WO2012142872A1 - Dispositif de coupe et de couture rectiligne - Google Patents

Dispositif de coupe et de couture rectiligne Download PDF

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Publication number
WO2012142872A1
WO2012142872A1 PCT/CN2012/071595 CN2012071595W WO2012142872A1 WO 2012142872 A1 WO2012142872 A1 WO 2012142872A1 CN 2012071595 W CN2012071595 W CN 2012071595W WO 2012142872 A1 WO2012142872 A1 WO 2012142872A1
Authority
WO
WIPO (PCT)
Prior art keywords
bar
notch
staple cartridge
cutter
linear cutting
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2012/071595
Other languages
English (en)
Chinese (zh)
Inventor
陈望东
傅开芬
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Touchstone International Medical Science Co Ltd
Original Assignee
Touchstone International Medical Science Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Touchstone International Medical Science Co Ltd filed Critical Touchstone International Medical Science Co Ltd
Publication of WO2012142872A1 publication Critical patent/WO2012142872A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • A61B17/07207—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 the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320052—Guides for cutting instruments

Definitions

  • the invention relates to a linear cutting and stapling device, belonging to the technical field of medical instruments. Background technique
  • Linear cutting staplers are widely used in surgical procedures for wound suturing, internal tissue suturing and cutting.
  • a typical linear cutting stapler is disclosed in US Pat. No. 5,129,570, which has two functions of suturing and cutting, and is used for suturing wounds. At the same time, the excess tissue is removed.
  • the linear cutting stapler generally comprises two upper and lower jaws, and a closing handle for closing the upper and lower jaws, and an anvil and a staple cartridge opposite to the front ends of the upper and lower jaws, and are arranged in the staple cartridge.
  • the firing piece and the cutter are simultaneously moved relative to the staple cartridge, and a push button for driving the firing piece and the cutter movement. Studs are arranged in the staple cartridge, and the firing sheets sequentially push the pusher tabs and push the staples toward the anvil, which cuts the tissue between the staple cartridge and the anvil.
  • the staple cartridge of the device can be replaced multiple times. In clinical use, it is often necessary to suture the tissue several times, so it is necessary to replace the staple cartridge several times during the operation. In order to prevent the doctor from inadvertently accidentally loading the stapled cartridge into the stapler to cause serious consequences of cutting only the unstitched, the prior art linear cutting stapler is provided with a nail to prevent the nail from being fired. The insurance institution that was once again fired (ie, second fired).
  • U.S. Patent No. 5,129,570 discloses an insurance mechanism in which a safety block with a cutter passage and a push rod passage is provided in the middle of the instrument, and a shrapnel is disposed under the cutter.
  • a safety block with a cutter passage and a push rod passage is provided in the middle of the instrument, and a shrapnel is disposed under the cutter.
  • the shrapnel will bounce the knife.
  • the cutter can not pass through the cutter passage to play the role of insurance; when the instrument is mounted on the staple cartridge, and the upper and lower jaws are closed, the staple cartridge presses the top of the knife, so that the cutter overcomes the elastic force of the elastic piece and recovers to When the cutter channel is aligned, the insurance can be released and the device can be fired.
  • the cutter pushes the top of the nail to the top of the knife, so that the cutter is returned to the initial position after the device is fired. It is no longer possible to press the top of the knife, so that the cutter cannot pass through the cutter passage on the safety block to prevent secondary firing.
  • U.S. Patent No. 7,055,730 Another mechanism for preventing secondary firing is disclosed in U.S. Patent No. 7,055,730.
  • the cutter Before the firing, the cutter is provided with a knife sleeve structure, the direction of the sleeve is consistent with the direction of the cutter, and the shaft is connected to the staple cartridge.
  • the knife sleeve rotates, so that the knife sleeve is perpendicular to the cutter, and the instrument can no longer be closed after being opened, thereby preventing the secondary firing.
  • An object of the present invention is to provide a linear cutting stapler which has a structurally simple safety mechanism for preventing secondary firing.
  • a linear cutting stapler comprising: upper and lower jaws that can be closed or opened to each other, a distal end of the lower jaw is provided with a staple cartridge, and the staple cartridge is axially provided with a knife pocket,
  • the lower jaw is U-shaped, and a pusher bar and a pusher bar are slidably disposed therein, a distal end of the pusher bar is provided with a cutter, and a proximal end of the staple cartridge is provided with an insurance mechanism, the insurance
  • the mechanism includes a first pressing block disposed in the staple cartridge, a triggering mechanism and at least one elastic member, a bottom end of the cutting blade is provided with a first notch, and the first pressing block is in the elastic member and the triggering mechanism
  • the longitudinal movement of the staple cartridge can be performed in a manner such that the first pressure block and the first gap can be selectively snapped or separated.
  • the first pressing block includes a latching bar that cooperates with the first notch, and the latching bar can be longitudinally moved in the staple cartridge by the elastic member and the triggering mechanism. So that the card bar and the first notch can be selectively snapped or separated.
  • the proximal end of the staple cartridge is axially provided with two or four slots, the four slots are symmetrically disposed on two sides of the movement groove, and a second gap is formed on the inner side of the groove.
  • the grooves are both connected to the knife groove;
  • the first pressure block is concave, and further includes a floating block disposed at two ends of the card bar and matched with the groove, The card position bar and the floating block cooperate to form a third notch for the cutter to pass; the floating blocks are respectively disposed in the groove.
  • the triggering mechanism is a second pressing block of the H-type, the second pressing block includes a limiting bar, and a limit disposed at the two ends of the limiting bar and matched with the floating block respectively Positioning block; a distal end of the cutter is axially disposed with a limiting slot; the second pressing block is longitudinally movable within the staple cartridge, such that the linear cutting stapler is selectively in two states :
  • the upper surface of the floating block is respectively provided with a fourth gap matching the limiting block, and the limiting block is respectively disposed in the fourth notch.
  • a longitudinally distributed waist groove is respectively disposed on each of the two side walls of the staple cartridge; and two ends of the limiting bar of the second pressing block are longitudinally movable in the waist groove Three raised.
  • a second arc-shaped protrusion is disposed at the slot of the limiting slot, and an upper surface of the limiting lever is a cam surface.
  • the shape and structure of the first pressure block are consistent with the internal structure of the staple cartridge, and the stability of the first pressure block during longitudinal movement in the staple cartridge is high; (3) The elastic member and the first pressure block are conveniently installed;
  • connection between the second pressure block and the first pressure block is relatively stable
  • the second protrusion on the limit groove has a limit function, which makes the safety of the product clear.
  • Figure 1 is an exploded view of the linear cutting stapler in the example
  • Figure 2 is a plan view of the linear cutting stapler in an initial state
  • Figure 3 is a cross-sectional view taken along line A-A of Figure 2;
  • Figure 4 is a cross-sectional view taken along line B-B of Figure 2;
  • Figure 5 is a cross-sectional view taken along line C-C of Figure 2;
  • Figure 6 is a cross-sectional view of the linear cutting stapler when the cutter is pushed out
  • Figure 7 is a cross-sectional view of the linear cutting stapler when the cutter is pulled back
  • Figure 8 is a cross-sectional view of the linear cutting stapler in a final state. Specific actual 1 ⁇ 2 ⁇
  • a linear cutting stapler comprises: upper and lower jaws (not shown) which can be closed or opened to each other, and the distal end of the lower jaw is provided with a nail.
  • the cartridge 1 has a knife groove 13 axially disposed therein, and the lower jaw is U-shaped, and a pusher bar and a pusher bar (not shown) are slidably disposed therein, and the pusher bar is
  • the distal end is provided with a cutter 2
  • the proximal end of the staple cartridge 1 is provided with a safety mechanism
  • the safety mechanism comprises a first pressure block 4 disposed in the staple cartridge 1, a trigger mechanism and at least one elastic member, and the cutter 2
  • the bottom end is provided with a first notch 22, and the first pressing block 4 can be longitudinally moved in the staple cartridge 1 by the elastic member and the triggering mechanism, so that the first pressing block 4 and the first notch 22 are selectively Ground card or sub-card Specific embodiments of the present invention are further described below by way of specific examples.
  • the linear cutting stapler in this embodiment includes: upper and lower jaws (not shown) that can be closed or opened to each other, and a staple cartridge 1 is disposed at a distal end of the lower jaw.
  • the nail cartridge 1 is provided with a knife groove 13 in the axial direction, and the lower jaw is U-shaped, and a pusher bar and a pusher bar (not shown) are slidably disposed therein, and the distal end of the pusher bar
  • the cutter 2 is provided with a first notch 22 at the bottom end of the cutter 2, and a strip-shaped limiting groove 21 is arranged at the top end thereof, and a circular arc-shaped second portion is arranged at the notch of the limiting groove 21.
  • the protrusion 24, the proximal end of the bottom of the cutter 2 is a circular arc-shaped inclined surface 23, the proximal end of the staple cartridge 1 is provided with a safety mechanism, and the insurance mechanism comprises a second pressure piece 3 disposed in the staple cartridge 1 A pressure block 4 and two elastic pieces 5.
  • the proximal end of the staple cartridge 1 is axially provided with two grooves 11 of the same shape.
  • the grooves 11 are symmetrically disposed on both sides of the knife groove 13 , and a concave groove 12 is defined on the inner side of the groove 11 so as to be concave.
  • the grooves 13 are respectively connected to the cutter groove 13; the two side walls of the staple cartridge 1 are respectively provided with a longitudinally distributed waist groove 14; the first pressure block 3 is concave, and the structure and the internal accommodation formed by the two grooves 11 are formed.
  • the first pressing block 4 includes a locking bar 41 corresponding to the shape of the first notch 22, and a floating block 43 disposed at the two ends of the locking bar 41 and engaging with the groove 13, the floating block 43
  • the upper surface is provided with a rectangular fourth notch 44.
  • the locking bar 41 and the floating block 43 are matched, and the middle portion forms a third notch 42 for the cutter 2 to pass, and the locking bar 41 is in contact with the cutter 2.
  • the second pressing block 3 includes a rectangular limiting rod 31 that cooperates with the limiting groove 21, and is disposed at both ends of the limiting rod 31 and respectively matched with the floating block 43
  • the limit block 32, and the upper surface of the limit bar 31 is a cam surface, which makes it easy Separated from the cutter 2, the two ends of the second press block 3 are respectively provided with third projections 33 which are movable in the waist groove 14.
  • the two elastic pieces 5 are respectively disposed in the corresponding grooves 11.
  • the elastic piece 5 is provided with a circular hole at one end thereof, and the bottom surface of the groove 11 is provided with a cylindrical protrusion corresponding to the circular hole, and the elastic piece 5 is connected through the circular hole.
  • the elastic piece 5 can also pass other Conventional means are attached to the bottom surface of the recess 11, such as: welding, screwing or riveting.
  • the first pressing block 4 is disposed in the accommodating space formed by the two recesses 11.
  • the two floating blocks 43 are respectively disposed in the corresponding recesses 11.
  • the latching bars 41 are located in the space formed by the second notch 12 and the slot 13 .
  • the second pressing block 3 is placed above the first pressing block 4, and the limiting block 32 is respectively placed in the corresponding fourth notch 44.
  • the limiting bar 31 can be selectively placed in the limiting slot 21 on the cutter 2.
  • the upper surface of the limiting rod 31 is a cam surface, which makes it easier to fit and disengage the limiting groove.
  • the second pressure block 3 is longitudinally movable within the staple cartridge 1 such that the linear cutting stapler is selectively in two states:
  • the limiting bar 31 of the second pressing block 3 is in a mating state with the limiting slot of the cutter 2.
  • the cutter can easily be separated from the first
  • the restriction of the two pressure blocks moves forward to cut the tissue.
  • the cutter 2 is pushed out toward the distal end of the staple cartridge 2 in the A direction, and the second projection 24 on the cutter 2 forces the limit lever 31 to move downward, so that the limit groove 21 and the limit bar The phase 31 is disengaged.
  • the limit bar 31 is not subjected to the longitudinal downward pressure of the cutter 2, and the elastic piece 5 acts on the lower surface of the slider 43, so that the first press block 4 and the second press block 3 move longitudinally upward. That is, the position of the card position bar 41 also moves upwards accordingly;
  • the direction moves toward the proximal end of the staple cartridge 2, and the inclined surface 23 of the cutter 2 first comes into contact with the wedge-shaped surface of the card post 41, and the latching lever 41 is longitudinally moved downward by the pressing, followed by the first notch 22 on the cutter 2.
  • the card position bar 41 is engaged in the first notch 22 by the elastic piece 5, and is in the final insurance shape as shown in FIG. Because the external force acts, the limit bar 31 is outside the limit groove 21, and the cutter 2 cannot be separated from the restriction of the card bar 41 even if it is subjected to the thrust at this time, and can not be fired again, thereby preventing the second shot. .
  • the elastic piece 5 may also be replaced by a spring or other elastic member; preferably, the lower surface of the floating block 43 is located longitudinally higher than the plane of the upper surface of the card post 41, so that the slider 43 and the card A step is formed between the bars 41. At this time, the depths of the two grooves 11 can be set shallow, so that the mounting of the elastic piece 5 is more convenient.
  • the beneficial effects of the embodiment are as follows: (1) the structure is simple, the processing is convenient, and the method is safe and reliable, and has good popularization value; (2) the shape and structure of the first pressure block 4 are consistent with the internal structure of the staple cartridge 1, Moreover, the first compact 4 has high stability when moving longitudinally in the staple cartridge 1; (3) the elastic piece 5 and the first compact 4 are conveniently installed; (4) the elastic piece 5 has a simple structure, low cost, and performance.
  • the structure of the second pressing block 3 is simple, and the pushing out of the cutter 2 can cause the entire securing mechanism to be triggered, so that the operation is very convenient; (6) between the second pressing block 3 and the first pressing block 4 The connection is relatively stable; (7) the stability of the second pressing block 3 in the longitudinal movement is high; (8) the second protrusion 24 on the limiting groove 21 has a limiting function, so that the safety of the product is improved.
  • the first pressure block 4 is provided with protruding levers (not shown) on both sides thereof, and the levers are placed in the waist grooves 14 on both sides of the staple cartridge 1.
  • the remaining structure is the same as that of the above embodiment.
  • the toggle lever can be vertically downwardly moved by the manual direction so that the linear cutting stapler is in a fired state.

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

Abstract

La présente invention concerne un dispositif de couture et de coupe rectiligne, comprenant un clamp supérieur et un clamp inférieur qui s'ouvrent et se ferment l'un avec l'autre. Une chambre d'agrafe (1) est disposée à l'extrémité distante du clamp inférieur. Une rainure de coupe (13) est disposée sur la chambre d'agrafe (1) dans la direction axiale de celui-ci. Le champ inférieur est en forme de U. Une tige de poussée d'agrafe et une tige de poussée de dispositif de coupe sont disposées de façon coulissante à l'intérieur du clamp inférieur. Un dispositif de coupe (2) est disposé à l'extrémité distante de la tige de poussée de dispositif de coupe. Un mécanisme de sécurité est disposé à l'extrémité proximale de la chambre d'agrafe (1). Le mécanisme de sécurité comprend un premier bloc de pression (4) à l'intérieur de la chambre d'agrafe (1), un mécanisme de déclenchement, et au moins une partie élastique. Une première encoche (22) est disposée à la base du dispositif de coupe (2). Le premier bloc de pression (4) se déplace à l'intérieur de la chambre d'agrafe (1) longitudinalement sous l'action de la partie élastique et du mécanisme de déclenchement, de sorte que le premier bloc de pression (4) puisse être sélectivement verrouillé avec ou séparé de la première encoche (22). Le dispositif de coupe et de couture rectiligne est de structure simple, commode pour le traitement, sûre et fiable, et a de nombreuses utilisations.
PCT/CN2012/071595 2011-04-20 2012-02-24 Dispositif de coupe et de couture rectiligne Ceased WO2012142872A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201110099702.6 2011-04-20
CN201110099702.6A CN102743201B (zh) 2011-04-20 2011-04-20 直线型切割缝合器

Publications (1)

Publication Number Publication Date
WO2012142872A1 true WO2012142872A1 (fr) 2012-10-26

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PCT/CN2012/071595 Ceased WO2012142872A1 (fr) 2011-04-20 2012-02-24 Dispositif de coupe et de couture rectiligne

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CN (1) CN102743201B (fr)
WO (1) WO2012142872A1 (fr)

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CN104027145A (zh) * 2014-06-06 2014-09-10 山东威瑞外科医用制品有限公司 防误操作型切割吻合器
CN108378885A (zh) * 2018-03-20 2018-08-10 常州威克医疗器械有限公司 一种具有空钉仓安全保险装置的外科吻合器钉仓组件
CN109893190A (zh) * 2019-03-25 2019-06-18 宁波市爱达维电器有限公司 医用缝合器的弧形钉盒结构
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US11266403B2 (en) 2019-04-26 2022-03-08 Cilag Gmbh International Tissue cutting washer for right angle surgical stapler
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