WO2019238094A1 - 一种可拆解的内镜吻合夹 - Google Patents

一种可拆解的内镜吻合夹 Download PDF

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Publication number
WO2019238094A1
WO2019238094A1 PCT/CN2019/091112 CN2019091112W WO2019238094A1 WO 2019238094 A1 WO2019238094 A1 WO 2019238094A1 CN 2019091112 W CN2019091112 W CN 2019091112W WO 2019238094 A1 WO2019238094 A1 WO 2019238094A1
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WIPO (PCT)
Prior art keywords
engaging member
detachable
elastic member
connection
elastic
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/CN2019/091112
Other languages
English (en)
French (fr)
Inventor
钟浩
陈智敏
吕世文
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.)
Ningbo Senscure Biotechnology Co Ltd
Original Assignee
Ningbo Senscure Biotechnology 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 Ningbo Senscure Biotechnology Co Ltd filed Critical Ningbo Senscure Biotechnology Co Ltd
Priority to AU2019284321A priority Critical patent/AU2019284321B2/en
Priority to KR1020207033212A priority patent/KR102539373B1/ko
Priority to JP2021514468A priority patent/JP7245322B2/ja
Priority to EP19820627.8A priority patent/EP3808285B1/en
Priority to BR112020023896-1A priority patent/BR112020023896B1/pt
Publication of WO2019238094A1 publication Critical patent/WO2019238094A1/zh
Priority to US17/087,820 priority patent/US11013518B2/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/083—Clips, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1227—Spring clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/10—Surgical instruments, devices or methods for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00336—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means with a protective sleeve, e.g. retractable or slidable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00862—Material properties elastic or resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0641—Surgical staples, i.e. penetrating the tissue having at least three legs as part of one single body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0645—Surgical staples, i.e. penetrating the tissue being elastically deformed for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B2017/12004—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for haemostasis, for prevention of bleeding

Definitions

  • the present application relates to the technical field of medical devices, and in particular, to a detachable endoscopic stapler.
  • Gastrointestinal bleeding is a common clinical symptom of gastrointestinal diseases. According to the site of bleeding, upper gastrointestinal bleeding and lower gastrointestinal bleeding are divided. Among them, the mortality rate of arterial hemorrhage is high, especially the acute arterial hemorrhage of digestive tract, the mortality rate is about 10%, and the mortality rate of bleeding is higher in patients over 60 years old, which is 30% -50%. In addition, gastrointestinal perforation is also a common clinical disease. Patients with perforation are mostly 30 to 60 years old (75%). The mortality of gastric ulcer perforation is 27%. The older the patient, the higher the mortality.
  • the main clinical method for the treatment of gastrointestinal bleeding and perforation is to use a hemostatic clip device for treatment, such as the Boston Scientific resolution hemostatic clip and Nanjing Minimally Invasive Harmonic Clip.
  • the disadvantages are the small clamping range and clamping force. Not enough. It does not work well for arterial bleeding and perforation.
  • Germany's Ovisco has developed an OTSC anastomosis clip with good clamping force and clamping range, but this product is expensive to sell in China, and it is not easy to remove after release. It needs the company's special arc The cutting device cuts off the staple and then removes it.
  • the present application aims to provide a detachable endoscopic stapler to solve the problems that the stapler is not easily removed and the clamping force is small in the prior art.
  • a detachable endoscope anastomosis clip includes an engaging member and an elastic member.
  • the number of the engaging member and the elastic member is at least two.
  • the end of the engaging member and the end of the elastic member are sequentially connected to form a plurality of connecting portions.
  • At least one of the connection portions is a detachable connection portion.
  • the detachable connection portion adopts a combination of one or more connection modes of a bundle connection, a sleeve connection, a pin connection, and a clamp connection.
  • the end of the engaging member and the elastic member is provided with a limiting portion, and the limiting portion includes a limiting groove, a pin hole, and a clamping groove.
  • the detachable connection portion is connected by a bundle, and the end of the engaging member and the elastic member is provided with a limiting groove.
  • the detachable connection portion is sleeved with a sleeve, the end of the engaging member and the elastic member is provided with a limiting groove, and the sleeve is provided with a clamping portion corresponding to the limiting groove.
  • the detachable connecting portion is connected by a pin, and a pin hole is provided at an end of the engaging member and the elastic member, and the pin fixes the end of the engaging member and the elastic member through the pin hole.
  • the detachable connection portion is connected with a clamp, and an end of the engaging member and the elastic member is provided with a clamping groove matching the clamp.
  • a binding wire, a sleeve, a pin or a clamp used in the connection mode is cooperatively connected with the limiting portion.
  • a pulling portion is provided on the binding wire, the sleeve, the bolt, or the clamp of the detachable connection portion.
  • the engaging member is composed of a first engaging member and a second engaging member
  • the elastic member is composed of a first elastic member and a second elastic member
  • ends of the first engaging member and the second engaging member are respectively connected to the first elastic member and The ends of the second elastic member are connected in sequence to form a plurality of connection portions.
  • At least one of the plurality of connection portions is connected by a detachable connection device. In a natural state, the first engaging member and the second engaging member are in an engaged state. After disassembling the detachable device, the first bite and the second bite can be separated.
  • connection portions located at diagonal positions are detachable connection portions.
  • connection portions are detachable connection portions.
  • the engaging member and the elastic member are integrally formed.
  • the engaging member includes teeth.
  • the elastic member is an extension section on both sides of the engaging member, and the extension section is elastic.
  • the elastic member is made of an elastic metal material.
  • a spiked portion is provided on the bite teeth of the engaging member.
  • the bite is made of a metal material or a polymer material.
  • the elastic member has an arc-shaped structure.
  • the elastic member is a torsion spring structure.
  • the binding connection is a winding binding, and one end of the binding wire is fixed on the engaging member or the elastic member.
  • binding connection is a twisted wire binding
  • the twisted ring is located in the limiting slot.
  • the binding wire is a metal wire or a polymer wire.
  • a pin hole is provided at an end of the engaging member and the elastic member, a sleeve is provided with a through hole corresponding to the pin hole, and the pin is inserted into the through hole and the pin hole to fix the sleeve.
  • the end of the engaging member and the elastic member is provided with a limiting groove
  • the side wall of the sleeve is provided with an opening corresponding to the limiting groove.
  • the limiting groove and the opening of the sleeve wall are bound with a binding wire to fix the sleeve.
  • the number of the engaging members and the elastic members are two, and the two engaging members and the two elastic members are four independent structures connected to form four detachable connecting portions.
  • the number of the engaging members and the elastic members are two, the first engaging member is fixedly connected to the first elastic member, and the second engaging member and the second elastic member are three independent structures, and the three independent structures are connected to form Three detachable connections.
  • the number of the engaging members and the elastic members are two, the first engaging member is fixedly connected to the first elastic member, the second engaging member is fixedly connected to the second elastic member, and the two independent structures are connected to form two located at opposite corners. Removable connection.
  • the number of the engaging members and the elastic members are two.
  • the first elastic member and the second elastic member are respectively fixedly connected to the two ends of the first engaging member, and are connected to the second engaging member to form two adjacent ones. Detachable connection at the corner.
  • the number of the engaging members and the elastic members are two.
  • the curvature of the first elastic member is greater than the curvature of the second elastic member.
  • the first engaging member and the second engaging member are respectively fixed to the two ends of the first elastic member.
  • the end of the second elastic member is fixedly connected to the end of the second engaging member, and the other end is detachably connected to the end of the first engaging member.
  • the number of the engaging members is at least three, the engaging members and the elastic members are fixedly connected, and the ends are connected end-to-end to form a plurality of detachable connecting portions, which are symmetrically distributed in the center.
  • anastomosis clip is installed outside the endoscope transparent cap for use.
  • anastomosis clip is released by being pulled by a pull wire.
  • the detachable endoscope anastomosis clip provided in this application, the connection part of the occlusal part and the elastic part is a detachable connection part, and the structure design is simple and clever, only the disassembly of the detachable connection part is needed to realize the disassembly of the anastomosis clip.
  • the anastomotic clip needs to be completely removed, but the method of dismantling and then removing can be used to achieve rapid removal of the anastomotic clip, which greatly reduces the difficulty of removing the endoscopic anastomotic clip, especially when the teeth of the anastomotic clip are organized
  • covering simply remove the disassembled anastomosis clip parts from the covering tissue to remove the anastomosis clip, reducing the damage to the surrounding tissue when the anastomosis clip is removed.
  • the elastic member is made of an elastic metal material, which can provide a stable and sufficient clamping force for the anastomosis clip;
  • the bite member is made of a metal material or a polymer material, Good biomechanical properties, corrosion resistance, and prolong the service life of the anastomosis clip;
  • a spiked part is provided on the teeth of the occluder, and the occluder is turned inside when released, the spiked part is inserted into the tissue, the tissue is grasped firmly, and the effect is gathered Well, a better clamping effect is achieved.
  • the detachable endoscope anastomosis clip provided in this application can be set at the opposite position of the anastomosis clip, it can also be set adjacent to the anastomosis clip, or it can be set at the middle of the anastomosis clip
  • the position is flexible, and it is more convenient for doctors to operate under the limited endoscopic field of view.
  • FIG. 1 is a schematic structural diagram of an endoscopic stapler according to a first embodiment of the present invention
  • FIG. 2 is a schematic structural diagram of the endoscope stapler shown in FIG. 1 after disassembly
  • FIG. 3 is a front view of the endoscopic stapler shown in FIG. 1;
  • FIG. 4 is a schematic structural view of the endoscope anastomosis clip shown in FIG. 1 after being opened and deformed;
  • FIG. 5 is a schematic structural diagram of an endoscope anastomosis clip in which the elastic member is a torsion spring structure according to the first embodiment of the present invention
  • FIG. 6 is a schematic structural diagram of an endoscope anastomosis clip connected with a twisted wire in a first embodiment of the present invention
  • FIG. 7 is a schematic structural diagram of an endoscope anastomosis clip sleeved by a sleeve according to a first embodiment of the present invention
  • FIG. 8 is a schematic structural diagram of a pin-connected endoscope anastomosis clip according to the first embodiment of the present invention.
  • FIG. 10 is a schematic structural diagram of an endoscope anastomosis clip that is combined with a sleeve socket and a pin connection according to the first embodiment of the present invention
  • FIG. 11 is a schematic structural diagram of an endoscope anastomosis clip that is combined with a sleeve socket and a wire bundle according to the first embodiment of the present invention
  • FIG. 12 is a schematic structural diagram of a diagonally detachably connected endoscope anastomosis clip according to a second embodiment of the present invention.
  • FIG. 13 is a schematic structural view of the endoscope stapler shown in FIG. 12 after disassembly
  • FIG. 14 is a schematic structural diagram of an endoscope anastomosis clip that is detachably connected to adjacent corners in Embodiment 2 of the present invention.
  • FIG. 15 is a schematic structural diagram of the endoscope stapler shown in FIG. 14 after disassembly
  • 16 is a schematic structural diagram of an endoscope stapler with a detachable connection portion according to the second embodiment of the present invention.
  • FIG. 17 is a schematic structural diagram of the endoscope stapler shown in FIG. 16 after disassembly
  • FIG. 18 is a schematic structural diagram of an endoscopic stapler according to a third embodiment of the present invention.
  • FIG. 19 is a schematic structural diagram of the endoscope stapler shown in FIG. 18 after disassembly
  • FIG. 20 is a schematic structural diagram of an endoscopic stapler according to a fourth embodiment of the present invention.
  • FIG. 21 is a schematic structural view of the endoscope anastomosis clip shown in FIG. 20 after being opened and deformed; FIG.
  • FIG. 22 is a schematic diagram of the installation and release of the endoscope stapler shown in FIG. 1.
  • FIG. 22 is a schematic diagram of the installation and release of the endoscope stapler shown in FIG. 1.
  • the first engaging member 2. The first elastic member; 3. The second engaging member; 4. The second elastic member; 5. The binding line; 6. The pulling portion; 7. The sleeve; 8. The pin; 9. Transparent cap; 10, pull line; 11, connecting part; 12, clamp.
  • the anastomosis clip includes a first engaging member 1, a first elastic member 2, a second engaging member 3, and a second elastic member 4. Both the first engaging member 1 and the second engaging member 3 include a bite. The teeth and the protruding section, the ends of the first engaging member 1, the first elastic member 2, the second engaging member 3, and the second elastic member 4 are connected end to end to form four detachable connecting portions 11, and the detachable connecting portion 11 is detachable by The connection device is connected. In a natural state, the first engaging member and the second engaging member are in an engaged state.
  • the detachable connection device is a binding wire 5, and the detachable connection portion 11 is connected by wire binding.
  • the detachable connection portion 11 in the connection state includes an end of the first engaging member 1, an end of the first elastic member 2, and a wound binding. Line 5.
  • Limiting portions are provided at the ends of the two engaging members and the two elastic members to restrict the positions of the elastic member and the engaging member and the binding line 5.
  • the limiting portion is a limiting groove
  • the binding line 5 is a metal wire or a polymer wire. The binding is completed after winding, and the disassembly can be completed by rewinding the binding wire 5.
  • the binding wire 5 is preferably stainless steel wire.
  • the stainless steel wire can be wound to maintain a certain shape, and can be tightened without knotting. The operation is convenient and the fixing effect is good.
  • the binding wire 5 is a monofilament without winding, thereby avoiding the knotting of the binding wire 5 during disassembly, which is convenient for the rapid disassembly and removal of the staple.
  • one end of the binding wire 5 is fixed to one of the occlusion members or an elastic member to ensure that after the disassembly of the anastomosis clip, the binding wire is maintained in a connected state with one of the occlusion members or elastic members, which is convenient for grasping. Remove the staples.
  • the free end of the binding wire 5 is provided with a ring-shaped pulling portion 6.
  • the disassembly device is inserted into the ring-shaped pulling portion 6, and then looped in the reverse winding direction. Disassembly of the binding line.
  • the first elastic member and the second elastic member are made of an elastic metal material, such as spring steel, which has a large clamping force, and a nickel-titanium memory alloy material is preferred. Its own plastic deformation automatically returns to its original shape at the use temperature, thereby providing a continuous and stable clamping force.
  • the first elastic member and the second elastic member may have a long structure, preferably an arc-shaped structure, and the arc-shaped elastic member may also have a torsion spring structure as shown in FIG. 5.
  • the anastomosis clip is arched in a natural state, and the teeth of the occluder are covered with tissue after being released, and the detachable connection portion is exposed outside the tissue.
  • the bite is made of a material with good elasticity, such as spring steel or nickel-titanium alloy, or a polymer material with good elasticity, such as polyoxymethylene.
  • the shape of the bite is a rake-like structure or a needle-like structure, and a spike is provided on the bite teeth. When the staple is released, the bite is turned inward, and the spike is easier to penetrate into the tissue, and the tissue is grasped firmly and gathered. The effect is good, and a better clamping effect is achieved.
  • the binding connection may also be a twisted wire binding connection.
  • the twisted wire is placed in the limiting groove to tighten the ends of the engaging member and the elastic member, and the binding is completed. Unscrew the thread, disassemble the staple and then remove it.
  • the binding wire is made of a hard material, preferably a metal wire. The metal wire is securely bound and convenient to operate. Ring-shaped pulling portions 6 may be provided at both ends of the twisted wire after the binding to reduce the difficulty of disassembling and removing the binding wire.
  • the detachable connecting portion 11 may also be sleeved with a sleeve.
  • a sleeve As shown in FIG. 7, the ends of the first engaging member 1, the second engaging member 3, the first elastic member 2 and the second elastic member 4
  • the slot 7 is provided with a limiting groove
  • the sleeve 7 is provided with a locking portion corresponding to the limit groove.
  • the locking portion on the sleeve 7 cooperates with the limiting groove to achieve a socket.
  • the sleeve 7 is provided with a spherical pulling portion 6 ,
  • the anastomotic clip can be disassembled by removing the sleeve 7, and the operation is simple and convenient.
  • the sleeve 7 is made of a hard material, preferably a metal sleeve. The metal sleeve is not easily deformed, is stronger, has a better fixing effect, and has a longer service life.
  • the detachable connecting portion 11 may also be connected by pins.
  • the ends of the first engaging member 1, the second engaging member 3, the first elastic member 2, and the second elastic member 4 are provided.
  • the limiting portion is a pin hole, and the pin 8 matched with the pin hole fixes the ends of the first engaging member 1, the second engaging member 3, the first elastic member 2 and the second elastic member 4 through the pin hole, and fixes the pin 8
  • the stapler can be disassembled by taking it out of the pin hole, and the operation is simple and convenient.
  • the detachable connecting portion 11 may also be connected by a clamp.
  • the ends of the first engaging member 1, the second engaging member 3, the first elastic member 2 and the second elastic member 4 are shown in FIG. 9.
  • a clamping groove is provided, and the clamp 12 cooperates with the clamping groove to fix the ends of the first engaging member 1, the second engaging member 3, the first elastic member 2 and the second elastic member 4, and then remove the clamp 12 Disassembling the stapler is simple and convenient.
  • the detachable connection portion 11 may also use a combination of a bushing socket and a pin connection.
  • the bushing 7 is provided with a through hole corresponding to the pin hole, and the pin 8 passes through the through hole and The pin hole connects the end of the engaging member and the elastic member.
  • the pin 8 not only plays a role of reinforcing the connection, but also prevents the sleeve 7 from coming out.
  • the detachable connecting portion 11 may also adopt a combination of sleeve sleeve connection and binding connection. As shown in FIG. 11, an opening is provided on the side of the sleeve 7, and the opening is aligned with the limiting groove, and the binding line is in the sleeve. The tube opening and the limiting slot are bundled together.
  • the binding wire 5 is preferably a metal wire, and can be bundled by winding or twisting. When removing the anastomosis clip, first untie the binding line 5 and then pull out the sleeve 7 to split the anastomosis clip and then remove it.
  • detachable connection methods of the bundled connection, sleeve socket connection, pin connection, or clamp connection used in this embodiment are applicable to all embodiments of this application, and will not be described one by one in other embodiments.
  • technical solutions using other detachable connection modes are also within the protection scope of this application.
  • FIGS. 12 to 17 show a second embodiment of the detachable endoscopic anastomosis clip of the present application.
  • the difference between this embodiment and the first embodiment is that the first engaging member 1 or the second engaging member 3 and the second The elastic member 2 or the second elastic member 4 is fixedly connected.
  • the anastomosis clip includes a first engaging member 1, a second engaging member 3, a first elastic member 2 and a second elastic member 4, and the first engaging member 1 and the second engaging member 3 each include a bite.
  • the teeth and the protruding section, the first engaging member 1 and the first elastic member 2 are fixedly connected, the second engaging member 3 and the second elastic member 4 are fixedly connected, and two independent structures are connected to form two detachable connecting portions at diagonal positions. 11.
  • the first elastic member 2 and the second elastic member 4 are fixedly connected to the two ends of the second engaging member 3 respectively, and are independent of each other with the first engaging member 1 and two independent structures.
  • the connection forms two detachable connection portions 11 at adjacent corners.
  • the two ends of the first elastic member 2 are fixedly connected to the ends of the first engaging member 1 and the second engaging member 3, and one end of the second elastic member 4 is engaged with the second engaging member.
  • the end portion of the piece 3 is fixedly connected, and the other end portion is detachably connected to the end portion of the first bite piece 1, such as a bundle connection.
  • the curvature of the first elastic member 2 is greater than the curvature of the second elastic member 4.
  • the anastomosis clip In a natural state, the anastomosis clip has a flat four-corner shape, and the first elastic member 2 and the second elastic member 4 The bending deformation occurs in the opening, but due to different curvatures, the rebound force of the first elastic member 2 is greater than that of the second elastic member 4.
  • the bundled binding line 5 is first untied.
  • the first elastic member 2 rebounds a lot, which drives the first engaging member 1 and the second engaging member 3 to open to one side, thereby releasing the first engaging member. 1 and the second occluder 3 pinch the tissue, and then remove the disassembled stapler.
  • the anastomosis clip of this structure reduces the number of disassembly and makes disassembly easier by virtue of the greater resilience of the first elastic member 2.
  • the detachable connection part of the anastomosis clip adopts a combination of a sleeve socket and a pin connection, and the engaging member is made of an elastic metal material.
  • the stretched sections on both sides of the first occlusal member 1 and the stretched sections on both sides of the second occluder member 3 are elastic.
  • the elastic members are the elongated sections on both sides of the occlusal member, and in a natural state, they are curved to the occlusal surface
  • the ends of the extended sections of the first and second engaging members 1 and 3 are provided with pin holes, the corresponding through holes are provided in the sleeve 7 and the pins 8 extend the first and second engaging members 1 and 2 through the pin holes.
  • the ends of the extended part of the occlusal part 3 are connected to form two symmetrically arranged detachable connecting parts located in the middle of the endoscope anastomosis clip.
  • the detachable connection part 11 includes the end of the extended part of the first occluder 1 and the second occluder 3 Extension section end, sleeve 7 and pin 8.
  • the sleeve 7 is preferably a metal sleeve
  • the pin 8 is preferably a metal pin.
  • the sleeve 7 or the pin 8 made of metal material can enhance the stability of the anastomosis clip connection and prolong the service life of the anastomosis clip.
  • the connecting part can be sleeved only with a sleeve, the end of the elastic member is provided with a limiting groove, and the sleeve 7 is provided with a clamping portion corresponding to the limiting groove.
  • the number of parts is small, the assembly and disassembly is easy, and it is not easy to lose. Components.
  • the number of pin holes and bushing through holes at the end of the elastic member may be one or more, and the number of pin pins is matched with it, and the specific number is selected according to circumstances.
  • the material of the elongated section of the first and second engaging members 1 and 3 is preferably a nickel-titanium memory alloy material, which can provide a stable and durable clamping force for the anastomotic clip, and the clamping effect is better.
  • the end of the pin 8 that is not inserted into the pin hole is provided with a ring-shaped pulling portion 6 for easy grasping and removal.
  • the anastomosis clip includes six occlusal members symmetrically distributed in the center.
  • the occlusal member 1 and the elastic member 2 are integrally formed. 1 includes teeth, the elastic member 2 is an elongated section on both sides of the engaging member 1, and the elongated section has elasticity.
  • the extended sections of the integrally formed occlusal member on both sides are curved back to the teeth.
  • the six detachable connection sections 11 formed by the end of the extended sections of the six occluded members are located at the six corners of the anastomosis clip.
  • the detachable connection portion adopts a bundle connection.
  • the detachable connection portion 11 in the connected state includes an end of an extended portion of the occlusal member and a wrapped binding wire 5.
  • the anastomotic clip in a natural state has a flat hexagonal star shape.
  • the ends of the protruding parts of the occlusal members are bundled and connected in order to realize the installation of the anastomosis clip.
  • the disassembly of the anastomosis clip can be achieved.
  • the engaging member is made of an elastic metal material, preferably a nickel-titanium memory alloy material, which can provide a stable and continuous clamping force and a better clamping effect.
  • the binding wire 5 is preferably a metal wire, such as stainless steel wire, which has a good binding effect.
  • one end of the binding line 5 is fixed to the extended portion of the occlusion member, and a ring-shaped pulling portion 6 is provided at the free end of the binding line. .
  • the number of the symmetric engaging elements is at least three, and the specific number is selected according to circumstances.
  • FIG. 22 is a schematic diagram of the installation and release of the endoscope stapler shown in FIG. 1.
  • the first elastic member 2 and the second elastic member 4 of the stapler are bent, and the first elastic member 2 and the second elastic member 4 are bent and deformed.
  • the first engaging member 1 and the second engaging member 3 are driven to turn outward, and the teeth are turned out, and the anastomosis clip in this state is installed outside the transparent cap 9 on the inner lens end.
  • the first and second engaging members 1 and 3 of the anastomosis clip are in an open state, and the spikes provided on the bite teeth point toward the end of the transparent cap.
  • the transparent cap 9 is detached and released.
  • the first elastic member 2 and the second elastic member 4 quickly recover the shape, driving the teeth of the first engaging member 1 and the second engaging member 3 to turn inward, grasp and gather. organization.
  • the dismantling instrument After the clamped tissue has healed, access the dismantling instrument through the endoscopic instrument channel, grab the ring-shaped pulling portion 6 of the binding wire 5, and unwind the winding wire in the opposite direction of the winding, and then disassemble the anastomotic clip. Removal, greatly reducing the difficulty of removing the staples. It should be noted that the method for releasing anastomosis clips provided in this embodiment is applicable to all embodiments of the present application.

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Abstract

一种可拆解的内镜吻合夹，属于医疗器械技术领域，解决了现有技术中吻合夹不容易移除、夹闭力小的问题。该可拆解的内镜吻合夹，包括咬合件（1,3）和弹性件（2,4），咬合件（1,3）和弹性件（2,4）的数量至少为两个，咬合件（1,3）的端部与弹性件（2,4）的端部依次连接构成多个连接部（11），多个连接部（11）中的至少一个连接部（11）为可拆卸连接部。采用该吻合夹能够实现术后方便快捷的拆解和移除。

Description

一种可拆解的内镜吻合夹 技术领域
本申请涉及医疗器械技术领域，尤其涉及一种可拆解的内镜吻合夹。
背景技术
消化道出血是消化道疾病临床常见的症状，根据出血的部位分上消化道出血和下消化道出血。其中，动脉出血的死亡率较高，尤其是消化道急性动脉出血，死亡率约为l0％，60岁以上患者出血死亡率更高，为30％～50％。除此之外，消化道穿孔也是临床常见疾病，穿孔病人的年龄多在30～60岁(占75％)，胃溃疡穿孔的病死率为27％，年龄越大，病死率越高。
目前临床上治疗消化道出血和穿孔的主要办法是采用一种止血夹的器械进行治疗，如波士顿科学公司的resolution止血夹和南京微创的和谐夹，其缺点是夹闭范围小，夹闭力不够，针对动脉性出血的和穿孔起不到很好的治疗效果。针对这些不足，德国奥维思科公司开发出具有良好夹闭力及夹闭范围的OTSC吻合夹，但该产品在国内销售价格昂贵，且释放后就不容易移除，需要借助该公司特制的电弧切割装置切断吻合夹后再移除。
目前市场上的内镜吻合夹大多为一体制造，不能拆解，术后只能将整个吻合夹取出，移除操作困难大，而且将吻合夹整体移除的过程中容易对组织造成二次损伤，吻合夹的术后移除更加困难，上述问题亟需解决。
发明内容
鉴于上述的分析，本申请旨在提供一种可拆解的内镜吻合夹，用以解决现有技术中吻合夹不容易移除、夹闭力小的问题。
本申请的目的主要是通过以下技术方案实现的：
一种可拆解的内镜吻合夹，包括咬合件和弹性件，咬合件和弹性件的数量至少为两个，咬合件的端部与弹性件的端部依次连接构成多个连接部，多个连接部中的至少一个连接部为可拆卸连接部。
在上述方案的基础上，本申请还做了如下改进：
进一步地，可拆卸连接部采用捆绑连接、套管套接、销连接、卡箍连接中的一种或多种连接方式的组合。
进一步地，咬合件和弹性件的端部设有限位部，限位部包括限位槽、销孔和卡槽。
更进一步地，可拆卸连接部采用捆绑连接，咬合件和弹性件的端部设有限位槽。
更进一步地，可拆卸连接部采用套管套接，咬合件和弹性件的端部设有限位槽，套管设有与限位槽对应的卡制部。
更进一步地，可拆卸连接部采用销连接，咬合件和弹性件的端部设有销孔，销通过销孔将咬合件和弹性件的端部固定。
更进一步地，可拆解连接部用卡箍连接，咬合件和弹性件端部设有与卡箍配合的卡槽。
进一步地，连接方式采用的捆绑线、套管、插销或卡箍与限位部配合连接。
进一步地，可拆卸连接部的捆绑线、套管、插销或卡箍上设有牵拉部。
进一步地，咬合件由第一咬合件和第二咬合件组成，弹性件由第一弹性件和第二弹性件组成，第一咬合件和第二咬合件的端部分别与第一弹性件和第二弹性件的端部依次连接构成多个连接部，多个连接部中的至少一个连接部通过可拆卸连接装置连接，在自然状态时第一咬合件与第二咬合件为咬合状态，拆解可拆卸装置后能够实现第一咬合件与第二咬合件分离。
进一步地，在多个连接部中，位于对角位的连接部为可拆卸连接部。
进一步地，在多个连接部中，相邻的两个连接部为可拆卸连接部。
进一步地，咬合件与弹性件一体成型，咬合件包括咬齿，弹性件为咬合件的两侧伸长段，所述伸长段具有弹性。
进一步地，弹性件由弹性金属材料制成。
进一步地，咬合件咬齿上设有尖刺部。
进一步地，咬合件由金属材料或高分子材料制成。
进一步地，弹性件为弧形结构。
进一步地，弹性件为扭簧结构。
进一步地，捆绑连接为绕线捆绑，捆绑线的一端固定在咬合件或弹性件上。
进一步地，捆绑连接为拧线捆绑，拧线环位于限位槽内。
进一步地，捆绑线为金属线或高分子线。
进一步地，咬合件和弹性件的端部设有销孔，套管设有与销孔对应的通孔，销插入通孔和销孔固定套管。
进一步地，咬合件和弹性件的端部设有限位槽，套管侧壁设有与限位槽对应的开口，在限位槽和套管壁开口处进行用捆绑线捆绑以固定套管。
进一步地，咬合件和弹性件的数量均为两个，两个咬合件和两个弹性件为四个独立结构，连接形成四个可拆卸连接部。
进一步地，咬合件和弹性件的数量均为两个，第一咬合件与第一弹性件为固定连接，与第二咬合件和第二弹性件为三个独立结构，三个独立结构连接形成三 个可拆卸连接部。
进一步地，咬合件和弹性件的数量均为两个，第一咬合件与第一弹性件固定连接，第二咬合件与第二弹性件固定连接，两个独立结构连接形成两个位于对角的可拆卸连接部。
进一步地，咬合件和弹性件的数量均为两个，第一弹性件和第二弹性件分别与第一咬合件的两个端部固定连接，与第二咬合件连接形成两个位于相邻角的可拆卸连接部。
进一步地，咬合件和弹性件的数量均为两个，第一弹性件的曲率大于第二弹性件的曲率，第一咬合件和第二咬合件分别与第一弹性件的两个端部固定连接，第二弹性件的端部与第二咬合件的端部固定连接，另一端与第一咬合件的端部可拆卸连接。
进一步的，咬合件的数量至少为三个，咬合件和弹性件固定连接，端部首尾连接构成多个可拆卸连接部，呈中心对称分布。
进一步地，吻合夹安装在内镜透明帽外使用。
进一步地，吻合夹由拉线牵拉释放。
与现有技术相比，本申请有益效果如下：
a)本申请提供的可拆解的内镜吻合夹，咬合件和弹性件连接部为可拆卸连接部，结构设计简单巧妙，只需要解开可拆卸连接部即实现吻合夹的拆解，不需要将吻合夹完整移除，而是采用先拆解后移除的方式，就能够实现吻合夹的快速移除，大大降低了内镜吻合夹的移除难度，尤其当吻合夹咬齿被组织覆盖时，只需要将拆解后的吻合夹零件从覆盖组织中拔出即可移除吻合夹，减少吻合夹取出时对周围组织带来的损伤。
b)本申请提供的可拆解的内镜吻合夹，弹性件由弹性金属材料制成，能够为吻合夹提供持续稳定足够大的夹闭力；咬合件由金属材料或高分子材料制成，生物力学性能好，耐腐蚀，延长了吻合夹的使用寿命；在咬合件的咬齿上设有尖刺部，释放时咬合件内翻，尖刺部扎进组织，组织抓取牢，收拢效果好，实现了更好的夹闭效果。
c)本申请提供的可拆解的内镜吻合夹，可拆卸连接部既可以被设置在吻合夹的对位，也可以被设置在吻合夹的邻位，还可以被设置在吻合夹的中部，位置灵活多变，在有限的内镜视野下，更便于医生操作。
本申请中，上述各技术方案之间还可以相互组合，以实现更多的优选组合方案。本申请的其他特征和优点将在随后的说明书中阐述，并且，部分优点可从说明书中变得显而易见，或者通过实施本申请而了解。本申请的目的和其他优点可通过说明书、权利要求书以及附图中所特别指出的内容中来实现和获得。
附图说明
附图仅用于示出具体实施例的目的，而并不认为是对本申请的限制，在整个附图中，相同的参考符号表示相同的部件。
图1为本实用新型实施例一的内镜吻合夹的结构示意图；
图2为图1所示内镜吻合夹拆解后的结构示意图；
图3为图1所示内镜吻合夹的主视图；
图4为图1所示内镜吻合夹张开变形后的结构示意图；
图5为本实用新型实施例一的弹性件为扭簧结构的内镜吻合夹的结构示意图；
图6为本实用新型实施例一的拧线捆绑连接的内镜吻合夹的结构示意图；
图7为本实用新型实施例一的套管套接的内镜吻合夹的结构示意图；
图8为本实用新型实施例一的销连接的内镜吻合夹的结构示意图；
图9为本实用新型实施例一的卡箍连接的内镜吻合夹的结构示意图；
图10为本实用新型实施例一的套管套接和销连接组合连接的内镜吻合夹的结构示意图；
图11为本实用新型实施例一的套管套接和线捆绑组合连接的内镜吻合夹的结构示意图；
图12为本实用新型实施例二的对角位可拆卸连接的内镜吻合夹的结构示意图；
图13为图12所示内镜吻合夹拆解后的结构示意图；
图14为本实用新型实施例二的相邻角可拆卸连接的内镜吻合夹的结构示意图；
图15为图14所示内镜吻合夹拆解后的结构示意图；
图16为本实用新型实施例二的具有一个可拆卸连接部的内镜吻合夹的结构示意图；
图17为图16所示内镜吻合夹拆解后的结构示意图；
图18为本实用新型实施例三的内镜吻合夹的结构示意图；
图19为图18所示内镜吻合夹拆解后的结构示意图；
图20为本实用新型实施例四的内镜吻合夹的结构示意图；
图21为图20所示内镜吻合夹张开变形后的结构示意图；
图22为图1所示内镜吻合夹安装释放示意图。
附图标记：
1、第一咬合件；2、第一弹性件；3、第二咬合件；4、第二弹性件；5、捆绑线；6、牵拉部；7、套管；8、销；9、透明帽；10、拉线；11、连接部；12、卡箍。
具体实施方式
下面结合附图来具体描述本申请的优选实施例，其中，附图构成本申请一部分，并与本申请的实施例一起用于阐释本申请的原理，并非用于限定本申请的范围。
实施例一
图1至图11示出了本申请可拆解的内镜吻合夹的第一种实施方式。如图1至图5所示，吻合夹包括第一咬合件1、第一弹性件2、第二咬合件3和第二弹性件4，第一咬合件1和第二咬合件3均包括咬齿和伸出段，第一咬合件1、第一弹性件2、第二咬合件3和第二弹性件4的端部首尾相连形成四个可拆卸连接部11，可拆卸连接部11通过可拆卸连接装置连接，在自然状态时第一咬合件与第二咬合件为咬合状态，拆解可拆卸连接装置后能够实现第一咬合件与第二咬合件分离。可拆卸连接装置为捆绑线5，即可拆卸连接部11采用绕线捆绑连接，连接状态下的可拆卸连接部11包括第一咬合件1端部、第一弹性件2端部以及缠绕的捆绑线5。两个咬合件和两个弹性件的端部均设置限位部以约束弹性件和咬合件以及捆绑线5的位置，限位部为限位槽，捆绑线5为金属线或高分子线，经缠绕完成捆绑，捆绑线5反绕即可完成拆解。
为了达到更好的捆绑效果，捆绑线5优选不锈钢丝，不锈钢丝经缠绕能够维持一定形状，不需要打结即可绑紧，操作方便，固定效果好。捆绑线5为单丝不叠压缠绕，从而避免了拆解过程中捆绑线5打结，便于吻合夹的快速拆解移除。
为了便捷地移除吻合夹，捆绑线5的一端固定在其中一个咬合件或一个弹性件上，保证吻合夹拆解后，捆绑线与其中的一个咬合件或弹性件保持连接状态，便于抓取移除吻合夹。
为了更便捷地移除吻合夹，捆绑线5的自由端设有环形的牵拉部6，在拆解吻合夹时，将拆解器械插入环形牵拉部6内，再反缠绕方向绕圈实现捆绑线的拆解。
为了提供持续稳定的夹闭力，第一弹性件和第二弹性件由弹性金属材料制成，如弹簧钢，夹闭力度大，优选镍钛记忆合金材料，该材料制成的弹性件能将自身的塑性变形在使用温度下自动恢复为原始形状，从而提供持续稳定的夹闭力。第一弹性件和第二弹性件可以为长条状结构，优选弧形结构，弧形弹性件还可以为如图5所示的扭簧结构。为了便于吻合夹拆解，吻合夹在自然状态时呈拱形，释放后咬合件咬齿被组织覆盖，可拆卸连接部露出在组织外。
为了确保咬合效果，咬合件由弹性良好的材料，如弹簧钢或镍钛合金制成，或由弹性良好的高分子材料如聚甲醛材质制成。进一步，咬合件的形状为耙状结 构或针状结构，并在咬齿上设有尖刺部，吻合夹释放时咬合件内翻，尖刺部更容易扎进组织，组织抓取牢，收拢效果好，实现了更好的夹闭效果。
在本实施例中，捆绑连接还可以是拧线捆绑连接，如图6所示，将拧线置于限位槽内拧紧咬合件和弹性件端部，完成捆绑，按拧线的反方向解开拧线，将吻合夹先拆分后取出。捆绑线为硬质材质制成，优选金属线，金属线捆绑牢靠，操作方便，在捆绑后的拧线两端可设有环形牵拉部6，降低捆绑线的拆解和移除难度。
在本实施例中，可拆卸连接部11还可以采用套管套接，如图7所示，第一咬合件1、第二咬合件3、第一弹性件2和第二弹性件4的端部设有限位槽，套管7设有与限位槽对应的卡制部，套管7上的卡制部与限位槽配合以实现套接，套管7上设有球形牵拉部6，取下套管7即可拆解吻合夹，操作简单方便。套管7由硬质材质制成，优选金属套管，金属套管不易变形，更结实，固定效果更好，使用寿命更长。
在本实施例中，可拆卸连接部11还可以采用销连接，如图8所示，第一咬合件1、第二咬合件3、第一弹性件2和第二弹性件4的端部设置的限位部为销孔，与销孔配合的销8通过销孔将第一咬合件1、第二咬合件3、第一弹性件2和第二弹性件4的端部固定，将销8从销孔中取出即可拆解吻合夹，操作简单方便。
在本实施例中，可拆卸连接部11还可以采用卡箍连接，如图9所示，第一咬合件1、第二咬合件3、第1弹性件2和第二弹性件4的端部设有卡槽，卡箍12与卡槽配合，将第一咬合件1、第二咬合件3、第一弹性件2和第二弹性件4的端部固定，取下卡箍12，即可将吻合夹拆解，操作简单方便。
在本实施例中，可拆卸连接部11还可以采用套管套接和销连接的组合，如图10所示，套管7上设有与销孔对应的通孔，销8通过通孔和销孔将咬合件和弹性件的端部连接，销8不仅起到加固连接作用，还能够防止套管7脱出。移除吻合夹时，先拔掉销8，再拔掉套管7使吻合夹先拆分再移除，方便快捷。
本实施例中，可拆卸连接部11还可以采用套管套接和捆绑连接的组合形式，如图11所示，套管7侧面设有开口，开口处与限位槽对齐，捆绑线在套管开口和限位槽内进行捆绑连接。捆绑线5优选金属线，可绕线捆绑也可拧线捆绑。移除吻合夹时，先解开捆绑线5，再拔掉套管7，将吻合夹拆分再移除。
需要特别说明的是，本实施例中采用的捆绑连接、套管套接、销连接或卡箍连接的可拆卸连接方式适用于本申请所有实施例，在其他实施例中不再一一说明。另外，采用其他可拆卸连接方式的技术方案也在本申请保护范围之内。
实施例二
图12至图17示出了本申请可拆解的内镜吻合夹的第二种实施方式，本实施例与实施例一的区别在于，第一咬合件1或第二咬合件3与第二弹性件2或第二弹性件4固定连接。
如图12至图13所示，吻合夹包括第一咬合件1、第二咬合件3、第一弹性件2和第二弹性件4，第一咬合件1和第二咬合件3均包括咬齿和伸出段，第一咬合件1与第一弹性件2固定连接，第二咬合件3与第二弹性件4固定连接，两个独立结构连接形成两个位于对角位的可拆卸连接部11。
如图14至图15所示，第一弹性件2和第二弹性件4分别与第二咬合件3的两个端部固定连接，与第一咬合件1互为独立结构，两个独立结构连接形成两个位于相邻角的可拆卸连接部11。
如图16至图17所示，第一弹性件2的两个端部与第一咬合件1和第二咬合件3的端部固定连接，第二弹性件4的一个端部与第二咬合件3的端部固定连接，另一个端部与第一咬合件1的端部可拆卸连接，如捆绑连接。为了实现更好的拆解移除吻合夹，第一弹性件2的曲率大于第二弹性件4的曲率，自然状态时，吻合夹呈平面四角形态，第一弹性件2和第二弹性件4张开发生弯曲变形，但因曲率大小不同，第一弹性件2的回弹力大于第二弹性件4的回弹力。拆解吻合夹时，先解开捆绑的捆绑线5，第一弹性件2发生回弹的幅度大，带动第一咬合件1和第二咬合件3向一侧打开，从而解除第一咬合件1和第二咬合件3对组织的夹闭状态，再将拆解的吻合夹移除。此结构的吻合夹，借助第一弹性件2的更大回弹力，减少了拆解次数，拆解更容易。
实施例三
图18至图19示出了本申请可拆解的内镜吻合夹的第三种实施方式，吻合夹的可拆卸连接部采用套管套接和销连接组合，咬合件由弹性金属材料制成，第一咬合件1的两侧伸长段和第二咬合件3的两侧伸长段具有弹性，弹性件为咬合件的两侧伸长段，自然状态下呈向咬合面弯曲的弧形，第一咬合件1和第二咬合件3伸长段的端部均设有销孔，套管7设置对应的通孔，销8通过销孔将第一咬合件1伸长段和第二咬合件3伸长段的端部连接形成两个对称设置的位于内镜吻合夹中部的可拆卸连接部，可拆卸连接部11包括第一咬合件1伸长段端部、第二咬合件3伸长段端部、套管7和销8。安装时，先将咬合件伸长段端部插入套管7，再将销8插入销孔和通孔完成吻合夹的安装，拆解时先拔下销8，再从套管7中抽出咬合件实现吻合夹的拆解。该结构的吻合夹，自然状态时呈拱起的椭圆形。
本实施例中，套管7优选金属套管，销8优选金属销，采用金属材质的套管7或销8，能够增强吻合夹连接的稳定性，延长吻合夹的使用寿命。
本实施例中，连接部可以仅用套管套接，弹性件的端部设有限位槽，套管7 设有与限位槽对应的卡制部，零件数量少，拆装方便，不易丢失零件。
本实施例中，弹性件端部销孔和套管通孔数量可以是一个也可以是多个，销插销数量与之匹配，具体数量视情况选取。
为提升吻合夹的夹闭效果，第一咬合件1和第二咬合件3伸长段材质优选镍钛记忆合金材质，能够为吻合夹提供稳定持久的夹闭力，夹闭效果更好。
为降低吻合夹的移除难度，销8未插入销孔的一端设置环形牵拉部6，便于抓取移除。
实施例四
图20至图21示出了本申请可拆解的内镜吻合夹的第四种实施方式，吻合夹包括六个呈中心对称分布的咬合件，咬合件1与弹性件2一体成型，咬合件1包括咬齿，弹性件2为咬合件1的两侧伸长段，伸长段具有弹性。一体成型的咬合件两侧伸长段呈背向咬齿弯曲的弧形，六个咬合件的伸长段端部首尾相连形成的六个可拆卸连接部11位于吻合夹的六个角，可拆卸连接部采用捆绑连接，连接状态下的可拆卸连接部11包括咬合件伸长段的端部和缠绕的捆绑线5，自然状态下的吻合夹呈平面六角星形。安装时，将咬合件伸出段的端部依次捆绑连接即实现吻合夹的安装，拆解时拆解捆绑线即可实现吻合夹的拆解。
优选地，咬合件由弹性金属材料制成，优选镍钛记忆合金材料，能够提供稳定持续的夹闭力，夹闭效果更好。
优选地，捆绑线5优选金属线，如不锈钢丝，捆绑效果好。
为了方便快捷的拆解吻合夹，在捆绑线5的一端固定在咬合件伸长段上，捆绑线的自由端设有环形牵拉部6，此结构使得吻合夹的拆解和移除更加快捷。
本实施例中，呈中心对称的咬合件的数量至少为三个，具体数量视情况选取。
图22为图1所示内镜吻合夹安装释放示意图，吻合夹释放前先弯曲吻合夹的第一弹性件2和第二弹性件4，第一弹性件2和第二弹性件4弯曲变形并带动第一咬合件1和第二咬合件3向外翻转，咬齿呈外翻状态，将此状态下的吻合夹在内镜头端的透明帽9外完成安装。安装完成后，吻合夹的第一咬合件1和第二咬合件3呈张开状态，咬齿上设置的尖刺部指向透明帽末端，拽动拉线10驱动吻合夹向透明帽9末端移动从透明帽9脱离并释放，在释放的瞬间，第一弹性件2和第二弹性件4迅速恢复形状，带动第一咬合件1和第二咬合件3的咬齿向内翻转，抓住并收拢组织。待夹闭的组织愈合后，再从内镜器械通道通入拆解器械，抓住捆绑线5的环形牵拉部6，按绕线的反方向解开缠绕线，将吻合夹先拆分再移除，大大降低了吻合夹的移除难度。需要特别说明的是，本实施例提供的吻合夹的释放方法适用于本申请所有实施例。
以上所述，仅为本申请较佳的具体实施方式，但本申请的保护范围并不局限 于此，任何熟悉本技术领域的技术人员在本申请揭露的技术范围内，可轻易想到的变化或替换，都应涵盖在本申请的保护范围之内。

Claims (10)

  1. 一种可拆解的内镜吻合夹，包括咬合件和弹性件，其特征在于，所述咬合件和所述弹性件的数量至少为两个，所述咬合件的端部与弹性件的端部依次连接构成多个连接部，多个所述连接部中的至少一个连接部为可拆卸连接部。
  2. 根据权利要求1所述的可拆解的内镜吻合夹，其特征在于，所述可拆卸连接部采用捆绑连接、套管套接、销连接、卡箍连接中的一种或多种连接方式的组合。
  3. 根据权利要求2所述的可拆解的内镜吻合夹，其特征在于，所述咬合件和所述弹性件的端部设有限位部。
  4. 根据权利要求3所述的可拆解的内镜吻合夹，其特征在于，所述连接方式采用的捆绑线、套管、插销或卡箍与所述限位部配合连接。
  5. 根据权利要求4所述的可拆解的内镜吻合夹，其特征在于，所述捆绑线、套管、插销或卡箍上设有牵拉部。
  6. 根据权利要求1所述的可拆解的内镜吻合夹，其特征在于，所述咬合件由第一咬合件和第二咬合件组成，所述弹性件由第一弹性件和第二弹性件组成，所述第一咬合件和第二咬合件的端部分别与所述第一弹性件和第二弹性件的端部依次连接构成多个所述连接部，多个所述连接部中的至少一个连接部通过可拆卸连接装置连接，在自然状态时所述第一咬合件与第二咬合件为咬合状态，拆解所述可拆卸连接装置后能够实现所述第一咬合件与第二咬合件分离。
  7. 根据权利要求6所述的可拆解的内镜吻合夹，其特征在于，在多个所述连接部中，位于对角位的所述连接部为可拆卸连接部。
  8. 根据权利要求6所述的可拆解的内镜吻合夹，其特征在于，在多个所述连接部中，相邻的两个所述连接部为可拆卸连接部。
  9. 根据权利要求1所述的可拆解的内镜吻合夹，其特征在于，所述咬合件与所述弹性件一体成型，所述咬合件包括咬齿，所述弹性件为所述咬合件的两侧伸长段，所述伸长段具有弹性。
  10. 根据权利要求1-10任一项权利要求所述的可拆解的内镜吻合夹，其特征在于，所述弹性件由弹性金属材料制成。
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EP3808285A4 (en) 2022-03-02
JP7245322B2 (ja) 2023-03-23
EP3808285B1 (en) 2023-07-05
KR20200144136A (ko) 2020-12-28
CN109044473B (zh) 2020-06-02
CN109044473A (zh) 2018-12-21
US11013518B2 (en) 2021-05-25
AU2019284321A1 (en) 2020-12-03
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BR112020023896A2 (pt) 2021-02-09
JP2021522986A (ja) 2021-09-02

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