WO2022143721A1 - Agrafeuse chirurgicale - Google Patents

Agrafeuse chirurgicale Download PDF

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Publication number
WO2022143721A1
WO2022143721A1 PCT/CN2021/142297 CN2021142297W WO2022143721A1 WO 2022143721 A1 WO2022143721 A1 WO 2022143721A1 CN 2021142297 W CN2021142297 W CN 2021142297W WO 2022143721 A1 WO2022143721 A1 WO 2022143721A1
Authority
WO
WIPO (PCT)
Prior art keywords
firing
assembly
staple cartridge
surgical stapler
anvil
Prior art date
Application number
PCT/CN2021/142297
Other languages
English (en)
Chinese (zh)
Inventor
单腾
曹元阳
Original Assignee
天臣国际医疗科技股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN202023274748.0U external-priority patent/CN214907505U/zh
Priority claimed from CN202023275224.3U external-priority patent/CN214907506U/zh
Priority claimed from CN202023275967.0U external-priority patent/CN214907508U/zh
Priority claimed from CN202011602221.8A external-priority patent/CN114680974B/zh
Priority claimed from CN202011607216.6A external-priority patent/CN114680976B/zh
Priority claimed from CN202011607211.3A external-priority patent/CN114680975B/zh
Application filed by 天臣国际医疗科技股份有限公司 filed Critical 天臣国际医疗科技股份有限公司
Priority to JP2023600092U priority Critical patent/JP3244798U/ja
Priority to BR212023012430U priority patent/BR212023012430U2/pt
Priority to DE212021000536.5U priority patent/DE212021000536U1/de
Publication of WO2022143721A1 publication Critical patent/WO2022143721A1/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
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • 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
    • A61B2017/07228—Arrangement of the staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—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
    • A61B2017/07271—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
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • 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 technical field of medical instruments, in particular to a surgical stapler.
  • fistula tracts may be formed in the human body due to various reasons, and the fistula tract refers to the pathological pus draining conduits caused by abscesses and connected between the body and the luminal organ or between the two luminal organs.
  • Anastomotic leakage is one of the common complications after gastrointestinal anastomosis. After gastrointestinal anastomosis, fistulas appear at the anastomosis, which will pose a great threat to the patient's health.
  • tissue openings that need to be closed may also appear after excision.
  • tissue openings that need to be closed may also appear after excision.
  • the structures of the existing instruments are often complicated, and the firing assembly is difficult to replace.
  • the purpose of the present invention is to provide a surgical stapler, which can complete the closure and firing of the stapler by driving the firing component through the driving component, perform anastomosis on tissue, realize tissue suture or tissue opening closure, and fire the component. It can be separated from the casing and replaced, so that the instrument can be reused.
  • An embodiment of the present invention provides a surgical stapler, comprising:
  • the side wall of the shell is provided with a window
  • a firing assembly located at the proximal end side of the anvil, the firing assembly is provided with staples inside, the firing assembly is at least partially detachably connected to the housing, and the firing assembly is relative to the housing the body is movable in the axial direction of the stapler;
  • the firing assembly includes a staple cartridge assembly and a firing block, the staple anvil, the staple cartridge assembly and the firing block in sequence from distal to proximal in the axial direction of the stapler
  • the firing block is detachably connected to the housing.
  • the firing block and the housing are detachably connected through a first connecting piece, the first connecting piece is fixed on the housing, and the firing block is provided with the first connecting piece.
  • the guide groove for the connector to mate with.
  • the first connecting member includes a first matching portion, a connecting portion and a second matching portion arranged in sequence, the width of the second matching portion is greater than the width of the guide groove; the first matching portion
  • the connecting portion is fixed on the casing, and the connecting portion is inserted into the guide groove, so that the first matching portion and the second matching portion are located on the inner and outer sides of the firing block, respectively.
  • the distal end side of the guide groove is provided with a guide groove hole, and the width of the guide groove hole is larger than the width of the second fitting portion.
  • the drive assembly includes a drive handle including a firing engagement portion, a pivot portion, and a grip portion in sequence, the pivot portion being rotatably connected to the housing, so that The firing engagement portion is rotatably connected to the firing assembly.
  • a fixed handle is disposed on the proximal end side of the housing, and the pivoting portion is detachably connected to the fixed handle through a second connecting member.
  • a safety pin is further included, inserted into the connection position of the pivot portion and the fixed handle.
  • a mounting groove for accommodating the pivoting portion is formed in the fixed handle, and the safety pin can enter or be disengaged from the mounting groove.
  • a transmission member is further included, and two ends of the transmission member are respectively rotatably connected to the proximal end side of the firing assembly and the firing matching portion of the driving handle.
  • the proximal end side of the firing assembly is provided with a first pivot shaft, and one end of the transmission member includes a hook portion, the hook portion is rotatably and detachably hung on the first pivot shaft .
  • the proximal end side of the firing assembly is provided with a stop portion located on the distal end side of the first pivot shaft.
  • one end of the transmission member includes a second connection hole
  • the proximal end side of the firing block is provided with a third connection hole
  • the second connection hole and the third connection hole can be connected through a connection pin. Swivel and detachable connection.
  • the anvil and the firing assembly are both disposed close to the inner sidewall of the housing, and the firing assembly and the pivoting portion are located on two sides of the centerline of the housing, respectively.
  • the drive assembly further includes a second elastic member located between the drive handle and the housing.
  • the staple cartridge assembly includes a staple cartridge, the staple cartridge has a first position and a second position, in an initial state, the staple cartridge is in the first position, and when the stapler is fired, the drive assembly pushes the staple cartridge toward the second position by the firing block toward the distal side of the stapler;
  • the drive assembly continues to push the firing block toward the distal side of the stapler, the firing block orients the staples in the staple cartridge toward the stapler Anvil is pushed out.
  • the staple cartridge assembly includes a staple cartridge and a first elastic member within the staple cartridge, a distal side of the first elastic member abuts a distal side of the staple cartridge, the staple cartridge The proximal side of the first elastic piece abuts the distal side of the firing block.
  • a guide rail extending along the axial direction of the stapler is further included, and the anvil and the firing assembly are sleeved on the guide rail.
  • two guide rails are included, and two sides of the staple cartridge assembly are respectively provided with a staple cartridge guide portion sleeved on the guide rails.
  • a light-emitting component is further included, and the light-emitting component is located inside the housing.
  • the staple cartridge assembly includes a staple cartridge with the staples disposed therein and a cutter disposed on the firing block.
  • the distal side of the staple cartridge is provided with a cutter slot and a staple hole
  • the distal side of the firing block is provided with a firing piece
  • the firing piece corresponds to the position of the staple hole
  • the cutter corresponds to the position of the cutter groove.
  • the cutter slot is a straight slot or an arc slot
  • the nail holes are located on the same side of the cutter slot, and the nail hole is close to the cutter slot relative to the cutter slot.
  • the inner wall of the casing is provided.
  • the anvil is further provided with a cutting engagement portion, and the cutting engagement portion corresponds to the position of the cutter slot.
  • the cutting engagement portion is an anvil or a groove extending distally on the anvil.
  • the firing assembly is provided with a first limiting portion
  • the first connecting member is provided with a second limiting portion
  • the first limiting portion and the second limiting portion The part cooperates to limit the movement of the firing assembly toward the anvil.
  • the first limiting portion is protruding from the firing assembly or a groove
  • the second limiting portion is a groove or protruding from the first connecting member; in an initial state, The second limiting portion is located at the distal end side of the first limiting portion or fitted with the first limiting portion.
  • opposite sides of the first limiting portion and the second limiting portion are respectively provided with a first guide surface and a second guide surface.
  • first limiting portion and the second limiting portion there are two sets of the first limiting portion and the second limiting portion, which are arranged symmetrically along the axial direction of the stapler.
  • the invention provides an instrument for tissue anastomosis.
  • a surgical stapler is placed at a diseased position, and the tissue to be anastomosed is pulled into between an anvil and a firing assembly through a window, and the firing assembly is driven by operating a driving assembly to complete the process.
  • the staples in the firing assembly are formed at the staple anvil to perform anastomosis on the tissue, so that tissue suture or tissue opening closure is realized, the structure is simplified, the operation is simple, and the firing assembly and the housing are detachable It can be easily replaced when not in use, and the instrument can be reused. For example, in patients with anorectal fistula, when there is more than one fistula and fistula, only the firing assembly needs to be replaced, which can reduce the cost of the patient. .
  • Fig. 1 is the front view of the surgical stapler in the initial state of the first embodiment of the present invention
  • FIGS. 2 and 3 are perspective views of the surgical stapler in the initial state of the first embodiment of the present invention.
  • Fig. 4 is the schematic diagram of the handle fitting in the initial state of the first embodiment of the present invention.
  • FIG. 5 is a schematic diagram of the cooperation of the nail anvil and the firing assembly in the initial state of the first embodiment of the present invention
  • Fig. 6 is the schematic diagram of the staple cartridge assembly and the firing block in the first embodiment of the present invention.
  • FIG. 7 is a schematic diagram of the cooperation between the anvil and the firing assembly according to the first embodiment of the present invention.
  • FIG. 8 is a schematic structural diagram of the staple according to the first embodiment of the present invention.
  • Fig. 9 is the sectional view of A1-A1 direction in Fig. 5;
  • FIG. 10 is a front view of the surgical stapler when the first embodiment of the present invention is fired
  • FIG. 11 is a perspective view of the surgical stapler during firing of the first embodiment of the present invention.
  • FIG. 12 is a schematic diagram of the cooperation between the nail anvil and the firing assembly during the firing process according to the first embodiment of the present invention
  • FIG. 13 is a schematic diagram of the cooperation between the nail anvil and the firing assembly when the firing is completed according to the first embodiment of the present invention
  • FIG. 14 is a cross-sectional view in the direction A2-A2 of FIG. 13;
  • 15 is a front view of the stapler reset after firing according to the first embodiment of the present invention.
  • 16 is a schematic diagram of the cooperation of the housing, the driving assembly and the firing assembly according to the first embodiment of the present invention
  • FIG. 17 is a schematic diagram of the cooperation between the housing and the drive assembly according to the first embodiment of the present invention.
  • FIGS. 18 and Figure 19 are schematic structural diagrams of the first embodiment of the present invention in which the firing block cooperates with the first connector;
  • 20 is a bottom view of the matching structure of the firing block and the first connecting piece in the initial state of the first embodiment of the present invention
  • Figure 21 is a bottom view of the matching structure of the firing block and the first connecting piece after the firing of the first embodiment of the present invention is completed;
  • FIG. 22 is a schematic structural diagram of a surgical stapler with a safety pin according to the first embodiment of the present invention.
  • 23 is a schematic structural diagram of the surgical stapler after the safety pin is taken out from the housing according to the first embodiment of the present invention.
  • FIG. 24 is a schematic structural diagram of a surgical stapler according to a second embodiment of the present invention.
  • Figure 25 and Figure 26 are schematic diagrams of the matching positions of the firing assembly and the driving assembly according to the second embodiment of the present invention.
  • Figure 27 is a schematic diagram of the firing assembly of the third embodiment of the present invention.
  • 29 is a cross-sectional view of the engagement of the nail anvil and the firing assembly in the initial state of the third embodiment of the present invention.
  • FIG. 30 is a cross-sectional view of the engagement of the nail anvil and the firing assembly under the firing state of the third embodiment of the present invention.
  • 31 and 32 are schematic diagrams of the cooperation of the cutter and the staple cartridge under the firing state of the third embodiment of the present invention.
  • FIG. 33 is a schematic structural diagram of the surgical stapler after removing the casing according to the fourth embodiment of the present invention.
  • Fig. 34 is the bottom view of the first connecting member and the firing block in the initial state of the fourth embodiment of the present invention.
  • FIG. 35 is a schematic diagram of the cooperation of the first connector and the firing block in the initial state of the fourth embodiment of the present invention.
  • FIG. 36 is a schematic structural diagram of the first connector according to the fourth embodiment of the present invention.
  • FIG. 38 and FIG. 39 are schematic diagrams of the cooperation of the first limiting portion and the second limiting portion according to the fifth embodiment of the present invention.
  • Example embodiments will now be described more fully with reference to the accompanying drawings.
  • Example embodiments can be embodied in various forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of example embodiments to those skilled in the art.
  • the same reference numerals in the drawings denote the same or similar structures, and thus their repeated descriptions will be omitted.
  • the present invention provides a surgical stapler, comprising: a hollow housing, a window is opened on the side wall of the housing; a nail anvil is fixed inside the housing; a firing assembly is located near the nail anvil On the end side, the interior of the firing assembly is provided with staples, the firing assembly is detachably connected to the housing, and the firing assembly is movable relative to the housing in the axial direction of the stapler and a drive assembly that pushes the firing assembly to move toward the distal side of the stapler when the stapler is fired, and pushes the staples in the firing assembly toward the anvil.
  • the surgical stapler can be used for tissue anastomosis. Firstly, a surgical stapler is placed at the lesion site, and the tissue to be anastomosed is pulled into the interior of the casing through the window of the side wall of the casing, so that the tissue is located between the anvil and the firing assembly, Then, the firing assembly is driven by the driving assembly to move toward the distal end of the stapler to clamp the tissue with the staple anvil to achieve the closure of the stapler, and the staples in the firing assembly are formed at the staple anvil to perform anastomosis on the tissue, the structure is simplified, easy to use.
  • the anvil and the firing component can be closed to clamp the tissue, and the staples can be driven to push out and form. That is, the stapler can be closed and fired by using a set of driving components. streamline.
  • the firing assembly is detachably connected to the housing, and the firing assembly can be replaced when not in use, thereby realizing the reusability of the instrument.
  • a first embodiment of the present invention provides a surgical stapler, comprising: a hollow casing 1, a window 13 is opened on the side wall of the casing 1; an anvil 2, which is fixed on the The interior of the housing 1; the firing assembly, located on the proximal end side of the anvil 2, the interior of the firing assembly is provided with staples, the firing assembly is at least partially detachably connected to the housing, and all The firing assembly is movable in the axial direction of the stapler; and a drive assembly 7 pushes the firing assembly toward the distal side of the stapler when the stapler is fired, and The staples in the firing assembly are pushed out toward the anvil 2 .
  • the surgical stapler When using the stapler to suture tissue or anastomotic tissue openings, the surgical stapler is first placed on the lesion site, for example, the surgical stapler is placed into the rectum through the anus to suture or suture the tissue in the rectum. The tissue opening is closed.
  • the surgical stapler can also be used for tissue suturing or tissue opening closure in other positions of the digestive tract, which all fall within the protection scope of the present invention.
  • the firing assembly is detachably connected to the housing, and the firing assembly can be replaced when not in use, thereby realizing the reusability of the instrument.
  • tools such as surgical forceps can be used to pull the tissue to be anastomosed into the housing 1 through the window 13 on the side wall of the housing 1, so that the tissue enters the staple anvil 2 and the firing assembly, then the firing assembly is driven by the driving assembly 7 to move toward the distal end of the stapler to clamp the tissue with the anvil 2, that is, the stapler is closed, and then the driving assembly 7 can further drive the firing
  • the staples in the assembly are formed at the anvil to perform anastomosis on the tissue, so as to achieve tissue suturing or tissue opening closure. Therefore, the present invention can realize the closing and firing of the stapler by using a set of driving components, and the structure is more simplified.
  • the housing 1 is tubular or approximately tubular, the window 13 is arranged on the side wall of the housing 1, and in the initial state, the nail anvil 2 and the firing assembly are respectively located in the window Both ends of 13, so that during the anastomosis of digestive tract tissue, the stapler fits the natural growth shape of the tissue, the window 13 is close to the tissue to be anastomosed, and it is easier to pull the tissue to be anastomosed into the casing. 1.
  • the tissue after anastomosis is closer to the natural shape of human tissue, and will not cause discomfort such as foreign body sensation after operation.
  • the firing assembly in an initial state, is located at the proximal side of the window 13 , and the driving assembly 7 pushes the firing assembly toward the distal side of the stapler During movement, the firing assembly gradually approaches the anvil 2 and gradually covers the window 13 and pushes out the staples in the firing assembly toward the anvil 2 .
  • the driving assembly 7 includes a driving handle 71 and a second elastic member 73 , the driving handle 71 is rotatably connected with the housing 1 , and the second elastic member 73 is located at the between the drive assembly 7 and the housing 1 .
  • a fixed handle 12 is disposed on the proximal side of the housing 1 , and the first end 731 and the second end 732 of the second elastic member 73 abut against the fixed handle 12 and the driving handle 71 respectively.
  • the driving handle 71 includes an elastic stopper 7131 extending along the length direction of the driving handle 71 , and the second end 732 of the second elastic piece 73 abuts against the elastic
  • the stopper portion 7131 of the elastic piece is movable along the extending direction of the stopper portion 7131 of the elastic piece.
  • the second end 732 of the second elastic member 73 has a raised portion, and the raised portion can be raised upward or downward compared with the main body portion of the second elastic member 73 . , the raised portion abuts against the side of the elastic member stop portion 7131 of the driving handle 71 facing the fixing handle 12 .
  • the structural shape of the raised portion of the second end 732 may also be other such as a circular arc surface, so as to reduce the frictional force between the second end 732 and the stop portion 7131 of the elastic member.
  • the second end 732 of the second elastic member 73 defines a through slot 733 , and the through slot 733 extends along the length direction of the second elastic member 73 .
  • the second elastic member 73 is more likely to elastically deform on the side close to the driving handle 71 , and it is more convenient for the operator to compress the second elastic member 73 to deform when holding the driving handle 71 .
  • the firing assembly includes a staple cartridge assembly 3 and a firing block 5.
  • the staple cartridge assembly 3 includes a staple cartridge 31 for carrying staples, from the distal side of the stapler to the proximal end In the lateral direction, the staple anvil 2, the staple cartridge 31 and the firing block 5 are sequentially arranged along the axial direction of the stapler.
  • the firing block 5 is detachably connected to the housing 1, and the firing block 5 and the staple cartridge 31 can move in the axial direction of the stapler.
  • the distal side and the proximal side are relative to the operator, the end that is closer to the operator is the proximal side, and the end that is farther from the operator, that is, the end that is closer to the surgical site, is the distal end
  • the end side, the direction along the axis of the stapler is the axial direction, that is, the direction from the distal side of the stapler to the proximal side, or the direction from the proximal side to the distal side of the stapler.
  • the distal side 11 of the housing 1 is the left side of the housing 1
  • the fixed handle 12 of the housing 1 is located on the proximal side of the housing 1 .
  • the S1 direction is the direction from the proximal side to the distal side
  • the S2 direction is the direction from the distal side to the proximal side
  • the distal end side 41 of the guide rail 4 is the left end side
  • the proximal end side 42 of the guide rail 4 is the right end side.
  • the up-down direction is defined as the up-down direction in the viewing angle of FIG. 1 , that is, in FIG. 1
  • the D1 direction is the upward direction.
  • the left-right direction is defined by the D2 direction in FIG. 20 .
  • the inner side and the outer side are relative to the axis of the component, the side close to the axis is the inner side, and the side away from the axis is the outer side.
  • the driving handle 71 when the driving handle 71 is held and moved in a first direction, the driving handle 71 pushes the firing block 5 toward the distal end of the stapler sideways movement.
  • the driving handle 71 includes a firing fitting portion 711 , a pivoting portion 712 and a gripping portion 713 arranged in sequence, the pivoting portion 712 is rotatably connected to the housing 1 , and the firing The engaging portion 711 is rotatably connected to the proximal end side of the firing block 5 . As shown in FIG.
  • the stapler further includes a transmission member 6 , and both ends of the transmission member 6 are rotatably connected to the proximal end side of the firing block 5 and the drive member 6 respectively.
  • the firing engagement portion 711 of the handle 71 Both the nail anvil 2 and the firing assembly are disposed close to the inner side wall of the housing 1 to increase the field of view and operating space in the housing 1 .
  • the firing assembly and the pivot portion 712 are located on both sides of the centerline of the housing 1 to obtain higher firing force transmission efficiency. In this embodiment, the firing assembly is located on the upper side of the centerline of the housing 1 , and the pivot portion 712 is located on the lower side of the centerline of the housing 1 .
  • the firing assembly may also be located on the lower side of the centerline of the housing 1, and the pivot portion 712 may be located on the upper side of the centerline of the housing 1, etc., all of which belong to the present invention. within the scope of protection of the invention.
  • a proximal end opening 15 is opened on the proximal end side of the casing 1 , and the firing assembly enters the interior of the casing 1 from the proximal end opening 15 .
  • the operator can also see the inside of the stapler through the proximal opening 15 and use surgical tools such as forceps to operate on the tissue to be stapled.
  • the staple anvil 2 and the staple cartridge assembly 3 are both located above the interior of the housing 1 , the window 13 is opened on the upper surface of the housing 1 , and the window 13
  • the position of the anvil 2 corresponds to the position of the staple anvil 2 , which facilitates pulling the tissue to be anastomosed between the staple anvil 2 and the staple cartridge assembly 3 through the window 13 .
  • the window 13 may also be provided at other positions on the side wall of the housing 1 , and is not limited to the position shown in FIG. 2 .
  • the distal end of the housing 1 is provided with a distal opening 111 , and the distal opening 111 prevents the distal end of the stapler from being damaged when the stapler is placed into the tissue.
  • a closed space is formed between the cavity and the tissue cavity to avoid the influence of the normally secreted gas or liquid and contents inside the digestive tract.
  • the anvil 2 and the cartridge assembly 3 are both disposed close to the inner upper surface of the housing 1, and the anvil 2 and the cartridge assembly 3 are both wall-shaped and occupy little space The structure is more convenient for the operator to observe the inside of the casing 1 and provides a larger operating space.
  • the distal opening 111 is located in the middle of the distal side surface of the housing 1, that is, the distal opening 111 is aligned with the axis of the stapler, and is a circular opening .
  • the distal opening 111 may also be opened at other positions or in other shapes.
  • the distal opening 111 may be disposed on at least two through distal sides of the distal side wall. Circular or elliptical openings of the wall all fall within the protection scope of the present invention.
  • the distal side surface of the housing 1 may be an arc-shaped surface for guiding, that is, the diameter of the distal side of the housing 1 is smaller than the diameter of the main body portion thereof, so that it is An approximately conical guide part is formed on the distal side, which can more easily guide the casing 1 to be inserted into the rectum through the anus, or guide the casing 1 to enter other pathological parts of the digestive tract more easily, while protecting the mucosal layer from damage. be damaged.
  • the surgical stapler further includes a light-emitting component, and the light-emitting component is located inside the housing 1 .
  • the light-emitting component may be a luminous coating, which is coated on the inner surface of the housing 1, and will naturally emit light in a dark environment.
  • the light-emitting component may also adopt other structures, such as a light-emitting block coated with a luminous coating or embedded with a luminous coating, which all fall within the protection scope of the present invention.
  • FIGS. 1 to 15 it is a schematic structural diagram of the surgical stapler in this embodiment in an initial state (ie, when it is not fired). As shown in Figures 10-14, it is a schematic structural diagram of the surgical stapler in this embodiment when it is fired. As shown in FIG. 15 , it is a schematic structural diagram of the surgical stapler in this embodiment being reset after firing.
  • the staple cartridge 31 in different states, has a first position and a second position, the second position being located on the distal side of the first position.
  • the firing block 5 has a third position, a fourth position, and a fifth position, the fourth position being on the distal side of the third position, and the fifth position being on the distal side of the fourth position.
  • the staple cartridge 31 in an initial state, is located at the first position, and the first position is located at the proximal end side of the window 13 .
  • the staple cartridge 31 may be completely located at the proximal end side of the window 13, that is, not overlapping with the window 13, or the staple cartridge 31 may be partially located at the proximal end side of the window 13, that is, partially aligned with the window 13.
  • the windows 13 coincide, but are entirely located on the opposite proximal side of said windows 13 .
  • the driving handle 71 in an initial state, the driving handle 71 is not held, the staple cartridge 31 is in an initial first position, and the firing block 5 is in an initial third position.
  • the surgical stapler further comprises a guide rail 4 extending along the axial direction of the stapler, the staple anvil 2 , the staple cartridge assembly 3 and the staple cartridge assembly 3 .
  • the firing block 5 is sequentially sleeved on the guide rail 4 from the distal side to the proximal side of the stapler.
  • the guide rail 4 can guide and limit the movement of the staple cartridge assembly 3 and the firing block 5 in the axial direction, and keep the staple cartridge assembly 3 and the staple anvil 2 aligned in the axial direction, thereby ensuring the After the staples in the staple cartridge assembly 3 are pushed out, they can be formed at corresponding positions on the staple anvil surface 22 of the staple anvil 2 .
  • the distal side 41 of the guide rail 4 can be fixed to the interior of the housing 1 and the nail anvil 2 to the interior of the housing 1 to keep the guide rail 4 and the nail anvil 2 relative to the housing The positional stability of the body 1, but the present invention is not limited to this.
  • the firing block 5 and the cartridge assembly 3 can be removed from the proximal side 42 of the guide rail 4 .
  • the surgical stapler includes two guide rails 4 , and two sides of the staple anvil 2 , the staple cartridge 31 and the firing block 5 are respectively sleeved Installed on the guide rail 4 .
  • the guide rails 4 are not limited to two, but can also be set to one or more, which all fall within the protection scope of the present invention.
  • An anvil guide portion 21 is respectively provided on both sides of the anvil anvil 2 , sleeved on the two guide rails 4 , and an anvil surface 22 is between the two anvil guide portions 21 .
  • the staple cartridge 31 includes two staple cartridge guide portions 311 , which are respectively sleeved on the two guide rails 4 , and a staple cartridge surface 312 is formed between the two staple cartridge guide portions 311 , and a plurality of staple holes are provided in the staple cartridge surface 312 .
  • the nail holes 3121 can be arranged in one row or in multiple rows. When the nail holes 3121 are in at least two rows, they can be arranged staggered with each other, that is, the projections of the nail holes 3121 on the inner ring and the nail holes 3121 on the outer ring in the diametrical direction coincide.
  • the staples 33 shown in FIG. 8 are disposed inside the staple holes 3121 of the staple cartridge 31 .
  • the firing block 5 pushes the staples 33 out of the staple holes 3121 of the staple cartridge 31 .
  • the distal side of the firing block 5 is provided with a firing piece 51 for pushing the staples 33 out of the staple cartridge 31 when the stapler is fired.
  • the sides are respectively provided with firing guides 52 .
  • the staple 33 includes a fixed end 331 and a pointed end 332 , and the fixed end 331 of the staple 33 is fixed to the inner side of the staple cartridge 31 .
  • the firing piece 51 of the firing block 5 pushes the spiked ends 332 of the staples 33 through the staple holes 3121 , and then reaches the staple anvil 2 after piercing the tissue.
  • the staples in FIG. 8 are only examples, and in other alternative embodiments, the staples may adopt other shapes and structures, which all fall within the protection scope of the present invention.
  • the staples are "B"-shaped staples, and the staples include two tissue-piercing legs on both sides. When the staples are formed on the anvil, The two staple legs of the staple are pressed against the staple groove of the staple anvil to bend and deform, so that the staple is shaped like a "B" shape.
  • the driving handle 71 when the driving handle 71 is held in the first direction (ie, the S3 direction in FIG. 10 ), the driving handle 71 rotates in the first direction, and the firing engaging portion 711 moves to the distal side direction (ie, FIG. 10 ). 1) push the firing block 5, so that the firing block 5 moves from the third position to the distal side direction to the fourth position, that is, to the position shown in Figure 12, when the firing block 5 moves from the third position to the fourth position.
  • the firing block 5 and the staple cartridge 31 are linked, and the staple cartridge 31 moves to the distal side under the pushing action of the firing block 5 to the second position, where the second position is the staple.
  • the anvil 2 and the staple cartridge 31 clamp the surgical site of the tissue, that is, the closure of the stapler is achieved.
  • the second elastic member 73 is pressed by the driving handle 71 to have a certain amount of elastic deformation.
  • the firing block 5 When the firing block 5 is in the fourth position, it continues to hold the driving handle 71 in the first direction, and the driving handle 71 drives the firing block 5 to continue to move in the distal direction to the fifth position, that is, the firing block 5 as shown in FIG. 13 .
  • the firing block 5 and the staple cartridge 31 are no longer linked, and the position of the staple cartridge 31 remains in the second position. Therefore, the distal end of the firing block 5 at least partially enters the interior of the staple cartridge 31, so that the distal end of the firing block 3 can push the staples inside the staple cartridge 31 toward the anvil 2 to achieve the firing of the stapler.
  • the second elastic member 73 is further pressed by the driving handle 71 to have a larger elastic deformation amount. Therefore, the present invention can realize the closing and firing of the stapler through one actuating handle 71 .
  • the driving handle 71 rotates from the firing position along the second direction (ie, the S4 direction in FIG. 15 ), and rebounds to its initial position, realizing the reset of the stapler, and the second direction is opposite to the first direction .
  • the driving handle 71 since the driving handle 71 is rotatably connected to the firing assembly, when the driving handle 71 rotates in the second direction, it drives the firing block 5 to move toward the proximal side of the stapler, thereby realizing the The staple cartridge 31 returns to the first position.
  • the second elastic member 73 may also be disposed between the fixed handle 12 and the firing fitting portion 711 of the driving handle 71 , or may be disposed on the side of the housing 1 .
  • the space between the wall and the firing engaging portion 711 or the holding portion 713 of the driving handle 71 falls within the protection scope of the present invention.
  • the second elastic member 73 may also adopt elastic structures such as compression springs, tension springs, and torsion springs.
  • the firing assembly further includes a first elastic member 32 , and two ends of the first elastic member 32 respectively press against the staple cartridge 31 and the firing Block 5.
  • the first elastic member 32 is located inside the staple cartridge 31 , the distal side of the first elastic member 32 abuts the distal side of the staple cartridge 31 , and the proximal side of the first elastic member 32 against the distal side of the firing block 5 .
  • the first elastic member 32 includes two compression springs, the two compression springs are respectively disposed in the two staple cartridge guide parts 311 of the staple cartridge 31 , and They are respectively sleeved on the two guide rails 4 .
  • the first elastic member 32 is disposed between the distal side of the firing guide portion 52 and the distal side of the staple cartridge 31 .
  • the staple cartridge 31 In the initial state (ie, the state of FIG. 9 ), the staple cartridge 31 is in the first position, the firing block 5 is in the third position, and at this time, the first elastic member 32 may be in an uncompressed state It can also be in a state with a certain initial compression amount.
  • the driving handle 71 is held, and the pushing force of the driving handle 71 to the firing block 5 is not enough to overcome the resistance of the first elastic member 32 to deformation. Therefore, the staple cartridge 31 and the firing block 5 realize linkage through the first elastic member 32, the firing block 5 pushes the staple cartridge 31 to move to the side of the staple anvil 2 synchronously, and the firing block 5 moves To the fourth position, the staple cartridge 31 moves to the second position (ie, the state of FIG.
  • the driving handle 71 drives the staple cartridge assembly 3 toward the stapler.
  • the end-side direction movement returns to the first position of the initial state.
  • the driving handle 71 is rotated and reset in the second direction, the first elastic member 32 is no longer subjected to the pushing force in the distal direction, and under the action of its own elastic restoring force, the first elastic member 32 is pushed toward the proximal direction.
  • the firing piece 51 and the firing block 5 are retracted relative to the staple cartridge 31 to a third position inside the staple cartridge 31 in the initial state under the action of the first elastic member 32 .
  • the first elastic member 32 can be a structure such as a spring, a metal shrapnel, or a flexible material block that can be compressed after being subjected to external force, such as a rubber block, a silicone block, etc., all of which belong to the protection of the present invention. within the range.
  • the first elastic member 32 may not be provided, but a friction damping mechanism (for example, the inner wall of the proximal end of the staple cartridge 31 or the outer wall of the distal end of the firing block 5 is provided with a friction damping layer of rubber particles), in the initial state, the driving handle 71 is held, and the driving handle 71 gives The thrust of the firing block 5 is not enough to overcome the frictional force of the friction damping mechanism, so the staple cartridge 31 and the firing block 5 realize linkage through the friction damping mechanism, and the firing block 5 pushes the staple cartridge 31 moves to the side of the staple anvil 2 synchronously, the firing block 5 moves to the fourth position, and the staple cartridge 31 moves to the second position (ie, the state in FIG. 12 ).
  • a friction damping mechanism for example, the inner wall of the proximal end of the staple cartridge 31 or the outer wall of the distal end of the firing block 5 is provided with a friction damping layer of rubber particles
  • FIG. 16 and FIG. 17 show the matching structure among the driving handle 71 , the housing 1 and the firing assembly.
  • an installation groove 121 is formed in the fixed handle 12
  • the pivot portion 712 of the driving handle 71 is located in the installation groove 121
  • the pivot portion 712 can be installed in the installation groove 121 Rotate in.
  • the side wall of the installation slot 121 defines a first through hole 122
  • the pivot portion 712 of the drive handle 71 defines a second through hole 7121
  • the drive assembly 7 further includes a second connecting member 75 .
  • the second connecting member 75 passes through the first through hole 122 and the second through hole 7121 of the pivot portion 712 , so that the pivot portion 712 can rotate around the second connecting member 75 .
  • the fixed handle 12 forms a certain angle with the axial direction of the stapler, which is convenient for the operator to hold, and does not block the proximal opening 15 of the housing 1, which is more convenient for the operator
  • the interior of the housing 1 is viewed from the proximal opening 15 .
  • the fixed handle 12 can also be extended along the axial direction of the stapler, or adopt other shapes and/or other connection methods with the housing 1, all belonging to the present invention within the scope of protection.
  • the fixing handle 12 may not be provided with the installation groove, and the outer side wall of the driving handle 71 is arranged to fit with the outer side wall of the fixing handle 12, or the driving handle 71 is provided with an installation groove, and the fixing handle 12 is inserted into the installation groove, which all belong to the protection scope of the present invention.
  • the second connecting member 75 when the firing assembly needs to be replaced without using the surgical stapler, the second connecting member 75 can be disengaged from the first through hole 122 and the second through hole 7121 , when the second connecting member 75 is disengaged from the first through hole 122 and/or the second through hole 7121 , the firing assembly is disengaged from the housing 1 as a whole. At the same time, the firing assembly can be separated from the housing 1 so that the drive handle 71 and the firing assembly can be separated from the housing 1 together.
  • the second connecting member 75 includes an operating portion 751 and a connecting portion 752 , the connecting portion 752 penetrates through the first through hole 122 and the second through hole 7121 , and the operating portion 751 is located in the driving portion. On the outside of the handle 71 , the connecting portion 752 can be pulled out from the first through hole 122 and the second through hole 7121 by performing a pulling action on the operation portion 751 .
  • the firing block 5 is detachably connected to the housing 1 through a first connecting piece 8 , and a surface of one side of the firing block 5 is provided along the axial direction of the stapler.
  • the extending guide groove 56, the first connecting member 8 is fixed to the housing 1, the first connecting member 8 is partially located in the guide groove 56, and the first connecting member 8 can be guided along the guide groove 56.
  • the extension direction of the slot 56 moves, so that the firing block 5 can move relative to the housing 1 in the axial direction of the stapler, and the guide groove 56 can also adjust the axial direction of the firing block 5 Movement provides direction.
  • the guide groove 56 is a through groove connecting the upper side surface and the lower side surface of the firing block 5 .
  • the first connecting member 8 includes a first matching portion 81 , a connecting portion 82 and a second matching portion 83 arranged in sequence, the first matching portion and the second matching portion 83 .
  • the width of the matching portion is larger than the width of the guide groove 56
  • the first matching portion 81 is fixedly connected to the housing 1
  • the connecting portion 82 is partially penetrated in the guide groove 56 , so that the first matching portion 81 is fixedly connected to the housing 1 .
  • a matching portion 81 and the second matching portion 83 are respectively located on the inner and outer sides of the firing block 5
  • the first matching portion 81 and the second matching portion 83 are located on the inner and outer sides of the firing block 5 respectively.
  • the two sides refer to the upper and lower sides of the firing block 5 respectively.
  • the connecting portion 82 can move along the extending direction of the guide groove 56, so that the firing block 5 can move relative to the housing 1 in the axial direction of the stapler, and the guide groove 56 is also movable. Guidance can be provided for the axial movement of the firing block 5 .
  • the housing 1 is provided with a first connector mounting portion, which is connected with the first matching portion 81 .
  • the first connector mounting portion is a connector mounting slot 16
  • the first matching portion 81 is fixedly embedded in the connector mounting slot 16 .
  • the first matching portion 81 and the housing 1 can also be fixedly connected in other ways, for example, the first matching portion 81 can be fixedly connected to the first
  • the matching portion 81 is fixedly connected to the side wall of the casing 1 .
  • the first matching portion 81 extends along the width direction of the firing block 5 (ie, the direction D2 in FIG. 20 ), but the present invention is not limited to this. In other alternative embodiments, The first matching portion 81 can also be set in other shapes.
  • the first connector mounting portion may also adopt a structure such as a bump, a beam, or the like, and the first matching portion is connected to the first connector mounting portion.
  • the first connector mounting portion is a convex block, and the first matching portion is provided with a groove matched with the protrusion, or the first matching portion is screwed with the first connector mounting portion , riveting, etc.
  • the width of the first matching portion can also be less than or equal to the width of the guide groove 56 , and the first matching portion is kept from entering the guide groove 56 through the connection between the housing 1 and the first matching portion. internal.
  • the distal end side of the guide slot 56 is provided with a guide slot hole 561 .
  • the width of the guide slot 561 is larger than the width of the second matching portion 83 .
  • the second matching portion 83 can pass through the guide slot 561 . Separated from the guide groove 56 to separate the firing block 5 from the housing 1 .
  • the width here refers to the width along the D1 direction in FIG. 20 .
  • FIG. 20 and FIG. 21 respectively show the structure in which the first connecting piece 8 cooperates with the firing block 5 in the initial state and the firing state.
  • the firing block 5 in the initial state, the firing block 5 is located at the third position, and the second matching portion 83 of the first connecting member 8 is located at the proximal end side of the guide slot hole 561 . Since the firing block 5 will not be displaced in the proximal direction under the holding action of the driving handle 71 at this time, the second engaging portion 83 will not enter the guide slot 561 and will The guide grooves 56 are separated, thereby ensuring a relatively stable connection between the firing block 5 and the housing 1 in an initial state. As shown in FIG.
  • the firing block 5 moves toward the distal side to the fourth position, and the first connecting piece 8 moves toward the proximal side 562 of the guide slot 56 .
  • the second matching portion 83 will not be separated from the guide groove 56, thereby ensuring a relatively stable connection between the firing block 5 and the housing 1 during the firing process.
  • the second connector 75 is first pulled out, the driving handle 71 is separated from the fixed handle 12, and the driving handle 71 can be pulled toward the proximal side
  • the firing block 5 causes the first connecting piece 8 to move relative to the firing block 5 toward the distal end of the guide groove 56 , so that the second matching portion 83 moves to the guide groove hole
  • the second matching part 83 can be separated from the guide groove 56 through the guide groove hole 561, so that the driving handle 12, the firing block 5 and the staple cartridge assembly 3 can be removed from the Take out the shell 1.
  • the proximal end side of the firing block 5 is provided with a first pivot shaft 54
  • one end of the transmission member 6 includes a hook portion 61 , which is rotatably hooked to the hook portion 61 . on the first pivot shaft 54
  • a second pivot shaft 7111 is provided on the firing engaging portion 711 of the driving handle 71
  • the second end of the transmission member 6 includes a first connecting hole 62 , which is rotatably sleeved on the second connecting hole 62 . Pivot shaft 7111.
  • the hook portion 61 can be rotated relative to the first pivot shaft 54 by a certain angle so as to be disengaged from the first pivot shaft 54 . Therefore, after the firing block 5 is separated from the housing 1 , by removing the hook portion 61 from the first pivot shaft 54 , the firing block 5 can be further separated from the driving handle 71 Separation.
  • the proximal end side of the firing block 5 is provided with a stopper portion 57
  • the stopper portion 57 is located at the distal end side of the first pivot shaft 54
  • the The proximal side of the stopper portion 57 is opposite to the distal side of the hook portion 61 .
  • the stopper portion 57 can limit the positional relationship between the hook portion 61 of the transmission member 6 and the firing block 5, so as to prevent the hook portion 61 and the first The pivot shaft 54 is accidentally disengaged.
  • the proximal side surface of the stopper portion 57 and the distal side surface of the hook portion 61 are respectively corresponding inclined guide surfaces.
  • the driving assembly 7 may further include a safety pin 74 for defining the position of the driving handle 71 in the initial position when the surgical stapler does not reach the operating position, so as to prevent false firing.
  • a side wall of the installation slot 121 defines a third through hole 1211 , and the safety pin 74 passes through the third through hole 1211 and at least partially enters the installation slot 121 , and the safety pin 74 can be pulled out from the third through hole 1211 .
  • the safety pin 74 includes a protruding portion 741 and a blocking portion 742.
  • the blocking portion 742 passes through the third through hole 1211 and at least partially enters the mounting groove 121
  • the protruding portion 741 is located at the outer side of the side wall of the mounting slot 121
  • the outer diameter of the protruding portion 741 is larger than the inner diameter of the third through hole 1211 .
  • the outer diameter of the blocking portion 742 is slightly smaller than the inner diameter of the third through hole 1211 , so that when the stapler needs to be fired, the blocking portion 742 can be pulled out from the third through hole 1211 .
  • the safety pin 74 passes through the third through hole 1211 and at least partially enters the installation groove 121 , the safety The pin 74 is located on the rotational path of the drive handle 71 in the first reverse direction. At this time, if the driving handle 71 is held, the rotational movement of the driving handle 71 in the first direction will be blocked by the safety pin 74, and the firing assembly will not be driven, and the misfire of the stapler will not be realized. send.
  • the safety pin 74 can be pulled out from the third through hole 1211 of the installation slot 121 . At this time, the safety The pin 74 will no longer block the rotational movement of the driving handle 71 in the first direction, and the stapler can be fired by holding the driving handle 71 .
  • FIGS. 24 to 26 the structure of the surgical stapler according to the second embodiment of the present invention is shown. Similar to the first embodiment shown in FIGS. 1 to 23 , when the second matching portion 83 moves to the guide slot hole, the second matching portion 83 can pass through the guide slot hole 561 from the guide slot hole 561 . The guide grooves 56 are separated.
  • the difference between the second embodiment and the first embodiment shown in FIGS. 1 to 23 is that the firing assembly can be separated from the housing 1 independently, and the firing assembly can be replaced independently.
  • One end of the transmission member 6 includes a second connection hole 63 , the proximal end side of the firing block 5 is provided with a transmission member matching portion 59 , and a third connection hole 58 is opened on the transmission member matching portion 59 .
  • the two connecting holes 63 are rotatably connected to the third connecting hole 58 through a connecting pin 9 .
  • One end of the connecting pin 9 is inserted into the second connecting hole 63 and the third connecting hole 58 , and the other end is located outside the second connecting hole 63 and the third connecting hole 58 for the operator Handheld operation.
  • the connecting pin 9 can be disengaged from the second connecting hole 63 and the third connecting hole 58 .
  • the staple cartridge assembly and the The firing block 5 can be disengaged from the housing 1 . Therefore, in this embodiment, the firing assembly can be replaced independently without separating the drive handle 71 from the housing 1 .
  • FIGS. 27-32 it is a schematic structural diagram of a surgical stapler according to a third embodiment of the present invention.
  • the difference between this embodiment and the first embodiment shown in FIGS. 1 to 23 is that a cutter 90 is also provided inside the firing assembly.
  • the surgical stapler can be used for tissue stapling and cutting.
  • the drive assembly 7 pushes the firing assembly toward the distal end of the stapler, and drives the staples and cutters 90 in the firing assembly toward the anvil 2 Pushing out, the firing assembly gradually approaches the anvil 2, the staples are formed at the anvil 2 to perform anastomosis on the tissue, and at the same time, the cutter 90 is pushed out to cut the tissue to suture and cut the tissue.
  • the firing assembly In the initial state, the firing assembly is located on the proximal side of the window 13 .
  • the drive assembly 7 pushes the firing assembly toward the distal end of the stapler, gradually covering the window 13 and moving the staples and cutters 90 in the firing assembly toward the anvil 2 roll out.
  • the staple cartridge assembly 3 includes a staple cartridge 31 , and the staple cartridge 31 is provided with the staples 33 .
  • the distal side of the firing block 5 is provided with a firing piece 51 corresponding to the staples and a cutter 90, the firing piece 51 and the cutter 90 are at least partially located in the staple cartridge 31, the The staples are located on the distal side of the firing piece 51 , and the position of the cutter 90 corresponds to the cutter slot 313 of the staple cartridge 31 .
  • the distal side of the staple cartridge 31 is a staple cartridge surface 312
  • the staple cartridge surface 312 is provided with a plurality of staple holes 3121
  • the staple holes 3121 can be arranged in a row or a row In multiple rows, when the nail holes 3121 are at least one row, they can be staggered, that is, the projections of the nail holes 3121 on the inner ring and the nail holes 3121 on the outer ring in the diametrical direction coincide.
  • FIG. 28 shows the positional relationship between the position of the cutter 90 and the staple cartridge 31 in the initial state, in which the firing block 5 is omitted.
  • FIG. 28 shows the structure in which the firing block 5 cooperates with the cutter 90 .
  • the cutting knife 90 is fixedly installed in the accommodating groove 519 on the distal end side of the firing block 5 , and the bottom surface of the accommodating groove 519 is a blade pushing surface 518 matched with the cutting knife 90 .
  • the distal side of the firing block 5 is provided with a firing piece 51 and a cutter 90, the firing piece 51 corresponds to the position of the staple hole 3121, and is used to pass the staple through the staple when the stapler is fired Hole 3121 is pushed out.
  • the pusher surface 518 is located on the proximal side 92 of the cutter 90 . When the firing block 5 moves toward the distal side, it drives the cutter 90 to move toward the distal side synchronously.
  • the firing piece 51 of the firing block 5 pushes the staples 33 through the staple holes 3121, pierces the tissue and reaches the staple anvil 2, and is formed on the staple anvil surface 22 of the staple anvil 2.
  • the staples 33 are separated from the staple cartridge 31 and fixed on the tissue to achieve anastomosis to the tissue.
  • the nail anvil 2 is further provided with a cutting matching portion, which corresponds to the position of the cutting knife groove 313 .
  • the cutting matching portion and the cutting knife 9 cooperate with each other. It is beneficial to improve the cutting effect of the cutter 9 on the tissue.
  • the cutting engagement portion may be an anvil or a groove extending distally on the anvil 2 .
  • the knife anvil can be a rigid plastic sheet fixed at a corresponding position on the nail anvil 2, or a method disclosed in the prior art such as a silicone sheet.
  • the cutter slot 313 is a linear slot or an arc-shaped slot
  • the nail holes 3121 are located on the same side of the cutter slot 313
  • the nail holes 3121 are opposite to the cutter slot 312 .
  • the knife groove 313 is disposed close to the inner wall of the casing 1 . That is, the cutter 90 is located at the inner side away from the side wall of the housing 1 , and the nail holes 3121 are all located close to the outer side of the side wall of the housing 1 .
  • FIG. 29 is a cross-sectional view of the engagement of the anvil and the firing assembly in the initial state of the third embodiment.
  • the cutting direction of FIG. 29 may refer to the cutting direction A1-A1 of FIG. 5 .
  • the structure of other components except the cutter 90 in this embodiment can refer to FIGS. 1 to 9 of the previous embodiment.
  • the driving handle 71 is not held, and the staple cartridge 31 is in the initial state.
  • the firing block 5 In the first position, the firing block 5 is in the initial third position, and the distal side 91 of the cutter 9 is located inside the cutter slot 313, does not protrude from the cartridge surface 312, and will not cut tissue.
  • the surgical stapler includes two guide rails 4 , and two sides of the staple anvil 2 , the staple cartridge 31 and the firing block 5 are respectively sleeved on the guide rails 4 .
  • the staple cartridge 31 includes two staple cartridge guide portions 311 , which are respectively sleeved on the two guide rails 4 , and the staples and the cutter 90 are disposed between the two staple cartridge guide portions 311 .
  • the firing engaging portion 711 pushes the firing block 5 in the distal direction, so that the firing block 5 is The third position moves in a distal direction to the fourth position.
  • the structure at this time may refer to the structure of FIG. 12 in the previous embodiment.
  • the firing block 5 and the staple cartridge 31 are linked together, and the staple cartridge 31 moves to the distal side to the second position simultaneously under the pushing action of the firing block 5, where the first The two positions are the surgical positions where the staple anvil 2 and the staple cartridge 31 clamp the tissue, that is, the stapler is closed.
  • the second elastic member 73 is pressed by the driving handle 71 to have a certain amount of elastic deformation.
  • the distal side 91 of the cutter 90 moves to the distal side for a distance along with the firing block 5 , it is still located inside the cutter slot 313 and does not interact with the staple cartridge 31 .
  • the relative position changes without protruding beyond the cartridge face 312 and without cutting tissue.
  • FIG. 30 is a cross-sectional view of the engagement of the anvil and the firing assembly in the fired state of the third embodiment.
  • the cutting direction of FIG. 30 may refer to the cutting direction A2-A2 of FIG. 13 .
  • 31 and 32 are schematic diagrams of the cooperation of the cutter and the staple cartridge in the fired state of the third embodiment.
  • the firing block 5 is no longer linked with the staple cartridge 31, the position of the staple cartridge 31 remains unchanged at the second position, and the firing The block 5 continues to move to the distal side into the interior of the staple cartridge 31, so that the distal side of the firing block 5 can push the staples inside the staple cartridge 31 toward the staple anvil 2, and drive the cutter 90 toward the staples
  • the anvil 2 moves in the direction, passes through the cutter slot 313 and reaches the cutting and matching part of the anvil 2, that is, reaches the position shown in FIG. 31 and FIG. 32 relative to the staple cartridge 31, cuts the tissue, and completes the anastomosis. the firing of the device.
  • the second elastic member 73 is further pressed by the driving handle 71 to have a larger elastic deformation amount.
  • the structures of other components in this embodiment may adopt the structures of the corresponding components shown in FIGS. 1 to 23 .
  • the cutter 90 in FIGS. 27 to 32 can also be combined with other embodiments.
  • the cutter 90 shown in FIGS. 27 to 32 and the structure of the cutter 90 and the nail anvil 2 are added.
  • the structure that the cutter 90 cooperates with the firing block 5 and the structure that the cutter 90 cooperates with the staple cartridge 31, or in the embodiments of FIGS. 33 to 39 described below, the cutter 90,
  • the structure in which the cutter 90 cooperates with the nail anvil 2 the structure in which the cutter 90 cooperates with the firing block 5
  • the structure in which the cutter 90 cooperates with the staple cartridge 31 are examples of the staple cartridge.
  • FIGS. 33-37 it is a schematic structural diagram of a surgical stapler according to a fourth embodiment of the present invention.
  • the difference between the fourth embodiment and the first embodiment shown in FIGS. 1 to 23 is that a first limiting portion is provided on one side surface of the firing assembly, and a second limiting portion is provided on the first connecting member 8 department.
  • the first limiting portion cooperates with the second limiting portion to limit the movement of the firing assembly toward the anvil 2; when the stapler is fired by an external force, the first limiting portion Getting rid of the second limiting portion, the firing assembly moves toward the anvil 2 .
  • the firing assembly in the initial state, can be maintained at the initial position through the cooperation of the first limiting portion and the second limiting portion, thereby improving the stability of the instrument structure.
  • the tissue is drawn between the anvil 2 and the firing assembly through the window 13 of the side wall of the housing 1, and under the action of external force, the first limiting portion can get rid of the second limiting portion.
  • the firing assembly moves toward the anvil 2 , the firing of the stapler can be completed through the cooperation of the firing assembly and the anvil 2 , and the operator can also obtain tactile feedback when operating the firing.
  • the first limiting portion is a boss 528 protruding on the side of the firing block 5 opposite to the second matching portion 83 , that is, the The boss 528 is located on the lower side of the firing block 5 , and the second limiting portion is the part where the second matching portion 83 of the first connecting member 8 is engaged with the boss 528 .
  • the second matching portion 83 is located on the distal side of the boss 528 , and the distal side of the boss 528 is matched with the proximal side of the second matching portion 83 .
  • the cooperation of the first connecting piece 8 fixed on the body 1 and the boss 528 of the firing assembly keeps the firing assembly in the initial position and improves the stability of the instrument structure.
  • tools such as surgical forceps can be used to pull the tissue to be anastomosed into the interior of the housing 1 through the window 13 on the side wall of the housing 1, so that the tissue enters the Between the anvil 2 and the firing assembly, at this time, the firing assembly is driven to the distal side by an external force, the firing assembly moves toward the anvil 2, and the first connecting member 8 After the two engaging parts 83 pass over the boss 528 and move toward the proximal side relative to the guide groove 56 , that is, the firing assembly moves toward the anvil 2 without being restricted by the second limiting part, The stapler can be fired through the cooperation of the firing assembly and the staple anvil 2 , and the operator can also get tactile feedback when operating firing.
  • the boss 528 has a first guide surface 5281 on the distal side thereof,
  • the first guide surface 5281 is an inclined plane or an arc surface.
  • the boss 528 is a circular truncated cone, but the present invention is not limited thereto.
  • the boss 528 may also be a rectangular block with a first guide surface, or A trapezoidal block with a first guide surface, etc., or a spherical frustum.
  • a second guide surface 84 may also be provided on the proximal end side of the second limiting portion that is matched with the boss 528 , and the second guide surface 84 is an inclined plane. or arc.
  • the first limiting portion may be a boss disposed on the upper surface of the firing block 5
  • the second limiting portion is the first stopper of the first connecting member 8
  • the first engaging portion 81 passes over the boss and moves toward the proximal side relative to the guide groove 56 .
  • the distal side surface of the boss is provided with an inclined first guide surface
  • the proximal end side surface of the first matching portion 81 is provided with an inclined second guide surface.
  • the first limiting portion may be a boss provided on the upper surface of the firing block 5
  • the second limiting portion may be provided on the first connecting member 8
  • the boss In the initial state, the boss is located in the groove, so as to keep the firing assembly in the initial position, when the stapler is fired by an external force, the boss is separated from the groove, and the firing assembly faces the Describe the anvil movement.
  • the distal side of the boss is provided with an inclined first guide surface
  • the proximal side of the groove is provided with an inclined second guide surface.
  • the first limiting portion may be a groove provided on the upper surface of the firing block 5 , and the second limiting portion is protruding from the first connecting member 8; or, the first limiting portion may be a groove provided on the lower surface of the firing block 5, and the second limiting portion is protruding on the lower surface of the firing block 5.
  • a boss on the upper surface of the second matching portion 83 of the first connector 8 In the initial state, the boss is located in the groove, so as to keep the firing assembly in the initial position, when the stapler is fired by an external force, the boss is separated from the groove, and the firing assembly faces the Describe the anvil movement. Further, the distal side of the boss is provided with an inclined first guide surface, and the proximal side of the groove is provided with an inclined second guide surface.
  • the guide groove 56 and the first limiting portion may also be provided on the left and right side surfaces of the firing block 5 or on the staple cartridge assembly 3, and the first limiting portion
  • the fitting portion and the second limiting portion can be the cooperation between the boss and the first/second matching portion, or the cooperation between the boss and the groove, all of which fall within the protection scope of the present invention.
  • the first connecting member 8 includes a first matching portion 81 , a connecting portion 82 and a second matching portion 83 , and the boss 528 is engaged with the second matching portion 83 .
  • the first connecting member 8 may only include the first matching portion 81 and the connecting portion 82 , but not the second matching portion 83 , and the boss 528 is provided on the The upper side of the firing block 5 is matched with the first matching portion 81 .
  • FIGS. 1 to 9 The structures of other components in this embodiment except the first limiting portion and the second limiting portion in the initial state can refer to FIGS. 1 to 9 in the previous embodiment.
  • the driving handle 71 is not held , the staple cartridge 31 is in the initial first position, the firing block 5 is in the initial third position, and the firing block 5 is in the initial third position.
  • the boss 528 cooperates with the second limiting portion of the second engaging portion 83 to limit the movement of the firing assembly in the distal direction and keep the staple cartridge 31 at the In the first position, the firing block 5 is held in the third position.
  • the firing matching portion 711 pushes the firing block 5 in the distal direction, under the driving action of the external force.
  • the second matching portion 83 goes over the boss 528, so that the first connecting piece 8 moves toward the proximal side relative to the guide groove 56, that is, the firing block 5 moves toward the distal side, The firing block 5 is moved distally from the third position to the fourth position.
  • the structure at this time may refer to the structure of FIG. 12 in the previous embodiment.
  • the two positions are the surgical positions where the staple anvil 2 and the staple cartridge 31 clamp the tissue, that is, the stapler is closed.
  • the firing block 5 When the firing block 5 is in the fourth position, it continues to hold the driving handle 71 in the first direction, and the driving handle 71 drives the firing block 5 to continue to move in the distal direction to the fifth position, that is, as shown in FIGS. 13 and 13 in the previous embodiment.
  • the position of the firing block 5 in FIG. 14 During the movement of the firing block 5 from the fourth position to the fifth position, the firing block 5 and the staple cartridge 31 are no longer linked, the position of the staple cartridge 31 remains unchanged at the second position, and the firing block 5 continues to move to the distal end
  • the side moves to the inside of the staple cartridge 31, so that the distal end of the firing block 5 can push out the staples inside the staple cartridge 31 toward the staple anvil 2, so as to realize the firing of the stapler.
  • the positional relationship between the firing block 5 and the boss 528 is shown in FIG. 37 .
  • FIG. 38 and FIG. 39 it is a schematic structural diagram of the stapler according to the fifth embodiment of the present invention. Similar to the fourth embodiment shown in FIGS. 33 to 37 , the fifth embodiment is provided with a first limiting portion and a second limiting portion to limit the initial position of the firing assembly.
  • the difference between the fifth embodiment and the fourth embodiment shown in FIGS. 33 to 37 is that the first limiting portion is a boss 528 disposed on the inner surface of the guide groove 56 , and the second limiting portion is a boss 528 .
  • the portion is a groove 85 provided in the connecting portion 82 of the first connecting member 8 . In the initial state, the boss 528 is located in the groove 85, so as to keep the firing assembly in the initial position.
  • the boss 528 When the stapler is fired by an external force, the boss 528 is separated from the groove 85, and the The firing assembly moves towards the anvil 2 . Further, the distal side of the boss 528 is provided with an inclined first guide surface, and the proximal side of the groove 85 is provided with an inclined second guide surface.
  • the boss 528 is a circular trough, and the groove 85 is a circular groove matched with the circular trough, but the invention is not limited to this, and the boss 528 may also be a The rectangular block of the first guide surface, or a trapezoidal block with the first guide surface, etc., or a spherical truncated cone.
  • the shape of the groove 85 can be adapted to the shape of the boss 528 .
  • the first limiting portion may also be a groove provided on the inner surface of the guide groove 56
  • the second limiting portion may be provided on the first connecting member 8 of the boss of the connecting part 82.
  • the guide grooves 56 may be disposed on the left and right sides of the firing block 5 or the staple cartridge assembly 3 , and the first limiting portion is disposed on the inner side of the guide grooves 56 The surface also falls within the protection scope of the present invention.
  • the first limiting portion and the second limiting portion are arranged in at least one group, or two groups.
  • the two groups of the first limiting portion and The second limiting portion can be symmetrically arranged on both sides of the stapler in the axial direction, that is, one side is provided with a set of first limiting portion and second limiting portion, and the other side is symmetrically provided with another Set the first limit part and the second limit part to obtain better structural stability.
  • the invention provides an instrument for tissue anastomosis.
  • a surgical stapler is placed at a diseased position, and the tissue to be anastomosed is pulled into between an anvil and a firing assembly through a window, and the firing assembly is driven by operating a driving assembly to complete the process.
  • the staples in the firing assembly are formed at the staple anvil to perform anastomosis on the tissue, so that tissue suture or tissue opening is closed, the structure is simplified, the operation is simple, and the firing assembly and the housing are detachable It can be easily replaced when not in use, and the instrument can be reused. For example, in patients with anorectal fistula, when there is more than one fistula and fistula, only the firing assembly needs to be replaced, which can reduce the cost of the patient. .

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

Abstract

L'invention concerne une agrafeuse chirurgicale, comprenant : un boîtier creux (1) comportant une paroi latérale pourvue d'une fenêtre (13) ; une enclume (2) fixée à l'intérieur du boîtier (1) ; un ensemble de déclenchement situé au niveau d'un côté d'extrémité proximale de l'enclume (2), une agrafe (33) étant disposée à l'intérieur de l'ensemble de déclenchement , l'ensemble de déclenchement étant au moins partiellement relié amovible au boîtier (1), et l'ensemble de déclenchement étant mobile dans une direction axiale de l'agrafeuse par rapport au boîtier (1) ; et un ensemble d'entraînement (7) poussant l'ensemble de déclenchement, lorsque l'agrafeuse est déclenchée, de façon à bouger dans une direction de côté d'extrémité distale de l'agrafeuse, et poussant l'agrafe (33) située dans l'ensemble de déclenchement vers l'enclume (2). L'ensemble d'entraînement (7) entraîne l'ensemble de déclenchement de façon à l'amener à achever la fermeture et le déclenchement de l'agrafeuse, de manière à réaliser une anastomose sur un tissu, réalisant ainsi une suture de tissu ou la fermeture d'une ouverture dans un tissu ; de plus, l'ensemble de déclenchement peut être séparé du boîtier (1) en vue de son remplacement, de façon à assurer la réutilisation d'un instrument.
PCT/CN2021/142297 2020-12-29 2021-12-29 Agrafeuse chirurgicale WO2022143721A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP2023600092U JP3244798U (ja) 2020-12-29 2021-12-29 外科ステープラー
BR212023012430U BR212023012430U2 (pt) 2020-12-29 2021-12-29 Grampeador cirúrgico
DE212021000536.5U DE212021000536U1 (de) 2020-12-29 2021-12-29 Chirurgisches Klammernahtgerät

Applications Claiming Priority (12)

Application Number Priority Date Filing Date Title
CN202023274748.0U CN214907505U (zh) 2020-12-29 2020-12-29 外科缝切装置
CN202023275967.0 2020-12-29
CN202011602221.8 2020-12-29
CN202023275224.3U CN214907506U (zh) 2020-12-29 2020-12-29 外科吻合器
CN202023275967.0U CN214907508U (zh) 2020-12-29 2020-12-29 外科吻合器
CN202023274748.0 2020-12-29
CN202011602221.8A CN114680974B (zh) 2020-12-29 2020-12-29 外科缝切装置
CN202011607216.6A CN114680976B (zh) 2020-12-29 2020-12-29 外科吻合器
CN202011607211.3A CN114680975B (zh) 2020-12-29 2020-12-29 外科吻合器
CN202011607211.3 2020-12-29
CN202011607216.6 2020-12-29
CN202023275224.3 2020-12-29

Publications (1)

Publication Number Publication Date
WO2022143721A1 true WO2022143721A1 (fr) 2022-07-07

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JP (1) JP3244798U (fr)
BR (1) BR212023012430U2 (fr)
DE (1) DE212021000536U1 (fr)
WO (1) WO2022143721A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060049231A1 (en) * 2004-07-30 2006-03-09 Leiboff Arnold R Surgical stapling instrument and method for its use
CN104224259A (zh) * 2014-09-15 2014-12-24 江苏钱璟医疗器械有限公司 一次性使用内口切闭吻合器
CN214907508U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科吻合器
CN214907506U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科吻合器
CN214907505U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科缝切装置
CN214907509U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科吻合器

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060049231A1 (en) * 2004-07-30 2006-03-09 Leiboff Arnold R Surgical stapling instrument and method for its use
CN104224259A (zh) * 2014-09-15 2014-12-24 江苏钱璟医疗器械有限公司 一次性使用内口切闭吻合器
CN214907508U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科吻合器
CN214907506U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科吻合器
CN214907505U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科缝切装置
CN214907509U (zh) * 2020-12-29 2021-11-30 天臣国际医疗科技股份有限公司 外科吻合器

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JP3244798U (ja) 2023-11-30
DE212021000536U1 (de) 2023-09-28
BR212023012430U2 (pt) 2023-11-21

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