WO2022222560A1 - 鼻中隔术后吻合器 - Google Patents

鼻中隔术后吻合器 Download PDF

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Publication number
WO2022222560A1
WO2022222560A1 PCT/CN2022/072497 CN2022072497W WO2022222560A1 WO 2022222560 A1 WO2022222560 A1 WO 2022222560A1 CN 2022072497 W CN2022072497 W CN 2022072497W WO 2022222560 A1 WO2022222560 A1 WO 2022222560A1
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Prior art keywords
handle
pliers
binding
post
forceps
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PCT/CN2022/072497
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English (en)
French (fr)
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俞晨杰
陈银
高下
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南京鼓楼医院
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Publication of WO2022222560A1 publication Critical patent/WO2022222560A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/282—Jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/2841—Handles

Definitions

  • the invention relates to the field of medical devices, in particular to a post-septal stapler.
  • the nasal septum is located between the bilateral nasal cavities and consists of the vertical plate of the ethmoid, the vomer, and the septal cartilage and the mucosa covering its surface. Deviated nasal septum can cause physiological dysfunction of the nasal cavity and sinuses and produce symptoms (such as nasal congestion, headache, epistaxis, etc.), surgical correction is the only effective treatment method.
  • the specific method of nasal septum deviation correction surgery is to strip the bilateral mucosa from the nasal septum bone/cartilage, remove the severely deviated part of the bone/cartilage in the cavity formed by the two layers of mucosa, or release the tension line that causes the deviation.
  • An important step after surgery is to reattach the bilateral mucosa to eliminate the surgical cavity and promote healing.
  • the most commonly used method to close the surgical cavity is compression with bilateral nasal gauze or expanded sponge to prevent the formation of intraoperative hematoma and promote mucosal healing, but correspondingly, it will cause strong discomfort to the patient, including pain, epiphora and Nasal infection.
  • continuous suturing of the bilateral mucosa of the nasal septum can also achieve the corresponding purpose and avoid nasal packing, but it is still not popular due to the narrow operation space, difficulty of getting started, and long suturing time in the deep nasal cavity with curved needles. use. Therefore, if an easy-to-operate nasal septal anastomosis device can be designed, the surgical experience of patients can be significantly improved, wound healing can be promoted, and the operation time can be greatly shortened.
  • the purpose of the present invention is to solve the above problems and provide an anastomotic device for simplifying mucosal suture after nasal septum operation.
  • a post-septal stapler comprising a lower handle and an upper anastomosis operation forceps
  • the handle is X-shaped
  • the handle includes two symmetrical handle bodies, and the middle parts of the two handle bodies are connected through a connection
  • the shaft connects the two handle bodies and can rotate relative to the connection shaft;
  • the lower part of the handle body is a semi-circular handle ring, and the upper part of the handle body is pierced with a connecting shaft and connected to the anastomotic operation pliers;
  • the anastomotic operation pliers include a left pliers body and a right pliers body, the left pliers body and the right pliers body both include a bent pliers upper part and a pliers lower part, and the pliers lower part is connected with the handle body, and the anastomotic operation pliers
  • the upper part of the tongs is a binding structure, and the parts of the tongs on the right and left tong
  • the binding portion is a push-out portion provided with binding needles
  • the anvil portion is a support portion for receiving pressing.
  • the binding part includes an upper casing, a pressing part and a chute with a binding pin inside, the chute is provided with an oblique slider, and the pressing part is installed on the lower end of the upper casing to press
  • the lower side of the part is a spring, the upper side is against the outer side of the bevel slider, and the binding needle is placed in the accommodating cavity in front of the bevel slider.
  • the lower part of the top of the chute is provided with a binding needle outlet.
  • anvil portion is provided with a pressing receiving groove at the outlet of the binding needle corresponding to the lower part of the top end of the chute.
  • the binding needle is made of a material that can be absorbed by the human body.
  • the lateral shape of the post-septal stapler is gun-like, that is, there is a curved angle between the lower handle and the upper anastomosis operation forceps, wherein the anastomosis operation forceps are the gun body, and the handle is the gun handle.
  • the present invention provides a device for performing anastomosis in the nose.
  • the advantages and effects of the present invention are:
  • the upper part of the post-septal stapler connection shaft is respectively extended into the nasal cavity on both sides, and the stripped mucosa on both sides are directly anastomosed through the instrument, which has the advantages of safety, speed, and convenient operation.
  • This operation can not only fasten the mucosa anastomosis, but also solve the discomfort caused by long-term nasal packing and the difficulty of the operator in the operation of deep nasal suture after conventional nasal septum deviation correction surgery.
  • the front end of the instrument used for anastomosis is a detachable device, which can be used for single-line anastomosis or single-line multi-line anastomosis, which can be used for precise site anastomosis and fast mucosal anastomosis.
  • the material used for anastomosis is made of absorbable material, which reduces the pain of the patient in taking out the nasal packing and removing the suture in the nose after operation.
  • the postoperative intranasal suture is instrumented, which not only facilitates the operation, shortens the operation time, but also reduces the pain of the patient.
  • Figure 1 Schematic diagram of the structure of the post-septal stapler of the present invention.
  • Figure 2 Schematic diagram of the combined structure of the post-septal stapler of the present invention.
  • Figure 3 Schematic diagram of the structure of the binding section.
  • Fig. 4 is a schematic side view of the structure of the post-septal stapler of the present invention.
  • connection should be understood in a broad sense, for example: it can be a fixed connection, a detachable connection or an integrated connection; it can also be a mechanical connection, an electrical connection
  • connection or direct connection can also be indirectly connected through an intermediate medium, or it can be the internal communication between two elements.
  • a post-septal stapler comprising a lower handle 1 and an upper anastomosis operation forceps 2, the handle 1 is X-shaped, and the handle 1 includes two symmetrical handle bodies 3, two handles.
  • the middle part of the body 3 passes through the connecting shaft 4, so that the two handle bodies 3 are connected and can be relatively rotated with the connecting shaft 4 as the center.
  • Each handle body 3 can rotate relative to the connection shaft 4 as the center; the lower part of the handle body 3 is a semicircular handle ring 5, and the upper part of the handle body 3 is pierced with the connection shaft 4 and connected to the anastomotic operation pliers 2;
  • the anastomotic operation forceps 2 includes a left forceps body and a right forceps body, which are respectively connected with the two handle bodies 3 in one-to-one correspondence.
  • the lower part of the pliers body is connected with the handle body 3, and the upper part of the anastomotic operation pliers 2 is a binding structure 6, wherein the upper parts of the right and left pliers body are the binding part 7 and the chopping board part 8 of the binding structure 6 respectively.
  • the binding portion 7 is a push-out portion equipped with a binding needle
  • the anvil portion 8 is a support portion for receiving pressing.
  • the binding part 7 includes an upper casing 9 , a pressing part 10 and a chute 11 with a binding needle inside, the chute 11 is provided with an oblique slider 12 , the pressing part 10 Installed on the lower end of the upper casing 9, the lower side of the pressing part 10 is a spring, and the upper side is against the outer side of the bevel slider 12.
  • the shape of the binding needle is a "door" shape similar to the binding needle of a stapler. in the accommodating cavity 13 in front of the bevel slider 12 .
  • the lower part of the top of the chute 11 is provided with a binding needle outlet 14 .
  • the anvil portion 8 is provided with a pressing receiving groove 15 corresponding to the staple outlet 14 at the lower part of the top end of the sliding groove 11 .
  • the binding needle is made of a material that can be absorbed by the human body.
  • the lateral shape of the post-septal stapler is a gun type, that is, there is a curved angle (120°) between the lower hand-held handle 1 and the upper anastomotic operation forceps 2, wherein the anastomotic operation forceps 2 are the gun body and the hand-held handle. 1 is the handle of the gun.
  • the handle 1 When in use, hold the handle 1 at the lower part of the stapler instrument for post-septal operation, insert the binding part 7 and the chopping board part 8 of the upper anastomotic operation forceps 2 into the deep part of the bilateral nasal cavity respectively and deliver it to the mucosa to be anastomosed, press the handle 1, the upper part is
  • the working principle is similar to that of a stapler. After penetrating the mucous membranes that need to be anastomosed on both sides, it can be fixed by bite at a time. It can be fixed at a single time or multiple times at a time.
  • the working part of the upper binding structure 6 can be designed to be disassembled at one time.

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  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
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  • Ophthalmology & Optometry (AREA)
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Abstract

一种鼻中隔术后吻合器，包括下部的手持柄（1）和上部的吻合操作钳（2），该手持柄（1）为X形，该手持柄（1）包括两个对称的柄身（3），两个柄身（3）中部穿过连接轴（4），使两个柄身（3）连接并可以连接轴（4）为中心进行相对转动；该柄身（3）的下部为半圆形的手柄环（5），该柄身（3）的上部穿有连接轴（4）并连接吻合操作钳（2）；该吻合操作钳（2）包括左钳身、右钳身，该左钳身、右钳身均包括弯折的钳身上部分与钳身下部分，钳身下部分与柄身（3）相连，该吻合操作钳（2）的上部为装订结构（6），其中右钳身、左钳身的钳身上部分分别为装订结构（6）的装订部（7）和砧板部（8）。该鼻中隔术后吻合器具有安全、快速、操作方便等优点。

Description

鼻中隔术后吻合器 技术领域
本发明涉及医疗器械领域，具体涉及一种鼻中隔术后吻合器。
背景技术
鼻中隔位于双侧鼻腔之间，由筛骨垂直板、犁骨和鼻中隔软骨及其表面被覆的黏膜构成。鼻中隔偏曲可引起鼻腔鼻窦生理功能障碍并产生症状(如鼻塞、头痛、鼻出血等)者，手术矫正是唯一有效的治疗方法。鼻中隔偏曲矫正手术的具体方式是将两侧黏膜与鼻中隔骨/软骨剥离，在两层黏膜形成的腔隙内去除严重偏曲的部分骨/软骨，或松解导致偏曲的张力线。术毕一个重要的步骤是将双侧黏膜重新贴合以消灭术腔、促进愈合。当前最常用的关闭术腔的方法是双侧鼻腔填塞纱条或膨胀海绵进行压迫，以防止术腔内血肿生成，促进黏膜愈合，但相应地会引起病人不适感强烈，包括疼痛、溢泪及鼻腔感染。虽然当前已有文献报道将鼻中隔双侧黏膜进行连续贯穿缝合亦可达到相应目的而避免鼻腔填塞，但由于医生手持弯针在鼻腔深部操作空间狭小、上手难度大、缝合时间长，因此仍然无法普及运用。因此，如能设计一种操作简便的鼻中隔吻合装置，则能显著改善患者手术体验，促进伤口愈合，且能大大缩短手术时间。
发明内容
本发明的目的是为解决上述问题，提供一种用于简化鼻中隔术后黏膜缝合的吻合器械。
为实现上述目的，本发明提供的技术方案是：
一种鼻中隔术后吻合器，包括下部的手持柄和上部的吻合操作钳，所述的手持柄为X形，所述的手持柄包括两个对称的柄身，两个柄身中部穿过连接轴，使两个柄身连接并可以连接轴为中心进行相对转动；所述柄身的下部为半圆形的手柄环，所述柄身的上部穿有连接轴并连接吻合操作钳；所述的吻合操作钳包括左钳身、右钳身，所述左钳身、右钳身均包括弯折的钳身上部分与钳身下部分，钳身下部分与柄身相连，所述吻合操作钳的上部为装订结构，其中右钳身、左钳身的钳身上部分分别为装订结构的装订部和砧板部。
进一步的，所述的装订结构中，所述的装订部为装有装订针的按压出钉部，所述的砧板部为用于承受按压的支承部。
进一步的，所述的装订部包括上壳体、按压部和内装有装订针的滑槽，所述的滑槽内设有 斜角滑块，所述的按压部安装在上壳体下端，按压部下侧为弹簧，上侧顶在斜角滑块外侧，所述的装订针置于斜角滑块前方的容纳腔内。
进一步的，所述的滑槽顶端下部设有装订针出口。
进一步的，所述的砧板部在相应于滑槽顶端下部的装订针出口处设有按压承受槽。
作为优选的方案，所述的装订针采用可被人体吸收的材料制成。
进一步的，所述的鼻中隔术后吻合器的侧面形状为枪式，即下部的手持柄和上部的吻合操作钳之间具有弯曲的角度，其中吻合操作钳为枪身、手持柄为枪柄。
本发明提供了一种可在鼻内进行吻合操作的器械，本发明的优点和效果在于：
(1)鼻中隔偏曲矫正手术后通过鼻中隔术后吻合器连接轴上部分别伸入两侧鼻腔，将剥离的两侧黏膜直接通过器械进行吻合，具有：安全、快速、操作方便等优点。
(2)此种操作不仅可以快速将黏膜吻合，而且解决了常规鼻中隔偏曲矫正手术术后患者因长期鼻腔填塞引起的不适感以及术者在鼻腔深部缝合操作的困难。
(3)用于吻合的器械前端为可拆卸装置，既可以单线吻合亦可以单次多线吻合，既可以精确部位吻合又可以快速完成黏膜吻合。
(4)用于吻合的材料由可吸收材料制成，减少了患者术后抽出鼻腔填塞物及鼻内拆除缝线的痛楚。
(5)将术后鼻腔内缝合器械化，既方便操作、缩短手术时间，又减少了患者痛苦。
附图说明
图1：本发明的鼻中隔术后吻合器的结构示意图。
图2：本发明的鼻中隔术后吻合器的合并结构示意图。
图3：装订部的结构示意图。
图4：本发明的鼻中隔术后吻合器的侧视结构示意图。
图中：1-手持柄，2-吻合操作钳，3-柄身，4-连接轴，5-手柄环，6-装订结构，7-装订部，8-砧板部，9-上壳体，10-按压部，11-滑槽，12-斜角滑块，13-容纳腔，14-装订针出口，15- 按压承受槽。
具体实施方式
以下通过实施例形式对本发明的上述内容再作进一步的详细说明，但不应将此理解为本发明上述主题的范围仅限于以下的实施例，凡基于本发明上述内容所实现的技术均属于本发明的范围。
术语中的“上、下、内和外”等指示的方位或位置关系为基于附图所示的方位或位置关系，仅是为了便于描述本发明和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本发明的限制。
此外，本发明中除非另有明确的规定和限定，术语如“安装、相连、连接”应做广义理解，例如：可以是固定连接、可拆卸连接或一体式连接；同样可以是机械连接、电连接或直接连接，也可以通过中间媒介间接相连，也可以是两个元件内部的连通。
对于本领域的普通技术人员而言，可以根据具体情况理解上述术语在本发明中的具体含义。
一种鼻中隔术后吻合器，包括下部的手持柄1和上部的吻合操作钳2，所述的手持柄1为X形，所述的手持柄1包括两个对称的柄身3，两个柄身3中部穿过连接轴4，使两个柄身3连接并可以连接轴4为中心进行相对转动，具体的，连接轴4与一个柄身3固定，与另一个柄身3转动连接，两个柄身3可以连接轴4为中心发生相对转动；所述柄身3的下部为半圆形的手柄环5，所述柄身3的上部穿有连接轴4并连接吻合操作钳2；所述的吻合操作钳2包括左钳身、右钳身，分别与两个柄身3一一对应相连，所述左钳身、右钳身均包括弯折的钳身上部分与钳身下部分，钳身下部分与柄身3相连，所述吻合操作钳2的上部为装订结构6，其中右钳身、左钳身的钳身上部分分别为装订结构6的装订部7和砧板部8。
实施例中，所述的装订结构6中，所述的装订部7为装有装订针的按压出钉部，所述的砧板部8为用于承受按压的支承部。
实施例中，所述的装订部7包括上壳体9、按压部10和内装有装订针的滑槽11，所述的滑槽11内设有斜角滑块12，所述的按压部10安装在上壳体9下端，按压部10下侧为弹簧，上侧顶在斜角滑块12外侧，所述的装订针的形状为类似订书机装订针的“门”字形，装订针置于斜角滑块12前方的容纳腔13内。
实施例中，所述的滑槽11顶端下部设有装订针出口14。
实施例中，所述的砧板部8在相应于滑槽11顶端下部的装订针出口14处设有按压承受槽15。
作为优选的方案，所述的装订针采用可被人体吸收的材料制成。
所述的鼻中隔术后吻合器的侧面形状为枪式，即下部的手持柄1和上部的吻合操作钳2之间具有弯曲的角度(120°)，其中吻合操作钳2为枪身、手持柄1为枪柄。
使用时，手持鼻中隔术后吻合器器械下部的手持柄1，将上部吻合操作钳2的装订部7和砧板部8分别插入双侧鼻腔深部递送至需要吻合的黏膜处，按压手持柄1，上部工作原理与订书机相似，穿透两侧需吻合的黏膜后咬合固定，可为单次单个或单次多个固定，上部装订结构6的工作部可设计为一次性拆卸，所用“装订针”为可吸收材料；完成所需吻合黏膜部固定后，松开吻合操作钳2经双侧鼻腔撤出手持鼻中隔术后吻合器器械即可，后期不需拆线操作，安全、快速、操作方便。
以上所述，仅是本发明的较佳实施例，并非对本发明作任何形式上的限制，任何熟悉本专业的技术人员，在不脱离本发明技术方案范围内，依据本发明的技术实质，对以上实施例所作的任何简单的修改、等同替换与改进等，均仍属于本发明技术方案的保护范围之内。

Claims (7)

  1. 一种鼻中隔术后吻合器，其特征在于：包括下部的手持柄和上部的吻合操作钳，所述的手持柄为X形，所述的手持柄包括两个对称的柄身，两个柄身中部穿过连接轴，使两个柄身连接并可以连接轴为中心进行相对转动；所述柄身的下部为半圆形的手柄环，所述柄身的上部穿有连接轴并连接吻合操作钳；所述的吻合操作钳包括左钳身、右钳身，所述左钳身、右钳身均包括弯折的钳身上部分与钳身下部分，钳身下部分与柄身相连，所述吻合操作钳的上部为装订结构，其中右钳身、左钳身的钳身上部分分别为装订结构的装订部和砧板部。
  2. 根据权利要求1所述的鼻中隔术后吻合器，其特征在于：所述的装订结构中，所述的装订部为装有装订针的按压出钉部，所述的砧板部为用于承受按压的支承部。
  3. 根据权利要求2所述的鼻中隔术后吻合器，其特征在于：所述的装订部包括上壳体、按压部和内装有装订针的滑槽，所述的滑槽内设有斜角滑块，所述的按压部安装在上壳体下端，按压部下侧为弹簧，上侧顶在斜角滑块外侧，所述的装订针置于斜角滑块前方的容纳腔内。
  4. 根据权利要求3所述的鼻中隔术后吻合器，其特征在于：所述的滑槽顶端下部设有装订针出口。
  5. 根据权利要求3所述的鼻中隔术后吻合器，其特征在于：所述的砧板部在相应于滑槽顶端下部的装订针出口处设有按压承受槽。
  6. 根据权利要求2-5任一项所述的鼻中隔术后吻合器，其特征在于：所述的装订针采用可被人体吸收的材料制成。
  7. 根据权利要求1所述的鼻中隔术后吻合器，其特征在于：所述的鼻中隔术后吻合器的侧面形状为枪式，下部的手持柄和上部的吻合操作钳之间具有弯曲的角度，其中吻合操作钳为枪身、手持柄为枪柄。
PCT/CN2022/072497 2021-04-20 2022-01-18 鼻中隔术后吻合器 WO2022222560A1 (zh)

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CN113081117A (zh) * 2021-04-20 2021-07-09 南京鼓楼医院 鼻中隔术后吻合器

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US5337937A (en) * 1991-10-18 1994-08-16 United States Surgical Corporation Surgical stapling apparatus
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