WO2012142917A1 - 直线缝切器 - Google Patents

直线缝切器 Download PDF

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Publication number
WO2012142917A1
WO2012142917A1 PCT/CN2012/073717 CN2012073717W WO2012142917A1 WO 2012142917 A1 WO2012142917 A1 WO 2012142917A1 CN 2012073717 W CN2012073717 W CN 2012073717W WO 2012142917 A1 WO2012142917 A1 WO 2012142917A1
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WO
WIPO (PCT)
Prior art keywords
push button
linear
axis
slider
button base
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/CN2012/073717
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English (en)
French (fr)
Inventor
陈望东
傅开芬
单腾
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
Priority to EP12773542.1A priority Critical patent/EP2700366B1/en
Priority to JP2014505494A priority patent/JP5657173B2/ja
Priority to ES12773542.1T priority patent/ES2568742T3/es
Publication of WO2012142917A1 publication Critical patent/WO2012142917A1/zh
Priority to US14/058,001 priority patent/US9381017B2/en
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
    • 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
    • A61B2017/0042—Surgical instruments, devices or methods with special provisions for gripping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/291—Handles the position of the handle being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2923—Toothed members, e.g. rack and pinion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2924—Translation movement of handle without rotating movement
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F04—POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
    • F04C—ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS
    • F04C2270/00—Control; Monitoring or safety arrangements
    • F04C2270/04—Force
    • F04C2270/042—Force radial
    • F04C2270/0421—Controlled or regulated

Definitions

  • the invention relates to a medical stapling device, in particular to a linear slitting device for surgery, belonging to the technical field of medical instruments.
  • the linear slitter generally comprises two upper and lower jaws, an anvil and a staple cartridge disposed opposite to the distal ends of the upper and lower jaws, and a closing handle for closing the upper and lower jaws; a pusher bar movable simultaneously along the axis of the instrument and a pusher bar having a cutter at the distal end, wherein one end of the pusher bar and the pusher bar are disposed on a slider;
  • the axis of the device is arranged with a plurality of nail holes, each of which is provided with a pusher piece and a staple; the movement of the slider drives the pusher bar to push the pusher piece in turn and push the staple to the nail
  • the anvil is formed on the tissue to be sutured and the cutter is used to cut or cut the tissue between the staple cartridge and the anvil.
  • All of the push buttons for driving the slider are generally disposed on the outside of the upper and lower jaws for the convenience of a doctor.
  • U.S. Patent No. 5,129,570 discloses a pusher for pushing a slider, a pusher bar, and a cutter.
  • a push button that is relatively fixed to the slider and protrudes to the left or right side of the upper and lower jaws.
  • the disadvantage of this type of push button is that the doctor can only push the push button on the side of the upper and lower jaws. Once the instrument is placed in a special operating position, the doctor can not control the push button well. This will greatly reduce the operational comfort of the linear seam cutter. On the other hand, the doctor's left and right hand habits can also cause inconvenience in the use of the device.
  • a new type of 'W' push button structure is disclosed in US Pat. No. 7,129,081 and US Pat. No. 7,568,604.
  • the push button is pivotally connected to the slider so that the two operating portions of the push button can be selectively extended. Out of the clamp of the instrument.
  • the push button operation portion on the left side of the clamp is extended beyond the clamp, and the push button operation portion on the right side of the clamp is gathered and attached to the clamp.
  • a plastic jaw housing for protecting the jaws is attached to the outside of the jaws, and the folded push button operating portion will abut the jaw housing.
  • the disadvantage of the push button of this structure is that the operating portions on both sides of the push button cannot be closed or opened at the same time, resulting in: (1) increasing the overall space of the device, increasing the cost of packaging and transportation; (2) in a specific operation For example, minimally invasive surgery for bowel resection, because of the direction of use of the instrument, requires the doctor to operate the operating parts on both sides of the push button at the same time to force the average, and merely pushing the operating part on one side will cause the instrument to be held unstable, bringing surgery Hidden dangers.
  • a linear slitter comprising: upper and lower jaws that can be closed or opened to each other, anvil and a staple cartridge disposed opposite the distal ends of the upper and lower jaws, and a closing handle for closing the upper and lower jaws
  • the surface of the staple cartridge is arranged along the axis of the device with a plurality of nail holes, each of which is provided with a pushing piece and a staple abutting each other;
  • the nail cartridge is provided with the same along the axis of the instrument a moving pusher bar and a pusher bar having a cutter at a distal end, the pusher bar sequentially driving the pusher piece during movement, and one end of the pusher bar and the pusher bar are disposed on a slider, the slider is provided with a push button base, the push button base is opposite to the slider, and the push button base is pivotally provided with at least one push button, and the push The button can be switched between two states whose operating surface is perpendicular to the instrument axis and its operating surface is parallel to
  • each of the two sides of the push button base is provided with a push button, and the two push buttons are symmetrical, and at the same time, the operating surface thereof is perpendicular to the instrument axis and the operating surface thereof is parallel to the instrument axis. Transition between states.
  • each of the two sides of the push button base is provided with a push button, and the two push buttons are symmetrical, and optionally one of the push buttons is perpendicular to the instrument axis and the operation surface thereof on the operation surface thereof. Transition between two states parallel to the axis of the instrument.
  • the push button base is manufactured integrally or separately from the slider.
  • the position of the pivoting pivot hole on the push button base is located outside the upper and lower jaws.
  • the push button base comprises a body fixed to the slider, and a shoulder protruding from the push button base body, wherein the shoulder is provided with a pivot hole; the push button comprises a connection a pivot end and an operating portion; a pin passing through the pivot end and the pivot hole to pivotally connect the push button base and the push button.
  • two sides of the push button base are provided with a pair of symmetrical shoulders, and each of the pivots on the shoulder is provided with a push button.
  • the side surface of the push button base is a flat surface and a circular arc surface which are smoothly connected, and the push button is provided with a forward thrust stop plane which can cooperate with the plane and the circular arc surface.
  • the push button is provided with a reverse rotation preventing plane which cooperates with the outer plane of the ribs disposed on both sides of the lower jaw.
  • the upper surface of the push button base is provided with a first concave strip and a second concave strip perpendicular to each other, and the push button is provided with the first concave strip or the second concave surface selectively Striped ribs.
  • a linear slitter comprising: upper and lower jaws that can be closed or opened to each other, anvil and a staple cartridge disposed opposite the distal ends of the upper and lower jaws, and a closing handle for closing the upper and lower jaws
  • the surface of the staple cartridge is arranged along the axis of the device with a plurality of nail holes, each of which is provided with a pushing piece and a staple abutting each other;
  • the nail cartridge is provided with the same along the axis of the instrument a moving pusher bar and a pusher bar having a cutter at a distal end, the pusher bar sequentially driving the pusher piece during movement, and one end of the pusher bar and the pusher bar are disposed on a slider,
  • the slider is provided with two push buttons rotatable relative to the slider; the two push buttons can be simultaneously perpendicular to the instrument axis and the operating surface thereof parallel to the instrument axis on the operating surface thereof Switching between two states, when the operating surface of the push button is perpen
  • the push button is provided with a driving gear
  • the driving gear is pivotally disposed on the slider
  • the slider is further provided with a plurality of or a plurality of slaves meshing with the driving gear.
  • Dynamic gear is provided.
  • the pivot portion of the push button and the push button base is a piezoelectric material.
  • the push button opens at the same time and extends out of the clamp to meet the needs of a specific operation
  • the push button has a simple structure, convenient assembly and is suitable for practical use.
  • Figure 1 is an exploded view of a first embodiment of a linear slitter of the present invention
  • Figure 2 is a cross-sectional view showing a first embodiment of the linear slitter of the present invention
  • Figure 3 is an enlarged view of the push button base and the push button of Figure 1;
  • Figure 4 is a plan view showing the initial state of the first embodiment of the linear slitter of the present invention, in which the axis of the push button is parallel to the axis of the instrument;
  • Figure 5 is a left side view of Figure 4.
  • Figure 6 is a cross-sectional view taken along line A-A of Figure 5;
  • Figure 7 is a plan view showing the working state of the first embodiment of the linear slitter of the present invention, wherein the axis of the push button is perpendicular to the axis of the instrument;
  • Figure 8 is a left side view of Figure 7;
  • Figure 9 is a cross-sectional view taken along line B-B of Figure 8.
  • Figure 10 is a cross-sectional view showing the working state of the second embodiment of the linear slitter of the present invention.
  • Figure 11 is a cross-sectional view showing the working state of the third embodiment of the linear slitter of the present invention.
  • Figure 12 is a cross-sectional view showing the first embodiment of the linear slitter of the present invention when the push button is retracted;
  • Figure 13 is a cross-sectional view of the first embodiment of the linear slitter of the present invention with the push button retracted, at which time the push button is disengaged from the rib;
  • Figure 14 is a cross-sectional view showing a fourth embodiment of the linear slitter of the present invention.
  • Figure 15 is a cross-sectional view showing an initial state of a fifth embodiment of the linear slitter of the present invention.
  • Figure 16 is a cross-sectional view showing an operational state of a fifth embodiment of the linear slitter of the present invention.
  • the present invention discloses a linear slitter comprising: upper and lower jaws 1, 5 which can be closed or opened to each other, and an anvil is arranged at the distal end of the upper jaw 1 3.
  • the distal end of the lower jaw 5 is provided with a staple cartridge 7, and the lower jaw 5 is also pivotally provided with a closing handle 11 for closing the upper and lower jaws.
  • the lower jaw 5 is in the shape of a dome having a pusher bar 13 slidable along the axis of the instrument and a pusher bar 15 (disclosed in Fig. 2) having a cutter at the distal end, the staple cartridge 7 Set in the U-shaped structure.
  • the surface of the staple cartridge 7 is arranged along the axis of the instrument with a plurality of nail holes 9, generally four rows.
  • Each of the nail holes 9 is provided with a pusher piece and a staple which abut each other (in accordance with the prior art, not shown).
  • the pusher bar 13 sequentially drives the pusher piece during the movement and pushes the staple out of the nail hole of the staple cartridge.
  • one end of the pusher bar 13 and the pusher bar 15 are disposed on a slider 17, and the movement of the slider 17 can drive the pusher bar 13 And push the knife bar 15 to move.
  • the slider 17 is provided with a push button base 21 which is fixed to the slider 17 in the direction of the instrument axis by a projection 19 and a setting provided on the slider 17. This is achieved by the cooperation of the through holes 23 on the push button base 21.
  • the push button base 21 and the slider 17 can be integrally manufactured in addition to the above-described split manufacturing, that is, both are completely fixed.
  • each of the two sides of the push button base 21 is provided with a push button 29, and the two push buttons 29 are symmetrical.
  • the push button base 21 includes a body fixed to the slider 17, and a pair of symmetrical shoulders 25 extending from opposite sides of the push button base body, the shoulders Each of the 25 is provided with a pivot hole 27; the push button 29 includes an associated pivot end 31 and an operating portion 33; a pin 35 passes through the pivot end 31 and the pivot hole 27, and the push button The base 21 and the push button 29 are pivotally connected.
  • the operating portion 33 includes a plane, that is, an operating surface of the push button, which is urged by the operator to push the push button to slide.
  • the side surface of the push button base 21 is a plane 55 and a circular arc surface 53 which are smoothly connected, and the push button 29 is provided with a forward thrust stop which can cooperate with the plane 55 and the circular arc surface 53. Plane 51.
  • the push button 29 is further provided with a reverse rotation preventing plane 57 which cooperates with the outer plane of the rib 59 provided on both sides of the lower jaw 5.
  • the first embodiment of the linear slitter of the present invention is in an initial state in which the operating surfaces of the two push buttons 29 are each substantially parallel to the instrument axis.
  • the space occupied by the shape of the instrument is relatively small, so that the package can be made relatively small, the raw material is reduced, and the cost is lowered.
  • the linear slitter of the present invention includes only one push button 29, the overall shape of the linear slitter is relatively small as compared with the prior art, since there is no push button that is opened relative to the clamp.
  • the forward thrust stop plane 51 of the push button 29 is tangential to the arcuate surface 53 of the push button base 21, so that the push button 29 can be rotated about the pin 35.
  • the first embodiment of the linear slitter of the present invention is in an operational state, in which case the operating surfaces of the two push buttons 29 are substantially perpendicular to the axis of the instrument, and the push button 29 is remote.
  • the pivoting end operating portion 33 extends beyond the upper and lower jaws, i.e., the push button 29 is in the open position.
  • the forward thrust stop plane 51 of the push button 29 abuts against the plane 55 of the push button base 21, the plane 55 restricts the push button 29 from continuing to rotate, and therefore, the push button 29 is in the direction
  • the distal end moves the push button 29 and the push button base 21 are relatively fixed due to the reaction force of the plane 55.
  • the doctor can operate the push button 29 with both hands to complete a special operation.
  • the upper surface of the push button base 21 is further provided with a first concave strip 63 and a second concave strip 65 which are perpendicular to each other.
  • the push button 29 is provided with a rib 61 that is selectively engageable with the first recess 63 or the second recess 65.
  • the operating surface of the push button 29 is parallel to the instrument axis, at which time the instrument is in an initial state; when the rib 61 enters the second recess 65, The operating surface of push button 29 is perpendicular to the instrument axis when the instrument is in operation. This further stabilizes the position of the push button 29 so that it does not shake.
  • the two push buttons 29 of the two embodiments and the first embodiment can be perpendicular to the operating surface thereof at the same time.
  • the difference between the instrument axis and the two states parallel to the instrument axis is that the two push buttons 29 are selectively at their operational surfaces perpendicular to the instrument axis and parallel to the instrument axis.
  • the transition is that the push button on the left side of the second embodiment is in an active state, and the push button on the right side of the third embodiment is in an active state.
  • the position of the pivoting pivot hole 27 on the push button base 21 is located outside the upper and lower jaws.
  • the reason for the arrangement is that the assembly is convenient, and the jaw structure can be relatively simple. .
  • Figure 12 is a cross-sectional view showing the linear slitter of the first embodiment when the push button 29 is retracted in the direction of the arrow in the figure after the operation is completed, since the retraction plane 57 of the push button 29 is a flat surface and is disposed in the lower jaw
  • the outer planes of the ribs 59 on both sides are matched, and the plane and the plane abut each other, which restricts the rotation of the push button 29, so that the push button can smoothly retreat from the distal end of the instrument to the position disclosed in FIG.
  • the push button 29 has completely retracted into position, and the reverse rotation preventing plane 57 is also disengaged from the rib, so that the push button 29 can be rotated about the pin 35 to the initial position after the force between the planes disappears.
  • the push button of the present invention also serves as a reminder that when the push button can be rotated relative to the push button base, it is proved that the push button and the slider have been retracted into position, the instrument can be opened, and the stitching is completed.
  • FIG. 14 shows a fourth embodiment of the present invention.
  • the push button 29 is provided with a driving gear 71.
  • the driving gear 71 is pivotally disposed on the slider 17, and the slider 17 is further provided with A driven gear 73 meshing with the driving gear 71.
  • a driven gear 73 meshing with the driving gear 71.
  • FIG. 15 and FIG. 16 illustrate a fifth embodiment of the present invention.
  • the push button 29 is provided with a driving gear 71.
  • the driving gear 71 is pivotally disposed on the slider 17, and the slider 17 is disposed on the slider 17.
  • the two push buttons 29 can simultaneously switch between two states whose operating surfaces are perpendicular to the instrument axis and parallel to the instrument axis, when the operating surface of the push button is perpendicular to the instrument axis An operating portion on the push button that is away from the pivot end protrudes beyond the upper and lower jaws.
  • driven gears in the fourth and fifth embodiments described above can be expanded to single or double numbers, and similar functions can be achieved.
  • the joint portion of the push button (ie, the pivot point of the push button and the push button base) in the present invention is a piezoelectric material, that is, the push button can be converted from a state in which the operation surface is parallel to the instrument axis to be perpendicular to the device.
  • the state of the axis Since the material is a known material, it will not be described here.
  • One end of the push rod and one end of the cutter are disposed on the slider, and not only one end of the push rod and one end of the cutter are completely fixed on the slider, and
  • the pusher bar and the cutter and the slider are fixed in the direction of the instrument axis, because in actual production, the pusher bar and the cut are made due to a certain amount of deformation of the upper and lower jaws during operation.
  • the knife and the slider have a certain offset in a direction perpendicular to the axis of the instrument. Of course, this 'fixed' also includes assembly errors.
  • the left or right side of the upper and lower jaws in the present invention refers to the left or right direction of the upper and lower jaws when the surface of the staple cartridge is upward.
  • the present invention has various embodiments, and all technical solutions formed by equivalent transformation or equivalent transformation are within the scope of the present invention.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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Description

直线缝切器
本申请要求了申请日为 2011 年 4 月 20 日，申请号为 201110099716.8 ，发明名称为 ' 直线缝切器 ' 中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本发明涉及一种医用钉合装置，尤其是一种外科手术用的直线缝切器，属于医疗器械技术领域。
背景技术
外科手术用直线缝切器被广泛用于伤口缝合、内部组织缝合与切割。典型的直线缝切器如美国专利US5129570所揭示，同时具有缝合与切割两个功能，即在进行伤口缝合的同时将多余的组织切除。该类直线缝切器一般包括上、下两个钳夹，相对设置在上、下钳夹远端的钉砧和钉仓，以及用于闭合上、下钳夹的闭合把手；该钉仓内设有可沿器械轴线同时移动的推钉杆和远端设有切刀的推刀杆，所述推钉杆和推刀杆的一端均配设于一滑块上；所述钉仓表面沿器械轴线排列设有若干个钉孔，每个钉孔内均设置有推钉片和缝合钉；所述滑块移动带动所述推钉杆依次推动推钉片并将所述缝合钉推向钉砧成形于待缝合组织上，并带动所述切刀将位于所述钉仓和钉砧之间的组织切断或切口。
所有器械用于驱动所述滑块移动的推钮一般都设置在上、下钳夹的外侧，以便于医生操作，如美国专利US5129570公开了一种用于推动滑块、推钉杆、切刀移动的推钮，所述推钮与滑块相对固定，且伸出于所述上、下钳夹的左侧或右侧。这种结构的推钮的不足在于：医生仅仅只能在上、下钳夹的一侧推动推钮，一旦当器械置于一个特殊的操作位置，导致医生不能很好地控制该推钮时，则会大大地降低该直线缝切器的操作舒适性。而且另一方面，医生的左右手习惯也会导致该器械的使用不便。
为了解决上述的技术问题，美国专利US7419081、US7568604揭示了一种新型的'W'型的推钮结构，该推钮与滑块枢轴连接，使该推钮的两个操作部可选择地伸出于器械的钳夹之外。当医生需要从左侧推动推钮时，则将钳夹左侧的推钮操作部伸出于钳夹之外，此时钳夹右侧的推钮操作部则收拢并贴紧于钳夹。一般来说，钳夹外还会固设有一用于保护钳夹的塑料钳夹外壳，则收拢的推钮操作部会贴紧钳夹外壳。这种结构的推钮的不足在于，推钮两侧的操作部不能同时地收拢或打开，导致：（1）会使器械整体的空间变大，包装和运输成本增加；（2）特定手术中，例如肠管切除的微创手术，由于器械使用方向的原因，需要医生同时操作推钮两侧的操作部才能用力平均，而仅仅推动一侧的操作部会导致器械的把持不稳，为手术带来隐患。
中国专利申请200910175667.4揭示了另一种推钮结构，该推钮亦与滑块枢轴连接，且设置在器械的近端，在初始位置时其自身轴线与钳夹的纵向轴线同轴。当需要使用时，则将推钮可选择地转动到钳夹的左侧或右侧。同样，这种结构的推钮的不足在于：推钮不能在钳夹的两侧同时地打开，从而导致产生前文中所述的缺陷。
发明内容
本发明的目的是提出一种具有新型推钮的直线缝切器，该推钮可以同时打开伸出于钳夹之外，或同时收拢贴紧于钳夹。
本发明的目的，将通过以下技术方案得以实现：
一种直线缝切器，包括：可相互闭合或打开的上、下钳夹，相对设置在上、下钳夹远端的钉砧和钉仓，以及用于闭合上、下钳夹的闭合把手；所述钉仓表面沿器械轴线排列设有若干个钉孔，每个钉孔内均设置有相互抵接的推钉片和缝合钉；所述钉仓内设有可沿所述器械轴线同时移动的推钉杆和远端设有切刀的推刀杆，所述推钉杆在移动的过程中依次驱动所述推钉片，所述推钉杆和推刀杆的一端均配设于一滑块上，所述滑块上设有一个推钮基座，该推钮基座与所述滑块相对固定，所述推钮基座上枢轴设有至少一推钮，所述推钮可在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换。
优选的，所述推钮基座的两侧各枢轴设有一推钮，所述2个推钮相对称，并可同时在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换。
优选的，所述推钮基座的两侧各枢轴设有一推钮，所述2个推钮相对称，并可选择地使其中一个推钮在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换。
优选的，所述推钮基座与滑块一体或分体制造。
优选的，所述推钮基座上起枢轴作用的枢轴孔之位置位于上、下钳夹的外侧。
优选的，所述推钮基座包括与滑块固定的本体，以及伸出于所述推钮基座本体的肩部，所述肩部上设有一个枢轴孔；所述推钮包括相连的枢轴端和操作部；有一销穿过所述枢轴端和枢轴孔，将所述推钮基座和推钮枢轴连接。
优选的，所述推钮基座的两侧设有一对相对称的肩部，所述肩部上各枢轴设有一个推钮。
优选的，所述推钮基座的侧面为平滑连接的一平面和一圆弧面，所述的推钮上设有一个可与所述平面和圆弧面配合的前推止转平面。
优选的，所述推钮上设有一个后退止转平面，与设置在下钳夹两侧的凸棱的外侧平面相配合。
优选的，所述推钮基座的上表面上设有相互垂直的第一凹条和第二凹条，所述推钮上设有可选择性地与所述第一凹条或第二凹条配接的凸条。
一种直线缝切器，包括：可相互闭合或打开的上、下钳夹，相对设置在上、下钳夹远端的钉砧和钉仓，以及用于闭合上、下钳夹的闭合把手；所述钉仓表面沿器械轴线排列设有若干个钉孔，每个钉孔内均设置有相互抵接的推钉片和缝合钉；所述钉仓内设有可沿所述器械轴线同时移动的推钉杆和远端设有切刀的推刀杆，所述推钉杆在移动的过程中依次驱动所述推钉片，所述推钉杆和推刀杆的一端均配设于一滑块上，所述滑块上设有2个可相对所述滑块转动的推钮；所述2个推钮可同时在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换，当所述推钮的操作表面垂直于器械轴线时，所述推钮上的远离枢轴端的操作部伸出于所述上、下钳夹之外；或者，所述2个推钮的其中一个的操作表面垂直于所述器械轴线，而另一个推钮的操作表面平行于所述器械轴线。
优选的，所述推钮上均设有主动齿轮，所述主动齿轮枢轴设于所述滑块上，所述滑块上还设有双数个或单数个与所述主动齿轮啮合的从动齿轮。
优选的，所述推钮与推钮基座的枢轴部分是压电材料。
本发明的有益效果主要体现在：
1.推钮同时打开且伸出于钳夹之外，可以满足特定手术的需求；
2.推钮同时收拢且贴紧于钳夹，可以相对减小器械整体的体积，包装和运输成本也会相对降低；
3.手术完成后，推钮后退并收拢，即起到手术完成的指示作用；
4.推钮的结构简单，装配方便，适于实用。
附图说明
图1是本发明直线缝切器的第一实施例的爆炸图；
图2是本发明直线缝切器的第一实施例的剖视图；
图3是图1中推钮基座和推钮的放大图；
图4是本发明直线缝切器的第一实施例的初始状态的俯视图，此时推钮的轴线平行于器械轴线；
图5是图4的左视图；
图6是图5中沿A-A方向的剖视图；
图7是本发明直线缝切器的第一实施例的工作状态的俯视图，此时推钮的轴线垂直于器械轴线；
图8是图7的左视图；
图9是图8中沿B-B方向的剖视图；
图10是本发明直线缝切器的第二实施例的工作状态的剖视图；
图11是本发明直线缝切器的第三实施例的工作状态的剖视图；
图12是本发明直线缝切器的第一实施例在推钮后退时的剖视图；
图13是本发明直线缝切器的第一实施例在推钮后退完的剖视图，此时推钮与凸棱脱离；
图14是本发明直线缝切器的第四实施例的剖视图；
图15是本发明直线缝切器的第五实施例的初始状态的剖视图；
图16是本发明直线缝切器的第五实施例的工作状态的剖视图。
具体实施方式
如图1、图2所示，本发明揭示了一种直线缝切器，包括：可相互闭合或打开的上、下钳夹1、5，所述上钳夹1的远端设有钉砧3，下钳夹5的远端设有钉仓7，所述下钳夹5上还枢轴设有一个用于闭合上、下钳夹的闭合把手11。
所述下钳夹5为∪形，其内设有可沿所述器械轴线滑动的推钉杆13和远端设有切刀的推刀杆15（图2中揭示），所述钉仓7设置在该U型结构内。所述钉仓7的表面沿器械轴线排列设有若干个钉孔9，一般来讲有四排。每个钉孔9内均设置有相互抵接的推钉片和缝合钉（与现有技术一致，图中未示出）。所述推钉杆13在移动的过程中依次驱动所述推钉片，并将缝合钉推出于所述钉仓的钉孔外。
结合图1-图3，本发明的第一实施例中，所述推钉杆13和推刀杆15的一端均配设于一滑块17上，滑块17的移动可带动推钉杆13和推刀杆15移动。
所述滑块17上设有一个推钮基座21，该推钮基座21在器械轴线方向上与所述滑块17固定，该原理是通过设置在滑块17上的凸起19和设置在推钮基座21上的通孔23配合而达成。当然，所述推钮基座21与滑块17除了上述的分体制造，还可以一体制造，即两者完全固定。
本发明的第一实施例中，所述推钮基座21的两侧各枢轴设有一推钮29，所述2个推钮29相对称。具体如图3所示，所述推钮基座21包括与滑块17固定的本体，以及伸出于所述推钮基座本体两侧的一对相对称的肩部25，所述肩部25上各设有一个枢轴孔27；所述推钮29包括相连的枢轴端31和操作部33；有一销35穿过所述枢轴端31和枢轴孔27，将所述推钮基座21和推钮29枢轴连接。本发明中，该操作部33包括一平面，即推钮的操作表面，操作者施力于此从而推动推钮滑动。
所述推钮基座21的侧面为平滑连接的一平面55和一圆弧面53，所述的推钮29上设有一个可与所述平面55和圆弧面53配合的前推止转平面51。所述推钮29上还设有一个后退止转平面57，与设置在下钳夹5两侧的凸棱59的外侧平面相配合。
下面结合附图来说明第一实施例的操作过程。
结合图4-图6所示，本发明直线缝切器的第一实施例处于初始状态，此时两个推钮29的操作表面均大致平行于所述器械轴线。在该初始状态中，由于推钮29同时贴紧收拢于钳夹，所以器械的外形所占的空间相对较小，因此包装也可以制作的相对较小，原料减少，成本降低。当然，即使本发明的直线缝切器仅仅包括一个推钮29，与现有技术相比，由于没有相对钳夹打开的推钮，所以直线缝切器整体的外形所占空间也是相对较小。另外，在该初始状态中，推钮29的前推止转平面51与推钮基座21的圆弧面53相切，所以该推钮29即可绕所述销35转动。
结合图7-图9所示，本发明直线缝切器的第一实施例处于工作状态，此时两个推钮29的操作表面大致垂直于所述器械轴线，所述推钮29上的远离枢轴端的操作部33伸出于所述上、下钳夹之外，即推钮29处于打开位置。在该工作状态中，由于推钮29的前推止转平面51与推钮基座21的平面55相抵接在一起，则该平面55会限制推钮29继续旋转，因此，推钮29在向远端移动时，由于平面55的反作用力而导致该推钮29与推钮基座21相对固定。此时，医生就可以双手操作推钮29，用以完成特殊手术。
结合图3所示，由于推钮29在两个位置间转动，所以，所述推钮基座21的上表面上还设有相互垂直的第一凹条63和第二凹条65，所述推钮29上设有可选择性地与所述第一凹条63或第二凹条65配接的凸条61。这样，当凸条61进入到第一凹条63内时，推钮29的操作表面平行于所述器械轴线，此时器械处于初始状态；当凸条61进入到第二凹条65内时，推钮29的操作表面垂直于所述器械轴线，此时器械处于工作状态。这样可以进一步地稳定推钮29的位置，使其不会晃动。
图10和图11分别揭示了本发明的第二实施例和第三实施例的工作状态示意图，这两个实施例与第一实施例所述两个推钮29可同时在其操作表面垂直于所述器械轴线和平行于所述器械轴线的两种状态间转换不同的是：两个推钮29可选择地在其操作表面垂直于所述器械轴线和平行于所述器械轴线的两种状态间转换，即第二实施例的左侧的推钮处于工作状态，而第三实施例的右侧的推钮处于工作状态。
以上三个实施例中，所述推钮基座21上起枢轴作用的枢轴孔27之位置位于上、下钳夹的外侧，这样设置的原因在于装配方便，钳夹结构也能相对简单。
图12揭示了第一实施例的直线缝切器在手术完毕后，推钮29沿图中箭头方向后退时的剖视图，由于推钮29的后退止转平面57为一平面，与设置在下钳夹5两侧的凸棱59的外侧平面相配合，平面与平面相互抵接，就会限制推钮29转动，这样推钮就能顺利地从器械的远端后退至图13所揭示的位置。此时，推钮29已经完全后退到位，而后退止转平面57也与凸棱脱离，这样平面之间的作用力消失后，推钮29即可以绕销35转动至初始位置。这样，本发明的推钮还起到一个提示作用，即当推钮可以相对推钮基座转动时，则证明推钮和滑块已经后退到位，器械可以打开，缝合结束。
图14揭示了本发明的第四实施例，所述推钮29上均设有主动齿轮71，所述主动齿轮71枢轴设于所述滑块17上，所述滑块17上还设有一个与所述主动齿轮71啮合的从动齿轮73。这样，所述两个推钮的其中之一的操作表面垂直于所述器械轴线时，而另一个推钮的操作表面随即平行于所述器械轴线。两个推钮相互联动，省去了医生的操作步骤，提高了操作舒适性。
图15、图16揭示了本发明的第五实施例，所述推钮29上均设有主动齿轮71，所述主动齿轮71枢轴设于所述滑块17上，所述滑块17上还设有两个与所述主动齿轮71啮合的从动齿轮73。这样，所述两个推钮29可同时在其操作表面垂直于所述器械轴线和平行于所述器械轴线的两种状态间转换，当所述推钮的操作表面垂直于所述器械轴线时，所述推钮上的远离枢轴端的操作部伸出于所述上、下钳夹之外。
当然，上述第四和第五实施例中的从动齿轮可以扩展到单、双数个，同样可以达到类似的功能。
本发明中所述推钮的关节部分（即推钮和推钮基座的枢轴点）是压电材料，即通电后推钮可以从其操作表面平行于器械轴线的状态转换成垂直于器械轴线的状态。由于该材料为已知材料，因此在此不在赘述。
本发明中所述的推钉杆的一端和切刀的一端配设于所述滑块上，不仅包括所述推钉杆的一端和切刀的一端完全固定于所述滑块上，还包括所述推钉杆和切刀与所述滑块为沿器械轴线方向的固定，因为实际的生产中还会因为操作过程中上下钳夹的一定的变形量，而使所述推钉杆和切刀与所述滑块在垂直于器械轴线方向上有一定的偏移量。当然，该'固定'也包括装配的误差。
本发明中的上、下钳夹的左侧或右侧是指当钉仓表面向上时上、下钳夹的左侧方向或右侧方向。
本发明尚有多种实施方式，凡采用等同变换或者等效变换而形成的所有技术方案，均落在本发明的保护范围之内。

Claims (13)

  1. 一种直线缝切器，包括：可相互闭合或打开的上、下钳夹，相对设置在上、下钳夹远端的钉砧和钉仓，以及用于闭合上、下钳夹的闭合把手；所述钉仓表面沿器械轴线排列设有若干个钉孔，每个钉孔内均设置有相互抵接的推钉片和缝合钉；所述钉仓内设有可沿所述器械轴线同时移动的推钉杆和远端设有切刀的推刀杆，所述推钉杆在移动的过程中依次驱动所述推钉片，其特征在于：所述推钉杆和推刀杆的一端均配设于一滑块上，所述滑块上设有一个推钮基座，该推钮基座与所述滑块相对固定，所述推钮基座上枢轴设有至少一推钮，所述推钮可在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换。
  2. 根据权利要求1所述的直线缝切器，其特征在于：所述推钮基座的两侧各枢轴设有一推钮，所述2个推钮相对称，并可同时在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换。
  3. 根据权利要求1所述的直线缝切器，其特征在于：所述推钮基座的两侧各枢轴设有一推钮，所述2个推钮相对称，并可选择地使其中一个推钮在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换。
  4. 根据权利要求1至3所述的任一种直线缝切器，其特征在于：所述推钮基座与滑块一体或分体制造。
  5. 根据权利要求1至3所述的任一种直线缝切器，其特征在于：所述推钮基座上起枢轴作用的枢轴孔之位置位于上、下钳夹的外侧。
  6. 根据权利要求1至3所述的任一种直线缝切器，其特征在于：所述推钮基座包括与滑块固定的本体，以及伸出于所述推钮基座本体的肩部，所述肩部上设有一个枢轴孔；所述推钮包括相连的枢轴端和操作部；有一销穿过所述枢轴端和枢轴孔，将所述推钮基座和推钮枢轴连接。
  7. 根据权利要求6所述的直线缝切器，其特征在于：所述推钮基座的两侧设有一对相对称的肩部，所述肩部上各枢轴设有一个推钮。
  8. 根据权利要求7所述的直线缝切器，其特征在于：所述推钮基座的侧面为平滑连接的一平面和一圆弧面，所述的推钮上设有一个可与所述平面和圆弧面配合的前推止转平面。
  9. 根据权利要求7所述的直线缝切器，其特征在于：所述推钮上设有一个后退止转平面，与设置在下钳夹两侧的凸棱的外侧平面相配合。
  10. 根据权利要求7所述的直线缝切器，其特征在于：所述推钮基座的上表面上设有相互垂直的第一凹条和第二凹条，所述推钮上设有可选择性地与所述第一凹条或第二凹条配接的凸条。
  11. 一种直线缝切器，包括：可相互闭合或打开的上、下钳夹，相对设置在上、下钳夹远端的钉砧和钉仓，以及用于闭合上、下钳夹的闭合把手；所述钉仓表面沿器械轴线排列设有若干个钉孔，每个钉孔内均设置有相互抵接的推钉片和缝合钉；所述钉仓内设有可沿所述器械轴线同时移动的推钉杆和远端设有切刀的推刀杆，所述推钉杆在移动的过程中依次驱动所述推钉片，其特征在于：所述推钉杆和推刀杆的一端均配设于一滑块上，所述滑块上设有2个可相对所述滑块转动的推钮；
    所述2个推钮可同时在其操作表面垂直于器械轴线和其操作表面平行于器械轴线的两种状态间转换，当所述推钮的操作表面垂直于器械轴线时，所述推钮上的远离枢轴端的操作部伸出于所述上、下钳夹之外；
    或者，所述2个推钮的其中一个的操作表面垂直于所述器械轴线，而另一个推钮的操作表面平行于所述器械轴线。
  12. 根据权利要求11所述的直线缝切器，其特征在于：所述推钮上均设有主动齿轮，所述主动齿轮枢轴设于所述滑块上，所述滑块上还设有双数个或单数个与所述主动齿轮啮合的从动齿轮。
  13. 根据权利要求1或2或3或11所述的任一种直线缝切器，其特征在于：所述推钮与推钮基座的枢轴部分是压电材料。
PCT/CN2012/073717 2011-04-20 2012-04-10 直线缝切器 Ceased WO2012142917A1 (zh)

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EP12773542.1A EP2700366B1 (en) 2011-04-20 2012-04-10 Straight stitching and cutting device
JP2014505494A JP5657173B2 (ja) 2011-04-20 2012-04-10 直線縫合切断装置
ES12773542.1T ES2568742T3 (es) 2011-04-20 2012-04-10 Dispositivo de cosido recto y corte
US14/058,001 US9381017B2 (en) 2011-04-20 2013-10-18 Linear surgical stapler with rotatable operation button

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CN102743202B (zh) 2014-10-29
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EP2700366B1 (en) 2016-03-16
EP2700366A4 (en) 2014-11-26
US20140103094A1 (en) 2014-04-17
ES2568742T3 (es) 2016-05-04
EP2700366A1 (en) 2014-02-26
JP2014518523A (ja) 2014-07-31
JP5657173B2 (ja) 2015-01-21

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