner core connecting block.
  • the cutting knife assembly includes an upper piece of the cutting knife assembly and a lower piece of the cutting knife assembly.
  • the upper piece of the cutting knife assembly and the lower piece of the cutting knife assembly respectively pass through the inner core connecting block, the steering connecting block and the nail abutment seat.
  • the upper part and the lower part of the positioning piece are connected together at the front end.
  • the rear end of the inner core connecting block is provided with a U-shaped groove, and the inner sides of the turning parts of the left and right turning pieces are matched with the U-shaped groove.
  • the upper surface and the lower surface of the inner core connecting block are respectively provided with a plurality of protruding locking steps, and a cutting knife assembly upper piece or a cutting knife assembly is formed between the plurality of protruding locking steps.
  • the accommodating space of the lower piece; the inner core shell includes an inner core upper cover and an inner core lower cover, and the inner core connecting block is connected with the inner core upper cover and the inner core lower cover through a locking step.
  • the device assembly also includes a push-pull block, the push-pull rod is inserted into the push-pull block hole provided at the rear of the push-pull block through a fixed boss provided at the front of the push-pull rod, and the push-pull block is inserted into the push-pull block shaft provided at the front of the push-pull block.
  • the fixing holes provided on the left or right side of the left and right turning pieces.
  • the rear turning parts of the left and right turning pieces are replaced with flexible steel ropes, and the flexible steel wire ropes are press-fitted with the front parts of the left and right turning pieces through a connecting ring; or all the left and right turning pieces are replaced with flexible steel ropes .
  • the present invention also provides a bendable cavity mirror linear cutting stapler, comprising a handle and a bendable cavity mirror linear cutting stapler assembly connected to the front end of the handle.
  • the bendable cavity mirror linear cutting stapler The component adopts the above-mentioned linear cutting stapler component under the bendable cavity mirror.
  • the present invention has at least the following advantages:
  • the invention adopts double rotation centers, can realize a large turning radius of the cutting knife, effectively reduces the firing force during use, and enables the doctor to obtain a better operating feel.
  • the turning radius can be enlarged, and a larger turning angle can be achieved, so that the doctor has a better operating space and is suitable for medical treatment under more complicated clinical conditions.
  • the present invention adopts flexible left and right turning blades to change direction, and always keep the left and right turning in the process of pulling, avoiding the reduction of the moment arm during the turning process, the torque is stable, and a larger turning angle can be achieved. .
  • Fig. 1 is a schematic diagram of the exploded structure of a linear cutting stapler assembly under a cavity mirror in the prior art
  • Figures 2 and 3 are schematic diagrams of the linear cutting stapler assembly under the endoscope in Figure 1 turning right and left;
  • FIG. 4 is a schematic diagram of the external structure of the linear cutting stapler assembly under the bendable endoscope in an embodiment of the present invention
  • Fig. 5 is a structural schematic diagram of a bent state of a linear cutting stapler assembly under a bendable endoscope in an embodiment of the present invention
  • Fig. 6 is a schematic top view of a linear cutting stapler assembly under a bendable endoscope in an embodiment of the present invention (the interior is visible);
  • Fig. 7 is a working principle diagram of a linear cutting stapler assembly under a bendable endoscope in an embodiment of the present invention
  • FIG. 8 is an exploded structure diagram of a linear cutting stapler assembly under a bendable cavity mirror in an embodiment of the present invention
  • Fig. 9 is a partial exploded structure diagram of the linear cutting stapler assembly under the bendable cavity mirror in an embodiment of the present invention (the connection point of the double rotation center);
  • FIG. 10 is a schematic diagram of the assembly structure of the cutting knife assembly and other components in an embodiment of the present invention.
  • Fig. 11 is a partial exploded structure diagram (bending control part) of a linear cutting stapler assembly under a bendable cavity mirror in an embodiment of the present invention.
  • the turning radius of the stapler will cause excessive firing force during the cutting and anastomosis process, which will affect the doctor’s operating feel, and the stapler will increase the risk of failure.
  • the steering link is rigidly connected and the length of the lever arm with the rotating shaft is limited by space, which results in the restriction of the left and right swing angles, which makes it possible to clamp, cross-cut, and anastomosis in some operations. The operation cannot reach the ideal operating position and cannot be suitable for medical treatment under more complicated clinical conditions.
  • the present invention defines the jaw end of the stapler as the front and the operator's end as the back.
  • the opening and closing directions of the stapler jaws are up and down, and the turning direction of the stapler jaws is left and right. invention.
  • this embodiment provides a linear cutting stapler assembly under a bendable endoscope, which includes a stapler jaw 1, a steering connecting block 2, an inner core 3, and a cutting knife assembly 4, wherein ,
  • the inner core 3 of the assembly belongs to the fixed part of the shell, including the inner core shell and the inner core connecting block 31 fixedly installed in the inner core shell.
  • the front end of the steering connecting block 2 is hinged with the rear end of the stapler jaw 1, and the hinge forms A vertical rotation axis A, the rear end of the steering connection block 2 is hinged with the front end of the inner core connection block 31, and the hinge forms a second vertical rotation axis B; the cutting knife assembly 4 passes through the inner core connection block 31, the steering connection block 2 and The stapler jaw 1 can slide back and forth.
  • the stapler jaw 1 when turning, can rotate around the dual rotation centers (the first vertical rotation axis A, the second vertical rotation axis B), which can achieve a large cutting knife turning radius and effectively reduce The firing force during the use process enables the doctor to obtain a better operating feel.
  • the turning radius can be enlarged, and a larger turning angle can be achieved, so that the doctor has a better operating space and is suitable for medical treatment under more complicated clinical conditions.
  • the bendable endoscope linear cutting stapler assembly of this embodiment also includes left and right turning pieces 5 and push-pull rods 6; specifically As shown in Figures 7, 8, 9, and 11, the left and right turning pieces 5 are U-shaped, and the rear turning part is turned by the inner core connecting block 31.
  • the rear end of the inner core connecting block 31 may be provided with U-shaped groove 313, the inner side of the turning part of the left and right turning piece 5 can be matched with the U-shaped groove 313.
  • the front two free ends of the left and right turning pieces 5 pass through the steering connecting block 2 from back to front, and then are fixedly connected to the rear end of the stapler jaw 1.
  • the connecting ends of the push-pull rod 6 and the left and right turning pieces 5 are located at the rear end of the left and right turning piece openings.
  • the left or right side of the left or right turning piece 5 is connected with the front end of the push-pull rod 6, which can drive the stapler jaw 1 around the first vertical rotation axis A and the second vertical rotation axis B under the push-pull action of the push-pull rod 6 Turn left and right.
  • the above-mentioned turning control process is implemented in the following way: Take the push-pull rod 6 arranged on the right side of the left and right turning pieces 5 as an example.
  • the right side of the turning piece 5 moves forward, which in turn drives the left side of the left and right turning piece 5 to move backwards and drives the stapler jaw 1 connected with the front end of the left and right turning piece 5 around the two rotation centers of the turning connecting block 2 Turn left.
  • the push-pull rod 6 drives the right side of the left and right turning pieces 5 to move backward, and then drives the left side of the left and right turning pieces 5 to move forward and drives the front end of the left and right turning pieces 5 to move forward.
  • the stapler jaw 1 turns to the right around the two rotation centers of the steering connecting block 2.
  • the push-pull rod 6 can also be installed on the left side of the left and right turning pieces 5. Turn, under the action of pulling force, turn to the left.
  • the push-pull rod 6 fixed on the side of the left and right turning piece 5 applies thrust or pulling force, which avoids the reduction of the moment arm during the turning process, the torque is stable, and can be larger.
  • the turning angle is the angle.
  • the front end of the steering connection block 2 is provided with a vertical positioning block connection hole 21, and the stapler jaw 1 (including the nail box assembly 11 at the upper part, the nail holder 12 at the lower part connected to the nail box assembly and the nail holder
  • a positioning block connecting shaft 131 is provided on the positioning block connecting shaft 131 of the positioning block positioning part 13) of the positioning block 13) inside the rear part 12 of the seat.
  • the positioning block connecting hole 21 is connected with the positioning block connecting shaft 131 to form a first vertical rotation axis A
  • a vertical inner core connecting block positioning hole 22 is provided at the rear end of the steering connecting block 2
  • an inner core connecting shaft 311 is provided at the front end of the inner core connecting block 31, and the inner core connecting block positioning hole 22 is connected to the inner core connecting shaft 311 , Form a second vertical rotation axis B.
  • the free ends of the left and right turning pieces 5 can be fixedly connected between the positioning member 13 of the abutting base and the rear of the abutting base 12 by a transverse connecting pin 14.
  • the cutting knife assembly 4 includes a cutting knife assembly upper piece 41 and a cutting knife assembly lower piece 42.
  • the cutting knife assembly upper piece 41 and the cutting knife assembly lower piece 42 respectively pass through the inner core connecting block in sequence. 31.
  • the upper part and the lower part of the steering connecting block 2 and the nail seat positioning member 13 are connected together at the front end.
  • the upper surface and the lower surface of the inner core connecting block 31 are respectively provided with a plurality of protruding locking steps 312, and the plurality of protruding locking steps 312 respectively form the upper surface of the cutting knife assembly.
  • the accommodating space of the sheet 41 or the lower sheet 42 of the cutting knife assembly; the inner core housing includes the inner core upper cover 32 and the inner core lower cover 33, and the inner core connecting block 31 can pass through the locking step 312 to connect with the inner core upper cover 32 and the inner core The lower cover 33 is connected.
  • the push-pull rod 6 can be connected to the left and right turning pieces 5 through the middle connecting piece.
  • the middle connecting piece is the push-pull block 7.
  • the push-pull rod 6 is installed behind the push-pull block 7 through the fixed boss 61 provided at the front of it.
  • the push-pull block 7 is inserted into the fixing hole 51 provided on the left or right side of the left and right turning piece 5 through the push-pull block shaft 72 provided in the front of the push-pull block 7.
  • the left and right turning pieces 5 in the above turning control part can also adopt other flexible connection methods.
  • the left and right turning pieces 5 can all be replaced with flexible wire ropes.
  • the rear turning portion 52 of the left and right turning piece 5 is replaced with a flexible steel wire rope, and the flexible steel wire is press-fitted with the front part of the left and right turning piece through a connecting ring 53.
  • This embodiment also provides a bendable endoscopic linear cutting stapler, including a handle and a endoscopic linear cutting stapler assembly connected to the front end of the handle, wherein the endoscopic linear cutting stapler assembly preferably adopts the above-mentioned Straight-line cutting stapler assembly under the cavity mirror.
  • the straight cutting stapler under the bendable endoscope enters the thoracic cavity or abdominal cavity through the trocar in a straight state, and the bending control mechanism on the handle outside the body controls the jaws of the stapler to bend to a certain angle.
  • a series of operations such as clamping, traverse, and anastomosis are performed on the part.
  • the turning radius of the cutting knife is increased, which effectively reduces the firing force during the use process, and enables the doctor to obtain a better operating feel; adopts flexibility By reversing the direction, the left and right turning piece can always keep the left and right turning in the pulling process, avoiding the reduction of the moment arm during the turning process, and the torque is stable; the above setting also has a large turning angle, so that the doctor has more Good operating space can be suitable for medical treatment under more complicated clinical conditions.

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Abstract

一种可弯转腔镜下直线切割吻合器及其组件，包括吻合器钳口（1）、转向连接块（2）、组件内芯（3）、切割刀组件（4）；组件内芯（3）包括内芯壳体及固定安装在内芯壳体内的内芯连接块（31）；转向连接块（2）前端与吻合器钳口（1）后端铰接，铰接处形成第一竖向旋转轴（A），转向连接块（2）后端与内芯连接块（31）前端铰接，铰接处形成第二竖向旋转轴（B）；切割刀组件（4）穿过内芯连接块（31）、转向连接块（2）及吻合器钳口（1）且可前后滑动。在双旋转轴的基础上，还采用了U形的左右弯转片（5），其通过内芯连接块（31）转向控制弯转过程。通过双旋转轴可加大弯转半径，降低了切割吻合过程中的击发力，使医生有更好的操作手感；同时还可做到更大的弯转角度，使医生有更好的操作空间。

Description

一种可弯转腔镜下直线切割吻合器及其组件 技术领域
本发明涉及医疗器械领域，特别是涉及一种可弯转腔镜下直线切割吻合器及其组件。
背景技术
腔镜吻合器在手术中扮演最关键的角色。由于腹腔或者胸腔内空间的限制，传统的直线腔镜吻合器不能完全有效地到达所需手术部位进行夹持、横断、吻合组织，所以需要一种吻合器钳口(包括钉匣组件、抵钉座)可转弯的弯头吻合器。在直线状态下，这种可转弯的弯头吻合器通过穿刺器进入胸腔或者腹腔，通过体外的手柄上面控弯机构控制吻合器钳口弯转一定的角度，并对手术部位进行夹持、横断、吻合等一系列操作。手术完成后，重新变为直线状态，退出体外。
在操作腔镜下直线切割吻合器及其组件进行手术时，通过操控腔镜下直线切割吻合器上的转向控制结构操控组件中的吻合器钳口进行向左和向右的旋转，完成不同术式环境的体位。配合图1所示，现有技术中腔镜下直线切割吻合器组件包括吻合器钳口1、组件内芯2，转向连杆3，吻合器钳口1通过上旋转头组件4、上下连接片5与组件内芯2之间可转动连接，通过转向连杆3的头端孔31与上旋转头组件4的转向旋钮销41的连接，在手给予助力的情况下推或拉转向连杆3使组件前端的吻合器钳口1围绕旋转轴产生左右摆动，形成左右各最大45°的弯转，如图2、3所示。上述结构中，当弯转状态时击发切割吻合，需要较大的击发力，影响医操作手 感，且吻合器钳口的左右摆动角度受限，使得在部分手术夹持、横断、吻合等一系列操作不能达到理想的操作位置，无法适于更复杂临床条件下的医疗。
发明内容
本发明要解决的技术问题是提供一种可降低切割吻合过程中的击发力且可增大弯转角度的可弯转腔镜下直线切割吻合器及其组件，以使医生有更好的操作手感及操作空间。
为解决上述技术问题，本发明采用如下技术方案：
一种可弯转腔镜下直线切割吻合器组件，包括吻合器钳口、转向连接块、组件内芯、切割刀组件；所述组件内芯包括内芯壳体及固定安装在内芯壳体内的内芯连接块；所述转向连接块前端与吻合器钳口后端铰接，铰接处形成第一竖向旋转轴，所述转向连接块后端与内芯连接块前端铰接，铰接处形成第二竖向旋转轴；所述切割刀组件穿过内芯连接块、转向连接块及吻合器钳口且可前后滑动。
作为本发明进一步地改进，还包括左右弯转片及推拉杆；所述左右弯转片呈U字形，其后部弯转部通过内芯连接块转向，其前端两个自由端由后至前穿过转向连接块再与吻合器钳口后端固定连接；所述左右弯转片的左侧或右侧与推拉杆的前端连接，可在推拉杆的推拉动作下带动吻合器钳口绕第一竖向旋转轴及第二竖向旋转轴左右转弯。
进一步地，所述吻合器钳口包括位于上部的钉匣组件及与钉匣组件连接的、位于下部的抵钉座，还包括位于抵钉座后部内侧的抵钉座定位件；所述左右弯转片的自由端通过横向连接销钉固定连接在抵钉座定位件与抵钉座后部之间，所述切割刀组件穿过所述抵钉座定位件。
进一步地，所述转向连接块通过前端设置的竖向的定位块连接孔与抵钉座定位件上设置的定位块连接轴连接；所述转向连接块通过后端设置的 竖向的内芯连接块定位孔与内芯连接块前端设置的内芯连接轴连接。
进一步地，所述切割刀组件包括切割刀组件上片及切割刀组件下片，所述切割刀组件上片和切割刀组件下片分别依次穿过内芯连接块、转向连接块及抵钉座定位件的上部、下部，并在前端连接为一体。
进一步地，所述内芯连接块的后端设置有U形凹槽，所述左右弯转片的弯转部内侧与U形凹槽配合。
进一步地，所述内芯连接块的上表面、下表面分别设置有多个凸出的卡位台阶，所述多个凸出的卡位台阶之间分别形成切割刀组件上片或切割刀组件下片的容纳空间；所述内芯壳体包括内芯上盖和内芯下盖，所述内芯连接块通过卡位台阶与内芯上盖和内芯下盖连接。
进一步地，所述转向连接块的左、右侧面分别设置有左右弯转片穿口，所述推拉杆与左右弯转片的连接端位于左右弯转片穿口的后端；所述吻合器组件还包括推拉块，所述推拉杆通过设置在其前部的固定凸台装入推拉块后部设置的推拉块孔内，所述推拉块通过设置在其前部的推拉块轴装入左右弯转片左侧或右侧设置的固定孔内。
进一步地，所述左右弯转片的后部弯转部替换为柔性钢丝绳，所述柔性钢丝绳与左右弯转片的前部通过连接环压装；或所述左右弯转片全部替换为柔性钢丝绳。
本发明还提供了一种可弯转腔镜下直线切割吻合器，包括手柄及连接在手柄前端的可弯转腔镜下直线切割吻合器组件，所述可弯转腔镜下直线切割吻合器组件采用上述的可弯转腔镜下直线切割吻合器组件。
通过采用上述技术方案，本发明至少具有以下优点：
1、本发明采用双旋转中心，可实现大的切割刀弯转半径，有效降低了使用过程的击发力，使医生获得了更好的操作手感。另外，可加大弯转半径，并可做到更大的弯转角度，使医生有更好的操作空间，适于更复杂临 床条件下的医疗。
2、本发明采用柔性的左右弯转片通过换向，始终保持左右弯转是拉拽的过程，避免弯转过程中的力臂减小，力矩稳定，并可做到更大的弯转角度。
附图说明
上述仅是本发明技术方案的概述，为了能够更清楚了解本发明的技术手段，以下结合附图与具体实施方式对本发明作进一步的详细说明。
图1是现有技术中的腔镜下直线切割吻合器组件爆炸结构示意图；
图2、3分别是图1中的腔镜下直线切割吻合器组件向右、向左弯转示意图；
图4是本发明一实施例中可弯转腔镜下直线切割吻合器组件的外部结构示意图；
图5是本发明一实施例中的可弯转腔镜下直线切割吻合器组件弯转状态结构示意图；
图6为本发明一实施例中的可弯转腔镜下直线切割吻合器组件的俯视结构示意图(可见内部)；
图7为本发明一实施例中的可弯转腔镜下直线切割吻合器组件的工作原理图；
图8是本发明一实施例中的可弯转腔镜下直线切割吻合器组件爆炸结构示意图；
图9是本发明一实施例中的可弯转腔镜下直线切割吻合器组件的局部爆炸结构示意图(双旋转中心连接处)；
图10是本发明一实施例中的切割刀组件与其它部件的组装结构示意图；
图11是本发明一实施例中的可弯转腔镜下直线切割吻合器组件的局部爆炸结构示意图(弯转控制部分)。
具体实施方式
以下结合附图对本发明的优选实施例进行说明，应当理解，此处所描述的优选实施例仅用于说明和解释本发明，并不用于限定本发明。
针对现有技术中存在的如下问题：当弯转状态时击发切割吻合，需要较大的击发力，影响医操作手感，且吻合器钳口的左右摆动角度受限，使得在部分手术夹持、横断、吻合等一系列操作不能达到理想的操作位置，无法适于更复杂临床条件下的医疗。申请人经过多次实验发现，其原因在于单旋转中心的设置，由于其为单旋转中心，在弯转过程切割刀随之弯转，转向角度过大，致使切割刀弯转过程中形成较小的弯转半径，造成切割吻合过程击发力过大，影响医生操作手感，并且吻合器还会加大故障风险。另外，申请人还发现，现有结构中，转向连杆为刚性连接且与旋转轴间力臂长度受空间限制，导致左右摆动角度受到限制，使得在部分手术夹持、横断、吻合等一系列操作不能达到理想的操作位置，无法适于更复杂临床条件下的医疗。
基于上述发现，申请人对现有技术的弯转部分及弯转控制部分分别进行了相应改进。
为了便于说明，本发明将吻合器钳口端定义为前、操作者端为后，吻合器钳口开合方向为上下，吻合器钳口弯转方向为左右，上述方向设置不应用于限制本发明。
配合图4-7所示，本实施例提供了一种可弯转腔镜下直线切割吻合器组件，包括吻合器钳口1、转向连接块2、组件内芯3、切割刀组件4，其中，组件内芯3属于外壳固定类零件，包括内芯壳体及固定安装在内芯壳体内的内芯连接块31，转向连接块2前端与吻合器钳口1后端铰接，铰接 处形成第一竖向旋转轴A，转向连接块2后端与内芯连接块31前端铰接，铰接处形成第二竖向旋转轴B；切割刀组件4穿过内芯连接块31、转向连接块2及吻合器钳口1且可前后滑动。
通过上述设置，当弯转时，吻合器钳口1可绕双旋转中心(第一竖向旋转轴A、第二竖向旋转轴B)旋转，可实现大的切割刀弯转半径，有效降低使用过程的击发力，使医生获得更好的操作手感。另外，可加大弯转半径，并可做到更大的弯转角度，使医生有更好的操作空间，适于更复杂临床条件下的医疗。
在上述基础上，为了进一步解决弯转控制问题，配合图7-11所示，本实施例的可弯转腔镜下直线切割吻合器组件还包括左右弯转片5、推拉杆6；具体地，配合图7、8、9、11所示，左右弯转片5呈U字形，其后部弯转部通过内芯连接块31转向，具体地，内芯连接块31的后端可设置有U形凹槽313，左右弯转片5的弯转部内侧可与U形凹槽313配合。左右弯转片5其前端两个自由端由后至前穿过转向连接块2再与吻合器钳口1后端固定连接，具体地，可在转向连接块2的左、右侧面分别设置有左右弯转片穿口，推拉杆6与左右弯转片5的连接端位于左右弯转片穿口的后端。左右弯转片5的左侧或右侧与推拉杆6的前端连接，可在推拉杆6的推拉动作下带动吻合器钳口1绕第一竖向旋转轴A及第二竖向旋转轴B左右转弯。
配合图7所示，上述弯转控制过程具体通过如下方式实现：以推拉杆6设置在左右弯转片5右侧为例，工作过程中，通过助力推推拉杆6时，推拉杆6带动左右弯转片5的右侧向前运动，进而带动左右弯转片5的左侧向后运动以及带动与左右弯转片5前端连接的吻合器钳口1绕转向连接块2的两个旋转中心向左弯转。反之，通过助力拉推拉杆6时，推拉杆6带动左右弯转片5的右侧向后运动，进而带动左右弯转片5的左侧向前运动以及带动与左右弯转片5前端连接的吻合器钳口1绕转向连接块2的两个旋转中心向右弯转。当然，上述仅是对本发明的推拉弯转工作原理的说明， 推拉杆6也可以安装在左右弯转片5的左侧，此时，吻合器钳口1的在推力作用下，向右侧弯转，在拉力作用下，向左侧弯转。
由于在上述推拉过程中，都是通过在左右弯转片5一侧固定的推拉杆6施以推力或拉力，避免了弯转过程中的力臂减小，力矩稳定，并可做到更大的弯转角度。
配合图8、9所示，在转向连接块2与吻合器钳口1、内芯连接块31的连接关系上，优选如下结构：
转向连接块2前端设置有竖向的定位块连接孔21，在吻合器钳口1(包括位于上部的钉匣组件11、与钉匣组件连接的、位于下部的抵钉座12以及位于抵钉座后部12内侧的抵钉座定位件13)的抵钉座定位件13上设置有定位块连接轴131，定位块连接孔21与定位块连接轴131连接，形成第一竖向旋转轴A；在转向连接块2后端设置有竖向的内芯连接块定位孔22，在内芯连接块31前端设置有内芯连接轴311，内芯连接块定位孔22与内芯连接轴311连接，形成第二竖向旋转轴B。
当然，可以理解的是，只要能形成双旋转中心即可实现合理的加大的弯转半径，本发明的双旋转中心的连接关系应不受上述设置的限制，如轴、孔的位置也可互换或交叉设计均可。
在设置有抵钉座定位件13的基础上，左右弯转片5的自由端可通过横向连接销钉14固定连接在抵钉座定位件13与抵钉座12后部之间。
再配合配合图8、10所示，切割刀组件4包括切割刀组件上片41及切割刀组件下片42，切割刀组件上片41和切割刀组件下片42分别依次穿过内芯连接块31、转向连接块2及抵钉座定位件13的上部、下部，并在前端连接为一体。具体地，如图9所示，内芯连接块31的上表面、下表面分别设置有多个凸出的卡位台阶312，多个凸出的卡位台阶312之间分别形成切割刀组件上片41或切割刀组件下片42的容纳空间；内芯壳体包括内芯上 盖32和内芯下盖33，内芯连接块31可通过卡位台阶312与内芯上盖32和内芯下盖33连接。
配合图11所示，推拉杆6可通过中间连接件与左右弯转片5连接，中间连接片为推拉块7，推拉杆6通过设置在其前部的固定凸台61装入推拉块7后部设置的推拉块孔71内，推拉块7通过设置在其前部的推拉块轴72装入左右弯转片5左侧或右侧设置的固定孔51内。
上述弯转控制部分中的左右弯转片5，除了采用片状形式，其也可采用其它柔性连接方式，如左右弯转片5可全部替换为柔性钢丝绳。或者，如图11所示，左右弯转片5的后部弯转部52替换为柔性钢丝绳，柔性钢丝绳与左右弯转片的前部通过连接环53压装。
本实施例还提供了一种可弯转腔镜下直线切割吻合器，包括手柄及连接在手柄前端的腔镜下直线切割吻合器组件，其中的腔镜下直线切割吻合器组件优选采用上述的腔镜下直线切割吻合器组件。
在手术操作时，可弯转腔镜下直线切割吻合器在直线状态下，通过穿刺器进入胸腔或者腹腔，通过体外的手柄上面控弯机构控制吻合器钳口弯转一定的角度，并对手术部位进行夹持、横断、吻合等一系列操作，通过双旋转中心的设置，增大了切割刀弯转半径，有效降低了使用过程的击发力，使医生获得更好的操作手感；采用柔性的左右弯转片通过换向，可始终保持左右弯转是拉拽的过程，避免弯转过程中的力臂减小，力矩稳定；上述设置也同时具有大的弯转角度，使医生有更好的操作空间，可适于更复杂临床条件下的医疗。
以上所述，仅是本发明的较佳实施例而已，并非对本发明作任何形式上的限制，本领域技术人员利用上述揭示的技术内容做出些许简单修改、等同变化或修饰，均落在本发明的保护范围内。

Claims (10)

  1. 一种可弯转腔镜下直线切割吻合器组件，其特征在于，包括吻合器钳口、转向连接块、组件内芯、切割刀组件；所述组件内芯包括内芯壳体及固定安装在内芯壳体内的内芯连接块；
    所述转向连接块前端与吻合器钳口后端铰接，铰接处形成第一竖向旋转轴，所述转向连接块后端与内芯连接块前端铰接，铰接处形成第二竖向旋转轴；所述切割刀组件穿过内芯连接块、转向连接块及吻合器钳口且可前后滑动。
  2. 根据权利要求1所述的可弯转腔镜下直线切割吻合器组件，其特征在于，还包括左右弯转片及推拉杆；
    所述左右弯转片呈U字形，其后部弯转部通过内芯连接块转向，其前端两个自由端由后至前穿过转向连接块再与吻合器钳口后端固定连接；所述左右弯转片的左侧或右侧与推拉杆的前端连接，可在推拉杆的推拉动作下带动吻合器钳口绕第一竖向旋转轴及第二竖向旋转轴左右转弯。
  3. 根据权利要求2所述的可弯转腔镜下直线切割吻合器组件，其特征在于，所述吻合器钳口包括位于上部的钉匣组件及与钉匣组件连接的、位于下部的抵钉座，还包括位于抵钉座后部内侧的抵钉座定位件；
    所述左右弯转片的自由端通过横向连接销钉固定连接在抵钉座定位件与抵钉座后部之间，所述切割刀组件穿过所述抵钉座定位件。
  4. 根据权利要求3所述的可弯转腔镜下直线切割吻合器组件，其特征在于，所述转向连接块通过前端设置的竖向的定位块连接孔与抵钉座定位件上设置的定位块连接轴连接；所述转向连接块通过后端设置的竖向的内芯连接块定位孔与内芯连接块前端设置的内芯连接轴连接。
  5. 根据权利要求3所述的可弯转腔镜下直线切割吻合器组件，其特征 在于，所述切割刀组件包括切割刀组件上片及切割刀组件下片，所述切割刀组件上片和切割刀组件下片分别依次穿过内芯连接块、转向连接块及抵钉座定位件的上部、下部，并在前端连接为一体。
  6. 根据权利要求2所述的可弯转腔镜下直线切割吻合器组件，其特征在于，所述内芯连接块的后端设置有U形凹槽，所述左右弯转片的弯转部内侧与U形凹槽配合。
  7. 根据权利要求5所述的可弯转腔镜下直线切割吻合器组件，其特征在于，所述内芯连接块的上表面、下表面分别设置有多个凸出的卡位台阶，所述多个凸出的卡位台阶之间分别形成切割刀组件上片或切割刀组件下片的容纳空间；所述内芯壳体包括内芯上盖和内芯下盖，所述内芯连接块通过卡位台阶与内芯上盖和内芯下盖连接。
  8. 根据权利要求1所述的可弯转腔镜下直线切割吻合器组件，其特征在于，所述转向连接块的左、右侧面分别设置有左右弯转片穿口，所述推拉杆与左右弯转片的连接端位于左右弯转片穿口的后端；
    所述吻合器组件还包括推拉块，所述推拉杆通过设置在其前部的固定凸台装入推拉块后部设置的推拉块孔内，所述推拉块通过设置在其前部的推拉块轴装入左右弯转片左侧或右侧设置的固定孔内。
  9. 根据权利要求2所述的可弯转腔镜下直线切割吻合器组件，其特征在于，所述左右弯转片的后部弯转部替换为柔性钢丝绳，所述柔性钢丝绳与左右弯转片的前部通过连接环压装；
    或所述左右弯转片全部替换为柔性钢丝绳。
  10. 一种可弯转腔镜下直线切割吻合器，包括手柄及连接在手柄前端的可弯转腔镜下直线切割吻合器组件，其特征在于，所述可弯转腔镜下直线切割吻合器组件采用权利要求1-9任一项所述的可弯转腔镜下直线切割吻合器组件。
PCT/CN2021/071122 2020-02-27 2021-01-11 一种可弯转腔镜下直线切割吻合器及其组件 WO2021169634A1 (zh)

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