CN104434241A - End effector, surgical operating instrument and purse-string forceps - Google Patents

End effector, surgical operating instrument and purse-string forceps Download PDF

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Publication number
CN104434241A
CN104434241A CN201310437983.0A CN201310437983A CN104434241A CN 104434241 A CN104434241 A CN 104434241A CN 201310437983 A CN201310437983 A CN 201310437983A CN 104434241 A CN104434241 A CN 104434241A
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CN
China
Prior art keywords
nail
pocket
tong arm
purse
kit
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Granted
Application number
CN201310437983.0A
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Chinese (zh)
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CN104434241B (en
Inventor
孙斌
刘刚
方云才
汪炬
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Tianjin Ricky surgical instruments Limited by Share Ltd
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REACH SURGICAL INSTRUMENT (CHINA) CO Ltd
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Priority to CN201310437983.0A priority Critical patent/CN104434241B/en
Publication of CN104434241A publication Critical patent/CN104434241A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical 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
    • A61B17/07207Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation
    • A61B17/1155Circular staplers comprising a plurality of staples

Abstract

The invention relates to the technical field of medical equipment, and discloses an end effector, a surgical operating instrument and purse-string forceps. The end effector and the surgical operating instrument can simplify the operation process of an operation, relieve trauma brought to a surgery patient and further make purse-string nails connected with lumen tissue firmly. The end effector comprises a first forceps arm, a second forceps arm, a suture mechanism, a purse-string suture mechanism and a cutting mechanism, wherein the suture mechanism is arranged on one side of the longitudinal direction of the first forceps arm and the second forceps arm, the purse-string suture mechanism is arranged on the other side of the longitudinal direction of the first forceps arm and the second forceps arm, and the cutting mechanism is arranged between the suture mechanism and the purse-string suture mechanism. The purse-string suture mechanism comprises a first purse-string nail box arranged on the first forceps arm and a second purse-string nail box arranged on the second forceps arm, and a purse-string nail triggering opening of the first purse-string nail box and a purse-string nail triggering opening of the second purse-string nail box are provided with closing-up structures enabling nail legs of the passing purse-string nails to be closed up.

Description

End effector, surgical operating instrument and purse-string forceps
Technical field
The present invention relates to technical field of medical instruments, particularly relate to a kind of end effector, a kind of surgical operating instrument and a kind of purse-string forceps.
Background technology
Gastrointestinal surgery needs to cut off closing tissue tube chamber usually, and carries out purse string suture at the tube chamber place, side disconnected, and the nail anvil of round anastomat is installed at purse string suture place for coordinating, to use round anastomat to carry out follow-up operation such as identical grade.
Purse string suture is the mode of a kind of common suturing skill in surgical operation, the purse string suture that known existence two kinds is main.A kind of mode carries out purse string suture by hand, as shown in Figure 1 a, 1 b, doctor first around the otch of lumen organization 59 with pocket pin with purse wire 58 through tissue surface, then tighten up purse wire 58 and can complete purse string suture.The mode complicated operation of manual suture, the more difficult assurance of performance accuracy, and easily because off-line causes sewing up unsuccessfully, be seldom used in the section's of being out at present operation.
Another kind of mode uses purse-string forceps to assist to carry out purse string suture.As shown in Figure 2 a, a kind of purse-string forceps is utilize the mode of (i.e. pocket pin) band wire (i.e. purse wire 58) of threading a needle to carry out purse string suture equally.As shown in Figure 2 b, a kind of purse-string forceps is also had to be by pocket nail 57, purse wire 58 be attached to lumen organization 59 surface and carry out purse string suture, common mode is percussion pocket nail 57 and makes it thrust and be fixed to lumen organization 59, and purse wire 58 or and pocket follow closely 57 between be interconnected, or be pressed between lumen organization 59 and pocket nail 57 by pocket nail 57, thus purse wire 58 is attached to lumen organization 59, to realize purse string suture.
Usually when performing the operation to lumen organization, except needing to carry out except purse string suture to the remaining end otch of lumen organization, also need to cut its pathological changes end, sew up.And existing purse-string forceps function singleness, the purse string suture to remaining end can only be completed, the cutting and stitching to pathological changes end cannot be realized.Therefore at least also need with the use of operating theater instruments such as other staplers, the operation changing operating theater instruments is comparatively loaded down with trivial details, and this can cause operating time longer, the misery increasing operation risk and bring to surgical patient.
In prior art shown in Fig. 2 b; pocket nail 57 needs employing, without nail anvil forming technique, purse wire 58 is fixed on lumen organization 59 surface; this purse-string forceps is used often to there will be the phenomenon of pocket nail avulsion; thus cause purse string suture failure, this misery that also can increase operation risk and bring to surgical patient.
And occurred endoscope-assistant surgery the 1980s, it main to make surgeon when performing a surgical operation without the need to causing patient when huge wound for a kind of through endoscope and various imaging technique.For open surgery, endoscope-assistant surgery has the significant advantages such as little to disorganization, post-operative recovery is fast, thus becomes the trend of development.In this case, having occurred the purse-string forceps for endoscope-assistant surgery, there is the single problem of above-mentioned functions in the existing purse-string forceps for endoscope-assistant surgery equally.
Summary of the invention
First object of the present invention is to provide a kind of end effector, carries out operating operating process to simplify to lumen organization, and reduce operating time, not easily avulsion followed closely by further pocket, and the safety of operation is higher.
This end effector comprises: the first tong arm and the second tong arm, the first tong arm and the second tong arm can under the effect of opening and closing mechanism relative motion, to open with the jaw making the first tong arm and the second tong arm be formed or closed; Suturing mechanism, suturing mechanism is arranged on the side of the longitudinal direction of the first tong arm and the second tong arm; Purse string suture mechanism, purse string suture organization establishes is at the opposite side of the longitudinal direction of the first tong arm and the second tong arm; Cutting mechanism, cutting mechanism is arranged between suturing mechanism and purse string suture mechanism; Purse string suture mechanism comprises: the first pocket nail nail kit that the first tong arm is arranged, the second pocket nail nail kit that second tong arm is arranged, pocket nail is respectively arranged with in first pocket nail nail kit and the second pocket nail nail kit, pocket nail is followed closely ejector pin mechanism by pocket and is pulled the trigger, the pocket nail percussion mouthpiece of the first pocket nail nail kit and the second pocket nail nail kit have make through the closing-in structure that draws in of the nail lower limb of pocket nail, the first pocket nail nail kit and the second pocket nail nail kit are provided with the purse wires between two nail lower limbs of pocket nail towards the surface of jaw.
In this technical scheme, the suturing mechanism of end effector side can realize the stitching of tissue, the purse string suture mechanism of opposite side can realize the purse string suture of tissue, cutting mechanism between suturing mechanism and purse string suture mechanism then can realize the cutting of tissue, visible, use end effector provided by the present invention can realize the purse string suture of tube chamber remaining end tissue, and the cutting of pathological changes end tissue and stitching, compared with prior art, enormously simplify and operating operating process is carried out to lumen organization, decrease operating time, alleviate the wound brought to surgical patient.
Preferably, first pocket nail nail kit and the second pocket nail nail kit pocket nail percussion mouthpiece have make through pocket nail nail lower limb intersect draw in closing-in structure.This end effector can make pocket nail be connected more securely with lumen organization, substantially improves the phenomenon that easy avulsion followed closely by pocket, improves the safety of operation.
Second object of the present invention is to provide a kind of surgical operating instrument, comprising: handle and the end effector as preceding solution by handle drives.Because end effector has above-mentioned effect, therefore this surgical operating instrument greatly can simplify and carry out operating operating process to lumen organization, reduce operating time, alleviate the wound brought to surgical patient, pocket can also be made further to follow closely be connected more securely with lumen organization, improve the safety of operation.
3rd object of the present invention is to provide a kind of purse-string forceps, and pocket nail can be made to be connected with lumen organization more firm, not easily avulsion followed closely by pocket, substantially increases the safety of operation.Purse-string forceps comprises: the first tong arm and the second tong arm, the first tong arm and the second tong arm can under the effect of opening and closing mechanism relative motion, to open with the jaw making the first tong arm and the second tong arm be formed or closed; Purse string suture mechanism, comprise: the first pocket nail nail kit that the first tong arm is arranged, the second pocket nail nail kit that second tong arm is arranged, pocket nail is respectively arranged with in first pocket nail nail kit and the second pocket nail nail kit, pocket nail is followed closely ejector pin mechanism by pocket and is pulled the trigger, the pocket nail percussion mouthpiece of the first pocket nail nail kit and the second pocket nail nail kit have make through the nail lower limb of pocket nail intersect the closing-in structure drawn in, the first pocket nail nail kit and the second pocket nail nail kit are provided with the purse wires between two nail lower limbs of pocket nail towards the surface of jaw.
When pocket nail is thrust lumen organization by percussion, the nail lower limb intersection of pocket nail is drawn in, and it is more firm to be connected with lumen organization, not easily deviates from from lumen organization, and therefore, this purse-string forceps substantially increases the safety of purse string suture.
Accompanying drawing explanation
Fig. 1 a is the schematic cross-section of lumen organization's purse string suture;
Fig. 1 b is the front view of lumen organization after purse wire tightens up;
Fig. 2 a is existing a kind of purse-string forceps purse string suture principle schematic;
Fig. 2 b is existing another kind of purse-string forceps purse string suture principle schematic;
Fig. 3 a is the end effector perspective view of the embodiment of the present invention;
Fig. 3 b is that the end effector jaw of the embodiment of the present invention closes schematic diagram;
Fig. 3 c is that end effector jaw after operation technique of the embodiment of the present invention opens schematic diagram;
Fig. 4 is the structural representation of the first tong arm in the embodiment of the present invention;
Fig. 5 a is the internal structure schematic three dimensional views (tissue apposition side, staple is not pulled the trigger) of the end effector of the embodiment of the present invention;
Fig. 5 b is the internal structure schematic three dimensional views (tissue apposition side, staple part is pulled the trigger) of the end effector of the embodiment of the present invention;
Fig. 6 a is the internal structure schematic three dimensional views (purse string suture side, pocket nail is not pulled the trigger) of the end effector of the embodiment of the present invention;
Fig. 6 b is the cross section structure schematic diagram (pocket nail is not pulled the trigger) of the end effector of the embodiment of the present invention;
Fig. 6 c is the internal structure schematic three dimensional views (purse string suture side, pocket nail part is pulled the trigger) of the end effector of the embodiment of the present invention;
Fig. 6 d is the cross section structure schematic diagram (pocket nail is pulled the trigger) of the end effector of the embodiment of the present invention;
Fig. 7 is the percussion process schematic of pocket nail in one embodiment of the invention;
Fig. 8 be carry out cutting, lumen organization's schematic diagram after tissue apposition and purse string suture;
Fig. 9 is the surgical operating instrument structural representation of the embodiment of the present invention.
Reference numeral:
57-pocket nail 58-purse wire 59-lumen organization
10a-first tong arm 10b-second tong arm 11-suturing mechanism
12-purse string suture mechanism 13-cutting mechanism 14a-first pocket nail nail kit
14b-second pocket nail nail kit 56-closing-in structure 17a-tightens up groove
15-line card 16-pocket nail ejector pin slide block 17-pocket nail nail pushing device
18-staple nail anvil 19-staple nail kit 20-staple
21-staple ejector pin slide block 22-staple nail pushing device 23-cutter
24-cutter groove 25-closure flange 26-handle
27-end effector 28-slender bodies 29-drive mechanism
571-follows closely lower limb 572-nail hat
Detailed description of the invention
Just purse string suture, cutting and stitching can be completed in order to use same apparatus, simplify needing the tissue (particularly lumen organization) carrying out purse string suture to carry out operating operating process, reduce the misery of operating time, risk and patient, can be used in endoscope-assistant surgery further, embodiments provide a kind of end effector and a kind of surgical operating instrument.In technical solution of the present invention, the suturing mechanism of end effector side can realize the stitching of tissue, the purse string suture mechanism of opposite side can realize the purse string suture of tissue, cutting mechanism between suturing mechanism and purse string suture mechanism then can realize the cutting of tissue, the end effector using the embodiment of the present invention to provide or surgical operating instrument can realize the purse string suture of tube chamber remaining end tissue, and the cutting of pathological changes end tissue and stitching, enormously simplify and operating operating process is carried out to lumen organization, decrease operating time, also can be used for endoscope-assistant surgery further.For making the object, technical solutions and advantages of the present invention clearly, by the following examples the present invention is described in further detail.
Shown in composition graphs 3a to Fig. 3 c and Fig. 6 b, the end effector of the embodiment of the present invention, comprising:
First tong arm 10a and the second tong arm 10b, the first tong arm 10a and the second tong arm 10b can under the effect of opening and closing mechanism relative motion, to open with the jaw making the first tong arm 10a and the second tong arm 10b be formed or closed;
Suturing mechanism 11, suturing mechanism 11 is arranged on the side of the longitudinal direction of the first tong arm 10a and the second tong arm 10b;
Purse string suture mechanism 12, purse string suture mechanism 12 is arranged on the opposite side of the longitudinal direction of the first tong arm 10a and the second tong arm 10b;
Cutting mechanism 13, cutting mechanism 13 is arranged between suturing mechanism 11 and purse string suture mechanism 12;
Purse string suture mechanism 12 comprises:
The first pocket nail nail kit 14a that first tong arm 10a is arranged, the second pocket nail nail kit 14b that second tong arm 10b is arranged, pocket nail 57 is respectively arranged with in first pocket nail nail kit 14a and the second pocket nail nail kit 14b, pocket nail 57 is followed closely ejector pin mechanism by pocket and is pulled the trigger, first pocket nail nail kit 14a and the second pocket nail nail kit 14b pocket nail percussion mouthpiece have make through pocket nail 57 nail lower limb 571 draw in closing-in structure 56, first pocket nail nail kit 14a and the second pocket nail nail kit 14b is provided with the purse wires 58 between two nail lower limbs 571 of pocket nail 57 towards the surface of jaw.
In various embodiments of the present invention, away from the side of user when " distally " refers to that this apparatus is operated, near the side of user when " nearside " then refers to that this apparatus is operated." advance " is pointed to and is moved away from the direction of user, and " retrogressing " is then pointed to and moved near the direction of user.The end effector that the embodiment of the present invention provides can coordinate driving mechanism to use, and provides driving force by driving mechanism.The specific constructive form of driving mechanism is not limit, such as, directly the end effector of existing stapler front end can be unloaded, the end effector embodiment of the present invention provided is loaded onto, by the driving mechanism of existing stapler be opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting mechanism provide driving force.In addition, the other design driven mechanism of the end effector that also can provide for the embodiment of the present invention.
The end effector that the embodiment of the present invention provides can be divided into opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting mechanism four part according to function.Wherein, the opening and closing of the jaw that opening and closing mechanism is formed for two tong arms realizing end effector, jaw can be driven during use to open lumen organization to be performed the operation to be placed in one, then jaw is driven to close lumen organization's clamping to carry out the surgical action such as purse string suture, cutting, stitching, and after surgical action terminates, jaw can be driven again to open to discharge tissue.Cutting mechanism, can by the pathological changes end of lumen organization and remaining end cutting and separating for realizing the cutting function to tissue.Suturing mechanism, can be sewed up in the incision of lumen organization's pathological changes end the stitching function of tissue for realizing.Purse string suture mechanism to the purse string suture function of tissue, can carry out purse string suture in the incision of lumen organization's remaining end for realizing, and to coordinate the nail anvil installing round anastomat in subsequent operation, uses round anastomat to carry out coincideing grade for operation.This tetrameric structure will be further described respectively below.
In the end effector of the embodiment of the present invention, can at least both synchronously be driven in opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting mechanism; Also can be that opening and closing mechanism, suturing mechanism, purse string suture mechanism and cutting mechanism are driven separately.The concrete structure of end effector can be designed according to different type of drive.
Opening and closing mechanism:
In the various embodiments of the invention, the first tong arm 10a and the second tong arm 10b can be movable relatively, and can be rotating movable tong arm; Or the first tong arm 10a is non-rotatable fixing tong arm, the second tong arm 10b is rotating movable tong arm; Or the second tong arm 10b is non-rotatable fixing tong arm, the first tong arm 10a is rotating movable tong arm.Two tong arms no matter only have a movable tong arm or two are movable tong arm, as long as can be driven the jaw opening and closing that make two tong arms be formed.
The opening and closing mechanism of end effector of the present invention can adopt the various technical schemes of the opening and closing mechanism of the end effector of existing stapler to realize, such as, and bushing type opening and closing scheme, I-shaped beam type opening and closing scheme etc.
Such as, opening and closing mechanism can comprise closed bar, closed bar distal end portion is provided with closure flange, stage clip is provided with between first tong arm and the second tong arm, when closed bar is by driving during longitudinal distal motion, closure flange engages the closing face on the first tong arm and/or the second tong arm, makes tong arm overcome the elastic force of stage clip and close, when closed bar rollback, jaw can open under the reset response of stage clip.When closed bar is by driving during longitudinal distal motion, closure flange only can engage the closing face on the first tong arm or the second tong arm, but in order to obtain comparatively balance stressed, preferably, closure flange engages the closing face on the first tong arm and the second tong arm simultaneously.
Wherein, closed bar can follow closely ejector pin bar from the staple ejector pin bar for pulling the trigger staple, the pocket followed closely for pulling the trigger pocket or for driving the knife bar of cutter be structure as a whole or be interconnected for different parts; Closed bar, staple ejector pin bar, knife bar or pocket nail ejector pin bar also can be different parts respectively; Closed bar also can from staple ejector pin bar, knife bar and pocket follow closely in ejector pin bar arbitrarily both are structure as a whole or are interconnected for different parts; In addition, also can be that closed bar is followed closely ejector pin bar from staple ejector pin bar, knife bar and pocket and is structure as a whole (can be described as drive rod) or is interconnected for different parts.
Shown in Fig. 3 c, Fig. 5 a and 5b, in one particular embodiment of the present invention, cutter 23 and knife bar are integrative-structure and as the closed bar of opening and closing mechanism, be provided with stage clip (not shown) between first tong arm 10a and the second tong arm 10b, the side that the distal end portion of closed bar deviates from jaw at movable tong arm is fixed with the closure flange 25 being parallel to cut direction; When closed bar advances, closure flange 25 promotion activity tong arm turns to jaw and closes, and when closed bar retreats, stage clip promotion activity tong arm turns to jaw and opens.Here it should be noted that, the stroke that closure flange 25 is walked when closing jaw does not need very large.
Cutting mechanism:
The cutting mechanism of end effector of the present invention can adopt the various technical schemes of the cutting mechanism of the end effector of existing stapler to realize.
Such as, shown in composition graphs 4, Fig. 5 a and Fig. 5 b, cutting mechanism can comprise cutter 23, cutter 23 can move under the effect of push broach mechanism between suturing mechanism and purse string suture mechanism, with by carry out respectively sewing up with purse string suture organize cutting and separating, push broach mechanism can be push broach bar or miscellaneous part, cutter 23 and push broach mechanism can be one also can be split (now, cutter 23 are arranged on the distally of push broach mechanism).First tong arm and the second tong arm are provided with the cutter groove 24(of accommodation cutter 23 motion as shown in Figure 4), think that the motion of cutter 23 provides guiding, make cutting movement more steadily, accurately.
Suturing mechanism:
The suturing mechanism of end effector of the present invention can adopt the various technical schemes of the suturing mechanism of the end effector of existing stapler to realize.
Such as, as shown in figure 5 a and 5b, suturing mechanism can be arranged on the side of the longitudinal direction of two tong arms, a tong arm arranges staple nail anvil 18, another tong arm arranges staple nail kit 19, arrange staple 20 in staple nail kit 19, staple 20 can be set to a row or multi-row along the longitudinal direction, and staple 20 can be pulled the trigger by staple ejector pin mechanism.Staple ejector pin mechanism for pulling the trigger staple 20 can comprise staple ejector pin bar (in this embodiment, the knife bar of cutter 23 is as staple ejector pin bar), staple ejector pin slide block 21 and staple nail pushing device 22.Percussion process can be the distad lengthwise movement and drive staple ejector pin slide block 21 of staple ejector pin bar, the ramp effect of staple ejector pin slide block 21 makes its transverse movement in staple nail pushing device 22, then staple 20 released staple nail kit 19 by staple nail pushing device 22, compress staple nail anvil 18 through lumen organization 59, staple 20 is B shape at the effect compacted under of staple nail anvil 18, thus completes stitching.
The row of staple 20 is not limit, but at least should be a row, is preferably at least two rows, like this, can carry out at least twice and sew up, greatly reduce and sew up failed risk at the pathological changes end of lumen organization.When staple 20 is longitudinally set to arrange more, multiple staple nail pushing devices 22 that a staple ejector pin slide block 21 promotes front can be only set.
When the knife bar of cutter 23 is as staple ejector pin bar, the position of cutter 23 can be set to relative to staple ejector pin slide block 21 more rearward (namely more near nearside), make first to sew up rear cutting, the outflow of pathological changes end interior tissue can be reduced like this, improve the success rate of operation.In one embodiment, the knife bar that staple ejector pin slide block 21 is cut cutter 23 promotes, before the blade of cutter 23 cuts tissue, staple 20 is pulled the trigger by the staple nail pushing device 22 that the inclined-plane of staple ejector pin slide block 21 has promoted front, namely first the lumen organization in front is sewed up, therefore, cutter 23 always just cut after tissue apposition.
Purse string suture mechanism:
Purse string suture mechanism can be arranged on the opposite side of the longitudinal direction of two tong arms, namely relative with suturing mechanism side.As shown in Figure 6 b, the first pocket nail nail kit 14a that the first tong arm 10a is arranged is relative with second pocket nail nail kit 14b position when jaw closes that the second tong arm 10b is arranged, and can obtain good purse string suture effect like this.
As shown in Fig. 6 a to Fig. 6 d, pocket nail ejector pin mechanism comprises: pocket nail ejector pin bar, and for the pocket nail ejector pin slide block 16 set by each pocket nail nail kit and pocket nail nail pushing device 17; For each pocket nail nail kit, when distad ejector pin slide block 16 followed closely by zigzag tread patterns pocket to pocket nail ejector pin bar, the inclined-plane of pocket nail ejector pin slide block 16 laterally drives pocket nail nail pushing device 17, makes pocket nail nail pushing device 17 pocket nail 57 be released pocket nail percussion mouths.
Pocket nail ejector pin mechanism and staple ejector pin mechanism can be separate, the Liang Ge mechanism be driven separately, at this moment pocket nail ejector pin bar and staple ejector pin bar are different parts respectively, pocket nail ejector pin slide block and staple ejector pin slide block are different parts respectively, in addition, pocket nail ejector pin mechanism and staple ejector pin mechanism can synchronously be driven, as shown in Figure 5 b, pocket nail ejector pin bar and the knife bar of staple ejector pin bar and cutter are structure as a whole, and (ejector pin bar followed closely by pocket, staple ejector pin bar and knife bar also can be interconnected for different parts), pocket nail ejector pin slide block 16 and staple ejector pin slide block 21 are structure as a whole (or being interconnected for different parts), such as, when ejector pin slide block is by zigzag tread patterns, the inclined-plane of ejector pin slide block can laterally drive pocket to follow closely nail pushing device 17 and staple nail pushing device 22, pocket nail and staple are pulled the trigger respectively.
As shown in Figure 4, the locate mode of purse wire 58 in nail kit surface is not limit, and preferably, the first pocket nail nail kit 10a and the second pocket nail nail kit are respectively arranged with line card 15 towards the surface of jaw, and purse wire 58 is arranged in line card 15.Purse wire is arranged between two nail lower limbs of pocket nail, when pocket nail is thrust lumen organization by percussion, purse wire is crushed between the nail hat of pocket nail and lumen organization, when the percussion of pocket nail is complete, when the jaw of end effector opens, purse wire and the first pocket are followed closely nail kit and are followed closely nail kit with the second pocket and be separated.
In order to make purse wire 58 comparatively smooth, be positioned nail kit surface reliably, preferably, between adjacent two pockets nail 57 of the first pocket nail nail kit 14a, be provided with at least two line cards 15; At least two line cards 15 are provided with between adjacent two pockets nail 57 of the second pocket nail nail kit 14b.The arranging distance that the concrete quantity of line card 15 can follow closely 57 according to pocket is determined, does not do concrete restriction here.
Preferably, first pocket nail nail kit 14a and the second pocket nail nail kit 14b pocket nail percussion mouthpiece have make through pocket nail 57 nail lower limb 571 intersect draw in closing-in structure 56.Shown in composition graphs 6b, Fig. 6 d and Fig. 7, the closing-in structure 56 of the first pocket nail nail kit 14a and the second pocket nail nail kit 14b is for being positioned at two closing in inclined-planes followed closely outside lower limbs 571 of pocket nail 57.When pocket nail 57 promotes to pocket nail percussion mouth direction by pocket nail nail pushing device 17, by compressing of closing in inclined-plane, two nail lower limbs 571 of pocket nail 57 are drawn close gradually after thrusting lumen organization 59, then intersect and embrace lumen organization 59.In Fig. 7, A is the width of pocket nail, and also equal the width of pocket nail nail kit nail groove, B is the width of pocket nail percussion mouth, and B<A, C are the height on closing in inclined-plane.Can according to correlation experience or test adjustment B, C size, two the nail lower limbs 571 making the pocket after percussion follow closely 57 intersect embraces lumen organization 59, and can not thrust another layer of lumen organization 59.
When pocket nail is thrust lumen organization by percussion, lumen organization is embraced in the gathering of pocket nail nail lower limb intersection, and it is more firm to be connected with lumen organization, and pocket nail is not easily deviate from from lumen organization, and therefore, the end effector of this embodiment substantially increases the safety of operation.
Preferably, bend to pocket nail percussion mouth in the middle part of the nail hat 572 of pocket nail 57, the shape of nail hat 572 can guide pocket to follow closely the distortion of 57, is conducive to the concordance improving the molding of pocket nail.
Movement travel during in order to ensure that pocket nail is pulled the trigger in nail kit, pocket nail nail pushing device 17 should enter the closing-in structure 56 of nail kit.Optionally, described pocket nail nail pushing device 17 is the pocket nail nail pushing device of elastic material, or, described pocket nail nail pushing device 17 is preced with 572 sides towards the nail of described pocket nail 57 and is offered and tighten up groove 17a, after described pocket nail 57 is released described pocket nail percussion mouth by described pocket nail nail pushing device 17, described pocket nail nail pushing device 17 is positioned at described closing-in structure 56 and is in compressive state.
In the technical scheme of the embodiment of the present invention, closed bar, staple ejector pin bar, knife bar and pocket nail ejector pin bar can be structure as a whole or be interconnected to realize synchronous driving for different parts, such as, in one embodiment, closed bar, staple ejector pin bar, knife bar and pocket nail ejector pin bar is structure as a whole, and can be described as drive rod.During use, drive rod distal motion is to drive, first drive opening and closing mechanism with closed tong arm, along with the further motion of drive rod, suturing mechanism and purse string suture mechanism are driven, staple is pulled the trigger to realize to sew up successively, pocket nail is pulled the trigger successively thrusts tissue to realize purse string suture, cutter cut tissue under the promotion of drive rod between suturing mechanism and purse string suture mechanism simultaneously, thus complete cutting simultaneously, stitching and purse string suture (cut, lumen organization after tissue apposition and purse string suture as shown in Figure 8, wherein, direction shown in arrow is the length direction of lumen organization), this further simplify and carries out operating operating process to lumen organization, decrease operating time, thus further mitigate the wound brought to surgical patient.
To sum up, in technical solution of the present invention, the suturing mechanism of end effector side can realize the stitching of tissue, the purse string suture mechanism of opposite side can realize the purse string suture of tissue, cutting mechanism between suturing mechanism and purse string suture mechanism then can realize the cutting of tissue, visible, the end effector using the embodiment of the present invention to provide can realize the purse string suture of tube chamber remaining end tissue, and the cutting of pathological changes end tissue and stitching, compared with prior art, greatly reduce the frequency changing operating theater instruments, simplify and operating operating process is carried out to lumen organization, decrease operating time, alleviate the wound brought to surgical patient.Further, when pocket nail is thrust lumen organization by percussion, pocket nail nail lower limb intersection is drawn in, and it is more firm to be connected with lumen organization, not easily deviates from from lumen organization, therefore, substantially increases the safety of purse string suture.
It should be noted that, in various embodiments of the present invention, the specification of end effector is not limit, and can design according to concrete operation needs.Such as, when end effector is the end effector with chamber mirror specification, can use by mating cavity mirror, operation is had concurrently, and safety is high, wound surface is little, pain is few, recover the advantage such as fast.
As shown in Figure 9, the embodiment of the present invention additionally provides a kind of surgical operating instrument, comprising: handle 26 and the end effector 27 as aforementioned any embodiment driven by handle 26.
The slender bodies 28 that inside is provided with drive mechanism 29 is also comprised in this embodiment, the distally of handle 26 is connected with end effector 27 by slender bodies 28, handle 26 drive transmission device 29, drive mechanism 29 and then driving is passed to end effector 27, thinks that its opening and closing, stitching, cutting and purse string suture provide driving.The surgical operating instrument with this structure can use by mating cavity mirror, and operation is had concurrently, and safety is high, wound surface is little, pain is few, recover the advantage such as fast.
The surgical operating instrument using the embodiment of the present invention to provide can realize the purse string suture of tube chamber remaining end tissue, and the cutting of pathological changes end tissue and stitching, compared with prior art, enormously simplify and operating operating process is carried out to lumen organization, decrease operating time, and pocket nail can be made to be connected more securely with lumen organization, improve the safety of operation, alleviate the wound brought to surgical patient, can also endoscope-assistant surgery be used for further.
The embodiment of the present invention additionally provides a kind of purse-string forceps, comprising:
First tong arm and the second tong arm, the first tong arm and the second tong arm can under the effect of opening and closing mechanism relative motion, to open with the jaw making the first tong arm and the second tong arm be formed or closed;
Purse string suture mechanism, comprise: the first pocket nail nail kit that described first tong arm is arranged, the second pocket nail nail kit that described second tong arm is arranged, pocket nail is respectively arranged with in described first pocket nail nail kit and described second pocket nail nail kit, described pocket nail is followed closely ejector pin mechanism by pocket and is pulled the trigger, described first pocket nail nail kit and described second pocket nail nail kit pocket nail percussion mouthpiece have make through pocket nail nail lower limb intersect draw in closing-in structure, described first pocket nail nail kit and described second pocket nail nail kit are provided with the purse wires between two nail lower limbs following closely at described pocket towards the surface of jaw.
When pocket nail is thrust lumen organization by percussion, pocket nail nail lower limb intersection is drawn in, and it is more firm to be connected with lumen organization, not easily deviates from from lumen organization, therefore, substantially increases the safety of purse string suture.
Pocket nail ejector pin mechanism comprises: pocket nail ejector pin bar, and for the pocket nail ejector pin slide block set by each pocket nail nail kit and pocket nail nail pushing device; For each pocket nail nail kit, when distad ejector pin slide block followed closely by zigzag tread patterns pocket to pocket nail ejector pin bar, the inclined-plane of pocket nail ejector pin slide block laterally drives pocket nail nail pushing device, makes pocket nail nail pushing device pocket nail be released pocket nail percussion mouth.
Preferably, described closing-in structure is closing in inclined-plane.The nail hat middle part of described pocket nail bends to described pocket nail percussion mouth.First pocket nail nail kit and the second pocket nail nail kit are respectively arranged with line card towards the surface of jaw, and purse wire is arranged in line card.Be provided with at least two line cards between adjacent two pockets nail of the first pocket nail nail kit, between adjacent two pockets nail of the second pocket nail nail kit, be provided with at least two line cards.Beneficial effect in each embodiment as front, no longer repeat specification here.
The purse-string forceps that the embodiment of the present invention provides, the concrete form of tong arm opening and closing mechanism is not limit, such as, the version similar with aforementioned end effector can be adopted, also the version that general surgery clamps can be adopted, first tong arm and the second tong arm hinged, by operator's manual operation two levers, jaw is closed.When adopting the version similar with aforementioned end effector, opening and closing mechanism and purse string suture mechanism can synchronously be driven, at this moment closed bar and pocket nail ejector pin bar can be structure as a whole or different parts are interconnected to realize synchronous driving, in addition, opening and closing mechanism and purse string suture mechanism also can be driven separately.
Obviously, those skilled in the art can carry out various change and modification to the present invention and not depart from the spirit and scope of the present invention.Like this, if these amendments of the present invention and modification belong within the scope of the claims in the present invention and equivalent technologies thereof, then the present invention is also intended to comprise these change and modification.

Claims (25)

1. an end effector, is characterized in that, comprising:
First tong arm (10a) and the second tong arm (10b), described first tong arm (10a) and described second tong arm (10b) can under the effect of opening and closing mechanism relative motion, to open with the jaw making described first tong arm (10a) and described second tong arm (10b) be formed or closed;
Suturing mechanism (11), described suturing mechanism (11) is arranged on the side of the longitudinal direction of described first tong arm (10a) and described second tong arm (10b);
Purse string suture mechanism (12), described purse string suture mechanism (12) is arranged on the opposite side of the longitudinal direction of described first tong arm (10a) and described second tong arm (10b);
Cutting mechanism (13), described cutting mechanism (13) is arranged between described suturing mechanism (11) and described purse string suture mechanism (12);
Described purse string suture mechanism (12) comprising:
Upper the first pocket nail nail kit (14a) arranged of described first tong arm (10a), upper the second pocket nail nail kit (14b) arranged of described second tong arm (10b), pocket nail (57) is respectively arranged with in described first pocket nail nail kit (14a) and described second pocket nail nail kit (14b), described pocket nail (57) is followed closely ejector pin mechanism by pocket and is pulled the trigger, the pocket nail percussion mouthpiece of described first pocket nail nail kit (14a) and described second pocket nail nail kit (14b) have make through pocket follow closely the closing-in structure (56) that the nail lower limb (571) of (57) draws in, described first pocket nail nail kit (14a) and described second pocket nail nail kit (14b) are provided with two purse wires (58) followed closely between lower limb (571) being positioned at described pocket nail (57) towards the surface of jaw.
2. end effector as claimed in claim 1, it is characterized in that, described first pocket nail nail kit (14a) and described second pocket nail nail kit (14b) pocket nail percussion mouthpiece have make through pocket nail (57) nail lower limb (571) intersect gathering closing-in structure (56).
3. end effector as claimed in claim 2, it is characterized in that, described closing-in structure (56) is closing in inclined-plane.
4. end effector as claimed in claim 2, is characterized in that, nail hat (572) middle part of described pocket nail (57) bends to described pocket nail percussion mouth.
5. end effector as claimed in claim 1, it is characterized in that, described first pocket nail nail kit (14a) and described second pocket are followed closely nail kit (14b) and are respectively arranged with line card (15) towards the surface of jaw, and described purse wire (58) is arranged in described line card (15).
6. end effector as claimed in claim 5, is characterized in that, is provided with at least two described line cards (15) between adjacent two described pockets nail (57) of described first pocket nail nail kit (14a); At least two described line cards (15) are provided with between adjacent two described pockets nail (57) of described second pocket nail nail kit (14b).
7. end effector as claimed in claim 1, it is characterized in that, described pocket nail ejector pin mechanism comprises: pocket nail ejector pin bar, and for pocket nail ejector pin slide block (16) set by each pocket nail nail kit and pocket nail nail pushing device (17);
For each pocket nail nail kit, when distad pocket described in zigzag tread patterns follows closely ejector pin slide block (16) to described pocket nail ejector pin bar, the inclined-plane of described pocket nail ejector pin slide block (16) laterally drives described pocket nail nail pushing device (17), makes described pocket nail nail pushing device (17) described pocket be followed closely (57) and releases described pocket nail percussion mouth.
8. end effector as claimed in claim 7, it is characterized in that, the pocket nail nail pushing device that described pocket nail nail pushing device (17) is elastic material, or, described pocket nail nail pushing device (17) is preced with (572) side towards the nail that described pocket follow closely (57) and is offered and tighten up groove (17a), when described pocket follow closely after (57) release described pocket nail percussion mouth by described pocket nail nail pushing device (17), described pocket is followed closely nail pushing device (17) and is positioned at described closing-in structure (56) and is in compressive state.
9. end effector as claimed in claim 1, it is characterized in that, described suturing mechanism (11) comprising:
The upper staple nail anvil (18) arranged of described first tong arm (10a), the staple nail kit (19) that described second tong arm (10b) position corresponding with described staple nail anvil (18) when jaw closes is arranged, staple (20) is provided with in described staple nail kit (19), described staple (20) can be pulled the trigger by staple ejector pin mechanism, wherein:
Described staple ejector pin mechanism comprises: staple ejector pin bar, staple ejector pin slide block (21) and staple nail pushing device (22), when described staple ejector pin bar is distad described in zigzag tread patterns during staple ejector pin slide block (21), the inclined-plane of described staple ejector pin slide block (21) laterally drives described staple nail pushing device (22), makes described staple nail pushing device (22) that described staple (20) is released described staple nail kit (19) and at the effect compacted under of described staple nail anvil (18).
10. end effector as claimed in claim 1, it is characterized in that, described cutting mechanism (13) comprising: the cutter (23) that can move between described suturing mechanism (11) and described purse string suture mechanism (12) under the effect of push broach mechanism.
11. end effectors as claimed in claim 10, is characterized in that, described first tong arm (10a) and described second tong arm (10b) have the cutter groove (24) holding described cutter (23) and move.
12. end effectors as claimed in claim 1, is characterized in that, described first tong arm (10a) and described second tong arm (10b) are rotating movable tong arm; Or described first tong arm (10a) is non-rotatable fixing tong arm, described second tong arm (10b) is rotating movable tong arm; Or described second tong arm (10b) is non-rotatable fixing tong arm, described first tong arm (10a) is rotating movable tong arm.
13. end effectors as claimed in claim 12, it is characterized in that, described opening and closing mechanism comprises closed bar, described closed bar distal end portion is provided with closure flange (25), stage clip is provided with between described first tong arm (10a) and described second tong arm (10b), when described closed bar is by driving during longitudinal distal motion, described closure flange (25) engages the closing face on the first tong arm (10a) and/or the second tong arm (10b) and makes described jaw overcome the elastic force of described stage clip and close, when described closed bar rollback, described jaw can open under the reset response of described stage clip.
14. end effectors as described in any one of claim 1 ~ 13, is characterized in that,
In described opening and closing mechanism, described suturing mechanism (11), described purse string suture mechanism (12) and described cutting mechanism (13), at least both are synchronously driven; Or,
Described opening and closing mechanism, described suturing mechanism (11), described purse string suture mechanism (12) and described cutting mechanism (13) are driven separately.
15. end effectors as claimed in claim 14, it is characterized in that, described end effector is the end effector with chamber mirror specification.
16. 1 kinds of surgical operating instruments, is characterized in that, comprising: handle (26) and the end effector (27) as described in any one of claim 1 ~ 15 driven by described handle (26).
17. surgical operating instruments as claimed in claim 16, it is characterized in that, also comprise the slender bodies (28) that inside is provided with drive mechanism (29), the distally of described handle (26) is connected with described end effector (27) by described slender bodies (28), and the opening and closing that described handle (26) is described end effector (27) by described drive mechanism (29), stitching, cutting and purse string suture provide driving.
18. 1 kinds of purse-string forceps, is characterized in that, comprising:
First tong arm and the second tong arm, described first tong arm and described second tong arm can under the effect of opening and closing mechanism relative motion, to open with the jaw making described first tong arm and described second tong arm be formed or closed;
Purse string suture mechanism, comprise: the first pocket nail nail kit that described first tong arm is arranged, the second pocket nail nail kit that described second tong arm is arranged, pocket nail is respectively arranged with in described first pocket nail nail kit and described second pocket nail nail kit, described pocket nail is followed closely ejector pin mechanism by pocket and is pulled the trigger, described first pocket nail nail kit and described second pocket nail nail kit pocket nail percussion mouthpiece have make through pocket nail nail lower limb intersect draw in closing-in structure, described first pocket nail nail kit and described second pocket nail nail kit are provided with the purse wires between two nail lower limbs following closely at described pocket towards the surface of jaw.
19. purse-string forceps as claimed in claim 18, it is characterized in that, described closing-in structure is closing in inclined-plane.
20. purse-string forceps as claimed in claim 18, is characterized in that, the nail hat middle part of described pocket nail bends to described pocket nail percussion mouth.
21. purse-string forceps as claimed in claim 18, is characterized in that, described first pocket nail nail kit and described second pocket nail nail kit are respectively arranged with line card towards the surface of jaw, and described purse wire is arranged in described line card.
22. purse-string forceps as claimed in claim 21, is characterized in that, are provided with at least two described line cards between adjacent two described pocket nails of described first pocket nail nail kit; At least two described line cards are provided with between adjacent two described pocket nails of described second pocket nail nail kit.
23. purse-string forceps according to any one of claim 18 ~ 22, is characterized in that,
Described opening and closing mechanism and described purse string suture mechanism are synchronously driven; Or described opening and closing mechanism and described purse string suture mechanism are driven separately.
24. purse-string forceps as claimed in claim 23, is characterized in that, described pocket nail ejector pin mechanism comprises: pocket nail ejector pin bar, and for the pocket nail ejector pin slide block set by each pocket nail nail kit and pocket nail nail pushing device;
For each pocket nail nail kit, when distad ejector pin slide block followed closely by pocket described in zigzag tread patterns to described pocket nail ejector pin bar, the inclined-plane of described pocket nail ejector pin slide block laterally drives described pocket nail nail pushing device, makes described pocket follow closely nail pushing device and described pocket nail is released described pocket nail percussion mouth.
25. purse-string forceps as claimed in claim 24, it is characterized in that, described pocket nail nail pushing device is the pocket nail nail pushing device of elastic material, or, described pocket nail nail pushing device offers towards the nail hat side that described pocket is followed closely and tightens up groove, after described pocket nail is released described pocket nail percussion mouth by described pocket nail nail pushing device, described pocket nail nail pushing device is positioned at described closing-in structure and is in compressive state.
CN201310437983.0A 2013-09-23 2013-09-23 End effector, surgical operating instrument and purse-string forceps Active CN104434241B (en)

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CN107242889A (en) * 2017-07-28 2017-10-13 广西壮族自治区人民医院 A kind of purse string suture cutting closer
CN107307891A (en) * 2017-07-28 2017-11-03 广西壮族自治区人民医院 Purse string suture cutting closer
CN107320144A (en) * 2017-07-28 2017-11-07 广西壮族自治区人民医院 Straight line purse string suture cutting closer
US11779342B2 (en) 2020-02-19 2023-10-10 Covidien Lp Laparoscopic purse string suture device

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CN107242889A (en) * 2017-07-28 2017-10-13 广西壮族自治区人民医院 A kind of purse string suture cutting closer
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CN107320144A (en) * 2017-07-28 2017-11-07 广西壮族自治区人民医院 Straight line purse string suture cutting closer
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US11779342B2 (en) 2020-02-19 2023-10-10 Covidien Lp Laparoscopic purse string suture device

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