WO2022161173A1 - 一种吻合夹取出套装以及一种吻合夹释放套装 - Google Patents

一种吻合夹取出套装以及一种吻合夹释放套装 Download PDF

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Publication number
WO2022161173A1
WO2022161173A1 PCT/CN2022/071619 CN2022071619W WO2022161173A1 WO 2022161173 A1 WO2022161173 A1 WO 2022161173A1 CN 2022071619 W CN2022071619 W CN 2022071619W WO 2022161173 A1 WO2022161173 A1 WO 2022161173A1
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Prior art keywords
extraction
anastomotic clip
cap
hook
loading
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PCT/CN2022/071619
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English (en)
French (fr)
Inventor
缪东林
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江苏唯德康医疗科技有限公司
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Application filed by 江苏唯德康医疗科技有限公司 filed Critical 江苏唯德康医疗科技有限公司
Priority to EP22726379.5A priority Critical patent/EP4082447A4/en
Priority to US17/806,600 priority patent/US20220304695A1/en
Publication of WO2022161173A1 publication Critical patent/WO2022161173A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/083—Clips, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/076—Surgical instruments, devices or methods, e.g. tourniquets for removing surgical staples or wound clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00907—Material properties transparent or translucent for light
    • 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
    • A61B2017/1132—End-to-end connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding

Definitions

  • the present application relates to the technical field of medical devices, and in particular, to an anastomotic clip removal set and an anastomotic clip release set.
  • Anastomotic clips are medically used to replace traditional manual suturing equipment. Due to the development of modern technology and the improvement of manufacturing technology, the currently used clinical anastomotic clips are of reliable quality and easy to use, especially their fast suture, easy operation and few The advantages of side effects and surgical complications also enable the tumor to be removed in the past unresectable surgery, which is very favored and respected by clinical surgeons at home and abroad.
  • the anastomotic clip is often built into the transparent cap, and at this time, the push rod used to push the anastomotic clip is also built into the transparent cap, which will cause the size of the transparent cap to be too large, and it is easy to send the transparent cap into the patient. It causes discomfort to the patient. For this reason, some anastomotic clips are also covered on the transparent cap. In order to prevent the anastomotic clip from falling off, it is necessary to ensure that the anastomotic clip is not easily loosened when it is loaded on the transparent cap, which makes it more difficult to release the anastomotic clip. This leads to the phenomenon of release failure. Therefore, it is necessary to design a sheath-type anastomotic clip device that can easily release the anastomotic clip.
  • Anastomotic clips play an important role in the field of modern medicine.
  • the spikes at the front end will penetrate into the tissue, and the clip is relatively firm and generally difficult to remove. This requires a high degree of operator proficiency and requires a one-time To clamp the perforated tissue accurately, once the clamp is in the wrong position, it will be difficult to disengage or even cause tissue damage. Therefore, it is necessary to design an anastomotic clip removal set that can easily remove the anastomotic clip and avoid tissue damage.
  • the present application provides an anastomotic clip extraction kit to solve the above problems.
  • an anastomotic clip extraction kit comprising an extraction cap, an extraction hook and an anastomotic clip
  • the extraction cap is suitable for being installed at the front end of an endoscope
  • the front end of the extraction cap is suitable for It is accommodated in the anastomotic clip, and the extraction hook can pass through the extraction cap and hook the anastomotic clip; when the extraction hook is pulled backward, the extraction hook drives the anastomotic clip to cover the outer periphery of the front end of the extraction cap .
  • the anastomotic clip includes an anastomotic clip body and a take-out wire, the front end of the anastomotic clip body can be closed, and the rear end of the anastomotic clip body is provided with a plurality of wire holes along the circumferential direction, and the take-out wire passes through the wire holes and is connected to the wire.
  • the anastomotic clip body is fixed.
  • each of the extraction wires is connected to each other, and the connection point of the extraction wires is located on the central axis of the anastomotic clip body.
  • the take-out hook includes a handle and a hook portion located at the front end of the handle.
  • the take-out hook also includes a slip ring and a cable, the slip ring is slidably connected to the handle, the handle has a shaft hole penetrating the front end of the handle, one end of the cable is connected to the slip ring, and the other end is connected to the handle. the hook.
  • the removal cap includes a removal cap body and a holder fixed at the rear end of the removal cap body, the holder is suitable for being installed at the front end of the endoscope, and the front end of the removal cap body has two or two notches above the bar.
  • the front end of the removal cap body is provided with an arc-shaped chamfer.
  • the notch extends in the axial direction of the extraction cap.
  • the front end of the removal cap body located on both sides of each of the slots has a chamfered slope.
  • the notch and the wire hole are arranged in a one-to-one correspondence.
  • the present application provides an anastomotic clip set to solve the above problems.
  • the present application also provides an anastomotic clip release kit, which is suitable for use with an endoscope, and the anastomotic clip is released through the endoscope to clamp the target tissue, wherein:
  • the release set includes a loading transparent cap and a push rod, the anastomotic clip is suitable for being sleeved on the front end of the loading transparent cap, the longitudinal center of the loading transparent cap is axially penetrated, the loading transparent cap is provided with a support portion, and the support portion is provided with an axial towards the through push hole, the push rod passes through the push hole, and is configured to move along the axial direction of the push hole, so that one end of the push rod pushes against the rear end of the anastomotic clip;
  • Applying a pre-set force to the push rod can push the anastomotic clip to disengage from the front end of the loading transparent cap to release the anastomotic clip, thereby clamping the target tissue.
  • the support part is arranged on the side wall of the loading transparent cap, and the front end of the loading transparent cap is also provided with a loading ring, and the loading ring is made of hard metal material.
  • the front end of the anastomotic clip is abuts against the outer wall of the loading ring.
  • the push rod includes a rod body and a push handle connected to one end of the rod body, and the other end of the rod body abuts against the rear end of the anastomotic clip.
  • the loading transparent cap includes a main body, which penetrates through the axial center and is made of transparent or translucent material; one end of the main body is a socket section suitable for the outer anastomosis clip, and the push hole is located at the rear of the socket section.
  • the ring is positioned near the front end of the socket segment, and the loading ring is located outside the body.
  • the front end of the socket section is provided with an inclined surface, and the outer side of the socket section located behind the inclined surface has an annular groove suitable for installing the loading ring.
  • the loading ring is fixedly connected to the end of the socket section.
  • the loading ring is a tapered structure whose outer diameter gradually decreases from the rear to the front.
  • the main body also has a limit section connected with the socket section, the outer diameter of the limit section is larger than the outer diameter of the socket section, and the push hole is located on the limit section.
  • the loading ring is pasted or snapped into the annular groove.
  • An anastomotic clip extraction set is suitable for use with an endoscope.
  • the anastomotic clip is taken out through the endoscope.
  • the anastomotic clip includes an anastomotic clip body and a removal wire.
  • the rear end of the body is provided with at least two wire holes along the circumferential direction, and the take-out wire passes through the wire holes and is fixed to the anastomotic clip body, wherein:
  • the removal set includes a removal cap that penetrates back and forth and a removal hook that can move back and forth along the internal axis of the removal cap.
  • the removal cap is suitable for being installed at the front end of the endoscope, and the front end of the removal cap is suitable for sleeves with an anastomotic clip, and the removal hook can pass through the removal cap and hook the take-out line;
  • the extraction hook When the extraction hook is pulled to drive the extraction wire to move backward, the extraction hook drives the anastomotic clip to cover the outer circumference of the front end of the extraction cap, so that the front end of the anastomotic clip is in an open state.
  • the removal cap includes a removal cap body and a holder fixed at the rear end of the removal cap body, the holder is suitable for being installed at the front end of the endoscope, and the front end of the removal cap body has two or more notches.
  • the take-out set includes a handle, and the handle and the take-out hook are relatively fixedly connected.
  • the front end of the take-out hook is provided with a hook portion
  • the handle also includes a slip ring and a pull cable
  • the slip ring is slidably connected to the handle
  • the handle has a shaft hole penetrating the front end of the handle, one end of the pull cable is connected to the slip ring, and the other end is connected to the handle. hook.
  • the extraction cap when the anastomotic clip is pulled out by the extraction hook, the extraction cap can stretch the anastomotic clip, so that the front-end spikes of the anastomotic clip loosen the tissue, thereby avoiding tissue damage when the anastomotic clip is taken out , the operator's operating proficiency requirements are greatly reduced, and multiple clamping operations can be performed until the optimal clamping position is found.
  • the front end of the extraction cap has a notch, and when the anastomotic clip moves outward with the extraction hook, the extraction wire can move along the slot to avoid bending of the extraction wire and lower the anastomotic clip. the removal resistance.
  • the anastomotic clip is mounted on the outer side of the transparent cap, and the push rod is also correspondingly arranged on the outer side of the transparent cap, thereby reducing the size of the transparent cap and improving the comfort of the patient.
  • the utility model is provided with a loading ring made of hard metal material at the front end of the original transparent cap, thereby reducing the frictional force when the anastomotic clip is released.
  • a loading ring made of hard metal is arranged at the front end of the anastomotic clip.
  • the spiked portion of the anastomotic clip is close to the height of the loading ring.
  • the spiked portion shrinks and tilts toward the loading ring, and the rigidity of the loading ring can prevent the spiked portion from being embedded and improve the success rate of release.
  • the main body has a limit section connected to the socket section.
  • the limit section can have an increased wall thickness for the push rod to pass through, and on the other hand
  • the limiting section can limit the anastomotic clip in the sleeve section, avoid the axial movement of the surgical instrument, and control the positional relationship between the thorn part of the surgical instrument and the loading ring.
  • FIG. 1 is a front view of the removal cap of one of the embodiments of the present application.
  • Fig. 2 is the A-A direction sectional view of Fig. 1;
  • Figure 3 is a top view of an anastomotic clip with two wire holes
  • FIG. 4 is a sectional view taken along the line B-B of FIG. 3;
  • Figure 5 is a top view of an anastomotic clip with four wire holes
  • Fig. 6 is the C-C direction sectional view of Fig. 3;
  • FIG. 7 is a schematic structural diagram of an anastomotic clip body in the anastomotic clip shown in FIG. 5;
  • FIG. 8 is a top view of an anastomotic clip with three wire holes
  • Fig. 9 is the D-D direction sectional view of Fig. 8.
  • FIG. 10 is a schematic structural diagram of the take-out hook described in one of the embodiments of the present application.
  • FIG. 11 is a schematic diagram of the state of the take-out set shown in one of the embodiments of the present application when it is in a ready-to-pull state;
  • Fig. 12 is a state schematic diagram of the take-out set shown in one of the embodiments of the present application when it is in a reset preparation state;
  • Figure 13 is a schematic diagram of the state when the anastomotic clip is completely pulled out
  • Figure 15 is a schematic diagram of the state of the release sleeve after releasing the anastomotic clip shown in one of the embodiments of the present application (the release sleeve is shown in a cross-sectional structure);
  • FIG. 16 is a cross-sectional view of the structure of the anastomotic clip shown in one of the embodiments of the present application after the transparent cap is loaded;
  • Fig. 17 is a structural cross-sectional view of the anastomotic clip shown in one of the embodiments of the present application after being released by the release sleeve;
  • FIG. 18 is an exploded view of the structure of the loading transparent cap and the loading ring shown in one of the embodiments of the present application;
  • FIG. 19 is an exploded view of the structure of the loading transparent cap and the loading ring shown in another embodiment of the present application;
  • Fig. 20 is an exploded cross-sectional view of the structure of the loaded transparent cap shown in one of the embodiments of the present application;
  • Fig. 21 is a structural cross-sectional view of the state in which the anastomotic clip is sleeved on the loading transparent cap shown in one of the embodiments of the present application;
  • Fig. 22 is a structural view showing a state in which the loading ring shown in Fig. 19 is assembled to the loading transparent cap.
  • Removing cap 101, Removing cap body, 1011, Notch, 102, Fixer, 2.
  • Removing hook 201, Handle, 202, Hook, 203, Slip ring, 204, Cable, 3, anastomotic clip, 301, anastomotic clip body, 3011, connecting ring, 3012, spiked portion, 302, extraction wire, 303, wire hole, 4, endoscope, 5, curved chamfer, 6, chamfer bevel, 7 , perforation, 8, tissue, 9, release set, 91, loading transparent cap, 92, push lever, 93, push hole, 94, loading ring, 95, support, 911, main body, 921, rod body, 922, push handle , 912, socket section, 913, limit section, 9121, inclined surface.
  • the "front end” refers to the end of the instrument close to the perforation 7 and the tissue 8 during the operation
  • the “rear end” refers to the end of the instrument away from the perforation 7 and the tissue 8 during the operation.
  • this embodiment provides a removal kit for an anastomotic clip 3 , including a removal cap 1 , a removal hook 2 and an anastomotic clip 3 .
  • the front end of the cap is suitable for being accommodated in the anastomotic clip, that is, the outer diameter of the extraction cap 1 is less than or equal to the inner diameter of the anastomotic clip 3, and the extraction hook 2 can pass through the extraction cap 1 and hook the anastomotic clip 3; when the extraction hook 2 is pulled backwards When the removal hook 2 drives the anastomotic clip 3 to cover the outer circumference of the front end of the removal cap 1 .
  • the extraction cap 1 is a tubular structure, and the anastomotic clip 3 can be sheathed on the outer periphery of the extraction cap 1 .
  • the endoscope 4 sends the extraction cap 1 to the anastomotic clip 3, and the extraction hook 2 passes through the extraction cap 1 through the forceps hole of the endoscope 4, and the extraction hook 2. Hook the anastomotic clip 3 and pull the anastomotic clip 3 backwards.
  • the anastomotic clip 3 is coaxial with the removal cap 1.
  • the thorns 3012 of the anastomotic clip 3 are gradually stretched by the extraction cap 1, so that the The anastomotic clip 3 is separated from the tissue 8 until the anastomotic clip 3 is completely sheathed on the extraction cap 1 , then the extraction hook 2 is disengaged from the anastomotic clip 3 , the extraction hook 2 is pulled out, and the anastomotic clip 3 is taken out together with the endoscope 4 .
  • the spikes 3012 of the anastomotic clip 3 can be opened synchronously, so as to avoid tearing and damage to the tissue 8 , and the tissue 8 can be clamped repeatedly.
  • the anastomotic clip 3 can adopt but is not limited to the following structure: the anastomotic clip 3 includes an anastomotic clip body 301 and a take-out wire 302, the front end of the anastomotic clip body 301 can be closed, and the rear end of the anastomotic clip body 301 is provided with a plurality of wire holes 303 along the circumferential direction, and the anastomotic clip body 301 can be taken out.
  • the wire 302 passes through the wire hole 303 and is fixed to the anastomotic clip body 301 . .
  • the anastomotic clip 3 passes through in the axial direction.
  • the anastomotic clip body 301 generally includes a connecting ring 3011 and a spiked portion 3012.
  • the wire hole 303 is located on the connecting ring 3011, and the spiked portion 3012 is located at the front end of the connecting ring 3011. It is composed of two spiked claws, the spiked portion 3012 is made of shape memory material, and the front end of the spiked portion 3012 is in a contracted and clamped state without external force.
  • the spiked claws can be of a conical structure or a toothed structure.
  • the spiked claws of the anastomotic clip 3 shown in FIG. 7 are of a toothed structure.
  • Each extraction wire 302 is connected to each other, and the connection point of the extraction wire 302 is located on the central axis of the anastomotic clip body 301.
  • the anastomotic clip 3 shown in FIG. 3 and FIG. 4 is provided with two wire holes 303. The two ends of the wire 302 are connected to the two wire holes 303.
  • the anastomotic clip 3 shown in FIG. 5 and FIG. At the same time, the two extraction wires 302 intersect and connect on the central axis of the anastomotic clip body 301 .
  • each extraction wire 302 is respectively connected to the three wire holes 303 , and the other ends of the three extraction wires 302 are on the central axis of the anastomotic clip body 301 .
  • upper intersect connection Setting the connection point of each extraction wire 302 on the central axis of the anastomotic clip body 301 allows the extraction hook 2 to extend into the endoscope 4 and directly hook on the connection point of the extraction wire 302 without bending to find the thread.
  • the take-out hook 2 includes a handle 201 and a hook portion 202 located at the front end of the handle 201 .
  • the hook portion 202 can be directly fixed on the front end of the handle 201.
  • the hook portion 202 is movably connected with the handle 201.
  • the take-out hook 2 further includes a slip ring 203 and a pull cable 204.
  • the slip ring 203 is slidably connected to the handle 201.
  • the handle 201 has a shaft hole penetrating the front end of the handle 201.
  • One end of the pull cable 204 is connected to the slip ring 203 and the other end.
  • the hook portion 202 is connected. After the extraction hook 2 reaches the target position through the forceps hole of the endoscope 4, the position of the hook portion 202 can be fine-tuned by pushing the sliding ring 203 back and forth.
  • the extraction cap 1 includes an extraction cap body 101 and a holder 102 fixed to the rear end of the extraction cap body 101 .
  • the holder 102 is adapted to be installed at the front end of the endoscope 4 and the front end of the extraction cap body 101 There are two or more notches 1011 .
  • the fixer 102 is an annular structure. Since the fixer 102 is installed and fixed with the endoscope 4, the specific structure of the fixer 102 is set according to the models of different endoscopes 4. After the anastomotic clip 3 is taken out, the anastomotic clip 3 is sleeved on the removal cap.
  • the notch 1011 is used to make way for the extraction wire 302. Since the anastomotic clip 3 is driven by the extraction wire 302 to move backward, if the extraction cap body 101 is an integral tubular structure, it is hindered by the front end of the extraction cap body 101. It will be difficult for the anastomotic clip 3 to be sleeved on the outer periphery of the extraction cap body 101 backwards, so a notch 1011 needs to be provided to make the extraction wire 302 move backwards gradually. Preferably, the notch 1011 extends along the axial direction of the extraction cap 1 .
  • the arrangement position of the slot 1011 can be random, and the extraction wire 302 can be corresponding to the slot 1011 by rotating the extraction hook 2, so that the extraction wire 302 can sink into the slot 1011.
  • the slot 1011 and the slot 1011 The wire holes 303 are arranged in a one-to-one correspondence.
  • the one-to-one correspondence means that the number of the slots 1011 and the wire holes 303 are equal, and the connection line between each slot 1011 and the corresponding wire hole 303 is parallel to the central axis of the removal cap 1 .
  • the front end of the extraction cap body 101 is provided with an arc-shaped chamfer 5.
  • the arc-shaped chamfer 5 is located on the outer peripheral edge of the extraction cap body 101.
  • the anastomotic clip 3 moves backwards, it is ready to be fitted over the extraction cap.
  • the anastomotic clip 3 first contacts the arc-shaped chamfer 5, and the arc-shaped chamfer 5 can play a transitional guiding role, and can also avoid causing damage to the human body cavity or scratching the surface of the anastomotic clip 3.
  • the front end of the removal cap body 101 located on both sides of each slot 1011 has a chamfered inclined surface 6 .
  • the setting of the chamfered inclined surface 6 makes the front end of the slot 1011 in an expanded structure, which facilitates the extraction of the wire 302 into the slot 1011 .
  • the working principle of the removal set in this embodiment is as follows: a special removal cap 1 is installed at the front end of the endoscope 4 , the endoscope 4 is first inserted into the target position, and then the removal hook is inserted through the forceps hole of the endoscope 4 2.
  • the extraction hook 2 is extended out of the extraction cap 1, the hook portion 202 hooks the extraction wire 302 on the anastomotic clip 3, and the device is in a ready state for extraction (as shown in Figure 11).
  • a removal kit for an anastomotic clip is provided.
  • the removal kit is suitable for use with an endoscope 4 , and the anastomotic clip 3 indwelled in the human body is taken out through the endoscope 4 .
  • the anastomotic clip 3 It includes an anastomotic clip body 301 and a take-out wire 302.
  • the front end of the anastomotic clip body 301 is set to be closed in a natural state, and the rear end of the anastomotic clip body 301 is provided with at least two wire holes along the circumferential direction.
  • the take-out wire 302 passes through the wire holes and the anastomotic clip body.
  • the removal set includes a removal cap 1 that penetrates front and rear and a removal hook 2 that can move back and forth along the internal axis of the removal cap 1.
  • the removal cap 1 is suitable for being installed at the front end of the endoscope 4, and the front end of the removal cap 1 is suitable for sleeve
  • the anastomotic clip 3, the extraction hook 2 can pass through the extraction cap 1 and hook the extraction wire 302.
  • the extraction hook 2 When the extraction hook 2 is pulled to drive the extraction wire 302 to move backward, the extraction hook 2 drives the anastomotic clip 3 to wrap around the outer periphery of the front end of the extraction cap 1 , so that the front end of the anastomotic clip 3 is in an open state.
  • the removal set in this embodiment does not contain the anastomotic clip 3, and the anastomotic clip 3 is taken out as the object to be removed, because the large-scale tissue wound in the human body needs to be closed to stop bleeding in advance, and the anastomotic clip release set is used to pass the endoscope.
  • the endoscope 4 clamps the target tissue wound to stop bleeding. After the hemostasis is completed, since the anastomotic clip 3 is made of metal material, it needs to be taken out again to prevent the patient from being affected by other examinations. At this time, the removal set is arranged to pass through the endoscope 4 Enter into the human body to take out the anastomotic clip 3 .
  • the extraction cap 1 includes an extraction cap body 101 and a holder 102 fixed at the rear end of the extraction cap body 101 , the holder 102 is adapted to be installed at the front end of the endoscope 4 , and the extraction cap body 101
  • the front end has two or more notches.
  • the take-out set includes a handle 201 , and the handle 201 is relatively fixedly connected with the take-out hook 2 .
  • the front end of the take-out hook 2 is provided with a hook portion 202.
  • the handle 201 also includes a slip ring 203 and a pull cable 204.
  • the slip ring 203 is slidably connected to the handle 201.
  • the slip ring 204 is connected, and the other end is connected to the hook 202 .
  • an anastomotic clip release set 9 is provided.
  • the release set 9 is similar to the aforementioned removal set.
  • the release sleeve 9 includes a loading transparent cap 91 and a push rod 92, the longitudinal center of the loading transparent cap 91 is axially penetrated, and is approximately a tubular structure, and the anastomotic clip 3 is configured to be suitable for being sleeved on
  • the front part of the loading transparent cap 91, and the head end of an endoscopic instrument such as a gastroscope or an enteroscope can be sleeved in the loading transparent cap 91, and a support part 95 is provided on the loading transparent cap 91 behind the anastomotic clip 3,
  • the support portion 95 has a pushing hole 93 penetrating in the axial direction.
  • the pushing rod 93 is configured to move along the axial direction of the pushing hole 93 , so that one end of the pushing rod 92 pushes against the rear end of the anastomotic clip 3 .
  • the support portion 95 and the transparent loading cap 91 are two independent parts, and the two can be fixed by means of bonding or interference fit.
  • the wall thickness of the transparent cap 91 in the area where the push hole 93 is located is increased, and the support portion 95 is equivalent to being integrally formed on the side wall of the transparent cap 91, while the other is not shown.
  • the support part 95 can be a separate part, which is fixed on the side of the transparent cap 91 by bonding or snapping. This design can make the support part 95 a replaceable part and reduce potential replacement. cost.
  • the push rod 92 is configured to pass through the push hole 93 and reciprocate along the axial direction of the push hole 93, so that the push rod 92 pushes against the rear end of the anastomotic clip 3, and the push rod 92 can move toward the rear end of the anastomotic clip 3. Push the anastomotic clip 3 forward to provide release power for the anastomotic clip 3 .
  • the anastomotic clip 3 is usually made of a shape memory alloy, and the target tissue is clamped by the shape memory property of the spiked portion 3012 at the front end of the anastomotic clip 3.
  • the spiked portion 3012 is opened, when the anastomotic clip 3 is released, under the action of the shape memory restoring force, the spiked portion 3012 is closed, and the transparent cap 91 is loaded with an approximate tubular structure, with a through cavity in the center, and one end of the push rod 92 After passing through the push hole 3 from the rear end, it abuts against the rear end of the anastomotic clip 3 .
  • the push rod 92 When the anastomotic clip 3 needs to be released, the push rod 92 is pushed forward, so that the anastomotic clip 3 has the power to move forward. Under the action of the shape memory alloy, it can be detached from the loading transparent cap 91 in an instant, and the target tissue can be clamped or a larger wound can be sutured.
  • the front end of the loading transparent cap 91 is also provided with a loading ring 94, and the loading ring 94 is made of hard metal material, such as stainless steel or Nitinol, because the loading transparent cap 91 is usually PTFE, PC or The PVC material is softer than the anastomotic clip 3. If the loading operation is performed directly, the thorn portion 3012 of the anastomotic clip 3 may penetrate into the outer wall of the loading transparent cap 91, which may lead to difficulty in loading or failure to release.
  • the anastomotic clip 3 can be easily installed on the loading transparent cap 91, when the anastomotic clip 3 is loaded on the loading transparent cap 91, the front end of the anastomotic clip 3 abuts on the outer wall of the loading ring 94, and the anastomotic clip 3
  • the rear end of the stapling clip 3 can also be released relatively easily by applying a certain thrust to the rear end. Therefore, when the anastomotic clip 3 is released, it contacts and rubs against the loading ring 94.
  • the transparent loading cap 91 made of PC, PTFE or PVC material in the prior art, the gap between the loading ring 94 made of hard metal and the anastomotic clip 3 The friction force is small, and the release success rate is greatly improved.
  • the spiked portion 3012 of the anastomotic clip 3 can abut against the outer wall of the loading ring 94 , and the anastomotic clip 3 itself is made of nickel-titanium alloy, so the spiked portion 3012 can be in the loading ring 94 The outer surface of the slide slides without embedding into the loading ring 94.
  • the spiked portion 3012 when the anastomotic clip 3 is in the loaded state, the spiked portion 3012 is stretched by the loading ring 94 on the loading transparent cap 91 , and the spiked portion 3012 at least partially abuts against the loading ring 94 .
  • the prongs 3012 of the anastomotic clip 3 are bent and contracted toward each other, so that the target tissue can be clamped.
  • the specific structure of loading the transparent cap 91 in this embodiment includes: a main body 911 and a loading ring 94 , the main body 911 penetrates through the center of the axial direction and is made of transparent or translucent material;
  • the loading ring 94 is disposed near the front end of the socket section 912, and the loading ring 94 is located outside the main body 911, and the push hole 3 is located at the rear of the socket section 912.
  • the setting of the loading ring 94 close to the front end of the socket section 912 means that the distance between the loading ring 94 and the front end of the socket section 912 is very small, usually within 0.5mm, and it can also be directly connected to the front end of the socket section 912.
  • the loading transparent cap 91 After leaving the loading ring 94, the loading transparent cap 91 can be disengaged instantly. Since the push hole 3 is arranged in the wall of the loading transparent cap 91, and the push rod 92 needs to abut against the rear end of the anastomotic clip 3 after passing through the push hole 3, the outer diameter of the end face of the loading transparent cap 91 where the push hole 3 is located should be larger than that of the anastomotic clip 3.
  • the main body 911 also has a socket
  • the limiting segment 913 connected to the segment 912 , the outer diameter of the limiting segment 913 is larger than the outer diameter of the socketing segment 912 , and the pushing hole 3 is located on the limiting segment 913 .
  • the limiting section 913 can increase the wall thickness of the loading transparent cap 91 for the push rod 92 to pass through, and at the front and rear ends of the limiting section 913, the outer diameter of the loading transparent cap 91 can be reduced, and on the other hand, the outer diameter of the loading transparent cap 91 can be reduced.
  • the limiting section 913 can limit the anastomotic clip 3 in the socket section 912 , avoid axial movement of the anastomotic clip 3 , and control the positional relationship between the spiked portion 3012 of the anastomotic clip 3 and the loading ring 94 .
  • the loading ring 94 can also be set to a tapered structure whose outer diameter gradually decreases from the rear to the front.
  • the push rod 92 can be, but is not limited to, the following structure: As shown in Figures 14-15 , the push rod 92 includes a rod body 921 and a push handle 922 connected to one end of the rod body 921, and the other end of the rod body 921 abuts against the rear end of the anastomotic clip 3 .
  • the rod body 921 is a straight rod, and the push handle 922 is for the staff to operate by hand. Since the push rod 92 is located outside, it needs to be in contact with human skin tissue during the operation. In order to avoid skin damage or contamination of the instruments, the outer circumference of the rod body 921 is also provided with a rubber sleeve 923.
  • the rubber sleeve 923 is made of medical silicone material and is completely wrapped around the rod body. The perimeter of 921.
  • the front end of the socket section 912 is provided with an inclined surface 9121
  • the outer side of the socket section 912 located behind the inclined surface 9121 has an annular groove 9122 suitable for installing the loading ring 94
  • the width of the loading ring 94 is 1 mm
  • the width of the annular groove 9122 is slightly larger than 1 mm
  • the width of the inclined surface 9121 is 0.5 mm.
  • the annular groove 9122 extends directly from the front end of the transparent cap 91 to the rear end of the transparent cap 91.
  • the loading ring 94 can be pasted in the annular groove 9122, or the loading ring 94 can be snapped into the annular groove 9122 by means of interference connection.
  • the setting of the inclined surface 9121 is also conducive to the installation of the loading ring 94.
  • the loading ring 94 in order to facilitate the quick release of the anastomotic clip 3, can also be set to a tapered structure whose outer diameter gradually decreases from the rear to the front.
  • the inclined surface 9121 plays a guiding role, and also prevents the endoscope forceps from being damaged when the release set is loaded on the endoscope.
  • the inner wall of the channel hole forms a larger frictional resistance or causes scratches, and the annular groove 9122 is used to fit the rear end of the inclined surface 9121 to snap and fix the loading ring 94 .
  • the annular groove 9122 is eliminated in the socket section 912 for loading the transparent cap 91 , and the loading ring 94 does not adopt the aforementioned straight cylindrical shape
  • the loading ring 94 is fixed to the inclined surface 9121 on which the transparent cap is loaded by dripping glue.
  • the annular groove 9122 is eliminated, so that the manufacturing process is relatively simplified, and the loading ring 94 and the front end of the socket section 912 are provided with inclined surfaces for dispensing and fixing.

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Abstract

一种吻合夹（3）取出套装，包括取出帽（1）、取出钩（2）和吻合夹（3），取出帽（1）适于安装在内窥镜（4）的前端，取出帽（1）的外径小于吻合夹（3）的内径，取出钩（2）能够穿过取出帽（1）并钩住吻合夹（3）；当向后拉出取出钩（2）时，吻合夹（3）能够套在取出帽（1）的外周，以使闭合的吻合夹（3）复位。该取出套装利用取出钩（2）拉出吻合夹（3）的同时，取出帽（1）可以撑开吻合夹（3），使吻合夹（3）的前端尖刺部（3012）松开组织，从而避免取出吻合夹（3）时损伤组织，对术者操作熟练度要求大大降低，可以进行多次夹合操作，直至找到最佳夹合位置。

Description

一种吻合夹取出套装以及一种吻合夹释放套装 技术领域
本申请涉及医疗器械技术领域，尤其涉及一种吻合夹取出套装以及一种吻合夹释放套装。
背景技术
吻合夹是医学上使用的替代传统手工缝合的设备，由于现代科技的发展和制作技术的改进，目前临床上使用的吻合夹质量可靠，使用方便，尤其是其缝合快速、操作简便及很少有副作用和手术并发症等优点，还使得过去无法切除的肿瘤手术得以病灶切除，很受国内外临床外科医生的青睐和推崇。
现有技术中往往将吻合夹内置于透明帽中，此时用于推送吻合夹的推杆也内置于透明帽中，这将导致透明帽的尺寸过大，将透明帽送至患者体内时容易引起患者的不适，为此也有部分吻合夹是外套在透明帽上的，为了防止吻合夹脱落，吻合夹装载在透明帽上时需要保证不易松动，这就导致吻合夹释放时难度增大，容易导致释放失败现象发生，为此需要设计一种易于释放吻合夹的外套式吻合夹装置。
吻合夹在现代医学领域有着重要的作用，一般的吻合夹，前端的尖刺会刺入组织，夹合比较牢固，一般比较难脱，这对术者的操作熟练度要求较高，需要一次性精准夹住穿孔组织，一旦夹错位置将很难脱开甚至造成组织损伤，为此，需要设计一种可以轻松取出吻合夹、避免组织损伤的吻合夹取出套装。
发明内容
为了解决现有技术中的吻合夹夹合组织后很难再脱离组织，对术者的操作熟练度要求较高的技术问题，本申请提供了一种吻合夹取出套装来解决上述问题。
本申请解决其技术问题所采用的技术方案是：一种吻合夹取出套装，包括取出帽、取出钩和吻合夹，所述取出帽适于安装在内窥镜的前端，取出帽的前端适于收容于所述吻合夹，所述取出钩能够穿过所述取出帽并钩住所述吻合夹；当向后拉出取出钩时，取出钩带动所述吻合夹套在所述取出帽前端的外周。
进一步的，所述吻合夹包括吻合夹本体和取出线，所述吻合夹本体的前端能够闭合，吻合夹本体的后端沿周向设有多个线孔，所述取出线穿过所述线孔与所述吻合夹本体固定。
进一步的，所述取出线为多条，每根所述取出线相互连接，所述取出线的连接点位于所述吻合夹本体的中心轴上。
进一步的，所述取出钩包括手柄和位于所述手柄前端的钩部。
进一步的，所述取出钩还包括滑环和拉索，所述滑环滑动连接于所述手柄上，所述手柄中具有贯通手柄前端的轴孔，拉索的一端连接滑环、另一端连接所述钩部。
进一步的，所述取出帽包括取出帽本体和固定于所述取出帽本体后端的固定器，所述固定器适于安装在内窥镜的前端，所述取出帽本体的前端具有两条或者两条以上的槽口。
进一步的，所述取出帽本体的前端设有弧形倒角。
优选的，所述槽口沿所述取出帽的轴向延伸。
优选的，位于每个所述槽口两侧的取出帽本体前端具有倒角斜面。
优选的，所述槽口与所述线孔一一对应设置。
为了解决现有技术中吻合夹匹配的透明帽尺寸过大，引起患者不适，或者吻合夹外置的装置容易发生释放失败现象的技术问题，本申请提供了一种吻合夹套装来解决上述问题。
本申请还提供一种吻合夹释放套装，释放套装适于与内窥镜配合使用，通过内窥镜释放吻合夹进而夹住目标组织，其中：
释放套装包括装载透明帽以及推送杆，吻合夹适于套设在装载透明帽的前端，装载透明帽的纵长方向中心轴向贯通，装载透明帽设置有支撑部，支撑部上设有沿轴向贯通的推送孔，推送杆穿过推送孔、并被配置为可沿推送孔的轴向进行运动，以使推送杆的一端推抵在吻合夹的后端；
对推送杆施加预设大小的作用力，可推动吻合夹从装载透明帽前端脱离进而使吻合夹释放，从而夹住目标组织。
进一步的，支撑部设于装载透明帽的侧壁，装载透明帽的前端还设有装载环，装载环采用硬质金属材质制成，当吻合夹安装到装载透明帽上时，吻合夹的前端抵接在装载环的外壁。
进一步的，推送杆包括杆体和连接于杆体一端的推送手柄，杆体的另一端抵在吻合夹的后端。
进一步的，装载透明帽包括主体，主体沿轴向中心贯通、且采用透明或者半透明材质制成；主体的一端为适于外套吻合夹的套接段，推送孔位于套接段的后方，装载环靠近套接段的前端设置，且装载环位于主体的外侧。
进一步的，套接段的前端设置有倾斜面，位于倾斜面后方的套接段的外侧具有适于安装装载环的环形槽。
进一步的，装载环固定连接于套接段的末端。
进一步的，装载环为由后至前外径逐渐减小的锥形结构。
进一步的，主体上还具有与套接段相接的限位段，限位段的外径大于套接段的外径，推送孔位于限位段上。
进一步的，装载环粘贴或者卡接在环形槽内。
一种吻合夹取出套装，取出套装适于与内窥镜配合使用，通过内窥镜取出吻合夹，吻合夹包括吻合夹本体和取出线，吻合夹本体的前端设置为自然状态下闭合，吻合夹本体的后端沿周向设有至少2个线孔，取出线穿过线孔与吻合夹本体固定，其中：
取出套装包括前后贯通的取出帽以及可沿取出帽内部轴线前后移动的取出钩，取出帽适于安装在内窥镜的前端，取出帽的前端适于套设吻合夹，取出钩能够穿过取出帽并钩住取出线；
当拉动取出钩带动取出线向后运动时，取出钩带动吻合夹套在取出帽前端的外周，从而使吻合夹的前端呈张开状态。
进一步的，取出帽包括取出帽本体和固定于取出帽本体后端的固定器，固定器适于安装在内窥镜的前端，取出帽本体的前端具有两条或者两条以上的槽口。
进一步的，取出套装包括手柄，手柄与取出钩相对固定连接。
进一步的，取出钩的前端设置有钩部，手柄还包括滑环和拉索，滑环滑动连接于手柄上，手柄中具有贯通手柄前端的轴孔，拉索的一端连接滑环、另一端连接钩部。
本申请的有益效果是：
(1)本申请所述的吻合夹取出套装，利用取出钩拉出吻合夹的同时，取出帽可以撑开吻合夹，使吻合夹的前端尖刺松开组织，从而避免取出吻合夹时损伤组织，对术者操作熟练度要求大大降低，可以进行多次夹合操作，直至找到最佳夹合位置。
(2)本申请所述的吻合夹取出套装，所述吻合夹的后端连接有取出线，且每根取出线相互连接，取出钩通过取出线的连接点钩住取出线，使吻合夹随取出钩移动。
(3)本申请所述的吻合夹取出套装，所述取出帽的前端具有槽口，吻合夹随取出钩向外运动时，取出线可以沿槽口运动，避免取出线折弯，降低吻合夹的取出阻力。
(4)本申请所述的吻合夹释放套装，将吻合夹装在透明帽的外侧，推送杆也相应地设置于透明帽的外侧，从而缩小了透明帽的尺寸，提高患者舒适度，另外，本实用新型在原有的透明帽的前端设置硬质金属材料制成的装载环，从而减少吻合夹释放时的摩擦力。
(5)本申请的释放套装，在吻合夹的前端设置硬质金属制成的装载环，当吻合夹在透明帽的外侧时，吻合夹的尖刺部与装载环所在高度相近，当释放吻合夹时，所述尖刺部收缩并向装载环方向倾斜，装载环的硬质特性能够避免尖刺部嵌入，提高释放成功率。
(6)本申请中的释放套装，所述主体上具有与所述套接段相接的限位段，一方面，限位段可以增加壁厚，用于供推送杆穿过，另一方面，限位段可以将吻合夹限制在套接段内，避免手术器械轴向窜动，控制手术器械的尖刺部与装载环的位置关系。
附图说明
下面结合附图和实施例对本申请进一步说明。
图1是本申请中其中一个实施例的所述取出帽的主视图；
图2是图1的A-A向剖视图；
图3是具有两个线孔的吻合夹的俯视图；
图4是图3的B-B向剖视图；
图5是具有四个线孔的吻合夹的俯视图；
图6是图3的C-C向剖视图；
图7是图5所示吻合夹中吻合夹本体的结构示意图；
图8是具有三个线孔的吻合夹的俯视图；
图9是图8的D-D向剖视图；
图10是本申请中其中一个实施例所述取出钩的结构示意图；
图11是本申请的其中一个实施例所示出的取出套装处于拉出准备状态时的状态示意图；
图12是本申请的其中一个实施例所示出的取出套装处于复位准备状态时的状态示意图；
图13是吻合夹完全拉出时的状态示意图；
图14是本申请的其中一个实施例所示出的释放套装的组装结构剖视图；
图15是本申请的其中一个实施例所示出的释放套装释放吻合夹之后的状态示意图(释放套装为剖 视结构展示)；
图16是本申请的其中一个实施例所示出的吻合夹被装载透明帽撑开后的结构剖视图；
图17是本申请的其中一个实施例所示出的吻合夹被释放套装释放之后的结构剖视图；
图18是本申请的其中一个实施例所示出的装载透明帽以及装载环的结构爆炸图；
图19是本申请的另一个实施例所示出的装载透明帽以及装载环的结构爆炸图；
图20是本申请的其中一个实施例所示出的装载透明帽结构爆炸剖视图；
图21是本申请的其中一个实施例所示出的吻合夹套设在装载透明帽上的状态结构剖视图；
图22是根据图19所示出的装载环装配到装载透明帽上的状态结构图。
图中，1、取出帽，101、取出帽本体，1011、槽口，102、固定器，2、取出钩，201、手柄，202、钩部，203、滑环，204、拉索，3、吻合夹，301、吻合夹本体，3011、连接环，3012、尖刺部，302、取出线，303、线孔，4、内窥镜，5、弧形倒角，6、倒角斜面，7、穿孔，8、组织，9、释放套装，91、装载透明帽，92、推送杆、93、推送孔，94、装载环，95、支撑部，911、主体，921、杆体，922、推送手柄，912、套接段，913、限位段，9121、倾斜面。
具体实施方式
下面详细描述本申请的实施例，所述实施例的示例在附图中示出，其中自始至终相同或类似的标号表示相同或类似的元件或具有相同或类似功能的元件。下面通过参考附图描述的实施例是示例性的，仅用于解释本实施例，而不能理解为对本实施例的限制。
本实施例中所述“前端”是指手术时器械上靠近穿孔7、组织8的一端，所述“后端”是指手术时器械上远离穿孔7、组织8的一端。
如图1-图10所示，本实施例提供一种吻合夹3的取出套装，包括取出帽1、取出钩2和吻合夹3，取出帽1适于安装在内窥镜4的前端，取出帽的前端适于收容于吻合夹，即取出帽1的外径小于或者等于吻合夹3的内径，取出钩2能够穿过取出帽1并钩住吻合夹3；当向后拉出取出钩2时，取出钩2带动吻合夹3套在取出帽1前端的外周。取出帽1为管状结构，吻合夹3能够套在取出帽1的外周。
当需要取出已经夹在组织8上的吻合夹3时，内窥镜4将取出帽1送至吻合夹3处，取出钩2通过内窥镜4的钳道孔穿过取出帽1，取出钩2钩住吻合夹3并将吻合夹3向后拉动，吻合夹3与取出帽1同轴，吻合夹3向后运动的同时吻合夹3的尖刺部3012逐渐被取出帽1撑开，使吻合夹3脱离组织8，直至吻合夹3完全套在取出帽1上，接着取出钩2与吻合夹3脱离，抽出取出钩2，吻合夹3随内窥镜4一同取出。本实施例在拉出吻合夹3的同时可以使吻合夹3的尖刺部3012同步张开，从而避免对组织8造成撕扯损伤，可以实现多次重复夹合组织8。
吻合夹3可以但不仅限于采用如下结构：吻合夹3包括吻合夹本体301和取出线302，吻合夹本体301的前端能够闭合，吻合夹本体301的后端沿周向设有多个线孔303，取出线302穿过线孔303与所述吻合夹本体301固定。。吻合夹3沿轴向贯通，吻合夹本体301通常包括连接环3011和尖刺部3012，线孔303位于连接环3011上，尖刺部3012位于连接环3011的前端，尖刺部3012 由至少两个尖刺爪组成，尖刺部3012采用形状记忆材质制成，在不受外力的情况下，尖刺部3012的前端处于收缩夹紧状态。所述尖刺爪可以为锥形结构或者齿型结构，图7所示的吻合夹3中尖刺爪为齿型结构，线孔303可以为两个或者两个以上，取出线302可以为多条，每根取出线302相互连接，取出线302的连接点位于吻合夹本体301的中心轴上，如图3和图4所示的吻合夹3中设有两个线孔303，一根取出线302的两端连接在两个线孔303上，如图5和图6所示的吻合夹3中设有四个线孔303，两根取出线302分别连接在两个相对的线孔303上，同时两根取出线302在吻合夹本体301的中心轴上相交连接。图8和图9所示的吻合夹3中设有三个线孔303，三根取出线302的一端分别连接在三个线孔303上，三根取出线302的另一端在吻合夹本体301的中心轴上相交连接。将每根取出线302的连接点设置于吻合夹本体301的中心轴上可以使取出钩2伸入内窥镜4后直接钩在取出线302的连接点上，不需要折弯找线。
如图10所示，取出钩2包括手柄201和位于手柄201前端的钩部202。钩部202可以直接固定在手柄201的前端，在本实施例的一个具体实施方式中，钩部202与手柄201活动连接，在手柄201固定的情况下，能够微调钩部202的前后位置。具体的，取出钩2还包括滑环203和拉索204，滑环203滑动连接于手柄201上，手柄201中具有贯通手柄201前端的轴孔，拉索204的一端连接滑环203、另一端连接钩部202。当取出钩2通过内窥镜4的钳道孔到达目标位置后，通过前后推动滑环203可以微调钩部202的位置。
如图1和图2所示，取出帽1包括取出帽本体101和固定于取出帽本体101后端的固定器102，固定器102适于安装在内窥镜4的前端，取出帽本体101的前端具有两条或者两条以上的槽口1011。固定器102为环形结构，由于固定器102与内窥镜4安装固定，因此固定器102的具体结构根据不同内窥镜4的型号设置，当吻合夹3取出后，吻合夹3套在取出帽本体101的外周，槽口1011用于为取出线302让位，由于吻合夹3由取出线302带动向后运动，若取出帽本体101为整体的管状结构，受取出帽本体101前端的阻碍，吻合夹3将难以向后套在取出帽本体101的外周，为此需要设置槽口1011，使取出线302逐渐向后运动。作为优选的，槽口1011沿取出帽1的轴向延伸。槽口1011的布置位置可以为随机的，可以通过旋转取出钩2的方式将取出线302与槽口1011对应，使取出线302陷入槽口1011内，在优选的实施方式中，槽口1011与线孔303一一对应设置，所述一一对应设置是指槽口1011与线孔303数量相等，且每个槽口1011与对应的线孔303的连线与取出帽1的中心轴平行。
作为优选的，取出帽本体101的前端设有弧形倒角5，如图1所示，弧形倒角5位于取出帽本体101的外周边缘，当吻合夹3向后运动准备套在取出帽1外周时，吻合夹3首先与弧形倒角5接触，弧形倒角5可以起到过渡引导作用，也可以避免对人体腔道造成损伤或划损吻合夹3表面。
作为优选的，位于每个槽口1011两侧的取出帽本体101前端具有倒角斜面6。倒角斜面6的设置使槽口1011的前端呈扩张结构，便于取出线302进入槽口1011内。
本实施例中的取出套装的工作原理为：专用的取出帽1安装在内窥镜4的前端，先将内窥镜4插入到目标位置，再通过内窥镜4的钳道孔插入取出钩2，使取出钩2伸出取出帽1，钩部202勾 住吻合夹3上的取出线302，此时装置处于拉出准备状态(如图11所示)。接着向前推动取出帽1或往回拉动取出钩2，取出钩2回撤进入内窥镜4的钳道孔内，直至连接环3011套在取出帽1的外周，此时装置处于复位准备状态，吻合夹3即将复位(如图12所示)。继续拉动取出钩2，利用取出帽1前端的弧形倒角5把吻合夹3牵拉复位，使吻合夹3重新装回取出帽1上，内窥镜4与吻合夹3一起从人体撤出，从而把吻合夹3取出(如图13所示)。
根据本申请的另一个实施例，提供一种针对吻合夹的取出套装，该取出套装适于与内窥镜4配合使用，通过内窥镜4取出留置在人体内的吻合夹3，吻合夹3包括吻合夹本体301和取出线302，吻合夹本体301的前端设置为自然状态下闭合，吻合夹本体301的后端沿周向设有至少2个线孔，取出线302穿过线孔与吻合夹本体301固定，取出套装包括前后贯通的取出帽1以及可沿取出帽1内部轴线前后移动的取出钩2，取出帽1适于安装在内窥镜4的前端，取出帽1的前端适于套设吻合夹3，取出钩2能够穿过取出帽1并钩住取出线302。
当拉动取出钩2带动取出线302向后运动时，取出钩2带动吻合夹3套在取出帽1前端的外周，从而使吻合夹3的前端呈张开状态。
与前述实施例相比，本实施例当中的取出套装不含吻合夹3，吻合夹3作为被取出对象，是事先因为人体内较大范围组织创口需要闭合止血，采用吻合夹释放套装通过内窥镜4对目标组织创口进行夹闭止血，当完成止血后，由于吻合夹3是金属材质制成，为避免患者做其他检查受到影响，需要再次取出，此时再安排取出套装通过内窥镜4进入到人体进行吻合夹3的取出操作。
在其中一个实施方式当中，参见图1，取出帽1包括取出帽本体101和固定于取出帽本体101后端的固定器102，固定器102适于安装在内窥镜4的前端，取出帽本体101的前端具有两条或者两条以上的槽口。
参见图10-图11，取出套装包括手柄201，手柄201与取出钩2相对固定连接。取出钩2的前端设置有钩部202，手柄201还包括滑环203和拉索204，滑环203滑动连接于手柄201上，手柄201中具有贯通手柄201前端的轴孔，拉索20的一端连接滑环204、另一端连接钩部202。
参见图14-图15，根据本申请的另一个实施例，提供一种吻合夹释放套装9，该释放套装9如前述的取出套装类似，作为内窥镜4的一种耗材，也是需要配合内窥镜4进行使用，通过内窥镜4进行吻合夹3的释放从而夹住目标组织，达到伤口闭合或止血的目的。
结合图15以及图20，该释放套装9包括装载透明帽91和推送杆92，装载透明帽91的纵长方向中心轴向贯通，近似呈管状结构，吻合夹3被配置为适于套设在装载透明帽91的前部，而胃镜或肠镜等内窥镜器械的头端可套设在该装载透明帽91之内，位于吻合夹3后方的装载透明帽91上设置有支撑部95，而支撑部95上具有沿轴向贯通的推送孔93，推送杆93被配置为可沿推送孔93的轴向进行运动，以使推送杆92的一端推抵在吻合夹3的后端。如图20所示出的，支撑部95与装载透明帽91为相互独立的两个零部件，二者可通过粘接或过盈配合的方式进行固定。
在另一个实施方式当中，将推送孔93所在区域的装载透明帽91的进行壁厚增大处理，支撑部95此时相当于一体成型在装载透明帽91的侧壁，而另一个未示出的实施方式当中，支撑部95可 以为单独的零部件，通过粘接或者卡接等方式固定在装载透明帽91的侧部，如此设计可以让支撑部95变成可替换件，减少潜在的更换成本。本实施方式当中，推送杆92被配置为可穿过推送孔93、并能够沿推送孔93的轴向往复运动，以使推送杆92推抵在吻合夹3的后端，推送杆92可以向前推动吻合夹3，为吻合夹3提供释放动力。
结合图15以及图16-图17，吻合夹3通常采用形状记忆合金制成，利用其前端的尖刺部3012的形状记忆特性夹住目标组织，当吻合夹3装载在装载透明帽91上时，尖刺部3012张开，当吻合夹3被释放时，在形状记忆恢复力的作用下，尖刺部3012闭合，装载透明帽91近似为管状结构，中心具有贯通腔，推送杆92的一端从后端穿过推送孔3后抵在吻合夹3的后端。当需要释放吻合夹3时，向前推动推送杆92，使吻合夹3具有向前运动的动力，当吻合夹3的尖刺部3012开始与装载透明帽91分离时，吻合夹3在自身的形状记忆合金作用下，可以在一瞬间从装载透明帽91上脱落，对目标组织进行夹取或者较大创口的缝合。
参见图18或图22，装载透明帽91的前端还设有装载环94，装载环94采用硬质金属材质制成，例如不锈钢材或者镍钛合金，因装载透明帽91通常为PTFE、PC或PVC材质，质地相对吻合夹3较软，如果直接进行装载操作，可能会因为吻合夹3的尖刺部3012扎入装载透明帽91外壁内，导致装载困难或者释放失败，所以通过设计该装载环94，可以较为轻松地将吻合夹3安装到装载透明帽91之上，当吻合夹3装载在装载透明帽91上时，吻合夹3的前端抵接在装载环94的外壁，对吻合夹3的后端施加一定的推力，也可以相对轻松的将吻合夹3进行释放。因此，吻合夹3释放时与装载环94接触摩擦，与现有技术中的PC、PTFE或者PVC材质制成的装载透明帽91相比，硬质金属材质的装载环94与吻合夹3之间的摩擦力较小，释放成功率大大提高。
参见图21，也就是说在本实施方式当中，吻合夹3的尖刺部3012能够抵接在装载环94的外壁，吻合夹3本身为镍钛合金，因此尖刺部3012能够在装载环94的外表面滑动，而不会嵌入装载环94内。
根据本申请的另一个实施方式，当吻合夹3处于装载状态时，尖刺部3012被装载透明帽91上的装载环94撑开，此时尖刺部3012至少部分抵接在装载环94的外表面，当吻合夹3释放时，在形状记忆合金自身的恢复力作用下，吻合夹3的尖刺部3012朝向彼此弯折收缩，从而可以夹住目标组织。
本实施例中装载透明帽91的具体结构为：包括主体911和装载环94，主体911沿轴向中心贯通、且采用透明或者半透明材质制成；主体911的一端为适于外套吻合夹3的套接段912，装载环94靠近套接段912的前端设置，且装载环94位于主体911的外侧，推送孔3位于套接段912的后方。装载环94靠近套接段912的前端设置是指装载环94与套接段912的前端的距离很小，通常为0.5mm以内，也可以直接连接在套接段912的前端，尖刺部3012离开装载环94后能够瞬间脱离装载透明帽91。由于推送孔3设置在装载透明帽91的壁面内，且推送杆92穿过推送孔3后需要抵在吻合夹3的后端，因此推送孔3所在的装载透明帽91端面外径应大于吻合夹3对应的装载透明帽91端面外径(即套接段912)，这样才能保证推送杆92位于装载透明帽91的外部，如图18-图 21所示，主体911上还具有与套接段912相接的限位段913，限位段913的外径大于套接段912的外径，推送孔3位于限位段913上。一方面，限位段913可以增加装载透明帽91的壁厚，用于供推送杆92穿过，而在限位段913的前后两端，装载透明帽91的外径则可以减小，另一方面，限位段913可以将吻合夹3限制在套接段912内，避免吻合夹3轴向窜动，控制吻合夹3的尖刺部3012与装载环94的位置关系。
本实施例中为了便于吻合夹3快速释放，装载环94也可以设置为由后至前外径逐渐减小的锥形结构。
推送杆92可以但不仅限于采用如下结构：如图14-图15所示，推送杆92包括杆体921和连接于杆体921一端的推送手柄922，杆体921的另一端抵在吻合夹3的后端。杆体921为直杆，推送手柄922供工作人员手持操作。由于推送杆92位于外部，手术时需要与人体皮肤组织接触，为避免皮肤受损或者污染器械，杆体921的外周还设置有胶套923，胶套923采用医用硅胶材质制成，完全包裹于杆体921的外周。
如图18所示，根据本申请的另一个实施例，套接段912的前端设置有倾斜面9121，位于倾斜面9121后方的套接段912的外侧具有适于安装装载环94的环形槽9122，装载环94的宽度为1mm，环形槽9122的宽度略大于1mm，倾斜面9121的宽度(即沿套接段912轴向的尺寸)为0.5mm。另一个未示出的实施方式中，环形槽9122为直接从装载透明帽91的前端向装载透明帽91的后端延伸，此时只需在装载透明帽91的前端或者装载环94的内壁刷上胶水，即可从装载透明帽91的前端套入装载环94进行胶水固定，或者将环形槽9122的外径尺寸设置略大，而装载环94的内径尺寸略小，使得二者可以卡接固定。倾斜面9121使位于装载环94前方的套接段912部分直径缩小，当吻合夹3脱离套接段912的瞬间，尖刺部3012不会陷入套接段912的末端。装载环94可以粘贴在环形槽9122内，也可以利用过盈连接方式将装载环94卡接在环形槽9122内，倾斜面9121的设置也有利于装载环94的安装。本实施例中为了便于吻合夹3快速释放，装载环94也可以设置为由后至前外径逐渐减小的锥形结构。
图18所示出的实施方式当中，在装载吻合夹3的过程中，倾斜面9121起到导引的作用，同时也避免在将释放套装装载到内窥镜上的时候，对内窥镜钳道孔内壁形成较大的摩擦阻力或造成划伤，而环形槽9122则是配合倾斜面9121的后端将装载环94卡接固定。
参见图19，根据本申请的另一个实施例，与图18所示出的实施方式相比，装载透明帽91的套接段912取消了环形槽9122，且装载环94非采用前述的直筒状结构，而采用的是锥形筒结构，从而适于与倾斜面9121配合安装，本实施例中，装载环94通过点滴胶水的方式与装载透明帽的倾斜面9121进行固定。在本实施方式当中，取消了环形槽9122，使得生产制造工艺流程相对简单化，装载环94和套接段912前端同时设置倾斜面进行点胶配合固定。这样，在完成装载环94以及装载透明帽91之间的装配之后，由于自然状态(闭合)下吻合夹3的尖刺部3012是朝向吻合夹3的径向轴心的，在套设吻合夹3到装载透明帽91的前端的倾斜面9121过程中，尖刺部3012不可避免地将与装载透明帽91的前端的倾斜面9121摩擦接触，而在本实施方式中，由于倾斜面9121外粘 接有硬质金属材质的装载环94，摩擦阻力得以明显降低，有利于提高装配效率。
此外，在本申请的描述中，除非另有说明，“多个”的含义是两个或两个以上。
在本说明书中，对所述术语的示意性表述不一定指的是相同的实施例。而且，描述的具体特征、结构、材料或者特点可以在任何的一个或多个实施例中以合适的方式结合。
以上述依据本申请的理想实施例为启示，通过上述的说明内容，相关工作人员完全可以在不偏离本项发明申请技术思想的范围内，进行多样的变更以及修改。本项发明申请的技术性范围并不局限于说明书上的内容，必须要根据权利要求范围来确定其技术性范围。

Claims (23)

  1. 一种吻合夹取出套装，其特征在于：包括取出帽(1)、取出钩(2)和吻合夹(3)，所述取出帽(1)适于安装在内窥镜(4)的前端，取出帽(1)的前端适于收容于所述吻合夹(3)，所述取出钩(2)能够穿过所述取出帽(1)并钩住所述吻合夹(3)；
    当向后拉出取出钩(2)时，取出钩(2)带动所述吻合夹(3)套在所述取出帽(1)前端的外周。
  2. 根据权利要求1所述的吻合夹取出套装，其特征在于：所述吻合夹(3)包括吻合夹本体(301)和取出线(302)，所述吻合夹本体(301)的前端能够闭合，吻合夹本体(301)的后端沿周向设有多个线孔(303)，所述取出线(302)穿过所述线孔(303)与所述吻合夹本体(301)固定。
  3. 根据权利要求2所述的吻合夹取出套装，其特征在于：所述取出线(302)为多条，每根所述取出线(302)相互连接，所述取出线(302)的连接点位于所述吻合夹本体(301)的中心轴上。
  4. 根据权利要求2或者3所述的吻合夹取出套装，其特征在于：所述取出帽(1)包括取出帽本体(101)和固定于所述取出帽本体(101)后端的固定器(102)，所述固定器(102)适于安装在内窥镜(4)的前端，所述取出帽本体(101)的前端具有两条或者两条以上的槽口(1011)。
  5. 根据权利要求4所述的吻合夹取出套装，其特征在于：所述取出帽本体(101)的前端设有弧形倒角(5)。
  6. 根据权利要求4所述的吻合夹取出套装，其特征在于：所述槽口(1011)沿所述取出帽(1)的轴向延伸。
  7. 根据权利要求4所述的吻合夹取出套装，其特征在于：位于每个所述槽口(1011)两侧的取出帽本体(101)前端具有倒角斜面(6)。
  8. 根据权利要求4所述的吻合夹取出套装，其特征在于：所述槽口(1011)与所述线孔(303)一一对应设置。
  9. 根据权利要求1所述的吻合夹取出套装，其特征在于：所述取出钩(2)包括手柄(201)和位于所述手柄(201)前端的钩部(202)。
  10. 根据权利要求9所述的吻合夹取出套装，其特征在于：所述取出钩(2)还包括滑环(203)和拉索(204)，所述滑环(203)滑动连接于所述手柄(201)上，所述手柄(201)中具有贯通手柄(201)前端的轴孔，拉索(204)的一端连接滑环(203)、另一端连接所述钩部(202)。
  11. 一种吻合夹释放套装，所述释放套装(9)适于与内窥镜(4)配合使用，通过所述内窥镜(4)释放吻合夹(3)进而夹住目标组织，其特征在于：
    所述释放套装(9)包括装载透明帽(91)以及推送杆(92)，所述吻合夹(3)适于套设在装载透明帽(91)的前端，所述装载透明帽(91)的纵长方向中心轴向贯通，所述装载透明帽(91)设置有支撑部(95)，所述支撑部(95)上设有沿轴向贯通的推送孔(93)，所述推送杆(92)穿过所述推送孔(93)、并被配置为可沿所述推送孔(93)的轴向进行运动，以使推送杆(92)的一端推抵在所述吻合夹(3)的后端；
    对所述推送杆(92)施加预设大小的作用力，可推动所述吻合夹(3)从所述装载透明帽(91)前 端脱离进而使所述吻合夹(3)释放，从而夹住目标组织。
  12. 根据权利要求11所述的释放套装，其特征在于：所述支撑部(95)设于所述装载透明帽(91)的侧壁，所述装载透明帽(91)的前端还设有装载环(94)，所述装载环(94)采用硬质金属材质制成，当所述吻合夹(3)安装到所述装载透明帽(91)上时，所述吻合夹(3)的前端抵接在所述装载环(94)的外壁。
  13. 根据权利要求11所述的释放套装，其特征在于：所述推送杆(92)包括杆体(921)和连接于所述杆体(921)一端的推送手柄(922)，杆体(921)的另一端抵在所述吻合夹(3)的后端。
  14. 根据权利要求11所述的释放套装，其特征在于：所述装载透明帽(91)包括主体(911)，所述主体(911)沿轴向中心贯通、且采用透明或者半透明材质制成；所述主体(911)的一端为适于外套吻合夹(3)的套接段(912)，所述推送孔(93)位于所述套接段(912)的后方，所述装载环(94)靠近所述套接段(912)的前端设置，且装载环(94)位于所述主体(911)的外侧。
  15. 根据权利要求14所述的释放套装，其特征在于：所述套接段(912)的前端设置有倾斜面(9121)，位于所述倾斜面(9121)后方的所述套接段(912)的外侧具有适于安装装载环(94)的环形槽(9122)。
  16. 根据权利要求14所述的释放套装，其特征在于：所述装载环(94)固定连接于所述套接段(912)的末端。
  17. 根据权利要求14所述的释放套装，其特征在于：所述装载环(94)为由后至前外径逐渐减小的锥形结构。
  18. 根据权利要求14所述的释放套装，其特征在于：所述主体(911)上还具有与所述套接段(912)相接的限位段(913)，所述限位段(913)的外径大于所述套接段(912)的外径，所述推送孔(93)位于所述限位段(913)上。
  19. 根据权利要求15所述的释放套装，其特征在于：所述装载环(94)粘贴或者卡接在所述环形槽(9122)内。
  20. 一种吻合夹取出套装，所述取出套装适于与内窥镜(4)配合使用，通过所述内窥镜(4)取出吻合夹(3)，所述吻合夹(3)包括吻合夹本体(301)和取出线(302)，所述吻合夹本体(301)的前端设置为自然状态下闭合，吻合夹本体(301)的后端沿周向设有至少2个线孔(303)，所述取出线(302)穿过所述线孔(303)与所述吻合夹本体(301)固定，其特征在于：
    所述取出套装包括前后贯通的取出帽(1)以及可沿所述取出帽(1)内部轴线前后移动的取出钩(2)，所述取出帽(1)适于安装在内窥镜(4)的前端，取出帽(1)的前端适于套设所述吻合夹(3)，所述取出钩(2)能够穿过所述取出帽(1)并钩住所述取出线(302)；
    当拉动取出钩(2)带动所述取出线(302)向后运动时，取出钩(2)带动所述吻合夹(3)套在所述取出帽(1)前端的外周，从而使所述吻合夹(3)的前端呈张开状态。
  21. 根据权利要求20所述的吻合夹取出套装，其特征在于：所述取出帽(1)包括取出帽本体(101)和固定于所述取出帽本体(101)后端的固定器(102)，所述固定器(102)适于安装在内窥镜(4)的前端，所述取出帽本体(101)的前端具有两条或者两条以上的槽口(1011)。
  22. 根据权利要求20所述的吻合夹取出套装，其特征在于：所述取出套装包括手柄(201)，所述 手柄(201)与所述取出钩(2)相对固定连接。
  23. 根据权利要求22所述的吻合夹取出套装，其特征在于：所述取出钩(2)的前端设置有钩部(202)，所述手柄(201)还包括滑环(203)和拉索(204)，所述滑环(203)滑动连接于所述手柄(201)上，所述手柄(201)中具有贯通手柄(201)前端的轴孔，拉索(204)的一端连接滑环(203)、另一端连接所述钩部(202)。
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