WO2023138124A1 - Mécanisme d'actionnement pour retourner un dispositif d'agrafage, dispositif d'agrafage et procédé d'inspection de qualité de dispositif d'agrafage - Google Patents

Mécanisme d'actionnement pour retourner un dispositif d'agrafage, dispositif d'agrafage et procédé d'inspection de qualité de dispositif d'agrafage Download PDF

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Publication number
WO2023138124A1
WO2023138124A1 PCT/CN2022/125848 CN2022125848W WO2023138124A1 WO 2023138124 A1 WO2023138124 A1 WO 2023138124A1 CN 2022125848 W CN2022125848 W CN 2022125848W WO 2023138124 A1 WO2023138124 A1 WO 2023138124A1
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WO
WIPO (PCT)
Prior art keywords
staple
anvil
actuator
nail
shrapnel
Prior art date
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PCT/CN2022/125848
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English (en)
Chinese (zh)
Inventor
薛建新
高子兵
刘俊
夏云
蔡正茂
Original Assignee
薛建新
南京五色石医疗科技有限公司
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Publication date
Priority claimed from CN202220154121.1U external-priority patent/CN217853123U/zh
Priority claimed from CN202221760550.XU external-priority patent/CN217987637U/zh
Priority claimed from CN202210805439.6A external-priority patent/CN115120293A/zh
Application filed by 薛建新, 南京五色石医疗科技有限公司 filed Critical 薛建新
Publication of WO2023138124A1 publication Critical patent/WO2023138124A1/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
    • A61B17/068—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
    • 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

Definitions

  • the invention relates to the field of medical devices, and relates to an executive mechanism for an eversion-type stapler, a stapler and a quality inspection method for the stapler.
  • a cutting stapler that replaces traditional manual suturing has been born; the cutting stapler has the advantages of rapid anastomosis, reliability, and fewer postoperative complications. Its working principle is similar to that of a stapler, that is, the process of stapling and cutting tissues and organs with titanium nails and blades, respectively.
  • Existing cutting staplers are mainly used for cutting and anastomosis of skin, digestive tract, blood vessels, lungs, etc., and are suitable for laparoscopic and open operations.
  • the current clinically used endoluminal staplers are mainly suitable for side-to-side suturing of digestive tract reconstruction, requiring the use of multiple linear cutting staplers or staple cartridges.
  • This suturing method has at least three defects: (1) the normal anatomical structure of the human body is changed, and tissue necrosis, suture leakage, and bleeding are prone to occur at the junction of the suturing nails after surgery; (2) after suturing, when the contents of the lumen pass through the stoma, a 90° turn is formed in the lumen, which is not smooth enough to easily cause obstruction; (3) two or more sutures are required, which greatly increases the cost and difficulty of the operation.
  • the existing endoluminal cutting and staplers are powerless in suturing small lumens such as biliary tract, fallopian tube, ureter, and urethra, or can only perform closed cutting functions.
  • two lumens to be sutured are formed during the operation, and the ends of the lumens need to be sutured together.
  • This suturing method has at least three defects: (1) Inverted anastomosis is used to form an inverted suture lumen tissue A2 protruding from the inner wall of the lumen in the lumen, which is easy to cause many complications such as stenosis and obstruction after the operation. (2) An incision A1 needs to be made on the lumen and needs to be anastomosed again. This incision is additionally opened due to the operation, which increases the difficulty of the operation and unnecessary pain to the patient. (3) Use multiple staplers, greatly increasing the cost of surgery.
  • Fistula A3 and finally the ends of the two lumens are anastomosed with the linear stapler shown in FIG. 5 .
  • the ostomy port A3 has just become the communicating port of the two sections of the lumen.
  • This anastomotic method has at least three defects: (1) Since the original orientation of a section of the lumen needs to be changed, the lumen is pulled by external force, and this method itself will cause damage to the lumen. (2) After the anastomosis, the flowing content in the lumen moves through the stoma A3, forming a 90° turn in the lumen, the flow is not smooth enough, and it is easy to block. (3) Two or more anastomoses are required, which greatly increases the cost and difficulty of the operation.
  • Figure 6 shows the eversion suture method.
  • the two stumps are everted to form a circle of everted suture lumen tissue A5 after suturing.
  • the advantages of this method are obvious.
  • the suture point is outside the lumen, which will not cause complications such as postoperative stenosis and obstruction.
  • this method is limited to manual suturing, and staplers cannot be used. It can be illustrated in conjunction with FIG. 3 that if the broken ends of the two sections of the lumen are turned outward on the circular anvil A8 and the circular staple bin A10 respectively, and then sutured together, there is no way to remove the stapler from the sutured lumen after suturing.
  • the invention patent with application number 201510282427X provides an extraluminal anastomosis method. After the lumen is sutured, the annular structure of the staple cartridge and the base is cut off with scissors, thereby removing the staple cartridge and the base.
  • this method is only an idea, without detailed structural features. There are at least four reasons why it cannot be applied clinically: (1) The surgical space is very small, and it is difficult to insert a pair of scissors between the tissue and the anastomotic ring after suturing to cut off the ring structure. (2) When using scissors to cut the annular structure, external force needs to be applied.
  • the object of the present invention is to provide an actuator for eversion-type sutures, so that the staplers can perform end-to-end, end-to-side, side-to-side, etc., valgus sutures in the human body through micro-channels such as sheath clips.
  • the executive mechanism for the eversion type stapler comprises a staple bin mechanism, a nail anvil mechanism, and a transmission mechanism;
  • the staple bin mechanism includes a staple bin cover and a staple bin seat, and a nail pushing mechanism is arranged in the space between the nail bin cover and the staple bin seat, and the anvil mechanism includes an anvil seat;
  • the transmission mechanism includes a transmission mechanism shrapnel; Openings are formed; on both sides of the penetrating groove, guide grooves extending along the length direction of the actuator are also provided on the staple bin cover and the staple anvil; the staples in the staple bin mechanism are arranged on both sides of the penetrating groove, and are located between the penetrating groove and the guiding groove;
  • the transmission mechanism shrapnel includes a transmission mechanism shrapnel A and a transmission mechanism shrapnel B.
  • the far ends of the transmission mechanism shrapnel A and the transmission mechanism shrapnel B extend into the space between the staple bin cover and the staple bin seat.
  • the important invention of the present invention is to break through the design structure of the conventional linear stapler.
  • the staple cartridge mechanism and the staple anvil mechanism are divided into two, and a penetration groove is provided in the middle, so that the two ends of the tissue to be sutured can be respectively drawn and penetrated from the penetration groove of the staple cartridge mechanism and the penetration groove of the nail anvil mechanism, and then the broken ends of the tissue to be sutured are turned outward to realize end-to-end suture.
  • the scheme design idea of the present invention isaki, only needs to change the conventional linear suturing device, can realize valgus suturing.
  • the guide groove includes a first guide segment at the proximal end, a second guide segment at the distal end, and a connecting segment connecting the first guide segment and the second guide segment, wherein the distance between the two first guide segments is smaller than the distance between the two second guide segments.
  • the transmission mechanism shrapnel A and the transmission mechanism shrapnel B are relatively close. After moving to the far end, the transmission mechanism shrapnel A and the transmission mechanism shrapnel B are separated far away by utilizing the deformation ability of the transmission mechanism shrapnel.
  • the design of the second guide section avoids interference to the staples and the like. Simultaneously, staples can be arranged at the proximal end of the penetration groove, and the driving shrapnel is close at the proximal end, and the staples can be fired along the connecting section at the proximal end.
  • staples are provided at the proximal end of the penetration groove of the staple cartridge seat.
  • This design can ensure that both sides of the penetration groove and the tissue to be sutured at the proximal end can be sutured, and the sutured intestinal tissue is moved out of the penetration groove, and then the intestinal tissue located at the far end of the penetration groove is artificially sutured to complete the overall suture.
  • the staples located on both sides and near ends of the penetration groove form a U-shape or a V-shape.
  • the guiding grooves on both sides are arranged in parallel from the distal end to the proximal end.
  • the staples are distributed in parallel on both sides of the penetration groove of the cartridge holder, and the broken ends of the tissues to be sutured on both sides can be sutured through the actuator, the sutured tissue can be moved out of the penetration groove, and then the overall stitching can be completed by manually suturing the tissues initially located at both ends of the penetration groove.
  • the nail pushing mechanism includes a nail pushing mechanism A and a nail pushing mechanism B.
  • the distal ends of the transmission mechanism shrapnel A and the transmission mechanism shrapnel B move along the guide grooves on the nail bin cover and the nail anvil, they respectively push the nail pushing mechanism A and the nail pushing mechanism B to move on both sides of the penetration groove.
  • the far ends of the transmission mechanism shrapnel A and the transmission mechanism shrapnel B are respectively connected with a sliding limiter A and a sliding limiter B with an I-shaped cross section, the upper and lower ends of the sliding limiter A and the sliding limiter B are respectively inserted into the guide grooves on one side of the nail bin cover and the nail anvil, and the top and bottom ends of the I-shape are respectively exposed outside the guide grooves on the nail bin cover and the nail anvil.
  • the pusher mechanism includes a pusher mechanism A and a pusher mechanism B, and the proximal ends of the two pusher mechanisms are respectively provided with connecting grooves, and the connecting columns of the vertical parts of the sliding limit block A and the slide limiter B can be respectively inserted into the connection grooves of the pusher mechanism A and the pusher mechanism B, so as to realize the detachable connection between the transmission mechanism shrapnel A, the transmission mechanism shrapnel B and the nail pusher mechanism A, pusher mechanism B.
  • the connecting groove is arranged near the outer side of the nail pushing mechanism.
  • a counterweight is provided on the outside of the nail pushing mechanism to ensure that the resistance on both sides is equal and the force is balanced, so that the nail pushing is smooth and the nail pushing mechanism will not be biased.
  • a cutting blade is provided at the lower end of the connecting column of the vertical part of the sliding limit block A and the sliding limit block B, and the excess tissue on the edge after the valgus suturing is cut off with the cutting blade.
  • the transmission mechanism shrapnel A and the transmission mechanism shrapnel B are arranged on both sides of the staple bin seat, and there will be no interference with the staple bin seat when moving. Otherwise, a guide groove extending along the length direction of the actuator must also be provided on the staple bin seat.
  • the openings of the staple cartridge cover, the staple cartridge seat, and the staple anvil are flaring with a wide outside and a narrow inside. This structure facilitates the insertion of the stump tissue to be sutured into the penetration groove.
  • a supporting plate is provided at the bottom of the anvil, and a penetration groove extending along the length direction of the actuator is also provided on the supporting plate, and a guard plate is provided at the proximal end of the supporting plate.
  • an elastic member is provided at the proximal connection of the anvil mechanism and the staple cartridge mechanism, and the elastic member promotes the opening state of the staple cartridge mechanism and the staple anvil mechanism, and when the transmission mechanism shrapnel A and the transmission mechanism shrapnel B move to the distal end, the staple cartridge mechanism and the nail anvil mechanism are urged to close.
  • the transmission mechanism is arranged in the casing.
  • the staple cartridge cover and the staple anvil are recessed inward, so that the size of the actuator is reduced to facilitate the passage of the sheath.
  • the cartridge holder is detachably arranged under the cartridge cover, so that the cartridge holder can be replaced with a new cartridge holder after the staples are used up, so that the main structure of the actuator can be reused.
  • the proximal end of the actuator is provided with a separation post for separating the spring piece A of the transmission mechanism and the spring piece B of the transmission mechanism.
  • the separation column can ensure that the shrapnel A of the transmission mechanism and the shrapnel B of the transmission mechanism are always separated in parallel at the proximal end, and ensure that the shrapnel of the transmission mechanism will not interfere with each other when pushing forward or turning.
  • the separation column is narrow at the proximal end and wide at the distal end, and can be spindle-shaped or semi-spindle-shaped.
  • the stapler has high requirements on product quality, and multiple verification tests are required to ensure that the quality is qualified.
  • the present invention also provides a quality inspection method for the stapler, which is characterized in that: the broken end B of the tissue to be sutured is penetrated into the actuator from the anvil seat, and the broken end B is turned outward, and laid on the upper surface of the nail anvil of the actuator; Flip outwards and lay on the lower surface of the staple bin seat; push the far ends of the transmission mechanism shrapnel A and the transmission mechanism shrapnel B of the stapler to move along the guide groove on the staple bin cover and the nail anvil, and the transmission mechanism shrapnel A and transmission mechanism shrapnel B push the nail pushing mechanism A and the nail pushing mechanism B to move on both sides of the penetration groove, thereby firing the staples; move the tissue to be sutured out of the actuator along the penetration groove, and check whether the broken ends A and B are placed between the guide groove and the penetration groove Stitch, and
  • the stumps A and B are everted, turn the stumps A and B to the outside of the guide groove, and use the cutting blade to cut off the excess tissue on the outer edge of the suture. If it is found that there is no cut or the cut is irregular, it means that the quality of the cutting blade is wrong or the setting position is wrong.
  • the present invention provides a brand-new executive mechanism for valgus and valgus suturing device, which has the following advantages: (1) The structure can realize valgus and valgus suturing through minimally invasive surgical channels such as sheath clips, which is a powerful supplement to open valgus sutures. Although they are all valgus sutures, the working principle of the mechanism is completely different and adapts to the requirements of clinical minimally invasive surgery; (2) There are new options for suturing tissues and organs (such as: blood vessels, urinary tract, etc.) (3) One-time suturing can basically achieve the reconstruction goal.
  • the use of multiple staples saves surgical steps and surgical costs; (4) It can realize end-to-end, end-to-side, side-to-side valgus sutures in the cavity, and is applicable to a wide range of suture scenarios; The recovery is favorable, which greatly reduces the occurrence of related complications; (6) External staples, the staples are located outside the cavity after suturing, which reduces the complications related to the staples, such as stenosis of the suture opening, bleeding related to the staples, and stone thrombosis.
  • Figure 1 is a schematic diagram of two sections of the lumen to be anastomosed
  • Figure 2 is a schematic diagram of varus anastomosis
  • Fig. 3 is a schematic diagram of a stapler for varus anastomosis
  • Fig. 4 is a schematic diagram of the second way of lumen anastomosis
  • Fig. 5 is a schematic diagram of a stapler for external anastomosis
  • Figure 6 is a schematic diagram of valgus anastomosis
  • Fig. 7 is a schematic diagram of a firing control mechanism commonly used in a linear cutting stapler
  • Fig. 8 is a schematic diagram of the actuator of the present invention.
  • Fig. 9 is a schematic diagram of the stapler passing through the minimally invasive channel of the present invention.
  • Figure 10 is an exploded view of the actuator of the present invention.
  • Fig. 11 is a schematic diagram of a transmission mechanism and a steering mechanism of the present invention.
  • Fig. 12 is a schematic diagram of the nail anvil of the present invention.
  • Fig. 13 is a schematic diagram of the staple magazine mechanism (including opening shrapnel, metal grooves, staples, nail presses, etc.) of the present invention
  • Fig. 14 is a schematic diagram of cooperation between the transmission mechanism and the push nail mechanism of the present invention.
  • Fig. 15 is a schematic diagram of the executive mechanism of Embodiment 2 of the present invention.
  • Fig. 16 is an exploded view of the actuator in Embodiment 2 of the present invention.
  • Fig. 17 is a schematic diagram of the nail anvil in Example 2 of the present invention.
  • Fig. 18 is a schematic diagram of the staple cartridge mechanism in Embodiment 2 of the present invention.
  • Fig. 19 is a schematic diagram of cooperation between the transmission mechanism and the push nail mechanism in Embodiment 2 of the present invention.
  • Fig. 20 is an exploded view of the executive mechanism of Embodiment 3 of the present invention.
  • Figure 21 is a schematic diagram of eversion suture of two broken ends.
  • 1-firing control mechanism 101-trigger, 102-ratchet, 103-propelling rod, 104-resetting button, 105-direction adjustment button, 106-turning propelling rod, 107-firing safety;
  • 5-transmission mechanism 501-connecting part, 5031-transmission mechanism shrapnel A, 5032-transmission mechanism shrapnel B, 5041-sliding limit block A, 5042-sliding limit block B, 5045-connecting column, 5046-cutting blade, 5047-connecting column A, 5048-connecting column B;
  • 6-Nail cartridge mechanism 601-Joint joint, 602-First guide section of staple cartridge, 603-Anchor mechanism, 604-Opening shrapnel, 605-Nail cartridge cover penetration groove, 606-Nail cartridge seat, 607-Second cartridge guide section, 608-Nail cartridge scale line, 609-Nail hole, 610-Stapling staple, 611-Nail press, 612-Proximal platform, 613-Nail cartridge cover expansion , 614-Nail bin connecting section; 615-Nail bin seat expansion, 616-Nail bin seat penetration groove, 617-Nail bin cover, 618-Nail bin cover guide groove, 619-Separation column;
  • 7-anvil mechanism 701-staple forming pit, 702-shield plate, 703-anvil connection section, 704-anvil first guide section, 705-anvil penetration groove, 706-anvil second guide section, 707-anvil flare, 708-support plate, 709-support plate penetration groove, 710-anvil seat, 711-anvil guide groove;
  • 8-Nail pushing mechanism 801-Connecting groove, 802-Nail pushing protrusion, 803-Nail pushing mechanism A, 804-Nailing mechanism B;
  • proximal and distal refer to a position close to the operator
  • distal refers to a position remote from the operator.
  • left refers to the left side of the operator
  • right refers to the right side of the operator
  • up refers to the direction opposite to gravity
  • down refers to the direction of gravity.
  • Other directional terms can be understood in light of the figures and description below.
  • the executive mechanism provided by the present invention needs to be used in connection with the firing control mechanism of a traditional linear cutting and stapler.
  • FIG. For traditional linear cutting and staplers, please refer to CN101156793A and US5762256B, which describe the structure of the firing control mechanism in detail, and will not be repeated in this application.
  • the actuator is usually a one-time loading part, which is discarded after use, and the firing control mechanism can be reused many times, and can be matched with the actuator of the traditional linear cutting stapler. It is also possible to make the disposable loading part and the firing control mechanism an integral disposable part.
  • the executive mechanism provided by the present invention is similar to the traditional linear stapler as a whole. It includes a staple bin mechanism 6, an anvil mechanism 7, a transmission mechanism 5, and a steering mechanism 4.
  • the steering mechanism 4 includes a sheet-shaped metal rod 401 , and a hook-shaped protrusion 402 is provided at the proximal end of the sheet-shaped metal rod.
  • the transmission mechanism 5 includes a transmission mechanism shrapnel A 5031, a transmission mechanism shrapnel B 5032, a sliding limit block A 5041, and a sliding limit block B 5042.
  • the shrapnel (A, B) of the transmission mechanism can be made of elastic material or non-elastic material, as long as it can produce a certain deformation.
  • the shrapnel A of the transmission mechanism is connected with the sliding limit block A, and the shrapnel B of the transmission mechanism is connected with the sliding limit block B.
  • the sliding limit block A and the sliding limit block B are I-shaped structures, and the lower part of the connecting column 5045 in the middle of the I-shaped structure is provided with a cutting blade 5046 .
  • the proximal end of the pusher mechanism 8 is provided with two connecting grooves 801, and the connecting posts of the shrapnel A and B of the transmission mechanism can be respectively inserted into one of the connecting grooves 801, and the bottom of the pusher mechanism 8 is provided with an estimating protrusion 802.
  • the steering mechanism 4 and the transmission mechanism 5 are installed in the casing 2 .
  • an upper half pipe 201 and a lower half pipe 202 are provided, and the transmission mechanism shrapnel A and the transmission mechanism shrapnel B are set in the groove of the lower half pipe, and then the upper half pipe and the lower half pipe are combined, which is convenient for installation and plays a guiding role.
  • an anchoring mechanism 603 may be provided at the distal end, and the distal ends of the transmission mechanism shrapnel A and the transmission mechanism shrapnel B pass through the anchoring mechanism 603 to play a guiding role.
  • the transmission mechanism 4 is arranged on the side part after the upper and lower half pipes are assembled, and then placed in the casing 2 as a whole.
  • the proximal end of the lower half pipe is provided with a limit block 3, including a limit block A 301 and a limit block B 302.
  • the proximal side of the actuator is combined with the firing control mechanism 1 of the linear cutting stapler and inserted into the firing control mechanism 1, and rotated 90°.
  • the limit block A 301 and the limit block B 302 are inserted into the corresponding holes on the firing control mechanism 1 to complete their docking; In the groove of the push rod 106, the two are fixedly connected.
  • the cartridge mechanism 6 includes a cartridge cover 617 and a cartridge seat 606 .
  • a staple hole 609 is provided on the staple cartridge seat 606, and a staple 610 is placed in the staple hole 609.
  • a staple pusher 611 is located above the staple 610, and the staple pusher 611 is pressed downward, and the staple pusher 611 fires the staple 610 toward the anvil mechanism 7.
  • the staple cartridge cover 617 covers the staple cartridge seat 606, and the space between the staple cartridge cover 617 and the staple cartridge seat 606 is accommodated for the nail pushing mechanism 8, so that the staple pushing mechanism 8 can move from the proximal end to the distal end of the actuator.
  • the side of the staple cartridge cover 617 is provided with a staple cartridge scale line 608 for indicating the positions of the staple holes and preventing tissue displacement.
  • a magazine cover penetration groove 605 and a magazine cover guide groove are provided in the middle of the magazine cover, and the magazine cover penetration groove and the magazine cover guide groove all extend from the distal end to the proximal end along the length direction of the actuator.
  • the nail bin cover penetration groove is formed with an opening at the far end of the nail bin cover, and the opening is a nail bin cover flare 613 that is wide on the outside and narrow on the inside.
  • the staple cartridge seat 606 is also provided with a corresponding staple cartridge seat penetration groove 616 extending along the length direction of the actuator and corresponding to the staple cartridge cover penetration groove 605.
  • the staple cartridge seat penetration groove 616 is formed with an opening at the far end of the staple cartridge seat.
  • the opening is a staple cartridge seat flare 615 that is wide outside and narrow inside.
  • the anvil mechanism 7 includes an anvil base 710, which is provided with an anvil penetration groove 705 extending along the length direction of the actuator and corresponding to the staple cartridge base penetration groove 616.
  • the anvil penetration groove 705 forms an opening at the far end of the anvil base 710, and the opening is an anvil flare 707 that is wide on the outside and narrow on the inside.
  • Anvil guide grooves extending along the length direction of the actuator are provided on both sides of the anvil penetration groove 705.
  • the anvil guide grooves include a first anvil guide section 704, an anvil second guide section 706, and an anvil connecting section 703, wherein the distance between the two anvil first guiding sections 704 is less than the distance between the two anvil second guiding sections 706, and the anvil connecting section 703 connects the anvil first guiding section 704 and the nail anvil second guiding section 706 to form a transition.
  • a supporting plate 708 is provided at the bottom of the nail anvil 710, and a supporting plate penetration groove 709 extending along the length direction of the actuator is arranged on the supporting plate 708.
  • the supporting plate penetration groove 709 forms an opening at the far end of the supporting plate 708.
  • the proximal end of the supporting plate 708 is provided with a guard plate 702. Referring to FIG.
  • the guard plate 702 prevents deviation from left and right from both sides.
  • the anvil base 710 is also provided with a staple forming recess 701 for matching with the staple.
  • the proximal end of the staple cartridge mechanism 6 and the staple anvil mechanism 7 are connected together, and an opening elastic piece 604 is provided between the staple cartridge mechanism and the staple anvil mechanism 7. Under no external force, the opening elastic piece 604 keeps the staple cartridge mechanism and the staple anvil mechanism separated, except for the part connected together at the proximal end.
  • the proximal end of the staple bin mechanism and the nail anvil mechanism is connected to the far end of the sheet metal rod 401 of the steering mechanism 4 through the connecting joint 601, and the sheet metal rod 401 can drive the nail bin mechanism 6 and the nail anvil mechanism 7 to swing.
  • the shrapnel A of the transmission mechanism and the shrapnel B of the transmission mechanism pass through the connecting joint 601 and can move in the space between the magazine cover and the magazine seat of the magazine mechanism 6 under the drive of the push rod 103 of the firing control mechanism.
  • the sliding limit block A 5041 and the sliding limit block B 5042 run through the nail bin cover guide groove and the nail anvil guide groove on one side respectively to play a guiding role.
  • the sliding limit block A 5041 and the sliding limit block B 5042 are in an I-shaped structure, and the upper end and the lower end are respectively located on the upper part of the nail bin cover and the bottom of the nail anvil to avoid falling off from the guide groove during the movement.
  • the same guide groove as that on the staple bin cover may also need to be set on the staple bin seat 606 for the sliding stoppers A and B to pass through. Whether it is set or not depends on the width of the nail anvil.
  • the quantity of the nail pushing protrusions 802 of the nail pushing mechanism 8 is determined according to the number of rows of staples. For example, if a row of staples is respectively set on both sides of the penetration groove, then the nail pushing mechanism 8 is provided with two nail pushing protrusions. If multiple rows are set, a plurality of nail pushing protrusions are set.
  • the protrusion of the push nail has an inclined surface, the inclined angle is the same as the angle of the nail pressing, and the directions are opposite. At the proximal end of the cartridge holder insertion slot, the staples converge inwardly.
  • the staple cartridge mechanism 6 and the anvil mechanism 7 are in a separated state due to the action of the opening shrapnel 604, the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032, the sliding limit block A 5041 and the sliding limit block B 5042 are located at the proximal end of the stapler, at this time the sliding limit block A 5041 and the sliding limit block B 5042 are located at the proximal platform 612 of the metal groove 605 of the staple bin Connect the joint 601, and the sliding limit blocks A and B squeeze the guide groove of the staple bin cover to prevent the opening angle of the staple bin mechanism and the anvil mechanism from being too large;
  • the push rod 103 respectively drives the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032 to move to the far end through the connecting part 501; at this time, the sliding limiting block A 5041 and the sliding limiting block B 5042 move distally along the guide groove until they move out of the proximal platform 612 as a whole; due to the sliding limiting block A 50 41 and the I-shaped structure of the sliding limit block B 5042 work together to lock, squeeze the staple cartridge mechanism 6 to move closer to the nail anvil mechanism 7, and compress the opening shrapnel 604 until the staple cartridge mechanism 6 and the staple anvil mechanism 7 are closed. As shown in Figure 9, at this time, the operator can insert the head of the stapler into the patient's body through a minimally invasive channel such as the laparoscopic sheath card 9, and prepare for suturing;
  • the present invention can be used for but not limited to intestinal suture, and can be used for all hollow organs that can be sutured everted.
  • the operator adjusts the two ends of the intestinal tract to an anatomically appropriate position, and sutures one or two traction lines on the sides of the two intestinal ends to be sutured corresponding to the side near the operator.
  • Pull the reset button 104 of the firing control mechanism of the stapler to move proximally in conjunction with the push rod 103, and the push rod 103 moves to the proximal end through the connection part 501 to link the shrapnel A 5031 of the transmission mechanism, the shrapnel B 5032 of the transmission mechanism, and the sliding limit block A 5041 and the sliding limit block B 5042 to move proximally.
  • the direction adjustment button 105 on the firing control mechanism 1 of the rotary stapler drives the steering propulsion rod 103 and then drives the steering mechanism 4 to move back and forth, and further promotes the swing of the overall structure of the connecting joint 601, the staple bin 6 mechanism and the nail anvil mechanism 7, and adjusts the direction.
  • valgus intestinal tract is incompletely covered or both ends protrude beyond the staple cartridge scale line 608, it is necessary to open the staple cartridge mechanism 6 again at this time, adjust the broken intestinal tract to be sutured to a suitable position, and close the staple cartridge mechanism 6 again to be sutured.
  • the operator unlocks the firing safety 107 on the firing control mechanism 1, pulls the trigger 101, squeezes the ratchet bar 102 to push the push rod 103 to move to the distal end, and the push rod 103 passes through the connecting part 501 to link the shrapnel A 5031 of the transmission mechanism, the shrapnel B 5032 of the transmission mechanism, and the sliding limit block A 5041 and B 5042 to move to the distal end, and the shrapnel A 5031 of the transmission mechanism and the shrapnel B 504 of the transmission mechanism move to the distal end 32, under the action of the first guide section (the first guide section 602 of the nail cartridge, the first guide section 704 of the nail anvil), continue to slide forward respectively.
  • the first guide section the first guide section 602 of the nail cartridge, the first guide section 704 of the nail anvil
  • the two are engaged through the connecting groove 801; the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032 push the nail pushing mechanism 8 to move to the far end, and when reaching the nail hole 609 and the nail pushing 611 proximal end, the nail pushing protrusion 802 at the far end of the nail pushing mechanism 8 is paired with the nail pushing 611 and pushes the nail pushing 611 and the staple 610 along the nail pushing 610.
  • the direction of the holes 609 is shifted longitudinally in the direction of the anvil 710 .
  • the staple 610 quickly pierces the intestinal tissue, and when the staple 610 touches the staple forming pit 701 on the surface of the anvil 710 , it curls inward with both ends in the direction of the pit, presenting a "B" shape or an encircling pattern.
  • the trigger 101 is fired continuously to push the staple pushing mechanism 8 to move to the distal end, and the staples 610 are sutured in sequence until the distal end; at this time, the cutting blade 5046 is pushed to the distal end along the outer peripheral track of the staple cartridge mechanism 6 under the action of thrust and excises excess intestinal tissue outside the staples 610.
  • the present invention lays the two intestinal stumps on the upper surface of the staple anvil and the lower surface of the staple cartridge respectively to form an ellipse, and then squeezes the staples to sew up the edges on both sides of the elliptical long axis.
  • the staples it is also possible to sew up the edges of the proximal end of the long axis simultaneously (place the staples at this position). Since it is difficult to place the staples at the far end of the long axis, this part requires manual sewing needles.
  • the present invention still solves the problem of cavity-inside-out suturing to a large extent, realizes instrumental operation, and has a very broad market prospect.
  • the stapler provided in this embodiment includes an executive mechanism and a firing control mechanism.
  • the specific structure of the firing control mechanism is as described in Embodiment 1. Except for the linear cutting stapler firing control mechanism, other devices that can drive the actuator of the present invention can be applied to the present invention, and the present invention does not involve the improvement of the firing control mechanism.
  • the executive mechanism of this embodiment includes a staple cartridge mechanism 6 , an anvil mechanism 7 , a transmission mechanism 5 , and a steering mechanism 4 .
  • the steering mechanism 4 includes a sheet-shaped metal rod 401 , and a hook-shaped protrusion 402 is provided at the proximal end of the sheet-shaped metal rod.
  • the transmission mechanism 5 includes a transmission mechanism shrapnel A 5031, a transmission mechanism shrapnel B 5032, a sliding limit block A 5041, and a sliding limit block B 5042.
  • the shrapnel (A, B) of the transmission mechanism can be made of elastic material or non-elastic material, as long as it can produce a certain deformation.
  • the shrapnel A of the transmission mechanism is connected with the sliding limit block A, and the shrapnel B of the transmission mechanism is connected with the sliding limit block B.
  • the sliding limit block A and the sliding limit block B are I-shaped structures, and the bottom of the connecting column (connecting column A 5047, connecting column B 5048) in the middle part of the I-shaped structure is provided with a cutting blade 5046.
  • the pusher mechanism 8 includes a pusher mechanism A 803 and a pusher mechanism B 804. The proximal ends of the two pusher mechanisms are respectively provided with connection grooves 801.
  • the shrapnel A and B of the transmission mechanism cooperate with the pusher mechanisms A and B respectively to push a pusher mechanism.
  • the connecting posts of the transmission mechanism shrapnel A and B can be respectively inserted into the connection grooves 801 of the pusher mechanisms A and B. The cooperation of the connection post and the connection groove can enhance the stability of pushing.
  • the connecting groove is arranged on the side of the nail pushing mechanism, and the force point is located near the outer side of the staple cartridge cover.
  • the force is not particularly uniform.
  • the bottom of the staple-pushing mechanism 8 is provided with a staple-pushing protrusion 802.
  • Two staple-pushing projections are shown in the figure, and two rows of staples can be fired. If there are more rows of staples, more staple-pushing projections can be provided. Of course, the thickness of the staple-pushing projections can also be increased to cover multiple rows of staples.
  • the number of the staple pushing protrusions 802 of the staple pushing mechanism 8 is determined according to the number of rows of staples, and the staples need only be fired.
  • the protrusion of the push nail has an inclined surface, the inclined angle is the same as the angle of the nail pressing, and the directions are opposite. At the proximal end of the cartridge holder insertion slot, the staples converge inwardly.
  • the shrapnel of the transmission mechanism and the push nail mechanism can be detachably connected through the cooperation of the connecting column and the connecting groove, and a fixed connection can also be adopted.
  • the steering mechanism 4 and the transmission mechanism 5 are installed in the casing 2 .
  • an upper half pipe 201 and a lower half pipe 202 are provided, and the transmission mechanism shrapnel A and the transmission mechanism shrapnel B are set in the groove of the lower half pipe, and then the upper half pipe and the lower half pipe are combined, which is convenient for installation and plays a guiding role.
  • an anchoring mechanism 603 may be provided at the distal end, and the distal ends of the transmission mechanism shrapnel A and the transmission mechanism shrapnel B pass through the anchoring mechanism 603 to play a guiding role.
  • the transmission mechanism 4 is arranged on the side part after the upper and lower half pipes are assembled, and then placed in the casing 2 as a whole.
  • the proximal end of the lower half pipe is provided with a limit block 3, including a limit block A 301 and a limit block B 302.
  • the proximal side of the actuator is combined with the firing control mechanism 1 of the linear cutting stapler and inserted into the firing control mechanism 1, and rotated 90°.
  • the limit block A 301 and the limit block B 302 are inserted into the corresponding holes on the firing control mechanism 1 to complete their docking; In the groove of the push rod 106, the two are fixedly connected.
  • the cartridge mechanism 6 includes a cartridge cover 617 and a cartridge seat 606 .
  • a staple hole 609 is provided on the staple cartridge seat 606, and a staple 610 is placed in the staple hole 609.
  • a staple pusher 611 is located above the staple 610, and the staple pusher 611 is pressed downward, and the staple pusher 611 fires the staple 610 toward the anvil mechanism 7.
  • the staple cartridge cover 617 covers the staple cartridge seat 606, and there is a space between the staple cartridge cover 617 and the staple cartridge seat 606 for accommodating the staple pushing mechanism 8, so that the staple pushing mechanism 8 can move from the proximal end to the distal end of the actuator.
  • the side of the nail bin cover 617 is provided with a nail bin scale line 608, which is used to indicate the position of the nail hole and prevent the tissue from shifting.
  • a nail bin scale line 608 which is used to indicate the position of the nail hole and prevent the tissue from shifting.
  • the present invention sets the nail bin cover penetrating groove 605 and the nail bin cover guiding groove in the middle of the nail bin cover.
  • the nail bin cover piercing groove and the nail bin cover guiding groove all extend from the far end to the proximal end along the length direction of the actuator, and the guiding grooves are distributed on both sides of the penetrating groove.
  • the nail bin cover penetration groove is formed with an opening at the far end of the nail bin cover, and the opening is a nail bin cover flare 613 that is wide on the outside and narrow on the inside.
  • the guide groove in this embodiment includes a first cartridge guide section 602, a staple cartridge connecting end 614, and a second cartridge guide section 607, wherein the first cartridge guide section 602 extends to the proximal platform 612, and the distance between the two first cartridge guide sections 602 is smaller than the distance between the two staple cartridge second guide sections 607, and the staple cartridge connecting section 614 connects the staple cartridge first guide section 602 and the staple cartridge second guide section 607 to form a transition.
  • the staple cartridge seat 606 is also provided with a corresponding staple cartridge seat penetration groove 616 extending along the length direction of the actuator and corresponding to the staple cartridge cover penetration groove 605.
  • the staple cartridge seat penetration groove 616 is formed with an opening at the far end of the staple cartridge seat.
  • the opening is a staple cartridge seat flare 615 that is wide outside and narrow inside.
  • the anvil mechanism 7 includes an anvil base 710, which is provided with an anvil penetration groove 705 extending along the length direction of the actuator and corresponding to the staple cartridge base penetration groove 616.
  • the anvil penetration groove 705 forms an opening at the far end of the anvil base 710, and the opening is an anvil flare 707 that is wide on the outside and narrow on the inside.
  • Anvil guide grooves extending along the length direction of the actuator are provided on both sides of the nail anvil penetration groove 705 .
  • the anvil guiding groove in this embodiment comprises a first anvil guiding section 704, an anvil second guiding section 706, and an anvil connecting section 703, wherein the distance between the two anvil first guiding sections 704 is smaller than the distance between the two anvil second guiding sections 706, and the nail anvil connecting section 703 connects the nail anvil first guiding section 704 and the nail anvil second guiding section 706 to form a transition.
  • a supporting plate 708 is provided at the bottom of the nail anvil 710, and a supporting plate penetration groove 709 extending along the length direction of the actuator is arranged on the supporting plate 708.
  • the supporting plate penetration groove 709 forms an opening at the far end of the supporting plate 708.
  • the proximal end of the supporting plate 708 is provided with a guard plate 702.
  • the guard plate 702 prevents left and right movement from both sides to avoid deviation.
  • the anvil base 710 is also provided with a staple forming recess 701 for matching with the staple.
  • the staple forming pockets are also configured to converge inwardly, forming a U-shape or a V-shape.
  • the staple bin cover and the staple anvil can be designed as an inwardly recessed structure to reduce the overall size and avoid being too large to penetrate the sheath card.
  • the staple cartridge seat can be designed as an independent component, which can be detachably arranged under the staple cartridge cover and can be removed from the actuator. In this way, only the staple cartridge seat can be replaced without replacing the entire actuator, so that the actuator can be reused.
  • An opening elastic piece 604 is arranged between the staple cartridge mechanism and the nail anvil mechanism 7, and under no external force, the opening elastic piece 604 keeps the staple cartridge mechanism and the nail anvil mechanism separated, except for the part connected together at the proximal end.
  • the proximal end of the staple cartridge mechanism and the staple anvil mechanism is connected to the distal end of the sheet metal rod 401 of the steering mechanism 4 through the connecting joint 601, and the sheet metal rod 401 can drive the staple cartridge mechanism 6 and the staple anvil mechanism 7 to swing.
  • the shrapnel A of the transmission mechanism and the shrapnel B of the transmission mechanism pass through the connecting joint 601 and can move in the space between the magazine cover and the magazine seat of the magazine mechanism 6 under the drive of the push rod 103 of the firing control mechanism.
  • the sliding limit block A 5041 and the sliding limit block B 5042 run through the nail bin cover guide groove and the nail anvil guide groove on one side respectively to play a guiding role.
  • the sliding limit block A 5041 and the sliding limit block B 5042 are in an I-shaped structure, and the upper end and the lower end are respectively located on the upper part of the nail bin cover and the bottom of the nail anvil to avoid falling off from the guide groove during the movement.
  • the same guide grooves distributed on both sides of the penetrating groove as on the nail bin cover may also need to be set on the staple bin seat 606, so that the sliding limit blocks A and B can pass through. Whether it is set or not depends on the width of the nail anvil.
  • the quality inspection process of the present invention will be described in detail below, and the operation process will be simulated during the quality inspection to ensure that the instrument will not have quality problems during the surgical operation.
  • the staple cartridge mechanism 6 and the anvil mechanism 7 are separated due to the action of the opening shrapnel 604, the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032, the sliding limiter A 5041 and the sliding limiter B 5042 are located at the proximal end of the stapler, and at this time the sliding limiter A 5041 and the sliding limiter B 5042 are located at the proximal platform 612 of the metal groove 605 of the staple bin Relying on the connecting joint 601, the sliding limit blocks A and B squeeze the guide groove of the staple bin cover, which can prevent the opening angle of the staple bin mechanism and the nail anvil mechanism from being too large;
  • the push rod 103 respectively drives the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032 to move to the far end through the connecting part 501; at this time, the sliding limit block A 5041 and the sliding limit block B 5042 move far away along the guide groove until they move out of the proximal platform 612 as a whole; due to the sliding limit block A 50 41 and the I-shaped structure of the sliding limit block B 5042 cooperate to lock, squeeze the staple cartridge mechanism 6 to move closer to the anvil mechanism 7, and compress the opening shrapnel 604 until the staple cartridge mechanism 6 and the staple anvil mechanism 7 are closed.
  • the staple pushing mechanism will not reach the position of the staples.
  • the inspector can insert the stapler head into the simulated object through a minimally invasive channel such as the laparoscopic sheath card 9, and prepare for suturing;
  • Figure 9 shows the state after the actuator passes through the sheath card, when passing through the sheath card, the staple cartridge mechanism and the anvil mechanism are closed.
  • the present embodiment utilizes the sliding limit block to close the staple cartridge mechanism and the anvil mechanism.
  • other structures are also provided to pre-close the staple cartridge mechanism and the staple anvil mechanism instead of the sliding limit block. This method has been widely realized.
  • a tubular structure is arranged at the proximal end of the actuator, and the actuator is pulled back, and the proximal end is pulled into the tubular structure, and the tubular structure squeezes the opening shrapnel to close the staple cartridge and the anvil.
  • the present invention can be used for but not limited to intestinal suture, and can be used for all hollow organs that can be sutured everted.
  • the examiner adjusts the two ends of the intestinal tract to an anatomically appropriate position, and sutures one or two traction lines on the two ends of the intestinal tract to be sutured corresponding to the side close to the examiner.
  • Pull the reset button 104 of the firing control mechanism of the stapler to move proximally in conjunction with the push rod 103, and the push rod 103 moves to the proximal end through the connection part 501 to link the shrapnel A 5031 of the transmission mechanism, the shrapnel B 5032 of the transmission mechanism, and the sliding limit block A 5041 and the sliding limit block B 5042 to move proximally.
  • the direction adjustment button 105 on the firing control mechanism 1 of the stapler is rotated to drive the steering push rod 103 to drive the steering mechanism 4 to move back and forth, and further promote the overall structure of the staple bin mechanism 6 and the nail anvil mechanism 7 to swing and adjust the direction.
  • the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032 bend left and right. At this time, it is necessary to keep the cross-sections of the two broken ends of the intestinal tract parallel to the staple cartridge mechanism 6 and the staple anvil mechanism 7, and fix the direction adjustment knob 105.
  • pull the traction line of the intestinal tract In conjunction with Fig. 21, pull the traction line of the intestinal tract.
  • the broken end A 1001 of the intestinal tract on one side is inserted through the opening of the distal end of the staple cartridge penetration groove (the staple cartridge cover penetration groove 605, the staple cartridge seat penetration groove 616) and pulled toward the proximal end until it reaches the proximal end of the staple cartridge penetration groove (the staple cartridge cover penetration groove 605, the staple cartridge seat penetration groove 616).
  • the intestinal opening at the broken end will expose the bottom surface of the staple cartridge seat 606 to a sufficient height.
  • the stump B 1101 of the stump intestinal tract on the other side is pulled and penetrated by the anvil mechanism 7.
  • valgus part 4 1103, valgus part 3, valgus part 4 cover the forming pit of the staple and extend out the moving path of the sliding limit blocks A and B, especially note that both the proximal end and the distal end of the intestinal section must be located within the staple bin scale line 608.
  • the examiner pulls the trigger 101, squeezes the spine 102 and pushes the push rod 103 to move to the distal end, and the push rod 103 moves to the distal end through the connection part 501 and the shrapnel A 5031 of the transmission mechanism and the shrapnel B 5032 of the transmission mechanism to move to the distal end, and then closes the magazine mechanism 6 and the nail anvil mechanism 7 again. And beyond the nail bin scale line 608 .
  • valgus intestinal tract is incompletely covered or both ends protrude beyond the scale line 608 of the staple cartridge, it is necessary to open the staple cartridge mechanism 6 again at this time, and the staple cartridge mechanism and the staple anvil mechanism are opened to adjust the stumped intestinal tract to be sutured to a suitable position, and close the staple cartridge mechanism 6 again to wait for suturing.
  • the inspector unlocks the firing safety 107 on the firing control mechanism 1, pulls the trigger 101, squeezes the ratchet bar 102 to push the push rod 103 to move to the far end, and the push rod 103 passes through the connecting part 501 to link the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032 and the sliding limit block A 5041 and the sliding limit block B 5042 to move to the distal end, and the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 50 32, under the action of the first guide section (the first guide section 602 of the nail cartridge, the first guide section 704 of the nail anvil), continue to slide forward respectively.
  • the push nail mechanism 8 is preset near the first guide section.
  • the two push nail mechanisms are close together at first.
  • the connecting column A 5047 of the sliding limit block A and the connecting column B 5048 of the sliding limit block B contact the screw pushing mechanism A 803 and the screw pushing mechanism B 804 respectively, the connecting columns are respectively inserted into the corresponding connecting grooves 801; the transmission mechanism shrapnel A 5031 and the transmission mechanism shrapnel B 5032 push the nail pushing mechanism A 80 3.
  • the nail pushing mechanism B 804 moves to the far end.
  • the nail pushing protrusion 802 on the nail pushing mechanism 8 is combined with the nail pressing 611 to push the nail pressing 611 and the staple 610 to longitudinally shift along the direction of the nail hole 609 to the direction of the anvil 710.
  • the staple 610 quickly pierces the intestinal tissue, and when the staple 610 touches the staple forming pit 701 on the surface of the anvil 710 , it curls inward with both ends in the direction of the pit, presenting a "B" shape or an encircling pattern.
  • the trigger 101 is fired continuously to push the staple pushing mechanism 8 to move to the distal end, and the staples 610 are sutured in sequence until the distal end; at this time, the cutting blade 5046 is pushed to the distal end along the outer peripheral track of the staple cartridge mechanism 6 under the action of thrust and excises excess intestinal tissue outside the staples 610.
  • the nail pushing mechanism moves in the space between the staple magazine cover and the staple magazine seat.
  • the shrapnel moves in the first guiding section, the shrapnel A and B are relatively close.
  • the two shrapnels begin to move to both sides, driving the nail pushing mechanism A and B to move on both sides.
  • the two nail pushing mechanisms are respectively located on both sides of the penetration groove.
  • the staple pushing mechanism B 804 is located on the left outer side of the broken end A 1001 (the broken end of the tissue to be sutured is separated from the staple pushing mechanism by the staple cartridge cover and the staple pushing mechanism, and will not touch)
  • the staple pushing mechanism A 803 is located on the right outer side of the broken end A 1001, and the staples are fired from top to bottom, and the eversion part 2 1003 and the eversion part are separated
  • the two nail pushing mechanisms respectively move between the guiding groove and the penetration groove.
  • the width of the nail pushing mechanism should not be greater than the distance between the guiding groove and
  • the present invention spreads the two intestinal stumps on the upper surface of the staple anvil and the lower surface of the staple cartridge respectively to form an ellipse, and then squeezes the staples to sew up the edges on both sides of the elliptical long axis.
  • the edges of the proximal end of the long axis can also be sutured synchronously (place the staples at this position). Since it is difficult to place the staples at the far end of the long axis, this part requires manual sewing needles. Although a small part of the head end needs manual sewing needles, the present invention still solves the problem of cavity-inside-out suturing to a large extent, realizes instrumental operation, and has a very broad market prospect.
  • the broken end B of the tissue to be sutured is penetrated into the actuator from the anvil block insertion groove, and the broken end B is turned outward, and spread on the upper surface of the nail anvil seat of the actuator;
  • the distal end moves along the guide groove on the staple bin cover and the staple anvil, and the transmission mechanism shrapnel A and transmission mechanism shrapnel B push the nail pushing mechanism A and the nail pushing mechanism B to move on both sides of the penetration groove, thereby firing the staples; move the tissue to be sutured out of the actuator along the penetration groove, and check whether the broken end A and the broken end B are sutured at the position between the guide groove and the penetration groove.
  • the stapler is qualified.
  • the broken ends are everted, try to extend the broken ends A and B out of the guide groove, so as to ensure the suture effect, and also use the blades on the transmission mechanism shrapnel A and transmission mechanism shrapnel B to cut off the excess part.
  • the stapler provided in this embodiment includes an executive mechanism and a firing control mechanism.
  • the specific structure of the firing control mechanism is as described in Embodiment 1. Except for the linear cutting stapler firing control mechanism, other devices that can drive the actuator of the present invention can be applied to the present invention, and the present invention does not involve the improvement of the firing control mechanism.
  • the executive mechanism includes a staple bin mechanism 6 , an anvil mechanism 7 , a transmission mechanism 5 and a steering mechanism 4 .
  • a staple cover guide groove 618 is respectively provided on both sides of the staple cover penetration groove 605, and two staple cover guide grooves are arranged in parallel, extending from the distal end of the staple cover to the proximal end of the staple cover, and to the proximal platform 612, keeping parallel from the distal end to the proximal end.
  • An anvil guide groove 711 is respectively arranged on both sides of the anvil penetration groove 705, and the two anvil guide grooves are arranged in parallel, extending from the distal end to the proximal end of the anvil block, and keeping parallel from the distal end to the proximal end.
  • the nail holes on the staple cartridge mechanism are set on both sides of the staple cartridge seat penetration groove 616, and the proximal end of the staple cartridge seat penetration groove is no longer provided with inward converging nail holes. If the cartridge holder is relatively wide and the moving path of the shrapnel conflicts with the cartridge holder, two parallel guide grooves are also provided on the cartridge holder.
  • this embodiment is also provided with a separation column 619, which is located at the proximal end of the actuator and at the proximal platform.
  • the separation column enables the shrapnel to move more stably along the guide groove, avoiding side bending during the movement.
  • the elastic pieces A, B of the transmission mechanism and the sliding limit block A, B form a U-shaped or V-shaped opening, which is more conducive to being separated by the separation column.
  • a separation column 619 may also be provided with reference to this embodiment.
  • the nail pushing mechanism moves in the space between the staple cartridge cover and the staple cartridge seat, and when moving from the proximal end to the distal end, under the guidance of the guide groove, the shrapnel A and the shrapnel B move in parallel.
  • Two nail pushing mechanisms are set separately on both sides of the penetration groove.
  • the shrapnel comes into contact with the nail pushing mechanism, the shrapnel drives the nail pushing mechanism along the direction of the guide groove to move in the space between the penetration groove and the guide groove.
  • the two nail pushing mechanisms are respectively located on both sides of the penetration groove. Since there is no inwardly converging staple at the staple cartridge seat, when suturing, the tissue to be sutured is not sutured at the proximal end and the far end, requiring manual suturing needles.

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Abstract

L'invention concerne un mécanisme d'actionnement pour un dispositif d'agrafage de retournement, comprenant un mécanisme de cartouche d'agrafes (6), un mécanisme d'enclume (7) et un mécanisme de transmission (5). Des fentes de pénétration (605, 616, 705) s'étendant le long de la direction de la longueur du mécanisme d'actionnement sont formées sur un couvercle de cartouche d'agrafes (617), une base de cartouche d'agrafes (606) et une base d'enclume (710). Les fentes de pénétration (605, 616, 705) sont pourvues d'ouvertures au niveau des extrémités distales du couvercle de cartouche d'agrafes (617), de la base de cartouche d'agrafes (606) et de la base d'enclume (710). Sur les deux côtés de chaque fente de pénétration (605, 616, 705), le couvercle de cartouche d'agrafes (617) et la base d'enclume (710) sont en outre pourvus de fentes de guidage (618, 711) s'étendant dans la direction de la longueur du mécanisme d'actionnement. Des agrafes (610) dans le mécanisme de cartouche d'agrafes (6) sont agencées en colonnes sur les deux côtés de chaque fente de pénétration (605, 616, 705), et sont situées entre les fentes de pénétration (605, 616, 705) et les fentes de guidage (618, 711). Le mécanisme d'actionnement est pourvu des fentes de pénétration (605, 616, 705), et des extrémités cassées de tissu anastomotique peuvent être tirées de l'ouverture pour entrer dans les fentes de pénétration (605, 616, 705), puis les deux extrémités rompues peuvent être tournées vers les deux côtés et nouées, puis alignées et agrafées, et un agrafage de retournement intracorporel peut être mis en oeuvre au moyen de l'instrument.
PCT/CN2022/125848 2022-01-20 2022-10-18 Mécanisme d'actionnement pour retourner un dispositif d'agrafage, dispositif d'agrafage et procédé d'inspection de qualité de dispositif d'agrafage WO2023138124A1 (fr)

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
CN202210066450.5 2022-01-20
CN202220154121.1 2022-01-20
CN202210066450 2022-01-20
CN202220154121.1U CN217853123U (zh) 2022-01-20 2022-01-20 一种外翻式缝合器
CN202210805439.6 2022-07-08
CN202221760550.XU CN217987637U (zh) 2022-07-08 2022-07-08 一种缝合器
CN202210805439.6A CN115120293A (zh) 2022-01-20 2022-07-08 一种用于外翻式缝合器的执行机构、缝合器及缝合器质量检验方法
CN202221760550.X 2022-07-08

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CN212996592U (zh) * 2020-07-05 2021-04-20 盈甲医疗科技(北京)有限公司 一种外翻式环形吻合器
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US5376095A (en) * 1993-11-04 1994-12-27 Ethicon Endo-Surgery Endoscopic multi-fire flat stapler with low profile
US20050127131A1 (en) * 1995-08-28 2005-06-16 Mastri Dominick L. Surgical stapler
CN101156792A (zh) * 2006-10-06 2008-04-09 Tyco医疗健康集团 包括锁闭组件的外科器械
CN201767999U (zh) * 2010-06-24 2011-03-23 北京中法派尔特医疗设备有限公司 一次性使用切割缝合器
CN201912156U (zh) * 2010-09-28 2011-08-03 常州市康迪医用吻合器有限公司 带有钉砧启闭结构的腔镜外科切割吻合器
CN104127219A (zh) * 2014-08-21 2014-11-05 常州健瑞宝医疗器械有限公司 外科手术器械
CN107582122A (zh) * 2016-07-08 2018-01-16 美迪涂丽普有限公司 外科线性缝合器的端部执行器
WO2020088629A1 (fr) * 2018-11-02 2020-05-07 逸思（苏州）医疗科技有限公司 Mécanisme d'assurance pour garantir qu'un dispositif peut être uniquement utilisé une fois
CN212996592U (zh) * 2020-07-05 2021-04-20 盈甲医疗科技(北京)有限公司 一种外翻式环形吻合器
CN214857062U (zh) * 2020-12-21 2021-11-26 湖北瑞沃医药材料有限公司 一种腔镜切割吻合器的钉仓组件
CN115120293A (zh) * 2022-01-20 2022-09-30 薛建新 一种用于外翻式缝合器的执行机构、缝合器及缝合器质量检验方法

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