WO2022111320A1

WO2022111320A1 - Detachable surgical instrument

Info

Publication number: WO2022111320A1
Application number: PCT/CN2021/130547
Authority: WO
Inventors: 杨光
Original assignee: 上海逸思医疗科技股份有限公司; 逸思（苏州）医疗科技有限公司; 浙江逸镜医疗器械有限公司
Priority date: 2020-11-24
Filing date: 2021-11-15
Publication date: 2022-06-02
Also published as: CN114533248A

Abstract

Provided is a detachable surgical instrument (A), comprising: a handle part (2), the handle part (2) comprising an outer housing and a handle casing extending from the distal end of the outer housing, the handle casing being provided with a first electrical docking mechanism and a first mechanical docking mechanism; an actuating mechanism (1) comprising an actuating casing, the proximal end of the actuating casing being correspondingly provided with a second electrical docking mechanism and a second mechanical docking mechanism; by means of the fit of the first electrical docking mechanism with the second electrical docking mechanism and the fit of the first mechanical docking mechanism with the second mechanical docking mechanism, the electrical connection and detachable mechanical connection of the handle part (2) to the actuator (1) are achieved; when the handle part (2) is connected to the actuating mechanism (1), the handle part (2) controls the operation of the actuating mechanism (1). When the actuating mechanism (1) and the handle part (2) of the surgical instrument (A) are detachably connected, the operation of the actuating mechanism (1) is controlled by means of the handle part (2), solving the existing problem of difficulty in cleaning the gap between the outer and inner casings of the surgical instrument (A).

Description

A detachable surgical instrument

technical field

The invention relates to the field of electrosurgical instruments, which is applied to electrocoagulation to stop bleeding and/or tissue cutting during surgical operations, in particular to a detachable surgical instrument.

Background technique

High frequency electrosurgical instruments are surgical instruments used for electrocoagulation hemostasis and/or tissue cutting during surgery, which generally include gun-type structures and forceps-type structures. The high-frequency electrosurgical surgical instrument with a clamp-type structure mainly clamps and physically pressurizes the blood vessel through two clamps at the front end. Collagen and fibrinolysis and degeneration in the blood vessels are fused together to close the blood vessels; after the blood vessels are closed, the knife is directly cut off to cut off the closure band. Therefore, the operation time is greatly shortened, the bleeding is reduced, and the operation risk is minimized, and it is widely used in surgical operations because of its high efficiency and reliability compared with traditional suture ligation.

The high-frequency electrosurgical instrument of the forceps structure is usually composed of a clamp, a cutting knife and a knife shank, an inner sleeve and an outer sleeve surrounding the outside of the knife shank, a power cable, and a holding mechanism. The energized cable transmits high-frequency electric energy to the clamp, and the combination of the clamp and the cutting knife realizes the functions of clamping tissue, closing blood vessels and cutting. Among them, on the one hand, the inner sleeve plays the role of protecting and supporting the cutter rod, and on the other hand, it forms a link mechanism with the clamp, which can drive the closing and opening of the clamp. On the one hand, the outer sleeve isolates the inner sleeve and the energized cable from the outside for protection, and on the other hand, it is fixed with the clamp to form the support end of the link mechanism. The holding mechanism is used by the doctor to hold the hand and operate the clamp to open. Closed, there is generally a switch on it to control the oscillating electrical signal output by the high-frequency energy generator to the clamp.

The sleeves of the mainstream surgical instruments currently on the market include an outer sleeve and an inner sleeve, and the cutter bar is located in the inner sleeve. The gap between the inner and outer casings, between the inner casing and the cutter bar is relatively small. After an operation is completed, blood or tissue fluid will enter between the inner and outer casings or between the inner casing and the cutter bar is very small and narrow. Clearance. Because the blood or tissue fluid entering the gap is difficult to clean, even if the structure and performance of the surgical instrument are still good, it cannot be reused in surgery, and can only be used as a disposable instrument, which makes its use cost very high.

SUMMARY OF THE INVENTION

The present invention provides a detachable surgical instrument comprising: an actuator and a handle portion. The actuator is used for contact with biological tissue in surgical operations, and often needs to be replaced to ensure cleanliness; the handle portion is not in contact with biological tissue, and can be reused after sterilization to reduce operating costs.

A detachable surgical instrument comprising:

a handle part, the handle part includes a casing and a handle sleeve extending from the distal end of the casing, the handle sleeve is provided with a first electrical docking mechanism and a first mechanical docking mechanism;

An actuator, the actuator includes an execution sleeve, the proximal end of the executive sleeve is correspondingly provided with a second electrical docking mechanism and a second mechanical docking mechanism, and through the cooperation of the first electrical docking mechanism and the second electrical docking mechanism, The handle part is electrically connected to the actuator, and the handle part is detachably connected to the actuator through the cooperation of the first mechanical docking mechanism and the second mechanical docking mechanism;

When the handle portion is connected with the actuator, the handle portion controls the operation of the actuator. In detail, the operation of the actuator here not only has the purpose of coagulating blood vessels, but also heating the tissue when the high-frequency high-voltage current generated by the effective electrode tip is in contact with the body, so as to realize the separation and coagulation of the body tissue, thereby playing The purpose of cutting and hemostasis.

Further, the first electrical docking mechanism includes a channel a and a handle electrode, the second electrical docking mechanism includes a clamp electrode corresponding to the channel a and the handle electrode, and the clamp electrode is inserted into the channel. a, the clamp electrode is matched with the handle electrode correspondingly, and the handle part is electrically connected with the actuator.

Further, the handle electrode is arranged on the handle sleeve, the handle electrode is connected with the high-frequency energy generator, and the clamp electrode is arranged at the proximal end of the clamp sleeve and insulated from each other. A pair of raised electrodes, one electrode of the pair of raised electrodes is electrically connected to a clamp, and the other electrode is electrically connected to another clamp.

Further, the first mechanical docking mechanism includes a channel b, the second mechanical docking mechanism includes a boss corresponding to the channel b, and a groove matched with the boss, and a pull rod is arranged in the handle sleeve , the groove is provided at the far end of the pull rod, insert the boss into the channel b to a certain position and rotate, the boss is clamped in the groove, the handle part is connected to the Actuator mechanical connection.

Further, a sliding block and a protrusion connected to the sliding block are also provided on the execution sleeve, and the protrusion can move axially under the driving of the sliding block. When the groove is inserted, the slider is pushed toward the proximal end of the actuator sleeve, the protrusion is inserted into the channel b, and the handle portion is circumferentially connected to the actuator.

Further, the housing of the handle part is provided with a closing trigger, and the closing trigger controls the pull rod to move axially along the handle sleeve, so as to control the opening and closing of the clamp on the actuator; The execution sleeve is also provided with a cutting knife, the handle sleeve is also provided with a central rod axially arranged and connected with the cutting knife, a push-knife button is provided on the outer shell of the handle part, and the push-knife is provided. The button is mechanically connected with the central rod, and the axial movement of the central rod is controlled by the push-knife button to drive the axial movement of the cutting knife.

Further, a reset mechanism is also provided in the execution sleeve, and the reset mechanism returns the cutting knife after cutting the tissue to the original position after releasing the knife push button.

Further, the central rod can pull back the pushed out cutting blade.

Further, the handle part is also provided with a power-on button for controlling the high-frequency energy generator to transmit high-frequency energy to the handle electrode.

Further, the handle part is reusable, and the actuator is disposable.

The surgical instrument provided by the present invention is a detachable structure, including a disposable actuator and a reusable handle part, wherein because the disposable clamp part is in contact with biological tissue, it is used in a disposable operation to protect the patient Safe, while the reusable handle portion does not come into contact with biological tissue, it can be reused after sterilization, reducing surgical costs.

Description of drawings

1 is a schematic diagram of a surgical system of a detachable surgical instrument provided by the present invention;

Figure 2 is a schematic diagram of the composition of the detachable surgical instrument provided by the present invention;

3 is a schematic diagram of an actuator in a detachable surgical instrument;

Fig. 4 is the axial cross-sectional schematic diagram of the actuator in the detachable surgical instrument;

Figure 5 is a schematic diagram of the proximal end structure of the actuator in the detachable surgical instrument;

6 is a schematic diagram of the structure of the distal end of the handle sleeve in the detachable surgical instrument;

FIG. 7 is a schematic view of the installation of the actuator and the handle part in the detachable surgical instrument;

Fig. 8 is the state schematic diagram of the connection part after the detachable surgical instrument is installed;

9 is an axial cross-sectional schematic view of the connecting portion after the detachable surgical instrument is installed;

FIG. 10 is a schematic transverse cross-sectional view of the connecting portion after the installation of the detachable surgical instrument is completed.

Detailed ways

In order to make the technical problems, technical solutions and beneficial effects solved by the present invention clearer, the present invention will be further described in detail below with reference to the accompanying drawings. It should be understood that the specific embodiments described herein are only used to explain the present invention, but not to limit the present invention.

The electrosurgical instrument system provided by the present invention, as shown in FIG. 1 , is mainly composed of a surgical instrument (electrosurgical instrument) A with a clamp-type structure and a high-frequency energy generator B. Among them, the high-frequency energy generator B is used to generate and transmit high-frequency electric energy to the surgical instrument A to control the operation of the surgical instrument A; Blood vessels are closed.

The main structure of surgical instrument A is shown in Figure 2, including a disposable actuator 1 and a reusable handle part 2, wherein the actuator 1 and the handle part 2 are detachably connected, and the actuator 1 is mainly connected with the handle part 2. Biological tissue-contacting and single-use jaw portion, which is used in a single-use procedure to protect patient safety, while the reusable handle portion 2 does not come into contact with biological tissue and is reused after sterilization, thereby Reduce surgery costs.

The actuator 1 of the surgical instrument A includes an execution sleeve, wherein the execution sleeve is an executive round tube 10 located at the proximal end of the actuator 1 , and the handle portion 2 includes a casing and a handle casing extending from the end of the casing. Specifically, the handle sleeve includes an elongated handle circular tube 20 extending axially from the outer shell of the handle portion 2 to the distal end, and the distal end of the handle circular tube 20 and the proximal end of the execution circular tube 10 are electrically connected to each other. The docking mechanism and the mechanical docking mechanism realize the detachable connection of the two.

The handle tube 20 is provided with a first electrical docking mechanism and a first mechanical docking mechanism; the proximal end of the execution cylinder 10 is provided with a second electrical docking mechanism and a second mechanical docking mechanism correspondingly, through the first electrical docking mechanism and the second With the cooperation of the electrical docking mechanism, the handle part 2 is electrically connected with the actuator 1 to realize the transmission of current; at the same time, through the cooperation of the first mechanical docking mechanism and the second mechanical docking mechanism, the detachable mechanical connection between the handle part 2 and the actuator 1 is realized. . When the handle part 2 is connected with the actuator 1, the actuator 1 will run under the control of the handle part 2. The operation of the actuator 1 includes not only coagulation of blood vessels, but also contact with the body through the high-frequency high-voltage current generated by the effective electrode tip. The tissue is heated to achieve the separation and coagulation of the body tissue, so as to achieve the purpose of cutting and hemostasis.

As shown in FIGS. 3-5 , the execution tube 10 includes an outer tube sleeve 10a and an inner tube sleeve 10b, and the distal end of the execution tube 10 has a pair of

clamps

11 and 12 for holding biological tissues, at least one of which is The

clamps

11 and 12 can be rotated around the

shafts

13 and 14 so as to realize the closing and opening of the

clamps

11 and 12 .

The proximal end of the execution tube 10 of the actuator 1 is made of insulating material, and a pair of fixed and mutually

insulated clamp electrodes

15 and 16 are arranged on the execution tube 10, and a pair of

clamp electrodes

15 and 16 can be moved in the axial direction for cutting the coagulated tissue. The cutting blade 18 and the pair of

clamp electrodes

15 and 16 are respectively connected to the

clamps

11 and 12 to energize the

clamps

11 and 12 . Preferably, the

clamp electrodes

15 and 16 are a pair of raised electrodes, one electrode of the pair of raised electrodes is electrically connected to one of the

clamps

11 and 12 , and the other electrode is electrically connected to one of the

clamps

11 and 12 . The other clamp is electrically connected.

The proximal end of the execution tube 10 is also provided with at least one boss 17, which is mechanically connected with the

clamps

11 and 12. By controlling the movement of the boss 17, the opening and closing of the

clamps

11 and 12 are controlled.

As shown in FIG. 6 , the casing of the handle part 2 is provided with a relatively movable closing trigger 21 and a knife push button 22 . The handle barrel 20 is provided with at least one pull rod 201 with a groove 201a and at least one central rod 202 arranged along the axial direction of the handle pipe 20. The pull rod 201 is mechanically connected with the closing trigger 21, and the pull rod 201 is controlled by the closing trigger 21 along the axis. The handle circular tube 20 moves axially, thereby driving the opening and closing of the

clamps

11 and 12; the central rod 202 is mechanically connected with the knife push button 22, and the central rod 202 is controlled to move axially along the handle circular pipe 20 through the push knife button 22, and then The axial movement of the cutting knife 18 is driven.

The distal end of the handle tube 20 includes a pair of

handle electrodes

203 and 204 which are insulated from each other. A power-on switch (not shown in the figure) is also provided on the outer shell of the handle part 2. The

handle electrodes

203 and 204 generate high-frequency energy. The high-frequency energy generator is used to transmit high-frequency energy to the

handle electrodes

203, 204, and the start or disconnection of the power-on switch can control the high-frequency energy generator to start or stop outputting oscillating electrical signals to send the

handle electrodes

203, 204. 204 transmits high-frequency electrical energy or stops transmitting high-frequency electrical energy to the

handle electrodes

203 and 204 .

The distal end of the handle round tube 20 is made of insulating material, and the distal end of the handle round tube 20 has a channel a for accommodating the

clamp electrodes

15 and 16 and a channel b for accommodating the boss 17 .

That is, the first electrical docking mechanism is the channel a provided at the distal end of the handle circular tube 20 and the

handle electrodes

203 and 204 provided on the wall of the channel a, and the first mechanical docking mechanism is provided at the distal end of the handle circular tube 20 Correspondingly, the second electrical docking mechanism is the

clamp electrodes

15 and 16 provided at the proximal end of the execution tube 10, and the second mechanical docking mechanism is the boss provided at the distal end of the execution tube 10. 17 and a groove 201a that is in motion with the boss 17, the groove 201a is located at the distal end of at least one pull rod 201 in the handle barrel 20, by inserting the clamp electrode 15 into the channel a, while the boss 17 is inserted into the channel b to At a certain position and rotating, the boss 17 is clamped in the groove 201a of the pull rod, so as to realize the mechanical connection between the handle part 2 and the actuator 1, and at the same time, the clamp electrode 15 and the

handle electrodes

203 and 204 are matched one by one, thereby realizing the handle The part is electrically connected to the actuator.

In the present invention, a reset mechanism is also provided in the execution sleeve (execution round pipe 10 ), preferably, the reset mechanism is a reset spring, wherein, when the knife push button 22 pushes the cutting knife to move to the distal end, the reset mechanism The return spring is compressed, and after the cutting is completed, the push-knife button is released, and the compressed spring returns to its original state to provide a restoring force for the proximal movement of the cutting knife, thereby returning the cutting knife after cutting the tissue to its original position.

In some embodiments, the distally protruding cutting blade may also be pulled back directly through the center rod.

The execution tube 10 also includes a knife push block 18a and a cutting knife spring 18b. The push block 18a is disposed near the proximal end of the execution pipe 10, and the knife push block 18a pushes the cutting knife to move in the axial direction. A sliding block 19a and a protrusion 19b connected to the sliding block 19a are also provided near the proximal end of the execution sleeve (execution round pipe 10). The block 19a can elastically move toward the proximal end or the distal end of the execution tube 10 under the push of an elastic member 18b (shown in FIG. 9 ) arranged inside the execution tube 10 .

As shown in Figure 7-9, the process of installing the actuator 1 and the handle part 2 is as follows:

Align the

clamp electrodes

15, 16 at the proximal end of the execution tube 10 with the channel a at the distal end of the handle tube 20 and insert them into the channel a, while the boss 17 is aligned with the channel b and inserted into the channel b correspondingly, the slider 19a Abutting on the end face of the handle barrel 20 and moving toward the distal end of the handle barrel 20, the elastic member arranged inside the execution barrel 10 is compressed, and when the protrusion 19b is aligned with the channel a of the handle barrel 20, the protrusion Under the action of the compressed elastic member, the 19b moves toward the proximal end of the execution tube 10 and is embedded in the channel a, preventing the actuator 1 and the handle part 2 from rotating in the circumferential direction.

At the same time, after the protrusion 19b is inserted into a certain position, rotate the execution tube 10 by a certain angle, which is approximately equal to α. At this time, the boss 17 fits into the groove 201 of the pull rod 201, and the closing trigger 21 pulls the boss through the pull rod 201. 17 to control the opening and closing of the

clamps

11 and 12; and the push-knife button 22 can control the axial movement of the central rod 202, push the push-knife block 18a while compressing the cutting knife spring 18b, which will perform the operation in the circular tube 10. The cutting blade 18 is pushed out to cut the coagulated vascular tissue.

After the knife push button 22 is released, the compressed knife spring 18b will return the knife in the execution tube 10 to the original position. In yet other embodiments, the central rod 201 may be configured to mechanically connect with the cutting blade 18 to directly pull the pushed out cutting blade 18 back through the central rod 201 . At the same time, the

clamp electrodes

15, 16 of the actuator 1 and the

handle electrodes

203, 204 are electrically connected to each other, so that the high frequency energy can be further transmitted to the

clamp electrodes

11, 12 through the

clamp electrodes

15, 16 and the

handle electrodes

203, 204, Thereby, the vascular closure operation is realized. Preferably, the

handle electrodes

203 and 204 can be configured as conductive elastic parts (such as metal sheets) to ensure good contact between the

clamp electrodes

15 and 16 and the

handle electrodes

203 and 204 .

Further, the handle portion may further include a power-on button (not shown) to selectively release high-frequency energy; in another embodiment, the power-on button may also be provided on the high-frequency generator.

When the actuator 1 and the handle part 2 are disassembled, the slider 19a is pushed to move to the distal end of the circular tube 10 of the actuator for a certain stroke, the elastic member arranged inside the circular tube 10 of the actuator is compressed, and the protrusion 19b is engaged with the channel a Disengage; reversely rotate the actuator 1 for a certain angle, and the angle is approximately equal to α, then the disassembly of the actuator 1 is completed (reverse operation of the installation process).

The surgical instrument provided by the present invention fundamentally solves the problem of difficulty in cleaning the gap between the outer casing and the inner casing of the existing surgical instrument, greatly reduces the cost of surgery; and has a simple structure, convenient assembly and disassembly, and easy cleaning.

Claims

A detachable surgical instrument, characterized in that the surgical instrument comprises:

a handle part, the handle part includes a casing and a handle sleeve extending from the distal end of the casing, the handle sleeve is provided with a first electrical docking mechanism and a first mechanical docking mechanism;

An actuator, the actuator includes an execution sleeve, the proximal end of the executive sleeve is correspondingly provided with a second electrical docking mechanism and a second mechanical docking mechanism, and through the cooperation of the first electrical docking mechanism and the second electrical docking mechanism, The handle part is electrically connected to the actuator, and the handle part is detachably connected to the actuator through the cooperation of the first mechanical docking mechanism and the second mechanical docking mechanism;

When the handle portion is connected with the actuator, the handle portion controls the operation of the actuator.
The surgical instrument of claim 1, wherein the first electrical docking mechanism comprises a channel a and a handle electrode, and the second electrical docking mechanism comprises a clamp corresponding to the channel a and the handle electrode electrode; insert the clamp electrode into the channel a, the clamp electrode is matched with the handle electrode correspondingly, and the handle part is electrically connected with the actuator.
The surgical instrument according to claim 2, wherein the handle electrode is provided on the handle sleeve, the handle electrode is connected with the high-frequency energy generator, and the clamp electrode is provided on the handle A pair of protruding electrodes at the proximal end of the clamp sleeve and insulated from each other, one electrode of the pair of protruding electrodes is electrically connected to one clamp, and the other electrode is electrically connected to the other clamp.
The surgical instrument according to claim 1, wherein the first mechanical docking mechanism includes a channel b, and the second mechanical docking mechanism includes a boss corresponding to the channel b and moves with the boss The matching groove, the handle sleeve is provided with a pull rod, the groove is set at the distal end of the pull rod, the boss is inserted into the channel b to a certain position and rotated, and the boss is clamped on the In the groove, the handle portion is mechanically connected with the actuator.
The surgical instrument according to claim 4, wherein the execution sleeve is further provided with a sliding block and a protrusion connected with the sliding block, and the protrusion can be driven by the sliding block Axial movement, when the boss is snapped into the groove, the slider is pushed towards the proximal end of the execution sleeve, the protrusion is inserted into the channel b, the handle part is connected to the actuator Circumferential connection.
5. The surgical instrument of claim 4, wherein the housing of the handle portion is provided with a closing trigger, the closing trigger controlling the axial movement of the pull rod along the handle sleeve to control the execution The opening and closing of the clamp on the mechanism; the execution sleeve is also provided with a cutting knife, the handle sleeve is also provided with a central rod arranged axially and connected with the cutting knife, and the handle part is provided with a central rod. A knife push button is provided on the casing, the knife push button is mechanically connected with the central rod, and the axial movement of the central rod is controlled by the push knife button to drive the cutting knife to move axially.
The surgical instrument according to claim 6, wherein the execution sleeve is further provided with a reset mechanism, and the reset mechanism returns the cutting knife to the original position after releasing the knife push button.
7. The surgical instrument of claim 6, wherein said central rod is further adapted to pull back said extruded cutting blade.
The surgical instrument according to claim 1, wherein the handle portion is further provided with a power-on button for controlling the high-frequency energy generator to transmit high-frequency energy to the handle electrode.
6. The surgical instrument of claim 1, wherein the handle portion is reusable and the actuator is disposable.